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--> 00:03.536\n各位晚上好啊，\n\n00:03.536 --> 00:09.612\n很荣幸的为大家科普一下变异性支气管肺曲霉病的一个科普。\n\n00:14.559 --> 00:17.608\n我们从六个方面来科普啊，\n\n00:17.809 --> 00:20.059\n第一个方面是疾病的概述，\n\n00:20.309 --> 00:21.884\n第二方面是症状表现，\n\n00:21.884 --> 00:23.434\n第三方面是诊断方法，\n\n00:23.434 --> 00:25.009\n第四方面是治疗方法，\n\n00:25.358 --> 00:27.358\n第五方面是预防与管理，\n\n00:27.358 --> 00:29.208\n第六方面是研究进展。\n\n00:31.065 --> 00:31.965\n疾病的概述。\n\n00:33.877 --> 00:38.377\n定义分类变异性支气管肺曲霉病是一种。\n\n00:39.631 --> 00:42.980\n由曲霉菌引起的过敏性疾病，\n\n00:43.030 --> 00:44.930\n主要影响肺部和支气管。\n\n00:47.243 --> 00:50.068\n它有侵袭性跟非侵袭性分类的，\n\n00:50.318 --> 00:50.818\n然后呢，\n\n00:50.818 --> 00:51.667\n根据感染程度。\n\n00:52.518 --> 00:52.993\n该病呢，\n\n00:52.993 --> 00:55.417\n分为侵袭性和非侵袭性两种类型。\n\n00:56.388 --> 00:56.563\n当然，\n\n00:56.563 --> 00:58.238\n侵袭性的是更更为严重的，\n\n00:58.238 --> 00:58.813\n可能呢，\n\n00:58.863 --> 01:00.263\n严重可能危及生命。\n\n01:01.861 --> 01:03.361\n过敏性支气管肺曲霉病。\n\n01:04.209 --> 01:06.260\n是变异性支气管肺曲霉，\n\n01:06.610 --> 01:07.809\n肺曲霉病的一种，\n\n01:08.209 --> 01:10.209\n表现为曲霉菌的过敏反应，\n\n01:10.410 --> 01:12.010\n就是一个对曲霉菌的过敏。\n\n01:15.143 --> 01:16.043\n发病机制，\n\n01:16.744 --> 01:17.344\n第一个呢，\n\n01:17.344 --> 01:18.244\n是免疫系统异常。\n\n01:20.171 --> 01:23.022\n变性变异性的支气管肺曲霉病呢，\n\n01:23.222 --> 01:25.972\n通常发生在免疫系统功能受损的个体中。\n\n01:26.869 --> 01:27.969\n我像艾滋病患者啊，\n\n01:27.969 --> 01:30.268\n还有一个接受免疫治疗的患者，\n\n01:30.319 --> 01:31.543\n肿瘤肿瘤病人，\n\n01:31.543 --> 01:33.719\n一种化疗的患者之类的，\n\n01:33.918 --> 01:35.043\n免疫系统差了，\n\n01:35.043 --> 01:35.918\n他就容易。\n\n01:37.654 --> 01:37.904\n然后呢，\n\n01:37.904 --> 01:39.504\n曲霉菌孢子的吸入。\n\n01:41.517 --> 01:42.318\n孢子呢，\n\n01:42.318 --> 01:44.242\n在肺部定植后呢，\n\n01:44.242 --> 01:45.242\n引发过敏，\n\n01:45.242 --> 01:46.568\n过敏反应或者感染。\n\n01:47.865 --> 01:48.916\n遗传的易感性啊，\n\n01:49.066 --> 01:49.990\n研究显示呢，\n\n01:49.990 --> 01:53.990\n某些的遗传因素可能增加个体对曲霉菌敏感性，\n\n01:53.990 --> 01:54.566\n从而呢，\n\n01:54.566 --> 01:57.015\n容易发展为变异性支气管肺曲霉病。\n\n01:57.669 --> 02:01.069\n就是比较少有些少量的遗传遗传因素啊。