{"id":10251,"date":"2020-04-23T05:00:56","date_gmt":"2020-04-23T02:00:56","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/angiotensina-ii\/"},"modified":"2025-02-07T09:21:05","modified_gmt":"2025-02-07T07:21:05","slug":"angiotensina-ii","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/angiotensina-ii\/","title":{"rendered":"\u0410\u043d\u0433\u0438\u043e\u0442\u0435\u043d\u0437\u0438\u0438\u043d II"},"content":{"rendered":"<p><strong><em>Informa<\/em><\/strong><strong><em>\u021b<\/em><\/strong><strong><em>ii generale \u0219i recomand\u0103ri pentru determinarea angiotensinei II<\/em><\/strong><\/p>\n<p style=\"text-align: justify;\">Angiotensina II (Ang II) este un peptid activ, vasoconstrictor puternic, dar labil. Este produs din angiotensina I (Ang I) sub ac\u021biunea angiotensin convertazei (ACE), prin \u00eendep\u0103rtarea a doi aminoacizi de la cap\u0103tul N-terminal<sup>1<\/sup>. Eliberarea sa este controlat\u0103 de renin\u0103, presiunea \u0219i volumul sanguin, balan\u021ba sodiului \u0219i nivelul de aldosteron<sup>2<\/sup>.<\/p>\n<p style=\"text-align: justify;\">Face parte din cascada sistemului renin-angiotensin\u0103 (RAS), sistem reglator al presiunii sanguine \u0219i al homeostaziei fluidelor \u0219i electroli\u021bilor. \u00cen conceptul clasic, RAS include un singur peptid bioactiv \u2013 ANG II \u2013 \u0219i doi receptori specifici (AT1 si AT2) a c\u0103ror activare induce efecte biologice opuse. Sc\u0103derea tensiunii arteriale reduce perfuzia aparatului juxtaglomerular \u0219i determin\u0103 eliberarea \u00een circula\u021bie a reninei. Renina ac\u021bioneaz\u0103 asupra angiotensinogenului \u0219i \u00eel transform\u0103 \u00een Ang I. Sub ac\u021biunea ACE, care se g\u0103se\u0219te \u00een special la nivelul capilarelor pulmonare, Ang I este transformat\u0103 \u00een Ang II. Rolul fiziologic al RAS clasic este de a men\u021bine tonusul vascular prin ac\u021biunea direct\u0103 asupra celulelor musculare netede vasculare \u0219i homeostazia apei \u0219i s\u0103rii prin stimularea secre\u021biei de aldosteron<sup>3;4;5<\/sup>.<\/p>\n<p style=\"text-align: justify;\">Cercet\u0103rile din ultimii ani au adus date noi privind RAS prin descrierea a noi componente, peptide \u0219i receptori, ale c\u0103ror func\u021bii sunt complementare, antagoniste sau diferite de cele ale componentelor clasice<sup>3<\/sup> (vezi fig.1). Conform conceptului nou, RAS include fragmente peptidice de Ang II rezultate sub ac\u021biunea unor diferite peptidaze: endopeptidaza neutr\u0103 (NEP), aminopeptidaza A (APA), aminopeptidaza N (APN) \u0219i aminopeptidaza B (APB). Printre peptidele nou identificate se num\u0103r\u0103 angiotensina (1-7) \u2013 Ang (1-7), angiotensina III (Ang III) \u0219i angiotensina IV (Ang IV) care \u00ee\u0219i exercit\u0103 ac\u021biunile prin legarea de receptorii Mas, AT1, AT2 \u0219i respectiv IRAP (aminopeptidaza reglat\u0103 de insulin\u0103). Trebuie men\u021bionat c\u0103 efectele Ang (1-7) sunt opuse fa\u021b\u0103 de cele ale Ang II, iar Ang IV prezint\u0103 un profil independent de ac\u021biuni biologice ce includ formarea memoriei \u0219i ingestia de ap\u0103<sup>5<\/sup>.