ΠΠ»ΠΈΡΠ½ΠΈΠ΅ Π³Π»ΠΈΠΊΠΎΠ·ΠΈΠ»ΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π½Π° ΠΏΡΠΎΡΠ΅ΡΡΠΈΠ½Π³ ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΈΠΊΠ° Π½Π°ΡΡΠΈΠΉΡΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠ΅ΠΏΡΠΈΠ΄Π° B-ΡΠΈΠΏΠ° ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ°
Π‘Π — ΠΏΠ°ΡΠΎΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅, Π²ΡΠ·Π²Π°Π½Π½ΠΎΠ΅ ΡΡ ΡΠ΄ΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΠΎΠΊΡΠ°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΠΈ ΡΠ΅ΡΠ΄ΡΠ°, ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π΅ΡΡΡ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΡΠΎΠ²Π½Ρ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ ΠΈ ΡΠ΅ΠΊΡΠ΅ΡΠΈΠΈ BNP. ΠΠ° ΡΠ°Π½Π½ΠΈΡ ΡΡΠ°Π΄ΠΈΡΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ Π‘Π ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ BNP Π² ΠΊΡΠΎΠ²ΠΈ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠΈΠ²Π°Π΅Ρ ΠΏΠΎΠ΄Π΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅ Π½ΠΎΡΠΌΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΡΠ½ΠΊΡΠΈΠΎΠ½ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ ΠΈ ΠΏΠΎΡΠ΅ΠΊ. ΠΠ΄Π½Π°ΠΊΠΎ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ Ρ ΡΡΠΆΠ΅Π»ΡΠΌΠΈ ΡΠΎΡΠΌΠ°ΠΌΠΈ Π‘Π Π΄Π°ΠΆΠ΅ Π½Π° ΡΠΎΠ½Π΅ ΠΎΡΠ΅Π½Ρ Π²ΡΡΠΎΠΊΠΈΡ Π·Π½Π°ΡΠ΅Π½ΠΈΠΉ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ… Π§ΠΈΡΠ°ΡΡ Π΅ΡΡ >
- Π‘ΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅
- ΠΡΠ΄Π΅ΡΠΆΠΊΠ°
- ΠΠΈΡΠ΅ΡΠ°ΡΡΡΠ°
- ΠΡΡΠ³ΠΈΠ΅ ΡΠ°Π±ΠΎΡΡ
- ΠΠΎΠΌΠΎΡΡ Π² Π½Π°ΠΏΠΈΡΠ°Π½ΠΈΠΈ
Π‘ΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅
- Π‘ΠΏΠΈΡΠΎΠΊ ΡΠΎΠΊΡΠ°ΡΠ΅Π½ΠΈΠΉ
- 2. ΠΠ±Π·ΠΎΡ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ
- 2. 1. Π‘Π΅ΠΌΠ΅ΠΉΡΡΠ²ΠΎ Π½Π°ΡΡΠΈΠΉΡΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠ΅ΠΏΡΠΈΠ΄ΠΎΠ²
- 2. 1. 1. ΠΡΠΊΡΡΡΠΈΠ΅ Π½Π°ΡΡΠΈΠΉΡΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ ΠΏΠ΅ΠΏΡΠΈΠ΄ΠΎΠ²
