2007 ԃ ԃѠӚӦᅱ܌ᆶ ύ୯ᙴᛰεᏢߕᙴଣ
I. ᆫӝ䁙ೱᙹϸᔈ (PCR: Polymerase Chain Reaction)
ճҔڗӳޑ DNA բࣁኳ݈ (template)Ǵ٠Ҕ Val158Met gene ޑ Їη (primer) εໆፄᇙ Val158Met ޑТࢤǶ
ϸᔈྋన ൂᆅᡏᑈ(μl) നಖϸᔈᐚࡋ
DNA ኳ݈ 2 0.2 μg/ul
ྐၸޑΒԛН 24.2
Fermentas 2.5mM dNTP 3.2 0.2 mM
Fermentas 10xBuffer 4 1X
COMT-Primer(F) 3.2 0.4 μM
COMT-Primer (R) 3.2 0.4 μM
Fermentas Dream Taq 0.1 0.025 units/μl
ᕴᡏᑈ (μl) 40
z PCR ܌ሡЇη
ЇηӜᆀ COMT-
Primer (F) Forward 5’- GGAGCTGGGGGCCTACTGTG-3’
COMT-
Primer (R) Reverse 5’- GGCCCTTTTTCCAGGTCTGACA-3’
z ϸᔈྕࡋ
Ӄ 95ʚ 5 ϩដǹௗ 94ʚ 30 ࣾǵ67ʚ 30 ࣾǵ72ʚ 30 ࣾǴӅ 38 ঁ cycleǹനࡕ 72ʚ 7 ϩដǶঁϸᔈֹԋࡕஒ PCR ౢނᆢӧ 4ʚǶ
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II. ࢩ
ࢩጤႝݚϩ (Agarose gel electrophoresis)ڗ 5 μl PCR ౢނҔ 2%ࢩጤՉጤᡏႝݚϩ (100VǴ30~40 ϩ ដ)ǶӆஒາֹޑጤܫΕ EtBr (0.5 μg/ml)ࢉՅ 15 ϩដࡕǴӆஒϐᑾࢉ
5~10ϩដǶϐࡕܫܭ UV ᐩΠ٠ྣ࣬Ǵаዴᇡፄᇙࡕޑ PCR ౢނελ
ࢂց಄ӝ܌ाޑТࢤ (Val158Met :185 bp)Ƕ
III. ज़ڋ䁙ߏࡋТࢤӭࠠ܄(RFLP:Restriction fragment length polymorphism)
ஒቚ൯ࡕޑ Val158Met ТࢤǴа Nla III ज़ڋ䁙ٰբ Val158Met ୷ Ӣࠠޑ᠘ۓǶ
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ᆶ 18 bp ౢނТࢤǶҗܭճҔज़ڋ䁙܌Ϫрޑ 36 bpǵ35 bp ᆶ 18 bp ೭ ΟᅿౢނТࢤၨอǴόܰӧጤᡏႝݚϩޑ่݀ύբղᘐǴӢԜҁࣴز Ьाࢂа 114 bp/114 bpǵ114 bp/96 bpǵ96 bp/96 bp բࣁ Val/Valǵ Val/MetǵMet/Met ޑΟᅿ୷Ӣࠠޑ᠘ۓǴࣁΑዴۓаԜᅿБԄբ୷Ӣࠠ
ղۓࢂց҅ዴǴҁࣴزஒϩޑ PCR ኬҁբۓׇǴаዴߥჴᡍ
่݀ޑ҅ዴǴԶۓׇ่݀ᆶҁࣴزჴᡍϐ୷ӢࠠղۓठǶ
(Ο
Ο) COMT Val158Met ୷ӢࠠीϩஒՈనኬҁჹ Val158Met ୷Ӣࠠ᠘ۓࡕޑीϩǴஒԖ คᛰނᔲҔՉࣁբࣁ٩ᡂ(ᜪձᡂ)Ǵϩձᆶ Val158Met ϐ Val /Valǵ Val / Met ᆶ Met / Met ୷ӢࠠаьБᔠۓٰբϩǴӆа܄ձբϩቫϩ
ت܄ᆶζ܄ HIV-1 ܄ޣځᛰނᔲҔՉࣁᆶ Val158Met ୷Ӣࠠϐ ໔ޑ࣬ᜢ܄Ƕ
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ಃ
ಃѤകǵࣴز่݀
ಃ ᛰނᔲҔϐ࣬ᜢᕉნӒᓀӢη
ӧᛰނᔲҔ॥ᓀႣෳኳԄࡌᄬޑࣴزύǴךॺԏΑୢڔၗǴа
ᛰނᔲҔᆶځ࣬ᜢӒᓀӢηϐ࣬ᜢǶԶჹܭᛰނᔲҔޣޑۓက߾ࢂ
ճҔୢڔᚒҞύ၌ୢȨԖؒԖ٬Ҕၸࢥࠔȩᆶම٬Ҕࢥࠔݩޑၗ
ٰղձࣴزჹຝࢂցࣁᛰނᔲҔޣǶࣴزჹຝࢂٰԾܭ 2007 ԃՏܭѠ
Ӧޑᅱᅢǵ࣮Ӻ܌Ϸיݯ܌ϣޑཥΕᅱت܄ڙӉΓ܌ޑᛰނᔲҔޕ
ǵᄊࡋکՉࣁϐӒᓀӢηፓୢڔϣϐၗǶҁࣴز௦ੰٯჹྣࣴز ݤ (Case-control study) ٰځӒᓀӢηǶځύᅱ܌х֖ѠύᅱᅢǵѠ ύ࣮Ӻ܌ǵѠύיݯ܌ǵ݅ಃΒᅱᅢǵଯᅱᅢǵጪᅱᅢǶԏڗୢ
ڔӅी 1089 ҽǴᛰ᠅ޣӅ 753 ΓǴߚᛰ᠅ޣӅ 336 ΓǶ)၁ـ߄*!
ǵࣴزჹຝΓαᏢ୷ҁၗ
ȨԃសȩБय़Ǵӄࣴزჹຝޑѳ֡ԃសࣁ 34.7 ± 8.8 ྃǹᛰނᔲҔ ޣځѳ֡ԃសࣁ 34.8 ± 7.8 ྃǴߚᛰނᔲҔޣځѳ֡ԃសࣁ 34.5 ± 10.6
ྃǴٿಔӧԃសޑी٠҂ၲᡉޑৡ౦ (P=0.656)!)၁ـ߄Ο!*Ƕ ӧȨ௲ػำࡋȩБय़Ǵӄޑࣴزჹຝа୯ύаΠᏢᐕ (хࡴ୯ύǵ ୯λǵ҂ڙ҅Ԅ௲ػ) эၨӭኧ (52.6%, 573/1089)ǴऊԖ 47.4%ࣁଯύа
Ꮲᐕ!)ଯύǵࣽǵεᏢǵࣴز܌а* (47.4%, 516/1089)ǹεϩᛰ ނᔲҔޣǴ௲ػำࡋа୯ύаΠࣁЬ (57.5%, 433/753)ǴԶߚᛰނᔲҔ ޣǴଯύаᏢᐕၨӭ (58.5%, 196/336)ǶԖคᛰނᔲҔޣӧ௲ػำࡋБ य़ԖܴᡉޑόӕǴЪӧीԖၲᡉৡ౦ (P<0.001)!)၁ـ߄Ο!*Ƕ
ӧȨۚՐȩϩǴӄࣴزჹຝεϩࢂᆶৎΓӕՐၨӭ (48.5%, 116/1081)Ƕ ᛰ ނ ᔲ Ҕ ޣ ᆶ ৎ Γ ӕ Ր ޑ К ٯ ၨ ଯ (80.1% Ǵ 600/749)ǴᐱۚޑКٯ߾ࢂКၨեޑ (8.8%, 66/749)ǹԶӧߚᛰނᔲҔޣ
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ޑϩ߾ёа࣮ډǴᗨฅԜࣴزჹຝӕኬаᆶৎΓӕՐࣁЬ (66.4%, 221/332)Ǵ ՠ ᐱ ۚ ޑ К ٯ ࠅ К ᛰ ނ ᔲ Ҕ ޣ ᗋ ा ଯ р ӭ (15.0%, 50/332)Ǵ่݀ᡉҢٿಔࣴزჹຝޑۚՐԖᡉޑৡ౦ (P<0.001) Ƕ )၁ـ߄Ο*
ԶӧȨۚՐӦϩȩǵȨᝤೣȩǵȨے௲ߞһȩǵȨࢂցԖȩǵȨஆ࠷
ރᄊȩǵȨ่ஆԃኧȩǵȨҺଛଽ୯ᝤȩᆶȨλ࠸ঁኧȩϩǴόፕӧᛰ ނᔲҔޣ܈ࢂߚᛰނᔲҔޣޑϩѲؒԖᡉޑৡ౦Ƕ)၁ـ߄Ο!*!
