Kungani amashubhu e-serum engasetshenziswa futhi ukuthola okuqukethwe kwe-D-dimer?Kuzoba khona ukwakheka kwehlule le-fibrin kushubhu le-serum, ngeke yini lehliswe libe yi-D-dimer?Uma ingehlisi, kungani kunokwanda okuphawulekayo kwe-D-dimer lapho amahlule egazi akheka eshubhuni le-anticoagulation ngenxa yesampula yegazi eliphansi ukuze kuhlolwe ukuhlolwa kwe-coagulation?
Okokuqala, ukuqoqwa kwegazi okungalungile kungaholela ekulimaleni kwe-vascular endothelial, kanye nokukhululwa kwe-subendothelial tissue factor kanye ne-tissue-type plasminogen activator (tPA) egazini.Ngakolunye uhlangothi, i-tissue factor ivula indlela ye-exogenous coagulation ukuze ikhiqize amahlule e-fibrin.Le nqubo ishesha kakhulu.Bheka nje isikhathi se-prothrombin (PT) ukuze wazi, ngokuvamile esingamasekhondi angu-10.Ngakolunye uhlangothi, ngemva kokwakhiwa kwe-fibrin, isebenza njenge-cofactor ukwandisa umsebenzi we-tPA izikhathi ezingu-100, futhi ngemva kokuba i-tPA ifakwe ebusweni be-fibrin, ngeke isavinjelwa kalula yi-plasminogen activation inhibitor-1 ( I-PAI-1).Ngakho-ke, i-plasminogen ingashintshwa ngokushesha futhi ngokuqhubekayo ibe yi-plasmin, bese i-fibrin ingancishiswa, futhi inani elikhulu le-FDP ne-D-Dimer lingakhiqizwa.Lesi yisizathu esenza ukuthi ukwakheka kwehlule legazi ku-vitro kanye nemikhiqizo yokuwohloka kwe-fibrin kwenyuke kakhulu ngenxa yokungathathwa kahle kwesampula yegazi.
Khona-ke, kungani iqoqo elivamile le-serum tube (ngaphandle kwezithasiselo noma ezine-coagulant) izibonelo zakha amahlule e-fibrin ku-vitro, kodwa azange awonakalise ukukhiqiza inani elikhulu le-FDP ne-D-dimer?Lokhu kuncike ku-serum tube.Okwenzeka ngemva kokuba isifanekiso siqoqwe: Okokuqala, alikho inani elikhulu le-tPA elingena egazini;okwesibili, ngisho noma inani elincane le-tPA lingena egazini, i-tPA yamahhala izoboshwa yi-PAI-1 futhi ilahlekelwe umsebenzi wayo cishe imizuzu engu-5 ngaphambi kokuba inamathele ku-fibrin.Ngalesi sikhathi, ngokuvamile akukho ukwakheka kwe-fibrin ku-serum tube ngaphandle kwezithasiselo noma nge-coagulant.Kuthatha imizuzu engaphezu kweshumi ukuze igazi elingenazo izithasiselo lijiye ngokwemvelo, kuyilapho igazi eline-coagulant (ngokuvamile i-silicon powder) liqala ngaphakathi.Kuphinde kuthathe imizuzu engaphezu kwemi-5 ukwakha i-fibrin emgudwini wokuhlangana kwegazi.Ngaphezu kwalokho, umsebenzi we-fibrinolytic ekamelweni lokushisa in vitro nawo uzothinteka.
Ake siphinde sikhulume nge-thromboelastogram ngalesi sihloko: ungaqonda ukuthi ihlule legazi ku-serum tube akonakaliswa kalula, futhi ungaqonda ukuthi kungani ukuhlolwa kwe-thromboelastogram (TEG) kungazwela ukukhombisa i-hyperfibrinolysis-zombili izimo Kuyafana, Yebo, izinga lokushisa ngesikhathi sokuhlolwa kwe-TEG lingagcinwa ku-37 degrees.Uma i-TEG izwela kakhulu ukuze ibonise isimo se-fibrinolysis, enye indlela iwukwengeza i-tPA ocwaningweni lwe-in vitro TEG, kodwa kusenezinkinga zokumisa futhi alukho uhlelo lokusebenza oluvamile;ngaphezu kwalokho, ingalinganiswa eceleni kombhede ngokushesha ngemva kokuthatha isampula, kodwa umphumela wangempela nawo ulinganiselwe kakhulu.Uhlolo lwendabuko nolusebenza kahle kakhulu lokuhlola umsebenzi we-fibrinolytic isikhathi sokuqedwa kwe-euglobulin.Isizathu sokuzwela kwayo kungaphezulu kwese-TEG.Esivivinyweni, i-anti-plasmin isuswa ngokulungisa inani le-pH kanye ne-centrifugation, kodwa ukuhlolwa kudla Kuthatha isikhathi eside futhi kulukhuni uma kuqhathaniswa, futhi akuvamile ukwenziwa ezindaweni zokucwaninga.
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