- 2. 1. 2. ΠΠ°ΡΡΠΈΠΉΡΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΏΠ΅ΠΏΡΠΈΠ΄ Π-ΡΠΈΠΏΠ° — ΠΏΡΠ΅Π΄ΡΡΠ°Π²ΠΈΡΠ΅Π»Ρ ΡΠ΅ΠΌΠ΅ΠΉΡΡΠ²Π° Π½Π°ΡΡΠΈΠΉΡΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ ΠΏΠ΅ΠΏΡΠΈΠ΄ΠΎΠ²
- 2. 2. Π‘ΠΈΠ½ΡΠ΅Π· ΠΈ ΡΠ΅ΠΊΡΠ΅ΡΠΈΡ BNP
- 2. 2. 1. Π‘ΡΡΡΠΊΡΡΡΠ° Π³Π΅Π½Π° BNP
- 2. 2. 2. ΠΠΊΡΠΏΡΠ΅ΡΡΠΈΡ BNP Π² ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ ΡΠΊΠ°Π½ΡΡ
- 2. 2. 3. Π Π΅Π³ΡΠ»ΡΡΠΈΡ ΡΠ΅ΠΊΡΠ΅ΡΠΈΠΈ ΠΈ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ BNP
- 2. 3. ΠΡΠΎΡΠ΅ΡΡΠΈΠ½Π³ ΠΌΠΎΠ»Π΅ΠΊΡΠ»-ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΈΠΊΠΎΠ² BNP
- 2. 3. 1. Π‘Π΅ΠΌΠ΅ΠΉΡΡΠ²ΠΎ ΠΊΠΎΠ½Π²Π΅ΡΡΠ°Π· ΠΏΡΠΎΠ³ΠΎΡΠΌΠΎΠ½ΠΎΠ²
- 2. 3. 2. ΠΠΊΡΠΏΡΠ΅ΡΡΠΈΡ ΠΈ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠ½Π³ ΠΌΠΎΠ»Π΅ΠΊΡΠ»-ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²ΠΈΠ½Π½ΠΈΠΊΠΎΠ² BNP
- 2. 3. 3. Π€ΡΡΠΈΠ½ ΠΈ ΠΊΠΎΡΠΈΠ½ — ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΡΠ΅ ΠΊΠΎΠ½Π²Π΅ΡΡΠ°Π·Ρ, ΠΎΡΡΡΠ΅ΡΡΠ²Π»ΡΡΡΠΈΠ΅ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠ½Π³ ΠΌΠΎΠ»Π΅ΠΊΡΠ»-ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΈΠΊΠΎΠ² BNP
- 2. 4. ΠΠΎΡΡΡΡΠ°Π½ΡΠ»ΡΡΠΈΠΎΠ½Π½ΡΠ΅ ΠΌΠΎΠ΄ΠΈΡΠΈΠΊΠ°ΡΠΈΠΈ proBNP ΠΈ NT-proBNP
- 2. 4. 1. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ΠΈΡ ΠΎ ΡΡΡΠ΅ΡΡΠ²ΠΎΠ²Π°Π½ΠΈΠΈ ΠΎΠ»ΠΈΠ³ΠΎΠΌΠ΅ΡΠ½ΡΡ ΡΠΎΡΠΌ proBNP ΠΈ NT-proBNP
- 2. 4. 2. ProBNP ΠΈ NT-proBNP ΠΊΠ°ΠΊ Π-Π³Π»ΠΈΠΊΠΎΠΏΡΠΎΡΠ΅ΠΈΠ½Ρ
- 2. 4. 3. Π-Π³Π»ΠΈΠΊΠΎΠ·ΠΈΠ»ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ — Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΡΠΉ ΡΠΈΠΏ ΠΏΠΎΡΡΡΡΠ°Π½ΡΠ»ΡΡΠΈΠΎΠ½Π½ΡΡ ΠΌΠΎΠ΄ΠΈΡΠΈΠΊΠ°ΡΠΈΠΉ Π±Π΅Π»ΠΊΠΎΠ²
- 2. 5. Π Π΅ΡΠ΅ΠΏΡΠΎΡΡ Π½Π°ΡΡΠΈΠΉΡΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠ΅ΠΏΡΠΈΠ΄ΠΎΠ²
- 2. 5. 1. Π‘Π΅ΠΌΠ΅ΠΉΡΡΠ²ΠΎ ΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠΎΠ² Π½Π°ΡΡΠΈΠΉΡΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ ΠΏΠ΅ΠΏΡΠΈΠ΄ΠΎΠ²