Β
ΒǵԖคᛰނᔲҔޣϐՉࣁރᄊ
ჹࣴزჹຝՉΓαᏢၗޑፓϩࡕǴҁࣴزޑΑှԖ คᛰނᔲҔޣӧᛰނᔲҔ࣬ᜢՉࣁϩࢂցԖόӕޑ߄Ƕ
ӧȨΕᅱԛኧȩϩǴҁࣴزаΕᅱԛኧȨԛаΠȩᆶȨΒԛа
ȩǴٰᢀჸࣴزჹຝයख़ᙟΕᅱޑݩǶӧ܌ԖࣴزჹຝύεӭኧΕᅱ ԛኧӧȨΒԛаȩၨӭ (66.4%, 722/1089)ǹԶКၨࣴزჹຝӧ ख़ᙟΕᅱޑёаܴᡉᢀჸډǴӧᛰނᔲҔޣޑϩǴځख़ᙟΕᅱ ޑКٯၨଯ (81.1%, 611/753)ǴԶߚᛰނᔲҔޣ߾ࢂа߃ԛΕᅱޑКٯၨ
ଯ (66.9%, 225/336)Ǵ่݀ёа࣮рᛰނᔲҔޣځख़ᙟΕᅱޑݩᡉଯ ܭߚᛰނᔲҔޣ (P<0.001)!)၁ـ߄Ѥ*ǴӕኬޑӧΕᅱԃኧޑϩ߾Ψ ёаᢀჸډᛰނᔲҔޣځΕᅱԃኧ (4.6±4.1) ܴᡉၨߚᛰނᔲҔޑΕᅱ ԃኧ (2.5±3.9) ٰޑߏ (P=0.039)Ƕ
ӧԖᜢ܄ՉࣁޑϩǴȨಃԛวғ܄Չࣁਔ൳ྃȩӧ܌Ԗࣴزჹຝ ύεӭࢂӧ 18 ྃа (53.3%, 506/1076); ಃԛวғ܄Չࣁԃសӧߚ
ᛰނᔲҔޣεӭኧࣁ 18 ྃа (65.5%, 220/336)ǴԶӧᛰނᔲҔޣ߾ࢂ
18ྃа (48.2%, 363/753)ᆶ 17 ྃаΠ (51.8%, 390/753)ऊӚэъኧǴ ё࣮рಃԛ܄ՉࣁวғԃសӧԖคᔲҔᛰނޣޑϩѲԖᡉৡ౦ (P
<0.001)Ƕ)၁ـ߄Ѥ*!!
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ԶӧȨΕᅱъԃᆶӭϿߚڰۓ܄ՔߧޑΓวғ܄Չࣁ(ٯӵວࡾǵ
ڹ) ȩޑϩǴӄࣴزჹຝӭኧࣁ 1 Γ (39.6%Ǵ67/169)Ǵӧᛰނ ᔲҔޣޑϩ߾ёа࣮ډ 1 Γᆶ 2 ΓޑКٯࢂኬޑ (38.5%Ǵ45/117)Ǵ ԶӧߚᛰނᔲҔޣ߾ࢂ 1 ΓޑКٯэനଯ (42.3%Ǵ22/52)Ǵҗ่݀ёа
࣮рԖคᛰނᔲҔޣӧȨΕᅱъԃᆶӭϿߚڰۓ܄ՔߧޑΓวғ܄Չ ࣁ(ٯӵວࡾǵڹ) ȩޑݩԖᡉޑৡ౦ (P=0.019)Ƕ)၁ـ߄Ѥ*!!
ԖᜢȨѳதکढ़ғΓ)ວࡾ܈ڹ*วғ܄ՉࣁԖؒԖ٬Ҕߥᓀȩ
ϩǴӄࣴزჹຝεϩԖ٬Ҕߥᓀ (65.9%, 145/220)ǹᛰނᔲҔޣ ӧό٬ҔߥᓀޑКٯ (40.6%, 63/155) Бय़ၨߚᛰނᔲҔޣ (18.5%, 12/65) ଯӭǴёـᛰނᔲҔޣᆶߚᛰނᔲҔޣӧ٬ҔߥᓀޑݩԖ ᡉޑόӕ (P=0.002)Ƕ)၁ـ߄Ѥ*!
ӧځд࣬ᜢޑՉࣁϩ:ȨΕᅱъԃԖؒԖڰۓ܄Քߧ)ٯӵϼϼǵ ӕۚΓ*ȩǵȨڰۓ܄ՔߧޑΓኧȩǵȨΕᅱъԃԖؒԖᆶڰۓ܄ՔߧѦޑ Γวғ܄Չࣁ)ٯӵວࡾǵڹ*ȩǵȨգள#ሡόሡा#ک܄Քߧፕ ӵՖՉӼӄ܄ՉࣁȩǵȨգԖک܄ՔߧፕӵՖՉӼӄ܄Չࣁၸ༏ȩǵ ȨԖؒԖளၸ܄ੰȩǴ߾ӧࣴزჹຝύ҂ᢀჸډԖᡉޑৡ౦Ƕ)၁ـ߄ Ѥ*!
ΟǵԖคᛰނᔲҔޣϐᛰނᔲҔᇡޕ
ΑှࣴزჹຝځӧᛰނᔲҔ࣬ᜢՉࣁޑৡ౦ࡕǴϩࣴز ჹຝჹܭᛰނᔲҔޑ࣬ᜢᇡޕБय़ࢂցԖ܌όӕǶ
ӧȨࢂցΑှঁΓςჹࢌᅿᛰނ᠅ΑȩޑҽǴᛰނᔲҔޣ เჹޑКٯКߚᛰނᔲҔޣٰޑଯޑᚒҞхࡴԖȨ ޔགྷा٬Ҕᛰ вȩ (48.1% v.s 30.4%ǴP <0.001)ǹȨ٬Ҕᛰвޑኧໆᆶԛኧቚуȩ (52.1%
v.s 31.3%, P <0.001)ǹȨό٬Ҕ܈෧Ͽ٬ҔᛰвǴശ(рיᘐੱރ)ȩ (61.2% v.s 28.9%, P <0.001)ǹȨϺѝགྷҔᛰвǴόکৎΓಠϺΨόрѐ
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Ѧय़פܻ϶ȩ (36.4% v.s 24.7%, P <0.001)ǶԶӧځдᛰނᔲҔᇡޕޑᚒ ҞύӕኬΨࢂаᛰނᔲҔޣเჹޑКٯКߚᛰނᔲҔޣٰޑଯǺȨ୷চ ଢ଼Ӣჹי᠅Ԗᔅշȩ (22.2% v.s 8.3%, P <0.001)ǹȨ٬ҔѤဦв(ੇࢶӢ) ёаቚу܄ૈΚȩ (45.7% v.s 22.9%, P <0.001)ǹȨӅҔଞᓐࢉ B ࠠط ݹȩ(68.4% v.s 53.6%, P <0.001)Ƕ)၁ـ߄ϖ*!
