Ho Nahana: Tlas'a maemo a tloaelehileng a 'mele

1. Ke hobane'ng ha mali a phallang methapong ea mali a sa hoama?

2. Ke hobane'ng ha methapo ea mali e senyehileng ka mor'a ts'oaetso e ka khaotsa ho tsoa mali?

Ka lipotso tse ka holimo, re qala thupelo ea kajeno!

Tlas'a maemo a tloaelehileng a 'mele, mali a phalla ka har'a methapo ea mali ea motho' me a ke ke a phalla ka ntle ho methapo ea mali ho baka mali, leha e le hore a ke ke a kopanya methapong ea mali 'me a baka thrombosis.Lebaka le ka sehloohong ke hore 'mele oa motho o na le hemostasis e rarahaneng le e phethahetseng le mesebetsi ea anticoagulant.Ha mosebetsi ona o sa tloaeleha, 'mele oa motho o tla ba kotsing ea ho tsoa mali kapa thrombosis.

1.Ts'ebetso ea Hemostasis

Kaofela ha rōna rea ​​tseba hore tshebetso ya hemostasis 'meleng oa motho ke pele ho khohlela ha methapo ea mali,' me joale ho khomarela, ho kopanya le ho lokolloa ha lintho tse sa tšoaneng tsa procoagulant ea li-platelet ho theha platelet emboli.Ts'ebetso ena e bitsoa hemostasis ea mohato o le mong.

Leha ho le joalo, habohlokoa le ho feta, e etsa hore tsamaiso ea coagulation e sebetse, e theha marang-rang a fibrin, 'me qetellong e theha thrombus e tsitsitseng.Mokhoa ona o bitsoa bobeli ba hemostasis.

2.Coagulation mochine

Ho kopana ha mali ke ts'ebetso eo ho eona lintlha tsa coagulation li etsoang ka tatellano e itseng ho hlahisa thrombin, 'me qetellong fibrinogen e fetoloa fibrin.Ts'ebetso ea coagulation e ka aroloa ka mehato e meraro ea motheo: ho thehoa ha prothrombinase complex, ts'ebetso ea thrombin le tlhahiso ea fibrin.

Coagulation factor ke lebitso le kopaneng la lintho tse amehang ka kotloloho ho coagulation ea mali ho plasma le liseleng.Hajoale, ho na le lintlha tse 12 tsa coagulation tse rehelletsoeng ho latela lipalo tsa Seroma, e leng lintlha tsa coagulation Ⅰ~XⅢ (VI ha e sa nkuoa e le lintlha tse ikemetseng tsa coagulation), ntle le Ⅳ E ka sebopeho sa ionic, 'me tse ling kaofela ke liprotheine.Tlhahiso ea Ⅱ, Ⅶ, Ⅸ, le Ⅹ e hloka ho kenya letsoho ha VitK.

Ho ea ka mekhoa e fapaneng ea ho qala le ho kopanya lintho tse amehang, litsela tsa ho hlahisa li-prothrombinase complexes li ka aroloa ka litsela tsa endogenous coagulation le exogenous coagulation pathways.

Endogenous blood coagulation pathway (e atisang ho sebelisoa APTT test) e bolela hore lintlha tsohle tse amehang maling a coagulation a tsoa maling, ao hangata a qalisoang ke ho kopana ha mali le bokaholimo ba 'mele bo tsoang kantle ho naha (joalo ka khalase, kaolin, collagen). , joalo-joalo);Ts'ebetso ea coagulation e qalisoang ke ho pepesehela ntho ea lisele e bitsoa exogenous coagulation pathway (e atisang ho sebelisoa tlhahlobo ea PT).

Ha 'mele o le boemong ba pathological, endotoxin ea baktheria, e tlatsanang le C5a, li-immune complexes, tumor necrosis factor, joalo-joalo li ka susumetsa lisele tsa vascular endothelial le monocyte ho hlalosa ntlha ea lisele, ka hona ho qala ts'ebetso ea coagulation, e bakang diffuse intravascular coagulation (DIC).

3.Mochine oa anticoagulation

a.Sistimi ea antithrombin (AT, HC-Ⅱ)

b.Sistimi ea protheine C (PC, PS, TM)

c.Tissue factor pathway inhibitor (TFPI)

Mosebetsi: Fokotsa sebopeho sa fibrin le ho fokotsa boemo ba ts'ebetso ea lintlha tse fapaneng tsa coagulation.

4.Mochine oa Fibrinolytic

Ha mali a kopana, PLG e kenngoa ho PL tlas'a ts'ebetso ea t-PA kapa u-PA, e khothalletsang ho qhibiliha ha fibrin le ho etsa lihlahisoa tsa degradation tsa fibrin (proto) (FDP), 'me fibrin e amanang le sefapano e senyeha e le sehlahisoa se itseng.E bitsoa D-Dimer. Ts'ebetso ea tsamaiso ea fibrinolytic e arotsoe haholo-holo ka tsela ea ka hare ea ts'ebetso, tsela ea ka ntle ea ts'ebetso le tsela ea ka ntle ea ts'ebetso.

Tsela ea ts'ebetso ea ka hare: Ke tsela ea PL e entsoeng ka ho phunyeha ha PLG ka tsela ea endogenous coagulation, e leng motheo oa thuto ea fibrinolysis ea bobeli. PLG ho theha PL, e leng motheo oa theory of primary fibrinolysis.Exogenous activation pathway: Lithethefatsi tsa thrombolytic tse kang SK, UK le t-PA tse kenang 'meleng oa motho ho tsoa lefats'eng le ka ntle li ka kenya PLG ho PL, e leng motheo oa theory. phekolo ea thrombolytic.

Ha e le hantle, mekhoa e amehang tsamaisong ea coagulation, anticoagulation, le fibrinolysis e rarahane, 'me ho na le liteko tse ngata tse amanang le laboratori, empa seo re lokelang ho se ela hloko haholoanyane ke ho leka-lekana ho matla pakeng tsa litsamaiso, tse ke keng tsa ba matla haholo kapa haholo. fokolang.