Reteplase ni iki: Ibikoreshwa, Urutonde rw'imiti, Ingaruka zayo n'ibindi

Reteplase ni umuti ukomeye uvura amaraso yiziba ushobora gukiza ubuzima bwawe mu gihe cy'umutima. Ni poroteyine yakozwe hifashishijwe ikoranabuhanga rya genetike ikora isesengura ry'amaraso y'ibibazo mu miyoboro y'amaraso yawe, ifasha gusubiza amaraso mu misitsi y'umutima wawe igihe buri munota ubarwa.

Uyu muti ubarizwa mu cyiciro cy'imiti yitwa thrombolytics, bisobanura "ibinyungunyuzi by'amaraso". Tekereza reteplase nk'igikoresho cyihariye abaganga b'indwara zihutirwa bakoresha kugira ngo bongere vuba imiyoboro y'amaraso yazibye kandi birinde kwangirika kw'umutima burundu.

Reteplase ni iki?

Reteplase ni igikorwa cyongera plasminogen ya tissue, bivuze ko ari verisiyo yakozwe muri laboratwari ya poroteyine umubiri wawe ukora mu buryo bwa kamere kugira ngo isesengure amaraso. Igice cya "recombinant" gisobanura gusa ko abahanga bashizeho bakoresheje ikoranabuhanga rya genetike kugira ngo bikore neza kandi bimare igihe kirekire kuruta poroteyine z'umubiri wawe zisesengura amaraso.

Uyu muti wagenewe gukoreshwa byihutirwa mu bitaro mu gihe cy'umutima. Ntabwo ari ikintu wakoresha mu rugo cyangwa ngo ukoreshwe mu gukumira. Ahubwo, ni umuti wo gutabara abaganga bakoresha iyo amaraso y'umutima wawe yazibye cyane.

Reteplase ikoreshwa mu iki?

Reteplase ikoreshwa cyane cyane mu kuvura myocardial infarction ikaze, iryo rikaba ari ijambo ry'ubuvuzi ry'umutima uterwa n'amaraso. Iyo amaraso yazibye imwe mu miyoboro itera umutima wawe, icyo gice cy'umutima wawe gitangira gupfa kubera kubura umwuka wa oxygen n'intungamubiri.

Uyu muti ukora neza cyane iyo utanzwe mu masaha make nyuma yuko ibimenyetso by'umutima bitangiye. Abaganga b'indwara zihutirwa bawukoresha nk'igice cy'icyitwa "reperfusion therapy" - mu by'ukuri kwihutira gusubiza amaraso mbere yuko kwangirika burundu kubaho.

Mu bindi bihe, abaganga bashobora gukoresha reteplase mu kuvura ibibazo bikomeye byo guhagarara kw'amaraso mu muhogo, ari amaraso y'amaraso ateza ubuzima mu muhogo. Ariko, ibi ntibisanzwe kandi bisaba isuzuma ryitondewe ry'ibibazo n'inyungu.

Reteplase ikora ite?

Reteplase ikora mugukora poroteyine mu maraso yawe yitwa plasminogen, ikayihindura plasmin. Plasmin isa nk'imikasi y'umubiri wawe isanzwe yo gutema fibrin, poroteyine ikora imiterere isa n'urushundura rw'amaraso.

Ibi bifatwa nk'umuti ukomeye cyane kuko ukora vuba kandi neza mu mikorere yawe yose y'amaraso. Bitandukanye n'imiti imwe yoroheje ituma amaraso atavura, reteplase ntabwo ikumira gusa amaraso mashya - ikora cyane mu gushonga ayasanzweho.

Umuti utangira gukora mumunota muke nyuma yo gutangwa, kandi ingaruka zawo zirashobora kumara amasaha menshi. Iki gikorwa cyihuse ni ngombwa mugihe cyo gufatwa n'umutima, aho "igihe ni imitsi" - bivuze ko amaraso yihuse asubizwa, imitsi myinshi y'umutima irashobora kurokoka.

Nkwiriye gufata Reteplase nte?

Ntabwo uzifata ""reteplase"" ubwawe - buri gihe itangwa n'abantu b'inzobere mu by'ubuvuzi mu bitaro binyuze mu murongo wa intravenous (IV) ukoreshwa mu maraso yawe. Uyu muti uza nk'ifu abaganga cyangwa abaganga bavanga n'amazi yoroshye mbere yo kuyiguha.

Uburyo busanzwe bukoresha inshinge ebyiri zitandukanye zitangwa nyuma yiminota 30. Inshinge zose zitangwa nka "bolus," bivuze ko ishyirwa muburyo bwawe bwa IV aho gushyirwa buhoro buhoro uko igihe kigenda.

