浠婂ぉ鏄細

瀹為獙瀹よ祫璁綉

WHO鑰愬鑽粨鏍哥梾娌荤枟鎸囧崡閲嶇鍑虹倝

瀹為獙瀹よ祫璁綉鏃堕棿:2019-01-04 鐐瑰嚮: 娆?/span> 鐧惧害鎼滅储

銆愬璇汇€?/strong>WHO 鑰愬鑽?/ 鍒╃骞宠€愯嵂缁撴牳鐥呮不鐤楁寚鍗?2018 骞存洿鏂扮増 鎽樿瘧锛氶珮闈欓煬銆佺帇绗戞槬 瀹℃牎锛氬垬瀹囩孩 2018骞?鏈堬紝WHO鍩轰簬涓村簥璇曢獙銆侀槦鍒楃爺绌躲€佽瀵熸€х爺绌躲€佽鍒掑疄璺电粡楠屽缓绔嬬殑MDR/RR-TB鍗曚釜鐥呬緥鏁版嵁搴擄紙individual patient data base, IPD锛夊垎鏋愮粨鏋滐紝鍙戝竷浜嗗叧浜庤€愬鑽拰鍒╃骞宠€愯嵂缁撴牳鐥呮不鐤楅噸澶у彉鍖栫殑鏃╂湡閫氬憡锛?缁撴牳甯?.....
TAG鏍囩锛?缁撴牳鐥?/a> WHO 鑰愬鑽粨鏍哥梾 娌荤枟鎸囧崡
WHO鑰愬鑽?鍒╃骞宠€愯嵂缁撴牳鐥呮不鐤楁寚鍗?br /> 2018骞存洿鏂扮増

鎽樿瘧锛氶珮闈欓煬銆佺帇绗戞槬

瀹℃牎锛氬垬瀹囩孩

2018骞?鏈堬紝WHO鍩轰簬涓村簥璇曢獙銆侀槦鍒楃爺绌躲€佽瀵熸€х爺绌躲€佽鍒掑疄璺电粡楠屽缓绔嬬殑MDR/RR-TB鍗曚釜鐥呬緥鏁版嵁搴擄紙individual patient data base, IPD锛夊垎鏋愮粨鏋滐紝鍙戝竷浜?ldquo;鍏充簬鑰愬鑽拰鍒╃骞宠€愯嵂缁撴牳鐥呮不鐤楅噸澶у彉鍖?rdquo; 鐨勬棭鏈熼€氬憡锛?“缁撴牳甯?rdquo;  鍒嗗埆浜?鏈?2鏃ュ拰9鏈?鏃ュ垔鍑轰簡蹇€熼€氬憡鐨勮瘧鏂囧拰瑙h鏂囩珷銆傝繎鏃ワ紝WHO鍙戝竷浜嗚€愬鑽?鍒╃骞宠€愯嵂缁撴牳鐥呮不鐤楁寚鍗楀叏鏂囷紝缁撴牳甯憳璇戝叾涓噸瑕佸彉鍖栧拰瑕佺偣锛屼緵骞垮ぇ璇昏€呭涔犮€佸弬鑰冦€?/p>

 

WHO缃戠珯鍘熸枃閾炬帴锛?/p>

https://www.who.int/tb/features_archive/updated-treatment-guidelines-multigrug-rifampicin-resistant-TB/en/

