I-methylene blue yokunqamuka kokuphefumula ebuthongweni nokuhona: ukuhlola isimangalo

Kunesimangalo esisakazeka ezinkundleni zokuxoxa ngokulala esicishe sibe kanje. Abantu bathi i-methylene blue ithuthukisa ukusetshenziswa komoya-mpilo emangqamuzaneni, futhi ngemva kwezinsuku ezimbalwa beyithatha bayeka ukuhona, bayeka ukuvuka behefuzela, baqala nokuphefumula ubusuku bonke ngaphandle kwesifihla-buso. Incazelo yokusebenza komuthi ehambisana nalesi simangalo ayisunguliwe nje. I-methylene blue iyasebenzisana ngempela nokudluliswa kwama-electron kuma-mitochondria. Kodwa le mpikiswano yeqa isinyathelo: ukunqamuka kokuphefumula ebuthongweni kuwukwehluleka komgudu wokuphefumula ongaphezulu ukuhlala uvulekile, futhi ukushintsha indlela ingqamuzana elisebenzisa ngayo umoya-mpilo akushintshi ukuthi umphimbo uhlala uvulekile yini.

Leli gebe lihlukanisa izinto ezintathu okukhulunywa ngazo sengathi ziyinto eyodwa: isimo ngokwaso, izilinganiso ezisichazayo, kanye nalokho umuntu akubikayo ngobususuku obungcono.

Inkinga isemgudwini wokugeleza komoya

Lapho umuntu elele, imisipha egcina umphimbo uvulekile iyaxega. Kwabanye abantu umgudu wokuphefumula uba mncane kangangokuba umoya odlula kuwo wenza izicubu ezithambile zidlidlize, futhi lokho kudlidliza kuwukuhona. Kwabanye umgudu uvaleka ngokuphelele imizuzwana eyishumi noma ngaphezulu, okuyi-apnea, noma uba mncane kangangokuba ukugeleza komoya kunciphe nomoya-mpilo wehle, okuyi-hypopnea. Lesi sehlakalo siphela lapho ukwehla komoya-mpilo nokwenyuka kwe-carbon dioxide kubangela ukuphaphama okufushane, imisipha iphinde iqine, umgudu uvuleke, umuntu aphinde alale.

Izici ezibalulekile zihlobene nokwakheka komzimba nokuziphatha. Ukuma komhlathi, isisekelo solimi, ububanzi bentamo, ukuvuleka kwekhala, ukuma komzimba, utshwala, imithi yokulalisa kanye nokujula kobuthongo konke kushintsha ukuthi umgudu uvaleka kangaki. Umuthi oshintsha indlela ingqamuzana elisebenzisa ngayo umoya-mpilo awukho ndawo kulolo hlu. Yingakho incazelo yendlela yokusebenza, noma izingxenye zayo zinembile, ingasebenzi kule nkinga. Ichaza olunye uhlelo lomzimba.

Okubalwayo ocwaningweni lokulala, nokungabalwa

Ukuhlolwa okubizwa nge-polysomnogram kuqopha ukugeleza komoya ekhaleni nasemlonyeni, umzamo wokuphefumula ngamabhande azungeze isifuba nesisu, izinga lokugcwala komoya-mpilo egazini ngenzwa efakwa emunweni, umsindo wokuhona, ukuma komzimba, kanye nomsebenzi kagesi wobuchopho. Kuhambisana neziteshi zokurekhoda ukunyakaza kwamehlo nomsebenzi wemisipha yesilevu ukuze kubalwe izigaba zobuthongo nokuphaphama. Ukuhlolwa kokunqamuka kokuphefumula ebuthongweni okwenziwa ekhaya kunciphisa lokhu, ngokuvamile kuqophe ukugeleza komoya, umzamo wokuphefumula, ukukalwa komoya-mpilo egazini nokuma komzimba.

Kulezo ziteshi kutholakala izinombolo. Inkomba ye-apnea ne-hypopnea ibala izehlakalo ze-apnea ne-hypopnea ngehora lobuthongo. Inkomba yokwehla kokugcwala komoya-mpilo ibala ukwehla kwalelo zinga ngehora. Inkomba yokuphaphama ibala ukuphazamiseka kobuthongo ngehora. Ngaphezu kwalokho ucwaningo lubika isikhathi sokulala esiphelele, ukusebenza kahle kokulala, isikhathi umuntu asichithe ephapheme ngemva kokuqala ukulala, kanye nesikhathi esichithwe esigabeni ngasinye sobuthongo.

