Kedu ihe bụ D-dimer?

D-dimer bụ ngwaahịa mmebi kachasị mfe nke fibrin, ọkwa ya dị elu nwere ike igosipụta ọnọdụ hypercoagulable na hyperfibrinolysis nke abụọ na vivo.Enwere ike iji D-dimer mee ihe dị ka akara nke hypercoagulability na hyperfibrinolysis na vivo, mmụba ya na-egosi na ọ metụtara ọrịa thrombotic kpatara ihe dị iche iche na vivo, ma na-egosikwa nkwalite ọrụ fibrinolytic.

N'ọnọdụ ndị dị aṅaa ka a na-ebuli ọkwa D-dimer elu?

Ma venous thromboembolism (VTE) na ọrịa thromboembolic na-abụghị venous nwere ike ime ka ọkwa D-dimer dị elu.

VTE gụnyere nnukwu akwara akpa ume, thrombosis miri emi (DVT) na cerebral venous (sinus) thrombosis (CVST).

Ọrịa thromboembolic na-adịghị venous na-agụnye nnukwu dissection aortic (AAD), ruptured aneurysm, stroke (CVA), disseminated intravascular coagulation (DIC), sepsis, nnukwu ọrịa obi na-arịa ọrịa obi (ACS), na ọrịa na-adịghị ala ala obstructive Pulmonary (COPD), wdg Na mgbakwunye. , A na-ebulikwa ọkwa D-dimer na ọnọdụ ndị dị ka ịka nká, ịwa ahụ / trauma na nso nso a, na thrombolysis.

Enwere ike iji D-dimer iji chọpụta amụma embolism nke akpa ume

D-dimer na-ebu amụma ọnwụ na ndị ọrịa nwere embolism akpa ume.N'ime ndị ọrịa nwere nnukwu akpa ume akpa ume, ọnụ ọgụgụ D-dimer dị elu jikọtara ọnụ ọgụgụ PESI dị elu (Pulmonary Embolism Severity Index Score) na ụbara ọnwụ.Nnyocha egosiwo na D-dimer <1500 μg/L nwere uru amụma amụma na-adịghị mma maka ọnwa 3 nke pulmonary embolism anwụ: ọnwụ ọnwa 3 bụ 0% mgbe D-dimer <1500 μg/L.Mgbe D-dimer karịrị 1500 μg/L, ekwesịrị iji nlezianya dị elu mee ihe.

Tụkwasị na nke ahụ, ụfọdụ nnyocha egosiwo na maka ndị ọrịa nwere ọrịa cancer akpa ume, D-dimer <1500 μg / L na-abụkarị ọrụ fibrinolytic na-emewanyewanye nke ụbụrụ na-akpata;D-dimer>1500 μg/L na-egosikarị na ndị ọrịa nwere ọrịa kansa akpa ume nwere thrombosis miri emi (DVT) na embolism pulmonary.

D-dimer na-ebu amụma nlọghachi VTE

D-dimer bụ amụma VTE na-aga n'ihu.Ndị ọrịa D-dimer-negative nwere ọnụọgụ nlọghachi nke ọnwa 3 nke 0. Ọ bụrụ na D-dimer bilitere ọzọ n'oge nleba anya, ihe ize ndụ nke nlọghachi VTE nwere ike ịba ụba nke ukwuu.

D-dimer na-enyere aka na nchọpụta nke dissection aortic

D-dimer nwere ezigbo amụma amụma na-adịghị mma na ndị ọrịa nwere nnukwu dissection aortic, na D-dimer negativity nwere ike wepụ nnukwu mgbasa nke aortic.A na-ebuli D-dimer elu na ndị ọrịa nwere nnukwu mgbawa aortic na-ebulighị elu nke ukwuu na ndị ọrịa nwere mgbatị aortic na-adịghị ala ala.

D-dimer na-agbanwe ugboro ugboro ma ọ bụ na-ebili na mberede, na-atụ aro ka ọ bụrụ ihe ize ndụ dị ukwuu nke nkwụsịtụ.Ọ bụrụ na ọkwa D-dimer nke onye ọrịa ahụ kwụsiri ike ma dị ala (<1000 μg / L), ihe ize ndụ nke mgbawa dissection dị obere.Ya mere, ọkwa D-dimer nwere ike iduzi ọgwụgwọ mmasị nke ndị ọrịa ahụ.

D-dimer na ọrịa

Ọrịa bụ otu n'ime ihe kpatara VTE.N'oge mmịpụta ezé, nje bacteria nwere ike ime, nke nwere ike ibute ihe omume thrombotic.N'oge a, ekwesịrị ileba anya na ọkwa D-dimer nke ọma, a ga-ewusi ọgwụgwọ mgbochi ọrịa ike mgbe ọkwa D-dimer dị elu.

Na mgbakwunye, ọrịa iku ume na mmebi akpụkpọ ahụ bụ ihe ize ndụ maka thrombosis miri emi.

D-dimer na-eduzi ọgwụgwọ anticoagulation

Nsonaazụ nke PROLONG multicenter, ọmụmụ ihe na-atụ anya ma na mbụ (nleba anya ọnwa 18) na ogologo oge (nsogbu ọnwa 30) gosiri na e jiri ya tụnyere ndị ọrịa na-enweghị ọgwụ mgbochi, ndị ọrịa D-dimer-positive na-aga n'ihu mgbe 1 gasịrị. Ọnwa nke nkwụsị ọgwụgwọ Anticoagulation nke ukwuu belatara ohere nke nlọghachite VTE, mana ọ nweghị nnukwu ọdịiche dị na ndị ọrịa D-dimer-adịghị mma.

Na nyocha nke Blood bipụtara, Prọfesọ Kearon kọwakwara na enwere ike iduzi ọgwụgwọ ọgwụ mgbochi dịka ọkwa D-dimer onye ọrịa siri dị.N'ime ndị ọrịa nwere DVT proximal proximal ma ọ bụ pulmonary embolism, enwere ike iduzi ọgwụgwọ anticoagulation site na nchọpụta D-dimer;Ọ bụrụ na ejighị D-dimer mee ihe, enwere ike ikpebi usoro mgbochi mgbochi dịka ihe egwu ọbara na-agba na ọchịchọ onye ọrịa siri dị.

Na mgbakwunye, D-dimer nwere ike iduzi ọgwụgwọ thrombolytic.