01. Kudziwana koyamba ndi D-dimer, FDP

1. FDP ndi mawu ofala a zinthu zosiyanasiyana zowononga za fibrin ndi fibrinogen pansi pa mphamvu ya plasmin, zomwe zimasonyeza kwambiri kuchuluka kwa fibrinolytic m'thupi;

2. D-dimer ndi chinthu chowonongeka cha fibrin yolumikizidwa ndi plasmin, ndipo kuwonjezeka kwa kuchuluka kwake kumasonyeza kukhalapo kwa hyperfibrinolysis yachiwiri;

02. Kugwiritsa ntchito mankhwala a D-dimer ndi FDP kuchipatala

Musamachite venous thrombosis (VTE ikuphatikizapo DVT, PE)

Kulondola kwa D-dimer negative exclusion of deep vein thrombosis (DVT) kungafikire 98%-100%

Kuzindikira D-dimer kungagwiritsidwe ntchito kutsimikizira venous thrombosis

♦Kufunika kwa matenda a DIC

1. DIC ndi njira yovuta ya pathophysiological komanso matenda oopsa a thrombo-hemorrhagic syndrome. Ma DIC ambiri amayamba msanga, matenda ovuta, kukula msanga, matenda ovuta, komanso matenda oopsa. Ngati sapezeka msanga ndikuchiritsidwa bwino, nthawi zambiri amaika moyo wa wodwalayo pachiwopsezo;

2. D-dimer imatha kuwonetsa kuopsa kwa DIC mpaka pamlingo winawake, FDP ingagwiritsidwe ntchito kuyang'anira kukula kwa matendawa pambuyo poti matendawa atsimikizika, ndipo antithrombin (AT) imathandiza kumvetsetsa kuopsa kwa matendawa komanso kugwira ntchito bwino kwa chithandizo cha heparin Kuphatikiza kwa mayeso a D-dimer, FDP ndi AT kwakhala chizindikiro chabwino kwambiri chodziwira DIC.

♦Kufunika kwa zotupa zoopsa

1. Zotupa zoopsa zimagwirizana kwambiri ndi kusagwira bwino ntchito kwa magazi m'thupi. Mosasamala kanthu za zotupa zolimba kapena khansa ya m'magazi, odwala adzakhala ndi vuto lalikulu la magazi kapena thrombosis. Adenocarcinoma yovutitsidwa ndi thrombosis ndiyo yofala kwambiri;

2. Ndikoyenera kutsindika kuti thrombosis ikhoza kukhala chizindikiro choyambirira cha chotupa. Kwa odwala omwe ali ndi thrombosis ya mtsempha wozama omwe sadziwa zomwe zimayambitsa thrombosis yotuluka magazi, pakhoza kukhala chotupa chomwe chingachitike.

♦Kufunika kwa matenda ena kuchipatala

1. Kuyang'anira chithandizo cha mankhwala ochepetsa magazi m'thupi

Pa nthawi ya chithandizo, ngati kuchuluka kwa mankhwala ochepetsa magazi m'thupi sikukwanira ndipo magazi m'thupi sanasungunuke kwathunthu, D-dimer ndi FDP zimakhalabe ndi mlingo wapamwamba zikafika pachimake; pomwe mankhwala owonjezera magazi m'thupi adzawonjezera chiopsezo cha kutuluka magazi.

2. Kufunika kwa chithandizo cha heparin yaing'ono pambuyo pa opaleshoni

Odwala omwe avulala/opaleshoni nthawi zambiri amapatsidwa mankhwala oletsa magazi kuundana.

Kawirikawiri, mlingo woyambira wa heparin yaing'ono ndi 2850IU/tsiku, koma ngati mlingo wa D-dimer wa wodwalayo uli 2ug/ml pa tsiku lachinayi pambuyo pa opaleshoni, mlingowo ukhoza kuwonjezeka kufika kawiri patsiku.

3. Kugawanika kwa mtsempha wamagazi (AAD)

Matenda a AAD ndi omwe amachititsa imfa zadzidzidzi mwa odwala. Kuzindikira msanga ndi kulandira chithandizo kungachepetse chiwerengero cha imfa za odwala ndikuchepetsa zoopsa zachipatala.

Njira yomwe ingathe kukulitsira D-dimer mu AAD: Pambuyo poti khoma lapakati la mtsempha wa aorta lawonongeka chifukwa cha zifukwa zosiyanasiyana, khoma la mitsempha yamagazi limaphulika, zomwe zimapangitsa kuti magazi alowe mkati ndi kunja kwa ziwalozo ndikupanga "khoma lonyenga", chifukwa cha magazi enieni ndi abodza omwe ali m'khoma. Pali kusiyana kwakukulu pa liwiro la kuyenda kwa magazi, ndipo liwiro la kuyenda kwa magazi m'khoma lonyenga ndi lochepa, zomwe zingayambitse thrombosis mosavuta, zimapangitsa kuti dongosolo la fibrinolytic liyambe kugwira ntchito, ndipo pamapeto pake zimapangitsa kuti D-dimer ikule.

03. Zinthu zomwe zimakhudza D-dimer ndi FDP

1. Makhalidwe a thupi

Kukwera: Pali kusiyana kwakukulu kwa zaka, amayi apakati, kuchita masewera olimbitsa thupi kwambiri, komanso kusamba.

2. Zotsatira za matenda

Kuwonjezeka: sitiroko ya mitsempha ya m'magazi, chithandizo cha thrombolytic, matenda oopsa, sepsis, chilonda cha minofu, preeclampsia, hypothyroidism, matenda oopsa a chiwindi, sarcoidosis.

3. Kuchuluka kwa mafuta m'thupi ndi zotsatira za kumwa mowa

Wokwezedwa: omwa mowa;

Kuchepetsa: hyperlipidemia.

4. Zotsatira za mankhwala

Wokwezedwa: heparin, mankhwala ochepetsa kuthamanga kwa magazi, urokinase, streptokinase ndi staphylokinase;

Kuchepa: mankhwala oletsa kubereka ndi estrogen.
04. Chidule

Kuzindikira D-dimer ndi FDP n'kotetezeka, kosavuta, mwachangu, kotsika mtengo, komanso kothandiza kwambiri. Zonsezi zimakhala ndi kusintha kosiyanasiyana kwa matenda a mtima, chiwindi, matenda a mitsempha yamagazi, kuthamanga kwa magazi komwe kumachitika chifukwa cha mimba, komanso pre-eclampsia. Ndikofunikira kuweruza kuopsa kwa matendawa, kuyang'anira chitukuko ndi kusintha kwa matendawa, ndikuwunika momwe matendawa angachiritsire.