Kwinjira no gukwirakwira kw’ubururu bwa metilene mu mubiri hakurikijwe inzira butangwamo

Ubururu bwa metilene bushobora kugera mu maraso nyuma yo gutangwa mu kanwa, kandi igerageza ku nyamaswa ryerekana ko bukwirakwira mu ngingo, harimo n’ubwonko. Ibyo byagaragajwe ntibyemeza ko ubururu bwa metilene bwateguwe mu buryo butandukanye bwose bugera ku rugero rumwe mu mubiri, cyangwa ko inzira yamamazwa nk’iyihuta kurushaho itanga umusaruro mwiza kurushaho mu buvuzi.

Ikibazo cy’ingirakamaro ni ikigaragaza neza ibi: ni ubururu bwa metilene bwateguwe mu buhe buryo, bwatanzwe binyuze mu yihe nzira, bwatanze ikihe gipimo, mu rihe tsinda ryakoreweho ubushakashatsi? Igipimo cy’ubwinshi bwabwo mu maraso, ishusho y’ubwonko n’igice cy’uruhu cyahindutse ubururu bisubiza ibibazo bitandukanye.

Kwinjira mu maraso ni intambwe imwe mu nzira ndende

Kwinjira mu maraso bisobanura kuva aho ikinyabutabire cyatangiwe kikagera mu maraso atembera mu mubiri. Gutanga ikinyabutabire binyuze mu mutsi (IV) bituma kijya mu maraso ako kanya, kitarinze kunyura muri iyo ntambwe. Gukwirakwira bisobanura urujya n’uruza rukurikiraho hagati y’amaraso n’ingirangingo.

Igipimo nyakuri cy’igice kigera mu maraso agera mu mubiri wose kigereranya ubwinshi bw’ikinyabutabire bugera muri ayo maraso nyuma yo gutangwa mu nzira itari iyo mu mutsi n’ubugera muri yo nyuma yo gutangwa mu mutsi, hagakosorwa itandukaniro ry’ingano zatanzwe. Ubushakashatsi bukunze gukoresha ubuso buri munsi y’umurongo ugaragaza ubwinshi bw’ikinyabutabire uko igihe gihita, cyangwa AUC. AUC ihuza ubwinshi bwapimwe n’igihe; si ubwinshi bwo hejuru gusa cyangwa igihe umuntu atangiriye kumva impinduka.

Ikinyabutabire cyinjiye gishobora guhindurwa n’umubiri mbere yo kugera mu maraso agera mu mubiri wose. Bityo, ijanisha ry’ikiva mu mara ntirigomba kuba rimwe n’ijanisha ry’ikinyabutabire gipimwa kigera muri ayo maraso. Mu igerageza rya Shin na bagenzi be ku mbeba nto, abanditsi bagereranyije ko hafi ya byose byinjiye bivuye mu nzira y’igogora, nubwo igipimo cyapimwe cy’igice kigera mu maraso nyuma yo gutangwa mu kanwa cyari gito; basobanuye ko guhindurwa n’umubiri ari byo byashoboraga kubitera. Ibyo byagaragajwe mu mbeba nto, si ijanisha ryo guha igicuruzwa kigenewe abantu.

Kugereranya inzira yo gutanga n’icyitegererezo

Uku kugereranya gutandukanya ibipimo bitaziguye by’ubwinshi bw’ikinyabutabire n’impinduka kiba cyateye mu mubiri. Ingano zakoreshejwe mu bushakashatsi zisobanura uko ubushakashatsi bwakozwe, si ingano zo gutanga zasimburana cyangwa amabwiriza yo gukoresha.

