{"id":132516,"date":"2020-02-01T09:01:52","date_gmt":"2020-04-21T03:13:20","guid":{"rendered":"http:\/\/www.05921.net\/index.php\/132516\/"},"modified":"2020-04-21T11:13:23","modified_gmt":"2020-04-21T03:13:23","slug":"23baa9ecc6","status":"publish","type":"post","link":"https:\/\/www.05921.net\/index.php\/132516\/","title":{"rendered":"\u91cd\u78c5\uff01\u7f8e\u56fd\u9996\u4f8b\u65b0\u51a0\u75c5\u6bd2\u80ba\u708e\u6cbb\u7597\u5eb7\u590d\u5168\u8fc7\u7a0b | NEJM \u5b98\u65b9\u7ffb\u8bd1"},"content":{"rendered":"
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\u4f4f\u9662\u540e\uff0c\u5bf9\u60a3\u8005\u8fdb\u884c\u4e86\u652f\u6301\u6cbb\u7597\uff0c\u5305\u62ec 2 L \u7684\u751f\u7406\u76d0\u6c34\u9759\u6ef4\u548c\u6602\u4e39\u53f8\u743c\u7f13\u89e3\u6076\u5fc3\u75c7\u72b6\u3002<\/span><\/section>\n

<\/section>\n
\"\u91cd\u78c5\uff01\u7f8e\u56fd\u9996\u4f8b\u65b0\u51a0\u75c5\u6bd2\u80ba\u708e\u6cbb\u7597\u5eb7\u590d\u5168\u8fc7\u7a0b<\/section>\n
\u56fe2. <\/span><\/strong><\/span>\u6309\u7167\u60a3\u8005\u53d1\u75c5\u53ca\u4f4f\u9662\u65e5\u671f\uff082020\u5e741\u670816\u65e5\u81f32020\u5e741\u670830\u65e5\uff09\u5217\u51fa\u7684\u75c7\u72b6\u548c\u6700\u9ad8\u4f53\u6e29\u3002<\/span><\/span>
<\/section>\n

<\/section>\n
\u4f4f\u9662\u7b2c 2 \u81f3 5 \u65e5\uff08\u53d1\u75c5\u7b2c 6 \u81f3 9 \u65e5\uff09\uff0c\u9664\u51fa\u73b0\u95f4\u6b47\u6027\u53d1\u70ed\u5e76\u4f34\u6709\u5fc3\u52a8\u8fc7\u901f\u4e4b\u5916\uff0c\u60a3\u8005\u751f\u547d\u4f53\u5f81\u57fa\u672c\u5e73\u7a33\u3002\u60a3\u8005\u4ecd\u6709\u5e72\u54b3\uff0c\u4e4f\u529b\u3002\u4f4f\u9662\u7b2c 2 \u65e5\u4e0b\u5348\uff0c\u60a3\u8005\u6392\u7a00\u4fbf\uff0c\u8179\u90e8\u4e0d\u9002\u3002\u591c\u95f4\u518d\u6b21\u6392\u7a00\u4fbf\uff1b\u91c7\u96c6\u7684\u7caa\u4fbf\u548c\u4e0a\u547c\u5438\u9053\u6837\u672c\uff0c\u4ee5\u53ca\u9f3b\u54bd\u548c\u53e3\u54bd\u62ed\u5b50\u7ecf rRT-PCR \u68c0\u6d4b 2019-nCoV \u5747\u5448\u9633\u6027\uff0c\u8840\u6e05\u68c0\u6d4b\u4e3a\u9634\u6027\u3002<\/span><\/section>\n

<\/section>\n
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<\/section>\n
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<\/span><\/section>\n
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<\/span><\/section>\n
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<\/section>\n
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<\/section>\n
\u4ee5\u4e0a\u5f71\u50cf\u5b66\u7684\u53d1\u73b0\u4e0e\u60a3\u8005\u4f4f\u9662\u7b2c 5 \u65e5\u665a\u4e0a\u5f00\u59cb\u7684\u547c\u5438\u75c7\u72b6\u6539\u53d8\u76f8\u543b\u5408\uff0c\u8be5\u60a3\u8005\u5f53\u65e5\u547c\u5438\u73af\u5883\u7a7a\u6c14\u65f6\u7684\u6c27\u9971\u548c\u5ea6\u4e0b\u964d\u81f3 90%\u3002\u4f4f\u9662\u7b2c 6 \u65e5\u7ed9\u60a3\u8005\u884c 2 L\/\u5206\u9f3b\u5bfc\u7ba1\u5438\u6c27\u3002<\/span><\/section>\n

