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鐣滅墽瀹剁缍�(w菐ng) 鏅�(sh铆)闁擄細2012/2/10 10:33:00 渚�(l谩i)婧愶細闆炵梾灏堟キ(y猫)缍�(w菐ng) 闁辫畝鏁�(sh霉)锛�
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銆€銆€铔嬫皑閰告槸闆為<鏂欎腑绗竴闄愬埗鎬ф皑鍩洪吀銆傝倝闆炴棩绯х己涔忚泲姘ㄩ吀鏅�(sh铆)锛岀敘(ch菐n)鐢熸姉楂旂殑鑳藉姏闄嶄綆銆傛棩绯ц泲姘ㄩ吀鐨勬按骞宠垏闆炲厤鐤€ц兘鏈夎憲寰堥噸瑕佺殑闂�(gu膩n)绯�銆俆siagbe(1987)鍦ㄨ倝闆炴棩绯т腑鍒嗗垾娣诲姞0锛�063锛�锛�0锛�125锛呭拰0锛�25锛呯殑铔嬫皑閰革紝妾㈡脯(c猫)琛€娓呮姉楂旀淮搴�銆両gG鍜孖gM鐨勫惈閲忕瓑鍏嶇柅鎸囨(bi膩o)銆傜祼(ji茅)鏋滈’绀�锛岄毃钁楁棩绯ц泲姘ㄩ吀姘村钩鐨勯€�(j矛n)姝ワ紝鑲夐洖琛€娓呮姉楂旀淮搴�銆両gG鐨勫惈閲忓拰娣嬪反绱�(x矛)鑳炶綁(zhu菐n)鍖栫巼鏄庨’澧為珮锛岃€屽皪(du矛)IgM鐨勫惈閲忕劇(w煤)鏄庨’褰遍熆锛岃€屼笖楂樻按骞宠泲姘ㄩ吀鍙槑椤€�(j矛n)姝ヨ倝闆炵殑楂旈噸銆傝〃鏄庤泲姘ㄩ吀闄ゅ姞蹇倝闆炵殑鐢熼暦(zh菐ng)閫熷害澶�锛岄倓鍙€�(j矛n)姝ラ洖鐨勫厤鐤姛鑳姐€傚挨鍏舵槸淇冮€�(j矛n)IgG鎶楅珨鐨勫悎鎴�銆�
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銆€銆€绾堟皑閰告槸绲勬垚闆瀁—鐞冭泲鐧界殑涓昏鎴愪唤锛屾棩绯х簣姘ㄩ吀涓嶈冻鎴栫己涔忔檪(sh铆)锛岄洖楂斿収(n猫i)鍚堟垚鎶楅珨鐨勮兘鍔涢檷浣�銆傝倝闆炴棩绯т腑娣诲姞0.5锛咃綖1锛�5锛呯簣姘ㄩ吀锛屾帴绋甆DV鐤嫍锛屾脯(c猫)瀹氬叾鑷存鐜囩敱40锛呴檷鍒�0锛岃€屾姉楂旀晥鍍�(ji脿)鍓囩敱2锛�751og2鍗囬珮鍒�5.31og2銆傝€屼笖闅ㄨ憲鏃ョ厂绾堟皑閰告按骞崇殑閫�(j矛n)姝�锛岃倝闆炵殑鐢熼暦(zh菐ng)閫熷害鍔犲揩锛岃〃鏄庣簣姘ㄩ吀灏�(du矛)闆為珨娑插厤鐤湁閲嶈褰遍熆锛岄珮姘村钩绾堟皑閰稿彲鍔犲挤(qi谩ng)闆炵殑鍏嶇柅鍔�锛屼績閫�(j矛n)鐢熼暦(zh菐ng)銆�
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銆€銆€绲﹁倝闆為<鍠傛棩绯х己涔�銆佸厖瓒冲拰閬�(gu貌)閲忎笁鍊�(g猫)姘村钩鐨勮槆姘ㄩ吀锛屾脯(c猫)瀹氬叾灏�(du矛)SRBC鐨勬姉楂旀晥鍍�(ji脿)锛岄毃钁楁棩绯ц槆姘ㄩ吀姘村钩鐨勯€�(j矛n)姝ワ紝琛€娓匰RBC鐨勬姉楂旀晥鍍�(ji脿)閫愭几鍗囬珮锛岃€屼笖鐢熼暦(zh菐ng)閫熷害鍔犲揩锛岄<鏂欒綁(zhu菐n)鍖栫巼閫�(j矛n)姝ャ€傝€岄<鍠傚惈40锛咃綖200锛呯殑璩存皑閰告棩绯ф檪(sh铆)锛屾棩绯ц炒姘ㄩ吀姘村钩閬�(gu貌)浣庢垨澶珮锛岃倝闆炲悎鎴愭姉楂旂殑鑳藉姏閮介檷浣�(TBkahashi锛�1994)銆�
