Kuzindikira ma nucleic acid atatu mu chimodzi: COVID-19, fuluwenza A ndi kachilombo ka fuluwenza B, zonse mu chubu chimodzi!

Covid-19 (2019-nCoV) yayambitsa matenda ambirimbiri ndi imfa mamiliyoni ambiri kuyambira pamene inayamba kufalikira kumapeto kwa chaka cha 2019, zomwe zapangitsa kuti ikhale vuto la thanzi padziko lonse lapansi. Bungwe la World Health Organization (WHO) lapereka "mitundu isanu ya nkhawa"^[1], monga Alpha, Beta, Gamma, Delta ndi Omicron, ndipo mtundu wa Omicron mutant ndiye mtundu waukulu kwambiri pa mliri wapadziko lonse lapansi pakadali pano. Pambuyo potenga kachilombo ka Omicron mutant, zizindikiro zake zimakhala zochepa, koma kwa anthu apadera monga anthu omwe ali ndi chitetezo chamthupi chofooka, okalamba, matenda osatha ndi ana, chiopsezo cha matenda oopsa kapena kufa atatenga kachilomboka chikadali chachikulu. Chiwerengero cha anthu omwe amwalira ndi mitundu ya Omicron, deta yeniyeni ikuwonetsa kuti chiwerengero cha anthu omwe amwalira ndi pafupifupi 0.75%, chomwe ndi pafupifupi nthawi 7 mpaka 8 kuposa chimfine, ndipo chiwerengero cha anthu okalamba, makamaka omwe ali ndi zaka zoposa 80, chimaposa 10%, chomwe ndi pafupifupi nthawi 100 kuposa chimfine wamba.^[2]Zizindikiro zodziwika bwino za matenda ndi malungo, chifuwa, pakhosi pouma, pakhosi lopweteka, myalgia, ndi zina zotero. Odwala oopsa akhoza kukhala ndi dyspnea ndi/kapena hypoxemia.

Pali mitundu inayi ya mavairasi a chimfine: A, B, C ndi D. Mitundu yayikulu ya mliriwu ndi subtype A (H1N1) ndi H3N2, ndi mtundu wa B (Victoria ndi Yamagata). Fuluwenza yoyambitsidwa ndi kachilombo ka chimfine imayambitsa mliri wa nyengo ndi mliri wosayembekezereka chaka chilichonse, ndipo chiwerengero cha anthu omwe akupezeka ndi chimfine chimakwera kwambiri. Malinga ndi ziwerengero, anthu pafupifupi 3.4 miliyoni amachiritsidwa matenda ofanana ndi chimfine chaka chilichonse.^[3], ndipo milandu pafupifupi 88,100 ya matenda opumira okhudzana ndi chimfine imapha anthu, zomwe zimapangitsa kuti 8.2% ya imfa za matenda opumira^[4]Zizindikiro zachipatala zimaphatikizapo malungo, mutu, myalgia ndi chifuwa chouma. Magulu omwe ali pachiwopsezo chachikulu, monga amayi apakati, makanda, okalamba ndi odwala matenda osatha, amakhala pachiwopsezo cha chibayo ndi mavuto ena, omwe angayambitse imfa pazochitika zazikulu.

1 COVID-19 yokhala ndi zoopsa za chimfine.

Kutenga kachilombo ka chimfine ndi COVID-19 kungawonjezere mphamvu ya matendawa. Kafukufuku wa ku Britain akusonyeza kuti^[5], poyerekeza ndi matenda a COVID-19 okha, chiopsezo cha mpweya wabwino wamakina komanso chiopsezo cha imfa m'chipatala mwa odwala a COVID-19 omwe ali ndi kachilombo ka chimfine chinawonjezeka ndi nthawi 4.14 ndi nthawi 2.35.

