Dhipatimendi reMushonga weLabhoritari, People's Hospital yeGuangxi Zhuang Autonomous Region, Nanning, China
Dhipatimendi reLabhoritari Mushonga, Yakabatana Chipatara cheShandong University yeTraditional Chinese Medicine, Jinan
Huang Huayi, School of Laboratory Medicine, Youjiang National Medical University, Baise, Guangxi, 533000, Mindray North America, Mahwah, New Jersey, 07430, USA.
Dhipatimendi reMushonga weLabhoritari, People's Hospital yeGuangxi Zhuang Autonomous Region, Nanning, China
Dhipatimendi reLabhoritari Mushonga, Yakabatana Chipatara cheShandong University yeTraditional Chinese Medicine, Jinan
Huang Huayi, School of Laboratory Medicine, Youjiang National Medical University, Baise, Guangxi, 533000, Mindray North America, Mahwah, New Jersey, 07430, USA.
Shandisa chinongedzo chiri pazasi kugovera yakazara chinyorwa chinyorwa chechinyorwa ichi neshamwari dzako uye vaunoshanda navo.Dzidza zvimwe.
Kuti unzwisise zvirinani shanduko yehutachiona hweCCIDID-19, inokodzera kukiriniki manejimendi echirwere uye kugadzirira kwemafungu ezvirwere zvakafanana mune ramangwana.
Iwo hematological paramita yevarwere makumi mashanu nevaviri veCCIDID-19 vakagamuchirwa muzvipatara zvakatarwa vakaongororwa zvakare.Iyo data yakaongororwa pachishandiswa SPSS statistical software.
Pamberi pekurapa, T cell subsets, yakazara lymphocytes, tsvuku tsvuku yeropa rekupararira kwehupamhi (RDW), eosinophils uye basophils zvakanyanya kuderera kupfuura mushure mekurapa, nepo kuzvimba zviratidzo zveutrophils, neutrophils uye lymphocytes The ratio (NLR) uye C β-reactive protein ( CRP) mazinga pamwe nemasero matsvuku eropa (RBC) uye hemoglobin yakaderera zvakanyanya mushure mekurapwa.The T cell subsets, yakazara lymphocytes uye basophils yevarwere vakanyanya uye vanorwara zvakanyanya vakanga vakaderera zvakanyanya kudarika avo vane mwero varwere.Neutrophils, NLR, eosinophils, procalcitonin (PCT) uye CRP zvakakwirira zvakanyanya muvarwere vakanyanya uye vanorwara zvakanyanya kupfuura varwere vane mwero.MaCD3+, CD8+, lymphocytes, maplatelet, uye basophils evarwere vane makore anopfuura makumi mashanu akaderera pane avo vari pasi pemakore makumi mashanu, nepo neutrophils, NLR, CRP, RDW muvarwere vanopfuura makore makumi mashanu yakakwirira kudarika avo vari pasi pemakore makumi mashanu.Muvarwere vakanyanya uye vanorwara zvakanyanya, pane kuwirirana kwakanaka pakati peprothrombin nguva (PT), alanine aminotransferase (ALT) uye aspartate aminotransferase (AST).
T cell subsets, lymphocyte count, RDW, neutrophils, eosinophils, NLR, CRP, PT, ALT uye AST zviratidzo zvakakosha mukutarisira, kunyanya kuvarwere vakanyanya uye vanorwara zvakanyanya vane COVID-19.
