{"id":47950,"date":"2025-02-20T05:10:34","date_gmt":"2025-02-20T05:10:34","guid":{"rendered":"https:\/\/zydq.1006ss.com\/?p=47950"},"modified":"2025-02-20T05:10:34","modified_gmt":"2025-02-20T05:10:34","slug":"%e6%8c%87%e5%8d%97%e5%85%b1%e8%af%86-%e4%b8%ad%e5%9b%bd%e5%85%8b%e7%bd%97%e6%81%a9%e7%97%85%e8%af%8a%e6%b2%bb%e6%8c%87%e5%8d%972023-%e5%b9%b4%e5%b9%bf%e5%b7%9e","status":"publish","type":"post","link":"http:\/\/zydq.1006ss.com\/?p=47950","title":{"rendered":"\u6307\u5357\u5171\u8bc6 | \u4e2d\u56fd\u514b\u7f57\u6069\u75c5\u8bca\u6cbb\u6307\u5357(2023 \u5e74·\u5e7f\u5dde)"},"content":{"rendered":"

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4.\u63a8\u8350\u610f\u89c1\u7684\u786e\u5b9a\uff1a\u672c\u6307\u5357\u63a8\u8350\u610f\u89c1\u7531\u4e34\u5e8a\u4e13\u5bb6\u7ec4\u7ed3\u5408CD \u8bca\u6cbb\u7684\u4e34\u5e8a\u9700\u6c42\uff0c\u901a\u8fc7\u5171\u8bc6\u4f1a\u8bae\u6cd5\u7b5b\u9009\u548c\u786e\u5b9a\u3002<\/p>\n

5.\u8bc1\u636e\u8d28\u91cf\u8bc4\u4ef7\uff1a\u6307\u5357\u5de5\u4f5c\u7ec4\u5728 PubMed\u3001Embase\u3001 Cochrane Library\u3001\u4e2d\u56fd\u77e5\u7f51\u6570\u636e\u5e93\u5b9e\u65bd\u4e86\u8bc1\u636e\u68c0\u7d22\u3002\u91c7\u7528\u300a\u725b\u6d25\u5faa\u8bc1\u533b\u5b66\u4e2d\u5fc3\u8bc1\u636e\u5206\u7ea7 2011 \u7248\u300b\uff3bOxford Center for Evidence\u2043 Based Medicine\uff08OCEBM\uff092011 Levels of Evidence\uff3d\u5bf9\u7eb3\u5165\u7684\u7814\u7a76\u8fdb\u884c\u8bc1\u636e\u8d28\u91cf\u8bc4\u4ef7\u548c\u5206\u7ea7\uff08\u88681\uff09\uff3b9\uff3d\u3002\u9488\u5bf9\u6bcf\u4e00\u6761\u63a8\u8350\u610f\u89c1\uff0c\u9009\u62e9\u5173\u952e\u8bc1\u636e\u8fdb\u884c\u8bc1\u636e\u8bc4\u7ea7\uff0c\u5e76\u5c06\u5173\u952e\u8bc1\u636e\u7684\u53c2\u8003\u6587\u732e\u7528\u201c*\u201d\u5728\u6587\u4e2d\u8fdb\u884c\u6807\u6ce8\u3002\u672c\u6307\u5357\u9ed8\u8ba41 \u7ea7\u8bc1\u636e\u4e3a\u9ad8\u8d28\u91cf\u8bc1\u636e\uff0c2 \u7ea7\u548c3 \u7ea7\u8bc1\u636e\u4e3a\u4e2d\u7b49\u8d28\u91cf\u8bc1\u636e\uff0c4 \u7ea7\u548c5 \u7ea7\u8bc1\u636e\u4e3a\u4f4e\u8d28\u91cf\u8bc1\u636e\u3002<\/p>\n<\/p>\n

6.\u5f62\u6210\u63a8\u8350\u610f\u89c1\uff1a\u63a8\u8350\u610f\u89c1\u5f62\u6210\u65f6\u53c2\u8003\u63a8\u8350\u5206\u7ea7\u7684\u8bc4\u4f30 \u3001\u5236 \u5b9a \u4e0e \u8bc4 \u4ef7\uff08grading  of  recommendations  assessment\uff0c development and evaluation\uff0cGRADE\uff09\u5206\u7ea7\u7cfb\u7edf\u5bf9\u63a8\u8350\u610f\u89c1\u8fdb\u884c\u5206\u7ea7\u3002GRADE \u63d0\u5021\u8003\u8651\u533b\u5b66\u5e72\u9884\u7684\u5229\u5f0a\u5e73\u8861\u3001\u8bc1\u636e\u8d28\u91cf\u3001\u4ef7\u503c\u89c2\u5ff5\u4e0e\u504f\u597d\u3001\u6210\u672c\u4e0e\u8d44\u6e90\u8017\u8d39\u7b49\u56e0\u7d20\u7684\u540c\u65f6\u5c06\u63a8\u8350\u610f\u89c1\u4e0e\u8bc1\u636e\u8d28\u91cf\u76f8\u5173\u8054\uff0c\u5bf9\u63a8\u8350\u5f3a\u5ea6\u8fdb\u884c\u5206\u7ea7\uff3b10\u204311\uff3d\u3002\u533b\u5b66\u5e72\u9884\u7684\u5229\u5f0a\u5dee\u522b\u8d8a\u5927\u3001\u8bc1\u636e\u8d28\u91cf\u8d8a\u9ad8\u3001\u4ef7\u503c\u89c2\u5ff5\u4e0e\u504f\u597d\u8d8a\u6e05\u6670\u8d8a\u8d8b\u540c\u3001\u6210\u672c\u4e0e\u8d44\u6e90\u8017\u8d39\u8d8a\u5c0f\uff0c\u5219\u8003\u8651\u5f3a\u63a8\u8350\uff1b\u53cd\u4e4b\uff0c\u5219\u8003\u8651\u5f31\u63a8\u8350\u3002\u7279\u6b8a\u60c5\u51b5\u4e0b\u4f4e\u8d28\u91cf\u8bc1\u636e\u4e5f\u53ef\u80fd\u5f62\u6210\u5f3a\u63a8\u8350\uff08\u88682\uff09\uff0c\u672c\u6307\u5357\u5728\u5236\u4f5c\u548c\u62a5\u9053\u8fc7\u7a0b\u4e2d\u53c2\u8003\u8be5\u539f\u5219\u6765\u5904\u7406\u4f4e\u8d28\u91cf\u8bc1\u636e\u548c\u5f3a\u63a8\u8350\u7684\u5173\u7cfb\u3002\u672c\u6307\u5357\u53c2\u8003\u4e86\u4e0a\u8ff0GRADE \u5bf9\u63a8\u8350\u610f\u89c1\u5206\u7ea7\u7684\u6307\u5bfc\u539f\u5219\uff0c\u7ed3\u5408\u8bc1\u636e\u8d28\u91cf\u5c06\u63a8\u8350\u5f3a\u5ea6\u5f52\u4e3a\u5f3a\uff08A \u7ea7\u63a8\u8350\uff09\u548c\u5f31\uff08B \u7ea7\u63a8\u8350\uff09\u4e24\u4e2a\u7b49\u7ea7\uff08\u88682\uff09\u3002\u6b64\u5916\uff0c\u9488\u5bf9\u4e13\u5bb6\u7ec4\u8ba4\u4e3a\u91cd\u8981\u4f46\u4e0d\u5b9c\u7528\u8bc1\u636e\u7ea7\u522b\u548c\u63a8\u8350\u5f3a\u5ea6\u8868\u8fbe\u7684\u5185\u5bb9\uff0c\u5219\u91c7\u7528\u6700\u4f73\u4e34\u5e8a\u5b9e\u8df5\uff08best practice statement\uff0cBPS\uff09\u6765\u8868\u8fbe\uff0c\u4e0d\u53e6\u4e88\u5206\u7ea7\u3002\u4e13\u5bb6\u7ec4\u901a\u8fc7\u5bf9\u7814\u7a76\u8bc1\u636e\u516c\u5f00\u8ba8\u8bba\u540e\uff0c\u6309\u7167\u4ee5\u4e0a\u63a8\u8350\u610f\u89c1\u5f62\u6210\u539f\u5219\uff0c\u4ee5\u6295\u7968\u5f62\u5f0f\u8fbe\u6210\u5bf9\u63a8\u8350\u610f\u89c1\u7684\u5171\u8bc6\u3002\u672c\u6307\u5357\u4e2d\u7684\u63a8\u8350\u610f\u89c1\u6216BPS \u987b\u5728\u4e13\u5bb6\u7ec4\u6295\u7968\u4e2d\u8fbe\u523075% \u53ca\u4ee5\u4e0a\u7684\u5171\u8bc6\u7387\u624d\u53ef\u901a\u8fc7\u3002\u5f53\u4e13\u5bb6\u7ec4\u610f\u89c1\u4e0d\u4e00\u81f4\u65f6\uff0c\u91c7\u7528\u5fb7\u5c14\u83f2\u65b9\u6cd5\u5bf9\u63a8\u8350\u610f\u89c1\u8fdb\u884c\u76f8\u5e94\u7684\u4fee\u6539\u548c\u7b2c\u4e8c\u8f6e\u6295\u7968\uff0c\u76f4\u81f3\u8fbe\u6210\u5171\u8bc6\u3002<\/p>\n<\/p>\n

7.\u6307\u5357\u4f20\u64ad\u3001\u5b9e\u65bd\u4e0e\u66f4\u65b0\uff1a\u6307\u5357\u5c06\u901a\u8fc7\u5b66\u672f\u671f\u520a\u3001\u7ebf\u4e0a\u6216\u7ebf\u4e0b\u5b66\u672f\u4f1a\u8bae\u5ba3\u8bb2\u548c\u89e3\u8bfb\u3001\u65b0\u5a92\u4f53\u63a8\u6587\u7b49\u591a\u79cd\u9014\u5f84\u4f20\u64ad\uff0c\u4fc3\u8fdb\u6307\u5357\u63a8\u8350\u610f\u89c1\u5728\u4e34\u5e8a\u5b9e\u65bd\u3002\u8ba1\u5212\u57282 \u5e74\u5185\uff0c\u8bc4\u4f30\u6700\u65b0\u7814\u7a76\u8bc1\u636e\u60c5\u51b5\u548c\u4e34\u5e8a\u9700\u6c42\uff0c\u5fc5\u8981\u65f6\u8fdb\u884c\u66f4\u65b0\u3002<\/p>\n

\u4e8c\u3001\u8bca\u65ad\u53ca\u8bc4\u4f30<\/p>\n

\u63a8\u8350\u610f\u89c1 1\uff1aCD \u7684\u8bca\u65ad\u7f3a\u4e4f\u91d1\u6807\u51c6\uff0c\u9700\u8981\u7ed3\u5408\u4e34\u5e8a\u8868\u73b0\u3001\u5b9e\u9a8c\u5ba4\u68c0\u67e5\u3001\u5f71\u50cf\u5b66\u68c0\u67e5\u3001\u5185\u955c\u53ca\u75c5\u7406\u7ec4\u7ec7\u5b66\u68c0\u67e5\u8fdb\u884c\u7efc\u5408\u5224\u65ad\u3002\uff08BPS\uff09<\/p>\n

\u5b9e\u65bd\u5efa\u8bae\uff1aCD \u6ca1\u6709\u5355\u4e00\u6216\u4e25\u683c\u5b9a\u4e49\u7684\u8bca\u65ad\u6807\u51c6\uff0c\u4e34\u5e8a\u8868\u73b0\u591a\u6837\uff0c\u8179\u75db\u3001\u8179\u6cfb\u3001\u4f53\u8d28\u91cf\u4e0b\u964d\u662f\u6700\u5e38\u89c1\u7684\u75c7\u72b6\uff0c\u5176\u4ed6\u91cd\u8981\u7684\u4e34\u5e8a\u8868\u73b0\u5305\u62ec\u4e4f\u529b\u3001\u53d1\u70ed\u3001\u751f\u957f\u53d1\u80b2\u8fdf\u7f13\u3001\u8d2b\u8840\u3001\u53cd\u590d\u7618\u7ba1\u5f62\u6210\u3001\u809b\u5468\u8113\u80bf\u6216\u809b\u7618\u53ca\u80a0\u5916\u8868\u73b0\u3002\u5e38\u89c1\u7684\u80a0\u5916\u8868\u73b0\u5305\u62ec IBD \u76f8\u5173\u5173\u8282\u708e\u3001\u5916\u5468\u6216\u4e2d\u8f74\u5173\u8282\u708e\u3001\u9644\u7740\u70b9\u708e\u3001\u7ed3\u8282\u6027\u7ea2\u6591\u3001\u53e3\u8154\u963f\u5f17\u4ed6\u6837\u6e83\u75a1\u3001\u524d\u8461\u8404\u819c\u708e\u3001\u8840\u6813\u6813\u585e\u75c7\uff1b\u53d1\u751f\u7387\u76f8\u5bf9\u8f83\u4f4e\u7684\u80a0\u5916\u8868\u73b0\u5305\u62ec\u539f\u53d1\u6027\u786c\u5316\u6027\u80c6\u7ba1\u708e\u3001\u81ea\u8eab\u514d\u75ab\u6027\u809d\u708e\u3001\u81ea\u8eab\u514d\u75ab\u6027\u80f0\u817a\u708e\u3001\u574f\u75bd\u6027\u8113\u76ae\u75c5\u3001Sweet \u7efc\u5408\u5f81\u3001\u53e3\u8154\u988c\u9762\u90e8\u8089\u82bd\u80bf\u75c5\u3001\u5de9\u819c\u708e\u3001\u975e\u611f\u67d3\u6027\u80ba\u708e\u7b49\uff3b12\uff3d*\u3002<\/p>\n

\u5b9e\u9a8c\u5ba4\u68c0\u67e5\u4e3b\u8981\u5305\u62ec\u708e\u6027\u6307\u6807\u53ca\u8425\u517b\u72b6\u6001\u8bc4\u4f30\uff0c\u5982\u8840\u5e38\u89c4\u3001C \u53cd\u5e94\u86cb\u767d\uff08C\u2043reactive protein\uff0cCRP\uff09\u3001\u7ea2\u7ec6\u80de\u6c89\u964d\u7387\u3001\u767d\u86cb\u767d\u7b49\u3002\u82e5\u68c0\u6d4b\u6761\u4ef6\u5141\u8bb8\uff0c\u5efa\u8bae\u884c\u7caa\u4fbf\u9499\u536b\u86cb\u767d\uff08fecal calprotectin\uff0cFC\uff09\u68c0\u67e5\u3002\u76ee\u524d\u4e0d\u63a8\u8350\u8840\u6e05\u5b66\u7b5b\u67e5\u7528\u4e8e CD \u7684\u75be\u75c5\u8bca\u65ad\uff3b6\uff3d\u3002<\/p>\n

CD \u80a0\u9053\u708e\u75c7\u7684\u5f71\u50cf\u5b66\u68c0\u67e5\u5305\u62ec\u5c0f\u80a0 CT \u6210\u50cf\uff08CT enterography\uff0cCTE\uff09\u3001\u5c0f\u80a0 MR \u6210\u50cf\uff08MR enterography\uff0cMRE\uff09\u3001\u80a0\u9053\u8d85\u58f0\u7b49\u3002\u5178\u578b\u7684CD \u80a0\u9053\u75c5\u53d8\u7684\u5f71\u50cf\u5b66\u7279\u70b9\u4e3b\u8981\u5305\u62ec\u80a0\u58c1\u589e\u539a\u3001\u80a0\u9ecf\u819c\u5f3a\u5316\u4f34\u80a0\u58c1\u5206\u5c42\u6539\u53d8\u3001\u80a0\u7cfb\u819c\u8840\u7ba1\u589e\u591a\u4f34\u6269\u5f20\u626d\u66f2\u5448\u201c\u68b3\u6837\u5f81\u201d\u3001\u80a0\u7cfb\u819c\u8102\u80aa\u722c\u884c\u7b49\u3002<\/p>\n

CD \u7684\u5185\u955c\u68c0\u67e5\u4e3b\u8981\u5305\u62ec\u56de\u7ed3\u80a0\u955c\u3001\u80c3\u5341\u4e8c\u6307\u80a0\u955c\u3001\u5c0f\u80a0\u80f6\u56ca\u5185\u955c\u53ca\u6c14\u56ca\u8f85\u52a9\u5c0f\u80a0\u955c\u3002CD \u5e76\u4e0d\u5b58\u5728\u5b8c\u5168\u7279\u5f02\u7684\u5185\u955c\u4e0b\u8868\u73b0\uff0c\u4f46\u6709\u5229\u4e8e\u8bca\u65ad\u7684\u5185\u955c\u4e0b\u8868\u73b0\u5305\u62ec\u975e\u8fde\u7eed\u6027\u75c5\u53d8\u3001\u7eb5\u884c\u6e83\u75a1\u3001\u94fa\u8def\u77f3\u6837\u6539\u53d8\u3001\u72ed\u7a84\u6216\u7618\u7ba1\u3001\u809b\u5468\u75c5\u53d8\u3002<\/p>\n

\u5bf9\u4e8eCD \u8bca\u65ad\u6700\u91cd\u8981\u7684\u75c5\u7406\u7279\u70b9\u5305\u62ec\u900f\u58c1\u6027\u3001\u8282\u6bb5\u6027\u5206\u5e03\u7684\u6162\u6027\u708e\u75c7\uff0c\u5e76\u5f15\u8d77\u76f8\u5e94\u80a0\u58c1\u7684\u4e0a\u76ae\u53ca\u95f4\u8d28\u7ed3\u6784\u6539\u53d8\u3001\u5c0f\u8089\u82bd\u80bf\u5f62\u6210\u7b49\u3002\u5e38\u89c1\u9ecf\u819c\u7ed3\u6784\u6539\u53d8\u5305\u62ec\u5c0f\u80a0\u7ed2\u6bdb\u589e\u7c97\u3001\u53d8\u77ed\uff0c\u9690\u7a9d\u7ed3\u6784\u6539\u53d8\uff0c\u5c0f\u80a0\u5e7d\u95e8\u817a\u5316\u751f\u7b49\uff1b\u5e38\u89c1\u95f4\u8d28\u7ed3\u6784\u6539\u53d8\u5305\u62ec\u56fa\u6709\u808c\u5c42\u589e\u539a\uff0c\u56fa\u6709\u808c\u5c42\u4e0e\u9ecf\u819c\u808c\u5c42\u878d\u5408\uff0c\u5e7f\u6cdb\u7ea4\u7ef4\u7ec4\u7ec7\u589e\u751f\uff0c\u795e\u7ecf\u7ec4\u7ec7\u589e\u751f\u7b49\u3002<\/p>\n

\u5f53\u5b58\u5728\u5178\u578b\u7684CD \u4e34\u5e8a\u8868\u73b0\u65f6\uff0c\u53ef\u7591\u8bca\u4e3aCD\uff0c\u6b64\u65f6\u9700\u8fdb\u4e00\u6b65\u68c0\u67e5\u8bc4\u4f30\uff1b\u5728\u53d6\u5f97\u652f\u6301CD \u7684\u5f71\u50cf\u5b66\u6216\u5185\u955c\u7684\u68c0\u67e5\u7ed3\u679c\u540e\uff0c\u5219\u53ef\u62df\u8bcaCD\uff1b\u5982\u53d6\u5f97\u4e86\u652f\u6301CD \u7684\u75c5\u7406\u4f9d\u636e\uff0c\u540c\u65f6\u9664\u5916\u5176\u4ed6\u75c5\u56e0\u540e\uff0c\u5373\u53ef\u8003\u8651\u786e\u8bca\u4e3aCD\u3002\u4e34\u5e8a\u5b9e\u8df5\u4e2d\u53ef\u53c2\u8003\u4e16\u754c\u80c3\u80a0\u7ec4\u7ec7\uff08World Gastroenterology Organization\uff0cWGO\uff09\u5efa\u8bae\u7684 CD \u8bca\u65ad\u6807\u51c6\uff3b13\uff3d\u3002\u9700\u6ce8\u610f\u8fd1\u5e74\u6765\u809b\u5468\u75c5\u53d8\u7684\u653e\u5c04\u5f71\u50cf\u5b66\u68c0\u67e5\u5df2\u5e94\u7528\u4e8e\u4e34\u5e8a\uff0c\u6545\u809b\u5468\u75c5\u53d8\u7684\u8bc4\u4f30\u5e94\u4e0d\u518d\u5c40\u9650\u4e8e\u4e34\u5e8a\u8868\u73b0\uff0c\u800c\u53ef\u5c06\u653e\u5c04\u5f71\u50cf\u5b66\u68c0\u67e5\u7eb3\u5165\u3002<\/p>\n

\u63a8\u8350\u610f\u89c1 2\uff1aFC \u6d53\u5ea6\u53ef\u7528\u4e8e\u8bc4\u4f30 CD \u60a3\u8005\u80a0\u9053\u708e\u75c7\u6c34\u5e73\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a1\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f31\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1aFC \u662f\u7531\u4e2d\u6027\u7c92\u7ec6\u80de\u4ea7\u751f\u7684\u4e00\u7c7b\u9499\u7ed3\u5408\u86cb\u767d\uff0c\u5176\u6c34\u5e73\u53cd\u6620\u4e86\u4e2d\u6027\u7c92\u7ec6\u80de\u5411\u80a0\u9ecf\u819c\u7684\u8fc1\u79fb\u60c5\u51b5\uff0c\u662f\u80a0\u9053\u5c24\u5176\u662f\u7ed3\u80a0\u708e\u75c7\u53cd\u5e94\u7684\u975e\u7279\u5f02\u6027\u6307\u6807\u3002FC \u6d53\u5ea6\u53ef\u7528\u4e8eCD \u4e0e\u80a0\u6613\u6fc0\u7efc\u5408\u5f81\u7684\u9274\u522b\u8bca\u65ad\uff0c\u5c24\u5176\u662f\u513f\u7ae5\u60a3\u8005\uff3b14\u204315\uff3d\uff1b\u9634\u6027\u7684FC \u7ed3\u679c\u5bf9\u6392\u9664\u6210\u4ebaCD \u6709\u8f83\u9ad8\u7684\u51c6\u786e\u6027\u3002\u987b\u6ce8\u610f\u7684\u662f\uff0c\u6b64\u5904\u7684CD\u60a3\u8005\u4e3b\u8981\u6307\u901a\u8fc7\u56de\u7ed3\u80a0\u955c\u53ca\u4e0a\u6d88\u5316\u9053\u68c0\u67e5\u786e\u8bca\u8005\uff3b16\uff3d*\u3002<\/p>\n

\u4f5c\u4e3a\u75be\u75c5\u6d3b\u52a8\u5ea6\u7684\u53c2\u8003\u6307\u6807\uff0cFC \u6d53\u5ea6\u4e0e\u7b80\u5316\u514b\u7f57\u6069\u75c5\u5185\u955c\u4e0b\u8bc4\u5206\uff08simple endoscopic score for Crohn\u2032s disease\uff0cSES\u2043 CD\uff09\u3001\u514b\u7f57\u6069\u75c5\u75be\u75c5\u6d3b\u52a8\u6307\u6570\uff08Crohn\u2032 s disease activity index\uff0c CDAI\uff09\u7b49\u6307\u6807\u5b58\u5728\u76f8\u5173\uff3b17\uff3d\uff0c\u53ef\u4f5c\u4e3a\u75be\u75c5\u6d3b\u52a8\u76d1\u6d4b\u7684\u65e0\u521b\u6307\u6807\u4e4b\u4e00\u3002\u5728\u56de\u7ed3\u80a0\u5207\u9664\u672f\u540e\u60a3\u8005\u4e2d\uff0cFC \u6d53\u5ea6\u5347\u9ad8\uff08\uff1e100 \u03bcg\/g\uff09\u5bf9\u75be\u75c5\u590d\u53d1\u7684\u9884\u6d4b\u654f\u611f\u6027\u7ea689%\uff3b18\uff3d\uff1b\u5728\u901a\u8fc7\u6297\u80bf\u7624\u574f\u6b7b\u56e0\u5b50\uff08tumor necrosis factor\uff0cTNF\uff09\u7c7b\u836f\u7269\u8bf1\u5bfc\u7f13\u89e3\u6210\u529f\u7684\u60a3\u8005\u4e2d\uff0cFC \u6d53\u5ea6\u5347\u9ad8\uff08\uff1e160 \u03bcg\/g\uff09\u5bf9\u75be\u75c5\u590d\u53d1\u7684\u9884\u6d4b\u654f\u611f\u6027\u7ea6 91.7%\uff3b19\u204320\uff3d\uff0c\u4f46\u76ee\u524d\u5bf9\u4e8eFC \u68c0\u6d4b\u5e94\u7528\u4e8e\u80a0\u9053\u708e\u75c7\u76d1\u6d4b\u7684\u53c2\u8003\u9608\u503c\u7f3a\u4e4f\u9ad8\u8d28\u91cf\u7814\u7a76\u3002<\/p>\n

\u9488\u5bf9\u5c0f\u80a0\u53d7\u7d2f\u7684CD\uff0cFC \u68c0\u6d4b\u7684\u4ef7\u503c\u5b58\u5728\u4e89\u8bae\uff0c\u6709\u89c2\u70b9\u8ba4\u4e3a\u5c0f\u80a0\u53d7\u7d2f\u7684CD \u60a3\u8005\u4e2dFC \u5bf9\u75be\u75c5\u6d3b\u52a8\u6027\u76d1\u6d4b\u7684\u654f\u611f\u6027\u4e0d\u8db3\uff0c\u5373\u5b58\u5728\u5c0f\u80a0\u708e\u75c7\u7684\u60a3\u8005\u4e2dFC \u6d53\u5ea6\u53ef\u80fd\u5e76\u4e0d\u5347\u9ad8\uff3b16\uff3d\uff0c\u4f46\u8fd1\u671f\u4e00\u9879Meta \u5206\u6790\u53d1\u73b0FC \u6d53\u5ea6\u572850 \u03bcg\/g \u4ee5\u4e0b\u5bf9\u5c0f\u80a0\u708e\u75c7\u7684\u9634\u6027\u9884\u6d4b\u7387\u9ad8\u4e8e90%\uff3b21\uff3d\u3002\u56e0\u6b64\uff0c\u5c3d\u7ba1FC \u6d53\u5ea6\u5347\u9ad8\u5bf9\u75be\u75c5\u6d3b\u52a8\u6709\u4e00\u5b9a\u63d0\u793a\u4f5c\u7528\uff0c\u4f46\u9700\u8c28\u614e\u89e3\u8bfbFC \u7684\u9634\u6027\u7ed3\u679c\uff0c\u5c24\u5176\u5bf9\u4e8e\u5c0f\u80a0\u53d7\u7d2f\u7684CD \u60a3\u8005\u3002<\/p>\n

\u63a8\u8350\u610f\u89c13\uff1a\u7ed3\u80a0\u955c\u5e94\u4f5c\u4e3a\u5e38\u89c4\u68c0\u67e5\u65b9\u6cd5\u7528\u4e8eCD \u8bca\u65ad\u3001\u7597\u6548\u8bc4\u4f30\u53ca\u75be\u75c5\u76d1\u6d4b\u3002\u5efa\u8bae\u68c0\u67e5\u65f6\u5c3d\u91cf\u8fdb\u5165\u56de\u80a0\u672b\u6bb5\uff0c\u7591\u8bca\u60a3\u8005\u5e94\u8fdb\u884c\u591a\u80a0\u6bb5\u6d3b\u68c0\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u5bf9\u7591\u8bcaCD \u8005\uff0c\u7ed3\u80a0\u955c\u68c0\u67e5\u5e94\u5c3d\u91cf\u8fdb\u5165\u56de\u80a0\u672b\u6bb5\uff0c\u7ea670% ~ 80% \u7684\u60a3\u8005\u5b58\u5728\u7ed3\u80a0\u955c\u53ef\u89c2\u5bdf\u75c5\u53d8\u3002CD \u7684\u5185\u955c\u4e0b\u8868\u73b0\u5305\u62ec\u6e83\u75a1\u3001\u9ecf\u819c\u7ea2\u6591\u3001\u7cdc\u70c2\u3001\u6c34\u80bf\u3001\u80a0\u8154\u72ed\u7a84\u3001\u606f\u8089\u6837\u589e\u751f\u3001\u7618\u7ba1\u7b49\u3002\u65e9\u671fCD \u7684\u80a0\u9053\u6e83\u75a1\u591a\u4e3a\u963f\u5f17\u4ed6\u6837\u6e83\u75a1\uff0c\u968f\u75c5\u53d8\u8fdb\u5c55\u800c\u9010\u6e10\u53d8\u5927\u53d8\u6df1\u3001\u878d\u5408\u5f62\u6210\u7eb5\u884c\u6e83\u75a1\uff0c\u65c1\u8fb9\u9ecf\u819c\u53ef\u5f62\u6210\u94fa\u8def\u77f3\u6837\u6539\u53d8\uff0c\u75c5\u53d8\u4e4b\u95f4\u9ecf\u819c\u5916\u89c2\u53ef\u5b8c\u5168\u6b63\u5e38\u3002\u6709\u5229\u4e8e CD \u8bca\u65ad\u7684\u5185\u955c\u4e0b\u8868\u73b0\u5305\u62ec\u975e\u8fde\u7eed\u6027\u75c5\u53d8\u3001\u72ed\u7a84\u6216\u7618\u7ba1\u3001\u809b\u5468\u75c5\u53d8\u3002\u5c24\u5176\u5f53\u51fa\u73b0\u7eb5\u884c\u6e83\u75a1\u53ca\u94fa\u8def\u77f3\u6837\u6539\u53d8\u65f6\u9700\u9ad8\u5ea6\u6000\u7591 CD\uff0c\u4f46\u8981\u5145\u5206\u6392\u9664\u5982\u7f3a\u8840\u6027\u80a0\u75c5\u3001UC \u7b49\u75be\u75c5\u3002<\/p>\n

\u9996\u6b21\u80a0\u955c\u8bc4\u4f30\u65f6\uff0c\u987b\u5728\u5305\u542b\u5168\u7ed3\u76f4\u80a0\u4ee5\u53ca\u672b\u6bb5\u56de\u80a0\u5728\u5185\u7684\u6bcf\u4e2a\u80a0\u6bb5\u8fdb\u884c\u591a\u70b9\u6d3b\u68c0\uff0c\u6bcf\u4e2a\u90e8\u4f4d\u5efa\u8bae\u81f3\u5c11\u53d62 \u5757\u6d3b\u68c0\uff0c\u5305\u62ec\u75c5\u53d8\u53ca\u975e\u75c5\u53d8\u90e8\u4f4d\u3002\u591a\u70b9\u6d3b\u68c0\u7684\u75c5\u7406\u8bc4\u4f30\u5bf9CD \u7684\u8bca\u65ad\u4ef7\u503c\u9ad8\u4e8e\u5355\u4e2a\u6d3b\u68c0\u3002<\/p>\n

\u5728\u542f\u52a8\u6cbb\u7597\u540e\uff0c\u7ed3\u80a0\u955c\u53ef\u89c1\u75c5\u53d8\u8005\u540e\u7eed\u53ef\u4ee5\u901a\u8fc7\u7ed3\u80a0\u955c\u8bc4\u4f30\u7597\u6548\uff0c\u76ee\u524d\u7ed3\u80a0\u955c\u8bc4\u4f30\u7684\u51c6\u786e\u65f6\u95f4\u70b9\u4ecd\u7f3a\u4e4f\u9ad8\u8d28\u91cf\u8bc1\u636e\u3002\u6765\u81eaSONIC \u7814\u7a76\u7684\u6570\u636e\u5206\u6790\u53d1\u73b026 \u5468\u5185\u955c\u4e0b\u9ecf\u819c\u6108\u5408\u53ef\u9884\u6d4b50 \u5468\u65e0\u6fc0\u7d20\u7f13\u89e3\uff3b22\uff3d\uff0c\u6765\u81eaEXTEND \u7814\u7a76\u7684\u6570\u636e\u5206\u6790\u53d1\u73b012 \u5468\u7ed3\u80a0\u955c\u4e0b\u9ecf\u819c\u6108\u5408\u53ef\u9884\u6d4b52 \u5468\u9ecf\u819c\u6108\u5408\uff3b23\uff3d\u3002\u56e0\u4e0d\u540c\u836f\u7269\u7684\u8d77\u6548\u65f6\u95f4\u5b58\u5728\u5dee\u5f02\uff0c\u7ed3\u80a0\u955c\u590d\u67e5\u65f6\u95f4\u9700\u7ed3\u5408\u6240\u9009\u62e9\u7684\u6cbb\u7597\u65b9\u6848\u51b3\u5b9a\u3002\u901a\u5e38\u8ba4\u4e3a\u542f\u52a8\u6216\u53d8\u66f4\u6cbb\u7597\u540e12 ~ 26 \u5468\u662f\u8bc4\u4f30\u9ecf\u819c\u6108\u5408\u7684\u654f\u611f\u65f6\u95f4\u7a97\u3002\u53e6\u5916\uff0c\u5728\u65e9\u671f\u76d1\u6d4b\u75be\u75c5\u590d\u53d1\u3001\u542f\u52a8\u6cbb\u7597\u6216\u75be\u75c5\u96be\u6cbb\u9700\u8f6c\u6362\u6cbb\u7597\u65f6\u4e5f\u5efa\u8bae\u884c\u7ed3\u80a0\u955c\u8bc4\u4f30\u3002<\/p>\n

