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研究生(外文):Po-Yu Tsai
論文名稱(外文):Stromal Cell-Derived Factor-1 is Associated with Inflammatory and Nutritional Markers in Hemodialysis Patients
指導教授(外文):Horng-Rong Chang
外文關鍵詞:Stromal cell derived factor- 1hemodialysisinflammation
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研究背景:基質細胞衍生因子(stromal cell-derived factor 1,SDF-1)的功能為在腎臟損傷時維持組織新生及再生恆定,然其對血液透析(HD)患者的效應尚未明瞭。
研究方法:本研究於2007年12月收錄152名血液透析患者,並持續追蹤至2012年12月。基質金屬蛋白酵素(matrix metalloproteinase-2/-9,MMP-2/-9)、骨髓過氧化酶(myeloperoxidase,MPO)、骨橋蛋白(osteopontin)及SDF-1利用酵素結合免疫吸附分析法測量;老人營養風險指標(Geriatric Nutritional Risk Index,GNRI)分數之計算方法為利用下列公式修正老年患者的營養風險指標:GNRI = [14.89 x 白蛋白(g/dL)] + [41.7 x(體重/理想體重)]。收錄五十名腎功能正常者作為對照組。
研究結果:對照組受試者平均年齡為40.06 ± 16.54歲,平均血清肌酸酐為0.76 ± 0.17 mg/dl;血液透析患者平均年齡為58.7 ± 14.07歲。相較於對照組,HD組的SDF-1(2946.62 ± 1314.2 pg/ml vs. 2242.99 ± 607.84 pg/ml, p<0.001)與MPO(64.9 ± 24.15 ng/ml vs. 55.39 ± 15.01 pg/ml, p = 0.012)較高,但骨橋蛋白(21.35 ± 41.02 ng/ml vs. 90.46 ± 130.87 ng/ml, p=0.017)、MMP-2(455.89 ± 175.15 ng/ml vs. 517.8 ± 220.86 ng/ml, p=0.077)與MMP-9(334.24 ± 179.18 ng/ml vs. 1165.05 ± 545.07 ng/ml, p<0.001)較低;SDF-1濃度與MMP-2(r = 0.31, p < 0.001)、MMP-9(r = 0.19, p = 0.021)、MPO(r = 0.532, p<0.001)及骨橋蛋白(r = 0.31, p<0.001)呈正相關,其與白蛋白(r = -0.192, p = 0.018)、GNRI分數(r = -0.227, p = 0.007)及標準化蛋白質代謝率(normalized protein catabolic ratio,nPCR)(r = -0.21, p = 0.012)呈負相關。
Stromal cell-derived factor 1 (SDF-1) functions to maintain homeostatic tissue renewal and regeneration upon renal injury but its effects were not clear on hemodialysis (HD) patients.

In December 2007, 152 HD patients were enrolled and received follow up until December 2012. Matrix metalloproteinase-2/-9 (MMP-2/-9), -myeloperoxidase (MPO), osteopontin and SDF-1 were measured by enzyme linked immunosorbent assay. The Geriatric Nutritional Risk Index (GNRI) score was calculated by modifying the Nutritional Risk Index for elderly patients based on the following formula: GNRI = [14.89 x albumin (g/dL)] + [41.7 x (body weight / ideal body weight)]. Fifty persons with normal renal function were enrolled as a control group.

The average age of the control group was 40.06±16.54 years old and the average serum creatinine was 0.76±0.17 mg/dl. The average age of HD patients was 58.7±14.07 years old. As compared with control group, the HD group had higher SDF-1 (2946.62±1314.2 pg/ml vs. 2242.99±607.84 pg/ml, p<0.001) and MPO (64.9±24.15 ng/ml vs. 55.39±15.01 pg/ml, p=0.012), but lower osteopontin (21.35±41.02 ng/ml vs. 90.46±130.87 ng/ml, p=0.017), MMP-2 (455.89±175.15 ng/ml vs. 517.8±220.86 ng/ml, p=0.077) and MMP-9 (334.24±179.18 ng/ml vs. 1165.05± 545.07 ng/ml, p<0.001 ). SDF-1 level indicated-positive correlations with MMP-2 (r = 0.31, p < 0.001), MMP-9 (r = 0.19, p = 0.021), MPO (r = 0.532, p<0.001) and oeteopontin (r=0.31, p<0.001), and negative correlations with albumin (r=-0.192, p=0.018), GNRI score (r=-0.227, p=0.007), and normalized protein catabolic ratio (r =-0.21, p = 0.012).

SDF-1 may have a role in influencing the inflammation and nutrition status of HD patients but further studies are necessary to investigate this possibility.
第一章 緒論 1
第二章 研究設計 5
第一節 材料與方法 5
第二節 統計分析 7
第三章 研究結果 8
第四章 討論 13
第五章 結論 18
參考文獻 19
表 1. Demographic and clinical characteristics of the patients-------------------------------------------16
表 2. Correlation between SDF-1 and clinical and laboratory parameters. ----------------------------19

圖1. The differences inMMP-2, MMP-9, Osteoportin, and MPO between HD patients and patients in the control group. -------------------------------------------------------17
圖2. The SDF-1 level is higher in HD patients than in those of the control group ---------------------------18
圖3. SDF-1與Albumin之關聯性----------------------------21
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