Thrombophilia - chii? Thrombophilia: Zvinokonzera, Zviratidzo, kuongorora chirwere neMarapirwo

Mamiriro muviri susceptibility kune vascular thrombosis, izvo zvinogona recur uye kuva zvakasiyana nzvimbo, rinonzi thrombophilia. The chirwere unogona kunge magene kana vawana. The mhaka chirwere kakawanda kwakawedzera kweropa. Akaora, chirwere vangapikisa zvakasiyana thrombosis munzvimbo dzakasiyana-siyana. Thrombophilia rakanyatsojeka kwakapararira munyika vemo uye rinowanikwa mune zvakasiyana siyana. The chirwere kunoda kurapwa pamwe mishonga kana zvomusejari nzira.

Thrombophilia: chii?

Zvokurwara anoreva nezvirwere ropa ezvinhu, richiratidzwa muitiro thrombosis uye hemostatic zvirwere. Multiple idzokororo thrombosis mu thrombophilia zvingabva pfungwa, kuvhiya, panyama kushushikana, kana panguva yepamuviri. Condition zvine ngozi nokuti zvinogona kuita kuti matambudziko akadai pulmonary embolism, sitiroko, myocardial infarction, yakadzika tsinga thrombosis. Kazhinji mazhinji siyana zvinouraya.

Research, chirwere uye mabatiro thrombophilia zvinobatanidzwa nzvimbo dzinoverengeka mishonga. Hematology inodzidza ehupfumi kuti zvinetso ropa, phlebology - chirwere uye nekuramba thrombosis pakati mutsinga, vachibvisa clots ropa kwaisanganisira vascular vanovhiya. thrombus inotungamirwa zvichiguma nokuvhiringidzirwa aibuda kwagara ropa, icho pamwe pokumuka ezvinhu ngozi kuti akaoma kubata. Nokufamba kwenguva kudzivisa dambudziko, iwe unofanira nguva nenguva vaedzwa nokuda kweropa. Ndozvakajairwa vakadzi Somuenzaniso, venous ropa riri maminitsi 5-10.

zvinokonzera

Zvinhu kuti anokonzera kukura zvirwere, vashoma. Anenge munhu wose anogona kusangana chirwere chakadai thrombophilia. Chii ngozi ezvinhu, varwere vakawanda dzimwe nguva havazivi uye kumbira kubatsirwa nani kunonoka. Pane mazita zvikonzero zvinogona kukonzera kukura zvokurwara.

Nhaka (kana majini) thrombophilia kunoitika somugumisiro majini kubatwa kusvika chirwere. Vaitama kare zvirwere ropa (thrombocytosis, erythremia, antiphospholipid chirwere) Kungavawo chikonzero chacho kukura. Ngozi zvinhu zvinosanganisira atherosclerosis, kenza, atrial fibrillation, varicose mutsinga, uye autoimmune zvirwere. The ndingangokuvara panowanikwa thrombophilia inowedzera pashure sitiroko kana mwoyo kurwisa. In ngozi rokufambira, varwere vari mukobvu, kutungamirira munhu ndakagara mararamiro, achitora hormone nhumbu, havadyi vekare paakakuvara kana kuvhiyiwa. Pazera chirwere hariwanikwi, kazhinji richiwanika vanhu vakwegura. Kudzivirira chirwere ezvinhu asingaiti kutanga kana, Zvinokurudzirwa nguva nenguva kupfuura muedzo thrombophilia.

zvekuchipatara mufananidzo

Clinical kuratidzwa zvirwere inozivikanwa kwakanaka kumuka nguva yacho ano, saka varwere haana pakarepo cherechedzai kuchinja utano mamiriro, uye regai kuita chinhu kunyunyuta. Laboratory parameters anogona rokuongorora thrombophilia, uone chiremba mufananidzo mune zvimwe zviitiko, zvinoitika makore mashomanana gare gare. Bright zvingaratidza kuitika kana clot akaumba. The mwero mhingaidzo ngarava lumen uye localization pakati thrombus sei kukomba zviratidzo.

