(1) i-D-dimer
Njengomkhiqizo wokuwohloka kwe-fibrin exhumene ne-cross-linked, i-D-dimer iyisibonakaliso esivamile esibonisa ukusebenza kwe-coagulation kanye ne-hyperfibrinolysis yesibili. Ezigulini ezine-COVID-19, amazinga aphezulu e-D-dimer ayisibonakaliso esibalulekile sezinkinga zokugoba okungenzeka. Amazinga e-D-dimer nawo ahlobene kakhulu nobunzima besifo, futhi iziguli ezine-D-dimer ephakeme kakhulu lapho zilaliswa zinesimo esibi kakhulu. Iziqondiso ezivela kwi-International Society of Thrombosis and Hemostasis (ISTH) zincoma ukuthi i-D-dimer ephakanyisiwe kakhulu (ngokuvamile engaphezu kwezikhathi ezi-3 noma ezi-4 kunomkhawulo ophezulu wejwayelekile) ingaba isibonakaliso sokulaliswa esibhedlela ezigulini ze-COVID-19, ngemuva kokukhishwa kweziphazamiso. I-Anticoagulation enemithamo yokuvimbela i-heparin enesisindo esiphansi sama-molecular kufanele inikezwe iziguli ezinjalo ngokushesha okukhulu. Lapho i-D-dimer ikhuphuka kancane kancane futhi kukhona izinsolo eziphezulu ze-venous thrombosis noma i-microvascular embolism, kufanele kucatshangelwe i-anticoagulation enemithamo yokwelapha ye-heparin.

Nakuba i-D-dimer ephezulu ingase iphakamise i-hyperfibrinolysis, ukuthambekela kokopha ezigulini ze-COVID-19 ezine-D-dimer ephakeme kakhulu akuvamile ngaphandle kokuthi kuqhubekele esigabeni esibonakalayo se-DIC esingaxubeki kahle, okuphakamisa ukuthi i-COVID-19 Uhlelo lwe-fibrinolytic lwe--19 lusavinjelwe kakhulu. Olunye uphawu oluhlobene ne-fibrin, okungukuthi, ukuthambekela kokushintsha kwezinga le-FDP kanye nezinga le-D-dimer kwakufana.

 

(2) I-PT
I-PT ende futhi iyinkomba yezinkinga zokujiya kwegazi ezigulini ze-COVID-19 futhi iboniswe ukuthi ihlotshaniswa nokubikezela okubi. Esigabeni sokuqala sesifo sokujiya kwegazi ku-COVID-19, iziguli ezine-PT zivame ukuba zijwayelekile noma zingajwayelekile, kanti i-PT ende esikhathini sokujiya kwegazi ngokuvamile ikhombisa ukusebenza nokusetshenziswa kwezinto zokujiya kwegazi zangaphandle, kanye nokwehla kwe-fibrin polymerization, ngakho-ke futhi kuyindlela yokuvimbela ukujiya kwegazi. Enye yezinkomba. Kodwa-ke, lapho i-PT iqhubeka isikhathi eside kakhulu, ikakhulukazi lapho isiguli sinezimpawu zokopha, ikhombisa ukuthi isifo sokujiya kwegazi singene esigabeni sokujiya kwegazi esiphansi, noma isiguli siyinkimbinkimbi ngenxa yokuntuleka kwesibindi, ukuntuleka kwe-vitamin K, ukusetshenziswa ngokweqile kwe-anticoagulant, njll., kanye nokumpontshelwa kwegazi nge-plasma kufanele kucatshangelwe. Ukwelashwa okunye. Enye into yokuhlola ukujiya kwegazi, isikhathi se-thromboplastin esisebenzayo (APTT), sigcinwa kakhulu ezingeni elijwayelekile ngesikhathi sesigaba sokujiya kwegazi esijiya kwegazi, okungase kuhlotshaniswe nokwanda kokusebenza kwe-factor VIII esimweni sokuvuvukala.

 

(3) Inani lamaplatelet kanye nokuhlolwa komsebenzi
Nakuba ukusebenza kokujiya kwe-coagulation kungaholela ekunciphiseni ukusetshenziswa kwe-platelet, ukwehla kwenani lama-platelet akuvamile ezigulini ze-COVID-19, okungase kuhlotshaniswe nokukhululwa okwandisiwe kwama-cytokines e-thrombopoietin, IL-6, akhuthaza ukusabela kwe-platelet ezimweni zokuvuvukala. Ngakho-ke, inani eliphelele lenani lama-platelet akuyona inkomba ebucayi ekhombisa ukuphazamiseka kokujiya kwe-coagulation ku-COVID-19, futhi kungaba usizo kakhulu ukunaka izinguquko zayo. Ngaphezu kwalokho, ukwehla kwenani lama-platelet kuhlotshaniswa kakhulu nokubikezela okubi futhi kungenye yezinkomba zokuvimbela ukujiya kwe-coagulation. Kodwa-ke, lapho inani lehla kakhulu (isb., <50×109/L), futhi isiguli sinezimpawu zokopha, kufanele kucatshangelwe ukumpontshelwa kwengxenye yama-platelet.

Ngokufanayo nemiphumela yezifundo zangaphambilini ezigulini ezine-sepsis, ukuhlolwa kokusebenza kwama-platelet e-in vitro ezigulini ze-COVID-19 ezinezinkinga zokugaya igazi ngokuvamile kuveza imiphumela ephansi, kodwa ama-platelet angempela ezigulini avame ukusebenza, okungabangelwa umsebenzi ophansi. Ama-platelet aphezulu asetshenziswa kuqala futhi adliwe yinqubo yokugaya igazi, futhi umsebenzi ohlobene wama-platelet ekujikelezeni kwegazi okuqoqiwe uphansi.

 

(4) I-FIB
Njengeprotheyini yokusabela kwesigaba esibucayi, iziguli ezine-COVID-19 zivame ukuba namazinga aphezulu e-FIB esigabeni esibucayi sokutheleleka, okungahlobene nje kuphela nobunzima bokuvuvukala, kodwa futhi ne-FIB ephakeme kakhulu ngokwayo futhi iyisici esiyingozi se-thrombosis, ngakho-ke ingasetshenziswa njenge-COVID-19 Enye yezinkomba zokuvimbela ukujiya kwegazi ezigulini. Kodwa-ke, lapho isiguli sinokwehla okuqhubekayo kwe-FIB, kungase kubonise ukuthi ukuphazamiseka kokujiya kwegazi sekuqhubekele esigabeni esingajiya igazi, noma isiguli sinokuhluleka okukhulu kwesibindi, okwenzeka kakhulu esigabeni sokugcina sesifo, lapho i-FIB <1.5 g/L futhi ihambisana nokopha, kufanele kucatshangelwe ukufakwa kwe-FIB.