01.Kev kuaj mob ntawm cov hlab ntsha sib sib zog nqus thrombosis thiab pulmonary embolism

Cov hlab ntsha sib sib zog nqus thrombosis (D-VT) yog qhov ua rau pulmonary embolism (PE), sib sau ua ke hu ua venous thromboembolism (VTE).Plasma D-dimer theem tau nce siab hauv cov neeg mob VTE.

Cov kev tshawb fawb cuam tshuam tau pom tias cov ntshav plasma D-dimer concentration hauv cov neeg mob PE thiab D-VT yog ntau dua 1 000 μg / L.

Txawm li cas los xij, vim muaj ntau yam kab mob lossis qee yam kab mob (kev phais, qog, kab mob plawv, thiab lwm yam) muaj qee yam cuam tshuam rau hemostasis, uas ua rau muaj D-dimer.Yog li ntawd, txawm hais tias D-dimer muaj qhov rhiab heev, nws qhov tshwj xeeb tsuas yog 50% txog 70%, thiab D-dimer ib leeg tsis tuaj yeem kuaj VTE.Yog li ntawd, qhov tseem ceeb ntawm D-dimer tsis tuaj yeem siv los ua qhov qhia tshwj xeeb ntawm VTE.Qhov tseem ceeb ntawm kev kuaj D-dimer yog qhov tshwm sim tsis zoo cuam tshuam qhov kev kuaj mob ntawm VTE.

 

02 Disseminated intravascular coagulation

Disseminated intravascular coagulation (DIC) yog ib qho mob ntawm microthrombosis uas nws kim heev hauv cov hlab ntsha me thoob plaws hauv lub cev thiab theem nrab hyperfibrinolysis nyob rau hauv qhov kev txiav txim ntawm qee yam kab mob, uas tuaj yeem nrog cov fibrinolysis theem nrab lossis inhibited fibrinolysis.

Cov ntsiab lus siab ntawm cov ntshav plasma ntawm D-dimer muaj tus nqi kho mob siab rau kev kuaj pom thaum ntxov ntawm DIC.Txawm li cas los xij, nws yuav tsum tau muab sau tseg tias qhov nce ntawm D-dimer tsis yog ib qho kev kuaj tshwj xeeb rau DIC, tab sis ntau yam kab mob nrog microthrombosis tuaj yeem ua rau D-dimer nce.Thaum fibrinolysis yog qhov thib ob rau kev coagulation extravascular, D-dimer kuj yuav nce ntxiv.

Cov kev tshawb fawb tau pom tias D-dimer pib nce hnub ua ntej DIC thiab siab dua li qub.

 

03 Neonatal asphyxia

Muaj ntau theem ntawm hypoxia thiab acidosis nyob rau hauv neonatal asphyxia, thiab hypoxia thiab acidosis tuaj yeem ua rau cov vascular endothelial puas tsuaj, uas ua rau tso tawm ntau cov coagulation tshuaj, yog li ua rau cov fibrinogen ntau lawm.

Cov kev tshawb fawb cuam tshuam tau pom tias D-dimer tus nqi ntawm cov ntshav qaum hauv pawg asphyxia yog qhov siab dua li ntawm pawg tswj hwm ib txwm muaj, thiab piv nrog D-dimer tus nqi hauv cov ntshav peripheral, nws kuj tseem ceeb dua.

 

04 Systemic lupus erythematosus (SLE)

Cov txheej txheem coagulation-fibrinolysis yog qhov txawv txav hauv cov neeg mob SLE, thiab qhov txawv txav ntawm coagulation-fibrinolysis system tau tshaj tawm nyob rau hauv cov theem ntawm tus kab mob, thiab kev nyiam ntawm thrombosis yog pom tseeb dua;Thaum tus kab mob no tau txo qis, coagulation-fibrinolysis system zoo li qub.

Yog li ntawd, theem D-dimer ntawm cov neeg mob uas muaj kab mob lupus erythematosus nyob rau hauv cov theem nquag thiab tsis ua haujlwm yuav nce ntxiv, thiab cov plasma D-dimer theem ntawm cov neeg mob nyob rau hauv lub active theem yog ntau dua li cov nyob rau hauv inactive theem.

05 Mob siab thiab mob qog noj ntshav

D-dimer yog ib qho ntawm cov cim qhia txog qhov hnyav ntawm daim siab mob.Cov kab mob siab ntau dua, cov ntshav plasma D-dimer ntau dua.

Cov kev tshawb fawb cuam tshuam tau pom tias D-dimer qhov tseem ceeb ntawm Child-Pugh A, B, thiab C qib hauv cov neeg mob siab cirrhosis yog (2.218 ± 0.54) μg / mL, (6.03 ± 0.76) μg / mL, thiab (10.536 ± 0.664) μg / mL, raws..

Tsis tas li ntawd, D-dimer tau nce siab hauv cov neeg mob uas muaj mob qog noj ntshav nrog kev loj hlob sai thiab tsis zoo.

06 Mob plab

Tom qab resection ntawm cov neeg mob qog noj ntshav, thromboembolism tshwm sim li ntawm ib nrab ntawm cov neeg mob, thiab D-dimer tau nce ntau hauv 90% ntawm cov neeg mob.

