{"id":2696,"date":"2022-09-14T22:10:48","date_gmt":"2022-09-14T14:10:48","guid":{"rendered":"http:\/\/oncolab.cn\/index.php\/2022\/09\/14\/%e5%85%8d%e7%96%ab%e5%ad%a6%e6%8b%be%e9%81%97-%e7%ac%ac33%e7%ab%a0%ef%bc%9a%e7%bb%a7%e5%8f%91%e6%80%a7%e5%85%8d%e7%96%ab%e7%bc%ba%e9%99%b7%e7%97%85\/"},"modified":"2022-09-14T22:10:48","modified_gmt":"2022-09-14T14:10:48","slug":"%e5%85%8d%e7%96%ab%e5%ad%a6%e6%8b%be%e9%81%97-%e7%ac%ac33%e7%ab%a0%ef%bc%9a%e7%bb%a7%e5%8f%91%e6%80%a7%e5%85%8d%e7%96%ab%e7%bc%ba%e9%99%b7%e7%97%85","status":"publish","type":"post","link":"http:\/\/oncolab.cn\/index.php\/2022\/09\/14\/%e5%85%8d%e7%96%ab%e5%ad%a6%e6%8b%be%e9%81%97-%e7%ac%ac33%e7%ab%a0%ef%bc%9a%e7%bb%a7%e5%8f%91%e6%80%a7%e5%85%8d%e7%96%ab%e7%bc%ba%e9%99%b7%e7%97%85\/","title":{"rendered":"\u514d\u75ab\u5b66\u62fe\u9057-\u7b2c33\u7ae0\uff1a\u7ee7\u53d1\u6027\u514d\u75ab\u7f3a\u9677\u200b\u75c5"},"content":{"rendered":"
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\u672c\u7ae0\u4ecb\u7ecd\u4e86\u51e0\u79cd\u7ee7\u53d1\u6027\u514d\u75ab\u7f3a\u9677\u75be\u75c5<\/strong>\uff0c\u5176\u4e2d\u6700\u91cd\u8981\u7684\u662f\u827e\u6ecb\u75c5<\/strong>\uff0c\u5176\u53d1\u75c5\u7387\u9ad8\uff0c\u5e76\u4e14\u53ef\u9020\u6210\u4e25\u91cd\u7684\u514d\u75ab\u7f3a\u9677\u3002\u7ee7\u53d1\u6027\u514d\u75ab\u7f3a\u9677\u75c5\u4e0e\u539f\u53d1\u6027\u514d\u75ab\u7f3a\u9677\u75c5\u4e00\u6837\u90fd\u4f1a\u5bfc\u81f4\u673a\u4f53\u611f\u67d3\u548c\u80bf\u7624\u7684\u8bf1\u53d1\u3002\u800c\u6240\u53d7\u611f\u67d3\u7684\u5177\u4f53\u7c7b\u578b\u5219\u53d6\u51b3\u4e8e\u7ee7\u53d1\u6027\u514d\u75ab\u7f3a\u9677\u5177\u4f53\u5f71\u54cd\u7684\u662f\u514d\u75ab\u7cfb\u7edf\u7684\u54ea\u90e8\u5206\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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HIV\u611f\u67d3<\/strong><\/span>
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\u76ee\u524d\u4e16\u754c\u4e0a\u7ea6\u67094000\u4e07\u4eba<\/strong>\u611f\u67d3\u4e86\u827e\u6ecb\u75c5\u75c5\u6bd2\uff0c\u6bcf\u5e74\u65b0\u589e\u611f\u67d3\u6570\u7ea6200\u4e07<\/strong>\uff0c\u5e76\u4e14\u5176\u4e2d10\uff05\u7684\u65b0\u589e\u75c5\u4f8b\u4e3a\u513f\u7ae5\uff0c\u4e14\u6bcf\u5e74\u7ea6120\u4e07\u4eba<\/strong>\u6b7b\u4e8e\u827e\u6ecb\u75c5\u3002<\/p>\n

\u4e86\u89e3HIV\u7684\u53d1\u5c55\u5386\u53f2\u53ca\u5176\u4e0e\u514d\u75ab\u7cfb\u7edf\u76f8\u4e92\u4f5c\u7528\u7684\u65b9\u5f0f<\/span>\uff0c\u53ef\u4ee5\u5e2e\u52a9\u6211\u4eec\u4e86\u89e3\u6297HIV\u836f\u7269\u5982\u4f55\u53d1\u6325\u4f5c\u7528\uff0cHIV\u75c5\u6bd2\u7684\u68c0\u6d4b\u65b9\u6cd5\uff0c\u4ee5\u53ca\u7406\u89e3\u4e3a\u4ec0\u4e48\u96be\u4ee5\u5f00\u53d1\u5177\u6709\u9488\u5bf9\u6027\u7684\u75ab\u82d7\u7b49\u95ee\u9898\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4eba\u7c7b\u514d\u75ab\u7f3a\u9677\u75c5\u6bd2(HIV)\u4fb5\u5165\u5bbf\u4e3b\u7ec6\u80de<\/strong><\/p>\n<\/section>\n

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HIV\u662f\u2f00\u79cd\u7ed3\u6784\u7b80\u5355\u7684\u75c5\u6bd2(Fig 33.1A<\/span>)\u3002\u5c3d\u7ba1\u7ecf\u8fc7RNA\u62fc\u63a5\u548c\u80bd\u5904\u7406\uff0c\u5b83\u53ef\u4ee5\u7f16\u7801\u5927\u7ea6\u4e5d\u79cd\u4e0d\u540c\u7684\u86cb\u767d\u8d28\uff0c\u4f46\u662f\u5b83\u7684\u57fa\u56e0\u7ec4\u5374\u53ea\u5305\u542b\u4e09\u4e2a\u57fa\u56e0<\/strong>\u3002<\/p>\n

HIV\u662f\u4e00\u79cd\u9006\u8f6c\u5f55\u75c5\u6bd2<\/strong>\uff0c\u5b83\u7684RNA\u57fa\u56e0\u7ec4\u4f1a\u5728\u5bbf\u4e3b\u7ec6\u80de\u4e2d\u9006\u8f6c\u5f55\u6210DNA\uff0c\u5b83\u7684\u57fa\u56e0\u7ec4\u548c\u4e00\u4e9b\u9176\u4f1a\u88ab\u5305\u819c<\/strong>\u5305\u88f9\uff0c\u800c\u8fd9\u79cd\u5305\u819c\u5219\u662f\u7531gp120<\/strong><\/span>\u548cgp41<\/strong><\/span>\u8fd9\u4e24\u79cd\u7cd6\u86cb\u767d<\/strong>\u7ec4\u6210\uff0c\u4e14\u8fd9\u4e24\u79cd\u7cd6\u86cb<\/span>\u767d\u5728HIV\u7ed3\u5408\u548c\u8fdb\u5165\u5bbf\u4e3b<\/strong>\u7ec6\u80de<\/strong>\u4e2d\u53d1\u6325\u91cd\u8981\u4f5c\u7528(Fig 33.1 B~E<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 33.1 <\/span>HIV\u501f\u52a9CD4\u548c\u8d8b\u5316\u56e0\u5b50\u53d7\u4f53\u611f\u67d3\u5bbf\u4e3b\u7ec6\u80de\u3002B ~ E \u662f HIV \u4e0e\u9776\u7ec6\u80de\u76f8\u4e92\u4f5c\u7528\u7684\u793a\u610f\u56fe\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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HIV\u4fb5\u5165\u4eba\u4f53\u7684\u5177\u4f53\u8fc7\u7a0b\u5982\u4e0b\uff1a<\/strong>
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1.\u9996\u5148\uff0cHIV\u4e0a\u7684gp120<\/strong>\u4e0eCD4\u5206\u5b50<\/strong>\u7ed3\u5408\u3002HIV\u53ef\u4ee5\u5f88\u5bb9\u6613\u5730\u4e0eCD4\u5206\u5b50\u7ed3\u5408\u3002\u867d\u7136\u8fd9\u79cd\u76f8\u4e92\u4f5c\u7528\u5e76\u4e0d\u80fd\u4f7f\u75c5\u6bd2\u63a5\u8fd1\u5bbf\u4e3b\u7ec6\u80de\u8868\u9762\uff0c\u4f46\u5bbf\u4e3b\u7ec6\u80de\u4e0aCD4\u7684\u5b58\u5728\u662fHIV\u5f97\u4ee5\u4fb5\u5165\u7684\u5148\u51b3\u6761\u4ef6\uff0c\u56e0\u6b64HIV\u53ea\u611f\u67d3CD4+<\/sup>T\u7ec6\u80de<\/span>\u3001\u5355\u6838\u7ec6\u80de<\/span>\u548c\u5355\u6838\u7ec6\u80de\u6765\u6e90\u7684\u5de8\u566c\u7ec6\u80de<\/span>\u53ca\u6811\u7a81\u72b6\u7ec6\u80de<\/span>(\u89c1Fig 33.1B<\/span>)\u3002<\/p>\n

2.\u968f\u540e\uff0cgp120<\/strong>\u4e0e\u51e0\u79cd\u8d8b\u5316\u56e0\u5b50\u53d7\u4f53<\/strong>\u4e2d\u7684\u2f00\u79cd\u76f8\u7ed3\u5408(\u89c1Fig 33.1C)\uff0c\u901a\u5e38\u662f\u4e0eCCR5<\/strong>\u7ed3\u5408\u3002
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3.\u7531\u4e8e\u8d8b\u5316\u56e0\u5b50\u53d7\u4f53\u7684\u80de\u5916\u533a\u8f83\u77ed(\u7b2c24\u7ae0<\/span>)\uff0c\u6240\u4ee5gp120\u4e0e\u8d8b\u5316\u56e0\u5b50\u53d7\u4f53\u7684\u7ed3\u5408\u4f1a\u4f7fgp120\u80fd\u591f\u63a5\u8fd1\u5bbf\u4e3b\u7ec6\u80de<\/strong>\u3002\u540c\u65f6\uff0c\u4e0e\u8d8b\u5316\u56e0\u5b50\u53d7\u4f53\u7684\u7ed3\u5408\u4e5f\u4f1a\u5f15\u8d77gp41\u5206\u5b50<\/strong>\u7684\u53d8\u5316\u3002gp41\u5206\u5b50\u7684\u7ed3\u6784\u7c7b\u4f3c\u4e8e\u5c01\u95ed\u7684\u62c9\u94fe\uff0c\u4f46\u5f53gp120\u4e0e\u8d8b\u5316\u56e0\u5b50\u53d7\u4f53\u7ed3\u5408\u65f6\uff0cgp41\u4f1a\u89e3\u5f00\u5e76\u7a7f\u900f<\/strong>\u5bbf\u4e3b\u7ec6\u80de\u7ec6\u80de\u819c(\u89c1Fig 33.1D<\/span>)\u3002<\/p>\n

