{"id":9173,"date":"2020-04-23T04:30:15","date_gmt":"2020-04-23T01:30:15","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/beta-crosslaps\/"},"modified":"2025-07-01T07:57:38","modified_gmt":"2025-07-01T04:57:38","slug":"beta-crosslaps-s-ctx","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/beta-crosslaps-s-ctx\/","title":{"rendered":"\u0411\u0435\u0442\u0430-CrossLaps (\u00df \u2013 CTx)"},"content":{"rendered":"

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

Osteoporoza este definit\u0103 ca o afec\u0163iune evolutiv\u0103 a sistemului osos caracterizat\u0103 prin pierderea de mas\u0103 osoas\u0103 \u015fi prin alter\u0103ri ale microarhitecturii \u0163esutului osos, av\u00e2nd drept consecin\u0163\u0103 cre\u015fterea fragilit\u0103\u0163ii osoase \u015fi a riscului de fracturi.<\/span><\/p>\n

Datorit\u0103 corela\u0163iei bine determinate dintre densitatea mineral\u0103 osoas\u0103 \u015fi riscul de fracturi, pentru monitorizarea tratamentului \u00een osteoporoz\u0103 se recomand\u0103, de obicei, efecturea osteodensitometriei. Cu toate acestea, indiferent de tratamentul utilizat, m\u0103surarea densit\u0103\u0163ii minerale osoase nu este relevant\u0103 pentru evaluarea eficien\u0163ei terapeutice, dec\u00e2t dup\u0103 un an de la \u00eenceputul tratamentului.<\/span><\/p>\n

Exist\u0103 mai multe motive care contribuie la un r\u0103spuns inadecvat la tratament, lipsa complian\u0163ei pacien\u0163ilor situ\u00e2ndu-se probabil pe primul loc. Din acest motiv, ar fi util at\u00e2t pentru medici c\u00e2t \u015fi pentru pacien\u0163i s\u0103 se ob\u0163in\u0103 precoce informa\u0163ii privind eficien\u0163a terapiei \u015fi \u00een acest sens subliniem contribu\u0163ia markerilor oso\u015fi. Dac\u0103 densitometria osoas\u0103 cuantific\u0103 masa osoas\u0103 \u2013 imagine static\u0103 \u2013 determinarea markerilor oso\u015fi furnizeaz\u0103 informa\u0163ii despre procesul de \u201eremodelare\u201d\u00a0osoas\u0103 \u2013 imagine dinamic\u01034<\/sup>.<\/span><\/p>\n

Astfel markerii oso\u015fi pot fi folosi\u0163i \u00een monitorizarea terapiei (inclusiv a complian\u0163ei la tratament) \u015fi pentru estimarea riscului de fracturi cauzate de osteoporoz\u0103. In momentul de fa\u0163\u0103 nu se recomand\u0103 folosirea markerilor oso\u015fi pentru estimarea riscului de pierdere osoas\u0103 spontan\u0103 la pacien\u0163ii netrata\u0163i1<\/sup>;2<\/sup>.<\/span><\/p>\n

Utilitatea markerilor oso\u015fi nu este limitat\u0103\u00a0 numai la evaluarea osteoporozei, ace\u015ftia av\u00e2nd valoare clinic\u0103 \u015fi \u00een alte afec\u0163iuni osoase, cum ar fi: boala Paget a osului, hiperparatiroidism primar \u015fi secundar, osteomalacie \u015fi boli metabolice ale osului3<\/sup>.<\/span><\/p>\n

Mai mult de 90% din matricea organic\u0103 a osului este alcatuit\u0103 din colagenul de tip I, care este sintetizat preferen\u0163ial la acest nivel. In cursul metabolismului osos normal colagenul de tip I matur sufer\u0103 un proces de degradare rezult\u00e2nd mici fragmente ce sunt eliberate \u00een circula\u0163ie \u015fi excretate apoi prin rinichi. In condi\u0163iile unei resorb\u0163ii osoase crescute (fiziologic: v\u00e2rsta \u00eenaintat\u0103, patologic: osteoporoza) colagenul de tip I este degradat \u00eentr-o m\u0103sur\u0103 mai mare, astfel c\u0103 nivelul fragmentelor eliberate \u00een circula\u0163ie este crescut. Printre fragmentele cu relevan\u0163\u0103 clinic\u0103 se num\u0103r\u0103 \u015fi telopeptidele C-terminale (CTx).\u00a0Pe m\u0103sur\u0103 ce osul \u201c\u00eemb\u0103tr\u00e2ne\u015fte\u201d acidul \u03b1-aspartic prezent \u00een telopeptidele C-terminale este convertit \u00een forma \u03b2 (\u03b2 \u2013CTx). Aceste telopeptide izomerizate sunt specifice pentru degradarea colagenului de tip I ce predomin\u0103 la nivelul osului.<\/span><\/p>\n