鑰愬鑽粨鏍哥梾锛圡DR-TB锛?鍒╃骞宠€愯嵂缁撴牳鐥咃紙RR-TB锛夎緝鑽墿鏁忔劅鎬х粨鏍哥梾娌荤枟闅惧害澶э紝瀵瑰疄鐜癢HO鍒跺畾鐨勭粓姝㈢粨鏍哥梾绛栫暐鐨勭洰鏍囨瀯鎴愬▉鑳併€傘€奧HO鑰愬鑽粨鏍哥梾/鍒╃骞宠€愯嵂缁撴牳鐥呮不鐤楁寚鍗?018鏇存柊鐗堛€嬫槸WHO鍚戝悇鎴愬憳鍥戒笓涓氭妧鏈汉鍛橀€氭姤濡備綍鎻愰珮瀵筂DR/RR-TB鐨勬不鐤椾笌鍏虫€€銆俉HO缁勭粐鍙紑浜嗘寚鍗椾慨璁㈠皬缁勪細璁紝瀹¢槄璇勪及浜嗕竴绯诲垪鏈€鏂扮殑璇佹嵁鍙婂崟鐥呬緥鏁版嵁meta鍒嗘瀽锛圛PD-MA锛夋暟鎹€傚墠鑰呭寘鎷痉鎷夐┈灏尖參鏈熼殢鏈哄鐓ц瘯楠岀粨鏋滃拰MDR-TB鐭▼鏂规娌荤枟缁撴灉锛屽悗鑰呭寘鎷潵鑷?0涓浗瀹躲€?3椤圭爺绌剁殑13104渚嬫偅鑰呰繘琛孧DR-TB闀跨▼娌荤枟鐨勬暟鎹€佹潵鑷?5涓浗瀹?600浣欎緥鎮h€呭紑灞?-12鏈圡DR-TB鐭▼娌荤枟鐨勬暟鎹拰鏉ヨ嚜鍦ㄥ効绔ヤ腑浣跨敤璐濊揪鍠瑰晧(Phase II TMC207鈥怌211 and Phase I/II IMPAACT P1108)鍜屽痉鎷夐┈灏间复搴婅瘯楠?Phase I 242鈥?2鈥?45,Phase I 242鈥?2鈥?32, Phase II 242鈥?7鈥?04,Phase II 242鈥?2鈥?33)鐨勮嵂浠e姩鍔涘鍜屽畨鍏ㄦ€ф暟鎹€傛寚鍗椾慨璁㈠皬缁勫涓婅堪璇佹嵁鍙婃暟鎹噰鐢ㄥ浗闄呰瘉鎹帹鑽愬垎绾х殑璇勪及銆佸埗璁笌璇勪环锛圙radingof Recommendations Assessment, Development and Evaluation, GRADE锛夋柟娉曡繘琛屼簡绯荤粺璇勪及銆?/p>

鏈増鎸囧崡鍏充簬MDR/RR-TB鐨勬不鐤椾笌鏃㈠線鎸囧崡涓槑鏄剧殑涓嶅悓涓昏浣撶幇鍦ㄤ互涓嬪嚑鏂归潰锛?.璁捐MDR-TB闀跨▼娌荤枟鏂规鏃朵笉鍐嶄紭鍏堣€冭檻娉ㄥ皠鍓傦紝骞朵笖鍗¢偅闇夌礌鍜屽嵎鏇查湁绱犱笉鍐嶆帹鑽愪娇鐢紱2.瀵瑰ぇ澶氭暟鎮h€呮帹鑽愰噰鐢ㄥ叏鍙f湇鑽墿锛屽己鐑堟帹鑽愬湪闀跨▼娌荤枟鏂规涓娇鐢ㄦ盁鍠硅閰被鑽墿锛堝乏姘ф盁娌欐槦鎴栬帿瑗挎矙鏄燂級銆佽礉杈惧柟鍟夊拰鍒╁鍞戣兒涓夌鑽墿锛屽苟鏍规嵁鑾风泭椋庨櫓鑰冭檻鑱斿悎鍏朵粬鎶楃粨鏍歌嵂鐗╃粍鎴愭不鐤楁柟妗堛€?.鍏充簬娌荤枟鐤楃▼锛屽墠6涓湀鐨勬柟妗堜腑闇€閫夌敤鑷冲皯4绉嶅彲鑳芥湁鏁堢殑鑽墿锛屼箣鍚庤嚦灏戜负3绉嶈嵂鐗┿€傚缓璁暱绋嬫不鐤楁柟妗堝叏鐤楃▼鏃堕暱涓?8-20涓湀骞舵牴鎹偅鑰呮不鐤楁晥鏋滀簣浠ヨ皟鏁达紱鏍囧噯9-12鏈堢煭绋嬫不鐤楁柟妗堢敤浜庣鍚堟潯浠剁殑鎮h€咃紝浣嗛渶瑕佹瘡鏃ヤ娇鐢ㄦ敞灏勫墏鑷冲皯4涓湀銆傛寚鍗楀悓鏃舵寚鍑哄湪瀹炴柦鎬х爺绌舵潯浠朵笅閲囩敤璐濊揪鍠瑰晧鏇夸唬娉ㄥ皠鍓備互鎺㈢储鍏ㄥ彛鏈嶈嵂鐗╂爣鍑嗙煭绋嬫不鐤楁柟妗堢殑鐤楁晥鍜屽畨鍏ㄦ€с€?.姣忔湀杩涜鐥板煿鍏绘鏌ヤ互鐩戞祴鏂规娌荤枟鏁堟灉锛岃嫢鍙戠幇鏂规澶辫触闇€鍙婃椂缁欎簣璋冩暣娌荤枟銆?/p>