Arterial thrombosis, izvo zviri kukonzerwa ropa clots ari vascular lumen ari arterial mubhedha, aine nokuumbwa thrombus ari lumen midziyo yacho placenta, intrauterine fetus rufu, akawanda kupfupfudzika, yokurwiswa chakasimba coronary insufficiency, ischemic sitiroko.

Venous thrombosis pakati ezasi wamativi zvekuchipatara zviratidzo anozviratidza muchimiro trophic kuchinja ganda, yakanyanya mumatenhere rezasi wamativi, chimiro marwadzo, kunzwa Kutambudzika dzakaderera migumo.

Mezentealny intestinal thrombosis kunoitika apo ropa clot iri localization pamusoro mesenteric midziyo uye achiperekedzwa zviratidzo zvakadai unzenza zvituru, kurutsa, kuda kurutsa, banga-marwadzo.

Kana hepatic tsinga thrombosis dzakabudirira hydrothorax (Budd-Chiari chirwere), ascites, edema pamusoro Anterior abdominal rusvingo uye ezasi kuviri, pernicious kurutsa uye kurwadziwa mukati epigastric nharaunda.

thrombophilia hematogenous

Thromboses sei mamiriro enyika vascular rusvingo, usachikanganisa uye achidzikisa nemishonga, kubatsira kunetesa ropa kuyerera uye kukura zvimwe zvirwere hemodynamic dzinoitwa nokuchinja viscosity uye pakugwamba. Thrombophilic mamiriro muzviitiko zvakawanda chokuita pamberi vascular zvirwere zvakadai atherosclerosis, vascular intimal kukuvara, vasculitis toxigenic, zvirwere kana chirwere mavambo. Multiple idzokororo thromboembolism kungava nokuda kuchinja ehupfumi ropa pacharo, aunopiwa kodzero yokutaura pamusoro chirwere anonzi "hematogenous thrombophilia." pathologies chokuita kukura muviri katsika kuva thrombosis, zvinokonzerwa abnormalities mu coagulation, havachanyatsogoni ropa hemostatic nekugona.

Thrombophilia hematogenous mu mavambo zvinogona vachiberekwa kana vawana. On huru mashandiro secrete nezvirwere izvo zvinokonzerwa: conjugated thrombogenic panofamba, platelet dysfunction, havachanyatsogoni fibrinolysis, chinovhiringidza, mwero kana wakareruka coagulation chinetso chikuru vasiri anticoagulant. Uyezve, imwe yoga dzichiri somugumisiro zvinodhaka zvinokonzerwa kana dzokurapwa kupindira iatrogenic thrombophilia.

nhaka thrombophilia

Dudzira vachiberekwa kana nhaka thrombosis anogona kuva hwaro zvinotevera zvinoratidza kurapwa: thrombosis vachiri vaduku, thrombosis zviitiko pulmonary tsinga, mesenteric, nechepazasi maoko nemakumbo ndiyo nhoroondo yemhuri, ndataura wokutanga idzokororo venous thrombosis pamberi makore 30, thrombosis panguva mangwanani pamuviri, thrombotic matambudziko. Nhaka kana majini thrombophilia kunotemwa pashure misoro chirwere wevarwere vane mukana thrombophilic yematambudziko.

Vachiberekwa chimiro chirwere angava akasiyana hunhu. In nechirwere chirwere kufungisisa nemagene zvezvinangwa kuti thrombophilia. Chokutanga chakaita chinowedzera kukura chirwere - nemagene kubatwa. Panyaya iyi, chirwere kurege kuitika pasina ezvinhu chirwise zvigadziriswe vayo kukura. Wechipiri - the mutation majini panguva embryo kukura. Chaizvo yakawedzera manjemanje wevasungwa zvinoita kuti afumure Gene mutation. Pakati pavo, avo kuti zvinobviswa mabasa evanhu: nemwaranzi choutsi, kushandiswa yokuvirisa zvokudya, Pharmaceuticals, kushatiswa kwezvakatipoteredza (imba makemikari, rinochiwedzera, mishonga yezvipembenene) manmade njodzi. Hazvibviri kufungidzira mamiriro ezvinhu ayo majini zvinogona modifiable, saka mutagenesis kwainzi kuva anongoitika chichiitwa, kunoitika roga uye anokwanisa kushandura nhaka unhu.

