Coagulation - chii? Decoding ropa coagulation: zviratidzo uye mwero

"Coagulation - chii?" - vaibvunza kushamisika, varwere vari vakatumwa kutora kuongorora zvakadaro. Kutaura zvazviri, vanhuwo nezvinoda akafanana kudzidza Kazhinji kazhinji mukugadzirira zvokuwedzera kuvhiyiwa. Emblem rinoita izwi nevakadzi zvose pamuviri. Kuongororwa coagulation muitiro akatakura mwana ose trimester.

Under shoko kujeka kudzidza nhema ropa. Isa vadzidza parameters dzingasiyana zvichienderana murabhoritari. The kuongorora unodoma muAtlantic. Muchiitiko chokutanga zvikaonekwa chete umo zvakananga vanobatanidza pakugwamba muitiro kutyora kwakaitika. Coagulation muAtlantic - mhando tsvakurudzo, izvo, kuwedzera Qualitative uye zvidzidzo quantitative uye zvikanganiso. Inogona kushandiswa kuziva platelet zvinetso, siyana thrombosis, kushayiwa zvimwe pakugwamba zvinhu uye zvakafanana. D.

Yakatarwa nzira yaishandiswa kuwana mugumisiro kunobva kunotoda mufananidzo, mhando zvokurwara kuongorora. Zvinofanira kucherechedzwa kuti inopangidza ropa coagulation - ichi kwakaoma guru kwete chete nokuda munhuwo zvake, asi dzimwe nguva kuti chiremba. Kazhinji, kuti kuongororwa zvakarurama, zvinotora mashomanana akanyatsosarudzwa nemiedzo.

Muitiro ropa coagulation

Ngatimboonai kuti pakugwamba hurongwa mabasa. In wokutanga danho makemikari kana zvokuimba kukuvara mudziyo masvingo ari dzinounzwa thromboplastin - chaiyo fuma triggering coagulation kuita. Zvadaro, activation pakati pakugwamba zvinhu kunoitika - dzakananga mapuroteni kuti kazhinji nguva dzose aripo muropa uye anopa nzvimbo kukuvara ari mudziyo rusvingo thrombus inotungamirwa.

Uyezve, thrombin (a dzinongoitika chezvinonhuwira ari coagulation ino kunobva prothrombin) zvaanopa simba kuti akaneta mapuroteni fibrinogen, vatendeuki ive inoshingaira fibrin clot siyana hwaro. Pezvokuvamba ropa, kusanganisira maplatelet, "Varasa" iri samambure fibrin. Somugumisiro, ropa maplatelet clot akagura uye chakatsindirwa kuumba akura thrombus wokugumisa kukuvadza vascular rusvingo. Mukusiyana, ropa coagulation wemuTesitamende muviri zvakare chinoshanda protivosvertyvaniya hurongwa. Pamwe chete vanobvumira kuti kuramba ropa mu hwandaiva ezvinhu.

pakugwamba dzepamusha pamuviri

Sezvambotaurwa, mumwe trimester, uye mune zvimwe zviitiko uye kakawanda, vakadzi vane pamuviri anofanira coagulation. Chii uye nei zvakakodzera, vanaamai pamuviri vanoziva akazvionera. Chokwadi ndechokuti panguva gestation mwana basa coagulation ezvinhu seboka inowedzerwa. Uyu dzinongoitika muitiro chokuita zvinooneka uteroplacental ropa denderedzwa kurapwa. Amai vanepamuviri saka kugadzirira zvinoita kurasikirwa neropa pakusununguka.

Kuziva zviri kweropa uye mamwe matambudziko akazvitakura anobudiswa coagulation. Pass ongororo pane unscheduled nguva chiremba anogona kukumbira kana paine zvarakasiya kubva chakaipa hemostatic parameters (zvinoumba ropa uye ropa midziyo, iro anobvumira kudyidzana kuramba kuvimbika vascular masvingo uye kurega ropa kana kukuvara). Ropa nokuti zvidzidzo kubatwa mangwanani usina chawadya kubva tsinga.

Decoding ropa coagulation

Kudzidza migumisiro kuongorora anofanira kungopfeka nyanzvi. Not nezivo inokosha, vanhu havazokwanisi kuti decipher ari coagulation parameters uye kuongorora dhigirii kwavo yakatsauka kubva vomureza tsika. Ngatiedzei kunzwisisa nezvehukorokodzwa kwacho uye rinotsanangura dzinokosha parameters kudzidza.

