Chinyorwa
Methylene blue inogara mumuviri kwenguva yakareba sei?
Methylene blue haina nguva imwe chete yakasimbiswa yekuti inenge “yabuda mumuviri wako.” Parizvino, mashoko ari pazita remushonga wejekiseni wePROVAYBLUE anoti nguva yekudzikira nehafu muvanhu inenge maawa 24. Chidzidzo chekare chevanhu vakazvipira chakafungidzira maawa 5.25 mushure mekupihwa nemutsinga. Nhamba idzi dzinotsanangura kuderera kwakayerwa kweuwandu hwemushonga mumamiriro akasiyana, kwete nguva inopera mushonga wose munyama dzose dzemuviri.
Mubvunzo unobatsira unoda kunyatsotsanangurwa: ndeupi musanganiswa uye nzira yekupihwa, muvanhu vapi, uchiyerwa musampuli ipi, uye kwenguva yakareba sei? Fungidziro yeuwandu hwemushonga muropa haigoni pachayo kukuudza kuti manzwiro aunocherechedza anofanira kutanga riini, kuti kudyidzana kwemishonga kunova kwakachengeteka riini, kana kuti kushandisa zuva nezuva kwakakodzera here.
Zvinoyerwa chaizvo nenguva yekudzikira nehafu
Nguva yekudzikira nehafu pakubviswa kwemushonga inguva inotora kuti uwandu hunoyerwa hudzikire nehafu panguva yechikamu chekubviswa kwemushonga chiri kuongororwa. Nguva yekudzikira nehafu muchikamu chekupedzisira inotsanangura chikamu chekupedzisira chegirafu reuwandu hwemushonga. Haisi nguva dzose kuderera kukuru kwekutanga kunoitika mushure mejekiseni.
Semuenzaniso wakarerutswa, ngatitii uwandu hunodzikira kubva pazvikamu 100 zvakasarudzwa zvekuenzanisira kuenda pa50 munguva imwe yekudzikira nehafu. Munguva yechipiri yakareba zvakafanana, hunodzikira kuenda pa25, kwete pazero. Aya maverengero emuenzaniso wakarerutswa, kwete fungidziro yakagadzirirwa munhu mumwe chete yemethylene blue yasara mumuviri.
Mamwe mazwi matatu anopindura mibvunzo yakasiyana:
- Nguva yekusvika pauwandu hwepamusoro, kana Tmax: nguva inowanika uwandu hwepamusoro mumasampuli akatorwa.
- Kuwanda kwemushonga wakasangana nemuviri, kana AUC: nzvimbo iri pasi pegirafu reuwandu hwemushonga nenguva, ichibatanidza uwandu nenguva yawagara.
- Mhinduro pakurapwa: shanduko pamamiriro kana mhedzisiro iri kurapwa, sekuderera kwakayerwa kwemethemoglobin.
Uwandu hwepamusoro hahufaniri hazvo kuenderana nekubatsira kwakanyanya. Uwandu hwakaderera hahurevi zvoga kuti kushanda kwemushonga mumuviri kana kudyidzana kwayo nemimwe mishonga kwapera.
Kuenzanisa zvidzidzo zvevanhu
Tafura iyi kuenzanisa kwakagadzirirwa pano kwechidzidzo chaPeter, chidzidzo chaWalter-Sack nemaitiro acho akazara, uye ongororo yeFDA yezvemafambiro nekushanda kwemushonga wePROVAYBLUE mumuviri. Madosi ezvidzidzo anoratidza zvakashandiswa mukuedza; haasi mirayiridzo yekushandisa. MB zvinoreva methylene blue.