\u7ed3\u80a0\u955c\u53ef\u7528\u4e8e\u76d1\u6d4b\u6cbb\u7597\u540e\u9ecf\u819c\u6108\u5408\uff0c\u4f46\u76ee\u524d\u4ecd\u7f3a\u4e4f\u4e25\u683c\u516c\u8ba4\u7684\u6807\u51c6\uff0c\u591a\u6570\u5c06\u9ecf\u819c\u6108\u5408\u5b9a\u4e49\u4e3a\u6e83\u75a1\u6d88\u5931\u3002\u514b\u7f57\u6069\u75c5\u5185\u955c\u4e0b\u4e25\u91cd\u7a0b\u5ea6\u6307 \u6570\uff08Crohn\u2032 s disease endoscopic index of severity\uff0cCDEIS\uff09\u3001SES\u2043CD \u5747\u53ef\u7528\u4e8e\u91cf\u5316CD \u7ed3\u80a0\u955c\u4e0b\u9ecf\u819c\u6e83\u75a1\u53ca\u708e\u75c7\u7684\u4e25\u91cd\u7a0b\u5ea6\uff0c\u5176\u5bf9\u4e8e\u8154\u5185\u708e\u75c7\u6d3b\u52a8\u8bc4\u4f30\u4ef7\u503c\u5df2\u5f97\u5230\u9a8c\u8bc1\u5e76\u5177\u53ef\u91cd\u590d\u6027\uff3b24\uff3d\u3002CDEIS \u8bc4\u5206\u8f83\u4e3a\u590d\u6742\uff0c\u4e34\u5e8a\u5b9e\u9645\u53ef\u64cd\u4f5c\u6027\u8f83\u5dee\uff1bSES\u2043CD \u662f\u7531CDEIS \u7b80\u5316\u800c\u6765\uff0c\u8bc4\u4f30\u4e86\u5305\u62ec\u56de\u80a0\u672b\u6bb5\u5728\u51855 \u4e2a\u80a0\u6bb5\u7684\u6e83\u75a1\u5927\u5c0f\u3001\u6e83\u75a1\u9762\u79ef\u3001\u975e\u6e83\u75a1\u9762\u79ef\u4ee5\u53ca\u72ed\u7a84\u60c5\u51b5\u3002\u8fd1\u671f\u4e00\u9879\u7814\u7a76\u53d1\u73b0\u52a0\u6743\u540e\u7684SES\u2043CD \u8bc4\u5206\u53ef\u9884\u6d4b\u6cbb\u75971 \u5e74\u540e\u5185\u955c\u6108\u5408\uff3b25\uff3d*\uff0c\u4f46\u76ee\u524d\u5c06SES\u2043CD \u53ca\u76f8\u5173\u8bc4\u5206\u5de5\u5177\u4f5c\u4e3a\u9ecf\u819c\u6108\u5408\u8bc4\u4ef7\u6307\u6807\u4ecd\u9700\u66f4\u591a\u9ad8\u8d28\u91cf\u7814\u7a76\u3002\u5bf9\u4e8e\u672f\u540e\u60a3\u8005\uff0c\u5219\u5efa\u8bae\u4f7f\u7528Rutgeerts \u8bc4\u5206\u8bc4\u4f30\u65b0\u672b\u6bb5\u56de\u80a0\u75be\u75c5\u590d\u53d1\uff0c\u76ee\u524d\u8ba4\u4e3ai2\u3001i3\u3001i4 \u63d0\u793a\u75be\u75c5\u590d\u53d1\uff0c\u8fd1\u5e74\u4e5f\u6709\u7814\u7a76\u8fdb\u4e00\u6b65\u5c06i2 \u533a\u5206\u4e3ai2a\u3001i2b\uff0c\u53d1\u73b0\u8bc4\u5206\u4e3ai2a \u8005\u75be\u75c5\u8fdb\u5c55\u98ce\u9669\u5c0f\uff0c\u4f46i2b \u4e0e\u75be\u75c5\u8fdb\u5c55\u76f8\u5173\uff3b26\uff3d*\u3002<\/p>\n

\u63a8\u8350\u610f\u89c14\uff1aCD \u62df\u8bca\u60a3\u8005\u5e94\u5e38\u89c4\u884c\u80c3\u5341\u4e8c\u6307\u80a0\u955c\u68c0\u67e5\u53ca\u75c5\u7406\u6d3b\u68c0\uff0c\u660e\u786e\u708e\u75c7\u6709\u65e0\u7d2f\u53ca\u4e0a\u6d88\u5316\u9053\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1aCD \u7684\u4e0a\u6d88\u5316\u9053\u7d2f\u53ca\u7387\u5e38\u56e0\u4e34\u5e8a\u533b\u5e08\u8ba4\u8bc6\u53ca\u7b5b\u67e5\u4e0d\u8db3\u800c\u88ab\u4f4e\u4f30\u3002\u4e00\u9879\u513f\u7ae5CD \u7fa4\u4f53\u7684\u524d\u77bb\u6027\u7814\u7a76\u53d1\u73b0\u4e0a\u6d88\u5316\u9053\u53d7\u7d2f\u7684\u60a3\u8005\u6bd4\u4f8b\u8fbe\u523016%\uff0c\u4f46\u5176\u4e2d\u4ec537% \u7684\u60a3\u8005\u5b58\u5728\u75c7\u72b6\uff3b27\uff3d*\u3002\u53e6\u5916\uff0c\u591a\u6570\u4e0a\u6d88\u5316\u9053\u53d7\u7d2f\u7684CD \u60a3\u8005\u540c\u65f6\u5b58\u5728\u5c0f\u80a0\u53ca\u7ed3\u80a0\u75c5\u53d8\uff0c\u5b64\u7acb\u80c3\u3001\u5341\u4e8c\u6307\u80a0\u75c5\u53d8\u7684CD \u76f8\u5bf9\u7f55\u89c1\uff0c\u53d1\u751f\u7387\u4e0d\u8db32%\uff3b28\uff3d*\u3002\u56e0\u6b64\uff0c\u5bf9\u4e8e\u62df\u8bcaCD \u60a3\u8005\u5e94\u5f00\u5c55\u5e38\u89c4\u80c3\u5341\u4e8c\u6307\u80a0\u955c\u7b5b\u67e5\uff0c\u4e0d\u5e94\u56e0\u60a3\u8005\u5df2\u901a\u8fc7\u7ed3\u80a0\u955c\u7b49\u660e\u786e\u8bca\u65ad\u800c\u5ffd\u7565\u4e0a\u6d88\u5316\u9053\u75c5\u53d8\u8bc4\u4f30\uff0c\u5c24\u5176\u662f\u513f\u7ae5\u3001\u5b58\u5728\u4e0a\u6d88\u5316\u9053\u75c7\u72b6\u4ee5\u53caIBD \u5f85\u5b9a\u578b\u7684\u60a3\u8005\u7fa4\u4f53\uff3b27\uff3d\u3002<\/p>\n

CD \u60a3\u8005\u4e0a\u6d88\u5316\u9053\u53d7\u7d2f\u75c7\u72b6\u65e0\u7279\u5f02\u6027\uff0c\u53ef\u8868\u73b0\u4e3a\u6076\u5fc3\u3001\u5455\u5410\u3001\u98df\u6b32\u4e0d\u4f73\u3001\u541e\u54bd\u56f0\u96be\u3001\u541e\u54bd\u75bc\u75db\u3001\u53e3\u8154\u963f\u5f17\u4ed6\u6837\u6e83\u75a1\u7b49\u3002\u80c3\u5341\u4e8c\u6307\u80a0\u955c\u4e0b\u53ef\u89c1\u9ecf\u819c\u7ed3\u8282\u6837\u6539\u53d8\u3001\u963f\u5f17\u4ed6\u6837\u6216\u7ebf\u72b6\u6e83\u75a1\u3001\u80c3\u7aa6\u589e\u539a\u3001\u5341\u4e8c\u6307\u80a0\u72ed\u7a84\uff3b29\uff3d\u3002\u76ee\u524d\u9488\u5bf9\u4e0a\u6d88\u5316\u9053\u53d7\u7d2f\u5e76\u65e0\u7edf\u4e00\u7684\u53ef\u91cf\u5316\u7684\u5185\u955c\u8bc4\u4ef7\u4f53\u7cfb\uff0c\u6709\u7814\u7a76\u53d1\u73b0\u53ef\u4f7f\u7528SES\u2043 CD \u8bc4\u5206\u5bf9\u80c3\u5185\u75c5\u53d8\u7684\u4e25\u91cd\u7a0b\u5ea6\u8fdb\u884c\u91cf\u5316\uff3b30\uff3d\u3002CD \u7684\u9996\u6b21\u80c3\u5341\u4e8c\u6307\u80a0\u955c\u8bc4\u4f30\u4e5f\u5efa\u8bae\u591a\u70b9\u6d3b\u68c0\uff0c\u6d3b\u68c0\u90e8\u4f4d\u5305\u62ec\u98df\u7ba1\u3001\u80c3\u4f53\u3001\u80c3\u7aa6\u3001\u5341\u4e8c\u6307\u80a0\u7b49\uff0c\u5efa\u8bae\u6bcf\u4e2a\u90e8\u4f4d\u81f3\u5c11\u53d62 \u5757\u7ec4\u7ec7\uff0c\u5728\u5185\u955c\u6240\u89c1\u708e\u75c7\u9ecf\u819c\u5904\u53d6\u6d3b\u68c0\uff0c\u6709\u6761\u4ef6\u8005\u5efa\u8bae\u5bf9\u5185\u955c\u65e0\u708e\u75c7\u9ecf\u819c\u4e5f\u8fdb\u884c\u6d3b\u68c0\uff3b31\uff3d\u3002CD \u4e0a\u6d88\u5316\u9053\u75c5\u7406\u53ef\u8868\u73b0\u4e3a\u8089\u82bd\u80bf\u6027\u708e\u3001\u5341\u4e8c\u6307\u80a0\u5c40\u7076\u9690\u7a9d\u708e\u3001\u5c40\u7076\u6027\u589e\u5f3a\u6027\u80c3\u708e\u3002\u5bf9\u4e8e\u7591\u8bcaCD \u4f46\u901a\u8fc7\u7ed3\u80a0\u955c\u7b49\u65b9\u5f0f\u96be\u4ee5\u83b7\u53d6\u75c5\u7406\u7684\u60a3\u8005\uff0c\u5c40\u7076\u6027\u589e\u5f3a\u6027\u80c3\u708e\u4e5f\u662f\u652f\u6301CD \u8bca\u65ad\u7684\u8bc1\u636e\u4e4b\u4e00\uff3b27\uff0c32\uff3d\u3002<\/p>\n

\u63a8\u8350\u610f\u89c15\uff1a\u80f6\u56ca\u5185\u955c\u68c0\u67e5\u4e3b\u8981\u7528\u4e8e\u7591\u8bcaCD \u4f46\u7ed3\u80a0\u955c\u53ca\u5c0f\u80a0\u653e\u5c04\u5f71\u50cf\u5b66\u68c0\u67e5\u672a\u80fd\u660e\u786e\u8bca\u65ad\u8005\u3002\u5efa\u8bae\u884c\u80f6\u56ca\u5185\u955c\u524d\u8bc4\u4f30\u80a0\u9053\u72ed\u7a84\u60c5\u51b5\uff0c\u964d\u4f4e\u80f6\u56ca\u6ede\u7559\u98ce\u9669\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a1\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f31\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u7ea630% \u7684CD \u60a3\u8005\u75c5\u53d8\u4ec5\u7d2f\u53ca\u5c0f\u80a0\uff0c\u7ed3\u80a0\u955c\u5e38\u89c2\u5bdf\u4e0d\u5230\u75c5\u53d8\u90e8\u4f4d\uff1b\u90e8\u5206\u60a3\u8005\u5c3d\u7ba1\u5b58\u5728\u7ed3\u80a0\u955c\u53ef\u53ca\u75c5\u53d8\uff0c\u4f46\u75c5\u53d8\u7684\u5185\u955c\u4e0b\u5f62\u6001\u4e0d\u5178\u578b\uff0c\u6216\u65e0\u6cd5\u901a\u8fc7\u7ed3\u80a0\u955c\u83b7\u53d6\u5178\u578b\u7684\u75c5\u7406\u8bc1\u636e\uff0c\u56e0\u800c\u4e0d\u80fd\u660e\u786e\u8bca\u65ad\u3002\u5728\u4e0a\u8ff0\u60c5\u5883\u4e0b\uff0c\u5c0f\u80a0\u75c5\u53d8\u7684\u8bc4\u4f30\u53d8\u5f97\u5341\u5206\u91cd\u8981\u3002\u5c0f\u80a0\u75c5\u53d8\u7684\u8bc4\u4f30\u624b\u6bb5\u5305\u62ec CTE \u6216 MRE\u3001\u80f6\u56ca\u5185\u955c\u3001\u80a0\u9053\u8d85\u58f0\u3001\u5c0f\u80a0\u94a1\u9020\u5f71\u7b49\u3002\u80f6\u56ca\u5185\u955c\u5bf9\u5c0f\u80a0\u9ecf\u819c\u75c5\u53d8\u7684\u63a2\u6d4b\u975e\u5e38\u654f\u611f\uff0c\u4e00\u9879Meta \u5206\u6790\u53d1\u73b0\u76f8\u8f83\u4e8e\u5c0f\u80a0\u94a1\u9020\u5f71\u53caCTE\uff0c\u80f6\u56ca\u5185\u955c\u7684\u9633\u6027\u68c0\u51fa\u7387\u53ef\u8fdb\u4e00\u6b65\u63d0\u534732% ~ 47%\uff3b33\uff3d*\u3002\u4e00\u9879\u7cfb\u7edf\u8bc4\u4ef7\u53d1\u73b0\uff0c\u5f53\u60a3\u8005\u5b58\u5728\u8fd1\u7aef\u5c0f\u80a0\u53d7\u7d2f\u65f6\uff0c\u76f8\u8f83\u4e8eMRE\uff0c\u80f6\u56ca\u5185\u955c\u7684\u9633\u6027\u53d1\u73b0\u7387\u663e\u8457\u63d0\u9ad8\uff3b34\uff3d*\u3002\u6b64\u5916\uff0c\u80f6\u56ca\u5185\u955c\u7528\u4e8e\u6392\u9664CD \u7684\u9634\u6027\u9884\u6d4b\u7387\u53ef\u8fbe\u523096%\uff3b35\uff3d\u3002\u56e0\u6b64\uff0c\u5f53\u5c0f\u80a0\u653e\u5c04\u5f71\u50cf\u5b66\u68c0\u67e5\u9634\u6027\u4f46\u4ecd\u6000\u7591CD \u65f6\uff0c\u5efa\u8bae\u8fdb\u4e00\u6b65\u884c\u80f6\u56ca\u5185\u955c\u8bc4\u4f30\u3002<\/p>\n

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\u80f6\u56ca\u5185\u955c\u5b58\u5728\u6ede\u7559\u5371\u9669\uff0c\u53d1\u751f\u7387\u6700\u9ad8\u53ef\u8fbe5.4%\u3002\u5c3d\u7ba1\u660e\u786e\u7684CD \u8bca\u65ad\u662f\u80f6\u56ca\u6ede\u7559\u7684\u5371\u9669\u56e0\u7d20\uff0c\u4f46\u5bf9\u4e8e\u7591\u8bcaCD \u7684\u60a3\u8005\u800c\u8a00\uff0c\u82e5\u65e0\u6897\u963b\u75c7\u72b6\u3001\u65e0\u5c0f\u80a0\u5207\u9664\u624b\u672f\u53f2\u4ee5\u53ca\u65e0\u5df2\u77e5\u72ed\u7a84\uff0c\u5176\u80f6\u56ca\u6ede\u7559\u98ce\u9669\u4e0e\u9690\u533f\u6d88\u5316\u9053\u51fa\u8840\u4eba\u7fa4\u76f8\u4eff\uff0c\u6ede\u7559\u7387\u7ea6\u4e3a 1% ~ 2%\uff3b37\uff3d\u3002\u53d1\u751f\u80f6\u56ca\u6ede\u7559\u540e\uff0c\u7ea685% \u60a3\u8005\u65e0\u75c7\u72b6\uff0c\u65e0\u75c7\u72b6\u60a3\u8005\u901a\u5e38\u53ef\u901a\u8fc7\u5185\u955c\u53d6\u51fa\u6216\u4fdd\u5b88\u6cbb\u7597\u6392\u51fa\u80f6\u56ca\uff3b38\uff3d\uff0c\u7ea615% \u60a3\u8005\u53ef\u80fd\u51fa\u73b0\u6897\u963b\u75c7\u72b6\uff0c\u6700\u7ec8\u9700\u624b\u672f\u5e72\u9884\u3002<\/p>\n

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\u63a8\u8350\u610f\u89c111:\u5b8c\u6574\u7684 CD \u8bca\u65ad\u5e94\u5305\u62ec\u75be\u75c5\u5206\u578b\u3001\u75be\u75c5\u6d3b \u52a8\u7a0b\u5ea6\u53ca\u5e76\u53d1\u75c7\u3002(\u8bc1\u636e\u7b49\u7ea7:1\uff0c\u63a8\u8350\u5f3a\u5ea6:\u5f3a)<\/p>\n

\u63a8\u8350\u7406\u7531:CD \u8bca\u65ad\u65f6\u7684\u75be\u75c5\u7279\u70b9\u5f71\u54cd\u7740\u75be\u75c5\u9884\u540e\u4ee5\u53ca \u6cbb\u7597\u51b3\u7b56\uff0c\u56e0\u6b64\u5b8c\u6574\u7684 CD \u8bca\u65ad\u5e94\u5305\u62ec\u75be\u75c5\u7279\u70b9\u76f8\u5173\u5185\u5bb9\uff0c\u5305 \u62ec\u5206\u578b\u3001\u6d3b\u52a8\u5ea6\u53ca\u5e76\u53d1\u75c7\u7b49\u3002<\/p>\n

CD \u7684\u5206\u578b\u76ee\u524d\u4ecd\u63a8\u8350\u4ee5\u8499\u7279\u5229\u5c14\u5206\u578b\u4e3a\u51c6\uff3b67\uff3d\uff0c\u8fd9\u4e2a\u5206\u578b\u4e2d\u5305\u542b\u8bca\u65ad\u5e74\u9f84\u3001\u75be\u75c5\u884c\u4e3a\u3001\u75be\u75c5\u53d7\u7d2f\u90e8\u4f4d\uff08\u5305\u62ec\u662f\u5426\u5b58\u5728\u809b\u7618\uff09\uff1b\u75be\u75c5\u53d7\u7d2f\u90e8\u4f4d\u4e2d\uff0c\u5df4\u9ece\u5206\u578b\u8fdb\u4e00\u6b65\u5c06\u4e0a\u6d88\u5316\u9053\u53d7\u7d2f\u4ee5\u5c48\u6c0f\u97e7\u5e26\u4e3a\u754c\u5206\u4e3aL4a \u548cL4b \u578b\uff0c\u591a\u7528\u4e8e\u513f\u7ae5CD \u7684\u75be\u75c5\u5206\u578b\uff3b68\uff3d\u3002\u901a\u5e38\u8ba4\u4e3a\u75be\u75c5\u7684\u53d7\u7d2f\u90e8\u4f4d\u53d8\u5316\u4e0d\u5927\uff0c\u4f46\u75be\u75c5\u884c\u4e3a\u4f1a\u968f\u7740\u65f6\u95f4\u7531\u975e\u72ed\u7a84\u3001\u975e\u7a7f\u900f\u578b\u75c5\u53d8\u8fdb\u5c55\u4e3a\u72ed\u7a84\u3001\u7a7f\u900f\u578b\u75c5\u53d8\uff08\u88683\uff09\u3002<\/p>\n<\/p>\n

CD \u75be\u75c5\u6d3b\u52a8\u5ea6\u4e3b\u8981\u5206\u4e3a\u4e34\u5e8a\u75be\u75c5\u6d3b\u52a8\u5ea6\u53ca\u5185\u955c\u4e0b\u75be\u75c5\u6d3b\u52a8\u5ea6\uff0c\u76ee\u524d\u6ca1\u6709\u7528\u4e8e\u8bc4\u4ef7\u75be\u75c5\u6d3b\u52a8\u5ea6\u7684\u91d1\u6807\u51c6\u3002\u5e38\u7528\u7684\u4e34 \u5e8a\u75be\u75c5\u6d3b\u52a8\u5ea6\u8bc4\u5206\u4e3b\u8981\u6307\u514b\u7f57\u6069\u75c5\u6d3b\u52a8\u6307\u6570(CDAI)\uff0c\u4ee5\u53ca \u5728\u6b64\u57fa\u7840\u4e0a\u884d\u751f\u51fa\u7b80\u5355\u6613\u64cd\u4f5c\u7684\u8bc4\u5206\uff0c\u4e3b\u8981\u5305\u62ec\u7b80\u5316 CDAI \u8bc4 \u5206( \u8868 4 )\u53ca B e s t C D A I( \u8868 5 )\u3002\u5e38 \u7528 \u7684 \u5185 \u955c \u75be \u75c5 \u6d3b \u52a8 \u5ea6 \u8bc4 \u4ef7\u65b9\u6cd5\u5305\u62ec\u514b\u7f57\u6069\u75c5\u5185\u955c\u4e0b\u4e25\u91cd\u7a0b\u5ea6\u6307\u6570(CDEIS)\u3001\u7b80\u5316\u514b \u7f57\u6069\u75c5\u5185\u955c\u4e0b\u8bc4\u5206(SES\u2043CD)\u3002\u800c SES\u2043CD \u7531 CDEIS \u7b80\u5316\u800c\u6765(\u8868 6)\u3002<\/p>\n<\/p>\n<\/p>\n

CD \u5e38\u89c1\u5e76\u53d1\u75c7\u5305\u62ec\u7618\u7ba1\u3001\u8179\u8154\u8113\u80bf\u3001\u80a0\u9053\u72ed\u7a84\u3001\u80a0\u6897\u963b\u3001\u809b\u5468\u75c5\u53d8\u5982\u590d\u6742\u809b\u7618\u53ca\u809b\u5468\u8113\u80bf\uff0c\u5c11\u89c1\u4f46\u9700\u91cd\u89c6\u7684\u4e25\u91cd\u5e76\u53d1\u75c7\u5305\u62ec\u6d88\u5316\u9053\u5927\u51fa\u8840\u3001\u80a0\u7a7f\u5b54\u3002CD \u60a3\u8005\u9aa8\u4ee3\u8c22\u5f02\u5e38\u3001\u9759\u8109\u8840\u6813\u98ce\u9669\u5347\u9ad8\uff0c\u56e0\u6b64\u4e5f\u662f\u5e76\u53d1\u75c7\u8bc4\u4f30\u4e2d\u9700\u5173\u6ce8\u7684\u5185\u5bb9\uff3b69\uff3d\u3002CD\u60a3\u8005\u5e76\u53d1\u80a0\u764c\u98ce\u9669\u5347\u9ad8\uff0c\u6545\u9700\u91cd\u89c6\u764c\u53d8\u7684\u7b5b\u67e5\uff0c\u5c24\u5176\u662f\u5728\u75c5\u53d8\u5e7f\u6cdb\u3001\u5b58\u5728\u80a0\u72ed\u7a84\u3001\u5408\u5e76\u539f\u53d1\u6027\u786c\u5316\u6027\u80c6\u7ba1\u708e\u3001\u6709\u7ed3\u76f4\u80a0\u764c\u5bb6\u65cf\u53f2\u53ca\u591a\u53d1\u80a0\u9053\u708e\u6027\u606f\u8089\u75c5\u53f2\u7684\u60a3\u8005\u4e2d\uff3b70\uff3d*\u3002<\/p>\n

\u6807\u51c6\u7684 CD \u8bca\u65ad\u4e3e\u4f8b\uff1a\u514b\u7f57\u6069\u75c5\uff08A2L3B1p\uff0c\u4e2d\u5ea6\u6d3b\u52a8\u671f\uff09+\u5e76\u53d1\u75c7\uff08\u5982\u5408\u5e76\u4e0b\u80a2\u9759\u8109\u8840\u6813\uff09\u3002<\/p>\n

\u63a8\u8350\u610f\u89c112\uff1a\u786e\u8bcaCD \u540e\u9700\u8fdb\u884c\u9ad8\u5371\u56e0\u7d20\u8bc4\u4f30\uff0cCD \u8fdb\u5c55\u7684\u9ad8\u5371\u56e0\u7d20\u5305\u62ec\u53d1\u75c5\u5e74\u9f84\u5c0f\u3001\u5438\u70df\u3001\u80a0\u9053\u53d7\u7d2f\u8303\u56f4\u5e7f\u3001\u7a7f\u900f\u6027\u6216\u72ed\u7a84\u6027\u75be\u75c5\u8868\u578b\u3001\u809b\u5468\u75c5\u53d8\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1aCD \u7684\u4e34\u5e8a\u8868\u73b0\u3001\u75be\u75c5\u4e25\u91cd\u7a0b\u5ea6\u5b58\u5728\u5f02\u8d28\u6027\uff0c\u7ea656% ~ 81% \u7684\u60a3\u8005\u5728\u521d\u59cb\u8bca\u65ad\u65f6\u4e3a\u975e\u72ed\u7a84\u975e\u7a7f\u900f\u578b\uff0c\u8fd9\u4e00\u90e8\u5206\u60a3\u8005\u4e2d\u7ea651% \u5728\u8bca\u65ad\u540e20 \u5e74\u5185\u75be\u75c5\u8fdb\u5c55\u51fa\u73b0\u72ed\u7a84\u6216\u7a7f\u900f\u578b\u75c5\u53d8\uff1b\u53e6\u67095% ~ 25% \u7684\u60a3\u8005\u5728\u8bca\u65ad\u65f6\u5c31\u51fa\u73b0\u72ed\u7a84\u6216\u80a0\u7618\u7b49\u5e76\u53d1\u75c7\u3002\u603b\u4f53\u800c\u8a00\uff0c\u4ec5\u7ea620% ~ 30% \u7684\u60a3\u8005\u53ef\u7ef4\u6301\u957f\u671f\u75be\u75c5\u4e0d\u8fdb\u5c55\u7684\u72b6\u6001\uff0c\u56e0\u6b64\u9700\u8bc6\u522b\u51fa\u5b58\u5728\u75be\u75c5\u8fdb\u5c55\u9ad8\u5371\u56e0\u7d20\u7684\u60a3\u8005\u7fa4\u4f53\uff0c\u4ee5\u6307\u5bfc\u6cbb\u7597\u51b3\u7b56\u53ca\u6162\u6027\u75c5\u7ba1\u7406\uff3b71\u204372\uff3d*\u3002<\/p>\n

\u8f83\u4f4e\u7684\u53d1\u75c5\u5e74\u9f84\u662f\u75be\u75c5\u8fdb\u5c55\u7684\u9ad8\u5371\u56e0\u7d20\u4e4b\u4e00\u3002\u6587\u732e\u56de\u987e\u4e8649 \u9879\u9752\u5c11\u5e74\u8d77\u75c5CD \u548c15 \u9879\u6210\u4ebaCD \u7814\u7a76\uff0c\u5206\u6790\u53d1\u73b0\u9752\u5c11\u5e74\u8d77\u75c5\u7684CD \u75be\u75c5\u8fdb\u5c55\u66f4\u8fc5\u901f\uff0c\u4e14\u591a\u6570\u60a3\u8005\u9700\u4f7f\u7528\u7cd6\u76ae\u8d28\u6fc0\u7d20\u6cbb\u7597\u3001\u5f62\u6210\u6fc0\u7d20\u4f9d\u8d56\u3001\u65e9\u671f\u63a5\u53d7\u751f\u7269\u5236\u5242\u6cbb\u7597\uff3b73\uff3d\u3002\u53e6\u5916\u6709\u7814\u7a76\u53d1\u73b0\uff0c\u5bf9\u6210\u4ebaCD \u800c\u8a00\uff0c\u8d77\u75c5\u5e74\u9f84\u4f4e\u4e0e\u540e\u671f\u624b\u672f\u98ce\u9669\u5347\u9ad8\u76f8\u5173\uff0c\u4f46\u513f\u7ae5\u7fa4\u4f53\u6ca1\u6709\u89c2\u5bdf\u5230\u8fd9\u4e2a\u73b0\u8c61\uff3b74\uff3d\u3002\u56e0\u6b64\uff0c\u8d77\u75c5\u5e74\u9f84\u4f4e\u4e0e\u75be\u75c5\u9884\u540e\u4e0d\u4f73\u7684\u56e0\u679c\u5173\u7cfb\u5c1a\u5f85\u8fdb\u4e00\u6b65\u7814\u7a76\u3002<\/p>\n

\u5438\u70df\u662f\u75be\u75c5\u9884\u540e\u4e0d\u826f\u7684\u5371\u9669\u56e0\u7d20\u3002\u5438\u70df\u4e0e\u505c\u7528\u6297TNF\u5355\u514b\u9686\u6297\u4f53\uff08\u7b80\u79f0\u5355\u6297\uff09\u540e\u75be\u75c5\u590d\u53d1\u3001\u624b\u672f\u3001\u4f4f\u9662\u98ce\u9669\u5747\u6709\u76f8\u5173\u6027\uff0c\u5438\u70df\u8fd8\u53ef\u80fd\u589e\u52a0\u7a7f\u900f\u6027\u75be\u75c5\u53d1\u751f\u7684\u53ef\u80fd\uff3b74\u204376\uff3d\u3002<\/p>\n

\u75be\u75c5\u884c\u4e3a\u5f71\u54cd\u7740\u75be\u75c5\u9884\u540e\uff0c\u5b58\u5728\u72ed\u7a84\u6216\u7a7f\u900f\u578b\u75c5\u53d8\u8005\u624b\u672f\u98ce\u9669\u9ad8\uff0c\u4e14\u7a7f\u900f\u578b\u75c5\u53d8\u624b\u672f\u7684\u60a3\u8005\u4e8c\u6b21\u624b\u672f\u98ce\u9669\u66f4\u9ad8\uff3b77\u204378\uff3d\u3002\u5bf9\u4e8e\u7ed3\u80a0\u578bCD \u800c\u8a00\uff0c\u7ed3\u80a0\u955c\u4e0b\u8868\u73b0\u51fa\u5e7f\u6cdb\u3001\u6df1\u5927\u6e83\u75a1\u662f\u75be\u75c5\u8fdb\u5c55\u9700\u624b\u672f\u7684\u5371\u9669\u56e0\u7d20\uff3b72\uff3d\u3002<\/p>\n

\u521d\u8bca\u65f6\u75c5\u53d8\u8303\u56f4\u662f\u75be\u75c5\u9884\u540e\u7684\u91cd\u8981\u5f71\u54cd\u56e0\u7d20\uff0c\u5e7f\u6cdb\u80a0\u9053\u75c5\u53d8\u63d0\u793a\u75be\u75c5\u9884\u540e\u4e0d\u826f\uff3b72\uff3d\u3002\u8bca\u65ad\u65f6\u5b58\u5728\u5c0f\u80a0\u75c5\u53d8\uff08\u5305\u62ec\u4e0a\u6d88\u5316\u9053\u75c5\u53d8\uff09\u8005\u8fdc\u671f\u624b\u672f\u98ce\u9669\u8f83\u9ad8\uff0c\u800c\u75c5\u53d8\u5c40\u9650\u4e8e\u7ed3\u80a0\u5219\u8fdc\u671f\u624b\u672f\u98ce\u9669\u76f8\u5bf9\u8f83\u4f4e\uff0c\u53ef\u80fd\u4e0e\u5c0f\u80a0\u53d7\u7d2f\u7684\u75c5\u53d8\u66f4\u6613\u51fa\u73b0\u72ed\u7a84\u3001\u7a7f\u900f\u6027\u75c5\u53d8\u76f8\u5173\uff3b72\uff3d\u3002<\/p>\n

\u809b\u5468\u75c5\u53d8\u3001\u590d\u6742\u809b\u7618\u4e5f\u662f\u75be\u75c5\u9884\u540e\u4e0d\u826f\u7684\u5371\u9669\u56e0\u7d20\u3002\u591a\u9879\u524d\u77bb\u6027\u7814\u7a76\u5747\u53d1\u73b0\u8d77\u75c5\u65f6\u5408\u5e76\u809b\u5468\u75c5\u53d8\u63d0\u793a\u75be\u75c5\u9884\u540e\u4e0d\u826f\uff0c\u5305\u62ec\u9700\u53cd\u590d\u4f7f\u7528\u7cd6\u76ae\u8d28\u6fc0\u7d20\u6cbb\u7597\u3001\u6fc0\u7d20\u4f9d\u8d56\u3001\u53cd\u590d\u56e0\u75be\u75c5\u6d3b\u52a8\u6216\u5e76\u53d1\u75c7\u4f4f\u9662\u3001\u9700\u80a0\u9053\u624b\u672f\u7b49\uff1b\u7ed3\u80a0\u578bCD \u5408\u5e76\u809b\u7618\u8005\u80a0\u9053\u6c38\u4e45\u9020\u53e3\u7684\u98ce\u9669\u66f4\u9ad8\uff1b\u800c\u65e0\u809b\u5468\u75c5\u53d8\u60a3\u8005\u663e\u793a\u51fa\u76f8\u5bf9\u6e29\u548c\u7684\u75be\u75c5\u75c5\u7a0b\uff3b53\uff0c79\u204380\uff3d\u3002<\/p>\n

