ATRA\u4ecb\u7ecd<\/p>\n
\u7ef4\u7532\u9178\uff08RA\uff09\u5177\u6709\u5f88\u5f3a\u7684\u8bf1\u5bfc\u7ec6\u80de\u5206\u5316\u53ca\u514d\u75ab\u8c03\u8282\u4f5c\u7528\uff0c\u662f\u76ee\u524d\u56fd\u5185\u6cbb\u7597\u6025\u6027\u65e9\u5e7c\u7c92\u7ec6\u80de\u767d\u8840\u75c5 ( acute promyelocytic leukemia\uff0cAPL) \u3001\u9aa8\u9ad3\u5f02\u5e38\u589e\u751f\u7b49\u8840\u6db2\u6076\u6027\u75be\u75c5\u7684\u4e34\u5e8a\u9996\u9009\u836f\u7269\uff0c\u540c\u65f6\u5728\u76ae\u80a4\u75c5\u3001\u5b9e\u4f53\u80bf\u7624\u53ca\u8840\u7ba1\u76f8\u5173\u75be\u75c5\u7b49\u4e34\u5e8a\u5176\u4ed6\u826f\u597d\u7684\u5e94\u7528\u3002<\/p>\n
\u7ef4\u751f\u7d20A\u662f\u6307\u6240\u6709\u5177\u6709\u89c6\u9ec4\u9187\u751f\u7269\u6d3b\u6027\u7684\u5316\u5408\u7269\u3002\u5305\u62ec\u89c6\u9ec4\u9187\uff08retinol\uff09\u3001\u89c6\u9ec4\u919b\uff08retinene\uff09\u3001\u89c6\u9ec4\u9178\uff08retinoic Acid\uff09\u3001\u89c6\u9ec4\u9187\u4e59\u9178\u916f\uff08retinyl AcetAte\uff09\u548c\u89c6\u9ec4\u9187\u68d5\u6988\u9178\u916f\uff08retinyl palmitate\uff09\u7b49\u5728\u5185\u7684\u89c6\u9ec4\u9187\u7684\u884d\u751f\u7269\u3002\u5176\u4e2d\u89c6\u9ec4\u9178\u548c\u89c6\u9ec4\u9170\u916f\u7684\u7a33\u5b9a\u6027\u6700\u597d\u3002<\/p>\n
\u5168\u53cd\u5f0f\u7ef4\u7532\u9178\uff08ATRA\uff09\uff0c\u53c8\u540d\u7ef4\u751f\u7d20A\u9178\u3001\u7ef4\u4ed6\u547dA\u9178\uff0c\u662f\u4f53\u5185\u7ef4\u751f\u7d20A\uff08VitA\uff09\u7684\u4ee3\u8c22\u4e2d\u95f4\u4ea7\u7269\uff0c\u7531\u758f\u6c34\u57fa\u56e2\u3001\u4eb2\u6c34\u57fa\u56e2\u548c\u5171\u8f6d\u94fe\u7ec4\u6210\uff0cATRA\u4f53\u5185\u8fd8\u53ef\u5f02\u6784\u5316\u4e3a9-\u987a\u5f0f\u7ef4A\u9178\uff089-Cis RA\uff09\uff0c\u4e8c\u8005\u751f\u7269\u529f\u80fd\u867d\u76f8\u4f3c\uff0c\u4f46\u662f\u7ed3\u5408\u53d7\u4f53\u4e0d\u540c\uff0cATRA\u4e3b\u8981\u7ed3\u5408\u7ef4A\u9178\u53d7\u4f53\uff08RAR\uff09\uff0c9-\u987a\u5f0f\u7ef4A\u9178\u7ed3\u5408\u7ef4A\u7c7bX\u53d7\u4f53\uff08RXR\uff09\uff0c\u7ed3\u5408\u4e0aRAR \u548c RXR\u4f5c\u4e3a\u8f6c\u5bfc\u56e0\u5b50\uff0c\u8c03\u63a7\u6b63\u5e38\u7ec6\u80de\u548c\u80bf\u7624\u7ec6\u80de\u7684\u751f\u957f\u548c\u5206\u5316\u3002<\/p>\n<\/p>\n
ATRA\u7684\u836f\u52a8\u5b66\u7279\u6027<\/p>\n
(1) \u5206\u5b50\u91cf\uff1a300.44\uff0c\u5206\u5b50\u5f0f\u4e3a C20H28O2\u3002<\/p>\n
(2) \u53e3\u670d\u751f\u7269\u5229\u7528\u5ea6\u4e3a50%\uff0c\u53e3\u670d\u5438\u6536\u540e\uff0c\u5e7f\u6cdb\u4e0e\u8840\u6d46\u86cb\u767d\u7ed3\u5408\uff0c\u5e73\u5747\u6d88\u9664\u534a\u8870\u671f\u4e3a0.7h\u3002<\/p>\n
