Iyiphi indlela engcono kakhulu?
-Ukuhlolwa kwe-SARS-CoV-2 Infection Diagnosis
Ezimweni eziqinisekisiwe ze-COVID-19, kubikwe izimpawu zomtholampilo ezijwayelekile zifaka imfiva, ukukhwehlela, i-myalgia noma ukukhathala.Nokho lezi zimpawu azizona izici ezihlukile ze-COVID-19 ngoba lezi zimpawu ziyefana nezezinye izifo ezitheleleke ngegciwane njengomkhuhlane.Njengamanje, i-virus nucleic acid Real-Time PCR (rt-PCR), imaging ye-CT kanye neminye imingcele ye-hematology ingamathuluzi ayinhloko okuxilongwa komtholampilo kwegciwane.Izinsiza eziningi zokuhlola zaselabhorethri zenziwe futhi zasetshenziswa ekuhloleni izibonelo zeziguli ze-COVID-19 yi-CDC yaseChina.1, I-US CDC2nezinye izinkampani ezizimele.I-IgG/IgM antibody test, indlela yokuhlola i-serological, nayo yengezwe njengendlela yokuxilonga enguqulweni ebuyekeziwe yaseShayina yokuxilongwa kanye nemihlahlandlela yokwelapha yenoveli yesifo i-coronavirus (COVID-19), eyakhishwa ngomhla zizi-3, Mashi.1.Ukuhlolwa kwe-virus nucleic acid rt-PCR kuseyindlela yamanje yokuxilonga evamile yokuxilonga i-COVID-19.
StrongStep®Inoveli Coronavlrus (SARS-COV-2)Multiplex Real-Time PCR Kit(ukutholwa kwezakhi zofuzo ezintathu)
Nokho lawa makhithi okuhlola e-PCR esikhathi sangempela, abheka izakhi zofuzo zaleli gciwane, ngokwesibonelo emakhaleni, omlomo, noma endunu, ahlushwa imikhawulo eminingi:
1) Lezi zivivinyo zinezikhathi ezinde zokuguqula futhi ziyinkimbinkimbi ekusebenzeni;ngokuvamile bathatha ngokwesilinganiso ngaphezu kwamahora angu-2 kuya kwangu-3 ukuze benze imiphumela.
2) Ukuhlolwa kwe-PCR kudinga amalabhorethri aqinisekisiwe, amathuluzi abizayo kanye nochwepheshe abaqeqeshiwe ukuze basebenze.
3) Kunezinombolo ezithile zokuphikisa okungamanga ze-rt-PCR ye-COVID-19.Kungase kube ngenxa yomthamo wegciwane egazini ophansi we-SARS-CoV-2 esibonelweni se-swab engenhla yokuphefumula (i-Novel coronavirus ihlasela kakhulu umgudu wokuphefumula ophansi, njenge-pulmonary alveoli) futhi ukuhlolwa akukwazi ukukhomba abantu abadlule ekuthelelekeni, abalulama, futhi. wasusa igciwane emizimbeni yabo.
Ucwaningo lukaLirong Zou et al4ithole ukuthi inani eliphezulu legciwane egazini latholwa ngokushesha ngemva kokuqala kwezimpawu, kwatholakala inani eliphezulu legciwane emakhaleni kunasemphinjeni kanye nephethini yokuchitheka kwe-nucleic acid yeziguli ezingenwe i-SARS-CoV-2 ifana neyeziguli ezinomkhuhlane.4futhi ibonakala ihlukile kulokho okubonwa ezigulini ezitheleleke nge-SARS-CoV-2.
Yang Pan et al5wahlola amasampula e-serial (umphimbo, isikhwehlela, umchamo, kanye nendle) ezigulini ezimbili e-Beijing futhi wathola ukuthi inani legciwane egazini le-swab yomphimbo kanye namasampula esikhwehlela afinyelela inani eliphakeme cishe ezinsukwini ezi-5-6 ngemuva kokuqala kwezimpawu, amasampula esikhwehlela ngokuvamile akhombisa inani legciwane egazini amasampula e-throat swab.Ayikho i-RNA yegciwane etholwe emchameni noma kumasampula esindle kulezi ziguli ezimbili.
Ukuhlolwa kwe-PCR kunikeza umphumela othize kuphela uma igciwane lisekhona.Ukuhlola akukwazi ukukhomba abantu abadlule ekuthelelekeni, abalulama, futhi basusa igciwane emizimbeni yabo.Ngokwezibalo, cishe ama-30% -50% kuphela ayenayo i-PCR ezigulini ezinenyumoniya ye-coronavirus etholakala emtholampilo.Iziguli eziningi ze-coronavirus pneumonia azikwazi ukutholakala ngenxa yokuhlolwa kwe-nucleic acid engalungile, ngakho-ke azikwazi ukuthola ukwelashwa okuhambisanayo ngesikhathi.Kusukela kushicilelo lokuqala kuya kolwesithupha lweziqondiso, kuncike kuphela esisekelweni sokuxilongwa kwemiphumela yokuhlolwa kwe-nucleic acid, okwadala inkinga enkulu kubahlengikazi.Owokuqala "oshaya ikhwela", uDkt. Li Wenliang, udokotela wamehlo eWuhan Central. Isibhedlela, ushonile.Ngesikhathi sokuphila kwakhe, wahlolwa kathathu i-nucleic acid esimweni somkhuhlane nokukhwehlela, futhi okokugcina wathola imiphumela emihle ye-PCR.