WHO鑰愬鑽粨鏍哥梾娌荤枟鎸囧崡閲嶇鍑虹倝

鍏充簬鏂版寚鍗楀疄鏂藉眰闈㈢殑鏇村寤鸿灏嗗湪銆奧HO鑰愯嵂缁撴牳鐥呰鍒掔鐞嗘寚鍗椾紮浼存墜鍐屾洿鏂扮増銆嬩腑浜堜互琛ュ厖銆備互涓嬪皢浠嶮DR-TB闀跨▼娌荤枟鏂规璁捐銆佺枟绋嬨€佹爣鍑嗙煭绋嬫不鐤楁柟妗堢殑浣跨敤鍙奙DR-TB鎮h€呮不鐤楃洃娴嬪洓涓儴鍒嗕粙缁嶆柊鎸囧崡缁欏嚭鐨勫缓璁€?/p>

琛? WHO2018鐗圡DR-TB/RR-TB鎸囧崡涓庢棦寰€鎸囧崡鏇存柊瀵圭収琛?/span>

WHO鑰愬鑽粨鏍哥梾娌荤枟鎸囧崡閲嶇鍑虹倝
WHO鑰愬鑽粨鏍哥梾娌荤枟鎸囧崡閲嶇鍑虹倝

01 鍏充簬MDR-TB闀跨▼娌荤枟鏂规缁勬垚鐨勫缓璁?/span>

1.1銆佸MDR/RR-TB鎮h€呬娇鐢ㄩ暱绋嬫不鐤楁柟妗堟椂锛屾柟妗堜腑瑕佸寘鍚墍鏈堿缁勮嵂鐗╁拰鑷冲皯涓€绉岯缁勮嵂鐗╀互纭繚娌荤枟浼婂鑷冲皯鏈?绉嶅彲鑳芥湁鏁堢殑鑽墿锛屽苟涓斿湪璐濊揪鍠瑰晧鍋滄鍚庤嚦灏戞湁3绉嶈嵂鐗╃户缁不鐤椼€傚鏋滄柟妗堜腑浠呰兘閫夌敤1-2绉岮缁勮嵂鐗╋紝鍒橞缁勪腑鎵€鏈夎嵂鐗╁潎瑕侀€夊叆鏂规锛涘鏋滀娇鐢ˋ缁勫拰B缁勪腑鐨勮嵂鐗╀粛鏃犳硶缁勬垚鏈夋晥鏂规锛屽垯闇€鍔犲叆C缁勮嵂鐗╋紙涓€瀹氭潯浠朵笅寤鸿锛岃瘉鎹川閲忔瀬浣庯級銆?/p>

1.2銆佸崱閭i湁绱犲拰鍗锋洸闇夌礌涓嶅啀鐢ㄤ簬MDR-/RR-TB闀跨▼娌荤枟鏂规涓€傦紙涓€瀹氭潯浠朵笅寤鸿锛岃瘉鎹川閲忔瀬浣庯級銆?/p>

1.3銆佸乏姘ф盁娌欐槦鎴栬帿瑗挎矙鏄熷簲鍔犺嚦MDR/RR-TB鎮h€呴暱绋嬫不鐤楁柟妗堜腑锛堝己鐑堝缓璁紝璇佹嵁璐ㄩ噺涓瓑锛夈€?/p>

1.4銆佸浜?8宀佹垨浠ヤ笂MDR-TB鎮h€咃紝寮虹儓鎺ㄨ崘灏嗚礉杈惧柟鍟夊簲鐢ㄤ簬闀跨▼娌荤枟鏂规涓紙寮虹儓寤鸿锛岃瘉鎹川閲忎腑绛夛級锛涘浜?-17宀佺殑闈掑皯骞存偅鑰咃紝涔熷彲灏嗚礉杈惧柟鍟夊簲鐢ㄤ簬闀跨▼娌荤枟鏂规涓紙涓€瀹氭潯浠朵笅寤鸿锛岃瘉鎹川閲忔瀬浣庯級銆?/p>

