I-Covid-19 (2019-nCoV) ibangele amakhulu ezigidi zokutheleleka kanye nokufa kwezigidi selokhu yaqubuka ekupheleni kuka-2019, okwenza kwaba yisimo esiphuthumayo sezempilo emhlabeni wonke. I-World Health Organization (WHO) iveze "izinhlobo ezinhlanu zokukhathazeka"[1], okungukuthi i-Alpha, i-Beta, i-Gamma, i-Delta kanye ne-Omicron, kanti uhlobo lwe-Omicron mutant luwuhlobo oluvelele obhubhaneni lomhlaba wonke njengamanje. Ngemva kokutheleleka nge-Omicron mutant, izimpawu zincane kakhulu, kodwa kubantu abakhethekile njengabantu abakhubazekile, asebekhulile, izifo ezingamahlalakhona kanye nezingane, ingozi yokugula okungathi sína noma ngisho nokufa ngemva kokutheleleka isephezulu. Izinga lokufa kwamacala ezinhlobo ze-mutant ku-Omicron, idatha yangempela yomhlaba ikhombisa ukuthi izinga lokufa kwamacala elimaphakathi licishe libe ngu-0.75%, okuphindwe cishe ngo-7 kuya ku-8 kunele-influenza, kanti izinga lokufa kwamacala eziguli, ikakhulukazi labo abaneminyaka engaphezu kuka-80 ubudala, lidlula u-10%, okuphindwe cishe ngo-100 kunele-common influenza.[2]Izimpawu ezivamile zokutheleleka umkhuhlane, ukukhwehlela, umphimbo owomile, umphimbo obuhlungu, i-myalgia, njll. Iziguli ezigula kakhulu zingase zibe nokuphelelwa umoya kanye/noma i-hypoxemia.
Kunezinhlobo ezine zamagciwane omkhuhlane: A, B, C kanye no-D. Izinhlobo eziyinhloko zobhubhane yi-subtype A (H1N1) kanye ne-H3N2, kanye nohlobo B (iVictoria kanye ne-Yamagata). Umkhuhlane obangelwa yigciwane lomkhuhlane uzobangela ubhubhane lwezinkathi kanye nobhubhane olungalindelekile minyaka yonke, ngesilinganiso esiphezulu sokwanda kwawo. Ngokwezibalo, cishe amacala ayizigidi ezingu-3.4 alashwa izifo ezifana nomkhuhlane minyaka yonke.[3], futhi cishe amacala angu-88,100 ezifo zokuphefumula ezihlobene nomkhuhlane aholela ekufeni, okubangela ukufa okungu-8.2% kwezifo zokuphefumula.[4]Izimpawu zomtholampilo zifaka phakathi umkhuhlane, ikhanda elibuhlungu, i-myalgia kanye nokukhwehlela okomile. Amaqembu asengozini enkulu, njengabesifazane abakhulelwe, izinsana, asebekhulile kanye neziguli ezinezifo ezingamahlalakhona, athambekele ekuhlaselweni yi-pneumonia nezinye izinkinga, ezingaholela ekufeni ezimweni ezimbi kakhulu.
1 I-COVID-19 enezingozi zomkhuhlane.
Ukutheleleka komkhuhlane kanye ne-COVID-19 kungase kubhebhethekise umthelela walesi sifo. Ucwaningo lwaseBrithani lubonisa ukuthi[5], uma kuqhathaniswa nokutheleleka kwe-COVID-19 kuphela, ingozi yokuphefumula ngomshini kanye nengozi yokufa esibhedlela ezigulini ze-COVID-19 ezinesifo segciwane lomkhuhlane ikhuphuke ngezikhathi ezingu-4.14 kanye nezikhathi ezingu-2.35.
