Coagulation - ke eng? Decoding tsa coagulation mali: litsupa le sekhahla

"Coagulation - ke eng?" - ile a botsa makala, bakuli ba romeloa ho nka e and analysis joalo. Ha e le hantle, batho ba tloaelehileng ba tobane le ho ithuta ka tsela e tšoanang infrequently, hangata ka ho lokisetsa bakeng sa ho buuoa elective. Tšoantšetsa a sebetsang a poleloana e reng 'me basali bohle ba baimana. Analysis ea ho coagulation ea jereng ngoana e mong le e mong trimester.

Tlas'a lentsoe hlaka ithuta Mashano tsoa mali. Seta entsprechen ithutile ka 'na ea fapana ho itšetlehile ka laboratoring. and analysis ke e bontsha gore go le malala. Tabeng ea pele e ikemiselitse feela eo ka kotloloho amahanya hoama thulaganyou e tlōla hlahile. Coagulation malala - mofuta oa ho etsa lipatlisiso, e leng, ho phaella ho boleng jo le lithuto tsa ditirisanommogo le likoli. E ka sebelisoa ho fumana maloetse a platelet, thrombosis tse sa tšoaneng, khaello ea lintlha tse itseng hoama le tse ling. D.

E behiloeng ea mekhoa sebediswa ho fumana sephetho itšetlehile ka setshwantsho ea tleleniki, mofuta oa and analysis malwetse. Re lokela ho hlokomela hore tlaleho ea coagulation mali - sena ke phephetso e khōlō eseng feela bakeng sa bao e seng baruti, empa ka linako tse ling le bakeng sa ngaka. Ka tloaelo ho, e le hore ho etsa phumano e nepahetseng, ho nka tse seng kae liteko tse khethiloeng ka hloko.

Tshebetso ya ho coagulation mali

A re hlahlobeng kamoo mesebetsi hoama tsamaiso. Ka mohato oa pele le lik'hemik'hale le phetha molao tshenyo mabota sejana e abetswe thromboplastin - ntho e khethehileng qalisa coagulation itšoara joang. Ka mor'a moo, Tshebediso ya mabaka hoama etsahala - liprotheine tse tobileng tse ka tsela e tloaelehileng kamehla o teng maling le ho fana ka sebaka sa ea bobe ba sejana leboteng thrombus sebopeho.

Ho ekelletsa moo, thrombin (a likoluoa tsa tlhaho karolo ea tsamaiso ea coagulation sephetho ho tswa prothrombin) activates ea khathetseng moeeng protheine fibrinogen fetola hore e be e sebetsang liforomo fibrin clot motheo oa. Metsoako ea mali, ho akarelletsa le li-platelet, "tšoasoa" ka marangrang a fibrin. Ka lebaka leo, li-platelet mali clot khaola le petelitsoe ho theha e hōlileng tsebong thrombus koaloa senya lerako vascular. Ka lehlakoreng le leng, tsamaiso ea mali coagulation 'meleng hape Mesebetsi oona tsamaisong protivosvertyvaniya. Hammoho ba u lumella hore u ho boloka mali ka boemo bo tloaelehileng.

lithuto tsa hoama ka mokhachane

Joalokaha ho se ho boletsoe, e mong le e trimester, 'me maemong a mang' me hangata feta moo, basali ba baimana le tla coagulation. Ke eng 'me ke hobane'ng ha e hlokahala, bo-'mè oa moimana tseba ka ho toba. 'Nete ke hore nakong ea emara lesea mosebetsi ea tsamaiso coagulation ka kakaretso e ntlafala. Ena ke tshebetso tsa tlhaho tse amanang le se bonahalang uteroplacental lesakaneng mali kalafo. 'Mè oa moimana e le ho lokisetsa ho lahleheloa ke khoneha mali ha ba beleha.

Ho khetholla litšobotsi tsa hoama mali le mathata a itseng ba boimana ba hlahiswa coagulation. Feta and analysis ka linako tse ling unscheduled ngaka ka botsa hore na ho na le bopengwi tswa entsprechen tloaelehile hemostatic (dikarolo tsa methapo ea mali le mali, e leng ho o dumella sebelisana boloka botšepehi ha marako vascular le thibela tsoa mali tabeng ea tšenyo e). Mali bakeng sa lithuto tsa nkiloeng hoseng ka mpeng letho ho tswa ho mothapo ka.

Decoding tsa coagulation mali

Sephetho ithuta and analysis lokela ho thibeloa ho setsebi sa. Se nang tsebo e khethehileng, batho ba ke ke ba khona ho hlalosa se boleloang ke entsprechen le coagulation le hlahloba lengolo la bona la kheloha ho tswa ho makgabane tekanyetso. A re ke re leka ho utloisisa intricacies ea tshebetso le hlalosa entsprechen motheo oa thuto.

