{"id":2768,"date":"2022-12-13T18:56:07","date_gmt":"2022-12-13T10:56:07","guid":{"rendered":"http:\/\/oncolab.cn\/index.php\/2022\/12\/13\/%e5%85%8d%e7%96%ab%e5%ad%a6%e6%8b%be%e9%81%97-%e7%ac%ac36%e7%ab%a0%ef%bc%9a%e7%94%9f%e7%89%a9%e5%88%b6%e8%8d%af%ef%bc%88%e6%9c%ac%e7%b3%bb%e5%88%97%e6%9b%b4%e6%96%b0%e5%ae%8c%e6%af%95%ef%bc%89\/"},"modified":"2022-12-13T18:56:07","modified_gmt":"2022-12-13T10:56:07","slug":"%e5%85%8d%e7%96%ab%e5%ad%a6%e6%8b%be%e9%81%97-%e7%ac%ac36%e7%ab%a0%ef%bc%9a%e7%94%9f%e7%89%a9%e5%88%b6%e8%8d%af%ef%bc%88%e6%9c%ac%e7%b3%bb%e5%88%97%e6%9b%b4%e6%96%b0%e5%ae%8c%e6%af%95%ef%bc%89","status":"publish","type":"post","link":"http:\/\/oncolab.cn\/index.php\/2022\/12\/13\/%e5%85%8d%e7%96%ab%e5%ad%a6%e6%8b%be%e9%81%97-%e7%ac%ac36%e7%ab%a0%ef%bc%9a%e7%94%9f%e7%89%a9%e5%88%b6%e8%8d%af%ef%bc%88%e6%9c%ac%e7%b3%bb%e5%88%97%e6%9b%b4%e6%96%b0%e5%ae%8c%e6%af%95%ef%bc%89\/","title":{"rendered":"\u514d\u75ab\u5b66\u62fe\u9057-\u7b2c36\u7ae0\uff1a\u751f\u7269\u5236\u836f\uff08\u672c\u7cfb\u5217\u66f4\u65b0\u5b8c\u6bd5\uff09"},"content":{"rendered":"
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\u4eca\u5929\u662f2022\u5e7412\u670813\u65e5\uff0c\u300a\u514d\u75ab\u5b66\u62fe\u9057\u300b\u7cfb\u5217\u81ea2020\u5e7412\u670813\u65e5\u53d1\u5e03\u7b2c\u4e00\u7bc7\u4ee5\u6765\uff0c\u5230\u4eca\u5929\uff0c\u6b63\u597d\u662f\u4e24\u5e74\u65f6\u95f4\uff0c\u4e24\u5e74\u95f4\u6211\u4eec\u4ee5\u5927\u6982\u6bcf\u4e24\u5468\u4e00\u7bc7\u7684\u901f\u5ea6\u53d1\u5e03\uff0c\u5171\u8ba1\u53d1\u5e03\u4e8636\u7ae0\u5185\u5bb9\uff0c\u80fd\u591f\u575a\u6301\u4e0b\u6765\u662f\u56e2\u961f\u534f\u540c\u4f5c\u6218\uff0c\u5171\u540c\u52aa\u529b\u7684\u7ed3\u679c\uff0c\u611f\u8c22\u6bcf\u4f4d\u6210\u5458\u7684\u4ed8\u51fa\uff0c\u4e5f\u611f\u8c22\u8bfb\u8005\u7684\u5173\u6ce8\uff0c\u8bfb\u8005\u7684\u5173\u6ce8\u4e0e\u9605\u8bfb\u5c31\u662f\u6211\u4eec\u4e0d\u65ad\u66f4\u65b0\u7684\u6700\u5927\u52a8\u529b\uff01<\/p>\n

\u5728\u6b64\u8fc7\u7a0b\u4e2d\uff0c\u6211\u4eec\u4e5f\u540c\u6837\u6536\u83b7\u4e86\u5f88\u591a\uff0c\u5bf9\u514d\u75ab\u5b66\u4e5f\u6709\u4e86\u66f4\u591a\u7684\u4e86\u89e3\u4e0e\u8ba4\u8bc6\uff0c\u6211\u4eec\u4e5f\u5e0c\u671b\u80fd\u591f\u5c06\u8fd9\u4ef6\u4e8b\u6301\u7eed\u505a\u4e0b\u53bb\uff0c\u76ee\u524d\u516c\u4f17\u53f7\u6b63\u5728\u66f4\u65b0\u7684\u662f\u300a\u80bf\u7624\u514d\u75ab\u5b66\u300b\u7cfb\u5217\u5185\u5bb9\uff0c\u6b22\u8fce\u5927\u5bb6\u6301\u7eed\u5173\u6ce8\uff01<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u751f\u7269\u533b\u836f\u5236\u54c1\u662f\u7531\u6d3b\u7ec6\u80de\u4ea7\u751f\u7684\u836f\u7269\u3002\u6700\u65e9\u7684\u751f\u7269\u836f\u7269\u5305\u62ec\u4ece\u4eba\u7c7b\uff08\u4f8b\u5982\u514d\u75ab\u7403\u86cb\u767d\u7f6e\u6362\uff1b\u7b2c32\u7ae0<\/span>\uff09\u6216\u52a8\u7269\uff08\u4f8b\u5982\uff0c\u5730\u9ad8\u8f9b\u7247\uff1b\u7b2c4\u7ae0<\/span>\uff09\u4e2d\u63d0\u7eaf\u7684\u6297\u4f53\u3002\u53e6\u5916\uff0c\u7528\u4e8e\u8fc7\u654f\u6cbb\u7597\u7684\u75ab\u82d7\uff08\u7b2c25\u7ae0<\/span>\uff09\u548c\u8fc7\u654f\u539f\uff08\u7b2c27\u7ae0<\/span>\uff09\u4e5f\u662f\u751f\u7269\u836f\u7269\uff0c\u8fd9\u4e9b\u7269\u8d28\u53ef\u4ee5\u901a\u8fc7\u63d0\u7eaf\u63d0\u53d6\u7269\u3001\u901a\u8fc7\u6709\u673a\u4f53\u6216\u4f7f\u7528\u5206\u5b50\u751f\u7269\u5b66\u6280\u672f\u6765\u751f\u4ea7\u3002\u751f\u7269\u836f\u7269\u8fd8\u5305\u62ec\u6cbb\u7597\u6027\u5355\u514b\u9686\u6297\u4f53\uff08mAb\uff09\u548c\u91cd\u7ec4\u7ec6\u80de\u56e0\u5b50\uff0c\u5b83\u4eec\u662f\u901a\u8fc7\u5206\u5b50\u751f\u7269\u5b66\u548c\u7ec6\u80de\u5b66\u6280\u672f\u751f\u4ea7\u7684\u3002\u503c\u5f97\u4e00\u63d0\u7684\u662f\uff0c\u7b2c5\u7ae0<\/span>\u4e2d\u63cf\u8ff0\u7684\u4fa7\u5411\u6d41\u52a8\u8bd5\u9a8c(\u5982\u598a\u5a20\u8bd5\u9a8c)\u3001\u9176\u8054\u514d\u75ab\u5438\u9644\u8bd5\u9a8c(ELISA)\u548c\u6d41\u5f0f\u7ec6\u80de\u672f\u90fd\u79bb\u4e0d\u5f00mAb\u7684\u5e94\u7528\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u751f\u7269\u836f\u7269\u7684\u672c\u8d28\u662f\u86cb\u767d\u8d28<\/span>\uff0c\u5b83\u4eec\u90fd\u6709\u5f15\u53d1\u673a\u4f53\u514d\u75ab\u53cd\u5e94\u7684\u53ef\u80fd\u6027\u3002\u5c31\u75ab\u82d7\u548c\u8fc7\u654f\u539f\u800c\u8a00\uff0c\u5f15\u8d77\u514d\u75ab\u53cd\u5e94\u662f\u7406\u60f3\u7684\uff1b\u800c\u5bf9\u4e8e\u5355\u6297\u548c\u7ec6\u80de\u56e0\u5b50\uff0c\u5219\u5e94\u907f\u514d\u5f15\u8d77\u514d\u75ab\u53cd\u5e94\uff0c\u901a\u5e38\u8981\u6539\u8fdb\u8fd9\u4e9b\u86cb\u767d\u8d28\u5206\u5b50\u7684\u7ed3\u6784\u4ee5\u964d\u4f4e\u514d\u75ab\u539f\u6027\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u672c\u7ae0\u4ecb\u7ecd\u4e86\u7528\u4e8e\u4e34\u5e8a\u533b\u5b66\u7684\u4e00\u4e9b\u751f\u7269\u6280\u672f\u65b9\u6cd5<\/span>\uff0c\u5b83\u4eec\u53ef\u4ee5\u7528\u4e8e\u6539\u8fdbmAbs\u548c\u7ec6\u80de\u56e0\u5b50\u3002\u5bf9\u751f\u7269\u6280\u672f\u7684\u8fdb\u4e00\u6b65\u4e86\u89e3\u6709\u52a9\u4e8e\u6539\u8fdbmAb\uff0c\u4f8b\u5982\uff0c\u51cf\u5c11\u5c0f\u9f20\u57fa\u56e0\u5e8f\u5217\u7684\u6570\u91cf\u3001\u589e\u52a0\u4eba\u7c7b\u57fa\u56e0\u5e8f\u5217\u7684\u6570\u91cf\uff0c\u540c\u65f6\u4fdd\u6301mAb(\u4eba\u6e90\u5316\u7684mAb)\u7684\u539f\u59cb\u7279\u5f02\u6027\u3002\u6b64\u5916\uff0c\u4e5f\u5df2\u91c7\u7528\u9057\u4f20\u5b66\u65b9\u6cd5\u6765\u6539\u53d8mAb\u7684\u4f4e\u805a\u7cd6\u4fa7\u94fe\uff0c\u4f7f\u5b83\u4eec\u4e0d\u90a3\u4e48\u201c\u50cf\u8001\u9f20\u201d\uff0c\u5e76\u4e14\u964d\u4f4e\u5176\u4e0e\u8bc6\u522b\u7269\u79cd\u7279\u5f02\u6027\u5dee\u5f02\u7684\u6297\u4f53\u53cd\u5e94\u7684\u53ef\u80fd\u6027\uff08\u7b2c34\u7ae0<\/span>\uff09\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u6539\u9020\u91cd\u7ec4\u7ec6\u80de\u56e0\u5b50\u4e0e\u805a\u4e59\u4e8c\u9187\u5316\uff08PEG\uff09\uff0c\u53ef\u4f7f\u673a\u4f53\u4ea7\u751f\u6297\u7ec6\u80de\u56e0\u5b50\u6297\u4f53\u7684\u53ef\u80fd\u6027\u964d\u4f4e\uff0c\u5e76\u589e\u52a0\u7ec6\u80de\u56e0\u5b50\u5728\u8840\u6e05\u4e2d\u7684\u534a\u8870\u671f\u3002\u672c\u7ae0\u8fd8\u4f1a\u5f15\u7528\u7b2c4\u7ae0<\/span>\u548c\u7b2c5\u7ae0<\/span>\u4e2d\u7684\u4e00\u4e9b\u6750\u6599\uff0c\u5e76\u4ecb\u7ecd\u751f\u7269\u6280\u672f\u5728\u4e34\u5e8a\u533b\u5b66\u4e2d\u7684\u5b9e\u9645\u514d\u75ab\u5b66\u7528\u9014\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5355\u514b\u9686\u6297\u4f53<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u6297\u4f53\u7684\u4e24\u4e2a\u5173\u952e\u533a\u57df\u5438\u5f15\u7740\u751f\u7269\u6280\u672f\u4e13\u5bb6\u56f4\u7ed5\u5176\u5f00\u53d1\u836f\u7269(Fig 36.1<\/span>)\uff1a<\/p>\n

