(1) D-dimer
Raws li cov khoom lag luam degradation ntawm cross-linked fibrin, D-dimer yog ib qho cim qhia txog kev ua haujlwm coagulation thiab secondary hyperfibrinolysis. Hauv cov neeg mob uas muaj COVID-19, cov qib D-dimer siab yog ib qho cim tseem ceeb rau qhov ua tau coagulation teeb meem. Cov qib D-dimer kuj muaj feem cuam tshuam nrog qhov hnyav ntawm tus kab mob, thiab cov neeg mob uas muaj D-dimer siab heev thaum nkag mus muaj qhov kev kwv yees tsis zoo. Cov lus qhia los ntawm International Society of Thrombosis and Hemostasis (ISTH) pom zoo tias D-dimer siab heev (feem ntau ntau dua 3 lossis 4 npaug ntawm qhov txwv siab tshaj plaws ntawm qhov ib txwm) tuaj yeem yog qhov qhia txog kev pw hauv tsev kho mob rau cov neeg mob COVID-19, tom qab tshem tawm cov kev tsis pom zoo Anticoagulation nrog cov koob tshuaj prophylactic ntawm cov tshuaj heparin qis-molecular-weight yuav tsum tau muab rau cov neeg mob zoo li no sai li sai tau. Thaum D-dimer nce siab zuj zus thiab muaj kev xav tias muaj venous thrombosis lossis microvascular embolism, anticoagulation nrog cov koob tshuaj heparin kho mob yuav tsum tau xav txog.

Txawm hais tias D-dimer siab kuj tseem yuav qhia txog hyperfibrinolysis, qhov kev los ntshav hauv cov neeg mob COVID-19 uas muaj D-dimer siab heev tsis tshua muaj tshwj tsis yog tias nce mus rau theem DIC hypocoagulable, qhia tias COVID-19 Lub cev fibrinolytic ntawm -19 tseem raug txwv tsis pub ua. Lwm lub cim qhia txog fibrin, uas yog, qhov kev hloov pauv ntawm FDP qib thiab D-dimer qib yeej zoo ib yam.

 

(2) PT
Kev ncua sijhawm PT kuj yog ib qho cim qhia txog kev mob ntshav coagulation hauv cov neeg mob COVID-19 thiab tau pom tias muaj feem cuam tshuam nrog kev kwv yees tsis zoo. Thaum ntxov ntawm kev mob ntshav coagulation hauv COVID-19, cov neeg mob uas muaj PT feem ntau yog ib txwm lossis me ntsis txawv txav, thiab kev ncua sijhawm PT hauv lub sijhawm hypercoagulable feem ntau qhia txog kev ua haujlwm thiab kev siv cov yam ntxwv coagulation sab nraud, nrog rau kev qeeb ntawm fibrin polymerization, yog li nws kuj yog kev tiv thaiv anticoagulation. ib qho ntawm cov cim qhia. Txawm li cas los xij, thaum PT ntev dua, tshwj xeeb tshaj yog thaum tus neeg mob muaj cov tsos mob los ntshav, nws qhia tias kev mob ntshav coagulation tau nkag mus rau theem qis coagulation, lossis tus neeg mob muaj teeb meem los ntawm kev tsis txaus siab, vitamin K tsis txaus, anticoagulant overdose, thiab lwm yam, thiab plasma transfusion yuav tsum tau xav txog. Lwm txoj kev kho mob. Lwm yam khoom siv tshuaj ntsuam xyuas coagulation, ua haujlwm ib nrab thromboplastin lub sijhawm (APTT), feem ntau yog khaws cia ntawm qib ib txwm thaum lub sijhawm hypercoagulable ntawm kev mob ntshav coagulation, uas tej zaum yuav yog vim muaj kev ua haujlwm ntau ntxiv ntawm yam VIII hauv lub xeev inflammatory.

 

(3) Kev suav cov ntshav thiab kev ua haujlwm ntawm cov ntshav
Txawm hais tias kev ua kom cov ntshav coagulation ua rau cov ntshav platelet tsawg zuj zus, tab sis cov ntshav platelet tsawg zuj zus tsis tshua muaj nyob rau hauv cov neeg mob COVID-19, uas tej zaum yuav muaj feem cuam tshuam nrog kev tso tawm ntawm thrombopoietin, IL-6, cytokines uas txhawb nqa cov ntshav platelet reactivity hauv cov xeev inflammatory. Yog li ntawd, qhov tseem ceeb ntawm cov ntshav platelet tsis yog qhov qhia txog kev coagulation teeb meem hauv COVID-19, thiab nws yuav muaj txiaj ntsig zoo dua los them sai sai rau nws cov kev hloov pauv. Tsis tas li ntawd, cov ntshav platelet tsawg zuj zus yog qhov tseem ceeb nrog kev kwv yees tsis zoo thiab kuj yog ib qho ntawm cov cim qhia rau kev tiv thaiv anticoagulation. Txawm li cas los xij, thaum cov lej raug txo qis (piv txwv li, <50 × 109 / L), thiab tus neeg mob muaj cov tsos mob los ntshav, yuav tsum xav txog kev hloov ntshav platelet.

Zoo ib yam li cov txiaj ntsig ntawm kev tshawb fawb yav dhau los hauv cov neeg mob uas muaj sepsis, kev kuaj mob platelet hauv vitro hauv cov neeg mob COVID-19 uas muaj teeb meem coagulation feem ntau muab cov txiaj ntsig qis, tab sis cov platelets tiag tiag hauv cov neeg mob feem ntau ua haujlwm, uas tej zaum yuav yog vim muaj kev ua haujlwm qis dua. Cov platelets siab thawj zaug siv thiab noj los ntawm cov txheej txheem coagulation, thiab cov haujlwm sib piv ntawm cov platelets hauv cov ntshav uas tau sau yog qis.

 

(4) FIB
Ua ib qho protein teb sai sai, cov neeg mob uas muaj COVID-19 feem ntau muaj cov FIB siab heev nyob rau theem mob sai sai, uas tsis yog tsuas yog cuam tshuam nrog qhov mob hnyav xwb, tab sis FIB nws tus kheej kuj yog ib qho kev pheej hmoo rau thrombosis, yog li nws tuaj yeem siv ua COVID-19 Ib qho ntawm cov cim qhia rau anticoagulation hauv cov neeg mob. Txawm li cas los xij, thaum tus neeg mob muaj FIB txo qis zuj zus, nws yuav qhia tau tias qhov teeb meem coagulation tau nce mus rau theem hypocoagulable, lossis tus neeg mob muaj mob siab tsis txaus, uas feem ntau tshwm sim nyob rau theem kawg ntawm tus kab mob, thaum FIB <1.5 g / L thiab nrog los ntawm kev los ntshav, FIB infusion yuav tsum tau xav txog.