Ukucabanga: Ngaphansi kwezimo ezijwayelekile zomzimba

1. Kungani igazi eligeleza emithanjeni yegazi lingajiyi?

2. Kungani umthambo wegazi owonakele ngemva kokulimala ungayekisa ukopha?

Ngemibuzo engenhla, siqala isifundo sanamuhla!

Ngaphansi kwezimo ezijwayelekile zomzimba, igazi ligeleza emithanjeni yegazi yomuntu futhi ngeke ligcwale ngaphandle kwemithambo yegazi ukuze libangele ukopha, futhi ngeke lijiye emithanjeni yegazi futhi libangele i-thrombosis. Isizathu esiyinhloko ukuthi umzimba womuntu unemisebenzi eyinkimbinkimbi nephelele ye-hemostasis kanye ne-anticoagulant. Uma lo msebenzi ungajwayelekile, umzimba womuntu uzoba sengozini yokopha noma i-thrombosis.

1. Inqubo ye-Hemostasis

Sonke siyazi ukuthi inqubo ye-hemostasis emzimbeni womuntu kuqala iwukufinyela kwemithambo yegazi, bese kuba ukunamathelana, ukuhlangana kanye nokukhululwa kwezinto ezahlukahlukene ze-procoagulant zama-platelet ukuze kwakheke i-emboli ye-platelet ethambile. Le nqubo ibizwa ngokuthi i-hemostasis yesigaba esisodwa.

Kodwa-ke, okubaluleke kakhulu, kuyenza isebenze isimiso sokujiya, kwakha inethiwekhi ye-fibrin, futhi ekugcineni kwakha i-thrombus ezinzile. Le nqubo ibizwa ngokuthi i-hemostasis yesibili.

2. Indlela yokujiya

Ukujiya kwegazi kuyinqubo lapho izici zokujiya zivuselelwa khona ngokulandelana okuthile ukuze kukhiqizwe i-thrombin, futhi ekugcineni i-fibrinogen iguqulwa ibe yi-fibrin. Inqubo yokujiya ingahlukaniswa ngezinyathelo ezintathu eziyisisekelo: ukwakheka kwe-prothrombinase complex, ukusebenza kwe-thrombin kanye nokukhiqizwa kwe-fibrin.

Izinto ezihlanganisa ukujiya kwegazi ziyigama elihlanganisiwe lezinto ezihileleke ngqo ekujiya kwegazi eplasma nasezicutshini. Njengamanje, kunezici eziyi-12 zokujiya kwegazi eziqanjwe ngokwezinombolo zamaRoma, okungukuthi izinto ezijiya igazi Ⅰ~XⅢ (i-VI ayisabhekwa njengezici ezizimele zokujiya kwegazi), ngaphandle kwe-Ⅳ Isesimo se-ionic, kanti ezinye zingamaprotheni. Ukukhiqizwa kwe-Ⅱ, Ⅶ, Ⅸ, kanye ne-Ⅹ kudinga ukubamba iqhaza kwe-VitK.

Ngokwezindlela ezahlukene zokuqalisa kanye nezici zokwakheka kwe-coagulation ezihilelekile, izindlela zokukhiqiza ama-prothrombinase complexes zingahlukaniswa zibe izindlela zokwakheka kwe-coagulation zangaphakathi kanye nezindlela zokwakheka kwe-coagulation zangaphandle.

Indlela yokujiya kwegazi engokwemvelo (ukuhlolwa kwe-APTT okusetshenziswa kakhulu) isho ukuthi zonke izici ezihilelekile ekujiya kwegazi zivela egazini, okuvame ukuqaliswa ngokuthintana kwegazi nobuso bomzimba wangaphandle obune-negative charge (njengengilazi, i-kaolin, i-collagen, njll.); Inqubo yokujiya eqalwa ngokuchayeka ku-tissue factor ibizwa ngokuthi indlela yokujiya kwegazi engaphandle (ukuhlolwa kwe-PT okusetshenziswa kakhulu).

Uma umzimba usesimweni se-pathological, i-endotoxin yebhaktheriya, i-complement C5a, ama-immune complexes, i-tumor necrosis factor, njll. kungavuselela amaseli e-vascular endothelial kanye nama-monocytes ukuveza i-tissue factor, ngaleyo ndlela kuqalise inqubo yokujiya, okubangela ukujiya kwe-intravascular (DIC).

3. Indlela yokuvimbela ukujiya kwegazi

a. Uhlelo lwe-Antithrombin (AT, HC-Ⅱ)

b. Uhlelo lwe-Protein C (PC, PS, TM)

c. Isithiyo sendlela ye-tissue factor (TFPI)

Umsebenzi: Nciphisa ukwakheka kwe-fibrin futhi wehlise izinga lokusebenza kwezinto ezahlukahlukene zokujiya.

4. Indlela ye-Fibrinolytic

Uma igazi lihlangana, i-PLG ivuselelwa ibe yi-PL ngaphansi kwesenzo se-t-PA noma i-u-PA, okukhuthaza ukuqhekeka kwe-fibrin futhi kwakha imikhiqizo yokubola kwe-fibrin (proto) (FDP), kanti i-fibrin exhumene nayo iyonakaliswa njengomkhiqizo othize. Ibizwa ngokuthi i-D-Dimer. Ukusebenza kohlelo lwe-fibrinolytic kuhlukaniswe kakhulu ngendlela yokusebenza yangaphakathi, indlela yokusebenza yangaphandle kanye nendlela yokusebenza yangaphandle.

Indlela yokusebenza kwangaphakathi: Yindlela ye-PL eyakhiwe ukuqhekeka kwe-PLG yindlela yokugoqa engaphakathi, okuyisisekelo semfundiso yenkolo ye-fibrinolysis yesibili. Indlela yokusebenza yangaphandle: Yindlela lapho i-t-PA ekhishwa kumaseli e-endothelial e-vascular iqhekeza khona i-PLG ukuze yakhe i-PL, okuyisisekelo semfundiso yenkolo ye-fibrinolysis eyinhloko. Indlela yokusebenza yangaphandle: izidakamizwa ze-thrombolytic ezifana ne-SK, i-UK kanye ne-t-PA ezingena emzimbeni womuntu zivela ezweni langaphandle zingasebenzisa i-PLG ibe yi-PL, okuyisisekelo semfundiso yenkolo yokwelapha nge-thrombolytic.

Eqinisweni, izindlela ezihilelekile ezinhlelweni zokujiya, zokulwa nokujiya kwegazi, kanye ne-fibrinolysis ziyinkimbinkimbi, futhi kunezivivinyo eziningi zelebhu ezihlobene, kodwa okudingeka sikunake kakhulu ibhalansi eguquguqukayo phakathi kwezinhlelo, engeke ibe namandla kakhulu noma ibe buthakathaka kakhulu.