2018-03-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/652319摘要：根據世界衛生組織報告，目前全世界主要傳染性疾病致死前三名為愛滋病、結核病、以及瘧疾，在這三項之中，結核病雖然可以治癒，然而其可藉由飛沫將結核桿菌大範圍傳播，且目前仍然缺乏有效且快速之診斷方式，2015年全世界約有一千四百萬新結核病例，並且約有一百四十萬人死於結核病，因此結核病的防治一直是一重要研究課題。 目前結核病診斷方法包含唾液塗片鏡檢法，細胞培養與分子物種診斷等。唾液塗片鏡檢法非常簡單且直接，可在幾分鐘內由唾液或痰採樣品進行染色得到結果，然而其靈敏度只約34~80%。桿菌培養法是臨床中心檢測結核病之標準方法，但即使使用快速液態培養基仍需要9~16天成長期，無法進行立即病理判斷。分子物種診斷法採用反轉譯聚合&#37238;連鎖反應，檢測特異性的結核分枝桿菌目標DNA，其準確度可達> 90%，然而測試時間長達2~5個小時。由於大多數新感染病例發生於資源相對缺乏區域，因此急需一種快速、簡易、低成本和高準確度之現場檢測平臺，能夠做到結核病早期檢測與感染控制。 為了要克服上述挑戰，在此吾人提出一微流體式快速傳染性疾病分析系統，此系統將提供下列關鍵技術與功能，(1)利用分流理論進行檢體處理，並同時(2)將微流體試紙分析平臺整合優化，篩選高專一性之DNA探針以及抗體，最後將(3)塑膠流體元件與試紙分析平臺結合，達到資源有限環境下高靈敏度結核病微量偵測目的。 <br> Abstract: According to the report from the World Health Organization (WHO), HIV, tuberculosis (TB) and malaria are the top 3 lethal diseases globally. Among them, the prevention of TB remains great challenging based on the highly infectious via saliva and the lack of effective detection platform. Even now there was an estimated 10 million people developed TB in the world, and approximately 1.4 million people died from TB in 2015. Current TB detection methods include mainly smear microscopy, a culture of bacilli and molecular diagnostics. The smear microscopy approach is a cost-effective way to obtain the results in minutes. However, this identification has a sensitivity of only approximately 34–80%. Bacillus is the standard method for TB detection in a clinical center. However, it takes 9-16 days to obtain the culture results. Molecular diagnostics adopting polymerase chain reaction to amplify the specific MTB target DNA from extracted sputum possesses a sensitivity of 90%. However, the turnaround time, including multiple hybridization processes requires 2-5 hours, and the sophisticated infrastructure and trained personnel limits the feasibility. Due to the majority of newly infected cases is in the resource-limited environments, a rapid, simple, low cost, and highly accurate on-site detection platform for TB diagnosis is needed for better infection control. To overcome these challenges, here I propose the microfluidic system that provides the following critical techniques including (a) sample preparation via the bifurcation fluidic manipulation together with (b) high specific DNA and protein probe selection, followed by (c) the integration of thermoplastic substrate and microfluidic paper-based analytical devices for rapid and sensitive TB diagnostics in resource-limited settings.微流體系統晶片實驗室傳染病診斷微型分析技術Microfluidicslab-on-a-chip microsysteminfectious disease diagnosisminiaturized analytical technique