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研究生:葉思均
研究生(外文):Yeh, Si-Jun
論文名稱:評估氧化壓力成為治療中第二型糖尿性腎病變參考指標
論文名稱(外文):Evaluating the oxidative stress as the biomarkers of therapeutic type 2 diabetic nephropathy
指導教授:曾維昌曾維昌引用關係
指導教授(外文):Tseng, Wei-Chang
口試委員:黃友利曹德安
口試委員(外文):Huang, Yeou-LihTsao, Der-An
口試日期:2019-05-24
學位類別:碩士
校院名稱:輔英科技大學
系所名稱:醫學檢驗生物技術系碩士班
學門:醫藥衛生學門
學類:醫學技術及檢驗學類
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:110
中文關鍵詞:糖尿性腎病變氧化壓力相關指標方法驗證
外文關鍵詞:Diabetic nephropathyOxidative stress related biomarkersMethod validation
相關次數:
  • 被引用被引用:0
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  • 下載下載:5
  • 收藏至我的研究室書目清單書目收藏:0
前言:近年來,第二型糖尿病(Type II diabetes mellitus, T2DM)發展為糖尿性腎病變(Diabetic nephropathy, DN)的比例逐漸增加,其中氧化壓力與其病理機轉有關,有些文獻表明氧化壓力指標可成為DN指標,但有些文獻卻持相反意見,因此,本研究目的在於評估氧化壓力相關指標是否可成為治療中DN的新興指標。方法:本研究分成兩部分實驗進行探討,第一部分,比較氧化壓力相關指標在各組臨床真實樣品間是否有顯著差異?將75位受試者依據HbA1C和eGFR區分為四組,分別為健康受試者(n=19)、非糖尿病引起的慢性腎病(n=12)、第二型糖尿病(n=24)和糖尿性腎病變(n=20),測定各種生化參數和氧化壓力的硫代巴比妥酸反應物(Thiobarbituric acid reactants, TBARS)、丙二醛(Malondialdehyde, MDA)及抗氧化酵素,再進行無母數統計分析;第二部分,驗證氧化壓力相關指標的分析方法是否穩定?本研究探討時間、溫度及儲存容器等因素是否影響氧化壓力指標測定的正確性。結果: (一)、氧化壓力指標在各組之間無非常顯著的差異。(二)、相關醫療病史、血糖及血脂等參數可能干擾TBARS和MDA的濃度。(三)、MDA方法比TBARS方法有更高的精密度(Precision)。(四)、儲存及分析因素可能影響氧化壓力指標。結果證實氧化壓力指標容易受到儲存及分析條件的影響,導致氧化壓力指標與糖尿性腎病變之間存在著微弱的相關性,基於本研究對於氧化壓力相關指標的討論需要更多的受試者加以支持,評估氧化壓力相關指標對於治療中DN之新興指標潛力。
Objective: In recent years, the ratio that type II diabetes mellitus (T2DM) develop to diabetic nephropathy (DN) gradually increased and the oxidative stress is related to its pathological mechanism. Some studies suggested that oxidative stress materials can as the biomarkers of DN, but some studies were against. In this study, we evaluated the oxidative stress materials whether they can act as the biomarkers of therapeutic diabetic nephropathy.
Methods: This study was divided into two parts. In the first part, we evaluated the oxidative stress-related biomarkers between four groups of clinical real samples. The 75 volunteers were divided into four groups according to HbA1C and eGFR, which were healthy subjects (n=19), non-diabetes chronic kidney disease (n=12), T2DM (n=24), and DN (n=20). Biochemical parameters and oxidative stress biomarkers such as thiobarbituric acid reactants (TBARS), malondialdehyde (MDA) and antioxidant enzymes were determined and followed by nonparametric statistical analysis. In the second part, the analytical methods were verified to evaluate the stability of oxidative stress-related biomarkers. This study investigated the factors of time, temperature and storage containers whether to affect the accuracy of oxidative stress biomarkers.
Results: (1) Oxidative stress biomarkers were not significant differences between groups. (2) Related medical record, blood glucose and lipids may interfere with the concentration of TBARS and MDA. (3) MDA method has higher precision than TBARS method. (4) Storage and analysis factors may affect the determination of oxidative stress biomarkers.
Conclusion: The results confirmed that the oxidative stress biomarkers is easily affected by storage and analysis conditions, resulting in a weak correlation between oxidative stress biomarker and DN. Based on this study, the discussion of oxidative stress-related biomarkers requires more volunteers to support the assessment of the potential of oxidative stress-related biomarkers for the emerging biomarkers of DN in treatment.
誌 謝--------------------------i
中文摘要------------------------ii
Abstract-----------------------iii
目 錄-------------------------iv
表 目 錄------------------------v
圖 目 錄------------------------vi
縮 寫 表------------------------vii
第一章 緒論---------------------1
第一節 糖尿病-------------------2
第二節 慢性腎病-----------------7
第三節 氧化壓力-----------------11
第四節 研究動機與目的-----------19
第二章 材料與方法----------------20
第一節 研究架構-----------------20
第二節 受試者檢體及實驗藥品------22
第三節 實驗相關設備-------------25
第四節 臨床受試者招募及收案流程--27
第五節 臨床收案研究變項---------29
第六節 檢體前處理及儲存---------31
第七節 測定脂質過氧化指標-------32
第八節 測定抗氧化酵素-----------38
第九節 監測氧化壓力相關指標於各種溫度穩定性---43
第十節 統計方法----------------45
第三章 研究結果----------------46
第一節 測試臨床檢體於氧化壓力指標之變化-------46
第二節 驗證氧化壓力指標之穩定性--------------50
第四章 討論與結論--------------53
第一節 探討DN與氧化壓力指標的相關------------53
第二節 探討影響因素與氧化壓力指標------------55
第三節 探討TBARS和MDA之精密度---------------59
第四節 探討檢體儲存條件---------------------61
第五節 探討氧化壓力指標之限制性--------------65
第六節 結論--------------------------------67
第五章 參考文獻----------------68
附錄一、採血管對於脂質過氧化物的影響--------108
附錄二、各種偵測脂質過氧化方法的優點和缺點-- 109
附錄三、2018年第10屆APFMLS亞太醫學檢驗科學國際研討壁報發表---110

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