Mhinduro yakananga
Kuongororwa kweCMV kunotsvaga hutachiona hwecytomegalovirus, kungave nekuyera ma antibodies (CMV IgM neIgG) muropa kana nekuona DNA yehutachiona ine PCR muropa, weti, mate, nyama kana amniotic fluid. Kuongororwa kwe antibodies kunoratidza kusangana nehutachiona uye nguva yakaoma; PCR inoratidza kuvapo kwehutachiona uye huwandu hwehutachiona. Hapana bvunzo imwe chete inoongorora chirwere cheCMV.
Key tora kutora
- Miedzo miviri yakasiyana, mibvunzo miviri yakasiyana: CMV serology inopindura kuti "munhu uyu abatwa here?"; CMV PCR inopindura kuti "hutachiona hunoonekwa here izvozvi, uye hwakadii?"
- Vanhu vakuru vazhinji muIndia vane CMV IgG positive, saka kuva neIgG yakanaka kunowanzoreva kuti munhu akambosangana nechirwere ichi kare, kwete chirwere chaari kurwara nacho.
- Mhedzisiro yakanaka haisi chirwere chinongoerekana chaitika: CMV inogona kuonekwa pasina kukonzera zviratidzo, kunyanya kuvanhu vane hutano hwakanaka.
- Nguva inosarudza zvese zvevacheche vachangozvarwa: Kuongororwa kweCMV yekuzvarwa nayo kunonyatsosimbiswa nePCR yemate kana urine mukati memavhiki matatu ekutanga ehupenyu.
- Mhedzisiro inoda kududzirwa kwekiriniki nachiremba akaraira bvunzo, pamwe chete nezviratidzo, mamiriro emuviri wekudzivirira chirwere pamwe nekumwe kuferefeta. Mhedzisiro yacho inosiyana zvichienderana nemamiriro ezvinhu ekiriniki emunhu mumwe nemumwe.
Pakuona
| mamiriro | umboo |
|---|---|
| Chii chinoedzwa | Ma antibodies eCMV IgM neIgG; Kuda kweIgG; CMV DNA nePCR (qualitative kana quantitative viral load) |
| Mhando dzemienzaniso | Ropa (serum kana plasma/ropa rose), weti, mate, sampuli dzekufema, nyama, cerebrospinal fluid, amniotic fluid |
| Kutsanya | Hazvidikanwi kuti uwane CMV serology kana PCR |
| Nguva yekuunganidza mienzaniso | Kutorwa kweropa: maminetsi mashoma. Kuunganidzwa kweweti kana mate: kazhinji pasi pemaminitsi mashanu |
| Nguva yese yekushanya | Kazhinji maminetsi gumi nemashanu kusvika makumi matatu anosanganisira kunyoresa uye kuunganidza sampuro |
| Main kushandiswa | Kuongororwa kweCMV yekuzvarwa nayo, kutarisa usati waisa mwana muchibereko uye mushure mekuisa mwana muchibereko, kuongororwa kweHIV yakakwira, chirwere chakafanana nemononucleosis, CMV inofungidzirwa panguva yekuzvitakura |
| Ndiani anoitsanangura | Chiremba ari kukumbira rubatsiro, chiremba wezvekubereka, chiremba wevana vacheche, chiremba wevana, chiremba wekuisira nhengo dzemuviri, nyanzvi yezvirwere zvinotapukira kana chiremba |
Uyewo anozivikanwa se
- Kuongororwa kweCytomegalovirus
- Kuongororwa kweCMV IgG neIgM; Kuongororwa kweCMV antibody
- Kuongororwa kweCMV PCR; Kuongororwa kweDNA reCMV; Kuongororwa kwehuwandu hwehutachiona hweCMV; Kuongororwa kwePCR yeCMV quantitative
- Kuongororwa kweCMV IgG avidity
- MuIndia, inowanzo bvunzwa se "CMV blood test", "CMV titre" kana "TORCH CMV" (CMV chimwe chezvinhu zviri muTORCH panel)
Chii chinonzi CMV test
Cytomegalovirus ivhairasi yemhuri yeherpes. Mushure mehutachiona hwekutanga, CMV inoramba iri mumuviri iri mumamiriro asina kujeka kweupenyu hwese uye inogona kudzoreredzwa, kunyanya kana masoja emuviri akadziviswa. Nekuti kunonoka kunoitika kwehupenyu hwese uye kwakajairika, kuongororwa kweCMV kunosanganisira kusiyanisa mamiriro matatu akasiyana: asina kumbobvira abatwa nechirwere, akambobatwa nechirwere uye ava kubatwa nechirwere, kana kuti ari kushanda pari zvino.
Bvunzo yeCMV haisi bvunzo imwe chete. Mafomu makuru ndeaya:
- CMV IgG: zvinoratidza kuti munhu agara ari panjodzi uye zvinoramba zviripo kweupenyu hwese. Zvinonyanya kushandiswa kuona mamiriro ekudzivirira muviri, semuenzaniso, kuongorora vanopa nevanoagamuchira vasati vaisirwa nhengo kana stem-cell, kana kuona kana mukadzi ane pamuviri akange atove neCMV asati abata pamuviri.
- CMV IgM: inogona kuwedzera kana utachiona huchangobva kuitika kana kuti hwakatanga kushandazve, asi IgM inogona kuramba iripo kwemwedzi yakati wandei uye inogona kuoneka kwete mune zvimwe zvirwere zvehutachiona. CMV IgM haisi chiratidzo chega chehutachiona huchangobva kuitika.