- 2. 5. 2. ΠΠΊΡΠΈΠ²Π°ΡΠΈΡ ΠΈ Π΄Π΅ΡΠ΅Π½ΡΠΈΡΠΈΠ·Π°ΡΠΈΡ ΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠΎΠ²
- 2. 6. ΠΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΠ·ΠΌ BNP Π² ΠΊΡΠΎΠ²ΠΎΡΠΎΠΊΠ΅
- 2. 7. Π€ΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π΄Π΅ΠΉΡΡΠ²ΠΈΠ΅ BNP
- 2. 7. 1. ΠΠ΅ΠΉΡΡΠ²ΠΈΠ΅ BNP Π½Π° ΠΏΠΎΡΠΊΠΈ
- 2. 7. 2. ΠΠ΅ΠΉΡΡΠ²ΠΈΠ΅ BNP Π½Π° ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ ΡΠΈΡΡΠ΅ΠΌΡ
- 2. 7. 3. ΠΠ΅ΠΉΡΡΠ²ΠΈΠ΅ Π½Π° ΡΠ½Π΄ΠΎΠΊΡΠΈΠ½Π½ΡΡ ΡΠΈΡΡΠ΅ΠΌΡ
- 2. 8. BNP — Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΈ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Π±ΠΈΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΌΠ°ΡΠΊΠ΅Ρ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ
- 2. 8. 1. Π‘Π΅ΡΠ΄Π΅ΡΠ½Π°Ρ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΡ. ΠΠ±ΡΠ°Ρ Ρ Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠ°
- 2. 8. 2. ΠΠ°ΡΠΎΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡ Π‘Π
- 2. 8. 3. Π’Π΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π½Π°ΡΡΠΈΠΉΡΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ ΠΏΠ΅ΠΏΡΠΈΠ΄ΠΎΠ²
- 2. 8. 4. ΠΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° Π‘Π
- 2. 8. 5. ΠΠ·ΠΌΠ΅ΡΠ΅Π½ΠΈΠ΅ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ BNP ΠΈ NT-proBNP Π² ΠΊΡΠΎΠ²ΠΈ
- 2. 9. ΠΡΠΎΡΠ΅ΡΡΠΈΠ½Π³ ΠΌΠΎΠ»Π΅ΠΊΡΠ»-ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΈΠΊΠΎΠ² BNP — Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΡΠΉ ΡΠ΅Π³ΡΠ»ΡΡΠΎΡΠ½ΡΠΉ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌ ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΡ Π°ΠΊΡΠΈΠ²Π½ΠΎΠΉ ΡΠΎΡΠΌΡ BNP Π² ΠΊΡΠΎΠ²ΠΈ
- 2. 9. 1. Π€ΠΎΡΠΌΡ BNP Π² ΠΊΡΠΎΠ²ΠΈ
- 2. 9. 2. ProBNP — ΠΏΡΠ΅Π²Π°Π»ΠΈΡΡΡΡΠ°Ρ ΡΠΎΡΠΌΠ° Π² ΠΊΡΠΎΠ²ΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ Ρ Π‘Π
- 2. 9. 3. ΠΠ½Π΄ΠΎΠΊΡΠΈΠ½Π½ΡΠΉ ΠΏΠ°ΡΠ°Π΄ΠΎΠΊΡ
