2022骞村│鐢�(ch菐n)绉戜富娌婚啱(y墨)甯簿閬哥煡璀�(sh铆)榛�(di菐n)锛氫笉瀛曠櫏

婧Θ鎻愮ず锛�2022骞磋(w猫i)鐢熻硣鏍煎│鐢�(ch菐n)绉戜富娌婚啱(y墨)甯€冭│鍫�(b脿o)鍚嶄簬2021骞�12鏈�8鏃ラ枊(k膩i)濮�锛屾兂瑕佸弮鍔�2022骞村│鐢�(ch菐n)绉戜富娌婚啱(y墨)甯€冭│鍙互榛�(di菐n)鎿� 鍏嶈不(f猫i)闋�(y霉)绱勭煭淇℃彁閱�鍔熻兘锛岄棞(gu膩n)浜�2022骞磋€冭│鍫�(b脿o)鍚嶃€佺钩璨�(f猫i)銆佹簴(zh菙n)鑰冭瓑鎵撳嵃绛夐噸瑕佹檪(sh铆)闁撶瘈(ji茅)榛�(di菐n)鐠�(hu谩n)鐞冪恫(w菐ng)鏍￠兘鏈�(hu矛)閫氶亷(gu貌)鐭俊鎻愬墠閫氱煡鎮�锛屽姪鎮ㄥ畨蹇冨倷鑰�銆�

涓嶈偛鑸囦笉瀛曠殑鍗€(q奴)鍒�?

鑳芥嚪瀛曡€岀劇(w煤)姝ｅ父瓒虫湀鍒嗗ī鐨勪笉鑲诧紝濡傛祦鐢�(ch菐n)銆佹棭鐢�(ch菐n)銆佹鑳庛€佹鐢�(ch菐n)銆佸澶栧瓡绛夛紝闆栧濞犺€岀劇(w煤)娲诲鐛插緱锛屼笉灞笉瀛曠櫏鑼冨湇銆�

銆愮梾鍥犮€�

鍘熷洜涓嶆槑鎬т笉瀛�?

——濡傛湭閫�(j矛n)琛岃吂鑵旈彙鑸囬枊(k膩i)鑵规墜琛�(sh霉)锛屽師鍥犱笉鏄庣殑瑷烘柗鍙兘瑾�(r猫n)鐐烘槸“鏈壘鍒板師鍥�”锛屽洜鏈夐伜婕忓瓙瀹収(n猫i)鑶滅暟浣嶇櫏鐨勫彲鑳�銆�

涓嶆槑鍘熷洜鎬т笉瀛�?

——缍�(j墨ng)鑵硅厰閺℃垨闁�(k膩i)鑵规墜琛�(sh霉)锛屼粛鐒舵湭鎵惧埌鍘熷洜鐨勪笉瀛�銆�

銆愯ê鏂疯榛�(di菐n)銆�

閫氶亷(gu貌)鐢峰コ闆欐柟鍏ㄩ潰妾㈡煡鎵惧嚭鍘熷洜锛屾槸瑷烘柗涓嶅瓡鐧ョ殑闂�(gu膩n)閸�锛岄渶鐢锋柟妾㈡煡銆佸コ鏂规鏌�銆佸厤鐤(xu茅)妾㈡煡銆�

涓€銆佺敺鏂规鏌�

瑭㈠晱(w猫n)鏃㈠線鏈夌劇(w煤)鎱㈡€х梾鐥呭彶锛屽绲�(ji茅)鏍�銆佽叜鑵虹値绛�;

浜嗚В鎬х敓娲绘儏娉�锛屾湁鐒�(w煤)鎬т氦鍥伴洠;

妾㈡煡澶栫敓娈栧櫒鏈夌劇(w煤)鐣稿舰鎴栫梾璁�;

閲嶉粸(di菐n)鏄簿娑插父瑕�(gu墨)妾㈡煡銆�

---绮炬恫甯歌(gu墨)妾㈡煡---

鍙栨潗锛歐HO寤鸿闁撻殧涓€鍊�(g猫)鏈堜互涓婅嚦灏戝叐娆″彇绮炬恫閫�(j矛n)琛屽垎鏋愮祼(ji茅)鏋滃彲闈�銆傚彇绮炬恫锛岃姹傜娆�3澶┿€�

绮炬恫甯歌(gu墨)姝ｅ父鍊硷細鎸塛HO鎻愮ず——

姣忔鎺掑嚭绮炬恫閲�≥2ml锛屼竴鑸笉瓒呴亷(gu貌)6ml;

瀹ゆ韩涓�60鍒嗛悩鑳芥恫鍖�;

pH鐐�7.2锝�7.8;

瀵嗗害≥20.0×106/ml;

绮惧瓙閬�(y霉n)鍕�(d貌ng)娲诲姏鍒嗙偤“a銆乥銆乧銆乨”4绱�(j铆)銆�

a锛氬揩閫熷墠鍚戦亱(y霉n)鍕�(d貌ng);

b锛氭參閫熷憜婊殑鍓嶅悜閬�(y霉n)鍕�(d貌ng);

c锛氶潪鍓嶅悜閬�(y霉n)鍕�(d貌ng);

d锛氫笉鍕�(d貌ng)

