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Bivalirudin: Cholepheretsa Thrombin Chosinthika cha Anticoagulation Yogwira Ntchito
Kufotokozera Mwatsatanetsatane
Bivalirudin ndi peptide yotsalira ya 20 yomwe imakhala ngati choletsa chosinthika cha thrombin, puloteni yofunika kwambiri yomwe imakhudzidwa ndi kupanga magazi. Pomanga malo omwe akugwira thrombin, bivalirudin imalepheretsa kutembenuka kwa fibrinogen kukhala fibrin, sitepe yofunika kwambiri pakupanga thrombus. Bivalirudin ikaperekedwa kudzera m'mitsempha, imathandizira kwambiri pamankhwala a anticoagulation. Komabe, kuwunika mosamala hematocrit, activated partial thromboplastin time (aPTT), international normalized ratio (INR), ndi kuthamanga kwa magazi ndikofunikira chifukwa chakutha kupangitsa kuti magazi aziyimilira.
Bivalirudin imawonetsa kulepheretsa kwa thrombin yosungunuka ndi thrombus-bound in vitro. Chofunika kwambiri, cholepheretsa ichi sichimakhudzidwa ndi zinthu zotulutsidwa ndi mapulateleti. Ndi njira yodalira mlingo, bivalirudin imatha kukulitsa plasma aPTT, nthawi ya thrombin, ndi nthawi ya prothrombin m'mitu yodziwika bwino yaumunthu. Makhalidwewa amachititsa kuti ikhale yoyenera kugwiritsidwa ntchito pa percutaneous coronary intervention (PCI) kwa odwala omwe ali ndi angina osakhazikika.
Cardioembolic stroke, yomwe imadziwikanso kuti cardiac stroke, imachitika pamene emboli yochokera kumtima ndi aortic arch imayenda m'magazi, zomwe zimatsogolera ku ubongo waubongo komanso kusokonezeka kwaubongo. Mitsempha ya mtima, poyerekeza ndi zikwapu za ischemic za etiologies ena, zimakhala zovuta kwambiri potengera zomwe zimayambitsa, zovuta kwambiri powonetsera, zimakhala ndi chidziwitso chochepa, komanso chiwongoladzanja chokwanira. Pafupifupi 70% ya zikwapu zonse zokhala ndi chiyambi cha mtima zimachitika chifukwa cha atrial fibrillation (AF). Thandizo la anticoagulant lolingana ndi momwe wodwalayo alili ndi lofunikira pakupewa kwachiwiri kwa sitiroko yamtima yokhudzana ndi AF.
Poganizira kugwiritsa ntchito bivalirudin, ndikofunikira kukumbukira zofunikira zowunikira kuti mukhale ndi chitetezo chokwanira cha odwala. Kusintha kwa hematocrit, aPTT, INR, ndi kuthamanga kwa magazi kuyenera kuyang'aniridwa mosamala kuti muwone zovuta zilizonse zomwe zingayambitse kusayenda kwa magazi. Kuwunika nthawi zonse kumathandiza akatswiri a zaumoyo kuti asinthe mlingo ndikuonetsetsa kuti wodwalayo akulandira mlingo woyenera wa anticoagulation.
Bivalirudin, monga reversible thrombin inhibitor, amagwira ntchito yofunika kwambiri pamankhwala a anticoagulation. Poletsa thrombin, imalepheretsa mapangidwe a fibrin ndi mapangidwe a magazi. Izi zimapangitsa kukhala njira yabwino yogwiritsira ntchito percutaneous coronary intervention, makamaka kwa odwala omwe ali ndi angina osakhazikika.
Ngati muli ndi zosowa zina zokhudzana ndi Bivalirudin, chonde musazengereze kulumikizana nafe pamtengo wabwinoko.
Ngati muli ndi zosowa zina zokhudzana ndi Bivalirudin, chonde musazengereze kulumikizana nafe pamtengo wabwinoko.
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