Ukucinga: Phantsi kweemeko eziqhelekileyo zomzimba

1. Kutheni igazi elihamba kwimithambo yegazi lingaqini?

2. Kutheni umthambo wegazi owonakeleyo emva kokwenzakala unokuyeka ukopha?

Ngemibuzo engentla, siqala ikhosi yanamhlanje!

Phantsi kweemeko eziqhelekileyo zomzimba, igazi lihamba kwimithambo yegazi yomntu kwaye aliyi kuphuma ngaphandle kwemithambo yegazi ukuze libangele ukopha, kwaye aliyi kugalela kwimithambo yegazi lize libangele i-thrombosis. Isizathu esiphambili kukuba umzimba womntu unemisebenzi enzima negqibeleleyo ye-hemostasis kunye ne-anticoagulant. Xa lo msebenzi ungaqhelekanga, umzimba womntu uya kuba sengozini yokopha okanye i-thrombosis.

1. Inkqubo yeHemostasis

Sonke siyazi ukuba inkqubo ye-hemostasis emzimbeni womntu kuqala kukuxinana kwemithambo yegazi, kuze emva koko kube kukunamathelana, ukuhlanganiswa kunye nokukhululwa kwezinto ezahlukeneyo ze-procoagulant zeeplatelets ukuze zenze i-emboli yeplatelet ethambileyo. Le nkqubo ibizwa ngokuba yi-hemostasis yesigaba esinye.

Nangona kunjalo, okubaluleke ngakumbi, ivuselela inkqubo yokujiya kwegazi, yenze inethiwekhi ye-fibrin, kwaye ekugqibeleni yenze i-thrombus ezinzileyo. Le nkqubo ibizwa ngokuba yi-secondary hemostasis.

2. Indlela yokujiya

Ukujiya kwegazi yinkqubo apho izinto ezijiya igazi zisebenza ngendlela ethile ukuze kuveliswe i-thrombin, kwaye ekugqibeleni i-fibrinogen iguqulwa ibe yi-fibrin. Inkqubo yokujiya igazi inokwahlulwa ibe ngamanyathelo amathathu asisiseko: ukwakheka kwe-prothrombinase complex, ukusebenza kwe-thrombin kunye nokuveliswa kwe-fibrin.

Izinto ezibangela ukuxinana kwegazi ngamagama adibeneyo ezinto ezibandakanyeka ngokuthe ngqo ekuxinaneni kwegazi kwi-plasma nakwizicubu. Okwangoku, kukho izinto ezili-12 ezibangela ukuxinana kwegazi ezibizwa ngokweenombolo zamaRoma, ezizezi: izinto ezibangela ukuxinana kwegazi Ⅰ~XⅢ (i-VI ayisabonwa njengezinto ezibangela ukuxinana kwegazi ezizimeleyo), ngaphandle kwe-Ⅳ Ikwimo ye-ionic, kwaye ezinye ziiproteni. Ukuveliswa kwe-Ⅱ, Ⅶ, Ⅸ, kunye ne-Ⅹ kufuna ukuba i-VitK ithathe inxaxheba.

Ngokweendlela ezahlukeneyo zokuqalisa kunye nezinto ezibangela ukujiya kweseli ezibandakanyekayo, iindlela zokuvelisa ii-prothrombinase complexes zinokwahlulwa zibe ziindlela zokujiya kweseli ezibangela ukujiya kweseli kunye neendlela zokujiya kweseli ezibangela ukujiya kweseli.

Indlela yokujiya kwegazi ehlala ikhona (uvavanyo lwe-APTT olusetyenziswa rhoqo) ithetha ukuba zonke izinto ezibandakanyekayo ekujiya kwegazi zivela egazini, okuhlala kuqala ngokudibana kwegazi nomphezulu womzimba wangaphandle one-negative charge (njengeglasi, i-kaolin, i-collagen, njl.njl.); Inkqubo yokujiya eqalwa ngokuchatshazelwa kwi-tissue factor ibizwa ngokuba yi-exogenous coagulation pathway (uvavanyo lwe-PT olusetyenziswa rhoqo).

Xa umzimba ukwimeko yesifo, i-bacterial endotoxin, i-complement C5a, i-immune complexes, i-tumor necrosis factor, njl.njl. zinokuvuselela ii-vascular endothelial cells kunye nee-monocytes ukuba ziveze i-tissue factor, ngaloo ndlela ziqalise inkqubo ye-coagulation, nto leyo ebangela i-diffuse intravascular coagulation (DIC).

3. Indlela yokuthintela ukugabha kwegazi

a. Inkqubo ye-Antithrombin (AT, HC-Ⅱ)

b. Inkqubo yeProtheyini C (PC, PS, TM)

c. I-Tissue factor pathway inhibitor (TFPI)

Umsebenzi: Ukunciphisa ukwakheka kwe-fibrin kunye nokunciphisa inqanaba lokusebenza kwezinto ezahlukeneyo zokujiya.

4. Indlela ye-Fibrinolytic

Xa igazi liqina, i-PLG iyasebenza kwi-PL phantsi kwesenzo se-t-PA okanye i-u-PA, ekhuthaza ukuchithwa kwe-fibrin kwaye yenze iimveliso zokuchithwa kwe-fibrin (proto) (FDP), kwaye i-fibrin edibeneyo iyonakaliswa njengemveliso ethile. Ibizwa ngokuba yi-D-Dimer. Ukusebenza kwenkqubo ye-fibrinolytic kwahlulwe ngokubanzi kwindlela yokusebenza yangaphakathi, indlela yokusebenza yangaphandle kunye nendlela yokusebenza yangaphandle.

Indlela yokusebenza yangaphakathi: Yindlela ye-PL eyenziwe kukuqhekeka kwe-PLG yindlela yokuxinana kwe-endogenous, esisiseko sethiyori se-fibrinolysis yesibini. Indlela yokusebenza yangaphandle: Yindlela apho i-t-PA ekhutshwa kwiiseli ze-endothelial zemithambo yegazi iqhekeza i-PLG ukuze yenze i-PL, esisiseko sethiyori se-fibrinolysis ephambili. Indlela yokusebenza yangaphandle: amayeza e-thrombolytic afana ne-SK, i-UK kunye ne-t-PA angena emzimbeni womntu evela kwihlabathi langaphandle anokusebenzisa i-PLG ibe yi-PL, esisiseko sethiyori sonyango lwe-thrombolytic.

Enyanisweni, iindlela ezibandakanyekayo kwiinkqubo zokujiya, zokulwa nokujiya kwegazi, kunye neenkqubo ze-fibrinolysis ziyinkimbinkimbi, kwaye kukho iimvavanyo ezininzi zelebhu ezinxulumene noko, kodwa into ekufuneka siyiqwalasele ngakumbi yibhalansi eguquguqukayo phakathi kweenkqubo, ezingenakuba namandla kakhulu okanye zibe buthathaka kakhulu.