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銆€銆€2锛�1锛�1 缍敓绱燗 鐩墠瑷卞鐮旂┒琛ㄦ槑锛岀董鐢熺礌A鍙槑椤€�(j矛n)姝ラ洖鐨勫厤鐤姛鑳姐€傜董鐢熺礌A鍙洿鎺ヤ綔鐢ㄤ簬B绱�(x矛)鑳�锛屽姞寮�(qi谩ng)姗�(j墨)楂斿彲婧舵€ф垨椤嗙矑鎬ф姉鍘熺敘(ch菐n)鐢熺殑楂旀恫鍏嶇柅鍔熻兘锛屽弮鑸囧拰淇冮€�(j矛n)鎶楅珨鐨勫悎鎴�锛屼績閫�(j矛n)娣嬪反绱�(x矛)鑳炶綁(zhu菐n)鍖�锛屽埡婵€鐧界窗(x矛)鑳炰粙绱犲拰骞叉摼绱犵殑鍒嗘硨锛岃獦灏�(d菐o)娣嬪反绱�(x矛)鑳炲娈�锛屼績閫�(j矛n)鍚炲櫖绱�(x矛)鑳炶檿鐞嗘姉鍘熷拰杓斿姪鎬绱�(x矛)鑳炵殑鎴愮啛锛屽姞寮�(qi谩ng)姗�(j墨)楂旂殑绱�(x矛)鑳炲厤鐤姛鑳�銆傛煇浜涘偝鏌撴€х柧鐥呭鐞冭煵鐥�銆佽爼锜茬梾绛夊彲闄嶄綆缍敓绱燗鍘熷湪楂斿収(n猫i)杞�(zhu菐n)鍖栨垚缍敓绱燗锛屽緸鑰屽皫(d菐o)鑷寸董鐢熺礌A缂轰箯銆傜董鐢熺礌A缂轰箯鎴栦笉瓒虫檪(sh铆)锛岄洖鍚堟垚鎶楅珨鐨勮兘鍔涘墛寮憋紝琛€娑叉穻宸寸窗(x矛)鑳炵殑鏁�(sh霉)鐩笡灏�锛屾硶姘忓泭鍜岃兏鑵虹殑閲嶉噺娓涜紩銆傛棩绯ф坊鍔犵董鐢熺礌A閫�(j矛n)姝ラ洖鍚堟垚鎶楅珨鐨勮兘鍔�銆傛棩绯ф坊鍔�4000IU锛弅g缍敓绱燗锛岃娓呮姉楂旀淮搴︾偤娣诲姞1000IU锛弅g鏅�(sh铆)鐨�2锝�5鍊嶃€傛棩绯ф坊鍔�2μg锛廹缍敓绱燗锛岄洖琛€娓匢gG銆両gM鍜孖gA鐨勫惈閲忓拰灏�(du矛)鏂板煄鐤梾姣掔殑鎶楅珨鏁堝児(ji脿)鍧囨槑椤珮浜庝笉娣诲姞缍敓绱燗(Catherine锛�1989)銆傛坊鍔犵董鐢熺礌A鍙€�(j矛n)姝ラ洖灏�(du矛)鏂板煄鐤拰棣珛鍏嬬柅鑻楀強澶ц吀妗胯弻鐨勫厤鐤弽鎳�(y墨ng)锛屾笡灏戞浜$巼銆傜郸闆為<鍠傜董鐢熺礌A缂轰箯鍜屽厖瓒崇殑鏃ョ厂涓€骞舵劅鏌撴柊鍩庣柅鐥呮瘨鍜屽ぇ鑵告】鑿岋紝绲�(ji茅)鏋滈’绀�锛屾棩绯х董鐢熺礌A鍏呰冻锛岄洖鍚堟垚鎶楅珨鐨勮兘鍔涘拰娣嬪反绱�(x矛)鑳炲鍊煎弽鎳�(y墨ng)鍔犲挤(qi谩ng)锛屽皪(du矛)鏂板煄鐤梾姣掑拰澶ц吀妗胯弻鐨勭櫦(f膩)鐥呯巼鍜屾浜$巼閮芥槑椤檷浣�(Friedman锛�1991)銆係klan(1994)鍦ㄨ倝闆炴棩绯т腑娣诲姞0锝�13.2μg锛廹涓嶅悓姘村钩缍敓绱燗锛岄毃钁楁棩绯х董鐢熺礌A姘村钩鐨勫鍔�锛岃娓呮姉楂旀淮搴﹀拰T娣嬪反绱�(x矛)鑳炶綁(zhu菐n)鍖栫巼閫愭几鍗囬珮锛屽湪6.66μg