\u03b2\u2013CTx (Beta-CrossLaps) apare \u00een faza incipient\u0103 a degrad\u0103rii colagenului de tip I; de aceea este un marker specific \u015fi stabil al resorb\u0163iei osoase4<\/sup>;5<\/sup>.<\/span><\/p>\n

Recomand\u0103ri pentru determinarea Beta-CrossLaps <\/em><\/strong>\u2013 osteoporoza: monitorizarea terapiei antiresorbtive (tratament de substitu\u0163ie hormonal\u0103, bifosfona\u0163i, calcitonina, modulatori selectivi ai receptorilor de estrogeni)\u00a0\u015fi estimarea riscului de fracturi (marker de elec\u0163ie)1<\/sup>.<\/span><\/p>\n

Preg\u0103tirea pacientului <\/em><\/strong>\u2013 \u00e0 jeun5<\/sup>.<\/span><\/p>\n

Specimen recoltat <\/em><\/strong>\u2013 s\u00e2nge venos5<\/sup>.<\/span><\/p>\n

Recipient de recoltare <\/em><\/strong>\u2013 vacutainer f\u0103r\u0103 anticoagulant, cu\/f\u0103r\u0103 gel separator5<\/sup>.<\/span><\/p>\n

Prelucrare necesar\u0103 dup\u0103 recoltare <\/em><\/strong>\u2013 se separ\u0103 serul prin centrifugare5<\/sup>.<\/span><\/p>\n

Volum prob\u0103<\/em><\/strong> \u2013 minim 0.5 mL ser5<\/sup>.<\/span><\/p>\n

Cauze de respingere a probei <\/em><\/strong>\u2013 specimen hemolizat5<\/sup>.<\/span><\/p>\n

Stabilitate prob\u0103 <\/em><\/strong>\u2013 serul separat este stabil 24 ore<\/em> la temperatura camerei; 3 luni<\/em> la -20\u00b0C; timp \u00eendelungat<\/em> la -70\u00b0C; se va evita decongelarea\/recongelarea5<\/sup>.<\/span><\/p>\n

Metod\u0103 <\/em><\/strong>- imunochimic\u0103 cu detec\u0163ie prin electrochemiluminiscen\u0163\u0103 (ECLIA);<\/span> testul utilizeaz\u0103 2 anticorpi monoclonali ce recunosc fiecare octapeptidele lineare \u03b2-8AA; astfel testul cuantific\u0103 fragmentele de degradare a colagenului de tip I ce con\u0163in de dou\u0103 ori octapeptidele lineare \u03b2-8AA (\u03b2\u2013CTx)5<\/sup>.<\/span><\/p>\n

Valori de referin\u0163\u0103<\/em><\/strong>5<\/sup>\u00a0<\/em><\/strong><\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n
\n

Sex<\/em><\/strong><\/span><\/p>\n<\/td>\n

\n

Valori<\/em><\/strong>(ng\/mL)<\/em><\/strong><\/span><\/p>\n<\/td>\n<\/tr>\n

\n

B\u0103rba\u0163i<\/em><\/strong><\/span><\/p>\n<\/td>\n<\/tr>\n

\n

30-51 ani<\/span><\/p>\n<\/td>\n

\n

\u2264\u00a0 0.584<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

51-70 ani<\/span><\/p>\n<\/td>\n

\n

\u2264\u00a0 0.704<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

>70 ani<\/span><\/p>\n<\/td>\n

\n

\u2264\u00a0 0.854<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Femei<\/em><\/strong><\/span><\/p>\n<\/td>\n

\u00a0<\/span><\/td>\n<\/tr>\n
\n

premenopauz\u0103<\/span><\/p>\n<\/td>\n

\n

\u2264\u00a0 0.573<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

postmenopauz\u0103<\/span><\/p>\n<\/td>\n

\n

\u2264\u00a0 1.008<\/span><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Factor de conversie: ng\/mL x 0.01 = pg\/mL.<\/em><\/span><\/p>\n

Limita de detec\u0163ie<\/em><\/strong> - <\/em>0.01 ng\/mL (10 pg\/mL)5<\/sup>.\u00a0<\/em><\/span><\/p>\n

