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Д-димер - Ревматологія - Форум лікарів
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Д-димер

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ММ77
Повідомлень: 21
З нами з: 08 червня 2018, 20:59
Спеціальність: терапія
Звідки: Черк.обл.
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Д-димер

Повідомлення#1 » 29 вересня 2019, 12:53

На прийомі жінка 34 роки з СЧВ, хронічний перебіг, з ураженням шкіри (еритема), суглобів (поліартралгія), легень (бронхообструктивний синдром по початку хвороби), ЦНС (енцефалопатія 1 ст), ПНР (вегетативно-сенсорна полінейропатія н.к.) . акт.2. С-м Шегрена. Хворіє 14 років. Приймає підтримуючу дозу метипреда 4 мг., НПЗЗ- при артралгіях, плаквеніл 2 т. Здавала контрольні аналізи- ЗАК-ШОЕ-35, лейк.-8,1, тромб-306, Нв-110.ЛЕ-клітин немає. СРБ високий, високий РФ. Д-димер-1880 (норма до 300). В анамнезі тромбозів немає, варикозу немає, Ф-графія грудної клітки норма, обструкції в даний час немає, препарати не приймає (був серетид- відмінений рік тому), ЕКГ-варіант норми. Скарги зараз тільки на артралгії і сухість в носі.

Про що може говорити такий рівень Д-димера, чи потрібно дообстеження?

Що призначити, якщо врахувати, що ревматологом може бути оглянута тільки через два тижні?

Darmidon
Повідомлень: 1055
З нами з: 19 березня 2015, 19:29
Спеціальність: хipургiя
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Місце роботи: ЛПЗ
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Re: Д-димер

Повідомлення#2 » 29 вересня 2019, 18:48


Аватар користувача
Вадим Олексійович
Повідомлень: 131
З нами з: 04 березня 2015, 14:33
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Re: Д-димер

Повідомлення#3 » 01 жовтня 2019, 21:33

+1, при підвищеному РФ результати Д-димера неінформативні

Аватар користувача
Наталія
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З нами з: 21 лютого 2015, 09:57
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Re: Д-димер

Повідомлення#4 » 21 листопада 2019, 12:47

Д-димер колеги це продукт "напіврозпаду" фібрину. Так що при системних захворюваннях сполучної тканини він завжди збільшений. Ревматоїдний фактор зазвичай вказує на подібні процеси. Забір д-димеру виправданий при наявності симптоматики, відсутності або незначному підвищенні ЦРБ, РФ.
Удачі.

Суховій
Повідомлень: 98
З нами з: 08 березня 2015, 22:09
Спеціальність: гінекологія
Звідки: Україна
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Re: Д-димер

Повідомлення#5 » 05 грудня 2019, 20:11

А що на рахунок вагітності? жінка ще молода. а рівень Д-димера повинен вирости в 3-4 рази. Зробіть тести на вагітність. Виключіть цукровий діабет і захворювання нирок.

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