Ikizamini cya Anticoagulant

Uhagarariye itsinda ry’indashyikirwa rya polysaccharide isanzwe, heparin yiswe bitewe n’uko yari yarigeze kwitandukanya n’umwijima mu binyejana bishize.Kugeza ubu, heparin imaze imyaka mirongo umunani ikora nk'imiti igabanya ubukana bwa anticagulant mu mavuriro kuva mu myaka umunani ishize abantu babanje gukoresha indwara ya trombotique.Ibinyabuzima, imiterere yibanze ya heparin igizwe no gusubiramo disaccharide ya acide ya uronic (L-iduronic cyangwa D-glucuronic aside) na N-acetyl-D-glucosamine.Bitewe nurutonde rwihariye rwa pentasaccharide, heparin ikora ibikorwa birwanya anticagulant iyo ihujwe na antithrombine, kugirango ihagarike ibikorwa bya Xa na IIa muri kasake ya coagulation。

Kurwanya anti-factor Xa heparin nibiri muburemere buke bwa heparine na heparine isanzwe mumaraso yoroheje mugutahura ibikorwa bya anti-xa.Heparin ni anticoagulant ibuza gutembera kw'amaraso.Uburemere bwa molekuline n'imbaraga z'ibikorwa bya heparin biratandukanye.Heparine isanzwe ikubiyemo uburemere butandukanye bwa molekile, mugihe uburemere buke bwa heparine burimo molekile zimwe na zimwe za heparin zifite intera ndende n'uburemere buke bwa molekile.Bimwe muribi bike-bifite uburemere buke bwa heparine bifite amavuriro, kandi hariho itandukaniro rito hagati ya buri.Heparin isanzwe hamwe na heparine ifite uburemere buke bwa heparin irashobora gutangwa mumitsi cyangwa munsi yubutaka kubarwayi barwaye trombose cyangwa prursors.

Thrombose nigisubizo gisanzwe cyumubiri kwangiza imiyoboro yamaraso nuduce.Ubu buryo bukubiyemo gutangiza urunigi rwimyenda aribwo buryo bwo gukora ibintu byinshi hamwe na poroteyine bigenga trombogenez.Hariho ibintu byinshi bikaze kandi bidakira, nko kubaga, trombose ndende, nizindi ndwara ziterwa na hypercoagulable - arteriovenous trombose, cyane cyane mumaguru.Utwo dusimba turashobora guhagarika amaraso kandi bigatera kwangirika kwinyama ahantu hafashwe.Ibice by'imyenda bigwa bikagenda mu bihaha bitera embolisme y'ibihaha;Cyangwa irashobora kugera kumutima igatera umutima.Ibibyimba bya Thrombus ku bagore batwite birashobora rimwe na rimwe kugira ingaruka ku maraso yinjira mu nda kandi bigatera gukuramo inda.

Heparin ibangamira imiterere yimyenda yihutisha kubuza ibintu kwambara (cyane cyane Xa na IIa) ikora kuri poroteyine bita antithrombine.Indwara ya heparine isanzwe ifata Xa na IIa, kandi ibikorwa byo guhagarika ibintu bya coagulation biratandukanye cyane, bigomba rero gukurikiranirwa hafi.Ingorane zirimo coagulation, kuva amaraso menshi hamwe na trombocytopenia.Ubuvuzi busanzwe bwa heparin butangwa mubitaro kandi bugakurikiranwa nigihe cyakorewe igice cya trombokinase (PTT) cyangwa anti-factor Xa heparin.Ubuvuzi bukabije bwa heparin bukoreshwa muburyo bwo kubaga nka bydiopulmonary bypass, kandi efficacy ikurikiranwa nigihe cyo kwambara (ACT).Uburemere buke bwa heparin ikora cyane kurwanya Xa kuruta kurwanya IIa kandi imikorere yayo irahanurwa.Ubuvuzi bwa heparin bufite uburemere buke busanzwe bukorerwa mubitaro cyangwa abarwayi, kandi ntibisabwa gukurikirana kugirango bivurwe bisanzwe.Nibiba ngombwa, efficacy irashobora kugaragara hamwe na anti-factor Xa heparin.