4.\u6700\u540egp41\u6062\u590d\u4e3a\u539f\u672c\u7684\u957f\u5ea6\uff0c\u5e76\u6709\u6548\u5730\u878d\u5408\u75c5\u6bd2\u7684\u5305\u819c\u548c\u7ec6\u80de\u819c<\/strong>\u3002(\u89c1Fig 33.1E<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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HIV\u57fa\u56e0\u7ec4\u7684\u9006\u8f6c\u5f55<\/p>\n<\/section>\n

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\u9006\u8f6c\u5f55\u9176<\/strong>\u968fRNA\u57fa\u56e0\u7ec4\u2f00\u8d77\u8fdb\u5165\u5bbf\u4e3b\u7ec6\u80de\u3002\u9006\u8f6c\u5f55\u9176\u5229\u7528RNA\u57fa\u56e0\u7ec4\u5236\u9020\u53cc\u94feDNA\u8f6c\u5f55\u672c\uff0c\u5c06\u5176\u81ea\u8eab\u57fa\u56e0\u5e8f\u5217\u63d2\u5165\u5bbf\u4e3b\u57fa\u56e0\u7ec4<\/strong>\uff08Fig 33.2A\uff0cB<\/span>)\u3002<\/p>\n

\u9006\u8f6c\u5f55\u9176\u662f\u4e00\u79cd\u5bb9\u6613\u51fa\u9519<\/strong>\u7684\u9176\uff0c\u5728\u9006\u8f6c\u5f55\u8fc7\u7a0b\u4e2d\uff0c\u6bcf10,000\u4e2a\u78b1\u57fa\u4e2d\u5c31\u67091\u4e2a\u53d1\u751f\u7a81\u53d8\uff0c\u800c\u827e\u6ecb\u75c5\u6bd2\u672c\u8eab\u4e0d\u5177\u5907\u7ea0\u6b63\u8fd9\u4e9b\u7a81\u53d8\u7684\u673a\u5236\u3002\u8fd9\u5c31\u610f\u5473\u7740\u827e\u6ecb\u75c5\u6bd2\u7684\u6bcf\u4e09\u4e2a\u751f\u547d\u5468\u671f\u4e2d\uff0c\u5c31\u4f1a\u4ea7\u751f\u4e00\u4e2a\u542b\u6709\u65b0\u53d8\u5f02\u7684\u75c5\u6bd2\u3002\u7531\u4e8e\u8fd9\u79cd\u9ad8\u53d8\u5f02\u7387<\/strong>\uff0c\u5728\u611f\u67d3\u4e00\u79cdHIV\u75c5\u6bd2\u540e\u7684\u51e0\u5468\u5185\uff0c\u5927\u591a\u6570\u60a3\u8005\u4f53\u5185\u90fd\u4f1a\u68c0\u6d4b\u5230\u8bb8\u591a\u4e0d\u540c\u7684\u75c5\u6bd2\u682a\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 33.2\uff1a<\/span>\u9006\u8f6c\u5f55\u662f\u4e00\u4e2a\u5bb9\u6613\u51fa\u9519\u7684\u8fc7\u7a0b\u3002\u8fd9\u4e2a\u8fc7\u7a0b\u4e2d\uff0c HIV \u80fd\u591f\u6539\u53d8\u5176\u6297\u539f\u7ed3\u6784\u3001\u5bf9\u4e0d\u540c\u8d8b\u5316\u56e0\u5b50\u53d7\u4f53\u7684\u4eb2\u548c\u529b\u4ee5\u53ca\u5bf9\u6297\u9006\u8f6c\u5f55\u75c5\u6bd2\u836f\u7269\u7684\u654f\u611f\u6027\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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HIV\u7684\u6f5c\u4f0f\u671f\u4e0e\u8f6c\u5f55<\/strong><\/p>\n<\/section>\n

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\u2f00\u65e6\u63d2\u5165\u5bbf\u4e3b\u57fa\u56e0\u7ec4\uff0cHIV\u7684\u4e09\u4e2a\u57fa\u56e0\u5c31\u4e0e\u5bbf\u4e3b\u57fa\u56e0\u4fdd\u6301\u534f\u540c\u4e00\u81f4\u3002\u5927\u591a\u6570\u60c5\u51b5\u4e0b\uff0c\u8fd9\u4e9b\u57fa\u56e0\u662f\u6c89\u9ed8\u7684\uff0c\u4e0d\u4f1a\u8fdb\u884c\u8f6c\u5f55\uff0c\u5904\u4e8e\u75c5\u6bd2\u6f5c\u4f0f\u671f<\/strong>\uff0c\u4e14\u5927\u591a\u6570\u53d7\u611f\u67d3\u7684\u7ec6\u80de\u75c5\u6bd2\u4f1a\u957f\u671f\u5904\u4e8e<\/span>\u6f5c\u4f0f\u671f\u3002\u8fd9\u4e9b\u88ab\u611f\u67d3\u7684\u7ec6\u80de\uff0c\u7279\u522b\u662f\u5de8\u566c\u7ec6\u80de<\/strong>\uff0c\u6e10\u6e10\u6210\u4e3a\u4e86\u611f\u67d3\u7684\u201c\u84c4\u6c34\u6c60\u201d\uff08\u79ef\u7d2f\u4e86\u8bb8\u591a\u53ef\u4ee5\u5bfc\u81f4\u611f\u67d3\u7684\u56e0\u7d20\uff09\u3002\u5728\u6ca1\u6709DNA\u590d\u5236\u7684\u60c5\u51b5\u4e0b\uff0cHIV\u80bd\u4e0d\u4f1a\u8868\u8fbe\uff0c\u6545\u611f\u67d3\u7684\u7ec6\u80de\u4e5f\u4e0d\u4f1a\u88ab\u514d\u75ab\u7cfb\u7edf\u8bc6\u522b\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4e00\u65e6\u5bbf\u4e3b\u7ec6\u80de\u88ab\u6fc0\u6d3b\uff0cHIV\u80bd\u4f1a\u5f00\u59cb\u8f6c\u5f55\u3002\u5728\u53d7\u611f\u67d3\u7684T\u7ec6\u80de\u4e2d\uff0cHIV\u57fa\u56e0\u7684\u8c03\u63a7\u65b9\u5f0f\u4e0e\u63a7\u5236\u514d\u75ab\u53cd\u5e94\u7684\u57fa\u56e0\u76f8\u540c<\/span>\u3002\u4f8b\u5982\uff0cT\u7ec6\u80de\u6fc0\u6d3b\u8fc7\u7a0b\u4e2d\u4ea7\u751f\u7684\u6838\u8f6c\u5f55\u56e0\u5b50NF-\u03baB<\/span><\/strong>\u548cNF-AT<\/strong>(\u7b2c11\u7ae0<\/span>)\u4e5f\u4f1a\u4fc3\u8fdb\u827e\u6ecb\u75c5\u75c5\u6bd2\u57fa\u56e0\u7684\u8f6c\u5f55\uff0c\u5f62\u6210\u65b0\u7684\u75c5\u6bd2RNA\uff0c\u5408\u6210HIV\u524d\u4f53\u86cb\u767d\u3002\u968f\u540e\u7531HIV\u7f16\u7801\u7684\u86cb\u767d\u9176\u4f1a\u88c2\u89e3\u8be5\u524d\u4f53\u86cb\u767d\uff0c\u5f62\u6210\u2f00\u79cd\u65b0\u7684\u75c5\u6bd2\u682a(\u89c1Fig 33.2C\uff0cD<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u9ad8\u6c34\u5e73\u7684\u75c5\u6bd2\u590d\u5236\u5bfc\u81f4\u5bbf\u4e3b\u7ec6\u80de\u53d7\u5230\u7834\u574f\u662f\u75c5\u6bd2\u6027\u7ec6\u80de\u75c5\u53d8\u6548\u5e94<\/strong>\uff0c\u800c\u8fd9\u53ea\u662fHIV\u635f\u5bb3CD4+<\/sup>T\u7ec6\u80de\u7684\u65b9\u5f0f\u4e4b\u4e00\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5bf9HIV\u7684\u514d\u75ab\u53cd\u5e94<\/strong><\/p>\n<\/section>\n

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\u5148\u5929\u514d\u75ab\u53cd\u5e94<\/p>\n<\/section>\n

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\u5148\u5929\u514d\u75ab\u7cfb\u7edf\u7684\u6d46\u7ec6\u80de\u6837\u6811\u7a81\u72b6\u7ec6\u80de<\/strong>\u4f1a\u5206\u6cccI\u578b\u5e72\u6270\u7d20<\/strong>\u4ee5\u5e94\u5bf9HIV(Fig 33.3A<\/span>)\u3002\u4f46\u8fd9\u4e9b\u7ec6\u80de\u53ea\u80fd\u591f\u5728\u4f53\u5916\u901a\u8fc7\u8be5\u673a\u5236\u6291\u5236HIV\u7684\u590d\u5236\uff0c\u5728\u88ab\u611f\u67d3\u60a3\u8005\u4f53\u5185\u65f6\uff0c\u5b83\u4eec\u7684\u529f\u80fd\u5f80\u5f80\u4f1a\u53d7\u5230\u635f\u5bb3\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u6297\u4f53\u53cd\u5e94<\/p>\n<\/section>\n

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\u53d7\u611f\u67d3\u7684\u60a3\u8005\u4f1a\u4ea7\u751f\u9ad8\u6c34\u5e73\u7684\u827e\u6ecb\u75c5\u75c5\u6bd2\u6297\u4f53<\/strong>\uff0c\u8fd9\u4e9b\u6297\u4f53\u6709\u52a9\u4e8eHIV\u68c0\u6d4b\uff0c\u76ee\u524d\u901a\u5e38\u7528ELISA\u8fdb\u884c\u68c0\u6d4b\u3002\u68c0\u6d4b\u4f7f\u7528\u7684\u6297\u4f53\u901a\u5e38\u8bc6\u522bgp120\u6216gp41<\/strong>\u7684\u8868\u4f4d\uff0c\u800c\u8fd9\u4e9b\u8868\u4f4d\u4e0d\u53c2\u4e0eHIV\u75c5\u6bd2\u4e0eCD4\u5206\u5b50\u6216\u8d8b\u5316\u56e0\u5b50\u53d7\u4f53\u7684\u7ed3\u5408\uff0c\u4e5f\u4e0d\u80fd\u9884\u9632\u611f\u67d3\u3002\u540c\u65f6\uff0cgp120\u4e2d\u4e0eCD4\u5206\u5b50\u548c\u8d8b\u5316\u56e0\u5b50\u53d7\u4f53\u7ed3\u5408\u7684\u4f4d\u70b9\u9690\u85cf\u5728\u5206\u5b50\u6df1\u5904\uff0c\u6297\u4f53\u901a\u5e38\u65e0\u6cd5\u63a5\u8fd1<\/span>(\u53c2\u89c1Fig 33.3B<\/span>)\u3002\u6240\u4ee5\uff0c\u8fd9\u4e9b\u6297\u4f53\u901a\u5e38\u4e0d\u80fd\u7528\u4e8e\u9884\u9632T\u7ec6\u80de\u611f\u67d3\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u7ec6\u80de\u6bd2\u6027T\u6dcb\u5df4\u7ec6\u80de\u53cd\u5e94<\/p>\n<\/section>\n

