Kungani amashubhu e-serum angasetshenziswa ukuthola okuqukethwe yi-D-dimer? Kuzoba nokwakheka kwe-fibrin clot eshubhuni le-serum, ngeke yini yonakale ibe yi-D-dimer? Uma ingawohloki, kungani kukhona ukwanda okukhulu kwe-D-dimer lapho kwakheka amahlule egazi eshubhuni elilwa nokuqina kwamahlule ngenxa yokuthatha amasampula egazi angemahle ukuze kuhlolwe ukuqina kwamahlule?
Okokuqala, ukuqoqwa kwegazi okungekuhle kungaholela ekulimaleni kwemithambo yegazi, kanye nokukhululwa kwe-subendothelial tissue factor kanye ne-tissue-type plasminogen activator (tPA) egazini. Ngakolunye uhlangothi, i-tissue factor isebenzisa indlela yokujiya kwangaphandle ukuze ikhiqize ama-fibrin clots. Le nqubo ishesha kakhulu. Bheka nje isikhathi se-prothrombin (PT) ukuze wazi, ngokuvamile esingaba yimizuzwana eyi-10. Ngakolunye uhlangothi, ngemva kokwakheka kwe-fibrin, isebenza njenge-cofactor yokwandisa umsebenzi we-tPA ngezikhathi eziyi-100, futhi ngemva kokuba i-tPA inamathele ebusweni be-fibrin, ngeke isavinjelwa kalula yi-plasminogen activation inhibitor-1 (PAI-1). Ngakho-ke, i-plasminogen ingaguqulwa ngokushesha nangokuqhubekayo ibe yi-plasmin, bese i-fibrin yonakaliswa, futhi inani elikhulu le-FDP kanye ne-D-Dimer lingakhiqizwa. Lesi yisizathu esenza ukwakheka kwama-blood clot in vitro kanye nemikhiqizo yokuwohloka kwe-fibrin kwande kakhulu ngenxa yokusampula igazi okungekuhle.
Pho-ke, kungani ukuqoqwa okuvamile kwe-serum tube (ngaphandle kwezithasiselo noma nge-coagulant) amasampula nawo adala ama-fibrin clots in vitro, kodwa azange anciphe ukuze kukhiqizwe inani elikhulu le-FDP kanye ne-D-dimer? Lokhu kuncike ku-serum tube. Kwenzekani ngemva kokuba i-specimen iqoqwe: Okokuqala, akukho inani elikhulu le-tPA elingena egazini; okwesibili, noma ngabe inani elincane le-tPA lingena egazini, i-tPA yamahhala izoboshwa yi-PAI-1 futhi ilahlekelwe umsebenzi wayo cishe ngemizuzu emi-5 ngaphambi kokuba inamathele ku-fibrin. Ngalesi sikhathi, ngokuvamile akukho ukwakheka kwe-fibrin ku-serum tube ngaphandle kwezithasiselo noma nge-coagulant. Kuthatha imizuzu engaphezu kweyishumi ukuthi igazi elingenazo izithasiselo lijike ngokwemvelo, kuyilapho igazi eline-coagulant (ngokuvamile i-silicon powder) liqala ngaphakathi. Kuthatha futhi imizuzu engaphezu kwemi-5 ukwakha i-fibrin kusuka endleleni yokujiya kwegazi. Ngaphezu kwalokho, umsebenzi we-fibrinolytic ekushiseni kwegumbi in vitro nawo uzothinteka.
Ake sixoxe nge-thromboelastogram futhi ngalesi sihloko: ungaqonda ukuthi i-clot yegazi eshubhu le-serum ayonakaliswa kalula, futhi ungaqonda ukuthi kungani ukuhlolwa kwe-thromboelastogram (TEG) kungazweli ekuboniseni i-hyperfibrinolysis - zombili izimo. Kuyafana, vele, izinga lokushisa ngesikhathi sokuhlolwa kwe-TEG lingagcinwa kuma-degrees angu-37. Uma i-TEG izwela kakhulu ekuboniseni isimo se-fibrinolysis, enye indlela iwukufaka i-tPA ekuhlolweni kwe-in vitro TEG, kodwa kusenezinkinga zokulinganisa futhi akukho ukusetshenziswa okujwayelekile; ngaphezu kwalokho, kungalinganiswa eceleni kombhede ngokushesha ngemva kokuthatha isampula, kodwa umphumela wangempela nawo ulinganiselwe kakhulu. Ukuhlolwa kwendabuko nokuphumelela kakhulu kokuhlola umsebenzi we-fibrinolytic isikhathi sokuncibilika kwe-euglobulin. Isizathu sokuzwela kwayo siphakeme kunese-TEG. Ekuhlolweni, i-anti-plasmin isuswa ngokulungisa inani le-pH kanye ne-centrifugation, kodwa ukuhlolwa kudla Kuthatha isikhathi eside futhi kuqinile, futhi akuvamile ukwenziwa ezindaweni zokucwaninga.
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