Indaba ngenhliziyo yakho: Ake sifunde ngama-enzyme enhliziyo noma ama-biomarker enhliziyo.

Ngezinye izikhathi sizizwa sesaba kakhulu lapho sizwa ubuhlungu esifubeni noma kunzima ukuphefumula, akunjalo? Sicabanga ukuthi, "Ingabe lokhu kuwukuhlaselwa yinhliziyo?" Ngezikhathi ezinjengalezi, kuba nokuhlolwa kwegazi okukhethekile odokotela abakusebenzisayo ukuthola ukuthi kukhona yini okungahambi kahle enhliziyweni yakho. Yilokho okubizwa ngakho lokhu kuhlolwa kwe-enzyme yenhliziyo.

Ziyini lezi enzyme zenhliziyo?

Kalula nje, ama-enzyme enhliziyo amaprotheni akhethekile atholakala ngaphakathi kwamaseli enhliziyo yethu. Ama-enzyme amakhemikhali asiza imizimba yethu ukuthi yenze izinqubo zamakhemikhali, njengokugaya ukudla , ngendlela efanele. Cabanga ngale ndlela: inhliziyo yakho ifana nendlu. Kunezinto eziningi eziyigugu ngaphakathi kule ndlu. Ngokuvamile, lezi zinto zihlala ngaphakathi endlini futhi aziphumi.

Kodwa-ke, uma kukhona okonakalayo kule ndlu okubizwa ngokuthi inhliziyo, isibonelo, uma inhliziyo ingatholi umoya-mpilo owanele (lokhu sikubiza ngokuthi ischemia ), noma uma kwenzeka isimo esifana nokuhlaselwa yinhliziyo, amaseli enhliziyo ayalimala. Kufana nalapho udonga lwendlu luphukile, okuqukethwe ngaphakathi kuyaphuma. Ngemuva kwalokho, ama-enzyme enhliziyo ayengaphakathi kwalawo maseli aqala ukuqongelela egazini. Ngakho-ke, ukwanda kwenani lala ma-enzyme egazini kuyinkomba ebalulekile yokuthi kube nokucindezelwa, ukulimala, noma ukucindezeleka enhliziyweni . Lawa abizwa nangokuthi ama-biomarker enhliziyo , ngoba anikeza "isignali" mayelana nempilo yenhliziyo.

Ngakho-ke, luyini lolu vivinyo lwe-Cardiac Enzyme Marker?

Ukuhlolwa kwe-enzyme yenhliziyoEsinye isivivinyo esithatha isampula yegazi lakho bese silinganisa amazinga ala ma-enzyme akhethekile, noma ama-biomarker. Lokhu ukuhlolwa kwegazi okulula kakhulu. Inani elincane legazi lithathwa emthanjeni osengalweni yakho.

Udokotela usebenzisa lolu vivinyo ukuhlola ukuthi izinga lale enzyme egazini lijwayelekile noma liphakeme. Uma izinga lale enzyme liphakeme kakhulu kunezinga elinconywayo , kusho ukuthi kungenzeka ukuthi kube nokuhlaselwa yinhliziyo, noma ukuthi kungase kube nokucindezeleka okuthile enhliziyweni. Ngakho-ke, lolu luvivinyo olubaluleke kakhulu.

Odokotela bazisebenzisa kanjani lezi zimpawu zenhliziyo?

Manje ungase uzibuze, odokotela bangasithola kanjani isifo ngalokhu kuhlolwa kwegazi? Eqinisweni, odokotela bangaqonda okuningi ngokubheka amazinga alezi zimpawu zenhliziyo. Kufana nomphenyi ohlanganisa izinkomba.

Ngokwesibonelo:

• I-Acute Coronary Syndrome (ACS): Lesi yisimo esibangelwa ukwehla okungazelelwe kokugeleza kwegazi enhliziyweni. Lokhu kungaba yimbangela yokuhlaselwa yinhliziyo noma kungaba ukuhlaselwa yinhliziyo. Amazinga e-enzyme yenhliziyo angakhuphuka ngokushesha phakathi nalesi sikhathi.
• I-Myocardial Ischemia: Lokhu kwenzeka lapho imisipha yenhliziyo ingatholi umoya-mpilo owanele. Njengoba nje isitshalo sibuna lapho singenawo amanzi. Lapho amangqamuzana enhliziyo entula umoya-mpilo, ayacindezeleka futhi akhulule la ma-enzyme.
• Ukulimala kwemisipha yenhliziyo: Ezinye izimbangela, njengokutheleleka okuthile kanye nokuhlaselwa yinhliziyo okukhulu, nazo zingabangela umonakalo emisipheni yenhliziyo. Lawa ma-enzyme aqoqana egazini ngaleso sikhathi.

