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\u76ee\u524d\u9488\u5bf9COVID-19\u7684\u6297\u75c5\u6bd2\u836f\u7269\u4e3b\u8981\u6709\uff1a\u2460\u5948\u739b\u7279\u97e6\/\u5229\u6258\u90a3\u97e6\uff08Paxlovid\uff09\uff1a\u5948\u739b\u7279\u97e6\u662f3CL\u86cb\u767d\u9176\uff083CL pro\uff09\u6291\u5236\u5242\uff0c\u53ef\u4ee5\u76f4\u63a5\u4e0e\u65b0\u51a0\u75c5\u6bd23CL pro\u6d3b\u6027\u4f4d\u70b9\u7ed3\u5408\uff0c\u963b\u6b62\u75c5\u6bd2\u7684\u590d\u5236\uff0c\u5229\u6258\u90a3\u97e6\u53ef\u4ee5\u6291\u5236\u5948\u739b\u7279\u97e6\u5728\u4f53\u5185\u7684\u4ee3\u8c22\uff0c\u4f7f\u5948\u739b\u7279\u97e6\u4f53\u5185\u8840\u6d46\u6d53\u5ea6\u589e\u52a0\uff0c\u5948\u739b\u7279\u97e6\/\u5229\u6258\u90a3\u97e6\u9002\u7528\u4e8e\u53d1\u75c55 d\u4ee5\u5185\u7684\u8f7b\u3001\u4e2d\u578b\u4e14\u4f34\u6709\u8fdb\u5c55\u4e3a\u91cd\u75c7\u9ad8\u98ce\u9669\u56e0\u7d20\u60a3\u8005\u3002\u2461\u745e\u5fb7\u897f\u97e6\uff08Remdesivir\uff09\uff1a\u8be5\u836f\u4e3aRNA\u4f9d\u8d56\u7684RNA\u805a\u5408\u9176\uff08Rdrp\uff09\u6291\u5236\u5242\uff0c\u76ee\u524d\u5728\u56fd\u5185\u5c1a\u4e0d\u53ef\u53ca\uff1b\u2462\u83ab\u52aa\u5339\u97e6\uff08Molnupiravir\uff09\uff1a\u5c5e\u6838\u7cd6\u6838\u82f7\u7c7b\u4f3c\u7269\uff0c\u9776\u70b9\u4e3aRdRp\uff0c\u80fd\u591f\u5e72\u6270\u75c5\u6bd2\u590d\u5236\uff0c\u9002\u7528\u4e8e\u53d1\u75c55 d\u5185\u7684\u8f7b\u3001\u4e2d\u578b\u4e14\u4f34\u6709\u8fdb\u5c55\u4e3a\u91cd\u75c7\u9ad8\u98ce\u9669\u56e0\u7d20\u60a3\u8005\uff0c\u5176\u63a8\u8350\u7ea7\u522b\u4f4e\u4e8ePaxlovid\u3002\u5bf9\u4e8e\u975e\u4f4f\u9662COVID-19\u60a3\u8005\uff0c\u7f8e\u56fd\u56fd\u7acb\u536b\u751f\u7814\u7a76\u9662\uff08NIH\uff09\u6210\u4ebaCOVID-19\u6cbb\u7597\u6307\u5357\u5efa\u8bae\uff0c\u5bf9\u4e8e\u4e0d\u9700\u8981\u6c27\u7597\u4f46\u5177\u6709\u8fdb\u5c55\u4e3a\u91cd\u75c7\u9ad8\u5371\u56e0\u7d20\u60a3\u8005\uff0c\u63a8\u8350\u6297\u75c5\u6bd2\u836f\u7269\u6cbb\u7597\uff1b\u6297\u75c5\u6bd2\u836f\u7269\u7684\u4f18\u5148\u7ea7\u5206\u522b\u4e3aPaxlovid\uff1e\u745e\u5fb7\u897f\u97e6\uff1e\u83ab\u52aa\u5339\u97e6\u3002\u5bf9\u4e8eCOVID-19\u4f4f\u9662\u60a3\u8005\u7684\u6297