01. Gano cutar thrombosis mai zurfi a cikin jijiyoyin jini da kuma embolism na huhu

Ciwon zuciya mai zurfi (D-VT) yana iya haifar da bugun zuciya na huhu (PE), wanda aka fi sani da venous thromboembolism (VTE). Matakan D-dimer na jini yana ƙaruwa sosai a cikin marasa lafiya na VTE.

Nazarin da suka shafi hakan ya nuna cewa yawan sinadarin D-dimer a cikin jini a cikin marasa lafiya da ke fama da PE da D-VT ya fi 1000 μg/L.

Duk da haka, saboda cututtuka da yawa ko wasu abubuwan da ke haifar da cututtuka (tiyata, ciwace-ciwacen zuciya, cututtukan zuciya, da sauransu) suna da wani tasiri ga hemostasis, wanda ke haifar da ƙaruwar D-dimer. Saboda haka, kodayake D-dimer yana da babban ƙarfin ji, takamaimansa yana tsakanin kashi 50% zuwa 70% ne kawai, kuma D-dimer kaɗai ba zai iya gano VTE ba. Saboda haka, ba za a iya amfani da babban ƙaruwa a cikin D-dimer a matsayin takamaiman alamar VTE ba. Mahimmancin aikin gwajin D-dimer shine cewa sakamako mara kyau yana hana ganewar VTE.

 

02 Hadin jini a cikin jijiyoyin jini

Hadin jini a cikin jijiyoyin jini (DIC) wata cuta ce ta ƙananan ƙwayoyin cuta a cikin ƙananan tasoshin jini a cikin jiki da kuma hyperfibrinolysis na biyu a ƙarƙashin tasirin wasu abubuwan da ke haifar da cututtuka, waɗanda ƙila za su iya kasancewa tare da fibrinolysis na biyu ko kuma hana fibrinolysis.

Yawan sinadarin D-dimer a cikin jini yana da babban darajar asibiti don gano cutar DIC da wuri. Duk da haka, ya kamata a lura cewa karuwar D-dimer ba gwaji ne na musamman ga DIC ba, amma cututtuka da yawa tare da ƙananan thrombosis na iya haifar da ƙaruwar D-dimer. Lokacin da fibrinolysis ya kasance na biyu ga coagulation na jini, D-dimer shima zai ƙaru.

Bincike ya nuna cewa D-dimer yana fara tashi kwanaki kafin DIC kuma yana da girma sosai fiye da yadda aka saba.

 

03 Ciwon mara na jarirai

Akwai matakai daban-daban na hypoxia da acidosis a cikin asphyxia na jarirai, kuma hypoxia da acidosis na iya haifar da mummunan lalacewar endothelial na jijiyoyin jini, wanda ke haifar da sakin adadi mai yawa na abubuwan da ke cikin jini, wanda hakan ke ƙara yawan samar da fibrinogen.

Nazarin da suka dace sun nuna cewa ƙimar D-dimer na jinin igiya a cikin rukunin asphyxia ya fi girma sosai fiye da na ƙungiyar kulawa ta yau da kullun, kuma idan aka kwatanta da ƙimar D-dimer a cikin jinin gefe, shi ma ya fi girma sosai.

 

04 Ciwon lupus erythematosus na tsarin jiki (SLE)

Tsarin coagulation-fibrinolysis ba shi da kyau ga marasa lafiya da ke fama da SLE, kuma rashin daidaituwar tsarin coagulation-fibrinolysis ya fi bayyana a matakin da cutar ke aiki, kuma yanayin thrombosis ya fi bayyana; idan aka rage cutar, tsarin coagulation-fibrinolysis yakan zama kamar al'ada.

Saboda haka, matakan D-dimer na marasa lafiya da ke fama da cutar lupus erythematosus a matakan aiki da marasa aiki za su ƙaru sosai, kuma matakan D-dimer na jini na marasa lafiya da ke matakin aiki sun fi na waɗanda ke matakin aiki.

05 Ciwon hanta da ciwon daji na hanta

D-dimer yana ɗaya daga cikin alamomin da ke nuna tsananin cutar hanta. Yayin da cutar hanta ta yi tsanani, haka nan yawan sinadarin D-dimer a cikin jini ke ƙaruwa.

Nazarin da suka dace sun nuna cewa ƙimar D-dimer na Child-Pugh A, B, da C a cikin marasa lafiya da ke fama da cutar hanta sune (2.218 ± 0.54) μg/mL, (6.03 ± 0.76) μg/mL, da (10.536 ± 0.664) μg/mL, bi da bi.

Bugu da ƙari, D-dimer ya karu sosai a cikin marasa lafiya da ke fama da ciwon hanta tare da ci gaba da sauri da kuma rashin kyakkyawan hasashen cutar.

06 Ciwon daji na ciki

Bayan an cire wa masu fama da cutar kansa, toshewar jijiyoyin jini (thromboembolism) yana faruwa a kusan rabin marasa lafiya, kuma D-dimer yana ƙaruwa sosai a cikin kashi 90% na marasa lafiya.

