Tātai Tāwhai o te Kōrero o te Kōkō: He mea tāwhai mō te whakamārama pono

Te Take ā-Anatomia me te Take ā-Virus mō te Uara o te Whakamātautau i te Kōrero o te Kōpū

Te rahi o ngā virus i te kōpū i te wā tuatahi o te mātātoko

Ko te nasopharynx te wāhi tuatahi hei whakamāngai i ngā wīrū o te mātāwaka, tāpiri i a SARS‑CoV‑2, te influenza, me te RSV. I ngā rā tuatahi 3–5 o te mātātoko, ko te whakamāngai o ngā wīrū heitekore mai i konei—i whakamāngai ai e te maha o ngā kōpae epithelial ciliated me ngā rōpū o ngā rākau ACE‑2—ā, koinei te wāhi e whai ana i ngā kōpae o ngā pūrākau o ngā mātātoko i mua i te hāere mai o ngā mātātoko ki ngā wāhi katoa o te tinana. I tēnei tau 2023, i kitea i tēnei whakamātautau ā-huinga ko ngā whakamāngai o te nasopharynx i whai ai i ngā taumaha o ngā wīrū i te waenganui 2 log₁₀ te nui ake i ngā whakamāngai o te ihu mātātoko, i te oropharynx rānei (ngā rerekētanga o ngā uara Ct i waenganui i ngā 6–8 whakamāngai), ā, koinei te whakamāngai i te whakamātautau i te wā tuatahi o te mātātoko i te 15–20 ōrau. Ko tēnei whakamāngai tāwhai i te 10³–10⁶ o ngā kōpae o te genome i te millilitre e tautokina ana i te whakamāngai tino pai, ahakoa ngā whakamātautau tāwhai i ngā rōpū nui.

Ko te tata o te ihu me te Waldeyer’s ring lymphoid tissue e whakamana ana i te whakamāngai pai rawa o ngā pūrākau

Ko te nasopharynx e takoto ana i raro tonu i te papa o te upoko, ā, e whakauru ana i te rōpū o ngā tīhanga lymphoid, ko ngā adenoids me ngā tonsils tubal. Ko tēnei whakarārohanga āhua e hanga ai he whakamātautau mātua mō te whakamātau i ngā pākanga i tāwhai ai i te kiko lymphoid o te mucus. Ko ngā influenza A me Neisseria meningitidis , hei tauira, e whakapā ana ki te kiko kore-cilia o te wāhi o te nasopharynx i mua i te whakamātatata ake. Mā te whakauru i te swab ki te roa o ≥6 cm, ka whakamāhi ngā kairangi i tēnei whakawhitinga o te kiko me ngā tīhanga lymphoid, kia tāpirihia ngā virions kore-ā-wāhi me ngā pākanga i roto i ngā sel. I whakaatu ngā rangahau ko te whakamātatata i te swab me te whakamau i tēnei i te 15 sekone e tāpiri ana i tēnei kōhinga maha o ngā sel o te hauāwhea me ngā sel o te whakamātau—ka whakapāpā mai i tēnei he whakaahua whānui o te whakawhitinga o te tinana me ngā pākanga. Ko tēnei kōhinga ā-rākau e whakamārama ana i te whakamāhuatanga o te kōhinga nasopharyngeal i ngā hāhā o te kōhinga i te kaki anake mō te whakamātau i ngā kaitāwhai o te meningitis bacterial me ngā whāinga tuatahi o te influenza, ahakoa ngā whāinga iti.

Te Whakamārama i te Hāpai: Te Tika o te Whakamātautau i ngā Mātua Mate o ngā Hauā o te Manawa

Te whakatairite i te mātātū: 92.4% mō te SARS-CoV-2 i tēnei, ā, 75.8% mō ngā kōwhai hauā i mua (NEJM, 2022)

He tau pūmau i te 2022 Te Pukapuka Tātai Hauā o Tēnei Ao Ko tēnei whakamātautau i whakamātauria ngā āhua o ngā tauākī: ko ngā kōwhaiwhai o te pūpū o te kaki i tūhono ai i te 92.4% o te mātua o te SARS-CoV-2, i te wā i rere ai ngā kōwhaiwhai o te pūpū o mua i te 75.8%. Ko tēnei rerekētanga o ngā wāhi e 16.6 he tohu o te maha ake o ngā wāhanga o te wāhanga o te kaki i te wā tuatahi o te mātua—i te wā i tino hiahiatia ai te whakamātau tūmatanui me te tika hei whakamārama mō te whakamāramatanga o te hauā me ngā mahi whakamātau i te hauā. Ko te kōwhaiwhai e tātai ana i te pūpū o te kaki e tātai ana i te kōhatu o te hauā i reira e whanake ana te wāhanga o te hauā, e whakamāmā ana i te tau o ngā whakamātau hē e kore nei e kitea i ngā huarahi iti ake o te whakamātau. Nō reira, ko ngā tikanga o ngā whakamātau o te motu me ngā whare whakamātau o ngā hōhipera e whakamārama ana i te whakamātau o te pūpū o te kaki hei tikanga tātai mātua mō ngā whakamātau molekūlar i ngā tangata e mātautau ana i ngā hauā me ngā wāhi e whakamārama ana i ngā whakamātau hauā.

