Waa maxay troponin? Norm, tilmaamayaasha muhiimka ah iyo macnahooda

In 2000, Community Yurub Wadnaha iyo College American ee Wadnaha ayaa isku raacay ogaanshaha Wadnaxanuun myocardial. Si loo xaqiijiyo cudurka go'aansaday in ay isticmaalaan falanqaynta ee heerka troponins wadnaha, sida loo arko ka badan gaarka ah ee cudurka wadnaha dhaawac muruqa ka badan creatine, xitaa mararka of galleeyda myocardial yar.

troponins

Troponin - Britain ayaa protein ah oo ka kooban saddex subunits (T, C, 1). Waxay ku taalaa on filaments actin in Wadnaxanuun muruqa iyo ka qayb-dhimista ay. subunit kasta oo buuxiya kaalinta gaarka ah ee joogto ah iyo nidaam waxqabad ee muruqa wadnaha. In jidhka, inta badan, heysatay troponin xidhxidhan. dhiigga caadiga ah (ng / ml) - 2.0, maxaa yeelay, boqolkiiba borotiinada, kuwaas oo lix oo kaliya ayaa lagu heli karaa cytosol ah.

Waxaa la sheegay in burburinta cardiomyocytes in dhiig durugsan kordhay heerka jajabyada kala duwan ee troponin. Mararka qaarkood tiradaasi kor ku xusan iska caadi ah in boqolaal ama xataa kun oo jeer.

function

Sida aynu hore u kor ku xusan, troponin lifaaqan tropomyosin protein ah. In dawlad aan firfircoonayn, markii muruqa uu yahay dabacsan, protein this ka hortagtaa u hogaansanaanta ee myosin in actin. Marka iman kara tallaabo gaadho unugyada muruqa helay udhigo si togan eedeeyay dhex channels calcium in cytoplasm gacanta. Qayb ka mid ah calcium waxaa ku lifaaqan troponin iyo jaalayaashooda. Tani waxay u ogolaaneysaa in ay helaan myosin iyo actin ka filaments sababta foosha.

Ma aha oo kaliya in myocardium waa troponin. Norm ay ku qabanaya waa shan iyo sagaashan boqolkiiba. Inta ka hartay waa in gobolka oo lacag la'aan ah ama qaybiyey noocyada kale ee unugyada muruqa. Farqiga muhiimka ah waa in murqaha lafaha troponin subunits afar, iyo muruqa wadnaha - saddex.

jirka

Soo gaabinta magacyada dhammaan noocyada muruqyada isku dubaridan by beddelo-fiirsashada ee udhigo calcium intracellular. Marka ay tirada kordhiyaa, heshiisyada muruqa, iyo qeybsanaan. protein The kaas oo qafis ku lifaaqan calcium - waa troponin. meesha ay caadi on tropomyosin u dhiganta dhererka dambe, kuwaas oo 40 nanomitir.

Troponin waxay leedahay saddex subunits, kuwaasoo mid walba uu leeyahay shaqo gaar ah. Marka calcium waxaa ku lifaaqan ku-C jab, tropomyosin ku dhaqaaqdo buuxieyey actin in myosin iyada biiri karaan. Haddii calcium ku filan, blocks tropomyosin goobaha firfircoon oo ka dhigaysa aan suuragal ahayn in lifaaq myosin myofilaments.

Ayidhi iyo histology ayaa sidoo kale lagu ogaaday in troponin 1 cabudhibayo formation of xididdada dhiigga cusub. Troponin C xidhana udhigo calcium, tanina waxay sababtaa inay isbedel ku troponin 1. Troponin T loo baahan yahay si ay u la tropomyosin iyo troponin 1 xiriiraan xidhana in actin, oo waxay kaloo ka caawisaa si ay ula falgalaan myosin actin markii udhigo calcium in cytoplasm ku filnayn.

Diyaarinta iyo falanqaynta muujinaya iyadoo ujeedada tahay

On heerka troponin iyo dhiig durugsan caadiga ah ee uu ugu fiican xukumaa falanqaynta taranta. Waayo, gaarsiinayo uma baahna diyaarinta gaar ah, laakiin, sida in dhammaan xaalado kasta oo deeq dhiig, waxa fiican in loo sameeyo in afar saacadood ka dib markaad cunto.

