Kutheni iityhubhu ze-serum zinokusetyenziselwa ukubona umxholo we-D-dimer? Kuya kubakho ukwakheka kwe-fibrin clot kwityhubhu ye-serum, ngaba ayizukubola ibe yi-D-dimer? Ukuba ayibola, kutheni kukho ukwanda okukhulu kwe-D-dimer xa kusenziwa amahlwili egazi kwityhubhu yokuthintela ukubola kwegazi ngenxa yokungafumani kakuhle iisampulu zegazi kwiimvavanyo zokubola kwegazi?
Okokuqala, ukuqokelelwa kwegazi okungalunganga kunokukhokelela kumonakalo we-vascular endothelial, kunye nokukhululwa kwe-subendothelial tissue factor kunye ne-tissue-type plasminogen activator (tPA) egazini. Kwelinye icala, i-tissue factor ivuselela indlela ye-coagulation yangaphandle ukuvelisa ama-fibrin clots. Le nkqubo ikhawuleza kakhulu. Jonga nje ixesha le-prothrombin (PT) ukuze wazi, elihlala limalunga nemizuzwana eli-10. Kwelinye icala, emva kokuba i-fibrin yenziwe, isebenza njenge-cofactor yokwandisa umsebenzi we-tPA ngamaxesha ali-100, kwaye emva kokuba i-tPA inamathele kumphezulu we-fibrin, ayisayi kuthintelwa lula yi-plasminogen activation inhibitor-1 (PAI-1). Ke ngoko, i-plasminogen inokuguqulwa ngokukhawuleza nangokuqhubekayo ibe yi-plasmin, kwaye emva koko i-fibrin inokonakala, kwaye inani elikhulu le-FDP kunye ne-D-Dimer zinokuveliswa. Esi sisizathu sokuba ukwakheka kwama-clot egazi kwi-vitro kunye neemveliso zokuchithwa kwe-fibrin kwandiswe kakhulu ngenxa yokuthathwa kwesampulu yegazi okungalunganga.
Kutheni ke, ingqokelela eqhelekileyo yetyhubhu yeserum (ngaphandle kwezongezo okanye nge-coagulant) iisampulu nazo zenze amahlwili e-fibrin kwi-vitro, kodwa azizange ziwohloke ukuze zenze inani elikhulu le-FDP kunye ne-D-dimer? Oku kuxhomekeke kwityhubhu yeserum. Kwenzeka ntoni emva kokuba isampuli iqokelelwe: Okokuqala, akukho bungakanani buninzi be-tPA engena egazini; okwesibini, nokuba inani elincinci le-tPA lingena egazini, i-tPA yasimahla iya kubotshelelwa yi-PAI-1 kwaye ilahlekelwe ngumsebenzi wayo malunga nemizuzu emi-5 ngaphambi kokuba inamathele kwi-fibrin. Ngeli xesha, kudla ngokungabikho ukwakheka kwe-fibrin kwityhubhu yeserum ngaphandle kwezongezo okanye nge-coagulant. Kuthatha imizuzu engaphezu kweshumi ukuba igazi elingenazo izongezo lijike ngokwendalo, ngelixa igazi eline-coagulant (ngesiqhelo i-silicon powder) liqala ngaphakathi. Kuthatha imizuzu engaphezu kwemi-5 ukwenza i-fibrin ukusuka kwindlela yokujikeka kwegazi. Ukongeza, umsebenzi we-fibrinolytic kubushushu begumbi kwi-vitro nawo uya kuchaphazeleka.
Makhe sithethe nge-thromboelastogram kwakhona ngale ngongoma: ungaqonda ukuba i-clot yegazi kwityhubhu ye-serum ayonakaliswa lula, kwaye ungaqonda ukuba kutheni uvavanyo lwe-thromboelastogram (TEG) lungenangxaki yokubonisa i-hyperfibrinolysis-zombini iimeko. Kuyafana, ewe, ubushushu ngexesha lovavanyo lwe-TEG bunokugcinwa kuma-degrees angama-37. Ukuba i-TEG inobuthathaka ngakumbi ekuboniseni imeko ye-fibrinolysis, enye indlela kukongeza i-tPA kuvavanyo lwe-in vitro TEG, kodwa kusekho iingxaki zokumisela umgangatho kwaye akukho setyenziso luqhelekileyo; ukongeza, inokulinganiswa ecaleni kwebhedi kwangoko emva kokuthatha isampuli, kodwa isiphumo sokwenyani sikwancinci kakhulu. Uvavanyo lwendabuko nolusebenzayo ngakumbi lokuvavanya umsebenzi we-fibrinolytic lixesha lokunyibilika kwe-euglobulin. Isizathu sobuthathaka bayo siphezulu kune-TEG. Kuvavanyo, i-anti-plasmin isuswa ngokulungisa ixabiso le-pH kunye ne-centrifugation, kodwa uvavanyo ludla Ithatha ixesha elide kwaye irhabaxa, kwaye ayifane yenziwe kwiilabhoratri.
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