җ่݀ёаวǴᛰނᔲҔޣදၹჹᛰނᔲҔޑ࣬ᜢᇡޕाКߚᛰ ނᔲҔޣٰளӳǶ
Ѥ
ѤǵԖคᛰނᔲҔޣჹᛰނᔲҔޑᄊࡋ
ࣴزჹຝჹܭᛰނᔲҔᄊࡋޑϩǴߚᛰނᔲҔޣ҅ӛᄊࡋ КٯၨᛰނᔲҔޣٰޑଯޑᚒҞхࡴԖ: ȨךளӢࣁӳڻߚݤ٬Ҕǵ ΒԛࢥࠔࢂؒԖᜢ߯ޑȩ (94.6% v.s 85.4%, P<0.001)ǹȨךளၶډᓸ Κਔѐ٬Ҕࢥࠔٰၲډ෧ᓸޑਏ݀ȩ (98.2% v.s 70.8%, P<0.001)ǹȨך
ளԾρԖ٬ҔࢥࠔޑಞᄍǴΨᙚܻ϶٬Ҕȩ(97.6% v.s 93.2%,
P=0.003); ȨךளӢࣁाуΕ٬Ҕࢥࠔܻ϶ޑ୮η္ǴךᏢ٬Ҕȩ
(95.8% v.s 86.2%, P<0.001); Ȩךள٬ҔࢥࠔࢂԾρޑ٣Ǵჸόᔈ၀ȩ(88.1% v.s 61.6%, P<0.001); Ȩך࣮ډԖΓ٬ҔࢥࠔǴૈլڋԾρ όѐуΕȩ(87.5% v.s 82.5%, P<0.001); Ȩךόௗڙܻ϶๏ޑࢥࠔȩ (87.8% v.s 73.7%, P<0.001); ȨךόکձΓӅҔଞᓐ()Ǵՠکڰۓ܄
ՔߧӅҔȩ(72.9% v.s 68.7%, P<0.001); ȨךளࢥࠔѝाϿໆ٬ҔǴ൩ ᆉ᠅Ψؒᜢ߯ȩ(97.0% v.s 87.4%, P<0.001)Ƕ)၁ـ߄Ϥ*!
ฅԶ٠ߚ܌ԖᛰނᔲҔޑ࣬ᜢᄊࡋࢂߚᛰނᔲޣ҅ӛᄊࡋޑК ٯၨଯǴӧȨךள٬ҔࢥࠔǴݙК१Ҕ্يᡏȩᚒҞ߾ࢂᛰނᔲ Ҕ ޣ ҅ ӛ ᄊ ࡋ К ٯ ၨ ߚ ᛰ ނ ᔲ Ҕ ޣ ٰ ޑ ଯ (77.8% v.s 58.9%,
P<0.001) Ǵӧ ȨךགྷाޕၰࢥࠔБय़ޑޕǴᗉխၸໆ٬ҔȩԜᄊࡋ
ᚒΨ࣮ډӕኬᛰނᔲҔޣ҅ӛᄊࡋޑКٯၨߚᛰނᔲҔޣٰளଯ52
(71.7% v.s 50.0%, P<0.001)Ƕ)၁ـ߄Ϥ*
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ಃ
ಃΒ ࡌҥᛰނᔲҔޣϐ॥ᓀႣෳኳԄ
ࣴزύа 2007 ԃᛰނᔲҔޣ܌ޑୢڔٰࡌҥᛰނᔲҔޣޑ॥ᓀႣ
ෳኳԄǶӧՉൂᡂϩࡕǴஒԖၲीᡉৡ౦ (P<0.05) ϐᡂ
ܫΕӭᡂᡄᒠථӣᘜύаБԄ (stepwise) ࡷᒧᡂǴନԜϐѦǴ ஒΓαᏢၗύӧࣴزჹຝϩѲԖৡ౦ޑᡂܫΕᡄᒠථӣᘜኳԄύ
Չਠ҅ǴԶԜਠ҅ࡕޑᡄᒠථӣᘜኳԄջࣁᛰނᔲҔޣޑ॥ᓀႣෳኳԄǶ ӧᛰނᔲҔޣޑ॥ᓀႣෳኳԄύǴஒΓαᏢၗύޑ௲ػำࡋǵۚ
ՐᆶᙍᡂՉਠ҅ࡕǴӅԖ 8 ঁޑᡉӒᓀӢηᒧΕኳԄ ύǴϩձࣁȨಃԛวғ܄Չࣁਔ൳ྃ (Չࣁᚒ)ȩ (OR=1.54ǹP=0.014)ǵ Ȩ೭ࢂգಃ൳ԛΕᅱ )Չࣁᚒ*ȩ (OR=4.37ǹP<0.001)ǵȨό٬Ҕ܈෧ Ͽ٬ҔᛰвǴശ)рיᘐੱރ*!)ޕᚒ*ȩ (OR=0.29ǹP<0.001)ǵȨ
୷চଢ଼Ӣჹי᠅Ԗᔅշ)ޕᚒ*ȩ (OR=0.56ǹP=0.029ǵȨ٬ҔѤဦв(ੇ
ࢶӢ)ёаቚу܄ૈΚ)ޕᚒ*ȩ (OR=0.46ǹP<0.001)ǵȨךளၶډ ᓸΚਔѐ٬Ҕࢥࠔٰၲډ෧ᓸޑਏ݀)ᄊࡋᚒ*ȩ (OR=7.90ǹP<0.001)ǵ Ȩ ך ள٬ Ҕ ࢥ ࠔ Ǵ ݙ К १ Ҕ ্ ي ᡏ )ᄊ ࡋᚒ * ȩ (OR=0.54 ǹ
P=0.015) ǵȨךόௗڙܻ϶๏ޑࢥࠔ(ᄊࡋᚒ*ȩ!(OR=2.29ǹP=0.017)Ƕ
)၁ـ߄Ύ*ஒ܌Ԗࣴزჹຝӧ೭ 8 ঁӒᓀӢηӣเޑ٩Ᏽځჹᔈ ޑ OR ॶǴуᕴ OR ॶࡕीᆉ௵གࡋటᆒዴࡋǴܫΕ ROC curve ࡕᛤ ᇙрӵკკϐ ROC curveǶԜკёᔅշךॺפډղᘐࢂցԖ၈ࣁᛰނᔲ Ҕޣޑ॥ᓀ⸣ॶǶӧԜ ROC curve კύǴа OR ॶࣁ 9.665 ٰࣁന
ޑ॥ᓀ⸣ॶǴځ௵གࡋࣁ 83.9%Ǵ౦ࡋࣁ 69.3%ǴΨ൩ࢂᇥǴऩ
٬Ҕ೭ঁ॥ᓀ⸣ॶٰղᘐԜဂࣴزჹຝࢂցԖԋࣁᛰނᔲҔޣޑ॥ᓀ ਔǴёӧӄԖᛰނᔲҔޑΓύǴճҔ೭ঁ॥ᓀ⸣ॶ҅ዴᑔᔠр 83.9%
ޑΓࣁᛰނᔲҔޣǶ
54
ਥᏵԜ॥ᓀႣෳኳԄᆶࡷᒧрޑ॥ᓀ⸣ॶǴаΠӈޑნٰᇥܴी
ϩᆶղ᠐Бݤ (၁ـ߄Ζ)Ǻ
ნ. Տڙ၂ޣǴځȨಃԛวғ܄Չࣁਔ൳ྃȩࣁ 17 ྃаΠǴ ȨΕᅱԛኧࣁΒԛаȩǴӧӣเਔȨเჹȩаΠޕᚒ:Ȩό٬Ҕ܈෧ Ͽ٬ҔᛰвǴശ)рיᘐੱރ*ǵȨ୷চଢ଼Ӣჹי᠅ԖᔅշȩǵȨ٬Ҕ Ѥဦв)ੇࢶӢ*ёаቚу܄ૈΚȩǴჹܭᛰނᔲҔޑȨךளၶډᓸΚ ਔѐ٬Ҕࢥࠔٰၲډ෧ᓸޑਏ݀ȩǵȨךόௗڙܻ϶๏ޑࢥࠔȩᄊࡋ ᚒࣣॄӛᄊࡋԶȨךள٬ҔࢥࠔǴݙК१Ҕ্يᡏȩ҅ӛᄊ ࡋǶளޕԜࣴزჹຝޑӣเࡕǴ᎙Ȩ߄Ϥ/ࣴزჹຝჹᛰނᔲҔޑ ޕǵᄊࡋǵՉࣁϐᡄᒠථӣᘜϩȩ٩ྣځӣเ๏ϒ၀ᚒ OR ॶ
ࣁϩኧǶϩࡕǴಃԛวғ܄Չࣁਔࣁ 17 ྃаΠी 1.54 ϩǴΕᅱ ԛኧΒԛаी 4.37 ϩǴޕᚒเჹी 1 ϩǴΟᚒჹܭᛰނᔲҔޑᄊ ࡋᚒҞϩձी 8.35 ϩǵ 2.29 ϩϷ 1 ϩǶӢԜǴԜࣴزჹຝ܌ளޑᕴ ϩࣁ 20.55 ϩǴςຬၸ॥ᓀ⸣ॶ 9.665 ϩǴ܌аղᘐԜΓёૈԖԋࣁᛰ ނᔲҔޣޑ॥ᓀǶ
