{"id":10237,"date":"2020-04-23T04:00:32","date_gmt":"2020-04-23T01:00:32","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/acizi-biliari-in-ser\/"},"modified":"2025-07-01T07:56:35","modified_gmt":"2025-07-01T04:56:35","slug":"acizi-biliari-in-ser","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/acizi-biliari-in-ser\/","title":{"rendered":"\u0416\u0435\u043b\u0447\u043d\u044b\u0435 \u043a\u0438\u0441\u043b\u043e\u0442\u044b \u0432 \u043a\u0440\u043e\u0432\u0438"},"content":{"rendered":"

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

Acizii biliari primari \u2013 acidul colic \u015fi chenodezoxicolic \u2013 se formeaz\u0103 \u00een ficat prin conjugarea colesterolului cu glicin\u0103 \u015fi taurin\u0103. Ace\u015ftia sunt depozita\u0163i \u015fi concentra\u0163i \u00een vezica biliar\u0103, apoi secreta\u0163i \u00een lumenul intestinal, av\u00e2nd rol \u00een emulsionarea gr\u0103similor alimentare, facilitand astfel ac\u0163iunea lipazei pancreatice asupra trigliceridelor \u015fi absorb\u0163ia acizilor gra\u015fi. Acizii biliari secundari, cuprinz\u00e2nd dezoxicolatul \u015fi litocolatul, sunt forma\u0163i \u00een colon ca metaboli\u0163i bacterieni ai acizilor biliari primari. Acidul ursodezoxicolic (UDCA), un izomer al chenodezoxicolatului (CDCA) precum \u015fi o varietate de acizi biliari \u201eaberan\u0163i\u201d se g\u0103sesc \u00een cantitate redus\u0103 la persoanele s\u0103n\u0103toase, dar sunt produ\u015fi\u00a0 \u00een cantit\u0103\u0163i crescute la pacien\u0163ii cu sindroame colestatice cronice.<\/p>\n

\u00cen bila normal\u0103 raportul dintre acizii conjuga\u0163i cu glicin\u0103 \u015fi cei cu taurin\u0103 este 3:1, \u00een timp ce la pacien\u0163ii cu colestaz\u0103 se \u00eent\u00e2lne\u015fte cre\u015fterea concentra\u0163iei acizilor biliari sulfata\u0163i sau glucuronoconjunga\u0163i.<\/p>\n

\u00cen timpul procesului de absorb\u0163ie aproximativ 90% din acizii biliari conjuga\u0163i \u015fi neconjuga\u0163i sunt reabsorbi\u0163i prin difuziune pasiv\u0103 de-a lungul \u00eentregului intestin. Ace\u015ftia reintr\u0103 \u00een circula\u0163ia sanguin\u0103 portal\u0103 \u015fi sunt rapid capta\u0163i de hepatocite, reconjuga\u0163i \u015fi secreta\u0163i din nou\u00a0\u00een bil\u0103. Acizii biliari reajun\u015fi\u00a0\u00een ficat suprim\u0103 sinteza hepatic\u0103 de novo, prin inhibarea enzimei reglatoare 7\u03b1-hidroxilaza. Restul acizilor biliari este excretat \u00een materiile fecale;\u00a0\u00een condi\u0163ii normale produc\u0163ia hepatic\u0103 compenseaz\u0103 pierderile prin scaun, lucru ce nu se \u00eent\u00e2mpl\u0103 \u00een cazul reducerii marcate a absorb\u0163iei intestinale. Se formeaz\u0103 \u00een acest fel un circuit hepato-entero-hepatic<\/em>\u00a0\u00een care acizii biliari sunt recircula\u0163i de aproximativ 5-10 ori pe zi.<\/p>\n

Nivelele acizilor biliari pot fi modificate chiar \u015fi atunci c\u00e2nd alte teste ale func\u0163iei hepatice sunt normale \u015fi deci pot servi ca un indicator sensibil \u015fi specific de boal\u0103 hepatic\u01032;3;4<\/sup>.<\/p>\n

Recomand\u0103ri pentru determinarea acizilor biliari <\/em><\/strong>\u2013 evaluarea ciclului hepato-entero-hepatic (sistem biliar, intestin, circula\u0163ia portal\u0103 \u015fi hepatocite)2<\/sup>.<\/p>\n

Preg\u0103tire pacient <\/em><\/strong>- <\/em>\u00e0 jeun (pe nem\u00e2ncate)1<\/sup>.<\/p>\n

