D-dimer feem ntau yog siv los ua ib qho tseem ceeb ntawm qhov ntsuas qhov ntsuas ntawm PTE thiab DVT hauv kev kho mob.Nws tuaj txog li cas?

Plasma D-dimer yog ib yam khoom degradation uas tsim los ntawm plasmin hydrolysis tom qab fibrin monomer yog cross-linked los ntawm activating factor XIII.Nws yog ib qho cim tshwj xeeb ntawm cov txheej txheem fibrinolysis.D-dimers yog muab los ntawm cross-linked fibrin clots lysed los ntawm plasmin.Tsuav yog muaj thrombosis nquag thiab ua haujlwm fibrinolytic hauv lub cev cov hlab ntsha, D-dimer yuav nce.Myocardial infarction, cerebral infarction, pulmonary embolism, venous thrombosis, phais, qog, disseminated intravascular coagulation, kab mob thiab cov ntaub so ntswg necrosis tuaj yeem ua rau siab D-dimer.Tshwj xeeb tshaj yog rau cov neeg laus thiab cov neeg mob pw hauv tsev kho mob, vim yog cov kab mob bacteremia thiab lwm yam kab mob, nws yooj yim ua rau cov ntshav coagulation tsis zoo thiab ua rau muaj D-dimer.

D-dimer feem ntau qhia txog kev ua haujlwm fibrinolytic.Nce los yog zoo pom nyob rau hauv theem nrab hyperfibrinolysis, xws li hypercoagulable lub xeev, disseminated intravascular coagulation, raum kab mob, organ transplant rejection, thrombolytic therapy, thiab lwm yam. Kev txiav txim siab ntawm lub ntsiab yam tseem ceeb ntawm lub fibrinolytic system yog qhov tseem ceeb heev rau kev kuaj mob thiab kev kho mob ntawm cov kab mob. cov kab mob fibrinolytic (xws li DIC, ntau yam thrombus) thiab cov kab mob cuam tshuam nrog cov kab mob fibrinolytic (xws li qog nqaij hlav, cev xeeb tub syndrome), thiab saib xyuas kev kho mob thrombolytic.

Kev nce qib ntawm D-dimer, cov khoom lag luam fibrin degradation, qhia tias nquag fibrin degradation hauv vivo.Yog li, fibrous D-dimer yog ib qho tseem ceeb qhia txog kev sib sib zog nqus vein thrombosis (DVT), pulmonary embolism (PE), disseminated intravascular coagulation (DIC).

Ntau yam kab mob ua rau kom ua rau lub cev coagulation thiab / lossis fibrinolytic system hauv lub cev, ua rau muaj kev nce qib ntawm D-dimer, thiab qhov kev ua kom zoo no yog ze rau theem, qhov hnyav thiab kev kho mob ntawm tus kab mob, yog li hauv cov kab mob no. Kev kuaj xyuas qib ntawm D-dimer tuaj yeem siv los ua tus cim ntsuas kev ntsuas tus kab mob, kev kwv yees thiab kev qhia txog kev kho mob.

Kev siv D-dimer hauv cov hlab ntsha sib sib zog nqus

Txij li thaum Wilson et al.thawj zaug siv cov khoom siv fibrin degradation rau kev kuaj mob pulmonary embolism hauv xyoo 1971, kev tshawb pom ntawm D-dimer tau ua lub luag haujlwm loj hauv kev kuaj mob pulmonary embolism.Nrog rau qee txoj kev kuaj pom muaj txiaj ntsig zoo, qhov tsis zoo D-dimer Lub cev tus nqi muaj qhov zoo tshaj plaws tsis zoo rau kev ua haujlwm ntawm pulmonary embolism, thiab nws tus nqi yog 0.99.Qhov tshwm sim tsis zoo tuaj yeem txiav txim siab tawm pulmonary embolism, yog li txo qis kev kuaj mob, xws li kev ntsuas cua perfusion thiab pulmonary angiography;tsis txhob dig muag anticoagulation therapy.D - Lub concentration ntawm dimer muaj feem xyuam rau qhov chaw ntawm lub thrombus, nrog ntau dua concentrations nyob rau hauv lub loj ceg ntawm lub ntsws lub ntsws thiab qis concentrations nyob rau hauv cov me ceg.

Tsis zoo plasma D-dimers txiav txim siab qhov ua tau ntawm DVT.Angiography paub tseeb tias DVT yog 100% zoo rau D-dimer.Yuav siv tau rau kev kho mob thrombolytic thiab heparin anticoagulation tshuaj qhia thiab kev soj ntsuam kev ua tau zoo.

D-dimer tuaj yeem cuam tshuam qhov kev hloov pauv hauv thrombus loj.Yog tias cov ntsiab lus nce ntxiv, nws qhia txog qhov rov tshwm sim ntawm thrombus;Thaum lub sij hawm kho, nws tseem yuav siab, thiab qhov loj ntawm cov thrombus tsis hloov, qhia tau hais tias qhov kev kho mob tsis zoo.