Ana amfani da D-dimer a matsayin ɗaya daga cikin muhimman alamun da ake zargi na PTE da DVT a aikin asibiti. Ta yaya aka samo shi?

D-dimer na plasma wani takamaiman samfurin lalacewa ne da plasmin hydrolysis ke samarwa bayan an haɗa fibrin monomer ta hanyar kunna factor XIII. Yana da takamaiman alamar tsarin fibrinolysis. D-dimers suna samo asali ne daga ƙwanƙwasa fibrin da plasmin ya shafa. Muddin akwai thrombosis mai aiki da aikin fibrinolytic a cikin jijiyoyin jini na jiki, D-dimer zai ƙaru. Infarction na zuciya, bugun zuciya, bugun zuciya, bugun zuciya, thrombosis na huhu, tiyata, ƙari, coagulation na cikin jijiyoyin jini, kamuwa da cuta da necrosis na nama na iya haifar da ƙaruwar D-dimer. Musamman ga tsofaffi da marasa lafiya da ke asibiti, saboda ƙwayoyin cuta da sauran cututtuka, yana da sauƙi a haifar da rashin daidaituwar coagulation na jini kuma ya haifar da ƙaruwar D-dimer.

D-dimer galibi yana nuna aikin fibrinolytic. Ana ganin ƙaruwa ko tabbatacce a cikin hyperfibrinolysis na biyu, kamar yanayin da jini ke iya tsayawa, yaduwar coagulation a cikin jijiyoyin jini, cututtukan koda, ƙin dashen gabobi, maganin thrombolytic, da sauransu. Tabbatar da manyan abubuwan da ke cikin tsarin fibrinolytic yana da matuƙar mahimmanci don ganowa da magance cututtukan tsarin fibrinolytic (kamar DIC, thrombosis daban-daban) da cututtuka da suka shafi tsarin fibrinolytic (kamar ciwace-ciwacen daji, ciwon ciki), da kuma sa ido kan maganin thrombolytic.

Yawan matakan D-dimer, wani samfurin lalata fibrin, yana nuna yawan lalacewar fibrin a cikin jiki. Saboda haka, fibrous D-dimer babban alama ne na thrombosis na jijiyoyin jini (DVT), pulmonary embolism (PE), disseminated intravascular coagulation (DIC).

Cututtuka da yawa suna haifar da kunna tsarin coagulation da/ko tsarin fibrinolytic a cikin jiki, wanda ke haifar da ƙaruwa a matakin D-dimer, kuma wannan kunnawa yana da alaƙa da matakin, tsananin da maganin cutar, don haka a cikin waɗannan cututtuka ana iya amfani da gano matakin D-dimer a matsayin alamar kimantawa don tantance yanayin cutar, hasashen cutar da jagorar magani.

Amfani da D-dimer a cikin thrombosis mai zurfi na jijiyoyin jini

Tun lokacin da Wilson da abokan aikinsa suka fara amfani da samfuran lalata fibrin don gano cutar embolism ta huhu a shekarar 1971, gano D-dimer ya taka rawa sosai wajen gano cutar embolism ta huhu. Tare da wasu hanyoyin gano cutar, D-dimer mara kyau yana da kyakkyawan tasirin hasashen cutar ga embolism ta huhu, kuma ƙimarsa ita ce 0.99. Sakamakon da ba shi da kyau zai iya kawar da embolism ta huhu, ta haka ne rage gwaje-gwajen da suka mamaye, kamar duba iska da kuma angiography na huhu; a guji maganin hana zubar jini ta makaho. D - Yawan dimer yana da alaƙa da wurin da thrombus yake, tare da yawan yawan a manyan rassan pulmonary da ƙananan yawan a ƙananan rassan.

D-dimers na plasma marasa kyau sun kawar da yiwuwar DVT. Angiography ya tabbatar da cewa DVT yana da 100% tabbatacce ga D-dimer. Ana iya amfani da shi don maganin thrombolytic da jagorar magungunan hana zubar jini na heparin da kuma lura da inganci.

D-dimer na iya nuna canje-canje a girman thrombus. Idan abun da ke ciki ya sake ƙaruwa, yana nuna sake dawowar thrombus; a lokacin jiyya, yana ci gaba da zama mai girma, kuma girman thrombus bai canza ba, wanda ke nuna cewa maganin ba shi da tasiri.