血漿中骨橋蛋白濃度與骨盆腔發炎疾病的相關性研究

Study of plasma osteopontin level in pelvic inflammatory disease

陳沛涵(Phei-Han Chen)

指導教授 ： 楊順發

中山醫學大學/醫學院/生化暨生物科技研究所/碩士(2011年)

https://doi.org/10.6834/CSMU.2011.00054

摘要

Osteopontin(OPN)，是最早從骨基質中分離得到的一種分泌型、且具粘附性的鈣結合磷酸化醣蛋白，是骨骼和牙齒礦化細胞外基質的主要組成成分。而根據之前的文獻指出，OPN在發炎及組織修復扮演一個促發炎激素（proinflammotory）的角色。而骨盆腔炎症的症狀與許多骨盆相關疾病類似，很難經由一般的實驗室檢查來診斷。因此，針對骨盆腔炎症，如何尋找較具專一性且特異性的血液指標就顯得格外重要。
因此，我們分別收集了62位骨盆腔炎症患者及70位健康婦女的血液檢體，以全自動血球分析儀、血清蛋白分析儀、ELISA及PCR-RFLP的方法進行白血球、嗜中性球、C反應蛋白、OPN濃度及其基因多型性的檢測。實驗結果發現骨盆腔炎症患者其白血球、嗜中性球、C反應蛋白與OPN的數值比健康婦女皆有較高的表現。另外，再比較骨盆腔炎症患者其治療前與治療後的數值，結果也得到相類似的結果。而我們最後分析白血球、嗜中性球、C反應蛋白與OPN之間的相關性，結果發現白血球、嗜中性球、C反應蛋白與OPN的數值皆呈現明顯的正相關。
接著進一步分析比較，骨盆腔炎症患者與正常婦女血漿中OPN SNPs（single nucleotide polymorphism）rs1126616 或rs9138的基因型，結果表示並沒有顯著的不同。且血漿中OPN濃度與OPN SNPs並沒有顯著的相關性。最後經由ROC分析設定白血球、嗜中性球、C反應蛋白與OPN cutoff level，若將OPN的cutoff level 設為58.53 ng/mL，罹患骨盆腔炎症的AOR值為3.87 (95% CIs：1.30-11.51）。另外，再進一步分析其靈敏度為82.26％、LR＋（likelihood ratios of positive）為2.06。因此，我們由實驗結果發現，血漿中OPN濃度或許可以提供輔助骨盆腔炎症診斷的指標。

關鍵字

骨橋蛋白 ； 骨盆腔發炎

並列摘要

Our purpose here was to detect the association among plasma osteopontin concentration, single nucleotide polymorphisms (SNPs) of osteopontin gene, and pelvic inflammatory disease (PID). The enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) were respectively used to measure the plasma osteopontin level and its gene polymorphisms. The level of plasma osteopontin was elevated in PID patients as compared to healthy subjects and decreased significantly after treatment. Plasma osteopontin concentration was significantly correlated with white blood cell (WBC) and neutrophil counts and plasma C-reactive protein (CRP) level in patients with PID. No significant difference was found in the genotypes or alleles distribution of osteopontin SNPs, rs1126616 or rs9138, between patients with PID and normal controls. Plasma osteopontin concentration was not associated with osteopontin polymorphism. When the cutoff level of the plasma osteopontin concentration was set to be 58.53 ng/mL, the adjusted odds ratio of plasma osteopontin for PID risk was 3.87 (95% confident interval: 1.30-11.51). Plasma osteopontin level may act as a prediction marker for PID.

並列關鍵字

osteopontin ； pelvic inflammatory disease

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