血清中氧化壓力狀態及微量元素於甲狀腺疾病與血液透析患者之檢驗分析研究

中文摘要微量元素的恆定與氧化壓力的狀態係維持與評估生物體內之生理與病理狀態的重要生物指標。本研究乃針對甲狀腺疾病與血液透析患者血清中微量元素與氧化壓力狀態的檢測，以探討甲狀腺荷爾蒙與奈米透析材質對微量元素的恆定與氧化壓力的狀態的影響。甲狀腺所分泌之甲狀腺荷爾蒙，可以促進體內各種組織的新陳代謝，為正常生長及發育所必需。甲狀腺體本身需要微量元素以維持其正常的生合成及代謝功能，因此微量元素在甲狀腺荷爾蒙的恆定上扮演相當重要的角色。此外，甲狀腺荷爾蒙在調節體內各器官組織的基礎代謝率的過程中可能會產生自由基，所以甲狀腺功能異常時應會造成體內氧化與抗氧化狀態的改變。因此，本研究目的之一在於探討血清中微量元素在甲狀腺生理功能所扮演的角色及甲狀腺疾病(甲狀腺功能亢進、甲狀腺功能低下)及正常甲狀腺功能體內微量元素、脂質過氧化及總抗氧化能力整體性變化。研究結果發現，甲狀腺荷爾蒙濃度變化顯著影響微量元素的濃度。脂質過氧化指標MDA 在不同甲狀腺疾病組別間並無顯著差異，但總抗氧化能力在甲狀腺功能低下疾病組顯著地高於正常甲狀腺功能對照組及甲狀腺功能亢進組。因此，檢測血清中微量元素，氧化與抗氧化狀態的變化，應可提供甲狀腺疾病診斷上的參考。血液透析技術為慢性腎衰竭病人常用的治療方法之一，因為血液透析病人常有微量元素失衡的危險性，而透析材質可能是造成微量元素失衡的因素。因此，本研究目的在於探討透析材質對血液透析前後微量元素的影響。針對銅、鋅、鎂三種微量元素的檢測與分析，本研究結果發現，透析後銅、鋅濃度皆顯著比透析前高，鎂濃度透析後則是比透析前顯著降低。然而，不同的透析膜材質並未顯著地影響透析前後微量元素(銅、鋅、鎂)的濃度。

關鍵字

氧化壓力；甲狀腺疾病；血液透析；微量元素

並列摘要

ABSTRACT Trace elements homeostasis and oxidative stress status are important biomarkers for maintain and evaluate the status of health. In the present study, we aimed to determine the concentrations of trace elements and the status of oxidative stress to explore the possible roles played by thyroid hormones and hemodialysis materials on their balance. Thyroid hormones promote cellular growth and development. Normal thyroid status is dependent on the presence of certain trace elements for both the synthesis and metabolism of thyroid hormones. The elements closely associated with the thyroid, their roles in thyroid hormone homeostasis are relatively well defined. In addition, free radicals may develop during several steps of normal metabolic events by thyroid hormones. To investigate whether thyroid hormones affect oxidative stress, total antioxidant status(TAS) and trace elements in hypothyroidism and hyperthyroidism, in this study, we aimed to determine thyroid hormones and trace elements in serum and to demonstrate their relationships. The results indicate that no significant alternation of malondialdehyde (MDA, a biomarker of oxidative damage) concentration was observed in patients with hypothyroidism or hyperthyroidism when compared to the control subjects. However, the total antioxidant status in patients with hypothyroidism was higher than in the control subjects. The monitoring of certain trace elements, MDA and TAS may be used to improve the diagnosis of thyroid diseases. Hemodialysis (HD) is one of the methods for treating patients with chronic renal failure. Trace elements imbalance is found in patients with chronic renal failure and the dialysis material may be the factor in this imbalance. To compare and explore the effect of dialysis materials on the changes of trace elements after HD, three kinds of trace elements (Cu, Zn, and Mg) were measured. The results indicate that serum trace elements concentrations in pre-dialysis patients are different compared to that of post-dialysis. However, no marked effects of dialysis membranes on trace element status were observed.