I-Tongji Medical College yase-Huazhong University of Science and Technology ishicilele ucwaningo[6], okuhlanganisa nezifundo ezingu-95 ezibandakanya iziguli ezingu-62,107 ezine-COVID-19. Izinga lokusabalala kokutheleleka kanye negciwane lomkhuhlane lalingu-2.45%, phakathi kwazo i-influenza A yayibalelwa engxenyeni ephezulu. Uma kuqhathaniswa neziguli ezine-COVID-19 kuphela, iziguli ezine-influenza kanye negciwane lomkhuhlane A zinengozi enkulu kakhulu yemiphumela emibi, okuhlanganisa ukwamukelwa e-ICU, ukwesekwa komoya kanye nokufa. Nakuba ukusabalala kokutheleleka kanye negciwane kuphansi, iziguli ezine-influenza kanye negciwane zibhekene nengozi enkulu yemiphumela emibi.
Ukuhlaziywa kwe-meta kukhombisa ukuthi[7], uma kuqhathaniswa nomfudlana we-B, umfudlana we-A kungenzeka kakhulu ukuthi utheleleke kanye ne-COVID-19. Phakathi kweziguli ezingu-143 ezitheleleke kanye, ezingama-74% zitheleleke nge-A-stream, kanti ezingama-20% zitheleleke nge-B-stream. Ukutheleleka kanyekanye kungaholela ekuguleni okukhulu kweziguli, ikakhulukazi phakathi kwamaqembu asengozini njengezingane.
Ucwaningo olwenziwe ezinganeni kanye nentsha engaphansi kweminyaka eyi-18 eyalaliswa esibhedlela noma yashona ngenxa yomkhuhlane ngesikhathi somkhuhlane e-United States ngo-2021-22 luthole ukuthi[8]ukuthi isimo sokutheleleka kanye nomkhuhlane ku-COVID-19 sidinga ukunakwa. Phakathi kwamacala okulaliswa esibhedlela ahlobene nomkhuhlane, abangu-6% batheleleke kanye ne-COVID-19 kanye nomkhuhlane, kanti inani lokufa okuhlobene nomkhuhlane lenyuke laya ku-16%. Lokhu okutholakele kusikisela ukuthi iziguli ezitheleleke kanye ne-COVID-19 kanye nomkhuhlane zidinga ukwesekwa kokuphefumula okuhlaselayo nokungenawo umkhuhlane ngaphezu kwalabo abatheleleke kuphela ngomkhuhlane, futhi kukhomba ukuthi ukutheleleka kanye kungaholela engcupheni enkulu yesifo ezinganeni.
2 Ukuxilongwa okuhlukile komkhuhlane kanye ne-COVID-19.
Zombili izifo ezintsha kanye nomkhuhlane ziyathelelana kakhulu, futhi kukhona ukufana kwezinye izimpawu zomtholampilo, njengomkhuhlane, ukukhwehlela kanye ne-myalgia. Kodwa-ke, izinhlelo zokwelapha la magciwane amabili zihlukile, kanti nemithi yokulwa namagciwane esetshenziswayo ihlukile. Ngesikhathi sokwelashwa, imithi ingashintsha ukubonakaliswa okuvamile kwesifo, okwenza kube nzima kakhulu ukuthola lesi sifo ngezimpawu kuphela. Ngakho-ke, ukuxilongwa okunembile kwe-COVID-19 kanye nomkhuhlane kudinga ukuthembela ekutholakaleni kwegciwane okuhlukile ukuqinisekisa ukuthi iziguli zingathola ukwelashwa okufanele nokuphumelelayo.
Izincomo eziningana ezivunyelwene ngazo mayelana nokuxilongwa nokwelashwa ziphakamisa ukuthi ukuhlonza ngokunembile igciwane le-COVID-19 kanye ne-influenza ngokuhlolwa kwelebhu kubaluleke kakhulu ekwakheni uhlelo lokwelapha olufanele.
