Ukuhlolwa kwe-lactate dehydrogenase (LDH) ukuhlolwa kwegazi okubalulekile okuhlinzeka ngolwazi olubalulekile mayelana nempilo yezicubu zomzimba. Amazinga e-enzyme ye-LDH egazini asebenza njenge-biomarker ewusizo ekutholeni ukulimala kwezicubu ekulimaleni, izifo, ukutheleleka noma umdlavuza. 

Iyini i-LDH? 

I-Lactate dehydrogenase noma i-LDH iyi-enzyme etholakala kuzo zonke izitho ezinkulu. 

• Kunama-isoforms amahlanu ama-enzyme e-LDH, ngalinye linekhodi ngezakhi zofuzo ezihlukene futhi abonisa ukusatshalaliswa okuguquguqukayo kuzo zonke izicubu zomzimba. 
• Uma ukulimala kweseli noma ukufa kwenzeka ngenxa yomonakalo, izimo zezokwelapha noma ukuvuvukala, i-LDH ye-intracellular ikhishwa ku-extracellular fluid kanye nokujikeleza kwegazi. 

Kuyini ukuhlolwa kwe-LDH?

Ukuhlolwa kwe-lactate dehydrogenase, okuvame ukubizwa ngokuthi ukuhlolwa kwe-LDH noma ukuhlolwa kwe-LD, ukuhlolwa kwegazi okuxilonga okunquma izinga lama-enzyme e-lactate dehydrogenase ajikeleza ku-plasma yegazi. 

• Ikala umsebenzi ohlangene wama-isoenzymes e-LDH amahlanu ukuhlinzeka ngesilinganiso esingaqondile sokuwohloka kwezicubu ezinkingeni zezempilo ezihlobene nokufa kweseli. 
• Ngokuhlola ukukhuphuka kwe-LDH ye-extracellular ekhishwe kumaseli, ukuhlolwa kwegazi kwe-LDH kuthola ngempumelelo ukulimala kwamangqamuzana nokuwohloka kwezicubu ku-spectrum ebanzi yezifo zenhliziyo, isibindi, amathambo, ezithathelwanayo, ze-neoplastic kanye ne-hematologic. 

Inhloso yokuhlolwa kwe-Lactate Dehydrogenase

Ezinye izinjongo ezinkulu zokulinganisa amazinga e-LDH egazi ngokuhlolwa zihlanganisa:

1. Ukuthola nokuhlola ukulimala kwezicubu: 

• I-LDH ephakeme ngokuphawulekayo ibonisa ukulimala kwezicubu kusuka ku-myocardial infarction, acute ukwehluleka kwesibindi, ukusha okukhulu, ukopha, ukopha, ukuwohloka kwemisipha, i-sepsis noma ezinye izinkinga zezokwelapha ezibangela ukufa kwamangqamuzana. 
• Iqinisekisa ukuxilongwa, ihlola ukuqina futhi iqaphe izifundo zesifo. 

2. Ukuxilongwa kwezifo nokuvuvukala:

• Ukwanda kwe-LDH okwenzeka ngezifo ezibangelwa amagciwane (i-meningitis, i-encephalitis), izifo ezibangelwa amagciwane (i-mononucleosis, i-cytomegalovirus), nokuvuvukala kwamalunga, imithambo yegazi, noma izicubu zenhliziyo kubonisa ukulimala kwezicubu.  

3. Ukuhlolwa komdlavuza kanye nokuqapha ukwelashwa:

• Amaseli amaningi omdlavuza anenkulumo ephakeme ye-LDH. 
• Amazinga aphezulu e-LDH egazi ahlonza izinhlobo ezithile zomdlavuza (i-lymphoma, i-seminoma, umdlavuza wamasende). 
• Izilinganiso ze-serial ze-LDH ngesikhathi sokwelashwa ngamakhemikhali zihlola ukusabela kwesimila futhi zihlole ukuphindelela noma ukuqhubeka komdlavuza njenge-lymphoma, i-melanoma kanye nezimila zamangqamuzana amagciwane. 

