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17Cetosteroizi
PostedBySynevoOnaugust13,2009@1:37pmInMarkeriendocrini,Markerisuprarenalieni|NoComments

Informatiigeneralesirecomandaripentrudeterminarea17cetosteroizilorurinari
Principaliiprecursoriai17cetosteroizilorurinarisuntdehidroepiandrostendionul(DHEA)si
dehidroepiandrostendionulsulfat(DHEAS).Labarbatiaproximativotreimedin17cetosteroizisuntdeorigine
gonadala,intimpcelafemeisicopiicorticosuprarenalareprezintasursapredominanta.Cortizolul,estrogenii,
pregnandiolul,pregnantriolul,testosteronulsidihidrotestosteronulnuconstituie17cetosteroizi.
Principalautilitateadeterminariiacestormetabolitiurinariesteinvestigareacazurilordehirsutismsivirilizare2.
Pregatirepacientnuestenecesaraopregatirespeciala1.
Specimenrecoltaturinadin24orelaora7dimineatapacientulurineazasinuretineaceastaurinaapoi
colecteazaintrunvascuratde23litritoateemisiiledeurinapanalaora7dimineatainziuaurmatoare,inclusiv
omogenizeaza(prinagitare)urinarecoltatamasoaraintreagacantitateretineaprox.10mLintrunpaharde
plasticdeunicafolosintapentruurina.Probasepastreazala28Cintimpulcolectariisiulterior,panaselucreaza
efectiv1.
Cauzederespingereaprobeispecimencarenuafostpastratla28Cutilizareadesubstanteconservante
(producinterferente)1.
Recipientderecoltarevasde23litrisipahardeplasticdeunicafolosintapentruurina,pecaresenoteaza
cantitateatotaladeurinadin24deore1.

Cantitaterecoltata10mL1.
Prelucrarenecesaraduparecoltaredepreferintaselucreazaimediatdacaacestlucrunuesteposibil,proba
sepoatestocala28Csaula20C,dupace,inprealabil,seadaugaacidclorhidricconcentratpanaseobtineun
pHde361.
Stabilitateprobaurinaestestabilacatevaorela28Csitimpindelungatla20C1.
Metodacromatograficaspectrofotometrica1.
Valoridereferinta1

Valoare(mg/24ore)
Varstain
ani

Barbati

Femei

06

<2.3

<2.2

610

1.15.6

0.94.5

11

3.96.5

2.98.9

12

4.57.3

3.311.5

13

4.88.0

4.812.6

14

5.39.0

4.813.4

1516

7.611.0

8.214.2

17

10.814.5

10.715.3

18

10.817.0

12.017.0

19

10.920.0

13.217.9

2025

15.623.4

14.018.8

2540

17.025.0

11.019.0

4050

11.422.0

10.019.0

5060

9.018.0

7.316.8

6070

5.813.5

5.513.4

7080

2.910.0

3.210.9

>80

2.78.0

1.85.8

Limitadedetectie0.8mg/L1.
Interpretarearezultatelor
Cresteri:sindromadrenogenital,sindromCushing,uneletumorisuprarenalienesigonadale,sindromStein
Leventhal,pseudohermafroidism(femeie)13.
Scaderi:boalaAddison,panhipopituitarism,hipotiroidie,sindromKlinefelter,nefroze,boliconsumptive3.
Limitesiinterferente
Valoricrescuteseintalnescinsarcinasilapacientiiobezi.

Desiesteadeseafolositpentruevaluareastatusuluiandrogenic,acesttestnudetecteazaandrogeniimajori,
testosteronulsidihidrotestosteronul.Dacaestesuspectatundeficitandrogenic,testuldeelectieestetestosteronul
liber2.
Medicamente
Cresteri:corticotropina,danazol,gonadotrofine,testosteron[1].
Scaderi:androgeni,contraceptiveorale,corticosteroizi,dexametazona,estrogeni,fenitoin,probenecid3.

Bibliografie
1.LaboratorSynevo.Referintelespecificetehnologieidelucruutilizate.2010.RefType:Catalog.
2.LaboratoryCorporationofAmerica.DirectoryofServicesandInterpretiveGuide.www.labcorp.com.2010RefType:Internet
Communication.
3.NorbertTietz.GeneralClinicalTests.InClinicalGuidetoLaboratoryTests.W.B.SAUNDERS,USA,3Ed.,1995,380.

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