Ntshav txhaws. Lub tswvyim ntawm cov ntshav coagulation

Ib tug ntawm cov tseem ceeb tshaj plaws dab tshwm sim nyob rau hauv peb lub cev yog cov ntshav txhaws. Scheme nws yuav tau piav rau hauv qab no (raws li tau muab rau ua piv txwv hom phiaj, thiab cov dluab). Thiab vim qhov no yog ib tug complex txheej txheem, nws yog tsim nyog los xav txog nws nyob rau hauv kom meej.

Yuav ua li cas puas tau nws li cas?

Yog li, lub li qhia txoj kev yog lub luag hauj lwm rau kev siv ceev xwmphem los ntshav, tshwm sim vim kev puas tsuaj rau ib tug los yog lwm feem ntawm cov vascular system ntawm lub cev.

Nyob rau hauv tej yam yooj yim, peb yuav paub qhov txawv peb theem. Thawj - ua kom. Tom qab raug mob rau cov hlab pib tshwm sim tom ntej tshua, uas nws thiaj li ua rau cov tsim ntawm thiaj li hu ua prothrombinase. Qhov no - ib tug complex muaj V thiab X coagulation yam. Nws yog tsim nyob rau saum npoo ntawm platelet membrane phospholipid.

Qhov thib ob theem - coagulation. Nyob rau hauv cov kauj ruam no, fibrin yog tsim los ntawm fibrinogen - siab molecular yuag protein uas yog lub hauv paus ntawm cov ntshav txhaws, thiab qhov tshwm sim ntawm uas yuav ntshav. Lub tswvyim muab rau hauv qab no qhia tau rau theem no.

Thiab thaum kawg, cov thib peb theem. Nws yuav fibrin los khov rau ntawd tag, yus muaj los ntawm ib tug tuab qauv. Los ntawm txoj kev, namely los ntawm ntxuav thiab so qhuav nws yog ua tau kom tau "cov ntaub ntawv" uas yog ces siv rau qhov kev npaj ntawm muaj menyuam tsis taus lub paj rwb thiab films rau siv ceev xwmphem los ntshav tshwm sim los ntawm kev sib tawg ntawm me me hlab ntsha thaum lub sij hawm kev phais haujlwm.

Hais txog tshua

Saum toj no nws yog luv luv piav lub txhaws ntawm cov ntshav. Lub tswvyim, los ntawm txoj kev, yog tsim rov qab nyob rau hauv 1905 ib tug paub txog-coagulation hu ua Paul Oscar Morawitz. Thiab nws tsis poob nws qhov tseeb rau hnub no.

Tab sis ntau npaum puas tau hloov txij 1905 nyob rau hauv qhov kev nkag siab ntawm cov ntshav coagulation raws li ib tug complex txheej txheem. Tsaug rau qhov kev kawm, ntawm chav kawm. Zaum twb tau mus qhib dozens ntawm cov tshiab kev tshua thiab cov proteins uas muab kev koom tes nyob rau hauv tus txheej txheem no. Thiab tam sim no muaj ntau heev cascade tswvyim ntawm cov ntshav coagulation. Tsaug rau nws xaav thiab nkag siab txog qhov no complex txheej txheem twg thiaj li raug ib tug yooj yim me ntsis kom to taub.

Raws li yuav pom nyob rau hauv lub hauv qab no daim duab, ua li cas cia "ua tawm nyob rau hauv lub cib." Noj rau hauv tus account lub sab hauv thiab sab nraud system - cov ntshav thiab cov ntaub so ntswg. Rau txhua yam ntxwv txhais deformation tshwm sim vim kev puas tsuaj. Cov ntshav system kev puas tsuaj thov vascular phab ntsa, collagen, protease (cleaving enzyme), thiab catecholamines (molecule neurotransmitters). Cov nqaij yog cai cell kev puas tsuaj raws li ib tug tshwm sim ntawm uas ib tug mus thromboplastin. Uas yog ib qho tseem ceeb stimulator ntawm cov ntshav txhaws txheej txheem (txwv tsis pub hu ua coagulation). Nws mus ncaj qha mus rau hauv cov ntshav. Qhov no yog nws "txoj kev", tab sis nws muaj ib tug defensive ua cim. Tom qab nws pib thromboplastin txhaws txheej txheem. Tom qab nws tso tawm nyob rau hauv cov ntshav pib ua raws li cov saum toj no peb theem.

lub sij hawm

Yog li ntawd, yog dab tsi hais txog yog ib tug ntshav, lub tswvyim tau pab kom to taub. Tam sim no kuv xav los tham me ntsis txog lub sij hawm.

