Kuyini Ukuhlolwa kweTroponin? Kubaluleke kangakanani ekuxilongweni kokuhlaselwa yinhliziyo?

Uma ngokuzumayo sizwa ubuhlungu obukhulu phakathi kwesifuba sethu, umuzwa wokuqina, noma ubunzima bokuphefumula, sonke sesaba, akunjalo? Into yokuqala efika engqondweni ukuthi, "Ingabe lokhu ukuhlaselwa yinhliziyo?" Ngesikhathi esinjengalesi, ngokushesha nje lapho uphuthunyiswa esibhedlela, ikakhulukazi uMnyango Wezimo Eziphuthumayo (ETU), odokotela bazokwenza izivivinyo eziningana ukuze bathole isimo sakho esiqondile. Phakathi kwazo, ukuhlolwa kwegazi okubaluleke kakhulu nokuyinhloko ukuhlolwa kwegazi i-Troponin. Nakuba abantu abaningi bezwile ngalokhu, abazi kahle ukuthi kwenzani nokuthi kungani kubaluleke kangaka. Ngakho-ke namuhla, ake sixoxe ngalokhu kalula, ngendlela ongayiqonda.

Kalula nje, luyini lolu vivinyo lweTroponin?

Kulungile, ake sikuqonde lokhu ngale ndlela. I-Troponin uhlobo olukhethekile lweprotheni olutholakala ngaphakathi kwamaseli ethu emisipha yenhliziyo. Cabanga ngamaseli ethu emisipha yenhliziyo njengezindlu ezincane. I-Troponin ifana nezinto ezingaphakathi kwalezo zindlu. Kumuntu ophilile kahle, lezi zinto, ezibizwa ngokuthi i-troponin, zingaphakathi kwezindlu. Azingeni egazini. Futhi noma ngabe zingena, ziza ngamanani amancane kangangokuthi azikwazi ukutholakala.

Kodwa-ke, esimweni esifana nokuhlaselwa yinhliziyo, umthambo wegazi ohlinzeka ngenhliziyo uyavaleka, futhi amangqamuzana emisipha yenhliziyo awatholi umoya-mpilo awudingayo, futhi lawo maseli aqala ukufa. Kufana nalapho izindlu zonakele. Kwenzekani lapho izindonga zendlu ziphuka? Okuqukethwe ngaphakathi kuyaphonswa ngaphandle, akunjalo? Ngendlela efanayo, lapho amangqamuzana emisipha yenhliziyo onakele, iphrotheni ye-troponin engaphakathi kwawo ikhishwa iye egazini.

Ukuhlolwa kwe-troponin kuhilela ukuthatha isampula yegazi lakho bese kulinganiswa ukuthi ikhona yini i-troponin kulo, futhi uma kunjalo, ingakanani. Uma izinga le-troponin liphezulu egazini lakho, kulapho umonakalo omkhulu uba khona emisipheni yenhliziyo. Lokhu kungasiza odokotela baqonde ubukhali bokuhlaselwa yinhliziyo.

Ukuhlolwa okusha kwe-troponin (ukuhlolwa kwe-troponin okuzwela kakhulu) kuyazwela kakhulu. Lokhu kusho ukuthi lokhu kuhlolwa kungathola ngisho nenani elincane kakhulu le-troponin egazini. Lokhu kuye kwehlisa kakhulu isikhathi esithathwayo ukuxilonga ukuhlaselwa yinhliziyo. Futhi, ngezinye izikhathi ngisho nalapho izimpawu zingabonakali, futhi kungekho shintsho olubalulekile ku-ECG, lokhu kuhlolwa kungaqinisekisa ukuthi kukhona yini ukuhlaselwa yinhliziyo noma cha.

Ingabe kunezinhlobo ezimbili ze-troponin?

Yebo, kunezinhlobo ezimbili eziyinhloko zama-troponins ezikhishwa egazini lapho inhliziyo yethu yonakele. Odokotela babiza lezi zinhlobo ngo-'I' no-'T'.

• I-Troponin I (i-Troponin I noma i-cTnI): Lokhu kukhetheke kakhulu ngoba lolu hlobo lwe-troponin lutholakala kuphela emisipheni yenhliziyo.Lokhu akutholakali kunoma yimuphi omunye umsipha emzimbeni wethu. Ngakho-ke uma izinga le-troponin I egazini liphakeme, kuyisibonakaliso esicacile sokuthi umsipha wenhliziyo wonakele. Kufana nekhadi lokuzazisa elihlukile enhliziyweni.