- 2. 1. Π‘Π΅ΠΌΠ΅ΠΉΡΡΠ²ΠΎ Π½Π°ΡΡΠΈΠΉΡΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠ΅ΠΏΡΠΈΠ΄ΠΎΠ²
- 3. 1. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ
- 3. 1. 1. Π Π΅Π°ΠΊΡΠΈΠ²Ρ ΠΈ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ Π΄Π»Ρ Π±ΠΈΠΎΡ ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΡ ΠΈ ΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΠΎ-Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ
- 3. 1. 2. Π Π΅Π°ΠΊΡΠΈΠ²Ρ ΠΈ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ Π΄Π»Ρ ΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎ-Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ
- 3. 2. ΠΠ΅ΡΠΎΠ΄Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ
- 3. 2. 1. ΠΠΌΠΌΡΠ½ΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈ Π±ΠΈΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ
- 3. 2. 1. 1. ΠΡΡΠΌΠΎΠΉ Π³ΡΠΌΡΠ½ΠΎΠ°Π½Π°Π»ΠΈΠ· ΠΈ Π³ΡΠΌΡΠ½ΠΎΠ°Π½Π°Π»Π½Π· ΡΡΠ½Π΄Π²ΠΈΡ-mima. ΠΠ±ΡΠΈΠ΅ ΠΏΡΠΈΠ½ΡΠΈΠΏΡ
- 3. 2. 1. 2. ΠΠΎΠ½ΡΠΎΠ³ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Π°Π½ΡΠΈΡΠ΅Π». Π°) ΠΠΎΠ½ΡΡΠ³ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Π°Π½ΡΠΈΡΠ΅Π» Ρ ΠΏΠ΅ΡΠΎΠΊΡΠΈΠ΄Π°Π·ΠΎΠΉ Ρ ΡΠ΅Π½Π°. Π±) ΠΠΎΠ½ΡΡΠ³ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Π°Π½ΡΠΈΡΠ΅Π» ΡΠΎ ΡΡΠ°Π±ΠΈΠ»ΡΠ½ΡΠΌ Ρ Π΅Π»Π°ΡΠΎΠΌ Π΅Π²ΡΠΎΠΏΠΈΡ. Π²) ΠΠΎΠ½ΡΡΠ³ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Π°Π½ΡΠΈΡΠ΅Π» Ρ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄Π½ΡΠΌ Π±ΠΈΠΎΡΠΈΠ½Π°
- 3. 2. 1. 3. ΠΡΡΠΌΠΎΠΉ ΠΈΠΌΠΌΡΠΏΠΎΡΠ΅ΡΠΌΠ΅Π½ΡΠ½ΡΠΉ Π°Π½Π°Π»ΠΈΠ·
- 3. 2. 1. 4. ΠΡΡΠΌΠΎΠΉ Π³ΠΌΠΌΡΠ½ΠΎΡΠΎΡΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠ½ΡΠΉ Π°Π½Π°Π»ΠΈΠ·
- 3. 2. 1. 5. ΠΠΌΠΌΡΠ½ΠΎΡΠΎΡΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠ½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· ΡΡΠ½Π΄Π²ΠΈΡ-ΡΠΈΠΏΠ°