- Kuda kweCMV IgG: Kusada hutachiona zvakanyanya kunoratidza hutachiona mukati memwedzi mishoma yapfuura; kushaya hutachiona zvakanyanya kunoratidza hutachiona hwekare. Inonyanya kushandiswa panguva yekuzvitakura kubatsira pakuwana hutachiona hwekutanga hunofungidzirwa kuti hwakatanga.
- Kuonekwa kweDNA neCMV PCR (DNA detection): inoona majini ehutachiona. Kuongororwa kwePCR kunoshuma huwandu hwehutachiona mumayuniti epasi rose pa milliliter (IU/mL) uye ndiyo nzira yakajairika yekutarisa vanogamuchira kuiswa kwechirwere pamwe nevamwe varwere vane dziviriro yemuviri inoderera.
Chikonzero nei bvunzo yeCMV yaitwa
- Zvinofungidzirwa kuti CMV yekuzvarwa nayo: mumwana achangoberekwa ane musoro mudiki, ane huremu hushoma panguva yekuzvitakura, jaundice, chiropa chakakura kana spleen, mapundu epetechial, mifananidzo isina kujairika yemusoro, kana kuti kutadza kuongorora kunzwa kwemwana achangoberekwa.
- Zvinofungidzirwa kuti une CMV hutachiona panguva yekuzvitakura: kazhinji mushure mekurwara nefivha uye kuzvimba kwema lymph node, kana mushure mekuonekwa kweultrasound kunoratidza hutachiona hwemwana ari mudumbu.
- Mushonga wekuisa chimwe chinhu: CMV IgG mamiriro emupi uye mugamuchiri gwara rekutarisa njodzi uye kudzivirira; serial quantitative PCR gwara rekurapa mavhairasi asati ashanda.
- Kuwanda kweHIV kana kumwe kudzvinyirirwa kwakanyanya kwemasoja emuviri: kana paine kufungidzirwa kuti une CMV retinitis, colitis, esophagitis, pneumonitis kana encephalitis.
- Chirwere chakafanana ne mononucleosis: fivha yenguva refu, kuneta, kurwadziwa pahuro uye lymphadenopathy umo kuongororwa kwehutachiona hwemononucleosis (Epstein-Barr virus) kunoratidza kuti hapana chirwere ichi.
- Chiropa chisina kutsanangurwa kana cytopenias apo CMV ndeimwe yemikana yakawanda iri kufungwa nezvayo.
Ndiani anofanira kuongororwa uku?
- Vachangozvarwa vane zviratidzo zvehutachiona hwekuzvarwa nahwo kana kuti bvunzo yekunzwa isina kushanda zvakanaka, yakaedzwa nemate kana weti PCR, zvakanaka mukati memazuva makumi maviri nerimwe ekuzvarwa.
- Vakadzi vane pamuviri vane chirwere chinoenderana nefivha, kana kuti vane zvirwere zvemudumbu zvakaita seultrasound, zvakaedzwa zvichibva pazano rachiremba wezvekubereka ari kurapa.
- Vanoda kuisirwa stem-cell, vanopa nevanogashira nhengo dzakasimba uye dzeropa: zvichienderana neprotocol yechikamu chekuisira kenza.
- Vanhu vane HIV yakanyanya kukura kana kuti vari kurapwa zvakasimba nemasoja emuviri vanotanga zviratidzo zvinonyengera, zvinosanganisira kuona zvinhu zvitsva zviri kuyerera kana kuona zvisipo, manyoka anogara aripo kana fivha isina tsananguro.
- Vanhu vane chirwere chakafanana ne mononucleosis kwenguva refu izvo zvichiri kusazivikanwa.
Kuongororwa kweCMV nguva dzose kwevanhu vakuru vane hutano, kana vakadzi vese vane pamuviri, hakukurudzirwi nevanhu vose uye kuchiri kukurukurwa. Kuongororwa kweCMV chisarudzo chechiremba ari kurapa, kwete chisarudzo chega.
Izvo CMV test isingakwanise kuona kana kusabvisa
- Hazvigone kuparadzanisa hutachiona nechirwere. DNA yeCMV inogona kuonekwa muropa, weti kana mate kumunhu asina chirwere chine chekuita neCMV zvachose. Kuonekwa chete hakuratidzi kuti CMV ndiyo iri kukonzera zviratidzo.
- Kuongororwa kweropa negative PCR hakubvisi chirwere cheCMV chenhengo dzakasiyana. CMV retinitis, colitis uye mamwe mamiriro epneumonia zvinogona kuitika kana CMV DNA isina kuoneka muropa. Kuongororwa kwechirwere kungada kuongororwa kwe retina, endoscopy ne biopsy, bronchoalveolar lavage kana kuongororwa kweCSF.
- Kuwanikwa kweIgM yakanaka hakutsigire hutachiona hwekutanga hwazvino, uye IgM isina kunaka haibvisi chirwere ichi, kunyanya kana ikaongororwa nekukurumidza kana kuti pave payakanyanya kurwara.
- Kuongororwa kwakaitwa naamai hakukuudze kana mwana ari mudumbu aine hutachiona. Izvi zvinoda amniocentesis ne amniotic fluid CMV PCR, kazhinji mushure menguva yakatarwa yekuzvitakura, uye kunyange izvozvo zvine false-negative rate kana zvikaitwa nekukurumidza.
- PCR yemvura isina kunaka yeamniotic haibvisi zvachose hutachiona hwemwana ari mudumbu, uye haifemberi kuti ndevapi vana vane hutachiona vachava nematambudziko ekunzwa kana kukura.
