°é°©×ÛºÏÕ÷ÓеÄʱºò¿ÉÒÔÏÈÓڸΰ©±¾ÉíµÄÖ¢×´³öÏÖ£¬³£¼ûµÄÓÐ×Ô·¢ÐÔµÍѪÌÇ£¬Õâ¸ö¼ûÓÚ10%µ½30%µÄ²¡ÈË£¬Ö÷ÒªÊÇÒòΪ¸Î°©Ï¸°ûµÄÒìλ·ÖÃÚÒȵºËØ»òÕßÊÇÒȵºËØÑùµÄÎïÖÊ£¬ÒªÃ´¾ÍÊÇÖ×ÁöÒÖÖÆÁËÒȵºËØÃ¸³É·Ö£¬»òÕßÊÇ·ÖÃÚÒ»ÖÖÒȵº¦Âϸ°û´Ì¼¤Òò×Ó£¬Ò²¿ÉÒÔÒòΪ¸Î°©×éÖ¯¹ý¶ÈÏûºÄÆÏÌÑÌǶøÒýÆð¡£¶þ¸ö¾ÍÊǺìϸ°ûÔö¶àÖ¢£¬¿ÉÄÜÊÇÑ»·Öкìϸ°ûÉú³ÉËØÔö¶àÒýÆðÀ´µÄ¡£
ÎÊÌâ·ÖÎö£ºÎ¸³¦µÀ°é°©×ÛºÏÕ÷ÊÇÖ¸ÒòΪÏû»¯ÏµÍ³Ö×ÁöËùÒýÆðµÄһϵÁÐÖ¢×´£¬µ«ÊÇËû²¢²»Êǰ©Ö¢µÄÈ«Éí·´Ó¦£¬Ö÷Òª±íÏÖΪµÍµ°°×Ѫ֢£¬ÒÔ¼°Óɵ͵°°×Ѫ֢ËùÖµÄË®Ö×£¬»¹Óи¹ÐºµÈµÈ¡£
Òâ¼û½¨Ò飺Ö÷ÒªÊÇÒªÕÒµ½Ô·¢°©Ö×£¬È·¶¨²¡ÒòÖ®ºó¾¡ÔçÊÖÊõÕý°æ²¶ÓãÓÎÏ·¹Ù·½ÍøÕ¾´óÈ«£¬ÆäËûµÄÖ¢×´¿ÉÒÔʹÓÃÒ©Îï¿ØÖÆ£¬ÒûʳÉÏÖ÷ÒªÒÔÖàµÈÈíʳΪÖ÷£¬ÉÙ³ÔÐÁÀ±´Ì¼¤¼°ÓÍÄåʳÎï¡£
¡¡¡¡1.X Ïß¼ì²é 賦µÀX Ïß¼ì²é¶Ô¼ø±ðÕï¶ÏÓÐÖØÒªÒâÒå¡£ÌØ±ðÊÇÒÔÏÂX ÏßÕ÷£ºÎ¸³¦ð¤Ä¤Öåôž޴ó·Êºñ(¼ûÓڷʺñÐÔ·ÖÃÚÐÔθ²¡);ÎüÊÕ²»Á¼µÄX ÏßÕ÷(³¦Ç»À©ÕÅ¡¢Ñ©»¨Ñù»òÓðëÑù±µ¼Á³Á×Å£¬±µ¼Á³Ê·Ö½Ú×´·Ö²¼£¬¼ûÓÚ¸÷ÖÖ°éÓÐÎüÊÕ²»Á¼µÄµ°°×ÖʶªÊ§ÐÔ賦¼²²¡);С³¦ð¤Ä¤ÖåôÅÆÕ±éÔöºñ(ÁܰÍÁö¡¢¿ËÂÞ¶÷²¡¡¢Ô·¢ÐÔ³¦Áܰ͹ÜÀ©ÕÅÖ¢»ò¼Ì·¢ÐÔ³¦Áܰ͹Ü×èÈû);С³¦ð¤Ä¤³Ê½á½ÚÑù¸Ä±äºóָѹÕ÷(ÁܰÍÁö¡¢¿ËÂÞ¶÷²¡)¡£¸¹²¿CT ɨÃèÓÐÖúÓÚ·¢ÏÖ³¦ÏµÄ¤ÁܰͽáÖ×´óµÈ¡£ ¡¡¡¡2.