Gịnị bụ troponin? Iwu, isi na-egosi na ha pụtara

Na 2000, European Community Cardiology na American College of Cardiology kwetara na nchoputa nke myocardial infarction. Iji nyochaa nchoputa kpebiri iji analysis of larịị nke gbasara obi troponins, dị ka ọ na-atụle ihe kpọmkwem maka nchoputa nke obi muscle mmebi karịa creatine, ọbụna mgbe nke obere myocardial necrosis.

troponins

Troponin - a protein molekul esịnede atọ subunits (T, C, 1). Ọ na-emi odude na actin filaments na muscle infarction na atụ ya, he. Onye ọ bụla subunit emezu ya kpọmkwem ọrụ ndị na inye ọrụ nke obi muscle. Ke idem, n'ihi na ọtụtụ akụkụ, adịkwaghị ibikwa troponin. Nkịtị ọbara (and / ml) - 2.0, n'ihi na isii percent nke ndị a na-edozi dị ke cytosol.

Ọ nọ na-ekpughe mbibi nke cardiomyocytes na elu ọbara ụba etoju nke dị iche iche ụmụ irighiri ihe nke troponin. Mgbe ụfọdụ, ọnụ ọgụgụ n'elu na-ahụkarị na ọtụtụ narị ma ọ bụ ọbụna ọtụtụ puku ugboro.

ọrụ

Ka ugbua kwuru n'elu, troponin mmasị a protein tropomyosin. Na ihe na-adịghị ejekwa ala, mgbe muscle bụ nọrọ jụụ, nke a protein na-egbochi ndị a na-agbaso nke myosin ka actin. Mgbe edinam nwere esịmde muscle mkpụrụ ndụ natara ghaghị ebubo ion site calcium ọwa na cell cytoplasm. Part nke calcium na-mmasị troponin na enyi. Nke a na-enye ohere ịnweta myosin na actin filaments akpata mkpi.

Ọ bụghị nanị na na myocardium bụ troponin. Ahụkarị ya nkịtị bụ iri itoolu na ise percent. The fọdụrụ akụkụ bụ na a free obodo ma ọ bụ na-ekesa na ndị ọzọ ụdị muscle anụ ahụ. Isi ihe dị iche bụ na skeletal muscle troponin subunits nke anọ, na nime obi muscle - atọ.

physiology

Acronyms niile ụdị uru ahụ na-achikota site na-agbanwe ịta nke intracellular calcium ion. Mgbe ha nọmba enwekwu, na muscle contracts, na Anglịkan. The protein nke onu na mmasị calcium - bụ troponin. ọnọdụ nke ya norm na tropomyosin kwekọrọ na ogologo nke ikpeazụ, ya bụ 40 nanometers.

Troponin nwere atọ subunits, ọ bụla nke nwere ya ọrụ. Mgbe calcium bụ mmasị na C-ibe akwụkwọ, tropomyosin na actin filament Nkea ka myosin nwere ike iso ya. Ọ bụrụ na ezuru calcium, tropomyosin nkanka ifịk na saịtị na-eme ka ọ gaghị ekwe omume itinye myosin myofilaments.

Of microbiology na histology na-hụrụ na troponin 1 suppresses guzobe ọhụrụ ọbara arịa. Troponin C ejikọ calcium ion, na nke a na-akpata mgbanwe troponin 1. Troponin T a chọrọ iji na-ekwurịta okwu na tropomyosin na troponin 1 ejikọ na actin, na-enyekwara na-emekọ ihe actin myosin mgbe calcium ion na cytoplasm ezughi oke.

Nkwadebe na analysis nke na-egosi maka nzube

Na larịị nke troponin na nkịtị elu ọbara ya kacha mma ekpe ikpe site na quantitative analysis. N'ihi ya nnyefe anaghị achọ ihe ọ bụla kpọmkwem nkwadebe, ma, dị ka mgbe nile ọbara onyinye, ọ dị mma na-eme ya na awa anọ mgbe eri.