Te whakamātau tūmatanui o te influenza A/B, o te RSV, me ngā wāhanga o te meningitis baktēria

I tē kōrero i wāhi atu i te SARS-CoV-2, ko ngā whakamātautau i ngā kōpae o te kōhanga-kōrero (nasopharyngeal swabs) e whakamātautau ana i ngā hāngā o te influenza A/B, te RSV, me ngā pūtake o te meningitis bacteriali e whakamātautau ana i te whānanga. I ngā rere o te influenza, ko ngā whakamātautau i ngā kōpae o te kōhanga-kōrero he 90% te mātua o te whakamātautau—ka whakamāhupeke i ngā whakamātautau i te kōrero, i te kōpae o te waenganui o te kōhanga-kōrero. Mō te RSV—ā, ākina i ngā tamariki—ko ia tonu te whakamātautau e whakamāhi ana i te CDC me ngā aratohu ā-hāpai o te AAP. Mo Neisseria meningitidis ā Haemophilus influenzae , ko ngā whakamātautau tuatahi i te kōhanga-kōrero ki te wāhi muri o te kōhanga-kōrero; nō reira, ko ngā whakamātautau i ngā kōpae o te kōhanga-kōrero he mea matua mō te whakamātautau i te whānanga. Ko tēnei whānanga whānui mai i te uru mai ki ngā whāriki o te kōhanga-kōrero me ngā tīwhenua lymphoid o Waldeyer’s ring—ngā wāhi matua o te whānanga o ngā pūtake me te whakauru mai o te rākau o te tinana. Nō reira, ko ngā pānui maha o ngā whakamātautau molekulari e whakamātautau ana i ngā kōpae o te kōhanga-kōrero hei whakamātautau tātai, kia whakamāhua ai te whakamātautau i ngā whakamātautau ā-tāhuhu me te whakamātautau ā-hāpai.

Te Whakamāhi i te Ao: Te Tikanga Whakamātautau o ngā Kōpae o te Kōhanga-kōrero

Kia rite te whakamāhua pūmau o te whakamāhua i te kōpae o te kōpae o te kōpae, me whai i te tikanga whakamāhua kia tika tonu. He iti ngā huringa i tēnei tikanga, ā, he paku huringa anō ka pakaru ai te kounga o ngā tauira—nō reira, me whakamāhinga i ngā hākinakina katoa i te tika, i te whakamārama, me te whakamārama.

Ngā hākinakina matua: te pākoki (≥6 cm), te huri, te wā e 10–15 hēkona, me ngā wāhi whakamāhinga tika

Te tīmata o te whakamahinga tika o ngā kōwhiringa he te whakamātautau i te tuarā o te rākau: ko te upoko e whakawhitinga ana i te āhua o te 70 degrees kia rite ai ngā huinga o te ihu. I te whakamāhi i tēnei wā, he pūrākau mātātoko, he pūrākau iti, he pūrākau kōpae (kāore he rākau, kāore hoki he calcium alginate, nā ngā mea nei e whakamāngai ana i te PCR), ka tāwhai te kaimātātai i te pūrākau i te rere o te ihu—kia rite ki te reo—kia tāwhai ai i te 6 cm, i te iti,, i te wā e tāwhai ana i te whakamātautau o te rear nasopharynx. I te wā e tāwhai ana, ka whakawhitinga te pūrākau i te 3–5 wā kia tāwhai ai ngā kōpae epithelial, ka tāwhai ai i te 10–15 sekone hei whakamātautau i ngā wāhanga o te rere. I muri i te tāwhai, ka tāwhai ai i te pūrākau ki te viral transport medium (VTM), i te universal transport medium (UTM), ā, he whakamātautau tēnei i ngā kōpae nucleic, ā, he whakamātautau hoki i te whakamātautau o ngā bakteria. Me whakamātautau ngā kōwhiringa i te whakamātautau o te hōhi, me tāwhai ai i te 72 hāora; ko te whakamātautau roa i te wāhanga o te rere e whakamāngai ana i ngā kōpae RNA virus, ā, e whakamāngai ana i te whakamātautau.

