Iyo enzyme inokonzera kuvhara ropa, inonzi chii?

Zvakanaka apo kunetseka kwakadaro, sekuchekwa kana kunya, kunorapa nokukurumidza uye pasina matambudziko. Hatisi kukoshesa kukosha kwokuti simba, zvinhu uye zvirongwa zvakabatanidzwa sei pakuvimbika kwemuviri wedu.

Chii chinonzi ropa coagulation system?

Mukusayenzi yezvokurapa, sangano rekugadzirisa ropa rinonzi "homeostasis." Iyi ndiyo nzira inopa mvura yakachena yeropa, uye inodzivirira kurasikirwa kwehamba yakawanda yayo. Ropa kuvanhu ndiro tsime roupenyu, nokuti nekubatsira kwayo zvinhu zvose zvinobatsira zvinopinda mumasero. Haisi chete inopa muviri muviri, asi unodzivirirawo. Izvi zvinotyisa mumuviri hazvisi zvakawanda, naizvozvo kuvhara kana kucheka kwose kunovhiringidza kuvimbika kwemidziyo, kunogona kuguma zvakashata. Asi sangano rinobatanidza rinouya kune rubatsiro, kunyanya kunyanya enzyme yayo, zvichikonzera kuwirirana kweropa. Iyo inonzi inopindirana nezvikamu zvemuchina uyu nemaplatelet.

Iyi nzira yakasiyana, sezvo iri muropa regairi mumidziyo yese yeropa. Pangosvika mudziyo wacho, zvinhu zvakasiyana-siyana uye nzira dzinopinda mubasa rinopfigira muhomwe. Izvi hazvisi kungovhara ropa, asi zvinodzivirirawo nenzira dzezvinhu zvakasiyana. Kazhinji, zvose zvinoratidzira zvakaenzana, nekuda kwekuti basa reropa rakazadziswa zvakakwana kunyange nemidziyo yakaora.

Anticoagulation yeropa

Basa remugadziriro ino nderokudzora kuvhara ropa. Pashure pezvose, kana izvi zvisingatongorongorwi, zvichaita kuti kutyora kwekukosha kwekudzivirira basa. Anticoagulant system inotarisira kudzivirira kuumbwa kwetrombi mumidziyo yose, kuitira kuti thrombin iite chete pane zvakakanganisika. Mukuwedzera, anticoagulants nguva dzose inochengetedza mhepo inenge yeropa rose, inopesana nemafungiro ekuona zvinyorwa uye kuwedzera kwechirwere ichi.

Panzvimbo yepanyama, heparin, antithrombin, mapuroteni, inhibitor yezvinhu zvakasiyana-siyana (anticoagulants of this system) inodzivisa kuumbwa kwe fibrin, inodzivisa kukanganisa kweyerythrocytes, maplatelets uye kudzivisa kubudiswa kwepromboplastin nemuviri. Asi zvakadaro, chinonzi zita rekuchenesa ropa rine enzyme , uye chii chinoguma?

Sei tichida kubviswa kweropa rega mu coagulation system?

Chikamu chechitatu chekushambadzira kwose kweropa rekugadzirisa chirongwa ndiyo fibrinolytic system. Basa rayo nderokuputsa trombi iripo. Iyi nzira inokosha apo basa guru rakapedzwa, uye pamusoro pemudziyo inodzorerwa. Hemostasis inogumisa zvakanaka kana izvi zvikamu zvitatu zvechiropa chekugadzirisa ropa zvinoshanda. Kana zvisina kudaro, pane kuputsa mune izvi - zvinogona kuve nokubuda ropa kana kupfurikidza zvakanyanya kufambisa. Iyi "kushamwaridzana" mubasa inowanikwa muzvirwere zvechiropa, mapapu, neoplasms, IHD, rheumatism nezvimwe zvirwere.

Kuvhara ropa kunotanga sei?

Kuvhara ishanduko, kushandurwa kwemvura yeropa mune jelly-like clot. Kuvonga nebasa iri, muviri unozvichengetedza kubva pakurasikirwa kweropa. Kana mudziyo muduku uchinge waparadzwa, ropa rekuvhara ropa (apo enzyme inokonzera coagulation inotanga kuita), iyo inoita sekumisa, iyo inobatsira kumisa kubuda ropa.