- Kuongororwa kweCMV hakuna zvakunotaura nezvekunzwa kana mhedzisiro yekukura kwetsinga. Vaya vanoda kuongororwa kwenzwi uye kuteverwa kwekukura kwevana nekufamba kwenguva.
- Huwandu hwehutachiona hahuenzaniswi zvakananga pakati pemarabhoritari. Kunyangwe paine kurongeka kweIU/mL, mwero wekutanga mishonga yekudzivirira mavhairasi unoenderana nepuratifomu uye protocol. Kuongororwa kwemushonga muzvikamu kunofanirwa kuitwa papuratifomu imwe chete.
- Hazvioni zvimwe zvirwere zveTORCH, kana kuramba mishonga. Kusakwanisa kurwisa mavhairasi kunofungidzirwa kunoda kuongororwa kwakasiyana kwekusagona kurwisa majini.
Mhedzisiro isingaratidze CMV inotsanangura zvakawanikwa mumuenzaniso iwoyo panguva iyoyo. Hazvina kufanana nekuti CMV haina kubatwa. Kana zviratidzo zvikaramba zviripo pasinei nemhedzisiro yakajairika kana isina kunaka, dzokera kuna chiremba wako.
Bvunzo dzakabatana asi dzakasiyana
| bvunzo | Bvunza inopindura | Musiyano mukuru kubva pakuongororwa kweCMV |
|---|---|---|
| CMV IgG / IgM serology | Munhu uyu akambobatwa nechirwere here? Chingava chirwere chazvino here? | Inoyera mashandiro emuviri wemuviri, kwete hutachiona. Haikwanise kuyera huwandu hwehutachiona hunoshanda. |
| CMV quantitative PCR (huwandu hwehutachiona) | DNA yehutachiona iripo here pari zvino, uye yakawanda sei? | Inoyera hutachiona zvakananga. Inoshandiswa pakutarisa varwere vane dziviriro yemuviri inoderera. |
| Kuda kweCMV IgG | Kurwara kwakaitika rini? | Inoshanda chete kana IgG yaonekwa kuti ine IgG; inonyanya kushandiswa panguva yekuzvitakura. |
| EBV serology / monospot | Chirwere ichi chinonzi mononucleosis chinokonzerwa nehutachiona hweEpstein-Barr here? | Hutachiona hwakasiyana hune mufananidzo wekiriniki unopindirana. Kuongororwa kweCMV neEBV kunopindura mibvunzo yakasiyana uye kazhinji kunorongwa pamwe chete. |
| Toxoplasma, rubella, HSV (zvimwe zvikamu zveTORCH panel) | Pane imwe hutachiona hwekuzvarwa nahwo hunokonzera here? | Zvipenyu zvakasiyana. Mapaneru makuru eTORCH akarongwa pasina chikonzero chekurapa anowanzo buritsa mhedzisiro yakaoma kududzira. |
| CMV histopathology / immunohistochemistry pa biopsy | CMV inokuvadza here nyama iyi chaiyo? | Zvinoratidza kupinda kwenyama mumuviri, izvo zvisingakwanise kuongororwa neropa. Kazhinji zvinosarudza CMV colitis. |
| Kuongororwa kwefundus yakafara | Pane CMV retinitis here? | Kuongororwa kwemaziso ekiriniki, kwete kuongororwa kwerabhoritari. Hazvigone kutsiviwa nekuongorora ropa. |
| Kuongororwa kwekunzwa kwevana vacheche (OAE / BERA) | Kunzwa kwakanganiswa here? | Inoongorora mashandiro emuviri, kwete hutachiona. Inodiwa pamwe chete, uye kakawanda mushure mekuongororwa kweCMV yekuzvarwa nayo. |
Maitiro ekugadzirira
Kugadzirira kwacho hakuna kunyanya kudiwa, asi ruzivo rwekuunganidza runoshanda uye runosiyana zvichienderana nemarabhoritari nezvipatara. Mirayiridzo yakanyorwa yeyuniti yako ndiyo inonyanya kukosha pane chero gwara rekushandisa pano.
- Kutsanya: hazvidiwi pakuongorora CMV serology kana CMV PCR. Kana CMV ichitorwa pamwe chete nedzimwe bvunzo dzakadai seglucose kana lipids, tevera mirairo yekutsanya yekuongorora ikoko.
- Mishonga: Ramba uchitora mishonga yese yawakanyorerwa kunze kwekunge chiremba wako akuudza zvakasiyana. Udza rabhoritari nachiremba wako nezvemishonga inorwisa mavhairasi, mishonga inodzvinyirira immune system, immunoglobulin kana kuwedzerwa ropa munguva pfupi yapfuura, uye chero kushandiswa kwemishonga yemishonga kana yekuwedzera.
- Kuongororwa kwehuwandu hwehutachiona: bvunza kana sampuro dzichifanira kutorwa panguva imwe chete uye, pazvinogoneka, murabhoritari imwe chete uchishandisa puratifomu imwe chete.
- Weti nemate: Zvirongo uye mitemo yenguva zvinosiyana zvichienderana nerabhoritari. Samples dzemate muvacheche dzinowanzo torwa kweinenge awa imwe mushure mekuyamwiswa zamu kana bhodhoro, nekuti mukaka unogona kukanganisa bvunzo.
Kuberekwa
Kuongororwa kweCMV panguva yekuzvitakura kunofanira kurairwa uye kududzirwa nachiremba wezvekubereka. Amniocentesis, kana ikafungwa nezvayo, inzira yakasiyana ine mvumo yayo uye hurukuro yenjodzi. Pasi pePC-PNDT Act 1994, chero ultrasound inoitwa panguva yekuzvitakura muIndia inofanirwa kuitwa panzvimbo yakanyoreswa uye haifanirwe kushandiswa pakuongorora bonde.
