{"id":9224,"date":"2020-04-23T04:31:51","date_gmt":"2020-04-23T01:31:51","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/electroforeza-proteinelor-serice\/"},"modified":"2025-07-01T07:56:38","modified_gmt":"2025-07-01T04:56:38","slug":"electroforeza-proteinelor-serice","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/electroforeza-proteinelor-serice\/","title":{"rendered":"\u042d\u043b\u0435\u043a\u0442\u0440\u043e\u0444\u043e\u0440\u0435\u0437 \u0431\u0435\u043b\u043a\u043e\u0432\u00a0\u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0438\u00a0\u043a\u0440\u043e\u0432\u0438"},"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>Proteinele serice indeplinesc functii variate in organism:<\/p>\n<p style=\"padding-left: 30px;\">\u2022 sursa de nutritie;<\/p>\n<p style=\"padding-left: 30px;\">\u2022 componente ale sistemelor tampon;<\/p>\n<p style=\"padding-left: 30px;\">\u2022 agenti imunologici (imunoglobulinele);<\/p>\n<p style=\"padding-left: 30px;\">\u2022 rol de carrier, asigurand transportul anumitor ioni si molecule (haptoglobina, prealbumina, transferina);<\/p>\n<p style=\"padding-left: 30px;\">\u2022 rol de reglare a activitatii diverselor enzime proteolitice (antiproteaze: alfa1-antitripsina, alfa2-macroglobulina);<\/p>\n<p style=\"padding-left: 30px;\">\u2022 rol in reglarea presiunii oncotice<sup>2<\/sup>.<\/p>\n<p>Metoda curenta pentru separarea proteinelor serice utilizata in laboratoarele de biochimie medicala este electroforeza. Se utilizeaza suporturi solide si pH alcalin, la care toate componentele proteice sunt incarcate negativ si migreaza spre polul pozitiv. Pe electroforegrama, dupa colorare, proteinele apar sub forma de benzi carora li se masoara densitatea optica, fiecare banda avand un maxim de absorbtie. Prin electroforeza, in conditiile amintite mai sus, se obtin cinci fractiuni: albumina serica, a<sub>1<\/sub>, a<sub>2<\/sub>, b, g \u2013 globuline<sup>3<\/sup>. Unele sisteme de electroforeza pot diferentia zona b in doua benzi distincte b<sub>1<\/sub> si b<sub>2<\/sub> rezultand astfel 6 fractiuni proteice in total.<\/p>\n<p>Albumina, a<sub>1<\/sub> si b apar sub forma unor benzi omogene, bine definite. a<sub>2<\/sub>, si g\u00a0 apar ca benzi difuze, iar fractiunea g prezinta in partea sa centrala o zona mai intens colorata<sup>2<\/sup>.<\/p>\n<p><strong><em>Recomandari pentru efectuarea electroforezei proteinelor serice <\/em><\/strong>\u2013 detectarea gamapatiilor\u00a0 monoclonale; evaluarea proteinelor serice si a statusului nutritional<sup>3<\/sup>.<\/p>\n<p><strong><em>Pregatire pacient <\/em><\/strong>\u2013 \u00e0 jeun (pe nemancate) sau postprandial<sup>1<\/sup>.<\/p>\n<p><strong><em>Specimen recoltat<\/em><\/strong> \u2013 sange<sup>1<\/sup>.<\/p>\n<p><strong><em>Recipient de recoltare<\/em><\/strong> \u2013 vacutainer fara anticoagulant cu\/fara gel separator<sup>1<\/sup>.<\/p>\n<p><strong><em>Prelucrare necesara dupa recoltare <\/em><\/strong>\u2013 se separa serul prin centrifugare<sup>1<\/sup>.<\/p>\n<p><strong><em>Volum proba<\/em><\/strong> \u2013 minim 0.5 mL ser<sup>1<\/sup>.<\/p>\n<p><strong><em>Cauze de respingere a probei <\/em><\/strong>\u2013 ser hemolizat<sup>1<\/sup>.<\/p>\n<p><strong><em>Stabilitate proba <\/em><\/strong><em>-<\/em> serul separat este stabil <em>4 zile<\/em> la temperatura camerei sau <em>o saptamana<\/em>\u00a0 la \u00a02-8\u00b0C<sup>1<\/sup>.<\/p>\n<p><strong><em>Metoda <\/em><\/strong>- <span style=\"text-decoration: underline;\">electroforetica<\/span> (in gel agar) urmata de scanarea densitometrica a fractiunilor obtinute<sup>1<\/sup>.