Chinyorwa
Methylene blue pakucheturwa kwemhuka huru nenitrate nenitrite
Boka remombe rinotanga kufura mapfunde akakanganiswa nekusanaya kwemvura masikati. Manheru, mombe dzakawanda dzinenge dzasarira shure, dzichifema nokukurumidza, dziine makanda emukati akasviba uye ropa rebhurawuni panobayiwa tsinga. Mabhiza ari mumafuro ari pedyo anoita seasina kukanganiswa. Musiyano uyu hausi wemhanza. Unobva panzvimbo inoshandukira nitrate kuva nitrite, uye nzvimbo iyoyo ndiyo inotema zvose kuziva dambudziko uye hurongwa hwemushonga unopikisa chepfu.
Pfungwa huru iri nyore: nitrate kazhinji chinhu chinotangira kuumbwa kwechepfu, nitrite ndiyo chepfu, uye methylene blue inoshandiswa pamombe dzakawana nitrate inorapa kukanganiswa kwehemoglobin nenitrite. Zvimwe zvose zviri muchinyorwa chino zvinobva pamatanho matatu iwayo.
Nitrate inoshanduka kuva nitrite mukati memhuka
Nitrate iri muzvirimwa zvinofurwa pachayo ine simba shoma rekuita oxidation. Tupukanana turi murumen tinoideredza mumatanho maviri, kutanga kubva panitrate kuenda panitrite, kozoti kubva panitrite kuenda paammonia. Kana nitrate yakawanda ikapinda panguva imwe chete, danho rokutanga rinokurumidza kupfuura rechipiri. Nitrite inoungana, yopinda muropa, yoita oxidation yesimbi iri muhemoglobin kubva pachimiro cheferrous chinotakura okisijeni kuenda pachimiro cheferric. Panobuda methemoglobin, isingakwanisi kutakura okisijeni.
Ongororo yeMSD Veterinary Manual pamusoro pekucheturwa nenitrate nenitrite inofungidzira kuti nitrite ine simba rechepfu rakapetwa kanenge kagumi pane nitrate uye inotsanangura kutevedzana kumwe cheteko. Zvinowanzokonzera dambudziko zvinosanganisira zvirimwa zvinofurwa zvinounganidza nitrate zvakadai seoats, mhunga, ryegrass, chibage, maringazuva, nemhando dzemapfunde, pamwe nemasora akadai sepigweed, lambsquarter, kochia, neJohnson grass, kudya fetereza, uye madziva kana matsime asina kudzika akasvibiswa nemvura inoyerera ichibva pamusoro pevhu. Kusanaya kwemvura, kushandisa fetereza ine nitrogen yakawanda, uye kumira kwekukura kwezvirimwa mushure memamiriro ekunze ane makore kana anotonhorera zvinowedzera nitrate muzvirimwa zvinofurwa.
Chikamu chemethemoglobin hachinyatsoratidzi kukomba kwedambudziko, asi hukama hwacho hunobatsira pakusarudza kuti ndezvipi zvinoda kubatsirwa nokukurumidza. MSD inoisa zviratidzo zvekutanga zvakadai sekurova kwemwoyo nokukurumidza, kushaya simba, kudedera, uye kusarongeka kwekufamba pedyo ne30 kusvika 40 muzana yemethemoglobin, kutadza kufema kwakanyanya nemakanda emukati ebhurawuni kana ebluish pamusoro peinenge 50 muzana, uye kufa kuchiwanzoitika pa80 muzana kana kupfuura. Ropa rebhurawuni rakaita sechokoreti rinoramba riri rebhurawuni kana riri mumhepo chiratidzo chinozivikanwa, asi hariratidzi dambudziko iri roga chete. Methemoglobin inodzokera kuchimiro chayo chokutanga nokukurumidza zvekuti masampuli anononoka kutorwa anoratidza huwandu huri pasi pehwepamusoro hwakanga hwasvikwa. Kuti dambudziko risimbiswe, MSD inosarudza kuongorora nitrate muplasma mhuka isati yafa uye mumvura yemukati meziso mushure mekufa, pamwe nekuongorora zvirimwa zvinofurwa nemvura. Huwandu hunopfuura inenge 20 ppm yenitrate kana 0.5 ppm yenitrite mumasampuli akakodzera anobva mumhuka hunowanzoratidza kuti mhuka yakawana zvakawandisa.
