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2020骞磋(w猫i)鐢熻硣鏍煎収(n猫i)绉戜富娌婚啱(y墨)甯€冭│椤屽韩(k霉)锛氬父瑕嬬櫏鐙€鑸囬珨寰丄3/A4椤�

B

1銆丄.榛忔恫鑶胯渚�

B.娲楄倝姘存ǎ琛€渚�

C.鏆楃磪鑹叉灉閱ǎ鑶胯渚�

D.鏌忔补渚�

E.榛戣壊渚�

<1> 銆佹€ユ€х窗(x矛)鑿屾€х棦鐤剧偤

A B C D E

<2> 銆侀樋绫冲反鐥㈢柧澶氱偤

A B C D E

2銆佷互涓嬬偤闂�(gu膩n)浜庝究琛€鐨勪即鐧�(f膩)鐧ョ媭閫�(j矛n)琛岄憭鍒ヨê鏂风殑瑕侀粸(di菐n)

A.浼村懆鏈熸€ц吂鐥�

B.浼撮噷鎬ュ悗閲�

C.浼寸毊鑶氱矘鑶滄垚绨囩殑姣涚窗(x矛)琛€绠℃摯(ku貌)寮�

D.浼磋吂閮ㄨ叓濉�

E.鐨啔绮樿啘鍑鸿

<1> 銆侀伜鍌虫€ф瘺绱�(x矛)琛€绠℃摯(ku貌)寮电櫏

A B C D E

<2> 銆佺洿鑵哥檶銆佺棦鐤�

A B C D E

<3> 銆佹祦琛屾€у嚭琛€鐔�

A B C D E

<4> 銆佽吀閬撴儭鎬ф穻宸寸槫

A B C D E

<5> 銆佹秷鍖栭亾娼扮槏

A B C D E

3銆丄.鐧�(f膩)绱轰即鍛煎惛鍥伴洠

B.涓績鎬х櫦(f膩)绱�

C.鍛ㄥ湇鎬х櫦(f膩)绱�

D.鐧�(f膩)绱轰即鏉电媭鎸�

E.鎱㈡€ц偤閮ㄧ柧鐥�

<1> 銆佸叏韬€х櫦(f膩)绱虹偤

A B C D E

<2> 銆佺櫦(f膩)绱哄父鍑虹従(xi脿n)鍦ㄨ偄楂旂殑鏈鑸囦笅鍨傞儴浣�

A B C D E

4銆丄.娉㈢媭鐔�

B.寮涘嫉鐔�

C.闁撴瓏鐔�

D.涓嶈(gu墨)鍓囩啽

E.绋界暀鐔�

<1> 銆佸偡瀵掔殑鍏稿瀷鐔卞瀷鐐�

A B C D E

<2> 銆佺槯鐤剧殑鍏稿瀷鐔卞瀷鐐�

A B C D E

<3> 銆佺祼(ji茅)鏍哥梾鐨勫吀鍨嬬啽鍨嬬偤

A B C D E

<4> 銆佸竷姘忔】鑿岀梾鐨勫吀鍨嬬啽鍨嬬偤

A B C D E

<5> 銆佸寲鑶挎€х値鐧ョ殑鍏稿瀷鐔卞瀷鐐�

A B C D E

5銆丄.绐佺櫦(f膩)鐨勪腑涓婅吂鍔囩儓鍒€鍓叉ǎ鐥涳紝鐕掔伡妯ｇ棝

B.涓笂鑵规寔绾�(x霉)鎬у妵鐥涙垨闄ｇ櫦(f膩)鎬у姞鍔�

C.闄ｇ櫦(f膩)鎬у妽绐佷笅閴嗛爞妯ｇ柤鐥�

D.鎸佺簩(x霉)寤ｆ硾鍔囩儓鑵圭棝浼磋吂澹佽倢绶婂嫉鎴栨澘妯ｅ挤(qi谩ng)鐩�

E.鍙充笅鑵瑰鐥�

<1> 銆佽喗閬撹洈锜茬櫏鍙嚭鐝�(xi脿n)

A B C D E

<2> 銆佹€ユ€у綄婕€ц吂鑶滅値鍙嚭鐝�(xi脿n)

A B C D E

<3> 銆佹€ユ€ц儍鐐庢垨鑳拌吅鐐庡彲鍑虹従(xi脿n)

A B C D E

<4> 銆佸崄浜屾寚鑵告桨鐦嶇┛瀛斿彲鍑虹従(xi脿n)

