Blood ekunqandeni. Icebo coagulation igazi

Enye yeenkqubo ibalulekileyo olwenzeka emzimbeni wethu ekunqandeni igazi. Scheme uya echazwe ngezantsi (njengoko kubonelelwe ngeenjongo yo fanekisela, kunye nemifanekiso). Yaye ekubeni le yinkqubo engelula, nto kubalulekile ukuqwalasela ukuba ngokweenkcukacha.

Njani ukuba yenzeke?

Ngenxa yoko, inkqubo olinikiweyo unoxanduva bokumisa ukopha, kwenzeka ngenxa yomonakalo omnye okanye kwelinye icandelo olujikeleza umzimba.

Ngamagama alula, sinako ukwahlula izigaba ezithathu. Okokuqala - kusebenze. Emva kokonzakala sitya kwenzeke reactions ezilandelayo, ekugqibeleni kukhokelela ukuyilwa kwento ekuthiwa-prothrombinase. Oku - elilukhuni equlathe V kunye X coagulation izinto. Oku kwakheka kwi kumphezulu zegazi ndizayo phospholipid.

Isigaba sesibini - coagulation. Kule nyathelo, fibrin kwenziwa ukususela lwefibrinogen - high ezinto protein ubunzima oko kukuthi sisiseko amahlwili egazi, kwaye isiganeko ebandakanya igazi ekunqandeni. Iskim enikwe ngezantsi ibonisa le sigaba.

Ke ekugqibeleni, lo Isigaba sesithathu. Oku kubandakanya fibrin ihlwili Ukwakheka, ebonakala ngu isakhiwo ashinyeneyo. Hi ndlela leyi, ezizezi yi ukuhlanjwa futhi omisa ngayo kunokwenzeka ukuba ufumane "eziphathekayo" nto leyo ke isetyenziselwa yokulungiselela iziponji ludlolo nakwiifilim bokumisa ukopha kubangelwa komsipha iinqanawa ezincinane ngexesha lomsebenzi yotyando.

malunga nezinto onokuzenza

Ngaphezu ke ngokufutshane ekunqandeni igazi. Le nkqubo, ngasendleleni, yasungulwa ngowe-1905 sisazinzulu-coagulation ogama Paul Oscar Morawitz. Kwaye oko singalahlekani ukufaneleka kwayo unanamhla.

Kodwa ingako itshintshileyo ukususela 1905 ekuqondeni coagulation igazi yinkqubo entsonkothileyo. Ngenxa inkqubela, kakade. Izazinzulu bakwazi ukuvula inqwaba reactions entsha kunye neeproteni abandakanyeka kule nkqubo. Kwaye ngoku scheme ndachithelwa eqhelekileyo ngakumbi coagulation kwegazi. Ngenxa imbono yakhe nokuqonda le yinkqubo entsonkothileyo ufumana ukuqonda lula kancinci.

Njengoko unokubona kulo mfanekiso ungezantsi, kwenzeka ntoni ngokoqobo "yenziwe phezu lezitena niya kulirhola." Kuthathelwa ingqalelo inkqubo lwangaphakathi nolwangaphandle - igazi kunye inyama. Kuba deformation ngalinye ezichazwe uphawu kwenzeka ngenxa yomonakalo. Umonakalo kwinkqubo yegazi isicelo iindonga semithambo, collagen, protease (enzyme ohlaba), kunye catecholamines (molecule neurotransmitters). I-tissue elifana neli umonakalo iseli ngenxa apho iya thromboplastin. Yeyiphi i stimulator ebalulekileyo igazi inkqubo amahlwili (ebizwa coagulation). Yena uya ngqo egazini. Le 'ndlela' yakhe, kodwa inophawu ukuzithethelela. Emva iqala inkqubo ekunqandeni thromboplastin. Emva kokukhululwa kwayo igazi iqala ukuphunyezwa izigaba ezithathu ngasentla.

