璩肩墿淇濋殰
鏀粯鏂瑰紡
閰嶉€佹湇鍕�(w霉)
鍞悗鏈嶅嫏(w霉)
闂�(gu膩n)浜庢垜鍊�
娑堢檶骞崇墖鍔熻兘涓绘不锛氭姉鐧�銆佹秷鐐庛€佸钩鍠�锛涚敤浜庨閬撶檶銆佽儍鐧屻€佽偤鐧�锛屽皪澶ц吀鐧�銆佸闋哥檶銆佺櫧琛€鐥呯瓑澶氱ó鎯℃€ц叓鐦や害鏈変竴瀹氱檪鏁�锛屼害鍙厤鍚堟斁鐧傘€佸寲鐧傚強鎵嬭(sh霉)鍚庢不鐧�锛涘苟鐢ㄤ簬娌荤檪鎱㈡€ф埃绠＄値鍜屾敮姘ｇ鍝枠銆傚湪鐢ㄨ棩涔嬪悗涔熻鍘婚棞(gu膩n)娉ㄦ槸鍚﹀瓨鍦ㄦ湁椋熸涓嶆尟鐧�(f膩)鐔变互鍙婄柤鐥涙柟闈㈢殑鍓綔鐢ㄦ儏娉�锛屽仛濂藉壇浣滅敤鐨勯爯(y霉)闃插拰鎳�(y墨ng)灏嶆帾鏂�銆� 瑭虫儏
鐢辩敇鑲呮壎姝ｈ棩妤�(y猫)绉戞妧鑲′唤鏈夐檺鍏徃鎵€鐢熺敘(ch菐n)鐨勮矠鑺壎姝ｈ啝鍥婂姛鑳戒富娌伙細瑁滄埃椁�(y菐ng)闄�锛岀敤浜庝箙鐥呰櫅鎼�锛屾埃闄颁笉瓒�锛涢厤鍚堟墜琛�(sh霉)銆佹斁灏勬不鐧�銆佸寲瀛�(xu茅)娌荤檪锛屼績閫叉甯稿姛鑳界殑鎭㈠京(f霉)銆傚皪浜庡瓨鍦ㄦ湁鐩搁棞(gu膩n)鍟忛鐨勬偅鑰呰€岃█锛屽彲浠ュ湪閱�(y墨)闄㈡垨鑰呮槸姝ｈ(gu墨)鐨勮棩鎴胯卜鍒拌棩鐗�锛岃臣璨峰埌涔嬪悗瑕佹纰虹殑浣跨敤銆� 瑭虫儏
鑳冪檶鏄竴绋瓨鍦ㄦ湁閫插睍鎬х殑鐤剧梾锛屼笉姝ｇ⒑鐨勯２椋熺祼(ji茅)妲�(g貌u)鍙兘鏈冨鍔犳偅鏈夌檶鐧ョ殑棰�(f膿ng)闅紝骞介杸铻烘】鑿岀殑鎰熸煋涔熸槸閫欎竴鐥呯櫏鍑虹従(xi脿n)鐨勪竴澶у洜绱�銆傚畨搴锋鑶犲泭娲昏鍖栫榾銆佽粺鍫呮暎绲�(ji茅)銆佹竻鐔辫В姣�銆佹壎姝ｅ浐鏈�锛涚敤浜庤偤鐧屻€佽儍鐧�銆佽倽鐧岀瓑鑵槫鐨勮紨鍔╂不鐧�銆� 瑭虫儏
瀛愬鑲岀槫瀹槸鑹€ц叓鐦�锛屽皪鎮ｈ€呯殑褰遍熆鏄笉涓€妯ｇ殑锛屼絾鏄竴鑸兘闇€瑕佸強鏅傜殑閫茶钘ョ墿鐨勬不鐧備締铏曠悊銆傜槫瀵ц啝鍥婅棩鐞嗘瘨鐞嗭細钘ョ悊瀛�(xu茅)瑭﹂绲�(ji茅)鏋滆〃鏄庯細瀹槫瀵ц啝鍥婂叿鏈夋彁楂樻楂旈潪鐗圭暟鎬у厤鐤拰绱拌優鍏嶇柅鍔熻兘锛屾椿琛€鍖栫榾锛屾敼鍠勫瓙瀹井寰挵(hu谩n)闅滅锛屾姉鑲夎娊绲勭箶澧炵敓銆佹琛€绛変綔鐢�銆� 瑭虫儏