\n\n02:02.896 --> 02:03.545\n影响人群。\n\n02:04.903 --> 02:06.503\n免疫系统的受损的第一个是，\n\n02:06.853 --> 02:07.603\n然后呢，\n\n02:07.903 --> 02:10.154\n常见于免疫系统受损的人群，\n\n02:10.503 --> 02:11.354\n艾滋病啊，\n\n02:11.354 --> 02:12.979\n然后接受化疗的癌症病人，\n\n02:12.979 --> 02:14.354\n这些人免疫功能差。\n\n02:15.382 --> 02:17.983\n就是容易容易感染这肺曲霉病，\n\n02:18.432 --> 02:20.632\n然后慢慢性的肺部疾病患者，\n\n02:20.983 --> 02:27.283\n我们常见的COPD慢阻肺的病人更容易感染曲霉菌。\n\n02:28.488 --> 02:29.238\n抵抗力差，\n\n02:29.488 --> 02:30.339\n然后第三个呢，\n\n02:30.339 --> 02:31.938\n是长期的使用激素的激素。\n\n02:31.938 --> 02:34.289\n长期使用类固醇激素呢，\n\n02:34.289 --> 02:36.188\n因为免疫抑制的抑制以后，\n\n02:36.238 --> 02:37.139\n抵抗力差，\n\n02:37.188 --> 02:37.664\n然后呢，\n\n02:37.664 --> 02:38.089\n然后呢，\n\n02:38.089 --> 02:39.089\n容易感染该病。\n\n02:40.652 --> 02:41.052\n曲霉菌。\n\n02:43.804 --> 02:46.003\n第二部分是症状表现。\n\n02:48.175 --> 02:49.324\n呼吸系统症状，\n\n02:49.375 --> 02:50.425\n持续性咳嗽，\n\n02:50.875 --> 02:52.824\n变异性支气管肺曲霉病。\n\n02:53.692 --> 02:53.867\n患者，\n\n02:53.867 --> 02:55.992\n常出现的是持续性的咳嗽，\n\n02:55.992 --> 02:56.893\n不是间歇性的，\n\n02:56.893 --> 02:57.893\n是持续性的咳嗽，\n\n02:58.143 --> 02:58.742\n有时呢，\n\n02:58.742 --> 02:59.492\n有咳痰的，\n\n02:59.792 --> 03:00.343\n然后呢，\n\n03:00.343 --> 03:01.992\n是一个常见的早期的症状。\n\n03:04.123 --> 03:04.774\n第二个呢，\n\n03:04.774 --> 03:05.498\n是呼吸困难。\n\n03:05.498 --> 03:06.949\n如果是病情进展了，\n\n03:07.199 --> 03:08.548\n说明病情加重了嘛。\n\n03:08.798 --> 03:09.423\n然后呢，\n\n03:09.423 --> 03:11.798\n可能会感到呼吸急促和困难，\n\n03:11.848 --> 03:13.649\n尤其是在体力活动后。\n\n03:14.589 --> 03:15.740\n症状更为明显，\n\n03:16.339 --> 03:17.740\n说明病情加重了，\n\n03:18.440 --> 03:19.190\n非常胸痛，\n\n03:19.190 --> 03:20.589\n胸痛可能是更严重了，\n\n03:20.839 --> 03:22.139\n尤其是在深呼吸，\n\n03:22.190 --> 03:23.039\n深吸气，\n\n03:23.539 --> 03:25.240\n深呼吸或者咳嗽时呢，\n\n03:25.339 --> 03:27.539\n可能由于肺部感染引起的胸膜炎，\n\n03:27.539 --> 03:28.240\n所以呢，\n\n03:28.289 --> 03:30.289\n会会引起引起胸痛的。\n\n03:31.126 --> 03:32.477\n感染性的胸膜炎的变成。\n\n03:33.796 --> 03:34.397\n全身反应。\n\n03:35.539 --> 03:36.440\n发热跟寒颤。\n\n03:37.544 --> 03:39.393\n因为这个肺曲霉病。