Inqaku
Imethylene blue nesifo sokuxhuzula: iimodeli zokuxhuzula xa zithelekiswa namabango onyango ebantwini
Umntu onyamekela isigulana okhangela ulwazi ngemethylene blue nesifo sokuxhuzula ufumana iingxelo ezimbini ezibonakala ziphikisana. Enye ithi imethylene blue yanciphisa ukuxhuzula kwiimpuku. Enye ithi kwaxelwa isiganeko esifana nokuxhuzula kwisigulana esanikwa imethylene blue. Zombini zinokuba yinyani ngaxeshanye, kuba ziphendula imibuzo eyahlukileyo kwiimeko ezahlukileyo.
Ukudideka kuvela ekuphatheni “imethylene blue nokuxhuzula” njengebango elinye. Ngamabango amabini. Elokuqala libuza ukuba imethylene blue, xa inikwa phantsi kweemeko ezilawulwayo, iyayitshintsha na imilinganiselo yokuxhuzula kwimodeli yezilwanyana. Elesibini libuza ukuba ukuxhuzula kwenzekile na njengeziganeko ezingafunekiyo kubantu abafumana eli chiza ngenxa yezinye izizathu. Eli nqaku ligcina le mibuzo mibini yahlukene, liphonononga oko kwenziwa ngokwenene zizifundo ezimbini zokuxhuzula ezicatshulwa kakhulu, lize lichaze ngokucacileyo oko zingakubonisiyo. Ukuze ufumane imvelaphi, jonga isishwankathelo esibanzi sophando ngemethylene blue; ngokuphathelele indlela yokufunda uphando, jonga isikhokelo sokufunda izifundo ngemethylene blue.
Izifundo ezimbini, ngokweenkcukacha ezicacileyo
Akukho lingo ebantwini elivavanye imethylene blue njengonyango lwesifo sokuxhuzula. Ubungqina bovavanyo buvela kwizifundo zezilwanyana. Amaphepha amabini acatshulwa rhoqo omabini asebenzisa iimpuku, omabini asebenzisa idosi eyi-1 mg nge-kg efakwa esiswini, kwaye omabini axela umqondiso wokunciphisa ukuxhuzula. Kodwa uyilo lwawo luvavanya iingcamango ezahlukileyo zonyango, ngoko iziphumo zawo zithetha izinto ezahlukileyo.
Isifundo 1: unyango emva kokuba i-status epilepticus iqalile
kwisifundo sango-2018 kwiimpuku se-status epilepticus eziqhubayo ngokwayo, uCui noogxa bakhe babangela ukuxhuzula okuthatha ixesha elide ngokuvuselela i-basolateral amygdala ngombane kangangemizuzu eyi-25, baza baqinisekisa nge-EEG ukuba ukuxhuzula kuyaqhubeka. Oku kubalulekile kuba imodeli yombane yahlula ukuxhuzula ngokwako kwityhefu yeekhemikhali zamachiza abangela ukuxhuzula. Imethylene blue yanikwa imizuzu eyi-5 emva kokuba imeko yokuxhuzula ezinzileyo iqalile, nto leyo eyenza imodeli yonyango kuneyothintelo. Ukurekhodwa kwe-EEG kwaqhubeka kangangeeyure eziyi-12, kwaza izicubu zobuchopho zahlolwa kwiiyure eziyi-24. Umbhalo opheleleyo wovavanyo lwe-status epilepticus unika iinkcukacha zokuvuselela nokurekhoda.
Ngexesha leeyure eziyi-12, iimpuku ezanyangwayo zaba nomyinge weziganeko zokuxhuzula ezahlukileyo ezimalunga ne-29 kwi-EEG, xa kuthelekiswa nezimalunga ne-39 kwizilwanyana ezinganyangwanga, nto leyo ekukuncipha okumalunga neepesenti eziyi-26. Ixesha elipheleleyo lokuxhuzula lehla lisuka kwimizuzu emalunga ne-62 laya kwimalunga ne-44, ukuncipha okumalunga neepesenti eziyi-29. Izilwanyana ezanyangwayo zabonisa noxinzelelo oluncinane lwe-oxidation (i-malondialdehyde ephantsi, i-glutathione egcinwe ngcono), ukulahleka okuncinane kweeseli zemithambo-luvo kwiindawo ze-hippocampus i-CA1 ne-CA3, kwaye izalathisi ze-apoptosis zatshintsha ngendlela ebonisa ukukhuseleka.
