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研究生:張翎婕
研究生(外文):Chang, Ling-Chieh
論文名稱:大腸直腸腺瘤及代謝症候群之相關性分析-以中部某區域教學醫院健檢者為例
論文名稱(外文):Exploring the Relationships between Metabolic Syndrome and Colorectal Adenoma – A hospital-based Health Examination Data Study in Central Taiwan
指導教授:何清治何清治引用關係
指導教授(外文):Ho, Chin-Chih
口試委員:洪錦墩吳漢屏
口試委員(外文):Hung, Chin-TunWu, Han-Ping
口試日期:2015-06-04
學位類別:碩士
校院名稱:中臺科技大學
系所名稱:醫療暨健康產業管理系碩士班
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:2015
畢業學年度:103
語文別:中文
論文頁數:86
中文關鍵詞:大腸直腸腺瘤代謝症候群健康檢查
外文關鍵詞:Colorectal adenomasMetabolic syndrome (MS)Health examination
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目的:近年來隨著國人生活品質的不斷提高,飲食結構的改變,自1982年起大腸直腸癌的發生率逐年上升。在2011年衛生署十大惡性腫瘤死因排名第三位,同時也連續四年高居台灣惡性腫瘤發生率第一名(衛生福利部,2015)。因此,本研究目的在於探究代謝症候群與大腸直腸腺瘤之相關性,期能早期發現並降低大腸直腸腫瘤發生率進而進行切除。
研究方法:以台中某區域教學醫院預防醫學中心2011年及2012年健康檢查者為調查對象,共收取5247份有效樣本。針對人口學基本資料及生活型態變項進行描述性分析,並以卡方分析及多變項羅吉斯迴歸等分析性統計,討論變項間的關聯與差異。
研究結果:代謝症候群盛行率為31.6 %,女性盛行率多於男性,分別為16.7 %及14.9 %,八成以上的人至少有一項代謝症候群指標異常的情形﹔全體樣本大腸直腸腺瘤盛行率為18.2 %,男性盛行率多於女性,分別為11.2 %、7.1 %。代謝症候群及大腸直腸腺瘤呈現正相關。年齡、教育程度、婚姻狀態、素食、抽菸、喝酒者與代謝症候群達統計上顯著;年齡、教育程度、素食、抽菸、喝酒、代謝症候群異常(血壓、三酸甘油脂及空腹血糖值)對大腸直腸腺瘤達統計上顯著相關。在代謝症候群指標中血壓、三酸甘油脂數、空腹血糖為大腸直腸腺瘤重要預測因子。
結論:衛生當局持續衛教宣導,鼓勵中高年齡民眾應定期接受大腸糞便篩檢,期能早期發現大腸直腸腺瘤並進行腫瘤切除,以提升個人生活品質及減少醫療支出。

Objective: With improving quality of life and diet changes in recent years, the incidence of colorectal cancer has increased since 1982. In 2014, colorectal cancer is the fourth leading cause of top ten cancer death and the incident of colorectal cancer is the first place of malignant tumors in Taiwanese during four year (HHS, 2015). Therefore, the aim of this study is to analyze the relationships between metabolic syndrome (MS) and colorectal adenomas, early detect colorectal adenomas, and reduce the incidence of colorectal cancer.
Methods: This study uses secondary analysis of a regional teaching hospital’s health examinations database from 2011 to 2012. A total of 5,247 valid subjects were collected. Descriptive statistical analysis, Chi-square test, and logistic regression analysis were used for data analysis.
Results: Prevalence of metabolic syndrome was 31.6%. Female were more prevalence of MS than male, 16.7% and 14.9% respectively. Over 80% of subjects have at least one MS abnormality. Prevalence of colorectal adenomas was 18.2 %. Male were more prevalence of colorectal adenomas than female, 11.2% and 7.1% respectively. MS was positively related to colorectal adenomas abnomality. Age, education, martial status, vegetarian, smoke, drink were significantly related to MS. Age, education, vegetarian, smoke, drink, and MS abnormality (ex. blood pressure, triglycerides and glucose abnormalities) were significantly related to colorectal adenomas. Three indicators of MS including blood pressure, triglycerides and glucose were significant predictions to colorectal adenoma.
Conclusions: The health authority continues to promote health examination, and encourages over 40-year-old citizens to arrange colonoscopy for early detection of colorectal adenomas, which enhance their quality of life and reduce medical expenditure.

目錄
中文摘要 Ⅰ
AbstractⅡ
目錄 Ⅳ
圖目錄 Ⅵ
表目錄 Ⅶ
第一章 前言 1
第一節 研究動機 1
第二節 研究重要性 2
第三節 研究目的 3
第二章 文獻探討 4
第一節 代謝症候群 4
第二節 大腸直腸腺瘤 16
第三章 研究方法 26
第一節 研究架構 26
第二節 研究假設 27
第三節 研究對象 29
第四節 操作型定義 30
第五節 資料處理與分析 33
第六節 倫理考量 34
第四章 結果與討論 35
第一節 全體樣本個人基本變項資料分佈 35
第二節 個人基本變項與代謝症候群之卡方分析 41
第三節 個人基本變項與大腸直腸腺瘤之卡方分析 44
第四節 代謝症候群指標與代謝症候群之卡方分析 47
第五節 代謝症候群指標與大腸直腸腺瘤之卡方分析 48
第六節 代謝症候群之羅吉斯迴歸分析 49
第七節 大腸直腸腺瘤之羅吉斯迴歸分析 51
第八節 代謝症候群與大腸直腸腺瘤之關聯分析 54
第五章 結果與建議 58
第一節 結論 58
第二節 建議 60
第三節 研究限制61
參考文獻 62
中文文獻 62
英文文獻 65
附錄 75

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