Mazwi emakemikari emumwoyo (zita rekare), kana kuti biodarkers yemwoyo (iyo zita idzva), vane kuongororwa kweropa kunoshandiswa kuona kuora kwemwoyo yemasero masero. Cardiac biomarkers mapuroteni anobva mumasero emuviri emwoyo ayo akabuda mukati memaropa mushure mekukuvara kumutsipa wemwoyo. Apo nharaunda yeropa yevakashambadziri iyi inokudzwa, zvinoreva kuti pane zvingangodaro kwave kwakanganisa kumutsipa wemwoyo.
Iyi miedzo inobatsira zvikuru pakuongorora myocardial infarctions (kurwadziwa kwemwoyo) , asi ikozvino iko kushandiswawo kuona kuora mwoyo kwema cell kubva kune zvimwe zvinokonzera, pamwe - zvakadai sekukuvadzwa kunorwadza kana myocarditis .
Creatine kinase uye troponin ndiwo mapurotini maviri iye zvino akayerwa muzvidzidzo zvebiomarker.
Kuti "chiratidzo cheCardiac Enzyme" chakava sei "Cardiac Biomarker Test"
Creatine kinase ndiyo yekutanga mapuroteni emwoyo yakashandiswa zvikuru navanachiremba kuti vabatsire kuongorora kushungurudzika kwemwoyo, uye creatine kinase ndiyo enzyme - puroteni inobatsira kuuya nezvimwe zvinokonzerwa nehupenyu hwehupenyu. Nokuda kwechikonzero ichi, kuongororwa kweropa kwekuongororwa kwekurwadziwa kwemoyo kwakatanga kuzivikanwa seanoridhia enzyme test.
Zvisinei, troponin yakave iyo yakakosha zvikuru mapuroteni eropa anoshandiswa pakuona mwoyo masero, uye troponin haisi enzyme. Pane kudaro, troponin inyanzvi yeprotein inoratidzika inokosha kumakumbo emutsipa wemwoyo.
Apo troponin paakawana ropa, iyo chiratidzo chinogona kuvhiringidzika kuti mwoyo wekuremara kwemawere yakaitika. Nokuti troponin haisi enzyme, vanachiremba vakawanda ikozvino vanotaura nezve "biomarker test" pane "enzyme test."
Ko Biomarker Miedzo inoshandiswa sei?
Kuyera biomarkers inowanzotanga danho rinokosha pakuongorora kuora mwoyo.
Mazuva ano, troponin ndiyo inoshandiswa inoshandiswa nechinangwa ichi, nokuti inonyanya kujekesa (uyewo inonyanya kuisa chiratidzo) yepfungwa yemusana kukuvara kupfuura creatine kinase. Vanachiremba vazhinji vacharamba vachienzanisa zviyero zvitatu zve troponin uye creatine kinase apo kurwisa kwemwoyo kunofungidzirwa - asi kana chirongwa chekusika kinase ichiri kuwedzera zvizhinji kuchipatara chinokanganisika.
Kana chirwere chemwoyo chikaitika, kusunungurwa kwemwoyo weseroti mapuroteni muropa iro kazhinji rinotevera chimiro chaiyo kwemaawa akawanda. Saka, kusimbisa kuti chirwere chemwoyo chakaitika chinowanzodikanwa kuongororwa kwakawanda kweropa kwechinguva, zvichiratidza kuwedzera uye kuwira kwehuwandu hwematongerwo enyika.
Creatine kinase inosunungurwa muropa ropa 4 kusvika maawa matanhatu mushure memwoyo chekuvadzwa kwemajeri kunoitika, uye nhamba yepamusoro yeropa ye creatine kinase inoonekwa mushure maawa makumi maviri nemaviri. Nzvimbo dzakakwirira dzeki creatine kinase kazhinji, asi kwete nguva dzose, zvinoratidza moyo wemisipiresi kukuvara. Zvisikwa zvinonzi Creatine kinase dzimwe nguva zvinogona kuwedzerwa nekukuvadza kune mamwe marudzi emasero pamwe chete, sezvo iripowo mune zvisiri mwoyo yemasero masero.
Troponin inosunungurwa muropa ropa 2 kusvika maawa matanhatu mushure memwoyo wema cell, uye ropa rinowedzera mumaawa 12 kusvika ku 26.
Kuwedzera kwezinga re troponin kunoonekwa sechiratidziro chinonyatsovhiringidza chekushaya misi yemisipiresi kupfuura yepamusoro yakasikwa inonzi kinase mazinga.
