Fibrinolysis? ??? FDP? D-dimer

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Fibrinolysis? ??? FDP? D-dimer
2004. 02. 04 ? ? ?
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Fibrinolysis? ??? FDP ? D-dimer

• Thrombin? ?? plasminogen? plasmin?? ????? ?
  plasmin? E domain ??? ??? ??? ??? ???? ???? X ,
  ??? Y, ??? ????? D2E ??? ????? ???? FDP?? ??. ??,
  D-dimer? ??? ??? ? plasmin? ???? ?? ???? ??? ???.

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lt??????gt
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??? ??? ?? ? ?? ?? ?? 1) Degradation of
fibrinogen and fibrin by plasmin
Formation of plasmin   
tissue plasminogen activator  
Plasminogen --------------gt Plasmin
??? ????? ????
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Fibrinogen Degradation Product FDP (???
????) ??? ??? ?????? ???? ??? ???? ???? ???
???? ???? ?? ???. ????? ????? ????? ??
????(fibrinogen)? ???(fibrin)? ?? ????? ???
??????(polymer)? ?? ??? ??? ??? ???. ???? ???
???????(plasmin)? ???????. ???????? ?? ???????
???? ???????(FDP)? ????. ???????? ????? ???? ??
?? ??? ?????? ???. .
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• 1.????
• Monoclonal anti-FDP? ??? latex ???
  ???? ??
• fibrin/fibrinogen degradation
  product(FDP)? ???? ?? ????
• ????? ???? ??? latex agglutination?
• 2. ?? ??
• ?? bottle
•         FDP tube (soybean trypsin inhibitor
  bovine thrombin ) 3
• 3. ??
• ? FDP ??, ???
• 4. ?? ???? ????
•         clot ? ??? ?? ???? hemolysis???
  ?? ??????.

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5. ?? ??-1

•  ????? FDP tube (soyabean trypsin inhibitor
  bovine
•       thrombin )? ??? 1???? ??? ??? ? ??

• ????? ???? 5,10,20,40,80,160?? ??
• ??? ????? ??? ???? ??? 100?? ??

????? ??? ???
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5. ?? ??-2
Latex 1??? ?????
2?? mix? ??????
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6. ?? ? ?? ?? ??? ??? ?? ?? ??? report ??. (
120?? ??? , 140?? ???? ) 7. ????? ??? ??
  ??? ??? ???, ????,???, ??? ?? ???,
?????,??,???? ? ?? ????? ? ??       8. ?????
??? ?? ? ?? ??     ?? ??? rheumatoid factor?
???? ??? ? ???? RF ???? RF? ????  ????.
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D-dimer test D-Dimer? ????? ?????? ?? ?? ???
???? ? ???? ?? ???? ???? ??? ????? ???? ?? ? ???
? ?? fibrin(oren) degradation products?? ?? ?? ??
??????? ??? ???? ??? ??? ???? ??. ???
D-Dimer? ??? ??? ??? ?? ?? ??? ????? ?? ??? ????
??? ???? (Pulmonary embolimPE)? ???? ??? (Deep
vein thromosisDVT), ?????(Myocardial
infractionMI) ??? ???? ???????? ???? ??? ???? ?
?? ???? ???? ??? ??? ??. ??? ??? ? ????? ?????
???? ??? ??? ???? ? ?? ??? ????? ???? ?? ??? ??.
?? ?? Nycocard D-Dimer test? ??? ??? ?? ????
D-Dimer? ??? ??? ? ??. 
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• ???? 0.1-20mg/L                Cut-off level
  0.3 mg/L                Positive control
  2mg/L ??- ?? ?? ?? (??)           - ?? ???
  ?? ??   - ? ? ?? ??           - ???
  calibration ??           - ?? ???? ????

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• 1. ?? ??
• Nycocard D-dimer? immunometric flowthrough ???
  ???? ??. plasma sample? card ??? 6?? hole? ???
  ????. sample? card?? ???? D-dimer????
  membrane? D-dimer specific monoclonal ??? ????.
  conjugate ??? ???D-dimer specific monoclonal ???
  membrane ?? D-dimer? antibody gold
  particle sandwich ??? ??? ????. ??? ??? ??? ????
  sample???? D-dimer? ??? ???? membrane
  color? ?? ? ??? ????. color? ??? reference color
  chart? ???? ????.
• 2. ????
• sod. citrate ??? APTT/PT ?? (??? 6???? ???? ?
  ??? 24???? ??!) ??? 2ml??? ??, ??? ??? ?????.
• 3. ??
• Test card, conjugate, washing solution,
  positive control

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4. ????-1
Test device? 50? ? platelet-free cirated  
plasma? ????.
50?? washing solution? Test device?  ????.
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4. ????-2
conjugate? 50? ????.
washing solution? 50? ????.
??? ????.
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Interpretation of result

• Interpretation of result
• NycoCard READER ?? Colour Reference Chart? ????
  ????.
• NycoCard READER? ???? 0.1 - 20.0 mg/L
• 2??? ???? ??