\u4e09\u3001\u6cbb\u7597<\/p>\n

\u63a8\u8350\u610f\u89c113\uff1aCD \u60a3\u8005\u6cbb\u7597\u539f\u5219\u662f\u8bf1\u5bfc\u75be\u75c5\u7f13\u89e3\u3001\u7ef4\u6301\u7f13\u89e3\uff1b\u8fd1\u671f\u76ee\u6807\u4e3a\u4e34\u5e8a\u75c7\u72b6\u7f13\u89e3\u3001\u8840\u6e05\/\u7caa\u4fbf\u708e\u6027\u6307\u6807\u6b63\u5e38\uff1b\u8fdc\u671f\u76ee\u6807\u4e3a\u4e34\u5e8a\u75c7\u72b6\u7f13\u89e3\u3001\u8840\u6e05\/\u7caa\u4fbf\u708e\u6027\u6307\u6807\u6b63\u5e38\u3001\u5185\u955c\u4e0b\u9ecf\u819c\u6108\u5408\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f31\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u201c\u8fbe\u6807\u6cbb\u7597\u201d\uff08treat\u2043to\u2043target\uff09\u662f\u5f53\u524dCD \u6cbb\u7597\u666e\u904d\u91c7\u7528\u7684\u7b56\u7565\uff3b81\u204382\uff3d*\uff0c\u5373\u9884\u5148\u8bbe\u5b9a\u6cbb\u7597\u76ee\u6807\uff0c\u968f\u540e\u5f00\u59cb\u6cbb\u7597\uff0c\u5b9a\u671f\u8bc4\u4f30\u662f\u5426\u8fbe\u5230\u9884\u8bbe\u7684\u6cbb\u7597\u76ee\u6807\uff0c\u5982\u672a\u8fbe\u6807\u5219\u4e88\u8c03\u6574\u6cbb\u7597\u7b56\u7565\uff0c\u76f4\u5230\u6700\u7ec8\u8fbe\u5230\u9884\u8bbe\u76ee\u6807\u3002CD \u6cbb\u7597\u662f\u5426\u8fbe\u6807\u7684\u8bc4\u4ef7\u9700\u7efc\u5408\u4e34\u5e8a\u3001\u751f\u7269\u5b66\u3001\u5185\u955c\u3001\u5f71\u50cf\u4ee5\u53ca\u7ec4\u7ec7\u5b66\u6307\u6807\u3002\u8fd1\u5e74\u6765\u8d8a\u6765\u8d8a\u591a\u7684\u8bc1\u636e\u652f\u6301\u91c7\u7528\u8fbe\u6807\u6cbb\u7597\u7b56\u7565\u80fd\u4f7f\u60a3\u8005\u83b7\u53d6\u66f4\u4f73\u7684\u4e34\u5e8a\u7ed3\u5c40\uff3b83\uff3d*\u3002<\/p>\n

\u8fd110 \u4f59\u5e74\u6765\uff0c\u968f\u7740\u6cbb\u7597\u53ca\u8bc4\u4f30\u624b\u6bb5\u7684\u8fdb\u6b65\uff0cCD \u6cbb\u7597\u76ee\u6807\u4ea6\u4e0d\u65ad\u53d8\u8fc1\uff0c\u65e9\u671f\u83b7\u53d6\u4e34\u5e8a\u75c7\u72b6\u7684\u6539\u5584\u53ca\u7f13\u89e3\u662f\u4e3b\u8981\u76ee\u6807\uff3b84\u204387\uff3d\uff0c\u4f46\u4e34\u5e8a\u75c7\u72b6\u7f13\u89e3\u4e0d\u80fd\u9884\u6d4b\u5185\u955c\u4e0b\u7597\u6548\uff0c\u4ec5\u4ee5\u75c7\u72b6\u6539\u5584\u4f5c\u4e3a\u6cbb\u7597\u76ee\u6807\uff0c\u5bb9\u6613\u53d1\u751f\u6cbb\u7597\u4e0d\u8db3\uff3b88\u204390\uff3d\u3002\u8fd1\u5e74\u9664\u4e34\u5e8a\u53ca\u751f\u7269\u5b66\u7597\u6548\u5916\uff0c\u5185\u955c\u4e0b\u9ecf\u819c\u6108\u5408\u5df2\u6210\u4e3a\u4e3b\u8981\u7684\u6cbb\u7597\u76ee\u6807\u53ca\u7ec8\u70b9\uff3b91\u204392\uff3d\uff0c\u800c\u66f4\u9ad8\u7684\u6cbb\u7597\u76ee\u6807\uff0c\u5982\u900f\u58c1\u6108\u5408\u3001\u7ec4\u7ec7\u5b66\u7f13\u89e3\u4e5f\u9010\u6e10\u8fdb\u5165\u7814\u7a76\u8005\u7684\u89c6\u91ce\uff0c\u751a\u81f3\u6210\u4e3a\u2162\u671f\u4e34\u5e8a\u8bd5\u9a8c\u7ec8\u70b9\uff3b93\u204394\uff3d\u3002\u8d8a\u6765\u8d8a\u591a\u7684\u8bc1\u636e\u8bc1\u5b9e\uff0c\u66f4\u9ad8\u7684\u6cbb\u7597\u76ee\u6807\u4e0e\u66f4\u597d\u7684\u8fdc\u671f\u8f6c\u5f52\u663e\u8457\u76f8\u5173\uff0c\u9ecf\u819c\u6108\u5408\u663e\u8457\u6539\u5584CD \u60a3\u8005\u75be\u75c5\u8fdb\u7a0b\uff3b95\u204397\uff3d\u3002<\/p>\n

\u56fd\u9645\u708e\u75c7\u6027\u80a0\u75c5\u7814\u7a76\u7ec4\u7ec7\uff08International Organization for the Study of IBD\uff0cIOIBD\uff09\u4e8e2021 \u5e74\u53d1\u8868\u7684STRIDE\u2043\u2161\u4e13\u5bb6\u5171\u8bc6\uff3b82\uff3d\uff0c\u628aCD \u6cbb\u7597\u76ee\u6807\u4eba\u4e3a\u5212\u5206\u4e3a\u77ed\u671f\u3001\u4e2d\u671f\u53ca\u957f\u671f\u76ee\u6807\uff0c\u5e76\u5206\u522b\u505a\u4e86\u5177\u4f53\u7684\u8bf4\u660e\uff0c\u4ee5\u66f4\u597d\u5730\u6307\u5bfc\u4e34\u5e8a\u6cbb\u7597\u65b9\u6848\u7684\u5b9e\u65bd\u53ca\u8c03\u6574\u3002\u901a\u5e38\u5c06\u542f\u52a8\u6cbb\u75973 ~ 6 \u4e2a\u6708\u540e\u8fbe\u5230\u4e34\u5e8a\u75c7\u72b6\u7f13\u89e3\u3001\u8840\u6e05\/\u7caa\u4fbf\u708e\u6027\u6307\u6807\u6062\u590d\u6b63\u5e38\u4f5c\u4e3a\u77ed\u671f\u76ee\u6807\u3002\u800c\u6cbb\u75979 ~ 12 \u4e2a\u6708\u540e\u9664\u8fbe\u5230\u4e34\u5e8a\u75c7\u72b6\u7f13\u89e3\u3001\u8840\u6e05\/\u7caa\u4fbf\u708e\u6027\u6307\u6807\u6b63\u5e38\u5916\uff0c\u8fd8\u9700\u8fbe\u5230\u5185\u955c\u4e0b\u9ecf\u819c\u6108\u5408\u3002\u5bf9\u4e8e\u5f71\u50cf\u5b66\u8bc4\u4f30\u7684\u900f\u58c1\u6108\u5408\uff0c\u867d\u7136\u5f53\u524d\u8fd8\u4e0d\u662f\u6b63\u5f0f\u76ee\u6807\uff0c\u4f46\u53ef\u4f5c\u4e3a\u6df1\u5ea6\u7f13\u89e3\u7684\u8861\u91cf\u6807\u51c6\u3002<\/p>\n

\u7ec4\u7ec7\u5b66\u6108\u5408\u662f\u5426\u5e94\u5f53\u4f5c\u4e3aCD \u7684\u6cbb\u7597\u76ee\u6807\u4ecd\u7136\u6709\u4e89\u8bae\u3002\u4e00\u822c\u8ba4\u4e3a\uff0c\u7531\u4e8eCD \u75be\u75c5\u90e8\u4f4d\u7684\u4e0d\u8fde\u7eed\u6027\uff0c\u7ec4\u7ec7\u5b66\u8bc4\u4f30\u5bb9\u6613\u53d7\u5230\u6d3b\u68c0\u504f\u501a\u7684\u5f71\u54cd\uff3b98\uff3d\u3002\u4f46\u4ea6\u6709\u8d8a\u6765\u8d8a\u591a\u7684\u8bc1\u636e\u663e\u793a\uff0c\u5728\u4e34\u5e8a\u7f13\u89e3\u7684\u56de\u80a0\u578bCD \u60a3\u8005\u4e2d\uff0c\u7ec4\u7ec7\u5b66\u6108\u5408\u800c\u975e\u5185\u955c\u6108\u5408\u4e0e\u4e34\u5e8a\u590d\u53d1\u3001\u836f\u7269\u5347\u7ea7\u6216\u4f7f\u7528\u7cd6\u76ae\u8d28\u6fc0\u7d20\u7684\u98ce\u9669\u964d\u4f4e\u76f8\u5173\uff3b99\uff3d\u3002<\/p>\n

\u63a8\u8350\u610f\u89c114\uff1a\u5bf9\u4e8e\u5b58\u5728\u9ad8\u5371\u56e0\u7d20\u7684\u60a3\u8005\uff0c\u5efa\u8bae\u65e9\u671f\u3001\u79ef\u6781\u4f7f\u7528\u751f\u7269\u5236\u5242\u6216\u7cd6\u76ae\u8d28\u6fc0\u7d20\u8bf1\u5bfc\u7f13\u89e3\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1aCD \u7684\u6cbb\u7597\u7b56\u7565\u53ef\u5206\u4e3a\u201c\u5347\u9636\u68af\u201d\u53ca\u201c\u964d\u9636\u68af\u201d\u6cbb\u7597\uff0c\u524d\u8005\u91c7\u7528\u7cd6\u76ae\u8d28\u6fc0\u7d20\u3001\u514d\u75ab\u6291\u5236\u5242\uff08\u560c\u5464\u7c7b\u836f\u7269\u3001\u7532\u6c28\u8776\u5464\u7b49\uff09\u3001\u751f\u7269\u5236\u5242\u9010\u6b65\u4e0a\u9636\u68af\u7684\u7b56\u7565\uff1b\u540e\u8005\u9996\u9009\u751f\u7269\u5236\u5242\u8bf1\u5bfc\u53ca\u7ef4\u6301\u7f13\u89e3\uff0c\u6216\u751f\u7269\u5236\u5242\u8bf1\u5bfc\u7f13\u89e3\u540e\u4f7f\u7528\u514d\u75ab\u6291\u5236\u5242\u7ef4\u6301\u7f13\u89e3\u7684\u7b56\u7565\u3002\u76ee\u524d\u7684\u89c2\u70b9\u591a\u8ba4\u4e3a\u6cbb\u7597\u65b9\u6848\u7684\u5236\u5b9a\u5e94\u5f53\u7ed3\u5408\u60a3\u8005\u662f\u5426\u5b58\u5728\u5371\u9669\u56e0\u7d20\u8fdb\u884c\u5206\u5c42\u7ba1\u7406\uff0c\u5177\u6709\u9ad8\u5371\u56e0\u7d20\u7684\u60a3\u8005\u5b58\u5728\u75be\u75c5\u5feb\u901f\u8fdb\u5c55\u3001\u9884\u540e\u6b20\u4f73\u7684\u75be\u75c5\u81ea\u7136\u75c5\u7a0b\uff0c\u5e94\u91c7\u7528\u65e9\u671f\u79ef\u6781\u5e72\u9884\u7684\u964d\u9636\u68af\u6cbb\u7597\u7b56\u7565\uff0c\u5373\u65e9\u671f\u79ef\u6781\u4f7f\u7528\u751f\u7269\u5236\u5242\u53ca\u7cd6\u76ae\u8d28\u6fc0\u7d20\u8bf1\u5bfc\u7f13\u89e3\uff3b100\u2043102\uff3d\u3002\u5927\u91cf\u7814\u7a76\u8bc1\u636e\u663e\u793a\u5bf9\u5177\u6709\u8fdb\u5c55\u9ad8\u5371\u56e0\u7d20\u7684\u60a3\u8005\u91c7\u7528\u65e9\u671f\u79ef\u6781\u5e72\u9884\u7684\u7b56\u7565\uff0c\u53ef\u663e\u8457\u6539\u5584\u60a3\u8005\u7684\u8fdc\u671f\u8f6c\u5f52\uff3b85\uff0c91*\uff0c103*\u2043110*\uff3d\u3002<\/p>\n

1.\u8bf1\u5bfc\u7f13\u89e3<\/p>\n

\u63a8\u8350\u610f\u89c115\uff1a\u8f7b\u5ea6\u6d3b\u52a8\u671fCD \u53ef\u8003\u8651\u4f7f\u7528\u5c40\u90e8\u6216\u7cfb\u7edf\u6027\u7cd6\u76ae\u8d28\u6fc0\u7d20\u8fdb\u884c\u8bf1\u5bfc\u7f13\u89e3\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u65e9\u572820 \u4e16\u7eaa70 \u5e74\u4ee3\uff0c\u591a\u4e2d\u5fc3\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\uff08randomized controlled trial\uff0cRCT\uff09\u7814\u7a76\u5df2\u8bc1\u5b9e\u7cfb\u7edf\u7cd6\u76ae\u8d28\u6fc0\u7d20\u53ef\u8bf1\u5bfc\u6d3b\u52a8\u671fCD \u7f13\u89e3\uff0c\u6709\u6548\u7387\u8fbe60%\uff0c\u9ad8\u4e8e\u5b89\u6170\u5242\u768430%\uff08P\uff1c0.0001\uff09\uff0c\u4f46\u5bf9\u9884\u9632CD \u590d\u53d1\u5219\u65e0\u6548\uff3b111\uff3d*\u3002\u63a8\u8350\u4f7f\u7528\u5242\u91cf\u4e3a\u6cfc\u5c3c\u677e0.75 ~ 1.00 mg\u00b7kg-1\u00b7d-1\uff0c\u6216\u76f8\u5f53\u5242\u91cf\u7684\u5176\u4ed6\u7cd6\u76ae\u8d28\u6fc0\u7d20\uff0c\u5982\u7532\u6cfc\u5c3c\u9f99\u6216\u6c22\u5316\u53ef\u7684\u677e\uff0c\u901a\u5e38\u7528\u836f2 ~ 4 \u5468\u5f00\u59cb\u9010\u6e10\u51cf\u91cf\uff0c\u6bcf\u5468\u51cf\u91cf\u6cfc\u5c3c\u677e2.5 ~ 5.0 mg\uff0c\u9010\u6e10\u57283 \u4e2a\u6708\u5185\u51cf\u505c\uff0c\u4ee5\u5176\u4ed6\u836f\u7269\u7ef4\u6301\u6cbb\u7597\uff0c\u5b9e\u73b0\u4ece\u8bf1\u5bfc\u7f13\u89e3\u5230\u7ef4\u6301\u7f13\u89e3\u7684\u8fc7\u6e21\uff3b111\u2043114\uff3d\u3002<\/p>\n

\u75c5\u53d8\u5c40\u9650\u4e8e\u56de\u76f2\u90e8\u8005\uff0c\u4e3a\u51cf\u5c11\u5168\u8eab\u4f5c\u7528\u7cd6\u76ae\u8d28\u6fc0\u7d20\u7684\u4e0d\u826f\u53cd\u5e94\uff0c\u53ef\u8003\u8651\u5e94\u7528\u53e3\u670d\u5e03\u5730\u5948\u5fb7\uff0c\u4e0e\u5168\u8eab\u7cd6\u76ae\u8d28\u6fc0\u7d20\u76f8\u6bd4\uff0c\u56de\u80a0\u91ca\u653e\u5242\u578b\u7684\u5e03\u5730\u5948\u5fb7\u5177\u6709\u663e\u8457\u7684\u809d\u810f\u9996\u8fc7\u6548\u5e94\uff0c\u4ec5\u7ea6 10% \u8fdb\u5165\u8840\u5faa\u73af\uff0c\u51cf\u8f7b\u4e86\u7cfb\u7edf\u7cd6\u76ae\u8d28\u6fc0\u7d20\u7684\u4e0d\u826f\u53cd\u5e94\uff0c\u663e\u793a\u51fa\u826f\u597d\u7684\u5b89\u5168\u6027\u3002\u4e00\u9879\u7eb3\u51653 \u4e2aRCT \u8bd5\u9a8c\u8fdb\u884c\u7684\u7cfb\u7edf\u8bc4\u4ef7\u53caMeta \u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u5e03\u5730\u5948\u5fb7\u6cbb\u7597\u7ec48 \u5468\u4e34\u5e8a\u7f13\u89e3\u7387\u7ea6 50%\uff0c\u9ad8\u4e8e\u5b89\u6170\u5242\u5bf9\u7167\u7ec4\uff3b115\uff3d*\u3002\u65e9\u671f\u7814\u7a76\u6bd4\u8f83\u4e86\u5e03\u5730\u5948\u5fb7\u4e0e\u7f8e\u6c99\u62c9\u55ea\u6cbb\u7597\u8f7b\u4e2d\u5ea6\u6d3b\u52a8\u6027CD \u7684\u7597\u6548\uff0c\u7ed3\u679c\u663e\u793a\u5bf9\u75c5\u53d8\u7d2f\u53ca\u56de\u80a0\u6216\u5347\u7ed3\u80a0\u7684\u6d3b\u52a8\u6027CD\uff0c\u5e03\u5730\u5948\u5fb7\u8bf1\u5bfc\u7f13\u89e3\u7387\u663e\u8457\u9ad8\u4e8e\u7f8e\u6c99\u62c9\u55ea\uff3b116\uff3d\u3002\u968f\u540e\u65e5\u672c\u4e00\u9879RCT \u7814\u7a76\u4e5f\u5f97\u51fa\u7c7b\u4f3c\u7ed3\u679c\uff0c\u5bf9\u8f7b\u4e2d\u5ea6\u6d3b\u52a8\u6027CD \u60a3\u8005\uff0c\u5e03\u5730\u5948\u5fb7\u7597\u6548\u663e\u8457\u4f18\u4e8e\u7f8e\u6c99\u62c9\u55ea\uff3b117\uff3d\u3002<\/p>\n

\u7531\u4e8e\u53e3\u670d\u5e03\u5730\u5948\u5fb7\u5236\u5242\u5c1a\u672a\u5728\u6211\u56fd\u4e0a\u5e02\uff0c\u800c\u7cfb\u7edf\u7cd6\u76ae\u8d28\u6fc0\u7d20\u4e0d\u826f\u53cd\u5e94\u53d1\u751f\u7387\u9ad8\uff0c\u6211\u56fd\u4e0d\u5c11\u5b66\u8005\u4ecd\u9009\u62e9\u6c28\u57fa\u6c34\u6768\u9178\u5236\u5242\u6cbb\u7597\u8f7b\u5ea6\u6d3b\u52a8\u671fCD\u3002\u65e9\u671f\u6709\u7814\u7a76\u663e\u793a\uff0c\u7f8e\u6c99\u62c9\u55ea\u5728\u7f13\u89e3 CD \u60a3\u8005\u75c7\u72b6\u4e0a\u663e\u8457\u4f18\u4e8e\u5b89\u6170\u5242\uff3b118\uff3d\u3002\u4e00\u9879\u5206\u6790\u6c28\u57fa\u6c34\u6768\u9178\u5236\u5242\u6cbb\u7597CD \u7597\u6548\u7684\u7cfb\u7edf\u8bc4\u4ef7\u53caMeta \u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u67f3\u6c2e\u78fa\u80fa\u5421\u5576\u5728\u8f7b\u4e2d\u5ea6\u6d3b\u52a8\u6027CD \u7597\u6548\u6709\u9650\uff0c\u4ec5\u6709\u4f18\u4e8e\u5b89\u6170\u5242\u7684\u8d8b\u52bf\uff0c\u4f46\u5dee\u5f02\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\u3002\u5965\u6c99\u62c9\u55ea\u3001\u7f8e\u6c99\u62c9\u55ea\uff08\u4f4e\u5242\u91cf1 ~2 g\/d \u53ca\u9ad8\u5242\u91cf3.2 ~ 4.0 g\/d\uff09\u5728\u8bf1\u5bfc\u7f13\u89e3\u4e0a\u4e0e\u5b89\u6170\u5242\u7684\u5dee\u5f02\u5747\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff3b119\uff3d*\u3002\u5982\u4f7f\u7528\u7f8e\u6c99\u62c9\u55ea\u6cbb\u7597 CD\uff0c\u9700\u53ca\u65f6\u968f\u8bbf\uff0c\u8bc4\u4f30\u7597\u6548\uff3b118\uff3d\u3002<\/p>\n

\u63a8\u8350\u610f\u89c116\uff1a\u5bf9\u4e8e\u4f34\u6709\u9ad8\u5371\u56e0\u7d20\u6216\u4f20\u7edf\u836f\u7269\u6cbb\u7597\u5931\u8d25\u7684\u8f7b\u5ea6\u6d3b\u52a8\u671fCD\uff0c\u53ef\u8003\u8651\u4f7f\u7528\u751f\u7269\u5236\u5242\u8fdb\u884c\u8bf1\u5bfc\u7f13\u89e3\u6cbb\u7597\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1aCD \u6cbb\u7597\u5f3a\u8c03\u5206\u5c42\u7ba1\u7406\u53ca\u4e2a\u4f53\u5316\u539f\u5219\uff0c\u5bf9\u5177\u6709\u8fdb\u5c55\u9ad8\u5371\u56e0\u7d20\u7684CD \u60a3\u8005\u4e3b\u5f20\u91c7\u7528\u65e9\u671f\u79ef\u6781\u5e72\u9884\u7684\u201c\u964d\u9636\u68af\u201d\u6cbb\u7597\u7b56\u7565\u3002\u6709\u7814\u7a76\u663e\u793a\u5bf9\u5177\u6709\u9ad8\u5371\u56e0\u7d20\u7684CD \u60a3\u8005\u5728\u786e\u8bca\u540e 2 \u5e74\u5185\u542f\u52a8\u6297TNF \u5236\u5242\u6216\u8005\u514d\u75ab\u6291\u5236\u5242\u6cbb\u7597\u53ef\u4ee5\u964d\u4f4e\u80a0\u9053\u72ed\u7a84\u7684\u8fdb\u5c55\u98ce\u9669\uff3b120\uff3d\u3002\u4e00\u7bc7\u7eb3\u516547 \u9879\u7814\u7a76\u3001\u517118 471 \u4f8bCD \u60a3\u8005\u7684Meta \u5206\u6790\u5bf9\u6bd4\u4e86\u65e9\u671f\u5e94\u7528\u751f\u7269\u5236\u5242\u7684\u201c\u964d\u9636\u68af\u201d\u6cbb\u7597\u7b56\u7565\uff08CD \u8bca\u65ad2 \u5e74\u5185\uff09\u4e0e\u4f20\u7edf\u7684\u201c\u5347\u9636\u68af\u201d\u6cbb\u7597\/\u540e\u671f\u4f7f\u7528\u751f\u7269\u5236\u5242\u7b56\u7565\uff08CD \u8bca\u65ad\u8d85\u8fc72 \u5e74\uff09\u7684\u7597\u6548\uff0c\u7ed3\u679c\u63d0\u793a\uff0c\u4e0e\u4f20\u7edf\u7684\u201c\u5347\u9636\u68af\u201d\u6cbb\u7597\/\u540e\u671f\u4f7f\u7528\u751f\u7269\u5236\u5242\u7b56\u7565\u7ec4\u76f8\u6bd4\uff0c\u65e9\u671f\u91c7\u7528\u751f\u7269\u5236\u5242\u7ec4\u663e\u8457\u6539\u5584\u60a3\u8005\u7684\u4e34\u5e8a\u8f6c\u5f52\uff0c\u53ef\u83b7\u5f97\u66f4\u9ad8\u7684\u4e34\u5e8a\u7f13\u89e3\u7387\uff08OR = 2.10\uff0c95%CI\uff1a1.69 ~ 2.60\uff0cP\uff1c0.00001\uff09\u3001\u66f4\u4f4e\u7684\u590d\u53d1\u7387\uff08OR = 0.31\uff0c95%CI\uff1a0.14 ~ 0.68\uff0cP = 0.003\uff09\u53ca\u66f4\u9ad8\u7684\u9ecf\u819c\u6108\u5408\u7387\uff08OR = 2.37\uff0c95%CI\uff1a1.78 ~ 3.16\uff0cP\uff1c0.00001\uff09\uff3b121\uff3d*\u3002\u6700\u65b0\u7814\u7a76\u4ea6\u663e\u793a\u786e\u8bca\u540e2 \u5e74\u5185\u542f\u52a8\u6297TNF \u5236\u5242\u6cbb\u7597\u80fd\u964d\u4f4eCD \u76f8\u5173\u5e76\u53d1\u75c7\u7684\u53d1\u751f\u98ce\u9669\uff0c\u63d0\u9ad8\u4e34\u5e8a\u548c\u5185\u955c\u7f13\u89e3\u7387\u3002\u4f46\u662f2 \u5e74\u4ee5\u5185\u7684\u5404\u4e2a\u6cbb\u7597\u7a97\uff08\u22646 \u4e2a\u6708\uff0c7 ~ 12 \u4e2a\u6708\uff0c13 ~ 18 \u4e2a\u6708\uff0c19 ~ 24\u4e2a\u6708\uff09\u5dee\u5f02\u5747\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff3b122\uff3d\u3002<\/p>\n

\u63a8\u8350\u610f\u89c117\uff1a\u63a8\u8350\u7cfb\u7edf\u6027\u7cd6\u76ae\u8d28\u6fc0\u7d20\u7528\u4e8e\u4e2d\u91cd\u5ea6\u6d3b\u52a8\u671fCD \u7684\u8bf1\u5bfc\u7f13\u89e3\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a1\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u65e9\u671f\u8bc1\u636e\u663e\u793a\u53e3\u670d\u7cd6\u76ae\u8d28\u6fc0\u7d20\u53ef\u6709\u6548\u8bf1\u5bfc\u4e2d\u91cd\u5ea6\u6d3b\u52a8\u6027CD \u75be\u75c5\u7f13\u89e3\uff3b101\u2043102\uff3d\u3002\u7cd6\u76ae\u8d28\u6fc0\u7d20\u7528\u6cd5\u7528\u91cf\u53c2\u7167\u4e0a\u8ff0\u8f7b\u5ea6\u6d3b\u52a8\u6027CD \u6cbb\u7597\u4e2d\u7684\u5e94\u7528\u3002\u7cd6\u76ae\u8d28\u6fc0\u7d20\u4f7f\u7528\u65f6\u9700\u8981\u8b66\u60d5\u76f8\u5173\u4e0d\u826f\u53cd\u5e94\u7684\u53d1\u751f\u3002\u7814\u7a76\u8868\u660e\uff0c\u4e0e\u5b89\u6170\u5242\u76f8\u6bd4\uff0c\u7cd6\u76ae\u8d28\u6fc0\u7d20\u4e0d\u826f\u53cd\u5e94\u53d1\u751f\u7387\u66f4\u9ad8\uff08RR = 4.89\uff0c95%CI\uff1a1.98 ~ 12.07\uff09\uff3b101\uff3d*\u3002<\/p>\n

\u63a8\u8350\u610f\u89c118\uff1a\u63a8\u8350\u6297TNF \u5355\u6297\u7528\u4e8e\u4e2d\u91cd\u5ea6\u6d3b\u52a8\u671fCD \u7684\u8bf1\u5bfc\u7f13\u89e3\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u82f1\u592b\u5229\u897f\u5355\u6297\uff08infliximab\uff0cIFX\uff09\u662f\u6211\u56fd\u9996\u4e2a\u83b7\u6279\u7528\u4e8e\u6d3b\u52a8\u671fCD \u8bf1\u5bfc\u6cbb\u7597\u7684\u751f\u7269\u5236\u5242\u30021997 \u5e74Targan \u7b49\uff3b84\uff3d*\u7684\u4e34\u5e8a\u7814\u7a76\u7ed3\u679c\u8868\u660e\uff0cIFX \u8bf1\u5bfc\u6cbb\u7597\u6210\u4eba\u4e2d\u91cd\u5ea6\u6d3b\u52a8\u6027CD\u76844 \u5468\u4e34\u5e8a\u5e94\u7b54\u7387\u4e3a81%\uff0c\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec4\u768417%\uff08P\uff1c0.001\uff09\u3002IFX \u63a8\u8350\u7684\u5e38\u89c4\u7528\u6cd5\u7528\u91cf\u4e3a5 mg\/kg\uff0c\u5206\u522b\u4e8e\u7b2c0\u30012\u30016 \u5468\uff0c\u9759\u8109\u8f93\u6ce8\u8bf1\u5bfc\u7f13\u89e3\uff0c\u968f\u540e\u6bcf8 \u54681 \u6b21\u7ef4\u6301\u6cbb\u7597\uff3b123\uff3d\u3002REACH \u7814\u7a76\u663e\u793a\uff0cIFX \u6cbb\u7597\u513f\u7ae5CD \u7597\u6548\u4e0e\u6210\u4eba\u4e00\u81f4\uff0c\u7b2c10 \u5468\u7684\u4e34\u5e8a\u5e94\u7b54\u7387\u4e3a 88.4%\uff3b124\uff3d \u3002CLASSIC \u2043 \u2160 \u7814\u7a76\u63a2\u7d22\u963f\u8fbe\u6728\u5355\u6297 \uff08adalimumab\uff0cADA\uff09\u6cbb\u7597CD \u7684\u5408\u9002\u8bf1\u5bfc\u5242\u91cf\uff0c\u7ed3\u679c\u663e\u793a\uff0c\u521d\u6cbb\u4e2d\u91cd\u5ea6CD \u60a3\u8005\u4e2d\uff0c\u5728\u7b2c4 \u5468\u65f6ADA \u7ec4\u4e34\u5e8a\u5e94\u7b54\u7387\u4e3a36%\uff0c\u4f18\u4e8e\u5b89\u6170\u5242\u7ec4\u768412%\uff3b86\uff3d*\u3002\u7cfb\u7edf\u56de\u987e\u53caMeta \u5206\u6790\u5747\u663e\u793aADA\u6cbb\u7597CD \u4e34\u5e8a\u7f13\u89e3\u7387\u663e\u8457\u4f18\u4e8e\u5b89\u6170\u5242\uff0cADA \u6cbb\u7597\u6210\u4ebaCD \u5e38\u89c4\u63a8\u8350\u7684\u7528\u6cd5\u7528\u91cf\u4e3a\u6bcf2 \u54681 \u6b21\u76ae\u4e0b\u6ce8\u5c04\uff0c\u9996\u6b21160 mg\uff0c\u7b2c2\u6b2180 mg\uff0c\u540e\u7eed\u6bcf\u6b2140 mg\uff3b125\u2043126\uff3d*\u3002\u4e2d\u56fd\u2162\u671f\u4e34\u5e8a\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0cADA \u6cbb\u75974 \u5468\u7684\u4e34\u5e8a\u7f13\u89e3\u7387\u4e3a37.3%\uff0c\u4f18\u4e8e\u5b89\u6170\u5242\u7ec4\u7684 6.8%\uff3b127\u2043128\uff3d\u3002Rutgeerts \u7b49\uff3b92\uff3d\u62a5\u9053\u4e86 ADA \u6cbb\u7597\u4e2d\u91cd\u5ea6\u6d3b\u52a8\u6027 CD \u7684\u5185\u955c\u4e0b\u5e94\u7b54\uff0c12 \u5468\u65f6\u9ecf\u819c\u6108\u5408\u7387\u4e3a27%\uff0c\u9ad8\u4e8e\u5bf9\u7167\u7ec4\u7684 13%\u3002\u5bf9\u4e8e IFX \u6cbb\u7597\u5931\u8d25\u6216\u4e0d\u8010\u53d7\u7684\u4e2d\u91cd\u5ea6\u6d3b\u52a8\u6027 CD \u60a3\u8005\uff0cADA \u6cbb\u7597\u540e\u7b2c4 \u5468\u65f6\u4e34\u5e8a\u7f13\u89e3\u7387\u4e3a21%\uff3b87\uff3d\u3002<\/p>\n

