Methylene blue pakumira kufema pakurara nekuridza ngonono: kuongorora chirevo

Pane chirevo chinotenderera mumaforamu anokurukura nezvekurara, chine pfungwa yakaita seiyi. Vanhu vanoti methylene blue inovandudza mashandisirwo eokisijeni mumasero, uye pashure pemazuva mashoma vachiitora vakarega kuridza ngonono, vakarega kumuka vachifemereka, uye vakatanga kufema usiku hwose vasina mask. Tsananguro yekushanda kwemushonga inosungirirwa pachirevo ichi haisi yekufungidzira. Methylene blue inopindirana zvechokwadi nekutamiswa kwemaerekitironi mumitochondria. Asi nharo iyi inosvetuka danho rimwe: kumira kufema pakurara kunokonzerwa nekutadza kushanda kwenzira yepamusoro yemhepo, uye kuchinja mabatiro anoita sero okisijeni hakuchinji kuti pahuro panoramba pakavhurika here.

Mukaha uyu unoparadzanisa zvinhu zvitatu zvinotaurwa sekunge chinhu chimwe chete: mamiriro acho, zviyero zvinotsanangura mamiriro acho, uye zvakataurwa nemunhu nezvekuva nehusiku huri nani.

Mamiriro acho idambudziko renzira inoyerera nemhepo

Pakurara, tsandanyama dzinochengeta pahuro pakavhurika dzinoregedzeka. Mune vamwe vanhu, nzira yemhepo inotetepa zvekuti mhepo inopfuura nayo inoita kuti nyama dzakapfava dzizunguzike, uye kuzunguzika ikoko ndiko kuridza ngonono. Mune vamwe, nzira yemhepo inovharika zvachose kwemasekonzi gumi kana kupfuura, izvo zvinonzi apnea, kana kuti inotetepa zvekuti kuyerera kwemhepo kunoderera uye okisijeni inodzikira, izvo zvinonzi hypopnea. Chiitiko chacho chinopera apo kuderera kweokisijeni nekukwira kwecarbon dioxide zvinokonzera kumuka kwechinguvana, kusimba kwetsandanyama kunodzoka, nzira yemhepo inovhurika, uye munhu anodzokera pakurara.

Zvinhu zvine chekuita neizvi zvinosanganisira maumbirwo emuviri nemaitiro emunhu. Maumbirwo eshaya, mudzi werurimi, kutenderera kwemutsipa, kuvhurika kwemhino, mamiriro akarara munhu, doro, mishonga inonyaradza uye kudzika kwehope zvose zvinochinja kuti nzira yemhepo inovharika kakawanda sei. Mushonga unoita kuti sero ribate okisijeni neimwe nzira hausi pakati pezvinhu izvozvo. Ndokusaka tsananguro yemashandiro acho, kunyange zvikamu zvayo zviri zvechokwadi, isingashandi pakutsanangura dambudziko iri. Itsananguro yehurongwa hwakasiyana.

Zvinoverengwa nekuongororwa kwekurara, nezvisingaverengwi

Polysomnogram inorekodha kuyerera kwemhepo pamhino nepamuromo, kuedza kufema kuburikidza nemabhandi akatenderedza chipfuva nedumbu, kuzara kweokisijeni muropa kuburikidza nechiyereso chepamunwe, ruzha rwengonono, mamiriro emuviri, uye mashandiro emagetsi europi pamwe nemasaini emeso netsandanyama dzechirebvu, kuitira kuti nhanho dzekurara nekumuka kwechinguvana zviverengwe. Kuongororwa kwekumira kufema pakurara kunoitwa kumba kunoderedza izvi, kuchiwanzosara nekuerera kwemhepo, kuedza kufema, kuyerwa kweokisijeni muropa uye mamiriro emuviri.

Masaini iwayo anobudisa nhamba. Apnea-hypopnea index inhamba yezviitiko zveapnea nehypopnea paawa yekurara. Oxygen desaturation index inoverenga kuderera kwekuzara kweokisijeni muropa paawa. Arousal index inoverenga kukanganiswa kwekurara paawa. Pamwe chete nadzo, kuongororwa kunoratidza nguva yose yekurara, chikamu chenguva yepamubhedha chakapedzwa wakarara, nguva yakapedzwa wakamuka pashure pokunge watanga kurara, uye nguva yakapedzwa munhanho imwe neimwe yekurara.

