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医院渴望精准医学中心建设攻略?梅奥专家赶来支招

2017-11-19 郝兰兰 健康界

国内公立医院如何建立精准医学中心?梅奥专家的经验和见解值得借鉴。

自2015年奥巴马提出“精准医学”理念以来,这一舶来品在我国也掀起热潮。

美国舒尔茨肿瘤信息技术中心、肿瘤研究学系主任研究员张金三认为,一家公立医院如果没有组建精准医学等相关平台,没有足够重视发展新兴医疗技术,即便已经成为三甲医院,实力亦有待挖掘。

“精准医学是一个系统工程,如果院领导不重视,缺乏整合资源的积极性,那就很难做。”张金三告诉健康界,当下美国很多医院成立了独立的精准医学中心,但由于这一模式的前期资金和人力投入较大,国内公立医院往往选择与第三方公司合作。在他看来,公立医院发展精准医学,终究要依靠自身实力组建精准医学中心,而且,“精准医学是医疗模式的改变,医生不仅要懂科研与生物信息等知识,还有很多事情需要做。”

梅奥专家为精准医学正名

“精准是一个相对的概念,个体化治疗的说法更贴切。”张金三解释,一项技术十年前可能被认为是精准的,但十年过去一旦评价标准发生变化,该技术可能就不能被称之为精准。而个体化医疗基于个体基因,同时结合环境和生活方式变化,可以针对性地开展新型疾病预防和治疗。

张金三表示,精准医学的实质是,通过基因测序、体外培养及药物筛选、生物信息技术等,结合患者的生活环境和临床数据,实现疾病精准分类和诊断,制定个性化的预防和治疗方案。

他认为,精准医疗主要包括三个层次:

一是基础层次方面,基因测序是精准医疗的基础。其中,无论是细胞治疗,还是基因治疗,首先都要通过基因测序诊断病情才能设计方案。

二是中等层次方面,主要涉及细胞免疫治疗。通过对免疫细胞的功能强化和缺损修复,提高免疫细胞的战斗力,以更好地治疗癌症等疾病。

三是最高层次方面,基因剪辑是关键。即对患者癌变细胞的变异基因进行批量改造,使之成为正常细胞。

张金三

医院和企业是精准医学探路力量

在张金三看来,尽管道阻且难,但精准医疗代表医疗发展的未来方向,必将改变疾病临床诊疗模式。实际上,越来越多的医院加入精准医疗探路阵营。

11月18日,丽水市人民医院与迪安诊断建立战略伙伴关系,组建精准医学中心。丽水市人民医院院长黄刚表示,该精准医学中心将发挥迪安诊断的资金、技术、人才优势,以及丽水市人民医院临床诊断、治疗方面的技术优势,共同建设高通量分子检测平台和质谱检测平台,开展肿瘤伴随诊断、遗传性肿瘤、生殖遗传、心血管疾病精准诊疗、药物浓度检测、健康管理等相关基因检测项目,给临床提供分子诊断和质谱检测的全面解决方案,并为临床研究提供技术支撑。

借势打造精准医学中心,丽水市人民医院将导入健康管理,从日常保健、营养、运动、就医指导、慢病跟踪干预等方面入手,帮助患者及时发现健康隐患,预防疾病,实现精准就医。

对于双方的合作,丽水市卫生计生委主任周一红评价,他们鼓励民营资本参与和推动公立医院发展,建立区域性医疗中心。

张金三认为,公立医院建立精准医学中心,重点在于建立一个科学的临床框架。对此,他分享了梅奥模式,同时说明,“国情不同,国内不能完全照搬美国经验,不过梅奥模式确实已得到美国医疗界认可。”

在梅奥肿瘤分子诊断工作流程中,通过推介,医生首先对患者进行个性化医疗初步咨询,随后,病人和遗传咨询师进行基因组和财政咨询。“主要询问患者是否有保险。”张金三补充道,如果患者没有保险,前期的医疗费用恐难以承担。

咨询工作结束后,医生负责收集患者组织和血液样品,以进行样本基因测序。接着,医疗机构将基因变异报告返回给患者。根据报告,临床和基因组专家会诊患者,给医师提供建议。最后,医师和遗传咨询师共同会见患者,告知结果和临床方案。

