{"id":10437,"date":"2007-12-14T15:23:15","date_gmt":"2007-12-14T13:23:15","guid":{"rendered":"https:\/\/www.synevo.ro\/afectiuni\/profil-trombofilie-2\/"},"modified":"2020-07-10T12:34:19","modified_gmt":"2020-07-10T09:34:19","slug":"profil-trombofilie-2","status":"publish","type":"synevo_diseases","link":"https:\/\/old.synevo.md\/ru\/afectiuni\/profil-trombofilie-2\/","title":{"rendered":"Profil trombofilie"},"content":{"rendered":"<p style=\"text-align: justify;\"><span style=\"color: #00539f;\"><strong>Profil trombofilie &#8211; Tromboza venelor<\/strong> \u015fi <\/span><span style=\"color: #000080;\"><strong><span style=\"color: #00539f;\">arterelo<\/span>r<\/strong><\/span> \u00eempreun\u0103 cu complica\u0163ia embolic\u0103 reprezint\u0103 probabil, cea mai important\u0103 cauz\u0103 de morbiditate \u015fi mortalitate din \u0163\u0103rile dezvoltate.<!--more--> Activarea excesiv\u0103 a coagul\u0103rii sau inhibarea mecanismelor anticoagulante pot determina o stare de hipercoagulabilitate cu apari\u0163ia trombozei.<\/p>\n<p style=\"text-align: justify;\"><strong>Triada<\/strong> <strong>Virchow<\/strong> cuprinde factorii majori implica\u0163i \u00een fiziopatologia trombozei:<\/p>\n<ul>\n<li style=\"text-align: justify;\">leziuni la nivelul peretelui vascular;<\/li>\n<li style=\"text-align: justify;\">anormalit\u0103\u0163i ale fluxului sanguin;<\/li>\n<li style=\"text-align: justify;\">modific\u0103ri \u00een compozi\u0163ia s\u00e2ngelui.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><span style=\"color: #000000;\"><strong>Trombofilia<\/strong> <\/span>reprezint\u0103 o condi\u0163ie ereditar\u0103 sau dob\u00e2ndit\u0103 ce predispune individul la evenimente trombotice. Mul\u0163i pacien\u0163i au o combina\u0163ie de defecte ereditare sau de defecte ereditare cu defecte dob\u00e2ndite.<\/p>\n<p style=\"text-align: justify;\"><strong>Afec\u0163iunile ereditare<\/strong> care predispun la evenimente trombotice includ deficien\u0163a sau anomaliile calitative ale factorilor activi ai coagul\u0103rii (deficien\u0163a de ATIII, deficien\u0163a de protein\u0103 C, deficien\u0163a de protein\u0103 S, rezisten\u0163a la protein\u0103 C activat\u0103, deficien\u0163a de trombomodulin\u0103), anomalii ale enzimelor coagul\u0103rii \u2013 muta\u0163ia protrombinic\u0103, afectarea lizei cheagului (disfibrinogenemia, deficien\u0163a de plasminogen etc.), defecte metabolice \u2013 homocisteinemia.<sup>1<\/sup><\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #000080;\"><strong><span style=\"color: #00539f;\">Deficitul de antitrombin\u0103 III <\/span><\/strong><\/span>a fost prima descris\u0103 \u00een 1965 de Egeberg, are o inciden\u0163\u0103 de 0,02%-1% \u00een popula\u0163ie (1-2% din pacien\u0163ii cu afec\u0163iuni trombotice ereditare) \u015fi poate fi ereditar, cu transmitere autosomal dominant\u0103 ca \u015fi cele mai multe din afec\u0163iunile ereditare trombotice sau dob\u00e2ndit.<br \/>Din punct de vedere al defectului implicat, exist\u0103 2 tipuri principale de deficit de antitrombin\u0103 III:<\/p>\n<ul>\n<li style=\"text-align: justify;\"><strong>tipul I (cantitativ)<\/strong> caracterizat printr-o cantitate inadecvat\u0103 de antitrombin\u0103, ce este normal\u0103 din punct de vedere func\u0163ional (sunt sc\u0103zute at\u00e2t activitatea c\u00e2t \u015fi antigenul antitrombinei III);<\/li>\n<li style=\"text-align: justify;\"><strong>tipul II (calitativ)<\/strong> asociat cu o cantitate normal\u0103 de antitrombin\u0103 III, care \u00eens\u0103 nu este capabil\u0103 s\u0103-\u015fi exercite func\u0163ia de inhibitor al coagul\u0103rii (antigenul antitrombinei III este normal cantitativ, dar activitatea este sc\u0103zut\u0103).