{"id":27427,"date":"2025-06-24T16:00:22","date_gmt":"2025-06-24T13:00:22","guid":{"rendered":"https:\/\/www.clinica-sante.com\/ro\/analize-fara-categorie\/d-dimeri\/"},"modified":"2026-01-05T19:12:49","modified_gmt":"2026-01-05T17:12:49","slug":"d-dimeri","status":"publish","type":"product","link":"https:\/\/www.clinica-sante.com\/ro\/analize-coagulare-si-hemostaza\/d-dimeri\/","title":{"rendered":"D-Dimeri"},"content":{"rendered":"<p><strong>1. Descriere general\u0103<\/strong><\/p>\n<p>D-dimerii sunt fragmente proteice eliberate \u00een s\u00e2nge \u00een timpul procesului de degradare a fibrinei, componenta principal\u0103 a cheagurilor de s\u00e2nge formate \u00een cursul coagul\u0103rii. Ace\u0219ti markeri apar atunci c\u00e2nd organismul descompune cheagurile de fibrin\u0103 printr-un mecanism natural numit fibrinoliz\u0103.<\/p>\n<\/p>\n<p>\u00cen mod normal, D-dimerii se reg\u0103sesc \u00een concentra\u021bii foarte sc\u0103zute sau nedetectabile \u00een circula\u021bie. Prezen\u021ba lor \u00een cantit\u0103\u021bi crescute indic\u0103 faptul c\u0103 \u00een organism s-au format \u0219i s-au degradat recent cheaguri de s\u00e2nge. Totu\u0219i, acest marker nu este specific \u2013 valorile crescute pot ap\u0103rea \u0219i \u00een afec\u021biuni non-trombotice precum infec\u021bii severe, interven\u021bii chirurgicale, sarcin\u0103 sau boli maligne.<\/p>\n<p>Testul D-dimerilor este utilizat frecvent pentru excluderea unor afec\u021biuni trombotice acute, cum ar fi tromboza venoas\u0103 profund\u0103 (TVP) \u0219i embolia pulmonar\u0103 (EP), \u00een special la pacien\u021bii cu risc clinic sc\u0103zut sau intermediar, stabilit prin scoruri de evaluare clinic\u0103 precum scorul Wells.<\/p>\n<\/p>\n<p><strong>2. Indica\u021bii testare<\/strong><\/p>\n<ul>\n<li>Suspectarea trombozei venoase profunde (TVP) \u2013 durere, edem, c\u0103ldur\u0103 local\u0103 \u0219i ro\u0219ea\u021b\u0103 la nivelul unui membru inferior;<\/li>\n<li>Suspectarea emboliei pulmonare (EP) \u2013 dispnee brusc\u0103, durere toracic\u0103, tuse, hemoptizie, tahicardie;<\/li>\n<li>Evaluarea \u0219i monitorizarea coagul\u0103rii intravasculare diseminate (CID);<\/li>\n<li>Evaluarea pacien\u021bilor cu risc trombotic crescut: neoplazii, afec\u021biuni cardiovasculare sau boli inflamatorii cronice;<\/li>\n<li>Sarcin\u0103 \u0219i perioada postpartum, \u00een special la pacientele cu factori de risc trombotic;<\/li>\n<li>Monitorizarea pacien\u021bilor cu COVID-19, \u00een scop prognostic \u0219i terapeutic;<\/li>\n<li>Evaluarea simptomelor sugestive pentru tromboembolism la pacien\u021bi cu factori de risc: durere toracic\u0103, dispnee, edem asimetric la membrele inferioare, ame\u021beli, episoade sincopale.<\/li>\n<\/ul>\n<p><strong>3. Preg\u0103tire pacient<\/strong><\/p>\n<ul>\n<li>Nu este necesar\u0103 o preg\u0103tire special\u0103 \u00eenaintea test\u0103rii.<\/li>\n<li>Recoltarea se face prin punc\u021bie venoas\u0103, preferabil diminea\u021ba. Este ideal ca testarea s\u0103 se efectueze \u00eenainte de ini\u021bierea tratamentului anticoagulant, deoarece acesta poate influen\u021ba valorile D-dimerilor.<\/li>\n<\/ul>\n<p><strong>4. Tipul probei recoltate:<\/strong> s\u00e2nge venos<\/p>\n<\/p>\n<p><strong>5. Valori de referin\u021b\u0103<\/strong><\/p>\n<ul>\n<li>&lt; 0,5 \u00b5g\/mL FEU (unit\u0103\u021bi echivalente de fibrinogen)<\/li>\n<li>La v\u00e2rstnici sau \u00een sarcin\u0103, valorile pot fi u\u0219or crescute \u00een mod fiziologic.<\/li>\n<\/ul>\n<p><strong>6. Interpretare rezultate<\/strong><\/p>\n<ul>\n<li><strong>Valori crescute<\/strong><\/li>\n<li>Pot fi asociate cu:\n<ul>\n<li>Tromboz\u0103 venoas\u0103 profund\u0103 (TVP)<\/li>\n<li>Embolie pulmonar\u0103 (EP)<\/li>\n<li>Coagulare intravascular\u0103 diseminat\u0103 (CID)<\/li>\n<li>Infec\u021bii severe, sepsis<\/li>\n<li>Neoplazii<\/li>\n<li>Boli hepatice avansate<\/li>\n<li>Interven\u021bii chirurgicale recente, traumatisme<\/li>\n<li>Sarcin\u0103 (\u00een special \u00een trimestrul III)<\/li>\n<li>Boli inflamatorii cronice (ex. poliartrit\u0103 reumatoid\u0103)<\/li>\n<li>COVID-19 cu afectare sistemic\u0103 sau pulmonar\u0103 sever\u0103<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Un rezultat cu o valoare crescut\u0103 NU confirm\u0103 diagnosticul de tromboz\u0103. Este necesar\u0103 completarea investiga\u021biei cu metode imagistice (ecografie Doppler, angio-CT pulmonar, RMN venos etc.), \u00een func\u021bie de contextul clinic.