Denda re2019 Coronavirus Denda (COVID-19) rakakonzerwa nemhando nyowani yekoronavirus rakatanga muna Zvita 2019 rikapararira nekukurumidza pasi rose.1-3 Pakutanga kwekuputika, kutariswa kwekiriniki kwaive pakuratidzwa uye epidemiology, yakasanganiswa nekomputa tomography kumufananidzo wevarwere 4 uye 5, uyezve yakaonekwa ine yakanaka nucleotide amplification mhedzisiro.Zvisinei, kukuvara kwakasiyana-siyana kwepathological kwakazowanikwa munhengo dzakasiyana.6-9 Humbowo huzhinji hunoratidza kuti pathophysiological shanduko yeCOVID-19 yakanyanya kuoma.Kurwiswa kwehutachiona kunokonzera kukanganisa kwenhengo dzakawanda uye immune system inonyanyisa.Kuwedzera kweserum uye alveolar cytokines uye mapuroteni ekupindura anoputika akaonekwa7, 10-12, uye lymphopenia uye abnormal T cell subsets akawanikwa mune varwere vanorwara zvakanyanya.13, 14 Zvinoshumwa kuti chiyero cheneutrophils kune lymphocytes chave chiratidzo chinobatsira chekusiyanisa mazamu akaipa uye asina kunaka muhutano hwekliniki.15 NLR inogonawo kubatsira kusiyanisa varwere vane ulcerative colitis kubva kune hutano kutonga.16 Inobatawo basa mu thyroiditis uye inosanganiswa nerudzi rwechipiri chirwere cheshuga.17, 18 RDW chiratidzo che erythrocytosis.Zvidzidzo zvakawana kuti zvinobatsira kusiyanisa thyroid nodules, kuongorora rheumatoid arthritis, lumbar disc chirwere, uye thyroiditis.19-21 CRP inoratidzira yepasirese yekuzvimba uye yakadzidzwa mune dzakawanda zviitiko.22 Munguva pfupi yadarika zvakaonekwa kuti NLR, RDW neCRP vanobatanidzwawo muCCIDID-19 uye vanoita basa rakakosha mukuongororwa uye kufungidzira kwechirwere.11, 14, 23-25 Naizvozvo, mhedzisiro yekuongororwa kwerabhoritari yakakosha pakuongorora mamiriro emurwere uye kuita sarudzo dzekurapa.Isu takaongororazve marabhoritari maparamendi evarwere makumi mashanu nevaviri veCCIDID-19 vakaiswa muzvipatara zvakatarwa muSouth China zvichienderana nekutanga uye mushure mekurapwa, kuomarara, uye zera, kuti vanzwisise shanduko yechirwere uye kubatsira mune ramangwana kutungamira kwekiriniki. yeCOVID-19.
Ongororo iyi yakaita ongororo yakadzokororwa yevarwere makumi mashanu nevaviri veCCIDID-19 vakapinzwa muchipatara chakasarudzwa cheNanning Fourth Hospital kubva Ndira 24, 2020 kusvika Kurume 2, 2020. Pakati pavo, makumi mana nevashanu vairwara zviri pakati nepakati uye vashanu vairwara zvakaipisisa.Semuenzaniso, zera rinobva kumwedzi mitatu kusvika kumakore makumi masere nemashanu.Panyaya yechikadzi, paive nevanhurume makumi maviri nevanomwe nevakadzi makumi maviri nevashanu.Murwere ane zviratidzo zvakadai sefivha, chikosoro chakaoma, kuneta, kutemwa nemusoro, kutadza kufema zvakanaka, mhino dzakazara, mhuno inoyerera, pahuro, kurwadziwa kwetsandanyama, manyoka, uye myalgia.Computed tomography yakaratidza kuti mapapu akanga ane zvigamba kana pasi girazi, zvichiratidza mabayo.Ongorora zvinoenderana neiyo 7th edition yeChinese COVID-19 Kuongororwa uye Kurapa Mazano.Yakasimbiswa neyechokwadi-nguva qPCR yekuona kwehutachiona nucleotides.Zvinoenderana nemaitiro ekuongorora, varwere vakakamurwa kuita mapoka ane mwero, akaoma, uye akakosha.Mune zviitiko zviri pakati nepakati, murwere anotanga kupisa uye kufema syndrome, uye kuwanikwa kwekufungidzira kunoratidza maitiro emabayo.Kana murwere akasangana nechimwe chezvinotevera, kuongororwa kwakasimba: (a) kufema kunetseka (kufema ≥30 kufema / min);(b) kuzorora munwe ropa oxygen saturation ≤93%;(c) arterial oxygen pressure (PO2) )/Inspiratory fraction O2 (Fi O2) ≤300 mm Hg (1 mm Hg = 0.133 kPa).Kana murwere akasangana nechimwe chezvinotevera, kuongororwa kwakanyanya: (a) kutadza kufema kunoda mechanical ventilation;(b) kuvhunduka;(c) kumwe kutadza kwenhengo kunoda kurapwa muintensive care unit (ICU).Zvinoenderana nemaitiro ari pamusoro apa, varwere makumi mashanu nevaviri vakaonekwa vachirwara zvakanyanya muzviitiko zviviri, kurwara zvakanyanya muzviitiko zvishanu, uye kurwara zvine mwero mumakumi mana neshanu.