Tag nrho cov txheej txheem yuav siv sij hawm ib tug tshaj plaws ntawm 7 feeb. Cov thawj theem kav los ntawm tsib mus rau xya. Thaum lub sij hawm lub sij hawm no, prothrombin tsim. Qhov no tshuaj yog ib hom ntawm complex cov protein lub luag hauj lwm rau hauv tus txheej txheem ndlwg ntawm cov ntshav coagulation thiab thooj muaj peev xwm. Uas yog siv los ntawm lub cev nyob rau hauv thiaj li yuav thrombus tsim. Nws clogs qhov puas site, yog li ntawd lub los ntshav nres. Tag nrho nws yuav siv sij hawm 5-7 feeb. Qhov thib ob thiab thib peb theem muab qhov chaw sai npaum li cas. Rau 2-5 vib nas this. Vim hais tias lub sij hawm ntawm cov ntshav coagulation (tswvyim muab saum toj no) cuam tshuam rau dab uas tshwm sim thoob plaws. Thiab qhov no txhais tau tias nyob rau kev raug mob rau ntawm qhov chaw tam sim ntawd.

Prothrombin, nyob rau hauv lem, tsim nyob rau hauv lub siab. Thiab nws synthesis yuav siv sij hawm lub sij hawm. Yuav ua li cas sai sai tsim txaus prothrombin, nws nyob ntawm tus nqi ntawm cov vitamin K uas muaj nyob rau hauv lub cev. Yog hais tias nws yog uas ploj lawm, cov ntshav yuav tsis yooj yim. Thiab nws yog ib tug teeb meem loj. Txij li thaum tsis muaj vitamin K qhia ib tug ua txhaum ntawm lub synthesis ntawm prothrombin. Thiab qhov no - tus kab mob no yuav tsum tau kho.

stabilization synthesis

Zoo, tus general tswvyim ntawm cov ntshav coagulation yog tseeb - tam sim no yuav tsum tau muab ib co xim rau lub npe hais txog dab tsi yuav tsum tau ua los yuav tsum tau npaum li cas ntawm vitamin K rau hauv lub cev.

Yuav pib nrog - mus noj kom zoo. Qhov loj tshaj npaum li cas ntawm vitamin K yog pom nyob rau hauv cov tshuaj yej ntsuab - 959 micrograms per 100 grams! Peb lub sij hawm ntau, incidentally, dua li nyob rau hauv dub. Vim hais tias nws yuav tsum nquag haus. Koj tsis saib tsis xyuas thiab zaub - spinach, dawb qhwv, txiv lws suav, ntsuab taum mog, dos.

Cov nqaij kuj muaj vitamin K, tiam sis tsis nyob rau hauv tag nrho cov - tsuas yog nyob rau hauv nqaij menyuam nyuj, nqaij nyuj siab, menyuam yaj. Tab sis qhov kawg tshaj plaws nws yog tsim los ntawm cov qij, raisins, mis nyuj, apples thiab cov txiv hmab.

Txawm li cas los, Yog hais tias qhov teeb meem no yog teeb meem loj, ces ib tug ntau yam ntawm menus los pab yuav tsis yooj yim. Feem ntau, cov kws kho mob xav kom muab koj cov zaub mov uas muaj cov tshuaj uas lawv muab rau koj. Nrog kev kho mob yuav tsum tsis txhob yuav raug ncua. Nws yog tsim nyog kom sai li sai li sai tau rau nws mus rau normalize ntshav mechanism. Cov kev kho mob regimen yog tshuaj tus kws kho mob tam sim ntawd, thiab nws kuj yog yuam ua hauj lwm yuav tsum ceeb toom dab tsi yuav tshwm sim yog hais tias peb tsis quav ntsej txog cov tswv yim pom. Thiab lub txim yuav ua tau ib tug siab kawg, trombogemorragichesky syndrome, pernicious anemia, mob kab mob thiab kev puas tsuaj hlwb pob txha qia hlwb.

Schmidt tswvyim

Qhov kawg ntawm XIX xyoo pua nyob ib tug naas ej physiologist thiab MD. Nws lub npe yog Aleksandr Aleksandrovich Shmidt. Nws nyob rau 63 xyoo thiab feem ntau ntawm cov sij hawm mob siab rau txoj kev tshawb no ntawm hematology teeb meem. Tab sis nws ua tib zoo kawm lub npe ntawm cov ntshav txhaws. Nws muaj kev tswj kom tsim kom muaj lub enzymatic xwm ntawm tus txheej txheem, yog li ntawd tus paub txog nws npaj ib tug theoretical piav. Uas kom meej meej qhia tau hais tias lub tswvyim muab hauv qab no txhaws.

