{"id":10247,"date":"2020-04-23T05:00:49","date_gmt":"2020-04-23T02:00:49","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/citomegalovirus-igg-in-lcr-ser\/"},"modified":"2025-02-06T11:14:31","modified_gmt":"2025-02-06T09:14:31","slug":"citomegalovirus-igg-in-lcr-ser","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/citomegalovirus-igg-in-lcr-ser\/","title":{"rendered":"\u0426\u0438\u0442\u043e\u043c\u0435\u0433\u0430\u043b\u043e\u0432\u0438\u0440\u0443\u0441 IgG \u0432 \u0441\u043f\u0438\u043d\u043d\u043e\u043c\u043e\u0437\u0433\u043e\u0432\u043e\u0439 \u0436\u0438\u0434\u043a\u043e\u0441\u0442\u0438\/\u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0435"},"content":{"rendered":"<p><strong><em>\u041e\u0431\u0449\u0430\u044f \u0438\u043d\u0444\u043e\u0440\u043c\u0430\u0446\u0438\u044f <\/em><\/strong><\/p>\n<p>Virusul citomegalic uman (CMV), un beta-herpes virus, este cel mai mare virus implicat in infectii la om; genomul sau poate codifica pana la 230 proteine, multe dintre acestea avand un rol semnificativ in reglarea raspunsului imun<sup>2<\/sup>.<\/p>\n<p>Infectia cu CMV este extrem de raspandita, astfel ca se inregistreaza o prevalenta a anticorpilor specifici in populatia adulta de pana la 80-100%. Virusul poate fi transmis prin secretii orale sau respiratorii, lapte matern, transfuzii de sange, contact sexual si vertical (de la mama la fat)<sup>1<\/sup>.<\/p>\n<p>Infectiile CMV ale sistemului nervos central se produc cel mai adesea la pacientii imunodeprimati, modificari histologice caracteristice fiind prezente la 20-40% dintre pacientii cu SIDA. La aceasta categorie de pacienti manifestarea SNC indusa cel mai frecvent de CMV este <em>poliradiculopatia<\/em>. Alte manifestari care pot sa apara la gazdele imunodeprimate sunt: encefalita, ventriculita, mielita, polineuropatia inflamatorie.<\/p>\n<p>Infectii SNC cu CMV (<em>meningoencefalita<\/em>) au fost raportate uneori si la pacienti imunocompetenti, in asociere cu sindromul mononucleozic. La acesti pacienti afectarea neuronala se caracterizeaza prin: cefalee, fotofobie, manifestari date de afectarea tractului piramidal, tulburari motorii sau senzitive<sup>2<\/sup>.<\/p>\n<p>Manifestarile SNC induse de infectia CMV congenitala sunt deosebit de grave: microcefalie, tulburari motorii, corioretinita.<\/p>\n<p>Detectarea prin PCR a CMV-ADN in LCR constituie testul cel mai sensibil pentru diagnosticul rapid infectiilor SNC asociate cu CMV, in timp ce demonstrarea productiei intratecale de anticorpi specifici constituie un element adjuvant pentru diagnosticul retrospectiv al infectiilor<sup>4;7<\/sup>. Prezenta intratecala a anticorpilor specifici trebuie evaluata luand in considerare variabilele esentiale ale lichidului cefalo-rahidian, cum ar fi: celularitatea, concentratia totala a anticorpilor IgG, concentratia albuminei. Pentru o cuantificare mai veridica a sintezei intratecale de imunoglobuline, trebuie aplicata o functie hiperbolica pentru a distinge intre fractiunile proteice derivate din sange si, respectiv, SNC prezente in LCR (diagrama lui Reiber)<sup>6<\/sup>.<\/p>\n<p><strong><em>Recomandari pentru determinarea CMV \u2013 IgG in LCR\/ser <\/em><\/strong>\u2013 diagnosticul infectiilor SNC asociate cu CMV<sup>4<\/sup>.<\/p>\n<p><strong><em>Specimen recoltat<\/em><\/strong> \u2013 se recolteaza obligatoriu 2 probe: a) lichid cefalorahidian recoltat prin punctie lombara si b) sange venos<sup>6<\/sup>.