中文摘要 研究背景: 藉由觀察及比較血液中生長休止特定蛋白6 (Gas6) 及其可溶性酪胺酸激?受體sAxl於正常婦女及患有骨盆腔發炎的婦女之變化，並探討其臨床診斷價值及評估預後病情發展之關係性。 研究方法： 我們自中山醫學大學附設醫院中找出59位骨盆腔發炎的病患及70位無骨盆腔發炎的健康女性為對照組參與本研究，收集其血液樣本。並使用?聯免疫吸附分析法(ELISA)測量血漿中Gas6與sAxl的濃度。所有樣本也均對Gas6、sAxl及C反應蛋白的濃度、及白血球與中性白血球數目進行評比配對分析。 研究結果： 在骨盆腔發炎的病患，其血漿中Gas6與sAxl的濃度比起無骨盆腔發炎的健康女性，確實出現顯著的增加；並且當骨盆腔發炎的病患在接受治療後，其血漿中Gas6與sAxl的濃度皆出現顯著的下降現象。Gas6與sAxl之間存在顯著的相關意義。當我們選擇以7.5 ng/mg及 15.2 ng/mg 為 Gas6以及 sAxl 之閾值(cut-off levels)時，其Gas6 與sAxl的敏感度分別為76.6%與75.0%。當Gas6 與sAxl兩者參數均參與比較時，其敏感度升為92.2%。在這項研究中，它們並沒有發現和輸卵管卵巢膿瘍或手術的執行率有直接的關係，而輸卵管膿瘍和手術皆與住院期間的長短有顯著相關。 結論： 結合Gas6與sAxl這兩種新型的檢測方式可以提高診斷骨盆腔發炎的敏感度，更重要的是兩者因可以提早診斷骨盆腔炎而可以避免可能所引發的更嚴重病程的後遺症。 Abstract Backgrounds: To investigate the concentrations of plasma growth arrest-specific protein 6 (Gas6) and its solubletyrosine kinase receptor sAxl in women with pelvic inflammatory disease (PID) and their association with clinicaloutcomes of PID. Methods: Blood specimens were consecutively collected fromthe 64 patients with pelvic inflammatory disease (PID) before and after treatmentand 70 healthy women in university hospital. Concentrations of plasma Gas6 and sAxl were detected usingenzyme-linked immunosorbent assay (ELISA). Results: The concentration of plasma growth arrest-specific protein 6 (Gas6) and solubletyrosine kinase receptor sAxl was significantly increased in the patients with PID comparedto the healthy controls, and then reduced significantly after treatment. Gas6 was significantly correlated withsAxl. When we selected 7.5 and 15.2 ng/ml as the cutoff concentration of plasma Gas6 and sAxl to detect PID respectively,the sensitivities of Gas6 and sAxl were 76.6% and 75.0%.When Gas6 and sAxlwere combined, the sensitivityrose to 92.2%. They were not related to the incidences of tubo-ovarian abscesses and surgery, which were,however, significantly associated with length of hospital stay. Conclusions: Novel application of Gas6 or sAxl in combination had a high sensitivity to detect PID and is importantin order to prevent severe sequelae.
