Ishami ry'ubuvuzi bwa Laboratoire, Ibitaro by'abaturage bya Guangxi Zhuang mu karere kigenga, Nanning, mu Bushinwa
Ishami ry'ubuvuzi bwa Laboratoire, Ibitaro bishamikiye kuri kaminuza ya Shandong y'Ubuvuzi gakondo bw'Abashinwa, Jinan
Huang Huayi, Ishuri ry'Ubuvuzi bwa Laboratoire, Kaminuza Nkuru y'Ubuvuzi ya Youjiang, Baise, Guangxi, 533000, Mindray Amerika y'Amajyaruguru, Mahwah, New Jersey, 07430, Amerika.
Ishami ry'ubuvuzi bwa Laboratoire, Ibitaro by'abaturage bya Guangxi Zhuang mu karere kigenga, Nanning, mu Bushinwa
Ishami ry'ubuvuzi bwa Laboratoire, Ibitaro bishamikiye kuri kaminuza ya Shandong y'Ubuvuzi gakondo bw'Abashinwa, Jinan
Huang Huayi, Ishuri ry'Ubuvuzi bwa Laboratoire, Kaminuza Nkuru y'Ubuvuzi ya Youjiang, Baise, Guangxi, 533000, Mindray Amerika y'Amajyaruguru, Mahwah, New Jersey, 07430, Amerika.
Koresha umurongo uri munsi kugirango usangire inyandiko yuzuye yiyi ngingo hamwe nabagenzi bawe na bagenzi bawe.Wige byinshi.
Kugirango twumve neza impinduka ziterwa na COVID-19, zifasha gucunga amavuriro yindwara no kwitegura guhangana n’ibyorezo nk'ibi mu gihe kiri imbere.
Ibipimo by’amaraso by’abarwayi 52 COVID-19 binjiye mu bitaro byabigenewe byasesenguwe bidasubirwaho.Amakuru yasesenguwe hakoreshejwe porogaramu y'ibarurishamibare ya SPSS.
Mbere yo kuvurwa, T selile iragabanuka, lymphocytes zose, ubugari bwamaraso atukura (RDW), eosinofile na basofile byari hasi cyane ugereranije na nyuma yo kuvurwa, mugihe ibimenyetso byerekana umuriro wa neutrophile, neutrophile na lymphocytes Ikigereranyo (NLR) na C β-reaction proteine (C) CRP) kimwe na selile yamaraso itukura (RBC) na hemoglobine byagabanutse cyane nyuma yo kuvurwa.T selile igabanuka, lymphocytes zose hamwe na basofili yabarwayi bakomeye kandi barembye cyane bari hasi cyane ugereranije n’abarwayi bashyira mu gaciro.Neutrophile, NLR, eosinofile, procalcitonine (PCT) na CRP biri hejuru cyane ku barwayi bakomeye kandi barwaye cyane kurusha abarwayi bashyira mu gaciro.CD3 +, CD8 +, lymphocytes zose, platine, na basofili y’abarwayi barengeje imyaka 50 bari munsi y’abatarengeje imyaka 50, mu gihe neutrophile, NLR, CRP, RDW ku barwayi barengeje imyaka 50 iri hejuru y’abatarengeje imyaka 50.Mu barwayi bakomeye kandi barembye cyane, hariho isano ryiza hagati ya prothrombine (PT), alanine aminotransferase (ALT) na aminotransferase (AST).
T selile ya selile, kubara lymphocyte, RDW, neutrophile, eosinofile, NLR, CRP, PT, ALT na AST nibimenyetso byingenzi mubuyobozi, cyane cyane kubarwayi bakomeye kandi barwaye cyane bafite COVID-19.
