01.Nchọpụta nke thrombosis miri emi nke akwara na pulmonary embolism

Ọ na-abụkarị ọrịa akwara miri emi (D-VT) nke a na-akpọ pulmonary embolism (PE), nke a na-akpọ venous thromboembolism (VTE). Ọkwa D-dimer nke plasma na-arị elu nke ukwuu n'ime ndị ọrịa VTE.

Ọmụmụ ihe ndị metụtara ya egosila na ntinye D-dimer na plasma n'ime ndị ọrịa nwere PE na D-VT karịrị 1 000 μg/L.

Agbanyeghị, n'ihi ọtụtụ ọrịa ma ọ bụ ụfọdụ ihe ndị na-akpata ọrịa (ịwa ahụ, etuto ahụ, ọrịa obi, wdg) nwere mmetụta ụfọdụ na hemostasis, na-ebute mmụba nke D-dimer. Ya mere, ọ bụ ezie na D-dimer nwere nnukwu mmetụta, nkọwapụta ya bụ naanị 50% ruo 70%, naanị D-dimer enweghị ike ịchọpụta VTE. Ya mere, enweghị ike iji nnukwu mmụba na D-dimer dị ka ihe ngosi kpọmkwem nke VTE. Ihe bara uru nke nnwale D-dimer bụ na nsonaazụ na-adịghị mma na-egbochi nchọpụta nke VTE.

 

02 Mgbasa nke coagulation n'ime akwara

Mkpọchi akwara ọbara nke a na-ekesa (DIC) bụ ọrịa nke obere obere akwara ọbara n'ime obere arịa ọbara n'ahụ na hyperfibrinolysis nke abụọ n'okpuru ọrụ nke ụfọdụ ihe ndị na-akpata ọrịa, nke nwere ike iso ya na fibrinolysis nke abụọ ma ọ bụ fibrinolysis nke a na-egbochi.

Mmụba dị na plasma nke D-dimer nwere uru dị elu maka nchọpụta mbụ nke DIC. Agbanyeghị, ekwesịrị ịmara na mmụba nke D-dimer abụghị nnwale kpọmkwem maka DIC, mana ọtụtụ ọrịa ndị na-eso microthrombosis nwere ike ibute mmụba nke D-dimer. Mgbe fibrinolysis bụ nke abụọ na coagulation extravascular, D-dimer ga-abawanyekwa.

Nnyocha egosila na D-dimer na-amalite ịrị elu ụbọchị tupu DIC ma dị elu nke ukwuu karịa ka ọ dị na mbụ.

 

03 Nkụchi obi nwa amụrụ ọhụrụ

E nwere ọkwa dị iche iche nke hypoxia na acidosis n'ime nwa amụrụ ọhụrụ, hypoxia na acidosis nwere ike ibute nnukwu mmebi endothelial vascular, na-ebute mwepụta nke ọtụtụ ihe coagulation, si otú a na-eme ka mmepụta nke fibrinogen dịkwuo elu.

Ọmụmụ ihe ndị metụtara ya egosila na uru D-dimer nke ọbara eriri dị na otu asphyxia dị elu nke ukwuu karịa nke otu njikwa nkịtị, ma e jiri ya tụnyere uru D-dimer dị na ọbara dị n'akụkụ, ọ dịkwa elu nke ukwuu.

 

04 Ọrịa lupus erythematosus (SLE)

Usoro coagulation-fibrinolysis adịghị mma n'ahụ ndị ọrịa SLE, nsogbu nke sistemu coagulation-fibrinolysis na-apụta ìhè karịa n'oge ọrịa ahụ na-arụ ọrụ, ọnọdụ nke thrombosis na-apụta ìhè karịa; mgbe ọrịa ahụ kwụsịrị, sistemu coagulation-fibrinolysis na-abụkarị ihe nkịtị.

Ya mere, ọkwa D-dimer nke ndị ọrịa nwere lupus erythematosus sistemụ na-arụ ọrụ na ndị na-anaghị arụ ọrụ ga-abawanye nke ukwuu, ọkwa D-dimer nke ndị ọrịa nọ n'ọkwa arụ ọrụ na plasma dịkwa elu nke ukwuu karịa ndị nọ n'ọkwa arụ ọrụ.

05 Ọrịa imeju na kansa imeju

D-dimer bụ otu n'ime ihe ndị na-egosi oke ọrịa imeju. Ka ọrịa imeju na-aka njọ, otú ahụ ka ọdịnaya D-dimer dị na plasma na-aka elu.

Ọmụmụ ihe ndị metụtara ya gosiri na uru D-dimer nke akara Child-Pugh A, B, na C n'ime ndị ọrịa nwere cirrhosis imeju bụ (2.218 ± 0.54) μg/mL, (6.03 ± 0.76) μg/mL, na (10.536 ± 0.664) μg/mL, n'otu n'otu.

Tụkwasị na nke ahụ, D-dimer dị elu nke ukwuu n'ime ndị ọrịa nwere kansa imeju nwere ọganihu ngwa ngwa na enweghị amụma.

06 Ọrịa kansa afọ

Mgbe a chụpụsịrị ndị ọrịa kansa, thromboembolism na-eme n'ime ihe dị ka ọkara nke ndị ọrịa, D-dimer na-amụbakwa nke ukwuu na 90% nke ndị ọrịa.