A B C D E

6銆丄. 鑵圭棝浼翠紤鍏嬨€佽钵琛€

B. 鑵圭棝浼撮粌鐤�銆佺櫦(f膩)鐔便€佸瘨鎴�(zh脿n)

C. 鑵圭棝浼磋吂鐎�

D. 鑵圭棝浼村弽閰搞€佺噿蹇�銆佸櫙姘�

E. 鑵圭棝浼磋灏�

<1> 銆佺暟浣嶅濞犵牬瑁傚彲瑕�

A B C D E

<2> 銆佹€ユ€ц喗鍥婄値鍙

A B C D E

<3> 銆佹秷鍖栨€ф桨鐦嶅彲瑕�

A B C D E

<4> 銆佹€ユ€ц吀鐐庡彲瑕�

A B C D E

<5> 銆佸翱璺祼(ji茅)鐭冲彲瑕�

A B C D E

7銆丄.楂樻徊鎬ц吂鐎�

B.鍚告敹闅滅鎬ц吂鐎�

C.鍒嗘硨鎬ц吂鐎�

D.閬�(y霉n)鍕�(d貌ng)鎬ц吂鐎�

E.钘ユ簮鎬ц吂鐎�

<1> 銆佽吀鏄撴縺缍滃悎寰�

A B C D E

<2> 銆佽儼鎬ч湇浜傜稖鍚堝緛

A B C D E

<3> 銆侀亥鑶犳€ц吀鐥�

A B C D E

<4> 銆佸厛澶╂€т钩绯栭叾缂轰箯鑵圭€�

A B C D E

8銆丄.鐧借壊娣樼背姘存ǎ渚�

B.澶氭垚绯婃ǎ鎴栨按妯ｄ究锛屽皯鏁�(sh霉)鐐鸿喛琛€渚�

C.鑵圭€変即閲屾€ュ悗閲�

D.鑵圭€変即鐨笅鍑鸿

E.鑵圭€変即鑵归儴鍖呭

<1> 銆佹€ユ€ф劅鏌撴€ц吂鐎夌殑鐗归粸(di菐n)鏄�

A B C D E

<2> 銆侀噸鐧ラ湇浜傛墍鑷磋吂鐎夌殑鐗归粸(di菐n)鏄�

A B C D E

9銆丄.Gilbert缍滃悎寰�

B.Dubin-Johnson缍滃悎寰�

C.Crigler—Najjar

D.Rotor缍滃悎寰�

E.鐒�(w煤)鏁堥€犺

<1> 銆佽倽绱�(x矛)鑳炲皪(du矛)绲�(ji茅)鍚堣喗绱呯礌鍙婂叾浠栨湁姗�(j墨)闄伴洟瀛愭瘺绱�(x矛)鑶界鎺掓硠闅滅澶氳浜�

A B C D E

<2> 銆佽倽绱�(x矛)鑳炴敐鍙栨父闆㈣喗绱呯礌鍜屾帓娉勭祼(ji茅)鍚堣喗绱呯礌鍧囨湁鍏堝ぉ鎬х己闄峰瑕嬩簬

A B C D E

<3> 銆佽喗绱呯礌鐢熸垚閬庡瑕嬩簬

A B C D E

<4> 銆佽倽绱�(x矛)鑳炴敐鍙栨父闆㈣喗绱呯礌闅滅鍙婄窔绮掗珨鍏�(n猫i)钁¤悇绯栭啗閰歌綁(zhu菐n)绉婚叾涓嶈冻澶氳浜�

A B C D E

10銆丄.澶滈枔闄ｇ櫦(f膩)鎬у懠鍚稿洶闆ｄ即鍜崇矇绱呮场娌ǎ鐥�

B.鍜冲椊鍔囩儓鏅�(sh铆)锛岀棸涓付琛€

C.45姝蹭互涓婁即澶ч噺闀�(zh菐ng)鏈熷惛鐓欏彶锛屾寔绾�(x霉)鐥颁腑甯惰

D.浣庣啽銆佺洔姹�銆佸挸楫鐥�

E.闀�(zh菐ng)鏈熷挸鍡斤紝鍜冲ぇ閲忚喛鐥�锛屽弽寰�(f霉)鍑虹従(xi脿n)澶у挴琛€

<1> 銆佽偤绲�(ji茅)鏍哥壒榛�(di菐n)鏄�

A B C D E

<2> 銆佽偤鐧岀壒榛�(di菐n)鏄�

A B C D E

<3> 銆佹敮姘ｇ鎿�(ku貌)寮�?zh铆)鏀竎(di菐n)鏄�

A B C D E

<4> 銆佹€ユ€у乏蹇冭“绔壒榛�(di菐n)鏄�

A B C D E

<5> 銆佹敮鍘熼珨鑲虹値鐗归粸(di菐n)鏄�

A B C D E

11銆丄.闋︿笅娣嬪反绲�(ji茅)

B.宸﹂帠楠ㄤ笂娣嬪反绲�(ji茅)

C.鍙抽帠楠ㄤ笂娣嬪反绲�(ji茅)

D.鑵嬬娣嬪反绲�(ji茅)

E.闋滀笅娣嬪反绲�(ji茅)

