D-dimer inowanzo shandiswa seimwe yeakakosha anofungidzirwa zviratidzo zvePTE neDVT mumakiriniki maitiro.Zvakauya sei?

Plasma D-dimer chinhu chakanyanya kushatisa chigadzirwa chinogadzirwa neplasmin hydrolysis mushure mefibrin monomer yakabatanidzwa ne activating factor XIII.Icho chiratidzo chaicho che fibrinolysis process.D-dimers inotorwa kubva kune-yakabatana-yakabatana fibrin clots akaiswa neplasmin.Chero bedzi paine inoshanda thrombosis uye fibrinolytic chiitiko mutsinga dzeropa, D-dimer ichawedzera.Myocardial infarction, cerebral infarction, pulmonary embolism, venous thrombosis, kuvhiyiwa, bundu, kuparadzira intravascular coagulation, utachiona uye tishu necrosis zvinogona kutungamirira kune yakakwirira D-dimer.Kunyanya kune vakwegura uye varwere vari muchipatara, nekuda kwebhakitiriya uye zvimwe zvirwere, zviri nyore kukonzera kusagadzikana kweropa coagulation uye kutungamirira kuwedzera D-dimer.

D-dimer inonyanya kuratidza fibrinolytic basa.Kuwedzera kana kunaka kunoonekwa mune yechipiri hyperfibrinolysis, yakadai se hypercoagulable state, yakaparadzira intravascular coagulation, chirwere chetsvo, kurambwa kweorgan transplant, thrombolytic therapy, nezvimwewo. iyo fibrinolytic system (yakadai seDIC, thrombus yakasiyana-siyana) uye zvirwere zvine chokuita nefibrinolytic system (yakadai semamota, pamuviri syndrome), uye kutarisa kwethrombolytic therapy.

Mazinga akakwidziridzwa eD-dimer, chigadzirwa chefibrin degradation, chinoratidza kuderera kwefibrin kakawanda mu vivo.Naizvozvo, fibrous D-dimer chiratidzo chakakosha cheyakadzika vein thrombosis (DVT), pulmonary embolism (PE), yakaparadzirwa intravascular coagulation (DIC).

Zvirwere zvakawanda zvinokonzera kushandiswa kweiyo coagulation system uye / kana fibrinolytic system mumuviri, zvichiita kuti kuwedzera kwehuwandu hweD-dimer, uye kushandiswa uku kunonyatsoenderana nedariro, kuoma uye kurapwa kwechirwere, saka muzvirwere izvi. Kuonekwa kweyero yeD-dimer inogona kushandiswa sechiratidzo chekuongorora chechirwere chetanho, kufungidzira uye kutungamira kwekurapa.

Kushandiswa kweD-dimer mune yakadzika vein thrombosis

Sezvo Wilson et al.Kekutanga kushandisa fibrin degradation zvigadzirwa zvekuongororwa kwepulmonary embolism muna 1971, kuwanikwa kweD-dimer kwaita basa rakakura mukuongororwa kwepulmonary embolism.Nedzimwe nzira dzekuona dzakanyanya kujeka, D-dimer Muviri kukosha ine yakanaka yakashata yekufungidzira mhedzisiro yepulmonary embolism, uye kukosha kwayo i0.99.Mhedzisiro isina kunaka inogona kunyatso bvisa pulmonary embolism, nekudaro ichidzikisa bvunzo dzeinvasive, senge ventilation perfusion scanning uye pulmonary angiography;dzivisa bofu anticoagulation therapy.D - Kusanganiswa kwe dimer kunoenderana nenzvimbo ye thrombus, nepamusoro-soro mumatavi makuru e pulmonary trunk uye kuderera kwakadzika mumatavi maduku.

Negative plasma D-dimers inobvisa mukana weDVT.Angiography yakasimbisa kuti DVT yaive 100% yakanaka kune D-dimer.Inogona kushandiswa thrombolytic therapy uye heparin anticoagulation mushonga kutungamira uye kushanda kwekutarisa.

D-dimer inogona kuratidza shanduko muhukuru hwethrombus.Kana zvinyorwa zvinowedzera zvakare, zvinoratidza kudzoka kwe thrombus;panguva yekurapa, inoramba ichikwira, uye ukuru hwe thrombus hahushanduki, zvichiratidza kuti kurapwa hakubatsiri.