ÉöÔಡÊÇÒ»Öָ߷¢¼²²¡£¬ÌìϹæÄ£ÄÚÆ½¾ùÿ10¸ö³ÉÄêÈËÖоÍÓÐ1ÈË»¼ÓÐÂýÐÔÉöÔಡ£¬ÆäÒý·¢µÄéæÃüÂÊÒ»Á¬ÉÏÉý£¬Ô¤¼Æµ½2040Ä꽫»á³ÉΪµÚÎå´óËÀÒò¡£½ñÌìÊǵÚ19¸öÌìÏÂÉöÔàÈÕ£¬ÈÃÎÒÃÇÒ»Æð¹Ø×¢ÕâÀàÌØÊâµÄÉöÔ༲²¡¡¡
һλ32ËêµÄÄÐÊ¿ÔÚÌå¼ìʱ·¢Ã÷ÉöÔàÉÏÓÐÄÒÖס£Ëû¸æËßÌå¼ì±¨¸æ½â¶ÁÒ½Éú£¬×Ô¼ºµÄÂèÂèÊÇһλ¶àÄÒÉö²¡»¼Õß¡£ÎªÁ˽øÒ»²½Ã÷È·Õï¶Ï£¬ÔÚÒ½Éú½¨ÒéÏ£¬Ëû×öÁËÏà¹Ø»ùÒò¼ì²â¡£×ÛºÏmg±ùÇòÍ»ÆÆ¹ÙÍøÍøÕ¾³ö¾ßµÄ¼ì²â±¨¸æºÍÒÅ´«×ÉѯʦÆÊÎö£¬¼ì³öËûµÄPKD1»ùÒòÓÐÒÉËÆÖ²¡±äÒ죨NM_001009944.3 c.10796C>G p.Ser3599Ter exon36£©£¬¸Ã±äÒìÒ²ÓëÆäÏÖÔÚµÄÁÙ´²ÐÅÏ¢Ò»Ö¡£ ͨ¹ýÉÏÊö·¢Ã÷£¬×îÖÕÕï¶ÏÕâλÄÐʿ¼µÄÊdz£È¾É«ÌåÏÔÐÔ¶àÄÒÉö¡£ÕâÊÇÒ»ÖÖ×î³£¼ûµÄÒÅ´«ÐÔÉö²¡Ö®Ò»£¬·¢²¡ÂÊԼΪ1/1000ÇÒ»áËæ×ÅÄêËêÔöÌí¶øÔöÌí¡£Ô¼Äª50%µÄ»¼ÕßÔÚ60Ëêʱ»¼ÓÐÖÕÄ©ÆÚÉö²¡£¬Ò²¾ÍÊÇ¡°Äò¶¾Ö¢¡±¡£
ΪʲôÒÅ´«ÐÔÉö²¡ÄÑÒÔÔçÆÚ²ì¾õ£¿ ÔÚµ¼ÖÂÖÕÄ©ÆÚÉö²¡µÄÔµ¹ÊÔÓÉÖУ¬ÒÅ´«ÐÔÉö²¡ÅÅÃûµÚÎ壬½ô¸úÔÚÂýÐÔÉöÑס¢ÌÇÄò²¡Éö²¡µÈÖ®ºó¡£ÓÐԼĪ10%-15%µÄÉöÔಡ»¼Õß¶¼ÊÇÓÉÓÚÒÅ´«ÒòËØ»¼²¡£¬ÌØÊâÊÇÔÚÄêÇáÈ˺ͶùͯȺÌåÖиüΪͻ³ö¡£ºÃ±È£¬ÔÚ25Ëêǰ»¼ÂýÐÔÉö²¡µÄÈËȺÖУ¬Ã¿5¸ö¾ÍÓÐ1¸öÊÇÒÅ´«ÐÔÉö²¡£»¶øÔÚÐèÒª¾ÙÐжùͯÉöÒÆÖ²µÄ²¡ÀýÖУ¬Èý³ÉÒÔÉ϶¼ÓëÒÅ´«Óйء£ ÒÅ´«ÐÔÉö²¡ÓÐ×ÅÖØ´óµÄ»ùÒòÅä¾°¡ª¡ªÏÖÔÚÒÑÖªÖ²¡»ùÒòÁè¼Ý600¸ö£¬²¢ÇÒÒÅ´«·½·¨¶àÖÖ¶àÑù£¬ÓеÄÊÇÏÔÐÔÒÅ´«£¬ÓеÄÊÇÒþÐÔÒÅ´«¡£ÕâÒâζ×Å£¬Ðí¶àÒÅ´«ÐÔÉö²¡ÔÚ³õÆÚ½×¶ÎÍùÍùÖ¢×´²»ÏÔ×Å»òÕßÓëÆäËûÀàÐÍÉö²¡ÏàËÆ£¬²»Ò×±»Ê¶±ð³öÀ´£¬ÉõÖÁÓÐʱֱµ½²¡ÇéÉú³¤µ½Éö¹¦Ð§Ë¥½ßµÄÌïµØ²Å±»È·Õï¡£ ±ðµÄ£¬ÉÐÓÐÐí¶à¹ýʧµÄ¿´·¨Ò²ÔÚÎóµ¼×Å»¼Õߣº¡°ÒÅ´«ÐÔÉö²¡¾ÍÊÇÏÈÌìÐÔÉö²¡£¬ÎÒ¶¼¼¸Ê®ËêÁ˲ŵõÄÉö²¡£¬Ò»¶¨²»ÊÇÒÅ´«²¡¡£¡±¡°âïÊѶ¼Ã»²¡£¬ÎÒÒ»¶¨²»ÊÇÒÅ´«²¡¡£¡±ÊÂʵÉÏ£¬ÒÅ´«²¡¼È¿ÉÒÔÊÇÓ¤Ó×¶ùʱÆÚ·¢²¡£¬Ò²»áÍíÖÁ¼¸Ê®ËêÉõÖÁÍíÄêʱ²ÅÊ×´ÎÕ¹ÏÖ²¡Ö¢¡£ÒÔÊÇ£¬ÏÖÔÚ¿´ÆðÀ´¿µ½¡µÄÈË£¬Ò²ÓпÉÄÜЯ´øÖ²¡»ùÒò¶ø²»×ÔÖª£¬²¢½«Õâ¸öΣº¦ÇÄÎÞÉùÏ¢µØ´«¸øÏÂÒ»´ú¡£
»ùÒò¼ì²âÖúÁ¦ÒÅ´«ÐÔÉö²¡ÔçÕï¶Ï
»ùÒò¼ì²âÊÖÒÕͨ¹ý¼ì²âÈËÌåDNAÖеıäÒ죬Äܹ»×¼È·Ê¶±ðÓëÒÅ´«ÐÔÉö²¡Ïà¹ØµÄÌØ¶¨»ùÒòÍ»±ä£¬ÊµÏÖ¼²²¡µÄÔçÆÚ¡¢¾«×¼Õï¶Ï£¬¿ÉÒÔÖ»¹Ü×èÖ¹½öÒÀÀµÁÙ´²Ö¢×´µ¼ÖµÄÎóÕï»òÑÓ³ÙÕï¶Ï¡£
ÄÄЩÉö²¡»¼Õß½¨Òé×ö»ùÒò¼ì²â£¿ 1.ÁÙ´²ÌåÏÖÀàËÆÒÅ´«ÐÔ¼²²¡£» 2.ÓÐÃ÷È·µÄÒÅ´«ÇãÏò£» 3.ÓмÒ×åÊ·£» 4.ͨÀýµÄÁÙ´²Á÷³ÌÄÑÒÔÈ·Õ 5.ÔçÆÚÕï¶ÏÓÐÖúÓÚÔ¤·ÀÐÔ¸ÉÔ¤£» 6.ÌØÊâµÄµØÇøºÍÖÖ×å¡£ ¼ò¶øÑÔÖ®£¬¹ØÓÚÄÇЩÔçÆÚ·¢²¡¡¢Õï¶Ï²»Ã÷¡¢ÖÎÁÆÐ§¹û²»¼Ñ¡¢ÏÓÒɾßÓÐÒÅ´«ÐÔ×Ó»òÓмÒ×åÉö²¡Ê·µÄ»¼Õߣ¬¶¼½¨Òé˼Á¿¾ÙÐлùÒò¼ì²â¡£
