Ukucinga: Phantsi kweemeko eziqhelekileyo zomzimba

1. Kutheni igazi elihamba kwimithambo yegazi lingajingi?

2. Kutheni umthambo wegazi owonakeleyo emva kokwenzakala unokuyeka ukopha?

Ngemibuzo engentla, siqala ikhosi yanamhlanje!

Ngaphantsi kweemeko eziqhelekileyo zomzimba, igazi lihamba kwimithambo yegazi yomntu kwaye aliyi kuphuphuma ngaphandle kwemithambo yegazi ukuze kubangele ukopha, kwaye akuyi kubambana kwimithambo yegazi kwaye kubangele i-thrombosis.Isizathu esona sizathu kukuba umzimba womntu une-hemostasis eyinkimbinkimbi kunye negqibeleleyo kunye nemisebenzi ye-anticoagulant.Xa lo msebenzi ungaqhelekanga, umzimba womntu uya kuba sengozini yokuphuma kwegazi okanye i-thrombosis.

1.Inkqubo yeHemostasis

Sonke siyazi ukuba inkqubo ye-hemostasis kumzimba womntu kukuqala ukunyanzeliswa kwemithambo yegazi, kwaye emva koko i-adhesion, aggregation kunye nokukhululwa kwezinto ezahlukeneyo ze-procoagulant ze-platelet ukwenza i-platelet emboli ethambileyo.Le nkqubo ibizwa ngokuba yinqanaba elinye le-hemostasis.

Nangona kunjalo, okubaluleke ngakumbi, ivuselela inkqubo yokudibanisa, yenza inethiwekhi ye-fibrin, kwaye ekugqibeleni yenza i-thrombus ezinzile.Le nkqubo ibizwa ngokuba yi-hemostasis yesibini.

2.Indlela yokudibanisa

I-blood coagulation yinkqubo apho izinto zokudibanisa zenziwe zisebenze ngendlela ethile yokuvelisa i-thrombin, kwaye ekugqibeleni i-fibrinogen iguqulwa ibe yi-fibrin.Inkqubo yokudibanisa ingahlulwa ibe ngamanyathelo amathathu asisiseko: ukubunjwa kweprothrombinase complex, ukusebenza kwe-thrombin kunye nokuveliswa kwefibrin.

Imiba yokudibanisa ligama elihlangeneyo lezinto ezibandakanyeka ngokuthe ngqo kwi-blood coagulation kwiplasma kunye nezicubu.Okwangoku, kukho izinto ezili-12 zokudityaniswa ezibizwa ngokwamanani aseRoma, ezizezi, izinto ezidityanisiweyo Ⅰ~XⅢ (i-VI ayisathathwa njengezinto ezizimeleyo zokuhlangana), ngaphandle kwe-Ⅳ Ikwimo ye-ionic, kwaye ezinye ziiproteni.Ukuveliswa kwe-Ⅱ, Ⅶ, Ⅸ, kunye ne-Ⅹ kufuna intatho-nxaxheba ye-VitK.

Ngokweendlela ezahlukeneyo zokuqalisa kunye nezinto zokudibanisa ezibandakanyekayo, iindlela zokuvelisa i-prothrombinase complexes zinokwahlulwa zibe ziindlela ezingapheliyo ze-coagulation kunye ne-exogenous coagulation pathways.

I-endogenous blood coagulation pathway (uvavanyo lwe-APTT oluqhelekileyo olusetyenziswayo) luthetha ukuba zonke izinto ezibandakanyekayo kwi-blood coagulation zivela egazini, elidla ngokuqalwa ngokudibana kwegazi kunye nomphezulu womzimba wangaphandle ohlawuliswa kakubi (njengeglasi, i-kaolin, i-collagen. , njl.);Inkqubo ye-coagulation eqaliswe kukuvezwa kwi-tissue factor ibizwa ngokuba yindlela yokudibanisa exogenous (eqhelekileyo isetyenziswe uvavanyo lwe-PT).

Xa umzimba ukwimeko ye-pathological, i-endotoxin yebhaktheriya, incedise i-C5a, i-immune complexes, i-tumor necrosis factor, njl.njl inokuvuselela iiseli ze-vascular endothelial kunye ne-monocytes ukuvakalisa i-tissue factor, ngaloo ndlela iqalise inkqubo yokudibanisa, ibangele i-diffuse intravascular coagulation (DIC).

3.Umatshini wokulwa nokuqina

a.Inkqubo yeAntithrombin (AT, HC-Ⅱ)

b.Inkqubo yeprotheyini C (iPC, PS, TM)

c.I-tissue factor pathway inhibitor (TFPI)

Umsebenzi: Ukunciphisa ukubunjwa kwe-fibrin kunye nokunciphisa inqanaba lokusebenzisa izinto ezahlukeneyo ze-coagulation.

4.Umatshini weFibrinolytic

Xa igazi lidibanisa, i-PLG ivuliwe kwi-PL phantsi kwesenzo se-t-PA okanye i-u-PA, ekhuthaza ukuchithwa kwe-fibrin kwaye yenze i-fibrin (proto) imveliso yokuthotywa kwe-fibrin (i-FDP), kwaye i-fibrin edibeneyo iyancipha njengemveliso ethile.Ebizwa ngokuba yi-D-Dimer.Ukusebenza kwenkqubo ye-fibrinolytic ihlulwe ngokukodwa kwindlela yokuvuselela yangaphakathi, indlela yokusebenza yangaphandle kunye nendlela yangaphandle yokuvula.

Indlela yokuvuselela yangaphakathi: Yindlela ye-PL eyenziwe yi-cleavage ye-PLG nge-endogenous coagulation pathway, eyona siseko se-fibrinolysis yesibini. I-PLG ukwenza i-PL, eyona siseko sethiyori ye-fibrinolysis ephambili.I-activation pathway exogenous: iziyobisi ze-thrombolytic ezifana ne-SK, UK kunye ne-t-PA ezingena emzimbeni womntu ukusuka kwihlabathi langaphandle zingenza i-PLG isebenze kwi-PL, eyisiseko sethiyori. unyango lwe-thrombolytic.

Enyanisweni, iindlela ezibandakanyekayo kwiinkqubo ze-coagulation, i-anticoagulation, kunye ne-fibrinolysis zintsonkothile, kwaye zininzi iimvavanyo zaselabhoratri ezinxulumeneyo, kodwa into ekufuneka siyithathele ingqalelo ngakumbi lulungelelwaniso oluguquguqukayo phakathi kweenkqubo, ezingenakomelela kakhulu okanye kakhulu. buthathaka.