{"id":267,"date":"2025-06-11T14:15:59","date_gmt":"2025-06-11T14:15:59","guid":{"rendered":"https:\/\/analizesanocare.ro\/?post_type=product&#038;p=267"},"modified":"2025-08-08T13:56:27","modified_gmt":"2025-08-08T13:56:27","slug":"aluminiu-in-sange","status":"publish","type":"product","link":"https:\/\/analizesanocare.ro\/en\/analiz\u0103\/aluminiu-in-sange\/","title":{"rendered":"Aluminiu \u00een s\u00e2nge"},"content":{"rendered":"<div class=\"info-content content-informatii-generale\">\n<h2><strong>Informa\u021bii generale \u2013 Aluminiu \u00een s\u00e2nge<\/strong><\/h2>\n<p>Aluminiul este omniprezent \u00een mediu, fiind al treilea element ca r\u0103sp\u00e2ndire \u00een scoar\u0163a terestr\u0103.<\/p>\n<p>In mod normal tractul gastro-intestinal este relativ impermeabil pentru aluminiu, absorb\u0163ia fiind de aproximativ 2%. Aciditatea gastric\u0103 \u015fi citratul administrat pe cale oral\u0103 favorizeaz\u0103 absorb\u0163ia,\u00a0\u00een timp ce blocantele receptorilor H2 o reduc. In condi\u0163ii \u00a0fiziologice doza de aluminiu ingerat\u0103 zilnic (5-10 mg) este complet eliminat\u0103. Excre\u0163ia se realizeaz\u0103 prin filtrarea aluminiului la nivelul glomerulilor renali, pacien\u0163ii cu insuficien\u0163\u0103 renal\u0103 pierz\u00e2ndu-\u015fi aceast\u0103 capacitate.<\/p>\n<p>In cazul\u00a0\u00een care nu se elimin\u0103 prin filtrare renal\u0103, aluminiu se acumuleaz\u0103\u00a0\u00een s\u00e2nge, se leag\u0103 de proteinele serice \u015fi este rapid distribuit\u00a0\u00een corp, cu prec\u0103dere la nivelul creierului \u015fi osului. Ca \u015fi\u00a0\u00een cazul altor oligoelemente, transferina este principalul carrier al aluminiului\u00a0\u00een plasm\u0103, celulele put\u00e2nd s\u0103-l preia de la aceast\u0103 protein\u0103 mai u\u015for. De asemenea, aluminiu a fost eviden\u0163iat\u00a0\u00een preparatele purificate de feritin\u0103 din creier \u015fi ficat, dar nu se cunoa\u015fte dac\u0103 aceasta are un site specific de legare pentru element. Modalitatea prin care aluminiul str\u0103bate bariera hemato-encefalic\u0103 nu este pe deplin \u00een\u0163eleas\u0103<sup>2,3<\/sup>.<\/p>\n<p>La persoanele cu afec\u0163iuni renale toxicitatea aluminiului poate fi crescut\u0103 de numero\u015fi factori, cum ar fi apa folosit\u0103 la dializ\u0103, albumina \u00eenc\u0103rcat\u0103 cu aluminiu \u015fi procesul propriu-zis de dializ\u0103 care nu este foarte eficient\u00a0\u00een eliminarea elementului<sup>2<\/sup>.<\/p>\n<p>Toxicitatea aluminiului apare\u00a0\u00een cazul\u00a0\u00een care expunerea este abundent\u0103 sau prelungit\u0103, dac\u0103 func\u0163ia renal\u0103 este afectat\u0103 sau\u00a0\u00een cazul\u00a0\u00een care elementul acumulat anterior\u00a0\u00een os este eliberat\u00a0\u00een condi\u0163ii de stres sau boal\u0103. Manifest\u0103rile asociate expunerii excesive la aluminiu includ: encefalopatie (tulbur\u0103ri de vorbire, de mers, convulsii, com\u0103, EEG anormal), osteomalacie sau boala aplastic\u0103 osoas\u0103 (asociat\u0103 cu fracturi spontane dureroase, hipercalcemie, calcinoz\u0103), miopatie proximal\u0103, risc crescut de infec\u0163ii, hipertrofie ventricular\u0103 st\u00e2ng\u0103 \u015fi sc\u0103derea func\u0163iei miocardice, anemie microcitar\u0103 \u015fi chiar moarte subit\u0103<sup>3<\/sup>.