(3) \u5728\u809d\u5185\u7ecfCYPP450\u9176\u4ee3\u8c22\uff0c\u4ee3\u8c22\u7269\u7ecf\u80c6\u6c41\u548c\u5c3f\u4e2d\u6392\u6cc4\u3002<\/p>\n
(4) ATRA\u7684\u4f53\u5185\u8fc7\u7a0b\uff1aATRA\u53d1\u6325\u5b8c\u836f\u7406\u4f5c\u7528\u540e\uff0cCyp26\u9176\u4f5c\u7528\u4e8e\u5168\u53cd\u5f0fRA\u7684\u03b2-\u7d2b\u7f57\u5170\u916e\u73af\u7684C4-C5\u548cC18\uff08\u9ec4\u8272\u663e\u793a\uff09\u751f\u6210\u6781\u6027\u4ee3\u8c22\u7269\uff1a4-\u7f9f\u57faRA\u30014-\u6c27\u57faRA\u4ee5\u53ca18-\u7f9f\u57faRA\u3002<\/p>\n<\/p>\n
ATRA\u7684\u836f\u7406\u5b66\u4f5c\u7528<\/p>\n
(1) \u7ec6\u80de\u6838\u6fc0\u7d20\u6837\u4f5c\u7528\uff1a\u901a\u8fc7\u7ec6\u80de\u6838\u5185RAR\uff0c\u8c03\u8282\u548c\u63a7\u5236\u7ec6\u80de\u6838\u5185\u4fe1\u4f7fRNA\u7684\u6fc0\u6d3b\u4e0e\u8868\u8fbe\u3002RARs\u53ef\u4ee5\u7ed3\u5408\u5e76\u5bf9ATRA\u53ca\u5f02\u6784\u4f53\u4ea7\u751f\u53cd\u5e94\uff0c\u800cRXRs\u5219\u7279\u5f02\u6027\u5730\u7ed3\u54089-\u987a\u5f0f\u89c6\u9ec4\u9178\u3002\u8fd9\u4e9b\u6838\u53d7\u4f53\u901a\u8fc7\u4e24\u4e24\u805a\u5408\uff0c\u5f62\u6210\u5404\u79cd\u540c\u4e8c\u805a\u4f53\u6216\u5f02\u4e8c\u805a\u4f53\uff0c\u4e0e\u76f8\u5e94\u7684\u89c6\u9ec4\u9178\u53cd\u5e94\u539f\u4ef6RARE\u6216RXRE\u7ed3\u5408\uff0c\u524d\u8005\u4e3b\u8981\u5f71\u54cd\u7ec6\u80de\u5468\u671f\u86cb\u767d\u800c\u8c03\u63a7\u7ec6\u80de\u5206\u5316\u3001\u751f\u957f\u53d1\u80b2\u3001\u751f\u6b96\u529f\u80fd\u3001\u514d\u529f\u80fd\u3001\u9020\u8840\u529f\u80fd\u7b49\u3002\u540e\u8005\u4e3b\u8981\u964d\u4f4e\u7ec6\u80de\u589e\u6b96\u5e76\u4fc3\u8fdb\u7ec6\u80de\u7a0b\u5e8f\u5316\u6b7b\u4ea1\uff08\u51cb\u4ea1\uff09\u3002<\/p>\n<\/p>\n
(2) \u7ef4\u6301\u548c\u4fc3\u8fdb\u514d\u75ab\u529f\u80fd\uff1aATRA\u5bf9\u7ef4\u62a4\u514d\u75ab\u529f\u80fd\u662f\u5fc5\u9700\u7684\uff0c\u901a\u8fc7\u6838\u53d7\u4f53\u5bf9\u9776\u57fa\u56e0\u7684\u8c03\u63a7\uff0c\u63d0\u9ad8\u7ec6\u80de\u514d\u75ab\u529f\u80fd\uff0c\u4fc3\u8fdb\u514d\u75ab\u7ec6\u80de\u4ea7\u751f\u6297\u4f53\uff0c\u4ee5\u53ca\u4fc3\u8fdbT\u6dcb\u5df4\u7ec6\u80de\u4ea7\u751f\u67d0\u4e9b\u6dcb\u5df4\u56e0\u5b50\u3002ATRA\u5bf9CD4+T\u7ec6\u80de\u4e9a\u7fa4\u7684\u514d\u75ab\u8c03\u8282\u4f5c\u7528\u3002ATRA\u901a\u8fc7\u4e0eTGF-\u03b2\u534f\u540c\u4f5c\u7528\uff0c\u4fc3\u8fdb\u539f\u59cbT\u7ec6\u80de\u8bf1\u5bfcTreg\u7ec6\u80de\uff0c\u540c\u6291\u5236IL-6\u7b49\u708e\u6027\u7ec6\u80de\u56e0\u5b50\u8bf1\u5bfcTh17\u7ec6\u80de\uff0c\u4ece\u800c\u7ef4\u6301\u514d\u75ab\u7a33\u6001\u3002\u6b64\u5916\uff0catRA\u901a\u8fc7\u964d\u4f4eIL-6R\u03b1\u7684\u8868\u8fbe\u6291\u5236nTreg\u7ec6\u80de\u5411Th17\u5206\u5316\u3002ATRA\u5728NLRP3\u708e\u75c7\u4f53\u4ecb\u5bfc\u7684\u514d\u75ab\u53cd\u5e94\u4e2d\u7684\u4f5c\u7528\u3002<\/p>\n<\/p>\n