| Humbowo | Nzira yekupihwa neboka revanhu | Chinhu chakayerwa, sampuli, nemaitiro | Kutorwa kwemasampuli nemhedzisiro yakataurwa |
|---|---|---|---|
| Peter nevamwe, 2000 | 100 mg IV uye nemuromo; vanhu vanomwe vakazvipira | MB muropa rose; high-performance liquid chromatography | Uwandu muropa hwakateverwa kusvika pamaawa 4, sezviri mutafura yeFDA; nguva yekudzikira nehafu muchikamu chekupedzisira yeIV yaiva maawa 5.25 |
| Walter-Sack nevamwe, 2009, chikamu cheIV | 50 mg IV; vanhu vakuru 16 vane utano vakanyoreswa, 15 vakapedza kuedzwa nenzira dzose dziri mbiri vachichinjana | MB muplasma nemuropa rose; chromatography ine tandem mass spectrometry | Masampuli akatorwa kakawanda kusvika pamaawa 24; avhareji yenguva yekudzikira nehafu yaiva maawa 18.5 muplasma nemaawa 13.6 muropa rose |
| Walter-Sack nevamwe, 2009, chikamu chekupihwa nemuromo | 500 mg yemusanganiswa wemvura unotorwa nemuromo; boka rimwe chete rakaedzwa nenzira dzose dziri mbiri richichinjana | Chinhu chakayerwa, zvikamu zveropa, nemaitiro ekuyera zvakafanana | Masampuli akatorwa kusvika pamaawa 24; avhareji yenguva yekudzikira nehafu yaiva maawa 18.3 muplasma nemaawa 14.7 muropa rose; avhareji yeTmax muplasma yaiva maawa 2.2 |
| Ongororo yeFDA, 2016, zvidzidzo zvekugadzira mushonga wejekiseni | Kupihwa kamwe chete neIV kuvanhu vane utano vakazvipira; ongororo inopfupikisa kupinzwa kwe2 mg/kg kwemaminitsi mashanu | MB neAzure B zvakayerwa zvakaparadzana muropa rose nemuplasma pachishandiswa liquid chromatography ine tandem mass spectrometry | Kuyera kwakaenderera kusvika pamaawa 72; ongororo inotsanangura nguva yekudzikira nehafu kweMB muchikamu chekupedzisira inenge maawa 24 |
Dhawunirodha kuenzanisa kwezvidzidzo setafura yeMarkdown.
Idzi hadzisi fungidziro dzinogona kutsinhaniswa dzechiyero chimwe chisingachinji mumiviri yose. Tafura iyi hainawo kusimbisa mutemo uri nyore wekuti mushonga unopihwa nemuromo unogara kwenguva yakareba kupfuura unopihwa neIV nguva dzose. Muchidzidzo chakaedza vanhu vamwe chete vachichinjanisa nzira dzekupihwa, chikamu cheropa chakasarudzwa kutorwa sampuli chakachinja fungidziro kunyange nzira yekupihwa isina kuchinja.
Nei nhamba dzichisiyana
Ropa rose neplasma masampuli akasiyana. Ropa rose rinosanganisira masero ari muplasma. Plasma chikamu chemvura chinowanikwa mushure mekuparadzanisa masero. Maitiro ekuyera anoverenga mushonga uri mumasero nemumvura anopindura mubvunzo wakasiyana neanoyera uri mumvura chete.
Nguva yekucherechedza ine basa. Chidzidzo chinomira nokukurumidza chine mashoko mashoma nezvekuderera kunoitika gare gare. Ongororo yeFDA inonyatsotaura kureba kwenguva yekutora masampuli nekuyera muropa rose kana muplasma sezvikonzero zvekusiyana kwemigumisiro yakabudiswa pamusoro pekufamba kwemethylene blue mumuviri. Kucherechedza kwenguva yakareba kunogona kuratidza chikamu chekuderera zvishoma nezvishoma chisinganyatsotsanangurwi nemasampuli akatorwa pakutanga.
Kemikari inoyerwa ine basa. Mhedzisiro yemushonga wekutanga, yechinhu chinogadzirwa kana mushonga wachinjwa nemuviri, uye yehuwandu hunosanganisira mafomu akashandurwa nemakemikari haifaniri yose kungonzi “uwandu hwemethylene blue” pasina kutsanangurwa. Kuenzanisa uku kunoratidza zvinhu zvakayerwa zvakataurwa, pane kubata zviyero zvose zvine chekuita neblue sezvakaenzana.
Musanganiswa wemushonga une basa. Kuedza kwenzira yekupihwa nemuromo kwakaitwa vanhu vachichinjanisa nzira kwakaedza musanganiswa wemvura wakati. Zvakawanikwa hazvisimbisi kapisi risina kutsanangurwa, mushonga wemvura unotengeswa kuzvitoro, kana imwe nzira yekupihwa. Saizvozvo, kuedza kwekupararira kwemushonga munyama dzemakonzo kuri mugwaro raPeter kwakasiyana nekuyera ropa revanhu vakazvipira kuri mugwaro iroro. Hakupi nguva inobuda mushonga muuropi hwemunhu.
