{"id":20454,"date":"2019-07-15T17:55:01","date_gmt":"2019-07-15T09:55:01","guid":{"rendered":"\/\/www.afterroberto.com\/?p=20454"},"modified":"2019-07-15T17:55:01","modified_gmt":"2019-07-15T09:55:01","slug":"%e9%86%ab%e8%a8%80%e6%9c%89%e7%90%86-%e6%be%b1%e7%b2%89%e6%a8%a3%e8%ae%8a%e6%80%a7-%e8%9b%8b%e7%99%bd%e6%b2%89%e7%a9%8d%e4%b8%bb%e5%99%a8%e5%ae%98%e6%94%9e%e5%91%bd","status":"publish","type":"post","link":"\/\/www.afterroberto.com\/%e9%86%ab%e8%a8%80%e6%9c%89%e7%90%86-%e6%be%b1%e7%b2%89%e6%a8%a3%e8%ae%8a%e6%80%a7-%e8%9b%8b%e7%99%bd%e6%b2%89%e7%a9%8d%e4%b8%bb%e5%99%a8%e5%ae%98%e6%94%9e%e5%91%bd\/","title":{"rendered":"\u91ab\u8a00\u6709\u7406\uff1a\u6fb1\u7c89\u6a23\u8b8a\u6027 \u86cb\u767d\u6c89\u7a4d\u4e3b\u5668\u5b98\u651e\u547d"},"content":{"rendered":"<p>\u3010\u660e\u5831\u5c08\u8a0a\u301180\u6b72\u7684\u9673\u5a46\u5a46\u5b9a\u671f\u6aa2\u67e5\u8eab\u9ad4\uff0c\u6700\u8fd1\u767c\u73fe\u6709\u300c\u86cb\u767d\u5c3f\u300d\uff08Proteinuria\uff09\uff0c\u814e\u81df\u53ca\u5fc3\u81df\u529f\u80fd\u4ea6\u9010\u6f38\u8f49\u5dee\uff1b\u300c\u814e\u81df\u6d3b\u7d44\u7e54\u6aa2\u67e5\u300d\uff08Renal biopsy\uff09\u986f\u793a\u300c\u6fb1\u7c89\u6a23\u8b8a\u6027\u300d\uff08Amyloidosis\uff09\uff0c\u5c6c\u8840\u6db2\u75be\u75c5\u4e00\u7a2e\u3002<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_10120\" aria-describedby=\"caption-attachment-10120\" style=\"width: 800px\" class=\"wp-caption aligncenter\"><img fetchpriority=\"high\" decoding=\"async\" class=\"size-large wp-image-10120\" src=\"\/\/www.afterroberto.com\/wp-content\/uploads\/2017\/09\/12b97ac09bb63d63dba2e79fed3140e6-1-1024x601.jpg\" alt=\"\" width=\"800\" height=\"470\" title=\"\" srcset=\"\/\/www.afterroberto.com\/wp-content\/uploads\/2017\/09\/12b97ac09bb63d63dba2e79fed3140e6-1-1024x601.jpg 1024w, \/\/www.afterroberto.com\/wp-content\/uploads\/2017\/09\/12b97ac09bb63d63dba2e79fed3140e6-1-300x176.jpg 300w, \/\/www.afterroberto.com\/wp-content\/uploads\/2017\/09\/12b97ac09bb63d63dba2e79fed3140e6-1-150x88.jpg 150w, \/\/www.afterroberto.com\/wp-content\/uploads\/2017\/09\/12b97ac09bb63d63dba2e79fed3140e6-1-768x451.jpg 768w, \/\/www.afterroberto.com\/wp-content\/uploads\/2017\/09\/12b97ac09bb63d63dba2e79fed3140e6-1-250x147.jpg 250w, \/\/www.afterroberto.com\/wp-content\/uploads\/2017\/09\/12b97ac09bb63d63dba2e79fed3140e6-1.jpg 