Haddii isbitaalka uu helo bukaanka qaba Wadnaxanuun myocardial ba'an, waxaa isla markiiba loo qaaday baaritaan dhiig. Sida laga soo xigtay maamuuska waxaa lagama maarmaan ah in ay ku celiyaan in ka badan 4 saacadood, ka dibna iyada oo maalin ka dib 8. troponin fuliyay hal jeer maalintii muddo laba toddobaad ah. In daawada casriga ah, hababka lagu go'aamiyo qadarka protein this si toos ah ugu sariirta iyada oo la isticmaalayo nidaamka baaritaanka. Natiijada A xun u ogolaanaya in ay ka horjoogsanaya in bukaan sida kuwa leeyihiin syndrome coronary ba'an laga yaabaa in mustaqbalka dhow.

qeexid dheeraad ah oo Wadnaxanuun myocardial ba'an (MI), tirada falanqaynta troponin waxaa loo sameeyaa si loo ogaado microinfarction foomka Wadnaxanuun sub-ba'an, "aamusan" wadno, iyo sidoo kale si loo ilaaliyo tayada dawaynta thrombolytic iyo saamaynta falka tooska ah ee daawada xinjirowga lidka ku ah, sida heparin.

troponin kordhay 1

Troponin 1 (caadi serum iyo 0.1 ng / ml) waxaa laga yaabaa in la kordhiyo ka dib markii qaliin wadnaha ah. Sayidka, taas badalida xubin fiirsashada troponin kordhay ilaa 5 nanograms per mililitir. Qiimaha Tani waa la kaydin karaa ilaa saddex bilood.

cudurka wadnaha bararka iyo dhaawac keena koror yar ee heerka troponin T, laakiin dhaqdhaqaaqa isbedelada ay dhiigga ka duwan in MI. iska caadi ah in troponin dhiigga ee ragga iyo dumarka isku mid. Tilmaamahan aan la xiriirin jinsiga ama da'da bukaanka. Mararka qaarkood waxaa laga yaabaa in natiijada been ah positive baaritaanka haddii bukaanku waa xaalad sarkhaan ba'an khamriga.

korodhka A yar ee troponin suurtoobaan waxyeelo ba'ani u murqaha lafaha. Wixii la barbardhigo, phosphokinase creatine (CPK) ee bukaanka, kuwaas oo si weyn u kordhiyaa, taasoo keentay in diiwaangelinta khaldan ee Wadnaxanuun myocardial.

Wadnaxanuun myocardial Ba'an

Troponin 1 (heerka dhiigga 0.1 ng / ml) waa calaamad pathognomonic of ba'an Wadnaxanuun myocardial oo keliya haddii ay qiimo ka badan 100 NG / ml, ama ka weyn tahay 99 boqolkiiba ee heerka caadiga ah. Laakiin kaliya in lala calaamado clinical iyo xarkaha ee ischemia myocardial.

Sidaas darteed of sal-dhaqan caafimaad falanqaynta this, tirada cudurka of wadne kordhay, tan iyo imtixaanka this wuu ka nugul yahay tyrosinkinashämmare creatine. Intaas waxaa sii dheer, marka la eego kor u troponin prognostic, waa calaamo xun. Qaar ka mid ah cilmi ku doodaya in size thrombus waa si toos ah uu u dhigmaa heerka troponin ee serum dhiigga.

Kordhinta heerka protein this bukaanka qaba myocardial diiwaan lix saacadood gudahood ka dib marka bilawga ah ee weerarka xanuun. Afar iyo toban maalmood troponin heerka hoos isa soo taraysa oo soo laabtay si caadi ah.

Xiisad syndrome coronary

troponin dhiigga caadiga ah la ba'an coronary syndrome (taladadii) u dhiganta in Wadnaxanuun myocardial iyo 50 ilaa 100 ng / ml. Kordhinta borotiinka taladadii oo noo ogolaadaa in la kala saaro ka angina degganayn. Mararka qaarkood, dadka qaba calaamado clinical caadiga ah iyo heerar troponin kacsantahay in ANGIOGRAFI ee wadnaha aan la diiwaan xadgudubyo daran oo loo hemodynamics. Sababta ifafaale this - formation of lama filaan ah dabar oo kala diray inta lagu jiro daaweynta thrombolytic. Fikradda labaad ayaa sheegtay in xinjir ah si fudud hoos weelashii, oo aan la arki karo shaashadda.

faragelinta KORONARKAR

Troponin (iska caadi in 2.0 ng / mL) ayaa in yar kordhay ka dib markii angioplasty ama meelaynta stent. Seynisyahanno Shaki iigama jiro in borotiinada, kuwaas oo la goostay, ka soo cardiomyocytes ah. Sababtuna waxay tahay, waqtiga ay ischemia muuqaalka marayay, taas waxaa keena qarxinta buufin iyo tirtirayaan halbowleyaasha wadnaha.