\u7279\u5b9a\u6297\u4f53\u7684Fab\u533a(\u7b2c4\u7ae0<\/span>)\u8d4b\u4e88\u5176\u5bf9\u6297\u539f\u7684\u7279\u5f02\u6027\uff0c\u5e76\u53ef\u5145\u5f53\u201c\u795e\u5947\u7684\u5b50\u5f39\u201d\uff0c\u5f15\u5bfc\u5176\u5bf9\u75c5\u539f\u4f53\u6216\u80bf\u7624\u7ec6\u80de\u7684\u4f5c\u7528\u3002\u4e0e\u5176\u4ed6\u4e0d\u80fd\u9488\u5bf9\u7279\u5b9a\u9776\u7ec6\u80de\u7684\u836f\u7269\u76f8\u6bd4\uff0c\u8fd9\u79cd\u7279\u5f02\u6027\u63d0\u4f9b\u4e86\u53ef\u9884\u6d4b\u7684\u6cbb\u7597\u6548\u679c\u5e76\u51cf\u5c11\u4e86\u526f\u4f5c\u7528\u3002<\/p>\n

\u6297\u4f53\u7684Fc\u533a\u662f\u6548\u5e94\u533a\u3002\u5bf9\u4e8e\u514d\u75ab\u7403\u86cb\u767dG(IgG)\uff0cFc\u533a\u7684\u751f\u7406\u4f5c\u7528\u5305\u62ec\u6fc0\u6d3b\u8865\u4f53\u7ea7\u8054\u53cd\u5e94\u3001\u5de8\u566c\u7ec6\u80de\u3001\u81ea\u7136\u6740\u4f24(NK)\u7ec6\u80de\u548c\u80a5\u5927\u7ec6\u80de\u3002\u4e5f\u53ef\u4ee5\u4eba\u4e3a\u6539\u53d8Fc\u533a\uff0c\u4ee5\u5c06\u836f\u7269\u548c\u6bd2\u7d20\u8f93\u9001\u5230\u7279\u5b9a\u7ec6\u80de\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 36.1 <\/span>\u514d\u75ab\u7403\u86cb\u767d\u7ed3\u6784<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u6709\u5173\u6297\u4f53\u7597\u6cd5\u7684\u63a2\u7d22<\/span><\/strong>
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\u5728\u8fc7\u53bb\u7684100\u5e74\u91cc\uff0c\u4eba\u4eec\u5c1d\u8bd5\u4e86\u5404\u79cd\u6297\u4f53\u7597\u6cd5\u3002\u5c06\u52a8\u7269\u591a\u514b\u9686\u514d\u75ab\u7403\u86cb\u767d\u4f5c\u4e3a\u8840\u6e05\u6ce8\u5c04\uff0c\u4f8b\u5982\u66fe\u88ab\u7528\u6765\u6cbb\u7597\u611f\u67d3\u548c\u4e2d\u548c\u86c7\u6bd2(\u6297\u86c7\u6bd2)\u3002\u9a6c\u8840\u6e05\u901a\u5e38\u80fd\u8bf1\u5bfc\u673a\u4f53\u4ea7\u751f\u6297\u9a6c\u6297\u4f53\uff0c\u8fd9\u4e9b\u6297\u4f53\u4e0e\u9a6c\u86cb\u767d\u5f62\u6210\u514d\u75ab\u590d\u5408\u7269\uff0c\u8be5\u514d\u75ab\u590d\u5408\u7269\u4f1a\u5f15\u53d1III\u578b\u8d85\u654f\u53cd\u5e94\uff0c\u5bfc\u81f4\u8840\u6e05\u75c5(\u7b2c30\u7ae0<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u591a\u514b\u9686\u4eba\u514d\u75ab\u7403\u86cb\u767d\u4e5f\u88ab\u8ba4\u4e3a\u662f\u88ab\u52a8\u514d\u75ab\u7684\u4e00\u79cd\u5f62\u5f0f\u3002\u6297\u4f53\u7f3a\u4e4f\u75c7\u60a3\u8005\u53ef\u63a5\u53d7\u514d\u75ab\u7403\u86cb\u767d\u66ff\u4ee3\u6cbb\u7597(\u7b2c32\u7ae0<\/span>)\uff1b\u6297-D\u514d\u75ab\u7403\u86cb\u767d\u53ef\u7528\u4e8e\u6000\u6709RH\u9633\u6027\u8840\u578b\u80ce\u513f\u4f46\u672c\u8eab\u662fRH\u9634\u6027\u8840\u578b\u7684\u5987\u5973\uff0c\u4ee5\u9884\u9632\u65b0\u751f\u513f\u6eb6\u8840\u75c5(\u7b2c29\u7ae0<\/span>)\u3002\u7136\u800c\uff0c\u901a\u8fc7\u4f9b\u8005\u6765\u83b7\u5f97\u5927\u91cf\u7684\u4eba\u7c7b\u514d\u75ab\u7403\u86cb\u767d\u662f\u5f88\u6602\u8d35\u7684\uff0c\u800c\u4e14\u6709\u8840\u6db2\u4f20\u64ad\u611f\u67d3\u7684\u98ce\u9669\u3002\u6b64\u5916\uff0c\u4eba\u7c7b\u6765\u6e90\u7684\u6cbb\u7597\u6027\u6297\u4f53\u7684\u8303\u56f4\u662f\u6709\u9650\u7684\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5355\u514b\u9686\u6297\u4f53\u6280\u672f<\/strong><\/p>\n<\/section>\n

