Chii chinonzi D-dimer?

D-dimer ndiyo yakapusa kushatisa chigadzirwa chefibrin, uye yakakwira mwero inogona kuratidza iyo hypercoagulable mamiriro uye yechipiri hyperfibrinolysis mu vivo.D-dimer inogona kushandiswa sechiratidzo che hypercoagulability uye hyperfibrinolysis mu vivo, uye kuwedzera kwayo kunoratidza kuti inobatana nezvirwere zvethrombotic zvinokonzerwa nezvikonzero zvakasiyana-siyana mu vivo, uye inoratidzawo kuwedzera kwebasa re fibrinolytic.

Mumamiriro ezvinhu akaita sei D-dimer mazinga anokwidziridzwa?

Ose ari maviri venous thromboembolism (VTE) uye asiri-venous thromboembolic kusagadzikana anogona kukonzera yakakwira D-dimer mazinga.

VTE inosanganisira acute pulmonary embolism, deep vein thrombosis (DVT) uye cerebral venous (sinus) thrombosis (CVST).

Non-venous thromboembolic disorders inosanganisira acute aortic dissection (AAD), ruptured aneurysm, sitiroko (CVA), disseminated intravascular coagulation (DIC), sepsis, acute coronary syndrome (ACS), uye chronic obstructive Pulmonary disease (COPD), nezvimwewo. , D-dimer mazinga anokwidziridzwawo mumamiriro ezvinhu akadai sezera rekukura, kuvhiyiwa kwemazuva ano / kushungurudzika, uye thrombolysis.

D-dimer inogona kushandiswa kuongorora pulmonary embolism prognosis

D-dimer inofanotaura kufa kwevarwere vane pulmonary embolism.Mune varwere vane acute pulmonary embolism, yakakwirira D-dimer tsika dzakabatana nepamusoro pePESI zvibodzwa (Pulmonary Embolism Severity Index Score) uye kuwedzera kufa.Zvidzidzo zvakaratidza kuti D-dimer <1500 μg/L ine zvirinani zvisina kunaka kufungidzira kukosha kwe3-mwedzi pulmonary embolism kufa: 3-mwedzi kufa ndeye 0% apo D-dimer <1500 μg/L.Kana D-dimer yakakura kupfuura 1500 μg/L, kungwarira kwakanyanya kunofanirwa kushandiswa.

Mukuwedzera, zvimwe zvidzidzo zvakaratidza kuti kune varwere vane kenza yemapapu, D-dimer <1500 μg / L inowanzoita basa rinowedzera fibrinolytic rinokonzerwa nemakumbo;D-dimer> 1500 μg/L inowanzoratidza kuti varwere vane kenza yemapapu vane yakadzika vein thrombosis (DVT) uye pulmonary embolism.

D-dimer inofanotaura VTE kudzokorora

D-dimer inofanotaura nezve inodzokororwa VTE.D-dimer-negative varwere vaiva nemwedzi we3 wekudzoka kwe 0. Kana D-dimer ichikwira zvakare panguva yekutevera, njodzi yeVTE kudzokorora inogona kuwedzera zvakanyanya.

D-dimer inobatsira mukuongororwa kweaortic dissection

D-dimer ine yakanaka yakaipa yekufungidzira kukosha kune varwere vane acute aortic dissection, uye D-dimer negativity inogona kubvisa acute aortic dissection.D-dimer inokwidziridzwa kune varwere vane acute aortic dissection uye kwete kunyanya kukwidziridzwa kune varwere vane chirwere chisingaperi cheaortic dissection.

D-dimer inochinja-chinja kakawanda kana kusimuka kamwe kamwe, zvichiratidza njodzi huru yekutsemuka kwe dissection.Kana chirwere cheD-dimer chemurwere chinenge chakadzikama uye chakaderera (<1000 μg/L), njodzi yekuparara kwepakati idiki.Naizvozvo, iyo D-dimer nhanho inogona kutungamira kurapwa kwakasarudzika kwevarwere ivavo.

D-dimer uye utachiona

Utachiona ndechimwe chezvikonzero zveVTE.Munguva yekubvisa zino, bacteremia inogona kuitika, iyo inogona kutungamirira kune zviitiko zvethrombotic.Panguva ino, mazinga eD-dimer anofanira kunyatsoongororwa, uye anticoagulation therapy inofanira kusimbiswa kana D-dimer mazinga akakwirira.

Mukuwedzera, zvirwere zvekufema uye kukuvara kweganda zvinhu zvine ngozi kune yakadzika vein thrombosis.

D-dimer inotungamira anticoagulation kurapwa

Migumisiro yePROLONG yakawanda, inotarisirwa kudzidza zvose mukutanga (mwedzi we18 kutevera) uye yakawedzerwa (mwedzi we30 kutevera) zvikamu zvakaratidza kuti zvichienzaniswa nevarwere vasina-anticoagulated, D-dimer-positive varwere vakaenderera mberi mushure me1. mwedzi wekukanganiswa kwekurapa Anticoagulation zvakanyanya kuderedza njodzi yeVTE kudzoka, asi pakanga pasina musiyano wakakosha muD-dimer-negative varwere.

Muongororo yakaburitswa neRopa, Muzvinafundo Kearon akataura zvakare kuti anticoagulation therapy inogona kutungamirwa zvinoenderana nemurwere D-dimer level.Mune varwere vane unprovoked proximal DVT kana pulmonary embolism, anticoagulation therapy inogona kutungamirirwa neD-dimer kuona;kana D-dimer ikasashandiswa, kosi yeanticoagulation inogona kutariswa zvinoenderana nenjodzi yekubuda ropa uye zvishuwo zvemurwere.

Mukuwedzera, D-dimer inogona kutungamira thrombolytic therapy.