Coagulation vs Clotting
Coagulation thiab clotting yog tib yam tshwm sim. Lub sij hawm kho mob yog coagulation thaum lub sij hawm pw tsaug zog. Clotting yog ib lo lus yooj yim thiab cov kws kho mob kuj tsis saum toj no siv.
Clot formation yog ib qho ntawm cov txheej txheem tiv thaiv tseem ceeb tshaj plaws hauv lub cev. Nws tiv thaiv exsanguinating los ntshav thiab kis kab mob, thiab nws yog ib qho tseem ceeb hauv kev kho qhov txhab. Nws muab lub moj khaum rau qhov kawg ntawm kev tsiv teb tsaws ntawm kev faib cov hlwb epithelial thiab fibroblasts uas ua ntej qhov txhab kho.
Thaum muaj kev puas tsuaj rau cov hlab ntsha, nws nthuav tawm cov khoom siv hauv cov cellular matrix heev rau cov qe ntshav. Muaj ntau qhov chaw khi rau cov qe ntshav hauv cov khoom siv ntxiv. Kev raug mob ua rau cov qe ntshav puas. Cov xwm txheej no ua rau platelet activation thiab sib sau ua ke. Cov platelets puas thiab endothelial hlwb secrete inflammatory mediators uas nyob rau hauv lem qhib cov ntshav los tsim ntau yam tshuaj muaj zog. Cov tshuaj no, nyob rau hauv lem, qhib ntau platelets thiab ua rau tsim ib tug platelet plug. Qhov no ntawm cov ntshav txhaws yog tag nrho nyob ntawm tus lej thiab kev ua haujlwm ntawm platelets. Yog li, platelet tsawg (thrombocytopenia) lossis platelet tsis ua haujlwm (thrombasthenia) ua rau qeeb ntawm platelet plug. Qhov no tuaj yeem kuaj tau los ntawm kev kuaj ntshav ntev ntev. Ib pob me me yog ua rau ntawm pob ntseg, thiab lub sij hawm nws yuav siv sij hawm los ntshav kom nres ua ntej yog coj raws li lub sij hawm los ntshav.
Cov kauj ruam tom ntej ntawm kev txhaws yog qhov tsim nyog coagulation cascade. Coagulation tuaj yeem tshwm sim ntawm ob txoj hauv kev loj. Lawv yog lub hauv paus thiab txoj kev extrinsic. Muaj ntau ntau yam khoom ua los ntawm lub siab thiab cov no tseem ceeb heev rau cov txheej txheem txhaws. Tsis muaj cov kab mob no cuam tshuam nrog cov ntshav txhaws. Tsis muaj yam VIII ua rau hemophilia A. Tsis muaj yam IX ua rau hemophilia B (Christmas disease). (Nyeem qhov txawv ntawm Hemophilia A thiab B). Cov kab mob no ncua sij hawm kuaj prothrombin lub sij hawm, uas yog cov qauv kev sim ua feem ntau los ntsuas cov kab mob coagulation.
Txoj kev tawm sab nraud tseem hu ua txoj hauv kev ntawm cov ntaub so ntswg. Hauv kev raug mob, thaum cov ntaub so ntswg puas lawm, cov ntaub so ntswg ntau heev tau nthuav tawm. Qhov no activates factor X nyob rau hauv lub xub ntiag ntawm factor VII thiab calcium ions. Txoj hauv kev hauv nruab nrog cev muaj ntau yam ua rau txhaws ntau dua li txoj kev tawm sab nraud. Nws pib nrog yam XII tau txais kev ua haujlwm tom qab kev sib cuag nrog cov vascular endothelium puas. XIIa activates factor XI uas nyob rau hauv lem activates factor IX nyob rau hauv lub xub ntiag ntawm factor VIII, calcium ions thiab phospholipids. Activated factor IXa activates factor X. Factor X activation marks nkag mus rau hauv cov kauj ruam kawg ntawm coagulation cascade, uas yog txoj hauv kev.
Activated factor Xa converts prothrombin rau hauv thrombin nyob rau hauv lub xub ntiag ntawm yam V, calcium ions thiab phospholipids. Thrombin converts fibrinogen rau hauv fibrin. Thrombin kuj ua kom muaj XIII thiab pab nrog crosslinking fibrin. Qhov tshwm sim yog complex fibrin meshwork. Cov qe ntshav tau txuas nrog rau cov meshwork thiab cov ntaub ntawv tseem ceeb.
Nyeem ntxiv:
1. Qhov txawv ntawm Thrombosis thiab Embolism
