Kodi zotsatira za kuyesa kwa magazi kwa prothrombin ndi fibrinogen zikuwonetsa chiyani ndipo chifukwa chiyani ndikofunikira kwa wodwala matenda ashuga? Mlozera wa Prothrombin: zodziwika ndi zopatuka

Seva yakumana ndi vuto la mkati kapena kusokonekera kolakwika ndipo sinathe kumaliza zomwe mwapempha.

Chonde funsani woyang'anira seva pa imelo yotetezedwa kuti muwadziwitse za nthawi yomwe cholakwika ichi chachitika, komanso zomwe mudachita musanalakwitsa izi.

Zambiri zokhudzana ndi vutoli zitha kupezeka mu chipika cholakwika cha seva.

Kuphatikiza apo, vuto la 503 Losapezeka ku Service takumana nalo poyesa kugwiritsa ntchito ErrorDocument kuthana ndi pempholi.

Ntchito wamba

Mwa munthu wamkulu wathanzi, kuchuluka kwa IPI kumatha kusiyanasiyana kuchokera ku 70% mpaka 140%, koma nthawi zina kupatuka kumakhala kofunika kwambiri komabe, kumawonedwa ngati kwabwinobwino. Mwachitsanzo, munthawi ya mankhwala ena. Pakadali pano, madokotala amagwiritsa ntchito Mndandanda wa Pulogalamu Yachangu kwa PTI, pamadongosolo ambiri owerengera pazinthu zopangira magazi aanthu athanzi, ndipo lero ndiwofunikira kwambiri.

• mpaka 6 80-100
• 6-12 79-102
• 12-18 78-110
• 18-25 82-115
• 25-45 78-135
• 45-65 kuchokera 78 mpaka 140

Izi ndizosangalatsa! Kuwerengera IPT, ndikofunikira kugawa nthawi ya prothrombin nthawi ndi nthawi ya prothrombin ya wodwalayo woyesedwa, ndikuchulukitsa ndi 100%.

Zifukwa zopatuka pamachitidwe wamba

Zizindikiro za PTI zimatengera kuchuluka kwa prothrombin m'magazi, zinthu zambiri zomwe zimakhudzana ndi matenda, mankhwala komanso momwe mumakhalira zimatha kukhudza kuwonjezeka kapena kuchepa kwake. Mlozera womwe uli pansipa ndi chizindikiro cha kutaya magazi, ndipo umatchedwa hypocoagulation. Cholozera chokwezeka, chimatchedwa hypercoagulation, chimawonetsa mwayi waukulu wamisempha yamagazi yomwe ingatsekere mitsempha ya magazi. Kupatuka konseku kumaopseza ndi zowopsa, kuphatikizapo imfa.

Zomwe zimayambitsa kuchuluka kwa prothrombin okwera:

1. Kuperewera kwa Vitamini K kumawonjezera magazi, kusokoneza kaphatikizidwe kazinthu zopangika.
2. Chiwindi ndi chomwe chimapangitsa kuti mavitamini omwe ali pamwambawa akhale m'thupi la munthu, chifukwa chake matenda a chiwindi amathanso kukhala omwe amayambitsa.
3. Metabolic njala yamthupi chifukwa cha matenda am'mimba.
4. Chithandizo cha mankhwala, kugwiritsa ntchito mankhwala olepheretsa
5. Kudziletsa.

Zomwe zimayambitsa kuchuluka kwa prothrombin otsika:

1. Zambiri.
2. Makamaka.
3. Mimba m'miyezi yotsiriza.
4. Oncology.
5. Mankhwala ena a steroid.
6. Heparin akusowa.

Zofunika! Ngakhale mukumva kuti ndinu athanzi, koma zina mwazomwe zalembedwazi zilipo m'moyo wanu, musakhale aulesi - pitani mukamawunika.

Nthawi yanu komanso ndalama zomwe mungawononge sizingafanane ndi zovuta zomwe zingachitike chifukwa cholephera kugwira ntchito.

Zomwe zimachitika pofufuza zizindikiro za akazi

Nthawi yapakati, mphamvu ya mkazi imakumana ndi mkuntho. Motere, chiwopsezo cha PTI chikukula, ndipo chimafunikira kuwunikira nthawi zonse, ndipo ngati kuli koyenera, kusintha, popeza kuwonjezeka kapena kuchepa kwa chizolowezi cha PTI kumaopseza zotsatira zoyipa kwambiri kwa mayi ndi mwana. Pankhani yakuwonjezeka kwa index ya prothrombin kufika pa 150% komanso kuposa pamenepo, pamakhala chiwopsezo cha kusokonekera kwa placental. Panthawi ya cholozera chotsika, 80% kapena kucheperachepera, mwayi wamagazi ochulukirapo umachulukirachulukira, zonse generic ndi postpartum. Kunyalanyaza kayendetsedwe ka PTI pa nthawi ya pakati sikovomerezeka.

Zofunika! Malinga ndi ziwerengero, mpaka 10% ya azimayi omwe amakana kuyesedwa magazi a PTI anali ndi zovuta zambiri panthawi yobereka, ngakhale kufa kumene.

Momwe mungaperekere kusanthula, ndipo ndani ayenera kuchita izi pafupipafupi?

Mosasamala kanthu za jenda, odwala ayenera kutsatira malangizo omwe amapereka mwachangu mukamapereka magazi kuti mupeze index ya prothrombin. Chakudya chotsiriza sichikhala choyambirira kuposa maola 9 kusanachitike. Kuyamwa magazi kuyenera kuchitika pamimba yopanda kanthu. Madzulo, tikulimbikitsidwa kupewa zakudya zomwe zili ndi zokometsera zambiri, mafuta ndi mchere. Musanapendeketse, musaphatikizire khofi, koko, tiyi, koloko ndi zakumwa zina. Imwani madzi oyera okha osadetsedwa. Muyenera kupewa mowa ndi kusuta tsiku lisanaperekedwe magazi. Kudziletsa kwa nthawi yayitali sikoletsedwa. Uzani dokotala wanu za mankhwala omwe mumamwa.

Zofunika! Maantibayotiki, njira zakulera za mahomoni, mankhwala opatsirana, ndi mankhwala ena ambiri amatha kukhala ndi mphamvu pakuwunikira kwa PTI. Onetsetsani kuti muchenjeze dokotala wanu za ndalama zotere.

Kuphatikiza pa kuwunika koyenera kwa index ya prothrombin pa nthawi yomwe ali ndi pakati, njira zopangira opaleshoni ndi maphunziro a mahomoni omwe adagwirizana ndi dokotala, ndikofunikanso kuwunika kuchuluka kwa prothrombin m'magazi pazokha, makamaka pazomwe tafotokozazi pansipa.

Ngati muli ndi zaka zopitilira 50, muyenera kuyang'anira index yanu ya prothrombin, mosasamala kanthu za jenda. Ku Russia, imodzi mwa ziwengo zapamwamba kwambiri zakufa kuchokera ku matenda amtima wapadziko lonse lapansi, kupezeka nthawi yake kumatha kupulumutsa moyo wa munthu wosazindikira. Ngati simulowa m'gulu lino la zaka, musataye mwayi wowunikira thanzi lanu. Yesetsani kufufuza kamodzi kamodzi pachaka pofuna kupewa, sikulemetsa, koma ngati pali matenda omwe amaphatikizidwa ndi index ya prothrombin, ikutumikirani bwino.

Yang'anani! Zaumoyo ndiye chuma chanu chachikulu. Osakoka mpaka zizindikiro zowoneka zikuwonekera, makamaka zikafika pamatenda amtima. Pitilizani mayeso pasadakhale, kuti mupewe.

Kuwunikira pafupipafupi kwa IPT kuyenera kukhala lamulo kwa onyamula mtima, omwe ali ndi matenda amtima, atherosulinosis, mitsempha ya varicose, mavuto azachipatala, ma neoplasms oyipa, komanso matenda a chiwindi. Ndi nzika zathanzi zomwe zimasamala zaumoyo wawo.

Kodi kuchuluka kwa prothrombin kungakhudzidwe popanda mankhwala?

Ngati vutoli ndi lalikulu, ndiye kuti simungathe kuchita popanda dokotala kulowererapo. Komabe, kuwona zina mwazofunikira zakuthambo, mutha kuthandizira kwambiri thanzi lanu.

• Oatmeal. Kuyambira ubwana, aliyense akudziwa kuti kudya chakudya cham'mawa ndikofunikira kwambiri tsiku lopambana, pali kufotokoza kwachipatala pazomwezi - zimalepheretsa magazi kukula.
• Maolivi, mafuta opaka
• Beetroot, timadziti ta phwetekere, chinthu chachikulu sikuti kuwonjezera mchere kwa iwo.
• Ginger - amalepheretsa mapangidwe am magazi ndi kupundula magazi.
• Phula la chinanazi, limatha kuwonjezeredwa ndi oatmeal.
• Beets - zathu zonse, ku borsch sataya katundu wake wofanana ndi prothrombin.

Zofunika! Ndi kuchuluka kwa prothrombin, zakumwa zoledzeretsa, kusuta komanso zakudya zamafuta ziyenera kuchepetsedwa.

Potsika pang'ono, idyani zakudya zotsatirazi monga momwe mungathere:

• Zinthu zomwe zili ndi omega-3 acid - mafuta a nsomba, nsomba zam'nyanja.
• Mofanananso onse oatmeal, iye ndiwopikisana ndi chilengedwe chonse.
• Garlic, anyezi.
• Tiyi yobiriwira.
• Zipatso zodziwika bwino ku Russia ndi cranberries, raspberries.
• Zipatso za citrus.

Zofunika! Ndi otsika kwambiri a prothrombin, chepetsani kugwiritsa ntchito ma legamu, katundu wophika, mafuta a buckwheat ndi mafuta a nyama.

Kuphatikiza pa mulingo wa prothrombin m'magazi, kuwunika zakudya zanu kumakupatsani mwayi wambiri wokhudza mavuto azaumoyo.

Mthupi la munthu mumakhala magazi osunthasintha - madzi opatsa moyo omwe amapereka thanzi ku maselo onse amthupi ndi kagayidwe. Kutalika kwa zombozo kuli ma kilomita masauzande ambiri, ndipo dera lawo limaposa theka la hekitala. Ndikosatheka kulingalira momwe izi zimakwanira m'thupi la munthu wamkulu.

Koma kuchuluka kwamadzi opatsa moyo ndi ochepa: kwa amuna - pang'ono malita asanu, ndi kwa akazi - pafupifupi anayi. Chifukwa chake, pamene kuvulala kapena kudula kumaphwanya umphumphu wamagetsi, zomwe zili mkati mwake zimatha kutaya, ndikuwopseza munthu yemwe waphedwa.
Ngati magazi sanatetezedwe, cholembera chachikulu chomwe chimadyetsa thupi lonse chimatha.

Pofuna kuti izi zisachitike, chilengedwe chimapanga dongosolo loyenera kupangika magazi. Ndi iye amene amatha kuyambitsa njira zoteteza zomwe zimatseka chilonda ndipo samalola magazi kutuluka m'mitsemayo.

Mtengo wa prothrombin mthupi

Gawo limodzi la mapulogalamu amenewa ndi mapuloteni apadera a m'madzi otchedwa coagulation factor. Amawonetsedwa ndi manambala achi Roma kuyambira I mpaka XIII. Prothrombin ndi imodzi mwazinthu zazikulu. Mapuloteni awa ndiwopeza chinthu II.

Dzinalo "prothrombin" likuwonetsa kuti ndiwotsogola kwa thrombin, enzyme yogwira. Mothandizidwa ndi iye, mafupa (a thrombus), ophimba chilondacho ndikuletsa magazi.

Mlingo wabwinobwino wa prothrombin umawonetsa kuti njira yophatikizira magazi imagwira ntchito moyenera ndipo thupi limatha kuyimitsa kutayika kwamadzi opatsa moyo awa munthawi.

Kuphunzira zamapuloteni sikuchitika nthawi zambiri monga kuyezetsa magazi. Njirayi siyophweka ndipo imangoperekedwa pokhapokha mwadzidzidzi, mwachitsanzo, ndi matenda am'magazi kapena pamaso pamavuto ake.

Kudziwitsa kwa prothrombin mulingo - mayeso ofunika kwambiri a heestasiogram .

Mlingo wa Prothrombin

Ma molekyulu a Prothrombin amaphulika mwachangu komanso mosavuta. Ndikosavuta kuwasiyanitsa ndi mapuloteni ena, omwe amaphatikizira kwambiri kutsimikiza kwa mulingo wake. Pakuwunika koyenera, njira zingapo zimagwiritsidwa ntchito.

• Prothrombin Mwachangu . Masiku ano, njirayi imavomerezedwa ndipo ndi yofala. Njira iyi imawerengera kuchuluka kwa chinthu monga peresenti ya zovomerezeka. Mfundo zotsatirazi zimatengedwa kuti ndizabwino kwambiri (%):
  • ochepera - 70,
  • pazabwino ndi 120.

  Chizindikirochi chimakulolani kuti mudziwe ntchito ya plasma yosakanikirana poyerekeza ndi ma dilutions a plasma a wodwala. Chithunzi cha kusintha kwa prothrombin chimapangidwa, kapangidwe kake kamodzinso ndi deta ya nthawi ya magazi.

  Kuwunikira mwachangu kumawonedwa ndi akatswiri kukhala olondola kwambiri pamene mfundo zotsika za prothrombin zalembedwa.

• Mlozera wa Prothrombin - komanso kutsimikiza ngati peresenti. Chizindikiro chofananira chimakhala ndi malire (%):
  • osachepera - 95,
  • pazabwino ndi 105.

  Zotsatira za mayeso awiri omwe atchulidwa pamwambapa zingagwirizane ngati prothrombin ndiyabwino. Koma mtengo wake ukakhala wotsika poyerekeza, amasiyana kwambiri. Cholozera chimadalira kwambiri kumvetsetsa kwa mankhwala omwe amagwiritsidwa ntchito poyesa.

  Prothrombin nthawi - chikuwonetsa masekondi angati plasma imangoyambika mutatha kuwonjezera chisakanizo chapadera.

  Zoyesa zomaliza zimatengera zaka. Mu makanda obadwa kumene, nthawi yowonjezera magazi imatha kukhala masekondi 14 mpaka 18. Ndipo izi ndizabwinobwino. Akuluakulu, nthawi yotalika masekondi 10 mpaka 15 imawoneka yolondola.

  Ubwenzi Wamayiko Osiyanasiyana - INR . Njirayi ndiosankha ndipo imagwiritsidwa ntchito kuwongolera zotsatira za mayeso a prothrombin.

  Njira ya INR imavomerezedwa ndi akatswiri a WHO ndi mabungwe ena apadziko lonse ndi makomiti omwe amaphunzira za thrombosis ndikuyimira hematology. Zotsatira za mayesowa zimathandiza dokotala kuti aziona momwe mankhwalawo amagwiritsidwira ntchito ndi mankhwala othandizira - zinthu zopangidwa zomwe zimachepetsa mulingo wa prothrombin m'magazi ndikuchepetsa kuchepa kwake. Mankhwalawa amagwiritsidwa ntchito pochiza thrombophlebitis, thrombosis, ndiko kuti, matenda omwe amapanga magazi owopsa m'mitsempha yama venous.

  INR nthawi zambiri imakhala 0.85-11.15.

  Mankhwalawa ngati matenda ofanana ndi pulmonary embolism, venous thrombosis, kapena pathology of valves a mtima akapezeka, malire ovomerezeka amawonjezeka mpaka 3.0.

  Zisonyezo za mayeso a prothrombin

  Kuyesedwa kwa magazi kwa prothrombin kukhoza kuikidwa ndi dokotala pazinthu zotere:

  • Wodwala amatuluka magazi osayima nthawi yayitali (izi zikuonetsa bwino kuti kuphatikizika kwa magazi kumakhala kofanana ndi koyenera),
  • ntchito za chiwindi michere ndi chiwindi chonse chikuchepa,
  • kuwunika kuwonongeka ndi kugwiritsidwa ntchito kwa nthawi yayitali
  • ndi antiphospholipid syndrome pofuna kufotokoza bwino zomwe zimayambitsa matendawa.
  • ngati pali matenda omwe amayenda limodzi ndi kusowa kwa Vitamini K.

  Zina mwatsatanetsatane zomwe zimafunikira kusanthula kwa prothrombin ndi munthu payekha. Nthawi zambiri, phunziroli limalembedwa kwa azimayi azaka zapakati pa 50 mpaka 60. Ndi nthawi imeneyi kuti kusintha kwa mahomoni kumachitika, ndikupangitsa kusintha kwa kapangidwe kake ndi kapangidwe ka magazi.

  Madotolo oterewa atha kupereka mayendedwe:

  • othandizira
  • traumatologist
  • dokotala wa opaleshoni
  • mtima
  • kuyambiranso,
  • pulmonologist
  • wazachipatala

  Pofufuza, magazi ochokera mu mtsempha amagwiritsidwa ntchito. Kuti muwonetsetse kuti zotsatira zake ndi zolondola monga momwe zingathere, malamulo oyenera ayenera kuonedwa phunzirolo lisanachitike:

  • chakudya pasanadutse maora eyiti madzulo, osachepera maola 12 musanayesedwe,
  • musanayambe phunziroli, ndikofunikira kuti mupeze misempha komanso kuti musamamwe kwambiri,
  • musasute fodya patsiku loyeserera ndipo musamwe mowa kwambiri.

  Monga mwachizolowezi, magazi amaperekedwa m'mawa m'mimba yopanda kanthu. Ndikofunikira kudziwitsa ogwira ntchito zachipatala zamankhwala onse omwe amamwa tsiku lomaliza.

  Prothrombin kuchuluka

  Kuchuluka kwa prothrombin m'magazi kumawonetsa kuti kuphatikizana kwa magazi ndizochulukirapo. Izi zikutanthauza kuti imayamba kukhala ya viscous kwambiri, yomwe imasakaniza magazi ndikuyenda m'magazi amitsempha yamagazi.

  Matendawa angapangitse kuchuluka kwa prothrombin, chifukwa chake magazi amachepa:

  • neoplasms yoyipa,
  • matenda a chiwindi
  • thromboembolism
  • polycythemia,
  • pang'onopang'ono angina pectoris.

  Zinthu zoterezi zimatha kuwonjezera kuchuluka kwa mapuloteni:

  • kuchuluka kwa vitamini K m'thupi lomwe prothrombin amapangidwa.
  • kugwiritsa ntchito anticoagulants, maantibayotiki, nicotinic acid, kulera kwa mahomoni pakuchiritsa. Kugwiritsa ntchito mopindulitsa kwa aspirin, mankhwala a anabolic, ndi mankhwala ofewetsa tuvi titha kukhudzanso kukula kwa prothrombin.

  Nthawi zambiri, zinthu zomanga thupi zimachulukana panthawi yomwe mwana wabereka. Nthawi zambiri, izi zimawonekera mu trimester yomaliza ndipo safuna kulandira chithandizo.

  Prothrombin yafupika: zimayambitsa

  Mlingo wotsika kwambiri wa prothrombin ndiowopsa chifukwa ngakhale kuvulala pang'ono komwe kumawononga mtsempha wamagazi kumatha kutaya magazi ambiri. Kupatula apo, kupangika kwa magazi kumakhala pang'onopang'ono kuposa momwe kuyenera kukhalira.

  Milingo yotsika ya prothrombin imayambitsa zifukwa izi:

  • Ma pathologies ena a chiwindi, ngakhale ambiri a iwo amaphatikizidwa ndi kukula kwa mapuloteni. Zambiri za prothrombin zimachepetsa pachimake komanso matenda a chiwindi. Momwemonso zimakhudza cirrhosis.
  • Matenda osakwanira a vitamini K mthupi. Izi zimachitika nthawi zambiri chifukwa cha matenda am'mimba komanso dysbiosis.
  • Kuperewera kwa Fibrinogen - mapuloteni omwe amapangidwa m'chiwindi kenako amasandulika kukhala fibrin, womwe ndi maziko a zovala panthawi ya magazi. Chovuta choterechi chimatha kukhala chobadwa komanso kupezedwa.
  • Kutenga njira zochizira mankhwala omwe amalimbikitsa kuchuluka kwa magazi.

  Ndikotheka kubweretsa kuchuluka kwa prothrombin kukhala yabwinobwino, koma china chake chimayenera kuchitika pokhapokha kukaonana ndi katswiri.

