Nkhani
Kodi methylene blue imakhala m’thupi kwa nthawi yaitali bwanji?
Methylene blue ilibe nthawi imodzi yotsimikiziridwa yomwe imakhala “itachokeratu m’thupi.” Zolemba zaposachedwa za jakisoni wa PROVAYBLUE zimati nthawi ya kuchepa kwake kufika theka mwa anthu ndi pafupifupi maola 24. Kafukufuku wakale wa anthu odzipereka anayerekeza kuti nthawiyi inali maola 5.25 pambuyo poperekedwa kudzera mumtsempha. Manambalawa akufotokoza kuchepa kwa kuchuluka komwe kunayezedwa m'mikhalidwe yosiyanasiyana, osati nthawi yomalizira yomwe ikadutsa ndiye kuti minofu yonse ilibenso mankhwalawo.
Funso lothandiza ndi lachindunji kwambiri: ndi mtundu uti wa mankhwala ndi njira iti yolowera, mwa anthu ati, zoyezedwa m’chitsanzo chotani, komanso pa nthawi yaitali bwanji? Kuyerekeza kuchuluka kwa mankhwala m’magazi kokha sikungakuuzeni nthawi imene kusintha komwe munthu amamva kuyenera kuyamba, nthawi imene kuyanjana kwa mankhwala kumakhala kotetezeka, kapena ngati kugwiritsa ntchito tsiku lililonse kuli koyenera.
Zimene nthawi ya kuchepa kufika theka imayezadi
Nthawi ya kuchepa kufika theka pamene mankhwala akuchotsedwa m’thupi ndi nthawi imene kuchuluka koyezedwa kumatenga kuti kutsike kufika theka pa gawo la kuchotsedwa lomwe likuwunikidwa. Nthawi ya kuchepa kufika theka ya gawo lomaliza imafotokoza gawo lakumapeto la mzere wosonyeza kusintha kwa kuchuluka. Si kuti nthawi zonse imafotokoza kutsika kofulumira koyambirira pambuyo pa jakisoni.
Mwachitsanzo chosavuta, tiyerekeze kuti kuchuluka kukutsika kuchokera pa mayunitsi 100 osankhidwa monga chitsanzo kufika pa 50 pa nthawi imodzi ya kuchepa kufika theka. Pa nthawi yachiwiri yofanana, kumatsika kufika pa 25, osati pa ziro. Awa ndi masamu a chitsanzo chosavuta cha m'maganizo, osati kuyerekeza kwa methylene blue yotsala m’thupi mwa munthu winawake.
Mawu ena atatu amayankha mafunso osiyana:
- Nthawi yofikira kuchuluka kwakukulu kwambiri, kapena Tmax: nthawi imene kuchuluka kwakukulu kwambiri pakati pa zitsanzo zomwe zinatengedwa kumapezeka.
- Kukhudzidwa ndi mankhwala, kapena AUC: dera la pansi pa mzere wosonyeza kuchuluka kwa mankhwala potengera nthawi, lomwe limaphatikiza kuchuluka ndi nthawi.
- Kuyankha kwa thupi ku chithandizo: kusintha kwa vuto kapena zotsatira zomwe zikuchiritsidwa, monga kuchepa koyezedwa kwa methemoglobin.
Kuchuluka kwakukulu kwambiri sikuyenera kuchitika nthawi imodzi ndi phindu lalikulu kwambiri. Kuchuluka kochepa sikutanthauza mwachindunji kuti kusintha kwa zochitika m’thupi kapena kuyanjana ndi mankhwala ena kwatha.
Kuyerekezera kafukufuku wa anthu
Tebuloli ndi kuyerekezera komwe takonza kwa kafukufuku wa Peter, kafukufuku wa Walter-Sack ndi njira zake zonse, komanso kuwunika kwa FDA kwa kayendedwe ndi zochita za PROVAYBLUE m’thupi. Miyezo ya mankhwala yomwe ili m’kafukufukuyi ikungozindikiritsa zoyesererazo; si malangizo ogwiritsira ntchito. MB imatanthauza methylene blue.