<\/span><\/section>\n
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<\/section>\n
\u88681.<\/span><\/strong> <\/span><\/span>\u4e34\u5e8a\u5b9e\u9a8c\u5ba4\u7ed3\u679c\u3002<\/span><\/span><\/section>\n
\"\u91cd\u78c5\uff01\u7f8e\u56fd\u9996\u4f8b\u65b0\u51a0\u75c5\u6bd2\u80ba\u708e\u6cbb\u7597\u5eb7\u590d\u5168\u8fc7\u7a0b<\/section>\n
\u5c06\u9499\u503c\u8f6c\u6362\u6210 mmol\/L \u9700\u4e58\u4ee5 0.250\u3002\u5c06\u8840\u5c3f\u7d20\u6c2e\u503c\u8f6c\u6362\u4e3a mmol\/L \u9700\u4e58\u4ee5 0.357\u3002\u5c06\u808c\u9178\u9150\u503c\u8f6c\u6362\u4e3a \u03bcmol\/L \u9700\u4e58\u4ee5 88.4\u3002\u5c06\u603b\u80c6\u7ea2\u7d20\u503c\u8f6c\u6362\u4e3a \u03bcmol\/L \u9700\u4e58\u4ee5 17.1.<\/span><\/section>\n
\u7ed3\u679c\u6765\u81ea POCT \u8840\u6c14\u5206\u6790\u4eea\uff08iSTAT\uff09.<\/span><\/section>\n
\u2021\u60a3\u8005\u8840\u6db2\u5206\u6790\u7ed3\u679c\u4f4e\u4e8e\u6b63\u5e38\u503c\u3002<\/span><\/section>\n
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<\/section>\n
\"\u91cd\u78c5\uff01\u7f8e\u56fd\u9996\u4f8b\u65b0\u51a0\u75c5\u6bd2\u80ba\u708e\u6cbb\u7597\u5eb7\u590d\u5168\u8fc7\u7a0b<\/section>\n
\u56fe3. <\/span><\/strong><\/span>\u540e\u524d\u4f4d\u53ca\u4fa7\u4f4d\u80f8\u7247\uff0c2020 \u5e74 1 \u6708 22 \u65e5(\u53d1\u75c5\u7b2c 7 \u65e5\uff0c\u4f4f\u9662\u7b2c 3 \u65e5)\u3002\u80f8\u5185\u7247\u5e73\u626b\u65e0\u5f02\u5e38\u63d0\u793a\u3002<\/span><\/span>
<\/section>\n

<\/section>\n
\u5728\u60a3\u8005\u4f4f\u9662\u7b2c6\u65e5\uff08\u53d1\u75c5\u7b2c 10 \u65e5\uff09\uff0c\u7b2c 4 \u6b21\u80f8\u7247\u68c0\u67e5\u663e\u793a\u53cc\u4e0b\u80ba\u6761\u7d22\u72b6\u9634\u5f71\u3002\u80f8\u7247\u7ed3\u679c\u4e0e\u4e0d\u5178\u578b\u80ba\u708e\u8bca\u65ad\u543b\u5408\uff08\u56fe 5\uff09\uff0c\u53cc\u80ba\u542c\u8bca\u63d0\u793a\u6709\u6c34\u6ce1\u97f3\u3002<\/span><\/section>\n

<\/span><\/section>\n
\u6839\u636e\u60a3\u8005\u7684\u5f71\u50cf\u5b66\u68c0\u67e5\u7ed3\u679c\uff0c\u5f00\u59cb\u5438\u6c27\u7684\u6cbb\u7597\u51b3\u7b56\uff0c\u60a3\u8005\u7684\u6301\u7eed\u53d1\u70ed\uff0c\u591a\u4e2a\u6837\u672c\u7684 2019-nCoV RNA \u6301\u7eed\u9633\u6027\u7ed3\u679c\uff0c\u4ee5\u53ca\u6709\u62a5\u9053\u6307\u51fa\u5176\u4ed6\u60a3\u8005\u5728\u4e0e\u8be5\u60a3\u8005\u7684\u5f71\u50cf\u5b66\u80ba\u708e\u4e00\u81f4\u7684\u65f6\u95f4\u6bb5\u53d1\u751f\u91cd\u5ea6\u80ba\u708e[3,4]\uff0c\u56e0\u6b64\u4e34\u5e8a\u533b\u5e08\u5c06\u4e00\u79cd\u8bd5\u9a8c\u6027\u6297\u75c5\u6bd2\u836f\u8fdb\u884c\u4e86\u7279\u8bb8\u7528\u836f\u3002<\/span><\/section>\n

<\/span><\/section>\n
\u4f4f\u9662\u7b2c 7 \u65e5\u665a\u4e0a\uff0c\u8fd9\u540d\u60a3\u8005\u63a5\u53d7\u4e86 remdesivir\uff08\u4e00\u79cd\u5904\u4e8e\u7814\u53d1\u9636\u6bb5\u7684\u6838\u82f7\u9178\u7c7b\u4f3c\u7269[10,11]\uff09\u9759\u8109\u8f93\u6ce8\uff0c\u65e0\u660e\u663e\u526f\u4f5c\u7528\u3002\u7b2c7\u65e5\u665a\u4e0a\uff0c\u5f97\u5230\u8fde\u7eed\u9634\u6027\u7684\u964d\u9499\u7d20\u539f\u6c34\u5e73\u548c\u8010\u7532\u6c27\u897f\u6797\u91d1\u9ec4\u8272\u8461\u8404\u7403\u83cc PCR \u9634\u6027\u7ed3\u679c\u540e\uff0c\u505c\u7528\u4e07\u53e4\u9709\u7d20\uff0c\u7b2c 8 \u65e5\u505c\u7528\u5934\u5b62\u5421\u809f\u3002<\/span><\/section>\n

<\/section>\n
\"\u91cd\u78c5\uff01\u7f8e\u56fd\u9996\u4f8b\u65b0\u51a0\u75c5\u6bd2\u80ba\u708e\u6cbb\u7597\u5eb7\u590d\u5168\u8fc7\u7a0b<\/section>\n
\u56fe4. <\/span><\/strong><\/span>2020 \u5e74 1 \u6708 24 \u65e5\u540e\u524d\u4f4d\u80f8\u7247\uff08\u53d1\u75c5\u7b2c 9 \u65e5\uff0c\u4f4f\u9662\u7b2c 5 \u65e5\uff09\u3002\u5de6\u80ba\u4e0b\u53f6\u6bdb\u73bb\u7483\u6837\u6539\u53d8\u52a0\u91cd\uff0c\u63d0\u793a\u80ba\u708e\u53ef\u80fd\u3002<\/span><\/span>
<\/section>\n

