A na-ejikọta ihe na-eme ka ihe dị n'ọbara nke akpọrọ "fibrin monomers" site na iji ihe X III arụ ọrụ, wee jiri plasmin rụọ ọrụ mee ka ọ dị mmiri mmiri iji mepụta ngwaahịa mmebi kpọmkwem nke a na-akpọ "fibrin degeneration product (FDP)." D-Dimer bụ FDP kachasị mfe, mmụba nke oke ya na-egosipụta ọnọdụ hypercoagulable na hyperfibrinolysis nke abụọ na vivo. Ya mere, ntinye nke D-Dimer dị oke mkpa maka nchọpụta, nyocha arụmọrụ na mkpebi amụma nke ọrịa thrombotic.
Kemgbe ọrịa COVID-19 malitere, ya na mmụba nke ihe ndị na-egosi ọrịa na nghọta ọrịa nke ọrịa ahụ na mmụba nke ahụmịhe nchọpụta na ọgwụgwọ, ndị ọrịa siri ike nwere ọrịa pneumonia ọhụrụ nwere ike ịmalite ọrịa iku ume ngwa ngwa. Ihe mgbaàmà, ihe mgbu septic, acidosis metabolic refractory, nsogbu coagulation, na ọdịda akụkụ ahụ dị iche iche. D-dimer na-abawanye na ndị ọrịa nwere nnukwu pneumonia.
Ndị ọrịa nwere nnukwu ọrịa kwesịrị ilebara anya n'ihe ize ndụ nke venous thromboembolism (VTE) n'ihi ezumike ogologo oge n'ihe ndina na ọrụ coagulation na-adịghị mma.
N'oge ọgwụgwọ ahụ, ọ dị mkpa ka a na-enyocha ihe ngosi ndị dị mkpa dịka ọnọdụ ahụ si dị, gụnyere ihe nrịbama myocardial, ọrụ coagulation, wdg. Ụfọdụ ndị ọrịa nwere ike inwe mmụba myoglobin, ụfọdụ ikpe siri ike nwere ike ịhụ mmụba troponin, na n'ọnọdụ ndị siri ike, enwere ike ịbawanye D-dimer (D-Dimer).
A pụrụ ịhụ na D-Dimer nwere mkpa nlekota ihe ndị metụtara nsogbu na ọganihu nke COVID-19, yabụ kedu ka o si arụ ọrụ na ọrịa ndị ọzọ?
1. Ọkpụkpụ akwara thromboembolism
A na-eji D-Dimer eme ihe nke ukwuu n'ọrịa ndị metụtara thromboembolism venous (VTE), dịka thrombosis miri emi nke akwara (DVT) na pulmonary embolism (PE). Nnwale D-Dimer na-adịghị mma nwere ike iwepụ DVT, enwere ike iji ntinye D-Dimer buru amụma ọnụego nlọghachi nke VTE. Ọmụmụ ihe ahụ chọpụtara na oke ihe egwu nke nlọghachi nke VTE na ndị nwere ntinye dị elu bụ ugboro 4.1 karịa nke ndị nwere ntinye nkịtị.
D-Dimer bụkwa otu n'ime ihe ngosi nchọpụta nke PE. Uru amụma ọjọọ ya dị oke elu, ihe ọ pụtara bụ iwepụ ọrịa akpa ume dị oke njọ, ọkachasị n'ime ndị ọrịa nwere obere enyo. Ya mere, maka ndị ọrịa a na-enyo enyo na ha nwere ọrịa akpa ume dị oke njọ, a ga-ejikọta ultrasound nke akwara miri emi nke nsọtụ ala na nyocha D-Dimer.
2. Mkpọchi ọbara n'ime akwara na-agbasa
Mkpọchi ọbara n'ime akwara (DIC) bụ ọrịa ahụike nke a na-akpọ ọbara ọgbụgba na ọdịda microcirculatory dabere na ọtụtụ ọrịa. Usoro mmepe ahụ gụnyere ọtụtụ sistemụ dị ka coagulation, anticoagulation, na fibrinolysis. D-Dimer mụbara na mbido mmalite nke DIC, ọnụ ọgụgụ ya nọgidere na-abawanye ihe karịrị okpukpu iri ka ọrịa ahụ na-aga n'ihu. Ya mere, enwere ike iji D-Dimer dị ka otu n'ime ihe ngosi bụ isi maka nchọpụta mbụ na nlekota ọnọdụ nke DIC.
3. Ngwuputa akwara obi
"Nkwekọrịta ndị ọkachamara na China gbasara nchọpụta na ọgwụgwọ nke ịwa ahụ nke ịwa ahụ nke akwara" gosiri na D-Dimer, dịka ule ụlọ nyocha a na-eme kwa ụbọchị maka ịwa ahụ nke akwara (AD), dị oke mkpa maka nchọpụta na nchọpụta ọdịiche nke ịwa ahụ. Mgbe D-Dimer nke onye ọrịa na-ebili ngwa ngwa, ohere nke ịchọpụta ọrịa dịka AD na-abawanye. N'ime awa 24 nke mmalite, mgbe D-Dimer ruru uru dị oke mkpa nke 500 µg/L, mmetụta ya maka ịchọpụta ọrịa AD dị oke njọ bụ 100%, nkọwapụta ya bụkwa 67%, yabụ enwere ike iji ya dị ka ihe ndeksi mwepụ maka nchọpụta nke ọrịa AD dị oke njọ.
4. Ọrịa Obi na Atherosclerotic
Ọrịa obi na akwara obi nke atherosclerotic bụ ọrịa obi nke ihe mkpuchi akwara ọbara na-akpata, gụnyere ST-segment elevation acute myocardial infarction, non-ST-segment elevation acute myocardial infarction, na angina na-adịghị agbanwe agbanwe. Mgbe ihe mkpuchi ahụ gbawara, ihe necrotic core dị na ihe mkpuchi ahụ na-apụ apụ, na-akpata ihe ndị na-adịghị mma na ọbara, na-eme ka usoro coagulation rụọ ọrụ, na mmụba nke D-Dimer. Ndị ọrịa nwere ọrịa obi obi nwere D-Dimer dị elu nwere ike ibu amụma ihe egwu dị elu nke AMI ma enwere ike iji ya dị ka ihe ngosi iji hụ ọnọdụ ACS.
5. Ọgwụgwọ Thrombolytic
Nnyocha Lawter chọpụtara na ọtụtụ ọgwụ thrombolytic nwere ike ime ka D-Dimer dịkwuo elu, a pụkwara iji ya mee ihe dị ka ihe ngosi maka ikpe ọgwụgwọ thrombolytic tupu na mgbe e mesịrị. Ọdịnaya ya mụbara ngwa ngwa ruo n'ọkwa kachasị elu mgbe e mechara thrombolysis, wee daa azụ n'oge dị mkpirikpi, na-enwe nnukwu mmụba na mgbaàmà ahụike, na-egosi na ọgwụgwọ ahụ dị irè.
- Ọkwa D-Dimer mụbara nke ukwuu site na awa 1 ruo awa 6 mgbe thrombolysis gasịrị maka nnukwu nkụchi obi na nkụchi ụbụrụ
- N'oge DVT thrombolysis, oke D-Dimer na-apụtakarị awa 24 ma ọ bụ karịa
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