Nansi ingxenye ebalulekile ekuhloleni noma yisiphi isimangalo sokwelapha. Ngayinye yalezi zinombolo ilinganisa into eyenzeke ngobusuku obuthile. Ayikho elinganisa ukuthambekela komgudu wokuphefumula ukuwa uvaleke. Lokho kuthambekela kucatshangelwa kususelwa kulobo busuku, futhi ukunemba kwalokho kuncike ekutheni lobo busuku bumele kahle kangakanani ubuthongo obuvamile.

Izibalo zezehlakalo nazo azizinzile. Umuntu ochitha isikhathi esiningi sobusuku elele ngohlangothi uzoba nezehlakalo ezimbalwa ezibalwayo. Ukuma komzimba, isigaba sobuthongo, ukuminyana kwekhala, ukuphuza utshwala kwakamuva, ukushintsha kwesisindo, uhlobo lwenzwa yokugeleza komoya nemithetho yokubala konke kushintsha umphumela, futhi ubusuku bokuqala elabhorethri buvame ukuba bubi kunobesibili. Kungakhathaliseki ukuthi yini enye edingekayo esimalweni sokwelapha, kudingeka uhlelo locwaningo oluzokwazi ukubhekana nokuthi ubusuku obubili obulandelanayo kumuntu ofanayo ongatholi ukwelashwa bungaveza imiphumela ehlukene.

Ubusuku obungcono abusho ushintsho olulinganisiwe

Izimpawu ezenza abantu bathathe isinyathelo ziyimibono yabo: ukuhona kwehlile, ukuhefuzela kuphelile, ngilale kangcono, nginamandla engeziwe. Lokhu yizinto abazizwa ngempela, kodwa akuzona izilinganiso ezinhle zokuvaleka komgudu wokuphefumula.

Isikali Sokozela sase-Epworth sicela umuntu ukuba alinganise ukuthi maningi kangakanani amathuba okuthi ozele ezimweni eziyisishiyagalombili zansuku zonke. Inkomba Yekhwalithi Yokulala yase-Pittsburgh ibuza ngenyanga edlule. Kokubili kuwukulandisa komuntu ngaye uqobo, okwenza kube lula ukukugcwalisa futhi kube lula ukuthi imiphumela ishintshe ngaphandle kokushintsha kwenkinga eyisisekelo. Abantu bafuna ukwelashwa lapho bezizwa kabi kakhulu, ngakho isilinganiso sokuqala sesivele sithambekele ohlangothini olubi, kanti esilandelayo sivame ukubukeka singcono ngenxa yaleso sizathu kuphela. Noma ubani owaziyo ukuthi uthole ukwelashwa ulindele ukuba ngcono.

Kunezindlela ezicacile ezingabangela ukuthi ubusuku bube ngcono ngaphandle koshintsho emgudwini wokuphefumula. Ukuphaphama okuphazamisa ubuthongo kungenzeka ngaphandle kokwehla okukhulu kokugcwala komoya-mpilo, futhi ebusuku bobuthongo obujulile kuba nokuphaphama okunjalo okumbalwa. Umuntu ovele achithe ubusuku elele ngohlangothi uba nezehlakalo ezimbalwa ezibalwayo. Akukho kulokhu okuwukukhohlisa; kuyisizathu esivamile esenza imibiko yomuntu ngalokho akuzwayo nezifundo ezibala izehlakalo zingavumelani.

Lapho i-methylene blue isebenza khona ngempela

I-methylene blue iwudayi we-redox. Yamukela futhi inikele ngama-electron, futhi ingawathwala ukusuka ezingxenyeni zochungechunge lokuthuthwa kwama-electron iye ku-cytochrome c. Kuma-mitochondria ahlukaniswe namangqamuzana obuchopho yandisa ukukhiqizwa kwe-ATP futhi yabuyisela umehluko wamandla kagesi kulwelwesi lapho i-complex I noma i-complex III ivinjelwe. Emangqamuzaneni esibindi samagundane amancane yavikela amangqamuzana okuthuthwa kwawo kwama-electron kwakuvinjwe imithi emibili, futhi kuma-astrocyte ayencishwe kokubili i-glucose nomoya-mpilo yathuthukisa ukuphefumula kwamangqamuzana.

