{"id":10007,"date":"2020-04-23T03:53:47","date_gmt":"2020-04-23T01:53:47","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/factor-x\/"},"modified":"2025-07-11T14:23:41","modified_gmt":"2025-07-11T11:23:41","slug":"factorul-x-al-coagularii","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/factorul-x-al-coagularii\/","title":{"rendered":"\u0424\u0430\u043a\u0442\u043e\u0440 \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u043d\u0438\u044f \u043a\u0440\u043e\u0432\u0438 X"},"content":{"rendered":"

\u041e\u0431\u0449\u0430\u044f \u0438\u043d\u0444\u043e\u0440\u043c\u0430\u0446\u0438\u044f <\/em><\/strong><\/span><\/p>\n

Factorul X sau factorul Stuart-Prower<\/strong> este o glicoprotein\u0103\u00a0care se sintetizeaz\u0103 la nivelul hepatocitului\u00a0\u00een prezen\u0163a vitaminei K6<\/sup>.<\/span><\/p>\n

Conform modelului actual al coagul\u0103rii,\u00a0\u00een prim\u0103 etap\u0103 (de ini\u0163iere) factorul X este activat de c\u0103tre complexul FVIIa-factor tisular. Factorul Xa se leag\u0103 de membrana trombocitelor \u015fi cliveaz\u0103 protrombina\u00a0\u00een trombin\u0103. Cantitatea redus\u0103 de trombin\u0103 generat\u0103 \u00een aceast\u0103 etap\u0103 activeaz\u0103 o serie de factori ce de\u0163in un rol critic\u00a0\u00een etapa a doua. In cea de-a doua faz\u0103 a coagul\u0103rii, factorul Xa interac\u0163ioneaz\u0103 cu cofactorul s\u0103u FVa\u00a0\u00een prezen\u0163a ionilor de calciu, alc\u0103tuind complexul protrombinazei.\u00a0Acest complex este mult mai activ dec\u00e2t factorul Xa izolat\u00a0\u00een catalizarea conversiei protrombinei\u00a0\u00een trombin\u0103. Astfel, 96% din cantitatea total\u0103 de trombin\u0103 este produs\u0103 \u00een aceast\u0103 faz\u01032<\/sup>.<\/span><\/p>\n

Deficitul Stuart-Prower este o afec\u0163iune hemoragic\u0103 congenital\u0103 sau dob\u00e2ndit\u0103 cu frecven\u0163\u0103 foarte redus\u0103 \u00een popula\u0163ie. Mecanismul de transmitere a defectului genetic \u00een sinteza FX este autozomal recesiv. Ambele sexe sunt afectate \u00een mod egal.<\/span><\/p>\n

Homozigo\u0163ii prezint\u0103 tabloul clinic complet al bolii, iar heterozigo\u0163ii pot fi asimptomatici (deficien\u0163a este exprimat\u0103 numai biologic), sau prezint\u0103 semne clinice u\u015foare8<\/sup>. Tratamentul manifest\u0103rilor hemoragice severe (care apar\u00a0\u00een cazul unei activit\u0103\u0163i a factorului X <1%) const\u0103 \u00een administrarea de plasm\u0103 \u015fi complex protrombinic activat3;4;9<\/sup>.<\/span><\/p>\n

Deficitul dob\u00e2ndit de FX apare \u00een urm\u0103toarele condi\u0163ii clinice:<\/span><\/p>\n

\u2013\u00a0\u00a0terapia cu anticoagulante orale, boli hemoragice ale nou-n\u0103scutului, ictere obstructive, terapie cu antibiotice, \u00een asociere cu deficitul de factor II, V \u015fi IX<\/span><\/div>\n
\u2013\u00a0 afec\u0163iuni hepatice (ciroz\u0103, hepatite), fibrinoliz\u0103, coagulare intravascular\u0103 diseminat\u0103,\u00a0\u00een asociere cu deficitul de factor II, V \u015fi VII7<\/sup><\/span><\/div>\n
\u2013\u00a0 amiloidoza9<\/sup><\/span><\/div>\n

In cazul deficitului de factor X testele de hemostaz\u0103 prezint\u0103 urm\u0103toarele modific\u0103ri: timpul de tromboplastin\u0103 par\u0163ial\u0103 activat (APTT) \u015fi timpul Quick sunt alungite,\u00a0\u00een timp ce timpul de trombin\u0103 este normal1;4<\/sup>.<\/span><\/p>\n

