Asɛm bi a ɛfa wo koma ho: Momma yensua koma mu enzymes anaa koma mu biomarkers ho ade.

Ɛtɔ mmere bi a, ehu ka yɛn kɛse bere a yɛn koko yɛ yɛn yaw mpofirim anaasɛ ɛyɛ den sɛ yɛbɛhome no, ɛnte saa? Yɛdwene sɛ, "So eyi yɛ komayare?" Wɔ mmere a ɛte sɛ eyinom mu no, mogya mu nhwehwɛmu titiriw bi wɔ hɔ a nnuruyɛfo de hu sɛ ebia biribi asɛe wo koma no pɛpɛɛpɛ anaa. Saa na wɔfrɛ saa koma mu enzyme sɔhwɛ yi.

Dɛn ne koma mu enzyme ahorow yi?

Sɛ yɛbɛka no tiawa a, koma mu enzymes yɛ protein soronko a ɛwɔ yɛn koma mu nkwammoaa mu. Enzyme yɛ nnuru a ɛboa yɛn nipadua ma ɛyɛ nnuruyɛ mu nneɛma, te sɛ aduan a wɔyam , yiye. Susuw ho saa kwan yi so: wo koma te sɛ ofie. Nneɛma a ɛsom bo pii wɔ ofie yi mu. Mpɛn pii no, saa nneɛma yi tra fie no mu na emfi adi.

Nanso, sɛ biribi sɛe wɔ ofie yi a wɔfrɛ no koma mu, sɛ nhwɛso no, sɛ koma no nnya mframa pa a ɛdɔɔso (yɛfrɛ eyi ischemia ), anaasɛ sɛ tebea bi te sɛ komayare ba a, koma no nkwammoaa sɛe. Ɛte sɛ nea sɛ wobubu ofie bi fasu a, emu nneɛma huruw fi adi. Afei, koma mu enzymes a na ɛwɔ saa nkwammoaa no mu no fi ase boaboa ano wɔ mogya no mu. Enti, saa enzymes yi dodow a ɛkɔ soro wɔ mogya no mu no yɛ ade titiriw a ɛkyerɛ sɛ nhyɛso, asɛe, anaa adwennwen bi aba koma no so . Wɔsan frɛ eyinom cardiac biomarkers , efisɛ ɛma wonya “sɛnkyerɛnne” a ɛfa koma no akwahosan ho.

Enti, dɛn ne saa Koma Enzyme Agyiraehyɛde Sɔhwɛ yi?

Koma mu enzyme agyiraehyɛde sɔhwɛBiako ne nhwehwɛmu a wogye wo mogya mu na wosusuw sɛnea enzyme titiriw anaa biomarkers yi dodow te. Eyi yɛ mogya mu nhwehwɛmu a ɛnyɛ den koraa. Woyi mogya kakraa bi fi ntini bi a ɛwɔ wo nsa mu mu.

Oduruyɛfo no de nhwehwɛmu yi di dwuma de hwɛ sɛ ebia saa enzyme yi dodow a ɛwɔ mogya no mu no te sɛ nea ɛfata anaasɛ ɛkɔ soro anaa. Sɛ saa enzyme yi dodow boro dodow a wɔkamfo kyerɛ no so koraa a , ɛkyerɛ sɛ ebia komayare bi aba, anaasɛ ebia adwennwen bi aba koma no so. Enti, eyi yɛ sɔhwɛ a ɛho hia paa.

Ɔkwan bɛn so na nnuruyɛfo de koma mu biomarkers yi di dwuma?

Afei ebia woresusuw ho sɛ, ɛbɛyɛ dɛn na nnuruyɛfo de mogya mu nhwehwɛmu yi ara ahu yare bi? Nokwarem no, nnuruyɛfo betumi ate nneɛma pii ase denam koma mu biomarkers yi dodow a wɔbɛhwɛ so. Ɛte sɛ nea ɔsraani a ɔhwehwɛ nkurɔfo ho nsɛm mu reboaboa nsɛnkyerɛnne ano.

Nhwɛsoɔ:

• Acute Coronary Syndrome (ACS): Eyi yɛ tebea a mogya a ɛkɔ koma no mu a ɛso tew mpofirim na ɛde ba. Eyi betumi ayɛ nea edi komayare anim anaasɛ ebetumi ayɛ komayare. Koma mu enzyme dodow betumi akɔ soro ntɛmntɛm wɔ saa bere yi mu.
• Myocardial Ischemia: Eyi ne bere a koma ntini no nnya mframa pa a ɛdɔɔso. Te sɛ afifide a ɛyow bere a nsu nni no no ara pɛ. Sɛ mframa pa nni koma nkwammoaa no mu a, ɛhaw wɔn na wogyae saa enzymes yi.
• Koma ntini a epira: Nneɛma afoforo a ɛde ba, te sɛ ɔyare mmoawa bi ne komayare a emu yɛ den nso betumi asɛe koma ntini no. Saa enzymes yi nso boaboa ano wɔ mogya no mu saa bere no.