\n\n03:41.988 --> 03:43.113\n一些过敏反应，\n\n03:43.113 --> 03:45.339\n它会引起的反复的发热跟寒颤。\n\n03:48.022 --> 03:48.572\n第二个呢，\n\n03:48.572 --> 03:49.371\n是体重减轻，\n\n03:49.671 --> 03:51.072\n因为长期的炎症反应啊，\n\n03:51.072 --> 03:52.322\n免疫系统过度活跃，\n\n03:52.671 --> 03:53.171\n然后呢，\n\n03:53.171 --> 03:56.022\n患者可能会有经历不明原因的体重减轻。\n\n03:57.570 --> 03:58.270\n疲劳和乏力，\n\n03:58.619 --> 03:59.970\n持续的全身炎症呢，\n\n03:59.970 --> 04:02.470\n会导致患者感到极度的疲劳和乏力，\n\n04:02.520 --> 04:04.345\n影响日常工作和生活。\n\n04:04.345 --> 04:04.744\n这个呢，\n\n04:04.744 --> 04:05.169\n可能。\n\n04:06.776 --> 04:08.326\n我们一般跟那个。\n\n04:09.567 --> 04:10.542\n肺结核有点类似，\n\n04:10.542 --> 04:11.516\n也是会引起。\n\n04:12.401 --> 04:15.501\n发热、寒颤、体重减轻、疲劳和乏力。\n\n04:17.808 --> 04:19.358\n肺结核病人也是这样的，\n\n04:19.358 --> 04:20.358\n容易混淆。\n\n04:22.838 --> 04:24.613\n诊断标准第一个呢，\n\n04:24.613 --> 04:25.687\n是影像学的检查。\n\n04:27.740 --> 04:33.240\n通过胸部的X光或CT扫描观察肺部是否有异常阴影，\n\n04:33.441 --> 04:33.941\n然后呢，\n\n04:33.941 --> 04:36.691\n以辅助诊断变异性支气管肺曲霉病。\n\n04:36.990 --> 04:39.740\n这个是可能是我们最重要的检查措施，\n\n04:39.740 --> 04:40.890\n就是拍片子。\n\n04:42.104 --> 04:42.854\n有没有阴影？\n\n04:42.854 --> 04:45.204\n有没有曲霉病的肺炎之类的？\n\n04:46.269 --> 04:46.519\n第二呢，\n\n04:46.519 --> 04:47.720\n血液跟体液检查。\n\n04:48.877 --> 04:49.101\n这个呢，\n\n04:49.101 --> 04:50.027\n是确诊性的，\n\n04:50.177 --> 04:52.277\n我们怀疑霉菌感染。\n\n04:53.019 --> 04:55.869\n我们要查血清中的曲霉菌特异性抗体。\n\n04:56.699 --> 04:57.199\n或通过呢，\n\n04:57.199 --> 04:58.648\n支气管肺泡灌洗液呢，\n\n04:58.898 --> 05:01.098\n我们培养培养出曲霉菌，\n\n05:01.148 --> 05:02.598\n那就是确诊了。\n\n05:04.397 --> 05:04.671\n然后，\n\n05:04.671 --> 05:05.397\n皮肤试验，\n\n05:05.596 --> 05:07.397\n曲霉菌皮肤试验呢，\n\n05:07.446 --> 05:09.247\n观察对曲霉菌抗原的反应，\n\n05:09.296 --> 05:10.747\n这个是能帮助诊断的。\n\n05:11.446 --> 05:13.696\n帮助诊断的是是不是过敏的。\n\n05:14.557 --> 05:17.282\n诊断过敏的好，\n\n05:17.282 --> 05:19.356\n第三章章的诊断方法。\n\n05:24.223 --> 05:24.973\n实验室检查呢，\n\n05:24.973 --> 05:26.473\n血清学检查我们通过呢，\n\n05:26.473 --> 05:28.773\n血清学的特异性抗体IGIG。\n\n05:29.901 --> 05:33.550\n来诊断变异性支气管肺曲霉病来诊断的，\n\n05:33.550 --> 05:34.651\n这个是用来诊断的。