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\u9f20\u6e90\u6027mAb(\u5c0f\u9f20\u5355\u6297)\u53d1\u660e\u4e8e1975\u5e74\uff0c\u5176\u76ee\u7684\u662f\u5f00\u53d1\u5927\u91cf\u7279\u5f02\u6027\u6297\u4f53\uff0c\u8fd9\u4e9b\u6297\u4f53\u5ec9\u4ef7\u4e14\u5b89\u5168\u3002\u9f20\u6e90\u6027mAb\u8fd8\u6709\u4e00\u4e2a\u4f18\u70b9\uff0c\u5b83\u4eec\u53ef\u4ee5\u9488\u5bf9\u65e0\u6cd5\u523b\u610f\u7528\u4e8e\u514d\u75ab\u4eba\u7c7b\u7684\u6297\u539f\uff08\u4f8b\u5982<\/span>\u67d0\u4e9b\u75c5\u539f\u4f53\u6216\u80bf\u7624\u7ec6\u80de\uff09\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5236\u5907\u9f20\u6e90\u6027mAb\u7684\u4f20\u7edf\u65b9\u6cd5<\/span>\u662f\u5c06\u514d\u75ab\u5c0f\u9f20\u7684B\u7ec6\u80de\u4e0e\u5c0f\u9f20\u9aa8\u9ad3\u7624\u7ec6\u80de\u878d\u5408(\u89c1Box 36.2<\/span>)\uff0c\u8fd9\u6837\u4f1a\u4ea7\u751f\u9ad8\u6c34\u5e73\u7684\u9f20\u6e90\u6027mAb\u3002\u9f20\u6e90\u6027mAb\u5e94\u7528\u5e7f\u6cdb\uff0c\u4f46\u4e5f\u5b58\u5728\u4e00\u4e9b\u7a81\u51fa\u95ee\u9898\u3002\u9f20\u6e90\u6027mAb\u5177\u6709\u9f20\u7684Fc\u533a\uff0c\u5728\u4f53\u5185\u4e0d\u80fd\u4e0e\u4eba\u7684\u8865\u4f53\u5206\u5b50\u6216\u4eba\u5de8\u566c\u7ec6\u80de\u3001NK\u7ec6\u80de\u4e0a\u7684Fc\u53d7\u4f53\u5f88\u597d\u5730\u76f8\u4e92\u4f5c\u7528\u3002\u6b64\u5916\uff0c\u6cbb\u7597\u6027\u9f20\u6e90\u6027mAb\u8fd8\u80fd\u4ea7\u751f\u6297\u5c0f\u9f20\u6297\u4f53\u3002\u8fd9\u4e9b\u6297\u5c0f\u9f20\u6297\u4f53\u65e2\u53ef\u4ee5\u8bc6\u522b\u5c0f\u9f20\u86cb\u767d\u4e0a\u8868\u8fbe\u7684\u72ec\u7279\u7684\u5be1\u7cd6\u4fa7\u94fe\uff0c\u4e5f\u53ef\u4ee5\u8bc6\u522b\u5c0f\u9f20\u514d\u75ab\u7403\u86cb\u767d\u94fe\u6052\u5b9a\u533a\u7684\u6c28\u57fa\u9178\u5e8f\u5217\u3002\u6297\u9f20\u6297\u4f53\u53ef\u5f15\u8d77\u514d\u75ab\u590d\u5408\u4f53\u75be\u75c5(IgG\u6297\u9f20\u6297\u4f53)\u6216\u8fc7\u654f\u53cd\u5e94(\u7b2c30\u7ae0<\/span>)\u3002\u6297\u9f20IgG\u6297\u4f53\u4e5f\u4f1a\u4e2d\u548c\u9f20\u6e90\u6027mAb\u7684\u4f5c\u7528\uff0c\u5927\u7ea640%\u7684\u60a3\u8005\u5728\u63a5\u53d7mAb\u6cbb\u7597\u540e\u4f1a\u4ea7\u751f\u6297\u9f20IgG\u6297\u4f53\u3002\u6297\u9f20\u6297\u4f53\u4f1a\u963b\u65ad\u5355\u6297\u7684\u6709\u76ca\u4f5c\u7528\u3002\u4f8b\u5982\uff0c\u5bf9\u4e8e\u7c7b\u98ce\u6e7f\u6027\u5173\u8282\u708e\u60a3\u8005\uff0c\u4e00\u79cd\u8fc7\u5f80\u6709\u6548\u7684\u836f\u7269\u53ef\u80fd\u4f1a\u56e0\u6297\u9f20\u6297\u4f53\u800c\u5931\u6548\uff0c\u5bfc\u81f4\u4e0d\u80fd\u518d\u4f7f\u7528\u9f20\u6e90\u6027\u5355\u6297\u3002\u4e3a\u4e86\u514b\u670d\u8fd9\u4e9b\u95ee\u9898\uff0c\u53ef\u901a\u8fc7\u4e00\u4e9b\u624b\u6bb5\u6765\u589e\u52a0mAb\u4e2d\u4eba\u7c7b\u57fa\u56e0\u5e8f\u5217\u7684\u6bd4\u4f8b\uff08Fig 36.2<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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1.\u5d4c\u5408mAb\uff1a\u4f7f\u7528\u6765\u81ea\u514d\u75ab\u5c0f\u9f20\u7684\u5c0f\u9f20\u514d\u75ab\u7403\u86cb\u767d\u53ef\u53d8\u533a\u57fa\u56e0\u5e8f\u5217\u548c\u4eba\u7c7b\u6052\u5b9a\u533a\u57fa\u56e0\u5e8f\u5217\uff0c\u4e24\u8005\u5d4c\u5408\u5e76\u5728\u54fa\u4e73\u52a8\u7269\u7ec6\u80de\u4e2d\u8fdb\u884c\u514b\u9686\uff0c\u7136\u540e\u8868\u8fbe\u5d4c\u5408\u514d\u75ab\u7403\u86cb\u767d\u5206\u5b50\u3002\u5d4c\u5408mAb\u53ea\u542b\u6709\u5927\u7ea630%\u7684\u5c0f\u9f20\u6c28\u57fa\u9178\u5e8f\u5217\uff0c\u4f46\u5728\u7528\u4e8e\u6cbb\u7597\u65f6\u4ecd\u6709\u5f15\u53d1\u6297\u4f53\u7684\u503e\u5411\u3002\u5d4c\u5408mAb\u7684\u540d\u79f0\u4e2d\u5305\u542b\u5b57\u6bcd\u201cxi\u201d\uff0c\u4f8b\u5982\uff0crituximab(\u7b2c35\u7ae0<\/span>)\u3001infliximab\u548cbasiliximab(\u7b2c34\u7ae0<\/span>)\u3002<\/p>\n