  Chithandizo cha mankhwalawa ndikufuna kuthana ndi mavuto omwe amayambitsa vutoli. Nthawi zambiri, maziko a mankhwalawa ndi chakudya chapadera.

  Zakusintha: Novembala 2018

  Mchitidwe wogwiritsa ntchito magazi ndi chimodzi mwazinthu zofunikira kwambiri zoteteza thupi lathu. Munthawi yovomerezeka, pamene thupi silili pachiwopsezo, kuwundana ndi zinthu zina zitha kukhala zofanana ndipo magaziwo amakhalabe madzi ofunda. Koma kuwonongeka kwa chotengera kukachitika, chiwopsezo chonsecho chimakonzedwa nthawi yomweyo, ndikupanga kuti chikhale magazi ndikutchingira kuti chiwononge.

  Kodi njira yophatikizira ndi chiyani?

  Dongosolo la hemostasis ndilovuta kwambiri, limakhudza minofu yambiri ndi seramu.Kukhazikitsidwa kwake kumawoneka ngati masewera; ndikutulutsa komwe kumachitika, kulumikizana kulikonse komwe kumachitika mwachangu ndi ma enzymes owonjezera.

  Pulogalamu yosinthika yamagazi yosavuta imawoneka motere: thromboplastin imamasulidwa ku endothelium yowonongeka, ndi gawo la calcium ions ndi vitamini K, imayendetsa prothrombin. Prothrombin imasinthidwa kukhala thrombin yogwira ntchito, yomwe imapangitsa kupangika kwa insoluble fibrin kuchokera ku sungunuka wa fibrinogen. Ndondomekoyo imatsirizika ndi gawo la kuchotsa kwa magazi, ndiye kuti, kapangidwe kake ndi kufalikira kumene.

  Pa gawo lililonse, zinthu zambiri zimakhudzidwa mu chiwembuchi. Okhathamira, ma plasma 13 ndi 22 mapulateleti 22 amabisa.

  Kodi prothrombin ndi chiyani

  Ichi ndi glycoprotein wopangidwa m'maselo a chiwindi, II plasma coagulation factor.

  Pa kapangidwe ka prothrombin, vitamini K ndi wofunikira, kotero chimodzi mwazifukwa zochepetsera kwake ndi kusakwanira kwa vitaminiyu kuchokera ku chakudya kapena kuchepa kwake kaphatikizidwe m'matumbo.

  Prothrombin ndi puloteni ya inert, kutsegula kwake kumachitika mothandizidwa ndi XII coagulation factor (mkati mwazinthu) kapena ndi kuwonongeka kwa endothelium (kunja kwamakanidwe a hemostasis).

  Pochita, mayeso apamwamba kwambiri a prothrombin amagwiritsidwa ntchito, omwe amawonetsa zomwe zili m'magazi okha osadziwika. Amakhala pa kuwerengera nthawi yomwe magazi amawundana pomwe othandizira a thrombokinase amawonjezeredwa kwa iwo (omwe amachititsa prothrombin, amawasanduliza kukhala thrombin, ndipo thrombin imathandizira kusintha kwa fibrinogen kukhala fibrin).

  Chifukwa chake, tikamati "kusanthula kwa prothrombin", "magazi a prothrombin", izi sizitanthauza kudziwa kuyika kwake m'magazi, mwachitsanzo, shuga, hemoglobin kapena bilirubin amawunika. Zotsatira zake siziperekedwa m'malo owonjezera, koma peresenti. Lingaliro ili limadziwika ndi makina akunja a hemocoagulation mwambiri ndikuwonetsa zochitika za gulu lonse la prothrombin (zinthu II, V, VII, X).

  Kodi mayeso a prothrombin amachitika bwanji?

  Chomwe chili pafupifupi njira zonse zophunzirira ntchito ya prothrombin zovuta ndikuwerengera nthawi yopanga mawonekedwe a fibrin pambuyo pomwe kuwonjezera kwa oyambitsa magazi, komanso kuyerekezera nthawi ino ndi malingaliro abwinobwino.

  Magazi amasonkhanitsidwa mu chubu choyesera ndi anticoagulant (sodium citrate). Bokosi lamwazi la citrate limayatsidwa pang'ono pakusamba kwamadzi. Reagent yopangidwa ndi thromboplastin ndi calcium chloride imawonjezedwanso kwa iye. Choimitsa chimawerengera nthawi yotayika kwa ulusi wa fibrin. Ino ndi nthawi ya prothrombin (PV). Mtengo wabwinobwino ndi masekondi 11-15.

  Popeza ndatsimikiza PV ya wodwalayo, imayerekezedwa ndi nthawi yokhazikika ya prothrombin (PVN). Nthawi zambiri amasonyezedwa pa vage reagent ndipo zimatengera ntchito ya thromboplastin yomwe imagwiritsidwa ntchito. Nthawi zambiri chiwerengerochi chimachokera masekondi 12 mpaka 18 (mu mtundu uliwonse watsopano wa reagent ukhoza kukhala wosiyana). Chiwerengero cha PVN kupita PV cha mayeso, chomwe chafotokozedwa ngati gawo, ndi prothrombin index (PI). Mtengo wake wabwinobwino ndi 80-105%. Kutalika nthawi yayitali yogwiritsa ntchito magazi (PV), kutsika PI, komwe kumawonetsa kuchepa kwa magazi.

  Prothrombin Mwachangu

  Kuyesaku kumakhudzanso kuchuluka kwa nthawi yofananira prothrombin nthawi yodwala PV, yowonetsedwa ngati peresenti. Koma njirayi imawonedwa yolondola kwambiri. Pa kafukufukuyu, maapozi angapo a plasma (1: 2, 1: 3,1: 4) ndi kapangidwe kazithunzi amagwiritsidwa ntchito. Pazowonjezera zilizonse, PV imatsimikizika ndikuwonekera pa graph.

  Mitengo ya prothrombin malinga ndi Quick ndichokera pa 75% mpaka 140%.

  Pakati pazomwe zili ndi mapuloteni abwinobwino, zotsatira za Quick and PTI zitha kufanana. Pokhala ndi zotsika, zizindikirozi nthawi zina zimasiyanasiyana.

  Chizindikiro china ndicho INR (chiwembu cha mayiko wamba). Amagwiritsidwa ntchito makamaka kuti athe kuyesa kugwiritsa ntchito anticoagulants. Chizindikiro ichi chimawerengeredwa ndi njira:

  INR = (wodwala wa PV / amatanthauza PV yabwinobwino) * mtengo wamalingaliro apadziko lonse a thromboplastinISI).

  Mlozera uwu umawonetsedwa phukusi lililonse la reagent. INR imakupatsani mwayi wofanizira zotsatira za PV ndi PTI zochitikira m'ma labotale osiyanasiyana. Mtengo wa INR mwa anthu athanzi ndi 0.8-1.2.

  Ziwerengero za prothrombin malinga ndi Quick ndi INR ndizofanana motere: ngati prothrombin malinga ndi Quick ikachuluka, ndiye INR yafupika ndipo mosemphanitsa.

  Pamene prothrombin imayesedwa

  Kusanthula kwa coagulation (coagulogram) sikuti kuyesedwa kwachizolowezi, sikuti kwa odwala onse motsatira. Kuyesedwa kumachitika m'malo otsatirawa:

  • Kukhalapo kwa zizindikiro zomwe zikuwonetsa zovuta zakusokonekera: kupumula kwa mphuno ndi magazi ena, kuvulala popanda chifukwa, magazi m'kamwa mukutsuka mano, hemorrhagic totupa pakhungu.
  • Thrombophlebitis ya mitsempha yam'munsi yopanda.
  • Kuyesedwa kwa wodwala musanachite opareshoni iliyonse.
  • Onetsetsani kuti mwayang'anitsitsa ali ndi pakati.
  • Kuwongolera pa mankhwala ndi anticoagulants. Amalembedwa kwa odwala omwe ali ndi arrhythmias, pambuyo pa valovu, ndi thrombophlebitis. Cholinga cha mankhwalawa ndikuwonjezera nthawi yoyanjana yamagazi, koma nthawi yomweyo kuiika pamalo otetezeka. Pankhaniyi, PV idzachulukitsidwa nthawi 1.5-2, IPT ndi prothrombin malinga ndi Quick zimachepetsedwa, INR ikuwonjezeka (bwinobwino mpaka 2-3).
  • Ndi matenda a chiwindi, kufotokozera ntchito zake zopanda mphamvu.
  • Asanakhazikitsidwe mahomoni okhala ndi estrogen, komanso panthawi yawo.

  Mitengo ya Prothrombin m'magulu osiyanasiyana odwala

  Miyezo ya glycoprotein iyi m'magazi ndi yosiyana pang'ono m'magulu osiyanasiyana. Mwa ana osaposa zaka 18, zomwe zili bwino zimachokera ku 80 mpaka 110%, mwa akulu - kuchokera 78 mpaka 145%.

  Zizindikiro zomwe zimachitika mwa abambo ndi akazi akuluakulu sizosiyana. Kuwonjezeka kwapang'onopang'ono kwa prothrombin kumatha kukhala mwa azimayi asanabadwe.

  Mlozera wa Prothrombin

  Chizindikiro ichi chimatsimikiziridwa mu coagulograms onse. Kodi index ya prothrombin ikutanthauza chiyani?

  Mlingo wa index ya prothrombin ndi 80-105%. PV yodwala kwambiri ndikayerekeza ndi yachibadwa, m'munsi imakhala PI yake komanso motsatana. Momwemo, index yotsika imawonetsa coagulability wosavomerezeka, ndipo mndandanda wokwera umawonetsa hypercoagulation (chizolowezi cha thrombosis).
  

  Prohrombin index assay imayikidwa muzochitika zomwezo monga ass prothrombin assay. Mwachidziwikire, zonsezi zimagwirizana mwachindunji ndipo zitha kukhala zofanana pamtundu wanthawi zonse.

  Zomwe zimachitika mu index ya prothrombin pa nthawi ya pakati zimasiyana pang'ono mu trimesters:

  Momwe mungapangirere coagulogram

  Kusanthula uku kuchitidwa kuti mupeze mayankho a mafunso:

  • Kodi magazi amayamba kugwira ntchito nthawi zonse?
  • Kodi pali chiopsezo chotupa pambuyo pake?
  • chifukwa chake ndimakonda kukha magazi pafupipafupi komanso kuvulala,
  • Mlingo wa mankhwala opatsirana ndi otetezeka ngati kuli kotheka.

  Zoyambitsa zazikulu za prothrombin kuchepa

  Kumbukirani kuti prothrombin ndi puloteni yomwe imapangidwa m'maselo a chiwindi ndikutenga nawo vitamini K. Amadutsa mu gawo lokangalika mothandizidwa ndi minofu ingapo komanso plasma coagulation. Jini yomwe imayambitsa kuphatikizika kwa prothrombin imapezekanso, ndipo imapezeka pa chromosome 11.

  Kuphatikiza apo, palinso zinthu zina zothandiza m'magazi, kuchuluka kowonjezereka komwe kungalepheretse zigawo zina za prothrombin zovuta.

  Kuchokera pamapangidwe achilengedwe awa, zoyambitsa zazikulu za prothrombin yotsika ndi IPT zimatsata (PV ndi INR zimachulukitsidwa):

  • Congenital pathology - kusintha kwa majini omwe amayambitsa kapangidwe ka prothrombin (osowa mokwanira).
  • Matenda a chiwindi, limodzi ndi kuchepa kwa ntchito kapena kufa kwa hepatocytes: hepatitis yayitali, matenda amisempha. Kupanda magawo a kapangidwe kazomwe zimapangira kumabweretsa kuti prothrombin m'magazi imachepetsedwa.
  • Kuperewera kwa Vitamini KIzi zimachitika ngati onse sakudya mokwanira, komanso kuphwanya mayamwidwe ake komanso matumbo ake. Chifukwa chake, matenda ammimba ophatikizidwa ndi dysbiosis komanso kuyamwa kwa mafuta kumatha kubweretsanso kuchepa.
  • Mitundu yochepetsedwa ya V, VIII, X ya kuphatikiza zinthu.
  • Matenda a Autoimmune, kuphatikizapo kupanga ma antibodies kupita ku prothrombin (makamaka, ku phosphatidylserine-prothrombin tata).
  • Mitundu yotsika ya fibrinogen.
  • Gawo lachiwiri la matenda a DIC (depletion gawo).
  • Kuchulukitsidwa kwa ntchito ya anticoagulation factor antithrombin III.
  • Chithandizo cha anticoagulants (heparin, fraxiparin, warfarin, neodicumarin).

  Zomwe zimayambitsa Prothrombin ndi IPT Kuchuluka

  Kuwonjezeka kwa IPT kumawonetsa hypercoagulation ndipo ndiowopsa pakukula kwa thrombosis (kugunda kwa mtima, stroko, mwendo mtsempha, pulmonary embolism). Vutoli limakhala losavomerezeka pambuyo pakuchita opaleshoni komanso atabereka mwana.

  • Masabata omaliza a mimba.
  • DIC - syndrome (gawo loyamba).
  • Kugwiritsa ntchito mahomoni okhala ndi estrogen azimayi (ndipo nthawi zina amuna).
  • Congenital thrombophilia.
  • Vitamini Wowonjezera K.
  • Kusintha kwa mtundu wa prothrombin G20210A (onyamula jini losalongosoka ndi 2-3% ya anthu).
  • Nthawi pambuyo yolemetsa ntchito, kutentha matenda.
  • Gawo lomaliza.
  • Zilonda zopweteka.
  • Kuperewera kwa Antithrombin III.
  • Antiphospholipid syndrome.

  Prothrombin ndi chiyani

  Prothrombin ndi puloteni yomwe imayambitsa magazi kuundana. Ndi chinthu ichi chomwe, pakuphatikizana kwa kuphatikizika, chimasandulika kukhala thrombin chitavulazidwa. Thrombus imapangidwa kuchokera pamenepo. Chifukwa cha magazi amtunduwu, chilondacho chimatsekeka, ndipo munthu sangataye magazi ambiri. Ndi kuwonjezeka kwa milingo ya prothrombin, pamakhala chiwopsezo cha kuundana kwa magazi m'mitsempha, mitsempha ndi ziwiya, ndipo ndi kuchepa kwake, zotupa zambiri zimachitika.

  Aliyense ayenera kuyang'anira kuchuluka kwa prothrombin, makamaka atakwanitsa zaka 40. Izi zimalola kudziwidwa koyenera kwa vutoli komanso kuletsa kukula kwa matenda oopsa. Malinga ndi ziwerengero, theka la anthu padziko lapansi pano ali ndi mitundu yosiyanasiyana yocheperako. Kulakwira kumakhala chifukwa cha matenda amtima, stroko, thrombosis komanso matenda ena owopsa.

  Kuyesedwa kwa magazi kwa PTI kwam'magazi kumapangitsa kuchuluka kwa magazi kwa munthu wathanzi komanso wodwala. Malinga ndi ndalamayi, madokotala amaweruza kuchuluka kwa prothrombin m'magazi.

  Zotsatira za kusanthula zikuwonetsedwa ngati peresenti.

  Kuphwanya mulingo wa PTI nthawi zambiri kumakhudzana ndi matenda a chiwindi, chifukwa mapuloteni awa amapangidwa momwemo. Chifukwa chake, kusanthula kumangotithandiza kudziwa matenda amwazi, komanso kudziwa matenda a chiwindi. Kuyesedwa kwa magazi kwa IPT ndikofunikira kwa anthu asanafike opaleshoni.

  Kodi muyenera kuwauza chiyani adotolo?

  • Onetsetsani kuti mwayika mndandanda mankhwala onse omwe mukumwa kapena mwangomwa posachedwa, kuphatikiza othandizira. Mankhwala ambiri amakhudzana ndi coagulogram indices, ndipo izi sizikugwiranso ntchito kwa anticoagulants okha. Chifukwa chake ikhoza kutsika prothrombin Nevigramon, Streptomycin, Tetracycline, Levomycetin, L-thyroxine, vitamini A, Aspirin waukulu.

  Kwezani IPT mwina: mahomoni oletsa kubereka, khansa, antihistamines, kuchuluka kwa mavitamini C, K, mahomoni a corticosteroid.

  • Kuledzera kwa nthawi yayitali kumathanso kuchepetsa IPT.
  • Kuchuluka kwa zakudya zopezeka ndi vitamini K kungayambitse kuchuluka kwa prothrombin, ndipo kudya kwawo kosakwanira - m'malo mwake, kutsika. Izi ndi zinthu monga amadyera, masamba obiriwira ndi zipatso, komanso chiwindi.
  • Amayi ayenera kudziwitsidwa za kukhalapo kwa pakati.

  Ndimaphunziro owonjezera ati omwe angalembedwe?

  • Kusanthula kwa ntchito ya chiwindi (kusanthula kwachulukidwe kachulukidwe ka micirubin, kusintha kwa chiwindi, mapuloteni onse, albumin).
  • Ultrasound a chiwindi ndi biliary thirakiti.
  • Fibroelastography ya chiwindi ndi cirrhosis wokayikitsa.
  • Kutsimikiza kwa ma antibodies ku hepatitis ya viral.
  • Kupenda kowonjezeredwa kwa njira yozizira (APTT, fibrinogen, nthawi ya thrombin, ma-D-dimers, plasminogen, antithrombin III, ntchito ya plasma fibrinolytic, lupus anticoagulant, etc.)
  • Kuunika kwamkati (kusanthula ndowe za dysbiosis, colonoscopy).

  Momwe mungachepetse kapena kuwonjezera kuchuluka kwa prothrombin index?

  Ngati zizindikirozo zingopita pang'ono pokha pokhapokha, musachite mantha. Mwinanso, patapita nthawi atatha kugwiritsa ntchito mankhwala ena, kuwunikiranso kwachiwiri sikuwulula. Amayi ambiri amadera nkhawa funso - chochita ndi njira zakulera? Ngati matenda amtima wapezeka, musiyeni kumwa; ngati mayiyo ali wathanzi, mapiritsi amatha kumwedwa, koma kuwunikira kumawunikidwa nthawi ndi nthawi.

  Mutha kuyesanso kusintha kwa zakudya za DTI ngati mukutsimikiza kuti zakudya zanu zikucheperachepera zakudya monga amadyera (parsley, katsabola, sipinachi), masamba (kabichi, broccoli), ng'ombe kapena chiwindi cha nkhumba. PTI imakweza tiyi wobiriwira bwino.

  Ndi kuchuluka kwa prothrombin komanso chiopsezo cha thrombosis, madokotala nthawi zambiri amapereka anticoagulants. Pankhaniyi, ndi warfarin yekha mwachidziwikire amachepetsa chizindikiro ichi. Ma Anticoagulants am'badwo watsopano (Pradax, Xarelto, Elikvis ndi ena) amachita zinthu zina pakupanga, pomwe kuchuluka kwa prothrombin sikungasinthe.

  Aspirin nawonso sasintha chizindikirocho, koma kuzipeza mumalingaliro ang'onoang'ono ndikumveka kuchepetsa chiopsezo cha thrombosis.

  Kodi ndi nthawi ziti pamene sikofunikira kupatula nthawi yocheza?

  • Ngati zisonyezo za coagulogram ndizapamwamba kwambiri kapena zotsika kuposa zabwinobwino.
  • Pali zizindikiro za homeostasis matenda: kubwereza magazi kapena thrombosis.
  • Kukhalapo kwa pakati.
  • Mankhwala osokoneza bongo a mwana.
  • Pali zizindikiro zina (khungu la khungu, mkodzo wakuda, kutupa, kutupa, kuyabwa, ndi zina).

  Muzochitika izi, muyenera kukayesedwa kwathunthu ndikupeza chomwe chimayambitsa matenda a coagulation dongosolo.

  > Kuyesa kwa magazi kwa prothrombin, INR (nthawi ya prothrombin)

  Izi sizingagwiritsidwe ntchito pakudzipangira nokha mankhwala!
  Onetsetsani kuti mukumane ndi katswiri!

  Njira yomwe imagwiritsidwira ntchito, imaganizira chiyani?

  Prothrombin ndi chimodzi mwazinthu zofunika kwambiri pakupanga magazi. Amapangidwa m'chiwindi ndikupanga vitamini K ndipo amayenda m'madzi a m'magazi. Mukamayanjana ndi thromboplastin ndi calcium ion, prothrombin imasandulika kukhala thrombin, popanda iyo kupangika kwa magazi ndizosatheka.

