Yintoni uvavanyo lweTroponin? Lubaluleke kangakanani ekuxilongeni isifo sentliziyo?

Xa ngequbuliso siva intlungu ebukhali esifubeni sethu, ukuziva sixinene, okanye ubunzima bokuphefumla, sonke siyoyika, akunjalo? Into yokuqala efika engqondweni kukuba, "Ngaba esi sisifo sentliziyo?" Ngexesha elinje, kwangoko nje ukuba ukhawuleziswe esibhedlele, ingakumbi iSebe leNgxamiseko (ETU), oogqirha baya kwenza iimvavanyo ezininzi ukuze bafumanise imeko yakho echanekileyo. Phakathi kwazo, uvavanyo lwegazi olubaluleke kakhulu noluphambili luvavanyo lweTroponin. Nangona abantu abaninzi bevile ngale nto, abazi ukuba yenza ntoni kanye kanye kwaye kutheni ibaluleke kangaka. Ke namhlanje, masithethe ngale nto ngokulula, ngendlela onokuyiqonda.

Ngamafutshane, yintoni olu vavanyo lweTroponin?

Kulungile, masiqonde oku ngale ndlela. I-Troponin luhlobo olukhethekileyo lweproteni olufumaneka ngaphakathi kweeseli zethu zemisipha yentliziyo. Cinga ngeeseli zethu zemisipha yentliziyo njengezindlu ezincinci. I-Troponin ifana nezinto ezingaphakathi kwezo zindlu. Kumntu ophilileyo oqhelekileyo, ezi zinto, ezibizwa ngokuba yi-troponin, zingaphakathi kwezindlu. Azingeni egazini. Kwaye nokuba ziyangena, ziza ngobuninzi obuncinci kangangokuba azinakubonwa.

Nangona kunjalo, kwimeko efana nokuhlaselwa yintliziyo, umthambo wegazi ohambisa intliziyo uyavalwa, kwaye iiseli zemisipha yentliziyo azifumani ioksijini eziyidingayo, kwaye ezo seli ziqala ukufa. Kufana naxa izindlu zonakele. Kwenzeka ntoni xa iindonga zendlu ziqhekeka? Umxholo ongaphakathi uphoswa ngaphandle, akunjalo? Ngendlela efanayo, xa iiseli zemisipha yentliziyo zonakele, iproteni ye-troponin engaphakathi kuzo ikhutshwa egazini.

Uvavanyo lwe-troponin lubandakanya ukuthatha isampuli yegazi lakho kunye nokulinganisa ukuba ingaba ikhona na i-troponin kuyo, kwaye ukuba kunjalo, ingakanani. Okukhona inqanaba le-troponin liphezulu egazini lakho, kokukhona umonakalo omkhulu kwimisipha yentliziyo. Oku kunokunceda oogqirha baqonde ubukhali bokuhlaselwa yintliziyo.

Uvavanyo olutsha lwe-troponin (uvavanyo lwe-troponin oluphezulu) lunobuthathaka kakhulu. Oku kuthetha ukuba olu vavanyo lunokufumanisa nokuba yi-troponin encinci kakhulu egazini. Oku kuye kunciphisa kakhulu ixesha elithathwayo ukufumanisa isifo sentliziyo. Kwakhona, ngamanye amaxesha nangona iimpawu zingacacanga, kwaye kungekho tshintsho lubalulekileyo kwi-ECG, olu vavanyo lunokuqinisekisa ukuba kukho isifo sentliziyo okanye akunjalo.

Ngaba kukho iintlobo ezimbini ze-troponin?

Ewe, kukho iintlobo ezimbini eziphambili ze-troponins ezikhutshwa egazini xa intliziyo yethu yonakele. Oogqirha babiza ezi ngoonobumba 'I' kunye 'T'.

• I-Troponin I (iTroponin I okanye i-cTnI): Le ikhethekile kakhulu kuba olu hlobo lwe-troponin lufumaneka kuphela kwimisipha yentliziyo.Oku akufumaneki nakweyiphi na enye imisipha emzimbeni wethu. Ngoko ke ukuba inqanaba le-troponin I egazini liphezulu, luphawu olucacileyo lokuba imisipha yentliziyo yonakele. Kufana nekhadi lokuzazisa elikhethekileyo entliziyweni.

