Sashen kula da dakunan gwaje-gwaje, asibitin jama'a na lardin Guangxi Zhuang mai cin gashin kansa, Nanning, kasar Sin
Sashen Nazarin Magunguna, Asibitin Haɗin Kan Jami'ar Shandong na Magungunan Gargajiya na Sinawa, Jinan
Huang Huayi, Makarantar Magungunan Laboratory, Jami'ar Kiwon Lafiya ta Kasa ta Youjiang, Baise, Guangxi, 533000, Mindray Arewacin Amurka, Mahwah, New Jersey, 07430, Amurka.
Sashen kula da dakunan gwaje-gwaje, asibitin jama'a na lardin Guangxi Zhuang mai cin gashin kansa, Nanning, kasar Sin
Sashen Nazarin Magunguna, Asibitin Haɗin Kan Jami'ar Shandong na Magungunan Gargajiya na Sinawa, Jinan
Huang Huayi, Makarantar Magungunan Laboratory, Jami'ar Kiwon Lafiya ta Kasa ta Youjiang, Baise, Guangxi, 533000, Mindray Arewacin Amurka, Mahwah, New Jersey, 07430, Amurka.
Yi amfani da hanyar haɗin da ke ƙasa don raba cikakken sigar wannan labarin tare da abokanka da abokan aiki.Ƙara koyo.
Don ƙarin fahimtar sauye-sauyen cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan hai da kuma ɓarkewar cututtukan da ke faruwa a nan gaba.
An sake nazarin sigogin jini na marasa lafiya 52 COVID-19 da aka shigar a asibitocin da aka keɓe.An yi nazarin bayanan ta amfani da software na ƙididdiga na SPSS.
Kafin jiyya, ƙwayoyin T cell, jimlar lymphocytes, jan jini rarraba nisa (RDW), eosinophils da basophils sun kasance da yawa ƙasa fiye da bayan jiyya, yayin da alamun kumburi na neutrophils, neutrophils da lymphocytes A rabo (NLR) da kuma C β-reactive gina jiki ((NLR). Matakan CRP da ƙwayoyin jajayen jini (RBC) da haemoglobin sun ragu sosai bayan jiyya.Rukunin tantanin halitta na T, jimlar lymphocytes da basophils na marasa lafiya masu tsanani da marasa lafiya sun kasance da ƙananan ƙananan marasa lafiya.Neutrophils, NLR, eosinophils, procalcitonin (PCT) da CRP sun fi girma a cikin marasa lafiya masu tsanani da marasa lafiya fiye da marasa lafiya masu matsakaici.CD3+, CD8+, jimlar lymphocytes, platelets, da basophils na marasa lafiya fiye da shekaru 50 sun kasance ƙasa da waɗanda ke ƙasa da shekaru 50, yayin da neutrophils, NLR, CRP, RDW a cikin marasa lafiya fiye da shekaru 50 sun fi wadanda ke ƙarƙashin shekaru 50.A cikin marasa lafiya mai tsanani da rashin lafiya, akwai kyakkyawar alaƙa tsakanin lokacin prothrombin (PT), alanine aminotransferase (ALT) da aspartate aminotransferase (AST).
Rukunin tantanin halitta T, ƙididdigar lymphocyte, RDW, neutrophils, eosinophils, NLR, CRP, PT, ALT da AST sune mahimman alamomin gudanarwa, musamman ga marasa lafiya masu tsanani da masu fama da COVID-19.