- 3. 2. 1. 5. ΠΠΌΠΌΡΠ½ΠΎΡΠΎΡΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠ½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· ΡΡΠ½Π΄Π²ΠΈΡ-ΡΠΈΠΏΠ° Ρ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½Π½ΠΎΠΉ ΡΠΎΡΠ±ΡΠΈΠ΅ΠΉ Π°Π½ΡΠΈΡΠ΅Π» Π½Π° ΠΏΠ»Π°Π½ΡΠ΅ΡΠ΅
- 3. 2. 1. 6. ΠΠΌΠΌΠΎΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΡ Π°Π½ΡΠΈΡΠ΅Π» Π½Π° CNBr — Π°ΠΊΡΠΈΠ²ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΡΠΎΠ·Π΅
- 3. 2. 1. 7. ΠΠ»Π΅ΠΊΡΡΠΎΡΠΎΡΠ΅Π· Π² ΠΠΠΠ Π² ΠΏΡΠΈΡΡΡΡΡΠ²ΠΈΠΈ ΠΠ‘Π Π² ΡΡΠΈΡ-ΡΡΠΈΡΠΈΠ½ΠΎΠ²ΠΎΠΉ Π±ΡΡΠ΅ΡΠ½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΠ΅
- 3. 2. 1. 8. ΠΠ΅ΡΡΠ΅ΡΠ½-Π±Π»ΠΎΡΡΠΈΠ½Π³
3.2.1.9. ΠΠΌΠΌΡΠ½ΠΎΡ ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΎΠΊΡΠ°ΡΠΈΠ²Π°Π½ΠΈΠ΅ Π±Π΅Π»ΠΊΠΎΠ², ΠΈΠΌΠΌΠΎΠ±ΡΡΠ·ΠΎΠ²Π°Π½Π½ΡΡ Π½Π° Π½ΠΈΡΡΠΎΡΠ΅Π»Π»ΡΠ»ΠΎΠ·Π½ΠΎΠΉ ΠΌΠ΅ΠΌΠ±ΡΠ°Π½Π΅. Π°) ΠΠΈΠ·ΡΠ°Π»ΠΈΠ·Π°ΡΠΈΡ Π±Π΅Π»ΠΊΠΎΠ²ΡΡ ΠΏΠΎΠ»ΠΎΡ Ρ ΠΏΠΎΠΌΠΎΡΡΡ Ρ ΡΠΎΠΌΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ ΡΡΠ±ΡΡΡΠ°ΡΠ° Π΄ΠΈΠ°ΠΌΠΈΠ½ΠΎΠ±Π΅Π½Π·ΠΈΠ΄ΠΈΠ½Π°. Π±) ΠΠΈΠ·ΡΠ°Π»ΠΈΠ·Π°ΡΠΈΡ Π±Π΅Π»ΠΊΠΎΠ²ΡΡ ΠΏΠΎΠ»ΠΎΡ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΌΠ΅ΡΠΎΠ΄Π° ΡΡΠΈΠ»Π΅Π½Π½ΠΎΠΉ Ρ Π΅ΠΌΠΈΠ»ΡΠΌΠΈΠ½Π΅ΡΡΠ΅Π½ΡΠΈΠΈ (Enhanced Chemioluminescence, ECL).
3.2.1.10. ΠΠΊΡΡΡΠ°ΠΊΡΠΈΡ ΠΈ ΠΈΠΌΠΌΡΠ½ΠΎΠΏΡΠ΅ΡΠΈΠΏΠΈΡΠ°ΡΠΈΡ proBNP Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π°ΡΡΠΈΠ½Π½ΠΎΠ³ΠΎ Π½ΠΎΡΠΈΡΠ΅Π»Ρ. Π°) ΠΠΊΡΡΡΠ°ΠΊΡΠΈΡ proBNP ΠΈΠ· ΠΎΠ±ΡΠ΅Π΄ΠΈΠ½Π΅Π½Π½ΠΎΠΉ ΠΏΠ»Π°Π·ΠΌΡ Π±ΠΎΠ»ΡΠ½ΡΡ Π‘Π. Π±) ΠΠΊΡΡΡΠ°ΠΊΡΠΈΡ ΡΠ΅ΠΊΠΎΠΌΠ±ΠΈΠ½Π°Π½ΡΠ½ΠΎΠ³ΠΎ proBNP ΠΈΠ· ΠΎΠ±ΡΠ΅Π΄ΠΈΠ½Π΅Π½Π½ΠΎΠΉ ΠΊΠΎΠ½Π΄ΠΈΡΠΈΠΎΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΡΡΠ΅Π΄Ρ. Π²) ΠΠΈΠΊΡΠΎΡΠΊΡΡΡΠ°ΠΊΡΠΈΡ proBNP ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π°ΡΡΠΈΠ½Π½ΠΎΠΉ Ρ ΡΠΎΠΌΠ°ΡΠΎΠ³ΡΠ°ΡΠΈΠΈ. Π³) ΠΠΌΠΌΡΠ½ΠΎΠΏΡΠ΅ΡΠΈΠΏΠΈΡΠ°ΡΠΈΡ proBNP.
3.2.1.11. Π₯ΡΠΎΠΌΠ°ΡΠΎΠ³ΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΡΠ°Π·Π΄Π΅Π»Π΅Π½ΠΈΠ΅ Π±Π΅Π»ΠΊΠΎΠ². Π°) ΠΠΎΠ½ΠΎΠΎΠ±ΠΌΠ΅Π½Π½Π°Ρ Ρ ΡΠΎΠΌΠ°ΡΠΎΠ³ΡΠ°ΡΠΈΡ. Π±) ΠΠ΅Π»Ρ-ΡΠΈΠ»ΡΡΡΠ°ΡΠΈΡ. Π²) ΠΠ±ΡΠ°ΡΠ½ΠΎ-ΡΠ°Π·ΠΎΠ²Π°Ρ Ρ ΡΠΎΠΌΠ°ΡΠΎΠ³ΡΠ°ΡΠΈΡ.
