D-dimer ve tanısal önemi
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Date
2013-10-22
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Uludağ Üniversitesi
Abstract
D-dimer çapraz bağlı fibrinin en küçük yıkım ürünüdür. Koagulasyon ve fibrinolizin global bir aktivasyonunu yansıtır ve bu nedenle trombo tik aktivitenin indirekt bir belirtecidir. D-dimer; venöz tromboembolizm (VTE) tanısı, ilk trombotik olay (arteryal ve venöz) ve tekrarlayan VTE riski artmış bireylerin tesbiti, gebelik ve yaygın damar içi pıhtılaşma (DIC) takibi gibi bir dizi trombozla ilişkili klinik tablonun tanı ve takibinde en değerli laboratuvar testi olarak kabul edilebilir. D-dimer ölçümünün klinik yararı üzerine kurulmuş senaryoların en önemlisi, VTE dışlanmasıdır. Derin ven trombozu (DVT) ve pulmoner embolizm (PE) geleneksel olarak VTE şeklinde ifade edilen benzer klinik tablolardır. Gecikmiş veya yanlış tanılar, ölüm veya uzun dönem komplikasyonlarla sonuçlanabileceği için zamanında ve doğru tanı önemli dir. Bu nedenle, DVT veya PE şüphesi olan hastalar klinik olasılık ön testleri, D-dimer testi ve görüntülemeyi içeren bir tanısal strateji ile değerlendirilmelidir.
D-dimer is the smallest degradation product of cross-linked fibrin. It reflects a global activation of blood coagulation and fibrinolysis and, therefore, an indirect marker of thrombotic activity. D-dimer can be regarded as a most valuable laboratory tool to diagnose and manage a vast array of thrombosis-related clinical conditions, including; diagnosis of venous thromboembolism (VTE), identification of individuals at increased risk of first thrombotic event (both arterial and venous), identification of individuals at increased risk of recurrent VTE, pregnancy monitoring, and diagnosis/monitoring of disseminated intravascular coagulation. The clinical utility of D-dimer measurement has been established in some scenarios, most notably for the exclusion of VTE. Deep venous thrombosis (DVT) and pulmonary embolism (PE) repre sent two expressions of a similar clinical pathological process traditionally referred to as venous thromboembolism. Timely and accurate diagnosis of both is essential as delayed or missed diagnoses can result in death or longer term complications. Therefore, patients with sus pected DVT or PE should be managed with a diagnostic strategy that includes clinical pretest probability assessment, D-dimer test, and imaging.
D-dimer is the smallest degradation product of cross-linked fibrin. It reflects a global activation of blood coagulation and fibrinolysis and, therefore, an indirect marker of thrombotic activity. D-dimer can be regarded as a most valuable laboratory tool to diagnose and manage a vast array of thrombosis-related clinical conditions, including; diagnosis of venous thromboembolism (VTE), identification of individuals at increased risk of first thrombotic event (both arterial and venous), identification of individuals at increased risk of recurrent VTE, pregnancy monitoring, and diagnosis/monitoring of disseminated intravascular coagulation. The clinical utility of D-dimer measurement has been established in some scenarios, most notably for the exclusion of VTE. Deep venous thrombosis (DVT) and pulmonary embolism (PE) repre sent two expressions of a similar clinical pathological process traditionally referred to as venous thromboembolism. Timely and accurate diagnosis of both is essential as delayed or missed diagnoses can result in death or longer term complications. Therefore, patients with sus pected DVT or PE should be managed with a diagnostic strategy that includes clinical pretest probability assessment, D-dimer test, and imaging.
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Keywords
D-dimer, Venöz tromboembolizm, Fibrin yıkım ürünü, Fibrin degradation product, Venous thromboembolism
Citation
Karagöz, İ. S. ve Serdar, Z. (2013). "D-dimer ve tanısal önemi". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 39(3), 197-203.