I-D-dimer idla ngokusetyenziswa njengenye yeempawu ezibalulekileyo ezirhanelwayo ze-PTE kunye ne-DVT kunyango. Yenzeka njani loo nto?

I-Plasma D-dimer yimveliso ethile yokubola eveliswa yi-plasmin hydrolysis emva kokuba i-fibrin monomer idityaniswe yi-activating factor XIII. Luphawu oluthile lwenkqubo ye-fibrinolysis. I-D-dimers ivela kwi-cross-linked fibrin clots edityaniswe yi-plasmin. Logama nje kukho i-thrombosis esebenzayo kunye nomsebenzi we-fibrinolytic kwimithambo yegazi yomzimba, i-D-dimer iya kwanda. I-Myocardial infarction, i-cerebral infarction, i-pulmonary embolism, i-venous thrombosis, utyando, i-tumor, i-dissemed intravascular coagulation, usulelo kunye ne-tissue necrosis inokukhokelela kwi-D-dimer ephezulu. Ingakumbi kubantu abadala kunye nabagula esibhedlele, ngenxa ye-bacteremia kunye nezinye izifo, kulula ukubangela i-blood coagulation engaqhelekanga kwaye ikhokelele kwi-D-dimer eyonyukileyo.

I-D-dimer ibonakalisa kakhulu umsebenzi we-fibrinolytic. Ukwanda okanye ukulunga kubonakala kwi-hyperfibrinolysis yesibini, efana ne-hypercoagulable state, i-disseminated intravascular coagulation, isifo sezintso, ukwaliwa kokufakelwa kwamalungu omzimba, unyango lwe-thrombolytic, njl. Ukuchonga izinto eziphambili zenkqubo ye-fibrinolytic kubaluleke kakhulu ekuxilongweni nasekunyangweni kwezifo zenkqubo ye-fibrinolytic (ezifana ne-DIC, i-thrombus eyahlukeneyo) kunye nezifo ezinxulumene nenkqubo ye-fibrinolytic (ezifana neethumba, isifo sokukhulelwa), kunye nokubeka esweni unyango lwe-thrombolytic.

Amanqanaba aphezulu e-D-dimer, imveliso yokubola kwe-fibrin, abonisa ukubola kwe-fibrin rhoqo emzimbeni. Ke ngoko, i-D-dimer ene-fibrous luphawu oluphambili lwe-deep vein thrombosis (DVT), i-pulmonary embolism (PE), kunye ne-disseminated intravascular coagulation (DIC).

Izifo ezininzi zibangela ukusebenza kwenkqubo yokujiya kunye/okanye inkqubo ye-fibrinolytic emzimbeni, nto leyo ebangela ukwanda kwinqanaba le-D-dimer, kwaye oku kusebenza kunxulumene kakhulu nenqanaba, ubunzima kunye nonyango lwesifo, ngoko ke kwezi zifo Ukufunyanwa kwenqanaba le-D-dimer kunokusetyenziswa njengophawu lovavanyo lokumisela isifo, ukuqikelela kwangaphambili kunye nesikhokelo sonyango.

Ukusetyenziswa kwe-D-dimer kwi-deep vein thrombosis

Ukususela oko uWilson nabanye baqala ukusebenzisa iimveliso zokubola kwe-fibrin ukufumanisa i-pulmonary embolism ngo-1971, ukufunyanwa kwe-D-dimer kudlale indima enkulu ekuchongeni i-pulmonary embolism. Ngeendlela ezithile zokufumanisa ezibuthathaka kakhulu, i-negative D-dimer Ixabiso lomzimba linesiphumo esifanelekileyo sokuqikelela i-pulmonary embolism, kwaye ixabiso layo yi-0.99. Isiphumo esibi sinokuyisusa ngokusisiseko i-pulmonary embolism, ngaloo ndlela kunciphisa uvavanyo oluhlaselayo, olufana nokuskena i-ventilation perfusion kunye ne-pulmonary angiography; kuthintelwe unyango olungabonakaliyo lwe-anticoagulation.D - Uxinzelelo lwe-dimer lunxulumene nendawo ye-thrombus, kunye noxinzelelo oluphezulu kumasebe amakhulu esiqu se-pulmonary kunye noxinzelelo oluphantsi kumasebe amancinci.

Ii-D-dimers zeplasma ezingezizo ezibonisa ukuba umntu akanayo i-DVT. I-Angiography iqinisekisile ukuba i-DVT yayine-100% kwi-D-dimer. Ingasetyenziselwa unyango lwe-thrombolytic kunye ne-heparin anticoagulation medication kunye nokujonga ukusebenza kakuhle.

I-D-dimer inokubonakalisa utshintsho kubungakanani be-thrombus. Ukuba umxholo uyanda kwakhona, oko kubonisa ukuphinda kwe-thrombus; ngexesha lonyango, iyaqhubeka nokuba phezulu, kwaye ubungakanani be-thrombus abutshintshi, nto leyo ebonisa ukuba unyango alusebenzi.