Mashandurirwo anoitwa kuvharika uku nemethylene blue
Mumamiriro enguva dzose, methemoglobin yakawanda inoderedzwa ichidzokera kuhemoglobin nehurongwa hweNADH necytochrome b5 reductase. Methylene blue inoshandisa imwe nzira yechipiri inowanzoshanda zvishoma. NADPH yemusero, inogadzirwa nenzira yepentose phosphate, inopfuudza maerekitironi kuburikidza nereductase inotsamira paNADPH kuenda kumethylene blue, ichiishandura kuva leucomethylene blue, iyo inozoderedza simbi yeferric ichidzokera kuhemoglobin ine simbi yeferrous. Ongororo yeStatPearls pamusoro pemashandiro acho inotsanangura basa iri rekutakura maerekitironi.
Makemikari mamwe chete aya ndiwo anounzawo chenjedzo huru. Methylene blue mushonga unoita redox, kwete antioxidant yakachena chete. Kana huwandu hwayo hwakanyanya, iyo pachayo inoita oxidation, ichigadzirazve methemoglobin uye ichikuvadza masero matsvuku eropa. Ndokusaka kusaita zvakanaka kwemushonga kuchifanira kuita kuti chiremba wemhuka aongororezve kuti dambudziko razivikanwa nemazvo here, kana nitrite ichiri kupinda muropa ichibva murumen, uye mamiriro emasero matsvuku eropa, pane kungodzokorora huwandu hukuru. Maitiro anowanzoteverwa muchipatara, anosanganisira kuziva dambudziko neco-oximetry uye kubaya mushonga zvichitarisirwa, anotsanangurwa mumethylene blue yemethemoglobinemia.
Kuenzanisa marudzi emhuka nenzira dzekuwana chepfu
Tafura iyi inobatsira pakuita zvisarudzo. Mutsetse mumwe nomumwe unobatanidza nzira inopinda nayo chepfu, nzvimbo inoshandurwa nitrate, uye zvinogona nezvisingagoni kuitwa nemethylene blue.
| Boka remarudzi emhuka | Panoumbwa nitrite | Zvinowanzopa chepfu | Mamiriro ekushandisa methylene blue |
|---|---|---|---|
| Mombe | Murumen, zvine pundutso yakakura | Zvirimwa zvinofurwa zvine nitrate yakawanda, fetereza, mvura yakasvibiswa | Dzinonyanya kutarisirwa kupiwa mushonga unopikisa chepfu; huwandu hunoshandiswa sereferensi i4 kusvika 15 mg/kg inopiwa zvishoma nezvishoma neIV mumhuka dzinodzeya, kudzokorora kuchienderana nekukomba kwedambudziko uye kuramba chepfu ichipinda muropa |
| Hwai nembudzi | Murumen, zvine pundutso yakakura | Zvirimwa zvinofurwa nemvura zvakafanana; hwai dzinowanzotsanangurwa sedzisingakanganiswi zvakanyanya semombe | Hurongwa humwe chete hwemhuka dzinodzeya; mishumo yakabudiswa inobva pahuwandu hushoma hwe mg/kg hwenhamba imwe hunoshandiswa mumafuro kusvika ku15 mg/kg mumiedzo, saka hwai hadzingofaniri kupiwa huwandu hushoma nguva dzose |
| Mabhiza | Mucecum necolon, nitrate ichideredzwa pamwero muduku | Nitrite yakatoumbwa inoramba ine ngozi; nitrate yezvirimwa zvinofurwa kazhinji haina simba rakaenzana nerainaro mumombe | Masero matsvuku eropa remabhiza haanyatsopinduri kumethylene blue mumiedzo yekare yein vitro, uye mushonga unogona kukonzera hemolysis ine mitumbi yeHeinz inobva kuoxidation mumabhiza; maitiro emhuka dzinodzeya haashandi sezvaari |
| Imbwa nekatsi | Kushandurwa muura kushoma kana kuchienzaniswa nehuwandu hunopinda | Mishonga nemakemikari anoita oxidation pane nitrate yemafuro | Katsi dzinonyanya kukurumidza kukuvadzwa neoxidation inogadzira mitumbi yeHeinz; mutemo wehurumende yemubatanidzwa, 21 CFR 500.27, wakabva pahemolysis yakauraya katsi dzakapiwa nemuromo zvigadzirwa zvemethylene blue zvaishandiswa pamatambudziko eweti |
