{"id":9203,"date":"2020-04-23T03:31:14","date_gmt":"2020-04-23T00:31:14","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/cortizol-liber-urinar\/"},"modified":"2025-07-01T07:57:22","modified_gmt":"2025-07-01T04:57:22","slug":"cortizol-liber-urinar","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/cortizol-liber-urinar\/","title":{"rendered":"\u0421\u0432\u043e\u0431\u043e\u0434\u043d\u044b\u0439 \u043a\u043e\u0440\u0442\u0438\u0437\u043e\u043b \u0432 \u043c\u043e\u0447\u0435"},"content":{"rendered":"

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

Determinarea cortizolului \u00een urina din 24 ore reprezint\u0103 metoda de elec\u0163ie pentru diagnosticul sindromului Cushing, deoarece rata excre\u0163iei urinare a cortizolului nu este influen\u0163at\u0103 de varia\u0163iile diurne ale secre\u0163iei acestui hormon corticosuprarenalian. Testul permite o diferen\u0163iere mai exact\u0103 a indivizilor s\u0103n\u0103to\u015fi de cei cu sindrom Cushing3<\/sup>.<\/p>\n

Cortizolul urinar reflect\u0103 cantitatea de cortizol liber seric filtrat\u0103 la nivel renal \u015fi se coreleaz\u0103 cu rata de secre\u0163ie a cortizolului2<\/sup>.<\/p>\n

De obicei exist\u0103 o rela\u0163ie direct propor\u0163ional\u0103 \u00eentre cortizolul liber urinar \u015fi por\u0163iunea nelegat\u0103, activ\u0103 biologic a cortizolului seric3<\/sup>.<\/p>\n

Recomand\u0103ri pentru determinarea cortizolului urinar <\/em><\/strong>\u2013 evaluarea func\u0163iei corticosuprarenalei (\u00een special a hipercorticismului); investigarea pacien\u0163ilor obezi sau hipertensivi ce prezint\u0103 intoleran\u0163\u0103 la glucoz\u0103, hirsutism, vergeturi, dureri lombare sau tulbur\u0103ri ale ciclului menstrual2<\/sup>.<\/p>\n

Preg\u0103tire pacient <\/em><\/strong>\u2013 se va evita stres-ul pe toat\u0103 durata recolt\u0103rii probei1<\/sup>.<\/p>\n

Specimen recoltat <\/em><\/strong>\u2013 urina din 24 ore; la ora 7 diminea\u0163a pacientul urineaz\u0103 \u015fi nu re\u0163ine aceast\u0103 urin\u0103; apoi colecteaz\u0103 \u00eentr-un vas curat de 2-3 litri toate\u00a0 emisiile de urin\u0103 p\u00e2n\u0103 la ora 7 diminea\u0163a\u00a0\u00een ziua urm\u0103toare, inclusiv; omogenizeaz\u0103 (prin agitare) urina recoltat\u0103; m\u0103soar\u0103 \u00eentreaga cantitate; re\u0163ine aprox. 10 mL \u00eentr-un pahar de plastic de unic\u0103 folosin\u0163\u0103 pentru urin\u0103. Proba se p\u0103streaz\u0103 la 2-8\u00b0C\u00a0\u00een timpul colect\u0103rii \u015fi ulterior, p\u00e2n\u0103 se lucreaz\u0103 efectiv1<\/sup>.<\/p>\n

Cauze de respingere a probei <\/em><\/strong>\u2013 specimen care nu a fost p\u0103strat\u00a0 la 2-8\u00b0C; utilizarea de substan\u0163e conservante (produc interferen\u0163e)1<\/sup>.<\/p>\n

Recipient de recoltare <\/em><\/strong>\u2013 vas de 2-3 litri \u015fi pahar de plastic de unic\u0103 folosin\u0163\u0103 pentru urin\u0103, pe care se noteaz\u0103 cantitatea total\u0103 de urin\u0103 din 24 de ore1<\/sup>.<\/p>\n

Cantitate recoltat\u0103 <\/em><\/strong>\u2013 aprox. 10 mL1<\/sup>.<\/p>\n

Prelucrare necesar\u0103 dup\u0103 recoltare <\/em><\/strong>\u2013 se lucreaz\u0103 \u00een aceea\u015fi zi; dac\u0103 acest lucru nu este posibil, urina se poate stoca la 2-8\u00b0C sau la -20\u00b0C1<\/sup>.<\/p>\n

Stabilitate prob\u0103 <\/em><\/strong>\u2013 urina este stabil\u0103 7 zile<\/em> la 2-8\u00b0C si 3 luni<\/em> la -20\u00b0C1<\/sup>.<\/p>\n

Metod\u0103 <\/em><\/strong>- imunochimic\u0103 cu detec\u0163ie prin electrochemiluminiscen\u0163\u0103 (ECLIA)<\/span>1<\/sup>.<\/p>\n

Valori de referin\u0163\u0103<\/strong><\/em> \u2013 sunt dependente de v\u00e2rst\u0103:<\/p>\n

1-10 ani: 55-745 nmol\/24h.
\n10-20 ani: 138-1517 nmol\/24h
\n> 20 ani: 100-379 nmol\/24h (36-137 \u03bcg\/24h)<\/p>\n

Factori de conversie: nmol\/L x 0.3625 = \u03bcg\/L; \u03bcg\/L x 2.7586 = nmol\/L1.<\/p>\n

Limita de detec\u0163ie<\/em><\/strong> \u2013 0.5 nmol\/L (0.018 \u03bcg\/dL)1<\/sup>.<\/p>\n

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

Ob\u0163inerea unei valori crescute a cortizolului liber urinar la un pacient care a recoltat adecvat proba de urin\u0103 este suficient\u0103 pentru diagnosticul sindromului Cushing; un rezultat normal exclude cu mare probabilitate acest diagnostic2<\/sup>.<\/p>\n

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

Ob\u0163inerea unor valori sc\u0103zute nu indic\u0103 neap\u0103rat insuficien\u0163a corticosuprarenalian\u0103.<\/div>\n
Sarcina \u015fi administrarea contraceptivelor orale se asociaz\u0103 cu valori crescute ale excre\u0163iei de cortizol2<\/sup>.<\/div>\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. Laboratory Corporation of America. Directory of Services and Interpretive Guide. Cortisol, Urinary Free. www.labcorp.com 2010. Ref Type: Internet Communication.<\/span><\/div>\n
3. Myiachi Y. Pathophysiology and Diagnosis of Cushing Syndrome. In Biomed Pharmacoter, 2000, 54:113-117. Ref Type: Journal (Full).<\/span><\/div>","protected":false},"excerpt":{"rendered":"

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