Ubururu bwa metilene na POTS: impamvu imikorere y'imiyoboro y'amaraso itemeza ko ari ubuvuzi

Ubururu bwa metilene ntabwo ari ubuvuzi bwemejwe bwa sindorome yo kwihuta kw'umutima iyo umuntu ahagaze, cyangwa POTS. Mu gushakisha inyandiko z'ubushakashatsi zakoreshejwe muri iyi ngingo, nta gerageza ryo kwa muganga ririmo itsinda ryo kugereranya ryabonetse ryerekana ko bugabanya ibimenyetso bya POTS cyangwa butuma umuntu arushaho gukora ibikorwa bya buri munsi. Ubushakashatsi kuri shock iterwa n'ubwandu no ku miyoboro y'amaraso ikoreshwa mu igerageza busubiza ibibazo bitandukanye.

Igitekerezo gishobora kureshya abantu ni uko POTS ifitanye isano n'itembera ry'amaraso, ubururu bwa metilene bushobora kurwanya zimwe mu mpuruza zituma imiyoboro y'amaraso irekura, bityo bukaba bwagombye kugabanya POTS. Buri ntambwe muri iki gitekerezo ikeneye gusuzumwa. Ingaruka umuti ugira ku nzira y'imikorere y'imiyoboro y'amaraso ntabwo zemeza ko iyo nzira ari yo itera ibimenyetso by'umuntu runaka, cyangwa ko kuyihindura bizamufasha guhagarara atabangamiwe.

Ibigomba kubanza gutandukanywa

Kutihanganira kuba umuntu ahagaze bivuga ibimenyetso bifitanye isano no kuba ahagaze. POTS ni imwe muri sindorome zisobanuwe neza ziri muri icyo kibazo cyagutse. Dysautonomia yo iragutse kurushaho, kuko ivuga ihungabana ry'imikorere y'uburyo umubiri ugenzura ibikorwa byawo byikora; ntabwo isobanura uburyo bumwe umuvuduko w'amaraso witwara.

Inyandiko y'ubwumvikane bw'impuguke za NIH kuri POTS isobanura ko umuvuduko w'umutima wiyongera bikagumaho nibura inshuro 30 ku munota mu minota 10 umuntu ahagaze, cyangwa nibura 40 ku bafite imyaka 12–19, hamwe n'ibimenyetso bimaze igihe bigaragara iyo umuntu ahagaze, bigabanuka iyo aryamye, kandi nta kugabanuka k'umuvuduko w'amaraso gukomeza kubaho iyo ahagaze. Ibimenyetso bigomba kuba bimaze nibura amezi atatu, kandi izindi mpamvu zishobora gutera kwihuta kw'umutima zigomba kuba zarakuweho. Igipimo cy'isaha yambarwa ku kuboko cyonyine ntigishobora kwemeza ko ibyo byose byujujwe.

Kugabanuka k'umuvuduko w'amaraso gusanzwe iyo umuntu ahagaze gusobanurwa n'igipimo gitandukanye: igisobanuro cyumvikanyweho n'imiryango y'inzobere mu mikorere y'umubiri yikora kivuga igabanuka rikomeza kubaho rya nibura 20 mmHg ku muvuduko w'amaraso igihe umutima wikanya cyangwa 10 mmHg igihe umutima uruhuka, mu minota itatu umuntu amaze guhagarara cyangwa kuryamishwa ku meza ahengamye umutwe uri hejuru. Shock ya vasoplegia ireba gutakaza gutunguranye k'ubushobozi bw'imiyoboro y'amaraso bwo kwikanya, bikagera ku rwego rubangamira itembera ry'amaraso. Ntisuzumwa hakoreshejwe ikizamini cyo guhagarara.

Igereranya: ikibazo, igipimo cy'ibisubizo, n'icyuho mu bimenyetso

Iri gereranya ritandukanya ibibazo by'ubushakashatsi; ntabwo ari urupapuro rwo gusuzumiraho indwara. Kuramo igereranya ry'ibibazo n'ibibazo byo kuganiraho kugira ngo ugumane hamwe ibyo bitandukaniro. Bifite akamaro no mu gusobanura ubururu bwa metilene n'impinduka z'umuvuduko w'amaraso.

