D-dimer inowanzo shandiswa seimwe yezviratidzo zvikuru zvinofungidzirwa zvePTE neDVT mukurapa. Zvakaitika sei?

Plasma D-dimer chigadzirwa chekuora kweropa chinogadzirwa ne plasmin hydrolysis mushure mekunge fibrin monomer yabatanidzwa ne activating factor XIII. Ichi chiratidzo chaicho che fibrinolysis process. D-dimers dzinobva mu cross-linked fibrin clots dzakasanganiswa ne plasmin. Chero bedzi paine active thrombosis uye fibrinolytic activity mutsinga dzeropa dzemuviri, D-dimer ichawedzera. Myocardial infarction, cerebral infarction, pulmonary embolism, venous thrombosis, kuvhiyiwa, bundu, disseminated intravascular coagulation, hutachiona uye tissue necrosis zvinogona kutungamira kuD-dimer yakakwira. Kunyanya kune vakwegura nevarwere vari muchipatara, nekuda kwebhakitiriya nezvimwe zvirwere, zviri nyore kukonzera kusagadzikana kweropa uye kutungamira kukuwedzera D-dimer.

D-dimer inonyanya kuratidza kushanda kwefibrinolytic. Kuwedzera kana kunaka kunoonekwa mu secondary hyperfibrinolysis, senge hypercoagulable state, disseminated intravascular coagulation, chirwere cheitsvo, kurambwa kwenhengo dzemuviri, thrombolytic therapy, nezvimwewo. Kuziva zvinhu zvikuru zve fibrinolytic system kwakakosha zvikuru pakuongorora nekurapa zvirwere zve fibrinolytic system (senge DIC, thrombus dzakasiyana-siyana) uye zvirwere zvine chekuita ne fibrinolytic system (senge bundu, pregnancy syndrome), uye kutarisa thrombolytic therapy.

Kuwanda kweD-dimer, chigadzirwa chekuora kwefibrin, kunoratidza kuora kwefibrin kakawanda mumuviri. Nokudaro, D-dimer ine fibrous chiratidzo chikuru che deep vein thrombosis (DVT), pulmonary embolism (PE), disseminated intravascular coagulation (DIC).

Zvirwere zvakawanda zvinokonzera kushanda kwe coagulation system uye/kana fibrinolytic system mumuviri, zvichikonzera kuwedzera kwe D-dimer, uye kushanda uku kwakabatana zvakanyanya nedanho, kuoma uye kurapwa kwechirwere, saka muzvirwere izvi Kuonekwa kwe D-dimer kunogona kushandiswa sechiratidzo chekuongorora kurongwa kwechirwere, kufanotaura uye gwara rekurapa.

Kushandiswa kweD-dimer mu deep vein thrombosis

Kubva Wilson nevamwe vake pavakatanga kushandisa zvigadzirwa zvekuora kwefibrin pakuongorora pulmonary embolism muna 1971, kuonekwa kweD-dimer kwakaita basa guru pakuongorora pulmonary embolism. Nedzimwe nzira dzekuongorora dzinonyanya kunzwisisika, negative D-dimer Body value ine mhedzisiro yakanaka yekufungidzira negative ye pulmonary embolism, uye kukosha kwayo i0.99. Mhedzisiro isina kunaka inogona kubvisa pulmonary embolism, nokudaro ichideredza kuongororwa kwemukati, senge ventilation perfusion scanning uye pulmonary angiography; kudzivirira blind anticoagulation therapy.D - Kuwanda kwedimer kwakabatana nenzvimbo yethrombus, nehuwandu hwakawanda mumapazi makuru e pulmonary trunk uye huwandu hwakaderera mumapazi madiki.

Negative plasma D-dimers inobvisa mukana wekuti DVT isashande. Angiography yakaratidza kuti DVT yaive 100% yakanaka kune D-dimer. Inogona kushandiswa pakurapa thrombolytic uye heparin anticoagulation mishonga inotungamira uye kuongorora kushanda kwayo.

D-dimer inogona kuratidza shanduko muhukuru hwe thrombus. Kana huwandu hwayo hukawedzera zvakare, zvinoratidza kudzoka kwe thrombus; panguva yekurapwa, inoramba yakakwira, uye saizi ye thrombus haichinje, zvichiratidza kuti kurapwa hakushande.