姝ｅ父鏅�(sh铆)鍓嶅悜閬�(y霉n)鍕�(d貌ng)绮惧瓙鏁�(sh霉)≥50%(灏勭簿1灏忔檪(sh铆)鍏�(n猫i));

闋舰鎱�(t脿i)姝ｅ父绮惧瓙鏁�(sh霉)鎳�(y墨ng)≥30%;

鐧界窗(x矛)鑳�<1×106/ml銆�

绮炬恫鐣板父——浣庝簬浠ヤ笂姝ｅ父妯�(bi膩o)婧�(zh菙n)!

绮惧瓙瀵嗗害灏戜簬2000钀�(w脿n)/ml鐐哄皯绮撅紝灏戜簬500钀�(w脿n)/ml鐐哄毚(y谩n)閲嶅皯绮�锛屽皠鍑烘湁绮炬恫鑰屾湭妾㈠嚭鏈夌簿瀛愮偤鐒�(w煤)绮�;

绮惧瓙娲诲姏a鑸嘼椤�(l猫i)涔嬪拰灏戜簬50%鎴朼灏戜簬25%鐐哄急绮�;

闋儴褰㈡厠(t脿i)姝ｅ父绮惧瓙灏戜簬30%鐐虹暩褰㈢簿瀛愮櫏銆�

WHO浜旂増灏�(du矛)浠ヤ笂妯�(bi膩o)婧�(zh菙n)閫�(j矛n)琛屼簡涓€浜涙柊鐨勪慨瑷傦細

瀵嗗害≥15.0×106/ml;

绮惧瓙蹇€熷悜鍓嶉亱(y霉n)鍕�(d貌ng)鍜屾參閫熷憜婊殑鍓嶅悜閬�(y霉n)鍕�(d貌ng)绲�(t菕ng)绋辩偤鍓嶅悜閬�(y霉n)鍕�(d貌ng)锛�≥32%鐐烘甯�;

姝ｅ父褰㈡厠(t脿i)绮惧瓙鏁�(sh霉)鎳�(y墨ng)≥15%锛�≥4%鍗冲彲鐢ㄤ簬瀛愬鑵斿収(n猫i)浜哄伐鎺堢簿

浜屻€佸コ鏂规鏌�

1.鍟�(w猫n)鐥呭彶

2.楂旀牸妾㈡煡——娉ㄦ剰妾㈡煡绗簩鎬у緛鍙婂収(n猫i)銆佸鐢熸畺鍣ㄧ殑鐧�(f膩)鑲叉儏娉�锛屾湁鐒�(w煤)鐣稿舰銆佺値鐧�銆佸寘濉婄瓑銆�

3.濂虫€т笉瀛曠壒娈婃鏌�

绗竴姝ワ細鍗靛发鍔熻兘妾㈡煡

绗簩姝ワ細杓稿嵉绠￠€氭殺瑭﹂(y脿n)

绗笁姝ワ細瀹厰閺℃鏌�

鑵硅厰閺℃鏌�

绗竴姝ワ細鍗靛发鍔熻兘妾㈡煡鐨勬柟娉曟湁鍝簺?

甯哥敤鐨勬柟娉曟湁---

B瓒�

鍩虹(ch菙)楂旀韩娓�(c猫)瀹�

闄伴亾绱�(x矛)鑳炴秱鐗�

瀹牳榛忔恫妾㈡煡

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鍩虹(ch菙)楂旀韩娓�(c猫)瀹氾細

鍠浉——鐒�(w煤)鎺掑嵉;

闆欑浉——鏈夋帓鍗�銆�

闄伴亾绱�(x矛)鑳炴秱鐗囷細

瑙掑寲绱�(x矛)鑳為毃闆屾縺绱犺紩銆佷腑銆侀噸搴﹀奖闊垮垎鍒ュ崰20%銆�20%锝�60%鍙�60%浠ヤ笂銆�

瀹牳榛忔恫妾㈡煡锛�

缇婇綊妞嶇墿鐙€绲�(ji茅)鏅�——E褰遍熆;

姗㈠湏楂旂媭绲�(ji茅)鏅�——P褰遍熆銆�

缍�(j墨ng)鍓嶈ê鏂锋€у埉瀹�(瀛愬鍏�(n猫i)鑶滅祫绻斿(xu茅)妾㈡煡)锛�

鍒嗘硨鏈熸敼璁�——琛ㄦ槑鏇炬湁閬�(gu貌)鎺掑嵉;

鍒嗘硨鐗瑰緛钀藉悗2澶╀互涓�——瑷烘柗榛冮珨鍔熻兘涓嶈冻;