Cutar cutar Coronavirus ta 2019 (COVID-19) ta haifar da sabon nau'in coronavirus ya barke a cikin Disamba 2019 kuma ya bazu cikin sauri a duniya.1-3 A farkon fashewar, an mayar da hankali ga asibiti a kan bayyanar cututtuka da cututtuka, hade tare da ƙididdigar ƙididdiga don hoton marasa lafiya 4 da 5, sa'an nan kuma an gano su tare da sakamako mai mahimmanci na nucleotide.Duk da haka, daga baya an sami raunuka daban-daban a cikin gabobin daban-daban.6-9 ƙarin shaidu sun nuna cewa sauye-sauyen pathophysiological na COVID-19 sun fi rikitarwa.Harin kwayar cutar yana haifar da lalacewar gabobin jiki da yawa kuma tsarin rigakafi ya wuce gona da iri.An lura da karuwa a cikin kwayoyin halitta da alveolar cytokines da furotin mai amsawa mai kumburi 7, 10-12, da kuma lymphopenia da ƙananan ƙwayoyin T cell marasa lafiya an gano su a cikin marasa lafiya marasa lafiya.13, 14 An bayar da rahoton cewa rabo daga neutrophils zuwa lymphocytes ya zama mai amfani mai nuna alama don bambanta m da benign thyroid nodules a cikin aikin asibiti.15 NLR kuma zai iya taimakawa wajen rarrabe marasa lafiya da ulcerative colitis daga kulawar lafiya.16 Hakanan yana taka rawa a cikin thyroiditis kuma yana da alaƙa da nau'in ciwon sukari na 2.17, 18 RDW alama ce ta erythrocytosis.Nazarin ya gano cewa yana taimakawa wajen rarrabe nodules na thyroid, bincikar cututtuka na rheumatoid, cutar diski na lumbar, da thyroiditis.19-21 CRP shine tsinkaye na duniya na kumburi kuma an yi nazari a lokuta da yawa.22 Kwanan nan an gano cewa NLR, RDW da CRP suma suna da hannu a cikin COVID-19 kuma suna taka muhimmiyar rawa wajen gano cutar da kuma hasashen cutar.11, 14, 23-25 Saboda haka, sakamakon gwaje-gwaje na dakin gwaje-gwaje yana da mahimmanci don kimanta yanayin marasa lafiya da yanke shawarar magani.Mun sake yin nazari kan ma'auni na dakin gwaje-gwaje na majinyata 52 na COVID-19 da aka kwantar da su a asibitocin da aka kebe a Kudancin kasar Sin bisa ga riga-kafi da bayan jiyya, tsanani, da shekaru, don kara fahimtar sauye-sauyen cututtukan cututtukan da ke tattare da cutar da kuma taimakawa wajen kula da asibiti a nan gaba. na COVID-19.
Wannan binciken ya gudanar da bincike na baya-bayan nan game da marasa lafiya 52 na COVID-19 da aka kwantar da su a asibitin da aka keɓe na Nanning Hospital daga 24 ga Janairu, 2020 zuwa Maris 2, 2020.Misali, shekarun sun kasance daga watanni 3 zuwa 85.Dangane da jinsi, akwai maza 27 da mata 25.Mara lafiya yana da alamomi kamar zazzabi, bushewar tari, gajiya, ciwon kai, ƙarancin numfashi, cunkoson hanci, hanci, ciwon makogwaro, ciwon tsoka, gudawa, da kuma myalgia.Hoton da aka yi na lissafta ya nuna cewa huhun sun yi laushi ko gilashin ƙasa, wanda ke nuna ciwon huhu.Binciko bisa ga bugu na 7 na COVID-19 na Sinawa na bincike da ka'idojin jiyya.An tabbatar ta hanyar gano qPCR na ainihin nucleotides.Bisa ga ka'idojin bincike, an raba marasa lafiya zuwa matsakaici, mai tsanani, da kuma ƙungiyoyi masu mahimmanci.A cikin matsakaicin yanayi, majiyyaci yana tasowa zazzabi da ciwo na numfashi, kuma binciken hoto yana nuna alamun ciwon huhu.Idan mai haƙuri ya cika kowane ɗayan waɗannan sharuɗɗan, ganewar asali yana da tsanani: (a) damuwa na numfashi (yawan numfashi ≥30 numfashi / min);(b) Jikin yatsa mai hutawa oxygen jikewa ≤93%;(c) karfin iskar oxygen na jijiya (PO2) )/Kashi mai ban sha'awa O2 (Fi O2) ≤300 mm Hg (1 mm Hg = 0.133 kPa).Idan mai haƙuri ya cika kowane ɗayan waɗannan sharuɗɗan, ganewar asali yana da tsanani: (a) gazawar numfashi wanda ke buƙatar samun iska;(b) girgiza;(c) sauran gazawar gabobin da ke buƙatar magani a cikin sashin kulawa mai zurfi (ICU).Dangane da sharuddan da ke sama, an gano marasa lafiya 52 da rashin lafiya mai tsanani a cikin lokuta 2, marasa lafiya a cikin lokuta 5, kuma suna da matsakaici a cikin lokuta 45.
