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服用新型口服抗凝血藥物患者基因多型性與凝血功能相關性研究= Relati...

陳瑋

服用新型口服抗凝血藥物患者基因多型性與凝血功能相關性研究= Relationship between new oral anticoagulants (NOACs) metabolism-related gene polymorphisms and coagulation function in NOAC-prescribed patients/

Record Type:	Language materials, printed : Monograph/item
Title/Author:	服用新型口服抗凝血藥物患者基因多型性與凝血功能相關性研究= / 陳瑋
Reminder of title:	Relationship between new oral anticoagulants (NOACs) metabolism-related gene polymorphisms and coagulation function in NOAC-prescribed patients/
remainder title:	Relationship between new oral anticoagulants (NOACs) metabolism-related gene polymorphisms and coagulation function in NOAC-prescribed patients.
Author:	陳瑋
Published:	[高雄市]: [撰者], : 民111,
Description:	71葉 :圖 ; : 30公分;
Notes:	指導教授: 吳明蒼, 梁富文.
基督教聖經之智慧書導讀 :	心房纖維顫動(Atrial fibrillation, AF)發生率及盛行率逐年增加且罹患中風風險較高，因此臨床上預防性服用新型口服抗凝血劑(Novel Oral Anticoagulants, NOACs)人數也隨之上升。儘管NOACs相較於傳統的維生素K拮抗劑(Vit K antagonist, VKAs)不需凝血功能監測追蹤，但抗凝血劑依舊有出血風險，本研究欲觀察影響NOACs代謝相關基因(ABCB1、ABCG2、CYP3A5、CES1)之單一核苷酸多型性(Single-nucleotide polymorphisms, SNP)與臨床常見凝血功能監測凝血酶原時間(Prothrombin time, PT)及部份凝血活酶時間(Activated partial thromboplastin Time, aPTT)之間是否有關聯性。自2021年3月至2022年3月期間於高雄醫學大學附設醫院及高雄市立大同醫院心臟內科共收集了95名服用NOACs患者(63男32女，平均年齡69.87±8.95)，使用醫院病歷調閱病人檢驗數值、問卷收集生活習慣，最後針對用藥時間收集最高血中藥物濃度(Cmax)與最低血中藥物濃度(Cmin)的凝血功能時間，萃取病人血液中DNA以即時聚合酶連鎖反應 (Real-Time Polymerase Chain Reaction, Real-Time PCR)找出病人SNP位點，觀察其SNPs、檢驗數值、凝血功能(PT/aPTT)與生活習慣之間影響。研究結果發現基因CES1 rs8192935 (A/G)與肝功能丙胺酸轉胺(Glutamic Pyruvic Transaminase, GPT)間有顯著差異(p<0.05)，且AA及AG型受試者GPT顯著高於GG型。凝血功能(PT/aPTT)則發現服用NOACs前後數值顯著上升(p<0.001)，但在服藥前後差值Cmax-Cmin與基因分型及生活習慣比較下並無顯著差異。本研究結果在NOACs代謝基因中未能發現與PT/aPTT之間顯著差異，發現過往研究PT/aPTT易受NOACs體內藥物濃度影響，因此期望未來能檢測體內藥物濃度，觀察病人Cmax與Cmin體內濃度變化與SNPs及PT/aPTT之間的關係，進而給予臨床監測NOACs患者凝血功能上提供幫助。關鍵字：新型口服抗凝血劑(NOACs)、基因多型性、凝血功能。.
Online resource:	電子資源
[NT 15000934]:	(平裝)

服用新型口服抗凝血藥物患者基因多型性與凝血功能相關性研究= Relationship between new oral anticoagulants (NOACs) metabolism-related gene polymorphisms and coagulation function in NOAC-prescribed patients/
陳瑋

服用新型口服抗凝血藥物患者基因多型性與凝血功能相關性研究= Relationship between new oral anticoagulants (NOACs) metabolism-related gene polymorphisms and coagulation function in NOAC-prescribed patients/ Relationship between new oral anticoagulants (NOACs) metabolism-related gene polymorphisms and coagulation function in NOAC-prescribed patients.陳瑋 - [高雄市]: [撰者], 民111 - 71葉 :圖 ;30公分

指導教授: 吳明蒼, 梁富文.

碩士論文--高雄醫學大學公共衛生學系碩士班.

參考書目：葉.