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\u7ec6\u80de\u6bd2\u6027T\u6dcb\u5df4\u7ec6\u80de(CTL)<\/strong>\u5728HIV\u611f\u67d3\u4e2d\u8d77\u7740\u6700\u4e3a\u91cd\u8981\u7684\u4f5c\u7528<\/strong>\uff0c\u5b83\u4eec\u80fd\u591f\u6740\u6b7b\u4e3b\u52a8\u8868\u8fbe\u548c\u5448\u9012<\/span><\/span>HIV\u591a\u80bd\u7684\u7ec6\u80de(\u89c1Fig 33.3A<\/span>)\uff0c\u4f46CTL\u4e0d\u80fd\u6740\u6b7b\u5904\u4e8e\u6f5c\u4f0f\u671f\u7684\u53d7\u611f\u67d3\u7ec6\u80de<\/span>\u3002\u6b64\u5916\uff0c\u5df2\u7ecf\u4ea7\u751f\u7684CTL\u4e0d\u80fd\u8bc6\u522b\u57fa\u56e0\u7a81\u53d8\u540e\u7684HIV\u80bd\uff0c\u6240\u4ee5HIV\u4e5f\u80fd\u591f\u901a\u8fc7\u7a81\u53d8<\/strong>\u6765\u9003\u907fCTL\u53cd\u5e94\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4e00\u4e2a\u53d7\u611f\u67d3\u7684\u4eba\u6bcf\u5929\u81f3\u5c11\u4ea7\u751f105<\/sup>\u79cd\u65b0\u75c5\u6bd2\u3002\u6bcf\u4e09\u4e2a\u611f\u67d3\u8005\u4e2d\u5c31\u6709\u2f00\u4e2a\u4f1a\u643a\u5e26\u65b0\u7684HIV\u7a81\u53d8\u57fa\u56e0\uff0c\u56e0\u6b64\uff0cCTL\u548c\u6297\u4f53\u6bcf\u5929\u5fc5\u987b\u4e0e\u81f3\u5c113\u00d7104<\/sup>\u4e2a\u65b0\u7684\u75c5\u6bd2\u682a\u4f5c\u6597\u4e89\u3002\u7136\u800c\uff0c\u514d\u75ab\u7403\u86cb\u767dG(IgG)\u6297\u4f53\u7684\u4ea7\u751f\u548cCTL\u53d1\u6325\u4f5c\u7528\u90fd\u9700\u8981CD4+<\/sup>T\u7ec6\u80de<\/strong>\u7684\u534f\u52a9\uff0c\u800cHIV\u4f1a\u6740\u6b7b\u6216\u7834\u574fCD4+<\/sup>T\u7ec6\u80de<\/strong>\uff0c\u56e0\u6b64\u514d\u75ab\u7cfb\u7edf\u4ea7\u751f\u65b0CTL\u53ca\u6297\u4f53\u53cd\u5e94\u7684\u80fd\u529b\u90fd\u4e0b\u964d\u4e86\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u7efc\u4e0a\u6240\u8ff0\uff0cHIV\u53ef\u4ee5\u901a\u8fc7\u4e09\u79cd\u65b9\u5f0f<\/strong>\u9003\u907f\u514d\u75ab\u7cfb\u7edf\uff1a(1) \u9690\u85cfgp120\u7684\u91cd\u8981\u8868\u4f4d\uff1b<\/p>\n

(2) \u5229\u7528\u81ea\u8eab\u9ad8\u7a81\u53d8\u7387\uff1b<\/p>\n

(3) \u5728\u53d7\u611f\u67d3\u7684\u5de8\u566c\u7ec6\u80de\u4e2d\u6c89\u9ed8\u4e0d\u8868\u8fbe\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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<\/section>\n<\/section>\n
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<\/p>\n<\/section>\n<\/section>\n

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Fig. 33.3<\/span> \u867d\u7136\u6709\u5148\u5929(I \u578b\u5e72\u6270\u7d20)\u548c\u83b7\u5f97\u6027(\u7ec6\u80de\u6bd2\u6027 T \u6dcb\u5df4\u7ec6\u80de[CTL]\u548c\u6297\u4f53)\u514d\u75ab\u7cfb\u7edf\u5bf9 HIV \u7684\u53cd\u5e94\uff0c\u4f46\u8fd9\u4e9b\u53cd\u5e94\u96be\u4ee5\u8ddf\u4e0a HIV \u53d8\u5f02\u7684\u6b65\u4f10\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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HIV\u5982\u4f55\u6740\u6b7b\u53d7\u611f\u67d3\u7ec6\u80de<\/p>\n<\/section>\n

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\u968f\u7740\u65f6\u95f4\u7684\u63a8\u79fb\uff0cH<\/span>I<\/span>V\u4f1a\u6740\u6b7b\u53d7\u611f\u67d3\u7684T\u7ec6\u80de\uff0c\u8fd9\u5728\u4e00\u5b9a\u7a0b\u5ea6\u4e0a\u662f\u56e0\u4e3a\u8be5\u75c5\u6bd2\u8fdb\u5165T\u7ec6\u80de\u540e\u4f1a\u4ea7\u751f\u7ec6\u80de\u75c5\u53d8\u6548\u5e94<\/strong>\u3002\u800c\u88ab\u611f\u67d3\u7684T\u7ec6\u80de\u4e5f\u662fCTL\u7684\u76ee\u6807\uff0c\u6240\u4ee5\u5373\u4fbf\u8fd9\u4e9bT\u7ec6\u80de\u672a\u88abHIV\u6740\u6b7b\uff0c\u6700\u7ec8\u4e5f\u4f1a\u88abCTL<\/strong>\u6d88\u706d\u3002\u6b64\u5916\uff0c\u514d\u75ab\u7cfb\u7edf\u5bf9T\u7ec6\u80de\u7684\u6301\u7eed\u6fc0\u6d3b<\/strong>\u4e5f\u4f1a\u8bf1\u5bfcCD4+<\/sup>T\u7ec6\u80de\u51cb\u4ea1\u3002\u7b2c18\u7ae0<\/span>\u63cf\u8ff0\u4e86T\u7ec6\u80de\u7684\u6301\u7eed\u6fc0\u6d3b\u8bf1\u5bfc\u7ec6\u80de\u51cb\u4ea1\u7684\u673a\u5236\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

\u4eba\u7c7b\u514d\u75ab\u7f3a\u9677\u75c5\u6bd2(HIV)\u611f\u67d3\u7684\u4e34\u5e8a\u7279\u70b9<\/strong><\/p>\n<\/section>\n

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\u4e00\u4e9b\u65b0\u611f\u67d3<\/strong>HIV\u7684\u75c5\u4eba\u4f1a\u51fa\u73b0\u76ae\u75b9\u3001\u4e0d\u9002\u6216\u53d1\u70e7\u7684\u75c7\u72b6\u3002\u8fd9\u2f00\u9636\u6bb5\u88ab\u79f0\u4e3aHIV\u8840\u6e05\u8f6c\u6362\u671f<\/strong>\uff0c\u5927\u6982\u53d1\u751f\u5728HIV\u6297\u4f53\u51fa\u73b0\u7684\u65f6\u5019\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5728\u63a5\u4e0b\u6765\u7684\u51e0\u5468<\/strong>\u91cc\uff0c\u524d\u6587\u6240\u8ff0\u673a\u5236\u4f7f\u75c5\u6bd2\u590d\u5236\u5f97\u5230\u63a7\u5236\u3002\u968f\u540e\uff0c\u8f83\u4f4e\u6c34\u5e73\u7684\u75c5\u6bd2\u4f1a\u7ee7\u7eed\u5728\u6dcb\u5df4\u7ed3<\/strong>\u4e2d\u8fdb\u884c\u590d\u5236\uff0c\u75c5\u6bd2\u7684\u4ea7\u751f\u3001CD4+<\/sup>T\u7ec6\u80de\u6b7b\u4ea1\u53caCD4+<\/sup>T\u7ec6\u80de\u7684\u4ea7\u751f\u5728\u4e00\u5b9a\u7a0b\u5ea6\u4e0a\u4fdd\u6301\u76f8\u4e92\u5236\u7ea6\u7684\u7a33\u5b9a\u72b6\u6001<\/span>\u3002<\/span>\u5728\u8fd9\u4e00\u9636\u6bb5\uff0c\u60a3\u8005\u6ca1\u6709\u4efb\u4f55\u75c7\u72b6\uff0c\u4f46\u53ef\u80fd\u4f1a\u51fa\u73b0\u6dcb\u5df4\u7ed3\u7684\u75c5\u53d8\uff0c\u827e\u6ecb\u75c5\u75c5\u6bd2\u611f\u67d3\u7684\u8fd9\u79cd\u65e0\u75c7\u72b6\u9636\u6bb5\u53ef\u80fd\u4f1a\u6301\u7eed\u51e0\u5e74\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u75c5\u6bd2\u590d\u5236\u7a0b\u5ea6\u662f\u53ef\u4ee5\u901a\u8fc7\u75c5\u6bd2\u8f7d\u91cf\u6d4b\u8bd5\u6765\u8861\u91cf\u7684\u3002\u5728\u65e0\u75c7\u72b6\u611f\u67d3\u671f\u95f4\uff0c\u673a\u4f53\u5185\u6bcf\u5929\u4ea7\u751f\u591a\u8fbe109<\/sup>\u4e2a<\/strong>\u75c5\u6bd2\uff0c\u5176\u4e2d\u8bb8\u591a\u6297\u539f\u80bd\u542b\u6709\u7a81\u53d8\u57fa\u56e0\u3002\u5728\u5927\u591a\u6570\u4e2a\u4f53\u4e2d\uff0cHIV\u6700\u7ec8\u4f1a\u9003\u8131\u6297\u4f53\u548cCTL\u7684\u63a7\u5236\uff0c\u968f\u540e\uff0c\u7531\u4e8e\u6b7b\u4ea1\u7684T\u7ec6\u80de\u589e\u52a0\uff0cCD4\u7ec6\u80de<\/strong>\u8ba1\u6570(\u5faa\u73afCD4+<\/sup>T\u7ec6\u80de\u6570\u91cf)\u5f00\u59cb\u4e0b\u964d<\/strong>\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u968f\u7740CD4+<\/sup>T\u7ec6\u80de\u6570\u91cf\u7684\u4e0b\u964d<\/span>\uff0c\u60a3\u8005\u66f4\u5bb9\u6613\u53d7\u5230\u611f\u67d3<\/strong>\u3002HIV\u540c\u65f6\u8fd8\u4f1a\u5f71\u54cd\u8f85\u52a9\u6027T\u7ec6\u80de1(TH1)\u548cTH17\u7ec6\u80de<\/strong>\uff0c\u7531\u6b64\u589e\u52a0\u60a3\u8005\u611f\u67d3\u7ec6\u80de\u5185\u751f\u7269(\u5982\u5206\u679d\u6746\u83cc\u3001\u75c5\u6bd2)\u548c\u7ec6\u80de\u5916\u751f\u7269(\u5982\u5ff5\u73e0\u83cc\u3001\u5409\u7f57\u7ef4\u6c0f\u80ba\u5b62\u5b50\u866b)\u7684\u98ce\u9669\u3002<\/p>\n