ნΒ/!Տڙ၂ޣځȨಃԛวғ܄Չࣁਔ൳ྃȩࣁ!18 ྃаǴ ԶΕᅱԛኧȨԛаΠȩǴӧӣเȨό٬Ҕ܈෧Ͽ٬ҔᛰвǴശ)р
יᘐੱރ*ǵȨ୷চଢ଼Ӣჹי᠅ԖᔅշȩǵȨ٬ҔѤဦв)ੇࢶӢ*ёа ቚу܄ૈΚȩ೭٤ޕᚒਔȨเᒱȩǴჹܭᛰނᔲҔޑȨךளၶډᓸ Κਔѐ٬Ҕࢥࠔٰၲډ෧ᓸޑਏ݀ȩǵȨךόௗڙܻ϶๏ޑࢥࠔȩᄊ ࡋᚒࣣ҅ӛᄊࡋǴԶჹܭȨךள٬ҔࢥࠔǴݙК१Ҕ্يᡏȩ
ॄӛᄊࡋǶ᎙Ȩ߄Ϥ/ࣴزჹຝჹᛰނᔲҔޑޕǵᄊࡋǵՉࣁϐᡄ ᒠථӣᘜϩȩࡕǴಃԛวғ܄Չࣁਔࣁ 18 ྃаी 1 ϩǴΕᅱԛ ኧԛаΠी 1 ϩǴޕᚒเᒱϩձी 0.29 ϩǵ0.56 Ϸ 0.46 ϩǴჹ ܭȨךளၶډᓸΚਔѐ٬Ҕࢥࠔٰၲډ෧ᓸޑਏ݀ȩǵȨךόௗ
55
ڙܻ϶๏ޑࢥࠔȩᄊࡋᚒ҅ӛᄊࡋी 1 ϩǴȨךள٬ҔࢥࠔǴݙ
К१Ҕ্يᡏȩॄӛᄊࡋी 0.53 ϩǶӢԜԜΓޑ OR ॶᕴϩࣁ 5.84 ϩǴ҂ຬၸ॥ᓀ⸣ॶ 9.665 ϩǴࡺԜΓёૈؒԖԋࣁᛰނᔲҔޣޑ
॥ᓀǶ
җܭӧҁࣴزЎೀԖගϷᛰނᔲҔёϩࣁঁΓǵৎΓᆶӕᏆ ޑӒᓀӢηǴӢԜҁࣴزΨஒ 8 ঁӒᓀӢηаӢનϩբ 8
ঁӒᓀӢηޑϩᜪǴ܌ளϐ่݀ࣁ 8 ঁӒᓀӢηԖ 3 ঁӒᓀӢηᘜᜪ ӧ 2 ঁӢη่ᄬǴځύȨךளၶډᓸΚਔѐ٬Ҕࢥࠔٰၲډ෧ᓸ ޑਏ݀ȩᆶȨךόௗڙܻ϶๏ޑࢥࠔȩᘜᜪӧӕӢηǴԶȨך
ள٬ҔࢥࠔǴݙК१Ҕ্يᡏȩᘜᜪӧӕӢηǴԶځд 5 ঁӒ ᓀӢηӢॄໆλܭ 0.4 ӢԜନѐǶ
56
ಃ
ಃΟ HIV-1
܄ޣ COMT Val158Met ୷Ӣӭࠠ܄ϐ᠘ۓ ӧϩ୷Ӣჹܭ HIV-1 ܄ޣჹᛰނᔲҔՉࣁޑቹៜϩǴךॺ ԏڗΑύ୯ᙴᛰεᏢᔠᡍࣽ HIV-1 ܄ޣՈనኬҁǴٰᛰނᔲҔ Չࣁᆶ Val158Met ୷Ӣӭࠠ܄ϐ࣬ᜢǶҗܭᔠᡍࣽύޑࣴزჹຝӄࣣؒԖୢڔፓǴჹܭ HIV-1 ܄ޣځᛰނᔲҔᆶ܄ձၗǴࢂவᙴ ଣύޑੰᐕၗளޕǶ
ҁࣴزԏڗޑ HIV-1 ܄ޣՈనኬҁӅԖ 381 ՏǴ٩Ᏽځੰᐕၗ
ϩࣁᛰނᔲҔޣᆶߚᛰނᔲҔޣǴځύᛰނᔲҔޣӅԖ 142 Տ)ت
܄;128 Տ<ζ܄;14 Տ*ǴߚᛰނᔲҔޣԖ 256 Տ)ت܄:203 Տ;ζ܄:36 Տ*)၁ـ߄Β*ǶԶКၨٿಔࣴزჹຝځ Val158Met ୷Ӣӭࠠ܄ޑᓎ
ৡ౦Ǵӧ่݀ύёа࣮ډԖคᛰނᔲҔՉࣁӧ Val158Met ୷Ӣӭࠠ܄
ޑᓎϩѲǴᛰނᔲҔޣᆶߚᛰނᔲҔޣӧ Val/ValǵVal/MetǵVal/Met ୷ Ӣӭࠠ܄ޑϩѲϩձࣁ 53.6%ǵ 39.4% ǵ 7.0% ᆶ 54.3%ǵ 37.9%ǵ 7.8%Ǵٿಔࣴزჹຝޑ୷ӢࠠᓎϩѲ٠ؒԖᡉৡ౦ (P=0.828) )၁ـ ߄ΐ*Ƕ
ஒ Val158Met ୷ӢࠠϩࣁԖคԖ Met ୷Ӣࠠ (Val/Val v.s Val/Met + Met/Met) ޑٿಔբϩǴӧࣴزჹຝύΨ҂࣮ډৡ౦ (ᛰނᔲ Ҕޣ: 53.5% v.s 46.5%;ߚᛰނᔲҔޣ: 54.3% v.s 45.7%; P=0.882);ԶϩࣁԖ คԖ Val ୷Ӣࠠ (Val/Val + Val/Met v.s Met/Met) ѐբКၨΨ҂࣮ډৡ ౦ ( ᛰ ނ ᔲ Ҕ ޣ : 93.0% v.s 7.0%; ߚ ᛰ ނ ᔲ Ҕ ޣ : 92.2% v.s 7.8%;
P=0.124)Ƕ)၁ـ߄ΐ*
ӧϩ HIV-1 ܄ޣځᛰނᔲҔՉࣁᆶ Val158Met ୷Ӣࠠϐ໔ ޑ࣬ᜢ܄ࡕǴҁࣴزஒࣴزჹຝа܄ձٰբϩǶ२Ӄӧت܄
HIV-1 ܄ ޣ ޑ ϩ Ǵ ᛰ ނ ᔲ Ҕ ޣ ᆶ ߚ ᛰ ނ ᔲ Ҕ ޣ ӧ Val/Val ǵ Val/MetǵVal/Met ୷Ӣӭࠠ܄ޑϩѲϩձࣁ 56.3%ǵ 36.7% ǵ7.0% ᆶ
57
53.7%ǵ38.4%ǵ7.9%ǶځԖคᛰނᔲҔՉࣁӧ Val158Met ୷Ӣࠠᓎϩ Ѳ٠ؒԖৡձ (P=0.892)Ƕբ୷ӢࠠޑٳಔࡕΨ҂࣮ډᡉৡ౦ (Val/Val v.s Val/Met + Met/Met, P=0.649;Val/Val + Val/Met v.s Met/Met,
P=0.776)Ƕ)၁ـ߄Μ*
ζ ܄ HIV-1 ܄ ޣ ޑ ϩ Ǵ ᛰ ނ ᔲ Ҕ ޣ ᆶ ߚ ᛰ ނ ᔲ Ҕ ޣ ӧ Val/ValǵVal/MetǵVal/Met ୷Ӣӭࠠ܄ޑϩѲϩձࣁ 28.6%ǵ64.3%ǵ 7.1% ᆶ 55.6%ǵ38.9%ǵ5.6%Ǵᗨฅӧ Val/Val ᆶ Val/Met ୷Ӣࠠޑϩ ѲԖ٤όӕǴՠࠅ҂ၲीޑᡉৡ౦ (P=0.199)Ǵ୷Ӣࠠޑٳಔ ࡕΨࢂؒԖ࣮ډᡉޑৡ౦ (Val/Val v.s Val/Met + Met/Met, P=0.086;
Val/Val + Val/Met v.s Met/Met, P=0.832)Ƕ)၁ـ߄Μ*!
