Chii chinonzi Coagulogram uye zvinoitwa sei?

Zvemukati

• Chii ichochi
• Zvinoitwa sei
• Coagulogram bvunzo
• 1.Kubuda ropa nguva (TS)
• 2. Prothrombin nguva (TP)
• 3. Yakagadziriswa Chikamu Chikamu Thromboplastin Nguva (APTT)
• 4. Thrombin nguva (TT)
• 5. Huwandu hwemaplatelet

Iyo coagulogram inoenderana neboka rekuyedzwa kweropa rakakumbirwa nachiremba kuti aongorore nzira yekuvhara ropa, achiratidza chero shanduko uye zvichidaro kuratidza kurapwa kwemunhu kuitira kuti arege kunetseka.

Muedzo uyu unokumbirwa kunyanya usati wavhiyiwa kuti uongorore njodzi yemurwere yekubuda ropa panguva yekuita, semuenzaniso, uye inosanganisira kubuda ropa nguva, prothrombin nguva, yakagadziriswa chikamu chetromboplastin nguva, nguva yetrombin uye kuongorora huwandu hwemaplatelet.

Chii ichochi

Iyo coagulogram inoratidzirwa kunyanya kusati kwavhiyiwa, asi inogona zvakare kukumbirwa nachiremba kuti aongorore chinokonzera chirwere chehematological uye kutarisa njodzi yetrombosis, kunyanya mumadzimai anoshandisa nzira dzekudzivirira.

Uye zvakare, iyo coagulogram inoratidzirwa mushure mekurumwa kwemhuka ine chepfu inogona kupindira mukugwamba uye mukutarisa kwevanhu vanoshandisa anticoagulants, senge Heparin naWarfarin, semuenzaniso. Ziva mamwe maanticoagulants uye pavanoratidzwa.

Zvinoitwa sei

Iyo coagulogram inofanira kuitwa nemunhu ari kutsanya kwemaawa maviri kusvika kumana uye inosanganisira kuunganidzwa kweropa rinotumirwa kuti riongororwe, kunze kweBleeding Time (TS), inoitwa ipapo ipapo uye inosanganisira kucherechedza. iyo nguva inotora kuti kubuda ropa kumire.

Izvo zvakakosha kuti bvunzo isati yaitwa, kushandiswa kweanticoagulant zvinodhaka kunoziviswa, nekuti zvinogona kukanganisa mhedzisiro kana kutarisirwa kana uchiongorora, semuenzaniso. Nekudaro, zvakakosha kuve nehungwaru kubva kuna chiremba maererano nekumiswa kwekushandisa kwechirimo usati waita coagulogram.

Coagulogram bvunzo

Iyo coagulogram inosanganisira kumwe kuyedza kunoongorora kuvapo kwezvinhu zvese zvinobatanidzwa mukugwamba kweropa uye, nekudaro, heestasis, inoenderana nemaitikiro anoitika mukati memidzi yeropa anovavarira kuchengetedza mvura yeropa kuitira kudzivirira kuumbika kubuda ropa. Nzwisisa zvese nezve heestasis.

Miedzo mikuru iriko mucoagulogram ndeiyi:

1.Kubuda ropa nguva (TS)

Bvunzo iyi inowanzokumbirwa senzira yekuzadzisa mimwe bvunzo uye inobatsira kuona chero shanduko mumaplatelet uye inoitwa nekuita kaburi kadiki munzeve, kunoenderana nehunyanzvi hwaDuke, kana nekucheka ruoko rwemberi runonzi nzira yeIvy, uyezve kuverenga iyo nguva iyo kubuda ropa kunomira.

Kuti uite hunyanzvi hweIvy, kumanikidza kunoiswa paruoko rwemurwere uyezve kucheka kudiki kunoitwa panzvimbo iyi. Panyaya yehunyanzvi hwaDuke, gomba munzeve rinogadzirwa uchishandisa lancet kana chinyoreso chinoraswa. Muzviitiko zvese izvi, kubuda ropa kunoongororwa mumasekondi ese makumi matatu uchishandisa pepa resafa, iro rinotora ropa kubva panzvimbo iyi. Muedzo unopera kana pepa resefa risingachapinza ropa.