1.5銆佸埄濂堝攽鑳哄簲鍔犺嚦MDR/RR-TB鎮h€呴暱绋嬫不鐤楁柟妗堜腑锛堝己鐑堝缓璁紝璇佹嵁璐ㄩ噺涓瓑锛夈€?/p>

1.6銆佹隘娉曢綈鏄庡拰鐜笣姘ㄩ吀鎴栫壒鍒╅綈閰彲鍔犺嚦MDR/RR-TB鎮h€呴暱绋嬫不鐤楁柟妗堜腑锛堜竴瀹氭潯浠朵笅寤鸿锛岃瘉鎹川閲忔瀬浣庯級銆?/p>

1.7銆佷箼鑳轰竵閱囧彲鍔犺嚦MDR/RR-TB鎮h€呴暱绋嬫不鐤楁柟妗堜腑锛堜竴瀹氭潯浠朵笅寤鸿锛岃瘉鎹川閲忔瀬浣庯級銆?/p>

1.8銆佸痉鎷夐┈灏煎彲鍔犺嚦3宀佹垨3宀佷互涓奙DR/RR-TB鎮h€呴暱绋嬫不鐤楁柟妗堜腑锛堜竴瀹氭潯浠朵笅寤鸿锛岃瘉鎹川閲忎腑绛夛級銆?/p>

1.9銆佸悺鍡叞鑳哄彲鍔犺嚦MDR/RR-TB鎮h€呴暱绋嬫不鐤楁柟妗堜腑锛堜竴瀹氭潯浠朵笅寤鸿锛岃瘉鎹川閲忔瀬浣庯級銆?/p>

1.10銆佷簹鑳哄煿鍗?瑗垮徃浠栦竵鎴栫編缃楀煿鍗楀彲鍔犺嚦MDR/RR-TB鎮h€呴暱绋嬫不鐤楁柟妗堜腑锛堜竴瀹氭潯浠朵笅寤鸿锛岃瘉鎹川閲忔瀬浣庯級銆?/p>

1.11銆佸浜?8宀佹垨18宀佷互涓婄殑MDR /RR-TB鎮h€咃紝鍙€夌敤闃跨背鍗℃槦鑷抽暱绋嬫不鐤楁柟妗堜腑锛屽墠鎻愭槸鎮h€呭璇ヨ嵂鏁忔劅涓旂‘淇濆彲瀵规偅鑰呴噰鍙栨不鐤楃洃娴嬪強鏃跺彂鐜颁笉鑹弽搴斻€傚鏋滈樋绫冲崱鏄熶笉鍙敤锛屽湪鍏朵粬涓嶅彉鎯呭喌涓嬶紝鍙噰鐢ㄩ摼闇夌礌鏇夸唬锛堜竴瀹氭潯浠朵笅寤鸿锛岃瘉鎹川閲忔瀬浣庯級銆?/p>

1.12 銆佷箼纭紓鐑熻兒鎴栦笝纭紓鐑熻兒浠呭湪MDR /RR-TB鎮h€呯殑闀跨▼娌荤枟鏂规涓笉鑳介€夌敤璐濊揪鍠瑰晧銆佸埄濂堝攽鑳恒€佹隘娉曢綈鏄庢垨寰锋媺椹凹鎴栨病鏈夋洿濂介€夋嫨缁勬垚娌荤枟鏂规鏃舵墠浜堜互搴旂敤锛堜竴瀹氭潯浠朵笅涓嶅缓璁娇鐢紝璇佹嵁璐ㄩ噺鏋佷綆锛夛紱

1.13銆佸姘ㄥ熀姘存潹閰镐篃浠呭湪MDR /RR-TB鎮h€呯殑闀跨▼娌荤枟鏂规涓笉鑳介€夌敤璐濊揪鍠瑰晧銆佸埄濂堝攽鑳恒€佹隘娉曢綈鏄庢垨寰锋媺椹凹鎴栨病鏈夋洿濂介€夋嫨缁勬垚娌荤枟鏂规鏃舵墠浜堜互搴旂敤锛堜竴瀹氭潯浠朵笅涓嶅缓璁娇鐢紝璇佹嵁璐ㄩ噺鏋佷綆锛夛紱

1.14銆佸湪MDR /RR-TB鎮h€呴暱绋嬫不鐤楁柟妗堜腑涓嶉€夌敤鍏嬫媺缁撮吀锛堝己鐑堜笉寤鸿浣跨敤锛岃瘉鎹川閲忎綆锛夈€?/p>

WHO鑰愬鑽粨鏍哥梾娌荤枟鎸囧崡閲嶇鍑虹倝

涓婅堪寤鸿鎵€瑙g瓟鐨凱ICO锛堢爺绌跺璞°€佸共棰勬帾鏂姐€佸鐓с€佺粨灞€锛夐棶棰?