Recomand\u0103ri privind efectuarea testului<\/em><\/strong> \u2013 manifest\u0103ri hemoragice cu debut precoce, la na\u015ftere (hemoragie ombilical\u0103) sau\u00a0\u00een cursul primului an de via\u0163\u0103; gama manifest\u0103rilor hemoragice este aproape identic\u0103 cu cea \u00eent\u00e2lnit\u0103 la pacien\u0163ii cu deficit de FVII (particularitatea deficitului Stuart-Prower const\u0103 \u00een frecven\u0163a net mai mare a hemartrozelor \u015fi declan\u015farea strict provocat\u0103 a hemoragiilor); prelungirea timpului Quick f\u0103r\u0103 o motiva\u0163ie\u00a0terapeutic\u0103 sau clinic\u01038<\/sup>.<\/span><\/p>\n

Preg\u0103tire pacient<\/em><\/strong> - <\/em>\u00e0 jeun (pe nem\u00e2ncate)5<\/sup>.<\/span><\/p>\n

Specimen <\/em><\/strong>recoltat<\/em><\/strong> - <\/em>\u0432\u0435\u043d\u043e\u0437\u043d\u0430\u044f \u043a\u0440\u043e\u0432\u044c5<\/sup>.<\/span><\/p>\n

Recipient de recoltare<\/em><\/strong> \u2013 vacutainer cu citrat de Na 0.105M (raport citrat de sodiu \u2013 sange=1\/9). Presiunea realizat\u0103 de garou trebuie s\u0103 fie \u00eentre valoarea presiunii sistolice \u015fi cea a presiunii diastolice \u015fi nu trebuie s\u0103 dep\u0103\u015feasc\u0103 1 minut. Dac\u0103 punc\u0163ia venoas\u0103 a e\u015fuat, o nou\u0103 tentativ\u0103 pe aceea\u015fi ven\u0103 nu se poate face dec\u00e2t dup\u0103 10 minute5<\/sup>.<\/span><\/p>\n

Cantitate recoltata<\/em><\/strong> \u2013 c\u00e2t permite vacuumul; pentru a preveni coagularea par\u0163ial\u0103 a probei se va asigura amestecul corect al s\u00e2ngelui cu anticoagulantul, prin mi\u015fc\u0103ri de inversiune a tubului5<\/sup>.<\/span><\/p>\n

Prelucrare necesar\u0103 dup\u0103 recoltare <\/em><\/strong>\u2013 proba va fi centrifugat\u0103 15 minute la 2500g, urmat\u0103 imediat de separarea plasmei \u015fi congelarea acesteia; probele recoltate\u00a0\u00een afara laboratorului vor fi transportate\u00a0\u00een recipientul destinat probelor congelate5<\/sup>.<\/span><\/p>\n

Cauze de respingere a probei<\/em><\/strong> - <\/em>vacutainer care nu este plin; proba de s\u00e2nge hemolizat\u0103 sau coagulat\u0103; plasma care nu a ajuns congelat\u0103 la laborator5<\/sup>.<\/span><\/p>\n

Stabilitate prob\u0103<\/em><\/strong> \u2013 plasma separat\u0103 este stabil\u0103 4 ore<\/em> la temperatura camerei; 3 s\u0103pt\u0103m\u00e2ni<\/em> la\u00a0 \u2013 20\u00baC; > 1 an<\/em> la \u2013 70\u00baC5<\/sup>.<\/span><\/p>\n

Metoda <\/strong>- coagulometric\u0103<\/span> (const\u0103 \u00een m\u0103surarea timpului de coagulare a probei de investigat\u00a0\u00een prezen\u0163a tromboplastinei \u015fi a unei plasme care con\u0163ine\u00a0\u00een exces to\u0163i factorii plasmatici ai coagul\u0103rii cu excep\u0163ia factorului X)4<\/sup>.<\/span><\/p>\n

Valori de referin\u0163\u0103 <\/em><\/strong>\u2013 75- 130%5<\/sup>.<\/span><\/p>\n