<\/p>\n<p>Figura 1. Sistem renin\u0103-angiotensin\u0103 (RAS) \u2013 concept clasic\/concept nou<\/p>\n<p><a title=\"\" href=\"\/wp-content\/uploads\/2010\/02\/Angiotensina-II.jpg\" rel=\"wpdevart_lightbox lightbox-gallery-dkwbOK5S\" data-=\"\" data-rl_title=\"\" data-rl_caption=\"\"><img decoding=\"async\" class=\"wp-image-24408 alignleft\" src=\"\/wp-content\/uploads\/2010\/02\/Angiotensina-II.jpg\" alt=\"-\" width=\"506\" height=\"345\"><\/a><\/p>\n<div><em><a class=\"shutterset_6716 cboxElement\" title=\"\u0410\u043d\u0433\u0438\u043e\u0442\u0435\u043d\u0437\u0438\u0438\u043d II\" href=\"https:\/\/www.synevo.md\/wp-content\/uploads\/2010\/02\/Angiotensina-II.jpg\" rel=\"wpdevart_lightbox lightbox[6716] nofollow noopener\" data-rel=\"lightbox-gallery-youK2cDp\" data-rl_title=\"\" data-rl_caption=\"\" target=\"_blank\"><img decoding=\"async\" class=\"wp-image-24408 alignleft\" src=\"\/wp-content\/uploads\/2010\/02\/Angiotensina-II.jpg\" alt=\"-\" width=\"506\" height=\"345\"><\/a><br \/>\n<\/em><\/div>\n<div><\/div>\n<div><\/div>\n<div><\/div>\n<div><\/div>\n<div><\/div>\n<div><\/div>\n<div><\/div>\n<div><\/div>\n<div><\/div>\n<div><\/div>\n<div><em>(Adaptare dup\u0103 Kumar R et al, Clinical Science 2012)<\/em><\/div>\n<div><\/div>\n<div style=\"text-align: justify;\">Studiile de laborator pe cardiomiocite \u00een cultur\u0103, au ar\u0103tat implicarea direct\u0103 a Ang II \u00een hipertrofia ventricular\u0103 st\u00e2ng\u0103 asociat\u0103 cu hipertensiunea arterial\u0103. De asemenea, Ang II poate inhiba secre\u021bia renal\u0103 de renin\u0103 printr-un mecanism de feed-back. Mai multe grupuri de cercet\u0103tori au constat prezen\u021ba unor niveluri plasmatice crescute de Ang II, la un subgrup de pacien\u021bi cu insuficien\u021b\u0103 cardiac\u0103 cronic\u0103 sever\u0103, \u00een pofida tratamentului pe termen lung cu inhibitori ACE<sup>4<\/sup>. Acest fenomen de \u201creactivare a Ang II\u201d a fost asociat cu mortalitate crescut\u0103<sup>4<\/sup>. Determinarea nivelului de Ang II \u00een plasm\u0103 \u00eempreun\u0103 cu cel al reninei poate fi util\u0103 \u00een clasificarea pacien\u021bilor hipertensivi<sup>6<\/sup>.<\/div>\n<div><\/div>\n<div style=\"text-align: justify;\"><strong><em>Preg\u0103tire pacient <\/em><\/strong><strong><em>- <\/em><\/strong>\u00e0 jeun (pe nem\u00e2ncate), \u00een pozi\u021bie culcat\u0103 (dup\u0103 cel pu\u021bin 30 de minute de decubit)<sup>2;7<\/sup>.<\/div>\n<div style=\"text-align: justify;\">Se recomand\u0103 ca pacien\u0163ii s\u0103 fie pe o diet\u0103 normal\u0103 de sare (110 mEq de Na)<sup>2;7<\/sup>.<\/div>\n<div style=\"text-align: justify;\">Administrarea de diuretice, mineralocorticoizi, glucocorticoizi, estrogeni, contraceptive orale, sodiu, potasiu, influen\u021beaz\u0103 nivelul de Ang II<sup>2;7<\/sup>.<\/div>\n<div style=\"text-align: justify;\">Pacien\u021bii nu vor primi substan\u021be radioactive cu 24 ore \u00eenainte de recoltare<sup>5;7<\/sup>.