\n\n05:34.901 --> 05:35.651\n然后呢，\n\n05:35.751 --> 05:36.825\n点刺试验呢，\n\n05:36.825 --> 05:38.851\n是查一些过敏反应的。\n\n05:39.973 --> 05:40.123\n是，\n\n05:40.123 --> 05:41.873\n是不是有过敏性的肺曲霉病？\n\n05:43.174 --> 05:44.674\n用皮肤点刺实验。\n\n05:46.295 --> 05:46.494\n然后呢，\n\n05:46.494 --> 05:47.795\n影像学检查呢，\n\n05:47.795 --> 05:48.595\nCT什么的，\n\n05:48.744 --> 05:50.795\n能够观察肺部的结构，\n\n05:50.845 --> 05:57.195\n帮助确定了肺曲霉肺肺曲霉曲霉菌感染的一个范围跟严重程度。\n\n05:58.147 --> 05:59.397\n主要是CT的检查。\n\n06:02.093 --> 06:02.843\n影像学检查，\n\n06:02.993 --> 06:05.444\n我们有胸片。\n\n06:05.544 --> 06:06.394\n胸片呢，\n\n06:06.493 --> 06:09.694\n最早期的筛查只能做个初步的看看，\n\n06:09.843 --> 06:11.243\n严重的才能看得清楚。\n\n06:11.243 --> 06:11.968\n比如结节啊，\n\n06:11.968 --> 06:13.593\n或者就有空洞啊，\n\n06:13.944 --> 06:14.493\n但是呢，\n\n06:14.493 --> 06:15.243\n不够特异性。\n\n06:16.140 --> 06:16.339\n然后呢，\n\n06:16.339 --> 06:17.290\n高分辨率CT呢，\n\n06:17.290 --> 06:18.140\n还是比较好的，\n\n06:18.190 --> 06:20.890\n能够清晰的显示肺部的结构。\n\n06:21.638 --> 06:22.088\n有助呢，\n\n06:22.088 --> 06:26.138\n发现早期的肺曲霉、霉曲霉菌病变，\n\n06:26.238 --> 06:29.588\n晕晕轮症、空气新月症，\n\n06:29.687 --> 06:32.287\n这些都是一个霉菌感染的一些。\n\n06:33.321 --> 06:33.671\n表现。\n\n06:35.378 --> 06:37.378\n派D47跟派D47扫描。\n\n06:38.424 --> 06:40.123\n这个更精确的定位感染区，\n\n06:40.424 --> 06:41.498\n对治疗的规划呢，\n\n06:41.498 --> 06:42.273\n有指导意义。\n\n06:43.161 --> 06:43.911\n全身性的pet。\n\n06:45.320 --> 06:48.070\n能全身心的定位感染。\n\n06:50.002 --> 06:51.752\n其他辅助诊断，\n\n06:52.351 --> 06:55.701\n血清学检查还是前面的血清IGIGG。\n\n06:56.721 --> 06:57.321\n辅助诊断。\n\n06:59.627 --> 07:00.778\n然后CT。\n\n07:01.985 --> 07:04.786\n评估一下严重程度和辅助诊断，\n\n07:05.085 --> 07:11.135\n肺部的曲霉菌感染平复试验是一个辅助诊断依据，\n\n07:11.135 --> 07:12.161\n因为这个简单，\n\n07:12.161 --> 07:13.135\n可操作性强。\n\n07:13.976 --> 07:15.701\n我们看一下皮肤的试验，\n\n07:15.701 --> 07:16.726\n过敏反应有没有？\n\n07:18.369 --> 07:19.970\n第四部分是治疗方法。\n\n07:22.329 --> 07:24.230\n治疗肯定是首选，\n\n07:24.230 --> 07:25.380\n肯定是抗真菌治疗。\n\n07:25.380 --> 07:30.380\n我们现在有那个伏利伏利康唑或者伊曲康唑等抗真菌的药物，\n\n07:30.679 --> 07:31.429\n那然后呢，\n\n07:31.429 --> 07:33.230\n以抑制曲霉菌生长，\n\n07:33.230 --> 07:34.329\n然后控制病情。