(3) \u4fc3\u8fdb\u751f\u957f\u53d1\u80b2\u548c\u7ef4\u6301\u751f\u6b96\u529f\u80fd\uff1a\u751f\u6b96\u7ec4\u7ec7\u548c\u54fa\u4e73\u52a8\u7269\u7684\u80da\u80ce\u53d1\u751f\u4f9d\u8d56RAR\u8fdb\u884c\u57fa\u56e0\u8c03\u8282\u3002 <\/p>\n
(4) \u8bf1\u5bfc\u51cb\u4ea1\u4f5c\u7528\uff1aATRA\u9664\u5f71\u54cd\u6b63\u5e38\u5065\u5eb7\u76f8\u5173\u8fdb\u5316\u529f\u80fd\u5916\uff0c\u7ef4\u751f\u7d20A\u8fd8\u6709\u4fc3\u8fdb\u80bf\u7624\u7ec6\u80de\u51cb\u4ea1\u7684\u4f5c\u7528\u300213\u987a\u5f0f\u5f02\u6784\u5316\u4e3aATRA\u5e76\u4e0eRAR\u7ed3\u5408\u540e\uff0c\u8f6c\u5f55\u56e0\u5b50FoxO3a\u4e0a\u8c03\u5e76\u8bf1\u5bfc\u80bf\u7624\u574f\u6b7b\u56e0\u5b50\u76f8\u5173\u51cb\u4ea1\u8bf1\u5bfc\u914d\u4f53\uff08TRAIL\uff09\u548cFoxO1\u7684\u8868\u8fbe\u3002TRAIL\u6fc0\u6d3b\u534a\u80f1\u5929\u51ac\u9176\u7ea7\u8054\uff0c\u5bfc\u81f4\u7ec6\u80de\u51cb\u4ea1\u3002FoxO1\u901a\u8fc7\u4e0a\u8c03\u7ec6\u80de\u5468\u671f\u6291\u5236\u5242p21\u548cp27\u4ecb\u5bfc\u7ec6\u80de\u5468\u671f\u963b\u6ede\u3002<\/p>\n
(5) \u8bf1\u5bfcAPL\u7ec6\u80de\u5206\u5316\uff1a<\/p>\n
\u2460 ATRA\u4f7f\u6838\u53d7\u4f53\u8f85\u52a9\u6291\u5236\u56e0\u5b50(Corepressor,CoR)\u4e0ePML-RAR\/RXR\u590d\u5408\u7269\u5206\u79bb\uff0c\u5e76\u62db\u52df\u8f85\u9176A\uff08CoA\uff09\uff0c\u5bfc\u81f4\u9776\u57fa\u56e0\u7684\u8f6c\u5f55\u3002<\/p>\n
\u2461 ATRA\u8c03\u8282cAMP-PKA\u86cb\u767d\u6fc0\u9176\u4fe1\u53f7\u901a\u8def\uff0c\u5bfc\u81f4APL\u7ec6\u80de\u8f6c\u5f55\u6fc0\u6d3b\u548c\u5206\u5316\u3002<\/p>\n
\u2462 ATRA\u8fd8\u53ef\u4ee5\u8c03\u8282PML-RAR\u764c\u86cb\u767d\u5e76\u5bf9\u5176\u8fdb\u884c\u964d\u89e3\u3002 \u2463 \u8bf1\u5bfc\u80fd\u529b\u4e0e\u5242\u91cf\u5448\u4f9d\u8d56\u6027,\u4e0e\u514b\u9686\u523a\u6fc0\u56e0\u5b50\u3001\u963f\u7cd6\u80de\u82f7\u7b49\u5408\u7528,\u53ef\u589e\u52a0\u5bf9\u80bf\u7624\u7ec6\u80de\u7684\u5206\u5316\u6d3b\u6027\u4f5c\u7528\u3002<\/p>\n<\/p>\n
ATRA\u5728\u4e34\u5e8a\u4e2d\u7684\u5e94\u7528<\/p>\n
\uff081\uff09\u7ef4A\u9178\u5728\u6076\u6027\u8840\u6db2\u75c5\u4e2d\u5e94\u7528<\/p>\n