<\/p>\n<p><strong><em>Valori de referinta <\/em><\/strong>\u2013 sunt dependente de varsta<sup>2<\/sup><\/p>\n<table class=\"wp-block-table w-100\" border=\"1\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"74\">\n<p style=\"text-align: center;\"><strong><em>Varsta<\/em><\/strong><\/p>\n<\/td>\n<td valign=\"top\" width=\"116\">\n<p style=\"text-align: center;\"><strong><em>Albumina (%)<\/em><\/strong><\/p>\n<\/td>\n<td valign=\"top\" width=\"90\">\n<p style=\"text-align: center;\"><strong><em>a<\/em><\/strong><strong><em><sub>1<\/sub><\/em><\/strong><strong><em>(%)<\/em><\/strong><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><strong><em>a<\/em><\/strong><strong><em><sub>2<\/sub><\/em><\/strong><strong><em>(%)<\/em><\/strong><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><strong><em>b<\/em><\/strong><strong><em>(%)<\/em><\/strong><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><strong><em>g<\/em><\/strong><strong><em>(%)<\/em><\/strong><\/p>\n<\/td>\n<td valign=\"top\" width=\"97\">\n<p style=\"text-align: center;\"><strong><em>A\/G<\/em><\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"74\">\n<p style=\"text-align: center;\">&lt; 1 an<\/p>\n<\/td>\n<td valign=\"top\" width=\"116\">\n<p style=\"text-align: center;\">40-65<\/p>\n<\/td>\n<td valign=\"top\" width=\"90\">\n<p style=\"text-align: center;\">2-5<\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\">6.6-13.5<\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\">8.5-14<\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\">10-21<\/p>\n<\/td>\n<td valign=\"top\" width=\"97\">\n<p style=\"text-align: center;\">1.16-2.23<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"74\">\n<p style=\"text-align: center;\">1 \u2013 16 ani<\/p>\n<\/td>\n<td valign=\"top\" width=\"116\">\n<p style=\"text-align: center;\">50-65<\/p>\n<\/td>\n<td valign=\"top\" width=\"90\">\n<p style=\"text-align: center;\">2-5<\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\">6-15<\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\">8.5-15<\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\">10-22<\/p>\n<\/td>\n<td valign=\"top\" width=\"97\">\n<p style=\"text-align: center;\">1.06-2.48<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"74\">\n<p style=\"text-align: center;\">&gt; 16 ani<\/p>\n<\/td>\n<td valign=\"top\" width=\"116\">\n<p style=\"text-align: center;\">52 \u2013 68<\/p>\n<\/td>\n<td valign=\"top\" width=\"90\">\n<p style=\"text-align: center;\">2-5<\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\">6,6-13,5<\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\">8,5 -14<\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\">11 \u2013 21<\/p>\n<\/td>\n<td valign=\"top\" width=\"97\">\n<p style=\"text-align: center;\">1.39-2.23<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>In cazul sistemului care separa 6 fractiuni se utilizeaza urmatoarele valori de referinta:<\/p>\n<p style=\"padding-left: 30px;\">Albumina:\u00a052-65.1%<\/p>\n<p style=\"padding-left: 30px;\">a<sub>1<\/sub> globuline: 1-3%<\/p>\n<p style=\"padding-left: 30px;\">a<sub>2<\/sub> globuline:\u00a0 9.5-14.4%<\/p>\n<p style=\"padding-left: 30px;\">b<sub>1 \u00a0<\/sub>globuline:\u00a0 6-9.8%<\/p>\n<p style=\"padding-left: 30px;\">b<sub>2 \u00a0<\/sub>globuline:\u00a0 2.6-5.8%<\/p>\n<p style=\"padding-left: 30px;\">g \u00a0\u00a0globuline:\u00a0 10.7-20.3%<sup>2<\/sup>.<\/p>\n<p><strong><em>Interpretarea rezultatelor<\/em><\/strong><sup>3<\/sup><\/p>\n<p>Pentru a facilita interpretarea rezultatelor va fi descrisa fiecare din cele 5 fractiuni cu proteinele componente:<em> (vezi figura 8.1.2)<\/em><sup>2<\/sup><\/p>\n<p><sup><a class=\"cboxElement\" title=\"\u042d\u043b\u0435\u043a\u0442\u0440\u043e\u0444\u043e\u0440\u0435\u0437 \u0431\u0435\u043b\u043a\u043e\u0432\u00a0\u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0438\u00a0\u043a\u0440\u043e\u0432\u0438\" href=\"https:\/\/www.synevo.md\/wp-content\/uploads\/2009\/08\/proteine-serice1.bmp\" rel=\"wpdevart_lightbox lightbox[2617] nofollow noopener\" data-rel=\"lightbox-gallery-FxXJHxJv\" data-rl_title=\"\" data-rl_caption=\"\" target=\"_blank\"><img decoding=\"async\" class=\"aligncenter wp-image-6842 size-full\" title=\"proteine