Kedu ihe kpatara a ga-eji chọpụta D-dimer, FDP na ndị ọrịa obi na ụbụrụ ụbụrụ?
1. Enwere ike iji D-dimer na-eduzi nhazi nke ike mgbochi.
(1) Mmekọrịta dị n'etiti ọkwa D-dimer na ihe omume ụlọ ọgwụ n'oge ọgwụgwọ anticoagulation na ndị ọrịa mgbe ejiri dochie valve obi obi.
Otu D-dimer na-eduzi ọgwụ mgbochi ọrịa ike na-eme mgbanwe na-edozi ahụ nke ọma na-edozi nchekwa na ịdị irè nke ọgwụgwọ ọgwụ mgbochi ọrịa, na ihe omume dị iche iche dị njọ dị ntakịrị karịa nke ndị na-ahụ maka njikwa na-eji ọkọlọtọ na obere ike anticoagulation.
(2) Nhazi nke thrombosis cerebral venous (CVT) nwere njikọ chiri anya na iwu thrombus.
Ntuziaka maka nyocha na njikwa nke akwara ime na venous sinus thrombosis (CVST)
Usoro nke Thrombotic: PC, PS, AT-lll, ANA, LAC, HCY
Mgbanwe mkpụrụ ndụ: prothrombin gene G2020A, ihe na-akpata coagulation LeidenV
Ihe na-ebute ụzọ: oge perinatal, ọgwụ mgbochi afọ, akpịrị ịkpọ nkụ, trauma, ịwa ahụ, ọrịa, etuto, mbelata ibu.
2. Uru nke nchọpụta jikọtara ọnụ nke D-dimer na FDP na ọrịa obi na ọrịa cerebrovascular.
(1) D-dimer mmụba (karịa 500ug/L) na-enye aka maka nchọpụta nke CVST.Ọdịmma anaghị ewepụ CVST, ọkachasị na CVST nwere isi ọwụwa dịpụrụ adịpụ naanị nso nso a.Enwere ike iji ya dị ka otu n'ime ihe na-egosi nchọpụta CVST.Enwere ike iji D-dimer dị elu karịa nke nkịtị dị ka otu n'ime ihe nrịba ama nke CVST (nkwanye ọkwa III, ihe akaebe ọkwa C).
(2) Ihe ngosi na-egosi ọgwụgwọ thrombolytic dị irè: nlekota D-dimer mụbara nke ukwuu wee jiri nwayọọ nwayọọ belata;FDP mụbara nke ukwuu wee jiri nwayọọ nwayọọ belata.Ihe ngosi abụọ a bụ ihe ndabere maka ọgwụgwọ thrombolytic dị irè.
N'okpuru ọrụ nke ọgwụ thrombolytic (SK, UK, rt-PA, wdg), emboli na arịa ọbara na-agbaze ngwa ngwa, D-dimer na FDP na plasma na-abawanye nke ukwuu, nke na-adịru ụbọchị 7.N'ime usoro ọgwụgwọ, ọ bụrụ na usoro ọgwụgwọ thrombolytic ezughị ezu na thrombus adịghị agbaze kpamkpam, D-dimer na FDP ga-anọgide na-adị elu mgbe ha rutere elu;Dị ka ọnụ ọgụgụ si kwuo, ọnụ ọgụgụ ọbara ọgbụgba mgbe ọgwụgwọ thrombolytic gasịrị dị elu dị ka 5% ruo 30%.Ya mere, maka ndị ọrịa nwere ọrịa thrombotic, ekwesịrị ịhazi usoro ọgwụgwọ siri ike, a ga-enyocha ọrụ coagulation plasma na ọrụ fibrinolytic ozugbo, yana ịkwesịrị ịchịkwa dose nke ọgwụ thrombolytic nke ọma.Enwere ike ịhụ na nchọpụta ike nke D-dimer na FDP na-agbanwe n'ihu, n'oge na mgbe ọgwụgwọ n'oge thrombolysis nwere nnukwu uru ụlọ ọgwụ maka nlekota oru na nchekwa nke ọgwụ thrombolytic.
Kedu ihe kpatara ndị ọrịa nwere obi na ọrịa cerebrovascular kwesịrị ịṅa ntị na AT?
