1. Isikhathi se-Prothrombin (PT):

I-PT ibhekisela esikhathini esidingekayo sokuguqulwa kwe-prothrombin ibe yi-thrombin, okuholela ekujiyileni kwe-plasma, okubonisa umsebenzi wokujiyileka kwendlela yokujiyileka kwangaphandle. I-PT inqunywa kakhulu amazinga ezici zokujiyileka I, II, V, VII, kanye no-X ezenziwe yisibindi. Isici esiyinhloko sokujiyileka endleleni yokujiyileka kwangaphandle yi-factor VII, eyakha i-FVIIa-TF complex ene-tissue factor (TF). , eqala inqubo yokujiyileka kwangaphandle. I-PT yabesifazane abakhulelwe abavamile imfushane kuneyabesifazane abangakhulelwe. Lapho izici X, V, II noma I zincipha, i-PT ingandiswa. I-PT ayizweli ekuntulekeni kwesici sokujiyileka esisodwa. I-PT indiswa kakhulu lapho ukuhlushwa kwe-prothrombin kwehla ngaphansi kuka-20% wezinga elijwayelekile kanye nezici V, VII, kanye no-X kwehla ngaphansi kuka-35% wezinga elijwayelekile. I-PT yandiswa kakhulu ngaphandle kokubangela ukopha okungajwayelekile. Isikhathi se-prothrombin esifushane ngesikhathi sokukhulelwa sibonakala ezifweni ze-thromboembolic kanye nezimo ze-hypercoagulable. Uma i-PT ide ngamasekhondi ama-3 kunokulawula okuvamile, kufanele kucatshangelwe ukuxilongwa kwe-DIC.

2. Isikhathi se-Thrombin:

Isikhathi se-Thrombin yisikhathi sokuguqulwa kwe-fibrinogen ibe yi-fibrin, okungabonisa ikhwalithi kanye nobuningi be-fibrinogen egazini. Isikhathi se-Thrombin sifinyezwa kwabesifazane abakhulelwe abavamile uma kuqhathaniswa nabesifazane abangakhulelwe. Azikho izinguquko ezibalulekile esikhathini se-thrombin kulo lonke ukukhulelwa. Isikhathi se-Thrombin siphinde sibe yipharamitha ebucayi yemikhiqizo yokuwohloka kwe-fibrin kanye nezinguquko ohlelweni lwe-fibrinolytic. Nakuba isikhathi se-thrombin sifinyezwa ngesikhathi sokukhulelwa, izinguquko phakathi kwezikhathi ezahlukene zokukhulelwa azibalulekile, okubonisa nokuthi ukusebenza kohlelo lwe-fibrinolytic ekukhulelweni okuvamile kuyathuthukiswa. , ukulinganisela nokuthuthukisa umsebenzi wokuqina kwama-coagulation. UWang Li nabanye [6] benze ucwaningo lokuqhathanisa phakathi kwabesifazane abakhulelwe abavamile nabesifazane abangakhulelwe. Imiphumela yokuhlolwa kwesikhathi se-thrombin yeqembu labesifazane abakhulelwe abaseminyakeni yokugcina yayimfushane kakhulu kuneyeqembu lokulawula kanye namaqembu okukhulelwa okuqala naphakathi, okubonisa ukuthi inkomba yesikhathi se-thrombin eqenjini lokukhulelwa eliseminyakeni yokugcina yayiphakeme kuneye-PT kanye ne-activated partial thromboplastin. Isikhathi (isikhathi se-thromboplastin esingasebenzi, i-APTT) sibucayi kakhulu.

