Tunani: Ƙarƙashin yanayin yanayin ilimin lissafi na al'ada

1. Me yasa jinin da ke gudana a cikin tasoshin jini baya yin coagulation?

2. Me yasa magudanar jinin da ta lalace bayan rauni zai iya daina zubar jini?

Tare da tambayoyin da ke sama, za mu fara karatun yau!

A karkashin yanayin dabi'a na al'ada, jini yana gudana a cikin magudanar jinin mutum kuma ba zai zubar da jini a waje da jini don haifar da zubar jini ba, kuma ba zai tashe cikin jini ba kuma ya haifar da thrombosis.Babban dalili shi ne cewa jikin mutum yana da hadaddun kuma cikakke aikin hemostasis da anticoagulant ayyuka.Lokacin da wannan aikin ba shi da kyau, jikin ɗan adam zai kasance cikin haɗarin zubar jini ko thrombosis.

1.Hemostasis tsari

Dukanmu mun san cewa tsarin hemostasis a cikin jikin mutum shine farkon ƙaddamarwar tasoshin jini, sannan kuma adhesion, haɗuwa da sakin abubuwa daban-daban na procoagulant na platelet don samar da platelet emboli mai laushi.Ana kiran wannan tsari hemostasis mataki daya.

Duk da haka, mafi mahimmanci, yana kunna tsarin coagulation, yana samar da hanyar sadarwa na fibrin, kuma a ƙarshe ya samar da thrombus barga.Wannan tsari shi ake kira secondary hemostasis.

2.Coagulation tsarin

Coagulation na jini wani tsari ne wanda ake kunna abubuwan haɗin gwiwa a cikin wani tsari don samar da thrombin, kuma a ƙarshe fibrinogen ya zama fibrin.Ana iya raba tsarin coagulation zuwa matakai na asali guda uku: samuwar hadaddun prothrombinase, kunna thrombin da samar da fibrin.

Abubuwan coagulation sune sunan gamayya na abubuwan da ke da hannu kai tsaye a cikin coagulation jini a cikin jini da kyallen takarda.A halin yanzu, akwai nau'o'in coagulation guda 12 da aka ambata bisa ga lambobin Romawa, wato abubuwan coagulation Ⅰ~XⅢ (ba a ɗaukar VI a matsayin abubuwan coagulation masu zaman kansu), sai dai Ⅳ Yana cikin siffar ionic, sauran kuma sunadaran sunadaran.Samar da Ⅱ, Ⅶ, Ⅸ, da Ⅹ yana buƙatar sa hannu na VitK.

Dangane da hanyoyi daban-daban na farawa da abubuwan haɗin gwiwa, hanyoyin samar da hadaddun prothrombinase za a iya raba su zuwa hanyoyin coagulation na endogenous da hanyoyin coagulation na waje.

Hanyar coagulation jini na endogenous (gwajin APTT da aka saba amfani da shi) yana nufin cewa duk abubuwan da ke tattare da coagulation na jini sun fito ne daga jini, wanda yawanci ana farawa ta hanyar haɗuwa da jini tare da yanayin jikin waje mara kyau (kamar gilashi, kaolin, collagen). , da sauransu);Tsarin coagulation wanda aka fara ta hanyar fallasa abubuwan nama ana kiransa hanyar coagulation exogenous (gwajin PT da aka saba amfani da shi).

Lokacin da jiki ya kasance a cikin yanayin cututtuka, kwayoyin endotoxin na kwayan cuta, mai dacewa da C5a, ƙwayoyin rigakafi, ƙwayar necrosis factor, da dai sauransu na iya tayar da kwayoyin endothelial na jijiyoyi da monocytes don bayyana nau'in nama, don haka fara tsarin coagulation, haifar da yaduwar coagulation na intravascular (DIC).

3.Anticoagulation inji

a.Tsarin Antithrombin (AT, HC-Ⅱ)

b.Protein C tsarin (PC, PS, TM)

c.Mai hana hanyar Tissue factor (TFPI)

Aiki: Rage samuwar fibrin kuma rage matakin kunna abubuwa daban-daban na coagulation.

4.Fibrinolytic inji

Lokacin da jini ya daidaita, ana kunna PLG a cikin PL a ƙarƙashin aikin t-PA ko u-PA, wanda ke haɓaka rushewar fibrin kuma ya samar da samfuran lalata fibrin (proto) (FDP), kuma fibrin mai haɗin giciye yana raguwa azaman takamaiman samfuri.Da ake kira D-Dimer. An rarraba tsarin kunna fibrinolytic zuwa hanyar kunnawa ta ciki, hanyar kunnawa ta waje da kuma hanyar kunnawa ta waje.

Hanyar kunnawa ta ciki: Hanya ce ta PL da aka kafa ta hanyar tsagewar PLG ta hanyar hanyar haɗin gwiwa, wanda shine tushen ka'idar fibrinolysis na biyu. Hanyar kunnawa ta waje: Hanya ce ta hanyar da t-PA ta fito daga sel endothelial na jijiyoyin bugun jini. PLG don samar da PL, wanda shine tushen ka'idar fibrinolysis na farko. Exogenous kunnawa hanya: thrombolytic kwayoyi irin su SK, UK da t-PA da suka shiga jikin mutum daga waje duniya na iya kunna PLG cikin PL, wanda shine tushen ka'idar. thrombolytic far.

A gaskiya ma, hanyoyin da ke cikin tsarin coagulation, anticoagulation, da tsarin fibrinolysis suna da wuyar gaske, kuma akwai gwaje-gwajen gwaje-gwaje masu dangantaka da yawa, amma abin da muke buƙatar kula da shi shine ma'auni mai ƙarfi tsakanin tsarin, wanda ba zai iya zama mai karfi ba ko kuma ma. mai rauni.