<\/p>\n<p><strong><em>Recipient de recoltare<\/em><\/strong>\u00a0\u2013 a) recipient steril; b) vacutainer fara anticoagulant cu\/fara gel separator<sup>7<\/sup>.<\/p>\n<p><strong><em>Prelucrare\u00a0 necesara dupa recoltare <\/em><\/strong>\u2013 se separa serul prin centrifugare<sup>6<\/sup>.<\/p>\n<p><strong><em>Volum minim proba<\/em><\/strong> \u2013 1) 2 mL; 2) 1mL<sup>6<\/sup>.<\/p>\n<p><strong><em>Cauze de respingere a probei <\/em><\/strong>\u2013 ser hemolizat; plasma in loc de ser<sup>6<\/sup>.<\/p>\n<p><strong><em>Stabilitate proba <\/em><\/strong>- <em>7 zile<\/em> la\u00a0 2-8<sup>0<\/sup>C atat pentru ser cat si pentru LCR<sup>6<\/sup>.<\/p>\n<p><strong><em>Metoda <\/em><\/strong>- <span style=\"text-decoration: underline;\">nefelometrica<\/span> (pentru determinarea albuminei, anticorpilor totali IgG in ser si LCR); <span style=\"text-decoration: underline;\">ELISA <\/span>(pentru determinarea anticorpilor specifici anti-CMV in ser si LCR)<sup>6<\/sup>.<\/p>\n<p><strong><em>Valori de referinta, comunicarea si interpretarea rezultatelor<\/em><\/strong><\/p>\n<p>Pe buletinul final de rezultate sunt comunicati urmatorii parametri:<\/p>\n<table class=\"wp-block-table w-100\" border=\"1\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"296\">\n<p style=\"text-align: center;\"><strong>Denumire parametru<\/strong><\/p>\n<\/td>\n<td valign=\"top\" width=\"294\">\n<p style=\"text-align: center;\"><strong>Valori de referinta<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"296\">\n<p style=\"text-align: center;\">Albumina in LCR<\/p>\n<\/td>\n<td valign=\"top\" width=\"294\">\n<p style=\"text-align: center;\">100-350 mg\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"296\">\n<p style=\"text-align: center;\">Albumina in ser<\/p>\n<\/td>\n<td valign=\"top\" width=\"294\">\n<p style=\"text-align: center;\">36.6-51 g\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"296\">\n<p style=\"text-align: center;\">Indice albuminic Qalb<\/p>\n<\/td>\n<td valign=\"top\" width=\"294\">\n<p style=\"text-align: center;\">&lt; 9<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"296\">\n<p style=\"text-align: center;\">IgG in LCR<\/p>\n<\/td>\n<td valign=\"top\" width=\"294\">\n<p style=\"text-align: center;\">&lt;40 mg\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"296\">\n<p style=\"text-align: center;\">IgG in ser<\/p>\n<\/td>\n<td valign=\"top\" width=\"294\">\n<p style=\"text-align: center;\">7-16 g\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"296\">\n<p style=\"text-align: center;\">IgG in LCR\/IgG in ser (QIgG)<\/p>\n<\/td>\n<td valign=\"top\" width=\"294\">\n<p style=\"text-align: center;\">&lt; 3<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"296\">\n<p style=\"text-align: center;\">Index IgG (QIgG\/ Qalb)<\/p>\n<\/td>\n<td valign=\"top\" width=\"294\">\n<p style=\"text-align: center;\">&lt; 0.7<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"296\">\n<p style=\"text-align: center;\"><strong>CMV IgG ASI<\/strong><\/p>\n<\/td>\n<td valign=\"top\" width=\"294\">\n<p style=\"text-align: center;\"><strong>&lt;1.3<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>\u00a0<\/strong>Buletinul va contine si interpretarea rezultatelor conform diagramei Reiber, cu urmatoarele situatii posibile:<\/p>\n<p style=\"padding-left: 30px;\">-bariera hematoencefalica integra; sinteza intratecala de imunoglobuline IgG absenta;<\/p>\n<p style=\"padding-left: 30px;\">-bariera hematoencefalica alterata; prezenta sinteza intratecala de imunoglobuline IgG;<strong>\u00a0<\/strong><\/p>\n<p style=\"padding-left: 30px;\">-bariera hematoencefalica alterata; sinteza intratecala de imunoglobuline IgG absenta;<strong>\u00a0<\/strong><\/p>\n<p style=\"padding-left: 30px;\">-bariera hematoencefalica integra; prezenta sinteza intratecala de imunoglobuline IgG<sup>6<\/sup>.