<\/section>\n
\"\u91cd\u78c5\uff01\u7f8e\u56fd\u9996\u4f8b\u65b0\u51a0\u75c5\u6bd2\u80ba\u708e\u6cbb\u7597\u5eb7\u590d\u5168\u8fc7\u7a0b<\/section>\n

<\/section>\n
\u56fe5. <\/span><\/strong><\/span>\u6b63\u4f4d\u80f8\u7247\u548c\u4fa7\u4f4d\u80f8\u7247\uff0c2020 \u5e74 1 \u6708 26 \u65e5\uff08\u53d1\u75c5\u7b2c 10 \u65e5\uff0c\u4f4f\u9662\u7b2c 6 \u65e5\uff09\u3002\u80ba\u53f6\u5e95\u90e8\u5448\u6301\u7eed\u6bdb\u73bb\u7483\u6837\u6591\u70b9\uff0c\u63d0\u793a\u53ef\u80fd\u4e3a\u975e\u5178\u578b\u80ba\u708e\uff1b\u6bdb\u73bb\u7483\u6837\u6539\u53d8\u968f\u65f6\u95f4\u63a8\u79fb\u4e0d\u65ad\u589e\u5f3a\u3002<\/span><\/span>
<\/section>\n

<\/section>\n
\u5728\u4f4f\u9662\u7b2c 8 \u65e5\uff08\u53d1\u75c5\u7b2c 12 \u65e5\uff09\uff0c\u60a3\u8005\u4e34\u5e8a\u75c7\u72b6\u5f97\u5230\u6539\u5584\u3002\u505c\u6b62\u4e86\u5438\u6c27\u6cbb\u7597\uff0c\u60a3\u8005\u547c\u5438\u73af\u5883\u7a7a\u6c14\u65f6\u7684\u6c27\u9971\u548c\u5ea6\u4e5f\u63d0\u9ad8\u5230 94~96%\u3002\u4e4b\u524d\u53cc\u4e0b\u80ba\u7684\u6c34\u6ce1\u97f3\u4e5f\u6d88\u5931\u3002\u60a3\u8005\u98df\u6b32\u4e5f\u51fa\u73b0\u597d\u8f6c\uff0c\u9664\u4e86\u95f4\u6b47\u6027\u5e72\u54b3\u548c\u6d41\u6d95\u5916\uff0c\u65e0\u5176\u4ed6\u4e34\u5e8a\u75c7\u72b6\u3002<\/span><\/section>\n

<\/span><\/section>\n
\u622a\u6b62 2020 \u5e74 1 \u6708 30 \u65e5\uff0c\u60a3\u8005\u8fd8\u5728\u4f4f\u9662\u6cbb\u7597\u3002\u4f46\u65e0\u53d1\u70ed\uff0c\u9664\u54b3\u55fd\u6539\u5584\u6bd4\u8f83\u7f13\u6162\u5916\uff0c\u6240\u6709\u5176\u4ed6\u4e34\u5e8a\u75c7\u72b6\u5747\u6d88\u9000\u3002<\/span><\/section>\n

<\/section>\n

<\/section>\n
\u65b9\u6cd5<\/strong><\/span><\/section>\n

<\/section>\n
\u6837\u672c\u91c7\u96c6<\/span><\/strong><\/span><\/strong><\/span><\/section>\n

<\/span><\/strong><\/span><\/section>\n<\/section>\n<\/section>\n<\/section>\n
\u7528\u4e8e 2019-nCoV \u8bca\u65ad\u68c0\u6d4b\u7684\u4e34\u5e8a\u6837\u672c\u662f\u4f9d\u7167\u7f8e\u56fd CDC \u6307\u5357\u91c7\u96c6[12]\u3002\u9f3b\u54bd\u548c\u53e3\u54bd\u62ed\u5b50\u6837\u672c\u662f\u91c7\u7528\u5408\u6210\u7ea4\u7ef4\u62ed\u5b50\u91c7\u96c6\uff1b\u6bcf\u4e2a\u62ed\u5b50\u88ab\u653e\u5165\u88c5\u6709 2~3 ml \u75c5\u6bd2\u8fd0\u9001\u57f9\u517b\u6db2\u7684\u5355\u72ec\u65e0\u83cc\u8bd5\u7ba1\u4e2d\u3002<\/span><\/section>\n

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\u8840\u6e05\u88ab\u91c7\u96c6\u5230\u8840\u6e05\u5206\u79bb\u7ba1\u4e2d\uff0c\u7136\u540e\u4f9d\u7167\u7f8e\u56fd CDC \u6307\u5357\u79bb\u5fc3\u3002\u5c3f\u6db2\u548c\u7caa\u4fbf\u6837\u672c\u5206\u522b\u91c7\u96c6\u5230\u65e0\u83cc\u6837\u672c\u5bb9\u5668\u5185\u3002\u8fd0\u9001\u5230\u7f8e\u56fd CDC \u4e4b\u524d\uff0c\u6837\u672c\u5728 2\u00b0C~8\u00b0C \u4fdd\u5b58\u3002\u7528\u4e8e\u91cd\u590d 2019-nCoV \u68c0\u6d4b\u7684\u6837\u672c\u662f\u5728\u53d1\u75c5\u7b2c 11 \u548c 12 \u65e5\u91c7\u96c6\uff0c\u5305\u62ec\u9f3b\u54bd\u548c\u53e3\u54bd\u62ed\u5b50\u3001\u8840\u6e05\u3001\u5c3f\u6db2\u548c\u7caa\u4fbf\u6837\u672c\u3002<\/span>
<\/section>\n