| Hove dzemumatangi nemumadziva | Nitrite iri mumvura inopinda nepamagill, zvichinzi chirwere cheropa rebhurawuni | Kukwira kwakanyanya kwenitrite muhurongwa hutsva kana hwakaremerwa | Huwandu hwemushonga mumvura yekunyudza hunoverengwa ne mg parita, kwete IV mg pakg; kukwikwidzana nechloride nekugadzirisa mvura ndizvo zvinotanga, sezvinotsanangurwa mukucheturwa kwenhove dzemumatangi nenitrite |
Mhuka dzinodzeya: mombe, hwai, nembudzi
Mombe ndidzo dzinowanzokanganiswa kupfuura mamwe marudzi, uye zvinyorwa zvemazano evarimi zvinowanzoisa mombe seboka rezvipfuyo rinonyanya kukanganisika. Hwai nembudzi zvinokanganisikawo zvakajeka asi zvinowanzotsanangurwa sezvinokanganiswa zvishoma, zvichida nokuti zvinogadzirisa nitrate yakawanda nokukurumidza. Tora kurongeka uku sechiratidzo chinobatsira chezvinowanzoitika, kwete somutemo wakasimbiswa usingachinji wemakemikari emuviri.
Kurasikirwa nezvibereko kunoda kutariswa kwakazvimirira. Mhou dzinopona methemoglobinemia yakanyanya inogara kwenguva refu dzinogona kupfupfudzika kana kubereka mhuru dzakafa mushure memazuva anenge 5 kusvika 14, zvinoenderana nekushomeka kweokisijeni kumhuru iri mudumbu. Mhuru yakajairika mangwanani anotevera hairatidzi kuti chepfu yakanga iri shoma, uye kupfupfudzika vhiki gare gare hakuratidzi kuti mhou yakawanazve chepfu kechipiri.
Huwandu hwemethylene blue hwemombe hwakabudiswa hunosiyana nokuti hunobva pamhando dzakasiyana dzeumbowo. Chinyorwa chazvino cheMSD chinopa 4 kusvika 15 mg/kg kana kupfuura, ichibayiwa mutsinga zvishoma nezvishoma kubva mumusanganiswa we1 kusvika 2 muzana, huwandu nekudzokorora zvichitemwa nekukomba kwedambudziko uye kuramba chepfu ichipinda muropa. Chinotaurawo pachena kuti mhuka dzinodzeya chete ndidzo dzinotsungirira huwandu hukuru zvakachengeteka. Pedyo nereferensi iyoyo pane miedzo miduku nemishumo yezvakaitika mumafuro: mumwe muedzo wekare wemombe wakaona kuti 1 mg/kg yakakwana mumamiriro awo, ongororo yemashandiro emushonga muhwai yakaongorora 15 mg/kg yakapinzwa mutsinga, miedzo yembudzi yakaedza 1 kusvika 4 mg/kg uye mapoka e4 mg/kg ndiwo akaita zvakanaka kupfuura mamwe, uye mishumo yemumafuro inotsanangura kupora pahuwandu huri pedyo ne4 mg/kg pamwe nechiitiko chimwe chemombe chakasiyana nezvimwe pahuwandu huri pedyo ne20 mg/kg. Ongororo ya1984 yemafambiro emushonga muhwai inonyatsoratidza rudzi urwu rweumbowo: inotsigira kufunga nezvekutsungirira mushonga, kwete murayiridzo uri paleibheri yemushonga.
Pakusarudza kushandisa methylene blue pamethemoglobinemia muhwai, chiremba wemhuka anofanira kunzwisisa kuti hapana nhamba imwe inokodzera chiitiko chose. Kuramba nitrite ichigadzirwa murumen kunoreva kuti mhuka iri kupora inogona kudzokerwa nedambudziko apo imwe nitrite inopinda muropa. Ndokusaka MSD ichiita kuti kudzokorora kuenderane nekuramba mhuka ichiwana chepfu, kwete nenguva dzakatarwa dzisingachinji. Rubatsiro rwekutsigira muviri runoitwa pamwe chete: kubata mhuka nenzira isingainetsi kuti kudikanwa kweokisijeni kuderere, kuibvisa pachikafu nemvura zvinofungidzirwa kuva nechepfu, kuipa chimwe chikafu chakachengeteka, uye kutarisira kufamba kweropa richisvika munyama. Methylene blue inopiwa nejekiseni inotsamwisa nzvimbo yainopinda, saka zvakakosha kunyatsopinda mutsinga uye kuipinza zvishoma nezvishoma. Kupendwa kwenyama dzomuviri, weti, nemasensa kunofanira kutarisirwa. Miganhu yedhayi nemasipireyi ekurapa mhuka inoisa miganhu yakafara yemarudzi emhuka mumamiriro ayo.
