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研究生:謝寶鳳
研究生(外文):Pao Feng Hsieh
論文名稱:運用抗磷脂相關抗體檢驗與診斷資料進行抗磷脂症候群合併症分析
論文名稱(外文):Analysis of antiphospholipid syndrome comorbidities using antiphospholipid-related antibody test and diagnosis
指導教授:陳春賢陳春賢引用關係曾意儒曾意儒引用關係
指導教授(外文):C. H. ChenY. J. Tseng
學位類別:碩士
校院名稱:長庚大學
系所名稱:商管專業學院碩士學位學程在職專班資訊管理組
學門:電算機學門
學類:電算機一般學類
論文種類:學術論文
論文出版年:2019
畢業學年度:107
語文別:中文
論文頁數:59
中文關鍵詞:抗磷脂症候群自體免疫抗體檢驗主成分分析合併症分析
外文關鍵詞:Antiphospholipid syndromeautoimmune antibody testmain component analysiscombined syndrome analysis.
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研究背景與目的:抗磷脂症候群是一種以抗磷脂抗體為特徵的自體免疫性疾病;其可呈現多種臨床表型,包括靜脈血栓形成,動脈和微脈管系統以及產科併發症等,近幾年的文獻提及因血栓引缺血性視神經病變,甚至發現與頭痛之間存在較高的合併症發生率。因此本研究以北區某醫學中心門診與住院診斷資料庫,以及自體免疫抗體檢驗資料,針對抗磷脂症候群病患研究與其他合併症之分析。
研究方法: 以2011至2016年間主要診斷碼為抗磷脂症候群之個案為主要分析對象,藉由資料收集、彙整,探討門診及住院資料庫中與其他診斷碼之風險評估與相關性,進行合併症分析。
研究結果: 女性易罹患之機率較男性高,合併症則為全身性紅斑狼瘡、發燒、慢性肝病及肝硬化、糖尿病、結膜疾患、其他尿道及泌尿道疾患、紅斑性病態與耳聾(失聽)共8種,其中紅斑性病態與耳聾(失聽),風險評估較全身性紅斑狼瘡為高,主成份分析,依結果生成2個主要成分以提供未來繼續進行調查或研究。
關鍵字:抗磷脂症候群、自體免疫抗體檢驗、主成分分析、合併症分析
Background and objective: Antiphospholipid syndrome (APS) is an autoimmune disease characterized by antiphospholipid antibodies, which can present a variety of clinical phenotypes, including venous thrombosis, arterial and microvassis systems, and obstetric complications. In recent years the literature mentions ischemic optic neuropathy due to thrombosis and even found a higher incidence of headaches. Therefore, the study used the outpatient and inpatient diagnostic database of a medical center in northern Taiwan, as well as autoimmune antibody test data, to study the analysis of APS patients with other comorbidities.
Research Methods: Based on the cases of the main diagnostic code as APS between 2011 and 2016, the combined analysis was carried out by collecting data and consolidating to explore the risk assessment and correlation with other diagnostic codes in outpatient and inpatient databases.
Research Result:Women are more likely to suffer from APS than men. Combined diseases are Systemic Lupus Erythematosus , fever, chronic liver disease and cirrhosis, diabetes, conjunctiva disorders, other urinary tract disorders, erythema, and hearing. Erythema and deafness (loss of hearing), risk assessment is higher than SLE, the main ingredient analysis, according to the results of the selection of 2 main ingredients: PC1 and PC2.
Keywords: Antiphospholipid syndrome, autoimmune antibody test, main component analysis, combined syndrome analysis.
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誌謝 iii
中文摘要 iv
英文摘要 v
目錄 vi
圖目錄 viii
表目錄 ix
第一章 緒論 1
1.1 研究動機 1
1.2 研究背景 3
1.3 研究目的 5
1.4 研究流程 6
第二章 文獻探討 8
2.1 抗磷脂抗體症候群 8
2.2 APS合併症 13
2.3 資料統計分析簡介 14
第三章 研究方法 15
3.1 研究架構 15
3.2 研究資料 16
3.3 研究工具 23
3.4 結果的評估方法 24
第四章 研究結果 27
4.1 資料分析 27
4.2 基本統計分析 29
4.3 進階分析 30
4.4 APS合併症分析 34
4.5 主成份分析的結果 36
第五章 結論與建議 40
5.1 結論 40
5.2 建議 40
參考文獻 42

圖1 抗磷脂症候群抗體檢測演進 4
圖2 疾病診斷流程 6
圖3 研究流程圖 7
圖4 研究架構圖 16
圖5 研究資料彙整暨方法分析圖 21
圖6 資料分析圖 29
圖7 門診及住院之檢驗數據雷達圖比較 33
圖8 檢驗開立項次數量圖 37
圖 9 主成分分析 39

表1. ICD-9 vs ICD-10 18
表2. 疾病診斷碼 (ICD-9)範例 19
表3. 醫療診斷明細檔 20
表4. 檢驗室資料明細 20
表5. 檢驗結果判定 22
表6. 勝算比 25
表7. 勝算比公式 25
表8. 描述性統計資料 30
表9. 年齡層*有無APS抗體 交叉列表 31
表10. 來源別*有無APS抗體 交叉列表 31
表11. 性別*有無APS抗體 交叉列表 32
表12. 分組卡方檢定 32
表13. 門診及住院之檢驗數據分析 33
表14. 初篩占比大於1%者之18種診斷 34
表15. 合併症與ICD-9對照表共8個 35
表16. 合併症彙總表 35
表17. 卡方測試 36
表18. 合併症勝算比結果 36
表19. 檢驗開立項次數量與百分比 37
表20. 6個變項之主成分分析 37
表21. 選擇2個主成分分析 38
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