  Ma laboratories azachipatala, monga lamulo, amachita mayeso a prothrombin, omwe amachitika monga kutsimikiza kwa prothrombin malinga ndi Quick, prothrombin time, global standardized ratio or prothrombin index.

  Nthawi ya Prothrombin (PTV) ndi nthawi yomwe plasma yamagazi imayamba ngati chisakanizo cha thromboplastin-calcium chiwonjezedwa. Amayeza masekondi.

  International Normalized Ratio (INR) ndiye muyeso wa wodwala PTV ku PTV wamba wamba. Zotsatira zakuwunikirazi ndi zokwanira (kachidutswa kakang'ono).

  Mlozera wa prothrombin (PTI) ndiwo kuchuluka kwa nthawi ya magazi a mankhwalawa kufikira nthawi yodzuka kwa plasma ya munthu amene akufufuzidwayo. Amanenedwa ngati peresenti.

  Kutsimikiza kwa prothrombin ndi Quick kumasiyana ndi mayeso am'mbuyomu kuti ma dilutions angapo a plasma amagwiritsidwa ntchito pakagwiridwe kake. Izi zimakuthandizani kuti mupeze zotsatira zolondola (nawonso peresenti).

  Zizindikiro zonsezi zimagwiritsidwa ntchito poyesa momwe mapangidwe a coagulation amathandizira ndikuwona mphamvu ya anticoagulant therapy.

  Kodi kuphunzira kumalembedwa pati?

  Zosintha pazizindikirozi zimatha kuchitika pakuwonjezeka, ndikuwongolera njira zawo.Mwachidziwitso, izi zimawonetsedwa ndi zizindikiro za kuchuluka kapena kuchepa kwa magazi.

  Zomwe zimayambitsa kuphatikizika kwa coagulability ndi kutayika kwakukulu kwa madzimadzi popanda kubwezeretsanso panthawi yake (kusanza, kuwotcha), kugwiritsa ntchito mankhwala osokoneza bongo, komanso kuphwanya kuvomerezedwa kwa zipupa za chotengera. Kuchulukana kwa coagulability kumawonedwa mu matenda, mtima wamitsempha, pakati, DIC, atatha kuchitapo kanthu opaleshoni ndipo nthawi zambiri amawonetsedwa ndi zovuta zingapo za thrombotic.

  Ndi kuchepa kwa magazi m'magazi, kutuluka kwa mabala kumakulirakulira, kuphulika kumachitika mu minofu yofewa ndikuvulala pang'ono, ndipo nosebleeds nthawi zambiri imachitika. Coagulability wovuta amadziwika ndi hemophilia, matenda a chiwindi. Amadwala odwala omwe amamwa anticoagulants kwa nthawi yayitali.

  Pazochitika zonsezi, kuyesa kwa prothrombin ndikofunikira.

  Kodi ndi madokotala ati omwe amakupatsani kafukufuku, ndipo ndingatani?

  Cholozera ku phunziroli chimaperekedwa ndi akatswiri othandizira, opaleshoni, gynecologist, mtima, hematologist, oncologist, nthawi zambiri akatswiri ena.

  Kuyeserera kuchitika mu labotale a diagnostic magulu a zachipatala omwe akuyesa biochemical magazi mayeso.

  Kodi phunziroli ndi chiyani, komanso momwe mungazikonzekerere

  Zomwe zimaphunziridwa ndi magazi. Amatengedwa kuchokera m'mitsempha nthawi yomweyo asanakonzedwe mu chubu chapadera ndi anticoagulant.

  Phunzirolo lisanachitike, adokotala amachotsa mankhwala omwe amasintha magazi m'magazi. Madzulo a njirayi, zakudya zamafuta ndi zonunkhira, mowa samachotsedwa pakudya. Ndikofunika kupewa kupsinjika kwamalingaliro ndi thupi. Kuyamwa magazi kumachitika pamimba yopanda kanthu.

  Zotsatira za phunziroli ndizabwinobwino.

  Nthawi zambiri, chizindikiro cha prothrombin chimachokera ku 11 mpaka 16 masekondi. Kutheka kwa INR ndi 0.85-1.35. Mlozera wa prothrombin uli mndandanda wa 80-100%. Prothrombin malinga ndi Mwachangu - 78-142%.

  Zoyipa za njirayi ndi kukhalapo kwa zifukwa zambiri zomwe zimakhudza kulondola kwa zotsatira za phunziroli (kusowa koyimira koonekeratu kwa thromboplastin wogwiritsidwa ntchito, mphamvu ya zina zophatikizira).

  Zofunikira zamaphunziro

  Njira imathandizira kuzindikira matenda amomwe magazi amapangidwira, kumveketsa kuuma kwake, kuwunika momwe mankhwalawo amathandizira. Koma prothrombin ndi gawo limodzi chabe la heestatic system ya thupi, ndipo kuyesa kwa prothrombin sikungavumbulutse kuphwanya konse. Chifukwa chake, ngati pali umboni, ndikofunikira kuchita kafukufuku wathunthu wamagazi.

  - mawu ofunikira kapena oyeserera a mayeso a labotale chifukwa cha coagulability. IPT ndi kuchuluka kwa ulamuliro (kapena wabwinobwino) PV ya plasma kwa plasma ya wodwala wina yemwe wachulukitsidwa ndi 100%. PV (nthawi ya prothrombin) ndi nthawi yomwe mawonekedwe a thrombin pambuyo pa calcium ndi thromboplastin amawonjezeredwa ku plasma.

  Chifukwa chake, cholosera cha prothrombin chikuwonetsa momwe njira yogwiritsira ntchito magazi imagwirira ntchito. Kutsika kwa IPT kumawonetsa kusayenda bwino (hypocoagulation), ndiko kuti, chizolowezi chowukha magazi. Kuwonjezeka kwa chizindikiro kumawonetsa coagulability (hypercoagulation) komanso chizolowezi chopanga magazi.

  Kuyesa kwa Mimba

  Kuunika koteroko kuyenera kuchitidwa ndi azimayi onse munthawi yamatumbo. Pokhudzana ndi kusintha kwa mahomoni ndi mawonekedwe a kufalikira kwa placental-uterine mwa amayi apakati, chizindikiro ichi chikuwonjezeka pang'ono ndipo chimakhala 90-120%, chomwe chimawerengedwa ngati chizolowezi.

  Pa nthawi yonse ya bere, amayi amawerengera kawiri kawiri. Izi ndizofunikira kwambiri atatsala pang'ono kubadwa, mu trimester yomaliza. Ndi kuchepa kwa IPT mpaka 80%, pamakhala chiopsezo chotaya magazi nthawi yayitali kapena itabadwa. Ngati chiwonjezerochi chikuchulukitsidwa kufika pa 160%, kusinthasintha kwa placenta sikuchotsedwa. Muzochitika izi, mayi woyembekezera amayikidwa mu chipatala, pomwe amayang'aniridwa asanabadwe.Chifukwa chake, madokotala ali ndi mwayi wokonzekera bwino kubadwa kwa mwana ndi kupewa zovuta, kuphatikiza zakupha.

  Zifukwa zokulitsa ndi kutsitsa IPT

  Chizindikiro ichi chimapatukira pazomwe zili ndi mitundu yambiri.

  IPT ikhoza kukana pazifukwa izi:

  • ndikusowa kwa Vitamini K, komwe kumafunikira kaphatikizidwe kazinthu zamagazi (kuperewera kwa vitaminiyu nthawi zambiri kumawonedwa m'matumbo am'matumbo: colitis, enterocolitis ndi ena),
  • ndi kuperewera kobadwa nako kwa zinthu zophatikizika,
  • mankhwalawa heparin ndi analogues,
  • mankhwala, monga Sincumar, Phenilin, Warfarin ndi ena,
  • matenda a chiwindi, momwe kaphatikizidwe kazinthu zoyipa m'magazi ndimasokonekera
  • Matenda amakulu:
  • ndili ndi leukemia wodwala kwambiri komanso
  • matenda a kapamba
  • kusowa kwa fibrinogen (kotenga kapena cholowa),
  • khansa ya kapamba
  • mapuloteni kagayidwe kachakudya.

  Kuwonjezeka kwa IPT kuonedwa:

  • ndi thrombosis ya kutulutsa kosiyanasiyana,
  • kutengedwa ndi - mikhalidwe momwe kuli kuthekera kwakukulu kwa thrombosis,
  • gawo lachitatu lokhala ndi pakati,
  • ntchito yayitali ya corticosteroids, barbiturates, kulera kwa mahomoni.

  

  Kodi ndi milandu iti yomwe imalembedwa?

  Pali zambiri zowunikira ku PTI. Zina mwa izo ndi:

  • Kusokonezeka kwa kayendedwe ka kayendedwe ka magazi,
  • mitsempha ya varicose,
  • matenda a chiwindi osachiritsika
  • antiphospholipid syndrome,
  • amene kale anali ndi stroko, mtima,
  • vuto la autoimmune
  • Vitamini K akusowa
  • coagulation dongosolo kuwongolera pa mankhwala ndi anticoagulants,
  • kukonzekera opareshoni,
  • mimba
  • kuwunika maphunziro azovuta zamavuto.

  Nthawi zina, kuyang'anira IPT nthawi zonse ndikofunikira. Izi zikugwiranso ntchito m'magulu otsatirawa a odwala:

  1. kwa anthu okhala ndimitsempha yama mtima osafunikira (chifukwa cha kuchuluka kwa magazi),
  2. odwala mitsempha ya varicose yovuta ndi thrombosis,
  3. anthu omwe ali ndi matenda amtima monga arrhythmia, angina pectoris ndi ena (mwanjira izi, kusintha kwamankhwala am'mwazi m'magazi kungasonyeze mapangidwe amitsempha yamagazi m'mitsempha.

  Chifukwa chani kubwereketsa?

  Malinga ndi zotsatira za kuwunika kumeneku, adotolo amatha kunena kuti:

  • Kodi pali zolakwika zilizonse mu chiwindi?
  • pali vitamini K wokwanira mthupi
  • Kodi chithandizo cha anticoagulant ndichothandiza?
  • ntchito zophatikiza ndi chiyani,
  • pali chiopsezo chotenga mitsempha yamagazi ndi mitsempha ya varicose,
  • Pali chiopsezo chachikulu cha matenda amtima ndi ziwopsezo.

  Kuyesedwa kwa magazi kwa IPT ndi kofunikira kuphunzira mawa la opaleshoni. Zotsatira zake zikuwonetsa kuphwanya komwe kumachitika mu coagulation system, ndiko kuti, chizolowezi cha kukhetsa magazi kapena thrombosis, zomwe zingathandize kupewa zovuta zowopsa.

  Kafukufukuyu amachitika pofuna kudziwa milandu yomwe imakhala ndi chiopsezo chotaya magazi komanso kuwundana kwa magazi ndi placental insufficiency komanso gestosis mwa amayi apakati.

  Njira yoyesera

  Asanatenge magazi kuti awunikize, adotolo ayenera kudziwa za mankhwala omwe amwe wodwala matenda ashuga. Ngati pali mankhwala omwe angakhudze zotsatira za phunziroli, amathetsa kwakanthawi.

  Pa phunziroli, simuyenera kutsatira zakudya zapadera kapena kutsatira zakudya (kupatula zakudya ndi regimen zofunika pa shuga).

  Kupunthika kwa magazi kumachitika kuchokera kumitsempha mkono, pambuyo pake malo omwe jakisoni imakanikizidwa ndi mpira wa thonje mpaka magazi atasiya. Ngati fupa lowonda pamalo opumira, njira zotenthetsera zimayikidwa.

  Kodi dongosolo la endocrine ndi chiyani ndipo limagwira bwanji? Kodi amagwira ntchito yanji?

  Matenda osokoneza bongo: arthrosis ya bondo - Zizindikiro ndi chithandizo. Werengani zambiri mu nkhaniyi.

  Kupatuka kuchoka pazomwe zimachitika

  Kuwonjezeka kwa nthawi ya prothrombin (masekondi oposa 13) kukuwonetsa kuthekera kwa thrombophilia chifukwa chowonjezera vitamini K (werengani zambiri za mavitamini osungunuka a mafuta, omwe akuphatikizapo vitamini K munkhaniyi). Mwa anthu omwe ali ndi matenda ashuga, ambiri amakhala ochulukirapo, motero ndikofunikira kupenda nthawi ndi nthawi kuti muwone kuchuluka kwa kupatuka.

  Kufunika kwa prothrombin nthawi yopatuka kwazinthu wamba kupita mbali yaying'ono (masekondi 9) kumatha kutha chifukwa cha kuchepa kwa magazi m'magazi, kuwonetsa kusowa kwa vitamini K kapena kuperewera bwino kwa vitamini m'matumbo chifukwa cha dysbiosis ndi enterocolitis.

  • Mowa
  • Kuwonongeka kwa maselo ofiira amthupi chifukwa chogwiritsa mosamala chubu yoyeserera ndi zinthu,
  • Capillary magazi zitsanzo.

  Zomwe masinthidwe amlozera amatengera

  PTI chizolowezi chake zimatengera mulingo wa prothrombin m'magazi. Ngati chizindikirochi chiri pansipa, pamakhala ngozi yotaya magazi kwambiri. Woopsa kwambiri ndi zotupa m'mimba ndi m'mimba. Index ya prothrombin itha kutsitsidwa pazifukwa zotsatirazi:

  • Vitamini K akusowa
  • Matenda a chiwindi.
  • Kuperewera kwa fibrinogen.
  • Owonjezera heparin.
  • Amyloidosis
  • Nephrotic syndrome.
  • Pancreatitis
  • Oncology ya ndulu.
  • Leukemia
  • Kumwa mankhwala amphamvu.

  Kuwonjezeka kwa IPT kumawonetsa kuchuluka kwa magazi patsogolo, zomwe zimatha kuyambitsa magazi omwe angalepheretse magazi kulowa ndikuwatsogolera ku zowopsa. Index yokwezeka ya prothrombin imatha kuchitika pazifukwa izi:

  • Makamaka.
  • Zambiri zam'magazi ofiira.
  • Matenda a oncological.
  • Heparin akusowa.
  • Mimba lachitatu trimester.
  • Kumwa mankhwala ena a mahomoni.

  Kuchotsera kwa kusanthula

  Masiku ano, njira zingapo zikugwiritsidwa ntchito kudziwa IPT. Izi zitha kusokoneza mayesowo, chifukwa zizindikirazo zimatha kusiyanasiyana kutengera zasayansi. Kusanthula kwa magazi kwa PTI decryption kuyenera kuchitika kokha ndi dokotala, poganizira zinthu zonse zomwe zingakhudze index.

  Kunja, sanagwiritse ntchito mankhwala achilengedwe kwa nthawi yayitali, m'maiko otukuka amapanga kafukufuku wina - INR. Kusanthula kumeneku ndikulondola kwambiri ndipo zikuwonetsa kuti ali ndi mitundu yowerengera. Pachifukwa ichi, m'makliniki amakono, m'malo mwa IPT, mdziko lathu amachitanso kafukufuku wa INR.

  Mawonekedwe a kusanthula kwa akazi

  Madokotala amapereka chidwi chapadera ndi zomwe zili prothrombin m'magazi a azimayi onyamula mwana. Amayi onse oyembekezera amayenera kupereka magazi ku IPT kuti madotolo azindikire zotheka munthawi yake. Ngati zotupa zapezeka, amayi oyembekezera amayembekezeredwa mankhwala ochiritsira mankhwala.

  Tsoka ilo, azimayi ambiri oyembekezera amanyalanyaza umboni wa madokotala kuti ayesedwe. Amakhulupirira kuti zizindikirozi ndizosafunikira kwenikweni pa thanzi lawo, chifukwa amamva bwino. Komabe, ziwerengero zimawonetsa zosiyana. Malinga ndi ziwerengero, azimayi 10% omwe sanayezetse magazi a IPT, mwatsoka, adamwalira pobereka pobadwa mwadzidzidzi kutulutsa magazi kwambiri kapena kuwononga magazi obisika.

  Phunziro likayenera kuchitika pafupipafupi

  Kuyesedwa kwa magazi kwa PTI, monga lamulo, kumaperekedwa asanachitidwe opaleshoni komanso panthawi yapakati. Komabe, pali odwala omwe amafunika kuyesedwa pafupipafupi kuti awone momwe mankhwalawo amathandizira. Odwala awa akuphatikizapo:

  • Odwala omwe amathandizidwa ndi mtima.
  • Odwala omwe ali ndi matenda amtima.
  • Odwala anapezeka ndi atherosulinosis.
  • Anthu okhala ndi mitsempha ya varicose.

  Ndikofunikira kwambiri kuwongolera mulingo wa IPT mwa abambo ndi amayi okulirapo kuposa zaka 50, chifukwa ndi omwe amagwera pagulu lowopsa la matenda a mtima ndi mtima. Kuzindikira kwakanthawi kwa okalamba kumatha kupulumutsa moyo wa munthu.Masiku ano, 70% ya okalamba mdziko lathu amwalira ndi vuto la mtima komanso sitiroko. Komanso, index ya prothrombin iyenera kuchitika pafupipafupi kwa odwala omwe ali ndi matenda otsatirawa:

  • Supomboembolism.
  • Hepatitis.
  • Matenda a chiwindi.
  • Matenda a coagulation.
  • Matenda a oncological.
  • Matenda azamankhwala.
  • Chiwonetsero cha pambuyo poti chachitika ndi pambuyo pake.

  Kuphatikiza apo, kuwongolera kwa mulingo wa PTI kumachitika ndi mahomoni ndi heparin. Mankhwalawa amatha kuthana ndi kusokonekera. Ndi kumwa kosagwiritsa ntchito mankhwalawa, mumayika moyo wanu pachiwopsezo. Kumbukirani kuti mankhwala aliwonse ayenera kumwedwa monga adokotala adanenera.

  Malamulo a Kutumiza Katswiri

  Monga kuyezetsa magazi konse, muyenera kutenga zomwe zimayesedwa m'mawa pamimba yopanda kanthu. Sabata isanakwane mpanda, zakumwa zoledzeretsa ndi zamafuta siziyenera kuphatikizidwa ndi zakudya. Tiyi ndi khofi siziyenera kudyera patsiku lotola; kusuta sikulimbikitsidwa mphindi 30 kusanachitike. Kuphatikiza apo, muyenera kuyesa kupatula pakati pamavuto, simungakhale amanjenje. Zinthu zonsezi zimatha kukhudza zotsatira za kuwunika. Ngati mumamwa mankhwala aliwonse, kapena ngakhale mankhwala azitsamba, muyenera kudziwitsa dokotala.

  Ngati zotupa zapezeka, mayeso owonjezera adzapatsidwa kwa inu kuti muthandizire kudziwa zomwe zimayambitsa vuto la kusokonekera. Tiyenera kukumbukira kuti kupatuka kwa cholozera cha PTI sikuti ndi matenda odziyimira pawokha, koma kungotengera thupi pakudwala komwe kulipo. Ndikofunika kwambiri kudziwa chomwe chimayambitsa kupatuka ndikuyenda bwino. Dokotalayo ayenera kuzindikira zomwe akuwunika.

  Mwazi -chinthu chovuta ndichopanga gawo lamadzi (plasma) ndi maselo, chikuchita ntchito zambiri mthupi. Kusungabe dongosolo lino mosalekeza ndi ntchito yoyamba, chifukwa mwinanso kusokonezeka kwamphamvu kwa ziwalo zonse kudzachitika.

  Khalidwe lofunikira la magazi - kuchuluka kwake kosalekeza. Kwa amuna, ndi malita 5, kwa akazi - malita 4. Ndi zovulala, ngakhale zazing'ono, kuchepa kwamtunduwu ndizotheka, komwe kachitidwe kake kamene kamalimbana. Tilankhule za chisonyezo cha kuthekera kwa magazi kugundana - index ya prothrombin.

  Ichi ndi chiyani

  Mapuloteni opangidwa mu chiwindi hepatocytes. Njirayi imagwirizana kwambiri ndi kuchuluka kwa mavitamini. Kuti . Ichi ndi chachiwiri pa magawo khumi ndi atatu ophimbira, popanda amene kuyerekeza magazi ndi kuyimitsidwa kwake chifukwa cha kuvulala kwa khoma la mtima ndikosatheka.

  Dzinalo lenilenilo limanenanso kuti prothrombin ndiyomwe imayambitsa thrombin. Ndiye chomaliza chomwe chidayambitsa kuti pakhale magazi amodzi - magazi.