Uhlelo Lokuxilonga Nokwelapha Umkhuhlane (Uhlelo Luka-2020)》[9]kanye ne-"Adult Influenza Diagnosis and Treatment Standard Emergency Expert Consensus (Uhlelo luka-2022)"》[10]konke kucacisa ukuthi umkhuhlane ufana nezinye izifo ku-COVID-19, kanti i-COVID-19 inezimpawu ezincane nezivamile njengomkhuhlane, ukukhwehlela okomile kanye nomphimbo obuhlungu, okungelula ukuhlukanisa nomkhuhlane; Izimpawu ezimbi nezibucayi zifaka phakathi i-pneumonia enzima, i-acute respiratory distress syndrome kanye nokungasebenzi kahle kwezitho zomzimba, okufana nezimpawu zemitholampilo zomkhuhlane onzima nobucayi, futhi kudingeka zihlukaniswe ngokwemvelaphi.
"Uhlelo olusha lokuxilonga nokwelapha ukutheleleka nge-coronavirus (uhlelo lweshumi lokuqaliswa kwesilingo"[11]ukhulume ngokuthi ukutheleleka kwe-Covid-19 kufanele kuhlukaniswe nokutheleleka kwendlela yokuphefumula ephezulu okubangelwa amanye amagciwane.
Umehluko o-3 ekwelapheni umkhuhlane kanye nokutheleleka kwe-COVID-19
I-2019-nCoV kanye ne-influenza yizifo ezahlukene ezibangelwa amagciwane ahlukene, futhi izindlela zokwelapha zihlukile. Ukusetshenziswa kahle kwemithi yokulwa namagciwane kungavimbela izinkinga ezinkulu kanye nengozi yokufa kwalezi zifo ezimbili.
Kunconywa ukusebenzisa imithi emincane yokulwa namagciwane efana ne-Nimatvir/Ritonavir, i-Azvudine, i-Monola kanye nemithi yokulwa namagciwane efana ne-Ambaviruzumab/Romisvir monoclonal antibody injection ku-COVID-19.[12].
Imithi yokulwa nomkhuhlane isebenzisa kakhulu ama-neuraminidase inhibitors (oseltamivir, zanamivir), ama-hemagglutinin inhibitors (Abidor) kanye nama-RNA polymerase inhibitors (Mabaloxavir), anemiphumela emihle kumagciwane adumile e-influenza A kanye ne-B.[13].
Ukukhetha uhlelo olufanele lokwelapha amagciwane kubaluleke kakhulu ekwelapheni i-2019-nCoV kanye ne-influenza. Ngakho-ke, kubaluleke kakhulu ukuhlonza i-pathogen ngokucacile ukuze kuqondiswe imithi yokwelapha.
4 I-COVID-19/ Umkhuhlane A / Umkhuhlane B ukuhlolwa okuphindwe kathathu kwemikhiqizo ye-nucleic acid
Lo mkhiqizo unikeza ukuhlonza okusheshayo nokunembile of 2019-nCoV, umkhuhlane A kanye namagciwane omkhuhlane B, futhi kusiza ukuhlukanisa i-2019-nCoV kanye ne-influenza, izifo ezimbili ezithathelwanayo zokuphefumula ezinezimpawu ezifanayo zomtholampilo kodwa amasu okwelapha ahlukene. Ngokubona i-pathogen, ingaqondisa ukuthuthukiswa kwezokwelapha kwezinhlelo zokwelapha eziqondiwe futhi iqinisekise ukuthi iziguli zingathola ukwelashwa okufanele ngesikhathi.
Isixazululo esiphelele:
Iqoqo lamasampula--Ukukhishwa kwe-Nucleic acid--I-reagent yokuthola--ukusabela kwe-polymerase chain
Ukuhlonza okunembile: thola i-Covid-19 (ORF1ab, N), igciwane le-influenza A kanye negciwane le-influenza B epayipini elilodwa.
Kuzwela kakhulu: I-LOD ye-Covid-19 ingamakhophi angu-300/mL, kanti eyamagciwane omkhuhlane A no-B ingamakhophi angu-500/mL.