\u75c5\u6bd2\u6cbb\u7597\uff0c\u4ec5\u6709\u745e\u5fb7\u897f\u97e6\u88ab\u63a8\u8350[1]\u3002\u4f46\u745e\u5fb7\u897f\u97e6\u7684\u4e34\u5e8a\u8bd5\u9a8c\u7ed3\u679c\u4e5f\u5b58\u5728\u4e00\u5b9a\u7684\u4e89\u8bae\uff0c\u4e14\u8be5\u836f\u7269\u76ee\u524d\u5728\u56fd\u5185\u65e0\u6cd5\u83b7\u5f97\u3002\u76ee\u524d\u5c1a\u65e0\u8bc1\u636e\u652f\u6301\u6297\u75c5\u6bd2\u836f\u7269\u7528\u4e8e\u91cd\u578b\u548c\u5371\u91cd\u578b\u60a3\u8005\u5b58\u5728\u83b7\u76ca\u3002\u4e34\u5e8a\u5b9e\u8df5\u4e2d\u4e5f\u9047\u5230\u4e00\u7cfb\u5217\u95ee\u9898\uff1a\u91cd\u75c7\u60a3\u8005\u662f\u5426\u9700\u8981\u5e94\u7528\u6297\u75c5\u6bd2\u836f\u7269\uff1f\u53d1\u75c5\u8d85\u8fc75 d\u80fd\u591f\u5e94\u7528\u6297\u75c5\u6bd2\u836f\u7269\uff1f\u75c5\u6bd2\u6301\u7eed\u5b58\u5728\u60c5\u51b5\u4e0b\u662f\u5426\u5ef6\u957f\u7597\u7a0b\uff1f\u201c\u590d\u9633\u201d\u540e\u5982\u4f55\u5904\u7406\uff1f\u5c3d\u7ba1\u76ee\u524d\u8fd8\u6ca1\u6709\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u80fd\u591f\u56de\u7b54\u8fd9\u4e9b\u95ee\u9898\uff0c\u4f46\u4e5f\u6709\u4e00\u4e9b\u4e34\u5e8a\u7814\u7a76\u4ece\u4fa7\u9762\u5e26\u7ed9\u6211\u4eec\u4e00\u4e9b\u542f\u793a\uff0c\u6216\u8bb8\u4f1a\u5bf9\u4e34\u5e8a\u5b9e\u8df5\u6709\u6240\u5e2e\u52a9\u3002<\/p>\n
Q1. \u5982\u679c\u60a3\u8005\u75c5\u6bd2\u8f7d\u91cf\u5f88\u9ad8\uff0c\u4e14\u53d1\u75c5\u5df2\u7ecf\u8d85\u8fc75 d\uff0c\u7528\u4e0d\u7528\u6297\u75c5\u6bd2\u836f\u7269\uff1f<\/p>\n
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Q2. \u4f7f\u7528\u6297\u75c5\u6bd2\u836f\u7269\u540e\u6ca1\u6709\u8f6c\u9634\uff0c\u75c5\u6bd2\u6392\u6bd2\u65f6\u95f4\u957f\uff0c\u540e\u7eed\u662f\u5426\u7ee7\u7eed\u4f7f\u7528\uff1f<\/p>\n
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\u5728\u65e0\u75c7\u72b6\u611f\u67d3\u8005\u548c\u6709\u75c7\u72b6\u611f\u67d3\u8005\u4e2d\u8fdb\u884c\u7684\u5bf9\u6bd4\u7814\u7a76\u53d1\u73b0\uff0c\u65e0\u75c7\u72b6\u611f\u67d3\u8005\u7684\u6392\u6bd2\u65f6\u95f4\u53ef\u80fd\u66f4\u957f\u3002\u56e0\u6b64\uff0c\u6392\u6bd2\u65f6\u95f4\u53ef\u80fd\u4e0e\u75c5\u60c5\u4e25\u91cd\u7a0b\u5ea6\u65e0\u5173\u3002\u4e5f\u6709\u7814\u7a76\u8868\u660e\u6301\u7eed\u6392\u6bd2\u63d0\u793a\u9884\u540e\u4e0d\u826f\uff0c\u5728\u521d\u59cb\u68c0\u6d4b\u9633\u6027\u540e\u8d85\u8fc714 