Tongji Medical College of Huazhong University of Science and Technology yatulutsa kafukufuku^[6], zomwe zinaphatikizapo maphunziro 95 okhudza odwala 62,107 omwe ali ndi COVID-19. Kufalikira kwa kachilombo ka chimfine kunali 2.45%, pakati pawo chimfine A chinali chachikulu. Poyerekeza ndi odwala omwe ali ndi COVID-19 okha, odwala omwe ali ndi chimfine A ali pachiwopsezo chachikulu cha zotsatirapo zoyipa, kuphatikizapo kulowa mu ICU, thandizo la makina opumira komanso imfa. Ngakhale kufalikira kwa kachilombo ka chimfine kuli kochepa, odwala omwe ali ndi kachilombo ka chimfine amakumana ndi chiopsezo chachikulu cha zotsatirapo zoopsa.

Kusanthula kwa meta kukuwonetsa kuti^[7], poyerekeza ndi B-stream, A-stream ili ndi mwayi waukulu woti itenge kachilombo ka COVID-19. Pakati pa odwala 143 omwe ali ndi kachilomboka, 74% ali ndi kachilombo ka A-stream, ndipo 20% ali ndi kachilombo ka B-stream. Kutenga kachilomboka kungayambitse matenda oopsa kwa odwala, makamaka pakati pa magulu omwe ali pachiwopsezo monga ana.

Kafukufuku wokhudza ana ndi achinyamata osakwana zaka 18 omwe adagonekedwa m'chipatala kapena kufa ndi chimfine panthawi ya chimfine ku United States mu 2021-2022 adapeza kuti^[8]kuti vuto la matenda opatsirana ndi chimfine mu COVID-19 liyenera kuganiziridwa bwino. Pakati pa milandu yokhudzana ndi chimfine, 6% anali ndi kachilombo ka COVID-19 ndi chimfine, ndipo chiwerengero cha imfa zokhudzana ndi chimfine chinakwera kufika pa 16%. Izi zikusonyeza kuti odwala omwe ali ndi kachilombo ka COVID-19 ndi chimfine amafunikira thandizo la kupuma lolowerera komanso losalowerera kuposa omwe ali ndi chimfine chokha, ndipo zikusonyeza kuti matenda opatsirana ndi chimfine angayambitse matenda aakulu mwa ana.

2 Kuzindikira matenda osiyanasiyana a chimfine ndi COVID-19.

Matenda atsopano ndi fuluwenza ndi opatsirana kwambiri, ndipo pali kufanana kwa zizindikiro zina zachipatala, monga malungo, chifuwa ndi myalgia. Komabe, njira zochiritsira mavairasi awiriwa ndi zosiyana, ndipo mankhwala oletsa mavairasi omwe amagwiritsidwa ntchito ndi osiyana. Pa nthawi ya chithandizo, mankhwala amatha kusintha zizindikiro za matenda, zomwe zimapangitsa kuti zikhale zovuta kuzindikira matendawa pogwiritsa ntchito zizindikiro zokha. Chifukwa chake, kuzindikira molondola za COVID-19 ndi fuluwenza kuyenera kudalira kuzindikira kwa kachilombo kuti zitsimikizire kuti odwala alandire chithandizo choyenera komanso chothandiza.

Malangizo angapo ogwirizana pankhani yozindikira ndi kuchiza matenda akusonyeza kuti kuzindikira molondola kachilombo ka COVID-19 ndi chimfine kudzera mu mayeso a labotale ndikofunikira kwambiri popanga dongosolo loyenera la chithandizo.

Ndondomeko Yodziwira ndi Kuchiza Fuluwenza (Kope la 2020)》^[9]ndi 《Kuzindikira ndi Kuchiza Fuluwenza Ya Akuluakulu Mwachangu (2022 Edition)》^[10]Zonsezi zikusonyeza bwino kuti chimfine ndi chofanana ndi matenda ena a COVID-19, ndipo COVID-19 ili ndi zizindikiro zochepa komanso zofala monga malungo, chifuwa chouma ndi pakhosi, zomwe sizophweka kusiyanitsa ndi chimfine; Zizindikiro zazikulu komanso zazikulu zimaphatikizapo chibayo chachikulu, matenda opumira kwambiri komanso kusagwira bwino ntchito kwa ziwalo, zomwe zimafanana ndi zizindikiro za chimfine chachikulu komanso chachikulu, ndipo ziyenera kusiyanitsidwa malinga ndi chifukwa chake.