<\/div>\n<p style=\"text-align: justify;\"><strong><em>Recipient de recoltare <\/em><\/strong><em>- <\/em>vacutainer cu EDTA K3<sup>7<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong><em>Cantitate recoltat\u0103 <\/em><\/strong><em>- <\/em>c\u00e2t permite vacuumul<sup>7<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong><em>Specimen recoltat <\/em><\/strong><em>- <\/em>s\u00e2nge venos; vacutainerul se agit\u0103 foarte u\u0219or \u015fi se transport\u0103 la laborator c\u00e2t mai repede posibil pentru a fi centrifugat<sup>7<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong><em>Prelucrare necesar\u0103 dup\u0103 recoltare <\/em><\/strong><em>- <\/em>\u00een maxim 1 or\u0103 de la recoltare se separ\u0103 plasma prin centrifugare, plasma va fi congelat\u0103 rapid la -20\u00b0C; probele de plasma recoltate \u00een afara sediilor laboratorului vor fi transportate \u00een recipientul destinat probelor congelate<sup>7<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong><em>Cauze de respingere a probei<\/em><\/strong> \u2013 specimen intens hemolizat; specimen recoltat pe alt tip de anticoagulant; plasma decongelat\u0103<sup>7<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong><em>Stabilitate<\/em><\/strong> <strong><em>prob\u0103 <\/em><\/strong><em>- <\/em>plasma separat\u0103 este stabil\u0103 <em>30 zile<\/em> la -20\u00b0C; nu decongela\u021bi\/recongela\u021bi<sup>7<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong><em>Metod\u0103 <\/em><\/strong>- <em>radioimunologic\u0103 (RIA)<\/em><sup>7<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong><em>Valori de referin\u021b\u0103 <\/em><\/strong><em>- <\/em>20-40 ng\/L<sup>7<\/sup>.<\/p>\n<div style=\"text-align: justify;\"><strong><em>Limite \u015fi interferen\u021be<\/em><\/strong><\/div>\n<div style=\"text-align: justify;\">Nu se recomand\u0103 utilizarea acestui test \u00een scop diagnostic, f\u0103r\u0103 confirmarea prin alte mijloace medicale<sup>2;4;7<\/sup>.<\/div>\n<p><strong><span style=\"font-size: 10pt;\">\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<\/span><\/strong><\/p>\n<ol>\n<li><span style=\"font-size: 10pt;\">PubChem \u2013 Open Chemistry Database. Angiotensin II. https:\/\/pubchem.ncbi.nlm.nih.gov\/compound\/angiotensin_ii.<\/span><\/li>\n<li><span style=\"font-size: 10pt;\">Mayo Clinic\/Mayo Medical Laboratories. Test Catalog.Angiotensin II.\u00a0<a href=\"http:\/\/www.mayomedicallaboratories.com\/test-catalog\/\" rel=\"nofollow noopener\" target=\"_blank\">www.mayomedicallaboratories.com\/test-catalog<\/a>, 2017. Ref Type: Catalog.<\/span><\/li>\n<li><span style=\"font-size: 10pt;\">Speth RC, Giese MJ (2013). Update on the Renin-Angiotensin System. J Pharmacol Clin Toxicol 1(1):1004.<\/span><\/li>\n<li><span style=\"font-size: 10pt;\">Laboratory Corporation of America. Directory of Services and Interpretive Guide. Angiotensin II. www.labcorp.com <\/span><span style=\"font-size: 10pt;\">Ref Type: Internet Communication.<\/span><\/li>\n<li><span style=\"font-size: 10pt;\">Kumar R, Thomas CM, Yong QC, Chen W, Baker KM. The intracrine renin-angiotensin system. Clin Sci (Lond). 