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I
343 鐛搁啱(y墨)鍩虹(ch菙)鑰冭│澶х侗
銆婄嵏閱�(y墨)鍩虹(ch菙)銆嬬鐩│鍗锋豢鍒嗙偤 150 鍒�?锛熻崥鍤俽闁� 180 鍒嗛悩銆�
鑰冭│鑼冨湇鍖呮嫭涓夐儴鍒嗭細鐛搁啱(y墨)钘ョ悊瀛�銆佺嵏閱�(y墨)鐥呯悊瀛�銆佺嵏閱�(y墨)鑷ㄥ簥瑷烘柗瀛搞€傛瘡閮ㄥ垎 75
鍒�銆�
鑰冪敓浠婚伕鍏朵腑鍏╅儴鍒嗕綔绛斻€傚涓夐儴鍒嗗叏閮ㄤ綔绛�锛屽彇鍒嗘暩(sh霉)杓冨皯鐨勫叐閮ㄥ垎瑷堝垎銆�
鐩� 閷�
绗� 1 閮ㄥ垎
鐛搁啱(y墨)钘ョ悊瀛�
1 绺借珫...............................................................................................................................1
1.1 绶掕█ .......................................................................................................................1
1.2 钘ョ墿灏嶆楂旂殑浣滅敤鈥斺€旇棩鏁堝 ...........................................................................1
1.3 姗熼珨灏嶈棩鐗╃殑浣滅敤鈥斺€旇棩鍕曞 ...........................................................................3
1.4 褰遍熆钘ョ墿浣滅敤鐨勫洜绱� ...........................................................................................5
2 澶栧懆绁炵稉(j墨ng)绯荤当(t菕ng)钘ョ悊.......................................................................................................6
2.1 鍌冲嚭绁炵稉(j墨ng)钘ョ墿 .......................................................................................................6
2.2 鍌冲叆绁炵稉(j墨ng)钘ョ墿 ..................................................................................................... 11
3 涓绁炵稉(j墨ng)绯荤当(t菕ng)钘ョ悊.....................................................................................................13
3.1 鍏ㄨ韩楹婚唹钘� .........................................................................................................13
3.2 閹�(zh猫n)闈滆棩鑸囨姉椹氬帴钘� .............................................................................................14
3.3 閹�(zh猫n)鐥涜棩 .................................................................................................................15
3.4 涓鑸堝ギ钘� .........................................................................................................16
4 鑷珨娲绘€х墿璩�(zh矛)钘ョ悊.....................................................................................................17
4.1 绲勮兒鍙婃姉绲勮兒钘� .................................................................................................18
4.2 鍓嶅垪鑵虹礌 .............................................................................................................18
4.3 瑙ｇ啽閹�(zh猫n)鐥涙姉鐐庤棩 .................................................................................................19
5 鍏�(n猫i)鑷熺郴绲�(t菕ng)钘ョ悊.............................................................................................................21
5.1 琛€娑插惊鐠�(hu谩n)绯荤当(t菕ng)钘� .................................................................................................21
5.2 鍒╁翱钘� .................................................................................................................22
5.3 娑堝寲绯荤当(t菕ng)钘� .........................................................................................................23
5.4 鍛煎惛绯荤当(t菕ng)钘� .........................................................................................................25
II
5.5 鐢熸畺婵€绱犻钘ョ墿鑸囩硸鐨唱(zh矛)婵€绱犻钘ョ墿..............................................................27
6 姘撮菇浠ｈ瑵瑾�(di脿o)绡€(ji茅)钘ュ拰鐕熼(y菐ng)钘� .........................................................................................30
6.1 姘村拰闆讳粙璩�(zh矛)瑾�(di脿o)绡€(ji茅)钘�..............................................................................................30
6.2 閳ｅ拰纾�..................................................................................................................31
6.3 寰噺鍏冪礌..............................................................................................................32
6.4 缍敓绱�..................................................................................................................34
7 鍖栧娌荤檪钘ョ墿钘ョ悊 .....................................................................................................37
7.1 鍚堟垚鎶楄弻钘�..........................................................................................................39
7.2 鎶楃敓绱�..................................................................................................................45
7.3 娑堟瘨闃茶厫钘�..........................................................................................................54
7.4 鎶楀瘎鐢熻煵钘�..........................................................................................................57
8 鐗规晥瑙ｆ瘨钘� .................................................................................................................66
8.1 鏈夋纾蜂腑姣掕В姣掑姂鈥斺€旇喗鍫块叝閰跺京(f霉)娲诲姂..........................................................67
8.2 閲戝爆鑸囬閲戝爆涓瘨鐨勮В姣掕棩鈥斺€旈噾灞怠(lu貌)鍚堝姂..................................................67
8.3 浜炵閰搁菇涓瘨瑙ｆ瘨钘モ€斺€旈珮閻佃绱呰泲鐧介倓鍘熷姂..............................................68
8.4 姘板寲鐗╀腑姣掕В姣掕棩..............................................................................................68
8.5 鏈夋姘熶腑姣掕В姣掕棩..............................................................................................69
绗� 2 閮ㄥ垎
鐛搁啱(y墨)鐥呯悊瀛�
1 姒傝堪 ...............................................................................................................................73
1.1 鐛搁啱(y墨)鐥呯悊瀛哥啊浠�.....................................................................................................73
1.2 鐤剧梾鐨勬蹇靛拰鐗归粸.................................................................................................73