Ọ bụrụ na ndị ụlọ ọgwụ na-enweta a ndidi na nnukwu myocardial infarction, ọ ozugbo weere a ọbara ule. Dị ka protocol ọ dị mkpa ikwugharị n'elu 4 awa, na mgbe ahụ site ụbọchị 8. Mgbe troponin rụrụ otu ugboro n'ụbọchị izu abụọ. Na nkà mmụta ọgwụ ọgbara, ụzọ kpebie ego nke a protein kpọmkwem na ndị àkwà iji ule na usoro. A na-adịghị mma n'ihi na-enye ohere ewepu ndị dị otú ahụ ọrịa si ndị nwere nnukwu akwara syndrome nwere ike ịzụlite na n'ọdịnihu dị nso.

Ọzọkwa definition nke nnukwu myocardial infarction (MI), ọnụ ọgụgụ nke troponin analysis a na-eme ka a mata sub-nnukwu ụdị infarction microinfarction, "nkịtị" nkụchi obi, na-na-nyochaa àgwà nke thrombolytic ọgwụ na mmetụta nke ime ihe n'onwe nke anticoagulants, dị ka heparin.

Mụbara troponin 1

Troponin 1 (nkịtị ọbara na 0,1 and / ml) nwere ike mgbe ịwa ahụ adọ na obi. N'ihi ya, na a ngwa transplantation troponin ịta-abawanye 5 nanograms kwa milliliter. Nke a bara uru nwere ike ịchekwa ruo ọnwa atọ.

Mkpali ọrịa obi na ọrịa na mmerụ na-akpata a nta na-abawanye na larịị nke troponin T, ma Ọnọdụ nke ya mgbanwe ọbara dị iche n'ebe na MI. The norm na ọbara troponin na ndị ikom na ndị inyom ahụ. Nke a na egosi na-adịghị metụtara okike ma ọ bụ afọ nke onye ọrịa. Mgbe ụfọdụ, e nwere ike ịbụ a ụgha mma ule ma ọ bụrụ na onye ọrịa bụ na a na steeti nke nnukwu mmanya igbu egbu.

A nta na-abawanye na troponin omume na oke mmebi skeletal muscle. N'ihi na ha tụnyere, creatine phosphokinase (CPK) na ndị ọrịa a enwekwu budata, dapụtara na-ekwesịghị ịdị na ndebanye aha nke myocardial infarction.

Nnukwu myocardial infarction

Troponin 1 (ọbara ọnụego ka 0,1 and / ml) bụ pathognomonic ịrịba ama nke nnukwu myocardial infarction naanị ma ọ bụrụ na ya bara uru karịa 100 and / ml, ma ọ bụ ukwuu karịa 99 percentile nke nkịtị nso. Ma ọ bụ nanị na njikọ na-adakarị na instrumental mgbaàmà nke myocardial ischemia.

Dị ka a n'ihi nke iwebata n'ime ọgwụ omume nke a analysis, ọnụ ọgụgụ nke diagnoses nke obi ọgụ mụbara, ebe ọ bụ na nke a ule bụ ihe mwute karịa creatine kinez. Ọzọkwa, na okwu nke ụba prognostic troponin ọ bụ a na-ezighị ezi ihe ịrịba ama. Ụfọdụ na-eme nnyocha na-ekwu na ndị thrombus size bụ ra nrata ka larịị nke troponin n'ime ọbara ọbara.

Ịba larịị nke a protein na ọrịa na myocardial dere n'ime isii awa mgbe mmalite nke ihe mgbu ọgụ. Iri na anọ na ụbọchị troponin larịị nwayọọ nwayọọ na-ọwọrọde na o kwesịrị.

Nnukwu akwara syndrome

Nkịtị ọbara troponin na nnukwu akwara syndrome (ACS) yiri na na na myocardial infarction na site 50 ruo 100 and / ml. Amụba protein ACS-enye anyị ohere iche si ejighị n'aka rịaworo. Mgbe ụfọdụ, ọrịa na-ahụkarị na-adakarị mgbaàmà na elu troponin etoju ke akwara angiography na-adịghị aha oké njọ imebi nke hemodynamics. Ihe kpatara nke a onu - n'amaghi guzobere mbadamba nkume ndị e nke dissolves n'oge thrombolytic ọgwụgwọ. The abụọ ozizi na-ekwu na ndị clot nanị dara n'okpuru arịa, na adịghị anya na ihuenyo.