Mbere yo kwakira reteplase, ntuzakenera kurya cyangwa kunywa ikintu cyihariye, kuko iyi ni imiti yihutirwa. Ariko, abakozi b'ubuvuzi barashobora kukubaza ibyerekeye amafunguro yawe ya vuba na imiti yo kureba imikoranire ishoboka cyangwa ibibazo.

Nkwiriye kumara igihe kingana iki mfata Reteplase?

Ubuvuzi bwa Reteplase burangira mu minota 30 kugeza ku isaha. Bitandukanye n'imiti ushobora gufata buri munsi mu rugo, ubu ni ubuvuzi bw'igihe gito, bukomeye butangwa gusa mu gihe cy'indwara y'umutima.

Nyuma yo guhabwa reteplase, mubisanzwe uzagenzurwa cyane mu bitaro byibuze amasaha 24 kugeza kuri 48. Muri iki gihe, abakozi b'ubuvuzi bazareba ibimenyetso byerekana ko ubuvuzi bwakoze kandi bagenzure niba hari ibibazo by'amaraso.

Nyuma yo kuvurwa na reteplase, muganga wawe ashobora gutegeka indi miti yo kurinda umutima igihe kirekire, nka aspirine, beta-blockers, cyangwa ACE inhibitors. Iyi miti ikomeza ifasha kwirinda indwara z'umutima mu gihe kizaza kandi igashyigikira imikoreshereze yawe.

Ni Ibihe Bikorwa Bigaragara bya Reteplase?

Ibintu by'ingenzi bishobora guteza ibibazo na reteplase ni ukuva amaraso, kuko umuti ugira ingaruka ku bushobozi bw'amaraso bwo gukora ibice mu mubiri wawe wose. Ibi birashobora gutangira kuva amaraso gake ahantu hakorerwa inshinge kugeza ku kuva amaraso menshi imbere mu mubiri.

Dore ibikorwa bisanzwe ushobora guhura nabyo mu gihe cyangwa nyuma yo kuvurwa:

• Kuva amaraso ahantu hashyizweho IV cyangwa ahandi hantu hakomeretse
• Gukomereka byoroshye kuruta uko bisanzwe
• Isesemi cyangwa kuruka
• Umubyimba muke w'amaraso
• Umutima utera nabi
• Urubore cyangwa ibikonjo

Ibi bikorwa muri rusange birashobora gucungwa kandi byitezwe nk'igice cy'inzira yo kuvura. Itsinda ryawe ry'ubuvuzi rizagukurikiranira hafi ibimenyetso byose by'ibibazo.

Ibikorwa bikomeye ariko bidasanzwe bishobora kuba birimo:

• Kuva amaraso menshi mu bwonko (intracranial hemorrhage)
• Kuva amaraso menshi imbere mu gifu cyangwa mu mara
• Ibikorwa by'uburwayi, nubwo bidasanzwe
• Kugabanuka gukomeye kw'umuvuduko w'amaraso bisaba ubufasha bw'ubuvuzi
• Ukwangirika kwa reperfusion, aho amaraso yagarutse atangira gutera umuvumo

Nubwo izi ngorane zikomeye ziteye impungenge, wibuke ko reteplase ikoreshwa gusa iyo ingaruka zo kutavura umutima wawe ziremereye kurusha izi ngaruka zishobora kuvuka. Itsinda ryawe ry’abaganga rifite uburambe bwinshi mu gukemura ibi bibazo.

Ninde utagomba gufata Reteplase?

Reteplase ntikwiriye buri wese, kabone niyo uri mu gihe cyo gufatwa n’umutima. Muganga wawe azihutira gusuzuma niba uri umukandida mwiza bitewe n'amateka yawe y'ubuzima n'uburwayi ufite ubu.

Ntabwo ukwiriye guhabwa reteplase niba ufite kimwe muri ibi bibazo:

• Kuva amaraso imbere mu mubiri cyangwa uburwayi butuma amaraso ava
• Kubagwa bikomeye vuba aha mu minsi 10 ishize
• Amateka yo gufatwa n'umutsi wo mu bwonko cyangwa imvune yo mu bwonko mu mezi 3 ashize
• Umubyigano ukabije w'amaraso utagenzurwa (kurenza 180/110)
• Ubwoko bw'umuturuko wo mu bwonko cyangwa imitsi idasanzwe y'amaraso mu bwonko
• Imvune ikomeye yo mu mutwe vuba aha

Muganga wawe azakoresha kandi ubushishozi bwihariye niba ufite ibibazo bimwe na bimwe byongera ibyago byo kuva amaraso, kabone niyo atari ibizitira rwose.