浜屽崄浜斿懗鑲虹梾鑶犲泭娓呯啽娑堢値锛屽鑲哄寲鐥�锛屾鍜冲钩鍠�锛涚敤浜庤偤閭梾寮曡捣鐨勫挸鐥颁笉姝紝鍛煎惛鎬ヤ績锛岃偤鐔�锛岀櫦(f膩)鐕�锛岄蓟濉�锛岃兏鑴呯柤鐥�锛屽挴琛€锛屽€︽€犵瓑锛涘叾娆�锛岃鏄庢浉鐢ㄦ硶鐢ㄩ噺锛氬彛鏈嶏紱涓€娆�3绮�锛屼竴鏃�3娆�銆傚湪鐢ㄨ棩鐨勯亷绋嬬暥(d膩ng)涓紝瑕佸爡鎸佹寜鐓ф纰虹殑鐢ㄦ硶鐢ㄩ噺渚嗕娇鐢�銆� 瑭虫儏
鑵槫瑕佺⿳妤电殑鐢ㄨ棩渚嗚檿鐞�锛屽钩娑堢墖鎬х媭鐐鸿杽鑶滆。鐗�锛岄櫎鍘诲寘琛ｅ悗椤繁鐏拌壊鑷抽粦鐏拌壊锛涙埃寰锛屽懗鑻︺€佹線銆傝棩鐗╃殑淇濊唱(zh矛)鏈熺偤36鍊嬫湀锛屾偅鑰呴渶瑕佸湪淇濊唱(zh矛)鏈熷収(n猫i)鍘讳娇鐢ㄨ棩鍝�锛岃秴鍑轰繚璩�(zh矛)鏈熺殑钘ョ墿瑕佸強鏅傜殑娓呯悊鎺夛紝骞朵笖閲嶆柊閬告搰姝ｈ(gu墨)鐨勮棩鎴挎垨鑰呮槸閱�(y墨)闄㈣臣璨�銆� 瑭虫儏
钘ョ墿浣跨敤涔嬪墠锛岄渶瑕佷簡瑙ｅ叾閬╂噳(y墨ng)鐧ュ拰鍔熻兘涓绘不锛屽鐦ゅ鑶犲泭瑾槑鏇稿姛鑳戒富娌伙細杌熷爡鏁ｇ祼(ji茅)锛屾椿琛€鍖栫榾锛屾壎姝ｅ浐鏈�锛涚敤浜庡瓙瀹倢鐦わ紙鑲屽闁�銆佹伎鑶滀笅锛夋埃婊鐦€鐧�锛岀櫏瑕嬬稉(j墨ng)鏈熷欢闀凤紝缍�(j墨ng)閲忛亷澶�锛岀稉(j墨ng)鑹茬传榛湁濉婏紝灏忚吂鎴栦钩鎴胯劰鐥涚瓑銆� 瑭虫儏
瀹槫瀵ц啝鍥婅粺鍫呮暎绲�(ji茅)锛屾椿琛€鍖栫榾锛屾壎姝ｅ浐鏈�锛涚敤浜庡瓙瀹倢鐦わ紙鑲屽闁�銆佹伎鑶滀笅锛夋埃婊鐦€鐧ワ紝鐧ヨ缍�(j墨ng)鏈熷欢闀�锛岀稉(j墨ng)閲忛亷澶氾紝缍�(j墨ng)鑹茬传榛湁濉�锛屽皬鑵规垨涔虫埧鑴圭棝绛�锛涘叾娆�锛岃鏄庢浉鐢ㄦ硶鐢ㄩ噺锛氬彛鏈�锛涗竴娆�3绮�锛屼竴鏃�3娆�锛�3鍊嬫湀缍�(j墨ng)鍛ㄦ湡鐐轰竴鐧傜▼銆� 瑭虫儏