¿Õ³¦ð¤Ä¤»î¼ì ¶à¿é¿Õ³¦ð¤Ä¤»î¼ì¶ÔÁܰÍÁö¡¢ÈéÃÓк¡¢ÊÈËáÐÔ賦Ñס¢½ºÔÐÔ賦Ñס¢³¦Áܰ͹ÜÀ©ÕÅÖ¢¡¢Whipple ²¡µÈÕï¶ÏÓÐÒâÒå¡£ ¡¡¡¡3.Áܰ͹ÜÔìÓ° ¾×ãÁܰ͹ÜÔìÓ°¶Ô¼ø±ðÏÈÌìÐÔ»ò¼Ì·¢ÐÔ³¦Áܰ͹ÜÀ©ÕÅÓкܴó°ïÖú¡£Ç°Õ߿ɼûÖÜΧÁܰ͹ܷ¢Óý²»Á¼ºÍÐØµ¼¹Ü²¡±ä£¬ÔìÓ°¼ÁÖÍÁôÓÚ¸¹Ä¤ºóÁܰͽᣬµ«³¦ÏµÄ¤ÁܰÍϵͳ²»³äÓ¯;ºóÕßÔìÓ°¼Á¿É·´Á÷ÖÁÀ©Õŵij¦ÏµÄ¤Áܰ͹ܣ¬²¢Òç³öÖÁ³¦Ç»»ò¸¹Ä¤Ç»¡£ ¡¡¡¡4.¸¹Ë®¼ì²é Óи¹Ë®Õß¿É×÷Õï¶ÏÐÔ´©´Ì£¬²é¸¹Ë®Ï¸°û¡¢µ°°×ÖÊ¡¢ÈéÃÓ΢Á£¡¢Ã¸¡¢¶ñÐÔϸ°ûµÈ¡£
ÎÊÌâ·ÖÎö£ºÄãºÃ£¬ÅóÓÑ£¬¸ù¾ÝÄãµÄÃèÊö£¬Î¸³¦µÀ°é°©×ÛºÏÕ÷ÊÇÒò°©×éÖ¯»µËÀÍÑÂä¶øÒýÆðÏàӦθ³¦Õ³Ä¤µÄͨ͸ÐÔÔö¸ß£¬Ñª½¬µ°°×´óÁ¿´Ó賦µÀ©³ö¶ªÊ§¡£°©ÁöѹÆÈºÍ¶ÂÈûÁܰ͹ܣ¬ÒýÆð賦ÁܰͻØÁ÷ÊÜ×裬Áܰ͹ÜÓÙ»ý¡¢ÆÆÁÑ£¬Ê¹´óÁ¿µ°°×¶ªÊ§¡£ÁÙ´²ÉÏÒԵ͵°°×Ѫ֢ºÍË®Ö×ΪÖ÷Òª±íÏÖ
Òâ¼û½¨Ò飺ÄúºÃ£¬Î¸³¦µÀ°é°©×ÛºÏÕ÷Õý°æ²¶ÓãÓÎÏ·¹Ù·½ÍøÕ¾´óÈ«µÄ»°½¨Ò飬ÍêÈ«²ÉÓÃÂÌÉ«Õý°æ²¶ÓãÓÎÏ·¹Ù·½ÍøÕ¾´óÈ«ÊÖ·¨£¬Ó¦ÓÃÖÐÒ½´«Í³Ò½Ñ§ÀíÂÛ£¬±çÖ¤ÂÛÖΣ¬Öβ¡Çó±¾£¬Í»ÏÔÖÐÒ½Ò©Õý°æ²¶ÓãÓÎÏ·¹Ù·½ÍøÕ¾´óȫ賦¼²²¡µÄ¶ÀÌØÁÆÐ§£¬ÐÞ¸´Î¸³¦ÊÜËðÉËճĤÔÙÉú³É£¬Õý³£×éÖ¯±ÜÃâÎ÷Ò©¸±×÷Óá£Õý°æ²¶ÓãÓÎÏ·¹Ù·½ÍøÕ¾´óÈ«Ö÷ÒªÊÇÔ·¢°©ÁöµÄÇгý£¬Ò²¿ÉÓ¦ÓÃÉú³¤ÒÖËØÀàËÆÎïÈç°ÂÇúëÄÕý°æ²¶ÓãÓÎÏ·¹Ù·½ÍøÕ¾´óÈ«£¬¶Ô¿ØÖƸ¹ÐºÓÐЧ¡£