Percutaneous akwara aka

Troponin (norm na 2.0 and / ml) e ubé ụba mgbe angioplasty ma ọ bụ stent pụrụ isi chọta. Ọkà mmụta sayensị nwere doro anya na ndi na-edozi, nke na-ekpebisi ike, pụta si cardiomyocytes. Ihe kpatara ya bụ usoro iheomume nke ọdịdị ha na-agafe ischemia, nke e mere site ịfụ elu balloon na clamping na akwara akwara.

Ọbụna na ikpe nke Micro mkpasasị uche bu oké mwute troponins infarction, nke, N'ezie, ekere ke elu ọbara. Ma, ihe nile elu, ọ na-egosi na ọrịa na a yiri ihe ize ndụ nke elu-etoju nke protein mgbanwe na mmepe nke akwara syndrome na myocardial infarction. Nwute, kpọmkwem ole ihe ụfọdụ, nke dọkịta nwere ike na-edu ha amụma adịghị adị. Ụfọdụ okwu banyere pathophysiology enye myocardial infarction mgbe troponin larịị karịa karịa ugboro atọ.

ịwa

Troponin (norm na 2.0 and / ml) ụba mgbe buu ịwa obi muscle. Nke a bụ n'ihi na-adịghị emezi emezi cardioprotective omume. Na Ozizi, ha na-azọrọ na e chebe ọrịa ahụ site hypoxia, ma na na omume na nke a bụ bụghị mgbe niile otu narị percent. Ma, ọ bụghị mgbe nile na-amụba troponin ga-ahuta ka a perioperative myocardial infarction.

Ọ ga-ekele ego na oge nke na-arụ ọrụ, nakwa dị ka na mbụ larịị nke protein. Diagnosis "myocardial infarction"-ekwe omume nanị site ọnụnọ nke na-adakarị, laabu na instrumental ịrịba ama n'out oge.

ọzọ ala

Ọtụtụ nnyocha e mere gosiri na eziokwu na troponin (nkịtị 2.0 and / ml) bụ a ukwuu kpọmkwem welara nke myocardial infarction. Ma e nwere ndị a ọnụ ọgụgụ nke enweghị nchịkwa ọnọdụ, nke na-na-esonyere na-abawanye na ego nke a protein na elu ọbara. Ndị a gụnyere sepsis, akpa ume embolism (Pee), obi ọdịda, mbufụt nke obi akpa, myocarditis, ala ala gbasara akụrụ odida, oké omumu, obi transplantation, na-anara ọgwụ.

Nke a na onu na-kpatara fever, tachycardia, hypoxia, a mebiri nke microvasculature, kpukpru usen nsogbu na anaemia. All a na-eduga ná myocardial ischemia na mbibi nke cardiomyocytes, nke na-akpata na-abawanye na troponin.

1 ma ọ bụ troponin T

Nkịtị ọbara troponin ka 2.0 and / ml, ma e nwere ụzọ dị iche iche maka ịchọpụta na ụmụ irighiri ihe nke troponin taa. Ọ na-ekwe ka ndị ọzọ n'ụzọ ziri ezi chọpụta mmebi nke myocardium. N'ihi na a ọnụ ọgụgụ nke ọmụmụ gosiri na troponin-T bụ ihe susceptible ka akụrụ odida, na troponin 1, ma ndị ọzọ kwa na-yiri, ya mere, nwere otu na-achọpụta ọrịa uru.

The peculiarity nke troponin T ke eziokwu na ọ na-arụpụta a na-achọpụta ọrịa kit maka naanị otu ike, ebe troponin 1, e nwere ọtụtụ ule na usoro. N'ihi nke a, e nwere ike ịbụ ụfọdụ ihe isi ike na-atụnyere ndị na-arụpụta. Ma clinicians na-eme ka otu usoro site nke neutralize ihe dị iche na-arụpụta n'etiti dị iche iche kwa labolatoriya.