2.\u4eba\u6e90\u5316mAb\uff1a\u4f7f\u7528\u4e00\u79cd\u7c7b\u4f3c\u4e8e\u5d4c\u5408\u6297\u4f53\u7684\u6280\u672f\uff0c\u4f46\u53ea\u4f7f\u7528\u4e86\u5c0f\u9f20\u9ad8\u53d8\u533a\u57fa\u56e0\u5e8f\u5217\uff0c\u53ea\u6709\u5927\u7ea610%\u7684\u6c28\u57fa\u9178\u6765\u81ea\u5c0f\u9f20\u7684\u5e8f\u5217\u3002\u4eba\u6e90\u5316mAb\u540d\u79f0\u4e2d\u5305\u542b\u5b57\u6bcd\u201cu\u201d\uff0c\u4f8b\u5982\uff0crituximab\u3001trastuzumab\u3001bevacizumab\u548cipilimumab\uff1b\u8fd9\u4e9b\u90fd\u53ef\u7528\u4e8e\u764c\u75c7\u6cbb\u7597(\u7b2c35\u7ae0<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u8fd9\u4e9b\u6280\u672f\u5df2\u7ecf\u88ab\u7528\u4e8e\u5f00\u53d1\u5177\u6709\u7c7b\u4f3c\u4eba\u7c7b\u6c28\u57fa\u9178\u5e8f\u5217\u7684\u5355\u6297\uff0c\u5b83\u4eec\u53ef\u4ee5\u964d\u4f4e\u5f15\u8d77\u6297\u9f20\u514d\u75ab\u53cd\u5e94\u7684\u98ce\u9669\u3002\u6b64\u5916\uff0c\u5728\u4eba\u7c7b\u548c\u975e\u4eba\u7c7b\u7ec6\u80de\u4e2d\u4ea7\u751f\u7684\u514d\u75ab\u7403\u86cb\u767d\u7cd6\u57fa\u5316\u7684\u5dee\u5f02\u4e5f\u4f1a\u5f15\u53d1\u4e00\u4e9b\u5e76\u53d1\u75c7\u3002\u7cd6\u57fa\u5316\u662f\u6307\u5c06\u4f4e\u805a\u7cd6\u4fa7\u94fe\u52a0\u5230\u86cb\u767d\u8d28\u4e0a\u3002\u7531\u4e8e\u5b83\u4eec\u7684\u5408\u6210\u6d89\u53ca\u7269\u79cd\u7279\u5f02\u6027\u7684\u9176\uff0c\u56e0\u6b64\u8fd9\u4e9b\u4fa7\u94fe\u7684\u7ed3\u6784\u5177\u6709\u7269\u79cd\u7279\u5f02\u6027\u3002\u7b2c34\u7ae0<\/span>\u4ecb\u7ecd\u4e86\u4e0d\u540c\u7684\u54fa\u4e73\u52a8\u7269\u6709\u4e0d\u540c\u7684\u7cd6\u57fa\u5316\u6a21\u5f0f\uff0c\u6297\u4f53\u53ef\u4ee5\u8bc6\u522b\u8fd9\u4e9b\u6a21\u5f0f\u3002\u5f53mAb\u5728\u975e\u4eba\u7c7b\u7ec6\u80de\u4e2d\u8868\u8fbe\u65f6\uff0c\u5b83\u4eec\u6709\u88ab\u6297\u78b3\u6c34\u5316\u5408\u7269\u6297\u4f53\u8bc6\u522b\u7684\u53ef\u80fd\u6027\u3002\u901a\u8fc7\u5206\u5b50\u751f\u7269\u5b66\u6280\u672f\u53ef\u4ee5\u6539\u53d8\u4eba\u6e90\u5316\u6297\u4f53\u7684\u7cd6\u57fa\u5316(\u89c1Fig 36.2<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 36.2 <\/span>\u7528\u4e8e\u964d\u4f4e\u4ea7\u751f\u9488\u5bf9MAb\u7684\u6297\u9f20\u6297\u4f53\u7684\u98ce\u9669\u7684\u4e00\u4e9b\u6280\u672f\u3002\u5c0f\u5706\u5708\u4ee3\u8868\u514d\u75ab\u7403\u86cb\u767d\u8868\u9762\u7684\u5be1\u7cd6\u5206\u5b50\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5bf9\u4e8e\u4f20\u7edf\u7684\u5c0f\u5206\u5b50\u836f\u7269<\/span>\uff0c\u5982\u9752\u9709\u7d20\u6216\u963f\u53f8\u5339\u6797\uff0c\u53ef\u4ee5\u66f4\u6362\u4e0d\u540c\u7684\u5236\u9020\u5546\uff0c\u800c\u4e0d\u4f1a\u51fa\u73b0\u4efb\u4f55\u4e34\u5e8a\u95ee\u9898\u3002\u4f46\u5bf9\u4e8e\u751f\u7269\u836f\u54c1\uff0c\u7531\u4e8e\u5b83\u4eec\u662f\u6d3b\u7ec6\u80de\u4ea7\u751f\u7684\uff0c\u6240\u4ee5\u5728\u4e0d\u540c\u7684\u836f\u7269\u4e4b\u95f4\u5207\u6362\u65f6\u5fc5\u987b\u66f4\u52a0\u8c28\u614e\uff0c\u56e0\u4e3a\u4e0d\u540c\u7684mAb\u53ef\u80fd\u6709\u4e0d\u540c\u7684\u6548\u5e94\u548c\u526f\u4f5c\u7528\u3002\u4f8b\u5982\uff0c\u5728\u7c7b\u98ce\u6e7f\u6027\u5173\u8282\u708e\u4e2d\uff0c\u5728\u4e24\u79cd\u4e0d\u540c\u7684\u6297\u80bf\u7624\u574f\u6b7b\u56e0\u5b50(TNF)\u5355\u6297(infliximab\u548cadalimumab)\u4e4b\u95f4\u8fdb\u884c\u5207\u6362\u4f7f\u7528\u65f6\u5fc5\u987b\u5c0f\u5fc3\u8c28\u614e(\u89c1Box 36.2<\/span>)\u3002\u5373\u4f7f\u4e24\u4e2a\u5382\u5bb6\u4f7f\u7528\u76f8\u540c\u7684\u6742\u4ea4\u7624\u6765\u751f\u4ea7\u751f\u7269\u836f\u7269\uff0c\u4e5f\u4e0d\u80fd\u7b80\u5355\u5730\u8ba4\u4e3a\u8fd9\u4e24\u79cd\u836f\u7269\u5c31\u662f\u76f8\u540c\u7684\u3002\u8fd9\u4e24\u79cd\u5355\u6297\u53ef\u63cf\u8ff0\u4e3a\u201c\u751f\u7269\u76f8\u4f3c\u201d\uff0c\u53ef\u80fd\u4f1a\u56e0\u5236\u9020\u6280\u672f\u7684\u4e0d\u540c\u800c\u7565\u6709\u4e0d\u540c\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u63d0\u9ad8mAb\u7684\u6548\u529b<\/strong><\/p>\n<\/section>\n

