{"id":9429,"date":"2020-04-23T04:37:45","date_gmt":"2020-04-23T01:37:45","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/estriol-neconjugat\/"},"modified":"2025-07-01T07:57:22","modified_gmt":"2025-07-01T04:57:22","slug":"estriol-neconjugat","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/estriol-neconjugat\/","title":{"rendered":"\u0421\u0432\u043e\u0431\u043e\u0434\u043d\u044b\u0439 \u044d\u0441\u0442\u0440\u0438\u043e\u043b(\u041d\u0435\u043a\u043e\u043d\u044a\u044e\u0433\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u044b\u0439)"},"content":{"rendered":"

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

Estriolul (E3) este hormonul estrogen predominant din s\u00e2ngele \u015fi urina femeilor gravide1<\/sup>.<\/p>\n

Cea mai mare parte a estriolului circulant este un produs al unit\u0103\u0163ii feto-placentare, rezult\u00e2nd dintr-un precursor (16-\u03b1-hidroxi-dehidroepiandrosteron) sintetizat \u00een suprarenalele f\u0103tului \u015fi transformat\u00a0\u00een estriol de c\u0103tre ficatul fetal \u015fi placent\u0103. Produc\u0163ia normal\u0103 a acestui hormon reprezint\u0103 un indicator al integrit\u0103\u0163ii unit\u0103\u0163ii feto-placentare \u015fi al st\u0103rii de bine a f\u0103tului1-3<\/sup>.<\/p>\n

Majoritatea estriolului circulant este alc\u0103tuit din forme conjugate, ce sunt excretate \u00een urin\u0103, estriolul liber (neconjugat) fiind prezent numai \u00eentr-un procent de 9%. \u00cen cursul dezvolt\u0103rii normale a f\u0103tului, produc\u0163ia de estriol cre\u015fte progresiv, ating\u00e2nd un maximum \u00een s\u0103pt\u0103m\u00e2na 36 de sarcin\u0103.<\/p>\n

Monitorizarea secven\u0163ial\u0103 a nivelurilor de estriol \u00een sarcinile cu risc crescut are valoare clinic\u0103 mai mare dec\u00e2t determin\u0103rile izolate \u015fi permite o interven\u0163ie terapeutic\u0103 precoce. Astfel nivelurile de estriol persistent sc\u0103zute sau care \u00eenregistreaz\u0103 o reducere brusc\u0103, sunt sugestive pentru suferin\u0163a fetal\u0103.<\/p>\n

Determinarea combinat\u0103 de estriol neconjugat, gonadotropina corionic\u0103 (HCG total sau free-beta HCG) \u015fi alfa-fetoproteina (AFP) \u00een trimestrul II de sarcin\u0103 \u2013 investiga\u0163ie cunoscut\u0103 sub numele de triplu test<\/em> \u2013 are utilitate, \u00eempreun\u0103 cu alte date clinice materne, \u00een estimarea riscului de anomalii fetale la na\u015ftere2<\/sup>.<\/p>\n

Recomand\u0103ri<\/em><\/strong> pentru determinarea estriolului neconjugat <\/em><\/strong>\u2013 \u00een cadrul triplului test; evaluarea suferin\u0163ei fetale \u015fi a func\u0163iei placentei\u00a0la pacientele care prezint\u0103 complica\u0163ii ale sarcinii: preeclampsie, \u00eent\u00e2rzierea cre\u015fterii fetale, diabet, izoimunizare Rh, coriocarcinom \u015fi mola hidatiform\u01033<\/sup>.<\/p>\n

Preg\u0103tire pacient <\/em><\/strong>- <\/em>\u00e0 jeun (pe nem\u00e2ncate) sau postprandial; pacientele vor men\u0163iona obligatoriu data ultimei menstrua\u0163ii sau v\u00e2rsta gesta\u0163ional\u0103 determinat\u0103 echografic; pentru triplul test se va completa fi\u015fa de calcul de risc prenatal2<\/sup>.<\/p>\n

Specimen recoltat <\/em><\/strong>- <\/em>\u0432\u0435\u043d\u043e\u0437\u043d\u0430\u044f \u043a\u0440\u043e\u0432\u044c2<\/sup>.<\/p>\n