\u63a8\u8350\u610f\u89c118a\uff1aIFX \u7528\u4e8eCD \u8bf1\u5bfc\u7f13\u89e3\u6cbb\u7597\uff0c\u5982\u65e0\u5236\u8861\u56e0\u7d20\uff0c\u5efa\u8bae\u8054\u5408\u4f7f\u7528\u786b\u5511\u560c\u5464\u6216\u7532\u6c28\u8776\u5464\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f31\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u4e00\u9879RCT \u7814\u7a76\u6bd4\u8f83IFX \u8054\u7528\u786b\u5511\u560c\u5464\u4e0eIFX\u5355\u836f\u6cbb\u7597CD \u7684\u7597\u6548\u53ca\u5b89\u5168\u6027\uff0c\u7ed3\u679c\u663e\u793a\u8054\u5408\u7528\u836f\u7ec4\u5728\u7b2c10\u5468\u65e0\u6fc0\u7d20\u4e34\u5e8a\u7f13\u89e3\u7387\u4e3a46.7%\uff0c\u4e0eIFX \u5355\u836f\u7ec4\uff0837.3%\uff09\u5dee\u5f02\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff08P = 0.07\uff09\uff3b91\uff3d*\uff0c\u7f13\u89e3\u7387\u4e0a\u7684\u5dee\u5f02\u5728\u7528\u836f\u7b2c26 \u5468\u5dee\u5f02\u51fa\u73b0\u7edf\u8ba1\u5b66\u610f\u4e49\uff08P = 0.02\uff09\u3002\u5c3d\u7ba1\u76ee\u524d\u5c1a\u65e0RCT \u7814\u7a76\u663e\u793a IFX \u8054\u5408\u7532\u6c28\u8776\u5464\u53ef\u660e\u786e\u63d0\u9ad8\u7597\u6548\uff0cFeagan \u7b49\uff3b129\uff3d\u7814\u7a76\u663e\u793a IFX \u8054\u5408\u7532\u6c28\u8776\u5464\u53ef\u663e\u8457\u63d0\u9ad8IFX \u836f\u7269\u8c37\u6d53\u5ea6\uff0c\u51cf\u5c11\u6297\u836f\u6297\u4f53\u7684\u4ea7\u751f\u30022017 \u5e74\u4e00\u9879Meta \u5206\u6790\u4e5f\u663e\u793a\u6297TNF \u5355\u6297\u8054\u5408\u514d\u75ab\u6291\u5236\u5242\uff08\u786b\u5511\u560c\u5464\u6216\u7532\u6c28\u8776\u5464\uff09\u53ef\u663e\u8457\u51cf\u5c11\u6297\u836f\u6297\u4f53\u7684\u4ea7\u751f\uff3b130\uff3d*\u3002\u56fd\u5916\u591a\u4e2a\u6307\u5357\u5747\u63a8\u8350IFX \u6cbb\u7597CD \u65f6\u53ef\u65e9\u671f\u8054\u5408\u514d\u75ab\u6291\u5236\u5242\uff3b6\uff0c131\u2043137\uff3d\u3002\u4f46\u5bf9\u4e8e\u5b58\u5728\u5236\u8861\u56e0\u7d20\u7684\u60a3\u8005\uff0c\u5982\u8001\u9f84\uff3b138\u2043140\uff3d\u53ca\u5e74\u8f7b\u7537\u6027\uff3b141\uff3d\u3001\u6162\u6027\u6d3b\u52a8\u6027EBV \u611f\u67d3\uff3b142\u2043143\uff3d\u3001\u65e2\u5f80\u6709\u6076\u6027\u80bf\u7624\u75c5\u53f2\uff3b138\uff3d\uff0c\u7531\u4e8e\u4f7f\u7528\u786b\u5511\u560c\u5464\u540e\u80bf\u7624\u53d1\u751f\u7684\u98ce\u9669\u5347\u9ad8\uff0c\u9700\u6743\u8861\u5229\u5f0a\u8c28\u614e\u4f7f\u7528\u3002\u53e6\u5916\u8fd8\u9700\u6ce8\u610f\uff0c\u8f83\u957f\u65f6\u95f4\uff08\uff1e2 \u5e74\uff09\u7684\u8054\u5408\u7528\u836f\u6709\u53ef\u80fd\u4f7f\u80bf\u7624\u98ce\u9669\u8fdb\u4e00\u6b65\u5347\u9ad8\uff3b141\uff3d\u3002<\/p>\n

\u63a8\u8350\u610f\u89c118b\uff1a\u5f53ADA \u4f5c\u4e3a\u4e8c\u7ebf\u751f\u7269\u5236\u5242\u7528\u4e8eCD \u8bf1\u5bfc\u7f13\u89e3\u65f6\uff0c\u53ef\u8003\u8651\u8054\u7528\u786b\u5511\u560c\u5464\u6216\u7532\u6c28\u8776\u5464\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a4\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f31\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u4e00\u9879Meta \u5206\u6790\u663e\u793a\uff0cADA \u8054\u5408\u514d\u75ab\u6291\u5236\u5242\u6cbb\u7597CD \u8bf1\u5bfc\u671f\uff083 \u4e2a\u6708\uff09\u7597\u6548\u663e\u8457\u4f18\u4e8e\u5355\u836f\u6cbb\u7597\uff0c\u4f46\u5728\u6cbb\u7597\u8fbe 12 \u4e2a\u6708\u65f6\u4e24\u7ec4\u5dee\u5f02\u65e0\u663e\u8457\u7edf\u8ba1\u5b66\u610f\u4e49\uff3b144\uff3d*\u3002\u4e00\u9879\u5f00\u653e\u6807\u7b7e\u968f\u673a\u5bf9\u7167\u7814\u7a76\uff08DIAMOND \u7814\u7a76\uff09\u6bd4\u8f83ADA \u8054\u5408\u786b\u5511\u560c\u5464\u4e0e ADA \u5355\u836f\u6cbb\u7597CD \u7684\u7597\u6548\u53ca\u5b89\u5168\u6027\uff0c\u7ed3\u679c\u663e\u793a\u4e24\u7ec4\u5728\u8bf1\u5bfc\u7f13\u89e3\u65b9\u9762\u5dee\u5f02\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff0c\u4f46\u7b2c26 \u5468\u5185\u955c\u4e0b\u7f13\u89e3\u7387\u5728\u8054\u5408\u6cbb\u7597\u7ec4\u4e2d\u4e3a84.2%\uff0c\u9ad8\u4e8e\u5355\u836f\u6cbb\u7597\u7ec4\u768463.8%\uff08P\uff1c0.05\uff09\uff3b145\uff3d*\u3002\u6709\u7814\u7a76\u663e\u793a\u5728\u53d1\u751f\u6297TNF \u5355\u6297\u7ee7\u53d1\u6027\u5931\u5e94\u7b54\u7684\u60a3\u8005\u4e2d\u4f7f\u7528\u53e6\u4e00\u79cd\u6297TNF \u5355\u6297\u65f6\uff0c\u8054\u7528\u786b\u5511\u560c\u5464\u7ec4\u7b2c24 \u4e2a\u6708\u65f6\u4e34\u5e8a\u590d\u53d1\u7387\u4e3a22%\uff0c\u663e\u8457\u4f4e\u4e8e\u6297TNF \u5355\u6297\u5355\u836f\u7ec4\u768477%\uff08P\uff1c0.001\uff09\uff3b146\uff3d\u3002\u7efc\u4e0a\uff0c\u5bf9\u4e8e\u65e2\u5f80\u751f\u7269\u5236\u5242\u6cbb\u7597\u5931\u8d25\u7684\u76f8\u5bf9\u96be\u6cbb\u7684\u60a3\u8005\uff0c\u5728\u9009\u62e9ADA \u4f5c\u4e3a\u4e8c\u7ebf\u751f\u7269\u5236\u5242\u6cbb\u7597\u65f6\uff0c\u53ef\u8003\u8651\u8054\u7528\u786b\u5511\u560c\u5464\u6216\u7532\u6c28\u8776\u5464\u3002<\/p>\n

\u63a8\u8350\u610f\u89c119\uff1a\u7ef4\u5f97\u5229\u73e0\u5355\u6297\u53ef\u7528\u4e8e\u4e2d\u91cd\u5ea6\u6d3b\u52a8\u671fCD \u60a3\u8005\u7684\u8bf1\u5bfc\u7f13\u89e3\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1aGEMINI 2 \u548cGEMINI 3 \u7814\u7a76\u662f\u4e24\u9879\u8bc4\u4f30\u7ef4\u5f97\u5229\u73e0\u5355\u6297\uff08vedolizumab\uff0cVDZ\uff09\u6cbb\u7597\u4e2d\u91cd\u5ea6\u6d3b\u52a8\u6027CD \u7597\u6548\u53ca\u5b89\u5168\u6027\u7684\u5168\u7403\u591a\u4e2d\u5fc3\u2162\u671f RCT \u4e34\u5e8a\u7814\u7a76\uff3b147\u2043148\uff3d*\u3002GEMINI 2\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0cVDZ \u7ec4\u5728\u7b2c6 \u5468\u4e34\u5e8a\u7f13\u89e3\u7387\u4e3a14.5%\uff0c\u663e\u8457\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec4\u76846.8%\uff08P = 0.02\uff09\uff0c\u4f46\u5e94\u7b54\u7387\u4e0e\u5b89\u6170\u5242\u7ec4\u5dee\u5f02\u65e0\u663e\u8457\u7edf\u8ba1\u5b66\u610f\u4e49\uff0831.4% \u6bd425.7%\uff0cP = 0.23\uff09\u3002GEMINI 3 \u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0c\u5728\u7b2c6 \u5468\u65f6VDZ \u7ec4\u4e0e\u5b89\u6170\u5242\u7ec4\u4e34\u5e8a\u7f13\u89e3\u7387\u7684\u5dee\u5f02\u65e0\u663e\u8457\u7edf\u8ba1\u5b66\u610f\u4e49\uff0815.2% \u6bd4 12.1%\uff0cP = 0.4\uff09\uff1b\u5728\u7b2c 10 \u5468\u65f6 VDZ \u6cbb\u7597\u7ec4\u4e34\u5e8a\u7f13\u89e3\u7387\u8fbe 26.6%\uff0c\u663e\u8457\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec4\u7684 12.1%\uff08P = 0.001\uff09\u3002\u8fd1\u5e74Dulai \u7b49\uff3b149\u2043150\uff3d\u5f00\u53d1\u7684VDZ \u7684CD \u4e34\u5e8a\u51b3\u7b56\u8bc4\u5206\u5de5\u5177\uff08CDST\uff09\u663e\u793a\uff0cCD \u65e9\u671f\u75be\u75c5\u7279\u5f81\u5982\u65e2\u5f80\u672a\u63a5\u53d7\u8fc7\u80a0\u9053\u624b\u672f\u3001\u672a\u63a5\u53d7\u8fc7\u6297TNF \u836f\u7269\u6cbb\u7597\u3001\u65e0\u7618\u7ba1\u3001\u57fa\u7ebf\u767d\u86cb\u767d\u6c34\u5e73\u9ad8\u53ca\u57fa\u7ebf CRP \u6c34\u5e73\u4f4e\uff0c\u53ef\u9884\u6d4bVDZ \u7597\u6548\u66f4\u4f73\u3002<\/p>\n

\u63a8\u8350\u610f\u89c120\uff1a\u63a8\u8350\u4e4c\u53f8\u5974\u5355\u6297\u7528\u4e8e\u4e2d\u91cd\u5ea6\u6d3b\u52a8\u671fCD \u60a3\u8005\u7684\u8bf1\u5bfc\u7f13\u89e3\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u4e4c\u53f8\u5974\u5355\u6297\uff08ustekinumab\uff0cUST\uff09\u6cbb\u7597\u4e2d\u91cd\u5ea6\u6d3b\u52a8\u6027CD \u7597\u6548\u53ca\u5b89\u5168\u6027\u7684\u2162\u671f\u4e34\u5e8aRCT \u7814\u7a76\u5305\u62ecUNIT\u20431\u53caUNIT\u20432\u3002\u5728UNIT\u20431 \u4e2d\uff0c\u6297TNF \u539f\u53d1\u6027\u5931\u5e94\u7b54\u7684\u60a3\u8005\u63a5\u53d7UST \u6cbb\u7597\u7b2c3\u30018 \u5468\u7684\u4e34\u5e8a\u7f13\u89e3\u7387\u5747\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec4\u548c\uff08\u7b2c3 \u5468\uff1a12.9% \u6bd45.7%\uff0cP\uff1c0.01\uff1b\u7b2c8 \u5468\uff1a20.9% \u6bd47.3%\uff0cP\uff1c0.01\uff09\uff3b151\uff3d*\u3002\u800c\u5728UNIT\u20432 \u4e2d\uff0c\u5bf9\u4e8e\u514d\u75ab\u6291\u5236\u5242\u6cbb\u7597\u5931\u8d25\u6216\u4e0d\u80fd\u8010\u53d7\u7684\u60a3\u8005\uff0c\u5176UST \u6cbb\u7597\u7b2c3\u30018 \u5468\u7684\u4e34\u5e8a\u7f13\u89e3\u7387\u5747\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec4\uff08\u7b2c3\u5468\uff1a23.0% \u6bd4 11.5%\uff0cP\uff1c0.01\uff1b\u7b2c 8 \u5468\uff1a40.2% \u6bd4 19.6%\uff0cP\uff1c 0.01\uff09\uff0c\u4e14UST \u6cbb\u7597\u7b2c3 \u5468\u53ef\u89c2\u5bdf\u5230CRP \u548cFC \u6c34\u5e73\u663e\u8457\u6539\u5584\u5e76\u6301\u7eed\u964d\u4f4e\uff3b151\uff3d*\u3002\u6700\u8fd1\u7684\u4e00\u9879Meta \u5206\u6790\u8868\u660e\uff0c\u4f7f\u7528UST \u8bf1\u5bfc CD \u7f13\u89e3\uff0c\u5728\u7b2c12 \u5468\u300124 \u5468\u53ca1 \u5e74\u7684\u4e34\u5e8a\u7f13\u89e3\u7387\u5206\u522b\u4e3a46%\u3001 51%\u300147%\uff0c\u4e9a\u6d32\u60a3\u8005\u4f7f\u7528UST \u8bf1\u5bfc\u6cbb\u7597\u540e\u7684\u4e34\u5e8a\u7f13\u89e3\u7387\u53ef\u80fd\u9ad8\u4e8e\u897f\u65b9\u4eba\u7fa4\uff3b152\uff3d\u3002\u56fd\u5185\u4e00\u9879\u591a\u4e2d\u5fc3\u771f\u5b9e\u4e16\u754c\u7814\u7a76\u7eb3\u5165\u4f7f\u7528UST \u8bf1\u5bfc\u6cbb\u7597\u7684122 \u4f8b\u4e2d\u91cd\u5ea6\u6d3b\u52a8\u6027CD \u60a3\u8005\uff0c\u7ed3\u679c\u663e\u793a\u5728\u7b2c8\u300120 \u5468\u7684\u4e34\u5e8a\u7f13\u89e3\u7387\u5206\u522b\u4e3a54.2%\u300164.9%\uff0c\u4e34\u5e8a\u5e94\u7b54\u7387\u5206\u522b\u4e3a62.9%\u300183.6%\uff3b153\uff3d\u3002\u4e00\u9879UST \u4e0eADA \u7597\u6548\u53ca\u5b89\u5168\u6027\u5bf9\u6bd4\u7684\u5934\u5bf9\u5934\u2162\u671fRCT \u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0c\u5bf9\u4e8e\u65e2\u5f80\u672a\u4f7f\u7528\u8fc7\u751f\u7269\u5236\u5242\u7684\u4e2d\u91cd\u5ea6\u6d3b\u52a8\u671fCD \u60a3\u8005\uff0cUST \u6216ADA \u8bf1\u5bfc\u671f\u4e34\u5e8a\u7f13\u89e3\u7387\u76f8\u5f53\uff3b154\uff3d*\u3002\u76ee\u524d\u5c1a\u65e0\u8bc1\u636e\u8868\u660eUST \u6cbb\u7597\u8fc7\u7a0b\u4e2d\u8054\u7528\u514d\u75ab\u6291\u5236\u5242\u53ef\u6709\u66f4\u9ad8\u83b7\u76ca\uff3b151\uff0c155\u2043156\uff3d\u3002<\/p>\n

\u63a8\u8350\u610f\u89c121\uff1a\u9009\u62e9\u6027JAK \u6291\u5236\u5242\u53ef\u7528\u4e8e\u6297TNF \u6cbb\u7597\u5931\u8d25\u7684\u4e2d\u91cd\u5ea6\u6d3b\u52a8\u671fCD \u60a3\u8005\u7684\u8bf1\u5bfc\u7f13\u89e3\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u4e4c\u5e15\u66ff\u5c3c\u662f\u76ee\u524d\u56fd\u5185\u552f\u4e00\u83b7\u6279CD \u9002\u5e94\u8bc1\u7684\u53e3\u670d\u5c0f\u5206\u5b50\u836f\u7269\uff0c\u4e3a\u9ad8\u9009\u62e9\u6027Janus \u6fc0\u9176\uff08Janus kinase\uff0cJAK\uff09 1 \u6291\u5236\u5242\u3002\u4e0a\u5e02\u524d\u5168\u7403\u591a\u4e2d\u5fc3\u7684\u2162\u671fRCT \u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0c\u5728 U\u2043 EXCEL \u7814\u7a76\u4e2d\u6cbb\u7597 12 \u5468\u4e4c\u5e15\u66ff\u5c3c\u7ec4\u8bf1\u5bfc\u7f13\u89e3\u7387\u8fbe 49.5%\uff0c\u663e\u8457\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec4\u768429.1%\uff08P\uff1c0.001\uff09\uff0c\u4e4c\u5e15\u66ff\u5c3c\u7ec4\u5185\u955c\u5e94\u7b54\u7387\u4e3a 38.9%\uff0c\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec4\u7684 21.1%\uff08P\uff1c0.001\uff09\u3002\u800c\u5728U\u2043EXCEED \u7814\u7a76\u4e2d\u4e5f\u6709\u7c7b\u4f3c\u7ed3\u679c\uff0c\u4e4c\u5e15\u66ff\u5c3c\u7ec4\u8bf1\u5bfc\u7f13\u89e3\u7387\u4e3a45.5%\uff0c\u663e\u8457\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec4\u768413.1%\uff0c\u4e4c\u5e15\u66ff\u5c3c\u7ec4\u5185\u955c\u5e94\u7b54\u7387\u4e3a34.6%\uff0c\u663e\u8457\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec43.5%\uff08P \u5747\uff1c0.001\uff09\uff3b157\uff3d*\u3002<\/p>\n

\u63a8\u8350\u610f\u89c122\uff1a\u5168\u80a0\u5185\u8425\u517b\u6709\u52a9\u4e8e\u6d3b\u52a8\u671fCD \u60a3\u8005\u7684\u8bf1\u5bfc\u7f13\u89e3\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a1\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u5168\u80a0\u5185\u8425\u517b\uff08exclusive enteral nutrition\uff0cEEN\uff09\u53ef\u4f5c\u4e3a\u513f\u7ae5\u53ca\u9752\u5c11\u5e74\u8f7b\u5ea6\u6d3b\u52a8\u6027CD \u8bf1\u5bfc\u7f13\u89e3\u7684\u4e00\u7ebf\u6cbb\u7597\u3002\u4e00\u9879\u8bc4\u4f30EEN \u6cbb\u7597\u513f\u7ae5\u6d3b\u52a8\u6027CD \u7684Meta \u5206\u6790\u7814\u7a76\u7ed3\u679c\u63d0\u793a\uff0cEEN \u5bf9\u513f\u7ae5\u6d3b\u52a8\u6027CD \u7684\u8bf1\u5bfc\u7f13\u89e3\u7387\u53ef\u8fbe80%\uff0c\u4e0e\u7cfb\u7edf\u6027\u7cd6\u76ae\u8d28\u6fc0\u7d20\u8bf1\u5bfc\u7f13\u89e3\u7387\u76f8\u5f53\u3002\u6b64\u5916\uff0cEEN \u8fd8\u5177\u6709\u7ea0\u6b63\u8425\u517b\u4e0d\u826f\u548c\u4fc3\u8fdb\u751f\u957f\u7684\u989d\u5916\u83b7\u76ca\uff3b158\uff3d*\u3002\u5173\u4e8eEEN \u6cbb\u7597\u6210\u4eba\u6d3b\u52a8\u6027 CD \u7684\u7597\u6548\uff0c\u65e9\u671f\u7814\u7a76\u663e\u793aEEN \u5728\u8bf1\u5bfc\u7f13\u89e3\u7597\u6548\u4e0a\u4e0e\u7cd6\u76ae\u8d28\u6fc0\u7d20\u76f8\u5f53\uff3b159\u2043160\uff3d\u3002\u8fd1\u671f\u4e00\u9879\u8bc4\u4f30EEN \u5bf9\u6d3b\u52a8\u6027CD \u7684\u8bf1\u5bfc\u7f13\u89e3\u4f5c\u7528\u7684 Meta \u5206\u6790\u663e\u793a\uff0c\u5728\u6210\u5e74\u4eba\u4e2d EEN \u8bf1\u5bfc\u7f13\u89e3\u7387\u4e3a 45%\uff0c\u4f4e\u4e8e\u7cd6\u76ae\u8d28\u6fc0\u7d20\u768473%\uff08RR = 0.65\uff0c95%CI\uff1a0.52 ~ 0.82\uff09\uff0c\u800c\u5728\u513f\u7ae5CD \u60a3\u8005\u4e2dEEN \u8bf1\u5bfc\u7f13\u89e3\u6709\u6548\u7387\u4e3a83%\uff0c\u7cd6\u76ae\u8d28\u6fc0\u7d20\u7ec4\u5219\u4e3a61%\uff08RR = 1.35\uff0c95%CI\uff1a0.92 ~ 1.97\uff09\uff3b161\uff3d*\u3002\u4e0d\u540cEEN\u5236\u5242\u5728\u8bf1\u5bfc\u7f13\u89e3\u7597\u6548\u4e0a\u65e0\u660e\u663e\u5dee\u522b\u3002EEN \u4f9d\u4ece\u6027\u8f83\u7cd6\u76ae\u8d28\u6fc0\u7d20\u5dee\uff0c\u8fd9\u4e5f\u662f\u4e34\u5e8a\u5b9e\u65bdEEN \u7684\u6700\u5927\u969c\u788d\u3002\u867d\u7136\u5173\u4e8e\u6210\u5e74\u4ebaEEN \u6cbb\u7597\u6d3b\u52a8\u671fCD \u7684\u7814\u7a76\u8bc1\u636e\u7ea7\u522b\u8f83\u4f4e\uff0c\u4ecd\u6709\u7814\u7a76\u663e\u793a\u5728\u8010\u53d7\u6027\u53ca\u4f9d\u4ece\u6027\u597d\u7684\u60c5\u51b5\u4e0b\uff0cEEN \u4e5f\u80fd\u6709\u6548\u5730\u8bf1\u5bfc\u6210\u4eba\u8f7b\u5ea6\u6d3b\u52a8\u6027CD \u7684\u7f13\u89e3\uff3b162\uff3d\u3002\u5bf9\u4e8e\u975e\u5355\u7eaf\u7ed3\u80a0\u7d2f\u53ca\u7684\u60a3\u8005\uff0cEEN\u7684\u8bf1\u5bfc\u7f13\u89e3\u6548\u679c\u4f18\u4e8e\u5355\u7eaf\u7ed3\u80a0\u7d2f\u53ca\u7684\u60a3\u8005\uff3b163\uff3d\u3002\u5728\u7ef4\u6301\u7f13\u89e3\u7597\u6548\u4e0a\uff0c\u4e00\u9879\u968f\u673a\u5bf9\u7167\u7814\u7a76\u7ed3\u679c\u663e\u793a\u90e8\u5206\u80a0\u5185\u8425\u517b\u7ec4\u590d\u53d1\u7387\u4e3a 34.6%\uff0c\u4f4e\u4e8e\u7cd6\u76ae\u8d28\u6fc0\u7d20\u7ec4 64.0%\uff08RR = 0.40\uff0c95%CI\uff1a0.16~ 0.98\uff09\uff3b164\uff3d\u3002<\/p>\n

\u63a8\u8350\u610f\u89c123\uff1a\u5408\u5e76\u611f\u67d3\u6216\u5b58\u5728\u809b\u5468\u590d\u6742\u7618\u7ba1\u7684CD \u60a3\u8005\u63a8\u8350\u4f7f\u7528\u6297\u751f\u7d20\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a1\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u603b\u4f53\u800c\u8a00\uff0c\u4e0e\u5b89\u6170\u5242\u76f8\u6bd4\uff0c\u5c1a\u65e0\u7814\u7a76\u663e\u793a\u6297\u751f\u7d20\u5728\u8bf1\u5bfc\u4e34\u5e8a\u7f13\u89e3\u6216\u9ecf\u819c\u6108\u5408\u4e0a\u7684\u786e\u5207\u7597\u6548\uff0c\u56e0\u6b64\u591a\u9879\u6307\u5357\u5747\u4e0d\u63a8\u8350\u4f7f\u7528\u6297\u751f\u7d20\u7528\u4e8e\u8bf1\u5bfc\u6216\u7ef4\u6301CD \u7f13\u89e3\uff3b2\uff0c133\uff0c135\uff0c164\uff3d\u3002\u6297\u751f\u7d20\u53ea\u7528\u4e8eCD \u5408\u5e76\u611f\u67d3\uff08\u8113\u80bf\u3001\u7ec6\u83cc\u8fc7\u5ea6\u751f\u957f\u3001\u8270\u96be\u68ad\u83cc\u7b49\uff09\u6216\u809b\u5468\u7618\u7ba1\u75c5\u53d8\u7684\u60a3\u8005\u3002<\/p>\n

2.\u7ef4\u6301\u7f13\u89e3<\/p>\n

\u7edd\u5927\u591a\u6570CD \u60a3\u8005\u8bf1\u5bfc\u7f13\u89e3\u6cbb\u7597\u540e\u9700\u7ef4\u6301\u6cbb\u7597\u3002\u7cd6\u76ae\u8d28\u6fc0\u7d20\u4f9d\u8d56\u662f\u7ef4\u6301\u6cbb\u7597\u7684\u7edd\u5bf9\u6307\u5f81\u3002\u5176\u4ed6\u60c5\u51b5\u5305\u62ec\u91cd\u5ea6CD \u8bf1\u5bfc\u7f13\u89e3\u540e\u3001\u9891\u7e41\u590d\u53d1\u3001\u5b58\u5728\u9ad8\u5371\u56e0\u7d20\uff0c\u5747\u5e94\u7ef4\u6301\u6cbb\u7597\u3002<\/p>\n

\u63a8\u8350\u610f\u89c124\uff1a\u7cd6\u76ae\u8d28\u6fc0\u7d20\u4e0d\u5e94\u7528\u4e8eCD \u7684\u7ef4\u6301\u6cbb\u7597\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a1\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u4e00\u9879\u7cfb\u7edf\u56de\u987e\u53caMeta \u5206\u6790\u7814\u7a76\u663e\u793a\uff0c\u968f\u8bbf24\u4e2a\u6708\uff0c\u91c7\u7528\u4f20\u7edf\u7cd6\u76ae\u8d28\u6fc0\u7d20\u7ef4\u6301\u6cbb\u7597\u5e76\u80fd\u4e0d\u964d\u4f4eCD \u60a3\u8005\u7684\u590d\u53d1\u98ce\u9669\uff3b165\uff3d*\u3002\u8fd1\u671f\u4e00\u9879\u7eb3\u5165\u5b89\u6170\u5242\u5bf9\u7167\u7814\u7a76\u7684Meta \u5206\u6790\u663e\u793a\uff0c\u7cd6\u76ae\u8d28\u6fc0\u7d20\u7684\u4f7f\u7528\u53ef\u63d0\u9ad8\u751f\u7269\u5236\u5242\u6cbb\u7597CD \u7684\u8bf1\u5bfc\u7f13\u89e3\u7387\uff0c\u4f46\u672a\u80fd\u6539\u5584\u7ef4\u6301\u7f13\u89e3\u7387\uff3b166\uff3d\u3002<\/p>\n

\u63a8\u8350\u610f\u89c125\uff1a\u560c\u5464\u7c7b\u836f\u7269\u53ca\u7532\u6c28\u8776\u5464\u53ef\u7528\u4e8eCD \u7684\u7ef4\u6301\u6cbb\u7597\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a1\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u4e00\u9879\u5305\u542b489 \u4f8b\u53d7\u8bd5\u8005\u7684Meta \u5206\u6790\u663e\u793a\uff0c\u786b\u5511\u560c\u5464\u5728\u7ef4\u6301\u7f13\u89e3\u65b9\u9762\u660e\u663e\u4f18\u4e8e\u5b89\u6170\u5242\u7ec4\uff3b167\uff3d*\u3002\u8fd1\u671f\u4e00\u9879\u7eb3\u516510 \u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u5171928 \u4f8b\u53d7\u8bd5\u8005\u7684Meta \u5206\u6790\u663e\u793a\uff0c\u786b\u5511\u560c\u5464\u548c6\u2043\u5def\u57fa\u560c\u5464\uff086\u2043mercaptopurine\uff0c6\u2043MP\uff09\u5728\u7ef4\u6301CD \u60a3\u8005\u672f\u540e\u7f13\u89e3\u65b9\u9762\u4f18\u4e8e\u5b89\u6170\u5242\uff3b168\uff3d\u3002\u82f1\u56fd\u8fd1\u671f\u4e00\u9879\u7eb3\u51656960 \u4f8b CD \u53d7\u8bd5\u8005\u7684\u56de\u987e\u6027\u961f\u5217\u7814\u7a76\u663e\u793a\uff0c\u7ed3\u80a0\u578bCD \u4f7f\u7528\u786b\u5511\u560c\u5464\u4f18\u4e8e\u56de\u7ed3\u80a0\u578b CD \u60a3\u8005\uff08OR = 1.60\uff0c95%CI\uff1a1.38 ~ 1.86\uff0cP = 0.002\uff09\uff0c\u800c\u5728\u75be\u75c5\u8bca\u65ad 1 \u5e74\u5185\u542f\u52a8\u6cbb\u7597\uff08OR = 0.69\uff0c95%CI\uff1a0.60 ~ 0.78\uff0cP\uff1c0.0001\uff09\u4ee5\u53ca\u5408\u5e76\u809b\u5468\u75c5\u53d8\u8005\uff08OR = 0.70\uff0c95%CI\uff1a0.61 ~ 0.80\uff0cP\uff1c0.0001\uff09\uff0c\u786b\u5511\u560c\u5464\u6548\u679c\u8f83\u4e0d\u660e\u663e\uff3b169\uff3d\u3002\u901a\u5e38\u60c5\u51b5\u4e0b\uff0c\u560c\u5464\u7c7b\u836f\u7269\u7528\u4e8e\u5bf9\u7cd6\u76ae\u8d28\u6fc0\u7d20\u4f9d\u8d56\u7684\u60a3\u8005\u6216\u8005\u4e0e\u751f\u7269\u5236\u5242\u8054\u7528\u4ee5\u51cf\u5c11\u514d\u75ab\u539f\u6027\uff3b6\uff3d\u3002\u4f7f\u7528\u560c\u5464\u7c7b\u836f\u7269\u53ef\u80fd\u4f1a\u5f15\u8d77\u6076\u5fc3\u3001\u8fc7\u654f\u53cd\u5e94\u3001\u6d41\u611f\u6837\u75c7\u72b6\u3001\u80f0\u817a\u708e\u3001\u809d\u6bd2\u6027\u3001\u9aa8\u9ad3\u6291\u5236\u3001\u6dcb\u5df4\u7624\u98ce\u9669\u589e\u52a0\uff0c\u7528\u836f\u671f\u95f4\u9700\u4e25\u5bc6\u76d1\u6d4b\u4e0d\u826f\u53cd\u5e94\uff3b167\uff3d\uff0c\u5efa\u8bae\u5b9a\u671f\u590d\u67e5\u8840\u5e38\u89c4\u3001\u809d\u529f\u80fd\u7b49\uff0c\u7279\u522b\u6ce8\u610f\u6709\u65e0\u9aa8\u9ad3\u6291\u5236\u3002NUDT15 \u57fa\u56e0\u591a\u6001\u6027\u68c0\u6d4b\u53ef\u5e2e\u52a9\u9884\u6d4b\u6211\u56fd\u4eba\u7fa4\u4f7f\u7528\u786b\u5511\u560c\u5464\u540e\u51fa\u73b0\u9aa8\u9ad3\u6291\u5236\u7684\u98ce\u9669\uff0c\u6709\u6761\u4ef6\u7684\u5355\u4f4d\u4f7f\u7528\u786b\u5511\u560c\u5464\u524d\u53ef\u884c\u68c0\u6d4b\uff3b170\uff3d\u3002\u53e6\u5916\uff0c\u957f\u671f\u4f7f\u7528\u786b\u5511\u560c\u5464\u9700\u8981\u5e73\u8861\u83b7\u76ca\u4e0e\u98ce\u9669\u3002<\/p>\n

\u560c\u5464\u7c7b\u836f\u7269\u6cbb\u7597\u65e0\u6548\u6216\u4e0d\u80fd\u8010\u53d7\u8005\u53ef\u8003\u8651\u6362\u7528\u7532\u6c28\u8776\u5464\u30022014 \u5e74\u4e00\u9879\u7cfb\u7edf\u6027\u56de\u987e\u663e\u793a\uff0c\u5728CD \u7ef4\u6301\u7f13\u89e3\u65b9\u9762\uff0c\u7532\u6c28\u8776\u546415 mg \u6bcf\u5468\u808c\u6ce81 \u6b21\u7597\u6548\u660e\u663e\u4f18\u4e8e\u5b89\u6170\u5242\u7ec4\uff0c\u4f46\u6bcf\u546812.5 ~ 15.0 mg \u53e3\u670d\u7532\u6c28\u8776\u5464\u7684\u7597\u6548\u4f18\u52bf\u4e0d\u660e\u663e\uff3b171\uff3d\u3002\u4f7f\u7528\u7532\u6c28\u8776\u5464\u4e5f\u9700\u8981\u76d1\u6d4b\u836f\u7269\u4e0d\u826f\u53cd\u5e94\uff0c\u5305\u62ec\u5b9a\u671f\u67e5\u8840\u5e38\u89c4\u3001\u809d\u529f\u80fd\u3002\u65e9\u671f\u6bd4\u8f83\u5e38\u89c1\u7684\u4e0d\u826f\u53cd\u5e94\u662f\u6d88\u5316\u9053\u75c7\u72b6\uff0c\u53f6\u9178\u53ef\u51cf\u8f7b\u6d88\u5316\u9053\u75c7\u72b6\uff0c\u53ef\u5e38\u89c4\u540c\u65f6\u4f7f\u7528\u3002\u6ce8\u610f\u598a\u5a20\u4e3a\u7532\u6c28\u8776\u5464\u4f7f\u7528\u7981\u5fcc\u8bc1\uff0c\u7528\u836f\u671f\u95f4\u548c\u505c\u836f\u540e\u6570\u6708\u5185\u907f\u514d\u598a\u5a20\u3002<\/p>\n

