D-dimer yog dab tsi?

D-dimer yog qhov yooj yim degradation khoom ntawm fibrin, thiab nws cov qib siab tuaj yeem cuam tshuam lub xeev hypercoagulable thiab theem nrab hyperfibrinolysis hauv vivo.D-dimer tuaj yeem siv los ua tus cim ntawm hypercoagulability thiab hyperfibrinolysis hauv vivo, thiab nws qhov kev nce ntxiv qhia tias nws muaj feem xyuam rau cov kab mob thrombotic los ntawm ntau yam hauv vivo, thiab tseem qhia txog kev txhim kho ntawm fibrinolytic kev ua haujlwm.

Hauv cov xwm txheej dab tsi yog D-dimer qib siab?

Ob leeg venous thromboembolism (VTE) thiab cov kab mob uas tsis yog-venous thromboembolic tuaj yeem ua rau D-dimer qib siab.

VTE muaj xws li mob pulmonary embolism, tob vein thrombosis (DVT) thiab cerebral venous (sinus) thrombosis (CVST).

Cov kab mob uas tsis yog venous thromboembolic muaj xws li mob aortic dissection (AAD), ruptured aneurysm, stroke (CVA), disseminated intravascular coagulation (DIC), sepsis, acute coronary syndrome (ACS), thiab chronic obstructive Pulmonary disease (COPD), thiab lwm yam. , D-dimer theem kuj tau nce siab hauv cov xwm txheej xws li hnub nyoog siab, kev phais / kev raug mob tsis ntev los no, thiab thrombolysis.

D-dimer tuaj yeem siv los ntsuas pulmonary embolism prognosis

D-dimer kwv yees kev tuag ntawm cov neeg mob pulmonary embolism.Hauv cov neeg mob uas muaj mob ntsws embolism, qhov siab dua D-dimer muaj feem cuam tshuam nrog cov qhab nia PESI siab dua (Pulmonary Embolism Severity Index Score) thiab nce kev tuag.Cov kev tshawb fawb tau pom tias D-dimer <1500 μg / L muaj qhov zoo dua qhov kev kwv yees tsis zoo rau 3 lub hlis pulmonary embolism tuag: 3-hli kev tuag yog 0% thaum D-dimer <1500 μg / L.Thaum D-dimer ntau dua 1500 μg / L, yuav tsum siv ceev faj.

Tsis tas li ntawd, qee qhov kev tshawb fawb tau pom tias rau cov neeg mob ntsws cancer, D-dimer <1500 μg / L feem ntau yog ib qho kev txhim kho fibrinolytic los ntawm cov qog;D-dimer> 1500 μg / L feem ntau qhia tias cov neeg mob ntsws cancer muaj cov hlab ntsha sib sib zog nqus (DVT) thiab pulmonary embolism.

D-dimer kwv yees VTE rov tshwm sim

D-dimer yog kwv yees ntawm rov tshwm sim VTE.D-dimer-negative cov neeg mob muaj 3-lub hlis rov ua dua tus nqi ntawm 0. Yog tias D-dimer nce ntxiv thaum rov qab los, qhov kev pheej hmoo ntawm VTE rov tshwm sim tuaj yeem nce ntxiv.

D-dimer pab rau kev kuaj mob ntawm aortic dissection

D-dimer muaj qhov txiaj ntsig zoo ntawm kev kwv yees tsis zoo hauv cov neeg mob uas muaj mob aortic dissection, thiab D-dimer negativity tuaj yeem txiav txim siab tawm qhov mob aortic.D-dimer yog nce siab hauv cov neeg mob uas mob aortic dissection thiab tsis tau nce siab hauv cov neeg mob uas muaj mob aortic dissection.

D-dimer fluctuates ntau zaus los yog dheev sawv, qhia tias muaj kev pheej hmoo ntau dua ntawm kev sib tsoo rupture.Yog tias tus neeg mob lub D-dimer theem yog qhov ruaj khov thiab qis (< 1000 μg / L), qhov kev pheej hmoo ntawm kev tawg ntawm qhov tawg yog me me.Yog li ntawd, qib D-dimer tuaj yeem coj cov kev kho mob tshwj xeeb ntawm cov neeg mob.

D-dimer thiab kab mob

Kab mob yog ib qho ua rau VTE.Thaum lub sij hawm tshem tawm cov hniav, bacteremia tuaj yeem tshwm sim, uas tuaj yeem ua rau cov kab mob thrombotic.Lub sijhawm no, qib D-dimer yuav tsum tau saib xyuas zoo, thiab kev kho anticoagulation yuav tsum tau ntxiv dag zog thaum D-dimer qib siab.

Tsis tas li ntawd, cov kab mob ua pa thiab kev puas tsuaj ntawm daim tawv nqaij yog qhov muaj feem cuam tshuam rau cov hlab ntsha sib sib zog nqus.

D-dimer qhia txoj kev kho anticoagulation

Cov txiaj ntsig ntawm PROLONG multicenter, kev kawm yav tom ntej ob qho tib si hauv thawj zaug (18-hli tom qab) thiab txuas ntxiv (30-hli kev soj ntsuam) theem pom tau tias piv nrog cov neeg mob uas tsis muaj tshuaj tiv thaiv kab mob, cov neeg mob D-dimer-zoo txuas ntxiv tom qab 1. Lub hlis ntawm kev cuam tshuam ntawm kev kho mob Anticoagulation txo qis kev pheej hmoo ntawm VTE rov tshwm sim, tab sis tsis muaj qhov sib txawv tseem ceeb hauv cov neeg mob D-dimer-negative.

Hauv kev tshuaj xyuas luam tawm los ntawm Ntshav, Xib Fwb Kearon kuj tau taw qhia tias kev kho anticoagulation tuaj yeem coj raws li tus neeg mob qib D-dimer.Hauv cov neeg mob uas tsis muaj kev cuam tshuam nrog DVT lossis pulmonary embolism, kev kho anticoagulation tuaj yeem raug coj los ntawm kev tshawb pom D-dimer;Yog tias tsis siv D-dimer, chav kawm anticoagulation tuaj yeem txiav txim siab raws li qhov txaus ntshai los ntshav thiab tus neeg mob qhov kev xav tau.

Tsis tas li ntawd, D-dimer tuaj yeem coj txoj kev kho thrombolytic.