Nokuti troponin "yekare" chiratidzo chechimiro chechimiro chinokanganisa kudarika creatine kinase, uye nokuti yakanyatsojeka pakuratidza mwoyo wekuremara kwechiremera kudarika creatine kinase, troponin ndiyo inosarudzwa nhasi kuti iongorore kushungurudzika kwemoyo.
Ndezvipi Zvisizvo Zvipenyu Zvinonyanya Kubatsira?
Apo murwere ane chimiro chechidimbu chemyocardial ine ST-sekumusoro kwepamusoro kune ECG ( a "STEMI" ), maitiro eEGG pachake, pamwe chete nezviratidzo zvechipatara, kazhinji zvinokwana kuti zviongororwe zvakajeka.
Saka ne STEMI kazhinji hazvidikanwe kuti chiremba amirire mhinduro yehuyo test biomarker asati atanga kurapa.
Biomarkers inobatsira zvikuru kune vanhu vane kurwadza kwepfungwa kusina avo vane STEMI chaiyo, kureva, kune vanhu vane "NSTEMI" . NeNSTEMI kuchinja kweEGG kunowanzove kusinganzwisisiki, kuitira kuti zvakaoma zvikuru kuita chirongwa chakarurama chinoenderana neEECG uye zviratidzo chete. Pano, muedzo webiomarker unowanzotambudza mukugadzirisa kana chirwere chakasimba chekurwadziwa kwemoyo chinodiwa.
Muvanhu vane NSTEMI, chirongwa chekutanga chekuongorora ropa chinogona kunge chiri mu "indeterminate". Muchiitiko ichi, rwechipiri ropa rekuedzwa kwemaawa mashomanana gare gare richaratidza kana zvikwata zve troponin (kana kuti zvisikwa zvinonzi kinase) zviri kuratidza chimiro chekumuka-uye-kugumburwa kunoonekwa nekurwadziwa kwemoyo.
Mumakore achangobva kupfuura, kuve-senitivity troponin testay yakagadzirwa kuti, kune vanhu vakawanda vane NSTEMI, inobvumira kuongororwa kuitwe kuongororwa ropa rimwe chete, nokudaro kubvumira kuti kurapwa kutange mberi kudarika zvimwe zvingave zvinokurudzirwa.
Chii Chinokonzera "Nhema" Kureva kweByomarkers?
Hasi dzose dzakakwirira mumasikirwo emwoyo dzinoratidza kurwisa kwemwoyo.
Zvisikwa zvinokonzerwa nechiremera zvinogona kuve zvakakonzerwa nekukuvadzwa kwemisungo, kana nekukuvara kweuropi kana mapapu, kana nechiropa kana chirwere chepfungwa.
Kukwirira mu troponin yehutachivi hweropa kunonyatsotsanangurwa nemukati memasikirini emuviri, zvakanyanyisa kutaura, hapana chinhu chakadai se "nhema" kukwirira kwe troponin. Zvisinei, kukanganisa kwemasikirini emwoyo kunogona kuitika nokuda kwezvikonzero zvimwe kunze kwekurwadza kwemoyo. Izvi zvinogona kusanganisira mwoyo kusakwanisa , myocarditis, kukurumidza kuyanana kweairgia , sepsis , coronary artery spasm , aortic dissection , stress cardiomyopathy , kana chirwere chakakomba chemapurmoni .
Ichi ndicho chikonzero kuongororwa kwepfungwa yepfungwa hakurevi kuongororwa kweropa rimwe chete, asiwo pane zviratidzo zvechipatara, ECG inoshanduka, uye (kazhinji) pane chimiro chezviomarker elevations zvinoratidza kuora mwoyo kwema cell cell.
Shoko Rinobva
Cardiac biomarkers mapuroteni anopinda muropa apo pave pane kuora kwemutsipa wemwoyo, sekurwadziwa kwemwoyo. Miedzo yeByomarker inowanzobatsira pakuita nekukurumidza kuongororwa kwepfungwa yepfungwa, kuitira kuti kurapwa kwekutanga kunogona kutanga.
> Sources:
> Mills NL, Churchhouse AM, Lee KK, et al. Kushandiswa kweSensitive Troponin I Assay uye Njodzi yeChirungu cheMyocardial Infarction uye Rufu muVachipatara neSpected Acute Coronary Syndrome. JAMA 2011; 305: 1210.
> Thygesen K, Mair J, Katus H, et al. Mazano ekushandiswa kweCardiac Troponin Measurement muAacute Cardiac Care. Eur Heart J 2010; 31: 2197.