Covid-19 (2019-nCoV) tau ua rau muaj ntau pua lab tus neeg kis tus kab mob thiab ntau lab tus neeg tuag txij li thaum nws tau kis tus kab mob thaum kawg ntawm xyoo 2019, ua rau nws yog qhov xwm txheej ceev hauv ntiaj teb. Lub Koom Haum Kev Noj Qab Haus Huv Ntiaj Teb (WHO) tau muab tsib "hom kab mob hloov pauv uas txhawj xeeb"[1], uas yog Alpha, Beta, Gamma, Delta thiab Omicron, thiab Omicron mutant strain yog hom kab mob tseem ceeb hauv kev sib kis thoob ntiaj teb tam sim no. Tom qab kis tus kab mob Omicron mutant, cov tsos mob tsis hnyav heev, 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 menyuam yaus, qhov kev pheej hmoo ntawm kev mob hnyav lossis txawm tias tuag tom qab kis tus kab mob tseem siab. Tus nqi tuag ntawm cov kab mob mutant hauv Omicron, cov ntaub ntawv hauv ntiaj teb tiag tiag qhia tias tus nqi tuag nruab nrab yog li 0.75%, uas yog li 7 txog 8 npaug ntawm tus kab mob khaub thuas, thiab tus nqi tuag ntawm cov neeg laus, tshwj xeeb tshaj yog cov neeg hnub nyoog tshaj 80 xyoo, tshaj 10%, uas yog ze li 100 npaug ntawm tus kab mob khaub thuas.[2]Cov tsos mob ntawm kev kis kab mob feem ntau yog kub taub hau, hnoos, caj pas qhuav, mob caj pas, mob nqaij, thiab lwm yam. Cov neeg mob hnyav yuav muaj mob ua pa nyuaj thiab/lossis hypoxemia.
Muaj plaub hom kab mob khaub thuas: A, B, C thiab D. Cov hom kab mob sib kis tseem ceeb yog hom A (H1N1) thiab H3N2, thiab hom B (Victoria thiab Yamagata). Kab mob khaub thuas los ntawm tus kab mob khaub thuas yuav ua rau muaj kev sib kis thoob plaws lub caij thiab kev sib kis thoob plaws uas tsis tuaj yeem kwv yees tau txhua xyoo, nrog rau tus nqi kis tau siab. Raws li cov ntaub ntawv, kwv yees li 3.4 lab tus neeg mob tau kho rau cov kab mob zoo li mob khaub thuas txhua xyoo.[3], thiab kwv yees li 88,100 tus neeg mob uas muaj kab mob ua pa uas cuam tshuam nrog mob khaub thuas ua rau tuag, uas yog 8.2% ntawm cov neeg tuag los ntawm kab mob ua pa[4]Cov tsos mob hauv tsev kho mob muaj xws li kub taub hau, mob taub hau, mob nqaij thiab hnoos qhuav. Cov neeg 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 kab mob ntev, feem ntau yuav mob ntsws thiab lwm yam teeb meem, uas yuav ua rau tuag taus yog tias mob hnyav.
1 COVID-19 nrog rau kev phom sij ntawm tus mob khaub thuas.
Kev sib kis tus kab mob khaub thuas nrog COVID-19 yuav ua rau tus kab mob hnyav zuj zus. Ib txoj kev tshawb fawb hauv tebchaws Askiv qhia tau tias[5], piv rau kev kis tus kab mob COVID-19 nkaus xwb, qhov kev pheej hmoo ntawm kev siv tshuab ua pa thiab kev pheej hmoo ntawm kev tuag hauv tsev kho mob hauv cov neeg mob COVID-19 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 tau tshaj tawm ib txoj kev tshawb fawb[6], uas suav nrog 95 txoj kev tshawb fawb uas muaj 62,107 tus neeg mob COVID-19. Tus nqi ntawm kev sib kis tus kab mob khaub thuas yog 2.45%, ntawm cov uas tus kab mob khaub thuas A suav nrog feem pua ntau heev. Piv nrog cov neeg mob uas tsuas yog kis tus kab mob COVID-19, cov neeg mob uas kis tus kab mob khaub thuas A muaj kev pheej hmoo siab dua ntawm cov txiaj ntsig loj, suav nrog kev nkag mus rau ICU, kev txhawb nqa lub tshuab ua pa thiab kev tuag. Txawm hais tias qhov kev sib kis ntawm kev sib kis tsawg, cov neeg mob uas muaj kev sib kis ntsib kev pheej hmoo siab dua ntawm cov txiaj ntsig loj.