»ùÒò¼ì²âÔÚÒÅ´«ÐÔÉö²¡ÕïÁÆÖеÄ×÷Óà 1.ÅжÏÏêϸÀàÐÍ£¬Ö¸µ¼ÖÎÁÆÆ«Ïò£¬ÅжÏÔ¤ºó¡£ ׼ȷʶ±ðÒÅ´«ÐÔÉö²¡µÄÀàÐÍ£¬Îª»¼ÕßÌṩÕë¶ÔÐÔµÄÖÎÁƼƻ®¡£²¿·ÖÒÅ´«ÐÔÉö²¡ÈçÊÊÓø¨Ã¸Q10¡¢Íз¥ÆÕ̹µÈÒ©ÎïÖÎÁƵÄÇéÐΣ¬Í¨¹ý¼ì²â¿ÉÃ÷È·ÓÃÒ©Ñ¡Ôñ£»Í¬Ê±×èÖ¹ÎÞЧÖÎÁÆ£¬¼õÇᾼü縺ºÍÒ©Î︱×÷Óᣠ×ÊÖúÕ¹Íû¼²²¡Éú³¤Àú³Ì£¬ÊÊʱÆô¶¯¸ÉÔ¤²½·¥£¬×ÊÖúÔ¤¹ÀÉöË¥½ßµÄ±¬·¢Ê±¼ä£¬ÒÔ±ãÊµÊ±ÖÆ¶©¸öÐÔ»¯Ò½ÁÆÕ½ÂÔ¡£ ÓÐÖúÓÚÒ½Éú¸üºÃµØÆÀ¹ÀÉöÒÆÖ²ÊÖÊõµÄÀÖ³ÉÂʼ°ºóÐø¹ÜÀí¡£ 2.ɸ²é¼ÒÍ¥¸ßΣ³ÉÔ±£¬Ö¸µ¼ÓÅÉúÓÅÓý¡£ ¿ÉÕ¹ÏÖ¼Ò×åÖÐÆäËû³ÉÔ±µÄ»¼²¡Î£º¦¡£ ¹ØÓÚÓÐÉúÓýÍýÏëµÄ¼ÒÍ¥À´Ëµ£¬¿Éͨ¹ý»ùÒò¼ì²â¾ÙÐÐÅßÌ¥Ö²Èëǰ»ò²úǰÒÅ´«É¸²é£¬ÌáǰµÃÖª×ÓÅ®ÊÇ·ñЯ´øÖ²¡»ùÒò£¬ÊµÏÖÓÅÉúÓÅÓý¡£
»ùÒò¼ì²âÔõô×ö£¿
ÉöÔàÏà¹Ø»ùÒò¼ì²âͨ³£Í¨¹ý¼òÆÓµÄ³éѪÀ´»ñÈ¡Ñù±¾£¬ÊܼìÈËÎÞÐèÌØÊâ×¼±¸£¬¿Õ¸¹¡¢ÓÃÒ©µÈ¾ù²»Ó°ÏìÑù±¾¡£µ«ÎªÁ˸üºÃµØÃ÷È·Õï¶Ï£¬ËͼìÕßÐèÌṩÏ꾡µÄ²¡Ê·ºÍÁÙ´²×ÊÁÏ¡£mg±ùÇòÍ»ÆÆ¹ÙÍøÍøÕ¾¿ÉÌṩÒÅ´«ÐÔÉö²¡Õï¶ÏÕûÌå½â¾ö¼Æ»®£¬²¢ÓÉרҵµÄÒÅ´«×ÉѯʦÍŶÓÌṩ±¨¸æ½â¶Á·þÎñ¡£
mg±ùÇòÍ»ÆÆ¹ÙÍøÍøÕ¾ÉöÔಡÏà¹Ø»ùÒò¼ì²âÏîÄ¿ mg±ùÇòÍ»ÆÆ¹ÙÍøÍøÕ¾³Ð¼Ì¡°ÁÙ´²±íÐÍ+¾¼Ã¸ßЧ¡±µÄ»ùÒòÕï¶ÏÀíÄÔÚÌá¸ßÒÅ´«ÐÔÉö²¡¼ì²âˮƽµÄͬʱ£¬³ä·ÖÍŽỼÕßµÄÁÙ´²ÌåÏÖÌØÕ÷¼°ÒÅ´«Åä¾°ÐÅÏ¢£¬ÖúÁ¦Ò½Éú¸ü׼ȷµØÕï¶Ï¼²²¡ÀàÐͺÍÕ¹Íû¼²²¡Éú³¤Ç÷ÊÆ£¬´Ó¶øÎª»¼ÕßÌṩÕë¶ÔÐÔÖÎÁÆ£¬ÓÐÓüõÇá¼²²¡ÕïÁÆÀú³ÌÖеľ¼Ã¼ç¸º¡£ ³ýÁËͨ¹ý»ùÒò¼ì²âÖúÁ¦ÒÅ´«ÐÔÉö²¡ÔçÕï¶Ï£¬mg±ùÇòÍ»ÆÆ¹ÙÍøÍøÕ¾ÔçÒѽ¨ÉèÉöÔಡ¼ì²âÖÐÐÄ£¬ÒÔ±ê×¼»¯ºÍ¹æ·¶»¯µÄÉö»î¼ì²¡Àí¼ì²é¼°±¨¸æÏµÍ³Îª»ù´¡£¬Á¢ÒìÈÚºÏÊý×Ö»¯²¡ÀíÊÖÒÕºÍÍøÂçÆ½Ì¨ÓÅÊÆ£¬ÎªÁÙ´²Õï¶Ï¡¢ÁÙ´²ÊÔÑéÓë¿ÆÑС¢ÐÂÖÎÁưеãµÄѰÕÒµÈÌṩ¼ì²â·þÎñ£¬ÖúÁ¦ÁÙ´²Öƶ©ÖÖÖÖÉöÔ༲²¡µÄ¸öÌ廯ÖÎÁƼƻ®¡£
²Î¿¼ÎÄÏ× [1]M¨¹ller RU, Messchendorp AL, Birn H, et al. An update on the use of tolvaptan for autosomal dominant polycystic kidney disease: consensus statement on behalf of the ERA Working Group on Inherited Kidney Disorders, the European Rare Kidney Disease Reference Network and Polycystic Kidney Disease International. Nephrol Dial Transplant. 2022 Apr 25;37(5):825-839. [2]ÐìµÂ³¬,÷³¤ÁÖ. ¶àÄÒÉö²¡µÄÁÙ´²Êµ¼ùÖ¸ÄÏ[J]. ÖлªÒ½Ñ§ÒÅ´«Ñ§ÔÓÖ¾, 2020(3): 277-283. [3]Íз¥ÆÕ̹ÖÎÁÆ¿ìËÙÏ£ÍûÐͳ£È¾É«ÌåÏÔÐÔ¶àÄÒÉö²¡×¨¼Ò×é. Íз¥ÆÕ̹ÖÎÁÆ¿ìËÙÏ£ÍûÐͳ£È¾É«ÌåÏÔÐÔ¶àÄÒÉö²¡Öйúר¼Ò¹²Ê¶[J]. ÖлªÉöÔಡÔÓÖ¾, 2022, 38(7): 644-652.