銆愭憳銆€瑕併€�: 銆€浠嬬垂浜嗘韩搴﹀偝鎰熷櫒鐨勯伕鎿囨柟娉�,瑷庤珫浜嗘韩搴﹀偝鎰熷櫒鐨勫竷缃師鍓�,灏嶅湅鍏�(n猫i)澶栧父鐢ㄧ殑骞剧ó婧害鍌虫劅鍣ㄧ殑鍎�(y艒u)鍖栧竷缃柟娉曢€�(j矛n)琛屼簡姣旇純鍒嗘瀽,灏嶄粖鍚庨€�(j矛n)涓€姝ョ殑鐮旂┒瓒ㄥ嫝鍋氬嚭浜嗗睍鏈�. 銆愰棞(gu膩n)閸佃銆�: 銆€鏁�(sh霉)鎺ф(j墨)搴�; 鐔辫宸�; 婧害鍌虫劅鍣�; 鏁忔劅榛�(di菐n) 涓湒鍒嗛铏�: 銆€TP2 銆€銆€銆€鏂囩嵒(xi脿n)妯�(bi膩o)璀樼⒓: 銆€A 闅ㄨ憲绮惧瘑鍙婅秴绮惧瘑鍔犲伐鎶€琛�(sh霉)鐨勭櫦(f膩)灞曞強鑷嫊鍖栫郴绲�(t菕ng)鐨勫嚭鐝�(xi脿n),浜哄€戝皪鏁�(sh霉)鎺ф(j墨)搴婄殑鍔犲伐绮惧害鎻愬嚭浜嗘洿楂樼殑瑕佹眰. 澶ч噺鐮旂┒琛ㄦ槑, 鐔辫宸槸姗�(j墨)搴婄殑鏈€澶ц宸簮,鍗犳(j墨)搴婄附瑾ゅ樊鐨�40 %锝� 70 %[sup][1 ,2][/sup] . 鍠磾渚濊炒鏀归€�(j矛n)姗�(j墨)搴婄祼(ji茅)妲�(g貌u)瑷�(sh猫)瑷堢瓑纭欢鏀硅壇鏂规硶, 鎴栫洿鎺ュ皪婧害鎺у埗渚嗘笡灏忔(j墨)搴婄啽瑾ゅ樊,鏃㈡彁楂樹簡鎴愭湰鑰屾晥鏋滃苟涓嶇悊鎯�.閫氶亷寤虹珛鏁�(sh霉)鎺ф(j墨)搴婄啽瑾ゅ樊妯″瀷, 閫�(j矛n)鑰屽(sh铆)鐝�(xi脿n)鐔辫宸(b菙)鍎�?sh霉)濮嗘?瀵�(sh铆)韪愯瓑鏄庢渶鐐虹稉(j墨ng)婵�(j矛)鏈夋晥[sup][3][/sup] . 鍦ㄦ暩(sh霉)鎺ф(j墨)搴婄殑鐔辫宸脯閲�銆佸缓妯″強鍏惰(b菙)鍎熺爺绌朵腑,婧害娓粸(di菐n)鐨勫竷缃拰閬告搰鏄竴鍊嬮洠榛�(di菐n). 鍌虫劅鍣ㄧ殑鏁�(sh霉)鐩強浣嶇疆閬稿彇娑夊強鎴愭湰銆佹晥鐩婄瓑澶氭柟闈㈢殑鍟忛. 寰炵稉(j墨ng)婵�(j矛)鏂归潰鑰冩叜,甯屾湜閲囩敤鐩″彲鑳藉皯鐨勫偝鎰熷櫒,浣嗗偝鎰熷櫒澶皯浜嗗嫝蹇呴檷浣庤瓨鍒ョ簿搴�. 鍥犳,灏嶆韩搴﹀偝鎰熷櫒閫�(j矛n)琛屽劒(y艒u)鍖�,纰哄畾鍌虫劅鍣ㄧ殑鏈€浣虫暩(sh霉)鐩垏鏈€鍎�(y艒u)浣嶇疆,鍏锋湁閲嶈鐨勫(sh铆)鐢ㄥ児鍊�,鍏跺劒(y艒u)鍖栧竷缃瓥鐣ユ垚鐐虹啽瑾ゅ樊杈ㄨ瓨寤烘ā鐮旂┒涓殑闂�(gu膩n)閸垫妧琛�(sh霉). 1 銆€鏁�(sh霉)鎺ф(j墨)搴婄啽瑾ゅ樊寤烘ā涓殑婧害鍌虫劅鍣ㄩ伕鎿� 銆€銆€ 鐩墠,鍦嬪収(n猫i)澶栧(xu茅)鑰呭閫氶亷瀵�(sh铆)椹�(y脿n)寤虹珛鐔辫宸垏姗�(j墨)搴婃韩搴﹀牬闂�(gu膩n)绯荤殑鏁�(sh霉)瀛�(xu茅)妯″瀷, 鍦ㄥ姞宸ラ亷绋嬩腑瀵�(sh铆)鏅傛脯閲忔(j墨)搴婄殑婧害鍫村苟瑷堢畻鐔辫畩褰�, 鐒跺悗鍙嶉绲︽暩(sh霉)鎺х郴绲�(t菕ng)閫�(j矛n)琛岃宸(b菙)鍎�. 濡備綍閬告搰鏈夋晥鐨勬脯婧厓浠�,鎼缓娓韩绯荤当(t菕ng),鐛插彇姗�(j墨)搴婃韩搴﹁畩鍖栭噺,鏄(sh铆)鐝�(xi脿n)姗�(j墨)搴婄啽璁婂舰寤烘ā鑸囪(b菙)鍎�?sh霉)闂瑰尵顎辫洨璞檚up][4] [/sup]. 