¡¡¡¡ÄÜÒýÆðµ°°×ÖʶªÊ§µÄ賦²¡Éõ¶à£¬Èç±í1 Ëùʾ¡£
¡¡¡¡ÉúÀíѧµÄÑо¿ÒÑ֤ʵ£¬Ñª½¬°×µ°°×ºÍÇòµ°°×µÄ·Ö½â²úÎïÖУ¬½ö10%×óÓÒ´Ó³¦µÀÅųö£¬Òò´ËÈÏΪÕý³£ÈËÉúÀíÇé¿öÏÂ賦µÀµ°°×ÖʵĶªÊ§¿ÉÒÔºöÂÔ²»¼Æ¡£
¡¡¡¡µ°°×ÖʶªÊ§ÐÔ賦²¡µÄ·¢²¡»úÖÆÖ÷ÒªÓÐÈý£º
¡¡¡¡1.賦ð¤Ä¤ÃÓÀûòÀ£Ññµ¼Öµ°°×Éø³ö»ò©³ö¡£
¡¡¡¡2.ð¤Ä¤Ï¸°ûËðÉË»òȱʧ£¬Ï¸°û¼ä½ôÃÜÁ¬½ÓÔö¿í£¬µ¼ÖÂð¤Ä¤Í¨Í¸ÐÔÔö¼Ó£¬Ñª½¬µ°°×©È볦ǻ¡£
¡¡¡¡3.³¦Áܰ͹Ü×èÈû£¬³¦¼äÖÊѹÁ¦Éý¸ß£¬Ê¹¸»º¬µ°°×Öʵij¦¼äÖʲ»µ«²»Äܱ£³ÖÔÚ¼äÖÊÖлò±»ÎüÊÕÈëѪѻ·£¬·´¶øÊ¹ÆäÒç³ö£¬½øÈ볦ǻ¶ø¶ªÊ§¡£³¦µÀÑ×Ö¢ÒýÆðµ°°×¶ªÊ§ÐÔ賦²¡µÄ»úÖÆ»¹²»Çå³þ£¬¿ÉÄÜÊÇÓÉÓÚÑ×Ö¢ÇøÏ¸°ûÍâÒººÍÑ×ÐÔÒºÌåÉø³öËùÖ¡£ÔÚÕý³£Çé¿öÏ£¬Â©Èë賦µÀµÄѪ½¬µ°°×Á¿²»¶à£¬¹À¼ÆÕâЩµ°°×Öʲ»µ½ÑªÑ»·°×µ°°×µÄ6%£¬Ö»Ï൱ÓÚÕâЩѪ½¬µ°°×ÿÌì·Ö½âÂʵÄ10%¡«20%£¬ÆäÖÐ90%ÒÔÉϱ»Ïû»¯ºóÓÖÖØÐÂÎüÊÕ£¬Òò´Ë£¬Î¸³¦µÀµÄ·Ö½â´úлÔÚѪ½¬µ°°××ܵķֽâ´úлÖв¢²»Õ¼ÖØÒªµØÎ»¡£ÔÚµ°°×¶ªÊ§ÐÔ賦²¡Ê±£¬Ñª½¬µ°°×ÖÊ´Ó賦µÀµÄ¶ªÊ§Ô¶Ô½¹ýÕý³£É¥Ê§Á¿¡£Ã¿Ììµ°°×ÖÊÔÚ賦µÀµÄ½µ½âÂʿɸߴïÑ»·Ñª½¬µ°°×ÖÊ×ÜÁ¿µÄ40%¡«60%ÒÔÉÏ¡£µ°°×ÖʶªÊ§ÐÔ賦²¡Ê±µ°°×ÖÊ´Ó賦µÀ¶ªÊ§Óëµ°°×ÖʵķÖ×ÓÁ¿Î޹ء£Ñª½¬µ°°×´óÁ¿Â©Èë賦µÀ£¬ÖÂʹѪ½¬µ°°×ÖʰëË¥ÆÚËõ¶Ì¡¢ÖÜתÂʼӿ졣ÓÐÑо¿±íÃ÷£¬±¾²¡Ê±ÓÉÓÚѪ½¬µ°°×ÖÊÎÞÂÛÆä·Ö×Ó´óС¾ù´Ó賦µÀð¤Ä¤Â©³ö£¬Òò¶øºÏ³ÉÂÊÔ½ÂýºÍ(»ò)°ëË¥ÆÚÔ½³¤µÄѪ½¬µ°°×ϽµÔ½Ã÷ÏÔ¡£°×µ°°×ºÍIgG