serice\" src=\"\/wp-content\/uploads\/2009\/08\/proteine-serice1.bmp\" alt=\"proteine serice\" width=\"325\" height=\"259\" \/><\/a><\/sup><\/p>\n<p><sup><a title=\"\" href=\"\/wp-content\/uploads\/2009\/08\/proteine-serice1.bmp\" rel=\"wpdevart_lightbox lightbox-gallery-5ElXx6PX\" data-=\"\" data-rl_title=\"\" data-rl_caption=\"\"><img decoding=\"async\" class=\"size-full wp-image-6842 aligncenter\" title=\"proteine serice\" src=\"\/wp-content\/uploads\/2009\/08\/proteine-serice1.bmp\" alt=\"-\"><\/a><\/sup><\/p>\n<p><sup>\u00a0<\/sup><strong><em>\u00a0<\/em><\/strong>Fig.8.1.2<\/p>\n<p><span style=\"text-decoration: underline;\">\u00a0Albumina<\/span><\/p>\n<p>Scaderea albuminei serice (hipoalbuminemie) survine in stari patologice variate si are semnificatii diferite (malnutritie, malabsorbtie, sindrom nefrotic, neoplazii). Cresteri ale albuminei apar in urma deshidratarilor. In cazuri speciale, in zona de migrare a albuminei se constata o banda suplimentara, datorata unor variatii genetice fara relevanta clinica (aloalbuminemie si bisalbuminemie).<\/p>\n<p><span style=\"text-decoration: underline;\">Zona <\/span><span style=\"text-decoration: underline;\">a<\/span><span style=\"text-decoration: underline;\"><sub>1<\/sub><\/span> \u00a0reflecta in special concentratia serica de alfa1-antitripsina, astfel ca reducerea acestei fractiuni se intalneste in deficitul de alfa1-antitripsina asociat cu anumite boli pulmonare (emfizem cu debut precoce) si hepatice (hepatita neonatala). Cresteri se inregistreaza in toate reactiile inflamatorii (\u201ereactant de faza acuta\u201d). In cazuri rare, obtinerea unei benzi suplimentare largi in aceasta zona poate sugera prezenta alfa-fetoproteinei.<\/p>\n<p><span style=\"text-decoration: underline;\">Zona <\/span><span style=\"text-decoration: underline;\">a<\/span><span style=\"text-decoration: underline;\"><sub>2<\/sub><\/span><sub>\u00a0\u00a0\u00a0 <\/sub>este constituita din 2 componente proteice: alfa2 macroglobulina si haptoglobina.<\/p>\n<p>Crestere de a<sub>2<\/sub> apare in infectii acute, reumatism articular acut, arterita, sindrom nefrotic, diabet zaharat, neoplazii; scaderea acestei fractiuni se poate intalni in pancreatite acute severe, leziuni hepatocelulare, sindroame de coagulare intravasculara diseminata, anemii hemolitice, anemii megaloblastice.<\/p>\n<p><span style=\"text-decoration: underline;\">Zona <\/span><span style=\"text-decoration: underline;\">b<\/span>\u00a0 este alcatuita din 2 benzi distincte: b<sub>1<\/sub> corespunzatoare transferinei si b<sub>2<\/sub> care include fractiunile complementului C<sub>3<\/sub> si C<sub>4<\/sub>. Al treilea component al acestei zone este beta-lipoproteina, a carei banda se poate suprapune pe cea a transferinei sau C<sub>3<\/sub> sau poate fi situata in zona beta-gamma.<\/p>\n<p>Nivelul seric de b globuline creste in anemia feripriva si ciroza biliara si scade in boli autoimune aflate in puseu activ (LES), nefroza, afectiuni hepatice, neoplazii, infectii acute si cronice. In unele cazuri de mielom multiplu de tip IgA se poate constata prezenta unui component monoclonal in aceasta zona.<\/p>\n<p><span style=\"text-decoration: underline;\">Zona <\/span><span style=\"text-decoration: underline;\">g<\/span>\u00a0 Gamma-globulinele sunt globulinele cele mai importante. Din aceasta categorie fac parte imunoglobulinele (IgG, IgA, IgM, IgD si IgE). Anomaliile suferite de acestea se traduc fie prin diverse deficite, fie prin hipergamaglobulinemii policlonale sau monoclonale.<\/p>\n<p>Procentul de g globuline scade in agamaglobulinemie, hipogamaglobulinemii si sindroame nefrotice. Hipogamaglobulinemia poate fi congenitala sau dobandita si poate fi usor detectata la electroforeza proteinelor serice atunci cand concentratiile principalelor 3 clase de imunoglobuline sunt scazute (IgG, IgA si IgM). Prezenta hipogamaglobulinemiei la adult impune continuarea investigatiilor in vederea depistarii unei posibile boli limfoproliferative (mielom cu lanturi usoare, leucemie limfatica cronica, limfoame).