Äê²ú1000¶ÖÇàÃ¹ËØ¹¤³§¹¤ÒÕÉè¼Æ

5¸øÅÅË®.......................................................................................................................................... 25

5.1 Éú²úÓÃË®Çé¿ö¸ÅÊö¼°ÒªÇó ............................................................................................. 25 5.2 ÅÅˮϵͳµÄ»®·ÖºÍ·ÏË®ÀûÓà ......................................................................................... 25 6»·¾³±£»¤...................................................................................................................................... 26

6.1 Éú²ú¹ý³ÌÖС°Èý·Ï¡±ÅÅ·ÅÇé¿ö ..................................................................................... 26 6.2 ´¦Àí·½°¸ ......................................................................................................................... 27 6.3 ÔëÉù¿ØÖÆ ......................................................................................................................... 27 7½ÚÄÜ ............................................................................................................................................. 28

7.1 ÄܺķÖÎö ......................................................................................................................... 28 7.2 ½ÚÄÜ´ëÊ© ......................................................................................................................... 28

5

1ǰÑÔ

1.1ÇàÃ¹ËØµÄ·¢ÏÖ

20ÊÀ¼Í40Äê´úÒÔǰ£¬ÈËÀàһֱδÄÜÕÆÎÕÒ»ÖÖÄܸßЧÖÎÁÆÏ¸¾úÐÔ¸ÐȾÇÒ¸±×÷ÓÃСµÄÒ©Îï¡£µ±Ê±ÈôijÈË»¼Á˷νáºË£¬ÄÇô¾ÍÒâζ×Å´ËÈ˲»¾Ã¾Í»áÀ뿪ÈËÊÀ¡£ÎªÁ˸ıäÕâÖÖ¾ÖÃæ£¬¿ÆÑÐÈËÔ±½øÐÐÁ˳¤ÆÚ̽Ë÷£¬È»¶øÔÚÕâ·½ÃæËùÈ¡µÃµÄÍ»ÆÆÐÔ½øÕ¹È´Ô´×ÔÒ»¸öÒâÍâ·¢ÏÖ¡£1928Ä꣬Ӣ¹úϸ¾úѧ¼ÒFleming·¢ÏÖÎÛȾÔÚÅàÑøÆÏÌÑÇò¾úµÄË«µûÉϵÄÒ»Öêù¾úÄÜɱËÀÖÜΧµÄÆÏÌÑÇò¾ú¡£Ëû½«´Ëù¾ú·ÖÀë´¿»¯ºóµÃµ½µÄ¾úÖê¾­¼ø¶¨ÎªµãÇàù£¬²¢½«Õâ¾úËù²úÉúµÄ¿¹ÉúÎïÖÊÃüÃûΪÇàÃ¹ËØ¡£

ĿǰÊÀ½çÇàÃ¹ËØÄêÐèÇóÁ¿Îª3.8Íò¶Ö£¬µ«Ö±½Ó×÷ΪעÉä¼ÁʹÓõÄÇàÃ¹ËØGºÍ×÷Ϊ¿Ú·þ¼ÁʹÓõÄÇàÃ¹ËØV½öռȫ²¿ÇàÃ¹ËØ²úÆ·µÄ20%£¬³ýÁËÁíÍâ3%¡«5%×÷ΪÊÞÒ©»òËÇÁÏÌí¼Ó¼ÁʹÓÃÍ⣬´ó²¿·ÖÇàÃ¹ËØÊÇ×÷ÎªÖÆ±¸6-°±»ùÇàÃ¹ËØÍé¡¢7-°±»ùÍÑÒÒõ£Ñõ»ùÍ·æßÏ©Ëá»òÂÈÑǼ׻ùÍ·æßϩĸºËµÄÔ­ÁÏ£¬Í¨¹ýÕâЩĸºËÖмäÌåת»¯³É¸ß¸½¼ÓÖµ²úÆ·ÍÆÏòÊг¡¡£¾Ý¹À¼Æ£¬ÔÚÊÀ½ç·¶Î§ÄÚĿǰ¶Ô6-°±»ùÇàÃ¹ËØÍéµÄÐèÇóÁ¿Ô¼Îª25800¶Ö£¬µ½2005Ä꽫´ïµ½32800¶Ö£»¶Ô7-°±»ùÍÑÒÒõ£Ñõ»ùÍ·æßÏ©ËáµÄÐèÇóÁ¿Ô¼Îª6000¶Ö£¬µ½2005ÄêΪ7000¶Ö¡£µ½2005Ä꣬ÊÀ½ç»ù±¾Ò©ÎïÖУ¬½öôǰ±ÜÐÇàÃ¹ËØ¡¢°±ÜÐÇàÃ¹ËØºÍÍ·æß°±ÜÐ3¸öÆ·ÖÖµÄÊÀ½çÐèÇóÁ¿½«´ï17800¶Ö¡£ÉÏÊöÈýÖÖ²úÆ·Õ¼¿¹¸ÐȾҩÎïÔ­ÁÏÒ©µÄ78%£¬ÓÃÓÚÉú²úÕâЩ°ëºÏ³É²úÆ·ËùÐèÏûºÄµÄÇàÃ¹ËØÔ¼Õ¼È«²¿²úÁ¿µÄ3/4¡£

