Ukufunyanwa kwe-nucleic acid ezintathu-kwinye: I-COVID-19, umkhuhlane A kunye nentsholongwane yomkhuhlane B, zonke zikwityhubhu enye!

I-Covid-19 (2019-nCoV) ibangele amakhulu ezigidi zosulelo kunye nezigidi zabantu ababhubhileyo ukusukela oko kwaqhambuka ekupheleni kuka-2019, nto leyo eyenza ukuba ibe yimeko kaxakeka yezempilo yehlabathi.Umbutho wezeMpilo weHlabathi (i-WHO) ubeke phambili "iintlobo zenkxalabo" ezintlanu[1], ezizezi, iAlpha, iBeta, iGamma, iDelta kunye ne-Omicron, kunye ne-Omicron mutant strain lolona xinzelelo luphambili kubhubhane wehlabathi ngoku.Emva kokuba usulelekile nge-Omicron mutant, iimpawu zincinci, kodwa kubantu abakhethekileyo njengabantu abakhubazekileyo, abantu abadala, izifo ezingapheliyo kunye nabantwana, umngcipheko wokugula kakhulu okanye ukufa emva kosulelo kusephezulu.Izinga lokufa kwemeko ye-mutant strains e-Omicron, idatha yehlabathi lokwenyani ibonisa ukuba izinga lokufa kwe-avareji limalunga ne-0.75%, elimalunga ne-7 ukuya ku-8 amaxesha omkhuhlane, kunye nenqanaba lokufa kwabantu abadala, ngakumbi abo bangaphezu kweminyaka engama-80. endala, idlula i-10%, nto leyo ephantse ibe li-100 elo xesha lomkhuhlane oqhelekileyo[2].Iimpawu eziqhelekileyo zeklinikhi zosulelo ngumkhuhlane, ukukhohlela, umqala owomileyo, umqala obuhlungu, i-myalgia, njl. Izigulane ezinzima zinokuba ne-dyspnea kunye / okanye i-hypoxemia.

Kukho iintlobo ezine zeentsholongwane zomkhuhlane: A, B, C kunye no-D. Iindidi eziphambili ze-epidemic ziyi-subtype A (H1N1) kunye ne-H3N2, kunye ne-strain B (i-Victoria ne-Yamagata).Umkhuhlane obangelwa yintsholongwane yomkhuhlane uya kubangela ubhubhane wamaxesha athile kunye nobhubhane ongalindelekanga minyaka le, ngesantya esiphezulu sezehlo.Ngokwezibalo, malunga ne-3.4 yezigidi zeemeko zinyangwa izifo ezifana nomkhuhlane minyaka le[3], kwaye malunga neemeko ze-88,100 zezifo zokuphefumula ezinxulumene nomkhuhlane zikhokelela ekufeni, zibalelwa kwi-8.2% yezifo zokuphefumula zokufa.[4].Iimpawu zeklinikhi ziquka umkhuhlane, intloko ebuhlungu, i-myalgia kunye nokukhohlela okomileyo.Amaqela asemngciphekweni omkhulu, njengabasetyhini abakhulelweyo, iintsana, abantu abadala kunye nezigulana ezinezifo ezingapheliyo, zivame ukuhlaselwa yinyumoniya kunye nezinye iingxaki, ezinokukhokelela ekufeni kwiimeko ezinzima.

1 COVID-19 kunye neengozi zomkhuhlane.

Ukosuleleka kunye komkhuhlane kunye ne-COVID-19 kunokuwenza mandundu ifuthe lesi sifo.Uphononongo lwaseBritani lubonisa ukuba[5], xa kuthelekiswa nosulelo lwe-COVID-19 kuphela, umngcipheko wokungena komoya ngoomatshini kunye nomngcipheko wokufa esibhedlele kwizigulana ze-COVID-19 ezinosulelo lwentsholongwane yomkhuhlane wonyuke ngamaxesha angama-4.14 kunye namaxesha angama-2.35.

