Methylene blue, Prussian blue na hydroxocobalamin: imiti itatu irwanya uburozi ku bibazo bitandukanye

Imiti itatu ihuriye ku ijambo ry'ibara, ariko nta bindi byinshi ihuriyeho. Methylene blue ni irangi ry'ubururu rigira uruhare mu guhererekanya electron. Prussian blue ni urusobe rw'utubuye twa kirisitali tw'ubururu. Hydroxocobalamin, igurishwa ku izina rya Cyanokit, ni ikinyabutabire gitukura kivamo vitamine B12. Umusomyi uyishyira mu itsinda rimwe ashingiye ku mazina yayo ashobora gutekereza ko ikora imirimo isa. Si ko biri. Buri muti washingiwe ku gusobanukirwa ikibazo cyihariye cyabaye mu mubiri, kandi nta cyo umara ku bibazo bitajyanye n'ubwo buryo ukora.

Isano nyayo hagati ya buri muti n'ikibazo ukemura iroroshye. Methylene blue isubiza ubushobozi bwo gukora hemoglobine yatakaje ubwo bushobozi kubera oxidasiya. Hydroxocobalamin ifata cyanide mu buryo butaziguye. Prussian blue ifatira cesium isohora imirasire na thallium mu mara kugira ngo umubiri ubisohore. Ibara ni icyo tubona. Uburyo ikora ni bwo shingiro, kandi urujijo ruri mu guhuza icyo tubona n'uko ikora.

Iri gereranya rigamije kwigisha, si amabwiriza yo kuvura. Gukeka methemoglobinemia, guhura na cyanide, guhura na monoxyde de carbone cyangwa kwanduzwa n'ibintu bisohora imirasire ni ikibazo cyihutirwa. Hamagara ubutabazi bwihutirwa kandi ukurikize inama z'urwego rw'iwanyu rushinzwe uburozi aho gufata icyemezo ushingiye ku nyandiko.

Methylene blue: umuhuza usubiza hemoglobine ubushobozi bwo gukora

Hemoglobine isanzwe itwara ogisijeni ku cyuma kiri mu miterere ya ferrous, Fe2+. Muri methemoglobinemia, icyo cyuma kiba cyarahinduwe na oxidasiya kikajya mu miterere ya ferric, Fe3+, idashobora gufata ogisijeni. Amaraso ashobora kugaragara ari umukara wijimye usa na shokola. Igipimo gisanzwe cya ogisijeni gipimwa hifashishijwe igikoresho gifatishwa ku ruhu gishobora kuyobya. Umurwayi aba afite hemoglobine nke ishoboye gukora nubwo ibihaha bikomeza kwinjiza no gusohora umwuka.

Methylene blue ikora kuri iki kibazo kuko ari umuhuza mu guhererekanya electron, nk'uko bisobanurwa mu buryo methylene blue yimura electron hagati y'ibizitanga n'ibizakira. Mu turemangingo dutukura tw'amaraso, ihinduka leucomethylene blue binyuze mu nzira ishingiye kuri NADPH, maze iyo miterere yakiriye electron ikaziha icyuma cya ferric nta misemburo ibigizemo uruhare, ikagisubiza mu miterere ya ferrous. Iryo rangi rikomeza kujya muri izo miterere yombi aho gushira. Ubwo buryo ikora ni bwo butuma gukoresha methylene blue kuri methemoglobinemia bikorwa mu bitaro, hapimwa urugero rwa methemoglobine kandi hagakurikiranwa uko umurwayi yitabira umuti, aho kuba gahunda yo kwivurira mu rugo.

Amabwiriza agezweho ya methylene blue agaragaza ko yemewe kuvura methemoglobinemia umuntu atavukanye, ku bantu bakuru no ku bana. Igipimo gisanzwe ku bantu bakuru no ku bana ni 1 mg kuri kg, itangwa mu mutsi mu gihe cy'iminota 5 kugeza kuri 30, kandi ishobora gutangwa rimwe rya kabiri niba urugero rwa methemoglobine cyangwa ibimenyetso bikomeje kuba hejuru. Ibisobanuro ku mipaka y'igipimo, ibisabwa kugira ngo umuti wongere gutangwa n'igihe cyo guhindura uburyo bwo kuvura biri mu mabwiriza agezweho ya methylene blue. Ibibazo bijyanye n'inzira yo gutanga umuti no gukurikirana umurwayi bisobanurwa mu buryo methylene blue itangwa ikanagenzurwa.