  Phunziro lili bwanji

  Kafukufuku wa prothrombin siofala ngati kuyezetsa magazi wamba. Izi ndichifukwa cha kukwera mtengo kwa ma reagents.

  Sichimalembedwa mayeso owonongera, pokhapokha ngati pali zoonekeratu (zamankhwala kapena zantchito). Malinga ndi kuchuluka kwa prothrombin, madokotala sawunika kusintha kosasintha kokha, komanso ntchito ya chiwindi.

  Pali njira zingapo zoyezera mulingo wa prothrombin m'magazi:

  1. Prothrombin nthawi - Nthawi (masekondi) ofunikira ndi magazi kuti athe kupukuta kwathunthu.
  2. Prothrombin Mwachangu. Njira yodziwika kwambiri yophunzirira. Chizindikiro chimatsimikizira ntchito ya prothrombin pazinthu zoyesera poyerekeza ndi munthu wathanzi (%).
  3. . Chiwerengero cha kuphatikizika kwa nthawi wodwala azikula moyenera, chomwe chafotokozedwa%.
  4. INR - malingaliro apadziko lonse lapansi. Kafukufuku yemwe amavomerezedwa ndi WHO kwa odwala onse omwe amathandizidwa ndi anticoagulants. Imawerengeredwa malinga ndi fomula yapadera ndipo sizitengera mtundu wa ma reagents, omwe amachititsa kuti ikhale yolunjika.

  Kuwunikira mwachangu masiku ano kumawerengedwa kuti ndi kwabwino, ndikupereka chithunzi chokwanira cha kuphatikiza kwa anthu.Itha kuthandizidwa mwa njira zopewera - mwa akazi azaka za 45-60 kuzindikira chizolowezi cha thrombophlebitis.

  Makhalidwe abwinobwino pazotsatira zachangu sizimasiyana malinga ndi jenda. Koma kutengera zaka, pali chizolowezi chowonjezera chizindikirocho. Timapereka zomwe zili pagome.

  Kusinthasintha pang'ono pamanambala kuwerengera kumatheka malinga ndi labotale. Malire a zomwe nthawi zonse amawonetsedwa pa fomu yosanthula. Nthawi ya Prothrombin ndichizindikiro chokhazikika ndipo chimayambira pa 9 mpaka 12 masekondi.

  Posachedwa, njira yogwiritsira ntchito magazi imayesedwa malinga ndi INR. Kutanthauzira kwa chizindikirochi pagome.

  Kufikira zaka 16, INR ili ndi mfundo zabwino kwambiri. Izi zimaganiziridwa ndi ana. Pa nthawi yoyembekezera, kuyambira sabata la 13, INR imayamba kuchepa.

  Kukonzekera

  Zinthu zambiri zimatha kuyambitsa zotsatira za kafukufuku. Natulande pa fimbi fimo.

  1. Monga kuwunika kachipatala kwapadera, prothrombin imawunika, nthawi zambiri m'mawa.
  2. Kwa masiku angapo, amakana zakudya zamafuta (zili ndi vitamini K2) ndi zakudya zomwe zili ndi vitamini K1 (chiwindi, kabichi, sipinachi, beets, nyemba, radara, radish, turnips, mtedza, mpiru, maswiti, ndi zakudya zosungika). Mndandandawu suti wathunthu, chifukwa chake chidziwitsocho chikufotokozedwanso mu labotale.
  3. Mowa uliwonse umabweretsa kuwonongeka kwa vitamini K, chifukwa chake, amasokoneza zotsatira za kusanthula.
  4. Kudalirika kumapangidwira kwambiri ndimankhwala ambiri (anticoagulants, nicotinic acid, heparin, glucocorticosteroids, aspirin, antihistamines, anabolic steroids, barbiturates, kulera pamlomo, caffeine ndi ena).
  5. Zowonjezera zachilengedwe zimakhala ndi zinthu zomwe zimasintha ntchito ya prothrombin. Onetsetsani kuti mwadziwitsa dokotala wanu za kapangidwe kake ka zinthuzo.
  6. Molunjika musanalandire magazi (mkati mwa maola 12), madzi abwinobwino okha ndi ololedwa.
  7. Ora limodzi lisanachitike phunziroli, siyani kumwa madzi, kusiya kusuta.
  8. Munthu ayenera kukhala wokhazikika. Kupsinjika ndi kuchita masewera olimbitsa thupi kwakanthawi kumasokoneza kukula kwa magazi.

  Ndikofunika kuti azimayi azimayi atayamba kusamba kapena atabereka pambuyo pake kuti asapereke kafukufuku wa prothrombin.

  Kupatuka kuzololedwa

  Odwala ali ndi chidwi ndi funso lomwe limatanthawuza kuwonjezeka kapena kuchepa kwa ntchito ya prothrombin. Poyambirira (kuchuluka), munthu angaganize za chizolowezi chowonjezereka cha thrombosis, chachiwiri (kuchepa) - kuchepa kwa ntchito ya magazi.

  Palinso chifukwa cha vitamini K: ngati ilipo yambiri - IPT imachulukitsidwa, kuchepa kwa kapangidwe kake m'chiwindi (matenda aliwonse a chotupa kapena chotupa) kumabweretsa kutsika kwa IPT.

  Zifukwa zakuchepa

  Chochititsa chachikulu mu izi ndi hypovitaminosis K. Izi zimachitika m'mikhalidwe yotere:

  • Matenda a chiwindi: onse, matenda enaake, zotupa, kuphatikizapo metastasis, matenda obadwa nawo a ziwalo.
  • Chotupa chovunda chifukwa cha kufalikira kwamtundu wa biliary.
  • Kuperewera.
  • Heparin mankhwalawa.
  • Kusokonezeka kwa kagayidwe kazakudya.
  • Matenda a impso.
  • Matenda a kapamba ndi kapamba.
  • Makanda obadwa kumene kumene amayi anali ndi vuto lalikulu la vitamini K m'thupi.
  • DIC, gawo la hypocoagulation.
  • Mitundu ikuluikulu ya kulephera kwa mtima.
  • Matenda oopsa oopsa.

  Mitengo yochepetsedwa ya IPT imatchedwa hypocoagulation. Nthawi yomweyo, kuwonjezeka kwa chizindikiro cha INR kumawonedwa.

  Zoyenera kuchita ndi matenda a PTI

  Kuphwanya dongosolo la kugaya kwa magazi ndi chinthu chowopsa chomwe chimafuna kukhudzidwa ndikuchiritsidwa ndi akatswiri. Zomwe munthu angachite payekha:

  1. Onani makhwala akumwa. Madzi ambiri amadzimadzi (madzi, madzi, zakumwa za zipatso) amatsogolera pakuchepa pang'ono kwa magazi ndi kuphatikizika kwake.
  2. Zakudya: ndikofunikira kupatula zonse zomwe zimapangidwa komanso zitsamba zomwe zimakhudzana ndi coagulability (pamwambapa mutha kuwonjezera sinamoni, tansy, nettle, dieelle, yarrow, plantain).
  3. Nthawi zambiri, ndi mitengo yayikulu ya PTI, anticoagulants amafunikira, koma nthawi yake iyenera kuvomerezedwa ndi adotolo, ndipo chithandizo nthawi zambiri chimachitika kuchipatala.

  Mwalandira zotsatira za kusanthula ndi kupatuka kwa chizindikiro cha prothrombin kuchokera ku chizolowezi, musathamangire kuti mumve zowopsa. Katswiri wodziwa bwino yekha ndi yemwe amatha kumvetsetsa zovuta zonse zomwe zimachitika.

  Dotoloyo akuwonetsa kuti awerenge kafukufuku wa index ya prothrombin, motsogozedwa ndi zifukwa zotsatirazi:

  • Kukayikira kulikonse kwachipatala kwa matenda opaka magazi (odwala akudandaula kuti magazi amatuluka m'matumbo mwachangu, mapangidwe akuthamanga kuchokera kumikwingwirima yaying'ono, ndikutupa kwamisempha m'misempha ndi mafupa, ndikutuluka kwa magazi kwa nthawi yayitali chifukwa cha mabala ndi mabala, azimayi omwe ali ndi magazi osamba a msambo.
  • Atherosulinosis, yozindikiritsidwa mwachipatala komanso yotsimikiziridwa ndi njira zasayansi.
  • Mitsempha ya Varicose.
  • Matenda osiyanasiyana a chiwindi omwe amatsogolera kaphatikizidwe ka mapuloteni, kuphatikizapo prothrombin.
  • Kuperewera kwa Vitamini K
  • Matenda a chitetezo chamthupi.
  • Antiphospholipid syndrome.
  • Amayi omwe ali ndi zolakwika mosalekeza.
  • Kuwona kafukufuku wamagulu amisala pamagulu ena a odwala.
  • Chithandizo cha anticoagulant.

  Kuzindikira komaliza kumapangidwa pokhapokha pofufuza mwatsatanetsatane wa njira zophatikizika, chifukwa chake, malingana ndi miyezo yamakono, kupatuka kokha mu ntchito ya prothrombin kapena nthawi yowundana sikuwonetsedwa ngati chitsimikiziro cha matenda omaliza.

  Maganizo a Post: 2,153

  Prothrombin Index (PTI) - Chizindikiro chimodzi cha kuyesa kwa magazi komwe kumadziwika kuti ndi hemostatic system (), yomwe imachitika ndi gawo la mapuloteni apadera, omwe amatchedwa coagulation factor. Mapuloteni a Prothrombin, omwe amapangidwa m'chiwindi mothandizidwa ndi vitamini K, amachititsa kuti njirayi ikhale.

  Chofunika cha phunziroli ndikuwona kuchuluka kwa nthawi ya magazi a munthu wina, komanso plasma yodziwika bwino komanso kuchuluka kwa chiwerengerochi peresenti.

  Hemostatic dongosolo

  • Maphunziro a heentatic system ndizofunikira kwambiri pakuwonetsa kutulutsa magazi kwa mitundu yosiyanasiyana ya magazi, ma thromboemolic syndromes, mawonekedwe a thrombotic komanso njira zina zodziwikiratu za magazi, kuphatikiza ngati pali vuto.
  • Mgwirizano wamagazi magazi imakonza magazi m'malo amadzimadzi, pamene ikugwira nawo ntchito kuti magazi asiye kutuluka, komanso ngati mawonekedwe a khoma la chotengera.
  • Amaperekedwa ndi kulimbana kwa machitidwe awiri:wosakakamira , yomwe ndi mndandanda wosiyanasiyana wogwiritsa ntchito ma enzymes pakati pa mapuloteni opukutira, ndi anticoagulant , zomwe, mmalo mwake, sizimalola kuti njirayi ipange ndikulepheretsa mapangidwe ndipo, chifukwa chake, kuwundana kwamagazi.
  • Gawo la njira zophatikizika pali mapuloteni omwe amayitanidwa zinthu zoyambitsa . Amawerengeredwa kuyambira 1 mpaka 12. Prothrombin ndiye chinthu chofunikira kwambiri. Mapuloteni awa ndi chinthu chachiwiri. Ndiwotsogola kwa michere yogwira, thrombin.
    Pansi pa kuchitapo kwake, mitundu yamafuta (magazi okwanira) omwe amatseka chilonda ndi kusiya kutaya magazi. Mlingo wake wabwinobwino umawonetsa kuti thupi limatha kupirira bwino ndikutuluka kwa magazi kwakanthawi. Chifukwa chake, tanthauzo la chizindikiro ichi ndilofunika kwambiri.

  Mwachidule za kuchuluka kwa magazi

  Pali makina ofunikira kuti magazi asiye kutuluka, kapena m'malo mwake, apange magazi a magazi (coagulation hemostasis), omwe cholinga chake ndikupanga gawo lofunikira - fibrin.

  Makinawa amaperekedwa ndi zinthu 12:

  1. fibrinogen
  2. prothrombin
  3. minofu thromboplastin,
  4. calcium ayoni
  5. labile factor (proaccelirin),
  6. zochepa zophunziridwa
  7. proconvertin (chinthu chokhazikika),
  8. antihemophilic globulin A,
  9. Khrisimasi chinthu (plasma thromboplastin) - antihemophilic factor C. Amatsimikiza mtima kuti adziwe matenda ovuta - hemophilia.
  10. prothrombinase
  11. Hagen factor (cholumikizira),
  12. fibrinostabilizing chinthu.

  Pakuwona labotale pamayendedwe a coagulation, ndimakonda kudziwa chinthu chachiwiri - prothrombin.

  Njira zophatikizika m'thupi la munthu zimagwira ntchito molimbika. Chifukwa chake, mukamayanjana ndi 10 ml ya magazi, magulu 300 a thrombin amapangidwa, omwe ndi okwanira kuphatikiza malita asanu a magazi.

  Ntchito zake ndi:

  • kupewa kutseguka kwa zinthu zophatikizika,
  • kusalowerera ndale komanso kutsekereza kwa zinthu zomwe zikuyenda bwino,
  • mapulogalamu oyendetsa magazi
  • lysis (cleavage) wa fibrin, yomwe idapangidwa pakupanga.

  Dongosolo la anticoagulant limaphatikizapo zinthu zomwe zimapangidwa mwabwinobwino, komanso ziwalo za thupi zomwe zimapangidwa munthawi ya coagulation ndi fibrinolysis ya zinthu zophatikizika, ntchito ya zinthu izi ndikusintha ndikulowerera zinthu zomwe zikugwira. Ma Anticoagulants amatha kukhala mapuloteni, lipids.

  Amayendedwe a zochita agawidwa:

  1. antithromboplamtins,
  2. antithrombin
  3. ma antifibrins.
  • Kuyesa njira ya heentatic ndikofunikira kudziwa zomwe zikuchitikazo komanso kuchuluka kwa ma cell ndi ma plasma am'dongosolo ili m'magazi ozungulira.
  • Nthawi yomweyo, kuchepa kwa ntchito (ntchito) pazomwe zili pamwambapa, zomwe zimatengera zifukwa zambiri, zitha kuyambitsa matenda (thrombosis kapena magazi), nthawi zina ngakhale motsutsana ndi maziko a kuchepa kwa kuchuluka (kusokonekera kwa kupanga kapena kuchepa - ndi DIC).
  • Kuzindikira molondola kwamatenda kumatsimikizira njira zamankhwala othandizira . Pankhaniyi, kufunika kwa kugwiritsa ntchito mankhwala opangira mankhwala omwe amathandizira chidwi kapena zolimbitsa thupi zoletsa ntchito. Kubwezeretsanso kuchuluka kwa zochulukazo ndizotheka kusintha mwa mankhwala kapena ziwalo zamagazi.

  Kodi chizindikirocho chikutsimikiziridwa bwanji?

  Pakuyesedwa, muyenera kupititsa kuyezetsa magazi kuchokera mu mtsempha.

  Pali njira ziwiri zothandizira kudziwa IPT: Kuyesedwa kwachangu ndi kuyeserera kwawotchi yoyeserera.

  Mayeso a Prothrombin Mwachangu amakhala ndi momwe amapangira magazi, kuti athe kuunika ntchito ya prothrombin ndi mathamangitsidwe ake kutembenuka kwake - zinthu zina za prothrombin zovuta ndi zinthu zina za heparin. Zochita za zovuta za prothrombin zimafotokozedwa ngati peresenti, kusinthasintha kwofanana kumafanana ndi 80-100%.
  Prothrombin index ndi nthawi - magawo akuluakulu omwe atsimikiza.

  Prothrombin Index

  Chifukwa chake, malinga ndi Quick, PTI ndiyambira 78 mpaka 142%, ndipo kudzera njira zina kuchokera pa 95 mpaka 100%. Ziwerengero zomwe zapezedwa pakuwunikidwako zimakhudzidwa ndi chizindikiro monga zaka za munthu.

  Zosintha mu heentatic system mu nthawi zamibadwo:

  • Mwa makanda wodekha magazi. Izi zimatchulidwa kwambiri patsiku lachiwiri la moyo. Zomwe zili zochepa m'magazi a zinthu zazikuluzikulu za kuphatikizika kwa magazi zimatsimikiziridwa pamlingo waukulu ndi kugwira ntchito kwa chiwindi, kusakwanira kwa vitamini K ndi microflora yamatumbo.
  • M'chaka choyamba cha moyo kuchuluka kwa mfundo zina m'magazi kumakwera, koma kumafika msinkhu wachikulire pokhapokha atakula.
  • Mwa anthu achikulire kukula kwa magazi kuyenera kuyembekezeredwa (izi zikuchitika chifukwa cha kuchuluka kwa mapulosi, kuwonjezeka kwa zomatira zawo).

  Kuyesedwa kwa prothrombin index kumaperekedwa liti?

  

  

  Kubwereza KWA OWERENGA Athu!

  Pali nthawi zina pamene tanthauzo la chidziwitso chimodzi chokha sichikwanira kupanga matenda kapena kupereka mankhwala okwanira.

  Zikatero, zimawerengedwa limodzi ndi zizindikiro zina zamomwe zimapangidwira magazi,

  

  Zifukwa zopatuka ku chizolowezi

  Pali zinthu zingapo mthupi pamene PTI ingasinthe.Kutengera mulingo: ndi kuchuluka kwa IPT kapena kuchepetsedwa, munthu akhoza kuweruza kukhalapo kwa matenda monga hyper- ndi hypocoagulation.

  Mkhalidwe monga hypercoagulation, kapena chizindikiro cha kuchulukitsa kwa magazi chitha kupangika pazifukwa:

  • kuchuluka kwa vitamini K m'thupi (popeza vitamini uyu ndiofunika kuti apangidwe prothrombin),
  • neoplasms yoyipa, mitundu yosiyanasiyana ya zotupa,
  • Odwala pambuyo m`mnyewa wamtima infaration, komanso ochita kugwidwa kwa mitsempha
  • mu postoperative nthawi pambuyo opaleshoni ya mtima, valavu m'malo
  • Odwala okhala ndi atritisitis ya nthawi yayitali osatenga ma antiplatelet agents,
  • kuchuluka kwa thupi kumawonedwa mwa amayi apakati (makamaka mu trimester yomaliza),
  • ndi matenda a chiwindi,
  • nthawi zina mukamagwiritsa ntchito njira zakulera za mahomoni, mankhwala a steroid, mahomoni a adrenal,
  • ndi thromboembolic zovuta, venous thrombosis,
  • ndi matenda osakhazikika a mitsempha ya varicose.

  Kukana mulingo wa prothrombin (chisangalalo ) sitiwona ngati chodabwitsa chambiri.

  • pachimake zotupa a chiwindi - hepatitis,
  • kuwonongeka kwa kapangidwe ka chiwindi (sclerosis, fibrosis, cirrhosis),
  • kugwiritsa ntchito mankhwala a anticoagulant (warfarin, aspirin),
  • Vitamini K akusowa (motsutsana ndi maziko a dysbiosis kapena matenda am'mimba, pamene mayamwidwe akusokoneza),
  • kusowa kwa yogwira fibrinogen.

  Chochita ndi IPT yokwezeka?

  Pankhaniyi, pali mwayi wotulutsa magazi, chifukwa popanda kuchuluka kwa prothrombin factor, kuwundana sikungagwire ntchito, monga zikuwonetsedwa ndi kuphwanya kwa zochitika zam'mbuyo.

  Anthu oterowo ayenera kuonana ndi dokotala pafupipafupi pakuyang'anira IPT, makamaka ngati pali vuto lalikulu.

  Ndikofunikira kumwa mankhwala ngati kuchitapo kanthu pakuchita opareshoni ndikofunikira, kaya ndi opareshoni yam'mimba kapena njira zazing'ono zodzikongoletsera. Onetsetsani kuti mukuchenjeza dokotala za momwe mayesowo adzayendera mukamayendera dotolo wamano, chifukwa kutulutsa mano kumatha kuyambitsa magazi kwa nthawi yayitali.

  Momwe mungayesere magazi a PTI

  Kuti mupeze zotsatira zolondola zofufuzira, malamulo angapo ayenera kutsatiridwa. Kuyesedwa kumachitika pamimba yopanda kanthu, theka loyamba la tsiku. Amaloledwa kumwa madzi ochepa. Ndikulimbikitsidwa dzulo, kwinakwake m'maola 24 kuti musamamwe mafuta, yokazinga, osuta fodya, komanso zakumwa zoledzeretsa.

  Momwe mungachepetse index ya prothrombin?

