I-methylene blue, i-Prussian blue ne-hydroxocobalamin: imithi emithathu yokunqanda ubuthi ezinkingeni ezihlukene

Imithi emithathu inegama lombala elifanayo, kodwa cishe akukho okunye efana ngakho. I-methylene blue ingudayi oluhlaza okwesibhakabhaka osebenza ngokudlulisa ama-electron. I-Prussian blue iwuhlaka lwekristalu oluluhlaza okwesibhakabhaka. I-hydroxocobalamin, ethengiswa njenge-Cyanokit, iyisandulela esibomvu sikavithamini B12. Umfundi oyihlanganisa ngamagama angalindela ukuthi yenza umsebenzi ofanayo. Ayenzi kanjalo. Ngamunye wakhelwe emqondweni ohlukile walokho okungahambanga kahle emzimbeni, futhi ngamunye uyehluleka ngaphandle kwalowo mqondo.

Ukuhlukanisa kahle kufushane. I-methylene blue ibuyisela ukusebenza kwe-hemoglobin engasakwazi ukusebenza ngenxa yokulahlekelwa ama-electron. I-hydroxocobalamin ibopha i-cyanide ngokuqondile. I-Prussian blue ibamba i-cesium ekhipha imisebe ne-thallium ngaphakathi emathunjini ukuze umzimba ukwazi ukukukhipha. Umbala uwuphawu olubonakalayo. Indlela yokusebenza eyisisekelo iyona mqondo, futhi ukudidanisa kuvela lapho kuhlanganiswa uphawu nalowo mqondo.

Lokhu ukuqhathanisa okufundisayo, hhayi isiqondiso sokwelapha. Ukusolwa kwe-methemoglobinemia, ukuchayeka ku-cyanide, ukuchayeka ku-carbon monoxide, noma ukungcoliswa ngezinto ezikhipha imisebe kuyisimo esiphuthumayo. Shayela abezimo eziphuthumayo futhi ulandele izeluleko zesikhungo sendawo esilawula ubuthi kunokuba uthathe isinyathelo ngokusekelwe esihlokweni.

I-methylene blue: umxhumanisi obuyisela ukusebenza kwe-hemoglobin

I-hemoglobin evamile ithwala umoya-mpilo nge-iron esesimweni se-ferrous, Fe2+. Ku-methemoglobinemia, leyo iron isilahlekelwe yi-electron yaba sesimweni se-ferric, Fe3+, esingakwazi ukubopha umoya-mpilo. Igazi lingabukeka linsundu njengoshokoledi. Ukulinganiswa okuvamile komoya-mpilo nge-pulse oximetry kuyadukisa. Isiguli siba ne-hemoglobin esebenzayo enganele nakuba amaphaphu engenisa futhi ekhipha umoya.

I-methylene blue iyasebenza lapha ngoba ingumxhumanisi wokudluliswa kwama-electron, njengoba kuchazwe endleleni i-methylene blue edlulisa ngayo ama-electron phakathi kwabawanikezayo nabawamukelayo. Ngaphakathi kwamangqamuzana abomvu egazi, yamukela ama-electron ibe yi-leucomethylene blue ngendlela encike ku-NADPH, bese lelo fomu elithole ama-electron liwanikeza i-ferric iron ngaphandle kokusebenzisa ama-enzyme, liyibuyisele esimweni se-ferrous. Udayi usebenza ngokujikeleza kunokuba uphele lapho usetshenziswa. Leyo ndlela yokusebenza iyisizathu sokuthi ukusetshenziswa kwe-methylene blue ku-methemoglobinemia kube inqubo yasesibhedlela enezilinganiso zamazinga nokubhekwa kokusabela, hhayi indlela yokwelapha ekhaya.