d\u4ecd\u5448\u9633\u6027\u7684\u60a3\u8005\u4f4f\u9662\u65f6\u95f4\u66f4\u957f\uff0c\u4e0e\u6ca1\u6709\u6301\u7eed\u91ca\u653e\u75c5\u6bd2\u60a3\u8005\u76f8\u6bd4\uff0c\u6b64\u7c7b\u60a3\u80056\u4e2a\u6708\u7684\u75c5\u6b7b\u7387\u66f4\u9ad8[4]\u3002\u8fd9\u4e00\u7ed3\u679c\u8bf4\u660e\uff0c\u5bf9\u4e8e\u6301\u7eed\u6392\u6bd2\u60a3\u8005\uff0c\u5982\u679c\u4e0d\u8fdb\u884c\u5e72\u9884\uff0c\u4efb\u7531\u75c5\u6bd2\u5b58\u5728\uff0c\u4f1a\u5bfc\u81f4\u4e0d\u826f\u9884\u540e\u3002\u8fd9\u5176\u4e2d\u53ef\u80fd\u6d89\u53caSARS-CoV-2\u5bfc\u81f4\u80ba\u635f\u4f24\u7684\u673a\u5236\u3002\u75c5\u6bd2\u611f\u67d3\u5bfc\u81f4\u80ba\u635f\u4f24\u7684\u673a\u5236\u4e3b\u8981\u6709\u4e24\u65b9\u9762\uff0c\u4e00\u662f\u5bf9\u80ba\u6ce1\u4e0a\u76ae\u7ec6\u80de\uff0c\u5c24\u5176\u662f2\u578b\u80ba\u6ce1\u4e0a\u76ae\u7ec6\u80de\u7684\u76f4\u63a5\u635f\u4f24\uff0c\u4e8c\u662f\u8bf1\u53d1\u8fc7\u5ea6\u708e\u75c7\u53cd\u5e94\uff0c\u8fdb\u4e00\u6b65\u9020\u6210\u514d\u75ab\u6027\u80ba\u635f\u4f24[5]\u3002SARS-CoV-2\u4f1a\u57282\u578b\u80ba\u6ce1\u4e0a\u76ae\u7ec6\u80de\u4e2d\u4e0d\u65ad\u590d\u5236\uff0c\u8fd8\u53ef\u4ee5\u653b\u51fb\u5de8\u566c\u7ec6\u80de\uff0c\u4f7f\u5de8\u566c\u7ec6\u80de\u91ca\u653e\u5927\u91cf\u7ec6\u80de\u56e0\u5b50\uff0c\u6b64\u5916\uff0c\u5176\u8fd8\u4f1a\u5e72\u6270T\u7ec6\u80de\u514d\u75ab\uff0c\u8fd9\u4e9b\u90fd\u4f1a\u5bf9\u80ba\u9020\u6210\u4e8c\u6b21\u635f\u4f24\u3002<\/p>\n<\/p>\n
\u56fe\u6e90\uff1aPhysiology (Bethesda), 2022, 37(2):88-100.\u5373\u4f7f\u75c5\u6bd2\u6838\u9178\u5df2\u7ecf\u8f6c\u9634\uff0c\u4f46\u75c5\u6bd2\u6240\u81f4\u8fc7\u5ea6\u708e\u75c7\u53cd\u5e94\u5bf9\u80ba\u7684\u653b\u51fb\u4ecd\u7136\u5b58\u5728\u3002\u6240\u4ee5\uff0c\u201c\u524d\u671f\u6297\u75c5\u6bd2\uff0c\u540e\u671f\u6297\u708e\u201d\u662f\u65e2\u5f80\u6211\u4eec\u6cbb\u7597\u75c5\u6bd2\u6027\u80ba\u708e\u7684\u56fa\u6709\u8ba4\u77e5\u3002\u4f46\u5bf9\u4e8eCOVID-19\u800c\u8a00\uff0c\u6216\u8bb8\u5e76\u4e0d\u5b8c\u5168\u5982\u6b64\u3002\u4e00\u9879\u7814\u7a76\u5bf942\u4f8b\u673a\u68b0\u901a\u6c14\u60a3\u8005\u6b7b\u4ea1\u540e2 