{"id":10002,"date":"2020-04-23T03:53:38","date_gmt":"2020-04-23T01:53:38","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/rezistenta-la-proteina-c-activata-apcr\/"},"modified":"2025-07-01T07:56:54","modified_gmt":"2025-07-01T04:56:54","slug":"rezistenta-la-proteina-c-activata-apcr","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/rezistenta-la-proteina-c-activata-apcr\/","title":{"rendered":"\u0420\u0435\u0437\u0438\u0441\u0442\u0435\u043d\u0442\u043d\u043e\u0441\u0442\u044c \u043a \u0430\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e\u043c\u0443 \u043f\u0440\u043e\u0442\u0435\u0438\u043d\u0443 \u0421 (APCR)"},"content":{"rendered":"

\u041e\u0431\u0449\u0430\u044f \u0438\u043d\u0444\u043e\u0440\u043c\u0430\u0446\u0438\u044f<\/em><\/strong><\/p>\n

Termenul de rezisten\u0163\u0103 la proteina C activat\u0103 descrie incapacitatea proteinei C activate (APC) de a anticoagula plasma, iar aceast\u0103 condi\u0163ie este asociat\u0103 cu o predispozi\u0163ie crescut\u0103 pentru tromboze venoase.<\/p>\n

Mecanismul rezisten\u0163ei la proteina C activat\u0103 a devenit mai bine cunoscut o dat\u0103 cu identificarea \u00een 1994 a muta\u0163iei punctiforme G1691A de la nivelul genei care codific\u0103 factorul V al coagul\u0103rii. Ca urmare a acestei muta\u0163ii este generat un factor V anormal (factorul V Leiden), caracterizat prin \u00eenlocuirea argininei din pozi\u0163ia 506 cu glutamina \u015fi modificarea consecutiv\u0103 a situsului de legare a APC. Ulterior a fost identificat \u015fi un alt defect cauzat de muta\u0163ia G1691A \u015fi anume incapacitatea factorului V Leiden de a ac\u0163iona ca un cofactor \u00een procesul de degradare a FVIII activat de c\u0103tre APC.<\/p>\n

APC inactiveaz\u0103 FVa prin clivarea a 3 leg\u0103turi de la nivelul lan\u0163ului greu (amino-terminal): Arg506, Arg306, Arg679. Clivarea de la nivelul Arg506 este necesar\u0103 pentru expunerea eficient\u0103 a celorlalte 2 situsuri de clivare, iar absen\u0163a sa determin\u0103 rezisten\u0163a la APC.<\/p>\n

Factorul V Leiden reprezint\u0103 principala cauz\u0103 de APCR, fiind prezent la aproximativ 90% dintre pacien\u0163i. \u00cen absen\u0163a factorului V Leiden, APCR constituie un factor de risc independent pentru tromboza venoas\u0103, riscul corel\u00e2ndu-se direct propor\u0163ional cu gradul rezisten\u0163ei. Printre condi\u0163iile asociate cu APCR \u00een absen\u0163a factorului V Leiden se num\u0103r\u0103: nivelul crescut de FVIII, sarcina, administrarea de contraceptive orale, terapia hormonal\u0103 de substitu\u0163ie, prezen\u0163a anticoagulantului lupic.<\/p>\n

APCR \u00een absen\u0163a factorului V Leiden este mult mai frecvent\u0103 la femei dec\u00e2t la b\u0103rba\u0163i ceea ce indic\u0103 o predispozi\u0163ie mai mare pentru tromboze post-operatorii la persoanele de sex feminin. Pe de alt\u0103 parte, cea mai mic\u0103 inciden\u0163a a APCR este \u00eent\u00e2lnit\u0103 la indivizii cu grupa sangvin\u0103 O, deoarece ace\u015ftia prezint\u0103 un nivel relativ mai sc\u0103zut de FVIII.<\/p>\n

Factorul V Cambridge, o condi\u0163ie rar\u0103 generat\u0103 de o muta\u0163ie care determin\u0103 \u00eenlocuirea argininei din pozi\u0163ia 306 cu treonina, este de asemenea asociat cu APCR. P\u00e2n\u0103 \u00een prezent nu a fost identificat\u0103 nici o muta\u0163ie la nivelul celui de-al treilea situs de clivare al FVa (Arg679)1;2<\/sup>.<\/p>\n

Recomand\u0103ri pentru determinarea APCR <\/em><\/strong>\u2013 test screening pentru factorul V Leiden3<\/sup>.<\/p>\n