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2019-nCoV\u7684\u8bca\u65ad\u68c0\u6d4b<\/strong><\/strong><\/span><\/section>\n

<\/strong><\/span><\/section>\n
\u4e34\u5e8a\u6837\u672c\u662f\u901a\u8fc7\u6839\u636e\u516c\u5f00\u75c5\u6bd2\u5e8f\u5217\u5f00\u53d1\u7684 rRT-PCR \u68c0\u6d4b\u6cd5\u8fdb\u884c\u68c0\u6d4b\u3002\u4e0e\u4e4b\u524d\u4e25\u91cd\u6025\u6027\u547c\u5438\u7efc\u5408\u5f81\u51a0\u72b6\u75c5\u6bd2\uff08SARS-CoV\uff09\u548c\u4e2d\u4e1c\u547c\u5438\u7efc\u5408\u5f81\u51a0\u72b6\u75c5\u6bd2\uff08MERS-CoV\uff09\u7684\u8bca\u65ad\u68c0\u6d4b\u6cd5\u76f8\u4f3c\uff0c2019-nCoV \u7684\u8bca\u65ad\u68c0\u6d4b\u6cd5\u5305\u62ec 3 \u4e2a\u6838\u8863\u58f3\u57fa\u56e0\u9776\u70b9\u548c\u4e00\u4e2a\u9633\u6027\u5bf9\u7167\u9776\u70b9\u3002\u5173\u4e8e\u8be5\u68c0\u6d4b\u6cd5\u7684\u8bf4\u660e[13] \u53ca rRT-PCR \u5f15\u7269\u548c\u63a2\u9488[14] \u7684\u5e8f\u5217\u7684\u4fe1\u606f\u53c2\u89c1\u5173\u4e8e 2019-nCoV \u7684\u7f8e\u56fd CDC \u5b9e\u9a8c\u5ba4\u4fe1\u606f\u7f51\u7ad9[15]\u3002<\/span><\/section>\n

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\u57fa\u56e0\u6d4b\u5e8f<\/strong><\/strong><\/span><\/section>\n

<\/strong><\/span><\/section>\n
2020 \u5e74 1 \u6708 7 \u65e5\uff0c\u4e2d\u56fd\u7814\u7a76\u4eba\u5458\u5728\u7f8e\u56fd\u56fd\u7acb\u536b\u751f\u7814\u7a76\u9662GenBank\u6570\u636e\u5e93[16] \u548c\u300c\u5168\u7403\u6d41\u611f\u6570\u636e\u5171\u4eab\u8ba1\u5212\u300d\uff08Global Initiative on Sharing All Influenza Data\uff0cGISAID\uff09[17] \u6570\u636e\u5e93\u5171\u4eab\u4e86 2019-nCoV \u7684\u5b8c\u6574\u57fa\u56e0\u5e8f\u5217\uff1b\u4e4b\u540e\u53c8\u53d1\u8868\u4e86\u5173\u4e8e\u5206\u79bb 2019-nCoV<\/span>\u7684\u62a5\u544a[18]\u3002<\/span><\/section>\n

<\/span><\/section>\n
\u6838\u9178\u662f\u4ece rRT-PCR \u9633\u6027\u6837\u672c\uff08\u53e3\u54bd\u90e8\u548c\u9f3b\u54bd\u90e8\uff09\u63d0\u53d6\u51fa\uff0c\u5e76\u5728\u6851\u683c\u548c\u4e8c\u4ee3\u6d4b\u5e8f\u5e73\u53f0\uff08Illumina\u548cMinIon\uff09\u8fdb\u884c\u4e86\u5168\u57fa\u56e0\u7ec4\u6d4b\u5e8f\u3002\u5e8f\u5217\u7ec4\u88c5\u91c7\u7528\u7684\u662f 5.4.6 \u7248 Sequencer \u8f6f\u4ef6\uff08Sanger\uff09\uff1b2.17 \u7248 minimap \u8f6f\u4ef6\uff08MiniON\uff09\u548c 1.3.1 \u7248 freebayes \u8f6f\u4ef6\uff08MiSeq\uff09\u3002\u5c06\u5b8c\u6574\u57fa\u56e0\u7ec4\u4e0e\u5df2\u53d1\u5e03\u7684 2019-nCoV \u53c2\u8003\u5e8f\u5217\uff08GenBank \u767b\u5f55\u53f7 NC_045512.2\uff09\u8fdb\u884c\u4e86\u6bd4\u8f83\u3002<\/span><\/section>\n