Recipient de recoltare <\/em><\/strong>- <\/em>vacutainer f\u0103r\u0103 anticoagulant, cu\/f\u0103r\u0103 gel separator2<\/sup>.<\/p>\n

Prelucrare necesar\u0103 dup\u0103 recoltare <\/em><\/strong>- <\/em>se separa serul prin centrifugare2<\/sup>.<\/p>\n

Stabilitate prob\u0103 <\/em><\/strong>- <\/em>serul separat este stabil 5 zile <\/em>la 2-8\u00b0C; 6 luni<\/em> la -20\u00b0C; nu decongela\u0163i\/recongela\u0163i2<\/sup>.<\/p>\n

Volum prob\u0103<\/em><\/strong> \u2013 minim 0.5 mL ser2<\/sup>.<\/p>\n

Cauze de respingere<\/em><\/strong> a probei<\/em><\/strong> \u2013 specimen intens hemolizat2<\/sup>.<\/p>\n

Metod\u0103 <\/em><\/strong>- imunofluorimetric\u0103 (time-resolved fluoroimmunoassay<\/span>); pentru marcare este utilizat europiu cu propriet\u0103\u0163i unice de fluorescen\u0163\u01032<\/sup>.<\/p>\n

Valori de referin\u0163\u0103 <\/em><\/strong><\/p>\n

\u00a0<\/em><\/strong>- <\/em>pentru interpretarea valorilor estriolului \u00een trimestrul II de sarcin\u0103 se utilizeaz\u0103 medianele corespunz\u0103toare v\u00e2rstei gesta\u0163ionale (furnizate de programul Wallac LifeCycleTM<\/sup> \u00een asociere cu Elipse Screening Engine) \u015fi se calculeaz\u0103 MoM corespunz\u0103tor (se \u00eemparte valoarea ob\u0163inut\u0103 pentru estriol la median\u0103)2<\/sup>;<\/p>\n

\u2013 pentru trimestrul III de sarcin\u0103 (monitorizarea suferin\u0163ei fetale) se vor utiliza orientativ urm\u0103toarele valori3<\/sup>:<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

S\u0103pt\u0103mana de sarcin\u0103<\/em><\/strong><\/p>\n<\/td>\n

\n

Valori mediane (nmol\/L)<\/em><\/strong><\/p>\n<\/td>\n

\n
Interval de referin\u0163\u0103<\/em><\/strong><\/div>\n
(nmol\/L)<\/em><\/strong><\/div>\n<\/td>\n<\/tr>\n
\n

27<\/p>\n<\/td>\n

\n

14.21<\/p>\n<\/td>\n

\n

7.9 \u2013 22.2<\/p>\n<\/td>\n<\/tr>\n

\n

28<\/p>\n<\/td>\n

\n

14.56<\/p>\n<\/td>\n

\n

7.9 \u2013 24.3<\/p>\n<\/td>\n<\/tr>\n

\n

29<\/p>\n<\/td>\n

\n

15.6<\/p>\n<\/td>\n

\n

7.9 \u2013 26.7<\/p>\n<\/td>\n<\/tr>\n

\n

30<\/p>\n<\/td>\n

\n

17<\/p>\n<\/td>\n

\n

8.3 \u2013 29.8<\/p>\n<\/td>\n<\/tr>\n

\n

31<\/p>\n<\/td>\n

\n

19.06<\/p>\n<\/td>\n

\n

9.0 \u2013 34.3<\/p>\n<\/td>\n<\/tr>\n

\n

32<\/p>\n<\/td>\n

\n

21.5<\/p>\n<\/td>\n

\n

9.7 \u2013 39.5<\/p>\n<\/td>\n<\/tr>\n

\n

33<\/p>\n<\/td>\n

\n

25<\/p>\n<\/td>\n

\n

10.4 \u2013 >41.6<\/p>\n<\/td>\n<\/tr>\n

\n

34<\/p>\n<\/td>\n

\n

29.1<\/p>\n<\/td>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 11.4 \u2013 >41.6<\/td>\n<\/tr>\n
\n