  Choyambirira kuchita ndikufunsira kwa hematologist poyendera malo apadera. Msika wogulitsa mankhwala umayimira unyinji wa mankhwala kuti akonzedwe a heestatic dongosolo. Komabe, ndikofunikira kusankha mlingo woyenera, ndipo muyenera kubwereza kuwunikako panthawi inayake ndipo, kutengera zotsatira zake, musinthe mlingo wa mankhwalawo.

  Njira yodziwira IPT

  Mwazi umayenda bwino ngati prothrombin, puloteni wopangidwa ndi maselo a chiwindi, atenga nawo mbali. Kuti chinthu chikhale chopangidwa mokwanira, ndikofunikira kukhala ndi zinthu zambiri zofufuza, makamaka vitamini K. Chifukwa chake, chifukwa cha kuperewera kwa vitaminiyu, mamolekyulu amapezeka amawanga magazi.

  Prothrombin ikugwira ntchito yokhazikitsa kuphatikiza kwamisempha yamadzimadzi. Mukazindikira nambala ya prothrombin, yomwe ndi chizindikiro cha kuchuluka kwa magazi, mutha kudziwa za kukhalapo kwa matenda. Kuti mudziwe prothrombin, pali mitundu yosiyanasiyana ya maphunziro.

  Makamaka, kuwerengera kumachitika:

  1. PTI Mwachangu. Njira yofufuzira iyi imawonedwa yolondola kwambiri. Zimathandizira kuwona kuchuluka kwa mapuloteni. Kuwunikaku kumawunikira kuwerengera kwa index ya plasma ya wodwalayo pamayeso oyang'anira. PTI imawerengedwa ngati peresenti.
  2. Prothrombin nthawi. Ndiye kuti, amakhazikitsidwa kwa nthawi yayitali magazi amawundana.
  3. Prothrombin index - chiwerengero cha nthawi ya prothrombin, chomwe ndi chizoloŵezi, ku data yankhaniyi.
  4. Mndandanda wa Prothrombin INR. Mothandizidwa ndi mayeso oterowo, chithandizo cha odwala omwe amalembedwa mwachindunji anticoagulants, mankhwala omwe amachepetsa kukonza ndi kuchepetsa kuchuluka kwa mapuloteni, amayang'aniridwa.

  Mitundu ya IPT ndi Zizindikiro Zoyeserera

  Kupatsa ntchito zakuwunikira ndikotheka ngati:

  • wodwalayo amadwala kutalika kwa magazi kwa nthawi yayitali, chomwe ndi zotsatira za kusayenda bwino kwa magazi,
  • pali kuchepa kwa ntchito kwa chiwindi ndi ma enzyme ake,
  • adotolo akuwaganizira kuti ali ndi khansa ya magazi,
  • imafunika kuwongolera kuchuluka kwa kusakanikirana pamankhwala ndi anticoagulants.

  Amayi oyembekezera omwe ali ndi vutoli amadutsa coagulogram kuti adziwitse, mwachitsanzo, kuchepa kwa index ya prothrombin.

  Amayi azaka zopitilira zaka 45 amatumizidwanso kukasinthidwa, chifukwa cha kusintha kwa kusintha kwa mahomoni, kusintha kumachitika mu:

  • kapangidwe ka magazi
  • kapangidwe kake - kachulukidwe komanso koyenera.

  Mu labotale iliyonse, deta imasankhidwa m'njira zosiyanasiyana.

  1. Miyezo yokhazikitsidwa payokha.
  2. Ubwino wa ma reagents omwe amagwiritsidwa ntchito komanso kuchuluka kwa zida zamakono.
  3. Zolemba m'mbiri ya nkhaniyi.

  Kwa amuna ndi akazi, chizindikiro chokhazikika ndi% (ngati njira yofulumira imagwiritsidwa ntchito). Zotsatira zikawonetsa IPT pansipa 77%, izi zikuwonetsa kuti wodwalayo ali ndi index yotsika ya prothrombin. Ngati iposa 120%, ndiye kuti chidziwitsocho chikuwonjezeka.

  IPT, mokulira, zimatengera kupezeka kwa matenda m'thupi. Okwatirana samasewera gawo lapadera. China chake ndikuti ngati mayiyo ali pamalo.

  Kufunika kodziwitsa IPT panthawi yapakati

  Mkazi aliyense wonyamula mwana amayenera kupatsidwa coagulogram, mothandizidwa ndi momwe mtengo wa prothrombin umakhazikitsidwa. Izi ndizofunikira kuti muchepetse magazi kwambiri pakubala kapena kupewa thrombosis.

  Mlingo wa PTI wokhazikitsidwa kwa amayi oyembekezera ndi%. PTI ikacheperachepera, ngati datayo ikusonyeza 80% kapena kuchepera, pamakhala chiwopsezo chachikulu chotaya magazi. Pankhaniyi, coagulants ndi mankhwala. Chifukwa chake, ngati cholingacho chikuwonjezereka, mudzafunika mankhwala omwe angagwiritsidwe ntchito kuti muchepetse magazi ambiri.

  Ndikofunikira kudziwa nthawi ya prothrombin. Chifukwa chiyani izi ndizofunikira?

  Dokotalayo akadziwa nthawi yomwe magazi amayambika mwa mkazi yemwe akubereka, ndiye kuti kupewa:

  • magazi
  • kupezeka kwa hemolytic kugwedezeka, zomwe zimachitika chifukwa cha kuchepa kwambiri kwa magazi komanso chifukwa chomwe azimayi pakubala nthawi zambiri amamwalira.

  Amayi ena oyembekezera amakana kutsatira malangizo a chipatala, ali ndi chidaliro kuti kuperekedwa kwa mayeso mokulira kumakhudza thanzi lawo. Komabe, popanda chidziwitso chakufunika kwa IPT, adotolo sangathe kupereka thandizo panthawi yake. Ngati cholozera chatsitsidwa, placenta ikhoza kutuluka kapena kutaya magazi pambuyo pake. Placental vascular thrombosis sichimaphatikizidwa ndi kuwonjezeka kwa zizindikiro.

  Chifukwa chiyani index ikutsika?

  Kuyesedwa kumachitidwanso kuti mutsimikizire kapena kupatula zopatuka kuzinthu wamba. Mwachilengedwe, pamene IPT idatsitsidwa, ndiye kuti pali zifukwa zofunika kukhazikitsidwa. Pambuyo pa kusanthula, wodwalayo amapatsidwa mawonekedwe amtundu wa tebulo, womwe umawonetsa kufunikira kwa index, komanso chinthu chochepetsera, chifukwa chomwe kusinthaku kunachitika.

  IPT idzatsitsidwa pomwe:

  • Vitamini K akusowa
  • kusowa kwa prothrombin wa kubereka kapena kutenga zinthu,
  • kulakwitsa kwa chiwindi ndi kapamba,
  • kugwiritsa ntchito mankhwala kwa nthawi yayitali komwe kumakhudza kuchuluka kwa magazi.

  Kutsika kwa mlozo kungaganiziridwe ndi zomwe zikuwonetsa zovuta za chiwindi ndi m'mimba thirakiti.

  Wodwala azunzika ndi:

  Koma chizindikiro chachikulu komanso chowopsa ndikutuluka magazi kwambiri, ngakhale ndikudula pang'ono. Kubwetekeka kwachilendo pamapewa ndi IPI yochepa kumatha kutayika kwa magazi pafupifupi 300 ml.

  Simuyenera konse kukayetsa mayeso, chifukwa ndi njira iyi yokha yomwe mungazindikire zoyipa zoyambirira m'thupi pakapita nthawi. Amayi amtsogolo akuyenera kuyang'anira makamaka momwe aliri, chifukwa osati thanzi lawo lokha, komanso moyo wa mwana, yemwe ayenera kubadwa, zimatengera zochita zawo.

  Prothrombin: zabwinobwino

  Mthupi la munthu mumakhala magazi osunthasintha - madzi opatsa moyo omwe amapereka thanzi ku maselo onse amthupi ndi kagayidwe. Kutalika kwa zombozo kuli ma kilomita masauzande ambiri, ndipo dera lawo limaposa theka la hekitala. Ndikosatheka kulingalira momwe izi zimakwanira m'thupi la munthu wamkulu.

  Koma kuchuluka kwamadzi opatsa moyo ndi ochepa: kwa amuna - pang'ono malita asanu, ndi kwa akazi - pafupifupi anayi. Chifukwa chake, pamene kuvulala kapena kudula kumaphwanya umphumphu wamagetsi, zomwe zili mkati mwake zimatha kutaya, ndikuwopseza munthu yemwe waphedwa.

  Ngati magazi sanatetezedwe, cholembera chachikulu chomwe chimadyetsa thupi lonse chimatha.

  Pofuna kuti izi zisachitike, chilengedwe chimapanga dongosolo loyenera kupangika magazi. Ndi iye amene amatha kuyambitsa njira zoteteza zomwe zimatseka chilonda ndipo samalola magazi kutuluka m'mitsemayo.

  Kodi kuchuluka kwa prothrombin index (PTI) kwa akazi ndi kotani?

  Prothrombin index (PTI) ndi imodzi mwazomwe zimayesa mayeso a magazi omwe amadziwika ndi hemostasis system (magazi akupanga), omwe amapezeka ndi gawo la mapuloteni apadera otchedwa coagulation factor. Mapuloteni a Prothrombin, omwe amapangidwa m'chiwindi mothandizidwa ndi vitamini K, amachititsa kuti njirayi ikhale.

  Chofunika cha phunziroli ndikuwona kuchuluka kwa nthawi ya magazi a munthu wina, komanso plasma yodziwika bwino komanso kuchuluka kwa chiwerengerochi peresenti.

  Ndi chiyani china chomwe mumaganizira mukamasanthula IPT?

  Pali nthawi zina pamene tanthauzo la chidziwitso chimodzi chokha sichikwanira kupanga matenda kapena kupereka mankhwala okwanira.

  Zikatero, zimawerengedwa limodzi ndi zizindikiro zina zamomwe zimapangidwira magazi,

  1. nthawi yokumana (kwa Li-oyera),
  2. plasma recalcation time,
  3. wopambana
  4. kutsimikiza kwa prothrombin nthawi,
  5. michere ya fibrinogen,
  6. kulolera kwa plasma kwa heparin,
  7. nthawi ya heparin
  8. fibrinolysis.

  Chochita ndi IPT yochepetsedwa?

  

  Chifukwa chake, mtengo wa prothrombin index (PTI) wapezeka. Chifukwa cha kutengera kwazinthu zina, zizindikiro zimatha kuchepa kapena kuwonjezeka, zomwe zikuwonetsa kuwopsa kwathanzi.

  Njira yodziwira IPT

  Mwazi umayenda bwino ngati prothrombin, puloteni wopangidwa ndi maselo a chiwindi, atenga nawo mbali. Kuti chinthu chikhale chopangidwa mokwanira, ndikofunikira kukhala ndi zinthu zambiri zofufuza, makamaka vitamini K. Chifukwa chake, chifukwa cha kuperewera kwa vitaminiyu, mamolekyulu amapezeka amawanga magazi.

  Prothrombin ikugwira ntchito yokhazikitsa kuphatikiza kwamisempha yamadzimadzi. Mukazindikira nambala ya prothrombin, yomwe ndi chizindikiro cha kuchuluka kwa magazi, mutha kudziwa za kukhalapo kwa matenda. Kuti mudziwe prothrombin, pali mitundu yosiyanasiyana ya maphunziro.

  Makamaka, kuwerengera kumachitika:

  1. PTI Mwachangu. Njira yofufuzira iyi imawonedwa yolondola kwambiri. Zimathandizira kuwona kuchuluka kwa mapuloteni. Kuwunikaku kumawunikira kuwerengera kwa index ya plasma ya wodwalayo pamayeso oyang'anira.PTI imawerengedwa ngati peresenti.
  2. Prothrombin nthawi. Ndiye kuti, amakhazikitsidwa kwa nthawi yayitali magazi amawundana.
  3. Prothrombin index - chiwerengero cha nthawi ya prothrombin, chomwe ndi chizoloŵezi, ku data yankhaniyi.
  4. Mndandanda wa Prothrombin INR. Mothandizidwa ndi mayeso oterowo, chithandizo cha odwala omwe amalembedwa mwachindunji anticoagulants, mankhwala omwe amachepetsa kukonza ndi kuchepetsa kuchuluka kwa mapuloteni, amayang'aniridwa.

  Mitundu ya IPT ndi Zizindikiro Zoyeserera

  Kupatsa ntchito zakuwunikira ndikotheka ngati:

  • wodwalayo amadwala kutalika kwa magazi kwa nthawi yayitali, chomwe ndi zotsatira za kusayenda bwino kwa magazi,
  • pali kuchepa kwa ntchito kwa chiwindi ndi ma enzyme ake,
  • adotolo akuwaganizira kuti ali ndi khansa ya magazi,
  • imafunika kuwongolera kuchuluka kwa kusakanikirana pamankhwala ndi anticoagulants.

  Amayi oyembekezera omwe ali ndi vutoli amadutsa coagulogram kuti adziwitse, mwachitsanzo, kuchepa kwa index ya prothrombin.

  Amayi azaka zopitilira zaka 45 amatumizidwanso kukasinthidwa, chifukwa cha kusintha kwa kusintha kwa mahomoni, kusintha kumachitika mu:

  • kapangidwe ka magazi
  • kapangidwe kake - kachulukidwe komanso koyenera.

  Mu labotale iliyonse, deta imasankhidwa m'njira zosiyanasiyana.

  1. Miyezo yokhazikitsidwa payokha.
  2. Ubwino wa ma reagents omwe amagwiritsidwa ntchito komanso kuchuluka kwa zida zamakono.
  3. Zolemba m'mbiri ya nkhaniyi.

  Kwa amuna ndi akazi, chizindikiro chokhazikika ndi% (ngati njira yofulumira imagwiritsidwa ntchito). Zotsatira zikawonetsa IPT pansipa 77%, izi zikuwonetsa kuti wodwalayo ali ndi index yotsika ya prothrombin. Ngati iposa 120%, ndiye kuti chidziwitsocho chikuwonjezeka.

  IPT, mokulira, zimatengera kupezeka kwa matenda m'thupi. Okwatirana samasewera gawo lapadera. China chake ndikuti ngati mayiyo ali pamalo.

  Kufunika kodziwitsa IPT panthawi yapakati

  Mkazi aliyense wonyamula mwana amayenera kupatsidwa coagulogram, mothandizidwa ndi momwe mtengo wa prothrombin umakhazikitsidwa. Izi ndizofunikira kuti muchepetse magazi kwambiri pakubala kapena kupewa thrombosis.

  Mlingo wa PTI wokhazikitsidwa kwa amayi oyembekezera ndi%. PTI ikacheperachepera, ngati datayo ikusonyeza 80% kapena kuchepera, pamakhala chiwopsezo chachikulu chotaya magazi. Pankhaniyi, coagulants ndi mankhwala. Chifukwa chake, ngati cholingacho chikuwonjezereka, mudzafunika mankhwala omwe angagwiritsidwe ntchito kuti muchepetse magazi ambiri.

  Ndikofunikira kudziwa nthawi ya prothrombin. Chifukwa chiyani izi ndizofunikira?

  Dokotalayo akadziwa nthawi yomwe magazi amayambika mwa mkazi yemwe akubereka, ndiye kuti kupewa:

  • magazi
  • kupezeka kwa hemolytic kugwedezeka, zomwe zimachitika chifukwa cha kuchepa kwambiri kwa magazi komanso chifukwa chomwe azimayi pakubala nthawi zambiri amamwalira.

  Amayi ena oyembekezera amakana kutsatira malangizo a chipatala, ali ndi chidaliro kuti kuperekedwa kwa mayeso mokulira kumakhudza thanzi lawo. Komabe, popanda chidziwitso chakufunika kwa IPT, adotolo sangathe kupereka thandizo panthawi yake. Ngati cholozera chatsitsidwa, placenta ikhoza kutuluka kapena kutaya magazi pambuyo pake. Placental vascular thrombosis sichimaphatikizidwa ndi kuwonjezeka kwa zizindikiro.

  Chifukwa chiyani index ikutsika?

  Kuyesedwa kumachitidwanso kuti mutsimikizire kapena kupatula zopatuka kuzinthu wamba. Mwachilengedwe, pamene IPT idatsitsidwa, ndiye kuti pali zifukwa zofunika kukhazikitsidwa. Pambuyo pa kusanthula, wodwalayo amapatsidwa mawonekedwe amtundu wa tebulo, womwe umawonetsa kufunikira kwa index, komanso chinthu chochepetsera, chifukwa chomwe kusinthaku kunachitika.

  IPT idzatsitsidwa pomwe:

  • Vitamini K akusowa
  • kusowa kwa prothrombin wa kubereka kapena kutenga zinthu,
  • kulakwitsa kwa chiwindi ndi kapamba,
  • kugwiritsa ntchito mankhwala kwa nthawi yayitali komwe kumakhudza kuchuluka kwa magazi.

  Kutsika kwa mlozo kungaganiziridwe ndi zomwe zikuwonetsa zovuta za chiwindi ndi m'mimba thirakiti.

  Wodwala azunzika ndi:

  Koma chizindikiro chachikulu komanso chowopsa ndikutuluka magazi kwambiri, ngakhale ndikudula pang'ono. Kubwetekeka kwachilendo pamapewa ndi IPI yochepa kumatha kutayika kwa magazi pafupifupi 300 ml.

  Simuyenera konse kukayetsa mayeso, chifukwa ndi njira iyi yokha yomwe mungazindikire zoyipa zoyambirira m'thupi pakapita nthawi. Amayi amtsogolo akuyenera kuyang'anira makamaka momwe aliri, chifukwa osati thanzi lawo lokha, komanso moyo wa mwana, yemwe ayenera kubadwa, zimatengera zochita zawo.

  Prothrombin: zabwinobwino

  Mthupi la munthu mumakhala magazi osunthasintha - madzi opatsa moyo omwe amapereka thanzi ku maselo onse amthupi ndi kagayidwe. Kutalika kwa zombozo kuli ma kilomita masauzande ambiri, ndipo dera lawo limaposa theka la hekitala. Ndikosatheka kulingalira momwe izi zimakwanira m'thupi la munthu wamkulu.

  Koma kuchuluka kwamadzi opatsa moyo ndi ochepa: kwa amuna - pang'ono malita asanu, ndi kwa akazi - pafupifupi anayi. Chifukwa chake, pamene kuvulala kapena kudula kumaphwanya umphumphu wamagetsi, zomwe zili mkati mwake zimatha kutaya, ndikuwopseza munthu yemwe waphedwa.

  Ngati magazi sanatetezedwe, cholembera chachikulu chomwe chimadyetsa thupi lonse chimatha.

  Pofuna kuti izi zisachitike, chilengedwe chimapanga dongosolo loyenera kupangika magazi. Ndi iye amene amatha kuyambitsa njira zoteteza zomwe zimatseka chilonda ndipo samalola magazi kutuluka m'mitsemayo.

  Mtengo wa prothrombin mthupi

  Gawo limodzi la mapulogalamu amenewa ndi mapuloteni apadera a m'madzi otchedwa coagulation factor. Amawonetsedwa ndi manambala achi Roma kuyambira I mpaka XIII. Prothrombin ndi imodzi mwazinthu zazikulu. Mapuloteni awa ndiwopeza chinthu II.

  Dzinalo "prothrombin" likuwonetsa kuti ndiwotsogola kwa thrombin, enzyme yogwira. Mothandizidwa ndi iye, mafupa (a thrombus), ophimba chilondacho ndikuletsa magazi.

  Mlingo wabwinobwino wa prothrombin umawonetsa kuti njira yophatikizira magazi imagwira ntchito moyenera ndipo thupi limatha kuyimitsa kutayika kwamadzi opatsa moyo awa munthawi.

  Kuphunzira zamapuloteni sikuchitika nthawi zambiri monga kuyezetsa magazi. Njirayi siyophweka ndipo imangoperekedwa pokhapokha mwadzidzidzi, mwachitsanzo, ndi matenda am'magazi kapena pamaso pamavuto ake.

  Kuwona mulingo wa prothrombin ndiye mayeso ofunikira kwambiri pakupangidwe kwa hemostasiogram.

  Mlingo wa Prothrombin

  Ma molekyulu a Prothrombin amaphulika mwachangu komanso mosavuta. Ndikosavuta kuwasiyanitsa ndi mapuloteni ena, omwe amaphatikizira kwambiri kutsimikiza kwa mulingo wake. Pakuwunika koyenera, njira zingapo zimagwiritsidwa ntchito.

