Fibrinolysis na -apụta na hemostasis physiological, mgbe coagulation ọbara gasịrị, iji kpochapụ clot hemostatic nke fibrin guzobere. Ọ bụrụ na ọ dị oke buru ibu, ọ nwere ike ibute ịkpụkọta ọbara na mgbasa na ihe egwu dị na ya. Nkọwa, ihe kpatara ya na ọgwụgwọ ya, ka anyị were ngwaahịa.

Fibrinolysis bụ usoro mbibi nke mejupụtara mgbasa nke mgbochi intravascular n'okpuru ọrụ nke plasmin. Site na usoro a, ọ na -ewepụ mgbasa nke mkpofu fibrin n'ime ọbara, yabụ na -enyere aka chebe ahụ megide ihe egwu nke thrombosis (ọbara ọgbụgba).

Plasmin, nke imeju na -emepụta, bụ protein bụ isi na -eme ka fibrinolysis rụọ ọrụ. A na -atụgharị Plasmin ka ọ bụrụ plasminogen site na plasminogen activator (tPA) na urokinase.

Plasminogen nwere nkwekọrịta maka fibrin ma a na -akpọkọta ya na mkpokọta ahụ n'oge a na -akpụpụta ya (nke ga -enye ya ohere imebi ya ma emechaa). Mgbanwe site na plasminogen gaa na plasmin na -ewere ọnọdụ n'akụkụ akpụ akpụ.

Usoro fibrinolytic ga -agbagharị n'etiti imebi mkpụkọ intravascular nke na -eme na anaghị ebute ọbara ọgbụgba mgbe mkpụkọ hemostatic na fibrinogen na -agbaze.

Ọ bụrụ na clot na -agbaze ngwa ngwa, site na ọgwụgwọ, site n'ọrịa ma ọ bụ site na nkwarụ nke hemostasis, ọ nwere ike bụrụ ihe kpatara ọbara ọgbụgba dị mkpa mgbe ụfọdụ.

Enwere ụdị fibrinolysis abụọ, nke mbụ na nke abụọ fibrinolysis. Fibrinolysis nke mbụ na -eme n'ụzọ nkịtị, na fibrinolysis nke abụọ na -eme n'ihi ụfọdụ ihe mpụga dịka ọgwụ ma ọ bụ ọnọdụ ahụike.

Ọ bụrụ na fibrin dị n'ọtụtụ nke ukwuu, ọ nwere ike bute kpụkọta akpụkọta na mgbasa, na -ebute ihe egwu nke thrombosis venous (phlebitis) ma ọ bụ akwara (ischemia).

Mmebi nke fibrinolysis na-eduga na thrombophilia na-ahụ maka nrụpụta oke nke mkpụkọ ọbara na-eyi ndụ egwu:

• Nnukwu ọrịa akwara ọbara (ACS) bụ ụkọ akwara nke otu ma ọ bụ karịa na -egbochi akwara akwara;
• Nnukwu infarction myocardial ọhụrụ: ntinye aka n'ime awa atọ mbụ ka mma;
• Ischemic ọrịa strok na nnukwu oge;
• Ọkpụkpụ ngụgụ na nkwarụ hemodynamic;
• Mweghachi nke pathe catheters venous (catheters venous na catheters dialysis), ma ọ bụrụ na enwere ihe mgbochi metụtara thrombus na -emepe emepe ma ọ bụ nke emepụtara n'oge na -adịbeghị anya.

N'ọnọdụ niile ekwuru n'elu, omume nke fibrinolytics ga -adị irè dabere na oge nchịkwa ma e jiri ya tụnyere mmalite nke mgbaàmà mbụ.

Ya mere, a ga -enyerịrị ọgwụgwọ ọkọlọtọ ugbu a, fibrinolysis ozugbo enwere ike yana gụnyere ịgbanye onye ọrịa ahụ ihe na -eme ka anụ ahụ plasminogen anụ ahụ nke ga -anwa igbari clot a wee si otú a bulie ihe mgbochi nke arịa ahụ.

Fibrinolytics na -akwalite mgbasa nke mkpụkọ ọbara intravascular wee rụọ ọrụ site n'ịgbanwe plasminogen na -adịghị arụ ọrụ ka ọ bụrụ plasmin na -arụ ọrụ, enzyme na -ahụ maka mmebi fibrin nke na -ebute lysis nke thrombus.

Anyị dị iche:

• Streptokinase nke sitere n'okike bụ protein nke pto-hemolytic streptococcus mepụtara, ya mere sitere na mpụga ma nwee ike ime ka e guzobe ọgwụ mgbochi ọrịa;
• Urokinase bụ protease, nke sitere n'okike, nke na -eme ozugbo na plasminogen;
• Ihe mgbapụta nke anụ ahụ plasminogen activator (t-PA), nke enwetara site na njikọta mkpụrụ ndụ ihe nketa sitere na mkpụrụ ndụ ihe nketa t-PA, ga-agbanwe plasminogen ozugbo ka ọ bụrụ plasmin site na i mimomi ihe t-PA. Ihe ngosi T-PA na-egosi site na rt-PA (alteplase), r-PA (reteplase) na TNK-PA (tenecteplase).

  A na -ejikọkarị Heparin na / ma ọ bụ aspirin na ọgwụgwọ fibrinolytics.

Ụzọ nyocha fibrinolysis.

Nnwale zuru ụwa ọnụ: oge ​​mgbasa nke euglobulins

Mmiri ozuzo nke euglobulins na -enye ohere ịkekọrịta fibrinogen, plasminogen na ndị na -eme ihe na -egbochi protease ya. Oge nkịtị karịrị awa 3 mana ọ bụrụ na obere oge, anyị na -enyo enyo “hyperfibrinolysis”.

Nnyocha nyocha

• Nnwale Plasminogen: arụ ọrụ yana immunological;
• TPA (plasminogen anụ ahụ) nnwale: usoro immunoenzymatic;
• Ọgwụgwọ nke antiplasmin.

Nnwale na -apụtaghị ìhè

• Mkpebi nke fibrinogen: nke a bụ nyocha na -apụtachaghị ìhè nke fibrinolysis. Site na obere fibrinogen, a na -enyo "hyperfibrinolysis";
• Oge reptilase na / ma ọ bụ oge thrombin: a na-agbatị ha n'ihu ngwaahịa mmebi fibrin;
• Mkpebi nke PDFs (Fibrin na fibrinogen deradaration ngwaahịa): elu na omume nke ịgbalite fibrinolysis;
• Nnwale D-dimer: ha kwekọrọ na iberibe PDF ma dị elu ma ọ bụrụ fibrinolysis.