Ukuhlolwa kwe-CPK: kwenzelwa ini futhi kungani kuguqulwa
-Delile
I-Creatinophosphokinase, eyaziwa nge-CPK noma i-CK, yi-enzyme esebenza kakhulu kwizicubu zemisipha, ebuchosheni nasenhliziyweni, futhi isilinganiso sayo siyacelwa ukuthi siphenye umonakalo ongaba khona kulezi zitho.
Udokotela angayalela lokhu kuhlolwa lapho umuntu efika esibhedlela ekhononda ngobuhlungu besifuba noma ukuhlola izimpawu zesifo sohlangothi noma esinye isifo esithinta imisipha, isibonelo.
Amanani ayizethenjwa
Amanani esithenjwa e-creatine phosphokinase (CPK) angama- 32 no-294 U / L wabesilisa futhi U-33 kuye ku-211 U / L wabesifazane kepha zingahluka ngokuya nge-laboratory lapho kwenziwa khona ukuhlolwa.
Yenzelwe ini
Ukuhlolwa kwe-creatinophosphokinase (CPK) kuyasiza ukusiza ukuxilonga izifo ezinjengesifo senhliziyo, ukwehluleka kwezinso noma kwamaphaphu, phakathi kokunye. Le enzyme ihlukaniswe yaba yizinhlobo ezintathu ngokuya ngendawo yayo:
- CPK 1 noma i-BB: Ingatholakala emaphashini nasebuchosheni, ikakhulukazi;
- I-CPK 2 noma i-MB: Itholakala emisipheni yenhliziyo ngakho-ke ingasetshenziswa njenge-marker ye-infarction, isibonelo;
- CPK 3 noma MM: Itholakala ezicutshini zemisipha futhi imele ama-95% ayo yonke i-creatine phosphokinases (BB ne-MB).
Umthamo wohlobo ngalunye lwe-CK wenziwa ngezindlela ezahlukahlukene zelabhoratri ngokuya ngezakhiwo zawo nangokuya ngesibonakaliso sezokwelapha. Lapho umthamo we-CPK ucelwa ukuthi uhlole i-infarction, ngokwesibonelo, i-CK MB ilinganiswa ngaphezu kwezinye izimpawu zomzimba, njenge-myoglobin ne-troponin, ikakhulukazi.
Inani le-CK MB elilingana noma elingaphansi kuka-5 ng / mL lithathwa njengelivamile futhi ukugxila kwalo kuvame ukuba phezulu uma kwenzeka isifo senhliziyo. Amaleveli we-CK MB ajwayele ukukhuphula amahora ama-3 kuye kwayi-5 ngemuva kwe-infarction, afinyelela phezulu kufika emahoreni angama-24 bese inani libuyela kokujwayelekile phakathi kwamahora angama-48 kuye kwangama-72 ngemuva kokutholwa. Yize kubhekwa njengesimpawu esihle senhliziyo, ukulinganiswa kwe-CK MB yokuxilongwa kwe-infarction kufanele kwenziwe kanye ne-troponin, ikakhulukazi ngoba amanani we-troponin abuyela kokujwayelekile cishe ezinsukwini eziyi-10 ngemuva kwe-infarction, ngakho-ke, kucaciswe kakhulu. Bona ukuthi yini ukuhlolwa kwe-troponin.
Kusho ukuthini ukuthi i-CPK ephezulu nephansi
Ukuhlushwa okwandisiwe kwe-enzyme ye-creatinophosphokinase kungakhombisa:
| I-CPK ephezulu | I-CPK ephansi | |
| CPK BB | I-infarction, isifo sohlangothi, isimila sobuchopho, ukuquleka, ukwehluleka kwamaphaphu | -- |
| CPK MB | Ukuvuvukala kwenhliziyo, ukulimala kwesifuba, ukushaqeka ngogesi, uma kwenzeka kwehliswa inhliziyo, ukuhlinzwa kwenhliziyo | -- |
| MM CPK | Ukulimala kokuchoboza, ukuvivinya umzimba kanzima, ukukhubaza isikhathi eside, ukusetshenziswa kwezidakamizwa ezingekho emthethweni, ukuvuvukala emzimbeni, imisipha yokukhubazeka, ngemuva kwe-electromyography | Ukulahleka kwemisipha, i-cachexia nokungondleki |
| ISIKHATHI CPK | Ukuphuza ngokweqile iziphuzo ezidakayo, ngenxa yokusetshenziswa kwemithi efana ne-amphotericin B, i-clofibrate, i-ethanol, i-carbenoxolone, i-halothane ne-succinylcholine efakwe ndawonye, ifaka ubuthi kuma-barbiturate | -- |
Ukwenza i-CPK dosing, ukuzila ukudla akuphoqelekile, futhi kungenzeka noma kunganconywa udokotela, kepha kubalulekile ukugwema ukwenza izivivinyo zomzimba ezinzima okungenani izinsuku ezimbili ngaphambi kokwenza ukuhlolwa, njengoba le enzyme ingaphakanyiswa ngemuva kokuzivocavoca umzimba ngenxa ekukhiqizweni kwayo ngemisipha, ngaphezu kokumiswa kwemithi, njenge-Amphotericin B kanye neClofibrate, ngokwesibonelo, njengoba zingaphazamisa umphumela wokuhlolwa.
Uma ukuhlolwa kucelwa ngenhloso yokuxilonga isifo senhliziyo, kunconywa ukuthi ubudlelwano phakathi kwe-CPK MB no-CPK buhlolwe kusetshenziswa ifomula elandelayo: 100% x (inani le-CK MB / CK). Uma umphumela walobu budlelwano ungaphezu kuka-6%, kukhombisa ukulimala kwemisipha yenhliziyo, kodwa uma kungaphansi kuka-6%, kuwuphawu lokulimala kwemisipha yamathambo, futhi udokotela kufanele aphenye imbangela.
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