Fibrinolysis waxay ku dhacdaa hemostasis physiological hemostasis, ka dib xinjirowga dhiigga, si loo baabi'iyo xinjirowga hemostatic ee uu sameeyay fibrin. Joogitaanka tiro aad u badan, waxay u horseedi kartaa samaynta xinjirta wareegga dhiigga oo ay weheliso khatarta ka dhalan karta. Qeexid, sababaha iyo daawaynta, aynu xisaabino.

Fibrinolysis waa habsocod burburin ah oo ka kooban kala dirida xinjirowga xididada xididada hoos yimaada ficilka plasmin. Habkan, waxay ka takhalustaa wareegga dhiigga ee wasakhda fibrin-ka sidaas darteed waxay ka caawisaa jirka inuu ka ilaaliyo khatarta xinjirowga dhiigga (xinjirowga dhiigga).

Plasmin, oo uu soo saaro beerku, waa borotiinka ugu muhiimsan ee firfircooniya fibrinolysis. Plasmin waxaa loo beddelaa plasminogen iyadoo la adeegsanayo unugyada plasminogen activator (tPA) iyo urokinase.

Plasminogen waxay leedahay xirmo loogu talagalay fibrin waxayna ku urursan tahay xinjirta inta lagu jiro samaynta (taas oo u oggolaan doonta in hadhow la jebiyo). Isbeddelka plasminogen ilaa plasmin wuxuu ku dhacaa meel u dhow xinjirta.

Nidaamka fibrinolytic waa in uu u dhaqmaa inta u dhaxaysa jebinta xinjirowga xididdada xididdada dhiigga ee sameysma oo aan keenin dhiigbax marka xinjirowga hemostatic iyo fibrinogen ay milaan.

Haddii xinjiruhu si dhakhso ah u milmo, daweyn, cudur ama dhiig-bax aan caadi ahayn, waxay markaa mas'uul ka noqon kartaa mararka qaarkood dhiig-bax weyn.

Waxaa jira laba nooc oo fibrinolysis ah, fibrinolysis hoose iyo sare. Fibrinolysis aasaasiga ah wuxuu u dhacaa si dabiici ah, fibrinolysis labaadna wuxuu ku dhacaa sababo dibadda ah sida daawo ama xaalad caafimaad.

Haddii fibrinku uu ku jiro tiro aad u badan, waxay keeni kartaa samaynta xinjirta wareegga wareegga, taasoo keenta khataraha xinjirowga dhiigga (phlebitis) ama halbowleyaasha (ischemia).

Cilladaha fibrinolysis waxay u horseedaan thrombophilia oo mas'uul ka ah samaynta xad-dhaafka ah ee xinjirowga dhiigga nafta halis gelinaya:

• Cudurka halbowlayaasha ba'an (ACS) waa ku filnaan la'aanta halbowlayaasha halbowlayaasha halbowlayaasha halbowlayaasha ah ee xiran;
• Wadnaxanuun myocardial oo aadka u dambeeyay: faragelinta saddexda saacadood ee ugu horreeya ayaa la doorbidaa;
• Ischemic stroke ee marxaladda ba'an;
• Sambabada sambabada oo leh xasiloonida hemodynamic;
• Dib-u-soo-celinta xajinta tuubbada xididka (catheters-ka dhexe ee xididka iyo kateetarka sifeynta), haddii ay dhacdo xannibaad la xiriirta xinjirowga dhiigga ee koraya ama dhowaan sameeyay.

Dhammaan kiisaska kor ku xusan, ficilka fibrinolytics wuxuu noqon doonaa mid waxtar leh oo kaliya iyadoo ku xiran waqtiga maamulka marka la barbardhigo bilawga calaamadaha ugu horreeya.

Daawaynta caadiga ah ee hadda jirta, fibrinolysis, waa in la bixiyaa sida ugu dhakhsaha badan waxayna ka kooban tahay in bukaanka lagu duro unuga plasminogen activator kaas oo isku dayi doona inuu milo xinjirahan oo uu kor u qaado xannibaadda markabka.

Fibrinolytics waxay soo dedejisaa kala diridda xinjirowga xididdada xididdada dhiigga waxayna ku shaqeeyaan beddelidda plasminogen-ka aan firfircoonayn ee plasmin firfircoon, enzyme mas'uul ka ah sii xumaanshaha fibriinka oo sidaas kiciya lysis of thrombus.

Waxaan kala soocnaa:

• Streptokinase ee asalka dabiiciga ah waa borotiin ay soo saarto β-hemolytic streptococcus, sidaas darteed asal ahaan ka baxsan oo awood u leh inuu keeno samaynta unugyada difaaca;
• Urokinase waa borotiin, asal dabiici ah, kaas oo si toos ah ugu shaqeeya plasminogen;
• Soosaarayaasha unugyada plasminogen activator (t-PA), oo laga helay dib-u-habaynta hidde-sideyaasha t-PA, waxay si toos ah ugu beddeli doontaa plasminogen plasmin iyadoo la jaanqaadaysa ficilka t-PA. Tusaalooyinka t-PA waxaa lagu muujiyey rt-PA (alteplase), r-PA (reteplase) iyo TNK-PA (tenecteplase).

  Heparin iyo/ama aspirin ayaa inta badan lala xiriiriyaa daawaynta fibrinolytics.

Hababka sahaminta fibrinolysis.

Tijaabooyin caalami ah: Waqtiga kala dirida euglobulins

Roobka euglobulins wuxuu u oggolaanayaa wadaagga fibrinogen, plasminogen iyo firfircoonayaasha protease-ka. Waqtiga caadiga ah wuxuu ka badan yahay 3 saacadood laakiin haddii ay dhacdo wakhti yar, waxaan ka shakisannahay "hyperfibrinolysis".

Imtixaannada falanqaynta

• Baaritaanka Plasminogen: shaqeynta iyo difaaca jirka;
• TPA (plasminogen unugyada unugyada) baaritaanka: farsamooyinka difaaca jirka;
• Qiyaasta antiplasmin.

Tijaabooyin aan toos ahayn

• Go'aaminta fibrinogen: tani waa qiimeyn aan toos ahayn oo fibrinolysis ah. Iyadoo fibrinogen hooseeya, "hyperfibrinolysis" ayaa la tuhunsan yahay;
• Waqtiga dib-u-celinta iyo / ama wakhtiga thrombin: waxay ku dheereeyaan joogitaanka alaabada hoos u dhigta fibrin;
• Go'aaminta PDF-yada (Fibrin iyo Fibrinogen-ka hoos u dhaca alaabta): sare haddii ay dhacdo firfircoonida fibrinolysis;
• D-dimer assay: waxay u dhigmaan jajabyada PDF waxayna ku badan yihiin dhacdada fibrinolysis.