Hari imbibi eshatu z'ingenzi. Icya mbere, kubura umusemburo glucose-6-phosphate dehydrogenase ni impamvu yemewe ibuza gukoresha uyu muti, kuko bigabanya NADPH ikenewe kugira ngo irangi ryakire electron. Ibyo bituma umuti udakora kandi bikongera ibyago byo gusenyuka kw'uturemangingo dutukura tw'amaraso. Icya kabiri, methylene blue ibuza monoamine oxidase A gukora no ku rugero rwa nanomolar. Ni yo mpamvu kuyitanga hamwe na SSRIs, SNRIs, MAOIs na opioids zimwe na zimwe bifite umuburo ukomeye uri mu gasanduku ku byago bya sindorome ya serotonine, nk'uko bisuzumwa mu bijyanye n'umutekano wa methylene blue n'imikoranire yayo n'indi miti. Icya gatatu, imikorere mibi y'impyiko ihindura urugero n'igihe umuti umara mu mubiri, kandi amabwiriza yawo ateganya ko abarwayi bafite ikibazo cy'impyiko giciriritse cyangwa gikomeye bahabwa igipimo kimwe gusa. Nta na kimwe muri ibi ari akantu gato ko kwirengagiza. Buri kimwe gituruka ku ihame rimwe ry'uwo muhuza: umuti ukoresha electron z'uturemangingo kandi ukagira icyo ukora ku misemburo ya monoamine uzagira imikoranire n'ibyo byombi.

Methylene blue inafite amateka yo gukoreshwa ku burozi bwa cyanide, guhera mu myaka ya 1930, ariko amateka si bwo buryo bwo kuvura bukoreshwa ubu. Abashakashatsi ba mbere bavuze ko ishobora kugira ingaruka binyuze mu guhererekanya electron cyangwa muri methemoglobine. Mu myaka ya 1950, hafashwe umwanzuro ko itakoraga neza kuri cyanide ugereranyije n'uburyo bukoresha nitrite na thiosulfate. Ubu nta ruhushya ifite muri Amerika rwo kuvura uburozi bwa cyanide. Ubushakashatsi bushya kuri cyanide bwakorewe ku mbeba no ku turemangingo ni ibimenyetso bibanziriza ubushakashatsi ku bantu, si impamvu yo kuyikoresha mu gihe cy'ubutabazi bwihutirwa kubera cyanide.

Hydroxocobalamin: igice cyo hagati cya cobalt gifata cyanide

Cyanide ibuza cytochrome c oxidase gukora muri mitochondria, bigatuma uturemangingo tudashobora gukoresha ogisijeni nubwo ogisijeni iri mu maraso yo mu mitsi iyavana ku mutima isa n'ihagije. Hakurikiraho kwiyongera kwa aside lactique mu maraso, ihinduka ry'imitekerereze cyangwa ry'ubushobozi bwo kumenya ibibera hafi, n'imikorere y'umutima n'imitsi y'amaraso igahungabana bikomeye. Ihame ryo kuvura ni ugukuraho cyanide ubwayo, si uguhindura hemoglobine.

Hydroxocobalamin, igurishwa ku izina rya Cyanokit, ibikora mu buryo butaziguye. Igice cyayo cyo hagati cya cobalt gifata ion ya cyanide mu mwanya wa ligand yayo ya hydroxo, kigakora cyanocobalamin, ari yo vitamine B12 isanzwe, isohorwa n'impyiko. Ubu ni uburyo bwo gufata cyanide ikagumishwa hamwe n'umuti, si ukuzenguruka mu miterere itanga n'iyakira electron. Igipimo cyemewe ku muntu mukuru ni 5 g zitangwa mu mutsi mu gihe cy'iminota igera kuri 15, hakiyongeraho izindi 5 g niba igisubizo kidahagije, kugeza ku gipimo ntarengwa cya 10 g. Ni yo mpamvu kugereranya methylene blue na Cyanokit guhita gusobanuka iyo ikibazo kibajijwe neza: ku burozi bwa cyanide bwemejwe cyangwa bukekwa, hydroxocobalamin ni wo muti ugezweho ubanza gukoreshwa muri Leta Zunze Ubumwe za Amerika, hamwe n'undi muti uhuza nitrite na thiosulfate ukoreshwa ku barwayi bamwe batoranyijwe. Methylene blue ntishobora kuyisimbura kuri icyo kibazo.