h\u5185\u8fdb\u884c\u4e86\u80ba\u7ec4\u7ec7\u53d6\u6837\u5e76\u8fdb\u884c\u75c5\u6bd2\u57f9\u517b\uff0c\u7ed3\u679c\u53d1\u73b0\uff1a38%\uff0816\/42\uff09\u7684\u60a3\u8005\u75c5\u6bd2\u57f9\u517b\u9633\u6027\uff0c\u6b64\u65f6\u8ddd\u53d1\u75c5\u5df2\u8d85\u8fc73\uff5e4\u5468\uff0c\u4e14\u75c5\u7406\u7ed3\u679c\u63d0\u793a\u75c5\u6bd2\u590d\u5236\u4e0e\u8fc7\u5ea6\u708e\u75c7\u53cd\u5e94\u540c\u65f6\u5b58\u5728[6]\u3002\u5728COVID-19\u60a3\u8005\u4e2d\uff0c\u53ef\u80fd\u75c5\u6bd2\u7684\u5b58\u5728\u4f1a\u5bf9\u80ba\u9020\u6210\u6301\u7eed\u635f\u4f24\u3002\u4ece\u8fd9\u4e00\u89d2\u5ea6\u51fa\u53d1\uff0c\u5bf9\u4e8e\u6301\u7eed\u6392\u6bd2\u7684COVID-19\u60a3\u8005\uff0c\u4f9d\u7136\u6709\u8f83\u5f3a\u7684\u6e05\u9664\u75c5\u6bd2\u7684\u6307\u5f81\u3002\u8be5\u6587\u732e\u5728\u8ba8\u8bba\u90e8\u5206\u4e5f\u5206\u6790\u4e86\u91cd\u75c7COVID-19\u60a3\u8005\u4f7f\u7528\u6297\u75c5\u6bd2\u836f\u7269\u6ca1\u6709\u83b7\u76ca\u7684\u539f\u56e0\uff0c\u8ba4\u4e3a\u65e2\u5f80\u7814\u7a76\u7f3a\u9677\u5728\u4e8e\u672a\u5bf9\u75be\u75c5\u4e25\u91cd\u7a0b\u5ea6\u6216\u673a\u68b0\u901a\u6c14\u4ece\u53d1\u75c5\u5230\u6b7b\u4ea1\u7684\u65f6\u95f4\u8fdb\u884c\u7edf\u8ba1\u5b66\u7684\u6821\u6b63\uff0c\u4f46\u4e0d\u80fd\u8bf4\u660e\u91cd\u75c7\u60a3\u8005\u5e94\u7528\u6297\u75c5\u6bd2\u836f\u7269\u6cbb\u7597\u6ca1\u6709\u83b7\u76ca\uff0c\u7ed3\u8bba\u662f\u90e8\u5206\u673a\u68b0\u901a\u6c14\u60a3\u8005\u53ef\u80fd\u4ece\u5ef6\u957f\u7597\u7a0b\u7684\u6297\u75c5\u6bd2\u6cbb\u7597\u4e2d\u83b7\u76ca\u3002<\/p>\n
Q3. \u5bf9\u4e8e\u201c\u590d\u9633\u201d\u60a3\u8005\u5982\u4f55\u5904\u7406\uff1f<\/p>\n
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\u5bf9\u4e8e\u91cd\u75c7COVID-19\u60a3\u8005\u7684\u6297\u75c5\u6bd2\u6cbb\u7597\uff0c\u76ee\u524d\u4ecd\u7f3a\u4e4f\u9ad8\u8d28\u91cf\u7684\u7814\u7a76\u4e0e\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u8868\u660e\u6297\u75c5\u6bd2\u6cbb\u7597\u80fd\u591f\u6539\u5584\u91cd\u75c7COVID-19\u60a3\u8005\u9884\u540e\uff0c\u4f46