Ku-odwa nini ukuhlolwa kwe-LDH?

Odokotela bayala ukuhlolwa kwegazi kwe-LDH lapho izimpawu zibonisa:

• Ubuhlungu besifuba, Isifo senhliziyo, Angina, Ukuhluleka kwenhliziyo
• I-Hepatitis, i-jaundice, i-cirrhosis
• Ukulimala kwezinso ezinzima, i-Glomerulonephritis 
• Inyumoniya, i-Pulmonary embolism  
• I-anemia, i-leukemia, i-lymphomas  
• I-muscular dystrophy, i-myositis  
• I-Meningitis, i-Encephalitis, ukulimala kobuchopho
• I-Sepsis, amathumba, i-mononucleosis  
• I-Lymphoma, i-Myeloma, i-Melanoma  

Kwenzekani Ngesikhathi Sokuhlolwa kwe-LDH? 

Ukuhlolwa kwe-LDH kuhilela ukudonsa igazi okulula, okubizwa nangokuthi i-venipuncture. Nazi izinyathelo:

1. I-tourniquet isongwe engalweni engenhla ukwenza imithambo engezansi igcwale igazi.
2. Kusetshenziswa inaliti engcolile, elahlwayo exhunywe kusirinji, cishe u-2-3 mL wegazi uyakhishwa futhi uqoqwe eshubhuni elimbozwe ngamahlule. 
3. Uma amasampula anele eseqoqiwe, ukusebenzisa i-swab kakotini nokugcina ingcindezi imizuzu emi-5 kuzomisa noma yikuphi ukopha okuqhubekayo noma ukugeleza endaweni yokubhoboza inaliti.

Ukusetshenziswa kokuhlolwa kwe-LDH ekunakekelweni kwezempilo

Ukulinganisa amazinga e-LDH egazi kunezinhlelo eziningi zomtholampilo ezihlanganisa:  

1. Ukuthola ukulimala kwenhliziyo ku-myocardial infarction:  

• I-LDH ikhuphuka emahoreni angu-12 ngemva kokuhlasela kwenhliziyo, ifinyelela umvuthwandaba ezinsukwini ezingu-2-3 futhi ibuyela esisekelweni ngezinsuku ezingu-5 kuya kwezingu-10. 
• Ukukhuphuka nokuwa kwayo kancane kancane kusiza ukuhlonza nokuqapha ukulimala kwenhliziyo.

2. Ukuhlola isifo sesibindi kanye ne-hepatitis: I-LDH ephakeme ngokuphawulekayo ibonisa i-hepatitis ethathelwanayo kanye ne-acute necrosis yesibindi etholwe yi i-biopsy yesibindi.  

3. Ukuhlonza izifo zokuphefumula: Lokhu kuhlola kusiza ukukhomba inyumoniya yegciwane lapho i-alveolar wall necrosis ikhipha i-LDH ekujikelezeni. 

4. Ukuxilongwa komdlavuza wobuchopho oyinhloko kanye ne-metastatic: Umdlavuza okhuphula ukunwebeka kwemithambo, okuvumela izicubu ze-LDH zingene egazini, nazo zingatholwa ngalokhu kuhlolwa. 

5. Ukubikezela izinkinga: Lokhu kuhlola kungaba usizo ekuvimbeleni izinkinga ezifana ne-sepsis, ukushaqeka, nokwehluleka kwezitho eziningi okubangelwa ukwanda kwe-LDH ezigulini ezigula kakhulu.

Inqubo Yokuhlola I-LDH

Inqubo yokuhlola i-LDH yesinyathelo ngesinyathelo ibandakanya:   

1. Iqoqo:

• Cishe u-2.5 mL wegazi eliphelele liqoqwa ngokuphuzwa kusetshenziswa inaliti eyinyumba. 
• Ngemuva kwe-centrifugation, i-plasma ehlukanisiwe ihlaziywa ngokushesha noma igcinwe ku-39 ° F-46 ° F (4 ° C-8 ° C).  