ixesha

Ngoko ke, kuthekani na igazi ekunqandeni, le nkqubo iye yanceda ukuba baqonde. Ngoku ndingathanda ukuthetha kancinane malunga nexesha.

yonke le nkqubo ithabatha ubuninzi imizuzu 7. Isigaba sokuqala ithatha ezintlanu ukuya kwezisixhenxe. Ngeli xesha, prothrombin kwakhiwa. Le nto uhlobo lwesakhiwo esimbaxa protini kusingatha inkqubo umthombo coagulation kwegazi kunye nokukwazi ukuqina. Esetyenziswa yi umzimba ukuze thrombus ukwakhiwa. Yena izihlangu isiza yonakele, ukuze ukuba ukopha oyekayo. Konke oku kuthatha imizuzu 5-7. Izigaba sesibini nesesithathu kwenzeka ngokukhawuleza kakhulu. Imizuzwana 2-5. Ngenxa isigaba coagulation igazi (scheme ezinikwe apha ngentla) kuchaphazela iinkqubo ezithi zenzeke kuwo. Kwaye oku kuthetha ukuba kwindawo kukwenzakala ngoko nangoko.

Prothrombin, ke, ekuveliseni esibindini. Kwaye ezwi yayo kuthatha ixesha. Indlela ngokukhawuleza ukuvelisa prothrombin ngokwaneleyo, kuxhomekeke kubungakanani vitamin K eziqulethwe emzimbeni. Ukuba ayinalo, ukopha uza kuyeka nzima. Kwaye ke yingxaki enkulu. Ekubeni yokungabikho vitamin K ibonisa kukwaphula Yindibanisela prothrombin. Kwaye oku - esi sifo ukuphathwa.

sinjalo yokuqaphela

Kaloku, ukuba icebo jikelele coagulation igazi icacile - ngoku kufuneka ukunikwa ingqalelo ukuba isihloko malunga yintoni ekufuneka yenziwe ukubuyisela anenani elifunekayo vitamin K emzimbeni.

Okokuqala - ukutya kakuhle. Isixa omkhulu vitamin K ifumaneka tea eluhlaza - micrograms 959 100 grams nganye! Izihlandlo ezithathu ngaphezulu, ngokuzenzekelayo, kunokuba emnyama. Kungenxa yokuba kufuneka ngenkuthalo ukusela. Musa ukukulibala kunye nemifuno - isipinatshi, ikhaphetshu emhlophe, iitumato, ertyisi eziluhlaza, amatswele.

Inyama iqulethe vitamin K, kodwa hayi zonke - kuphela yemvu, yenkomo isibindi, yanye imvana emnyaka. Kodwa ke into yokugqibela le nto ndiyibhalayo ikonofile, zeerasintyisi, ubisi, ama-apile kunye iidiliya.

Noko ke, ukuba imeko leyo ixhomisa amehlo, ngoko ezahlukeneyo menu ukunceda kuya kuba nzima. Ngokuqhelekileyo, oogqirha Siyaleza ngamandla ukudibanisa otya yakho iziyobisi ukuba emiselweyo. Nge unyango kufuneka ukuba zilibaziseke. Kuyimfuneko ngokukhawuleza kangangoko kunokwenzeka yena bunjani indlela ekunqandeni igazi. Irejimeni yonyango emiselweyo ugqirha ngoko nangoko, kwaye kananjalo linyanzelekile ukuba alumkise yintoni enokwenzeka xa ngoyaba iingcebiso. Kunye neziphumo kunokuba kwekhono isibindi, syndrome trombogemorragichesky, igazi iyingozi, izifo ithumba kunye bone umonakalo iiseli ngumongo stem.

Schmidt scheme

Ekupheleni kwenkulungwane XIX waphila komzimba wodumo MD. Igama lakhe uAleksandr Aleksandrovich Shmidt. Wayephila iminyaka 63 kwaye ixesha elininzi eyayinikelwe nasekufundweni iingxaki Haematology. Kodwa wafunda ngenyameko isihloko igazi ekunqandeni. Wakwazi ukuseka uhlobo enzymatic zenkqubo, ukuze ukuba sisazinzulu kwakhe ecetywayo inkcazelo theoretical component. Obonisa ngokucacileyo scheme inikezelwe ngezantsi amahlwili.