Kusangana kweropa kunowanzoitika nekuda kwechirongwa chakasiyana, chinonzwisiswa se inhibitors chekugadzirisa, kushandisa zvinhu. Iyo enzyme, iyo inokonzera kuvhara ropa, inoumbwa nguva dzose. Inhibitor inoshanda nenzira inopfuurira muzvikamu:

• 1 chikamu. Heparin uye antiprothrombinase inotanga kuita.
• 2 chikamu. Thrombin inhibitors (fibrinogen, fibrin, prethrombin I uye II, michina ye hydrolytic thrombin) inopinda mubasa.

Munguva dzezvirwere zvakawanda mumuviri, zvimwe inhibitor zvinoumbwa. Kune vakawanda, inoramba iri chinhu chisingazivikanwi iyo enzyme inokonzera ropa coagulability. Pashure pezvose, vazhinji vanocherechedza zvinhu uye zvinhu zvinobatanidzwa mune izvi. Asi ivo vose vanoita zvakasimba mabasa avo, kana enzyme iyi ichirasikirwa neropa-kusimba kwayo, kunyange kunyanganisa kwakanyanya kumudziyo kunotungamirira kubuda ropa kunouraya.

Enzyme inokonzera ropa kuvhara

Takafunga kuti chii chatinoda sangano rinogutsa, ikozvino tichazotarisisa zvakanyanya nzira dzaro dzepanyama. Zita rei enzyme rinokonzera ropa kuvhara? Chinhu chikuru munharaunda iyi inokonzera kubva ku trypsin yemhuri. Mukati yekushandiswa kwemakemikari, inoshanda pa fibrinogen uye inouita mu fibrin. Iyo enzyme inokonzera kuvhara ropa, inonyanya kuronga fibrinolysis uye thrombosis, inzwi revascular. Kuumbwa kwe enzyme kunowanikwa mukuputira maitiro.

Kubva ku prothrombin inoratidzika kuti ichrombin pachikamu chekupedzisira chekugadzirisa. Thrombin inokurudzira kushandiswa kweV, VIII, XIII kuvhara zvinhu. Iine hormonal properties, inoratidzirwa nekutaurirana nema platelet uye endothelial masero. Munguva yekubatana ne thrombomodulin, iyi enzyme inorega kupeta ropa.

Hemostasis phases: ropa rinovhara enzyme rinoita sei

Chimwe chinhu chehemostasis ndechokuvharwa kwemvura yakakonzerwa. Mavara e fibrin anokurudzira kugadzirwa kwetrombus, shure kwaizvozvo ropa rinowana astringent nzvimbo. Zita rei enzyme rinokonzera ropa kuvhara? Zita racho rakafanana chaizvo neshoko rokuti "thrombus" - thrombin. Anogara akagadzirira kushanda, uye kana kukanganisa kunotanga kuita zvakasimba. Hemostasis yakakamurwa muzvikamu zvakasiyana:

1. Chikamu cheprothrombinase chiitiko. Panguva ino, majekiseni eropa uye eropa anoumbwa, iyo nzira yekugadzirisa kwavo inowanikwa pamitengo yakasiyana. Kuumbwa kweropa prothrombinase zvakanamatira kunobva mumashuga prothrombinase (temaue enzyme inobata zvinhu zvekugadzirisa ropa enzyme). Muchikamu chimwechete, pane kunze uye mukati maitiro we hemocoagulation.
2. Chikamu chechirombin chizvarwa. Pachikamu chino, tinowana mhinduro kumubvunzo weiyo enzyme inokonzera kuvhara ropa. Prothrombin inoparadzaniswa kuita zvikamu uye chinhu chinonzi thrombin-activating chinoumbwa, chinoita kuti zvikamu zvinotevera zvivepo uye anoziva mutori wenhau.
3. Chikamu chekutanga kwe fibrin. Thrombin (enzyme inokonzera kuvhara ropa) inokanganisa fibrinogen, amino acids inonamatwa.
4. Ichi chikamu chakakosha mune iyo polymerization ye fibrin uye kuumbwa kwejira rinowanikwa.
5. Fibrinolysis. Pachikamu ichi, hemocoagulation yapera.