  • Prothrombin Mwachangu. Masiku ano, njirayi imavomerezedwa ndipo ndi yofala. Njira iyi imawerengera kuchuluka kwa chinthu monga peresenti ya zovomerezeka. Mfundo zotsatirazi zimatengedwa kuti ndizabwino kwambiri (%):
    • ochepera - 70,
    • pazabwino ndi 120.

    Chizindikirochi chimakulolani kuti mudziwe ntchito ya plasma yosakanikirana poyerekeza ndi ma dilutions a plasma a wodwala. Chithunzi cha kusintha kwa prothrombin chimapangidwa, kapangidwe kake kamodzinso ndi deta ya nthawi ya magazi.

    Kuwunikira mwachangu kumawonedwa ndi akatswiri kukhala olondola kwambiri pamene mfundo zotsika za prothrombin zalembedwa.

  • Mlozera wa Prothrombin - wofunsidwanso ngati peresenti. Chizindikiro chofananira chimakhala ndi malire (%):
    • osachepera - 95,
    • pazabwino ndi 105.

    Zotsatira za mayeso awiri omwe atchulidwa pamwambapa zingagwirizane ngati prothrombin ndiyabwino. Koma mtengo wake ukakhala wotsika poyerekeza, amasiyana kwambiri.Cholozera chimadalira kwambiri kumvetsetsa kwa mankhwala omwe amagwiritsidwa ntchito poyesa.

    Nthawi ya Prothrombin - imawonetsa masekondi angati pambuyo pakuphatikizira msanganizo wapadera kwa iwo.

    Zoyesa zomaliza zimatengera zaka. Mu makanda obadwa kumene, nthawi yowonjezera magazi imatha kukhala masekondi 14 mpaka 18. Ndipo izi ndizabwinobwino. Akuluakulu, nthawi yotalika masekondi 10 mpaka 15 imawoneka yolondola.

    Makhalidwe apadziko lonse lapansi - INR. Njirayi ndiosankha ndipo imagwiritsidwa ntchito kuwongolera zotsatira za mayeso a prothrombin.

    Njira ya INR imavomerezedwa ndi akatswiri a WHO ndi mabungwe ena apadziko lonse ndi makomiti omwe amaphunzira za thrombosis ndikuyimira hematology. Zotsatira za mayesowa zimathandiza dokotala kuti aziona momwe mankhwalawo amagwiritsidwira ntchito ndi mankhwala othandizira - zinthu zopangidwa zomwe zimachepetsa mulingo wa prothrombin m'magazi ndikuchepetsa kuchepa kwake. Mankhwalawa amagwiritsidwa ntchito pochiza thrombophlebitis, thrombosis, ndiko kuti, matenda omwe amapanga magazi owopsa m'mitsempha yama venous.

    INR nthawi zambiri imakhala 0.85-11.15.

    Mankhwalawa ngati matenda ofanana ndi pulmonary embolism, venous thrombosis, kapena pathology of valves a mtima akapezeka, malire ovomerezeka amawonjezeka mpaka 3.0.

    Zisonyezo za mayeso a prothrombin

    Kuyesedwa kwa magazi kwa prothrombin kukhoza kuikidwa ndi dokotala pazinthu zotere:

    • Wodwala amatuluka magazi osayima nthawi yayitali (izi zikuonetsa bwino kuti kuphatikizika kwa magazi kumakhala kofanana ndi koyenera),
    • ntchito za chiwindi michere ndi chiwindi chonse chikuchepa,
    • kuwunika kuwonongeka ndi kugwiritsidwa ntchito kwa nthawi yayitali
    • ndi antiphospholipid syndrome pofuna kufotokoza bwino zomwe zimayambitsa matendawa.
    • ngati pali matenda omwe amayenda limodzi ndi kusowa kwa Vitamini K.

    Zina mwatsatanetsatane zomwe zimafunikira kusanthula kwa prothrombin ndi munthu payekha. Nthawi zambiri, phunziroli limalembedwa kwa azimayi azaka zapakati pa 50 mpaka 60. Ndi nthawi imeneyi kuti kusintha kwa mahomoni kumachitika, ndikupangitsa kusintha kwa kapangidwe kake ndi kapangidwe ka magazi.

    Madotolo oterewa atha kupereka mayendedwe:

    Pofufuza, magazi ochokera mu mtsempha amagwiritsidwa ntchito. Kuti muwonetsetse kuti zotsatira zake ndi zolondola monga momwe zingathere, malamulo oyenera ayenera kuonedwa phunzirolo lisanachitike:

    • chakudya pasanadutse maora eyiti madzulo, osachepera maola 12 musanayesedwe,
    • musanayambe phunziroli, ndikofunikira kuti mupeze misempha komanso kuti musamamwe kwambiri,
    • musasute fodya patsiku loyeserera ndipo musamwe mowa kwambiri.

    Monga mwachizolowezi, magazi amaperekedwa m'mawa m'mimba yopanda kanthu. Ndikofunikira kudziwitsa ogwira ntchito zachipatala zamankhwala onse omwe amamwa tsiku lomaliza.

    Prothrombin kuchuluka

    Kuchuluka kwa prothrombin m'magazi kumawonetsa kuti kuphatikizana kwa magazi ndizochulukirapo. Izi zikutanthauza kuti imayamba kukhala ya viscous kwambiri, yomwe imasakaniza magazi ndikuyenda m'magazi amitsempha yamagazi.

    Matendawa angapangitse kuchuluka kwa prothrombin, chifukwa chake magazi amachepa:

    • neoplasms yoyipa,
    • matenda a chiwindi
    • thromboembolism
    • polycythemia,
    • pang'onopang'ono angina pectoris.

    Zinthu zoterezi zimatha kuwonjezera kuchuluka kwa mapuloteni:

    • kuchuluka kwa vitamini K m'thupi lomwe prothrombin amapangidwa.
    • kugwiritsa ntchito anticoagulants, maantibayotiki, nicotinic acid, kulera kwa mahomoni pakuchiritsa. Kugwiritsa ntchito mopindulitsa kwa aspirin, mankhwala a anabolic, ndi mankhwala ofewetsa tuvi titha kukhudzanso kukula kwa prothrombin.

    Nthawi zambiri, zinthu zomanga thupi zimachulukana panthawi yomwe mwana wabereka. Nthawi zambiri, izi zimawonekera mu trimester yomaliza ndipo safuna kulandira chithandizo.

    Prothrombin yafupika: zimayambitsa

    Mlingo wotsika kwambiri wa prothrombin ndiowopsa chifukwa ngakhale kuvulala pang'ono komwe kumawononga mtsempha wamagazi kumatha kutaya magazi ambiri. Kupatula apo, kupangika kwa magazi kumakhala pang'onopang'ono kuposa momwe kuyenera kukhalira.

    Milingo yotsika ya prothrombin imayambitsa zifukwa izi:

    • Ma pathologies ena a chiwindi, ngakhale ambiri a iwo amaphatikizidwa ndi kukula kwa mapuloteni. Zambiri za prothrombin zimachepetsa pachimake komanso matenda a chiwindi. Momwemonso zimakhudza cirrhosis.
    • Matenda osakwanira a vitamini K mthupi. Izi zimachitika nthawi zambiri chifukwa cha matenda am'mimba komanso dysbiosis.
    • Kuperewera kwa Fibrinogen - mapuloteni omwe amapangidwa m'chiwindi kenako amasandulika kukhala fibrin, womwe ndi maziko a zovala panthawi ya magazi. Chovuta choterechi chimatha kukhala chobadwa komanso kupezedwa.
    • Kutenga njira zochizira mankhwala omwe amalimbikitsa kuchuluka kwa magazi.

    Ndikotheka kubweretsa kuchuluka kwa prothrombin kukhala yabwinobwino, koma china chake chimayenera kuchitika pokhapokha kukaonana ndi katswiri.

    Chithandizo cha mankhwalawa ndikufuna kuthana ndi mavuto omwe amayambitsa vutoli. Nthawi zambiri, maziko a mankhwalawa ndi chakudya chapadera.

    Kodi kuchuluka kwa prothrombin index (PTI) kwa akazi ndi kotani?

    Prothrombin index (PTI) ndi imodzi mwazomwe zimayesa mayeso a magazi omwe amadziwika ndi hemostasis system (magazi akupanga), omwe amapezeka ndi gawo la mapuloteni apadera otchedwa coagulation factor. Mapuloteni a Prothrombin, omwe amapangidwa m'chiwindi mothandizidwa ndi vitamini K, amachititsa kuti njirayi ikhale.

    Chofunika cha phunziroli ndikuwona kuchuluka kwa nthawi ya magazi a munthu wina, komanso plasma yodziwika bwino komanso kuchuluka kwa chiwerengerochi peresenti.

    Hemostatic dongosolo

    • Kafukufuku wokhudza heestasis yofunikira kwambiri pakuzindikiridwa kwa magazi osiyanasiyana, ma thromboembolic syndromes, ma thrombotic ndi njira zina zodziwika za magazi, kuphatikizira milandu.
    • Mchitidwe wamagazi ogwiritsira ntchito magazi umatsimikizira kuti magazi amasungidwa m'malo amadzimadzi, pomwe amatenga nawo mbali pakuletsa kutulutsa magazi, komanso mawonekedwe abwinobwino a khoma la chotengera.
    • Amaperekedwa ndi kukhudzidwa kwa magawo awiri: coagulant, yomwe imayimira zochitika zingapo zovuta ndi ma enzymes pakati pazinthu zomanga mapuloteni, ndi anticoagulant, omwe, m'malo mwake, amalepheretsa njirayi kupanga ndikulepheretsa mapangidwe ndipo chifukwa chake, magazi amawundana.
    • Gawo lazinthu zophatikizika ndi mapuloteni, omwe amatchedwa coagulation factor. Amawerengeredwa kuyambira 1 mpaka 12. Prothrombin ndiye chinthu chofunikira kwambiri. Mapuloteni awa ndi chinthu chachiwiri. Ndiwotsogola kwa michere yogwira, thrombin.

    Ndi kayendedwe kake, mawonekedwe a (thrombus), omwe amatseka chilonda ndikuleka magazi. Mlingo wake wabwinobwino umawonetsa kuti thupi limatha kupirira bwino ndikutuluka kwa magazi kwakanthawi. Chifukwa chake, tanthauzo la chizindikiro ichi ndilofunika kwambiri.

    Mwachidule za kuchuluka kwa magazi

    Pali makina ofunikira kuti magazi asiye kutuluka, kapena m'malo mwake, apange magazi a magazi (coagulation hemostasis), omwe cholinga chake ndikupanga gawo lofunikira - fibrin.

    Makinawa amaperekedwa ndi zinthu 12:

    1. fibrinogen
    2. prothrombin
    3. minofu thromboplastin,
    4. calcium ayoni
    5. labile factor (proaccelirin),
    6. zochepa zophunziridwa
    7. proconvertin (chinthu chokhazikika),
    8. antihemophilic globulin A,
    9. Khrisimasi chinthu (plasma thromboplastin) - antihemophilic factor C. Amatsimikiza mtima kuti adziwe matenda ovuta - hemophilia.
    10. prothrombinase
    11. Hagen factor (cholumikizira),
    12. fibrinostabilizing chinthu.

    Pakuwunika kwawotchi kwazomwe zimachitika, ndizachikhalidwe kudziwa chinthu chachiwiri, prothrombin.

    • kupewa kutseguka kwa zinthu zophatikizika,
    • kusalowerera ndale komanso kutsekereza kwa zinthu zomwe zikuyenda bwino,
    • mapulogalamu oyendetsa magazi
    • lysis (cleavage) wa fibrin, yomwe idapangidwa pakupanga.

    Dongosolo la anticoagulant limaphatikizapo zinthu zomwe zimapangidwa mwabwinobwino, komanso ziwalo za thupi zomwe zimapangidwa munthawi ya coagulation ndi fibrinolysis ya zinthu zophatikizika, ntchito ya zinthu izi ndikusintha ndikulowerera zinthu zomwe zikugwira. Ma Anticoagulants amatha kukhala mapuloteni, lipids.

    Amayendedwe a zochita agawidwa:

    1. antithromboplamtins,
    2. antithrombin
    3. ma antifibrins.
    • Kuti muwone momwe hentatic imakhalira, ndikofunikira kudziwa zonse zomwe zikuchitika komanso kuchuluka kwa ma cell ndi ma plasma a dongosolo ili m'magazi ozungulira.
    • Nthawi yomweyo, kuchepa kwa ntchito (zochitika) za zinthu zomwe tatchulazi, zomwe zimatengera zifukwa zambiri, zitha kuyambitsa matenda kuwonetsa (thrombosis kapena magazi), nthawi zina ngakhale motsutsana ndi maziko a kuchepa kwa kuchuluka (kusokonekera kwa kupanga kapena kufooka - ndi DIC).
    • Kuzindikira molondola kwamatenda kumatsimikizira njira zamankhwala ochiritsira. Pankhaniyi, kufunika kwa kugwiritsa ntchito mankhwala opangira mankhwala omwe amathandizira chidwi kapena zolimbitsa thupi zoletsa ntchito. Kubwezeretsanso kuchuluka kwa zochulukazo ndizotheka kusintha mwa mankhwala kapena ziwalo zamagazi.

    Kodi chizindikirocho chikutsimikiziridwa bwanji?

    Pakuyesedwa, muyenera kupititsa kuyezetsa magazi kuchokera mu mtsempha.

    Pali njira ziwiri zothandizira kudziwa IPT: kuyesa Kwachangu ndi kuyesa mayeso a labotale.

    Mayeso a Prothrombin Quik amakhala ndi njira yowonjezera magazi, ndikupangitsa kuti athe kuwunika ntchito ya prothrombin ndi kusintha kwake kotembenuka - zinthu zomwe zimapangitsa kuti prothrombin ikhale yovuta komanso zinthu ngati heparin. Zochita za zovuta za prothrbin zimafotokozedwa ngati peresenti, kusinthasintha kwofanana kumafanana ndi%.

    Mndandanda wa prothrombin ndi nthawi ndizofunikira kwambiri, zomwe zimatsimikiziridwa.

    Prothrombin Index

    Chifukwa chake, malinga ndi Quick, PTI ndiyambira 78 mpaka 142%, ndipo kudzera njira zina kuchokera pa 95 mpaka 100%. Ziwerengero zomwe zapezedwa pakuwunikidwako zimakhudzidwa ndi chizindikiro monga zaka za munthu.

    Zosintha mu heentatic system mu nthawi zamibadwo:

    • Mwa makanda, kuphatikizana kwa magazi kumachedwa. Izi zimatchulidwa kwambiri patsiku lachiwiri la moyo. Zomwe zili zochepa m'magazi a zinthu zazikuluzikulu za kuphatikizika kwa magazi zimatsimikiziridwa pamlingo waukulu ndi kugwira ntchito kwa chiwindi, kusakwanira kwa vitamini K ndi microflora yamatumbo.
    • M'chaka choyamba cha moyo, kuchuluka kwa mfundo zina m'magazi kumakwera, koma amafika pamlingo wachikulire pokhapokha atakula.
    • Mwa anthu achikulire, kukula kwa magazi kuyenera kuyembekezeredwa (izi zikuchitika chifukwa cha kuchuluka kwa maplatelet, kuwonjezeka kwa zomatira zawo).

    Kuyesedwa kwa prothrombin index kumaperekedwa liti?

    • Ngati pali magazi ena alionse, kuvulala kwambiri popanda chifukwa,
    • Kuphunzira kolimbikitsa,
    • Kuti mupeze mayendedwe a kuphatikizika komanso,
    • Pozindikira matenda am'magazi,
    • Ngati khansa ikukayikiridwa,
    • Kuwunikira chithandizo chautali ndi anticoagulants osadziwika monga warfarin,
    • Kuyesa momwe ntchito ya chiwindi imayendera,
    • Ndi thrombosis,
    • Kuti mudziwe kupezeka kwa DIC.

    Kubwereza KWA OWERENGA Athu!

    Posachedwa, ndidawerenga nkhani yomwe imakamba za tiyi wa Monastic pochiza matenda a mtima. Kugwiritsa ntchito tiyi, MUTHA KUTI muchiritse matenda a arrhythmia, kulephera kwa mtima, matenda a mtima, matenda amtima, matenda amitsempha yam'mimba komanso matenda ena ambiri a mtima ndi mitsempha yamagazi kunyumba. Sindinazolowere kudalira zidziwitso zilizonse, koma ndidaganiza zowunika ndikulamula chikwama.

    Ndi chiyani china chomwe mumaganizira mukamasanthula IPT?

    Pali nthawi zina pamene tanthauzo la chidziwitso chimodzi chokha sichikwanira kupanga matenda kapena kupereka mankhwala okwanira.

    Zikatero, zimawerengedwa limodzi ndi zizindikiro zina zamomwe zimapangidwira magazi,

    1. nthawi yokumana (kwa Li-oyera),
    2. plasma recalcation time,
    3. wopambana
    4. kutsimikiza kwa prothrombin nthawi,
    5. michere ya fibrinogen,
    6. kulolera kwa plasma kwa heparin,
    7. nthawi ya heparin
    8. fibrinolysis.

    Kuchita kwabwino mwa akazi

    • Kwa akazi, kuchuluka kwa index ya prothrombin ndi chimodzimodzi kwa amuna ndipo ndi%. Kupatula ndiye nthawi yomwe muli ndi pakati, makamaka trimester yomaliza, pamene kuchuluka kwa chisonyezo kumakulirakulira. Chiwerengero cha% pa nthawi ya kubereka chimawerengedwa kuti ndi chizolowezi.
    • Pankhaniyi, ndikofunikira kuyang'anira njira yoyeserera magazi, kutenga mayeso a coagulogram, chifukwa ndikofunikira kwambiri kudziwa momwe magazi amakhalira, pokonzekera kubadwa kwa mwana. Kuunikira chimodzi mwazizindikiro, monga IPT, mutha kuneneratu za zovuta zomwe zingachitike pakubadwa kwa mwana kapena pambuyo pake, monga mwayi wokhetsa magazi.
    • Kuzindikira koyambirira kotereku kumapangitsa kuti pakhale zovuta kuti munthu asadwale kugwiritsa ntchito mankhwala enaake, pomwe mfundo yake ndiomwe imayambitsa dongosolo la coagulation.

    Zifukwa zopatuka ku chizolowezi

    Pali zinthu zingapo mthupi pamene PTI ingasinthe. Kutengera mulingo: ndi kuchuluka kwa IPT kapena kuchepetsedwa, munthu akhoza kuweruza kukhalapo kwa matenda monga hyper- ndi hypocoagulation.

    Mkhalidwe monga hypercoagulation, kapena chizindikiro cha kuchulukitsa kwa magazi chitha kupangika pazifukwa:

    • kuchuluka kwa vitamini K m'thupi (popeza vitamini uyu ndiofunika kuti apangidwe prothrombin),
    • neoplasms yoyipa, mitundu yosiyanasiyana ya zotupa,
    • Odwala pambuyo m`mnyewa wamtima infaration, komanso ochita kugwidwa kwa mitsempha
    • mu postoperative nthawi pambuyo opaleshoni ya mtima, valavu m'malo
    • Odwala okhala ndi atritisitis ya nthawi yayitali osatenga ma antiplatelet agents,
    • kuchuluka kwa thupi kumawonedwa mwa amayi apakati (makamaka mu trimester yomaliza),
    • ndi matenda a chiwindi,
    • nthawi zina mukamagwiritsa ntchito njira zakulera za mahomoni, mankhwala a steroid, mahomoni a adrenal,
    • ndi thromboembolic zovuta, venous thrombosis,
    • ndi matenda osakhazikika a mitsempha ya varicose.

    Kutsika kwa prothrombin level (hypocoagulation) sikumawerengedwa kuti ndizabwino kwambiri zakukula.

    • pachimake zotupa a chiwindi - hepatitis,
    • kuwonongeka kwa kapangidwe ka chiwindi (sclerosis, fibrosis, cirrhosis),
    • kugwiritsa ntchito mankhwala a anticoagulant (warfarin, aspirin),
    • Vitamini K akusowa (motsutsana ndi maziko a dysbiosis kapena matenda am'mimba, pamene mayamwidwe akusokoneza),
    • kusowa kwa yogwira fibrinogen.

    Chochita ndi IPT yokwezeka?

    Anthu oterowo ayenera kuonana ndi dokotala pafupipafupi pakuyang'anira IPT, makamaka ngati pali vuto lalikulu.