\n\n07:36.566 --> 07:37.015\n第二部分呢，\n\n07:37.015 --> 07:38.115\n是长期的维持治疗。\n\n07:38.115 --> 07:42.316\n因为真菌感染可能需要需要一个长期的治疗，\n\n07:42.665 --> 07:44.615\n特别是一个慢性的反复发作的病例，\n\n07:44.915 --> 07:47.066\n需要长期的用抗真菌的药物的，\n\n07:47.216 --> 07:47.865\n然后呢，\n\n07:48.216 --> 07:49.466\n维持了病情的稳定。\n\n07:49.466 --> 07:52.665\n因为真菌感染还是比较比较顽固的。\n\n07:54.454 --> 07:55.403\n免疫调节剂，\n\n07:55.403 --> 07:56.428\n在某些情况下，\n\n07:56.428 --> 07:58.229\n医生可能会开具一个免疫调节剂，\n\n07:58.229 --> 08:00.104\n因为有些人抵抗力差。\n\n08:01.368 --> 08:02.518\n抵抗力差的一些，\n\n08:02.667 --> 08:06.018\n然后补充一些皮质类固醇，\n\n08:06.417 --> 08:08.067\n减少免疫系统的过度反应。\n\n08:10.467 --> 08:13.167\n改善一下这种症状。\n\n08:15.270 --> 08:15.920\n外科手术。\n\n08:17.394 --> 08:20.420\n我提到外科手术肯定是病情进展的比较严重的。\n\n08:21.429 --> 08:25.654\n我们通过药物治疗可能无法无法完全根治，\n\n08:25.654 --> 08:28.654\n或者反复发作以后无法通过药物治疗根治，\n\n08:28.654 --> 08:32.530\n或者药物药物对有些区域的话已经起不到作用了，\n\n08:32.530 --> 08:35.655\n就因为有些有些感染是可能封闭在腔里面的。\n\n08:36.241 --> 08:37.991\n药物很难很难进到这个地方，\n\n08:38.541 --> 08:42.491\n本身那个真霉菌感染也是很比比较顽固的。\n\n08:43.981 --> 08:44.682\n然后呢，\n\n08:44.682 --> 08:45.132\n肺叶，\n\n08:45.132 --> 08:46.281\n第一个是肺叶切除，\n\n08:46.281 --> 08:47.432\n肺叶切除整个，\n\n08:47.432 --> 08:48.531\n切除整个肺叶。\n\n08:49.349 --> 08:51.099\n如果是严重变异性支气管肺，\n\n08:51.150 --> 08:53.000\n肺就是霉菌感染以后。\n\n08:53.866 --> 08:56.382\n整累积整个肺叶的可能，\n\n08:56.382 --> 08:58.015\n要把整个肺叶都切掉。\n\n08:59.038 --> 09:03.312\n然后肺段切除可能感染相对来讲比较比较小的局限性的，\n\n09:03.312 --> 09:03.638\n但是呢，\n\n09:03.638 --> 09:05.487\n反复感染治疗不好，\n\n09:05.588 --> 09:08.213\n那就行肺段切除啊，\n\n09:08.213 --> 09:10.838\n以最小的话对肺功能的影响。\n\n09:11.890 --> 09:12.815\n第三个胸廓成形术，\n\n09:12.815 --> 09:13.815\n那肯定是胸壁了，\n\n09:13.815 --> 09:17.690\n胸壁胸壁部分结结构的手术嘛。\n\n09:18.718 --> 09:20.818\n一些药物治疗无效的，\n\n09:20.818 --> 09:22.244\n只能做这个胸廓成形术。\n\n09:24.380 --> 09:24.681\n嗯。\n\n09:26.416 --> 09:31.041\n其他的治疗手段就是前面讲的一个抗真菌药物嘛，\n\n09:31.041 --> 09:32.416\n氟利康唑、伊曲康唑。\n\n09:33.265 --> 09:35.866\n针对针对性的抑制霉菌的生长和繁殖，\n\n09:36.366 --> 09:37.366\n然后免疫调节。