Metanefrinlar, fraksiyalangan, plazmada erkin
Kod:9039|CPT:83835|LOINC:2669-0, 38494-1
| Kabi | Normetanefrin, plazmada erkin Metanefrin, plazmada erkin |
|---|
Tahlil ma'lumotlari
Tadqiqot usuli
- Suyuq xromatografiya va tandem mass-spektrometriya (LC-MS/MS)
Kutilayotgan natija topshirish vaqti
1–2 kun
Maxsus tayyorlik
- If collection after full supine rest is not feasible, use a 24-hour urine metanephrines study instead.
- Infants younger than 1 year: withhold feeds for 30–40 minutes before the draw.
- Children 1–5 years: fast for 2–3 hours prior to collection.
- Adolescents and adults: fast for 12 hours; water is allowed.
- Avoid avocado, bananas, eggplant, pineapple, plums, tomatoes, and walnuts for 72 hours before collection.
- With clinician approval, stop sympathomimetic agents 14 days before the test.
- With clinician approval, avoid all nonessential medications for 24 hours before collection.
- Do not smoke during the 2 hours before collection.
Qanday foydalanish
Metanefrinlar, fraksiyalangan, plazmada erkin (erkin metanefrin va erkin normetanefrin) katexolamin ajratuvchi o‘smalarni, jumladan buyrak usti bezi feoxromotsitomasini va buyrak ustidan tashqari simpatik yoki parasimpatik paragangliomalarni baholash uchun qo‘llanadi. Tahlil davolashga javobni baholash va qaytalanishni kuzatishda yordam beradi hamda siydikdagi metanefrinlar tahlilini o‘tkazishning imkoni bo‘lmaganda yoki u noaniq natijalar berganda tanlanishi mumkin.
Cheklovlar
Metanefrinlar katexolaminlar biotransformatsiyasining terminal O-metillangan metabolitlaridir: noradrenalin normetanefringa, adrenalin metanefringa aylanadi. Plazmada erkin (kon’yugatsiyalanmagan) metanefrinlarni miqdoriy aniqlash to‘g‘ridan-to‘g‘ri katexolaminlarni o‘lchashga nisbatan yuqoriroq diagnostik sezgirlikni ta’minlaydi, chunki qon aylanishidagi katexolaminlar tez o‘zgaruvchan va stressga labil. G‘ayritabiiy natijalar klinik ehtimollik bilan korrelyatsiyani talab qiladi va ko‘tarilish darajasi hamda xarakteriga qarab tasdiqlovchi testlar yoki tasvirlashni o‘tkazishga sabab bo‘lishi mumkin. Namuna olish sharoitlarining yetarli emasligi va fiziologik stress soxta-ijobiy oshishlarga olib kelishi mumkin; talqin chog‘ida buni hisobga olish zarur.
| O'lchov birligi | pg/mL | ||||
|---|---|---|---|---|---|
| Referens oraliq |
| ||||
| Ko'rsatmalar | Evaluation of episodic or sustained hypertension accompanied by tachycardia, flushing, or excessive sweating, Hypertension that remains uncontrolled despite appropriate therapy, Incidentally detected adrenal mass or other neuroendocrine incidentaloma on imaging, First-degree family history of pheochromocytoma or paraganglioma |
Natija og'ishlarining mumkin sabablari
Oshgan daraja
- alpha blockers
- caffeine
- carcinoid tumor
- cigarette smoking
- ganglioneuroblastoma
- ganglioneuroma
- hepatitis
- hypoglycemia (insulin-induced)
- monoamine oxidase inhibitors
- neuroblastoma
- neuroendocrine tumor
- paraganglioma
- pheochromocytoma
- renal impairment
- serotonin and norepinephrine reuptake inhibitors
- strenuous exercise
- sympathomimetics
Pasaygan daraja
- aromatic l-amino acid decarboxylase deficiency
- biopterin deficiency
- dopamine beta-hydroxylase deficiency
- iron deficiency
- sepiapterin reductase deficiency
- tyrosine hydroxylase deficiency
- vitamin b3 deficiency
Namunangiz talablari
| Namunangiz | Plazma |
|---|---|
| Container | Och ko'k qopqoqli probirka (3,2% natriy sitrat) |
| Hajm | 1.2 mL (min 0.7 mL) |
| Saqlash tayyorlik | Sovutilgan, Muzlatilgan |