Ib qho kev tshuaj xyuas meta qhia tau hais tias[7], piv rau B-stream, A-stream muaj feem ntau yuav kis tus kab mob COVID-19 ua ke. Ntawm 143 tus neeg mob uas kis tus kab mob ua ke, 74% kis tus kab mob A-stream, thiab 20% kis tus kab mob B-stream. Kev kis tus kab mob ua ke yuav ua rau cov neeg mob muaj mob hnyav dua, tshwj xeeb tshaj yog cov neeg tsis muaj zog xws li cov menyuam yaus.
Cov kev tshawb fawb txog cov menyuam yaus thiab cov hluas hnub nyoog qis dua 18 xyoo uas tau pw hauv tsev kho mob lossis tuag vim mob khaub thuas thaum lub caij mob khaub thuas hauv Tebchaws Meskas xyoo 2021-22 pom tias[8]tias qhov xwm txheej ntawm kev sib kis kab mob khaub thuas hauv COVID-19 tsim nyog tau txais kev saib xyuas. Ntawm cov neeg mob hauv tsev kho mob uas muaj feem cuam tshuam nrog mob khaub thuas, 6% tau sib kis nrog COVID-19 thiab mob khaub thuas, thiab feem pua ntawm cov neeg tuag uas muaj feem cuam tshuam nrog mob khaub thuas tau nce mus txog 16%. Qhov kev tshawb pom no qhia tau hais tias cov neeg mob uas muaj feem cuam tshuam nrog COVID-19 thiab mob khaub thuas xav tau kev pab txhawb nqa kev ua pa thiab tsis ua pa ntau dua li cov neeg uas tsuas yog kis tus mob khaub thuas xwb, thiab taw qhia tias kev sib kis kab mob yuav ua rau muaj kev pheej hmoo loj dua rau cov menyuam yaus.
2 Kev kuaj mob sib txawv ntawm tus mob khaub thuas thiab COVID-19.
Ob qho kab mob tshiab thiab mob khaub thuas sib kis tau yooj yim heev, thiab muaj qhov zoo sib xws hauv qee cov tsos mob hauv kev kho mob, xws li kub taub hau, hnoos thiab mob myalgia. Txawm li cas los xij, cov txheej txheem kho mob rau ob hom kab mob no txawv, thiab cov tshuaj tiv thaiv kab mob siv txawv. Thaum lub sijhawm kho mob, cov tshuaj yuav hloov cov tsos mob ntawm tus kab mob, ua rau nws nyuaj dua los kuaj mob tsuas yog los ntawm cov tsos mob xwb. Yog li ntawd, kev kuaj mob COVID-19 thiab mob khaub thuas kom raug yuav tsum vam khom kev kuaj mob sib txawv ntawm tus kab mob kom ntseeg tau tias cov neeg mob tuaj yeem tau txais kev kho mob kom zoo thiab zoo.
Muaj ntau cov lus pom zoo sib xws txog kev kuaj mob thiab kev kho mob qhia tias kev txheeb xyuas COVID-19 thiab tus kab mob khaub thuas kom raug los ntawm kev kuaj hauv chaw kuaj mob yog qhov tseem ceeb heev rau kev tsim cov phiaj xwm kho mob tsim nyog.