Vacheche nevana
Kune CMV inofungidzirwa kuti yakaberekwa, nguva inokosha kupfuura chero chimwe chinhu: PCR yemate kana weti mukati memavhiki matatu ekutanga ehupenyu inosiyanisa hutachiona hwekuzvarwa nahwo nehutachiona hunowanikwa mushure mekuzvarwa. Mushure memazuva makumi maviri nerimwe, mhedzisiro yakanaka inova yakaoma kududzira. Mhedzisiro yakanaka yemate inowanzo simbiswa paweti.
Vanhu vanoisirwa mishonga pamwe chete nevanhu vane mishonga inodzvinyirira immune system
Usambofa wakagadzirisa kana kurega mishonga inodzvinyirira masoja emuviri kana mishonga inorwisa mavhairasi wega zvichienderana nehuwandu hwehuwandu hwehutachiona. Shanduko dzinofanira kubva kuchikwata chako chekuisirwa kana chezvirwere zvinotapukira.
Vanhu vakuru nevanhu vane zvimwe zvirwere
Kuboorwa kweropa kunogona kuda kutarisirwa zvakanyanya kuvanhu vane tsinga dzisina kusimba, matambudziko ekubuda ropa kana vanonwa mishonga inorwisa kuganda kweropa. Taura nezvekushandisa mishonga inorwisa kuganda kweropa usati watora ropa kuti ropa rikwanise kumanikidzwa kwenguva yakareba.
Chii chinoitika panguva yekuongororwa kweCMV
- Muenzaniso weropa: tourniquet inoiswa, ganda rinocheneswa, uye ropa rinotorwa kubva mutsinga iri muruoko. Tsono yacho inogara panzvimbo kwayo kweinenge miniti. Kuruma kwenguva pfupi uye kupwanyika dzimwe nguva zvinoitika.
- Muenzaniso weti: inounganidzwa mumudziyo usina utachiona. Muvacheche, bhegi revana rekutora kana nzira yekubvisa tsvina inoshandiswa.
- Muenzaniso wemate: chirauro chinokweshwa mukati medama. Hazvirwadzi.
- Amniotic fluid, CSF, bronchoalveolar lavage kana biopsy: inowanikwa sechikamu chechirongwa chekiriniki chakasiyana chine maitiro ayo ekubvumira, chinoitwa chete kana zvakakodzera kurapwa.
Zvinotora nguva yakareba sei kuti maitiro acho aite
- Kutorwa kweropa: kwemaminitsi mashoma.
- Kushanya kwese kwekuunganidza mienzaniso: kazhinji maminetsi gumi nemashanu kusvika makumi matatu, zvichienderana nemitsara iri panzvimbo yekuunganidzira zvinhu.
- Kugadziriswa kwerabhoritari: serology nePCR zvinoitwa neboka rese, saka nguva dzekushuma dzinosiyana zvichienderana nerabhoritari, mhando yemuenzaniso uye kana bvunzo yacho yakatumirwa kurabhoritari. Kuongororwa kwePCR nehuwandu hwebvudzi uye kuyedzwa kweavidity zvinowanzotora nguva yakareba kupfuura IgG/IgM yenguva dzose. Bvunza nzvimbo yako yekuunganidza kuti ikupe purogiramu yayo yekuzivisa iripo.
Kunzwisisa mushumo wako weCMV
Mishumo inosiyana pakati pemarabhoritari muzvikamu, zvikamu zvekupedzisira uye mazwi. Verenga zvawakawana zvichienderana nehuwandu hwemareferensi akadhindwa pamushumo wako wega, kwete zvichienderana nenhamba dzinobva kune imwe lab kana webhusaiti.
Mhedzisiro yemasoja ekudzivirira chirwere
- IgG isina kunaka, IgM isina kunaka: Hapana humbowo hwekuti pane hutachiona hweCMV hwakamboitika. Mumukadzi ane pamuviri izvi zvinoreva kuti anogona kubatwa nechirwere ichi, uye matanho ekuchengetedza hutsanana anova akakosha. Utachiona hwechangobva kuitika hunogona kunge husina kugadzira masoja ekudzivirira chirwere.
- IgG yakanaka, IgM yakaipa: chirwere cheCMV chapfuura, icho chinowanzoonekwa muvanhu vakuru vekuIndia. Hazvirevi kuti chirwere ichi chichazotanga kushanda zvakare gare gare.
- IgG yakanaka, IgM yakanaka: Kuongororwa kwehutachiona hwekutanga, kudzoserwa kwesimba, kana IgM isina kujeka. Kuongororwa kwehutachiona uye kudzokorora kutora sampuro kunowanzo dikanwa vasati vawana mhedziso.
- IgG isina kunaka, IgM yakanaka: zvinogona kureva hutachiona hwepakutanga kana kuti IgM yenhema. Kudzokorora bvunzo mushure memavhiki mashoma, kutsvaga IgG seroconversion, kunowanzo dikanwa.
Mhedzisiro yePCR
- Hazvina kuonekwa: CMV DNA haina kuwanikwa mumuenzaniso iwoyo uri pamusoro pemuganhu wekuongororwa kweassay. Izvi hazvibvisi chirwere chenhengo dzakaparadzaniswa.
- Zvawanikwa, zviri pasi pehuwandu hunogona kuverengerwa: DNA iri pasi pemazinga. Kazhinji inoteverwa nekuongororwazve pane kurapwa nekukurumidza.
