Kutheni iityhubhu zeserum nazo zingasetyenziselwa ukubona umxholo we-D-dimer?Kuya kubakho i-fibrin clot formation kwi-tube ye-serum, ngaba ayiyi kuthotywa ibe yi-D-dimer?Ukuba ayithobi, kutheni kukho ukwanda okukhulu kwe-D-dimer xa amahlule egazi enziwa kwi-tube ye-anticoagulation ngenxa yesampula yegazi elibi kwiimvavanyo ze-coagulation?
Okokuqala, ukuqokelela kwegazi okungahambi kakuhle kunokukhokelela kumonakalo we-vascular endothelial, kunye nokukhululwa kwe-subendothelial tissue factor kunye ne-tissue-type plasminogen activator (tPA) egazini.Kwelinye icala, i-tissue factor ivula indlela ye-exogenous coagulation ukwenza amahlwili e-fibrin.Le nkqubo ikhawuleza kakhulu.Jonga nje ixesha prothrombin (PT) ukwazi, leyo ngokubanzi malunga 10 imizuzwana.Ngakolunye uhlangothi, emva kokuba i-fibrin yenziwe, isebenza njenge-cofactor yokwandisa umsebenzi we-tPA ngamaxesha angama-100, kwaye emva kokuba i-tPA ifakwe kwindawo ye-fibrin, ayiyi kuphinda ivinjwe lula yi-plasminogen activation inhibitor-1 ( PAI-1).Ngoko ke, i-plasminogen inokuguqulwa ngokukhawuleza kwaye ngokuqhubekayo ibe yi-plasmin, kwaye ke i-fibrin inokuthotywa, kwaye inani elikhulu le-FDP kunye ne-D-Dimer inokuveliswa.Esi seso sizathu sokuba ukwenziwa kwamahlwili egazi kwi-vitro kunye neemveliso zokuthotywa kwefibrin zonyuswe kakhulu ngenxa yokungathathwa kakuhle kwesampulu yegazi.
Emva koko, kutheni iqoqo eliqhelekileyo letyhubhu ye-serum (ngaphandle kwezongezo okanye nge-coagulant) imizekelo nayo yenza i-fibrin clots in vitro, kodwa ayizange ithobe ukuvelisa inani elikhulu le-FDP kunye ne-D-dimer?Oku kuxhomekeke kwityhubhu ye-serum.Kwenzeka ntoni emva kokuba isampuli iqokelelwe: Okokuqala, akukho xabiso elikhulu le-tPA elingena egazini;okwesibini, nokuba inani elincinci le-tPA lingena egazini, i-tPA yamahhala iya kubotshwa yi-PAI-1 kwaye ilahlekelwe ngumsebenzi wayo malunga nemizuzu emi-5 ngaphambi kokuba ifake kwi-fibrin.Ngeli xesha, kaninzi akukho kwakheka kwe-fibrin kwi-tube ye-serum ngaphandle kwezongezo okanye nge-coagulant.Kuthatha ngaphezu kwemizuzu elishumi ukuba igazi ngaphandle kwezongezo lidibanise ngokwemvelo, ngelixa igazi eline-coagulant (ngokuqhelekileyo i-silicon powder) iqala ngaphakathi.Kwakhona kuthatha ngaphezu kwemizuzu emi-5 ukwenza i-fibrin kwi-coagulation pathway yegazi.Ukongeza, umsebenzi we-fibrinolytic kwiqondo lobushushu begumbi kwi-vitro nawo uya kuchaphazeleka.
Makhe sithethe nge-thromboelastogram kwakhona kunye nesi sihloko: unokuqonda ukuba ihlwili legazi kwi-tube ye-serum ayithotywanga ngokulula, kwaye unokuqonda ukuba kutheni uvavanyo lwe-thromboelastogram (TEG) alukhathaleli ukubonisa i-hyperfibrinolysis-zombini iimeko Kuyafana, kunjalo, iqondo lobushushu ngexesha uvavanyo TEG zingagcinwa 37 degrees.Ukuba i-TEG inovakalelo ngakumbi ekuboniseni isimo se-fibrinolysis, enye indlela yokongeza i-tPA kwi-in vitro TEG yokulinga, kodwa kusekho iingxaki zokulinganisa kwaye akukho sicelo siphela;Ukongeza, inokulinganiswa ecaleni kwebhedi ngokukhawuleza emva kokuthatha isampuli, kodwa umphumo wangempela nawo ulinganiselwe kakhulu.Uvavanyo lwendabuko kunye nolusebenzayo ngakumbi lokuvavanya umsebenzi we-fibrinolytic lixesha lokuchithwa kwe-euglobulin.Isizathu sovakalelo lwayo luphezulu kunelo lwe-TEG.Kuvavanyo, i-anti-plasmin isuswa ngokulungelelanisa ixabiso le-pH kunye ne-centrifugation, kodwa uvavanyo ludla Kuthatha ixesha elide kwaye kunqabile, kwaye kunqabile ukuba kuqhutywe kwiibhubhoratri.
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