01. Kuzindikira matenda a deep vein thrombosis ndi pulmonary embolism

Matenda a deep vein thrombosis (D-VT) amapezeka mosavuta m'mapapo otchedwa pulmonary embolism (PE), omwe amadziwikanso kuti venous thromboembolism (VTE). Magazi a D-dimer amawonjezeka kwambiri mwa odwala a VTE.

Kafukufuku wofanana wasonyeza kuti kuchuluka kwa D-dimer m'magazi mwa odwala omwe ali ndi PE ndi D-VT ndi kopitilira 1 000 μg/L.

Komabe, chifukwa cha matenda ambiri kapena zinthu zina zomwe zimayambitsa matenda (opaleshoni, zotupa, matenda a mtima, ndi zina zotero) zimakhudza kwambiri magazi kutuluka, zomwe zimapangitsa kuti D-dimer iwonjezeke. Chifukwa chake, ngakhale D-dimer ili ndi mphamvu zambiri, kudziwika kwake ndi 50% mpaka 70% yokha, ndipo D-dimer yokha singathe kuzindikira VTE. Chifukwa chake, kuwonjezeka kwakukulu kwa D-dimer sikungagwiritsidwe ntchito ngati chizindikiro cha VTE. Kufunika kothandiza kwa mayeso a D-dimer ndikuti zotsatira zoyipa zimalepheretsa kuzindikira VTE.

 

02 Kugawanika kwa magazi m'mitsempha yamagazi

Kugawanika kwa magazi m'mitsempha yamagazi (DIC) ndi matenda a microthrombosis yayikulu m'mitsempha yaying'ono m'thupi lonse komanso hyperfibrinolysis yachiwiri chifukwa cha zinthu zina zomwe zimayambitsa matenda, zomwe zitha kutsagana ndi fibrinolysis yachiwiri kapena fibrinolysis yoletsa.

Kuchuluka kwa D-dimer m'magazi kuli ndi phindu lalikulu pa matenda opatsirana pochiza matenda a DIC. Komabe, ziyenera kudziwika kuti kuwonjezeka kwa D-dimer si mayeso enieni a DIC, koma matenda ambiri omwe amatsagana ndi microthrombosis angayambitse kuwonjezeka kwa D-dimer. Ngati fibrinolysis imayamba chifukwa cha magazi kutuluka m'magazi, D-dimer imawonjezekanso.

Kafukufuku wasonyeza kuti D-dimer imayamba kukwera masiku angapo DIC isanachitike ndipo imakhala yokwera kwambiri kuposa masiku onse.

 

03 Kusowa mpweya wokwanira kwa ana obadwa kumene

Pali mitundu yosiyanasiyana ya hypoxia ndi acidosis mu ana obadwa kumene, ndipo hypoxia ndi acidosis zimatha kuwononga kwambiri mitsempha yamagazi, zomwe zimapangitsa kuti pakhale kutulutsidwa kwa zinthu zambiri zotsekeka, zomwe zimapangitsa kuti fibrinogen ipangidwe kwambiri.

Kafukufuku wofunikira wasonyeza kuti kuchuluka kwa D-dimer m'magazi a chingwe m'gulu la asphyxia ndi kwakukulu kwambiri kuposa kwa gulu lolamulira bwino, ndipo poyerekeza ndi kuchuluka kwa D-dimer m'magazi ozungulira, ndikokweranso kwambiri.

 

04 Matenda a systemic lupus erythematosus (SLE)

Dongosolo la coagulation-fibrinolysis silili bwino mwa odwala a SLE, ndipo vuto la coagulation-fibrinolysis system limawonekera kwambiri pa nthawi yogwira ntchito ya matendawa, ndipo chizolowezi cha thrombosis chimawonekera bwino; matendawa akachepa, dongosolo la coagulation-fibrinolysis limakhala labwinobwino.

Chifukwa chake, kuchuluka kwa D-dimer kwa odwala omwe ali ndi lupus erythematosus m'magawo ogwirira ntchito komanso osagwira ntchito kudzawonjezeka kwambiri, ndipo kuchuluka kwa D-dimer m'magazi mwa odwala omwe ali mugawo logwira ntchito ndi kwakukulu kwambiri kuposa omwe ali mu gawo logwira ntchito.

05 Matenda a chiwindi ndi khansa ya chiwindi

D-dimer ndi chimodzi mwa zizindikiro zomwe zimasonyeza kuopsa kwa matenda a chiwindi. Matenda a chiwindi akakula kwambiri, kuchuluka kwa D-dimer m'magazi kumawonjezeka.

Kafukufuku wofunikira adawonetsa kuti ma D-dimer ​​a magiredi a Child-Pugh A, B, ndi C mwa odwala omwe ali ndi matenda a chiwindi anali (2.218 ± 0.54) μg/mL, (6.03 ± 0.76) μg/mL, ndi (10.536 ± 0.664) μg/mL, motsatana.

Kuphatikiza apo, D-dimer inali yokwera kwambiri mwa odwala omwe ali ndi khansa ya chiwindi omwe anali ndi vuto la kuthamanga kwa magazi komanso omwe anali ndi vuto losakhazikika.

06 Khansa ya m'mimba

Pambuyo pochotsa opaleshoni kwa odwala khansa, thromboembolism imachitika pafupifupi theka la odwala, ndipo D-dimer imawonjezeka kwambiri mwa 90% ya odwala.

