I-D-dimer idla ngokusetyenziswa njengenye yezalathi ezibalulekileyo ezikrokrelekayo ze-PTE kunye ne-DVT kuqeqesho lwezonyango.Yenzeka njani?

I-Plasma D-dimer yimveliso ethile yokuthotywa kwemveliso eveliswa yi-plasmin hydrolysis emva kokuba i-fibrin monomer idityaniswe ngokunqamlezileyo yi-activating factor XIII.Luphawu oluthile lwenkqubo ye-fibrinolysis.I-D-dimers ithathwe kwi-cross-linked fibrin clots lysed by plasmin.Ngethuba nje kukho i-thrombosis esebenzayo kunye nomsebenzi we-fibrinolytic kwimithambo yegazi yomzimba, i-D-dimer iya kwanda.I-Myocardial infarction, i-cerebral infarction, i-pulmonary embolism, i-thrombosis ye-venous, utyando, i-tumor, ukusabalalisa i-intravascular coagulation, usulelo kunye ne-necrosis yezicubu kunokukhokelela kwi-D-dimer ephakamileyo.Ngokukodwa kubantu abadala kunye nezigulane ezibhedlele, ngenxa ye-bacteremia kunye nezinye izifo, kulula ukubangela ukudibanisa kwegazi okungaqhelekanga kwaye kukhokelela ekwandeni kwe-D-dimer.

I-D-dimer ikakhulu ibonisa umsebenzi we-fibrinolytic.Ukunyuka okanye okulungileyo kubonakala kwi-hyperfibrinolysis yesibini, efana ne-hypercoagulable state, i-intravascular coagulation, isifo sezintso, ukwaliwa kwe-organ transplant, unyango lwe-thrombolytic, njl njl. inkqubo ye-fibrinolytic (njenge-DIC, i-thrombus eyahlukeneyo) kunye nezifo ezinxulumene nenkqubo ye-fibrinolytic (njenge-tumor, ukukhulelwa kwesifo), kunye nokubeka iliso kwi-thrombolytic therapy.

Amanqanaba aphakamileyo e-D-dimer, imveliso yokuthotywa kwefibrin, ibonisa ukuthotywa rhoqo kwe-fibrin kwi-vivo.Ngoko ke, i-fibrous D-dimer isalathiso esibalulekileyo se-deep vein thrombosis (DVT), i-pulmonary embolism (PE), i-disseminated intravascular coagulation (DIC).

Izifo ezininzi zibangela ukuba kusebenze inkqubo ye-coagulation kunye / okanye inkqubo ye-fibrinolytic emzimbeni, okukhokelela ekunyuseni kwinqanaba le-D-dimer, kwaye oku kusebenze kuhambelana ngokusondeleyo nenqanaba, ubunzima kunye nokunyangwa kwesi sifo, ngoko ke kwezi zifo. Ukufunyaniswa kwenqanaba le-D-dimer kungasetyenziswa njengophawu lovavanyo lwenqanaba lesifo, ukuxela kwangaphambili kunye nesikhokelo sonyango.

Ukusetyenziswa kwe-D-dimer kwi-thrombosis ye-vein deep

Ekubeni uWilson et al.okokuqala ukusetyenziswa kwemveliso ye-fibrin yokuthotywa kokuxilongwa kwe-pulmonary embolism ngo-1971, ukufunyanwa kwe-D-dimer kuye kwadlala indima enkulu ekuxilongweni kwe-pulmonary embolism.Ngeendlela ezithile zokubona uvakalelo oluphezulu, ixabiso le-D-dimer loMzimba elibi linesiphumo esifanelekileyo sokuxela kwangaphambili kwi-pulmonary embolism, kwaye ixabiso layo yi-0.99.Isiphumo esibi sinokuyikhupha i-pulmonary embolism, ngaloo ndlela inciphisa iimviwo ezihlaselayo, ezifana ne-ventilation perfusion scanning kunye ne-pulmonary angiography;gwema unyango lwe-anticoagulation oluyimfama.D - Ukuxinwa kwe-dimer kuhambelana nendawo ye-thrombus, kunye noxinzelelo oluphezulu kumasebe amakhulu e-trunk ye-pulmonary kunye nokugxila okuphantsi kumasebe amancinci.

I-Plasma engalunganga i-D-dimers ilawula ukuba nokwenzeka kwe-DVT.I-Angiography iqinisekisile ukuba i-DVT yayiyi-100% elungileyo kwi-D-dimer.Ingasetyenziselwa unyango lwe-thrombolytic kunye ne-heparin anticoagulation isikhokelo samayeza kunye nokuqwalaselwa ngempumelelo.

I-D-dimer ingabonakalisa utshintsho kwisayizi ye-thrombus.Ukuba umxholo uyanda kwakhona, ubonisa ukuphindaphinda kwe-thrombus;ngexesha lonyango, liqhubeka liphezulu, kwaye ubukhulu be-thrombus abutshintshi, bubonisa ukuba unyango alusebenzi.