Ilebula lamanje le-methylene blue lichaza ukusetshenziswa okugunyaziwe njengokwelapha i-methemoglobinemia etholwe kamuva kubantu abadala nasezinganeni, ngesilinganiso esivamile sabantu abadala nezingane esingu-1 mg nge-kg ngayinye, esifakwa emthanjeni ngemizuzu engu-5 kuya ku-30, futhi kungase kuphindwe kanye uma amazinga noma izimpawu kuqhubeka. Imininingwane yemikhawulo yesilinganiso, imibandela yokuphinda, nokuthi kushintshwa nini kusetshenziswe enye indlela yokwelapha ibekwe kulebula lamanje le-methylene blue, kanti imibuzo ephathelene nendlela yokufaka umuthi nokuqapha ixoxwa encazelweni yokuthi i-methylene blue ilinganiswa futhi iqashwa kanjani.

Imikhawulo emithathu ibalulekile. Okokuqala, ukushoda kwe-glucose-6-phosphate dehydrogenase kuyisizathu esisemthethweni sokungawusebenzisi umuthi, ngoba ukuhlinzekwa kwe-NADPH edingekayo ukuze udayi wamukele ama-electron kuyaphazamiseka, okwenza umuthi ungasebenzi futhi kwandise ingozi yokubhidlika kwamangqamuzana abomvu egazi. Okwesibili, i-methylene blue ivimbela i-monoamine oxidase A emazingeni e-nanomolar, ngakho ukuyinikeza kanye nama-SSRI, ama-SNRI, ama-MAOI nama-opioid amaningana kunesexwayiso esigqanyiswe ebhokisini mayelana ne-serotonin syndrome, udaba olubuyekezwa engxoxweni yokuphepha kwe-methylene blue nokusebenzisana kwayo neminye imithi. Okwesithathu, ukungasebenzi kahle kwezinso kushintsha izinga lomuthi emzimbeni, futhi ilebula livumela iziguli ezinokungasebenzi kahle okumaphakathi noma okukhulu ukuba zithole isilinganiso esisodwa kuphela. Akukho kulokhu okuwumbhalo omncane ongabalulekile. Ngakunye kuvela emqondweni ofanayo womxhumanisi: umuthi osebenzisa ama-electron eseli futhi uthinta ama-enzyme e-monoamine uzosebenzisana nakho kokubili.

I-methylene blue iphinde ibe nomlando ekwelapheni ubuthi be-cyanide, oqala ngawo-1930, kodwa umlando awukona ukwelapha okusetshenziswa manje. Abacwaningi bokuqala baphakamisa ukuthi isebenza ngokudluliswa kwama-electron noma nge-methemoglobin, futhi ngawo-1950 umuthi wabhekwa njengongasebenzi kahle ngokumelene ne-cyanide uma uqhathaniswa nezindlela ze-nitrite ne-thiosulfate. Namuhla ayigunyaziwe e-US ukwelapha ubuthi be-cyanide. Ucwaningo oluvuselelwe ngamagundane nangamaseli mayelana ne-cyanide luyizinkomba zangaphambi kokuhlolwa kubantu, hhayi isizathu sokusebenzisa lo muthi esimweni esiphuthumayo se-cyanide.

I-hydroxocobalamin: isikhungo se-cobalt esibopha i-cyanide

I-cyanide ivimbela i-cytochrome c oxidase kuma-mitochondria, ngakho amaseli awakwazi ukusebenzisa umoya-mpilo ngisho noma umoya-mpilo osegazini lemithambo ubonakala wanele. Kulandela i-lactic acidosis, ukushintsha kwesimo sokuphaphama, nokwehluleka kohlelo lwenhliziyo nemithambo yegazi. Umqondo wokwelapha uwukususa i-cyanide uqobo, hhayi ukulungisa i-hemoglobin.

I-hydroxocobalamin, ethengiswa njenge-Cyanokit, ikwenza lokho ngokuqondile. Isikhungo sayo se-cobalt sibopha i-ion ye-cyanide esikhundleni se-hydroxo ligand yayo, kwakheke i-cyanocobalamin, uvithamini B12 ovamile, okhishwa yizinso. Lokhu kuwukubopha nokuhlukanisa ubuthi, hhayi ukujikeleza kokudluliswa kwama-electron. Isilinganiso esigunyaziwe sabantu abadala singu-5 g ofakwa emthanjeni ngemizuzu ecishe ibe ngu-15, bese kufakwa omunye u-5 g uma ukusabela kunganele, kuze kufinyelelwe emkhawulweni ongu-10 g. Yingakho ukuqhathaniswa kwe-methylene blue ne-Cyanokit kuxazululeka ngokushesha uma umbuzo ubekwe ngokunembile: uma ubuthi be-cyanide buqinisekisiwe noma busolwa, i-hydroxocobalamin ingumuthi wesimanje okhethwa kuqala e-United States, kanye nomkhiqizo ohlukile we-nitrite ne-thiosulfate ezimweni ezikhethiwe. I-methylene blue ayiyona enye indlela kuleso simo.