\u63a8\u8350\u610f\u89c126\uff1a\u4f7f\u7528\u751f\u7269\u5236\u5242\u8bf1\u5bfc\u7f13\u89e3\u7684CD \u60a3\u8005\uff0c\u5efa\u8bae\u7ee7\u7eed\u4f7f\u7528\u540c\u79cd\u751f\u7269\u5236\u5242\u7ef4\u6301\u6cbb\u7597\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1aACCENT\u2043\u2160\u7814\u7a76\u8868\u660eIFX \u7ef4\u6301\u6cbb\u7597\u80fd\u66f4\u597d\u5730\u5b9e\u73b0\u9ecf\u819c\u6108\u5408\u7684\u6cbb\u7597\u76ee\u6807\uff0c\u7ef4\u6301\u6cbb\u7597 30 \u5468\u4e34\u5e8a\u7f13\u89e3\u7387\u4e3a 39%\uff085 mg\/kg \u7ec4\uff09\u548c45%\uff0810 mg\/kg \u7ec4\uff09\uff3b85\uff3d\u3002\u8bc4\u4f30ADA \u7ef4\u6301\u7f13\u89e3\u6709\u6548\u6027\u7684CHARM \u7814\u7a76\u663e\u793a\uff0cADA \u6cbb\u7597\u7ec4\u5728\u7b2c26 \u5468\u65f6\u4e34\u5e8a\u7f13\u89e3\u7387\u4e3a40%\uff0c\u9ad8\u4e8e\u5b89\u6170\u5242\u768417%\uff08P\uff1c0.01\uff09\uff1b\u5728\u7b2c56 \u5468\u65f6\u7f13\u89e3\u7387\u4e3a36%\uff0c\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec4\u768412%\uff0c\uff08P\uff1c0.01\uff09\uff0c\u7ef4\u6301\u6cbb\u7597 CD \u8fbe4 \u5e74\u548c6 \u5e74\u4ecd\u53ef\u7ef4\u6301\u8f83\u4e3a\u7a33\u5b9a\u7684\u4e34\u5e8a\u7f13\u89e3\u7387\uff3b108\uff0c172\u2043173\uff3d\u3002\u4e00\u9879Meta \u5206\u6790\u663e\u793a\uff0c\u76f8\u8f83\u4e8e\u5b89\u6170\u5242\u800c\u8a00\uff0c\u6297TNF \u5236\u5242\u80fd\u591f\u66f4\u597d\u5730\u7ef4\u6301\u7f13\u89e3\uff0c\u4e14\u4e0d\u589e\u52a0\u6b7b\u4ea1\u3001\u6076\u6027\u80bf\u7624\u53ca\u4e25\u91cd\u611f\u67d3\u7684\u98ce\u9669\uff3b174\uff3d*\u3002<\/p>\n

\u7531\u4e8e\u6297TNF \u5236\u5242\u5b58\u5728\u514d\u75ab\u539f\u6027\u548c\u5931\u5e94\u7b54\u7684\u98ce\u9669\uff0c\u5efa\u8bae\u8054\u5408\u4f7f\u7528\u514d\u75ab\u6291\u5236\u5242\u4ee5\u51cf\u5c11IFX \u6297\u836f\u6297\u4f53\u7684\u4ea7\u751f\uff3b175\u2043176\uff3d\u3002\u4e00\u9879\u53cc\u76f2\u968f\u673a\u5bf9\u7167\u7814\u7a76\uff08SONIC\uff09\u8868\u660e\uff0c\u76f8\u8f83\u4e8eIFX \u5355\u836f\u6cbb\u7597\uff0cIFX\u8054\u7528\u786b\u5511\u560c\u5464\u5728\u6cbb\u7597\u7b2c26 \u5468\u7684\u65e0\u6fc0\u7d20\u4e34\u5e8a\u7f13\u89e3\u7387\u8fbe56.8%\uff0c\u663e\u8457\u9ad8\u4e8e\u5355\u836f\u6cbb\u7597\u768444.4%\uff08P = 0.02\uff09\uff1b\u8054\u5408\u6cbb\u7597\u7ec4\u7684\u9ecf\u819c\u6108\u5408\u7387\u8fbe43.9%\uff0c\u4e5f\u9ad8\u4e8e\u5355\u836f\u6cbb\u7597\u7ec4\u768430.1%\uff08P = 0.02\uff09\uff3b91\uff3d*\u3002\u8fdb\u4e00\u6b65\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u5728\u8fbe\u5230\u6df1\u5ea6\u7f13\u89e3\uff08\u4e34\u5e8a\u7f13\u89e3\u548c\u9ecf\u819c\u6108\u5408\uff09\u65b9\u9762\uff0c\u8054\u5408\u6cbb\u7597\u6bd4 IFX \u5355\u836f\u6216\u8005\u786b\u5511\u560c\u5464\u5355\u836f\u6cbb\u7597\u66f4\u5177\u4f18\u52bf\uff3b177\uff3d\u3002\u4e00\u9879\u6bd4\u8f83 ADA \u5355\u836f\u4e0e\u8054\u7528\u786b\u5511\u560c\u5464\u7597\u6548\u7684\u7814\u7a76\uff08DIAMOND\uff09\u663e\u793a\uff0c\u8054\u5408\u6cbb\u7597\u7ec4\u5728\u7b2c 26 \u5468\u7684\u4e34\u5e8a\u7f13\u89e3\u7387\u4e3a68.1%\uff0c\u76f8\u6bd4\u4e8e\u5355\u836f\u6cbb\u7597\u7ec4\u768471.8%\uff0c\u5dee\u5f02\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff08P =0.63\uff09\uff0c\u4f46\u8054\u5408\u6cbb\u7597\u7ec4\u7684\u5185\u955c\u4e0b\u6539\u5584\u7387\u4e3a84.2%\uff0c\u663e\u8457\u9ad8\u4e8e\u5355\u836f\u6cbb\u7597\u7ec4\u768463.8%\uff08P = 0.019\uff09\uff3b145\uff3d\u3002\u8fd1\u671f\u591a\u4e2a\u6307\u5357\u5747\u5efa\u8bae\u5bf9\u4e8e\u4f7f\u7528\u6297TNF \u5236\u5242\uff08\u5305\u62ecIFX \u548cADA\uff09\u8bf1\u5bfc\u7f13\u89e3\u7684CD \u60a3\u8005\uff0c\u5728\u7ef4\u6301\u671f\u5e94\u8be5\u7ee7\u7eed\u4f7f\u7528\u6297TNF \u5236\u5242\uff3b6\uff0c91\uff0c177\uff3d\u3002<\/p>\n

\u4e00\u7cfb\u5217\u7814\u7a76\u663e\u793a VDZ \u53ef\u6709\u6548\u6cbb\u7597\u4e2d\u91cd\u5ea6\u6d3b\u52a8\u6027 CD\uff3b147\u2043148\uff0c178\u2043187\uff3d*\u3002\u5728\u672a\u4f7f\u7528\u8fc7\u6297TNF \u5236\u5242\u7684\u4eba\u7fa4\u4e2d\uff0c\u4f7f\u7528VDZ\u5355\u6297\u6cbb\u7597\u7684\u83b7\u76ca\u53ef\u80fd\u8981\u9ad8\u4e8e\u65e2\u5f80\u4f7f\u7528\u8fc7\u6297 TNF \u5236\u5242\u7684\u4eba\u7fa4\uff3b188\uff3d\u3002GEMINI 2 \u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0c\u7b2c52 \u5468\u65f6\uff0cVDZ \u6bcf4 \u54681\u6b21\u548c\u6bcf8 \u54681 \u6b21\u6cbb\u7597\u7ec4\u4e34\u5e8a\u7f13\u89e3\u7387\u5206\u522b\u4e3a36.4% \u548c39.0%\uff0c\u5747\u663e\u8457\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec4\u768421.6%\uff08P \u5747\uff1c0.01\uff09\uff3b147\uff3d*\u3002VERSIFY \u7814\u7a76\u662f\u4e00\u9879\u8bc4\u4f30VDZ \u6cbb\u7597\u4e2d\u91cd\u5ea6CD \u60a3\u8005\u5185\u955c\u4e0b\u7597\u6548\u7684\u7814\u7a76\uff0c\u7b2c 26 \u548c 52 \u5468\u65f6\uff0c\u5206\u522b\u6709 11.9% \u548c 17.9% \u7684\u60a3\u8005\u83b7\u5f97\u5185\u955c\u4e0b\u7f13\u89e3\uff0c\u5c0f\u80a0\u78c1\u5171\u632f\u7ed3\u679c\u663e\u793a21.9% \u548c38.1% \u7684\u60a3\u8005\u83b7\u5f97\u5f71\u50cf\u5b66\u7f13\u89e3\uff3b94\uff3d\u3002VDZ \u5f00\u653e\u6807\u7b7e\u7684\u5ef6\u957f\u7814\u7a76\u663e\u793a\uff0c\u7b2c6 \u5468\u6709\u4e34\u5e8a\u5e94\u7b54\u7684\u4e2d\u91cd\u5ea6CD \u60a3\u8005\u6301\u7eed\u63a5\u53d7VDZ \u6cbb\u7597\uff0c\u5728\u7b2c104 \u548c152 \u5468\u5206\u522b\u670983% \u548c89% \u7684\u60a3\u8005\u83b7\u5f97\u4e34\u5e8a\u7f13\u89e3\uff3b189\uff3d\u3002\u6700\u8fd1\u7684Meta \u5206\u6790\u8868\u660e\uff0c\u5728\u4f7f\u7528VDZ \u8bf1\u5bfc\u53ca\u7ef4\u6301\u6cbb\u7597\u7684\u60a3\u8005\u4e2d\uff0c\u4e34\u5e8a\u5e94\u7b54\u7387\u8fbe56%\uff0c\u7f13\u89e3\u7387\u8fbe36%\uff0c\u65e0\u6fc0\u7d20\u4e34\u5e8a\u7f13\u89e3\u7387\u8fbe30%\uff0c\u9ecf\u819c\u6108\u5408\u7387\u8fbe29%\uff3b187\uff3d\u3002<\/p>\n

IM\u2043UNITI \u7814\u7a76\u663e\u793a\uff0cUST \u7ef4\u6301\u6cbb\u759744 \u5468\u540e\u7684\u4e34\u5e8a\u7f13\u89e3\u7387\u4e3a53.1%\uff08\u6bcf8 \u5468\u6ce8\u5c041 \u6b21\uff09\u548c48.8%\uff08\u6bcf12 \u5468\u6ce8\u5c041 \u6b21\uff09\uff0c\u5747\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec4\u768435.9%\uff08P \u5747\uff1c0.05\uff09\uff3b151\uff3d*\u3002UST \u7ef4\u6301\u6cbb\u75973 \u5e74\u7684\u4e34\u5e8a\u7f13\u89e3\u7387\u4e3a43.0%\uff08\u6bcf8 \u5468\u6ce8\u5c041 \u6b21\uff09\u548c38.0%\uff08\u6bcf12\u5468\u6ce8\u5c041 \u6b21\uff09\uff3b190\uff3d\u3002\u7ef4\u6301\u6cbb\u75975 \u5e74\u540e\u7684\u4e34\u5e8a\u7f13\u89e3\u7387\u4e3a54.9%\uff08\u6bcf8\u5468\u6ce8\u5c04 1 \u6b21\uff09\u548c 45.2%\uff08\u6bcf 12 \u5468\u6ce8\u5c04 1 \u6b21\uff09\uff3b191\uff3d\u3002\u5176\u4ed6\u7814\u7a76\u663e\u793a\uff0cUST \u7ef4\u6301\u6cbb\u75971 \u5e74\u65f6\u9ecf\u819c\u6108\u5408\u7387\u4e3a31%\uff3b192\uff3d*\uff0c\u7ec4\u7ec7\u5b66\u5e94\u7b54\u7387\u4e3a54%\uff3b193\uff3d\uff0c\u900f\u58c1\u6108\u5408\u7387\u4e3a24.1%\uff0c\u5176\u4e2d\u7ed3\u80a0\u900f\u58c1\u6108\u5408\u7387\u4e3a 50.0%\uff3b194\uff3d\u3002\u8fd1\u671f\u53e6\u4e00\u9879UST \u548cADA \u5934\u5bf9\u5934\u6bd4\u8f83\u7684\u2162b \u671f\u591a\u4e2d\u5fc3\u968f\u673a\u4e34\u5e8a\u8bd5\u9a8c\u7ed3\u679c\u663e\u793a\uff0cUST \u548cADA \u572852\u3001124 \u5468\u7684\u4e34\u5e8a\u7f13\u89e3\u7387\u76f8\u5f53\uff3b154\uff3d*\u3002\u4e00\u9879UST \u767b\u8bb0\u7814\u7a76\u663e\u793a\u5176\u5728\u8001\u5e74\u60a3\u8005\u4e2d\u4f7f\u7528\u7684\u5b89\u5168\u6027\u4e0e\u975e\u8001\u5e74CD \u60a3\u8005\u76f8\u5f53\uff3b195\uff3d\u3002\u800c\u6700\u8fd1\u4e00\u9879\u524d\u77bb\u6027\u961f\u5217\u7814\u7a76\u8bc4\u4f30\u4f7f\u7528UST \u957f\u8fbe104 \u5468\u7684\u6709\u6548\u6027\u548c\u5b89\u5168\u6027\uff0c\u7ed3\u679c\u663e\u793a 104 \u5468\u540e\u8d85\u8fc7\u4e00\u534a\u7684 CD \u60a3\u8005\u7ee7\u7eed\u4f7f\u7528UST \u7ef4\u6301\u6cbb\u7597\uff0c\u4e14\u4e09\u5206\u4e4b\u4e00\u8fbe\u5230\u65e0\u6fc0\u7d20\u7f13\u89e3\u72b6\u6001\uff0c7% \u60a3\u8005\u56e0\u4e3a\u836f\u7269\u4e0d\u826f\u53cd\u5e94\u505c\u7528UST\uff0c\u63d0\u793aUST \u6cbb\u7597CD \u662f\u6709\u6548\u4e14\u53ef\u8010\u53d7\u7684\uff3b196\uff3d\u3002<\/p>\n

\u63a8\u8350\u610f\u89c127\uff1a\u4f7f\u7528\u9009\u62e9\u6027JAK \u6291\u5236\u5242\u8bf1\u5bfc\u7f13\u89e3\u7684CD \u60a3\u8005\uff0c\u5efa\u8bae\u7ee7\u7eed\u4f7f\u7528\u540c\u79cd\u836f\u7269\u7ef4\u6301\u6cbb\u7597\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u5728\u5168\u7403\u591a\u4e2d\u5fc3\u7684\u2162\u671fRCT \u4e2d\uff0c\u4f7f\u752815 mg \u548c30 mg \u4e4c\u5e15\u66ff\u5c3c\u7ef4\u6301\u7f13\u89e3\uff0c\u5728\u7b2c 52 \u5468\u7684\u4e34\u5e8a\u7f13\u89e3\u7387\u5206\u522b\u4e3a37.3% \u548c47.6%\uff0c\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec4\u768415.1%\uff08P\uff1c0.001\uff09\uff1b\u5185\u955c\u5e94\u7b54\u7387\u5206\u522b\u4e3a 27.6% \u548c 40.1%\uff0c\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec4\u7684 7.3%\uff08P\uff1c 0.001\uff09\uff3b157\uff3d*\u3002<\/p>\n

\u9664\u4e0a\u8ff0\u7ecf\u5178\u7684\u6cbb\u7597CD \u7684\u836f\u7269\u5916\uff0c\u7814\u7a76\u62a5\u9053\u6c99\u5229\u5ea6\u80fa\u53ef\u6709\u6548\u6cbb\u7597\u6210\u4eba\u96be\u6cbb\u6027 CD\uff0c8 ~ 12 \u5468\u8bf1\u5bfc\u7f13\u89e3\u7387\u4e3a 46.8% ~ 85.1%\uff0c\u7d2f\u79ef\u7ef4\u6301\u7f13\u89e3\u73872 \u5e74\u5185\u572880% \u4ee5\u4e0a\uff0c24 \u5468\u65f6\u5185\u955c\u4e0b\u6709\u6548\u738763.6% ~ 68.4%\uff0c\u5185\u955c\u4e0b\u9ecf\u819c\u6108\u5408\u7387 23.6% ~ 28.1%\uff0c\u8bf1\u5bfc\u548c\u7ef4\u6301CD \u7f13\u89e3\u65f6\u591a\u91c7\u752850 mg\/d \u6216\u4ee5\u4e0a\u5242\u91cf\uff3b197\u2043200\uff3d\u3002\u5bf9\u4e8e\u5408\u5e76\u7618\u7ba1\u7684CD \u60a3\u8005\uff0c\u65e2\u5f80\u5c0f\u6837\u672c\u7684\u524d\u77bb\u6027\u7814\u7a76\u91c7\u7528200 mg\/d\u7684\u66f4\u9ad8\u5242\u91cf\uff0c\u5728\u7528\u836f\u540e\u7b2c4 \u5468\u4e34\u5e8a\u5e94\u7b54\u7387\u8fbe69%\uff0c\u4e34\u5e8a\u7f13\u89e3\u7387\u8fbe23%\uff0c\u670913% \u60a3\u8005\u7618\u7ba1\u95ed\u5408\uff3b201\uff3d\u3002\u6c99\u5229\u5ea6\u80fa\u6cbb\u7597\u9752\u5c11\u5e74\u548c\u513f\u7ae5\u96be\u6cbb\u6027CD \u60a3\u8005\u7684Meta \u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u8bf1\u5bfc\u671f\u4e34\u5e8a\u7f13\u89e3\u7387\u9ad8\u8fbe\u523080% ~ 100%\uff3b202\uff3d\u3002\u6c99\u5229\u5ea6\u80fa\u6cbb\u7597\u513f\u7ae5CD \u65f6\uff0c\u63a8\u8350\u5242\u91cf\u4e3a1.5 ~ 2.5 mg\u00b7kg-1\u00b7d-1\uff3b203\u2043204\uff3d\u3002\u8fd1\u671f\u8fd8\u6709\u7814\u7a76\u663e\u793a\u6c99\u5229\u5ea6\u80fa\u7528\u4e8eCD \u6cbb\u7597\u6709\u52a9\u4e8e\u7cd6\u76ae\u8d28\u6fc0\u7d20\u51cf\u505c\uff3b202\uff0c205\uff3d\u3002\u4f46\u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0c\u8be5\u836f\u7684\u7597\u6548\u53ca\u4e0d\u826f\u53cd\u5e94\u4e0e\u5242\u91cf\u76f8\u5173\uff0c\u9700\u8fdb\u884c\u76d1\u6d4b\u548c\u9884\u9632\u3002\u4f8b\u5982\u6c99\u5229\u5ea6\u80fa\u6709\u5f3a\u81f4\u7578\u4f5c\u7528\uff0c\u670d\u836f\u671f\u95f4\u5fc5\u987b\u4e25\u683c\u907f\u5b55\u3002\u5e38\u89c1\u4e0d\u826f\u53cd\u5e94\u6709\u55dc\u7761\u3001\u4fbf\u79d8\u3001\u76ae\u75b9\u3001\u5916\u5468\u795e\u7ecf\u75c5\u53d8\u7b49\u3002\u5f53\u51fa\u73b0\u5916\u5468\u795e\u7ecf\u75c5\u53d8\u65f6\uff0c\u987b\u51cf\u91cf\u6216\u505c\u836f\uff0c\u4ee5\u514d\u51fa\u73b0\u4e0d\u53ef\u9006\u7684\u635f\u4f24\u3002<\/p>\n

\u63a8\u8350\u610f\u89c128\uff1a\u5bf9\u4e8e\u957f\u5ea6\u5c0f\u4e8e5 cm \u7684\u80a0\u9053\u72ed\u7a84CD \u60a3\u8005\uff0c\u53ef\u8003\u8651\u4f7f\u7528\u5185\u955c\u4e0b\u7403\u56ca\u6269\u5f20\u6216\u5185\u955c\u4e0b\u72ed\u7a84\u5207\u5f00\u672f\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a3\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f31\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u7cfb\u7edf\u6027\u56de\u987e\u5206\u6790\u8868\u660e\uff0c\u5bf9\u4e8eCD \u80a0\u9053\u72ed\u7a84\u60a3\u8005\uff0c\u4f7f\u7528\u5185\u955c\u4e0b\u7403\u56ca\u6269\u5f20\u672f\uff0c\u53ef\u6709\u77ed\u671f\u53ca\u957f\u671f\u83b7\u76ca\u3002\u76f8\u8f83\u4e8e\u4f20\u7edf\u80a0\u9053\u5207\u9664\u672f\u540e\u8f83\u9ad8\u7684\u5e76\u53d1\u75c7\u53d1\u751f\u7387\uff0832.2%\uff09\uff0c\u5185\u955c\u4e0b\u7403\u56ca\u6269\u5f20\u672f\u672f\u540e\u5e76\u53d1\u75c7\u53d1\u751f\u7387\u8f83\u4f4e\uff0c\u4ec5\u4e3a4.7%\uff0c\u4f46\u518d\u6b21\u624b\u672f\u98ce\u9669\u8f83\u9ad8\uff0c\u4e3a44.4%\uff0c\u9ad8\u4e8e\u4f20\u7edf\u80a0\u9053\u624b\u672f\u768421.7%\uff3b206\u2043207\uff3d*\u3002\u72ed\u7a84\u957f\u5ea6\u5c0f\u4e8e5 cm\u3001\u4ec5\u4e00\u6bb5\u80a0\u7ba1\u7684\u72ed\u7a84\u3001\u5185\u955c\u4e0b\u7403\u56ca\u6269\u5f20\u6cbb\u7597\u95f4\u671f\u8f83\u957f\u3001\u975e\u5438\u70df\u8005\u7403\u56ca\u6269\u5f20\u672f\u540e\u624b\u672f\u98ce\u9669\u8f83\u4f4e\uff3b206\u2043208\uff3d\u3002\u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0c\u708e\u75c7\u6027\u72ed\u7a84\u5e76\u975e\u5185\u955c\u4e0b\u7403\u56ca\u6269\u5f20\u7684\u7981\u5fcc\u8bc1\uff0c\u4f46\u5bf9\u4e8e\u5408\u5e76\u6df1\u6e83\u75a1\u3001\u4e25\u91cd\u7c98\u8fde\u5904\u9700\u8c28\u614e\u8bc4\u4f30\uff3b209\uff3d\u3002\u76f8\u8f83\u4e8e\u5185\u955c\u4e0b\u7403\u56ca\u6269\u5f20\uff0c\u5185\u955c\u4e0b\u72ed\u7a84\u5207\u5f00\u672f\u7684\u75c7\u72b6\u53ca\u5185\u955c\u6539\u5584\u7387\u8f83\u9ad8\uff0c\u518d\u6b21\u624b\u672f\u98ce\u9669\u4e3a9.5%\uff0c\u4f4e\u4e8e\u5185\u955c\u4e0b\u7403\u56ca\u6269\u5f20\u768433.5%\u3002\u5185\u955c\u4e0b\u72ed\u7a84\u5207\u5f00\u672f\u6240\u81f4\u80a0\u9053\u7a7f\u5b54\u98ce\u9669\u8f83\u4f4e\uff0c\u4f46\u51fa\u8840\u98ce\u9669\u8f83\u9ad8\uff3b210\u2043211\uff3d*\u3002<\/p>\n

\u56db\u3001CD \u5408\u5e76\u809b\u5468\u75c5\u53d8\/\u7618\u7ba1\u578bCD \u5904\u7406\u539f\u5219<\/p>\n

\u63a8\u8350\u610f\u89c129\uff1a\u5408\u5e76\u809b\u5468\u8113\u80bf\u6216\u590d\u6742\u578b\u809b\u7618\uff0c\u9700\u5185\u5916\u79d1\u8054\u5408\u8bc4\u4f30\u53ca\u6cbb\u7597\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u4e00\u9879\u591a\u4e2d\u5fc3\u3001RCT \u7814\u7a76\uff08PISA\uff09\u6bd4\u8f83\u6302\u7ebf\u5f15\u6d41\u3001\u6297TNF \u6cbb\u7597\u53ca\u6297TNF \u6cbb\u7597\u540e\u5916\u79d1\u95ed\u5408\u7618\u53e33 \u79cd\u65b9\u5f0f\u5bf9CD \u809b\u7618\u7684\u7597\u6548\u5dee\u5f02\u3002PISA \u7814\u7a76\u539f\u8ba1\u5212\u7eb3\u5165126 \u4f8b\uff0c\u4f46\u56e0\u5355\u72ec\u6302\u7ebf\u5f15\u6d41\u7ec4\u7684\u518d\u6b21\u5e72\u9884\u7387\u660e\u663e\u9ad8\u4e8e\u6297TNF \u7ec4\u548c\u6297TNF \u8054\u5408\u624b\u672f\u7ec4\uff0810\/15 \u6bd46\/15 \u548c3\/14\uff0cP = 0.02\uff09\uff0c\u7ecf\u6570\u636e\u5b89\u5168\u76d1\u6d4b\u59d4\u5458\u4f1a\u5ba1\u67e5\u540e\u63d0\u524d\u4e2d\u6b62\u8be5\u9879\u7814\u7a76\uff1b\u968f\u540e\u57fa\u4e8e\u60a3\u8005\u504f\u597d\u3001\u975e\u968f\u673a\u7684\u524d\u77bb\u6027PISA \u6ce8\u518c\u961f\u5217\uff08n = 50\uff09\u672a\u89c2\u5bdf\u5230\u6302\u7ebf\u6cbb\u7597\u7684\u52a3\u6548\u6027\uff3b212\uff3d*\u3002\u4f46\u8be5\u7814\u7a76\u6837\u672c\u91cf\u5c0f\u4e14\u672a\u968f\u673a\u5316\uff0c\u8bc1\u636e\u7ea7\u522b\u6709\u9650\u3002\u4ee5\u4e0a\u6570\u636e\u63d0\u793a\u6302\u7ebf\u5f15\u6d41\u4e0d\u9002\u5408\u4f5c\u4e3aCD \u809b\u7618\u7684\u552f\u4e00\u6cbb\u7597\u65b9\u5f0f\uff0c\u800c\u5e94\u8054\u5408\u5185\u79d1\u6cbb\u7597\u3002<\/p>\n

\u4e00\u9879\u591a\u4e2d\u5fc3\u7684RCT \u7814\u7a76\uff08PISA\u2043\u2161\uff09\u6bd4\u8f83\u77ed\u671f\u6297TNF \u6cbb\u7597\u8054\u5408\u624b\u672f\u95ed\u5408\u7618\u53e3\u548c\u5355\u7eaf\u6297TNF \u6cbb\u7597\u5bf9CD \u809b\u7618\u7684\u7597\u6548\u5dee\u5f02\uff0866% \u53d7\u8bd5\u8005\u662f\u6309\u7167\u504f\u597d\u5206\u7ec4\uff09\u3002\u8be5\u7814\u7a76\u7eb3\u516594 \u4f8b\u5408\u5e76\u6d3b\u52a8\u6027\u9ad8\u4f4d\u809b\u7618\u4e14\u4ec5\u6709\u4e00\u4e2a\u5185\u53e3\u7684CD \u60a3\u8005\uff0c\u5176\u4e2d38 \u4f8b\uff0840%\uff09\u60a3\u8005\u63a5\u53d7\u624b\u672f\u95ed\u5408\u7618\u53e3\u6cbb\u7597\u8054\u54084 \u4e2a\u6708\u7684\u6297TNF \u6cbb\u7597\uff0c56 \u4f8b\uff0860%\uff09\u60a3\u8005\u63a5\u53d71 \u5e74\u7684\u6297TNF \u6cbb\u7597\uff0c\u4e3b\u8981\u7ec8\u70b9\u662f\u7b2c18 \u4e2a\u6708\u653e\u5c04\u5b66\u7618\u7ba1\u6108\u5408\u3002\u7ed3\u679c\u8868\u660e\uff0c\u8054\u5408\u6cbb\u7597\u7ec4\u653e\u5c04\u5b66\u7618\u7ba1\u6108\u5408\u7387\u4e3a 42%\uff0c\u9ad8\u4e8e\u6297TNF \u7ec4\u768418%\uff08P = 0.014\uff09\uff1b\u4e24\u7ec4\u7684\u4e0d\u826f\u4e8b\u4ef6\u53d1\u751f\u7387\u5dee\u5f02\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff3b213\uff3d*\u3002\u4e00\u9879\u7eb3\u5165 24 \u9879\u56de\u987e\u6027\u7814\u7a76\u7684 Meta \u5206\u6790\u4ea6\u663e\u793a\uff0c\u4e0e\u5355\u72ec\u7684\u624b\u672f\u6216\u6297TNF \u6cbb\u7597\u76f8\u6bd4\uff0c\u5185\u5916\u79d1\u8054\u5408\u6cbb\u7597CD \u5408\u5e76\u809b\u7618\u53ef\u80fd\u5177\u6709\u66f4\u597d\u7684\u7597\u6548\uff3b214\uff3d*\u3002<\/p>\n

\u63a8\u8350\u610f\u89c130\uff1a\u4e0d\u63a8\u8350\u5355\u7528\u6297\u751f\u7d20\u53ca\u786b\u560c\u5464\u7c7b\u836f\u7269\u6cbb\u7597CD \u5408\u5e76\u809b\u7618\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u4ec5\u6709\u4e00\u9879\u5c0f\u6837\u672c\u7684RCT \u7814\u7a76\u6bd4\u8f83\u5b89\u6170\u5242\u4e0e\u6297\u751f\u7d20\uff08\u73af\u4e19\u6c99\u661f\u6216\u7532\u785d\u5511\uff09\u6cbb\u7597\u809b\u7618\u7684\u7597\u6548\uff0c\u73af\u4e19\u6c99\u661f\u7ec4\u3001\u7532\u785d\u5511\u7ec4\u548c\u5b89\u6170\u5242\u7ec4\u7b2c10 \u5468\u7684\u809b\u7618\u7f13\u89e3\u7387\u5206\u522b\u662f2\/10\u30010\/7 \u548c 1\/8\uff0c\u7b2c10 \u5468\u7684\u809b\u7618\u5e94\u7b54\u7387\u5206\u522b\u662f4\/10\u30011\/7 \u548c1\/8\uff0c\u5dee\u5f02\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff08RR = 1.20\uff0c95%CI\uff1a0.17 ~ 8.38\uff0cP = 0.85\uff09\uff0c\u968f\u8bbf\u671f\u95f4\u5404\u7ec4\u6ca1\u6709\u89c2\u5bdf\u5230\u4e25\u91cd\u7684\u4e0d\u826f\u4e8b\u4ef6\uff3b215\uff3d*\u3002\u4e00\u9879\u968f\u673a\u3001\u53cc\u76f2\u3001\u5b89\u6170\u5242\u5bf9\u7167\u7684\u8bd5\u9a8c\uff08ADAFI\uff09\u8bc4\u4f30ADA \u8054\u5408\u73af\u4e19\u6c99\u661f\u6cbb\u7597CD \u5408\u5e76\u809b\u7618\u7684\u7597\u6548\u3002\u7814\u7a76\u7eb3\u516576 \u4f8b\u6709\u6d3b\u52a8\u6027\u809b\u7618\u7684CD \u60a3\u8005\uff0c\u7ed3\u679c\u663e\u793a\uff0cADA \u8054\u540812 \u5468\u73af\u4e19\u6c99\u661f\u7ec4\u7684\u809b\u7618\u4e34\u5e8a\u5e94\u7b54\u7387\u548c\u809b\u7618\u7f13\u89e3\u7387\u5206\u522b\u4e3a71% \u548c65%\uff0c\u5747\u663e\u8457\u9ad8\u4e8eADA \u8054\u5408\u5b89\u6170\u5242\u7ec4\uff0c\u4f4624 \u5468\u968f\u8bbf\u65f6\u4e24\u7ec4\u809b\u7618\u4e34\u5e8a\u5e94\u7b54\u7387\u5dee\u5f02\u65e0\u663e\u8457\u7edf\u8ba1\u5b66\u610f\u4e49\uff08P = 0.22\uff09\uff1b\u4e24\u7ec4\u7684\u603b\u4e0d\u826f\u4e8b\u4ef6\u548c\u4e25\u91cd\u4e0d\u826f\u4e8b\u4ef6\u53d1\u751f\u7387\u76f8\u5f53\u3002\u8fd9\u63d0\u793a\u6297\u751f\u7d20\u8054\u5408\u751f\u7269\u5236\u5242\u6cbb\u7597CD \u60a3\u8005\u6d3b\u52a8\u6027\u809b\u7618\u7684\u77ed\u671f\u7597\u6548\u4f18\u4e8eADA \u5355\u836f\u6cbb\u7597\uff0c\u4f46\u5c1a\u65e0\u8bc1\u636e\u63d0\u793a\u5176\u5f71\u54cd\u957f\u671f\u7597\u6548\uff3b216\uff3d*\u3002\u7efc\u4e0a\uff0c\u6297\u751f\u7d20\u5355\u836f\u7528\u4e8e\u4fc3\u8fdb\u809b\u7618\u6108\u5408\u7684\u8bc1\u636e\u6709\u9650\uff0c\u4f46\u6297\u751f\u7d20\u4ecd\u9002\u7528\u4e8eCD \u5408\u5e76\u809b\u5468\u6d3b\u52a8\u6027\u611f\u67d3\u3002<\/p>\n