Ngayinye yalezi zimo inendlela yayo yokwelapha ehlukile. Ngakho-ke, kubalulekile ukuthola ukuxilongwa okunembile , ngoba yilapho ungathola khona ukwelashwa okufanele kakhulu nokusheshayo.

Iyini imigomo yalolu vivinyo lwe-biomarker yenhliziyo?

Odokotela bahlola amazinga alezi zimpawu zenhliziyo ngezizathu ezimbalwa eziyinhloko. Ake sibheke ukuthi ziyini:

• Ukuhlolwa komonakalo wenhliziyo nezinye izinkinga: Ngezinye izikhathi singase singabi nazo izimpawu ezinkulu, kodwa singase sibe nezinkinga ezincane eziqala ngaphakathi ezinhliziyweni zethu. Lokhu kuhlolwa kungaphinde kubone izinkinga ezinjalo ezifihliwe.
• Thola izimo zenhliziyo ezibangela izimpawu ezifana nobuhlungu besifuba kanye nokuphelelwa umoya : Lokhu ukuhlolwa okuvame ukwenziwa esimweni esiphuthumayo. Uma uya esibhedlela unesifo sesifuba, lokhu kungenye yezivivinyo zokuqala odokotela abazozenza.
• Qaphela ukuthi imithi yenhliziyo kanye nokuhlinzwa kwenhliziyo kusebenza kahle kangakanani: Ngemva kokuqala ukwelashwa kokuhlaselwa yinhliziyo, la mazinga e-enzyme kufanele anciphe kancane kancane. Ngokubona ukuthi lokho kuyenzeka yini, ungalinganisa impumelelo yokwelashwa.
• Bika isibikezelo sezimo ezahlukahlukene zenhliziyo: Okusho ukuthi, la mazinga e-enzyme asiza ekutholeni umbono wokuthi lesi sifo sizoqhubeka kanjani, ukuthi sibi kangakanani, nokuthi amathuba okululama angakanani.

"Lolu vivinyo lufana nencwadi elandisa indaba yenhliziyo. Lunikeza izinkomba ngalokho okwenzeke enhliziyweni, isimo sayo samanje, kanye nalokho okungenzeka esikhathini esizayo."

Kwenziwa kuphi lokhu kuhlolwa kwe-enzyme yenhliziyo?

Ukuthatha isampula yegazi ukuze kwenziwe lokhu kuhlolwa kwe-enzyme yenhliziyo kungenziwa ngemizuzu embalwa nje.

• Esimweni esiphuthumayo: Uma unesimo esiphuthumayo, njengobuhlungu besifuba, bese uya e-Emergency Treatment Unit (ETU) yesibhedlela, lokhu kuhlolwa kwegazi kuzokwenziwa khona lapho.
• Esimweni esingesona esiphuthumayo: Ngezinye izikhathi udokotela wakho angase akuyalele lokhu kuhlolwa, kungaba ngesikhathi sokuhlolwa okuvamile noma ngenxa yezinye izimpawu. Uma kunjalo, ungaya elabhorethri yokuhlola igazi bese ukwenza lokho.

Yiziphi izinhlobo zama-enzyme enhliziyo (ama-biomarker) akhona?

Kunezinhlobo ezahlukene ze-biomarker zenhliziyo ezingakutshela ngezinkinga zenhliziyo. Cishe zonke lezi ziyi-enzyme noma amaprotheni. Amazinga aphezulu ezinye zalezi zingabonisa ukuthi ungase ube nesifo senhliziyo noma esinye isimo senhliziyo.