1. Fibrinogen

protheine ena e tsa maiketsetso ka sebete, ho retelehela tlas'a tšusumetso ea lintlha tse itseng mali ho fibrin. palo ena e lokela ho kenyeletsa coagulation ea mali. Normal fibrinogen - 2-4 g, / k. Ha e ntse e eketseha, ho li bolela'ng hoama eketseha, 'me ho na le ke kotsi ya clots mali. Ka tloaelo ho, boemo bona bo hlaha ka pele a tsoaloa, serame sa matšoafo, ka mor'a ho buuoa, le tshwaetso le ho ruruha ea tlhaho hlobaetsang (lefuba, ntaramane), myocardial infarction le leqeba (letsatsi la pele), le chesa, hypothyroidism, lithibela-pelehi molomo le estrogens. Fokotswa fibrinogen ka 'na ba e loketseng ho toxicity, ho thatafala ha sebete kapa lefu la sebete ka mokgwa matla, e le khaello ea vithamine B12 kapa C fumana androgens anabolic steroid, oli tlhapi, anticoagulants.

2. butswe leeme thromboplastin nako (APTT)

Coagulation hlahloba nako eo ka eona, ka mor'a mabapi ho chloride lero la mali k'halsiamo le lintho tse ling thehoa mali clot. Haeba bonyane le nngwe coagulation Ntho e ke tlase ntho e tloaelehileng le ka liphesente tse 30-40, aPTT phetoho boemong ba. Sekhahla karolelano ke metsotsoana 30-40. nako eo a ka eketsa le vithamine ea K khaello, lefu sebete. The le lebaka la ho prolonging le aPTT le ka lebaka leo, ea liehang coagulation ka ba hemophilia.

3. Lupus anticoagulant

paramethara ena kamehla e na le coagulation. ke eng palo ee? Ke mang ea tla bolella. Sena IgC antibody le IgM, entailing e leng keketseho ea aPTT. Ka tloaelo, basali ba baimana, ha baa lokela ho hlahisoa. Lisireletsi hlaha tabeng ea mafu a autoimmune, gestosis. Boimana le bolwetse ena hangata e fella ka ho ntša mpa ho itlelang feela, e leng lefu fetal kapa infarction ya placenta ho.

4. Prothrombin

Ho e rarahaneng protheine eo ke selelekela sa thrombin (a protheine hore di hlohleletsago sebopeho sa clots mali). Sena ke e mong oa ke litsupa bohlokoa ka ho fetisisa coagulation. Prothrombin, le ho kenya letsoho oa vithamine ea K e tsa maiketsetso ka sebete. Ka mor'a ho hlahloba boleng ena, ngaka e ka khetholla bolwetse gastrointestinal pampitsana le sebete.

5. Nako prothrombin

Nako e leng nakong eo lero la mali ka ho eketsa tlhokeng chloride k'halsiamo, thromboplastin le fibrin clot thehoa. palo ena e bontšitsoeng ka metsotsoana e 'me ke ka tsela e tloaelehileng ba lekanang 11-15.

6. Prothrombin-index (PTI)

Coagulation hangata e akarelletsa ho hantle khetho ena ho ena le ho ea pele. karo-karolelano ena ke nako e hoama ya lero la mali tse tloaelehileng tsa batho le lero la mali a le mamello, a bontša e le karolo e itseng. Ka tsela e tloaelehileng prothrombin karo-karolelano e lokela ho fapana pakeng tsa liphesente tse 93-107. Lintlha tsa paramethara ena di tsa maiketsetso ka lisele tsa tsona li sebete, lefu le sebete palo ea tsona e fokotsehile, kahoo IPT kgona ho ea bohōleng bo itseng ba sebeletsa e le paramethara ho beha boemo ba 'mele oa tshebetso.

Ha PTI eketseha, kahoo hoama e eketseha, 'me ho na le ke kotsi ya thrombosis. Kgolo ya ka etsahala ha noa lithibela-pelehi molomo le ka likhoeli tse fetileng tsa nkile ngoana. Phokotso ea prothrombin index ea bontša senyeha thepa mali coagulation. Sebopeho sa lintlha prothrombin rarahaneng itšetlehile ka vithamine ea K, joalo mosing lona, malabsorption ka intestine le (dysbacteriosis, enterocolitis) le ka 'na ho kenyelletsa phokotso IPT. Hape, sena e ka fella ka hore ho nka tekanyetso e phahameng ea aspirini, diuretics.

