Me yasa ya kamata a gano D-dimer, FDP a cikin marasa lafiya da cututtukan zuciya da jijiyoyin jini?
1. Ana iya amfani da D-dimer don jagorantar daidaita ƙarfin hana zubar jini.
(1) Alaƙa tsakanin matakin D-dimer da abubuwan da suka faru a asibiti yayin maganin hana zubar jini a cikin marasa lafiya bayan maye gurbin bawul ɗin zuciya na inji.
Ƙungiyar maganin daidaita yawan zubar jini ta D-dimer ta daidaita aminci da ingancin maganin hana zubar jini yadda ya kamata, kuma yawan aukuwar wasu abubuwan da ba su dace ba sun yi ƙasa sosai fiye da na ƙungiyar kula da lafiya ta amfani da maganin hana zubar jini na yau da kullun da kuma na ƙarancin ƙarfi.
(2) Samar da jijiyoyin jini na kwakwalwa (CVT) yana da alaƙa da tsarin thrombus.
Jagora don Ganowa da Kula da Thrombosis na Jijiyoyin Jijiyoyin Jini da Jijiyoyin Hanci (CVST)
Tsarin Thrombotic: PC, PS, AT-ll, ANA, LAC, HCY
Sauye-sauyen kwayoyin halitta: kwayar halittar prothrombin G2020A, sinadarin coagulation LeidenV
Abubuwan da ke haifar da hakan: lokacin haihuwa, hana haihuwa, rashin ruwa, rauni, tiyata, kamuwa da cuta, ƙari, rage kiba.
2. Darajar gano D-dimer da FDP a cikin cututtukan zuciya da jijiyoyin jini.
(1) Ƙara D-dimer (fiye da 500ug/L) yana da amfani wajen gano CVST. Daidaito ba ya kawar da CVST, musamman a cikin CVST tare da ciwon kai da aka ware kwanan nan. Ana iya amfani da shi azaman ɗaya daga cikin alamun gano CVST. Ana iya amfani da D-dimer sama da na al'ada azaman ɗaya daga cikin alamun gano CVST (shawarar mataki na III, shaidar matakin C).
(2) Alamomi da ke nuna ingantaccen maganin thrombolytic: Kula da D-dimer ya ƙaru sosai sannan ya ragu a hankali; FDP ya ƙaru sosai sannan ya ragu a hankali. Waɗannan alamomi guda biyu su ne tushen maganin thrombolytic mai tasiri.
A ƙarƙashin tasirin magungunan thrombolytic (SK, UK, rt-PA, da sauransu), embol da ke cikin jijiyoyin jini suna narkewa da sauri, kuma D-dimer da FDP a cikin jini suna ƙaruwa sosai, wanda gabaɗaya yana ɗaukar kwanaki 7. A lokacin jiyya, idan yawan magungunan thrombolytic bai isa ba kuma thrombus bai narke gaba ɗaya ba, D-dimer da FDP za su ci gaba da kasancewa a manyan matakan bayan sun kai kololuwa; A cewar ƙididdiga, yawan zubar jini bayan maganin thrombolytic yana da yawa har zuwa 5% zuwa 30%. Saboda haka, ga marasa lafiya da cututtukan thrombotic, ya kamata a tsara tsarin magani mai tsauri, ya kamata a sa ido kan aikin coagulation na plasma da aikin fibrinolytic a ainihin lokaci, kuma ya kamata a kula da yawan magungunan thrombolytic sosai. Ana iya ganin cewa gano yawan D-dimer da FDP yana canzawa kafin, lokacin da kuma bayan magani yayin thrombolysis yana da babban darajar asibiti don sa ido kan inganci da amincin magungunan thrombolytic.
Me yasa marasa lafiya da cututtukan zuciya da jijiyoyin jini ya kamata su kula da AT?