Kwindawo yokuqala kukho ukwehla benqanawa yonakele. Emva koko, behleli-apho wambumba isiphako evakalala, primary zegazi kwiplagi. Ke lukhuni. Ngaloo ndlela eyakha thrombus obomvu (ngenye ekubhekiswa kuwo ihlwili legazi). Emva koko unyityilikiswa ngokuyinxenye okanye ngokupheleleyo.

Kule nkqubo, wabonakalaliswa izinto ezithile amahlwili. Le kwisiphaluka ngobuwena yayo zenzeka kwakhona abonisa ngayo. Bona kuboniswe Amanani Arabhu. Kwaye kukho ezingama-13 Kwaye ngamnye kufuneka uxelele.

izinto

A isekethi epheleleyo coagulation igazi akunakwenzeka ngaphandle kokubala kubo. Kaloku ke, kufuneka uqale ekuqaleni.

Factor I - yinto iproteni lwefibrinogen enemibala. Kuhlelwe esibindini, ichithiwe iplaza. Factor II - prothrombin, leyo sele ikhankanyiwe apha ngasentla. ukukwazi efana sokuwubopha ion calcium. Kwaye ke ngoko cleavage le into eyenziwa enzyme ekunqandeni.

Factor III - yinto iproteni esimbaxa lipoprotein, izicwili thromboplastin. Its ebizwa ukuthuthwa phospholipids, cholesterol, triacylglycerols kunye nangaphezulu.

Enye into, IV, ezi ion Ca2 +. Abo ukuba ezinxibelelene phantsi kweempembelelo iproteni enemibala. Bona inxaxheba kwiinkqubo entsonkothileyo ezininzi, ukongeza ekunqandeni kwi secretion of neurotransmitters, umzekelo.

Factor V - it globulin. Nto leyo nayo ziveliswa esibindini. Kulindeleke ukuba nomphetho corticosteroids (kwezinto hormone) kunye yokuhamba. Factor VI esithile ixesha apho, kodwa ngoko kwagqitywa ukuba lirhoxe yokuhlela. Ngenxa yokuba izazinzulu ziye zafumanisa - oku kuquka i V. factor

Kodwa yokuhlela ayizange iguquke. Ngenxa emva V uya factor VII. Iquka proconvertin, ukusuka apho inxaxheba wambumba ijwabu prothrombinase (isigaba sokuqala).

Factor VIII - iproteni obubonakaliswa kwikhonkco efanayo. Eyaziwa njenge anti-hemophilic globulin A. Oku kungenxa yokuba nokusilela yokuphuhlisa iseliswelekile, ilifa sifo, ezifana kubazali bakhe. Factor IX i "enxulumene" okhankanywe ngaphambili. Ekubeni le globulin antihemophilic B. Factor X - globulin ngqo, kuhlelwe esibindini.

Ke ekugqibeleni, iingongoma ezintathu zokugqibela. Lo mba Rosenthal, Hageman kunye fibrin nozinzo. Bona, ewonke afunyenwe ngumviwa, kuchaphazela ukuyilwa iibhondi aphakathi kunye eqhelekileyo yokusebenza yenkqubo efana ekunqandeni igazi.

Schmidt sihlanganisa zonke ezi zinto. Uze ufunde ngendlela ngokuqhabalaka ukuba baqonde indlela inkqubo echazwe untsokothile kwaye iintsingiselo ezininzi.

inkqubo anticoagulative

Lo mba kufuneka kuqatshelwe ingqalelo. Inkqubo ekunqandeni ochazwe ngasentla - isikimu nayo ibonisa ukuhamba yenkqubo. Kodwa babizwa ngokuba "protivosvortyvanie" kwakhona lwenzeka.