Hechino chikamu chakakosha pakuongorora chero chirevo chekurapa. Imwe neimwe yenhamba idzi inoyera chimwe chinhu chakaitika muhusiku hwakati. Hapana inoyera kuti nzira yemhepo inowanzoda kuvharika zvakadii. Izvozvo zvinofungidzirwa kubva kuhusiku hwacho, uye kuvimbika kwefungidziro yacho kunoenderana nekuti husiku ihwohwo hunomiririra zvakadii kurara kwemunhu kazhinji.

Nhamba dzezviitiko hadzigari dzakafanana. Munhu anopedza chikamu chikuru chehusiku akarara nedivi anova nezviitiko zvishoma zvinoverengwa. Mamiriro emuviri, nhanho yekurara, kuvharika kwemhino, doro richangobva kunwiwa, kuchinja kweuremu, rudzi rwechiyereso chekuerera kwemhepo uye mitemo yekuverenga zvose zvinochinja mugumisiro, uye husiku hwekutanga murabhoritari hunowanzova hwakaipa kupfuura hwechipiri. Kunze kwezvimwe zvinodiwa nechirevo chekurapa, chinoda marongerwo emuedzo anokwanisa kumira kunyange zvazvo husiku huviri hunotevedzana mumunhu mumwe chete asina kurapwa huchigona kubudisa zvakasiyana.

Husiku huri nani hahusi shanduko yakayerwa

Zviratidzo zvinoita kuti vanhu vatore matanho zvinobva pane zvavanonzwa: ngonono dzakaderera, kufemereka kwakamira, ndakarara zviri nani, ndine simba rakawanda. Izvi zvinhu zvinonyatsoitika kwavari, asi zviyero zvisina kunyatsovimbika zvekuvharika kwenzira yemhepo.

Epworth Sleepiness Scale inokumbira munhu kuti aone kuti angangotsumwaira zvakadii mumamiriro masere ezuva nezuva. Pittsburgh Sleep Quality Index inobvunza nezvemwedzi wapfuura. Zvose zvinobva pane zvinotaurwa nemunhu nezvake, izvo zvinoita kuti zvive nyore kuzadza uye zvive nyore kuchinja pasina kuchinja kwedambudziko riri pasi pazvo. Vanhu vanotsvaga kurapwa pavanonzwa zvakanyanya kuipa, saka chiyero chekutanga chinotova chakarerekera kudivi rakaipa, uye chinotevera chinowanzotaridzika chiri nani nechikonzero ichocho chete. Chero munhu anoziva kuti atora kurapwa anotarisira kuvandudzika.

Pane nzira chaidzo dzinoita kuti husiku huvandudzike pasina kuchinja kwenzira yemhepo. Kumuka kwechinguvana kunokanganisa kurara kunogona kuitika pasina kuderera kukuru kweokisijeni, uye husiku hwehope dzakadzika hunenge huine kumuka kwakadaro kushoma. Munhu anongoitika kuti arara nedivi usiku hwacho anova nezviitiko zvishoma zvinoverengwa. Hapana pazviri apa panoreva kunyengera; ndizvo zvikonzero zvakajairika zvinoita kuti zvinotaurwa nevanhu pamusoro pezvavanonzwa nezvinobuda mukuongororwa kwakaverengwa zvisawirirane.

Panonyatsoshanda methylene blue

Methylene blue idhayi inoita redox. Inogamuchira uye inopa maerekitironi, uye inogona kuatakura kubva mune zvimwe zvikamu zvecheni yekutakura maerekitironi ichiaendesa kucytochrome c. Mumitochondria yeuropi yakabviswa kuti iongororwe iri yoga, yakawedzera kugadzirwa kweATP uye yakadzorera musiyano wemagetsi pamembrane apo complex I kana complex III yakanga yadziviswa kushanda. Mumasero echiropa emakonzo, yakadzivirira masero aiva akavharirwa kutakurwa kwemaerekitironi nemishonga miviri, uye mumaastrocytes akanga anyimwa zvose glucose neokisijeni, yakavandudza kufema kwemasero.