<\/p>\n<p>Cresterile policlonale de gamaglobuline indica un proces imunologic cronic asociat cu afectiuni hepatice (hepatita cronica activa, ciroza), boli de colagen (LES, poliartrita reumatoida), neoplazii (ex. boala Hodgkin), leucemie mielo-monocitara cronica. In aceste cazuri, hipergamaglobulinemia se datoreaza activarii unui numar mare de clone plasmocitare care elibereaza imunoglobuline. Trebuie mentionat aspectul caracteristic cirozei alcoolice de \u201epunte\u201d beta-gama, vizualizat pe gel ca o zona intens colorata intre zonele beta si gamma.<\/p>\n<p>Uneori, in zona gamma se pot observa cateva benzi mici, inguste, denumite oligoclonale, intalnite la pacienti cu hepatita,\u00a0 boli ale complexelor imune, sindromul imunodeficientei dobandite, limfomul angioimunoblastic.<\/p>\n<p>Gamapatiile monoclonale includ un numar mare de conditii clinice si biologice asociate de obicei cu afectiuni maligne (mielom multiplu, boala Waldenstr\u00f6m, amiloidoza, limfoame) dar si cu unele afectiuni benigne sau chiar cu absenta unei modificari patologice (gamapatii monoclonale cu semnificatie nedeterminata). In aceste cazuri, se depisteaza la electroforeza proteinelor un component monoclonal (banda M), rezultat ca urmare a proliferararii unei singure clone plasmocitare. Pe gel, componentele monoclonale apar sub forma unor benzi inguste, net definite, iar dupa scanarea densitometrica, se obtin \u201evarfuri\u201d (peak-uri) caracteristice, ce pot fi intalnite oriunde intre zonele alfa si gamma, datorita mobilitatii electroforetice variabile, cel mai frecvent insa in zona gamma.<\/p>\n<p>Imunoglobulinele monoclonale sunt omogene din punct de vedere structural si biochimic, fiind alcatuite dintr-un singur tip de lant usor (kappa sau lambda). In circulatie pot fi eliberate imunoglobuline complete sau numai subunitati ale acestora (ex. lanturi usoare monoclonale, denumite proteine Bence-Jones). Prezenta componentului monoclonal va fi precizata pe buletinul final de analize al pacientului, cu recomandarea de a se efectua electroforeza proteinelor serice cu imunofixare<sup>1-3<\/sup>.<\/p>\n<p>In tabelul de mai jos sunt sintetizate informatiile prezentate:<\/p>\n<table class=\"wp-block-table w-100\" border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"center\">\n<tbody>\n<tr>\n<td colspan=\"6\" valign=\"top\" width=\"583\">\n<p style=\"text-align: center;\"><strong>Zone electroforetice<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><strong><em>Descriere aspect<\/em><\/strong><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">\n<p style=\"text-align: center;\"><strong><em>Albumina %<\/em><\/strong><\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\"><strong><em>Alfa \u2013 1<\/em><\/strong><\/p>\n<p style=\"text-align: center;\"><strong><em>%<\/em><\/strong><\/p>\n<\/td>\n<td valign=\"top\" width=\"60\">\n<p style=\"text-align: center;\"><strong><em>Alfa \u2013 2<\/em><\/strong><\/p>\n<p style=\"text-align: center;\"><strong><em>%<\/em><\/strong><\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\"><strong><em>Beta<\/em><\/strong><\/p>\n<p style=\"text-align: center;\"><strong><em>%<\/em><\/strong><\/p>\n<\/td>\n<td valign=\"top\" width=\"89\">\n<p style=\"text-align: center;\"><strong><em>Gamma<\/em><\/strong><\/p>\n<p style=\"text-align: center;\"><strong><em>%<\/em><\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><em>Normal<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"60\">\u041d<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"89\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><em>Enteropatie cu pierdere de proteine<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">\n<p style=\"text-align: center;\">-<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">N+<\/p>\n<\/td>\n<td valign=\"top\" width=\"60\">\n<p style=\"text-align: center;\">N+<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u00a0N-<\/p>\n<\/td>\n<td valign=\"top\" width=\"89\">\n<p style=\"text-align: center;\">-N+<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><em>Sindrom nefrotic<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">\n<p style=\"text-align: center;\">-<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"60\">\n<p style=\"text-align: center;\">+++<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"89\">\n<p style=\"text-align: center;\">N-<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><em>Hipogamaglobulinemie<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">\n<p style=\"text-align: center;\">N-<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"60\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"89\">\n<p style=\"text-align: center;\">-<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><em>Agamaglobulinemie<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">\n<p style=\"text-align: center;\">N-<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"60\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"89\">\n<p style=\"text-align: center;\">Absenta<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><em>Gamopatie policlonala<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">\n<p style=\"text-align: center;\">N-<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"60\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"89\">\n<p style=\"text-align: center;\">+<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><em>Raspuns inflamator cronic<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">\n<p style=\"text-align: center;\">N-<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">N+<\/p>\n<\/td>\n<td valign=\"top\" width=\"60\">\n<p style=\"text-align: center;\">+<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"89\">\n<p style=\"text-align: center;\">+<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><em>Raspuns inflamator acut<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">\n<p style=\"text-align: center;\">N-<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">+<\/p>\n<\/td>\n<td valign=\"top\" width=\"60\">\n<p style=\"text-align: center;\">+<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"89\">\n<p style=\"text-align: center;\">N-<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><em>Raspuns inflamator subacut<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">\n<p style=\"text-align: center;\">N-<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"60\">\n<p style=\"text-align: center;\">+<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"89\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><em>Ciroza hepatica<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">\n<p style=\"text-align: center;\">-<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"60\">\n<p style=\"text-align: center;\">N-<\/p>\n<\/td>\n<td colspan=\"2\" valign=\"top\" width=\"156\">\n<p style=\"text-align: center;\">\u201ePunte\u201d beta-gamma<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><em>Hipoalfa-1 globulinemie<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">-<\/p>\n<\/td>\n<td valign=\"top\" width=\"60\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"89\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><em>Gamopatie monoclonala (tip \u03b3)<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">\n<p style=\"text-align: center;\">N-<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"60\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"89\">\n<p style=\"text-align: center;\">Banda M<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><em>Gamopatie monoclonala (tip \u03b2)<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">\n<p style=\"text-align: center;\">N-<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"60\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">Banda