Ni iki cyitwa igeragezwa rya Prothrombin Time? Intego, Urwego, Uburyo & Ibipimo

Igeragezwa rya prothrombin time ripima igihe amaraso yawe afata kugirango avure. Iri geragezwa ry'amaraso ryoroshye rifasha abaganga gusobanukirwa niba sisitemu yawe yo kuvura amaraso ikora neza kandi ikagenzura imikorere y'imiti ituma amaraso atavura.

Tekereza kuvura amaraso nk'imbyino itunganyijwe neza. Iyo wagize igikomere, umubiri wawe ugomba gukora uruvange rw'amaraso vuba bihagije kugirango uhagarike kuva amaraso, ariko ntabwo vuba ku buryo byateza uruvange rw'amaraso ruteje akaga imbere mu miyoboro y'amaraso yawe. Igeragezwa rya prothrombin time riha umuganga wawe umwanya wo kureba iyi ngaruka.

Ni iki cyitwa igeragezwa rya prothrombin time?

Prothrombin time (PT) ni igeragezwa ry'amaraso ripima uko amaraso yawe avura vuba. By'umwihariko, ireba poroteyine iri mu maraso yawe yitwa clotting factors, ikorana kugirango ihagarike kuva amaraso iyo wakomeretse.

Iri geragezwa rishingiye kuri poroteyine yitwa prothrombin, umwijima wawe ukora. Iyo uvuye amaraso, prothrombin ihinduka thrombin, hanyuma ikagira uruhare mu gukora imigozi ya fibrin ikora uruvange rw'amaraso. Niba iyi nzira ifata igihe kirekire cyangwa ikaba vuba cyane, irashobora kugaragaza ibibazo by'ubuzima.

Ibipimo akenshi bitangazwa nka INR (International Normalized Ratio), isanzurwa ry'ibipimo mu mashami atandukanye. Ibi byorohereza umuganga wawe kugereranya ibipimo uko igihe kigenda kandi agahindura imiti niba bibaye ngombwa.

Kuki igeragezwa rya prothrombin time rikoreshwa?

Umuganga wawe ategeka iri geragezwa kugirango akurikirane imiti ituma amaraso atavura nka warfarin cyangwa kugirango akore iperereza ku bibazo byo kuva amaraso. Ni bumwe mu buryo busanzwe bwo kumenya niba sisitemu yawe yo kuvura amaraso ikora neza.

Niba ufata imiti ituma amaraso atavura, isuzuma rya PT risanzwe rifasha umuganga wawe kubona urugero rukwiye. Imiti mike cyane ntishobora gukumira uruvange rw'amaraso ruteje akaga, mugihe nyinshi cyane zishobora gutera kuva amaraso cyane. Iri geragezwa rifasha gushyira mu gaciro ako gace k'ingenzi.

Icyo kizamini gifasha kandi kumenya ibibazo by’umwijima kuko umwijima wawe ukora ibintu byinshi bifasha amaraso kuvura. Iyo imikorere y’umwijima igabanuka, akenshi bigaragara nk’igihe kirekire amaraso avura. Byongeye kandi, abaganga bakoresha iki kizamini kugira ngo barebe niba hari ukubura kwa vitamine K, bigira ingaruka ku bintu byinshi bifasha amaraso kuvura.

Mbere yo kubagwa, itsinda ry’abaganga rishobora gutegeka iki kizamini kugira ngo barebe ko utazava amaraso menshi mu gihe cyo kubagwa. Bifasha kandi mu gukora iperereza ku gukomereka cyangwa kuva amaraso bitumvikana.

Ni iki gikorerwa mu kizamini cy’igihe cya prothrombin?

Ikizamini cy’igihe cya prothrombin ni ugukuramo amaraso byoroshye bifata iminota mike gusa. Umuganga azakusanya amaraso make mu urugingo rwawe akoresheje urushinge ruto.

Mbere na mbere, bazasukura ahantu hakoreshejwe umuti kandi bashobora guhambira agahago ku rutugu rwawe kugira ngo imitsi igaragara neza. Uzumva urumuri rwihuse iyo urushinge rwinjiye, bisa nk'urushinge ruto. Gukusanya amaraso nyakuri akenshi bifata munsi y'umunota umwe.

