臺灣博碩士論文加值系統

本研究為了了解Hypoxanthine-guanine phosphoribosyltransferase
(HPRT,HGPRT)酵素活性與痛風和尿酸值之間的關係，並比較痛風及高尿酸盛行率高的原住民與一般民眾是否在酵素活性值上有所不同，所以選取了牡丹鄉的排灣族、三民鄉的布農族及非原住民之痛風患者與非痛風對照為研究樣本。原住民個案以訪視的方式進行問卷調查與血液之收集；非原住民部份，痛風個案來自醫療機構，而非痛風對照則以職業健康檢查者及社區民眾為主。於民國89年9月至90年6月共收得可用個案172名。
本研究以高效能液態層析儀(high-performance liquid chromatography,HPLC)分析周邊白血球中的HPRT酵素活性，研究結果顯示痛風與非痛風二組在尿酸值上為痛風者顯著高於非痛風者，但HPRT酵素活性平均值在痛風與非痛風者分別為6.76nmol/106 cell/h與7.36nmol/106 cell/h，沒有統計上差異；將性別分開分析後,女性痛風與非痛風二組HPRT酵素活性則是非痛風對照顯著高於痛風病人，其平均值分別是7.94nmol/106 cell/h、5.48 nmol/106/h。至於在探討影響HPRT酵素活性值的因子上，以開始抽菸年齡、總暴露菸量與是否有痛風家族史跟活性值有統計上的相關。
最後依尿酸值分佈將研究個案分成三組作HPRT酵素活性平均值的比較，結果發現非原住民男性在三組中的酵素活性平均值變化無一致方向；原住民男性在三組幾乎相同；原住民女性尿酸值大於9.0mg/dl的組別，其HPRT酵素活性值顯著低於尿酸值9.0mg/dl以下者。
本研究最大限制在於要建立尿酸值與HPRT酵素活性值關係上的困難，因為非原住民的痛風患者來源為醫療機構，所以大多數均已接受藥物治療，其尿酸值已非原始值，而原住民樣本中亦有藥物干擾的問題存在，因此造成解釋結果上的困擾。
關鍵字：HPRT， HGPRT， 痛風，尿酸

Abstract
There are two aboriginal tribes (Bunun, Paiwan) and one non-aboriginal tribe (Fukien-Taiwan) included as the study population. The subjects were used to explore the relationship between the activity of hypoxanthine-guanine phosphoribosyltransferase (HPRT) and gout disease or uric acid level. Comparison the difference of HPRT activity between aborigines and non-aborigines and the related factors are the study major aims. A total of 172 samples included in this study.
A questionnaire was completed by the subjects to obtain the social demographic data, and a whole blood was drawn to perform the biochemical and HPRT activity analysis. A screening method for detection of HPRT activity in peripheral blood mononuclear cells (PBMCs) was used by high-performance liquid chromatography (HPLC).
The results showed that：
(1)The mean HPRT activities of subjects with gout and non-gout were 6.76±3.69 nmol/106 cell/h and 7.36±3.50 nmol/106 cell/h, respectively, and they did not make difference in statistics.
(2)The mean HPRT activities of subjects aborigines and non-aborigines were 6.90±3.45 nmol/106 cell/h and 7.32±3.85 nmol/106 cell/h, respectively, and they did not different.
(3)The mean HPRT activity of women with gout was 5.48±2.89 nmol/106 cell/h that had significant difference to femeal contol was 7.94±3.78 nmol/106 cell/h.
(4)The related factors of enzyme activity were amount smoking, history of gout,and triglyceride.
The study’s conclusion was the relationship of HPRT activity and gout or uric acid level had not to arrive at significant, and the reason was maybe we could not avoide counfounding of treatment with gouty drug.
Key word: HPRT, HPLC, GOUT, URIC ACID

目錄
第一章前言-------------------------------------------6
研究目的---------------------------------------7
第二章文獻探討
第一節、高尿酸血症與痛風 -----------------------8
第二節、普呤、尿酸代謝途徑與調節機構-----------10
第三節、HPRT酵素相關研究-----------------------13
第三章材料與方法
第一節、樣本的選取 ----------------------------18
第二節、實驗處理步驟---------------------------20
第三節、統計分析 ------------------------------25
第四章結果 ---------------------------------------- 27
第五章 討論------------------------------------------35
第六章參考文獻 -------------------------------------42
第七章附表 ----------------------------------------- 46
附錄一 ----------------------------------------60

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