He aha te mea troponin? Norm, nga tohu matua me o ratou tikanga

I roto i 2000, kua whakaae te Pākehā Community Cardiology me te College o Cardiology American i runga i te tātaritanga o infarction myocardial. Hei manatoko i te tātaritanga faaoti ki te whakamahi i te tātaritanga o te taumata o troponins cardiac, kia rite ki te whakaaro reira atu tauwhāiti mō te tātaritanga o te ngakau uaua kino atu i creatine, ara i roto i te wā o te necrosis myocardial iti.

troponins

Troponin - he muingota o te pūmua tënei o toru subunits (T, C, 1). Kei runga i te kakawaea actin i roto i uaua infarction me whai wāhi i roto i ona motu. Ia subunit faatupu tona tūranga motuhake i roto i ture te mahi o te uaua ngakau. I roto i te tinana, mo te wahi tino, te nuinga troponin here. toto Pūnoa (ng / ml) - 2.0, no te mea e wātea ana i roto i te cytosol ono anake ōrau o ēnei pūmua.

I whakakitea mai te reira i e nui haere te whakangaromanga o cardiomyocytes i roto i te toto piringa taumata o ngā hautau o troponin. I te tahi taime te ahua i runga i te täkupu i roto i te rau ara mano o nga wa ranei.

mahi

Ka rite ki kua whakahuatia i runga ake, piri troponin ki te tropomyosin pūmua. I roto i te āhua paruparu, ina he māhorahora te uaua, tenei pūmua ārai te pipiki o myosin ki actin. A, no te te pūmanawa mahi tae pūtau uaua riro katote pai whakatupato i roto i takere konupūmā i roto i te cytoplasm pūtau. Kei te piri wāhanga o te konupūmā ki troponin me hoa. Tenei ka taea te uru ki te myosin me actin kakawaea take hukihuki.

Ehara i anake i roto i te myocardium he troponin. Norm tona here he iwa tekau-rima ōrau. Ko te toe tetahi wahi kei roto i te āhua noa tohaina i roto i te tahi atu momo o te uaua kiko ranei. Ko te rerekētanga matua ko e i roto i te uaua kōhiwi troponin subunits o wha, a i roto i te uaua ngakau - toru.

whaiaroaro

Acronyms momo katoa o uaua e ruruku e te huri i te kukū o ngā katote konupūmā intracellular. A, no te faarahi to ratou tokomaha, nga kirimana uaua, a hurihia. Ko te pūmua ki i piri te whare herehere te konupūmā - he troponin. wāhi o tona täkupu i runga i tropomyosin hāngai ki te roa o te muri, ara 40 nanometers.

E toru subunits, ia o nei he ona ake mahi Troponin. A, no te te piri konupūmā ki te C-kongakonga, tropomyosin i runga i te nekehanga actin kakawaea ki myosin taea uru ia. Ki te nui konupūmā, poraka tropomyosin pae kaha, me te hanga e taea ki te tāpiri ki te myosin myofilaments.

O te koiora me te histology i kitea ano e troponin 1 Kōpeke te hanganga o oko toto hou. herea Troponin C katote konupūmā, me tenei ai huringa i roto i te troponin hiahiatia 1. Troponin T te i roto i te tikanga ki te kōrero ki te tropomyosin me troponin 1 herea ki actin, a hoki āwhina ki te taunekeneke ki actin myosin ka katote konupūmā i roto i te cytoplasm iti.

Te whakarite me te tātaritanga o te tohu mō te whakaaro

I runga i te taumata o te troponin me toto piringa noa i roto i tona pai whakawakia e te tātari ine. Hoki e kore tona tuku e rapua e tetahi faaineineraa motuhake, engari, pera i roto i te wā katoa o te takoha toto, he pai ki te mahi i te reira i roto i wha haora i muri i te kai.

Ki te tango ana te hōhipera i te manawanui ki te infarction myocardial whakapeka, kua riro tonu reira he whakamātautau toto. E ai ki te kawa he tika reira ki te faahiti runga 4 haora, a ka i roto i te ra 8. I muri troponin kawea i roto i kotahi te ra mo te rua wiki. I roto i te rongoā hou, tikanga mō te whakatau i te nui o tenei pūmua tika i te ro'i mā te whakamahi i ngā pūnaha whakamātautau. He hua kino ka taea ki te aukati i taua tūroro i te hunga e whai syndrome coronary whakapeka kia whakawhanake i roto i te heke mai e tata ana.

whakamāramatanga atu o whakapeka infarction myocardial (MI), mahi te maha o te tātari troponin te ki te tautuhi i iti-whakapeka microinfarction puka infarction, "puku" whakaeke ngakau, a hoki ana ki te aroturuki i te kounga o te therapy thrombolytic me te pānga o te mahi tika o anticoagulants, pērā i heparin.

troponin nui ake 1

Troponin 1 (noa serum me 0.1 ng / ml) kia whakapiki ake i muri i wawaotanga hāparapara i runga i te ngakau. Ko te kupu, ki tenei okana transplantation piki troponin kukū ki te 5 nanograms ia ritamano. Ka taea te rongoa i tēnei uara ki runga ki te toru marama.

mate ngakau inflammatory me te whara ai te hua iti i roto i te taumata o te troponin T, engari nga akiakinga o ona huringa i roto i te toto rerekē i taua i roto i MI. Ko te täkupu i roto i te troponin toto i roto i nga tangata, me nga wahine i te taua. e kore e pā ana tēnei tohu ki te ira tangata tau ranei o te manawanui. I te tahi taime i reira kia kia he hua whakamātautau pai teka ki te ko te manawanui i roto i te āhua o te haurangi waipiro whakapeka.

