Igazi ekunqandeni. Isikimu wegazi coagulation

Omunye izinqubo ezibaluleke kakhulu olwenzeka emzimbeni yethu igazi ekunqandeni. Isikimu kuyothiwa ezichazwe ngezansi (njengoba kunikeziwe ngenhloso engokomfanekiso, nezithombe). Futhi njengoba lokhu kuyinqubo eyinkimbinkimbi, kubalulekile ukuba sicabangele ke ngokuningiliziwe.

Kwenzeke kanjani?

Ngakho, inqubo kubonakala unesibopho ephumula ukopha, iphutha ngenxa ukulimala elilodwa noma kwenye ingxenye isimiso semithambo yegazi yomzimba.

Ngamagama alula, singakwazi ukuhlukanisa izigaba ezintathu. Okokuqala - kusebenze. Ngemva kokulimala isitsha kuqale nokuqala ukwenzeka ukusabela okwalandela, okuyinto luholele kumiswa okuthiwa prothrombinase. Lokhu - a eziyinkimbinkimbi ehlanganisa V futhi X ezijiyisa igazi. Kumiswa It is phezu platelet ulwelwesi phospholipid.

Eyesibili isigaba - coagulation. Kulo sinyathelo, kwakhiwa fibrin is kusukela fibrinogen - eliphezulu yamangqamuzana isisindo amaprotheni ngesisekelo amahlule, futhi okuvela okubandakanya igazi ekunqandeni. Isikimu ehlinzekwe ngezansi ubonisa kulomkhakha.

Futhi ekugcineni, esigabeni sesithathu. Luhilela fibrin ihlule ekwakhekeni, elinesimo isakhiwo obukhulu. By the way, okungukuthi ngokuhlanza impahla kanye omiswe kungenzeka ukuthola "impahla" bese kusetshenziswa ukulungiswa izipanji oyinyumba namafilimu bokumisa ukopha kubangelwa ukudabuka emincane phakathi nokuhlinzwa kuhlinzwa.

mayelana ukusabela

Ngenhla kwaba echazwe kafushane egazini ekunqandeni ukopha. Isikimu, ngasendleleni, yasungulwa emuva ngo-1905 usosayensi-coagulation okuthiwa uPaul Oscar Morawitz. Futhi akaphelelwa ngokuhlathulula ukusebenza kwawo kuze kube yilolu suku.

Kodwa kuningi osekushintshile kusukela ngo-1905 ekuqondeni igazi coagulation njengoba inqubo eyinkimbinkimbi. Ngenxa intuthuko, yebo. Ososayensi bakwazi ukuvula inqwaba ukusabela entsha namaprotheni ukuthi abantu abahilelekile kule nqubo. Futhi manje kwande wendlale isikimu wegazi coagulation. Ngenxa Umbono wakhe nokuqonda yale nqubo eziyinkimbinkimbi uthola kancane kulula ukuqonda.

Njengoba singabona esithombeni ngezansi, kwenzekani ngokoqobo "wenza phezu kwezitini." Ikhumbula uhlelo zangaphakathi nezangaphandle - wegazi nezicubu. Ukuze ukusonteka ngamunye isici kuchazwe kwenzeka ngenxa umonakalo. Umonakalo uhlelo igazi isicelo izindonga imithambo yegazi, i-collagen, protease (sakhathala salokhu sinamathele enzyme), kanye catecholamines (i-molecule neurotransmitters). Nezicubu siyenzeka ukulimala kwamangqamuzana ngenxa iyiphi uya thromboplastin. Yikuphi kuyinto stimulator ebalulekile igazi ekunqandeni inqubo (esibizwa ngenye coagulation). Yena lingene egazini samaqanda. Lena "indlela" yakhe, kodwa yena unalo uhlamvu ukuzivikela. Ngemva kokuthi iqale thromboplastin ekunqandeni inqubo. Ngemva kokukhululwa yayo egazini iqala ukuqaliswa okungenhla izigaba ezintathu.

isikhathi

Ngakho, kuthiwani kuyinto ekunqandeni igazi, isikimu uye sasizwa ukuba siwaqonde. Manje ngingathanda ukukhuluma okuncane mayelana nesikhathi.