Uma ufunda imininingwane, isithombe siyashintsha. Kuwo lawo ma-mitochondria obuchopho, i-methylene blue yandisa ukukhiqizwa kwe-hydrogen peroxide futhi yandisa ukusetshenziswa komoya-mpilo ngesikhathi sokuphumula, kodwa ayizange ishintshe ukuphefumula okugqugquzelwa yi-ADP. Ukusetshenziswa komoya-mpilo owengeziwe lapho i-mitochondrion ingasebenzi akusho ukukhiqizwa kwamandla engeziwe. Kuma-mitochondria ahlukaniswe namangqamuzana esibindi samagundane, ukwanda kokugxila kwe-methylene blue kwehlisa izilinganiso zokulawulwa kokuphefumula futhi kwabangela ukuvuvukala, ababhali abakuchaza njengokuhlukaniswa kwezinqubo ezixhumene ku-oxidative phosphorylation. I-methylene blue ayigcini nje ngokwenza ukuphefumula kusebenze kahle; ishintsha ukuxhumana phakathi kokusetshenziswa komoya-mpilo nokukhiqizwa kwe-ATP, ngendlela encike ekugxileni kwayo.

Incazelo evamile, yokuthi i-methylene blue ivimbela ukudluliswa kwezimpawu ze-nitric oxide, nayo ayilula njengoba ivame ukuxoxwa. Emangqamuzaneni emisipha ebushelelezi yemithambo yamaphaphu akhuliswe elabhorethri, ukuvinjelwa kokuqongelela kwe-cyclic GMP okubangelwa izinto ezinweba imithambo nge-nitric oxide kanye nesici esixegisa imisipha esivela ku-endothelium kwaphinde kwatholakala ngokukhiqiza i-superoxide, kanti i-methylene blue nayo ngokwayo yakhiqiza i-superoxide. Emangqamuzaneni e-endothelium akhuliswe elabhorethri lapho ingekho i-glucose etholakalayo, ukugxila okungaphezu cishe kuka-5 micromolar kwandisa ukucindezeleka okubangelwa ama-oxidant ngaphakathi kwamangqamuzana. Ukubuyekezwa kwezincwadi zocwaningo ezimayelana nomthamo nempendulo kuchaza le ndlela ngokuthi i-hormesis: imithamo ephakathi nendawo yandisa umsebenzi we-cytochrome oxidase, kanti imithamo ephezulu iyawehlisa. Umphumela uyaguquka ube ngowokuphambene lapho umthamo ukhuphuka.

Ezinye izilinganiso ezimbili zibonisa iphuzu elifanayo. Ezinjeni, i-methylene blue yashintsha isilinganiso se-lactate ne-pyruvate egazini lemithambo esuka enhliziyweni, okuyinkomba yesimo se-redox ezicutshini, futhi cishe ayizange ishintshe umthamo wegazi ompompwa yinhliziyo, ijubane lokushaya kwenhliziyo nomfutho wegazi kule mithambo. Kumavolontiya angabantu anikezwa i-methylene blue ngomthambo, ukugeleza kwegazi ebuchosheni bonke kwehla kunokuba kwenyuke, okuyinto enzima ukuyivumelanisa nombono wokuthi umuthi uletha umoya-mpilo owengeziwe ebuchosheni.

Ushintsho lwamakhemikhali emzimbeni olulinganisekayo kodwa olungenalo ushintsho oluhambisanayo ekusebenzeni yisimo isimangalo okufanele sinqobe, hhayi ubufakazi bokuthi sesiqinisekisiwe kakade.

Izimpikiswano ezintathu ezingalivali leli gebe

Eyokuqala iphathelene nekhala. Ikhala elivalekile lenza abantu baphefumule ngomlomo, kanti ukuphefumula ngomlomo kwenza ukuhona kube kubi kakhulu, ngakho kulula ukucabanga ngokwelapha izimpawu zekhala bese ulindela ukuthi yonke inkinga ibe ngcono. Ukuvuleka kwekhala kungenye yezinto ezinomthelela ekuphefumuleni okuphazamisekile ngesikhathi sokulala. Akukhona ukuwa komgudu uvaleke. Ukuvaleka ekunqamukeni kokuphefumula ebuthongweni kwenzeka ngemva kolwanga oluthambile nasesisekelweni solimi, ngemva kwekhala endleleni umoya odlula ngayo, futhi akukho ocwaningweni olushicilelwe nge-methylene blue okubonisa ukuthi ivula lezo zakhiwo.