Imiterere y'uyu muti ituma habaho ingaruka ebyiri z'ingenzi mu kuwukoresha. Umuti uratukura cyane, bityo uruhu rutukura n'inkari zitukura ni ibintu byitezwe; rimwe na rimwe ibara ry'inkari rishobora kumara ibyumweru. Kuba winjiza urumuri cyane binabangamira ibipimo byo muri laboratwari bishingiye ku ibara n'ibipimo bya carboxyhemoglobine, methemoglobine na oxyhemoglobine bifatwa hakoreshejwe co-oximetry. Ingano y'ikosa n'uko ryongera cyangwa rigabanya igipimo biterwa n'igikoresho gipima. Umuganga utabizi ashobora gusoma nabi imibare ubwayo ikoreshwa mu gusuzuma uburozi. Imithi ya kera yo kuvura uburozi bwa cyanide yari ishingiye kuri amyl nitrite, sodium nitrite na sodium thiosulfate yakoraga mu bundi buryo: nitrite yakoraga methemoglobine ku bushake kugira ngo ifate cyanide, naho thiosulfate igafasha guhindura cyanide ikaba thiocyanate. Ubwo buryo bugabanya ubushobozi bwo gutwara ogisijeni kandi bushobora kugabanya umuvuduko w'amaraso. Ibyo ni igihombo kitifuzwa iyo guhumeka umwotsi bivuze ko monoxyde de carbone na yo ishobora kuba ihari. Hydroxocobalamin yirinda icyo gihombo kuko ifata cyanide idakoze methemoglobine.

Prussian blue: umutego wa kirisitali uguma mu mara

Prussian blue, igurishwa ku izina rya Radiogardase, ni ferric hexacyanoferrate idashonga. Ijambo cyanide muri iyo nyandiko y'ikinyabutabire risobanura ligands zifungiye muri kirisitali y'icyuma, si cyanide yigenga, kandi uyu muti nta ruhare ufite mu kuvura uburozi bwa cyanide. Wemewe kuvura kwanduzwa imbere mu mubiri na cesium isohora imirasire cyangwa na thallium isohora cyangwa idasohora imirasire.

Ihame ryawo ni uguhanahana ion mu mwanya w'imbere mu mara. Utwo tubuye twa kirisitali ntitwinjira mu mubiri tunyuze mu rukuta rw'amara rudafite ikibazo. Tuguma mu mara, tugafatira ion za cesium cyangwa thallium mu rusobe twubatsemo, harimo n'izasohowe mu ndurwe, kandi tugahagarika uruzenguruko rwo kuva mu mara kujya mu mwijima no gusubira mu mara, bityo ubutare bwinshi bukava mu mubiri mu mwanda. Urupapuro rwa CDC ku kuvura hakoreshejwe Prussian blue rusobanura ubwo buryo mu magambo yoroshye: ifatira ibyo byuma mu mara kandi ikihutisha gusohoka kwabyo mu mwanda. Gahunda y'umuti ku bantu bakuru n'ingimbi n'abangavu ni 3 g zinyobwa gatatu ku munsi. Abana bato bahabwa ibipimo biri hasi bishingiye ku buremere bwabo, kandi umuti ukunze gukomeza gutangwa mu gihe cy'iminsi 30 cyangwa irenga, hakurikiranwa urugero rw'iyanduzwa riri mu mubiri.