<\/section>\n
\u88682. <\/span><\/strong><\/span>2019\u65b0\u578b\u51a0\u72b6\u75c5\u6bd2\uff082019-nCoV\uff09\u7684\u5b9e\u65f6\u9006\u8f6c\u5f55\u9176\u805a\u5408\u9176\u94fe\u53cd\u5e94\u68c0\u6d4b\u7ed3\u679c\u3002<\/span><\/strong><\/span><\/strong>*<\/span><\/strong><\/span><\/strong><\/span><\/span><\/section>\n
\"\u91cd\u78c5\uff01\u7f8e\u56fd\u9996\u4f8b\u65b0\u51a0\u75c5\u6bd2\u80ba\u708e\u6cbb\u7597\u5eb7\u590d\u5168\u8fc7\u7a0b<\/section>\n
* \u5faa\u73af\u9608\u503c\uff08Ct\uff09\u8f83\u4f4e\u8868\u793a\u75c5\u6bd2\u8f7d\u91cf\u8f83\u9ad8\u3002NT\u8868\u793a\u672a\u68c0\u6d4b\u3002<\/span><\/section>\n

<\/section>\n

<\/section>\n
\u7ed3\u679c<\/strong><\/span><\/section>\n

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2019-nCoV \u7684\u6837\u672c\u68c0\u6d4b<\/strong><\/strong><\/span><\/section>\n

<\/section>\n
\u4e8e\u8be5\u60a3\u8005\u53d1\u75c5\u7b2c 4 \u65e5\u91c7\u96c6\u7684\u521d\u59cb\u547c\u5438\u9053\u6837\u672c\uff08\u9f3b\u54bd\u62ed\u5b50\u548c\u53e3\u54bd\u62ed\u5b50\uff09\u5448 2019-nCoV \u9633\u6027\uff08\u88682\uff09\u3002\u75be\u75c5\u7b2c 4 \u65e5\u7684\u5faa\u73af\u9608\u503c\uff08Ct\uff09\u4f4e\uff08\u9f3b\u54bd\u6837\u672c\u4e3a 18~20\uff0c\u53e3\u54bd\u6837\u672c\u4e3a 21~22\uff09\uff0c\u56e0\u6b64\u63d0\u793a\u5c3d\u7ba1\u60a3\u8005\u7684\u521d\u59cb\u75c7\u72b6\u8f7b\uff0c\u4f46\u8fd9\u4e9b\u6837\u672c\u4e2d\u7684\u75c5\u6bd2\u8f7d\u91cf\u9ad8\u3002<\/span><\/section>\n

<\/span><\/section>\n
\u53d1\u75c5\u7b2c 7 \u65e5\u91c7\u96c6\u7684\u4e24\u4efd\u4e0a\u547c\u5438\u9053\u6837\u672c\u4ecd\u5448 2019-NcV \u9633\u6027\uff0c\u5e76\u4e14\u9f3b\u54bd\u62ed\u5b50\u6837\u672c\u7684\u75c5\u6bd2\u8f7d\u91cf\u4ecd\u7136\u9ad8\uff08Ct \u503c\uff0c23~24\uff09\u3002\u53d1\u75c5\u7b2c7\u65e5\u91c7\u96c6\u7684\u7caa\u4fbf\u6837\u672c\u4e5f\u54482019-NcV\u9633\u6027\uff08Ct\u503c\uff0c36~38\uff09\u3002<\/span><\/section>\n

<\/span><\/section>\n
\u4e24\u4e2a\u91c7\u6837\u65e5\u671f\u91c7\u96c6\u7684\u8840\u6e05\u6837\u672c\u5747\u5448 2019-nCoV \u9634\u6027\u3002<\/span><\/section>\n

<\/span><\/section>\n
\u53d1\u75c5\u7b2c 11 \u65e5\u548c\u7b2c 12 \u65e5\u91c7\u96c6\u7684\u9f3b\u54bd\u548c\u53e3\u54bd\u6837\u672c\u663e\u793a\u51fa\u75c5\u6bd2\u8f7d\u91cf\u4e0b\u964d\u8d8b\u52bf\u3002\u53d1\u75c5\u7b2c 12 \u65e5\u91c7\u96c6\u7684\u53e3\u54bd\u6837\u672c\u5448 2019-nCoV \u9634\u6027\u3002\u6211\u4eec\u4ecd\u5728\u7b49\u5f85\u4e0a\u8ff0\u65e5\u671f\u91c7\u96c6\u7684\u8840\u6e05\u6837\u672c rRT-PCR \u7ed3\u679c\u3002<\/span><\/section>\n

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\u57fa\u56e0\u6d4b\u5e8f<\/strong><\/strong><\/span><\/section>\n

<\/strong><\/span><\/section>\n
\u53e3\u54bd\u548c\u9f3b\u54bd\u6837\u672c\u5168\u57fa\u56e0\u7ec4\u5e8f\u5217\u5b8c\u5168\u76f8\u540c\uff0c\u5e76\u4e14\u4e0e\u5df2\u53d1\u5e03\u7684\u5176\u4ed6 2019-nCoV \u5e8f\u5217\u51e0\u4e4e\u76f8\u540c\u3002\u5728\u8be5\u60a3\u8005\u7684\u75c5\u6bd2\u548c 2019-nCoV \u53c2\u8003\u5e8f\u5217\uff08NC_045512.2\uff09\u4e4b\u95f4\uff0c\u53ea\u6709\u4f4d\u4e8e\u5f00\u653e\u9605\u8bfb\u6846 8 \u7684 3 \u4e2a\u6838\u82f7\u9178\u548c 1 \u4e2a\u6c28\u57fa\u9178\u5b58\u5728\u5dee\u5f02\u3002\u8be5\u5e8f\u5217\u53c2\u89c1 GenBank\uff08\u767b\u5f55\u53f7MN985325\uff09[16]\u3002<\/span><\/section>\n