\u00a0<\/span><\/p>\n

\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<\/span><\/strong><\/p>\n

1. Daniela Badea. Veronica Sfredel. Homeostazia s\u00e2ngelui. Editura Medical\u0103 Universitar\u0103 Craiova Ed. 2003, 217-233.<\/span><\/div>\n
2. Denise O\u2019 Shaughnessy, Michael Makris, David Lilicrap. Basic principles underlying coagulation system. In Practical hemostasis and Thrombosis, Balckwell Publishing, 2008, 4-6.<\/span><\/div>\n
3. Florica Enache. Maria Stuparu. Diagnosticul de laborator \u00een hemostaz\u0103. Editura ALL, 1998, pag.155-167.<\/span><\/div>\n
4. Jacques Wallach. Interpretarea testelor de diagnostic. Editura Stiin\u0163elor Medicale, Romania, 7 ed., 2001, pg.639 641.<\/span><\/div>\n
5. Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate 2010. Ref Type: Catalog.<\/span><\/div>\n
6. Laboratory Corporation of America. Directory of Services and Interpretive Guide. Factor X Activity -Clot Based. www.labcorp.com 2010. Ref Type: Internet Communication.<\/span><\/div>\n
7. Radu P\u0103un. Tratat de medicin\u0103 intern\u0103. Hematologie. Partea I. Ed.Medical\u0103 1997, 353-404.<\/span><\/div>\n
8. Radu P\u0103un. Tratat de medicin\u0103 intern\u0103. Hematologie. Partea II. Ed. Medical\u0103 1999, 779-854.<\/span><\/div>\n
9. Richard A. McPetersen, Matthew R. Pincus. Clinical diagnosis and management by laboratory methods. 2007, 729- 743.<\/span><\/div>","protected":false},"excerpt":{"rendered":"

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\u0424\u0430\u043a\u0442\u043e\u0440 \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u0435\u043c\u043e\u0441\u0442\u0438 \u043a\u0440\u043e\u0432\u0438 X (F\u0425) \u0441\u0438\u043d\u0442\u0435\u0437\u0438\u0440\u0443\u0435\u0442\u0441\u044f \u0432 \u043f\u0435\u0447\u0435\u043d\u0438 \u0432 \u043f\u0440\u0438\u0441\u0443\u0442\u0441\u0442\u0432\u0438\u0438 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 \u041a \u0438 \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u043a\u043e\u043c\u043f\u043e\u043d\u0435\u043d\u0442\u043e\u043c \u0430\u043a\u0442\u0438\u0432\u0430\u0442\u043e\u0440\u0430 \u043f\u0440\u043e\u0442\u0440\u043e\u043c\u0431\u0438\u043d\u0430.<\/p>\n

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\u041f\u0440\u0438\u043e\u0431\u0440\u0435\u0442\u0435\u043d\u043d\u043e\u0435 \u0441\u043d\u0438\u0436\u0435\u043d\u0438\u0435 \u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u0438 FX \u043d\u0430\u0431\u043b\u044e\u0434\u0430\u0435\u0442\u0441\u044f \u043f\u0440\u0438 \u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0435 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 \u041a \u043b\u044e\u0431\u043e\u0439 \u044d\u0442\u0438\u043e\u043b\u043e\u0433\u0438\u0438, \u043f\u0430\u0442\u043e\u043b\u043e\u0433\u0438\u0438 \u043f\u0435\u0447\u0435\u043d\u0438 \u0438 \u043f\u0440\u0438\u0435\u043c\u0435 \u0430\u043d\u0442\u0438\u043a\u043e\u0430\u0433\u0443\u043b\u044f\u043d\u0442\u043d\u044b\u0445 \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442\u043e\u0432.<\/p>\n

\u0410\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u044b\u0439 FX (FXa) \u0438 \u0435\u0433\u043e \u043a\u043e\u0444\u0430\u043a\u0442\u043e\u0440, \u0444\u0430\u043a\u0442\u043e\u0440 \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u043d\u0438\u044f \u043a\u0440\u043e\u0432\u0438 V (FV), \u0432\u0445\u043e\u0434\u044f\u0442 \u0432 \u0441\u043e\u0441\u0442\u0430\u0432 \u043f\u0440\u043e\u0442\u0440\u043e\u043c\u0431\u0438\u043d\u0430\u0437\u043d\u043e\u0433\u043e \u043a\u043e\u043c\u043f\u043b\u0435\u043a\u0441\u0430, \u043a\u043e\u0442\u043e\u0440\u044b\u0439 \u0430\u043a\u0442\u0438\u0432\u0438\u0440\u0443\u0435\u0442 \u043f\u0440\u043e\u0442\u0440\u043e\u043c\u0431\u0438\u043d.<\/p>\n