M<\/p>\n<\/td>\n<td valign=\"top\" width=\"89\">\n<p style=\"text-align: center;\">N-<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><em>Gamopatie biclonala<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">\n<p style=\"text-align: center;\">N-<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"60\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">Banda M<\/p>\n<\/td>\n<td valign=\"top\" width=\"89\">\n<p style=\"text-align: center;\">Banda M<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><em>Benzi oliglonale <\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">\n<p style=\"text-align: center;\">N-<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">N+<\/p>\n<\/td>\n<td valign=\"top\" width=\"60\">\n<p style=\"text-align: center;\">N+<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"89\">\n<p style=\"text-align: center;\">Benzi oligl.<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><em>Bisalbuminemie<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">\n<p style=\"text-align: center;\">Varf dublu<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\"><\/td>\n<td colspan=\"3\" valign=\"top\" width=\"216\"><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"222\">\n<p style=\"text-align: center;\"><em>Hipoalbuminemie<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"78\">-<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"60\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"67\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<td valign=\"top\" width=\"89\">\n<p style=\"text-align: center;\">\u041d<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><em>\u00a0Legenda <\/em><\/p>\n<table class=\"wp-block-table w-100\" border=\"1\" width=\"588\" cellspacing=\"0\" cellpadding=\"0\" align=\"center\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"171\">\n<p style=\"text-align: center;\"><strong><em>\u041d<\/em><\/strong><em> = nivel normal<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"180\"><strong>+<\/strong><em> =nivel crescut<\/em><\/td>\n<td valign=\"top\" width=\"237\">\n<p style=\"text-align: center;\">-<em> =nivel scazut<\/em><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"171\">\n<p style=\"text-align: center;\"><strong><em>N+<\/em><\/strong><em> =nivel normal\/crescut<\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"180\">\n<p style=\"text-align: center;\"><strong><em>N-<\/em><\/strong><em> =nivel normal\/scazut\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/em><\/p>\n<\/td>\n<td valign=\"top\" width=\"237\">\n<p style=\"text-align: center;\"><strong><em>-N+<\/em><\/strong><em> =nivel scazut\/normal\/crescut <\/em><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong><em>\u00a0<\/em><\/strong><strong><em>Limite si interferente<\/em><\/strong><\/p>\n<p>\u2022 Variatii fiziologice: in sarcina scade albumina si cresc alfa2, beta- si gamaglobulinele (IgG); valori mai scazute ale gamaglobulinelor pot fi intalnite la varstnici<sup>3<\/sup>.<\/p>\n<p>\u2022 Medicamente<\/p>\n<p style=\"padding-left: 30px;\"><span style=\"text-decoration: underline;\">Albumina<\/span> (scaderi): acid valproic, allopurinol, asparaginaza, azatioprina, clorpropamid, cisplatin, contraceptive orale, dapsona, dextran, estrogeni, fenitoin, ibuprofen, izoniazida, nitrofurantoin, prednison (doze mari), sargramostim.<\/p>\n<p style=\"padding-left: 30px;\"><span style=\"text-decoration: underline;\">Alfa1-globuline<\/span> (cresteri): testosteron.<\/p>\n<p style=\"padding-left: 30px;\"><span style=\"text-decoration: underline;\">Alfa2-globuline<\/span>: estrogeni, contraceptive orale, fenitoin (cresteri), asparaginaza (scaderi).<\/p>\n<p style=\"padding-left: 30px;\"><span style=\"text-decoration: underline;\">Beta-globuline<\/span>:\u00a0 estrogeni, contraceptive orale (cresteri);\u00a0 asparaginaza (scaderi).