<\/p>\n<p>In os aluminiul \u00eenlocuie\u015fte calciul\u00a0\u00een procesul de mineralizare, \u00eempiedic\u00e2nd formarea normal\u0103 de osteoid. Calciul devine indisponibil pentru resorb\u0163ie sub controlul fiziologic al hormonului paratiroidian (<a href=\"https:\/\/www.synevo.ro\/shop\/pth-rp-parathormon-related-protein\/\" data-wpel-link=\"internal\">PTH<\/a>), determin\u00e2nd hiperparatiroidism secundar. Pe termen lung hiperparatiroidismul secundar poate conduce la hiperparatiroidism ter\u0163iar (hipersecre\u0163ie paratiroidian\u0103 autonom\u0103)<sup>2<\/sup>.<\/p>\n<p>Toxicitatea acut\u0103 poate fi tratat\u0103 cu desferoxamin\u0103, un chelator de metale. De obicei se recomand\u0103 o abordare conservatoare pentru tratamentul supra\u00eenc\u0103rc\u0103rii de aluminiu, deoarece desferoxamina mobilizeaz\u0103 rapid cantit\u0103\u0163i mari de aluminiu, care pot accentua encefalopatia<sup>2<\/sup>.<\/p>\n<h2><strong>Recomand\u0103ri pentru determinarea aluminiului seric: <\/strong><\/h2>\n<ul>\n<li>monitorizarea pacien\u0163ilor dializa\u0163i;<\/li>\n<li>monitorizarea implantului cu proteze metalice;<\/li>\n<li>monitorizarea persoanelor care sunt sau au fost expuse la aluminiu;<\/li>\n<li>pacien\u0163ii (adul\u0163i sau copii) cu nutri\u0163ie parenteral\u0103;<\/li>\n<li>pacien\u0163ii cu arsuri care primesc albumin\u0103 intravenos, in special cei cu insuficien\u0163\u0103 renal\u0103 coexistent\u0103;<\/li>\n<li>adul\u0163ii si copiii cu insuficien\u0163\u0103 renal\u0103 cronic\u0103, care pot acumula aluminiu din medicamentele administrate si dializ\u0103<sup>2;3<\/sup>.<\/li>\n<\/ul>\n<h2><strong>Preg\u0103tire pacient<\/strong><\/h2>\n<p>\u00e0 jeun (pe nem\u00e2ncate)<sup>1<\/sup>.<\/p>\n<p><strong>Specimen recoltat<\/strong> \u2013 s\u00e2nge venos<sup>1<\/sup>.<\/p>\n<p><strong>Recipient de recoltare <\/strong>\u2013 vacutainer pentru metale care con\u0163ine K2 EDTA 6ml (albastru \u00eenchis) (ref 368381).<\/p>\n<p><strong>Prelucrare necesar\u0103 dup\u0103 recoltare<\/strong> \u2013 nu este necesar\u0103<sup>1<\/sup>.<\/p>\n<p><strong>Volum prob\u0103 <\/strong>\u2013 c\u00e2t permite vacuumul<sup>1<\/sup>.<\/p>\n<p><strong>Cauze\u00a0 de respingere a probei<\/strong> \u2013 specimen coagulat<sup>1<\/sup>.<\/p>\n<p><strong>Stabilitate prob\u0103<\/strong> \u2013 probele de s\u00e2nge se men\u0163in la temperatura camerei sau la frigider p\u00e2n\u0103\u00a0\u00een momentul lucrului<sup>1<\/sup>.<\/p>\n<p><strong>Metoda <\/strong>\u2013 plasma cuplata inductiv cu spectrometrie de mas\u0103 (ICP\/MS)<sup>1<\/sup>.<\/p>\n<h2><strong>Valori de referin\u0163\u0103 Aluminiu \u00een s\u00e2nge<\/strong><\/h2>\n<p>&lt;11.4 \u03bcg\/L (ng\/mL).<\/p>\n<p>Pacien\u0163i care fac dializa:<\/p>\n<p>nivel acceptabil: &lt;60 \u03bcg\/L;<\/p>\n<p>nivel \u00eengrijor\u0103tor: &lt;100 \u03bcg\/L;<\/p>\n<p>nivel toxic: &gt; 200 \u03bcg\/L<sup>1<\/sup>.<\/p>\n<h2><strong>Interpretarea rezultatelor<\/strong><\/h2>\n<p>Pacien\u0163ii cu insuficien\u0163\u0103 renal\u0103 au, \u00een mod invariabil, nivele serice de aluminiu peste 60 ng\/mL.<\/p>\n<p>La persoanele care fac dializ\u0103 s-a definit un profil biochimic, caracteristic supra\u00eenc\u0103rc\u0103rii cu aluminiu:<\/p>\n<ul>\n<li>\u00a0pacien\u0163ii far\u0103 semne sau simptome de osteomalacie sau encefalopatie au, de obicei, valori plasmatice &lt;20 ng\/mL \u015fi concentra\u0163ia PTH \u00a0&gt;16 pmol\/L, ceea ce este tipic pentru hiperparatiroidism secundar;<\/li>\n<li>persoanele cu semne \u015fi simptome de osteomalacie sau encefalopatie au concentra\u0163ia seric\u0103 de aluminiu &gt;60 ng\/mL, iar nivelul PTH &lt;16 pmol\/mL;<\/li>\n<li>pacien\u0163ii cu valori plasmatice cuprinse \u00eentre 60-100 ng\/mL vor dezvolta manifest\u0103ri clinice ale supra\u00eenc\u0103rc\u0103rii cu aluminiu \u015fi se impun m\u0103suri specifice de reducere a expunerii zilnice.