NgoNovemba 2021, i-American Heart Association (AHA) kanye ne-American College of Cardiology (ACC) ngokuhlanganyela bakhipha imihlahlandlela ebanzi yokuhlolwa nokuxilongwa kobuhlungu besifuba.Imihlahlandlela inemininingwane yokuhlolwa kwengozi okujwayelekile, izindlela zomtholampilo, namathuluzi okuxilonga obuhlungu besifuba, okunikeza izincomo kanye nezinqubo zokuthi odokotela bahlole futhi bahlole ubuhlungu besifuba ezigulini ezikhulile.
Umhlahlandlela wethula imilayezo eyisihluthulelo eyi-10 ezindabeni nezincomo zokuhlolwa kwanamuhla kokuxilonga ubuhlungu besifuba, okufingqiwe ngobunono ezinhlamvu eziyishumi “izinhlungu zesifuba”, kanje:
I-Cardiac troponin iwuphawu oluthile lokulimala kweseli ye-myocardial futhi iyi-biomarker ethandwayo yokuxilongwa, ukuhlukaniswa kwengozi, ukwelashwa kanye nokubikezelwa kwe-acute coronary syndromes.Imihlahlandlela ehlanganiswe nokusetshenziswa kwe-troponin ephezulu yokuzwela, ezigulini ezinobuhlungu obukhulu besifuba kanye ne-ACS esolwayo (ngaphandle kwe-STEMI), nikeza izincomo ezilandelayo lapho ubeka izindlela zesinqumo somtholampilo:
I-1.Ezigulini ezethula ubuhlungu obukhulu besifuba kanye ne-ACS esolwayo, izindlela zokuthatha izinqumo zomtholampilo (CDPs) kufanele zihlukanise iziguli zibe yi-strata ephansi, ephakathi-, kanye nengozi enkulu ukuze kube lula isimo kanye nokuhlolwa kokuxilonga okulandelayo.
2.Ekuhlolweni kweziguli ezethula ubuhlungu obukhulu besifuba kanye ne-ACS esolwayo lapho i-serial troponins iboniswa ukuthi ingabandakanyi ukulimala kwe-myocardial, izikhawu zesikhathi ezinconyiwe ngemuva kokuqoqwa kwesampula yokuqala ye-troponin (isikhathi esiyiziro) sokulinganisa okuphindaphindiwe yilezi: 1 kuya kumahora angu-3 ukuphakama. -sensitivity troponin kanye 3 ukuze 6 amahora for ezivamile troponin assays.
3.Ukuze kumiswe ukutholwa nokuhlukaniswa kokulimala kwe-myocardial ezigulini eziveza ubuhlungu obukhulu besifuba kanye ne-ACS esolwayo, izikhungo kufanele zisebenzise i-CDP ehlanganisa iphrothokholi yesampula ye-troponin ngokusekelwe ekuhloleni kwabo okuthile.
I-4.Ezigulini ezinobuhlungu obukhulu besifuba kanye ne-ACS esolwayo, ukuhlolwa kwangaphambilini lapho kutholakala kufanele kucatshangelwe futhi kufakwe kuma-CDP.
5.Ezigulini ezinobuhlungu obukhulu besifuba, i-ECG evamile, nezimpawu eziphakamisa i-ACS ezaqala okungenani amahora angu-3 ngaphambi kokufika kwe-ED, ukuhlushwa okukodwa kwe-hs-cTn okungaphansi komkhawulo wokutholwa ekulinganisweni kokuqala (isikhathi esiyiziro) sinengqondo. ukukhipha ukulimala kwe-myocardial.
I-cTnI ne-cTnT zivame ukusetshenziswa ekuxilongweni kwekhwalithi ye-myocardial infarction, i-MYO ivame ukusetshenziswa ekuxilongweni kokuqala kwe-myocardial infarction, futhi i-CK-MB ivame ukusetshenziswa ekuxilongweni kwe-myocardial infarction ngemva kwe-myocardial infarction.I-cTnI njengamanje iwuphawu oluzwela kakhulu emtholampilo kanye nethize yokulimala kwe-myocardial, futhi isibe isisekelo sokuxilonga esibaluleke kakhulu sokulimala kwezicubu ze-myocardial (njenge-myocardial infarction) .I-AeHealth inokuhlolwa okuphelele kwezinto ze-myocardial, eziphumelele isitifiketi se-CE, ihlinzeka isisekelo esithembekile sokuxilongwa okuyisizayo seziguli ezibuhlungu zemitholampilo nesifuba, nokusiza ngenkuthalo ukwakhiwa kwezikhungo zobuhlungu besifuba.
Isikhathi sokuthumela: Apr-02-2022