鍦ㄦ暩(sh霉)鎺ф(j墨)搴婁笂浣跨敤鐨勬韩搴﹀偝鎰熷櫒鐨勭櫦(f膩)灞曞ぇ鑷寸稉(j墨ng)姝蜂簡浠ヤ笅3 鍊嬮殠娈�:鍌崇当(t菕ng)婧害鍌虫劅鍣�銆佹ā鎿泦鎴愭韩搴﹀偝鎰熷櫒/ 鎺у埗鍣�銆佹櫤鑳芥韩搴﹀偝鎰熷櫒.鍌崇当(t菕ng)婧害鍌虫劅鍣ㄤ互鐔遍浕闃�銆佺啽闆诲伓銆佺啽鏁忛浕闃荤偤浠ｈ〃. 閫欎簺鍌虫劅鍣ㄤ竴鑸互妯℃摤淇¤櫉杓稿嚭,闇€瑕佸悗绾�(x霉)淇¤櫉铏曠悊鑸嘇/ D 杞�(zhu菐n)鎻涢浕璺殑閰嶅悎. 姝ら鍌虫劅鍣ㄥ瓨鍦ㄧ窔鎬у害宸€佷俊铏熼噺灏�銆佹姉骞叉摼鑳藉姏宸瓑缂洪粸(di菐n). 妯℃摤闆嗘垚婧害鍌虫劅鍣ㄩ噰鐢ㄧ鍗婂皫(d菐o)楂旈泦鎴愬伐钘濆埗鎴�;妯℃摤闆嗘垚婧害鎺у埗鍣ㄤ富瑕佸寘鎷韩鎺ч枊闂�(gu膩n)銆佸彲绶ㄧ▼婧害鎺у埗鍣�,鑷垚绯荤当(t菕ng),宸ヤ綔鏅備笉鍙楀井铏曠悊鍣ㄧ殑鎺у埗,鍏锋湁涓€瀹氱殑甯傚牬鍗犵敤鐜�. 鍌崇当(t菕ng)鐨勬韩搴﹀偝鎰熷櫒鑸囨ā鎿泦鎴愭韩搴﹀偝鎰熷櫒/ 鎺у埗鍣ㄦ噳(y墨ng)鐢ㄥ崄鍒嗗唬娉�,浣嗙敱浜庢柊鍨嬫櫤鑳芥韩搴﹀偝鎰熷櫒鐒℃硶姣旀摤鐨勫劒(y艒u)鍕�,姝ｉ€愭几灏囧畠鍊戞浛浠�.鐩墠,鍦嬮殯涓婃柊鍨嬫韩搴﹀偝鎰熷櫒姝ｅ緸妯℃摤寮忓悜鏁�(sh霉)瀛楀紡銆佺敱闆嗘垚鍖栧悜鏅鸿兘鍖栥€佺恫(w菐ng)绲�(lu貌)鍖栫殑鏂瑰悜鐧�(f膩)灞�. 鏅鸿兘婧害鍌虫劅鍣紙浜︾ū鏁�(sh霉)瀛楁韩搴﹀偝鎰熷櫒锛� 鏄井闆诲瓙鎶€琛�(sh霉)銆佽▓绠楁(j墨)鎶€琛�(sh霉)鍜岃嚜鍕曟脯瑭︽妧琛�(sh霉)锛圓 TE锛� 鐨勭祼(ji茅)鏅�,鍏跺収(n猫i)閮ㄥ寘鍚韩搴﹀偝鎰熷櫒銆丄/ D 杞�(zhu菐n)鎻涘櫒銆佷俊铏熻檿鐞嗗櫒銆佸瓨鍎插櫒锛堟垨瀵勫瓨鍣級 鍜屾帴鍙ｉ浕璺�. 鐢变簬鏁�(sh霉)瀛楁韩搴﹀偝鎰熷櫒鐩稿皪鍌崇当(t菕ng)婧害鍌虫劅鍣ㄥ叿鏈夋姉骞叉摼鑳藉姏寮�(qi谩ng)銆佸垎杈ㄥ姏楂�銆佺窔鎬у害濂�銆佹垚鏈綆绛夊劒(y艒u)榛�(di菐n). 鍥犳, 鍦ㄨō(sh猫)瑷堟暩(sh霉)鎺ф(j墨)搴婄殑娓韩绯荤当(t菕ng)鏅�,鍎�(y艒u)鍏堣€冩叜閬告搰浣跨敤鏁�(sh霉)瀛楁韩搴﹀偝鎰熷櫒浣滅偤婧害娓噺鍏冧欢. 2 銆€婧害鍌虫劅鍣ㄥ竷缃師鍓� 2. 1 銆€婧害鏁忔劅榛�(di菐n) 鍦ㄦ暩(sh霉)鎺ф(j墨)搴婄啽瑾ゅ樊鎺у埗瑁�(b菙)鍎熸妧琛�(sh霉)涓�, 鍚堢悊閬告搰娓韩榛�(di菐n)鐨勪綅缃槸鍏堕棞(gu膩n)閸垫墍鍦�. 鐢变簬鐔辫宸槸鏅傞枔鐨勫嚱鏁�(sh霉),鎵€浠ュ湪瑾ゅ樊娓噺鐨勫悓鏅�,蹇呴爤瑷橀寗姗�(j墨)搴婄殑婧害鍫寸壒寰�. 