Ɛsono ɔkwan a wɔfa so sa tebea horow yi mu biara. Enti, ɛho hia sɛ wunya diagnosis a edi mu , efisɛ ɛno ne bere a wubetumi anya ayaresa a ɛfata na ɛyɛ ntɛm sen biara.

Dɛn ne koma mu biomarker sɔhwɛ yi botae ahorow?

Nnuruyɛfo hwɛ koma mu agyiraehyɛde ahorow yi dodow esiane nneɛma atitiriw kakraa bi nti. Momma yɛnhwɛ nea wɔyɛ:

• Hwɛ sɛnea koma asɛe ne ɔhaw afoforo: Ɛtɔ mmere bi a ebia yɛrennya yare no ho sɛnkyerɛnne atitiriw biara, nanso ebia yebenya ɔhaw nketenkete a efi ase wɔ yɛn koma mu. Saa sɔhwɛ yi nso betumi ahu ɔhaw ahorow a ahintaw a ɛte saa.
• Hwehwɛ komayare a ɛde sɛnkyerɛnne te sɛ koko mu yaw ne ahome a ɛyɛ tiaa : Eyi yɛ sɔhwɛ a wɔtaa yɛ wɔ tebea a egye ntɛmpɛ mu. Sɛ wokɔ ayaresabea a wo koko yɛ wo yaw a, eyi yɛ nhwehwɛmu a edi kan a nnuruyɛfo bɛyɛ no mu biako.
• Hwɛ sɛnea koma nnuru ne koma oprehyɛn yɛ adwuma yiye: Sɛ wufi ase sa komayare a, ɛsɛ sɛ saa enzyme dodow yi so tew nkakrankakra. Sɛ wohwɛ sɛ ɛba saa anaa a, wubetumi asusuw sɛnea ayaresa no ayɛ yiye.
• Hyɛ nkɔmhyɛ a ɛbɛba wɔ komayare ahorow ho: Ɛne sɛ, saa enzyme dodow yi boa ma wonya adwene wɔ sɛnea yare no bɛkɔ so, sɛnea emu yɛ den, ne hokwan ahorow a ɛwɔ hɔ sɛ ne ho bɛtɔ no ho.

“Sɛsɔhwɛ yi te sɛ nhoma a ɛka koma no ho asɛm. Ɛma yehu nea ɛtoo koma no, ne tebea a ɛwɔ hɔ mprempren, ne nea ebetumi asi daakye.”

Ɛhe na wɔyɛ koma mu enzyme nhwehwɛmu yi?

Wobetumi ayɛ mogya a wɔbɛfa de ayɛ koma mu enzyme nhwehwɛmu yi wɔ simma kakraa bi pɛ mu.

• Wɔ tebea a egye ntɛmpɛ mu: Sɛ wowɔ tebea a egye ntɛmpɛ, te sɛ wo koko mu yaw, na wokɔ ayaresabea hɔ Emergency Treatment Unit (ETU) a, wɔbɛyɛ mogya mu nhwehwɛmu yi wɔ hɔ ara.
• Wɔ tebea a ɛnyɛ ntɛmpɛ mu: Ɛtɔ mmere bi a wo duruyɛfo betumi ahyɛ nhwehwɛmu yi, bere a wɔreyɛ nhwehwɛmu daa anaasɛ esiane sɛnkyerɛnne afoforo nti. Sɛ ɛba saa a, wubetumi akɔ baabi a wɔyɛ mogya mu nhwehwɛmu na woama wɔayɛ.

Koma mu enzymes (biomarkers) ahorow bɛn na ɛwɔ hɔ?

Koma mu biomarkers ahorow wɔ hɔ a ebetumi aka komayare ho asɛm akyerɛ wo. Ɛkame ayɛ sɛ eyinom nyinaa yɛ enzyme anaa protein. Eyinom bi dodow a ɛkɔ soro no betumi akyerɛ sɛ ebia wowɔ koma ne ntini mu yare anaa komayare foforo.