Amaraso akoreshwa mu giti cyihariye kirimo sodium citrate, ibyo bituma amaraso atavura ako kanya. Uyu muti urinda ni ngombwa kuko laboratori ikeneye kumenya neza igihe uburyo bwo kuvura butangiriye mu gihe cyo gupima.

Muri laboratori, abahanga bashyiraho calcium na tissue factor ku maraso yawe, bitangiza uburyo bwo kuvura. Hanyuma bapima neza igihe biba bifata kugira ngo amaraso avure. Iki gihe, gihujwe n'ibizamini byo kugenzura, bitanga igisubizo cyawe cya PT.

Ni gute wakwitegura ikizamini cy’igihe cya prothrombin?

Abantu benshi ntibakeneye kwitegura byihariye ikizamini cy’igihe cya prothrombin. Urashobora kurya uko bisanzwe kandi ugakomeza ibikorwa byawe bisanzwe mbere y’ikizamini, keretse muganga wawe aguha amabwiriza yihariye.

Ariko, ni ngombwa kubwira umuganga wawe ibijyanye n'imiti yose urimo gufata. Imiti myinshi ishobora kugira ingaruka ku gihe amaraso afata gukama, harimo aspirine, antibiyotike, n'ibiyongera biva mu bimera. Ntuzahagarike gufata imiti yandikiwe na muganga utabanje kubisaba, ariko menyesha neza ibyo ukoresha byose.

Niba ufata warfarin cyangwa indi miti ituma amaraso ataguma, muganga wawe azaguha amabwiriza yihariye y'igihe. Ashobora kwifuza ko ufata umuti wawe ku gihe kimwe buri munsi kandi amaraso agafatwa mu gihe gihamye kugira ngo abone ubugenzuzi nyabwo.

Ubusinzi bushobora no kugira ingaruka ku bintu bituma amaraso akama, bityo vuga niba wanyoye icyo ari cyo cyose vuba aha. Abantu bamwe basanga bifasha kuguma bafite amazi ahagije mbere yo gufata amaraso, kuko ibi bishobora koroshya uburyo kandi bigatuma bishimisha.

Ni gute usoma ibisubizo byawe byo gupima igihe cya prothrombin?

Ibisubizo bya prothrombin bisanzwe bitangwa mu masegonda, hamwe n'agaciro gasanzwe gakunda kuva ku masegonda 11 kugeza kuri 13. Ariko, INR (International Normalized Ratio) akenshi ifite akamaro kanini mu gusobanura ibisubizo, hamwe n'agaciro gasanzwe kari hagati ya 0.8 na 1.2.

Niba ufata imiti ituma amaraso ataguma, intego yawe ya INR izaba iri hejuru y'ibisanzwe. Ku bintu byinshi bisaba gukoresha imiti ituma amaraso ataguma, abaganga bagamije INR iri hagati ya 2.0 na 3.0. Imitima y'imashini ikoreshwa mu mutima isaba intego ziri hejuru cyane, rimwe na rimwe hagati ya 2.5 na 3.5.

PT yatinze cyangwa INR yiyongereye bivuze ko amaraso yawe afata igihe kirekire kuruta uko bisanzwe kugira ngo akame. Ibi bishobora kwerekana ko urimo gufata imiti ituma amaraso ataguma nyinshi cyane, ufite ibibazo by'umwijima, cyangwa ufite ikibazo cya vitamine K. Muganga wawe azatekereza ku bimenyetso byawe n'amateka yawe y'ubuvuzi kugira ngo amenye icyateye ikibazo.

PT ngufi kuruta ibisanzwe cyangwa INR ntoya yerekana ko amaraso yawe akama vuba kuruta uko bisanzwe. Ibi bishobora kuvuga ko urugero rwawe rw'imiti ituma amaraso ataguma ari ruto cyane, cyangwa ushobora kuba ufite ibintu byongera ibyago byo gukama. Umuganga wawe azahindura uburyo bwo kuvura hakurikijwe ibyo.

Ni gute wakosora urwego rwawe rwa prothrombin?

