Muhimmancin Clinical na Coagulation


Marubuci: Magaji   

1. Lokacin Prothrombin (PT)

Yafi nuna yanayin tsarin coagulation na exogenous, wanda yawanci ana amfani da INR don saka idanu akan maganin ciwon ciki.PT alama ce mai mahimmanci don ganewar asali na prethrombotic jihar, DIC da cutar hanta.Ana amfani da shi azaman gwajin gwaji don tsarin coagulation na waje kuma yana da mahimmancin hanyar kula da maganin maganin maganin maganin baka na asibiti.

PTA <40% yana nuna babban necrosis na sel hanta da rage haɓakar abubuwan coagulation.Misali, 30%

Ana ganin tsawaitawa a:

a.Lalacewar hanta mai yawa kuma mai tsanani shine saboda haɓakar prothrombin da abubuwan da ke da alaƙa.

b.Rashin isasshen VitK, ana buƙatar VitK don haɗa abubuwa II, VII, IX, da X. Lokacin da VitK bai isa ba, samarwa yana raguwa kuma lokacin prothrombin ya tsawaita.Ana kuma ganin shi a cikin jaundice mai hanawa.

C. DIC (ya yadu coagulation na intravascular), wanda ke cinye babban adadin abubuwan haɗin gwiwa saboda babban ƙwayar ƙwayar ƙwayar cuta.

d.Zubar da jini ba tare da bata lokaci ba, rashin lafiyar prothrombin na haihuwa.

An gajarta a cikin:

Lokacin da jini yana cikin yanayin hypercoagulable (kamar farkon DIC, ciwon zuciya na zuciya), cututtuka na thrombotic (irin su thrombosis na cerebral), da dai sauransu.

 

2. Lokacin Thrombin (TT)

Yafi nuna lokacin da fibrinogen ya zama fibrin.

Ana ganin tsawaitawa a cikin: haɓakar heparin ko abubuwan heparinoid, ƙara yawan ayyukan AT-III, ƙarancin adadin da ingancin fibrinogen.DIC hyperfibrinolysis mataki, ƙananan (ba) fibrinogenemia, haemoglobinemia mara kyau, fibrin (proto) samfurori na lalata (FDPs) ya karu.

Ragewar ba shi da mahimmancin asibiti.

 

3. Kunna lokaci na thromboplastin (APTT)

Yafi nuna yanayin tsarin coagulation na endogenous kuma galibi ana amfani dashi don saka idanu akan adadin heparin.Nuna matakan abubuwan coagulation na VIII, IX, XI, XII a cikin plasma, gwajin gwaji ne don tsarin coagulation na endogenous.Ana amfani da APTT da yawa don sa ido kan maganin rigakafin heparin.

Ana ganin tsawaitawa a:

a.Rashin abubuwan coagulation na VIII, IX, XI, XII:

b.Factor coagulation II, V, X da rage fibrinogen kadan;

C. Akwai abubuwa masu hana jini jini kamar heparin;

d, samfuran lalata fibrinogen sun karu;e, DIC.

An gajarta a cikin:

Halin hypercoagulable: Idan abun da ke cikin procoagulant ya shiga cikin jini kuma ayyukan abubuwan coagulation yana ƙaruwa, da sauransu:

 

4.Fibrinogen Plasma (FIB)

Yafi nuna abun ciki na fibrinogen.Plasma fibrinogen shine furotin na coagulation tare da mafi girman abun ciki na duk abubuwan coagulation, kuma abu ne mai saurin amsa lokaci.

Ƙara gani a: konewa, ciwon sukari, m kamuwa da cuta, m tarin fuka, ciwon daji, subacute na kwayan cuta endocarditis, ciki, ciwon huhu, cholecystitis, pericarditis, sepsis, nephrotic ciwo, uremia, m myocardial infarction.

Ragewar da ake gani a cikin: rashin daidaituwa na fibrinogen na haihuwa, DIC ɓata lokacin hypocoagulation, fibrinolysis na farko, hepatitis mai tsanani, hanta cirrhosis.

 

5.D-Dimer (D-Dimer)

Yafi nuna aikin fibrinolysis kuma alama ce don sanin kasancewar ko rashin thrombosis da fibrinolysis na biyu a cikin jiki.

D-dimer wani takamaiman samfurin lalacewa ne na fibrin mai haɗin gwiwa, wanda ke ƙaruwa a cikin jini kawai bayan thrombosis, don haka alama ce mai mahimmanci ta ƙwayoyin cuta don gano cutar thrombosis.

D-dimer ya karu sosai a cikin hyperactivity na fibrinolysis na biyu, amma bai karu ba a cikin fibrinolysis hyperactivity na farko, wanda shine muhimmiyar alama don bambanta biyu.

Ana ganin karuwar a cikin cututtuka irin su thrombosis mai zurfi, ciwon huhu, da hyperfibrinolysis na biyu na DIC.