Ngaphantsi kweemeko ze-physiological, iinkqubo ezimbini ze-blood coagulation kunye ne-anticoagulation emzimbeni zigcina ibhalansi eguquguqukayo ukugcina igazi lihamba kwimithambo yegazi.Ukuba ibhalansi ayilingani, inkqubo ye-anticoagulation iyona nto iphambili kwaye ukuthambekela kokuphuma kwegazi kulungele ukwenzeka, kwaye inkqubo ye-coagulation ibaluleke kakhulu kwaye i-thrombosis iyenzeka.Inkqubo ye-fibrinolysis idlala indima ebalulekileyo kwi-thrombolysis.Namhlanje siza kuthetha ngezinye izibonakaliso ezimbini zenkqubo ye-fibrinolysis, i-D-dimer kunye ne-FDP, ukuqonda ngokupheleleyo i-hemostasis eyenziwa yi-thrombin kwi-thrombus eqaliswe yi-fibrinolysis.Indaleko.Ukubonelela ngolwazi olusisiseko lweklinikhi malunga ne-thrombosis yezigulane kunye nomsebenzi we-coagulation.
I-D-dimer yimveliso ethile yokuthotywa eveliswa yi-fibrin monomer cross-linked by activated factor XIII kwaye emva koko i-hydrolyzed yi-plasmin.I-D-dimer ivela kwi-clot ye-fibrin edibeneyo edibeneyo echithwa yi-plasmin.I-D-dimer ephakamileyo ibonisa ubukho be-hyperfibrinolysis yesibini (njenge-DIC).I-FDP ligama eliqhelekileyo leemveliso zokuthotywa eziveliswe emva kokuba i-fibrin okanye i-fibrinogen idilizwe phantsi kwesenzo se-plasmin eveliswa ngexesha le-hyperfibrinolysis.I-FDP ibandakanya i-fibrinogen (i-Fg) kunye ne-fibrin monomer (i-FM) iimveliso (i-FgDPs), kunye neemveliso zokunciphisa i-fibrin edibeneyo (i-FbDPs), phakathi kwazo i-FbDPs ziquka i-D-dimers kunye nezinye iziqwenga, kwaye amanqanaba abo anyuka aphezulu abonisa ukuba umzimba umsebenzi we-fibrinolytic uyasebenza kakhulu (i-fibrinolysis yokuqala okanye i-fibrinolysis yesibini)
【Umzekelo】
Indoda eneminyaka ephakathi yangeniswa esibhedlele kwaye iziphumo zokuxilonga igazi zaba ngolu hlobo lulandelayo:
Into | Isiphumo | Uluhlu lweeReferensi |
PT | 13.2 | 10-14s |
I-APTT | 28.7 | 22-32s |
TT | 15.4 | 14-21s |
I-FIB | 3.2 | 1.8-3.5g/l |
DD | 40.82 | 0-0.55mg/I FEU |
FDP | 3.8 | 0-5mg/l |
AT-III | 112 | 75-125% |
Izinto ezine ze-coagulation zazingalunganga, i-D-dimer yayilungile, kwaye i-FDP yayingalunganga, kwaye iziphumo zaziphikisana.Ekuqaleni kwakurhanelwa ukuba yimpembelelo ye-hook, isampuli yaphinda yavavanywa ngokutsha yi-multiple kunye ne-1: uvavanyo lokuhlanjululwa kwe-1:10, umphumo waba ngolu hlobo lulandelayo:
Into | Eyoqobo | 1:10 ukuhlanjululwa | Uluhlu lweeReferensi |
DD | 38.45 | 11.12 | 0-0.55mg/I FEU |
FDP | 3.4 | Ngaphantsi komda osezantsi | 0-5mg/l |
Inokubonwa kwi-dilution ukuba umphumo we-FDP kufuneka ube yinto eqhelekileyo, kwaye i-D-dimer ayikho i-linear emva kokuhlanjululwa, kwaye ukuphazamiseka kuyakrokrelwa.Kungabandakanyi i-hemolysis, i-lipemia, kunye ne-jaundice kwimeko yesampuli.Ngenxa yeziphumo ezingalinganiyo zokuhlanjululwa, iimeko ezinjalo zinokuthi zenzeke kukuphazamiseka okuqhelekileyo kunye ne-heterophilic antibodies okanye i-rheumatoid factor.Jonga imbali yonyango yesigulane kwaye ufumane imbali ye-rheumatoid arthritis.ILabhoratri Iziphumo zovavanyo lwe-RF factor beziphezulu kakhulu.Emva kokunxibelelana neklinikhi, isigulane saphawulwa kwaye sakhupha ingxelo.Ekulandeleni kamva, isigulane sasingenazo iimpawu ezinxulumene ne-thrombus kwaye yagwetywa njengemeko yobuxoki ye-D-dimer.
【shwankathela】
I-D-dimer yisalathisi esibalulekileyo sokukhutshwa kakubi kwe-thrombosis.Inovakalelo oluphezulu, kodwa ukuchaneka okuhambelanayo kuya kuba buthathaka.Kukwakho nomlinganiselo othile wobuxoki.Ukudityaniswa kwe-D-dimer kunye ne-FDP kunokunciphisa inxalenye ye-D- Nge-positive yobuxoki ye-dimer, xa isiphumo sebhubhoratri sibonisa ukuba i-D-dimer ≥ FDP, ezi zigwebo zilandelayo zingenziwa kwisiphumo sovavanyo:
1. Ukuba amaxabiso aphantsi (
2. Ukuba umphumo lixabiso eliphezulu (>Ixabiso lokusika), hlalutya izinto ezichaphazelayo, kunokubakho izinto eziphazamisayo.Kucetyiswa ukwenza uvavanyo lwe-dilution emininzi.Ukuba isiphumo singqamene, i-positive yokwenyani inokwenzeka ngakumbi.Ukuba ayingomgca, iimpawu zobuxoki.Ungasebenzisa kwakhona i-reagent yesibini yokuqinisekisa kwaye unxibelelane nekliniki ngexesha.