Nyob rau hauv thawj qhov chaw muaj ib tug yuav txo tau ntawm lub puas txog ntsha. Ces, nyob rau hauv situ tsim xoob kho raws, cov thawj platelet plug. Ces nws hardens. Li txoj kev liab thrombus (txwv tsis pub xa mus rau raws li ib tug ntshav los khov rau ntawd). Tom qab hais tias nws yog cov los yog kiag li yaj.

Nyob rau hauv tus txheej txheem, tau qhia tej yam txhaws yam. Lub Circuit Court nyob rau hauv nws unfolded embodiment kuj qhia lawv. Lawv qhia los ntawm Arabic numerals. Thiab muaj ib tug tag nrho ntawm 13. Thiab nej txhua tus yuav tsum qhia.

yam

Ib tug ua tiav Circuit Court ntawm cov ntshav coagulation yog tsis yooj yim sua yam uas tsis tau qhia lawv. Zoo, nws yuav tsum tau pib nrog tus thawj.

Qhov zoo tshaj yuav kuv - yog ib tug tsis muaj kob protein fibrinogen. Tsim nyob rau hauv lub siab, yaj nyob rau hauv plaza. Qhov zoo tshaj yuav II - prothrombin, uas twb tau hais saum toj no. Nws cim muaj peev xwm yog mus khi calcium ions. Thiab nws yog ces lub cleavage ntawm no substance tsim txhaws enzyme.

Qhov zoo tshaj yuav III - nws yog ib tug complex protein lipoprotein, ntaub so ntswg thromboplastin. Nws hu ua cov thauj ntawm phospholipids, cholesterol, triacylglycerols thiab tshaj.

Qhov zoo tshaj, IV, yog Ca2 + ions. Cov sawv daws yuav hais tias yog txuas nyob rau hauv tus ntawm ib tug tsis muaj kob protein. Lawv muab kev koom tes nyob rau hauv ntau txoj dab, nyob rau hauv tas li ntawd mus txhaws nyob rau hauv lub tso pa tawm ntawm neurotransmitters, piv txwv li.

Qhov zoo tshaj yuav V - nws globulin. Uas yog tseem ua nyob rau hauv lub siab. Nws yuav tsum tau rau cov thwj toob ntawm corticosteroids (hormonal tshuaj) thiab lawv kev thauj mus los. Qhov zoo tshaj yuav VI tej lub sij hawm muaj, tab sis, ces nws tau txiav txim siab tawm ntawm lub cais. Vim hais tias zaum tau pom - nws muaj xws li qhov zoo tshaj yuav V.

Tab sis lub kev faib tsis hloov. Vim hais tias tom qab V mus tau VII. Xws li proconvertin, los ntawm uas kev koom tes los tsim cov ntaub so ntswg prothrombinase (thawj theem).

Qhov zoo tshaj yuav VIII - ib tug protein uas yog qhia nyob rau hauv tib lub saw. Lub npe hu ua anti-hemophilic globulin A. Nws yog vim hais tias ntawm nws tsis muaj kev tsim ib tug tsis tshua muaj, pub tus kab mob, xws li hemophilia. Qhov zoo tshaj yuav IX yog ib tug "hais txog" yav tas los hais. Vim qhov no antihemophilic globulin B. Factor X - ncaj qha globulin, tsim nyob rau hauv lub siab.

Thiab thaum kawg, qhov kawg peb cov ntsiab lus. Qhov no zoo tshaj Rosenthal, Hageman thiab fibrin stabilization. Lawv yog cov, nyob rau hauv lub sau ua ib pawg, muaj feem xyuam rau tsim ntawm intermolecular bonds thiab lub cev tau hauj lwm ntawm ib tug txheej txheem xws li cov ntshav txhaws.

Schmidt Circuit Court muaj xws li tag nrho cov yam tseem ceeb. Thiab heev liag nyeem lawv to taub yuav ua li cas lub piav cov txheej txheem yog complex thiab muaj ntau yam ntsiab.

anticoagulative system

Cov tswvyim no yuav tsum tau muab sau tseg sai sai. Qhov saum toj no piav system txhaws - tswvyim kuj qhia txog cov ndlwg ntawm tus txheej txheem. Tab sis qhov thiaj li hu ua "protivosvortyvanie" kuj yuav siv sij hawm qhov chaw.