2. I-Assay Methodology:

• Amalabhorethri amaningi manje asebenzisa abahlaziyi bamakhemikhali omtholampilo abazenzakalelayo abanquma umsebenzi we-LDH ngezindlela zokuhlola ze-spectrophotometric. 
• I-LDH idala ukuncishiswa kwe-pyruvate kusetshenziswa i-NADH okugxilwa kwayo okunciphayo kukalwa njengokwehla kokumunca ku-339 nm okunikeza ukulinganisa okungaqondile komsebenzi we-LDH.

3. Ukuhunyushwa kobubanzi bereferensi: 

• Amanani e-LDH alinganisiwe atolikwa ngokuqhathanisa nenkathi yereferensi, ehlukanisa okuvamile nemiphumela engajwayelekile. 
• Ububanzi bereferensi yabadala buhluka phakathi kwabesilisa nabesifazane njengokuthi:
  • Abesilisa = 135-225 U/L
  • Abesifazane = 135-214 U/L

Kubuhlungu Kangakanani Ukuhlolwa kwe-LDH?

Njengoba kushiwo ngaphambili, ukuhlolwa kwe-LDH kumane kudinga u-2-3 mL wegazi eliqoqwe ngokuphuzwa kwemithambo emthanjeni osengalweni, okungase kuzwakale njengokuhlaba yenaliti esheshayo. 

Ukusebenzisa amasu okuphazamisa, imithi yokubamba, izindlela zokuphumula, kanye ne-nitrous oxide yezingane kungadambisa lesi siqephu esifushane sokuzwa okubukhali nakakhulu. Ngokuvamile, ukuhlolwa kukhululekile kakhulu, futhi iziguli eziningi azizwa ubuhlungu noma ukungakhululeki ngesikhathi noma ngemva kwenqubo.  

Ukulungiselela kanjani Ukuhlolwa kwe-LDH?

Ngokuvamile, akukho ukulungiswa okukhethekile okudingekayo ngaphambi kokuhlolwa kwe-LDH. Nakhu okufanele ukulindele futhi ukwenze ngaphambi kwenqubo: 

• Akukho ukuzila okudingekayo ngaphambi kokuthi ukudla akuthinti imiphumela. 
• Gwema umsebenzi okhathazayo wemisipha ngosuku olungaphambi kokuhlolwa, okungakhuphula amazinga e-LDH ngamanga okwesikhashana. 
• Yazisa udokotela wakho nganoma yimiphi imithi, izithasiselo noma imikhiqizo yemithi oyiphuzayo njengamanje.
• Yeka ukusebenzisa izithako ze-Vitamin C okungenani amahora angu-9-12 ngaphambi kokudonsa igazi, njengoba zingashintsha ukunemba kokuhlolwa. 
• Gqoka izingubo zangaphezulu ezinethezekile ezinemikhono egoqeka kalula ukuze ufinyelele indawo yendololwane yangaphakathi ngokushelela ukuze uthole amasampula. 

Usho ukuthini umphumela wokuhlolwa kwe-LDH? 

Imibiko yokuhlolwa kwe-LDH ihlinzeka ngesilinganiso sezinga le-enzyme yegazi lakho le-lactate dehydrogenase kanye nezikhawu ezijwayelekile zereferensi zokuqhathanisa ezimakwe njengokuthi “Okuvamile”, “Phansi” noma “Phezulu”.

1. Ileveli ye-LDH evamile: 

• Umphumela ojwayelekile osukela ku-140-280 amayunithi/L ubonisa ukuthi akukho kulimala okubalulekile kwezicubu noma ukufa kweseli. 
• Kuyisivivinyo esinegethivu noma esivamile. 

