Impilo yenhliziyo isiyinkinga namuhla, nakubantu abasha. Amacala akhulayo we ukuboshwa komzimba kwenze kubaluleke kakhulu ukuthi wonke umuntu ahlole ezabo impilo inhliziyo futhi uhlole izinkinga zenhliziyo ezingaba khona. Ukuhlolwa kwe-CPK kuwukuhlolwa kwelabhorethri okubalulekile okusiza odokotela ukuthi bahlole ukuthi kukhona yini umonakalo emisipha yenhliziyo noma imisipha yamathambo ezigulini ezinezimpawu.

Lesi sihloko sifingqa imininingwane ebalulekile okufanele uyazi mayelana nokuhlolwa kwe-Creatine Phosphokinase.

Kuyini Ukuhlolwa kwe-CPK?

Ukuhlolwa kwegazi kwe-CPK kubhekisela ekuhlolweni kwegazi okulula okulinganisa izinga lama-enzyme e-creatine phosphokinase. Lapho inhliziyo yakho noma izicubu zemisipha zilimala, i-CPK iphuma kumaseli iye egazini. Lokhu kungenzeka ngezizathu ezihlukahlukene, kuhlanganise:

• Ukucindezeleka
• Ukulimala
• Ukuntuleka Kwe-Oxygen 
• Isifo Esiyisisekelo

Besebenzisa i-CPK Test, odokotela banganquma ukuthi ungakanani umonakalo owenziwe ezithweni zomzimba nemisipha.

Inhloso yokuhlolwa kwe-CPK

Ukuhlolwa kwegazi kwe-CPK kufeza izinjongo ezimbalwa ezibalulekile zokuxilonga:

• Ivumela ukutholwa kusenesikhathi kokuhlaselwa yinhliziyo ngokubonisa ukulimala kwezicubu zenhliziyo ngamaleveli e-CPK aphakeme. Kuyasiza ukuhlukanisa ukuhlaselwa yinhliziyo nezinye izimbangela ubuhlungu besifuba.
• Isiza ukuhlonza izifo zemisipha njenge-muscular dystrophy, dermatomyositis kanye ne-polymyositis, ebangela ukuvuvuka kwemisipha kanye nokulimala.
• Ivumela ukuhlolwa kwembangela yezimpawu ezingachazwanga njengobuhlungu obungapheli bemisipha kanye nobuthakathaka ngokusekelwe ekutheni ukulimala kwemisipha kutholakele yini.
• Inika amandla ukuqapha inqubekelaphambili yokuphulukiswa nokusebenza ngempumelelo kokwelashwa ngemva kokuhlinzwa, ukulimala noma izimo ezithinta inhliziyo nemisipha yamathambo ngokulandelela izinguquko kumazinga e-CPK.

Kudingeka Nini Ukuhlolwa Kwe-CPK?

Ezinye izinkomba ezijwayelekile zokwenza ukuhlolwa kwegazi kwe-CPK isoenzymes zifaka phakathi

• Uma isiguli sinezimpawu zokuhlaselwa yinhliziyo njengobuhlungu obukhulu besifuba kanye nokujuluka, isicanucanu, njll. Ivumela ukuxilongwa okusheshayo kwe-myocardial infarction.
• Ukuphenya ngembangela yezimpawu ezingacacisiwe njengobuhlungu bemisipha obungachazeki kanye nobuthakathaka.
• Uma umuntu enomlando womndeni wezinkinga zemisipha ezitholwa njengefa njenge-muscular dystrophy, ukuhlolwa kweleveli ye-CPK eyisisekelo kuvumela ukutholwa kusenesikhathi esikhathini esizayo.
• Ukwazi amazinga e-CPK ayisisekelo uma isiguli sinqunyelwe ukwelashwa ngezidakamizwa ezifana nama-statins nama-steroids aziwa ngokudala ukulimala kwemisipha kwabanye abantu.
• Ukuqapha ukuphulukiswa kanye nokusabela kokwelashwa kwezimo zenhliziyo ezihlonziwe noma izifo zemisipha ngokuqhathanisa amazinga e-CPK ngaphambi nangemuva kwemithi.

