1. Ka manawa prothrombin (PT):
Hōʻike ka PT i ka manawa e pono ai no ka hoʻololi ʻana o ka prothrombin i thrombin, e alakaʻi ana i ka coagulation plasma, e hōʻike ana i ka hana coagulation o ke ala coagulation extrinsic.Hoʻoholo nui ʻia ka PT e nā pae o nā kumu coagulation I, II, V, VII, a me X synthesized e ke ake.ʻO ke kumu coagulation koʻikoʻi ma ke ala coagulation extrinsic ʻo ka helu VII, ka mea i hoʻokumu i ka FVIIa-TF paʻakikī me ka kiko kiko (TF)., ka mea e hoʻomaka i ke kaʻina coagulation extrinsic.He pōkole ka PT o nā wāhine hāpai maʻamau ma mua o nā wāhine hāpaiʻole.Ke emi nā kumu X, V, II a i ʻole I, hiki ke hoʻolōʻihi ʻia ka PT.ʻAʻole pili ka PT i ka nele o kahi kumu coagulation hoʻokahi.Hoʻolōʻihi nui ʻia ka PT ke hāʻule ka neʻe o ka prothrombin ma lalo o 20% o ka pae maʻamau a hāʻule nā kumu V, VII, a me X ma lalo o 35% o ka pae maʻamau.Ua hoʻolōʻihi ʻia ka PT me ka hoʻokahe ʻole ʻana i ke koko.Hōʻike ʻia ka manawa prothrombin i ka wā hāpai i ka maʻi thromboembolic a me nā kūlana hypercoagulable.Inā he 3 s ka lōʻihi o ka PT ma mua o ka mana maʻamau, pono e noʻonoʻo ʻia ka ʻike o DIC.
2. Ka manawa thrombin:
ʻO ka manawa Thrombin ka manawa no ka hoʻololi ʻana o fibrinogen i fibrin, hiki ke hōʻike i ka maikaʻi a me ka nui o ka fibrinogen i loko o ke koko.Hoʻopau ʻia ka manawa thrombin i nā wahine hāpai maʻamau i hoʻohālikelike ʻia me nā wahine hāpai ʻole.ʻAʻohe loli nui i ka manawa thrombin i ka wā hāpai.ʻO ka manawa Thrombin kekahi mea maʻalahi no nā huahana degradation fibrin a me nā loli i ka ʻōnaehana fibrinolytic.ʻOiai ua pōkole ka manawa thrombin i ka wā hāpai, ʻaʻole nui nā loli ma waena o nā wā hāpai like ʻole, e hōʻike ana hoʻi i ka hoʻoikaika ʻana o ka ʻōnaehana fibrinolytic i ka wā hāpai maʻamau., e kaulike a hoʻonui i ka hana coagulation.Ua hana ʻo Wang Li et al [6] i kahi haʻawina hoʻohālikelike ma waena o nā wahine hāpai maʻamau a me nā wahine hāpai ʻole.ʻOi aku ka pōkole o nā hopena hoʻāʻo manawa thrombin o ka pūʻulu wahine hāpai hope ma mua o ka pūʻulu hoʻomalu a me nā pūʻulu hāpai mua a me waena, e hōʻike ana ʻoi aku ka kiʻekiʻe o ka thrombin time index i ka pūʻulu hāpai hope ma mua o ka PT a me ka thromboplastin ʻāpana hoʻāla.ʻOi aku ka maʻalahi o ka manawa (ʻāpana thromboplastin manawa, APTT).