Icyo igerageza kuri shock ryasuzumye koko

Mu igerageza rya Ibarra-Estrada na bagenzi be ryo mu 2023 ryagabanyije abitabiriye mu matsinda ku buryo bwa tombola, abantu bakuru bari bafite shock iterwa n'ubwandu bahawe ubururu bwa metilene mu mutsi cyangwa amazi arimo umunyu nk'ikintu cyo kugereranya kitagira umuti, hamwe n'ubuvuzi bw'indembe. Isesengura ryarimo abarwayi 91, 45 bahawe ubururu bwa metilene na 46 bahawe ikintu kitagira umuti. Ubuvuzi bwarimo kubatonyangiriza umuti mu mutsi mu gihe cy'iminsi itatu, ibisubizo bikurikiranwa kugeza ku minsi 28.

Igipimo nyamukuru cy'ibisubizo cyari igihe cyashize mbere y'uko imiti izamura umuvuduko w'amaraso ishobora guhagarikwa. Iyi ni imiti ikoreshwa mu gufasha umuvuduko w'amaraso igihe habaye shock. Igihe cyo hagati cyari amasaha 69 ku bahawe ubururu bwa metilene n'amasaha 94 ku bahawe ikintu kitagira umuti. Impfu n'igihe cyo gufashwa guhumeka n'imashini byari bisa mu matsinda yombi.

Ibyo ni ibimenyetso ku muti wunganira ubuvuzi mu gihe cyo kunanirwa gutunguranye kw'itembera ry'amaraso gufitanye isano n'ubwandu. Ntibyerekana ko ubururu bwa metilene bunyobwa bugabanya kwihuta kw'umutima iyo umuntu ahagaze, burinda kumva ugiye guta ubwenge, cyangwa butuma abafite POTS barushaho kujya ku ishuri. Abarwayi, inzira yo gutanga umuti, ubundi buvuzi buwuherekeza, igihe gikurikiranwa, n'igipimo nyamukuru cy'ibisubizo byose biratandukanye. Isesengura ryihariye ry'amagerageza y'ubururu bwa metilene muri vasoplegia na shock iterwa n'ubwandu risuzuma ibyo bimenyetso byo mu buvuzi bw'indembe mu rwego rwabyo.

Impamvu ibisobanuro bya okiside ya azote bituzuye

Okiside ya azote igira uruhare mu kurekura kw'imiyoboro y'amaraso, harimo no kohereza impuruza binyuze kuri guanylate cyclase ishonga na GMP y'uruziga. Ubururu bwa metilene bushobora kubangamira iyi mikorere, ariko kubuvuga gusa nk'ikibuza okiside ya azote gukora bihisha itandukaniro riri hagati y'amagerageza.

Urugero, igerageza rya Wolin na bagenzi be ryo mu 1990 ku miyoboro y'amaraso ryashyize ubururu bwa metilene ahantu hihariye ku miyoboro mito y'amaraso yo mu mikaya ifatanye n'amagufwa, yari yashyizwe ahagaragara mu mbeba zatewe ikinya. Bwagabanyije kwaguka kw'imiyoboro guterwa na acetylcholine na okiside ya azote. Superoxide dismutase yabujije uko gukumirwa, bishyigikira uruhare rwa superoxide iri hanze y'uturemangingo muri iyo miterere y'igerageza. Iri ryari igerageza ku mitsi mito itwara amaraso ava ku mutima mu gace kamwe, ntabwo ryari ubushakashatsi ku muti unyobwa n'abantu bafite POTS. Ibisubizo byaryo ntibishobora kwemeza inyungu mu buvuzi cyangwa kwangirika kw'imyakura muri abo barwayi.

Igitekerezo gishingiye ku miterere y'indwara na cyo ntikirahamye. Ubushakashatsi bwo mu 2005 ku myitwarire y'imiyoboro mito y'amaraso muri POTS bwagereranyije abitabiriye 15 bafite POTS irangwa n'itembera rito ry'amaraso, 17 bafite POTS irangwa n'itembera risanzwe, n'abitabiriye 13 bazima bo kugereranyaho, bafite imyaka 14–22. Abashakashatsi bapimye itembera ry'amaraso mu ruhu mu gihe imiyoboro y'amaraso yakorerwaga ibizamini mu gace kamwe. Ibyo babonye byerekanaga ko mu itsinda rifite itembera rito ry'amaraso hashobora kuba hari igabanuka ry'irekurwa rya okiside ya azote rishingiye ku mitembere y'amaraso. Ntibagerageje ubururu bwa metilene nk'ubuvuzi.

