01.Ukuxilongwa kwe-thrombosis ye-vein deep kunye ne-pulmonary embolism

I-Deep vein thrombosis (D-VT) ithande ukuba ne-pulmonary embolism (PE), eyaziwa ngokuba yi-venous thromboembolism (VTE).Amanqanaba e-Plasma D-dimer aphakanyiswe kakhulu kwizigulane ze-VTE.

Izifundo ezihambelanayo zibonise ukuba i-plasma D-dimer concentration kwizigulane ezine-PE kunye ne-D-VT inkulu kune-1 000 μg / L.

Nangona kunjalo, ngenxa yezifo ezininzi okanye ezinye izinto ze-pathological (utyando, amathumba, izifo zentliziyo, njl.) zinefuthe elithile kwi-hemostasis, okubangela ukunyuka kwe-D-dimer.Ngoko ke, nangona i-D-dimer inovakalelo oluphezulu, ukuchaneka kwayo kuphela yi-50% ukuya kwi-70%, kwaye i-D-dimer iyodwa ayikwazi ukuxilonga i-VTE.Ngoko ke, ukunyuka okukhulu kwe-D-dimer akukwazi ukusetyenziswa njengesalathisi esithile se-VTE.Ukubaluleka okusebenzayo kovavanyo lwe-D-dimer kukuba isiphumo esibi sithintela ukuxilongwa kwe-VTE.

 

02 Ukusasazwa kwe-intravascular coagulation

Ukusabalalisa i-intravascular coagulation (DIC) yi-syndrome ye-microthrombosis ebanzi kwiinqanawa ezincinci kuwo wonke umzimba kunye ne-hyperfibrinolysis yesibini phantsi kwesenzo sezinto ezithile ze-pathogenic, ezinokuhamba kunye ne-fibrinolysis yesibini okanye i-fibrinolysis evinjelwe.

Umxholo ophakamileyo weplasma we-D-dimer unexabiso eliphezulu lokubhekisela kwikliniki yokuxilongwa kwangaphambili kwe-DIC.Nangona kunjalo, kufuneka kuqatshelwe ukuba ukunyuka kwe-D-dimer akulona uvavanyo oluthile lwe-DIC, kodwa izifo ezininzi ezihamba ne-microthrombosis zingakhokelela ekwandeni kwe-D-dimer.Xa i-fibrinolysis ingeyesibini kwi-coagulation ye-extravascular, i-D-dimer nayo iya kwanda.

Uphononongo lubonise ukuba i-D-dimer iqala ukunyuka kwiintsuku ngaphambi kwe-DIC kwaye iphezulu kakhulu kunesiqhelo.

 

03 I-Neonatal asphyxia

Kukho amanqanaba ahlukeneyo e-hypoxia kunye ne-acidosis kwi-asphyxia ye-neonatal, kunye ne-hypoxia kunye ne-acidosis inokubangela umonakalo omkhulu we-vascular endothelial, okukhokelela ekukhululweni kwezinto ezininzi zokudibanisa, ngaloo ndlela ukwandisa ukuveliswa kwe-fibrinogen.

Izifundo ezifanelekileyo zibonise ukuba ixabiso le-D-dimer legazi lentambo kwiqela le-asphyxia liphezulu kakhulu kuneqela eliqhelekileyo lokulawula, kwaye xa kuthelekiswa nexabiso le-D-dimer kwigazi le-peripheral, liphezulu kakhulu.

 

04 Systemic lupus erythematosus (SLE)

Inkqubo ye-coagulation-fibrinolysis ayiqhelekanga kwizigulane ze-SLE, kwaye ukungaqhelekanga kwenkqubo ye-coagulation-fibrinolysis ibonakala ngakumbi kwinqanaba elisebenzayo lesi sifo, kwaye ukuthambekela kwe-thrombosis kubonakala ngakumbi;xa isifo siphelile, inkqubo ye-coagulation-fibrinolysis ithande ukuba yinto eqhelekileyo.

Ngoko ke, amanqanaba e-D-dimer yezigulane ezine-systemic lupus erythematosus kwizigaba ezisebenzayo nezingasebenziyo ziya kwandiswa kakhulu, kwaye amanqanaba e-plasma ye-D-dimer yezigulane kwinqanaba elisebenzayo liphezulu kakhulu kunalawo akwinqanaba elingasebenziyo.

05 Ukuqina kwesibindi kunye nomhlaza wesibindi

I-D-dimer yenye yeempawu ezibonisa ubunzima besifo sesibindi.Ubunzima besifo sesibindi, i-plasma D-dimer content iphezulu.

Uphononongo olufanelekileyo lubonise ukuba amaxabiso eD-dimer kuMntwana-Pugh A, B, kunye namabanga C kwizigulane ezine-cirrhosis yesibindi (2.218 ± 0.54) μg/mL, (6.03 ± 0.76) μg/mL, kunye (10.536 ± ± 0.76). 0.664) μg/mL, ngokulandelanayo..

Ukongezelela, i-D-dimer yayiphakanyiswe kakhulu kwizigulane ezinomhlaza wesibindi kunye nokuqhubela phambili ngokukhawuleza kunye nokugula okubi.

06 Umhlaza wesisu

Emva kokutshatyalaliswa kwezigulane zomhlaza, i-thromboembolism iyenzeka malunga nesiqingatha sezigulane, kwaye i-D-dimer inyuke kakhulu kwi-90% yezigulane.

