Iikhonsepthi ezisisiseko ezinxulumene nokunyuswa kwe-coagulation

Umgaqo we-Anticoagulant kunye nokusetyenziswa kwee-anticoagulants eziqhelekileyo

1. I-Heparin yi-anticoagulant ekhethiweyo yokufumanisa ukubunjwa kweekhemikhali zegazi.I-Heparin yi-mucopolysaccharide equkethe iqela le-sulfate, kunye ne-avareji ye-molecular weight of the dispersed phase yi-15000. Umgaqo wayo we-anticoagulation ikakhulu ukudibanisa ne-antithrombin III ukwenza utshintsho ekubunjweni kwe-antithrombin III kunye nokukhawulezisa ukubunjwa kwe-thrombin thrombin complex ukuvelisa i-anticoagulation. .Ukongezelela, i-heparin inokuthintela i-thrombin ngoncedo lwe-plasma cofactor (i-heparin cofactor II).I-heparin anticoagulants eqhelekileyo i-sodium, i-potassium, i-lithium kunye ne-ammonium salts ye-heparin, phakathi kwayo i-lithium heparin iyona nto ibhetele, kodwa ixabiso layo libiza kakhulu.Iityuwa zesodium kunye ne-potassium ziya kwandisa umxholo we-sodium kunye ne-potassium egazini, kwaye i-ammonium salts iya kwandisa umxholo we-urea nitrogen.Idosi ye-heparin ye-anticoagulation idla ngokuba yi-10. 0 ～ 12.5 IU/ml igazi.I-Heparin inokuphazamiseka okuncinci kumacandelo egazi, ayichaphazeli umthamo weeseli ezibomvu zegazi, kwaye ayibangeli i-hemolysis.Ilungele uvavanyo lokungena kweseli, igesi yegazi, i-plasma permeability, i-hematocrit kunye nokuzimisela ngokubanzi kwe-biochemical.Nangona kunjalo, i-heparin ine-antithrombin effect kwaye ayifanelekanga kuvavanyo lwe-coagulation yegazi.Ukongeza, i-heparin egqithisileyo inokubangela ukuhlanganiswa kwe-leukocyte kunye ne-thrombocytopenia, ngoko ke ayifanelekanga ukuhlelwa kwe-leukocyte kunye nokubala kweplatelet, okanye uvavanyo lwe-hemostasis Ukongeza, i-heparin anticoagulation ayikwazi ukusetyenziswa ukwenza i-blood smears, kuba imvelaphi emnyama ebomvu ibonakala emva kokungcoliswa kwe-Wright. , echaphazela ukunciphisa ukuveliswa kwe-microscopic.I-Heparin anticoagulation kufuneka isetyenziswe ixesha elifutshane, ngaphandle koko igazi liyakwazi ukujiya emva kokubekwa ixesha elide.

2. EDTA ityuwa.I-EDTA inokudibanisa ne-Ca2+ egazini yenze ichelate.Inkqubo ye-coagulation ivaliwe kwaye igazi alikwazi ukudibanisa i-EDTA iityuwa ziquka i-potassium, i-sodium kunye neetyuwa ze-lithium.I-International Hematology Standardization Committee incoma ukusetyenziswa kwe-EDTA-K2, ene-solubility ephezulu kunye nesantya esiphezulu se-anticoagulation.Ityuwa ye-EDTA idla ngokulungiswa kwisisombululo esinamanzi kunye neqhekeza elikhulu le-15%.Yongeza i-1.2mgEDTA nge-ml yegazi, oko kukuthi, yongeza i-0.04ml ye-15% isisombululo se-EDTA nge-5ml yegazi.Ityuwa ye-EDTA inokomiswa kwi-100 ℃, kwaye umphumo wayo we-anticoagulation uhlala ungatshintshi ityuwa ye-EDTA ayichaphazeli ukubala kweeseli ezimhlophe zegazi kunye nobukhulu, inempembelelo encinci kwi-morphology yeeseli ezibomvu zegazi, inhibits platelet aggregation, kwaye ifanelekile kwi-hematological jikelele. ukubhaqwa.Ukuba i-concentration ye-anticoagulant iphezulu kakhulu, uxinzelelo lwe-osmotic luya kunyuka, oluya kubangela ukuba i-cell shrinkage I-pH yesisombululo se-EDTA inobudlelwane obukhulu kunye neetyuwa, kwaye i-pH ephantsi ingabangela ukwanda kweeseli.I-EDTA-K2 inokwandisa kancinci umthamo weeseli ezibomvu zegazi, kunye ne-avareji yeplatelet volume ngexesha elifutshane emva kokuqokelelwa kwegazi alizinzile kwaye lihlala lizinzile emva kwesiqingatha seyure.I-EDTA-K2 iyancipha i-Ca2 +, i-Mg2 +, i-creatine kinase kunye ne-alkaline phosphatase.Uxinzelelo oluphezulu lwe-EDTA-K2 lwaluyi-1. 5mg / ml igazi.Ukuba kukho igazi elincinci, i-neutrophils iya kudumba, i-lobulate kwaye iphele, iiplatelet ziya kukhukhumala kwaye ziqhekeke, zivelise amaqhekeza eeplatelet eziqhelekileyo, eziya kukhokelela kwiimpazamo kwiziphumo zohlalutyo i-salts ze-EDTA zinokunqanda okanye ziphazamise i-polymerization ye-fibrin monomers ngexesha lokusekwa. i-fibrin clots, engafanelekanga ukuba kuchongwe ukuxinana kwegazi kunye nomsebenzi weplatelet, okanye ukuzimisela kwe-calcium, i-potassium, i-sodium kunye ne-nitrogenous substances.Ukongeza, i-EDTA inokuchaphazela umsebenzi wezinye i-enzymes kwaye inhibit lupus erythematosus factor, ngoko ayifanelekanga ukwenza i-histochemical staining kunye nokuvavanya igazi le-lupus erythematosus cells.

3. I-Citrate ikakhulu i-sodium citrate.Umgaqo wayo we-anticoagulation kukuba unokudibanisa ne-Ca2 + egazini ukwenza i-chelate, ukwenzela ukuba i-Ca2 + ilahlekelwe ngumsebenzi wayo wokudibanisa kunye nenkqubo yokudibanisa ivaliwe, ngaloo ndlela ikhusela ukudibanisa kwegazi.I-sodium citrate ineentlobo ezimbini zeekristale, i-Na3C6H5O7 · 2H2O kunye ne-2Na3C6H5O7 · 11H2O, ngokuqhelekileyo i-3.8% okanye i-3 kunye neyangaphambili.I-2% isisombululo samanzi, esixutywe negazi kwi-1: 9 umthamo.Uninzi lweemvavanyo ze-coagulation lunokuthi lube ne-anticoagulated nge-sodium citrate, eluncedo ekuzinzeni kwe-factor V kunye ne-factor VIII, kwaye inempembelelo encinci kumthamo weplatelet ephakathi kunye nezinye izinto zokudibanisa, ngoko ingasetyenziselwa uhlalutyo lomsebenzi weplatelet.I-sodium citrate ine-cytotoxicity encinci kwaye ikwayenye yezinto ezisetyenziselwa ukugcinwa kwegazi kwigazi.Nangona kunjalo, i-citrate ye-sodium i-6mg inokunqanda igazi le-1ml, eline-alkaline enamandla, kwaye ayifanelekanga ukuhlalutya igazi kunye neemvavanyo ze-biochemical.