Mamonomeri eFibrin muropa anobatanidzwa neactivated factor X III, uye obva anyudzwa ne activated plasmin kuti agadzire chigadzirwa chekuora chinonzi "fibrin degradation product (FDP)." D-Dimer ndiyo FDP iri nyore, uye kuwedzera kwehuwandu hwayo kunoratidza mamiriro e hypercoagulable uye secondary hyperfibrinolysis in vivo. Nokudaro, huwandu hweD-Dimer hunokosha zvikuru pakuongororwa, kuongororwa kwekushanda uye kuongororwa kwekufanotaura kwezvirwere zve thrombotic.
Kubva pakatanga COVID-19, nekuwanda kwezviratidzo zvekiriniki uye kunzwisisa kwechirwere ichi uye kuunganidzwa kweruzivo rwekuongorora nekurapa, varwere vakakomba vane coronary pneumonia itsva vanogona kukurumidza kukura nechirwere chekufema chakasimba. Zviratidzo, septic shock, refractory metabolic acidosis, coagulation dysfunction, uye multiple organ failure. D-dimer yakakwira muvarwere vane pneumonia yakakomba.
Varwere vanorwara zvakanyanya vanofanira kungwarira njodzi ye venous thromboembolism (VTE) nekuda kwekuzorora kwenguva refu pamubhedha uye kusashanda zvakanaka kweropa.
Munguva yekurapwa, zvakakosha kutarisa zviratidzo zvinoenderana nemamiriro ezvinhu, kusanganisira zviratidzo zvemoyo, mashandiro ekugwamba kweropa, nezvimwewo. Vamwe varwere vanogona kunge vaine myoglobin yakawedzera, vamwe varwere vakakomba vanogona kuona kuwedzera kwetroponin, uye muvarwere vakakomba, D-dimer (D-Dimer) inogona kuwedzerwa.
Zvinogona kuonekwa kuti D-Dimer ine kukosha kwekutarisa matambudziko mukufambira mberi kweCOVID-19, saka inoita sei basa mune zvimwe zvirwere?
1. Kubuda kwetsinga mutsinga
D-Dimer yave ichishandiswa zvakanyanya muzvirwere zvine chekuita ne venous thromboembolism (VTE), zvakaita se deep vein thrombosis (DVT) uye pulmonary embolism (PE). Kuongororwa kweD-Dimer kusina kunaka kunogona kubvisa DVT, uye huwandu hweD-Dimer hunogonawo kushandiswa kufanotaura huwandu hweVTE huchadzoka. Chidzidzo ichi chakawana kuti njodzi yekudzoka kweVTE muvanhu vane huwandu hwakanyanya yaive ka4.1 pane yevanhu vane huwandu hwakajairwa.
D-Dimer ndeimwe yezviratidzo zvekuonekwa kwePE. Kukosha kwayo kwekufanotaura kwakakwira zvikuru, uye kukosha kwayo ndekwekubvisa acute pulmonary embolism, kunyanya kuvarwere vane fungidziro shoma. Saka, kune varwere vanofungidzirwa kuti vane acute pulmonary embolism, ultrasound yetsinga dzakadzika dzemuviri wepazasi uye kuongororwa kweD-Dimer kunofanirwa kubatanidzwa.
2. Kuvharika kweropa mutsinga
Kubatana kweropa muropa (DIC) chirwere chinoratidzwa nekubuda ropa uye kutadza kufamba kweropa zvakanaka zvichibva pazvirwere zvakawanda. Kukura kwechirwere ichi kunosanganisira masisitimu akasiyana-siyana akadai sekuungana kweropa, kudzivirira kuungana kweropa, uye fibrinolysis. D-Dimer yakawedzera pakutanga kwekuumbwa kweDIC, uye kuwanda kwayo kwakaramba kuchikwira kanopfuura kagumi sezvo chirwere ichi chairamba chichienderera mberi. Nokudaro, D-Dimer inogona kushandiswa seimwe yezviratidzo zvikuru zvekuongororwa kwekutanga uye kutarisa mamiriro eDIC.
3. Kuchekwa kwetsinga yeropa (aortic breakage)
"Kubvumirana kwenyanzvi dzekuChina pamusoro pekuongororwa nekurapwa kwekupatsanurwa kwetsinga yeropa" kwakataura kuti D-Dimer, sebvunzo yerabhoritari yenguva dzose yekupatsanurwa kwetsinga yeropa (AD), yakakosha zvikuru pakuongororwa nekusiyana kwekupatsanurwa kwetsinga. Kana D-Dimer yemurwere ikakwira nekukurumidza, mukana wekuongororwa seAD unowedzera. Mukati memaawa makumi maviri nemana ekutanga, kana D-Dimer yasvika pa500 µg/L, kunzwisiswa kwayo pakuongorora acute AD ndeye 100%, uye hunyanzvi hwayo nde67%, saka inogona kushandiswa sechiratidzo chekusabvisa pakuongororwa kweacute AD.
4. Chirwere chemwoyo cheAtherosclerotic
Chirwere chemwoyo chinonzi atherosclerotic cardiovascular disease chirwere chemwoyo chinokonzerwa ne arteriosclerotic plaque, kusanganisira ST-segment elevation acute myocardial infarction, non-ST-segment elevation acute myocardial infarction, uye unstable angina. Mushure mekuputika kweplaque, necrotic core material iri muplaque inobuda, zvichikonzera kusagadzikana kweropa, kushanda kwe coagulation system, uye kuwedzera kwe D-Dimer concentration. Varwere vane chirwere chemwoyo vane D-Dimer yakakwira vanogona kufanotaura njodzi yakakura yeAMI uye vanogona kushandiswa sechiratidzo chekuona mamiriro eACS.
5. Kurapa kweThrombolytic
Ongororo yaLawter yakawana kuti mishonga yakasiyana-siyana yekudzivirira thrombolysis inogona kuwedzera D-Dimer, uye huwandu hwayo hunochinja usati waitwa thrombolysis uye mushure mekuita thrombolysis hunogona kushandiswa sechiratidzo chekuongorora kurapwa kwethrombolytic. Zviri mukati mayo zvakawedzera nekukurumidza kusvika padanho repamusoro mushure mekuita thrombolysis, uye zvakadzokera shure munguva pfupi nekuvandudzika kukuru muzviratidzo zvekiriniki, zvichiratidza kuti kurapwa kwacho kwaishanda.
- Huwandu hweD-Dimer hwakawedzera zvakanyanya awa imwe kusvika maawa matanhatu mushure mekuvhiyiwa kweropa nekuda kwechirwere chemwoyo chakanyanya uye chirwere chepfungwa.
- Munguva yeDVT thrombolysis, D-Dimer peak inowanzoitika maawa makumi maviri nemana kana kuti gare gare
Kadhi rebhizinesi
WeChat yeChinese