    Ndikofunikira kumwa mankhwala ngati kuchitapo kanthu pakuchita opareshoni ndikofunikira, kaya ndi opareshoni yam'mimba kapena njira zazing'ono zodzikongoletsera. Onetsetsani kuti mukuchenjeza dokotala za momwe mayesowo adzayendera mukamayendera dotolo wamano, chifukwa kutulutsa mano kumatha kuyambitsa magazi kwa nthawi yayitali.

    Momwe mungayesere magazi a PTI

    Kuti mupeze zotsatira zolondola zofufuzira, malamulo angapo ayenera kutsatiridwa. Kuyesedwa kumachitika pamimba yopanda kanthu, theka loyamba la tsiku. Amaloledwa kumwa madzi ochepa. Ndikulimbikitsidwa dzulo, kwinakwake m'maola 24 kuti musamamwe mafuta, yokazinga, osuta fodya, komanso zakumwa zoledzeretsa.

    Momwe mungachepetse index ya prothrombin?

    Choyambirira kuchita ndikufunsira kwa hematologist poyendera malo apadera. Msika wogulitsa mankhwala umayimira unyinji wa mankhwala kuti akonzedwe a heestatic dongosolo.Komabe, ndikofunikira kusankha mlingo woyenera, ndipo muyenera kubwereza kuwunikako panthawi inayake ndipo, kutengera zotsatira zake, musinthe mlingo wa mankhwalawo.

    Chochita ndi IPT yochepetsedwa?

    • Vutoli limadziwika ndi mwayi waukulu wa thrombosis, ndipo, monga chotulukapo chake, potuluka kwa ziwiya zazikulu, zomwe zadzala ndi zovuta za thromboembolic. Itha kuonedwa ndi kukula koyambirira kwamitsempha ya mwendo, ndi polycythemia, mu trimester yomaliza yamimba.
    • Kuphatikiza apo, zosintha zina zikuluzikulu zimatha kusintha zokha. Madandaulo oterowo nthawi zambiri amauzidwa kwa wothandizira, yemwe amapereka mayeso, kuphatikiza kuphunzira kwa IPT. Zovuta zokhudzana ndi khungu, kufooka, kupweteka mutu pafupipafupi, chizungulire, kuchepa kwa ntchito, kusokonezeka kwa mgwirizano.
    • Komabe, zinthu ngati izi zimachitika popanda izi. Nthawi zambiri kuzindikiritsa kupatuka kumachitika mwamwayi, mukamayendera dokotala chifukwa cha njira ina yopezera matenda.
    • Kugwiritsa ntchito ma anticoagulants - ochepa magazi, kumathandizira kukulitsa cholozera cha prothrombin. Amathandizira kuwongolera malire pakati pa kayendedwe ka magazi ndi anticoagulant. Kugwiritsa ntchito pamenepa ndi mankhwala azikhalidwe. Malingaliro amathandizira kuti amenye nkhondoyo ndi magazi "akuda".

    Kuti muchotse mgwirizano, kulumikizana ndi imelo:

    Zambiri patsamba lino zimaperekedwa pazidziwitso zokha. Musanapange chisankho chilichonse, funsani kwa dokotala. Kuwongolera kwa KardioHelp.com sikuti kuyambitsa kugwiritsa ntchito chidziwitso adalemba patsamba.

    Kukopera zinthu ndizotheka pokhapokha ngati pali cholumikizira chake.

    Kuyesedwa kwa magazi ndi kuphunzira koyenera komwe kumathandizira kudziwa zomwe zimayambitsa matenda ambiri. Zimathandizira kupewa thrombosis kapena kutaya magazi nthawi.

    PTI (prothrombin index) - ndi chiyani? Panthawi ya phunziroli, kuyezetsa magazi, mutha kudziwa kuti munthu wina amapezeka m'magazi anthawi yayitali bwanji, ndikufanizira mtengo ndi mfundo zomwe zakhazikitsidwa. Kukula kwa kusiyana kumeneku kumasinthidwa kukhala peresenti . Chololedwa mu magazi ndi 78-142%, index ya prothrombin malinga ndi Quick - 95-105%.

    Prothrombin ndi puloteni yemwe amatsogolera thrombin. Ndipo thrombin, imathandizanso kwambiri mu thrombosis. Prothrombin amapangidwa m'chiwindi. Vitamini K amathandizira pa izi. Ngati vitamini K sikokwanira, magazi amatha kutuluka chifukwa cha kuchepa kwa kuchuluka kwa prothrombin.

    Kusanthula kumachitika liti

    Ndikofunikira pankhani zotsatirazi:

    • poyembekezera opareshoni,
    • kwa odwala omwe amagwiritsa ntchito anticoagulants kuti aletse thrombosis,
    • pa mimba
    • odwala coagulation ndi varicose mitsempha,
    • mwa anthu omwe ali ndi vuto la mtima.
    • Ndili ndi vitamini K,
    • ndi matenda a chiwindi.

    Akatswiri otsatirawa atha kuwunika kusanthula koteroko:

    

    Kulemba zotsatira

    Zifukwa zamtengo wotsika:

    • Kuperewera kwa Vitamini K
    • Matenda a chiwindi.
    • Khalidweli.

    Kuchulukitsa kuchuluka chifukwa:

    

    • Mavuto obwera chifukwa cha kuphatikizika.
    • Kuperewera kwa Vitamini K
    • Heparin.
    • Matenda a oncological.
    • Kugwiritsa ntchito ma anti-spectrum antibayotiki.

    Zomwe zimachitika mwa amayi apakati

    Mlozera wa prothrombin pa nthawi yomwe mayi ali ndi pakati umakwera kukhala chizindikiro cha 90-120%. Izi zitha kudziwika chifukwa cha kusintha kwa mahomoni mthupi la mayi wapakati.

    Kuwunikira kwa IPT, makamaka panthawi yapakati, ndikofunikira kawiri mpaka kanayi. Kutsimikizira kwakukulu kuyenera kuchitidwa mu trimester yomaliza, chifukwa nthawi yotsala isanakhale nthawi yochepa kwambiri ndipo ndikofunikira kuyang'ana mphamvu.

    Peresentiyo ikadzakwera kufika ku 150, imatha kukhala choopsezo cha placenta. Miyezoyo ikagwera pansi pa 90%, kutaya magazi kwambiri kumatha kuyembekezeredwa pakabadwa kapena pambuyo pake.

    Ngati mayi woyembekezera akuonetsa zolakwika zina mwanjira, musataye mtima poyang'anira odwala pachipatala cha amayi oyembekezera. Ndikofunikira kuti mayi woyembekezera azikhala moyang'aniridwa ndi akatswiri.

    Zizindikiro zofulumira

    Kusanthula mwachangu kumachitika kuti mupeze maphunziro owonjezera am'mimba, komanso chiwindi.

    Kusanthula mwachangu kumachitika mu milandu yotsatirayi:

    1. Pomwe kusokonekera kumasulidwa.
    2. Pali matenda omwe amayambitsidwa ndi chiwindi.
    3. Pali njira yowonjezereka ya thrombosis.
    4. Ndi matenda ngati khansa ya magazi.
    5. Panthawi ya vitamini K akusowa

    Zomwe zili zovomerezeka:

    

    • Kufikira wazaka 6 - 80-100.
    • Kuyambira pa 6 mpaka 12 - 79-102.
    • Kuyambira 12 mpaka 18 - 78-110.
    • Kuyambira 18 mpaka 25 - 82-115.
    • Kuyambira 25 mpaka 45 - 78-135.
    • Kuchokera pa 45 mpaka 65 - 78-142.

    Mwambo kwa akazi ndi muyezo wa amuna ndi ofanana ngakhale ali ndi zaka zambiri.

    Nthawi ya Prothrombin ndi chisonyezo chomwe chimawonetsa masekondi omwe plasma imagwirizana pambuyo powonjezera kusakaniza kofunikira kwa icho.

    • Mwa ana, makamaka akhanda, chiwerengerochi ndi masekondi 14-18.
    • Kwa akulu, mulingo wabwinobwino ndi 10-15. Mtengo woyenera kwambiri wa nthawi ya prothrombin umachokera ku 9-12 masekondi.

    INR - malingaliro apadziko lonse lapansi

    INR ndi njira yapadera yomwe imagwiritsidwa ntchito kuwongolera zotsatira zomaliza za prothrombin test. Kugwiritsa ntchito njirayi kumalimbikitsidwa kwambiri ndi oyimira mabungwe azaumoyo apadziko lonse.

    Chifukwa cha zotsatira zomwe katswiri amalandila pambuyo pa phunziroli, amatha kudziwa momwe mankhwalawa alili ndi othandizira ena.

    • ndi 0.85-1.15.
    • Ngati tikulankhula za mankhwalawa kapena kupewa venous thrombosis, matenda am'mapapo mwanga kapena kuwonongeka kwa ma valfa amtima, ndiye kuti kuchuluka kwa INR kungathe kufika pa 3.0.

    Zomwe mungachite ndi kuchuluka kwa prothrombin

    

    Momwe mungachepetse prothrombin? Gululi la anthu lifunika kutsatira zakudya zinazake komanso moyo wawo.

    Muyenera kudya zakudya zambiri momwe mungathere zomwe zimapangitsa kuti magazi azichepa. Ndikofunikira kumvetsetsa kuti pali zakudya zingapo zomwe zingayambitse kukula kwa magazi.

    Mndandanda wazofunikira kuti muchepetse prothrombin wambiri:

    • Aliyense amadziwa oatmeal. Oatmeal samangothandiza kukhazikika kwa chimbudzi, komanso kupewa magazi. Zoyenera, muyenera kudya izi ngati chakudya cham'mawa. Ngati mungafune, mutha kuwonjezera ufa ndi zipatso zatsopano.
    • Madzi a phwetekere, makamaka mukakonza nokha masamba abwino nokha. Ambiri amalakwitsa kwambiri mwakuwonjezera mchere ku msuzi.
    • Beetroot ndi masamba abwino omwe amathandiza prothrombin wotsika.
    • Ndi chakudya chotani chopanda ginger! Itha kuwonjezeredwa tiyi. Muzu wa ginger umachepetsa magazi, umakana kupangika kwa magazi.
    • Mafuta a flaxse, maolivi.
    • Mafuta a nsomba. Pakadali pano, zitha kugulidwa m'mafakitare mumawonekedwe a makapisozi. Iyi ndi njira yabwino yopanda kununkhira komanso kukoma.
    • Mukaphika, tikulimbikitsidwa kugwiritsa ntchito viniga cha apulo.
    • Chinanazi Ndikokwanira kudya pang'ono kuti ndiyambe njira zothandiza mthupi.

    Malamulo omwe akuyenera kutsatidwa mukamadya:

    

    1. Chitani zokonda zamasamba, zipatso ndi zipatso zatsopano.
    2. Nyama imatha kupezeka pagome, koma pamlingo wocheperako.
    3. Nyama imatha kusinthidwa ndi nsomba.
    4. Chepetsani kugwiritsa ntchito kuphika.
    5. Kuphika ndikwabwino kwambiri mu boiler iwiri.
    6. Muyenera kudya pafupipafupi, koma.
    7. Onetsetsani kuti mumamwa pafupipafupi.

    Zomwe muyenera kudya ndi kumwa ndizoletsedwa:

    • Zakudya zakusuta.
    • Mafuta, msuzi wambiri.
    • Zakudya zamatenda.
    • Zakumwa zoledzeretsa.

    Kuchepetsa prothrombin

    Ngati index ya prothrombin yatsitsidwa, izi zitha kuwonetsa kuchuluka kwa mapuloteni a prothrombin. Kuchepa kumatha kuwonedwa mwa amayi apakati, odwala omwe ali ndi polycythemia (izi ndizowonjezereka kwamitsempha yamagazi), odwala omwe ali ndi venous thrombosis.

    Kutsika kwa chizindikirocho kungathe kuwonetsa matenda otsatirawa:

    • Matenda am'mimba.
    • Dysbacteriosis
    • Prothrombin akusowa.
    • Hypovitaminosis.
    • Matenda a oncological.
    • Momwe thupi limasokoneza.

    Nthawi zambiri, kutsika kwa chizindikirochi kumachitika chifukwa chakudya ndipo kumapezeka mwa oimira theka laanthu amphamvu. Amuna ndi omwe amasankha mokomera nyama, kudya masamba ndi zipatso zochepa.

    Zoyenera kuchita ngati index ya prothrombin yatsitsidwa?

    Nthawi zambiri, akatswiri amalamula odwala awo kugwiritsa ntchito mankhwala monga heparin, warfarin.

    Molumikizana ndi mankhwala osokoneza bongo, muyenera kuyang'anira zakudya zanu. Nayi mndandanda wazinthu zomwe sizili zoyenera kugwiritsa ntchito ndi prothrombin yotsika:

    • Mafuta a nyama.
    • Buckwheat phala.
    • Beets, kabichi wofiira, tsabola wofiyira.
    • Zinthu zophika buledi.
    • Pickles ndi kusuta.
    • Mitundu.
    • Ziphuphu

    Kulephera kwa prothrombin kungayambitse magazi. Zitha kupewedwa ngati zakudya zoyenera zikuphatikizidwa ngati njira yolepheretsa zakudya zanu:

    

    • Nsomba ndi nsomba.
    • Anyezi ndi adyo.
    • Ma macross, makamaka ndimu.
    • Muzu wa Ginger
    • Tiyi wobiriwira ndi koko.
    • Oatmeal.
    • Ma Cranberries, rasipiberi kapena nkhuyu.

    Fibrinogen

    Kupangidwa ndi chiwindi. Ndiye amene amatenga nawo mbali mu thrombosis. Kusanthula kwa prothrombin index ndi protein fibrinogen kumakhala kulumikizana ndi tcheni chimodzi.

    Thrombin ikayatsidwa, izi zimaphatikizapo kusintha kwa fibrinogen. Ndipo iye, akusinthidwa kukhala nyuzi - fibrin. Zingwe zosasinthika izi zimawoneka ngati mawonekedwe a magazi, omwe amathandizira kale poletsa chotengera.

    Protein fibrinogen imafika pachimake masiku angapo pambuyo poti sitiroko, vuto la mtima, kutupa ndi chimfine. Kuwonjezeka kwa chizindikiro ichi kungawonedwe mwa osuta, amayi apakati, anthu odwala matenda amtundu wa endocrine, komanso kugwiritsa ntchito mankhwala a mahomoni kwa nthawi yayitali.

    Kutsika kwa mapuloteni a fibrinogen kumawonedwa mwa anthu:

    • ndi chiwindi ndi matenda am'mimba,
    • osakwanira mu vitamini B12,
    • pa mimba, toxicosis,
    • mukumwa ma anabolics,
    • mukamamwa mankhwala enaake.

    Njira yokhayo yopeweretsera matenda aliwonse ndi kukana zizolowezi zoyipa, kudya zakudya zoyenera, kusiya kuchita masewera olimbitsa thupi komanso kuyezetsa nthawi.

    Momwe mungakonzekerere kusanthula:

    Kupatula zinthu zomwe zingakhudze zotsatira za phunziroli, ndikofunikira kutsatira malamulo ophunzitsidwa awa:

    • m'mimba yopanda kanthu yokha yomwe imaperekedwa kuti ifufuze!
    • musanapereke magazi a venous, makamaka mphindi 15 kuti mupumule,
    • Kutatsala maola 12 kuti phunzirolo lisachitike popewa kumwa mowa, kusuta fodya, kudya, kulimbitsa thupi,
    • kupatula mankhwala. Ngati nkosatheka kusiya kumwa mankhwalawa, muyenera kudziwitsa a
    • ana osakwana zaka 5, musanapereke magazi, onetsetsani kuti mumamwa madzi owiritsa (m'magawo, mpaka 150-200 ml, kwa mphindi 30)

    Prothrombin (PT) mu kapangidwe kake ndi mapuloteni ovuta omwe ali mbali ya thupi la munthu. Muzochita zamankhwala, imagwiritsidwa ntchito kupenda nthawi yowonjezera magazi. Mapuloteni awa ndi gawo limodzi la kafukufuku wopanga njira zopangira magazi, otchedwa, motero, coagulogram. Kuphatikiza pa kudziwa mapuloteni awa, amaphatikizanso (PV), (PI) ndi (INR).

    Njira yodziwika kwambiri yopangira mapuloteni ena ndi yotchedwa Quick Prothrombin (PC). Amatchulidwa pambuyo pa wasayansi A. Kvik, yemwe adafotokoza njira yofufuzira mulingo wa PT m'magazi kumbuyo mu 1935. Mpaka pano, njira yofulumira idadziwika kwambiri ndipo imagwiritsidwa ntchito kwambiri pakupanga coagulogram. Pakatikati pake, njirayi imakhala poyerekeza coagulogram ya wodwala ndi mtengo wowonekera wa plasma wabwinobwino. Zotsatira za PC zimafotokozedwa ngati peresenti.

    PC yaying'ono kwambiri imaganiziridwa ngati chizindikiro chili pansi pa 78 peresenti, chikuwonjezeka ngati chizindikiro chiri pamwamba 142%.
    

    Chiyeso cha PC chimagwiritsidwa ntchito kwambiri osati mu coagulology kuti mupeze zomwe zimachitika popanga zinthu, komanso maphunziro a mphamvu yogwira chiwindi, m'mimba ndi matumbo. Ndikofunika kudziwa kuti PV ndi prothrombin coagulation index (PI) zimagwiritsidwa ntchito kwambiri kawirikawiri, chifukwa kupezeka konsekonse kumakhala kotsika - deta yomwe imapezeka m'mabotchi osiyanasiyana silingafanane.

    Zizindikiro zakusanthula pa PC zimaperekedwa kwa anthu milandu:

    • akuwonetsetsa kusokonezeka kwa njira zopangira magazi,
    • kuwongolera mankhwala mukamamwa ma anticoagulants (heparin, warfarin),
    • chiwopsezo chowopsa cha chiwindi,
    • antiphospholipid syndrome,
    • pazovuta zomwe zimapangitsa kuti kagayidwe kokhala ndi vitamini K kakhale kocheperako kapena kachulukidwe.

    Kuti muwoneke, magazi ochepa a venous amatengedwa. Tisanayesedwe, tikulimbikitsidwa kuti tisadye chakudya osachepera maola 6 mayeso asanayesedwe. Tsiku lisanafike mayeso, muyenera kuchepetsa zakudya zamafuta ndi nyama yokazinga. Anthu omwe amatenga kawirikawiri mavitamini a vitamini K (warfarin) amagwera m'gulu lokonzekera kusanthula. Amayenera kumwa mankhwalawa tsiku lililonse pasanadutse 16-00 patsiku lisanafike mayeso.

    Ndizofunikira kudziwa kuti kupezeka kwa mapuloteni a fibrin kapena myeloma m'thupi kungakhudze zotsatira za phunziroli.

    Kusintha kwa zotsatira zoyeserera ndi kusankhidwa kwa mankhwala olondola kuyenera kuchitika kokha ndi dokotala. Atha kuwunika kuchuluka kwa madongosolo a coagulogram ndikuwonetsetsa kuopsa kwa matenda omwe akupitiliza.

    Kodi zotsatira za kusanthula pa PC zikutanthauza chiyani? Kusintha kwa phunziroli

    Ngati prothrombin malinga ndi Quick ichulukitsidwa kwambiri (kwambiri kuposa 150%), ndiye kuti matenda otsatirawa angatengedwe:

    • kuperewera kwazinthu zina zomwe zimayambitsa kusokonekera,
    • kusowa kwa coagulation zinthu, koma zopezeka kale munthawi ya matenda ena a chiwindi, amyloidosis, nephrotic syndrome, kukhalapo kwa autoantibodies kuzinthu zopangika,
    • kutsika kwa ntchito ya Vitamini K chifukwa cha cholestasis (ndi matenda ena),
    • kufalitsa intravascular coagulation syndrome (DIC)
    • kumwa mankhwala, kuphatikiza anticoagulants, hepatin, warfarin, mankhwala a anabolic, mankhwala, acetylsalicylic acid, mankhwala othandizira, methotrexate, nicotinic acid, okodzetsa,
    • fibrin ntchito matenda.

    Ngati chikhazikitso Chachangu chatsitsidwa, adotolo amatha kudziwa zotsatirazi:

    • thrombosis (kufalikira kwa mitsempha chifukwa cha magazi),
    • polycythemia (kuchulukitsa kwa magazi, kuchepa kwa magazi),
    • kuwonongeka kwa minofu kumabweretsa kulowa kwa thromboplastin m'mitsempha yamagazi,
    • mimba ndi pambuyo
    • kumwa kwa mankhwala ena (njira zakulera za pakamwa, mercaptopurine).