\u6700\u521d\uff0cHIV\u75c5\u4eba\u4f1a\u611f\u67d3\u767d\u5ff5\u73e0\u83cc<\/strong><\/span>(\u89c1Box<\/span>16.4<\/span>)\u548c\u7ed3\u6838\u5206\u679d\u6746\u83cc<\/strong>\u7b49\u6613\u611f\u7684\u6709\u5bb3\u751f\u7269\u3002\u5728CD4\u7ec6\u80de\u6570\u91cf\u8fdb\u2f00\u6b65\u4e0b\u964d\u540e\uff0c\u60a3\u8005\u5bb9\u6613\u611f\u67d3\u673a\u4f1a\u6027\u5fae\u751f\u7269\uff0c\u5982\u80ba\u5b62\u5b50\u866b<\/strong>(Fig 33.4<\/span>)\u3002\u6700\u540e\uff0c\u5f53\u673a\u4f53\u514d\u75ab\u53cd\u5e94\u51e0\u4e4e\u5b8c\u5168\u6d88\u5931\u65f6\uff0c\u4f4e\u6bd2\u529b\u7684\u5206\u679d\u6746\u83cc\u548c\u5de8\u7ec6\u80de\u75c5\u6bd2(CMV)<\/strong>\u7b49\u751f\u7269\u4f53\u4e5f\u4f1a\u5f15\u8d77\u60a3\u8005\u673a\u4f53\u611f\u67d3\u3002\u6b64\u5916\uff0c\u975e\u970d\u5947\u91d1\u6dcb\u5df4\u7624\u548c\u5361\u6ce2\u897f\u8089\u7624<\/strong>\u7b49\u80bf\u7624\u4e5f\u4f1a\u76f8\u7ee7\u53d1\u751f\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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<\/section>\n<\/section>\n
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<\/p>\n<\/section>\n<\/section>\n

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Fig. 33.4<\/span> \u5728 HIV \u5f15\u8d77\u4e0d\u540c\u7a0b\u5ea6\u7684\u514d\u75ab\u7f3a\u9677\u4e4b\u540e\u4f1a\u53d1\u751f\u4e0d\u540c\u7684\u673a\u4f1a\u6027\u611f\u67d3<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

\u5f71\u54cdHIV\u75be\u75c5\u8fdb\u5c55\u7684\u56e0\u7d20<\/strong><\/p>\n<\/section>\n

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\u75be\u75c5\u8fdb\u5c55\u7684\u901f\u5ea6\u56e0\u4eba\u800c\u5f02\uff0c\u5e76\u53d7\u9057\u4f20\u56e0\u7d20\u5f71\u54cd\u3002\u4f8b\u5982\uff0cCCR5\u8d8b\u5316\u56e0\u5b50\u53d7\u4f53<\/strong>\u7684\u591a\u6001\u6027\u964d\u4f4e\u4e86HIV\u4e0e\u7c98\u819c\u5de8\u566c\u7ec6\u80de\u3001\u6811\u7a81\u72b6\u7ec6\u80de\u548cT\u7ec6\u80de\u7ed3\u5408\u548c\u878d\u5408\u7684\u80fd\u529b\u3002\u8fd9\u79cd\u591a\u6001\u6027\u7eaf\u5408\u5b50\u4f7f\u4e2a\u4f53\u5728\u6027\u63a5\u89e6\u540e\u611f\u67d3HIV\u7684\u98ce\u9669\u964d\u4f4e\uff0c\u4e14\u5373\u4fbf\u611f\u67d3\u4e86\u827e\u6ecb\u75c5\u75c5\u6bd2\uff0c\u6bd4\u5982\u901a\u8fc7\u8f93\u8840\u611f\u67d3\uff0c\u75be\u75c5\u8fdb\u5c55\u901f\u5ea6\u4e5f\u4f1a\u5ef6\u7f13\u3002\u540c\u65f6\uff0cCCR5\u57fa\u56e0\u591a\u6001\u6027\u4e0d\u4f1a\u5bf9\u514d\u75ab\u7cfb\u7edf\u9020\u6210\u4efb\u4f55\u4e0d\u5229\u5f71\u54cd\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u9488\u5bf9HIV\u7684CTL\u53cd\u5e94\u7a0b\u5ea6\u4e5f\u56e0\u60a3\u8005\u800c\u5f02\u3002<\/span>\u4eba\u7c7b\u767d\u7ec6\u80de\u6297\u539f(HLA)\u57fa\u56e0\u591a\u6001\u6027\u53ef\u80fd\u901a\u8fc7\u4e24\u4e2a\u91cd\u8981\u65b9\u9762\u51b3\u5b9a\u673a\u4f53\u4ea7\u751f\u6297HIV\u7684CTL\u7684\u80fd\u529b\uff1a\u7b2c\u4e00<\/strong>\uff0c\u4e0d\u540c\u7684HLA\u7b49\u4f4d\u57fa\u56e0\u4e0eHIV\u591a\u80bd\u7ed3\u5408\u5e76\u5c06\u5176\u5448\u9012\u7ed9CTL\u7684\u80fd\u529b\u53ef\u80fd\u4e0d\u540c\uff1b\u7b2c\u4e8c<\/strong>\uff0c\u6240\u6709HLA\u7b49\u4f4d\u57fa\u56e0\u7eaf\u5408\u7684\u4e2a\u4f53\u53ef\u7528\u4e8e\u5448\u9012HIV\u7684\u80bd\u4e0d\u540c\uff0cHLA\u5206\u5b50\u7684\u6570\u91cf\u662f\u6240\u6709\u7b49\u4f4d\u57fa\u56e0\u6742\u5408\u4e2a\u4f53\u7684\u4e00\u534a\u3002\u6240\u4ee5HLA\u7b49\u4f4d\u57fa\u56e0\u5747\u4e3a\u6742\u5408\u5b50\u7684\u4eba\u5728\u611f\u67d3HIV\u540e\u5f80\u5f80\u5bf9\u5176\u6709\u66f4\u5f3a\u7684\u62b5\u6297\u529b(Box 3.1<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u75ab\u82d7<\/p>\n<\/section>\n

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\u5230\u76ee\u524d\u4e3a\u6b62\uff0c\u8fd8\u6ca1\u6709\u4e00\u79cd\u75ab\u82d7\u53ef\u4ee5\u6301\u7eed\u6709\u6548\u5730\u5bf9\u6297\u827e\u6ecb\u75c5\u75c5\u6bd2\u611f\u67d3<\/span>\u3002\u8bb8\u591a\u5f00\u53d1HIV\u75ab\u82d7\u7684\u5b9e\u9a8c\u90fd\u96c6\u4e2d\u5728\u8bf1\u5bfc\u6297gp120<\/strong>\u7684\u6297\u4f53\u4e0a\uff0c\u7814\u7a76\u5e0c\u671b\u901a\u8fc7\u9488\u5bf9gp120\u548cgp41\u5206\u5b50\u5728HIV\u7ed3\u5408\u548c\u8fdb\u5165\u7ec6\u80de\u671f\u95f4\u66b4\u9732\u7684\u8868\u4f4d\u7684\u514d\u75ab\u7403\u86cb\u767dG(IgG)\u6765\u6291\u5236HIV\u611f\u67d3(Fig 33.3C<\/span>)\u3002\u6b64\u5916\uff0c\u4eba\u4eec\u8fd8\u5e0c\u671b\u751f\u6b96\u5668\u5206\u6ccc\u7269\u4e2d\u5b58\u5728\u7684\u6297HIV\u7684IgA\u6297\u4f53\u80fd\u5bf9\u673a\u4f53\u8d77\u5230\u4fdd\u62a4\u4f5c\u7528\u3002\u7136\u800c\uff0c\u5728\u75ab\u82d7\u7684\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\uff0c\u5c3d\u7ba1\u8bd5\u9a8c\u8005\u673a\u4f53\u5df2\u6210\u529f\u4ea7\u751f\u4e86\u6297HIV\u7684IgG\u548cIgA\u6297\u4f53\uff0c\u4f46\u5230\u76ee\u524d\u4e3a\u6b62\u8fd8\u6ca1\u6709\u7814\u7a76\u53d1\u73b0\u8fd9\u4e9b\u6297\u4f53\u5bf9HIV\u611f\u67d3\u6709\u4fdd\u62a4\u4f5c\u7528\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u6b63\u5982\u524d\u9762\u6240\u8ba8\u8bba\u7684\uff0c\u5f3a\u70c8\u7684CTL\u53cd\u5e94\u5728\u9884\u9632HIV\u611f\u67d3\u65b9\u9762\u8d77\u7740\u91cd\u8981\u7684\u4f5c\u7528\u3002\u4f46\u662f\uff0c\u4e3a\u4e86\u6fc0\u6d3b\u8fd9\u4e9b\u53cd\u5e94\uff0c\u75ab\u82d7\u9700\u8981\u5c06\u6297\u539f\u8f93\u9001\u5230\u7ec6\u80de\u8d28\uff0c\u4f7f\u5176\u643a\u5e26\u7684\u6297\u539f\u80bd\u6700\u7ec8\u80fd\u5728MHC-I\u7c7b\u5206\u5b50<\/strong>\u4e0a\u8868\u8fbe<\/span>\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u827e\u6ecb\u75c5\u75ab\u82d7\u7814\u53d1\u6b63\u9762\u4e34\u7740\u91cd\u5927\u56f0\u96be\u3002\u7531\u4e8e\u827e\u6ecb\u75c5\u75c5\u6bd2\u7684\u5feb\u901f\u53d8\u5f02\uff0c\u5bfc\u81f4\u4ece\u4e0d\u540c\u4f4d\u7f6e\u83b7\u5f97\u7684\u75c5\u6bd2\u6837\u672c\u4e2d\u5b58\u5728\u5de8\u5927\u7684\u6297\u539f\u6027\u53d8\u5f02\u3002\u540c\u65f6\u8fd9\u79cd\u5feb\u901f\u53d8\u5f02<\/strong>\u5bfc\u81f4\u4e00\u79cd\u75ab\u82d7\u53ef\u4ee5\u6740\u6b7b\u4e00\u4e2a\u60a3\u8005\u8eab\u4e0a\u7684\u827e\u6ecb\u75c5\u75c5\u6bd2\uff0c\u4f46\u4e0d\u4e00\u5b9a\u5bf9\u5176\u4ed6\u4eba\u6709\u6548\u3002\u7efc\u4e0a\u6240\u8ff0\uff0c\u5c3d\u7ba1\u75ab\u82d7\u5df2\u7ecf\u88ab\u8bc1\u5b9e\u80fd\u591f\u6210\u529f\u8bf1\u5bfcCTL\u53cd\u5e94\uff0c\u4f46\u5230\u76ee\u524d\u4e3a\u6b62\uff0c\u5728\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\u5c1a\u672a\u53d1\u73b0\u7531\u75ab\u82d7\u8bf1\u5bfc\u7684CTL\u53cd\u5e94\u80fd\u6709\u6548\u7684\u4fdd\u62a4\u673a\u4f53\u514d\u53d7\u827e\u6ecb\u75c5\u75c5\u6bd2\u611f\u67d3\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

