Chifukwa chiyani machubu a seramu angagwiritsidwenso ntchito kuzindikira za D-dimer?Padzakhala kupangika kwa magazi a fibrin mu chubu cha seramu, kodi sichitha kukhala D-dimer?Ngati sichikunyozeka, nchifukwa ninji pali kuwonjezeka kwakukulu kwa D-dimer pamene magazi amaundana mu chubu cha anticoagulation chifukwa cha kuperewera kwa magazi kwa mayesero a coagulation?
Choyamba, kusonkhanitsa magazi kosakwanira kungayambitse kuwonongeka kwa mitsempha ya mitsempha, komanso kutulutsidwa kwa subendothelial tissue factor ndi tissue-type plasminogen activator (tPA) m'magazi.Kumbali ina, chinthu cha minofu chimayambitsa njira ya exogenous coagulation kuti apange fibrin kuundana.Njirayi ndi yofulumira kwambiri.Tangoyang'anani nthawi ya prothrombin (PT) kuti mudziwe, yomwe nthawi zambiri imakhala pafupifupi masekondi 10.Kumbali ina, fibrin itapangidwa, imakhala ngati cofactor kuti ionjezere ntchito ya tPA ndi nthawi 100, ndipo tPA itayikidwa pamwamba pa fibrin, sichidzalepheretsedwanso mosavuta ndi plasminogen activation inhibitor-1. PAI-1).Choncho, plasminogen ikhoza kusinthidwa mofulumira komanso mosalekeza kukhala plasmin, ndiyeno fibrin ikhoza kuchepetsedwa, ndipo kuchuluka kwa FDP ndi D-Dimer kungapangidwe.Ichi ndichifukwa chake mapangidwe a magazi kuundana kwa magazi mu vitro ndi kuwonongeka kwa fibrin kumachulukirachulukira chifukwa chakusatsamira bwino kwa magazi.
Ndiye, chifukwa chiyani kusonkhanitsa kwabwino kwa seramu chubu (popanda zowonjezera kapena zokhala ndi coagulant) zitsanzo zinapanganso mafinya a fibrin mu m'galasi, koma sanawononge kuti apange kuchuluka kwa FDP ndi D-dimer?Izi zimatengera chubu la seramu.Zomwe zinachitika pambuyo poti chitsanzocho chinasonkhanitsidwa: Choyamba, palibe kuchuluka kwa tPA komwe kumalowa m'magazi;chachiwiri, ngakhale pang'ono tPA ikalowa m'magazi, tPA yaulere idzamangidwa ndi PAI-1 ndikutaya ntchito yake pafupifupi mphindi 5 isanayambe kulumikiza fibrin.Panthawiyi, nthawi zambiri palibe mapangidwe a fibrin mu chubu cha seramu popanda zowonjezera kapena coagulant.Zimatenga mphindi zopitirira khumi kuti magazi opanda zowonjezera agwirizane mwachibadwa, pamene magazi okhala ndi coagulant (kawirikawiri silicon ufa) amayamba mkati.Zimatenganso mphindi zopitilira 5 kuti apange fibrin kuchokera munjira yolumikizira magazi.Kuphatikiza apo, ntchito ya fibrinolytic pa kutentha kwa chipinda mu vitro nayonso imakhudzidwa.
Tiyeni tikambiranenso za thromboelastogram pamutuwu: mutha kumvetsetsa kuti magazi omwe ali mu chubu la seramu sawonongeka mosavuta, ndipo mutha kumvetsetsa chifukwa chake mayeso a thromboelastogram (TEG) samakhudzidwa kuti awonetse hyperfibrinolysis-zonsezi ndizofanana, kumene, kutentha pa TEG mayeso akhoza anakhalabe pa 37 madigiri.Ngati TEG imakhudzidwa kwambiri kuti iwonetse mawonekedwe a fibrinolysis, njira imodzi ndiyo kuwonjezera tPA mu kuyesa kwa in vitro TEG, komabe pali zovuta zokhazikika ndipo palibe ntchito yapadziko lonse;kuonjezera apo, imatha kuyeza pambali pa bedi mutangotenga zitsanzo, koma zotsatira zake zimakhala zochepa kwambiri.Kuyesa kwachikhalidwe komanso kothandiza kwambiri pakuwunika ntchito ya fibrinolytic ndi nthawi yakufa kwa euglobulin.Chifukwa cha chidwi chake ndi chapamwamba kuposa cha TEG.Poyesa, anti-plasmin imachotsedwa posintha pH mtengo ndi centrifugation, koma kuyesa kumadya Zimatenga nthawi yayitali ndipo zimakhala zovuta, ndipo sizichitika kawirikawiri m'ma laboratories.
Business khadi
China WeChat
English WeChat