PICO闂2. 瀵筂DR/RR-TB鎮h€咃紝鍝鑽墿鍦ㄦ牴鎹甒HO鎸囧崡缁勬垚闀跨▼娌荤枟鏂规鏃惰兘鏈夊姪浜庢敼鍠勬不鐤楄浆褰掞紵

PICO闂3. 鎸夌収WHO鎸囧崡涓篗DR/RR-TB鎮h€呭埗瀹氶暱绋嬫不鐤楁柟妗堟椂锛屽己鍖栨湡閫夌敤涓嶈冻5绉嶈繕鏄?绉嶄互涓婃湁鏁堣嵂鐗╂墠鑳戒繚璇佽幏寰楄壇濂芥不鐤楄浆褰掞紵

02 鍏充簬 MDR-TB闀跨▼娌荤枟鏂规鐤楃▼鐨勫缓璁?/span>

2.1銆丮DR/RR-TB鎮h€呯殑闀跨▼娌荤枟鏂规涓寘鍚樋绫冲崱鏄熸垨閾鹃湁绱犳椂锛屽缓璁己鍖栨湡鐤楃▼涓?-7涓湀锛屽彲鏍规嵁鎮h€呯殑娌荤枟鏁堟灉缂╃煭鎴栧欢闀跨枟绋嬶紙涓€瀹氭潯浠朵笅寤鸿锛岃瘉鎹川閲忔瀬浣庯級锛?/p>

2.2銆佸浜嶮DR/RR-TB鎮h€呴暱绋嬫不鐤楁柟妗堢殑鎬荤枟绋嬪缓璁负18-20涓湀锛屽彲鏍规嵁鎮h€呯殑娌荤枟鏁堟灉璋冩暣鐤楃▼锛堜竴瀹氭潯浠朵笅寤鸿锛岃瘉鎹川閲忔瀬浣庯級锛?/p>

2.3銆佸浜嶮DR/RR-TB鎮h€呯殑闀跨▼娌荤枟鏂规锛屽缓璁湪鐥板煿鍏婚槾杞悗缁х画娌荤枟15-17涓湀锛屽彲鏍规嵁鎮h€呯殑娌荤枟鏁堟灉璋冩暣鐤楃▼锛堜竴瀹氭潯浠朵笅寤鸿锛岃瘉鎹川閲忔瀬浣庯級銆?/p>

WHO鑰愬鑽粨鏍哥梾娌荤枟鎸囧崡閲嶇鍑虹倝

涓婅堪寤鸿鎵€瑙g瓟鐨凱ICO锛堢爺绌跺璞°€佸共棰勬帾鏂姐€佸鐓с€佺粨灞€锛夐棶棰?

PICO闂4. 鎸夌収WHO鎸囧崡涓篗DR/RR-TB鎮h€呭埗瀹氶暱绋嬫不鐤楁柟妗堟椂锛屽己鍖栨湡閫夋嫨鐭簬8涓湀杩樻槸8涓湀浠ヤ笂鐨勭枟绋嬫墠鑳戒繚璇佽幏寰楄壇濂芥不鐤楄浆褰掞紵

PICO闂5. 鎸夌収WHO鎸囧崡涓篗DR/RR-TB鎮h€呭埗瀹氶暱绋嬫不鐤楁柟妗堟椂锛屽叏鐤楃▼鐭簬20涓湀杩樻槸20涓湀浠ヤ笂鎵嶈兘淇濊瘉鑾峰緱鑹ソ娌荤枟杞綊锛?