Kana ukaverenga zvakadzama, mufananidzo wacho unochinja. Mumitochondria imwe chete iyoyo yeuropi, methylene blue yakawedzera kugadzirwa kwehydrogen peroxide uye yakawedzera kushandiswa kweokisijeni pakuzorora, uku kufema kunokurudzirwa neADP kusina kuchinja. Kushandiswa kweokisijeni yakawanda apo mitochondrion isiri kushanda nesimba hakurevi kugadzirwa kwesimba rakawanda. Mumitochondria yechiropa chemakonzo yakabviswa kuti iongororwe iri yoga, kuwedzera kweconcentration kwakadzikisa respiratory control ratios uye kwakakonzera kuzvimba, izvo vanyori vakatsanangura sekuparadzaniswa kwemaitiro akabatana eoxidative phosphorylation. Methylene blue haingoiti kuti kufema kuve kunobudirira zvikuru; inoshandura kubatana pakati pekushandiswa kweokisijeni nekugadzirwa kweATP, munzira inoenderana neconcentration.

Tsananguro yakajairika yekuti methylene blue inodzivisa kutumirwa kwemasaini enitric oxide hainawo kuva yakapusa sezvainowanzotaurwa. Mumasero etsandanyama dzakatsetseka dzetsinga dzemapapu akakuriswa murabhoritari, kudziviswa kwekuunganidzwa kwecyclic GMP kunokurudzirwa nenitrovasodilators uye nechinhu chinoregedzesa tsandanyama chinobva muendothelium kwakadzokororwa nokugadzira superoxide, uye methylene blue pachayo yakagadzira superoxide. Mumasero eendothelium akakuriswa murabhoritari pasina glucose, concentrations dzinopfuura anenge 5 micromolar dzakawedzera kushushikana kunokonzerwa nemaoxidant mukati memasero. Ongororo yezvinyorwa pamusoro peukama hwehuwandu hwemushonga nemhinduro yemuviri inotsanangura maitiro acho sehormesis: huwandu huri pakati hunowedzera kushanda kwecytochrome oxidase, uye huwandu hwepamusoro hunohuderedza. Mugumisiro wacho unochinja uchipikisana newaimbovapo apo huwandu hunokwira.

Zvimwe zviyero zviviri zvinoratidza pfungwa imwe chete. Muimbwa, methylene blue yakachinja reshiyo yelactate nepyruvate muropa rematsinga anoenda kubva pamwoyo, chiratidzo chemamiriro eredox munyama, uye yakasiya huwandu hweropa hunopombwa nemwoyo, kurova kwemwoyo uye kumanikidzwa kweropa mutsinga zvisina kuchinja zvakakosha. Muvanhu vakazvipira vakapiwa methylene blue mutsinga, kuyerera kweropa muuropi hwose kwakaderera panzvimbo pekuwedzera, izvo zvakaoma kuwiriranisa nepfungwa yekuti mushonga unoendesa okisijeni yakawanda kuuropi.

Shanduko yebiochemistry inoyerika isina shanduko inoenderana nayo mukushanda ndiyo mamiriro anofanira kukundwa nechirevo, kwete humbowo hwekuti chirevo chacho chatosimbiswa.

Nharo nhatu dzisingazadzi mukaha uyu

Yekutanga ndeyemhino. Mhino dzakavharika dzinoita kuti vanhu vafeme nemuromo, uye kufema nemuromo kunowedzera ngonono, saka zvinokwezva kurapa zviratidzo zvemhino wotarisira kuti dambudziko rose rivandudzike. Kuvhurika kwemhino ndechimwe chinhu chinobatsira pakufema kusina kujairika pakurara. Hakusi iko kuvharika kwacho. Kuvharika kunoitika pakumira kufema pakurara kunoitika kuseri kwechikamu chakapfava chedenga remukanwa uye pamudzi werurimi, mushure memhino munzira inofambwa nemhepo, uye hapana muzvidzidzo zvakabudiswa pamusoro pemethylene blue chinoratidza kuti inovhura zvikamu izvozvo.