\u827e\u6ecb\u75c5\u75c5\u6bd2\u611f\u67d3\u7684\u6cbb\u7597\u65b9\u5f0f<\/strong><\/p>\n<\/section>\n

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\u9ad8\u6548\u6297\u9006\u8f6c\u5f55\u75c5\u6bd2\u7597\u6cd5<\/span>(HAART)<\/strong>\u53ef\u4ee5\u6781\u5927\u5730\u6539\u5584HIV\u611f\u67d3\u7684\u9884\u540e\u3002HAART\u7531\u591a\u79cd\u6297\u9006\u8f6c\u5f55\u75c5\u6bd2\u836f\u7269\u7ec4\u5408\u800c\u6210\uff0c\u76ee\u524d\u6709\u56db\u7c7b\u836f\u7269<\/strong>\u83b7\u5f97\u4f7f\u7528\u8bb8\u53ef(Fig 33.5<\/span>)\uff1a<\/p>\n

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  • \n

    \u9006\u8f6c\u5f55\u9176\u6291\u5236\u5242<\/span>\u901a\u5e38\u662f\u53ef\u4ee5\u88ab\u5408\u5e76\u5230DNA\u8f6c\u5f55\u672c\u4e2d\u7684\u6838\u82f7\u7c7b\u4f3c\u7269\u3002<\/span>\u56e0\u4e3a\u9006\u8f6c\u5f55\u9176\u4e0d\u80fd\u7ea0\u6b63\u9519\u8bef\uff0c\u6240\u4ee5\u5728\u5408\u5e76\u4e86\u8fd9\u4e9b\u836f\u7269\u540e\uff0cDNA\u94fe\u7684\u5408\u6210\u4f1a\u88ab\u7ec8\u6b62(Fig 33.5B<\/span>)\u3002<\/p>\n<\/li>\n

  • \n

    \u6574\u5408\u9176\u6291\u5236\u5242<\/span>\u53ef\u4ee5\u963b\u6b62\u75c5\u6bd2DNA\u94fe\u6574\u5408\u5230\u5bbf\u4e3b\u57fa\u56e0\u7ec4\u4e2d(Fig 33.5B<\/span>)\u3002<\/p>\n<\/li>\n

  • \n

    \u86cb\u767d\u9176\u6291\u5236\u5242<\/span>\u53ef\u4ee5\u6291\u5236\u8d1f\u8d23\u4ea7\u751fHIV\u7ed3\u6784\u86cb\u767d\u7684\u9176\u7684\u4f5c\u7528<\/span>(Fig 33.5C<\/span>)\u3002<\/p>\n<\/li>\n

  • \n

    \u4e0egp41\u7ed3\u5408\u7684\u878d\u5408\u6291\u5236\u5242<\/span>\u53ef\u4ee5\u963b\u6b62HIV\u75c5\u6bd2\u4e0e\u5bbf\u4e3b\u7ec6\u80de\u63a5\u89e6\u53ca\u878d\u5408(Fig 33.5A<\/span>)\u3002<\/p>\n<\/li>\n<\/ul>\n<\/section>\n<\/section>\n<\/section>\n

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    \u5982\u679c\u53ea\u670d\u7528\u4e00\u79cd\u836f\u7269\uff0c\u827e\u6ecb\u75c5\u75c5\u6bd2\u4f1a\u8fc5\u901f\u53d8\u5f02\u5e76\u4ea7\u751f\u6297\u836f\u6027\u3002\u57fa\u4e8e\u6b64\uff0c\u6297HIV\u9006\u8f6c\u5f55\u75c5\u6bd2\u836f\u7269\u5fc5\u987b\u8054\u5408\u4f7f\u7528\uff0c\u901a\u5e38\u662f\u4e09\u79cd\u836f\u7269\u8054\u5408\u4f7f\u7528<\/span>\uff0c\u4ee5\u964d\u4f4e\u51fa\u73b0\u8010\u836f\u6bd2\u682a\u7684\u98ce\u9669\u3002\u7ecf\u8fc7HAART\u540e\uff0c\u75c5\u6bd2\u8f7d\u91cf\u5e94\u8be5\u4f1a\u6709\u6240\u4e0b\u964d\uff0cCD4+<\/sup>T\u7ec6\u80de\u8ba1\u6570\u5e94\u8be5\u4f1a\u6709\u6240\u6062\u590d\uff0c\u4e14\u514d\u75ab\u529f\u80fd\u5f97\u5230\u4e00\u5b9a\u7684\u6062\u590d\uff0c\u673a\u4f1a\u6027\u611f\u67d3\u53d1\u751f\u53ef\u80fd\u6027\u4e5f\u4f1a\u964d\u4f4e\u3002<\/span>HAART<\/strong>\u53ef\u4ee5\u4f7f\u827e\u6ecb\u75c5\u6210\u4e3a\u2f00\u79cd\u6162\u6027\u7684\u3001\u53ef\u63a7\u5236\u7684\u75be\u75c5\uff0c\u4f46\u7531\u4e8e\u6f5c\u4f0f\u671f\u75c5\u6bd2\u53ef\u4ee5\u6301\u7eed\u5b58\u5728\u4e8e\u5b58\u6d3b\u7684\u7ec6\u80de\u4e2d\uff0c\u6240\u4ee5\u76ee\u524d\u7684\u6cbb\u7597\u65b9\u6cd5\u4f9d\u65e7\u65e0\u6cd5\u5b8c\u5168\u6cbb\u6108\u827e\u6ecb\u75c5\u75c5\u6bd2\u611f\u67d3\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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    <\/section>\n<\/section>\n
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    <\/p>\n<\/section>\n<\/section>\n

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    Fig 33.5 <\/span>\u6297\u9006\u8f6c\u5f55\u75c5\u6bd2\u6cbb\u7597\u7684\u56db\u5927\u7c7b\u836f\u7269<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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    <\/p>\n<\/section>\n<\/section>\n

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    \u5176\u4ed6\u7ee7\u53d1\u6027\u514d\u75ab\u7f3a\u9677<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

    \n
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    \u9664\u4e86HIV\u75c5\u6bd2\u5916\uff0c\u5176\u4ed6\u56e0\u7d20\u4e5f\u53ef\u80fd\u5bfc\u81f4\u7ee7\u53d1\u6027\u514d\u75ab\u7f3a\u9677\uff0c\u4e14\u8fd9\u4e9b\u56e0\u7d20\u5f80\u5f80\u662f\u5171\u540c\u4f5c\u7528\u7684\u3002\u5176\u4e2d\u7ee7\u53d1\u6027\u514d\u75ab\u7f3a\u9677\u5728\u4f4f\u9662\u671f\u95f4\u5f88\u5bb9\u6613\u53d1\u751f\uff0c\u56e0\u4e3a\u60a3\u8005\u66b4\u9732\u5728\u538b\u529b\u3001\u836f\u7269\u548c\u53ef\u80fd\u5b58\u5728\u7684\u673a\u4f53\u8425\u517b\u4e0d\u8db3\u7684\u73af\u5883\u4e2d\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

    \n

    \u5e74\u9f84\u7684\u5f71\u54cd<\/strong><\/p>\n<\/section>\n

    \n

    \u65b0\u751f\u513f\u7684\u514d\u75ab\u7cfb\u7edf<\/p>\n<\/section>\n

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    \u5728\u521a\u51fa\u751f\u7684\u7b2c\u4e00\u5e74<\/strong>\u91cc\uff0c\u65b0\u751f\u513f\u7684\u7279\u5f02\u6027\u514d\u75ab\u7cfb\u7edf\u4ecd\u672a\u53d1\u80b2\u6210\u719f\uff0c\u867d\u7136\u4f53\u5185\u6709\u5927\u91cf\u7684T\u7ec6\u80de\uff0c\u4f46\u90fd\u5c1a\u672a\u53d1\u80b2\u5b8c\u5168\uff0c\u5bf9\u6297\u539f\u7684\u53cd\u5e94\u80fd\u529b\u4f4e\uff08\u7b2c17\u7ae0<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

    \n
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    \u80ce\u513f\u7684\u6297\u4f53<\/strong>\u572820\u5468\u65f6\u5f00\u59cb\u5408\u6210\uff0c\u4f46\u8981\u8fbe\u5230\u6210\u4eba\u7684IgG\u6c34\u5e73\u5927\u7ea6\u9700\u89815\u5e74\u3002\u5728\u6700\u521d\u7684\u51e0\u4e2a\u6708\uff0c\u5a74\u513f\u9700\u8981\u4f9d\u8d56\u6bcd\u4f53\u7684IgG<\/strong>\uff0c\u5728\u96cc\u6fc0\u7d20\u7684\u4f5c\u7528\u4e0b\uff0c\u5b55\u5987\u4f1a\u4ea7\u751f\u66f4\u591a\u7684\u514d\u75ab\u7403\u86cb\u767d\uff0c\u5728\u6000\u5b55\u7684\u6700\u540e10\u5468\uff0cIgG\u4f1a\u901a\u8fc7\u4e13\u95e8\u7684Fc\u53d7\u4f53\u548c\u80ce\u76d8<\/strong>\u8f6c\u8fd0\u5230\u5a74\u513f\u4f53\u5185\u3002<\/p>\n

    \u6b64\u5916\uff0c\u6bcd\u4e73\u4e2d\u7684\u514d\u75ab\u7403\u86cb\u767d(IgA)<\/strong>\u662f\u751f\u547d\u65e9\u671f\u7684\u53e6\u4e00\u79cd\u4fdd\u62a4\u63aa\u65bd<\/span>\uff0c\u5b83\u53ef\u4ee5\u9884\u9632\u65b0\u751f\u513f\u80ba\u90e8\u548c\u80c3\u80a0\u9053\u611f\u67d3\u3002\u5976\u74f6\u5582\u517b\u7684\u5a74\u513f\u5728\u51fa\u751f\u540e\u7684\u524d3\u4e2a\u6708\u60a3\u80ba\u708e\u7684\u53ef\u80fd\u6027\u662f\u6bcd\u4e73\u5582\u517b\u5a74\u513f\u768460\u500d<\/span>\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

    \n
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    \u65e9\u4ea7\u513f<\/strong>\u5728\u6000\u5b55\u540e\u671f\u63a5\u53d7\u6bcd\u4f53\u514d\u75ab\u7403\u86cb\u767d\u7684\u65f6\u95f4\u8f83\u77ed\uff0c\u6240\u4ee5\u4ed6\u4eec\u9762\u4e34\u7684\u611f\u67d3\u98ce\u9669\u66f4\u5927\u3002\u5148\u5929\u514d\u75ab\uff08\u5982\u80ba\u8868\u9762\u6d3b\u6027\u7269\u8d28\uff09(\u7b2c20\u7ae0<\/span>)\u7684\u4e0d\u6210\u719f\u4f1a\u589e\u52a0\u547c\u5438\u9053\u611f\u67d3\u7684\u98ce\u9669\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

