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研究生: 姜義彬
Chiang, Yi-Pin
論文名稱: 不同強度運動對自體富含血小板血漿中生長因子濃度之影響
Effect of Different Intensity of Exercises to the Growth Factor Concentration in Homologous Platelet-Rich Plasma
指導教授: 方進隆
Fang,Chin-Lung
學位類別: 博士
Doctor
系所名稱: 體育學系
Department of Physical Education
論文出版年: 2015
畢業學年度: 103
語文別: 中文
論文頁數: 74
中文關鍵詞: 血小板衍生生長因子血管內皮生長因子轉化生長因子類胰島素生長因子活化
英文關鍵詞: platelet-derivated growth factor, vascular endothelial growth factor, transforming growth factor, insulin-like growth factor, activate
論文種類: 學術論文
相關次數: 點閱:100下載:7
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  • 研究背景:人類血小板內含有多種生長因子,可促進組織再生與修補。臨床上抽取血液加以離心後,可以得到較高濃度的「富含血小板血漿」(簡稱PRP),用於局部肌肉、肌腱或關節的治療。過去研究較少探討單次運動對PRP中血小板與生長因子的影響。研究目的: 本研究目的在比較單次三十分鐘中等強度和高強度運動前後PRP中血小板與生長因子濃度之變化。 方法:本研究徵求15位平均年齡為31.9歲之健康男性自願受試者,在相隔一周的時間分別從事三十分鐘(含十分鐘走路熱身) 50% (中等強度)及85% (高強度) 儲備心跳率之跑步機運動,並於每次跑步運動後收集血液製作PRP。所得資料以二因子變異數分析,比較運動前後與不同強度在全血及PRP中血小板濃度之差異,並以成對t-檢定檢測不同強度下運動前後血小板及各種生長因子濃度之差別。結果:1, 全血中血小板之濃度,在中等強度與高強度運動後較運動前分別上升了6.12%及18.09%, 在PRP中血小板濃度則分別上升了10.25%及17.19%。2, 在中等強度運動後,PRP中IGF-1、PDGF、VEGF、TGF-β四種生長因子濃度分別上升0.86%, 12.18%, 22.18%, 13.73%,但只有VEGF濃度的增加達顯著差異(p<0.05); PRP中生長因子數量增加分別為0.11%, 17.48%, 25.48%, 15.72%, 且PDGF、VEGF、TGF-β三項升高均達顯著差異(p<0.05)。3, 在高強度運動後,IGF-1、PDGF、VEGF、TGF-β濃度分別上升10.35%, 8.20%, 4.67%, 19.06%, 而生長因子數量則上升7.57%, 7.45%, 5.85%, 19.05% ,其中只有IGF-1與TGF-β的濃度及TGF-β的數量有顯著上升(p<0.05)。結論:單次三十分鐘中等和高強度運動後,全血和PRP中血小板濃度和數量皆有上升,而且某些生長因子濃度和數量會增加。

    BACKGROUND: The human platelets contain many kinds of growth factors and play important roles in tissue repair and regeneration. The blood must be collected and centrifuged to obtain so-called “Platelet-rich plasma” (PRP) to reach a higher concentration for clinical use. To date, there are only few articles discussing about the effect of exercise to the platelet and growth factors in PRP. The purpose of this study was to investigate the effect of 30-minute acute exercise to concentration and count of platelet and growth factors in PRP. METHODS: Fifteen male volunteers at average age of 31.9 years were recruited in the study. Thirty-minutes of running exercises (including 10 minutes of walk as warm-up) with intensity of 50% (moderate) and 85% (intensive) of heart rate reserve were performed by all the participants in two consecutive weeks. Blood samples were drawn before and after each exercise to produce PRP. Two-way ANOVA was utilized to check the interaction between intensity and status of exercise. Paired-t test was used to determine the significance of change regarding to platelet and growth factors before and after exercises. RESULTS: 1, Platelet concentration increased by 6.12% and 18.09% in whole blood while 10.25% and 17.19% in PRPs after moderate and high intensity exercises. 2, After moderate exercise, concentration of IGF-1, PDGF, VEGF and TGF-β in PPR increased by 0.86%, 12.18%, 22.18% and 13.73%, with only VEGF increased significantly (p<0.05). The amount of those growth factors in PRP raised by 0.11%, 17.48%, 25.48% and 15.72% respectively while PDGF, VEGF and TGF-β increased significantly (p<0.05). 3, After intensive exercise, concentration of IGF-1, PDGF, VEGF and TGF-β increased by 10.35%, 8.20%, 4.67% and 19.06%. Their amount raised by 7.57%, 7.45%, 5.85% and 19.05% in the mean time. The concentration of IGF-1 and TGF-β as well as amount of TGF-β increased significantly (p<0.05). CONCLUSIONS: After 30 minutes of either moderate or high intensity exercise, platelets in whole blood and PRP as well as some growth factors in PRP significantly increased in the concentrations and amount.