• Troponin: Eyi ne biomarker a ɛho hia sen biara na wɔtaa de di dwuma . Nnuruyɛfo di kan hwɛ troponin dodow mu hwɛ sɛ ebia komayare anaa ACS asɛe koma no anaa. Troponin dodow fi ase kɔ soro wɔ mogya no mu wɔ nnɔnhwerew kakraa bi (bɛyɛ nnɔnhwerew 3-4) akyi wɔ komayare akyi, na ebetumi akɔ soro akodu nnɔnhwerew 12. Afei nso, ebetumi akɔ so akɔ soro wɔ mogya no mu dapɛn biako anaa abien. Enti, ɛtɔ mmere bi a nnuruyɛfo san yɛ troponin sɔhwɛ yi nnɔnhwerew anaa nna kakraa biara de te baabi a asɛe no kodu ne sɛnea tebea no resakra no ase.

• Natriuretic Peptides (NPs): Eyinom yɛ protein foforo. Wɔma ɛkɔ mogya no mu bere a koma no ayɛ basaa dodo, titiriw wɔ tebea horow te sɛ koma a entumi nyɛ adwuma yiye mu . Ɛwom sɛ nnuruyɛfo tumi susuw peptide ahorow yi ahorow pii de, nanso wɔfrɛ nea wɔtaa de di dwuma kɛse no N-terminal proBNP (NT-proBNP) . Wobetumi de eyi ahwɛ sɛnea koma no ayɛ den esiane koma a entumi nyɛ adwuma yiye nti.

Hena na ohia koma mu enzyme (biomarker) nhwehwɛmu yi?

Ebia wo duruyɛfo bɛhyɛ saa koma mu enzyme nhwehwɛmu yi sɛ wowɔ sɛnkyerɛnne ahorow a ɛkyerɛ sɛ wowɔ komayare bi a. Nsɛnkyerɛnne a ɛtete saa no bi ne:

• Koko mu yaw anaasɛ ɛnyɛ dɛ:Eyi ne sɛnkyerɛnne titiriw a nnipa dodow no ara suro. Ebetumi aba ɔkwan bi so anaa ɔkwan foforo so. Ebinom fam no, ɛte sɛ nhyɛso, ebinom fam no, ɛte sɛ nea emu duru, ebinom fam no, ɛte sɛ nea wɔrehyew. Saa ɛyaw yi betumi atrɛw akɔ anom, kɔn, akyi mfinimfini, mmati, anaa nsa benkum nso.
• Adwenemhaw: Sɛ koma no ntumi nyɛ adwuma yiye a, mogya dodow a ɛsen kɔ amemene no mu no so betumi atew, na ama obi adwenem ayɛ no yaw.
• Akisikuru anaa Ɔfe: Komayare binom nso da saa sɛnkyerɛnne ahorow yi adi, titiriw wɔ mmea mu.
• Fifiri pii: Sɛ wote awɔw nka mpofirim na wo ho fifiri pii a ntease biara nnim a, ɛno nso yɛ sɛnkyerɛnne a ɛsɛ sɛ wode w’adwene si so.
• Ahome tiaa: Sɛ ɛyɛ den ma wo sɛ wobɛhome bere a worebɔ mmɔden nketenkete mpo, te sɛ antweri a wobɛforo, anaasɛ sɛ wote nka sɛ wo home yɛ tiaa bere a wugyina hɔ kɛkɛ mpo a, ɛsɛ sɛ wususuw eyi nso ho.
• Koma a entumi nyɛ adwuma yiye: Sɛ obi anya komayare dedaw a, ne sɛnkyerɛnne ahorow no kɔ soro mpofirim (e.g., ne nan ho ahonhon, ɔhome a ɛyɛ tiaa a ɛkɔ soro).

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi mu biako anaa nea ɛboro saa a, ɛho hia yiye sɛ wohwehwɛ aduruyɛfo afotu ntɛm ara.

Mogya mu nhwehwɛmu foforo bɛn na nnuruyɛfo de hu sɛ obi anya komayare anaa koma a asɛe?

Wɔ koma mu enzyme nhwehwɛmu akyi no, wo duruyɛfo betumi ahyɛ sɛ wɔnyɛ mogya mu nhwehwɛmu afoforo pii na ama woate wo tebea no ase yiye:

• Mogya Dodow a Edi Mu (CBC): Eyi kyerɛ nkwammoaa kɔkɔɔ, nkwammoaa fitaa, ne mogya mu nkwammoaa dodow a ɛwɔ mogya no mu. Ɛboa ma wohu tebea horow te sɛ mogya a ɛtɔ kɔ nipadua mu.
• Basic Metabolic Panel (BMP) : Eyi sɔ nneɛma te sɛ electrolytes (te sɛ sodium ne potassium), asaabo dwumadi, ne asikre dodow a ɛwɔ mogya mu hwɛ.
• Mogya mu Mframa Ho Nhwehwɛmu (ABG): Eyi na ɛkyerɛ sɛnea oxygen, carbon dioxide, ne acid-base kari pɛ wɔ mogya no mu. Eyi ho hia na ama woahu nea ɛde ɔhome a ɛyɛ den ba.