- Huwandu hwehutachiona (IU/mL) hwakayerwa: zvinoreva zvakanyanya senzira yekupfuura mienzaniso yakatevedzana papuratifomu imwe chete. Miganho yekutanga kurapwa kwehutachiona inogadzwa nechikamu chega chega chekuisira kana cheID; hapana muganho mumwe chete wepasi rose.
Hapana mhedzisiro yeCMV inofanira kududzirwa yoga. Chiremba akakumbira bvunzo achaiverenga pamwe chete nezviratidzo zvako, mamiriro emuviri wako, mifananidzo nezvimwe zvakaongororwa.
Kana mhedzisiro yeCMV inogona kutsausa
Mhedzisiro inogona kutaurwa zvisiri pamutemo kana kuti yakanaka zvisiri pamutemo
- IgM isiri chaiyo mune zvimwe zvirwere zvinotapukira zvine hutachiona, kusanganisira EBV, uye kana paine rheumatoid factor kana mamwe ma autoantibodies.
- IgM inogara iripo kwemwedzi yakawanda mushure mechirwere chisingachashandi pakurapa.
- Mienzaniso yakasvibiswa, kunyanya mate evacheche anounganidzwa nguva pfupi mushure mekuyamwisa, kana weti inounganidzwa isina kucheneswa zvakakwana.
- Antibody inowanikwa isina chinhu: Kurapwa kweimmunoglobulin munguva pfupi yapfuura kana kuwedzerwa ropa kunogona kugadzira IgG yakanaka inoratidza mupi, kwete murwere. IgG yemwana achangoberekwa inonyanya kuratidza maantibody emuviri waamai anoyambuka placenta, saka IgG yemwana achangoberekwa haigone kuona CMV yekuzvarwa nayo.
- DNA yakawanikwa asi isina basa: Vana vadiki vane hutano vanowanzo bvisa CMV muweti nemumate kwemwedzi yakati wandei. Kuongororwa kwePCR yeweti mumwana mudiki kunowanzo reva kubuda ropa, kwete chirwere.
Mhedzisiro inogona kudzikiswa zvisirizvo kana kuti isina kunaka zvisirizvo
- Kuedzwa nekukurumidza, masoja ekudzivirira chirwere asati avapo (nguva iyo masoja ekudzivirira chirwere asati aonekwa).
- Mhinduro yemasoja ekudzivirira chirwere isina simba kana kuti isina simba Muvanhu vane kudzvinyirirwa kwakanyanya kwemasoja emuviri, agammaglobulinemia kana vari pakurapwa kweB-cell depleting therapy, muvarwere ava serology haina kuvimbika uye PCR ndiyo inosarudzwa.
- Kurapa nemishonga inorwisa mavhairasi kwatotanga, izvo zvinogona kuderedza huwandu hwehutachiona husingaonekwe uku chirwere chenhengo dzemuviri chichienderera mberi.
- Chirwere chakaiswa muzvikamu: retinitis, colitis uye chirwere cheCNS zvinogona kuitika kana munhu aine negative blood PCR.
- Kutakurwa kwakanonoka kana kuchengetwa zvisina kunaka nucleic acid inoderera mumuenzaniso.
- Kuedza mwana achangoberekwa mushure memavhiki matatu ekuberekwa, izvo zvisingagoni kusiyanisa hutachiona hwekuzvarwa nahwo kubva kune hwakatorwa mushure mekusununguka.
Njodzi nekuchengetedzeka
Kuongororwa kweropa, weti uye mate
Kuboorwa kweropa (venepuncture) inzira isinganyanyi kukonzera njodzi. Migumisiro inotarisirwa inosanganisira kurwadziwa kwenguva pfupi, mavanga uye dzimwe nguva kusviba musoro. Kashoma kazhinji, kubuda ropa diki kana hutachiona hwepanzvimbo pakaboorwa kunogona kuitika. Kuunganidzwa kweweti nemate hazvina njodzi mumuviri.
Kutora sampuro dzeCMV kubva muongororo yeInvasive Sampling
Amniocentesis, lumbar puncture, bronchoscopy uye endoscopic biopsy imwe neimwe ine njodzi dzayo dzakasiyana, dzakasiyana zvikuru nedzekuongororwa ropa zviri nyore. Maitiro aya anoitwa chete kana mubvunzo wekiriniki waratidza kuti akarurama, uye chiremba anoita basa iri achatsanangura njodzi dzacho uye obvuma zvakasiyana.
Kuvanzika kwedata
Zvakawanikwa paCMV zvinoumba chikamu chenhoroondo yako yehutano. Kubatwa kwedata rehutano hwemunhu muIndia kunotongwa neMutemo weDhijitari weDziviriro yeData reMunhu Wega we2023, uye unogona kubvunza rabhoritari kuti data rako rinochengetwa sei uye rinogovaniswa sei.
Mireza tsvuku
Emergency izvozvi: enda kudhipatimendi re emergency riri pedyo
- Kuvhiringidzika kutsva, pfari, musoro wakanyanya nekuoma kwemutsipa, kana kushaya simba kutsva kana kusanzwa kune rumwe rutivi
- Kurasikirwa kamwe kamwe kana kudzikira kwakanyanya kwekuona
- Kushaya mweya panguva yekuzorora, kurwadziwa pachipfuva, kana miromo neminwe zvichishanduka kuita bhuruu
- Kurutsa ropa, tsvina nhema, kana manyoka ane ropa pamwe nedzungu
- Mumwana achangoberekwa: kusadya zvakanaka, kuneta, kupererwa nepfungwa, fivha, kufema kana mapundu anopararira nekukurumidza
Zuva rimwe chete: taura nechikwata chako chekurapa nhasi
- Zvitsva zvinoyangarara, mwenje inopenya kana kusaona zvakanaka kune chero munhu ane dziviriro yemuviri inokundikana, pamwe CMV retinitis, iyo inoda kuongororwa nekukurumidza kwemaziso
- Manyoka anogara achiitika, kurwadziwa mudumbu kana kuoma kumedza munhu anoisirwa mushonga kana munhu ane HIV yakakura
- Fivha mumugamuchiri wechirwere, kana kuti huwandu hwehutachiona hweCMV huri kukwira hwakataurwa kwauri
- Kufamba kwemwana ari mudumbu kwakaderera, kana kuti kuongororwa neultrasound kwawakaitwa kuti uite chimwe chinhu.