ϩ Val158Met ୷Ӣӭࠠ܄ჹت܄ HIV-1 ܄ޣᆶζ܄ HIV-1
܄ޣჹᛰނᔲҔՉࣁޑቹៜࡕǴҁࣴزᛰނᔲҔޣᆶߚᛰނ ᔲҔޣа܄ձբϩቫǴѐᢀჸ Val158Met ୷Ӣӭࠠ܄ӧᛰނᔲҔޣύځ ቹៜำࡋࢂցӧ܄ձԖৡ౦Ƕ
ӧ ᛰ ނ ᔲ Ҕ ޣ ޑ ϩ Ǵ ت ܄ ᛰ ނ ᔲ Ҕ ޣ ᆶ ζ ܄ ᛰ ނ ᔲ Ҕ ޣ ځ Val/ValǵVal/MetǵVal/Met ୷Ӣӭࠠ܄ޑϩѲϩձࣁ 56.3%ǵ36.7%ǵ 7.0% ᆶ 28.6%ǵ64.3%ǵ7.1%Ǵջ٬ٿಔࣴزჹຝޑϩѲݩόϼ࣬ӕǴ ՠࢂࠅؒԖᡉޑৡ౦ (P=0.116)ǶԶբ୷Ӣࠠޑٳಔࡕ (Val/Val + Val/Met v.s Met/Met)Ǵ߾ёа࣮ډت܄ᛰނᔲҔޣᆶζ܄ᛰނᔲҔޣӧ
୷ӢࠠᓎޑϩѲԖᡉޑৡ౦(ت܄ᛰނᔲҔޣǺ 56.3%v.s 43.8%;
ζ܄ᛰނᔲҔޣ: 28.6% v.s 71.4%, P=0.049)Ƕ)၁ـ߄ΜΒ*!
ӧߚᛰނᔲҔޣޑϩǴت܄ߚᛰނᔲҔޣᆶζ܄ߚᛰނᔲҔޣځ Val/ValǵVal/MetǵVal/Met ୷Ӣӭࠠ܄ޑϩѲϩձࣁ 53.7%ǵ38.4%ǵ 7.9% ᆶ 55.6%ǵ38.9%ǵ5.6%Ǵ୷Ӣᓎӧ܄ձޑϩ߾ؒԖᡉৡ౦ (P=1.000)ǴԶӧբ୷Ӣࠠٳಔ (Val/Val + Val/Met v.s Met/Met) ࡕӕኬΨ
58
ؒԖৡ౦(ت܄ᛰނᔲҔޣǺ53.7% v.s 46.3%;ζ܄ᛰނᔲҔޣ: 55.6%
v.s 44.4%, P=0.836)Ƕ
җа่݀ёа࣮рǴVal158Met ୷Ӣࠠჹ HIV-1 ܄ޣӧᛰނ ᔲҔՉࣁޑቹៜǴ՟ЯԖ܄ձޑৡ౦Ƕ
59
ಃ
ಃϖകǵፕ
ت܄ڙӉΓϐᛰނᔲҔ॥ᓀႣෳኳԄ
җ܌ࡌҥрϐኳԄёа࣮рᛰނ࣬ᜢޑΓαᏢ፦ǵՉࣁǵޕǵ ᄊࡋჹᛰނᔲҔޑቹៜǴаΠଞჹ೭Οঁϩѐբ:
ӧΓαᏢ፦ޑϩǴ่݀ύёа࣮ډᛰނᔲҔޣᆶৎΓӕՐޑК ٯࢂၨଯޑǴԶӧҁࣴزޑЎύԖගϷӧৎޑӒᓀӢηύǴৎ ΓԖҔᛰಞᄍΨࢂቹៜᛰނᔲҔޑख़ाӢન(6)ǴӢԜΑှᛰނᔲҔޣځӕ ՐৎΓࢂցԖҔᛰಞᄍࣁຑৎӒᓀӢηޑख़ᗺϐǶ
ӧՉࣁϩǴख़ᙟΕᅱޣᆶಃԛวғ܄Չࣁޑԃសၨեޣځᛰނ ᔲҔޑ॥ᓀΨ࣬ჹၨଯǶҗ่࣮݀ډᛰނᔲҔޣख़ᙟΕᅱޑКٯၨଯǴ ёаΑှᛰނᔲҔޣԖӆҍၴݤՉࣁޑݩǴෳҗܭᛰނᔲҔՉࣁό
ܰיݯǴ٬ᛰނᔲҔޣܰӢᛰ᠅ӆҍԶᏤठख़ᙟΕᅱޑԛኧቚуǶ ӧ܄ՉࣁޑϩǴёаᢀჸډᛰނᔲҔޣځಃԛวғ܄Չࣁޑԃ សၨᇸǴԖၨଯКٯӧ҂ԋԃа൩ςԖၸ܄ᡍǴӧӃޑЎ
ύԖගډӧঁΓӒᓀӢηޑϩǴځ܄ՉࣁቹៜᛰނᔲҔޑՉࣁǴ ୯ϣଞჹଯᙍғޑࣴزว܄ՉࣁᆶҔᛰՉࣁԖᜢ(7)ǶᏃᆅӧ่݀ύёа
࣮ډࣴزჹຝӧ܄Չࣁวғԃសޑৡ౦ǶՠҗܭԜࣴزޑज़ڋǴคݤ
ᘐ܄ՉࣁᆶᛰނᔲҔՉࣁϐ໔ޑӢ݀ᜢ߯Ƕ
ӧޕϩǴᕴӅΖᚒޑޕᚒύԖΎᚒځᛰނᔲҔޣӧ࣬ᜢᛰނ ᔲҔޑޕБय़ځ҅ዴޑКٯࢂၨߚᛰނᔲҔޣٰளଯޑǴෳЬाࢂ
җܭӧךॺޑ่݀ύ࣮ډᛰނᔲҔޣख़ᙟΕᅱޑКٯၨଯǴӢԜ܌ௗڙ
ᛰނᔲҔ࣬ᜢޑፁ௲ԛኧၨӭǶӧޕޑᚒҞ္ԖϩᚒҞᆶᛰ᠅ޑ߄
ԖᜢǴԶᛰނᔲҔޣҁيԖ٬ҔᛰނޑᡍǴԶჹᛰނᔲҔޑᇡޕ ำࡋΨКၨଯǶ
60
ҁࣴزวᛰނᔲҔޣӧ࣬ᜢᛰނᔲҔޑᄊࡋϩځॄӛᄊࡋޑК ٯКߚᛰނᔲҔޣٰளଯӭǴԜ่݀ᆶӭࣴزԖ࣬՟ޑݩǴች
ृ(136)ࣴزεᏢғᛰނ٬ҔՉᆶځ࣬ᜢЈޗӢનϐଓᙫࣴزว
ǴӧঁΓЈӢનБय़Ǵ٬ҔࢥࠔޑεᏢғჹ٬Ҕࢥࠔޑ҅ӛႣයȐӳ
ೀȑၨӭǵॄӛႣයȐᚯೀȑၨϿǴԖόϸჹӕᏆ٬ҔࢥࠔϐᇡޕǶ ୯Ѧ Brook Γ(137)КၨԖคᛰނ٬ҔޣǴวᛰނᔲҔޣჹᛰނޑॄ
य़ᄊࡋКၨλǵӛ࣬ߞ٬Ҕᛰނࢂ҅தޑՉࣁǴаϷৎჹᛰނॄय़ ޑᄊࡋၨλǶ௲ػޑၗᡉҢǴჹᛰނᔲҔ҅ӛႣයଯǵॄय़Ⴃයեǵ ܔ๊٬ҔߞЈեޣǴឦᛰނᔲҔӒᓀӢηޑቻϐ(138)Ƕ
ӧჹܭճҔᛰނ෧ᓸޑᄊࡋᛰނᔲҔޣځॄӛᄊࡋޑКٯКߚ
ᛰނᔲҔޣଯӭǴёΑှӧᛰނᔲҔޣύᓸΚёૈࢂ٬Ҕᛰނޑख़
ाচӢϐǶ୯ϣࣴزวǴᎁڙששคݤှ،ԶᗉჴǴࢂ໒ۈ
ௗࢥࠔޑӢન(58,60,61)Ƕ୯ϣଞჹ୯ύғϷଯύғᔲҔᛰނޑፓᡉҢǴ ෧ ᇸ Ј Ϸ ᆒ ઓ ᓸ Κ ࣁ ಃ ԛ Ҕ ᛰ ޑ চ Ӣ ϐ (139)Ƕ Newcomb ȿ Bentler ޑࣴز(140)ࡰрǴԾךགڙډคݤڋॄӛᓸΚਔǴགғڮ
ؒԖཀက (meaningless) ܈ԾךడคҔೀ (useless)ǴӢԶᏤठᛰނᔲҔՉ ࣁǶ
ฅԶӧᆶ٬Ҕᛰނ࣬ᜢᡍԖᜢޑᄊࡋϩ)ךள٬ҔࢥࠔǴݙ
К१Ҕ্يᡏ*Ǵ߾࣮ډᛰނᔲҔޣځ҅ӛᄊࡋКٯࠅࢂКၨଯޑǴ
ෳ೭ኬޑ่݀ёૈᆶᛰނᔲҔޑ࣬ᜢᡍԖ࣬ᜢ܄Ƕ