    \n
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    \u8bb8\u591a\u5a74\u513f\u5728\u51fa\u751f\u7684\u7b2c\u4e00\u5e74\u53ef\u4ea7\u751f\u4f4e\u6c34\u5e73\u7684\u6297\u4f53\u3002\u5a74\u513f\u671f\u6682\u65f6\u6027\u4f4e\u4e19\u79cd\u7403\u86cb\u767d\u8840\u75c7\u662f\u7531\u4e8e\u6bcd\u4f53\u6297\u4f53\u6c34\u5e73\u4e0b\u964d\u65f6\u514d\u75ab\u7403\u86cb\u767d\u5408\u6210\u4e0e\u6210\u719f\u7684\u5ef6\u8fdf\u6240\u5bfc\u81f4\u7684\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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    \u8001\u5e74\u4eba\u7684\u514d\u75ab\u7cfb\u7edf<\/p>\n<\/section>\n

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    \u8001\u5e74\u4eba\u6bd4\u5e74\u8f7b\u60a3\u8005\u66f4\u6613\u53d7\u5230\u611f\u67d3\u3002\u968f\u7740\u5e74\u9f84\u589e\u957f\u800c\u51fa\u73b0\u7684\u8f7b\u5ea6\u514d\u75ab\u7f3a\u9677\u4e3b\u8981\u5f71\u54cd\u7684\u662fT\u7ec6\u80de<\/strong>\uff0c\u800c\u8bb0\u5fc6T\u7ec6\u80de<\/span><\/strong>\u514d\u75ab\u529b\u7684\u4e27\u5931\u4f3c\u4e4e\u6bd4\u8bb0\u5fc6B\u7ec6\u80de\u66f4\u5feb<\/span>(Fig 25.4<\/span>)\u3002\u540c\u65f6\uff0c\u8001\u5e74\u4eba\u8f7b\u5ea6\u7f3a\u9677\u7684\u514d\u75ab\u7cfb\u7edf\u4e5f\u5f88\u96be\u4ea7\u751f\u66f4\u591a\u65b0\u7684\u8bb0\u5fc6T\u7ec6\u80de<\/span>(Fig 33.6<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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    \u5728\u6574\u4e2a\u4e2d\u5e74\u65f6\u671f\uff0c\u80f8\u817a\u6bcf\u5e74\u840e\u7f29\u7ea63%<\/span>\uff0c\u80f8\u817a\u4e2d\u5e7c\u7a1aT\u7ec6\u80de<\/strong>\u7684\u751f\u6210\u91cf\u4e5f\u4f1a\u968f\u4e4b\u4e0b\u964d\uff0c\u8fd9\u5bfc\u81f4\u5728\u673a\u4f53\u665a\u5e74\u65f6\u4ece\u80f8\u817a\u4e2d\u4ea7\u51fa\u7684T\u7ec6\u80de\u8f83\u5c11\u3002<\/p>\n

    \u867d\u7136\u5916\u5468T\u7ec6\u80de<\/strong>\u7684\u589e\u6b96\u53ef\u4ee5\u4f7f\u6210\u4eba\u673a\u4f53\u7ef4\u6301\u8db3\u591f\u6570\u91cf\u5f97T\u7ec6\u80de\uff0c\u4f46\u662fT\u7ec6\u80de\u7684\u590d\u5236\u589e\u6b96\u6b21\u6570\u662f\u6709\u9650\u7684\u3002\u8fd9\u662f\u56e0\u4e3a\u7ec6\u80de\u6bcf\u5206\u88c2\u4e00\u6b21\uff0c\u7aef\u7c92DNA\u5c31\u4f1a\u9010\u6e10\u7f29\u77ed\uff0c\u5f53\u7aef\u7c92\u957f\u5ea6\u663e\u8457\u7f29\u77ed\u65f6\uff0c\u7ec6\u80de\u5c31\u4e0d\u80fd\u518d\u5206\u88c2\u4e86\u3002\u5728\u5927\u7ea640\u6b21\u5206\u88c2\u540e\uff0c\u8fd9\u79cd\u590d\u5236\u6027\u8870\u8001<\/strong>\u5c31\u4f1a\u5bf9T\u7ec6\u80de\u4ea7\u751f\u5f71\u54cd\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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    \n
    \n

    \u7b2c\u4e09\u4e2a\u5f71\u54cd\u8001\u5e74\u4eba\u4f53\u5185T\u7ec6\u80de\u7684\u56e0\u7d20\u662fCMV<\/strong>\uff0c\u8fd9\u662f\u4e00\u79cd\u75b1\u75b9\u75c5\u6bd2\uff0c\u53ef\u4ee5\u63a8\u52a8T\u7ec6\u80de\u6570\u91cf\u7684\u589e\u52a0\u3002\u5728\u8001\u5e74\u4eba\u673a\u4f53\u4e2d\uff0cT\u7ec6\u80de\u53cd\u5e94\u901a\u5e38\u662f\u9ad8\u5ea6\u5be1\u514b\u9686<\/strong>\uff0c\u5177\u6709CMV\u7279\u5f02\u6027\u7684<\/span>T\u7ec6\u80de\u5728\u514d\u75ab\u7cfb\u7edf\u4e2d\u51e0\u4e4e\u4e0d\u4f1a\u7ed9\u5176\u4ed6\u7279\u5f02\u6027\u7ec6\u80de\u7559\u4e0b\u7a7a\u95f4\uff0c\u7531\u6b64\u5f71\u54cd\u4e86\u5176\u4ed6\u7279\u5f02\u6027T\u7ec6\u80de\u7684\u6b63\u5e38\u529f\u80fd\u3002\u8001\u5e74\u4ebaT\u7ec6\u80de\u6570\u91cf\u548c\u529f\u80fd\u53d7\u635f\u4f1a\u5bfc\u81f4\u5bf9\u75ab\u82d7\u7684\u53cd\u5e94\u4e0d\u4f73\uff0c\u611f\u67d3\u53ef\u80fd\u6027\u589e\u52a0\uff0c\u4ee5\u53ca\u60a3\u6076\u6027\u80bf\u7624\u98ce\u9669\u589e\u52a0\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

    \n
    \n
    \n

    \u4e0d\u8fc7\u8001\u5e74\u4eba\u7684B\u7ec6\u80de<\/strong>\u529f\u80fd\u5e76\u6ca1\u6709\u4e0b\u964d\u3002\u5982\u7b2c25\u7ae0<\/span>\u6240\u8ff0\uff0c\u9488\u5bf9\u75ab\u82d7\u643a\u5e26\u5165\u673a\u4f53\u7684\u6297\u539f\u7684\u8bb0\u5fc6\u6027\u6297\u4f53\u53cd\u5e94\uff0c\u53ef\u80fd\u7ef4\u6301\u957f\u8fbe50\u81f360\u5e74<\/span>\uff0c\u5373\u8001\u5316\u7684B\u7ec6\u80de\u4ecd\u53ef\u4ee5\u4fdd\u6301\u529f\u80fd\u3002<\/span>\u4f46\u662f<\/span>\u514d\u75ab\u7403\u86cb\u767d\u5408\u6210\u589e\u52a0\uff0cB\u7ec6\u80de\u514b\u9686\u7684\u589e\u591a\u53ef\u80fd\u4f1a\u5bfc\u81f4\u8840\u6db2\u4e2d\u51fa\u73b0\u5355\u514b\u9686\u514d\u75ab\u7403\u86cb\u767d\u6216\u5bfc\u81f4B\u7ec6\u80de\u6076\u6027\u80bf\u7624\u53d1\u751f(\u7b2c35\u7ae0<\/span>)\u3002\u6b64\u5916\uff0c\u867d\u7136\u5728\u8001\u5e74\u4eba\u4e2d\u81ea\u8eab\u6297\u4f53\u66f4\u5e38\u89c1\uff0c\u4f46\u5176\u901a\u5e38\u4e0e\u75be\u75c5\u65e0\u5173\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

    \n
    <\/section>\n<\/section>\n
    \n
    \n
    \n


    <\/p>\n<\/section>\n<\/section>\n

    \n
    \n

    Fig. 33.6 <\/span>\u4e3a\u4ec0\u4e48T\u7ec6\u80de\u5728\u665a\u5e74\u4f1a\u51cf\u5c11\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

    \n

    \u5176\u4ed6\u56e0\u7d20<\/strong><\/p>\n<\/section>\n

    \n

    \u836f\u7269<\/p>\n<\/section>\n

    \n
    \n
    \n

    \u836f\u7269\u662f\u8bf1\u5bfc\u7ee7\u53d1\u6027\u514d\u75ab\u7f3a\u9677\u7684\u5e38\u89c1\u539f\u56e0\uff0c\u800c\u505c\u6b62\u4f7f\u7528\u8fdd\u89c4\u836f\u7269\u901a\u5e38\u4f1a\u6539\u5584\u514d\u75ab\u53cd\u5e94\u3002\u5728\u6076\u6027\u80bf\u7624\u7684\u7ec6\u80de\u6bd2\u6027\u6cbb\u7597<\/strong>\u8fc7\u7a0b\u4e2d\uff0c\u60a3\u8005\u56e0\u4e3a\u4f7f\u7528\u836f\u7269\u7ecf\u5e38\u51fa\u73b0\u4e2d\u6027\u7c92\u7ec6\u80de\u51cf\u5c11\u75c7<\/strong>(Box 21.1<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

    \n
    \n
    \n

    \u5bf9T\u3001B\u7ec6\u80de\u7684\u635f\u4f24<\/strong>\u662f\u7cd6\u76ae\u8d28\u6fc0\u7d20\u3001\u7ec6\u80de\u6bd2\u6027\u836f\u7269\u4ee5\u53ca\u7528\u4e8e\u81ea\u8eab\u514d\u75ab\u6027\u75be\u75c5\u548c\u9884\u9632\u79fb\u690d\u6392\u65a5\u7684\u514d\u75ab\u6291\u5236\u7597\u6cd5\u7684\u5e38\u89c1\u526f\u4f5c\u7528\u3002\u670d\u7528\u8fd9\u4e9b\u836f\u7269\u7684\u60a3\u8005\u5f88\u5bb9\u6613\u53d1\u751f\u673a\u4f1a\u6027\u611f\u67d3<\/strong>\uff0c\u5176\u4e2d\u2f00\u4e9b\u836f\u7269\u53ef\u80fd\u8fd8\u4f1a\u5bfc\u81f4\u6297\u4f53\u7684\u7f3a\u5931\uff0c\u4f46\u8fd9\u79cd\u526f\u4f5c\u7528\u5e76\u4e0d\u5e38\u89c1\u3002\u5176\u4e2d\u5bf9\u514d\u75ab\u7cfb\u7edf\u5f71\u54cd\u6700\u5927\u7684\u662f\u7528\u4e8e\u6cbb\u7597\u766b\u75eb\u7684\u6297\u60ca\u53a5\u836f\u7269<\/strong>\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