Vose varwere, kusanganisira varwere vane mwero, vakaoma uye vanorwara zvakanyanya, vanorapwa maererano nemitemo inotevera: (a) General adjuvant therapy;(b) Antiviral therapy: lopinavir/ritonavir uye α-interferon;(c) Kuyerwa kwechinyakare Chinese mushonga formula inogona kugadziriswa zvinoenderana nemamiriro emurwere.
Ichi chidzidzo chakabvumidzwa neKomiti Yekuongorora yeResearch Institute yeNanning Fourth Hospital uye yakashandiswa kuunganidza ruzivo rwevarwere.
Peripheral blood hematology analysis: routine hematology analysis of peripheral blood inoitwa paMindray BC-6900 hematology analyzer (Mindray) uye Sysmex XN 9000 hematology analyzer (Sysmex).Iyo yekutsanya ethylenediaminetetraacetic acid (EDTA) anticoagulant sampu yeropa yakaunganidzwa mangwanani mushure mekunge murwere apinzwa muchipatara.Kuongororwa kwekusagadzikana pakati pevaviri vekuongorora ropa pamusoro apa kwakasimbiswa maererano ne laboratory quality control maitiro.Mukuongorora hematology, chena masero eropa (WBC) kuverenga uye kusiyanisa, tsvuku tsvuku yeropa (RBC) uye indekisi zvinowanikwa pamwe chete nekuparadzira mapundu uye histograms.
Flow cytometry yeT lymphocyte subpopulations: BD (Becton, Dickinson uye Company) FACSCalibur flow cytometer yakashandiswa pakuyerera kwecytometry kuongorora kuongorora T cell subpopulations.Ongorora iyo data neMultiSET software.Chiyero chakaitwa maererano nemaitiro ekushanda maitiro uye mirayiridzo yemugadziri.Shandisa EDTA anticoagulated yekuunganidza ropa chubhu kuunganidza 2 ml yeropa re venous.Zvinyoro sanganisa samuenzaniso nekutenderedza chubhu yekuenzanisira kakawanda kudzivirira kudzikama.Mushure mekunge sampu yaunganidzwa, inotumirwa kurabhoritari uye inoongororwa mukati memaawa matanhatu patembiricha yekamuri.
Immunofluorescence analysis: C-reactive protein (CRP) uye procalcitonin (PCT) yakaongororwa pakarepo mushure mekupedzwa kwekuongorora kushandiswa kweropa rakaongororwa nehematology, uye yakaongororwa paFS-112 immunofluorescence analyzer (Wondfo Biotech Co., LTD.) kuongorora.) Tevedzera mirairo yemugadziri uye zviyero zverabhoritari.
Ongorora serum alanine aminotransferase (ALT) uye aspartate aminotransferase (AST) paHITACHI LABOSPECT008AS chemical analyzer (HITACHI).Iyo prothrombin nguva (PT) yakaongororwa pane STAGO STA-R Evolution analyzer (Diagnostica Stago).
