توصیف بالینی و آزمایشگاهی تشخیص تفریقی اختلالات انعقادی در اسب

نوع مقاله : مقاله مروری

نویسندگان

چکیده

فرآیند تشکیل لخته فیبرینی در واقع مجموعه‌ای از واکنش‌های پیچیده و به خوبی تنظیم شده است که عروق خونی، پلاکت‌ها، پروتئین‌های پیش انعقادی پلاسما، مهار کننده‌های طبیعی و آنزیم‌های فیبرینولیتیک در این فرایند مشارکت دارند. عوامل مختلفی از جمله میکروارگانیسم‌هایی نظیر باکتری‌ها، ویروس‌ها، پروتوزوآها، ریکتزیاها و نیز سموم، داروها، اقدامات درمانی‌ و نئوپلاسم‌ها می‌توانند سبب ایجاد التهاب عروقی شوند. شایع‌ترین علت التهاب عروقی پورپورای خون‌ریزی دهنده است که خود با قرار گرفتن در معرض‌ استرپتوکوکوس اکوئی زیرگونه اکوئی یا به ندرت توسط آنفلوانزای اسبی ایجاد می‌شود. نقصان یا اختلال در هر یک از اجزای سیستم انعقاد خون می‌تواند سبب بروز خون‌‌ریزی یا ترومبوز شود. اختلالات وراثتی هموستاز اولیه (بیماری ون ‌ویلبراند: vWD و ترومباستنی گلانزمن: GT) و هموستاز ثانویه (هموفیلی A و پره کالیکرئین: کمبود PK) به ندرت در طب بالینی اسب گزارش شده‌اند. در حالی که اختلالات اکتسابی هموستاز اولیه و ثانویه به وفور یافت می‌شوند. این اختلالات شامل ترومبوسیتوپنی، اختلال عملکردی پلاکت‌ها به علت تجویز برخی از داروها و ترکیبات ضد پلاکتی هدفمند، کاهش ساخت فاکتورها (اختلالات کبدی یا کمبود ساخت ویتامین K) آزاد سازی فاکتورهای غیر فعال، مهار فعالیت فاکتورهای انعقادی و یا مصرف بیش از حد و تخلیه فاکتورها (پلاکت‌ها‏، فاکتورهای انعقاد و فاکتورهای ضد انعقادی مثل آنتی ترومبین (AT) و پروتئین C) می‌باشند. انعقاد درون رگی منتشر (DIC) شایع‌ترین و پیچیده‌ترین اختلال انعقادی در اسب‌ها است که به نظر می‌رسد که با سپسیس‌ها، اختلالات التهابی و ایسکمیک دستگاه گوارش و سایر بیماری‌های شدید سیستمیک مرتبط باشد. این اختلالات به طور معمول در بیمارهایی مشاهده می‌شوند که تحت مراقبت‌های ویژه هستند.

کلیدواژه‌ها

موضوعات


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