瀵�(sh铆)椹�(y脿n)琛ㄦ槑,鏁�(sh霉)鎺ф(j墨)搴婅〃闈㈠強鍏�(n猫i)閮ㄥ悇榛�(di菐n)鐨勬韩鍗囧皪姗�(j墨)搴婄啽瑾ゅ樊鐨勫奖闊跨▼搴︿笉鍚�,绺藉瓨鍦ㄩ€欎箞涓€浜涢粸(di菐n),閫欎簺榛�(di菐n)鐨勬韩鍗囪畩鍖栧皣寮曡捣姗�(j墨)搴婄啽瑾ゅ樊鐨勬槑椤畩鍖�,鍦ㄧ啽瑾ゅ樊瑁�(b菙)鍎熺郴绲�(t菕ng)涓�, 鍙湁灏囬€欎簺榛�(di菐n)浣滅偤妯″瀷鐨勮几鍏�,鎵嶈兘鍦ㄤ繚璀夌簿搴︾殑鎯呮硜涓�, 浣挎脯婧粸(di菐n)鏁�(sh霉)鏈€灏�, 瀵�(sh铆)鏅傝(b菙)鍎熸檪瑷堢畻閫熷害蹇�,瑁�(b菙)鍎熸晥鏋滄渶浣�,閫欎簺榛�(di菐n)琚ū鐐哄奖闊挎暩(sh霉)鎺ф(j墨)搴婄啽瑾ゅ樊鐨勬晱鎰熼粸(di菐n)[sup][5][/sup] . 2. 2 銆€婧害鍌虫劅鍣ㄥ竷缃師鍓� 婧害鍌虫劅鍣ㄦ噳(y墨ng)鑳借繀閫熴€佹簴(zh菙n)纰哄湴鍙嶆槧婧害淇℃伅鐨勮畩鍖�,浠ユ彁楂樼郴绲�(t菕ng)鐨勬娓簿搴�. 渚濇摎(j霉)婧害鏁忔劅榛�(di菐n)鐞嗚珫,鎳�(y墨ng)瑭插皣婧害鍌虫劅鍣ㄥ竷缃湪灏嶄俊铏熺殑璁婂寲鍙嶆噳(y墨ng)鏈€鏁忔劅銆佸彈鍏朵粬娓粸(di菐n)骞叉摼鏈€灏忕殑鍦版柟,鍗虫韩搴﹁畩鍖栨渶鏁忔劅鐨勫湴鏂�,浠ョ簿纰哄湴鍙嶆槧婧害璁婇噺淇¤櫉鐨勮畩鍖�. 瑕佹垚鍔熷湴瀵�(sh铆)鐝�(xi脿n)鐔辨厠(t脿i)寤烘ā, 绯荤当(t菕ng)蹇呴爤婊胯冻鍙帶鎬у拰鍙鎬ф浠�,灏嶄簬婧害鍌虫劅鍣ㄧ殑甯冪疆, 鍦ㄦ豢瓒冲彲瑙€鎬ф浠跺悗,涓€鑸伒寰互涓嬫簴(zh菙n)鍓嘯sup][6][/sup] : 锛�1锛� 鍌虫劅鍣ㄦ噳(y墨ng)鐩″彲鑳藉湴甯冪疆鍦ㄧ啽婵€鍕垫簮铏�, 鎴栫啽璁婂舰鏈€澶ц檿; 锛�2锛� 濡傚潎鍕诲姞鐔辨檪,鍌虫劅鍣ㄦ噳(y墨ng)甯冪疆鍦ㄥ浐瀹氱; 锛�3锛� 鍌虫劅鍣ㄥ郊姝や笉鎳�(y墨ng)闈犲緱寰堣繎, 浠ユ笡灏忕浉浜掑共鎿�,鎻愰珮绯荤当(t菕ng)妾㈡脯鐨勬晱鎰熷害. 浠ヤ竴鑷鸿嚗寮忓姞宸ヤ腑蹇冪偤渚媅sup][7][/sup] ,濡傚湒1 鎵€绀�,灏嶅叾閫�(j矛n)琛岀啽璁婂舰寤烘ā瑭﹂(y脿n), 闇€瑕侀伕鎿囦竴绯诲垪鐨勬韩搴︽晱鎰熼粸(di菐n)鍦ㄥ叾涓婂竷缃韩搴﹀偝鎰熷櫒,娓噺姗�(j墨)搴婃韩鍗�. 鍦�1 閬告搰浜�14 鍊嬫韩搴︽晱鎰熼粸(di菐n),婧害鍌虫劅鍣═1 銆乀2 鐢ㄤ簬娓噺X杌哥挡鏉�銆佽灪姣嶇殑婧害; T3 銆乀4 娓噺Y 杌哥挡鏉�銆佽灪姣嶇殑婧害; T5 銆乀6 娓噺Z 杌哥挡鏉�銆佽灪姣嶇殑婧害; T7 銆乀8 娓噺涓昏桓婧害; T9 銆乀10 銆乀11 銆乀12 娓噺绔嬫煴婧害; T13娓噺X 杌稿簥韬韩搴�; T14 娓噺Z杌稿簥韬韩搴�. 闈炴帴瑙稿紡浣嶇Щ鍌虫劅鍣ㄥ畨缃湪Z 杌稿簥韬笂, 鐢ㄤ簬娓噺涓昏桓鐔辫畩褰㈣宸�. 閫�14 鍊嬫韩搴﹀偝鎰熷櫒鑸�1 鍊嬩綅绉诲偝鎰熷櫒閲囬泦鐨勬暩(sh霉)鎿�(j霉),鍗冲彲鐢ㄤ簬鍚庣簩(x霉)鐨勬暩(sh霉)鎺ф(j墨)搴婄啽瑾ゅ樊寤烘ā鑸囪(b菙)鍎�. 3 銆€婧害鍌虫劅鍣ㄥ竷缃劒(y艒u)鍖� 涓€鑸渚�,姗�(j墨)搴婁笂婧害娓粸(di菐n)鏁�(sh霉)瓒婂,鎵€寤虹珛鐨勭啽瑾ゅ樊闋�(y霉)娓ā鍨嬭秺绮剧⒑,灏嶇啽瑾ゅ樊鐨勪及瑷堜篃瓒婄簿纰�. 