Vim li cas cov raj xa ntshav thiaj siv tau los ntsuas cov D-dimer? Yuav muaj cov fibrin clot tsim nyob rau hauv cov raj xa ntshav, nws puas yuav tsis raug rhuav tshem mus ua D-dimer? Yog tias nws tsis lwj, vim li cas thiaj muaj D-dimer nce ntxiv thaum cov ntshav txhaws tsim nyob rau hauv cov raj xa ntshav vim yog kev kuaj ntshav tsis zoo rau kev kuaj coagulation?
Ua ntej tshaj plaws, kev sau cov ntshav tsis zoo tuaj yeem ua rau cov hlab ntsha endothelial puas tsuaj, thiab tso tawm cov ntaub so ntswg subendothelial thiab cov ntaub so ntswg-hom plasminogen activator (tPA) rau hauv cov ntshav. Ntawm ib sab tes, cov ntaub so ntswg ua rau txoj kev coagulation sab nraud los tsim cov fibrin clots. Cov txheej txheem no ceev heev. Tsuas yog saib lub sijhawm prothrombin (PT) kom paub, uas feem ntau yog li 10 vib nas this. Ntawm qhov tod tes, tom qab fibrin tsim, nws ua haujlwm ua tus cofactor los ua kom cov haujlwm ntawm tPA nce 100 zaug, thiab tom qab tPA txuas rau ntawm qhov chaw ntawm fibrin, nws yuav tsis yooj yim txwv los ntawm plasminogen activation inhibitor-1 (PAI-1). Yog li ntawd, plasminogen tuaj yeem hloov pauv sai thiab txuas ntxiv mus rau hauv plasmin, thiab tom qab ntawd fibrin tuaj yeem degraded, thiab ntau FDP thiab D-Dimer tuaj yeem tsim tau. Qhov no yog qhov laj thawj vim li cas cov ntshav txhaws hauv vitro thiab cov khoom lag luam fibrin degradation tau nce ntxiv vim yog kev kuaj ntshav tsis zoo.
Tom qab ntawd, vim li cas cov qauv serum ib txwm muaj (tsis muaj cov khoom ntxiv lossis nrog cov tshuaj coagulant) kuj tsim cov fibrin clots hauv vitro, tab sis tsis tau lwj kom tsim cov FDP thiab D-dimer ntau? Qhov no nyob ntawm lub raj serum. Muaj dab tsi tshwm sim tom qab sau cov qauv: Ua ntej, tsis muaj ntau tPA nkag mus rau hauv cov ntshav; qhov thib ob, txawm tias muaj me me ntawm tPA nkag mus rau hauv cov ntshav, tPA dawb yuav raug khi los ntawm PAI-1 thiab poob nws cov haujlwm hauv li 5 feeb ua ntej nws txuas rau fibrin. Lub sijhawm no, feem ntau tsis muaj fibrin tsim hauv lub raj serum yam tsis muaj cov khoom ntxiv lossis nrog cov tshuaj coagulant. Nws siv sijhawm ntau dua kaum feeb rau cov ntshav yam tsis muaj cov khoom ntxiv kom coagulate ntuj, thaum cov ntshav nrog coagulant (feem ntau yog silicon hmoov) pib sab hauv. Nws kuj siv sijhawm ntau dua 5 feeb los tsim fibrin los ntawm txoj kev coagulation ntshav. Tsis tas li ntawd, qhov kev ua haujlwm fibrinolytic ntawm chav tsev kub hauv vitro kuj tseem yuav raug cuam tshuam.
Cia peb tham txog qhov thromboelastogram dua raws li cov ncauj lus no: koj tuaj yeem nkag siab tias cov ntshav txhaws hauv lub raj xa dej tsis yooj yim puas tsuaj, thiab koj tuaj yeem nkag siab tias vim li cas qhov kev xeem thromboelastogram (TEG) tsis rhiab heev rau kev cuam tshuam hyperfibrinolysis-ob qho xwm txheej Nws zoo sib xws, tau kawg, qhov kub thaum lub sijhawm xeem TEG tuaj yeem tswj tau ntawm 37 degrees. Yog tias TEG rhiab heev dua los cuam tshuam qhov xwm txheej fibrinolysis, ib txoj hauv kev yog ntxiv tPA hauv kev sim TEG hauv vitro, tab sis tseem muaj teeb meem kev teeb tsa tus qauv thiab tsis muaj kev siv thoob ntiaj teb; ntxiv rau, nws tuaj yeem ntsuas ntawm lub txaj tam sim ntawd tom qab kuaj, tab sis qhov cuam tshuam tiag tiag kuj txwv heev. Ib qho kev xeem ib txwm muaj thiab zoo dua rau kev ntsuam xyuas kev ua haujlwm fibrinolytic yog lub sijhawm yaj ntawm euglobulin. Qhov laj thawj rau nws qhov rhiab heev yog siab dua li ntawm TEG. Hauv kev xeem, cov tshuaj tiv thaiv plasmin raug tshem tawm los ntawm kev kho qhov pH thiab centrifugation, tab sis qhov kev xeem siv sijhawm ntev thiab tsis tshua muaj, thiab nws tsis tshua muaj nyob hauv chaw soj nstuam.
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