Te Hiranga o te Kimitanga Ngātahi o te D-dimer me te FDP


Kaituhi: Succeeder   

I raro i ngā āhuatanga ā-tinana, ka mau tonu te taurite hihiri o ngā pūnaha e rua o te toto totoka me te ārai totoka i roto i te tinana kia mau tonu te rere o te toto i roto i ngā oko toto. Mēnā kāore i te taurite te taurite, ko te pūnaha ārai totoka te mea nui, ā, ka tere te puta o te toto, ā, ko te pūnaha ārai totoka te mea nui, ā, ka tere te puta o te thrombosis. He mahi nui tā te pūnaha fibrinolysis i roto i te thrombolysis. I tēnei rā ka kōrero tātou mō ētahi atu tohu e rua o te pūnaha fibrinolysis, arā, ko te D-dimer me te FDP, kia mārama ai ki te hemostasis i hangaia e te thrombin ki te thrombus i tīmatahia e te fibrinolysis. Te whanaketanga. Whakaratohia he mōhiohio haumanu taketake mō te thrombosis me te mahi ārai totoka o ngā tūroro.

Ko te D-dimer he hua pakaru motuhake i hangaia e te monomer fibrin kua honoa e te factor XIII kua whakahohehia, kātahi ka waikurahia e te plasmin. Ko te D-dimer i ahu mai i te totoka fibrin kua honoa kua whakarewahia e te plasmin. Ko te D-dimer teitei e tohu ana i te aroaro o te hyperfibrinolysis tuarua (pērā i te DIC). Ko te FDP te kupu whānui mō ngā hua pakaru i hangaia i muri i te pakaru o te fibrin, te fibrinogen rānei i raro i te mahi a te plasmin i hangaia i te wā hyperfibrinolysis. Kei roto i te FDP ngā hua fibrinogen (Fg) me te fibrin monomer (FM) (FgDP), tae atu ki ngā hua pakaru fibrin kua honoa (FbDP), kei roto i ngā FbDP ko ngā D-dimers me ētahi atu kongakonga, ā, ka piki ake ō rātou taumata. Ko te Teitei e tohu ana he tino kaha te mahi fibrinolytic o te tinana (fibrinolysis tuatahi, fibrinolysis tuarua rānei).

【Tauira】

I whakaurua tētahi tāne pakeke ki te hōhipera, ā, ko ngā hua o te tirotiro toto totoka i penei:

Taonga Hua Awhe Tohutoro
PT 13.2 10-14 hēkona
APTT 28.7 22-32 hēkona
TT 15.4 14-21 hēkona
FIB 3.2 1.8-3.5g/rita
DD 40.82 0-0.55mg/I FEU
FDP 3.8 0-5mg/rita
AT-III 112 75-125%

I kino katoa ngā tūemi e whā o te toto totoka, i pai te D-dimer, ā, i kino te FDP, ā, he rerekē ngā hua. I te tīmatanga i whakapaetia he pānga matau, i tirotirohia anō te tauira mā te whakamātautau taurangi taketake me te whakamātautau waimeha 1:10, ko te hua i penei:

Taonga Taketake te waimehatanga 1:10 Awhe Tohutoro
DD 38.45 11.12 0-0.55mg/I FEU
FDP 3.4 I raro i te rohe o raro 0-5mg/rita

Ka kitea i roto i te waimehatanga he tika te hua FDP, ā, kāore te D-dimer i te rārangi i muri i te waimehatanga, ā, e whakapaetia ana te pokanoa. Kaua e whakaurua te hemolysis, te lipemia, me te jaundice ki te āhua o te tauira. Nā te koretake o ngā hua o te waimehatanga, ka puta pea ēnei āhuatanga i roto i te pokanoa noa ki ngā paturopi heterophilic, ki ngā take rheumatoid rānei. Tirohia te hītori hauora o te tūroro, ā, kimihia he hītori o te rumatiki rheumatoid. Taiwhanga He teitei te hua o te whakamātautau take RF. Whai muri i te kōrero ki te whare hauora, i kitea te tūroro, ā, i tukuna he pūrongo. I te whai muri mai, kāore he tohu e pā ana ki te thrombus i te tūroro, ā, i whakatauhia he take pai teka o te D-dimer.


【Whakarāpopototanga】

He tohu nui te D-dimer mō te whakakorenga kino o te toto toto. He tino aro nui tōna, engari he ngoikore te motuhaketanga e rite ana. He ōwehenga anō hoki o ngā hua pai teka. Mā te whakakotahitanga o te D-dimer me te FDP ka taea te whakaiti i tētahi wāhanga o te D-. Mō te hua pai teka o te dimer, ina whakaatu te hua taiwhanga he ≥ FDP te D-dimer, ka taea te whakatau i ēnei e whai ake nei i runga i te hua whakamātautau:

1. Mena he iti ngā uara (

2. Mena he nui te uara o te hua (>Uara tapahi), tātarihia ngā āhuatanga whakaawe, tera pea he āhuatanga pokanoa. E taunakihia ana kia whakahaerehia he whakamātautau whakamātao maha. Mena he hua rārangi te hua, he nui ake te tūponotanga he pai tūturu. Mena ehara i te mea rārangi, he pai teka. Ka taea hoki e koe te whakamahi i te tuarua o ngā matū hei manatoko me te whakapā atu ki te whare hauora i te wā tika.