Indwara ya Coronavirus ya 2019 (COVID-19) yatewe n'ubwoko bushya bwa coronavirus yadutse mu Kuboza 2019 ikwirakwira ku isi hose.1-3 Mu ntangiriro y’iki cyorezo, ivuriro ryibanze ku kwigaragaza no kwandura epidemiologiya, hamwe na tomografi yabazwe ku barwayi b’ishusho 4 na 5, hanyuma basuzumwa n’ibisubizo byiza bya nucleotide.Ariko, ibikomere bitandukanye byindwara byaje kuboneka mubice bitandukanye.6-9 Ibimenyetso byinshi kandi byinshi byerekana ko impinduka za patrophysiologique ya COVID-19 zigoye cyane.Igitero cya virusi gitera kwangirika kwingingo nyinshi kandi sisitemu yumubiri ikabije.Ubwiyongere bwa serumu na alveolar cytokine hamwe na poroteyine zisubiza umuriro byagaragaye 7, 10-12, na lymphopenia hamwe na selile T idasanzwe byagaragaye ku barwayi barembye cyane.13, 14 Biravugwa ko igipimo cya neutrophile na lymphocytes cyabaye ikimenyetso cyingirakamaro mu gutandukanya indwara ya tiroyide mbi kandi nziza mu buvuzi.15 NLR irashobora kandi gufasha gutandukanya abarwayi bafite colitis ibisebe no kubagenzura neza.16 Ifite kandi uruhare muri tiroyide kandi ifitanye isano na diyabete yo mu bwoko bwa 2.17, 18 RDW ni ikimenyetso cya erythrocytose.Ubushakashatsi bwerekanye ko bufasha gutandukanya nodules ya tiroyide, gusuzuma indwara ya rubagimpande, indwara ya disiki, na tiroyide.19-21 CRP ni isi yose itangaza umuriro kandi yarizwe mubibazo byinshi.22 Vuba aha byavumbuwe ko NLR, RDW na CRP nabo bagize uruhare muri COVID-19 kandi bafite uruhare runini mugupima no kumenya indwara.11, 14, 23-25 Kubwibyo, ibisubizo byibizamini bya laboratoire ni ngombwa mugusuzuma uko umurwayi ameze no gufata ibyemezo byo kuvura.Twongeye gusesengura ibipimo bya laboratoire y’abarwayi 52 COVID-19 bari mu bitaro mu bitaro byabigenewe byo mu Bushinwa bw’Amajyepfo dukurikije ubuvuzi bwabo mbere na nyuma y’ubuvuzi, ubukana, n'imyaka, kugira ngo turusheho gusobanukirwa n'impinduka z’indwara kandi dufashe imiyoborere y’amavuriro. ya COVID-19.
Ubu bushakashatsi bwakoze isesengura ryisubiramo ry’abarwayi 52 COVID-19 binjiye mu bitaro byabigenewe ibitaro bya kane bya Nanning kuva ku ya 24 Mutarama 2020 kugeza ku ya 2 Werurwe 2020. Muri bo, 45 bari barwaye mu rugero naho 5 bari barembye cyane.Kurugero, imyaka iri hagati yamezi 3 kugeza 85.Ku bijyanye n'uburinganire, hari abagabo 27 n'abagore 25.Umurwayi afite ibimenyetso nk'umuriro, inkorora yumye, umunaniro, kubabara umutwe, guhumeka neza, kunanuka mu mazuru, izuru ritemba, kubabara mu muhogo, kubabara imitsi, impiswi, na myalgia.Kubara tomografiya yerekanaga ko ibihaha byari byoroshye cyangwa ikirahure cyubutaka, byerekana umusonga.Suzuma ukurikije integuro ya 7 yubushinwa COVID-19 Amabwiriza yo gusuzuma no kuvura.Byemejwe nigihe nyacyo qPCR kumenya virusi nucleotide.Ukurikije ibipimo byo gusuzuma, abarwayi bagabanyijwemo amatsinda aringaniye, akomeye, kandi akomeye.Mugihe giciriritse, umurwayi agira umuriro na syndrome yubuhumekero, kandi ubushakashatsi bwakozwe bwerekana amashusho yerekana umusonga.Niba umurwayi yujuje kimwe mu bipimo bikurikira, kwisuzumisha birakomeye: (a) ibibazo byo guhumeka (igipimo cyo guhumeka ≥30 guhumeka / min);(b) kuruhuka urutoki rwamaraso ya ogisijeni ≤93%;.Niba umurwayi yujuje kimwe mu bipimo bikurikira, isuzuma rirakomeye: (a) kunanirwa k'ubuhumekero bisaba guhumeka;(b) guhungabana;(c) ibindi kunanirwa kw'ingingo bisaba kuvurwa mu gice cyita ku barwayi (ICU).Dukurikije ibipimo byavuzwe haruguru, abarwayi 52 basuzumwe ko barembye cyane mu bihe 2, barwaye cyane mu bantu 5, naho barwaye mu rugero 45.