Bugu da ƙari, akwai nau'in sinadarai masu yawan sukari a cikin ƙwayoyin ƙari waɗanda tsarinsu da abubuwan da ke cikin kyallen suna kama da juna. Shiga cikin ayyukan metabolism na ɗan adam na iya haɓaka aikin tsarin coagulation na jiki da kuma ƙara haɗarin thrombosis, kuma matakin D-dimer yana ƙaruwa sosai. Kuma matakin D-dimer a cikin marasa lafiya da ke fama da ciwon daji na ciki tare da mataki na III-IV ya fi girma sosai fiye da na marasa lafiya da ke fama da ciwon daji na ciki tare da mataki na I-II.

 

07 Ciwon huhu na Mycoplasma (MMP)

Sau da yawa MPP mai tsanani yana tare da ƙaruwar matakan D-dimer, kuma matakan D-dimer sun fi yawa a cikin marasa lafiya da ke da MPP mai tsanani fiye da a cikin marasa lafiya masu rauni.

Idan MPP ta yi rashin lafiya mai tsanani, za a samu raguwar iskar oxygen, ischemia da acidosis a cikin jiki, tare da mamayewar ƙwayoyin cuta kai tsaye, waɗanda za su lalata ƙwayoyin jijiyoyin jini, su fallasa collagen, su kunna tsarin coagulation, su samar da yanayin coagulation mai yawa, sannan su samar da microthrombi. Haka kuma tsarin fibrinolytic na ciki, kinin da sauran su suna aiki a jere, wanda ke haifar da ƙaruwar matakan D-dimer.

 

08 Ciwon suga, ciwon suga

Matakan D-dimer sun yi yawa sosai a cikin marasa lafiya da ke fama da ciwon sukari da kuma nephropathy na ciwon sukari.

Bugu da ƙari, ma'aunin D-dimer da fibrinogen na marasa lafiya da ke fama da ciwon suga sun fi na masu ciwon suga nau'in 2 girma. Saboda haka, a aikin asibiti, ana iya amfani da D-dimer a matsayin ma'aunin gwaji don gano tsananin ciwon suga da cututtukan koda a cikin marasa lafiya.

09 Maganin rashin lafiyan Purpura (AP)

A cikin lokaci mai tsanani na AP, akwai matakai daban-daban na yawan zubar jini da kuma inganta aikin platelet, wanda ke haifar da vasospasm, tarin platelet da thrombosis.

Ƙara yawan D-dimer a cikin yara masu fama da AP abu ne da ya zama ruwan dare bayan makonni 2 da fara shi kuma ya bambanta tsakanin matakan asibiti, yana nuna girman da matakin kumburin jijiyoyin jini.

Bugu da ƙari, shi ma alama ce ta hasashen yanayi, tare da yawan matakan D-dimer akai-akai, cutar sau da yawa tana daɗe kuma tana iya haifar da lalacewar koda.

 

Ciki 10

Bincike mai alaƙa ya nuna cewa kusan kashi 10% na mata masu juna biyu sun sami ƙaruwar matakan D-dimer sosai, wanda ke nuna haɗarin toshewar jini.

Ciwon preeclampsia matsala ce da ake yawan samu a cikin ciki. Manyan canje-canjen da ke faruwa a cikin cututtukan preeclampsia da eclampsia sune kunna coagulation da haɓaka fibrinolysis, wanda ke haifar da ƙaruwar ƙananan jijiyoyin jini da kuma D-dimer.

D-dimer ya ragu da sauri bayan haihuwa a cikin mata masu lafiya, amma ya ƙaru a cikin mata masu preeclampsia, kuma bai dawo yadda yake ba har sai makonni 4 zuwa 6.

11 Ciwon Zuciya Mai Tsanani da Rarraba Zuciyar Aneurysm

Marasa lafiya da ke fama da cututtukan zuciya masu tsanani suna da matakan D-dimer na yau da kullun ko kuma kaɗan ne kawai suka ƙaru, yayin da aorta ke da yawan aneurysms masu rarraba aorta.

Wannan yana da alaƙa da babban bambanci a cikin nauyin thrombus a cikin tasoshin jijiyoyin biyu. Lumen na zuciya ya fi siriri kuma thrombus a cikin jijiyar zuciya ya fi ƙasa. Bayan fashewar intima na aortic, yawan jinin jijiya yana shiga bangon jijiyoyin don samar da aneurysm mai rarrabawa. Ana samar da adadi mai yawa na thrombus a ƙarƙashin aikin tsarin coagulation.

12 Ciwon kwakwalwa mai tsanani

A cikin bugun zuciya mai tsanani, thrombolysis na kwatsam da kuma aikin fibrinolytic na biyu suna ƙaruwa, wanda ke bayyana a matsayin ƙaruwar matakan D-dimer a cikin jini. Matsayin D-dimer ya ƙaru sosai a farkon matakin bugun kwakwalwa mai tsanani.

Matakan D-dimer na plasma a cikin marasa lafiya da ke fama da bugun jini mai tsanani sun ɗan ƙaru a makon farko bayan fara shi, sun ƙaru sosai cikin makonni 2 zuwa 4, kuma ba su bambanta da matakan da aka saba gani ba a lokacin murmurewa (fiye da watanni 3).