Yonke inqubo ithatha esingengaphezu kwemizuzu engu-7. Isigaba sokuqala ithatha izinsuku ezinhlanu kuya eziyisikhombisa. Phakathi nalesi sikhathi, prothrombin kwakhiwa. Le into is a uhlobo eziyinkimbinkimbi amaprotheni isakhiwo obhekene inqubo enomopho coagulation futhi ukuqina ikhono. Yikuphi isetshenziswa umzimba ukuze thrombus kumiswa. Yena clogs isayithi ezilimele, ukuze ukopha sithule. Zonke kuthatha imizuzu 5-7. Izigaba lesibili nelesithathu zenzeke ngokushesha okungaka. Ukuze 2-5 imizuzwana. Ngenxa esigabeni wegazi coagulation (scheme letinikwe lapha ngenhla) kuthinte izinqubo ezenzeka kulo. Futhi lokhu kusho ukuthi ngo-isayithi ukulimala ngokushesha.

Prothrombin yena, ekhiqizwa esibindini. Futhi zamagama alo kuthatha isikhathi. Kanjani ngokushesha ukukhiqiza prothrombin ngokwanele, kuncike Izinga lika-vitamin K eziqukethwe umzimba. Uma ishoda, ukopha uzoyeka nzima. Futhi kuyinkinga enkulu. Njengoba ukungabi vitamin K kubonisa kokunikezwa kwe-synthesis prothrombin. Futhi lokhu - lesi sifo zingelashwa.

sinjalo zamagama

Nokho, isikimu jikelele igazi coagulation kucacile - manje kumele kunikezwe ukunakekela isihloko ngokuphathelene nalokho okufanele kwenziwe ukubuyisela imali edingekayo vitamin K emzimbeni.

Okokuqala - ukudla kahle. Inani enkulu vitamin K itholakala itiye eliluhlaza - 959 micrograms 100 grams ngasinye! izikhathi ezintathu, ngenhlanhla kuka omnyama. Ngoba kufanele ngenkuthalo ukuphuza. Ingabe sizikhandle nemifino - isipinashi, iklabishi emhlophe, utamatisi, uphizi oluhlaza, u.

Inyama iqukethe vitamin K, kodwa hhayi kuzo zonke - kuphela inyama yenkonyana, yenkomo kwesibindi, iwundlu. Kodwa yinto yokugcina yakhiwa garlic, omisiwe, ubisi, apula kanye amagilebhisi.

Nokho, uma isimo sibi ke ezihlukahlukene amamenyu ukusiza kuyoba nzima. Ngokuvamile, odokotela batusa kakhulu ukuhlanganisa ekudleni kwakho nge izidakamizwa ukuthi ebekiwe. Ngempatho akufanele imisiwe. Kuyadingeka ngokushesha ngangokunokwenzeka ngaye kulesetayelekile igazi ekunqandeni indlela. Isimiso ukwelashwa ezinqunyiwe udokotela ngokushesha, futhi ibizwa nangokuthi enesibopho sokuxwayisa yini engenzeka uma singazinaki izincomo. Futhi imiphumela ingaba ukungasebenzi kwesibindi, syndrome trombogemorragichesky, anaemia eziyingozi, izifo unesimila umonakalo umnkantsha stem cells.

Schmidt isikimu

Ekupheleni XIX leminyaka waphila physiologist ezidumile MD. Igama lakhe kwakungu-Aleksandr Aleksandrovich Shmidt. Waphila iminyaka engu-63 futhi iningi isikhathi esisisebenzisela ekutadisheni izinkinga Haematology. Kepha uzifunde ngokucophelela isihloko igazi ekunqandeni. Wakwazi ukusungula uhlobo enzymatic of inqubo, ngakho-ke ukuthi usosayensi wasikisela incazelo theory. Elibonisa ngokucacile isikimu ehlinzekwe ngezansi ekunqandeni.

