Kuganiza: Pansi pa zochitika zakuthupi

1. N’cifukwa ciani magazi amene amayenda m’mitsempha saunjikana?

2. Chifukwa chiyani chotengera chamagazi chomwe chawonongeka pambuyo povulala chimasiya kutuluka?

Ndi mafunso pamwamba, tikuyamba maphunziro lero!

Pazikhalidwe zodziwika bwino za thupi, magazi amayenda m'mitsempha yamagazi amunthu ndipo sangasefukire kunja kwa mitsempha yamagazi kuti apangitse magazi, komanso sangatseke m'mitsempha ndikuyambitsa thrombosis.Chifukwa chachikulu ndi chakuti thupi la munthu liri ndi zovuta komanso zangwiro za hemostasis ndi anticoagulant ntchito.Ntchitoyi ikakhala yachilendo, thupi la munthu limakhala pachiwopsezo chotaya magazi kapena thrombosis.

1.Njira ya Hemostasis

Ife tonse tikudziwa kuti ndondomeko hemostasis mu thupi la munthu ndi choyamba chidule cha mitsempha ya magazi, ndiyeno adhesion, aggregation ndi kumasulidwa kwa zinthu zosiyanasiyana procoagulant ya kupatsidwa zinthu za m`mwazi kupanga zofewa kupatsidwa zinthu za m`mwazi emboli.Njirayi imatchedwa gawo limodzi la hemostasis.

Komabe, chofunika kwambiri, imayambitsa dongosolo la coagulation, imapanga fibrin network, ndipo pamapeto pake imapanga thrombus yokhazikika.Njira imeneyi imatchedwa secondary hemostasis.

2.Coagulation makina

Kuphatikizika kwa magazi ndi njira yomwe ma coagulation factor amalumikizidwa mwanjira inayake kuti apange thrombin, ndipo pamapeto pake fibrinogen imasinthidwa kukhala fibrin.The coagulation ndondomeko akhoza kugawidwa mu magawo atatu: mapangidwe prothrombinase zovuta, kutsegula kwa thrombin ndi kupanga fibrin.

Coagulation factor ndi dzina lophatikizana la zinthu zomwe zimakhudzidwa mwachindunji ndi magazi a plasma ndi minofu.Pakadali pano, pali 12 coagulation zinthu zotchulidwa malinga ndi manambala achiroma, zomwe ndi coagulation factor Ⅰ~XⅢ (VI sichikuonedwanso ngati zinthu zodziyimira pawokha coagulation), kupatula Ⅳ Ili mu mawonekedwe a ionic, ndipo ena onse ndi mapuloteni.Kupanga kwa Ⅱ, Ⅶ, Ⅸ, ndi Ⅹ kumafuna kutenga nawo gawo kwa VitK.

Malinga ndi njira zosiyanasiyana zoyambira komanso zolumikizirana zomwe zimakhudzidwa, njira zopangira ma prothrombinase complexes zitha kugawidwa m'matenda a endogenous coagulation komanso njira zakunja za coagulation.

The endogenous blood coagulation pathway (yomwe imagwiritsidwa ntchito kawirikawiri APTT test) imatanthauza kuti zinthu zonse zomwe zimakhudzidwa ndi magazi a coagulation zimachokera ku magazi, omwe nthawi zambiri amayamba ndi kukhudzana kwa magazi ndi thupi lachilendo (monga galasi, kaolin, collagen). ndi zina);Njira yolumikizirana yomwe imayambitsidwa ndi kukhudzana ndi minofu imatchedwa exogenous coagulation pathway (yomwe imagwiritsidwa ntchito poyesa PT).

Pamene thupi liri mu chikhalidwe cha matenda, bakiteriya endotoxin, wothandizira C5a, chitetezo cha mthupi, chotupa necrosis factor, ndi zina zotero zimatha kulimbikitsa ma cell endothelial cell ndi monocytes kuti afotokoze chinthu cha minofu, potero kuyambitsa ndondomeko ya coagulation, kuchititsa kufalikira kwa intravascular coagulation (DIC).

3. Anticoagulation makina

a.Antithrombin system (AT, HC-Ⅱ)

b.Mapuloteni C dongosolo (PC, PS, TM)

c.Tissue factor pathway inhibitor (TFPI)

Ntchito: Chepetsani mapangidwe a fibrin ndikuchepetsa kuyambitsa kwa zinthu zosiyanasiyana za coagulation.

4.Fibrinolytic njira

Magazi akamangika, PLG imalowetsedwa mu PL pansi pa zochita za t-PA kapena u-PA, zomwe zimalimbikitsa kusungunuka kwa fibrin ndikupanga fibrin (proto) degradation products (FDP), ndipo fibrin yolumikizana ndi mtanda imawonongeka ngati chinthu china.Wotchedwa D-Dimer. The activation ya fibrinolytic system imagawidwa m'njira yotsegulira mkati, njira yotsegulira kunja ndi njira yotsegulira kunja.

Njira yotsegulira mkati: Ndi njira ya PL yopangidwa ndi kupasuka kwa PLG ndi endogenous coagulation pathway, yomwe ndi maziko a chiphunzitso cha sekondale fibrinolysis.Njira yotsegula kunja: Ndi njira yomwe t-PA imatulutsidwa kuchokera ku maselo a vascular endothelial. PLG kupanga PL, yomwe ndi maziko a chiphunzitso cha primary fibrinolysis.Exogenous activation pathway: mankhwala a thrombolytic monga SK, UK ndi t-PA omwe amalowa m'thupi la munthu kuchokera kunja akhoza kuyambitsa PLG mu PL, yomwe ndi maziko a chiphunzitso cha thrombolytic mankhwala.

M'malo mwake, njira zomwe zimakhudzidwa ndi ma coagulation, anticoagulation, ndi fibrinolysis system ndizovuta, ndipo pali mayeso ambiri okhudzana ndi labotale, koma chomwe tikuyenera kusamala kwambiri ndi kusinthasintha kwamphamvu pakati pa machitidwe, omwe sangakhale amphamvu kwambiri kapena kwambiri. ofooka.