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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 江伯倫(Bor-Luen Chiang) | |
dc.contributor.advisor | 江伯倫(Bor-Luen Chiang | gicmbor@ntu.edu.tw | ), | |
dc.contributor.author | Yung-Hsien Huang | en |
dc.contributor.author | 黃永賢 | zh_TW |
dc.date.accessioned | 2023-03-19T22:26:15Z | - |
dc.date.copyright | 2022-10-05 | |
dc.date.issued | 2022 | |
dc.date.submitted | 2022-08-31 | |
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/84799 | - |
dc.description.abstract | 目的: 臨床上我們會檢驗常規的發炎生物標記去監測兒童特發生關節炎的疾病活性,但在不同的分型, 其相關性可能會有差異。本研究的目的是探討不同兒童特發性關節炎分型的疾病活性與發炎生物標記的相關性。 方法: 我們搜集從2018年3月到2019年12月在台大醫院門診看診有做抽血檢驗的兒童特發性關節炎的病童病歷,總共92人次,記錄當下疾病活性的醫師整體評估(Physician Global Assessment)、兒童健康評估問卷的失能指標(Childhood Health Assessment Questionnaire- disability index)、以及抽血的結果,包括白血球數、血色素、血小板數、C-反應蛋白(CRP)、紅血球沉降速率(ESR)、補體3和4 (C3和C4)。分析醫師整體評估與這些檢驗數據的相關性。 結果: 在寡關節炎(Oligoarthritis)的病人,醫師整體評估與這些檢驗數據沒有明顯統計的相關性。在多關節炎(Polyarthritis)的病人,醫師整體評估與CRP、ESR和C4有中度正相關(rho=0.469, p=0.004; rho=0.601, p=0.000; rho=0.441, p=0.015)。接骨點炎型關節炎的病人,醫師整體評估與血小板,CRP, C3, 和C4呈中度正相關(rho=0.448, p=0.037; rho=0.439, p=0.041; rho=0.519, p=0.033; rho=0.510, p=0.036),而和血色素呈中度負相關(rho=-0.493, p=0.020)。在醫師整體評估大於等於10以上的病人,寡關節病人的醫師整體評估與白血球數呈中度負相關(rho=-0.693, p=0.026); 多關節炎的病人醫師整體評估與CRP和ESR呈中度正相關(rho=0.527, p=0.012; rho=0.665, p=0.001); 接骨點炎型關節炎的病人,醫師整體評估與血小板呈強度正相關,雖然沒有達到顯著統計意義(rho=0.750, p=0.052)。 結論: 不同分型的兒童特發性關節炎的病人在疾病活性與發炎生物標記的相關性有各自的特性,了解這樣的差別可以幫助我們對於不同分型的兒童特發性關節炎的檢驗數據判讀更加精準。 | zh_TW |
dc.description.abstract | Background: The Physician Global Assessment (PGA) has been widely used to evaluate disease activity of juvenile idiopathic arthritis (JIA), and it is simple for physicians to perform. Laboratory tests including WBC, Hb, PLT, ESR, CRP, C3, and C4 are routinely performed to provide objective parameters for JIA evaluation, but they are barely moderate correlated with disease activity in whole patients with JIA. JIA consists of seven different subtypes, there may be different correlations between disease activity and inflammatory biomarkers in each subtype. In the study, we investigated the correlations between disease activity and inflammatory biomarkers in different juvenile idiopathic arthritis subtypes. Methods: Ninety-two patients with JIA were retrospectively recruited in this study. The PGA score and inflammatory biomarkers including WBC, Hb, PLT, ESR, CRP, C3, C4 were collected. The correlations among the PGA score, the Childhood Health Assessment Questionnaire‐disability index (CHAQ-DI), and laboratory data were analyzed in different subtypes of JIA. Results: There were no strong or moderate correlations between the PGA score and the biomarkers in whole patients with JIA. The PGA score was moderately positively correlated with CRP, ESR, C4 (rho=0.469, p=0.004; rho=0.601, p=0.000; rho=0.441, p=0.015) in patients with polyarthritis, and was moderately negatively correlated with Hb (rho=-0.493, p=0.020) and was moderately positively correlated with PLT, CRP, C3, and C4 (rho=0.448, p=0.037; rho=0.439, p=0.041; rho=0.519, p=0.033; rho=0.510, p=0.036) in patients with Enthesitis related arthritis (ERA). When the patients’ PGA were above 10, the PGA score was moderately negatively correlated with WBC (rho=-0.693, p=0.026) in those with oligoarthritis, was moderately positively correlated with CRP and ESR (rho=0.527, p=0.012; rho=0.665, p=0.001) in those with polyarthritis, and was strongly positively correlated with PLT without statistical significance (rho=0.750, p=0.052). Conclusion: The correlations between disease activity and inflammatory biomarkers were different in different subtypes of JIA. The results can help us make better interpretations of the biomarkers in these patients. | en |