வҁࣴز܌ࡌҥޑႣෳኳԄύёаᢀჸډǴځᛰނᔲҔޣޑޕၨ
٫ǴՠࢂӧჹܭᛰނᔲҔ࣬ᜢޑᄊࡋϩǴεӭࣁॄӛޑᄊࡋǴЀځӧ ճҔᛰނ෧ᓸޑᄊࡋϩ׳࣮ډځॄӛᄊࡋԖၨଯޑᛰނᔲҔ॥ᓀǶԶ ӧځдޑࣴزύΨԖ࣮ډᜪ՟ޑ่݀Ƕ୯ѦჹܭᎻТᔲҔޣޑࣴزࡰ
рǴᛰނᔲҔޣځڀԖࡐӳޑᛰނᔲҔޕǴՠӧჹᛰނᔲҔޑᄊࡋ
61
ࠅࢂࡐཱུޑǴ೭٤ᛰނᔲҔޣԾॊҁيჹܭڋᛰނ٬ҔޑߞЈό ىǴԶ٬ளᗨԖࡐӳޑޕࠅᗋࢂӧᛰނᔲҔޑݩؒԖܴᡉޑׯ๓
(141)
Ƕ
வҁࣴزޕ่݀ёаΑှǴӧᅱ܌ύନΑፁ௲ࣁख़ाٛݯᛰނᔲҔ ޑౣаѦǴځׯ๓ჹᛰނᔲҔޑᄊࡋΨࢂࡐख़ाޑǶନԜϐѦǴቚу
ᛰނᔲҔޣӧיݯᔲҔᛰނਔޑߞЈΨࢂׯ๓ᛰނᔲҔՉࣁޑख़ᗺǶ
HIV-1
܄ޣ Val158Met ୷Ӣӭࠠ܄ϐ᠘ۓӧҁࣴزޑ่݀ύǴ٠คݤᢀჸډᛰނᔲҔՉࣁᆶ Val158Met ୷Ӣ ӭࠠ܄ϐ໔Ԗܴᡉޑ࣬ᜢ܄ǴԶჹܭ Val158Met ୷Ӣӭࠠ܄ᆶԋ᠅ޑ࣬
ᜢ܄ǴԖόϼठޑࣴز่݀Ƕӧ Tiihonen ᆶ Wang Γ(142,143)ޑࣴز วեࢲ܄ޑ Met158 ჹଽ୷ӢᆶഀଚԖ࣬ᜢ܄Ǵՠӧ Ishiguro ᆶ Hallikainen(144,145) ߾҂วԜфૈ܄ޑ୷Ӣӭࠠ܄ᆶഀଚԖ࣬ᜢǶନԜϐ ѦǴᅿޑόӕΨԖόӕޑࣴز่݀ǴLi Γ(83)ӧᅇΓޑࣴزวҘ୷ ӼߚдڮΑᔲҔޣԖၨଯᓎޑ Val ჹଽ୷ӢǴԶ Tiihonen Γ(144)а
ើΓࣁࣴزჹຝޑ่݀วǴMet158 ჹଽ୷ӢᆶഀଚԖ࣬ᜢ܄ǴฅԶ ӧ Ishiguro ΓӧВҁΓޑࣴز߾ؒԖว Val158Met ୷Ӣӭࠠ܄ᆶ
ഀଚԖ࣬ᜢ܄Ƕ
ӧჹᛰނᔲҔՉࣁբ܄ձϩቫࡕࠅёаว Val158Met ୷Ӣӭࠠ
܄ӧت܄ᆶζ܄ᛰނᔲҔޣޑϩѲԖᡉޑόӕǴ೭ኬޑ่݀՟Яё аෳჹᛰނᔲҔՉࣁޑቹៜӧ܄ձࢂԖৡ౦ޑǶ
ӧځдޑࣴزࡰрǴCOMT ନΑૈжᖴӭЃữϐѦǴΨࢂୖᆶሟ ᐟનжᖴύख़ाޑ䁙ǴځЬाଞჹణ਼ሟΒᎇҘ୷ϯ٬ϐόࢲϯ(146)Ƕ Զ٤ނޑࣴزวǴሟᐟનቚуԴႵჹђᡵޑԾךڗ१(147)Ǵҁ
ࣴزޑ่݀วζ܄ᛰނᔲҔޣԖ Val/Met + Met/Met ୷Ӣࠠޑᓎ
62
ाКت܄ᛰނᔲҔޣٰளଯ(71.4%v.s 43.8%)ǶӢԜҁࣴزෳӧζ܄ᛰ ނᔲҔޣǴӢࣁԖ COMT Val/Met ܈ Met/Met ୷ӢࠠǴ٬ COMT ޑ ࢲ܄ၨեǴԶжᖴሟᐟનޑૈΚၨեΠǴԶቹៜჹᔲҔᛰނޑ௵ག܄Ƕ ฅԶाዴϪޑᡍ೭ኬޑෳǴ߾ሡा׳ӭޑࣴزჹຝᆶߏਔ໔ޑଓᙫ
ࣴزωૈளډჴǶ
63
ಃ
ಃϤകǵ่ፕᆶࡌ
ಃ ่ፕ
ت܄ڙӉΓϐᛰނᔲҔޣ॥ᓀႣෳኳԄ
ҁࣴز܌ࡌҥϐኳԄёа࣮рᛰނᔲҔӧՉࣁǴޕǴᄊࡋБय़ޑ
ݩǴኳԄύаख़ᙟΕᅱӧᛰނᔲҔޣޑКٯၨଯǴё࣮рᛰ᠅ޑיݯ όܰǶाᗉխᛰނᔲҔޣޑҍՉࣁӆҍǴځჹᛰނᔲҔޣޑיݯࢂࡐ ख़ाޑፐᚒǶԶӧ܄ՉࣁБय़ǴёΑှᛰނᔲҔޣځ܄ᡍޑԃសၨᇸǴ ᗨฅӧҁࣴزύคݤዴۓ܄ՉࣁᆶᛰނᔲҔϐ໔ޑӢ݀ᜢ߯Ǵவϩޑ
่݀ёа࣮рᔈуமᛰނᔲҔޣҁيӧ܄ՉࣁБय़ޑޕǴаᗉխӢ܄
Չࣁวғޑԃសၨᇸ܈ࢂჹ܄ޕޑΑှόԶቚу܄ࢉੰ॥ᓀǶኳ Ԅύё࣮ډߚᛰނᔲҔޣځჹᛰނᔲҔޑޕࢂၨόىޑǴᏃᆅёаҔ
ᛰނᔲҔޣ܌ௗڙޑፁ௲ԛኧၨӭٰբှញǴՠჹܭߚᛰނᔲҔޣӧᛰ ނᔲҔޑޕуமᗋࢂࡐख़ाޑǶኳԄύΨёа࣮ډǴᛰނᔲҔޣჹܭ
ᛰނᔲҔޑॄӛᄊࡋޑКٯࢂКၨଯޑǶёޕӧᛰނᔲҔޑႣٛǴନΑ ቚуჹᛰނᔲҔޑᇡޕѦǴӵՖуமჹᛰނᔲҔԖ׳҅ӛޑᄊࡋΨࢂᛰ ނᔲҔႣٛౣࡐख़ाޑӢηǶ
HIV-1
܄ޣ Val158Met ୷Ӣӭࠠ܄ϐ᠘ۓҁࣴزޑ่݀ύёаᢀჸډζ܄ᛰނᔲҔޣӧ Val158Met ୷Ӣӭ
ࠠ܄ᆶᛰނᔲҔޑ߄ᆶت܄ᛰނᔲҔޣόӕǹζ܄ϐሟᐟનჹᛰނ ᔲҔޑቹៜёૈ٬ӭЃữޑਏᔈό࣮ܰـǴԶӧت܄ϐӭЃữჹᛰ ނᔲҔޑቹៜࢂКၨܴᡉޑǶӢԜ҂ٰёаଞჹόӕ܄ձǴѐΑ
ှӭЃữᆶሟᐟનჹᛰނᔲҔޑቹៜǶ
64
ಃ
ಃΒ ࣴزज़ڋ
ت܄ڙӉΓϐᛰނᔲҔޣ॥ᓀႣෳኳԄ
ҁࣴزჹຝٰԾܭѠӚӦᅱ܌ޑت܄ڙӉΓǴԶჹܭᛰނᔲҔޣ ϐۓကǴࢂаԾ༤ୢڔύ࣬ᜢᛰނᔲҔޑ٬ҔᡍٰբϩǴฅԶҗܭ ᅱ܌ύϐڙӉΓࢂӢࣁҍՉࣁԶΕᅱǴԶ೭٤ߚӢࣁᛰނᔲҔ࣬ᜢӉ
ೢԶΕᅱޑڙӉΓǴΨёૈԖᛰނᔲҔޑՉࣁǴՠӢࣁӧѠࢥࠔޑ
٬ҔࣁҍՉࣁǴԶ٬ࣴزჹຝӧ༤เୢڔਔёૈᗦᑀჴ٬ҔᔲҔ
ᛰނޑݩǴӧҁࣴزޑࣴزჹຝύǴନΑٰԾיݯ܌ϐჹຝёаዴᇡ
ࢂᛰނᔲҔޣϐѦǴځдࣴزჹຝࢂа܌༤เϐୢڔၗٰբᛰނᔲ ҔՉࣁޑϩǴԶёૈ٬ҁࣴزԖᒱᇤϩಔ (misclassification) ޑ
