Creatinine clearance

Nyob rau hauv niaj hnub tshuaj, lub sij hawm "clearance", uas nruab nrab yog ib tug ntau qhia ceev purifying tej lom kua. Siv qhov ntsuas no muaj yig broaden peb nkag siab txog cov tshuaj thiab pharmacodynamics ntawm no thiab lwm yam tshuaj.

Yog li, piv txwv li, creatinine clearance yog txiav txim siv diagnostic kev ntsuam xyuas Reberga-Toreeva. Nws yog ib nqi sau cia hais tias nyob rau hauv cov ntaub ntawv no nws yog ua tau los mus txiav txim lub filtration rate raws li lub endogenously tsim tshuaj thiab nkag los ntawm sab nraum (rau cov tshuaj thiab lwm yam txhais tau tias). Kwv yees yog ua los ntawm kev xam xyuas cov kev siv filtering (glomeruli) ntawm cov ntshav tso tawm tus nqi los ntawm ib tug kev tshuaj. Lub account yog nyob rau hauv ib tug taag lub sij hawm (feem ntau - hnub).

Hais txog creatinine, yuav tsum xyuam xim rau lub fact tias tshem nws tawm ntawm lub cev mas yog vim lub pom kev ua ntawm ob lub raum. Raws li nyob rau hauv no, xws li ib tug creatinine clearance tus nqi yuav tseem ceeb nyob rau hauv qhov kev luj xyuas ntawm lub raum glomerular filtration tau hauj lwm. Nws yuav tsum tau muab sau tseg hais tias qhov no daim duab yog yus tsis tau tsuas yog tej peev xwm ntawm lub taub lim system, tab sis kuj muaj ib co lwm yam cuam tshuam ntawm tib neeg nruab nrog cev thiab tshuab. Hloov downward, creatinine clearance thiab tej zaum yuav qhia ntawm tsis txaus ntshav txaus rau lub ob lub raum (atherosclerosis, thiab nrog ib tug ntse mob thiab kev loj hlob - thromboembolism).

Tus nqi ntawm poob ntawm lub raum kev ua no tshwm sim tom qab plaub caug xyoo. Txo glomerular filtration rate of 1% tauj ib xyoos. Tom qab caum xyoo, lub theem ntawm kev ua si yog luv me ntsis sai (cov kev hloov no muaj feem kev cob cog rua nrog cov laus uas tau tus kab mob). Txawm li cas los, nws yuav tsum tau muab sau tseg tias txhua yam ces xws li ib tug transformation yog tsis cai rau cov yog vim li cas tias cov neeg laus yog slowing down tag nrho metabolic dab, nrog rau cov synthesis ntawm endogenous creatinine.

Thaum npaj rau cov qauv Rehberg yog tsim nyog los tshem tawm cov kev siv ntawm tej yam tshuaj uas muaj peev xwm muaj kev cuam tshuam hauv chav kawm ntawm txoj kev tshawb no (tshuaj "Cortisol" "Furosemide", "Corticotropin", "Methylprednisolone," "Thyroxine" thiab lwm tus neeg).

Yuav kom muab tso ib tug qauv ntawm cov zis piv txwv yog ua, raws li zoo raws li cov ntshav mus kuaj rau hauv nruab nrab theem ntawm ntshav creatinine.

Ntawm cov indications rau txoj kev tshawb no lub hom phiaj: endocrine pathology, kev soj ntsuam ntawm lub raum haumxeeb ua si, raws li zoo raws li qhov kev soj ntsuam ntawm tej yam ntawm lub cev ua si.

Nyob rau qib uas yuav txo tau nyob rau hauv clearance txhais no los yog lwm ua txhaum.

• 30 ml / min / m2 thiab ib tug 1.7 - txo nyob rau hauv lub raum muaj nuj nqi nyob rau hauv ntsis;
• 30-15 ml / min / m2 1.7 - xub ntiag ntawm lub raum tsis ua hauj lwm (los yog compensated subcompensated degree);
• <15 ml / min / m2 1.7 - raum tsis ua hauj lwm decompensation theem.

Nws yog ib qho tseem ceeb kom to taub tias tej peev xwm ntawm tus pom system txiav txim raum clearance ntawm creatinine, tus nqi ntawm uas thaum lub sij hawm qauv Reberga qhia ib txwm ob lub raum.

Txawm li cas los, ib co kab mob tsis ua rau kev hloov ntawm qhov ntsuas (e.g., mob pyelonephritis).

creatinine theem nyob rau hauv cov ntshav nyob rau cov kev ua ntawm nws endogenous synthesis thiab rau nws cov nqi ntawm urinary feem. Nws yog ib qho tseem ceeb kom nkag siab txog hais tias qhov no daim duab nyob tsis tau tsuas yog nyob rau hauv cov kev ua ntawm lub filtering system, tab sis kuj cov kev ceev thiab ntim ntawm reabsorption ntawm tshuaj nyob rau hauv lub tsim ntawm thawj zis.

Yog li, tam sim no Reberga qauv (kev txiav txim creatinine clearance) txaus mus nrhiav thoob plaws siv nyob rau hauv diagnostic tshuaj. Ib tug ncaj qha kev sib raug zoo ntawm cov clearance thiab raum muaj nuj nqi muaj siab diagnostic tseem ceeb txoj kev.