I Nowemapa 2021, ua hoʻopuka pū ka American Heart Association (AHA) a me ka American College of Cardiology (ACC) i nā alakaʻi āpau no ka loiloi a me ka ʻike ʻana i ka ʻeha o ka umauma.Hōʻike nā alakaʻi i nā loiloi pilikia maʻamau, nā ala lapaʻau, a me nā mea hana diagnostic no ka ʻeha o ka umauma, e hāʻawi ana i nā ʻōlelo aʻoaʻo a me nā algorithm no nā kauka e loiloi a ʻike i ka ʻeha o ka umauma i nā maʻi makua.
Hōʻike ke alakaʻi i nā leka koʻikoʻi he 10 e pili ana i nā pilikia a me nā ʻōlelo aʻoaʻo no ka loiloi diagnostic o kēia lā i ka ʻeha o ka umauma, i hōʻuluʻulu ʻia i loko o nā leka he ʻumi "ʻeha ʻeha", penei:
ʻO ka cardiac troponin kahi hōʻailona kikoʻī o ka hōʻeha o ka myocardial cell a ʻo ia ka biomarker i makemake ʻia no ka maʻi, ka stratification pilikia, ka mālama ʻana a me ka wānana o nā maʻi maʻi coronary acute.ʻO nā alakaʻi i hui pū ʻia me ka hoʻohana ʻana i ka troponin kiʻekiʻe, no nā poʻe maʻi me ka ʻeha o ka umauma a me ka ACS i manaʻo ʻia (koe ʻole ʻo STEMI), hāʻawi i nā ʻōlelo aʻe i ka wā e hoʻonohonoho ai i nā ala hoʻoholo lāʻau lapaʻau:
1. I nā poʻe maʻi e hōʻike ana me ka ʻeha o ka umauma a me ka ACS i manaʻo ʻia, nā ala hoʻoholo hoʻoholo (CDPs) pono e hoʻokaʻawale i nā maʻi i nā papa haʻahaʻa haʻahaʻa, waena, a kiʻekiʻe e hoʻomaʻamaʻa i ka hoʻokaʻawale ʻana a me ka loiloi diagnostic ma hope.
2. I ka loiloi ʻana i nā maʻi e hōʻike ana me ka ʻeha o ka umauma a me ka ACS i manaʻo ʻia nona nā troponins serial i hōʻike ʻia e kāpae i ka hōʻeha myocardial, ʻōlelo ʻia nā manawa manawa ma hope o ka hōʻiliʻili ʻana o ka troponin mua (manawa zero) no nā ana hou ʻana he: 1 a 3 mau hola no ke kiʻekiʻe. -ʻike troponin a me 3 a 6 mau hola no nā hoʻokolohua troponin maʻamau.
3. No ka hoʻomaʻamaʻa ʻana i ka ʻike a me ka hoʻokaʻawale ʻana o ka ʻeha myocardial i nā poʻe maʻi e hōʻike ana me ka ʻeha o ka umauma a me ka ACS i manaʻo ʻia, pono nā hui e hoʻokō i kahi CDP e loaʻa ana kahi protocol no ka troponin sampling e pili ana i kā lākou hōʻike ponoʻī.
4. I nā poʻe maʻi me ka ʻeha o ka umauma a me ka ACS i manaʻo ʻia, pono e noʻonoʻo ʻia ka hoʻāʻo mua inā loaʻa a hoʻokomo ʻia i loko o nā CDP.
5. No nā poʻe maʻi me ka ʻeha o ka umauma nui, kahi ECG maʻamau, a me nā hōʻailona manaʻo o ACS i hoʻomaka ma ka liʻiliʻi o 3 mau hola ma mua o ka hōʻea ʻana o ED, kūpono kahi ʻike hs-cTn ma lalo o ka palena o ka ʻike ma ke ana mua (manawa ʻole) kūpono. e wehe i ka ʻeha myocardial.
Hoʻohana pinepine ʻia ka cTnI a me ka cTnT i ka hōʻailona qualitative o ka myocardial infarction, hoʻohana pinepine ʻia ʻo MYO i ka hoʻomaka mua ʻana o ka myocardial infarction, a hoʻohana pinepine ʻia ʻo CK-MB i ka hōʻailona o ka myocardial infarction ma hope o ka myocardial infarction.ʻO cTnI i kēia manawa ka hōʻailona koʻikoʻi a me ka kikoʻī o ka hōʻeha myocardial, a ua lilo i kumu diagnostic nui loa no ka hōʻeha o ka myocardial tissue (e like me ka myocardial infarction). he kumu hōʻoia kōkua ʻoi aku ka hilinaʻi no nā maʻi maʻi maʻi a me ka ʻeha o ka umauma, a me ke kōkua ikaika ʻana i ke kūkulu ʻana i nā kikowaena ʻeha umauma.
Ka manawa hoʻouna: Apr-02-2022