01. Kuongororwa kwe deep vein thrombosis uye pulmonary embolism

Kutsemuka kwetsinga dzeropa (D-VT) kunowanzoita pulmonary embolism (PE), inozivikanwawo sevenous thromboembolism (VTE). Mazinga ePlasma D-dimer akakwira zvakanyanya muvarwere vane VTE.

Zvidzidzo zvakafanana zvakaratidza kuti huwandu hweD-dimer muplasma muvarwere vane PE neD-VT hwakakura kupfuura 1 000 μg/L.

Zvisinei, nekuda kwezvirwere zvakawanda kana zvimwe zvinhu zvinokonzera chirwere (kuvhiyiwa, bundu, zvirwere zvemwoyo, nezvimwewo) zvine simba guru pakubvisa ropa mumuviri, zvichikonzera kuwedzera kweD-dimer. Saka, kunyange zvazvo D-dimer ine kunzwa kwakanyanya, kujeka kwayo kunongova 50% kusvika 70% chete, uye D-dimer yega haigone kuongorora VTE. Saka, kuwedzera kukuru kweD-dimer hakugone kushandiswa sechiratidzo chaicho cheVTE. Kukosha kwekuyedzwa kweD-dimer ndekwekuti mhedzisiro isina kunaka inodzivisa kuongororwa kweVTE.

 

02 Kupararira kweropa rakavharirwa

Kubatanidzwa kweropa mutsinga (DIC) chirwere che microthrombosis yakakura mutsinga diki mumuviri wese uye secondary hyperfibrinolysis pasi pechiito chezvimwe zvinhu zvinokonzera hutachiona, izvo zvinogona kuperekedzwa nesecondary fibrinolysis kana inhibited fibrinolysis.

Kuwedzera kwehuwandu hweD-dimer muropa kune kukosha kukuru kwekuongorora DIC pakutanga. Zvisinei, zvinofanira kucherechedzwa kuti kuwedzera kweD-dimer hakusi bvunzo chaiyo yeDIC, asi zvirwere zvakawanda zvinoperekedzwa ne microthrombosis zvinogona kutungamira kukuwedzera kweD-dimer. Kana fibrinolysis ikakonzerwa nekuvharika kweropa muropa, D-dimer inowedzerawo.

Ongororo dzakaratidza kuti D-dimer inotanga kukwira mazuva mashoma DIC isati yasvika uye yakakwira zvakanyanya kupfuura zvakajairwa.

 

03 Kushaya simba rekufema mushure mekusununguka

Kune mwero wakasiyana wekushaya hope uye acidosis mukushaya hope kwevana vacheche, uye kushaya hope uye acidosis zvinogona kukonzera kukuvara kukuru kweropa, zvichikonzera kuburitswa kwehuwandu hwakawanda hwezvinhu zvinosunga ropa, nokudaro zvichiwedzera kugadzirwa kwefibrinogen.

Ongororo dzakakosha dzakaratidza kuti kukosha kweD-dimer kweropa retambo muboka rekushaya mweya kwakanyanya kupfuura kweboka rekutonga rakajairika, uye kana tichienzanisa neD-dimer muropa rekunze, kwakakwirawo zvakanyanya.

 

04 Systemic lupus erythematosus (SLE)

Sisitimu yecoagulation-fibrinolysis haina kujairika muvarwere vane SLE, uye kusagadzikana kwesisitimu yecoagulation-fibrinolysis kunonyanya kuoneka padanho rekushanda kwechirwere, uye maitiro e thrombosis anoonekwa zvakanyanya; kana chirwere chacho chapera, sisitimu yecoagulation-fibrinolysis inowanzova yakajairika.

Saka, huwandu hweD-dimer hwevarwere vane systemic lupus erythematosus vari muzvikamu zvinoshanda uye zvisina kushanda huchawedzera zvakanyanya, uye huwandu hweD-dimer muplasma hwevarwere vari muchikamu chekuita basa hwakakwira zvakanyanya kupfuura hwevari muchikamu chekuita basa.

05 Kurwara kwechiropa nekenza yechiropa

D-dimer chimwe chezviratidzo zvinoratidza kuoma kwechirwere chechiropa. Kana chirwere chechiropa chikanyanya kuoma, huwandu hweD-dimer muropa hunowedzera.

Ongororo dzakakodzera dzakaratidza kuti D-dimer kukosha kweChild-Pugh A, B, uye C mamakisi muvarwere vane cirrhosis yechiropa yaive (2.218 ± 0.54) μg/mL, (6.03 ± 0.76) μg/mL, uye (10.536 ± 0.664) μg/mL, zvichiteerana.

Pamusoro pezvo, D-dimer yakakwira zvakanyanya muvarwere vane kenza yechiropa vane kufambira mberi nekukurumidza uye kufambira mberi kwechirwere kusingafadzi.

06 Gomarara remudumbu

Mushure mekuvhiyiwa kwevarwere vegomarara, thromboembolism inoitika muinenge hafu yevarwere, uye D-dimer inowedzera zvakanyanya mu90% yevarwere.