Reverse transcription quantitative polymerase chain reaction (RT-qPCR): Shandisa RNA matemplate akaparadzaniswa kubva nasopharyngeal swabs kana yakadzika turakiti rekufema turakiti kuita RT-qPCR kuona SARS-CoV-2.Nucleic acids yakaparadzaniswa paSSNP-2000A nucleic acid automatic separation platform (Bioperfectus Technologies).Iyo kit yekuona yakapihwa neSun Yat-sen University Daan Gene Co., Ltd. uye Shanghai BioGerm Medical Biotechnology Co., Ltd. Thermal cycle yakaitwa paABI 7500 thermal cycler (Applied Biosystems).Viral nucleoside test results inotsanangurwa seyakanaka kana yakaipa.
SPSS version 18.0 software yakashandiswa kuongorora data;paired-sample t-test, yakazvimirira-sample t-test, kana Mann-Whitney U bvunzo yakashandiswa, uye P kukosha <.05 yakaonekwa yakakosha.
Varwere vashanu vairwara zvakanyanya uye vaviri vairwara zvakanyanya vaive vakura kupfuura avo vari muboka rine mwero (69.3 vs. 40.4).Ruzivo rwakadzama rwevashanu vanorwara zvakanyanya uye 2 vanorwara zvakanyanya vanoratidzwa muTables 1A uye B. Varwere vakanyanya uye vanorwara zvakanyanya vanowanzove vakaderera muT cell subsets uye yakazara lymphocyte kuverenga, asi chena masero eropa akaenzana, kunze kwevarwere. ane masero machena eropa akakwirira (11.5 × 109/L).Neutrophils uye monocytes zvakare kazhinji yakakwirira.Iyo serum PCT, ALT, AST uye PT tsika dzevarwere vaviri vairwara zvakanyanya uye 1 murwere airwara zvakanyanya aive akakwira, uye PT, ALT, AST ye1 murwere airwara zvakanyanya uye 2 varwere vairwara zvakanyanya vaive vakabatana.Vanenge vese varwere ve7 vaive nepamusoro CRP mazinga.Eosinophils (EOS) uye basophils (BASO) inowanzove yakaderera muvarwere vanorwara zvakanyanya uye vanorwara zvakanyanya (Table 1A uye B).Tafura 1 inodonongodza tsananguro yeyakajairwa huwandu hwehematological paramita muhuwandu hwevanhu vakuru vekuChina.
Nhamba yekuongorora yakaratidza kuti vasati varapwa, CD3 +, CD4 +, CD8 + T masero, lymphocytes yose, RBC distribution width (RDW), eosinophils uye basophils zvakanyanya kuderera kupfuura mushure mekurapa (P = .000,. 000, .000, .012, . 04, .000 uye .001).Zviratidzo zvekuputika neutrophils, neutrophil / lymphocyte ratio (NLR) uye CRP vasati varapwa zvakanyanya kudarika mushure mekurapa (P = .004, .011 uye .017, maererano).Hb uye RBC yakaderera zvakanyanya mushure mekurapa (P = .032, .026).PLT yakawedzera mushure mekurapa, asi yakanga isingakoshi (P = .183) (Tafura 2).
The T cell subsets (CD3 +, CD4 +, CD8 +), yakazara lymphocytes uye basophils yevarwere vakanyanya uye vanorwara zvakanyanya zvakanyanya kuderera kupfuura avo vane mwero varwere (P = .025, 0.048, 0.027, 0.006 uye .046).Mazinga e-neutrophils, NLR, PCT uye CRP muvarwere vakanyanya uye vanorwara zvakanyanya zvakanyanya kudarika avo vari muvarwere vane mwero (P = .005, .002, .049 uye .002, maererano).Varwere vakanyanya uye vanorwara zvakanyanya vaiva nePLT yakaderera kupfuura varwere vane mwero;zvisinei, kusiyana kwakanga kusiri kwenhamba (Tafura 3).