    \n

    B\u7ec6\u80de\u6076\u6027\u80bf\u7624<\/p>\n<\/section>\n

    \n
    \n
    \n

    \u9aa8\u9ad3\u7624<\/strong>\u548c\u6162\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5<\/strong>\u662fB\u7ec6\u80de\u76f8\u5173\u7684\u6076\u6027\u80bf\u7624(\u7b2c35\u7ae0<\/span>)\u3002\u867d\u7136\u4e24\u8005\u90fd\u53ef\u80fd\u4ea7\u751f\u5927\u91cf\u7684\u5355\u514b\u9686\u514d\u75ab\u7403\u86cb\u767d\uff0c\u4f46\u5b83\u4eec\u90fd\u53ef\u5bfc\u81f4\u4f4e\u6c34\u5e73\u7684\u75c5\u539f\u4f53\u6297\u4f53\u3002\u9aa8\u9ad3\u7624\u548c\u6162\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5\u662f\u8001\u5e74\u4eba\u51fa\u73b0\u7ee7\u53d1\u6027\u514d\u75ab\u7f3a\u9677\u7684\u5e38\u89c1\u539f\u56e0\uff0c\u6b64\u5916\uff0c\u80f8\u817a\u7624<\/strong>\u4e5f\u53ef\u5bfc\u81f4\u514d\u75ab\u7f3a\u9677\uff0c\u4f46\u5176\u8f83\u7f55\u89c1\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

    \n

    \u80be\u810f\u548c\u80a0\u9053\u75be\u75c5<\/p>\n<\/section>\n

    \n
    \n
    \n

    \u5728\u80be\u75c5\u7efc\u5408\u5f81<\/strong>(\u7b2c30\u7ae0<\/span>)\u4e2d\uff0cIgM\u6b63\u5e38\u7684\u60a3\u8005\u53ef\u80fd\u4f1a\u51fa\u73b0\u660e\u663e\u7684\u80be\u810f\u86cb\u767d\u4e22\u5931\u3001\u8840\u4e2dIgG\u548cIgA\u6c34\u5e73\u964d\u4f4e\u7684\u75c7\u72b6\u3002\u5728\u4e25\u91cd\u7684\u8179\u6cfb<\/strong>\u75be\u75c5\u4e2d\uff0c\u514d\u75ab\u7403\u86cb\u767d\u4e5f\u53ef\u80fd\u901a\u8fc7\u80a0\u9053\u4e22\u5931\u3002\u80be\u529f\u80fd\u8870\u7aed<\/strong>\u548c\u7cd6\u5c3f\u75c5<\/strong>\u4e5f\u4f1a\u5bfc\u81f4\u7ee7\u53d1\u6027\u541e\u566c\u7ec6\u80de\u7f3a\u9677\uff0c\u5176\u673a\u5236\u5c1a\u4e0d\u6e05\u695a\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

    \n

    \u8425\u517b<\/p>\n<\/section>\n

    \n
    \n
    \n

    \u7f3a\u950c\u3001\u7f3a\u9541<\/strong>\u4f1a\u635f\u5bb3\u7ec6\u80de\u514d\u75ab<\/strong>\uff0c\u5c24\u5176\u662f\u964d\u4f4eTH1<\/strong>\u7c7b\u7ec6\u80de\u56e0\u5b50\u7684\u5206\u6ccc\u3002\u8fd9\u79cd\u7c7b\u578b\u7684\u5fae\u91cf\u8425\u517b\u7d20\u7f3a\u4e4f\u5f88\u5e38\u89c1\uff0c\u4f8b\u5982\u5728\u672f\u540e\u60a3\u8005\u8eab\u4e0a\u3002\u867d\u7136\u514d\u75ab\u7cfb\u7edf\u4e5f\u9700\u8981\u7ef4\u751f\u7d20\uff0c\u7279\u522b\u662f\u7ef4\u751f\u7d20A\u548cE\uff0c\u4f46\u5b83\u4eec\u7684\u4f5c\u7528\u4e0d\u5982\u77ff\u7269\u8d28\u8425\u517b\u7d20\u90a3\u4e48\u91cd\u8981\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

    \n

    \u751f\u7406\u5e94\u6fc0<\/p>\n<\/section>\n

    \n
    \n
    \n

    \u538b\u529b<\/strong>\u5bf9\u9002\u5e94\u6027\u514d\u75ab\u7cfb\u7edf\u6709\u5f88\u5927\u7684\u5f71\u54cd\u3002\u6dcb\u5df4\u7ec6\u80de<\/strong>\u65e2\u6709\u80be\u4e0a\u817a\u7d20\u53d7\u4f53<\/strong>\uff0c\u4e5f\u6709\u76ae\u8d28\u7c7b\u56fa\u9187\u53d7\u4f53<\/strong>\u3002\u8fd9\u4e9b\u6fc0\u7d20\u662f\u5728\u538b\u529b\u8c03\u8282\u4e0b\u5206\u6ccc\u7684\uff1a\u80be\u4e0a\u817a\u7d20\u4ecb\u5bfc\u5feb\u901f\u53d1\u4f5c\u7684\u77ed\u671f\u6548\u5e94\uff0c\u800c\u76ae\u8d28\u7c7b\u56fa\u9187\u8c03\u8282\u957f\u671f\u6548\u5e94\u3002\u56e0\u6b64\uff0c\u751f\u7406\u538b\u529b\uff0c\u5982\u8010\u529b\u8bad\u7ec3\uff0c\u53ef\u4ee5\u6291\u5236\u673a\u4f53\u7684\u514d\u75ab\u53cd\u5e94\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

    \n

    \u4f20\u67d3\u75c5<\/p>\n<\/section>\n

    \n
    \n
    \n

    \u611f\u67d3<\/strong>\u4e5f\u4f1a\u5bfc\u81f4\u514d\u75ab\u7f3a\u9677\u3002\u759f\u75be\u548c\u5148\u5929\u6027\u98ce\u75b9\u4e5f\u53ef\u80fd\u4f1a\u5bfc\u81f4\u6297\u4f53\u7684\u7f3a\u4e4f\u3002\u9ebb\u75b9\u4f1a\u5bfc\u81f4\u7ec6\u80de\u514d\u75ab\u7f3a\u9677\u2014\u2014\u6709\u65f6\u751a\u81f3\u4f1a\u91cd\u65b0\u6fc0\u6d3b\u7ed3\u6838\u75c5\u3002\u4e0a\u8ff0\u56e0\u7d20\u4e2d\u7684\u4e00\u90e8\u5206\u4f1a\u5171\u540c\u4f5c\u7528\u4e8e\u6025\u6027\u75be\u75c5\u60a3\u8005(Box 33.2<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

    \n
    \n
    \n
    \n
    \n

    BOX 33.1<\/span> \u76d1\u6d4b\u827e\u6ecb\u75c5\u75c5\u6bd2\u611f\u67d3<\/span><\/p>\n<\/section>\n<\/section>\n

    \n
    <\/svg><\/section>\n
    <\/svg><\/section>\n<\/section>\n
    \n
    \n

    29\u5c81\u5973\u6027\u60a3\u8005<\/span>\u56e0\u9888\u90e8\u80bf\u5757\u5728\u666e\u901a\u5185\u79d1\u8bca\u6240\u5c31\u8bca\uff0c\u65e0\u53d1\u70e7\u3001\u51fa\u6c57\u75c7\u72b6\u300220\u591a\u5c81\u65f6\u4e24\u6b21\u6b63\u5e38\u6000\u5b55\uff0c26\u5c81\u65f6\u6709\u4e00\u6b21\u76c6\u8154\u708e(\u7531\u8863\u539f\u4f53\u611f\u67d3\u5f15\u8d77)\uff0c\u76ee\u524d\u662f\u5355\u4eb2\u5988\u5988\uff0c\u5b69\u5b50\u90fd\u5f88\u5065\u5eb7\u3002<\/p>\n

    \u533b\u751f\u68c0\u67e5\u53d1\u73b0\u5979\u60a3\u6709\u5168\u8eab\u6027\u6dcb\u5df4\u7ed3\u75c5\uff0c\u5df2\u7ecf\u5f71\u54cd\u5230\u5979\u7684\u9888\u90e8\u3001\u814b\u7a9d\u548c\u8179\u80a1\u6c9f\u6dcb\u5df4\u7ed3\u3002\u8fd9\u79cd\u5168\u8eab\u6027\u6dcb\u5df4\u7ed3\u75c5\u5e76\u4e0d\u662f\u764c\u75c7\u6216\u5c40\u90e8\u611f\u67d3\u7684\u7279\u5f81\uff0c\u800c\u662f HIV \u611f\u67d3\u53ef\u80fd\u4f1a\u51fa\u73b0\u7684\u7279\u5f81\u3002<\/span>\u60a3\u8005\u540c\u610f\u8fdb\u884c HIV \u6297\u4f53\u6d4b\u8bd5\uff0c\u7ed3\u679c\u5448\u9633\u6027\uff0c\u8fdb\u4e00\u6b65\u68c0\u6d4b\u663e\u793a\u5176\u4f53\u5185CD4\u7ec6\u80de\u51cf\u5c11(\u7ea6\u4e3a310\u00d7106<\/sup>\/L\uff0c\u800c\u6b63\u5e38\u503c\u5728500\u00d7106<\/sup>\/L \u4ee5\u4e0a)\uff0c\u75c5\u6bd2\u8f7d\u91cf\u4e3a 2\u00d7105<\/sup>\/mL\u3002\u5c3d\u7ba1\u5979\u6ca1\u6709\u827e\u6ecb\u75c5\u76f8\u5173\u75c7\u72b6\uff0c\u4f46\u8fd9\u4e9b\u7ed3\u679c\u4e0e\u4e2d\u671f\u7684\u827e\u6ecb\u75c5\u611f\u67d3\u7684\u8868\u73b0\u662f\u4e00\u81f4\u7684\u3002\u5979\u62c5\u5fc3\u5979\u7684\u5b69\u5b50\u662f\u5426\u6709\u88ab\u611f\u67d3\uff0c\u5728\u533b\u751f\u68c0\u67e5\u5979\u7684\u4ea7\u524d\u8bb0\u5f55\u540e\uff0c\u786e\u8ba4\u5979\u5728\u4e24\u6b21\u6000\u5b55\u671f\u95f4\u7684\u827e\u6ecb\u75c5\u75c5\u6bd2\u7b5b\u67e5\u6d4b\u8bd5\u90fd\u662f\u9634\u6027\u7684\u3002<\/p>\n

