1. Nguva yeProthrombin (PT):

PT inoreva nguva inodiwa pakushandurwa kweprothrombin kuita thrombin, zvichikonzera kuvharika kweplasma, zvichiratidza basa rekuvharika kwenzira yekuvharika kwekunze. PT inonyanya kutariswa nemazinga ezvinokonzera kuvharika I, II, V, VII, uye X zvinogadzirwa nechiropa. Chinhu chakakosha chekuvharika kwenzira yekuvharika kwekunze ifactor VII, iyo inoumba FVIIa-TF complex ine tissue factor (TF). , iyo inotanga maitiro ekuvhara kwekunze. PT yevakadzi vane pamuviri vakajairwa ipfupi pane yevakadzi vasina pamuviri. Kana zvinhu X, V, II kana I zvikadzikira, PT inogona kuwedzerwa nguva. PT haina hanya nekushaikwa kwechinhu chimwe chete chekuvharika. PT inowedzera nguva zvakanyanya kana huwandu hweprothrombin huchidzikira pasi pe20% yemazinga akajairwa uye zvinhu V, VII, uye X zvichidzikira pasi pe35% yemazinga akajairwa. PT yakareba nguva zvakanyanya pasina kukonzera kubuda ropa kusingawanzoitiki. Nguva pfupi yeprothrombin panguva yekuzvitakura inoonekwa muzvirwere zve thromboembolic uye mamiriro ekudzivirira kuungana kweropa zvakanyanya. Kana PT yakareba nemasekonzi matatu kupfuura nguva yakatarwa, kuongororwa kweDIC kunofanirwa kufungwa nezvako.

2. Nguva yeTrombin:

Nguva yeTrombin inguva yekushandurwa kwefibrinogen kuita fibrin, iyo inogona kuratidza hunhu nehuwandu hwefibrinogen muropa. Nguva yeTrombin ipfupikiswa mumadzimai ane pamuviri akajairwa zvichienzaniswa nevakadzi vasina pamuviri. Pakanga pasina shanduko huru munguva yeTrombin panguva yekuzvitakura. Nguva yeTrombin zvakare ipfungwa inonzwisisika yezvigadzirwa zvekuora kwefibrin uye shanduko muhurongwa hwefibrinolytic. Kunyangwe nguva yeTrombin ichipfupikiswa panguva yekuzvitakura, shanduko pakati penguva dzakasiyana dzekuzvitakura hadzina kukosha, izvo zvinoratidzawo kuti kushanda kwehurongwa hweTrombin mukuzvitakura kwakajairwa kunowedzerwa. , kuti kuenzana uye kuwedzera mashandiro ekugwamba kweropa. Wang Li et al[6] vakaita ongororo yekuenzanisa pakati pevakadzi vane pamuviri vakajairwa nevasina pamuviri. Mhedzisiro yekuedzwa kweTrombin yenguva yeboka revakadzi vane pamuviri vakasvika pakupera yakanga yakapfupika zvakanyanya kupfuura yeboka rekudzora nemapoka epamberi nepakati ekuzvitakura, zvichiratidza kuti index yenguva yeTrombin muboka rekupedzisira rekuzvitakura yakanga yakakwira kupfuura yePT uye activated partial thromboplastin. Nguva (nguva inoshandiswa pakubvisa thromboplastin, APTT) inonyanya kubatwa nechirwere.

3. APTT:

Nguva ye thromboplastin inoshandiswa zvakanyanya kuona shanduko mubasa re coagulation pathway ye intrinsic coagulation. Pasi pemamiriro emuviri, zvinhu zvikuru zve coagulation zvinobatanidzwa munzira ye coagulation iXI, XII, VIII neVI, izvo coagulation factor XII chinhu chakakosha munzira iyi. XI neXII, prokallikrein uye high molecular weight excitogen zvinobatana mu contact phase ye coagulation. Mushure me activation ye contact phase, XI neXII zvinoitwa activated zvichitevedzana, nokudaro zvichitanga endogenous coagulation pathway. Mishumo yemabhuku inoratidza kuti kana tichienzanisa nevakadzi vasina pamuviri, activated partial thromboplastin nguva mukuzvitakura kwakajairika inopfupikiswa mukati mekuzvitakura, uye trimester yechipiri neyechitatu ipfupi zvikuru pane dziri pakutanga. Kunyangwe mukuzvitakura kwakajairika, coagulation factors XII, VIII, X, uye XI inowedzera zvinoenderana nekuwedzera kwemavhiki ekuzvitakura mukati mekuzvitakura, nekuti coagulation factor XI inogona kusachinja mu trimester yechipiri neyechitatu yekuzvitakura, endogenous coagulation function yese Pakati pepakati nepakupera kwekuzvitakura, shanduko dzakanga dzisiri pachena.

4. Fibrinogen (Fg):

Se glycoprotein, inoumba peptide A ne peptide B pasi pe thrombin hydrolysis, uye pakupedzisira inoumba insoluble fibrin kuti imise kubuda ropa. Fg inoita basa rakakosha mukuita kwe platelet aggregation. Kana ma platelet achishanda, fibrinogen receptor GP Ib/IIIa inoumbwa pa membrane, uye ma platelet aggregates anoumbwa kuburikidza nekubatana kweFg, uye pakupedzisira thrombus inoumbwa. Pamusoro pezvo, seprotein inokurumidza kuita, kuwedzera kwehuwandu hweFg muplasma kunoratidza kuti pane kuzvimba mutsinga dzeropa, izvo zvinogona kukanganisa rheology yeropa uye ndicho chinhu chikuru chinoita kuti plasma viscosity iwedzere. Inobatanidzwa zvakananga mukugwamba uye inowedzera kugwamba kweplatelet. Kana preeclampsia ikaitika, mazinga eFg anowedzera zvakanyanya, uye kana basa remuviri rekugwamba rapera, mazinga eFg anozopedzisira aderera. Huwandu hwakawanda hwezvidzidzo zvekudzoka shure zvakaratidza kuti mazinga eFg panguva yekupinda mukamuri rekusununguka ndicho chiratidzo chinonyanya kukosha chekufanotaura kuitika kwekubuda ropa mushure mekusununguka. Kukosha kwekufanotaura kwakanaka i100% [7]. Mumwedzi mitatu mitatu yekuzvitakura, plasma Fg inowanzova 3 kusvika 6 g/L. Panguva yekuvhiyiwa kweropa, plasma Fg yakakwira inodzivirira hypofibrinemia yekiriniki. Kana plasma Fg>1.5 g/L ichigona kuona kuti ropa rinobuda zvakanaka, kana plasma Fg<1.5 g/L, uye muzviitiko zvakakomba Fg<1 g/L, kutarisirwa kunofanira kupihwa kune njodzi yeDIC, uye kuongororwa kwakasimba kunofanira kuitwa. Tichitarisa shanduko mbiri dzeFg, huwandu hweFg hune chekuita nebasa rethrombin uye hunoita basa rakakosha mukuita kweplatelet aggregation. Muzviitiko zvine Fg yakakwira, kutarisirwa kunofanirwa kupihwa pakuongororwa kwezviratidzo zvine chekuita nehypercoagulability uye ma antibodies e autoimmune [8]. Gao Xiaoli naNiu Xiumin[9] vakaenzanisa huwandu hweFg muplasma hwevakadzi vane pamuviri vane chirwere cheshuga chepamuviri uye vakadzi vane pamuviri vakajairwa, uye vakaona kuti huwandu hweFg hwaive hwakabatana zvakanaka nebasa rethrombin. Pane katsika kekubuda ropa.