01.Diagnosis of deep vein thrombosis and pulmonary embolism

Zurfin thrombosis mai zurfi (D-VT) yana da saurin kamuwa da cututtukan huhu (PE), wanda aka fi sani da venous thromboembolism (VTE).Matakan Plasma D-dimer suna haɓaka sosai a cikin marasa lafiya na VTE.

Nazarin da ke da alaƙa sun nuna cewa ƙwayar plasma D-dimer a cikin marasa lafiya tare da PE da D-VT ya fi 1 000 μg / L.

Duk da haka, saboda cututtuka da yawa ko wasu cututtukan cututtuka (fida, ciwace-ciwacen ƙwayoyi, cututtuka na zuciya, da dai sauransu) suna da wani tasiri akan hemostasis, wanda ya haifar da karuwar D-dimer.Saboda haka, ko da yake D-dimer yana da babban hankali, ƙayyadaddun sa shine kawai 50% zuwa 70%, kuma D-dimer kadai ba zai iya tantance VTE ba.Sabili da haka, ba za a iya amfani da haɓaka mai mahimmanci a cikin D-dimer azaman takamaiman alamar VTE ba.Mahimman mahimmancin gwajin D-dimer shine cewa mummunan sakamako ya hana ganewar asali na VTE.

 

02 Yaduwa coagulation na intravascular

Rarraba intravascular coagulation (DIC) wani ciwo ne na m microthrombosis a cikin kananan tasoshin a ko'ina cikin jiki da kuma sakandare hyperfibrinolysis karkashin mataki na wasu pathogenic dalilai, wanda zai iya zama tare da sakandare fibrinolysis ko hana fibrinolysis.

Maɗaukakin abun ciki na jini na D-dimer yana da ƙima mai girma na asibiti don farkon ganewar asali na DIC.Duk da haka, ya kamata a lura cewa karuwar D-dimer ba takamaiman gwajin DIC ba ne, amma yawancin cututtuka tare da microthrombosis na iya haifar da karuwar D-dimer.Lokacin da fibrinolysis ya kasance na biyu zuwa coagulation na extravascular, D-dimer kuma zai karu.

Nazarin ya nuna cewa D-dimer ya fara tashi kwanaki kafin DIC kuma yana da girma fiye da al'ada.

 

03 Asphyxia na jariri

Akwai nau'i daban-daban na hypoxia da acidosis a cikin asphyxia na jarirai, kuma hypoxia da acidosis na iya haifar da mummunar lalacewar endothelial na jijiyoyi, wanda ya haifar da sakin adadi mai yawa na abubuwan coagulation, don haka ƙara samar da fibrinogen.

Nazarin da suka dace sun nuna cewa ƙimar D-dimer na jinin igiya a cikin ƙungiyar asphyxia yana da girma fiye da na ƙungiyar kulawa ta al'ada, kuma idan aka kwatanta da darajar D-dimer a cikin jini na gefe, yana da girma sosai.

 

04 Lupus erythematosus (SLE)

Tsarin coagulation-fibrinolysis ba shi da kyau a cikin marasa lafiya na SLE, kuma rashin daidaituwa na tsarin coagulation-fibrinolysis ya fi bayyana a cikin matakin aiki na cutar, kuma yanayin thrombosis ya fi bayyana;lokacin da cutar ta sauƙaƙa, tsarin coagulation-fibrinolysis yakan zama na al'ada.

Sabili da haka, matakan D-dimer na marasa lafiya tare da lupus erythematosus na tsarin aiki a cikin matakai masu aiki da marasa aiki za su kasance da yawa sosai, kuma matakan D-dimer na plasma na marasa lafiya a mataki na aiki sun fi girma fiye da wadanda ke cikin mataki mara aiki.

05 Ciwon hanta da ciwon hanta

D-dimer yana ɗaya daga cikin alamun da ke nuna tsananin cutar hanta.Mafi girman cutar hanta, mafi girman abun ciki na D-dimer na plasma.

Nazarin da suka dace ya nuna cewa ƙimar D-dimer na Child-Pugh A, B, da C maki a cikin marasa lafiya tare da cirrhosis 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 kasance mai girma sosai a cikin marasa lafiya da ciwon hanta tare da saurin ci gaba da rashin fahimta.

06 Ciwon daji

Bayan resection na masu ciwon daji, thromboembolism yana faruwa a kusan rabin marasa lafiya, kuma D-dimer yana ƙaruwa sosai a cikin 90% na marasa lafiya.