<\/section>\n

<\/section>\n
\u8ba8\u8bba<\/strong><\/span><\/section>\n

<\/section>\n
\u6211\u4eec\u62a5\u544a\u7684\u7f8e\u56fd\u9996\u4f8b 2019-nCoV \u786e\u8bca\u75c5\u4f8b\u8bf4\u660e\u8fd9\u4e00\u65b0\u66b4\u53d1\u7684\u75ab\u60c5\u6709\u51e0\u4e2a\u65b9\u9762\u5c1a\u672a\u5b8c\u5168\u660e\u4e86\uff0c\u5305\u62ec\u4f20\u64ad\u52a8\u529b\u5b66\u548c\u4e34\u5e8a\u75be\u75c5\u7684\u5168\u75be\u75c5\u8c31\u3002<\/span><\/section>\n

<\/span><\/section>\n
\u8be5\u60a3\u8005\u66fe\u524d\u5f80\u4e2d\u56fd\u6b66\u6c49\uff0c\u4f46\u81ea\u8bc9\u5728\u6b66\u6c49\u671f\u95f4\u672a\u53bb\u8fc7\u6d77\u9c9c\u6279\u53d1\u5e02\u573a\uff0c\u672a\u53bb\u8fc7\u533b\u7597\u673a\u6784\uff0c\u4e5f\u672a\u63a5\u89e6\u8fc7\u4efb\u4f55\u60a3\u8005\u3002\u5c3d\u7ba1\u5176 2019-nCoV \u611f\u67d3\u7684\u6765\u6e90\u4e0d\u660e\uff0c\u4f46\u6709\u5173\u4eba\u9645\u4f20\u64ad\u7684\u8bc1\u636e\u5df2\u7ecf\u53d1\u5e03\u3002\u622a\u81f3 2020 \u5e74 1 \u6708 30 \u65e5\uff0c\u5c1a\u672a\u53d1\u73b0\u4e0e\u8be5\u75c5\u4f8b\u76f8\u5173\u7684 2019-nCoV \u7ee7\u53d1\u75c5\u4f8b\uff0c\u4f46\u5bf9\u5176\u5bc6\u5207\u63a5\u89e6\u8005\u7684\u76d1\u6d4b\u4ecd\u5728\u7ee7\u7eed[19]\u3002<\/span><\/section>\n

<\/section>\n
\u6211\u4eec\u5728\u60a3\u8005\u53d1\u75c5\u7b2c 4 \u65e5\u548c\u7b2c 7 \u65e5\u7684\u4e0a\u547c\u5438\u9053\u6837\u672c\u4e2d\u68c0\u51fa 2019-nCoV RNA\uff0c\u4e14 Ct \u503c\u4f4e\uff0c\u56e0\u6b64\u63d0\u793a\u75c5\u6bd2\u8f7d\u91cf\u9ad8\uff0c\u6709\u4f20\u64ad\u6f5c\u529b\u3002\u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0c\u6211\u4eec\u8fd8\u5728\u60a3\u8005\u53d1\u75c5\u7b2c 7 \u65e5\u91c7\u96c6\u7684\u7caa\u4fbf\u6837\u672c\u4e2d\u68c0\u51fa\u4e86 2019-nCoV RNA\u3002\u867d\u7136\u8be5\u60a3\u8005\u8840\u6e05\u6837\u672c\u7684 2019-nCoV \u68c0\u6d4b\u7ed3\u679c\u53cd\u590d\u5448\u9634\u6027\uff0c\u4f46\u4e2d\u56fd\u91cd\u75c5\u60a3\u8005\u8840\u6db2\u5185\u5df2\u68c0\u51fa\u75c5\u6bd2 RNA [4]\u3002<\/span><\/section>\n

<\/span><\/section>\n
\u7136\u800c\uff0c\u80ba\u5916\u68c0\u51fa\u75c5\u6bd2 RNA \u4e0d\u4e00\u5b9a\u610f\u5473\u7740\u5b58\u5728\u4f20\u67d3\u6027\u75c5\u6bd2\uff0c\u76ee\u524d\u5c1a\u4e0d\u660e\u786e\u547c\u5438\u9053\u5916\u68c0\u51fa\u75c5\u6bd2 RNA \u7684\u4e34\u5e8a\u610f\u4e49\u3002<\/span><\/section>\n

<\/section>\n
\u76ee\u524d\uff0c\u6211\u4eec\u5bf9 2019-nCoV \u611f\u67d3\u7684\u4e34\u5e8a\u8c31\u4e86\u89e3\u975e\u5e38\u6709\u9650<\/strong>\u3002\u4e2d\u56fd\u5df2\u62a5\u544a\u4e86\u91cd\u5ea6\u80ba\u708e\u3001\u547c\u5438\u8870\u7aed\u3001\u6025\u6027\u547c\u5438\u7a98\u8feb\u7efc\u5408\u5f81\uff08ARDS\uff09\u548c\u5fc3\u810f\u635f\u4f24\u7b49\u5e76\u53d1\u75c7\uff0c\u5305\u62ec\u81f4\u6b7b\u75c5\u4f8b[4,18,20]\u3002<\/span><\/section>\n

<\/section>\n
\u7136\u800c\uff0c\u9700\u8981\u6ce8\u610f\u7684\u662f\uff0c\u8fd9\u4e9b\u75c5\u4f8b\u662f\u5728\u5176\u80ba\u708e\u8bca\u65ad\u7684\u57fa\u7840\u4e0a\u786e\u5b9a\u7684\uff0c\u56e0\u6b64\u62a5\u544a\u53ef\u80fd\u504f\u5411\u66f4\u4e25\u91cd\u7684\u7ed3\u5c40\uff0c\u5b58\u5728\u504f\u501a\u3002<\/span><\/section>\n

