Nyob rau hauv cov xwm txheej ntawm lub cev, ob lub cev ntawm cov ntshav coagulation thiab anticoagulation hauv lub cev tswj hwm qhov sib npaug dynamic kom cov ntshav ntws hauv cov hlab ntsha. Yog tias qhov sib npaug tsis sib npaug, lub cev anticoagulation yog predominant thiab qhov kev los ntshav yuav tshwm sim, thiab lub cev coagulation yog predominant thiab thrombosis yuav tshwm sim. Lub cev fibrinolysis ua lub luag haujlwm tseem ceeb hauv thrombolysis. Hnub no peb yuav tham txog ob qho cim ntawm lub cev fibrinolysis, D-dimer thiab FDP, kom nkag siab tag nrho cov hemostasis tsim los ntawm thrombin rau thrombus pib los ntawm fibrinolysis. Kev hloov pauv. Muab cov ntaub ntawv kho mob yooj yim txog cov neeg mob thrombosis thiab coagulation ua haujlwm.
D-dimer yog ib yam khoom tawg tshwj xeeb uas tsim los ntawm fibrin monomer cross-linked los ntawm activated factor XIII thiab tom qab ntawd hydrolyzed los ntawm plasmin. D-dimer yog los ntawm cross-linked fibrin clot yaj los ntawm plasmin. D-dimer siab qhia txog qhov muaj secondary hyperfibrinolysis (xws li DIC). FDP yog lo lus dav dav rau cov khoom tawg tsim tom qab fibrin lossis fibrinogen raug rhuav tshem raws li qhov kev ua ntawm plasmin tsim thaum lub sijhawm hyperfibrinolysis. FDP suav nrog fibrinogen (Fg) thiab fibrin monomer (FM) cov khoom (FgDPs), nrog rau cov khoom tawg cross-linked fibrin (FbDPs), ntawm cov FbDPs suav nrog D-dimers thiab lwm yam khoom tawg, thiab lawv cov qib nce siab qhia tias lub cev fibrinolytic kev ua haujlwm yog hyperactive (primary fibrinolysis lossis secondary fibrinolysis).
【Piv txwv】
Muaj ib tug txiv neej hnub nyoog nruab nrab tau raug xa mus rau tsev kho mob thiab cov txiaj ntsig ntawm kev kuaj ntshav txhaws yog raws li nram no:
| Khoom | Qhov tshwm sim | Qhov Siv Tau |
| PT | 13.2 | 10-14 vib nas this |
| 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% |
Plaub yam khoom ntawm kev coagulation yog tsis zoo tag nrho, D-dimer yog qhov zoo, thiab FDP yog qhov tsis zoo, thiab cov txiaj ntsig tsis sib xws. Chiv thawj xav tias yog qhov cuam tshuam hook, cov qauv tau rov kuaj dua los ntawm thawj qhov ntau thiab 1:10 dilution test, qhov tshwm sim yog raws li nram no:
| Khoom | Thawj | 1:10 dilution | Qhov Siv Tau |
| DD | 38.45 | 11.12 | 0-0.55mg/I FEU |
| FDP | 3.4 | Hauv qab qhov txwv qis dua | 0-5mg/l |
Nws tuaj yeem pom los ntawm kev dilution tias FDP qhov tshwm sim yuav tsum yog qhov qub, thiab D-dimer tsis yog linear tom qab dilution, thiab kev cuam tshuam yog xav tias muaj. Tshem tawm hemolysis, lipemia, thiab jaundice los ntawm qhov xwm txheej ntawm cov qauv. Vim yog cov txiaj ntsig tsis sib xws ntawm kev dilution, cov xwm txheej zoo li no yuav tshwm sim hauv kev cuam tshuam nrog heterophilic antibodies lossis rheumatoid factors. Tshawb xyuas tus neeg mob keeb kwm kho mob thiab nrhiav keeb kwm ntawm rheumatoid mob caj dab. Kuaj Mob Qhov tshwm sim ntawm kev kuaj RF factor yog qhov siab heev. Tom qab sib txuas lus nrog lub tsev kho mob, tus neeg mob tau hais thiab muab daim ntawv tshaj tawm. Hauv kev saib xyuas tom qab, tus neeg mob tsis muaj cov tsos mob ntsig txog thrombus thiab tau txiav txim siab tias yog qhov tseeb ntawm D-dimer.
【Sau luv luv】
D-dimer yog ib qho cim qhia tseem ceeb ntawm kev tsis suav nrog qhov tsis zoo ntawm thrombosis. Nws muaj kev nkag siab siab, tab sis qhov tshwj xeeb sib xws yuav tsis muaj zog. Kuj tseem muaj qee qhov feem pua ntawm cov cuav zoo. Kev sib xyaw ua ke ntawm D-dimer thiab FDP tuaj yeem txo qee qhov ntawm D- Rau qhov cuav zoo ntawm dimer, thaum cov txiaj ntsig hauv chav kuaj qhia tias D-dimer ≥ FDP, cov kev txiav txim siab hauv qab no tuaj yeem ua rau ntawm qhov tshwm sim ntawm kev xeem:
1. Yog tias cov nqi qis (
2. Yog tias qhov tshwm sim yog tus nqi siab (> Tus nqi txiav tawm), tshuaj xyuas cov yam cuam tshuam, tej zaum yuav muaj cov yam cuam tshuam. Nws raug pom zoo kom ua qhov kev sim dilution ntau zaus. Yog tias qhov tshwm sim yog linear, qhov tseeb zoo dua yuav muaj feem ntau. Yog tias nws tsis yog linear, qhov cuav zoo. Koj tuaj yeem siv cov tshuaj reagent thib ob rau kev txheeb xyuas thiab sib txuas lus nrog lub tsev kho mob raws sijhawm.
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