(1) D-dimer
Ma ke ʻano he huahana hoʻohaʻahaʻa o ka fibrin i hoʻopili ʻia, ʻo D-dimer kahi hōʻailona maʻamau e hōʻike ana i ka hoʻoulu ʻana o ka coagulation a me ka hyperfibrinolysis lua. I nā poʻe maʻi me COVID-19, ʻo nā pae D-dimer kiʻekiʻe he hōʻailona koʻikoʻi no nā maʻi coagulation hiki. Pili pū nā pae D-dimer i ka paʻakikī o ka maʻi, a ʻoi aku ka maikaʻi ʻole o ka prognosis o nā poʻe maʻi me ka D-dimer kiʻekiʻe i ka wā i komo ai. Manaʻo nā alakaʻi mai ka International Society of Thrombosis and Hemostasis (ISTH) i kahi D-dimer kiʻekiʻe loa (ʻoi aku ma mua o 3 a 4 mau manawa o ka palena kiʻekiʻe o ka maʻamau) hiki ke lilo i hōʻailona no ka hoʻokipa ʻana i nā poʻe maʻi COVID-19, ma hope o ka hoʻokaʻawale ʻana i nā contraindications. Pono e hāʻawi ʻia ka Anticoagulation me nā dosis prophylactic o ka heparin kaumaha haʻahaʻa-molecular i kēlā mau poʻe maʻi i ka hikiwawe loa. Ke hoʻokiʻekiʻe mau ʻia ka D-dimer a he kānalua nui no ka thrombosis venous a i ʻole ka microvascular embolism, pono e noʻonoʻo ʻia ka anticoagulation me nā dosis therapeutic o ka heparin.

ʻOiai ʻo ke kiʻekiʻe o ka D-dimer e hōʻike pū i ka hyperfibrinolysis, ʻo ke ʻano o ke kahe koko i nā poʻe maʻi COVID-19 me ka D-dimer kiʻekiʻe loa he mea maʻamau ʻole ia ke ʻole e holomua i ka pae hypocoagulable DIC ākea, e hōʻike ana ua kāohi nui ʻia ka ʻōnaehana fibrinolytic o -19. ʻO kekahi hōʻailona e pili ana i ka fibrin, ʻo ia hoʻi, ʻo ke ʻano o ka loli o ka pae FDP a me ka pae D-dimer ua like like.

 

(2) PT
ʻO ka PT lōʻihi kekahi hōʻailona o nā maʻi coagulation hiki i nā maʻi COVID-19 a ua hōʻike ʻia e pili ana me ka prognosis maikaʻi ʻole. I ke kahua mua o ka maʻi coagulation ma COVID-19, ʻo nā maʻi me PT he maʻamau a ʻano ʻē paha, a ʻo ka PT lōʻihi i ka wā hypercoagulable e hōʻike pinepine ana i ka hoʻoulu ʻana a me ka hoʻopau ʻana i nā mea coagulation exogenous, a me ka lohi o ka polymerization fibrin, no laila he anticoagulation pale nō hoʻi. kekahi o nā hōʻailona. Eia nō naʻe, i ka wā e hoʻolōʻihi nui ʻia ai ka PT, ʻoiai ke loaʻa i ka mea maʻi nā hōʻike koko, hōʻike ia ua komo ka maʻi coagulation i ke kahua coagulation haʻahaʻa, a i ʻole ua paʻakikī ka mea maʻi e ka lawa ʻole o ke ake, ka nele o ka huaora K, ka overdose anticoagulant, a pēlā aku, a pono e noʻonoʻo ʻia ka hoʻoili ʻana o ka plasma. Lapaʻau ʻē aʻe. ʻO kekahi mea nānā coagulation, ka manawa thromboplastin hapa i hoʻāla ʻia (APTT), mālama nui ʻia ma kahi pae maʻamau i ka wā hypercoagulable o nā maʻi coagulation, hiki ke hoʻopili ʻia i ka hoʻonui ʻia o ka reactivity o ka factor VIII i ke kūlana mumū.

 

(3) Ka helu platelet a me ka hoʻāʻo hana
ʻOiai ʻo ka hoʻoulu ʻana o ka coagulation hiki ke alakaʻi i ka emi ʻana o ka hoʻohana ʻana o ka platelet, ʻaʻole maʻamau ka emi ʻana o ka helu platelet i nā poʻe maʻi COVID-19, kahi e pili ana paha i ka hoʻonui ʻia ʻana o ka hoʻokuʻu ʻana o nā thrombopoietin, IL-6, nā cytokines e paipai ana i ka hana platelet i nā kūlana mumū No laila, ʻo ka waiwai paʻa o ka helu platelet ʻaʻole ia he hōʻailona koʻikoʻi e hōʻike ana i nā maʻi coagulation ma COVID-19, a ʻoi aku ka waiwai o ka hoʻolohe ʻana i kāna mau loli. Eia kekahi, ʻo ka emi ʻana o ka helu platelet e pili nui ana me ka prognosis maikaʻi ʻole a ʻo ia kekahi o nā hōʻailona no ka anticoagulation prophylactic. Eia nō naʻe, i ka wā e emi nui ai ka helu (e laʻa, <50 × 109 / L), a loaʻa i ka mea maʻi nā hōʻike koko, pono e noʻonoʻo ʻia ka hoʻoili ʻāpana platelet.

E like me nā hopena o nā noiʻi mua i nā poʻe maʻi me ka sepsis, ʻo nā hoʻokolohua hana platelet in vitro i nā poʻe maʻi COVID-19 me nā maʻi coagulation e hāʻawi pinepine i nā hopena haʻahaʻa, akā hoʻāla pinepine ʻia nā platelets maoli i nā poʻe maʻi, kahi mea e pili ana i ka hana haʻahaʻa. Hoʻohana mua ʻia nā platelets kiʻekiʻe a hoʻopau ʻia e ke kaʻina hana coagulation, a haʻahaʻa ka hana pili o nā platelets i ke kahe koko i hōʻiliʻili ʻia.

 

(4) FIB
Ma ke ʻano he protein hopena pae koke, loaʻa pinepine i nā maʻi me COVID-19 nā pae kiʻekiʻe o FIB i ka pae koke o ka maʻi, ʻaʻole pili wale i ke koʻikoʻi o ka mumū, akā ʻo ka FIB kiʻekiʻe loa he mea pilikia hoʻi no ka thrombosis, no laila hiki ke hoʻohana ʻia ma ke ʻano he COVID-19 ʻO kekahi o nā hōʻailona no ka anticoagulation i nā maʻi. Eia nō naʻe, i ka wā e emi mālie ai ka FIB o ka mea maʻi, hiki ke hōʻike ʻia ua holomua ka maʻi coagulation i ke kahua hypocoagulable, a i ʻole he hemahema koʻikoʻi ko ka maʻi hepatic, ka mea i loaʻa pinepine i ka wā hope o ka maʻi, i ka wā e emi ai ka FIB <1.5 g/L a hele pū me ke kahe koko, pono e noʻonoʻo ʻia ka hoʻokomo ʻana o FIB.