I-Covid-19 (2019-nCoV) ibangele amakhulu ezigidi zosulelo kunye nezigidi zokufa ukusukela oko yaqhambuka ekupheleni kuka-2019, nto leyo eyenza ukuba ibe yingxamiseko yezempilo kwihlabathi liphela. I-World Health Organisation (WHO) ibeke phambili "iintlobo ezintlanu zenkxalabo eziguquliweyo"[1], oko kukuthi i-Alpha, i-Beta, i-Gamma, i-Delta kunye ne-Omicron, kwaye uhlobo lwe-Omicron mutant lolona hlobo lubalaseleyo kubhubhane lwehlabathi okwangoku. Emva kokosulelwa yi-Omicron mutant, iimpawu zincinci, kodwa kubantu abakhethekileyo abafana nabantu abane-immune system ephantsi, abantu abadala, izifo ezingapheliyo kunye nabantwana, umngcipheko wokugula kakhulu okanye nokufa emva kokosulelwa usephezulu. Izinga lokufa kweentlobo ze-mutant kwi-Omicron, idatha yehlabathi yokwenyani ibonisa ukuba izinga lokufa kwezigulane eziguqukileyo limalunga ne-0.75%, elimalunga ne-7 ukuya kwi-8 ye-influenza, kwaye izinga lokufa kwezigulane eziguqukileyo, ingakumbi abo baneminyaka engaphezu kwama-80 ubudala, lidlula i-10%, eliphantse libe li-100 le-common influenza.[2]Iimpawu eziqhelekileyo zesifo ngumkhuhlane, ukukhohlela, umphimbo owomileyo, umphimbo obuhlungu, i-myalgia, njl. Izigulana eziqatha zinokuba nokuphelelwa ngamandla kunye/okanye i-hypoxemia.
Kukho iintlobo ezine zeentsholongwane zomkhuhlane: A, B, C kunye no-D. Iintlobo eziphambili zesifo somkhuhlane ziintlobo ezimbini ze-A (H1N1) kunye ne-H3N2, kunye nohlobo lwe-B (iVictoria kunye neYamagata). Umkhuhlane obangelwa yintsholongwane yomkhuhlane uya kubangela ubhubhane wexesha lonyaka kunye nobhubhane ongenakuqikelelwa minyaka le, kunye nesantya esiphezulu sokusasazeka kwawo. Ngokwezibalo, malunga ne-3.4 yezigidi zeemeko zonyango zinyangwa izifo ezifana nomkhuhlane minyaka le.[3], kwaye malunga ne-88,100 iimeko zezifo zokuphefumla ezinxulumene nomkhuhlane zikhokelela ekufeni, nto leyo ebangela ukuba i-8.2% yezifo zokuphefumla zife.[4]Iimpawu zeklinikhi ziquka umkhuhlane, intloko ebuhlungu, i-myalgia kunye nokukhwehlela okomileyo. Amaqela asengozini enkulu, njengabasetyhini abakhulelweyo, iintsana, abantu abadala kunye nezigulane ezinezifo ezingapheliyo, basengozini yokuba ne-pneumonia kunye nezinye iingxaki, ezinokukhokelela ekufeni kwiimeko ezinzima.
1 I-COVID-19 eneengozi zomkhuhlane.
Ukosuleleka yi-influenza kunye ne-COVID-19 kunokubangela ukuba esi sifo sibe sibi kakhulu. Uphononongo lwaseBritane lubonisa ukuba[5], xa kuthelekiswa nokosulelwa yi-COVID-19 kuphela, umngcipheko womoya ophuma ngoomatshini kunye nomngcipheko wokufa esibhedlele kwizigulana ze-COVID-19 ezinosulelo lwentsholongwane yomkhuhlane unyuke ngama-4.14 amaxesha kunye namaxesha angama-2.35.
Ikholeji yezonyango yaseTongji kwiYunivesithi yeSayensi neTekhnoloji yaseHuazhong ipapashe uphando[6], equka izifundo ezingama-95 ezibandakanya izigulana ezingama-62,107 kwi-COVID-19. Izinga lokuxhaphaka kosulelo oluhlangeneyo lwentsholongwane yomkhuhlane yayiyi-2.45%, phakathi kwazo i-influenza A yayilinani eliphezulu. Xa kuthelekiswa nezigulana ezosulelwe yi-COVID-19 kuphela, izigulana ezosulelwe yi-influenza A zinomngcipheko omkhulu weziphumo ezibi, kubandakanya ukungeniswa e-ICU, inkxaso yomoya kunye nokufa. Nangona ukuxhaphaka kosulelo oluhlangeneyo kuphantsi, izigulana ezosulelweyo zijongene nomngcipheko ophezulu weziphumo ezibi.