Okokuqala, kufanele kuqatshelwe ukuba ekuhambeni zazivelela, izazinzulu ziye isonjululwe ingxaki ezimbini malunga ngokupheleleyo. Baye uzama uku bana phandle - indlela umzimba ilawula ukuthintela yayikukuphuphuma igazi imithambo yegazi umonakalo, yaye ngaloo ndlela, ukuba ayigcine ukwimeko ulwelo lonke? Kaloku, isigqibo ingxaki yesibini kwafunyanwa kwinkqubo anticoagulation.

It is a iseti ethile iiproteni zeplasma leyo bayakwazi yokucutha isantya ekudibaneni kwemichiza. Oko ukuncokola.

Kwaye kule nqubo antithrombin III. Owona msebenzi walo ukulawula ukusebenza yeemeko ezithile eziquka umzobo coagulation igazi. Kubalulekile ukucacisa: ayithethi ukulawula ukuyilwa ihlwili legazi, kwaye akubikho enzayim olungeyomfuneko, ivaleleke wegazi ukusuka kwindawo esizicelayo kuyo. Kutheni kuyimfuneko? Ukuzama ukunqanda ukusasazeka igazi ekunqandeni kwimimandla egazini ukuba ziye zonakaliswa.

element ekunqandeni

Ukuxelela emele inkqubo coagulation yegazi (beesekethe ukuba eboniswe ngasentla), ukhathalelo kufuneka kuqatshelwe ukuba ekhobokisayo njengoko lweeHedfowuni. It is a glycosaminoglycan asidi nesalfure-equlathe (a uhlobo polysaccharide).

Le - le anticoagulant ngqo. Iziyobisi nokukhuthaza inkqubo inhibition umsebenzi coagulation. It livalela inkqubo lweeHedfowuni egazi. Yenzeka njani le nto? LweeHedfowuni kunciphisa nje umsebenzi thrombin egazini. Nangona kunjalo, oku - into yendalo. Kwaye bayazuza. Ukuba makayazise le anticoagulant emzimbeni, oko negalelo ipoti ye antithrombin III kunye lipoprotein lipase (enzayim anamathele triglycerides - umthombo wamandla siphambili iiseli).

Ngoku, lweeHedfowuni isoloko isetyenziswa A unyango iimeko thrombotic. Kuphela enye molecule wayo isebenze inani elikhulu antithrombin III. Ngako oko, lweeHedfowuni zingathathwa njengesixhobo - njengokuba kulo mzekelo okunene kuyafana isiphumo okubangelwa ngabo yesenzo.

Kukho nezinye izinto kunye intshukumo enye, equlathwe plasma yegazi. Ngokomzekelo, α2- macroglobulin. Yena kukhuthaza yokuwa ihlwili legazi, ichaphazela inkqubo fibrinolysis, isebenza ezothutho ukwenzela ion ze-2-valent, kunye neeproteni ezithile. Kwaye nangoku abangaphangeliyo izinto ezibandakanyekayo amahlwili.

utshintsho kokubona

Kukho nenye ezincinane ukuba alubonisi scheme yemveli coagulation kwegazi. I zomzimba somzimba lokuba uninzi iinkqubo ziquka kungekuphela nje utshintsho imichiza. Kodwa emzimbeni. Ukuba bagubhe ekunqandeni ukuya ngeliso lenyama, uya kubona ukuba ubume zegazi kwinkqubo ukuyitshintsha. Aba iiseli ahanjiswa kunye neenkqubo spinous ekuqhelekileyo ukuba eziyimfuneko ukuze ukuphunyezwa udibaniso olunzulu - edibanisa izinto zibe iyunithi enye.