\n\n09:37.466 --> 09:38.466\n然后用一些。\n\n09:39.659 --> 09:41.609\n免疫调节免疫系统，\n\n09:41.659 --> 09:46.159\n增加对对这个真菌感染的防御能力嘛，\n\n09:46.159 --> 09:47.135\n减少感染风险。\n\n09:47.135 --> 09:50.159\n外科手术是无治疗药物治疗无效的情况下。\n\n09:50.862 --> 09:51.812\n可能需要手术，\n\n09:52.163 --> 09:55.088\n然后切除感染的肺组织，\n\n09:55.088 --> 09:55.513\n然后呢，\n\n09:55.513 --> 09:56.362\n以控制病情。\n\n09:59.320 --> 09:59.919\n第五章。\n\n10:01.463 --> 10:02.213\n预防与管理。\n\n10:05.418 --> 10:06.067\n预防措施，\n\n10:06.067 --> 10:08.418\n第一个就是避免接触霉菌。\n\n10:10.185 --> 10:11.236\n在潮湿的环境下，\n\n10:11.236 --> 10:15.786\n潮湿的环境避免接触可能含有曲霉菌的物品，\n\n10:16.036 --> 10:17.310\n像潮湿的土壤啊，\n\n10:17.310 --> 10:17.861\n植物啊，\n\n10:17.861 --> 10:18.786\n灰尘等等。\n\n10:20.065 --> 10:20.690\n抵抗力差的人，\n\n10:20.690 --> 10:22.315\n潮湿的地方注意点，\n\n10:22.616 --> 10:23.140\n然后呢，\n\n10:23.140 --> 10:24.265\n改善室内的通风，\n\n10:24.466 --> 10:26.216\n保持室内空气通畅，\n\n10:26.815 --> 10:28.616\n然后使用空气净化器啊，\n\n10:28.616 --> 10:31.565\n然后减少霉菌孢子在室内的聚集，\n\n10:31.565 --> 10:33.366\n尤其尤其是抵抗力差的人，\n\n10:33.716 --> 10:35.515\n我们讲那个肿瘤化疗的病人，\n\n10:36.216 --> 10:37.828\n艾滋病病人等。\n\n10:37.828 --> 10:38.940\n第三个呢，\n\n10:38.940 --> 10:40.466\n是佩戴防护口罩。\n\n10:41.174 --> 10:41.374\n然后呢，\n\n10:41.374 --> 10:45.273\n进行园艺活动或者清理可能受霉菌感染的区域，\n\n10:45.273 --> 10:46.523\n污染的区域时呢，\n\n10:46.674 --> 10:49.174\n建议佩戴一个N95等防护口罩。\n\n10:49.473 --> 10:50.124\n然后呢，\n\n10:50.174 --> 10:51.924\n减少吸入的霉菌孢子。\n\n10:53.533 --> 10:54.833\n也是蛮重要的。\n\n10:58.153 --> 10:58.603\n疾病管理，\n\n10:58.603 --> 10:59.752\n定期监测肺功能，\n\n10:59.802 --> 11:01.502\n定期进行肺功能测试。\n\n11:01.853 --> 11:02.353\n如果呢，\n\n11:02.353 --> 11:05.453\n肺活量和呼如肺活量和呼气流量，\n\n11:05.653 --> 11:07.302\n以监测病情的变化，\n\n11:07.403 --> 11:08.603\n及时调整治疗方案，\n\n11:08.603 --> 11:11.353\n就是看看病情的进展进展情况。\n\n11:12.098 --> 11:12.947\n避免了接触霉菌。\n\n11:15.278 --> 11:17.228\n前面讲的就是病菌高发的环境，\n\n11:17.578 --> 11:19.278\n减少接触嘛。\n\n11:19.578 --> 11:20.752\n如果有些接触嘛，\n\n11:20.752 --> 11:22.203\n是实在要接触，\n\n11:22.203 --> 11:23.528\n可以戴好N95口罩。