Chii troponin? Norm, huru zviratidzo uye dzavo nezvaanoreva

Muna 2000, European Community Cardiology uye American College of Cardiology vakatenderana zvokuongorora kuti myocardial infarction. Kuti asimbise nechirwere vakasarudza kushandisa kuongorora pachiyero cardiac troponins, sezvazvakanyorwa vaiona zvikuru chaicho nechirwere komoyo tsandanyama kukuvadzwa pane creatine, kunyange vanenge zviduku myocardial necrosis.

troponins

Troponin - imwe puroteni Morekuru rine subunits matatu (T, C, 1). Riri pamusoro actin filaments mu tsandanyama infarction uye paChikoro maronda ayo. Mumwe subunit anozadzika yaro chaiyo basa yokudzora basa pomwoyo. Mumuviri, kazhinji kacho, vakatonga vakasungwa troponin. Normal ropa (kumar / Rine mamiririta) - 2.0, nekuti muzana matanhatu chete kwemapurotini izvi zvinowanikwa cytosol.

Wakazvizivisa kuti kuparadzwa cardiomyocytes mu peripheral ropa yakawedzera kwevari zvikamu siyana troponin. Dzimwe nhamba pamusoro ndozvakajairwa mazana kana kunyange kane zviuru.

shanda

Sezvambotaurwa pamusoro, troponin kuda imwe puroteni tropomyosin. In imwe akaneta mamiriro, kana tsandanyama akadekara, mapuroteni ichi kunotadzisa kuti kuomerera kuti myosin kuti actin. Kana zviito zvinogona kunosvika tsandanyama masero vakagamuchira chokwadi mhosva ions kuburikidza karusiyamu mugero muchitokisi cytoplasm. Part of karusiyamu wanamatira troponin uye neshamwari. Izvi zvinobvumira kuwana myosin uye actin filaments chikonzero marwadzo.

Kwete myocardium ndiyo troponin. Norm kwayo tichisunga ndiyo makumi mapfumbamwe nezvishanu kubva muzana. Chikamu yasara iri yepachena ezvinhu kana akaparadzirwa dzimwe mhando tsandanyama tishu. Chinokosha musiyano ndechokuti skeletal tsandanyama troponin subunits mana, uye mumwoyo tsandanyama - vatatu.

physiology

Acronyms kwemarudzi ose tsandanyama vari chikwata nokuchinja wevasungwa ose intracellular karusiyamu ions. Kana nhamba yavo kunowedzera, uye tsandanyama makondirakiti, uye vakutarisire. Puroteni uko keji wanamatira karusiyamu - ndiko troponin. nzvimbo wokuyera kwayo tropomyosin unoenderana kureba neyokupedzisira, kureva 40 nanometers.

Troponin ane subunits matatu, imwe neimwe ine zvayo pachake nerevane. Kana karusiyamu wanamatira kuna C-chinyorwa, tropomyosin pamusoro actin filament inofamba ichienda myosin aigona aitewo. Kana zvakakwana calcium, tropomyosin kutigumbura vanoshingaira nzvimbo uye haikwani kuti kuisa myosin myofilaments.

Of zvidukuduku uye histology rainge kuwanikwa kuti troponin 1 anovanza nokuumbwa midziyo itsva ropa. Troponin C anosunga karusiyamu ions, uye izvi zvinokonzera kuchinja troponin 1. Troponin T chinodiwa kuti kukurukurirana tropomyosin uye troponin 1 anosunga kuti actin, uye kunobatsirawo kuti kushamwaridzana actin myosin apo karusiyamu ions ari cytoplasm kukwana.

Kugadzirira uye Kuongorora zvairatidza kuti chinangwa

Nenhanho troponin uye vakakwana peripheral ropa yake yakanakisisa ichizotongwa quantitative kuongorora. Pakukurukura yayo hakurevi chinhu wakananga gadziriro, asi, sezvo mune zvose hwomumba kuzozvidzorerwa, zviri nani kuzviita maawa mana pashure kudya.

