Enzymes (magaca hore), ama biomarkerka wadnaha (magaca cusub), waa tijaabo dhiig oo loo isticmaalo in lagu ogaado dhaawaca unugyada muruqyada wadnaha. Biomarkers-ka wadnaha waa borotiinada unugyada muruqyada wadnaha ee ku soo daatay dhiigga ka dib dhaawaca muruqyada wadnaha. Marka heerarka dhiigga ee biomarkers ay sare u kacaan, waxay la macno tahay in ay jiri karto dhaawici muruqa wadnaha.
Tijaabooyinkaan ayaa ka faa'iideysanaya baarista infakshanka miyokardiyanka (wadno xanuunka) , laakiin waxaa sidoo kale loo isticmaalaa in lagu ogaado dhaawaca unugyada wadnaha ee sababo kale, sidoo kale - sida dhaawac ka soo gaaray maskaxda ama miyokardit .
Creatine kinase iyo troponin waa laba borotiin oo hadda lagu qiyaaso imtixaanada biomarker.
Sidee "Baaritaanka Enzyme Imtixaanka" wuxuu noqonayaa "Imtixaanka Wadnaha Biyomarkerka"
Creatine kinase wuxuu ahaa protein-kii ugu horreeyey ee wadnaha ah ee loo isticmaalo dhakhaatiirta si loo caawiyo baarista cudurka wadnaha, iyo abuurista kinase waa enzyme - oo ah borotiinka ka caawiya inuu keeno falcelin gaar ah oo ku saabsan biochemical. Sababtan awgeed, baaritaannada dhiigga ee lagu ogaanayo weerarka wadnaha ayaa markii hore loo yaqaanaa baaritaanada wadnaha ee enzymes.
Si kastaba ha noqotee, troponin wuxuu noqonayaa borotiinka dhiigga ee muhiimka ah oo loo isticmaalo in lagu ogaado dhaawaca unugyada wadnaha, iyo troponin ma aha enzim. Halkii, troponin waa kakooban borotiinka qawaaniinta ah ee muhiim u ah foosha muruqyada wadnaha.
Marka troponin laga helo dhiigga, waa calaamad lagu kalsoon yahay in dhaawaca unugyada wadnaha uu dhacay. Sababtoo ah troponin ma aha enzim, dhakhtarrada intooda badani waxay tixraacayaan "baaritaanada biomarker" halkii laga heli lahaa "enzim tests."
Sidee loo isticmaalaa Baarisyada Biyomarker?
Cabbiraadda baayoolajiyeyaasha ayaa badanaa ah tallaabo muhiim ah oo hore u ah oo lagu ogaanayo wadna xanuunka.
Maanta, troponin waa biomarker loo doorbiday ujeedadaas, maxaa yeelay waa calaamad gaar ah (iyo sidoo kale calaamad aad u xasaasi ah) ee muruqa wadnaha oo ka badan tinta kinase. Dhakhaatiirta intooda badani waxay wali cabbirayaan troponin iyo heerarka kinase-koodhka marka wadnuhu uu ka shakisan yahay - laakiin haddii qiyaasta kinase-abuurka ah ay weli ku dareyso daryeelka badan ee bukaan-socodka waa su'aal.
Marka uu wadno xanuunka wadnuhu, sii daayo unugyada unugyada wadnaha ee geedka dhiigga inta badan waxay raacaan qaab caadi ah mudo saacado ah. Sidaa darteed, xaqiijinta in weerarka wadnaha uu dhaco inta badan waxay u baahan tahay dhowr baaritaano dhiig ah oo muddo dheer ah, taasoo muujinaysa kor u kaca iyo hoos u dhaca heerarka nooloolayaasha.
Creatine kinase waxaa lagu sii daayaa dhiigga 4 ilaa 6 saacadood ka dib marka dhaawac yimaada unugyada wadnaha, iyo heerarka dhiigga ee ugu sareeya ee kinase creatase ayaa la arkaa 24 saacadood ka dib. Heerarka kiniiniga kicin ee xajmiga ah sida caadiga ah, laakiin had iyo jeer maaha, waxay muujiyaan dhaawaca murqaha wadnaha. Heerka Creatine kinase mararka qaarkood waxaa lagu kordhin karaa waxyeelo noocyada kale ee unugyada sidoo kale, maaddaama ay sidoo kale ku jirto unugyada unugyada aan wadnaha ahayn.
Troponin ayaa loo sii daayaa dhiigga 2 ilaa 6 saacadood ka dib marka uu ku dhaco unugyada wadnaha, iyo heerarka dhiigga u sarreeya 12 ilaa 26 saacadood.
Heerarka sarreeya ee troponin waxaa loo tixgeliyaa inuu yahay tilmaamo lagu kalsoonaan karo oo ah dhibaatada muruqyada wadnaha oo ka badan heerarka kinase creatine sare.