Uhlalutyo lwe-meta lubonisa ukuba[7], xa kuthelekiswa nomsinga we-B, umsinga we-A unokuba nosulelo oluhambelana ne-COVID-19. Phakathi kwezigulane ezili-143 ezinazo zombini izifo, ama-74% asulelwe yi-A-stream, kwaye ama-20% asulelwe yi-B-stream. Ukosulelwa yi-B-stream kunokukhokelela kwizifo ezinzulu kwizigulane, ingakumbi phakathi kwamaqela asengozini njengabantwana.
Uphando olwenziwe ngabantwana kunye nabakwishumi elivisayo abangaphantsi kweminyaka eli-18 ubudala abalaliswe esibhedlele okanye abasweleke ngenxa yomkhuhlane ngexesha lomkhuhlane eMelika ngo-2021-22 lufumanise ukuba[8]ukuba imeko yokosulelwa ngaxeshanye yi-influenza kwi-COVID-19 ifanelwe yingqwalaselo. Phakathi kweemeko zokulaliswa esibhedlele ezinxulumene nomkhuhlane, i-6% yayinosulelo ngaxeshanye yi-COVID-19 kunye ne-influenza, kwaye inani lokufa okunxulumene nomkhuhlane lenyuke laya kwi-16%. Olu phando lubonisa ukuba izigulana ezinosulelo ngaxeshanye yi-COVID-19 kunye ne-influenza zifuna inkxaso yokuphefumla ehlaselayo nengangenisi ngaphezu kwezo zosulelo kuphela, kwaye zibonisa ukuba ukosulelwa ngaxeshanye kunokukhokelela kumngcipheko omkhulu wesifo ebantwaneni.
2 Ukuxilongwa okwahlukileyo komkhuhlane kunye ne-COVID-19.
Zombini izifo ezintsha kunye nomkhuhlane ziyosulela kakhulu, kwaye kukho ukufana kwezinye iimpawu zonyango, ezinje ngomkhuhlane, ukukhwehlela kunye ne-myalgia. Nangona kunjalo, iindlela zonyango zezi ntsholongwane zimbini zahlukile, kwaye amayeza okulwa neentsholongwane asetyenziswayo ahlukile. Ngexesha lonyango, amayeza anokutshintsha iimpawu eziqhelekileyo zesifo, okwenza kube nzima ukufumanisa isifo kuphela ngeempawu. Ke ngoko, ukuxilongwa ngokuchanekileyo kwe-COVID-19 kunye nomkhuhlane kufuneka kuxhomekeke ekufumaneni umahluko kwiintsholongwane ukuqinisekisa ukuba izigulana zinokufumana unyango olufanelekileyo nolusebenzayo.
Iingcebiso ezininzi ezivunyelweneyo malunga nokuxilongwa kunye nonyango zibonisa ukuba ukuchongwa ngokuchanekileyo kwe-COVID-19 kunye nentsholongwane yomkhuhlane ngovavanyo lwelebhu kubaluleke kakhulu ekwenzeni isicwangciso sonyango esifanelekileyo.
《Isicwangciso sokuQondwa koMkhuhlane kunye noNyango (uHlelo luka-2020)》[9]kunye ne-《Ukuchongwa koMkhuhlane wabantu abadala kunye neMvumelwano yoNgxamiseko oluQhelekileyo (uHlelo luka-2022)》[10]Zonke ezi zinto zicacisa ukuba umkhuhlane ufana nezinye izifo kwi-COVID-19, kwaye i-COVID-19 ineempawu ezincinci neziqhelekileyo ezifana nomkhuhlane, ukukhwehlela okomileyo kunye nomqala obuhlungu, okungelula ukwahlula kumkhuhlane; Iimpawu eziqatha nezibalulekileyo ziquka i-pneumonia eqatha, isifo sokuphefumla esibuhlungu kunye nokungasebenzi kakuhle kwamalungu omzimba, ezifana neempawu zeklinikhi zomkhuhlane oqatha nobalulekileyo, kwaye kufuneka zahlulwe ngokwemvelaphi.
"Isicwangciso esitsha sokuxilonga nonyango losulelo lwe-coronavirus (uhlelo lweshumi lokuphunyezwa kovavanyo")[11]ukhankanye ukuba usulelo lwe-Covid-19 kufuneka lwahlulwe kusulelo lwendlela yokuphefumla ephezulu olubangelwa zezinye iintsholongwane.
Umahluko o-3 kunyango lomkhuhlane kunye nosulelo lwe-COVID-19
I-2019-nCoV kunye ne-influenza zizifo ezahlukeneyo ezibangelwa ziintsholongwane ezahlukeneyo, kwaye iindlela zonyango zahlukile. Ukusetyenziswa ngokufanelekileyo kwamayeza okulwa neentsholongwane kunokuthintela iingxaki ezinkulu kunye nomngcipheko wokufa kwezi zifo zimbini.
