Troponin t
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Troponin T. 10 febr úar 2010 Martina Vigdís Nardini. Troponin eru pr ótein Þrjár mismunandi einingar , I, C & T. Koma við sögu í samdrætti þverráka vöðva & hjartavöðva Troponin er ekki að finna í sléttum vöðvum. Vöðvasamdr áttur.

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Troponin T

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Troponin t

Troponin T

10 febrúar 2010

Martina VigdísNardini


Troponin t

  • Troponineruprótein

  • Þrjármismunandieiningar, I, C & T.

  • Komaviðsöguísamdrættiþverrákavöðva & hjartavöðva

  • Troponinerekkiaðfinnaísléttumvöðvum


V vasamdr ttur

Vöðvasamdráttur

  • Innanvöðvafrumaerus.k. myofibrillureðavöðvaþræðirseminnihalda myosin ogaktínþræði


Troponin t

  • Í hvíldliggurpróteiniðtropomyosinyfirákveðnumbindisetumáaktíni

  • Tropomyosinliggur fast íþessaristöðufyrirtilstuðlantroponincomplexins


Troponin t

Bindisetinsemtropomyosinhylurerufyrirákveðna myosin hausasembíðaspenntireftirþvíaðgetatengst


Troponin t

  • Meðtaugaboði um samdráttberst calcium tilumfrymisins. Calcium binstviðTnCogaflæsirþettafyrristöðucomplexinsogTnTlosnarfráaktínþræðinum

  • Tropomyosinafhjúparþannigbindisætinsemundireruáaktíninuogmyosinhausargetanútengstvið.


Troponin t

  • Viðtengingunabreytistlögunmyosinsinslíktog myosin hausinnreygihöfuðiðafturogaktínþráðurinndregsttil

  • Þ.e. samdrátturverðurívöðvanum


Cardiac troponin

Cardiac Troponin

  • Troponin T & I eruásértækuformiíhjartavöðvanum

  • HægteraðgreinaámilliþessTnTogTnIsemkemurfráhjartavöðvanumvsþaðsemkemurfráþverrákavöðvumlíkamans

  • Troponin C erekkinotaðíklíníktilaðgreiningarþarsemenginnmunureráþvímillihjartavöðvaogannarravöðva


Myocardial infarct

Myocardial infarct

  • Viðdauðahjartavöðvafrumalekurinnihaldþeirraútogverðurmælanlegtíblóði

  • MælingáTroponini T ergagnlegust 12 klsteftirupphafeinkenna, s.shjartverk.

    • Næmierþá 100%.

  • Greiningin myocardial infarct geturveriðútilokuðséTnT <0,1μg/l

  • TnTgeturhaldisthækkaðeftir MI í 2 vikur


Orsakir h kka s cardiac troponins

Orsakirhækkaðs cardiac troponins

  • Hjartabilun

  • Myocarditis

  • Kransæðalokun

  • Kransæðaspasmar (Prinzmetal angina)

  • Stroke og SAH

  • Trauma, d. skurðaðgerðoghverskyns cardiac contusion, pacemaker, biopsia, defibrillation

  • Tachycardia

  • Tachy- ogbradyarrithmiur

  • HCM

  • Vinstri ventricular hypertrophia

  • Aorta dissection ogaortulokusjúdkómar

  • Respiratory Syncytial virus


A rar orsakir

Aðrarorsakir

  • Öndunarbilun

  • Emboliapulmonalis

  • Sepsis

  • Hypovolemia

  • Nýrnabilun

  • Toxíns.s. snákaeitur, 5flurouracil, adriamycin

  • Amfetamínogkókaín (tachycardia)

  • Bruni >25% afyfirborði

  • Bólgusjúdkómars.s

    • Kawasaki

    • myocardit,

    • pericardit,

    • endocardit

  • Infiltrativirsjúkdómars.s.

    • amyloidosis

    • Sarcoidosis

    • Hemochromatosis

    • sclerodera


Au velt a muna og annig skilja flestar st ur tnt h kkunar

AuðveltaðmunaogþannigskiljaflestarástæðurTnThækkunar

  • Aukinsúrefnisþörf en minnkaðsúrefnisframboðveldurischemiuogtroponinlekurútúrdeyjandimyocytum

  • Meðauknugegndræpifrumuhimnakomastsmærritroponin fragment útí system blóðrásina, þanniggeturtroponinveriðhækkaðþóaðnecrosaímyocytumhafiekkiáttsérstað


Falskt j kv tt tnt e a tni

FalsktjákvættTnTeðaTnI

  • Heterophilic antibodies = mótefnisemkrossreagera, t.d. RF

    • Rannsóknsemsegiraðtilséákv antibody blocking agent semfylgir immune-assay mæli kit-inusem nota skalíslíkumvafatilfellum.

    • Virðistekkivirka!

  • Rheumatoid Factor

    • Rheumatoid factor blocking agent gefinn

  • Fibrin kekkjuneðahækkunáfibrini

    • Nota hepariniseruðglös

    • Spinnaniðurískilvindunnioftar en ella

  • Rannsakandinnóhæfureðaprófiðskemmt


Heimildir

Heimildir

  • Clinical biochemistry e. Alan Gawogfélaga

  • Uptodate.com/online/content/topic.do?topicKey=chd/1260&view=print ( Elevated cardiac roponin concentration in the absence of an acute coronary syndrome)

  • Cardiac troponin T levels and myocardial involvement in children with severe respiratory syncytial virus lung disease eM.Eisenhut et al. Júlí 2004

  • http://chestjournal.chestpubs.org/content/125/5/1877.full#sec-7.

  • http://www.thailabonline.com/diseasegeneral/troponin1.gif

  • http://media-2.web.britannica.com/eb-media/35/2835-004-889E54BA.gif

  • http://www.bio.miami.edu/~cmallery/150/neuro/sciam.muscle.1.jpg

  • http://www.journalclub.org/vol2/a58.html

  • http://webanatomy.net/anatomy/myosin.jpg

  • http://images.google.com/imgres?imgurl=http://www.ncbi.nlm.nih.gov/bookshelf/picrender.fcgi%3Fbook%3Dcooper%26part%3DA1790%26blobname%3Dch11f25.jpg&imgrefurl=http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi%3Fbook%3Dcooper%26part%3DA1790&usg=__ngHyTkmmRD7Ugzdi7M5VJqm-4M0=&h=457&w=458&sz=75&hl=en&start=42&um=1&itbs=1&tbnid=b11OFWFJlZLUkM:&tbnh=128&tbnw=128&prev=/images%3Fq%3Dtroponin%2Bt%26ndsp%3D18%26hl%3Den%26client%3Dsafari%26rls%3Den%26sa%3DN%26start%3D36%26um%3D1


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