Mabhiza inyaya yakasiyana
Mabhiza anoita kuviriswa kwefaibha muchikamu chekumashure cheura pane murumen. Tupukanana twececum tunogona kuderedza nitrate, asi kushandurwa kwayo kushoma zvikuru pane kwemombe, saka mabhiza akura kazhinji haanyanyi kukanganiswa nenitrate yezvirimwa zvinofurwa. Nitrite yakatoumbwa inodarika dziviriro iyoyo uye inoramba ine ngozi.
Mafungiro ekushandisa mushonga unopikisa chepfu anochinjawo. Mune imwe ongororo yekare yaienzanisa kutongwa kwemethemoglobin mumasero matsvuku eropa, methylene blue yakawedzera kuderedzwa kwayo mumasero evanhu asi kwete mumasero emabhiza (ongororo yemasero matsvuku eropa remabhiza). Zvinyorwa zvechepfu mumabhiza zvinotsanangurawo methylene blue pachayo sechinhu chinokonzera hemolysis ine mitumbi yeHeinz nemaeccentrocyte inobva kuoxidation, uye zvinoyambira pamusoro pekuishandisa pamatambudziko eoxidation akadai sechepfu yered maple. Hapana pazviviri izvi chinoratidza kuti mushonga uyu haungambobatsiri rimwe bhiza, asi pamwe chete zvinodzivisa kukanganisa kwakajairika kwekungoderedza huwandu hwemushonga wemombe zvichienderana nehuremu. Bhiza rinofungidzirwa kuva nemethemoglobinemia inobva kunitrite rinoda kuongororwa kwaro, kuzivikanwa kwechinhu chiri kuita oxidation, uye kuongororwa kwenjodzi, kwete tafura yehuwandu hwemushonga wemhuka dzinodzeya.
Mhuka dzinochengetwa mumba nemhando dzehove dzemumatangi zvinoratidza kuti nei kuenzanisa nehuremu kusingashandi
Katsi dzinonyatsoratidza chenjedzo iyi. Hemoglobin yekatsi inonyanya kukurumidza kuchinjwa chimiro neoxidation, uye kuwana methylene blue yakawanda kana kudzokororwa kwayo kunogadzira mitumbi yeHeinz nehemolysis pane kurapa. Imbwa hadzina kusasimba kwakafanana nekwekatsi asi dzichiri kunyorwa pakati pemarudzi anokurumidza kukanganiswa muongororo dzinoenzanisa marudzi. Zvinhu zvinoita oxidation zvinowanikwa nemhuka dzinochengetwa mumba zvinosiyanawo, nokuti mishonga, makemikari, uye zviitiko zvekumedza zvinhu ndizvo zvinonyanya kukonzera dambudziko pane nitrate yemafuro.
Hove dzinoratidza hurongwa hwakasiyana zvachose. Nitrite inopinda nepamagill, saka chinonyanya kugadzirisa dambudziko makemikari emvura, kunyanya kukwikwidzana nechloride uye kubviswa kwenitrite, mushonga usati washandiswa. Methylene blue yehove inopiwa sehuwandu huri mumvura yekunyudza, zvichienderana nerudzi rwehove, nguva, tembiricha, uye zvinokanganiswa pasefa inoshandisa tupukanana. Hurongwa uhwu hunotsanangurwa mumethylene blue mumvura yekunyudza uye mukurapa mutangi. Nhamba ye mg parita yemvura yekunyudza haigoni kushandurwa kuva nhamba ye mg pakg inobayiwa mutsinga yemhuru, uye maitiro ekurapa mhuru haagoni kungoderedzwa nesimba nekuwedzera mvura obva ashandiswa mutangi.
