Cizon ƙwayoyin Cardiac (tsohuwar sunan), ko masu kare rayuka na zuciya (sabon suna), sune gwajin jini wanda ake amfani dashi don gano lalacewar kwayoyin tsoka. Masu cin gashin kwayar cutar Cardiac sune sunadarai daga kwayoyin tsohuwar ƙwayar jiki waɗanda suka shiga cikin jini bayan da ciwo ga ƙwayar zuciya. Lokacin da matakan jini na waɗannan mawallafa suna daukaka, yana nufin cewa akwai yiwuwar lalacewar ƙwayar zuciya.
Wadannan gwaje-gwaje sun fi amfani a cikin bincikar cututtuka na ƙananan hanzari (ciwon zuciya) , amma ana amfani da su yanzu don gano lalacewa ta zuciya daga wasu mawuyacin, da kuma - irin su daga cututtukan zuciya ko na myocarditis .
Creatine kinase da troponin sune sunadarai guda biyu a halin yanzu ana auna a cikin gwaje-gwaje na biomarker.
Yaya "gwajin Enzyme na Cardiac" Ya zama "Testing Biomarker Testiac"
Creatine kinase shine farkon kwakwalwa na zuciya na zuciya wanda likitoci ke amfani dasu don taimakawa wajen bincikar ciwon zuciya, kuma creatine kinase shine enzyme - furotin da ke taimakawa wajen samar da wani maganin halitta. Saboda wannan dalili, gwaje-gwaje na jini don bincikar ciwon zuciya ya kasance sananne ne a matsayin gwaje-gwajen enzyme na zuciya.
Duk da haka, troponin ya zama mafi yawan sinadaran jini da ake amfani dashi don gano lalacewa na zuciya, kuma troponin ba wani enzyme ba ne. Maimakon haka, troponin shine hadaddun maganin sunadarai masu mahimmanci ga mahimmancin ƙwayar ƙwayar zuciya.
Lokacin da troponin ke samo jini, yana nuna alama cewa lalacewar ƙwayar zuciya ta faru. Saboda troponin ba wani enzyme ba ne, mafi yawan likitoci sun koma zuwa "gwajin biomarker" maimakon "gwajin enzyme".
Yaya ake amfani da gwaje-gwaje na Biomarker?
Nuna ma'aunin 'yan kasuwa yawancin lokaci shine mahimmancin matakai na bincikar ciwon zuciya.
A yau, troponin shine masanin halitta wanda ya fi dacewa da shi don wannan dalili, saboda shi alama ce ta musamman (da kuma alama mai mahimmanci) don lalacewar tsoka da zuciya fiye da creatine kinase. Yawancin likitoci za su iya auna matakan biyu da halayen kinase kinase yayin da ake zaton damuwa ta zuciya - amma ko harkar cutin kinase har yanzu yana kara yawan abin da yake kulawa a asibiti.
Lokacin da ciwon zuciya ya auku, sakin sunadaran kwayar halitta a cikin jini yana biye da dabi'un al'ada a tsawon sa'o'i. Sabili da haka, yana tabbatar da cewa ciwon zuciya ya faru sau da yawa yana buƙatar gwaje-gwaje da yawa na jini masu rai a tsawon lokaci, yana nuna haɓaka da kuma lalacewa na matakan halitta.
An fitar da Creatine kinase a cikin jini 4 zuwa 6 hours bayan ciwon zuciya ta lalacewa, kuma ana ganin samsarin jini na creatine kinase bayan sa'o'i 24. Hannun ƙananan halayen kinase yawanci, amma ba koyaushe, suna nuna lalacewar tsoka ba. Hakanan ƙananan ƙananan ƙananan ƙwayar halitta za a iya karuwa tare da lalacewar wasu nau'in kwayoyin halitta, tun da yake shi ma yana kasancewa a cikin kwayoyin muscle marasa zuciya.
An saki Troponin a cikin jini zuwa 2 zuwa 6 hours bayan lalata kwayar cutar zuciya, kuma matakin ƙimar jini a cikin sa'o'i 12 zuwa 26.
Matsayi mai girma na troponin ana daukar su a matsayin mai nuna alama akan lalacewar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙarancin kinase.