2012 Sep;123(5):273-84<\/span><\/li>\n<li><span style=\"font-size: 10pt;\">Quest Diagnostics. Angiotensin II. <a href=\"http:\/\/www.questdiagnostics.com\/\" rel=\"nofollow noopener\" target=\"_blank\">www.questdiagnostics.com<\/a> 2017.<\/span><\/li>\n<li><span style=\"font-size: 10pt;\">Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate 2017. Ref Type: Catalog<\/span><\/li>\n<\/ol>","protected":false},"excerpt":{"rendered":"<p>\u0410\u043d\u0433\u0438\u043e\u0442\u0435\u043d\u0437\u0438\u043d II \u2014 \u0430\u043a\u0442\u0438\u0432\u043d\u044b\u0439, \u043c\u043e\u0449\u043d\u044b\u0439, \u043d\u043e \u043b\u0430\u0431\u0438\u043b\u044c\u043d\u044b\u0439 (\u043d\u0435\u0441\u0442\u0430\u0431\u0438\u043b\u044c\u043d\u044b\u0439) \u043f\u0435\u043f\u0442\u0438\u0434. \u041e\u043d \u0432\u044b\u0440\u0430\u0431\u0430\u0442\u044b\u0432\u0430\u0435\u0442\u0441\u044f \u0438\u0437 \u0430\u043d\u0433\u0438\u043e\u0442\u0435\u043d\u0437\u0438\u043d\u0430 I \u043f\u0440\u0438 \u0443\u0447\u0430\u0441\u0442\u0438\u0438 \u0430\u043d\u0433\u0438\u043e\u0442\u0435\u043d\u0437\u0438\u043d\u043f\u0440\u0435\u0432\u0440\u0430\u0449\u0430\u044e\u0449\u0435\u0433\u043e \u0444\u0435\u0440\u043c\u0435\u043d\u0442\u0430. \u0415\u0433\u043e \u043f\u0440\u043e\u0438\u0437\u0432\u043e\u0434\u0441\u0442\u0432\u043e \u043a\u043e\u043d\u0442\u0440\u043e\u043b\u0438\u0440\u0443\u0435\u0442\u0441\u044f \u0440\u0435\u043d\u0438\u043d\u043e\u043c, \u0430\u0440\u0442\u0435\u0440\u0438\u0430\u043b\u044c\u043d\u044b\u043c \u0434\u0430\u0432\u043b\u0435\u043d\u0438\u0435\u043c \u0438 \u043e\u0431\u044a\u0435\u043c\u043e\u043c \u043a\u0440\u043e\u0432\u0438, \u0431\u0430\u043b\u0430\u043d\u0441\u043e\u043c \u043d\u0430\u0442\u0440\u0438\u044f \u0438 \u0443\u0440\u043e\u0432\u043d\u0435\u043c \u0430\u043b\u044c\u0434\u043e\u0441\u0442\u0435\u0440\u043e\u043d\u0430.<\/p>\n<p>\u0410\u043d\u0433\u0438\u043e\u0442\u0435\u043d\u0437\u0438\u043d II \u0443\u0447\u0430\u0441\u0442\u0432\u0443\u0435\u0442 \u0432 \u0440\u0435\u043d\u0438\u043d-\u0430\u043d\u0433\u0438\u043e\u0442\u0435\u043d\u0437\u0438\u043d\u043e\u0432\u043e\u043c \u043a\u0430\u0441\u043a\u0430\u0434\u0435, \u0440\u0435\u0433\u0443\u043b\u044f\u0446\u0438\u0438 \u0430\u0440\u0442\u0435\u0440\u0438\u0430\u043b\u044c\u043d\u043e\u0433\u043e \u0434\u0430\u0432\u043b\u0435\u043d\u0438\u044f, \u043f\u043e\u0434\u0434\u0435\u0440\u0436\u0430\u043d\u0438\u0438 \u0436\u0438\u0434\u043a\u043e\u0441\u0442\u0438, \u044d\u043b\u0435\u043a\u0442\u0440\u043e\u043b\u0438\u0442\u043e\u0432 \u0438 \u0433\u043e\u043c\u0435\u043e\u0441\u0442\u0430\u0437\u0430.<\/p>\n<p>\u0420\u0435\u043d\u0438\u043d-\u0430\u043d\u0433\u0438\u043e\u0442\u0435\u043d\u0437\u0438\u043d\u043e\u0432\u0430\u044f \u0441\u0438\u0441\u0442\u0435\u043c\u0430 \u0441\u043e\u0434\u0435\u0440\u0436\u0438\u0442 \u043e\u0434\u0438\u043d \u0430\u043a\u0442\u0438\u0432\u043d\u044b\u0439 \u043f\u0435\u043f\u0442\u0438\u0434 \u2014 \u0430\u043d\u0433\u0438\u043e\u0442\u0435\u043d\u0437\u0438\u043d II \u0438 \u0434\u0432\u0430 \u0441\u043f\u0435\u0446\u0438\u0444\u0438\u0447\u0435\u0441\u043a\u0438\u0445 \u0440\u0435\u0446\u0435\u043f\u0442\u043e\u0440\u0430 (\u0410\u04221 \u0438 \u0410\u04222), \u0430\u043a\u0442\u0438\u0432\u0430\u0446\u0438\u044f \u043a\u043e\u0442\u043e\u0440\u044b\u0445 \u0434\u0430\u0435\u0442 \u043f\u0440\u043e\u0442\u0438\u0432\u043e\u0440\u0435\u0447\u0438\u0432\u044b\u0435 \u044d\u0444\u0444\u0435\u043a\u0442\u044b. \u0412 \u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u0435 \u0441\u043d\u0438\u0436\u0435\u043d\u0438\u044f \u0430\u0440\u0442\u0435\u0440\u0438\u0430\u043b\u044c\u043d\u043e\u0433\u043e \u0434\u0430\u0432\u043b\u0435\u043d\u0438\u044f \u0443\u043c\u0435\u043d\u044c\u0448\u0430\u0435\u0442\u0441\u044f \u043a\u0440\u043e\u0432\u043e\u0441\u043d\u0430\u0431\u0436\u0435\u043d\u0438\u0435 \u044e\u043a\u0441\u0442\u0430\u0433\u043b\u043e\u043c\u0435\u0440\u0443\u043b\u044f\u0440\u043d\u043e\u0433\u043e \u0430\u043f\u043f\u0430\u0440\u0430\u0442\u0430 (\u0432 \u043f\u043e\u0447\u043a\u0430\u0445), \u0447\u0442\u043e \u0441\u043e\u043f\u0440\u043e\u0432\u043e\u0436\u0434\u0430\u0435\u0442\u0441\u044f \u0432\u044b\u0431\u0440\u043e\u0441\u043e\u043c \u0440\u0435\u043d\u0438\u043d\u0430 \u0432 \u043a\u0440\u043e\u0432\u043e\u043e\u0431\u0440\u0430\u0449\u0435\u043d\u0438\u0435.<\/p>\n<p>\u0420\u0435\u043d\u0438\u043d \u0434\u0435\u0439\u0441\u0442\u0432\u0443\u0435\u0442 \u043d\u0430 \u0430\u043d\u0433\u0438\u043e\u0442\u0435\u043d\u0437\u0438\u043d\u043e\u0433\u0435\u043d \u0438 \u043f\u0440\u0435\u0432\u0440\u0430\u0449\u0430\u0435\u0442 \u0435\u0433\u043e \u0432 \u0430\u043d\u0433\u0438\u043e\u0442\u0435\u043d\u0437\u0438\u043d I (ANG-1). \u041f\u043e\u0441\u0440\u0435\u0434\u0441\u0442\u0432\u043e\u043c \u0430\u043d\u0433\u0438\u043e\u0442\u0435\u043d\u0437\u0438\u043d\u043f\u0440\u0435\u0432\u0440\u0430\u0449\u0430\u044e\u0449\u0435\u0433\u043e \u0444\u0435\u0440\u043c\u0435\u043d\u0442\u0430 \u0430\u043d\u0433\u0438\u043e\u0442\u0435\u043d\u0437\u0438\u043d I \u043f\u0440\u0435\u0432\u0440\u0430\u0449\u0430\u0435\u0442\u0441\u044f \u0432 \u0430\u043d\u0433\u0438\u043e\u0442\u0435\u043d\u0437\u0438\u043d II (\u044d\u0442\u043e\u0442 \u0444\u0435\u0440\u043c\u0435\u043d\u0442 \u043e\u0441\u043e\u0431\u0435\u043d\u043d\u043e \u0430\u043a\u0442\u0438\u0432\u0435\u043d \u0432 \u043b\u0435\u0433\u043e\u0447\u043d\u044b\u0445 \u043a\u0430\u043f\u0438\u043b\u043b\u044f\u0440\u0430\u0445). \u0420\u0435\u043d\u0438\u043d-\u0430\u043d\u0433\u0438\u043e\u0442\u0435\u043d\u0437\u0438\u043d\u043e\u0432\u0430\u044f \u0441\u0438\u0441\u0442\u0435\u043c\u0430 \u043e\u043a\u0430\u0437\u044b\u0432\u0430\u0435\u0442 \u043d\u0435\u043f\u043e\u0441\u0440\u0435\u0434\u0441\u0442\u0432\u0435\u043d\u043d\u043e\u0435 \u0432\u043b\u0438\u044f\u043d\u0438\u0435 \u043d\u0430 \u0433\u043b\u0430\u0434\u043a\u0443\u044e \u043c\u0443\u0441\u043a\u0443\u043b\u0430\u0442\u0443\u0440\u0443 \u0441\u043e\u0441\u0443\u0434\u043e\u0432 \u0438 \u043e\u0431\u0435\u0441\u043f\u0435\u0447\u0438\u0432\u0430\u0435\u0442 \u043f\u043e\u0434\u0434\u0435\u0440\u0436\u0430\u043d\u0438\u0435 \u0442\u043e\u043d\u0443\u0441\u0430 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