Fibrinolysis yana faruwa a cikin hemostasis na ilimin lissafi, bayan coagulation na jini, don kawar da haɓakar hemostatic da fibrin ya kafa. Kasancewa da yawa, yana iya haifar da samuwar ɗigon jini a cikin zagayawa tare da haifar da haɗarin. Ma'ana, sanadi da jiyya, bari mu yi la'akari.

Fibrinolysis wani tsari ne na lalata wanda ya ƙunshi rushewar jijiyoyin jini a ƙarƙashin aikin plasmin. Ta wannan tsari, yana kawar da zub da jini na fibrin a cikin jini don haka yana taimakawa kare jiki daga haɗarin thrombosis (ƙin jini).

Plasmin, wanda hanta ke samarwa, shine babban furotin da ke kunna fibrinolysis. Ana canza Plasmin zuwa plasminogen ta hanyar plasminogen activator (tPA) da urokinase.

Plasminogen yana da concordance na fibrin kuma an haɗa shi a cikin gudan jini yayin samuwar sa (wanda zai ba da damar rushe shi daga baya). Canje -canjen daga plasminogen zuwa plasmin yana faruwa a kusa da gudan jini.

Dole ne tsarin fibrinolytic ya yi motsi tsakanin fashewar jijiyoyin jijiyoyin jini da ke faruwa kuma baya haifar da zubar jini lokacin da haɓakar hemostatic da fibrinogen suka narke.

Idan gudan jini ya narke da sauri, ta hanyar magani, ta cuta ko ta hanyar rashin lafiyar hemostasis, to yana iya zama alhakin wani lokacin mahimmin zubar jini.

Akwai nau'ikan fibrinolysis iri biyu, na farko da na biyu na fibrinolysis. Fibrinolysis na farko yana faruwa ta halitta, kuma fibrinolysis na sakandare yana faruwa saboda wasu dalilai na waje kamar magani ko yanayin likita.

Idan fibrin ya kasance da yawa, yana iya haifar da samuwar ɗigon jini a cikin zagayawa, yana haifar da haɗarin venous thrombosis (phlebitis) ko jijiya (ischemia).

Lahani a cikin fibrinolysis yana haifar da thrombophilia da ke da alhakin haifar da wuce haddi na haɗarin jini:

• Cutar ciwon jijiya mai tsanani (ACS) cuta ce da ta shafi jijiyoyin jini wadda daya ko fiye ta toshe jijiyoyin jijiyoyin jini;
• Ciwon zuciya na kwanan nan: shiga tsakanin sa'o'i uku na farko ya fi dacewa;
• Ischemic bugun jini a cikin m lokaci;
• Ruwan huhu tare da rashin kwanciyar hankali na hemodynamic;
• Mayar da ladabi na magudanar jini (tsakiyar jijiyoyin jijiyoyin bugun jini da dialysis catheters), idan an sami cikas da ke da alaƙa da trombus mai tasowa ko kwanannan.

A duk lamuran da aka ambata a sama, aikin fibrinolytics zai yi tasiri ne kawai dangane da lokacin gudanarwa idan aka kwatanta da farkon alamun farko.

Don haka dole ne a ba da magani na yau da kullun, fibrinolysis da wuri -wuri kuma ya ƙunshi allurar mai haƙuri tare da mai kunna plasminogen nama wanda zai yi ƙoƙarin narkar da wannan ɗigon jini don haka ya ɗaga toshewar jirgin.

Fibrinolytics yana haifar da rushewar jijiyoyin jijiyoyin jini kuma yana aiki ta hanyar canza plasminogen mara aiki a cikin plasmin mai aiki, enzyme da ke da alhakin lalacewar fibrin wanda hakan ke haifar da lysis na thrombus.

Mun bambanta:

• Streptokinase na asalin halitta shine furotin da produced-hemolytic streptococcus ya samar, sabili da haka daga asalin halitta kuma yana iya haifar da samuwar ƙwayoyin cuta;
• Urokinase protease ne, na asalin halitta, wanda ke aiki kai tsaye akan plasminogen;
• Abubuwan da aka samo na mai kunna plasminogen activator (t-PA), wanda aka samu ta hanyar sake haɗawa da kwayoyin halittar t-PA, za su canza plasminogen kai tsaye zuwa plasmin ta hanyar kwaikwayon aikin t-PA. Ana nuna alamun t-PA ta rt-PA (alteplase), r-PA (reteplase) da TNK-PA (tenecteplase).

  Heparin da / ko aspirin ana yawan haɗa su da magani tare da fibrinolytics.

Hanyoyin binciken fibrinolysis.

Gwajin duniya: Lokacin rushewar euglobulins

Ruwan haɓakar euglobulins yana ba da damar raba fibrinogen, plasminogen da masu kunna masu hana protease. Lokacin al'ada ya fi awanni 3 amma idan ƙasa da lokaci, muna zargin “hyperfibrinolysis”.

Gwajin nazari

• Gwajin Plasminogen: aiki da rigakafi;
• TPA (plasminogen nama) gwaji: dabarun immunoenzymatic;
• Sashi na antiplasmin.

Gwajin kai tsaye

• Tabbatar da fibrinogen: wannan shine kimantawa kai tsaye na fibrinolysis. Tare da ƙarancin fibrinogen, ana zargin "hyperfibrinolysis";
• Lokacin maimaitawa da / ko lokacin thrombin: an tsawaita su a gaban samfuran lalata fibrin;
• Ƙaddamar da PDFs (fibrin da fibrinogen lalata samfurori): babba a yayin da ake kunna fibrinolysis;
• D-dimer assay: sun dace da gutsuttsuran PDF kuma suna da girma a yayin fibrinolysis.