Kungabonakala ukuthi i-D-Dimer inokubaluleka kokuqapha okuhlobene nenkinga ekuqhubekeleni phambili kwe-COVID-19, ngakho-ke idlala kanjani indima kwezinye izifo?

1. I-venous thromboembolism

I-D-Dimer isetshenziswe kabanzi ezifweni ezihlobene ne-venous thromboembolism (VTE), njenge-deep vein thrombosis (DVT) kanye ne-pulmonary embolism (PE).Ukuhlola okunegethivu kwe-D-Dimer kungakhipha i-DVT, futhi ukugxiliswa kwe-D-Dimer nakho kungasetshenziswa ukubikezela izinga lokuphinda kwe-VTE.Ucwaningo luthole ukuthi isilinganiso sengozi yokuphindaphinda kwe-VTE kubantu abanokugxila okuphezulu sasiphindwe izikhathi ezingu-4.1 kunesibalo sabantu esinokugxila okuvamile.

I-D-Dimer futhi ingesinye sezinkomba zokutholwa kwe-PE.Inani layo elibi lokubikezela liphezulu kakhulu, futhi ukubaluleka kwalo ukukhipha i-acute pulmonary embolism, ikakhulukazi ezigulini ezinokusola okuncane.Ngakho-ke, ezigulini ezisolwa ukuthi zine-acute pulmonary embolism, i-ultrasound ye-veins ejulile yamaphethelo aphansi kanye nokuhlolwa kwe-D-Dimer kufanele kuhlanganiswe.

2. Ukuhlanganiswa kwe-intravascular coagulation

I-Disseminated intravascular coagulation (DIC) yisifo somtholampilo esibonakala ngokuphuma kwegazi kanye nokwehluleka kwe-microcirculatory ngesisekelo sezifo eziningi.Inqubo yokuthuthukisa ihilela amasistimu amaningi afana ne-coagulation, i-anticoagulation, ne-fibrinolysis.I-D-Dimer yanda esigabeni sokuqala sokubunjwa kwe-DIC, futhi ukugxila kwayo kwaqhubeka nokwandisa izikhathi ezingaphezu kwezingu-10 njengoba isifo siqhubeka.Ngakho-ke, i-D-Dimer ingasetshenziswa njengenye yezinkomba eziyinhloko zokuxilongwa kusenesikhathi kanye nokuqapha isimo se-DIC.

3. Ukuhlukaniswa kwe-aortic

"Ukuvumelana kochwepheshe baseShayina mayelana nokuxilongwa nokwelashwa kwe-aorta dissection" yabonisa ukuthi i-D-Dimer, njengokuhlolwa kwelabhorethri evamile ye-aortic dissection (AD), ibaluleke kakhulu ekuxilongweni nasekuxilongeni okuhlukile kokuhlakazeka.Lapho i-D-Dimer yesiguli ikhuphuka ngokushesha, amathuba okuba kutholakale ukuthi i-AD ayanda.Phakathi namahora angu-24 okuqala, lapho i-D-Dimer ifinyelela inani elibalulekile lika-500 µg/L, ukuzwela kwayo ekuxilongeni i-AD eyingozi ingu-100%, futhi ukucaciswa kwayo kungama-67%, ngakho ingasetshenziswa njengenkomba yokungabandakanyi ekuxilongeni Acute AD.

4. I-Atherosclerotic Cardiovascular Disease

I-Atherosclerotic cardiovascular disease yisifo senhliziyo esibangelwa uqweqwe lwe-arteriosclerotic, okuhlanganisa i-ST-segment elevation acute myocardial infarction, non-ST-segment elevation acute myocardial infarction, kanye ne-angina engazinzile.Ngemva kokugqabuka kwe-plaque, i-necrotic core material ku-plaque iyaphuma, ibangele izingxenye zokugeleza kwegazi okungavamile, ukusebenza kwesistimu yokuhlangana, kanye nokukhula kwe-D-Dimer.Iziguli ze-Coronary heart disease ezine-D-Dimer ephakeme zingase zibikezele ingozi ephakeme ye-AMI futhi ingasetshenziswa njengenkomba yokubona isimo se-ACS.

5. Ukwelashwa kwe-thrombolytic

Ucwaningo luka-Lawter lwathola ukuthi imithi ehlukahlukene ye-thrombolytic ingakhuphula i-D-Dimer, futhi izinguquko zayo zokugxila ngaphambi nangemva kwe-thrombolysis zingasetshenziswa njengenkomba yokwahlulela ukwelashwa kwe-thrombolytic.Okuqukethwe kwayo kwanda ngokushesha kwafinyelela inani eliphakeme ngemva kwe-thrombolysis, futhi yabuyela emuva ngesikhathi esifushane ngokuthuthuka okuphawulekayo kwezimpawu zomtholampilo, okubonisa ukuthi ukwelashwa kwakuphumelela.

Izinga le-D-Dimer lenyuke kakhulu ihora eli-1 kuye kwayi-6 ngemuva kwe-thrombolysis ye-acute myocardial infarction kanye ne-cerebral infarction.
- Ngesikhathi se-DVT thrombolysis, ukuphakama kwe-D-Dimer ngokuvamile kwenzeka amahora angu-24 noma kamuva