Kev Npaj Kuaj Mob Khaub Thuas Thiab Kev Kho Mob (Tsab Xyoo 2020)》[9]thiab "Kev Kuaj Mob Khaub Thuas Rau Cov Neeg Laus thiab Kev Kho Mob Tus Qauv Kev Pom Zoo Thaum Muaj Xwm Ceev (Tsab Xyoo 2022)"》[10]txhua tus ua kom pom tseeb tias tus mob khaub thuas zoo ib yam li qee yam kab mob hauv COVID-19, thiab COVID-19 muaj cov tsos mob me me thiab pom tseeb xws li kub taub hau, hnoos qhuav thiab mob caj pas, uas tsis yooj yim rau kev paub qhov txawv ntawm tus mob khaub thuas; Cov tsos mob hnyav thiab mob hnyav suav nrog mob ntsws hnyav, mob ua pa nyuaj thiab ua haujlwm tsis zoo ntawm lub cev, uas zoo ib yam li cov tsos mob ntawm tus mob khaub thuas hnyav thiab mob hnyav, thiab yuav tsum tau sib txawv los ntawm etiology.
"Kev kuaj mob thiab kev kho mob rau tus kab mob coronavirus tshiab (tsab ntawv thib kaum rau kev sim siv"[11]tau hais tias kev kis tus kab mob Covid-19 yuav tsum tau sib txawv ntawm kev kis tus kab mob sab saud los ntawm lwm cov kab mob.
3 Qhov sib txawv ntawm kev kho mob khaub thuas thiab kev kis tus kab mob COVID-19
2019-nCoV thiab mob khaub thuas yog cov kab mob sib txawv uas tshwm sim los ntawm cov kab mob sib txawv, thiab cov txheej txheem kho mob kuj sib txawv. Kev siv tshuaj tua kab mob kom raug tuaj yeem tiv thaiv cov teeb meem loj thiab kev pheej hmoo tuag ntawm ob hom kab mob no.
Nws raug pom zoo kom siv cov tshuaj tua kab mob me me xws li Nimatvir/Ritonavir, Azvudine, Monola thiab cov tshuaj tiv thaiv kab mob xws li Ambaviruzumab/Romisvir monoclonal antibody txhaj rau COVID-19.[12].
Cov tshuaj tiv thaiv kab mob khaub thuas feem ntau siv cov tshuaj neuraminidase inhibitors (oseltamivir, zanamivir), hemagglutinin inhibitors (Abidor) thiab RNA polymerase inhibitors (Mabaloxavir), uas muaj cov txiaj ntsig zoo rau cov kab mob khaub thuas A thiab B tam sim no.[13].
Kev xaiv cov tshuaj tua kab mob kom haum rau kev kho mob 2019-nCoV thiab mob khaub thuas yog qhov tseem ceeb heev. Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum txheeb xyuas tus kab mob kom meej kom coj tau cov tshuaj kho mob.
4 COVID-19/ Kab mob khaub thuas A / Kab mob khaub thuas B kev tshuaj xyuas peb lub pob qij txha cov khoom siv nucleic acid
Cov khoom no muab kev txheeb xyuas sai thiab raug ntawmf 2019-nCoV, kab mob khaub thuas A thiab kab mob khaub thuas B, thiab pab kom paub qhov txawv ntawm 2019-nCoV thiab mob khaub thuas, ob hom kab mob sib kis los ntawm kev ua pa uas muaj 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 txhim kho kev kho mob ntawm cov kev pab cuam kho mob thiab xyuas kom meej tias cov neeg mob tuaj yeem tau txais kev kho mob kom raug raws sijhawm.
Tag nrho cov kev daws teeb meem:
Kev sau cov qauv - Kev rho tawm nucleic acid - Kev tshawb nrhiav cov tshuaj reagent - polymerase chain reaction
Kev txheeb xyuas kom meej: txheeb xyuas Covid-19 (ORF1ab, N), tus kab mob khaub thuas A thiab tus kab mob khaub thuas B hauv ib lub raj.