Ukusabalala okuphelele: I-Covid-19 ihlanganisa zonke izinhlobo ezaziwayo ze-mutant, kanye ne-influenza A kufaka phakathi i-H1N1 yesizini, i-H3N2, i-H1N1 2009, i-H5N1, i-H7N9, njll., kanye ne-influenza B kufaka phakathi izinhlobo ze-Victoria ne-Yamagata, ukuze kuqinisekiswe ukuthi ngeke kube khona ukutholakala okuphuthelwe.
Ukulawulwa kwekhwalithi okuthembekile: ukulawula okungekuhle/okuhle okwakhelwe ngaphakathi, ukubhekisela kwangaphakathi kanye nokulawulwa kwekhwalithi okuphindwe kane kwe-enzyme ye-UDG, ukuqapha ama-reagent kanye nokusebenza ukuqinisekisa imiphumela enembile.
Kusetshenziswa kabanzi: kuyahambisana nethuluzi le-PCR le-fluorescence leziteshi ezine elijwayelekile emakethe.
Ukukhipha okuzenzakalelayo: nge-Macro kanye ne-Micro-Ti-estuhlelo lokukhipha i-nucleic acid oluzenzakalelayo kanye nama-reagent okukhipha, ukusebenza kahle komsebenzi kanye nokuvumelana kwemiphumela kuyathuthuka.
Ulwazi lomkhiqizo
Izinkomba
1. Inhlangano Yezempilo Yomhlaba. Ukulandelela izinhlobo ze-SARS‑CoV‑2[EB/OL]. (2022‑12‑01) [2023‑01‑08]. https://www.who.int/activities/tracking‑SARS‑CoV‑2‑variants.
2. Ukuhumusha Okugunyaziwe _ ULiang Wannian: Izinga lokufa e-Omicron liphindwe izikhathi ezingu-7 kuya kwezingu-8 kunelomkhuhlane _ Umkhuhlane _ Ubhubhane _ UMick _ Izindaba zeSina. http://k.sina.com.cn/article_3121600265_ba0fd7090010198ol.html.
3. Feng LZ, Feng S, Chen T, et al. Umthwalo wokubonisana ngezifo ezifana nomkhuhlane ezihambisana nomkhuhlane eShayina, 2006-2015: ucwaningo olusekelwe kubantu [J]. Umkhuhlane Amanye Amagciwane Okuphefumula, 2020, 14(2): 162-172.
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5. Swets MC, Russell CD, Harrison EM, nabanye. Ukutheleleka kwe-SARS-CoV-2 okuhlangene namagciwane omkhuhlane, igciwane lokuphefumula elihambisanayo, noma ama-adenovirus. Lancet. 2022; 399(10334):1463-1464.
6. Yan X, Li K, Lei Z, Luo J, Wang Q, Wei S. Ukusabalala kanye nemiphumela ehambisanayo yokutheleleka ngasikhathi sinye phakathi kwe-SARS-CoV-2 kanye nomkhuhlane: isibuyekezo esihlelekile kanye nokuhlaziywa kwe-meta. Int J Infect Dis. 2023; 136:29-36.
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10. Igatsha Lodokotela Bezimo Eziphuthumayo le-Chinese Medical Association, Igatsha Lokwelapha Eziphuthumayo le-Chinese Medical Association, I-China Emergency Medical Association, I-Beijing Emergency Medical Association, I-China People's Liberation Army Emergency Medicine Professional Committee. Ukuvumelana Kochwepheshe Bezimo Eziphuthumayo Ngokuhlonza Nokwelapha Umkhuhlane Wabantu Abadala (Uhlelo luka-2022) [J]. ijenali yesiShayina yezokwelapha ezibucayi, 2022, 42(12): 1013-1026.
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Isikhathi sokuthunyelwe: Mashi-29-2024