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\u0422\u0435\u043c \u043d\u0435 \u043c\u0435\u043d\u0435\u0435, \u0437\u0430\u0440\u0435\u0433\u0438\u0441\u0442\u0440\u0438\u0440\u043e\u0432\u0430\u043d\u044b \u0442\u044f\u0436\u0435\u043b\u044b\u0435 \u043f\u0440\u043e\u044f\u0432\u043b\u0435\u043d\u0438\u044f \u0433\u0435\u043c\u043e\u0440\u0440\u0430\u0433\u0438\u0447\u0435\u0441\u043a\u043e\u0433\u043e \u0441\u0438\u043d\u0434\u0440\u043e\u043c\u0430 \u0443 \u043b\u044e\u0434\u0435\u0439 \u0441 \u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u044c\u044e FX 0,1 – 39%. \u042d\u0442\u043e \u0443\u043a\u0430\u0437\u044b\u0432\u0430\u0435\u0442 \u043d\u0430 \u043e\u0442\u0441\u0443\u0442\u0441\u0442\u0432\u0438\u0435 \u043f\u0440\u044f\u043c\u043e\u0439 \u043a\u043e\u0440\u0440\u0435\u043b\u044f\u0446\u0438\u0438 \u043c\u0435\u0436\u0434\u0443 \u043a\u043b\u0438\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u043c \u0438 \u043b\u0430\u0431\u043e\u0440\u0430\u0442\u043e\u0440\u043d\u044b\u043c \u0444\u0435\u043d\u043e\u0442\u0438\u043f\u043e\u043c \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f.<\/p>\n

\u0414\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u044b\u0439 \u0433\u0435\u043c\u043e\u0441\u0442\u0430\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0439 \u0443\u0440\u043e\u0432\u0435\u043d\u044c: \u043a\u0440\u043e\u0432\u043e\u0442\u0435\u0447\u0435\u043d\u0438\u044f \u043d\u0435 \u043d\u0430\u0431\u043b\u044e\u0434\u0430\u044e\u0442\u0441\u044f \u043f\u0440\u0438 \u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u0438 FX> 40 %. \u0423 \u0433\u0435\u0442\u0435\u0440\u043e\u0437\u0438\u0433\u043e\u0442\u043d\u044b\u0445 \u043d\u043e\u0441\u0438\u0442\u0435\u043b\u0435\u0439 \u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0430 FX \u0432 \u0431\u043e\u043b\u044c\u0448\u0438\u043d\u0441\u0442\u0432\u0435 \u0441\u043b\u0443\u0447\u0430\u0435\u0432 \u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u044c FX \u0441\u043e\u0441\u0442\u0430\u0432\u043b\u044f\u0435\u0442 \u043e\u043a\u043e\u043b\u043e 50%, \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0435 \u043f\u0440\u0438 \u044d\u0442\u043e\u043c \u043f\u0440\u043e\u0442\u0435\u043a\u0430\u0435\u0442 \u0431\u0435\u0441\u0441\u0438\u043c\u043f\u0442\u043e\u043c\u043d\u043e.<\/p>\n

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\n\u0412\u0437\u044f\u0442\u0438\u0435 \u043a\u0440\u043e\u0432\u0438 \u043f\u0440\u043e\u0432\u043e\u0434\u0438\u0442\u044c \u0443\u0442\u0440\u043e\u043c, \u0434\u043e 11 \u0447., \u0434\u043e\u043f\u0443\u0441\u0442\u0438\u043c\u043e \u043f\u043e\u0441\u043b\u0435 \u043b\u0435\u0433\u043a\u043e\u0433\u043e \u043f\u0440\u0438\u0435\u043c\u0430 \u043d\u0435\u0436\u0438\u0440\u043d\u043e\u0439 \u043f\u0438\u0449\u0438.\u0416\u0435\u043d\u0449\u0438\u043d\u0430\u043c \u043f\u0440\u043e\u0432\u043e\u0434\u0438\u0442\u044c \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435 \u0432\u043e \u0432\u0440\u0435\u043c\u044f \u043c\u0435\u043d\u0441\u0442\u0440\u0443\u0430\u0446\u0438\u0438 \u043d\u0435 \u0440\u0435\u043a\u043e\u043c\u0435\u043d\u0434\u0443\u0435\u0442\u0441\u044f. \u0418\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435 \u043d\u0435 \u0441\u043b\u0435\u0434\u0443\u0435\u0442 \u043f\u0440\u043e\u0432\u043e\u0434\u0438\u0442\u044c \u043d\u0430 \u0444\u043e\u043d\u0435 \u043f\u0440\u0438\u043c\u0435\u043d\u0435\u043d\u0438\u044f \u0430\u043d\u0442\u0438\u043a\u043e\u0430\u0433\u0443\u043b\u044f\u043d\u0442\u043d\u043e\u0439 \u0442\u0435\u0440\u0430\u043f\u0438\u0438.<\/p>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[951],"product_tag":[],"class_list":{"0":"post-10007","1":"product","2":"type-product","3":"status-publish","5":"product_cat-teste-de-hemostaza","7":"first","8":"instock","9":"sold-individually","10":"shipping-taxable","11":"purchasable","12":"product-type-simple"},"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product\/10007","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/comments?post=10007"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10007"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=10007"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=10007"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=10007"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}