臺灣博碩士論文加值系統

近年來，尿路結石疾病的盛行率達10~15 %，且5~10年復發率約50 %，20年內復發率高達75%。結石復發與患者的飲食習慣、生活作息及先天性體質有很大的關係。先前研究顯示，結石患者的結石種類與其尿液結晶成份，具高度關聯性。因此正確的診斷尿路微結石/結晶成分，對於防治尿路結石復發及患者飲食控制，尤為重要。本研究利用拉曼光譜具有高度準確性的特性，並善用拉曼光譜不怕水分干擾的優勢，將尿液樣本注入於微流體晶片晶體槽中，並且在濕式環境下結合自動化拉曼尿結晶檢測系統檢測，此方法能準確地判斷尿液中結晶成分。再利用拉曼光譜分析結果並建立尿路結石與尿液結晶比對的資料庫。將有助於提供臨床醫師對尿路結石的早期輔助診斷工具，有益於術前評估、衛教及患者飲食控制之用。

Urolithiasis is a common disease with high recurrence rate. According to the statistics, the prevalence rate of urolithiasis is about 10-15%. The recurrence rate of urolithiasis is more than 50% after the treatment in five to ten years and 75% after the treatment in 20 years. Its dependence on patient dietary habit, daily routine and innate physique. Previously we have developed the automatic Raman urine crystals detection system. Therefore, the system will be a useful auxiliary diagnostic tool for doctors to estimate urolithiasis patient in the early stage. Besides, it will be helpful to preoperative evaluation, health education, and patient’s diet control. Microfluidic chip applied in this study to improve the performance of urolithiasis detection. We make good use of Raman signal that is hardly interfered by water, thus we inject sample into microfluidic chip on the Raman system to detect its Raman spectra in wet environment. Then, we established a database for analyzing the compound of urine crystals and urine micro-stones powers. The system will help to provide a measurement instrument for early analysis of urinary stones, preoperative assessment, health education, and guide the diet of patient.

目錄
致謝 i
摘要 iii
Abstract iv
圖目錄 vii
表目錄 ix
1 第一章 緒論 1
1.1 研究背景 1
1.2 尿路結石 3
1.2.1 尿路結石種類 3
1.2.2 尿路結石外科手術方法 4
1.3 研究動機及目的 6
1.4 論文架構 6
2 第二章 文獻回顧 7
2.1 拉曼散射原理 8
2.2 磁性奈米粒子 9
3 第三章 研究材料與方法 11
3.1 實驗流程 11
3.1.1 尿液樣本蒐集 11
3.1.2 尿液樣本前處理步驟 12
3.1.3 尿液集中系統之微流體晶片 13
3.2 奈米氧化鐵的合成與表面修飾 13
3.3 實驗儀器 14
3.3.1 儀器介紹 14
3.4 實驗方法 15
3.4.1 尿液結晶樣本檢測 15
3.4.2 微流體晶片尿液檢測系統 16
4 第四章 研究結果與討論 19
4.1 研究結果 19
4.1.1 濕式環境檢測標準品 19
4.1.2 濕式臨床尿液樣本 20
4.2 乾濕式環境圖譜SNR分析 30
4.3 尿液結晶/結石比對 32
4.4 微流體晶片設計及檢測 33
5 第五章 結論與未來展望 38
6 參考文獻 40

圖目錄
圖1- 1 臨床尿路結石分佈比例 4

圖2- 1 雷利散射與史托克拉曼散射能量圖變化 9

圖3- 1 前處理流程圖 12
圖3- 2 拉曼光譜儀量測系統示意圖 14
圖3- 3 尿液前處理流程及自組濕式量測平台 16
圖3- 4 微流體晶片尿液集中系統俯視圖 17
圖3- 5 微流體晶片晶體收集槽示意圖 17
圖3- 6 微流體晶片晶體前視圖 18

圖4- 1 濕式標準品光譜圖， 20
圖4- 2 雙水草酸鈣尿液晶體(Calcium oxalate dihydrate，COD)圖譜峰值分析 23
圖4- 3 雙水草酸鈣尿液晶體(Calcium oxalate monohydrate，COM) 圖譜峰值分析 24
圖4- 4 氫氧磷灰石尿液晶體(Hydroxyapatite，HAP) 圖譜峰值分析26
圖4- 5 雙水磷酸氫鈣尿液晶體(Dicalcium phosphate dihydrate，DCPD) 圖譜峰值分析 27
圖4- 6磷酸銨鎂尿液晶體(Magnesium ammonium phosphate hexahydrate) 圖譜峰值分析 28
圖4- 7　尿酸尿液晶體(Uric acid) 圖譜峰值分析 29
圖4- 8　胱胺酸尿液晶體(Cystine) 圖譜峰值分析 30
圖4- 9溼式狀態臨床尿液樣本訊雜比(SNR)比較 32
圖4- 10微流體晶片測試實體架設圖 35
圖4- 11微流體晶片樣本測試結果 37
圖4- 12流體晶片設計圖 39
 
表目錄
表4-1 濕式環境結晶圖譜訊雜比分析(此表參考圖4.2-4.8) 31
表4-2 尿液結晶結石比對資料庫 33

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