Duk marasa lafiya, ciki har da matsakaita, masu tsanani da marasa lafiya marasa lafiya, ana bi da su daidai da hanyoyin da suka biyo baya: (a) Gabaɗaya magani;(b) Maganin rigakafi: lopinavir/ritonavir da α-interferon;(c) Za a iya daidaita adadin nau'in maganin gargajiya na kasar Sin bisa ga yanayin majiyyaci.
Kwamitin Bita na Cibiyar Bincike na Asibitin Nanning Fourth ya amince da wannan binciken kuma an yi amfani da shi don tattara bayanan marasa lafiya.
Binciken jini na jini na gefe: Ana yin nazari na yau da kullum na jini na jini a kan Mindray BC-6900 hematology analyzer (Mindray) da Sysmex XN 9000 hematology analyzer (Sysmex).An tattara samfurin jini na ethylenediaminetetraacetic acid (EDTA) mai azumi da safe bayan an shigar da majiyyaci a asibiti.An tabbatar da daidaito tsakanin masu binciken jini guda biyu na sama daidai da hanyoyin sarrafa ingancin dakin gwaje-gwaje.A cikin nazarin ilimin halittar jini, ƙididdigewa da bambance-bambancen ƙwayoyin farin jini (WBC), ana samun kwayar cutar jajayen jini (RBC) da fihirisa tare da ɓangarorin watsawa da histograms.
Sitometry mai gudana na ƙananan jama'a na T lymphocyte: BD (Becton, Dickinson da Kamfani) An yi amfani da sitometer kwarara na FACSCalibur don nazarin cytometry na kwarara don nazarin ƙananan ƙananan ƙwayoyin T cell.Yi nazarin bayanan ta software na MultiSET.An yi ma'aunin daidai da daidaitattun hanyoyin aiki da umarnin masana'anta.Yi amfani da bututun tattara jini na EDTA don tattara 2 ml na jinin venous.A hankali haxa samfurin ta hanyar jujjuya bututun samfurin sau da yawa don hana kumburi.Bayan an tattara samfurin, ana aika shi zuwa dakin gwaje-gwaje kuma an bincika cikin sa'o'i 6 a cikin zafin jiki.
Binciken Immunofluorescence: C-reactive protein (CRP) da procalcitonin (PCT) an bincika nan da nan bayan kammala binciken ta amfani da samfuran jini da aka bincika ta hanyar ilimin halittar jini, kuma an yi nazari akan FS-112 immunofluorescence analyzer (Wondfo Biotech Co., LTD.) da bincike.) Bi umarnin masana'anta da ka'idojin aikin dakin gwaje-gwaje.
Yi nazarin maganin alanine aminotransferase (ALT) da aspartate aminotransferase (AST) akan HITACHI LABOSPECT008AS mai nazarin sinadarai (HITACHI).An yi nazarin lokacin prothrombin (PT) akan STAGO STA-R Evolution analyzer (Diagnostica Stago).
Juya juzu'i na jujjuyawar sarkar polymerase (RT-qPCR): Yi amfani da samfuran RNA waɗanda ke ware daga swabs na hanci ko ƙananan ɓoyayyun hanyoyin numfashi don yin RT-qPCR don gano SARS-CoV-2.Nucleic acid an rabu a kan SSNP-2000A nucleic acid atomatik rabuwa dandamali (Bioperfectus Technologies).Jami'ar Sun Yat-sen ta Daan Gene Co., Ltd. da Shanghai BioGerm Medical Biotechnology Co., Ltd ne suka samar da kayan aikin ganowa. An yi zagayowar thermal a kan ABI 7500 thermal cycler (Applied Biosystems).Sakamakon gwajin nucleoside na kwayar cuta ana bayyana shi azaman tabbatacce ko mara kyau.