浣嗛亷澶氱殑婧害娓粸(di菐n)鏁�(sh霉)鏈冨ぇ澶у鍔犳暩(sh霉)鎿�(j霉)铏曠悊鐨勫伐浣滈噺,鍚屾檪涔熻€冩叜鍒版韩搴︽脯閲忕郴绲�(t菕ng)鐨勬垚鏈�, 鏈夊繀瑕佸皪娓韩榛�(di菐n)閫�(j矛n)琛屽劒(y艒u)鍖栭亱(y霉n)绠楀拰铏曠悊. 娓韩榛�(di菐n)鐨勫劒(y艒u)鍖栨槸鎸囧湪淇濊瓑鐔辫宸ā鍨嬬簿搴︾殑姊濅欢涓�, 浠ヨ純灏戠殑娓韩榛�(di菐n)浠ｆ浛鐪惧鐨勬脯婧粸(di菐n),浠ョ啊鍖栫啽瑾ゅ樊寤烘ā鑸囪(b菙)鍎熺郴绲�(t菕ng). 灏嶆脯婧偝鎰熷櫒甯冮粸(di菐n)浣嶇疆鍎�(y艒u)鍖�, 鐩墠鍦嬪収(n猫i)澶栭噰鐢ㄤ簡浠ヤ笅骞剧ó鏂规硶: 3. 1 銆€瑭︽箠娉� 鍦ㄦ棭鏈熺殑鐔辫宸(b菙)鍎熺郴绲�(t菕ng)涓�, 婧害鍌虫劅鍣ㄧ⒑瀹氱殑閬庣▼鍦ㄤ竴瀹氱▼搴︿笂鏄牴鎿�(j霉)缍�(j墨ng)椹�(y脿n)閫�(j矛n)琛岃│婀婄殑閬庣▼.閫氬父鏄厛鍩轰簬宸ョ▼鍒ゆ柗, 鍦ㄤ笉鍚屼綅缃畨瑁濆ぇ閲忕殑鍌虫劅鍣�,鍐嶉噰鐢ㄧ当(t菕ng)瑷堟垨鍒嗘瀽鏂规硶閬稿嚭灏戦噺鐨勬韩搴﹀偝鎰熷櫒鐢ㄤ簬瑾ゅ樊鍒嗛噺鐨勫缓妯sup][4][/sup] . 瑭︽箠娉曟槸鏈€鐩存帴鑸囩洿瑙€鐨勬柟娉�,浣嗗瓨鍦ㄧ殑缂洪櫡鍦ㄤ簬宸ョ▼鍒ゆ柗鐨勬簴(zh菙n)纰鸿垏鍚︽渻褰遍熆鐔辫宸ā鍨嬬殑闋�(y霉)鍫辩簿搴﹀拰榄鎬�, 寤虹珛缍滃悎瑾ゅ樊鍜屾韩搴﹀牬鐨勫皪鎳�(y墨ng)闂�(gu膩n)绯绘檪, 瑕佽€楄不(f猫i)澶ч噺鐨勬檪闁撳拰鍌虫劅鍣�,鑰岄€欏偝鎰熷櫒鍦ㄥ劒(y艒u)鍖栧悗灏变笉鍐嶇敤浜庢渶绲傜殑鐔辫宸缓妯′腑. 濡傛灉鑳藉湪淇濊瓑瑁�(b菙)鍎熺簿搴︾殑姊濅欢涓�,浣跨敤鏈€灏戠殑婧害娓粸(di菐n),閫欏皣鏈冪郸瑁�(b菙)鍎熸妧琛�(sh霉)瀵�(sh铆)闅涙噳(y墨ng)鐢ㄥ付渚嗘サ澶ф柟渚垮拰浣跨敤鎴愭湰闄嶄綆. 3. 2 銆€楂樻柉绌嶅垎娉� 楂樻柉绌嶅垎鏄皪姗�(j墨)搴婃韩搴﹀牬鐞嗚珫寤烘ā涓€绋柟娉�.閫氶亷妲�(g貌u)寤烘(j墨)搴婃韩搴﹀牬鑸囩啽璁婂舰鍫寸殑瑙ｆ瀽鏂圭▼骞舵眰瑙�,浠ョ嵅寰楁(j墨)搴婄啽璁婂舰妯″瀷,骞跺彲渚濇摎(j霉)姝ゆā鍨嬮€�(j矛n)琛屽悗绾�(x霉)鐔辫宸(b菙)鍎�. Debra A. Krulewich[sup][8][/sup] 閫氶亷楂樻柉绌嶅垎娉�,灏嶆暣鍊嬫(j墨)搴婃韩搴﹀牬閫�(j矛n)琛屽垎鏋�,灏囨韩搴﹀偝鎰熷櫒甯冪疆榛�(di菐n)浣滅偤楂樻柉绌嶅垎榛�(di菐n),鍒嗗竷鍦ㄩ爯(y霉)鍏堢⒑瀹氱殑婧害鍫翠腑. 鐢变簬鍙互闋�(y霉)鍏堢⒑瀹氭韩搴︽脯榛�(di菐n)鐨勬暩(sh霉)閲忓拰鍒嗗竷浣嶇疆, 鎵€浠ラ伩鍏嶄簡鐐虹嵅寰楁(j墨)搴婃韩搴﹀牬鎵€闇€鐨勫ぇ閲忕殑娓噺鏅傞枔. 鐢变簬娓韩榛�(di菐n)鍗崇偤鏂圭▼鐨勮几鍏�, 鍥犳, 娓韩榛�(di菐n)鐨勬暩(sh霉)閲忓彧鑸囨柟绋嬬殑缍暩(sh霉)鏈夐棞(gu膩n), 鍗虫豢瓒虫柟绋嬬董鏁�(sh霉)鎵€闇€鐨勬脯婧粸(di菐n)鏁�(sh霉),鍓囨ā鍨嬪緱浠ユ(g貌u)寤�, 鐩稿皪浜庡叾浠栨柟娉�, 瑭﹂(y脿n)鎵€闇€瑕佺殑娓韩榛�(di菐n)鏁�(sh霉)椤憲娓涘皯骞跺彲闋�(y霉)鍏堢嵅寰�. 