1091w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption id=\"caption-attachment-10120\" class=\"wp-caption-text\">\uff08\u8a2d\u8a08\u5716\u7247\uff0c\u76f8\u4e2d\u6a21\u7279\u5152\u8207\u6587\u4e2d\u63d0\u53ca\u75be\u75c5\u7121\u95dc\uff0c\u5716\uff1aToa55@iStockphoto\uff09<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p>\u300c\u6fb1\u7c89\u6a23\u86cb\u767d\u300d\uff08Amyloid proteins\uff09\u4e43\u300c\u4f4e\u5206\u5b50\u91cf\u7684\u8840\u6f3f\u86cb\u767d\u300d\uff08Low molecular weight plasma proteins\uff09\uff0c\u53ef\u5728\u8eab\u9ad4\u5404\u5668\u5b98\u7d44\u7e54\u7d30\u80de\u5916\u6c89\u7a4d\uff0c\u5f62\u6210\u5e7c\u5c0f\u7684\u300c\u7e96\u7d72\u300d\uff08Fibrils\uff09\uff0c\u7834\u58de\u7d30\u80de\u7d44\u7e54\uff0c\u5f71\u97ff\u5668\u5b98\u6b63\u5e38\u529f\u80fd\uff0c\u9019\u7a31\u70ba\u300c\u6fb1\u7c89\u6a23\u8b8a\u6027\u300d\u3002<\/p>\n<p>\u300c\u6fb1\u7c89\u6a23\u8b8a\u6027\u300d\u6709\u591a\u7a2e\uff0c\u5c6c\u7f55\u898b\u75be\u75c5\uff0c\u5176\u4e2d\u4ee5\u300c\u539f\u767c\u6027\u6fb1\u7c89\u6a23\u8b8a\u6027\u300d\uff08Primary amyloidosis\uff09\u8f03\u591a\u898b\uff0c\u53c8\u7a31AL amyloidosis\uff0c\u5c6c\u300c\u514b\u9686\u6f3f\u7d30\u80de\u589e\u751f\u75c5\u300d\uff08Clonal plasma cell proliferative disorder\uff09\uff0c\u75c5\u56e0\u5305\u62ec\u300c\u6f3f\u7d30\u80de\u9aa8\u9ad3\u7624\u300d\uff08plasma cell myeloma\uff09\u53ca\u300c\u5de8\u7403\u86cb\u767d\u8840\u75c7\u300d\uff08Waldenstrom macroglobulinemia\uff09\u3002<\/p>\n<p>\u4eba\u9ad4\u6b63\u5e38\u300cB\u6dcb\u5df4\u7d30\u80de\u300d\u53ef\u8f49\u5316\u6210\u300c\u6f3f\u7d30\u80de\u300d\uff0c\u5206\u6ccc\u300c\u514d\u75ab\u7403\u86cb\u767d\u300d\uff08Immunoglobulins\uff09\uff0c\u5373\u5c0d\u4ed8\u7d30\u83cc\u548c\u75c5\u6bd2\u7684\u6297\u9ad4\uff08Antibody\uff09\uff0c\u5c6c\u4eba\u9ad4\u514d\u75ab\u7cfb\u7d71\u7684\u4e00\u500b\u91cd\u8981\u90e8\u5206\u3002\u300c\u514d\u75ab\u7403\u86cb\u767d\u300d\u7684\u5206\u5b50\u7d50\u69cb\u6709\u300c\u91cd\u93c8\u300d\uff08Heavy chain\uff09\u548c\u300c\u8f15\u93c8\u300d\uff08Light chain\uff09\u5169\u90e8\u5206\uff0c\u4e0d\u540c\u7684\u57fa\u56e0\u7d44\u5408\u53ef\u7d44\u6210\u5343\u5343\u842c\u842c\u4e0d\u540c\u7d50\u69cb\u7684\u6297\u9ad4\uff0c\u5c0d\u4ed8\u4e0d\u540c\u76ee\u6a19\uff0c\u5c24\u5176\u7d30\u83cc\u548c\u75c5\u6bd2\u3002<\/p>\n<p>&nbsp;<\/p>\n<h2>\u53ef\u81f4\u820c\u982d\u8139\u5927 \u5fc3\u814e\u8870\u7aed<\/h2>\n<p>\u300c\u6fb1\u7c89\u6a23\u86cb\u767d\u300d\u6e90\u81ea\u7570\u5e38\u6f3f\u7d30\u80de\u6240\u5206\u6ccc\u7684\u300c\u55ae\u514b\u9686\u8f15\u93c8\u300d\uff08Monoclonal light chain\uff09\uff0c\u300c\u55ae\u514b\u9686\u300d\uff08Monoclonality\uff09\u4e43\u300c\u6f3f\u7d30\u80de\u300d\u4f86\u81ea\u55ae\u4e00\u300c\u6bcd\u7d30\u80de\u300d\uff0c\u5176\u300c\u5b50\u7d30\u80de\u300d\u5206\u6ccc\u5206\u5b50\u7d50\u69cb\u5b8c\u5168\u76f8\u540c\u7684\u300c\u8f15\u93c8\u300d\u3002\u300c\u6fb1\u7c89\u6a23\u86cb\u767d\u300d\u6c89\u6fb1\u75c5\u8005\u9ad4\u5167\u91cd\u8981\u5668\u5b98\uff0c\u9020\u6210\u7834\u58de\uff0c\u4e3b\u8981\u5f71\u97ff\u5fc3\u81df\u3001\u814e\u81df\u3001\u8178\u9053\u3001\u76ae\u819a\u3001\u809d\u81df\u3001\u820c\u982d\u53ca\u9aa8\u9ad3\u7b49\u91cd\u8981\u5668\u5b98\u3002\u60a3\u8005\u820c\u982d\u8139\u5927\uff0c\u53c8\u7a31\u300c\u5de8\u820c\u982d\u300d\uff08Macroglossia\uff09\u3002\u814e\u81df\u53d7\u640d\u5f15\u767c\u56b4\u91cd\u300c\u86cb\u767d\u5c3f\u300d\uff0c\u53ef\u5f15\u81f4\u5168\u8eab\u6c34\u816b\uff0c\u751a\u81f3\u814e\u529f\u80fd\u8870\u7aed\u3002\u5fc3\u81df\u53d7\u5f71\u97ff\u5c24\u5176\u5371\u96aa\uff0c\u5f15\u81f4\u5fc3\u81df\u529f\u80fd\u8870\u7aed\uff0c\u53ef\u8fc5\u901f\u81f4\u547d\u3002\u300c\u6fb1\u7c89\u6a23\u8b8a\u6027\u300d\u5e38\u8207\u300c\u6f3f\u7d30\u80de\u9aa8\u9ad3\u764c\u300d\u6709\u95dc\uff0c\u6cbb\u7642\u65b9\u6cd5\u4ea6\u5927\u540c\u5c0f\u7570\uff0c\u6709\u6548\u85e5\u7269\u5305\u62ec\u300c\u985e\u56fa\u9187\u300d\uff08Steroid\uff09\u3001\u300c\u787c\u66ff\u4f50\u7c73\u300d\uff08Bortezomib\uff09\u3001\u300c\u6c99\u5229\u5ea6\u80fa\u300d\uff08Thalidomide\uff09\u3001\u300c\u74b0\u78f7\u9170\u80fa\u300d\uff08Cyclophosphamide\uff09\u53ca\u300c\u99ac\u6cd5\u862d\u300d\uff08Melphalan\uff09\u7b49\u85e5\u7269\uff1b\u8f03\u5e74\u8f15\u75c5\u8005\u53ef\u8003\u616e\u63a5\u53d7\u300c\u81ea\u9ad4\u5468\u908a\u8840\u5e79\u7d30\u80de\u79fb\u690d\u300d\uff08Autologous peripheral blood stem cell transplantation\uff09\uff0c\u53ef\u66f4\u6709\u6548\u63a7\u5236\u75c5\u60c5\u3002<\/p>\n<p>&nbsp;<\/p>\n<p>\u6587\uff1a\u6881\u61b2\u5b6b\uff08\u8840\u6db2\u53ca\u8840\u6db2\u816b\u7624\u79d1\u5c08\u79d1\u91ab\u751f\uff09<\/p>\n<p>&nbsp;<\/p>\n<p><strong>\u91ab\u8a00\u6709\u7406\u7cfb\u5217\u6587\u7ae0:<br \/>\n<\/strong><br \/>\n<a title=\"\u96f7\u8afe\u6c0f\u73fe\u8c61 \u624b\u6307\u8b8a\u8272\u767d\u85cd\u7d05\" href=\"\/\/www.afterroberto.com\/%e9%86%ab%e8%a8%80%e6%9c%89%e7%90%86-%e9%9b%b7%e8%ab%be%e6%b0%8f%e7%8f%be%e8%b1%a1-%e6%89%8b%e6%8c%87%e8%ae%8a%e8%89%b2%e7%99%bd%e8%97%8d%e7%b4%85\/\">\u96f7\u8afe\u6c0f\u73fe\u8c61 \u624b\u6307\u8b8a\u8272\u767d\u85cd\u7d05<\/a><\/p>\n<p><a title=\"\u91ab\u8a00\u6709\u7406\uff1a\u51b7\u51dd\u96c6\u7d20\u75c5 \u4f4e\u6eab\u6613\u75c5\u767c\" href=\"\/\/www.afterroberto.com\/%e9%86%ab%e8%a8%80%e6%9c%89%e7%90%86-%e5%86%b7%e5%87%9d%e9%9b%86%e7%b4%a0%e7%97%85-%e4%bd%8e%e6%ba%ab%e6%98%93%e7%97%85%e7%99%bc\/\">\u51b7\u51dd\u96c6\u7d20\u75c5 \u4f4e\u6eab\u6613\u75c5\u767c<\/a><\/p>\n<p><a title=\"\u91ab\u8a00\u6709\u7406\uff1a\u4e2d\u6027\u7d30\u80de\u6578\u91cf\u6e1b \u7d30\u83cc\u611f\u67d3\u98a8\u96aa\u589e\" href=\"\/\/www.afterroberto.com\/%e9%86%ab%e8%a8%80%e6%9c%89%e7%90%86%ef%bc%9a%e4%b8%ad%e6%80%a7%e7%b4%b0%e8%83%9e%e6%95%b8%e9%87%8f%e6%b8%9b-%e7%b4%b0%e8%8f%8c%e6%84%9f%e6%9f%93%e9%a2%a8%e9%9a%aa%e5%a2%9e\/\">\u4e2d\u6027\u7d30\u80de\u6578\u91cf\u6e1b \u7d30\u83cc\u611f\u67d3\u98a8\u96aa\u589e<\/a><\/p>\n<p><a title=\"\u63a5\u53d7\u5316\u7642 \u6613\u60a3\u5ff5\u73e0\u83cc\u611f\u67d3\" href=\"\/\/www.afterroberto.com\/%e9%86%ab%e8%a8%80%e6%9c%89%e7%90%86%ef%bc%9a%e6%8e%a5%e5%8f%97%e5%8c%96%e7%99%82-%e6%98%93%e6%82%a3%e5%bf%b5%e7%8f%a0%e8%8f%8c%e6%84%9f%e6%9f%93\/\">\u63a5\u53d7\u5316\u7642 \u6613\u60a3\u5ff5\u73e0\u83cc\u611f\u67d3<\/a><\/p>\n<p><a title=\"\u91cd\u7de8\u57fa\u56e0\u5f71\u97ff\u5f8c\u4ee3\" href=\"\/\/www.afterroberto.com\/%e9%86%ab%e8%a8%80%e6%9c%89%e7%90%86%ef%bc%9a%e9%87%8d%e7%b7%a8%e5%9f%ba%e5%9b%a0%e5%bd%b1%e9%9f%bf%e5%be%8c%e4%bb%a3\/\">\u91ab\u8a00\u6709\u7406\uff1a\u91cd\u7de8\u57fa\u56e0\u5f71\u97ff\u5f8c\u4ee3<\/a><\/p>\n<p><a href=\"\/\/www.afterroberto.com\/tag\/%e9%86%ab%e8%a8%80%e6%9c%89%e7%90%86\/\">\u5176\u4ed6\u91ab\u8a00\u6709\u7406\u7cfb\u5217\u6587\u7ae0<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u3010\u660e\u5831\u5c08\u8a0a\u301180\u6b72\u7684\u9673\u5a46\u5a46\u5b9a\u671f\u6aa2\u67e5\u8eab\u9ad4\uff0c\u6700\u8fd1\u767c\u73fe\u6709\u300c\u86cb\u767d\u5c3f\u300d\uff08Proteinuria\uff09\uff0c\u814e\u81df\u53ca\u5fc3\u81df\u529f\u80fd\u4ea6\u9010\u6f38\u8f49\u5dee\uff1b\u300c\u814e\u81df\u6d3b\u7d44\u7e54\u6aa2\u67e5\u300d\uff08Renal