| Umboni | Njira yolowera ndi gulu la anthu | Chinthu choyezedwa, chitsanzo, ndi njira yoyezera | Katengedwe ka zitsanzo ndi zotsatira zofotokozedwa |
|---|---|---|---|
| Peter ndi anzake, 2000 | 100 mg kudzera mumtsempha (IV) ndi pakamwa; anthu asanu ndi awiri odzipereka | MB m’magazi athunthu; njira ya chromatography yamadzimadzi yogwira ntchito kwambiri | Mbiri ya kuchuluka m’magazi mpaka maola 4, monga yalembedwera m’tebulo la FDA; nthawi ya kuchepa kufika theka ya gawo lomaliza pambuyo pa IV inali maola 5.25 |
| Walter-Sack ndi anzake, 2009, gulu la IV | 50 mg IV; akuluakulu 16 athanzi analembetsa, 15 anamaliza kuyesedwa ndi njira zonse mosinthana | MB m’plazima ndi m’magazi athunthu; chromatography limodzi ndi tandem mass spectrometry | Zitsanzo zobwerezabwereza mpaka maola 24; avereji ya nthawi ya kuchepa kufika theka inali maola 18.5 m’plazima ndi maola 13.6 m’magazi athunthu |
| Walter-Sack ndi anzake, 2009, gulu la pakamwa | 500 mg ya mankhwala osungunulidwa m’madzi operekedwa pakamwa; gulu lomwelo loyesedwa ndi njira zonse mosinthana | Chinthu choyezedwa, magawo, ndi njira yoyezera zomwezo | Zitsanzo mpaka maola 24; avereji ya nthawi ya kuchepa kufika theka inali maola 18.3 m’plazima ndi maola 14.7 m’magazi athunthu; avereji ya Tmax m’plazima inali maola 2.2 |
| Kuwunika kwa FDA, 2016, kafukufuku wopanga jakisoni | Kuperekedwa kamodzi kudzera mu IV mwa anthu athanzi odzipereka; kuwunikaku kumafotokoza mwachidule kulowetsedwa kwa 2 mg/kg kwa mphindi zisanu | MB ndi Azure B zinayezedwa mosiyana m’magazi athunthu ndi m’plazima pogwiritsa ntchito chromatography yamadzimadzi limodzi ndi tandem mass spectrometry | Kuyeza kunapitirira mpaka maola 72; kuwunikaku kumafotokoza kuti nthawi ya kuchepa kwa MB kufika theka ya gawo lomaliza ndi pafupifupi maola 24 |
Tsitsani kuyerekezera kafukufukuyu monga tebulo la Markdown.
Izi si ziwerengero zosinthanitsika zoyerekeza muyezo umodzi wosasinthika wa m’thupi womwe umagwira ntchito kwa aliyense. Tebuloli silikukhazikitsanso lamulo losavuta loti mankhwala operekedwa pakamwa nthawi zonse amakhala m’thupi nthawi yaitali kuposa operekedwa kudzera mu IV. M’kafukufuku woyesa njira zonse mosinthana, gawo la magazi limene linasankhidwa ngati chitsanzo linasintha nthawi yoyerekezeredwa ngakhale njira yolowera inali yomweyo.
Chifukwa chake manambalawa amasiyana
Magazi athunthu ndi plazima ndi zitsanzo zosiyana. Magazi athunthu amaphatikiza maselo omwe ali m’plazima. Plazima ndi gawo lamadzimadzi lomwe limapezeka maselo atachotsedwa. Njira yoyezera yomwe imawerengera mankhwala m’maselo komanso m’madzimadzi imayankha funso losiyana ndi yomwe imangoyeza m’madzimadzi.
Nthawi yowunikira ndi yofunika. Kafukufuku amene amatha msanga amakhala ndi zambiri zochepa zokhudza kuchepa komwe kumachitika pambuyo pake. Kuwunika kwa FDA kumatchula makamaka kutalika kwa nthawi yotengera zitsanzo komanso kuyeza m’magazi athunthu poyerekeza ndi m’plazima ngati zifukwa za kusiyana kwa kayendedwe ka methylene blue m’thupi komwe kwafotokozedwa m’kafukufuku wofalitsidwa. Kuwunikira kwa nthawi yaitali kungasonyeze gawo la kuchepa pang’onopang’ono limene kutenga zitsanzo koyambirira sikulifotokoza bwino.
Chinthu cha mankhwala chomwe chikuyezedwa ndi chofunika. Zotsatira za mankhwala oyambirira, zotsatira za chinthu chopangidwa thupi litasintha mankhwalawo, komanso kuchuluka konse komwe kumaphatikiza mitundu yosinthidwa mwa zochita za mankhwala siziyenera zonse kutchedwa “mlingo wa methylene blue” popanda kufotokoza zomwe zikuyezedwa. Kuyerekezera uku kumatchula zinthu zomwe kafukufukuyo ananena kuti anayeza, m'malo motenga miyeso yonse yokhudzana ndi mtundu wabuluu ngati yofanana.
Kapangidwe ka mankhwala ndi kofunika. Kuyesera kwa pakamwa komwe anthu anayesedwa ndi njira zonse mosinthana kunayesa mankhwala enaake okonzedwa m’madzi. Zotsatira zake sizikutsimikizira kapisozi wosadziwika bwino, mankhwala amadzimadzi ogulitsidwa kwa anthu, kapena njira ina yolowera. Momwemonso, zoyesera za kugawikana kwa mankhwala m’minofu ya makoswe zomwe zili m’nkhani ya Peter ndi zosiyana ndi miyeso ya magazi ya anthu odzipereka m’kafukufuku wake. Sizipereka nthawi yochokera kwa mankhwalawa mu ubongo wa munthu.