Kubudikidza neTS mhedzisiro, zvinokwanisika kuongorora hemostasis uye kuvapo kana kusavapo kwe von Willebrand factor, chinova chinhu chiripo mumaplatelet ane basa rakakosha mukuvhara kweropa.Kunyangwe bvunzo iyi ichikosha mukutsvaga shanduko muheestasis, inogona kukonzera kusagadzikana kunyanya muvana, sezvo bvunzo ichi inogona kuitwa nekuita buri munzeve, semuenzaniso.

Maitiro ekunzwisisa mhedzisiro: Mushure mekuchera gomba, chiremba kana nyanzvi inoongorora bvunzo inoverenga iyo nguva iyo ropa rinosunga uye rinotarisa kuburikidza nebepa resafa rinotora ropa kubva panzvimbo. Kana iyo bepa remafuta risingachabatise ropa, bvunzo rinogumiswa. Kana muyedzo wakaitwa uchishandisa Ivy Technique, rinova ruoko, inguva yekubuda ropa iri pakati pemaminetsi matanhatu ne9. Panyaya yehunyanzvi hweDuke, inova iyo yezeve, iyo yakajairwa nguva yekubuda ropa iri pakati pemaminitsi matatu kusvika matatu.

Kana nguva yacho yareba kudarika nguva yekureva, zvinonzi mune yakawedzerwa TS bvunzo, zvichiratidza kuti nzira yekugwamba inotora nguva yakareba kupfuura zvakajairwa, izvo zvinogona kuratidza chirwere chaVon Willebrand, kushandisa anticoagulant zvinodhaka kana thrombocytopenia, semuenzaniso. Ziva izvo zvinonyanya kukonzera thrombocytopenia.

2. Prothrombin nguva (TP)

Prothrombin, inozivikanwawo seCoagulation Factor II, ipuroteni inoitwa panguva yekugadziriswa uye basa rayo ndere kusimudzira kushandurwa kwefibrinogen mu fibrin, ichiumba yechipiri kana yakajeka platelet plug.

Bvunzo iyi inovavarira kuongorora mashandiro enzira yekunze yekugwamba, sezvo iine kuyerwa kwenguva iyo ropa rinotora kuumba yechipiri buffer mushure mekuratidzwa necalcium thromboplastin, inova reagent inoshandiswa muyedzo.

Maitiro ekunzwisisa mhedzisiro: Mumamiriro ezvinhu akajairika, mushure mekubatana kweropa necalcium thromboplastin, iyo nzira yekunze inoitwa, nekumisikidzwa kwezvinhu VII ne X zve coagulation uye, zvichidaro, factor II, inova prothrombin, inosimudzira kushandurwa kweFibrinogen kupinda muFibrin, ichimisa kubuda kweropa. Maitiro aya anowanzo kutora pakati pegumi nesere masekondi.

Zvisinei, mune dzimwe mamiriro ezvinhu coagulogram inoona yakawedzerwa PT, zvinoreva kuti prothrombin activation inoitika munguva yakareba kupfuura zvakajairwa. Kuwedzera kwePT kukosha kunowanzoitika kana anticoagulants ichishandiswa, kushomeka kwevhitamini K, kushomeka kwechikonzero VII uye matambudziko echiropa, semuenzaniso, sezvo prothrombin inogadzirwa muchiropa.

Muzviitiko zvisingawanzoitika, PT inogona kudzikira, senge mune yekushandisa kwevhitamini K inowedzera kana mapiritsi ekudzivirira kubata pamuviri ane estrogen, semuenzaniso. Nzwisisa zvimwe nezve iyo Prothrombin Nguva bvunzo mhedzisiro.

3. Yakagadziriswa Chikamu Chikamu Thromboplastin Nguva (APTT)

Bvunzo iyi inoshandiswa zvakare kuongorora hemostasis, zvisinei iyo inobvumidza kuvapo kana kusavapo kwezvinhu zvecoagulation zviripo munzira yemukati yeiyo coagulation cascade kuti ive nechokwadi.