IKholeji yezoNyango yaseTongji yeYunivesithi yaseHuazhong yeSayensi kunye neTekhnoloji ipapashe isifundo[6], ezibandakanya izifundo ezingama-95 ezibandakanya izigulana ezingama-62,107 kwi-COVID-19.Izinga lokuxhaphaka losulelo oluhlangeneyo lwentsholongwane yomkhuhlane yayiyi-2.45%, phakathi kwayo umkhuhlane A ubalelwa kumlinganiselo ophezulu.Xa kuthelekiswa nezigulana ezosulelwe kuphela yi-COVID-19, abaguli abosulelwe ngumkhuhlane A banomngcipheko ophezulu kakhulu weziphumo ezibi, kubandakanya nokwamkelwa e-ICU, inkxaso yokungenisa umoya ngoomatshini kunye nokufa.Nangona ukuxhaphaka kwe-co-infection kuphantsi, izigulane ezinosulelo oludibeneyo zijongene nomngcipheko ophezulu wemiphumo emibi.

Uhlalutyo lwemeta lubonisa ukuba[7], xa kuthelekiswa nomsinga we-B, umsinga we-A kunokwenzeka ukuba wosulelwe yi-COVID-19.Phakathi kwezigulane ze-143 ezosulelekileyo, i-74% yosulelwa ngu-A-stream, kwaye i-20% yosulelwa ngu-B-stream.Ukosuleleka kunye kunokukhokelela kwisigulo esibi kakhulu sezigulane, ngakumbi phakathi kwamaqela asemngciphekweni njengabantwana.

Uphando lwabantwana kunye nolutsha olungaphantsi kweminyaka eyi-18 abalaliswe esibhedlele okanye babulawa ngumkhuhlane ngexesha lomkhuhlane e-United States ngo-2021-22[8]ukuba into yokosulela ngokubambisana nomkhuhlane kwi-COVID-19 ifuna ukuqwalaselwa.Phakathi kweemeko zokulaliswa esibhedlele ezinxulumene nomkhuhlane, iipesenti ezi-6 zosulelwe yi-COVID-19 kunye nomkhuhlane, kwaye inani lokufa okunxulumene nomkhuhlane linyuke laya kutsho kwi-16%.Oku kufunyanisiweyo kucebisa ukuba abaguli abosulelwe yi-COVID-19 kunye nomkhuhlane bafuna inkxaso ehlaselayo nengachaphazelekiyo yokuphefumla ngakumbi kunabo bosulelwe ngumkhuhlane kuphela, kwaye ikhomba ukuba ukosuleleka ngokubambisana kunokukhokelela kumngcipheko omkhulu wesifo ebantwaneni. .

2 Ukuxilongwa okwahlukileyo komkhuhlane kunye ne-COVID-19.

Zombini izifo ezitsha kunye nomkhuhlane ziyosulela kakhulu, kwaye kukho ukufana kwezinye iimpawu zekliniki, ezinjengomkhuhlane, ukukhohlela kunye ne-myalgia.Nangona kunjalo, izikimu zonyango zezi ntsholongwane zimbini zahlukile, kwaye amachiza okulwa neentsholongwane asetyenziswayo ahlukile.Ngexesha lonyango, amachiza anokutshintsha iimpawu zeklinikhi eziqhelekileyo zesi sifo, okwenza kube nzima ukuxilonga isifo kuphela ngeempawu.Ke ngoko, ukuxilongwa ngokuchanekileyo kwe-COVID-19 kunye nomkhuhlane kufuneka kuxhomekeke ekubonweni kokwahluka kwentsholongwane ukuqinisekisa ukuba izigulana zinokufumana unyango olufanelekileyo nolusebenzayo.

Inani leengcebiso zemvumelwano malunga noxilongo kunye nonyango lucebisa ukuba ukuchongwa ngokuchanekileyo kwe-COVID-19 kunye nentsholongwane yomkhuhlane ngovavanyo lwaselabhoratri kubaluleke kakhulu ekuqulunqeni isicwangciso sonyango esifanelekileyo.