35<\/p>\n<\/td>\n

\n

35.4<\/p>\n<\/td>\n

\n

13.5 \u2013 >41.6<\/p>\n<\/td>\n<\/tr>\n

\n

36<\/p>\n<\/td>\n

\n

>41.6<\/p>\n<\/td>\n

\n

16.3- >41.6<\/p>\n<\/td>\n<\/tr>\n

\n

37<\/p>\n<\/td>\n

\n

>41.6<\/p>\n<\/td>\n

\n

19.4- >41.6<\/p>\n<\/td>\n<\/tr>\n

\n

38<\/p>\n<\/td>\n

\n

>41.6<\/p>\n<\/td>\n

\n

22.8- >41.6<\/p>\n<\/td>\n<\/tr>\n

\n

39<\/p>\n<\/td>\n

\n

>41.6<\/p>\n<\/td>\n

\n

25.3- >41.6<\/p>\n<\/td>\n<\/tr>\n

\n

40<\/p>\n<\/td>\n

\n

>41.6<\/p>\n<\/td>\n

\n

26.3- >41.6<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Factori de conversie: ng\/mL x 3.467 = nmol\/L; nmol\/L x 0.287 = ng\/mL.<\/em><\/p>\n

!Men\u0163iune: valorile mediane se refer\u0103 la o sarcin\u0103 unic\u0103; in cazul sarcinilor multiple valorile sunt mult mai mari3<\/sup>.<\/p>\n

Limita de detec\u0163ie <\/em><\/strong>\u2013 0.1ng\/mL3<\/sup>.<\/p>\n

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

Valori sc\u0103zute ale estriolului neconjugat (<0.4 MoM) se int\u00e2lnesc \u00een sindromul Down, trisomia 18 \u015fi sindromul Smith-Lemli-Opitz. De asemenea valori sc\u0103zute ale estriolului se asociaz\u0103 cu risc de: \u00eent\u00e2rziere a cre\u015fterii fetale, moarte fetal\u0103, preeclampsie, izoimunizare Rh. Niveluri sc\u0103zute mai pot fi \u00eent\u00e2lnite\u00a0\u00een anemii, diabet zaharat, malnutri\u0163ie, afec\u0163iuni hepatice1<\/sup>. Nivelul estriolului poate fi redus \u00een prezen\u0163a unui f\u0103t viu anencefalic3<\/sup>. Valorile estriolului pot fi crescute \u00een hidropsul fetal3<\/sup>.<\/div>\n

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

Determin\u0103rile izolate de estriol sunt dificil de interpretat3<\/sup>. Estriolul poate avea valori normale \u00een unele sarcini cu risc crescut1<\/sup>. Valori sc\u0103zute de estriol pot fi \u00eent\u00e2lnite\u00a0\u00een cazurile de deficit de sulfataz\u0103 placentar\u0103,\u00a0\u00een prezen\u0163a unui f\u0103t s\u0103n\u0103tos. Niveluri sc\u0103zute de estriol mai pot ap\u0103rea la pacientele care locuiesc la mare altitudine,\u00a0\u00een prezen\u0163a anemiei, malnutri\u0163iei \u015fi a afec\u0163iunilor hepatice severe3<\/sup>.<\/div>\n

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

Anticorpii heterofili prezen\u0163i \u00een serul pacien\u0163ilor pot interac\u0163iona cu imunoglobulinele incluse\u00a0\u00een componentele kit-ului \u015fi d\u0103 rezultate neconcludente2<\/sup>.<\/p>\n

\u00a0<\/span><\/p>\n

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

1. Frances Fischbach. Prenatal Diagnosis and Tests of Fetal Well-Being. In A Manual of Laboratory and Diagnostic Tests. Lippincott Williams & Wilkins, USA, 8 Ed., 2009, 1027-1028.<\/span><\/div>\n
2. Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate. 2010. Ref Type: Catalog.<\/span><\/div>\n
3. Laboratory Corporation of America. Directory of Services and Interpretive Guide. Estriol, Serum. www.labcorp.com 2010. Ref Type: Internet Communication.<\/span><\/div>","protected":false},"excerpt":{"rendered":"