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\u4e0a\u8ff0\u6280\u672f\u53ef\u7528\u4e8e\u751f\u4ea7mAb\uff0c\u8fd9\u4e9bmAb\u5728\u4eba\u4f53\u5185\u5f15\u53d1\u8f83\u4f4e\u7684\u514d\u75ab\u53cd\u5e94\u3002<\/span>\u5728\u8bb8\u591a\u60c5\u51b5\u4e0b\uff0cmAb\u662f\u76f8\u5f53\u6709\u6548\u7684\u3002\u4f8b\u5982\uff0c\u76ee\u524d\u5df2\u5e7f\u6cdb\u4f7f\u7528\u7684\u963b\u65ad\u7ec6\u80de\u56e0\u5b50\u6548\u5e94\u7684\u5355\u6297\uff0c\u5176\u4e2d\u5305\u62ec\u7528\u4e8e\u7c7b\u98ce\u6e7f\u6027\u5173\u8282\u708e\u7684\u6297TNF\u5355\u6297(\u7b2c31\u7ae0<\/span>\uff1b\u89c1Box 36.2<\/span>)\u548c\u7528\u4e8e\u6cbb\u7597\u79fb\u690d\u6392\u65a5\u53cd\u5e94\u7684\u6297\u767d\u7ec6\u80de\u4ecb\u7d202(IL-2)\u53d7\u4f53\u5355\u6297(\u7b2c34\u7ae0<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u7136\u800c\uff0c\u5728\u764c\u75c7\u514d\u75ab\u6cbb\u7597\u4e2d\uff0c\u53ea\u6709\u4e00\u5c0f\u90e8\u5206mAb\u901a\u8fc7\u8865\u4f53\u6fc0\u6d3b\u548c\u6297\u4f53\u4f9d\u8d56\u7684\u7ec6\u80de\u4ecb\u5bfc\u7684\u7ec6\u80de\u6bd2\u4f5c\u7528(ADCC)\u800c\u6709\u6548\u5730\u6740\u4f24\u9776\u7ec6\u80de\u3002\u5176\u4e2d\u5305\u62ec\u7b2c35\u7ae0<\/span>\u63d0\u5230\u7684\u6297CD20\u548c\u6297HER2\u5355\u6297\u3002\u5728\u5927\u591a\u6570\u5176\u4ed6\u764c\u75c7\u4e2d\uff0c\u7b80\u5355\u7684\u5355\u6297\u5e76\u4e0d\u80fd\u63d0\u4f9b\u8db3\u591f\u7684\u6548\u529b\u3002\u901a\u8fc7\u4e0d\u540c\u7684\u65b9\u6cd5\u53ef\u63d0\u5347\u5355\u6297\u7684\u6548\u679c\uff0c\u5982Fig 36.3<\/span>\u4e2d\u7684\u764c\u75c7\u514d\u75ab\u7597\u6cd5\u6240\u793a\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 36.3 <\/span>\u5bf9mAb Fc\u533a\u7684\u4fee\u9970\u53ef\u589e\u5f3a\u6548\u5e94\u529f\u80fd\u3002NK\uff0c\u81ea\u7136\u6740\u4f24\u7ec6\u80de\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u751f\u7269\u7279\u5f02\u6027\u6297\u4f53<\/p>\n<\/section>\n

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\u751f\u7269\u7279\u5f02\u6027\u6297\u4f53\u7ed3\u5408\u4e86\u4e24\u79cd\u4e0d\u540c\u6297\u4f53\u7684\u7279\u5f02\u6027\u3002\u5728\u764c\u75c7\u514d\u75ab\u6cbb\u7597\u4e2d\uff0c\u5b83\u4eec\u9488\u5bf9\u7ec6\u80de\u6bd2\u6027T\u6dcb\u5df4\u7ec6\u80de(CTL)\u4e0a\u7684T\u7ec6\u80de\u53d7\u4f53(TCR)\u548c\u80bf\u7624\u7ec6\u80de\u4e0a\u7684\u9776\u6297\u539f\u3002\u751f\u7269\u7279\u5f02\u6027\u6297\u4f53\u5c06CTL\u548c\u9776\u7ec6\u80de\u7ed3\u5408\u5728\u4e00\u8d77\uff0c\u5e76\u6fc0\u6d3bCTL\u4ee5\u542f\u52a8\u7ec6\u80de\u6740\u4f24\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u6297\u4f53\u8026\u8054\u7597\u6cd5<\/p>\n<\/section>\n

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\u4e00\u4e9b\u5728\u5355\u72ec\u4f7f\u7528\u65f6\u6d53\u5ea6\u8f83\u9ad8\u3001\u6bd2\u6027\u592a\u5927\u7684\u7269\u8d28\u53ef\u4ee5\u4e0emAb\u7ed3\u5408\u4f7f\u7528\u3002\u4f8b\u5982\uff0c\u5355\u6297\u53ef\u4ee5\u4e0e\u6bd2\u7d20\u6216\u653e\u5c04\u6027\u540c\u4f4d\u7d20\u7ed3\u5408\uff0c\u5e76\u5c06\u5b83\u4eec\u8fd0\u9001\u5230\u9776\u7ec6\u80de\u3002\u4e8c\u8005\u7684\u7ed3\u5408\u63d0\u9ad8\u4e86\u6bd2\u7d20\u6216\u540c\u4f4d\u7d20\u5bf9\u9776\u7ec6\u80de\u7684\u7279\u5f02\u6027\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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mAb\u7597\u6cd5\u7684\u6210\u529f\u4e0e\u5931\u8d25<\/strong><\/p>\n<\/section>\n

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mAb\u5728\u8bb8\u591a\u5e38\u89c1\u75be\u75c5\u7684\u6cbb\u7597\u4e2d\u5360\u6709\u91cd\u8981\u5730\u4f4d\u3002\u6709\u8da3\u7684\u662f\uff0c\u5728\u8fd8\u6ca1\u6709\u8bc1\u636e\u8868\u660e\u6297\u4f53\u662f\u4eba\u7c7b\u5e94\u5bf9\u764c\u75c7\u7684\u6b63\u5e38\u514d\u75ab\u53cd\u5e94\u7684\u4e00\u90e8\u5206\u65f6\uff0c\u5355\u6297\u5c31\u5df2\u7ecf\u5f00\u59cb\u5728\u764c\u75c7\u6cbb\u7597\u4e2d\u53d1\u6325\u4f5c\u7528\u4e86\u3002\u53e6\u4e00\u65b9\u9762\uff0c\u867d\u7136\u6297\u4f53\u5728\u6297\u611f\u67d3\u7684\u751f\u7406\u9632\u5fa1\u4e2d\u6709\u975e\u5e38\u660e\u663e\u7684\u4f5c\u7528\uff0c\u4f46\u5230\u76ee\u524d\u4e3a\u6b62\uff0c\u7814\u7a76\u8868\u660emAb\u5e76\u6ca1\u6709\u5728\u8fd9\u65b9\u9762\u8d77\u5230\u5f88\u5927\u7684\u4f5c\u7528\u3002\u5982\u4eca\u5df2\u7ecf\u5f00\u5c55\u4e86\u8bb8\u591a\u7814\u7a76\uff0c\u5229\u7528mAb\u8fdb\u884c\u88ab\u52a8\u514d\u75ab\u6cbb\u7597\u6765\u6297\u611f\u67d3\u3002\u4f8b\u5982\uff0c\u9488\u5bf9\u8102\u591a\u7cd6(LPS)\u7684\u5355\u6297\uff0c\u8102\u591a\u7cd6\u662f\u751f\u7269\u4f53\u91ca\u653e\u7684\u7269\u8d28\uff0c\u5728\u611f\u67d3\u6027\u4f11\u514b\u65f6\u4f1a\u523a\u6fc0\u673a\u4f53\u91ca\u653e\u7ec6\u80de\u56e0\u5b50(\u7b2c21\u7ae0<\/span>)\u3002\u673a\u4f53\u4e5f\u53ef\u80fd\u4f1a\u751f\u4ea7\u6297LPS\u7684mAb\uff0c\u4f46\u7531\u4e8e\u91ce\u751f\u751f\u7269\u4e2d\u6297\u539f\u7684\u591a\u6837\u6027\uff0c\u8fd9\u4e9bmAb\u5bf9\u6709\u6bd2\u529b\u7684\u83cc\u682a\u7684\u62b5\u6297\u529b\u5e76\u4e0d\u603b\u662f\u6709\u6548\u7684\u3002\u4e0e\u5176\u4ed6\u7c7b\u578b\u7684\u75c5\u539f\u4f53\u76f8\u4f3c\uff0cmAb\u7684\u9ad8\u5ea6\u7279\u5f02\u6027\u9650\u5236\u4e86\u5b83\u4eec\u5728\u6cbb\u7597\u611f\u67d3\u65b9\u9762\u7684\u5e94\u7528\u3002\u53e6\u4e00\u65b9\u9762\uff0c\u75ab\u82d7\u7684\u4e3b\u52a8\u514d\u75ab\u6240\u8bf1\u5bfc\u7684\u591a\u514b\u9686\u53cd\u5e94\u5728\u9884\u9632\u611f\u67d3\u65b9\u9762\u975e\u5e38\u6210\u529f(\u7b2c25\u7ae0<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5728\u836f\u7269\u8fc7\u91cf\u548c\u836f\u7269\u6ee5\u7528\u7684\u6cbb\u7597\u65b9\u9762\uff0c\u5355\u6297\u4e5f\u5df2\u7ecf\u53d6\u5f97\u4e86\u6210\u529f\u3002\u6709\u4e9b\u836f\u7269\uff08\u4f8b\u5982\u5730\u9ad8\u8f9b\uff09\u7684\u8fc7\u91cf\u4f7f\u7528\u662f\u5f88\u5371\u9669\u7684\uff0c\u5b83\u4eec\u96be\u4ee5\u4ece\u4f53\u5185\u6e05\u9664\uff0c\u800c\u4f7f\u7528\u6297\u5730\u9ad8\u8f9b\u5355\u6297\u6cbb\u7597\u5219\u53ef\u8fc5\u901f\u6e05\u9664\u8fd9\u4e9b\u836f\u7269(\u7b2c4\u7ae0<\/span>)\u3002\u6b64\u5916\uff0cmAb\u5df2\u7528\u4e8e\u5e0c\u671b\u51cf\u5c11\u6216\u6d88\u9664\u5bf9\u836f\u7269\u4f9d\u8d56\u7684\u60a3\u8005\uff0c\u8fd9\u79cd\u836f\u7269\u4f1a\u548cmAb\u5f62\u6210\u4e00\u79cd\u514d\u75ab\u590d\u5408\u7269\uff0c\u963b\u6b62\u836f\u7269\u5230\u8fbe\u5927\u8111\u4e2d\u7684\u7279\u5b9a\u53d7\u4f53\uff0c\u5e76\u5c06\u836f\u7269\u5f15\u5bfc\u5230\u813e\u810f\uff0c\u4ee5\u6b64\u6446\u8131\u5bf9\u5b83\u7684\u4f9d\u8d56\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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

