D-dimer ke eng?

D-dimer ke sehlahisoa se bonolo ka ho fetisisa sa ho senyeha ha fibrin, 'me boemo ba eona bo phahameng bo ka bonahatsa boemo ba hypercoagulable le hyperfibrinolysis ea bobeli ka vivo.D-dimer e ka sebelisoa e le letšoao la hypercoagulability le hyperfibrinolysis in vivo, 'me keketseho ea eona e fana ka maikutlo a hore e amana le mafu a thrombotic a bakoang ke mabaka a sa tšoaneng a vivo, hape e bontša ntlafatso ea mosebetsi oa fibrinolytic.

Maemo a D-dimer a phahame tlas'a maemo afe?

Ka bobeli venous thromboembolism (VTE) le mafu a non-venous thromboembolic a ka baka maemo a phahameng a D-dimer.

VTE e kenyelletsa acute pulmonary embolism, deep vein thrombosis (DVT) le cerebral venous (sinus) thrombosis (CVST).

Mathata a non-venous thromboembolic a kenyelletsa acute aortic dissection (AAD), aneurysm e phatlohileng, stroke (CVA), disseminated intravascular coagulation (DIC), sepsis, acute coronary syndrome (ACS), le chronic obstructive Pulmonary disease (COPD), joalo-joalo. , Maemo a D-dimer a boetse a phahame maemong a kang botsofali, opereishene ea morao-rao / ts'oaetso, le thrombolysis.

D-dimer e ka sebelisoa ho hlahloba prognosis ea pulmonary embolism

D-dimer e bolela esale pele lefu ho bakuli ba nang le pulmonary embolism.Ho bakuli ba nang le acute pulmonary embolism, litekanyetso tse phahameng tsa D-dimer li ne li amahanngoa le lintlha tse phahameng tsa PESI (Pulmonary Embolism Severity Index Score) le ho eketseha ha lefu.Liphuputso li bontšitse hore D-dimer <1500 μg/L e na le boleng bo botle ba ho bolela esale pele bo bobe bakeng sa likhoeli tse 3 tsa lefu la pulmonary embolism: ho shoa ha likhoeli tse 3 ke 0% ha D-dimer <1500 μg/L.Ha D-dimer e le kholo ho feta 1500 μg/L, ho falimeha ho hoholo ho lokela ho sebelisoa.

Ho phaella moo, liphuputso tse ling li bontšitse hore ho bakuli ba nang le kankere ea matšoafo, D-dimer <1500 μg / L hangata ke mosebetsi o ntlafetseng oa fibrinolytic o bakoang ke lihlahala;D-dimer> 1500 μg/L hangata e bontša hore bakuli ba nang le mofetše oa matšoafo ba na le thrombosis e tebileng ea methapo (DVT) le pulmonary embolism.

D-dimer e bolela esale pele ho hlaha ha VTE

D-dimer e bolela esale pele ka VTE e iphetang.Bakuli ba D-dimer-negative ba ne ba e-na le khoeli ea 3 ea likhoeli tse 0. Haeba D-dimer e phahama hape nakong ea ho latela, kotsi ea ho khutlela VTE e ka eketseha haholo.

D-dimer e thusa ho hlahloba lefu la aortic dissection

D-dimer e na le boleng bo botle ba ho bolela esale pele ho bakuli ba nang le aortic dissection e matla, 'me D-dimer negativity e ka thibela ho phatloha ho hoholo ha aortic.D-dimer e phahame ho bakuli ba nang le aortic dissection e matla 'me ha e phahame haholo ho bakuli ba nang le bothata bo sa foleng ba aortic dissection.

D-dimer e feto-fetoha khafetsa kapa ka tšohanyetso e phahama, e fana ka maikutlo a kotsi e kholo ea ho phatloha ha sekhahla.Haeba boemo ba mokuli ba D-dimer bo batla bo tsitsitse ebile bo le tlase (<1000 μg/L), kotsi ea ho phatloha ho hoholo e nyane.Ka hona, boemo ba D-dimer bo ka tataisa kalafo e khethehileng ea bakuli bao.

D-dimer le tšoaetso

Tšoaetso ke e 'ngoe ea lisosa tsa VTE.Nakong ea ho ntšoa ha leino, ho ka etsahala baktheria, e leng se ka lebisang liketsahalong tsa thrombotic.Nakong ena, maemo a D-dimer a lokela ho behoa leihlo ka hloko, 'me phekolo ea anticoagulation e lokela ho matlafatsoa ha maemo a D-dimer a phahame.

Ho feta moo, mafu a phefumolohang le tšenyo ea letlalo ke mabaka a kotsi bakeng sa thrombosis e tebileng ea methapo.

D-dimer e tataisa kalafo ea anticoagulation

Liphello tsa li-multicenter tsa PROLONG, thuto e lebelletsoeng ka bobeli nakong ea pele (tsalo-morao ea likhoeli tse 18) le mekhahlelo e atolositsoeng (ea likhoeli tse 30) e bonts'itse hore ha ho bapisoa le bakuli ba se nang anticoagulated, bakuli ba D-dimer-positive ba ile ba tsoela pele kamora 1. Khoeli ea tšitiso ea phekolo Anticoagulation e fokolitse haholo kotsi ea ho khutlela VTE, empa ho ne ho se na phapang e khōlō ho bakuli ba D-dimer-negative.

Tlhahlobong e hatisitsoeng ke Blood, Moprofesa Kearon o boetse a bontša hore phekolo ea anticoagulation e ka tataisoa ho latela boemo ba mokuli ba D-dimer.Ho bakuli ba nang le DVT ea proximal e sa tsitsang kapa embolism ea pulmonary, phekolo ea anticoagulation e ka tataisoa ke ho lemoha D-dimer;haeba D-dimer e sa sebelisoe, thupelo ea anticoagulation e ka khethoa ho latela kotsi ea ho tsoa mali le litakatso tsa mokuli.

Ho feta moo, D-dimer e ka tataisa phekolo ea thrombolytic.