1.3 鐥呭洜?q奴)W.....................................................................................................................74
1.4 鐧�(f膩)鐥呭.....................................................................................................................76
1.5 鐤剧梾鐨勭稉(j墨ng)閬庡拰杞�(zhu菐n)姝�.................................................................................................76
2 灞€閮ㄨ娑插惊鐠�(hu谩n)闅滅 .......................................................................................................77
2.1 鍏呰.........................................................................................................................77
2.2 鍑鸿.........................................................................................................................79
2.3 琛€鏍撳舰鎴�.................................................................................................................80
2.4 鏍撳.........................................................................................................................81
2.5 姊楁.........................................................................................................................82
3 鎳�(y墨ng)婵€鍙嶆噳(y墨ng) .......................................................................................................................83
3.1 姒傝堪.........................................................................................................................83
3.2 鎳�(y墨ng)婵€鐨勫熀鏈〃鐝�(xi脿n).....................................................................................................84
3.3 鎳�(y墨ng)婵€鍙嶆噳(y墨ng)鏅傜殑姗熻兘鍜屼唬璎濊畩鍖�.............................................................................85
3.4 鎳�(y墨ng)婵€鍙嶆噳(y墨ng)鍦ㄧ嵏閱�(y墨)瀛镐腑鐨勬剰缇�.................................................................................86
4 閰稿牽骞宠 绱婁簜 ...............................................................................................................86
4.1 姒傝堪.........................................................................................................................86
4.2 閰镐腑姣�.....................................................................................................................87
4.3 鍫夸腑姣�.....................................................................................................................89
III
4.4 娣峰悎鍨嬮吀鍫垮钩琛￠殰绀� ............................................................................................90
5 姘�銆侀浕瑙ｈ唱(zh矛)浠ｈ瑵闅滅 ..................................................................................................91
5.1 鑴按 ........................................................................................................................91
5.2 姘磋叓 ........................................................................................................................93
5.3 閴€浠ｈ瑵闅滅 ............................................................................................................95
6 缂烘哀...............................................................................................................................95
6.1 缂烘哀鐨勫師鍥犲拰椤炲瀷 ................................................................................................95
6.2 鍚勫瀷缂烘哀鐨勮姘ｈ畩鍖� ............................................................................................96
6.3 缂烘哀灏嶆楂旂殑褰遍熆 ................................................................................................97
7 绲勭箶鑸囩窗鑳炴悕鍌�...........................................................................................................98
7.1 璁婃€� ........................................................................................................................98
7.2 鐥呯悊鎬х墿璩�(zh矛)娌夎憲 ...................................................................................................99
7.3 澹炴 ......................................................................................................................102
8 閬╂噳(y墨ng)鑸囦慨寰�(f霉) ................................................................................................................104
8.1 绲勭箶鍜屽櫒瀹樼殑閬╂噳(y墨ng) .............................................................................................104
8.2 鍐嶇敓 ......................................................................................................................106
8.3 鑲夎娊绲勭箶鑸囧壍(chu脿ng)鍌锋剤鍚� ..........................................................................................106
9 鐐庣櫏 ............................................................................................................................107
9.1 姒傝堪 ......................................................................................................................107
9.2 灞€閮ㄧ殑鍩烘湰鐥呯悊璁婂寲 ..........................................................................................108
9.3 鍏ㄨ韩鍙嶆噳(y墨ng) ..............................................................................................................109
9.4 鐐庣櫏浠嬭唱(zh矛) .............................................................................................................. 110
9.5 鐐庣櫏鐨勯鍨嬭垏绲�(ji茅)灞€ ............................................................................................. 111
9.6 鏁楄鐧� .................................................................................................................. 112
