Isihloko
I-methylene blue ihlala isikhathi esingakanani emzimbeni?
I-methylene blue ayinaso isikhathi esisodwa esifakazelwe sokuthi “isiphumile emzimbeni wakho.” Imininingwane esemthethweni yamanje yomjovo we-PROVAYBLUE ibika isikhathi sokuncipha ngesigamu kubantu esingaba amahora angu-24. Ucwaningo oludala lwamavolontiya lwalinganisela amahora angu-5.25 ngemva kokunikezwa emthanjeni. Lezi zinombolo zichaza ukwehla kwesilinganiso sobuningi bomuthi okwalinganiswa ngaphansi kwezimo ezihlukene, hhayi isikhathi esinqunyiwe okuthi ngemva kwaso zonke izicubu zingabe zisaba nawo umuthi.
Umbuzo owusizo ucacisa okwengeziwe: yiluphi uhlobo lomuthi nendlela yokuwunikeza, kubaphi abantu, kulinganiswa kuliphi isampula, futhi ngasiphi isikhathi? Isilinganiso sobuningi bomuthi egazini asikwazi ngokwaso ukukutshela ukuthi umphumela owuzwayo kufanele uqale nini, ukuthi ukusebenzelana kwemithi kuphephe nini, noma ukuthi ukusetshenziswa nsuku zonke kufanelekile yini.
Lokho isikhathi sokuncipha ngesigamu esikulinganisa ngempela
Isikhathi sokuncipha ngesigamu ngesikhathi sokususwa komuthi yisikhathi esidingekayo ukuze isilinganiso sobuningi bomuthi esilinganisiwe sehle ngesigamu esigabeni sokususwa komuthi esihlaziywayo. Isikhathi sokuncipha ngesigamu esigabeni sokugcina sichaza ingxenye yakamuva yejika lesilinganiso sobuningi bomuthi. Akusona ngempela isikhathi sokwehla okusheshayo kwasekuqaleni ngemva komjovo.
Njengesibonelo esenziwe saba lula, ake sithi isilinganiso sobuningi bomuthi sehla sisuka kumayunithi angu-100 akhethwe nje siye kwangu-50 esikhathini esisodwa sokuncipha ngesigamu. Esikhathini sesibili esilinganayo sehla siye ku-25, hhayi kuziro. Lokhu kuyizibalo zemodeli eyenziwe yaba lula, hhayi isilinganiso esiqondene nomuntu se-methylene blue esele emzimbeni.
Amanye amagama amathathu aphendula imibuzo ehlukene:
- Isikhathi sokufinyelela esilinganisweni esiphezulu sobuningi bomuthi, noma i-Tmax: isikhathi lapho kutholakala khona isilinganiso esiphezulu sobuningi bomuthi kumasampula.
- Ukuchayeka, noma i-AUC: indawo engaphansi kwejika lesilinganiso sobuningi bomuthi ngokuhamba kwesikhathi, ehlanganisa isilinganiso sobuningi nesikhathi.
- Ukusabela ekwelashweni: ushintsho esimweni noma emphumeleni owelashwayo, njengokwehla kwe-methemoglobin okulinganisiwe.
Isilinganiso esiphezulu sobuningi bomuthi akudingeki sihambisane nenzuzo enkulu kakhulu. Isilinganiso esiphansi sobuningi bomuthi asisho ngokuzenzakalela ukuthi umphumela emzimbeni noma ukusebenzelana kwemithi sekuphelile.
Ukuqhathaniswa kwezifundo zabantu
Ithebula liwukuqhathanisa okwenziwe ngokukhethekile ucwaningo lukaPeter, ucwaningo lukaWalter-Sack nezindlela zalo eziphelele, kanye nokubuyekezwa kwe-FDA kwe-pharmacology yezokwelapha kwe-PROVAYBLUE. Imithamo yocwaningo ihlonza izivivinyo; ayiyona imiyalo yokusetshenziswa. U-MB usho i-methylene blue.