An yi amfani da software na SPSS 18.0 don nazarin bayanai;T-gwaji-nau'i-nau'i, samfurin t-test mai zaman kansa, ko gwajin Mann-Whitney U an yi amfani da shi, kuma an ɗauki ƙimar P <.05 mai mahimmanci.
Marasa lafiya biyar marasa lafiya da marasa lafiya guda biyu sun girmi waɗanda ke cikin rukunin matsakaici (69.3 vs. 40.4).An nuna cikakken bayani game da 5 marasa lafiya da marasa lafiya 2 a cikin Tables 1A da B. Marasa lafiya masu tsanani da rashin lafiya yawanci suna raguwa a cikin sassan T cell da kuma jimlar lymphocyte, amma adadin jinin jini yana da kusan al'ada, sai dai ga marasa lafiya. tare da manyan sel farin jini (11.5 × 109/L).Neutrophils da monocytes suma yawanci suna da yawa.Magungunan PCT, ALT, AST da PT na 2 marasa lafiya marasa lafiya da 1 marasa lafiya marasa lafiya sun kasance masu girma, kuma PT, ALT, AST na 1 marasa lafiya marasa lafiya da 2 marasa lafiya marasa lafiya sun kasance daidai.Kusan duk marasa lafiya 7 suna da matakan CRP masu girma.Eosinophils (EOS) da basophils (BASO) sun kasance marasa lafiya a cikin marasa lafiya marasa lafiya da marasa lafiya (Table 1A da B).Shafi na 1 ya lissafa bayanin ma'auni na al'ada na ma'aunin jini a cikin yawan manya na kasar Sin.
Nazarin kididdiga ya nuna cewa kafin jiyya, CD3 +, CD4 +, CD8 + T Kwayoyin, jimlar lymphocytes, RBC rarraba nisa (RDW), eosinophils da basophils sun kasance da muhimmanci fiye da bayan magani (P = .000,. 000, .000, .012, . 04, .000 da .001).Ma'anar kumburi neutrophils, neutrophil / lymphocytes rabo (NLR) da CRP kafin jiyya sun kasance mafi girma fiye da bayan jiyya (P = .004, .011 da .017, bi da bi).Hb da RBC sun ragu sosai bayan jiyya (P = .032, .026).PLT ya karu bayan jiyya, amma ba shi da mahimmanci (P = .183) (Table 2).
Ƙungiyoyin T cell (CD3 +, CD4 +, CD8 +), jimlar lymphocytes da basophils na marasa lafiya masu tsanani da marasa lafiya sun kasance da yawa fiye da na marasa lafiya marasa lafiya (P = .025, 0.048, 0.027, 0.006 da .046).Matakan neutrophils, NLR, PCT da CRP a cikin marasa lafiya masu tsanani da marasa lafiya sun kasance mafi girma fiye da wadanda ke cikin marasa lafiya marasa lafiya (P = .005, .002, .049 da .002, bi da bi).Marasa lafiya masu tsanani da marasa lafiya suna da ƙananan PLT fiye da marasa lafiya masu matsakaici;duk da haka, bambancin bai kasance mai mahimmanci a kididdiga ba (Table 3).
CD3 +, CD8 +, jimlar lymphocytes, platelets, da basophils na marasa lafiya fiye da shekaru 50 sun kasance mafi ƙanƙanta fiye da na marasa lafiya a ƙarƙashin shekaru 50 (P = .049, 0.018, 0.019, 0.010 da .039, bi da bi), yayin da waɗanda suka wuce. 50 shekaru neutrophils na marasa lafiya, NLR rabo, CRP matakan da RDW sun kasance mafi girma fiye da na marasa lafiya a karkashin shekaru 50 (P = .0191, 0.015, 0.009, da .010, bi da bi) (Table 4).