Nnwinnade ne nhwehwɛmu afoforo bɛn na wɔde hu sɛ obi anya komayare anaa koma a asɛe?

Mogya mu nhwehwɛmu akyi no, wo duruyɛfo betumi asi gyinae sɛ ɔbɛyɛ nhwehwɛmu afoforo pii de ahu wo koma tebea pɔtee:

• Chest X-ray: Wobetumi de eyi ahu nneɛma te sɛ ahurututu ne koma no kɛse ne ne nsɛso.
• Echocardiogram: Eyi te sɛ koma no mu ultrasound scan. Ebetumi ahwɛ koma no mu adan, ntini ahorow, ne sɛnea koma no rebɔ no yiye. Ɛtɔ mmere bi a wobetumi ayɛ echo sɔhwɛ titiriw bi a wɔfrɛ no Transesophageal Echocardiogram (TEE) nso.
• Electrocardiogram (ECG anaa EKG): Eyi kyerɛw anyinam ahoɔden dwumadi a ɛwɔ koma no mu. Etumi hu ɔhaw ahorow a ɛwɔ koma no nnyigyei mu ne komayare ho sɛnkyerɛnne ahorow.
• Apɔw-mu-teɛteɛ mu adwennwen ho sɔhwɛ anaa nuklea koma mu adwennwen sɔhwɛ: Wɔyɛ nhwehwɛmu ahorow yi de hwɛ sɛnea wo koma yɛ n’ade bere a woreteɛteɛ w’apɔw mu no.
• Angiogram: Wɔyɛ nhwehwɛmu yi de hu baabi pɔtee a asiw wɔ ahrawa mu ntini a ɛde mogya kɔ koma no mu no mu.
• Positron Emission Tomography (PET) Scan: Wɔde saa mfiridwuma mu nhwehwɛmu a ɛkorɔn yi di dwuma de hwɛ sɛnea koma mu nkwammoaa no te apɔw ne sɛnea mogya retu yiye.

Asɛmmisa a ɛne sɛ, “So merenya komayare anaasɛ minni?” yɛ kɛse. Wɔ mmere te sɛ eyinom mu no, wuhia mmuae a emu da hɔ na ama woakɔ w’anim. Ɛno nti na nnuruyɛfo de koma mu biomarker nhwehwɛmu ne nhwehwɛmu afoforo di dwuma no. Sɛ koma mu enzyme dodow a ɛwɔ wo mogya mu no kɔ soro a, ebetumi akyerɛ sɛ wo koma asɛe, ayɛ basaa, anaasɛ ayɛ wo hyew. Mprempren ne bere a ɛsɛ sɛ wubisa wo duruyɛfo nsɛm fa wo koma mu enzymes ne nea wo nhwehwɛmu no mu aba kyerɛ ho.

Nneɛma a ɛho hia a ɛsɛ sɛ wokae (Take-Home Message) .

Okay, enti momma yɛnbɔ nneɛma bi a ɛsɛ sɛ wokae fi nea yɛaka ho asɛm no mu no mua:

• Koma mu enzymes yɛ protein ahorow a efi koma nkwammoaa mu ba. Eyinom boaboa ano wɔ mogya no mu bere a koma no asɛe no.
• Koma mu enzyme nhwehwɛmu yɛ mogya mu nhwehwɛmu a ɛnyɛ den a ɛkyerɛ sɛnea saa enzyme ahorow yi dodow te.
• Saa sɔhwɛ yi tumi hu tebea horow te sɛ komayare, komayare afoforo, ne koma mu nhyɛso. Troponin ne enzyme titiriw a wɔde yɛ eyi.
• Sɛ wuhu sɛnkyerɛnne ahorow te sɛ wo koko mu yaw, ɛyɛ den sɛ wobɛhome, anaasɛ wo ho yɛ wo yaw a, ɛho hia sɛ wohwehwɛ aduruyɛfo afotu ntɛm ara.
• Mma w’adwene mu nyɛ wo naa wɔ wo sɔhwɛ mu aba no ho. Wo ne oduruyɛfo no nkasa na ma biribiara mu nna hɔ.

Wo koma ne w’agyapade a ɛsom bo sen biara. Ɛyɛ w’asɛyɛde sɛ wobɛhwɛ so. Sɛ wuhu sɔhwɛ ahorow te sɛ eyinom a, ɛbɛboa wo ma woadi saa asɛyɛde no ho dwuma!