Specimen recoltat <\/em><\/strong>- <\/em>\u0432\u0435\u043d\u043e\u0437\u043d\u0430\u044f \u043a\u0440\u043e\u0432\u044c1<\/sup>.<\/p>\n

Recipient de recoltare <\/em><\/strong>- <\/em>vacutainer f\u0103r\u0103 anticoagulant, cu\/f\u0103r\u0103 gel separator1<\/sup>.<\/p>\n

Prelucrare necesar\u0103 dup\u0103 recoltare <\/em><\/strong>- <\/em>se separ\u0103 serul prin centrifugare; se lucreaz\u0103 serul proasp\u0103t; dac\u0103 acest lucru nu este posibil, serul se p\u0103streaza la 2-8\u00b0C sau la -20\u00b0C1<\/sup>.<\/p>\n

Volum prob\u0103<\/em><\/strong> \u2013 1 mL ser1<\/sup>.<\/p>\n

Cauze de respingere<\/em><\/strong> a probei \u2013 <\/em><\/strong>specimen intens hemolizat1<\/sup>.<\/p>\n

Stabilitate prob\u0103 <\/em><\/strong>- <\/em>serul separat este stabil 7 zile<\/em> la 2-8\u00b0C; timp \u00eendelungat<\/em> la -20\u00b0C sau la -70\u00b0C. Acizii biliari sunt instabili atunci c\u00e2nd sunt supu\u015fi la varia\u0163ii de temperatur\u0103 \u015fi, prin urmare, nu decongela\u0163i\/recongela\u0163i1<\/sup>;3<\/sup>.<\/p>\n

Metod\u0103 <\/em><\/strong>- <\/em>fotometric\u0103<\/span>1<\/sup>.<\/p>\n

Valori de referin\u0163\u0103:<\/em><\/strong><\/p>\n

0-1\u00a0\u00a0an: <25 \u03bcmol\/L<\/div>\n
1-2 ani: <9 \u03bcmol\/L<\/div>\n
\u22652\u00a0 ani: <\/i><10 \u03bcmol\/L1<\/sup><\/div>\n

Interpretarea rezultatelor<\/em><\/strong><\/p>\n

Eficien\u0163a clearance-ului hepatic determin\u0103 un nivel plasmatic sc\u0103zut la persoanele normale. O cre\u015ftere rapid\u0103 a concentra\u0163iei serice a acizilor biliari este un indicator sensibil al afec\u0163iunilor hepatice caracterizate prin modific\u0103ri ale clearance-ului. Postprandial concentra\u0163iile serice de acizi biliari cresc doar u\u015for la persoanele normale, spre deosebire de pacien\u0163ii cu afec\u0163iuni hepatice diverse (ciroz\u0103 hepatit\u0103, colestaz\u0103, tromboz\u0103 venoas\u0103 portal\u0103, sindrom Budd-Chiari, colangit\u0103, boala Wilson si hemocromatoz\u0103) la care cre\u015fterea este semnificativ\u0103. At\u00e2t tulbur\u0103rile metabolice hepatice (boala Gilbert, sindromul Crigler-Najjar \u015fi Dubin-Johnson), c\u00e2t \u015fi sindromul de malabsorb\u0163ie intestinal\u0103 nu determin\u0103 varia\u0163ii ale concentra\u0163iilor plasmatice de acizi biliari.<\/p>\n

Colestaza intrahepatic\u0103 de sarcin\u0103 (ICP) este o afec\u0163iune temporar\u0103 cauzat\u0103 de o disfunc\u0163ie a ficatului ap\u0103rut\u0103 \u00een timpul sarcinii. Aceasta este caracterizat\u0103 prin prurit intens generalizat care \u00eencepe de obicei \u00een al treilea trimestru.<\/p>\n