Abarwayi bose, harimo abarwayi bashyira mu gaciro, bakomeye kandi barembye cyane, bavurwa hakurikijwe uburyo bukurikira: (a) Ubuvuzi rusange;(b) Ubuvuzi bwa virusi: lopinavir / ritonavir na α-interferon;(c) Ingano yimiti gakondo yubushinwa irashobora guhinduka ukurikije uko umurwayi ameze.
Ubu bushakashatsi bwemejwe na komite ishinzwe gusuzuma Ikigo cy’ubushakashatsi cy’ibitaro bya kane bya Nanning kandi byakoreshejwe mu gukusanya amakuru y’abarwayi.
Isesengura ryamaraso ya periferique: isesengura rya hematologiya isanzwe yamaraso ya peripheri ikorerwa kuri Mindray BC-6900 isesengura hematologiya (Mindray) na Sysmex XN 9000 isesengura hematologiya (Sysmex).Icyorezo cya Ethylenediaminetetraacetic aside (EDTA) anticoagulant icyitegererezo cyakusanyirijwe mugitondo nyuma yuko umurwayi yinjiye mu bitaro.Isuzuma rihoraho hagati yisesengura ryamaraso yavuzwe haruguru ryagenzuwe hakurikijwe uburyo bwo kugenzura ubuziranenge bwa laboratoire.Isesengura rya hematologiya, selile yamaraso yera (WBC) kubara no gutandukanya, selile yamaraso itukura (RBC) hamwe na index biboneka hamwe nibibanza bitatanye hamwe na histogramu.
Flow cytometrie ya T lymphocyte subpopulations: BD (Becton, Dickinson na Sosiyete) FACSCalibur itemba cytometer yakoreshejwe mugusuzuma cytometrie yo gusesengura isesengura rya selile.Gisesengura amakuru ukoresheje software ya MultiSET.Ibipimo byakozwe hakurikijwe inzira zisanzwe zikorwa n'amabwiriza yabakozwe.Koresha umuyoboro wo gukusanya amaraso ya EDTA kugirango ukusanye miriyoni 2 zamaraso.Kuvanga witonze witonze uhinduranya icyitegererezo inshuro nyinshi kugirango wirinde gukomera.Icyitegererezo kimaze gukusanywa, cyoherezwa muri laboratoire kandi kigasesengurwa mu masaha 6 ku bushyuhe bwicyumba.
Isesengura rya Immunofluorescence: C-reaction proteine (CRP) na procalcitonine (PCT) byasesenguwe ako kanya nyuma yo kurangiza isesengura hakoreshejwe ingero zamaraso zasesenguwe na hematologiya, hanyuma zisesengurwa ku isesengura rya immunofluorescence FS-112 (Wondfo Biotech Co., LTD.) Kuri isesengura.) Kurikiza amabwiriza yabakozwe nubuziranenge bwa laboratoire.
Gisesengura serumu alanine aminotransferase (ALT) hamwe na aminotransferase (AST) kuri HITACHI LABOSPECT008AS isesengura imiti (HITACHI).Igihe cya prothrombin (PT) cyasesenguwe ku isesengura rya STAGO STA-R Ubwihindurize (Diagnostica Stago).