\u8fd9\u5e76\u4e0d\u4ee3\u8868\u6297\u75c5\u6bd2\u836f\u7269\u5bf9\u91cd\u75c7\u60a3\u8005\u65e0\u7528\uff0c\u7406\u60f3\u7684\u6297\u75c5\u6bd2\u836f\u7269\u4ecd\u6709\u5f85\u5bfb\u627e\u3002\u5b9e\u9645\u4e0a\uff0c\u91cd\u75c7\u60a3\u8005\u7684\u6297\u75c5\u6bd2\u6cbb\u7597\u5728\u75c5\u6bd2\u6027\u80ba\u708e\u6cbb\u7597\u4e2d\u662f\u666e\u904d\u5b58\u5728\u7684\u95ee\u9898\u3002\u4ee5\u6d41\u611f\u75c5\u6bd2\u80ba\u708e\u4e3a\u4f8b\uff0c\u5bf9\u4e8e\u91cd\u75c7\u6d41\u611f\u60a3\u8005\u7684\u6297\u75c5\u6bd2\u6cbb\u7597\uff0c\u7814\u7a76\u7ed3\u679c\u4f9d\u7136\u4ee4\u4eba\u5931\u671b\uff0c\u5f88\u591a\u6297\u75c5\u6bd2\u836f\u7269\u7814\u7a76\u76ee\u524d\u4ecd\u672a\u5f97\u51fa\u6709\u6548\u7684\u7ed3\u8bba\uff0c\u5305\u62ec\u65b0\u836f\u739b\u5df4\u6d1b\u6c99\u97e6\uff0c\u5176\u5728\u91cd\u75c7\u6d41\u611f\u60a3\u8005\u4e2d\u4ecd\u4e3a\u9634\u6027\u7ed3\u679c\uff0c\u4f46\u8fd9\u5e76\u4e0d\u59a8\u788d\u6211\u4eec\u5728\u4e34\u5e8a\u5b9e\u8df5\u4e2d\u6839\u636e\u60a3\u8005\u7684\u5177\u4f53\u60c5\u51b5\u8fdb\u884c\u6297\u75c5\u6bd2\u6cbb\u7597\u3002\u4f46\u5e94\u6ce8\u610f\uff0c\u75c5\u6bd2\u8010\u836f\u98ce\u9669\u786e\u5b9e\u5b58\u5728\u3002\u76ee\u524d\u4e5f\u6709\u75c5\u6bd2\u5b66\u76d1\u6d4b\u53d1\u73b0\uff0cOmicron\u5df2\u7ecf\u51fa\u73b0\u4e86\u5bf9Paxlovid\u8010\u836f\u7684\u6bd2\u682a\uff0c\u8fd9\u4e5f\u662f\u4e0d\u53ef\u907f\u514d\u7684\u5b9e\u9645\u95ee\u9898\u3002\u65b0\u7684\u6297\u75c5\u6bd2\u836f\u7269\u4f9d\u7136\u9700\u8981\u4e0d\u65ad\u8fdb\u884c\u7814\u53d1\uff0c\u75c5\u6bd2\u5b66\u4e0e\u8840\u6e05\u5b66\u76d1\u6d4b\u4e5f\u5fc5\u4e0d\u53ef\u5c11\uff0c\u53ef\u6307\u5bfc\u6297\u75c5\u6bd2\u836f\u7269\u7684\u4e34\u5e8a\u5e94\u7528\uff0c\u4e5f\u53ef\u4e3a\u540e\u7eed\u6297\u75c5\u6bd2\u836f\u7269\u6cbb\u7597\u7597\u7a0b\u63d0\u4f9b\u53c2\u8003\u3002<\/p>\n
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[1] NIH. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines[EB\/OL].https:\/\/www.covid19treatmentguidelines.\/<\/p>\n
[2] Dadras O, Afsahi A M, Pashaei Z, et al. The relationship between COVID-19 viral load and disease severity: A systematic review[J]. Immun Inflamm Dis, 2022, 10(3):e580. <\/p>\n