<\/li>\n<\/ul>\n<div>Acest lucru poate fi realizat prin \u00eenlocuirea chelatorilor de fosfa\u0163i baza\u0163i pe aluminiu cu unii pe baz\u0103 de calciu, asigur\u00e2ndu-se totodat\u0103 c\u0103 apa de dializ\u0103 are &lt;10 ng\/mL aluminiu \u015fi c\u0103 albumina utilizat\u0103 \u00een timpul tratamentului post-dializ\u0103 este far\u0103 aluminiu. Actualmente noile tehnologii de filtrare ofer\u0103 posibilitatea evit\u0103rii concentra\u0163iilor ridicate de aluminiu \u00een s\u00e2ngele pacien\u0163ilor dializa\u0163i \u015fi mic\u015foreaz\u0103 riscul dezvolt\u0103rii osteodistrofiei secundare.<\/div>\n<p>Concentra\u0163iile de aluminiu\u00a0\u00een s\u00e2nge \u00eenregistreaz\u0103 cre\u015fteri peste intervalul de referin\u0163\u0103 la pacien\u0163i cu proteze metalice. Valorile &gt;10 ng\/mL la un pacient cu un implant bazat pe aluminiu \u015fi care nu este supus dializei sugereaz\u0103 o uzur\u0103 semnificativ\u0103 a protezei<sup>2<\/sup>.<\/p>\n<p><strong>Limite \u015fi interferen\u0163e<\/strong><\/p>\n<p>Un nivel seric crescut de gadoliniu sau iod interfer\u0103 cu testele la metale, de aceea\u00a0\u00een cazul\u00a0\u00een care au fost administrate substan\u0163e de contrast cu gadoliniu sau iod, recoltarea trebuie am\u00e2nat\u0103 cel pu\u0163in 96 ore<sup>2<\/sup>.<\/p>\n<p>&nbsp;<\/p>\n<h2><strong>Bibliografie<\/strong><\/h2>\n<div>1. Laborator Synevo. Referinte specifice tehnologiei de lucru utilizate 2015. Ref Type: Catalog.<\/div>\n<div>2. Mayo Clinic. Mayo Medical Laboratories. Test Catalog. Aluminum, Serum. <a href=\"https:\/\/www.mayomedicallaboratories.com\" target=\"_blank\" rel=\"noopener nofollow external noreferrer\" data-wpel-link=\"external\">www.mayomedicallaboratories.com<\/a>. Ref Type: Internet Communication.<\/div>\n<div>3. Laboratory Corporation of America. Directory of Services and Interpretive Guide. Aluminum, Plasma or Serum <a href=\"https:\/\/www.labcorp.com\" target=\"_blank\" rel=\"noopener nofollow external noreferrer\" data-wpel-link=\"external\">www.labcorp.com<\/a> 2015. Ref Type: Internet Communication.<\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Informa\u021bii generale \u2013 Aluminiu \u00een s\u00e2nge Aluminiul este omniprezent \u00een mediu, fiind al treilea element ca r\u0103sp\u00e2ndire \u00een scoar\u0163a terestr\u0103. In mod normal tractul gastro-intestinal este relativ impermeabil pentru aluminiu, absorb\u0163ia fiind de aproximativ 2%. Aciditatea gastric\u0103 \u015fi citratul administrat pe cale oral\u0103 favorizeaz\u0103 absorb\u0163ia,\u00a0\u00een timp ce blocantele receptorilor H2 o reduc. In condi\u0163ii \u00a0fiziologice [&hellip;]<\/p>\n","protected":false},"featured_media":0,"template":"","meta":{"_acf_changed":false},"product_brand":[],"product_cat":[110,48],"product_tag":[],"class_list":["post-267","product","type-product","status-publish","product_cat-metale","product_cat-toxicologie","first","instock","shipping-taxable","purchasable","product-type-simple"],"acf":[],"_links":{"self":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product\/267","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/types\/product"}],"wp:attachment":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/media?parent=267"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_brand?post=267"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_cat?post=267"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_tag?post=267"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}