Diagnosticul se poate confirma prin mai multe teste de laborator, care includ \u015fi acizii biliari. Valorile plasmatice materne de s\u0103ruri biliare sunt adesea de cel pu\u0163in trei ori mai mari dec\u00e2t concentra\u0163ia normal\u0103 \u00een ICP, dar pot cre\u015fte \u015fi de 10-100 de ori. \u00cen timp ce nivelul de ALT\/AST poate fi normal sau u\u015for crescut, concentra\u0163iile fosfatazei alcaline sunt aproape \u00eentotdeauna mai mari dec\u00e2t valorile de referin\u0163\u0103, de\u015fi acest lucru se poate datora,\u00a0\u00een parte, prezen\u0163ei fosfatazei alcaline de origine placentar\u0103. Pe de alt\u0103 parte,\u00a0\u00een cazul\u00a0\u00een care enzimele hepatice sunt extrem de ridicate, alte cauze, cum ar fi hepatita viral\u0103, ar trebui s\u0103 fie luate\u00a0\u00een considerare. De\u015fi pruritul poate provoca o stare de disconfort, colestaza de sarcin\u0103 este considerat\u0103 o afec\u0163iune benign\u0103 pentru mam\u0103; riscul este \u00eens\u0103 semnificativ crescut la f\u0103t, ICP fiind asociat\u0103 cu o mortalitate intrauterin\u0103 crescut\u0103. Dup\u0103 na\u015ftere simptomele mamei se reduc\u00a0\u00een termen de 48 de ore \u015fi dispar complet la aproximativ patru s\u0103pt\u0103m\u00e2ni postpartum2;4<\/sup>.<\/p>\n

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

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

1. Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate. 2010. Ref Type: Catalog.<\/span><\/div>\n
2. Lothar Thomas. Extravascular Body Fluids. In Clinical Laboratory Diagnostics-Use and Assessment of Clinical Laboratory Results. TH-Books Verlagsgesellschaft mbH, Frankfurt \/Main, Germany, 1 Ed., 1998, 1341-1343.<\/span><\/div>\n
3. Laboratory Corporation of America. Directory of Services and Interpretive Guide. Bile Acids. www.labcorp.com 2010. Ref Type: Internet Communication.<\/span><\/div>\n
4. Mayo Clinic\/Mayo Medical LaboratoriesTest Catalogs and Guides. Test Catalog. Bile Acids, Total. www.mayomedicallaboratories.com. Ref Type: Internet Communication.<\/span><\/div>","protected":false},"excerpt":{"rendered":"

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

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\u041e\u0431\u0449\u0438\u0439 \u0443\u0440\u043e\u0432\u0435\u043d\u044c \u0436\u0435\u043b\u0447\u043d\u044b\u0445 \u043a\u0438\u0441\u043b\u043e\u0442 \u0432 \u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0435 \u043a\u0440\u043e\u0432\u0438 \u043e\u0442\u0440\u0430\u0436\u0430\u0435\u0442 \u0440\u0435\u0430\u0431\u0441\u043e\u0440\u0431\u0446\u0438\u044e \u0438\u0437 \u043a\u0438\u0448\u0435\u0447\u043d\u0438\u043a\u0430 \u0442\u0435\u0445 \u0436\u0435\u043b\u0447\u043d\u044b\u0445 \u043a\u0438\u0441\u043b\u043e\u0442, \u043a\u043e\u0442\u043e\u0440\u044b\u0435 \u044d\u043a\u0441\u0442\u0440\u0430\u0433\u0438\u0440\u043e\u0432\u0430\u043b\u0438\u0441\u044c \u043f\u0440\u0438 \u043f\u0435\u0440\u0432\u043e\u043c \u043f\u0440\u043e\u0445\u043e\u0436\u0434\u0435\u043d\u0438\u0438 \u0447\u0435\u0440\u0435\u0437 \u043f\u0435\u0447\u0435\u043d\u044c. \u0418\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435 \u0443\u0440\u043e\u0432\u043d\u044f \u0436\u0435\u043b\u0447\u043d\u044b\u0445 \u043a\u0438\u0441\u043b\u043e\u0442 \u0432 \u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0435 \u043a\u0440\u043e\u0432\u0438 \u043d\u0435 \u0442\u043e\u043b\u044c\u043a\u043e \u043f\u043e\u0434\u0442\u0432\u0435\u0440\u0436\u0434\u0430\u0435\u0442 \u043f\u043e\u0432\u0440\u0435\u0436\u0434\u0435\u043d\u0438\u0435 \u043f\u0435\u0447\u0435\u043d\u0438, \u043d\u043e \u0438 \u043f\u043e\u0437\u0432\u043e\u043b\u044f\u0435\u0442 \u043e\u0446\u0435\u043d\u0438\u0442\u044c \u0435\u0451 \u0432\u044b\u0434\u0435\u043b\u0438\u0442\u0435\u043b\u044c\u043d\u0443\u044e \u0444\u0443\u043d\u043a\u0446\u0438\u044e \u0438 \u043d\u0430\u043b\u0438\u0447\u0438\u0435 \u0441\u0438\u0441\u0442\u0435\u043c\u043d\u043e\u0433\u043e \u0448\u0443\u043d\u0442\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u044f \u043a\u0440\u043e\u0432\u0438 (\u043f\u0440\u0438 \u043d\u0430\u043b\u0438\u0447\u0438\u0438 \u0430\u043d\u0430\u0441\u0442\u043e\u043c\u043e\u0437\u043e\u0432 \u0436\u0435\u043b\u0447\u043d\u044b\u0435 \u043a\u0438\u0441\u043b\u043e\u0442\u044b \u043f\u043e\u043f\u0430\u0434\u0430\u044e\u0442 \u0432 \u043e\u0431\u0449\u0438\u0439 \u043a\u0440\u043e\u0432\u043e\u0442\u043e\u043a, \u043c\u0438\u043d\u0443\u044f \u043f\u0435\u0447\u0435\u043d\u044c).<\/p>\n