COVID-19 yana faruwa ne ta hanyar kamuwa da cutar sankara ta coronavirus SARS-CoV-2, wacce ta fara bayyana a Wuhan, China a cikin Disamba 2019. Barkewar SARS-CoV-2 ya bazu cikin sauri bayan haka kuma ya haifar da annoba ta duniya.1-3 Saboda karancin ilimin cututtukan cututtukan da ke tattare da kwayar cutar, yawan mace-mace a farkon barkewar cutar yana da yawa.Kodayake babu magungunan rigakafin cutar, an inganta kulawa da kulawa da COVID-19 sosai.Wannan lamari ne musamman a kasar Sin yayin da aka hada hanyoyin kwantar da tarzoma tare da magungunan gargajiya na kasar Sin don magance matsalolin da wuri da matsakaici.26 marasa lafiya na COVID-19 sun amfana daga ingantacciyar fahimtar sauye-sauyen cututtuka da sigogin dakin gwaje-gwaje na cutar.cuta.Tun daga lokacin, adadin mace-macen ya ragu.A cikin wannan rahoto, babu mace-mace a cikin shari'o'in 52 da aka bincika, ciki har da marasa lafiya 7 masu tsanani da marasa lafiya (Table 1A da B).
Abubuwan lura na asibiti sun gano cewa yawancin marasa lafiya da ke da COVID-19 sun rage yawan ƙwayoyin lymphocytes da ƙananan ƙwayoyin T, waɗanda ke da alaƙa da tsananin cutar.13, 27 A cikin wannan rahoto, an gano cewa CD3 +, CD4 +, CD8 + T Kwayoyin, jimlar lymphocytes, RDW kafin jiyya, eosinophils da basophils sun kasance da yawa fiye da bayan magani (P = .000, .000, .000, .012, .04, .000 da .001).Sakamakonmu yayi kama da rahotannin baya.Waɗannan rahotanni suna da mahimmancin asibiti a cikin lura da tsananin COVID-19.8, 13, 23-25, 27, yayin da alamun kumburin neutrophils, neutrophils/lymphocyte rabo (NLR) da CRP bayan riga-kafi fiye da jiyya (P = .004, . 011 da .017, bi da bi), waɗanda aka lura kuma aka ruwaito a baya a cikin marasa lafiya na COVID-19.Don haka, ana ɗaukar waɗannan sigogi a matsayin alamomi masu amfani don maganin COVID-19.8.Bayan jiyya, 11 haemoglobin da jajayen jini sun ragu sosai (P = .032, 0.026), yana nuna cewa mai haƙuri yana da anemia a lokacin jiyya.An sami karuwa a cikin PLT bayan jiyya, amma ba shi da mahimmanci (P = .183) (Table 2).Ana tsammanin raguwar ƙwayoyin lymphocytes da T cell suna da alaƙa da raguwar tantanin halitta da apoptosis lokacin da suka taru a wurare masu kumburi da ke yaki da cutar.Ko kuma, ƙila an cinye su ta hanyar wuce gona da iri na cytokines da sunadarai masu kumburi.8, 14, 27-30 Idan ƙwayoyin lymphocyte da T cell suna da ƙasa da ƙasa kuma rabon CD4+/CD8+ yana da girma, tsinkayen ba shi da kyau.29 A cikin lura da mu, ƙwayoyin lymphocytes da ƙananan ƙwayoyin T sun murmure bayan jiyya, kuma duk lokuta 52 sun warke (Table 1).An lura da manyan matakan neutrophils, NLR, da CRP kafin jiyya, sannan kuma sun ragu sosai bayan jiyya (P = .004, .011, da .017, bi da bi) (Table 2).Aiki na sassan T cell a cikin kamuwa da cuta da amsawar rigakafi an ruwaito a baya.29, 31-34