Imida icacile. Kwahlalutywa ukuxhuzula kwizilwanyana ezimalunga ne-12 kwiqela ngalinye, kwavavanywa idosi enye kuphela ngoko akukho jika lobudlelwane bedosi nempendulo, ukulandelwa kwathatha iiyure kungekhona iinyanga, kwaye akuzange kuthelekiswe nechiza eliqhelekileyo elithintela ukuxhuzula. Isiphumo sixhasa umqondiso wokunciphisa ukuxhuzula okwethutyana nowokukhusela imithambo-luvo kwimodeli enye ye-status epilepticus kwiimpuku. Asibonisi ukuba imethylene blue ithintela isifo sokuxhuzula esingapheliyo, kwaye asithethi nto ngedosi okanye ngokhuseleko kubantu abanesifo sokuxhuzula.
Isifundo 2: ukunika ichiza kwangaphambili ngaphambi kwesiganeko ngasinye sokuxhuzula esibangelwayo
Kwisifundo sango-2026 se-kindling ebangelwa yi-pentylenetetrazole kwiimpuku, uJing noogxa bakhe basebenzisa ixesha lokunika ichiza elichaseneyo. Iimpuku zanikwa ngokuphindaphindiweyo into ebangela ukuxhuzula (i-pentylenetetrazole eyi-35 mg nge-kg, ngosuku ngalunye lwesibini, izihlandlo eziyi-15), yaye imethylene blue yanikwa imizuzu eyi-30 ngaphambi kwesihlandlo ngasinye. Olu luyilo olujoliswe kuthintelo: luvavanya ukuba ukunika idosi yokuthintela ngokuphindaphindiweyo kuyaphazamisa na ukukhula kwemeko yokuthambekela ekuxhuzuleni ebangelwa yi-kindling, kungekhona ukuba ichiza liyayeka na ukuxhuzula okuqhubekayo okanye liyanyanga na isifo sokuxhuzula esele sikhona.
Ukuxhuzula okubangelwa yi-kindling epheleleyo kwavela kwiipesenti eziyi-30 zeempuku ezanikwa ichiza kwangaphambili, xa kuthelekiswa neepesenti ezimalunga ne-85 kwezinganyangwanga, umahluko omkhulu othe ngqo onexabiso le-P elixelweyo elingu-0.0078. Ukunika ichiza kwangaphambili kwaphinda kwalibazisa ukuqala kokuxhuzula kwe-tonic-clonic okuchaphazela umzimba wonke, kwaza kwanciphisa nobude bako xa kuthe kwenzeka. I-EEG, ukusinda kweeseli ze-hippocampus, izalathisi zoxinzelelo lwe-oxidation, nemilinganiselo yenkumbulo kwileyibhulinti yamanzi zonke zabonisa iziphumo ezingcono kwiqela elanyangwayo.
Olu yilo lunemida yalo. Ichiza lalikho ngaphambi kovavanyo ngalunye lokubangela ukuxhuzula, ngoko uvavanyo alukwazi ukwahlula ukucinezelwa kokuxhuzula ekuphazanyisweni kokukhula kwe-kindling. Kwakhona kwasetyenziswa idosi enye kuphela, amaqela amancinci awayehlolwa izicubu nokuziphatha ayenamalungu ambalwa, i-kindling ivelisa inxalenye kodwa kungekhona yonke ibhayoloji yesifo sokuxhuzula ebantwini, kwaye la maphepha mabini anababhali abafanayo (uCui noLuo bavela kuwo omabini), ngoko ayizoziphindaphindo ezizimeleyo ngokupheleleyo. Isiphumo sixhasa ukuncipha kokukhula kwe-kindling xa kunikwa idosi yokuthintela ngokuphindaphindiweyo kwiimpuku. Asimiseli imethylene blue njengonyango kuye nabani na osele enesifo sokuxhuzula.