µÄ°ëË¥ÆÚ½Ï³¤£¬¼´Ê¹»úÌå½øÐдú³¥ÐԺϳɣ¬ÆäÄÜÁ¦ÓÐÏÞ£¬¸ÎÔàºÏ³É°×µ°°×µÄËÙÂÊ×î¶àÄÜÌá¸ß1 ±¶;¶øIgG µÈÃâÒßÇòµ°°×µÄºÏ³É»¹²»ÊÜѪ½¬Å¨¶È½µµÍµÄ´Ì¼¤£¬ËùÒÔ°×µ°°×ºÍIgG µÄѪ½¬Å¨¶ÈÔÚ±¾²¡Ê±Ï½µ³Ì¶È×îÖØ£¬Ê¹µÃ±¾²¡»¼Õß³£°éÓеͰ׵°°×Ѫ֢¡£ÖÜתÂʿ졢°ëË¥ÆÚ¶ÌµÄѪ½¬µ°°×£¬ÈçתÌúµ°°×¡¢ÍÀ¶µ°°×¡¢IgM µÈ²»Ò×Êܵ½Ó°Ï죬±¾²¡Ê±½öÇá¶È½µµÍ¡£¶øÏËάµ°°×Ô°ëË¥ÆÚ×î¶Ì¡¢ºÏ³ÉËÙÂÊ×î¿ì£¬¹ÊѪ½¬Å¨¶ÈÒ»°ãÕý³£¡£¶ªÊ§Èëθ³¦Ç»µÄµ°°×ÖÊÔÚ³¦Ç»ÄÚ±»·Ö½â³É°±»ùËá¡¢ëĶø±»ÔÙÎüÊÕÈëѪѻ·£¬×÷Ϊ»úÌåµÄµªÔ´£¬Èç¹û¶ªÊ§Èë賦µÀµÄµ°°×ÖÊÁ¿½Ï¶à¡¢½øÈ볦µÀµÄËٶȽϿì»ò³¦È䶯½Ï¿ì£¬ÔòÓдóÁ¿µÄµ°°×´Ó³¦µÀÅųö¡£Òò³¦Áܰ͹Ü×èÈû¶øÖµ°°×ÖÊ´Ó³¦µÀ¶ªÊ§Õߣ¬¿ÉͬʱÓÐÁܰÍϸ°û´Ó³¦µÀ¶ªÊ§¶øÖÂѪÁܰÍϸ°û¼õÉÙ¡£´ËÍ⣬ÆäËûѪ½¬³É·ÖÈçÍ¡¢¸Æ¡¢Ìú¡¢Ö¬ÖʵÈÒ²¿É´Ó賦µÀ¶ªÊ§¡£
Ö¸µ¼Òâ¼û£ºÒò°©×éÖ¯»µËÀÍÑÂä¶øÒýÆðÏàӦθ³¦Õ³Ä¤µÄͨ͸ÐÔÔö¸ßѪ½¬µ°°×´óÁ¿´Ó賦µÀ©³ö¶ªÊ§°©ÁöѹÆÈºÍ¶ÂÈûÁܰ͹ÜÒýÆð賦ÁܰͻØÁ÷ÊÜ×èÁܰ͹ÜÓÙ»ý¡¢ÆÆÁÑʹ´óÁ¿µ°°×¶ªÊ§ÁÙ´²ÉÏÒԵ͵°°×Ѫ֢ºÍË®Ö×ΪÖ÷Òª±íÏÖ½¨ÒéÄãÆ½Ê±×¢ÒâÐÝÏ¢²»Òª³ÔÐÁÀ±¡¢´Ì¼¤µÄʳÎï±£³ÖÁ¼ºÃµÄÐÄ̬²»ÒªÉúÆøÉúÆø¶ÔθҲ²»ºÃµÄ