東南亞地區農藥自殺密集事件密集，而農藥中毒的病理診斷是急迫且複雜，不同種類的農藥中毒需有不同的因應治療方法，所以開發即時性快速篩檢醫檢器材是相當重要的。在台灣地區，以有機磷中毒比例最高，已知有機磷對血液中乙醯膽鹼酯酶(Acetylcholine esterase)有強烈抑制效果，臨床上多以檢驗血液中乙醯膽鹼酯酶的活性，做判斷中有機磷中毒的依據。本研究中，開發易取得且便宜的新型試紙作為血液農藥檢測平台，以有機磷作為測試品，結合能用肉眼辨別的酵素顯色偵測法來的檢驗血液中乙醯膽鹼酯酶活性。選擇Whatman 一號型濾紙作為基板，利用噴蠟式印表機將設計的樣板印製於紙上。加熱基材促使蠟的融解，控制蠟均勻滲透至紙的纖維內，形成親水性的檢測區及疏水性的限制區。乙醯膽鹼經由血液中的乙醯膽鹼酯酶分解成乙酸及乙醯膽鹼氧化酶分解，且產生過氧化氫，在過氧化氫酶催化下會與TMB顯色劑產生顏色反應，肉眼之能辨識範圍在檢測值為0.2~0.4 U / mL，比正常血液值7~19 U / mL靈敏一個級數，並可將檢測時間縮短至二十分鐘以內。兩個林口長庚醫院臨床血清樣本，利用紙型印記平台測量治療成功前後的血清樣本，提供兩倍的訊號差異。半定量結果對照長庚醫院醫檢部之檢測數值，顯示乙醯膽鹼活性濃度正常值差1.40~1.54倍，中毒值則差1.05~1.49倍。

This research provides a fast scanning of organophosphorus pesticide device for diagnostic self-poisoning. They are estimated 200,000 people dead from organophosphorus pesticide poisoning around the world every year. Especially, in rural regions of the developing world, fatality rises because pesticides are more accessible and the medical management is relatively difficult. To address this unwanted need, we developed a paper-based colorimetric device which allows visual recognition of organophosphorus self-poisoning in few minutes without expensive equipments. We used filter paper printed out with wax to created a specific region for the detection of the inhibition of plasma cholinesterase activity as an important clinical bio-maker for organophosphorus and carbamates. Total operation time was shorten down to fewer than twenty minutes and portable for on-sited detection. The Visually recognizable range for plasma cholinesterase is 0.2~0.4 U / mL and it is 10 times lower than the normal plasma cholinesterase range 7~19 U / mL. Two clinical samples included during poisoned and after recovery were provided by Linkou Cheng-Kung Memorial Hospital. Organophosphorus-recovered patient sample’s the signal from is two times to that of the poisoned status assessed by using our devices. The ratios of signals obtained by using paper-based devices signal to that of commercial testing in hospital is 1.05~149 and 1.05~1.5 for poisoned samples, respectively.

摘要 ............................................................................................................. 2
Abstract ....................................................................................................... 3
致謝 ............................................................................................................. 4
總目錄 ......................................................................................................... 5
圖目錄 ......................................................................................................... 8
表目錄 ....................................................................................................... 10
1 第一章 緒論 .................................................................................... 11
1.1 研究動機 ................................................................................. 11
1.2 台灣自殺議題 ......................................................................... 11
1.2.2 自殺方法 ....................................................................... 12
1.3 農藥危害 ................................................................................. 15
1.3.1 農藥的定義與分類 ....................................................... 15
1.3.2 農藥銷售與管理 ........................................................... 16
1.3.3 農藥毒害機制 ............................................................... 19
1.4 有機磷 ..................................................................................... 21
1.4.1 有機磷之基本特性 ....................................................... 21
1.4.2 有機磷農藥的生理反應 ............................................... 22

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