Ukusetshenziswa kokuhlolwa kwe-CPK

Okunye ukusetshenziswa kokuhlolwa kwegazi kwe-CPK kufaka phakathi:

• Ivumela ukuxilonga ngokushesha kwe-myocardial infarction ngokuthola ukulimala kwemisipha yenhliziyo ngama-enzymes enhliziyo e-CPK aphakeme.
• Kuyasiza ukuhlukanisa i-angina nezinye izimbangela zobuhlungu besifuba obukhulu kusukela ekuhlaselweni kwenhliziyo kwangempela.
• Inika amandla ukuhlonzwa kokuphazamiseka kwemisipha okuzuzwe njengefa nokutholiwe okufana ne-muscular dystrophy ne-dermatomyositis, okubangela ukuvuvukala kwemisipha ngokubonisa ukulimala kohlaka lwamathambo.
• Misa amazinga e-CPK ayisisekelo ngaphambi kokuqala ukwelashwa ngezidakamizwa ze-cholesterol nama-anabolic steroids angakwazi ukulimaza imisipha.
• Gada ukusebenza kokwelashwa kwezifo ezinciphisa imisipha.
• Hlola ukululama ngemva kokuhlinzwa kwenhliziyo ye-bypass, amanxeba okugwazwa, nokulimala okuchoboza okubangela ukulimala kwemisipha.

Uzilungiselela kanjani Ukuhlolwa kwe-CPK

Ukulungiselela ukuhlolwa kwegazi kwe-CPK, iziguli kufanele:

• Dalula imithi yamanje njengoba imithi ethile ithinta imiphumela.
• Gwema ukuzivocavoca umzimba kakhulu ngosuku olungaphambi kokuhlolwa njengoba kungase kubangele ukuphakama kwe-CPK yesikhashana.
• Gwema ukuphuza utshwala amahora angama-24 ngaphambi kokuhlolwa njengoba kuthinta amazinga e-CPK okwesikhashana.
• Bika noma yiziphi izigameko zakamuva ezingase zidale ukulimala kwemisipha, njengokuhlukumezeka kwezingozi noma imijovo ye-IM engakhuphula amazinga e-CPK.
• Akukho ukuqokwa kwangaphambili, ukuzila ukudla noma izinguquko ekudleni okudingekayo ekuhlaziyweni kwegazi le-CPK.

Kwenzekani Ngesikhathi Sokuhlolwa Kwe-CPK?

Ukuhlolwa kwe-CPK ukuhlolwa kwegazi okujwayelekile okudinga ukulungiswa okuncane kakhulu futhi kuqedwa ngokushesha:

• Umhlinzeki wezempilo uzoqale ahlanze indawo ngekhambi elibulala amagciwane, imvamisa ukugoba kwendololwane noma ngemuva kwesundu, lapho imithambo itholakala kalula khona. Lokhu kunciphisa ingozi yokutheleleka.
• Ibhande eliqinile lingase liboshwe engalweni engenhla njenge-tourniquet, okwenza imithambo iqhume ngegazi futhi ibonakale kakhudlwana. Lokhu kusiza ekufinyeleleni imithambo ngokushesha.
• Kusetshenziswa inaliti eyinyumba, cishe u-2-5 mL wegazi uyadonswa bese uqoqwa ebhodleleni eliyisampula. Ukuzwa okuncane okuhlabayo kungase kuzwakale ngesikhathi sokufakwa inaliti.
• Ngemva kokuba igazi elanele seliqoqwe, inaliti ikhishwa ngokushesha, futhi indawo yokubhoboza icindezelwe ukuze kunqandwe ukopha futhi imbozwe ngebhandishi.
• Isampula yegazi lithunyelwa elabhorethri ukuze kuhlolwe amazinga e-CPK.
• Elabhorethri yokuxilonga, okuhlukile kwe-CPK i-CPK1, i-CPK2 ne-CPK3 kuyahlukaniswa futhi kukalwe kusetshenziswa indlela ebizwa ngokuthi i-electrophoresis ukuze kukhiqizwe imibiko yokuhlola.

Isho Ukuthini Imiphumela Yokuhlolwa Kwe-CPK?

• Ibanga elijwayelekile le-CPK:
  • I-CPK Normal Value iphakathi kwamayunithi ayi-10 kuya kwayi-120 ilitha ngalinye legazi.
• Amazinga aphansi e-CPK:
  • Amazinga angaphansi kuka-10 U/L abonisa amazinga e-CPK aphansi ngokungavamile.
  • Kubonakala ekuntulekeni komsoco kanye nokuphazamiseka kwesibindi.
  • Ingase iphakamise imisipha yenhliziyo ebuthakathaka noma imisipha yamathambo ngenxa yokulimala okuthuthukile.
• Amazinga aphezulu e-CPK:
  • Amazinga angaphezu kuka-200 U/L athathwa njengamazinga aphezulu egazi le-CPK.
  • Izimpawu zokulimala kwengqondo, inhliziyo, amaphaphu noma izicubu zemisipha yamathambo.
  • Siza ukucacisa izitho ezithintekayo ngokusekelwe ekutheni iyiphi i-CPK subtype (CPK1, CPK2 noma CPK3) ephakanyiswe ngokukhethekile.