\u042d\u0441\u0442\u0440\u0438\u043e\u043b \u2013 \u0441\u0442\u0435\u0440\u043e\u0438\u0434\u043d\u044b\u0439 \u0433\u043e\u0440\u043c\u043e\u043d, \u043e\u0442\u043d\u043e\u0441\u044f\u0449\u0438\u0439\u0441\u044f \u043a \u044d\u0441\u0442\u0440\u043e\u0433\u0435\u043d\u0430\u043c. \u0412 \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c\u0435 \u0447\u0435\u043b\u043e\u0432\u0435\u043a\u0430 \u043e\u0431\u0440\u0430\u0437\u0443\u0435\u0442\u0441\u044f \u0438\u0437 \u044d\u0441\u0442\u0440\u043e\u043d\u0430 \u0438 \u044d\u0441\u0442\u0440\u0430\u0434\u0438\u043e\u043b\u0430.<\/p>\n

\u041e\u0441\u043d\u043e\u0432\u043d\u043e\u0435 \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u043e \u044d\u0441\u0442\u0440\u0438\u043e\u043b\u0430, \u0446\u0438\u0440\u043a\u0443\u043b\u0438\u0440\u0443\u044e\u0449\u0435\u0433\u043e \u0432 \u043a\u0440\u043e\u0432\u0438 \u0432 \u0442\u0435\u0447\u0435\u043d\u0438\u0435 3-\u0433\u043e \u0442\u0440\u0438\u043c\u0435\u0441\u0442\u0440\u0430 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438, \u043f\u0440\u043e\u0434\u0443\u0446\u0438\u0440\u0443\u0435\u0442\u0441\u044f \u043f\u043b\u0430\u0446\u0435\u043d\u0442\u043e\u0439 \u0438\u0437 \u043f\u0440\u0435\u0434\u0448\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u0438\u043a\u043e\u0432, \u0432\u044b\u0440\u0430\u0431\u0430\u0442\u044b\u0432\u0430\u0435\u043c\u044b\u0445 \u043d\u0430\u0434\u043f\u043e\u0447\u0435\u0447\u043d\u0438\u043a\u0430\u043c\u0438 \u0438 \u0442\u0440\u0430\u043d\u0441\u0444\u043e\u0440\u043c\u0438\u0440\u0443\u0435\u043c\u044b\u0445 \u043f\u0435\u0447\u0435\u043d\u044c\u044e \u043f\u043b\u043e\u0434\u0430. \u041e\u0447\u0435\u043d\u044c \u043d\u0435\u0431\u043e\u043b\u044c\u0448\u0430\u044f \u0447\u0430\u0441\u0442\u044c \u043e\u0431\u0440\u0430\u0437\u0443\u0435\u0442\u0441\u044f \u043f\u0440\u0438 \u043f\u0435\u0440\u0438\u0444\u0435\u0440\u0438\u0447\u0435\u0441\u043a\u043e\u0439 \u0442\u0440\u0430\u043d\u0441\u0444\u043e\u0440\u043c\u0430\u0446\u0438\u0438 \u044d\u0441\u0442\u0440\u043e\u043d\u0430 \u0432 \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c\u0435 \u0436\u0435\u043d\u0449\u0438\u043d\u044b.<\/p>\n

\u0423\u0440\u043e\u0432\u0435\u043d\u044c \u0433\u043e\u0440\u043c\u043e\u043d\u0430 \u0430\u0434\u0435\u043a\u0432\u0430\u0442\u043d\u043e \u043e\u0442\u0440\u0430\u0436\u0430\u0435\u0442 \u0444\u0443\u043d\u043a\u0446\u0438\u043e\u043d\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u0435 \u0444\u0435\u0442\u043e\u043f\u043b\u0430\u0446\u0435\u043d\u0442\u0430\u0440\u043d\u043e\u0433\u043e \u043a\u043e\u043c\u043f\u043b\u0435\u043a\u0441\u0430. \u041f\u043e\u0441\u0442\u0435\u043f\u0435\u043d\u043d\u043e\u0435 \u043f\u043e\u0432\u044b\u0448\u0435\u043d\u0438\u0435 \u0443\u0440\u043e\u0432\u043d\u044f \u0441\u0432\u043e\u0431\u043e\u0434\u043d\u043e\u0433\u043e \u044d\u0441\u0442\u0440\u0438\u043e\u043b\u0430 \u0432 \u0445\u043e\u0434\u0435 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u043e\u0442\u0440\u0430\u0436\u0430\u0435\u0442 \u043d\u043e\u0440\u043c\u0430\u043b\u044c\u043d\u043e\u0435 \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u0435 \u043f\u043b\u043e\u0434\u0430 \u0438 \u043f\u0440\u0430\u0432\u0438\u043b\u044c\u043d\u043e\u0435 \u0444\u0443\u043d\u043a\u0446\u0438\u043e\u043d\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u0435 \u043f\u043b\u0430\u0446\u0435\u043d\u0442\u044b.<\/p>\n