Yechipiri inharo yemitochondria, ndiyo inowanzotaurwa zvikuru. Kuti masero anoshandisa okisijeni zvinobudirira zvikuru ishoko rinotaura nezvemetabolism yenyama. Apnea inotaura nezvekuerera kwemhepo. Panguva yechiitiko chekuvharika, okisijeni muropa rematsinga anoenda kubva pamwoyo inoderera nokuti mhepo yamira kufamba, kwete nokuti masero aramba kuishandisa. Kutakura maerekitironi zviri nani mukati memitochondrion hakuvhuri pharynx yakavharika, uye kana methylene blue ichiwedzera kushandiswa kweokisijeni pakuzorora uku kufema kwakabatana nekugadzirwa kwesimba kusina kuchinja, mubvunzo wainomutsa muhusiku hune okisijeni shoma ndewezvinodiwa, kwete wezvinopiwa.

Yechitatu inyaya yezvakaitika kumunhu. Munhu anoedza methylene blue haakwanisi kuita muedzo paari asingazivi kurapwa kwaari kupiwa, uye pamushonga uyu dambudziko racho rakanyanya: idhayi ine ruvara rwakajeka. Weti inoita bhuruu, uye dikita nemisodzi zvinogonawo kudaro. Methylene blue zvakare inodzivisa monoamine oxidase A zvine simba uye nenzira inogona kudzokera pakare, izvo zvinochinja mabatiro anoita ura maamine anobva muchikafu kana yatorwa nemuromo, uye ine njodzi dzakanyorwa dzekupindirana nemishonga inobata serotonin. Kumutsa muviri kwakadaro kunogona nyore kunzwika sekurara zviri nani pasina shanduko munzira yemhepo.

Hapana pane izvi chinoti munhu ari kukanganisa pamusoro pehusiku hwake. Zvinoti chirevo chekuti husiku hwava nani chinoda chiyero padivi pacho chisati chava chirevo pamusoro peapnea.

Zvinofanira kuratidzwa nechirevo

Kana zvikaiswa pachena, chirevo chinovimbika chinofanira kuva seizvi.

Kuonekwa kwechirwere kwakasimbiswa nekuongororwa kwekurara kwakaverengwa kurapwa kusati kwatanga, kuchitaurwa kuoma kwacho, kuitira kuti pave nechinhu chekuenzanisa nacho.
Boka rekuenzanisa rinoongororwa panguva imwe chete, vanhu vachigoverwa mumapoka nenzira yemukana. Nokuti nhamba dzezviitiko dzinochinja dzoga, kuongorora zvakatevedzana zvisati zvaitwa kurapwa nepashure pacho pasina boka rekuenzanisa hakugoni kusiyanisa mugumisiro wekurapwa nekuchinja ikoko. Marongerwo ekuti vatori vechikamu vachinjane pakati pekurapwa kwakasiyana anokwezva asi ane matambudziko awo: ruvara rweweti chiratidzo chakasimba chekuti mutori wechikamu ari muchikamu chipi chemuedzo.
Tsananguro yakatendeseka yekuvanzwa kweruzivo rwekurapwa. Muedzo wechinhu chine ruvara runooneka unofanira kutaura kuti wakabata sei nyaya yekuti vatori vechikamu vanogona kuona kuti vari muboka ripi, uye placebo ine dhayi yeruvara rwakafanana ndiyo imwe nzira yekuzviita.
Chiyero chikuru chemugumisiro chisingatsamiri pamanzwiro emunhu: shanduko kubva pachiyero chekutanga munhamba yezviitiko paawa, kana mudesaturation index. Zvibodzwa zvemibvunzo zvinofanira kuva pazviyero zvechipiri, pazvinogona kutaurwa nokutendeseka pasina kuva izvo zvinotsigira chirevo.
Husiku hwakarekodwa hwakakwana kuti husiyano hwehusiku nehusiku husakanganisa mugumisiro, izvo zvinowanzoreva hunopfuura humwe pasi pemamiriro ega ega.
Kutevedzera kurapwa kuyerwe, kwete kungofungidzirwa.
Kutaurwa kwekuchengeteka kunoenderana neboka revanhu vari kuongororwa, kusanganisira vanotora mishonga inobata serotonin.
Hurongwa hwemigumisiro nekuongorora hwakasarudzwa data risati raunganidzwa.

