I-Bivalirudin: I-Thrombin Inhibitor ebuyiselwayo kwi-Anticoagulation esebenzayo
Inkcazo eneenkcukacha
I-Bivalirudin yi-peptide ye-synthetic ye-20-residue esebenza njenge-inhibitor eguquguqukayo ye-thrombin, i-enzyme ephambili echaphazelekayo ekubunjweni kwegazi. Ngokubophelela kwindawo esebenzayo ye-thrombin, i-bivalirudin inqanda ukuguqulwa kwe-fibrinogen kwi-fibrin, inyathelo elibalulekileyo ekubunjweni kwe-thrombus. Ukulawulwa nge-intravenously, i-bivalirudin idlala indima ebalulekileyo kunyango lwe-anticoagulation. Nangona kunjalo, ukujongwa ngononophelo kwe-hematocrit, ixesha elisebenzayo le-thromboplastin (aPTT), umlinganiselo oqhelekileyo wamazwe ngamazwe (INR), kunye noxinzelelo lwegazi luyimfuneko ngenxa yamandla ayo okubangela ukumisa kwegazi.
I-Bivalirudin ibonisa umphumo wokuthintela kwi-thrombin e-soluble kunye ne-thrombus-bound in vitro. Okubalulekileyo kukuba, le mpembelelo yokuthintela ihlala ingachaphazeleki kwiimveliso ezikhutshwe ngeplatelet. Ngendlela exhomekeke kwidosi, i-bivalirudin inokwandisa i-plasma aPTT, ixesha le-thrombin, kunye nexesha le-prothrombin kwizifundo eziqhelekileyo zabantu. Ezi mpawu zenza ukuba zilungele ukusetyenziswa kwi-percutaneous coronary intervention (PCI) kwizigulane ezine-angina engazinzanga.
I-Cardioembolic stroke, ekwaziwa ngokuba sisibetho sentliziyo, yenzeka xa i-emboli isuka entliziyweni kunye ne-aorta arch ihamba phakathi kwegazi, ikhokelela kwi-cerebral arterial embolism kunye nokungasebenzi kakuhle kobuchopho. Ukubetha kwentliziyo, xa kuthelekiswa nokubethelwa kwe-ischemic yezinye i-etiologies, kudla ukuba nzima ngakumbi ngokwezizathu ezisisiseko, ezinzima kakhulu ngokubhekiselele kumboniso, zine-prognosis ehluphekileyo, kunye nezinga eliphezulu lokuphindaphinda. Phantse i-70% yazo zonke izibetho ezinemvelaphi yentliziyo zibangelwa yi-fibrillation ye-atrial (AF). Unyango lwe-Anticoagulant olufanelekileyo kwimeko yesigulane luyimfuneko kuthintelo lwesibini lwe-AF-related cardioembolic stroke.
Xa kuqwalaselwa ukusetyenziswa kwe-bivalirudin, kubalulekile ukugcina engqondweni iimfuno zokubeka iliso zokhuseleko oluphezulu lwesigulane. Utshintsho kwi-hematocrit, i-APTT, i-INR, kunye noxinzelelo lwegazi kufuneka lujongwe ngokusondeleyo ukuze kubonwe naziphi na iingxaki ezinokubakho ezinxulumene negazi. Ukubeka iliso rhoqo kuvumela iingcali zempilo ukuba zilungelelanise umthamo kwaye ziqinisekise ukuba isigulane sifumana inqanaba elifanelekileyo le-anticoagulation.
I-Bivalirudin, njenge-thrombin inhibitor eguqulwayo, idlala indima ebalulekileyo kunyango lwe-anticoagulation. Ngokuthintela i-thrombin, ikhusela ukubunjwa kwe-fibrin kunye nokwakheka kwe-clot elandelayo. Oku kwenza kube yinto esebenzayo yokusetyenziswa kwi-percutaneous coronary intervention, ngakumbi kwizigulane ezine-angina engazinzanga.
Ukuba unazo naziphi na iimfuno ezinxulumene ne-Bivalirudin, nceda unganqikazi ukuqhagamshelana nathi ngexabiso elingcono.
Ukuba unazo naziphi na iimfuno ezinxulumene ne-Bivalirudin, nceda unganqikazi ukuqhagamshelana nathi ngexabiso elingcono.
Inkcazo