• I-Troponin T (iTroponin T okanye i-cTnT): Olu hlobo lwe-troponin T lufumaneka ngobuninzi obuncinci kwezinye izihlunu emzimbeni wethu (umzekelo, izihlunu ezinamathele emathanjeni). Kodwa ungakhathazeki. Ulwakhiwo lwe-troponin T entliziyweni lwahlukile kancinci kolo lufumaneka kwenye indawo. Uvavanyo lwanamhlanje lunokukhetha kuphela kwaye lulinganise i-troponin T ethile yentliziyo.

Emva kohlaselo lwentliziyo, la manqanaba e-troponin adla ngokuqala ukunyuka ngokukhawuleza phakathi kweeyure ezi-3 nezili-12 . Afikelela kwinqanaba eliphezulu malunga neeyure ezingama-24 . Ahlala ephezulu egazini kangangeentsuku ezimbalwa emva koko. Ke ngoko, nokuba unentlungu esifubeni kwaye uye esibhedlele emva kosuku okanye ezimbini, olu vavanyo lunokufumanisa ukuba ukhe wahlaselwa yintliziyo na.

Ingaba olu vavanyo lwenzelwa isifo sentliziyo kuphela?

Hayi. Uvavanyo lwe-troponin lusetyenziswa kakhulu ukuxilonga uhlaselo lwentliziyo, kodwa amanqanaba e-troponin anokunyuswa nakweyiphi na imeko enokwenzakalisa izihlunu zentliziyo. Oku kuthetha ukuba amanqanaba aphezulu e-troponin akuthethi ukuba uhlaselo lwentliziyo. Ugqirha wakho uya kwenza uxilongo oluchanekileyo ngokusekelwe kwiimpawu zakho kunye nazo zonke ezinye iziphumo zovavanyo lwakho.

Nazi ezinye izizathu zokuba amanqanaba e-troponin anokunyuka:

• Isifo sezintso esingapheliyo: Xa izintso zingasebenzi kakuhle, izinto ezifana ne-troponin emzimbeni azihluzwa kwaye azisuswa ngokufanelekileyo. Ke ngoko, inqanaba le-troponin egazini linokuba phezulu.
• I-Pulmonary embolism: Le yimeko engxamisekileyo. Oku kubeka uxinzelelo olukhulu entliziyweni, nto leyo ebangela umonakalo kwimisipha yentliziyo kunye nokukhululwa kwe-troponin.
• Ukusilela kwentliziyo okubangelwa kukungaqini kakuhle: Xa intliziyo iba buthathaka kwaye ingakwazi ukupompa igazi elaneleyo emzimbeni, izihlunu zentliziyo zinokuqhubeka nokonakala.
• Utyando lwentliziyo: Kuqhelekile ukuba kubekho umonakalo othile kwimisipha yentliziyo ngexesha lotyando lwentliziyo, ngoko ke amanqanaba e-troponin ayanda emva kotyando.
• Izifo zevalvu yentliziyo: Xa iivalvu zentliziyo zingasebenzi kakuhle, intliziyo kufuneka isebenze nzima. Oku kungonakalisa izihlunu zentliziyo ngokuhamba kwexesha.
• I-Arrhythmias: Xa intliziyo ibetha ngesantya esingaqhelekanga, inokonakalisa izihlunu zentliziyo.
• Usulelo olunzima oluye lwasasazeka emzimbeni wonke (iSepsis): Kwimeko enjalo, ukusabela komzimba kungonakalisa amalungu omzimba kuquka nentliziyo.
• Ukuzilolonga okugqithisileyo: Nokuba umthambo onzima kakhulu, onganyamezelekiyo ngamanye amaxesha unokunyusa amanqanaba e-troponin okwethutyana.
• Uxinzelelo okanye ukwenzakala okugqithisileyo: Umsebenzi wehomoni owenzeka xa uziva ulusizi, ukwenzakala, okanye uxinzelelo olungenakunyamezeleka unokonakalisa izihlunu zentliziyo.

Lwenziwa njani olu vavanyo? Yintoni ekufuneka uyazi?