Preg\u0103tire pacient <\/em><\/strong>\u2013 se va evita recoltarea probei de pe catetere heparinizate3<\/sup>.<\/p>\n

Specimen recoltat <\/em><\/strong>\u2013 s\u00e2nge venos3<\/sup>.<\/p>\n

Recipient de recolt\u0103 <\/em><\/strong>\u2013 vacutainer cu citrat Na 0.105 M (1\/9), capac bleu\/verde3<\/sup>.<\/p>\n

Cantitate recoltat\u0103 <\/em><\/strong>\u2013 c\u00e2t permite vacuumul3<\/sup>.<\/p>\n

Cauze de respingere a probei <\/em><\/strong>\u2013 prob\u0103 \u00een cantitate inadecvat\u0103 (sub nivelul indicat pe vacutainer); specimen hemolizat; prezen\u0163\u0103 de coaguli \u00een prob\u01033<\/sup>.<\/p>\n

Prelucrare necesar\u0103 dup\u0103 recoltare <\/em><\/strong>\u2013 centrifugare 15 min. la 2500 g pentru ob\u0163inerea plasmei (plasma trebuie s\u0103 fie foarte s\u0103rac\u0103 \u00een trombocite, T <10000\/\u03bcL \u2013 dubl\u0103 centrifugare), urmat\u0103 imediat de separarea plasmei \u015fi congelarea acesteia; probele recoltate \u00een afara laboratorului vor fi transportate \u00een recipientul destinat probelor congelate1<\/sup>.<\/p>\n

Stabilitate prob\u0103 <\/em><\/strong>\u2013 plasma separat\u0103 este stabil\u0103 1 lun\u0103<\/em> la -20\u00b0C3<\/sup>.<\/p>\n

Metod\u0103 <\/em><\/strong>- test de coagulare<\/u> care ac\u0163ioneaz\u0103 specific la nivelul complexului protrombinazei, prin utilizarea unui activator de protrombin\u0103 dependent de FVa izolat dintr-un venin de \u015farpe; sunt eliminate astfel posibilele interferen\u0163e exercitate de c\u0103tre factorii situa\u0163i \u00een amonte<\/em> \u00een cascada coagul\u0103rii precum \u015fi dependen\u0163a fa\u0163\u0103 de ionii de calciu; \u00eentr-o prim\u0103 etap\u0103, plasma diluat\u0103 a pacientului va fi incubat\u0103 la 37\u00b0C cu un activator de factor V provenit din veninul de Daboia russeli<\/em>, care converte\u015fte FV \u00een FVa; coagularea va fi ini\u0163iat\u0103 \u00een absen\u0163a calciului prin ad\u0103ugarea unui activator de protrombin\u0103 dependent de FVa izolat din veninul de Notechis scutatus<\/em>; se efectueaz\u0103 dou\u0103 teste de coagulare cu \u015fi f\u0103r\u0103 ad\u0103ugarea de APC, dup\u0103 care se calculeaz\u0103 raportul dintre cei doi timpi; ad\u0103ugarea APC va alungi semnificativ timpul de coagulare la persoanele cu genotip s\u0103lbatic, \u00een timp ce pacien\u0163ii cu factor V Leiden prezint\u0103 rezisten\u0163\u0103 la APC, astfel c\u0103 timpul lor de coagulare nu va fi influen\u0163at semnificativ de ad\u0103ugarea acestui reactiv; reactivii con\u0163in un inhibitor de heparin\u0103 ceea ce permite efectuarea testului la pacien\u0163i afla\u0163i sub heparinoterapie, av\u00e2nd concentra\u0163ii ale heparinei \u22642UI\/mL3<\/sup>.<\/p>\n

Valori de referin\u0163\u0103 <\/em><\/strong>\u2013 \u22652.5 (raport)3<\/sup>.<\/p>\n

