{"id":268753,"date":"2022-12-05T14:31:39","date_gmt":"2022-12-05T13:31:39","guid":{"rendered":"https:\/\/zakrasnejsivimperk.cz\/?p=268753"},"modified":"2022-12-05T14:31:39","modified_gmt":"2022-12-05T13:31:39","slug":"vseobecna-zdravotni-pojistovna-vysetreni-na-leidenskou-mutaci","status":"publish","type":"post","link":"https:\/\/zakrasnejsivimperk.cz\/?p=268753","title":{"rendered":"V\u0160EOBECN\u00c1 ZDRAVOTN\u00cd POJI\u0160\u0164OVNA: Vy\u0161et\u0159en\u00ed na Leidenskou mutaci"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-201756 size-full\" src=\"https:\/\/zakrasnejsivimperk.cz\/wp-content\/uploads\/2020\/08\/31\/vzp-logo.png\" alt=\"\" width=\"646\" height=\"223\" srcset=\"https:\/\/zakrasnejsivimperk.cz\/wp-content\/uploads\/2020\/08\/31\/vzp-logo.png 646w, https:\/\/zakrasnejsivimperk.cz\/wp-content\/uploads\/2020\/08\/31\/vzp-logo-300x104.png 300w\" sizes=\"(max-width: 646px) 100vw, 646px\" \/><\/p>\n<h6 style=\"text-align: center;\">OT\u00c1ZKA T\u00ddDNE:<\/h6>\n<h6 style=\"text-align: center;\">Chci za\u010d\u00edt u\u017e\u00edvat hormon\u00e1ln\u00ed antikoncepci a zaj\u00edm\u00e1 m\u011b, zda je z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed placeno genetick\u00e9 vy\u0161et\u0159en\u00ed kv\u016fli hrozb\u011b tromb\u00f3zy z d\u016fvodu Leidensk\u00e9 mutace?<\/h6>\n<h6 style=\"text-align: center;\">ODPOV\u011a\u010e:<\/h6>\n<p class=\"-wm-MsoNoSpacing\">Mutace v\u00a0genu pro koagula\u010dn\u00ed faktor\u00a0V (Leidensk\u00e1 mutace) je nejb\u011b\u017en\u011bj\u0161\u00ed genetickou predispozic\u00ed k\u00a0tromb\u00f3z\u00e1m. U\u017e\u00edv\u00e1n\u00ed hormon\u00e1ln\u00ed antikoncepce v p\u0159\u00edpad\u011b vrozen\u00e9 dispozice zv\u00fd\u0161en\u00e9 krevn\u00ed sr\u00e1\u017elivosti m\u016f\u017ee v\u00e9st k vy\u0161\u0161\u00edmu riziku z\u00e1va\u017en\u00fdch komplikac\u00ed. Pacienti trp\u00edc\u00ed trombofili\u00ed maj\u00ed zv\u00fd\u0161en\u00fd sklon k\u00a0tvorb\u011b krevn\u00edch sra\u017eenin, tzv. tromb\u016f. U nemocn\u00fdch m\u016f\u017ee doj\u00edt a\u017e ke vzniku hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy \u2013 krevn\u00ed sra\u017eeniny se pak mohou dostat do vzd\u00e1len\u00e9ho m\u00edsta a zp\u016fsobit nap\u0159. plicn\u00ed embolii, srde\u010dn\u00ed \u010di mozkovou p\u0159\u00edhodu.<\/p>\n<p class=\"-wm-MsoNoSpacing\"><b>Vy\u0161et\u0159en\u00ed na Leidenskou mutaci<\/b><\/p>\n<p class=\"-wm-MsoNoSpacing\"><b>Nejprve by m\u011bl registruj\u00edc\u00ed gynekolog s pacientkou proj\u00edt v r\u00e1mci preventivn\u00ed gynekologick\u00e9 prohl\u00eddky anamn\u00e9zu a zjistit, zda m\u00e1 v rodin\u011b sklon k\u00a0tromboembolick\u00fdm p\u0159\u00edhod\u00e1m<\/b>\u00a0(nap\u0159. jeden z rodi\u010d\u016f m\u011bl opakovan\u011b \u017eiln\u00ed tromb\u00f3zu nebo prod\u011blal infarkt myokardu v\u00a0mlad\u0161\u00edm v\u011bku).<\/p>\n<p class=\"-wm-MsoNoSpacing\"><b>V\u00a0p\u0159\u00edpad\u011b, \u017ee je rodinn\u00e1 anamn\u00e9za pozitivn\u00ed\u00a0<\/b>(zv\u00fd\u0161en\u00fd sklon k\u00a0tromb\u00f3z\u00e1m)<b>\u00a0a gynekolog chce pacientce kombinovanou hormon\u00e1ln\u00ed antikoncepci p\u0159edepsat, m\u011bl by tuto pacientku poslat na vy\u0161et\u0159en\u00ed ke specialistovi \u2013 klinick\u00e9mu genetikovi.<\/b>\u00a0<b>Ten pak na z\u00e1klad\u011b klinick\u00e9ho vy\u0161et\u0159en\u00ed p\u0159\u00edpadn\u011b indikuje speci\u00e1ln\u00ed molekul\u00e1rn\u011b genetick\u00e9 vy\u0161et\u0159en\u00ed na Leidenskou mutaci.<\/b>\u00a0Pokud je v\u00fdsledek genetick\u00e9ho vy\u0161et\u0159en\u00ed pozitivn\u00ed, m\u016f\u017ee b\u00fdt hormon\u00e1ln\u00ed antikoncepce kontraindikov\u00e1na.