Malingaliro oyambira okhudzana ndi kukwezedwa kwa coagulation

Mfundo ya anticoagulant ndi kugwiritsa ntchito wamba anticoagulants

1. Heparin ndi anticoagulant yomwe imakonda kwambiri pozindikira kuchuluka kwa magazi.Heparin ndi mucopolysaccharide yomwe ili ndi sulphate gulu, ndipo pafupifupi maselo olemera a gawo lobalalika ndi 15000. Mfundo yake ya anticoagulation makamaka imaphatikizana ndi antithrombin III kuti iwononge kusintha kwa antithrombin III ndikufulumizitsa mapangidwe a thrombin thrombin complex kupanga anticoagulation. .Kuphatikiza apo, heparin imatha kuletsa thrombin mothandizidwa ndi plasma cofactor (heparin cofactor II).Mankhwala a heparin anticoagulants ndi sodium, potaziyamu, lithiamu ndi ammonium salt ya heparin, yomwe lithiamu heparin ndi yabwino, koma mtengo wake ndi wokwera mtengo.Mchere wa sodium ndi potaziyamu udzawonjezera kuchuluka kwa sodium ndi potaziyamu m'magazi, ndipo ammonium salt amawonjezera zomwe zili mu urea nayitrogeni.Mlingo wa heparin wa anticoagulation nthawi zambiri ndi 10. 0 ~ 12.5 IU/ml magazi.Heparin ilibe kusokoneza pang'ono ndi zigawo za magazi, sizimakhudza kuchuluka kwa maselo ofiira a magazi, ndipo sizimayambitsa hemolysis.Ndiwoyenera kuyesedwa kwa ma cell permeability, mpweya wamagazi, plasma permeability, hematocrit ndi kutsimikiza kwachilengedwe chonse.Komabe, heparin imakhala ndi antithrombin ndipo siyoyenera kuyesa magazi a coagulation.Kuphatikiza apo, heparin yochulukirapo imatha kuyambitsa kuphatikizika kwa leukocyte ndi thrombocytopenia, chifukwa chake sikoyenera kugawika kwa leukocyte ndi kuwerengera mapulateleti, kapena kuyesa kwa hemostasis Kuphatikiza apo, heparin anticoagulation singagwiritsidwe ntchito kupanga smears yamagazi, chifukwa buluu wakuda umawoneka pambuyo pa kuipitsidwa kwa Wright. , zomwe zimakhudza kuchepetsa kupanga kwa microscopic.Heparin anticoagulation iyenera kugwiritsidwa ntchito kwakanthawi kochepa, apo ayi magazi amatha kukhazikika atayikidwa kwa nthawi yayitali.

2. EDTA mchere.EDTA imatha kuphatikiza ndi Ca2+ m'magazi kupanga chelate.Njira ya coagulation imatsekedwa ndipo magazi sangathe kugwirizanitsa mchere wa EDTA monga potaziyamu, sodium ndi lithiamu mchere.International Hematology Standardization Committee imalimbikitsa kugwiritsa ntchito EDTA-K2, yomwe imakhala yosungunuka kwambiri komanso kuthamanga kwambiri kwa anticoagulation.Mchere wa EDTA nthawi zambiri umakonzedwa kukhala yankho lamadzi ndi gawo lalikulu la 15%.Onjezani 1.2mgEDTA pa ml ya magazi, ndiko kuti, onjezerani 0.04ml ya 15% yankho la EDTA pa 5ml ya magazi.Mchere wa EDTA ukhoza kuumitsidwa pa 100 ℃, ndipo zotsatira zake za anticoagulation zimakhala zosasinthika EDTA mchere sizimakhudza chiwerengero cha maselo oyera a magazi ndi kukula kwake, zimakhala ndi zotsatira zochepa pa morphology ya maselo ofiira a magazi, zimalepheretsa kuphatikizika kwa mapulateleti, ndipo ndizoyenera ku hematological. kuzindikira.Ngati kuchuluka kwa anticoagulant ndikwambiri, kuthamanga kwa osmotic kudzakwera, zomwe zingayambitse kuchepa kwa maselo.EDTA-K2 imatha kukulitsa pang'ono kuchuluka kwa maselo ofiira a magazi, ndipo kuchuluka kwa mapulateleti pakangopita nthawi yochepa pambuyo pa kusonkhanitsa magazi kumakhala kosakhazikika ndipo kumakhala kokhazikika pakatha theka la ola.EDTA-K2 yachepetsa Ca2+, Mg2+, creatine kinase ndi alkaline phosphatase.Kuchuluka kwabwino kwa EDTA-K2 kunali 1. 5mg/ml magazi.Ngati pali magazi pang'ono, neutrophils pathupi, lobulate ndi kutha, kupatsidwa zinthu za m`mwazi adzatupa ndi kupasuka, kupanga zidutswa za kupatsidwa zinthu za m`mwazi yachibadwa, zomwe zingachititse zolakwika kusanthula zotsatira EDTA mchere akhoza ziletsa kapena kusokoneza polymerization wa fibrin monomers pa mapangidwe. a fibrin kuundana, amene si oyenera kuzindikira magazi coagulation ndi kupatsidwa zinthu za m`mwazi ntchito, kapena kudziwa kashiamu, potaziyamu, sodium ndi nitrogenous zinthu.Kuphatikiza apo, EDTA ingakhudze ntchito ya ma enzymes ena ndikuletsa lupus erythematosus factor, kotero sikoyenera kupanga madontho a histochemical ndikuwunika magazi a maselo a lupus erythematosus.

3. Citrate makamaka sodium citrate.Mfundo yake ya anticoagulation ndi yakuti ikhoza kugwirizanitsa ndi Ca2 + m'magazi kuti apange chelate, kotero kuti Ca2 + imataya ntchito yake yowonongeka ndipo ndondomeko ya coagulation imatsekedwa, motero imalepheretsa kusungunuka kwa magazi.Sodium citrate ili ndi mitundu iwiri ya makristasi, Na3C6H5O7 · 2H2O ndi 2Na3C6H5O7 · 11H2O, kawirikawiri 3.8% kapena 3 ndi yakale.2% yankho lamadzimadzi, losakanikirana ndi magazi mu 1: 9 voliyumu.Mayesero ambiri a coagulation amatha kukhala anticoagulated ndi sodium citrate, yomwe imathandiza kukhazikika kwa factor V ndi factor VIII, ndipo imakhala ndi mphamvu zochepa pa kuchuluka kwa mapulateleti ndi zinthu zina za coagulation, kotero ingagwiritsidwe ntchito pofufuza ntchito ya mapulateleti.Sodium citrate imakhala ndi cytotoxicity yochepa komanso ndi imodzi mwa zigawo za madzi osungira magazi poika magazi.Komabe, sodium citrate 6mg imatha anticoagulate magazi a 1ml, omwe ali amchere kwambiri, ndipo sali oyenera kusanthula magazi ndi kuyezetsa magazi.