DC 欄位 | 值 | 語言 |
dc.contributor | 李啟明 | zh-TW |
dc.contributor | 臺灣大學:臨床藥學研究所 | zh-TW |
dc.contributor.author | 徐莞曾 | zh-TW |
dc.contributor.author | Hsu, Wan-Tseng | en |
dc.creator | 徐莞曾 | zh-TW |
dc.creator | Hsu, Wan-Tseng | en |
dc.date | 2009 | en |
dc.date.accessioned | 2010-06-01T10:34:45Z | - |
dc.date.accessioned | 2018-07-09T05:50:12Z | - |
dc.date.available | 2010-06-01T10:34:45Z | - |
dc.date.available | 2018-07-09T05:50:12Z | - |
dc.date.issued | 2009 | - |
dc.identifier.other | U0001-1708200910153300 | en |
dc.identifier.uri | http://ntur.lib.ntu.edu.tw//handle/246246/184594 | - |
dc.description.abstract | 背景:臟異體移植血管病變 (cardiac allograft vasculopathy, CAV) 為心臟移植病患手術一年以後死亡之主因。已有研究指出,心臟移植病患血液循環中肝細胞生長因子 (hepatocyte growth factor,HGF) 濃度較高者,其CAV發生嚴重程度較低,但此HGF血液循環濃度升高現象是否受心臟移植手術本身所影響則未知。本試驗研究HGF於接受開心手術病患血液循環濃度的變化,作為後續應用HGF於CAV臨床治療之基礎。法:試者依據所接受之開心手術,分為使用體外循環 (cardiopulmonary bypass) 與未使用體外循環兩組,分別於開心手術前、開心手術後7天、30天、90天四個時間點,收集血液樣本;並將分離所得之血漿利用酵素連結免疫吸附分析方法 (Enzyme-linked immunosorbent assay, ELISA) 測量HGF濃度。獲得HGF濃度變化之初步結果後,再於開心手術後1天、5天、7天三個時間點收集血液樣本,分析HGF於手術後急性期之濃度變化。果:細胞生長因子血漿濃度自手術前1296.1 ± 118.9 pg/mL,至手術後7天顯著升高至1820.2 ± 104.9 pg/mL (p < 0.05),但於手術後30天已回至基礎值;且於手術後各個時間點,HGF濃度並未因手術中使用體外循環與否而有顯著差異。於開心手術後7天之急性期內,手術中使用體外循環者HGF濃度變化 (手術前為1569.10 ± 303.36 pg/mL;手術後第1天為4751.71 ± 971.28 pg/mL )則顯著高於未使用體外循環者(手術前為1131.16 ± 107.6 pg/mL;手術後第1天為 1970.98 ± 146.81 pg/mL,p < 0.05)。論:心手術趨使體內HGF濃度升高的影響於手術後30天已消失,故於心臟移植病患手術後一年體內HGF濃度與CAV嚴重程度的負相關性,已不受開心手術此變因的干擾。開心手術中使用體外循環增強手術後HGF濃度變化的現象,則需進一步收納相同病因的病人以釐清疾病本身的干擾。 | zh-TW |
dc.description.abstract | Background— Cardiac allograft vasculopathy (CAV) is the leading cause of death after the first year in heart transplant recipients. An inverse correlation has been reported between circulating hepatocyte growth factor (HGF) levels and the severity of CAV. Before further application, the dynamically regulated production of HGF triggered by surgical insults after open heart surgery should be clarified. ethods and Results— We investigated the serial change in plasma HGF levels in 50 patients undergoing open heart surgery. The patients were divided into two groups, depending on the use of cardiopulmonary bypass (CPB): CPB group and off-pump coronary artery bypass (OPCAB) group. For the initial 34 patients, the measurement time points were 7 (POD7), 30 (POD30), and 90 days postoperatively (POD90). The plasma HGF levels significantly increased from baseline (1296.1 ± 118.9 pg/mL) to 1820.2 ± 104.9 pg/mL (p < 0.05) on POD7, returning to baseline on POD30, and did not have any significant difference between groups at each time point. For the latter 16 patients, the measurement time points were 1(POD1), 5 (POD5), and 7 days postoperatively (POD7) in the postoperative acute phase. The response changes of plasma HGF levels were significantly higher in patients operated upon procedures requiring CPB. onclusions— High plasma HGF levels after open heart surgery may indicate the occurrence or necessity for tissue protection and regeneration after acute systemic insults with temporal effect fading out on the 30th postoperative day and thereafter. Thus the inverse correlation between circulating HGF levels and the severity of CAV detected by intravascular ultrasound at least 1 year after heart transplantation is not influenced by the duration post-operation. Further study is required to clarify the difference in response changes in plasma HGF levels during postoperative acute phase is made by CPB use or patient’s underlying disease indicated for surgical intervention. | en |
dc.description.tableofcontents | Approval sheet icknowledgments iihinese abstract iiibstract vontents viiist of Figures xist of Tables xiiihapter 1 Introduction 1.1 Background 1.2 Statement of the Problem 2.3 Hypothesis 3.4 Aims 3hapter 2 Literature Review 5.1 Introduction to HGF 5.1.1 Discovery, structure, biological and physiological properties 5.1.2 Cardiovascular Application 6.2 Factors Regulating HGF Production 7.3 HGF Levels in Normal and Pathophysiological Situations 10.3.1 Measurement hepatocyte growth factor in serum and plasma 10.3.2 Alteration during aging of serum HGF levels in normal condition 10.3.3 HGF Levels in various disease and pathophysiological situation 11.3.3.1 Liver disease 11.3.3.2 Chronic renal failure 12.4 Changes of HGF after Non-cardiac and Cardiac Surgery 16.4.1 Serum HGF levels after non-cardiac surgery 16.4.2 Plasma HGF levels after open heart surgery for congenital heart disease 17hapter 3 Methodology 19.1 Patients 19.2 Study Protocol 20.3 Hepatocyte Growth Factor Level Determination 21.4 Statistical Analysis 30hapter 4 Results 33.1 Changes in Plasma HGF Levels in the Postoperative Chronic Phase 33.2 Changes in Plasma HGF Levels in the Postoperative Acute Phase 41.3 Factors Predicting the Baseline Plasma HGF Levels 46hapter 5 Discussion 48.1 Physiological Significance of Increase in Circulating HGF after Open Heart Surgery 48.2 Implication of HGF in the Pathogenesis of Cardiovascular Disease 52.3 Limitation 56.4 Suggestion for Further Work 58onclusions 59eferences 60 | en |
dc.format | application/pdf | en |
dc.format.extent | 756124 bytes | - |
dc.format.mimetype | application/pdf | - |
dc.language | en | en |
dc.language.iso | en_US | - |
dc.subject | 肝細胞生長因子 | zh-TW |
dc.subject | 開心手術 | zh-TW |
dc.subject | 體外循環 | zh-TW |
dc.subject | hepatocyte growth factor | en |
dc.subject | open heart surgery | en |
dc.subject | cardiopulmonary bypass | en |
dc.title | 接受開心手術病患體內肝細胞生長因子的濃度變化 | zh-TW |
dc.title | Serial Changes of Circulating Hepatocyte Growth Factor in Patients Undergoing Open Heart Surgery | en |
dc.identifier.uri.fulltext | http://ntur.lib.ntu.edu.tw/bitstream/246246/184594/1/ntu-98-R95451004-1.pdf | - |
item.languageiso639-1 | en_US | - |
item.grantfulltext | open | - |
item.fulltext | with fulltext | - |
顯示於: | 臨床藥學研究所
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