Ko te D-dimer tētahi o ngā tohu nui e whakapaetia ana mō te PTE me te DVT i roto i ngā mahi haumanu. Nō hea i puta ai?

Ko te D-dimer plasma he hua whakapōrearea motuhake i hangaia e te waikura plasmin i muri i te hononga o te monomer fibrin e te factor whakahohe XIII. He tohu motuhake tēnei mō te tukanga fibrinolysis. Ka ahu mai ngā D-dimer i ngā totoka fibrin kua honoa kua pakaruhia e te plasmin. I te mea kei roto tonu te thrombosis me te mahi fibrinolytic i roto i ngā oko toto o te tinana, ka piki ake te D-dimer. Ko te infarction myocardial, te infarction roro, te embolism pulmonary, te thrombosis venous, te pokanga, te pukupuku, te coagulation intravascular horapa, te mate me te necrosis kiko ka arahi ki te D-dimer teitei. Ina koa mō ngā kaumātua me ngā tūroro kei te hōhipera, nā te bacteremia me ētahi atu mate, he ngawari ki te whakaputa i te coagulation toto rerekē me te arahi ki te pikinga o te D-dimer.

Ko te D-dimer te mea nui e whakaata ana i te mahi fibrinolytic. Ka kitea te pikinga, te pai rānei i roto i te hyperfibrinolysis tuarua, pērā i te āhua hypercoagulable, te dispersed intravascular coagulation, te mate tākihi, te whakakorenga o te whakawhitinga okana, te rongoā thrombolytic, me ētahi atu. He mea nui te whakatau i ngā āhuatanga matua o te pūnaha fibrinolytic mō te tātaritanga me te maimoatanga o ngā mate o te pūnaha fibrinolytic (pērā i te DIC, ngā momo thrombus) me ngā mate e pā ana ki te pūnaha fibrinolytic (pērā i te pukupuku, te mate haputanga), me te aroturuki i te rongoā thrombolytic.

Ko te nui haere o te D-dimer, he hua o te pakaru o te fibrin, e tohu ana i te pakaru pinepine o te fibrin i roto i te tinana ora. Nō reira, ko te D-dimer muka he tohu matua mō te thrombosis uaua hohonu (DVT), te embolism pūkahukahu (PE), me te coagulation intravascular dispersed (DIC).

He maha ngā mate ka whakaoho i te pūnaha toto totoka me/ranei te pūnaha fibrinolytic i roto i te tinana, ka hua ake te pikinga o te taumata o te D-dimer, ā, he hononga tata tēnei whakahohenga ki te wāhanga, te kaha me te maimoatanga o te mate, nō reira i roto i ēnei mate ka taea te whakamahi i te kitenga o te taumata o te D-dimer hei tohu aromatawai mō te wāhanga o te mate, te matapae me te aratohu maimoatanga.

Te whakamahinga o te D-dimer i roto i te thrombosis uaua hohonu

Mai i te wā tuatahi i whakamahia ai e Wilson me ētahi atu ngā hua whakapōrearea fibrin hei tātaritanga i te embolism pūkahukahu i te tau 1971, he nui te mahi a te kitenga o te D-dimer i roto i te tātaritanga o te embolism pūkahukahu. Mē ētahi tikanga kitenga tino tairongo, he pānga matapae kino pai te uara tinana D-dimer kino mō te embolism pūkahukahu, ā, ko tōna uara he 0.99. Ka taea e te hua kino te whakakore i te embolism pūkahukahu, ā, ka whakaitihia ngā whakamātautau whakaeke, pērā i te matawai toto manawa me te angiography pūkahukahu; karohia te rongoā anticoagulation matapo. D - Ko te kukū o te dimer e pā ana ki te wāhi o te thrombus, me te kukū teitei ake i roto i ngā peka nui o te pūtake pūkahukahu me te kukū iti ake i roto i ngā peka iti.

Mā te whakamahi i ngā D-dimer plasma kino ka kore pea he DVT. I whakaūtia e te angiography he pai te DVT mō te 100% D-dimer. Ka taea te whakamahi mō te rongoā thrombolytic me te aratohu rongoā heparin anticoagulation me te tirotiro i te whai huatanga.

Ka taea e te D-dimer te whakaatu i ngā panonitanga o te rahi o ngā thrombus. Mēnā ka piki anō te ihirangi, he tohu tēnei kua hoki mai anō ngā thrombus; i te wā e rongoatia ana, ka piki tonu, ā, kāore te rahi o ngā thrombus e rerekē, he tohu tēnei kāore i te whai hua te maimoatanga.