Itheyibhile yeemodeli neemeko: isixhobo sokuqala
Itheyibhile engezantsi yeyona ndawo iphambili yokubhekisa kweli phepha. Umqolo ngamnye uqala ngokucacisa imeko, uze uchaze indima edlalwe yimethylene blue noko uqwalaselo lunokukubonisa nolungenakukubonisa. Ungenelelo lovavanyo neengxelo zeziganeko ezingathandekiyo zibekwe kwimiqolo eyahlukileyo ngenjongo.
| Imeko | Indima yemethylene blue | Ixesha | Isiphumo esilinganisiweyo | Oko ikubonisayo |
|---|---|---|---|---|
| I-status epilepticus ebangelwe ngombane kwiimpuku, 2018 | Unyango lovavanyo, 1 mg/kg efakwa esiswini | 5 min emva kokuzinza kwemeko yokuxhuzula; i-EEG kangange-12 h | Inani leziganeko zokuxhuzula kwi-EEG nexesha elipheleleyo lokuxhuzula; izicubu ze-hippocampus kwi-24 h | Umqondiso wokunciphisa ukuxhuzula okwethutyana kwimodeli enye; hayi ukuthintela isifo sokuxhuzula esingapheliyo, hayi ukusebenza ebantwini |
| I-kindling ebangelwa yi-pentylenetetrazole ngokuphindaphindiweyo kwiimpuku, 2026 | Ukunika ichiza lovavanyo kwangaphambili, 1 mg/kg ngaphambi kovavanyo ngalunye lokubangela ukuxhuzula | 30 min ngaphambi kwesihlandlo ngasinye kweziyi-15 zokunika into ebangela ukuxhuzula | Izinga le-kindling epheleleyo, ixesha ngaphambi kokuqalisa kokuxhuzula nobude bako, i-EEG, ukuziphatha okunxulumene nenkumbulo, izalathisi zezicubu | Ukukhula okuncinane kwe-kindling xa kunikwa idosi yokuthintela; hayi unyango lwesifo sokuxhuzula esele sikhona |
| I-methemoglobinemia efunyenweyo, ukusetyenziswa okufakwa emthanjeni ngokomyalelo kagqirha | Unyango oluvunyiweyo lwesifo esahlukileyo | Ngexesha lokhathalelo lwezonyango, ubukhulu becala 1 mg/kg | Ukuhlolwa kokhuseleko | Isiganeko esinye esinzulu esifana nokuxhuzula kwiqela lokuhlolwa kokhuseleko lezigulana eziyi-24 ngokweleyibhile yangoku yemethylene blue efakwa emthanjeni; ingxelo yonxulumano lwexesha, hayi izinga lokwenzeka, ingengobungqina besizathu |
| Isindromu ye-serotonin xa kusetyenziswa amachiza achaphazela i-serotonin | Into ebangela isindromu ngokuthintela i-monoamine oxidase | Emva kokusetyenziswa kunye namachiza okudakumba okanye amachiza anxulumene nawo | Isindromu yezonyango, enokuquka ukuxhuzula | Ukusebenzisana kwamachiza okwaziwayo okunesilumkiso esikwibhokisi kwinkcazelo yokumisela ichiza; jonga isindromu ye-serotonin kunye nokusebenzisana namachiza okudakumba namanye amachiza achaphazela i-serotonin; uphononongo olucwangcisiweyo lwafumana iimeko eziyi-50 ezipapashiweyo, zonke zinokusetyenziswa ngaxeshanye kwamachiza okudakumba achaphazela i-serotonin |
| I-encephalopathy ebangelwe yi-ifosfamide | Unyango lwe-encephalopathy olungaphandle kokusetyenziswa okuvunyiweyo | Ngexesha okanye emva kwetyhefu ye-ifosfamide kwimithambo-luvo | Ukudideka, ukuxhuzula, isiqaqa, ukuchacha | Ukuxhuzula kule meko kulindelekile ngenxa ye-encephalopathy ngokwayo, ngoko akunakuthiwa ngokuzenzekelayo kubangelwe yimethylene blue; ubungqina benzuzo ubukhulu becala ziingxelo zeemeko, yaye kwaxelwa ukuphucuka kwizigulana eziyi-28 kweziyi-38 ezanyangwayo kolunye uphononongo lonyango lwe-encephalopathy ye-ifosfamide |
Kutheni ixesha neziphumo ezilinganisiweyo zigqiba intsingiselo yesifundo
Iinkcukacha ezimbini zithwala eyona ntsingiselo kuphando lokuxhuzula: ixesha elanikwa ngalo ichiza, noko kwalinganiswa.