• I-Troponin T (i-Troponin T noma i-cTnT): Lolu hlobo lwe-troponin T lukhona ngobuningi obuncane kweminye imisipha emzimbeni wethu (isibonelo, imisipha enamathele emathanjeni). Kodwa ungakhathazeki. Isakhiwo se-troponin T enhliziyweni sihluke kancane kunesitholakala kwenye indawo. Ukuhlolwa kwanamuhla kungakhetha futhi kulinganise kuphela i-troponin T eqondene nenhliziyo.

Ngemva kokuhlaselwa yinhliziyo, la mazinga e-troponin avame ukuqala ukukhuphuka ngokushesha phakathi kwamahora amathathu kuya kwangu-12 . Afinyelela esicongweni cishe emahoreni angu-24 . Ahlala ephakeme egazini izinsuku eziningana ngemva kwalokho. Ngakho-ke, noma ngabe uzwa ubuhlungu esifubeni futhi uya esibhedlela ngemva kosuku noma ezimbili, lokhu kuhlolwa kungabona ukuthi uke waba nokuhlaselwa yinhliziyo.

Ingabe lokhu kuhlolwa kwenziwa kuphela ngenxa yesifo senhliziyo?

Cha. Ukuhlolwa kwe-troponin kuvame ukusetshenziselwa ukuxilonga ukuhlaselwa yinhliziyo, kodwa amazinga e-troponin angakhushulwa kunoma yisiphi esinye isimo esingalimaza imisipha yenhliziyo. Lokhu kusho ukuthi amazinga aphezulu e-troponin akusho ngaso sonke isikhathi ukuthi uhlaselwe yinhliziyo. Udokotela wakho uzokwenza ukuxilongwa okunembile ngokusekelwe ezimpawu zakho kanye nayo yonke eminye imiphumela yakho yokuhlolwa.

Nazi ezinye izizathu zokuthi kungani amazinga e-troponin engase akhuphuke:

• Isifo sezinso esingamahlalakhona: Uma izinso zingasebenzi kahle, izinto ezifana ne-troponin emzimbeni azihlungwa futhi azisuswa kahle. Ngakho-ke, izinga le-troponin egazini lingaba phezulu nje.
• I-pulmonary embolism: Lokhu kuyisimo esiphuthumayo. Lokhu kubeka ingcindezi enkulu enhliziyweni, okubangela umonakalo emisipheni yenhliziyo kanye nokukhishwa kwe-troponin.
• Ukwehluleka kwenhliziyo okubangelwa ukuminyana: Lapho inhliziyo iba buthakathaka futhi ingakwazi ukupompa igazi elanele emzimbeni, imisipha yenhliziyo ingaqhubeka nokulimala.
• Ukuhlinzwa kwenhliziyo: Kuvamile ukuthi kube nomonakalo othile emisipheni yenhliziyo ngesikhathi sokuhlinzwa kwenhliziyo, ngakho amazinga e-troponin ayanda ngemva kokuhlinzwa.
• Izifo zamavalvu enhliziyo: Uma amavalvu enhliziyo engasebenzi kahle, inhliziyo kufanele isebenze kanzima. Lokhu kungalimaza imisipha yenhliziyo ngokuhamba kwesikhathi.
• I-Arrhythmias: Uma inhliziyo ishaya ngokushesha okungajwayelekile, ingalimaza imisipha yenhliziyo.
• Ukutheleleka okukhulu okusakazeke kuwo wonke umzimba (i-Sepsis): Kulesi simo, ukusabela komzimba kungalimaza izitho zomzimba okuhlanganisa nenhliziyo.
• Ukuvivinya umzimba ngokweqile: Ngisho nokuvivinya umzimba okunzima kakhulu nokungabekezeleleki ngezinye izikhathi kungakhuphula amazinga e-troponin okwesikhashana.
• Ukucindezeleka noma ukuhlukumezeka ngokweqile: Umsebenzi wama-hormone owenzeka lapho uzwa ukudabuka okungabekezeleleki, ukuhlukumezeka, noma ukucindezeleka nakho kungalimaza imisipha yenhliziyo.

