Feem ntau D-dimer yog siv ua ib qho ntawm cov cim qhia tseem ceeb ntawm PTE thiab DVT hauv kev kho mob. Nws tshwm sim li cas?

Plasma D-dimer yog ib yam khoom tshwj xeeb uas tsim los ntawm plasmin hydrolysis tom qab fibrin monomer raug cross-linked los ntawm activating factor XIII. Nws yog ib qho cim tshwj xeeb ntawm cov txheej txheem fibrinolysis. D-dimers yog los ntawm cov cross-linked fibrin clots uas plasmin lysed. Tsuav yog muaj cov thrombosis thiab fibrinolytic ua haujlwm hauv cov hlab ntsha ntawm lub cev, D-dimer yuav nce ntxiv. Myocardial infarction, cerebral infarction, pulmonary embolism, venous thrombosis, phais, qog, disseminated intravascular coagulation, kev kis kab mob thiab cov nqaij necrosis tuaj yeem ua rau D-dimer siab. Tshwj xeeb tshaj yog rau cov neeg laus thiab cov neeg mob hauv tsev kho mob, vim yog bacteremia thiab lwm yam kab mob, nws yooj yim ua rau cov ntshav coagulation tsis zoo thiab ua rau D-dimer nce ntxiv.

D-dimer feem ntau qhia txog kev ua haujlwm fibrinolytic. Kev nce lossis zoo pom nyob rau hauv hyperfibrinolysis theem ob, xws li lub xeev hypercoagulable, disseminated intravascular coagulation, kab mob raum, kev tsis lees txais hloov pauv lub cev, kev kho mob thrombolytic, thiab lwm yam. Kev txiav txim siab ntawm cov yam tseem ceeb ntawm lub cev fibrinolytic yog qhov tseem ceeb heev rau kev kuaj mob thiab kho cov kab mob ntawm lub cev fibrinolytic (xws li DIC, ntau yam thrombus) thiab cov kab mob cuam tshuam nrog lub cev fibrinolytic (xws li qog, cev xeeb tub syndrome), thiab kev saib xyuas kev kho mob thrombolytic.

Cov theem siab ntawm D-dimer, ib qho khoom lag luam fibrin degradation, qhia txog kev puas tsuaj ntawm fibrin ntau zaus hauv vivo. Yog li ntawd, fibrous D-dimer yog ib qho cim tseem ceeb ntawm kev mob ntshav hauv cov hlab ntsha tob (DVT), pulmonary embolism (PE), disseminated intravascular coagulation (DIC).

Muaj ntau yam kab mob ua rau lub cev coagulation system thiab/lossis fibrinolytic system ua haujlwm, ua rau muaj kev nce ntxiv ntawm D-dimer, thiab qhov kev ua haujlwm no muaj feem cuam tshuam nrog theem, qhov hnyav thiab kev kho mob ntawm tus kab mob, yog li ntawd hauv cov kab mob no Kev kuaj pom ntawm D-dimer tuaj yeem siv ua lub cim ntsuas rau kev ntsuas tus kab mob, kev kwv yees thiab kev taw qhia kev kho mob.

Kev siv D-dimer hauv kev kho mob thrombosis ntawm cov hlab ntsha tob

Txij li thaum Wilson et al. thawj zaug siv cov khoom siv fibrin degradation rau kev kuaj mob pulmonary embolism hauv xyoo 1971, kev kuaj pom D-dimer tau ua lub luag haujlwm tseem ceeb hauv kev kuaj mob pulmonary embolism. Nrog rau qee txoj kev kuaj mob rhiab heev, D-dimer tsis zoo Lub cev tus nqi muaj qhov cuam tshuam tsis zoo rau kev kwv yees pulmonary embolism, thiab nws tus nqi yog 0.99. Qhov tshwm sim tsis zoo tuaj yeem tshem tawm pulmonary embolism, yog li txo qhov kev kuaj mob invasive, xws li kev ntsuas cua perfusion thiab pulmonary angiography; zam kev kho mob dig muag anticoagulation.D - Qhov concentration ntawm dimer yog cuam tshuam nrog qhov chaw ntawm thrombus, nrog rau cov concentration siab dua hauv cov ceg loj ntawm lub cev pulmonary thiab cov concentration qis dua hauv cov ceg me.

Cov ntshav plasma D-dimers uas tsis pom tseeb tsis qhia tias muaj peev xwm muaj DVT. Kev kuaj ntshav angiography tau lees paub tias DVT muaj 100% D-dimer. Siv tau rau kev kho mob thrombolytic thiab kev qhia txog kev siv tshuaj heparin anticoagulation thiab kev soj ntsuam qhov ua tau zoo.

D-dimer tuaj yeem qhia txog kev hloov pauv ntawm qhov loj ntawm cov ntshav txhaws. Yog tias cov ntsiab lus nce ntxiv dua, nws qhia txog kev rov tshwm sim ntawm cov ntshav txhaws; thaum lub sijhawm kho mob, nws tseem siab, thiab qhov loj ntawm cov ntshav txhaws tsis hloov pauv, qhia tias kev kho mob tsis zoo.