Kuphatikiza apo, pali gulu la zinthu zomwe zimakhala ndi shuga wambiri m'maselo a chotupa omwe kapangidwe kake ndi minofu yake zimafanana kwambiri. Kuchita nawo ntchito za kagayidwe kachakudya m'thupi la munthu kungathandize kuti thupi lizigwira ntchito bwino komanso kuonjezera chiopsezo cha thrombosis, ndipo kuchuluka kwa D-dimer kumawonjezeka kwambiri. Ndipo kuchuluka kwa D-dimer mwa odwala khansa ya m'mimba omwe ali ndi gawo la III-IV kunali kwakukulu kwambiri kuposa kwa odwala khansa ya m'mimba omwe ali ndi gawo la I-II.

 

07 Mycoplasma chibayo (MMP)

MPP yoopsa nthawi zambiri imayenderana ndi kuchuluka kwa D-dimer, ndipo kuchuluka kwa D-dimer kumakhala kwakukulu kwambiri kwa odwala omwe ali ndi MPP yoopsa kuposa odwala ofooka.

Pamene MPP ikudwala kwambiri, kuchepa kwa magazi m'thupi, ischemia ndi acidosis zimachitika m'deralo, limodzi ndi kulowa mwachindunji kwa tizilombo toyambitsa matenda, zomwe zimawononga maselo a mitsempha yamagazi, kutulutsa collagen, kuyambitsa dongosolo lozungulira magazi, kupanga mkhalidwe wowonjezereka wa magazi, ndikupanga microthrombi. Machitidwe amkati a fibrinolytic, kinin ndi complement amayambitsidwanso motsatizana, zomwe zimapangitsa kuti milingo ya D-dimer iwonjezeke.

 

08 Matenda a shuga, matenda a shuga

Mlingo wa D-dimer unakwera kwambiri mwa odwala matenda a shuga ndi matenda a shuga.

Kuphatikiza apo, ziwerengero za D-dimer ndi fibrinogen za odwala matenda a shuga zinali zapamwamba kwambiri kuposa za odwala matenda a shuga amtundu wa 2. Chifukwa chake, m'machitidwe azachipatala, D-dimer ingagwiritsidwe ntchito ngati chizindikiro choyesera kuzindikira kuopsa kwa matenda a shuga ndi matenda a impso mwa odwala.

09 Allergic Purpura (AP)

Mu gawo loopsa la AP, pali madigiri osiyanasiyana a hypercoagulability ya magazi ndi ntchito yowonjezera ya ma platelet, zomwe zimapangitsa kuti mitsempha yamagazi ichuluke, kusonkhana kwa ma platelet ndi thrombosis.

Kuwonjezeka kwa D-dimer mwa ana omwe ali ndi AP kumachitika kawirikawiri patatha milungu iwiri kuyambira pomwe matendawa ayamba ndipo kumasiyana malinga ndi magawo azachipatala, zomwe zikuwonetsa kukula ndi kuchuluka kwa kutupa kwa mitsempha yamagazi.

Kuphatikiza apo, ndi chizindikiro cha kulosera, chifukwa cha kuchuluka kwa D-dimer komwe kumakhalapo nthawi zonse, matendawa nthawi zambiri amakhala nthawi yayitali ndipo amatha kuwonongeka ndi impso.

 

10 Mimba

Kafukufuku wofanana ndi ameneyu wasonyeza kuti pafupifupi 10% ya amayi apakati ali ndi milingo yokwera kwambiri ya D-dimer, zomwe zikusonyeza kuti magazi amaundana.

Matenda a preeclampsia ndi vuto lofala kwambiri la mimba. Kusintha kwakukulu kwa matenda a preeclampsia ndi eclampsia ndi kuyambitsa magazi kuundana ndi kuwonjezeka kwa fibrinolysis, zomwe zimapangitsa kuti magazi azituluka m'mitsempha yamagazi komanso D-dimer ichuluke.

D-dimer inachepa msanga akazi akabereka bwino, koma inawonjezeka mwa akazi omwe ali ndi preeclampsia, ndipo sinabwererenso bwino mpaka masabata 4 mpaka 6.

11 Matenda a Acute Coronary ndi Kugaya Magazi

Odwala omwe ali ndi matenda a mtima oopsa amakhala ndi D-dimer yabwinobwino kapena yokwera pang'ono, pomwe aneurysms yochotsa mtsempha wamagazi imakhala yokwera kwambiri.

Izi zikugwirizana ndi kusiyana kwakukulu kwa kuchuluka kwa magazi m'mitsempha ya mitsempha ya mitsempha ya mitsempha iwiriyi. Chiwalo cha mtima chimakhala chocheperako ndipo magazi m'mitsempha ya mtima amakhala ochepa. Pambuyo poti aortic intima breakage, magazi ambiri amitsempha amalowa m'khoma la mitsempha yamagazi kuti apange dissecting aneurysm. Magazi ambiri amapangidwa chifukwa cha mphamvu ya coagulation mechanism.

12 Kutsekeka kwa ubongo koopsa

Mu matenda a mtima oyambitsa matenda a mtima, kutsekeka kwa magazi m'thupi (insontative thrombolysis) ndi ntchito yachiwiri ya fibrinolytic zimawonjezeka, zomwe zimaonekera ngati kuchuluka kwa D-dimer m'magazi. Mlingo wa D-dimer unawonjezeka kwambiri kumayambiriro kwa matenda a mtima oyambitsa matenda a mtima.

Milingo ya D-dimer m'magazi mwa odwala omwe ali ndi sitiroko ya ischemic yoopsa idakwera pang'ono m'sabata yoyamba atangoyamba, idakwera kwambiri m'masabata awiri mpaka anayi, ndipo sinali yosiyana ndi milingo yachibadwa panthawi yochira (> miyezi itatu).