Isihloko
I-methylene blue nesifo sezinso noma sesibindi
Isifo sezinso noma sesibindi sishintsha imibuzo okudingeka iphendulwe ngaphambi kokusetshenziswa kwe-methylene blue. Udaba oluyinhloko ukuthi umzimba uyisingatha kanjani le nhlanganisela yamakhemikhali, kanye nesizathu sokwelashwa. Into ingaba wusizo enkingeni ethile yezokwelapha kodwa idinge izinyathelo zokuqapha ezengeziwe lapho isitho esibandakanyeka ekuyikhipheni emzimbeni singasebenzi kahle.
Ku-methylene blue, ubufakazi obuphathelene nezinso nobuphathelene nesibindi abulingani. Izilinganiso ezenziwe kubantu zibonisa ukwanda kokuchayeka lapho ukusebenza kwezinso kukhubazekile. Ukukhubazeka kokusebenza kwesibindi kunesinyathelo sokuqapha esidinga ukubhekwa ngesikhathi sokwelashwa, kodwa imininingwane yomuthi ehlolwe lapha ayinikezi izilinganiso ezifanayo zokuchayeka ngokwezinga lobunzima. Akukho kulokhu okubonisa ukuthi i-methylene blue iwukwelapha isifo sezinso esingamahlalakhona noma isifo sesibindi.
Isifo sezinso: ukwanda kokuchayeka kuwumphumela olinganisiwe
I-pharmacokinetics ichaza okwenzeka emuthini ngemva kokunikezwa kwawo: ukusatshalaliswa kwawo, ukuguqulwa kwawo ngamakhemikhali nokukhishwa kwawo emzimbeni. Ukuchayeka kuhlanganisa ukuthi ungakanani umuthi okhona nokuthi uhlala isikhathi esingakanani. Abantu ababili banganikezwa inani elifanayo kodwa ukuchayeka kwabo kuhluke.
Imininingwane yokunqunywa kwe-PROVAYBLUE ibika izilinganiso ze-pharmacokinetics eziphathelene nezinso ngemva kokunikezwa kanye emthanjeni. Ukuchayeka ku-methylene blue phakathi kwamahora angu-96 kwanda ngo-52%, 116% no-192% lapho ukukhubazeka kokusebenza kwezinso kwakuncane, kuphakathi nendawo futhi kubi kakhulu, ngokulandelana. Isilinganiso kwakuyi-AUC, indawo engaphansi kwejika elibonisa ukugxila komuthi ngokuhamba kwesikhathi.
Ukwanda ngo-192% kusho ukuchayeka okucishe kube izikhathi ezingu-2.92 kunalokho okuqhathaniswa nakho. Akusho ukuthi amathuba okulimala kwezinso angu-192%. Ukuchayeka nokulimala kuyizilinganiso zemiphumela ezihlukene: okokuqala kukala umuthi; okwesibili kukala umphumela esigulini. Ukuqhathanisa kwe-pharmacokinetics akukwazi ngokwakho ukunikeza umkhawulo lapho umuthi uba nobuthi kumuntu ngamunye.
Lezi zilinganiso futhi azikwazi ukusungula uhlelo lokuphuza umuthi nsuku zonke. Zichaza ucwaningo oluthile lokunikezwa komuthi emthanjeni, kuyilapho ukuwuphuza ngokuphindaphindiwe kushintsha indlela yokuwunikeza, izikhathi nokwakheka kokuchayeka okuhlolwayo. Ukuhlukanisa umthamo otholwe ku-inthanethi ngesilinganiso sokuchayeka bekungeke kuguqule lolo cwaningo lube uhlelo lokwelapha oluqinisekisiwe.
Isifo sesibindi: isinyathelo sokuqapha esihambisana negebe elibalulekile lemininingwane
Umbuzo ophathelene nesibindi akufanele uphendulwe ngokukopisha amaphesenti aphathelene nezinso. Imininingwane yomkhiqizo we-Proveblue yaseYurophu iveza ukuntuleka kwemininingwane yokuphepha nokusebenza komuthi lapho isibindi singasebenzi kahle. Ukuntuleka kwemininingwane kusho ukuthi ayikho impendulo eqinisekisiwe ngeqembu labantu elichaziwe; akusho ukuthi kubonisiwe ukuthi umzimba uwusingatha ngendlela evamile umuthi.