<strong>\u00a0<\/strong><\/p>\n<p>Indicele anticorpilor specifici (index specific antibodies = ASI) ASI este calculat conform formulei:<\/p>\n<p>ASI = Qspec \/ QIgG.<\/p>\n<p>Qspec = coeficientul anticorpilor IgG specifici = anticorpi IgG specifici in LCR\/anticorpi IgG specifici in ser.<\/p>\n<p>QIgG = coeficientul anticorpilor IgG totali = anticorpi IgG in LCR\/anticorpi IgG in ser.<\/p>\n<p>Daca este necesar (QIgG &gt; Qlim), se va efectua corectia pentru sinteza locala de IgG policlonale:<\/p>\n<p>ASI = Qspec \/ Qlim.<\/p>\n<p>Qlim reprezinta fractia anticorpilor\u00a0 IgG din LCR care provin numai din sange si se calculeaza cu ajutorul unei formule din indicele albuminic individual (Qalb).<\/p>\n<p>In mod normal ASI &lt;1.3. Valorile ASI = 1.3-1.5 constituie un rezultat echivoc.. O valoare a ASI mai mare de 1.5 indica o productie locala crescuta de anticorpi specifici<sup>5;6<\/sup>.<\/p>\n<p><span style=\"font-size: small;\">\u00a0<\/span><\/p>\n<p><span style=\"font-size: small;\">\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<\/span><\/p>\n<p><span style=\"font-size: small;\">1. Ann M. Gronowski. Prenatal Screening and Diagnosis of Congenital Infections. In Handbook of Clinical Laboratory Testing During Pregnancy, Humana Press, Totowa, New Jersey, 2004, 254-255.<\/span><\/p>\n<p><span style=\"font-size: small;\">2. Clyde S. Crumpacker, Jie Lin Zhang. Cytomegalovirus. In Mandell, Douglas, and Bennett\u2019s Principles and Practice of Infectious Diseases, 7th edition, Churchill Livingstone, Elsevier, 2010, 1971-1985.<\/span><\/p>\n<p><span style=\"font-size: small;\">3. Gaytant MA et al. Congenital Cytomegalovirus Infection: Review of the Epidemiology and Outcome. In Obstet. Gynecol Surv, 2002; 57(4): 245-256.<\/span><\/p>\n<p><span style=\"font-size: small;\">4. Guy Boivin. Diagnosis of Herpesvirus Infections of the Central Nervous System. In HERPES 11, Supplement, 2004.<\/span><\/p>\n<p><span style=\"font-size: small;\">5. Hansotto Reiber, Peter Lange. Quantification of Virus-Specific Antibodies in Cerebrospinal Fluid and Serum: Sensitive and Specific Detection of Antibody Synthesis in Brain. In Clinical Chemistry, 37\/7, 1153-1160, 1991.<\/span><\/p>\n<p><span style=\"font-size: small;\">6. Laborator Synevo. Referintele specifice tehnologiei de lucru utilizate 2010. Ref Type: Catalog.<\/span><\/p>\n<p><span style=\"font-size: small;\">7. Lothar Thomas. Laboratory diagnosis of neurological diseases. In Clinical Laboratory Diagnostics-Use and Assessment of Clinical Laboratory Results. TH-Books Verlagsgesellschaft mbH, Frankfurt \/Main, Germany, 1 Ed., 1998, 1308 \u2013 1325.