Endaweni yokuqala kukhona ukwehliswa bomkhumbi lilimele. Khona-ke, ngo-situ kwakhiwa isici okuxekethile, eyinhloko platelet ipulaki. Khona-ke Uqinisa. Ngaleyo ndlela ukwakha obomvu thrombus (ngenye ukubizwa ngokuthi ihlule legazi). Ngemva kwalokho-ke kancane noma ngokuphelele siphela.

Phakathi nalokho kubingelelana, wabonakaliswa izici ezithile ekunqandeni. Isifunda e samuntu yayo zenzeka futhi ubonisa kubo. Basuke kuboniswa zesi-Arabhu. Futhi kukhona ingqikithi 13. Futhi ngamunye kumelwe sisho.

izici

Umbonisi ephelele igazi coagulation akunakwenzeka ngaphandle ukufakwa kuhlu kubo. Hhayi-ke, kufanele uqale nge kuqala.

Factor mina - kuyinto kungekho nto enemibala emihle amaprotheni fibrinogen. Kuhlelwe kwesibindi, ziyoncibilika plaza. Factor II - prothrombin, okuyinto sesivele eshiwo ngenhla. ikhono laso eliyingqayizivele kuyinto ukuhlanganisa uxhumano nomsebenzisi calcium ion. Futhi kwaba ke cleavage yalolu ketshezi kwakhiwa enzyme ekunqandeni.

Factor III - kuba a eyinkimbinkimbi amaprotheni Esilula, izicubu thromboplastin. Its ngokuthi ezokuthutha phospholipids, cholesterol, triacylglycerols nokuningi.

Esinye isici, IV, kukhona Ca2 + ion. Khona-ke abakhululiwe ahlanganisiwe ngaphansi kwethonya iprotheni kungekho nto enemibala emihle. Ababandakanyeka izinqubo eziningi eziyinkimbinkimbi, ngaphezu ekunqandeni ku uketshezi of neurotransmitters, isibonelo.

Factor V - ke globulin. Okuyinto nawo owabhalwa kwesibindi. It iyadingeka ukuze yokubopha corticosteroids (izinto hormone) kanye yokuhamba. Factor VI khona isikhathi esithile, kodwa ke kwanqunywa ukuba bahoxe ekungeneleni ngezigaba. Ngenxa ososayensi bathole - ifaka V isici

Kodwa ngezigaba awushintshanga. Ngoba ngemva V uya isici VII. Kufaka proconvertin, kusukela lapho iqhaza kwakhiwa izicubu prothrombinase (isigaba sokuqala).

Factor VIII - iprotheni lubonakaliswa yochungechunge olufanayo. Njengoba zibizwa ngokuthi ama-anti-hemophilic globulin A. Kuyinto ngenxa ukuntula kwayo ukwakha ezingavamile, ngofuzo isifo, ezifana hemophilia. Factor IX kuyinto "ahlobene" kushiwo ngaphambili. Njengoba lokhu globulin antihemophilic B. Factor X - ngqo globulin, kwemiqondo esibindini.

Futhi ekugcineni, zinyanga amaphuzu amathathu. Lokhu isici Rosenthal, Hageman futhi fibrin sinjalo. Ababona, sesisonke, kuthinta ukwakheka izibopho aphakathi futhi ukusebenza evamile inqubo efana igazi ekunqandeni.

Schmidt isifunda sihlanganisa iSifundazwe zonke lezi zici. Futhi ngempela ngokushelelayo ukufunda baqonde indlela inqubo echazwe liyinkimbinkimbi futhi inezincazelo eziningi.

uhlelo anticoagulative

Lo mqondo futhi kufanele ukunakwa kuphawulwe. I ezichazwe ngenhla uhlelo ekunqandeni - scheme futhi inikeza nomfanekiso wendaba ukugeleza inqubo. Kodwa lokho okuthiwa "protivosvortyvanie" futhi senzeka.

