He aha ka troponin? Kūmau, i ka papa kuhikuhiE nā hoailona a me kā lākou mau manaʻo

I ka makahiki 2000, i ka Europa Community Cardiology a me ka College American o Cardiology ua ae like ma luna o kaʻike, o myocardial infarction. E hōʻoia i kaʻike, manao e hana i ka Ka Ikepili o ka nui o cardiac troponins, e like me ka mea ua noʻonoʻo hou i ho'ākāka 'ia no kaʻike, o ka naau Muscle pōʻino ma mua o creatine, a hiki i ka manawa o ka nīnūnē myocardial necrosis.

troponins

Troponin - he kumuʻiʻo lātoma iloko olaila o ekolu subunits (T, C, 1). Ua Ua Aia ma luna o ka actin filaments ma Muscle infarction a me 'oe e komo i loko o konaʻoki. hoʻokōʻana kēlā subunit kona ilepili kūlana ma ka hooponopono ana i ka ha awina o ka naau Muscle. Ma ke kino, no ka hapanui loa, Kīwala'ō nakinakiia troponin. Normal koko (ng / ml) - 2.0, no ka mea, eono wale pakeneka o kēia nā polokina mea i loaʻa i loko o ka cytosol.

Ua Ua hōʻike ana i ka lukuia'na o cardiomyocytes iʻike ākea koko māhuahua pae o kekahi mau mahele o ka troponin. I kekahi manawa, o ka huahelu ma luna o ke kūmau i loko o nā haneri, a me na tausani o ka manawa.

kuleana pili i

Me ua i haiia ae maluna, troponin pili i ke kumuʻiʻo tropomyosin. Ma ka AEeOEXAaI ana, i ka wa a ka Muscle Ua nanea wale, keia kumuʻiʻo ua ālai 'ka adherence o myosin i ka actin. A hiki aku i ka hanaʻia kīnā Muscle aeee loaa ikaika hoopiiia Ion ma kalipuna kaha i loko o ka halepaahao cytoplasm. Part o ke kalipuna ua pili i ka troponin a me ka hoa. Ua apono 'komo i ka myosin a me ka actin filaments pono contraction.

'Aʻole wale nō i loko o ka myocardium ka troponin. Kūmau kona paa o kanaiwa-kumamalima pakeneka. Ke koe kuleana i loko o ka noa moku'āina a māhele i nāʻano o ka Muscle'aʻaʻa. Ke ki koena unuhi o ia i loko o skeletal Muscle troponin subunits o ka eha, a ma ka naau Muscle - ekolu.

physiology

Acronyms a pau ano o nāʻiʻo i papa hoʻolaukahi e hoʻololi i ka lehulehu o intracellular kalipuna Ion. A pau lākou helu maoli, ke Muscle aelike, a me ka hope versa. Ke kumuʻiʻo ia i ka hīnaʻi manu ua pili kalipuna - ka troponin. wahi o kona kūmau ma tropomyosin hoʻopili like me ka lōʻihi o ka mea hope, o 40 nanometers.

Troponin He ekolu subunits, kela mea keia mea o ka a i kona mau kuleana pili i. I ka kalipuna ua pili i ka C-apana nahaha, tropomyosin ma ka actin filament e neʻe aku i ka myosin ke hui ia. Inā lawa kalipuna, tropomyosin ālai 'ʻeleu hoʻopunipuni, aʻo ia ka mea hiki ole i ka paʻa i ka myosin myofilaments.

O ka microbiology a me ka histology i ike ia ia troponin 1 suppresses ke kahua o ka hou moku koko. Troponin C e hoopaa ana kalipuna Ion, a me keia kumu loli ma ka troponin 1. Troponin T Ua koi 'ia ma ka mea e kamaʻilio me ka tropomyosin a me ka troponin 1 e hoopaa ana i ka actin, a no hoi e kokua i ka pāʻani aku me ka actin myosin wā kalipuna Ion ma ka cytoplasm lawa.

E hoomakaukau ai a me Ka Ikepili o na nāʻikepili no ka hana

Ma o ka nui o ka troponin a me ka maʻamauʻike ākea koko i loko o kona maikai loa hookolokoloiaʻi e au, ma laupaʻi Ka Ikepili. No kona hānau 'Aʻole e koi i kekahi kekahi la hoomalolo, akā, e like me ia ma nā hihia o ke koko donation, ia mea maikaʻi, e hana ia i ka eha hora ma hope o kaʻaiʻana.