Nhaka thrombophilia anogona kunge nokuda STRUCTURAL kana genomic mutation okutodza nhaka kubva nezvizvarwa. Pane zvinoiswa mamiriro chirwere Gene: recessive kureva. Kana yechipiri, zvokurwara kuratidza pacharo ose ezvinhu.

vawana thrombophilia

Kwete chete nhaka asiwo vawana kwakatangira vave chirwere. Murwere anogona rokuongorora antiphospholipid syndrome (APS). Rakanga saka kakawanda hworatidza pacharo vawana thrombophilia. Chii, chii vari zvigadziriswe waro kukura, uye kurwisa sei?

Antiphospholipid chirwere chiri chiratidzo kunzwisisa kuti rinobatanidza rabhoritari Data uye zvekuchipatara zviratidzo. The chirwere achiperekedzwa chetsinga zvinetso, masoja thrombocytopenia, fetus kurasikirwa chirwere, venous uye arterial thrombosis. Govera muchimiro APS: chikuru, yechipiri uye nemafashamo; serological kusarudza: seronegative uye seropositive. Syndrome unomuka pamusoro neoplastic, chirwere, autoimmune kana sema zvirwere kana somugumisiro zvinodhaka asingashiviriri.

Development APS anogona chokuita kudaro zvemamiriro ezvinhu akadai akaipa neoplasm (kenza, lymphoproliferative chirwere, neleukemia), zvirwere (mycoplasmosis, HIV, njovhera), asymptomatic kuparadzirwa AFA, chisingaperi renal kukundikana, zvirwere peripheral arteries uye mwoyo mavharuvhu, chiropa chirwere, connective zvinyama zvirwere, uye autoimmune zvirwere (Crohn, chirwere systemic vasculitis, SLE).

Thrombophilia mu pamuviri

Panguva pamuviri, masero kana nhaka thrombophilia kazhinji hworatidza pacharo kekutanga. Izvi anonyanya nokuda veMubatanidzwa wechitatu, ari placental riparadzirwe denderedzwa rine pamusoro kweropa hurongwa zvimwe mutoro. Nezvekugadzirwa ropa clots kunoitawo kuti vanoverengeka zvinoitwa placental denderedzwa. The placenta hapana capillaries, inopinda muropa ramai kubva arteries, ipapo inoyerera kuburikidza chorionic villi, runoyerera munzvimbo achiine rukuvhute tambo.

Nokuti muviri mukadzi pamuviri kunoratidzwa wakawedzera pakugwamba ropa, iro kunoderedza kurasikirwa neropa pakukurukura kana iri chiitiko yematambudziko zvakadai nokupfupfudzika uye placental abruption. Zvinoita kuti mikana ropa clots, uye kuti zviri mazviri nhema ngozi. Kana vari vemunyika muropa nemidziyo achitungamirira placenta, zvinokurisa, hypoxia kunoitika vanorega chokubuda kuti azvarwa. Zvichienderana padanho clogging midziyo ropa uye uwandu ropa clots, zvingateverwa nezvikuru kwazvo matambudziko, magadzirira kubereka, zvinoguma nokupfupfudzika, pamuviri wasvava, malformations kana fetus rufu, fetoplacental insufficiency, placental abruption. vanoonekwa, kazhinji pashure pevhiki 10. Yokutanga nguva thrombophilia mune pamuviri hariwanikwi chaizvo. Kana chirwere hwapedyo pashure pemavhiki 30, ipapo painoguma muzviitiko zvakawanda, placental abruption, placental insufficiency kana zvakakomba preeclampsia. On kuongororwa chiremba vanofanira kuteerera kweropa, mwero vakadzi "mu" chiri siyanei kubva mureza.