Limite \u015fi interferen\u0163e<\/em><\/strong><\/p>\n

Ob\u0163inerea unui rezultat pozitiv necesit\u0103 efectuarea testului genetic care depisteaz\u0103 muta\u0163ia factorului V Leiden \u015fi stabile\u015fte statusul homozigot\/heterozigot.<\/div>\n
\u00cen unele cazuri (la valori de grani\u0163\u0103 ale raportului) testul poate e\u015fua \u00een distingerea indivizilor heterozigo\u0163i pentru factorul V Leiden fa\u0163\u0103 de normali.<\/div>\n
Testul nu<\/strong> detecteaz\u0103 rezisten\u0163a la proteina C activat\u0103 de cauz\u0103 dob\u00e2ndit\u0103.<\/div>\n
Deficitul de fibrinogen, protrombin\u0103, FVIII, FX, ATIII, protein\u0103 C, protein\u0103 S (p\u00e2n\u0103 la 100%), c\u00e2t \u015fi excesul de fibrinogen, factor VIII, sau ATIII (de p\u00e2n\u0103 la 5 ori normalul) nu influen\u0163eaz\u0103 semnificativ valoarea raportului \u015fi sensibilitatea testului3<\/sup>.<\/div>\n
Prezen\u0163a anticoagulantului lupic nu exercit\u0103 influen\u0163\u0103 asupra testului. \u00cen urma unor studii efectuate s-a constatat c\u0103 de asemenea sarcina, contraceptivele orale \u015fi anticoagulantele orale nu afecteaz\u0103 performan\u0163a testului4<\/sup>.<\/div>\n
Deficitul important de factor V \u00een plasm\u0103 (<50%) poate conduce la timpi de coagulare alungi\u0163i \u015fi astfel se poate pierde performan\u0163a discriminatorie. Prezen\u0163a aprotininei (care inhib\u0103 APC utilizat\u0103 \u00een test) sau a protaminei \u00een plasma pacientului poate conduce la sc\u0103derea timpilor de coagulare \u015fi de asemenea la afectarea capacit\u0103\u0163ii discriminatorii. Inhibitorii direc\u0163i ai trombinei (hirudin, argatroban) influen\u0163eaz\u0103 timpii de coagulare \u015fi valoarea raportului. Din aceste motive, trebuie \u00eentrerupt tratamentul cu aprotinin\u0103, protamin\u0103 sau inhibitori de trombin\u0103 cu cel pu\u0163in 24 ore \u00eenaintea recolt\u0103rii3<\/sup>.<\/div>\n

\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<\/strong><\/span><\/p>\n

    \n
  1. \n
    Jennings I, Cooper P. Screening for Thrombophilia: A Laboratory Perspective. In British Journal of Biomedical Science<\/em>, 2003, 60(1):39-51.<\/span><\/div>\n<\/li>\n
  2. \n
    Laboratory Corporation of America. Directory of Services and Interpretive Guide. Activated Protein C Resistance www.labcorp.com<\/a> 2015. Ref Type: Internet Communication.<\/span><\/div>\n<\/li>\n
  3. \n
    Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate 2015. Ref Type: Catalog.<\/span><\/div>\n<\/li>\n
  4. \n
    Reta Sch\u00f6ni, Peter Quehenberger, Jogin R Wu, Marianne Wilmer. Clinical evaluation of a new functional test for detection of activated protein C resistance (Pefakit\u00ae APC-R Factor V Leiden) at two centers in Europe and the USA. In Thrombosis Research<\/em> 2007; 119(1): 17-26.<\/span><\/div>\n<\/li>\n<\/ol>","protected":false},"excerpt":{"rendered":"

    \u0420\u0435\u0437\u0438\u0441\u0442\u0435\u043d\u0442\u043d\u043e\u0441\u0442\u044c \u043a \u0430\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e\u043c\u0443 \u043f\u0440\u043e\u0442\u0435\u0438\u043d\u0443 C (APCR) \u2014 \u044d\u0442\u043e \u0441\u043b\u043e\u0436\u043d\u043e\u0435 \u044f\u0432\u043b\u0435\u043d\u0438\u0435, \u0441\u0432\u044f\u0437\u0430\u043d\u043d\u043e\u0435 \u0441 \u0443\u043c\u0435\u043d\u044c\u0448\u0435\u043d\u043d\u043e\u0439 \u0447\u0443\u0432\u0441\u0442\u0432\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u0441\u0442\u044c\u044e \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c\u0430 \u043a \u0438\u043d\u0433\u0438\u0431\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u044e \u043a\u043e\u0430\u0433\u0443\u043b\u044f\u0446\u0438\u0438 \u043f\u043e\u0441\u0440\u0435\u0434\u0441\u0442\u0432\u043e\u043c \u0430\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e\u0433\u043e \u043f\u0440\u043e\u0442\u0435\u0438\u043d\u0430 C. \u042d\u0442\u043e\u0442 \u0441\u043f\u0435\u0446\u0438\u0430\u043b\u0438\u0437\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u044b\u0439 \u0430\u043d\u0430\u043b\u0438\u0437 \u0438\u0433\u0440\u0430\u0435\u0442 \u043a\u043b\u044e\u0447\u0435\u0432\u0443\u044e \u0440\u043e\u043b\u044c \u0432 \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0438 \u0433\u0435\u043d\u0435\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0445 \u0438 \u043b\u0430\u0431\u043e\u0440\u0430\u0442\u043e\u0440\u043d\u044b\u0445 \u0444\u0430\u043a\u0442\u043e\u0440\u043e\u0432 \u0440\u0438\u0441\u043a\u0430 \u0442\u0440\u043e\u043c\u0431\u043e\u0437\u0430. \u041e\u0437\u043d\u0430\u043a\u043e\u043c\u043b\u0435\u043d\u0438\u0435 \u0441\u043e \u0441\u043f\u0435\u0446\u0438\u0444\u0438\u043a\u043e\u0439 \u0438 \u043f\u043e\u0434\u0442\u0438\u043f\u0430\u043c\u0438 \u044d\u0442\u043e\u0433\u043e \u0430\u043d\u0430\u043b\u0438\u0437\u0430 \u043f\u043e\u043c\u043e\u0436\u0435\u0442 \u043b\u0443\u0447\u0448\u0435 \u043f\u043e\u043d\u044f\u0442\u044c \u0432\u0430\u0448\u0435 \u0437\u0434\u043e\u0440\u043e\u0432\u044c\u0435 \u0438 \u043f\u043e\u0442\u0435\u043d\u0446\u0438\u0430\u043b\u044c\u043d\u044b\u0435 \u0440\u0438\u0441\u043a\u0438.<\/p>\n