\n\n11:24.945 --> 11:26.221\n然后合理使用抗真菌药，\n\n11:26.221 --> 11:26.895\n真菌药物，\n\n11:26.895 --> 11:29.195\n因为抗真菌药物有些慢性的可能，\n\n11:29.546 --> 11:32.096\n可能用的时间疗程比较长的。\n\n11:33.392 --> 11:36.341\n还是要还是要合理使用。\n\n11:40.114 --> 11:40.963\n患者的教育，\n\n11:41.963 --> 11:42.564\n第一个呢，\n\n11:42.564 --> 11:45.213\n认识疾病要让患者了解。\n\n11:46.671 --> 11:47.671\n肺的真菌感染，\n\n11:47.971 --> 11:48.622\n病因啊，\n\n11:48.622 --> 11:49.122\n症状啊，\n\n11:49.122 --> 11:50.096\n潜在风险啊，\n\n11:50.096 --> 11:50.721\n还能。\n\n11:51.731 --> 11:54.031\n以提高他的自己的自我管理的能力。\n\n11:54.330 --> 11:54.931\n第二个呢，\n\n11:54.931 --> 11:55.630\n环境控制。\n\n11:56.718 --> 11:58.068\n在家中患者的家中啊，\n\n11:58.068 --> 11:59.193\n减少霉菌暴露，\n\n11:59.494 --> 12:01.294\n保持室内干燥啊，\n\n12:01.294 --> 12:03.268\n定期清洁空调系统等。\n\n12:03.268 --> 12:04.193\n第三个呢，\n\n12:04.193 --> 12:04.994\n药物管理呢，\n\n12:05.393 --> 12:06.794\n向患者解释啊，\n\n12:06.843 --> 12:10.494\n抗真菌药物正确的使用方法和可能的副作用。\n\n12:11.254 --> 12:11.629\n然后呢，\n\n12:11.629 --> 12:13.929\n一定要强调按按时服药的重要性。\n\n12:13.929 --> 12:14.479\n定期呢，\n\n12:14.479 --> 12:19.129\n到医院去检查检查看看看看疾病的病情的变化呀，\n\n12:19.129 --> 12:23.179\n或者有些有些药物的不良反应之类的一些要复查，\n\n12:23.179 --> 12:24.778\n要查检查检查肝功能之类，\n\n12:24.778 --> 12:27.653\n肝功能之类的有没有一些药物的不良反应。\n\n12:29.106 --> 12:31.705\n第六章就是研究的进展，\n\n12:34.455 --> 12:35.906\n最新的研究成果，\n\n12:36.505 --> 12:37.130\n现在呢，\n\n12:37.130 --> 12:40.406\n是有这种新型的抗真菌药物，\n\n12:40.406 --> 12:41.455\n如三唑类。\n\n12:42.422 --> 12:47.372\n鸡白菌素类提高了治疗变异性支气管肺曲霉病的效率，\n\n12:47.473 --> 12:48.023\n这呢，\n\n12:48.023 --> 12:53.223\n是我们期待的最好有一些更好的一些抗真菌药物的药物的出出来，\n\n12:53.223 --> 12:53.622\n我们。\n\n12:54.392 --> 12:54.666\n我们呢，\n\n12:54.666 --> 12:56.692\n能够对这种真菌感染。\n\n12:58.039 --> 12:59.489\n更有更多的办法，\n\n12:59.739 --> 13:02.814\n要不然真菌感染真的是一个对我们医生来说，\n\n13:02.814 --> 13:04.414\n医生来讲都是很棘手的，\n\n13:04.414 --> 13:05.338\n棘手的问题，\n\n13:05.439 --> 13:06.838\n真菌感染很难治疗。\n\n13:07.658 --> 13:08.109\n很顽固。\n\n13:09.974 --> 13:11.075\n叫免疫治疗策略。\n\n13:12.215 --> 13:13.664\n最新的免疫治疗策略，\n\n13:14.015 --> 13:16.914\n靶向T、H二细胞的生物制剂。