Diagnostics

The zvekuchipatara Kuratidza thrombosis nekusimbiswa kiriniki uchishandisa rabhoritari (cytological, nemakemikari, kuvabereki, coagulologic) uye richishanda nzira. In nechitarisiko uye mamiriro ezvinhu muviri anogona ZIVA vanofungidzirwa venous thrombosis (kuzvimba). Vose venous uye arterial pamwe chenguva zvenzara nemarwadzo uye bloating. Dzimwe ganda tembiricha (venous) kunowedzera mudunhu localization. In arterial thrombosis mugove pedyo thrombus iri kuchengetwa kuderera tembiricha, cyanosis (cyanosis), marwadzo. Zviratidzo izvi - Ndivo zvezvinangwa ose thrombophilia, inova chikonzero chinokosha kushanyira nyanzvi rokutanga.

Zvakananga pachipatara ichiitwa kunyatsodzidza murwere. Iva nechokwadi kuti bvunzo kuti thrombophilia, ita vascular Ultrasound (anosarudza hunhu, kukura uye nzvimbo ine ropa clot), kuita musiyano arteriography uye venography, izvo zvinoita kuti localize uye kuongorora anatomi pamusoro thrombotic kwendangariro. Uyewo, radiographic kushandiswa, radioisotopic nzira, masero kuongorora polymorphisms, kuziva wevasungwa kuti homocysteine.

mabatiro

The mubvunzo yokukurira hosha kunoitika vaya nezvinoda chirwere kuti thrombophilia. Chii uye sei kubata navo kuitira kudzivisa migumisiro? kurapwa chirwere vanofanira kuva chinoratidza uye inosanganisira kutora chikamu wenyanzvi siyana unyanzvi: vascular kuvhiyiwa, phlebology hematologist. Pakutanga Danho zvakafanira chokudzidza etiopathogenic zvigadziriswe chirwere kukura. Positive migumisiro kurapa kunogona kutarisirwa chete pashure kuchaitwa zvinokonzera. Chinhu chinokosha kurapwa pane zvokudya, izvo kubvisa zvekudya dzakakwirira remafuta akawandisa, asi kukamurwa mafuta uye zvakakangwa zvokudya. Zvinokurudzirwa kuti zvinyorwe zvokudya zvibereko akaoma, michero uye miriwo, nemiriwo matsva.

Drug kurapwa unotora rinopa antiplatelet, izvo kuzadzikiswa nokushandisa anticoagulation kurapwa ropa riyerere, gemodelyutsiey. Mune zvimwe zviitiko zvinokosha kuita Kuwedzerwa manyoro muchando yeplasma pamwe heparinization. Kuzvitsinhanisa jekiseni nachiremba nhaka chimiro, inova nokuda kushayiwa antithrombin III.

Easy thrombophilia (bvunzo ropa kuchabatsira kuona chimiro), kubatwa lyophilized plasma (intravenous) kana yakaoma yeplasma kuzozvidzorerwa. In kwazvo siyana inoshandiswa zvinodhaka fibrinolytic kuti raitongwa panguva occluded mudziyo uchishandisa anobudisa mushonga zvishoma nezvishoma. Apo chirwere kuti thrombophilia kurapwa inofanira munhu mumwechete uye kunzwisisa, kuona kukurumidza uye akarongeka kupora.

dziviriro

Kuti varege kuva atarisana chirwere ichi chakakomba kana zvayo matambudziko, matanho kudzivisa kuva nenguva. Varwere thrombophilia zvinganaka akatakura yeplasma kuisira zvishoma mishonga uye subcutaneous zvinodhaka "Heparin". Patient nokuti prophylaxis vanofanira mishonga mishonga kuti kusimbisa vascular rusvingo ( "Trental" intravenous "papaverine" nomuromo).

Nokuti kudzivirirwa uye Mabatirwo thrombophilia inokurudzirwa kushandisa chevarwere mishonga, akadai makwenzi. Saka, kuderedza platelet basa kuchatibatsira tii cranberry kana muto wemazambiringa. Rarefy ropa nokushandisa tincture Japanese mbeu Sophora pamusoro. Uyezve, zviri chinodiwa kuti zvakanaka kudya, zvimwe kufamba yakachena mhepo uye kurega miitiro yakaipa.