Iche echiche: N'okpuru ọnọdụ physiological nkịtị

1. Gịnị mere na ọbara na-eru na arịa ọbara anaghị agbakọ?

2. Gịnị mere arịa ọbara mebiri emebi mgbe trauma nwere ike ịkwụsị ọbara ọgbụgba?

Site n'ajụjụ ndị dị n'elu, anyị na-amalite nkuzi nke taa!

N'okpuru ọnọdụ physiological nkịtị, ọbara na-asọba n'ime arịa ọbara mmadụ ma ọ gaghị eruba n'èzí arịa ọbara iji mee ka ọbara ọgbụgba, ma ọ bụ na ọ gaghị agbakọta n'ime arịa ọbara ma mee ka thrombosis.Isi ihe kpatara ya bụ na ahụ mmadụ nwere mgbagwoju anya na hemostasis zuru oke na ọrụ anticoagulant.Mgbe ọrụ a na-adịghị mma, ahụ mmadụ ga-anọ n'ihe ize ndụ nke ọbara ọgbụgba ma ọ bụ thrombosis.

1.Hemostasis usoro

Anyị niile maara na usoro nke hemostasis na ahụ mmadụ bụ nke mbụ mkpụkọ nke arịa ọbara, na mgbe ahụ adhesion, nchịkọta na ntọhapụ nke dị iche iche procoagulant bekee nke platelet na-etolite adụ platelet emboli.A na-akpọ usoro a hemostasis otu ogbo.

Agbanyeghị, nke kachasị mkpa, ọ na-eme ka sistemu coagulation rụọ ọrụ, mepụta netwọkụ fibrin, wee mepụta thrombus kwụsiri ike.A na-akpọ usoro a hemostasis nke abụọ.

2.Coagulation usoro

Mkpokọta ọbara bụ usoro nke na-eme ka ihe ndị na-akpata coagulation na-arụ ọrụ n'otu oge iji mepụta thrombin, na n'ikpeazụ fibrinogen na-agbanwe ghọọ fibrin.Enwere ike kewaa usoro coagulation n'ime usoro atọ bụ isi: nhazi nke mgbagwoju prothrombinase, ịgbalite thrombin na mmepụta fibrin.

Ihe na-akpata coagulation bụ aha mkpokọta nke ihe ndị na-etinye aka na coagulation ọbara na plasma na anụ ahụ.Ugbu a, enwere ihe coagulation 12 akpọrọ dị ka ọnụọgụ Rome si dị, ya bụ coagulation factor Ⅰ~XⅢ (a naghị ele VI anya dị ka ihe na-akpata coagulation nọọrọ onwe ya), ewezuga Ⅳ Ọ dị n'ụdị ionic, ndị ọzọ bụ protein.Mmepụta Ⅱ, Ⅶ, Ⅸ, na Ⅹ chọrọ nsonye nke VitK.

Dị ka ụzọ dị iche iche nke mmalite na coagulation ihe metụtara, ụzọ maka imepụta prothrombinase complexes nwere ike kewaa n'ime endogenous coagulation ụzọ na exogenous coagulation ụzọ.

The endogenous ọbara coagulation ụzọ (nke a na-ejikarị APTT ule) pụtara na ihe niile na-etinye aka na coagulation ọbara na-esite n'ọbara, nke a na-ebutekarị site na kọntaktị ọbara na elu ahụ nke mba ọzọ na-adịghị mma (dị ka iko, kaolin, collagen). , wdg);Usoro coagulation malitere site na ikpughe na ihe anụ ahụ ka a na-akpọ ụzọ coagulation exogenous (nke a na-ejikarị PT ule).

Mgbe ahụ nọ n'ọnọdụ ọnọdụ ọrịa, nje bacteria endotoxin, complement C5a, complexes na-alụso ọrịa ọgụ, ụbụrụ necrosis factor, wdg nwere ike kpalie sel endothelial vaskụla na monocytes iji gosipụta ihe anụ ahụ, si otú ahụ na-amalite usoro coagulation, na-eme ka coagulation intravascular gbasaa (DIC).

3.Anticoagulation usoro

a.Sistemụ Antithrombin (AT, HC-Ⅱ)

b.Sistemụ Protein C (PC, PS, TM)

c.Ihe mgbochi ụzọ ihe mgbochi anụ ahụ (TFPI)

Ọrụ: Belata nguzobe fibrin ma belata ọkwa ịgbalite ihe dị iche iche coagulation.

4.Fibrinolytic usoro

Mgbe ọbara na-agbakọta, PLG na-arụ ọrụ n'ime PL n'okpuru ọrụ nke t-PA ma ọ bụ u-PA, nke na-akwalite mgbasa nke fibrin ma mepụta fibrin (proto) ngwaahịa deradaration (FDP), na fibrin jikọtara ya na-emebi dị ka ngwaahịa a kapịrị ọnụ.A na-akpọ D-Dimer. A na-ekewa ntinye nke usoro fibrinolytic n'ime ụzọ ntinye nke ime, ụzọ ntinye aka na mpụga.

Inner activation pathway: Ọ bụ ụzọ nke PL kpụrụ site na mgbawa nke PLG site na endogenous coagulation ụzọ, nke bụ usoro ihe ndabere nke abụọ fibrinolysis. External activation ụzọ: Ọ bụ ụzọ nke t-PA wepụtara site na vaskụla endothelial mkpụrụ ndụ cleaves. PLG na-etolite PL, nke bụ usoro iwu ndabere nke isi fibrinolysis.Exogenous activation ụzọ: thrombolytic ọgwụ dị ka SK, UK na t-PA nke na-abanye n'ahụ mmadụ site n'èzí ụwa nwere ike rụọ ọrụ PLG n'ime PL, nke bụ usoro iwu ndabere nke. ọgwụgwọ thrombolytic.

N'ezie, usoro ndị na-etinye aka na coagulation, anticoagulation, na usoro fibrinolysis dị mgbagwoju anya, na e nwere ọtụtụ nyocha ụlọ nyocha metụtara ya, ma ihe anyị kwesịrị ilebara anya karị bụ nguzozi ike n'etiti usoro ahụ, nke na-enweghị ike ịdị ike ma ọ bụ oke. adịghị ike.