3.2.1.12. Π€Π΅ΡΠΌΠ΅Π½ΡΠ°ΡΠΈΠ²Π½ΠΎΠ΅ Π΄Π΅Π³Π»ΠΈΠΊΠΎΠ·ΠΈΠ»ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ proBNP.
3.2.1.13. Π₯ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π΄Π΅Π³Π»ΠΈΠΊΠΎΠ·ΠΈΠ»ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠ΅ΠΊΠΎΠΌΠ±ΠΈΠ½Π°Π½ΡΠ½ΠΎΠ³ΠΎ proBNP, ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ Π² ΠΊΠ»Π΅ΡΠΊΠ°Ρ ΠΠΠ 293.
3.2.1.14. Π Π°ΡΡΠ΅ΠΏΠ»Π΅Π½ΠΈΠ΅ proBNP ΡΠ΅ΠΊΠΎΠΌΠ±ΠΈΠ½Π°Π½ΡΠ½ΡΠΌ ΡΡΡΠΈΠ½ΠΎΠΌ in vitro. Π°) Π Π°ΡΡΠ΅ΠΏΠ»Π΅Π½ΠΈΠ΅ ΡΠ΅ΠΊΠΎΠΌΠ±ΠΈΠ½Π°Π½ΡΠ½ΠΎΠ³ΠΎ proBNP. Π±) Π Π°ΡΡΠ΅ΠΏΠ»Π΅Π½ΠΈΠ΅ ΡΠ½Π΄ΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ proBNP.
3.2.1.15. ΠΠ°ΡΡ-ΡΠΏΠ΅ΠΊΡΡΠΎΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ·.
3.2.2. ΠΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΠΎ-Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ.
3.2.2.1. ΠΠΎΠ»ΡΡΠ΅Π½ΠΈΠ΅ ΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΠΎ-Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠΈpCMV/proBNP Π΄Π»Ρ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ ΡΠ΅ΠΊΠΎΠΌΠ±ΠΈΠ½Π°Π½ΡΠ½ΠΎΠ³ΠΎ proBNP Π² ΠΊΠ»Π΅ΡΠΊΠ°Ρ ΠΌΠ»Π΅ΠΊΠΎΠΏΠΈΡΠ°ΡΡΠΈΡ .
3.2.2.2. ΠΠΎΠ»ΡΡΠ΅Π½ΠΈΠ΅ ΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΠΎ-Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠΉ Π΄Π»Ρ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ ΠΌΡΡΠ°Π½ΡΠ½ΡΡ ΡΠΎΡΠΌ proBNP.
3.2.3. ΠΠ»Π΅ΡΠΎΡΠ½ΠΎ-Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ.
3.2.3.1. ΠΡΠ»ΡΡΠΈΠ²ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΊΠ»Π΅ΡΠΎΡΠ½ΡΡ Π»ΠΈΠ½ΠΈΠΉ ΠΠΠ 293, Π‘ΠΠ-Π1, NIH ΠΠ’Π.
3.2.3.2. Π’ΡΠ°Π½Π·ΠΈΡΠΎΡΠ½Π°Ρ ΡΡΠ°Π½ΡΡΠ΅ΠΊΡΠΈΡ ΡΡΠΊΠ°ΡΠΈΠΎΡΠΈΡΠ΅ΡΠΊΠΈΡ ΠΊΠ»Π΅ΡΠΎΡΠ½ΡΡ Π»ΠΈΠ½ΠΈΠΉ.
4. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΈ ΠΈΡ ΠΎΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅.
4.1. Π‘ΡΠ°Π²Π½Π΅Π½ΠΈΠ΅ ΠΏΡΠΎΡΠΈΠ»Π΅ΠΉ ΠΈΠΌΠΌΡΠ½ΠΎΡΠ΅Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠ½Π΄ΠΎΠ³Π΅Π½Π½ΡΡ proBNP ΠΈ NT-proBNP
4.2. Π‘ΠΎΠ·Π΄Π°Π½ΠΈΠ΅ ΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΠΎ-Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠΈ Π΄Π»Ρ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ ΡΠ΅ΠΊΠΎΠΌΠ±ΠΈΠ½Π°Π½ΡΠ½ΠΎΠ³ΠΎ proBNP Π² Π»ΠΈΠ½ΠΈΡΡ ΠΊΠ»Π΅ΡΠΎΠΊ ΠΌΠ»Π΅ΠΊΠΎΠΏΠΈΡΠ°ΡΡΠΈΡ .