閫氶亷閫欑ó鏂规硶寤虹珛鐨勭啽瑾ゅ樊瑁�(b菙)鍎熸ā鍨嬪彲浠ユ笡灏戜富杌哥啽璁婂舰瑾ゅ樊. 楂樻柉绌嶅垎娉曠嵅寰楃殑妯″瀷鏄竴鍊嬬啊鍠殑鐞嗚珫绶氭€фā鍨�,浣嗗(sh铆)闅涙暩(sh霉)鎺ф(j墨)搴婄啽璁婂舰鍫存槸涓€鍊嬪鍥犵礌浣滅敤鐨勯潪绶氭€х郴绲�(t菕ng),鐞嗚珫妯″瀷鑸囧(sh铆)闅涜畩褰㈤亷绋嬪瓨鍦ㄤ竴瀹氱殑鍋忓樊,鏁呴珮鏂⿳鍒嗘硶鍏锋湁寰堝ぇ鐨勫眬闄愭€�. 3. 3 銆€鐔辨ā鎱�(t脿i)鍒嗘瀽鍎�(y艒u)鍖栨硶 鐔辨ā鎱�(t脿i)鐞嗚珫鏄皣妯℃厠(t脿i)鍒嗘瀽鏂规硶寮曞叆鍒版(j墨)搴婄啽璁婂舰鍟忛涓�. 渚濇摎(j霉)鐔辨ā鎱�(t脿i)鑸囨尟鍕曟ā鎱�(t脿i)鐨勭浉浼兼€�,蹇界暐閲忕侗涓婄殑宸暟,鍙互鐛插緱姗�(j墨)搴婄殑鐔辨ā鎱�(t脿i)鐗规€�. 鏍规摎(j霉)鐔辨ā鎱�(t脿i)鐞嗚珫[sup][9][/sup] ,閬�(y霉n)鐢ㄧ啽妯℃厠(t脿i)鍒嗘瀽鏂规硶,灏嬫壘鐔辨晱鎰熷害鏈€楂樼殑骞惧€嬮粸(di菐n),浣滅偤婧害鍌虫劅鍣ㄧ殑鍎�(y艒u)鍖栧竷缃粸(di菐n). 鐔辨晱鎰熼粸(di菐n)鐨勬悳灏嬬瓥鐣ョ偤: 锛�1锛� 灏囨(j墨)搴婃寜鍩虹(ch菙)浠跺垎瑙ｇ偤鏁�(sh霉)濉�; 锛�2锛� 灏嶅熀绀�(ch菙)浠�,濡傜楂斾欢,鎸夐潰鏌ュ皨; 锛�3锛� 闈㈡煡灏嬫檪,鍏堢恫(w菐ng)鐙€绡€(ji茅)榛�(di菐n)婵€鍕�, 姣旇純鍏剁啽鏁忔劅搴�,閫愭鏀剁府婵€鍕甸粸(di菐n)鎵€鍦嶅崁(q奴)鍩�,纰哄畾鏈€浣抽粸(di菐n); 锛�4锛� 姣旇純鍚勯潰鏈€浣抽粸(di菐n),纰哄畾鍩虹(ch菙)浠舵渶浣抽粸(di菐n), 閫�(j矛n)涓€姝ョ⒑瀹氭暣姗�(j墨)鏈€浣抽粸(di菐n). 閬�(y霉n)鐢ㄧ啽妯℃厠(t脿i)鍒嗘瀽鍎�(y艒u)鍖栨柟娉�, 鍦ㄧ悊璜栦笂寰楀埌浜嗗弽寰�(f霉)椹�(y脿n)璀�,浣嗙敱浜庣啽妯℃厠(t脿i)姒傚康骞朵笉鍏锋湁鐩磋鐨勭墿鐞嗗惈缇�,鐔辫級鑽峰緢闆ｇ敤瑭﹂(y脿n)鏂规硶鐛插彇, 鍥犳, 鐔辨ā鎱�(t脿i)鍒嗘瀽娉曞(sh铆)鏂借捣渚嗚純鐐哄洶闆�. 3. 4 銆€鑱氶鑸囩浉闂�(gu膩n)鍒嗘瀽娉� 鑱氶娉曚互鍙婄浉闂�(gu膩n)鍒嗘瀽娉曟槸杩戝勾渚嗗湪鏁�(sh霉)鎺ф(j墨)搴婄啽瑾ゅ樊寤烘ā涓殑婧害榛�(di菐n)鍎�(y艒u)鍖栭伕鎿囦腑浣跨敤鏈€闋荤箒鐨勬柟娉�. Chih2Hao Lo 绛塠sup][10][/sup] 鍦ㄥ偝绲�(t菕ng)鏂规硶鐨勫熀绀�(ch菙)涓婁綔浜嗘敼閫�(j矛n):閬�(y霉n)鐢ㄤ簡Mallow 鐨凣绲�(t菕ng)瑷堝垎鏋愭硶,寤虹珛澶氬€嬬啽瑾ゅ樊鍒嗛噺鐨勬ā鍨�,灏囨韩搴﹀偝鎰熷櫒鍒嗙祫鎼滅储銆佸皨鍎�(y艒u), 鍒╃敤鐩搁棞(gu膩n)鎬у垎绲勩€佸吀鍨嬭畩閲忔悳绱㈠拰鍒嗙祫鎼滅储绛夋柟娉�,閬�(d谩)鍒板劒(y艒u)鍖栨韩搴︽脯榛�(di菐n)鍒嗗竷鐨勭洰鐨�. 