Njira yabwino kwambiri ndi iti?
-Kuyesa kwa Matenda a SARS-CoV-2
Pamilandu yotsimikizika ya COVID-19, zidziwitso zachipatala zodziwika bwino zimaphatikizapo kutentha thupi, chifuwa, myalgia kapena kutopa.Komabe zizindikilozi sizosiyana ndi za COVID-19 chifukwa zizindikilozi ndizofanana ndi matenda ena omwe ali ndi kachilombo monga fuluwenza.Pakadali pano, virus nucleic acid Real-Time PCR (rt-PCR), kujambula kwa CT ndi magawo ena a hematology ndi zida zazikulu zowunikira matenda.Zida zambiri zoyezera mu labotale zidapangidwa ndikugwiritsidwa ntchito poyesa zitsanzo za odwala za COVID-19 ndi CDC yaku China.1, US CDC2ndi makampani ena apadera.IgG/IgM antibody test, njira yoyesera ya serological, yawonjezedwanso ngati njira yodziwira matenda mu mtundu wosinthidwa waku China wowunikira komanso malangizo amankhwala a matenda a coronavirus (COVID-19), omwe adaperekedwa pa 3 Marichi.1.Mayeso a virus nucleic acid rt-PCR akadali njira yodziwira matenda a COVID-19.
StrongStep®Novel Coronavlrus (SARS-COV-2)Multiplex Real-Time PCR Kit(kuzindikira majini atatu)
Komabe zida zoyeserera zenizeni za PCR, kufunafuna chibadwa cha kachilomboka, mwachitsanzo m'mphuno, m'kamwa, kapena kumatako, zimakhala ndi zofooka zambiri:
1) Mayesowa amakhala ndi nthawi yayitali yosinthira ndipo ndi ovuta kugwira ntchito;nthawi zambiri amatenga pafupifupi maola awiri kapena atatu kuti apange zotsatira.
2) Mayeso a PCR amafunikira ma laboratories ovomerezeka, zida zodula komanso akatswiri ophunzitsidwa bwino kuti azigwira ntchito.
3) Pali ziwerengero zina zabodza za rt-PCR ya COVID-19.Zitha kukhala chifukwa cha kuchuluka kwa ma virus a SARS-CoV-2 pachiwonetsero chapamwamba chopumira (Novel coronavirus makamaka imalowa m'mapapo am'munsi, monga pulmonary alveoli) ndipo mayesowo sangathe kuzindikira anthu omwe adadwala, achira, komanso anachotsa kachilomboka m'matupi awo.
Kafukufuku wa Lirong Zou et al4adapeza kuti kuchuluka kwa ma virus kumawonekera chizindikiro chitangoyamba kumene, pomwe kuchuluka kwa ma virus kumawonekera pamphuno kuposa pakhosi komanso ma virus a nucleic acid kukhetsa kwa odwala omwe ali ndi SARS-CoV-2 amafanana ndi odwala omwe ali ndi chimfine.4ndipo zikuwoneka mosiyana ndi zomwe zimawonedwa mwa odwala omwe ali ndi SARS-CoV-2.
Yang Pan et al5Anawunikanso zitsanzo zingapo zapakhosi (pakhosi, sputum, mkodzo, ndi ndowe) kuchokera kwa odwala awiri ku Beijing ndipo anapeza kuti kuchuluka kwa ma virus pakhosi ndi sputum kunachuluka pafupifupi masiku 5 mpaka 6 chiyambireni zizindikiro, zitsanzo za sputum nthawi zambiri zimawonetsa kuchuluka kwa ma virus kuposa zitsanzo zapakhosi.Palibe kachilombo ka RNA komwe kanapezeka mumkodzo kapena zitsanzo za chopondapo kwa odwala awiriwa.
Kuyeza kwa PCR kumangopereka zotsatira za kachiromboka pamene kachilomboka kadalipo.Mayesowa sangazindikire anthu omwe adadwala, achira, ndikuchotsa kachilomboka m'matupi awo.Mwachiwonetsero, pafupifupi 30% -50% yokha inali yabwino kwa PCR mwa odwala omwe adapezeka ndi chibayo cha coronavirus.Odwala ambiri omwe ali ndi chibayo cha coronavirus sangadziwike chifukwa cha kuyesedwa koyipa kwa nucleic acid, kotero kuti sangalandire chithandizo choyenera munthawi yake.Kuyambira kukope loyamba mpaka lachisanu ndi chimodzi la malangizowo, kudalira kokha pamaziko a zotsatira za mayeso a nucleic acid, zomwe zidabweretsa vuto lalikulu kwa asing'anga. "Wowombera mluzu" wakale, Dr. Li Wenliang, dokotala wamaso ku Wuhan Central Hospital, wafa.M'moyo wake, adayezetsa atatu nucleic acid pankhani ya kutentha thupi ndi chifuwa, ndipo nthawi yomaliza adapeza zotsatira zabwino za PCR.
Pambuyo pokambirana ndi akatswiri, adaganiza zoonjezera njira zoyezera seramu ngati njira yatsopano yodziwira matenda.Pomwe kuyezetsa kwa antibody, komwe kumatchedwanso kuyesa kwa serological, komwe kumatha kutsimikizira ngati wina ali ndi kachilombo ngakhale chitetezo chawo chamthupi chachotsa kachilombo komwe kamayambitsa COVID-19.
StrongStep® SARS-COV-2 IgG/IgM Antibody Rapid Test
Kuyeza kwa ma antibody a IgG/IgM kudzathandizira kutsata anthu ambiri omwe ali ndi kachilomboka, chifukwa milandu yambiri ikuwoneka kuti imafalikira kuchokera kwa odwala opanda zizindikiro omwe sangadziwike mosavuta.Banja lina ku Singapore, mwamunayo adayezetsa ndi PCR, zotsatira za kuyezetsa kwa PCR za mkazi wake zinalibe, koma zotsatira za mayeso a antibody zidawonetsa kuti anali ndi ma antibodies, monganso mwamuna wake.
Mayesero a serological amayenera kutsimikiziridwa mosamala kuti atsimikizire kuti achita modalirika, koma ndi ma antibodies olimbana ndi kachilomboka.Chodetsa nkhawa chimodzi chinali chakuti kufanana pakati pa ma virus omwe amayambitsa matenda opumira kwambiri komanso COVID-19 atha kubweretsa kusinthana.IgG-IgM yopangidwa ndi Xue Feng wang6ankaonedwa kuti akhoza kugwiritsidwa ntchito ngati kuyesa kwachisamaliro (POCT), monga momwe zingathere pafupi ndi bedi ndi magazi a chala.Chidacho chili ndi chidwi cha 88.66% ndi kutsimikizika kwa 90.63%.Komabe, panali zotsatira zabodza zabwino ndi zabodza.
Mu mtundu waposachedwa waku China wakuzindikira komanso kuwongolera chithandizo cha matenda a coronavirus (COVID-19)1, milandu yotsimikizika imafotokozedwa ngati milandu yokayikiridwa yomwe imakwaniritsa chimodzi mwazinthu izi:
(1) Zitsanzo zamathira opumira, magazi kapena ndowe zoyesedwa kuti zili ndi SARS-CoV-2 nucleic acid pogwiritsa ntchito rt-PCR;
(2) Kutsatizana kwa ma virus kuchokera m'magawo opuma, magazi kapena ndowe ndizofanana kwambiri ndi SARS-CoV-2 yodziwika;
(3) Serum novel coronavirus yeniyeni ya IgM antibody ndi IgG antibody inali yabwino;
4
Kuzindikira ndi kuchiza COVID-19
| Malangizo | Zosindikizidwa | Zotsimikizika zoyezetsa matenda |
| Mtundu wa 7 | 3 Marichi 2020 | ❶ PCR ❷ NGS ❸ IgM+IgG |
| Mtundu wa 6 | 18 Feb.2020 | ❶ PCR ❷ NGS |
Buku
1. Malangizo ozindikira ndi kuchiza matenda a chibayo cha coronavirus (mtundu woyeserera 7, National Health Commission of the People's Republic of China, woperekedwa pa 3.Mar.2020)
http://www.nhc.gov.cn/yzygj/s7652m/202003/a31191442e29474b98bfed5579d5af95.shtml
2. Kafukufuku Gwiritsani Ntchito Yeniyeni Yeniyeni RT-PCR Protocol pozindikiritsa 2019-nCoV
https://www.cdc.gov/coronavirus/2019-ncov/lab/rt-pcr-detection-instructions.html
3. Singapore imati kugwiritsa ntchito koyamba kuyesa kwa antibody kutsatira matenda a coronavirus
https://www.sciencemag.org/news/2020/02/singapore-claims-first-use-antibody-test-track-coronavirus-infections
4.SARS-CoV-2 Viral Load mu Zitsanzo Zam'mwamba Za Odwala Odwala February 19,2020 DOI: 10.1056/NEJMc2001737
5.Viralloads of SARS-CoV-2 mu zitsanzo zachipatala Lancet Infect Dis 2020 Yosindikizidwa Pa intaneti February 24, 2020 (https://doi.org/10.1016/S1473-3099(20)30113-4)
6. Kupititsa patsogolo ndi Kugwiritsa Ntchito Kachipatala kwa Mayeso a Rapid IgM-IgG Ophatikiza Antibody a SARS-CoV-2
Matenda a matenda XueFeng Wang ORCID iD: 0000-0001-8854-275X
Nthawi yotumiza: Mar-17-2020
