D-dimer nthawi zambiri imagwiritsidwa ntchito ngati chimodzi mwazizindikiro zokayikiridwa za PTE ndi DVT muzachipatala.Kodi zinatheka bwanji?

Plasma D-dimer ndi chinthu chowonongeka chomwe chimapangidwa ndi plasmin hydrolysis pambuyo pa fibrin monomer imalumikizidwa ndi activating factor XIII.Ndilo chizindikiro cha ndondomeko ya fibrinolysis.Ma D-dimers amachokera ku magazi olumikizana ndi ma fibrin omwe amapangidwa ndi plasmin.Malinga ngati pali yogwira thrombosis ndi fibrinolytic ntchito mu mitsempha ya thupi, D-dimer adzawonjezeka.Myocardial infarction, cerebral infarction, pulmonary embolism, venous thrombosis, opaleshoni, chotupa, kufalikira kwa intravascular coagulation, matenda ndi necrosis ya minofu imatha kukweza D-dimer.Makamaka okalamba ndi odwala m'chipatala, chifukwa cha bacteremia ndi matenda ena, n'zosavuta chifukwa magazi coagulation ndi kuchititsa kuchuluka D-dimer.

D-dimer imawonetsa kwambiri ntchito ya fibrinolytic.Kuwonjezeka kapena zabwino anawona yachiwiri hyperfibrinolysis, monga hypercoagulable boma, kufalitsidwa intravascular coagulation, aimpso matenda, limba kumuika kukanidwa, thrombolytic mankhwala, etc. fibrinolytic system (monga DIC, zosiyanasiyana thrombus) ndi matenda okhudzana ndi fibrinolytic system (monga zotupa, mimba syndrome), ndi kuyang'anira chithandizo cha thrombolytic.

Magulu okwera a D-dimer, chinthu chowonongeka cha fibrin, akuwonetsa kuwonongeka kwa fibrin pafupipafupi mu vivo.Choncho, fibrous D-dimer ndi chizindikiro chachikulu cha deep vein thrombosis (DVT), pulmonary embolism (PE), disseminated intravascular coagulation (DIC).

Matenda ambiri amachititsa kutsegula kwa dongosolo coagulation ndi/kapena fibrinolytic dongosolo m'thupi, zomwe zimabweretsa kuwonjezeka kwa mlingo wa D-dimer, ndipo kutsegula uku kumagwirizana kwambiri ndi siteji, kuopsa ndi chithandizo cha matendawa, kotero m'matendawa. Kuzindikira mulingo wa D-dimer kungagwiritsidwe ntchito ngati chizindikiritso chowunikira matenda, kuneneratu komanso chitsogozo chamankhwala.

Kugwiritsa ntchito D-dimer mu deep vein thrombosis

Popeza Wilson et al.Mu 1971, kuzindikirika kwa D-dimer kwathandiza kwambiri pozindikira matenda a pulmonary embolism.Ndi njira zina zodziwira zovuta kwambiri, mtengo wa D-dimer Body umakhala ndi zotsatira zoyipa zolosera za pulmonary embolism, ndipo mtengo wake ndi 0.99.Zotsatira zoyipa zimatha kuletsa pulmonary embolism, potero kuchepetsa mayeso obwera, monga kuwunika kwa mpweya wabwino komanso pulmonary angiography;pewani chithandizo chakhungu cha anticoagulation.D - Kuchuluka kwa dimer kumagwirizana ndi malo a thrombus, omwe ali ndi mphamvu zambiri m'nthambi zazikulu za thunthu la pulmonary ndi kutsika kochepa mu nthambi zazing'ono.

Negative plasma D-dimers amachotsa kuthekera kwa DVT.Angiography idatsimikizira kuti DVT inali 100% yabwino kwa D-dimer.Angagwiritsidwe ntchito thrombolytic mankhwala ndi heparin anticoagulation mankhwala malangizo ndi lachangu kuonerera.

D-dimer imatha kuwonetsa kusintha kwa kukula kwa thrombus.Ngati zomwe zili zikuwonjezeka kachiwiri, zimasonyeza kubwereza kwa thrombus;panthawi ya chithandizo, ikupitirizabe kukhala yapamwamba, ndipo kukula kwa thrombus sikusintha, kusonyeza kuti mankhwalawa ndi osagwira ntchito.