<1> 銆佽儍鐧屽父杞�(zhu菐n)绉诲埌

A B C D E

<2> 銆佽偤鐧屽父杞�(zhu菐n)绉诲埌

A B C D E

12銆丄. 鑰冲悗涔崇獊娣嬪反绲�(ji茅)鑵ぇ

B. 宸﹂帠楠ㄤ笂娣嬪反绲�(ji茅)鑵ぇ

C. 鑵嬬涓嬫穻宸寸祼(ji茅)鑵ぇ

D. 鍙抽帠楠ㄤ笂娣嬪反绲�(ji茅)鑵ぇ

E. 闋告繁閮ㄦ穻宸寸祼(ji茅)涓嬬兢鑵ぇ

<1> 銆佽儍鐥呰畩鍙嚧

A B C D E

<2> 銆侀牠鐨梾璁婂彲鑷�

A B C D E

<3> 銆佸捊鍠�銆佹埃绠°€佺敳鐙€鑵虹梾璁婂彲鑷�

A B C D E

13銆丄.鎬ユ€у乏蹇冭“绔偅鑰呭皯灏�锛屽翱姣旈噸1.025

B.灏块牷銆佸翱鎬�

C.绐佺櫦(f膩)鐒�(w煤)灏�锛岄洐鑵庣泜鎿�(ku貌)寮�

D.灏戝翱锛屽翱姣旈噸0.009

E.澶滃翱澶�锛岄洐鑵庤悗绺�

<1> 銆佽厧鍓嶆€ф€ユ€ц厧琛扮

A B C D E

<2> 銆佽厧鎬ф€ユ€ц厧琛扮

A B C D E

<3> 銆佽厧鍚庢€ф€ユ€ц厧琛扮

A B C D E

14銆丄.绁炵稉(j墨ng)鍘熸€ц唨鑳卞姛鑳介殰绀�

B.鑶€鑳辫叓鐦�

C.灏胯矾绲�(ji茅)鐭充即鎰熸煋

D.鑵庝笅鍨�

E.灏胯矾姊楅樆

<1> 銆佸翱鎰忛牷绻佽嚦涓嶈兘闆㈤枊渚垮櫒锛屽翱閲忎笉澶�锛岀劇(w煤)灏跨棝锛岃浜�

A B C D E

<2> 銆佸コ鎬�60姝�锛屼粖骞村父鏈夊翱闋�銆佸翱鎬�锛岀劇(w煤)灏跨棝锛屽翱甯歌(gu墨)妾㈡煡姝ｅ父锛屽彲鑳界殑瑷烘柗鏄�

A B C D E

<3> 銆佺櫦(f膩)鐔憋紝灏跨棝锛岃灏匡紝浼磋叞閮ㄧ棝鍚戞渻(hu矛)闄版斁灏�锛岃浜�

A B C D E

15銆丄.鎰熸煋鎬ц劸澶�

B.娣よ鎬ц劸澶�

C.鍘熺櫦(f膩)鎬ц劸澶�

D.鍏嶇柅鎬ц劸澶�

E.娴告饯(r霉n)鎬ц劸澶�

<1> 銆佸偝鏌撶梾鍠牳绱�(x矛)鑳炲澶氱櫏鐨勮劸澶ф槸

A B C D E

<2> 銆佹參鎬х矑绱�(x矛)鑳炴€х櫧琛€鐥呯殑鑴惧ぇ鏄�

A B C D E

<3> 銆佽倽纭寲鐨勮劸澶ф槸

A B C D E

16銆丄.寰炶冻閮ㄩ枊濮�锛屼笅鍨傞儴浣嶆槑椤�

B.瓒抽儴闁嬪锛岃吂姘村父鏇寸獊鍑�

C.鐪肩灱鎴栬冻閮ㄩ枊濮�

D.瓒抽儴闁嬪

E.鑴涘墠鎴栫溂鐪跺懆鍦�

<1> 銆佸績婧愭€ф按鑵殑闁嬪閮ㄤ綅

A B C D E

<2> 銆佽厧婧愭€ф按鑵殑闁嬪閮ㄤ綅

A B C D E

17銆丄.椤卞収(n猫i)澹撳楂�

B.鍋忛牠鐥�

C.闋告鐥呰畩

D.楂樿澹撶梾

E.鑲岀簴缍祫绻旂値

<1> 銆侀閮ㄩ牠鐥涘瑕嬩簬

A B C D E

<2> 銆佷竴鍋�(c猫)椤抽儴闋棝澶氳浜�

A B C D E

18銆丄.鎰忚瓨(sh铆)闅滅浼村懠鍚哥珐鎱�

B.鎰忚瓨(sh铆)闅滅浼村叐鐪煎悜涓€鍋�(c猫)鍑濊

C.鎰忚瓨(sh铆)闅滅浼寸櫦(f膩)鐔�

D.鎰忚瓨(sh铆)闅滅浼村績鍕�(d貌ng)閬庣珐

E.鎰忚瓨(sh铆)闅滅浼撮珮琛€澹�

<1> 銆佽厧鐐�

A B C D E

<2> 銆佸棊鍟′腑姣�

A B C D E

<3> 銆佹埧瀹ゅ偝灏�(d菐o)闃绘化

A B C D E

19銆丄. 琛€绠″鍔熻兘鐣板父

B. 琛€灏忔澘娓涘皯

C. 琛€灏忔澘娓涘皯浼村嚌琛€鍔熻兘闅滅

D. 琛€灏忔澘鍔熻兘鐣板父

E. 鍑濊鍔熻兘闅滅

<1> 銆侀亷鏁忔€х传鐧滅殑鍑鸿鏄敱浜�

A B C D E

<2> 銆佸啀鐢熼殰绀欐€ц钵琛€鐨勫嚭琛€鏄敱浜�

A B C D E

<3> 銆佸綄婕€ц绠″収(n猫i)鍑濊鐨勫嚭琛€鏄敱浜�

A B C D E

<4> 銆佽灏忔澘鐒�(w煤)鍔涚櫏鐨勫嚭琛€鏄敱浜�

A B C D E

<5> 銆佽鍙嬬梾鐨勫嚭琛€鏄敱浜�

A B C D E

20銆丄.婧㈠嚭鎬ц泲鐧藉翱

B.寰噺鐧借泲鐧藉翱

C.澶ч噺鐧借泲鐧藉翱

D.鐩寸珛鎬ц泲鐧藉翱

E.绲勭箶鎬ц泲鐧藉翱

<1> 銆佹棭鏈熺硸灏跨梾鑵庣梾

A B C D E

<2> 銆佸鐧�(f膩)鎬ч楂撶槫

A B C D E

绛旀

1銆�

銆愭纰虹瓟妗堛€� A

銆愭纰虹瓟妗堛€� C

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2銆�

銆愭纰虹瓟妗堛€� C

銆愭纰虹瓟妗堛€� B

銆愭纰虹瓟妗堛€� E

銆愭纰虹瓟妗堛€� D

銆愭纰虹瓟妗堛€� A

銆愮瓟妗堣В鏋愩€�

3銆�

銆愭纰虹瓟妗堛€� B

銆愮瓟妗堣В鏋愩€� 鍏ㄨ韩鎬х櫦(f膩)绱虹偤涓績鎬х櫦(f膩)绱�銆�

銆愭纰虹瓟妗堛€� C

銆愮瓟妗堣В鏋愩€� 鐧�(f膩)绱哄父鍑虹従(xi脿n)鍦ㄨ偄楂旂殑鏈鑸囦笅鍨傞儴浣嶇偤鍛ㄥ湇鎬х櫦(f膩)绱�

4銆�

銆愭纰虹瓟妗堛€� E

銆愭纰虹瓟妗堛€� C

銆愭纰虹瓟妗堛€� D

銆愭纰虹瓟妗堛€� A

銆愭纰虹瓟妗堛€� B

銆愮瓟妗堣В鏋愩€� 绋界暀鐔卞父瑕嬩簬澶ц憠鑲虹値銆佹枒鐤瑰偡瀵掑強鍌峰瘨楂樼啽鏈�;寮涘嫉鐔卞父瑕嬩簬鏁楄鐧ュ拰閲嶇櫏鑲虹祼(ji茅)鏍哥瓑;闁撴瓏鐔卞父瑕嬩簬鐦х柧銆佹€ユ€ц厧瀛熻厧鐐�銆佹晽琛€鐧ョ瓑;娉㈢媭鐔卞父瑕嬩簬甯冩皬妗胯弻鐥�;涓嶈(gu墨)鍓囩啽瑕嬩簬绲�(ji茅)鏍哥梾銆侀ⅷ(f膿ng)婵曠啽銆佹敮姘ｇ鑲虹値绛�銆�

5銆�

銆愭纰虹瓟妗堛€� C

銆愭纰虹瓟妗堛€� D

銆愭纰虹瓟妗堛€� B

銆愭纰虹瓟妗堛€� A

6銆�

銆愭纰虹瓟妗堛€� A

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銆愭纰虹瓟妗堛€� B

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銆愭纰虹瓟妗堛€� D

銆愮瓟妗堣В鏋愩€� 娑堝寲鎬ф桨鐦嶈〃鐝�(xi脿n)涓婃秷鍖栭亾涓嶉仼鐧ョ媭锛屽鍙嶉吀銆佺噿蹇�銆佸櫙姘ｇ瓑銆�

銆愭纰虹瓟妗堛€� C

銆愮瓟妗堣В鏋愩€� 鎬ユ€ц吀鐐庤〃鐝�(xi脿n)鐐鸿吂鐥涖€佽吂鐎�銆�

銆愭纰虹瓟妗堛€� E

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7銆�

銆愭纰虹瓟妗堛€� D

銆愭纰虹瓟妗堛€� C

銆愭纰虹瓟妗堛€� B

銆愮瓟妗堣В鏋愩€� 楹ヨ啝鎬ц吀鐥呭張绋变钩绯滅€�銆侀潪鐔卞付鎬ц剛鑲€�锛屽湪鍖楃編銆佸寳姝�銆佹境澶у埄浜炵櫦(f膩)鐥呯巼杓冮珮锛屽湅(gu贸)鍏�(n猫i)寰堝皯瑕�銆傜敺濂充箣姣旂偤1鈭�1.3锝�2.0锛屽コ鎬у浜庣敺鎬�锛屼换浣曞勾榻″潎鍙櫦(f膩)鐥�锛岀櫦(f膩)鐥呴珮宄板勾榻′富瑕佹槸鍏掔鑸囬潚骞达紝浣嗚繎骞翠締(l谩i)鑰佸勾浜虹櫦(f膩)鐢熸湰鐥呯殑浜烘暩(sh霉)鍦ㄥ澶�銆�

灏�(du矛)闀�(zh菐ng)鏈熻吂鐎�銆侀珨閲嶆笡杓曠殑鐥呬緥锛屾噳(y墨ng)璀︽儠灏忚吀鍚告敹涓嶈壇鐨勫瓨鍦�銆傝ê鏂烽亥鑶犳€ц吀鐥呴鍏堣鑸囧叾浠栬吀閬撳櫒璩�(zh矛)鎬х柧鐥�銆佽儼鑵虹柧鐥呮墍鑷寸殑鍚告敹涓嶈壇鍔犱互閼掑垾銆傛牴鎿�(j霉)绯炶剛銆佽儍鑵竂绶氭鏌�锛屽悇闋�(xi脿ng)灏忚吀鍚告敹瑭﹂(y脿n)閱囨憾楹ヨ啝铔嬬櫧绛夋姉楂旀脯(c猫)瀹�锛屽収(n猫i)閺′互鍙婂皬鑵哥矘鑶滄椿绲勭箶妾㈡煡鍙垵姝ヤ綔鍑鸿ê鏂�锛岀劧鍚庣稉(j墨ng)娌荤檪瑭﹂(y脿n)鍙(shu艒)鏄庤垏楹ヨ啝鏈夐棞(gu膩n)锛屾墠鑳芥渶鍚庣⒑瀹氳ê鏂�銆�

銆愭纰虹瓟妗堛€� A

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8銆�

銆愭纰虹瓟妗堛€� B

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銆愭纰虹瓟妗堛€� A

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9銆�

銆愭纰虹瓟妗堛€� B

銆愮瓟妗堣В鏋愩€� 鐒�(w煤)鏁堥€犺----鍦ㄩ楂撳収(n猫i)绱呯窗(x矛)鑳炲垎瑁傛垚鐔熺殑閬庣▼涓�锛岀敱浜庢煇绋師鍥犱娇鍏跺湪鎴愮啛鍜岄€�(j矛n)鍏ュ鍛ㄥ惊鐠�(hu谩n)涔嬪墠灏辫鐮村锛屾浜�锛岀ū涔嬬偤鐒�(w煤)鏁堥€犺锛屾垨鑰呯劇(w煤)鏁堟€х磪绱�(x矛)鑳炵敓鎴�锛屾垨鍘熶綅婧惰銆傚湪宸ㄥ辜绱呯窗(x矛)鑳炴€ц钵琛€锛岄惖绮掑辜绱呯窗(x矛)鑳炴€ц钵琛€鍜岀彔铔嬬櫧鍚堟垚闅滅鎬ц钵琛€(鍦颁腑娴疯钵琛€鎴栫暟甯歌绱呰泲鐧界梾)绛�锛岀劇(w煤)鏁堥€犺鏄庨’澧炲姞锛屽皫(d菐o)鑷撮噵鏀惧埌鏈ⅱ琛€涓殑绱呯窗(x矛)鑳炴笡灏戯紝鏄€犳垚璨ц鐨勪竴鍊�(g猫)閲嶈鍘熷洜銆�

Rotor缍滃悎寰�(RS)鏄伜鍌虫€х祼(ji茅)鍚堣喗绱呯礌澧為珮鈪″瀷锛屼簬1948骞寸敱Rotor棣栧厛鍫�(b脿o)鍛婏紝鐣�(d膩ng)鍒濊獚(r猫n)鐐烘槸DJS鐨勪簽鍨�锛屼絾閫氶亷鏈夋(j墨)闄伴洟瀛愭竻闄よ│椹�(y脿n)鍜屽翱涓碁鍗熷晧鐣版(g貌u)楂斿垎鏋�锛岃瓑瀵�(sh铆)RS鏄崹(d煤)绔嬬殑鐤剧梾锛屾瘮DJS灏戣锛屼害灞父鏌撹壊楂旈毐鎬ч伜鍌炽€�

RS鐨勭櫦(f膩)鐥呮儏娉佸拰鑷ㄥ簥鐧ョ媭锛岃垏DJS寰堢浉浼硷紝闋�(y霉)鍚庤壇濂�锛屼篃涓€妯ｇ劇(w煤)闇€娌荤檪銆備絾鍦ㄥ(sh铆)椹�(y脿n)瀹ゆ鏌ヤ笂锛屼笅杩�4鏂归潰鑸嘍JS椤劧涓嶅悓锛氣憼BSP娼寸暀瑭﹂(y脿n)45min椤憲鍗囬珮锛屽父閬�(d谩)20%-40%锛�90-120min鐒�(w煤)鍐嶆涓婂崌鏇茬窔;鈶¤倽鑷熷瑙€涓嶅憟鐝�(xi脿n)榛戣鑹�锛岃倽绱�(x矛)鑳炲収(n猫i)鐒�(w煤)鐗圭暟鑹茬礌椤嗙矑娌夎憲;鈶�24h灏夸腑绯炲崯鍟夌附鎺掓硠鏈€鏄庨’澧炲姞锛屼絾绯炲崯鍟夌暟妲�(g貌u)楂旂殑鍒嗗竷濡傚父浜�;鈶ｅ彛鏈嶈喗鍥婇€犲奖椤奖鑹ソ銆�

crigler-najjar缍滃悎寰�(crigler-najjarsyndrome锛孋NS)鍙堢ū鐐哄厛澶╂€ц憽钀勭硸閱涢吀杞�(zhu菐n)绉婚叾缂轰箯鐧�銆佸厛澶╂€ч潪姊楅樆鎬ч潪婧惰鎬ч粌鐤搞€傛槸涓€绋皯瑕嬬殑锛岀櫦(f膩)鐢熶簬鏂扮敓鍏掑拰瀣板辜鍏掔殑閬哄偝鎬ч珮鑶界磪绱犺鐧�锛屽張绋卞厛澶╂€ц憽钀勭硸閱涢叞杞�(zhu菐n)绉婚叾缂轰箯鐧ャ€佷即鏈夎喗绱呯礌鑵︾梾(鏍搁粌鐤�)鐨勫厛澶╂€ч潪婧惰鎬ч粌鐤哥瓑銆傛摎(j霉)鑲濈窗(x矛)鑳炲収(n猫i)钁¤悇绯栭啗閰拌綁(zhu菐n)绉婚叾缂轰箯绋嬪害锛屽張鍒嗙偤crigler-Najjar缍滃悎寰佲厾鍨嬪拰鈪″瀷銆傗厾鍨嬬綍瑕�锛屾柊鐢熷厭鍑虹敓2鍛ㄥ収(n猫i)甯稿嚭鐝�(xi脿n)鑲岃倝鐥欐敚鍜屽挤(qi谩ng)鐩�銆侀鍘�銆佽寮撳弽寮电瓑鑶界磪绱犺叇鐥呰〃鐝�(xi脿n)銆�

Dubin-Johnson缍滃悎寰佸張绋辩偤鎱㈡€х壒鐧�(f膩)鎬ч粌鐤�锛岀偤閬哄偝鎬х祼(ji茅)鍚堣喗绱呯礌澧為珮鈪犲瀷锛�1954骞碊ubin绛夐鍏堝牨(b脿o)鍛�銆侱ubin-Johnson缍滃悎寰佽嚚搴婅〃鐝�(xi脿n)鐗归粸(di菐n)鐐洪暦(zh菐ng)鏈熸€ф垨闁撴瓏鎬ч粌鐤�銆傚鏁�(sh霉)鐮旂┒琛ㄦ槑Dubin-Johnson缍滃悎寰佽绶ｇ浉杩戞瘮鐜囧緢楂�锛屽爆甯告煋鑹查珨闅辨€ч伜鍌虫€х柧鐥�锛屼竴瀹跺彲澶氫汉鐧�(f膩)鐥�锛岀梾浜烘槸Dubin-Johnson缍滃悎寰佽嚧鐥呭熀鍥犵殑绱斿悎瀛�锛屼絾涔熸湁浜涚梾浜哄苟鐒�(w煤)瀹舵棌鍙�銆傚父瑕嬩簬闈掑勾浜猴紝涓栫晫鍚勫湴鍧囨湁鐥呬緥鍫�(b脿o)鍛�銆�

鑷ㄥ簥琛ㄧ従(xi脿n):

1.鍙劇(w煤)鏄庨’鐧ョ媭;

2.杓曚腑搴﹂粌鐤搞€佸翱鑹插姞娣�;

3.鍙充笂鑵逛笉閬╂垨闅辩棝銆佷箯鍔涖€侀娆蹭笉鎸�銆佹儭蹇冦€佸様鍚�;

4.榛冪柛銆佽倽鑴捐紩搴﹁叓澶ф垨杓曞井澹撶棝銆�

Gilbert缍滃悎寰�(娑堝寲鍏�(n猫i)绉�)鍙堢ū鐐洪珨璩�(zh矛)鎬ц倽鍔熻兘涓嶈壇鎬ч粌鐤革紝灞竴绋純甯歌鐨勯伜鍌虫€ч潪绲�(ji茅)鍚堣喗绱呯礌琛€鐧�锛�1901骞碐ilbert棣栧厛鍫�(b脿o)鍛娿€侴ilbert缍滃悎寰佽嚚搴婅〃鐝�(xi脿n)鐗归粸(di菐n)鐐洪暦(zh菐ng)鏈熼枔姝囨€ц紩搴﹂粌鐤�锛屽鐒�(w煤)鏄庨’鐧ョ媭銆侴ilbert缍滃悎寰佺偤甯告煋鑹查珨椤€ч伜鍌虫€х柧鐥咃紝鐧�(f膩)鐥呯巼澶х磩鐐�5%宸﹀彸銆傜敺鎬у瑕�锛岀敺濂崇櫦(f膩)鐥呮瘮渚�1.5:1鍒�7:1銆備互闈掑勾鏈�(15锝�20姝�)鐧�(f膩)鐥呮渶澶氳锛屽彲鍥犵穵寮�銆佸嫗绱�銆侀２閰掋€佹劅鏌�銆佸彈娑笺€佽吂鐎�銆佷究绉�銆侀椁撱€佹垨鍚堝苟鍏朵粬鐤剧梾鑰屽姞閲嶆垨瑾樼櫦(f膩)銆備竴鑸儏娉佽壇濂�锛屽鐒�(w煤)鏄庨’鐧ョ媭锛岄粌鐤稿姞閲嶅彲鏈変箯鍔涖€佹秷鍖栦笉鑹�銆佽倽鍗€(q奴)涓嶉仼绛夌櫏鐙€銆傜毊鑶氬拰闉忚啘杓曚腑搴﹂粌鏌撴槸鍞竴鐨勯珨寰�銆傝鑶界磪绱犳尝鍕�(d貌ng)鍦�1锝�3mg/dl锛岄珮鎴栦綆浜庢鍊间篃?锛熷惞?銆傝紩鍨嬩竴鑸笉瓒呴亷5mg/dl锛岄噸鍨嬪彲瓒呴亷5mg/dl銆�

銆愭纰虹瓟妗堛€� D

銆愭纰虹瓟妗堛€� E

銆愮瓟妗堣В鏋愩€� 鍦ㄩ楂撳収(n猫i)绱呯窗(x矛)鑳炲垎瑁傛垚鐔熺殑閬庣▼涓紝鐢变簬鏌愮ó鍘熷洜浣垮叾鍦ㄦ垚鐔熷拰閫�(j矛n)鍏ュ鍛ㄥ惊鐠�(hu谩n)涔嬪墠灏辫鐮村锛屾浜�锛岀ū涔嬬偤鐒�(w煤)鏁堥€犺锛屾垨绋辩劇(w煤)鏁堟€х磪绱�(x矛)鑳炵敓鎴�锛屾垨鍘熶綅婧惰銆傚洜绱呯窗(x矛)鑳炵牬澹炲澶�锛屾晠灏�(d菐o)鑷磋喗绱呯礌鐢熸垚閬庡銆�

銆愭纰虹瓟妗堛€� A

銆愮瓟妗堣В鏋愩€� Gilbert缍滃悎寰�(娑堝寲鍏�(n猫i)绉�)鍙堢ū鐐洪珨璩�(zh矛)鎬ц倽鍔熻兘涓嶈壇鎬ч粌鐤�锛屽爆涓€绋純甯歌鐨勯伜鍌虫€ч潪绲�(ji茅)鍚堣喗绱呯礌琛€鐧ワ紝1901骞碐ilbert棣栧厛鍫�(b脿o)鍛�銆侴ilbert缍滃悎寰佽嚚搴婅〃鐝�(xi脿n)鐗归粸(di菐n)鐐洪暦(zh菐ng)鏈熼枔姝囨€ц紩搴﹂粌鐤�锛屽鐒�(w煤)鏄庨’鐧ョ媭銆侴ilbert缍滃悎寰佺偤甯告煋鑹查珨椤€ч伜鍌虫€х柧鐥�锛岀櫦(f膩)鐥呯巼澶х磩鐐�5%宸﹀彸銆傜敺鎬у瑕�锛岀敺濂崇櫦(f膩)鐥呮瘮渚�1.5:1鍒�7:1銆備互闈掑勾鏈�(15锝�20姝�)鐧�(f膩)鐥呮渶澶氳锛屽彲鍥犵穵寮�銆佸嫗绱€侀２閰�銆佹劅鏌�銆佸彈娑笺€佽吂鐎�銆佷究绉�銆侀椁撱€佹垨鍚堝苟鍏朵粬鐤剧梾鑰屽姞閲嶆垨瑾樼櫦(f膩)銆備竴鑸儏娉佽壇濂�锛屽鐒�(w煤)鏄庨’鐧ョ媭锛岄粌鐤稿姞閲嶅彲鏈変箯鍔�銆佹秷鍖栦笉鑹�銆佽倽鍗€(q奴)涓嶉仼绛夌櫏鐙€銆傜毊鑶氬拰闉忚啘杓曚腑搴﹂粌鏌撴槸鍞竴鐨勯珨寰併€傝鑶界磪绱犳尝鍕�(d貌ng)鍦�1锝�3mg/dl锛岄珮鎴栦綆浜庢鍊间篃甯哥湅鍒�銆傝紩鍨嬩竴鑸笉瓒呴亷5mg/dl锛岄噸鍨嬪彲瓒呴亷5mg/dl銆�

鐥呭洜锛�

鏄寚鐢变簬鑶界窗(x矛)鑳炴敐鍙栭潪绲�(ji茅)鍚堣喗绱呯礌(UCB)鍔熻兘闅滅鍙婂井绮掗珨鍏�(n猫i)钁¤悇绯栭啗閰歌綁(zhu菐n)绉婚叾涓嶈冻锛岃嚧琛€涓璘CB澧為珮鑰屽嚭鐝�(xi脿n)榛冪柛銆�

瑷烘柗渚濇摎(j霉)锛�

1.闈掑皯骞寸櫦(f膩)鐥咃紝闅ㄥ勾榻″鍔�锛岄粌鐤搁€愭几娓涢€€锛屽父鏈夊鏃忓彶;2.鎱㈡€у弽寰�(f霉)鐧�(f膩)浣滄€ч粌鐤�锛岀柌鍕�銆侀２閰掋€佹劅鏌撴垨鏈堢稉(j墨ng)鏈熼粌鐤稿姞閲�銆�3.鑻反姣斿Ε鎴�?q奴)顬″悾鑺稿瑁筍鐤告笡杓曟垨娑堥€€銆�4.琛€娓呴潪绲�(ji茅)鍚堣喗绱呯礌澧為珮锛屽翱鑶界磪绱犻櫚鎬�锛屽翱鑶藉師鍚噺姝ｅ父銆傜劇(w煤)椤€ф垨闅辨€ф憾琛€鎬ч粌鐤�;5.鑲濆姛鑳借│椹�(y脿n)銆佹捍纾哄お閳夎│椹�(y脿n)銆佽倽鑷熸椿妾㈡甯搞€�

杓斿姪妾㈡煡锛�

鑷ㄥ簥涓婂父鐢ㄧ殑杓斿姪妾㈡煡鏈夐椁撹│椹�(y脿n)(浣庣啽閲忛２椋熻│椹�(y脿n))锛岃嫰宸存瘮濡ヨ│椹�(y脿n)锛岀厵閰告縺鐧�(f膩)瑭﹂(y脿n)锛屽彛鏈嶅埄绂忓钩瑭﹂(y脿n)锛岃倽鑷熺┛鍒�銆傝倽鑷熺┛鍒烘櫘閫氱梾鐞嗘煋鑹插潎姝ｅ父锛孶GT鐨勫厤鐤祫绻斿寲瀛�(xu茅)鏌撹壊鍧囨湁闄嶄綆銆傜偤纰鸿ê澧炴坊浜嗕竴鍊�(g猫)閲嶈鐨勫瑙€瑷烘柗鎸囨(bi膩o)銆�

10銆�

銆愭纰虹瓟妗堛€� D

銆愭纰虹瓟妗堛€� C

銆愭纰虹瓟妗堛€� E

銆愭纰虹瓟妗堛€� A

銆愭纰虹瓟妗堛€� B

11銆�

銆愭纰虹瓟妗堛€� B

銆愮瓟妗堣В鏋愩€� 鑳冪檶甯歌綁(zhu菐n)绉诲埌宸﹂帠楠ㄤ笂娣嬪反绲�(ji茅)銆�

銆愭纰虹瓟妗堛€� C

銆愮瓟妗堣В鏋愩€� 鑲虹檶甯歌綁(zhu菐n)绉诲埌鍙抽帠楠ㄤ笂娣嬪反绲�(ji茅)銆�

12銆�

銆愭纰虹瓟妗堛€� B

銆愮瓟妗堣В鏋愩€� 鑳冪檶杞�(zhu菐n)绉昏嚦宸﹂帠楠ㄤ笂娣嬪反绲�(ji茅)锛岃偤鐧岃綁(zhu菐n)绉昏嚦鍙抽帠楠ㄤ笂娣嬪反绲�(ji茅)銆�

銆愭纰虹瓟妗堛€� A

銆愮瓟妗堣В鏋愩€� 琛ㄦ泛娣嬪反绲�(ji茅)鍛堢祫缇ゅ垎甯�锛屼竴鍊�(g猫)绲勭兢鐨勬穻宸寸祼(ji茅)鏀堕泦涓€瀹氬崁(q奴)鍩熺殑娣嬪反娑层€傚鑰冲悗銆佷钩绐佸崁(q奴)鐨勬穻宸寸祼(ji茅)缇ゆ敹闆嗛牠鐨寖鍦嶇殑娣嬪反娑�銆傚眬閮ㄧ値鐧ユ垨鑵槫寰€寰€绱強鐩告噳(y墨ng)鍗€(q奴)鍩熺殑娣嬪反绲�(ji茅)鑵ぇ銆�

銆愭纰虹瓟妗堛€� E

銆愮瓟妗堣В鏋愩€� 闋告繁閮ㄦ穻宸寸祼(ji茅)涓婄兢(鑳搁帠涔崇獊鑲屼笂閮�)鏀堕泦榧诲捊閮ㄦ穻宸存恫锛屼笅缇�(鑳搁帠涔崇獊鑲屼笅閮�)鏀堕泦鍜藉枆銆佹埃绠�銆佺敳鐙€鑵虹瓑铏曠殑娣嬪反娑�;灞€閮ㄧ値鐧ユ垨鑵槫寰€寰€绱強鐩告噳(y墨ng)鍗€(q奴)鍩熺殑娣嬪反绲�(ji茅)鑵ぇ銆�

13銆�

銆愭纰虹瓟妗堛€� A

銆愮瓟妗堣В鏋愩€� 鑵庡墠鎬э細鍑¤兘灏�(d菐o)鑷村惊鐠�(hu谩n)鍔熻兘闅滅锛屾湁鏁堣瀹归噺娓涘皯鑰屼娇鑵庣亴娉ㄤ笉瓒�銆佽厧灏忕悆?y脿n)V閬庣巼闄嶄綆鐨勭柧鐥呴兘鍙紩璧峰皯灏�銆傚父瑕嬩簬锛氣憼鑴按鎴栦紤鍏�;鈶″績鍔熻兘涓嶅叏銆侀噸鐧ヨ倽鐥呬即鑵规按褰㈡垚鏈�銆佽厧鐥呯稖鍚堝緛鎴栦綆鐧借泲鐧借鐧ヤ即閲嶅害姘磋叓褰㈡垚鏅�(sh铆)銆�

銆愭纰虹瓟妗堛€� D

銆愮瓟妗堣В鏋愩€� 鑵庢€э細鍑¤厧瀵�(sh铆)璩�(zh矛)鎬ф悕瀹冲皫(d菐o)鑷磋厧灏忕悆?y脿n)V閬庤啘鎼嶅偡銆佽厧灏忕悆姣涚窗(x矛)琛€绠¤厰璁婄獎鎴栫悆-绠″钩琛″け瑾�(di脿o)閮藉皣灏�(d菐o)鑷磋厧灏忕悆?y脿n)V閬庣巼涓嬮檷鑰屽紩璧峰皯灏�銆傚父瑕嬶細鈶犳€ャ€佹參鎬ц厧琛扮;鈶℃€ユ€ц厧灏忕澹炴(鍙敱浜庣己琛€鎬ф垨鑵庡墠鎬у皯灏块€�(j矛n)灞曡€屼締(l谩i)銆佷腑姣掓€�);鈶㈣厧鐨唱(zh矛)鎴栭珦璩�(zh矛)澹炴;鈶ｆ€ユ€ч枔璩�(zh矛)鎬ц厧鐐�;鈶よ厧琛€绠℃€х柧鐥呫€�

銆愭纰虹瓟妗堛€� C

銆愮瓟妗堣В鏋愩€� 鑵庡悗鎬э細鍑″皫(d菐o)鑷翠笂灏胯矾姊楅樆鑰屼娇鑵庡皬鐞冨泭鍏�(n猫i)澹撳楂�銆佸翱娑茬敓鎴愭垨寮曟祦鍙楅樆鏅�(sh铆)閮藉彲鑳介€犳垚灏戝翱鐒�(w煤)灏�锛岀敋鑷冲畬鍏ㄧ劇(w煤)灏�銆傚父瑕嬶細鈶犲翱璺湰韬梾璁�?n猫i)缂Y鎴栫槩鐥曠嫻绐�銆佺祼(ji茅)鐭�銆佽叓鐦�銆佸厛澶╃暩褰互鍙婅喛鏍撳嚌琛€濉婄瓑闃诲;鈶″翱璺鐥呰畩?n猫i)缂抂鐦ゅ杩�銆佺矘閫�(鐗圭櫦(f膩)鎬ц吂鑶滃悗绾栫董澧炵敓鐧�)銆傜梾璁婃噳(y墨ng)鐐轰笅灏胯矾(濡傝唨鑳辨酱鐣�銆佸墠鍒楄吅鑲ュぇ銆佸翱閬撶嫻绐�)鎴栧叐鍋�(c猫)涓婂翱璺�;浣嗕篃鏈変竴鍋�(c猫)姊楅樆鐥呰畩鍚屾檪(sh铆)寮曡捣灏�(du矛)鍋�(c猫)鍙嶅皠鎬у姛鑳芥敼璁婅€岀敘(ch菐n)鐢熷皯灏裤€佺劇(w煤)灏跨殑銆�

14銆�

銆愭纰虹瓟妗堛€� B

銆愮瓟妗堣В鏋愩€� 鑶€鑳卞閲忔笡灏戞€у翱闋�锛岃〃鐝�(xi脿n)鐐烘寔绾�(x霉)鎬у翱闋�锛岃棩鐗╂不鐧傞洠浠ョ珐瑙�锛屾瘡娆″翱閲忓皯锛岃浜庤唨鑳卞崰浣嶆€х梾璁�銆�

銆愭纰虹瓟妗堛€� A

銆愮瓟妗堣В鏋愩€� 绁炵稉(j墨ng)鍘熸€ц唨鑳卞姛鑳介殰绀�锛屽翱闋昏€屾瘡娆″翱閲忓皯锛屼笉浼村翱鎬�銆佸翱鐥涳紝灏挎恫閺℃鐒�(w煤)鐐庢€х窗(x矛)鑳�锛岃浜庝腑妯炲強鍛ㄥ湇绁炵稉(j墨ng)鐥呰畩?n猫i)鐝╊嚗Y銆佺缍�(j墨ng)婧愭€ц唨鑳�銆�

銆愭纰虹瓟妗堛€� C

銆愮瓟妗堣В鏋愩€� 鐐庣櫏鎬у翱闋�锛屾瘡娆″翱閲忓皯锛屼即鏈夊翱鎬ュ拰灏跨棝锛屽翱娑查彙妾㈠彲瑕嬬値鎬х窗(x矛)鑳�銆�

15銆�

銆愭纰虹瓟妗堛€� A

銆愭纰虹瓟妗堛€� E

銆愮瓟妗堣В鏋愩€� 鏈閬窫锛屾蹈娼�(r霉n)鎬ц劸澶э細鍚勯鎬ユ參鎬х櫧琛€鐥呫€佹穻宸寸槫銆侀楂撳鐢熸€х柧鐥呭強鑴傝唱(zh矛)璨⿳鐥�銆佹儭鎬х祫绻旂窗(x矛)鑳炵梾鍙婃穩绮夋ǎ璁婃€х瓑銆�

鎰熸煋鎬ц劸澶э細鍚勭ó鎬�銆佹參鎬ф劅鏌撳鍌峰瘨銆佸壇鍌峰瘨銆侀粦鐔辩梾銆佽鍚歌煵鐥�銆佺槯鐤俱€佺梾姣掓€ц倽鐐�銆佹晽琛€鐧ャ€佹櫄鏈熸姣掔瓑.

娣よ鎬ц劸鑵ぇ锛氭枒鏇挎皬缍滃悎寰�銆佽倽纭寲銆佹參鎬у績鍔涜“绔嚧蹇冨師鎬ц倽纭寲銆佹參鎬х府绐勬€у績鍖呯値銆侀杸闈滆剤鎴栬劸闈滆剤琛€鏍撳舰鎴�銆�

銆愭纰虹瓟妗堛€� B

16銆�

銆愭纰虹瓟妗堛€� A

銆愮瓟妗堣В鏋愩€� 蹇冩簮鎬ф按鑵殑闁嬪閮ㄤ綅鐐哄緸瓒抽儴闁嬪锛屼笅鍨傞儴浣嶆槑椤€�

銆愭纰虹瓟妗堛€� C

銆愮瓟妗堣В鏋愩€� 鑵庢簮鎬ф按鑵殑闁嬪閮ㄤ綅鐐虹溂鐬兼垨瓒抽儴闁嬪銆�

17銆�

銆愭纰虹瓟妗堛€� A

銆愮瓟妗堣В鏋愩€� 椤嶉儴闋棝涓€鑸敱澶╁箷涓婄梾璁婂紩璧�锛屼絾涔熻浜庨蓟绔囩値銆侀”鍏�(n猫i)澹撳楂樼瓑銆�

銆愭纰虹瓟妗堛€� B

銆愮瓟妗堣В鏋愩€� 涓€鍋�(c猫)椤抽儴闋棝鍙浜庨潚鍏夌溂銆佽櫣鑶滅潾鐙€楂旂値;鍋忛牠鐥�銆侀〕鍕�(d貌ng)鑴堢値銆佺缍�(j墨ng)鐥涚瓑銆�

18銆�

銆愭纰虹瓟妗堛€� E

銆愭纰虹瓟妗堛€� A

銆愭纰虹瓟妗堛€� D

銆愮瓟妗堣В鏋愩€� 鍤�(y谩n)閲嶇殑鎴跨獟鍌冲皫(d菐o)闃绘化灏�(d菐o)鑷村績瀹ょ巼绶╂參锛岀劇(w煤)娉曟豢瓒宠叇渚涜锛屽彲鍑虹従(xi脿n)鎶芥悙鎴栨剰璀�(sh铆)闅滅銆�

19銆�

銆愭纰虹瓟妗堛€� A

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銆愭纰虹瓟妗堛€� B

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