Pepa rebasa raunogona kuzadza uchiongorora chero chirevo chakati rakabatanidzwa nechinyorwa chino: pepa rebasa rekuenzanisa migumisiro. Faira reHTML rine zvose zvarinoda rinoshandawo pasina internet kana rachengetwa uye ravhurwa mubhurawuza.

Kana muedzo ukaratidza kuderera kwakakosha kwezviitiko paawa muvanhu vane chirwere chakasimbiswa, iwoyo ungava mugumisiro unoshamisa, uye ungada tsananguro yekuti chinhu chinoshanda pakutamiswa kwemaerekitironi chakakwanisa sei kusvika papharynx.

Zvimwe zvekuverenga zvine chekuita nenyaya iyi: humbowo pamusoro pemethylene blue nekurara, hunotaura nezvekushaya hope nenguva yekutora mushonga, uye nyaya yakafanana yemethylene blue muCOPD neokisijeni yakaderera. Mapeji maviri akakosha kana uri kushandisa izvi chaizvo: zvinoitwa nemethylene blue pakuyerwa kweokisijeni muropa nepulse oximetry uye pakuongororwa murabhoritari, nokuti dhayi iri muropa inochinja zvinoratidzwa nemimwe michina, uye rondedzero yemibvunzo yekubvunza nyanzvi yezvekurapa pamusoro pemethylene blue.

Zvaungaita panzvimbo pezvo, nechimwe chinhu chakakodzera kuongororwa

Hapana chiri pamusoro chiri chikonzero chekurega kurapwa nekumanikidzwa kwemhepo kunochengeta nzira yemhepo yakavhurika kana kusaita kuongororwa kwekurara kuti chirwere chionekwe. Izvozvo zvinoramba zviri mwero mukuru wekuenzanisa, uye husiku uchishandisa muchina hunobudisa zviyero zvisingagoni kubudiswa nechokuwedzera pakudya.

Kana uri kutora methylene blue nechimwe chikonzero uye uchirara zvisina kunaka, ita kuti kurara kuyerwe pane kungofungidzirwa. Kumbira nhamba: zviitiko zvingani paawa, desaturation index, nguva yakawanda sei yakapedzwa kuzara kweokisijeni muropa kuri pasi pemakumi mapfumbamwe kubva muzana, uye arousal index. Zviyero izvozvo ndizvo zvinofanira kuchinjwa nekurapwa.

Chinhu chimwe chete chinogona kunyatsoongororwa nemutengi ndechezviri muchigadzirwa. Kuchena ndiwo musiyano pakati pechinhu chinoenderana nezvinodiwa nemwero wepharmacopeia nechisingaenderani nawo, uye nzira inoshanda yekuwana kuchena kwepamusoro kunowanika ndeyekuenderana nemonograph yemethylene blue iri muUnited States Pharmacopeia. Vatengesi vakawanda vanoti vanoenderana nazvo vanongoyedza simbi dzinorema vogumira ipapo. Blupreme inoshanda nemugadziri wemishonga, inoedza zvose zvinodiwa nemwero wacho, kusanganisira kuzivikanwa kwechinhu, kuchena, tsvina dzemakemikari eorganic, zvinonyungudutsa zvinenge zvasara, tsvina dzemaelement, zvinosara kana chapiswa, miganhu yeutachiona uye endotoxin dzemabhakitiriya, uye inobudisa chitupa chakazara chekuongorora chebatch yacho. Magwaro iwayo anokuudza zviri muchinhu chacho. Haakuudzi kuti chinhu chacho chinorapa kumira kufema pakurara.