Kana chipatara anogamuchira murwere chakasimba myocardial infarction, yava pakarepo akatora bvunzo ropa. Maererano dzakati zvakafanira kudzokorora maawa anopfuura 4, uye zvino kuburikidza zuva 8. Pashure troponin kuitwa kamwe pazuva kwevhiki mbiri. In mushonga ano, nzira nokuda kuziva uwandu mapuroteni ichi zvakananga panguva parutivi pomubhedha uchishandisa bvunzo enyika. A akaipa mugumisiro kunoita kuti asava varwere yakadaro yevaya vane chakasimba coronary chirwere anogona kuva mune ramangwana.

Humwe tsanangudzo chakasimba myocardial infarction (MI), nhamba troponin kuongorora zvinoitwa kuziva Sub-rikwanise chimiro infarction microinfarction, "nyarara" mwoyo kurwisa, uye kuongorora unhu thrombolytic kurapa nokuitika rakananga zviito anticoagulants, akadai heparin.

Inosimudzira troponin 1

Troponin 1 (kwomuzvarirwo serum uye 0.1 kumar / Rine mamiririta) kungawedzera pashure zvomusejari kupindira pamwoyo. Saka, iyi nhengo transplantation troponin wevasungwa inowedzera kuti 5 nanograms muzana milliliter. ukoshi Izvi zvinogona zvakachengetwa kusvikira mwedzi mitatu.

Anogumbura mwoyo chirwere uye kukuvara kunokonzera zvishomanana kuwedzera padanho troponin T, asi simba kuchinja ayo muropa kwakasiyana kuti MI. Ndozvakajairwa muropa troponin mune varume navakadzi chete. chakarurama ichi haina chokuita vakadzi kana zera murwere. Dzimwe nguva pangava wenhema akanaka bvunzo mugumisiro kana murwere ari ezvinhu rikwanise doro kudhaka.

A zvishomanana kuwedzera troponin zvinogoneka muhombe kukuvara skeletal tsandanyama. Enzanisa creatine phosphokinase (cpk Mumbai) Varwere izvi kunowedzera chaizvo, zvichiita sizvo kunyoresa myocardial infarction.

Chenjera myocardial infarction

Troponin 1 (ropa mwero kuti 0.1 kumar / Rine mamiririta) ndiyo pathognomonic chiratidzo chakasimba myocardial infarction chete kana mutengo wayo kwazvo 100 Ng / Rine mamiririta, kana kupfuura 99 percentile pakati inowanzotorwa kwaasingasvikiri. Asi chete pachiimbwa kurapwa uye richishanda zviratidzo myocardial ischemia.

Somugumisiro sumo kupinda okurapa kuti kuongorora uku, nhamba diagnoses nomwoyo kurwiswa yakawedzera, sezvo bvunzo iyi unokurumidza pane creatine kinase. Uyezve, maererano yakawedzera prognostic troponin chinhu asina chiratidzo. Vamwe vaongorori vanoti thrombus saizi iri Proportional kusvika padanho troponin muropa serum zvakananga.

Kuwedzera padanho mapuroteni ino varwere myocardial akanyorwa mumaawa matanhatu pashure kutanga marwadzo kurwiswa. Gumi mazuva troponin sandara zvishoma rovira uye unodzokera dzose.

Chenjera coronary urwere

Normal ropa troponin pamwe chakasimba coronary chirwere (ACS) unoenderana kuti myocardial infarction uye kubvira 50 kusvika 100 kumar / Rine mamiririta. Kuwedzera puroteni ACS anotibvumira kusiyanisa kubva kusagadzikana angina. Apo neapo, varwere kwese zvekuchipatara zviratidzo uye yakakwirira troponin mumatunhu ari coronary angiography haisi pamutemo zvakakomba kutyorwa hemodynamics. Chikonzero ichi chinonakidza - vaingoerekana inotungamirwa plaques iyo urwa munguva thrombolytic kurapwa. Chechipiri pfungwa anoti kuti clot anongotaura inowira pasi midziyo, uye haisi kuonekwa pamadziro.