Ibi bisubiza mu buryo butaziguye ikibazo cyo gushaka itandukaniro hagati ya Prussian blue na methylene blue. Methylene blue ikorera mu maraso nk'umuhuza mu guhererekanya electron. Prussian blue ikorera mu mara nk'umutego utinjira mu mubiri. Umwe usubiza ubushobozi bwo gukora poroteyine irimo icyuma. Undi ugabanya igihe icyuma kimara mu mubiri. Kuyisimburanya byasiga ibyo bibazo byombi bitavuwe: methemoglobine yaguma mu miterere yahinduwe na oxidasiya, naho cesium igakomeza kuzenguruka.

Monoxyde de carbone: aho methylene blue idakwiye gukoreshwa

Monoxyde de carbone ifata hemoglobine mu buryo bukomeye cyane kurusha ogisijeni kandi igahindura uko ogisijeni itandukana na hemoglobine, ikanagira ingaruka ku mutima no muri mitochondria. Ubuvuzi busanzwe ni ugukura umurwayi aho ahurira na yo no kumuha ogisijeni ya 100 ku ijana kugeza ibimenyetso bishize, akenshi mu gihe cy'amasaha menshi. Ogisijeni itangwa mu cyumba gifite umuvuduko uri hejuru y'usanzwe ishobora kwitabazwa ku barwayi bamwe bafite ibimenyetso bikomeye, nko guhungabana gukomeye kw'imikorere y'ubwonko n'imyakura, guta ubwenge, kugira ikibazo ku mutima cyangwa kwiyongera gukomeye kwa aside mu maraso. Inyandiko z'inzego za Leta Zunze Ubumwe za Amerika zivuga ku butabazi bwihutirwa, zegeranyijwe mu nyandiko za CDC ku buvuzi bwihutirwa, zishyira ogisijeni n'ubuvuzi bufasha imikorere y'umubiri ku isonga muri ubu buryo bwo kuvura.

Bityo, gushaka amakuru ya methylene blue ku burozi bwa monoxyde de carbone bishingiye ku kwibeshya gusa n'aho gufite ishingiro: niba irangi ry'ubururu rikosora ikibazo kimwe cya hemoglobine, wenda ryakosora n'ikindi. Si ko biri. Uyu muti ntiwemewe kuvura uburozi bwa monoxyde de carbone, kandi gahunda zigezweho zo kuvura ubwo burozi ntiziwushyiramo. Iki gitekerezo ni icya kera: cyatanzwe mu bushakashatsi ku nyamaswa mu ntangiriro z'imyaka ya 1930 kandi kinyomozwa n'isuzuma ry'ubushakashatsi mu gihe cy'umwaka umwe. Ubushakashatsi bumwe bugezweho ku mbeba, rimwe na rimwe buvugwa kuri iyi ngingo, bwagerageje kurinda ubwonko nyuma y'igihe runaka imbeba zihuye n'ubwo burozi, aho guhita bukuraho carboxyhemoglobine. Icyuma cyahinduwe na oxidasiya n'icyuma gifashe monoxyde de carbone ni imiterere ibiri itandukanye ya poroteyine imwe, kandi umuhuza ugenewe iya mbere nta ngaruka zemejwe ufite ku ya kabiri. Abasomyi bakurikirana iyi mbibi bazasanga ari ingirakamaro kuyihuza n'ishusho yagutse y'ubushakashatsi kuri methylene blue, itandukanya ikoreshwa ryemewe ku bantu n'ibimenyetso biva ku turemangingo no ku nyamaswa.

Igenzura rigereranya mbere yo kugira indi myanzuro

Gereranya iyo mbonerahamwe n'amakosa atatu akunze gukorwa. Amazina asa ntavuze ko imiti igamije gukemura ibibazo bisa. Ibara rikomeye ntirivuze ko imiti ikorera mu mubiri mu buryo bumwe; gutukura kwa hydroxocobalamin n'ubururu bw'indi miti ibiri nta cyo bivuga ku kuba yasimburana. Kandi igisubizo cy'ubushakashatsi ku burozi bumwe ntigishobora kwimurirwa ku bundi burozi gusa kubera ko busa n'aho buri hafi yabwo. Banza wumve amahame y'uko imiti ikora, ukurikizeho amazina, naho ibyemezo by'ubutabazi bwihutirwa ubifate hamwe n'abaganga babushinzwe.