He hua iti i roto i te troponin taea ki kino nui ki te uaua kōhiwi. No te whakarite, faarahi creatine phosphokinase (CPK) i roto i enei tūroro tino, hua i roto i te rēhitatanga hē o te infarction myocardial.

infarction myocardial whakapeka

Troponin 1 (auau toto ki te 0.1 ng / ml) he tohu pathognomonic o whakapeka infarction myocardial anake, ki te nui tona uara 100 ng / ml, nui atu i 99 ōrau o te awhe noa ranei. Otiia anake i roto i te taha ki te tohu haumanu me te mauhaa o te ischemia myocardial.

Ka rite ki te hua o te whakataki ki ngā hauora o tenei tātaritanga, te maha o tātaritanga o whakaeke ngakau nui haere, mai te mea atu tairongo atu creatine kinase tenei whakamātautau. I tua atu, i roto i ngā o nui haere troponin prognostic ko reira he tohu kino. Ētahi kairangahau tautohe e he tika hautanga ki te taumata o troponin i roto i te serum toto te rahi thrombus.

Te whakanui ake i te taumata o tenei pūmua i roto i te tūroro ki te myocardial tuhia i roto i te ono haora i muri i te tīmatanga o te whakaeke mamae. Kotahi tekau ma wha nga ra troponin taumata titaha haeretia me hoki ki noa.

syndrome coronary whakapeka

troponin toto Pūnoa ki whakapeka syndrome coronary (ACS) hāngai ki taua i roto i te infarction myocardial me i 50 ki te 100 ng / ml. Te whakanui ake i te pūmua ACS taea ki tatou rerekëtanga i angina iu. Wā, e kore te tūroro ki angamaheni tohu haumanu me te taumata troponin teitei i roto i te angiography coronary rēhita maumaui nui o hemodynamics. Ko te take mō tenei āhuatanga - māhorahora hanganga o whakatū papa e memeha i roto i te maimoatanga thrombolytic. Kerēme te ariā tuarua e te katinga taka noa i raro i te oko, me kahore he kitea i runga i te mata.

wawaotanga coronary Percutaneous

I paku nui haere Troponin (täkupu ki te 2.0 ng / mL) i muri i angioplasty stent whakanohonga ranei. Scientists kahore feaa te pūmua, e kua whakaritea, e puta i te cardiomyocytes. Ko te take i te wā o to ratou ischemia ahua haere, meinga nei e pupuhi ake te poihau me clamping te iatuku pūngākau.

Ahakoa i roto i te take o traumas moroiti nga troponins tino tairongo infarction, e, o te akoranga, kitea i roto i te kaute toto piringa. Ko, runga ake katoa, whakaatu i te reira e i roto i te tūroro ki te mōrea rite o ngā taumata tiketike o te huringa pūmua i te whanaketanga o te syndrome coronary me infarction myocardial. Kia aroha mai, e kore e tau motuhake, e taea te arahina tākuta i roto i o ratou matapae tīariari. Ētahi korero e pā ana ki te pathophysiology whakahere infarction myocardial ka nui te taumata troponin neke atu i toru ngā wā.

pokanga

Troponin (täkupu ki te 2.0 ng / ml) nui haere i muri i te pokanga tuwhena i runga i te uaua ngakau. he tika ki te tōnounoú mahi cardioprotective tenei. I roto i te ariā, kua mahara ratou ki te tiaki i te tinana o te manawanui i hypoxia, engari i roto i te mahi e kore te mea tonu tenei kotahi rau ōrau. Otiia kihai i roto i te wā katoa te whakanui ake troponin kia i titiro rite te infarction myocardial perioperative.

Ka maioha te reira i te i te nui, me te roanga o te mahi, me te te taumata tuatahi o te pūmua. Tātaritanga "infarction myocardial" Ko taea anake e te aroaro o haumanu, taiwhanga me tohu mauhaa te wā kotahi.

atu āhua

Kua whakapumautia rangahau maha nga meka e troponin (noa 2.0 ng / ml) ko te tohu tino motuhake o infarction myocardial. Ko reira ko te maha o ngā āhuatanga pathological, e e hoki tahi e te hua i roto i te nui o tenei pūmua i roto i te toto piringa. Ko ētahi o ēnei sepsis, Embolism pūkahukahu (PE), kore ngakau, mumura o te putea ngakau, myocarditis, ma'i täkihi, mahi nui, transplantation ngakau, hahau.

meinga ana tēnei āhuatanga e te kirika, tachycardia, hypoxia, he takahi o te microvasculature, whakaiti i te pēhanga me anemia. arata'i tenei katoa ki ischemia myocardial me te whakangaromanga o cardiomyocytes, e ai he hua i roto i te troponin.

1 ranei troponin T

troponin Normal toto ki te 2.0 ng / ml, engari i reira e ngā tikanga mō te whakatau i te hautau o troponin tenei ra. Kei te whakaaetia te reira ki atu tika te whakatau i te kino ki te myocardium. Kua whakaaturia hoki te maha o nga rangahau e he ngoikore ake ki te hēnga o ōna whatukuhu, te troponin 1 troponin-T, engari he rite te tahi atu tawhā, na kua ki te uara tātaritanga taua.

Ko te taa o te troponin T i te meka e hua reira he kete tātaritanga mō te kotahi anake u, mea troponin 1, i reira e rave rahi pūnaha whakamātautau. No te mea o tenei, i reira kia kia etahi fifi i roto i te whakatairite i te hua. Ko e ngana matahauroa ki te kawe i te taua tātai i ai ki te haamou i te rerekētanga i roto i ngā hua i roto i ngā tawhā rerekē labolatoriya.