Ibi bihe bisaba kuzirikana cyane:

• Imyaka irenze 75
• Kubagwa guto cyangwa ibikorwa by'ubuvuzi bya vuba aha
• Gusama cyangwa kubyara vuba aha
• Uburwayi bukomeye bwo mu gifu
• Uburwayi bukomeye bw'umwijima cyangwa impyiko
• Gukoresha imiti ituma amaraso ataguma mu mubiri vuba aha

Muri ibi bihe, muganga wawe azagereranya ingaruka n'inyungu neza, rimwe na rimwe agahitamo ubuvuzi bundi nk'ubushakashatsi bwihutirwa bw'umutima aho kubikora.

Amazina y'ubwoko bwa Reteplase

Reteplase izwi cyane ku izina ry'ubwoko bwayo rya Retavase muri Leta Zunze Ubumwe z'Amerika. Ubu ni bwo buryo bw'ibanze bw'ubucuruzi bw'umuti ibitaro bibika kandi bikoresha mu kuvura umutima wihutirwa.

Bitandukanye na imiti imwe ifite amazina menshi y'ubwoko, reteplase yagumye ihinduka cyane mu izina ryayo. Ibihugu bimwe bishobora gukoresha amazina y'ubwoko atandukanye, ariko ibikoresho bikora n'imikorere biraguma kimwe.

Iyo wakira uyu muti, ushobora kugaragara mu nyandiko zawe z'ibitaro cyangwa mu mpapuro z'ishyuza nk'"reteplase" cyangwa "Retavase," bitewe n'uburyo ikigo cyawe cy'ubuvuzi cyandika imiti.

Uburyo bwo gusimbuza Reteplase

Imiti myinshi ikuraho ibimina yindi ishobora gukoreshwa mu mwanya wa reteplase, bitewe n'uko ubuzima bwawe buhagaze n'ibiboneka mu bitaro byawe. Uburyo bwo gusimbuza busanzwe burimo alteplase (tPA), tenecteplase, na streptokinase.

Alteplase, akenshi yitwa tPA, birashoboka ko ari yo ikoreshwa cyane. Ikora kimwe na reteplase ariko bisaba igihe kirekire cyo kuyikoresha no kuyipima bigoye. Ubushakashatsi bumwe buvuga ko reteplase ishobora koroha gukoreshwa mu bihe by'ubutabazi.

Tenecteplase ni nshya kandi ishobora gutangwa nk'urushinge rumwe aho gutanga doze ebyiri zitandukanye. Ariko, ntiboneka cyane nka reteplase cyangwa alteplase mu bitaro byinshi.

Mu bihe bimwe na bimwe, muganga wawe ashobora kugusaba ubufasha bwa mekaniki aho gukoresha imiti. Ibi bishobora kuba harimo gukoresha catheterization y'umutima yihutirwa hamwe na balloon angioplasty, aho abaganga bafungura umuyoboro wazibye bakoresheje agafuka gato kandi akenshi bashyiraho stent kugira ngo ukomeze gufunguka.

Ese Reteplase iruta Alteplase?

Reteplase na alteplase ni imiti ikuraho ibimina ikora neza cyane, kandi ubushakashatsi bwerekana ko zikora kimwe mu kuvura indwara z'umutima. Guhitamo hagati yazo akenshi biterwa n'ibitekerezo bifatika aho kuba imwe iruta iyindi.

Reteplase ifite inyungu mu bihe byihutirwa kuko itangwa mu nshinge ebyiri byihuse aho gutangwa mu mvura ihoraho mu minota 90 nkuko alteplase ikorwa. Ibi birashobora korohereza abakozi bo mu buvuzi kuyitanga kandi bishobora kugabanya amahirwe yo kwibeshya mu gupima imiti mu bihe byihutirwa.

Ariko, alteplase imaze igihe kinini kandi yigwa cyane. Abaganga bamwe bumva bameze neza kuyikoresha kubera ko bafite uburambe bwinshi bwo kuyikoresha. Alteplase yemerewe kandi kuvura sitiroki, naho reteplase ikoreshwa cyane cyane mu gitero cy'umutima.

Ikintu cy'ingenzi ntabwo ari umuti runaka wakira, ahubwo ni ukuntu wihutira kugera kwa muganga no kwakirwa. Imiti yombi ni amahitamo meza iyo ikoreshwa neza n'amakipe y'abaganga bafite uburambe.

Ibikunze Kubazwa Kuri Reteplase

Ese Reteplase irakoreshwa neza ku bantu barwaye diyabete?