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    2017-11-22 sunfeifeiyang

    0

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1774960, encodeId=564b1e74960a8, content=<a href='/topic/show?id=17135e073b5' target=_blank style='color:#2F92EE;'>#支招#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57073, encryptionId=17135e073b5, topicName=支招)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21738724507, createdName=psybestwish, createdTime=Mon Nov 27 23:59:00 CST 2017, time=2017-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263273, encodeId=6eef2632e3d1, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Wed Nov 22 07:23:59 CST 2017, time=2017-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1368275, encodeId=8a2c13682e5b2, content=<a href='/topic/show?id=8a5e6242257' target=_blank style='color:#2F92EE;'>#梅奥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62422, encryptionId=8a5e6242257, topicName=梅奥)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Tue Nov 21 01:59:00 CST 2017, time=2017-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1403247, encodeId=6925140324e77, content=<a href='/topic/show?id=ebbde6353be' target=_blank style='color:#2F92EE;'>#精准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76353, encryptionId=ebbde6353be, topicName=精准)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83epQX9hfEIBiaPg0e9KvLYVBCSGYydH6K6OQxBh3RaOC0TYP9HYy2v0XdHib1LFnZNU5Siak0P8oh8Aqw/132, createdBy=acd92440184, createdName=shijzhiewnjhch, createdTime=Tue Nov 21 01:59:00 CST 2017, time=2017-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=262541, encodeId=2dfa262541b4, content=不错的.学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdqKgfW3nMpOkC3jXxiaW2po0PtglY5ZuVjERqKADW4HyMI8bcZXWlKgH7tEP9ULBoBzuQMibia4pr1s9rQPqLvqQJ/0, createdBy=e8c02060444, createdName=中医痴, createdTime=Sun Nov 19 11:26:31 CST 2017, time=2017-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=262534, encodeId=8a25262534a8, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Sun Nov 19 11:17:35 CST 2017, time=2017-11-19, status=1, ipAttribution=)]
    2017-11-19 中医痴

    不错的.学习了.谢谢分享!

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1774960, encodeId=564b1e74960a8, content=<a href='/topic/show?id=17135e073b5' target=_blank style='color:#2F92EE;'>#支招#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57073, encryptionId=17135e073b5, topicName=支招)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21738724507, createdName=psybestwish, createdTime=Mon Nov 27 23:59:00 CST 2017, time=2017-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263273, encodeId=6eef2632e3d1, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Wed Nov 22 07:23:59 CST 2017, time=2017-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1368275, encodeId=8a2c13682e5b2, content=<a href='/topic/show?id=8a5e6242257' target=_blank style='color:#2F92EE;'>#梅奥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62422, encryptionId=8a5e6242257, topicName=梅奥)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Tue Nov 21 01:59:00 CST 2017, time=2017-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1403247, encodeId=6925140324e77, content=<a href='/topic/show?id=ebbde6353be' target=_blank style='color:#2F92EE;'>#精准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76353, encryptionId=ebbde6353be, topicName=精准)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83epQX9hfEIBiaPg0e9KvLYVBCSGYydH6K6OQxBh3RaOC0TYP9HYy2v0XdHib1LFnZNU5Siak0P8oh8Aqw/132, createdBy=acd92440184, createdName=shijzhiewnjhch, createdTime=Tue Nov 21 01:59:00 CST 2017, time=2017-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=262541, encodeId=2dfa262541b4, content=不错的.学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdqKgfW3nMpOkC3jXxiaW2po0PtglY5ZuVjERqKADW4HyMI8bcZXWlKgH7tEP9ULBoBzuQMibia4pr1s9rQPqLvqQJ/0, createdBy=e8c02060444, createdName=中医痴, createdTime=Sun Nov 19 11:26:31 CST 2017, time=2017-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=262534, encodeId=8a25262534a8, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Sun Nov 19 11:17:35 CST 2017, time=2017-11-19, status=1, ipAttribution=)]
    2017-11-19 yfjms

    学习

    0

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