\u2460\u3000\u6025\u6027\u65e9\u5e7c\u7c92\u7ec6\u80de\u767d\u8840\u75c5\uff08APL\uff09\uff1a1983\u5e74\uff0cKoeffler \u603b\u7ed3\u4e86\u591a\u79cd\u5316\u5408\u7269\uff08\u5305\u62ec\u7ef4\u7532\u9178\uff09\u5728\u4f53\u5916\u7ec6\u80de\u57f9\u517b\u5bf9\u4eba\u767d\u8840\u75c5\u7ec6\u80de\u7684\u5206\u5316\u4f5c\u7528\u30021985\u5e74\uff0c\u4e0a\u6d77\u7b2c\u4e8c\u533b\u79d1\u5927\u5b66\u738b\u632f\u4e49\u7528\u5168\u53cd\u5f0f\u7ef4\u7532\u9178\u6cbb\u6108\u4e00\u4f8b5\u5c81\u767d\u8840\u75c5\u513f\u7ae5\u30021987\u5e74\u738b\u632f\u4e49\u8bfe\u9898\u7ec4\u5728\u82f1\u6587\u7248\u300a\u4e2d\u534e\u533b\u5b66\u6742\u5fd7\u300b\u62a5\u9053\u7528\u5168\u53cd\u5f0f\u7ef4\u7532\u9178\uff08\u5408\u5e76\u5176\u4ed6\u5316\u7597\u836f\u7269\u6216\u5355\u72ec\uff09\u6cbb\u7597\u516d\u4f8bAPL\u75c5\u4eba\u30021988\u5e74\uff0c\u738b\u632f\u4e49\u8bfe\u9898\u7ec4\u5728\u7f8e\u56fd\u300a\u8840\u6db2\u300b\u6742\u5fd7\u53d1\u8868\u8bba\u6587\uff0c\u603b\u7ed3\u4ed6\u4eec\u7528\u5168\u53cd\u5f0f\u7ef4\u7532\u9178\u6cbb\u759724\u4f8bAPL\u75c5\u4eba\uff0c\u83b7\u5f97\u5b8c\u5168\u7f13\u89e3\u3002<\/p>\n
\u2461\u3000\u9aa8\u9ad3\u589e\u751f\u5f02\u5e38\u7efc\u5408\u5f81\uff1a\u9020\u8840\u5e72\u7ec6\u80de\u5728\u4e0d\u540c\u7684\u589e\u751f\u5206\u5316\u9636\u6bb5\u53d7\u4e0d\u540c\u7684 \u539f\u764c\u57fa\u56e0\u548c\u6291\u764c\u57fa\u56e0\u8c03\u63a7\uff0cMDS \u53d1\u75c5\u5177\u6709\u9636\u6bb5\u7279\u6027\uff0c \u53ef\u80fd\u4e0e\u4e0d\u540c\u539f\u764c\u57fa\u56e0\u548c\u6291\u764c\u57fa\u56e0\u7684\u53d8\u5316\u6709\u5173\uff0c\u539f\u764c\u57fa\u56e0\u6d3b\u5316\u5305\u62ec\u57fa\u56e0\u8fc7\u5ea6\u8868\u8fbe\u3001\u6269\u5f20\u3001\u91cd\u6392\u3001\u6613\u4f4d\u3001\u70b9\u7a81\u53d8\u7b49\uff0c\u6291\u764c\u57fa\u56e0\u53d8\u5316\u5305\u62ec\u7b49\u4f4d\u57fa\u56e0\u4e22\u5931\u3001\u7f3a\u5931\u3001\u91cd\u6392\u3001 \u7a81\u53d8\u3001\u8868\u8fbe\u4e0b\u8c03\u7b49\uff0cATRA \u5bf9\u57fa\u56e0\u8868\u8fbe\u6709\u76f4\u63a5\u8c03\u63a7\u4f5c\u7528\uff0c\u540c\u65f6\u5bf9\u7ec6\u80de\u5206\u5316\u53ca\u51cb\u4ea1\u5747\u6709\u8c03\u63a7\u4f5c\u7528\uff0c\u6545\u4e34\u5e8a\u7528\u4e8e\u6cbb\u7597MDS\u3002\u76ee\u524d\u7814\u7a76\u8ba4\u4e3a\uff0cATRA \u8054\u5408\u4e09\u6c27\u5316\u4e8c\u7837\u3001\u6c99\u5229\u5ea6\u80fa\u6216\u96f7\u90a3\u5ea6\u80fa\u53ca\u5c0f\u5242\u91cf\u963f\u7cd6\u80de\u82f7\u7b49\u6cbb\u7597 MDS\u6709\u4e00\u5b9a\u6548\u679c\uff0c\u60a3\u8005\u5373\u4f7f\u4e0d\u80fd\u83b7\u5f97\u5b8c\u5168\u7f13\u89e3\uff0c\u4e5f\u80fd\u6539\u5584\u8f93\u8840\u4f9d\u8d56\uff0c\u6539\u5584\u751f\u6d3b\u8d28\u91cf\uff0c\u5ef6\u957f\u751f\u5b58\u671f\uff0c\u4f46\u76ee\u524d\u4f5c\u7528\u673a\u5236\u5c1a\u4e0d\u5b8c\u5168\u660e\u786e\u3002<\/p>\n