Yego, reteplase irashobora gukoreshwa neza ku bantu barwaye diyabete mu gihe cy'igitero cy'umutima. Kurwara diyabete ntibibuza kwakira uyu muti w'agaciro kuko uramira ubuzima, nubwo bigushyira mu kaga ko kurwara ibitero by'umutima.

Ariko, niba ufite indwara ya retinopathy ya diyabete (kwangirika kw'amaso biturutse kuri diyabete), muganga wawe azakenera kwitonda cyane kuko iyi ndwara ishobora kongera ibyago byo kuva amaraso mu maso. Bazagereranya ibi byago n'akaga gahita k'igitero cy'umutima wawe.

Urwego rw'isukari mu maraso yawe ruzagenzurwa neza mu gihe cyo kuvurwa no nyuma yaho, kuko umunaniro w'igitero cy'umutima no kuryama mu bitaro bishobora kugira ingaruka ku miyoborere ya diyabete yawe.

Nigomba gukora iki niba nifashishije reteplase ku buryo butunganye?

Ntuzaba uri mu mwanya wo kwifashisha reteplase ku buryo butunganye kuko itangwa gusa n'abantu b'inzobere mu buvuzi mu bitaro bigenzurwa. Uyu muti uza mu bipimo byapimwe mbere, kandi abakozi bafite imyitozo bafata ibikorwa byose byo gutegura no gutanga.

Niba abakozi bo mu buvuzi batanze reteplase nyinshi mu buryo butunganye, bafite gahunda zashyizweho zo gukemura iki kibazo. Ikintu cy'ingenzi cyaba ari kongera ibyago byo kuva amaraso, bashobora gukurikiranira hafi no kuvura niba bibaye ngombwa.

Iki ni kimwe mu byiza byo guhabwa reteplase mu bitaro - uhita ubona ubufasha bw'ubuvuzi niba hari ingorane zivutse zituruka ku buvuzi.

Nkwiriye gukora iki niba nciwe urugero rwa reteplase?

Iki kibazo ntigisobanura neza kuri reteplase kuko ni ubuvuzi bwihutirwa butangwa rimwe gusa mu bitaro. Ntabwo uzajya ufata imiti iteganyijwe mu rugo ushobora gucikanwa.

Ubuvuzi busanzwe bwa reteplase bukubiyemo inshinge ebyiri zitangwa mu minota 30. Niba impamvu runaka inshinge ya kabiri yakererewe, ikipe yawe y'abaganga izagena uburyo bwiza bwo gukora bushingiye ku buryo wakiriye urugero rwa mbere n'ubuzima bwawe muri rusange.

Nyuma yo kurangiza ubuvuzi bwawe bwa reteplase, birashoboka ko uzatangira gukoresha indi miti yo kurinda umutima. Iyo miti izaba ifite gahunda zayo zo gutanga imiti umuganga wawe azagusobanurira.

Nshobora guhagarika ryari gufata reteplase?

Ubuvuzi bwa reteplase burangizwa mu gihe cy'isaha imwe uhereye igihe watangiriye. Iyi si imiti ukomeza gufata cyangwa ukeneye gufata icyemezo cyo guhagarika - ni ubufasha bwihutirwa bw'igihe gito.

Nyuma yo guhabwa reteplase, icyo uzibandaho ni ukoroherwa no kurinda umutima igihe kirekire. Umuganga wawe azandika indi miti ushobora gukenera gufata mu mezi cyangwa imyaka kugira ngo wirinde gutera umutima mu gihe kizaza.

Ingaruka za reteplase ubwayo zirashira mu masaha make, ariko inyungu zo kuba waragaruye imigezi y'amaraso mu mikaya y'umutima wawe zirashobora kumara ubuzima bwose niba ukurikiza inama z'umuganga wawe zo kwitabwaho buri gihe.

Nshobora gutwara imodoka nyuma yo guhabwa reteplase?

Oya, ntuzashobora gutwara imodoka mu minsi myinshi nyuma yo guhabwa reteplase. Uzasuzumwa mu bitaro nyuma yo kuvurwa, ndetse no nyuma yo kuva mu bitaro, uzakenera igihe cyo koroherwa n'umutima wawe.

Muganga wawe azakumenyesha igihe bizaba byemewe kongera gutwara imodoka, akenshi biterwa n'uko witeguye, ibikorwa byose wakoze, n'uko umutima wawe ukora neza. Icyemezo nk'iki gikunze gufatirwa mu gihe cyo gusuzumwa nyuma y'icyumweru kimwe cyangwa bibiri nyuma yo kuva mu bitaro.

Mugihe cyo koroherwa, uzakenera gutegura abagize umuryango wawe cyangwa inshuti kugirango bagufashe mu ngendo zo kujya kwa muganga no mu bindi bikorwa bya ngombwa.