Chii chinonzi D-dimer?

D-dimer ndiyo nzira iri nyore yekuparadza fibrin, uye huwandu hwayo hwakakwira hunogona kuratidza mamiriro ekugwamba kweropa zvakanyanya uye hyperfibrinolysis yechipiri mumuviri. D-dimer inogona kushandiswa sechiratidzo chekugwamba kweropa zvakanyanya uye hyperfibrinolysis mumuviri, uye kuwedzera kwayo kunoratidza kuti ine chekuita nezvirwere zvinokonzerwa neropa zvakanyanya zvinokonzerwa nezvikonzero zvakasiyana mumuviri, uye zvakare zvinoratidza kuwedzera kwebasa re fibrinolytic.

Mazinga eD-dimer anokwidziridzwa mumamiriro api ezvinhu?

Matambudziko e venous thromboembolism (VTE) uye asiri evenous thromboembolic anogona kukonzera mazinga eD-dimer akakwira.

VTE inosanganisira acute pulmonary embolism, deep vein thrombosis (DVT) uye cerebral venous thrombosis (sinus) thrombosis (CVST).

Zvirwere zveNon-venous thromboembolic zvinosanganisira acute aortic dissection (AAD), ruptured aneurysm, stroke (CVA), dissembled intravascular coagulation (DIC), sepsis, acute coronary syndrome (ACS), uye chronic obstructive Pulmonary disease (COPD), nezvimwewo. Pamusoro pezvo, huwandu hweD-dimer hunokwirawo mumamiriro ezvinhu akadai sekukwegura, kuvhiyiwa/kushungurudzika kuchangobva kuitika, uye thrombolysis.

D-dimer inogona kushandiswa kuongorora kufambira mberi kwechirwere chepulmonary embolism

D-dimer inofanotaura kufa kwevarwere vane pulmonary embolism. Muvarwere vane acute pulmonary embolism, D-dimer values ​​​​yakakwira yakabatana nePESI scores yakakwira (Pulmonary Embolism Severity Index Score) uye kuwedzera kwekufa. Zvidzidzo zvakaratidza kuti D-dimer <1500 μg/L ine kunaka kwekufa kwe pulmonary embolism kwemwedzi mitatu: kufa kwemwedzi mitatu i0% kana D-dimer <1500 μg/L. Kana D-dimer iri kupfuura 1500 μg/L, kungwarira kwakanyanya kunofanira kushandiswa.

Pamusoro pezvo, zvimwe zvidzidzo zvakaratidza kuti kune varwere vane kenza yemapapu, D-dimer <1500 μg/L inowanzo kuve kuwedzera kwefibrinolytic activity inokonzerwa nemabundu; D-dimer >1500 μg/L inowanzoratidza kuti varwere vane kenza yemapapu vane deep vein thrombosis (DVT) uye pulmonary embolism.

D-dimer inofanotaura kudzoka kweVTE

D-dimer inofungidzira kuti VTE inogona kudzoka zvakare. Varwere vasina D-dimer vaive nehuwandu hwekudzokazve kwe0 mumwedzi mitatu. Kana D-dimer ikakwira zvakare panguva yekutevera, njodzi yekudzokazve kweVTE inogona kuwedzera zvakanyanya.

D-dimer inobatsira pakuongorora kupatsanurwa kweaorta yeropa

D-dimer ine mukana wakanaka wekufanotaura zvakaipa muvarwere vane acute aortic dissection, uye D-dimer negativity inogona kubvisa acute aortic dissection. D-dimer yakakwira muvarwere vane acute aortic dissection uye haina kukwira zvakanyanya muvarwere vane acute aortic dissection.

D-dimer inochinja-chinja kakawanda kana kuti inomuka kamwe kamwe, zvichiratidza kuti pane njodzi huru yekutsemuka kwechikamu. Kana huwandu hweD-dimer hwemurwere hwakagadzikana uye hwakaderera (<1000 μg/L), njodzi yekutsemuka kwechikamu idiki. Nokudaro, huwandu hweD-dimer hunogona kutungamira kurapwa kwakanaka kwevarwere ivavo.

D-dimer uye hutachiona

Utachiona ndechimwe chezvikonzero zveVTE. Panguva yekubviswa kwezino, hutachiona hunogona kuitika, izvo zvinogona kukonzera matambudziko eropa. Panguva ino, huwandu hweD-dimer hunofanira kutariswa zvakanyanya, uye kurapwa kwekudzivirira ropa kunofanira kusimbiswa kana huwandu hweD-dimer hwakwira.

Pamusoro pezvo, hutachiona hwekufema uye kukuvara kweganda zvinhu zvinokonzera thrombosis yetsinga yakadzika.

D-dimer inotungamira mukurapa kwekudzivirira ropa kuvhara ropa

Zvakabuda muongororo yePROLONG multicenter, muzvikamu zvekutanga (zvekutevera kwemwedzi gumi nemisere) uye zvakarebeswa (zvekutevera kwemwedzi makumi matatu) zvakaratidza kuti zvichienzaniswa nevarwere vasina anticoagulant, varwere vane D-dimer vakaramba vachinwa mushure memwedzi mumwe chete wekurapwa. Anticoagulant yakaderedza zvakanyanya njodzi yekudzoka kweVTE, asi pakanga pasina musiyano wakakosha muvarwere vasina D-dimer.

Muongororo yakaburitswa neBlood, Purofesa Kearon akataurawo kuti kurapwa kwekudzivirira ropa kuvhara kunogona kutungamirirwa zvichienderana nedanho reD-dimer remurwere. Muvarwere vane DVT isina kukurudzirwa kana pulmonary embolism, kurapwa kwekudzivirira ropa kuvhara kunogona kutungamirirwa nekuona D-dimer; kana D-dimer ikasashandiswa, nzira yekudzivirira ropa kuvhara inogona kuonekwa zvichienderana nenjodzi yekubuda ropa uye zvinodiwa nemurwere.

Pamusoro pezvo, D-dimer inogona kutungamira kurapwa kwethrombolytic.