Nei Fibrinogen Ichikosha Mukuvhara Ropa
Kugwamba kweropa inzira inokosha yekudzivirira muviri kuti umise kubuda ropa kana kukuvara kwaitika. Pasina sisitimu inoshanda zvakanaka yekugwamba kweropa, kunyangwe kukuvara kudiki kunogona kuuraya sezvo ropa richiramba richiyerera zvisingadzoreki. Seri kweiyi nzira inoita seiri nyore kune nhevedzano yakaoma yemaitiro emakemikari anosanganisira zvikamu zvakawanda, kubva mutsinga dzeropa nemaplatelet kusvika kumapuroteni akakosha anonzi coagulation factors. Imwe puroteni inokosha muiyi nzira ifibrinogen. Fibrinogen inowanzonzi "zvinhu zvitsva" zvekutanga zvekuumbwa kweropa, uye basa rayo rakakosha pakuona kana muviri uchigona kuvhara ronda nekukurumidza uye zvakadzikama.
Chii chinonzi fibrinogen?
Fibrinogen ipuroteni inogadzirwa nechiropa uye inowanikwa muplasma yeropa. Sainzi, fibrinogen inozivikanwa seFactor I mu coagulation system. Mumamiriro ezvinhu akajairwa, fibrinogen inotenderera muropa iri muchimiro chinonyungudika. Zvisinei, kana muviri ukakuvara uye tsinga dzeropa dzikakuvara, fibrinogen inoshandurwa kuita chimiro chisinganyungudike chinonzi fibrin, iyo inobva yaumba network yakasimba yekubata masero eropa uye kuvhara nzvimbo yakakuvara.
Mwero we fibrinogen wakajairika muvanhu vakuru unowanzova pakati pe200–400 mg/dL, kunyange zvazvo huwandu hwezviratidzo hunogona kusiyana zvishoma kubva mumarabhoritari. Mazinga aya anogona kuchinja nekuda kwemamwe mamiriro akadai sehutachiona, kuzvimba, pamuviri, chirwere chechiropa, kana matambudziko ekugwamba kweropa.
Pfupiso yemaitiro ekugwamba kweropa
Kuti tinzwisise kukosha kwe fibrinogen, tinofanira kuona kugonya kweropa senzira inoitika mumatanho akati wandei:
1. Kudzikira kwetsinga dzeropa (kutetepa kwetsinga dzeropa): kana tsinga yeropa yakuvara, muviri unodzikisa tsinga yeropa kuti ropa risabude zvakanyanya.
2. Kuumbwa kweplatelet plug: maplatelet anonamatira kune nyama yakakuvara, anobatana, uye anoumba "plug yekutanga" inomisa kubuda kweropa.
3. Kugwamba kweropa (kuumbwa kwegwamba rakagadzikana): zvinhu zvinogwamba zvakatevedzana zvinoitwa mucheni kuti zvigadzire enzyme inonzi thrombin.
4. Kuumbwa kwefibrin: thrombin inoshandura fibrinogen kuita fibrin, uye fibrin inoumba network inosimbisa platelet plug kuita clot yakasimba.
5. Fibrinolysis (kutyoka kweropa): mushure mekunge ronda rapora, ropa rinotyoka zvishoma nezvishoma kuitira kuti ropa ridzokere pakare.
Ndipo panguva ino apo fibrinogen inotora nzvimbo yakakosha: ndiyo "chinangwa chekupedzisira" chenzira yekugwamba kwemasero kuti igadzire chimiro chakasimba chekugwamba kwemasero.
Basa guru re fibrinogen: chinhu chinoumba network ye fibrin
Basa rinozivikanwa zvikuru reFibrinogen nderekutanga kwefibrin. Kana thrombin ikaumbwa panguva yekuvharika kweropa, "inocheka" fibrinogen, yogadzira shinda dzefibrin. Idzi shinda dzefibrin dzinoumba network yakaita semesh inobata masero matsvuku eropa, maplatelet, nezvimwe zvikamu, ichivhara ronda zvakasimba.
Pasina fibrin, chivharo cheplatelet chinongogara kwenguva pfupi uye chisina kusimba. Zvakafanana nekuisa chirabwe paronda risina bhandeji rakasimba: rinogona kumisa donhwe diki, asi rinodonha nyore nyore. Fibrin ndiyo inoita kuti ropa rigadzikane, zvichiita kuti rikwanise kumira kumanikidzwa kweropa.
Fibrinogen inobatsirawo kuti maplatelet anamatire pamwe chete.
Kunze kwekuva chinhu chisina kugadzirwa che fibrin, fibrinogen ine basawo mukuunganidzwa kwemaplatelet, maitiro ayo maplatelet anonamatirana. Fibrinogen inogona kushanda se "bhiriji" rinobatanidza maplatelet kuburikidza nemareceptor chaiwo ari pamusoro pawo. Nemamwe mashoko, fibrinogen inobatsira kuvaka platelet plug pakutanga kwemaitiro ekugwamba kweropa.
Basa iri rine mbiri—kubatsira maplatelet kuti aungane uye ozogadzira fibrin—rinoita kuti fibrinogen ive chinhu chikuru chinobatanidza chikamu chekutanga nechekupedzisira chekuumbwa kwegwamba.
Chii chinoitika kana huwandu hwe fibrinogen hwakaderera zvakanyanya?