Bugu da ƙari, akwai nau'in sinadarai masu yawan sukari a cikin ƙwayoyin tumor wanda tsarin su da kuma nama sun yi kama da juna.Kasancewa cikin ayyukan rayuwa na ɗan adam na iya haɓaka ayyukan tsarin coagulation na jiki da haɓaka haɗarin thrombosis, kuma matakin D-dimer yana ƙaruwa sosai.Kuma matakin D-dimer a cikin marasa lafiya na ciwon daji na ciki tare da mataki na III-IV ya kasance mafi girma fiye da wanda ke cikin ciwon daji na ciki tare da mataki I-II.

 

07 Mycoplasma ciwon huhu (MMP)

MPP mai tsanani sau da yawa yana tare da haɓakar matakan D-dimer, kuma matakan D-dimer sun fi girma a cikin marasa lafiya da MPP mai tsanani fiye da lokuta masu laushi.

Lokacin da MPP ke da rashin lafiya mai tsanani, hypoxia, ischemia da acidosis za su faru a cikin gida, tare da kai tsaye kai tsaye na ƙwayoyin cuta, wanda zai lalata ƙwayoyin endothelial na jijiyoyin jini, fallasa collagen, kunna tsarin coagulation, samar da yanayin hypercoagulable, da kuma samar da microthrombi.Hakanan ana kunna tsarin fibrinolytic na ciki, kinin da tsarin haɓaka gaba ɗaya, yana haifar da haɓaka matakan D-dimer.

 

08 Ciwon sukari, ciwon sukari nephropathy

An haɓaka matakan D-dimer a cikin marasa lafiya masu ciwon sukari da ciwon sukari nephropathy.

Bugu da ƙari, ƙididdigar D-dimer da fibrinogen na marasa lafiya da ciwon sukari nephropathy sun kasance mafi girma fiye da na nau'in ciwon sukari na 2.Sabili da haka, a cikin aikin asibiti, ana iya amfani da D-dimer azaman gwajin gwaji don gano tsananin ciwon sukari da cututtukan koda a cikin marasa lafiya.

09 Allergic Purpura (AP)

A cikin matsanancin lokaci na AP, akwai nau'i daban-daban na hypercoagulability na jini da ingantaccen aikin platelet, wanda ke haifar da vasospasm, tarawar platelet da thrombosis.

D-dimer mai girma a cikin yara tare da AP yana da yawa bayan makonni 2 na farawa kuma ya bambanta tsakanin matakan asibiti, yana nuna girman da matakin kumburi na jijiyoyin jini.

Bugu da ƙari, shi ma alama ce mai ƙididdigewa, tare da yawan matakan D-dimer na ci gaba, cutar sau da yawa ta tsawaita kuma tana iya haifar da lalacewar koda.

 

10 Ciki

Nazarin da ke da alaƙa sun nuna cewa kusan kashi 10% na mata masu juna biyu sun haɓaka matakan D-dimer sosai, suna ba da shawarar haɗarin bugun jini.

Preeclampsia cuta ce ta gama gari na ciki.Babban canje-canje na pathological na preeclampsia da eclampsia sune kunnawar coagulation da haɓaka fibrinolysis, wanda ke haifar da haɓakar thrombosis microvascular da D-dimer.

D-dimer ya ragu da sauri bayan haihuwa a cikin mata na al'ada, amma ya karu a cikin mata masu fama da preeclampsia, kuma bai dawo al'ada ba har sai 4 zuwa 6 makonni.

11 Mugun Ciwon Ciwon Jiji da Rarraba Aneurysm

Marasa lafiya masu fama da ciwon zuciya na yau da kullun suna da matakan D-dimer na al'ada ko kuma a hankali kawai, yayin da aortic dissecting aneurysms suna da girma sosai.

Wannan yana da alaƙa da babban bambanci a cikin nauyin thrombus a cikin tasoshin jijiya na biyu.Lumen na jijiyoyin jini ya fi sirara kuma thrombus a cikin jijiyoyin jijiyoyin jini ya ragu.Bayan katsewar intima na aortic, babban adadin jinin jijiya yana shiga bangon jirgin don samar da anerysm mai rarrabawa.An kafa adadi mai yawa na thrombi a ƙarƙashin aikin tsarin coagulation.

12 Mugun ciwon kwakwalwa

A cikin mummunan rauni na cerebral, thrombolysis na kwatsam da aikin fibrinolytic na biyu yana ƙaruwa, yana bayyana azaman ƙara yawan matakan plasma D-dimer.Matsayin D-dimer ya ƙaru sosai a farkon matakin ƙwayar cuta mai tsanani.

Matsayin Plasma D-dimer a cikin marasa lafiya tare da bugun jini mai tsanani sun karu a cikin mako na farko bayan farawa, ya karu sosai a cikin makonni 2 zuwa 4, kuma ba su bambanta da matakan al'ada ba a lokacin dawowa (> watanni 3).