Zviratidzo zvekuvhara ropa panguva yekuzvitakura


Munyori: Succeeder   

Mukuzvitakura kwakajairika, kubuda kwemoyo kunowedzera uye kuramba kwemoyo kunowedzera nekukura kwenguva yekuzvitakura. Zvinotendwa kuti kubuda kwemoyo kunotanga kuwedzera pamavhiki masere kusvika gumi ekuzvitakura, uye kunosvika pakakwirira pamavhiki makumi matatu nemaviri kusvika makumi matatu nemana ekuzvitakura, izvo zviri pamusoro ne30% kusvika 45% pane zvisina pamuviri, uye zvinoramba zviri padanho iri kusvika pakusununguka. Kuderera kwekuramba kweropa kunoderedza kumanikidzwa kweropa, uye kumanikidzwa kweropa kwediastolic kunoderera zvakanyanya, uye musiyano wekumanikidzwa kwemwoyo unowedzera. Kubva pamavhiki matanhatu kusvika gumi ekuzvitakura, huwandu hweropa revakadzi vane pamuviri hunowedzera nekuwedzera kwezera rekuzvitakura, uye hunowedzera neinenge 40% pakupera kwekuzvitakura, asi kuwedzera kwehuwandu hweropa muplasma kunodarika huwandu hwemasero matsvuku eropa, plasma inowedzera ne40% kusvika 50%, uye masero matsvuku eropa anowedzera ne10% kusvika 15%. Nokudaro, mukuzvitakura kwakajairika, ropa rinoderedzwa, rinoonekwa sekudzikira kweropa, kudzikira kwehematocrit, uye kuwedzera kwechiyero cheerythrocyte sedimentation [1].

Zvinhu zvinobatanidza ropa Ⅱ, Ⅴ, VII, Ⅷ, IX, uye Ⅹ zvese zvinowedzera panguva yekuzvitakura, uye zvinogona kusvika panguva imwe chete kusvika kaviri pane zvakajairika pakati nepakati pekuzvitakura, uye mabasa ezvinobatanidza ropa Ⅺ uye  anodzikira. Fibrinopeptide A, fibrinopeptide B, thrombinogen, platelet factor Ⅳ uye fibrinogen akawedzera zvakanyanya, nepo antithrombin Ⅲ uye protein C neprotein S zvakadzikira. Munguva yekuzvitakura, nguva yeprothrombin nenguva yeprothrombin yakabatidzwa inopfupikiswa, uye huwandu hwefibrinogen muplasma hunowedzera zvakanyanya, izvo zvinogona kuwedzera kusvika 4-6 g/L mu trimester yechitatu, iyo iri pamusoro pe50% pane iyo munguva isiri yekuzvitakura. Pamusoro pezvo, plasminogen yakawedzera, nguva ye euglobulin dissolving yakawedzerwa, uye shanduko dze coagulation-anticoagulation dzakaita kuti muviri uve mumamiriro ekuonda zvakanyanya, izvo zvaive zvinobatsira ku hemostasis inoshanda mushure mekubviswa kwe placenta panguva yekusununguka. Pamusoro pezvo, zvimwe zvinhu zvinogona kuonda panguva yekuzvitakura zvinosanganisira kuwedzera kwecholesterol yese, phospholipids uye triacylglycerols muropa, androgen neprogesterone zvinoburitswa neplacenta zvinoderedza simba remamwe ma "blood coagulation inhibitors", placenta, uterine decidua uye embryos. Kuvapo kwe "thromboplastin substances", nezvimwewo, kunogona kukurudzira kuti ropa rionda zvakanyanya, uye shanduko iyi inowedzera nekuwedzera kwenguva yekuzvitakura. Kuonda zvishoma nezvishoma inzira yekudzivirira muviri, iyo inobatsira kuchengetedza fibrin mumidziyo yeropa, madziro echibereko uye placental villi, inobatsira kuchengetedza kusimba kweplacenta uye kugadzira thrombus nekuda kwekubvisa, uye kubatsira kukurumidza hemostasis panguva uye mushure mekusununguka. , inzira yakakosha yekudzivirira kubuda ropa mushure mekusununguka. Panguva imwecheteyo yekuonda, secondary fibrinolytic activity inotangawo kubvisa thrombus mumidziyo yeropa yechibereko uye venous sinuses uye kukurumidzisa kudzokororwa nekugadzirisa endometrium [2].

Zvisinei, mamiriro ekudzivirira ropa anogonawo kukonzera matambudziko akawanda ekusununguka. Mumakore achangopfuura, zvidzidzo zvakaratidza kuti vakadzi vazhinji vane pamuviri vanowanzobatwa nechirwere che thrombosis. Chirwere ichi che thromboembolism mumadzimai ane pamuviri nekuda kwezvikanganiso zvemajini kana zvinhu zvine njodzi zvakaita semapuroteni anorwisa ropa, zvinhu zvinodzivirira ropa, uye mapuroteni e fibrinolytic chinonzi thrombosis. (thrombophilia), inozivikanwawo se prothrombotic state. Mamiriro aya ekudzivirira ropa haangotungamiriri kuchirwere che thrombotic, asi anogona kutungamira kumhedzisiro yakaipa yekuzvitakura nekuda kwekusawirirana mu coagulation-anticoagulation mechanisms kana fibrinolytic activity, microthrombosis ye uterine spiral arteries kana villus, zvichikonzera kutadza kwe placental perfusion kana kutofa, senge Preeclampsia, placental abruption, placental infarction, disseminated intravascular coagulation (DIC), fetal growth restriction, recurrent miscarriage, stillbing uye pregnancy growth, nezvimwewo, zvinogona kutungamira kurufu rwaamai nepamuviri muzviitiko zvakakomba.