Munyika inokurumidza yekutarisira varwere zvakanyanya uye kutarisira zvirwere zvinotapukira, nguva inhengo yemuviri, uye kunyatsoongorora kupona. Kwemakore akawanda, vanachiremba vanga vachivimba nezviratidzo zvebiomarker kuti vatungamirire kurapwa nemishonga inorwisa mabhakitiriya uye kuongorora kuzvimba. Zvisinei, vezvekurapa vari kusvika pakubvumirana kuti chiratidzo chimwe chete hachina kukwana. Kuonekwa panguva imwe chete kweProcalcitonin (PCT) neInterleukin-6 (IL-6) kunomiririra shanduko huru—inopa maonero ekubatana kwehutachiona anopfuura huwandu hwezvikamu zvahwo.

Mabasa Ekuwedzera ePCT neIL-6

Kuti tinzwisise kukosha kwekuyedza kaviri, tinofanira kutanga tanzwisisa mabasa akasiyana ezviyero izvi:

• IL-6: Sisitimu Yekunyevera Yekutanga. IL-6 i cytokine inodzivirira kuzvimba inokwira mukati memaawa maviri ekutanga ehutachiona kana kukuvara kwenyama. Ndiyo chiratidzo chekutanga chekuratidza kutanga kwekuzvimba kwemuviri. Zvisinei, kushaya kwayo zvakananga (kunowedzera mukukuvadzwa, kuvhiyiwa, uye mamiriro ekudzivirira muviri) kunoita kuti ive nzira isina kunaka yekuongorora hutachiona hwebhakitiriya.
• PCT: Musiyano weMabhakitiriya. Procalcitonin, zvinopesana, inokonzerwa zvakasiyana panguva yehutachiona hwakasimba hwebhakitiriya uye sepsis. Inokwira mukati memaawa mana kusvika matanhatu uye inoramba yakakwira chero bedzi hutachiona hwebhakitiriya huchiramba huripo. Kusiyana neIL-6, PCT inonyanya kukonzerwa nehutachiona uye hainyanyi kukanganiswa nehutachiona hwehutachiona kana kuzvimba kwenzvimbo.

Mutemo Wegoridhe: Yambiro Yekutanga + Kunyatsojeka

Kana ukasanganisa zviviri izvi, unowana simba rekuongorora chirwere. IL-6 inopa "nyevero yekutanga" - ichizivisa chiremba nezvemhinduro yekudzivirira chirwere usati waona zviratidzo zvekiriniki. PCT inobva yapa "simbiso" - ichisiyanisa kana mhinduro yekudzivirira chirwere ichi ingangove bhakitiriya, nokudaro zvichiita kuti pave nemishonga inorwisa mabhakitiriya nekukurumidza.

Musanganiswa uyu une simba unobvumira vanachiremba kuti:

1. Bvisa hutachiona hwemabhakitiriya nekukurumidza: Kana PCT yakaderera asi IL-6 yakakwira, chikonzero chingave hutachiona kana kuzvimba, zvichibvumira nzira ye "kurinda nekumirira" yemishonga inorwisa mabhakitiriya.
2. Kuona sepsis nekukurumidza: Kuwedzera kwe IL-6 kunotanga nekukurumidza, nepo PCT ichiratidza kuomarara uye huwandu hwebhakitiriya.
3. Tarisa kurapwa zvinobudirira: IL-6 inodonha nekukurumidza kana mushonga wemishonga inorwisa mabhakitiriya wabudirira, nepo PCT ichiderera zvishoma nezvishoma, zvichibvumira musiyano pakati pekubudirira kwekurapa uye mhinduro dzechipiri dzekuzvimba.

Chinangwa Chekupedzisira: Kuderedza Kutarisirwa Kwemishonga Inorwisa Mabhakitiriya

Pamwe kukanganisa kukuru kwePCT/IL-6 bvunzo mbiri kuri mukurwisa kusakwanisa kurwisa mabhakitiriya. Kunyorerwa mishonga inorwisa mabhakitiriya zvakanyanya kuchiri kutyisidzira hutano hwepasi rose. Nekushandisa IL-6 kudzivirira kutapukirwa nekukurumidza uye PCT kurega mishonga inorwisa mabhakitiriya zvakachengeteka kana huwandu hwayo hwaderera pasi pe0.5 µg/L kana kuderera ne80%, vanachiremba vanogona kuderedza nguva yekurapwa nemishonga inorwisa mabhakitiriya zvakanyanya. Zvidzidzo zvinoratidza kuti nzira dzinotungamirirwa nePCT dzinogona kuderedza kubatwa nemishonga inorwisa mabhakitiriya kusvika pa30-40%, zvichideredza chepfu, mari yechipatara, uye kubuda kwezvipembenene zvisingapindi mishonga yakawanda.

Kuvandudza Kukosha Kwekufanotaura

Uyezve, chiyero uye mafambiro ari pakati pezviratidzo izvi zvinopa ruzivo rwakakosha rwekufanotaura. Murwere ane IL-6 iri kudzikira asi PCT iri kukwira anogona kuratidza hutachiona huri kuramba huchiwedzera kunyangwe paine mhinduro yekutanga yekuzvimba, zvichiratidza kudiwa kwekuchinja kwenzira yekurapa. Kusiyana neizvi, kana PCT iri yakaderera asi IL-6 ikaramba yakakwira, inonyevera nezvechirwere chemuviri chisingatapukire (SIRS) chinogona kuda kurapwa nemuviri kwete nehutachiona.

Mhedziso

Munguva ino apo mushonga chaiwo unonyanya kukosha, kuvimba nechiratidzo chimwe chete chebiomarker kunenge kuri kubheja. Kuongororwa pamwe chete kweProcalcitonin neInterleukin-6 kunopa nzira yakasimba, yakavakirwa pauchapupu inowedzera kururama kwekuongorora, inovandudza kutarisira maantibiotic, uye pakupedzisira inovandudza mhedzisiro yemurwere. Nekubatanidza iyi nzira yekuedza kaviri mukuita kwakajairika, varapi vehutano vanogona kufamba munzvimbo yakaoma ye sepsis nekuzvimba nekujeka uye nechivimbo.