Inzira n’ubushakashatsi	Itsinda ryakoreweho ubushakashatsi n’uburyo ikinyabutabire cyateguwe	Icyitegererezo cyangwa igipimo cy’umusaruro	Icyo ibyagaragajwe byemeza
Mu kanwa ugereranyije no mu mutsi, Walter-Sack na bagenzi be	Abantu bakuru 16 bafite ubuzima bwiza; ingano imwe ya 500 mg yashongeshejwe mu mazi igatangwa mu kanwa, ugereranyije na 50 mg mu mutsi, mu bushakashatsi buri muntu yakorewemo uburyo bwombi mu bihe bitandukanye	Imirongo yerekana ubwinshi muri plasma uko igihe gihita	Impuzandengo y’igipimo nyakuri cy’igice kigera mu maraso nyuma yo gutangwa mu kanwa yari 72.3%, naho ubuyobe busanzwe bwari ingingo 23.9 z’ijanisha. Iri gereranya rireba uburyo bwo gutegura n’amabwiriza y’ubushakashatsi byageragejwe.
Mu kanwa ugereranyije no mu mutsi, Peter na bagenzi be	Abakorerabushake barindwi; 100 mg muri buri nzira; incamake ntigaragaza ibisobanuro birambuye by’uburyo ikinyabutabire cyateguwe ngo gitangwe mu kanwa	Ubururu bwa metilene mu maraso yose bwapimwe hakoreshejwe HPLC	AUC yo mu maraso yose nyuma yo gutangwa mu kanwa yari hasi cyane ugereranyije na AUC yo gutangwa mu mutsi. Icyitegererezo n’amabwiriza y’ubu bushakashatsi bitandukanye n’iby’ubushakashatsi bwakoresheje ikinyabutabire cyashongeshejwe mu mazi.
Mu gice cya mbere cy’amara mato ugereranyije no mu mutsi, Peter na bagenzi be	Imbeba nini; ubururu bwa metilene bwashyizwe mu gice cya mbere cy’amara mato cyangwa mu mutsi	Ubwinshi mu ngirangingo no mu maraso yose	Gutanga mu gice cya mbere cy’amara mato byatanze ubwinshi buri hejuru mu rukuta rw’amara no mu mwijima, ariko buri hasi mu bwonko no mu maraso yose ugereranyije no gutanga mu mutsi. Ibi byari ibipimo byo mu ngirangingo z’imbeba nini.
Gukwirakwira mu ngirangingo nyuma yo gutangwa mu kanwa, Shin na bagenzi be	Imbeba nto; ubururu bwa metilene bwashongeshejwe mu mazi yatunganyijwe hakoreshejwe guteka no gukonjesha umwuka wayo, buhabwa imbeba hakoreshejwe umuyoboro ujya mu gifu; habayeho n’igereranya ritandukanye ryo gutanga mu mutsi	Plasma n’ingirangingo zavanywe mu mubiri zigasya zigahinduka imvange imwe, hakoreshejwe kromatografiya y’amazi hamwe na sipéktrometriya ya mase	Gukwirakwira mu mwijima kwari kugaragara cyane. Ubwinshi mu ngirangingo ntibwemeza inyungu y’ubuvuzi mu bantu.
Mu mazuru, Peng na bagenzi be	Imbeba nini zogaga kugeza zinaniwe cyane; ubururu bwa metilene mu mazi arimo umunyu, bwatanzwe nk’ibitonyanga mu mazuru imbeba zatewe ikinya	Imyitwarire, ibimenyetso byo mu ngirangingo z’ubwonko n’imiterere ya mitokondiriya	Igerageza ryagaragaje impinduka mu mikorere y’umubiri. Ntiryemeje igipimo cy’igice kigera mu maraso y’abantu nyuma yo gutangwa mu mazuru cyangwa ko iyo nzira iruta gutanga mu kanwa cyangwa mu mutsi.
Gusiga ku ruhu, ubushakashatsi bwo muri 2023 ku duce duto cyane no ku gukoresha amajwi arenze ayo amatwi yumva kugira ngo ikinyabutabire cyinjire mu ruhu	Uruhu rw’ugutwi kw’ingurube rwavanywe ku mubiri; ubururu bwa metilene mu mazi bugereranyijwe n’uburi mu duce duto cyane twa polimeri, uruhu rwabanje cyangwa rutabanje gukorerwa amajwi arenze ayo amatwi yumva	Irangi mu byiciro by’uruhu no mu mazi yakiraga icyambutse uruhu nyuma y’amasaha 16	Igice cyagumye mu ruhu cyarashoboraga gupimwa, mu gihe ubururu bwa metilene mu mazi yakiraga icyambutse uruhu bwari munsi y’urugero uburyo bwo gupima bwashoboraga kubariraho ubwinshi. Kwinjira mu ruhu aho byashyizwe no kwambuka uruhu byari ibisubizo bitandukanye.

Plasma n’amaraso yose ntibishobora gufatwa nk’ibingana

Amaraso yose arimo plasma n’uturemangingo tw’amaraso. Gupima plasma bireba igice cy’amazi nyuma yo gutandukanya uturemangingo na cyo. Iyo ikinyabutabire kigabanyuka kikinjira mu turemangingo, ubwinshi bwacyo butangazwa buterwa n’igice laboratwari yapimye.