Eyesibili impikiswano yama-mitochondria, okuyiyona esetshenziswa kakhulu. Ukuthi amangqamuzana asebenzisa umoya-mpilo kahle kakhulu kuyisitatimende mayelana nokusebenza kwamakhemikhali ezicutshini. I-apnea imayelana nokugeleza komoya. Ngesikhathi sesigameko sokuvaleka komgudu, umoya-mpilo osegazini lemithambo esuka enhliziyweni uyehla ngoba umoya uyekile ukuhamba, hhayi ngoba amangqamuzana enqabile ukuwusebenzisa. Ukudlulisa ama-electron kangcono ngaphakathi kwe-mitochondrion akuwuvuli kabusha umphimbo ovalekile, futhi uma i-methylene blue yandisa ukusetshenziswa komoya-mpilo ngesikhathi sokuphumula kodwa ingashintshi ukuphefumula okuxhumene nokukhiqizwa kwamandla, umbuzo ewuphakamisayo ngobusuku obunomoya-mpilo ophansi umayelana nesidingo, hhayi nokutholakala kwawo.

Eyesithathu indaba yokuhlangenwe nakho komuntu. Umuntu ozama i-methylene blue akakwazi ukwenza kuye ucwaningo lapho engazi ukuthi uthole muphi umuthi, futhi kulo muthi inkinga inkulu ngendlela engavamile: uwudayi ogqamile. Umchamo uba luhlaza okwesibhakabhaka, futhi umjuluko nezinyembezi nakho kungaba njalo. I-methylene blue iphinde ibe yisivimbeli esinamandla se-monoamine oxidase A esisebenza ngendlela engahlehliseka, esishintsha indlela amathumbu asingatha ngayo ama-amine asekudleni lapho ithathwa ngomlomo, futhi inezingcuphe ezibhaliwe zokusebenzisana nemithi ethinta i-serotonin. Umphumela ovuselelayo walolu hlobo ungahunyushwa kalula njengokulala kangcono ngaphandle kokuba kube noshintsho emgudwini wokuphefumula.

Akukho kulokhu okusho ukuthi umuntu unephutha ngalokho okwenzeka ebusuku bakhe. Kusho ukuthi umbiko wobusuku obungcono udinga ukuhambisana nesilinganiso ngaphambi kokuba ube yisimangalo mayelana nokunqamuka kokuphefumula ebuthongweni.

Lokho isimangalo okufanele sikubonise

Uma kubekwa ngokucacile, isimangalo esikholakalayo sibukeka kanje.

Ukuxilongwa okuqinisekiswe ucwaningo lokulala olubala izehlakalo ngaphambi kokuba kuqale ukwelashwa, nobukhulu besimo buchaziwe, ukuze kube khona into okuqhathaniswa nayo.
Iqembu lokuqhathanisa elihlolwa ngesikhathi esifanayo, abantu babelwe amaqembu ngokungahleliwe. Ngenxa yokuthi izibalo zezehlakalo ziyashintshashintsha ngokwazo, uchungechunge lokuhlolwa ngaphambi nangemva kokwelashwa olungenalo iqembu lokuqhathanisa alukwazi ukuhlukanisa umphumela wokwelashwa kulokho kushintshashintsha. Uhlelo lapho ababambiqhaza beshintshana phakathi kokwelashwa nokwesimo sokuqhathanisa luyakhanga, kodwa lunezinkinga zalo: umbala womchamo uyinkomba enamandla yokuthi umbambiqhaza ukusiphi isikhathi sokuhlolwa.
Incazelo engagunci yokufihlwa kokuthi ubani uthola kuphi ukwelashwa. Ucwaningo lwento enombala obonakalayo kufanele luchaze ukuthi lwasingatha kanjani iqiniso lokuthi ababambiqhaza bangabona ukuthi bakuliphi iqembu, futhi ukusebenzisa i-placebo enombala olingana nowodayi kungenye yezindlela zokwenza lokhu.
Umphumela oyinhloko olinganiswa ngendlela engancikile emibonweni yomuntu: ushintsho lwezehlakalo ngehora, noma lwenkomba yokwehla kokugcwala komoya-mpilo, uma kuqhathaniswa nezilinganiso zokuqala. Amaphuzu emibuzo kufanele abe sohlwini lwemiphumela yesibili, lapho engabikwa khona ngokwethembeka ngaphandle kokuthi kube yiwo asekela isimangalo.
Ubusuku obuqoshiwe obanele ukuze kubhekwane nokwehlukahluka kobusuku ngabunye, okuvame ukusho ubusuku obungaphezu kobubodwa esimweni ngasinye sokuhlolwa.
Ukulandela uhlelo lokwelashwa okulinganisiwe kunokuba kucatshangelwe.
Ukubikwa kokuphepha okufanele abantu abacwaningwayo, okuhlanganisa nabantu abathatha imithi ethinta i-serotonin.
Uhlelo lwemiphumela nokuhlaziywa olubekwe ngaphambi kokuba kuqoqwe imininingwane.