• I-Troponin: Lena yi-biomarker ebaluleke kakhulu futhi evame ukusetshenziswa . Odokotela baqala ngokubheka amazinga e-troponin ukuze babone ukuthi inhliziyo yonakaliswe yini ukuhlaselwa yinhliziyo noma i-ACS. Amazinga e-Troponin aqala ukukhuphuka egazini zingakapheli amahora ambalwa (cishe amahora angu-3-4) ngemva kokuhlaselwa yinhliziyo, futhi angahlala ephakeme kuze kube amahora angu-12. Futhi, ingahlala iphakeme egazini isonto elilodwa noma amabili. Ngakho-ke, odokotela ngezinye izikhathi baphinda lokhu kuhlolwa kwe-troponin njalo emahoreni ambalwa noma ezinsukwini ezimbalwa ukuze baqonde ubukhulu bomonakalo nokuthi isimo sishintsha kanjani.

• Ama-Natriuretic Peptides (NPs): Lawa ngolunye uhlobo lweprotheni. Akhishwa egazini lapho inhliziyo ingaphansi kokucindezeleka okukhulu, ikakhulukazi ezimweni ezifana nokwehluleka kwenhliziyo . Nakuba odokotela bengalinganisa izinhlobo eziningana zala ma-peptide, avame kakhulu abizwa ngokuthi i-N-terminal proBNP (NT-proBNP) . Lokhu kungasetshenziswa ukuhlola ukuthi inhliziyo ingaphansi kokucindezeleka okungakanani ngenxa yokwehluleka kwenhliziyo.

Ubani odinga lolu vivinyo lwe-enzyme yenhliziyo (i-biomarker)?

Udokotela wakho angase akuyalele lokhu kuhlolwa kwe-enzyme yenhliziyo uma unezimpawu ezibonisa ukuthi unenkinga yenhliziyo. Izimpawu ezinjalo zifaka:

• Ubuhlungu besifuba noma ukungakhululeki:Lesi yisibonakaliso esiyinhloko abantu abaningi abasisabayo. Singafika ngesimo esithile noma esinye. Kwabanye, kuzwakala njengokucindezeleka, kwabanye, kuzwakala njengomthwalo, kwabanye kuzwakala njengomuzwa wokushisa. Lobuhlungu bungasakazekela emhlathini, entanyeni, emaphakathi nomhlane, emahlombe, noma engalweni yesobunxele.
• Isiyezi: Uma inhliziyo ingasebenzi kahle, inani legazi eligeleza liye ebuchosheni lingancipha, okubangela isiyezi.
• Isicanucanu noma Ukuhlanza: Ezinye izifo zenhliziyo nazo zibonisa lezi zimpawu, ikakhulukazi kwabesifazane.
• Ukujuluka kakhulu: Uma uzizwa ubanda ngokuzumayo futhi ujuluka kakhulu ngaphandle kwesizathu, lokho futhi kuyisibonakaliso okufanele usiqaphele.
• Ukuphefumula kanzima: Uma ukuthola kunzima ukuphefumula ngisho nangomzamo omncane, njengokukhwela izitebhisi, noma uma uzizwa uphelelwa umoya ngisho noma umi nje, lokhu kufanele kucatshangelwe.
• Ukwanda kokwehluleka kwenhliziyo: Uma umuntu esevele enesifo senhliziyo, izimpawu ziyanda ngokuzumayo (isib. ukuvuvukala kwemilenze, ukuphefumula okwandayo).

Uma unesinye noma ngaphezulu salezi zimpawu, kubaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha.

Yiziphi ezinye izivivinyo zegazi ezisetshenziswa odokotela ukuthola ukuhlaselwa yinhliziyo noma ukulimala kwenhliziyo?

Ngaphezu kokuhlolwa kwe-enzyme yenhliziyo, udokotela wakho angase acele ezinye izivivinyo eziningana zegazi ukuze aqonde kangcono isimo sakho:

• Ukubalwa Kwegazi Okuphelele (i-CBC): Lokhu kulinganisa inani lamaseli abomvu, amaseli amhlophe, nama-platelet egazini. Kusiza ekutholeni izimo ezifana ne-anemia.
• Iphaneli Eyisisekelo Ye-Metabolic (BMP) : Lokhu kuhlola izinto ezifana nama-electrolyte (njenge-sodium ne-potassium), ukusebenza kwezinso, kanye namazinga kashukela egazini.
• Ukuhlolwa Kwegesi Yegazi (ABG): Lokhu kulinganisa ibhalansi ye-oxygen, i-carbon dioxide, kanye ne-acid-base egazini. Lokhu kubalulekile ukuthola imbangela yobunzima bokuphefumula.