Guhindura inyandiko-mvugo ya polymerase yerekana (RT-qPCR): Koresha inyandikorugero ya RNA itandukanijwe na nasopharyngeal swabs cyangwa imyanya y'ubuhumekero yo hepfo kugirango ukore RT-qPCR kugirango umenye SARS-CoV-2.Acide nucleique yatandukanijwe kuri SSNP-2000A acide nucleic aside itandukanya byikora (Bioperfectus Technologies).Igikoresho cyo gutahura cyatanzwe na Sun Yat-sen University Daan Gene Co., Ltd na Shanghai BioGerm Medical Biotechnology Co., Ltd. Umuzenguruko w’ubushyuhe wakorewe ku cyuma cy’ubushyuhe bwa ABI 7500 (Applied Biosystems).Ibisubizo bya virusi nucleoside bisobanurwa nkibintu byiza cyangwa bibi.
Porogaramu ya SPSS 18.0 yakoreshejwe mu gusesengura amakuru;byombi-icyitegererezo t-ikizamini, cyigenga-icyitegererezo t-ikizamini, cyangwa ikizamini cya Mann-Whitney U cyakoreshejwe, kandi P agaciro <.05 byafatwaga nkibyingenzi.
Abarwayi batanu barembye cyane n’abarwayi babiri barembye cyane bari bakuru kuruta abo mu itsinda rito (69.3 na 40.4).Amakuru arambuye y’abarwayi 5 bakomeye n’abarwayi 2 barembye cyane yerekanwa mu mbonerahamwe ya 1A na B. Abarwayi bakomeye n’abarwayi bakomeye bakunze kuba bake mu bice bya selile T na lymphocyte zose, ariko umubare w’amaraso yera ni ibisanzwe, usibye abarwayi hamwe na selile yera yuzuye (11.5 × 109 / L).Neutrophile na monocytes nabyo mubisanzwe ni hejuru.Serumu PCT, ALT, AST na PT indangagaciro zabarwayi 2 barembye cyane n’umurwayi 1 urwaye cyane bari hejuru, kandi PT, ALT, AST y’umurwayi 1 urwaye cyane n’abarwayi 2 bakomeye cyane byari bifitanye isano nziza.Abarwayi hafi ya 7 bose bari bafite urwego rwo hejuru rwa CRP.Eosinofile (EOS) na basofili (BASO) bakunda kuba muke kubarwayi barembye cyane kandi barwaye cyane (Imbonerahamwe 1A na B).Imbonerahamwe 1 irerekana ibisobanuro byurwego rusanzwe rwibipimo byamaraso mubushinwa bukuze.
Isesengura mibare ryerekanye ko mbere yo kuvurwa, CD3 +, CD4 +, CD8 + T selile, lymphocytes zose, ubugari bwa RBC (RDW), eosinofili na basofili byari hasi cyane ugereranije no kuvurwa (P = .000,. 000, .000, .012 ,. 04, .000 na .001).Ibipimo byerekana umuriro neutrophile, neutrophil / lymphocyte ratio (NLR) na CRP mbere yo kuvurwa byari hejuru cyane ugereranije no kuvurwa (P = .004, .011 na .017).Hb na RBC byagabanutse cyane nyuma yo kuvurwa (P = .032, .026).PLT yiyongereye nyuma yo kuvurwa, ariko ntabwo yari ikomeye (P = .183) (Imbonerahamwe 2).
T selile ya T (CD3 +, CD4 +, CD8 +), lymphocytes zose hamwe na basofili yabarwayi bakomeye kandi barwaye cyane bari hasi cyane ugereranije n’abarwayi bashyira mu gaciro (P = .025, 0.048, 0.027, 0.006 na .046).Urwego rwa neutrophile, NLR, PCT na CRP ku barwayi bakomeye kandi barembye cyane rwari hejuru cyane ugereranije n’abarwayi bashyira mu gaciro (P = .005, .002, .049 na .002).Abarwayi bakomeye kandi barwaye cyane bari bafite PLT yo hasi ugereranije n’abarwayi bashyira mu gaciro;icyakora, itandukaniro ntabwo ryari rifite imibare (Imbonerahamwe 3).