Kucetyiswa ukusebenzisa amayeza amancinci e-antiviral afana ne-Nimatvir/Ritonavir, i-Azvudine, i-Monola kunye namayeza e-antibody anciphisa i-antibody afana ne-Ambaviruzumab/Romisvir monoclonal antibody injection kwi-COVID-19.[12].
Amayeza okulwa nomkhuhlane asebenzisa ikakhulu i-neuraminidase inhibitors (oseltamivir, zanamivir), i-hemagglutinin inhibitors (Abidor) kunye ne-RNA polymerase inhibitors (Mabaloxavir), ezinefuthe elihle kwiintsholongwane ze-influenza A kunye ne-B ezidumileyo ngoku.[13].
Ukukhetha indlela efanelekileyo yokuthintela iintsholongwane kubaluleke kakhulu kunyango lwe-2019-nCoV kunye nomkhuhlane. Ke ngoko, kubaluleke kakhulu ukuchonga intsholongwane ngokucacileyo ukuze kukhokele amayeza ezonyango.
4 I-COVID-19/ Umkhuhlane A / Umkhuhlane B Ukuhlolwa okuphindwe kathathu kweemveliso ze-nucleic acid
Le mveliso ibonelela ngokuchongwa okukhawulezileyo nokuchanekileyof 2019-nCoV, i-influenza A kunye neentsholongwane ze-influenza B, kwaye inceda ukwahlula i-2019-nCoV kunye ne-influenza, izifo ezimbini ezisulelayo zokuphefumla ezineempawu ezifanayo zeklinikhi kodwa iindlela zonyango ezahlukeneyo. Ngokuchonga i-pathogen, inokukhokela uphuhliso lweklinikhi lweenkqubo zonyango ezijoliswe kuzo kwaye iqinisekise ukuba izigulana zinokufumana unyango olufanelekileyo ngexesha.
Isisombululo sipheleleyo:
Ingqokelela yesampulu--Ukukhupha i-Nucleic acid--I-reagent yokufumanisa--i-polymerase chain reaction
Ukuchonga ngokuchanekileyo: chonga i-Covid-19 (ORF1ab, N), intsholongwane ye-influenza A kunye nentsholongwane ye-influenza B kwityhubhu enye.
Ibuthathaka kakhulu: I-LOD ye-Covid-19 yiikopi ezingama-300/mL, kwaye eye-influenza A kunye ne-B yiikopi ezingama-500/mL.
Ugutyungelwe ngokupheleleyo: I-Covid-19 ibandakanya zonke iintlobo ezaziwayo ze-mutant, kunye ne-influenza A kuquka i-H1N1 yexesha lonyaka, i-H3N2, i-H1N1 2009, i-H5N1, i-H7N9, njl.njl., kunye ne-influenza B kuquka iintlobo zeVictoria kunye neYamagata, ukuqinisekisa ukuba akukho ngxaki yokubhaqwa.
Ulawulo lomgangatho oluthembekileyo: ulawulo olungalunganga/oluhle olwakhelwe ngaphakathi, isalathiso sangaphakathi kunye nolawulo lomgangatho oluphindwe kane lwe-enzyme ye-UDG, ukujonga ii-reagents kunye nemisebenzi ukuqinisekisa iziphumo ezichanekileyo.
Isetyenziswa kakhulu: iyahambelana nesixhobo sePCR esisetyenziswa kakhulu kwimarike esineetshaneli ezine ze-fluorescence.
Ukukhupha ngokuzenzekelayo: ngeMacro kunye neMicro-TEstInkqubo yokukhupha i-nucleic acid ngokuzenzekelayo kunye nee-reagents zokukhupha, ukusebenza kakuhle komsebenzi kunye nokuhambelana kweziphumo kuyaphucuka.
Ulwazi lwemveliso
Iireferensi
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2. Ingcaciso Egunyazisiweyo _ Liang Wannian: Izinga lokufa e-Omicron liphindwe ka-7 ukuya ku-8 kunelomkhuhlane _ Influenza _ Ubhubhane _ Mick _ Sina News.http://k.sina.com.cn/article_3121600265_ba0fd7090010198ol.html.
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12. Zhang Fujie, Zhuo Wang, Wang Quanhong, et al. Imvumelwano yeengcali malunga nonyango lweentsholongwane kubantu abatsha abane-coronavirus [J]. Ijenali yaseTshayina yeZifo eziSulelayo zeKlinikhi, 2023, 16(1): 10-20.
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Ixesha leposi: Matshi-29-2024