3. APTT:
Hoʻohana nui ʻia ka manawa thromboplastin ʻāpana e ʻike i nā loli i ka hana coagulation o ke ala coagulation intrinsic.Ma lalo o nā kūlana physiological, ʻo nā kumu coagulation nui i komo i ke ala coagulation intrinsic ʻo XI, XII, VIII a me VI, a he mea nui ka coagulation factor XII i kēia ala.ʻO XI a me XII, prokallikrein a me excitogen kaumaha kiʻekiʻe e komo pū i ka pae hoʻopili o ka coagulation.Ma hope o ka ho'ā ʻana o ka pae hoʻopili, hoʻāla ʻia ʻo XI a me XII, a laila hoʻomaka i ke ala coagulation endogenous.Hōʻike nā moʻolelo moʻokalaleo i ka hoʻohālikelike ʻia me nā wahine hāpai ʻole, ua pōkole ka manawa thromboplastin ʻāpana i ka wā hāpai maʻamau i ka wā hāpai, a ʻoi aku ka pōkole o ka lua a me ke kolu o ka trimesters ma mua o ka wā mua.ʻOiai i ka wā hāpai maʻamau, hoʻonui ʻia nā kumu coagulation XII, VIII, X, a me XI e like me ka hoʻonui ʻana o nā wiki gestational i ka wā hāpai, no ka mea, ʻaʻole hiki ke loli ka coagulation factor XI i ka lua a me ke kolu trimesters o ka hāpai ʻana, ka hana coagulation endogenous holoʻokoʻa I ka waena. a ʻaʻole ʻike ʻia nā loli.
4. Fibrinogen (Fg):
Ma ke ʻano he glycoprotein, hana ia i ka peptide A a me ka peptide B ma lalo o ka thrombin hydrolysis, a i ka hopena e hana i ka fibrin insoluble e hoʻōki i ke koko.He kuleana koʻikoʻi ka Fg i ke kaʻina hana o ka platelet aggregation.Ke hoʻoikaika ʻia nā platelets, ua hoʻokumu ʻia ka fibrinogen receptor GP Ib/IIIa ma ka membrane, a ua hoʻokumu ʻia nā platelet aggregates ma o ka hoʻopili ʻana o Fg, a ma hope o ka thrombus.Eia kekahi, ma ke ʻano he protein reactive acute, ʻo ka piʻi ʻana o ka plasma concentration o Fg e hōʻike ana aia kahi hopena inflammatory i loko o nā kīʻaha koko, hiki ke hoʻopilikia i ka rheology koko a ʻo ia ka mea nui o ka viscosity plasma.Hoʻopili pololei ia i ka coagulation a hoʻonui i ka platelet aggregation.Ke hiki mai ka preeclampsia, pi'i nui nā pae Fg, a i ka wā i ho'emi 'ia ai ka hana coagulation o ke kino, e emi ana nā pae Fg.Ua hōʻike ʻia he helu nui o nā haʻawina retrospective ʻo ka pae Fg i ka manawa o ke komo ʻana i ke keʻena hānai ʻo ia ka hōʻailona koʻikoʻi no ka wānana ʻana i ka hiki ʻana o ka hemorrhage postpartum.ʻO 100% ka waiwai wānana maikaʻi [7].I ke kolu o ka trimester, ʻo ka plasma Fg ma ke ʻano he 3 a 6 g/L.I ka wā o ka hoʻoulu ʻana o ka coagulation, ʻoi aku ka nui o ka plasma Fg e pale i ka hypofibrinemia.I ka wā wale nō e hiki ai i ka plasma Fg>1.5 g/L ke hōʻoia i ka hana coagulation maʻamau, i ka wā o ka plasma Fg<1.5 g/L, a i nā hihia koʻikoʻi Fg<1 g/L, pono e uku ʻia ka nānā ʻana i ka pilikia o DIC, a pono e nānā ʻia ka loiloi ikaika. hāpai i waho.Ke nānā nei i nā hoʻololi bidirectional o Fg, pili ka ʻike o Fg i ka hana o ka thrombin a he hana koʻikoʻi i ke kaʻina o ka platelet aggregation.I nā hihia me ka Fg kiʻekiʻe, pono e uku ʻia ka nānā ʻana i nā hōʻailona pili i ka hypercoagulability a me nā antibodies autoimmune [8].Ua hoʻohālikelike ʻo Gao Xiaoli lāua ʻo Niu Xiumin [9] i ka plasma Fg maʻiʻo o nā wahine hāpai me ka maʻi diabetes gestational a me nā wahine hāpai maʻamau, a ʻike ʻia ua pili maikaʻi ka ʻike o Fg me ka hana thrombin.Aia kahi ʻano o ka thrombosis.