Yintoni i-D-dimer?

I-D-dimer yeyona mveliso ilula yokuwohloka kwe-fibrin, kwaye inqanaba layo eliphezulu linokubonisa imeko yokubola kwe-hypercoagulable kunye ne-hyperfibrinolysis yesibini kwi-vivo. I-D-dimer ingasetyenziswa njengophawu lwe-hypercoagulability kunye ne-hyperfibrinolysis kwi-vivo, kwaye ukwanda kwayo kubonisa ukuba inxulumene nezifo ze-thrombotic ezibangelwa zizizathu ezahlukeneyo kwi-vivo, kwaye ikwabonisa ukonyuka komsebenzi we-fibrinolytic.

Amanqanaba e-D-dimer anyuswa phantsi kweziphi iimeko?

Zombini iingxaki ze-venous thromboembolism (VTE) kunye ne-non-venous thromboembolic disorders zinokubangela amanqanaba aphezulu e-D-dimer.

I-VTE ibandakanya i-acute pulmonary embolism, i-deep vein thrombosis (DVT) kunye ne-cerebral venous (sinus) thrombosis (CVST).

Izifo ezingezizo ezemithambo-luvo ziquka ukuqhekeka kwemithambo-luvo okukhawulezileyo (AAD), ukuqhekeka kwemithambo-luvo okuqhekekileyo, isifo sohlangothi (CVA), ukuqhekeka kwemithambo-luvo okusasazekileyo (DIC), i-sepsis, isifo sentliziyo esikhawulezileyo (ACS), kunye nesifo semiphunga esingapheliyo (COPD), njl. Ukongeza, amanqanaba e-D-dimer nawo ayanda kwiimeko ezifana nokwaluphala, utyando/ukwenzakala kutshanje, kunye nokuqhekeka kwemithambo-luvo.

I-D-dimer ingasetyenziselwa ukuvavanya i-pulmonary embolism prognosis

I-D-dimer iqikelela ukufa kwizigulane ezine-pulmonary embolism. Kwizigulane ezine-acute pulmonary embolism, amaxabiso aphezulu e-D-dimer ​​adibene namanqaku aphezulu e-PESI (i-Pulmonary Embolism Severity Index Score) kunye nokunyuka kokufa. Izifundo zibonise ukuba i-D-dimer <1500 μg/L inexabiso elingcono lokuqikelela ukufa kwe-pulmonary embolism kwiinyanga ezi-3: ukufa kweenyanga ezi-3 yi-0% xa i-D-dimer <1500 μg/L. Xa i-D-dimer ingaphezulu kwe-1500 μg/L, kufuneka kusetyenziswe unonophelo oluphezulu.

Ukongeza, ezinye izifundo zibonise ukuba kwizigulane ezinomhlaza wemiphunga, i-D-dimer <1500 μg/L idla ngokuba ngumsebenzi we-fibrinolytic ophuculweyo obangelwa ziithumba; i-D-dimer >1500 μg/L idla ngokubonisa ukuba izigulane ezinomhlaza wemiphunga zine-deep vein thrombosis (DVT) kunye ne-pulmonary embolism.

I-D-dimer iqikelela ukuphinda kwe-VTE

I-D-dimer ixela kwangaphambili ukuba isifo siphinde sibuye. Izigulane ezingenayo i-D-dimer zazinezinga lokuphinda sibuye leenyanga ezi-3 elingu-0. Ukuba i-D-dimer iphinda inyuke ngexesha lokulandelela, umngcipheko wokuphinda sibuye kwi-VTE unokwanda kakhulu.

I-D-dimer inceda ekuxilongeni ukuqhekeka kwe-aorta

I-D-dimer inexabiso elihle lokuqikelela elibi kwizigulane ezine-acute aortic dissection, kwaye i-D-dimer negativity inokuthintela i-acute aortic dissection. I-D-dimer iphezulu kwizigulane ezine-acute aortic dissection kwaye ayiphezulu kakhulu kwizigulane ezine-aortic dissection engapheliyo.

I-D-dimer iyatshintshatshintsha ngokuphindaphindiweyo okanye ngequbuliso inyuke, nto leyo ebonisa umngcipheko omkhulu wokuqhekeka kwezicubu. Ukuba inqanaba le-D-dimer lesigulana lizinzile kwaye liphantsi (<1000 μg/L), umngcipheko wokuqhekeka kwezicubu uncinci. Ke ngoko, inqanaba le-D-dimer linokukhokela unyango olukhethekileyo lwezo zigulana.

I-D-dimer kunye nosulelo

Usulelo lolunye lwezizathu ze-VTE. Ngexesha lokukhupha amazinyo, i-bacteremia inokwenzeka, nto leyo enokubangela ukuba kubekho i-thrombosis. Ngeli xesha, amanqanaba e-D-dimer kufuneka ajongwe ngokusondeleyo, kwaye unyango lokuthintela ukujiya kwegazi kufuneka luqiniswe xa amanqanaba e-D-dimer ephakanyisiwe.

Ukongeza, usulelo lokuphefumla kunye nomonakalo wesikhumba zizinto ezibangela i-deep vein thrombosis.

Izikhokelo ze-D-dimer zonyango lokuthintela ukujiya kwegazi

Iziphumo zophando olujoliswe kwiziko le-PROLONG, oluneziko ezininzi, zombini kwizigaba zokuqala (zokulandelelana kweenyanga ezili-18) kunye nezongezelelweyo (zokulandelelana kweenyanga ezingama-30) zibonise ukuba xa kuthelekiswa nezigulane ezingenayo i-anticoagulation, izigulane ezine-D-dimer zaqhubeka emva kwenyanga e-1 yokuphazamiseka konyango lwe-Anticoagulation yanciphisa kakhulu umngcipheko wokubuyela kwakhona kwe-VTE, kodwa akukho mahluko ubalulekileyo kwizigulane ezingenayo i-D-dimer.

Kuphononongo olupapashwe yiBlood, uNjingalwazi uKearon ukwathe ukuba unyango lokuthintela ukugabha kwegazi lunokukhokelwa ngokwenqanaba le-D-dimer yesigulane. Kwizigulane ezine-DVT engavuselelwanga okanye i-pulmonary embolism, unyango lokuthintela ukugabha kwegazi lunokukhokelwa kukufunyanwa kwe-D-dimer; ukuba i-D-dimer ayisetyenziswa, ikhosi yokuthintela ukugabha kwegazi inokufunyanwa ngokwengozi yokopha kunye neminqweno yesigulane.

Ukongeza, i-D-dimer ingakhokela unyango lwe-thrombolytic.