    目 次 口試委員與系主任簽字之論文通過簽名表……………………………… i 論文授權書…………………………………………………………………ii 中文摘要…………………………………………………………………iii 英文摘要…………………………………………………………………iv 謝誌………………………………………………………………………v 目次………………………………………………………………………vi 圖次………………………………………………………………………ix 表次………………………………………………………………………x 第壹章 緒論 第一節、前言………………………………………………………………1 第二節、研究問題…………………………………………………………2 第三節、研究目的…………………………………………………………3 第四節、研究假設…………………………………………………………3 第五節、研究範圍與限制…………………………………………………3 第六節、名詞操作性定義…………………………………………………4 第七節、研究的重要性……………………………………………………4 第貳章 文獻探討 第一節、血小板的生成與代謝……………………………………………5 第二節、血小板的構造……………………………………………………7 第三節、血小板的凝血功能………………………………………………9 第四節、血小板的活化…………………………………………………12 第五節、血小板的生長因子……………………………………………13 第六節、富含血小板血漿與其製作……………………………………16 第七節、富含血小板血漿對組織修復的影響…………………………19 第八節、運動對血小板濃度的影響……………………………………22 第九節、運動對富含血小板血漿中生長因子濃度之影響………………24 第十節、本章總結………………………………………………………25 第參章 研究方法 第一節、研究對象………………………………………………………26 第二節、實驗設計與方法………………………………………………26 第三節、統計分析………………………………………………………30 第四節、預期結果………………………………………………………30 第肆章 結果 第一節、受試者基本資料………………………………………………31 第二節、實驗數據………………………………………………………32 4.2.1 兩次運動前後之生理數據變化……………………………………32 4.2.2 兩次測驗運動前後所採全血生理檢測數據………………………33 4.2.3 PRP與PPP中血球變化之數據…………………………………34 4.2.3.1 PRP 體積與血球變化之數據…………………………………34 4.2.3.2 PPP 體積與血球變化之數據…………………………………36 4.2.3.3 運動前後全血與PRP、PPP 中血小板濃度之比較…………37 4.2.3.4 PRP 與PPP中血小板之萃取率………………………………38 4.2.4 PRP與PPP 中生長因子之數據…………………………………39 4.2.4.1 生長因子濃度……………………………………………………39 4.2.4.2 生長因子量………………………………………………………40 第伍章 討論與分析 第一節、不同強度運動對全血中血球濃度之影響………………………43 第二節、運動對PRP中血球濃度之影響………………………………45 第三節、運動對PRP中生長因子濃度之影響…………………………47 第陸章 結論與建議………………………………………………………54 參考文獻 中文文獻…………………………………………………………………56 英文文獻…………………………………………………………………56 附錄 附錄一、馬偕紀念醫院醫學研究部專題研究計畫申請書 ……………66 附錄二、馬偕紀念醫院人體研究倫理審查委員會同意臨床試驗證明…67 附錄三、馬偕紀念醫院人體研究倫理審查委員會通過之受試者同意書 69 附錄四、運動自覺量表(Borg Rate of Perceived Exertion Scale) …72 附錄五、不同強度運動前後全血中血小板濃度之二因子變異數分析…73 附錄六、不同強度運動前後PRP中血小板濃度之二因子變異數分析…74 圖次 圖1、正常血小板的生成 …………………………………………………6 圖2、血小板之細胞構造…………………………………………………7 圖3、血小板栓塞之形成機轉 …………………………………………11 圖4、未活化與活化後血小板血球形狀之比較…………………………12 圖5、市售PRP製作流程示意圖…………………………………………17 圖6、本研究實驗室PRP之製作與生長因子之檢測……………………29 圖7、中等強度與高強度運動後PRP中生長因子濃度增減率…………49 圖8、中等強度與高強度運動後PRP中生長因子數量增減率…………51   表次 表1、血小板內生長因子及其作用………………………………………14 表2、生長因子對軟組織之功效…………………………………………21 表3、不同運動型態與強度之血小板數量變化…………………………22 表4、受試者基本資料……………………………………………………31 表5、運動前後之生理數據………………………………………………32 表6、運動前後全血之生理檢測數據……………………………………33 表7、運動前後PRP之檢測數據…………………………………………35 表8、運動前後離心後血漿PPP之檢測數據……………………………36 表9、運動前後血小板濃度 ……………………………………………37 表10、運動前後血小板數量(x1000) 及萃取率…………………………38 表11、中等強度與高強度運動前後PRP中生長因子濃度之比較………39 表12、中等強度與高強度運動前後PPP中生長因子濃度之比較………40 表13、運動前後PRP中生長因子總量之比較…………………………41 表14、運動前後PPP中生長因子總量之比較…………………………41 表15、運動前後PRP+PPP中生長因子總量之比較…………………42

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