Iwo CD3+, CD8+, yakazara lymphocytes, maplatelet, uye basophils evarwere vane makore anopfuura makumi mashanu aive akaderera zvakanyanya pane evarwere vari pasi pemakore makumi mashanu (P = .049, 0.018, 0.019, 0.010 uye .039, zvichiteerana), nepo avo vapfuura 50 yemakore eVarwere 'neutrophils, NLR ratio, CRP mazinga uye RDW akanga akakwirira zvikuru kupfuura evarwere vari pasi pemakore makumi mashanu (P = .0191, 0.015, 0.009, uye .010, maererano) (Table 4).
COVID-19 inokonzerwa nekutapukirwa neconavirus SARS-CoV-2, iyo yakatanga kuoneka muWuhan, China muna Zvita 2019. Kupararira kweSARS-CoV-2 kwakapararira nekukurumidza mushure mezvo uye kwakakonzera denda repasi rose.1-3 Nekuda kweruzivo rushoma rwechirwere chechirwere uye hutachiona hwehutachiona, huwandu hwevanhu vanofa pakutanga kwekuputika kwakakwira.Kunyangwe pasina antiviral mishonga, iyo yekutevera manejimendi uye kurapwa kweCCIDID-19 yakavandudzwa zvakanyanya.Izvi ndezvechokwadi kunyanya kuChina apo marapiro eAdjuvant anosanganiswa nemishonga yechivanhu yeChinese kurapa nyaya dzekutanga uye dzine mwero.26 varwere veCCIDID-19 vakabatsirwa nekunzwisisa kuri nani kwekuchinja kwepathological uye marabhoritari maparamendi echirwere.chirwere.Kubva ipapo, nhamba yevanhu vanofa yakaderera.Mumushumo uyu, pakanga pasina kufa pakati penyaya makumi mashanu nembiri dzakaongororwa, kusanganisira vanomwe varwere vakanyanya uye vanorwara zvakanyanya (Table 1A uye B).
Kucherechedzwa kwemakiriniki kwakaona kuti varwere vazhinji vane COVID-19 vakadzikisa lymphocytes uye T cell subpopulations, zvine chekuita nekuoma kwechirwere.13, 27 Mumushumo uyu, zvakaonekwa kuti CD3+, CD4+, CD8+ T masero, lymphocytes yose, RDW isati yarapwa, eosinophils uye basophils zvakanyanya kuderera kupfuura mushure mekurapa (P = .000, .000, .000, .012, .04, .000 uye .001).Mibairo yedu yakafanana nemishumo yapfuura.Mishumo iyi ine kukosha kwekiriniki mukutarisa kuoma kweCCIDID-19.8, 13, 23-25, 27, ukuwo kuzvimba kunoratidza neutrophils, neutrophils/lymphocyte ratio (NLR) Uye CRP mushure mekutanga kurapwa pane kurapwa (P = .004, . 011 uye .017, zvichiteerana), izvo zvakacherechedzwa uye zvakambotaurwa muvarwere veCOVID-19.Naizvozvo, aya ma paramita anoonekwa seanobatsira zviratidzo pakurapa COVID-19.8.Mushure mokurapa, 11 hemoglobin uye masero matsvuku eropa zvakaderedzwa zvakanyanya (P = .032, 0.026), zvichiratidza kuti murwere aiva neanemia panguva yekurapa.Kuwedzera kwePLT kwakaonekwa mushure mekurapa, asi kwakanga kusina kukosha (P = .183) (Tafura 2).Kudzikira kwemalymphocytes uye T cell subpopulations inofungidzirwa kuti ine chekuita nekuderera kwesero uye apoptosis painoungana munzvimbo dzekuzvimba dzinorwisa hutachiona.Kana kuti, vangave vakapedzwa nekunyanya secretion ye cytokines uye mapuroteni anopisa.8.29 Mukuona kwedu, lymphocytes uye T cell subsets zvakadzorerwa mushure mekurapa, uye zvose 52 zviitiko zvakaporeswa (Tafura 1).Mazinga akakwirira eutrophils, NLR, uye CRP akaonekwa asati arapwa, uye akazoderera zvakanyanya mushure mekurapa (P = .004, .011, uye .017, maererano) (Tafura 2).Basa reT cell subsets muhutachiona uye mhinduro yekudzivirira muviri yakambotaurwa.29, 31-34