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

Frecven\u0163a test\u0103rii la pacien\u0163ii sub tratament antiresorbtiv:<\/span><\/p>\n

\u2022 \u00eenainte de ini\u0163ierea tratamentului (concentra\u0163ia bazal\u0103);<\/span><\/div>\n
\u2022 la 3 luni (reducerea concentra\u0163iei cu minimum 35-55% indic\u0103 succes terapeutic);<\/span><\/div>\n
\u2022 continuarea monitoriz\u0103rii la fiecare 6-12 luni.<\/span><\/div>\n

Estimarea riscului de fracturi osteoporotice: valori crescute cu 2 devia\u0163ii standard fa\u0163\u0103 de valoarea corespunz\u0103toare perioadei de premenopauz\u0103 se asociaz\u0103 cu o cre\u015fterea de dou\u0103 ori\u00a0a riscului de fracturi1<\/sup>.<\/span><\/p>\n

Limite \u015fi interferen\u0163e<\/em><\/strong><\/span><\/p>\n

Interpretarea rezultatelor la pacien\u0163ii cu disfunc\u0163ii renale trebuie efectuat\u0103 cu pruden\u0163\u0103 (se poate produce o diminuare a excre\u0163iei markerului \u015fi o cre\u015ftere \u00een consecin\u0163\u0103 a nivelului seric al\u00a0\u00a0acestuia)5<\/sup>.<\/span><\/p>\n

\u2022 Interferen\u0163e analitice<\/span><\/p>\n

Pot produce interferen\u0163e cu unele componente ale kit-ului \u015fi conduce la rezultate neconcludente urm\u0103<\/span>toarele:<\/span><\/p>\n

\u2013 tratamentul cu biotin\u0103<\/span> \u00een doze mari (>5 mg\/zi); de aceea se recomand\u0103<\/span> ca recoltarea de s\u00e2nge s\u0103<\/span> se\u00a0fac\u0103<\/span> dup\u0103<\/span> minimum 8 ore de la ultima administrare;<\/span><\/div>\n
\u2013 titrurile foarte crescute de anticorpi anti-streptavidina \u015fi anti-ruteniu;<\/span><\/div>\n
\u2013 anticorpii monoclonali proveni\u0163i de la \u015foarece administra\u0163i la unii pacien\u0163i \u00een scop diagnostic sau terapeutic5<\/sup>.<\/span><\/div>\n

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

1. Delmas PD, Eastell R, Garnero P, et.al. The use of biochemical markers of bone turnover in osteoporosis. In Osteoporosis Int. IOF Recommendations, 11 (Suppl 6):S2-S17, 2000. Ref Type: Journal (Full).<\/span><\/div>\n
2. Frances Fischbach. Chemistry Studies. In A Manual of Laboratory and Diagnostic Tests. Lippincott Williams & Wilkins, USA, 8 Ed., 2009, 382-383.<\/span><\/div>\n
3. Hermien W. Goderie-Plomp, Marjolein van der Klift, Willem de Ronde, et.al. Endogenous Sex Hormones, Sex Hormone-Binding Globulin and the Risk of Incident Vertebral Fractures in Elderly Men and Women: The Rotterdam Study. In The Journal of Clinical Endocrinology & Metabolism, 8:3261-3269, 2004. Ref Type: Journal (Full).<\/span><\/div>\n
4. Johnell O, Kanis JA, Od\u00e9n A, et.al. Mortality after osteoporotic fractures. In Osteoporosis Int , 15:38-42, 2004. Ref Type: Journal (Full).<\/span><\/div>\n
5. Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate. 2010. Ref Type: Catalog.<\/span><\/div>","protected":false},"excerpt":{"rendered":"