《Uxilongo loMkhuhlane kunye neSicwangciso soNyango (uHlelo luka-2020)[9]kunye 《UFundo loMkhuhlane waBantu abadala kunye neMvumelwano yeNgcali yoMgangatho kaNgxamiseko yoNyango (uHlelo luka-2022)[10]zonke zikwenza kucace ukuba umkhuhlane uyafana nezinye izifo kwi-COVID-19, kwaye i-COVID-19 ineempawu ezithambileyo neziqhelekileyo ezinjengomkhuhlane, ukhohlokhohlo olomileyo kunye nomqala obuhlungu, ekungekho lula ukwahlula kumkhuhlane;Izibonakaliso ezinzima kunye nezibalulekileyo ziquka i-pneumonia enzima, i-syndrome yokuphefumula yokuphefumula kunye nokungasebenzi kakuhle kwamalungu, afana nokubonakaliswa kweklinikhi yomkhuhlane onzima kunye onzima, kwaye kufuneka uhluke nge-etiology.

《ukuxilongwa kosulelo lwe-coronavirus entsha kunye nesicwangciso sonyango (uhlelo lweshumi lokuphunyezwa kolingo》[11]Utshilo ukuba usulelo lwe-Covid-19 kufuneka lohlulwe kusulelo lwendlela yokuphefumla ephezulu ebangelwa zezinye iintsholongwane.

3 Umahluko kunyango lomkhuhlane kunye nosulelo lwe-COVID-19

I-2019-nCoV kunye nomkhuhlane zizifo ezahlukeneyo ezibangelwa ziintsholongwane ezahlukeneyo, kwaye iindlela zonyango zahlukile.Ukusetyenziswa ngokufanelekileyo kweziyobisi ezichasayo kunokuthintela iingxaki ezinzulu kunye nomngcipheko wokufa kwezi zifo zibini.

Kuyacetyiswa ukuba kusetyenziswe amachiza amancinci e-antiviral anjenge-Nimatvir/Ritonavir, i-Azvudine, i-Monola kunye ne-anti-anti-anti-anti-uultizing amayeza afana ne-Ambaviruzumab/Romisvir monoclonal antibody injection kwi-COVID-19.[12].

Amachiza okulwa umkhuhlane ikakhulu asebenzisa i-neuraminidase inhibitors (oseltamivir, zanamivir), ihemagglutinin inhibitors (Abidor) kunye ne-RNA polymerase inhibitors (Mabaloxavir), anemiphumo emihle kwiintsholongwane zomkhuhlane ezithandwayo ngoku A no-B.[13].

Ukukhetha irejimeni efanelekileyo ye-antiviral kubaluleke kakhulu kunyango lwe-2019-nCoV kunye nomkhuhlane.Ngoko ke, kubaluleke kakhulu ukuchonga i-pathogen ngokucacileyo ukukhokela unyango lweklinikhi.

4 COVID-19/ Umkhuhlane A / Umkhuhlane B uhlolo oluphindwe kathathu lweemveliso ze-nucleic acid

Le mveliso ibonelela ngokukhawuleza nangokuchanekileyo of 2019-nCoV, umkhuhlane A kunye neentsholongwane zomkhuhlane B, kwaye inceda ukwahlula i-2019-nCoV kunye nomkhuhlane, izifo ezibini eziphefumlayo ezosulelayo ezineempawu zeklinikhi ezifanayo kodwa iindlela ezahlukeneyo zonyango.Ngokuchonga i-pathogen, inokukhokela uphuhliso lweklinikhi yeenkqubo zonyango ezijoliswe kuyo kwaye iqinisekise ukuba izigulane zinokufumana unyango olufanelekileyo ngexesha.

Isisombululo sisonke:

Ingqokelela yesampulu--Nucleic acid extraction--Detection reagent--polymerase chain reaction