Kuderera kwe fibrinogen kunogona kuita kuti zviomere ropa kuti rigwambe, zvichiita kuti munhu ade kubuda ropa zvakanyanya. Dambudziko iri rinogona kuitika nekuda kwezvikonzero zvakasiyana-siyana:
– Matambudziko ekuzvarwa nawo akadai seafibrinogenemia (anenge asina fibrinogen) kana hypofibrinogenemia (fibrinogen yakaderera).
– Chirwere chechiropa, nekuti fibrinogen inogadzirwa muchiropa.
– DIC (disseminated intravascular coagulation), chirwere chakakomba apo kugwinha kweropa kunoitika zvakanyanya uye zvinhu zvinogwamba ropa, kusanganisira fibrinogen, "zvinopera" zvobva zvakonzera kubuda ropa.
– Kubuda ropa rakawanda, semuenzaniso kana munhu akuvara zvakanyanya, apo fibrinogen inodzikira nekukurumidza nekuda kwekushandisa nguva dzose.
– Kuderedza ropa kunokonzerwa nekuwedzerwa ropa rine mvura kana kuwedzerwa ropa rakawanda pasina kutsiva zvakakwana zvinhu zvinosunga ropa.
Zviratidzo zvinogona kuoneka zvinosanganisira kubuda ropa mumhino kunonetsa kumisa, kubuda ropa nyore nyore, mavanga akawanda, kubuda ropa rakawanda panguva yekuenda kumwedzi, uye kubuda ropa mushure mekuvhiyiwa kana mushure mekusununguka.
Ko kana fibrinogen yakakwira zvakanyanya?
Zvinofadza kuti huwandu hwakawanda hwefibrinogen hahuna kunakawo. Fibrinogen inogona kuwedzera kana paine kuzvimba, hutachiona, kushushikana kwemuviri, kusvuta, kufuta, kana mamwe mamiriro ekugaya chikafu. Fibrinogen yakawanda inowanzoonekwa sechiratidzo chekuzvimba mumuviri.
Kuwanda kwe fibrinogen kunogona kuwedzera mukana wekuti ropa rikure zvakanyanya uye kuve nengozi yekuumba magwamba, zvichigona kuwedzera njodzi yekuumbwa kweropa rakagwamba mutsinga dzeropa, izvo zvinogona kukonzera matambudziko akakomba akadai sestroke kana chirwere chemwoyo, kunyanya kana paine zvimwe zvinhu zvinokonzera njodzi.
Kuongororwa kweFibrinogen: kunodiwa riini?
Vanachiremba vanogona kutarisa huwandu hwe fibrinogen kuburikidza nekuongororwa ropa, kazhinji sechikamu chekuongorora chirwere chekugwamba kweropa kana kubuda ropa. Kuongororwa uku kunogona kukurudzirwa kana munhu:
- kazhinji kubuda ropa pasina chikonzero chakajeka,
- vanofungidzirwa kuti vane chirwere cheDIC,
- vachavhiyiwa zvakanyanya,
- kubuda ropa mushure mekusununguka,
- vane chirwere chechiropa kana chirwere chakakomba chekuzvimba,
– akabuda ropa rakawanda nekuda kwekukuvara.
Kuongororwa kweFibrinogen kunowanzo sanganiswa nedzimwe bvunzo dzakadai sePT/INR, aPTT, D-dimer, uye platelet count kuti zvipe mufananidzo wakazara we coagulation system.
Kurapa kana fibrinogen iri dambudziko
Kurapwa kunoenderana nechikonzero chacho. Kana fibrinogen yakaderera uye kubuda ropa kuri kubuda kana kuti chirongwa chekuvhiya chiri kurongwa, chiremba anogona kunyora mushonga wekutsiva, wakadai se:
- fibrinogen concentrate,
– cryoprecipitate (chigadzirwa cheropa chine fibrinogen yakawanda),
- kana kurapwa kwechikonzero chakaita sekugadzirisa DIC kana matambudziko echiropa.
Panguva imwecheteyo, kune fibrinogen yakawanda, nzira iyi inowanzo tarisa pakugadzirisa dambudziko riripo (semuenzaniso, kuzvimba), kuvandudza mararamiro (kurega kusvuta, kudzora huremu), uye kudzora zvinhu zvinoisa njodzi pamwoyo sezvinoongororwa nachiremba.
Mhedziso
Fibrinogen inokosha pakugwamba kweropa nekuti chinhu chakakosha chinoita kuti muviri ugadzire mavanga akasimba uye akasimba. Fibrinogen haisi chinhu chakakosha chete pakuumbwa kwefibrin—mesh inovhara maronda—asi inobatsirawo maplatelet kunamirana pakutanga kwekugwamba kweropa. Kana huwandu hwefibrinogen hwakaderera zvakanyanya, njodzi yekubuda ropa inowedzera; kana hwakanyanya, njodzi yekugwamba kweropa zvakanyanya inogonawo kuwedzera. Nokudaro, fibrinogen chiratidzo chakakosha chehutano hwesystem yekugwamba kweropa uye mamiriro ekuzvimba mumuviri. Kunzwisisa basa rayo kunotibatsira kuona kuti "kugwamba kweropa" hakusi kungowedzera ropa, asi inzira yakarongeka inotsamira pakuenzanisa kwezvikamu zvakakosha, fibrinogen iri chinhu chakakosha.