Kev rhiab heev: LOD ntawm Covid-19 yog 300 daim / mL, thiab ntawm cov kab mob khaub thuas A thiab B yog 500 daim / mL.
Kev them nqi tag nrho: Covid-19 suav nrog txhua hom kab mob sib txawv uas paub lawm, nrog rau tus kab mob khaub thuas A suav nrog tus kab mob H1N1 raws caij nyoog, H3N2, H1N1 2009, H5N1, H7N9, thiab lwm yam, thiab tus kab mob khaub thuas B suav nrog tus kab mob Victoria thiab Yamagata, kom ntseeg tau tias yuav tsis muaj kev kuaj pom tsis raug.
Kev tswj xyuas zoo txhim khu kev qha: kev tswj tsis zoo/zoo uas ua tiav, kev siv sab hauv thiab kev tswj xyuas zoo plaub npaug ntawm UDG enzyme, saib xyuas cov tshuaj reagents thiab kev ua haujlwm kom ntseeg tau tias muaj txiaj ntsig zoo.
Siv dav: sib xws nrog cov cuab yeej siv plaub-channel fluorescence PCR hauv kev ua lag luam.
Kev rho tawm tsis siv neeg: nrog Macro & Micro-Tyogtsis siv neeg nucleic acid extraction system thiab extraction reagents, kev ua haujlwm zoo thiab kev sib xws ntawm cov txiaj ntsig tau zoo dua.
Cov ntaub ntawv khoom
Cov ntaub ntawv siv los ua piv txwv
1. Lub Koom Haum Kev Noj Qab Haus Huv Ntiaj Teb. Kev Tshawb Xyuas 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 Tso Cai _ Liang Wannian: Tus nqi tuag hauv Omicron yog 7 txog 8 npaug ntawm tus mob khaub thuas _ Kab mob khaub thuas _ Kev sib kis thoob qhov txhia chaw _ Mick _ Xov Xwm Sina.http://k.sina.com.cn/article_3121600265_ba0fd7090010198ol.html.
3. Feng LZ, Feng S, Chen T, et al. Lub nra hnyav ntawm kev sab laj nrog cov neeg mob sab nraud uas muaj tus kab mob khaub thuas zoo li tus kab mob khaub thuas hauv Suav teb, 2006-2015: kev tshawb fawb raws li pej xeem [J]. Kab mob khaub thuas lwm yam kab mob ua pa, 2020, 14(2): 162-172.
4. Li L, Liu YN, Wu P, et al. Kev tuag ntau dhau los ntawm kev ua pa los ntawm tus kab mob khaub thuas hauv Suav teb, 2010-15: kev tshawb fawb raws li pej xeem [J]. Lancet Public Health, 2019, 4(9): e473-e481.
5. Swets MC, Russell CD, Harrison EM, thiab lwm tus. SARS-CoV-2 sib kis nrog cov kab mob khaub thuas, kab mob ua pa, lossis adenoviruses. Lancet. 2022; 399(10334):1463-1464.
6. Yan X, Li K, Lei Z, Luo J, Wang Q, Wei S. Kev kis tus kab mob thiab cov txiaj ntsig cuam tshuam ntawm kev sib kis kab mob ntawm SARS-CoV-2 thiab mob khaub thuas: kev tshuaj xyuas thiab kev tshuaj xyuas meta. Int J Infect Dis. 2023; 136: 29-36.
7. Dao TL, Hoang VT, Colson P, Million M, Gautret P. Kev sib kis kab mob ntawm SARS-CoV-2 thiab cov kab mob khaub thuas: Kev tshuaj xyuas thiab kev sib piv. J Clin Virol Plus. 2021 Cuaj Hlis; 1(3):100036.