CD3 +, CD8 +, lymphocytes zose, platine, na basofili y’abarwayi barengeje imyaka 50 bari hasi cyane ugereranije n’abarwayi bari munsi y’imyaka 50 (P = .049, 0.018, 0.019, 0.010 na .039), naho abari hejuru Imyaka 50 ya neutrophile y’abarwayi, igipimo cya NLR, urwego rwa CRP na RDW yari hejuru cyane ugereranije n’abarwayi bari munsi y’imyaka 50 (P = .0191, 0.015, 0.009, na .010) (Imbonerahamwe 4).
COVID-19 iterwa no kwandura coronavirus SARS-CoV-2, yagaragaye bwa mbere i Wuhan mu Bushinwa mu Kuboza 2019. Icyorezo cya SARS-CoV-2 cyakwirakwiriye vuba nyuma bituma havuka icyorezo ku isi.1-3 Bitewe n'ubumenyi buke kuri epidemiologiya na patologiya ya virusi, umubare w'abapfa mu ntangiriro y'icyorezo ni mwinshi.Nubwo nta miti igabanya ubukana bwa virusi, gukurikirana no kuvura COVID-19 byateye imbere cyane.Ibi ni ukuri cyane cyane mubushinwa mugihe imiti ivura ihujwe nubuvuzi gakondo bwabashinwa kugirango bavure indwara hakiri kare kandi zoroheje.26 abarwayi ba COVID-19 bungukiwe no gusobanukirwa neza n’imihindagurikire y’indwara n’ibipimo bya laboratoire.indwara.Kuva icyo gihe, umubare w'abapfa wagabanutse.Muri iyi raporo, nta bantu bapfuye mu manza 52 zasesenguwe, harimo abarwayi 7 bakomeye kandi barembye cyane (Imbonerahamwe 1A na B).
Ubushakashatsi bwakozwe ku mavuriro bwerekanye ko abarwayi benshi barwaye COVID-19 bagabanije lymphocytes na T selile subpopulations, zifitanye isano n'uburemere bw'indwara.13, 27 Muri iyi raporo, byagaragaye ko CD3 +, CD4 +, CD8 + T, lymphocytes zose, RDW mbere yo kuvurwa, eosinofile na basofili byari hasi cyane ugereranije no kuvurwa (P = .000, .000, .000, .012, .04, .000 na .001).Ibisubizo byacu bisa na raporo zabanjirije iyi.Izi raporo zifite akamaro kanini mugukurikirana ubukana bwa COVID-19.8, 13, 23-25, 27, mugihe ibipimo byerekana umuriro neutrophile, neutrophile / lymphocyte ratio (NLR) na CRP nyuma yo kuvurwa mbere yo kuvurwa (P = .004 ,. 011 na .017, kimwe), byagaragaye kandi byavuzwe mbere mu barwayi ba COVID-19.Kubwibyo, ibipimo bifatwa nkibipimo byingirakamaro mu kuvura COVID-19.8.Nyuma yo kuvurwa, hemoglobine 11 na selile zitukura byagabanutse cyane (P = .032, 0.026), byerekana ko umurwayi yagize amaraso make mugihe cyo kwivuza.Ubwiyongere bwa PLT bwagaragaye nyuma yo kuvurwa, ariko ntabwo bwari bukomeye (P = .183) (Imbonerahamwe 2).Kugabanuka kwa lymphocytes na T selile subpopulations bikekwa ko bifitanye isano no kugabanuka kwingirabuzimafatizo na apoptose iyo byegeranije ahantu hatwika virusi.Cyangwa, zishobora kuba zarakoreshejwe no gusohora cyane kwa cytokine na proteyine zitera umuriro.8, 14, 27-30 Niba insimburangingo ya lymphocyte na T ikomeza kuba hasi kandi igipimo cya CD4 + / CD8 + kiri hejuru, prognoz ni mbi.29 Mu byo twabonye, lymphocytes na T selile zagabanutse nyuma yo kuvurwa, kandi 52 zose zarakize (Imbonerahamwe 1).Urwego rwo hejuru rwa neutrophile, NLR, na CRP byagaragaye mbere yo kuvurwa, hanyuma bigabanuka cyane nyuma yo kuvurwa (P = .004, .011, na .017) (Imbonerahamwe 2).Imikorere ya selile T igabanuka mu kwandura no gukingira indwara byavuzwe mbere.29, 31-34