4.3. ΠΠΊΡΠΏΡΠ΅ΡΠΈΠΈΡ rec-proBNP Π² ΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠΉ Π»ΠΈΠ½ΠΈΠΈ ΠΠΠ 293.
4.3.1. ΠΡΠ΅Π½ΠΊΠ° ΡΡΠΎΠ²Π½Ρ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ rec-proBNP.
4.3.2. ΠΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΠΎΠ³ΠΎ Π²ΡΠ΅ΠΌΠ΅Π½ΠΈ ΠΊΡΠ»ΡΡΠΈΠ²ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΊΠ»Π΅ΡΠΎΠΊ ΠΠΠ 293 ΠΏΠΎΡΠ»Π΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΡΡΠ°Π½ΡΡΠ΅ΠΊΡΠΈΠΈ.
4.3.3. ΠΠ½Π°Π»ΠΈΠ· ΡΠΎΡΠΌ rec-proBNP Π² ΠΊΠΎΠ½Π΄ΠΈΡΠΈΠΎΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΡΡΠ΅Π΄Π΅ ΠΊΠ»Π΅ΡΠΎΠΊ Π»ΠΈΠ½ΠΈΠΈ ΠΠΠ 293, ΡΡΠ°Π½ΡΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠ΅ΠΉ pCMV/proBNP.
4.4. Π‘ΡΠ΅ΠΏΠ΅Π½Ρ Π³Π»ΠΈΠΊΠΎΠ·ΠΈΠ»ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΡΠ°ΡΡΠΊΠ° 63−76 rec-proBNP ΠΈ ΡΡΠΎΠ²Π΅Π½Ρ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠ½Π³Π°
4.4.1. ΠΠΌΠΌΡΠ½ΠΎΡΠ΅Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ rec-proBNP ΠΈ rec-NT-proBNP, ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ Π² ΠΊΠ»Π΅ΡΠΎΡΠ½ΡΡ Π»ΠΈΠ½ΠΈΡΡ Π‘ΠΠ-Π1 ΠΈ NIH ΠΠ’Π.
4.4.2. Π£ΡΠΎΠ²Π΅Π½Ρ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠ½Π³Π° rec-proBNP ΠΏΡΠΈ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ Π² ΠΊΠ»Π΅ΡΠΎΡΠ½ΡΡ Π»ΠΈΠ½ΠΈΡΡ ΠΠΠ 293, Π‘ΠΠ-Π1 UNIH3T3.
4.5. ΠΠΎΠ»ΡΡΠ΅Π½ΠΈΠ΅ ΠΎΡΠΈΡΠ΅Π½Π½ΠΎΠ³ΠΎ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° rec-proBNP, ΡΠΊΡΠ½ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ Π² ΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠΉ Π»ΠΈΠ½ΠΈΠΈ ΠΠΠ 293.
4.5.1. ΠΡΠ΄Π΅Π»Π΅Π½ΠΈΠ΅ ΠΈ ΠΎΡΠΈΡΡΠΊΠ° rec-proBNP (ΠΠΠ 293).
4.5.2. Π₯Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·Π°ΡΠΈΡ ΠΎΡΠΈΡΠ΅Π½Π½ΠΎΠ³ΠΎ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° rec-proBNP (ΠΠΠ 293).