涓嶇鏄瑕�(gu墨)鐨勮棩鎴块倓鏄啱(y墨)闄㈤兘鏈夎壘鍔涘彲锛屾湰钘ョ墿钘ョ悊姣掔悊锛氱偤绱拌優瑾樺皫(d菐o)鍒嗗寲钘�锛涚董A閰告槸缍敓绱燗鐨勪唬璎濅腑闁撻珨锛屼富瑕佸奖闊块鐨勭敓闀疯垏涓婄毊浠ｈ瑵锛涢€氶亷瑾�(di脿o)绡€(ji茅)琛ㄧ毊绱拌優鐨勬湁绲插垎瑁傚拰琛ㄧ毊绱拌優鐨勬洿鏂帮紝淇冮€叉甯歌鍖�锛屽奖闊夸笂鐨唬璎�锛屽皪涓婄毊瑙掔窗鑳炵殑鐢熼暦鍜岃璩�(zh矛)灞ょ殑鑴惤鏈夋槑椤殑淇冮€蹭綔鐢紝鍙績浣垮凡鏈夌殑绮夊埡鍘婚櫎锛屽悓鏅傚張鎶戝埗鏂扮殑绮夊埡锛涘彲闃绘瑙掕唱(zh矛)鏍撶殑鍫靛锛屽皪瑙掕泲鐧界殑鍚堟垚鏈夋姂鍒朵綔鐢�銆� 瑭虫儏
闁嬪潶灏硷紙鍗″害灏煎埄鍠姉娉ㄥ皠娑诧級鐐虹劇鑹茶嚦娣￠粌鑹叉緞鏄庢恫楂�锛屽彲鐣ュ付涔冲厜銆傝棩鐗╃殑鐩搁棞(gu膩n)淇℃伅涓€鑸鏄庢浉涓婇兘鑳藉椤ず鐨�锛屽湪鐢ㄨ棩涔嬪墠澶у鍙互鍔犱互鍙冭€�銆傚湪韬珨鐙€娉佸厑瑷辩殑鎯呮硜涓�锛屽闋哥檶鎮ｈ€呮噳(y墨ng)閬╃暥(d膩ng)閫茶閬嬪嫊閸涚厜锛屽鏁ｆ銆佹參璺�銆佺憸浼界瓑銆傞亱鍕曚笉鍍呰兘澶犲寮疯韩楂斿厤鐤姏锛屾彁楂樻姉鐥呰兘鍔涳紝閭勮兘淇冮€查珨鍏�(n猫i)琛€娑插惊鐠�(hu谩n)锛屽姞閫熸柊闄充唬璎濄€備絾闇€娉ㄦ剰閬嬪嫊寮峰害鍜岄牷鐜�锛岄伩鍏嶉亷搴﹀嫗绱�銆� 瑭虫儏
鍗″害灏煎埄鍠姉娉ㄥ皠娑叉不鐧傜殑鎮ｈ€呭彲鐧�(f膩)鐢熷厤鐤浉闂�(gu膩n)鎬т笉鑹弽鎳�(y墨ng)锛屽柈钘ユ不鐧傜殑鎮ｈ€呬腑鏈夊厤鐤浉闂�(gu膩n)鎬ц偤鐐庡牨鍛婏紝鍠棩娌荤檪鐨勬偅鑰呬腑鏈夊厤鐤浉闂�(gu膩n)鎬ц儍鐐�銆佽吂鐎夊強绲�(ji茅)鑵哥値鍫卞憡銆傚闋哥檶鎮ｈ€呭鏋滃湪娌荤檪鏈熼枔鍑虹従(xi脿n)鍓綔鐢ㄧ殑鎯呮硜锛岄偅涔堜篃鎳�(y墨ng)瑭插湪閱�(y墨)鐢熺殑鎸囧皫(d菐o)涓嬫纰鸿檿鐞�銆� 瑭虫儏
灏忛噾涓告暎绲�(ji茅)娑堣叓锛屽寲鐦€姝㈢棝锛涚敤浜庣棸姘ｅ嚌婊墍鑷寸殑鐦扮櫂銆佺櫗鐦�銆佷钩宸�銆佷钩鍍�锛岀櫏瑕嬭倢鑶氭垨鑲岃啔涓嬭叓濉婁竴铏曟垨鏁�(sh霉)铏曪紝鎺ㄤ箣鑳藉嫊锛屾垨楠ㄥ強楠ㄩ棞(gu膩n)绡€(ji茅)鑵ぇ锛岀毊鑹蹭笉璁�锛岃叓纭綔鐥�锛涜€岃棩鐗╃殑鐢ㄦ硶鐢ㄩ噺锛氭墦纰庡悗鍙ｆ湇锛涗竴娆�1.2锝�3g锛屼竴鏃�2娆�锛屽皬鍏掗厡娓�銆� 瑭虫儏