    Kuphunzira kwa PC mwa amayi panthawi yapakati

    Chiyeso chowongolera panthawi yapakati chimaperekedwa kwa azimayi ngati kuphunzira koyenera, komwe ndi gawo la coagulogram limodzi ndi cholozera cholimbira. Kuunikira phunziroli mndondomeko ya coagulation ndi PC kumathandizira adotolo kuti azitha kuyang'anira bwino zaumoyo komanso kupewa zovuta zina zowopsa.

    Ndizofunikira kudziwa kuti mwa amayi nthawi yomwe ali ndi pakati, chizolowezi cha PC chimachepetsedwa pang'ono chifukwa cha kupangika ndi chitukuko cha magazi kuchokera kwa mayi kupita kwa mwana. Komanso, mulingo wapamwamba kuposa momwe umathandizira mzimayi kukonzekera kutaya magazi kwambiri pakubala.

    Ngati PC imakwezedwa panthawi yapakati, imatha kuyambitsa magazi kwambiri pakubadwa kwa mwana, kuphatikizapo kutulutsa magazi mkati. Kuzindikira chizolowezi chofotokozera mwachangu kumatha kudzetsa hemolytic. Chiwopsezo cha kufa kwa azimayi pa nthawi yobadwa mwana kuchokera ku matendawa ndiwokwera kuposa chifukwa china chilichonse.
    

    Zizindikiro pansipa ndizomwe zimayambitsa kupangika kwa ophatikizana.

    Kutsika kwa PC pa nthawi ya pakati kumawopseza mkazi yemwe ali ndi thrombosis, kufalikira kwamitsempha yamagazi ndi zovuta zina.Zikatero, madokotala nthawi zambiri amalembera anticoagulants - mankhwala owonda (warfarin).

    Mwazi -chinthu chovuta ndichopanga gawo lamadzi (plasma) ndi maselo, chikuchita ntchito zambiri mthupi. Kusungabe dongosolo lino mosalekeza ndi ntchito yoyamba, chifukwa mwinanso kusokonezeka kwamphamvu kwa ziwalo zonse kudzachitika.

    Khalidwe lofunikira la magazi - kuchuluka kwake kosalekeza. Kwa amuna, ndi malita 5, kwa akazi - malita 4. Ndi zovulala, ngakhale zazing'ono, kuchepa kwamtunduwu ndizotheka, komwe kachitidwe kake kamene kamalimbana. Tilankhule za chisonyezo cha kuthekera kwa magazi kugundana - index ya prothrombin.

    Kufunika kwa prothrombin zovuta

    Zoyipa za izi zitha kukhala zatsopano komanso zophunzitsidwa ndi moyo. Kuperewera kwa Congenital prothrombin sikufala kwambiri, ndiye kuti, ndi gawo lachipembedzo chosowa. Prothrombin wotsika pobadwa imayamba chifukwa cha kusintha kwa majini omwe amapezeka pa chromosome 11.

    Ndi hypoproteinemia ya chiyambi chilichonse, monga lamulo, kuchuluka kwa mapuloteni awa kumachepetsedwa. Chiwindi chodwala matendawa (hepatocytes ndiye malo opanga zinthu zazikuluzikulu za prothrombin zovuta) komanso kuchepa kwa K-Vitamini (Vitamini K akukhudzidwa ndi kapangidwe ka FII ndi zinthu zina zotchedwa K-amadalira) zimaponya dontho lakugwa kwa chisonyezo ichi.

    Zomwe zimatsitsa prothrombin zimatenga nthawi yayitali kuti ziziundana . Kuti muwone momwe pulogalamu ya coagulation imagwirira ntchito molingana ndi kuchuluka kwa prothrombin, mayeso a coagulation amagwiritsidwa ntchito pazachipatala cha matenda othandizira, omwe amakupatsani malingaliro pazomwe boma lonselo ya prothrombin ili yonse:

    • PTI (prothrombin index, peresenti),
    • Chiwerengero (prothrombin ratio, mtengo wosiyana wa PTI, peresenti),
    • PTV (nthawi ya prothrombin, m'masekondi),
    • Prothrombin malinga ndi mwachangu (kuwunika kovuta kwambiri kuposa PTI ndi PTV, peresenti),
    • INR (chiwembu choyerekeza mayiko ena, peresenti).

    Kuchita kwambiri kwa prothrombin popanda chosowa chilichonse chomwe chimadzala ndimavuto osiyanasiyana, ndipo, nthawi zina, chowopsa cha thupi. Kuchulukana kowonjezereka, mapangidwe omwe amatha kutseka mtsempha wamagazi ofunikira, amatha kusintha kukhala oopsa, ngakhale kupha kumene.

    Mayeso a Benchmark ndi kusanthula kwathunthu

    Kuwerenga kwa kugundika ndimagazi, monga lamulo, kumayambira ndi njira zoyenerana zomwe zimapangitsa kuti athe kuzindikira anomatic (prothrombin) popanda kuwulula tanthauzo lake. Kenako, motengera zotsatira za kusanthula kwa luso la kuphatika kwa magazi, njira zina (zodziwika kale) zimayikidwa (PTV, INR, APTT ndi zizindikiro zina za hemostasiogram).

    

    Ponena za kuyesa kwa prothrombin, ndizofunikira kwambiri ndipo zitha kuperekedwa m'njira zosiyanasiyana. Kuperewera kwa zinthu za prothrombin zovuta (II, V, VII, X) zimatsimikiziridwa makamaka ndi kusanthula kwa PTV malinga ndi Quick, yomwe imawulula kuphwanya kapangidwe kake ka thromboplastin. Komabe, kupatula kosiyanako kwa zizindikirozi pamfundo yoyendetsera zitsanzo ndikotheka.

    Pakadali pano, munthu sanganyalanyaze zisonyezo za kuthekera kwa magazi pakupezeka kwa akazi panthawi yakukonzekera kapena nthawi yomwe mayi ali ndi pakati, chifukwa izi zimakupatsani kuwerengera kuopsa komwe kungachitike mukabereka mwana. Kukumbukira kuchuluka kwa zisonyezo pa nthawi yomwe muli ndi pakati, ndizotheka kudziwiratu komanso kupewa kutaya magazi (ngati PTV imatenga nthawi yayitali) kapena kukula kwa thrombosis komanso kuwonekera msanga kwa placenta, ngati magazi akuwonetsa kuthekera kwakukulu kophatikizana. Panthawi yobereka, nthawi ya prothrombin imafupikitsidwa poyerekeza ndi chizolowezi, ndipo index ya prothrombin imachulukitsidwa. Mwa azimayi pa nthawi yobereka komanso pobereka, kuphunzira momwe magazi amathandizira sikumangotenga zisonyezo za zovuta za prothrombin. Pofuna kukhala ndi chithunzi chonse cha momwe magwiridwe amachitidwe a heentatic system, amayi oyembekezera amathandizira kuwonetsa zochuluka za coagulogram .

    Prothrombin nthawi

    

    Nthawi ya Prothrombin, ngati mayeso a labotale, imalola azachipatala kuti ayese mwachangu osati dongosolo lakunja la hemostasis, koma mawonekedwe onse a zochita za magazi.

    Pazinthu zadzidzidzi kwa thupi (kuvulala ndi kuwonongeka kwa minofu, kutulutsa magazi kwambiri, necrosis ndi zina zina zam'magazi), glycoprotein imalowa m'magazi, mapuloteni a membrane - minofu ya thromboplastin, yomwe imawonetsera kuphatikizika kwa malo osungirako (akunja) heestasis.

    Tissue (ma cellular) thromboplastin, yotchedwa izichipsi (TF), yolumikizana ndi zinthu zozungulira (FVII) zomwe zimayenda mozungulira m'magazi, motsatizana zimaphatikizanso zinthu zina za plasma thromboplastic. Izi zikutanthauza kuti dongosolo la hemocoagulation limayendetsedwa ndipo gawo loyamba la kupangika liyamba - kutembenuka kwa prothrombin kosagwira ntchito kukhala thrombin yogwira. Thrombin imayambitsa kusintha kwa enzymatic kwa fibrinogen kukhala fibrin, zinthu (V, VIII, IX, XIII) zimayendetsedwa mchikakamizo chake, zimawononga mapulateleti, omwe amachititsa (pamodzi ndi Ca ++) metamorphosis ya viscinous yamagazi, yomwe imathandizira kutulutsidwa kwa mapuloteni am'magazi.

    Chizindikiro cha PTV mwa achikulire chimachokera pamasekondi 11 mpaka 15 (mwa ana obadwa kumene mpaka masiku 3-4 a moyo - 12-18, makanda asanakwane - 15-20). Mu makanda okhanda okhazikika kwa masiku 4-5 amoyo, nthawi ya prothrombin imafanana ndi ya munthu wamkulu.

    Chizindikirochi chikuwonjezereka (nthawi yayitali)

    1. Matenda a chiwindi, chifukwa pali kapangidwe ka prothrombin,
    2. Kuperewera kwa Vitamini K, kutenga nawo gawo komwe ndikofunikira pakuwonekera kwa zinthu zomwe zimadalira K - (prothrombin ndiyonso ndi yawo),
    3. Kuchulukitsa, kutsekereza thrombin ndi zinthu zina za hemocoagulation system,
    4. Kuchulukitsa kwa magazi a fibrinolytic (kusungunuka kwamaunda),
    5. Khansa yapakansa
    6. Sepatate hematological path (myeloid metaplasia),
    7. Grbn (hemorrhagic matenda obadwa kumene),
    8. Mitundu yayikulu ya maselo ofiira am'magazi (pamwamba pa 6.0 x 10 12 / L),

    Magazi onse omwe atengedwa ndi anticoagulant (sodium citrate) amagwira ntchito monga chilengedwe pophunzira nthawi ya prothrombin pogwiritsa ntchito njira ya Quik single-siteji (komwe kumatchedwa kusanthula).

    PTV, Kuyesedwa mwachangu kapena nthawi ya thromboplastin - chisonyezero cha dongosolo lakunja la kuthandizira kwa chinthu II, komwe nthawi ya prothrombin imadalira kuchuluka kwa fibrinogen mu plasma yamagazi, zinthu V, VII, X. Chizoloŵezi cha PTV (Kuyesedwa mwachangu) kwatsimikizika ntchito ya thromboplastin ndipo ndi masekondi 12-20.

    Umodzi ndi kulimbana kwa otsutsa

    Kuphwanya mu he hentatic dongosolo kumabweretsa kukula kwa coagulopathies, pomwe matenda, omwe amakonda kuphatikizana ndi thrombosis, nthawi zambiri amawonetsedwa ndi mawuwo, ndipo matenda omwe amaphatikizidwa ndi kuchuluka kwa magazi amatchedwa "hemorrhagic diathesis." Kuphwanya maluso a coagulation wamagazi kumatha kukhala cholowa kapena kusinthidwa kuchokera pazinthu zomwe zimapangidwa nthawi ya moyo (matenda a chiwindi parenchyma, kuchepa kwa Vitamini K, kugwiritsa ntchito anticoagulants kuchitira achire, kutsegula kwa dongosolo la fibrinolytic).

    

    Kukula kwa hemocoagulation chisokonezo kumachitika chifukwa cha kutayika (kapena kuchepa) mu mphamvu ya maselo a chiwindi kupita ku biosynthesis ya zinthu zophatikizika. Komanso, ziyenera kudziwidwa kuti zinthu zomwe zimapangitsa kuti ma coagulation, anticoagulation ndi fibrinolysis sizipezeka pazokha, kuphwanya kwa ntchito yolumikizana kumayambitsa matenda a ziwalo zina. Mwachitsanzo:

    • Kusokonezeka kwa biosynthesis kwa mapuloteni omwe taganiziridwa ndi ife - prothrombin, adzatsogolera pakupanga kuphwanya kwa zinthu zina (VII, IX, X) ndi kuchepa kwa zinthu zonse za prothrombin zovuta, zomwe pambuyo pake zimapangitsa kuchepa kwa ntchito ya FV, kuwonjezeka kwa kuchuluka kwa fayilo ya fibrin, kuchepa kwa ntchito ya FXIII ndikuwonjezereka kwa ntchito ya FXIII lasis.
    • Kuphwanya michere ya fibrinogen kumapangitsa kusintha kwa mapangidwe a mafupa amitsempha ya profibrin, ndikutseguka kwa kayendedwe ka maselo ofiira m'mitsempha.

    Kuphatikizika kwa zinthu zomwe zikuwoneka kuti ndizotsutsana kwathunthu ndi machitidwe omwe ali pamwambapa (malinga ndi momwe zimakhalira zikugwira ntchito) kumatsimikizira kuti magazi amadzimadzi amayenda momasuka m'mitsempha yonse ya magazi, ndikuwonekera kwake, ngati pakufunika kuyika mipata yopangidwa chifukwa cha kuwonongeka kwa minofu.

    Kufufuza kungakulitsidwe ...

    Ngati njira zomwe zafotokozedwerazi sizikhala ndi chidziwitso chokwanira, maphunziro a he hetaticatic angakulidwe, mwachitsanzo, mwa kuphunzira ntchito zaumwini ndi kuchuluka kwa zinthu zamagulu a zinthu za m'magazi. Chiyeso cha prothrombin chimapereka maziko osaka zovuta zosiyanasiyana za hemocoagulation, ndikuwonetsa kutsogoleredwa kwa kafukufuku wina. Kuti izi zitheke, pitani kutsimikiza kwa magawo ena a hemostasiogram:

    Mulingo wa kusintha kwa fibrinogen kukhala fibrin (nthawi ya thrombin),

    Kuyesedwa kwa prothrombin kukhazikitsidwa liti?

    Kutsimikiza kwa magawo amodzi a magazi kumakhala ndi chofunikira kwambiri chodziwunikira. Cholinga chachikulu ndicho kudziwa kuopsa kwa magazi akulu kapena magazi. Kuwerengeredwa kwa prothrombin malinga ndi Quick, index of PTI, prothrombin time and prothrombin malinga ndi INR amachitidwa pazinthu zotsatirazi:

    • Wodwalayo amakonzekera kuchita opareshoni.
    • Mimba
    • Kulakwitsa (makamaka mobwerezabwereza).
    • Mitsempha ya Varicose, thrombosis, pulmonary embolism.
    • Matenda a mtima ndi mitsempha yamagazi.
    • Kuwunika kuchuluka kwa magazi mukamamwa ma anticoagulants.
    • Kuzindikira matenda a chiwindi.
    • Kuchuluka kwa msambo mu akazi.
    • Wodwala amakonda kuchita mphuno, kutaya magazi kwambiri ndi zikanga zazing'ono, kutekeseka kwa magazi.
    • Kupangidwe kwa hematomas akulu ndi mabala, ngakhale ndi mikwingwirima yaying'ono komanso kuvulala pang'ono.

    Mwakutero, kukayikira kulikonse kwa vuto la magazi ndichizindikiro pakuwerengera kwa prothrombin index ndi magawo ena a prothrombin. Chifukwa chake, kuwunikira koteroko kuzidziwitso zitha kuperekedwa ndi dokotala wamtima, katswiri wa matenda amisala kapena dokotala wofunsa kuti adziwe mwadzidzidzi, komanso dotolo wochokera kuchipatala cha antenatal kuti awunikire kuchuluka kwa prothrombin panthawi yapakati.

    

    Kodi kusanthula kumachitika bwanji?

    Kwa kusanthula, magazi amatengedwa kuchokera mu mtsempha. Mwazi umayikidwa mu chubu choyesera ndi sodium citrate, yoyikidwa mu rotor ya centrifuge yachipatala, komwe plasma imalekanitsidwa ndi ma cell am'magazi pakasinthana.

    Kuyamwa kwa magazi kuyenera kuchitidwa pamimba yopanda kanthu - makamaka, chakudya chomaliza chinali maola 12 musanatenge biomaterial (koma osapitirira maola 15). Madzulo a kusanthula, wodwalayo ayenera kupewa kugwiritsidwa ntchito ndi zokometsera ndi zakudya zamafuta kuti asasokoneze zotsatira zake. Zomwezi zimaphatikiziranso mowa. Wodwala amayenera kuwunikira mofatsa - popanda kuchita khama komanso kupsinjika. Osamamwa khofi, juwisi, Coca-Cola, mowa kapena utsi musanawunikidwe.

    Chisonyezo chachikulu pazotsatira za kusanthula ndi mankhwala omwe wodwala amatenga. Ngati ndi kotheka, masiku angapo musanatenge magazi, muyenera kusokoneza njira ya mankhwalawa. Ngati kupuma kotereku sikungatheke, dziwitsani dokotala.

    Chifukwa chiyani prothrombin imakwera?

    Prothrombin ikakwezedwa, magaziwo amakhala ochepa, omwe amachepetsa mayendedwe ake m'mitsempha. Magazi onenepa kwambiri amawonjezera chiopsezo cha kuundana kwa magazi, komwe kumatseka magazi. Ichi ndi chowopsa kwambiri chomwe chitha kuchititsa kuti mugwidwe ndi vuto la mtima kapena kugunda kwa mtima ndi zotsatira zake zakupha, choncho chithandizo chiyenera kuyambika nthawi yomweyo.

    Zomwe zimathandizira pakuwonjezeka kwa prothrombin malinga ndi Quick:

    • Vitamini K yowonjezera m'thupi - ndi kudya kwakutali, komanso kumwa kwambiri chiwindi cha nkhumba, mazira a nkhuku, sipinachi, zitsamba, tiyi wobiriwira.
    • Kugwiritsa ntchito antihistamines nthawi yayitali, kuchuluka kwa ma aspirin, mankhwala othandizira, anticoagulants, kugwiritsidwa ntchito kwa barbiturates, corticosteroids, heparin, nicotinic acid, mapiritsi oletsa kubereka.
    • Mimba - mu trimester yachitatu, kusanthula kwa prothrombin ndikofunikira.
    • Matenda a chiwindi.
    • Choyambitsa chibadwa ndi matenda obisika magazi.
    • Kuyika magazi, vasculitis, thromboembolism.
    • DIC-syndrome - yogawa intravascular coagulation.
    • The age factor - prothrombin, malinga ndi Quick, amadzuka pambuyo pa zaka 45 mwa amuna ndi akazi.

    Zoyenera kuchita

    Kuti muchepetse prothrombin m'magazi, wodwalayo ayenera kusintha moyo wake ndikutsatira zakudya zapadera. Muyenera kukhuta zakudya zanu ndi zakudya zomwe zimapangitsa kuti magazi azichepa. Tiyeni tiwatchule: beets, mafuta am'madzi, msuzi wa phwetekere, oatmeal, zipatso zatsopano, ginger, mafuta a azitona, viniga cider viniga, chinanazi, kale kale. Zakudya za oatmeal, masamba komanso zakudya zam'madzi ndizofunikira kwambiri pazakudya zanu. Imwani madzi ambiri atsopano komanso madzi okwanira malita 1.5 patsiku.

    Pali zoletsa mu chakudya: muyenera kusiyiratu kusuta, mafuta ndi zonunkhira, zakudya zamzitini, mowa pazakudya, ndikuchepetsa kugwiritsa ntchito zinthu zophika, zitsamba, ndi offal momwe mungathere. Nyamayo ndi yovomerezeka, koma yophika yokha (yopanda kukazinga!), Ndi bwino kusinthira nyama ndi nsomba - tikulimbikitsidwa kuphika ziwotchera.

    Osamadya kwambiri. Bwino kuwonjezera chakudya china pachakudya chanu, koma muchepetse magawo. Osamadya usiku - ndizovulaza ngakhale kwa anthu athanzi lathunthu.

    Zochita zolimbitsa thupi ziyenera kulembedwa, koma pafupipafupi. Pewani kugwira ntchito mopitirira muyeso, chifukwa chake katundu pamtima ndi mitsempha yamagazi amawonjezeka. Kuyenda kwamadzulo tsiku lililonse popanda mpweya wabwino ndiye njira yabwino koposa.

    Ndi kuchuluka kwa prothrombin komanso mavuto aliwonse omwe amakumana ndi magazi mwa akazi, mapiritsi othandizira kubereka nthawi zambiri amasiya. Kumwa mankhwala ena omwe mumamwa pafupipafupi muyenera kukambirana ndi dokotala.