Akwụsịghị Antithrombin (AT) Antithrombin (AT) na-arụ ọrụ dị mkpa n'igbochi usoro thrombus, ọ bụghị naanị na ọ na-egbochi thrombin, kamakwa ọ na-egbochi ihe coagulation dị ka IXa, Xa, Xla, Xlla na Vlla.Ngwakọta heparin na AT bụ akụkụ dị mkpa nke mgbochi AT.N'ebe heparin nọ, ọrụ anticoagulant nke AT nwere ike ịbawanye ọtụtụ puku ugboro.Ọrụ nke AT, ya mere AT bụ ihe dị mkpa maka usoro anticoagulant nke heparin.
1. Heparin eguzogide: Mgbe ọrụ nke AT na-ebelata, ọrụ anticoagulant nke heparin na-ebelata nke ukwuu ma ọ bụ adịghị arụ ọrụ.Ya mere, ọ dị mkpa ịghọta ọkwa AT tupu ọgwụgwọ heparin iji gbochie ọgwụgwọ heparin dị elu na-enweghị isi na ọgwụgwọ adịghị arụ ọrụ.
N'ọtụtụ akwụkwọ akụkọ, uru ụlọ ọgwụ nke D-dimer, FDP, na AT na-egosipụta na ọrịa obi na ọrịa ụbụrụ, nke nwere ike inyere aka na nchọpụta mbụ, ikpe ikpe na nyocha nke ọrịa ahụ.
2. Nyocha maka etiology nke thrombophilia: A na-egosipụta ndị ọrịa nwere thrombophilia site na nnukwu thrombosis miri emi na thrombosis ugboro ugboro.Enwere ike ịme nyocha maka ihe kpatara thrombophilia n'ime otu ndị a:
(1) VTE na-enweghị ihe kpatara ya (gụnyere thrombosis nke nwa ọhụrụ)
(2) VTE nwere ihe mkpali <40-50 afọ
(3) thrombosis ugboro ugboro ma ọ bụ thrombophlebitis
(4) Akụkọ ezinụlọ nke thrombosis
(5) Thrombosis na saịtị ndị na-adịghị mma: vein mesenteric, sinus cerebral venous.
(6) Ime ọpụpụ ugboro ugboro, ịmụ nwa, wdg.
(7) Ime ime, ihe mgbochi afọ, thrombosis nke homonụ kpatara
(8) Necrosis akpụkpọ anụ, karịsịa mgbe ejiri warfarin
(9) Mgbochi akwara akwara nke amaghị ihe kpatara ya <20 afọ
(10) Ndị ikwu nke thrombophilia
3. Nyochaa ihe omume obi na nlọghachi azụ: Nnyocha egosiwo na mbelata ọrụ AT na ndị ọrịa nwere ọrịa obi bụ n'ihi mmebi nke cell endothelial nke na-eduga n'ọtụtụ AT na-eri.Ya mere, mgbe ndị ọrịa nọ na ọnọdụ hypercoagulable, ha na-enwekarị thrombosis ma mee ka ọrịa ahụ ka njọ.Ọrụ nke AT dịkwa ntakịrị ala na ndị mmadụ na-enwe ihe omume obi ugboro ugboro karịa na ndị mmadụ na-enweghị ihe omume obi na-eme ugboro ugboro.
4. Ntụle nke ihe ize ndụ thrombosis na-adịghị valvular atrial fibrillation: obere ọrụ AT na-ejikọta ya na akara CHA2DS2-VASc;N'otu oge ahụ, ọ nwere uru ntụaka dị elu maka ịlele thrombosis na fibrillation na-abụghị valvular.
5. Mmekọrịta dị n'etiti AT na ọrịa strok: AT na-ebelata nke ukwuu na ndị ọrịa nwere nnukwu ọrịa strok, ọbara dị n'ọnọdụ hypercoagulable, na a ga-enye ọgwụgwọ ọgwụ mgbochi n'oge;Ndị ọrịa nwere ihe ize ndụ strok kwesịrị ka a na-anwale ya mgbe niile maka AT, na nchọpụta mmalite nke ọbara mgbali elu nke ndị ọrịa kwesịrị ime.Ekwesịrị ịgwọ ọnọdụ coagulation n'oge iji zere ihe omume nke nnukwu ọrịa strok.
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