1. Fibrinogen

mapuroteni Izvi synthesized ari chiropa, akatendeuka pasi pokudzora zvimwe zvokufunga fibrin ropa. Nhamba iyi inofanira kusanganisira coagulation ropa. Normal fibrinogen - 2-4 g / l. Kana zvikava, Zvichakadaro pakugwamba ikawanda, uye pane mukana ropa. Kazhinji, izvi kunoitika asati aberekwa, mabayo, pashure pokuvhiyiwa, pamwe chirwere uye kuzvimba rikwanise hunhu (tibhii, yokuSpain), myocardial infarction uye ronda (zuva rokutanga), pamwe kutsva, hypothyroidism, nemumuromo nhumbu uye estrogens. Akaderedza fibrinogen kungava nokuda toxicity, cirrhosis kana kuzvimba chiropa iri huru chimiro, kushayikwa vhitamini B12 kana C kugamuchira androgens anabolic steroids, mafuta hove, anticoagulants.

2. Activated haasaruri thromboplastin nguva (APTT)

Coagulation anoongorora panguva iyo, pashure riine yeplasma karusiyamu chloride uye zvimwe zvinhu kuumbwa ropa clot. Kana pane imwe coagulation chacho pasi wokuyera 30-40 muzana, aPTT yakati change. Avhareji zvazvingava ndiyo 30-40 seconds. The nguva kungawedzera pamwe vhitamini K kushaikwa, chiropa chirwere. Chikonzero nguva refu ari aPTT uye Somugumisiro, anonoke coagulation zvinogona hemophilia.

3. Lupus anticoagulant

parameter ichi nguva dzose rine coagulation. Chii chinonzi mufananidzo uyu? Ndiani vachakuudza. Izvi antibody IgC uye IgM, entailing nokuwedzera aPTT. Kazhinji, vakadzi pamuviri, varege kubudiswa. Antibodies kuonekwa kune autoimmune zvirwere, gestosis. Pregnancy pamwe zvokurwara ichi kazhinji kuguma vaingoerekana pamuviri, fetus rufu kana infarction yacho placenta.

4. Prothrombin

Chinhu kunzwisisa mapuroteni kuti ari aizotangira kuti thrombin (a puroteni kuti kunomutsa paumbwe ropa clots). Ichi chimwe chezvinhu zvinokosha zviratidzi ose coagulation. Prothrombin, pamwe nekupinda vhitamini K iri synthesized mune chiropa. Aongorora kukosha ichi, chiremba anogona kuzivisa zvokurwara nemudumbu uye chiropa.

5. The prothrombin nguva

The panguva iyo plasma nokuwedzera kwazviri karusiyamu chloride, thromboplastin uye fibrin clot aumba. Nhamba iyi runoratidzwa masekonzi uye dzinowanzoona kuenzana 11-15.

6. Prothrombin indekisi (PTI)

Coagulation zvinowanzosanganisira chaizvo nezvechisarudzo ichi pachinzvimbo yapfuura mumwe. reshiyo Ndiyo pakugwamba nguva dzose dzevanhu yeplasma uye plasma murwere, akaratidza kuva chikamu. In kwomuzvarirwo prothrombin reshiyo vanofanira siyana pakati 93-107 muzana. Zvinhu zviri parameter ichi vari synthesized ari chiropa mumasero, chiropa chirwere nhamba yavo ipfupi, saka IPT vanokwanisa pamwero wakati vanoshumira parameter nokuda Pakusarudza dzichipfekeka mamiriro muviri.

Kana PTI yakawedzera, saka pakugwamba rwuchiwanzwa, uye pane mukana thrombosis. Kukura anogona kuitika kana achitora dzinogamuchidzanwa nhumbu uye okupedzisira mwedzi akatakura mwana. Rutapudzo of prothrombin indekisi kunoratidza Kuipa ropa coagulation zvivako. Paumbwe prothrombin kunzwisisa zvinhu runotsamira vhitamini K, zvisinei ayo chinetso, malabsorption ari ura (dysbacteriosis, enterocolitis) uye kungada rutapudzo IPT. Uyewo, izvi zvinogona kutora dzakakwirira mishonga kuti aspirin, diuretics.