<\/section>\n
\u6211\u4eec\u7684\u60a3\u8005\u6700\u521d\u8868\u73b0\u4e3a\u8f7b\u5ea6\u54b3\u55fd\u548c\u8f7b\u5ea6\u95f4\u6b47\u6027\u53d1\u70ed\uff0c\u53d1\u75c5\u7b2c 4 \u65e5\u80f8\u7247\u5e76\u65e0\u80ba\u708e\u8ff9\u8c61\uff0c\u4e4b\u540e\u5728\u53d1\u75c5\u7b2c 9 \u65e5\u65f6\u8fdb\u5c55\u4e3a\u80ba\u708e\u3002\u5728 2019-nCoV \u611f\u67d3\u7684\u4e34\u5e8a\u75c5\u7a0b\u65e9\u671f\uff0c\u8f7b\u5ea6\u75be\u75c5\u7684\u8fd9\u4e9b\u975e\u7279\u5f02\u6027\u75c7\u72b6\u548c\u4f53\u5f81\u5728\u4e34\u5e8a\u4e0a\u4e0e\u8bb8\u591a\u5176\u4ed6\u5e38\u89c1\u4f20\u67d3\u75c5\u53ef\u80fd\u65e0\u6cd5\u533a\u5206\uff0c\u5c24\u5176\u662f\u5728\u51ac\u5b63\u547c\u5438\u9053\u75c5\u6bd2\u611f\u67d3\u5b63\u3002\u6b64\u5916\uff0c\u8be5\u60a3\u8005\u5728\u53d1\u75c5\u7b2c 9 \u65e5\u8fdb\u5c55\u4e3a\u80ba\u708e\uff0c\u8fd9\u4e00\u65f6\u95f4\u4e0e\u6700\u8fd1\u4e00\u7bc7\u8bba\u6587\u4e2d\u62a5\u9053\u7684\u547c\u5438\u56f0\u96be\u8fdf\u53d1\u76f8\u7b26\uff08\u4e2d\u4f4d\u65f6\u95f4\u4e3a\u53d1\u75c5\u7b2c 8 \u65e5\uff09[4]\u3002<\/span><\/section>\n

<\/strong><\/span><\/section>\n
\u5c3d\u7ba1\u6211\u4eec\u56e0\u60a3\u8005\u4e34\u5e8a\u72b6\u51b5\u6076\u5316\u800c\u51b3\u5b9a\u7279\u8bb8\u4f7f\u7528 remdesivir\uff0c\u4f46\u6211\u4eec\u9700\u8981\u901a\u8fc7\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u6765\u786e\u5b9a remdesvir \u53ca\u7528\u4e8e\u6cbb\u7597 2019-nCoV \u611f\u67d3\u60a3\u8005\u7684\u5176\u4ed6\u8bd5\u9a8c\u6027\u836f\u7269\u7684\u5b89\u5168\u6027\u548c\u7597\u6548\u3002<\/strong><\/span><\/section>\n

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\u6211\u4eec\u5728\u672c\u6587\u4e2d\u62a5\u544a\u4e86\u7f8e\u56fd\u62a5\u544a\u7684\u9996\u4f8b 2019-nCoV \u611f\u67d3\u60a3\u8005\u4e34\u5e8a\u7279\u5f81\u3002\u8be5\u75c5\u4f8b\u8981\u70b9\u5305\u62ec\u60a3\u8005\u770b\u5230\u5173\u4e8e\u75ab\u60c5\u7684\u516c\u5171\u536b\u751f\u8b66\u544a\u540e\u51b3\u5b9a\u5c31\u533b<\/strong>\uff1b\u5f53\u5730\u533b\u52a1\u4eba\u5458\u4e86\u89e3\u5230\u60a3\u8005\u8fd1\u671f\u66fe\u524d\u5f80\u6b66\u6c49\uff0c\u4e4b\u540e\u5f53\u5730\u3001\u5dde\u548c\u56fd\u5bb6\u516c\u5171\u536b\u751f\u5de5\u4f5c\u4eba\u5458\u5f7c\u6b64\u534f\u8c03\uff1b\u8bc6\u522b\u51fa\u53ef\u80fd\u6709 2019-nCoV \u611f\u67d3\uff0c\u56e0\u800c\u53ef\u4ee5\u8fc5\u901f\u9694\u79bb\u60a3\u8005\uff0c\u7531\u5b9e\u9a8c\u5ba4\u786e\u8ba4 2019-nCoV \u611f\u67d3\uff0c\u5e76\u5c06\u60a3\u8005\u6536\u5165\u9662\uff0c\u8fdb\u884c\u8fdb\u4e00\u6b65\u68c0\u67e5\u548c\u6cbb\u7597\u3002<\/span><\/section>\n