Tsis tas li ntawd, muaj ib chav kawm ntawm cov piam thaj ntau hauv cov qog hlwb uas nws cov qauv thiab cov ntaub so ntswg zoo sib xws.Kev koom tes hauv tib neeg cov dej num metabolic tuaj yeem txhawb kev ua haujlwm ntawm lub cev coagulation system thiab ua rau muaj kev pheej hmoo ntawm thrombosis, thiab qib ntawm D-dimer yog nce ntau.Thiab qib ntawm D-dimer hauv cov neeg mob qog noj ntshav hauv plab nrog theem III-IV tau nce siab dua li cov neeg mob qog noj ntshav nrog theem I-II.

 

07 Mycoplasma pneumonia (MMP)

Cov MPP hnyav feem ntau nrog rau qib D-dimer siab, thiab D-dimer qib siab dua rau cov neeg mob uas MPP hnyav dua li cov mob me.

Thaum MPP mob hnyav, hypoxia, ischemia thiab acidosis yuav tshwm sim hauv zos, ua ke nrog kev cuam tshuam ncaj qha ntawm cov kab mob, uas yuav ua rau cov kab mob vascular endothelial, nthuav tawm collagen, qhib lub coagulation system, tsim lub xeev hypercoagulable, thiab tsim microthrombi.Internal fibrinolytic, kinin thiab complement systems kuj tau qhib ua tiav, ua rau muaj ntau dua D-dimer.

 

08 Mob ntshav qab zib nephropathy

D-dimer qib tau nce siab hauv cov neeg mob ntshav qab zib thiab mob ntshav qab zib nephropathy.

Tsis tas li ntawd, D-dimer thiab fibrinogen indexes ntawm cov neeg mob ntshav qab zib nephropathy tau nce siab dua li cov neeg mob ntshav qab zib hom 2.Yog li, hauv kev kho mob, D-dimer tuaj yeem siv los ua qhov ntsuas ntsuas rau kev kuaj mob ntshav qab zib thiab mob raum rau cov neeg mob.

09 Allergic Purpura (AP)

Nyob rau theem mob ntawm AP, muaj ntau theem ntawm cov ntshav hypercoagulability thiab txhim kho platelet muaj nuj nqi, ua rau vasospasm, platelet aggregation thiab thrombosis.

Kev nce siab D-dimer hauv cov menyuam yaus uas muaj AP yog tshwm sim tom qab 2 lub lis piam ntawm qhov pib thiab nws txawv ntawm cov theem kho mob, qhia txog qhov twg thiab qib ntawm cov kab mob vascular o.

Tsis tas li ntawd, nws kuj yog ib qho kev ntsuas ntsuas, nrog rau cov qib siab D-dimer tsis tu ncua, tus kab mob no feem ntau ua rau lub raum puas tsuaj.

 

10 Kev xeeb tub

Cov kev tshawb fawb cuam tshuam tau pom tias kwv yees li 10% ntawm cov poj niam cev xeeb tub tau nce qib D-dimer, qhia txog kev pheej hmoo ntawm cov ntshav txhaws.

Preeclampsia yog ib qho teeb meem ntawm kev xeeb tub.Lub ntsiab pathological hloov ntawm preeclampsia thiab eclampsia yog coagulation activation thiab fibrinolysis li, ua rau muaj zog microvascular thrombosis thiab D-dimer.

D-dimer poob sai sai tom qab yug me nyuam hauv cov poj niam ib txwm muaj, tab sis nce hauv cov poj niam uas muaj preeclampsia, thiab tsis rov qab mus rau qhov qub mus txog 4 mus rau 6 lub lis piam.

11 Tus Mob Coronary Syndrome thiab Dissecting Aneurysm

Cov neeg mob uas muaj tus mob coronary syndromes muaj qhov qub lossis tsuas yog nce siab me ntsis D-dimer, thaum aortic dissecting aneurysms tau nce siab.

Qhov no muaj feem xyuam rau qhov sib txawv tseem ceeb nyob rau hauv lub thrombus load nyob rau hauv cov hlab ntsha ntawm ob.Lub coronary lumen yog thinner thiab thrombus nyob rau hauv lub coronary hlab ntsha yog tsawg.Tom qab lub aortic intima ruptures, ib tug loj npaum li cas ntawm cov ntshav hlab ntsha nkag mus rau hauv lub hlab ntsha phab ntsa los tsim ib tug dissecting aneurysm.Ib tug loj tus naj npawb ntawm thrombi yog tsim nyob rau hauv qhov kev txiav txim ntawm lub coagulation mechanism.

12 Mob cerebral infarction

Nyob rau hauv mob cerebral infarction, spontaneous thrombolysis thiab lwm yam fibrinolytic kev ua ub no tau nce, manifested li nce plasma D-dimer qib.Qib D-dimer tau nce siab nyob rau theem pib ntawm kev mob cerebral infarction.

Plasma D-dimer qib hauv cov neeg mob uas mob stroke ischemic tau nce me ntsis hauv thawj lub lim tiam tom qab pib, nce ntau ntxiv hauv 2 mus rau 4 lub lis piam, thiab tsis txawv ntawm cov theem ib txwm nyob rau lub sijhawm rov zoo (> 3 lub hlis).