\u2462\u3000\u96be\u6cbb\u6027\u514d\u75ab\u6027\u8840\u5c0f\u677f\u51cf\u5c11\u6027\u7d2b\u765c\uff1a\u5bf9\u4e8e\u96be\u6cbb\u6027\u514d\u75ab\u6027\u8840\u5c0f\u677f\u51cf\u5c11\u6027\u7d2b\u765c\uff0c\u7ecf\u7cd6\u76ae\u8d28\u6fc0\u7d20\u3001\u9759\u8109\u6ce8\u5c04\u514d\u75ab \u7403\u86cb\u767d\u3001\u514d\u75ab\u6291\u5236\u5242\u548c( \u6216) \u813e\u5207\u9664\u7b49\u6cbb\u7597\u65e0\u6548\u6216\u9700\u8f83\u9ad8\u5242\u91cf\u7cd6\u76ae\u8d28\u6fc0\u7d20\u624d\u80fd\u7ef4\u6301\u5b89\u5168\u7684\u8840\u5c0f\u677f\u6c34\u5e73\u3002\u8fd9\u90e8\u5206\u60a3\u8005\u4f53\u5185\u53ef\u68c0\u6d4b\u5230\u8840\u5c0f\u677f\u76f8\u5173\u6297\u4f53\u548c\u8840\u5c0f\u677f\u7279\u5f02\u6027\u6297\u4f53\uff0c\u8fd9\u4e9b\u6297\u4f53\u4e0e\u4e3b\u8981\u8840\u5c0f\u677f\u819c\u6297\u539f GP\u2161b \/\u2162a \u548c GPIb \/\u2168\u7ed3\u5408\uff0c\u4f7f\u8840\u5c0f\u677f\u5728\u7f51\u72b6\u5185\u76ae\u7cfb\u7edf\u4e2d\u88ab\u7834\u574f\u3002ATRA \u662f\u4e00\u79cd\u8bf1\u5bfc\u5206\u5316\u5242\uff0c\u540c\u65f6\u4e5f\u662f\u4e00 \u79cd\u514d\u75ab\u8c03\u8282\u5242\uff0c\u8c03\u8282\u4f53\u5185\u514d\u75ab\uff0c\u4e34\u5e8a\u7528\u4e8e\u6cbb\u7597\u96be\u6cbb\u6027\u514d\u75ab\u6027\u8840\u5c0f\u677f\u51cf\u5c11\u6027\u7d2b\u765c\u6709\u4e00\u5b9a\u6548\u679c\u3002<\/p>\n
\uff082\uff09\u7ef4A\u9178\u5728\u5b9e\u4f53\u7624\u4e2d\u5e94\u7528<\/p>\n
ATRA \u5728\u7ec6\u80de\u6709\u4e1d\u5206\u88c2\u8fc7\u7a0b\u4e2d\u8d77\u5230\u91cd\u8981\u7684\u8c03\u63a7\u4f5c\u7528\uff0c\u53ef\u5f71\u54cd\u591a\u79cd\u7ec6\u80de\u8f6c\u5316\u751f\u957f\u56e0\u5b50\u7684\u8868\u8fbe\uff0c\u6539\u53d8\u7ec6\u80de\u8d85\u5fae\u7ed3\u6784\uff0c\u6838\/\u6d46\u6bd4\u503c\u51cf\u5c11\uff0c\u8bf1\u5bfc\u80bf\u7624\u51cb\u4ea1\uff0c\u4fc3\u8fdb\u514d\u75ab\u7ec6\u80de\u7684\u589e\u6b96\u53ca\u589e\u5f3a\u514d\u75ab\u7ec6\u80de\u5bf9\u80bf\u7624\u7ec6\u80de\u6740\u706d\u4f5c\u7528\uff0cATRA \u8fd8\u5177\u6709\u8c03\u8282 Bcl-2 \u57fa\u56e0\u548c c-myc \u57fa\u56e0\u7b49\u764c\u57fa\u56e0\u8868\u8fbe\u7684\u4f5c\u7528\uff0c\u8bf1\u5bfc\u8868\u8fbe\u51cf\u5c11\uff0c\u4fc3\u8fdb\u7ec6\u80de\u51cb\u4ea1\u3002<\/p>\n
ATRA\u540c\u65f6\u80fd\u589e\u52a0\u764c\u7ec6\u80de\u5bf9\u5316\u7597\u836f\u7269\u654f\u611f\u6027\u7684\u4f5c\u7528\uff0c\u7528\u4e8e\u80c3\u764c\u3001\u809d\u764c\u3001\u80f0\u817a\u764c\u3001\u80ba\u764c\u3001 \u4e73\u817a\u764c\u3001\u8180\u80f1\u764c\u3001\u5987\u79d1\u80bf\u7624\u7b49\u6cbb\u7597\u6709\u4e00\u5b9a\u6548\u679c\u3002<\/p>\n
