01.Ukuxilongwa kwe-deep vein thrombosis kanye ne-pulmonary embolism

I-Deep vein thrombosis (D-VT) ijwayele ukuba ne-pulmonary embolism (PE), eyaziwa ngokuthi yi-venous thromboembolism (VTE).Amazinga e-Plasma D-dimer aphakeme kakhulu ezigulini ze-VTE.

Ucwaningo oluhlobene lubonise ukuthi i-plasma D-dimer concentration ezigulini ezine-PE ne-D-VT inkulu kune-1 000 μg/L.

Kodwa-ke, ngenxa yezifo eziningi noma ezinye izici ze-pathological (ukuhlinzwa, izimila, izifo zenhliziyo nemithambo yegazi, njll.) zinomthelela othile ku-hemostasis, okuholela ekwandeni kwe-D-dimer.Ngakho-ke, nakuba i-D-dimer inokuzwela okuphezulu, ukucaciswa kwayo ku-50% kuya ku-70% kuphela, futhi i-D-dimer iyodwa ayikwazi ukuxilonga i-VTE.Ngakho-ke, ukwanda okuphawulekayo kwe-D-dimer akukwazi ukusetshenziswa njengenkomba ethile ye-VTE.Ukubaluleka okungokoqobo kokuhlolwa kwe-D-dimer ukuthi umphumela ongemuhle uvimbela ukuxilongwa kwe-VTE.

 

02 Kusatshalaliswe i-intravascular coagulation

I-Disseminated intravascular coagulation (DIC) i-syndrome ye-microthrombosis ejulile emithanjeni emincane kuwo wonke umzimba kanye ne-hyperfibrinolysis yesibili ngaphansi kwesenzo sezici ezithile ze-pathogenic, ezingase zihambisane ne-fibrinolysis yesibili noma i-fibrinolysis evinjelwe.

Okuqukethwe kwe-plasma okuphakeme kwe-D-dimer kunevelu yereferensi ephezulu yomtholampilo yokuxilonga kusenesikhathi kwe-DIC.Kodwa-ke, kufanele kuqashelwe ukuthi ukwanda kwe-D-dimer akuyona isivivinyo esithile se-DIC, kodwa izifo eziningi ezihambisana ne-microthrombosis zingaholela ekwandeni kwe-D-dimer.Lapho i-fibrinolysis ingeyesibili ku-extravascular coagulation, i-D-dimer nayo izokhula.

Ucwaningo lubonise ukuthi i-D-dimer iqala ukukhuphuka ezinsukwini ngaphambi kwe-DIC futhi iphezulu kakhulu kunokujwayelekile.

 

03 I-Neonatal asphyxia

Kunamazinga ahlukene e-hypoxia kanye ne-acidosis ku-asphyxia yengane, futhi i-hypoxia ne-acidosis ingabangela umonakalo omkhulu we-vascular endothelial, okuholela ekukhululweni kwenani elikhulu lezinto zokuhlanganisa, ngaleyo ndlela kwandiswe ukukhiqizwa kwe-fibrinogen.

Ucwaningo olufanele lubonise ukuthi inani le-D-dimer legazi lezintambo eqenjini le-asphyxia liphakeme kakhulu kuneqembu elivamile lokulawula, futhi uma liqhathaniswa nenani le-D-dimer egazini le-peripheral, libuye liphakeme kakhulu.

 

04 I-Systemic lupus erythematosus (SLE)

Uhlelo lwe-coagulation-fibrinolysis aluvamile ezigulini ze-SLE, futhi ukungavamile kwesistimu ye-coagulation-fibrinolysis kubonakala kakhulu esigabeni esisebenzayo sesifo, futhi ukuthambekela kwe-thrombosis kubonakala kakhulu;lapho lesi sifo sikhululiwe, uhlelo lwe-coagulation-fibrinolysis luvame ukujwayelekile.

Ngakho-ke, amazinga e-D-dimer eziguli ezine-systemic lupus erythematosus ezigabeni ezisebenzayo nezingasebenzi azokwanda kakhulu, futhi amazinga e-plasma D-dimer eziguli ezisesigabeni esisebenzayo aphakeme kakhulu kunalawo asesiteji esingasebenzi.

05 I-cirrhosis yesibindi kanye nomdlavuza wesibindi

I-D-dimer ingenye yezimpawu ezibonisa ubunzima besifo sesibindi.Uma isifo sesibindi sinzima kakhulu, izinga le-plasma D-dimer liphezulu.

Ucwaningo olufanelekile lubonise ukuthi amanani e-D-dimer e-Child-Pugh A, B, kanye ne-C ezigulini ezine-cirrhosis yesibindi ayengu-(2.218 ± 0.54) μg/mL, (6.03 ± 0.76) μg/mL, kanye (10.536 ± 0.664) μg/mL, ngokulandelana..

Ngaphezu kwalokho, i-D-dimer yaphakanyiswa kakhulu ezigulini ezinomdlavuza wesibindi ngokuqhubekela phambili okusheshayo kanye nokubikezela okubi.

06 Umdlavuza wesisu

Ngemuva kokuhlinzwa kweziguli ezinomdlavuza, i-thromboembolism yenzeka cishe engxenyeni yeziguli, kanti i-D-dimer yanda kakhulu ku-90% yeziguli.

