He aha te D-dimer?

Ko te D-dimer te hua tino māmā o te pirau o te fibrin, ā, ko tōna taumata teitei ka taea te whakaata i te āhua toto totoka nui me te hyperfibrinolysis tuarua i roto i te tinana ora. Ka taea te whakamahi i te D-dimer hei tohu mō te toto totoka nui me te hyperfibrinolysis i roto i te tinana ora, ā, ko tōna pikinga e tohu ana he hononga ki ngā mate toto totoka i puta mai i ngā take maha i roto i te tinana ora, ā, e tohu ana hoki i te whakanui ake i te mahi fibrinolytic.

I raro i ngā āhuatanga hea ka piki ake ai ngā taumata o te D-dimer?

Ka taea e ngā mate thromboembolism venous (VTE) me ngā mate thromboembolic kore-uaua te whakanui ake i ngā taumata D-dimer.

Kei roto i te VTE te embolism pūkahukahu whakapeka, te thrombosis uaua hohonu (DVT) me te thrombosis uaua cerebral (sinus) (CVST).

Ko ngā mate thromboembolic kore-uaua ko te acute aortic dissection (AAD), te ruptured aneurysm, te stroke (CVA), te disseminated intravascular coagulation (DIC), te sepsis, te acute coronary syndrome (ACS), me te chronic obstructive pulmonary disease (COPD), me ētahi atu. Hei tāpiri, ka piki ake hoki ngā taumata D-dimer i roto i ngā āhuatanga pēnei i te koroheketanga, te pokanga/whara tata nei, me te thrombolysis.

Ka taea te whakamahi i te D-dimer hei aromatawai i te matapae o te embolism pūkahukahu

Ka tohu te D-dimer i te mate o ngā tūroro e pāngia ana e te pulmonary embolism. Mō ngā tūroro e pāngia ana e te acute pulmonary embolism, ko ngā uara D-dimer teitei ake i honoa ki ngā kaute PESI teitei ake (Pulmonary Embolism Severity Index Score) me te pikinga o te mate. Kua whakaatuhia e ngā rangahau he pai ake te uara matapae kino o te D-dimer <1500 μg/L mō te mate pulmonary embolism 3-marama: ko te mate 3-marama he 0% ina iti iho te D-dimer i te 1500 μg/L. Ina nui ake te D-dimer i te 1500 μg/L, me tino mataara.

Hei tāpiritanga, kua whakaatuhia e ētahi rangahau, mō ngā tūroro matepukupuku pūkahukahu, ko te D-dimer <1500 μg/L he mahi fibrinolytic nui ake i puta mai i ngā pukupuku; ko te D-dimer >1500 μg/L he tohu pinepine kei te pāngia ngā tūroro matepukupuku pūkahukahu e te thrombosis uaua hohonu (DVT) me te embolism pūkahukahu.

Ka matapaetia e te D-dimer te hokinga mai o te VTE

He tohu te D-dimer mō te hokinga mai o te VTE. Ko te auau hokinga mai o te mate i roto i ngā marama e 3 o ngā tūroro kāore i te D-dimer he 0. Mena ka piki anō te D-dimer i te wā o te arotakenga, ka tino piki ake te mōrearea o te hokinga mai o te VTE.

Ka āwhina te D-dimer ki te tautuhi i te wehenga aorta

He pai te uara matapae kino o te D-dimer i roto i ngā tūroro e pangia ana e te tapahi aorta whakapeka, ā, ka taea e te korenga o te D-dimer te whakakore i te tapahi aorta whakapeka. Ka piki ake te D-dimer i roto i ngā tūroro e pangia ana e te tapahi aorta whakapeka, ā, kāore i te tino piki ake i roto i ngā tūroro e pangia ana e te tapahi aorta mau tonu.

Ka piki haere tonu, ka piki ohorere rānei te D-dimer, e tohu ana i te nui ake o te tūponotanga o te pakaru o te wae. Mena he pumau, he iti hoki te taumata D-dimer o te tūroro (<1000 μg/L), he iti te tūponotanga o te pakaru o te wae. Nō reira, ka taea e te taumata D-dimer te ārahi i te maimoatanga pai mō aua tūroro.

D-dimer me te mate urutā

Ko te mate pāwera tētahi o ngā tino take o te VTE. I te wā e tangohia ana te niho, ka puta pea he bacteremia, ka arahi pea ki ngā mate toto toto. I tēnei wā, me aro turuki tonu ngā taumata o te D-dimer, ā, me whakapakari ake te rongoā anticoagulation ina teitei ake ngā taumata o te D-dimer.

Hei tāpiri, ko ngā mate manawa me te kino o te kiri he take morearea mō te thrombosis uaua hohonu.

He aratohu a te D-dimer mō te rongoā ārai toto

Ko ngā hua o te rangahau tirohanga whānui a PROLONG i ngā wāhanga tuatahi (aroturuki 18-marama) me ngā wāhanga roa (aroturuki 30-marama) i whakaatu, ki te whakaritea ki ngā tūroro kāore i te rongoā ārai toto, i haere tonu ngā tūroro D-dimer-pai i muri i te 1 marama o te whakamutu i te maimoatanga. I tino whakaitihia e te rongoā ārai toto te tūponotanga o te hokinga mai o te VTE, engari kāore he rerekētanga nui i waenga i ngā tūroro D-dimer-kino.

I roto i tētahi arotake i whakaputaina e Blood, i tohu anō a Ahorangi Kearon ka taea te ārahi i te rongoā ārai toto i runga i te taumata D-dimer o te tūroro. Mō ngā tūroro he DVT proximal kāore i puta he take, he embolism pūkahukahu rānei, ka taea te ārahi i te rongoā ārai toto mā te kimi D-dimer; ki te kore e whakamahia te D-dimer, ka taea te whakatau i te akoranga ārai toto i runga i te mōrearea toto me ngā hiahia o te tūroro.

Hei tāpiri, ka taea e te D-dimer te ārahi i te rongoā thrombolytic.