\n\n13:17.627 --> 13:19.276\n为患者提供了新的治疗选择，\n\n13:19.276 --> 13:20.226\n改善预后。\n\n13:20.276 --> 13:21.127\n免疫治疗。\n\n13:21.981 --> 13:22.807\n从根本出发嘛，\n\n13:22.807 --> 13:24.632\n增加增加自己的免疫力，\n\n13:24.932 --> 13:27.132\n针对这个真菌的抵抗力。\n\n13:28.674 --> 13:30.448\n诊断技术的革新啊，\n\n13:30.448 --> 13:34.499\n通过一些高通量测序和生物标志物，\n\n13:34.499 --> 13:36.874\n提高了变异性支气管肺曲霉病的。\n\n13:37.617 --> 13:39.367\n一些早期的诊断率缩短了。\n\n13:40.354 --> 13:40.979\n诊断时间，\n\n13:40.979 --> 13:41.929\n缩短诊断时间，\n\n13:41.929 --> 13:42.554\n早诊断，\n\n13:42.905 --> 13:43.580\n早诊断，\n\n13:43.580 --> 13:44.054\n早治疗，\n\n13:44.054 --> 13:47.205\n肯定是对疾病肯定是有很多好处的。\n\n13:50.523 --> 13:51.672\n治疗方法的创新，\n\n13:52.072 --> 13:53.223\n靶向药物治疗。\n\n13:55.302 --> 13:58.077\n一些靶向药物去治疗，\n\n13:58.476 --> 13:58.976\n然后呢，\n\n13:58.976 --> 14:00.226\n第二个是免疫疗法。\n\n14:01.132 --> 14:02.833\n通过增增加患者免疫系统，\n\n14:03.182 --> 14:04.833\n然后改善患者的预后，\n\n14:05.182 --> 14:06.158\n手术治疗呢，\n\n14:06.158 --> 14:09.333\n是最臭的手段，\n\n14:09.682 --> 14:11.083\n有些难以控制的。\n\n14:11.958 --> 14:17.208\n局部感染手术切除感染组织也是一种非常有效的治疗选择。\n\n14:21.049 --> 14:22.249\n未来的研究方向。\n\n14:23.908 --> 14:25.059\n精准医疗的开发。\n\n14:26.911 --> 14:32.260\n我们正致力于呢开发针对个体基因和免疫反应的精准医疗方案，\n\n14:32.611 --> 14:33.911\n以提高治疗效果。\n\n14:35.245 --> 14:35.520\n新型，\n\n14:35.520 --> 14:36.796\n新型的抗真菌药物。\n\n14:40.002 --> 14:41.653\n新型抗真菌药物肯定是对，\n\n14:42.252 --> 14:43.853\n不仅是肺气霉病。\n\n14:44.721 --> 14:47.372\n跟针对其他的真菌感染可能。\n\n14:48.215 --> 14:51.315\n希望的有新的更更有效的，\n\n14:51.315 --> 14:54.414\n然后副作用小的一些抗真菌药物的问世，\n\n14:54.965 --> 14:56.289\n让我们有更多的办法。\n\n14:56.289 --> 14:56.590\n然后，\n\n14:56.590 --> 14:57.364\n第三第二个，\n\n14:57.364 --> 14:57.864\n第三个呢，\n\n14:57.864 --> 14:59.215\n是免疫调节治疗，\n\n14:59.465 --> 15:03.614\n增加患者抵抗真菌的能力。\n\n15:04.450 --> 15:05.099\n然后找诊断。\n\n15:05.919 --> 15:06.195\n早诊断，\n\n15:06.195 --> 15:08.570\n可能是任何病疾病都是要早诊断。\n\n15:09.283 --> 15:12.383\n然后我们能才能更早的去干预好，\n\n15:12.383 --> 15:13.133\n谢谢大家。\n\n","v0347cg10004d7344vqljht2k22vr7o0",918,602,"2026-03-25 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