10 鐧�(f膩)鐔� .......................................................................................................................... 112
10.1 姒傝堪 .................................................................................................................... 112
10.2 鐧�(f膩)鐔辩殑鍘熷洜鑸囨鐞� ............................................................................................ 112
10.3 鐧�(f膩)鐔辩殑鐧�(f膩)灞曢亷绋嬪強鐗归粸 .................................................................................... 114
10.4 鐧�(f膩)鐔辨楂旂殑涓昏鍔熻兘鑸囦唬璎濊畩鍖� .................................................................... 116
11 褰屾暎鎬ц绠″収(n猫i)鍑濊 .................................................................................................. 117
11.1 姒傝堪..................................................................................................................... 117
11.2 DIC 鍒嗘湡鍜屽悗鏋�................................................................................................. 118
12 浼戝厠 .......................................................................................................................... 118
12.1 鍒嗛 .................................................................................................................... 119
12.2 鍒嗘湡鍙婂井寰挵(hu谩n)鐨勬敼璁� ........................................................................................ 119
13 鑵槫...........................................................................................................................121
13.1 姒傚康 ....................................................................................................................121
13.2 褰㈡厠(t脿i)绲�(ji茅)妲�(g貌u)鑸囦唬璎濈壒寰� ........................................................................................121
13.3 鑵槫绲勭箶鐨勪唬璎濈壒榛� ........................................................................................122
13.4 鑵槫鐨勭敓闀疯垏鎿存暎 ............................................................................................122
13.5 鑵槫鐨勫懡鍚嶈垏鍒嗛 ............................................................................................122
13.6 鍕曠墿甯歌鑵槫 ....................................................................................................123
14 绯荤当(t菕ng)鐥呯悊瀛�.............................................................................................................128
IV
14.1 琛€娑茶垏閫犺绯荤当(t菕ng)鐥呯悊.........................................................................................128
14.2 蹇冭嚐琛€绠＄郴绲�(t菕ng)鐥呯悊.............................................................................................131
14.3 鍛煎惛绯荤当(t菕ng)鐥呯悊.....................................................................................................132
14.4 娑堝寲绯荤当(t菕ng)鐥呯悊.....................................................................................................134
14.5 娉屽翱绯荤当(t菕ng)鐥呯悊.....................................................................................................135
14.6 绁炵稉(j墨ng)绯荤当(t菕ng)鐥呯悊.....................................................................................................136
15 灏搁珨鍓栨鎶€琛�(sh霉) .........................................................................................................139
15.1 灏搁珨鍓栨姒傝堪.....................................................................................................139
15.2 灏搁珨鍓栨鎶€琛�(sh霉).....................................................................................................140
绗笁閮ㄥ垎
鐛搁啱(y墨)鑷ㄥ簥瑷烘柗瀛�
1 绶掕█ ...........................................................................................................................145
1锛�1 鐛搁啱(y墨)鑷ㄥ簥瑷烘柗瀛告璜�.....................................................................................145
1锛�2 鐛搁啱(y墨)鑷ㄥ簥瑷烘柗瀛哥殑涓昏鍏�(n猫i)瀹�.........................................................................146
2 鑷ㄥ簥妾㈡煡鐨勫熀鏈柟娉曡垏绋嬪簭 ...................................................................................148
2锛�1 鑷ㄥ簥妾㈡煡鐨勫熀鏈柟娉�.....................................................................................148
2锛�2 鑷ㄥ簥妾㈡煡鐨勭▼搴忓拰鏂规.................................................................................154
3 鏁撮珨鍙婁竴鑸鏌� .......................................................................................................156
3锛�1 鏁撮珨鐙€鎱�(t脿i)鐨勮瀵�.............................................................................................156
3锛�2 琛ㄨ鐙€鎱�(t脿i)鐨勬鏌�.............................................................................................159
3锛�3 鐪肩祼(ji茅)鍚堣啘鐨勬鏌�.............................................................................................161
3锛�4 娣哄湪娣嬪反绲�(ji茅)鍙婃穻宸寸鐨勬鏌�.........................................................................163
3锛�5 楂旀韩銆佽剤鎼忓強鍛煎惛鏁�(sh霉)鐨勬脯瀹�.........................................................................164
4 鍛煎惛绯荤当(t菕ng)鐨勮嚚搴婃鏌� ...............................................................................................167
4锛�1 鍛煎惛閬嬪嫊鐨勬鏌�.............................................................................................168
4锛�2 涓婂懠鍚搁亾鐨勬鏌�.............................................................................................171
4锛�3 鑳稿粨鐨勮瑷鸿垏瑙歌ê.........................................................................................175