Pamusoro pezvo, kune boka rezvinhu zvine shuga yakawanda mumasero egomarara ane chimiro netishu zvakafanana zvikuru. Kutora chikamu mumabasa emuviri wemunhu kunogona kukurudzira kushanda kwemuviri wemuviri uye kuwedzera njodzi ye thrombosis, uye huwandu hweD-dimer hunowedzerwa zvakanyanya. Uye huwandu hweD-dimer muvarwere vegomarara remudumbu vane danho rechitatu-IV hwaive hwakakwira zvakanyanya kupfuura hwevarwere vegomarara remudumbu vane danho rechitatu-chipiri.

 

07 Mycoplasma pneumonia (MMP)

MPP yakanyanya inowanzoperekedzwa nemazinga eD-dimer akakwira, uye mazinga eD-dimer akakwira zvakanyanya muvarwere vane MPP yakanyanya kupfuura muzviitiko zvisina kuoma.

Kana MPP yarwara zvakanyanya, kushaya hope, ischemia uye acidosis zvinoitika munharaunda, pamwe chete nekupinda zvakananga kwezvirwere, izvo zvinokuvadza masero eropa, collagen, zvinomutsa coagulation system, zvinoumba hypercoagulable state, uye zvinoumba microthrombi. Internal fibrinolytic, kinin uye complement systems dzinoshandawo zvakatevedzana, zvichikonzera kuwedzera kweD-dimer levels.

 

08 Chirwere cheshuga, chirwere cheshuga nephropathy

Mazinga eD-dimer akakwira zvakanyanya muvarwere vane chirwere cheshuga uye chirwere cheshuga nephropathy.

Pamusoro pezvo, nhamba dzeD-dimer nefibrinogen dzevarwere vane chirwere cheshuga nephropathy dzaive dzakakwira zvakanyanya kupfuura dzevarwere vane chirwere cheshuga cherudzi rwechipiri. Nokudaro, mukurapa, D-dimer inogona kushandiswa senhamba yekuedza kuongorora kuoma kwechirwere cheshuga nechirwere cheitsvo muvarwere.

09 Allergic Purpura (AP)

Muchikamu cheAP chakanyanya, kune mwero wakasiyana wekuwanda kweropa uye kushanda kwemaplatelet kwakawedzerwa, zvichikonzera kusimba kweropa, kuungana kwemaplatelet uye thrombosis.

Kukwidziridzwa kweD-dimer muvana vane AP kunowanzoitika mushure memavhiki maviri ekutanga kwechirwere ichi uye kunosiyana zvichienderana nematanho ekurapa, zvichiratidza kukura uye mwero wekuzvimba kwetsinga dzeropa.

Pamusoro pezvo, chiratidzo chekufanotaura, nekuwedzera kweD-dimer nguva dzose, chirwere ichi chinowanzo tora nguva refu uye chinogona kukuvara itsvo.

 

10 Pamuviri

Ongororo dzakabatana dzakaratidza kuti vanenge 10% yevakadzi vane pamuviri vane huwandu hwakakwira hweD-dimer, zvichiratidza njodzi yekugwamba kweropa.

Preeclampsia idambudziko rinowanzoitika panguva yekuzvitakura. Kuchinja kukuru kwepreeclampsia ne eclampsia kunoshanda pakuita kuti ropa rivhare uye kuwedzera kwe fibrinolysis, zvichikonzera kuwedzera kwe microvascular thrombosis uye D-dimer.

D-dimer yakaderera nekukurumidza mushure mekusununguka mumadzimai akajairwa, asi yakawedzera mumadzimai ane preeclampsia, uye haina kudzokera kune yakajairika kusvika mavhiki mana kusvika matanhatu.

11 Acute Coronary Syndrome uye Kuparadzanisa Aneurysm

Varwere vane acute coronary syndromes vane mwero weD-dimer wakajairika kana kuti wakakwira zvishoma, nepo aortic dissecting aneurysms yakakwira zvakanyanya.

Izvi zvine chekuita nemusiyano mukuru uripo pakati peropa neropa mumidziyo yeropa yemidziyo miviri iyi. Moyo wemoyo watetepa uye ropa mutsinga yeropa rakaderera. Mushure mekunge aortic intima ruptures, ropa rakawanda reropa rinopinda mumadziro emidziyo yeropa kuti riite dissecting aneurysm. Huwandu hwakawanda hweropa rinoumbwa pasi pesimba re coagulation mechanism.

12 Kurwara kweuropi zvakanyanya

Muchirwere chepfungwa chinorwadza, thrombolysis inongoerekana yaitika uye fibrinolytic activity inowedzera, zvichiratidzwa nekuwedzera kwemazinga eD-dimer muropa. Huwandu hweD-dimer hwakawedzera zvakanyanya pakutanga kwechirwere chepfungwa chinorwadza.

Mazinga ePlasma D-dimer muvarwere vane chirwere chemwoyo chakanyanya akawedzera zvishoma muvhiki yekutanga mushure mekutanga kwechirwere, akawedzera zvakanyanya mumavhiki maviri kusvika mana, uye akanga asina kusiyana nemazinga akajairika panguva yekupora (>mwedzi mitatu).