鏈€鍒濆湪姗�(j墨)搴婁笂鍏卞竷缃簡80 浣欏€嬫韩搴﹀偝鎰熷櫒, 浣嗘渶绲傜稉(j墨ng)鍒嗙祫閬稿劒(y艒u)鍚�, 灏嶄簬涓昏桓鍧愭(bi膩o)绯诲師榛�(di菐n)鍦▁ 杌告柟鍚戠殑鐔辨紓绉�,鏈€绲傚儏鐢�4 鍊�.鍦ㄥ(sh铆)闅涙噳(y墨ng)鐢ㄤ腑,閲囩敤姝ゅ劒(y艒u)鍖栨柟娉曢噰闆嗙嵅寰楃殑婧害淇℃伅鑸囩啽璁婂舰淇℃伅閫�(j矛n)琛屽缓妯¤(b菙)鍎�, 鍙互灏囩啽瑾ゅ樊寰�20渭m 娓涘皯鍒�2. 2渭m. 涓婃捣浜ら€氬ぇ瀛�(xu茅)妤婂缓鍦嬬瓑[sup][11 ,12] [/sup]閲囩敤鍩轰簬鑱氶鍒嗘瀽鍩烘湰鍘熺悊鐨勮畩閲忛伕鎿囨柟娉�, 閫氶亷鍒嗘瀽鍚勮畩閲忎箣闁撶殑鐩搁棞(gu膩n)鎬�,骞朵娇鐢ㄤ竴瀹氱殑鑱氬悎鏂规硶灏囪畩閲忛€�(j矛n)琛岃仛椤�.鏍规摎(j霉)鑱氶绲�(ji茅)鏋滈伕鎿囦竴瀹氳畩閲忓悗鍐嶅埄鐢ㄩ€愭鍥炴鐨勬柟娉曢€�(j矛n)涓€姝ュ墧闄ゅ洖姝告ā鍨嬩腑涓嶉渶瑕佺殑婧害璁婇噺, 寤虹珛鏈€鍎�(y艒u)鍥炴妯″瀷. 閫欏叐绋柟娉曠殑绲�(ji茅)鍚堟姷娑堜簡鑱氶鍒嗘瀽涓笉鍚岃仛鍚堟柟娉曠敘(ch菐n)鐢熺殑绲�(ji茅)鏋滃樊鐣扮殑褰遍熆, 骞朵笖娓涘皯浜嗛€愭鍥炴灏嶈畩閲忛€愬€嬪垽鍒ョ殑宸ヤ綔閲�, 鍙互寰堟柟渚垮湴閬告搰鏈€灏戞暩(sh霉)閲忕殑婧害璁婇噺, 寤虹珛閬�(d谩)鍒扮簿搴﹁姹傜殑妯″瀷. 灏嶄簬璁婇噺绡╅伕閬庣▼,鑱氶鍒嗘瀽涓殑璺濋洟閬告搰鐐虹浉闂�(gu膩n)绯绘暩(sh霉),鍙互寰楀埌璁婇噺闁撶殑鐩镐技鐭╅櫍. 鎸夌収閲嶅績娉曢€�(j矛n)琛岃仛椤�,鎸夌浉浼肩郴鏁�(sh霉)灏囪窛闆㈡渶杩戠殑璁婇噺鍚堝苟鐐轰竴椤�,鍐嶆瘮杓冩柊椤炲拰鍓╀笅椤炵殑鐩镐技闂�(gu膩n)绯�,閬告搰璺濋洟鏈€杩戠殑2 鍊嬮绻肩簩(x霉)鍚堝苟, 鐩村埌鎵€鏈夌殑璁婇噺閮借仛鍚堢偤涓€椤炵偤姝�,浠ユ瀵�(sh铆)鐝�(xi脿n)婧害璁婇噺鐨勫劒(y艒u)鍖栭伕鎿�.娴欐睙澶у(xu茅)鍌呭缓涓瓑[sup][4][/sup] , 閲囩敤涓诲洜绱犵瓥鐣ヤ互鍙婁簰涓嶇浉闂�(gu膩n)绛栫暐灏嶆暩(sh霉)鎺ч姂搴婁笂鐨�14 鍊嬫脯婧粸(di菐n)閫�(j矛n)琛屼簡鍎�(y艒u)鍖�,鏈€绲傞伕鍑轰簡4 鍊嬫脯婧粸(di菐n)閫�(j矛n)琛岀啽瑾ゅ樊瑁�(b菙)鍎熷缓妯�. 澶╂触澶у(xu茅)寮靛缇ょ瓑浜篬sup][13][/sup] 涔熼噰鐢ㄤ簡妯＄硦鑱氶鍒嗘瀽鏂规硶灏嶆(j墨)搴婄啽瑾ゅ樊寤烘ā涓殑婧害娓粸(di菐n)閫�(j矛n)琛岄伕鎿�, 骞跺皣鍏舵噳(y墨ng)鐢ㄤ簬绔嬪紡涓夎桓鍔犲伐涓績, 鏈夋晥鍦版笡灏戜簡婧害娓粸(di菐n)鐨勬暩(sh霉)閲�. 鑱氶鑸囩浉闂�(gu膩n)鍒嗘瀽娉曞湪娓韩榛�(di菐n)鍎�(y艒u)鍖栦腑楂旂従(xi脿n)鍑哄叾椤憲鐨勫劒(y艒u)鍕�,浣嗕粛鏈夊緟閫�(j矛n)涓€姝ユ帰绱㈣垏瀹屽杽. 