4锛�4 鑳�銆佽偤鐨勫彥瑷�.................................................................................................175
4锛�5 鑳搞€佽偤鐨勮伣瑷�.................................................................................................177
5 蹇冭绠＄郴绲�(t菕ng)鐨勮嚚搴婃鏌� ...........................................................................................181
5锛�1 蹇冭嚐鐨勮嚚搴婃鏌�.............................................................................................181
5锛�2 鑴堢鐨勬鏌�.....................................................................................................188
6 娑堝寲绯荤当(t菕ng)鐨勮嚚搴婃鏌� ...............................................................................................189
6锛�1 椋查鐙€鎱�(t脿i)鐨勮瀵�.............................................................................................189
6锛�2 鍙�銆佸捊鑸囬绠″強鍡夊泭鐨勬鏌�.........................................................................192
6锛�3 鑵归儴鍙婅儍鑵哥殑妾㈡煡.........................................................................................194
7 娉屽翱绯荤当(t菕ng)鐨勬鏌� .......................................................................................................197
7 . 1 鎺掑翱鍕曚綔妾㈡煡..................................................................................................198
7锛�2 灏挎恫鐨勬劅瀹樻鏌�.............................................................................................199
8 绁炵稉(j墨ng)绯荤当(t菕ng)妾㈡煡 ...........................................................................................................200
8锛�1 闋”鍜岃剨鏌辩殑妾㈡煡.........................................................................................201
V
8锛�2 鎰熻姗熻兘妾㈡煡 ................................................................................................202
8锛�3 鍙嶅皠姗熻兘鐨勬鏌� ............................................................................................204
9 寤虹珛瑷烘柗...................................................................................................................206
9锛�1 鐧ョ媭銆佽ê鏂峰強闋�(y霉)鍚庣殑姒傚康鍜屽垎椤� ................................................................206
9锛�2 寤虹珛瑷烘柗鐨勬椹� ............................................................................................208
绗� 1 閮ㄥ垎
鐛搁啱(y墨)钘ョ悊瀛�
1
1 绺借珫
1.1 绶掕█
1.1.1 钘ョ墿鑸囨瘨鐗�
钘ョ墿鏄寚鐢ㄤ簬娌荤檪銆侀爯(y霉)闃叉垨瑷烘柗鐤剧梾鐨勫悇绋寲瀛哥墿璩�(zh矛)銆傛噳(y墨ng)鐢ㄤ簬鍕曠墿鐨勭当(t菕ng)绋辩偤鐛歌棩锛屽寘鎷噳(y墨ng)鐢ㄤ簬
鐣滅銆侀瓪銆佽渹銆佽牰鐨勮棩鐗�锛岃兘淇冮€插嫊鐗╃敓鐢�(ch菐n)銆佹彁楂樼敓鐢�(ch菐n)鎬ц兘鐨勫悇绋墿璩�(zh矛)銆�
姣掔墿鏄寚鑳藉皪鍕曠墿楂旂敘(ch菐n)鐢熸悕瀹充綔鐢ㄧ殑鍖栧鐗╄唱(zh矛)锛岃棩鐗╄秴閬庝竴瀹氬姂閲忔垨鐢ㄦ硶涓嶇暥锛屽皪鍕曠墿涔熻兘鐢�(ch菐n)
鐢熸瘨瀹充綔鐢�锛屾墍浠ュ湪钘ョ墿鑸囨瘨鐗╀箣闁撳苟娌掓湁绲曞皪鐨勭晫闄�銆�
1.1.2 鍒跺姂鑸囧姂鍨�
钘ョ墿鍘熸枡渚嗚嚜妞嶇墿銆佸嫊鐗�銆佺う鐗�銆佸寲瀛稿悎鎴愬拰鐢熺墿鍚堟垚绛夛紝鐐轰簡浣跨敤鐨勫畨鍏�銆佹湁鏁堝拰渚夸簬淇濆瓨銆�
閬嬭几锛屽師鏂欒棩鍦ㄤ娇鐢ㄥ墠瑕佸姞宸ュ埗鎴愪竴瀹氬寘瑁濇垨瑕�(gu墨)鏍肩殑钘ュ搧锛岀ū鐐哄埗鍔�锛涚稉(j墨ng)鍔犲伐鍚庣殑鍒跺姂鏈夊悇绋舰寮�锛�
鍗崇ū鐐哄姂鍨�锛岃嚚搴婂父鐢ㄧ殑鍔戝瀷涓€鑸垎鐐� 3 椤烇細鈶犳恫楂斿姂鍨�锛屽婧舵恫鍔戙€侀厞鍔�銆佹敞灏勫姂绛夛紱鈶″崐鍥洪珨
鍔戝瀷锛屽杌熻啅鍔戙€佹蹈鑶忓姂绛�锛涒憿鍥洪珨鍔戝瀷锛屽绮夊姂銆佺墖鍔戠瓑銆�
1.1.3 鐛搁啱(y墨)钘ョ悊瀛哥殑鎬ц唱(zh矛)鍜屼换鍕�(w霉)
鐛搁啱(y墨)钘ョ悊瀛告槸鐮旂┒钘ョ墿鑸囧嫊鐗╂楂�(鍖呮嫭鐥呭師楂�)闁撶浉浜掍綔鐢ㄨ(gu墨)寰嬬殑涓€闁€绉戝銆備竴鏂归潰锛岀爺绌惰棩
鐗╁皪姗熼珨浣滅敤鐨勮(gu墨)寰� 锛岄棥鏄庤棩鐗╅槻娌� 鐤剧梾鐨勫師鐞�锛� 绋辩偤钘ョ墿鏁堟噳(y墨ng)鍕� 鍔涘锛岀啊绋辫棩 鏁堝
(pharmacodynamics)銆傚彟涓€鏂归潰锛岀爺绌舵楂斿皪钘ョ墿铏曠疆鐨勫嫊鎱�(t脿i)璁婂寲锛屽寘鎷湪楂斿収(n猫i)鐨勫惛鏀�銆佸垎甯�銆佺敓
鐗╄綁(zhu菐n)鍖栧強鎺掓硠閬庣▼涓棩鐗╂績搴﹂毃鏅傞枔璁婂寲鐨勮(gu墨)寰�锛岀ū鐐鸿棩鐗╀唬璎濆嫊鍔涘锛岀啊绋辫棩鐗╁嫊鍔涘
(pharmacookinetics)銆傚缈掔嵏閱�(y墨)钘ョ悊瀛哥殑涓昏鐩殑鏄鏈冩纰洪伕钘�銆佸悎鐞嗙敤钘�銆佹彁楂樿棩鏁堛€佹笡灏戜笉
鑹弽鎳�(y墨ng)銆�
1.2 钘ョ墿灏嶆楂旂殑浣滅敤鈥斺€旇棩鏁堝
1.2.1 钘ョ墿鐨勫熀鏈綔鐢�
钘ョ墿浣滅敤鏄寚钘ョ墿鑸囨楂旂祫绻旂窗鑳為枔鐨勪綔鐢�銆傚湪钘ョ墿鐨勪綔鐢ㄤ笅锛屾楂旂殑鐢熺悊鐢熷寲姗熻兘鏈冪櫦(f膩)鐢熷悇
绋畩鍖栵紝鍑¤兘浣挎楂旂敓鐞嗗拰鐢熷寲鍙嶆噳(y墨ng)鍔犲挤鐨勭ū鐐鸿垐濂�锛屼富瑕佸紩璧疯垐濂殑钘ョ墿绋辩偤鑸堝ギ钘�锛涜€屼娇姗熻兘
娲诲嫊娓涘急鐨勭ū鐐烘姂鍒�锛屼富瑕佸紩璧锋姂鍒剁殑钘ョ墿绋辩偤鎶戝埗钘�銆�
1.2.2 钘ョ墿鐨勪綔鐢ㄦ柟寮�
钘ョ墿鏈夌殑鍦ㄧ敤钘ュ眬閮ㄧ櫦(f膩)鎻綔鐢�锛岀ū鐐哄眬閮ㄤ綔鐢�锛屽鏉剧瘈(ji茅)娌规秱鎼界毊鑶�锛屽眬閮ㄩ夯閱夎棩娉ㄥ叆绁炵稉(j墨ng)鏈ⅱ
鐢�(ch菐n)鐢熺殑灞€閮ㄩ夯閱変綔鐢ㄣ€傛湁鐨勫惛鏀堕€插叆琛€娑插惊鐠�(hu谩n)锛屽垎甯冨叏韬€岀櫦(f膩)鎻綔鐢�锛岀ū鐐哄惛鏀朵綔鐢ㄦ垨鍏ㄨ韩浣滅敤锛�
濡傚惛楹婚唹钘ユ垨鍏ㄨ韩楹婚唹钘�銆傝棩鐗╁惛鏀跺悗鐩存帴鍒伴仈鏌愪竴鍣ㄥ畼鐢�(ch菐n)鐢熺殑浣滅敤锛岀ū鐐虹洿鎺ヤ綔鐢ㄦ垨鍘熺櫦(f膩)浣滅敤锛�
2
濡傚挤蹇冭嫹娲嬪湴榛冭鍚告敹鍚�锛屽皪蹇冭嚐鐢�(ch菐n)鐢熺洿鎺ヤ綔鐢�锛屽姞寮峰績鑲屾敹绺姏锛涜€屽挤蹇冧綔鐢ㄧ殑绲�(ji茅)鏋�锛岄枔鎺ュ鍔�
鑵庣殑琛€娴侀噺锛岃〃鐝�(xi脿n)鍒╁翱浣滅敤锛屼娇蹇冭嚐鎬ф按鑵緱浠ユ笡杓曟垨娑堥櫎锛岄€欑ó浣滅敤绋辩偤闁撴帴浣滅敤锛屽張绋辩偤绻肩櫦(f膩)
浣滅敤銆�
1.2.3 钘ョ墿浣滅敤鐨勯伕鎿囨€�
钘ョ墿浣滅敤鐨勯伕鎿囨€ф槸鎸囨楂斿悇绲勭箶鍜屽櫒瀹樺皪钘ョ墿鐨勬晱鎰熸€т笉鍚�锛岃€岃〃鐝�(xi脿n)寮峰急鏈夋槑椤笉鍚岀殑钘ョ墿
鏁堟噳(y墨ng)銆傚娌荤檪閲忕殑娲嬪湴榛冨皪蹇冭嚐鏈夐珮搴︾殑閬告搰鎬э紝浣垮績鑷熸敹绺姞寮�锛岃€屽皪鍏朵粬鍣ㄥ畼鍩烘湰娌掓湁浣滅敤銆�
钘ョ墿浣滅敤鐨勯伕鎿囨€ф槸娌荤檪浣滅敤鐨勫熀绀�(ch菙)锛岄伕鎿囨€ч珮锛岄嚌灏嶆€у挤锛岃兘鐢�(ch菐n)鐢熷緢濂界殑娌荤檪鏁堟灉锛屽緢灏戞垨娌掓湁
涓嶈壇鍙嶆噳(y墨ng)锛涘弽涔嬶紝閬告搰鎬т綆锛岄嚌灏嶆€т笉寮�锛屽壇浣滅敤杓冨銆�
1.2.4 钘ョ墿鐨勬不鐧備綔鐢ㄨ垏涓嶈壇鍙嶆噳(y墨ng)
钘ョ墿灏嶅嫊鐗╃柧鐥呯敘(ch菐n)鐢熷ソ鐨勬不鐧傛晥鏋滅殑浣滅敤绋辩偤娌荤檪浣滅敤锛屼篃鏈冪敘(ch菐n)鐢熻垏娌荤檪鐒￠棞(gu膩n)鐨勪綔鐢�锛岀敋鑷冲皪
姗熼珨涓嶅埄鐨勪綔鐢�锛岀ū鐐轰笉鑹弽鎳�(y墨ng)銆傝嚚搴婄敤钘ユ檪锛屾噳(y墨ng)鎯虫硶鏈€澶ч檺搴︾櫦(f膩)鎻棩鐗╃殑娌荤檪浣滅敤锛岃€岀洝閲忔笡灏�
钘ョ墿鐨勪笉鑹弽鎳�(y墨ng)銆�
娌荤檪浣滅敤鍙堝彲鍒嗙偤灏嶅洜娌荤檪鍜屽皪鐧ユ不鐧�銆傚墠鑰呴嚌灏嶇梾鍥狅紝濡傚寲鐧傝棩娈烘粎鐥呭師寰敓鐗╀互鎺у埗鎰熸煋銆�
鍚庤€呴嚌灏嶇櫏鐙€鏀瑰杽锛屽瑙ｇ啽钘ュ彲闄嶄綆鐧�(f膩)鐔卞嫊鐗╃殑楂旀韩锛屼絾涓嶈兘瑙ｉ櫎鐧�(f膩)鐔辩殑鍘熷洜銆�
涓嶈壇鍙嶆噳(y墨ng)涓€鑸垎鐐哄壇浣滅敤鍜屾瘨鎬у弽鎳�(y墨ng)銆傝棩鐗╁壇浣滅敤鏄寚鐢ㄦ不鐧傞噺鏅�锛岃棩鐗╁嚭鐝�(xi脿n)鑸囨不鐧傜劇闂�(gu膩n)鐨勪笉
閬╁弽鎳�(y墨ng)銆傛瘨鎬у弽鎳�(y墨ng)鏄敤閲忛亷澶ф垨鐢ㄨ棩鏅傞枔閬庨暦鑰屽紩璧�锛屾瘨鎬у弽鎳�(y墨ng)姣斿壇浣滅敤灏嶆楂斿嵄瀹虫€уぇ銆備笉鑹弽
鎳�(y墨ng)閭勫彲鍥犳煇浜涜棩鐗╃殑娌荤檪浣滅敤鑰屽紩璧�锛屼篃绋辩辜鐧�(f膩)鎬у弽鎳�(y墨ng)銆傚鎴愬勾鑽夐鍕曠墿鑳冭吀閬撴湁瑷卞寰敓鐗╁瘎鐢�锛�
鑿岀兢涔嬮枔缍寔骞宠 鐨勫叡鐢熺媭鎱�(t脿i)锛岄暦鏈熸噳(y墨ng)鐢ㄥ洓鐠�(hu谩n)绱犻寤ｈ瓬鎶楃敓绱犳檪锛屽皪钘ョ墿鏁忔劅鐨勮弻鏍彈鍒版姂鍒�锛岃弻
缇ら枔鐩稿皪骞宠 鐙€鎱�(t脿i)鍙楀埌鐮村锛岃€屼笉鏁忔劅鐨勫井鐢熺墿濡傜湡鑿�銆佸ぇ鑵告】鑿�銆佹矙闁€姘忚弻绛夊ぇ閲忕箒娈�锛岄€犳垚涓�
姣掓€ц儍鑵哥値鍜屽叏韬劅鏌�銆傞€欑ó绻肩櫦(f膩)鎬ф劅鏌撶ū鐐轰簩閲嶆劅鏌�銆傝ū澶氳棩鐗╃殑涓嶈壇鍙嶆噳(y墨ng)鏄彲浠ラ爯(y霉)鐭ョ殑锛屽湪鐢�
钘ユ檪鎳�(y墨ng)鍋氬ソ闋�(y霉)闃插伐浣溿€�
涓嶈壇鍙嶆噳(y墨ng)鏈夋檪閭勮〃鐝�(xi脿n)鐐洪亷鏁忓弽鎳�(y墨ng)(璁婃厠(t脿i)鍙嶆噳(y墨ng))鎴栫壒鐣拌唱(zh矛)鍙嶆噳(y墨ng)銆傞€欐槸涓€绋垏钘ョ墿鍔戦噺鐒￠棞(gu膩n)鐨勫弽鎳�(y墨ng)銆�
1.2.5 钘ョ墿鐨勪綔鐢ㄦ鍒�
钘ョ墿浣滅敤姗熷埗鏄棩鏁堝鐨勪富瑕佸収(n猫i)瀹�锛岀洰鐨勫湪闂℃槑钘ョ墿鍦ㄥ嫊鐗╅珨鎴栫梾鍘熼珨鍏�(n猫i)浣滅敤鐨勯儴浣嶅強鐢�(ch菐n)鐢熻棩
鐗╂晥鎳�(y墨ng)鐨勭敓鐞嗙敓鍖栧師鐞�銆�
钘ョ墿鏍规摎(j霉)浣滅敤姗熷埗涓嶅悓锛屽垎鐐洪潪鐗圭暟鎬ц棩鐗╁強鐗圭暟鎬ц棩鐗�銆傞潪鐗圭暟鎬ц棩鐗╃殑浣滅敤姗熷埗鏄垏钘ョ墿
鐨勭悊鍖栨€ц唱(zh矛)锛屽瑙ｉ洟搴�銆佹憾瑙ｅ害銆佽〃闈㈠嫉鍔涚瓑鏈夐棞(gu膩n)銆備緥濡傝ū澶氬叏韬夯閱夎棩鐨勮剛婧舵€у緢楂�锛屽皪绁炵稉(j墨ng)绱�
鑳炶啘鏈夐珮搴﹁Κ鍜屽姏锛屾姂鍒惰啘鍔熻兘寰炶€岀敘(ch菐n)鐢熸姂鍒朵腑妯炰綔鐢�锛涢噾灞В姣掑姂浜屽钒鍩轰笝閱囩殑瑙ｆ瘨浣滅敤鏄垏姹�銆�
鐮风瓑绲�(lu貌)鍚堟垚鐠�(hu谩n)鐙€绲�(lu貌)鍚堢墿锛岃В闄ゅ悗鑰呮瘨鎬�銆�
鐗圭暟鎬ц棩鐗╃殑浣滅敤姗熷埗鍓囪垏鍏跺寲瀛哥祼(ji茅)妲�(g貌u)鏈夊瘑鍒囬棞(gu膩n)绯�銆傚洜姝�锛屽叿鏈夌浉鍚岀殑鏈夋晥鍩哄湗鐨勮棩鐗�锛屼竴鑸�
鍏锋湁椤炰技鐨勮棩鐞嗕綔鐢ㄣ€傚畠鍊戠殑浣滅敤姗熷埗锛氭湁灏嶉叾娲绘€у奖闊胯€岀敘(ch菐n)鐢熶綔鐢�锛屽瑙ｇ７瀹氳兘浣块珨鍏�(n猫i)鑶藉牽閰叾
寰�(f霉)娲昏€岃В闄ゆ湁姗熺７閰搁叝姣掓€�锛涙湁褰遍熆楂斿収(n猫i)娲绘€х墿璩�(zh矛)鑰岀敘(ch菐n)鐢熶綔鐢�锛屽鎶楃値閹�(zh猫n)鐥涜棩鑳芥姂鍒堕珨鍏�(n猫i)鍓嶅垪鑵虹礌
鐨勭敓鐗╁悎鎴�锛涙湁褰遍熆閬炶唱(zh矛)鐨勯噵鏀�锛屽楹婚粌鍫夸綔鐢ㄤ簬鑵庝笂鑵虹礌鑳界缍�(j墨ng)鏈ⅱ锛屼績閫插幓鐢茶厧涓婅吅绱犻噵鏀�锛�
鏈夊奖闊块洟瀛愰€氶亾鑰岀敘(ch菐n)鐢熶綔鐢�锛屽閳ｉ洟瀛愰€氶亾闃绘柗鍔�銆�
鐗圭暟鎬ц棩鐗╁ぇ澶氭暩(sh霉)閮界稉(j墨ng)閬庡彈楂旀鍒惰€岀敘(ch菐n)鐢熺壒瀹氱殑鐢熺悊鐢熷寲鍔熻兘鐨勮畩鍖栵紝寰炶€岀櫦(f膩)鎻棩鐗╃殑浣滅敤锛�
3
绋辩偤鍙楅珨瀛歌銆傚彈楂�(receptor)鏄寚鑳借垏钘ョ墿绲�(ji茅)鍚堢敘(ch菐n)鐢熸晥鎳�(y墨ng)鐨勭窗鑳炴垚鍒嗭紝瀹冩槸浣嶄簬绱拌優鑶滀笂鎴栬優婕垮収(n猫i)
鐨勫ぇ鍒嗗瓙铔嬬櫧璩�(zh矛)銆傜洰鍓嶅凡鐭ョ殑鍙楅珨鑷冲皯鏈� 30 绋互涓�銆傚彲鍒嗙偤鍏╅锛氫竴椤炴槸绱拌優鑶滃彈楂斿涔欓叞鑶藉牽
鍙楅珨锛涘彟涓€椤炴槸鑳炴伎鍙楅珨濡傝厧涓婅吅鐨唱(zh矛)婵€绱犲彈楂斻€�
灏嶅彈楂斿叿鏈夎瓨鍒ヨ兘鍔涘苟鑳借垏涔嬬祼(ji茅)鍚堢殑鐗╄唱(zh矛)绋辩偤閰嶉珨銆傚寘鎷悇绋棩鐗╁拰鍏�(n猫i)婧愭€х殑绁炵稉(j墨ng)閬炶唱(zh矛)銆佹縺绱�
鎴栫敓鐗╂椿鎬х墿璩�(zh矛)绛�銆�
钘ョ墿鑸囧彈楂旂祼(ji茅)鍚堢殑鏂瑰紡涓€鑸€氶亷闆㈠瓙閸点€佹矮閸靛拰鑼冨痉鑿嵉锛屾墍浠ユ槸鍙€嗙殑锛屽皯鏁�(sh霉)閫氶亷鍏卞児閸电祼(ji茅)
鍚堬紝鏄笉鍙€嗙殑銆傝棩鐗╄垏鍙楅珨绲�(ji茅)鍚堝繀闋堝叿鏈夎Κ鍜屽姏锛屼絾閭勯渶瑕佹湁鍏�(n猫i)鍦ㄦ椿鎬э紝鎵嶈兘鐢�(ch菐n)鐢熻棩鐞嗘晥鎳�(y墨ng)锛涙晠
鎶婅垏鍙楅珨绲�(ji茅)鍚堝悗鑳界敘(ch菐n)鐢熻棩鐞嗘晥鎳�(y墨ng)鐨勮棩鐗╃ū鐐烘縺鍕曞姂(agonist)锛屼緥濡傛瘺鏋滆晸棣欏牽鏄� M-鍙楅珨鐨勬縺鍕曞姂锛�
鎶婅兘鑸囧彈楂旂祼(ji茅)鍚堜絾涓嶇敘(ch菐n)鐢熻棩鐞嗘晥鎳�(y墨ng)鐨勮棩鐗╁墖绋辩偤鎷姉鍔�(antagonist)锛屼緥濡傞樋鎵樺搧鏄� M-鍙楅珨鎷姉鍔�銆�
1.2.6 钘ョ墿鐨勬(g貌u)鏁堥棞(gu膩n)绯�
钘ョ墿鐨勬(g貌u)鏁堥棞(gu膩n)绯绘寚鐗圭暟鎬ц棩鐗╃殑鍖栧绲�(ji茅)妲�(g貌u)鑸囪棩鐗╂晥鎳�(y墨ng)鏈夊瘑鍒囬棞(gu膩n)绯�銆傜祼(ji茅)妲�(g貌u)椤炰技鐨勫寲鍚堢墿鑳借垏鍚屼竴
鍙楅珨绲�(ji茅)鍚堢敘(ch菐n)鐢熸縺鍕曚綔鐢�銆傚姘ㄧ敳閰拌喗鍫跨殑绲�(ji茅)妲�(g貌u)鑸囬珨鍏�(n猫i)绁炵稉(j墨ng)閬炶唱(zh矛)涔欓叞鑶藉牽鐩镐技锛屽洜姝ゅ畠灏辨湁鎿技涔欓叞
鑶藉牽鐨勪綔鐢�锛岀ū鐐烘摤鑶藉牽钘�銆�
1.2.7 钘ョ墿鐨勯噺鏁堥棞(gu膩n)绯�
閲忔晥闂�(gu膩n)绯绘寚涓€瀹氳寖鍦嶅収(n猫i)锛岃棩鐗╃殑鏁堟噳(y墨ng)闅ㄨ憲鍔戦噺鐨勫鍔犺€屽寮�锛屽畠鍙畾閲忓湴鍒嗘瀽鍜岄棥鏄庤棩鐗╁姂閲�
鑸囨晥鎳�(y墨ng)涔嬮枔鐨勮(gu墨)寰�銆�
钘ョ墿鍔戦噺鐨勫ぇ灏忛棞(gu膩n)绯诲埌閫插叆楂斿収(n猫i)浣滅敤闈堕儴浣嶇殑婵冨害楂樹綆鍜岃棩鏁堢殑寮峰急銆傝棩鐗╁姂閲忛亷灏�锛屼笉鐢�(ch菐n)鐢�
浠讳綍鏁堟噳(y墨ng)锛岀ū鐒℃晥閲�銆傝兘寮曡捣钘ョ墿鏁堟噳(y墨ng)鐨勬渶灏忓姂閲�锛岀ū鏈€灏忔湁鏁堥噺銆傞毃钁楀姂閲忓鍔狅紝鏁堟噳(y墨ng)寮峰害鐩告噳(y墨ng)
澧炲ぇ锛岄仈鍒版渶澶ф晥鎳�(y墨ng)锛岀ū鐐烘サ閲�銆傝嫢鍐嶅鍔犲姂閲�锛屾渻鍑虹従(xi脿n)姣掓€у弽鎳�(y墨ng)锛屽嚭鐝�(xi脿n)涓瘨鐨勬渶浣庡姂閲忕ū鐐烘渶灏�
涓瘨閲�锛屼腑姣掑毚閲嶅紩璧锋浜＄殑鍔戦噺锛岀ū鐐鸿嚧姝婚噺銆傝棩鐗╃殑鏈€灏忔湁鏁堥噺鍒颁腑姣掗噺涔嬮枔鐨勮寖鍦嶇ū瀹夊叏鑼�
鍦�锛涜棩鐗╃殑甯哥敤閲忔垨娌荤檪閲忔噳(y墨ng)姣旀渶灏忔湁鏁堥噺澶т簺锛屾瘮妤甸噺灏忎簺?锛佸惃琚婎埦F钘ュ吀銆嬫垨銆婄嵏閱�(y墨)钘ュ搧浣跨敤
瑕�(gu墨)鑼冦€嬪皪钘ョ墿鐨勫父鐢ㄩ噺銆佸妵姣掕棩鐨勬サ閲忛兘鏈夎(gu墨)瀹�銆傝嚚搴婄敤钘ヤ竴瀹氳鎸夎(gu墨)瀹氬姂閲忕敤钘�锛屼笉鑳介毃鎰忓鍔�
鐢ㄨ棩鍔戦噺銆�
1.3 姗熼珨灏嶈棩鐗╃殑浣滅敤鈥斺€旇棩鍕曞
1.3.1 钘ョ墿鐨勯珨鍏�(n猫i)閬庣▼
钘ョ墿閫插叆鍕曠墿楂斿収(n猫i)瑕佺稉(j墨ng)閬庡惛鏀�(鐢辩郸钘ラ儴浣嶉€插叆琛€娑插惊鐠�(hu谩n))銆佸垎甯�(鐢辫娑查€插叆鍏ㄨ韩鍚勭ó绲勭箶)銆�
杞�(zhu菐n)鍖�(鎸囪棩鐗╁湪楂斿収(n猫i)鐨勫寲瀛哥祼(ji茅)妲�(g貌u)鏀硅畩)鍜屾帓娉�(鎸囪棩鐗╁師褰㈡垨浠ｈ瑵鐢�(ch菐n)鐗╁緸楂斿収(n猫i)鎺掑嚭)鐨勯亷绋�锛岀ū鐐鸿棩鐗�
鐨勯珨鍏�(n猫i)閬庣▼锛屼篃灏辨槸钘ョ墿鐨勫嫊鍔涘閬庣▼銆備笉鍚岃棩鐗╂湁涓嶅悓鐨勫嫊鍔涘閬庣▼锛屽悓涓€钘ョ墿鍦ㄤ笉鍚屽嫊鐗╃殑鍕�
鍔涘涔熻〃鐝�(xi脿n)涓嶅悓锛屾晠鐢ㄨ棩鏅傝鐔熸倝姣忎竴绋棩鐗╃殑鍕曞姏瀛哥壒寰�锛屾墠鑳藉仛鍒板悎鐞嗙敤钘�銆�
1.3.2 钘ョ墿鍦ㄩ珨鍏�(n猫i)鐨勮綁(zhu菐n)閬�
钘ョ墿閫插叆楂斿収(n猫i)瑕佸埌閬斾綔鐢ㄩ儴浣嶆墠鑳界敘(ch菐n)鐢熸晥鎳�(y墨ng)锛屽湪閬斿埌浣滅敤閮ㄤ綅鍓嶈棩鐗╁繀闋堥€氶亷鐢熺墿鑶�锛岀ū鐐鸿法
鑶滆綁(zhu菐n)閬�銆傜敓鐗╄啘鏄窗鑳炲琛ㄧ殑鑳炴伎鑶滃拰绱拌優鍏�(n猫i)鍚勭ó绱拌優鍣ㄨ啘锛屽寘鎷牳鑶�銆佺窔绮掗珨鑶�銆佸収(n猫i)璩�(zh矛)缍�(w菐ng)鑶滃拰婧�
4
閰堕珨鑶滅殑绺界ū銆傝啘鐨勭祼(ji茅)妲�(g貌u)鏄互娑叉厠(t脿i)鐨勮剛璩�(zh矛)闆欏垎瀛愬堡鐐哄熀鏋讹紝鍏朵腑閼插祵钁椾竴浜涜泲鐧借唱(zh矛)璨┛鏁村€嬭剛鑶�锛�
绲勬垚鐢熺墿鑶滅殑鍙楅珨銆侀叾銆佽級楂斿拰闆㈠瓙閫氶亾绛夈€傝啘涓婇倓鏈夎搏绌胯啘鍏�(n猫i)澶栫殑瀛旈亾绋辩偤鑶滃瓟銆�
钘ョ墿鐨勮綁(zhu菐n)閬嬫柟寮忎富瑕佹湁锛氣憼绨″柈鎿存暎锛屽張绋辫鍕曟摯鏁�锛屾槸鐢辫棩鐗╂績搴﹂珮鐨勪竴鍋�(c猫)鎿存暎鍒版績搴︿綆鐨�
涓€鍋�(c猫)銆傚叾杞�(zhu菐n)閬嬮€熷害鏄垏鑶滃叐鍋�(c猫)钘ョ墿鐨勬績搴﹀樊(婵冨害姊害)鐨勫ぇ灏忔垚姝ｆ瘮銆傜暥鑶滃叐鍋�(c猫)鐨勮棩鐗╂績搴﹂仈鍒板钩
琛℃檪锛岃綁(zhu菐n)閬嬩究鍋滄銆傞€欑ó杞�(zhu菐n)閬嬩笉闇€娑堣€楄兘閲�锛屼緷闈犳績搴︽搴︾殑杞�(zhu菐n)閬嬫柟寮�銆傗憽涓诲嫊杞�(zhu菐n)閬�銆傞€欐槸鐢辫啘鐨�
涓€鍋�(c猫)杞�(zhu菐n)閬嬪埌鍙︿竴鍋�(c猫)锛屼笉鍙楁績搴﹀樊鐨勫奖闊�锛屼篃鍙敱钘ョ墿婵冨害浣庣殑涓€鍋�(c猫)杞�(zhu菐n)閬嬪埌杓冮珮涓€鍋�(c猫)銆傞€欑ó杞�(zhu菐n)閬嬫柟寮�
闇€瑕佹秷鑰楄兘閲忓強鑶滀笂鐨勭壒鐣版€ц級楂旇泲鐧斤紝濡� Na
锛嬧杹
K
锛嬧杹
ATP 閰跺弮鑸�銆傞€欑ó杞�(zhu菐n)閬嬭兘鍔涙湁涓€瀹氶檺搴︼紝鍗�
杓夐珨铔嬬櫧鏈夐＝鍜屾€�锛屽悓鏅�锛屽悓涓€杓夐珨杞�(zhu菐n)閬嬬殑鍏╃ó钘ョ墿涔嬮枔鍙嚭鐝�(xi脿n)绔剁埈鎬�銆傗憿鏄撳寲鎿存暎锛屼篃鏄湁杓夐珨
浠嬪皫(d菐o)鐨勮綁(zhu菐n)閬�锛屼絾瀹冩槸闋嗘績搴︽搴﹁綁(zhu菐n)閬�锛屼笉闇€娑堣€楄兘閲�锛岄€欐槸鑸囦富鍕曡綁(zhu菐n)閬嬬殑鍗€(q奴)鍒�銆傗懀鑳為２浣滅敤锛屾槸鐢�
鐗╄啘鍏�(n猫i)闄峰皣澶у垎瀛愯棩鐗╂垨铔嬬櫧璩�(zh矛)鍚為２閫插叆绱拌優鍏�(n猫i)銆傝優鍚愪綔鐢ㄦ槸灏囧ぇ鍒嗗瓙钘ョ墿寰炵窗鑳炲収(n猫i)杞�(zhu菐n)閬嬪埌绱拌優澶栵紝
濡傝吅楂旂窗鑳炲垎娉�銆�
1.3.3 钘ョ墿鐨勭敓鐗╄綁(zhu菐n)鍖�
钘ョ墿鍦ㄩ珨鍏�(n猫i)鐧�(f膩)鐢熺殑绲�(ji茅)妲�(g貌u)璁婂寲绋辩偤鐢熺墿杞�(zhu菐n)鍖栵紝鍙堢ū鐐鸿棩鐗╀唬璎�銆傝棩鐗╀唬璎濈殑绲�(ji茅)鏋滄槸浣胯棩鐞嗘椿鎬ф敼
璁�锛岀敱鍏锋椿鎬ц棩鐗╄綁(zhu菐n)鍖栫偤鐒℃椿鎬х殑浠ｈ瑵鐗�锛岀ū鐐烘粎娲�锛涜€岀敱鐒℃椿鎬ц棩鐗╄畩?y艒u)姒涢挌杩愬宫?锛屾垨娲绘€ц純浣�
璁�?y艒u)姒涢挌鏆俕寮疯棩鐗╃ū鐐烘椿鍖�銆傝棩鐗╀唬璎濇槸绲傛钘ョ墿浣滅敤锛屼績浣胯棩鐗╄嚜楂斿収(n猫i)鎺掑嚭銆傝棩鐗╁収(n猫i)鏈嶉€插叆鑳冭吀
閬�锛岀稉(j墨ng)闁€闈滆剤绗竴娆″湪鑲濊嚐浠ｈ瑵婊呮椿锛屽畠浣块€插叆琛€娑插惊鐠�(hu谩n)鐨勬湁鏁堣棩閲忔笡灏�锛岃棩鏁堜笅闄嶃€傜ū鐐鸿棩鐗╃殑
棣栭亷鏁堟噳(y墨ng)锛屾垨绋遍閬庢秷闄�銆傚洜姝わ紝钘ョ墿鍦ㄩ珨鍏�(n猫i)杞�(zhu菐n)鍖栧皪淇濊姗熼珨閬垮厤钃勭⿳涓瘨鏈夐噸瑕佹剰缇�銆傝棩鐗╁湪楂�
鍏�(n猫i)杞�(zhu菐n)鍖栫殑鍣ㄥ畼涓昏鍦ㄨ倽鑷�锛屼絾琛€婕�銆佽厧鑷�銆佽儙鐩�銆佽吀榛忚啘銆佽吀閬撳井鐢熺墿浜﹁兘閫茶钘ョ墿浠ｈ瑵銆傚弮鑸囪棩
鐗╀唬璎濈殑閰朵富瑕佺偤鑲濊嚐鐨勫井绮掗珨閰剁郴锛屼富瑕佺偤娣峰悎鍔熻兘姘у寲閰�銆�
钘ョ墿鍦ㄩ珨鍏�(n猫i)浠ｈ瑵锛岄€氬父鍒嗙偤鍏╃浉鍙嶆噳(y墨ng)锛欼 鐩稿弽鎳�(y墨ng)鍖呮嫭姘у寲銆侀倓鍘熷拰姘磋В鍙嶆噳(y墨ng)锛汭I 鍙嶆噳(y墨ng)鏄祼(ji茅)鍚堝弽
鎳�(y墨ng)銆傜稉(j墨ng)绲�(ji茅)鍚堝弽鎳�(y墨ng)鐨勪唬璎濈墿澶氱偤瑕按鎬э紝鏄撳緸灏挎恫鎺掑嚭銆�
1.3.4 钘ョ墿鍕曞姏瀛哥殑鍩烘湰姒傚康
钘ョ墿鍕曞姏瀛告槸鐮旂┒钘ョ墿鍦ㄩ珨鍏�(n猫i)閬庣▼涓績搴﹂毃鏅傞枔璁婂寲鐨勫嫊鎱�(t脿i)瑕�(gu墨)寰嬬殑绉戝銆傚父鐢ㄧ殑琛€钘ユ績搴︽槸鎸�
鐢ㄨ棩鍚庝笉鍚屾檪闁撻噰琛€娓畾鐛插緱鐨勶紝鐒跺悗鍐嶅€熷姪鐗瑰畾鐨勬暩(sh霉)瀛告ā鍨嬪強鏁�(sh霉)瀛歌〃閬斿紡锛岃▓绠楀嚭涓€绯诲垪钘ョ墿鍕�
鍔涘鍙冩暩(sh霉)锛屽緸閫熷害鑸囬噺鍏╁€嬫柟闈㈤€茶鎻忚堪銆佹鎷苟鎺ㄨ珫钘ョ墿鍦ㄩ珨鍏�(n猫i)鐨勫嫊鎱�(t脿i)閬庣▼瑕�(gu墨)寰�銆�
1.琛€钘ユ績搴�-鏅傞枔鏇茬窔绨＄ū鐐鸿棩鏅傛洸绶�锛屾槸浠ヨ钘ユ績搴︾偤绺卞潗妯�锛屾檪闁撶偤姗潗妯欑躬鍑虹殑鏇茬窔銆�
琛€钘ユ績搴﹀彲鍙嶆槧钘ョ墿鍦ㄤ綔鐢ㄩ儴浣嶇殑婵冨害鍜屾晥鎳�(y墨ng)寮峰害锛岄€氶亷鏇茬窔鍙畾閲忓湴鍒嗘瀽钘ョ墿鍦ㄩ珨鍏�(n猫i)鍕曟厠(t脿i)璁婂寲鐨�
瑕�(gu墨)寰嬫€у拰鐗归粸銆�
2.鎴垮妯″瀷鐐轰簡鍒嗘瀽钘ョ墿鍦ㄩ珨鍏�(n猫i)杞�(zhu菐n)閬嬪拰杞�(zhu菐n)鍖�锛岃棩鐗╁嫊鍔涘灏囨楂旂湅鎴愪竴鍊嬬郴绲�(t菕ng)锛屽垎鐐鸿嫢骞查殧瀹わ紝
鎴垮鐨勫妰鍒嗚垏鍣ㄥ畼銆佺祫绻旂殑琛€娴侀噺銆佽啘閫氶€忔€�銆佽棩鐗╄垏绲勭箶鐨勮Κ鍜屽姏绛夊洜绱犳湁闂�(gu膩n)銆�
涓嶅悓钘ョ墿鐢变簬鐞嗗寲鎬ц唱(zh矛)鐨勪笉鍚�锛屽湪楂斿収(n猫i)鐨勮綁(zhu菐n)閬�銆佽綁(zhu菐n)鍖栥€佹帓娉勭瓑閬庣▼涔熻〃鐝�(xi脿n)鍑轰笉鍚岀殑鐗规€�锛屽湪琛€
钘ユ績搴︹€旀檪闁撴洸绶氫笂涔熸湁涓嶅悓鐨勮〃鐝�(xi脿n)锛屾牴鎿�(j霉)閫欎簺涓嶅悓涓€鑸妸鎴垮妯″瀷鍒嗙偤涓€瀹ゆā鍨�銆佷簩瀹ゆā鍨嬫垨涓�
瀹ゆā鍨�锛屽€熶互妯℃摤琛€钘ユ績搴︹€旀檪闁撴暩(sh霉)鎿�(j霉)锛岃▓绠楀嚭钘ュ嫊瀛稿弮鏁�(sh霉)銆�
3.钘ュ嫊瀛稿弮鏁�(sh霉)鍙婂叾鎰忕京
(1)娑堥櫎鍗婅“鏈�(T1/2尾) 鎸囬珨鍏�(n猫i)钘ョ墿绺介噺鎴栨績搴︽秷闄や竴鍗婃墍闇€鐨勬檪闁�銆傝〃绀鸿棩鐗╁湪楂斿収(n猫i)鐨勬秷闄ら€�
搴�锛屾槸姹哄畾钘ョ墿鏈夋晥鏅傞枔鐨勪富瑕佸弮鏁�(sh霉)銆�
5
(2)琛ㄨ鍒嗗竷瀹圭⿳(Vd) 琛ㄧず钘ョ墿鍦ㄩ珨鍏�(n猫i)鍒嗗竷鐨勭媭娉�锛岃〃瑙€鍒嗗竷瀹圭⿳澶�锛屾彁绀鸿棩鐗╁湪楂斿収(n猫i)鍒嗗竷寤�
娉�锛岀祫绻旀績搴﹁純楂�銆傝〃瑙€鍒嗗竷瀹圭⿳灏�锛屾彁绀鸿棩鐗╄純闆ｅ垎甯冨埌绲勭箶锛屼竴鑸钘ユ績搴﹁純楂�銆�
(3)楂旀竻闄ょ巼(CLB) 琛ㄧず钘ョ墿鐨勬秷闄ら€熺巼锛岃垏鍗婅“鏈熼暦鐭湁瀵嗗垏闂�(gu膩n)绯�銆�
(4)宄版績搴�(Cmax) 鎸囩郸钘ュ悗琛€涓仈鍒扮殑鏈€楂樻績搴�锛屽嘲婵冨害楂樻彁绀鸿棩鐗╁惛鏀舵瘮杓冨畬鍏ㄣ€�
(5)宄版檪(Tmax) 鎸囬仈鍒板嘲婵冨害鐨勬檪闁�锛屽嘲鏅傜煭鎻愮ず钘ョ墿鍚告敹杓冨揩锛涘弽涔�锛屽墖鍚告敹鎱�銆�
(6)钘モ€旀檪鏇茬窔涓嬮潰绌�(AUC) 鎻愮ず钘ョ墿閫插叆鍏ㄨ韩寰挵(hu谩n)鐨勮棩鐗╃附閲�銆傚ぇ澶氭暩(sh霉)钘ョ墿鐨� AUC 鑸囧姂閲�
鎴愭姣�锛屼絾涔熸湁灏戞暩(sh霉)钘ョ墿渚嬪銆侫UC 甯哥敤鍋氳▓绠楃敓鐗╁埄鐢ㄥ害鍜屽叾浠栧弮鏁�(sh霉)鐨勫熀绀�(ch菙)鍙冩暩(sh霉)銆�
(7)鐢熺墿鍒╃敤搴�(9) 鎸囪棩鐗╁惛鏀剁殑绋嬪害鍜岄€熷害銆傚湪闈為潨鑴堥€斿緫绲﹁棩鏅�锛屾槸鍙嶆槧钘ョ墿琚埄鐢ㄧ▼搴�
鐨勯噸瑕佸弮鏁�(sh霉)銆傝▓绠楁柟娉曟槸鍦ㄧ浉鍚屽姂閲忔浠朵笅锛屽収(n猫i)鏈嶆垨鍏朵粬闈炶绠″収(n猫i)绲﹁棩鐨� AUC 鑸囬潨鑴堟敞灏勭殑 AUC
鐨勬瘮鍊�銆�
1.4 褰遍熆钘ョ墿浣滅敤鐨勫洜绱�
钘ョ墿鏁堟噳(y墨ng)鐨勫挤寮卞彇姹轰簬闈剁祫绻斾綔鐢ㄩ儴浣嶆父闆㈣棩鐗╂績搴︾殑澶у皬銆備綔鐢ㄩ儴浣嶇殑钘ョ墿婵冨害鑸囩郸钘ュ姂閲�銆�
閫斿緫鍜屽嫊鐗╃殑绋銆佸勾榻�銆佹€у垾绛夋湁闂�(gu膩n)锛屽悓鏅傞倓鍙楀叾浠栬ū澶氬洜绱犲奖闊�銆傚湪鍒惰▊钘ョ墿鐨勭郸钘ユ柟妗堟檪锛�
灏嶅悇绋洜绱犻兘鎳�(y墨ng)瑭插叏闈㈣€冩叜銆�
1.4.1. 钘ョ墿鏂归潰
1.鍔戦噺钘ョ墿鐨勫姂閲忔槸姹哄畾閫插叆楂斿収(n猫i)鐨勮钘ユ績搴﹀強钘ョ墿浣滅敤寮峰害鎵€涓昏鍥犵礌銆傝棩鐗╃殑甯哥敤閲�(鎴�
娌荤檪閲�)鏈変竴鍊嬪姂閲忚寖鍦嶏紝婧栫⒑鍦伴伕鎿囩敤閲忔墠鑳界嵅寰楅爯(y霉)鏈熺殑钘ユ晥銆�
2.鍔戝瀷钘ョ墿鐨勫姂鍨嬪皪钘ョ墿鐨勫惛鏀跺奖闊垮緢澶э紝甯哥敤鐨勫姂鍨嬩腑娉ㄥ皠鍔戠殑鍚告敹蹇�锛屽収(n猫i)鏈嶅姂鍨嬪绮夊姂銆�
澶т父鍔�銆佺墖鍔�銆佽啝鍥婂姂銆佺厧鍔戠瓑鍚告敹杓冩參銆傚姂鍨嬬殑閬告搰甯告牴鎿�(j霉)鐤剧梾銆佺梾鎯�銆佹不鐧傛柟妗堟垨鐢ㄨ棩鐩殑鑰�
瀹�銆�
3.绲﹁棩閫斿緫甯哥敤鐨勭郸钘ラ€斿緫涓昏鏈夊収(n猫i)鏈嶃€佽倢鑲夋敞灏�銆佺毊涓嬫敞灏�銆侀潨鑴堟敞灏�銆佷钩鎴跨亴娉ㄧ瓑銆備竴鑸�
渚嗚锛岀郸钘ラ€斿緫鍙栨焙浜庤棩鐗╃殑鍔戝瀷锛屽娉ㄥ皠鍔戝繀闋堜綔娉ㄥ皠锛岀墖鍔戜綔鍏�(n猫i)鏈�銆備笉鍚岀殑绲﹁棩閫斿緫鐢变簬钘ョ墿
閫插叆琛€娑茬殑閫熷害鍜屾暩(sh霉)閲忓潎鏈変笉鍚�锛岀敘(ch菐n)鐢熻棩鏁堢殑蹇參鍜屽挤搴︿篃鏈夊緢澶у樊鍒�锛岀敋鑷崇敘(ch菐n)鐢熻唱(zh矛)鐨勫樊鍒�锛屽纭�
閰搁巶婧舵恫鍏�(n猫i)鏈嶈捣涓嬬€変綔鐢�锛岃嫢浣滈潨鑴堟敞灏勫墖璧蜂腑妯炴姂鍒朵綔鐢�銆傚彟澶�锛屽収(n猫i)鏈嶇郸钘ョ殑鐢熺墿鍒╃敤搴﹀彈鍕曠墿
绋爆褰遍熆杓冨ぇ锛屽鍠儍鍕曠墿鍏�(n猫i)鏈嶅鏄撳惛鏀讹紝鍙嶈娀鍕曠墿鍓囧惛鏀跺緢灏�锛岃ū澶氳棩鐗╁彲鍦ㄧ槫鑳冨垎瑙ｇ牬澹�銆�
4.鐧傜▼鏈変簺钘ョ墿绲﹁棩涓€娆″嵆鍙兘濂忔晥锛屽瑙ｇ啽閹�(zh猫n)鐥涜棩銆備絾澶у鏁�(sh霉)钘ョ墿蹇呴爤鎸夎(gu墨)瀹氱殑鍔戦噺鍜屾檪闁�
闁撻殧閫ｇ簩(x霉)绲︿簣涓€瀹氱殑鏅傞枔锛屾墠鑳介仈鍒版不鐧傛晥鏋�锛岀ū鐐虹檪绋�?锛熷挄顚氬宫閿旑彎顎︾璋愭弗鎰曞癁鐓舵哗鎷嶉紮锛稢
绌�(w臎n)瀹氱殑鐧傛晥锛屽苟閬垮厤鐢�(ch菐n)鐢熻€愯棩鎬�锛屾焙涓嶅彲绲﹁棩 1锝�2 娆″嚭鐝�(xi脿n)钘ユ晥灏辩珛鍗冲仠钘ャ€備緥濡�锛屾姉鐢熺礌涓€鑸
姹� 2~3 澶╃偤涓€鐧傜▼锛岀：鑳鸿棩鍓囪姹� 3~5 澶╃偤涓€鐧傜▼銆�
5.鑱�(li谩n)鍚堢敤钘ョ偤浜嗗寮疯棩鏁堟垨娓涘皯钘ョ墿鐨勪笉鑹弽鎳�(y墨ng)锛岃嚚搴婁笂甯搁噰鐢ㄨ伅(li谩n)鍚堢敤钘�銆傝伅(li谩n)鍚堢敤钘ユ檪锛屽叐绋�
浠ヤ笂鐨勮棩鐗╅枔?锛涖儚鍢ょ粖鎲筋潻a(ch菐n)鐢熺浉浜掍綔鐢�銆傝棩鐗╃殑鐩镐簰浣滅敤鍙湪楂斿娣峰悎钘ョ墿鏅傜櫦(f膩)鐢�锛屽鍏╃ó娉ㄥ皠
娑插湪鍚屼竴娉ㄥ皠瀹瑰櫒鍏�(n猫i)娣峰悎锛屽彲鑳藉嚭鐝�(xi脿n)娣锋縼銆佹矇娣€鎴栧叾浠栧弽鎳�(y墨ng)锛岀ū鐐洪厤浼嶇蹇�銆傜櫦(f膩)鐢熷湪楂斿収(n猫i)鐨勭浉浜掍綔
鐢ㄥ彲鍒嗙偤锛氳棩鍕曞鐨勭浉浜掍綔鐢紝鍗冲湪钘ョ墿鍚告敹銆佸垎甯�銆佷唬璎濆拰鎺掓硠閬庣▼涓浉浜掑奖闊�锛屼娇钘ョ墿鐨勫嫊鍔�
瀛搁亷绋嬫敼璁�锛屼娇浣滅敤鏅傞枔寤堕暦鎴栫府鐭�锛涜棩鏁堝鐨勭浉浜掍綔鐢�锛屽悓鏅備娇鐢ㄥ叐绋棩鐗╀娇钘ユ晥澧炲姞鐨勭ū鍗�(xi茅)鍚�
6
浣滅敤锛屽叾涓�锛屽垎鐐虹浉鍔犱綔鐢ㄥ拰澧炲挤浣滅敤锛屽墠鑰呮寚钘ユ晥绛変簬鍏╄棩鍒嗗垾浣滅敤鐨勪唬鏁�(sh霉)鍜�锛屽悗鑰呮寚钘ユ晥澶т簬
鍏╄棩鏁堟噳(y墨ng)鐨勫拰銆傚叐钘ュ悎鐢ㄨ棩鏁堟笡寮�锛岀ū鐐烘嫯鎶椾綔鐢�銆傚闈掗湁绱犺垏鍥涚挵(hu谩n)绱犻鍚堢敤鍙娇鍓嶈€呯殑娈鸿弻浣滅敤
娓涘急灏辨槸鎷姉浣滅敤鐨勪緥瀛�銆�
1.4.2 鍕曠墿鏂归潰
1.绋爆宸暟鐣滅鐨勭ó灞笉鍚屽皪鍚屼竴钘ョ墿鐨勫弽鎳�(y墨ng)鏈夊緢澶у樊鐣�銆傛湁鏅傜敋鑷崇浉鍙�锛屼緥濡傜姮鐢ㄥ棊鍟″彲琛�
鐝�(xi脿n)涓鎶戝埗锛岃€岃矒琛ㄧ従(xi脿n)鑸堝ギ銆傚悓涓€钘ョ墿鍦ㄤ笉鍚屽嫊鐗╃殑鍗婅“鏈熶笉鍚�锛岃棩鏁堢董鎸佹檪闁撲害鏈夊樊鐣�銆傚 SMM
鍦ㄨ爆鐨勫崐琛版湡鐐� 8.87h锛屽湪濂跺北缇婂墖鐐� 1.45h銆傚洜姝�锛屼笉鍚岀ó灞嫊鐗╀笉鑳界敤楂旈噸澶у皬浣滅偤绲﹁棩鍔戦噺鐨�
渚濇摎(j霉)銆�
2.鐢熺悊宸暟涓嶅悓骞撮健銆佹€у垾銆佹嚪瀛曞嫊鐗╁皪鍚屼竴钘ョ墿鍙嶆噳(y墨ng)涓嶄竴銆傝€侀健鍕曠墿鑲濊厧鍔熻兘娓涢€€锛屽皪钘ョ墿
杓冪偤鏁忔劅锛屽辜榻″強瀛曠暅涔熻純鏁忔劅锛岃嚚搴婄敤钘ユ檪鎳�(y墨ng)閬╃暥瑾�(di脿o)鏁村姂閲�銆�
3.鐥呯悊鍥犵礌鍚勭ó鐥呯悊鍥犵礌閮借兘鏀硅畩钘ョ墿鍦ㄥ仴搴锋楂旂殑姝ｅ父杞�(zhu菐n)閬嬭垏杞�(zhu菐n)鍖�锛屽奖闊胯钘ユ績搴�锛屽緸鑰屽奖
闊胯棩鐗╂晥鎳�(y墨ng)銆傚鑵庡姛鑳芥悕瀹虫檪锛岃棩鐗╃稉(j墨ng)鑵庢帓鍑哄彈闃昏€屽紩璧风⿳钃�锛涜倽鍔熻兘涓嶅叏鏅�锛屼唬璎濇笡灏�锛屽彲寮曡捣
钘ョ墿鍗婅“鏈熷欢闀锋垨浣滅敤澧炲挤銆�
1.4.3 鐠�(hu谩n)澧冨拰鍏朵粬鏂归潰
1.椋奸(y菐ng)绠＄悊椋奸(y菐ng)绠＄悊姊濅欢鐨勫ソ澹烇紝鏃ョ厂閰嶅悎鏄惁鍚堢悊鍧囧彲褰遍熆钘ョ墿鐨勪綔鐢�锛岃ū澶氳棩鐗╃殑娌荤檪浣�
鐢ㄩ兘蹇呴爤鍦ㄥ嫊鐗╅珨鍏锋湁鎶垫姉鍔涚殑姊濅欢涓嬫墠寰椾互鐧�(f膩)鎻�锛屽纾鸿兒椤炶棩娌荤檪鎰熸煋鎬х柧鐥呮檪锛岀梾鍘熼珨鐨勬渶鍚�
娑堥櫎蹇呴爤闈犳楂旂殑闃插尽绯荤当(t菕ng)锛涘嫊鐗╁鏋滅嚐椁�(y菐ng)涓嶈壇锛屼笉鍚岃棩鐗╃殑鍙嶆噳(y墨ng)涔熸湁涓嶅悓鐨勮〃鐝�(xi脿n)銆�
2.鐠�(hu谩n)澧冪敓鎱�(t脿i)姊濅欢鐠�(hu谩n)澧冩浠�銆佸嫊鐗╅＜椁�(y菐ng)瀵嗗害锛岄€氶ⅷ鎯呮硜锛屽粍鑸嶆韩搴︼紝鍏夌収绛夊潎鍙奖闊胯棩鐗╃殑鏁堟噳(y墨ng)銆�
2 澶栧懆绁炵稉(j墨ng)绯荤当(t菕ng)钘ョ悊
2.1 鍌冲嚭绁炵稉(j墨ng)钘ョ墿
2.1.1 姒傝堪
1.鍌冲嚭绁炵稉(j墨ng)绯荤当(t菕ng)鍒嗛鍌冲嚭绁炵稉(j墨ng)绯荤当(t菕ng)鎸夎В鍓栧鍙垎鐐烘鐗╃缍�(j墨ng)鑸囬亱鍕曠缍�(j墨ng)銆傛鐗╃缍�(j墨ng)鍙堝垎浜ゆ劅绁�
缍�(j墨ng)鑸囧壇浜ゆ劅绁炵稉(j墨ng)鍏╁ぇ椤�锛岄兘寰炰腑妯炵櫦(f膩)鍑洪€氶亷绁炵稉(j墨ng)绡€(ji茅)銆佹洿鎻涚缍�(j墨ng)鍏冨悗鎵嶅埌閬旀晥鎳�(y墨ng)鍣�銆傛墍浠ユ湁绡€(ji茅)鍓嶇簴缍�
鑸囩瘈(ji茅)鍚庣簴缍箣鍒嗐€傞亱鍕曠缍�(j墨ng)鑷腑妯炵櫦(f膩)鍑哄悗锛屼笉鏇存彌绁炵稉(j墨ng)鍏�锛岀洿鎺ュ埌閬旀墍鏀厤鐨勯楠艰倢銆�
鍌冲嚭绁炵稉(j墨ng)绯荤当(t菕ng)鎸夐仦璩�(zh矛)鍒嗗彲鍒嗙偤鑶藉牽鑳界缍�(j墨ng)鍜岃厧涓婅吅绱犺兘绁炵稉(j墨ng)銆�
2.鍌冲嚭绁炵稉(j墨ng)绐佽Ц鐨勫寲瀛稿偝閬炵獊瑙告槸鎸囩缍�(j墨ng)鍏冧箣闁撴垨绁炵稉(j墨ng)鍏冭垏鏁堟噳(y墨ng)鍣ㄤ箣闁撶殑鍔熻兘鎺ヨЦ榛烇紝鏄俊鎭�
鍌抽仦鐨勭壒娈婄祼(ji茅)妲�(g貌u)銆傚ぇ澶氭暩(sh霉)绐佽Ц鐨勪俊鎭偝閬炴槸閫氶亷绁炵稉(j墨ng)閬炶唱(zh矛)浠嬪皫(d菐o)锛岀ū鍖栧鍌抽仦銆傜獊瑙哥殑鍖栧鍌抽仦閬庣▼
鍖呮嫭閬炶唱(zh矛)鐨勭敓鐗╁悎鎴�銆佸劜瀛�銆侀噵鏀�銆侀仦璩�(zh矛)浣滅敤鐨勬秷澶辩瓑銆傜獊瑙稿偝閬為亷绋嬪鏄撳彈鍒拌棩鐗╃殑褰遍熆銆�
3.鍌冲嚭绁炵稉(j墨ng)閬炶唱(zh矛)鍜屽彈楂斿偝鍑虹缍�(j墨ng)閬炶唱(zh矛)涓昏鍖呮嫭鍘荤敳鑵庝笂鑵虹礌鍜屼箼閰拌喗鍫�銆傚幓鐢茶厧涓婅吅绱犵殑鍚堟垚
鍘熸枡鏄叒姘ㄩ吀锛屽湪閰皑閰哥茎鍖栭叾鍌寲涓嬬敓鎴愬宸�锛屽啀缍�(j墨ng)澶氬反鑴晶閰剁殑鍌寲锛岀敓鎴愬宸磋兒锛屽悗鑰呴€插叆
鍥婃场涓稉(j墨ng)澶氬反鑳� 尾-缇ュ寲閰跺偓鍖栬綁(zhu菐n)璁�?y艒u)妲裤偧鍟処涓婅吅绱犮€傚幓鐢茶厧涓婅吅绱犲舰鎴愬悗鍎插瓨浜庡泭娉″収(n猫i)銆傜缍�(j墨ng)娌�
7
鍕曞埌閬旂缍�(j墨ng)鏈ⅱ鐢�(ch菐n)鐢熷幓妤靛寲鏅傦紝绱拌優鑶滅殑閫氶€忔€ф敼璁�锛岄垼闆㈠瓙鍏�(n猫i)娴侊紝淇冧娇绐佽Ц鑶滆垏闈犺繎鐨勪竴浜涘泭娉�
鑶滅櫦(f膩)鐢熻瀺鍚�锛屽苟褰㈡垚瑁傚瓟锛岀劧鍚庡皣鍏朵腑鐨勫幓鐢茶厧涓婅吅绱犳帓鑷崇獊瑙搁枔闅�銆傚幓鐢茶厧涓婅吅绱犻噵鏀惧悗澶ч儴鍒�
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鎿村嫉绛夋晥鎳�(y墨ng)銆�
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鐨勬敐鍙�锛岃€岃嚧鍚庤€呴€愭几娓涘皯锛岃〃鐝�(xi脿n)鎶楄厧涓婅吅绱犺兘绁炵稉(j墨ng)浣滅敤銆傚垎椤炶琛� 1-1銆�
8
琛� 1-1 甯哥敤鍌冲嚭绁炵稉(j墨ng)绯荤当(t菕ng)钘ョ墿鐨勫垎椤�
鎿技钘ユ嫯鎶楄棩
鎿喗鍫胯棩鎶楄喗鍫胯棩
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M 鍙楅珨婵€鍕曡棩(姣涙灉钑撻鍫�) Nl 鍙楅珨闃绘柗钘�(鍏敳闆欒兒)
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鎶楄喗鍫块叝閰惰棩(鏂版柉鐨勬槑) 鑶藉牽閰叾寰�(f霉)娲昏棩(纰樿В纾峰畾)
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a銆佄� 鍙楅珨婵€鍕曡棩(鑵庝笂鑵虹礌銆佸宸磋兒) a1銆乤2 鍙楅珨闃绘柗钘�(閰氬Ε鎷夋槑)
a 鍙楅珨婵€鍕曡棩(鍘荤敳鑵庝笂鑵虹礌) a1 鍙楅珨闃绘柗钘�(鍝屽攽鍡�)
a2 鍙楅珨闃绘柗钘�(鑲蹭酣璩�)
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鎶楄厧涓婅吅绱犺兘绁炵稉(j墨ng)钘�(鍒╄骞�)
2.1.2 鎿喗鍫胯棩
鈼忔皑鐢查叞鑶藉牽
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銆愭噳(y墨ng)鐢ㄣ€戠敤浜庢不鐧傜槫鑳冨紱绶╁拰绌嶉鍙婂垎濞╂檪鍙婂垎濞╁悗瀛愬寮涚珐銆佽儙琛ｄ笉涓嬪強瀛愬钃勮喛绛�銆傛巸浜�
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姹楄吅澶ч噺鍒嗘硨蹇呴爤璎规厧銆�
鈼忔瘺鏋滆晸棣欏牽
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鐢ㄦ瘮杓冩韩鍜岋紝鍏剁敤娉曚害鍏堣杌熷寲绯炰究锛岄殧 30锝�60 min 姣忔灏忛噺锛岀毊涓嬫敞灏� 20~40 mg銆�
姣涙灉钑撻鍫夸害鑳戒綔鐢ㄤ簬鐪艰櫣鑶滃収(n猫i)鐠�(hu谩n)鐙€鑲岀殑 M 鑶藉牽鍙楅珨锛屼娇鐠�(hu谩n)鐙€鑲屽悜涓績鏀剁府锛岀敘(ch菐n)鐢熺府鐬筹紱鍦�
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10锝�15min 闁嬪浣滅敤銆�
鈼忔柊鏂殑鏄�
銆愪綔鐢ㄣ€戞湰鍝佸爆鑶藉牽閰叾鎶戝埗鍔戣棩銆傝垏鑶藉牽閰叾鐨勮Κ鍜屽姏姣斾箼閰拌喗鍫垮ぇ寰楀锛岀祼(ji茅)鍚堢殑寰�(f霉)鍚堢墿鍙�
閫茶鍒嗚В锛屼絾姘磋В鎱�锛屽洜鑰屽嚭鐝�(xi脿n)鎸佷箙鐨勫収(n猫i)婧愭€т箼閰拌喗鍫夸綔鐢�銆傛湰鍝佸皪蹇冭绠�銆佽吅楂斻€佹敮姘ｇ骞虫粦鑲�
浣滅敤杓冨急锛屽皪鑳冭吀銆佽唨鑳卞钩婊戣倢浣滅敤杓冨挤锛屽彟澶�锛岄櫎鍦ㄧ缍�(j墨ng)鑲岃倝鎺ラ牠鎶戝埗鑶藉牽閰叾澶�锛岄倓鑳界洿鎺ヨ垏
9
楠ㄩ鑲岄亱鍕曠祩鏉跨殑 N2 鍙楅珨绲�(ji茅)鍚堬紝鍔犲挤楠ㄩ鑲屾敹绺�銆�
銆愭噳(y墨ng)鐢ㄣ€戣嚚搴婄敤浜庣槫鑳冨紱绶�锛屼績閫茶爼鍕�銆傚皪鐗�銆佺緤銆侀Μ銆佽爆鑳芥彁楂橀楠艰倢鏀剁府鍔�銆傛湰鍝佷害鍙綔
鐙椾繚瀹氫娇鐢ㄧ姣掗亷閲忔檪鐨勬嫯鎶楄棩鍙婇噸鐧ヨ倢鐒″姏鐨勮ê鏂疯垏娌荤檪銆�1锛呮憾娑茬敤鍋氱府鐬宠棩銆�
銆愭敞鎰忎簨闋呫€戔憼灏嶆姊版€ц吀闃诲銆佽儍鑵稿畬鍏ㄩ樆濉炴垨楹荤椆銆佺棛鏀ｇ枬鍙婃嚪瀛曞悗鏈熺鐢紱鈶℃湰鍝侀亷閲�
鏅�锛岄鍏堝仠钘ュ苟鑲岃倝娉ㄥ皠鎷姉鍔戦樋鎵樺搧锛屼害鍙潨鑴堟敞灏勭～閰搁巶锛屽悗鑰呭皪楠ㄩ鑲屽叿鏈夌洿鎺ユ姂鍒朵綔鐢ㄣ€�
2.1.3 鎶楄喗鍫胯棩
1.M 鍙楅珨闃绘柗钘�
鈼忛樋鎵樺搧
銆愪綔鐢ㄣ€戞湰鍝佽兘鑸囩瘈(ji茅)鍚庡壇浜ゆ劅绁炵稉(j墨ng)鏈ⅱ鏀厤鏁堟噳(y墨ng)鍣ㄤ笂 M-鑶藉牽鍙楅珨鐩镐簰浣滅敤锛岄樆鏂峰彈楂旇垏涔欓叞
鑶藉牽鎴栧叾浠栬喗鍫胯兘婵€鍕曡棩绲�(ji茅)鍚堬紝鐢�(ch菐n)鐢熺鐖€ф姂鍒朵綔鐢�銆傜暥鑶藉牽鑳界缍�(j墨ng)娌栧嫊琚樆鏂蜂箣鍚�锛岃厧涓婅吅绱犺兘
绁炵稉(j墨ng)鏀厤鍗犲劒(y艒u)鍕紝绲�(ji茅)鏋滃嚭鐝�(xi脿n)鎿氦鎰熺缍�(j墨ng)妯ｄ綔鐢�銆傚皬鍔戦噺鑳戒娇鍞炬恫鑵�銆佹埃绠″強姹楄吅(闄らΜ澶�)鍒嗘硨娓涘皯锛�
涓姂閲忔摯鐬冲強澧炲姞蹇冪巼锛涘ぇ鍔戦噺娓涘皯鑳冭吀鍙婂翱閬撴椿鍕�锛涘姞澶у姂閲忔笡灏戣儍娑插垎娉�銆傜暥澶у姂閲忛亷澶ф檪锛�
澶ч噺闃挎墭鍝佸彲閫插叆涓绁炵稉(j墨ng)绯荤当(t菕ng)锛屽紩璧蜂腑妯炶垐濂�銆�
銆愭噳(y墨ng)鐢ㄣ€戣嚚搴婁笂闃挎墭鍝佸叏韬敤钘ュ彲浣滅偤锛氣憼楹婚唹鍓嶇郸钘ヤ互娓涘皯鍞炬恫銆佸懠鍚搁亾鍒嗘硨鍙婃敼鍠勫績鑷熸椿
鍕�锛涒憽娌荤檪绔囨€у績鍕曢亷绶┿€佹埧瀹や笉瀹屽叏闃绘化锛涒憿鎿喗鍫块亷閲忔檪鐨勮В姣掕棩锛涒懀鏈夋纾烽吀閰腑姣掕В姣掕棩锛�
鈶らΜ鐤濈棝鐨勮В鐥欒棩锛涒懃0.5锛厏1锛呮憾娑茬敤鍋氭暎鐬筹紝娌荤檪铏硅啘鐐�銆佸懆鏈熸€х溂鐐庡強鍋氱溂搴曟鏌�銆�
銆愭敞鎰忎簨闋呫€戞湰鍝佺殑缂洪粸鍦ㄤ簬钘ョ墿鐨勫鏂归潰浣滅敤锛屽洜姝ゅ繀闋堢⒑瑷哄悗鐢ㄨ棩锛屽嚭鐝�(xi脿n)涓嶈壇鍙嶆噳(y墨ng)寰€寰€鑸�
鍔戦噺鏈夐棞(gu膩n)?锛涘す绗ラ潯璇濋妸鈹濈箳r浣滅敤绋嶈紩锛岀敤楂樻垨涓瘨鍔戦噺鍓囩敘(ch菐n)鐢熷毚閲嶅悗鏋溿€傛湰鍝佺殑涓嶈壇鍙嶆噳(y墨ng)涔熷寘鎷�
鐦よ儍鑷岃劰銆佷究绉樺強灏挎酱鐣欑瓑銆傝鐞嗗疁澶氱郸椋叉按銆�
鈼忔澅鑾ㄨ彧鍫�
銆愪綔鐢ㄨ垏鎳�(y墨ng)鐢ㄣ€戝熀鏈悓闃挎墭鍝�锛屼絾灏嶄腑妯炰綔鐢ㄥ洜鍕曠墿绋爆涓嶅悓鑰岀暟銆傛湰鍝佹姉闇囬～浣滅敤鏄樋鎵樺搧
鐨� 10 涓€ 20 鍊�銆備篃鍙互鐢ㄤ簬楹婚唹鍓嶇郸钘�.鍎�(y艒u)浜庨樋鎵樺搧銆傛敞鎰忛Μ灞嫊鐗╁父鍑虹従(xi脿n)涓鑸堝ギ銆�
2.N2 鍙楅珨闃绘柗钘�(楠ㄩ鑲屾澗寮涜棩)鐛搁啱(y墨)鑷ㄥ簥涓婁娇鐢� N2 鑶藉牽鍙楅珨闃绘柗钘ワ紝鍗抽楠艰倢鏉惧紱钘�(绨＄ū鑲�
鏉捐棩)銆傚畠浣滅敤浜庣缍�(j墨ng)鑲岃倝鎺ラ牠銆傞樆绀欑缍�(j墨ng)娌栧嫊鍌抽仦锛屼娇楠ㄩ鑲屾澗寮涖€傜敤浜庡嫊鐗╀繚瀹氬強閰嶅悎娣洪夯閱�
鐨勬墜琛�(sh霉)銆�
鑲屾澗钘ュ垎闄ゆサ鍖栧瀷鍜岄潪闄ゆサ鍖栧瀷鍏╅銆傞櫎妤靛寲鍨嬭倢鏉捐棩鍙堢ū闈炵鐖瀷鑲屾澗钘ュ鐞ョ弨鑶藉牽锛岃兘鑸�
閬嬪嫊绲傛澘鑶滀笂鐨� N2 鑶藉牽鍙楅珨鐩哥祼(ji茅)鍚�銆傚湪鑲岃倝绱拌優鑶滅敘(ch菐n)鐢熻垏涔欓叞鑶藉牽鐩镐技浣嗚純鎸佷箙鐨勫幓妤靛寲浣滅敤锛�
浣块楠艰倢鏉惧紱銆傞潪闄ゆサ鍖栧瀷鑲屾澗钘ュ張绋辩鐖瀷鑲屾澗钘ュ绛掔姣掑牽锛岃兘鑸囬亱鍕曠祩鏉胯啘涓婄殑 N2 鑶藉牽鍙�
楂旂祼(ji茅)鍚�锛屾湰韬苟涓嶆縺鍕曞彈楂�锛岃€屾槸绔剁埈鎬у湴闃绘柗涔欓叞鑶藉牽鐨勫幓妤靛寲浣滅敤锛屼娇楠ㄩ鑲屾澗寮涖€傜瓛绠瘨鍫�
鐨勭缍�(j墨ng)鑲岃倝闃绘柗浣滅敤鍙鎶楄喗鍫块叝閰惰棩鏂版柉鐨勬槑灏嶆姉锛屼娇寰椾箼閰拌喗鍫跨殑鍒嗚В鐮村鎺ㄩ伈锛屽苟鍦ㄥ彈楂旈儴
浣嶇⿳鑱�锛屾湁鏁堝湴鑸囩瓛绠瘨鍫跨鐖喗鍫垮彈楂斻€�
鈼忕惀鐝€鑶藉牽
銆愪綔鍔囥€戞湰鍝佹槸瓒呯煭鏅傚幓妤靛寲鍨嬭倢鏉捐棩銆傝倢鑲夋敞灏勬湰鍝佸悗 2~3min 闁嬪浣滅敤锛岀董鎸� 10~30min銆�
鑲屾澗鏅傞枔鐭殑鍘熷洜鏄洜鐐鸿棩鐗╁惛鏀跺悗锛屽緢蹇琛€婕垮亣鎬ц喗鍫块叝閰舵按瑙ｇ偤鐞ョ弨鍠喗鍫垮拰鑶藉牽銆傚墠鑰呴儴
鍒嗙敱灏挎帓鍑�锛屼絾濡傝厧鍔熻兘涓嶅叏鏅傚彲鍦ㄩ珨鍏�(n猫i)绌嶈搫銆傚悇绋嫊鐗╃殑鍋囨€ц喗鍫块叝閰跺惈閲忎笉鍚�銆傞Μ銆佽爆鐨勫惈閲�
姣旂墰缇婇珮锛屾晠棣€佽爆鐢ㄦ湰鍝佹檪杓冪墰銆佺緤瀹夊叏銆傝倢鑲夋澗寮涙€ч夯鐥瑰厛寰為牠銆佺溂閮ㄨ倢鑲夐枊濮嬶紝闅ㄥ悗鏄枆銆�
鑳搞€佽吂鑲�銆佸洓鑲㈣倢鑲�锛屾渶鍚庣偤鑶堣倢銆傚娆℃噳(y墨ng)鐢ㄤ笉鐢�(ch菐n)鐢熻搫绌嶅拰鑰愬彈鐝�(xi脿n)璞�銆�
10
銆愭噳(y墨ng)鐢ㄣ€戔憼鑲屾澗鎬т繚瀹氳棩锛屽湅鍏�(n猫i)甯哥敤浜庝繚瀹氶噹鐢熷嫊鐗╀綔鏂疯銆侀嫺鑼�銆傚湅澶栧鐢ㄤ簬棣€佺姮銆佽矒銆�
鈶℃墜琛�(sh霉)鏅傜敤鍋氳紨鍔╅夯閱夎棩銆�
銆愭敞鎰忎簨闋呫€戔憼鏈搧鏈夋摤鑶藉牽浣滅敤锛岃兘浣垮斁娑茶吅銆佹敮姘ｇ鑵哄ぇ閲忓垎娉岋紝鐢ㄨ棩鍓嶅疁娉ㄥ皠灏忛噺闃挎墭
鍝�銆傚皪鍙嶈娀鍕曠墿鐢ㄨ棩鍓嶆噳(y墨ng)鍋滈鍗婂ぉ銆傗憽鍤撮噸鑲濈梾銆佹參鎬ц钵琛€銆佺嚐椁�(y菐ng)涓嶈壇绛夋偅鐣滅殑琛€婕胯喗鍫块叝閰舵椿鎬�
涓嬮檷?锛熻怠鑻庡ūL鏈搧鐨勮棩鏁堬紱骞磋€侀珨寮卞拰濡婂瀹剁暅锛屽繉鐢ㄦ湰鍝併€傗憿鏈夋纾烽﹨(q奴)锜茶棩鑳芥姂鍒惰喗鍫块叝閰舵椿
鎬�锛岄’钁楀鍔犲皪鏈搧鐨勬晱鎰熸€�锛屾噳(y墨ng)閬垮厤浣跨敤銆�
2.1.4 鎿厧涓婅吅绱犺棩
1.a-鍙楅珨婵€鍕曡棩
鈼忓幓鐢茶厧涓婅吅绱�
銆愪綔鐢ㄣ€戜富瑕佽垐濂� a-鍙楅珨锛屼娇琛€绠℃敹绺�锛屾敹绺▼搴﹁垏鍔戦噺鏈夐棞(gu膩n)銆傚皬鍔戦噺鍍呰紩搴︽敹绺�锛岃純澶у姂
閲忓彲浣垮鍛ㄨ绠￠’钁楁敹绺�銆傚叾娆″皪蹇冭嚐 尾1 鍙楅珨涔熸湁鑸堝ギ浣滅敤锛屼絾姣旇厧涓婅吅绱犲急锛屽皪 尾2 鐒′綔鐢�銆傚皬
鍔戦噺鏅傜敱浜庡懆鍦嶈绠℃敹绺€佸績鑷熻垐濂強蹇冭几鍑洪噺澧炲姞锛屾晠鏈夎純寮风殑鍗囧浣滅敤銆�
銆愭噳(y墨ng)鐢ㄣ€戜富瑕佺敤浜庢不鐧備紤鍏�锛屽澶辫鎬с€佸壍(chu脿ng)鍌锋€ф垨鎰熸煋鎬т紤鍏�锛岃〃鐝�(xi脿n)鍦ㄥ井寰挵(hu谩n)琛€娴佺亴娉ㄤ笉鏄拰
鏈夋晥琛€瀹归噺涓嬮檷銆傚洜姝や紤鍏嬬殑娌荤檪棣栧厛渚濋潬杓告恫鎴栬几琛€浠ヨ鍏呰瀹归噺锛屾敼閫查噸瑕佸櫒瀹樼殑琛€娑蹭緵鎳�(y墨ng)锛�
鏀瑰杽寰惊鐠�(hu谩n)銆傚杓告恫鎴栬几琛€鍚庢偅鐣滆澹撲粛鐒朵綆涓�锛屽彲閬╃暥鐭湡鎳�(y墨ng)鐢ㄦ湰鍝佷互鎻愰珮琛€澹�锛屽鍔犺叇銆佸績鐨�
琛€娴侀噺锛屽苟鍦ㄧ煭鏅傞枔鍏�(n猫i)淇濊瓑閲嶈鑷熷櫒鐨勮娑蹭緵鎳�(y墨ng)銆備絾涓嶅疁澶у姂閲忓強闀锋湡鎳�(y墨ng)鐢ㄤ互鍏嶈绠″挤鐑堟敹绺�銆佽
绠＄棛鏀ｃ€佸井寰挵(hu谩n)鐨勮娴佺亴娉ㄤ笉瓒�锛屼娇浼戝厠鎯″寲銆�
2.a-鍙楅珨鍙� 尾-鍙楅珨婵€鍕曡棩
鈼忚厧涓婅吅绱�
銆愪綔鐢ㄣ€戞湰鍝佽垐濂� a-鍙楅珨鍙� 尾-楂�銆傞潨鑴堟敞灏勭洿鎺ヤ綔鐢ㄤ簬蹇冭嚐锛屾彁楂樺績鐜囧強鏀剁府鍔�锛屽鍔犳敹绺�
澹�锛涜倢鑲夋敞灏勬瘮鐨笅娉ㄥ皠鍚告敹绋嶅揩锛屽悗鑰呭湪 5~10min 鍑虹従(xi脿n)浣滅敤銆傛湰鍝侀倓鍏锋湁鎶楃祫绻旇兒浣滅敤锛屾敹绺�
琛€绠�銆佽垝寮垫敮姘ｇ骞虫粦鑲�銆佽В闄ゅ収(n猫i)婧愭€х祫绻旇兒閲嬫斁寮曡捣鐨勮绠℃摯寮点€佸井琛€绠￠€氶€忔€у鍔犲強鏀埃绠″钩
婊戣倢鐥欐敚绛夐亷鏁忔€т紤鍏嬬櫏鐙€銆�
銆愭噳(y墨ng)鐢ㄣ€戣嚚搴婁笂鐢ㄤ簬蹇冭嚐寰�(f霉)铇囥€佹姉閬庢晱锛屽姞鍏ュ眬閮ㄩ夯閱夎棩涓互鏀剁府琛€绠�锛屾笡灏戝眬閮ㄩ夯閱夎棩鐨勫惛
鏀惰€屽欢闀疯棩鏁�銆�
蹇冭嚐寰�(f霉)铇囨€ユ晳鏅傦紝灏� 0.1锛呴菇閰歌厧涓婅吅绱犳敞灏勬恫鐢ㄧ敓鐞嗛菇姘存垨钁¤悇绯栨敞灏勬恫浣� 10 鍊嶇█閲嬪悗閫茶
闈滆剤杓稿叆銆傚繀瑕佹檪浣滃績鍏�(n猫i)娉ㄥ皠骞堕爤閰嶅悎浜哄伐鍛煎惛銆傚皪涓嶇敋鍗辨€ョ殑蹇冨姏琛扮鎴栬紩搴﹂亷鏁忔€х柧鐥�锛屽彲
10 鍊嶇█閲嬪悗鐨笅鎴栬倢鍏�(n猫i)娉ㄥ皠銆�
鈼忛夯榛冨牽
銆愪綔鐢ㄨ垏鎳�(y墨ng)鐢ㄣ€戜腑钘ラ夯榛冩彁鍙栫殑鐢熺墿鍫匡紝宸茶兘浜哄伐鍚堟垚锛屽寲瀛告€ц唱(zh矛)绌�(w臎n)瀹氥€傛湰鍝佽垏鑵庝笂鑵虹礌浣滅敤
鍩烘湰鐩镐技锛岃兘鑸堝ギ a-楂斿強 尾-楂�锛屽苟鑳戒績閫茶厧涓婅吅绱犺兘绁炵稉(j墨ng)鏈ⅱ閲嬫斁鍏�(n猫i)婧愭€у幓鐢茶厧涓婅吅绱�锛岃€岀敘(ch菐n)鐢�
闁撴帴鐨勬摤鑵庝笂鑵虹礌浣滅敤銆�
浣滅敤寮峰害杓冭厧涓婅吅绱犲急鑰屾寔涔�锛屼互蹇冭绠′綔鐢ㄧ偤渚嬶紝鏈搧鐨勫崌澹撲綔鐢ㄦ檪闁撹純鑵庝笂鑵虹礌闀� 7~10
鍊�锛屼笖鑳藉収(n猫i)鏈�锛岄€欐槸瀹冪殑鍎�(y艒u)榛炪€傚湪鎳�(y墨ng)鐢ㄤ笂鍙互闈滆剤娉ㄥ皠鎴栬倢鑲夋敞灏勪互缍寔鍜屾彁楂樿澹�銆傛湰鍝佽兘鏈夋晥
鍦版澗寮涙敮姘ｇ骞虫粦鑲�锛屾摯寮垫敮姘ｇ閫氶亾鍙婃笡杓曢亷鏁忓弽鎳�(y墨ng)鐨勭櫏鐙€锛屼絾浣滅敤姣旇厧涓婅吅绱犳參銆備富瑕佺敤鍋氬钩
鍠樿棩锛屾不鐧傛敮姘ｇ鍝枠锛涘鐢ㄦ不鐧傞蓟鐐�锛屾秷闄ら粡鑶滃厖琛€鑵劰銆�
3. 尾-鍙楅珨婵€鍕曡棩
11
鈼忕暟涓欒厧涓婅吅绱�
銆愪綔鐢ㄣ€戞湰鍝佸皪 尾1 鍙� 尾2 鍙楅珨鍏锋湁寮风儓鑸堝ギ浣滅敤锛屽皪 a-鍙楅珨鐒′綔鐢�銆傝垐濂� 尾1 鍙楅珨锛岃兘鑸堝ギ蹇冭嚐銆�
澧炲姞蹇冭倢鏀剁府鍙婃埧瀹ゅ偝灏�(d菐o)銆佸鍔犺几鍑洪噺銆佸強鎿村嫉鍛ㄥ湇琛€绠�(楠ㄩ鑲�)锛岃В闄や紤鍏嬫檪灏忓嫊鑴堢棛鏀�锛屾敼鍠�
寰惊鐠�(hu谩n)銆傝垐濂� 尾2 鍙楅珨锛岃兘鏉惧紱鏀埃绠″钩婊戣倢锛屽鍔犲懠鍚告埃閲忋€�
銆愭噳(y墨ng)鐢ㄣ€戜富瑕佺敤浜庢不鐧傛€ユ€ф敮姘ｇ鐥欐敚锛涗害鐢ㄤ簬蹇冭嚐椹熷仠銆侀珮搴︽埧瀹ゅ偝灏�(d菐o)闃绘化鍜屼紤鍏嬫不鐧�锛屾不
鐧備紤鍏嬪繀鍏堣瓒宠瀹归噺銆�
鈼忓厠鍊壒缇�
銆愪綔鐢ㄨ垏鎳�(y墨ng)鐢ㄣ€戞湰鍝佸皪 尾2 鍙楅珨鍏锋湁閬告搰鎬ц垐濂綔鐢�锛岄’钁楄垝寮垫敮姘ｇ骞虫粦鑲屻€傜珐瑙ｅ懠鍚稿洶闆�锛�
瑕嬫晥蹇�锛屼綔鐢ㄦ檪闁撻暦銆備富瑕佺敤浜庢敮姘ｇ鍝枠銆佽偤姘ｈ叓绛夌柧鐥呯殑娌荤檪銆傚湅鍏�(n猫i)澶栧潎绂佺敤鍋氬嫊鐗╀績鐢熼暦鍔�銆�
2.1.5 鎶楄厧涓婅吅绱犺棩
1.a-鍙楅珨闃绘柗钘ユ椤炶棩鐗╄兘閬告搰鎬у湴闃绘柗 a-鍙楅珨锛屽彇娑堣厧涓婅吅绱�(浣滅敤 a-鍙楅珨锛屛�-鍙楅珨)鐨勬敹绺�
琛€绠″崌楂樿澹撶殑浣滅敤鑰岀炕杞�(zhu菐n)鐐鸿垐濂� 尾-鍙楅珨鐨勮垝寮佃绠￠檷澹撲綔鐢�銆備絾灏嶄簬鍘荤敳鑵庝笂鑵虹礌(涓昏浣滅敤 a-
鍙楅珨)鍙兘娓涘急鎴栧彇娑堝叾鍗囧浣滅敤鑰岀劇缈昏綁(zhu菐n)鐐洪檷澹撲綔鐢紱鑰屽皪鐣颁笝鑵庝笂鑵虹礌(涓昏浣滅敤 尾-鍙楅珨)鍓囩劇
褰遍熆銆�
鈼忛厷濡ユ媺鏄�
銆愪綔鐢ㄨ垏鎳�(y墨ng)鐢ㄣ€戞湰鍝佺偤鐭晥椤� a-鍙楅珨闃绘柗钘�銆備富瑕佺敤浜庣姮浼戝厠娌荤檪锛岄爤瑁滃厖琛€瀹归噺銆�
2.尾-鍙楅珨闃绘柗钘ユ椤炶棩鐗╄兘閬告搰鎬у湴鑸囧厭鑼堕厷鑳虹鐖� 尾-鍙楅珨锛屽洜鑰屽彇娑� 尾-鍨嬫摤鑵庝笂鑵虹礌浣滅敤锛�
濡傚皪鎶楀績鑷熻垐濂�(尾1 鍙楅珨)銆佽绠″強鏀埃绠℃摯寮�(尾2 浣滅敤)銆�
鈼忔櫘钀樻礇鐖�(蹇冨緱瀹�)
鏈搧鍙樆鏂峰績鑷� 尾1 鍙楅珨锛屾姂鍒跺績鑷熸敹绺姏鑸囨埧瀹ゅ偝灏�(d菐o)锛屾笡鎱㈠績鐜�锛岄檷浣庤澹�锛涢樆鏂� 尾2 鍙楅珨锛�
琛ㄧ従(xi脿n)鏀埃绠℃敹绺�銆備富瑕佺敤浜庢姉蹇冪巼澶卞父锛屽鐘績鏃╂悘銆�
2.2 鍌冲叆绁炵稉(j墨ng)钘ョ墿
浣滅敤浜庡偝鍏ョ缍�(j墨ng)(鍙堢ū鎰熻绁炵稉(j墨ng))鐨勮棩鐗╁寘鎷眬閮ㄩ夯閱夎棩銆佷繚璀疯棩鍜屽埡婵€钘ャ€�
2.2.1 灞€閮ㄩ夯閱夎棩