Inā ka haukapila hookipa mai i ka hoomanawanui me ka huʻi myocardial infarction, ka mea, ua lawe koke ia ke koko hōʻike. E like me ka Hola Pūnaewele ia mea pono e 'oe ma luna o 4 hola, a laila, ma ka lā 8. Ma hope o troponin lawe mai i kekahi manawa, i ka lā i mau pule. Ma ke kālā no lapaau, epekema ka 'ike i ka nui o keia kumuʻiʻo' ana ma ka moe me ka hoʻohana 'hoao nenoai. A hopena maikaʻi hopena e leie aku e hookaawale ia na nā mea maʻi, mai ka poe i huʻi coronary maʻi pale i hoʻomōhala i loko o ka wā e hiki mai ma kahi o.

Hou ia ka wehewehena o ka huʻi myocardial infarction (MI), i ka helu o ka troponin Ka Ikepili ua hana e hōʻike iiaciiie-huʻi palapala infarction microinfarction, "i pane" naʻau kaua, a hoi i ka kanaka hoʻoponopono i ka mea e like ai o ka thrombolytic Inc, a me ka hope o ka pololei hana o anticoagulants, e like me heparin.

Mahuahua troponin 1

Troponin 1 (maʻamau lāʻau lapaʻau e mahuahua ma hope oʻoki lāʻau lapaʻau uao ai 'ma ka naau, a 0,1 ng / ml). Penei, a me keia hui, transplantation troponin lehulehu piʻina i 5 nanograms no mililika me. Kēia waiwai hiki ke hūnāʻia i na malama ekolu.

Hoʻoʻino naʻau maʻi a me ka eha ke kumu no ka hōʻemi iki ulu i loko o ka nui o ka troponin T, akā, i nāʻano o kona loli i loko o ke koko i kekahi mai ia i loko o MI. Ke kūmau i loko o ke koko troponin i loko o nā kānaka a me nā wāhine i ka ia. Kēia anakahi ua i pili i ka hoohanau paha makahiki o ka hoʻomanawanui. I kekahi manawa, loaʻa paha e ka wahahee maikaʻi ho'āʻo? Acoeueoao ina ka hoʻomanawanui i loko o ka moku'āina o ka huʻi waiʻona intoxication.

A hōʻemi iki mahuahua ma ka troponin hiki me ka papakaukau poino i skeletal Muscle. No ka nane, creatine phosphokinase (CPK) i loko o kēia mau nā mea maʻi maoli me ka nui loa, kūpono i ka pololei ole kakau o myocardial infarction.

Huʻi myocardial infarction

Troponin 1 (koko ana i 0,1 ng / ml) mea pathognomonic hoailona o ka huʻi myocardial infarction wale ina kona waiwai aku i 100 ng / ml, a oi aku mamua o 99% o nā ka maʻamau laulā. Akā, i loko o ka huipūʻana me ka lapaʻau a me ka vocal symptoms o myocardial ischemia wale.

E like me ka hopena o ka hoike i loko o 'inikua hana maʻamau o kēia Ka Ikepili, i ka helu ana o diagnoses o ka naau ino, a mahuahua nui, mai keia hoʻokolohua Ua oi ikepili koʻikoʻi ma mua o creatine kinase. Eia kekahi, ma ka hua'ōlelo o ka mahuahua prognostic troponin ia mea he io hōʻailona. Kekahi noiʻi hoʻopaʻapaʻa i ka thrombus nui mea pololei hapaʻauhau i ke kiʻekiʻe o ka troponin i loko o ke koko lāʻau lapaʻau.

Mahuahua ka nui o keia kumuʻiʻo i loko o nā mea maʻi me ka myocardial kākau i loko o eono hola ma hope o ka hoouka kaua ana o eha hoouka. Heʻumikumamāhā mau lā troponin ilikai progressively aku kakou, a hoike i ka maʻamau.

Huʻi coronary maʻi pale

Normal koko troponin me ka huʻi coronary maʻi pale (ACS) hoʻopili like i ka mea i loko o myocardial infarction, a mai ka 50 a hiki i 100 ng / ml. Mahuahua ke kumuʻiʻo ACS e leie aku mākou e differentiate mai lolelua ka angina. Kēlā wā i kēia wā, nā mea maʻi me ka typical lapaʻau symptoms a me ke kiekie troponin pae ma ka coronary angiography ua i heluʻia aʻe 'nui o hemodynamics. Ke kumu no keia kŰia - noho'na makaainana i ulu ho okumu ana o plaques i hoike mai iloko o thrombolytic lapaau. Ka lua o ka kumumanaʻo koi ana i ka clot wale hina ma lalo o nā ipu, a me ka mea i hiki ma luna o ka pale.