Yuav pib, nws yuav tsum tau muab sau tseg tias nyob rau hauv lub chav kawm ntawm evolution, zaum muaj solved ob tag opposite teeb meem. Lawv sim mus xyuas seb - yuav ua li cas rau hauv lub cev tswj los mus tiv thaiv lub outflow ntawm cov ntshav los ntawm puas cov hlab ntsha, thiab yog li kom nws nyob rau hauv ib lub kua hauv lub xeev nyob rau hauv tag nrho cov? Zoo, qhov kev txiav txim ntawm lub thib ob teeb meem yog lub foundations ntawm anticoagulation system.

Nws yog ib qho ntawm ntshav cov nqaijrog uas muaj peev xwm ntawm kev txo tus nqi ntawm cov tshuaj tshua. Qhov ntawd yog inhibited.

Thiab nyob rau hauv tus txheej txheem no muab kev koom tes antithrombin III. Nws lub ntsiab muaj nuj nqi yog los tswj lub lag luam los ntawm tej yam tseem ceeb uas muaj xws li ib daim duab ntawm cov ntshav coagulation. Nws yog ib qho tseem ceeb hais tias: nws tsis tswj lub tsim ntawm ib tug ntshav los khov rau ntawd, thiab yuav rhuav tshem ruaj enzymes, daig nyob rau hauv cov hlab ntsha los ntawm qhov chaw uas nws tsim. Yog vim li cas yog nws tsim nyog? Yuav kom tiv thaiv kev kis tus kab ntshav nyob rau hauv cov hlab ntsha qhov chaw uas raug puas.

tiv thaiv lub caij

Qhia hais tias sawv cev rau ib tug system ntawm cov ntshav coagulation (Circuit Court yog qhia saum toj no), kev kho mob yuav tsum tau muab sau tseg hais tias tshuaj raws li heparin. Nws yog ib tug leej faj uas muaj acidic glycosaminoglycan (ib yam ntawm polysaccharide).

Qhov no - qhov ncaj anticoagulant. Substance txhawb coagulation kev ua si inhibition system. Nws impedes tus txheej txheem ntawm heparin ntshav txhaws. Yuav ua li cas no tshwm sim? Heparin tsuas thiaj li cov kev ua ntawm thrombin nyob rau hauv cov ntshav. Txawm li cas los, qhov no yog - ib tug natural tshuaj. Thiab nws theem kev pab. Yog hais tias peb ua kom paub cov anticoagulant rau lub cev, nws yuav ua rau kom qhov ua kom ntawm antithrombin III thiab lipoprotein lipase (enzymes uas muab siab npuab triglycerides - lub ntsiab lub zog qhov chaw rau lub hlwb).

Tam sim no, heparin yog feem ntau siv nyob rau hauv Ib tug kev kho mob ntawm thrombotic tej yam kev mob. Tsuas yog ib qho ntawm nws molecule yuav qhib ib tug loj tus naj npawb ntawm antithrombin III. Raws li, heparin yuav ntshai raws li ib tug catalyst - raws li nyob rau hauv cov ntaub ntawv no qhov kev txiav txim yeej yog zoo ib yam li cov nyhuv tshwm sim los ntawm lawv.

Nws muaj lwm yam tshuaj nrog rau cov tib txiav txim, muaj nyob rau hauv cov ntshav ntshav. Noj, piv txwv li, α2- macroglobulin. Nws yeej txhawb lub neej puas ib cov ntshav los khov rau ntawd, muaj feem xyuam rau tus txheej txheem ntawm fibrinolysis, ua hauj lwm pab raws li thauj rau lub 2-valent ions, thiab tej yam proteins. Thiab tseem cheeb tshuaj muab kev koom tes nyob rau hauv txhaws.

cai hloov

Yog lwm nuance uas tsis qhia cov tsoos tswvyim ntawm cov ntshav coagulation. Lub physiology ntawm lub cev yog zoo li no hais tias muaj ntau ntawm cov txheej txheem koom nrog tsis tau tsuas yog tshuaj hloov. Tab sis kuj lub cev. Yog hais tias peb yuav soj ntsuam cov txhaws rau cov liab qab qhov muag, koj yuav pom tias tus duab ntawm platelets nyob rau hauv tus txheej txheem ntawm hloov nws. Lawv ua sib npaug hlwb uas raug spinous dab uas tsim nyog rau kev siv ntawm intensive aggregation - combining lub ntsiab rau hauv ib chav tsev xwb.