\u786b\u560c\u5464\u7c7b\u836f\u7269\u4fc3\u8fdb\u590d\u6742\u809b\u7618\u6108\u5408\u7684\u7814\u7a76\u540c\u6837\u6709\u9650\uff0c\u57fa\u4e8e\u8fd9\u4e9b\u7814\u7a76\u7684\u7cfb\u7edf\u8bc4\u4ef7\u63d0\u793a\u786b\u5511\u560c\u5464\u5728\u4fc3\u8fdb\u809b\u7618\u6108\u5408\u65b9\u9762\u548c\u5b89\u6170\u5242\u76f8\u5f53\uff3b167\uff3d\u3002\u56e0\u6b64\uff0c\u4e0d\u63a8\u8350\u5355\u7528\u786b\u560c\u5464\u7c7b\u836f\u7269\u4fc3\u8fdb\u809b\u7618\u6108\u5408\u3002<\/p>\n

\u63a8\u8350\u610f\u89c131\uff1a\u63a8\u8350IFX \u7528\u4e8eCD \u5408\u5e76\u809b\u7618\u7684\u6cbb\u7597\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1aIFX \u662f\u9996\u4e2a\u7ecfRCT \u7814\u7a76\u8bc1\u5b9e\u53ef\u6709\u6548\u8bf1\u5bfc\u809b\u7618\u95ed\u5408\u7684\u836f\u7269\u3002\u4e00\u9879\u7eb3\u5165 94 \u4f8b\u7618\u7ba1\u578b CD \u60a3\u8005\u7684 RCT \u7814\u7a76\uff0890% \u4e3a\u809b\u7618\u60a3\u8005\uff09\u663e\u793a\uff0c5 mg\/kg IFX \u7ec4\u548c10 mg\/kg IFX \u7ec4\u7684\u7618\u7ba1\u6108\u5408\u7387\u5206\u522b\u4e3a 55% \u548c 38%\uff0c\u5747\u663e\u8457\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec4\u7684 13%\uff3b217\uff3d\u3002ACCENT \u2161\u8bd5\u9a8c\u8bc4\u4ef7\u4e86IFX \u5bf9\u7618\u7ba1\u578bCD \u7684\u7597\u6548\uff0c\u5176\u4e2d87% \u4e3a\u809b\u7618\u60a3\u8005\u300254 \u5468\u5b89\u6170\u5242\u7ec4\u548c5 mg\/kg IFX \u7ec4\u7684\u7618\u7ba1\u6108\u5408\u7387\u5206\u522b\u4e3a 19% \u548c 36%\uff0c\u5dee\u5f02\u5177\u6709\u7edf\u8ba1\u5b66\u610f\u4e49\uff08P = 0.009\uff09\uff3b218\uff3d*\u3002<\/p>\n

\u4e00\u4e9b\u56de\u987e\u6027\u6570\u636e\u8868\u660e\uff0c\u5728\u9ad8IFX \u8c37\u6d53\u5ea6\u7684\u60a3\u8005\u4e2d\uff0c\u7618\u7ba1\u6108\u5408\u7684\u53ef\u80fd\u6027\u66f4\u5927\uff0c\u4f46\u7f3a\u4e4f\u516c\u8ba4\u7684IFX \u8c37\u6d53\u5ea6\u9608\u503c\uff3b219\u2043221\uff3d\u3002<\/p>\n

\u63a8\u8350\u610f\u89c1 32\uff1a\u5efa\u8bae ADA\u3001UST \u7528\u4e8e CD \u5408\u5e76\u809b\u7618\u7684\u6cbb\u7597\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u76ee\u524d\u6ca1\u6709RCT \u7814\u7a76\u76f4\u63a5\u8bc4\u4f30ADA \u6cbb\u7597CD \u809b\u7618\u7684\u7597\u6548\u3002\u4e00\u9879\u53cc\u76f2\u3001\u5b89\u6170\u5242\u5bf9\u7167\u3001\u968f\u673a\u8bd5\u9a8c\uff08CHARM\uff09\u7684\u4e8b\u540e\u5206\u6790\uff0c\u7eb3\u5165\u57fa\u7ebf\u5b58\u5728\u809b\u7618\u548c\uff08\u6216\uff09\u80a0\u76ae\u7618\u7684CD \u60a3\u8005\uff08\u809b\u7618 113 \u4f8b\u3001\u80a0\u76ae\u76184 \u4f8b\uff09\u8fdb\u884c\u4e9a\u7ec4\u5206\u6790\uff0c\u7ed3\u679c\u663e\u793a\uff0c\u572856 \u5468\u7684\u968f\u8bbf\u671f\u95f4\uff0cADA \u7ec4\u7684\u5e73\u5747\u6bcf\u65e5\u6d3b\u52a8\u6027\u7618\u7ba1\u6570\u4e3a0.88 \u4e2a\uff0c\u663e\u8457\u4f4e\u4e8e\u5b89\u6170\u5242\u7ec4\u76841.34 \u4e2a\uff08P = 0.002\uff09\uff1b\u5728\u7b2c56 \u5468\u8fbe\u5230\u7618\u7ba1\u6108\u5408\u7684\u60a3\u8005\u4e2d\uff08\u5305\u62ecADA \u7ec4\u548c\u5b89\u6170\u5242\u7ec4\uff09\uff0c90% \u5728ADA \u5f00\u653e\u6807\u7b7e\u6cbb\u75971 \u5e74\u540e\u4fdd\u6301\u7618\u7ba1\u6108\u5408\uff3b222\uff3d*\u3002\u4e00\u9879\u5f00\u653e\u6807\u7b7e\u3001\u5355\u81c2\u3001\u591a\u4e2d\u5fc3\u3001 \u2162b \u671f\u8bd5\u9a8c\uff08CHOICE\uff09\u7eb3\u5165\u57fa\u7ebf\u6297 TNF \u6548\u679c\u6b20\u4f73\u7684\u7618\u7ba1\u578b CD \u60a3\u8005\uff08\u4e3b\u8981\u662f\u809b\u7618\uff09\uff0c\u663e\u793a\u5728ADA \u6cbb\u7597\u540e\uff0c39% \u60a3\u8005\u57284 ~ 36 \u5468\u7684\u968f\u8bbf\u671f\u95f4\u8fbe\u5230\u7618\u7ba1\u5b8c\u5168\u6108\u5408\uff3b223\uff3d*\u3002<\/p>\n

\u76ee\u524d\u6ca1\u6709\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u76f4\u63a5\u8bc4\u4f30UST \u6cbb\u7597CD \u809b\u7618\u7684\u7597\u6548\u3002\u5728\u5bf9CERTIFI \u548cUNITI 1\/2 \u7814\u7a76\u6570\u636e\u8fdb\u884c\u4e8b\u540e\u7684\u4e9a\u7ec4\u5206\u6790\u4e2d\uff0c\u57fa\u7ebf\u5408\u5e76\u6d3b\u52a8\u6027\u809b\u7618\u7684CD \u60a3\u8005\u5171150 \u4f8b\uff0cUST \u7ec4\u76848\u5468\u7618\u7ba1\u6108\u5408\u7387\u4e3a24.7%\uff0c\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec4\u768410%\uff0c\u4f46\u5dee\u5f02\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff08P = 0.073\uff09\uff3b224\uff3d\u3002IM\u2043UNITI \u7814\u7a76\u4e2d\u8d44\u6599\u5b8c\u6574\u7684\u5408\u5e76\u809b\u7618\u7684 CD \u60a3\u8005\u4e2d\uff0c\u7ed3\u679c\u663e\u793a UST \u7ec4 44 \u5468\u7684\u7618\u7ba1\u5e94\u7b54\u7387\u4e3a 80%\uff0812\/15\uff09\uff0c\u5b89\u6170\u5242\u7ec4\u4e3a45.5%\uff085\/11\uff09\uff0c\u5dee\u5f02\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff08P = 0.64\uff09\uff3b224\uff3d\u3002\u4e00\u9879\u591a\u4e2d\u5fc3\u7684\u56de\u987e\u6027\u961f\u5217\u7814\u7a76\uff08BioLAP\uff09\u5206\u6790 UST \u5bf9\u4e8e\u5408\u5e76\u6d3b\u52a8\u6027\u809b\u7618\u7684CD \u7684\u7597\u6548\uff0c\u7ed3\u679c\u663e\u793a6 \u4e2a\u6708\u7684\u6cbb\u7597\u6210\u529f\u7387\u4e3a 38.5%\uff0857\/148\uff09\uff0c\u800c 59 \u4f8b\u5408\u5e76\u9759\u6b62\u6027\u809b\u7618\u7684 CD \u60a3\u8005\u7b2c26 \u5468\u548c\u7b2c52 \u5468\u65e0\u809b\u7618\u590d\u53d1\u7684\u6982\u7387\u5206\u522b\u4e3a86.2%\u548c 75.1%\uff3b225\uff3d*\u3002\u4e00\u9879\u7cfb\u7edf\u6027 Meta \u5206\u6790\u7eb3\u5165 9 \u9879\u961f\u5217\u7814\u7a76\u7684 396 \u4f8b\u60a3\u8005\uff0c\u7ed3\u679c\u663e\u793a\u7b2c 8\u300124\u300152 \u5468\u7684\u7618\u7ba1\u5e94\u7b54\u7387\u5206\u522b\u662f41.0%\u300139.7% \u548c55.9%\uff1b\u7618\u7ba1\u7f13\u89e3\u7387\u5206\u522b\u4e3a17.1%\u300117.7% \u548c16.7%\uff3b226\uff3d*\u3002<\/p>\n

\u63a8\u8350\u610f\u89c133\uff1aVDZ \u53ef\u8003\u8651\u7528\u4e8eCD \u5408\u5e76\u809b\u7618\u7684\u6cbb\u7597\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f31\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u76ee\u524d\u6ca1\u6709\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u76f4\u63a5\u8bc4\u4f30VDZ \u6cbb\u7597 CD \u809b\u7618\u7684\u7597\u6548\u3002GEMINI 2 \u7814\u7a76\u7684\u4e9a\u7ec4\u5206\u6790\u7eb3\u5165 75 \u4f8b\u5bf9 VDZ \u6cbb\u75976 \u5468\u6709\u5e94\u7b54\u540c\u65f6\u57fa\u7ebf\u5408\u5e76\u6d3b\u52a8\u6027\u7618\u7ba1\u7684CD \u60a3\u8005\uff0c\u7ed3\u679c\u63d0\u793a\uff0cVDZ \u7ec4\u768414 \u53ca52 \u5468\u7618\u7ba1\u6108\u5408\u7387\u7edd\u5bf9\u503c\u867d\u7136\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec4\uff0c\u4f46\u5dee\u5f02\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff3b227\uff3d*\u3002\u4e00\u9879\u968f\u673a\u3001\u53cc\u76f2\u3001\u591a\u4e2d\u5fc3\u76844 \u671f\u8bd5\u9a8c\uff08ENTERPRISE\uff09\u6bd4\u8f832 \u79cdVDZ \u7684\u8bf1\u5bfc\u7b56\u7565\u6cbb\u7597 CD \u5408\u5e76\u809b\u7618\u7684\u7597\u6548\uff0c\u5408\u5e76\u4e24\u7ec4\u6570\u636e\u540e\u53d1\u73b0\uff0cVDZ \u6cbb\u7597\u7ec430\u5468\u809b\u7618\u5e94\u7b54\u7387\u548c\u809b\u7618\u6108\u5408\u7387\u5206\u522b\u662f53.6% \u548c42.9%\uff0c\u4f46\u8be5\u7814\u7a76\u7f3a\u4e4f\u5b89\u6170\u5242\u5bf9\u7167\u7ec4\uff3b228\uff3d*\u3002\u4e00\u9879Meta \u5206\u6790\u663e\u793a\uff0cVDZ \u6cbb\u7597\u540e\u809b\u7618\u5b8c\u5168\u6108\u5408\u548c\u90e8\u5206\u6108\u5408\u7387\u5206\u522b\u4e3a27.6% \u548c34.9%\uff3b229\uff3d*\u3002<\/p>\n

\u4e94\u3001CD \u56f4\u624b\u672f\u671f\u7ba1\u7406\u53ca\u9884\u9632\u672f\u540e\u590d\u53d1<\/p>\n

\u63a8\u8350\u610f\u89c134\uff1a\u5916\u79d1\u624b\u672f\u9002\u5e94\u8bc1\u5305\u62ec\u4e25\u91cd\u7684CD \u5e76\u53d1\u75c7\u3002\u5185\u79d1\u6cbb\u7597\u65e0\u6548\u8005\u53ef\u914c\u60c5\u8003\u8651\u624b\u672f\u6cbb\u7597\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u5f53CD \u60a3\u8005\u51fa\u73b0\u4e25\u91cd\u5e76\u53d1\u75c7\u5305\u62ec\u80a0\u7a7f\u5b54\u3001\u6301\u7eed\u6027\u6216\u590d\u53d1\u6027\u80a0\u6897\u963b\u3001\u4e0d\u9002\u5408\u7ecf\u76ae\u7a7f\u523a\u5f15\u6d41\u7684\u8179\u90e8\u8113\u80bf\u3001\u987d\u56fa\u6027\u6d88\u5316\u9053\u51fa\u8840\u3001\u5f02\u578b\u589e\u751f\u6216\u764c\u75c7\u65f6\uff0c\u9700\u8981\u5916\u79d1\u624b\u672f\uff3b230\u2043231\uff3d*\u3002<\/p>\n

\u80a0\u6897\u963b\u662fCD \u6700\u5e38\u89c1\u7684\u624b\u672f\u539f\u56e0\uff3b232\uff3d\u3002\u72ed\u7a84\u578bCD\uff0c\u5982\u679c\u4f34\u6709\u5185\u7618\u3001\u5c0f\u80a0\u6269\u5f20\uff1e3 cm\u3001\u708e\u6027\u5305\u5757\u6216\u8113\u80bf\uff0c\u88ab\u8ba4\u4e3a\u662f\u9ad8\u98ce\u9669\u7684\u72ed\u7a84\uff0c\u901a\u5e38\u9700\u8981\u624b\u672f\u6cbb\u7597\uff3b233\uff3d*\u3002\u65e0\u75c7\u72b6\u7618\u7ba1\u901a\u5e38\u4e0d\u9700\u8981\u624b\u672f\u6cbb\u7597\uff0c\u800c\u80a0\u76ae\u80a4\u7618\u3001\u80a0\u9634\u9053\u7618\u548c\u80a0\u8180\u80f1\u7618\u7b49\u5219\u901a\u5e38\u9700\u8981\u624b\u672f\u6cbb\u7597\uff3b234\u2043235\uff3d\u3002\u5f53\u60a3\u8005\u51fa\u73b0\u6076\u6027\u80bf\u7624\u3001\u975e\u817a\u7624\u6027\u4e0d\u5178\u578b\u589e\u751f\u76f8\u5173\u7684\u75c5\u53d8\u6216\u80bf\u5757\u3001\u9ad8\u5ea6\u5f02\u578b\u589e\u751f\u6216\u591a\u7076\u6027\u8f7b\u5ea6\u5f02\u578b\u589e\u751f\u65f6\uff0c\u5f3a\u70c8\u5efa\u8bae\u884c\u624b\u672f\u6cbb\u7597\uff3b236\uff3d\u3002\u5927\u90e8\u5206CD \u60a3\u8005\u51fa\u73b0\u6d88\u5316\u9053\u51fa\u8840\u65f6\u53ef\u4ee5\u901a\u8fc7\u5185\u79d1\u4fdd\u5b88\u6cbb\u7597\uff0c\u624b\u672f\u4ec5\u7528\u4e8e\u62a2\u6551\u8840\u6d41\u52a8\u529b\u5b66\u4e0d\u7a33\u5b9a\u7684\u96be\u6cbb\u6027\u6d88\u5316\u9053\u51fa\u8840\u60a3\u8005\uff3b237\uff3d\u3002<\/p>\n

\u53e6\u5916\uff0c\u5185\u79d1\u6cbb\u7597\u65e0\u6548\u7684CD \u60a3\u8005\u4e5f\u9700\u8981\u914c\u60c5\u8003\u8651\u624b\u672f\u6cbb\u7597\uff3b234\uff3d\u3002\u8179\u8154\u955c\u4e0b\u5207\u9664\u56de\u80a0\u672b\u7aef\u72ed\u7a84\u3001\u7ea4\u7ef4\u5316\u75be\u75c5\u548c\u75be\u75c5\u6d3b\u52a8\u7684\u56de\u80a0\u672b\u7aef\uff08\uff1c40 cm\uff09\u662f\u8f83\u597d\u7684\u6cbb\u7597\u9009\u62e9\uff0c\u5176\u76ca\u5904\u548c\u98ce\u9669\u53ef\u4e0e\u836f\u7269\u6cbb\u7597\u76f8\u5ab2\u7f8e\uff3b2\uff3d\u3002\u4e00\u9879\u6765\u81ea\u6b27\u6d32\u7684\u524d\u77bb\u6027\u3001\u968f\u673a\u5bf9\u7167\u3001\u591a\u4e2d\u5fc3\u8bd5\u9a8c\u5c06\u8179\u8154\u955c\u4e0b\u56de\u76f2\u90e8\u5207\u9664\u672f\u4e0eIFX \u8fdb\u884c\u6bd4\u8f83\uff0c\u8be5\u8bd5\u9a8c\u7eb3\u5165\u5c40\u9650\u6027\u56de\u80a0\u672b\u7aef\u7684CD \u60a3\u8005\uff0c\u4e14\u5176\u5bf9\u5e38\u89c4\u7684\u514d\u75ab\u8c03\u8282\u5242\u6216\u7cd6\u76ae\u8d28\u6fc0\u7d20\u6cbb\u7597\u65e0\u6548\u8fbe3 \u4e2a\u6708\u4ee5\u4e0a\uff0c\u540c\u65f6\u6ca1\u6709\u51fa\u73b0\u660e\u663e\u7684\u80a0\u9053\u72ed\u7a84\u3002\u5728\u6cbb\u759712 \u4e2a\u6708\u540e\uff0c\u4e0eIFX \u7ec4\u76f8\u6bd4\uff0c\u624b\u672f\u5207\u9664\u7ec4\u60a3\u8005\u7684\u751f\u6d3b\u8d28\u91cf\u5f97\u5230\u66f4\u597d\u7684\u6539\u5584\uff3b238\uff3d*\u3002<\/p>\n

\u63a8\u8350\u610f\u89c135\uff1a\u62e9\u671f\u624b\u672f\u7684CD \u60a3\u8005\u672f\u524d\u5e94\u8fdb\u884c\u8bc4\u4f30\uff0c\u5e76\u8fdb\u884c\u56f4\u624b\u672f\u671f\u7ba1\u7406\uff0c\u5305\u62ec\u8425\u517b\u652f\u6301\u6cbb\u7597\u3001\u836f\u7269\u7ba1\u7406\u7b49 \u3002\uff08BPS\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u62e9\u671f\u624b\u672f\u7684CD \u60a3\u8005\u672f\u524d\u5e94\u63a5\u53d7\u7cfb\u7edf\u8bc4\u4f30\uff0c\u5305\u62ec\u672f\u524d\u6a2a\u65ad\u9762\u5f71\u50cf\u5b66\uff08CTE\u3001MRE\u3001\u80a0\u9053\u8d85\u58f0\uff09\u3001\u5185\u955c\u3001\u8425\u517b\u72b6\u51b5\u7b49\u8bc4\u4f30\uff0c\u5e76\u8fdb\u884c\u56f4\u624b\u672f\u671f\u7ba1\u7406\uff0c\u5982\u8425\u517b\u4f18\u5316\u3001\u9002\u5f53\u8c03\u6574\u836f\u7269\u6cbb\u7597\u3001\u672f\u524d\u8113\u80bf\u548c\u8702\u7a9d\u7ec7\u708e\u7684\u5904\u7406\u3001\u6212\u70df\u548c\u8840\u6813\u6813\u585e\u9884\u9632\u7b49\uff3b239\uff3d\u3002<\/p>\n

\uff081\uff09\u8425\u517b\uff1aCD \u60a3\u8005\u5728\u624b\u672f\u524d\u5e94\u8fdb\u884c\u8425\u517b\u8bc4\u4f30\uff3b240\u2043241\uff3d\u3002\u8425\u517b\u4e0d\u826f\u662fCD \u672f\u540e\u51fa\u73b0\u5e76\u53d1\u75c7\u7684\u4e3b\u8981\u98ce\u9669\u56e0\u7d20\uff3b241\uff3d\uff0c\u4e0e\u60a3\u8005\u7684\u4e34\u5e8a\u75c5\u7a0b\u3001\u672f\u540e\u5e76\u53d1\u75c7\u7684\u53d1\u751f\u7387\u548c\u6b7b\u4ea1\u7387\u5448\u8d1f\u76f8\u5173\uff3b241\uff3d\u300230% ~ 50% \u7684 CD \u60a3\u8005\u5728\u75c5\u7a0b\u7684\u67d0\u4e2a\u65f6\u6bb5\u9700\u8981\u624b\u672f\uff0c\u636e\u4f30\u8ba1\u9ad8\u8fbe85% \u7684\u62e9\u671f\u624b\u672f\u60a3\u8005\u5b58\u5728\u8425\u517b\u4e0d\u826f\u3002\u672f\u524d\u8fdb\u884c\u8425\u517b\u4f18\u5316\u6cbb\u7597\uff0c\u53ef\u4ee5\u51cf\u5c11CD \u60a3\u8005\u672f\u540e\u5e76\u53d1\u75c7\uff0c\u5c24\u5176\u662f\u8113\u6bd2\u6027\u5e76\u53d1\u75c7\u7684\u53d1\u751f\u7387\uff3b242\u2043245\uff3d\u3002\u5bf9\u8425\u517b\u7f3a\u4e4f\u7684CD \u60a3\u8005\uff0c\u53e3\u670d\u8425\u517b\u8865\u5145\u5242\u6216\u7ba1\u9972\u996e\u98df\u53ef\u4f5c\u4e3a\u9996\u9009\uff3b241\uff3d\u3002\u672f\u524d\u8425\u517b\u4f18\u5316\u63aa\u65bd\u5305\u62ec\u672f\u524d\u81f3\u5c111 \u5468\u8fdb\u884c\u672f\u524d\u8425\u517b\u652f\u6301\uff0c\u5305\u62ec\u80a0\u5185\u8425\u517b\u3001\u80a0\u5916\u8425\u517b\u6216\u8054\u5408\u8425\u517b\u65b9\u6cd5\uff3b246\uff3d\u3002\u672f\u524dEEN \u53ef\u4ee5\u964d\u4f4e\u8840\u6e05CRP \u7684\u6c34\u5e73\uff0c\u7f29\u77ed\u624b\u672f\u65f6\u95f4\u53ca\u51cf\u5c11\u672f\u540e\u8113\u80bf\u3001\u79ef\u6db2\u53ca\u543b\u5408\u53e3\u7618\u7684\u53d1\u751f\uff3b247\u2043248\uff3d\u3002\u4f46\u4e5f\u6709\u6587\u732e\u63d0\u793a\u5728\u624b\u672f\u524d 18 ~ 30 d \u884c EEN \u53ef\u4ee5\u6062\u590d\u8eab\u4f53\u7684\u8425\u517b\u8d2e\u5b58\uff0c\u964d\u4f4e\u672f\u540e\u5e76\u53d1\u75c7\uff0c\u7f29\u5c0f\u624b\u672f\u5207\u9664\u8303\u56f4\uff3b244\uff3d*\u3002\u6d3b\u52a8\u671fCD \u60a3\u8005\u7684\u86cb\u767d\u8d28\u6444\u5165\u91cf\u5e94\u8fbe\u52301.2 ~ 1.5 g\u00b7kg-1\u00b7d-1\uff3b249\uff3d\u3002\u5e94\u53ca\u65f6\u76d1\u6d4b\u548c\u7ea0\u6b63\u5fae\u91cf\u8425\u517b\u7d20\u7f3a\u4e4f\uff0c\u4f8b\u5982\u94c1\u3001\u7ef4\u751f\u7d20B12\u3001\u7ef4\u751f\u7d20D \u548c\u950c\u7b49\uff3b249\uff3d\u3002<\/p>\n

\uff082\uff09\u7cd6\u76ae\u8d28\u6fc0\u7d20\uff1a\u672f\u524d\u4f7f\u7528\u7cd6\u76ae\u8d28\u6fc0\u7d20\u4e0e\u591a\u79cd\u672f\u540e\u5e76\u53d1\u75c7\u7684\u9ad8\u98ce\u9669\u76f8\u5173\uff0c\u5305\u62ec\u6d45\u8868\u5916\u79d1\u624b\u672f\u90e8\u4f4d\u611f\u67d3\u3001\u6df1\u90e8\u95f4\u9699\u611f\u67d3\u548c\u543b\u5408\u53e3\u7618\uff3b250\u2043253\uff3d*\u3002\u6b64\u5916\uff0c\u7cd6\u76ae\u8d28\u6fc0\u7d20\u4e0e\u9759\u8109\u8840\u6813\u6813\u585e\u7684\u98ce\u9669\u589e\u52a0\u76f8\u5173\uff3b252\uff3d\u3002\u56f4\u624b\u672f\u671f\u901a\u8fc7\u51cf\u5c11\u672f\u4e2d\u5e94\u6fc0\u5242\u91cf\u5e76\u5728\u53ef\u80fd\u7684\u60c5\u51b5\u4e0b\u8fc5\u901f\u51cf\u5c11\u7cd6\u76ae\u8d28\u6fc0\u7d20\u66b4\u9732\uff08\u7406\u60f3\u60c5\u51b5\u4e0b\u624b\u672f\u65f6\u6cfc\u5c3c\u677e\u5242\u91cf\uff1c20 mg\/d\uff09\u53ef\u4ee5\u6539\u5584\u672f\u540e\u611f\u67d3\u5e76\u53d1\u75c7\u7684\u53d1\u751f\u7387\uff3b254\uff3d\u3002<\/p>\n

\u56de\u987e\u6027\u7814\u7a76\u8868\u660e\uff0c\u5728\u591a\u91cd\u98ce\u9669\u56e0\u7d20\uff08\u7cd6\u76ae\u8d28\u6fc0\u7d20\u3001\u514d\u75ab\u6291\u5236\u5242\u53ca\u751f\u7269\u5236\u5242\u8054\u5408\u6cbb\u7597\u548c\u591a\u6b21\u624b\u672f\u5207\u9664\uff09\u7684\u80cc\u666f\u4e0b\uff0c\u60a3\u8005\u53d1\u751f\u8179\u8154\u5185\u8113\u6bd2\u75c7\u7684\u98ce\u9669\u663e\u8457\u589e\u52a0\uff0c\u5728\u8fd9\u4e9b\u60c5\u51b5\u4e0b\uff0c\u5e94\u8003\u8651\u884c\u4fdd\u62a4\u6027\u9020\u53e3\u672f\uff3b255\u2043256\uff3d\u3002\u4e00\u9879\u524d\u77bb\u6027\u7814\u7a76\u8868\u660e\uff0c\u7cd6\u76ae\u8d28\u6fc0\u7d20\u7684\u4f7f\u7528\u548c\u672f\u524d\u8113\u80bf\u4e0eCD \u56de\u7ed3\u80a0\u5207\u9664\u672f\u540e\u543b\u5408\u53e3\u5e76\u53d1\u75c7\u7684\u53d1\u751f\u7387\u8f83\u9ad8\u76f8\u5173\uff0c\u5f53\u4e24\u79cd\u5371\u9669\u56e0\u7d20\u5747\u5b58\u5728\u65f6\uff0c\u5e94\u907f\u514d\u4e00\u671f\u543b\u5408\uff0c\u8003\u8651\u4fdd\u62a4\u6027\u9020\u53e3\u672f\uff3b257\uff3d\u3002<\/p>\n

\uff083\uff09\u514d\u75ab\u6291\u5236\u5242\uff1a\u652f\u6301\u786b\u5511\u560c\u5464\u3001\u5def\u57fa\u560c\u5464\u6216\u7532\u6c28\u8776\u5464\u5728\u56f4\u624b\u672f\u671f\u5b89\u5168\u6027\u7684\u6570\u636e\u5927\u591a\u662f\u56de\u987e\u6027\u7684\uff0c\u8868\u660e\u624b\u672f\u524d\u6301\u7eed\u4f7f\u7528\u4e0d\u4f1a\u5bf9\u672f\u540e\u7ed3\u679c\u4ea7\u751f\u4e0d\u5229\u5f71\u54cd\uff3b251\uff0c258\uff3d\u3002\u7136\u800c\uff0c\u4e00\u9879\u524d\u77bb\u6027\u7814\u7a76\u62a5\u544a\u663e\u793a\uff0c\u5728\u63a5\u53d7\u4e00\u671f\u543b\u5408\u624b\u672f\u7684CD \u60a3\u8005\u4e2d\uff0c\u672f\u524d\u8d85\u8fc7 3 \u4e2a\u6708\u53ca\u672f\u540e6 \u5468\u5185\u670d\u7528\u786b\u560c\u5464\u7c7b\u836f\u7269\uff0c\u5176\u8179\u90e8\u8113\u6bd2\u6027\u5e76\u53d1\u75c7\u7684\u98ce\u9669\u589e\u52a0\uff08\u4f7f\u7528\u786b\u560c\u5464\u7c7b\u836f\u7269\u7684\u98ce\u9669\u4e3a16%\uff0c\u800c\u4e0d\u4f7f\u7528\u786b\u560c\u5464\u7c7b\u836f\u7269\u6cbb\u7597\u7684\u98ce\u9669\u4e3a6%\uff0cP\uff1c0.05\uff09\uff3b259\uff3d*\u3002\u5982\u679c\u540c\u65f6\u5b58\u5728\u5176\u4ed6\u5371\u9669\u56e0\u7d20\u5982\u672f\u524d\u8179\u8154\u5185\u8113\u80bf\u6216\u7ed3\u80a0\u2043\u7ed3\u80a0\u543b\u5408\uff0c\u5219\u8113\u6bd2\u6027\u5e76\u53d1\u75c7\u7684\u98ce\u9669\u589e\u52a0\u523024%\uff0c\u4f46\u5f53\u8fd9\u4e24\u79cd\u5371\u9669\u56e0\u7d20\u5747\u4e0d\u5b58\u5728\u65f6\uff0c\u611f\u67d3\u6027\u5e76\u53d1\u75c7\u7684\u98ce\u9669\u4ec5\u4e3a4%\uff08P = 0.001\uff09\u3002<\/p>\n

\uff084\uff09\u751f\u7269\u5236\u5242\uff1a\u672f\u524d\u4f7f\u7528\u6297TNF \u5236\u5242\u662f\u5426\u589e\u52a0\u672f\u540e\u5e76\u53d1\u75c7\u66fe\u6709\u4e89\u8bae\u3002\u6709Meta \u5206\u6790\u663e\u793a\u672f\u524d12 \u5468\u5185\u4f7f\u7528\u6297TNF \u5236\u5242\u663e\u8457\u589e\u52a0CD \u672f\u540e\u8179\u8154\u5185\u8113\u80bf\u548c\u518d\u4f4f\u9662\u7387\uff3b260\uff3d\u3002\u4f46\u6240\u7eb3\u5165\u7684\u7814\u7a76\u591a\u4e3a\u56de\u987e\u6027\u3001\u5c0f\u6837\u672c\u7684\u7814\u7a76\uff0c\u8bc1\u636e\u7ea7\u522b\u6781\u4f4e\uff3b261\uff3d\u3002\u800c\u6700\u8fd1\u7684\u4e00\u9879\u524d\u77bb\u6027\u591a\u4e2d\u5fc3\u961f\u5217\u7814\u7a76\uff0c\u5171\u7eb3\u5165947 \u4f8bIBD \u60a3\u8005\uff0c\u5176\u4e2dCD \u60a3\u8005640 \u4f8b\uff0c\u591a\u56e0\u7d20\u5206\u6790\u663e\u793a\u672f\u524d12 \u5468\u5185\u5e94\u7528\u6297TNF\u5236\u5242\u5e76\u4e0d\u589e\u52a0\u4efb\u4f55\u611f\u67d3\u548c\u624b\u672f\u90e8\u4f4d\u611f\u67d3\u98ce\u9669\uff3b262\uff3d*\u3002\u4e00\u9879\u56de\u987e\u6027\u7814\u7a76\u663e\u793a\uff0cCD \u60a3\u8005\u884c\u5fae\u521b\u56de\u7ed3\u80a0\u5207\u9664\u672f\u672f\u524d\u63a5\u53d7\u6297TNF\u5236\u5242\u3001UST\u3001VDZ \u4e0e\u672f\u524d3 \u4e2a\u6708\u5185\u672a\u63a5\u53d7\u751f\u7269\u5236\u5242\u6cbb\u7597\u76f8\u6bd4\uff0c\u672f\u540e\u5177\u6709\u7b49\u540c\u7684\u5b89\u5168\u6027\uff0c4 \u7ec4\u8179\u8154\u5185\u8113\u6bd2\u6027\u5e76\u53d1\u75c7\u3001\u624b\u672f\u90e8\u4f4d\u611f\u67d3\u7387\u300130 d \u603b\u4f53\u53d1\u75c5\u7387\u7b49\u5dee\u5f02\u5747\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff3b263\uff3d\u3002\u6545\u76ee\u524d\u7684\u8bc1\u636e\u663e\u793aCD \u672f\u524d\u4f7f\u7528\u751f\u7269\u5236\u5242\u5982\u6297TNF \u5236\u5242\u3001VDZ\u548cUST \u6cbb\u7597\uff0c\u4e0d\u4f1a\u589e\u52a0\u672f\u540e\u5e76\u53d1\u75c7\u7684\u98ce\u9669\uff0cCD \u672f\u524d\u65e0\u9700\u5f3a\u5236\u505c\u7528\u751f\u7269\u5236\u5242\uff3b2\uff3d\uff0c\u4f46\u5177\u4f53\u7684\u51b3\u7b56\u5e94\u8be5\u662f\u4e2a\u4f53\u5316\u7684\u3002<\/p>\n