Imiphumela emibili ephathelene nokusetshenziswa ivela kule chemistry. Umuthi ubomvu kakhulu, ngakho kulindeleke ukuba isikhumba nomchamo kube bomvu, futhi ngezinye izikhathi ukushintsha kombala womchamo kuhlala amasonto. Ukumunca kwawo ukukhanya ngamandla kuphazamisa nokuhlolwa kwaselabhorethri okusekelwe emibaleni kanye nezilinganiso ze-co-oximetry ze-carboxyhemoglobin, i-methemoglobin ne-oxyhemoglobin, kanti ubukhulu nokuthi iphutha lenyusa noma lehlisa isilinganiso kuya ngomshini wokuhlaziya. Umelaphi ongakwazi lokhu angazihumusha kabi zona kanye izilinganiso ezisetshenziselwa ukuhlola ubuthi. Isethi endala yokwelapha ubuthi be-cyanide esekelwe ku-amyl nitrite, sodium nitrite ne-sodium thiosulfate yayisebenza ngendlela ehlukile: i-nitrite yayakha ngamabomu i-methemoglobin ukuze ibophe i-cyanide, kuyilapho i-thiosulfate isiza ukuguqula i-cyanide ibe yi-thiocyanate. Lelo qhinga linciphisa ikhono lokuthwala umoya-mpilo futhi lingase lehlise umfutho wegazi, okuyindlela engafanele lapho ukuhogela intuthu kusho ukuthi kungenzeka kube khona ne-carbon monoxide. I-hydroxocobalamin igwema lokho ngokubopha i-cyanide ngaphandle kokwakha i-methemoglobin.

I-Prussian blue: isicupho sekristalu esihlala emathunjini

I-Prussian blue, ethengiswa njenge-Radiogardase, iyi-ferric hexacyanoferrate engancibiliki. Igama elithi cyanide kuleyo fomula lichaza ama-ligand avaleleke ekristalwini ye-iron, hhayi i-cyanide ekhululekile, futhi ayinandima ekwelapheni ubuthi be-cyanide. Ukusetshenziswa kwayo okugunyaziwe kuwukungcoliswa ngaphakathi emzimbeni yi-cesium ekhipha imisebe noma yi-thallium ekhipha imisebe noma engayikhiphi.

Umqondo wayo uwukushintshana kwama-ion emgodini wamathumbu. Amakristalu awamuncwa odongeni lwamathumbu olungonakele. Ahlala emathunjini, abambe ama-ion e-cesium noma e-thallium ohlakeni lwawo, kuhlanganise nama-ion akhishwe ngenyongo, futhi aphazamise ukujikeleza kabusha phakathi kwamathumbu nesibindi ukuze insimbi eningi iphume ngendle. Ikhasi le-CDC lokwelapha nge-Prussian blue lichaza indlela efanayo ngamagama alula: ibamba lezi zinsimbi emathunjini futhi isheshise ukukhishwa kwazo ngendle. Uhlelo lwabantu abadala nabasakhula lungu-3 g ophuzwa ngomlomo kathathu ngosuku, ngezilinganiso eziphansi ezisekelwe esisindweni ezinganeni ezincane, futhi ngokuvamile luqhubeka izinsuku ezingu-30 noma ngaphezulu kuqashwe izinga lokungcoliswa.