Amakuru yo kwandika PROVAYBLUE ku murwayi agaragaza impamvu gukoresha igipimo kidahinduka mu guhindura ubwinshi bwo mu maraso yose ukabugira ubwo muri plasma bidakwiriye kwizerwa. Mu bushakashatsi bumwe bwo gutanga mu mutsi bwakorewe ku bantu, igipimo cy’ubwinshi mu maraso ugereranyije n’ubwo muri plasma cyari 5.1 ± 2.8 ku munota wa gatanu, maze kigera ku rugero rudakomeza guhinduka rwa 0.6 ku isaha ya kane. Iyo sano yagiye ihinduka uko igihe cyahitaga.

Ayo makuru anavuga ko hafi 94% bifatana na poroteyine za plasma mu igerageza ryo muri laboratwari (in vitro). Ibi bisobanura kwifatanya na poroteyine mu bihe bya laboratwari. Ntibisobanura ko 94% bitinjiye mu maraso, cyangwa ko igice gisigaye kidahinduka cyinjiye mu bwonko. Ubwinshi bwose muri plasma bukubiyemo ikinyabutabire cyifatanyije na poroteyine n’ikitazifatanyije na zo.

Ndetse n’igisubizo ku mikoranire y’imiti gishobora guterwa n’icyitegererezo. Mu bushakashatsi bwo gutanga mu kanwa ikinyabutabire cyashongeshejwe mu mazi, chloroquine yongereye ubwinshi bw’ubururu bwa metilene muri plasma ariko ntiyabwongera mu maraso yose. Isomo ry’ingirakamaro ni ugukomeza kugaragaza ubwoko bw’icyitegererezo igihe usubiramo igisubizo, aho guhitamo ijanisha rinini kurusha ayandi mu bushakashatsi butandukanye.

Kugera mu bwonko ntibyemeza inyungu ku bwonko

Ibimenyetso by’uko ubururu bwa metilene bushobora kwambuka inzitizi iri hagati y’amaraso n’ubwonko bishyigikira ubushakashatsi ku mpinduka mu bwonko. Ntibigaragaza ingano igera mu gace runaka k’ubwonko bw’umuntu, cyangwa niba kugerayo bifasha mu ndwara.

Igerageza ku mikoranire y’ibice by’ubwonko nyuma yo gutanga mu kanwa ryitabiriwe n’abantu bakuru 28 bafite ubuzima bwiza, rigereranya ubururu bwa metilene n’ikinyabutabire kidafite umuti hakoreshejwe MRI. Ibyo ryabonye byarebaga imikorere y’ubwonko n’imikoranire y’ibice byabwo, si ugupima mu buryo butaziguye ubururu bwa metilene imbere mu bwonko.

Ubundi bushakashatsi bwo gutanga mu mutsi bwakorewe ku bantu bafite ubuzima bwiza no ku mbeba nini bwagaragaje kugabanuka kw’amaraso atembera mu bwonko n’ibipimo by’imikorere yo guhindura ibinyabutabire mu mubiri, mu bihe by’iryo gerageza. Ibyo bisubizo bituburira kudafata ko kugera mu bwonko byanze bikunze byongera ingufu bukoresha. Ntibishobora kandi kugaragaza niba gutanga mu kanwa biruta gutanga mu mutsi, kuko ubwo bushakashatsi bwakoresheje amatsinda, amabwiriza n’ibipimo by’umusaruro bitandukanye.

Kwinjira mu turemangingo binyuze mu kugabanywa, kongera okisidasiyo no kugabanyuka hagati y’ibice bireba urundi rwego rw’iki kibazo. Kuba ikinyabutabire cyinjiye mu karemangingo kororewe muri laboratwari ntibiba byerekanye ko gifite akamaro mu buvuzi. Itandukaniro ry’uburyo bw’igerageza risobanurwa mu buryo bwo gusoma ubushakashatsi ku bururu bwa metilene.

Ibivugwa ku gutanga munsi y’ururimi, mu mazuru, mu guhumeka no kwambutsa uruhu

Gutanga munsi y’ururimi bisobanura kwinjira mu maraso binyuze mu ngirangingo ziri munsi y’ururimi. Kumira igice cy’amazi byongeraho igice gica mu nzira yo gutanga mu kanwa. Inyandiko zabonetse zikoreshwa muri iyi ngingo ntizemeza ijanisha ryizewe ry’igice kigera mu maraso y’abantu nyuma yo gutangwa munsi y’ururimi, cyangwa inyungu yagaragajwe yo kurutisha ubwo buryo kumira. Gusigara kw’ibara munsi y’ururimi ntibishobora gutandukanya ibyinjiye binyuze mu rurenda n’ibyageze mu mubiri nyuma yo kumirwa.

