Sei machubhu emuropa achigona kushandiswawo kuona huwandu hweD-dimer? Pachava nekuumbwa kwefibrin clot muchubhu yemuropa, haingazodziki here kuita D-dimer? Kana ikasadziki, sei paine kuwedzera kukuru kweD-dimer kana machubhu eropa akaumbwa muchubhu inodzivirira kuungana kweropa nekuda kwekusatorwa zvakanaka kweropa kuti riongororwe kuungana kweropa?
Chekutanga, kusaunganidzwa zvakanaka kweropa kunogona kukonzera kukuvara kweropa muropa, uye kuburitswa kwesubendothelial tissue factor uye tissue-type plasminogen activator (tPA) muropa. Kune rumwe rutivi, tissue factor inomutsa nzira ye exogenous coagulation kuti igadzire fibrin clots. Maitiro aya anokurumidza zvikuru. Ingo tarisa nguva yeprothrombin (PT) kuti uzive, iyo inowanzo kuve masekondi gumi. Kune rumwe rutivi, mushure mekunge fibrin yaumbwa, inoshanda se cofactor yekuwedzera basa re tPA ka100, uye mushure mekunge tPA yabatanidzwa pamusoro pe fibrin, haizodzorerwi nyore nyore ne plasminogen activation inhibitor-1 (PAI-1). Saka, plasminogen inogona kushandurwa nekukurumidza uye nguva dzose kuita plasmin, uye fibrin inogona kuora, uye huwandu hwakawanda hweFDP neD-Dimer hunogona kugadzirwa. Ichi ndicho chikonzero nei kuumbwa kweropa mu vitro uye fibrin degradation products kwakawedzera zvakanyanya nekuda kwekusatorwa zvakanaka kweropa.
Saka, sei kuunganidzwa kwakajairika kwechubhu yeropa (isina zvinowedzerwa kana ine coagulant) kwakagadzirawo fibrin clots mu vitro, asi isina kuora kuti igadzire huwandu hwakawanda hweFDP neD-dimer? Izvi zvinoenderana nechubhu yeropa. Chii chakaitika mushure mekunge sampuli yatorwa: Chekutanga, hapana huwandu hwakawanda hwetPA hunopinda muropa; chechipiri, kunyangwe huwandu hushoma hwetPA hukapinda muropa, tPA yemahara ichasungwa nePAI-1 uye inorasikirwa nebasa rayo mumaminitsi angangoita mashanu isati yabatana nefibrin. Panguva ino, kazhinji hapana kuumbwa kwefibrin muchubhu yeropa isina zvinowedzerwa kana ne coagulant. Zvinotora anopfuura maminetsi gumi kuti ropa risina zvinowedzerwa rigwine zvakasikwa, nepo ropa rine coagulant (kazhinji silicon powder) richitanga mukati. Zvinotorawo anopfuura maminetsi mashanu kugadzira fibrin kubva munzira yekugwina kweropa. Pamusoro pezvo, chiitiko chefibrinolytic patembiricha yekamuri mu vitro chichakanganiswawo.
Ngatitaurei nezve thromboelastogram zvakare panyaya iyi: unogona kunzwisisa kuti ropa rakagwamba mu serum tube harisi nyore kukanganiswa, uye unogona kunzwisisa kuti nei thromboelastogram test (TEG) isinganzwisisi kuratidza hyperfibrinolysis - mamiriro ese ari maviri. Zvakafanana, hongu, tembiricha panguva yebvunzo yeTEG inogona kuchengetwa pamadhigirii 37. Kana TEG ichinzwa zvakanyanya kuratidza mamiriro e fibrinolysis, imwe nzira ndeyekuwedzera tPA mukuyedza kwe in vitro TEG, asi kuchine matambudziko ekuenzanisa uye hapana kushandiswa kwese; pamusoro pezvo, inogona kuyerwa padivi pemubhedha nekukurumidza mushure mekutora sampuro, asi mhedzisiro chaiyo yakaganhurirwawo. Muedzo wekare uye unoshanda zvakanyanya wekuongorora mashandiro e fibrinolytic inguva yekunyungudika kwe euglobulin. Chikonzero chekunzwa kwayo kwakanyanya kupfuura kwe TEG. Muedzo, anti-plasmin inobviswa nekugadzirisa pH value uye centrifugation, asi bvunzo inoshandisa. Inotora nguva yakareba uye yakaoma, uye haiwanzoitwa mumarabhoritari.
Kadhi rebhizinesi
WeChat yeChinese