"Kunze" coagulation

Iyi nzira yakaoma zvikuru uye danho-nhanho. Chokutanga, nzvimbo dzakakanganisika dzinosangana neropa, zvichiita hutatu hwehutachiplastin. Pashure pacho, anotendeuka VII (proconvertin) kuVII-A (convertin). Somugumisiro wekuita uku, dambudziko reCa + + III + VIIIa, kushandura X-factor, rinooneka, uye rinoshandura kuva Xa. Somugumisiro wezvinhu zvose, imwe shanduko inoratidzika iyo inobata mabasa ose ezvinyorwa zveprothrombinase. Kuvapo kwaVaV kunoratidza kuti kuvapo kwe thrombin kunobatsira V-factor. Icho chinonzi prothrombinase chinoita kuti prothrombin iite thrombin. Iyi enzyme inokonzera kuvhara ropa, kuita zvinhu zvinonzi V uye VIII, izvo zvinodiwa apo ropa protrombinase inowanikwa.

"Mukati" ropa kuvhara

Pamwe chete nechokunze, mukati mekogi inotanga. Mukubatana nechikamu chisina kukwana chemudziyo, icho XII chikonzero (XII-XIIa) chinoshandiswa. Panguva imwecheteyo, mbambo ye hemostatic inoumbwa. Iyo XII inoshanda inobatsira XI, pashure XIIa + Ca ++ + XIa + III inowanikwa, iyo inobata IX uye inoita shanduko yakaoma. Anoshandisa X, uye apo Xa + Va + Ca + + + III anooneka, iyo ropa prothrombinase. Pano, imwe enzyme inokonzera kuvhara ropa. Kupatsanurana kuva "kunze" uye "mukati" kunonyanya kushandiswa uye kunoshandiswa chete mumasikirwo esayenzi kuti zvive nyore, sezvo izvi zvinowirirana zvikuru.

Basa rekuvhara zvinhu mune izvi

Tatove tataura kuti kushanda kwekuvhara ropa hakuiti pasina zvimwe zvinhu zvinonzi zvinhu. Izvo zvinhu zvinokonzerwa neeplasma mapuroteni, ayo mune sayenzi yezvokurapa inonzi zvinhu.

• Fibrin uye fibrinogen. Fibrinogen yakafukidzwa nechiito che thrombin.
• Thrombin uye prothrombin. Prothrombin glycoprotein, zvakakwana muropa kushandura fibrinogen mu fibrin. Thrombin ine enzyme inokonzera coagulability yeropa, chete maratidzo ayo anoonekwa mairi.
• Thromboplastin. Ane phospholipid sangano, pakutanga haisi kushanda. Iye ndiye mutungamiri mukuru wechikamu chekutanga.
• Calcium ionized Ca ++. Anotora chikamu chinoshingaira mumagetsi e homeostasis.
• Proaccelerin uye acceclerin (AC-globulin). Inobatanidzwa muzvikamu zviviri zve coagulation. Maitiro mazhinji enzyme anotengesa.
• Proconvertin uye convertin. Iyo ipuroteni yekamu beta-globulin. Inobata mishonga protobinase.
• Antigemophilic globulin A (AGG-A). Nhengo yeropa prothrombinase. Kana pasina puroteni iyi, iyo hemophilia inokura. Yaro duku muropa, asi inonyanya kukosha kuvanhu.
• Antigemophilic globulin B (AGH-B, Krisimasi chinhu). Chikamu uye X-factor activator.
• The Koller factor, Steward-Prawer factor. Vabatanidzwa veprothrombinase.
• Chinhu che Rosenthal, mutambo we plasma we thromboplastin (PPT). Inokurumidza kufambisa nzira yekuitika kweprothrombinase.
• Izvo zvakabatana, Hagemann factor. Izvo zvinokonzera kushandiswa kwekuvhara. Inobatanidzwa mukushandiswa kwezvimwe zvinhu.
• Lucky-Lorand fibrinstabilizer. Izvo zvinodiwa pakuwana insoluble fibrin.