\uff083\uff09\u7ef4A\u9178\u5728\u76ae\u80a4\u75c5\u4e2d\u5e94\u7528<\/p>\n
ATRA \u662f\u4e00\u7ec4\u7ef4\u751f\u7d20A\u7684\u884d\u751f\u7269\uff0c\u5177\u6709\u4e0e\u7ef4\u751f\u7d20A\u7c7b\u4f3c\u7684\u7ed3\u6784\u548c\u4e0d\u540c\u7684\u836f\u7406\u4f5c\u7528\uff0c\u53e3\u670d\u6216\u5916\u7528\u7ef4\u7532\u9178( \u7ef4 A \u9178) \u80fd\u4fc3\u8fdb\u7ec6\u80de\u5206\u5316\u3001\u6291\u5236\u89d2\u5316\u8fc7\u7a0b\u3001\u51cf\u5c11\u76ae\u8102\u5206\u6ccc\u3001\u963b\u65ad\u5316\u5b66\u81f4\u764c\u8fc7\u7a0b\u3001\u589e\u5f3a\u7ec6\u80de\u75ab\u548c\u6e38\u79bb\u5de8\u566c\u7ec6\u80de\u7684\u529f\u80fd\uff0c\u4ee5\u53ca\u6297\u708e\u3001\u6291\u5236\u548c\u6740\u706d\u75e4\u75ae\u6746\u83cc\u7b49\u4f5c\u7528\uff0c\u5bf9\u7f13\u89e3\u96be\u6cbb\u7684\u89d2\u5316\u6027\u76ae\u80a4\u75c5\u3001\u76ae\u80a4\u80bf\u7624\u53ca\u6539\u5584\u6162\u6027\u5149\u635f\u5bb3\u65b9\u9762\u63d0\u4f9b\u4e86\u65b0\u7684\u9014\u5f84\u3002<\/p>\n
\u76ee\u524d\u7ef4A\u9178\u7c7b\u836f\u7269\u662f\u4e34\u5e8a\u6cbb\u7597\u76ae\u80a4\u89d2\u5316\u5f02\u5e38\u6027\u75be\u75c5\u7684\u4e3b\u8981\u836f\u7269\uff0c\u5c24\u5176\u662f\u5728\u6cbb\u7597\u725b\u76ae\u7663\u7684\u836f\u7269\u4e2d\u6709\u7740\u4e0d\u53ef\u66ff\u4ee3\u7684\u5730\u4f4d\uff0c\u540c\u65f6\u4e34\u5e8a\u663e\u793a\u7528\u4e8e\u6cbb\u7597\u75e4\u75ae\u3001\u6241\u5e73\u82d4\u85d3\u3001\u591a\u53d1\u6027\u5bfb\u5e38\u75a3\u7b49\u4e5f\u6709\u663e\u8457\u7597\u6548\u3002<\/p>\n
ATRA\u7684\u7528\u6cd5\u7528\u91cf<\/p>\n
(1) APL\uff1a20-45mg\/m2.d\uff0c\u52062-4\u6b21\u670d\u7528\uff0c\u6700\u5927\u65e5\u5242\u91cf\u4e3a120mg\u3002<\/p>\n
(2) \u9aa8\u9ad3\u589e\u751f\u5f02\u5e38\u7efc\u5408\u5f81\uff1a\u6210\u4eba30 mg\/d, \u52063\u6b21\u53e3\u670d\uff0c\u513f\u7ae5\u5c1a\u65e0\u76f8\u5173\u62a5\u9053\u3002<\/p>\n
(3) \u96be\u6cbb\u6027\u514d\u75ab\u6027\u8840\u5c0f\u677f\u51cf\u5c11\u6027\u7d2b\u765c\uff1a\u6210\u4eba\u5728\u539f\u7cd6\u76ae\u8d28\u6fc0\u7d20\u6cbb\u7597\u57fa\u7840\u4e0a\u52a0\u7528ATRA (10mg, \u6bcf\u65e53\u6b21)\uff0c\u513f\u7ae5\u5c1a\u65e0\u76f8\u5173\u62a5\u9053 \u3002<\/p>\n
(4) \u5b9e\u4f53\u7624\uff1a\u8054\u5408\u591a\u79cd\u5316\u7597\u836f\u7269\uff0c\u5242\u91cf\u901a\u5e38\u4e3a1-1.5mg\/kg\/d\u3002<\/p>\n
(5) \u76ae\u80a4\u75c5\uff1a<\/p>\n
\u2460 \u5916\u7528\u5236\u5242\uff1a<\/p>\n
1) \u5bfb\u5e38\u75e4\u75ae\uff1a\u4e00\u65e51\u6b21\uff0c\u4e8e\u7761\u524d\u5c06\u836f\u7269\u8f7b\u6d82\u4e8e\u60a3\u5904\u3002<\/p>\n