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\u91cd\u7ec4\u7ec6\u80de\u56e0\u5b50<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5927\u591a\u6570\u5173\u4e8e\u91cd\u7ec4\u7ec6\u80de\u56e0\u5b50\u7684\u7814\u7a76\u90fd\u96c6\u4e2d\u5728\u751f\u957f\u56e0\u5b50\u3001\u7ec6\u80de\u56e0\u5b50\u5728\u63d0\u9ad8\u514d\u75ab\u529b\u65b9\u9762\u7684<\/span>\u6f5c\u5728\u4f5c\u7528\u4e0a\u3002\u8f83\u9891\u7e41\u4f7f\u7528\u7684\u4e3b\u8981\u514d\u75ab\u7ec6\u80de\u56e0\u5b50\u662f\u5e72\u6270\u7d20-\u03b1(IFN-\u03b1)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
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IFN-\u03b1\u7528\u4e8e\u6cbb\u7597\u67d0\u4e9b\u7c7b\u578b\u7684\u75c5\u6bd2\u6027\u809d\u708e(\u7b2c20\u7ae0<\/span>)\u3002IFN-\u03b1\u53ef\u5f15\u8d77\u8f7b\u5fae\u7684\u6025\u6027\u53cd\u5e94\uff0c\u5927\u591a\u6570\u60a3\u8005\u5728\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u4f1a\u611f\u5230\u4e0d\u9002(\u7b2c24\u7ae0<\/span>)\u3002\u4e00\u4e9b\u60a3\u8005\u4f1a\u4ea7\u751f\u6297IFN-\u03b1\uff0c\u8d77\u5230\u4e2d\u548c\u6cbb\u7597\u7684\u4f5c\u7528\u3002\u76ee\u524d\u4e34\u5e8a\u5e94\u7528\u7684\u4e3b\u8981\u95ee\u9898\u662f\u6cbb\u7597\u8d39\u7528\u2014\u2014\u6bcf\u5e74\u9ad8\u8fbe15000\u7f8e\u5143\u3002\u5982\u6b64\u9ad8\u6210\u672c\u7684\u90e8\u5206\u539f\u56e0\u662fIFN-\u03b1\u7684\u534a\u8870\u671f\u975e\u5e38\u77ed\uff0c\u53ea\u67094\u5c0f\u65f6\uff0c\u8fd9\u610f\u5473\u7740\u6bcf\u5929\u90fd\u5fc5\u987b\u8f93\u6ce8\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
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\u5173\u4e8eIFN-\u03b1\u7684\u90e8\u5206\u95ee\u9898\uff0c\u53ef\u4ee5\u901a\u8fc7\u5728IFN-\u03b1\u7ed3\u6784\u4e2d\u6dfb\u52a0\u805a\u4e59\u4e8c\u9187\u5206\u5b50\u6765\u89e3\u51b3\u3002\u5728\u6240\u8c13\u7684\u805a\u4e59\u4e8c\u9187\u5316\u8fc7\u7a0b\u4e2d\uff0c\u805a\u4e59\u4e8c\u9187\u5206\u5b50\u5171\u4ef7\u8fde\u63a5\u5230IFN-\u03b1\u5206\u5b50\u4e0a\u3002\u589e\u52a0\u4e86\u5206\u5b50\u91cf\uff0c\u4ece\u800c\u5ef6\u957f\u4e86\u5206\u5b50\u7684\u534a\u8870\u671f\uff0c\u4f7f\u5176\u4e0d\u4f1a\u5728\u80be\u810f\u4e2d\u88ab\u8fc7\u6ee4\u3002\u805a\u4e59\u4e8c\u9187\u5316\u8fd8\u6709\u6548\u5730\u5305\u88f9\u4e86IFN-\u03b1\u5206\u5b50\uff0c\u4f7f\u5176\u4e0d\u88ab\u86cb\u767d\u9176\u6d88\u5316(Fig 36.4<\/span>)\u3002\u8fd9\u4e9b\u53d8\u5316\u5c06IFN-\u03b1\u7684\u534a\u8870\u671f\u589e\u52a0\u523040\u5c0f\u65f6\uff0c\u8fd9\u610f\u5473\u7740\u53ef\u4ee5\u6bcf\u5468\u8f93\u6ce8\u4e00\u6b21\uff0c\u800c\u4e0d\u5fc5\u518d\u6bcf\u5929\u8f93\u6ce8\u3002\u805a\u4e59\u4e8c\u9187\u5316\u8fd8\u53ef\u4ee5\u4fdd\u62a4IFN-\u03b1\u5206\u5b50\u4e0d\u53d7\u60a3\u8005\u514d\u75ab\u7cfb\u7edf\u7684\u5f71\u54cd\uff0c\u5e76\u964d\u4f4e\u8bf1\u5bfc\u6297IFN-\u03b1\u6297\u4f53\u7684\u98ce\u9669\u3002\u5f53\u8fdb\u884c\u9002\u5f53\u7684\u805a\u4e59\u4e8c\u9187\u5316\u65f6\uff0c\u4e0d\u4f1a\u5f71\u54cdIFN-\u03b1\u4e0e\u5176\u53d7\u4f53\u7684\u7ed3\u5408\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 36.4<\/span> \u805a\u4e59\u4e8c\u9187\u5316\u53ef\u5ef6\u957f\u67d0\u4e9b\u91cd\u7ec4\u5206\u5b50\u7684\u751f\u7269\u534a\u8870\u671f\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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BOX 36.1 <\/span>\u5355\u514b\u9686\u6297\u4f53\u7684\u5236\u5907<\/span><\/p>\n<\/section>\n<\/section>\n