<\/li>\n<\/ul>\n<hr \/>\n<p style=\"text-align: justify;\">Clinic, deficitul de ATIII se manifest\u0103 prin: <strong>trombembolism venos recurent<\/strong> (\u00een principal), inclusiv \u00een locuri neobi\u015fnuite (ex. vasele mezenterice), \u00een absen\u0163a factorilor precipitan\u0163i sau posibil cu diverse ocazii (sarcin\u0103, administrare de estrogeni, traumatisme, interven\u0163ii chirurgicale), risc crescut de moarte fetal\u0103, prezen\u0163a rezisten\u0163ei la heparin\u0103 (ob\u0163inerea unui nivel subterapeutic APTT, la doze mari de heparin\u0103) datorit\u0103 func\u0163iei sc\u0103zute ATIII, cu incapacitatea de inactivare a enzimelor coagul\u0103rii de c\u0103tre complexul heparin\u0103 \u2013 ATIII.<\/p>\n<p style=\"text-align: justify;\">Ambele tipuri de deficit prezint\u0103 un risc de tromboz\u0103 de ~50% \u015fi manifest\u0103rile trombotice devin mai obi\u015fnuite cu v\u00e2rsta.<\/p>\n<p style=\"text-align: justify;\">APTT \u015fi PT sunt normale, iar m\u0103surarea nivelului ATIII const\u0103 din teste func\u0163ionale (de preferat pentru c\u0103 detecteaz\u0103 ambele tipuri de deficit) \u015fi imunologice.<br \/>Deficitul dob\u00e2ndit de ATIII este asociat cu numeroase afec\u0163iuni cum ar fi: CID, boli hepatice, sindrom nefrotic, preeclamsie \u015fi cu administrarea de contraceptive orale.<sup>1<\/sup><\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #00539f;\"><strong>Deficitul de protein\u0103 C <\/strong><\/span>are o inciden\u0163\u0103 \u00een popula\u0163ia general\u0103 de aproximativ 0.2%-3% (5-6% din pacien\u0163ii cu tromboz\u0103 ereditar\u01033) \u015fi poate fi ereditar, cu transmitere autosomal dominant\u0103 sau dob\u00e2ndit.<br \/>Pe baza testelor func\u0163ionale \u015fi imunologice, deficitul de protein\u0103 C poate fi subdivizat \u00een 2 tipuri:<\/p>\n<ul>\n<li style=\"text-align: justify;\"><strong>tipul I (cantitativ)<\/strong>, prezent \u00een majoritatea cazurilor de deficit de protein\u0103 C, se caracterizeaz\u0103 printr-o func\u0163ionalitate normal\u0103 a proteinei C, care se g\u0103se\u015fte \u00eens\u0103 \u00eentr-o cantitate insuficient\u0103 pentru a controla cascada coagul\u0103rii (reducere concomitent\u0103 a antigenului proteinei C \u015fi a gradului de activitate);<\/li>\n<li style=\"text-align: justify;\"><strong>tipul II (calitativ)<\/strong> se caracterizeaz\u0103 printr-o cantitate normal\u0103 de protein\u0103 C, care este \u00eens\u0103 incapabil\u0103 s\u0103-\u015fi exercite func\u0163ia (activitate redus\u0103) ca urmare a unor defecte moleculare.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><strong>Clinic,<\/strong> <strong>trei sindroame sunt asociate cu deficitul de protein C<\/strong>:<\/p>\n<ul>\n<li style=\"text-align: justify;\">trombembolismul venos la adul\u0163ii heterozigo\u0163i;<\/li>\n<li style=\"text-align: justify;\">purpura fulminant\u0103 neonatal\u0103 la nou-n\u0103scu\u0163ii homozigo\u0163i;<\/li>\n<li style=\"text-align: justify;\">necroza tegumentar\u0103 indus\u0103 de warfarin\u0103 la unii adul\u0163i heterozigo\u0163i (warfarina \u00een special \u00een doze mari, \u00een absen\u0163a tratamentului cu heparin\u0103, reduce mai rapid nivelul proteinei C dec\u00e2t cel al factorilor coagul\u0103rii dependen\u0163i de vitamina K).