Gịnị bụ D-dimer?

D-dimer bụ ihe kachasị mfe nke fibrin na-emebi emebi, ọkwa ya dị elu nwekwara ike igosipụta ọnọdụ hypercoagulable na hyperfibrinolysis nke abụọ na vivo. Enwere ike iji D-dimer mee ihe dị ka ihe nrịbama nke hypercoagulability na hyperfibrinolysis na vivo, mmụba ya na-egosikwa na ọ metụtara ọrịa thrombotic nke ihe dị iche iche kpatara na vivo, ọ na-egosikwa mmụba nke ọrụ fibrinolytic.

N'ọnọdụ ndị dị aṅaa ka ọkwa D-dimer dị elu?

Ma nsogbu thromboembolism nke venous (VTE) ma nke na-abụghị nke venous nwere ike ibute mmụba nke ọkwa D-dimer.

VTE gụnyere ọrịa akpa ume dị elu, ọrịa akwara miri emi (DVT) na ọrịa akwara ụbụrụ (CVST).

Nsogbu thromboembolic nke na-abụghị nke venous gụnyere acute aortic dissection (AAD), ruptured aneurysm, strok (CVA), disseminated intravascular coagulation (DIC), sepsis, acute coronary syndrome (ACS), na chronic obstructive pulmonary disease (COPD), wdg. Na mgbakwunye, ọkwa D-dimer na-abawanyekwa n'ọnọdụ dịka afọ ime, ịwa ahụ/trauma ọhụrụ, na thrombolysis.

Enwere ike iji D-dimer chọpụta ihe kpatara embolism akpa ume iji chọpụta mgbaàmà nke embolism akpa ume

D-dimer na-ebu amụma ọnwụ n'ime ndị ọrịa nwere embolism nke akpa ume. N'ime ndị ọrịa nwere embolism nke akpa ume dị elu, a jikọtara ọnụ ọgụgụ D-dimer dị elu na akara PESI dị elu (Nkeji Oke Ndekọ nke Pulmonary Embolism) na mmụba nke ọnwụ. Ọmụmụ ihe egosila na D-dimer nke na-erughị 1500 μg/L nwere uru amụma na-adịghị mma ka mma maka ọnwụ embolism nke ọnwa 3: ọnwụ ọnwa 3 bụ 0% mgbe D-dimer nke na-erughị 1500 μg/L. Mgbe D-dimer karịrị 1500 μg/L, a ga-eji nlezianya dị elu.

Na mgbakwunye, ụfọdụ nnyocha egosila na maka ndị ọrịa nwere kansa akpa ume, D-dimer nke na-erughị 1500 μg/L na-abụkarị ọrụ fibrinolytic ka mma nke etuto na-akpata; D-dimer nke karịrị 1500 μg/L na-egosikarị na ndị ọrịa nwere kansa akpa ume nwere thrombosis miri emi nke akwara (DVT) na pulmonary embolism.

D-dimer buru amụma nlọghachi nke VTE

D-dimer na-ebu amụma na VTE ga-amaliteghachi. Ndị ọrịa D-dimer-negative nwere ọnụego nlọghachi nke 0 n'ime ọnwa atọ. Ọ bụrụ na D-dimer ebili ọzọ n'oge nlele, ohere nke nlọghachi nke VTE nwere ike ịbawanye nke ukwuu.

D-dimer na-enyere aka ịchọpụta mgbasa nke aorta

D-dimer nwere ezigbo uru amụma na-adịghị mma n'ahụ ndị ọrịa nwere nnukwu mwepụ akwara aorta, D-dimer negativity nwekwara ike iwepụ nnukwu mwepụ akwara aorta. D-dimer na-abawanye elu n'ahụ ndị ọrịa nwere nnukwu mwepụ akwara aorta ma ọ dịghị abawanye nke ukwuu n'ahụ ndị ọrịa nwere nnukwu mwepụ akwara aorta na-adịghị ala ala.

D-dimer na-agbanwe ugboro ugboro ma ọ bụ na-ebili na mberede, nke na-egosi na ihe egwu dị ukwuu nke mgbawa mgbawa. Ọ bụrụ na ọkwa D-dimer nke onye ọrịa ahụ kwụsiri ike ma dị ala (<1000 μg/L), ihe ize ndụ nke mgbawa mgbawa dị obere. Ya mere, ọkwa D-dimer nwere ike iduzi ọgwụgwọ kacha mma maka ndị ọrịa ahụ.

D-dimer na ọrịa

Ọrịa bụ otu n'ime ihe na-akpata VTE. N'oge mwepụ ezé, nje bacteria nwere ike ime, nke nwere ike ibute thrombosis. N'oge a, a ga-enyocha ọkwa D-dimer nke ọma, a ga-emekwa ka ọgwụgwọ anticoagulation dịkwuo mma mgbe ọkwa D-dimer dị elu.

Tinyere nke ahụ, ọrịa iku ume na mmebi akpụkpọ ahụ bụ ihe ndị nwere ike ibute thrombosis miri emi nke akwara.

D-dimer na-enye iwu maka ọgwụgwọ coagulation n'ime ọbara

Nsonaazụ nke ọmụmụ ihe PROLONG multicenter, nke a na-atụ anya ya, ma n'oge mbụ (nlele ọnwa 18) na nke agbatịkwuru (nlele ọnwa 30) gosiri na ma e jiri ya tụnyere ndị ọrịa na-anaghị egbochi coagulation, ndị ọrịa D-dimer-positive gara n'ihu mgbe otu ọnwa nke nkwụsị ọgwụgwọ gasịrị, anticoagulation belatara nke ukwuu ohere nke ịmaliteghachi VTE, mana enweghị nnukwu ọdịiche dị na ndị ọrịa D-dimer-negative.

N'ime nyocha nke Blood bipụtara, Prọfesọ Kearon kwukwara na enwere ike iduzi ọgwụgwọ anticoagulation dịka ọkwa D-dimer nke onye ọrịa si dị. N'ime ndị ọrịa nwere proximal DVT ma ọ bụ pulmonary embolism, enwere ike iduzi ọgwụgwọ anticoagulation site na nchọpụta D-dimer; ọ bụrụ na ejirighị D-dimer, enwere ike ikpebi usoro anticoagulation dịka ihe egwu ọbara ọgbụgba na ọchịchọ onye ọrịa si dị.

Ọzọkwa, D-dimer nwere ike iduzi ọgwụgwọ thrombolytic.