<\/p>\n<p style=\"padding-left: 30px;\"><span style=\"text-decoration: underline;\">Gamma-globuline<\/span>: tratament citostatic sau imunosupresor (scaderi)<sup>4<\/sup>.<\/p>\n<p>\u2022 Interferente analitice:<\/p>\n<p style=\"padding-left: 30px;\">-o crestere usoara a largimii benzii de albumina poate fi datorata legarii unor medicamente (penicilina) sau a bilirubinei (pacienti cu icter);<\/p>\n<p style=\"padding-left: 30px;\">-bisalbuminemia tranzitorie (non-ereditara) poate fi intalnita ca rezultat al unui tratament medicamentos sau unei perturbari metabolice severe (ex. pancreatita)<\/p>\n<p style=\"padding-left: 30px;\">-benzi monoclonale false pot fi date de: hemoglobina libera, in cazul unui ser hemolizat sau a unei hemolize intravasculare (banda in zona alfa2 \u2013 beta); proteina C reactiva in cantitate mare; lizozim crescut, fibrinogen (la pacientii tratati cu anticoagulante; in coagulopatii, daca sangele a fost centrifugat inainte de a coagula complet); alfa-fetoproteina in concentratii mari, seruri vechi.<\/p>\n<p style=\"padding-left: 30px;\">-vizualizarea este dificila in cazul in care banda monoclonala se suprapune peste o banda normala (ex. banda monoclonala in zona beta1 va migra in aceeasi pozitie ca si transferina)<sup>2;4<\/sup>.<\/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. Frances Fischbach. Immunodiagnostic Studies. In A Manual of Laboratory and Diagnostic Tests. Lippincott Williams &amp; Wilkins, USA, 7 ed. 2004, 575-578.<\/span><\/p>\n<p><span style=\"font-size: small;\">2. Laborator Synevo. Referintele specifice tehnologiei de lucru utilizate 2010. Ref Type: Catalog<\/span><\/p>\n<p><span style=\"font-size: small;\">3. Laboratory Corporation of America.Directory of Services and Interpretive Guide. Protein Electrophoresis, Serum. www.labcorp.com 2010. Ref Type: Internet Communication<\/span><\/p>\n<p><span style=\"font-size: small;\">4. Norbert Tietz.General Clinical Tests. In Clinical Guide to Laboratory Tests. W.B.SAUNDERS, USA, 3 ed. 1995, 524-526.<\/span><\/p>","protected":false},"excerpt":{"rendered":"<p>\u042d\u043b\u0435\u043a\u0442\u0440\u043e\u0444\u043e\u0440\u0435\u0437 \u0431\u0435\u043b\u043a\u043e\u0432 \u0432 \u0430\u0433\u0430\u0440\u043e\u0437\u043d\u043e\u043c \u0433\u0435\u043b\u0435 \u2013 \u044d\u0442\u043e \u043c\u0435\u0442\u043e\u0434 \u0440\u0430\u0437\u0434\u0435\u043b\u0435\u043d\u0438\u044f \u0431\u0435\u043b\u043a\u043e\u0432\u044b\u0445 \u043c\u043e\u043b\u0435\u043a\u0443\u043b, \u043e\u0441\u043d\u043e\u0432\u0430\u043d\u043d\u044b\u0439 \u043d\u0430 \u0440\u0430\u0437\u043b\u0438\u0447\u043d\u043e\u0439 \u0441\u043a\u043e\u0440\u043e\u0441\u0442\u0438 \u0438\u0445 \u0434\u0432\u0438\u0436\u0435\u043d\u0438\u044f \u0432 \u044d\u043b\u0435\u043a\u0442\u0440\u0438\u0447\u0435\u0441\u043a\u043e\u043c \u043f\u043e\u043b\u0435 \u0432 \u0437\u0430\u0432\u0438\u0441\u0438\u043c\u043e\u0441\u0442\u0438 \u043e\u0442 \u0440\u0430\u0437\u043c\u0435\u0440\u0430, \u0437\u0430\u0440\u044f\u0434\u0430 \u0438 \u0444\u043e\u0440\u043c\u044b. \u041f\u0440\u0438 \u0440\u0430\u0437\u0434\u0435\u043b\u0435\u043d\u0438\u0438 \u043e\u0431\u0449\u0435\u0433\u043e \u0431\u0435\u043b\u043a\u0430 \u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0438 \u043a\u0440\u043e\u0432\u0438 \u0443\u0434\u0430\u0435\u0442\u0441\u044f \u0432\u044b\u044f\u0432\u0438\u0442\u044c 5 \u043e\u0441\u043d\u043e\u0432\u043d\u044b\u0445 \u0444\u0440\u0430\u043a\u0446\u0438\u0439. \u041f\u0440\u0438 \u043f\u0440\u043e\u0432\u0435\u0434\u0435\u043d\u0438\u0438 \u044d\u043b\u0435\u043a\u0442\u0440\u043e\u0444\u043e\u0440\u0435\u0437\u0430 \u0431\u0435\u043b\u043a\u043e\u0432\u044b\u0435 \u0444\u0440\u0430\u043a\u0446\u0438\u0438 \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u044f\u044e\u0442\u0441\u044f \u0432 \u0432\u0438\u0434\u0435 \u043f\u043e\u043b\u043e\u0441 \u0440\u0430\u0437\u043b\u0438\u0447\u043d\u043e\u0439 \u0448\u0438\u0440\u0438\u043d\u044b \u0441 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