\u042d\u0441\u0442\u0440\u0438\u043e\u043b \u043c\u0435\u043d\u0435\u0435 \u0430\u043a\u0442\u0438\u0432\u0435\u043d, \u0447\u0435\u043c \u044d\u0441\u0442\u0440\u0430\u0434\u0438\u043e\u043b \u0438 \u044d\u0441\u0442\u0440\u043e\u043d. \u0415\u0433\u043e \u044d\u0444\u0444\u0435\u043a\u0442\u044b \u0437\u0430\u0432\u0438\u0441\u044f\u0442 \u043e\u0442 \u043a\u043e\u043d\u0446\u0435\u043d\u0442\u0440\u0430\u0446\u0438\u0438 \u0433\u043e\u0440\u043c\u043e\u043d\u0430 \u0432 \u043a\u0440\u043e\u0432\u0438. \u0412\u043d\u0435 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u044d\u0441\u0442\u0440\u0438\u043e\u043b \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u044f\u0435\u0442\u0441\u044f \u0432 \u043a\u0440\u043e\u0432\u0438 \u0432 \u043d\u0438\u0437\u043a\u043e\u0439 \u043a\u043e\u043d\u0446\u0435\u043d\u0442\u0440\u0430\u0446\u0438\u0438. \u041f\u0440\u0438 \u043d\u043e\u0440\u043c\u0430\u043b\u044c\u043d\u043e\u043c \u0442\u0435\u0447\u0435\u043d\u0438\u0438 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u0443\u0440\u043e\u0432\u0435\u043d\u044c \u0441\u0432\u043e\u0431\u043e\u0434\u043d\u043e\u0433\u043e \u044d\u0441\u0442\u0440\u0438\u043e\u043b\u0430 \u043f\u0440\u043e\u0433\u0440\u0435\u0441\u0441\u0438\u0432\u043d\u043e \u0440\u0430\u0441\u0442\u0435\u0442, \u043d\u0430\u0447\u0438\u043d\u0430\u044f \u0441 \u043c\u043e\u043c\u0435\u043d\u0442\u0430 \u0444\u043e\u0440\u043c\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u044f \u043f\u043b\u0430\u0446\u0435\u043d\u0442\u044b.<\/p>\n

\u042d\u0441\u0442\u0440\u0438\u043e\u043b \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u0433\u043b\u0430\u0432\u043d\u044b\u043c \u044d\u0441\u0442\u0440\u043e\u0433\u0435\u043d\u043e\u043c \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438:<\/p>\n

    \n
  • \u0443\u0432\u0435\u043b\u0438\u0447\u0438\u0432\u0430\u0435\u0442 \u043a\u0440\u043e\u0432\u043e\u0442\u043e\u043a \u043f\u043e \u0441\u043e\u0441\u0443\u0434\u0430\u043c \u043c\u0430\u0442\u043a\u0438, \u0441\u043d\u0438\u0436\u0430\u044f \u0438\u0445 \u0441\u043e\u043f\u0440\u043e\u0442\u0438\u0432\u043b\u0435\u043d\u0438\u0435;<\/li>\n
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    \u041f\u0440\u0435\u0434\u0435\u043b\u044b \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u044f: 0,24-462 \u043d\u043c\u043e\u043b\u044c\/\u043b.<\/p>\n

    \u0421 \u043a\u0430\u043a\u043e\u0439 \u0446\u0435\u043b\u044c\u044e \u0432\u044b\u043f\u043e\u043b\u043d\u044f\u044e\u0442 \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435<\/p>\n

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    \u0427\u0442\u043e \u0441\u043b\u0435\u0434\u0443\u0435\u0442 \u0443\u0447\u0435\u0441\u0442\u044c \u043f\u0440\u0438 \u043f\u0440\u043e\u0432\u0435\u0434\u0435\u043d\u0438\u0438 \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f<\/p>\n

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