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dc.description.tableofcontents | 目 錄 口試委員會審定書……………………………………………………………… I 誌謝……………………………………………………………………………… II 中文摘要………………………………………………………………………… III 英文摘要………………………………………………………………………… V 目錄………………………………………………………………………………… VII 圖目錄………………………………………………………………………………… IX 表目錄………………………………………………………………………………… X 第一章 緒論………………………………………………………………………1 第一節、文獻回顧……………………………………………………………… 1 第二節、研究動機與架構…………………………………………………6 一、 研究動機………………………………………………………………6 二、 研究架構………………………………………………………………7 第二章 兒童特發性關節炎疾病活性與發炎生物標記相關性..………………… 8 第一節、前言……………………………………………………………………8 第二節、研究方法………………………………………………………………9 一、 病人……………………………………………………………………9 二、 臨床與實驗室檢驗的評估……………………………………………9 三、統計方法………………………………………………………………10 第三節、結果………………………………………………………………11 一、 病人的基本資料與疾病分型…………………………………………11 二、 疾病活性與身體功能評分……………………………………………11 三、 兒童特發性關節炎的臨床評估與發炎生物標記的相關性…………11 四、兒童特發性關節炎各分型疾病活性與發炎生物標記和 CHAQ-DI 的相關性………………………………………………………………………12 五、兒童特發性關節炎各分型CHAQ-DI與發炎生物標記的相關性……12 六、在疾病活性活躍及不活躍時,疾病活性與發炎生物標記的相關性 ……………………………………………………………………………13 第三章、綜合討論……………………………………………………………………15 疾病活性的醫師整體評估的臨床實用性………………………………15 整體兒童特發性關節炎患者疾病活性與發炎生物標記的相關性……………17 少關節型關節炎患者病病活性與發炎生物標記的相關性…………18 多關節型關節炎患者疾病活性與發炎生物標記的相關性…………21 接骨點炎型關節炎患者疾病活性與發炎生物標記的相關性………24 研究限制…………………………………………………………………………27 第四章 結論與展望…………………………………………………………………29 參考文獻…………………………………………………………………….…………34 圖目錄 圖 1 研究架構……………………………………………………………………………………………40 圖 2 PGA 和 CHAQ-DI 的相關性散佈圖………………………………………41 圖 3疾病活躍的兒童特發性關節炎病患,PGA 和白血球數的相關性散佈圖……42 圖 4疾病活躍的兒童特發性關節炎病患,PGA 和血小板數的相關性散佈圖……44 圖 5 10 歲女孩患有少關節型兒童特發性關節炎…………………………………46 圖 6 根據兒童特發性關節炎疾病分型選擇適當的實驗數據輔助判讀疾病活性的 流程圖………………………………………………………………………………………………...47 表目錄 表 1 病人基本資料與疾病分型……………………………………………………48 表 2臨床評估與發炎生物標記的相關性……………………………………………49 表 3 在兒童特發性關節炎各分型醫師整體評估與發炎生物標記的相關性……50 表 4 在兒童特發性關節炎各分型CHAQ與發炎生物標記的相關性……51 表 5 疾病活躍與不活躍時各分型醫師整體評估與生物標記的相關性…………52 | |
dc.language.iso | zh-TW | |
dc.title | 不同兒童特發性關節炎分型的疾病活性與發炎生物標記的相關性 | zh_TW |
dc.title | The correlations between disease activity and inflammatory biomarkers in different subtypes of juvenile idiopathic arthritis | en |
dc.type | Thesis | |
dc.date.schoolyear | 110-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 楊曜旭(Yao-Hsu Yang),李克仁(Ko-Jen Li) | |
dc.subject.keyword | 兒童特發性關節炎,疾病活性,醫師整體評估,發炎生物標記, | zh_TW |
dc.subject.keyword | juvenile idiopathic arthritis,disease activity,physician global assessment,inflammatory biomarkers, | en |
dc.relation.page | 52 | |
dc.identifier.doi | 10.6342/NTU202203019 | |
dc.rights.note | 同意授權(限校園內公開) | |
dc.date.accepted | 2022-08-31 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 臨床醫學研究所 | zh_TW |
dc.date.embargo-lift | 2022-10-05 | - |
顯示於系所單位: | 臨床醫學研究所 |
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U0001-3108202214154900.pdf 授權僅限NTU校內IP使用(校園外請利用VPN校外連線服務) | 2.05 MB | Adobe PDF | 檢視/開啟 |
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