Ngaphansi kwezimo zomzimba, izinhlelo ezimbili zokubopha igazi kanye nokuvimbela ukujiya kwegazi emzimbeni zigcina ibhalansi eguquguqukayo ukuze igazi ligeleze emithanjeni yegazi. Uma ibhalansi ingalingani, uhlelo lokuvimbela ukujiya kwegazi luvame kakhulu futhi ukuthambekela kokopha kuvame ukwenzeka, kanti uhlelo lokubopha igazi luvame kakhulu futhi i-thrombosis ivame ukwenzeka. Uhlelo lwe-fibrinolysis ludlala indima ebalulekile ekujiya kwegazi. Namuhla sizokhuluma ngezinye izinkomba ezimbili zohlelo lwe-fibrinolysis, i-D-dimer kanye ne-FDP, ukuze siqonde ngokugcwele i-hemostasis ekhiqizwa yi-thrombin kuya ku-thrombus eqalwa yi-fibrinolysis. Ukuziphendukela kwemvelo. Nikeza ulwazi oluyisisekelo lwezokwelapha mayelana nomsebenzi we-thrombosis kanye ne-coagulation weziguli.
I-D-dimer umkhiqizo othize wokubola okhiqizwa yi-fibrin monomer exhunywe nge-cross-linked yi-activated factor XIII bese i-hydrolyzed yi-plasmin. I-D-dimer isuselwa ku-cross-linked fibrin clot encibilikiswe yi-plasmin. I-D-dimer ephakanyisiwe ikhombisa ukuba khona kwe-secondary hyperfibrinolysis (njenge-DIC). I-FDP yigama elijwayelekile lemikhiqizo yokubola ekhiqizwa ngemuva kokuba i-fibrin noma i-fibrinogen ihlukaniswe ngaphansi kwesenzo se-plasmin ekhiqizwa ngesikhathi se-hyperfibrinolysis. I-FDP ifaka phakathi i-fibrinogen (Fg) kanye nemikhiqizo ye-fibrin monomer (FM) (FgDPs), kanye nemikhiqizo yokubola ye-cross-linked fibrin (FbDPs), phakathi kwayo ama-FbDP afaka phakathi ama-D-dimers nezinye izingcezu, futhi amazinga awo ayanda. Okuphezulu kubonisa ukuthi umsebenzi we-fibrinolytic womzimba usebenza ngokweqile (i-primary fibrinolysis noma i-secondary fibrinolysis)
【Isibonelo】
Indoda eneminyaka ephakathi nendawo ingeniswe esibhedlela futhi imiphumela yokuhlolwa kwegazi yayimi kanje:
| Into | Umphumela | Ibanga Lokubhekisela |
| PT | 13.2 | Amasekhondi angu-10-14 |
| I-APTT | 28.7 | Amasekhondi angu-22-32 |
| TT | 15.4 | Amasekhondi angu-14-21 |
| I-FIB | 3.2 | 1.8-3.5g/l |
| DD | 40.82 | 0-0.55mg/I FEU |
| I-FDP | 3.8 | 0-5mg/l |
| I-AT-III | 112 | 75-125% |
Izinto ezine zokujiya zonke bezine-negative, i-D-dimer yayine-positive, kanti i-FDP yayine-negative, kanti imiphumela yayiphikisana. Ekuqaleni kwakusolwa ukuthi i-hook effect, isampula yahlolwa kabusha ngokuhlolwa kokuqala kwe-multiple kanye ne-1:10 dilution, umphumela wawunjengokulandelayo:
| Into | Okwangempela | 1:10 ukuncibilikisa | Ibanga Lokubhekisela |
| DD | 38.45 | 11.12 | 0-0.55mg/I FEU |
| I-FDP | 3.4 | Ngaphansi komkhawulo ophansi | 0-5mg/l |
Kungabonakala ekuncibilikisweni ukuthi umphumela we-FDP kufanele ube ojwayelekile, kanti i-D-dimer ayiqondile ngemva kokunciphisa, futhi kusolwa ukuphazamiseka. Khipha i-hemolysis, i-lipemia, kanye ne-jaundice esimweni sesampula. Ngenxa yemiphumela engalingani yokunciphisa, amacala anjalo angase avele ekuphazamisekeni okuvamile kwama-antibodies e-heterophilic noma izici ze-rheumatoid. Hlola umlando wezokwelapha wesiguli bese uthola umlando we-rheumatoid arthritis. Ilebhu Umphumela wokuhlolwa kwe-RF factor wawuphezulu kakhulu. Ngemva kokuxhumana nomtholampilo, isiguli saphawulwa futhi sakhishwa umbiko. Ekulandeleni kamuva, isiguli sasingenazo izimpawu ezihlobene ne-thrombus futhi sahlulelwa njengecala elingelona iqiniso le-D-dimer.
【Fingqa】
I-D-dimer iyinkomba ebalulekile yokukhishwa okungekuhle kwe-thrombosis. Inozwela oluphezulu, kodwa ukucaciswa okuhambisanayo kuzoba buthakathaka. Kukhona futhi nengxenye ethile yemiphumela engamanga. Ukuhlanganiswa kwe-D-dimer ne-FDP kunganciphisa ingxenye ye-D- Ngemiphumela engamanga ye-dimer, lapho umphumela webhulebhu ubonisa ukuthi i-D-dimer ≥ FDP, izinqumo ezilandelayo zingenziwa ngomphumela wokuhlolwa:
1. Uma amanani ephansi (
2. Uma umphumela uyinani eliphezulu (>Inani elinqunyiwe), hlaziya izici ezithonyayo, kungase kube nezici zokuphazamiseka. Kunconywa ukwenza ukuhlolwa okuningi kokuxuba. Uma umphumela ungowomugqa, kungenzeka kakhulu ukuthi kube nokuhle kweqiniso. Uma ungewona oqondile, kube nokuhle kweqiniso. Ungasebenzisa futhi i-reagent yesibili ukuqinisekisa futhi uxhumane nomtholampilo ngesikhathi.
Ikhadi lebhizinisi
I-WeChat yesiShayina