Olu luvavanyo olulula kakhulu. Lubandakanya ukuthatha isampuli encinci yegazi kumthambo osengalweni yakho. Ukuba sele unomgca we-IV, ungathabatha igazi kuloo mthambo. Ngoko ke akufuneki ufumane inaliti.

Ekubeni olu vavanyo ludla ngokwenziwa xa kukho imeko engxamisekileyo, akukho mfuneko yokululungiselela kwangaphambili. Kodwa kukho into enye ebaluleke kakhulu ekufuneka uyazi.

Ukuba uthatha iivithamini okanye izongezo ezinevithamini B7, okanye i-biotin, ngokuqinisekileyo kufuneka uxelele ugqirha wakho ngayo loo nto. Ezinye iimveliso zobuhle, ingakumbi iivithamini zeenwele, ulusu, kunye nempilo yezipikili, ziqulethe i-biotin eninzi. Le biotin inokuchaphazela iziphumo zovavanyo lwe-troponin. Oku kuthetha ukuba nokuba inqanaba lakho le-troponin liphezulu, linokubonakala liphantsi kwingxelo ngenxa ye-biotin. Ayiyongozi loo nto? Ngoko ke luxanduva lwakho ukwazisa ugqirha wakho ngale nto.

Ngokwesiqhelo, oogqirha abalindi ukuba ingxelo ye-troponin ifike xa kurhanelwa ukuba kukho isifo sentliziyo. Bajonga iimpawu kunye ne-ECG, baze baqale amayeza okuhlaselwa sisifo sentliziyo ngoko nangoko. Kuba umzuzwana ngamnye uxabisekile ngexesha elinje. Emva koko, xa ingxelo ye-troponin ifika, batshintsha unyango ngokufanelekileyo, ukuba kuyimfuneko.

Ndiyiqonda njani ingxelo yovavanyo?

Ingxelo yovavanyo lwe-troponin idla ngokufumaneka kwisithuba seyure okanye ezimbini. Nje ukuba iziphumo zifunyenwe, ugqirha uza kukuchazela zona.

Ngokwesiqhelo, inqanaba le-troponin egazini lomntu ophilileyo liphantsi kakhulu, okanye alibonakali. La maxabiso anokwahluka kancinci kwilabhoratri nganye kwaye kuxhomekeke kumatshini osetyenzisiweyo. Nangona kunjalo, la ngamaxabiso amkelekileyo ngokubanzi.

I-`ng/mL` kule ngxelo imele ii-nanograms nge-milliliter. Cinga ngayo, i-nanogram yibhiliyoni enye yegram. Elo lixabiso lincinci kakhulu. Oku kufanele kukunike umbono wokuba lincinci kangakanani inani le-troponin egazini lomntu ophilileyo.

Ukuba iziphumo zakho ze-troponin ziphezulu kunolu luhlu luqhelekileyo, zibizwa ngokuba yi-"evated troponin." Oku kuthetha ukuba izihlunu zentliziyo zonakele kwaye i-troponin iqokelelene egazini.

Kutheni kufuneka uphinde uvavanyo?

Usenokuba ukhe wambona ugqirha wakho ekwenza uvavanyo lwe-troponin kanye xa ungeniswa esibhedlele, waze waphinda wenza uvavanyo emva kweeyure ezimbalwa (umz. iiyure ezi-3, iiyure ezi-6). Bakwenza oko ngesizathu esithile.

• Jonga ukuba inqanaba liyanyuka na: Ukuba inqanaba le-troponin liphezulu kwingxelo yesibini kunakwingxelo yokuqala ("ipateni enyukayo"), oku kubonelela ngobungqina obuqinileyo bokuba kukho uhlaselo lwentliziyo.
• Qonda ubungakanani bomonakalo: Ukuba inqanaba le-troponin liphakama kangakanani kwaye lihlala liphezulu kangakanani kunokunika umbono wobunzima bomonakalo.

Amanqanaba eTroponin I ahlala ephakanyisiwe kangangeentsuku ezi-5-7 emva kokuhlaselwa yintliziyo. Amanqanaba eTroponin T anokuhlala ephakanyisiwe ukuya kuthi ga kwiiveki ezi-3.