Zimatenga nthawi yaitali bwanji kuti ayambe kugwira ntchito?
Izi zimadalira zimene “kugwira ntchito” zikutanthauza. Pa methemoglobinemia yopezeka pambuyo pa kubadwa yomwe ikulandira chithandizo chamankhwala, akatswiri a zaumoyo angatsatire muyezo wodziwika wa magazi. Zolemba za jakisoniyo zimati akuluakulu 9 mwa 12 omwe anali ndi miyeso yoyambirira yofunikira anali ndi kuchepa kwa methemoglobin kosachepera 50% patatha ola limodzi atapatsidwa mankhwalawo. Ichi ndi chimene chinaonedwa pa kuyankha ku chithandizo, osati nthawi ya kuchepa kwa methylene blue kufika theka pamene ikuchotsedwa m’thupi.
Pa mankhwala operekedwa pakamwa, kufika pa kuchuluka kwakukulu kwambiri m’plazima pafupifupi maola awiri m’kuyesera kwa anthu odzipereka sikutsimikizira kuti kuwonjezeka kwa chidwi, mphamvu, kapena kukumbukira kumayamba patatha maola awiri. Kafukufuku wa kayendedwe ka mankhwala m’thupi anayeza kuchuluka kwa mankhwalawo, osati mapindu amenewo. Zimene munthu amanena kuti akumva sizingasonyezenso kuchuluka kwa mankhwala m’plazima yake kapena kutsimikizira kuti mankhwalawo achokeratu m’thupi pamene zimene akumvazo zatha.
Mtundu wa mkodzo, kugwiritsa ntchito mobwerezabwereza, ndi nthawi yogwiritsira ntchito mankhwala
Mkodzo wabuluu kapena wobiriwira si mayeso okonzedwa kuti ayeze kuchuluka kwa mankhwala molondola. Zolembazo zimavomereza kuti mtundu wa madzi a m’thupi ungasinthe, koma sizipereka mlingo wa mtundu womwe umatsimikizira kuti mankhwalawo achokeratu m’thupi. Kuona mtunduwo ukusazika sikungalowe m'malo mwa kuwunika kuyanjana kwa mankhwala.
Mmene impso zikugwirira ntchito kumasinthanso kumasulira kwa zotsatira. Zolemba zaposachedwa zimati thupi limakhudzidwa kwambiri ndi mankhwalawo pamene impso sizikugwira ntchito bwino, ngakhale nthawi ya kuchepa kufika theka sinali yosiyana kwa anthu omwe kuchepa kwa ntchito ya impso kunali kochepa kapena kwapakati. Kusiyana kumeneku kumasonyeza chifukwa chake nthawi ya kuchepa kufika theka yokha si muyezo wokwanira wa chitetezo. Buku lathu lofotokoza chitetezo cha methylene blue limafotokoza zinthu zambiri zokhudza wodwala zomwe ziyenera kuganiziridwa.
Kugwiritsa ntchito mobwerezabwereza kumabweretsa funso lina: kodi chimatsala n’chiyani pamene mankhwalawo aperekedwanso? Nthawi ya kuchepa kufika theka pambuyo poperekedwa kamodzi sikukhazikitsa ndondomeko yotetezeka ya tsiku lililonse, njira yogwira ntchito ya kugwiritsa ntchito ndi kupumitsa mosinthana, kapena chitetezo cha kugwiritsa ntchito kwa miyezi. Zimenezo zimafuna umboni wokhudza ndondomeko yeniyeni ya kugwiritsa ntchito mobwerezabwereza ndi zotsatira zake.
Musagwiritse ntchito kuwerengera nthawi ya kuchepa kufika theka kuti musiye, muyambirenso, kapena musiyanitse nthawi zotengera mankhwala olembedwa ndi dokotala. Zosankha zokhudza mankhwala ochepetsa kuvutika maganizo ndi mankhwala ena omwe amayanjana zimafuna mndandanda weniweni wa mankhwala, kapangidwe kake, njira yolowera, mbiri ya kugwiritsa ntchito, komanso mmene thanzi lilili. Buku lofotokoza kuyanjana kwa methylene blue ndi mankhwala ena limafotokoza kusiyana kumeneku. Kuti muthandize katswiri wa zaumoyo kapena wamankhwala, lembani dzina la chinthucho, kuchuluka kwake, njira yolowera, nthawi iliyonse yomwe chinagwiritsidwa ntchito, mankhwala omwe anatengedwa, ndi zizindikiro zilizonse. Mfundo zimenezi ndi zothandiza kuposa tsiku loyerekezeredwa loti mankhwalawo adzakhala atachokeratu m’thupi.