ݩǴԶቹៜࣴزϐ่݀ǶԜѦǴୢڔϣύԖኧᚒࢂाࣴزჹຝӣྉ ӃޑǴࡺёૈԖӣᏫᇤৡ (recall bias) ޑౢғǶ
ҁࣴز܌ࡌҥޑᛰނᔲҔ॥ᓀႣෳኳԄࢂаت܄ڙӉΓࣁࣴزჹຝ
܌ࡌҥǴӢԜคݤᔈҔܭӧζ܄܈ࢂ҇يǶ
HIV-1
܄ޣ Val158Met ୷Ӣӭࠠ܄ϐ᠘ۓҁࣴزޑࣴزჹຝନΑՈనኬҁѦǴ٠ؒԖଞჹԜࣴزჹຝբୢڔ ޑፓǴӢԜคݤჹࣴزჹຝբ׳ుΕޑǴԶჹܭᛰނᔲҔޑϩಔ
ࢂவੰᐕၗϩǴӢԜёૈӢࣁࣴزჹຝᗦᑀᛰނᔲҔՉࣁԶԖᒱ ᇤϩಔޑݩǶନԜϐѦǴჹܭࣴزჹຝ܌٬Ҕޑᛰނคݤբޑ
ϩǴҗܭࣴزჹຝޑᛰނᔲҔݩǴࢂவੰᐕύڗளǴฅԶੰᐕύѝ
ૈޕၰࣴزჹຝࢂցࣁᛰނᔲҔޣǴ٠όޕၰࣴزჹຝ܌٬Ҕϐᛰނᅿ ᜪǴӢԜคݤΑှ Val158Met ୷Ӣӭࠠ܄ჹ٬ҔۓᛰނޑቹៜǶ
65
ಃ
ಃΟ ᔈҔᆶࡌ
ҁࣴز܌ࡌҥϐت܄ڙӉΓϐᛰނᔲҔ॥ᓀႣෳኳԄǴёၮҔӧᅱ
܌ύჹཥΕᅱϐتڙӉΓբჹᛰނᔲҔޑ߃ᑔᔠπڀǴԜᑔᔠπڀޑ ߚதޑᙁܰᆶᔮǴନԜϐѦΨёаቚуڙӉΓҁيޑԾךǴᗉխ ΕᅱܺӉޑၸำύԋࣁᛰނᔲҔޣǶ
ҁࣴزޑ่݀ёа࣮рଯӒᓀဂҁيᛰނᔲҔޑᕉნӒᓀӢηǴ
҂ٰёаଞჹ೭٤ӒᓀӢηբׯ๓ǴԶᔈҔӧᛰނᔲҔޑፁ௲Бय़Ǵ܈
ࢂჹᛰނᔲҔޣޑיݯౣǴԶΨёኳᔕԜኳԄޑБԄǴଞჹόӕ
ဂࡌҥ၀ဂޑ॥ᓀႣෳኳԄǴԶᔈҔӧ҇ޑيǴ٬׳ӭΓૈ
ჹᛰނᔲҔԖ׳ుޑΑှǴ٠ቚமԾךჹᛰނᔲҔޑӢԶၲډჹᛰ ނᔲҔՉࣁޑႣٛǶ
ԶӧᛰނᔲҔޑᒪӒᓀӢηޑࣴزϩǴ҂ٰёаଞჹ COMT ୷ Ӣޑځд୷Ӣӭࠠ܄ଆբ׳ుΕޑǴѐᢀჸόӕᔲҔᛰނᆶ COMT ϐ໔ޑቹៜǴ٠ӝٳѐᢀჸӧᆒઓ੯ੰӅੰޑวǴаϷӧ܄ձ ޑৡ౦ǴऩࢂૈפډᆶᔲҔᛰނϐ໔׳మཱޑᐒڋᆶ࣬ᜢ܄Ǵჹ ܭᛰނᔲҔޑݯᕍᆶႣٛΨёаԖ׳ӭޑᒧǶ
҂ٰёаӕਔჹᛰނᔲҔޑᕉნᆶᒪӒᓀӢηբుΕǴߡё а׳ֹޑӕਔᢀჸᕉნᆶᒪӢηჹᛰނᔲҔޑቹៜǶ
66
ୖ
ୖԵЎ
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81
߄ ߄
!߄ǵ ت܄ڙӉΓϐᛰނᔲҔ॥ᓀႣෳኳԄϐࣴزჹຝٰྍϷΓኧ
ࣴزჹຝٰྍ ᛰނᔲҔޣ(Γኧ) ߚᛰނᔲҔޣޣ(Γኧ) Total(Γኧ)
Ѡύᅱᅢ 295 190 485
Ѡύ࣮Ӻ܌ 138 2 140
Ѡύיݯ܌ 63 0 63
݅ಃΒᅱᅢ 132 72 204
ଯᅱᅢ 89 50 139
ጪᅱᅢ 36 22 58
Total (Γኧ) 753 336 1089
82
߄
߄ΒǵHIV-1 ܄ޣ COMT Val158Met ୷Ӣӭࠠ܄ᅱෳϐ
ࣴزჹຝΓኧ
ࣴزჹຝ܄ձ ᛰނᔲҔޣ(Γኧ) ߚᛰނᔲҔޣ(Γኧ) Total(Γኧ)
ت܄ 128 203 331
ζ܄ 14 36 50
Total (
Γኧ) 142 239 38183
84
Mean ± SD 34815.9±34584.5 31247.3±29212.8 33728.3±33066.7 0.111
*ǺT-test †ǺChi-square test §ǺFisher exact test
85
86
߄
߄Ѥ(ុ)ǵԖคᛰނᔲҔޣϐՉࣁރᄊ
ᛰނᔲҔޣ (n=753)
ߚᛰނᔲҔ ޣ(n=336)
Total(n=1089) P value
n (%) n (%) n (%)
գள"ሡόሡा"ک܄Քߧ
ፕӵՖՉӼӄ܄Չࣁ (n=739) (n=330) (n=1069)
ሡा 605 (81.9%) 258 (78.2%) 863 (80.7%) 0.158 όሡा 134 (18.1%) 72 (21.8%) 206 (19.3%)
գԖک܄ՔߧፕӵՖՉ
Ӽӄ܄Չࣁၸ༏ (n=744) (n=334) (n=1078)
Ԗ 452 (60.8%) 208 (62.3%) 660 (61.2%) 0.635
ؒԖ 292 (39.2%) 126 (37.7%) 418 (38.8%)
ԖؒԖளၸ܄ੰ (n=753) (n=336) (n=1089)
Ԗ 66 (9.8%) 29 (8.6%) 95 (8.7%) 0.942
ؒԖ 687 (91.2%) 307 (91.4%) 994 (91.3%)
*ǺT-test †ǺChi-square test §ǺFisher exact test
87
†ǺChi-square test
88
†ǺChi-square test
89
†ǺChi-square test
90
Βԛа 4.85(3.48-6.76) <0.001 4.37(3.11-6.15) <0.001
ό٬Ҕ܈෧Ͽ٬ҔᛰвǴ
ശ
ശ(ррיᘐੱރ)
เჹ 1.00 1.00 -