7. Thrombin nguva

Iyi ndiyo nguva panguva iyo fibrinogen iri kuva fibrin. Its normative ukoshi - 15-18 seconds. Kuwedzera indekisi ichi kuchengetwa panguva vachiberekwa kusava fibrinogen kana zvakakomba kukuvara chiropa. Rutapudzo pamusoro parameter, kureva rutapudzo pamusoro thrombin nguva, inoratidza kuvapo paraprotein (immunoglobulin mapuroteni) kana nekumwisa fibrinogen. Kazhinji, kuti chinoratidza ukoshi kuzvidzora panguva kurapwa fibrinolytics kana heparin.

8. Antithrombin III

It is inhibitor pamusoro thrombin, imwe puroteni anticoagulation hurongwa. Ane mwoyo zvainoita coagulation rikurumidze. Level chakarurama pakutsvaga nokusungwa thrombin pabvunzo yokuenzanisira (chinovhiringidza). Average ukoshi antithrombin III - 71-115 muzana. Rutapudzo marongero kuti 50 muzana dzose rinobatanidza mukana thrombosis.

Tsanangudzo chakarurama izvi kunyanya kukosha kuti vakadzi vane pamuviri nekutora anticoagulants. zvinodhaka izvi zvinoshandiswa nekubereka, kana ropa pakugwamba rwuchiwanzwa, uye pane ngozi inotungamirwa placental insufficiency, pamuviri kugumiswa.

9. D-dimer

Izvi zvinokosha chakarurama kuti chirwere ose thrombosis, izvo zvinosanganisira coagulation. parameter Izvi zvinoratidza? Zvaanozivisa dzinotsanagura thrombosis uye fibrinolysis. Kazhinji, D-dimer idukusa 248 Ng / Rine mamiririta. The sandara chakarurama iri kutanga kukura tanga pamuviri. Kusiya parameter ukoshi anogona kusapfuudza kutanga nhatu mana nguva. Zvinonzi vaiona vasingambooni chakaipa nazvo. A pangozi mune vakadzi vane yakaoma nzira pamuviri (preeclampsia), uyewo vaya vanotambura cheitsvo, chirwere cheshuga.

10. maplatelet

It chinodiwa kupa hemostasis maplatelet. Ivo achiumbwa mumwongo. Normative ukoshi - 150-400 zviuru / Rine mamiririta. Mune zvimwe zviitiko, vakadzi utano vanogona vasanyanye platelet kuverenga kusvika 130 zviuru. / L. Rinokosha kuderera ropa Data zvinhu anonzi "thrombocytopenia" uye rinooneka somugumisiro kuderedza paumbwe maplatelet, kuwedzera vapera kana kuparadzwa. With kukwana zvokudya akaderedza platelet inotungamirwa. Pana DIC, iyo ichakurukurwa pazasi ichirondedzerwa shaped ropa masero kunowedzera.

11. DIC

Kusakarongeka pakati maplatelet, coagulation zvinhu uye fibrinolysis kwacho rinopa pakati nepakati coagulation uye anticoagulation enyika. Kana chipi Links izvi vachatongerwa zvinetso zviri pamuviri kunogona kukonzera mamwe matambudziko zvakakomba. Inonyanya ngozi vavo neakangwara intravascular coagulation. Inokudziridza somugumisiro wacho activation pakati fibrinolytic ino uye coagulation gadziriro. Vakadzi vane pamuviri, zvinokonzera DIC angava Líquido mvura embolism, kukurumidza yokuzviparadzanisa pamusoro placenta, endometritis.

12. The antiphospholipid syndrome (APS)

Zviri kunzwisisa zviratidzo izvo zvaizobatsira thrombosis (venous uye arterial). Vakadzi APS vane yakakwirira mukana nokupfupfudzika uye panowanikwa vaingoerekana pamuviri, nokuti ichi kana kuwedzera uwandu nhumbi placenta akashatirwa uye kukura fetoplacental insufficiency. Rokuongorora Anti-phospholipid urwere, yakawedzera thrombogenesis mukuwedzera, uyewo wanikidza antibodies kuchivanze goko membranes (phospholipids).

In mhedziso

coagulation vaiona zviratidzo havasi dzoga. Sezvataurwa pamusoro apa, kusarudzwa chaiyo parameters chidzidzo kunoenderana siyana zvinokonzera pamusoro. Results of kuongorora achava kuwanikwa rakatevera kupa ropa.