\uff085\uff09\u6297 \u51dd \uff1aCD \u60a3 \u8005 \u4e0d \u4ec5 \u60a3 \u6df1 \u9759 \u8109 \u8840 \u6813\uff08deep vein thrombosis\uff0cDVT\uff09\u5f62\u6210\u548c\u80ba\u90e8\u6813\u585e\u7684\u98ce\u9669\u9ad8\u4e8e\u56e0\u5176\u4ed6\u75be\u75c5\u9700\u8981\u8179\u90e8\u624b\u672f\u7684\u60a3\u8005\uff0c\u800c\u4e14\u60a3\u5176\u4ed6\u8840\u6813\u6813\u585e\u5e76\u53d1\u75c7\u7684\u98ce\u9669\u4e5f\u66f4\u9ad8\uff3b264\u2043265\uff3d*\u3002\u9759\u8109\u8840\u6813\u6813\u585e\uff08venous thromboembolism\uff0cVTE\uff09\u98ce\u9669\u7684\u589e\u52a0\u662f\u591a\u56e0\u7d20\u7684\uff0c\u708e\u75c7\u6d3b\u52a8\u3001\u957f\u671f\u4f4f\u9662\u3001\u7cd6\u76ae\u8d28\u6fc0\u7d20\u66b4\u9732\u3001\u8425\u517b\u4e0d\u826f\u3001\u8d2b\u8840\u3001\u8840\u5c0f\u677f\u589e\u591a\u548c\u884c\u52a8\u80fd\u529b\u4e0b\u964d\u90fd\u4f1a\u589e\u52a0 CD \u56f4\u624b\u672f\u671fVTE \u98ce\u9669\uff3b264\uff0c266\uff3d\u3002\u6025\u8bca\u624b\u672f\u4e5f\u662fVTE \u7684\u4e00\u4e2a\u72ec\u7acb\u98ce\u9669\u56e0\u7d20\uff3b267\uff3d\u3002CD \u60a3\u8005\u672f\u540e\u51fa\u73b0VTE \u7684\u5e73\u5747\u65f6\u95f4\u4e3a10.8 d\uff0c\u5c3d\u7ba1\u98ce\u9669\u81f3\u5c11\u5ef6\u957f\u523030 d\uff3b267\uff3d\u3002<\/p>\n

\u63a8\u8350\u610f\u89c136\uff1a\u5bf9\u4e8e\u6709\u590d\u53d1\u5371\u9669\u56e0\u7d20\u7684CD \u60a3\u8005\uff0c\u5efa\u8bae\u5728\u80a0\u5207\u9664\u672f\u540e\u8fdb\u884c\u79ef\u6781\u9884\u9632\u6027\u6cbb\u7597\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1aCD \u672f\u540e\u590d\u53d1\u7684\u5371\u9669\u56e0\u7d20\u5305\u62ec\u5438\u70df\u3001\u8bca\u65ad\u65f6\u5e74\u9f84\u8f83\u8f7b\u3001\u65e2\u5f80\u80a0\u9053\u624b\u672f\u53f2\u3001\u7a7f\u900f\u6027\u75be\u75c5\u3001\u809b\u5468\u75c5\u53d8\u3001\u5e7f\u6cdb\u5c0f\u80a0\u75be\u75c5\uff08\u7d2f\u53ca\u80a0\u9053\u957f\u5ea6\u226550 cm\uff09\uff3b268\uff3d\u3002\u5207\u9664\u65f6\u7684\u7ec4\u7ec7\u5b66\u7279\u5f81\uff0c\u5982\u9633\u6027\u5207\u9664\u8fb9\u7f18\u3001\u808c\u95f4\u548c\u9ecf\u819c\u4e0b\u795e\u7ecf\u4e1b\u708e\u4ee5\u53ca\u8089\u82bd\u80bf\uff0c\u4e5f\u53ef\u4ee5\u9884\u6d4b\u672f\u540eCD \u590d\u53d1\uff3b269\uff3d*\u3002\u6b64\u5916\uff0c\u5fae\u751f\u7269\u56e0\u7d20\u5982\u5207\u9664\u548c\u672f\u540e\u56de\u80a0\u9ecf\u819c\u4e2d\u7684\u7ec6\u83cc\u5fae\u751f\u6001\u5931\u8c03\u548c\u4f4e\u4e30\u5ea6\u7684\u7caa\u6746\u83cc\uff0c\u4e0e\u5185\u955c\u4e0b\u590d\u53d1\u7684\u98ce\u9669\u589e\u52a0\u6709\u5173\uff3b270\uff3d\u3002\u5bf9\u4e8e\u6709\u590d\u53d1\u5371\u9669\u56e0\u7d20\u7684CD \u60a3\u8005\uff0c\u5efa\u8bae\u5728\u80a0\u5207\u9664\u672f\u540e\u8fdb\u884c\u9884\u9632\u6027\u6cbb\u7597\uff3b271\u2043272\uff3d\u3002\u9884\u9632\u6027\u6cbb\u7597\u901a\u5e38\u5728\u624b\u672f\u540e2 ~ 4 \u5468\u5de6\u53f3\u5f00\u59cb\u3002<\/p>\n

\u7f8e\u6c99\u62c9\u55ea\u5728\u9884\u9632 CD \u672f\u540e\u590d\u53d1\u65b9\u9762\u7684\u7597\u6548\u6709\u9650\uff0c\u4e00\u9879 Meta \u5206\u6790\u8868\u660e\uff0c5\u2043ASA \u7ec4\u672f\u540e12 \u4e2a\u6708\u7684\u5185\u955c\u7f13\u89e3\u7387\u672a\u4f18\u4e8e\u5b89\u6170\u5242\u7ec4\uff3b273\uff3d*\u3002\u7532\u785d\u5511\u548c\u5965\u785d\u5511\u5df2\u88ab\u8bc1\u660e\u6709\u52a9\u4e8e\u9884\u9632\u672f\u540e\u4e34\u5e8a\u548c\u5185\u955c\u4e0b\u590d\u53d1\uff3b274\u2043275\uff3d*\uff0c\u4f46\u8010\u53d7\u6027\u5dee\u548c\u957f\u671f\u4f7f\u7528\u7684\u4e0d\u826f\u53cd\u5e94\u9650\u5236\u4e86\u54aa\u5511\u7c7b\u6297\u751f\u7d20\u7684\u4e34\u5e8a\u5e94\u7528\u3002\u590d\u53d1\u9ad8\u5371\u60a3\u8005\u53ef\u9009\u62e9\u751f\u7269\u5236\u5242\u6216\u514d\u75ab\u6291\u5236\u5242\u9884\u9632\u590d\u53d1\uff3b276\uff3d\u3002<\/p>\n

\u63a8\u8350\u610f\u89c137\uff1a\u786b\u560c\u5464\u7c7b\u836f\u7269\u80fd\u591f\u6709\u6548\u9884\u9632CD \u672f\u540e\u7684\u4e34\u5e8a\u548c\u5185\u955c\u4e0b\u590d\u53d1\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f31\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u786b\u560c\u5464\u7c7b\u836f\u7269\u662fCD \u6cbb\u7597\u4e2d\u5e38\u7528\u7684\u514d\u75ab\u6291\u5236\u836f\u7269\uff0c\u5305\u62ec\u786b\u5511\u560c\u5464\u548c6\u2043MP\u3002\u76ee\u524d\u7684\u7814\u7a76\u663e\u793a\u786b\u560c\u5464\u7c7b\u836f\u7269\u80fd\u591f\u6709\u6548\u9884\u9632CD \u672f\u540e\u7684\u4e34\u5e8a\u548c\u5185\u955c\u4e0b\u590d\u53d1\uff3b271\uff0c277\uff3d*\uff0c\u540c\u65f6\u8054\u5408\u7532\u785d\u5511\u6548\u679c\u66f4\u4f73\uff3b271\uff0c278\uff3d\u3002\u786b\u560c\u5464\u7c7b\u836f\u7269\u7684\u7597\u6548\u4f18\u4e8e\u7f8e\u6c99\u62c9\u55ea\u4f46\u4e0d\u5982\u6297TNF \u5355\u6297\uff3b279\u2043280\uff3d*\u3002<\/p>\n

\u4e00\u9879\u9884\u9632\u672f\u540e\u590d\u53d1\u7684\u968f\u673a\u5bf9\u7167\u7814\u7a76\u5c0681 \u4f8b\u4f34\u22651 \u4e2a\u9ad8\u5371\u56e0\u7d20\u7684CD \u60a3\u8005\u672f\u540e\u968f\u673a\u5206\u4e3a\u89c2\u5bdf\u7ec4\u548c\u5bf9\u7167\u7ec4\uff0c\u89c2\u5bdf\u7ec4\u4e3a\u7532\u785d\u5511\uff083 \u4e2a\u6708\uff09+\u786b\u5511\u560c\u5464\uff0812 \u4e2a\u6708\uff09\u7ec4\uff0c\u5bf9\u7167\u7ec4\u4e3a\u7532\u785d\u5511\uff083 \u4e2a\u6708\uff09+\u5b89\u6170\u5242\uff0812 \u4e2a\u6708\uff09\uff0c\u968f\u8bbf1 \u5e74\u53d1\u73b0\u7532\u785d\u5511+\u786b\u5511\u560c\u5464\u7ec4\u7684\u5185\u955c\u590d\u53d1\u7387\u663e\u8457\u4f4e\u4e8e\u7532\u785d\u5511+ \u5b89\u6170\u5242\u5bf9\u7167\u7ec4\uff0843.7% \u6bd4 69.0%\uff0cP = 0.048\uff09\uff3b281\uff3d\u3002\u5bf9 6 \u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u7684\u6c47\u603b\u5206\u6790\u663e\u793a\uff0c\u5728\u4f4e\u98ce\u9669\u60a3\u8005\u4e2d\uff0cCD \u60a3\u8005\u56de\u7ed3\u80a0\u5207\u9664\u672f\u540e1 \u5e74\u4e34\u5e8a\u590d\u53d1\u7684\u7edd\u5bf9\u98ce\u9669\u5728\u6297TNF \u5355\u6297\u7ec4\u4e3a3.7%\uff0c\u786b\u560c\u5464\u7ec4\u4e3a17.9%\uff1b\u5728\u9ad8\u5371\u60a3\u8005\u4e2d\uff0c\u6297TNF \u5355\u6297\u7ec4\u548c\u786b\u560c\u5464\u7ec4\u7684\u4e34\u5e8a\u590d\u53d1\u7387\u5206\u522b\u4e3a 18.2% \u548c27.3%\uff1b\u63d0\u793a\u5728\u9884\u9632CD \u56de\u7ed3\u80a0\u5207\u9664\u672f\u540e\u5185\u955c\u548c\u4e34\u5e8a\u590d\u53d1\u65b9\u9762\uff0c\u6297TNF \u5355\u6297\u4f18\u4e8e\u786b\u560c\u5464\u7c7b\u836f\u7269\uff3b282\uff3d*\u3002<\/p>\n

\u63a8\u8350\u610f\u89c138\uff1a\u751f\u7269\u5236\u5242\u53ef\u6709\u6548\u9884\u9632\u53ca\u6cbb\u7597\u672f\u540eCD \u590d\u53d1\uff0c\u53ef\u4f7f\u7528\u672f\u524d\u6709\u6548\u751f\u7269\u5236\u5242\u5728\u672f\u540e\u7ee7\u7eed\u6cbb\u7597\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1aIFX \u9884\u9632\u53ca\u6cbb\u7597CD \u672f\u540e\u590d\u53d1\u7684\u4f5c\u7528\u5df2\u88ab\u5e7f\u6cdb\u7814\u7a76\uff0c\u53ef\u964d\u4f4e\u5185\u955c\u4e0b\u53ca\u7ec4\u7ec7\u5b66\u590d\u53d1\u7387\uff3b276\uff0c283\u2043284\uff3d\uff0c\u7597\u6548\u4f18\u4e8e\u5b89\u6170\u5242\u3001\u7f8e\u6c99\u62c9\u55ea\u548c\u786b\u560c\u5464\u7c7b\u836f\u7269\u3002\u4e00\u9879\u968f\u673a\u8bd5\u9a8c\u663e\u793a\u63a5\u53d7 IFX \u6cbb\u7597\u7684\u60a3\u80051 \u5e74\u5185\u955c\u590d\u53d1\u7387\u4e3a9.1%\uff0c\u663e\u8457\u4f4e\u4e8e\u5b89\u6170\u5242\u7ec4\u60a3\u8005\u7684 84.6%\uff08P = 0.0006\uff09\uff1bIFX \u6cbb\u7597\u7ec4\u7ec4\u7ec7\u5b66\u590d\u53d1\u7387\u4e3a27.3%\uff0c\u663e\u8457\u4f4e\u4e8e\u5b89\u6170\u5242\u7ec4\u768484.6%\uff08P = 0.01\uff09\uff3b284\uff3d\u3002\u4e00\u9879\u5168\u7403\u591a\u4e2d\u5fc3\u968f\u673a\u5bf9\u7167\u7814\u7a76\u5171\u7eb3\u5165297 \u4f8bCD \u672f\u540e\u60a3\u8005\uff0c\u968f\u673a\u63a5\u53d7 IFX \u6216\u5b89\u6170\u5242\u6cbb\u7597\uff0c\u7ed3\u679c\u53d1\u73b076 \u5468\u65f6\uff0cIFX \u7ec4\u7684\u5185\u955c\u4e0b\u590d\u53d1\u7387\u4e3a31%\uff0c\u4f4e\u4e8e\u5b89\u6170\u5242\u7ec4\u768460%\uff08P\uff1c0.001\uff09\uff0c\u4f46IFX \u7ec4\u4e34\u5e8a\u590d\u53d1\u7387\u4e3a13%\uff0c\u5b89\u6170\u5242\u7ec4\u5219\u4e3a20%\uff0c\u4e24\u7ec4\u95f4\u5dee\u5f02\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff08P = 0.097\uff09\uff3b285\uff3d\u3002\u5bf9\u524d\u77bb\u6027\u7814\u7a76\u7684Meta \u5206\u6790\u663e\u793a\uff0c\u4e0e\u975e\u751f\u7269\u5236\u5242\u6cbb\u7597\u7ec4\u76f8\u6bd4\uff0c\u6297TNF \u5236\u5242\u53ef\u663e\u8457\u964d\u4f4e\u5185\u955c\u590d\u53d1\u7387\u3001\u4e25\u91cd\u5185\u955c\u590d\u53d1\u7387\u548c\u4e34\u5e8a\u590d\u53d1\u7387\uff0c\u63d0\u9ad8\u7ef4\u6301\u7f13\u89e3\u7387\uff3b286\uff3d*\u3002\u6297TNF \u5236\u5242\u662f\u9884\u9632\u548c\u6cbb\u7597CD \u672f\u540e\u590d\u53d1\u7684\u6709\u6548\u836f\u7269\uff3b287\u2043288\uff3d\uff0c\u5728\u624b\u672f\u524d\u540e\u4f7f\u7528\u76f8\u540c\u7684\u6297TNF \u5236\u5242\u5bf9\u9884\u9632\u672f\u540e\u590d\u53d1\u6709\u6548\uff3b287\uff3d\u3002ADA \u548cIFX\u5728\u9884\u9632CD \u672f\u540e\u5185\u955c\u548c\u4e34\u5e8a\u590d\u53d1\u65b9\u9762\u7597\u6548\u76f8\u4f3c\uff3b289\u2043290\uff3d\u3002<\/p>\n

VDZ \u548cUST \u901a\u5e38\u7528\u4e8e\u6297TNF \u5236\u5242\u6cbb\u7597\u5931\u8d25\u6216\u6709\u6297TNF\u5236\u5242\u836f\u7269\u7981\u5fcc\u8bc1\u7684CD \u672f\u540e\u60a3\u8005\uff3b291\uff3d\u3002\u4e00\u9879\u897f\u73ed\u7259ENEIDA \u6570\u636e\u5e93\u7684\u7814\u7a76\u7eb3\u5165\u7684\u75c5\u4f8b\u4e2d80% \u4e3a\u5177\u6709\u81f3\u5c11\u4e00\u9879\u590d\u53d1\u9ad8\u5371\u56e0\u7d20\u7684CD \u60a3\u8005\uff0c\u7ed3\u679c\u663e\u793a\uff0cCD \u672f\u540e3 \u4e2a\u6708\u63a5\u53d7UST \u548cVDZ \u6cbb\u7597\uff0c\u5728\u624b\u672f\u540e12 \u4e2a\u6708\u51fa\u73b0\u4e34\u5e8a\u590d\u53d1\u7684\u7d2f\u79ef\u6982\u7387\u5206\u522b\u4e3a32%\u548c 30%\uff0c\u5185\u955c\u590d\u53d1\u7387\uff08Rutgeerts \u8bc4\u5206\uff1ei1\uff09\u5206\u522b\u4e3a 42% \u548c 40%\uff3b292\uff3d*\uff0c\u4e0e\u6297TNF \u5236\u5242\u7597\u6548\u76f8\u4f3c\uff3b287\uff3d\uff0c\u63d0\u793aUST \u548cVDZ \u5bf9\u9884\u9632CD \u672f\u540e\u590d\u53d1\u9ad8\u5371\u60a3\u8005\u6709\u6548\uff3b292\uff3d\u3002\u8fd1\u671f\u4e00\u9879\u56de\u987e\u6027\u3001\u591a\u4e2d\u5fc3\u771f\u5b9e\u4e16\u754c\u7684\u7814\u7a76\u89c2\u5bdfCD \u672f\u540e\u65e9\u671f\u4e88\u4ee5\u6297TNF \u5236\u5242\u3001VDZ \u548c UST \u9884\u9632\u7684\u7597\u6548\uff0c\u5305\u62ec297 \u4f8b\u60a3\u8005\uff0c\u5176\u4e2d224\u300139 \u548c34 \u4f8b\u60a3\u8005\u5206\u522b\u63a5\u53d7\u6297TNF \u5236\u5242\u3001VDZ \u548cUST \u6cbb\u7597\uff0c1 \u5e74\u5185\u603b\u4f53\u5185\u955c\u4e0b\u590d\u53d1\u7387\u4e3a41.8%\uff1b\u5728\u63a7\u5236\u6df7\u6742\u56e0\u7d20\u540e\uff0c\u6297TNF \u7ec4\u548c\u5176\u4ed6\u7ec4\u4e4b\u95f4\u7684\u5185\u955c\u4e0b\u590d\u53d1\u7387\u5dee\u5f02\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff3b293\uff3d\u3002<\/p>\n

\u63a8\u8350\u610f\u89c139\uff1a\u63a8\u8350CD \u60a3\u8005\u672f\u540e6 \u4e2a\u6708\u6216\u51fa\u73b0\u75c7\u72b6\u65f6\u590d\u67e5\u5185\u955c\uff0c\u4ee5\u8bc4\u4f30\u662f\u5426\u590d\u53d1\u3002\u5982\u679c\u4e0d\u80fd\u8010\u53d7\u5185\u955c\u68c0\u67e5\uff0c\u4f7f\u7528FC\u8054\u5408CTE\/MRE \u66ff\u4ee3\u8bc4\u4f30\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1aCD \u672f\u540e1 \u5e74\u5185\u955c\u68c0\u67e5\u7684\u60a3\u8005\u4e2d\uff0cCD \u7684\u590d\u53d1\u7387\u4e3a72%\uff3b294\uff3d\u3002\u5185\u955c\u4e0b\u590d\u53d1\u901a\u5e38\u5148\u4e8e\u4e34\u5e8a\u75c7\u72b6\uff0c\u56e0\u6b64\u5185\u955c\u68c0\u67e5\u88ab\u8ba4\u4e3a\u662fCD \u672f\u540e\u590d\u53d1\u7684\u8bca\u65ad\u91d1\u6807\u51c6\uff3b295\uff3d\u3002\u672f\u540e6 \u4e2a\u6708\u5185\u955c\u68c0\u67e5\u65f6\u543b\u5408\u53e3\u6e83\u75a1\u6df1\u5ea6\u548c\u6e83\u75a1\u73af\u5468\u8303\u56f4\u4e0e\u672f\u540e18 \u4e2a\u6708\u590d\u53d1\u76f8\u5173\uff3b296\uff3d*\u3002\u5efa\u8bae CD \u60a3\u8005\u672f\u540e 6 \u4e2a\u6708\u590d\u67e5\u5185\u955c\uff0c\u4ee5\u8bc4\u4f30\u662f\u5426\u590d\u53d1\u3002\u65e9\u671f\u7ed3\u80a0\u955c\u68c0\u67e5\u548c\u9488\u5bf9\u5185\u955c\u4e0b\u590d\u53d1\u7684\u9010\u7ea7\u6cbb\u7597\uff0c\u6bd4\u5355\u72ec\u4f7f\u7528\u5e38\u89c4\u836f\u7269\u6cbb\u7597\u66f4\u80fd\u9884\u9632CD \u672f\u540e\u590d\u53d1\uff3b280\uff3d\u3002<\/p>\n

\u5982\u4e0d\u80fd\u8010\u53d7\u5185\u955c\u68c0\u67e5\uff0c\u53ef\u7528\u5176\u4ed6\u66ff\u4ee3\u8bc4\u4f30\u65b9\u6cd5\uff0c\u5982FC\u3001\u80a0\u9053\u8d85\u58f0\u3001CTE\u3001MRE \u7b49\u3002<\/p>\n

\u524d\u77bb\u6027\u4e34\u5e8a\u8bd5\u9a8c\u663e\u793aFC \u68c0\u6d4b\u5177\u6709\u8db3\u591f\u7684\u654f\u611f\u6027\u76d1\u6d4b\u80a0\u5207\u9664\u672f\u540eCD \u590d\u53d1\uff0c\u5176\u9884\u6d4b\u503c\u53ef\u7528\u4e8e\u8bc6\u522b\u6700\u6709\u53ef\u80fd\u590d\u53d1\u7684\u60a3\u8005\uff0c\u540c\u65f6FC \u6c34\u5e73\u53ef\u7528\u4e8e\u76d1\u6d4bCD \u590d\u53d1\u60a3\u8005\u5bf9\u6cbb\u7597\u7684\u53cd\u5e94\uff3b18\uff3d\u3002<\/p>\n

\u80a0\u9053\u8d85\u58f0\u5728\u68c0\u6d4bCD \u672f\u540e\u65b9\u9762\u5177\u6709\u8f83\u597d\u7684\u654f\u611f\u6027\u548c\u7279\u5f02\u6027\uff0c\u5e76\u4e14\u4e0e\u56de\u80a0\u7ed3\u80a0\u955c\u6709\u5f88\u597d\u7684\u76f8\u5173\u6027\uff3b57\uff3d\u3002\u4e00\u9879\u7cfb\u7edf\u7efc\u8ff0\u548c Meta \u5206\u6790\u53d1\u73b0\uff0c\u80a0\u9053\u8d85\u58f0\u5728\u68c0\u6d4b\u672f\u540e\u590d\u53d1\u65b9\u9762\u7684\u654f\u611f\u6027\u4e3a 0.94\uff0c\u7279\u5f02\u6027\u4e3a0.84\uff1b\u80a0\u58c1\u539a\u5ea6\u22655.5 mm \u662f\u9884\u6d4b\u672f\u540e\u4e25\u91cd\u590d\u53d1\uff08Rutgeerts \u8bc4\u5206\u2265i3\uff09\u7684\u6700\u4f73\u9608\u503c\uff3b297\uff3d\u3002<\/p>\n

CTE \u662f\u8bc4\u4f30CD \u60a3\u8005\u56de\u7ed3\u80a0\u5207\u9664\u672f\u540e\u590d\u53d1\u7684\u53ef\u9760\u65b9\u6cd5\uff0c CTE \u53ef\u4ee5\u4f5c\u4e3a\u5185\u955c\u68c0\u67e5\u7684\u4e00\u4e2a\u91cd\u8981\u7684\u8865\u5145\u5de5\u5177\u6765\u8bc4\u4f30CD \u7684\u672f\u540e\u75c5\u7a0b\uff3b298\uff3d\u3002MRE \u5bf9\u8bc4\u4f30CD \u56de\u7ed3\u80a0\u5207\u9664\u672f\u540e\u590d\u53d1\u5177\u6709\u540c\u6837\u4ef7\u503c\uff3b299\uff3d\u3002<\/p>\n

\u516d\u3001\u6cbb\u7597\u76d1\u6d4b\u53ca\u60a3\u8005\u7ba1\u7406<\/p>\n

\u63a8\u8350\u610f\u89c140\uff1a\u63a5\u53d7\u786b\u560c\u5464\u7c7b\u836f\u7269\u6cbb\u7597\u7684CD \u60a3\u8005\uff0c\u6cbb\u7597\u524d\u53ef\u8003\u8651\u8fdb\u884cNUDT15 \u57fa\u56e0\u578b\u68c0\u6d4b\uff0c\u6709\u6761\u4ef6\u7684\u5355\u4f4d\u53ef\u5728\u6cbb\u7597\u4e2d\u76d1\u6d4b6\u2043TGN \u6d53\u5ea6\u6307\u5bfc\u836f\u7269\u5242\u91cf\u8c03\u6574\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f31\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1a\u786b\u560c\u5464\u7c7b\u836f\u7269\u4e3b\u8981\u4e0d\u826f\u53cd\u5e94\u5305\u62ec\u9aa8\u9ad3\u6291\u5236\u3001\u809d\u529f\u80fd\u635f\u5bb3\u3001\u80c3\u80a0\u9053\u53cd\u5e94\u3001\u611f\u67d3\u7b49\uff0c\u5176\u4e2d\u767d\u7ec6\u80de\u51cf\u5c11\u662f\u4e9a\u6d32\u4eba\u7fa4\u6700\u5e38\u89c1\u7684\u4e0d\u826f\u53cd\u5e94\u30022014 \u5e74\u97e9\u56fd\u5b66\u8005\u9996\u5148\u62a5\u9053\uff0cNUDT15\u57fa\u56e0R139C \u4f4d\u70b9\u53d8\u5f02\u4e0e\u786b\u560c\u5464\u7c7b\u836f\u7269\u5bfc\u81f4\u7684\u65e9\u671f\u767d\u7ec6\u80de\u51cf\u5c11\u663e\u8457\u76f8\u5173\uff08OR = 35.6\uff0cP = 4.88\u00d710-94\uff09\uff0c\u5176\u9884\u6d4b\u786b\u560c\u5464\u7c7b\u836f\u7269\u8bf1\u5bfc\u7684\u65e9\u671f\u767d\u7ec6\u80de\u51cf\u5c11\u654f\u611f\u6027\u548c\u7279\u5f02\u6027\u5206\u522b\u9ad8\u8fbe89.4% \u548c 93.2%\uff3b300\uff3d*\u3002\u6765\u81ea\u4e2d\u56fd\u3001\u65e5\u672c\u53ca\u6b27\u7f8e\u4eba\u7fa4\u7684\u7814\u7a76\u6570\u636e\u5747\u8bc1\u5b9e\u8be5\u7a81\u53d8\u7684\u610f\u4e49\uff3b170\uff0c301\u2043302\uff3d\uff0c\u4e14\u4e9a\u6d32\u4eba\u7fa4 T \u7b49\u4f4d\u57fa\u56e0\u7a81\u53d8\u9891\u7387\u9ad8\u8fbe 13%\uff0c\u76f8\u6bd4\u4e8eTPMT \u57fa\u56e0\u578b\uff0cNUDT15 \u66f4\u9002\u5408\u4f5c\u4e3a\u4e9a\u6d32\u4eba\u7fa4\u7528\u836f\u524d\u7b5b\u67e5\u7684\u57fa\u56e0\u6807\u5fd7\u7269\uff3b303\uff3d\u3002\u6b64\u5916\uff0cNUDT15 \u57fa\u56e0c.415C\uff1eT\u3001 c.36_37insGGAGTC \u548cc.52G\uff1eA \u7a81\u53d8\u4e5f\u662f\u786b\u560c\u5464\u7c7b\u836f\u7269\u76f8\u5173\u767d\u7ec6\u80de\u51cf\u5c11\u75c7\u7684\u5371\u9669\u56e0\u7d20\uff3b170\uff3d\u3002\u5927\u6837\u672c\u968f\u673a\u5bf9\u7167\u7814\u7a76\u663e\u793a\uff0c\u7528\u836f\u524d\u6839\u636eNUDT15 \u57fa\u56e0\u578b\u8fdb\u884c\u836f\u7269\u5242\u91cf\u7684\u8c03\u6574\u53ef\u663e\u8457\u51cf\u5c11\u786b\u560c\u5464\u76f8\u5173\u767d\u7ec6\u80de\u51cf\u5c11\uff3b304\uff3d*\u3002\u4ee5\u4e0a\u7ed3\u679c\u63d0\u793a\u5728\u4e9a\u6d32\u4eba\u7fa4\u4e2d\uff0c\u7528\u836f\u524d\u68c0\u6d4bNUDT15 \u57fa\u56e0\u578b\u53ef\u663e\u8457\u51cf\u5c11\u767d\u7ec6\u80de\u51cf\u5c11\u7684\u4e0d\u826f\u53cd\u5e94\u3002<\/p>\n

6\u2043\u786b\u9e1f\u560c\u5464\u6838\u82f7\u9178\uff086\u2043thioguanine nucleotide\uff0c6\u2043TGN\uff09\u662f\u786b\u560c\u5464\u7c7b\u836f\u7269\u53d1\u6325\u6cbb\u7597\u4f5c\u7528\u7684\u4e3b\u8981\u6d3b\u6027\u4ee3\u8c22\u4ea7\u7269\uff0c\u4e00\u9879\u7cfb\u7edf\u8bc4\u4ef7\u63d0\u793aCD \u7f13\u89e3\u671f\u60a3\u80056\u2043TGN \u6d53\u5ea6\u9ad8\u4e8e\u6d3b\u52a8\u671f\u60a3\u8005\u30026\u2043 TGN \u5927\u4e8e230 pmol\/8\u00d7108 \u7ea2\u7ec6\u80de\uff08red blood cells\uff0cRBC\uff09\u7684\u60a3\u8005\u4e34\u5e8a\u7f13\u89e3\u7387\u8f83\u9ad8\uff0c\u5176\u6bd2\u6027\u9608\u503c\u4e3a450 pmol\/8\u00d7108 RBC\uff0c\u56e0\u6b64\u63a8\u8350\u6cbb\u7597\u671f\u95f46\u2043TGN \u6d53\u5ea6\u4e3a230 ~ 450 pmol\/8\u00d7108 RBC\uff3b305\uff3d*\u3002\u4f46\u7814\u7a76\u7684\u5f02\u8d28\u6027\u5927\uff0c\u81f3\u4eca\u5bf96\u2043TGN \u7684\u9608\u503c\u548c\u4f5c\u7528\u4ecd\u5b58\u4e89\u8bae\uff0c\u4e14\u68c0\u6d4b\u8981\u6c42\u8f83\u9ad8\uff0c\u76ee\u524d\u4ec5\u63a8\u8350\u6709\u6761\u4ef6\u5355\u4f4d\u8fdb\u884c\u786b\u560c\u5464\u7c7b\u836f\u7269\u7684\u6d53\u5ea6\u76d1\u6d4b\u3002<\/p>\n

