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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

Troponin T

10 febrúar 2010

Martina VigdísNardini

slide2
Troponineruprótein
  • Þrjármismunandieiningar, I, C & T.
  • Komaviðsöguísamdrættiþverrákavöðva & hjartavöðva
  • Troponinerekkiaðfinnaísléttumvöðvum
v vasamdr ttur
Vöðvasamdráttur
  • Innanvöðvafrumaerus.k. myofibrillureðavöðvaþræðirseminnihalda myosin ogaktínþræði
slide5
Í hvíldliggurpróteiniðtropomyosinyfirákveðnumbindisetumáaktíni
  • Tropomyosinliggur fast íþessaristöðufyrirtilstuðlantroponincomplexins
slide6
Bindisetinsemtropomyosinhylurerufyrirákveðna myosin hausasembíðaspenntireftirþvíaðgetatengst
slide8
Meðtaugaboði um samdráttberst calcium tilumfrymisins. Calcium binstviðTnCogaflæsirþettafyrristöðucomplexinsogTnTlosnarfráaktínþræðinum
  • Tropomyosinafhjúparþannigbindisætinsemundireruáaktíninuogmyosinhausargetanútengstvið.
slide10
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