Kufunika Kwachipatala Kwa Coagulation


Wolemba: Wolowa m'malo   

1. Nthawi ya Prothrombin (PT)

Imawonetsa makamaka momwe ma exogenous coagulation system, momwe INR imagwiritsidwa ntchito nthawi zambiri kuyang'anira oral anticoagulants.PT ndi chizindikiro chofunikira pakuzindikiritsa prethrombotic state, DIC ndi matenda a chiwindi.Amagwiritsidwa ntchito ngati kuyesa kuyesa kwa exogenous coagulation system komanso ndi njira yofunikira pakuwongolera kwamankhwala oral anticoagulation.

PTA <40% imasonyeza necrosis yaikulu ya maselo a chiwindi ndi kuchepa kwa kaphatikizidwe ka coagulation factor.Mwachitsanzo, 30%

Kutalika kumawonedwa mu:

a.Kuwonongeka kwakukulu komanso kwakukulu kwa chiwindi kumachitika makamaka chifukwa cha kubadwa kwa prothrombin ndi zina zomwe zimapangitsa kuti magazi aziundana.

b.VitK yosakwanira, VitK imayenera kupanga zinthu II, VII, IX, ndi X. Pamene VitK sichikwanira, kupanga kumachepa ndipo nthawi ya prothrombin imatalika.Zimawonekeranso mu obstructive jaundice.

C. DIC (diffuse intravascular coagulation), yomwe imadya kuchuluka kwa zinthu za coagulation chifukwa cha kuchuluka kwa microvascular thrombosis.

d.Neonatal mowiriza kukha magazi, kobadwa nako prothrombin kusowa anticoagulant mankhwala.

Kufupikitsa kumawoneka mu:

Pamene magazi ali mu hypercoagulable state (monga DIC oyambirira, myocardial infarction), thrombotic matenda (monga thrombosis ubongo), etc.

 

2. Thrombin nthawi (TT)

Makamaka amawonetsa nthawi yomwe fibrinogen imasandulika kukhala fibrin.

Kutalikitsa kumawonedwa mu: kuchuluka kwa heparin kapena heparinoid zinthu, kuchuluka kwa AT-III ntchito, kuchuluka kwachilendo ndi mtundu wa fibrinogen.DIC hyperfibrinolysis stage, low (no) fibrinogenemia, abnormal hemoglobinemia, blood fibrin (proto) degradation products (FDPs) zawonjezeka.

Kuchepetsa kulibe tanthauzo lachipatala.

 

3. Activated partial thromboplastin time (APTT)

Imawonetsa kwambiri momwe amkati mwamkati amagwirira ntchito ndipo nthawi zambiri amagwiritsidwa ntchito kuyang'anira mlingo wa heparin.Kuwonetsa milingo ya coagulation factor VIII, IX, XI, XII mu plasma, ndikuyesa kuyesa kwa endogenous coagulation system.APTT imagwiritsidwa ntchito poyang'anira heparin anticoagulation therapy.

Kutalika kumawonedwa mu:

a.Kupanda coagulation zinthu VIII, IX, XI, XII:

b.Coagulation factor II, V, X ndi kuchepetsa fibrinogen ochepa;

C. Pali anticoagulant zinthu monga heparin;

d, zinthu zowonongeka za fibrinogen zawonjezeka;ndi, DIC.

Kufupikitsa kumawoneka mu:

Hypercoagulable state: Ngati mankhwala a procoagulant alowa m'magazi ndipo ntchito ya coagulation factor imawonjezeka, etc.:

 

4.Plasma fibrinogen (FIB)

Makamaka amawonetsa zomwe zili mu fibrinogen.Plasma fibrinogen ndiye mapuloteni ophatikizana omwe ali ndi zinthu zambiri zomwe zimaphatikizana, ndipo ndi gawo loyankha mwachangu.

Kuwonjezeka anawona mu: amayaka, shuga, pachimake matenda, pachimake TB, khansa, subacute bakiteriya endocarditis, mimba, chibayo, cholecystitis, pericarditis, sepsis, nephrotic syndrome, uremia, pachimake m`mnyewa wamtima infarction.

Kuchepetsa kumawoneka mu: Kubadwa kwa fibrinogen zolakwika, DIC kuwononga gawo la hypocoagulation, fibrinolysis yoyamba, chiwindi chachikulu, matenda a chiwindi.

 

5.D-Dimer (D-Dimer)

Imawonetsa makamaka ntchito ya fibrinolysis ndipo ndi chizindikiro chodziwira kukhalapo kapena kusapezeka kwa thrombosis ndi fibrinolysis yachiwiri m'thupi.

D-dimer ndi chinthu china chowonongeka cha fibrin yolumikizana ndi mtanda, yomwe imawonjezeka mu plasma pokhapokha thrombosis, chifukwa chake ndi chizindikiro chofunikira kwambiri cha thrombosis.

D-dimer idakwera kwambiri mu sekondale ya fibrinolysis hyperactivity, koma osati kuchuluka kwa primary fibrinolysis hyperactivity, chomwe ndi chizindikiro chofunikira chosiyanitsa ziwirizi.

Kuwonjezeka kumawoneka mu matenda monga deep vein thrombosis, pulmonary embolism, ndi DIC secondary hyperfibrinolysis.