Ihe jikọrọ coagulation COVID-19


Onye edemede: Onye nọchiri   

Ihe coagulation metụtara COVID-19 gụnyere D-dimer, ngwaahịa mmebi fibrin (FDP), oge prothrombin (PT), ọnụọgụ platelet na ule ọrụ, na fibrinogen (FIB).

(1) D-dimer
Dị ka ngwaahịa na-emebi emebi nke fibrin jikọtara ọnụ, D-dimer bụ ihe ngosi a na-ahụkarị na-egosipụta ịgbalite coagulation na hyperfibrinolysis nke abụọ.N'ime ndị ọrịa nwere COVID-19, ọkwa D-dimer dị elu bụ akara dị mkpa maka ọrịa coagulation nwere ike ime.Ọkwa D-dimer nwekwara njikọ chiri anya na oke ọrịa, na ndị ọrịa nwere nnukwu D-dimer dị elu na nnabata nwere amụma ka njọ.Ntuziaka sitere na International Society of Thrombosis na Hemostasis (ISTH) na-atụ aro na D-dimer dị elu (karịa ugboro 3 ma ọ bụ 4 karịa oke nkịtị) nwere ike bụrụ ihe ngosi maka ụlọ ọgwụ na ndị ọrịa COVID-19, mgbe ewepụrụ contraindications. Ekwesịrị inye ndị ọrịa dị otú ahụ ọgwụ mgbochi ọrịa na usoro prophylactic nke heparin dị obere obere ihe.Mgbe D-dimer na-ebuli elu nke nta nke nta ma enwere nnukwu enyo maka thrombosis venous ma ọ bụ microvascular embolism, a ga-atụle ọgwụ mgbochi ọrịa na usoro ọgwụgwọ heparin.

Agbanyeghị na D-dimer dị elu nwekwara ike na-atụ aro hyperfibrinolysis, ọbara ọgbụgba na ndị ọrịa COVID-19 nwere D-dimer dị elu bụ ihe a na-ahụkarị ma ọ bụrụ na ọ na-aga n'ihu na usoro hypocoagulable DIC, na-atụ aro na COVID-19 sistemu fibrinolytic nke -19 ka na-egbochi ya.Ihe akara ọzọ metụtara fibrin, ya bụ, mgbanwe mgbanwe nke ọkwa FDP na ọkwa D-dimer bụ otu ihe ahụ.

 

(2) PT
PT ogologo oge bụkwa ihe na-egosi ọrịa coagulation nwere ike ime na ndị ọrịa COVID-19 ma egosila na ọ jikọtara ya na amụma adịghị mma.N'oge mmalite nke ọrịa coagulation na COVID-19, ndị ọrịa nwere PT na-abụkarị ndị nkịtị ma ọ bụ dị nro, na PT ogologo oge n'ime oge hypercoagulable na-egosipụtakarị ịgbalite na oriri nke ihe coagulation exogenous, yana mbelata nke fibrin polymerization. ya mere ọ bụkwa ihe mgbochi mgbochi.otu n'ime ihe ngosi.Agbanyeghị, mgbe PT na-agbatịkwu ogologo oge nke ukwuu, ọkachasị mgbe onye ọrịa nwere ngosipụta ọbara ọgbụgba, ọ na-egosi na ọrịa coagulation abanyela na ọkwa coagulation dị ala, ma ọ bụ onye ọrịa ahụ gbagwojuru anya site na ụkọ imeju, ụkọ vitamin K, ọgwụ mgbochi mgbochi, wdg. Ekwesịrị ịtụle mmịnye plasma.Ọgwụgwọ ọzọ.Ihe ọzọ na-enyocha coagulation, oge thromboplastin na-arụ ọrụ (APTT), na-edobekarị na ọkwa nkịtị n'oge usoro hypercoagulable nke ọrịa coagulation, nke enwere ike ịsị na mmụba nke ihe VIII na steeti mkpasu iwe.

 

(3) Nlele ọnụọgụ platelet na ọrụ
Ọ bụ ezie na ịgbalite coagulation nwere ike iduga mbelata oriri platelet, mbelata ọnụ ọgụgụ platelet bụ ihe a na-ahụkarị na ndị ọrịa COVID-19, nke nwere ike jikọta na mmụba nke thrombopoietin, IL-6, cytokines nke na-akwalite mmeghachi omume platelet na steeti mkpali Ya mere, uru zuru oke nke Ọnụọgụ platelet abụghị ihe na-emetụ n'ahụ na-egosipụta ọrịa coagulation na COVID-19, yana ọ nwere ike ịba uru karịa itinye uche na mgbanwe ya.Na mgbakwunye, ọnụ ọgụgụ platelet mbelata na-ejikọta nke ọma na prognosis na-adịghị mma ma bụrụkwa otu n'ime ihe na-egosi mgbochi mgbochi ọrịa.Agbanyeghị, mgbe ọnụ ọgụgụ ahụ belatara nke ukwuu (dịka ọmụmaatụ, <50×109/L), ma onye ọrịa nwere ngosipụta ọbara ọgbụgba, a ga-atụle mmịnye ihe mejupụtara platelet.

Dị ka nsonaazụ ọmụmụ ndị gara aga na ndị ọrịa nwere sepsis, ule ọrụ platelet in vitro na ndị ọrịa COVID-19 nwere ọrịa coagulation na-arụpụtakarị nsonaazụ dị ala, mana platelet n'ezie na ndị ọrịa na-arụ ọrụ mgbe niile, nke nwere ike ịsị na ọrụ dị ala.A na-ebu ụzọ jiri platelet dị elu mee ihe ma rie ya site na usoro coagulation, na ọrụ mmekọrịta nke platelet na mgbasa ozi anakọtara dị ntakịrị.

 

(4) FIB
Dị ka nnukwu protein mmeghachi omume mmeghachi omume nke akụkụ ahụ, ndị ọrịa nwere COVID-19 na-enwekarị ọkwa FIB dị elu n'oge nnukwu ọrịa, nke na-abụghị nanị na oke mbufụt, ma ọ bụ ihe dị elu FIB n'onwe ya bụkwa ihe ize ndụ maka thrombosis, ya mere. enwere ike iji ya dị ka COVID-19 Otu n'ime ihe na-egosi anticoagulation na ndị ọrịa.Otú ọ dị, mgbe onye ọrịa ahụ na-enwe ọganihu na-aga n'ihu na FIB, ọ nwere ike igosi na ọrịa coagulation na-aga n'ihu na ọkwa hypocoagulable, ma ọ bụ onye ọrịa ahụ nwere nnukwu ụkọ ịba ọcha n'anya, nke na-emekarị na njedebe nke ọrịa ahụ, mgbe FIB <1.5 g. / L na-esonyere ya na ọbara ọgbụgba, FIB infusion kwesịrị ịtụle.