Xataa in ay dhacdo xamilo micro ahaayeen troponins aad u xasaasi ah Wadnaxanuun, kaas oo, Dabcan, ka muuqataa count dhiigga durugsan. Laakiin, dhammaan ayuu ka sarreeyaa, waxa uu muujinayaa in bukaanka qaba halis la mid ah heerarka sare ee isbedel protein horumarinta syndrome wadnaha iyo Wadnaxanuun myocardial. Nasiib darro, tiro gaar ah, taas oo dhakhaatiirtu la hanuunin lahaa in saadaasha ay kajirin. Qaar ka mid ah hadal ah oo ku saabsan pathophysiology bixin Wadnaxanuun myocardial marka heerka troponin ku dhaafto in ka badan saddex jeer.

qalliinka

Troponin (iska caadi in 2.0 ng / ml) oo kordhay ka dib markii qaliin xagjirka ah ee muruqa wadnaha. Tan waxa u sabab ceebaha falalka cardioprotective. In aragtida, ay u malaynayeen in la ilaaliyo jirka bukaanka by hypoxia, laakiin dhab ahaan tani ma aha had iyo jeer mid boqolkiiba boqol. Laakiin ma aha in dhammaan xaaladaha sii kordhaya troponin waa in loo arkaa a Wadnaxanuun myocardial perioperative.

Waxaa la qadariyo doonaa qadarka iyo muddada hawlgalka, iyo sidoo kale heerka bilowga ah ee protein ah. Cilad-"Wadnaxanuun myocardial" ayaa suuragal ah keliya by joogitaanka bukaan eegida, shaybaar iyo calaamooyin xarkaha isku mar.

gobolka kale

Daraasado badan ayaa xaqiijisay in xaqiiqda ah in troponin (caadi 2.0 ng / ml) waa calaamad aadka u gaar ah oo Wadnaxanuun myocardial. Laakiin waxaa jira tiro ka mid ah xaaladaha bahal ah, kuwaas oo sidoo kale ay la socdaan in la kordhiyo cadadka protein this ee dhiigga durugsan. Kuwaas waxaa ka mid sepsis, lungemboli (PE), wadnaha oo shaqadiisa gaba, caabuq bac qalbiga ku jira, myocarditis, kilyaha joogtada ah, jimicsi xad dhaaf ah, wadnaha-tallaalidda, chemotherapy.

Tani waxay ifafaale waxaa sababa qandho, tachycardia, hypoxia, xadgudub ku ah microvasculature ah, hoos u cadaadiska iyo dhiig la'aan. Waxaas oo dhan waxay keenaysaa in ischemia myocardial iyo burburinta cardiomyocytes, kaas oo keena in la kordhiyo troponin.

1 ama troponin T

troponin Normal dhiigga 2.0 NG / ml, laakiin waxaa jira habab kala duwan oo lagu ogaanayo ee jajabka ee troponin maanta. Waxaa la oggol yahay in si sax ah lagu ogaado khasaaraha ay u myocardium ah. Waayo, tiro ka mid ah diraasado ah ayaa muujiyay in troponin-T waa laga baqaa in ay kelyaha, troponin 1, laakiin xuduudaha kale ee la mid yihiin, sidaa darteed waxay leeyihiin qiime isku mid cudur-aqoonsiga.

peculiarity ee troponin T ee xaqiiqda ah in ay soo saartaa qalabka ogaanshaha muddo hal shirkad oo kaliya, halka troponin 1, waxaa jira dhowr nidaamka baaritaanka. Taas darteed, waxaa laga yaabaa in qaar ka mid adag tahay in la barbar natiijada. Laakiin rugaha caafimaadka ayaa isku dayaya in ay keenaan caanaha isku by kaas oo ay uga takhalusi lahaayeen farqiga u natiijooyinka ka mid ah koobin kala duwan labolatoriya.