I-D-dimer ivame ukusetshenziswa njengenye yezinkomba ezibalulekile ezisolwayo ze-PTE ne-DVT ekusebenzeni komtholampilo.Kwenzeka kanjani?

I-Plasma D-dimer iwumkhiqizo othile wokuwohloka okhiqizwa yi-plasmin hydrolysis ngemuva kokuthi i-fibrin monomer ixhunywe ngokuphambana ngokuvula isici XIII.Kuwuphawu oluthile lwenqubo ye-fibrinolysis.I-D-dimers isuselwa kumahlule e-fibrin axhumene ne-lysed by plasmin.Uma nje kukhona i-thrombosis esebenzayo kanye nomsebenzi we-fibrinolytic emithanjeni yegazi yomzimba, i-D-dimer izokhula.I-myocardial infarction, i-cerebral infarction, i-pulmonary embolism, i-venous thrombosis, ukuhlinzwa, isimila, ukusatshalaliswa kwe-intravascular coagulation, ukutheleleka kanye ne-necrosis yezicubu kungaholela ekukhuphukeni kwe-D-dimer.Ikakhulukazi kubantu asebekhulile kanye neziguli ezisesibhedlela, ngenxa ye-bacteremia nezinye izifo, kulula ukubangela ukuhlangana kwegazi okungavamile futhi kubangele ukwanda kwe-D-dimer.

I-D-dimer ibonisa ngokuyinhloko umsebenzi we-fibrinolytic.Ukwanda noma okuhle kubonakala ku-hyperfibrinolysis yesibili, njenge-hypercoagulable state, ukusatshalaliswa kwe-intravascular coagulation, isifo sezinso, ukwenqaba ukufakelwa kwesitho, ukwelashwa kwe-thrombolytic, njll. uhlelo lwe-fibrinolytic (njenge-DIC, i-thrombus ehlukahlukene) kanye nezifo ezihlobene nesistimu ye-fibrinolytic (njengamathumba, isifo sokukhulelwa), nokuqapha ukwelashwa kwe-thrombolytic.

Amazinga aphakeme e-D-dimer, umkhiqizo wokuwohloka kwe-fibrin, abonisa ukuwohloka kwe-fibrin okuvamile ku-vivo.Ngakho-ke, i-fibrous D-dimer iyinkomba eyinhloko ye-deep vein thrombosis (DVT), i-pulmonary embolism (PE), isabalalisa i-intravascular coagulation (DIC).

Izifo eziningi zibangela ukusebenza kwe-coagulation system kanye/noma uhlelo lwe-fibrinolytic emzimbeni, okuholela ekwandeni kwezinga le-D-dimer, futhi lokhu kusebenze kuhlobene eduze nesiteji, ukuqina nokwelashwa kwesifo, ngakho-ke kulezi zifo. Ukutholwa kwezinga le-D-dimer kungasetshenziswa njengomaka wokuhlola wesigaba sesifo, ukubikezela kanye nokuqondiswa kokwelashwa.

Ukusetshenziswa kwe-D-dimer ku-deep vein thrombosis

Kusukela uWilson et al.okokuqala kwasetshenziswa imikhiqizo yokuwohloka kwe-fibrin ukuze kutholwe i-pulmonary embolism ngo-1971, ukutholwa kwe-D-dimer kubambe iqhaza elikhulu ekuxilongweni kwe-pulmonary embolism.Ngezinye izindlela zokutholwa ezizwela kakhulu, inani lomzimba we-D-dimer elingalungile linomphumela omuhle wokuqagela ongalungile we-pulmonary embolism, futhi inani lawo lingu-0.99.Umphumela ongemuhle ungakhipha i-pulmonary embolism, ngaleyo ndlela unciphise ukuhlolwa okuhlaselayo, njengokuskena kwe-ventilation perfusion kanye ne-pulmonary angiography;gwema i-blind anticoagulation therapy.D - Ukugxila kwe-dimer kuhlobene nendawo ye-thrombus, nokugxila okuphezulu emagatsheni amakhulu e-trunk yamaphaphu kanye nokugxila okuphansi emagatsheni amancane.

I-Plasma D-dimers engemihle ikhipha ithuba le-DVT.I-Angiography iqinisekise ukuthi i-DVT ibilungile ngo-100% ku-D-dimer.Ingasetshenziselwa ukwelashwa kwe-thrombolytic kanye ne-heparin anticoagulation imithi yokuqondisa kanye nokubona ukusebenza kahle.

I-D-dimer ingabonisa izinguquko kusayizi we-thrombus.Uma okuqukethwe kwanda futhi, kubonisa ukuphindaphinda kwe-thrombus;phakathi nenkathi yokwelashwa, iyaqhubeka iphakeme, futhi ubukhulu be-thrombus abushintshi, okubonisa ukuthi ukwelashwa kungasebenzi.