Zvinotora nguva yakareba sei kuti utange kushanda?
Izvozvo zvinoenderana nezvinorehwa nekuti “kushanda.” Pakurapwa kwemethemoglobinemia yakazovapo, varapi vanogona kutevera chiyero cheropa chakatsanangurwa. Mashoko ari pazita remushonga wejekiseni anoti 9 pavanhu vakuru 12 vaiva nezviyero zvepakutanga zvakakodzera vakava nekuderera kwemethemoglobin kweinenge 50% kana kupfuura paawa imwe mushure mekupihwa mushonga. Uku kucherechedzwa kwemhinduro pakurapwa, kwete nguva yekudzikira nehafu kwemethylene blue pakubviswa kwayo mumuviri.
Pamusanganiswa unotorwa nemuromo, kusvika pauwandu hwepamusoro muplasma pamaawa anenge maviri mukuedza vanhu vakazvipira hakusimbisi kuti kuvandudzwa kwekuisa pfungwa pachinhu, simba, kana ndangariro kunotanga mushure memaawa maviri. Chidzidzo chekufamba kwemushonga mumuviri chakayera uwandu hwemushonga, kwete kubatsira ikoko. Manzwiro anotaurwa nemunhu haakwanisewo kuratidza uwandu hwemushonga muplasma yake kana kuratidza kuti mushonga wabuda wose kana manzwiro acho apera.
Ruvara rweweti, kushandisa kakawanda, nenguva yekutora mishonga
Weti yebhuruu kana yegirini haisi bvunzo yeuwandu hwemushonga yakagadziridzwa kuva nechiyero chakarurama. Mashoko ari pazita remushonga anobvuma kuti zvinwiwa zvemuviri zvinogona kuchinja ruvara, asi haapi muganhu weruvara unoratidza kuti mushonga wabuda mumuviri wose. Kuona ruvara ruchipera hakugoni kutsiva kuongororwa kwekudyidzana kwemishonga.
Mashandiro eitsvo anochinjawo madudzirwo ezviyero. Mashoko azvino ari pazita remushonga anoti uwandu hwemushonga unosangana nemuviri hunowedzera kana itsvo dzisingashandi zvakanaka, kunyange nguva yekudzikira nehafu isina kuchinja pakukanganisika kweitsvo kudiki kusvika kuri pakati nepakati. Musiyano uyu unoratidza nei nguva yekudzikira nehafu chete isiri chiyero chakakwana chekuchengeteka. Gwaro redu rekuchengeteka kwemethylene blue rinotsanangura zvimwe zvinhu zvine chekuita nemurwere.
Kushandisa kakawanda kunounza mumwe mubvunzo: chii chinosara panopihwa mushonga zvakare? Nguva yekudzikira nehafu yedosi rimwe chete haisimbisi hurongwa hwakachengeteka hwezuva nezuva, maitiro anoshanda ekushandisa nekumbomira, kana kuchengeteka kwekushandisa kwemwedzi yakawanda. Izvozvo zvinoda humbowo pamusoro pehurongwa chaihwo hwekushandisa kakawanda nemhedzisiro yahwo.
Usashandisa kuverenga nguva yekudzikira nehafu kuti umire, utangezve, kana uparadzanise nguva dzekutora mishonga yakanyorerwa nachiremba. Zvisarudzo zvine chekuita nemishonga yekurapa kuora mwoyo nemimwe mishonga inodyidzana zvinoda runyorwa rwemishonga chaiyo, musanganiswa wayo, nzira yekupihwa, nhoroondo yekushandiswa, nemamiriro ekurapwa. Gwaro rekudyidzana kwemethylene blue nemimwe mishonga rinotsanangura misiyano iyi. Kuti ubatsire murapi kana wemishonga, nyora chigadzirwa, uwandu, nzira yekupihwa, nguva yechimwe nechimwe chakashandiswa, mishonga yakatorwa, uye zviratidzo zvipi nezvipi. Mashoko iwayo anobatsira kupfuura zuva rinofungidzirwa kuti mushonga unenge wabuda mumuviri.