Ma lalo o nā kūlana physiological, mālama nā ʻōnaehana ʻelua o ke coagulation koko a me ka anticoagulation i loko o ke kino i kahi kaulike dynamic e mālama i ke kahe ʻana o ke koko i loko o nā kīʻaha koko. Inā kūlike ʻole ke kaulike, ʻoi aku ka nui o ka ʻōnaehana anticoagulation a ʻoi aku ka maʻalahi o ke kahe koko, a ʻoi aku ka nui o ka ʻōnaehana coagulation a ʻoi aku ka maʻalahi o ka thrombosis. He kuleana koʻikoʻi ka ʻōnaehana fibrinolysis i ka thrombolysis. I kēia lā e kamaʻilio mākou e pili ana i nā ʻōuli ʻelua ʻē aʻe o ka ʻōnaehana fibrinolysis, ʻo D-dimer a me FDP, e hoʻomaopopo piha i ka hemostasis i hana ʻia e thrombin i ka thrombus i hoʻomaka ʻia e fibrinolysis. Evolution. Hāʻawi i ka ʻike kumu lapaʻau e pili ana i ka thrombosis a me ka hana coagulation o nā maʻi.
ʻO D-dimer kahi huahana hoʻohaʻahaʻa kikoʻī i hana ʻia e ka fibrin monomer i hoʻopili ʻia e ka factor XIII i hoʻāla ʻia a laila hydrolyzed e plasmin. Loaʻa ʻo D-dimer mai ka clot fibrin i hoʻopili ʻia i hoʻoheheʻe ʻia e plasmin. Hōʻike ka D-dimer kiʻekiʻe i ke alo o ka hyperfibrinolysis lua (e like me DIC). ʻO FDP ka huaʻōlelo maʻamau no nā huahana hoʻohaʻahaʻa i hana ʻia ma hope o ka haki ʻana o ka fibrin a i ʻole fibrinogen ma lalo o ka hana a plasmin i hana ʻia i ka wā o ka hyperfibrinolysis. Loaʻa iā FDP nā huahana fibrinogen (Fg) a me nā huahana fibrin monomer (FM) (FgDPs), a me nā huahana hoʻohaʻahaʻa fibrin i hoʻopili ʻia (FbDPs), kahi i loaʻa ai i nā FbDP nā D-dimers a me nā ʻāpana ʻē aʻe, a piʻi ko lākou pae. Hōʻike ke kiʻekiʻe he hyperactive ka hana fibrinolytic o ke kino (fibrinolysis mua a i ʻole fibrinolysis lua).
【Laʻana】
Ua hoʻokomo ʻia kekahi kāne waena i ka haukapila a ʻo nā hopena o ka nānā ʻana i ke koko e like me kēia:
| Mea | Hopena | Pae Kuhikuhi |
| PT | 13.2 | 10-14s |
| APTT | 28.7 | 22-32s |
| TT | 15.4 | 14-21s |
| FIB | 3.2 | 1.8-3.5g/l |
| DD | 40.82 | 0-0.55mg/I FEU |
| FDP | 3.8 | 0-5mg/l |
| AT-III | 112 | 75-125% |
ʻO nā mea ʻehā o ka coagulation ua maikaʻi ʻole, ua maikaʻi ʻo D-dimer, a ua maikaʻi ʻole ʻo FDP, a ua kūʻē nā hopena. I ka wā mua i manaʻo ʻia he hopena makau, ua nānā hou ʻia ka hāpana e ka hoʻāʻo mua a me ka hoʻoheheʻe ʻana o 1:10, penei ka hopena:
| Mea | Kumu | hoʻoheheʻe 1:10 | Pae Kuhikuhi |
| DD | 38.45 | 11.12 | 0-0.55mg/I FEU |
| FDP | 3.4 | Ma lalo o ka palena haʻahaʻa | 0-5mg/l |
Hiki ke ʻike ʻia mai ka dilution e pono ke maʻamau ka hopena FDP, a ʻaʻole linear ka D-dimer ma hope o ka dilution, a ke kānalua ʻia nei ke komo ʻana. E kāpae i ka hemolysis, lipemia, a me ka jaundice mai ke kūlana o ka laʻana. Ma muli o nā hopena kūlike ʻole o ka dilution, hiki ke loaʻa kēlā mau hihia i ka hoʻopilikia maʻamau me nā antibodies heterophilic a i ʻole nā mea rheumatoid. E nānā i ka mōʻaukala olakino o ka mea maʻi a loaʻa ka mōʻaukala o ka rheumatoid arthritis. Keʻena hoʻokolohua Ua kiʻekiʻe iki ka hopena o ka hoʻokolokolo ʻana o ka RF factor. Ma hope o ke kamaʻilio ʻana me ke keʻena lapaʻau, ua ʻōlelo ʻia ka mea maʻi a ua hoʻopuka ʻia kahi hōʻike. I ka hahai ʻana ma hope, ʻaʻohe hōʻailona pili i ka thrombus o ka mea maʻi a ua manaʻo ʻia he hihia maikaʻi ʻole o D-dimer.
【Hōʻuluʻulu Manaʻo】
He hōʻailona koʻikoʻi ka D-dimer no ka hoʻokaʻawale maikaʻi ʻole ʻana o ka thrombosis. Loaʻa iā ia ka ʻike kiʻekiʻe, akā e nāwaliwali ka kikoʻī e pili ana. Aia kekahi hapa o nā maikaʻi wahaheʻe. Hiki i ka hui pū ʻana o D-dimer a me FDP ke hōʻemi i kahi hapa o D- No ka maikaʻi wahaheʻe o ka dimer, ke hōʻike ka hopena o ka hale hana he D-dimer ≥ FDP, hiki ke hana ʻia nā hoʻoholo aʻe ma ka hopena hoʻāʻo:
1. Inā haʻahaʻa nā waiwai (
2. Inā he waiwai kiʻekiʻe ka hopena (>Cut-off value), e kālailai i nā mea hoʻohuli, aia paha nā mea hoʻopilikia. Manaʻo ʻia e hana i ka hoʻāʻo dilution he nui. Inā linear ka hopena, ʻoi aku ka nui o ka maikaʻi maoli. Inā ʻaʻole linear, nā maikaʻi wahaheʻe. Hiki iā ʻoe ke hoʻohana i ka lua o ka reagent no ka hōʻoia a kamaʻilio me ke keʻena lapaʻau i ka manawa kūpono.
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