Rashin Antithrombin (AT) Antithrombin (AT) yana taka muhimmiyar rawa wajen hana samuwar thrombus, ba wai kawai yana hana thrombin ba, har ma yana hana abubuwan da ke haifar da coagulation kamar IXa, Xa, Xla, Xlla da Vlla. Haɗin heparin da AT muhimmin ɓangare ne na anticoagulation na AT. A gaban heparin, ana iya ƙara yawan aikin anticoagulant na AT sau dubbai. Ayyukan AT, don haka AT muhimmin abu ne ga tsarin anticoagulant na heparin.
1. Juriyar Heparin: Idan aikin AT ya ragu, aikin hana zubar jini na heparin yana raguwa sosai ko kuma ba ya aiki. Saboda haka, ya zama dole a fahimci matakin AT kafin a yi maganin heparin don hana maganin heparin mai yawan gaske da ba dole ba kuma maganin ba shi da tasiri.
A cikin rahotannin wallafe-wallafe da yawa, ƙimar asibiti na D-dimer, FDP, da AT ana nuna su a cikin cututtukan zuciya da jijiyoyin jini, waɗanda zasu iya taimakawa wajen gano cutar da wuri, yanke hukunci game da yanayinta da kuma kimanta hasashen cutar.
2. Binciken dalilin thrombophilia: Marasa lafiya da ke fama da thrombophilia suna bayyana a asibiti ta hanyar babban thrombosis na jijiyoyin jini da kuma maimaita thrombosis. Ana iya yin gwajin dalilin thrombophilia a cikin ƙungiyoyi masu zuwa:
(1) VTE ba tare da wani dalili ba (gami da thrombus na jarirai)
(2) VTE tare da kyaututtuka <40-50 shekaru
(3) Maimaita zubar jini ko toshewar jijiyoyin jini
(4) Tarihin iyali na thrombosis
(5) Ciwon thrombosis a wurare marasa kyau: jijiyar mesenteric, sinus na jijiyoyin kwakwalwa
(6) Yawan zubar da ciki akai-akai, haihuwa a cikin mamaci, da sauransu.
(7) Ciki, hana haihuwa, thrombosis da hormones ke haifarwa
(8) Ciwon fata, musamman bayan amfani da warfarin
(9) Ciwon jijiyoyin jini wanda ba a san dalili ba wanda ya kai ƙasa da shekaru 20
(10) Dangin da ke fama da cutar thrombophilia
3. Kimanta abubuwan da suka faru a zuciya da jijiyoyin jini da kuma sake dawowa: Bincike ya nuna cewa raguwar ayyukan AT a cikin marasa lafiya da ke fama da cututtukan zuciya da jijiyoyin jini yana faruwa ne sakamakon lalacewar ƙwayoyin endothelial wanda ke haifar da yawan shan AT. Saboda haka, lokacin da marasa lafiya ke cikin yanayin da ke iya yin coagulable, suna iya kamuwa da thrombosis kuma suna ƙara ta'azzara cutar. Ayyukan AT kuma sun yi ƙasa sosai a cikin mutanen da ke fama da cututtukan zuciya da jijiyoyin jini na sake dawowa fiye da mutanen da ba su da cututtukan zuciya da jijiyoyin jini na sake dawowa.
4. Kimanta haɗarin thrombosis a cikin fibrillation na atrial wanda ba na valvular ba: ƙarancin matakin aikin AT yana da alaƙa mai kyau da maki CHA2DS2-VASc; a lokaci guda, yana da babban ƙimar ma'ana don tantance thrombosis a cikin fibrillation na atrial wanda ba na valvular ba.
5. Alaƙar da ke tsakanin AT da bugun jini: AT yana raguwa sosai a cikin marasa lafiya da ke fama da bugun jini mai tsanani, jinin yana cikin yanayin da za a iya yin coagulable, kuma ya kamata a ba da maganin hana coagulation akan lokaci; ya kamata a yi wa marasa lafiya da ke da abubuwan da ke haifar da bugun jini gwajin AT akai-akai, kuma a yi gwajin hawan jini na marasa lafiya da wuri. Ya kamata a yi wa yanayin coagulation magani akan lokaci don guje wa faruwar bugun jini mai tsanani.
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