澧炴畺鏈熸敼璁�——鎻愮ず鐒�(w煤)鎺掑嵉銆�

濂虫€ф縺绱犳脯(c猫)瀹氾細

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2.琛€瀛曢叜姘村钩澶т簬16nmol/L(5ng/ml)鎻愮ず鎺掑嵉;榛冮珨涓湡琛€瀛曢叜婵冨害鎳�(y墨ng)楂橀仈(d谩)31.8nmol/L(10ng/ml)锛屼綆浜庢鍊煎彲浠ヨ獚(r猫n)鐐洪粌楂斿姛鑳戒笉瓒炽€�

3.闁夌稉(j墨ng)鎮ｈ€呰FSH>40IU/L鎻愮ず鍗靛发鍏�(n猫i)鍗垫场鑰楃锛岄枆缍�(j墨ng)鐐哄嵉宸㈡€с€�

绗簩姝ワ細杓稿嵉绠￠€氭殺瑭﹂(y脿n)锛�

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绗笁姝ワ細瀹厰閺�銆佽吂鑵旈彙

涓�銆佸厤鐤(xu茅)妾㈡煡

1.鎬т氦鍚庤│椹�(y脿n)

鐩殑锛氫富瑕佹娓�(c猫)瀹牳榛忔恫灏�(du矛)绮惧瓙鐨勫弽鎳�(y墨ng)鍙婄簿瀛愮┛閫忛粡娑茬殑鑳藉姏锛屾槸妾㈡脯(c猫)濂虫€х敓娈栭亾灞€閮ㄦ姉绮惧瓙鎶楅珨鐨勬柟娉�銆�

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绲�(ji茅)鏋滐細濡傛瘡楂樺€嶈閲�(400×)鏈�50鍊�(g猫)浠ヤ笂娲诲嫊(d貌ng)绮惧瓙锛岃獚(r猫n)鐐虹祼(ji茅)鏋滆壇濂�;鍏锋湁20鍊�(g猫)浠ヤ笂娲诲嫊(d貌ng)绮惧瓙锛屽彲瑾�(r猫n)鐐烘甯�銆�

2.绮惧瓙鍏嶇柅瀛�(xu茅)妾㈡煡

鈶犳鏌ョ簿瀛愯〃闈㈡姉楂旓紝鐢ㄧ洿鎺ユ硶銆�

鏂规硶锛歁AR瑭﹂(y脿n)鍓囧皣鏂伴绮炬恫鑸囧寘瑁逛汉IgG涔宠啝绮掓垨缍跨緤绱呯窗(x矛)鑳炴贩鍚�锛屾贩鍚堟恫涓姞鍏ユ姉浜篒gG鎶楄娓呫€�

绲�(ji茅)鏋滐細琚绮掗粡闄勭殑绮惧瓙鎳�(y墨ng)灏戜簬10%;

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銆愯檿鐞嗚榛�(di菐n)銆�

绶ㄨ集鎺ㄨ枽锛�2022骞村│鐢�(ch菐n)绉戜富娌婚啱(y墨)甯牨(b脿o)鍚嶆浠舵湁鍝簺锛�

閫欏洓椤�(l猫i)鍚屽(xu茅)鍙彁鍓嶅牨(b脿o)鑰�2022骞村│鐢�(ch菐n)绉戜富娌婚啱(y墨)甯€冭│!

浠ヤ笂鏄挵(hu谩n)鐞冪恫(w菐ng)鏍″皬绶ㄧ偤澶у鏁寸悊鐨勯棞(gu膩n)浜�“2022骞村│鐢�(ch菐n)绉戜富娌婚啱(y墨)甯簿閬哥煡璀�(sh铆)榛�(di菐n)锛氫笉瀛曠櫏锛堜笂锛�”鐨勫収(n猫i)瀹�锛屽鏋滄兂浜嗚В鏇村鑰冭│璩囪▕锛岃珛(q菒ng)瀵嗗垏闂�(gu膩n)娉ㄥ│鐢�(ch菐n)绉戜富娌婚啱(y墨)甯€冭│闋婚亾锛屾彁鍓嶄娇鐢� 鍏嶈不(f猫i)闋�(y霉)绱勭煭淇℃彁閱�鍔熻兘锛岀嵅鍙栬€冭│鐩搁棞(gu膩n)鐨勯噸瑕佹檪(sh铆)闁撶瘈(ji茅)榛�(di菐n)銆傜挵(hu谩n)鐞冪恫(w菐ng)鏍¤€佸斧鐐哄ぇ瀹舵簴(zh菙n)鍌欎簡濠︾敘(ch菐n)绉戜富娌婚啱(y墨)甯€冭│澶х侗銆侀珮闋昏€冮粸(di菐n)銆佹ā鎿│椤岀瓑鍌欒€冭硣鏂�锛屽彲榛�(di菐n)鎿婁笅鏂规垨鑰呮枃绔犲彸鍋�(c猫)“濠︾敘(ch菐n)绉戜富娌婚啱(y墨)甯硣鏂欎笅杓�”閫�(j矛n)琛�鍏嶈不(f猫i)涓嬭級鍚э紒