Zvose izvi zvinodiwa kuti zvive zvakakwana, kana izvi zvichiitika nekukurumidza uye zvine chimiro, pasina kutungamirira muviri wemunhu kuwedzerwa kurasikirwa kweropa.

Mechanism of thrombus formation

Kudzorerwa kwemidziyo yakakanganisika hakuitike nenzira yakadaro, inosanganisira zvinhu zvakawanda zvinoshanda nenzira yakarongeka, kuita mabasa avo. Chinokosha chekuita izvi ndechekuti kusagadzikana kweganda reprotein uye masero eropa kunoitika. Iyo thrombus inonamatira kumadziro evascula, kana thrombus yakabatana nemudziyo, ipapo musasa wayo unowedzera hauna kuitika.

Apo mudziyo unoparara, zvinhu zvinobatsira kudzivisa maitiro ekugadzirisa anosunungurwa kubva mairi. Thrombocytes inoshanduka uye inoputsika, zvichiita kuti kuputira muropa reprocoagulants: thromboplastin uye thrombin, enzyme inokonzera kuvhara ropa. Pasi pechiito chayo, fibrinogen inova fibrin, iyo ine mhando ye mesh uye inotangira trombus. Iyi mesh kwenguva yakati yakaoma. Panguva ino, kuumbwa kwe thrombi kunopera, ropa rinomiswa.

Kuvhara nguva sechiratidzo chekuita kweenzyme

Nguva kubva panguva yekukuvara kumigumo yekubuda ropa inotora kubva pamaminitsi maviri kusvika mana. Iyo enzyme inokonzera kuvhara ropa kwemaminitsi gumi. Nguva ino ichafanana neicho chaiicho mune chimwe chiitiko chokuti hapana kutyora muhurongwa hukuru hunobatanidzwa mukugadzirisa. Asi pane zvirwere umo kubvisa kwekuvhara kunopera kana kusakwanisika zvachose. Zvirwere zvakadai zvinokonzera hemophilia, chirwere cheshuga mellitus nezvimwewo.

Kubatanidzwa kwehurongwa hwemagandanga mune izvi

Kana kukanganisa kuitika, muviri unotumira chirwere chinorwadza kuuropi. Pain changes processes. Izvozvo zvinokurudzira zvinobatsira kukurumidza kuvhara. Kune zvinorwadza, kutya kunowedzerwa, izvo zvinowedzera kuwedzera coagulability uye chiito chekutapisa. Kana kurwadziwa kwacho kwechinguva chiduku, ropa rekuchenesa ropa rinokonzera kushandiswa kuitira kuti kudzokera kune zvinoitika kunowanikwa nekukurumidza zvakanyanya, uye kungofanana nekugadzirisa mafungiro akabatanidzwa. Utano hurefu hunobatanidza maitiro ehuori uye kuvhara ropa, kuporeswa kwepanyama kunoitika zvishoma nezvishoma.

Paunenge uchitaridzirwa kunzwira tsitsi kana mushure mejeri adrenaline, coagulability inowedzera. Kunyange zvazvo chiito pamapurisa ane chirwere chinokonzera kupera kunoderedza izvi. Dhipatimendi inoshanda pamwechete uye inotsigirana. Mushure mekumira ropa, basa reparasympathetic system rinowedzera, izvo zvinoita kuti basa reanticoagulation.

Endocrine system yekubatsira hemostasis

Zvose zvikamu izvo zvikamu zve endocrine system zvakakosha mumabasa avo. Mahomoni ane simba rakasimba pamasimba emuviri. Kurumidza kuisa nzira yekuvhara ropa mahomoni akadaro se ACTH, STG, adrenaline, cortisone, testosterone, progesterone. Kupera kunokonzerwa ne hemostasis vane: thyroid-stimulating hormone, thyroxine uye estrogens. Kana pane kukanganisa mukushanda kwemasmoni, zvinogona kuchinja mune izvi uye zvinogona kuva nezvinetso zvakakomba zvinoda kuzokurukurwa nemumwe nyanzvi.