Domin troponin alama ce ta "baya" ta lalacewa ta zuciya ta zuciya fiye da creatine kinase, kuma saboda ya fi dacewa a nuna nuna lalacewar zuciya ta zuciya fiye da creatine kinase, troponin shine alamar da aka fi so a yau don bincikar ciwon zuciya.
Yaushe Masu Mahimmanci ne Mafi Girma?
Yayin da mai haifa yana da ƙananan haɗari na wucin gadi tare da matakin tayi na ST a kan ECG ( "STEMI" ), yanayin ECG da kanta, tare da maganin cututtuka, yawanci ya isa ya tabbatar da ganewar asali.
Don haka tare da STEMI ba dole ba ne don likita ya jira sakamakon binciken gwajin biomarker kafin farawa magani.
Masu amfani da kwayoyin halitta sun fi taimaka wa mutanen da ke da mummunan zuciya wanda ba su da wani hali na STEMI, wato, a cikin mutanen da suke da "NSTEMI" . Tare da NSTEMI ECG canje-canje bazai kasance da ingancin ba ƙayyadaddu ba, don haka yana da wuya a yi daidai ganewar asali bisa ECG da bayyanar cututtuka kawai. A nan, jarrabawar nazarin halittu yana da mahimmanci a yanke shawara idan an buƙaci farfadowa mai tsanani don ciwon zuciya.
A cikin mutanen da ke da NSTEMI, gwajin jini na farko zai iya kasancewa a cikin '' indeterminate 'range. A wannan yanayin, jinin na biyu zai gwada 'yan sa'o'i kadan bayan haka zai bayyana ko matakan troponin (ko matakai na kinase) suna nuna nau'in haɗari-da-fall da aka gani da ciwon zuciya.
A cikin 'yan shekarun nan, an samo wani gwaji mai mahimmanci ga samfurori da cewa, a cikin mutane da dama da ke da NSTEMI, sun ba da ganewar asali ta gwajin jini, saboda haka izinin magani ya fara a baya fiye da yadda zai yiwu.
Mene ne yake haifar da "Maƙarƙashiya" na Masu Magana?
Ba dukkanin halayen masu kwakwalwa na zuciya suna nuna alamar zuciya.
Shirye-shiryen ƙananan ƙananan ƙananan ƙananan za a iya haɓaka da wani rauni na tsoka, ko lalacewar kwakwalwa ko huhu, ko hanta ko koda.
Hanyoyin da aka samu a cikin ƙwayar cuta na troponin shine ainihin ƙayyadaddun lalacewa na kwayar zuciya, saboda haka yana magana sosai, babu wani abu kamar "tarkon" na troponin. Duk da haka, lalacewar kwayoyin zuciya na iya faruwa saboda dalilai banda ƙananan zuciya. Wadannan ka'idodin na iya haɗawa da rashin tausayi na zuciya , maocarditis, tsinkaya a kan fibrillation , sepsis , cututtuka na jijiyoyin jini , kwaskwarima , kwakwalwa na cardiomyopathy , ko burbushin tayi .
Wannan shine dalilin da yasa ganewar asibiti ta dogara ba akan gwaje-gwajen gwaje-gwaje guda ba, har ma a kan bayyanar cututtuka, gyaran ECG, da kuma (sau da yawa) a kan yanayin yanayin haɓakaccen mai bada shawara game da mummunan rauni na zuciya.
Kalma Daga
Masu cin nama na cardiac sunadaran sunadarai ne suka shiga jini yayin da lalacewar zuciya ke da rauni, kamar yadda a cikin ciwon zuciya. Gwaje-gwaje na biomarker suna taimakawa wajen gano ƙwaƙwalwar ƙwaƙwalwar zuciya, don haka za'a fara farawa da wuri.
> Sources:
> Mills NL, Churchhouse AM, Lee KK, et al. Aiwatar da wani abu mai tsaurin ra'ayi da na dan damuwa da rashin lafiyar marasa lafiya da damuwa tare da tsammanin cutar ciwo mai cututtuka. JAMA 2011; 305: 1210.
> Thygesen K, Mair J, Katus H, et al. Shawarwari don Amfani da Ƙungiyar Cardiac Taron a cikin Kulawa mai Kulawa ta Kyau. Eur Heart J 2010; 31: 2197.