Te Mahi a ngā Peretā i roto i te Pupuri Toto
Ko ngā pereti toto, e mōhiotia whānuitia ana ko ngā pereti toto i roto i te kupu hauora, he wāhanga toto e tino hira ana mō te tukanga toto totoka (coagulation). Ahakoa he iti ake i ngā toto toto whero me ngā toto toto mā, he mahi nui tā ngā pereti toto ki te tiaki i te tinana mai i te nui o te toto e ngaro ana i te wā e whara ana. I roto i tēnei tuhinga, ka tūhuratia e mātou te mahi, te tikanga, me te hiranga o ngā pereti toto ki te toto totoka.
He Kupu Whakataki ki ngā Peretā
Ehara ngā pereti toto i te pūtau tino rite ki ngā toto toto whero, ki ngā toto toto mā rānei; he kongakonga noa iho ēnei o ngā megakaryocytes, arā, ngā pūtau nunui kei roto i te hinu wheua. Ka taea e ia megakaryocyte te whakaputa i ngā mano tini o ngā pereti toto. Ko te tikanga, ko te roanga o te ora o ngā pereti toto he 7-10 ngā rā i roto i te toto i mua i te whakangaromanga e te whēkau, i te whakamahinga rānei i roto i te tukanga whakapūngao toto.
Te Mahi a ngā Peretā i roto i te Pupuri Toto
He tikanga uaua te toto totoka e uru ana ki te taunekeneke o ngā pūmua maha (ngā mea totoka) me ngā pūtau, ā, he mahi matua tā ngā pereti totoka. Ko ngā mahi matua o tēnei tikanga koia ēnei:
1. Te whakawhāiti i te toto
Ina whara te uaua toto, ko te urupare tuatahi a te tinana ko te vasoconstriction, arā, ko te whakawhāiti i ngā uaua toto hei whakaiti i te rere o te toto, hei ārai hoki i te turuturu atu. Koinei te arai tuatahi a te tinana ki te toto nui rawa.
2. Te Hanganga o te Mono Pereti
Ina whara te oko toto, ka whakahohehia e te collagen me te tissue factor ngā pereti toto e tata ana ki te wāhi i whara ai. Ka piri ēnei pereti toto, arā, ka piri ki te wāhi i whara mā te taunekeneke ki te collagen me te von Willebrand factor, he pūmua nui mō tēnei tukanga. Whai muri i tēnei, ka whakahohehia ngā pereti toto, ka puta te tukunga o ngā momo granules kei roto ngā matū pro-coagulation pērā i te ADP, te thromboxane A2, me te serotonin.
Ka kukume te ADP me te thromboxane A2 i ngā pereti toto ki te wāhi whara, ka meinga te whakakotahitanga o ngā pereti toto kia hanga he mono tuatahi hei aukati i te rere o te toto. E mōhiotia ana tēnei tukanga ko te hanganga mono pereti toto.
3. Te totohu
I tēnei wā, ka mutu noa te toto i te puru pereti toto mō te wā poto. Kātahi ka tīmata te tinana i te tukanga toto toto, e uru ana ki tētahi raupapa o ngā tauhohenga whākōkī e mōhiotia ana ko te "coagulation cascade." Kei roto i tēnei ko ngā matū toto toto totoro e rere ana i roto i te toto i roto i tētahi āhua kore mahi (zymogens) e whakahohehia ana i ia wā.
Ko tētahi o ngā mahi tino nui ko te hurihanga o te fibrinogen (he pūmua toto wairewa) ki te fibrin (he āhua kore wairewa) e te whākōkī thrombin. Kātahi ka hangaia e te fibrin he whatunga e mau ana i ngā pereti toto me ngā pūtau toto, ka whakapakari i te mono pereti toto hei toto toto pumau.
4. Te Hokinga me te Whakaora o te Totoka
Kia puta he toto totoka, ka āwhina ngā pereti toto i te whakahekenga o te toto totoka—he tukanga e mōhiotia ana ko te whakahokinga toto totoka. Ka tutuki tēnei mā te mahi a ngā pūmua whakaheke i roto i ngā pereti totoka, e whakakaha ana i te toto totoka, e whakaiti ana i tōna rahi, e āwhina ana hoki i te whakaora i te patunga. Ka tukuna hoki e ngā pereti totoka ngā mea whakatipu pēnei i te mea whakatipu totoka-i ahu mai i te pereti totoka (PDGF), e tautoko ana i te tukanga whakaora mā te whakaoho i ngā pūtau i te wāhi patunga ki te whakatika me te whakakapi i te kiko kua pakaru.