Isho Ukuthini Imiphumela Engavamile

• Amazinga aphezulu e-CPK1 angase abonise - unhlangothi, ukulimala kobuchopho, ukopha, i-pulmonary infarction
• Amazinga aphezulu e-CPK2 angase abonise - i-myocardial infarction, i-myocarditis noma isifo senhliziyo
• Ukwenyuka kwamazinga e-CPK3 kungasho - i-muscular dystrophy, ukuhlukumezeka kwezingozi, izithombe, ukusha, njll.

Isiphetho

Ukuhlolwa kwe-CPK kusebenza njengethuluzi elibalulekile lokuxilonga emisebenzini yesimanje yezokwelapha ukuze kutholwe ngokunephutha ukulimala kwangaphambi kwesikhathi kwezicubu, okusiza ukuqondisa ukwelashwa ngokushesha ukuze kuncishiswe ukulimala okungapheli ezimeni ezizwelayo ngesikhathi njenge-myocardial infarction. Ihlinzeka ngobufakazi obuqinisekisayo bezifo ezithinta imisipha futhi iwukuhlola okungabizi futhi okungenabungozi okusiza ekuthathweni kwezinqumo zomtholampilo ezindabeni ze-musculoskeletal.

Imibuzo Evame Ukubuzwa

1. Liyini izinga elijwayelekile lokuhlolwa kwe-CPK noma i-CK?

Ibanga elijwayelekile lereferensi ye-CPK liphakathi kuka-10-120 U/L egazini. Amanani kulobu bubanzi athathwa njengejwayelekile.

2. Kwenzekani uma ukuhlolwa kwe-CPK kungathiwa unayo?

Ukuhlola ukuthi une-positive kusho ukuthi amazinga e-CPK egazini angaphezulu komkhawulo ongenhla omisiwe ongu-120 U/L. Imiphumela ephakeme ngokungavamile isho ukulimala noma ukulimala ebuchosheni, enhliziyweni, emaphashini noma ezicutshini zemisipha yamathambo.

3. Kwenzekani uma ukuhlolwa kwe-CPK kungathi awunayo?

Umphumela wokuhlola we-CPK omubi noma ovamile ubonisa amazinga angaphakathi kwebanga elilindelekile le-10-120 U/L. Ikhipha ukulimala okukhulu, okukhulu enhliziyweni noma emcupheni wamathambo lapho izimpawu zingase zingacaci, njengokuqaqamba komzimba okungachazeki. 

4. Yimaphi amapharamitha akalwa ekuhlolweni kwe-CPK?

Ukuhlaziywa kwegazi kwe-CPK kulinganisa ngokuqondile amaleveli ezinhlobonhlobo ze-CPK i-CPK1, i-CPK2 ne-CPK3 kusetshenziswa indlela yelebhu ebizwa ngokuthi i-electrophoresis. I-CPK1 subtype igcwele ebuchosheni nasemaphashini nase-CPK2 emisipheni yenhliziyo, kuyilapho i-CPK3 igcwele imisipha yohlaka lwamathambo kanye ne-plasma yegazi.

5. Kuthatha isikhathi esingakanani ukwenza ukuhlolwa kwe-CPK?

Inqubo yokuqoqa isampula yegazi langempela ithatha imizuzu embalwa kuphela. Ukuthutha okuyisampula, ukuhlaziya ilabhorethri kusetshenziswa i-electrophoresis nokukhiqizwa kombiko ngokuchazwa kwemiphumela kungase kuthathe noma kuphi phakathi kwamahora ambalwa kuya osukwini olungu-1 kuya kwezingu-2, kuye ngendawo yokuxilonga.

6. Ingabe kukhona ubungozi ekuhlolweni?

Ukuhlolwa kwe-CPK kudala ubungozi obungathi sína njengoba kuhilela ukudonsa kwegazi okujwayelekile kuphela. Noma kunjalo, ukungaphatheki kahle okuncane, imihuzuko noma ukutheleleka okungajwayelekile okutholakala ezindaweni zokubhoboza noma isiyezi sezinaliti. Ayihlaseli futhi ibhekwa njengephephile kakhulu, ayinakho ukulungiswa noma imikhawulo edingekayo.