Gukemura ibibazo byo mu gihe cyo gupima prothrombin biterwa n'icyateye ikibazo. Niba urimo gufata imiti igabanya amaraso, muganga wawe azahindura urugero rw'umuti wawe bitewe n'ibisubizo byawe n'ibimenyetso.

Ku rwego rwo hejuru rwa PT/INR, muganga wawe ashobora kugabanya urugero rwa warfarin cyangwa agasaba kurya ibiryo byinshi bikungahaye kuri vitamine K nk'imboga zifite amababi. Mu bihe by'ubutabazi hamwe no kuva amaraso menshi, bashobora kuguha inshinge za vitamine K cyangwa plasma nshya yafashwe kugirango bahindure vuba ingaruka.

Niba PT yawe ngufi cyane mugihe ufata imiti igabanya amaraso, muganga wawe ashobora kongera urugero rw'umuti wawe. Bazareba kandi indi miti n'ibyongerera imbaraga urimo gufata, kuko bimwe bishobora kubangamira imikorere y'imiti igabanya amaraso.

Iyo indwara y'umwijima itera ibibazo byo gupfuka amaraso, kuvura byibanda ku gufasha imikorere y'umwijima no gukemura ikibazo cyateye. Ibi bishobora gushingira ku miti, guhindura imirire, cyangwa mu bihe bikomeye, kwimura umwijima.

Kubura vitamine K bisaba guhindura imirire cyangwa ibyongerera imbaraga. Muganga wawe ashobora kugusaba kurya imboga nyinshi, gufata ibyongerera vitamine K, cyangwa gukemura ibibazo byateye ibyo bituma vitamine itinjira neza.

Ni uruhe rwego rwa prothrombin ruri hejuru?

Urugero rwa prothrombin ruri hejuru ruterwa n'ubuzima bwawe bwite niba urimo gufata imiti igabanya amaraso. Ku bantu badafata imiti igabanya amaraso, agaciro gasanzwe ka PT ka amasegonda 11-13 cyangwa INR ya 0.8-1.2 ni byiza.

Niba urimo gufata warfarin kubera atrial fibrillation cyangwa amaraso yiziritse, muganga wawe azaharanira INR iri hagati ya 2.0 na 3.0. Uru rwego rutanga uburinzi bwiza ku maraso ateje akaga mugihe bigabanya ibyago byo kuva amaraso. Intego yawe yihariye ishobora gutandukana bitewe n'amateka yawe y'ubuvuzi n'ibintu bigushyira mu kaga.

Abantu bafite imitsi y'umutima ikora mu buryo bwa mekaniki akenshi bakeneye intego zikomeye za INR, akenshi hagati ya 2.5 na 3.5. Izi mitsi y'ubwenge ituma habaho ibyago byinshi byo kuvura, bityo hakaba hakenewe imiti ikomeye yo kurwanya kuvura. Umuganga wawe w'umutima azagena intego yawe yihariye hashingiwe ku bwoko n'ahantu imitsi yawe iherereye.

Ibintu bike bidasanzwe bishobora gusaba intego zitandukanye. Umuganga wawe azakorana nawe kugira ngo abone urwego rurwanya kuvura neza hamwe n'ibyago byo kuva amaraso kubera uko ubuzima bwawe buteye.

Ni ibihe bintu byongera ibyago byo kugira igihe kidasanzwe cya prothrombin?

Ibintu byinshi bishobora kugira ingaruka ku gihe cyawe cya prothrombin kandi bikagushyira mu kaga ko kubona ibisubizo bidasanzwe. Kubisobanukirwa bifasha wowe n'umuganga wawe gukurikirana imikorere yawe yo kuvura neza.

Dore ibintu by'ingenzi bishobora kugira ingaruka ku bisubizo byawe bya PT:

• Imiti: Imiti ituma amaraso atavura nka warfarin, aspirine, antibiotics, n'indi miti myinshi ishobora kugira ingaruka ku gihe cyo kuvura
• Indwara y'umwijima: Indwara nka hepatite, cirrhosis, cyangwa kanseri y'umwijima igabanya umusaruro w'ibintu byo kuvura
• Kubura vitamine K: Imirire mibi, kutagira ubushobozi bwo gukurura, cyangwa imiti imwe n'imwe bishobora gukuraho iyi vitamine y'ingenzi
• Ibintu bya genetike: Abantu bamwe barazwa indwara zigira ingaruka ku musaruro w'ibintu byo kuvura
• Imyaka: Abantu bakuze bashobora kugira igihe gito cyo kuvura kubera igikorwa cy'umwijima kigabanuka
• Gukoresha inzoga: Kunywa inzoga nyinshi bishobora kubangamira imikorere y'umwijima no kugira ingaruka ku bintu byo kuvura
• Ubwoko bw'ibiryo bimwe na bimwe: Ibintu byinshi by'ibiryo bikungahaye kuri vitamine K bishobora kugira ingaruka ku bisubizo niba uri ku miti ituma amaraso atavura

Ibintu bike bidasanzwe nka disseminated intravascular coagulation (DIC) cyangwa kubura ibintu bishobora kandi gutera ibisubizo bidasanzwe. Umuganga wawe azatekereza kuri ibi bintu byose mugihe asobanura ibisubizo byawe by'ibizamini.

Ni byiza kugira igihe kirekire cyangwa gito cya prothrombin?

Ntabwo igihe kirekire cyangwa gito cya prothrombin ari cyo cyiza - intego ni ukugira urwego rukwiye rwo gukemura ikibazo cyawe cy'ubuzima. PT yawe nziza biterwa n'uburwayi bwawe niba ukeneye imiti ituma amaraso atavura.

Niba utarafata imiti ituma amaraso atavura, agaciro gasanzwe ka PT kerekana ko sisitemu yawe yo kuvura amaraso ikora neza. PT ndende cyane ishobora kwerekana ibibazo byo kuva amaraso, mugihe igufi cyane ishobora kwerekana ibyago byiyongereye byo kuvura.

Kubantu bakoresha imiti irwanya amaraso, PT yiyongereye gato (muri gahunda yawe) irashimwa. Ibi byongera igihe cyo kuvura amaraso bifasha kwirinda amaraso akomeye mugihe bigifasha gukira neza ibikomere bito.

Urufunguzo ni ukubona uburinganire bukwiye kuri wewe. Muganga wawe azakorana nawe kugirango agere ku rwego rwa PT rutanga uburinzi bwiza kurwanya amaraso cyangwa kuva amaraso, bitewe n'ibintu byawe byihariye by'ibyago n'amateka y'ubuvuzi.

Ni izihe ngaruka zishoboka z'igihe gito cya prothrombin?

Igihe gito cya prothrombin bivuze ko amaraso yawe avura vuba kuruta uko bisanzwe, ibyo bishobora kongera ibyago byo guteza amaraso akomeye. Ibi bishobora guhangayikisha cyane niba ufite uburwayi busanzwe bugushyira mu byago byinshi byo kuvura.

Ingaruka zikomeye zirimo thrombosis yimitsi yimbitse (DVT), aho amaraso akora mumitsi y'amaguru, na pulmonary embolism, aho amaraso ajya mumahaha yawe. Ibi birwara bishobora guteza ubuzima niba bitavuwe vuba. Ushobora guhura n'ububabare bw'amaguru, kubyimba, kubabara mu gituza, cyangwa guhumeka bigoranye.

Ibyago bya stroke nabyo biriyongera hamwe nurwego rwa PT ruto, cyane cyane niba ufite atrial fibrillation cyangwa izindi ndwara zumutima. Amaraso ashobora gukora mumutima akajya mubwonko, bigatuma ibimenyetso bya stroke nk'intege nke zitunguranye, ibibazo byo kuvuga, cyangwa impinduka zumuyoboro.

Niba urimo gufata imiti igabanya amaraso kandi ufite agaciro gato ka PT, bishobora kwerekana ko imiti yawe idakora neza. Ibi bikongerera ibyago byo kurwara indwara iyo miti yagenewe gukumira. Muganga wawe azagomba guhindura gahunda yawe yo kuvurwa kugira ngo akurinde neza.

Abantu bamwe bafite PT ntoya ihoraho bashobora kuba bafite indwara zibatera kwipfundika kw'amaraso. Umuganga wawe ashobora gukenera gukora iperereza ryimbitse kugira ngo amenye kandi avure izo ndwara neza.

