Sei serum machubhu achigona kushandiswawo kuona D-dimer zvirimo?Pachave nekuumbwa kwefibrin clot muserum chubhu, haizodzikisirwe kuita D-dimer?Kana iyo isingaderedze, nei paine kuwedzera kukuru kweD-dimer kana magwamba eropa akaumbwa muchubhu yeanticoagulation nekuda kwekushayikwa kweropa sampling yekuongorora coagulation?
Chokutanga pane zvose, kuunganidza ropa kwakashata kunogona kutungamirira kukuvadzwa kwevascular endothelial, uye kusunungurwa kwe subendothelial tissue factor uye tissue-type plasminogen activator (tPA) muropa.Kune rimwe divi, tissue factor inomutsa exogenous coagulation nzira kugadzira fibrin clots.Iyi nzira inokurumidza zvikuru.Ingotarisa nguva yeprothrombin (PT) kuti uzive, iyo inowanzoita masekonzi gumi.Kune rumwe rutivi, mushure mokunge fibrin yakaumbwa, inoshanda se cofactor kuwedzera basa re tPA ne100 nguva, uye mushure mokunge tPA yakanamatirwa pamusoro pefibrin, haichazodziviriri nyore nyore ne plasminogen activation inhibitor-1 ( PAI-1).Nokudaro, plasminogen inogona kukurumidza uye inoramba ichishandurwa kuva plasmin, uye ipapo fibrin inogona kuderedzwa, uye yakawanda yeFDP neD-Dimer inogona kubudiswa.Ichi ndicho chikonzero nei kuumbwa kweropa mu vitro uye fibrin degradation zvigadzirwa zvakawedzera zvakanyanya nekuda kwekushata kwesampling yeropa.
Zvino, nei kuunganidzwa kwakajairwa kweserum chubhu (isina zvinowedzerwa kana necoagulant) zvienzaniso zvakagadzirawo fibrin clots in vitro, asi isina kushatisa kugadzira huwandu hukuru hweFDP neD-dimer?Izvi zvinoenderana neserum chubhu.Chii chakaitika mushure mokunge mufananidzo wacho wakaunganidzwa: Kutanga, hapana tPA yakawanda inopinda muropa;chechipiri, kunyange kana tPA shoma inopinda muropa, tPA yakasununguka ichasungwa nePAI-1 uye inorasikirwa nebasa rayo mukati memaminitsi mashanu isati yanamatira fibrin.Panguva ino, kazhinji hapana kuumbwa kwefibrin muserum chubhu isina zvinowedzera kana necoagulant.Zvinotora anopfuura maminetsi gumi kuti ropa risina zvinowedzerwa rigadzikane, nepo ropa rine coagulant (kazhinji silicon powder) rinotanga mukati.Zvinotorawo anopfuura maminetsi mashanu kugadzira fibrin kubva muropa coagulation nzira.Uye zvakare, iyo fibrinolytic chiitiko pakamuri tembiricha in vitro ichakanganiswawo.
Ngatitaure nezve thromboelastogram zvakare pamwe nemusoro wenyaya iyi: unogona kunzwisisa kuti kuvharika kweropa muserum chubhu hakusi nyore kuderedzwa, uye iwe unogona kunzwisisa kuti nei thromboelastogram bvunzo (TEG) isinganzwisisike kuratidza hyperfibrinolysis-ese ari maviri mamiriro Zvakafanana, hongu, tembiricha panguva yebvunzo yeTEG inogona kuchengetedzwa pa37 degrees.Kana TEG ichinyanya kunzwisiswa kuratidza chimiro chefibrinolysis, imwe nzira ndeyekuwedzera tPA mu in vitro TEG kuyedza, asi pachine matambudziko ekumira uye hapana pasi rose application;uyezve, inogona kuyerwa padivi pemubhedha pakarepo mushure mekuita sampling, asi iyo chaiyo mhedzisiro zvakare yakanyanya kushomeka.Muedzo wechinyakare uye unoshanda zvakanyanya wekuongorora chiitiko chefibrinolytic ndiyo nguva yekuparara kweeuglobulin.Chikonzero chekunzwa kwayo chakakwira kupfuura icho cheTEG.Muyedzo, iyo anti-plasmin inobviswa nekugadzirisa pH kukosha uye centrifugation, asi bvunzo inopedza Inotora nguva yakareba uye ine hutsinye, uye haiwanzo kuitwa mumarabhoritari.
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