Sezvo nhamba yevarwere vakanyanya uye vanorwara zvakanyanya zvishoma, hatina kuita nhamba yekuongorora pamiganhu pakati pevarwere vakanyanya uye vanorwara zvakanyanya uye varwere vane mwero.T cell subsets (CD3+, CD4+, CD8+) uye yakazara lymphocyte yevarwere vakanyanya uye vanorwara zvakanyanya yakaderera zvakanyanya pane yevarwere vane mwero.Mazinga e-neutrophils, NLR, PCT, uye CRP muvarwere vakanyanya uye vakanyanya kurwara zvakanyanya kudarika avo vane varwere vane mwero (P = .005, .002, .049, uye .002, maererano) (Tafura 3).Shanduko mumarabhoritari paramita dzine chekuita nekuoma kweCOVID-19.35.36 Chikonzero chebasophilia hachina kujeka;izvi zvinogona kunge zvakakonzerwa nekudya kwekudya paunenge uchirwisana nehutachiona panzvimbo yehutachiona hwakafanana ne lymphocytes.35 Chidzidzo ichi chakawana kuti varwere vane COVID-19 yakaoma zvakare vaive vadzikisira eosinophils;14 Zvisinei, data yedu haina kuratidza kuti chiitiko ichi chinogona kunge chiri nekuda kwenhamba shoma yematambudziko akaoma uye akaoma akaonekwa muchidzidzo.
Sezvineiwo, takaona kuti muvarwere vakanyanya uye vanorwara zvakanyanya, pane kuwirirana kwakanaka pakati pePT, ALT, uye AST tsika, zvichiratidza kuti kukuvadzwa kwenhengo dzakawanda kwakaitika mukurwiswa kwehutachiona, sezvakataurwa mune zvimwe zvakaonekwa.37 Naizvozvo, anogona kunge ari matsva anobatsira ma paramita ekuongorora mhinduro uye fungidziro yeCOVID-19 kurapwa.
Kumwe kuongorora kwakaratidza kuti CD3 +, CD8+, yakazara lymphocytes, maplatelet uye basophils evarwere vanopfuura makore makumi mashanu aive akaderera zvakanyanya kupfuura evarwere vari pasi pemakore makumi mashanu (P = P = .049, .018, .019, .010 uye. 039, zvichiteerana), nepo mazinga eutrophils, NLR, CRP, uye RBC RDW muvarwere vanopfuura makore makumi mashanu ezera aive akakwira zvakanyanya kupfuura evarwere vari pasi pemakore makumi mashanu ezera (P = .0191, 0.015, 0.009, uye .010 , zvichiteerana) (Tafura 4) .Mishumo iyi yakafanana nemishumo yapfuura.14, 28, 29, 38-41 Kuderera kweT cell subpopulations uye yakakwirira CD4 +/ CD8 + T cell ratios inoenderana nekuoma kwechirwere;nyaya dzevakuru dzinowanzova dzakanyanya kuoma;saka, mamwe lymphocytes achapedzwa ari immune mhinduro kana Zvakakomba kukuvara.Saizvozvo, RBC RDW yepamusoro inoratidza kuti varwere ava vakagadzira anemia.
Mhedzisiro yedu yekutsvagisa inosimbisa zvakare kuti hematological paramita yakakosha zvikuru kuti unzwisise zviri nani shanduko yekiriniki yevarwere veCCIDID-19 uye nekuvandudza nhungamiro yekurapa uye kufungidzira.
Liang Juanying naNong Shaoyun vakaunganidza data uye ruzivo rwekiriniki;Jiang Liejun naChi Xiaowei vakaita ongororo yedata;Dewu Bi, Jun Cao, Lida Mo, uye Xiaolu Luo vakaita ongororo yenguva dzose;Huang Huayi ndiye aitarisira kubata uye kunyora.
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Nguva yekutumira: Jul-22-2021