灞€閮ㄩ夯閱夎棩鏄竴椤炶兘鍦ㄧ敤钘ュ眬閮ㄥ彲閫嗘€у湴闃绘柗鎰熻绁炵稉(j墨ng)鐧�(f膩)鍑烘矕鍕曡垏鍌冲皫(d菐o)锛屽苟鐛插緱灞€閮ㄧ祫绻旂棝瑕�
鏆檪娑堝け鐨勮棩鐗┿€傛噳(y墨ng)鐢ㄥ眬閮ㄩ夯閱夎棩鐨勭洰鐨勬槸閫茶澶栫鎵嬭(sh霉)锛岃垏鍏ㄨ韩楹婚唹钘ヤ笉鍚�锛屽嫊鐗╂槸鍦ㄦ剰璀樻竻閱�
姊濅欢涓嬮€茶鐨�銆�
灞€楹昏棩绲�(ji茅)妲�(g貌u)鐗归粸鏄細瑕剛閮ㄥ垎鑺抽鍩烘湁鍒╄棩鐗╂徊鍏ョ缍�(j墨ng)绲勭箶鐧�(f膩)鎻眬楹讳綔鐢�锛涜Κ姘撮儴鍒嗙兎鑳哄熀鏈�
涓瓑寮峰害鍫挎€�锛屽埄浜庡埗鎴愭按婧舵€ч菇閰搁菇锛涗腑闁撻儴鍒嗕互閰嵉鎴栭叞鑳洪嵉褰㈠紡绲�(ji茅)鍚堟垚鑺抽閰 (鏅鍗″洜)
鎴栭叞鑳洪(鍒╁鍗″洜)锛屽墠鑰呮槗姘磋В锛屼綔鐢ㄦ檪闁撶煭锛屽悗鑰呬笉鏄撴按瑙ｏ紝浣滅敤鏅傞枔闀�銆�
灞€楹昏棩閫插叆绲勭箶锛岃涓拰鍚庨噵鍑烘父闆㈠牽鍩烘墠鐧�(f膩)鎻綔鐢�锛屽叾浣滅敤寮峰害涓昏鍙栨焙娓搁洟鍫垮熀婵冨害銆傛€�
鎬х値鐧ユ檪锛岀祫绻旂殑 pH 鍋忛吀锛屼笉鍒╀簬娓搁洟鍫挎按瑙�锛屾晠灞€楹昏棩浣滅敤杓冨急銆傚眬楹昏棩鐨勪綔鐢ㄥ厛鍚庢槸鐥涜銆�
婧銆佽Ц瑕恒€佸瑕�銆傚鍛ㄧ缍�(j墨ng)绾栫董瓒婄窗鎺ュ彈灞€楹昏棩鐨勮〃闈㈢⿳鎰堝ぇ浣滅敤鎰堝揩銆�
12
灞€楹讳綔鐢ㄧ殑鏂瑰紡鏈夛細
(1)琛ㄩ潰楹婚唹鍦ㄧ溂銆侀蓟銆佸彛鑵旈粡鑶滀笂鐢ㄨ棩锛屼娇鎰熻绁炵稉(j墨ng)鏈ⅱ楹荤椆銆�
(2)娴告饯楹婚唹浠ュ皬鍔戦噺灞€楹昏棩澶氶粸娉ㄥ叆绲勭箶鍏�(n猫i)锛屽緸娉ㄥ皠榛炴摯鏁ｅ埌鍛ㄥ湇绲勭箶浠ラ夯閱夌缍�(j墨ng)鏈ⅱ銆�
(3)鍌冲皫(d菐o)楹婚唹鍦ㄧ缍�(j墨ng)骞查檮杩戞敞鍏ュ姂閲忓皬鑰屾績搴﹁純澶х殑灞€楹昏棩锛屼娇鍚戠缍�(j墨ng)骞叉摯鏁�锛屽緸鑰岄夯閱夌缍�(j墨ng)
骞插垎甯冪殑鍗€(q奴)鍩熴€�
(4)纭啘澶栭夯閱変互灞€楹昏棩娉ㄥ叆鑴婇珦鐨勭‖鑶滃鑵�(閫氬父鍦ㄨ枽妞庤垏绗竴灏炬闁撻枔闅欏埡鍏�)锛屼娇瑭茶檿鑴婄
缍�(j墨ng)楹婚唹銆�
(5)灏侀枆鐧傛硶灏囪棩鐗╂敞灏勮垏鎮ｉ儴鍛ㄥ湇鎴栫缍�(j墨ng)閫氳矾锛屼互闃绘柗鐥呯伓閮ㄤ綅鐨勪笉鑹矕鍕曞悜涓鍌抽仦銆�
灞€楹昏棩鍚告敹鍚庡湪鑲濊嚐鍙婂叾浠栫祫绻斾唬璎�锛屽惛鏀朵綔鐢ㄨ〃鐝�(xi脿n)鍦ㄤ腑妯炵缍�(j墨ng)绯荤当(t菕ng)鐨勫弽鎳�(y墨ng)锛屽寘鎷垐濂笉瀹�銆�
鑲岃倝闇囬～鍜岄鍘�銆傚鐣滃洜浣跨敤灞€楹昏棩鑷存杓冨皯瑕�?锛熸ⅱ绮ら﹢濞＄c闈滆剤娉ㄥ皠鎬ユ晳銆傜偤浜嗛伩鍏嶅眬楹昏棩鍚�
鏀�锛岄檷浣庡叾姣掓€у欢闀峰眬楹讳綔鐢ㄦ檪闁�锛屽彲鍦ㄥ眬楹昏棩涓姞鍏ヨ厧涓婅吅绱�锛屾瘮渚嬬偤 100 000锛�1銆�
鈼忔櫘榄崱鍥�
銆愪綔鐢ㄣ€戞湰鍝佹槸鏈€鐐哄唬娉涙噳(y墨ng)鐢ㄧ殑绗竴鍊嬪悎鎴愬眬閮ㄩ夯閱夎棩锛屽畨鍏ㄦ湁鏁�銆傜敱浜庡皪榛忚啘绌块€忓姏宸笉閬�
浜庤〃闈㈤夯閱夛紝鑰岄仼鐢ㄤ簬娴告饯楹婚唹銆傛湰鍝佸皪琛€绠＄劇鏀剁府浣滅敤锛屽洜姝ょ郸钘ュ悗鍙€插叆琛€娑插惊鐠�(hu谩n)锛屽眬楹绘檪闁�
鍍呴仈 30min锛岃嫢鍔犲叆鑵庝笂鑵虹礌鍓囧彲缍寔 1.5h銆�
鍦ㄩ珨鍏�(n猫i)澶ч儴鍒嗚垏琛€婕胯泲鐧界祼(ji茅)鍚�锛屽湪琛€婕垮拰绲勭箶琚亣鎬ц喗鍫块叝閰惰繀閫熸按瑙ｏ紝寰炲翱鎺掑嚭銆傜暥鎳�(y墨ng)鐢ㄥぇ
鍔戦噺鎴栬娉ㄥ叆闈滆剤鏅傚惛鏀堕€熷害瓒呴亷鍋囨€ц喗鍫块叝閰剁殑姘磋В鑳藉姏锛屽墖鍑虹従(xi脿n)姣掓€�銆傚叾琛ㄧ従(xi脿n)鐐轰腑妯炵缍�(j墨ng)绯荤当(t菕ng)
鑸堝ギ锛屽績鑲岃垐濂€у拰鍌冲皫(d菐o)鎬ч檷浣�銆傚鐣滃皪鍚告敹鏈搧鍚庣敘(ch菐n)鐢熸晱鎰熸€х殑闋嗗簭鏄Μ銆佽爆銆佺墰锛岀櫏鐙€鐐鸿垐濂�銆�
鐙傝簛銆佸懠鍚稿洶闆ｇ瓑銆�
銆愭噳(y墨ng)鐢ㄣ€戜富瑕佺敤鍋氬眬閮ㄩ夯閱夎棩锛涗害鍙敤浜庤В鐥欒垏閹�(zh猫n)鐥涳紝棣棛鏀ｇ枬锛�5锛呮憾娑茬珐鎱㈤潨婊�锛屾瘡 100kg
楂旈噸 1.3~1.8mL銆�
鈼忓埄澶氬崱鍥�
銆愪綔鐢ㄨ垏鎳�(y墨ng)鐢ㄣ€戞湰鍝佺殑鐗归粸鏄祫绻旂┛閫忓姏寮�锛屽綄鏁ｅ唬锛岄仼浜庝綔琛ㄩ潰楹婚唹锛岃垏鏅鍗″洜姣旇純锛屼綔
鐢ㄥ嚭鐝�(xi脿n)蹇� 2 鍊�锛岀董鎸佹檪闁撻暦涓€鍗婁互涓�锛屽彲閬� 1.5h銆傚悓鏅傛湰鍝佺殑鎿村嫉灞€閮ㄨ绠′綔鐢ㄤ笉椤憲銆�
鍙敤鍋氳〃闈㈤夯閱夈€佹蹈娼ら夯閱�銆佸偝灏�(d菐o)鏄ч唹鍜岀‖鑶滃楹婚唹婵冨害銆�
鈼忎竵鍗″洜
銆愪綔鐢ㄨ垏鎳�(y墨ng)鐢ㄣ€戜竵鍗″洜閰憾鎬ч珮锛岀祫绻旂┛閫忓姏寮枫€傞夯閱夊挤搴︽槸鏅鍗″洜鐨� 10锝�15 鍊�锛屼綔鐢ㄦ檪
闁撴瘮鏅鍗″洜闀� 1 鍊�锛屾瘨鎬у弽鎳�(y墨ng)鐐烘櫘榄崱鍥犵殑 10锝�12 鍊�銆備富瑕佺敤浜庤〃闈㈤夯閱夊拰纭啘澶栭夯閱夈€�
2.2.2 淇濊钘�
淇濊钘ヤ篃绋辩毊鑶氶粡鑶滀繚璀疯棩锛屾槸涓€椤炲皪鐨啔鍜岄粡鑶滈儴浣嶇殑绁炵稉(j墨ng)鎰熷彈鍣ㄦ湁姗熸淇濊浣滅敤锛岀珐鍜屾湁
瀹冲洜瀛愮殑鍒烘縺锛屾笡杓曠値鐧ュ拰鐤肩棝鐨勮棩鐗�銆傛牴鎿�(j霉)鍏朵綔鐢ㄧ壒榛炲彲鍒嗙偤鏀舵杺钘ャ€侀粡婕胯棩銆佸惛闄勮棩鍜屾饯婊戣棩銆�
1.鏀舵杺钘ヨ兘娌夋穩鐮存悕绲勭箶鐨勮〃灞よ泲鐧借唱(zh矛)锛屽舰鎴愪竴灞や繚璀锋€ц杽鑶滐紝绶╁拰灏嶆劅瑕虹缍�(j墨ng)鏈ⅱ鍒烘縺锛屾笡
杓曠柤鐥涜垏婊插嚭銆傚闉ｉ吀婧舵恫锛岄灒閰歌泲鐧�锛屾槑绀瓑銆�
2.鍚搁檮钘ユ槸涓€椤炰笉婧朵簬姘�銆佹€ц唱(zh矛)绌�(w臎n)瀹氱殑寰窗绮夋湯鐙€鐗╄唱(zh矛)锛岃兘鍚搁檮鏈夋瘨鐗╄唱(zh矛)鍜屽寲瀛稿埡婵€鐗�銆傚钘�
鐢ㄧ偔銆佺櫧闄跺湡绛夈€�
3.榛忔伎钘ユ槸涓€椤炶棩鐞嗘€ц唱(zh矛)涓嶆椿娼戠殑楂樺垎瀛愯啝鎬х墿璩�(zh矛)锛屽钘ョ敤娣€绮夌瓑銆�
4.娼ゆ粦钘ュ寘鎷鐗╂补椤炴饯婊戣棩锛屽璞嗘补銆佽姳鐢熸补绛夊拰绀﹁剛椤炴饯婊戣棩濡傚嚒澹灄銆佹恫楂旂煶锠熺瓑銆�
13
2.2.3 鍒烘縺钘�
鍒烘縺钘ュ皪鐨啔榛忚啘鎰熷彈鍣ㄥ拰鎰熻绁炵稉(j墨ng)鏈ⅱ鍏锋湁閬告搰鎬у埡婵€浣滅敤銆傝嚚搴婃噳(y墨ng)鐢ㄥ埡婵€钘�锛岄€氶亷鍦ㄧ敤钘�
閮ㄤ綅閬斿埌鍏呰銆佺櫦(f膩)绱呭拰绶╄В鎱㈡€х値鐧�銆傚父鐢ㄧ殑鏈夋澗绡€(ji茅)娌�銆佹皑婧舵恫銆�
3 涓绁炵稉(j墨ng)绯荤当(t菕ng)钘ョ悊
3.1 鍏ㄨ韩楹婚唹钘�
鑳戒娇鍕曠墿鎰熻娑堝け锛岀壒鍒ユ槸鐥涜娑堝け锛屼互渚块€茶澶栫鎵嬭(sh霉)鐨勮棩鐗╃ū鐐洪夯閱夎棩銆傝兘浣垮嫊鐗╃殑涓
绁炵稉(j墨ng)绯荤当(t菕ng)姗熻兘鏆仠锛岃€岃〃鐝�(xi脿n)鎰熻鑸囨剰璀樻秷澶�锛屽弽灏勮垏鑲屽嫉鍔涢儴鍒嗘垨瀹屽叏娑堝け锛屼絾浠嶄繚鎸佸欢楂撶敓鍛戒腑
妯炶垐濂€х殑楹婚唹钘ョū鐐哄叏韬夯閱夎棩銆傛牴鎿�(j霉)绲﹁棩閫斿緫锛屽叏韬夯閱夊垎鐐哄惛鍏ラ夯閱夊拰娉ㄥ皠楹婚唹(鑲岃倝娉ㄥ皠銆�
闈滆剤娉ㄥ皠)銆�
3.1.1 鍚稿叆楹婚唹钘�
鍚稿叆楹婚唹钘ュ寘鎷彯鐧�(f膩)鎬ф恫楂旂殑姘熺兎銆佺暟姘熺兎銆佷箼閱氥€佺敳姘ф盁鐑峰拰鎻櫦(f膩)鎬ф埃楂旂殑姘у寲浜炴爱绛�銆傛彯
鐧�(f膩)鎬ч夯閱夎棩閫氶亷鍛煎惛閬撳惛鍏ヨ偤娉�锛岃偤娉′腑楹婚唹钘ユ埃楂旀績搴︽剤楂�锛屽垎澹撴剤澶�锛屽湪琛€娑蹭腑鐨勬憾瑙ｅ害涔熻秺
澶�銆傞€欎簺楹婚唹鎬ф埃楂斿湪鑴傝偑鍏�(n猫i)鐨勬憾瑙ｅ害杓冨湪姘寸偤澶�锛岃€岃寰挵(hu谩n)閫佸埌鍏ㄨ韩椤炶剛绲勭箶锛岀敱浜庝腑妯炵缍�(j墨ng)绯�
绲�(t菕ng)鐨勮剛璩�(zh矛)姣旀楂斿叾浠栭儴鍒嗗锛屽洜鑰岄夯閱夎棩姘ｉ珨鏇存槗鍒嗗竷鍒拌叇绲勭箶骞剁櫦(f膩)鐢熼夯閱変綔鐢�銆傛墍浠�锛岄毃钁楀惛鍏�
楹婚唹钘ュ埌閬斾腑妯炵殑婵冨害鍙嚭鐝�(xi脿n)闅ㄦ剰閬嬪嫊鏈熴€佽垐濂湡鍜屽绉戦夯閱夋湡锛屽鏋滆棩鐗╅亷閲�锛屽墖鍙嚭鐝�(xi脿n)楹荤椆鏈熴€�
鍚稿叆楹婚唹闋堟湁闈㈢僵鍙婂皝闁夊紡鎴栧崐灏侀枆寮忚缃互骞姪鍕曠墿鍚稿叆鎻櫦(f膩)鎬ф恫楂旀垨鑰呮埃楂旈仈鍒伴夯閱夌殑
鐩殑銆傚叾鍎�(y艒u)榛炴槸鏄撲簬瑾�(di脿o)绡€(ji茅)楹婚唹娣卞害锛屼絾闋堢壒娈婅缃拰灏堜汉鐩�(ji膩n)瑕�銆�
鈼忛夯閱変箼閱�
銆愰珨鍏�(n猫i)閬庣▼銆戝垎甯冧簬椤炶剛璩�(zh矛)楂樼殑绲勭箶濡傝叇绲勭箶锛屽啀鍒嗗竷浜庤娑查噺澶氱殑鍣ㄥ畼濡傚績銆佽倽銆佽厧銆傚湪鑲�
鑸囧井绮掗珨鎺ヨЦ杞�(zhu菐n)鍖栫偤涔欓啗銆佷箼閱�銆佷箼閰稿強 CO2锛屽垎鍒ラ毃灏垮強鍛兼埃鎺掑嚭銆�
銆愪綔鐢ㄣ€戦鍏堟姂鍒剁毊灞�锛屽嚭鐝�(xi脿n)涓嶉毃鎰忛亱鍕曟€ц垐濂�锛屾鏈�(瑾樺皫(d菐o)鏈�)鍙仈 10~15 min锛岄毃钘ョ墿鍚稿叆
閲忓鍔犺€岀府鐭€傚洜姝�锛岄渶瑕佸厛闈滆剤娉ㄥ皠纭櫞濡ラ垑浣滃熀绀�(ch菙)楹婚唹锛屼娇杩呴€熼€插叆楹婚唹鏈�銆傚悓鏅傜偤娓涘皯涔欓啔
鍒烘縺鍛煎惛閬撳垎娉屾噳(y墨ng)浣滈夯閱夊墠绲﹁棩锛屽彲鍏堣倢鑲夋敞灏勯樋鎵樺搧銆傚湪楹婚唹閬庣▼涓�锛屽嫊鐗╄倢鑲夋澗寮涘ソ锛屽畨鍏ㄨ寖
鍦嶅ぇ銆�
鈼忔盁鐑�
銆愰珨鍏�(n猫i)閬庣▼銆戝ぇ閮ㄥ垎缍�(j墨ng)鑲轰互鍘熷舰鍛兼埃鎺掑嚭锛屽皬閮ㄥ垎鍦ㄨ倽涓敓鐗╄綁(zhu菐n)鍖栫偤姘€佹盁銆佹捍鍖栫墿锛岄毃灏�銆�
姹�銆佺碁鎺掑嚭锛孋O2 鐢辫偤鎺掑嚭銆�
銆愪綔鐢ㄣ€戞盁鐑疯獦灏�(d菐o)鏈熸瘮涔欓啔鐭�锛岃捣鏁堝揩锛岃槆閱掑揩锛岄夯閱変綔鐢ㄥ挤锛屼絾鑲屾澗浣滅敤鍙婇幃(zh猫n)鐥涗綔鐢ㄥ急锛岀劇
榛忚啘鍒烘縺鎬с€�
3.1.2 娉ㄥ皠楹婚唹钘�
閫欓钘ョ墿甯哥敤闈滆剤娉ㄥ皠楹婚唹锛屾煇浜涢夯閱夎棩涔熷彲鐢ㄤ簬鑲岃倝娉ㄥ皠楹婚唹銆傞潨鑴堟敞灏勯夯閱夋槸鐩存帴浣胯棩鐗�
14
閫插叆寰挵(hu谩n)锛屽洜姝や笉鍑虹従(xi脿n)涓嶉毃鎰忛亱鍕曟湡(鑸堝ギ鏈�)鍙嶆噳(y墨ng)锛屽嫊鐗╄繀閫熼仈鍒伴夯閱�銆傛柟娉曠啊渚�锛屼絾楹婚唹鍒嗘湡涓�
鏄庨’銆傜敱浜庣暥鍓嶅皻鐒′竴绋夯閱夋柟娉曟垨楹婚唹钘ョ敘(ch菐n)鐢熺悊鎯崇殑楹婚唹锛屽線寰€浣跨敤鐭檪浣滅敤鐨勯潨鑴堟敞灏勯夯閱夎棩
浣滃惛鍏ラ夯閱夊墠鐨勮獦灏�(d菐o)楹婚唹鎴栫ū鍩虹(ch菙)楹婚唹銆�
楹婚唹钘ユ敞灏勫悗鍦ㄩ珨鍏�(n猫i)涓嶆槗鎺掑嚭锛岄夯閱夋繁搴︿笉鏄撴帶鍒�锛岄€欐槸娉ㄥ皠楹婚唹鐨勫急榛�銆備絾灏嶄娇鐢ㄩ夯閱夎棩鏈�
缍�(j墨ng)椹楃殑鐛搁啱(y墨)甯告噳(y墨ng)鐢ㄩ潨鑴堟敞灏勯夯閱変互浣垮嫊鐗╁畨闈滈€插叆澶栫楹婚唹鏈�锛屼笉鏈冨嚭鐝�(xi脿n)鑸堝ギ銆佹帣鎵庡強鐧�(f膩)鐢熷偡瀹充汉
鐣滀簨鏁咃紝涓斾笉蹇呮湁鍚稿叆楹婚唹瑁濈疆銆傞潨鑴堟敞灏勯夯閱夊悗鐨勮槆閱掓湡姣斿惛鍏ラ夯閱夐暦銆�
鈼忕～鍣村Ε閳�
銆愰珨鍏�(n猫i)閬庣▼銆戠敱浜庡叾鑴傛憾鎬ч珮锛屾サ鏄撻€忛亷琛€鑵﹀睆闅滐紝1 min 鍏�(n猫i)鍕曠墿杩呴€熼夯閱�銆傛暩(sh霉)鍒嗛悩鍚庤棩鐗╁湪
楂斿収(n猫i)閲嶆柊鍒嗗竷鑷宠剛鑲祫绻旇€岃嚧鑵﹀収(n猫i)钘ョ墿婵冨害涓嬮檷锛屾渶鍚庡湪鑲濈牬澹�锛岀敱灏挎帓鍑�銆�
銆愪綔鐢ㄨ垏鎳�(y墨ng)鐢ㄣ€戝皪澶ц叇鐨堡鎶戝埗浣滅敤蹇紝杩呴€熷嚭鐝�(xi脿n)楹婚唹锛岀敱浜庤棩鐗╁湪楂斿収(n猫i)蹇€熻綁(zhu菐n)閬嬨€佸劜瀛樹簬鑴�
鑲祫绻斿収(n猫i)鑰岃嚧楹婚唹浣滅敤妤电偤鐭毇銆備互鐘偤渚�锛岄潨鑴堟敞灏� 15~17mg/kg锛屽彲鐛插緱 7~10min 楹婚唹锛�
18~22mg/kg 閬� 10~15min 楹婚唹锛岃€� 22~29mg/kg 鍓囬仈 15~25min 楹婚唹銆傜敤鍏跺ぇ鍔戦噺鎴栭噸寰�(f霉)绲﹁棩锛屽彲
澧炲挤楹婚唹娣卞害锛屽欢闀烽夯閱夋檪闁�锛屼絾涔熷鏄撳紩璧峰懠鍚告姂鍒讹紝蹇呴爤鎱庣敤銆傛湰鍝佽倢鏉句綔鐢ㄥ樊锛岄幃(zh猫n)鐥涗綔鐢ㄥ急銆�
甯哥敤浜庣墰銆佽爆銆佺姮鐨勫叏韬夯閱夋垨鍩虹(ch菙)楹婚唹钘ャ€侀Μ灞嫊鐗╃殑鍩虹(ch菙)楹婚唹钘�銆�
鈼忔隘
鍏嶈铂鑱叉槑锛氭湰鏂囩郴杞�(zhu菐n)杓夎嚜缍�(w菐ng)绲�(lu貌)锛屽鏈変镜鐘紝璜嬭伅(li谩n)绯绘垜鍊戠珛鍗冲埅闄�锛屽彟锛氭湰鏂囧儏浠ｈ〃浣滆€呭€嬩汉瑙€榛�锛岃垏鏈恫(w菐ng)绔欑劇闂�(gu膩n)銆傚叾鍘熷壍(chu脿ng)鎬т互鍙婃枃涓櫝杩版枃瀛楀拰鍏�(n猫i)瀹规湭缍�(j墨ng)鏈珯璀夊锛屽皪鏈枃浠ュ強鍏朵腑鍏ㄩ儴鎴栬€呴儴鍒嗗収(n猫i)瀹广€佹枃瀛楃殑鐪熷鎬�銆佸畬鏁存€�銆佸強鏅傛€ф湰绔欎笉浣滀换浣曚繚璀夋垨鎵胯锛岃珛璁€鑰呭儏浣滃弮鑰�锛屽苟璜嬭嚜琛屾牳瀵︾浉闂�(gu膩n)鍏�(n猫i)瀹广€�
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鏂囩珷鎼滅储
鎮ㄧ従(xi脿n)鍦ㄧ殑浣嶇疆锛� 
