| 摘要: | 行政院衛生署自民國86年3月19日正式公佈菸害防制法以來，香菸燃燒後所產生之二手菸(Environmental tobacco smoke, ETS)的暴露及危害便廣受重視。香菸中含有許多致癌物質，目前已知香菸中具有致癌物質約有幾十種，主要以多環芳香碳氫化合物(Polycyclic aromatic hydrocarbon ,PAHs)為主。人體暴露PAHs後會經由呼吸、皮膚及腸胃道吸收。一般PAHs在體內暴露濃度的情況通常以尿液中1-羥基芘(1-hydroxypyrene; 1-OHP)及2-奈酚（2-naphthol；2-NAP）當作生物標記〈biomarker〉。 香菸燃燒後會產生含氧自由基（Reactive Oxygen Species；ROS），造成人體DNA氧化性傷害，一般以8-羥基去氧鳥糞嘌呤核醣（8-Hydroxy- 2- deoxyguanosine，8-OHdG）作DNA氧化性傷害生物指標。過去許多文獻均指出懷孕婦女暴露二手菸會影響新生兒之出生結果。因此，本研究之目的為探討懷孕婦女暴露二手菸之代謝物（1-OHP、2-NAP、8-OHdG及Cotinine）與其新生兒結果之影響。 結果顯示孕婦尿液中之1-OHP、2-NAP及Cotinine濃度之分析均有良好的品質管制，在懷孕婦女ETS暴露組中，尿液中之1-OHP、2-NAP、8-OHdG及Cotinine之值皆高於非ETS暴露組，且新生兒體重、身長及頭圍之結果看來在ETS暴露組皆略低於非ETS暴露組，且尿液2-NAP及8-OHdG之濃度有統上之顯著相關性；在基因型分析中，8-OHdG 濃度在CYP1A1（s/s）、GSTT1 null及GSTM1 null對1-OHP、2-NAP及Cotinine之影響均有呈現劑量效應之趨勢。 本研究初步結論得知懷孕婦女暴露二手菸會增加其尿液中1-OHP、2-NAP、8-OHdG及Cotinine之濃度且可能會影響新生兒之結果，由於國內此方面的研究資料較少。因此，本研究結果可提供懷孕婦女暴露二手菸中多環芳香碳氫化合物的暴露資料，以作為政府機關在菸害防治上施政之依據及未來相關研究的探討。; Abstract In 1997, the Tobacco Act in Taiwan was announced and prohibited the indoor smoking in public areas. Environmental Tobacco smoke (ETS) contains thousands of compounds, many of which have been proven to be carcinogenic, such as polycyclic aromatic hydrocarbons (PAH). Human exposed to PAHs and absorbed by respiratory tract, skin and gastrointestinal tract. Biomarkers were used to an internal dose of PAHs exposure, included 1-hydroxypyrene (1-OHP) and 2-naphthol (2-NAP). 8-Hydroxy-2’-deoxyguanosine (8-OHdG) is a biomarker of oxidative stress and show the DNA damage by reactive oxygen species. Many previous studies revealed that pregnant women exposed to ETS would affect newborns outcome, including birth weight, birth height and head circumference. Therefore, the objectives of this study are to compare the correlations between metabolites levels of pregnant women who exposed to ETS (1-OHP、2-NAP、8-OHdG and cotinine) and health outcomes for newborn. Urinary 1-OHP、2-NAP、8-OHdG and cotinine levels were measured in all participants. For all measurements, strict quality control were performed by the published guideline by governmental regulation. Urinary 1-OHP、2-NAP、8-OHdG and cotinine levels revealed in ETS-exposure group higher than the non-exposure group. However, birth weight, birth height and head circumference slightly lower in non-exposure group; and there revealed significant between ETS exposure group and non-exposure group in the urinary 2-NAP and 8-OHdG levels. In the polymorphisms analysis, dose-response effects were demostrated in urinary 1-OHP, 2-NAP and cotinine level with 8-OHdG levels in the different phenotype of CYP1A1(s/s), GSTT1 null and GSTM1 null. Our results showed that pregnant women exposed to ETS showed higher in urinary 1-OHP, 2-NAP, 8-OHdG and cotinine levels and affected outcomes of newborns. These findings of this study will be used by the Taiwan’s Department of Health as a reference to help reduce ETS exposure, particularly among pregnant women. |