"Ndondomeko yatsopano yodziwira matenda a coronavirus ndi chithandizo (kope la khumi loyesera kukhazikitsa"^[11]adanenanso kuti matenda a Covid-19 ayenera kusiyanitsidwa ndi matenda a m'mapapo omwe amayamba chifukwa cha mavairasi ena.

Kusiyana kwa 3 pa chithandizo cha chimfine ndi matenda a COVID-19

2019-nCoV ndi fuluwenza ndi matenda osiyanasiyana omwe amayamba chifukwa cha mavairasi osiyanasiyana, ndipo njira zochizira ndi zosiyana. Kugwiritsa ntchito bwino mankhwala oletsa mavairasi kungachepetse mavuto aakulu komanso chiopsezo cha imfa ya matenda awiriwa.

Ndikoyenera kugwiritsa ntchito mankhwala ang'onoang'ono oletsa mavairasi monga Nimatvir/Ritonavir, Azvudine, Monola ndi mankhwala oletsa ma antibodies monga jakisoni wa Ambaviruzumab/Romisvir monoclonal antibody mu COVID-19.^[12].

Mankhwala oletsa fuluwenza amagwiritsa ntchito kwambiri mankhwala oletsa neuraminidase (oseltamivir, zanamivir), hemagglutinin inhibitors (Abidor) ndi RNA polymerase inhibitors (Mabaloxavir), zomwe zimakhudza bwino mavairasi otchuka a fuluwenza A ndi B.^[13].

Kusankha njira yoyenera yogwiritsira ntchito mavairasi ndikofunikira kwambiri pochiza matenda a 2019-nCoV ndi fuluwenza. Chifukwa chake, ndikofunikira kwambiri kuzindikira tizilombo toyambitsa matenda momveka bwino kuti tiwongolere mankhwala azachipatala.

4 COVID-19/ Fuluwenza A / Fuluwenza B yowunikira majeremusi atatu

Katunduyu amapereka chidziwitso chachangu komanso cholondola cha of 2019-nCoV, mavairasi a chimfine A ndi chimfine B, ndipo zimathandiza kusiyanitsa 2019-nCoV ndi chimfine, matenda awiri opatsirana opumira omwe ali ndi zizindikiro zofanana zachipatala koma njira zosiyanasiyana zochiritsira. Mwa kuzindikira tizilombo toyambitsa matenda, zitha kutsogolera chitukuko cha mapulogalamu ochiritsira omwe akufunidwa ndikuwonetsetsa kuti odwala atha kulandira chithandizo choyenera munthawi yake.

Yankho lonse:

Kusonkhanitsa zitsanzo -- Kuchotsa Nucleic acid -- Kuzindikira reagent -- polymerase chain reaction

Kuzindikira kolondola: kuzindikira Covid-19 (ORF1ab, N), kachilombo ka chimfine A ndi kachilombo ka chimfine B m'chubu chimodzi.

Wokhudzidwa kwambiri: LOD ya Covid-19 ndi makope 300/mL, ndipo ya kachilombo ka fuluwenza A ndi B ndi makope 500/mL.

Kufotokozera kwathunthu: Covid-19 ikuphatikizapo mitundu yonse yodziwika bwino ya matenda opatsirana, kuphatikizapo fuluwenza A kuphatikizapo H1N1 ya nyengo, H3N2, H1N1 2009, H5N1, H7N9, ndi zina zotero, ndi fuluwenza B kuphatikiza mitundu ya Victoria ndi Yamagata, kuti zitsimikizire kuti palibe amene adzazindikire matendawa.

Kuwongolera khalidwe kodalirika: kuwongolera koyipa/kwabwino komwe kwamangidwa mkati, kuwongolera kwamkati ndi enzyme ya UDG yowongolera khalidwe kasanu, kuyang'anira ma reagents ndi ntchito kuti zitsimikizire zotsatira zolondola.

Amagwiritsidwa ntchito kwambiri: amagwirizana ndi chida chachikulu cha PCR cha fluorescence cha njira zinayi pamsika.

Kutulutsa kokha: ndi Macro ndi Micro-TEstDongosolo lodzichotsera la nucleic acid lokha komanso ma reagents ochotsera, magwiridwe antchito komanso kusinthasintha kwa zotsatira zake kumawonjezeka.

Zambiri za malonda