Kugadzwa kwenguva dzose
- Kuneta kwenguva refu, fivha isina kunaka kana kuzvimba kwemasero zvinogara kwemavhiki anopfuura maviri
- Mhedzisiro yeCMV IgM kana IgG yausinganzwisisi, kana mhinduro mbiri dzisingawirirani
- Kutadza kuona mwana achangoberekwa, kana kunetseka nezvekutaura kwemwana nekukura kwemutauro wake
- Kuronga pamuviri uye kuda kukurukura nezvenjodzi dzeCMV uye matanho ekuchengetedza hutsanana
Mamiriro ezvinhu anokosha
Kuberekwa
Dambudziko guru mukuzvitakura nderekuti utachiona hweCMV hunowanzova nenjodzi huru yekutapurirana kumwana ari mudumbu kupfuura kudzoserwa kumuviri, kunyange zvazvo kudzoserwa kumuviri uye kudzoserwa kuhutachiona kunogonawo kukonzera CMV yekuzvarwa nayo. Kusiyanisa hutachiona hwepakutanga kubva kune hwakamboitika kunowanzoda serology, kuongororwa kweavity uye dzimwe nguva kuchengetwa kwemasampuli ekutanga. Amniotic fluid PCR ndiyo bvunzo inotarisa hutachiona hwemwana ari mudumbu, uye ine mitemo yayo yenguva. Matanho ehutsanana, kugeza maoko zvakakwana mushure mekuchinja manapukeni, kusagovana chikafu, midziyo kana midziyo yekunwira nevana vadiki, uye kudzivirira kusangana nemate emwana mudiki, ndiwo matanho anonyanya kukurudzirwa.
Vacheche nevacheche
Kuberekwa neCMV ndicho chikonzero chikuru chekurasikirwa nekunzwa kwemasero etsinga. Kurasikirwa nekunzwa kunogona kuitika pakuzvarwa kana kuonekwa pave paya muhudiki, saka bvunzo imwe chete yekunzwa yakajairika haigadzirise nyaya yacho; kuteverwa kweruzivo rwekunzwa kwakarongwa kunodiwa. Sarudzo dzekurapa CMV yezviratidzo zvekuzvarwa nayo dzinoitwa nevanoongorora zvirwere zvinotapukira zvevana, uye kurapwa kwemishonga inorwisa mavhairasi kunoda kutariswa zvakanyanya kuti uone migumisiro yacho.
Vagamuchiri vekudyara
Njodzi yacho inoenderana zvikuru nemusanganiswa weCMV IgG weanopa neanogamuchira, nhengo yakasimwa uye kusimba kwekudzivirira kwezvirwere mumuviri. Zvikamu zvinoshandisa kudzivirira mavhairasi emuropa kana kuti pre-emptive therapy zvichitungamirirwa nePCR. Nzira dzese dziri mbiri dzakarurama uye maitiro akasiyana pakati pezvipatara.
Vanhu vanorarama neHIV
Njodzi huru iri pakuwanda kweCD4. CMV retinitis inogona kuramba ichikura, saka chero chiratidzo chitsva chinoda kuongororwa maziso nekukurumidza pane kuongororwa ropa chete. Kurapa nemishonga inorwisa mabhakitiriya kunoderedza zvikuru njodzi yechirwere cheCMV.
Vanhu vane CKD, mwoyo kusashanda zvakanaka kana kuti vari kutora mishonga yakawanda
Mishonga inorwisa mavhairasi yeCMV yakadai seganciclovir nevalganciclovir inoda kugadziriswa kwemushonga weitsvo kana itsvo dzisisina kushanda zvakanaka uye inogona kuderedza huwandu hweropa. Kusarudzwa kwemushonga, kuyerwa kwemushonga uye kutariswa kwemushonga ndizvo zvinosarudzwa nechikwata chinopa mushonga.
Kuongororwa kweCMV muIndia
- Kupararira kweropa kwakanyanya kumashure: Kuvapo kweCMV IgG pakati pevanhu vakuru vekuIndia, kusanganisira vakadzi vari pazera rekubereka, kwakanyanya. Izvi zvine mhedzisiro inoshanda: mushumo weIgG wakazvimiririra unokonzera kunetseka kwakanyanya kusingakoshi uye hauwanzo shandura manejimendi wega.
- Mapaneru eTOCHI akarongwa nepfungwa: Mapurofayiro eTORCH anowanzo kurongeka pakutanga kwekuzvitakura kana mushure mekurasikirwa nepamuviri pasina chiratidzo chaicho chekiriniki. Izvi zvinowanzoburitsa mhedzisiro yakanaka yeIgG kana IgM isina kunaka iyo inonetsa kupindura. Bvunza chiremba wezvekubereka kuti bvunzo yacho inopindurwa nemubvunzo upi wekiriniki.