Kamar yadda adadin marasa lafiya masu tsanani da marasa lafiya ya yi ƙanƙanta, ba mu yi nazarin ƙididdiga ba game da ma'auni tsakanin marasa lafiya masu tsanani da marasa lafiya da marasa lafiya masu matsakaici.Rukunin tantanin halitta T (CD3+, CD4+, CD8+) da kuma jimlar lymphocytes na marasa lafiya masu tsanani da rashin lafiya sun fi na marasa lafiya matsakaici.Matakan neutrophils, NLR, PCT, da CRP a cikin marasa lafiya masu tsanani da marasa lafiya sun kasance mafi girma fiye da wadanda ke cikin marasa lafiya marasa lafiya (P = .005, .002, .049, da .002, bi da bi) (Table 3).Canje-canje a cikin sigogin dakin gwaje-gwaje suna da alaƙa da tsananin COVID-19.35.36 Ba a san dalilin basophilia ba;wannan na iya zama saboda cin abinci yayin yaƙi da ƙwayoyin cuta a wurin kamuwa da cuta irin na lymphocytes.35 Binciken ya gano cewa marasa lafiya masu tsananin COVID-19 suma sun rage eosinophils;14 Duk da haka, bayananmu ba su nuna cewa wannan al'amari na iya kasancewa saboda ƙananan ƙananan lokuta masu tsanani da mahimmanci da aka gani a cikin binciken.
Abin sha'awa, mun gano cewa a cikin marasa lafiya masu tsanani da rashin lafiya, akwai dangantaka mai kyau tsakanin PT, ALT, da AST dabi'u, yana nuna cewa lalacewar gabobin jiki da yawa sun faru a cikin harin kwayar cutar, kamar yadda aka ambata a cikin wasu abubuwan lura.37 Don haka, ƙila su zama sabbin sigogi masu amfani don kimanta amsa da hasashen jiyya na COVID-19.
Ƙarin bincike ya nuna cewa CD3 +, CD8 +, jimlar lymphocytes, platelets da basophils na marasa lafiya fiye da shekaru 50 sun kasance da yawa fiye da na marasa lafiya a karkashin shekaru 50 (P = P = .049, .018, .019, .010 da. 039, bi da bi), yayin da matakan neutrophils, NLR, CRP, da RBC RDW a cikin marasa lafiya fiye da shekaru 50 sun kasance mafi girma fiye da na marasa lafiya a karkashin shekaru 50 (P = .0191, 0.015, 0.009, da .010). , bi da bi) (Table 4).Waɗannan sakamakon sun yi kama da rahotannin baya.14, 28, 29, 38-41 Rage raguwa a cikin ƙananan ƙwayoyin ƙwayoyin cuta na T cell da babban CD4 +/ CD8+ T cell rabo suna da alaka da rashin lafiya;tsofaffi lokuta sukan zama mafi tsanani;sabili da haka, za a cinye ƙarin lymphocytes a cikin martanin rigakafi ko Lalacewa sosai.Hakanan, RBC RDW mafi girma yana nuna cewa waɗannan marasa lafiya sun sami anemia.
Sakamakon bincikenmu ya kara tabbatar da cewa sigogin hematological suna da matukar mahimmanci don ingantaccen fahimtar canje-canjen asibiti na marasa lafiya na COVID-19 da haɓaka jagorar jiyya da tsinkaye.
Liang Juanying da Nong Shaoyun sun tattara bayanai da bayanan asibiti;Jiang Liejun da Chi Xiaowei sun yi nazarin bayanai;Dewu Bi, Jun Cao, Lida Mo, da Xiaolu Luo sun yi bincike na yau da kullun;Huang Huayi ne ke da alhakin daukar ciki da rubutu.
Da fatan za a duba imel ɗin ku don umarnin sake saita kalmar wucewa.Idan ba ku sami imel a cikin mintuna 10 ba, adireshin imel ɗin ku bazai yi rajista ba kuma kuna iya buƙatar ƙirƙirar sabon asusun Laburare na Wiley Online.
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Lokacin aikawa: Yuli-22-2021