    \u0427\u0442\u043e \u0442\u0430\u043a\u043e\u0435 APCR (\u0440\u0435\u0437\u0438\u0441\u0442\u0435\u043d\u0442\u043d\u043e\u0441\u0442\u044c \u043a \u0430\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e\u043c\u0443 \u043f\u0440\u043e\u0442\u0435\u0438\u043d\u0443 C)?<\/strong><\/p>\n

    \u0420\u0435\u0437\u0438\u0441\u0442\u0435\u043d\u0442\u043d\u043e\u0441\u0442\u044c \u043a \u0430\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e\u043c\u0443 \u043f\u0440\u043e\u0442\u0435\u0438\u043d\u0443 C \u043f\u0440\u0435\u0434\u0441\u0442\u0430\u0432\u043b\u044f\u0435\u0442 \u0441\u043e\u0431\u043e\u0439 \u0433\u0435\u043d\u0435\u0442\u0438\u0447\u0435\u0441\u043a\u043e\u0435 \u0438 \u043b\u0430\u0431\u043e\u0440\u0430\u0442\u043e\u0440\u043d\u043e\u0435 \u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u0435 \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u0435\u043c\u043e\u0441\u0442\u0438 \u043a\u0440\u043e\u0432\u0438, \u0441\u0432\u044f\u0437\u0430\u043d\u043d\u043e\u0435 \u0441 \u0443\u043c\u0435\u043d\u044c\u0448\u0435\u043d\u043d\u043e\u0439 \u0447\u0443\u0432\u0441\u0442\u0432\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u0441\u0442\u044c\u044e \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c\u0430 \u043a \u0438\u043d\u0433\u0438\u0431\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u044e \u043a\u043e\u0430\u0433\u0443\u043b\u044f\u0446\u0438\u0438 \u0447\u0435\u0440\u0435\u0437 \u0430\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u044b\u0439 \u043f\u0440\u043e\u0442\u0435\u0438\u043d C (APC). APC \u2014 \u044d\u0442\u043e \u0435\u0441\u0442\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u0439 \u0430\u043d\u0442\u0438\u043a\u043e\u0430\u0433\u0443\u043b\u044f\u043d\u0442, \u0441\u043f\u043e\u0441\u043e\u0431\u0441\u0442\u0432\u0443\u044e\u0449\u0438\u0439 \u0440\u0435\u0433\u0443\u043b\u044f\u0446\u0438\u0438 \u043f\u0440\u043e\u0446\u0435\u0441\u0441\u0430 \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u043d\u0438\u044f \u043a\u0440\u043e\u0432\u0438.<\/p>\n