- Kukura kwehuwandu hwezvishandiso zvekuisa Munzvimbo dzakasiyana-siyana dzemuIndia, kuongorora huwandu hwehutachiona hweCMV kwagara kuri chikamu chekurapa mushure mekuisirwa mwana, nemaitiro akaiswa munharaunda nechikamu chimwe nechimwe.
- Zvirwere zvefivha zvinopindirana: MuIndia, fivha yenguva refu ine hepatosplenomegaly uye ma enzymes echiropa asina kujairika (SGPT/ALT, SGOT/AST) anogona kunge achikonzerwa nedengue, enteric fever, hepatitis A kana E, TB, malaria kana EBV. CMV inofanira kufungwa pamwe chete, kwete panzvimbo peizvi.
- Kusiyana kwemurabhoritari: Mapuratifomu nemiganhu yekurapwa zvakasiyana zvikuru pakati pemarabhoritari ekuIndia, izvo zvinonyanya kukosha pakuenzanisa huwandu hwehutachiona hwakatevedzana. Kuenderera mberi kwerabhoritari kwakakosha kukumbirwa.
- Kuongororwa kwekunzwa kwevana vacheche inowanikwa muzvipatara zvakawanda zvekuIndia, kunyange zvisiri zvese. Kana CMV yekuzvarwa nayo yaonekwa, bvunza zvakananga nezvenguva yekuongororwa kwekunzwa zvakare.
Mutengo neinishuwarenzi muIndia
Mitengo haina kuenzana muIndia yese uye inochinja nekufamba kwenguva. Pane kutaura nhamba, hezvino zvinhu zvinoita kuti izvi zviitike:
- Rudzi rwebvunzo: Kuongororwa kweCMV IgG kana IgM immunoays ndiko kusingadhuri zvakanyanya. Quantitative PCR (viral load) uye IgG avidity zvinodhura zvakanyanya nekuda kwe reagent uye mitengo yepuratifomu.
- Bvunzo imwe chete ichienzaniswa nepaneru: Panel yeTORCH inodhura kupfuura bvunzo imwe chete yeCMV, uye chikamu chikuru chepanel chingave chisiri kudiwa muchipatara.
- Mhando yemuenzaniso uye kuoma kwayo: kuyedza amniotic fluid, CSF kana tishu kunosanganisira kugadziriswa kwakawedzerwa.
- Kuongororwa kwemukati meimba kana kuongororwa kwakatumirwa: sampuro dzinotumirwa kurabhoritari dzinowedzera mari yekufambisa uye nguva yekubika.
- Guta, chikamu uye kubvumidzwa: Mitengo yemetro kana iri yemaguta madiki, hurumende kana iri yemakambani, uye marabhoritari ane mvumo yeNABL anogona kutenga zvakasiyana.
- Frequency: Kuongororwa kwehuwandu hwehutachiona mushure mekuisirwa mwana mushonga unodhura nguva nenguva, kazhinji kacho mari yakawanda.
Inishuwarenzi: bvunzo dzekuongorora dzinoitwa pakurapwa kwekunze dzinowanzo bviswa muinishuwarenzi yehutano inobhadharwa nemurwere, nepo kuferefeta panguva yekubvumidzwa kana pasi pechirongwa chakatarwa chekuchengeta varwere masikati kana mushure mekuisirwa mwana kunogona kuvharwa. Kufukidzwa pasi pezvirongwa zvehurumende zvakaita seAyushman Bharat PM-JAY kunoenderana nepakeji yekurapwa iri pasi payo. Simbisa mutengo wazvino uye zvinodiwa zvekutanga zvekubvumidzwa nerabhoritari neinishuwarenzi yako usati waongororwa.
Ngano nezvokwadi
| Nhema | chokwadi |
|---|---|
| "CMV IgG positive zvinoreva kuti ndine hutachiona hunoda kurapwa." | IgG yakanaka inowanzo ratidza hutachiona hwekare. Vanhu vazhinji vane CMV IgG vane hutano hwakanaka uye havadi kurapwa. |
| "Kuwanikwa kweIgG kunoreva kuti handina dziviriro mumuviri uye mwana wangu akachengeteka." | Kutapukirwa kwakaitwa kare kunoderedza asi hakubvisi njodzi yekuzvarwa nayo yeCMV. Kudzoserwa kwechirwere uye kutapukirwazve kwechirwere kunogona kupararira. |
| "IgM yakanaka inosimbisa hutachiona hwazvino." | CMV IgM inogona kuramba iripo kwemwedzi yakati wandei uye inogona kunge isina chokwadi. Kuongororwa kwehutachiona uye kudzokorora kutora sampu kunowanzo dikanwa. |
| "Kuongororwa kweropa negative zvinoreva kuti hapana chirwere cheCMV." | Retinitis, colitis uye chirwere cheCNS zvinogona kuitika kana ropa risingaonekwe reCMV DNA. Kuongororwa kwakaitwa nenhengo dzemuviri kunogona kudiwa. |
| "CMV chirwere chinotapuriranwa pabonde chete." | CMV inopararira kuburikidza nemvura zhinji dzemuviri, mate, weti, mukaka wezamu, ropa uye zvinobuda munhengo dzekubereka nadzo. Mate neweti yemwana mudiki ndizvo zvinowanzo wanikwa. |
| "Kurapwa nemishonga inorwisa utachiona kunobvisa CMV mumuviri." | Mishonga inorwisa mavhairasi inodzora kupararira kwehutachiona. CMV inoramba yakavharika kweupenyu hwese uye inogona kuporazve; izwi rekuti "kurapa" harishandi. |
| "Mukadzi wese ane pamuviri anofanira kunge aine TORCH panel." | Kuongororwa kweTORCH kwese hakukurudzirwi nguva dzose. Kuongororwa kunofanira kupindura mubvunzo chaiwo wekiriniki. |
| "Kuyamwisa kunofanira kumira kana amai vane CMV positive." | Kune vacheche vane hutano hwakanaka, kuyamwisa kunowanzo enderera mberi. Sarudzo dzevana vasati vasvika nguva dzinosarudzwa nechikwata chevacheche. |
Mibvunzo inowanzobvunzwa
Chii chinoonekwa neCMV test?