Mhuka dzinopa chikafu dzinowedzera chisungo chemitemo
Hapana leibheri yakajairika yakatenderwa neFDA yemethylene blue semushonga unopikisa chepfu mumombe, hwai, kana mbudzi. FDA inonyora methylene blue yemarudzi aya sechinhu chakaiswa pachirongwa chezvinhu zvakawanda zvekugadzira mishonga inopikisa chepfu yemhuka dzinopa chikafu, chiri kuongororwa pari zvino (peji reFDA rekugadzira mishonga yakasanganiswa). Izvi zvinongoratidza nzvimbo yayo mumutsara wezviri kuongororwa, kwete kutenderwa uye kwete nguva yekumirira chikafu chisati chashandiswa.
MuUnited States, kushandiswa kwacho nokudaro kunoitwa nachiremba wemhuka pasi pemitemo yekushandisa mushonga kunze kwemirayiridzo iri paleibheri. Mutemo weAnimal Medicinal Drug Use Clarification Act unoda hukama hunoshanda pakati pachiremba wemhuka, muridzi, nemhuka inorapwa. Pamhuka dzinopa chikafu, unodawo nguva yakawedzerwa yekumirira inotsigirwa nesainzi, pamwe nekuzivikanwa kwemhuka nematanho ekudzivirira masaririra emushonga. Imwe ongororo yemazuva ano yemasaririra mumombe sere dzine utano dzakapiwa 6 mg/kg yemethylene blue yakasanganiswa, ichibayiwa mutsinga, yakaverenga nguva dzakabva paongororo dzemazuva 5 emukaka nemazuva 6 enyama (ongororo yemafambiro emushonga mumuviri wemombe nenguva yekumirira). Nhamba idzodzo ndedzehurongwa hweongororo iyoyo. Hadzisi nguva yekumirira yakatenderwa neFDA, uye mazano azvino emasaririra emushonga pamhuka yarapwa anofanira kubva kuna chiremba wemhuka ari kuirapa nezviwanikwa zvakadai seFARAD.
Mitemo yeEurope yakasimba zvikuru pachinhu chinoshandiswa mumushonga pachacho. Zvinhu zvine basa remushonga mumarudzi anopa chikafu kazhinji zvinofanira kuva nechinyorwa chinoratidza muganhu mukuru wemasaririra unobvumirwa kana kuiswa muboka rakaenzana pasi pehurongwa hweEU hwemasaririra (mazano eEMA pamusoro pemas aririra), uye ongororo dzeEU dzakakurukura methylene blue pakati pezvinhu zvisina kunyoreswa kuti zvishandiswe mumhuka dzinopa chikafu. Itsanangure sechisina kutenderwa kushandiswa nguva dzose mumhuka dzinopa chikafu muEU pane kugadzira boka rekurambidzwa risipo. Mabhiza anoverengerwa mucheni yechikafu anodawo kuongororwa kumwe chete mushonga usati washandiswa pasi pehurongwa hwecascade.
Kutevedzana kupfupi kwezvisarudzo zvachiremba wemhuka ari kurapa
Simbisa methemoglobinemia uchitsvagawo chinhu chinoita oxidation: ropa rebhurawuni pamwe nemakanda emukati, kurova kwemwoyo nokukurumidza, uye kutadza kufema zvinonongedzera kwairi, ukuwo kuongorora nitrate muplasma kana mumvura yemukati meziso, zvirimwa zvinofurwa, nemvura kuchinongedzera kunobva dambudziko. Tanga wabvisa panobva chepfu, nokuti methylene blue inopiwa nitrite ichiri kupinda muropa kubva murumen inorapa chiratidzo rumen ichiramba ichigadzira chinokonzera dambudziko. Sarudza hurongwa hunoenderana nerudzi rwemhuka usati wasarudza huwandu: mabhiza haagoni kushandisa huwandu hwereferensi hwemethylene blue hwemhuka dzinodzeya, katsi dzinoda chenjedzo yakasimba zvikuru yeoxidation, uye hove dzinoda kugadziriswa kwemvura pamwe nemaitiro ekunyudza anobva mumashandisirwo nemiganhu mukurima hove. Ipa mushonga zvishoma nezvishoma mutsinga uchinyatsova nechokwadi chekuti wapinda mutsinga, tarisa kudzoka kwedambudziko nehemolysis, uye nyora pasi mamiriro emukaka nenyama pasi pemitemo yemasaririra emushonga yemunharaunda mhuka isati yadzoserwa mucheni yechikafu.