<\/span><\/p>","protected":false},"excerpt":{"rendered":"<p>\u0426\u0438\u0442\u043e\u043c\u0435\u0433\u0430\u043b\u043e\u0432\u0438\u0440\u0443\u0441 (\u0426\u041c\u0412) \u2013 \u0448\u0438\u0440\u043e\u043a\u043e \u0440\u0430\u0441\u043f\u0440\u043e\u0441\u0442\u0440\u0430\u043d\u0435\u043d\u043d\u044b\u0439 \u0414\u041d\u041a-\u0441\u043e\u0434\u0435\u0440\u0436\u0430\u0449\u0438\u0439 \u0432\u0438\u0440\u0443\u0441 \u0441\u0435\u043c\u0435\u0439\u0441\u0442\u0432\u0430 \u0433\u0435\u0440\u043f\u0435\u0441\u0432\u0438\u0440\u0443\u0441\u043e\u0432, \u0442\u0430\u043a\u0436\u0435 \u043d\u0430\u0437\u044b\u0432\u0430\u0435\u043c\u044b\u0439 \u0432\u0438\u0440\u0443\u0441 \u0433\u0435\u0440\u043f\u0435\u0441\u0430 \u0447\u0435\u043b\u043e\u0432\u0435\u043a\u0430 5-\u0433\u043e \u0442\u0438\u043f\u0430. \u041e\u0431\u043b\u0430\u0434\u0430\u0435\u0442 \u0432\u044b\u0441\u043e\u043a\u0438\u043c \u0442\u0440\u043e\u043f\u0438\u0437\u043c\u043e\u043c \u043a \u043a\u043b\u0435\u0442\u043a\u0430\u043c \u0441\u043b\u044e\u043d\u043d\u044b\u0445 \u0436\u0435\u043b\u0435\u0437 \u0438 \u0432 \u043b\u043e\u043a\u0430\u043b\u0438\u0437\u043e\u0432\u0430\u043d\u043d\u043e\u0439 \u0444\u043e\u0440\u043c\u0435 \u043d\u0430\u0445\u043e\u0434\u0438\u0442\u0441\u044f \u0442\u043e\u043b\u044c\u043a\u043e \u0442\u0430\u043c.<\/p>\n<p>\u0426\u0438\u0442\u043e\u043c\u0435\u0433\u0430\u043b\u0438\u044f \u2013 \u0445\u0440\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u0430\u044f \u043f\u0435\u0440\u0441\u0438\u0441\u0442\u0438\u0440\u0443\u044e\u0449\u0430\u044f \u0438\u043d\u0444\u0435\u043a\u0446\u0438\u044f. \u041f\u043e\u0441\u043b\u0435 \u043e\u043a\u043e\u043d\u0447\u0430\u043d\u0438\u044f \u043e\u0441\u0442\u0440\u043e\u0433\u043e \u043f\u0435\u0440\u0438\u043e\u0434\u0430 \u0446\u0438\u0442\u043e\u043c\u0435\u0433\u0430\u043b\u043e\u0432\u0438\u0440\u0443\u0441\u043d\u0430\u044f \u0438\u043d\u0444\u0435\u043a\u0446\u0438\u044f \u043e\u0431\u044b\u0447\u043d\u043e \u043f\u0435\u0440\u0435\u0445\u043e\u0434\u0438\u0442 \u0432 \u043b\u0430\u0442\u0435\u043d\u0442\u043d\u043e\u0435 \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u0435, \u0438\u0437 \u043a\u043e\u0442\u043e\u0440\u043e\u0433\u043e \u043c\u043e\u0436\u0435\u0442 \u0440\u0435\u0430\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u0442\u044c\u0441\u044f. \u0418\u0441\u0442\u043e\u0447\u043d\u0438\u043a \u0437\u0430\u0440\u0430\u0436\u0435\u043d\u0438\u044f \u2013 \u0447\u0435\u043b\u043e\u0432\u0435\u043a \u0441 \u043e\u0441\u0442\u0440\u043e\u0439 \u0438\u043b\u0438 \u043b\u0430\u0442\u0435\u043d\u0442\u043d\u043e\u0439 \u0441\u0442\u0430\u0434\u0438\u0435\u0439 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f. \u041f\u0443\u0442\u0438 \u043f\u0435\u0440\u0435\u0434\u0430\u0447\u0438 \u0438\u043d\u0444\u0435\u043a\u0446\u0438\u0438 \u0440\u0430\u0437\u043d\u043e\u043e\u0431\u0440\u0430\u0437\u043d\u044b \u2013 \u0432\u043e\u0437\u0434\u0443\u0448\u043d\u043e-\u043a\u0430\u043f\u0435\u043b\u044c\u043d\u044b\u0439, \u043a\u043e\u043d\u0442\u0430\u043a\u0442\u043d\u043e-\u0431\u044b\u0442\u043e\u0432\u043e\u0439, \u043f\u043e\u043b\u043e\u0432\u043e\u0439, \u0442\u0440\u0430\u043d\u0441\u043f\u043b\u0430\u0446\u0435\u043d\u0442\u0430\u0440\u043d\u044b\u0439.<\/p>\n<p><strong>\u0421\u0438\u043c\u043f\u0442\u043e\u043c\u044b \u0446\u0438\u0442\u043e\u043c\u0435\u0433\u0430\u043b\u043e\u0432\u0438\u0440\u0443\u0441\u043d\u043e\u0439 \u0438\u043d\u0444\u0435\u043a\u0446\u0438\u0438<\/strong><\/p>\n<p>\u041b\u0430\u0442\u0435\u043d\u0442\u043d\u043e\u0435 \u043d\u043e\u0441\u0438\u0442\u0435\u043b\u044c\u0441\u0442\u0432\u043e \u0438 \u0441\u0443\u0431\u043a\u043b\u0438\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u0435 \u0444\u043e\u0440\u043c\u044b \u0445\u0440\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u043e\u0439 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