Ni izihe ngaruka zishobora guterwa n'igihe kirekire cyo gupfundika kw'amaraso?

Igihe kirekire cyo gupfundika kw'amaraso bivuze ko amaraso yawe atinda gupfundika, ibyo bikongerera ibyago byo kuva amaraso. Nubwo bishobora kumvikana nk'ibidafite akamaro kurusha ibibazo byo kwipfundika, kuva amaraso nabyo birashobora kuba biteye akaga kandi bikica.

Ibimenyetso bito byo kuva amaraso birimo gukomereka byoroshye, amazuru ava amaraso atagira uko ahagarara, cyangwa gushishuka kw'ishinya iyo wiyogoshesha amenyo. Ushobora kubona ko ibikomere bito bitinda cyane guhagarara kuva amaraso kurusha uko bisanzwe. Ibi bimenyetso, nubwo biteye impungenge, mubisanzwe birashobora gucungwa neza n'ubuvuzi bukwiye.

Ingaruka zikomeye zo kuva amaraso zirimo kuva amaraso imbere mu gifu cyawe, mu mara, cyangwa mu bwonko. Ibimenyetso byo kwitondera birimo amase yirabura cyangwa avamo amaraso, kuruka amaraso, kubabara umutwe cyane, cyangwa guhumuka. Ibi bihe bisaba ubuvuzi bwihutirwa kandi bishobora kwica.

Niba urimo gufata imiti igabanya amaraso kandi ufite agaciro kanini ka PT, n'ibikomere bito bishobora gutera kuva amaraso cyane. Ibikorwa byoroheje nko kwiyogoshesha cyangwa guhinga bishobora gutera ibikomere bigoye gucunga. Muganga wawe azagomba guhindura imiti yawe kugira ngo agabanye ibyago byo kuva amaraso.

Mu bihe bidasanzwe, urwego rwo hejuru cyane rwa PT rushobora gutera kuva amaraso nta gikomere. Ibi bishobora kugaragara nk'ibikomere bitasobanuwe, kuva amaraso mu ngingo, cyangwa kuva amaraso mu misitsi. Izo ngaruka zikomeye zisaba ubuvuzi bwihutirwa.

Ni ryari nkwiriye kubona umuganga kubera impungenge z'igihe cyo gupfundika kw'amaraso?

Ugomba guhamagara muganga wawe ako kanya niba ubonye amaraso adasanzwe igihe urimo gufata imiti ituma amaraso atavura cyangwa niba ufite ibisubizo bidasanzwe bya PT. Ntukegere igihe cyo guhura na muganga wawe gitewe n'uko wateganyije niba urimo kugira ibimenyetso.

Shaka ubufasha bwihutirwa bw'ubuvuzi niba ufite ibimenyetso by'amaraso akomeye, harimo kuruka amaraso, imyanda yirabura, kubabara umutwe bikabije, cyangwa kuva amaraso bitahagarara. Ibi bimenyetso bishobora kwerekana kuva amaraso imbere mu mubiri bishobora gutera urupfu kandi bisaba kuvurwa ako kanya.

Hamagara muganga wawe niba ubonye gukomeretsa kwiyongera, kuvira amazuru kenshi, cyangwa ibikomere bitinda cyane guhagarara kuva amaraso kurusha uko bisanzwe. Nubwo bishobora kugaragara nk'ibitari ibikomeye, bishobora kwerekana ko urugero rw'umuti wawe utuma amaraso atavura ruri hejuru cyane kandi rugomba guhindurwa.

Niba urimo kugira ibimenyetso by'amaraso yiziritse nk'ububabare no kubyimba kw'ukuguru, kubabara mu gituza, cyangwa guhumeka bigoye, shaka ubufasha bw'ubuvuzi ako kanya. Ibi bishobora kuba ibimenyetso byerekana ko imiti yawe ituma amaraso atavura idahagije kandi amaraso y'akaga ari kwiremamo.

Igihe cyose cyo kugenzura ni ngombwa niba uri ku miti ituma amaraso atavura. Ntukirengagize izi ngendo, kuko zifasha muganga wawe gukomeza PT yawe mu rwego rwiza, ruzima kandi rugatanga umusaruro kandi bikakumira ingorane mbere yuko ziba zikomeye.