Kubera ko umubare w’abarwayi bakomeye kandi barembye cyane ari muto cyane, ntabwo twakoze isesengura mibare ku bipimo biri hagati y’abarwayi bakomeye n’abarwayi bakomeye n’abarwayi bashyira mu gaciro.T selile igabanuka (CD3 +, CD4 +, CD8 +) hamwe na lymphocytes zose z’abarwayi bakomeye kandi barwaye cyane ziri hasi cyane ugereranije n’abarwayi bashyira mu gaciro.Urwego rwa neutrophile, NLR, PCT, na CRP ku barwayi bakomeye kandi barembye cyane rwari hejuru cyane ugereranije n’abarwayi bashyira mu gaciro (P = .005, .002, .049, na .002) (Imbonerahamwe 3).Guhindura ibipimo bya laboratoire bifitanye isano n'uburemere bwa COVID-19.35.36 Impamvu ya basofilia ntisobanutse;ibi birashobora guterwa no kurya ibiryo mugihe urwanya virusi aho yanduye isa na lymphocytes.35 Ubushakashatsi bwerekanye ko abarwayi bafite COVID-19 ikabije na bo bagabanije eosinofile;14 Ariko, amakuru yacu ntiyerekanye ko iki kintu gishobora guterwa numubare muto wimanza zikomeye kandi zikomeye zagaragaye mubushakashatsi.
Igishimishije, twasanze mubarwayi bakomeye kandi barembye cyane, hariho isano ryiza hagati yindangagaciro za PT, ALT, na AST, byerekana ko kwangirika kwingingo nyinshi kwatewe na virusi, nkuko byavuzwe mubindi byagaragaye.37 Kubwibyo, birashobora kuba ibipimo bishya byingirakamaro mugusuzuma igisubizo no gutangaza imiti ya COVID-19.
Ubundi isesengura ryerekanye ko CD3 +, CD8 +, lymphocytes zose, platine na basofili y’abarwayi barengeje imyaka 50 bari hasi cyane ugereranije n’abarwayi bari munsi y’imyaka 50 (P = P = .049, .018, .019, .010 na. 039, uko bikurikirana), mugihe urwego rwa neutrophile, NLR, CRP, na RBC RDW ku barwayi barengeje imyaka 50 rwarushijeho kuba rwinshi ugereranije n’abarwayi bari munsi y’imyaka 50 (P = .0191, 0.015, 0.009, na .010 , uko bikurikirana) (Imbonerahamwe 4).Ibisubizo bisa na raporo zabanjirije iyi.Kugabanuka kwa 14, 28, 29, 38-41 Kugabanuka kwabaturage ba T selile hamwe na CD4 + / CD8 + T igereranije ningirabuzimafatizo;imanza zishaje zikunda kuba nyinshi;kubwibyo, lymphocytes nyinshi zizakoreshwa mugukingira indwara cyangwa kwangiritse cyane.Mu buryo nk'ubwo, RBC RDW yo hejuru yerekana ko abo barwayi barwaye amaraso make.
Ibisubizo byubushakashatsi byacu byemeza kandi ko ibipimo by’amaraso bifite akamaro kanini mu gusobanukirwa neza n’imihindagurikire y’amavuriro y’abarwayi ba COVID-19 no kunoza ubuyobozi bwo kuvura no gutangaza.
Liang Juanying na Nong Shaoyun bakusanyije amakuru n'amakuru yo kwa muganga;Jiang Liejun na Chi Xiaowei bakoze isesengura ryamakuru;Dewu Bi, Jun Cao, Lida Mo, na Xiaolu Luo bakoze isesengura risanzwe;Huang Huayi yari ashinzwe gusama no kwandika.
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Igihe cyo kohereza: Nyakanga-22-2021