Hoʻohana pinepine ʻia ʻo D-dimer ma ke ʻano he hōʻailona koʻikoʻi i manaʻo ʻia o PTE a me DVT i ka hana lapaʻau.Pehea i hiki mai ai?

ʻO ka Plasma D-dimer kahi huahana hoʻohaʻahaʻa kikoʻī i hana ʻia e ka plasmin hydrolysis ma hope o ka hoʻopili ʻia ʻana o ka monomer fibrin e ka mea hoʻāla XIII.He hōʻailona kikoʻī ia o ka hana fibrinolysis.Loaʻa ʻia nā D-dimer mai nā ʻāpana fibrin i hoʻopili ʻia e ka plasmin.ʻOiai ka lōʻihi o ka thrombosis ikaika a me ka hana fibrinolytic i loko o nā kīʻaha koko o ke kino, e hoʻonui ʻia ka D-dimer.Myocardial infarction, cerebral infarction, pulmonary embolism, venous thrombosis, surgery, tumor, disseminated intravascular coagulation, infection and tissue necrosis hiki ke alakaʻi i ka D-dimer kiʻekiʻe.Maikaʻi no nā poʻe maʻi maʻi a me nā maʻi maʻi, ma muli o ka bacteremia a me nā maʻi ʻē aʻe, maʻalahi ke kumu o ka coagulation koko maʻamau a alakaʻi i ka hoʻonui D-dimer.

Hōʻike ka D-dimer i ka hana fibrinolytic.Hoʻonui a maikaʻi paha i ʻike ʻia i ka hyperfibrinolysis lua, e like me ka hypercoagulable state, disseminated intravascular coagulation, renal disease, organ transplant rejection, thrombolytic therapy, a me nā mea ʻē aʻe. ʻo ka ʻōnaehana fibrinolytic (e like me DIC, thrombus like ʻole) a me nā maʻi e pili ana i ka ʻōnaehana fibrinolytic (e like me nā maʻi maʻi, ka maʻi hāpai ʻana), a me ka nānā ʻana i ka thrombolytic therapy.

ʻO nā kiʻekiʻe kiʻekiʻe o D-dimer, kahi huahana hoʻohaʻahaʻa fibrin, e hōʻike ana i ka hoʻohaʻahaʻa pinepine ʻana o ka fibrin in vivo.No laila, ʻo ka D-dimer fibrous kahi hōʻailona nui o ka thrombosis vein hohonu (DVT), pulmonary embolism (PE), disseminated intravascular coagulation (DIC).

ʻO nā maʻi he nui ke kumu o ka hoʻoulu ʻana o ka ʻōnaehana coagulation a me / a i ʻole ka ʻōnaehana fibrinolytic i loko o ke kino, e hopena i ka piʻi ʻana o ke kiʻekiʻe o D-dimer, a pili kēia hoʻāla i ke kahua, ke kaumaha a me ka mālama ʻana i ka maʻi, no laila i kēia mau maʻi. Hiki ke hoʻohana ʻia ka ʻike ʻana i ke kiʻekiʻe o D-dimer ma ke ʻano he hōʻailona loiloi no ka hoʻokau ʻana o ka maʻi, prognosis a me ke alakaʻi lapaʻau.

Hoʻohana i ka D-dimer i ka thrombosis vein hohonu

ʻOiai ʻo Wilson et al.Ua hoʻohana mua i nā huahana hoʻohaʻahaʻa fibrin no ka ʻike ʻana i ka pulmonary embolism i ka makahiki 1971, ʻo ka ʻike ʻana o D-dimer i hana nui i ka ʻike o ka pulmonary embolism.Me kekahi mau ʻano ʻike koʻikoʻi koʻikoʻi, loaʻa ka waiwai D-dimer kino kino i kahi hopena wānana maikaʻi ʻole no ka pulmonary embolism, a ʻo kona waiwai he 0.99.Hiki i ka hopena maikaʻi ʻole ke hoʻokuʻu i ka pulmonary embolism, ma laila e hōʻemi ai i nā hoʻokolohua invasive, e like me ka nānā ʻana i ka ventilation perfusion a me ka pulmonary angiography;e pale i ka lāʻau anticoagulation makapō.D - ʻO ke kuʻina o ka dimer e pili ana i kahi o ka thrombus, me nā kiʻekiʻe kiʻekiʻe ma nā lālā nui o ke kumu pulmonary a me nā haʻahaʻa haʻahaʻa i nā lālā liʻiliʻi.

Hoʻopau nā D-dimers plasma maikaʻi ʻole i ka hiki ke DVT.Ua hōʻoia ka Angiography he 100% maikaʻi ʻo DVT no D-dimer.Hiki ke hoʻohana ʻia no ka thrombolytic therapy a me ka heparin anticoagulation alakaʻi a me ka nānā pono.

Hiki i ka D-dimer ke hōʻike i nā loli i ka nui o ka thrombus.Inā hoʻonui hou ka ʻike, hōʻike ia i ka hoʻi hou ʻana o ka thrombus;i ka wā o ka mālama ʻana, hoʻomau ka kiʻekiʻe, a ʻaʻole loli ka nui o ka thrombus, e hōʻike ana ʻaʻole pono ka mālama ʻana.