Ma lalo o nā kūlana physiological, nā ʻōnaehana ʻelua o ka coagulation koko a me ka anticoagulation i loko o ke kino e mālama i kahi kaulike ikaika e mālama i ke kahe o ke koko i loko o nā kīʻaha koko.Inā ʻaʻohe kaulike, ʻoi aku ka nui o ka ʻōnaehana anticoagulation a ʻoi aku ka maikaʻi o ke kahe koko, a ʻoi aku ka nui o ka ʻōnaehana coagulation a hiki i ka thrombosis ke hana.He mea nui ka ʻōnaehana fibrinolysis i ka thrombolysis.I kēia lā, e kamaʻilio mākou e pili ana i nā hōʻailona ʻelua o ka ʻōnaehana fibrinolysis, D-dimer a me FDP, e hoʻomaopopo pono i ka hemostasis i hana ʻia e ka thrombin i ka thrombus i hoʻomaka ʻia e fibrinolysis.Hoʻoulu.Hāʻawi i ka ʻike kumu lapaʻau e pili ana i ka thrombosis a me ka hana coagulation.
ʻO D-dimer kahi huahana hoʻohaʻahaʻa kikoʻī i hana ʻia e ka monomer fibrin i hoʻopili ʻia e ka mea XIII i hoʻāla ʻia a laila hydrolyzed e plasmin.Loaʻa ʻia ʻo D-dimer mai ke kaulahao fibrin i hoʻoheheʻe ʻia e ka plasmin.Hōʻike ka D-dimer kiʻekiʻe i ka loaʻa ʻana o ka hyperfibrinolysis lua (e like me DIC).ʻO FDP ka huaʻōlelo maʻamau no nā huahana degradation i hana ʻia ma hope o ka wāwahi ʻia ʻana o ka fibrin a i ʻole fibrinogen ma lalo o ka hana a ka plasmin i hana ʻia i ka wā hyperfibrinolysis.Loaʻa i ka FDP nā huahana fibrinogen (Fg) a me ka fibrin monomer (FM) (FgDPs), a me nā huahana hoʻohaʻahaʻa fibrin cross-linked (FbDPs), ma waena o nā FbDPs e komo pū me D-dimer a me nā ʻāpana ʻē aʻe, a piʻi ko lākou pae. ʻO ka hana fibrinolytic he hyperactive (fibrinolysis mua a i ʻole fibrinolysis lua)
【Laʻana】
Ua hoʻokomo ʻia kekahi kāne waena i ka haukapila a ʻo nā hopena o ka nānā ʻana i ke koko e like me kēia:
| 'ikamu | Ka hopena | Lahui Kuhikuhi |
| PT | 13.2 | 10-14s |
| APTT | 28.7 | 22-32s |
| TT | 15.4 | 14-21s |
| FIB | 3.2 | 1.8-3.5g/l |
| DD | 40.82 | 0-0.55mg/I FEU |
| FDP | 3.8 | 0-5mg/l |
| AT-III | 112 | 75-125% |
ʻO nā mea ʻehā o ka coagulation he maikaʻi ʻole, D-dimer ka maikaʻi, a ʻo ka FDP maikaʻi ʻole, a he kūʻē nā hopena.I ka wā mua i manaʻo ʻia he hopena makau, ua nānā hou ʻia ka hāpana e ka hoʻāʻo hoʻoheheʻe 1:10, a penei ka hopena:
| 'ikamu | Kumu | 1:10 dilution | Lahui Kuhikuhi |
| DD | 38.45 | 11.12 | 0-0.55mg/I FEU |
| FDP | 3.4 | Ma lalo o ka palena haʻahaʻa | 0-5mg/l |
Hiki ke ʻike ʻia mai ka dilution he mea maʻamau ka hopena FDP, a ʻaʻole linear ka D-dimer ma hope o ka hoʻoheheʻe ʻana, a manaʻo ʻia ke keakea.E kāpae i ka hemolysis, lipemia, a me ka jaundice mai ke kūlana o ka hāpana.Ma muli o nā hopena like ʻole o ka hoʻoheheʻe ʻana, hiki i ia mau hihia ke hana i ka hoʻopilikia maʻamau me nā antibodies heterophilic a i ʻole nā kumu rheumatoid.E nānā i ka mōʻaukala lapaʻau o ka mea maʻi a e ʻimi i ka mōʻaukala o ka maʻi rumatika.Laboratory Ua kiʻekiʻe ka hopena o ka hōʻike RF factor.Ma hope o ke kamaʻilio ʻana me ke keʻena kino, ua ʻōlelo ʻia ka mea maʻi a hoʻopuka i kahi hōʻike.Ma hope o ka hahai ʻana, ʻaʻohe hōʻailona pili i ka thrombus a ua hoʻoholo ʻia he hihia maikaʻi ʻole o D-dimer.
【Hōʻuluʻulu】
ʻO D-dimer kahi hōʻailona koʻikoʻi o ka haʻalele maikaʻi ʻole o ka thrombosis.Loaʻa iā ia ka naʻau kiʻekiʻe, akā e nāwaliwali ka kikoʻī pili.Aia kekahi mahele o nā mea maikaʻi ʻole.ʻO ka hui pū ʻana o D-dimer a me FDP hiki ke hōʻemi i kahi hapa o D- No ka hoʻopunipuni wahaheʻe o ka dimer, ke hōʻike ka hopena o ke keʻena ʻo D-dimer ≥ FDP, hiki ke hoʻoholo ʻia ma ka hopena o ka hoʻāʻo:
1. Inā haʻahaʻa nā waiwai (
2. Inā he waiwai kiʻekiʻe ka hopena (>Waiwai ʻoki ʻia), e noʻonoʻo i nā mea hoʻoikaika, aia paha nā kumu hoʻopilikia.Manaʻo ʻia e hana i nā hoʻāʻo dilution he nui.Inā laina ka hopena, ʻoi aku ka maikaʻi o ka maikaʻi.Inā ʻaʻole ia he laina, he mau huaʻōlelo wahaheʻe.Hiki iā ʻoe ke hoʻohana i ka reagent ʻelua no ka hōʻoia a kamaʻilio me ke keʻena i ka manawa.
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