Tinyere nke ahụ, e nwere otu ụdị ihe ndị nwere shuga dị elu n'ime mkpụrụ ndụ kansa nke nhazi na ihe ndị metụtara anụ ahụ yiri nke ukwuu. Iso na ọrụ metabolic mmadụ nwere ike ịkwalite ọrụ nke sistemụ coagulation nke ahụ ma mee ka ohere nke thrombosis dịkwuo elu, ọkwa nke D-dimer na-abawanye nke ukwuu. Ọkwa D-dimer na ndị ọrịa kansa afọ nwere ọkwa nke atọ-IV dị elu nke ukwuu karịa nke ndị ọrịa kansa afọ nwere ọkwa nke mbụ-II.

 

07 Ọrịa oyi baa nke Mycoplasma (MMP)

A na-ejikarị ọkwa D-dimer dị elu na MPP dị oke njọ, ọkwa D-dimer dịkwa elu karịa na ndị ọrịa nwere MPP dị oke njọ.

Mgbe MPP dara ọrịa nke ukwuu, hypoxia, ischemia na acidosis ga-eme n'ógbè ahụ, tinyere mwakpo kpọmkwem nke nje ndị na-akpata ọrịa, nke ga-emebi mkpụrụ ndụ endothelial vaskụla, kpughee collagen, mee ka usoro coagulation rụọ ọrụ, mepụta ọnọdụ hypercoagulable, ma mepụta microthrombi. Sistemụ fibrinolytic dị n'ime, kinin na complement na-arụkwa ọrụ n'usoro, na-ebute mmụba nke ọkwa D-dimer.

 

08 Ọrịa shuga, ọrịa akụrụ nke ndị ọrịa mamịrị

Ọkwa D-dimer dị elu nke ukwuu n'ime ndị ọrịa nwere ọrịa shuga na ọrịa nephropathy nke ọrịa shuga.

Tinyere nke ahụ, ihe ngosi D-dimer na fibrinogen nke ndị ọrịa nwere ọrịa shuga dị elu karịa nke ndị ọrịa nwere ụdị shuga nke abụọ. Ya mere, n'ọrụ ahụike, enwere ike iji D-dimer dị ka ihe ngosi nnwale maka ịchọpụta oke ọrịa shuga na ọrịa akụrụ n'ime ndị ọrịa.

09 Nfụkasị Purpura (AP)

N'oge ọrịa AP, enwere ọkwa dị iche iche nke hypercoagulation ọbara na ọrụ platelet ka mma, nke na-eduga na vasospasm, nchịkọta platelet na thrombosis.

A na-ahụkarị mmụba nke D-dimer n'ime ụmụaka nwere AP mgbe izu abụọ gachara ma na-agbanwe agbanwe n'etiti ọkwa ahụike, na-egosipụta oke na oke nke mbufụt akwara sistemụ.

Tinyere nke ahụ, ọ bụkwa ihe ngosi amụma, ebe ọ na-anọgide na-enwe oke D-dimer, ọrịa ahụ na-adịte aka ma na-enwe ike imebi akụrụ.

 

Afọ ime 10

Nnyocha ndị metụtara ya egosila na ihe dị ka pasentị iri nke ụmụ nwanyị dị ime nwere oke ọkwa D-dimer, nke na-egosi na ha nwere ike inwe mkpụkọ ọbara.

Ọrịa Preeclampsia bụ nsogbu a na-ahụkarị n'afọ ime. Mgbanwe ndị bụ isi nke ọrịa preeclampsia na eclampsia bụ mkpali coagulation na mmụba fibrinolysis, nke na-ebute mmụba nke microvascular thrombosis na D-dimer.

D-dimer belatara ngwa ngwa mgbe a mụsịrị nwa n'ime ụmụ nwanyị nkịtị, mana ọ mụbara n'ime ụmụ nwanyị nwere preeclampsia, ọ laghachighịkwa otú ọ dị ruo izu anọ ruo isii.

11 Ọrịa akwara obi na-akpata ọrịa akwara ozi

Ndị ọrịa nwere ọrịa akwara obi dị oke njọ nwere ọkwa D-dimer dị elu ma ọ bụ naanị obere mmụba, ebe aneurysms aortic dissecting na-abawanye nke ukwuu.

Nke a metụtara nnukwu ọdịiche dị na ibu thrombus n'ime arịa akwara abụọ ahụ. Lumen akwara akwara dị gịrịgịrị, thrombus dị n'akwara akwara akwara na-ebelatakwa. Mgbe mgbawa nke aortic intima gbawara, nnukwu ọbara akwara na-abanye n'ime mgbidi arịa ahụ iji mepụta aneurysm na-agbasa. A na-emepụta ọtụtụ thrombi n'okpuru ọrụ nke usoro coagulation.

12 Ọrịa ụbụrụ dị oke njọ

N'ọrịa ụbụrụ nke na-akpata nnukwu nsogbu, a na-amụba ọrụ thrombolysis na-enweghị enyemaka na nke abụọ nke fibrinolytic, nke a na-egosipụta dịka mmụba nke ọkwa D-dimer na plasma. Ọkwa D-dimer mụbara nke ukwuu na mbido ọrịa ụbụrụ nke na-akpata nnukwu nsogbu.

Ọkwa D-dimer nke plasma n'ime ndị ọrịa nwere ọrịa strok ischemic dị oke njọ mụbara ntakịrị n'izu mbụ mgbe mmalite ya, mụbara nke ukwuu n'ime izu 2 ruo 4, ọ dịghịkwa iche na ọkwa nkịtị n'oge mgbake (karịa ọnwa 3).