Ana haɗa ƙwayoyin fibrin a cikin jini ta hanyar kunna factor X III, sannan a haɗa su da sinadarin hydrolyzed ta hanyar kunna plasmin don samar da wani takamaiman samfurin lalacewa da ake kira "samfurin lalata fibrin (FDP)." D-Dimer shine mafi sauƙin FDP, kuma ƙaruwar yawan taro yana nuna yanayin da za a iya haɗa shi da kuma hyperfibrinolysis na biyu a cikin jiki. Saboda haka, yawan D-Dimer yana da matuƙar mahimmanci ga ganewar asali, kimanta inganci da kuma yanke hukunci game da cututtukan thrombosis.
Tun bayan barkewar cutar COVID-19, tare da zurfafa bayyanar cututtuka da fahimtar cutar game da cututtuka da kuma tarin gwaje-gwaje da kuma magani, marasa lafiya masu tsanani da ke fama da cutar huhu ta zuciya na iya kamuwa da cutar matsananciyar damuwa ta numfashi cikin sauri. Alamomi, girgizar septic, acidosis na metabolism, matsalar coagulation, da gazawar gabobin jiki da yawa. D-dimer yana ƙaruwa a cikin marasa lafiya da ke fama da cutar huhu mai tsanani.
Marasa lafiya masu fama da rashin lafiya mai tsanani suna buƙatar kula da haɗarin kamuwa da cutar thromboembolism ta hanyar jijiyoyin jini (VTE) saboda tsawaita lokacin kwanciya da kuma rashin aikin coagulation na jini.
A lokacin jiyya, ya zama dole a sa ido kan alamun da suka dace bisa ga yanayin, gami da alamun zuciya, aikin coagulation, da sauransu. Wasu marasa lafiya na iya samun ƙaruwar myoglobin, wasu lokuta masu tsanani na iya ganin ƙaruwar troponin, kuma a cikin mawuyacin hali, ana iya ƙara yawan D-dimer (D-Dimer).
Za a iya ganin cewa D-Dimer yana da mahimmancin sa ido kan cututtuka a ci gaban COVID-19, to ta yaya yake taka rawa a wasu cututtuka?
1. Ciwon jijiyoyin jini
An yi amfani da D-Dimer sosai a cikin cututtukan da suka shafi jijiyoyin jini (VTE), kamar su thrombosis na jijiyoyin jini mai zurfi (DVT) da embolism na huhu (PE). Gwajin D-Dimer mara kyau na iya kawar da DVT, kuma ana iya amfani da yawan D-Dimer don annabta yawan sake dawowar VTE. Binciken ya gano cewa rabon haɗarin sake dawowar VTE a cikin mutanen da ke da yawan haɗuwa ya ninka sau 4.1 na yawan mutanen da ke da yawan haɗuwa akai-akai.
D-Dimer kuma yana ɗaya daga cikin alamun gano PE. Darajar hasashensa mara kyau tana da yawa sosai, kuma mahimmancinsa shine a cire embolism na huhu mai tsanani, musamman ga marasa lafiya da ba su da tabbas. Saboda haka, ga marasa lafiya da ake zargi da embolism na huhu mai tsanani, ya kamata a haɗa hoton ultrasonography na jijiyoyin jini na ƙananan gaɓoɓi da kuma gwajin D-Dimer.
2. Yaɗuwar coagulation a cikin jijiyoyin jini
Hadin jini a cikin jijiyoyin jini (DIC) wata cuta ce ta asibiti wadda ke da alaƙa da zubar jini da gazawar ƙwayoyin cuta bisa ga cututtuka da yawa. Tsarin ci gaban ya ƙunshi tsarin da yawa kamar hadi, hana zubar jini, da fibrinolysis. D-Dimer ya ƙaru a farkon matakin samuwar DIC, kuma yawansa ya ci gaba da ƙaruwa fiye da ninki 10 yayin da cutar ke ci gaba. Saboda haka, ana iya amfani da D-Dimer a matsayin ɗaya daga cikin manyan alamun gano cutar da wuri da kuma sa ido kan yanayin DIC.
3. Ragewar jijiyoyi
"Masana kasar Sin sun amince kan gano cutar da kuma maganin tabar wiwi ta hanyar tiyatar cirewa daga aorta" sun nuna cewa D-Dimer, a matsayin gwajin dakin gwaje-gwaje na yau da kullun don cirewa daga aorta (AD), yana da matukar muhimmanci ga ganewar cutar da kuma gano bambancin tabar wiwi. Lokacin da D-Dimer na majiyyaci ya tashi da sauri, yuwuwar a gano cutar yayin da AD ke karuwa. Cikin awanni 24 da fara cutar, lokacin da D-Dimer ya kai ga mahimmancin ƙimar 500 µg/L, hankalinsa na gano cutar mai tsanani shine 100%, kuma takamaimansa shine 67%, don haka ana iya amfani da shi azaman ma'aunin keɓewa don gano cutar mai tsanani.
4. Cutar Zuciya da Jijiyoyin Jini (Atherosclerotic Heart Disease)
Cutar zuciya da jijiyoyin jini ta Atherosclerotic cuta ce ta zuciya da ke faruwa sakamakon plaque na arteriosclerotic, gami da ST-segment elevation acute myocardial infarction, non-ST-segment elevation acute myocardial infarction, da kuma rashin kwanciyar hankali. Bayan fashewar plaque, kayan necrotic core a cikin plaque suna fitowa, suna haifar da rashin daidaituwar abubuwan kwararar jini, kunna tsarin coagulation, da kuma ƙaruwar yawan D-Dimer. Marasa lafiya da ke fama da cututtukan zuciya da D-Dimer mai yawa na iya hasashen haɗarin kamuwa da AMI mafi girma kuma ana iya amfani da su azaman alamar lura da yanayin ACS.
5. Maganin Thrombolytic
Binciken Lawter ya gano cewa magungunan thrombolytic daban-daban na iya ƙara D-Dimer, kuma yawan sinadarinsa yana canzawa kafin da kuma bayan thrombolysis ana iya amfani da shi a matsayin alamar auna tasirin thrombolytic. Abubuwan da ke cikinsa sun karu da sauri zuwa ƙimar kololuwa bayan thrombolysis, kuma sun ragu cikin ɗan gajeren lokaci tare da ci gaba mai mahimmanci a cikin alamun asibiti, wanda ke nuna cewa maganin yana da tasiri.
- Matsayin D-Dimer ya ƙaru sosai bayan awa 1 zuwa awanni 6 bayan thrombolysis don bugun zuciya mai tsanani da bugun kwakwalwa.
- A lokacin DVT thrombolysis, kololuwar D-Dimer yawanci yana faruwa awanni 24 ko fiye
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