Kodwa loo nto bonke. Ngenxa zegazi ngexesha amahlwili abelwe izinto ezahlukeneyo - catecholamines, serotonin, njl Ngenxa mithambo kwemithambo yegazi, ezo ziye zonakaliswa, imithambo. Ngenxa yokuba apho kukho ischemia olusebenzayo. Blood unikezelo kwindawo eyonakeleyo lifinyele. Kwaye, oko, ukuba ukuthululwa efanayo kancane kancane kuze ubuncinane. Oku kunika ithuba lokuba ukuvala ziiplatelets iindawo ezonakeleyo. Bathi ke, ngeendleko seenkqubo zabo spinous, ngokungathi 'okunamathela' kungqameko imicu collagen, ezo zibekwe emiphethweni isilonda. Iphelile yokuqala, ukuqalisa isigaba elide. Ubomi ukubunjwa thrombin. Elandelwa embalwa imizuzwana inqanaba coagulation kunye esokuqala. Kwaye ke isigaba sokugqibela - ukubuyiselwa nokuhamba kwegazi obuqhelekileyo. Kwaye ke kubaluleke kakhulu. Ekubeni ukuphilisa ngokupheleleyo inxeba kunokwenzeka ngaphandle kokuba unikezelo kwegazi ezilungileyo.

luncedo ukwazi

Kulungile, into enjengale ngamagama ikhangeleka ngathi umzobo lula coagulation igazi. Nangona kunjalo, kukho bokuqonda ezimbalwa, ukuba ndingathanda ukuqaphela ingqalelo.

Kubazali bakhe. Phezu kwayo okhankanywe ngasentla. Esi sisifo kuyingozi kakhulu. Nayiphi na indoda ukopha, bona ubunzima, waba nzima. isifo ilifa iphuhlise ngenxa yokulimala kwiiproteni inxaxheba kwinkqubo ekunqandeni. Ukubona kungaba kakhulu elula - e ukucuthwa encinane abantu aphulukane ligazi elininzi. Aze achithe ixesha elininzi nto ukunqanda oko. Yaye iintlobo ngokuqatha ukopha ingaqala kungekho sizathu. Abantu abanengxaki kubazali bakhe, kusenokubakho nokukhubazeka ekuqaleni. Ekubeni ukopha rhoqo kwi izihlunu zomzimba (hematoma eziqhelekileyo) kwamalunga - asinto ingaqhelekanga. nokuba iphathwa? Kunye nobunzima. Umntu kufuneka ngokoqobo umzimba wakho njengesitya-ethe, kwaye kusoloko ngenyameko. Ukuba ukopha kwenzeka - imfuneko engxamisekileyo ukwazisa donor igazi elitsha, eliqulethe XVIII factor.

Ngokwesiqhelo esi sifo sichaphazela abantu. Kunye nabafazi asebenze abathwali lezakhi kubazali bakhe. Okubangel 'umdla kukuba, i-British koroleva Viktoriya into enjalo. Omnye woonyana bakhe ezosulela izifo. Ezinye ezimbini ayaziwa. Ukususela kubazali bakhe, ngasendleleni, idla ngokuba isifo yasebukhosini.

Kodwa ke kukho iimeko esahlukileyo. Oku kubhekisela nokwanda ekunqandeni igazi. Ukuba kwenzeka, loo mntu naye kufuneka abe oluchanileyo ubuncinane. ekunqandeni Ukwanda kubonisa emngciphekweni omkhulu egazi intravascular. Oko ingathintela nempahla yonke. Amaxesha amaninzi ngenxa inokuba thrombosis, ekhatshwa ukudumba beendonga emthanjeni. Kodwa kule isiphene iphathwa lula. Ngokufuthi, ngasendleleni, kukho ethengiwe.

Iyamangalisa indlela eyenzekayo emzimbeni womntu, xa phawu kungacentwa intwana yephepha. Kunokuba ixesha elide ukuthetha iimpawu igazi, igazi linqume kunye neenkqubo zayo, ukuba bahambe ngayo. Kodwa iinkcukacha umdla, ngokunjalo ebonisa ngokucacileyo amacebo wayo apha ngasentla. Nabanye, ukuba oyifunayo, zinokufumaneka ngamnye.