Ibikunze kubazwa ku bijyanye n'igeragezwa ry'igihe cya prothrombin

Q.1 Ese igeragezwa ry'igihe cya prothrombin ni ryiza mu kugenzura indwara z'umutima?

Yego, igeragezwa ry'igihe cya prothrombin ni ryiza cyane mu kugenzura indwara zimwe na zimwe z'umutima, cyane cyane iyo urimo gufata imiti ituma amaraso atavura nka warfarin. Niba ufite atrial fibrillation, ibibazo bya valve y'umutima, cyangwa wigeze kugira amaraso yiziritse, igeragezwa risanzwe rya PT rifasha kumenya ko imiti yawe ikora neza.

Igeragezwa ni ngombwa cyane cyane ku bantu bafite valve z'umutima zikora, bakeneye imiti ikomeye ituma amaraso atavura kugirango birinde amaraso yiziritse kwiremamo kuri valve y'ubukorano. Umuganga wawe w'umutima azakoresha ibisubizo bya PT kugirango ahindure urugero rw'imiti yawe kandi akugumane mu rwego rwiza.

Q.2 Ese igihe gito cya prothrombin gitera amaraso yiziritse?

Igihe gito cya prothrombin ntigiteza imvura y'amaraso mu buryo butaziguye, ariko kigaragaza ko amaraso yawe akora imvura vuba kuruta uko bisanzwe, ibyo bikongerera ibyago byo gukora imvura. Bitekereze nk'ikimenyetso cyo kwirinda kuruta uko byaba bikurura.

Niba urimo gufata imiti ituma amaraso atavura kandi ufite agaciro gato ka PT, birerekana ko umuti wawe utatanga uburinzi buhagije ku mvura. Muganga wawe azagomba guhindura uburyo uvurwa kugira ngo agabanye ibyo byago no kwirinda gukora imvura y'akaga.

Q.3 Mbese nshobora kurya uko bisanzwe mugihe nkora ibizamini bya PT?

Urashobora kurya uko bisanzwe mbere yibizamini byinshi bya PT, ariko niba urimo gufata warfarin, gerageza kugumana urugero rwa vitamine K. Ibiryo nk'isipinashi, kale, na brokoli birimo vitamine K nyinshi, ishobora kugira ingaruka ku ngaruka z'ibizamini byawe.

Ntabwo ukeneye kwirinda rwose ibyo biryo bifitiye akamaro, ariko kurya ibiryo byinshi cyane mu buryo butajegajega bishobora gutuma urwego rwawe rwa PT ruzamuka no kumanuka. Muganga wawe ashobora kugufasha gutegura imirire yuzuye ikora hamwe n'imiti yawe.

Q.4 Ni kangahe nkwiriye gukora ibizamini bya PT?

Uburyo bwo gukora ibizamini buterwa n'uko ubuzima bwawe bumeze n'uko ibisubizo byawe bihagaze. Mugihe utangira imiti ituma amaraso atavura, ushobora gukenera ibizamini buri minsi mike kugeza urwego rwawe ruhagaze neza. Iyo bihagaze neza, gukora ibizamini buri kwezi akenshi birahagije.

Niba urimo guhindura urugero rw'imiti, urwaye, cyangwa guhindura indi miti, muganga wawe ashobora gushaka ibizamini byinshi. Abantu bamwe bafite ibisubizo bihagaze neza bashobora kwagura gukora ibizamini buri byumweru 6-8, ariko ibi bitandukanye bitewe n'umuntu.

Q.5 Mbese hari izindi ngaruka zituruka ku kizamini cya PT ubwacyo?

Ibizamini bya PT birizewe cyane bifite ingaruka nke. Ushobora kugira ibibazo bito cyangwa kubabara ahantu urushinge rwashyizweho, akenshi bikemuka muminsi mike cyangwa ibiri. Abantu bamwe bumva bafite umutwe gato, ariko ibi ntibisanzwe.

Inyungu zo gukurikirana imikorere yawe yo kuvura amaraso ziruta cyane ibi bibazo bito by'igihe gito. Icyo kizamini gitanga amakuru y'ingenzi afasha kugufata neza mugihe ufata imiti ituma amaraso atavura.