Ngaphezu kwalokho, kukhona ikilasi lezinto ezinoshukela ophezulu kumaseli wesimila ukwakheka kwawo kanye nesici sethishu sifana kakhulu.Ukubamba iqhaza emisebenzini ye-metabolism yabantu kungakhuthaza umsebenzi wesistimu ye-coagulation yomzimba futhi kwandise ingozi ye-thrombosis, futhi izinga le-D-dimer landa kakhulu.Futhi izinga le-D-dimer ezigulini zomdlavuza wesisu ezinesiteji III-IV laliphakeme kakhulu kunalelo ezigulini ezinomdlavuza wesisu ezinesigaba I-II.

 

07 I-Mycoplasma pneumonia (MMP)

I-MPP eqinile ivamise ukuhambisana namazinga aphakeme e-D-dimer, futhi amazinga e-D-dimer aphezulu kakhulu ezigulini ezine-MPP enzima kunasezimeni ezithambile.

Lapho i-MPP igula kakhulu, i-hypoxia, ischemia kanye ne-acidosis izokwenzeka endaweni, kuhlanganiswe nokuhlasela okuqondile kwamagciwane, okuzolimaza amangqamuzana e-vascular endothelial, adalule i-collagen, enze kusebenze uhlelo lwe-coagulation, enze isimo se-hypercoagulable, futhi enze i-microthrombi.I-fibrinolytic yangaphakathi, i-kinin kanye nezinhlelo ezihambisanayo nazo zenziwa zisebenze ngokulandelana, okuholela ekwandeni kwamazinga e-D-dimer.

 

08 Isifo sikashukela, isifo sikashukela

Amazinga e-D-dimer anyuswe kakhulu ezigulini ezinesifo sikashukela kanye ne-nephropathy yesifo sikashukela.

Ngaphezu kwalokho, izinkomba ze-D-dimer ne-fibrinogen zeziguli ezine-nephropathy yesifo sikashukela zaziphakeme kakhulu kuneziguli zesifo sikashukela sohlobo 2.Ngakho-ke, ekusebenzeni komtholampilo, i-D-dimer ingasetshenziswa njengenkomba yokuhlola yokuxilonga ukuqina kwesifo sikashukela nesifo sezinso ezigulini.

09 I-Allergic Purpura (AP)

Esigabeni esibucayi se-AP, kunamazinga ahlukene e-hypercoagulability yegazi kanye nokusebenza okuthuthukisiwe kweplatelet, okuholela ku-vasospasm, ukuhlangana kweplatelet kanye ne-thrombosis.

I-D-dimer ephakeme ezinganeni ezine-AP ivamile ngemva kwamaviki angu-2 okuqala futhi iyahlukahluka phakathi kwezigaba zomtholampilo, okubonisa izinga nezinga lokuvuvukala kwemithambo ye-systemic.

Ngaphezu kwalokho, futhi kuyinkomba yokubikezela, enamazinga aphezulu e-D-dimer aqhubekayo, lesi sifo sivame ukunwetshwa futhi sithambekele ekulimaleni kwezinso.

 

10 Ukukhulelwa

Ucwaningo oluhlobene luye lwabonisa ukuthi cishe amaphesenti angu-10 abesifazane abakhulelwe baye baphakamisa kakhulu amazinga e-D-dimer, okuphakamisa ingozi yamahlule egazi.

I-Preeclampsia iyinkinga evamile yokukhulelwa.Izinguquko eziyinhloko ze-pathological ze-preeclampsia ne-eclampsia ukuvuthwa kwe-coagulation kanye nokuthuthukiswa kwe-fibrinolysis, okuholela ekwandeni kwe-microvascular thrombosis kanye ne-D-dimer.

I-D-dimer yehla ngokushesha ngemva kokubeletha kwabesifazane abavamile, kodwa yanda kwabesifazane abane-preeclampsia, futhi ayizange ibuyele kokujwayelekile kwaze kwaba ngamaviki angu-4 kuya kwangu-6.

11 I-Acute Coronary Syndrome kanye ne-Dissecting Aneurysm

Iziguli ezine-acute coronary syndromes zinamazinga avamile noma aphakeme kuphela e-D-dimer, kuyilapho i-aortic dissecting aneurysms iphakeme ngokuphawulekayo.

Lokhu kuhlobene nomehluko obalulekile kumthwalo we-thrombus emithanjeni ye-arterial kokubili.I-coronary lumen incane futhi i-thrombus kumthambo we-coronary incane.Ngemuva kokuphuka kwe-aortic intima, inani elikhulu legazi le-arterial lingena odongeni lomkhumbi ukuze lenze i-aneurysm ehlukanisayo.Inani elikhulu le-thrombi lakhiwa ngaphansi kwesenzo se-coagulation mechanism.

12 I-acute cerebral infarction

Ku-acute cerebral infarction, i-thrombolysis ezenzakalelayo kanye nomsebenzi wesibili we-fibrinolytic uyakhuphuka, obonakaliswa njengokukhuphuka kwamazinga e-plasma D-dimer.Izinga le-D-dimer lenyuke kakhulu esigabeni sokuqala se-acute cerebral infarction.

Amazinga e-Plasma D-dimer ezigulini ezine-acute ischemic stroke anyuswe kancane ngesonto lokuqala ngemuva kokuqala, akhuphuka kakhulu kumaviki angu-2 kuya kwangu-4, futhi ayengafani namazinga avamile ngesikhathi sokutakula (> izinyanga ezingu-3).