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

\u5355\u514b\u9686\u6297\u4f53(mAb)\u662f\u4e00\u79cd\u5747\u4e00\u7684\u514d\u75ab\u7403\u86cb\u767d\u3002\u5b83\u4eec\u5927\u90e8\u5206\u53ef\u4ee5\u6309\u7167\u6240\u9700\u7684\u7279\u5f02\u6027\u5236\u5907\u3002\u8fd0\u7528\u57fa\u672c\u7684\u751f\u4ea7\u6280\u672f\u6765\u4ea7\u751f\u6742\u4ea4\u7624\uff0c\u8fd9\u662f\u4e00\u79cd\u4ea7\u751f\u7279\u5f02\u6027\u6297\u4f53\u7684B\u7ec6\u80de\u548c\u9aa8\u9ad3\u7624\u7ec6\u80de\u7684\u7ec4\u5408\u3002\u6742\u4ea4\u7624\u7684\u751f\u4ea7\u8fc7\u7a0b\u5982Fig 36.5<\/span>\u6240\u793a\u3002\u5176\u76ee\u7684\u662f\u5236\u9020\u6c38\u751f\u5316\u7ec6\u80de\uff0c\u5176\u4ec5\u5206\u6ccc\u4e0e\u76ee\u7684\u6297\u539f\u7ed3\u5408\u7684\u514d\u75ab\u7403\u86cb\u767d\u3002\u5236\u5907\u8fc7\u7a0b\u4e2d\u8981\u786e\u4fdd\u672a\u4e0e\u514d\u75abB\u7ec6\u80de\u878d\u5408\u7684\u9aa8\u9ad3\u7624\u7ec6\u80de\u4e0d\u80fd\u5b58\u6d3b\u3002\u4e3a\u4e86\u505a\u5230\u8fd9\u4e00\u70b9\uff0c\u6240\u4f7f\u7528\u7684\u9aa8\u9ad3\u7624\u7ec6\u80de\u5e26\u6709\u4e00\u79cd\u7a81\u53d8\uff0c\u8be5\u7a81\u53d8\u5bfc\u81f4\u7ec6\u80de\u7f3a\u4e4f\u4e00\u79cd\u7279\u5b9a\u7684\u4ee3\u8c22\u9176\uff0c\u56e0\u6b64\u8fd9\u4e9b\u7ec6\u80de\u5728\u67d0\u4e9b\u7279\u5b9a\u57f9\u517b\u57fa\u4e2d\u5c31\u4f1a\u6b7b\u4ea1\u3002\u5f53\u878d\u5408\u540e\uff0c\u672a\u6c38\u751f\u5316\u7684B\u7ec6\u80de\u548c\u672a\u878d\u5408\u7684\u9aa8\u9ad3\u7624\u7ec6\u80de\u90fd\u4f1a\u6b7b\u4ea1\u3002\u53ea\u6709\u4e0eB\u7ec6\u80de\u878d\u5408\u5e76\u5229\u7528\u5176\u6b63\u786e\u4ee3\u8c22\u9176\u7684\u9aa8\u9ad3\u7624\u7ec6\u80de\u624d\u80fd\u5b58\u6d3b\u3002\u901a\u8fc7\u57f9\u517b\u548c\u7b5b\u9009\u6742\u4ea4\u7ec6\u80de\u7684\u514b\u9686\uff0c\u4ee5\u4ea7\u751f\u6240\u9700\u7684\u7279\u5f02\u6027\u6297\u4f53\u3002\u6297\u4f53\u9633\u6027\u514b\u9686\u7684\u7b5b\u9009\u901a\u5e38\u6d89\u53ca\u5230\u9176\u8054\u514d\u75ab\u5438\u9644\u8bd5\u9a8c(ELISA)\uff0c\u5982\u7b2c5\u7ae0<\/span>\u6240\u8ff0\u3002<\/p>\n

\u8fd9\u4e00\u57fa\u672c\u8fc7\u7a0b\u7528\u4e8e\u751f\u4ea7\u9f20\u7c7b\u5355\u514b\u9686\u6297\u4f53\uff0c\u4f7f\u7528\u5206\u5b50\u751f\u7269\u5b66\u6280\u672f\u53ef\u5bf9\u5176\u8fdb\u884c\u4fee\u9970\u4ee5\u751f\u4ea7\u5d4c\u5408\u6216\u4eba\u6e90\u5316\u5355\u514b\u9686\u6297\u4f53\u3002<\/p>\n

\u53e6\u4e00\u79cd\u65b9\u6cd5\u662f\u907f\u514d\u5b8c\u5168\u514d\u75ab\u52a8\u7269\uff0c\u800c\u4f7f\u7528\u566c\u83cc\u4f53\u6587\u5e93\u3002\u5b83\u662f\u5728\u566c\u83cc\u4f53\u4e2d\u8868\u8fbe\u7684\u8f7b\u94fe\u548c\u91cd\u94fe\u53ef\u53d8\u533a\u57fa\u56e0\u7684\u6587\u5e93\uff0c\u53ef\u4ee5\u4ea7\u751f\u8bb8\u591a\u4e0d\u540c\u7684\u566c\u83cc\u4f53\uff0c\u6bcf\u4e2a\u566c\u83cc\u4f53\u8868\u8fbe\u4e0d\u540c\u7684\u53ef\u53d8\u533a\u5206\u5b50\u3002\u8fd9\u4e9b\u57fa\u56e0\u7ecf\u8fc7\u7b5b\u9009\uff0c\u7136\u540e\u514b\u9686\u5230\u54fa\u4e73\u52a8\u7269\u7ec6\u80de\u4e2d(\u4ee5\u53ca\u6052\u5b9a\u533a\u57fa\u56e0)\u8fdb\u884c\u8868\u8fbe\u3002<\/p>\n

\u4ece\u6742\u5408OMA\u6216\u566c\u83cc\u4f53\u6587\u5e93\u4e2d\u5236\u5907mAb\u7684\u4f20\u7edf\u65b9\u6cd5\u662f\u5728\u5668\u76bf\u4e2d\u57f9\u517b\u5206\u6cccmAb\u7684\u7ec6\u80de\u3002\u800c\u66f4\u65b0\u7684\u6280\u672f\u53ef\u5728\u519c\u573a\u52a8\u7269\u751a\u81f3\u690d\u7269\u4e2d\u751f\u4ea7\u5355\u6297\uff0c\u75ab\u82d7\u548c\u5176\u4ed6\u86cb\u767d\u8d28\u4e5f\u53ef\u4ee5\u7528\u540c\u6837\u7684\u65b9\u5f0f\u751f\u4ea7\u3002\u8fd9\u4e9b\u201c\u5236\u836f\u201d\u6280\u672f\u6709\u671b\u5927\u5e45\u964d\u4f4e\u751f\u7269\u836f\u54c1\u7684\u4ef7\u683c\u3002<\/p>\n<\/section>\n<\/section>\n

\n
<\/section>\n<\/section>\n
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Fig 36.5<\/span> \u6742\u4ea4\u7624\u7ec6\u80de\u682a\u7684\u4ea7\u751f\u3002ELISA\u3001\u9176\u8054\u514d\u75ab\u5438\u9644\u8bd5\u9a8c<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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BOX 36.2<\/span> <\/span><\/strong>TNF\u963b\u65ad\u6cbb\u7597\u7c7b\u98ce\u6e7f\u6027\u5173\u8282\u708e<\/span><\/p>\n<\/section>\n<\/section>\n

