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Troponin T

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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  1. Troponin T 10 febrúar 2010 Martina VigdísNardini

  2. Troponineruprótein • Þrjármismunandieiningar, I, C & T. • Komaviðsöguísamdrættiþverrákavöðva & hjartavöðva • Troponinerekkiaðfinnaísléttumvöðvum

  3. Vöðvasamdráttur • Innanvöðvafrumaerus.k. myofibrillureðavöðvaþræðirseminnihalda myosin ogaktínþræði

  4. Í hvíldliggurpróteiniðtropomyosinyfirákveðnumbindisetumáaktíni • Tropomyosinliggur fast íþessaristöðufyrirtilstuðlantroponincomplexins

  5. Bindisetinsemtropomyosinhylurerufyrirákveðna myosin hausasembíðaspenntireftirþvíaðgetatengst

  6. Meðtaugaboði um samdráttberst calcium tilumfrymisins. Calcium binstviðTnCogaflæsirþettafyrristöðucomplexinsogTnTlosnarfráaktínþræðinum • Tropomyosinafhjúparþannigbindisætinsemundireruáaktíninuogmyosinhausargetanútengstvið.

  7. Viðtengingunabreytistlögunmyosinsinslíktog myosin hausinnreygihöfuðiðafturogaktínþráðurinndregsttil • Þ.e. samdrátturverðurívöðvanum

  8. Cardiac Troponin • Troponin T & I eruásértækuformiíhjartavöðvanum • HægteraðgreinaámilliþessTnTogTnIsemkemurfráhjartavöðvanumvsþaðsemkemurfráþverrákavöðvumlíkamans • Troponin C erekkinotaðíklíníktilaðgreiningarþarsemenginnmunureráþvímillihjartavöðvaogannarravöðva

  9. Myocardial infarct • Viðdauðahjartavöðvafrumalekurinnihaldþeirraútogverðurmælanlegtíblóði • MælingáTroponini T ergagnlegust 12 klsteftirupphafeinkenna, s.shjartverk. • Næmierþá 100%. • Greiningin myocardial infarct geturveriðútilokuðséTnT <0,1μg/l • TnTgeturhaldisthækkaðeftir MI í 2 vikur

  10. 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

  11. 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

  12. AuðveltaðmunaogþannigskiljaflestarástæðurTnThækkunar • Aukinsúrefnisþörf en minnkaðsúrefnisframboðveldurischemiuogtroponinlekurútúrdeyjandimyocytum • Meðauknugegndræpifrumuhimnakomastsmærritroponin fragment útí system blóðrásina, þanniggeturtroponinveriðhækkaðþóaðnecrosaímyocytumhafiekkiáttsérstað

  13. 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

  14. 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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