Imininingwane yomuthi yase-US yeluleka ukuthi ukubhekwa kwezimpawu zobuthi nokuxhumana okungenzeka phakathi kwemithi kuqhubeke isikhathi eside lapho ukusebenza kwesibindi kukhubazekile, ngoba ukukhishwa komuthi emzimbeni kungase kubambezeleke. Leso yisinyathelo sokuqapha ekwelashweni, hhayi ukwanda okulinganisiwe ngamaphesenti kwesifo sesibindi esincane, esiphakathi nendawo noma esibi kakhulu. Ayisho inani elisebenza kubo bonke lamahora engeziwe okubhekwa kwesiguli noma ifomula yokulungisa ekhethwa isiguli.
Lo mehluko ubalulekile lapho ufunda iseluleko esinjengokuthi “isibindi siyawuguqula umuthi, ngakho usekela isibindi.” Ukuguqulwa komuthi emzimbeni kuchaza ukucutshungulwa kwawo ngamakhemikhali. Akuchazi ukulungiswa kwesibindi, ukuthuthuka kokusebenza kwaso noma ukubuyiselwa emuva kokwakheka kwezicubu eziyizibazi. Lezo zinzuzo zidinga ucwaningo oluklanyelwe ukukala leyo miphumela.
Ukuqhathaniswa kwezinyathelo zokuqapha ekwelashweni namagebe obufakazi
Lokhu kuqhathanisa kugcina umthombo, umongo wokwelashwa nombuzo ongakaphendulwa ndawonye. I-PROVAYBLUE iwumkhiqizo wase-US; i-Proveblue iwumkhiqizo waseYurophu. Womabili amadokhumenti aphathelene nemithi ejovwayo ye-methemoglobinemia, ukuphazamiseka okuthinta ikhono legazi lokuthwala umoya-mpilo. Imiyalelo yawo akufanele ihlanganiswe ibe uhlelo lokusebenzisa umuthi ekhaya.
| Umbuzo | Ukukhubazeka kokusebenza kwezinso | Ukukhubazeka kokusebenza kwesibindi |
|---|---|---|
| Yini elinganiswa ngokuqondile? | Imininingwane yomuthi yase-US, isigaba 12.3: ukwanda kwe-AUC ngemva kokunikezwa kanye nge-IV. | Imininingwane yomuthi yaseYurophu, isigaba 4.2: ukuphepha nokusebenza komuthi lapho isibindi singasebenzi kahle akuqinisekisiwe; imininingwane ayitholakali. |
| Yisiphi isinyathelo sokuqapha ekwelashweni esishicilelwe? | Imininingwane yomuthi yase-US, izigaba 2.2 no-8.6: ukunikezwa kanye lapho ukukhubazeka kokusebenza kuphakathi nendawo noma kubi kakhulu, kucatshangelwe ezinye izindlela zokwelapha uma impendulo inganele. | Imininingwane yomuthi yase-US, isigaba 8.7: ukubhekwa isikhathi eside kwezimpawu zobuthi nokuxhumana phakathi kwemithi. |
| Bukuphi ubufakazi obufinyelela khona? | Imininingwane yomuthi yaseYurophu, isigaba 4.2: ukuphepha nokusebenza komuthi akuqinisekisiwe esifweni sezinso esisesigabeni sokugcina, kungakhathaliseki ukuthi kusetshenziswa i-dialysis noma cha. | Ayikho kule mininingwane yomuthi emibili enikeza isiphindaphindi sokuchayeka esihambisana nezinga lobunzima. |
| Yini engafakazela inzuzo esithweni? | Ucwaningo kubantu olukala imiphumela ebalulekile yezinso eqenjini labantu abanaleso sifo okuhloswe ukubelapha. | Ucwaningo kubantu olukala imiphumela ebalulekile yesibindi eqenjini labantu abanaleso sifo okuhloswe ukubelapha. |
Umugqa wokugcina uchaza ubufakazi obudingekayo ukuze kuhlolwe isimangalo. Awusona isimangalo sokuthi ucwaningo oludingekayo lukhiqize imiphumela emihle.
Ingabe ucwaningo lwezilwane lubonisa ukuvikelwa kwezinso noma kwesibindi?
Olunye ucwaningo lunikeza isizathu sokuphenya. Alunikezi isincomo sokwelapha umuntu onesifo sesitho esingamahlalakhona.