4.6. ΠΠ»ΠΈΡΠ½ΠΈΠ΅ Π³Π»ΠΈΠΊΠΎΠ·ΠΈΠ»ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΡΠ°ΡΡΠΊΠ°, ΡΠ°ΡΠΏΠΎΠ»ΠΎΠΆΠ΅Π½Π½ΠΎΠ³ΠΎ Π²Π±Π»ΠΈΠ·ΠΈ ΡΠ°ΠΉΡΠ° ΠΏΡΠΎΡΠ΅ΡΡΠΈΠ½Π³Π°, Π½Π° ΡΠ°ΡΡΠ΅ΠΏΠ»Π΅Π½ΠΈΠ΅ proBNP ΠΊΠΎΠ½Π²Π΅ΡΡΠ°Π·ΠΎΠΉ ΠΏΡΠΎΠ³ΠΎΡΠΌΠΎΠ½ΠΎΠ² ΡΡΡΠΈΠ½ΠΎΠΌ.
4.6.1. Π Π°ΡΡΠ΅ΠΏΠ»Π΅Π½ΠΈΠ΅ rec-proBNP, ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ Π² ΠΊΠ»Π΅ΡΠΊΠ°Ρ ΠΠΠ 293, ΡΠ΅ΠΊΠΎΠΌΠ±ΠΈΠ½Π°Π½ΡΠ½ΡΡ ΡΡΡΠΈΠ½ΠΎΠΌ.
4.6.2. Π Π°ΡΡΠ΅ΠΏΠ»Π΅Π½ΠΈΠ΅ ΡΠ½Π΄ΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ proBNPΡΠ΅ΠΊΠΎΠΌΠ±ΠΈΠ½Π°Π½ΡΠ½ΡΠΌ ΡΡΡΠΈΠ½ΠΎΠΌ.
4.7. ΠΡΠΎΡΠ΅ΡΡΠΈΠ½Π³ ΠΌΡΡΠ°Π½ΡΠ½ΡΡ ΡΠΎΡΠΌ rec-proBNP (ΠΠΠ 293).
4.7.1. Π‘ΠΊΠ°Π½ΠΈΡΡΡΡΠΈΠΉ Π°Π»Π°Π½ΠΈΠ½ΠΎΠ²ΡΠΉ ΠΌΡΡΠ°Π³Π΅Π½Π΅Π·.
4.7.2. ΠΡΠ΅Π½ΠΊΠ° ΡΡΠΎΠ²Π½Ρ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠ½Π³Π° ΠΌΡΡΠ°Π½ΡΠ½ΡΡ ΡΠΎΡΠΌ rec-proBNP.
4.7.3. ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠ½Π³Π° rec-proBNP Π΄ΠΈΠΊΠΎΠ³ΠΎ ΡΠΈΠΏΠ° ΠΈ ΡΠΎΡΠΌΡ Π’71Π Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΌΠ΅ΡΠΎΠ΄Π° Π³Π΅Π»Ρ-ΡΠΈΠ»ΡΡΡΠ°ΡΠΈΠΈ.
4.7.4. ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ BNP, ΠΎΠ±ΡΠ°Π·ΡΡΡΠ΅Π³ΠΎΡΡ ΠΏΡΠΈ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠ½Π³Π΅ ΠΌΡΡΠ°Π½ΡΠ½ΠΎΠΉ ΡΠΎΡΠΌΡ Π³Π΅Ρ-proBNP Π’71Π, Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΌΠ΅ΡΠΎΠ΄Π° ΠΌΠ°ΡΡ-ΡΠΏΠ΅ΠΊΡΡΠΎΠΌΠ΅ΡΡΠΈΠΈ.
4.8. ΠΠ½Π°Π»ΠΈΠ· ΡΠΈΠ»ΠΎΠ³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΠΎΠ½ΡΠ΅ΡΠ²Π°ΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠ΅Π½ΠΎΠΌΠ΅Π½Π° ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠ½Π³Π° proBNP ΠΏΠΎΠ΄ Π΄Π΅ΠΉΡΡΠ²ΠΈΠ΅ΠΌ Π³Π»ΠΈΠΊΠΎΠ·ΠΈΠ»ΠΈΡΠΎΠ²Π°Π½ΠΈΡ.
- 3. 2. 1. ΠΠΌΠΌΡΠ½ΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈ Π±ΠΈΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ
Π‘ΠΏΠΈΡΠΎΠΊ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ
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