Yimiphi eminye imishini kanye nokuhlolwa okusetshenziselwa ukuxilonga ukuhlaselwa yinhliziyo noma ukulimala kwenhliziyo?

Ngaphezu kokuhlolwa kwegazi, udokotela wakho angase anqume ukwenza ezinye izivivinyo eziningana ukuze athole isimo esiqondile senhliziyo yakho:

• I-X-ray yesifuba: Lokhu kungasetshenziswa ukubona izinto ezifana nosayizi nesimo samaphaphu nenhliziyo.
• I-Echocardiogram: Lokhu kufana nokuskena kwenhliziyo nge-ultrasound. Kungabheka eduze amakamelo, ama-valve, nokuthi inhliziyo ishaya kanjani. Ngezinye izikhathi ukuhlolwa okukhethekile kwe-echo okubizwa nge -Transesophageal Echocardiogram (TEE) nakho kungenziwa.
• I-Electrocardiogram (ECG noma EKG): Lokhu kurekhoda umsebenzi kagesi wenhliziyo. Kungabona izinkinga ngesigqi senhliziyo kanye nezimpawu zokuhlaselwa yinhliziyo.
• Ukuhlolwa kokucindezeleka kokuzivocavoca noma ukuhlolwa kokucindezeleka kwenhliziyo: Lokhu kuhlolwa kwenziwa ukuze kubonwe ukuthi inhliziyo yakho isabela kanjani lapho uzivocavoca.
• I-Angiogram: Lokhu kuhlolwa kwenziwa ukuze kubonakale kahle ukuthi kukhona ukuvaleka kwemithambo yenhliziyo ehambisa igazi enhliziyweni.
• I-Positron Emission Tomography (PET) Scan: Lokhu kuskena kobuchwepheshe obuphezulu kusetshenziselwa ukubona ukuthi amangqamuzana enhliziyo aphilile kangakanani nokuthi igazi ligeleza kahle kangakanani.

Umbuzo othi, “Ingabe ngihlaselwa yinhliziyo noma cha?” ubaluleke kakhulu. Ngezikhathi ezinjengalezi, udinga izimpendulo ezicacile ukuze uqhubekele phambili. Yingakho odokotela besebenzisa izivivinyo ze-cardiac biomarker kanye nezinye izivivinyo. Uma amazinga akho egazi lama-enzyme enhliziyo ephakanyisiwe, kungabonisa ukuthi inhliziyo yakho yonakele, icindezelekile, noma ivuvukele. Manje yisikhathi sokubuza udokotela wakho imibuzo mayelana nama-enzyme akho enhliziyo nokuthi imiphumela yakho yokuhlolwa isho ukuthini.

Izinto ezibalulekile okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ake sifingqe ezinye zezinto okudingeka uzikhumbule kulokho esikhulume ngakho:

• Ama-enzyme enhliziyo amaprotheni akhishwa emaseli enhliziyo. Lawa aqoqana egazini lapho inhliziyo yonakele.
• Ukuhlolwa kwe-enzyme yenhliziyo kuwukuhlolwa kwegazi okulula okukala amazinga ala ma-enzyme.
• Lokhu kuhlolwa kungabona izimo ezifana nokuhlaselwa yinhliziyo, okunye ukulimala kwenhliziyo, kanye nokucindezeleka kwenhliziyo. I-Troponin iyi-enzyme eyinhloko esetshenziselwa lokhu.
• Uma uzwa izimpawu ezifana nobuhlungu besifuba, ubunzima bokuphefumula, noma isiyezi, kubalulekile ukufuna iseluleko sezokwelapha ngokushesha.
• Ungabi nokungabaza ngemiphumela yokuhlolwa kwakho. Khuluma nodokotela futhi ucacise konke.

Inhliziyo yakho iyimpahla yakho eyigugu kakhulu. Kungumthwalo wakho ukuyinakekela. Ukuqaphela izivivinyo ezinjengalezi kuzokusiza ukufeza lowo mthwalo wemfanelo!