    \u56e0\u4e3a\u7b2c\u4e00\u6b21\u7684CD4\u7ec6\u80de\u8ba1\u6570\u4e5f\u53ef\u80fd\u662f\u7531\u4e8e\u5fc3\u7406\u538b\u529b\u800c\u964d\u4f4e\u7684\uff0c\u6240\u4ee5\u533b\u751f\u5bf9CD4\u7ec6\u80de\u8fdb\u884c\u4e86\u91cd\u590d\u8ba1\u6570\uff0c\u7b2c\u4e8c\u6b21\u7684\u8ba1\u6570\u7ed3\u679c\u662f 290\u00d7106<\/sup>\/L\u3002\u786e\u8bca\u540e\uff0c\u5979\u63a5\u53d7\u4e86\u9ad8\u6548\u6297\u9006\u8f6c\u5f55\u75c5\u6bd2\u6cbb\u7597(HAART)\uff0c\u4f7f\u7528\u7531\u4e09\u79cd\u4e0d\u540c\u9006\u8f6c\u5f55\u9176\u6291\u5236\u5242\u7ec4\u5408\u800c\u6210\u7684\u836f\u7269\u3002<\/span>\u5979\u5bf9\u9006\u8f6c\u5f55\u9176\u6291\u5236\u5242\u7ec4\u5408\u836f\u7269\u8010\u53d7\u6027\u9ad8\uff0c\u5f00\u59cb\u6cbb\u7597\u540e\uff0c\u5979\u4f53\u5185\u7684\u75c5\u6bd2\u8f7d\u91cf\u8fc5\u901f\u4e0b\u964d\uff0cCD4\u7ec6\u80de\u8ba1\u6570\u9010\u6e10\u6539\u5584(Fig. 33.7<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n

    \n
    <\/section>\n<\/section>\n
    \n
    \n
    \n


    <\/p>\n<\/section>\n<\/section>\n

    \n
    \n

    Fig. 33.7<\/span> \u9ad8\u6548\u6297\u9006\u8f6c\u5f55\u75c5\u6bd2\u7597\u6cd5(HAART)\u5bf9 HIV \u75c5\u6bd2\u8f7d\u91cf\u548cCD4\u7ec6\u80de\u8ba1\u6570\u7684\u5f71\u54cd\u3002\u75c5\u6bd2\u8f7d\u91cf\u5728\u5176\u590d\u5236\u5468\u671f\u88ab\u963b\u65ad\u540e\u8fc5\u901f\u4e0b\u964d\uff0cCD4\u7ec6\u80de\u8ba1\u6570\u9700\u8981\u66f4\u957f\u7684\u65f6\u95f4\u624d\u80fd\u6062\u590d<\/p>\n<\/section>\n<\/section>\n<\/section>\n

    \n

    HIV\u611f\u67d3\u7684\u60a3\u8005\u9700\u8981\u514d\u75ab\u5b66(CD4\u7ec6\u80de\u8ba1\u6570)\u548c\u75c5\u6bd2\u5b66(\u75c5\u6bd2\u8f7d\u91cf)\u76d1\u6d4b\u3002CD4\u7ec6\u80de\u8ba1\u6570\u7684\u7ed3\u679c\u4ee3\u8868\u7740\u4e0d\u540c\u7a0b\u5ea6\u7684\u673a\u4f1a\u6027\u611f\u67d3\u98ce\u9669\u3002\u4f8b\u5982\uff0cCD4\u7ec6\u80de\u8ba1\u6570\u4f4e\u4e8e 200\u00d7106<\/sup>\/L \u7684\u60a3\u8005\u60a3\u5409\u7f57\u7ef4\u6c0f\u80ba\u5b62\u5b50\u866b\u80ba\u708e(PJP)\u7684\u98ce\u9669\u5f88\u9ad8\uff0c\u5e94\u8be5\u63a5\u53d7\u9884\u9632\u6027\u836f\u7269\u6cbb\u7597(\u9884\u9632\u6027\u6cbb\u7597)\u3002\u75c5\u6bd2\u8f7d\u91cf\u6d4b\u8bd5\u53ef\u4ee5\u6d4b\u91cfHIV\u75c5\u6bd2\u8840\u75c7\uff0c\u5e76\u53cd\u6620\u75be\u75c5\u8fdb\u5c55\u7684\u957f\u671f\u98ce\u9669\u3002\u75c5\u6bd2\u8f7d\u91cf\u548cCD4\u7ec6\u80de\u8ba1\u6570\u7528\u4e8e\u786e\u5b9a\u4f7f\u7528\u6297\u9006\u8f6c\u5f55\u75c5\u6bd2\u836f\u7269\u6cbb\u7597\u7684\u9884\u540e\u6548\u679c<\/span>\u3002\u4e0a\u8ff0\u8fd9\u540d\u60a3\u8005\u7684\u75c5\u6bd2\u8f7d\u91cf\u975e\u5e38\u9ad8\uff0c\u5e76\u4e14\u68c0\u6d4b\u8868\u660e\u5979\u7684CD4<\/span>+<\/sup>T\u7ec6\u80de\u663e\u8457\u6d88\u8017\u3002CD4\u7ec6\u80de\u8ba1\u6570\u91c7\u7528\u6d41\u5f0f\u7ec6\u80de\u4eea(<\/span>Fig. 5.7<\/span>)\uff0c\u5176\u6570\u91cf\u53d7\u6fc0\u7d20\u5f71\u54cd\u3002\u4f8b\u5982\uff0cCD4\u7ec6\u80de\u8ba1\u6570\u968f\u7740\u76ae\u8d28\u7c7b\u56fa\u9187\u5728\u4e00\u5929\u7684\u4e0d\u540c\u65f6\u95f4\u6bb5\u5206\u6ccc\u91cf\u7684\u4e0d\u540c\u800c\u51fa\u73b0\u53d8\u5316\uff0c<\/span>\u5728\u65e9\u4e0a\u65f6CD4\u7ec6\u80de\u8ba1\u6570\u6700\u4f4e\uff0c\u5f53\u673a\u4f53\u51fa\u73b0\u6025\u3001\u6162\u6027\u5e94\u6fc0\u65f6\u76ae\u8d28\u7c7b\u56fa\u9187\u7684\u5206\u6ccc\u4f1a\u6291\u5236CD4\u7ec6\u80de\u8ba1\u6570\u3002\u6b64\u5916\uff0cCD4\u7ec6\u80de\u8ba1\u6570\u4e5f\u4f1a\u53d7\u5230\u96cc\u6fc0\u7d20\u6c34\u5e73\u7684\u5f71\u54cd\uff0c\u56e0\u6b64\u5728\u6708\u7ecf\u5468\u671f\u7684\u4e0d\u540c\u9636\u6bb5\u4e5f\u4f1a\u6709\u6240\u4e0d\u540c\u3002\u5728\u76d1\u6d4bCD4\u7ec6\u80de\u8ba1\u6570\u65f6\u9700\u8981\u7efc\u5408\u8003\u8651\u4e0a\u8ff0\u56e0\u7d20\u3002<\/span><\/span>
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    Box 33.2 <\/span>\u6025\u6027\u75be\u75c5\u4e2d\u7684\u7ee7\u53d1\u6027\u514d\u75ab\u7f3a\u9677<\/span><\/p>\n<\/section>\n<\/section>\n

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    30\u5c81\u7537\u5b50\u8f66\u7978\u540e\u5165\u9662\uff0c<\/span>\u660f\u8ff7\u3001\u8111\u6c34\u80bf\uff0c\u533b\u751f\u7ed9\u4ed6\u8fdb\u884c\u4e86\u4e2d\u5fc3\u9759\u8109\u5bfc\u7ba1\u548c\u5bfc\u5c3f\u7ba1\u7684\u63d2\u7ba1\u3002\u4e3a\u4e86\u51cf\u8f7b\u8111\u6c34\u80bf\uff0c\u4f7f\u7528\u4e86\u5927\u5242\u91cf\u7684\u76ae\u8d28\u7c7b\u56fa\u9187\u3002\u5728\u51fa\u73b0\u4e00\u7cfb\u5217\u60ca\u53a5\u53cd\u5e94\u540e\uff0c\u9759\u8109\u6ce8\u5c04\u4e86\u6297\u60ca\u53a5\u836f\u82ef\u59a5\u82f1\u94a0(Fig.33.8<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n

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    \u4e24\u5468\u540e\uff0c\u75c5\u4eba\u4ece\u795e\u7ecf\u6027\u53d1\u4f5c\u4e2d\u6062\u590d\u8fc7\u6765\u540e\u53c8\u51fa\u73b0\u4e86\u80ba\u708e<\/span>(<\/span>Fig.33.9<\/span>)\u3002\u9664\u4e86\u751f\u7406\u538b\u529b\u548c\u8425\u517b\u4e0d\u826f\uff0c\u8fd9\u540d\u60a3\u8005\u7684\u5148\u5929\u5c4f\u969c\u5728\u4e09\u4e2a\u4e0d\u540c\u7684\u90e8\u4f4d\u88ab\u7a7f\u900f\uff0c\u66b4\u9732\u5728\u4e24\u79cd\u635f\u5bb3\u514d\u75ab\u7cfb\u7edf\u7684\u836f\u7269\u4e2d\uff0c\u800c\u8fd9\u4e9b\u56e0\u7d20\u4f7f\u4ed6\u5bf9\u611f\u67d3\u7684\u62b5\u6297\u529b\u964d\u4f4e\u3002<\/span><\/span>
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    Fig.33.9<\/span> \u80f8\u7247\u663e\u793a\u4e3a\u5178\u578b\u7684\u8461\u8404\u7403\u83cc\u80ba\u708e\u8113\u80bf\u3002\u8fd9\u79cd\u5371\u53ca\u751f\u547d\u4f46\u53ef\u4ee5\u907f\u514d\u7684\u611f\u67d3\u662f\u8bf1\u5bfc\u514d\u75ab\u7f3a\u9677\u7684\u591a\u79cd\u56e0\u7d20\u5171\u540c\u4f5c\u7528\u7684\u7ed3\u679c\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

    \u672c\u6587\u7531Oncolab\u5b9e\u9a8c\u5ba4\u5fae\u4fe1\u516c\u4f17\u53f7\u7ffb\u8bd1\u6574\u7406\u81eaImmunology for Medical Students\uff0c\u4ec5\u7528\u4e8e\u5b66\u4e60\u4ea4\u6d41\u4f7f\u7528\uff0c\u5982\u9700\u8d2d\u4e70\u539f\u7248\u4e66\u7c4d\u53ef\u70b9\u51fb\u9605\u8bfb\u539f\u6587\u8d2d\u4e70\u3002<\/span><\/p>\n


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    \u2014 THE  END \u2014<\/span><\/p>\n


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    \u6765\u6e90 | Immunology for Medical Students<\/span><\/section>\n
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    \u8be5\u661f\u7403\u7528\u4e8eOncoLab\u516c\u4f17\u53f7\u8bfb\u8005\u4ea4\u6d41\u5b66\u4e60\u4f7f\u7528\uff0c\u6c38\u4e45\u514d\u8d39<\/span>\u3002<\/p>\n<\/section>\n

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    \u672c\u7bc7\u6587\u7ae0\u6765\u6e90\u4e8e\u5fae\u4fe1\u516c\u4f17\u53f7: OncoLab <\/p>\n<\/blockquote>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

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