Ukuze uqale, kufanele kuphawulwe ukuthi ngokuhamba kwemvelo, ososayensi sixazulula inkinga ezimbili okuphambene ngokuphelele. Babezama uzodlala - indlela umzimba uphatha ukuvimbela outflow legazi kusuka imithambo yegazi ezilimele, futhi ngaleyo ndlela ukugcina lisesimweni ketshezi wonke? Nokho, isinqumo yenkinga yesibili kwakunguDodayi kokutholakala anticoagulation uhlelo.

Kuyinto iqoqo ezithile plasma amaprotheni okuyinto bayakwazi ekunciphiseni izinga zamakhemikhali. Lokho engasenamahloni.

Futhi kule nqubo abathintekayo antithrombin III. umsebenzi wayo lomkhulu ukulawula ukusebenza yezizathu ezithile ezihlanganisa idayagramu we coagulation igazi. Kubalulekile ukucacisa: awusebenzi alawule kumiswa ihlule legazi, futhi aqede enzyme ezingadingekile, ivaleleke egazini lisuka endaweni lapho kwakhiwa. Kuqakatheke ngani? Ukuze ugweme ukusabalala igazi ekunqandeni ezindaweni egazini lawo ayelimele.

elementi ekuvimbeleni

Ukutshela ukuthi limelela uhlelo wegazi coagulation (wesifunda kuboniswa ngenhla), ukunakekelwa kufanele kuphawulwe ukuthi imfuyo njengoba heparin. Kuyinto glycosaminoglycan esidi nesibabule-aqukethe (uhlobo polysaccharide).

Lokhu - the anticoagulant oqondile. Into ukugqugquzela coagulation okwenziwa kwisistimu okusithiyayo. It kukhinyabeza inqubo heparin amahlule. Kwenzeka kanjani lokhu? Heparin nje kunciphisa umsebenzi thrombin egazini. Nokho, lokhu - into yemvelo. Futhi iletha inzuzo. Uma sethula anticoagulant emzimbeni, ke kungaba nomthelela ukusebenza antithrombin III futhi Esilula lipase (enzyme ukuthi ninamathele triglyceride - main amandla umthombo amaseli).

Manje, heparin ngokuvamile sisetshenziswa A ekwelapheni izinkinga thrombotic. Kuphela omunye-molecule ayo kusebenze inombolo enkulu antithrombin III. Ngakho, heparin kungase kubhekwe njengokwelapha kulethe - njengoba kulokhu senzo empeleni kufana umphumela kubangelwa kubo.

Kukhona nezinye izinto nge isenzo efanayo, eziqukethwe plasma yegazi. Ngokwesibonelo, cabangela izinkondlo, α2- macroglobulin. Ugqugquzela ukuhlukaniswa ihlule legazi, kuthinta inqubo fibrinolysis, ukhonza njengomPristi zokuthwalwa ion 2-valent, namaprotheni ezithile. Futhi namanje kuvimbela izinto ezihilelekile ekunqandeni.

izinguquko waphawula

Kunenye ehilelekile ukuthi alibonisi isikimu yendabuko igazi coagulation. I physiology umzimba kangangokuthi abaningi izinqubo akuhileli nje izinguquko kwamakhemikhali. Kodwa umzimba. Uma besingabuka ekunqandeni ngokubona okubonakala ngeso lenyama, uzothola ukuthi ukuma zegazi inqubo ukuyishintsha. Ziba amaseli oyindilinga ne izinqubo ejwayelekile spinous ezidingekayo ukuze ukuqaliswa wokuhlanganisa olunzulu - ngokuhlanganisa izakhi ukuze zibe yisikhungo esisodwa.