涓嶅悓鐨勮棩搴楅姺鍞殑闁嬪潶灏硷紙鍗″害灏煎埄鍠姉娉ㄥ皠娑诧級钘ョ墿鍍规牸鏈冩湁鎵€宸垾锛屽湪缍�(w菐ng)涓婅棩搴楃泭钘ュ悍寰锋▊澶ц棩鎴胯臣钘�锛屽児鏍煎鎯狅紝杓冨競鍫翠笂杓冪偤浣庡粔锛屽叿楂斾互闁€搴楃暥(d膩ng)澶╁敭鍍圭偤婧�(zh菙n)?锛涢鍜€惰＞钄梩(y墨)鐢熺殑鍥戞墭锛屽畾鏈熷幓閱�(y墨)闄㈤€茶寰�(f霉)鏌�锛屼簡瑙ｈ韩楂旂殑鎭㈠京(f霉)鎯呮硜銆� 瑭虫儏
闁嬪潶灏硷紙鍗″害灏煎埄鍠姉娉ㄥ皠娑诧級鐢ㄦ硶鐢ㄩ噺锛氭湰鍝侀爤鍦ㄦ湁鑵槫娌荤檪缍�(j墨ng)椹楃殑閱�(y墨)鐢熸垨钘ュ斧鎸囧皫(d菐o)涓嬬敤钘ャ€傛帹钖﹀姂閲忥細鏈搧閲囩敤闈滆剤杓告敞鐨勬柟寮忕郸钘�锛屾帹钖﹀姂閲忕偤6mg/kg锛屾瘡2鍛ㄧ郸钘ヤ竴娆�?锛涢鍜€磠(di脿o)鏁村ソ鑷繁鐨勫績鎱�(t脿i)锛屼繚鎸佸績鎯呯殑鎰夋倕锛屼笉瑕佸洜鐐虹柧鐥呰€岀劍鎱洶鎿惧灞�銆� 瑭虫儏
闁嬪潶灏硷紙鍗″害灏煎埄鍠姉娉ㄥ皠娑诧級鐢ㄦ硶鐢ㄩ噺锛氭湰鍝侀爤鍦ㄦ湁鑵槫娌荤檪缍�(j墨ng)椹楃殑閱�(y墨)鐢熸垨钘ュ斧鎸囧皫(d菐o)涓嬬敤钘�銆傛帹钖﹀姂閲忥細鏈搧閲囩敤闈滆剤杓告敞鐨勬柟寮忕郸钘ワ紝鎺ㄨ枽鍔戦噺鐐�6mg/kg锛屾瘡2鍛ㄧ郸钘ヤ竴娆�?锛涢鍜€磠(di脿o)鏁村ソ鑷繁鐨勯２椋�锛屽钩鏅傝澶氬悆楂樿泲鐧�銆侀珮缍敓绱犵殑椋熺墿銆� 瑭虫儏
瀹夊悍娆ｈ啝鍥婄殑涓嶈壇鍙嶆噳(y墨ng)锛氬皻涓嶆槑纰�锛岃棩鐗╃殑鎴愪唤绲勬垚鏈夊崐鏋濊摦銆佸北璞嗘牴銆佽挷鍏嫳銆侀瓪鑵ヨ崏銆佸鏋崏銆佺煶涓婃煆銆佹灨鏉炲瓙銆佺┛鐮寸煶銆佷汉鍙�銆侀粌鑺�銆侀洖琛€钘�銆侀潏鑺�銆侀粌绮�銆佺櫧琛�(sh霉)銆侀花鍙�銆佹帆缇婅椏銆佸厰绲插瓙銆佷腹鍙冨崄鍏懗涓棩绲勬垚銆傚鏋滃叾涓湁閬庢晱鐨勬垚浠斤紝鎮ｈ€呬竴鑸槸涓嶈兘澶犵敤钘ョ殑閬垮厤寮曡捣閬庢晱鍙嶆噳(y墨ng)銆� 瑭虫儏