<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">Pacien\u0163ii heterozigo\u0163i au APTT \u015fi PT normale, \u00een timp ce homozigo\u0163ii au teste anormale de coagulare din cadrul CID. Nivelul proteinei C poate fi m\u0103surat prin teste func\u0163ionale \u015fi imunologice.<sup>1<\/sup><\/p>\n<p style=\"text-align: justify;\">Deficitul dob\u00e2ndit de protein\u0103 C poate fi prezent la pacien\u0163ii cu: afec\u0163iuni hepatice, coagulare intravascular\u0103 diseminat\u0103 (CID), diabet insulino-dependent, hipertensiune esen\u0163ial\u0103, siclemie, procese maligne \u015fi \u00een cursul terapiei cu anticoagulante orale sau L-asparaginaz\u0103.<sup>4<\/sup><\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #00539f;\"><strong>Deficitul de protein\u0103 S<\/strong> <\/span>cu o inciden\u0163\u0103 de 5-6% din pacien\u0163ii cu tromboze recurente, poate fi ereditar cu transmitere autosomal dominant\u0103 \u015fi dob\u00e2ndit. Cei mai mul\u0163i dintre pacien\u0163ii cu deficit ereditar sunt heterozigo\u0163i, cu un nivel de aproximativ 50% din nivelul normal de protein\u0103 S. Pentru c\u0103 numai proteina S liber\u0103 este biologic activ\u0103 a fost propus\u0103 o clasificare revizuit\u0103 a deficitului de proteina S:<\/p>\n<ul>\n<li style=\"text-align: justify;\"><strong>tipul I<\/strong>: proteina S total\u0103 50% din nivelul normal \u015fi proteina S liber\u0103 50% din nivelul normal;<\/li>\n<li style=\"text-align: justify;\"><strong>tipul IIa<\/strong>: proteina S total\u0103 normal\u0103, proteina S liber\u0103 redus\u0103 cantitativ;<\/li>\n<li style=\"text-align: justify;\"><strong>tipul IIb<\/strong>: proteina S total\u0103 \u015fi proteina S liber\u0103 normale cantitativ, dar proteina S liber\u0103 are activitate redus\u0103.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">Clinic, ca \u015fi \u00een cazul deficien\u0163elor de ATIII \u015fi protein\u0103 C mul\u0163i pacien\u0163i dezvolt\u0103 trombembolism venos \u015fi spre deosebire de alte afec\u0163iuni ereditare trombotice &gt;25% din pacien\u0163i pot prezenta tromboze arteriale, inclusiv stroke.<\/p>\n<p style=\"text-align: justify;\">Pacien\u0163ii cu deficit de protein\u0103 S heterozigo\u0163i au APTT \u015fi PT normale.<\/p>\n<p style=\"text-align: justify;\"><strong>Diagnosticul de laborator al deficien\u0163ei de protein\u0103 S<\/strong> este complicat de trei factori: nivelul proteinei C4b (C4b-binding protein), coexistent\u0103 la unii pacien\u0163i cu rezisten\u0163\u0103 la proteina C activat\u0103 \u015fi tratamentul cu warfarin\u0103. Testele func\u0163ionale \u015fi imunologice sunt utilizate pentru determinarea nivelului proteinei S plasmatice.<sup>1<\/sup><\/p>\n<p style=\"text-align: justify;\">Deficitul dob\u00e2ndit de protein\u0103 S poate fi \u00eent\u00e2lnit \u00een sarcin\u0103, administrarea contraceptivelor orale, afec\u0163iuni hepatice, nefropatie diabetic\u0103, tromboza venelor cerebrale, purpura trombotic\u0103 trombocitopenic\u0103 precum \u015fi \u00een alte afec\u0163iuni autoimune \u015fi inflamatorii \u00een care se \u00eenregistreaz\u0103 o cre\u015ftere a proteinei de legare a frac\u0163iunii C4b \u015fi concomitent o sc\u0103dere a frac\u0163iunii libere.