Kuqala lixesha. Ichiza elinikwa ngaphambi kovavanyo ngalunye lokubangela ukuxhuzula, njengakwisifundo se-kindling, linokubonakala lisebenza nje ngokuthomalalisa isiganeko ngasinye esibangelweyo okanye ngokucothisa inkqubo ye-kindling. Ichiza elinikwa emva kokuba ukuxhuzula kuqalile, njengakwisifundo se-status epilepticus, lijongana novavanyo olunzima ngakumbi nolubaluleke ngakumbi kunyango. Akukho nanye kwezi ndlela zoyilo ehambelana nemeko yomntu onesifo sokuxhuzula esele sikhona othatha iyeza lokuthintela ukuxhuzula yonke imihla, yiyo loo nto ixesha lokunika ichiza kwizilwanyana lingenakuguqulwa libe licebiso lonyango.
Okwesibini ziziphumo ezilinganisiweyo. Inani leziganeko zokuxhuzula kwi-EEG kwiiyure eziyi-12, izinga le-kindling, nokungabikho kokuxhuzula ebantwini ziziphumo ezahlukileyo. Izalathisi zezicubu ezifana ne-glutathione okanye amanani eeseli zichaza iindlela ezinokwenzeka zokusebenza, yaye ukuziphatha kwileyibhulinti yamanzi kucebisa unxulumano nokusebenza kwiimpuku, kodwa akukho nanye kwezi esisiphumo sesifo sokuxhuzula esilinganiswa kunyango lwabantu. Isiphumo esihle kwizicubu kunye nesiphumo esilinganiselweyo sokunciphisa ukuxhuzula someleza inkcazelo yebhayoloji; asiguquli isiphumo sokuxhuzula sibe bubungqina bonyango ebantwini.
Oku kuthetha ntoni kwizigqibo zonyango
Imiqondiso yokunciphisa ukuxhuzula kwizilwanyana sisizathu sokwenza uphando olungakumbi, hayi isizathu sokutshintsha ukhathalelo. Akukho mntu omele aqale, ayeke, okanye ahlengahlengise iyeza elimiselweyo lokuthintela ukuxhuzula ngokusekelwe kwizifundo zeempuku, kwaye imethylene blue ayilonyango oluvunyiweyo lwesifo sokuxhuzula nangaluphi na uhlobo lwayo. Nabani na ocinga ukuyisebenzisa kufuneka aqale axoxe ngoluhlu olupheleleyo lwamayeza akhe nengcali yakhe yezonyango, kuba ukusebenzisana namachiza achaphazela i-serotonin okuchazwe ngasentla yeyona ngozi inxulumene nokuxhuzula enobungqina obucacileyo kwiingxelo zabantu, kwaye inokuthintelwa.
Isishwankathelo esinyanisekileyo singena kumhlathi omnye. Izifundo ezimbini ezincinane kwiimpuku, zombini zisebenzisa idosi efanayo eyi-1 mg nge-kg, zixela ukuxhuzula okumbalwa okanye okungephi ngobuzaza: esinye xa ichiza linikwa emva kwe-status epilepticus ebangelwe ngombane, esinye xa linikwa ngaphambi kovavanyo oluphindaphindiweyo lokubangela ukuxhuzula ngemichiza. Ngokwahlukileyo, iingxelo zokhuseleko ebantwini ziqulethe iziganeko ezifana nokuxhuzula, ezigxile kwiimeko zokusebenzisana kwamachiza nezokugula kakhulu kunakunyango lwesifo sokuxhuzula. Akukho qela lobungqina elibonisa ukuba elinye alichanekanga, kwaye akukho nalinye elimisela imethylene blue njengonyango lwesifo sokuxhuzula. Imibuzo eqhelekileyo ngeziphumo ebezingalindelekanga nezilumkiso iqokelelwe kwimibuzo ebuzwa rhoqo ngokhuseleko lwemethylene blue.