\u63a8\u8350\u610f\u89c141\uff1a\u63a5\u53d7IFX \u6cbb\u7597\u7684CD \u60a3\u8005\uff0c\u5efa\u8bae\u8fdb\u884c\u6cbb\u7597\u836f\u7269\u76d1\u6d4b\u6307\u5bfc\u6cbb\u7597\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8 \u8350 \u7406 \u7531 \uff1aIFX \u6cbb \u7597 \u836f \u7269 \u76d1 \u6d4b\uff08therapeutic drug monitoring\uff0cTDM\uff09\u5305 \u62ec \u836f \u7269 \u6d53 \u5ea6 \u76d1 \u6d4b \u53ca \u6297 IFX \u6297 \u4f53 \uff08antibodies to infliximab\uff0cATI\uff09\u76d1\u6d4b\uff3b306\uff3d\u3002TDM \u65b9\u5f0f\u5206\u4e3a\u4e3b\u52a8 TDM \u548c\u88ab\u52a8TDM \u4e24\u79cd\u3002\u4e3b\u52a8TDM \u662f\u4e00\u79cd\u57fa\u4e8e\u9884\u5b9a\u7684\u8840\u6e05\u836f\u7269\u6c34\u5e73\u7684\u4e2a\u4f53\u5316\u6cbb\u7597\u3002\u4e00\u9879\u968f\u673a\u3001\u5e73\u884c\u7ec4\u3001\u5f00\u653e\u6807\u7b7e\u7684\u4e34\u5e8a\u8bd5\u9a8c\u5171\u5206\u6790\u4e86\u632a\u5a0120 \u5bb6\u533b\u9662\u7684454 \u4f8b\u63a5\u53d7IFX \u7ef4\u6301\u6cbb\u7597\u7684\u6210\u4eba\u7c7b\u98ce\u6e7f\u5173\u8282\u708e\u3001\u810a\u67f1\u5173\u8282\u708e\u3001\u94f6\u5c51\u75c5\u5173\u8282\u708e\u3001UC\u3001CD\u6216\u94f6\u5c51\u75c5\u60a3\u8005\uff0c\u5176\u4e2d\uff0c227 \u4f8b\u60a3\u8005\u5728IFX \u7ef4\u6301\u6cbb\u7597\u671f\u95f4\u4e3b\u52a8 TDM \u5e76\u5bf9\u836f\u7269\u5b9e\u65f6\u8c03\u6574\u5242\u91cf\u548c\u95f4\u9694\uff0c\u8be5\u7814\u7a76\u76ee\u6807\u836f\u7269\u6d53\u5ea6\u4e3a3 ~ 8 \u03bcg\/ml\uff0c\u82e5\u6297\u836f\u6297\u4f53\uff1e50 \u03bcg\/L\uff0c\u5219\u8f6c\u6362\u6cbb\u7597\u65b9\u6848\uff1b227\u4f8b\u60a3\u8005\u63a5\u53d7\u6807\u51c6 IFX \u6cbb\u7597\uff0c\u672a\u884c TDM\u3002\u5728\u89c2\u5bdf\u81f3 52 \u5468\u65f6\uff0c TDM \u7ec4\u7ef4\u6301\u7f13\u89e3\u7387\u4e3a73.6%\uff0c\u663e\u8457\u9ad8\u4e8e\u6807\u51c6\u6cbb\u7597\u7ec4\u768455.9%\uff08P\uff1c0.001\uff09\uff3b307\uff3d*\u3002\u7136\u800c\uff0c\u6765\u81ea\u8be5\u7814\u7a76\u7ec4\u7684\u53e6\u4e00\u7bc7\u62a5\u9053\u663e\u793a\uff0c\u5728\u6cbb\u759730 \u5468\u89c2\u5bdf\u7ec8\u70b9\u65f6\uff0c\u4e3b\u52a8TDM \u7684\u7f13\u89e3\u7387\u4e3a50.5%\uff0c\u6807\u51c6\u6cbb\u7597\u7ec4\u7684\u7f13\u89e3\u7387 53.0%\uff0c\u4e24\u7ec4\u4e4b\u95f4\u7f13\u89e3\u7387\u5dee\u5f02\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff08P = 0.78\uff09\uff3b308\uff3d*\u3002TAXIT \u7814\u7a76\u89c2\u5bdf\u4e3b\u52a8TDM \u7ed9\u60a3\u8005\u5e26\u6765\u7684\u4e34\u5e8a\u83b7\u76ca\uff0c\u8be5\u7814\u7a76\u5c06IFX \u76ee\u6807\u8c37\u6d53\u5ea6\u8bbe\u5b9a\u57283 ~ 7 \u03bcg\/ml\u3002\u5bf9\u4e8e\u8c37\u6d53\u5ea6\u4e0d\u8db33 \u03bcg\/ml \u7684\u60a3\u8005\uff0c\u91c7\u53d6\u4f18\u5316\u6cbb\u7597\u7684\u65b9\u5f0f\u63d0\u9ad8IFX\u8c37\u6d53\u5ea6\u3002\u7ecf\u8fc7\u4f18\u5316\u6cbb\u7597\uff0c\u60a3\u8005\u7684\u4e34\u5e8a\u7f13\u89e3\u7387\u4ece65\uff05\u63d0\u9ad8\u81f3 88\uff05\uff08P = 0.02\uff09\uff3b309\uff3d*\u3002\u88ab\u52a8TDM \u901a\u5e38\u662f\u5bf9\u836f\u7269\u7597\u6548\u6b20\u4f73\u6216\u836f\u7269\u5931\u5e94\u7b54\u7684\u60a3\u8005\uff0c\u5728\u75be\u75c5\u6d3b\u52a8\u65f6\u8fdb\u884c\u7684TDM\u3002\u4e00\u9879\u6765\u81ea\u4e39\u9ea6\u7684\u968f\u673a\u3001\u5355\u76f2\u3001\u591a\u4e2d\u5fc3\u3001\u5bf9\u7167\u7814\u7a76\uff0c\u5171\u7eb3\u516569 \u4f8b\u5bf9IFX \u7ee7\u53d1\u6027\u5931\u5e94\u7b54\u7684CD \u60a3\u8005\uff0c33 \u4f8b\u60a3\u8005\u4f9d\u636eTDM \u7ed3\u679c\uff08IFX \u6cbb\u7597\u6d53\u5ea6\u22653 \u03bcg\/ml\uff09\uff0c\u800c\u53e6\u591636 \u4f8b\u60a3\u8005\u57fa\u4e8e\u4e34\u5e8a\u7ecf\u9a8c\u8fdb\u884c\u6cbb\u7597\u7b56\u7565\u8c03\u6574\uff0c\u7ed3\u679c\u663e\u793a\uff0c\u4e24\u7ec4\u60a3\u8005\u4e34\u5e8a\u7f13\u89e3\u7387\u5206\u522b\u4e3a58% \u548c53%\uff0c\u5dee\u5f02\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff08P = 0.81\uff09\uff0c\u4f46\u524d\u8005\u533b\u7597\u8d39\u7528\u660e\u663e\u964d\u4f4e\uff3b310\uff3d\u3002\u4e00\u9879Meta \u5206\u6790\u5206\u6790\u663e\u793a\uff0c\u4e0e\u88ab\u52a8TDM \u76f8\u6bd4\uff0c\u4e3b\u52a8TDM \u6cbb\u7597\u5931\u8d25\u7387\uff08RR = 0.46\uff0c95%CI\uff1a0.21 ~ 0.98\uff0cP = 0.04\uff09\u548c\u4f4f\u9662\u7387\uff08RR = 0.33\uff0c95%CI\uff1a0.21 ~ 0.54\uff0cP\uff1c0.01\uff09\u5747\u663e\u8457\u4e0b\u964d\uff3b311\uff3d*\u3002<\/p>\n

\u63a8\u8350\u610f\u89c142\uff1a\u63a8\u8350\u75c5\u7a0b\u8d85\u8fc78 \u5e74\u7684\u7ed3\u80a0\u53d7\u7d2f\u7684CD \u60a3\u8005\u63a5\u53d7\u80a0\u955c\u68c0\u67e5\u4ee5\u7b5b\u67e5\u80a0\u9053\u764c\u53d8\uff0c\u7ed3\u80a0\u955c\u7b5b\u67e5\u7684\u9891\u7387\u53d6\u51b3\u4e8e\u764c\u53d8\u98ce\u9669\u5206\u7ea7\u3002\u5bf9\u4e8eCD \u76f8\u5173\u5c0f\u80a0\u764c\u53ca\u809b\u5468\u764c\u53d8\uff0c\u76ee\u524d\u5c1a\u65e0\u8bc1\u636e\u652f\u6301\u5e38\u89c4\u7b5b\u67e5\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a3\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u5b9e\u65bd\u5efa\u8bae\uff1a\u4e0e\u666e\u901a\u4eba\u7fa4\u76f8\u6bd4\uff0cCD \u60a3\u8005\u7f79\u60a3\u7ed3\u76f4\u80a0\u764c\u7684\u6807\u51c6\u5316\u53d1\u75c5\u7387\uff08standardized incidence ratio\uff0cSIR\uff09\u66f4\u9ad8\uff08SIR=4.4\uff0c 95%CI\uff1a1.5 ~ 7.4\uff09\uff0c\u5c24\u5176\u662f\u5e7f\u6cdb\u7ed3\u80a0\u53d7\u7d2f\u7684 CD \u60a3\u8005\uff08SIR\uff1a18.2\uff0c95%CI\uff1a7.8 ~ 35.8\uff09\u3002\u968f\u7740\u75c5\u7a0b\u7684\u5ef6\u957f\uff0c\u7ed3\u76f4\u80a0\u764c\u7d2f\u79ef\u53d1\u75c5\u98ce\u9669\u9010\u6e10\u5347\u9ad8\uff0c10 \u5e74\u300120 \u5e74\u548c20 \u5e74\u4ee5\u4e0a\u7684\u7d2f\u79ef\u53d1\u75c5\u98ce\u9669\u5206\u522b\u4e3a1%\u30012% \u548c5%\uff3b312\uff3d\u3002\u4e00\u9879\u5927\u578b\u961f\u5217\u7814\u7a76\u663e\u793a\uff0c\u4e0e\u6b63\u5e38\u4eba\u7fa4\u76f8\u6bd4\uff0cCD  \u60a3\u8005\u7f79\u60a3\u7ed3\u76f4\u80a0\u764c\u7684\u98ce\u9669\uff08HR=1.40\uff0c95%CI\uff1a1.27 ~ 1.53\uff09\u53ca\u56e0\u7ed3\u76f4\u80a0\u764c\u6b7b\u4ea1\u7684\u98ce\u9669\uff08HR=1.74\uff0c95%CI\uff1a1.54 ~ 1.96\uff09\u66f4\u9ad8\uff1b\u75c5\u7a0b\u22658 \u5e74\u7684\u7ed3\u80a0\u53d7\u7d2f\u7684CD \u60a3\u8005\u5177\u6709\u66f4\u9ad8\u7684\u7ed3\u76f4\u80a0\u764c\u53d1\u75c5\u98ce\u9669\uff3b313\uff3d*\u3002IBD \u76f8\u5173\u7ed3\u76f4\u80a0\u764c\u7ea6\u5360\u7ed3\u76f4\u80a0\u764c\u5e74\u6b7b\u4ea1\u7387\u76842%\uff0c\u5360IBD \u60a3\u8005\u5e74\u6b7b\u4ea1\u7387\u768410% ~ 15%\uff3b314\uff3d\u3002\u4ee5\u4e0a\u6d41\u884c\u75c5\u5b66\u6570\u636e\u63d0\u793a\u7ed3\u76f4\u80a0\u764c\u98ce\u9669\u5728\u8bca\u65ad\u4e3a\u7ed3\u80a0\u53d7\u7d2f\u7684CD\u540e8 ~ 10 \u5e74\u5f00\u59cb\u4e0a\u5347\uff0c\u56e0\u6b64\uff0c\u63a8\u8350\u6240\u6709\u7ed3\u80a0\u53d7\u7d2f\u7684CD \u60a3\u8005\u5e94\u5728\u75be\u75c5\u8bca\u65ad\u8d85\u8fc78 \u5e74\u540e\u5e38\u89c4\u63a5\u53d7\u7ed3\u80a0\u955c\u68c0\u67e5\uff0c\u4ee5\u7b5b\u67e5\u80a0\u9053\u764c\u53d8\u3002\u63a5\u53d7\u80a0\u955c\u7b5b\u67e5\u65f6\uff0c\u5e94\u4ece\u591a\u4e2a\u7ed3\u80a0\u6bb5\u8fdb\u884c\u591a\u90e8\u4f4d\u80a0\u9ecf\u819c\u6d3b\u68c0\uff0c\u7279\u522b\u662f\u5bf9\u708e\u75c7\u90e8\u4f4d\u6e83\u75a1\u8fb9\u7f18\u8fdb\u884c\u6d3b\u68c0\uff0c\u4ee5\u8bc4\u4f30\u7ec4\u7ec7\u5b66\u75be\u75c5\u6d3b\u52a8\u5ea6\u548c\u53d7\u7d2f\u8303\u56f4\uff0c\u5c06\u6709\u52a9\u4e8e\u4e0d\u5178\u578b\u589e\u751f\u7684\u68c0\u51fa\uff0c\u5e76\u6307\u5bfc\u672a\u6765\u7684\u76d1\u6d4b\u95f4\u9694\uff3b315\uff3d\u3002\u5728\u521d\u6b21\u80a0\u955c\u7b5b\u67e5\u540e\uff0c\u540e\u7eed\u80a0\u955c\u7b5b\u67e5\u7684\u95f4\u9694\u65f6\u95f4\u53ef\u6839\u636e\u75be\u75c5\u98ce\u9669\u6765\u51b3\u5b9a\u3002\u63a8\u8350\u9ad8\u3001\u4e2d\u3001\u4f4e\u98ce\u9669\u60a3\u8005\u80a0\u955c\u7b5b\u67e5\u7684\u95f4\u9694\u65f6\u95f4\u5206\u522b\u4e3a\u6bcf\u5e74\u3001\u6bcf2 ~ 3 \u5e74\u3001\u6bcf5 \u5e74\u3002\u5efa\u8bae\u5728\u75be\u75c5\u7f13\u89e3\u671f\u8fdb\u884c\u80bf\u7624\u7b5b\u67e5\uff0c\u4ee5\u51cf\u5c11\u708e\u75c7\u5bf9\u80bf\u7624\u7b5b\u67e5\u7684\u5f71\u54cd\uff08\u56fe1\uff09\uff3b316\uff3d*\u3002<\/p>\n<\/p>\n

\u4e00\u9879Meta \u5206\u6790\u663e\u793a\uff0cCD \u5c0f\u80a0\u764c\u7684\u53d1\u75c5\u7387\u4e3a30\/100 000\u4eba\u5e74\uff3b317\uff3d\u3002CD \u60a3\u8005\u5c0f\u80a0\u764c\u7684\u53d1\u751f\u7387\u4e3a\u6b63\u5e38\u4eba\u7fa4\u768410 \u500d\uff3b318\uff3d*\u3002CD \u76f8\u5173\u5c0f\u80a0\u764c\u591a\u4e3a\u817a\u764c\uff0c\u591a\u89c1\u4e8e\u7a7a\u80a0\u4e0b\u6bb5\u548c\u56de\u80a0\uff0c\u4e14\u4e0e\u7a7f\u900f\u548c\u72ed\u7a84\u578b\u75be\u75c5\u884c\u4e3a\u3001\u65e2\u5f80\u624b\u672f\u53f2\u53ca\u75c5\u7a0b\u76f8\u5173\u3002\u76ee\u524d\u5c1a\u65e0\u660e\u786e\u8bc1\u636e\u652f\u6301\u5bf9CD \u5c0f\u80a0\u764c\u98ce\u9669\u8fdb\u884c\u5e38\u89c4\u7b5b\u67e5\uff0c\u4f46\u662f\u5982\u679c\u60a3\u8005\u5b58\u5728\u75c5\u53f2\u957f\u3001\u96be\u6cbb\u6027\u3001\u80a0\u9053\u72ed\u7a84\u6216\u76f8\u5173\u75c7\u72b6\uff0c\u9700\u6ce8\u610f\u662f\u5426\u5408\u5e76\u5c0f\u80a0\u764c\u53d8\uff3b316\uff3d\u3002<\/p>\n

CD \u5408\u5e76\u809b\u5468\u75c5\u53d8\u60a3\u8005\u809b\u5468\u764c\u53d8\u7684\u98ce\u9669\u589e\u52a0\uff0c\u901a\u5e38\u53d1\u751f\u4e8e\u8bca\u65adCD 25 \u5e74\u540e\u53ca\u53d1\u73b0\u809b\u761810 \u5e74\u540e\uff3b319\uff3d*\u3002\u6709\u9650\u7684\u6d41\u884c\u75c5\u5b66\u6570\u636e\u663e\u793aCD \u5408\u5e76\u809b\u95e8\u9cde\u72b6\u7ec6\u80de\u764c\u7684\u53d1\u751f\u7387\u4e0e\u6b63\u5e38\u4eba\u7fa4\u76f8\u4f3c\uff3b320\uff3d*\u3002\u76ee\u524d\u5c1a\u65e0\u8db3\u591f\u8bc1\u636e\u652f\u6301\u5e38\u89c4\u5bf9CD \u809b\u5468\u764c\u53d8\u8fdb\u884c\u7b5b\u67e5\uff0c\u4f46\u662f\u4e34\u5e8a\u533b\u751f\u5e94\u8be5\u5728\u65e5\u5e38\u5b9e\u8df5\u4e2d\u6ce8\u610f\u53ef\u7591\u7684\u809b\u5468\u75c7\u72b6\u6539\u53d8\uff3b316\uff3d\u3002<\/p>\n

\u63a8\u8350\u610f\u89c1 43\uff1aCD \u60a3\u8005\u5e94\u5e38\u89c4\u8fdb\u884c\u8425\u517b\u8bc4\u4f30\u4e0e\u8425\u517b\u76d1\u6d4b\uff0c\u5e76\u6839\u636e\u7ed3\u679c\u5236\u5b9a\u4e2a\u4f53\u5316\u7684\u8425\u517b\u652f\u6301\u6cbb\u7597\u65b9\u6848\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a2\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u5b9e\u65bd\u5efa\u8bae\uff1aIBD \u7684\u8425\u517b\u969c\u788d\u5305\u62ec\u8425\u517b\u4e0d\u826f\u548c\u8425\u517b\u98ce\u9669\u3002\u8425\u517b\u4e0d\u826f\u662f\u7531\u4e8e\u673a\u4f53\u7ed3\u6784\u548c\u529f\u80fd\u53d1\u751f\u6539\u53d8\uff0c\u5bfc\u81f4\u8425\u517b\u4f9b\u7ed9\u3001\u6d88\u5316\u3001\u5438\u6536\u548c\u9700\u6c42\u4e0d\u5e73\u8861\u7684\u75c5\u7406\u72b6\u6001\uff0c\u5305\u62ec\u5b8f\u91cf\u8425\u517b\u7d20\u7f3a\u4e4f\u548c\u5fae\u91cf\u8425\u517b\u7d20\u7f3a\u4e4f\u3002\u8425\u517b\u98ce\u9669\u662f\u6307\u73b0\u5b58\u7684\u6216\u6f5c\u5728\u7684\u8425\u517b\u56e0\u7d20\u5bfc\u81f4\u60a3\u8005\u51fa\u73b0\u4e0d\u826f\u9884\u540e\u7ed3\u5c40\u7684\u98ce\u9669\u300280% \u4ee5\u4e0a\u7684CD \u60a3\u8005\u5b58\u5728\u8425\u517b\u4e0d\u826f\u6216\u8425\u517b\u98ce\u9669\uff3b321\u2043322\uff3d*\u3002\u8425\u517b\u4e0d\u826f\u53ca\u8425\u517b\u98ce\u9669\u662f\u5bfc\u81f4\u4e0d\u826f\u9884\u540e\u7684\u4e3b\u8981\u56e0\u7d20\uff0c\u5305\u62ec\u4f4f\u9662\u65f6\u95f4\u5ef6\u957f\u3001\u5e76\u53d1\u75c7\u53d1\u751f\u7387\u548c\u6b7b\u4ea1\u7387\u589e\u52a0\u7b49\u3002\u56e0\u6b64\uff0c\u5e94\u5e38\u89c4\u5bf9CD \u60a3\u8005\u8fdb\u884c\u8425\u517b\u8bc4\u4f30\u3002\u8425\u517b\u98ce\u9669\u7b5b\u67e5\u7684\u5de5\u5177\u6709\u591a\u79cd\uff0c\u6700\u5e38\u4f7f\u7528\u7684\u662f\u8425\u517b\u98ce\u9669\u7b5b\u67e5\u5de5\u51772002\uff08NRS\u20432002\uff09\uff0c\u8be5\u8bc4\u5206\u65e8\u5728\u8bc6\u522b\u9700\u8981\u63a5\u53d7\u8425\u517b\u6cbb\u7597\u7684\u76ee\u6807\u4eba\u7fa4\u3002\u5bf9\u4e8e\u8425\u517b\u4e0d\u826f\u7684\u8bc4\u4f30\uff0c\u5c1a\u9700\u5b8c\u5584\u7684\u8425\u517b\u8bc4\u4f30\uff0c\u5305\u62ec\u4e3b\u89c2\u548c\u5ba2\u89c2\u4e24\u90e8\u5206\u3002\u4e3b\u89c2\u8bc4\u4f30\u591a\u91c7\u7528\u60a3\u8005\u4e3b\u89c2\u6574\u4f53\u8bc4\u4f30\u91cf\u8868\uff08PG\u2043SGA\uff09\u4f5c\u4e3a\u8bc4\u5b9a\u5de5\u5177\u3002\u5ba2\u89c2\u8bc4\u4f30\u6307\u6807\u5305\u62ec\u4f53\u8d28\u91cf\u6307\u6570\uff08BMI\uff09\u3001\u5b9e\u9a8c\u5ba4\u68c0\u67e5\uff08\u542b\u4ee3\u8c22\u6307\u6807\uff09\u53ca\u4eba\u4f53\u6210\u5206\u5206\u6790\uff08\u542b\u808c\u8089\u91cf\u53ca\u808c\u529b\uff09\u7b49\uff3b323\uff3d\u3002\u76ee\u524d\u5e38\u7528\u5168\u7403\u9886\u5bfc\u4eba\u53d1\u8d77\u7684\u8425\u517b\u4e0d\u826f\uff08GLIM\uff09\u6807\u51c6\u5bf9\u8425\u517b\u4e0d\u826f\u8fdb\u884c\u8bc4\u4f30\u548c\u5206\u7ea7\uff3b324\uff3d\u3002<\/p>\n

\u63a8\u8350\u610f\u89c144\uff1a\u5efa\u8bae\u5bf9 CD \u60a3\u8005\u7684\u7cbe\u795e\u5065\u5eb7\u72b6\u51b5\u8fdb\u884c\u8bc4\u4f30\uff0c\u53d1\u73b0\u60a3\u8005\u51fa\u73b0\u5fc3\u7406\u95ee\u9898\u65f6\uff0c\u5e94\u53ca\u65f6\u5e72\u9884\u3002\uff08\u8bc1\u636e\u7b49\u7ea7\uff1a1\uff0c\u63a8\u8350\u5f3a\u5ea6\uff1a\u5f3a\uff09<\/p>\n

\u63a8\u8350\u7406\u7531\uff1aCD \u60a3\u8005\u5e38\u5408\u5e76\u6291\u90c1\u548c\u7126\u8651\uff3b325\u2043326\uff3d\u3002\u4e00\u9879Meta\u5206\u6790\u663e\u793a\uff0cIBD \u60a3\u8005\u5408\u5e76\u7126\u8651\u75c7\u7684\u6bd4\u4f8b\u4e3a32.1%\uff0c\u5408\u5e76\u6291\u90c1\u75c7\u7684\u6bd4\u4f8b\u4e3a 25.2%\uff0c\u5176\u4e2d \uff0cCD \u60a3\u8005\u5408\u5e76\u7126\u8651 \u75c7\uff08OR=1.2\uff0c 95%CI\uff1a1.1 ~ 1.4\uff09\u548c\u6291\u90c1\u75c7\uff08OR=1.2\uff0c95%CI\uff1a1.1 ~ 1.4\uff09\u7684\u98ce\u9669\u9ad8\u4e8eUC \u60a3\u8005\uff3b327\uff3d*\u3002\u5408\u5e76\u7126\u8651\u53ca\u6291\u90c1\u4e0eCD \u60a3\u8005\u5168\u56e0\u4f4f\u9662\u7387\u53ca\u533b\u7597\u4fdd\u5065\u5229\u7528\u7387\u589e\u52a0\u76f8\u5173\uff3b328\uff3d\uff0c\u4e14\u663e\u8457\u589e\u52a0\u6cbb\u7597\u5347\u7ea7\u3001\u6025\u8bca\u5c31\u8bca\u53ca\u4e0d\u826f\u9884\u540e\u7684\u98ce\u9669\uff3b329\uff3d\u3002\u56e0\u6b64\uff0c\u5efa\u8bae\u5bf9CD \u60a3\u8005\u8fdb\u884c\u5fc3\u7406\u5065\u5eb7\u72b6\u6001\u8bc4\u4f30\u3002\u76ee\u524d\u6700\u5e38\u7528\u7684\u7b5b\u9009\u5de5\u5177\u4e3a\u533b\u9662\u7126\u8651\u6291\u90c1\uff08HADS\uff09\u91cf\u8868\u53caSCL\u204390 \u75c7\u72b6\u81ea\u8bc4\u91cf\u8868\u7b49\u3002<\/p>\n

\u4e00\u9879\u968f\u673a\u5bf9\u7167\u7814\u7a76\u8bc4\u4f30\u4e24\u79cd\u5fc3\u7406\u5e72\u9884\u7597\u6cd5\u5bf9CD \u60a3\u8005\u6291\u90c1\u548c\u75be\u75c5\u6d3b\u52a8\u5ea6\u7684\u5f71\u54cd\uff3b330\uff3d\u3002161 \u4f8b\u60a3\u6709\u6291\u90c1\u75c7\u7684CD \u9752\u5c11\u5e74\u60a3\u8005\u88ab\u968f\u673a\u5206\u914d\u63a5\u53d73 \u4e2a\u6708\u7684\u8ba4\u77e5\u884c\u4e3a\u7597\u6cd5\u6216\u975e\u6307\u5bfc\u6027\u7684\u652f\u6301\u6027\u503e\u542c\u6cbb\u7597\uff0c\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u57fa\u7ebf\u76f8\u6bd4\uff0c\u4e24\u79cd\u6cbb\u7597\u624b\u6bb5\u5747\u53ef\u663e\u8457\u964d\u4f4e\u513f\u7ae5\u6291\u90c1\u7684\u91cf\u8868\u8bc4\u5206\uff08P\uff1c0.0001\uff09\uff1b\u4e14\u5728\u975e\u7cd6\u76ae\u8d28\u6fc0\u7d20\u4f7f\u7528\u4e9a\u7ec4\u4e2d\uff0c\u4e0e\u975e\u6307\u5bfc\u6027\u652f\u6301\u6027\u6cbb\u7597\u76f8\u6bd4\uff0c\u8ba4\u77e5\u884c\u4e3a\u7597\u6cd5\u80fd\u663e\u8457\u964d\u4f4e\u513f\u7ae5CD \u6d3b\u52a8\u6307\u6570\uff08\u03b2=5.54\uff0c95%CI\uff1a0.49 ~ 10.06\uff0c P = 0.03\uff09\uff0c\u63d0\u793a\u5fc3\u7406\u6cbb\u7597\u53ef\u4f5c\u4e3aCD \u6cbb\u7597\u7684\u6709\u6548\u8f85\u52a9\u624b\u6bb5\uff3b330\uff3d\u3002\u56e0\u6b64\uff0c\u4e00\u65e6\u53d1\u73b0CD \u60a3\u8005\u5b58\u5728\u5fc3\u7406\u95ee\u9898\u65f6\uff0c\u5e94\u53ca\u65f6\u4e0e\u5fc3\u7406\u533b\u751f\u6c9f\u901a\uff0c\u5fc5\u8981\u65f6\u7ed9\u4e88\u60a3\u8005\u4e13\u4e1a\u7684\u5fc3\u7406\u548c\u7cbe\u795e\u65b9\u9762\u7684\u6cbb\u7597\u3002<\/p>\n

\u4e03\u3001\u5c55\u671b<\/p>\n

\u5c3d\u7ba1\u8fd1\u5e74CD \u7684\u6cbb\u7597\u836f\u7269\u53d6\u5f97\u5f88\u5927\u8fdb\u5c55\uff0c\u4f46\u4ecd\u65e0\u6cd5\u7a81\u7834\u6cbb\u7597 \u7684\u201c \u5929\u82b1\u677f \u201d\uff0c\u5185\u955c\u4e0b\u6709\u6548\u7387\u62a5\u9053\u5927\u591a\u5728 40% ~ 60%\uff3b331\u2043332\uff3d\u3002\u9664\u4e86\u76ee\u524d\u5df2\u6709\u7684\u751f\u7269\u5236\u5242\u53ca\u5c0f\u5206\u5b50\u836f\u7269\u5916\uff0c\u91c7\u7528\u591a\u9776\u70b9\u836f\u7269\u53ca\u8054\u5408\u6cbb\u7597\u96be\u6cbb\u6027CD\u3001\u7caa\u83cc\u79fb\u690d\u3001\u5e72\u7ec6\u80de\u6ce8\u5c04\u6cbb\u7597\u3001\u63a2\u7d22\u65b0\u7684\u6cbb\u7597\u9776\u70b9\u836f\u7269\u7b49\u4ecd\u662f\u5f53\u4e0b\u7814\u7a76\u7684\u70ed\u70b9\uff3b333\u2043335\uff3d\u3002\u591a\u9879\u7814\u7a76\u8868\u660e\uff0c\u8054\u5408\u751f\u7269\u5236\u5242\u6cbb\u7597\u76f8\u5bf9\u4e8e\u5355\u72ec\u4f7f\u7528\u80fd\u591f\u63d0\u9ad8\u6cbb\u7597\u6548\u679c\uff3b336\u2043337\uff3d\uff0cChapman \u7b49\uff3b338\uff3d\u8fd8\u63d0\u51fa\u751f\u7269\u5236\u5242\u964d\u9636\u68af\u6cbb\u7597\u7684\u7b56\u7565\u3002\u6b64\u5916\uff0c2019 \u53ca2020 \u5e74\u56fd\u5185\u7684\u4e24\u9879\u5171\u8bc6\u63a8\u8350\u5e72\u7ec6\u80de\u5c40\u90e8\u6ce8\u5c04\u53ef\u4f5c\u4e3a\u809b\u5468CD \u7684\u6709\u6548\u6cbb\u7597\u624b\u6bb5\uff3b339\u2043340\uff3d\u3002\u65b0\u7684\u751f\u7269\u5236\u5242\u5982\u6297\u767d\u7ec6\u80de\u4ecb\u7d2023\uff08IL\u204323\uff09\u5355\u6297\u53ca\u53e3\u670d\u5c0f\u5206\u5b50\u836f\u7269\u5982\u9798\u6c28\u9187\u2043\u78f7\u9178\u53d7\u4f53\u8c03\u8282\u5242\u6709\u671b\u5728\u4e0d\u4e45\u7684\u5c06\u6765\u5e94\u7528\u4e8e\u4e34\u5e8a\uff3b341\u2043345\uff3d\u3002<\/p>\n

\u672a\u6765\uff0c\u57fa\u4e8e\u73b0\u4ee3\u751f\u7269\u5b66\u7684\u591a\u7ec4\u5b66\u7814\u7a76\uff0c\u5c06\u6709\u52a9\u4e8e\u6211\u4eec\u5bf9 CD \u7684\u53d1\u75c5\u673a\u5236\u6709\u66f4\u6df1\u7684\u7406\u89e3\uff0c\u5e76\u5e94\u7528\u4e8e\u75be\u75c5\u5206\u578b\u3001\u75be\u75c5\u8fdb\u5c55\u53ca\u836f\u7269\u7597\u6548\u9884\u6d4b\uff0c\u4ece\u800c\u63d0\u9ad8\u7597\u6548\uff0c\u964d\u4f4e\u5e76\u53d1\u75c7\u53d1\u751f\u7387\uff0c\u6539\u5584\u60a3\u8005\u7684\u9884\u540e\u3002<\/p>\n

\u6307\u5357\u7f16\u5199\u7ec4\u4e13\u5bb6\u540d\u5355\uff08\u6309\u59d3\u6c0f\u6c49\u8bed\u62fc\u97f3\u6392\u5e8f\uff09<\/p>\n

\u8d77\u8349\u5c0f\u7ec4\u4e13\u5bb6\uff1a<\/p>\n

\u66f9\u5029\uff08\u6d59\u6c5f\u5927\u5b66\u533b\u5b66\u9662\u9644\u5c5e\u90b5\u9038\u592b\u533b\u9662\u6d88\u5316\u5185\u79d1\uff09\u3001\u9648\u65fb\u6e56\uff08\u4e2d\u5c71\u5927\u5b66\u9644\u5c5e\u7b2c\u4e00\u533b\u9662\u6d88\u5316\u5185\u79d1\uff09\u3001\u9ad8\u7fd4\uff08\u4e2d\u5c71\u5927\u5b66\u9644\u5c5e\u7b2c\u516d\u533b\u9662\u6d88\u5316\u5185\u79d1\uff09\u3001\u4f55\u7476\uff08\u4e2d\u5c71\u5927\u5b66\u9644\u5c5e\u7b2c\u4e00\u533b\u9662\u6d88\u5316\u5185\u79d1\uff09\u3001\u5189\u5fd7\u534e\uff08\u4e0a\u6d77\u5065\u5eb7\u533b\u5b66\u9662\u9644\u5c5e\u5468\u6d66\u533b\u9662\u6d88\u5316\u5185\u79d1\uff09\u3001\u590f\u541b\uff08\u5b81\u6ce2\u8bfa\u4e01\u6c49\u5927\u5b66 GRADE \u4e2d\u5fc3\uff09<\/p>\n

\u4e13\u5bb6\u7ec4\u6210\u5458\uff1a<\/p>\n

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\u5317\u4eac\u534f\u548c\u533b\u5b66\u9662 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