第壹章、緒論 1

心房纖維顫動(Atrial fibrillation, AF)發生率及盛行率逐年增加且罹患中風風險較高，因此臨床上預防性服用新型口服抗凝血劑(Novel Oral Anticoagulants, NOACs)人數也隨之上升。儘管NOACs相較於傳統的維生素K拮抗劑(Vit K antagonist, VKAs)不需凝血功能監測追蹤，但抗凝血劑依舊有出血風險，本研究欲觀察影響NOACs代謝相關基因(ABCB1、ABCG2、CYP3A5、CES1)之單一核苷酸多型性(Single-nucleotide polymorphisms, SNP)與臨床常見凝血功能監測凝血酶原時間(Prothrombin time, PT)及部份凝血活酶時間(Activated partial thromboplastin Time, aPTT)之間是否有關聯性。自2021年3月至2022年3月期間於高雄醫學大學附設醫院及高雄市立大同醫院心臟內科共收集了95名服用NOACs患者(63男32女，平均年齡69.87±8.95)，使用醫院病歷調閱病人檢驗數值、問卷收集生活習慣，最後針對用藥時間收集最高血中藥物濃度(Cmax)與最低血中藥物濃度(Cmin)的凝血功能時間，萃取病人血液中DNA以即時聚合酶連鎖反應 (Real-Time Polymerase Chain Reaction, Real-Time PCR)找出病人SNP位點，觀察其SNPs、檢驗數值、凝血功能(PT/aPTT)與生活習慣之間影響。研究結果發現基因CES1 rs8192935 (A/G)與肝功能丙胺酸轉胺(Glutamic Pyruvic Transaminase, GPT)間有顯著差異(p<0.05)，且AA及AG型受試者GPT顯著高於GG型。凝血功能(PT/aPTT)則發現服用NOACs前後數值顯著上升(p<0.001)，但在服藥前後差值Cmax-Cmin與基因分型及生活習慣比較下並無顯著差異。本研究結果在NOACs代謝基因中未能發現與PT/aPTT之間顯著差異，發現過往研究PT/aPTT易受NOACs體內藥物濃度影響，因此期望未來能檢測體內藥物濃度，觀察病人Cmax與Cmin體內濃度變化與SNPs及PT/aPTT之間的關係，進而給予臨床監測NOACs患者凝血功能上提供幫助。關鍵字：新型口服抗凝血劑(NOACs)、基因多型性、凝血功能。.

(平裝)Subjects--Index Terms:

基因多型性

服用新型口服抗凝血藥物患者基因多型性與凝血功能相關性研究= Relationship between new oral anticoagulants (NOACs) metabolism-related gene polymorphisms and coagulation function in NOAC-prescribed patients/
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100 1 $a 陳瑋 $3 409632
245 1 0 $a 服用新型口服抗凝血藥物患者基因多型性與凝血功能相關性研究= $b Relationship between new oral anticoagulants (NOACs) metabolism-related gene polymorphisms and coagulation function in NOAC-prescribed patients/ $c 陳瑋
246 1 1 $a Relationship between new oral anticoagulants (NOACs) metabolism-related gene polymorphisms and coagulation function in NOAC-prescribed patients.
260 # $a [高雄市]: $b [撰者], $c 民111
300 $a 71葉 : $b 圖 ; $c 30公分
500 $a 指導教授: 吳明蒼, 梁富文.
500 $a 學年度: 110.
502 $a 碩士論文--高雄醫學大學公共衛生學系碩士班.
504 $a 參考書目：葉.
505 0 # $a 第壹章、緒論 1
520 3 $a 心房纖維顫動(Atrial fibrillation, AF)發生率及盛行率逐年增加且罹患中風風險較高，因此臨床上預防性服用新型口服抗凝血劑(Novel Oral Anticoagulants, NOACs)人數也隨之上升。儘管NOACs相較於傳統的維生素K拮抗劑(Vit K antagonist, VKAs)不需凝血功能監測追蹤，但抗凝血劑依舊有出血風險，本研究欲觀察影響NOACs代謝相關基因(ABCB1、ABCG2、CYP3A5、CES1)之單一核苷酸多型性(Single-nucleotide polymorphisms, SNP)與臨床常見凝血功能監測凝血酶原時間(Prothrombin time, PT)及部份凝血活酶時間(Activated partial thromboplastin Time, aPTT)之間是否有關聯性。自2021年3月至2022年3月期間於高雄醫學大學附設醫院及高雄市立大同醫院心臟內科共收集了95名服用NOACs患者(63男32女，平均年齡69.87±8.95)，使用醫院病歷調閱病人檢驗數值、問卷收集生活習慣，最後針對用藥時間收集最高血中藥物濃度(Cmax)與最低血中藥物濃度(Cmin)的凝血功能時間，萃取病人血液中DNA以即時聚合酶連鎖反應 (Real-Time Polymerase Chain Reaction, Real-Time PCR)找出病人SNP位點，觀察其SNPs、檢驗數值、凝血功能(PT/aPTT)與生活習慣之間影響。研究結果發現基因CES1 rs8192935 (A/G)與肝功能丙胺酸轉胺(Glutamic Pyruvic Transaminase, GPT)間有顯著差異(p<0.05)，且AA及AG型受試者GPT顯著高於GG型。凝血功能(PT/aPTT)則發現服用NOACs前後數值顯著上升(p<0.001)，但在服藥前後差值Cmax-Cmin與基因分型及生活習慣比較下並無顯著差異。本研究結果在NOACs代謝基因中未能發現與PT/aPTT之間顯著差異，發現過往研究PT/aPTT易受NOACs體內藥物濃度影響，因此期望未來能檢測體內藥物濃度，觀察病人Cmax與Cmin體內濃度變化與SNPs及PT/aPTT之間的關係，進而給予臨床監測NOACs患者凝血功能上提供幫助。關鍵字：新型口服抗凝血劑(NOACs)、基因多型性、凝血功能。.
520 3 $a The incidence rates and prevalence rates of atrial fibrillation (AF) have seen an annual increase with higher risks of strokes. Therefore, clinically, the number of people that take preventive Novel Oral Anticoagulants (NOACs) has increased. Compared to traditional Vit K antagonists (VKAs), although NOACs require no coagulation monitoring, coagulants are still at risk of resulting in bleeding. In this study, the correlations among single-nucleotide polymorphisms (SNP) in genes for NOACs metabolism (ABCB1, ABCG2, CYP3A5, CES1), prothrombin time (PT) in common clinical coagulation monitoring, and activated Partial Thromboplastin Time (aPTT) were observed. From March 2021 to March 2022, 95 patients from Kaohsiung Medical University Chung-Ho Memorial Hospital (KMUH) and Kaohsiung Municipal Ta-Tung Hospital Division of Cardiology taking (KTTH) NOACs were collected (63 men and 32 women, with the average age of 69.87±8.95). The hospital medical records were used to access the test values of patients, and the lifestyles of patients were collected through a questionnaire. Finally, targeting medication time, the coagulation times of the highest serum drug level (Cmax) and the lowest serum drug level (Cmin) were collected. The DNA in the patients’ blood was extracted, and the SNP sites of patients were found through Real-Time Polymerase Chain Reaction, Real-Time PCR to observe the effects among SNPs, clinical test values, coagulation (PT/aPTT), and life styles. The results show that the gene CES1 rs8192935 (A/G) and Glutamic Pyruvic Transaminase (GPT) had significant differences (p<0.05). Additionally, the AA and AG subjects’ GPT was significantly higher than that of the GG subjects. The coagulation (PT/aPTT) showed that the value significantly increased (p<0.001) after taking NOACs compared to before taking them. However, the difference between Cmax and Cmin before and after taking NOACs, genotyping, and daily habits showed no significant differences. The findings show that no significant differences in PT/aPTT were found in the genes for NOACs metabolism. Based on past studies, it was found that PT/aPTT were prone to the effects of the in vivo NOACs concentration in the body. Hence, it is hoped that the in vivo NOACs concentration detection can be tested in the future to observe changes in the in vivo concentrations of Cmax and Cmin and the relationship between SNPs and PT/aPTT. Assistance can, in turn, be provided in the clinical monitoring of the coagulation of patients on NOACs. Keywords: Novel Oral Anticoagulants (NOACs), Gene Polymorphism, Coagulation Function..
563 $a (平裝)
653 # # $a 基因多型性 $a 新型口服抗凝血劑 $a 凝血功能.
653 # # $a Coagulation Function $a Gene Polymorphism $a Novel Oral Anticoagulants $a NOACs.
856 7 # $u https://handle.ncl.edu.tw/11296/792d6p $z 電子資源 $2 http