Ekupheleni kowe-1995, iWorld Health Organization (WHO) yamisela umhla wama-24 kuMatshi njengoSuku lweSifo sePhepha lweHlabathi.
1 Ukuqonda isifo sephepha
Isifo sephepha (TB) sisifo sokusela esingapheliyo, esikwabizwa ngokuba "sisifo sokusebenzisa".Sisifo esosulelayo esingapheliyo esibangelwa sisifo sephepha se-mycobacterium esihlasela umzimba womntu.Ayichatshazelwa bubudala, isini, uhlanga, umsebenzi kunye nommandla.Amalungu amaninzi kunye neenkqubo zomzimba womntu zinokuba nesifo sofuba, phakathi kwayo isifo sephepha sixhaphake kakhulu.
Isifo sephepha sisifo esosulelayo esinganyangekiyo esibangelwa yiMycobacterium tuberculosis, esihlasela amalungu omzimba wonke.Ngenxa yokuba indawo yosulelo oluxhaphakileyo ngumphunga, ihlala ibizwa ngokuba sisifo sephepha.
Ngaphezulu kwe-90% yosulelo lwesifo sephepha lusasazwa ngendlela yokuphefumula.Izigulana zesifo sephepha zosulelwa ngokukhohlela, ukuthimla, ukwenza ingxolo evakalayo, ebangela ukuba amathontsi esifo sephepha (abizwa ngokuba yi-microdroplets ngokwezonyango) akhutshelwe emzimbeni aze aphefumlwe ngabantu abasempilweni.
2 Unyango lwezigulane zesifo sephepha
Unyango lweziyobisi lusisiseko sonyango lwesifo sephepha.Xa kuthelekiswa nezinye iintlobo zosulelo lwentsholongwane, unyango lwesifo sephepha lunokuthatha ixesha elide.Kwi-TB ye-pulmonary esebenzayo, amachiza okulwa nesifo sephepha kufuneka athathwe ubuncinane kwiinyanga ezi-6 ukuya kwezi-9.Amachiza athile kunye nexesha lonyango lixhomekeke kwiminyaka yesigulana, impilo iyonke kunye nokuxhathisa kumachiza.
Xa izigulane zinganyangeki kumachiza odidi lokuqala, kufuneka endaweni yawo kufakwe amachiza odidi lwesibini.Awona machiza asetyenziswa kakhulu kunyango lwesifo sephepha semiphunga esinganyangekiyo ngamachiza aquka isoniazid (INH), rifampicin (RFP), ethambutol (EB), pyrazinamide (PZA) kunye ne-streptomycin (SM).La machiza mahlanu abizwa ngokuba ngamachiza odidi lokuqala kwaye asebenza ngaphezu kwama-80% ezigulane zesifo sephepha semiphunga esandula ukusuleleka.
3 Umbuzo kunye nempendulo yesifo sephepha
Umbuzo: Ngaba isifo sephepha sinokunyangeka?
A: I-90% yezigulane ezine-pulmonary tuberculosis zinganyangwa emva kokuba zigxininise kumayeza aqhelekileyo kwaye zigqibe inkqubo yonyango emiselweyo (iinyanga ezi-6-9).Naluphi na utshintsho kunyango kufuneka lugqitywe ngugqirha.Ukuba awuwathathi ngexesha amayeza kwaye ugqibezele ikhosi yonyango, oko kuya kukhokelela ngokulula kuxhathiso lwamachiza kwisifo sephepha.Nje ukuba uxhathiso lwamachiza lwenzekile, inkqubo yonyango iyakwandiswa kwaye iya kukhokelela ngokulula kukusilela kunyango.
Umbuzo: Yintoni ekufuneka izigulane zesifo sephepha ziqwalasele ngexesha lokunyanga?
IMPENDULO: Emva kokuba kufunyaniswe ukuba unesifo sephepha, kufuneka ufumane unyango rhoqo ngokukhawuleza, ulandele iingcebiso zikagqirha, uthathe amayeza ngexesha, uhlole rhoqo kwaye wenze ukuzithemba.1. Nika ingqalelo ekuphumleni kwaye womeleze isondlo;2. Nika ingqalelo kucoceko lobuqu, kwaye ugqume umlomo nempumlo yakho ngeetawuli zephepha xa ukhohlela okanye uthimla;3. Nciphisa ukuphuma kwaye unxibe imaski xa kufuneka uphume.
Umbuzo: Ngaba isifo sephepha sisenosulelo emva kokuba sinyangiwe?
A: Emva konyango olusemgangathweni, ukusuleleka kwezigulane ze-pulmonary tuberculosis ngokuqhelekileyo kuncipha ngokukhawuleza.Emva kweeveki ezininzi zonyango, inani lebhaktheriya yesifo sephepha kwisikhohlela liya kuncitshiswa kakhulu.Uninzi lwezigulane ezine-non-infectious pulmonary tuberculosis zigqiba yonke inkqubo yonyango ngokwesicwangciso sonyango esimiselweyo.Emva kokufikelela kwinqanaba lokunyanga, akukho bhaktheriya yesifo sephepha inokufumaneka kwisikhohlela, ngoko ke ayisasuleli.
Umbuzo: Ngaba isifo sephepha sisenosulelo emva kokuba sinyangiwe?
A: Emva konyango olusemgangathweni, ukusuleleka kwezigulane ze-pulmonary tuberculosis ngokuqhelekileyo kuncipha ngokukhawuleza.Emva kweeveki ezininzi zonyango, inani lebhaktheriya yesifo sephepha kwisikhohlela liya kuncitshiswa kakhulu.Uninzi lwezigulane ezine-non-infectious pulmonary tuberculosis zigqiba yonke inkqubo yonyango ngokwesicwangciso sonyango esimiselweyo.Emva kokufikelela kwinqanaba lokunyanga, akukho bhaktheriya yesifo sephepha inokufumaneka kwisikhohlela, ngoko ke ayisasuleli.
Isisombululo sesifo sephepha
IMacro kunye neMicro-Test ibonelela ngezi mveliso zilandelayo:
Ukufunyanwa kweI-MTB (Mycobacterium tuberculosis) i-nucleic acid
1. Ukuqaliswa kokulawulwa komgangatho wereferensi yangaphakathi kwinkqubo inokubeka iliso ngokubanzi inkqubo yovavanyo kunye nokuqinisekisa umgangatho wokulinga.
2. Ukukhulisa i-PCR kunye ne-fluorescent probe inokudibaniswa.
3. Uvakalelo oluphezulu: ubuncinci bomda wokufumanisa yi-1 ibhaktheriya / mL.
Ukufunyanwa kweukunganyangeki kwe-isoniazid kwi-MTB
1. Ukuqaliswa kokulawulwa komgangatho wereferensi yangaphakathi kwinkqubo inokubeka iliso ngokubanzi inkqubo yovavanyo kunye nokuqinisekisa umgangatho wokulinga.
2. I-self-implification-blocking mutation system yamkelwa, kwaye indlela yokudibanisa iteknoloji ye-ARMS kunye neprobe ye-fluorescent yamkelwa.
3. Uvakalelo oluphezulu: ubuncinci bomda wokufumanisa i-1000 ibhaktheriya / mL, kunye neentlobo ezingalinganiyo ezichasene neyeza kunye ne-1% okanye ngaphezulu kweentlobo eziguquguqukayo zingabonwa.
4. Ukuchaneka okuphezulu: Akukho ukuphendula okunqamlezayo kunye nokuguqulwa kwe-(511, 516, 526 kunye ne-531) iindawo ezine zokuxhathisa iziyobisi ze-rpoB gene.
Ukufunyanwa koGuquko lweI-MTB kunye neRifampicin Resistance
1. Ukuqaliswa kokulawulwa komgangatho wereferensi yangaphakathi kwinkqubo inokubeka iliso ngokubanzi inkqubo yovavanyo kunye nokuqinisekisa umgangatho wokulinga.
2. Indlela ye-melting curve edityaniswe neprobe ye-fluorescent evaliweyo eneziseko ze-RNA isetyenziselwe ukufumanisa i-in vitro amplification.
3. Uvakalelo oluphezulu: ubuncinci bomda wokufumanisa yi-50 ibhaktheriya / mL.
4. Ukuchaneka okuphezulu: akukho mpendulo enqamlezileyo kunye ne-genome yomntu, enye i-mycobacteria engabonakaliyo kunye ne-pneumonia pathogens;Iziza zotshintsho zezinye iijini ezixhathisa ngamachiza zohlobo lwasendle lwe-mycobacterium tuberculosis, ezifana ne-katG 315G>C\A kunye ne-InhA -15 C>T, zichongiwe, kwaye iziphumo azibonisi kusabela okunqamlezayo.
Ukufunyanwa kwe-nucleic acid ye-MTB (EPIA)
1. Ukuqaliswa kokulawulwa komgangatho wereferensi yangaphakathi kwinkqubo inokubeka iliso ngokubanzi inkqubo yovavanyo kunye nokuqinisekisa umgangatho wokulinga.
2. I-enzyme digestion probe indlela yokukhulisa ubushushu obuqhubekayo iyamkelwa, kwaye ixesha lokufumanisa lifutshane, kwaye umphumo wokufumanisa unokufumaneka kwimizuzu engama-30.
3. Idityaniswe ne-Macro & Micro-Test i-agent yokukhulula isampula kunye ne-Macro & Micro-Test rhoqo ukushisa kwe-nucleic acid amplification analyzer, kulula ukuyisebenzisa kwaye ifanelekile kwimiboniso eyahlukeneyo.
4. Uvakalelo oluphezulu: ubuncinci bomda wokufumanisa yi-1000Copies / mL.
5. Ukucaciswa okuphezulu: Akukho mpendulo enqamlekileyo kunye nezinye i-mycobacteria ye-non-tuberculosis mycobacteria complex (efana ne-Mycobacterium kansas, i-Mycobacterium Sukarnica, i-Mycobacterium marinum, njl.) kunye nezinye iintsholongwane (ezifana ne-Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli, njl. .).
Ixesha lokuposa: Mar-22-2024