<sup>5<\/sup><\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #00539f;\"><strong>Rezisten\u0163a la proteina C activat\u0103 (factorul V Leiden)<\/strong><\/span> a fost recunoscut\u0103 ca afec\u0163iune din 1993 de Dahlback \u015fi colab., \u00een urma constat\u0103rii c\u0103 ad\u0103ugarea de APC (proteina C activat\u0103) la plasma unor pacien\u0163i cu tromboze recurente, nu prelunge\u015fte APTT, a\u015fa cum se \u00eent\u00e2mpl\u0103 c\u00e2nd APC este ad\u0103ugat la plasma normal\u0103. Rezisten\u0163a la APC a fost g\u0103sit\u0103 la 20-60% din pacien\u0163ii cu tromboze recurente. La cei mai mul\u0163i pacien\u0163i, baza molecular\u0103 este reprezentat\u0103 de o muta\u0163ie punctiform\u0103 \u00een pozi\u0163ia 1691 a genei factorului V, care determin\u0103 substitu\u0163ia glutaminei cu arginina, cu ob\u0163inerea unei molecule mutante de factor V (factor V Leiden), rezistent la degradarea prin APC.<\/p>\n<p style=\"text-align: justify;\">Clinic, cei mai mul\u0163i homozigo\u0163i pentru rezisten\u0163a la APC, prezint\u0103 cel pu\u0163in un eveniment trombotic de-a lungul vie\u0163ii, iar expresia trombozei la heterozigo\u0163i are variabilitate mare put\u00e2nd fi crescut\u0103 de prezen\u0163a suplimentar\u0103 a altor factori de risc genetici sau non-genetici (contraceptive orale, sarcin\u0103, traumatisme, etc.).<\/p>\n<p style=\"text-align: justify;\"><strong>Manifest\u0103rile clinice includ:<\/strong><\/p>\n<ul>\n<li style=\"text-align: justify;\">trombembolismul venos (cea mai frecvent\u0103 manifestare),<\/li>\n<li style=\"text-align: justify;\">avorturi spontane recurente,<\/li>\n<li style=\"text-align: justify;\">purpura fulminant\u0103 neonatal\u0103, tromboza venoas\u0103 cerebral\u0103.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><strong>Investiga\u0163iile de laborator<\/strong> constau \u00een evaluarea rezisten\u0163ei la PCA, de obicei prin determinarea APTT \u00eenainte \u015fi dup\u0103 ad\u0103ugarea \u00een plasma pacientului de APC \u015fi analiza ADN pentru eviden\u0163ierea muta\u0163iei la nivelul genei factorului V.<\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #00539f;\"><strong>Muta\u0163ia protrombinic\u0103 <\/strong><\/span>asociaz\u0103 nivele plasmatice crescute de protrombin\u0103 \u015fi prezen\u0163a de tromboze venoase; 5-10% din pacien\u0163ii cu tromboze prezint\u0103 aceast\u0103 muta\u0163ie.<\/p>\n<p style=\"text-align: justify;\">Alte afec\u0163iuni asociate cu risc de apari\u0163ie a trombozei sunt: deficien\u0163a de trombomodulin\u0103, fibrinoliza anormal\u0103, homocisteinemia etc.<\/p>\n<p style=\"text-align: justify;\">Afec\u0163iunile dob\u00e2ndite, care predispun la apari\u0163ia trombozei includ:<\/p>\n<ul>\n<li style=\"text-align: justify;\">afec\u0163iuni vasculare (ex. ateroscleroza, diabetul zaharat, vasculitele);<\/li>\n<li style=\"text-align: justify;\">reologie anormal\u0103 (ex. staza, hipervascozitatea);<\/li>\n<li style=\"text-align: justify;\">disfunc\u0163ia plachetar\u0103 (sindromul mieloproliferativ cronic, hemoglobinuria paroxistic\u0103 nocturn\u0103);<\/li>\n<li style=\"text-align: justify;\">alte afec\u0163iuni (neoplazii, contraceptive orale, sarcina, sindromul nefrotic, purpura trombotic\u0103 trombocitopenica, CID, sindromul anticorpilor antifosfolipidici \u2013 vezi Profil sindrom antifosfolipidic etc.) administrarea de contraceptive orale, tratamentul cu estrogeni.