Te whakamātautau i ngā rerekētanga o te kaimātātai i te whakamāhi i ngā whakamātautau me ngā rārangi whakamātautau

Te rerekētanga o ngā whakamātautau he take matua o ngā whakatau hāngai kore—engari ko ngā whakamātautau āhua pūkenga anō he whakamārama pai ake i te tika o ngā tauira. Ko ngā wāhanga e whakamāhi ana i ngā tauira āhua pūkenga me ngā whakaahua kiriata hei āwhina i ngā kaimātātaki kia mārama ai i te āhua tika o te āki, o te pākoki, me te wā e noho ana. Ko te whakamāhi i ngā whakamātautau tuatahi i te tāwhai i ngā whakamātautau āhua pūkenga i ngā wā e tāwhai ana hei whakamārama i te whakamārama. He rārangi whakamātautau māmā, e whakamāhi ana i ngā whakamātautau āhua pūkenga—e whakauru ana i te whakawhitinga o te upoko, te momo kōpae, te pākoki o te whakauru, te tau o ngā huri, te wā e noho ana, me te whakauru tonu ki te wāhi whakamātautau—hei whakamārama i ngā hapa o te whakakore. I ngā āwhina ā-taumata maha, i ngā rōpū e whakamāhi ana i ēnei rārangi, i tāwhai ngā taumata i te tauira tika mai i te 68% ki te 90% i roto i ngā ono marama. Ko ngā whakamātautau āhua pūkenga e whakamāhi ana i ngā whakamātautau āhua pūkenga hei whakamārama i ngā rerekētanga o ngā mahi i waenganui i ngā kaimātātaki mātauranga me ngā kaimātātaki hou—hei whakamārama i te whakamārama o ngā kōpae katoa ki te pūkenga o te tāwhai.

Ngā rerekētanga me ngā whakaaro ā-hapori mō te whakamāhi i ngā kōpae nasopharyngeal

Ahakoa tōna whakamārama pūmau ake, he rerekē ngā here o te kōpae o te kōhanga-kōrero (NP) i te ao o te ao. Ko te whakauru atu ki te 6 cm, he rerekē ngā whakamāmā, ā, he whāinga hoki i te whakamāmā, te whakamāmā, i te whakamāmā iti—e hiahiatia ana ngā tohunga hauora e mātua, ā, kāore he wāhi mō te whakamāmā ake. Nā reira, kāore ngā kōpae NP i te tino pai mō ngā rōpū whakamātautau i te hapori, i reira ko ngā whāinga, ko ngā whakamāmā o ngā kaiwhakamātautau, me ngā whāinga o te whakamāmā. I te whakamātautau i te kōhanga-kōrero o mua—ka taea te 75.8% o te whakamārama mō te SARS-CoV-2, ā, ka taea hoki te whakamāmā ake—ko te whakamārama o te kōpae NP, 92.4%, he rerekē ngā whāinga o te whakamāmā, ngā whāinga o ngā kaimahi, me te whāinga o te whakamāmā. I ngā wāhi o ngā wāhi e haere mai ana, i ngā kura, i ngā wāhi e iti ana ngā rākau, he rerekē ngā here i te whakamāmā. Nō reira, ahakoa ko ngā kōpae NP tonu ngā whakamārama mō te whakamārama, me whakamārama i ō rātou whakamāmā i ngā kaimahi e wātea ana, i te whakamāmā o ngā kiritaki, me ngā whāinga o te whakamāmā.

Wāhanga FAQ

He aha te wāhi tuatahi o te whakapiri o ngā wīhara o te manawa i te wā tuatahi o te mātaitai?

Ko te wāhi tuatahi o te whakapiri i te wā tuatahi o te mātaitai ko te nasopharynx, i te rere o te tau o ngā pūkoro ciliated me ngā rōpū o ngā rōpū ACE-2.

He aha te take i tēnei i tāwhai i te nasopharynx he pai ake i te tāwhai i te ihu mua?

Ko ngā tāwhai i te nasopharynx e whakamāhinga ana i te mātauranga o te whakamārama i te rere o te whakamāhi i ngā wīhara nui i te nasopharynx i te wā tuatahi o te mātaitai.

He tika te whakamātautau i te kōpae o te pūpū o te kaki mō ngā whakamātautau maha?

Kāore, nā tōna āhua pāpātanga me ngā hākinakina o ngā kaiwhakamātautau hauora e whai ana, kāore he tika ki ngā whakamātautau maha, ngā whakamātautau i te hapori.

He aha ngā tauira o ngā whakamātautau hei whiwhi i te kōpae o te pūpū o te kaki?

Ngā tauira matua ko te whakawhitinga o te upoko, te whakauru i te kōpae ≥6 cm, te huri i te kōpae i te wāhi, te tāwhai i te wā 10–15 hēkona, me te whakauru tonu i te whakamātautau ki te wai whakamātautau o te wīrūs.

He aha ngā whakamātautau e pā ana ki te whiwhi i te kōpae o te pūpū o te kaki?

Ngā whakamātautau ko te ririhau, te whakamā, te toto, me ngā rerekētanga o ngā whakamātautau e hiahiatia ana te whakamātautau āhua me ngā whakamātautau ā-umanga hei whakamāmā.