\u041c\u0430\u0442\u0435\u0440\u0438\u0430\u043b :<\/strong> \u0432\u0435\u043d\u043e\u0437\u043d\u0430\u044f \u043a\u0440\u043e\u0432\u044c
\n\u041f\u0440\u0430\u0432\u0438\u043b\u0430 \u043f\u043e\u0434\u0433\u043e\u0442\u043e\u0432\u043a\u0438 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u0430 : <\/strong>\u0441\u0442\u0430\u043d\u0434\u0430\u0440\u0442\u043d\u044b\u0435
\n\u0422\u0440\u0430\u043d\u0441\u043f\u043e\u0440\u0442\u043d\u0430\u044f \u0441\u0440\u0435\u0434\u0430, \u043f\u0440\u043e\u0431\u0438\u0440\u043a\u0430 :\u00a0<\/strong> \u0432\u0430\u043a\u0443\u0442\u0430\u0439\u043d\u0435\u0440 \u0441\/\u0431\u0435\u0437 \u0430\u043d\u0442\u0438\u043a\u043e\u0430\u0433\u0443\u043b\u044f\u043d\u0442\u0430 \u0441\/\u0431\u0435\u0437 \u0433\u0435\u043b\u0435\u0432\u043e\u0439 \u0444\u0430\u0437\u044b
\n\u041f\u0440\u0430\u0432\u0438\u043b\u0430 \u0438 \u0443\u0441\u043b\u043e\u0432\u0438\u044f \u0442\u0440\u0430\u043d\u0441\u043f\u043e\u0440\u0442\u0438\u0440\u043e\u0432\u043a\u0438, \u0441\u0442\u0430\u0431\u0438\u043b\u044c\u043d\u043e\u0441\u0442\u044c \u043f\u0440\u043e\u0431\u044b:<\/strong> \u0441\u0442\u0430\u043d\u0434\u0430\u0440\u0442\u043d\u044b\u0435
\n\u041c\u0435\u0442\u043e\u0434 \u0442\u0435\u0441\u0442\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u044f: <\/strong>\u0444\u0435\u0440\u043c\u0435\u043d\u0442\u0430\u0442\u0438\u0432\u043d\u043e-\u043a\u043e\u043b\u043e\u0440\u0438\u043c\u0435\u0442\u0440\u0438\u0447\u0435\u0441\u043a\u0438\u0439<\/p>\n

\u0420\u0435\u0444\u0435\u0440\u0435\u043d\u0442\u043d\u044b\u0435 \u0437\u043d\u0430\u0447\u0435\u043d\u0438\u044f<\/strong>, \u043c\u043a\u043c\u043e\u043b\u044c\/\u043b : \u0434\u0435\u0442\u0438: \u0434\u043e 1 \u0433\u043e\u0434\u0430: \u0434\u043e 25,0; 1-2 \u0433\u043e\u0434\u0430: \u0434\u043e 9,0. \u0414\u0435\u0442\u0438 \u0441\u0442\u0430\u0440\u0448\u0435 2 \u043b\u0435\u0442 \u0438 \u0432\u0437\u0440\u043e\u0441\u043b\u044b\u0435: \u0434\u043e 10,0<\/p>\n

