Vim li cas cov hlab ntshav tuaj yeem siv los ntsuas D-dimer cov ntsiab lus?Yuav muaj fibrin clot tsim nyob rau hauv cov hlab ntshav, puas yuav tsis degraded rau hauv D-dimer?Yog tias nws tsis degrade, vim li cas thiaj li muaj qhov nce ntxiv hauv D-dimer thaum cov ntshav txhaws tau tsim hauv cov hlab ntsha anticoagulation vim cov ntshav tsis zoo rau kev kuaj coagulation?
Ua ntej tshaj plaws, kev sau cov ntshav tsis zoo tuaj yeem ua rau vascular endothelial puas tsuaj, thiab tso tawm cov ntaub so ntswg subendothelial thiab cov ntaub so ntswg-type plasminogen activator (tPA) rau hauv cov ntshav.Ntawm qhov tod tes, cov ntaub so ntswg activates exogenous coagulation txoj kev los tsim 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 tsim fibrin, nws ua raws li cofactor kom nce cov kev ua ntawm tPA los ntawm 100 lub sij hawm, thiab tom qab tPA txuas rau saum npoo ntawm fibrin, nws yuav tsis yooj yim inhibited los ntawm plasminogen activation inhibitor-1 ( PAB-1).Yog li ntawd, plasminogen tuaj yeem hloov mus rau hauv plasmin sai thiab tsis tu ncua, thiab tom qab ntawd fibrin tuaj yeem raug degraded, thiab ntau ntawm FDP thiab D-Dimer tuaj yeem tsim tau.Qhov no yog vim li cas vim li cas cov ntshav txhaws hauv vitro thiab cov khoom siv fibrin degradation tau nce ntau vim qhov tsis zoo ntawm cov ntshav kuaj.
Tom qab ntawd, vim li cas qhov kev sau ib txwm ntawm cov hlab ntshav (tsis muaj tshuaj ntxiv lossis nrog cov coagulant) cov qauv kuj tsim fibrin clots hauv vitro, tab sis tsis degrade los tsim kom muaj ntau ntawm FDP thiab D-dimer?Qhov no nyob ntawm seb lub raj dej.Dab tsi tshwm sim tom qab sau cov qauv: Ua ntej, tsis muaj ntau npaum li cas ntawm tPA nkag mus rau hauv cov ntshav;thib ob, txawm tias 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 nyob rau hauv cov hlab ntshav tsis muaj cov tshuaj ntxiv lossis nrog coagulant.Nws siv sijhawm ntau tshaj kaum feeb rau cov ntshav yam tsis muaj cov tshuaj ntxiv rau coagulate ib txwm, thaum cov ntshav nrog coagulant (feem ntau silicon hmoov) pib sab hauv.Nws tseem siv sijhawm ntau dua 5 feeb los tsim cov fibrin los ntawm txoj kev ntshav coagulation.Tsis tas li ntawd, kev ua haujlwm fibrinolytic ntawm chav tsev kub hauv vitro kuj tseem yuav cuam tshuam.
Cia peb tham txog thromboelastogram dua nyob rau hauv cov ncauj lus no: koj tuaj yeem nkag siab tias cov ntshav txhaws hauv cov hlab ntshav tsis yooj yim degraded, thiab koj tuaj yeem nkag siab tias yog vim li cas qhov kev kuaj thromboelastogram (TEG) tsis nkag siab los cuam tshuam txog hyperfibrinolysis-ob qhov xwm txheej zoo sib xws, Yog lawm, qhov ntsuas kub thaum lub sijhawm ntsuas TEG tuaj yeem tswj tau ntawm 37 degrees.Yog tias TEG muaj kev cuam tshuam ntau dua los cuam tshuam cov xwm txheej fibrinolysis, ib txoj hauv kev yog ntxiv tPA hauv kev sim hauv vitro TEG, tab sis tseem muaj teeb meem kev tsim qauv thiab tsis muaj daim ntawv thov thoob ntiaj teb;Tsis tas li ntawd, nws tuaj yeem ntsuas ntawm lub txaj txaj tam sim tom qab kuaj, tab sis qhov tseeb cov nyhuv kuj tseem txwv.Ib qho kev sim tshuaj thiab ua tau zoo dua rau kev ntsuas kev ua haujlwm fibrinolytic yog lub sijhawm tawg ntawm euglobulin.Qhov laj thawj rau nws qhov rhiab heev yog siab dua li ntawm TEG.Hauv kev sim, cov tshuaj tiv thaiv plasmin raug tshem tawm los ntawm kev kho cov nqi pH thiab centrifugation, tab sis qhov kev sim siv nws siv sij hawm ntev thiab kuj ntxhib, thiab nws tsis tshua muaj nyob rau hauv lub chaw soj nstuam.
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