8. Adams K, Tastad KJ, Huang S, thiab lwm tus. Kev kis tus kab mob SARS-CoV-2 thiab kev sib kis kab mob khaub thuas thiab cov yam ntxwv ntawm kev kho mob ntawm cov menyuam yaus thiab cov hluas hnub nyoog qis dua 18 xyoo uas tau mus pw hauv tsev kho mob lossis tuag nrog tus kab mob khaub thuas - Tebchaws Meskas, 2021-22 Lub Caij Mob Khaub Thuas. MMWR Morb Mortal Wkly Rep. 2022; 71(50):1589-1596.
9. Pawg Neeg Saib Xyuas Kev Noj Qab Haus Huv thiab Kev Noj Qab Haus Huv Hauv Tebchaws ntawm Tib Neeg Lub Tebchaws Suav (PRC), kev tswj hwm lub xeev ntawm cov tshuaj suav ib txwm muaj. Kev Tshawb Fawb Txog Kab Mob Khaub Thuas thiab Kev Kho Mob (Tsab 2020) [J]. Phau Ntawv Xov Xwm Suav Txog Kab Mob Sib Kis, 2020, 13(6): 401-405,411.
10. Ceg Kws Kho Mob Thaum Muaj Xwm Ceev ntawm Lub Koom Haum Kho Mob Suav, Ceg Tshuaj Thaum Muaj Xwm Ceev ntawm Lub Koom Haum Kho Mob Suav, Lub Koom Haum Kho Mob Thaum Muaj Xwm Ceev Suav, Lub Koom Haum Kho Mob Thaum Muaj Xwm Ceev Beijing, Pawg Neeg Saib Xyuas Kev Kho Mob Thaum Muaj Xwm Ceev ntawm Cov Neeg Suav. Kev Pom Zoo ntawm Cov Kws Tshaj Lij Thaum Muaj Xwm Ceev ntawm Kev Kuaj Mob Khaub Thuas thiab Kev Kho Mob rau Cov Neeg Laus (Tsab 2022) [J]. phau ntawv xov xwm suav txog kev kho mob tseem ceeb, 2022, 42(12): 1013-1026.
11. Chaw Ua Haujlwm Dav Dav ntawm Pawg Neeg Saib Xyuas Kev Noj Qab Haus Huv thiab Kev Noj Qab Haus Huv ntawm Xeev, Chav Haujlwm Dav Dav ntawm Lub Xeev Kev Tswj Xyuas Tshuaj Kho Mob Suav. Daim Ntawv Ceeb Toom txog Kev Luam Tawm thiab Kev Faib Cov Kev Npaj Kuaj Mob thiab Kho Mob Kab Mob coronavirus tshiab (Tsab Thib Kaum).
12. Zhang Fujie, Zhuo Wang, Wang Quanhong, thiab lwm tus. Kev pom zoo ntawm cov kws tshaj lij txog kev kho mob tiv thaiv kab mob rau cov neeg mob coronavirus tshiab [J]. Chinese Journal of Clinical Infectious Diseases, 2023, 16(1): 10-20.
13. Ceg Kws Kho Mob Thaum Muaj Xwm Ceev ntawm Lub Koom Haum Kho Mob Suav, Ceg Tshuaj Thaum Muaj Xwm Ceev ntawm Lub Koom Haum Kho Mob Suav, Lub Koom Haum Kho Mob Thaum Muaj Xwm Ceev Suav, Lub Koom Haum Kho Mob Thaum Muaj Xwm Ceev Beijing, Pawg Neeg Saib Xyuas Kev Kho Mob Thaum Muaj Xwm Ceev ntawm Cov Neeg Suav. Kev Pom Zoo ntawm Cov Kws Tshaj Lij Thaum Muaj Xwm Ceev ntawm Kev Kuaj Mob Khaub Thuas thiab Kev Kho Mob rau Cov Neeg Laus (Tsab 2022) [J]. phau ntawv xov xwm Suav txog kev kho mob tseem ceeb, 2022, 42(12): 1013-1026.
Lub sijhawm tshaj tawm: Lub Peb Hlis-29-2024