濡傛灉鑳藉鎵惧埌鐔辫宸垏鎵€閬告韩搴﹀牬娓噺鏁�(sh霉)鎿�(j霉)涔嬮枔鐨勭窔鎬ф垨鎺ヨ繎绶氭€х殑闂�(gu膩n)绯�,鍓囪(b菙)鍎熸ā鍨嬪彲浠ュぇ澶х啊鍖�,鑰屼笖鐔辩壒鎬ц鲸璀樻檪闁撳皣鐢变簬绶氭€ч爯(y霉)鍫辨ā鍨嬫墍鍏锋湁鐨勮壇濂藉収(n猫i)鎻掑拰澶栨彃鎬ц兘鑰屽ぇ澶ф笡灏�. 4 鐧�(f膩)灞曡定鍕� 杩戝勾渚�, 涓€浜涙柊鐨勫偝鎰熷櫒浣嶇疆鍎�(y艒u)鍖栨柟娉曞緱鍒拌繀閫熺殑鐧�(f膩)灞�,濡傛嫇?f霉)閶�?y艒u)鍖�銆佸鐣板€煎垎瑙�銆侀伜鍌崇畻娉曠瓑. 閫欎簺鏂规硶鍦ㄦ尟鍕曞煼(zh铆)琛屽櫒/ 鎺у埗鍣�銆侀樆灏煎櫒浠ュ強鏉愭枡鎺㈡脯鍣ㄥ劒(y艒u)鍖栫瓑闋�(l菒ng)鍩熷緱鍒颁簡寤ｆ硾鐨勬噳(y墨ng)鐢╗sup][14 ,15][/sup] , 浣嗛鏈夋秹鍙婂埌姗�(j墨)搴婄啽瑾ゅ樊杈ㄨ瓨寤烘ā闋�(l菒ng)鍩熶腑鐨勫偝鎰熷櫒鍎�(y艒u)鍖�. 灏囬€欎簺鏂规硶寮曞叆鍒版(j墨)搴婃韩搴﹀偝鎰熷櫒鐨勫劒(y艒u)鍖栧竷缃腑, 鍙互浣滅偤鏂扮殑鎺㈢储鑸囧槜瑭�. 4. 1 閬哄偝绠楁硶鍎�(y艒u)鍖� 閬哄偝绠楁硶鐨勫熀鏈€濇兂灏辨槸鍦ㄩ伜鍌宠▓绠楅亷绋嬩腑,閬╂噳(y墨ng)搴﹁純澶х殑鍊嬮珨鍩哄洜寰楀埌閬哄偝, 鑰岄仼鎳�(y墨ng)搴﹁純宸殑鍊嬮珨鍩哄洜鏈冮€愭几鍦版秷澶盵sup][16][/sup] . 閬告搰銆佷氦鍙夊拰璁婄暟, 鏄伜鍌崇畻娉曠殑3 鍊嬩富瑕佹搷浣滅畻瀛�, 瀹冨€戞(g貌u)鎴愪簡鎵€璎傜殑閬哄偝鎿嶄綔,浣块伜鍌崇畻娉曞叿鏈変簡鍏跺畠鍌崇当(t菕ng)鏂规硶鎵€娌掓湁鐨勭壒鎬�. 閬哄偝绠楁硶涓寘鍚簡濡備笅5 鍊嬪熀鏈绱�:鍙冩暩(sh霉)绶ㄧ⒓銆佸垵濮嬬兢楂旂殑瑷�(sh猫)瀹�銆侀仼鎳�(y墨ng)搴﹀嚱鏁�(sh霉)鐨勮ō(sh猫)瀹�銆侀伜鍌虫搷浣滆ō(sh猫)瑷�銆佹帶鍒跺弮鏁�(sh霉)瑷�(sh猫)瀹�. 閫�5 鍊嬭绱犳(g貌u)鎴愪簡閬哄偝绠楁硶鐨勬牳蹇冨収(n猫i)瀹�. 鍦ㄥ彲鏌ラ柋鐨勬枃鐛�(xi脿n)鍫遍亾涓�,閬哄偝绠楁硶骞舵湭鍦ㄦ(j墨)搴婄啽瑾ゅ樊杈ㄨ瓨寤烘ā闋�(l菒ng)鍩熶腑鐨勫偝鎰熷櫒鍎�(y艒u)鍖栧晱椤屼腑寰楀埌鎳�(y墨ng)鐢�. 鐞嗚珫璀夋槑,鍙閬告搰鍚堥仼鐨勯仼鎳�(y墨ng)搴﹀嚱鏁�(sh霉), 閬哄偝绠楁硶鍙互寮曞叆鍒版(j墨)搴婃韩搴﹀偝鎰熷櫒鍎�(y艒u)鍖栧竷缃牁(l菒ng)鍩�,浠ユ敼鍠勫叾鍎�(y艒u)鍖栫祼(ji茅)鏋�, 浣滅偤姗�(j墨)搴婄啽瑾ゅ樊寤烘ā婧害鍌虫劅鍣ㄥ劒(y艒u)鍖栧晱椤岀殑涓€鍊嬬爺绌舵柟鍚�. 4. 2 铏涙摤鍎€鍣� 婧害鍌虫劅鍣ㄥ劒(y艒u)鍖栧竷缃殑鍙﹀涓€鍊嬬爺绌舵柟鍚戞槸寮曞叆铏涙摤鍎€鍣ㄦ妧琛�(sh霉)[sup][17][/sup] . 铏涙摤鍎€鍣ㄦ槸閫氶亷杌熶欢灏囬€氱敤瑷堢畻姗�(j墨)鑸囨湁闂�(gu膩n)鍎€鍣ㄧ‖浠剁祼(ji茅)鍚堣捣渚�, 鐢ㄦ埗閫氶亷鍦栧舰鐣岄潰锛堥€氬父绋辩偤铏涙摤鍓嶉潰鏉匡級 閫�(j矛n)琛屾搷浣滅殑涓€绋剙鍣�. 