\u041f\u043e\u043a\u0430\u0437\u0430\u043d\u0438\u044f \u043a \u043d\u0430\u0437\u043d\u0430\u0447\u0435\u043d\u0438\u044e:<\/strong><\/p>\n

\u0416\u0435\u043b\u0447\u043d\u044b\u0435 \u043a\u0438\u0441\u043b\u043e\u0442\u044b — \u043e\u0434\u0438\u043d \u0438\u0437 \u043c\u0430\u0440\u043a\u0435\u0440\u043e\u0432 \u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u044f \u0432\u044b\u0434\u0435\u043b\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u0439 \u0444\u0443\u043d\u043a\u0446\u0438\u0438 \u043f\u0435\u0447\u0435\u043d\u0438<\/p>\n

    \n
  • \u041d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u0435 \u0432\u044b\u0434\u0435\u043b\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u0439 \u0444\u0443\u043d\u043a\u0446\u0438\u0438 \u043f\u0435\u0447\u0435\u043d\u0438 \u043f\u0440\u0438 \u0440\u0430\u0437\u043b\u0438\u0447\u043d\u044b\u0445 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f\u0445<\/li>\n
  • \u0418\u043d\u0442\u0435\u0440\u043f\u0440\u0435\u0442\u0430\u0446\u0438\u044f \u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u043e\u0432<\/li>\n<\/ul>\n

    \u041f\u043e\u0432\u044b\u0448\u0435\u043d\u0438\u0435 \u0443\u0440\u043e\u0432\u043d\u044f:<\/strong><\/p>\n

      \n
    • \u043f\u043e\u0434\u043f\u0435\u0447\u0435\u043d\u043e\u0447\u043d\u0430\u044f \u0436\u0435\u043b\u0442\u0443\u0445\u0430;<\/li>\n
    • \u043f\u0435\u0440\u0432\u0438\u0447\u043d\u044b\u0439 \u0431\u0438\u043b\u0438\u0430\u0440\u043d\u044b\u0439 \u0446\u0438\u0440\u0440\u043e\u0437;<\/li>\n
    • \u0430\u043b\u043a\u043e\u0433\u043e\u043b\u044c\u043d\u043e\u0435 \u043f\u043e\u0440\u0430\u0436\u0435\u043d\u0438\u0435 \u043f\u0435\u0447\u0435\u043d\u0438;<\/li>\n
    • \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u043e\u043f\u043e\u0434\u043e\u0431\u043d\u044b\u0439 \u0441\u0438\u043d\u0434\u0440\u043e\u043c \u0443 \u043d\u043e\u0432\u043e\u0440\u043e\u0436\u0434\u0435\u043d\u043d\u044b\u0445;<\/li>\n
    • \u0432\u0438\u0440\u0443\u0441\u043d\u044b\u0439, \u0442\u043e\u043a\u0441\u0438\u0447\u0435\u0441\u043a\u0438\u0439 \u0433\u0435\u043f\u0430\u0442\u0438\u0442;<\/li>\n
    • \u0432\u0440\u043e\u0436\u0434\u0435\u043d\u043d\u044b\u0435 \u0430\u043d\u043e\u043c\u0430\u043b\u0438\u0438 \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u044f \u0436\u0435\u043b\u0447\u0435\u0432\u044b\u0432\u043e\u0434\u044f\u0449\u0438\u0445 \u043f\u0443\u0442\u0435\u0439;<\/li>\n
    • \u043e\u0441\u0442\u0440\u044b\u0439 \u0445\u043e\u043b\u0435\u0446\u0438\u0441\u0442\u0438\u0442;<\/li>\n
    • \u043e\u043f\u0443\u0445\u043e\u043b\u0438 \u0436\u0435\u043b\u0447\u043d\u044b\u0445 \u043f\u0440\u043e\u0442\u043e\u043a\u043e\u0432 \u0438 \u0436\u0435\u043b\u0447\u043d\u043e\u0433\u043e \u043f\u0443\u0437\u044b\u0440\u044f<\/li>\n<\/ul>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[1000,953],"product_tag":[],"class_list":{"0":"post-10237","1":"product","2":"type-product","3":"status-publish","5":"product_cat-biochimie-generala-sange-urina","6":"product_cat-teste-de-biochimie","8":"first","9":"instock","10":"sold-individually","11":"shipping-taxable","12":"purchasable","13":"product-type-simple"},"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product\/10237","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=10237"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10237"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=10237"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=10237"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=10237"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}