7. Thrombin nako

Ena ke nako eo ka eona fibrinogen e fetoloa fibrin. boleng lona normative - metsotsoana 15-18. Keketseho ea li-index ena e hlokomela ka ho hloka congenital tsa fibrinogen kapa tshenyo e matla sebete. Phokotso ea paramethara, ke hore, phokotsong ea nako thrombin, e bontša ho ba teng ha paraprotein (immunoglobulin protheine) kapa e fetang fibrinogen. Ka tloaelo ho, ho pontshi boleng taolo nakong fibrinolytics kalafo kapa heparin.

8. Antithrombin III

Ke sesitisa tsa thrombin, tsamaiso protheine anticoagulation. O na le phello e tepeletsang maikutlo ka tsamaiso e coagulation. Level pontshi laolwang ke tlama tsa thrombin ka sampole teko (thibelo). Karolelano ea boleng ba antithrombin III - liphesente tse 71-115. Phokotso bophirima ho karolo ea 50 lekholong ea ho tloaelehile akarelletsa monyetla oa hore thrombosis.

Tlhaloso ya pontshi ena ke bohlokoa ka ho khetheha bakeng sa basali ba baimana noa anticoagulants. lithethefatsi tsena li ka sebelisoang ka ngoana o jereng, ha mali hoama e ntse e eketseha, 'me ha ho na le kotsi ea sebopeho sa insufficiency placental, ho ima qetello.

9. D-dimer

Sena ke e pontshi bohlokoa bakeng sa fumanoe tsa thrombosis, e kenyeletsang coagulation. paramethara Sena se bontša? O senola le thulaganyo ya thrombosis le fibrinolysis. Ka tloaelo, D-dimer e ka tlase ho 248 Ng / ml tse. Kofuto boemong ba e qala ho hōle ka mekhahlelo ea pele ea bokhachane. Ho siea boleng paramethara ka 'na feta ka lekhetlo la pele ka makhetlo a mararo ho a mane. E nkoa e le ntho e tloaelehileng. A sekhahla e phahameng ka ho basali ba nang le 'nete hore e rarahaneng ea bokhachane (preeclampsia), hammoho le ba neng ba le bothata ba ho lefu liphio, lefu la tsoekere.

10. li-platelet

E amehang ka ho fana ka hemostasis liplatelete. Di thehoa e moko masapo. Normative boleng - 150-400 likete / ml tse. Maemong a mang, ho basali ba phela hantle ka ba le ea fokotseha ka platelet bala ho 130 tse likete tse. / L. Bohlokoa fokotseha ka likarolo ya data mali bitsoa "thrombocytopenia" le hlaha ka lebaka la ho fokotsa sebopeho sa liplatelete, e ntseng e eketseha tshebediso ya bona kapa timetso. Le phepo e nepahetseng lekana fokotswa platelet sebopeho. Ka DIC, e leng tla tšohloa mona ka tlase, ho hlalosoa lisele tse bopehileng mali ea eketseha.

11. DIC

Sebelisana tsa li-platelet, lintlha coagulation le thulaganyo fibrinolysis fana ho leka-lekana pakeng tsa coagulation le anticoagulation tsamaiso ea. Ha e 'ngoe ea maqhama ana tla feta mafu a ka ho ima ho ka etsa hore ba bang ba mathata a tebileng. The kotsi ka ho fetisisa oa bona o disseminated intravascular coagulation. E develops ka lebaka la ho Tshebediso ya a tsamaiso fibrinolytic le tsamaiso coagulation. Ka basali ba baimana, lisosa tsa DIC ka 'na ba amniotic mokelikeli embolism, pele ho nako detachment ya placenta ho, endometritis.

12. lefu antiphospholipid (APS)

Ho e rarahaneng matšoao hore khethollang thrombosis (venous le ea bohlokoa). Basali ba nang le APS ba le kotsing e khōlō ea ho senyeheloa le ketsahalo e ea ho ntša mpa ho itlelang feela, hobane tabeng ena ea ho eketseha ha palo ea lijana tsa placenta e tšoenngoa le ho ntshetsa pele fetoplacental insufficiency. Ho hlahloba lefu-ba khahlanong le phospholipid, e ile ea eketseha thrombogenesis ho phaella moo, e boetse e khona ho utloa lisireletsi ho lera la ka ntle shell a (phospholipids).

Qetellong

coagulation nkoa litsupa ha fago. Joalokaha ho boletsoe ka holimo, tlhopho ya ditekanyetso itseng bakeng sa thuto e itšetlehile ka lintho tse fapa-fapaneng. Diphetho tsa and analysis e tla fumaneha letsatsi le hlahlamang ka mor'a ho mali.