2) \u9c7c\u9cde\u75c5\u3001\u94f6\u5c51\u75c5\u7b49\uff1a\u4f4d\u4e8e\u906e\u76d6\u90e8\u4f4d\u7684\u60a3\u5904\uff0c\u4e00\u65e51-3\u6b21\u3002<\/p>\n
3) \u9762\u90e8\u5355\u7eaf\u7ce0\u75b9\uff1a\u4f7f\u7528\u672c\u836f0.025%\u4e73\u818f\u6216\u8f6f\u818f\uff0c\u4e00\u65e52\u6b21\u3002<\/p>\n
4) \u6241\u5e73\u82d4\u7663\u3001\u6bdb\u53d1\u7ea2\u7ce0\u75b9\u3001\u767d\u6591\u7b49\uff1a0.1%\u4e73\u818f\u6216\u8f6f\u818f\uff0c\u4e00\u65e52\u6b21\u3002<\/p>\n
\u2461 \u53e3\u670d\u7ed9\u836f \u53e3\u670d\u5236\u5242\uff1a\u4e00\u6b2110mg\uff0c\u4e00\u65e52-3\u6b21\u3002<\/p>\n
ATRA\u7684\u5e38\u89c1\u4e0d\u826f\u53cd\u5e94\u53ca\u5904\u7406<\/p>\n
(1) \u8bf1\u5bfc\u5206\u5316\u7efc\u5408\u5f81 <\/p>\n
\u2460 \u8868\u73b0\uff1a\u5e38\u89c1\u4e8e ATRA \u548c\/\u6216\u7837\u5242\u8bf1\u5bfc\u6cbb\u7597\u7684\u65e9\u671f\uff0c\u8868\u73b0\u4e3a\u767d\u7ec6\u80de\u589e\u9ad8\u3001\u53d1\u70ed\u3001\u4f53\u91cd\u589e\u52a0\u3001\u808c\u8089\u9aa8\u9abc\u75bc\u75db\u3001\u547c\u5438\u7a98\u8feb\u3001\u80ba\u95f4\u8d28\u6d78\u6da6\u3001\u80f8\u8154\u79ef\u6db2\u3001\u5fc3\u5305\u79ef\u6db2\u3001\u76ae\u80a4\u6c34\u80bf\u3001\u4f4e\u8840\u538b\u3001\u6025\u6027\u80be\u8870\u7aed\u751a\u81f3\u6b7b\u4ea1\uff1b\u4e25\u91cd\u7684\u9ad8\u767d\u7ec6\u80de\u8840\u75c7\u8fd8\u53ef\u5bfc\u81f4\u80ba\u3001\u8111\u53ca\u5176\u4ed6\u810f\u5668\u6897\u585e\u3002<\/p>\n
\u2461 \u8bf1\u5bfc\u65e9\u671f\u5bc6\u5207\u76d1\u6d4b\u8840\u5e38\u89c4 qd-bid\u3002<\/p>\n
\u2462 \u65e0\u8bba\u5728\u8bf1\u5bfc\u5f00\u59cb\u65f6\u6216\u5728\u8bf1\u5bfc\u671f\u95f4\uff0cWBC>10\u00d7109 \/L \u7528\u7f9f\u57fa\u8132(HU)100mg\/kg.d\uff0c\u5206 2-3 \u6b21\uff0c\u76f4\u81f3 WBC<10\u00d7109 \/L\u3002\u51fa\u73b0\u75c7\u72b6\u7528\u6c1f\u7f8e\u677e(DXM)0.3-0.5mg\/Kg.d\uff0c\u76f4\u81f3\u75c7\u72b6\u6d88\u5931\u3002<\/p>\n
\u2463 \u75c7\u72b6\u4e25\u91cd\u8005\u5e94\u6682\u505c ATRA\uff0c\u597d\u8f6c\u540e\u53ef\u518d\u7528\uff0c\u5e76\u914c\u60c5\u7528 DXM \u9884\u9632\u518d\u53d1\u3002<\/p>\n
\u2464 \u9884\u9632\uff1aWBC>30\u00d7109 \/L \u8005\uff0c\u9664\u7528 HU \u5916\uff0c\u5efa\u8bae\u540c\u65f6\u7528 DXM \u9884\u9632\u8bf1\u5bfc\u5206\u5316\u7efc\u5408\u5f81\u3002<\/p>\n
(2) ATRA \u7684\u5176\u4ed6\u4e0d\u826f\u53cd\u5e94<\/p>\n
\u2460 \u9ad8\u9885\u538b\u7efc\u5408\u5f81\uff1a\u8868\u73b0\u4e3a\u5934\u75db\u3001\u5455\u5410\u3001\u89c6\u4e73\u5934\u6c34\u80bf\u3001CSF \u538b\u529b\u9ad8\uff0c\u6392\u9664 CNSL \u548c\u9885 \u5185\u51fa\u8840\u53ef\u8bca\u65ad\uff0c\u53ef\u7528\u8131\u6c34\u5242\u548c DXM \u81f3\u75c7\u72b6\u6d88\u5931\uff0c\u96be\u63a7\u5236\u8005\u53ef\u5c06 ATRA \u51cf\u91cf\u6216\u6682\u505c\uff1b<\/p>\n
