Siydikdagi erkin kortizol
Kod:7010|CPT:82530|LOINC:33346-8, 2147-7
| Kabi | Kortizol, erkin, ug/L, siydik Kortizol, erkin, ug/24 soat, siydik |
|---|
Tahlil ma'lumotlari
Tadqiqot usuli
- Suyuq xromatografiya va tandem mass-spektrometriya (LC-MS/MS)
- Kimyoluminessent immunoanaliz (CLIA)
Kutilayotgan natija topshirish vaqti
1 kun
Maxsus tayyorlik
- Record the total urine volume collected over 24 hours and provide this value with the specimen.
- With clinician approval, stop estrogens and androgens 48 hours before starting the collection.
- With clinician approval, withhold diuretics for 48 hours before and throughout the 24-hour urine collection.
- Avoid strenuous exercise and significant emotional stress for the duration of the 24-hour collection.
- Do not smoke during the 24-hour urine collection.
Qanday foydalanish
Siydikdagi erkin kortizol (urinary free cortisol; urine cortisol) giperkortizolizmni dastlabki baholash uchun keng qo‘llanadi, chunki 24 soatlik siydik to‘plami sutkalik kortizol ishlab chiqarilishini to‘liq qamrab oladi va kortizolga bog‘lovchi globulin o‘zgarishlaridan ta’sirlanmaydi. Tahlil, shuningdek, Kushing sindromi bo‘yicha davolanayotgan bemorlarni kuzatishda qo‘llanadi. Natijalar yuqori bo‘lganda, ular ACTH ishlab chiqaruvchi gipofiz adenomasi tufayli endogen Kushing sindromiga, kortizolni avtonom ishlab chiqaruvchi buyrak usti bez neoplazmasiga yoki ektopik ACTH sekretsiyasiga ishora qilishi mumkin.
Cheklovlar
Gipofizdan ajraladigan ACTH manfiy qaytish halqasi orqali buyrak usti bezlarida kortizol sekretsiyasini boshqaradi. ACTH ning ortiqcha ajralishi (masalan, ACTH-sekretor gipofiz adenomasi) yoki buyrak usti bezining avtonom kortizol ishlab chiqarishi siydikdagi erkin kortizol ajralishini oshiradi. Giperkortizolizmli bemorlarda ko‘pincha arterial gipertenziya, giperglikemiya, markaziy semirish, terining yupqalashishi va qorin sohasida binafsha rangli striyalar kuzatiladi. Siydikdagi erkin kortizol buyrak usti yetishmovchiligini baholash uchun mos emas, chunki zararlangan shaxslarda qiymatlar referens oraliq bilan ustma-ust tushishi mumkin. Yuksalgan UFC psevdokushing holatlarida va interkurrent kasallik vaqtida ham kuzatilishi mumkin.
| O'lchov birligi | mcg/24h |
|---|---|
| Referens oraliq | — |
| Ko'rsatmalar | Clinical suspicion for Cushing syndrome, including features such as central adiposity, proximal muscle weakness, hypertension, and violaceous striae, Hypertension that remains uncontrolled or recurs despite appropriate therapy, Monitoring therapeutic response in individuals treated for Cushing syndrome |
Natija og'ishlarining mumkin sabablari
Oshgan daraja
- alcohol
- infection
- nicotine (smoking)
- oral contraceptives
- pregnancy
- pseudo-cushing syndrome
- spironolactone
- stress (surgery, trauma)
- tetracyclines
Pasaygan daraja
- dexamethasone
- prednisolone
Namunangiz talablari
| Namunangiz | Urina |
|---|---|
| Container | Sutkalik siydik yig'ish idishi |
| Hajm | 100 mL (min 10 mL) |
| Saqlash tayyorlik | Xona harorati, Sovutilgan, Muzlatilgan |
References
Canalis E, Reardon GE, Caldarella AM. A more specific, liquid-chromatographic method for free cortisol in urine. Clin Chem. 1982 Dec;28(12):2418-2420. PubMed 7139923