Abubuwan da ke Rushewar Jini tare da D-Dimer


Marubuci: Magaji   

Me yasa kuma za'a iya amfani da bututun jini don gano abun cikin D-dimer?Za a sami gudan jini na fibrin a cikin bututun jini, shin ba za a lalata shi zuwa D-dimer ba?Idan bai ragu ba, me yasa ake samun karuwa mai yawa a cikin D-dimer lokacin da aka samu ɗigon jini a cikin bututun anticoagulation saboda rashin kyawun samfurin jini don gwajin coagulation?

Da farko, tarin jini mara kyau zai iya haifar da lalacewar jijiyar jijiyar jijiyoyi, da kuma sakin nau'in nama na subendothelial da nau'in plasminogen activator (tPA) a cikin jini.A gefe guda, ƙwayar nama yana kunna hanyar coagulation exogenous don haifar da ɗigon fibrin.Wannan tsari yana da sauri sosai.Kawai duba lokacin prothrombin (PT) don sani, wanda yawanci kusan daƙiƙa 10 ne.A gefe guda kuma, bayan da aka samar da fibrin, yana aiki a matsayin mai haɗin gwiwa don ƙara yawan ayyukan tPA da sau 100, kuma bayan an haɗa tPA zuwa saman fibrin, ba za a iya hana shi da sauƙi ta hanyar plasminogen activation inhibitor-1. PAI-1).Saboda haka, plasminogen na iya zama cikin sauri kuma a ci gaba da canzawa zuwa plasmin, sa'an nan kuma fibrin zai iya lalacewa, kuma ana iya samar da adadi mai yawa na FDP da D-Dimer.Wannan shine dalilin da ya sa samuwar jini a cikin vitro da samfuran lalata fibrin suna ƙaruwa sosai saboda ƙarancin samfurin jini.

 

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Bayan haka, me yasa tarin tarin jini na al'ada (ba tare da ƙari ba ko tare da coagulant) samfuran kuma sun haifar da ƙumburi na fibrin a cikin vitro, amma ba su ƙasƙantar da su don samar da adadi mai yawa na FDP da D-dimer ba?Wannan ya dogara da bututun jini.Abin da ya faru bayan da aka tattara samfurin: Na farko, babu adadi mai yawa na tPA da ke shiga cikin jini;na biyu, ko da ƙaramin adadin tPA ya shiga cikin jini, tPA ɗin kyauta za a ɗaure shi da PAI-1 kuma ya rasa aikinsa cikin kusan mintuna 5 kafin ya manne da fibrin.A wannan lokacin, sau da yawa ba a samun fibrin a cikin bututun jini ba tare da ƙari ba ko tare da coagulant.Yana ɗaukar fiye da mintuna goma don jini ba tare da ƙari ba don daidaitawa ta halitta, yayin da jini tare da coagulant (yawanci foda silicon) yana farawa a ciki.Hakanan yana ɗaukar fiye da mintuna 5 don samar da fibrin daga hanyar haɗin jini.Bugu da kari, aikin fibrinolytic a dakin da zafin jiki in vitro shima zai shafa.

Bari mu sake magana game da thromboelastogram tare da wannan batu: za ku iya fahimtar cewa jinin jini a cikin bututun jini ba a sauƙaƙe ba, kuma za ku iya fahimtar dalilin da yasa gwajin thromboelastogram (TEG) ba shi da hankali don yin la'akari da hyperfibrinolysis-duk yanayi yana kama da, Tabbas, ana iya kiyaye zafin jiki yayin gwajin TEG a digiri 37.Idan TEG ya fi damuwa don nuna matsayi na fibrinolysis, hanya ɗaya ita ce ƙara tPA a cikin gwajin TEG in vitro, amma har yanzu akwai matsalolin daidaitawa kuma babu aikace-aikacen duniya;Bugu da kari, ana iya auna shi a gefen gado nan da nan bayan samfurin, amma ainihin tasirin kuma yana da iyaka.Gwajin gargajiya kuma mafi inganci don kimanta ayyukan fibrinolytic shine lokacin rushewar euglobulin.Dalilin hankalinsa ya fi na TEG.A cikin gwajin, an cire anti-plasmin ta hanyar daidaita ƙimar pH da centrifugation, amma gwajin yana cinye Yana ɗaukar lokaci mai tsawo kuma yana da ɗanɗano, kuma ba a cika yin shi a cikin dakunan gwaje-gwaje ba.