Kuongororwa kweCMV kunoona mhinduro yemuviri ku cytomegalovirus (IgG, IgM, avidity) kana DNA yehutachiona kuburikidza nePCR. Ma antibodies anoratidza kusangana kwacho nenguva yakatarwa; PCR inoratidza kana DNA yehutachiona iripo izvozvi uye, kana ichienzaniswa, yakawanda sei. Hapana chimwe chezvinoitika chinoratidza kuti CMV iri kukonzera zviratidzo zvemunhu.
Ndeipi bvunzo yeCMV yandinofanira kukumbira?
Izvi zvinoenderana nemubvunzo wekiriniki, saka hausi sarudzo yekuzvisarudzira wega. Serology inokodzera mibvunzo yemamiriro emuviri uye fungidziro yehutachiona huchangobva kuitika panguva yekuzvitakura. PCR inokodzera kuongororwa kwevana vacheche uye kutarisa varwere vane dziviriro yemuviri yakakanganisika. Chiremba wako anosarudza bvunzo, mhando yemuenzaniso uye nguva zvichienderana nemamiriro ako ezvinhu.
Kuongororwa kweCMV kunorwadza here?
Kutorwa ropa kunokonzera kuruma kwenguva pfupi uye dzimwe nguva kukuvara kudiki. Kuunganidzwa kweweti nemate hazvirwadzi. Mienzaniso inopararira yakaita seamniotic fluid kana biopsy tissue inzira dzakasiyana dzine kusagadzikana kwadzo uye njodzi, dzinotsanangurwa nachiremba anodziita.
CMV yakasiyana sei ne monospot kana EBV test?
Vhairasi yeCMV neEpstein-Barr zvinogona kukonzera chirwere chakafanana nemononucleosis chine fivha, pahuro, kuneta uye kuzvimba kwematumbu. Kuongorora kweMonospot neEBV kunotsvaga EBV; kuongororwa kweCMV kunotsvaga CMV. Kuongororwa kweEBV kusina kunaka hakubvisi CMV, ndosaka izvi zviviri zvichiwanzokumbirwa pamwe chete.
Mhedzisiro yekuti handina CMV zvinoreva here kuti handina CMV?
Kwete. Mhedzisiro isina kunaka zvinoreva kuti CMV haina kuwanikwa musampuli iyoyo nenzira iyoyo panguva iyoyo. Kuongororwa nekukurumidza, kudzvinyirirwa kwemasoja emuviri, kurapwa kwekare kwehutachiona, kana chirwere chakavharirwa kunhengo imwe chete yemuviri zvinogona kukonzera mhedzisiro isina kunaka. Kana zviratidzo zvikaramba zviripo, dzokera kuna chiremba wako kuti aongororwe zvakare.
Sei kuongororwa kwevana vacheche kuchifanira kuitwa mukati memavhiki matatu?
Usati wasvika mazuva makumi maviri nerimwe ekuberekwa, kuongororwa kwemushonga wemate kana weti kunoratidza hutachiona hwakawanikwa mwana asati azvarwa kana kuti pedyo nekuzvarwa. Mushure meizvozvo, CMV inotorwa kubva mumukaka wezamu kana kusangana kwepedyo haigoni kusiyaniswa nehutachiona hwekuzvarwa nahwo, izvo zvinoshandura hurongwa hwese hwekutarisira nekutevera.
Ko CMV inogona kurapwa nemishonga here?
CMV haibviswi mumuviri, inoramba yakavanzika kweupenyu hwese. Mishonga inorwisa mavhairasi yakaita seganciclovir nevalganciclovir inogona kudzora kupararira kwemasero emuviri uye kuderedza kukuvara kwenhengo dzemuviri muvarwere vakasarudzwa. Kurapa kunochengeterwa mamiriro ezvinhu chaiwo, kunoda kutariswa kwemigumisiro, uye kunosarudzwa nenyanzvi yekurapa.
Ndingaderedza sei mukana wekubata CMV panguva yekuzvitakura?
Matanho anoshanda anosanganisira hutsanana hwevana vadiki: kugeza maoko nesipo zvakanaka mushure mekuchinjwa manapukeni, kupukuta mhino uye kubata matoyi; kudzivisa kudya pamwe chete, zvipunu, makapu kana mabhurashi emazino; uye kudzivisa kutsvoda vana vadiki pamuromo. Mhedzisiro yacho inosiyana zvichienderana nevanhu, uye hapana chiyero chinobvisa njodzi zvachose.
Ndingaitei neCMV report yandakaita ndega?
Endesa kuna chiremba usati wawana mhedziso. CMV serology yakazvigadzirira inowanzo ratidza IgG yakanaka, iyo inotarisirwa muvanhu vakuru vazhinji vekuIndia uye kashoma kuchinja chero chinhu. Dudziro inoenderana nezviratidzo zvako, mamiriro epamuviri uye mamiriro ekudzivirira muviri, izvo zvisingagone kupihwa nemushumo.
Sources
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- Sangano reHutano reNyika (World Health Organization International Standard for human cytomegalovirus DNA nucleic acid amplification techniques) (hwaro hweIU/mL reporting).
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