Ukongeza, kukho iklasi yezinto ezineswekile ephezulu kwiiseli zethumba elinolwakhiwo kunye nomgangatho wethishu zifana kakhulu.Ukuthatha inxaxheba kwimisebenzi ye-metabolism yabantu kunokukhuthaza umsebenzi we-coagulation system yomzimba kunye nokwandisa umngcipheko we-thrombosis, kwaye inqanaba le-D-dimer landa kakhulu.Kwaye inqanaba le-D-dimer kwizigulane zomhlaza wesisu kunye nenqanaba le-III-IV laliphezulu kakhulu kunelo kwizigulane zomhlaza wesisu kunye nesigaba I-II.

 

07 Inyumoniya yeMycoplasma (MMP)

I-MPP enzima ihlala ihamba kunye namanqanaba aphezulu e-D-dimer, kwaye amanqanaba e-D-dimer aphezulu kakhulu kwizigulane ezine-MPP enzima kunezimo ezincinci.

Xa i-MPP igula kakhulu, i-hypoxia, ischemia kunye ne-acidosis iya kwenzeka kwindawo, idibene nokuhlasela ngokuthe ngqo kwe-pathogens, eya konakalisa iiseli ze-vascular endothelial, iveze i-collagen, isebenze inkqubo ye-coagulation, yenza i-hypercoagulable state, kunye ne-microthrombi.I-fibrinolytic yangaphakathi, i-kinin kunye neenkqubo zokuncedisana nazo zenziwe zisebenze ngokulandelelana, okukhokelela ekunyuseni kwamanqanaba e-D-dimer.

 

08 Isifo seswekile, isifo seswekile

Amanqanaba e-D-dimer aphakanyiswe kakhulu kwizigulane ezine-diabetes kunye ne-nephropathy yesifo sikashukela.

Ukongezelela, i-D-dimer kunye ne-fibrinogen indexes yezigulane ezine-nephropathy yesifo sikashukela zaziphezulu kakhulu kunezo zezigulane ze-2 zeswekile.Ke ngoko, ekusebenzeni kweklinikhi, i-D-dimer ingasetyenziswa njengesalathiso sokuvavanya ukufumanisa ubunzima besifo sikashukela kunye nesifo sezintso kwizigulane.

09 I-Alergic Purpura (AP)

Kwinqanaba elibukhali le-AP, kukho amanqanaba ahlukeneyo e-hypercoagulability yegazi kunye nokusebenza kweplatelet ephuculweyo, ekhokelela kwi-vasospasm, i-platelet aggregation kunye ne-thrombosis.

I-D-dimer ephakamileyo kubantwana abane-AP ixhaphake emva kweeveki ezi-2 zokuqala kwaye iyahluka phakathi kwezigaba zeklinikhi, ebonisa ubungakanani kunye neqondo lokudumba kwe-vascular systemic.

Ukongeza, ikwaluphawu lwe-prognostic, kunye namanqanaba aphezulu aqhubekayo e-D-dimer, isifo sihlala sithatha ixesha elide kwaye sithambekele kumonakalo wezintso.

 

10 Ukukhulelwa

Uphononongo olunxulumeneyo lubonise ukuba malunga ne-10% yabasetyhini abakhulelweyo baye baphakamisa kakhulu amanqanaba e-D-dimer, ebonisa umngcipheko wegazi.

I-Preeclampsia yingxaki eqhelekileyo yokukhulelwa.Utshintsho oluphambili lwe-pathological ye-preeclampsia kunye ne-eclampsia yi-coagulation activation kunye nokuphucula i-fibrinolysis, okubangelwa ukunyuka kwe-microvascular thrombosis kunye ne-D-dimer.

I-D-dimer yehla ngokukhawuleza emva kokunikezelwa kwabasetyhini abaqhelekileyo, kodwa yanda kubasetyhini abane-preeclampsia, kwaye ayizange ibuyele kwisiqhelo ukuya kwiiveki ezi-4 ukuya kwezi-6.

I-11 ye-Acute Coronary Syndrome kunye ne-Dissecting Aneurysm

Izigulane ezine-acute coronary syndromes zinamanqanaba aqhelekileyo okanye aphakamileyo aphakamileyo e-D-dimer, ngelixa i-aortic dissecting aneurysms iphakanyiswe ngokuphawulekayo.

Oku kuhambelana nokwahlukana okuphawulekayo kumthwalo we-thrombus kwiinqanawa ze-arterial ezimbini.I-coronary lumen incinci kwaye i-thrombus kwi-coronary artery incinci.Emva kokuqhekeka kwe-aortic intima, isixa esikhulu segazi le-arterial singena eludongeni lwenqanawa ukwenza i-aneurysm yokukhupha.Inani elikhulu le-thrombi lenziwa phantsi kwesenzo se-coagulation mechanism.

12 I-acute cerebral infarction

Kwi-acute cerebral infarction, i-thrombolysis ezenzekelayo kunye nomsebenzi wesibini we-fibrinolytic yanda, ibonakaliswe njengokwandiswa kwamanqanaba e-plasma D-dimer.Inqanaba le-D-dimer linyuswe kakhulu kwinqanaba lokuqala le-acute cerebral infarction.

Amanqanaba e-Plasma D-dimer kwizigulane ezine-acute ischemic stroke yanda kancinci kwiveki yokuqala emva kokuqala, yanda kakhulu kwii-2 kwiiveki ze-4, kwaye yayingahlukanga kumanqanaba aqhelekileyo ngexesha lokubuyisela (> iinyanga ze-3).