เᒱ 0.27(0.14-0.52) <0.001 0.29(0.15-0.58) <0.001
୷চଢ଼Ӣჹי᠅Ԗᔅշ
เᒱ 0.46(0.32-0.66) <0.001 0.46(0.32-0.67) <0.001 ךளၶډᓸΚਔѐ٬
Ҕ
Ҕࢥࠔٰၲډ෧ᓸޑਏ݀
҅ӛ(ߚதόӕཀ/όӕཀ) 1.00 1.00 -
ॄӛ(ӕཀ/ߚதӕཀ) 8.04(3.25-19.87) <0.001 8.35(3.35-20.83) <0.001 ךள٬ҔࢥࠔǴݙК१Ҕ
91
92
߄
߄ΐǵԖคᛰނᔲҔՉࣁϐ HIV-1 ܄ޣځ Val158Met ୷Ӣࠠᓎ
ᛰނᔲҔޣ ߚᛰނᔲҔޣ Total P
value n (%) n (%) n (%)
୷Ӣࠠᓎ (n=142) (n=256) (n=398)
Val/Val 76 53.6% 139 54.3% 215 54% 0.828 Val/Met 56 39.4% 97 37.9% 153 38.4%
Met/Met 10 7.0% 20 7.8% 30 7.5%
ӝٳ Val/Met + Met/Met ϐ୷୷Ӣࠠᓎ
Val/Val 76 53.5% 139 54.3% 215 54% 0.882 Val/Met + Met/Met 66 46.5% 117 45.7% 183 46%
ӝٳ Val/Va + Val/Met ϐ
୷Ӣࠠᓎ
Val/Val + Val/Met 132 93.0% 236 92.2% 368 92.5%
Met/Met 10 7.0% 20 7.8% 30 7.5%
ჹଽ୷Ӣᓎ
Val 208 73.2% 375 73.3% 583 73.2% 0.124 Met 76 26.8% 137 26.7% 213 26.8%
93
ӝٳ Val/Met + Met/Met ϐ୷୷Ӣࠠᓎ
Val/Val 72 56.3% 109 53.7% 181 54.7% 0.649 Val/Met + Met/Met 56 43.8% 94 46.3% 150 45.3%
ӝٳ Val/Val + Val/Met ϐ୷Ӣࠠᓎ
ӝٳ Val/Met + Met/Met ϐ୷୷Ӣࠠᓎ
Val/Val 4 28.6% 20 55.6% 24 48% 0.086 Val/Met + Met/Met 10 71.4% 16 44.4% 26 52%
ӝٳ Val/Val + Val/Met ϐ୷Ӣࠠᓎ
Val/Val + Val/Met 13 92.9% 34 94.4% 47 94% 0.832 Met/Met 1 7.1% 2 5.6% 3 6%
94
ӝٳ Val/Met + Met/Met ϐ୷୷Ӣࠠᓎ
Val/Val 72 56.3% 4 28.6% 76 53.5% 0.049† Val/Met + Met/Met 56 43.8% 10 71.4% 66 46.5%
†ǺChi-square test
߄ΜΟǵКၨ HIV-1 ߚᛰނᔲҔޣځ COMT Val158Met ୷Ӣࠠᓎӧ܄ձϐৡ౦
95
კ კ
კ 1. ճҔ ROC curve ϩᛰނᔲҔޣ॥ᓀႣෳኳԄϐ॥ᓀ⸣ॶ.
1-ᆒዴࡋ
96
ߕ
ߕᒵǺୢڔ
ӕཀਜ!
!
ாӳǺ!
!!!!೭ࢂҗՉࡹଣፁғᆅڋᛰࠔᆅֽہૼύ୯ᙴᛰεᏢᙔॕߙշ
௲܌ЬঁճҔ॥ᓀኳԄᆶፁғ௲ػ௲ჹܭᛰނᔲҔଯӒᓀ ဂϐޕᄊࡋׯᡂޑፓǶीฝӜᆀࣁճҔ॥ᓀϩБݤࡌҥᛰނ ᔲҔႣෳኳԄϷځٛڋ௲(ीฝጓဦ:
DOH98-NNB-1048)Ƕ
!!!!ҁୢڔаӜБԄՉǴஒாεऊ 31 ϩដޑਔ໔༤ቪǴ೭ҽୢ
ڔޑၗ๊ჹߥஏǴፎா୍Ѹ٩ჴሞݩբเா܌༤เޑၗஒჹךॺ Αှך୯ᛰ᠅ޣԖཱུεޑᔅշǴӵ݀ாԖ࣮όᔉޑୢᚒǴፎாᖐЋวୢǶ ፎா٩ᚒҞ।ǵᚒเǴགᖴாޑୖᆶǶ!!
!
!!!!!!!!!!!!!!!!!!!!!!!!!!!ڙෳޣᛝӜǺ`````````````!
ᏢဦǺ`````````````!
!
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!ڙෳВයǺ98 ԃ Д В
97
3. ΕᅱۚՐӦǺ______ᑜ/ѱ______/ᙼ/ѱ/ໂ
4. ᝤೣǺ □መࠄΓ ˎѦ࣪Γ ˎ࠼ৎΓ ˎচՐ҇ ˎѦ୯Γ.୯ᝤࢂ____
11. ΕᅱДѳ֡πբԏΕ:________________ϡ
12. ೭ࢂாಃ൳ԛΕᅱ܌(יݯ܌ǵ࣮Ӻ܌Ϸᅱᅢ)Ǻ_____ԛǴᕴӅ______ԃ 13.ಃԛวғ܄Չࣁਔ൳ྃǺˎ17 ྃаΠ ˎ18 ྃа
98
99
100
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