<\/p>\n<\/p>\n<ul>\n<li><strong> Valori normale:<\/strong>\n<ul>\n<li>Exclud cu o probabilitate mare (85\u201395%) existen\u021ba unei tromboze acute la pacien\u021bii cu risc clinic sc\u0103zut sau intermediar<\/li>\n<li>Pot fi utilizate pentru evitarea expunerii nejustificate la iradiere sau investiga\u021bii imagistice invazive.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>7. Factori care pot influen\u021ba rezultatul<\/strong><\/p>\n<ul>\n<li><strong>Fiziologici<\/strong>: v\u00e2rsta avansat\u0103, sarcina, na\u0219terea recent\u0103, efort fizic intens<\/li>\n<li><strong>Patologici<\/strong>: boli inflamatorii, infec\u021bii acute, boli hepatice, cancer<\/li>\n<li><strong>Medicamente<\/strong>: tratamente anticoagulante (pot sc\u0103dea valorile), estrogeni, contraceptive orale<\/li>\n<\/ul>\n<ul>\n<li>\u00a0<strong>Interferen\u021be de laborator<\/strong>:\n<ul>\n<li>Prezen\u021ba factorului reumatoid \u2013 risc de rezultate fals pozitive<\/li>\n<li>Fibrinogen &gt; 900 mg\/dL \u2013 poate duce la supraestimarea valorii<\/li>\n<li>Hemoliza probei sau recoltarea incorect\u0103 \u2013 poate altera rezultatele<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>8. Analize complementare<\/strong><\/p>\n<ul>\n<li>Coagulograma\t\t<\/li>\n<li>Fibrinogen<\/li>\n<li>APTT\t<\/li>\n<li>Timp Quick, Activitatea de protrombina, INR<\/li>\n<li>Anticoagulant lupic<\/li>\n<li>Timp de trombina (TT)<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>D-dimerii sunt fragmente proteice eliberate \u00een s\u00e2nge \u00een cursul degrad\u0103rii fibrinei, o component\u0103 a cheagurilor de s\u00e2nge. Nivelurile crescute pot sugera tromboz\u0103 venoas\u0103 profund\u0103, embolie pulmonar\u0103 sau alte afec\u021biuni trombotice. Un rezultat negativ are valoare de excludere a trombozei.<\/p>\n","protected":false},"featured_media":0,"template":"","meta":{"_acf_changed":false,"inline_featured_image":false},"product_brand":[],"product_cat":[1209,3171,2876],"product_tag":[3273,3271,3270,3269,3272,3267,3268],"class_list":{"0":"post-27427","1":"product","2":"type-product","3":"status-publish","5":"product_cat-analize","6":"product_cat-coagulare-si-hemostaza","7":"product_cat-serviciu-laborator","8":"product_tag-cid","9":"product_tag-coagulare","10":"product_tag-embolie-pulmonara","11":"product_tag-ep","12":"product_tag-fibrina","13":"product_tag-tromboza","14":"product_tag-tvp","15":"pa_conditii-medicale-afecti-boala-vasculara-periferica-venoasa-arteriala","16":"pa_conditii-medicale-afecti-insuficienta-hepatica-ciroza-hepatica","17":"pa_conditii-medicale-afecti-tulburari-de-coagulare-trombofilie-hemofilie","18":"pa_parti-ale-corpului-organ-ficat-si-colecist","19":"pa_parti-ale-corpului-siste-sistem-digestiv","21":"first","22":"instock","23":"sale","24":"virtual","25":"purchasable","26":"product-type-simple"},"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.clinica-sante.com\/ro\/wp-json\/wp\/v2\/product\/27427","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.clinica-sante.com\/ro\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/www.clinica-sante.com\/ro\/wp-json\/wp\/v2\/types\/product"}],"wp:attachment":[{"href":"https:\/\/www.clinica-sante.com\/ro\/wp-json\/wp\/v2\/media?parent=27427"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/www.clinica-sante.com\/ro\/wp-json\/wp\/v2\/product_brand?post=27427"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/www.clinica-sante.com\/ro\/wp-json\/wp\/v2\/product_cat?post=27427"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/www.clinica-sante.com\/ro\/wp-json\/wp\/v2\/product_tag?post=27427"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}