1953Äê5Ô£¬ÖйúµÚÒ»Åú¹ú²úÇàÃ¹ËØµ®Éú£¬½Ò¿ªÁËÖйúÉú²ú¿¹ÉúËØµÄÀúÊ·¡£ÔÚ1996ÄêµÃµ½Ñ¸ËÙÀ©Õ¹£¬µ±Ê±È«ÇòÇàÃ¹ËØÔ­ÁÏÒ©Äê²úÏúÁ¿´ï4Íò¶Ö×óÓÒ£¬ÆäÖÐÖйúµÄÇàÃ¹ËØÔÚ¹ú¼ÊÊг¡µÄ·Ý¶îÕ¼µ½30%£¬ÇÒ³ö¿ÚÁ¿ÃÍÔö¡£½ØÖÁĿǰ£¬ÖйúÇàÃ¹ËØÄê·¢½ÍÄÜÁ¦ÔÚ1500¶ÖÒÔÉϵÄÓлª±±ÖÆÒ©3200¶Ö£¬¹þÒ©¼¯ÍÅΪ2100

6

¶Ö£¬É½¶«Â³¿¹Îª1290¶Ö£¬ÕâÈý´óÇàÃ¹ËØÉú²úÆóÒµÄê·¢½ÍÄÜÁ¦Îª6590¶Ö£¬Äê·¢½ÍÄÜÁ¦³¬¹ý1000¶ÖµÄÆóÒµ»¹ÓÐËÄ´¨ÖÆÒ©³§¡¢ºÓ±±ÖÆÒ©¼¯ÍźÍÕżҿÚÖÆÒ©×ܳ§¡£ÖйúĿǰÊÇÊÀ½çÉÏ×î´óÇàÃ¹ËØÉú²ú¹ú£¬ÇàÃ¹ËØÔ­ÁÏÖ÷Òª³ö¿ÚÊг¡ÊÇ£ºÓ¡¶È¡¢º«¹ú¡¢ÈÕ±¾¡¢Ì¨Íå¡¢µÂ¹ú¡¢ºÉÀ¼¡¢°®¶ûÀ¼¡¢·¨¹ú¡¢Ïã¸ÛºÍÃÀ¹ú£¬ÕâÊ®´óÊг¡ºÏ¼ÆÕ¼Öйú×ܳö¿ÚÁ¿µÄ82%¡£ÇàÃ¹ËØ¹¤Òµ¼ØÑεÄÉú²úÄÜÁ¦ÒÑÕ¼ÊÀ½çÉú²úÄÜÁ¦40000¶ÖµÄ40%£¬Êµ¼Ê²úÁ¿Õ¼ÊÀ½çµÄ35.29%£¬ÌرðÊǽøÈë2000Ä꣬ÖйúµÄÔ­ÁÏÒ©²úÁ¿ÖÐÓÐÆßÖÖÇàÃ¹ËØÏµÁвúÆ·¾ù³ÊÏÖÔö³¤Ç÷ÊÆ£¬ÆäÖÐßßÀ­Î÷ÁÖÔö³¤ÁË267%£¬ÒÔ6-APAΪÖмäÌåµÄϵÁвúÆ·°¢ÄªÎ÷ÁÖÔö³¤69%£¬²úÁ¿½ü2000¶Ö¡£ 1.2ÇàÃ¹ËØ·Ö×ӽṹ¼°·ÖÀà

