Hana ʻia ʻo Fibrinolysis i ka hemostasis physiological, ma hope o ke kōkō ʻana o ke koko, e hoʻopau i ka ʻeke hemostatic i hana ʻia e fibrin. I kēia manawa i kahi nui loa, hiki iā ia ke alakaʻi i ka hoʻokumu ʻana o kahi ʻōpala i ke kaapuni me nā hopena hopena. Ka wehewehe ʻana, nā kumu a me nā mālama ʻana, e lawe i nā waihona.

ʻO Fibrinolysis kahi hana o ka luku kahi i loko o ka hoʻoheheʻe ʻia ʻana o nā clots intravastral ma lalo o ka hana o plasmin. Ma kēia kaʻina hana, holo ia i ka holo o ka ʻōpala fibrin i loko o ke koko a no laila kōkua ia i ka pale ʻana i ke kino i ka makaʻu o ka thrombosis (kōkuʻu koko).

ʻO Plasmin, hana ʻia e ke akepaʻa, ʻo ia ke protein nui e hoʻonāukiuki i ka fibrinolysis. Hoʻohuli ʻia ʻo Plasmin i plasminogen e ka mea hoʻoulu kino plasminogen (tPA) a me urokinase.

He concordance ko Plasminogen no fibrin a ʻākoakoa ʻia i loko o ke kapa i ka wā o kona hoʻokumu ʻia (kahi e ʻae ai e wāwahi ʻia ma hope). Hoʻololi ka hoʻololi mai plasminogen i plasmin ma kahi o ka clot.

Pono ka ʻōnaehana fibrinolytic e hoʻoponopono i waena o ka haki ʻana i nā ʻōpū o ke kino e hana a me ka ʻole o ke kahe ʻana o ke kahe ke hemo nā hemostatic clots a me fibrinogen.

Inā hemo koke ka ʻōpala, ma ka mālama ʻana, ma ka maʻi a i ʻole kahi maʻi maʻamau ʻole o ka hemostasis, hiki iā ia ke kuleana no kekahi kahe nui ke koko.

ʻElua ʻano fibrinolysis, fibrinolysis mua a me ka lua. Kū maoli ka fibrinolysis mua, a kū ka fibrinolysis lua ma muli o kekahi kumu kūwaho e like me ka lāʻau lapaʻau a i ʻole ke ʻano olakino.

Inā loaʻa ka fibrin i ka nui loa, hiki iā ia ke kumu i ka hoʻokumu ʻia ʻana o kahi ʻōpala i ke kahe, ke kumu o nā pilikia o ka thrombosis venous (phlebitis) a i ʻole arterial (ischemia).

ʻO nā kīnā i ka fibrinolysis ke alakaʻi i ka thrombophilia kuleana no ka hana nui ʻana i nā clots koko hoʻoweliweli ola.

• ʻO ka acon coronary syndrome (ACS) ka lawa ʻole o ka coronary i hoʻokumu ʻia e hoʻokahi a ʻoi paha o nā aʻa coronary i ālai ʻia;
• ʻO ka infarction myocardial hou loa: ʻoi aku ka maikaʻi ma waena o nā hola ʻekolu i mua.
• ʻO ka maʻi Ischemic i ka wā koʻikoʻi;
• ʻO ka pulmonary embolism me ka hemodynamic instability;
• Hoʻihoʻi hou ʻana i ka mana o nā catheters venous (catheters venous central a me dialysis catheters), i ka hanana o kahi ālai e pili ana i kahi thrombus e ulu nei a i hana ʻia paha.

I nā hihia āpau i ʻōlelo ʻia ma luna, e holo wale ka hana o fibrinolytic ma muli o ka manawa o ka hoʻokele i hoʻohālikelike ʻia i ka hoʻomaka ʻana o nā ʻōuli mua.

ʻO ka maʻamau maʻamau o kēia manawa, fibrinolysis, pono e hāʻawi ʻia i ka wā hikiwawe a hoʻokomo ʻia i ka hoʻopili ʻana i ka mea maʻi me kahi mea hoʻāʻo plasminogen e hoʻāʻo e hoʻopau i kēia ʻōpala a pēlā e hāpai ai i ka ālai o ka moku.

Hoʻopili ka Fibrinolytic i ka hoʻopau ʻana o nā clots intravaskular a hana ʻia e ka hoʻololi ʻana i ka plasminogen hana ʻole i loko o ka plasmin hana, kahi enzyme e pili ana i ka deterioration o fibrin a ʻo ia ka mea e hoʻoulu ai i ka lysis o ka thrombus.

ʻIke mākou:

• ʻO Streptokinase o ke kumu kūlohelohe kahi protein i hana ʻia e β-hemolytic streptococcus, no laila o ka exogenous origin a hiki ke hoʻokumu i nā antibodies;
• ʻO Urokinase kahi protease, no ke kumu maoli, e hana pololei ma ka plasminogen;
• ʻO nā mea loaʻa o ka mea hoʻoulu kino plasminogen (t-PA), i loaʻa ʻia e ka recombination genetical mai ka genode encode t-PA, e hoʻololi pololei i ka plasminogen i plasmin ma ka mimicking ʻana i ka hana o ka PA. Hōʻike ʻia nā derivatives t-PA e rt-PA (alteplase), r-PA (reteplase) a me TNK-PA (tenecteplase).

  Pili pinepine ʻia ʻo Heparin a me / a aspirin paha me ka lapaʻau me fibrinolytic.

Nā ʻano hana e ʻimi ai i ka fibrinolysis.

Nā hoʻāʻo honua: Ka wā hoʻopau o nā euglobulins

ʻO ka ua o nā euglobulins e ʻae i ka kaʻana like ʻana o fibrinogen, plasminogen a me nā mea hoʻoheheʻe inhibitor protease. ʻOi aku ka manawa maʻamau ma mua o 3 mau hola akā i ka manawa o ka liʻiliʻi o ka manawa, manaʻo mākou "hyperfibrinolysis".

Nā ho'āʻo anamanaʻo

• ʻIke Plasminogen: hana a me ka immunological;
• ʻIke TPA (nāʻaʻaʻa plasminogen): nā hana immunoenzymatic;
• Nā hana o antiplasmin.

Nā hoʻāʻo ʻole

• Ka hoʻoholo ʻana i ka fibrinogen: he loiloi ʻole kēia o fibrinolysis. Me ka fibrinogen haʻahaʻa, manaʻo ʻia ʻo "hyperfibrinolysis";
• ʻO ka manawa Reptilase a me / a i ʻole ka manawa thrombin: hoʻolōʻihi ʻia lākou i mua o nā huahana degradation fibrin;
• Ka hoʻoholoʻana i nā PDF (Fibrin a me nā huahana hoʻohaʻahaʻa fibrinogen): kiʻekiʻe i ka wā o ka hoʻouluʻana o ka fibrinolysis;
• ʻIke D-dimer: pili lākou i nā ʻāpana PDF a kiʻekiʻe i ka hanana o fibrinolysis.