| Ubufakazi | Indlela yokunikeza neqembu labantu | Into ehlaziywayo, isampula, nendlela yokuhlola | Ukuthathwa kwamasampula nomphumela obikiwe |
|---|---|---|---|
| Peter nabanye, 2000 | 100 mg emthanjeni (IV) nangomlomo; amavolontiya ayisikhombisa | MB egazini eliphelele; i-liquid chromatography esebenza kahle kakhulu | Iphrofayili yegazi kuze kufike emahoreni angu-4, njengoba ibekwe ethebuleni yi-FDA; isikhathi sokuncipha ngesigamu esigabeni sokugcina ngemva kwe-IV singamahora angu-5.25 |
| Walter-Sack nabanye, 2009, ingxenye ye-IV | 50 mg IV; kwabhaliswa abantu abadala abanempilo enhle abangu-16, abangu-15 baqeda ucwaningo lapho umuntu ngamunye ethola zombili izindlela ngezikhathi ezihlukene | MB ku-plasma nasegazini eliphelele; i-chromatography ehambisana ne-tandem mass spectrometry | Amasampula aphindaphindiwe kuze kufike emahoreni angu-24; isikhathi sokuncipha ngesigamu esimaphakathi singamahora angu-18.5 ku-plasma nangu-13.6 egazini eliphelele |
| Walter-Sack nabanye, 2009, ingxenye yomlomo | 500 mg womuthi olungiswe ngamanzi onikezwa ngomlomo; iqembu elifanayo elathola zombili izindlela ngezikhathi ezihlukene | Into ehlaziywayo, izingxenye zesampula, nokuhlolwa okufanayo | Amasampula kuze kufike emahoreni angu-24; isikhathi sokuncipha ngesigamu esimaphakathi singamahora angu-18.3 ku-plasma nangu-14.7 egazini eliphelele; i-Tmax ye-plasma emaphakathi ingamahora angu-2.2 |
| Ukubuyekezwa kwe-FDA, 2016, izifundo zokuthuthukiswa komjovo | Ukuchayeka okukodwa nge-IV kumavolontiya anempilo enhle; ukubuyekezwa kufingqa ukufakwa emthanjeni kuka-2 mg/kg ngemizuzu emihlanu | MB ne-Azure B kulinganiswa ngokwehlukana egazini eliphelele naku-plasma nge-liquid chromatography ehambisana ne-tandem mass spectrometry | Izilinganiso zaqhubeka kuze kufike emahoreni angu-72; ukubuyekezwa kuchaza isikhathi sokuncipha ngesigamu se-MB esigabeni sokugcina esingaba amahora angu-24 |
Landa ukuqhathaniswa kwezifundo njengethebula le-Markdown.
Lezi akuzona izilinganiso ezingasetshenziswa ngokushintshana zenani elilodwa elingaguquki kuwo wonke umuntu. Ithebula futhi alibeki umthetho olula wokuthi ukuchayeka ngomlomo kuhlala kuthatha isikhathi eside kunokuchayeka nge-IV. Ocwaningweni lapho abantu bathola khona zombili izindlela ngezikhathi ezihlukene, ingxenye yesampula ekhethiwe yashintsha isilinganiso ngisho nangaphakathi kwendlela efanayo yokunikeza umuthi.
Kungani izinombolo zihluka
Igazi eliphelele ne-plasma kungamasampula ahlukene. Igazi eliphelele lihlanganisa amaseli antanta ku-plasma. I-plasma yingxenye ewuketshezi etholakala ngemva kokuhlukanisa amaseli. Ukuhlolwa okubala umuthi osemaselini nasoketshezini kuphendula umbuzo wokulinganisa ohlukile kulokho okulinganisa uketshezi kuphela.
Isikhathi sokubheka sibalulekile. Ucwaningo oluphela kusenesikhathi lunolwazi oluncane ngokwehla okwenzeka kamuva. Ukubuyekezwa kwe-FDA kuveza ngokuqondile ubude besikhathi sokuthatha amasampula nokulinganisa egazini uma kuqhathaniswa ne-plasma njengezizathu zokuhlukahluka kwe-pharmacokinetics ye-methylene blue eshicilelwe. Ukubheka isikhathi eside kungaveza isigaba esihamba kancane esingachazwa kahle ukuthathwa kwamasampula kwasekuqaleni.
Ikhemikhali elinganisiwe libalulekile. Umphumela womuthi wokuqala, umphumela wento eyakheka lapho umzimba uguqula umuthi, nesamba esihlanganisa izinhlobo eziguqulwe ngokwekhemikhali akufanele konke kubizwe “ngezinga le-methylene blue” ngaphandle kokucacisa. Ukuqhathanisa kuhlonza izinto ezibikiwe ezahlaziywa kunokuba kuthathe zonke izilinganiso ezihlobene ne-methylene blue njengezilinganayo.
Uhlobo lokulungiswa komuthi lubalulekile. Isivivinyo somlomo lapho abantu bathola khona zombili izindlela ngezikhathi ezihlukene sahlola umuthi othile olungiswe ngamanzi. Okutholwe kuso akuqinisekisi ikhepsuli engacacisiwe, uketshezi oludayiswa ezitolo, noma enye indlela yokunikeza umuthi. Ngokufanayo, izivivinyo zamagundane zokubheka ukusatshalaliswa komuthi ezicutshini ezifakwe ephepheni likaPeter zihlukile ezilinganisweni zegazi zamavolontiya angabantu. Azinikezi isikhathi sokususwa komuthi ebuchosheni bomuntu.