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• 5. D-dimer? ???? lt0.3?/L
• ( gt0.3?/L?? positive? ??)
• ????? ?????? Hb? ???? D-dimer? ?? ?? ??? ???
  ?? ????. sample? cell?? ???, ??? ??? ??? ????
  ?? sample ?? ??? flow rate? ???? ?? ?? ? ?
  ????. ??? sample?? ?? ? ????? ??? ????? ?????
  ??? ?? ??? ??? ???.
• 6. ??? ??
• DIC , ?? ???? ???, ???????, ????, ?????,
  ??? ??, ?, ??? ???, ?????, ???? ??.
• ??????? ?? ??? FDP? D-dimer? ?? ?? ??? ???? ???
  ???? ???, DIC(??? ??? ???) ?? ???? ???, ???????,
  ????, ?????, ??? ??, ?, ??? ???, ?? ???, ?????
  ???? ????? ???? ????? FDP? D-dimer? ???? ??, ???
  ????, ???? ???? ?? ??? ??? ????? screening ?? ???
  ???? ????.

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• ?? ??? ???????? ?? ??? ????? ??? ???
  ???(DIC, Disseminated intravascular coagulation)?
  ??? ? ????. ??? ????, ????, ??? ???? ?? ??? ????
  ??? ????? ??? ????. ?? ??????? ??? ?? ????? ?????
  FDP? ??? ??? ??? ??? ????? ?????? ??????.
• ??? ??? ???? ????? D-Dimer? ???? ???.
  D-Dimer? ????? ???? ???? ?? ??? ??????? ?????
  ?????. ????? ???? E??? ???? ???? D??? ????. ???
  ????? ?????? D???? ??? ???. ???????? D? D? ???
  ??? ? ?? ??? ????. ???? DD ??? ???? ??????? ???
  ?????? ??? ? ? ????.

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???? ????
???
???
Plasmin
Plasmin
Plasmin
Plasmin
D
D
E
D
D
D
E
D
D
D
E
D
D
E
D
D
Plasmin
Plasmin
D
D
D
E
D
D
D
D
E
D
E
D
D
E
D
D
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• Disseminated Intravascular Coagulation DIC
• ????? ????? ?????? ??? ?? ????. ????? ??? ?????
  ???? ????? ???? ?? ???? ????? ?? ??? ???? ???
  ????? ??? ????? ?????? ??.
• DIC? ??? ????? ???? ???? clqackr?? ??? ??? ???
  ??? ??? ??? ????? ???? ???? ???? ?????? ???. ??
  ??????? ???? ??? ??? ? ????? ??? ?? ??? ????.
  ??? ???? ? ? ??? ??? ????(FDP)? ??? ??? ??? ???
  ????? ???? ???? ????? ??? DIC??? ??? ???.
• DIC? ???? ???? ??? ??? ????? ??? ?? ??? ?? ????
  ???? ????? ? ?????. ?? ??, ???, ? , ?????? , ????
  ???, ????? ?? ??? ? ????. ??? ???? ??? ??????
  X???? ???? ???? DIC? ???? ??. ????
• DIC? ???? ????? ???? ??, ????? ?? ????, ??? ?? ,
  ??? ?? ??? ??? ????. ?????? ???, ????, ?????
  ????? ?????? ?? ??? ????? ??, ???? ?????? ????
  ????, ??? ???, ??, ?? ??? ?? ??? ????? ????.
• ?? ?? ??? ??? ??? ???? , ??? ????. ?????? ?????
  ???? ???? ????? ??? ??, ??? ???? ?? ?? ????.
• ??? ???? ? ????? ???. ????? ???? PT? PTT? ????
  ??????? ???? ??? ????(fibrin degradation
  produce)? ????.
• protamine sulgate??? ?? ??? ??? ???? ????
  ?,?.???? ??? ???.