\u2461 \u9ad8\u7ec4\u80fa\u8840\u75c7\uff1a\u53d1\u70ed\u3001\u5168\u8eab\u6f6e\u7ea2\u3001\u5fc3\u7387\u5feb\u3001\u4f11\u514b\uff0c\u53ef\u7528\u6297\u7ec4\u80fa\u836f\u548c DXM\u3002\u4e0a\u8ff0\u4e0d\u826f\u53cd\u5e94\u4e25\u91cd\u6216\u96be\u5904\u7406\u65f6\u53ef\u6682\u505c ATRA\uff0c\u5f85\u597d\u8f6c\u540e\u7ee7\u7eed\u7528\u3002<\/p>\n
\u6ce8\u610f\u4e8b\u9879<\/p>\n
(1) \u672c\u54c1\u5e94\u8fdc\u79bb\u773c\u90e8\u3002\u3000<\/p>\n
(2) \u4e0d\u5b9c\u4f7f\u7528\u4e8e\u76ae\u80a4\u76b1\u6298\u90e8\u4f4d\u3002\u3000<\/p>\n
(3) \u7528\u836f\u671f\u95f4\u52ff\u7528\u5176\u5b83\u53ef\u5bfc\u81f4\u76ae\u80a4\u523a\u6fc0\u53ca\u7834\u635f\u7684\u836f\u7269\u3001\u5316\u5986\u54c1\u6216\u6e05\u6d01\u5242\uff0c\u4ee5\u514d\u52a0\u91cd\u76ae\u80a4\u53cd\u5e94\u3001\u5bfc\u81f4\u836f\u7269\u5438\u6536\u589e\u52a0\u53ca\u5f15\u8d77\u7cfb\u7edf\u4e0d\u826f\u53cd\u5e94\u3002<\/p>\n
(4) \u65e5\u5149\u53ef\u52a0\u91cd\u7ef4A\u9178\u5bf9\u76ae\u80a4\u7684\u523a\u6fc0\u5bfc\u81f4\u7ef4A\u9178\u5206\u89e3\uff0c\u52a8\u7269\u5b9e\u9a8c\u63d0\u793a\u7ef4A\u9178\u53ef\u589e\u5f3a\u7d2b\u5916\u7ebf\u81f4\u764c\u80fd\u529b\uff0c\u56e0\u6b64\u672c\u54c1\u6700\u5b9c\u5728\u665a\u95f4\u53ca\u7761\u524d\u5e94\u7528\uff0c\u6cbb\u7597\u8fc7\u7a0b\u5e94\u907f\u514d\u65e5\u6652\uff0c\u6216\u91c7\u7528\u906e\u5149\u63aa\u65bd\u3002\u3000<\/p>\n
(5) \u672c\u54c1\u4e0d\u5b9c\u5927\u9762\u79ef\u5e94\u7528\uff0c\u65e5\u7528\u91cf\u4e0d\u5e94\u8d85\u8fc720g\u3002<\/p>\n
(6) \u7981\u5fcc\u75c7\uff1a\u598a\u5a20\u8d77\u521d3\u4e2a\u6708\u5185\u5987\u5973\u7981\u7528\u3002\u6025\u6027\u6216\u4e9a\u6025\u6027\u76ae\u708e\uff0c\u6e7f\u75b9\u7c7b\u76ae\u80a4\u75c5\u60a3\u8005\u7981\u7528\u3002<\/p>\n<\/p>\n
\u5434\u8389\uff0c\u5357\u65b9\u533b\u79d1\u5927\u5b66\u73e0\u6c5f\u533b\u9662\u5c0f\u513f\u8840\u6db2\u79d1\u533b\u5e08\uff0c\u533b\u5b66\u7855\u58eb\uff0c\u4e3b\u8981\u4ece\u4e8b\u5c0f\u513f\u8840\u6db2\u80bf\u7624\u75be\u75c5\u7684\u7814\u7a76\u548c\u4e34\u5e8a\u5de5\u4f5c\u3002<\/p>\n<\/p>\n
\u7f16\u5199\uff1a\u5434\u8389<\/p>\n
\u5ba1\u9605\uff1a\u6768\u4e3d\u534e<\/p>\n","protected":false},"excerpt":{"rendered":"
01 ATRA\u4ecb\u7ecd \u7ef4\u7532\u9178\uff08RA\uff09\u5177\u6709\u5f88\u5f3a\u7684\u8bf1\u5bfc\u7ec6\u80de\u5206\u5316\u53ca\u514d\u75ab\u8c03\u8282\u4f5c\u7528\uff0c\u662f\u76ee\u524d\u56fd … \u7ee7\u7eed\u9605\u8bfb