Sababtoo ah troponin waa calaamad muujinaysa "dhaawicid" oo ah unugyada kelyaha oo ka yimaada kinase creatine, iyo sababtoo ah waa mid sax ah oo muujinaysa dhaawaca unugyada wadnaha oo ka yimaada kinase creatase, troponin waa calaamad la doorbido maanta oo loogu talagalay in lagu ogaado weerarada wadnaha.
Goorma Ayay Bixiyeyaasha Ugu Caawiyaan?
Marka bukaanku leeyahay infekshanka miyir-wareerka caadiga ah ee la socoshada ST-segment ee ECG ( "STEMI" ), qaabka ECG laftiisa, oo ay weheliso astaamaha bukaanka, ayaa badanaa ku filan inay sameeyaan baaritaanka saxda ah.
Sidaa awgeed STEMI guud ahaan maaha daruuri in dhakhtarku sugo natiijada tijaabada biomarker ka hor inta aan la bilaabin daaweynta.
Biomarkers waxay ku caawiyaan dadka qaba cudurada wadnaha ee daran oo aan lahayn STEMI caadi ah, taas oo ah, dadka qaba "NSTEMI" . Iyadoo NAMEI ah isbeddelada ECG waxay u muuqdaan inay yihiin kuwo aan gaar aheyn, sidaa daraadeed waxa aad u adag in la sameeyo baarista saxda ah ee ku saleysan ECG iyo astaamaha kali. Halkan, imtixaanka bayoolaji inta badan waa mid muhiim u ah go'aaminta haddii daaweynta degdega ah ee loo baahan yahay wadna xanuunka loo baahan yahay.
Dadka qaba NAMEI, baaritaanka dhiigga ee bilowga ah ayaa laga yaabaa inay ku jiraan "aan xaddidneyn". Xaaladdan, tijaabada labaad ee dhiigga dhowr saacadood ka dib ayaa muujinaysa in heerarka troponin (ama heerarka kinine creatine) ay muujinayaan qaabka caadiga ah ee kor u kaca iyo hoos u dhaca ee lagu arko weerarada wadnaha.
Sanadihii la soo dhaafay, baaritaan lagu sameeyo dareenka sare ee troponin ayaa la sameeyey in, dad badan oo qaba NISTI, waxay u oggolaanayaan in cudurka lagu sameeyo baaris dhiig oo keliya, sidaas awgeed u oggolaanaya daaweyn si uu u bilaabo bilawga kahor intii laga yaabo in la talin karo.
Maxay Sababta "Been ah" Dhiirrigelinta Biomarkers?
Dhamaan heerarka sare ee ku yaala biomarkerka wadnaha ayaa tilmaamaya wadna garaac.
Heerka Creatine kinase wuxuu kicin karaa dhaawac kasta oo muruqa ah, ama waxyeello maskaxda ama sambabada, ama qaba beerka ama kalyaha.
Heerarka heerarka dhiigga ee troponin ayaa dhab ahaantii si gaar ah loogu talagalay dhaawaca wadnaha ee wadnaha, sidaa daraadeed si adag u hadla, ma jiro wax caynkaas ah sida "khaladka" kor u qaadista troponin. Si kastaba ha ahaatee, waxyeellada unugyada wadnaha waxay dhici karaan sababo kale oo aan ahayn wadno-qabasho daran. Xaaladahaas waxaa ka mid noqon kara wadnaha oo aan shaqaynin , miyokarditis, fayrilenta degdega ah, sepsis , isdifaaca xididada wadnaha , kala-soocida aortuska , kardhiyooomiyaatka , ama embolus daran ee sanbabada .
Tani waa sababta ciladeynta wadno-qabadka wadnaha uusan ku tiirsaneynin hal baaritaan oo dhiig ah, laakiin sidoo kale calaamadaha kiliinikada, isbeddelka ECG, iyo (badanaa) oo ku jira qaabka kor u kiciyeyaasha biomarker ee soo jeedinaya dhaawaca daran ee mobilka.
Ereyga
Biyoolajiyeyaasha wadnaha ayaa ah borotiinka gelaya dhiigga marka uu jirku ku dhaawacmay muruqa wadnaha, sida wadnaha wadnaha. Baadhayaasha Biomarker ayaa badanaa ku caawiya sameynta baadhis deg-deg ah oo wadno-qabasho wadnaha ah, si markaa loo bilaabo daaweynta hore.
> Ilo:
> Mills NL, Churchhouse AM, Lee KK, et al. Hirgelinta Cudurka Troponin I Baaritaanka iyo Khatarta Cudurka Miyokardiyanka ee Dhimashada iyo Dhimashada ee bukaanka qaba Cudurka Dabaysha ee loo yaqaan 'Suspected Acute Coronary Syndrome'. JAMA 2011; 305: 1210.
> Thygesen K, Mair J, Katus H, iyo al. Talooyinka loogu talagalay Isticmaalka Qalabka Cudurka Wadnaha ee Troponin ee Daryeelka Daaweynta Cudurka ah. Eur Heart J 2010; 31: 2197.