3. I-APTT:

Isikhathi se-thromboplastin esingaphelele esisebenzayo sisetshenziswa kakhulu ukuthola izinguquko emsebenzini wokujiya kwendlela yokujiya kwangaphakathi. Ngaphansi kwezimo zomzimba, izici eziyinhloko zokujiya ezihilelekile endleleni yokujiya kwangaphakathi yi-XI, XII, VIII kanye ne-VI, lapho i-coagulation factor XII iyisici esibalulekile kule ndlela. I-XI kanye ne-XII, i-prokallikrein kanye ne-excitogen enesisindo esiphezulu sama-molecule zihlanganyela ndawonye esigabeni sokuxhumana sokujiya. Ngemva kokusebenza kwesigaba sokuxhumana, i-XI kanye ne-XII ziyavuselelwa ngokulandelana, ngaleyo ndlela ziqala indlela yokujiya kwangaphakathi. Imibiko yezincwadi ikhombisa ukuthi uma kuqhathaniswa nabesifazane abangakhulelwe, isikhathi se-thromboplastin esingaphelele esisebenzayo ekukhulelweni okuvamile sifinyezwa kulo lonke ukukhulelwa, kanti i-trimester yesibili neyesithathu imfushane kakhulu kunaleyo esesigabeni sokuqala. Nakuba ekukhulelweni okuvamile, izici zokujiya XII, VIII, X, kanye ne-XI zanda ngokuhambisana nokwanda kwamasonto okukhulelwa kulo lonke ukukhulelwa, ngoba i-coagulation factor XI ingase ingashintshi ku-trimester yesibili neyesithathu yokukhulelwa, wonke umsebenzi wokujiya kwangaphakathi Ekukhulelweni okuphakathi nasekupheleni, izinguquko zazingabonakali.

4. I-Fibrinogen (Fg):

Njenge-glycoprotein, yakha i-peptide A kanye ne-peptide B ngaphansi kwe-thrombin hydrolysis, futhi ekugcineni yakha i-fibrin enganyibiliki ukuze iyeke ukopha. I-Fg idlala indima ebalulekile enkambisweni yokuhlanganiswa kwama-platelet. Lapho ama-platelet esebenza, i-fibrinogen receptor GP Ib/IIIa yakheka ku-membrane, futhi ama-platelet aggregates akheka ngokuxhumeka kwe-Fg, futhi ekugcineni kwakheka i-thrombus. Ngaphezu kwalokho, njengeprotheni esabela ngokushesha, ukwanda kokuhlushwa kwe-Fg ku-plasma kubonisa ukuthi kukhona ukusabela kokuvuvukala emithanjeni yegazi, okungathinta i-rheology yegazi futhi kuyisici esiyinhloko se-plasma viscosity. Ihlanganyela ngqo ekujiyaneni futhi ithuthukise ukuhlanganiswa kwama-platelet. Lapho kwenzeka i-preeclampsia, amazinga e-Fg ayanda kakhulu, futhi lapho umsebenzi wokuqina komzimba uncishiswa, amazinga e-Fg agcina ehlile. Inani elikhulu lezifundo ezibuyela emuva likhombisile ukuthi izinga le-Fg ngesikhathi sokungena egumbini lokubeletha liyisibonakaliso esibaluleke kakhulu sokubikezela ukwenzeka kokuphuma kwegazi ngemva kokubeletha. Inani elihle lokubikezela lingu-100% [7]. Ku-trimester yesithathu, i-plasma Fg ngokuvamile ingama-3 kuya ku-6 g/L. Ngesikhathi sokusebenza kokujiya, i-plasma Fg ephezulu ivimbela i-hypofibrinemia yezokwelapha. Kuphela uma i-plasma Fg>1.5 g/L ingaqinisekisa ukusebenza okujwayelekile kokujiya, lapho i-plasma Fg<1.5 g/L, kanye nasezimweni ezimbi kakhulu i-Fg<1 g/L, kufanele kunakwe ingozi ye-DIC, futhi kufanele kwenziwe ukubuyekezwa okunamandla. Ukugxila ezinguqukweni ze-bidirectional ze-Fg, okuqukethwe kwe-Fg kuhlobene nomsebenzi we-thrombin futhi kudlala indima ebalulekile enkambisweni yokuhlanganiswa kwama-platelet. Ezimweni ezine-Fg ephezulu, kufanele kunakwe ekuhlolweni kwezinkomba ezihlobene ne-hypercoagulability kanye nama-antibodies okuzivikela komzimba [8]. UGao Xiaoli noNiu Xiumin[9] baqhathanise okuqukethwe kwe-plasma Fg kwabesifazane abakhulelwe abanesifo sikashukela sokukhulelwa kanye nabesifazane abakhulelwe abavamile, futhi bathola ukuthi okuqukethwe kwe-Fg kwakuhlobene kahle nomsebenzi we-thrombin. Kukhona ukuthambekela kwe-thrombosis.