Percutaneous coronary kupindira

Troponin (wokuyera kusvika 2.0 kumar / ML) yakawedzera zvishoma pashure angioplasty kana stent placement. Masayendisiti hapana mubvunzo kuti mapuroteni, izvo takatsunga, yakabuda kubva cardiomyocytes. Chikonzero ndiyo nguva yavo chitarisiko achipfuura ischemia, izvo zviri kukonzerwa vachiridza kukwira chibharuma uye clamping ari coronary arteries.

Kunyange kune micro traumas vaiva nehanya troponins infarction, izvo, chokwadi, mumashoko peripheral ropa count. Asi, kupfuura zvose, zvinoratidza kuti mune varwere akafanana pangozi yakakwirira siyana mapuroteni kuchinja kukura coronary chirwere uye myocardial infarction. Zvinosuruvarisa chaizvo nhamba, iro vanachiremba aigona kutungamirirwa fungidziro dzavo haako. Vamwe hurukuro pamusoro pathophysiology kupa myocardial infarction apo troponin pamwero vakapfuura kanopfuura katatu.

sejari

Troponin (wokuyera kusvika 2.0 kumar / Rine mamiririta) yakawedzera pashure yakakura kuvhiyiwa pamusoro pomwoyo. Izvi imhaka kutadza cardioprotective zviito. In Nemuromo, vari vakafunga kudzivirira muviri murwere nokuda hypoxia, asi tsika iyi haisi nguva dzose zana muzana. Asi kwete nguva dzose kuwedzera troponin dzinofanira kuonekwa sechinhu perioperative myocardial infarction.

It achaongwa mari uye nguva hwokushanda, uyewo kutanga pamwero puroteni. Chirwere "myocardial infarction" Zvinogoneka chete nokuvapo kunotoda kurapwa, rabhoritari uye richishanda zviratidzo panguva imwe chete.

mamwe mamiriro

ongororo kwakaratidza kuti troponin (kuipa 2.0 kumar / Rine mamiririta) iri zvikuru chaizvo zvechinguvana pamusoro myocardial infarction. Asi pane zvinoverengeka pathological ezvinhu, izvo vanoitwa pamwe nokuwedzera uwandu mapuroteni ichi muna peripheral ropa. Izvi zvinosanganisira sepsis, pulmonary embolism (Pe), mwoyo nokukundikana, kuzvimba wehomwe mwoyo, myocarditis, chisingaperi renal kukundikana, kunyanya muviri, mwoyo transplantation, mishonga.

Fani iyi anokonzerwa fivha, tachycardia, hypoxia, kutyora microvasculature, kudzikira kumanikidza uye kupererwa neropa. izvi zvose zvinotungamirira myocardial ischemia uye kuparadzwa cardiomyocytes, iro rinoita kuwedzera troponin.

1 kana troponin T

Normal ropa troponin kuti 2.0 Ng / Rine mamiririta, asi pane nzira dzakasiyana-siyana kuti Pakusarudza zvikamu zviduku troponin nhasi. Zvinonzi anobvumirwa zvakarurama kuona kuvadza myocardium. Kwemakore anoverengeka netsvakurudzo kuti troponin-T zvikuru kubatwa itsvo kukundikana, asi troponin 1, asi vamwe parameters akafanana, saka zvakafanana chirwere ukoshi.

The peculiarity kuti troponin T iri chokwadi chokuti pave yokuongororwa Kit kuti makasimba imwe chete, asi troponin 1, pane dzakawanda bvunzo enyika. Nokuda kwaizvozvi, kungava dambudziko iri kuenzanisa nemigumisiro. Asi vanachiremba vari kuedza kuunza imwe nzira iyo kuti neutralize musiyano iri migumisiro pakati dzakasiyana parameters labolatoriya.