Lokhu kuchaza ngokuqondile ukusesha okuqhathanisa i-Prussian blue ne-methylene blue. I-methylene blue isebenza egazini njengomxhumanisi wokudluliswa kwama-electron. I-Prussian blue isebenza emathunjini njengesicupho esingamuncwa. Omunye ubuyisela ukusebenza kwephrotheni equkethe insimbi. Omunye unciphisa isikhathi insimbi esihlala ngaso emzimbeni. Ukusebenzisa omunye esikhundleni somunye kungashiya zombili izinkinga zingelashwanga: i-methemoglobin ingahlala ilahlekelwe ama-electron, kanti i-cesium ingaqhubeka ijikeleza kabusha.

I-carbon monoxide: lapho i-methylene blue ingafanele khona

I-carbon monoxide ibopha i-hemoglobin ngamandla amakhulu kakhulu kunomoya-mpilo futhi igudluzela ijika lokuhlukana kwayo nomoya-mpilo, iphinde isebenze ezindaweni zenhliziyo nezama-mitochondria. Ukunakekelwa okuvamile kuwukususa umuntu endaweni achayeka kuyo bese kunikezwa umoya-mpilo ongu-100 wamaphesenti kuze kuphele izimpawu, ngokuvamile amahora amaningana, kucatshangelwe umoya-mpilo ongaphansi kwengcindezi ephakeme ezimweni ezinzima ezikhethiwe njengokuphazamiseka okukhulu kwesimiso sezinzwa, ukuquleka, ukuthinteka kwenhliziyo, noma i-acidosis enkulu. Izinkomba zikahulumeni wesifundazwe zezimo eziphuthumayo eziqoqwe eqoqweni le-CDC lezinkomba zokwelapha okuphuthumayo zibeka umoya-mpilo nokunakekelwa okusekelayo enkabeni yale ndlela.

Ngakho ukusesha i-methylene blue ekwelapheni ubuthi be-carbon monoxide kusekelwe ephutheni elizwakala linengqondo: uma udayi oluhlaza okwesibhakabhaka ulungisa inkinga eyodwa ye-hemoglobin, mhlawumbe ulungisa nenye. Awukwenzi lokho. Umuthi awugunyaziwe ukwelapha ubuthi be-carbon monoxide, futhi izinhlelo zamanje zezinyathelo zokwelapha ubuthi be-carbon monoxide aziwufaki. Lo mqondo mdala, waphakanyiswa ocwaningweni lwezilwane ekuqaleni kwawo-1930 futhi wenqatshwa ukuhlolwa kokuhlola kungakapheli unyaka, kanti ucwaningo olulodwa lwesimanje ngamagundane olucashunwa ngezinye izikhathi lwahlola ukuvikelwa kwesimiso sezinzwa okufika sekudlule isikhathi ngemva kokuchayeka, kunokuba luhlole ukuhlehliswa okusheshayo kwe-carboxyhemoglobin. I-iron elahlekelwe ama-electron ne-iron eboshwe yi-carbon monoxide ziyizimo ezihlukene zephrotheni efanayo, futhi umxhumanisi olungiselelwe isimo sokuqala awunawo umsebenzi oqinisekisiwe kwesesibili. Abafundi abalandela lo mkhawulo bazowuthola uwusizo uma bewubheka kanye nocwaningo olubanzi nge-methylene blue, oluhlukanisa ukusetshenziswa okugunyaziwe kubantu nezinkomba zocwaningo lwamaseli nezilwane.

Ukuhlola okuhambisanayo ngaphambi kwanoma yikuphi ukuqhathanisa

Sebenzisa leli thebula ukuhlola amaphutha amathathu avamile. Amagama afanayo awasho izinto eziqondiswe umuthi ezifanayo. Umbala ogqamile awusho ukuthi imithi isebenza ngokufanayo; ububomvu be-hydroxocobalamin nobuluhlaza okwesibhakabhaka beminye emibili akusho lutho ngokuthi ingasetshenziswa ngokushintshana. Futhi umphumela wokuhlola ohlotsheni olulodwa lobuthi awudluliselwa kolunye uhlobo lobuthi ngoba nje luzwakala luhlobene nalo. Imiqondo kuqala, amagama kamuva, kanti izinqumo zezimo eziphuthumayo zenziwa nabelaphi bezimo eziphuthumayo.