01.Kuzindikira kwa thrombosis ya mitsempha yakuya ndi pulmonary embolism

Deep vein thrombosis (D-VT) imakonda kukhala pulmonary embolism (PE), yomwe imadziwika kuti venous thromboembolism (VTE).Miyezo ya Plasma D-dimer imakwezedwa kwambiri mwa odwala a VTE.

Kafukufuku wofananira wasonyeza kuti plasma D-dimer ndende mwa odwala PE ndi D-VT ndi wamkulu kuposa 1 000 μg/L.

Komabe, chifukwa cha matenda ambiri kapena zinthu zina za pathological (opaleshoni, zotupa, matenda amtima, ndi zina zambiri) zimakhudza kwambiri hemostasis, zomwe zimapangitsa kuti D-dimer ichuluke.Chifukwa chake, ngakhale D-dimer ili ndi chidwi chachikulu, kutsimikizika kwake kumangokhala 50% mpaka 70%, ndipo D-dimer yekha sangathe kuzindikira VTE.Choncho, kuwonjezeka kwakukulu kwa D-dimer sikungagwiritsidwe ntchito ngati chizindikiro cha VTE.Kufunika kothandiza pakuyezetsa kwa D-dimer ndikuti zotsatira zoyipa zimalepheretsa kupezeka kwa VTE.

 

02 Kufalitsa intravascular coagulation

Dissemination intravascular coagulation (DIC) ndi matenda a microthrombosis yochulukirapo m'mitsempha yaying'ono m'thupi lonse ndi hyperfibrinolysis yachiwiri pansi pa zinthu zina zoyambitsa matenda, zomwe zimatha kutsagana ndi fibrinolysis yachiwiri kapena fibrinolysis yoletsa.

Zomwe zili m'madzi a m'magazi a D-dimer zili ndi tanthauzo lalikulu lachipatala pakuzindikiritsa koyambirira kwa DIC.Komabe, tisaiwale kuti kuwonjezeka kwa D-dimer si yeniyeni mayeso kwa DIC, koma matenda ambiri limodzi ndi microthrombosis zingachititse kuwonjezeka D-dimer.Pamene fibrinolysis ndi yachiwiri kwa extravascular coagulation, D-dimer idzawonjezekanso.

Kafukufuku wasonyeza kuti D-dimer imayamba kukwera masiku DIC isanachitike ndipo imakhala yokwera kwambiri kuposa yanthawi zonse.

 

03 Neonatal asphyxia

Pali magawo osiyanasiyana a hypoxia ndi acidosis mu neonatal asphyxia, ndi hypoxia ndi acidosis zingayambitse kuwonongeka kwa endothelial yamitsempha, zomwe zimabweretsa kutulutsidwa kwa zinthu zambiri za coagulation, potero kukulitsa kupanga kwa fibrinogen.

Kafukufuku woyenerera wasonyeza kuti mtengo wa D-dimer wa magazi a chingwe mu gulu la asphyxia ndi wapamwamba kwambiri kuposa gulu lolamulira bwino, ndipo poyerekeza ndi mtengo wa D-dimer m'magazi ozungulira, nawonso ndi apamwamba kwambiri.

 

04 Systemic lupus erythematosus (SLE)

Dongosolo la coagulation-fibrinolysis ndi lachilendo kwa odwala a SLE, ndipo kusakhazikika kwa dongosolo la coagulation-fibrinolysis kumawonekera kwambiri pagawo logwira ntchito la matendawa, ndipo chizoloŵezi cha thrombosis chikuwonekera;pamene matendawa achotsedwa, dongosolo la coagulation-fibrinolysis limakhala lachilendo.

Choncho, D-dimer misinkhu odwala zokhudza zonse lupus erythematosus yogwira ndi osagwira magawo adzakhala kwambiri kuchuluka, ndi plasma D-dimer misinkhu odwala yogwira siteji ndi kwambiri kuposa amene anafooka siteji.

05 Matenda a chiwindi ndi khansa ya chiwindi

D-dimer ndi chimodzi mwa zizindikiro zosonyeza kuopsa kwa matenda a chiwindi.Matenda a chiwindi akamakula kwambiri, m'pamenenso plasma D-dimer ili pamwamba.

Kafukufuku woyenerera adawonetsa kuti milingo ya D-dimer ya Child-Pugh A, B, ndi C mwa odwala omwe ali ndi vuto la chiwindi anali (2.218 ± 0.54) μg/mL, (6.03 ± 0.76) μg/mL, ndi (10.536 ± 0.664) μg/mL, motero..

Kuphatikiza apo, D-dimer idakwezedwa kwambiri kwa odwala omwe ali ndi khansa ya chiwindi ndikupita patsogolo mwachangu komanso kusazindikira bwino.

06 Khansa ya m'mimba

Pambuyo resection odwala khansa, thromboembolism kumachitika pafupifupi theka la odwala, ndi D-dimer kwambiri kuchuluka mu 90% odwala.