PICO闂6. 鎸夌収WHO鎸囧崡涓篗DR/RR-TB鎮h€呭埗瀹氶暱绋嬫不鐤楁柟妗堟椂锛屽湪鍩瑰吇闃磋浆鍚庢渶鐭渶瑕佸闀跨枟绋嬫墠鑳戒繚璇佽幏寰楄壇濂芥不鐤楄浆褰掞紵

03 鍏充簬MDR-TB鏍囧噯鐭▼娌荤枟鏂规浣跨敤鐨勫缓璁?/span>

瀵逛簬鏃㈠線鏈娇鐢ㄧ煭绋嬫不鐤楁柟妗堜腑鎵€鍖呭惈鐨勪簩绾挎姉缁撴牳鑽墿杩涜娌荤枟瓒呰繃涓€涓湀鎴栨帓闄ゅ姘熷柟璇洪叜绫昏嵂鐗╁強浜岀嚎娉ㄥ皠鍓傝€愯嵂鐨凪DR/RR-TB鎮h€咃紝鎺ㄨ崘浣跨敤9-12涓湀鐭▼娌荤枟鏂规鏇夸唬闀跨▼鏂规锛堜竴瀹氭潯浠朵笅寤鸿锛岃瘉鎹川閲忎綆锛夈€?/p>

鎸囧崡鍐嶆寮鸿皟锛屽湪鑰冭檻杩涜鐭▼娌荤枟鏂规鍓嶏紝鎺掗櫎瀵规盁鍠硅閰被鑽墿鍜屼簩绾挎敞灏勫墏鐨勮€愯嵂锛屾澶栧鏋滃彲鑳斤紝寮€灞曞悺鍡叞鑳虹殑鑽晱璇曢獙鍜屽紓鐑熻偧鑰愯嵂鐨勫熀鍥犲瀷妫€娴嬩篃寰堥噸瑕併€備互涓嬫儏鍐典笉閫傚疁閲囩敤MDR-TB鏍囧噯鐭▼娌荤枟鏂规锛?/p>

  • 瀵筂DR-TB鐭▼鏂规涓煇涓€鑽墿鏄庣‘鑰愯嵂鎴栨€€鐤戝鍏舵不鐤楀弽搴斾笉浣宠€咃紙闄ゅ寮傜儫鑲艰€愯嵂锛夛紱

  •  浣跨敤MDR-TB鐭▼鏂规涓竴绉嶆垨浠ヤ笂浜岀嚎鑽墿瓒呰繃涓€涓湀锛堥櫎闈炵‘璁よ繖浜涗簩绾胯嵂鐗╀负鏁忔劅锛夛紱

  • 瀵筂DR-TB鐭▼鏂规涓殑浠讳竴鑽墿涓嶈兘鑰愬彈鎴栧瓨鍦ㄦ瘨鎬у弽搴旓紙濡傝嵂鐗╅棿鐩镐簰浣滅敤锛夛紱

  • 濡婂锛?/span>

  • 鎾暎鎬ц偤缁撴牳銆佺粨鏍告€ц剳鑶滅値鎴栦腑鏋㈢缁忕郴缁熺粨鏍革紱

  • HIV闃虫€ц€呭嚭鐜颁换涓€涓€绉嶈偤澶栫粨鏍搞€?/span>

涓婅堪寤鸿鎵€瑙g瓟鐨凱ICO锛堢爺绌跺璞°€佸共棰勬帾鏂姐€佸鐓с€佺粨灞€锛夐棶棰?

 

PICO闂1. 瀵筂DR/RR-TB鎮h€呴噰鐢ㄧ煭绋嬫不鐤楁柟妗堣兘鍚︽瘮闀跨▼娌荤枟鏂规鏇磋兘鑾峰緱鑹ソ娌荤枟杞綊锛?/p>

04 鍏充簬閲囩敤鐥板煿鍏绘潵鐩戞祴鎮h€呮不鐤楁晥鏋滅殑寤鸿

瀵筂DR/RR-TB鎮h€呴噰鐢ㄩ暱绋嬫不鐤楁柟妗堟椂锛屽缓璁湪鐥版秱鐗囬暅妫€鍩虹涓婂鍔犵棸鍩瑰吇浣滀负娌荤枟鏁堟灉鐩戞祴鎵嬫骞朵笖鐩戞祴棰戠巼涓烘瘡鏈堜竴娆°€傦紙寮虹儓寤鸿锛屾娴嬪噯纭€ц瘉鎹川閲忎腑绛夛級銆?/p>

涓婅堪寤鸿鎵€瑙g瓟鐨凱ICO锛堢爺绌跺璞°€佸共棰勫璞°€佸鐓с€佺粨灞€锛夐棶棰?