Percutaneous coronary uao

Troponin (kūmau i 2.0 ng / ML) Ua iki mahuahua ma hope o angioplasty a stent hoʻokomo '. ʻepekema, i koʻu kiiiaʻe nei i na nā polokina, a i paa, i waho, mai ka cardiomyocytes. Ke kumu o ka manawa o ko lākou mau helehelena hele ischemia, a ua kauoha ia e puhi i ka hoʻonui a me ka hopuʻana i ka coronary arteries.

E like ma ka hihia o ke anakahi iki traumas, he mau loa ikepili koʻikoʻi troponins infarction, a, o ka papa, lewa i loko o kaʻike ākea koko helu. Akā, ma luna o nā mea a pau, e hōʻike i loko o nā mea maʻi me ka like kamepiula o ke kiʻekiʻe o ka pae kumuʻiʻo loli i loko o ka ulu ana o coronary maʻi pale a me myocardial infarction. Eia naʻe, kekahi helu, a kauka hiki ke alakai i loko o kā lākou mau Time] hakuʻole. Kekahi kamaʻilio e pili ana i ka pathophysiology kaumaha aku myocardial infarction ka wā o ka troponin pae loa aku ma mua o ekolu manawa.

ʻoki kino

Troponin (kūmau i 2.0 ng / ml) a mahuahua nui ma hope o'ano'ēʻoki kino ma luna o ka naʻau Muscle. Kēia mea ma muli o ka hewa cardioprotective hana. Ma kumumanaʻo, ka mea i manao e hoʻopale ai i ka hoʻomanawanuiʻana kino ma ka hypoxia, akā, ma ka hoʻomaʻamaʻa i kēia mea,ʻaʻole mau hoʻokahi haneri pakeneka. Akā,ʻaʻole i loko o nā hihia mahuahua troponin e e manao like i kekahi perioperative myocardial infarction.

It e e mahalo i ka nui a me ka lōʻihi like 'ole o ka hana, e like me ka pono me ka loiloi mua kiʻekiʻe o ke kumuʻiʻo. ʻike, "myocardial infarction" Ua hiki wale ma ke alo o ka lapaʻau, keʻena hoʻokolohua, a komo na hoailona ka poʻe.

nā moku'āina

He haʻawina i hoopaa i ka mea i troponin (maʻamau 2.0 ng / ml) o ka lahui kekahi peni mäka o myocardial infarction. Akā, loaʻa nō i ka helu o ka pathological rula, a i pu aku la keia ma ka ulu i loko o ka nui o keia kumuʻiʻo i loko o kaʻike ākea koko. O nā sepsis, pulmonary embolism (PE), naau e hemahema, li nui o ka naau eke, myocarditis, maʻiʻaʻa puʻuwai e hemahema, excessive hoounauna, naau transplantation, chemotherapy.

O kŰia ua kena ae la ia e ke kuni, tachycardia, hypoxia, he 'aʻe' ana o ka microvasculature, ka hōʻemiʻana i ka manaʻo koikoi a me ka anaemia. A pau i kēia hiki aku ai i myocardial ischemia a me ka luku ana o cardiomyocytes, i ke kumu no ka hoomahuahua i troponin.

1 ole troponin T

Normal koko troponin i 2.0 ng / ml, akā, ma laila e likeʻole epekema ka 'ike i ka hapa iki o ka troponin i keia la. Ua Ua 'ae' ia oi pololei hooholo i ka poino i ka myocardium. No ka helu o nā haʻawina i hoike ia troponin-T mea oi susceptible i ka hakuʻala ka hoʻokō 'ole, ka troponin 1, akā,ʻo nā mea kiko'î e like, no laila, i ka ia PalekanaEND_LINK cia.

Ke peculiarity o ka troponin T ma ka oiaio i ka mea produces he PalekanaEND_LINK kini puʻe wale no wale kekahi naue ole, no ka mea hoi troponin 1, loaʻa nō kekahi mau hoʻokolohua nenoai. No ka mea, o keia, aia i e kekahi pilikia ma ke kapakai a ka hopena. Akā, clinicians Ke ho'āʻo nei e lawe mai i ka ia haʻilula ana a e neutralize i ke koena unuhi i loko o nā hualoaʻa ma waena o kekahi mea kiko'î labolatoriya.