ÇàÃ¹ËØ£¨Benzylpenicillin/Penicillin£©ÓÖ±»³ÆÎªÇàÃ¹ËØG¡¢peillinG¡¢ÅÌÄáÎ÷ÁÖ¡¢ÅäÄáÎ÷ÁÖ¡¢ÇàÃ¹ËØÄÆ¡¢ÜÐÇàÃ¹ËØÄÆ¡¢ÇàÃ¹ËØ¼Ø¡¢ÜÐÇàÃ¹ËØ¼Ø¡£

ͼ1 ÇàÃ¹ËØ·Ö×ӽṹʽ

Àí»¯ÐÔÖÊ:ÇàÃ¹ËØ×㿹¾úË÷µÄÒ»ÖÖ£¬×ãÖ¸´ÓÇàÃ¹ËØÅàÑøÒºÖÐÌáÖÆµÄ·Ö×ÓÖк¬ÓÐÇàÃ¹ËØÍé¡¢ÄÜÆÆ»µÏ¸¾úµÄϸ°û±Ú²¢ÔÚϸ¾úϸ°ûµÄ·±Ö³ÆÚÆðɱ¾ú×÷ÓõÄÒ»À࿹ÉúËØ£¬ÊǵÚÒ»ÖÖÄܹ»ÖÎÁÆÈËÀ༲²¡µÄ¿¹ÉúË÷¡£ÇàùË÷À࿹ÉúË÷ÊǦÂ-ÄÚõ£°·ÀàÖÐÒ»´óÀ࿹ÉúË÷µÄ×ܳơ£µ«Ëü²»ÄÜÄÍÊÜÄÍÒ©¾úÖê(ÈçÄÍÒ©½ðÆÏ)Ëù²úÉúµÄø£¬Ò×±»ÆäÆÆ»µ£¬ÇÒÆä¿¹¾úÆ×½ÏÕ­£¬Ö÷Òª¶Ô¸ïÀ¼ÊÏÑôÐÔ¾úÓÐЧ¡£ÇàÃ¹ËØGÓмØÑΡ¢ÄÆÑÎÖ®·Ö£¬¼ØÑβ»½ö²»ÄÜÖ±½Ó¾²×¢£¬¾²ÂöµÎעʱ£¬Ò²Òª×Ðϸ¼ÆËã¼ØÀë×ÓÁ¿£¬ÒÔÃâ×¢ÈëÈËÌåÐγɸßѪ¼Ø¶øÒÖÖÆÐÄÔ๦ÄÜ£¬Ôì³ÉËÀÍö[1]¡£ 1.3ÇàÃ¹ËØµÄµ¥Î»

7

Ŀǰ¹ú¼ÊÉÏÇàÃ¹ËØ»îÐÔµ¥Î»±íʾ·½·¨ÓÐÁ½ÖÖ:Ò»ÊÇÖ¸¶¨µ¥Î»(unit );¶þÊÇ»îÐÔÖÊÁ¿(¦Ìg£©£¬×îÔçΪÇàÃ¹ËØ¹æ¶¨µÄÖ¸¶¨µ¥Î»ÊÇ:50mLÈâÌÀÅàÑø»ùÖÐÇ¡ÄÜÒÖÖÆ±ê×¼½ð»ÆÉ«ÆÏÌѾúÉú³¤µÄ×îСÇàÃ¹ËØ¼ÁÁ¿ÎªÒ»¸öÇàÃ¹ËØµ¥Î»¡£ÔÚÒÔºó£¬Ö¤Ã÷ÁËÒ»¸öÇàÃ¹ËØµ¥Î»Ï൱ÓÚ0.6¦ÌgÇàÃ¹ËØÄÆ¡£Òò´ËÇàÃ¹ËØµÄÖÊÁ¿µ¥Î»Îª:0.6¦ÌgÇàÃ¹ËØÄÆµÈÓÚ1¸öÇàÃ¹ËØµ¥Î»¡£ÓÉ´Ë£¬lmgÇàÃ¹ËØÄÆµÈÓÚ1667¸öÇàÃ¹ËØµ¥Î»(unit)[2]¡£ 1.4×÷ÓûúÀí