Gutanga mu mazuru ni ikibazo ukwacyo. Ubushakashatsi ku mbeba nini twavuze haruguru bwakoresheje ibitonyanga byo mu mazuru byatanzwe mu buryo bugenzurwa imbeba zatewe ikinya. Ibyagaragajwe ku myitwarire no ku ngirangingo ntibyemeza igice cyinjiye binyuze mu ngirangingo z’amazuru, igice cyavuye mu mazuru kigahita kigera mu bwonko, cyangwa imikorere y’igicuruzwa cyo gutera mu mazuru gikoreshwa n’abaguzi. Ibyo bivugwa bisaba ibipimo by’ubwinshi byihariye kuri iyo nzira n’uburyo bukwiye bwo kubigereranya.

Guhumeka hakoreshejwe igikoresho gihindura amazi igihu byongeraho gukora igihu n’aho gitura mu nzira z’ubuhumekero, byose biterwa n’igikoresho. Raporo y’igerageza ry’ibanze ku gukoresha icyo gikoresho nyuma ya COVID ireba ibisubizo ku mikorere y’ibihaha no ku rugero rw’ogisijeni mu maraso. Kuba iyo raporo iriho ntibitanga uburyo bwo guhindura ubwinshi bugera mu mubiri nyuma yo gutangwa mu kanwa cyangwa mu mutsi ngo buhwane n’ubwo mu gikoresho cyo mu rugo gihindura amazi igihu. Igikoresho cyongerera ogisijeni ubuhehere na cyo ni ikindi gikoresho; nta bushakashatsi bwo gutanga mu kanwa cyangwa iryo gerageza ry’ibanze byemeza gushyira ubururu bwa metilene mu kigega cyacyo. Ntugakoreshe ibisukika bigenewe kunyuzwa mu kanwa cyangwa gukoreshwa muri laboratwari mu bikoresho by’ubuhumekero.

Gutanga binyuze mu ruhu bisobanura kwambuka uruhu ugana mu maraso agera mu mubiri wose. Ahubwo, ikinyabutabire cyateguwe ngo gisigwe ku ruhu gishobora gutuma ubururu bwa metilene buguma mu ruhu. Igerageza ku ruhu rw’ingurube ryerekana impamvu ibyo bigomba gupimwa ukwabyo. Igerageza ryajyanaga na ryo ku kwangiza uturemangingo twa kanseri bitewe n’urumuri na ryo ntiryemeza ingaruka y’ubuvuzi ituruka ku gapapuro gafatishwa ku ruhu cyangwa kuri kereme bikoreshwa n’umuntu.

Ingaruka z’ibiribwa zikeneye igereranya ryazo

Ubushakashatsi bwakozwe abantu bamaze igihe batarya bugaragaza ibyabaye muri ibyo bihe byo kutarya. Ntibwemeza ko kutarya bituma ikinyabutabire cyinjira neza kurushaho mu maraso. Kuvuga ko ibiribwa bigira ingaruka bisaba kugereranya abariye n’abamaze igihe batarya, hakoreshejwe ikinyabutabire cyateguwe mu buryo bumwe n’ibipimo bikwiye by’ubwinshi bugera mu mubiri.

Ubushakashatsi bwanditswe kuri LMTB n’ingaruka z’ibiribwa bureba ikinyabutabire gifitanye isano n’ubururu bwa metilene, ariko inyandiko y’iyandikisha igitandukanya na methylthioninium chloride. Ibisobanuro by’ubwo bushakashatsi si igisubizo ku ngaruka z’ibiribwa ku gisukika gisanzwe cy’ubururu bwa metilene. Ibimenyetso byasuzumwe hano ntibishyigikira kuvuga muri rusange ko kurya bigabanya kwinjira mu maraso cyangwa ko kutarya bikongera.

Igihe umuntu yumva impinduka zitangiye, ibara ry’inkari n’ibara risigara ku rurimi ntibishobora gusimbura ibipimo by’ubwinshi uko igihe gihita. Ibibazo bijyanye n’igihe bimara birebwa mu gihe ubururu bwa metilene bugabanukira ku gice n’igihe bumara mu mubiri. Guhitamo inzira yo gutanga mu buvuzi na byo biterwa n’impamvu y’ubuvuzi no ku bisabwa ku binyabutabire byateguwe ngo biterwe mu mubiri, si ku gipimo cy’igice kigera mu maraso gusa.