Kodwa akugcini lapho. Ngenxa platelet ngesikhathi ekunqandeni labelwe izinto ezahlukene - catecholamines, serotonin, njll Ngenxa mafutha anciphisa isikhala esingaphakathi imithambo yegazi, okuyinto zalimala, ayisesemikhulu. Ngenxa okuyinto kukhona ischemia sokusebenza. Liningi igazi endaweni ezilimele kuyehla. Futhi, ngokufanele, kokuthululwa komoya efanayo kancane kancane kuyehla kube sezingeni eliphansi. Lokhu kunikeza kungenzeka ukuvimba platelet izindawo ezilimele. Ababona, bangakunaki izinqubo zabo spinous, njengokungathi "ziboshelwe" imiphetho kwezintambo zesivikelo sesifuba i-collagen, okuyinto zitholakala at emaphethelweni isilonda. Lokhu uphela ngowokuqala, waqopha kusebenze isigaba. Waqeda kumiswa thrombin. Kulandelwa imizuzwana isigaba ambalwa coagulation futhi sokuhoxisa. Futhi esigabeni sokugcina - ukubuyiselwa evamile kwegazi. Futhi kubaluleke kakhulu. Njengoba ukuphulukiswa egcwele isilonda akunakwenzeka ngaphandle ukuphakelwa kahle kwegazi.

ewusizo ukwazi

Nokho, ube esesho into enjengokuthi ngamagama nangezithombe libukeka idayagramu lula we coagulation igazi. Nokho, kukhona umehluko wemisindo nemiqondo yamagama ezimbalwa, ukuthi ngingathanda uqaphele ukunakwa.

Hemophilia. On it okukhulunywa ngenhla. Lesi isifo esiyingozi kakhulu. Nokopha indoda, ababuzwayo, wazibonela kanzima. esiwufuzo eba ngenxa yokulimala amaprotheni abahilelekile ekunqandeni. Thola kungaba ulula - at ukusikeka okuncane abantu balahlekelwa igazi eliningi. Futhi ukuchitha isikhathi esiningi ukuze uwumise. Futhi amafomu olunzima kunalo lonke ake ukopha ungaqala ngaphandle kwesizathu. Abantu abaphethwe hemophilia, kungenzeka zibe ngaphansi kwe ukukhubazeka ekuseni. Njengoba ukopha kaningi imisipha izicubu (hematoma evamile) emalungeni - akuyona into engavamile. kungaba iphathwa? Kanzima. Umuntu kufanele ngokoqobo ngayo umzimba wakho njengoba esibuthakathaka iyashesha ukuthinteka, futhi uqaphele njalo. Uma ukopha kwenzeka - esiphuthumayo ukwethula fresh igazi donor, equkethe XVIII isici.

Ngokuvamile lesi sifo sihlasela amadoda. Futhi abesifazane isinyathelo njengabathwali bendlu isakhi sofuzo hemophilia. Ngokuthakazelisayo, i-British koroleva Viktoriya kwaba enjalo. Enye yamadodana akhe izifo ezithathelana. Njengoba for nye ezimbili alwaziwa. Njengoba hemophilia, ngasendleleni, ngokuvamile okubizwa ngokuthi isifo wasebukhosini.

Kodwa kukhona izimo okuphambene. Lokhu kubhekisela anda igazi ekunqandeni. Uma kwenzeka, umuntu futhi idinga ukuba okungenani olunembile. ekunqandeni Ukwandiswa kubonisa ingozi eliphezulu amahlule intravascular. Lokho clog wonke izitsha. Ngokuvamile umphumela kungaba thrombosis, ephelezelwa ukuvuvukala ezindongeni emthanjeni. Kodwa le nkinga iphathwa kulula. Ngokuvamile, ngendlela, it is uthenge.

Kuyamangalisa ukuthi kungakanani kwenzekani emzimbeni womuntu, lapho aphansi usike yena ephepheni. Kungaba isikhathi eside ukukhuluma mayelana izici igazi, ekunqandeni kanye izinqubo zayo ezihambisana naso. Kodwa ulwazi ezithakazelisayo kakhulu, kanye obonisa ngokucacile izikimu zawo ngaphezulu. Nalo lonke, uma uthanda, lungatholakala ngamunye.