[3] Cimrman \u0160, Mackov\u00e1 L, Kr\u00e1l V, et al. The duration of SARS-CoV-2 shedding in patients recovering from COVID-19[J]. Epidemiol Mikrobiol Imunol, 2020, 69(3):148-151.<\/p>\n
[4] Batra A, Clark J R, Kang A K, et al. Persistent viral RNA shedding of SARS-CoV-2 is associated with delirium incidence and six-month mortality in hospitalized COVID-19 patients[J]. Geroscience, 2022, 44(3):1241-1254. <\/p>\n
[5] Upadhya S, Rehman J, Malik A B, et al. Mechanisms of Lung Injury Induced by SARS-CoV-2 Infection[J]. Physiology (Bethesda), 2022, 37(2):88-100. <\/p>\n
[6] Tomasicchio M, Jaumdally S, Pooran A, et al. SARS-CoV-2 viral replication persists in the human lung for several weeks after onset of symptomatic severe COVID-19 and is associated with attenuated pulmonary immunity and variant-specific clinical sequalae[EB\/OL]. https:\/\/www.\/content\/10.1101\/2023.03.06.23286834v1<\/p>\n
[7] Epling B P, Rocco J M, Boswell K L, et al. Clinical, Virologic, and Immunologic Evaluation of Symptomatic Coronavirus Disease 2019 Rebound Following Nirmatrelvir\/Ritonavir Treatment[J]. Clin Infect Dis, 2023, 76(4):573-581. <\/p>\n
[8] \u4e2d\u534e\u533b\u5b66\u4f1a\u547c\u5438\u75c5\u5b66\u5206\u4f1a, \u4e2d\u56fd\u533b\u5e08\u534f\u4f1a\u547c\u5438\u533b\u5e08\u5206\u4f1a\u5371\u91cd\u75c7\u533b\u5b66\u4e13\u5bb6\u7ec4. \u5965\u5bc6\u514b\u620e\u53d8\u5f02\u682a\u6240\u81f4\u91cd\u75c7\u65b0\u578b\u51a0\u72b6\u75c5\u6bd2\u611f\u67d3\u4e34\u5e8a\u6551\u6cbb\u4e13\u5bb6\u63a8\u8350\u610f\u89c1[J]. \u4e2d\u534e\u7ed3\u6838\u548c\u547c\u5438\u6742\u5fd7, 2023, 46(2):101-110. <\/p>\n
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\u5df2\u5b8c\u6210PCCM\u4e13\u79d1\u57f9\u8bad<\/p>\n<\/li>\n
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\u4ee5\u7b2c\u4e00\u4f5c\u8005\/\u5171\u540c\u7b2c\u4e00\u4f5c\u8005\u5728Clin Microbiol Infect, Eur Respir J, Respir Res\u7b49\u53d1\u8868\u591a\u7bc7SCI\u6587\u7ae0<\/p>\n<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"
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