Ngemva kwengxoxo yochwepheshe, kunqunywe ukuthi kwandiswe izindlela zokuhlola i-serum njengendlela entsha yokuxilonga.Ngenkathi ukuhlolwa kwe-antibody, okubuye kubizwe ngokuthi ukuhlolwa kwe-serological, okungaqinisekisa ukuthi umuntu uthelelekile ngisho nangemva kokuba amasosha omzimba eselisulile igciwane elibangela i-COVID-19.
I-StrongStep® SARS-COV-2 IgG/IgM Antibody Rapid Test
Ukuhlolwa kwe-antibody ye-IgG/IgM kuzosiza ukulandelela ngendlela esekwe inani labantu ukuthi ubani onaleli gciwane, ngoba izimo eziningi zibonakala zisakazwa ezigulini ezingenazimpawu ezingabonakali kalula.Umbhangqwana eSingapore, umyeni uhlolwe ukuthi une-PCR, umphumela wokuhlolwa kwe-PCR yomkakhe wawungenayo, kodwa imiphumela yokuhlolwa kwe-antibody yabonisa ukuthi wayenamasosha omzimba, njengoba kwenza umyeni wakhe.
Izivivinyo ze-serological zidinga ukuqinisekiswa ngokucophelela ukuze kuqinisekiswe ukuthi zisabela ngendlela ethembekile, kodwa kuphela kuma-antibodies ngokumelene negciwane lenoveli.Okunye okukhathazayo ukuthi ukufana phakathi kwamagciwane adala i-acute acute respiratory syndrome kanye ne-COVID-19 kungaholela ekuvukeleni.I-IgG-IgM eyakhiwe nguXue Feng wang6kwakucatshangelwa ukuthi kungasetshenziswa njengendlela yokuhlola ukunakekelwa (i-POCT), njengoba kungenziwa eduze nombhede ngegazi leminwe.Ikhithi inokuzwela okungu-88.66% kanye nokucaciswa okungu-90.63%.Kodwa-ke, kwakusenemiphumela engemihle nengalungile engamanga.
Enguqulweni ebuyekeziwe yaseShayina yokuxilonga nokwelashwa kwesifo se-coronavirus (COVID-19)1, amacala aqinisekisiwe achazwa njengamacala asolwayo ahlangabezana nanoma iyiphi yalezi zindlela ezilandelayo:
(1)Amasampula epheshana lokuphefumula, igazi noma indle ehlolwe ukuthi ine-SARS-CoV-2 nucleic acid kusetshenziswa i-rt-PCR;
(2) Ukulandelana kofuzo kwegciwane eliphuma emgudwini wokuphefumula, amasampula egazi noma ezindle kufana kakhulu ne-SARS-CoV-2 eyaziwayo;
(3)I-antibody ye-Serum coronavirus ethize ye-IgM kanye ne-IgG antibody yayilungile;
4
Ukuxilongwa nokwelashwa kwe-COVID-19
| Iziqondiso | Ishicilelwe | Imibandela yokuxilonga eqinisekisiwe |
| Inguqulo yesi-7 | 3 Mar.2020 | ❶ PCR ❷ NGS ❸ I-IgM+IgG |
| Inguqulo yesi-6 | 18 Feb.2020 | ❶ PCR ❷ NGS |
Ireferensi
1. Imihlahlandlela yokuxilongwa nokwelashwa kwenoveli inyumoniya ye-coronavirus (inguqulo yesilingo 7, Ikhomishini Yezempilo Kazwelonke yase-People's Republic of China, ikhishwe ngo-3.Mar.2020)
http://www.nhc.gov.cn/yzygj/s7652m/202003/a31191442e29474b98bfed5579d5af95.shtml
2. Sebenzisa Ucwaningo Lwephrothokholi Yesikhathi Sangempela kuphela ye-RT-PCR ukuze Uhlonze i-2019-nCoV
https://www.cdc.gov/coronavirus/2019-ncov/lab/rt-pcr-detection-instructions.html
3. I-Singapore ithi iqala ukusetshenziswa ukuhlolwa kwe-antibody ukulandelela izifo ze-coronavirus
https://www.sciencemag.org/news/2020/02/singapore-claims-first-use-antibody-test-track-coronavirus-infections
I-4.SARS-CoV-2 Viral Load Ezimbonini Zokuphefumula Ezingenhla Zeziguli Ezinegciwane February 19,2020 DOI: 10.1056/NEJMc2001737
5.Ama-Viralloads e-SARS-CoV-2 kumasampuli omtholampilo i-Lancet Infect Dis 2020 Ishicilelwe Ku-inthanethi ngomhla ka-24 February, 2020 (https://doi.org/10.1016/S1473-3099(20)30113-4)
6. Ukuthuthukiswa kanye Nokusebenza Komtholampilo Kokuhlolwa Okusheshayo Okuhlanganisiwe kwe-IgM-IgG kwe-SARS-CoV-2
Ukuxilongwa Kokutheleleka XueFeng Wang ORCID iD: 0000-0001-8854-275X
Isikhathi sokuthumela: Mar-17-2020