2. Izinga le-LDH eliphakanyisiwe:

• I-LDH ephakeme kunejwayelekile ikhombisa ukulimala kwamaselula okuvela ezifweni ezifana i-sepsis, umdlavuza wegazi noma ukuhlukumezeka kwemisipha, ukukhulula ama-enzyme e-intracellular egazini. 
• Amazinga angaphezu kuka-500 amayunithi/L aqinisekisa ukubhujiswa kwezicubu okungavamile okudinga ukuhlolwa okwengeziwe. 
• Iphakeme ngempela>amayunithi angu-1500/L iphakamisa i-necrosis enkulu yamaselula njengokushiswa okukhulu, i-hemolysis noma umdlavuza othuthukile.

3. Amazinga aphansi we-LDH: 

• Ukufundwa ngezansi kwereferensi akubalulekile ngokwezempilo. 
• Amaphutha okusebenza ngesikhathi sokuhlaziya noma ukuqoqwa kwesampula kungase kube nomthelela kumanani ehliswe ngokungeyikho. 
• Uma kungenjalo, amazinga e-LDH aphansi ngokungapheli angabonisa ukungondleki noma ukudakwa okuvamile. 

Isiphetho

Ukuhlolwa kwe-LDH noma i-lactate dehydrogenase kuthola ngempumelelo ukulimala kwezicubu okusiza ukuxilonga Isifo senhliziyo, isifo sesibindi, umdlavuza, izifo, ukuphazamiseka kwemisipha, nezinye izimo zezokwelapha. Ukulandelela amazinga e-LDH njalo kusebenza njenge-biomarker ebalulekile yokuqapha ukuqhubeka kwesifo kanye nokusabela kokwelashwa ezigulini ezinomdlavuza.

Imibuzo Evame Ukubuzwa

1. Liyini izinga le-LDH elivamile?

Izimpendulo: Izinga le-LDH elivamile lisukela ku-140 kuya ku-280 amayunithi/litha (U/L) egazini. Nokho, ububanzi bereferensi bungase buhluke kuwo wonke ama-laboratories. 

2. Kwenzekani uma ukuhlolwa kwe-LDH kukhombisa ukuthi unayo?  

Izimpendulo: Ukuhlolwa okuqinisekile kwe-LDH kusho ukuthi izinga lakho le-LDH lingaphezu kwebanga elivamile. I-LDH ephakeme ibonisa ukulimala kwezicubu noma amaseli okubangelwa izimo ezifana nesifo senhliziyo, isifo sesibindi, umdlavuza, ukutheleleka, ukulimala noma ukulimala kwemisipha. 

3. Kwenzekani uma ukuhlolwa kwe-LDH kungenayo?

Izimpendulo: Ukuhlolwa kwe-LDH okunegethivu kusho ukuthi izinga lakho le-LDH lingaphakathi kobubanzi obujwayelekile obungu-140-280 U/L, okubonisa ukuthi akukho kulimala okubalulekile kwezicubu. Iyasikhipha isimo sokugula okusolekayo. Akukho okunye ukuhlola okungase kudingeke ngaphandle uma izimpawu ziphikelela.

4. Yiziphi izinkinga zokuhlolwa kwe-LDH?

Izimpendulo: Ukuhlolwa kwe-LDH kuyinqubo ephephile. Izinkinga ezingavamile zihlanganisa ukopha kakhulu, ukuquleka, ukutheleleka noma ukujiyisa endaweni yokubhoboza inaliti. Ukulimaza kwesikhumba kungase kwenzeke.   

5. Kuthatha isikhathi esingakanani ukuhlolwa kwe-LDH? 

Izimpendulo: Ukuhlolwa kwe-LDH kwenziwa ngokushesha futhi kuthatha cishe imizuzu eyi-15 kuphela. Umhlinzeki wezempilo udonsa isampula yegazi, elithunyelwa elabhorethri ukuze lihlaziywe. Imibiko yokuhlolwa kwedijithali iyatholakala emahoreni ambalwa noma ngosuku olulandelayo.