鍒╂櫘鍗擄紙濂ф媺甯曞埄鐗囷級閬╃敤浜庯細鏀滃付鑳氱郴鎴栭珨绱拌優 BRCA 绐佽畩鐨勶紙gBRCAm 鎴� sBRCAm锛夋櫄鏈熶笂鐨€у嵉宸㈢檶銆佽几鍗电鐧屾垨鍘熺櫦(f膩)鎬ц吂鑶滅檶鍒濇不鎴愪汉鎮ｈ€呭湪涓€绶氬惈閴戝寲鐧傞仈鍒板畬鍏ㄧ珐瑙ｆ垨閮ㄥ垎绶╄В鍚庣殑缍寔娌荤檪锛涢墤鏁忔劅鐨勫京(f霉)鐧�(f膩)鎬т笂鐨€у嵉宸㈢檶銆佽几鍗电鐧屾垨鍘熺櫦(f膩)鎬ц吂鑶滅檶鎴愪汉鎮ｈ€呭湪鍚墤鍖栫檪閬斿埌瀹屽叏绶╄В鎴栭儴鍒嗙珐瑙ｅ悗鐨勭董鎸佹不鐧傘€� 瑭虫儏
瀹槫瀵ц啝鍥婄殑鍔熻兘涓绘不锛涜粺鍫呮暎绲�(ji茅)锛屾椿琛€鍖栫榾锛屾壎姝ｅ浐鏈�锛涚敤浜庡瓙瀹倢鐦わ紙鑲屽闁撱€佹伎鑶滀笅锛夋埃婊鐦€鐧�锛岀櫏瑕嬬稉(j墨ng)鏈熷欢闀凤紝缍�(j墨ng)閲忛亷澶�锛岀稉(j墨ng)鑹茬传榛湁濉婏紝灏忚吂鎴栦钩鎴胯劰鐥涚瓑锛涘叾娆★紝钘ョ墿鐨勬垚浠芥湁娴疯椈銆佷笁妫�銆佽泧鑾�銆佺煶瑕嬬┛銆佸崐鏋濊摦銆佹嫵鍙�銆侀花鍙冦€佸北钘�銆佽胺鑺�銆佺敇鑽�?锛涢鍜濇灠顎搭悵_鐨勪娇鐢ㄨ棩鐗�锛岄伩鍏嶅嚭鐝�(xi脿n)鍓綔鐢ㄣ€� 瑭虫儏
闁嬪潶灏硷紙鍗″害灏煎埄鍠姉娉ㄥ皠娑诧級閬╂噳(y墨ng)鐧ワ細閬╃敤浜庢棦寰€鎺ュ彈鍚墤鍖栫檪娌荤檪澶辨晽鐨勫京(f霉)鐧�(f膩)鎴栬綁(zhu菐n)绉绘€у闋哥檶鎮ｈ€呯殑娌荤檪?锛涢鍜€磠(di脿o)鏁村ソ鑷繁鐨勬儏绶掞紝淇濇寔绌嶆サ妯傝鐨勬厠(t脿i)搴�锛岄伩鍏嶅嚭鐝�(xi脿n)娌柂銆佺劍鎱瓑鐨勬儏绶掔媭鎱�(t脿i)锛屽湪椋查鏂归潰瑕佹敞鎰忓爡鎸侀珮铔嬬櫧銆侀珮缍敓绱犵殑椋查銆� 瑭虫儏
鍗″害灏煎埄鍠姉娉ㄥ皠娑插児鏍煎叾瀵﹀苟娌掓湁寰堟槀璨达紝涓嶉亷澶у濡傛灉閫氶亷涓嶅悓鐨勮棩鎴胯臣璨�锛岄渶瑕佹敮浠樼殑璨荤敤涔熷彲鑳藉瓨鍦ㄥ樊鐣帮紝瀹冪殑鍞児鍦ㄥ競闈笂鐝�(xi脿n)鍦ㄥ苟娌掓湁閬斿埌绲�(t菕ng)涓€妯�(bi膩o)婧�(zh菙n)锛屽叿楂旀儏娉佸ぇ瀹舵噳(y墨ng)瑭茶嚜宸辨娊鏅傞枔鍘讳簡瑙ｃ€� 瑭虫儏
姝ｅ搧淇濋殰 鏀惧績閬歌臣
鐢ㄨ棩鍏ㄧ▼鎸囧皫(d菐o)
寤犲鎺堟瑠(qu谩n) 姝ｅ搧娓犻亾
瀹夊叏鏀惧績 闅辩閰嶉€�
