Covid-19 (2019-nCoV) tau ua rau ntau pua lab tus kab mob thiab ntau lab tus neeg tuag txij li thaum nws tshwm sim thaum kawg ntawm 2019, ua rau nws muaj kev kub ntxhov thoob ntiaj teb.Lub Koom Haum Saib Xyuas Kev Noj Qab Haus Huv Ntiaj Teb (WHO) tau tshaj tawm tsib "kev txhawj xeeb ntawm kev hloov pauv"[1], uas yog Alpha, Beta, Gamma, Delta thiab Omicron, thiab Omicron mutant strain yog qhov tseem ceeb hauv kev sib kis thoob ntiaj teb tam sim no.Tom qab kis tus kab mob Omicron mutant, cov tsos mob me me, tab sis rau cov neeg tshwj xeeb xws li cov neeg tsis muaj zog tiv thaiv kab mob, cov neeg laus, cov kab mob ntev thiab cov me nyuam, kev pheej hmoo ntawm kev mob hnyav lossis kev tuag tom qab kis kab mob tseem muaj ntau.Cov ntaub ntawv kev tuag ntawm cov kab mob mutant hauv Omicron, cov ntaub ntawv hauv ntiaj teb tiag qhia tias qhov nruab nrab ntawm cov neeg tuag yog li 0.75%, uas yog kwv yees li 7 mus rau 8 npaug ntawm tus mob khaub thuas, thiab cov neeg mob tuag taus ntawm cov neeg laus, tshwj xeeb tshaj yog cov neeg laus dua 80 xyoo. laus, tshaj 10%, uas yog ze li ntawm 100 npaug ntawm tus mob khaub thuas[2].Cov tsos mob tshwm sim ntawm tus kab mob no feem ntau yog kub taub hau, hnoos, caj pas qhuav, mob caj pas, myalgia, thiab lwm yam. Cov neeg mob hnyav tuaj yeem muaj kev ua pa nyuaj thiab / lossis hypoxemia.
Muaj plaub hom kab mob khaub thuas: A, B, C thiab D. Hom kab mob loj yog subtype A (H1N1) thiab H3N2, thiab hom B (Victoria thiab Yamagata).Tus kab mob npaws uas tshwm sim los ntawm tus kab mob npaws yuav ua rau muaj kev sib kis raws caij nyoog thiab kev kis tus kab mob tsis tuaj yeem tshwm sim txhua xyoo, nrog rau qhov tshwm sim ntau.Raws li kev txheeb cais, kwv yees li 3.4 lab tus neeg raug kho rau cov kab mob khaub thuas zoo li txhua xyoo[3], thiab kwv yees li 88,100 tus neeg mob ntawm tus mob ua npaws ntsig txog kev ua pa ua rau tuag, suav txog 8.2% ntawm cov kab mob ua pa tuag.[4].Cov tsos mob tshwm sim muaj xws li kub taub hau, mob taub hau, myalgia thiab hnoos qhuav.Cov pab pawg muaj kev pheej hmoo siab, xws li cov poj niam cev xeeb tub, cov menyuam mos, cov neeg laus thiab cov neeg mob uas muaj cov kab mob ntev, ua rau mob ntsws thiab lwm yam teeb meem, uas tuaj yeem ua rau tuag taus.
1 COVID-19 nrog rau mob khaub thuas.
Kev sib koom ua ke ntawm tus mob khaub thuas nrog COVID-19 tuaj yeem ua rau muaj kev cuam tshuam ntawm tus kabmob.Ib txoj kev tshawb fawb Askiv qhia tau tias[5], piv nrog COVID-19 tus kab mob ib leeg, qhov kev pheej hmoo ntawm kev siv tshuab ua pa thiab kev pheej hmoo ntawm kev tuag hauv tsev kho mob hauv COVID-19 cov neeg mob uas muaj tus kab mob khaub thuas tau nce 4.14 npaug thiab 2.35 npaug.
Tongji Medical College ntawm Huazhong University of Science thiab Technology luam tawm ib txoj kev tshawb no[6], uas suav nrog 95 qhov kev tshawb fawb suav nrog 62,107 tus neeg mob hauv COVID-19.Qhov kev sib kis ntawm tus kab mob khaub thuas sib kis yog 2.45%, ntawm cov kab mob khaub thuas A suav nrog feem ntau.Piv nrog rau cov neeg mob tsuas yog kis tus kab mob COVID-19, cov neeg mob sib koom ua ke nrog tus mob khaub thuas A muaj kev pheej hmoo siab dua ntawm qhov tshwm sim hnyav, suav nrog kev nkag mus rau ICU, kev txhawb nqa tshuab ua pa thiab kev tuag.Txawm hais tias feem ntau ntawm cov kab mob sib kis tsawg, cov neeg mob uas muaj tus kab mob sib kis tau ntsib kev pheej hmoo siab dua ntawm qhov tshwm sim loj.
Ib tug meta-kev tshuaj ntsuam qhia tau hais tias[7], piv nrog B-kwj, A-kwj muaj feem ntau yuav kis tau nrog COVID-19.Ntawm 143 tus neeg mob sib kis, 74% kis tus kab mob A-kwj, thiab 20% kis tus kab mob B-kwj.Kev sib kis kab mob tuaj yeem ua rau muaj mob hnyav dua ntawm cov neeg mob, tshwj xeeb tshaj yog cov pab pawg tsis muaj zog xws li menyuam yaus.
Kev tshawb fawb txog cov menyuam yaus thiab cov tub ntxhais hluas hnub nyoog qis dua 18 xyoo uas tau mus pw hauv tsev kho mob lossis tuag los ntawm tus mob khaub thuas thaum lub caij mob khaub thuas hauv Tebchaws Meskas xyoo 2021-22 pom.[8]tias qhov tshwm sim ntawm kev sib koom ua ke nrog tus mob khaub thuas hauv COVID-19 tsim nyog tau txais kev saib xyuas.Ntawm cov mob khaub thuas ntsig txog kev pw hauv tsev kho mob, 6% tau sib koom ua ke nrog COVID-19 thiab mob npaws, thiab feem pua ntawm cov neeg mob khaub thuas cuam tshuam txog kev tuag tau nce mus rau 16%.Qhov kev tshawb pom no qhia tias cov neeg mob uas koom nrog COVID-19 thiab mob khaub thuas xav tau kev txhawb nqa kev ua pa tsis zoo thiab tsis cuam tshuam ntau dua li cov neeg uas tsuas kis tus kab mob khaub thuas, thiab taw qhia tias kev sib koom ua ke tuaj yeem ua rau muaj kev pheej hmoo kis mob hnyav ntxiv rau cov menyuam yaus. .
2 Kev kuaj mob sib txawv ntawm tus mob khaub thuas thiab COVID-19.
Ob yam kab mob tshiab thiab kab mob khaub thuas yog kis tau zoo heev, thiab muaj qhov zoo sib xws hauv qee cov tsos mob, xws li ua npaws, hnoos thiab myalgia.Txawm li cas los xij, cov txheej txheem kev kho mob rau ob tus kab mob no txawv, thiab cov tshuaj tiv thaiv kab mob siv sib txawv.Thaum kho, cov tshuaj tuaj yeem hloov pauv cov kev kho mob tshwm sim ntawm tus kab mob, ua rau nws nyuaj rau kev kuaj mob tsuas yog los ntawm cov tsos mob.Yog li, kev kuaj mob kom raug ntawm COVID-19 thiab mob khaub thuas yuav tsum tau tso siab rau kev kuaj xyuas tus kab mob sib txawv kom ntseeg tau tias cov neeg mob tuaj yeem tau txais kev kho mob tsim nyog thiab muaj txiaj ntsig.
Ntau qhov kev pom zoo pom zoo ntawm kev kuaj mob thiab kev kho mob qhia tias kev txheeb xyuas qhov tseeb ntawm COVID-19 thiab tus kab mob khaub thuas los ntawm kev kuaj sim yog qhov tseem ceeb heev rau kev tsim cov phiaj xwm kho mob tsim nyog.
《Influenza Diagnosis and Treatment Plan (2020 Tsab)》[9]thiab 《Adult Influenza Diagnosis and Treatment Standard Emergency Expert Consensus (2022 Edition)》[10]txhua tus ua kom pom tseeb tias tus mob khaub thuas zoo ib yam li qee cov kab mob hauv COVID-19, thiab COVID-19 muaj cov tsos mob me thiab tshwm sim xws li ua npaws, hnoos qhuav thiab mob caj pas, uas tsis yooj yim rau kev sib txawv ntawm tus mob khaub thuas;Cov tsos mob hnyav thiab tseem ceeb muaj xws li mob ntsws loj, mob ua pa nyuaj thiab lub cev tsis ua haujlwm, uas zoo ib yam li kev kho mob ntawm tus mob khaub thuas hnyav thiab tseem ceeb, thiab yuav tsum tau sib txawv los ntawm etiology.
《Kev kuaj mob tus kabmob tshiab tshiab thiab npaj khomob (thib thib kaum rau kev sim siv 》[11]tau hais tias Covid-19 yuav tsum sib txawv ntawm cov kab mob ua pa sab saud los ntawm lwm cov kab mob.
3 Qhov sib txawv ntawm kev kho mob khaub thuas thiab kab mob COVID-19
2019-nCoV thiab influenza yog cov kab mob sib txawv los ntawm cov kab mob sib txawv, thiab cov kev kho mob sib txawv.Kev siv cov tshuaj tiv thaiv kab mob kom raug tuaj yeem cuam tshuam cov teeb meem loj thiab kev tuag ntawm ob kab mob.
Nws raug pom zoo kom siv cov tshuaj tiv thaiv kab mob me me xws li Nimatvir / Ritonavir, Azvudine, Monola thiab neutralizing tshuaj tiv thaiv kab mob xws li Ambaviruzumab / Romisvir monoclonal antibody txhaj tshuaj hauv COVID-19.[12].
Cov tshuaj tiv thaiv kab mob khaub thuas feem ntau yog siv neuraminidase inhibitors (oseltamivir, zanamivir), hemagglutinin inhibitors (Abidor) thiab RNA polymerase inhibitors (Mabaloxavir), uas muaj txiaj ntsig zoo rau cov kab mob khaub thuas nrov A thiab B tam sim no.[13].
Kev xaiv cov tshuaj tiv thaiv kab mob tsim nyog yog qhov tseem ceeb heev rau kev kho mob 2019-nCoV thiab mob khaub thuas.Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tau txheeb xyuas cov kab mob kom meej meej los qhia cov tshuaj kho mob.
4 COVID-19 / Influenza A / Influenza B triple kev kuaj xyuas cov khoom lag luam nucleic acid
Cov khoom no muab kev txheeb xyuas sai thiab meej of 2019-nCoV, influenza A and influenza B viruses, thiab pab kom paub qhov txawv ntawm 2019-nCoV thiab mob npaws, ob qho tib si ua pa sib kis nrog cov tsos mob zoo sib xws tab sis cov tswv yim kho mob sib txawv.Los ntawm kev txheeb xyuas tus kab mob, nws tuaj yeem coj kev kho mob ntawm cov phiaj xwm kev kho mob thiab xyuas kom cov neeg mob tuaj yeem tau txais kev kho mob raws sijhawm.
Tag nrho cov tshuaj:
Cov qauv sau --- Nucleic acid extraction - Tshawb nrhiav reagent - polymerase saw cov tshuaj tiv thaiv
Kev txheeb xyuas qhov tseeb: txheeb xyuas Covid-19 (ORF1ab, N), tus kab mob khaub thuas A thiab kab mob khaub thuas B hauv ib lub raj.
rhiab heev: LOD ntawm Covid-19 yog 300 daim ntawv / mL, thiab cov kab mob khaub thuas A thiab B yog 500 daim ntawv / mL.
Kev pab them nqi kho mob: Covid-19 suav nrog txhua hom kab mob sib kis, nrog mob khaub thuas A nrog rau lub caij H1N1, H3N2, H1N1 2009, H5N1, H7N9, thiab lwm yam, thiab mob khaub thuas B suav nrog cov kab mob Victoria thiab Yamagata, txhawm rau xyuas kom meej tias yuav tsis muaj kev ploj. kuaj pom.
Txhim khu kev tswj tau zoo: built-in tsis zoo / zoo tswj, kev siv sab hauv thiab UDG enzyme plaub-fold zoo tswj, saib xyuas cov tshuaj reagents thiab kev ua haujlwm kom paub meej cov txiaj ntsig.
Kev siv dav: sib xws nrog cov khoom siv hluav taws xob plaub-channel fluorescence PCR hauv khw.
Tsis siv neeg rho tawm: nrog Macro & Micro-Tyogtsis siv neeg nucleic acid extraction system thiab extraction reagents, kev ua hauj lwm efficiency thiab sib xws ntawm cov txiaj ntsig tau txhim kho.