Kwenziwa kanjani lokhu kuhlolwa? Yini okudingeka uyazi?

Lokhu ukuhlolwa okulula kakhulu. Kuhilela ukuthatha isampula encane yegazi emthanjeni osengalweni yakho. Uma usuvele une-IV line, ungathatha igazi kulokho. Ngakho-ke awudingi ukuthola inalithi.

Njengoba lokhu kuhlolwa kuvame ukwenziwa esimweni esiphuthumayo, asikho isidingo sokukulungiselela kusenesikhathi. Kodwa kukhona into eyodwa ebaluleke kakhulu okufanele uyazi.

Uma uthatha amavithamini noma izithasiselo eziqukethe i-vitamin B7, noma i-biotin, kufanele nakanjani utshele udokotela wakho ngakho. Eminye imikhiqizo yobuhle, ikakhulukazi amavithamini ezinwele, isikhumba, kanye nempilo yezinzipho, iqukethe i-biotin eningi. Le biotin ingathinta imiphumela yokuhlolwa kwe-troponin. Lokhu kusho ukuthi noma ngabe izinga lakho le-troponin liphezulu, lingabonakala liphansi embikweni ngenxa ye-biotin. Akuyona yini ingozi lokho? Ngakho-ke kungumthwalo wakho wemfanelo ukwazisa udokotela wakho ngalokhu.

Ngokuvamile, odokotela abalindi ukuthi kufike umbiko we-troponin uma kusolwa ukuthi kukhona ukuhlaselwa yinhliziyo. Babheka izimpawu kanye ne-ECG, bese beqala imithi yokuhlaselwa yinhliziyo ngokushesha. Ngoba umzuzwana ngamunye uyigugu ngesikhathi esinjengalesi. Bese kuthi lapho kufika umbiko we-troponin, bashintshe ukwelashwa ngokufanele, uma kudingeka.

Ngiwuqonda kanjani umbiko wokuhlolwa?

Umbiko wokuhlolwa kwe-troponin uvame ukutholakala phakathi nehora noma amabili. Uma imiphumela isitholiwe, udokotela uzokuchazela yona.

Ngokuvamile, izinga le-troponin egazini lomuntu ophilile liphansi kakhulu, noma alibonakali. Lawa manani angahluka kancane kusukela elabhorethri kuya elabhorethri futhi kuye ngomshini osetshenzisiwe. Kodwa-ke, lawa manani amukelekayo ngokuvamile.

I-`ng/mL` kulo mbiko imele ama-nanograms nge-milliliter. Cabanga ngakho, i-nanogram iyi-1 billionth yegremu. Lelo inani elincane kakhulu. Lokhu kufanele kukunike umbono wokuthi lincane kangakanani inani le-troponin egazini lomuntu ophilile.

Uma umphumela wakho we-troponin uphakeme kunalolu hlu olujwayelekile, ubizwa ngokuthi "i-troponin ephakanyisiwe." Kusho ukuthi imisipha yenhliziyo yonakele futhi i-troponin iqongelele egazini.

Kungani kufanele uphinde uvivinye?

Kungenzeka ukuthi uke wabona udokotela wakho enza ukuhlolwa kwe-troponin kanye lapho ungeniswa esibhedlela, bese enza ukuhlolwa futhi ngemva kwamahora ambalwa (isib. amahora ama-3, amahora ayisithupha). Bakwenza lokho ngesizathu esithile.

• Bheka ukuthi izinga liyakhuphuka yini: Uma izinga le-troponin liphezulu embikweni wesibili kunasembikweni wokuqala ("iphethini ekhuphukayo"), lokhu kunikeza ubufakazi obuqinile bokuthi kukhona ukuhlaselwa yinhliziyo.
• Qonda ubukhulu bomonakalo: Ukuthi izinga le-troponin likhuphuka kangakanani nokuthi lihlala isikhathi esingakanani liphakeme kunganikeza umbono wobukhulu bomonakalo.

Amazinga e-Troponin I ahlala ephakeme cishe izinsuku ezi-5-7 ngemva kokuhlaselwa yinhliziyo. Amazinga e-Troponin T angahlala ephakeme kuze kube amasonto ama-3.