Ocwaningweni lukaSarac nozakwabo lokunqamuka nokubuyiselwa kokugeleza kwegazi ezinso, amagundane angu-21 angamaduna ahlukaniswa aba amaqembu amathathu. Indlela yokudala ukulimala yaphazamisa ukugeleza kwegazi emithanjeni yezinso ihora elilodwa, kwalandela amahora amane okugeleza okubuyiselwe. I-methylene blue yajovwa ngaphakathi esiswini ngaphambi kokulimala. Uma kuqhathaniswa neqembu elalilimele kodwa lingelashwanga, izilwane ezelashwa zazinokulimala kwezicubu okungatheni nezinguquko ezilinganisweni eziningana zokucindezeleka okubangelwa yi-oxidation.
Lobo ubufakazi bokulimala kwesikhashana okudalwe ngenhloso yocwaningo emagundaneni. Abubonisi ukuthi ukuphuza i-methylene blue kuthuthukisa ukuhlunga kwezinso kumuntu osenesikhathi eside enesifo sezinso esingamahlalakhona. Ukwelapha ngaphambi kokulimala okuhleliwe ocwaningweni nakho kuhlukile ekwelapheni isifo esesikhona.
Imiphumela ephathelene nesibindi ibonisa ukuthi kungani igama elithi “antioxidant” liyincazelo engaphelele yenzuzo. Ucwaningo lwango-2018 olwenziwa emagundaneni e-Wistar angu-35 angamaduna lwahlola ukunqanyulwa kokugeleza kwegazi engxenyeni yesibindi imizuzu engu-60 nokubuyiselwa kokugeleza imizuzu engu-15. Abacwaningi banikeza i-methylene blue emthanjeni ngaphambi kokubuyiselwa kokugeleza kwegazi, base beqhathanisa izilinganiso zezicubu nezegazi emaqenjini ocwaningo. I-lipid peroxidation yehla, kodwa izilinganiso ezihloliwe zama-mitochondria azibuyelanga esimweni sazo. I-AST yanda emaqenjini ayenokunqamuka kokugeleza kwegazi, kungakhathaliseki ukuthi ayenikezwe i-methylene blue noma cha.
Umphumela omuhle wamakhemikhali emzimbeni nomphumela wokusebenza ongashintshile kungaba khona ngesikhathi esisodwa. Ukubika isilinganiso esihle kuphela kungenza lolu cwaningo lubonakale luphendula umbuzo obanzi kunalowo oluwuhlolile ngempela. Lolu cwaningo noma ucwaningo lwezinso alufakazeli ukwelashwa kwe-cirrhosis, isifo sesibindi esinamafutha noma isifo sezinso esingamahlalakhona kubantu.
Okufanele uze nakho engxoxweni nochwepheshe wezempilo
Uma ukusetshenziswa kungokuzikhethela, isifo sezinso noma sesibindi sidinga ukuxoxwa ngaphambi kokuchayeka. Letha imininingwane eyenza isiphakamiso sikwazi ukuhlolwa:
- Ukuxilongwa kwesifo nemiphumela yakamuva efanele yokuhlolwa elabhorethri, kuhlanganise nanoma yimuphi umlando we-dialysis.
- Umkhiqizo oqondile, ukugxila kwawo, indlela okuhloswe ukuwusebenzisa ngayo nesizathu sokuwucabangela.
- Yonke imithi nezithasiselo, kanye nezikhathi nenani lanoma iyiphi i-methylene blue osuyithathile.
Imininingwane yemithi ihlala ibalulekile kanye nokusebenza kwezitho. Ukubuka kabanzi ukuphepha kuchaza izimo lapho umuthi kungafanele usetshenziswe khona nemiphumela engemihle; umthombo wokuxhumana phakathi kwemithi uchaza ukuthi kungani uhlu lwemithi lubalulekile. Ungaziyekeli ngokwakho ukwelashwa okunqunyiwe ukuze uvulele i-methylene blue indawo.
Umbuzo owusizo kufanele ucace: yibuphi ubufakazi obusekela lo mkhiqizo nale ndlela yokuwusebenzisa ngale njongo, kumuntu onaleli zinga lokukhubazeka kokusebenza kwesitho? Isimangalo esijwayelekile ngokusebenza kwama-mitochondria asikwazi ukuwuphendula.