Ishidi lokusebenza ongakwazi ukuligcwalisa ukuze uhlole noma yisiphi isimangalo esithile lifakwe kulesi sihloko: ishidi lokusebenza lokuqhathanisa imiphumela. Ifayela le-HTML elizimele lisebenza nangaphandle kwe-inthanethi uma ligcinwe bese livulwa kusiphequluli.

Uma ucwaningo belubika ukwehla okubalulekile kwezehlakalo ngehora kubantu abanesifo esiqinisekisiwe, lowo bekuyoba umphumela ophawulekayo, futhi ubuyodinga incazelo yokuthi into esebenza ekudlulisweni kwama-electron iwuthinte kanjani umphimbo.

Okunye ongakufunda kulolu chungechunge: ubufakazi nge-methylene blue nokulala, obuhlanganisa ukuqwasha nesikhathi sokuthatha umthamo, kanye nodaba olufanayo lwe-methylene blue ku-COPD nasemazingeni aphansi omoya-mpilo. Amakhasi amabili abalulekile uma usebenzisa lokhu empilweni yangempela: lokho i-methylene blue ekwenzayo ekukalweni komoya-mpilo egazini ngenzwa nasezivivinyweni zaselabhorethri, ngoba udayi osegazini ushintsha lokho okubikwa ezinye izinsimbi, kanye nohlu lwemibuzo ongayibuza uchwepheshe wezempilo nge-methylene blue.

Okufanele ukwenze esikhundleni salokho, nento eyodwa okufanele uyihlole

Akukho okungenhla okuyisizathu sokuyeka ukwelashwa okusebenzisa umfutho womoya ogcina umgudu wokuphefumula uvulekile noma sokweqa ucwaningo lokulala lokuxilonga. Lokho kusalokhu kuyizinga elisetshenziswa njengesisekelo sokuqhathanisa, futhi ubusuku emshinini bukhiqiza izilinganiso isithasiselo esingakwazi ukuzikhiqiza.

Uma uthatha i-methylene blue ngesinye isizathu futhi ungalali kahle, yenza ukuthi ukulala kwakho kulinganiswe kunokuba kucatshangelwe. Cela izinombolo: zingaki izehlakalo ngehora, inkomba yokwehla kokugcwala komoya-mpilo, singakanani isikhathi esichithwe izinga lokugcwala komoya-mpilo lingaphansi kwamaphesenti angamashumi ayisishiyagalolunye, kanye nenkomba yokuphaphama. Lezo zilinganiso yizo ukwelashwa okufanele kuzishintshe.

Into eyodwa umthengi angayiqinisekisa ngempela yilokho okuqukethwe ngumkhiqizo. Ubumsulwa buhlukanisa into ehambisana nemininingwane yezinga lencwadi esemthethweni yemithi kuleyo engahambisani nayo, futhi indlela esebenzayo yokufinyelela ebumsulweni obuphakeme kakhulu obutholakalayo ukuhambisana nencazelo esemthethweni ye-methylene blue ku-United States Pharmacopeia. Abathengisi abaningi abathi bayahambisana nalelo zinga bahlola izinsimbi ezisindayo kuphela bese begcina lapho. Blupreme isebenza nomkhiqizi wemithi, ihlola yonke imininingwane yezinga, okuhlanganisa ukuhlonza into, ubumsulwa, ukungcola kwezinto eziphilayo, izincibilikisi ezisele, ukungcola kwezakhi, insalela ngemva kokushiswa, imingcele yamagciwane kanye nama-endotoxin avela kumabhaktheriya, futhi ishicilela isitifiketi sokuhlaziywa esiphelele seqoqo lomkhiqizo. Leyo mibhalo ikutshela ukuthi yini esentweni. Ayikutsheli ukuthi leyo nto yelapha ukunqamuka kokuphefumula ebuthongweni.