Tab sis hais tias yog tsis yog txhua txhua. Vim hais tias platelets thaum lub sij hawm txhaws faib sib txawv tshuaj - catecholamines, serotonin, thiab lwm yam Los ntawm yog vim li cas ntawm lub lumen ntawm cov hlab ntsha, uas raug puas, roj. Vim uas muaj ib tug kev haumxeeb ischemia. Ntshav mov mus rau lub puas chaw yog txo. Thiab, raws li, tib outpouring maj txo mus rau ib tug tsawg kawg nkaus. Qhov no yuav qhia tau rau thaiv platelets puas qhov chaw. Lawv yog cov, ntawm cov nuj nqis ntawm lawv spinous dab, raws li yog hais tias "txuas" mus rau cov npoo ntawm cov collagen fibers, uas yog nyob rau ntawm cov npoo ntawm cov qhov txhab. Qhov no xaus thawj, tus coos kom theem. Nws ua tiav lub tsim ntawm thrombin. Raws li los ntawm ib tug ob peb lub vib nas this theem ntawm coagulation thiab retraction. Thiab lub xeem theem - lub restoration ntawm ntshav ncig. Thiab nws yog ib yam uas tseem ceeb heev. Txij li thaum tag nrho cov kev kho neeg mob ntawm lub qhov txhab tseem tsis tau tsis muaj ib tug zoo cov ntshav mov.

pab tau kom paub

Zoo, ib yam dab tsi zoo li no nyob rau hauv lo lus thiab zoo li ib tug yooj yim to taub daim duab ntawm cov ntshav coagulation. Txawm li cas los, muaj ib tug ob peb nuances, uas kuv xav kom nco ntsoov cov xim.

Hemophilia. Nyob rau nws tau hais saum toj no. Qhov no yog ib tug heev txaus ntshai tus kab mob. Cov txiv neej los ntshav, lawv raug kev txom nyem, tej nyuaj. Mob muaj keeb kab mob kev vim tsis xws luag nyob rau hauv cov nqaijrog muab kev koom tes nyob rau hauv lub txhaws txheej txheem. Ntes nws yuav ua tau yooj yim heev - nyob rau ntawm slightest txiav cov neeg poob ib tug ntau ntawm cov ntshav. Thiab siv ib tug ntau lub sij hawm kom nws. Thiab nrog qhov loj tshaj plaws ntaub ntawv ntawm cov ntshav muaj peev xwm pib rau tsis muaj yog vim li cas. Cov neeg kev txom nyem los ntawm hemophilia, tej zaum yuav raug mus rau thaum ntxov tsis taus. Txij li thaum heev los ntshav nyob rau hauv cov nqaij cov ntaub so ntswg (qub hematoma) nyob rau hauv cov pob qij txha - nws tsis yog yooj yim dua. seb nws yog kho li cas? Muaj ib co teeb meem. Ib tug neeg yuav tsum cia kho koj lub cev raws li ib tug lub cev tsis kho txog ntsha, thiab yeej ib txwm yuav tau ceev faj. Yog hais tias los ntshav tshwm sim - ib qho mob ceev yuav tsum tau ua kom paub tshiab ntshav pub, uas muaj ib tug zoo tshaj XVIII.

Feem ntau tus kab mob no muaj feem xyuam rau cov txiv neej. Thiab cov poj niam ua raws li nqa ntawm lub hemophilia noob. Interestingly, lub British Koroleva Viktoriya yog xws li. Ib tug ntawm nws cov tub kis kab mob. Raws li rau lwm yam ob yog tsis paub hais tias. Txij li thaum hemophilia, los ntawm txoj kev, yog feem ntau hu ua lub muaj koob muaj npe kab mob.

Tab sis muaj opposite mob. Qhov no yog hais txog qhov muaj zog cov ntshav txhaws. Yog hais tias nws tshwm sim, tus neeg uas tseem xav tau kev pab yuav tsum tau tsawg kawg yog muaj tseeb. Nce txhaws qhia ib tug yuav muaj intravascular txhaws. Uas txhaws tag nrho cov hlab ntsha. Feem ntau qhov tsim nyog tau tej zaum yuav ua tau ib tug thrombosis, nrog los ntawm o ntawm lub hlab ntsha phab ntsa. Tab sis qhov no kho raws kho yooj yim dua. Feem ntau, los ntawm txoj kev, nws yog lub muas.

Nws yog amazing li cas npaum li cas yog tshwm sim nyob rau hauv tib neeg lub cev, thaum lub elementary txiav nws tus kheej ib daim ntawm daim ntawv. Nws yuav ua tau ib tug ntev lub sij hawm los tham txog cov yam ntxwv ntawm cov ntshav, txhaws thiab nws cov dab uas nrog nws. Tab sis qhov tseem nthuav qhia, li zoo li kom meej meej qhia nws cov schemes muab saum toj no. Nrog tus so, yog koj nyiam yuav tsum accessed ib lub zuj zus.