鍏跺埄鐢ㄨ▓绠楁(j墨)绯荤当(t菕ng)鐨勫挤(qi谩ng)澶у姛鑳�,绲�(ji茅)鍚堢浉鎳�(y墨ng)鐨勫剙鍣ㄧ‖浠�,閲囩敤妯″寮忕祼(ji茅)妲�(g貌u),澶уぇ绐佺牬浜嗗偝绲�(t菕ng)鍎€鍣ㄥ湪淇¤櫉鍌抽€併€佹暩(sh霉)鎿�(j霉)铏曠悊銆侀’绀哄拰瀛樺劜绛夋柟闈㈢殑闄愬埗,浣跨敤鎴跺彲浠ユ柟渚垮湴灏嶅叾閫�(j矛n)琛屽畾缇�銆佺董璀�(h霉)銆佹摯(ku貌)灞曞拰鍗囩礆绛�. 鍚屾檪瀵�(sh铆)鐝�(xi脿n)浜嗚硣婧愬叡浜�,闄嶄綆浜嗘垚鏈�, 寰炶€岄’绀哄嚭寮�(qi谩ng)澶х殑鐢熷懡鍔�,骞舵帹鍕曞剙鍣ㄦ妧琛�(sh霉)鑸囪▓绠楁(j墨)鎶€琛�(sh霉)鐨勯€�(j矛n)鈥旀绲�(ji茅)鍚�. 閲囩敤铏涙摤鍎€鍣ㄦ妧琛�(sh霉),鐐哄(sh铆)鐝�(xi脿n)姗�(j墨)搴婄啽瑾ゅ樊杈ㄨ瓨寤烘ā闋�(l菒ng)鍩熶腑鐨勫偝鎰熷櫒鍎�(y艒u)鍖栭枊杈熶簡鍙﹀涓€姊濋亾璺�. 5 绲�(ji茅)銆€瑾� 閫氶亷瑾ゅ樊瑁�(b菙)鍎熸妧琛�(sh霉)渚嗘彁楂樻(j墨)搴婄簿搴︽棩鐩婂彈鍒板唬娉涢噸瑕�,鍥犳姗�(j墨)搴婄啽瑾ゅ樊杈ㄨ瓨閬庣▼涓韩搴﹀偝鎰熷櫒鐨勫劒(y艒u)鍖栧竷缃晱椤岄’寰楄嚦闂�(gu膩n)閲嶈. 鍌虫劅鍣ㄥ劒(y艒u)鍖栫殑鐮旂┒闂�(gu膩n)閸靛湪浜庡浣曠⒑瀹氭渶灏戠殑娓韩榛�(di菐n)鏁�(sh霉), 浠ユ鐐哄熀绀�(ch菙)妲�(g貌u)寤虹殑妯″瀷鑳界啊鍠笖婧�(zh菙n)纰虹殑鍙嶆槧姗�(j墨)搴婄殑鐔辫畩褰㈡儏娉�. 閫欐柟闈㈢殑鐮旂┒閫愭几璧板嚭鍠磾渚濋潬缍�(j墨ng)椹�(y脿n)瑭︽箠娉�, 绮惧害涓嶉珮,鎴栨暩(sh霉)鍊艰▓绠�,閬庣▼寰�(f霉)闆滅殑闅庢. 鍒╃敤绲�(t菕ng)瑷堝垎鏋愭墜娈�,浣垮緱婧害鏁忔劅榛�(di菐n)鐨勭⒑瀹氭洿鍔犲悎鐞�. 閬哄偝鍎�(y艒u)鍖栫畻娉曡垏铏涙摤鍎€鍣ㄦ妧琛�(sh霉),鍥犲叾鍎�(y艒u)鐣扮殑鐗规€�,鐐轰粖鍚庣殑閫�(j矛n)涓€姝ョ爺绌�,鎻愪緵浜�2 绋彲琛岀殑鏂瑰悜.鐩墠,娓韩榛�(di菐n)鐨勫劒(y艒u)鍖栭伕鎿囦腑浠嶇劧瀛樺湪瑷卞闇€瑕佽В姹虹殑鍟忛. 棣栧厛,杈ㄨ瓨鎶€琛�(sh霉)濡備綍閬�(y霉n)鐢ㄥ埌瀵�(sh铆)韪愮暥(d膩ng)涓�,鍦ㄦ脯閲忔墜娈典笂閭勯渶瑕侀€�(j矛n)涓€姝ユ彁楂�;鍏舵,娓韩榛�(di菐n)鍎�(y艒u)鍖栫殑绲�(ji茅)鏋滈渶瑕佺敤鐔辫宸ā鍨嬬殑绮惧害渚嗛(y脿n)璀�,鍥犳,濡備綍妲�(g貌u)閫犵簿搴﹂珮,榄鎬уソ鐨勭啽瑾ゅ樊妯″瀷,鏄彟涓€鍊嬮棞(gu膩n)閸垫€у晱椤�. 缍滀笂鎵€杩�,姗�(j墨)搴婄啽瑾ゅ樊蹇€熻鲸璀樿垏瑁�(b菙)鍎熸妧琛�(sh霉)缍�(j墨ng)閬庝笉鏂风殑娣卞寲鐮旂┒,鏃ユ几灞曠従(xi脿n)鍑哄唬闂婄殑鎳�(y墨ng)鐢ㄥ墠鏅�. 鍙冭€冩枃鐛�(xi脿n): [ 1 ] 銆€Ranesh R , Mannan M A. 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