Mafibrin monomers ari muropa anochinjika-akabatanidzwa ne activated factor X III, uyezve hydrolyzed ne activated plasmin kuti ibudise chaiyo degradation chigadzirwa chinonzi "fibrin degradation product (FDP)."D-Dimer ndiyo FDP yakapfava, uye kuwedzera kwehuwandu hwayo kunoratidza iyo hypercoagulable state uye yechipiri hyperfibrinolysis mu vivo.Nokudaro, kusanganiswa kweD-Dimer kwakakosha zvikuru pakuongororwa, kuongororwa kwehutano uye kutonga kwekufungidzira kwezvirwere zvethrombotic.
Kubva pakatanga kubuda kweCCIDID-19, nekudzika kwekiriniki kuratidzwa uye pathological kunzwisisa kwechirwere uye kuunganidzwa kwekuongororwa uye ruzivo rwekurapa, varwere vakanyanya vane nyowani coronary pneumonia vanogona kukurumidza kukura acute kufema kusagadzikana syndrome.Zviratidzo, septic shock, refractory metabolic acidosis, coagulation dysfunction, uye kutadza kwenhengo dzakawanda.D-dimer yakakwira kune varwere vane pneumonia yakaoma.
Varwere vanorwara zvakanyanya vanofanirwa kutarisisa kune njodzi yevenous thromboembolism (VTE) nekuda kwekugara kwenguva refu pamubhedha uye kusagadzikana coagulation basa.
Munguva yekurapa, zvakakosha kutarisa zviratidzo zvakakodzera maererano nemamiriro ezvinhu, kusanganisira myocardial markers, coagulation function, etc. Vamwe varwere vangave vakawedzera myoglobin, mamwe maitiro akaoma anogona kuona kuwedzera troponin, uye mumatambudziko akaoma, D-dimer (D-dimer) D-Dimer) inogona kuwedzerwa.
Zvinogona kuoneka kuti D-Dimer ine kuomarara-kwakanangana nekutarisa kukosha mukufambira mberi kweCCIDID-19, saka inoita sei basa mune zvimwe zvirwere?
1. Venous thromboembolism
D-Dimer yakashandiswa zvakanyanya muzvirwere zvine chekuita nevenous thromboembolism (VTE), seyakadzika vein thrombosis (DVT) uye pulmonary embolism (PE).Muedzo wakashata weD-Dimer unogona kutonga kunze kweDVT, uye iyo D-Dimer concentration inogonawo kushandiswa kufanotaura chiyero chekudzoka kweVTE.Chidzidzo chacho chakawana kuti chiyero chengozi chekudzoka kweVTE muhuwandu hwevanhu vane huwandu hwepamusoro hwakanga huri 4.1 nguva yehuwandu hwevanhu vane hutano hwakanaka.
D-Dimer zvakare imwe yezviratidzo zvekuona zvePE.Kukosha kwayo kwekufanotaura kwakashata kwakanyanya, uye kukosha kwayo ndeyekubvisa acute pulmonary embolism, kunyanya kune varwere vane fungidziro shoma.Nokudaro, kune varwere vanofungidzirwa kuti vane acute pulmonary embolism, ultrasonography yemvura yakadzika yemakumbo ezasi uye D-Dimer kuongororwa kunofanira kusanganiswa.
2. Yakaparadzirwa intravascular coagulation
Disseminated intravascular coagulation (DIC) chirwere chekliniki chinoratidzwa nekubuda ropa uye microcirculatory kukundikana pamusana pezvirwere zvakawanda.Maitiro ekuvandudza anosanganisira akawanda masisitimu akadai se coagulation, anticoagulation, uye fibrinolysis.D-Dimer yakawedzera mukutanga kweDIC kuumbwa, uye kusungirirwa kwayo kwakaramba kuchiwedzera kupfuura 10-nguva apo chirwere chacho chaifambira mberi.Naizvozvo, D-Dimer inogona kushandiswa seimwe yezviratidzo zvikuru zvekutanga kuongororwa uye kutarisisa mamiriro eDIC.
3. Aortic dissection
"Nyanzvi yekuChina inobvumirana pamusoro pekuongororwa uye kurapwa kweaortic dissection" yakaratidza kuti D-Dimer, sechinyakare chemurabhoritari bvunzo yeaortic dissection (AD), yakakosha zvikuru pakuongororwa uye kusiyanisa kuongororwa kwe dissection.Kana D-Dimer yemurwere ichikwira nekukurumidza, mukana wekuonekwa seAD unowedzera.Mukati memaawa makumi maviri nemana ekutanga, kana D-Dimer yasvika paukoshi hwakakosha hwe500 µg/L, kunzwisiswa kwayo pakuongorora acute AD i100%, uye chaiyo i67%, saka inogona kushandiswa senge indekisi yekusabatanidzwa yekuongororwa acute AD.
4. Atherosclerotic Cardiovascular Disease
Atherosclerotic cardiovascular disease chirwere chemoyo chinokonzerwa nearteriosclerotic plaque, kusanganisira ST-segment elevation acute myocardial infarction, non-ST-segment elevation acute myocardial infarction, uye angina isina kugadzikana.Mushure mekuputika kweplaque, iyo necrotic core material in the plaque inoyerera ichibuda, zvichiita kuti ropa rive neropa, activation ye coagulation system, uye kuwedzera D-Dimer concentration.Coronary heart disease varwere vane D-Dimer yakakwirira vanogona kufanotaura njodzi yepamusoro ye AMI uye inogona kushandiswa sechiratidzo chekucherechedza mamiriro eAACS.
5. Thrombolytic therapy
Ongororo yaLawter yakawana kuti mishonga yakasiyana-siyana yethrombolytic inogona kuwedzera D-Dimer, uye kuchinja kwayo kusati kwaitika uye shure kwethrombolysis inogona kushandiswa sechiratidzo chekutonga thrombolytic therapy.Zvinyorwa zvaro zvakakurumidza kuwedzera kusvika pakukosha kwepamusoro mushure me thrombolysis, uye yakadzokera shure munguva pfupi nekunatsiridza kukuru kwezviratidzo zvechipatara, zvichiratidza kuti kurapwa kwakashanda.
- Chiyero cheD-Dimer chakawedzera zvakanyanya 1 awa kusvika maawa matanhatu mushure me thrombolysis yeacute myocardial infarction uye cerebral infarction.
- Munguva yeDVT thrombolysis, iyo D-Dimer peak inowanzoitika maawa makumi maviri nemana kana gare gare
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