Kuphatikiza apo, pali gulu la zinthu zokhala ndi shuga wambiri m'maselo otupa omwe kapangidwe kake ndi minyewa ndizofanana.Kuchita nawo ntchito za kagayidwe kazakudya za anthu kumatha kulimbikitsa ntchito ya thupi la coagulation system ndikuwonjezera chiopsezo cha thrombosis, ndipo mulingo wa D-dimer umachulukitsidwa kwambiri.Ndipo mlingo wa D-dimer mu chapamimba khansa odwala ndi siteji III-IV anali kwambiri apamwamba kuposa chapamimba odwala khansa ndi siteji I-II.

 

07 Chibayo cha Mycoplasma (MMP)

MPP yoopsa nthawi zambiri imatsagana ndi kuchuluka kwa D-dimer, ndipo milingo ya D-dimer imakhala yokwera kwambiri mwa odwala omwe ali ndi MPP yayikulu kuposa ocheperako.

MPP ikadwala kwambiri, hypoxia, ischemia ndi acidosis zidzachitika kwanuko, kuphatikiza ndi kuwukira kwachindunji kwa tizilombo toyambitsa matenda, zomwe zingawononge ma cell endothelial cell, kuwulula kolajeni, kuyambitsa dongosolo la coagulation, kupanga hypercoagulable state, ndikupanga microthrombi.Ma fibrinolytic amkati, kinin ndi complement system amayatsidwanso motsatizana, zomwe zimapangitsa kuchuluka kwa D-dimer.

 

08 Matenda a shuga, matenda ashuga nephropathy

Miyezo ya D-dimer idakwezedwa kwambiri mwa odwala omwe ali ndi matenda ashuga komanso matenda ashuga nephropathy.

Kuphatikiza apo, ma index a D-dimer ndi fibrinogen a odwala omwe ali ndi matenda ashuga nephropathy anali okwera kwambiri kuposa omwe ali ndi matenda amtundu wa 2.Chifukwa chake, muzochita zachipatala, D-dimer angagwiritsidwe ntchito ngati cholozera choyesa kudziwa kuopsa kwa matenda a shuga ndi matenda a impso mwa odwala.

09 Allergic Purpura (AP)

Mu gawo lachimake la AP, pali magawo osiyanasiyana a hypercoagulability ya magazi ndi kupititsa patsogolo ntchito zamapulateleti, zomwe zimatsogolera ku vasospasm, kuphatikizika kwa mapulateleti ndi thrombosis.

Kukwera kwa D-dimer mwa ana omwe ali ndi AP kumakhala kofala pakatha milungu iwiri yoyambira ndipo kumasiyana pakati pa magawo azachipatala, kuwonetsa kuchuluka ndi kuchuluka kwa kutupa kwa mitsempha yamagazi.

Kuphatikiza apo, ndi chizindikiro chodziwikiratu, chokhala ndi kuchuluka kwa D-dimer mosalekeza, matendawa amakhala nthawi yayitali komanso amatha kuwonongeka kwaimpso.

 

10 Mimba

Kafukufuku wokhudzana ndi izi awonetsa kuti pafupifupi 10% ya amayi apakati adakweza kwambiri ma D-dimer, zomwe zikuwonetsa chiopsezo cha kuundana kwa magazi.

Preeclampsia ndi vuto lomwe nthawi zambiri limakhala ndi pakati.Kusintha kwakukulu kwapathological kwa preeclampsia ndi eclampsia ndiko kuyambitsa kwa coagulation ndi kulimbikitsa fibrinolysis, zomwe zimapangitsa kuchuluka kwa microvascular thrombosis ndi D-dimer.

D-dimer idatsika mwachangu pambuyo pobereka mwa amayi abwinobwino, koma imawonjezeka mwa amayi omwe ali ndi preeclampsia, ndipo sanabwerere mwakale mpaka masabata 4 mpaka 6.

11 Acute Coronary Syndrome ndi Dissecting Aneurysm

Odwala omwe ali ndi matenda oopsa a coronary syndromes amakhala ndi ma D-dimer abwinobwino kapena ochepera pang'ono, pomwe ma aneurysms aortic dissecting amakhala okwera kwambiri.

Izi zikugwirizana ndi kusiyana kwakukulu kwa katundu wa thrombus m'mitsempha yamagazi awiriwo.Mphuno yapamtima imakhala yocheperapo ndipo thrombus mu mtsempha wamagazi ndi wochepa.Pambuyo pa kuphulika kwa aortic intima, magazi ochuluka kwambiri amalowa mu khoma la chombo kuti apange dissecting aneurysm.Chiwerengero chachikulu cha thrombi chimapangidwa pansi pa machitidwe a coagulation.

12 Acute cerebral infarction

Mu pachimake cerebral infarction, mowiriza thrombolysis ndi sekondale fibrinolytic ntchito zimachulukira, kuwonekera monga kuchuluka plasma D-dimer milingo.Mulingo wa D-dimer udawonjezeka kwambiri kumayambiriro kwa infarction yaubongo.

Miyezo ya Plasma D-dimer kwa odwala omwe ali ndi vuto la ischemic stroke idawonjezeka pang'ono sabata yoyamba itangoyamba kumene, kuwonjezeka kwambiri mu 2 mpaka masabata a 4, ndipo sizinali zosiyana ndi zomwe zimachitika panthawi yochira (> 3 miyezi).