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  • \u0427\u0442\u043e\u0431\u044b \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0438\u0442\u044c \u0438\u0441\u0445\u043e\u0434\u043d\u0443\u044e \u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u044c \u0440\u0435\u0437\u043e\u0440\u0431\u0446\u0438\u0438 \u043a\u043e\u0441\u0442\u043d\u043e\u0439 \u0442\u043a\u0430\u043d\u0438 \u0434\u043e \u043d\u0430\u0447\u0430\u043b\u0430 \u0442\u0435\u0440\u0430\u043f\u0438\u0438.<\/li>\n
  • \u0414\u043b\u044f \u043c\u043e\u043d\u0438\u0442\u043e\u0440\u0438\u043d\u0433\u0430 \u0442\u0435\u0440\u0430\u043f\u0438\u0438 \u043e\u0441\u0442\u0435\u043e\u043f\u043e\u0440\u043e\u0437\u0430 \u0438 \u043e\u0446\u0435\u043d\u043a\u0438 \u0435\u0435 \u044d\u0444\u0444\u0435\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u0438.<\/li>\n
  • \u0427\u0442\u043e\u0431\u044b \u043a\u043e\u043d\u0442\u0440\u043e\u043b\u0438\u0440\u043e\u0432\u0430\u0442\u044c \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u0435 \u043a\u043e\u0441\u0442\u043d\u043e\u0439 \u0442\u043a\u0430\u043d\u0438 \u0443 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u0432 \u0441 \u043e\u0441\u0442\u0435\u043e\u043f\u043e\u0440\u043e\u0437\u043e\u043c, \u0431\u043e\u043b\u0435\u0437\u043d\u044c\u044e \u041f\u0435\u0434\u0436\u0435\u0442\u0430 \u0438 \u043c\u0435\u0442\u0430\u0441\u0442\u0430\u0437\u0430\u043c\u0438 \u0432 \u043a\u043e\u0441\u0442\u0438.<\/li>\n<\/ul>\n

    \u041a\u043e\u0433\u0434\u0430 \u043d\u0430\u0437\u043d\u0430\u0447\u0430\u0435\u0442\u0441\u044f \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435?<\/strong><\/p>\n

      \n
    • \u041f\u0440\u0438 \u043f\u043b\u0430\u043d\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u0438 \u0442\u0435\u0440\u0430\u043f\u0438\u0438 \u043e\u0441\u0442\u0435\u043e\u043f\u043e\u0440\u043e\u0437\u0430 \u0438 \u0447\u0435\u0440\u0435\u0437 3-6 \u043c\u0435\u0441\u044f\u0446\u0435\u0432 \u043f\u043e\u0441\u043b\u0435 \u043d\u0430\u0447\u0430\u043b\u0430 \u043b\u0435\u0447\u0435\u043d\u0438\u044f.<\/li>\n
    • \u041f\u0440\u0438 \u043e\u0431\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0438 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u0432 \u0441 \u043e\u0441\u0442\u0435\u043e\u043f\u043e\u0440\u043e\u0437\u043e\u043c, \u043c\u0435\u0442\u0430\u0441\u0442\u0430\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u043c \u043f\u043e\u0440\u0430\u0436\u0435\u043d\u0438\u0435\u043c \u043a\u043e\u0441\u0442\u043d\u043e\u0439 \u0442\u043a\u0430\u043d\u0438, \u0431\u043e\u043b\u0435\u0437\u043d\u044c\u044e \u041f\u0435\u0434\u0436\u0435\u0442\u0430.<\/li>\n<\/ul>\n

      \u041a\u0430\u043a \u043f\u0440\u0430\u0432\u0438\u043b\u044c\u043d\u043e \u043f\u043e\u0434\u0433\u043e\u0442\u043e\u0432\u0438\u0442\u044c\u0441\u044f \u043a \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044e?<\/strong><\/p>\n

        \n
      • \u041d\u0435 \u043f\u0440\u0438\u043d\u0438\u043c\u0430\u0442\u044c \u043f\u0438\u0449\u0443 \u0432 \u0442\u0435\u0447\u0435\u043d\u0438\u0435 12 \u0447\u0430\u0441\u043e\u0432 \u0434\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f.<\/li>\n
      • \u0418\u0441\u043a\u043b\u044e\u0447\u0438\u0442\u044c \u0444\u0438\u0437\u0438\u0447\u0435\u0441\u043a\u043e\u0435 \u0438 \u044d\u043c\u043e\u0446\u0438\u043e\u043d\u0430\u043b\u044c\u043d\u043e\u0435 \u043f\u0435\u0440\u0435\u043d\u0430\u043f\u0440\u044f\u0436\u0435\u043d\u0438\u0435 \u0437\u0430 30 \u043c\u0438\u043d\u0443\u0442 \u0434\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f.<\/li>\n
      • \u041d\u0435 \u043a\u0443\u0440\u0438\u0442\u044c \u0432 \u0442\u0435\u0447\u0435\u043d\u0438\u0435 30 \u043c\u0438\u043d\u0443\u0442 \u0434\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f.<\/li>\n<\/ul>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[927],"product_tag":[],"class_list":{"0":"post-9173","1":"product","2":"type-product","3":"status-publish","5":"product_cat-markeri-ososi","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\/9173","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=9173"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=9173"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=9173"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=9173"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=9173"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}