APTT inowanzo kukosha kutarisa varwere vanoshandisa Heparin, inova anticoagulant, kana vane matambudziko nekugwamba kweropa, zvichibatsira kuona shanduko dzine chekuita nekugwamba.

Mune bvunzo iyi, muyenzaniso weropa rakaunganidzwa unoratidzwa kune ma reagents, uyezve nguva yainotora kuti ropa riumbane rinoverengerwa.

Maitiro ekunzwisisa mhedzisiro: Pasi pemamiriro ezvinhu, APTT ndeye 21 kusvika 32 masekondi. Nekudaro, kana munhu wacho achishandisa anticoagulants, senge heparin, kana kushomeka kwezvakanangana nenzira yemukati, senge zvinhu XII, XI kana VIII uye IX, izvo zvinoratidza hemophilia, iyo nguva inowanzo kuve yakareba kupfuura nguva yekureva ., ichiratidzwa mubvunzo kuti APTT inowedzerwa.

4. Thrombin nguva (TT)

Iyo nguva ye thrombin inoenderana nenguva inodiwa kuti kugwamba kuumbwe mushure mekuwedzera kwetrombin, inova ndiyo inodikanwa yekugwamba yekumisikidza ye fibrinogen mu fibrin, iyo inovimbisa kudzikama kweiyo clot.

Muedzo uyu unonzwisisika uye unoitwa nekuwedzera thrombin mune yakadzika kuwanda muropa plasma, iyo nguva yekugunzva ichikanganiswa nehuwandu hweiyo fibrinogen irimo muplasma.

Maitiro ekunzwisisa mhedzisiro: Kazhinji mushure mekuwedzeredzwa kwetrombin muplasma, iyo clot inoumba pakati pe14 ne21 seconds, izvi zvichitarisirwa sereferensi kukosha, iyo inogona kusiyana zvichienderana neirabhoritari inoitwa bvunzo.

TT inoonekwa seyakareba kana munhu achishandisa anticoagulants, achiunza zvigadzirwa zvekushatisa kwefibrin, ine chinhu XIII kana kushomeka kwefibrinogen, semuenzaniso.

5. Huwandu hwemaplatelet

Maplatelet zvidimbu zvemasero aripo muropa anoita basa rakakosha muheestasis, sezvo iine zvinhu zvakakosha pakuvhara, senge von Willebrand factor, semuenzaniso.

Kana paine kukuvara kwetishu, maplatelet anokurumidza kuenda kunzvimbo yekukuvara, nechinangwa chekubatsira mukumira kweropa. Iwo maplatelet akaomeswa anozvibatanidza kune endothelium yemudziyo wakakuvara nenzira ye von Willebrand factor uye vozoshandura kuumbwa kwayo uye kuburitsa zvinhu muplasma kuti inyore mamwe maplatelet kunzvimbo yekukuvara uye nekudaro inoumba iplatelet plug yekutanga.

Nekudaro, kutarisa huwandu hwemaplatelet kwakakosha mu coagulogram sezvo ichibvumidza chiremba kuziva kana paine shanduko mukuita kweiyo yekutanga hemostasis, ichikurudzira imwe yakanyanya kurapwa.

Maitiro ekunzwisisa mhedzisiro: Huwandu hwemaplatelet muropa huri pakati pe150000 ne450000 / mm³. Maitiro akaderera pane kukosha kukosha anoratidzwa mune bvunzo se thrombocytopenia, zvichiratidza kuti pane mashoma maplatelet anotenderera, ayo anogona kukonzeresa matambudziko ekuvhara ropa, achida kubuda ropa, mukuwedzera pakukwanisa kuratidza kushomeka kwehutano, shanduko mupfupa. mongo kana hutachiona, semuenzaniso.

Maitiro ari pamusoro pechirevo anonzi thrombocytosis, ayo anogona kukonzeresa kuwanda, izvo zvinogona kuitika nekuda kwemaitiro ehupenyu, sekusvuta kana kudhakwa, semuenzaniso, kana nekuda kwemamiriro ekurwara, senge kushomeka kwesimbi anemia, myeloproliferative syndrome uye leukemia , Semuyenzaniso. Dzidza nezve zvimwe zvikonzero zveplatelet kuwedzera.