<sup>1<\/sup><\/li>\n<\/ul><div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-1 wp-block-columns-is-layout-flex\"><div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\"><p><strong>Analize medicale disponibile \u00een laboratoarele Synevo:<\/strong><\/p><\/div>\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\"><div class=\"synevo-shop-products\">\r\n    <div class=\"sysprod\">\r\n        \r\n        <div class=\"sysprod-products\">\r\n                            <div class=\"sysprod-product\">\r\n                    <a class=\"sysprod-product-title\" href=\"https:\/\/old.synevo.md\/ru\/shop\/anticorpi-anticardiolipinici-igg\/\">Anticorpi anticardiolipinici IgG<\/a>\r\n                    <div class=\"sysprod-product-price\">\r\n                        <span>Pre\u021b:<\/span>\r\n                        <span>290 lei<\/span>\r\n                    <\/div>\r\n                                            <div class=\"sysprod-product-addcart\">\r\n                            <a\r\n                                href=\"?add-to-cart=9157\"\r\n                                data-quantity=\"1\"\r\n                                class=\"addToCart button product_type_simple add_to_cart_button ajax_add_to_cart \"\r\n                                data-product_id=\"9157\"\r\n                                data-product_sku=\"IM66\"\r\n                                rel=\"nofollow\"\r\n                            ><div><\/div><\/a>\r\n                        <\/div>\r\n                                    <\/div>\r\n                            <div class=\"sysprod-product\">\r\n                    <a class=\"sysprod-product-title\" href=\"https:\/\/old.synevo.md\/ru\/shop\/anticoagulant-lupic\/\">Anticoagulant lupic<\/a>\r\n                    <div class=\"sysprod-product-price\">\r\n                        <span>Pre\u021b:<\/span>\r\n                        <span>740.00 lei<\/span>\r\n                    <\/div>\r\n                                            <div class=\"sysprod-product-addcart\">\r\n                            <a\r\n                                href=\"?add-to-cart=9141\"\r\n                                data-quantity=\"1\"\r\n                                class=\"addToCart button product_type_simple add_to_cart_button ajax_add_to_cart \"\r\n                                data-product_id=\"9141\"\r\n                                data-product_sku=\"HE32\"\r\n                                rel=\"nofollow\"\r\n                            ><div><\/div><\/a>\r\n                        <\/div>\r\n                                    <\/div>\r\n                            <div class=\"sysprod-product\">\r\n                    <a class=\"sysprod-product-title\" href=\"https:\/\/old.synevo.md\/ru\/shop\/antitrombina-antitrombina-iii\/\">Antitrombina (antitrombina III)<\/a>\r\n                    <div class=\"sysprod-product-price\">\r\n                        <span>Pre\u021b:<\/span>\r\n                        <span>300.00 lei<\/span>\r\n                    <\/div>\r\n                                            <div class=\"sysprod-product-addcart\">\r\n                            <a\r\n                                href=\"?add-to-cart=9165\"\r\n                                data-quantity=\"1\"\r\n                                class=\"addToCart button product_type_simple add_to_cart_button ajax_add_to_cart \"\r\n                                data-product_id=\"9165\"\r\n                                data-product_sku=\"HE34\"\r\n                                rel=\"nofollow\"\r\n                            ><div><\/div><\/a>\r\n                        <\/div>\r\n                                    <\/div>\r\n                            <div class=\"sysprod-product\">\r\n                    <a class=\"sysprod-product-title\" href=\"https:\/\/old.synevo.md\/ru\/shop\/mutatia-factorului-v-leiden\/\">Mutatia factorului V 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href=\"https:\/\/old.synevo.md\/ru\/shop\/mutatia-protrombinica-factor-ii\/\">Mutatia protrombinica (factor II)<\/a>\r\n                    <div class=\"sysprod-product-price\">\r\n                        <span>Pre\u021b:<\/span>\r\n                        <span>1100.00 lei<\/span>\r\n                    <\/div>\r\n                                            <div class=\"sysprod-product-addcart\">\r\n                            <a\r\n                                href=\"?add-to-cart=9274\"\r\n                                data-quantity=\"1\"\r\n                                class=\"addToCart button product_type_simple add_to_cart_button ajax_add_to_cart \"\r\n                                data-product_id=\"9274\"\r\n                                data-product_sku=\"BM06\"\r\n                                rel=\"nofollow\"\r\n                            ><div><\/div><\/a>\r\n                        <\/div>\r\n                                    <\/div>\r\n                            <div class=\"sysprod-product\">\r\n                    <a class=\"sysprod-product-title\" href=\"https:\/\/old.synevo.md\/ru\/shop\/proteina-c\/\">Proteina C<\/a>\r\n                    <div class=\"sysprod-product-price\">\r\n                        <span>Pre\u021b:<\/span>\r\n                        <span>320.00 lei<\/span>\r\n                    <\/div>\r\n                                            <div class=\"sysprod-product-addcart\">\r\n                            <a\r\n                                href=\"?add-to-cart=9287\"\r\n                                data-quantity=\"1\"\r\n                                class=\"addToCart button product_type_simple add_to_cart_button ajax_add_to_cart \"\r\n                                data-product_id=\"9287\"\r\n                                data-product_sku=\"HE35\"\r\n                                rel=\"nofollow\"\r\n                            ><div><\/div><\/a>\r\n                        <\/div>\r\n                                    <\/div>\r\n                            <div class=\"sysprod-product\">\r\n                    <a class=\"sysprod-product-title\" href=\"https:\/\/old.synevo.md\/ru\/shop\/proteina-s-activitate\/\">Proteina S (activitate)<\/a>\r\n                    <div class=\"sysprod-product-price\">\r\n                        <span>Pre\u021b:<\/span>\r\n                        <span>440.00 lei<\/span>\r\n                    <\/div>\r\n                                            <div class=\"sysprod-product-addcart\">\r\n                            <a\r\n                                href=\"?add-to-cart=9289\"\r\n                                data-quantity=\"1\"\r\n                                class=\"addToCart button product_type_simple add_to_cart_button ajax_add_to_cart \"\r\n                                data-product_id=\"9289\"\r\n                                data-product_sku=\"HE36\"\r\n                                rel=\"nofollow\"\r\n                            ><div><\/div><\/a>\r\n                        <\/div>\r\n                                    <\/div>\r\n                    <\/div>\r\n        \r\n    <\/div>\r\n<\/div>\r\n\r\n<style>\r\n.synevo-shop-products {\r\n    padding: 24px 0;\r\n    margin: 24px 0;\r\n    border-radius: 10px;\r\n    background: #F6F7F9;\r\n}\r\n.synevo-shop-products .sysprod-product {\r\n    position: relative;\r\n    margin: 0 24px;\r\n    margin-bottom: 24px;\r\n    border-radius: 10px;\r\n    background: #fff;\r\n    display: flex;\r\n    flex-direction: row;\r\n    align-items: center;\r\n}\r\n.synevo-shop-products .sysprod-product:last-child {\r\n    margin-bottom: 0;\r\n}\r\n.synevo-shop-products .sysprod-product-title {\r\n    flex-grow: 1;\r\n    padding: 15px;\r\n    margin-left: 14px;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 16px;\r\n    color: #29263F;\r\n}\r\n.synevo-shop-products .sysprod-product-price {\r\n    flex-shrink: 0;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 18px;\r\n    color: #FDB813;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart {\r\n    flex-shrink: 0;\r\n    position: relative;\r\n    width: 38px;\r\n    height: 38px;\r\n    margin-left: 24px;\r\n    margin-right: 24px;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart .button {\r\n    top: unset;\r\n    right: unset;\r\n}\r\n<\/style><\/div><\/div><p><small><strong>Bibliografie:<\/strong><\/small><\/p><p><small>1. George M. Rodgers, Thrombosis and Antithrombotic Therapy, In Wintrobe\u2019s Clinical Hematology, 10 Ed., 1999,1781-1791<br>2. Antithrombin Deficiency. www.med.uiuc.edu\/hematology<br>3. Protein C Deficiency. www.med.uiuc.edu\/hematology<br>4. Frances Fischbach. Blood Studies; Hematology and Coagulation. In A Manual of Laboratory and Diagnostic Tests. Lippincott Williams &amp; Wilkins, , 7 ed. 2004, 157-159<br>5. Frances Fischbach. Blood Studies; Hematology and Coagulation. In A Manual of Laboratory and Diagnostic Tests. Lippincott Williams &amp; Wilkins, USA, 7 ed. 2004, 159-160<\/small><\/p><hr class=\"wp-block-separator\"\/><p>Mai multe informa\u021bii despre testele disponibile \u00een laboratoarele Synevo:<\/p><ul class=\"wp-block-list\"><li><a href=\"\/shop\/anticorpi-anticardiolipinici-igg\/\" class=\"rank-math-link\">Anticorpi anticardiolipinici IgG<\/a><\/li><li><a href=\"\/shop\/anticoagulant-lupic\/\" class=\"rank-math-link\">Anticoagulant lupic<\/a><\/li><li><a href=\"\/shop\/antitrombina-antitrombina-iii\/\" class=\"rank-math-link\">Antitrombina III<\/a><\/li><li><a href=\"\/shop\/mutatia-factorului-v-leiden-detectie-si-genotipare\/\" class=\"rank-math-link\">Muta\u0163ia factorului V Leiden<\/a><\/li><li><a href=\"\/shop\/mutatia-protrombinica-factor-ii\/\" class=\"rank-math-link\">Muta\u0163ia protrombinic\u0103<\/a><\/li><li><a href=\"\/shop\/proteina-c\/\" class=\"rank-math-link\">Proteina C<\/a><\/li><li><a href=\"\/shop\/proteina-s-activitate\/\" class=\"rank-math-link\">Proteina S<\/a><\/li><\/ul><p><\/p>","protected":false},"featured_media":0,"template":"","synevo_diseases_category":[891,896,897],"class_list":["post-10437","synevo_diseases","type-synevo_diseases","status-publish","hentry","synevo_diseases_category-cardiologie","synevo_diseases_category-ginecologie-si-obstetrica","synevo_diseases_category-hematologie-si-oncologie"],"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases\/10437","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/synevo_diseases"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10437"}],"wp:term":[{"taxonomy":"synevo_diseases_category","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases_category?post=10437"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}