 

PICO闂7. 瀵逛簬浣跨敤鎸夌収WHO鎸囧崡鍒跺畾鐨勯暱绋嬫垨鐭▼娌荤枟鏂规鐨凪DR/RR-TB鎮h€咃紝鍦ㄧ棸娑傜墖闀滄鍩虹涓婂鍔犳瘡鏈堢棸鍩瑰吇鐩戞祴鑳藉惁鏇村ソ鍦板彂鐜版不鐤楄浆褰掍笉浣宠€咃紵

琛? MDR-TB闀跨▼娌荤枟鏂规鎺ㄨ崘鑽墿鍒嗙粍1

WHO鑰愬鑽粨鏍哥梾娌荤枟鎸囧崡閲嶇鍑虹倝

1銆佹湰琛ㄧ敤浜庢寚瀵煎埗瀹氫釜浣撳寲鐨凪DR-TB闀跨▼娌荤枟鏂规锛圡DR-TB鐭▼娌荤枟鏂规鑽墿缁勬垚鍩烘湰涓婁负鏍囧噯鍖栨柟妗堬級銆侰缁勪腑鐨勮嵂鐗╂牴鎹帹鑽愪娇鐢ㄧ殑璇佹嵁寮哄害闄嶅簭鎺掑垪銆?018骞碔PD-MA鐨勯暱绋嬫不鐤楁暟鎹腑鏃犱娇鐢ㄦ皑纭劜锛圱锛夌殑鎮h€咃紝浣跨敤鍔犳浛娌欐槦锛圙fx锛夊拰楂樺墏閲忓紓鐑熻偧锛圚h锛夌殑鎮h€呮暟閲忎篃鏈夐檺锛屽洜鑰屼笉鍏锋湁鍒嗘瀽鎰忎箟銆傚彟澶栵紝鐢变簬缂哄皯鏉ヨ嚜鍚堥€傜爺绌剁殑鎮h€呮渶缁堟不鐤楄浆褰掓暟鎹紝鏁呭perchlozone,γ-骞叉壈绱犳垨鎭跺攽鐑烽叜绫昏嵂鐗╃殑浣跨敤鏈粰鍑哄缓璁€?/span>

2銆丅dq浣跨敤瓒呰繃6涓湀鍜屽湪6宀佷互涓嬪効绔ユ偅鑰呬腑浣跨敤鐨勫畨鍏ㄦ€у拰鏈夋晥鎬ц瘉鎹笉瓒筹紝鏁呭湪涓婅堪鎯呭喌涓嬩娇鐢˙dq搴旈伒寰?ldquo;瓒呴€傚簲鐥?rdquo;浣跨敤瑙勮寖銆?/p>

3銆丅dq鍜孌lm鑱斿悎浣跨敤鐨勮瘉鎹笉瓒炽€?/p>

4銆佸凡鏈夎瘉鎹樉绀轰娇鐢↙zd鑷冲皯6涓湀鍙彁楂樼枟鏁堬紝浣嗕即闅忕殑鑽墿姣掓€у彲鑳介檺鍒跺叾闀挎湡浣跨敤銆傚垎鏋愭樉绀哄叏鐤楃▼浣跨敤Lzd鍙彁楂樼枟鏁堬紙70%鐨勬偅鑰呬娇鐢↙zd瓒呰繃6涓湀锛?0%鐨勬偅鑰呬娇鐢ㄨ揪鍒?8涓湀鎴栧叏鐤楃▼锛夈€侷PD浜氱粍鍒嗘瀽娌℃湁鑾峰緱鏃╂湡鍋滅敤Lzd娌荤枟鐨勫彲鑳界粨鏋溿€?/p>

5.銆丏lm浣跨敤瓒呰繃6涓湀鍜屽湪3宀佷互涓嬪効绔ユ偅鑰呬腑浣跨敤鐨勫畨鍏ㄦ€у拰鏈夋晥鎬ц瘉鎹笉瓒筹紝鏁呭湪涓婅堪鎯呭喌涓嬩娇鐢―lm搴旈伒寰?ldquo;瓒呴€傚簲鐥?rdquo;浣跨敤瑙勮寖銆?/p>