biopsy\uff09\u986f\u793a\u300c\u6fb1\u7c89\u6a23\u8b8a\u6027\u300d\uff08Amyloidosis\uff09\uff0c\u5c6c\u8840\u6db2\u75be\u75c5\u4e00\u7a2e\u3002 &nbsp; &nbsp; \u300c\u6fb1\u7c89\u6a23\u86cb\u767d\u300d\uff08Amyloid proteins\uff09\u4e43\u300c\u4f4e\u5206\u5b50\u91cf\u7684\u8840\u6f3f\u86cb\u767d\u300d\uff08Low molecular weight plasma proteins\uff09\uff0c\u53ef\u5728\u8eab\u9ad4\u5404\u5668\u5b98\u7d44\u7e54\u7d30\u80de\u5916\u6c89\u7a4d\uff0c\u5f62\u6210\u5e7c\u5c0f\u7684\u300c\u7e96\u7d72\u300d\uff08Fibrils\uff09\uff0c\u7834\u58de\u7d30\u80de\u7d44\u7e54\uff0c\u5f71\u97ff\u5668\u5b98\u6b63\u5e38\u529f\u80fd\uff0c\u9019\u7a31\u70ba\u300c\u6fb1\u7c89\u6a23\u8b8a\u6027\u300d\u3002 \u300c\u6fb1\u7c89\u6a23\u8b8a\u6027\u300d\u6709\u591a\u7a2e\uff0c\u5c6c\u7f55\u898b\u75be\u75c5\uff0c\u5176\u4e2d\u4ee5\u300c\u539f\u767c\u6027\u6fb1\u7c89\u6a23\u8b8a\u6027\u300d\uff08Primary amyloidosis\uff09\u8f03\u591a\u898b\uff0c\u53c8\u7a31AL amyloidosis\uff0c\u5c6c\u300c\u514b\u9686\u6f3f\u7d30\u80de\u589e\u751f\u75c5\u300d\uff08Clonal plasma cell proliferative disorder\uff09\uff0c\u75c5\u56e0\u5305\u62ec\u300c\u6f3f\u7d30\u80de\u9aa8\u9ad3\u7624\u300d\uff08plasma cell myeloma\uff09\u53ca\u300c\u5de8\u7403\u86cb\u767d\u8840\u75c7\u300d\uff08Waldenstrom macroglobulinemia\uff09\u3002 \u4eba\u9ad4\u6b63\u5e38\u300cB\u6dcb\u5df4\u7d30\u80de\u300d\u53ef\u8f49\u5316\u6210\u300c\u6f3f\u7d30\u80de\u300d\uff0c\u5206\u6ccc\u300c\u514d\u75ab\u7403\u86cb\u767d\u300d\uff08Immunoglobulins\uff09\uff0c\u5373\u5c0d\u4ed8\u7d30\u83cc\u548c\u75c5\u6bd2\u7684\u6297\u9ad4\uff08Antibody\uff09\uff0c\u5c6c\u4eba\u9ad4\u514d\u75ab\u7cfb\u7d71\u7684\u4e00\u500b\u91cd\u8981\u90e8\u5206\u3002\u300c\u514d\u75ab\u7403\u86cb\u767d\u300d\u7684\u5206\u5b50\u7d50\u69cb\u6709\u300c\u91cd\u93c8\u300d\uff08Heavy chain\uff09\u548c\u300c\u8f15\u93c8\u300d\uff08Light chain\uff09\u5169\u90e8\u5206\uff0c\u4e0d\u540c\u7684\u57fa\u56e0\u7d44\u5408\u53ef\u7d44\u6210\u5343\u5343\u842c\u842c\u4e0d\u540c\u7d50\u69cb\u7684\u6297\u9ad4\uff0c\u5c0d\u4ed8\u4e0d\u540c\u76ee\u6a19\uff0c\u5c24\u5176\u7d30\u83cc\u548c\u75c5\u6bd2\u3002 &nbsp; \u53ef\u81f4\u820c\u982d\u8139\u5927 \u5fc3\u814e\u8870\u7aed \u300c\u6fb1\u7c89\u6a23\u86cb\u767d\u300d\u6e90\u81ea\u7570\u5e38\u6f3f\u7d30\u80de\u6240\u5206\u6ccc\u7684\u300c\u55ae\u514b\u9686\u8f15\u93c8\u300d\uff08Monoclonal light 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