锛廹缍敓绱燗姘村钩鏅�(sh铆)鍒伴仈(d谩)*锛岃秴閬�(gu貌)6.66μg锛廹鏅�(sh铆)鎶楅珨婊村害鍜屾穻宸寸窗(x矛)鑳炶綁(zhu菐n)鍖栫巼闁嬪闄嶄綆銆傝〃鏄庨洖铏曚簬鏈€楂樺厤鐤姏鏅�(sh铆)鏃ョ厂缍敓绱燗鐨勬按骞虫瘮NRC(1994)鐨勬帹钖﹂噺0.52μg锛廹(1500IU锛弅g)瑕侀珮鍑哄崄骞惧€嶏紝浣嗛亷(gu貌)閲忔坊鍔犵董鐢熺礌A鏈�(hu矛)鎶戝埗鍏嶇柅鍔�銆傚洜姝�锛岄洖鏃ョ厂缍敓绱燗鐨勬按骞抽€�(j矛n)姝ュ埌姣旂嚐(y铆ng)椁�(y菐ng)妯�(bi膩o)婧�(zh菙n)鐨勬坊鍔犻噺鏇撮珮鐨勬按骞�锛屽彲浣块洖鐛插緱杓冮珮鐨勫厤鐤姏銆�
銆€銆€2锛�1锛�2 缍敓绱燛 瑷卞鐮旂┒琛ㄦ槑锛屾棩绯ч珮姘村钩缍敓绱燛鍙€�(j矛n)姝ラ洖灏�(du矛)鍌虫煋鎬ф硶姘忓泭鐥�銆佹煍瀚╄壘缇庤€崇悆锜茬梾銆侀洖鏂板煄鐤拰鍤�(y谩n)閲嶅ぇ鑵告】鑿屾劅鏌撶殑鍏嶇柅鍔�锛岄檷浣庣櫦(f膩)鐥呯巼鍜屾浜$巼銆傛棩绯ф坊鍔�300 mg锛弅g缍敓绱燛锛屽嵆鍒伴仈(d谩)闇€瑕侀噺鐨�6鍊嶆檪(sh铆)锛屽彲浣块洖灏�(du矛)澶ц吀妗胯弻鑴傚绯栫殑鎶楅珨鏁堝児(ji脿)鍜屽悶鍣窗(x矛)鑳炵殑娲诲嫊(d貌ng)鎬ц兘閫�(j矛n)姝�3锝�6鍊�(Heinzerling锛�1974)銆傝│椹�(y脿n)琛ㄦ槑灏�(du矛)鍏嶇柅绯荤当(t菕ng)鍙楀埌渚靛鐨勯洖缇�锛岄噰鍙栭珮姘村钩缍敓绱燛鏃ョ厂渚�(l谩i)閫�(j矛n)姝ラ洖鐨勫厤鐤姏鏄湁鏁堢殑銆傜董鐢熺礌E鍙€�(j矛n)姝ラ洖鐨勯珨娑插厤鐤拰绱�(x矛)鑳炲厤鐤姏銆傛枃鏉�(1996)绲﹁倝闆炴棩绯ф坊鍔�20mg锛弅g鍜�80mg锛弅g鍏╁€�(g猫)姘村钩缍敓绱燛锛岀祼(ji茅)鏋滆〃鏄庨珮姘村钩缍敓绱燛鍙€�(j矛n)姝ラ洖琛€娓呮柊鍩庣柅鎶楅珨婊村害鍜岃娑叉穻宸寸窗(x矛)鑳炶綁(zhu菐n)鍖栫巼锛涢毃钁楁棩榻″鍔�锛岃娓呯董鐢熺礌E鍚噺鏄庨’闄嶄綆銆傛彁绀烘噳(y墨ng)鐩℃棭娣诲姞杓冮珮姘村钩缍敓绱燛锛屼互娓涚珐琛€娓呯董鐢熺礌E鐨勪笅闄嶉€熷害銆傛棩绯х己涔忕董鐢熺礌E鍙檷浣庨洖鍚堟垚鎶楅珨鐨勮兘鍔涘拰鍏嶇柅鍣ㄥ畼鐨勯噸閲�銆侻arsh(1986)绲﹂洖椋煎杺缂轰箯鍜屾坊鍔�130mg锛弅g缍敓绱燛鐨勬棩绯э紝缂轰箯缍敓绱燛闆炶娓呮姉楂旀晥鍍�(ji脿)姣旀坊鍔犵祫浣�1锛�0锛岃劸鑷熼噸閲忔笡灏�27锛�1mg锛屾硶姘忓泭閲嶉噺娓涘皯56锛�4mg銆傜洰鍓嶇殑鐮旂┒閭勮〃鏄庯紝缍敓绱燛鍙檷浣庢硶姘忓泭绱�(x矛)鑳炲墠鍒楄吅绱犵殑鐢�(ch菐n)鐢�銆傜敱浜庡墠鍒楄吅绱犳槸T娣嬪反绱�(x矛)鑳炵殑鎶戝埗鍔戯紝鍏锋湁鍏嶇柅鎶戝埗浣滅敤锛屽洜姝よ獚(r猫n)鐐猴紝缍敓绱燛鏄互闄嶄綆鍓嶅垪鑵虹礌鐨勭敓鐗╁悎鎴愪締(l谩i)淇冮€�(j矛n)鎶楅珨鐨勭敘(ch菐n)鐢熺殑銆