6銆佸彧鏈夊綋DST缁撴灉纭畾鏁忔劅鏃讹紝Z鎵嶅彲瑙嗕负鏈夋晥鑽墿浣跨敤銆?/p>

7銆両mp-Cln鍜孧pm闇€涓庡厠鎷夌淮閰歌仈鍚堜娇鐢紝鑰屽厠鎷夌淮閰稿彧鏈変笌闃胯帿瑗挎灄鐨勫鍚堝埗鍓傦紙Amx-Clv锛夈€侫mx-Clv涓嶈兘瑙嗕綔鏈夋晥鐨勬姉缁撴牳鑽墿鍗曠嫭浣跨敤锛岄渶鑱斿悎Imp-Cln鎴朚pm銆?/span>

8銆丄m鍜孲浠呭湪DST缁撴灉纭畾鍏舵晱鎰熶笖鍏峰鍚姏鐩戞祴鑳藉姏涓旈珮璐ㄩ噺瀹炴柦鐨勬潯浠朵笅浣跨敤銆係浠呭湪涓嶈兘浣跨敤Am锛堣嵂鐗╀笉鍙強鎴栫‘瀹欰m鑰愯嵂锛変笖DST缁撴灉纭畾鍏舵晱鎰燂紙浜岀嚎鍒嗗瓙绾挎€ф帰閽堟棤娉曟娴婼鑰愯嵂鎬э紝闇€杩涜琛ㄥ瀷鑽晱妫€娴嬶級鏃舵柟鍙娇鐢ㄣ€傚崱閭i湁绱狅紙Km锛夊拰鍗锋洸闇夌礌锛圕m锛変笉鍐嶆帹鑽愮敤浜嶮DR-TB娌荤枟銆?/p>

9銆佽繖浜涜嵂鐗╀粎鍦ㄤ笉鍖呭惈Bdq銆丩zd銆丆fz鎴朌lm鐨勬柟妗堜腑鏄剧ず鍑烘湁鏁堟€э紝鍥犳寤鸿鍦ㄦ棤娉曠粍鎴愭湁鏁堟柟妗堟椂鏂瑰彲閫夌敤銆?/p> 锛堟湰鏂囨潵婧愶細缁撴牳甯?锛?

(璐d换缂栬緫锛氬ぇ鏋?

寮曠敤鍦板潃锛?a href="#" target=_blank>

TAG鏍囩锛?缁撴牳鐥?/a> WHO 鑰愬鑽粨鏍哥梾 娌荤枟鎸囧崡
椤朵竴涓?/div>
(5)
100%
韪╀竴涓?/div>
(0)
0%
鍏嶈矗澹版槑锛?/strong> 闄ゆ爣鏄庛€婂疄楠屽璧勮缃戙€嬪師鍒涘锛屾湰缃戦儴鍒嗘枃绔犺浆杞借嚜鍏跺畠濯掍綋锛岃浆杞界洰鐨勫湪浜庝紶閫掓洿澶氫俊鎭紝 骞朵笉浠h〃鏈綉璧炲悓鍏惰鐐瑰拰瀵瑰叾鐪熷疄鎬ц礋璐o紝涓斾笉鎵挎媴姝ょ被浣滃搧渚垫潈琛屼负鐨勭洿鎺ヨ矗浠诲強杩炲甫璐d换銆? 濡傚叾浠栧獟浣撱€佺綉绔欐垨涓汉浠庢湰缃戜笅杞戒娇鐢紝鑷礋鐗堟潈绛夋硶寰嬭矗浠汇€傚娑夊強浣滃搧鍐呭銆佺増鏉冨拰鍏跺畠闂锛? 璇峰湪30鏃ュ唴涓庢湰缃戣仈绯伙紝鎴戜滑灏嗗湪绗竴鏃堕棿鍒犻櫎鍐呭锛?
------鍒嗛殧绾?---------------------------
鍙戣〃璇勮
璇疯嚜瑙夐伒瀹堜簰鑱旂綉鐩稿叧鐨勬斂绛栨硶瑙勶紝涓ョ鍙戝竷鑹叉儏銆佹毚鍔涖€佸弽鍔ㄧ殑瑷€璁恒€?/small>
璇勪环:
琛ㄦ儏:
鏈€鏂拌瘎璁?/strong> 杩涘叆璇︾粏璇勮椤?gt;>