Ibyo byabonetse bishidikanya ku gitekerezo cy'uko POTS yose igaragaza okiside ya azote irenze urugero igomba kugabanywa. Ariko ntibyemeza ko buri muntu ufite POTS afite okiside ya azote idahagije. Nk'uko isesengura rya Mar na Raj rishingiye ku buvuzi ribisobanura, kwangirika kw'igice cy'imyakura igenzura ibikorwa by'umubiri byikora, ingano nke y'amaraso atembera, n'ubwiyongere bw'imikorere iterwa na adrenaline bishobora kugira uruhare mu buryo buhurirana. Itandukaniro hagati ya NOS, cGMP, n'impuruza zo mu miyoboro y'amaraso rifite akamaro kuko izina ry'inzira y'imikorere ritari isuzuma ryihariye ry'umurwayi.

Icyo inkuru z'abarwayi zivuguruzanya zishobora kutubwira

Ikiganiro kuri Phoenix Rising kirimo inkuru ivuga ko POTS yarushijeho gukomera cyane mu gihe cyo gukoresha ubururu bwa metilene. Ku rundi ruhande, ikiganiro kuri Reddit ku POTS kirimo inkuru ivuga ko umuvuduko w'umutima wahise ugenda neza, bikitirirwa ubururu bwa metilene. Izi nkuru zisobanura ibyabaye ku bantu n'ibibazo bibaza; ntabwo zemeza icyateye koroherwa cyangwa kuremba.

Ibibazo by'ingirakamaro birasobanutse. Ese ibimenyetso byapimwe umuntu ari mu mwanya umwe w'umubiri? Ese umuvuduko w'amaraso wahindutse hamwe n'umuvuduko w'umutima? Ese imiti cyangwa ibindi byunganira imirire byarahinduwe? Ese umuntu yumvise amerewe neza akanya gato gusa, cyangwa yongeye gushobora kumara igihe ahagaze akora ibikorwa mu minsi yakurikiyeho? Inkuru itarimo ayo makuru ntishobora gutandukanya ingaruka z'umuti n'impinduka zabereye icyarimwe cyangwa ihindagurika risanzwe ry'ibimenyetso.

Ku bantu banarwaye ME/CFS, kumva bafite imbaraga ako kanya ntibisubiza ikibazo cyo kumenya niba ibikorwa bakoze byaratumye barushaho kuremba nyuma. ME/CFS, ubururu bwa metilene, no kuremba nyuma yo gukora ibikorwa bisaba imbaraga bisuzuma icyo gipimo cy'ibisubizo cyihariye. Inkuru zishima cyane cyangwa iziteye impungenge nta na zimwe zitanga ishingiro ry'uburyo bwo kwigeragerezaho umuti mu rugo.

Ni iki cyatuma ibivugwa kuri POTS byemeza?

Ubushakashatsi bw'ingirakamaro bwakwakira abarwayi bafite isuzuma ryanditse, bugasobanura imiterere y'umuti n'inzira yo kuwutanga, bugakoresha uburyo bwizewe bwo kugereranya, kandi bugapima ibimenyetso n'ubushobozi bwo gukora ibikorwa. Umuvuduko w'umutima n'umuvuduko w'amaraso bigomba gusuzumirwa hamwe. Igihe cyo gukurikirana kigomba kuba gihagije kugira ngo hasuzumwe inyungu zirambye n'ingaruka mbi, aho gufata igipimo kimwe cyiza nk'ikimenyetso cyo gukira. Ibi ni ibisabwa kugira ngo ibivugwa bigeragezwe, ntabwo ari ibimenyetso by'uko ubuvuzi bukora.

Umutekano ufite akamaro kuri iki cyifuzo nyirizina. Amakuru yo muri Amerika agenewe kwandika ProvayBlue itangwa mu mutsi aburira ko kuyikoresha hamwe n'imiti igirana imikoranire na yo bishobora gutera sindorome ya serotonine ishobora kwica, kandi akabuza kuyikoresha ku bafite ibura rya G6PD kubera ibyago by'ibura ry'amaraso riterwa no gusenyuka kw'insoro zitukura. Yemewe gukoreshwa mu kuvura methemoglobinemia yabonetse nyuma yo kuvuka, ntabwo ari POTS. Ayo makuru ntabwo yemeza uburyo bwo kuyinywa mu kuvura ibimenyetso bifitanye isano no guhagarara.

Shyira umuganga usanzwe azi ibimenyetso byawe bifitanye isano no guhagarara ibivugwa nyirizina, igicuruzwa, urutonde rw'imiti ukoresha ubu, n'igisubizo wifuza kugeraho. Ibibazo byo kubaza mbere yo gutekereza gukoresha ubururu bwa metilene bifasha gutegura icyo kiganiro. Ikibazo kitarasubizwa ni ukumenya niba butanga inyungu ifatika kandi irambye ku barwayi bafite POTS, ntabwo ari ukumenya niba bushobora guhindura imiyoboro y'amaraso mu rundi rwego.