Kuthatha isikhathi esingakanani ukuze isebenze?
Lokho kuncike ekutheni “ukusebenza” kusho ukuthini. Ekulashweni ngokwezokwelapha kwe-methemoglobinemia etholakele, abelaphi bangalandela inkomba yegazi echazwe ngokucacile. Imininingwane esemthethweni yomjovo ibika ukuthi abantu abadala abangu-9 kwabangu-12 ababenezilinganiso zakuqala ezifanele babe nokwehla kwe-methemoglobin okungenani ngo-50% ehoreni elilodwa ngemva kokunikezwa umthamo. Lokho kuwukubonwa kokusabela ekwelashweni, hhayi isikhathi sokuncipha ngesigamu se-methylene blue ngesikhathi isuswa emzimbeni.
Ngomuthi onikezwa ngomlomo, ukufinyelela esilinganisweni esiphezulu ku-plasma cishe emahoreni amabili esivivinyweni samavolontiya akufakazeli ukuthi ukuthuthuka kokugxila, kwamandla, noma kwenkumbulo kuqala emahoreni amabili. Ucwaningo lwe-pharmacokinetics lwalinganisa ubuningi bomuthi, hhayi lezo zinzuzo. Lokho umuntu abika ukuthi uyakuzwa nakho akukwazi ukuhlonza isilinganiso sobuningi bomuthi ku-plasma yakhe noma ukufakazela ukuthi umuthi ususwe ngokuphelele lapho lowo muzwa uphela.
Umbala womchamo, ukusetshenziswa okuphindaphindiwe, nezikhathi zokuthatha imithi
Umchamo oluhlaza okwesibhakabhaka noma oluhlaza okotshani awusona isivivinyo esilinganiselwe sokubheka ubuningi bomuthi. Imininingwane esemthethweni iyakuqaphela ukushintsha kombala woketshezi lomzimba, kodwa ayinikezi umkhawulo wombala ofakazela ukuthi umuthi ususwe kuwo wonke umzimba. Ukubuka umbala ufiphala akukwazi ukuthatha indawo yokuhlolwa kokusebenzelana kwemithi.
Ukusebenza kwezinso nakho kushintsha indlela imiphumela eqondwa ngayo. Imininingwane esemthethweni yamanje ibika ukwanda kokuchayeka lapho ukusebenza kwezinso kuphazamisekile, nakuba isikhathi sokuncipha ngesigamu singazange sishintshe ekuphazamisekeni okuncane kuya kokulingene. Lowo mehluko ukhombisa ukuthi kungani isikhathi sokuncipha ngesigamu sisodwa siyisilinganiso esingaphelele sokuphepha. Umhlahlandlela wethu wokuphepha kwe-methylene blue uchaza izici zesiguli ezibanzi.
Ukusetshenziswa okuphindaphindiwe kuletha omunye umbuzo: yini esele lapho kwenzeka ukuchayeka okulandelayo? Isikhathi sokuncipha ngesigamu somthamo owodwa asifakazeli uhlelo oluphephile lwansuku zonke, iphethini ephumelelayo yokushintshanisa izikhathi zokusebenzisa nokungasebenzisi, noma ukuphepha kokusetshenziswa izinyanga eziningi. Lokho kudinga ubufakazi ngohlelo lwangempela lokusetshenziswa okuphindaphindiwe nemiphumela yalo.
Ungasebenzisi ukubalwa kwesikhathi sokuncipha ngesigamu ukuze uyeke, uqale kabusha, noma uhlukanise izikhathi zokuthatha imithi enqunywe udokotela. Izinqumo ezihilela imithi yokucindezeleka neminye imithi esebenzelana nayo zidinga uhlu lwangempela lwemithi, uhlobo lokulungiswa kwayo, indlela yokuyinikeza, umlando wokuchayeka, nezimo zokwelashwa. Umhlahlandlela wokusebenzelana kwe-methylene blue nemithi uchaza lo mehluko. Ukuze usize umelaphi noma usokhemisi, bhala phansi umkhiqizo, inani, indlela yokuwunikeza, isikhathi sokuchayeka ngakunye, imithi ethathiwe, nanoma yiziphi izimpawu. Leyo mininingwane iwusizo kakhulu kunosuku olulinganiselwe lokususwa komuthi emzimbeni.