Cov ntaub ntawv khoom
Cov ntaub ntawv
1. Lub Koom Haum Ntiaj Teb Kev Noj Qab Haus Huv.Tracking SARS-CoV-2 variants[EB/OL].(2022-12-01) [2023-01-08].https://www.who.int/activities/tracking-SARS-CoV-2-variants.
2. Kev Txhais Lus _ Liang Wannian: Tus neeg tuag hauv Omicron yog 7 mus rau 8 npaug ntawm tus mob khaub thuas _ Influenza _ Epidemic _ Mick _ Sina News.http://k.sina.com.cn/article_3121600265_ba0fd70900101
3. Feng LZ, Feng S, Chen T, et al.Burden ntawm influenza-associated outpatient influenza-zoo li kev sib tham nyob rau hauv Tuam Tshoj, 2006-2015: ib tug pejxeem-raws li txoj kev tshawb no [J].Influenza Other Respir Viruses, 2020, 14(2): 162-172.
4. Li L., Li YN, Wu P, et al.Influenza-associated over respiratory mortality in China, 2010-15: a population-based study[J].Lancet Public Health, 2019, 4(9): e473-e481.
5. Swets MC, Russell CD, Harrison EM, et al.SARS-CoV-2 co-infection with influenza viruses, respiratory syncytial virus, or adenoviruses.Lancet.2022;399 (10334): 1463-1464.
6. Yan X, Li K, Lei Z, Luo J, Wang Q, Wei S. Prevalence and related outcomes of coinfection between SARS-CoV-2 and influenza: a systematic review and meta-analysis.Int J Infect Dis.2023;136:29-36.
7. Dao TL, Hoang VT, Colson P, Million M, Gautret P. Co-infection of SARS-CoV-2 and influenza viruses: A systematic review and meta-analysis.J Clin Virol Plus.Peb 2021;1(3):100036.
8. Adams K, Tastad KJ, Huang S, et al.Prevalence of SARS-CoV-2 and Influenza Coinfection and Clinical Characteristics among Children and Adolescents age <18 Years who were hospitalized or death with Influenza - United States, 2021-22 Influenza Season.MMWR Morb Mortal Wkly Rep. 2022;71 (50): 1589-1596.
9. National Health and Wellness Committee of People's Republic of China (PRC), lub xeev tswj hwm cov tshuaj suav tshuaj.Influenza Diagnosis and Treatment Program (2020 Edition) [J].Suav Journal of Clinical Infectious Diseases, 2020, 13(6): 401-405,411.
10. Tus kws kho mob xwm txheej ceev ntawm Tuam Tshoj Medical Association, Emergency Medicine Branch ntawm Tuam Tshoj Medical Association, Tuam Tshoj Emergency Medical Association, Beijing Emergency Medical Association, Tuam Tshoj Cov Neeg Liberation Army Emergency Medicine Professional Committee.Kev pom zoo ntawm Cov Kws Tshaj Lij Xwm Txheej Xwm Ceev rau Cov Neeg Laus Kab Mob Sib Kis thiab Kev Kho Mob (2022 Tsab) [J].Suav Journal of Critical Care Medicine, 2022, 42(12): 1013-1026.
11. General Office of the State Health and Wellness Commission, General Department of State Administration of Traditional Chinese Medicine.Daim Ntawv Ceeb Toom Txog Kev Luam Ntawv thiab Tshaj Tawm Txog Kab Mob Kab Mob Kab Mob Kab Mob Tshiab thiab Kev Npaj Kho Mob (Tib Hlis Kaum Ib Hlis).
12. Zhang Xu, Zhuo Wang, Wang Quanhong, et al.Cov kws tshaj lij pom zoo rau kev kho tshuaj tiv thaiv kab mob rau cov neeg mob coronavirus tshiab [J].Suav Journal of Clinical Infectious Diseases, 2023, 16(1): 10-20.
13. Tus Kws Kho Mob Xwm Ceev ntawm Tuam Tshoj Medical Association, Emergency Medicine Branch of Chinese Medical Association, Tuam Tshoj Emergency Medical Association, Beijing Emergency Medical Association, Tuam Tshoj Cov Neeg Liberation Army Emergency Medicine Professional Committee.Kev pom zoo ntawm Cov Kws Tshaj Lij Xwm Txheej Xwm Ceev rau Cov Neeg Laus Kab Mob Sib Kis thiab Kev Kho Mob (2022 Tsab) [J].Suav Journal of Critical Care Medicine, 2022, 42(12): 1013-1026.
Lub sij hawm xa tuaj: Mar-29-2024