5. Te Whakapūtanga Fibrino
Kia ora te kiko, kāore te tinana e hiahia ki te toto totoka. Ko te fibrinolysis te tukanga e pakaru ai te toto totoka, e tangohia ai. Ka hurihia te plasminogen ki te plasmin, e wawahi ana i te fibrin kia iti ake ngā kongakonga, ka whakarewa i te toto totoka, ka whakahokia mai te rere o te toto ki te āhua noa.
Ngā Mate me ngā Āhuatanga e Pā Ana ki ngā Peretā
Ka taea e te mahi rerekē o ngā pereti toto te arahi ki ngā momo mate hauora. Anei ētahi mate e pā ana ki ngā pereti toto:
Te toto toto iti
Ko te thrombocytopenia he āhuatanga e iti iho ana te maha o ngā pereti toto i roto i te toto i te tikanga noa, ā, he maha ngā wā ka puta he toto ngāwari, he toto uaua hoki ki te aukati. Ka taea tēnei āhuatanga te puta mai i ngā āhuatanga maha, tae atu ki te toto tere, ngā mate pūnaha ārai mate, te chemotherapy, ngā mate pāwera rānei. He rerekē ngā maimoatanga, mai i te whakawhiti pereti toto ki te whakamahinga o ngā rongoā e whakaoho ana i te hanga pereti toto.
Te Thrombocytopenia Idiopathic (ITP)
He mate pūnaha ārai mate te ITP, e whakaekehia ana e te pūnaha ārai mate o te tinana ōna ake pereti toto, ka heke nui te maha o aua pereti toto. Ko te maimoatanga mō te ITP he whakamahi i ngā steroids, i te immunoglobulin rānei hei pehi i te urupare ārai mate hē.
Ngā Pereti Polycythemia
Ka puta tēnei āhuatanga ina nui rawa te maha o ngā pereti toto, ka piki ake te mōrearea o te toto totoka nui rawa (thrombosis), ka arahi pea ki te whiu, ki te mate ngakau rānei. Ko ētahi o ngā take ko ngā mate wheua wheua, ko te uruparenga rānei a te tinana ki te ngaronga toto mau tonu.
Hemophilia
Ahakoa he hononga nui ake te hemophilia ki te korenga o ētahi āhuatanga toto totoka, he mahi nui tonu tā ngā pereti toto. I roto i ngā tūroro hemophilia, ka ngoikore ake ngā toto totoka e puta mai ana nā te kore e taea te whakaputa i te fibrin e tika ana, ahakoa te mahi tika a ngā pereti totoka.
Aromatawai me te Ine i te Mahi a te Pereti
He wāhanga nui o te aromatawai toto toto te ine i te mahi me te tatau o ngā pereti toto. Ko ngā whakamātautau taiwhanga noa ko:
– Te Tatau o ngā Pereti: Ka tatauhia te maha o ngā pereti i roto i tētahi rahinga toto hei whakatau mēnā kei roto i te awhe noa.
– Ngā Whakamātautau Mahi a ngā Pereti: Ko ētahi whakamātautau, pērā i te 'PFA-100' me te 'aggregometry', ka ine i te kaha o ngā pereti ki te hanga i tētahi mono.
– Ngā Whakamātautau Whakapūpū: Ko ngā whakamātautau pēnei i te PT (Wā Prothrombin) me te aPTT (Wā Thromboplastin Āhua-ā-Wā) ka ine i te whai huatanga o te ara whakapūpū e uru ana ngā pereti toto me ngā āhuatanga whakapūpū.
Whakamutunga
Mai i ngā wāhanga tuatahi o te piri ki te hanganga toto totoka pumau, he mahi nui tā ngā pereti toto i roto i te tukanga toto totoka. Mā ngā raruraru o te maha, o te mahi rānei o ngā pereti totoka ka arahi pea ki ngā mate toto totoka kino, tae atu ki te toto nui, te hanganga toto totoka nui rānei. Nō reira, ko te mārama me te pupuri i te mahi a ngā pereti totoka te mea nui ki te hauora toto pai.
Kei te haere tonu ngā rangahau i tēnei wāhanga ki te whakawhanake i ngā rongoā whai hua ake mō ngā mate pereti toto, me te whakapai ake i te kounga o te oranga o ngā tūroro e pāngia ana e ēnei āhuatanga.