<\/p>\n<p class=\"-wm-MsoNoSpacing\">A\u010dkoli se doporu\u010duje genetick\u00fd test ud\u011blat je\u0161t\u011b p\u0159ed zah\u00e1jen\u00edm hormon\u00e1ln\u00ed antikoncepce, gynekolog m\u016f\u017ee pacientku odeslat na zm\u00edn\u011bn\u00e9 vy\u0161et\u0159en\u00ed kdykoli p\u0159i podez\u0159en\u00ed na zdravotn\u00ed komplikace, tedy i ji\u017e v\u00a0pr\u016fb\u011bhu u\u017e\u00edv\u00e1n\u00ed hormon\u00e1ln\u00ed antikoncepce.<\/p>\n<p class=\"-wm-MsoNoSpacing\"><b>\u00dahrada z\u00a0ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed<\/b><\/p>\n<p class=\"-wm-MsoNoSpacing\"><b>Podm\u00ednkou \u00fahrady vy\u0161et\u0159en\u00ed na Leidenskou mutaci v\u00a0souvislosti s\u00a0p\u0159edpisem antikoncepce z\u00a0ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed je indikace opr\u00e1vn\u011bn\u00fdm l\u00e9ka\u0159em s prokazateln\u00fdm od\u016fvodn\u011bn\u00edm vy\u0161et\u0159en\u00ed<\/b>, tedy u \u017een s pozitivn\u00ed osobn\u00ed anamn\u00e9zou prod\u011blan\u00e9 tromboembolick\u00e9 nemoci (TEN), nebo s pozitivn\u00ed rodinnou anamn\u00e9zou v\u00fdskytu TEN u p\u0159\u00edbuzn\u00fdch prvn\u00ed linie (matky, otce, vlastn\u00edch sourozenc\u016f a d\u011bt\u00ed pacientky). Genetick\u00fd test je nutn\u00e9 prov\u00e9st u poskytovatele zdravotn\u00edch slu\u017eeb, kter\u00fd m\u00e1 smlouvu se zdravotn\u00ed poji\u0161\u0165ovnou pacientky.<\/p>\n<p class=\"-wm-MsoNoSpacing\">Hormon\u00e1ln\u00ed antikoncepce nen\u00ed z\u00a0ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed hrazen\u00e1, ale indikovan\u00e1\u00a0<b>vy\u0161et\u0159en\u00ed prov\u00e1d\u011bna v\u00a0souvislosti s\u00a0mo\u017en\u00fdmi kontraindikacemi nebo vedlej\u0161\u00edmi \u00fa\u010dinky hormon\u00e1ln\u00ed antikoncepce, hrazen\u00e1 jsou<\/b>\u00a0(pacientky jejich registruj\u00edc\u00ed gynekolog pravideln\u011b klinicky sleduje v\u00a0r\u00e1mci dispenz\u00e1rn\u00ed p\u00e9\u010de).<\/p>\n<p class=\"-wm-MsoNoSpacing\"><b>Absolvov\u00e1n\u00ed testu na zji\u0161t\u011bn\u00ed p\u0159\u00edtomnosti trombofiln\u00edch mutac\u00ed\u00a0<a name=\"-wm-_Hlk120190007\"><\/a>z\u00a0vlastn\u00edho rozhodnut\u00ed a\u00a0na vlastn\u00ed \u017e\u00e1dost \u017eeny nen\u00ed z\u00a0ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed hrazeno<\/b>. Pacientka si vy\u0161et\u0159en\u00ed mus\u00ed v\u00a0takov\u00e9m p\u0159\u00edpad\u011b zaplatit sama, cenu pro samopl\u00e1tce si ur\u010duje poskytovatel zdravotn\u00edch slu\u017eeb.<\/p>\n<p><strong>(tz-vz)<\/strong><\/p>\n<hr \/>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>OT\u00c1ZKA T\u00ddDNE: <\/p>\n","protected":false},"author":2,"featured_media":268754,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"gallery","meta":{"footnotes":""},"categories":[88],"tags":[],"jetpack_featured_media_url":"https:\/\/zakrasnejsivimperk.cz\/wp-content\/uploads\/2022\/12\/05\/r\u00e1m-vzp.jpg","_links":{"self":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/268753"}],"collection":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=268753"}],"version-history":[{"count":1,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/268753\/revisions"}],"predecessor-version":[{"id":268755,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/268753\/revisions\/268755"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/media\/268754"}],"wp:attachment":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=268753"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=268753"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=268753"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}