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\u6b64\u4efd\u75c5\u4f8b\u62a5\u544a\u7a81\u663e\u51fa\u4e34\u5e8a\u533b\u5e08\u9762\u5bf9\u56e0\u6025\u6027\u75c5\u75c7\u72b6\u800c\u5c31\u8bca\u7684\u60a3\u8005\u65f6\uff0c\u8be2\u95ee\u6e05\u695a\u8fd1\u671f\u65c5\u884c\u53f2\u6216\u4e0e\u5176\u4ed6\u60a3\u8005\u63a5\u89e6\u53f2\u7684\u91cd\u8981\u610f\u4e49\uff0c\u8fd9\u6837\u624d\u80fd\u786e\u4fdd\u6b63\u786e\u8bc6\u522b\u548c\u8fc5\u901f\u9694\u79bb\u53ef\u80fd\u6709 2019-nCoV \u611f\u67d3\u98ce\u9669\u7684\u60a3\u8005\uff0c\u4ece\u800c\u51cf\u5c11\u75be\u75c5\u8fdb\u4e00\u6b65\u4f20\u64ad\u3002<\/span><\/section>\n

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Michelle L. Holshue, M.P.H., Chas DeBolt, M.P.H., Scott Lindquist, M.D., Kathy H. Lofy, M.D., John Wiesman, Dr.P.H., Hollianne Bruce, M.P.H., Christopher Spitters, M.D., Keith Ericson, P.A.-C., Sara Wilkerson, M.N., Ahmet Tural, M.D., George Diaz, M.D., Amanda Cohn, M.D., LeAnne Fox, M.D., Anita Patel, Pharm.D., Susan I. Gerber, M.D., Lindsay Kim, M.D., Suxiang Tong, Ph.D., Xiaoyan Lu, M.S., Steve Lindstrom, Ph.D., Mark A. Pallansch, Ph.D., William C. Weldon, Ph.D., Holly M. Biggs, M.D., Timothy M. Uyeki, M.D., and Satish K. Pillai, M.D. for the Washington State 2019-nCoV Case Investigation Team*<\/span><\/section>\n

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1. World Health Organization. Pneumonia of unknown cause \u2014 China. 2020 (https:\/\/www.who.int\/csr\/don\/05-january-2020-pneumonia-of-unkown-cause-china\/en\/. opens in new tab).<\/span><\/section>\n
2. World Health Organization. Novel coronavirus \u2014 China. 2020 (https:\/\/www.who.int\/csr\/don\/12-january-2020-novel-coronavirus-china\/en\/.).<\/span><\/section>\n
3. Chan JF-W, Yuan S, Kok K-H, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020 January 24 (Epub ahead of print).<\/span><\/section>\n
4. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020 January 24 (Epub ahead of print).<\/span><\/section>\n
5. Centers for Disease Control and Prevention. 2019 Novel coronavirus, Wuhan, China: 2019-nCoV situation summary. January 28, 2020 (https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/summary.html.).<\/span><\/section>\n
6. Phan LT, Nguyen TV, Luong QC, et al. Importation and human-to-human transmission of a novel coronavirus in Vietnam. N Engl J Med. DOI: 10.1056\/NEJMc2001272.<\/span><\/section>\n
7. Johns Hopkins University CSSE. Wuhan coronavirus (2019-nCoV) global cases (https:\/\/gisanddata.maps.arcgis.com\/apps\/opsdashboard\/index.html#\/bda7594740fd40299423467b48e9ecf6.).<\/span><\/section>\n
8. Centers for Disease Control and Prevention. Interim guidance for healthcare professionals: criteria to guide evaluation of patients under investigation (PUI) for 2019-nCoV. 2020 (https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/clinical-criteria.html.).<\/span><\/section>\n
9. Centers for Disease Control and Prevention. Infection control. 2019 Novel coronavirus, Wuhan, China. 2020 (https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/infection-control.html.).<\/span><\/section>\n
10. Mulangu S, Dodd LE, Davey RT Jr, et al. A randomized, controlled trial of ebola virus disease therapeutics. N Engl J Med 2019;381:2293-2303.<\/span><\/section>\n
11. Sheahan TP, Sims AC, Leist SR, et al. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun 2020;11:222-222.<\/span><\/section>\n
12. Centers for Disease Control and Prevention. Interim guidelines for collecting, handling, and testing clinical specimens from patients under investigation (PUIs) for 2019 novel coronavirus (2019-nCoV). 2020 (https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/guidelines-clinical-specimens.html.).<\/span><\/section>\n
13. Centers for Disease Control and Prevention, Respiratory Viruses Branch, Division of Viral Diseases. Real-time RT-PCR panel for detection 2019-novel coronavirus. 2020 (https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/downloads\/rt-pcr-panel-for-detection-instructions.pdf.).<\/span><\/section>\n
14. Centers for Disease Control and Prevention, Respiratory Viruses Branch, Division of Viral Diseases. 2019-novel coronavirus (2019-nCoV) real-time rRT-PCR panel primers and probes. 2020 (https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/downloads\/rt-pcr-panel-primer-probes.pdf.).<\/span><\/section>\n
15. Centers for Disease Control and Prevention. Information for laboratories. 2019 novel coronavirus, Wuhan, China. 2020 (https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/guidance-laboratories.html.).<\/span><\/section>\n
16. National Institutes of Health. GenBank overview (https:\/\/www.ncbi.nlm.nih.gov\/genbank\/.).<\/span><\/section>\n
17. GISAID (Global Initiative on Sharing All Influenza Data) home page (https:\/\/www.gisaid.org\/.).<\/span><\/section>\n
18. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. DOI: 10.1056\/NEJMoa2001017.<\/span><\/section>\n
19. Washington State Department of Health. Novel coronavirus outbreak 2020 (https:\/\/www.doh.wa.gov\/Emergencies\/Coronavirus.).<\/span><\/section>\n
20. Chen N, Zhou M, Dong X Jr, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020 January 30 (Epub ahead of print).<\/span><\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n
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