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<\/svg><\/section>\n
<\/svg><\/section>\n<\/section>\n
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\u80bf\u7624\u574f\u6b7b\u56e0\u5b50(TNF)\u662f\u7c7b\u98ce\u6e7f\u6027\u5173\u8282\u708e(RA)\u7b49\u8fdf\u53d1\u578b\u8d85\u654f\u53cd\u5e94\u7684\u5173\u952e\u7ec6\u80de\u56e0\u5b50\u3002\u76ee\u524d\u5df2\u5f00\u53d1\u4e86\u4e09\u79cd\u7b56\u7565\u6765\u963b\u6b62TNF\u4e0e\u53c2\u4e0e\u708e\u75c7\u53cd\u5e94\u7684\u7ec6\u80de\u4e0a\u7684\u53d7\u4f53\u7ed3\u5408(Fig 36.6<\/span>)\u3002<\/p>\n

1.\u5c0f\u9f20\u5355\u514b\u9686\u6297\u4f53\u53ef\u963b\u6b62TNF\u4e0e\u5176\u53d7\u4f53\u7ed3\u5408\u3002\u7136\u800c\uff0c\u60a3\u8005\u4f1a\u4ea7\u751f\u9488\u5bf9\u514d\u75ab\u7403\u86cb\u767d\u4e0a\u7684\u5c0f\u9f20\u7279\u5f02\u6027\u8868\u4f4d\u7684\u6297\u4f53\u3002\u8fd9\u4e9b\u4e2d\u548c\u6297\u4f53\u4f1a\u963b\u6b62\u6297TNF\u6297\u4f53\u53d1\u6325\u4f5c\u7528\uff0c\u4ece\u800c\u5f15\u8d77\u8840\u6e05\u75c5(\u7b2c30\u7ae0<\/span>)\u3002<\/p>\n

2.Infliximab\u7b49\u5d4c\u5408\u6297\u4f53\u7ed3\u5408\u4e86\u5c0f\u9f20\u548c\u4eba\u7c7b\u7684\u7247\u6bb5\uff0c\u8fd9\u79cd\u5d4c\u5408\u6297TNF\u6297\u4f53\u975e\u5e38\u6709\u6548\uff0c\u53ef\u4f7f\u9ad8\u8fbe80%\u7684RA\u60a3\u8005\u7684\u4e34\u5e8a\u75c7\u72b6\u6709\u6240\u6539\u5584\u3002<\/p>\n

3.\u53e6\u4e00\u79cd\u7b56\u7565\u662f\u5236\u9020\u91cd\u7ec4\u7684TNF\u53d7\u4f53\/Fc\u5206\u5b50\u6765\u201c\u6e05\u9664\u201dTNF\u3002\u8fd9\u4e9b\u6297\u4f53\u662f\u7528\u4eba\u7c7b\u86cb\u767d\u8d28\u5e8f\u5217\u6784\u5efa\u7684\uff0c\u4ee5\u514b\u670d\u4e2d\u548c\u6297\u4f53\u7684\u95ee\u9898\u3002\u8fd9\u4e9b\u5206\u5b50\u5bf9RA\u4e5f\u6709\u6548\u3002<\/p>\n

\u8fd9\u4e09\u79cd\u65b9\u6cd5\u5728RA\u6cbb\u7597\u4e2d\u90fd\u662f\u6709\u6548\u7684\uff0c\u4f46\u6ca1\u6709\u4e00\u79cd\u6297TNF\u836f\u7269\u53ef\u5b8c\u5168\u6cbb\u6108RA\u3002\u8fd9\u662f\u56e0\u4e3a\u673a\u4f53\u5b58\u5728\u5927\u91cf\u7684\u7ec6\u80de\u56e0\u5b50\uff0c\u6362\u53e5\u8bdd\u8bf4\uff0c\u5728\u5927\u591a\u6570\u60c5\u51b5\u4e0b\uff0c\u4f1a\u6709\u5f88\u591a\u79cd\u7ec6\u80de\u56e0\u5b50\u53c2\u4e0e\u514d\u75ab\u8fc7\u7a0b\u3002\u5982\u4eca\u5df2\u7ecf\u5f00\u53d1\u51fa\u4e00\u79cd\u6297IL-1\u836f\u7269\u2014\u2014\u963f\u7eb3\u91d1\u62c9(Anakinra)\uff0c\u5e76\u5728\u4e00\u4e9bRA\u60a3\u8005\u4e2d\u53d6\u5f97\u4e86\u826f\u597d\u7684\u7597\u6548\u3002\u5728\u67d0\u4e9b\u60c5\u51b5\u4e0b\uff0c\u4f7f\u7528\u6297\u7ec6\u80de\u56e0\u5b50\u836f\u7269\u7684\u7ec4\u5408\u53ef\u80fd\u4f1a\u6709\u66f4\u597d\u7684\u6cbb\u7597\u6548\u679c\u3002<\/p>\n

TNF\u5728\u6297\u611f\u67d3\u65b9\u9762\u4e5f\u4f1a\u53d1\u6325\u4f5c\u7528\u3002\u6545\u963b\u65adTNF\u4f5c\u7528\u7684\u836f\u7269\u7684\u4e00\u4e2a\u5f0a\u7aef\u662f\uff0c\u8fd9\u53ef\u80fd\u5bfc\u81f4\u6613\u611f\u7ed3\u6838\u75c5\u3001\u674e\u65af\u7279\u6c0f\u83cc(\u7b2c24\u7ae0<\/span>)\u6216\u4e59\u809d\u3002\u53e6\u4e00\u4e2a\u95ee\u9898\u662f\u5176\u9ad8\u6602\u7684\u6210\u672c\u3002\u4eba\u4eec\u5e0c\u671b\uff0c\u901a\u8fc7\u8c28\u614e\u4f7f\u7528\u751f\u7269\u4eff\u5236\u836f\u53ef\u4fc3\u8fdb\u5f00\u53d1\u51fa\u66f4\u5177\u6210\u672c\u6548\u76ca\u7684\u6cbb\u7597\u65b9\u6cd5\u3002<\/p>\n<\/section>\n<\/section>\n

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Fig 36.6 <\/span>\u751f\u7269\u836f\u7269\u53ef\u963b\u65ad\u80bf\u7624\u574f\u6b7b\u56e0\u5b50\u5728\u7c7b\u98ce\u6e7f\u5173\u8282\u708e\u4e2d\u7684\u4f5c\u7528<\/p>\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 | <\/span>Immunology for Medical Students<\/span><\/section>\n
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\u7f51\u5740\u662f\uff1aoncolab.cn<\/span><\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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OncoLab\u77e5\u8bc6\u661f\u7403\u4e5f\u5df2\u5f00\u901a\uff0c\u5728\u5b66\u4e60\u672c\u516c\u4f17\u53f7\u5185\u5bb9\u7684\u8fc7\u7a0b\u4e2d\u5982\u679c\u6709\u4ec0\u4e48\u9700\u8981\u8ba8\u8bba\u4ea4\u6d41\u7684\u5730\u65b9\u53ef\u4ee5\u5728\u661f\u7403\u53d1\u8868\u7559\u8a00\uff0c\u4e5f\u53ef\u4ee5\u5206\u4eab\u4e00\u4e0b\u81ea\u5df1\u7684\u5b66\u4e60\u5fc3\u5f97\u4f53\u4f1a\uff0c\u5176\u4ed6\u5c0f\u4f19\u4f34\u770b\u5230\u4e86\u53ef\u4ee5\u79ef\u6781\u7559\u8a00\u56de\u590d\uff0c\u6211\u4e5f\u4f1a\u79ef\u6781\u53c2\u4e0e\u5176\u4e2d\uff0c\u5e76\u65f6\u5e38\u653e\u4e00\u4e9b\u5b66\u4e60\u8d44\u6599\u5728\u4e0a\u9762\uff0c\u5e0c\u671b\u5927\u5bb6\u80fd\u591f\u5728\u79ef\u6781\u4ea4\u6d41\u4e92\u5e2e\u4e92\u52a9\u4e2d\u5171\u540c\u8fdb\u6b65~<\/p>\n

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