ÇàÃ¹ËØÊǦ£­ÄÚõ£°·ÄÚ¿¹ÉúËØ£¬×÷ÓûúÀíÈçÏ£º

£¨1£©Í¨¹ý¾ºÕùϸ¾úµÄÕ³ëĺϳÉø£¬¼´ÇàÃ¹ËØ½áºÏµ°°×£¨penicillin binding proteins£¬PBP£©£¬ÒÖÖÆÏ¸°û±ÚµÄÕ³ëĺϳɣ¬Ôì³Éϸ¾úϸ°û±ÚȱË𣬴óÁ¿µÄË®·ÖÓ¿½øÏ¸¾úÌåÄÚ£¬Ê¹Ï¸¾úÖ×ÕÍ¡¢ÆÆÁÑ¡¢ËÀÍö£»

£¨2£©´Ù·¢×ÔÈÜø»îÐÔ£¬Ê¹Ï¸¾úÈܽ⡣ϸ¾ú¾ßÓÐÌØ¶¨µÄϸ°û±ÚºÏ³ÉÐèÒªµÄºÏ³Éø£¬¼´ÇàÃ¹ËØ½áºÏµ°°×£¨penicillin binding proteins, PBP£©µ±¦Â-ÄÚõ£°·À࿹¾úÒ©ÎïÓëPBP½áºÏºó£¬PBP±ãʧȥøµÄ»îÐÔ£¬ÊÇϸ°û±ÚµÄºÏ³ÉÊܵ½×è°­£¬×îÖÕÔì³Éϸ°ûÈܽ⡢ϸ¾úËÀÍö¡£PBP°´·Ö×ÓÁ¿µÄ²»Í¬¿É·ÖΪÎåÖÖ£ºÃ¿ÖÖÓÖÓÐÈô¸ÉÑÇÐÍ£¬ÕâЩPBP´æÔÚÓÚϸ¾úϸ°ûµÄÖÊĤÖУ¬¶Ôϸ¾úϸ°û±ÚµÄºÏ³ÉÆð²»Í¬µÄ×÷Óá£

×î³õÇàÃ¹ËØµÄÉú²ú¾úÊÇÒô·ûÐÍÇàù¾ú£¬Éú²úÄÜÁ¦Ö»Óм¸Ê®¸öµ¥Î»£¬²»ÄÜÂú×㹤ҵÐèÒª¡£ËæºóÕÒµ½ÁËÊʺÏÓÚÉî²ãÅàÑøµÄéÏé­ÐÍÇàù¾ú£¬¼´²ú»ÆÇàù£¨P. chrosogenum£©£¬Éú²úÄÜÁ¦Îª100U/ml¡£¾­¹ýX¡¢×ÏÍâÏßÓձ䣬Éú²úÄÜÁ¦´ïµ½1000£­1500U/ml¡£Ëæºó¾­¹ýÓձ䣬µÃµ½²»²úÉúÉ«ËØµÄ±äÖÖ£¬Ä¿Ç°Éú²úÄÜÁ¦¿É´ï66000£­70000U/ml¡£ÇàÃ¹ËØÊÇ¿¹ÉúËØ¹¤ÒµµÄÊ×Òª²úÆ·¡£ 1.5ÇàÃ¹ËØµÄÓ¦ÓÃ

ÁÙ´²Ó¦ÓÃ:40¶àÄ꣬Ö÷Òª¿ØÖÆÃô¸Ð½ð»ÆÉ«ÆÏÌÇÇò¾ú¡¢Á´Çò¾ú¡¢·ÎÑ×Ë«Çò¾ú¡¢ÁÜÇò¾ú¡¢ÄÔĤÑ×Ë«Çò¾ú¡¢ÂÝÐýÌåµÈÒýÆð¸ÐȾ£¬¶Ô´ó¶àÊý¸ïÀ¼ÊÏÑôÐÔ¾ú(Èç½ð»ÆÉ«

8

ÁªÏµ¿Í·þ£º779662525#qq.com(#Ìæ»»Îª@)