Ukucabanga: Ngaphansi kwezimo ezijwayelekile zomzimba

1. Kungani igazi eligeleza emithanjeni yegazi lingajiki?

2. Kungani umkhumbi wegazi owonakele ngemva kokuhlukumezeka ungayeka ukopha?

Ngemibuzo engenhla, siqala izifundo zanamuhla!

Ngaphansi kwezimo ezijwayelekile zomzimba, igazi ligeleza emithanjeni yegazi yomuntu futhi ngeke lichichime ngaphandle kwemithambo yegazi ukuze libangele ukopha, futhi ngeke lihlangane emithanjeni yegazi futhi libangele i-thrombosis.Isizathu esiyinhloko ukuthi umzimba womuntu une-hemostasis eyinkimbinkimbi futhi ephelele kanye nemisebenzi ye-anticoagulant.Uma lo msebenzi ungavamile, umzimba womuntu uzoba sengozini yokopha noma i-thrombosis.

1.Inqubo ye-Hemostasis

Sonke siyazi ukuthi inqubo ye-hemostasis emzimbeni womuntu iqala ukufinyela kwemithambo yegazi, bese kuba ukunamathela, ukuhlanganisa kanye nokukhululwa kwezinto ezihlukahlukene ze-procoagulant zamaplatelet ukwenza i-platelet emboli ethambile.Le nqubo ibizwa ngokuthi i-hemostasis yesigaba esisodwa.

Kodwa-ke, okubaluleke nakakhulu, ivuselela uhlelo lwe-coagulation, yakha inethiwekhi ye-fibrin, futhi ekugcineni yakha i-thrombus ezinzile.Le nqubo ibizwa ngokuthi i-hemostasis yesibili.

2.Umshini wokuhlanganisa

I-blood coagulation inqubo lapho izici zokuhlangana zenziwa zisebenze ngendlela ethile ukuze kukhiqizwe i-thrombin, futhi ekugcineni i-fibrinogen iguqulwa ibe i-fibrin.Inqubo ye-coagulation ingahlukaniswa ngezinyathelo ezintathu eziyisisekelo: ukwakheka kwe-prothrombinase complex, ukusebenza kwe-thrombin nokukhiqizwa kwe-fibrin.

Ama-coagulation factor yigama eliqoqiwe lezinto ezibandakanyeka ngokuqondile ku-blood coagulation ku-plasma nezicubu.Njengamanje, kunezici eziyi-12 zokuhlangana eziqanjwe ngokwezinombolo zesi-Roman, okuyizinto zokuhlangana okungu-Ⅰ~XⅢ (VI ayisathathwa njengezici ezizimele zokuhlangana), ngaphandle kokuthi Ⅳ Isesimweni se-ionic, kanti okunye kungamaprotheni.Ukukhiqizwa kwe-Ⅱ, Ⅶ, Ⅸ, kanye no-Ⅹ kudinga ukubamba iqhaza kwe-VitK.

Ngokwezindlela ezihlukene zokuqalwa kanye nezici zokuhlangana ezihilelekile, izindlela zokukhiqiza ama-prothrombinase complexes zingahlukaniswa zibe izindlela ezingapheli zokuhlanganisa kanye nezindlela zokuhlangana zangaphandle.

Indlela ye-endogenous blood coagulation (ukuhlolwa okuvame ukusetshenziswa kwe-APTT) isho ukuthi zonke izici ezihilelekile ekujikeni kwegazi zivela egazini, elivame ukuqaliswa ngokuthintana kwegazi nendawo yangaphandle enecala elibi (njengengilazi, i-kaolin, i-collagen. , njll.);Inqubo ye-coagulation eqalwa ukuchayeka kusici sethishu ibizwa ngokuthi i-exogenous coagulation pathway (evame ukusetshenziswa ukuhlolwa kwe-PT).

Uma umzimba usesimweni se-pathological, i-endotoxin yebhaktheriya, ihambisana ne-C5a, i-immune complexes, i-tumor necrosis factor, njll. ingashukumisa amangqamuzana e-vascular endothelial kanye nama-monocyte ukuveza isici se-tissue, ngaleyo ndlela iqalise inqubo ye-coagulation, ibangele i-diffuse intravascular coagulation (DIC).

3.I-Anticoagulation mechanism

a.Isistimu ye-Antithrombin (AT, HC-Ⅱ)

b.Uhlelo lwephrotheni C (PC, PS, TM)

c.I-Tissue factor pathway inhibitor (TFPI)

Umsebenzi: Yehlisa ukwakheka kwe-fibrin futhi unciphise izinga lokuvula lezici ezihlukahlukene ze-coagulation.

4.I-Fibrinolytic mechanism

Uma igazi lijiya, i-PLG yenziwa isebenze ibe yi-PL ngaphansi kwesenzo se-t-PA noma i-u-PA, ekhuthaza ukuchithwa kwe-fibrin futhi yakha imikhiqizo ye-fibrin (proto) degradation products (FDP), futhi i-fibrin exhunywe ngokuphambana yonakaliswa njengomkhiqizo othile.Ibizwa ngokuthi i-D-Dimer.Ukwenziwa kusebenze kwesistimu ye-fibrinolytic ihlukaniswe ngokuyinhloko ibe yindlela yangaphakathi yokuvula, indlela yokuvula yangaphandle kanye nendlela yokuvula yangaphandle.

Indlela yokuvula yangaphakathi: Iyindlela ye-PL eyakhiwe ukuqhekeka kwe-PLG nge-endogenous coagulation pathway, okuyisisekelo sethiyori se-fibrinolysis yesibili.Indlela yokuvula yangaphandle: Iyindlela lapho i-t-PA ekhishwa ngayo kumaseli e-vascular endothelial ehlukana. I-PLG ukuze yakhe i-PL, okuyisisekelo sethiyori se-fibrinolysis eyinhloko.Indlela yokuvula yangaphandle: izidakamizwa ze-thrombolytic ezifana ne-SK, UK kanye ne-t-PA ezingena emzimbeni womuntu zivela emhlabeni wangaphandle zingenza i-PLG isebenze ku-PL, okuyisisekelo sethiyori ukwelashwa kwe-thrombolytic.

Eqinisweni, izinqubo ezihilelekile ohlelweni lwe-coagulation, i-anticoagulation, kanye ne-fibrinolysis ziyinkimbinkimbi, futhi ziningi izivivinyo zaselabhorethri ezihlobene, kodwa okudingeka sikunake kakhulu ukulingana okuguquguqukayo phakathi kwezinhlelo, ezingeke zibe namandla kakhulu noma kakhulu. buthaka.