Me yasa za a gano D-dimer, FDP a cikin marasa lafiya na zuciya da jijiyoyin jini?
1. D-dimer za a iya amfani da shi don jagorantar daidaitawar ƙarfin anticoagulation.
(1) Dangantakar da ke tsakanin matakin D-dimer da abubuwan da suka faru na asibiti a lokacin maganin rigakafi a cikin marasa lafiya bayan maye gurbin bawul na zuciya na inji.
D-dimer-guide-guide anticoagulation intensity gyare-gyaren magani kungiyar yadda ya kamata daidaita aminci da ingancin maganin anticoagulation, da kuma aukuwa daban-daban m al'amurran da suka shafi ya kasance da muhimmanci a kasa fiye da na kula da kungiyar ta yin amfani da daidaitattun daidaito da kuma low-intensity anticoagulation.
(2) Samuwar thrombosis na cerebral venous thrombosis (CVT) yana da alaƙa da tsarin tsarin thrombus.
Sharuɗɗa don ganewar asali da kuma kula da jijiya na ciki da venous sinus thrombosis (CVST)
Tsarin Tsarin Thrombotic: PC, PS, AT-lll, ANA, LAC, HCY
maye gurbin Halittu: prothrombin gene G2020A, coagulation factor LeidenV
Abubuwan da za a iya ganowa: lokacin haihuwa, maganin hana haihuwa, rashin ruwa, rauni, tiyata, kamuwa da cuta, ƙari, asarar nauyi.
2. Darajar haɗuwa da gano D-dimer da FDP a cikin cututtukan zuciya da jijiyoyin jini.
(1) D-dimer karuwa (fiye da 500ug/L) yana taimakawa wajen gano cutar CVST.Al'ada baya kawar da CVST, musamman a cikin CVST tare da keɓantaccen ciwon kai kawai kwanan nan.Ana iya amfani da shi azaman ɗaya daga cikin alamun cutar CVST.Ana iya amfani da D-dimer mafi girma fiye da na al'ada azaman ɗaya daga cikin alamun gano CVST (shawarar matakin III, shaidar matakin C).
(2) Masu nuna alamar maganin thrombolytic mai tasiri: D-dimer saka idanu ya karu sosai sannan kuma ya ragu a hankali;FDP ya karu sosai sannan ya ragu a hankali.Wadannan alamomi guda biyu sune tushen kai tsaye don ingantaccen maganin thrombolytic.
A karkashin aikin thrombolytic kwayoyi (SK, UK, rt-PA, da dai sauransu), da emboli a cikin jini suna da sauri narkar da, da kuma D-dimer da FDP a cikin plasma suna karuwa sosai, wanda kullum yana da kwanaki 7.A lokacin jiyya, idan adadin magungunan thrombolytic bai isa ba kuma thrombus ba a narkar da shi gaba ɗaya ba, D-dimer da FDP za su ci gaba da kasancewa a manyan matakan bayan sun kai kololuwa;A cewar kididdigar, yawan zubar jini bayan maganin thrombolytic ya kai kashi 5% zuwa 30%.Don haka, ga marasa lafiya da ke fama da cututtukan thrombotic, yakamata a tsara tsarin magani mai tsauri, ana kula da ayyukan coagulation na plasma da ayyukan fibrinolytic a ainihin lokacin, kuma yakamata a sarrafa adadin magungunan thrombolytic da kyau.Ana iya ganin cewa ganowar D-dimer da FDP maida hankali ya canza kafin, lokacin da kuma bayan jiyya a lokacin thrombolysis yana da babban darajar asibiti don saka idanu da inganci da amincin magungunan thrombolytic.
Me yasa marasa lafiya da cututtukan zuciya da cututtukan cerebrovascular kula da AT?
Rashin Antithrombin (AT) Antithrombin (AT) yana taka muhimmiyar rawa wajen hana samuwar thrombus, ba wai kawai yana hana thrombin ba, har ma yana hana abubuwan haɗin gwiwa kamar IXa, Xa, Xla, Xlla da Vlla.Haɗuwa da heparin da AT wani muhimmin sashi ne na AT anticoagulation.A gaban heparin, aikin anticoagulant na AT zai iya karuwa da dubban sau.Ayyukan AT, don haka AT wani abu ne mai mahimmanci don tsarin anticoagulant na heparin.
1. Heparin juriya: Lokacin da aikin AT ya ragu, aikin anticoagulant na heparin yana raguwa sosai ko rashin aiki.Sabili da haka, yana da mahimmanci don fahimtar matakin AT kafin maganin heparin don hana babban maganin heparin da ba dole ba kuma maganin ba shi da amfani.
A cikin rahotannin wallafe-wallafe da yawa, ƙimar asibiti na D-dimer, FDP, da AT suna nunawa a cikin cututtuka na zuciya da jijiyoyin jini, wanda zai iya taimakawa a farkon ganewar asali, yanayin yanke hukunci da kuma kimantawa game da cutar.
2. Nunawa ga etiology na thrombophilia: Marasa lafiya tare da thrombophilia suna bayyana a asibiti ta hanyar thrombosis mai zurfi mai zurfi da maimaita thrombosis.Ana iya yin gwajin dalilin thrombophilia a cikin ƙungiyoyi masu zuwa:
(1) VTE ba tare da tabbataccen dalili ba (ciki har da thrombosis na jarirai)
(2) VTE tare da ƙarfafawa <40-50 shekaru
(3) Maimaita thrombosis ko thrombophlebitis
(4) Tarihin iyali na thrombosis
(5) Thrombosis a wuraren da ba na al'ada ba: mesenteric vein, sinus venous cerebral.
(6) Maimaita zubewar ciki, haihuwa da sauransu.
(7) Ciki, maganin hana haihuwa, thrombosis mai haifar da hormone
(8) Necrosis na fata, musamman bayan amfani da warfarin
(9) Ciwon jini na jijiya wanda ba a san dalilinsa ba <20 shekaru
(10) 'Yan uwan thrombophilia
3. Ƙididdigar abubuwan da ke faruwa na zuciya da kuma sake dawowa: Nazarin ya nuna cewa rage yawan ayyukan AT a cikin marasa lafiya da cututtukan zuciya shine saboda lalacewar kwayoyin halitta wanda ke haifar da babban adadin AT da ake cinyewa.Sabili da haka, lokacin da marasa lafiya ke cikin yanayin hypercoagulable, suna da haɗari ga thrombosis kuma suna tsananta cutar.Ayyukan AT kuma ya kasance ƙasa da ƙasa a cikin yawan jama'a tare da abubuwan da ke faruwa na zuciya da jijiyoyin jini fiye da na yawan jama'a ba tare da maimaita abubuwan da ke faruwa na zuciya ba.
4. Ƙididdigar haɗarin thrombosis a cikin fibrillation maras kyau: ƙananan matakin AT na aiki yana da dangantaka da CHA2DS2-VASc;a lokaci guda, yana da ƙima mai mahimmanci don tantance thrombosis a cikin fibrillation maras nauyi.
5. Dangantakar da ke tsakanin AT da bugun jini: AT yana raguwa sosai a cikin marasa lafiya tare da bugun jini mai tsanani, jini yana cikin yanayin hypercoagulable, kuma ya kamata a ba da maganin rigakafi a cikin lokaci;Ya kamata a gwada marasa lafiya da ke da haɗarin bugun jini akai-akai don AT, kuma a fara gano cutar hawan jini na marasa lafiya.Ya kamata a kula da yanayin coagulation a cikin lokaci don guje wa faruwar bugun jini mai tsanani.
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