    \u0420\u0435\u0437\u0438\u0441\u0442\u0435\u043d\u0442\u043d\u043e\u0441\u0442\u044c \u043a \u0430\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e\u043c\u0443 \u043f\u0440\u043e\u0442\u0435\u0438\u043d\u0443 C \u043e\u0431\u044b\u0447\u043d\u043e \u043e\u0431\u0443\u0441\u043b\u043e\u0432\u043b\u0435\u043d\u0430 \u043d\u0430\u0441\u043b\u0435\u0434\u0441\u0442\u0432\u0435\u043d\u043d\u043e\u0439 \u043c\u0443\u0442\u0430\u0446\u0438\u0435\u0439 \u0444\u0430\u043a\u0442\u043e\u0440\u0430 V Leiden, \u044f\u0432\u043b\u044f\u044e\u0449\u0435\u0439\u0441\u044f \u043d\u0430\u0438\u0431\u043e\u043b\u0435\u0435 \u0447\u0430\u0441\u0442\u043e\u0439 \u043f\u0440\u0438\u0447\u0438\u043d\u043e\u0439 \u043d\u0430\u0441\u043b\u0435\u0434\u0441\u0442\u0432\u0435\u043d\u043d\u043e\u0439 \u0442\u0440\u043e\u043c\u0431\u043e\u0444\u0438\u043b\u0438\u0438. \u041c\u0443\u0442\u0430\u0446\u0438\u044f \u0432\u044b\u0437\u044b\u0432\u0430\u0435\u0442 \u0438\u0437\u043c\u0435\u043d\u0435\u043d\u0438\u0435 \u0432 \u0444\u0430\u043a\u0442\u043e\u0440\u0435 V, \u043c\u0435\u0448\u0430\u044e\u0449\u0435\u0435 \u0430\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e\u043c\u0443 \u043f\u0440\u043e\u0442\u0435\u0438\u043d\u0443 C \u0430\u0434\u0435\u043a\u0432\u0430\u0442\u043d\u043e \u0438\u043d\u0430\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u0442\u044c \u0444\u0430\u043a\u0442\u043e\u0440 V, \u0447\u0442\u043e \u0432\u043b\u0435\u0447\u0435\u0442 \u0437\u0430 \u0441\u043e\u0431\u043e\u0439 \u0443\u0432\u0435\u043b\u0438\u0447\u0435\u043d\u043d\u044b\u0439 \u0440\u0438\u0441\u043a \u0442\u0440\u043e\u043c\u0431\u043e\u0437\u0430.<\/p>\n

    \u041a\u043e\u0433\u0434\u0430 \u043f\u0440\u043e\u0432\u043e\u0434\u0438\u0442\u0441\u044f \u044d\u0442\u043e\u0442 \u0430\u043d\u0430\u043b\u0438\u0437?<\/strong><\/p>\n

    \u041b\u0430\u0431\u043e\u0440\u0430\u0442\u043e\u0440\u043d\u044b\u0439 \u0442\u0435\u0441\u0442 \u043d\u0430 APCR \u043e\u0431\u044b\u0447\u043d\u043e \u043f\u0440\u043e\u0432\u043e\u0434\u0438\u0442\u0441\u044f \u0441 \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u043e\u0432\u0430\u043d\u0438\u0435\u043c \u043a\u043e\u0430\u0433\u0443\u043b\u044f\u0446\u0438\u043e\u043d\u043d\u043e\u0433\u043e \u0442\u0435\u0441\u0442\u0430, \u0438\u0437\u0432\u0435\u0441\u0442\u043d\u043e\u0433\u043e \u043a\u0430\u043a \u0442\u0435\u0441\u0442 \u043d\u0430 \u0440\u0435\u0437\u0438\u0441\u0442\u0435\u043d\u0442\u043d\u043e\u0441\u0442\u044c \u043a \u0430\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e\u043c\u0443 \u043f\u0440\u043e\u0442\u0435\u0438\u043d\u0443 C (\u0442\u0435\u0441\u0442 APCR). \u042d\u0442\u043e\u0442 \u0442\u0435\u0441\u0442 \u0441\u0440\u0430\u0432\u043d\u0438\u0432\u0430\u0435\u0442 \u0432\u0440\u0435\u043c\u044f \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u043d\u0438\u044f \u043a\u0440\u043e\u0432\u0438 \u043f\u043e\u0441\u043b\u0435 \u0434\u043e\u0431\u0430\u0432\u043b\u0435\u043d\u0438\u044f APC \u0434\u043b\u044f \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u044f \u0447\u0443\u0432\u0441\u0442\u0432\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u0441\u0442\u0438 \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c\u0430 \u043a APC. \u0414\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0430 \u0440\u0435\u0437\u0438\u0441\u0442\u0435\u043d\u0442\u043d\u043e\u0441\u0442\u0438 \u043a \u0430\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e\u043c\u0443 \u043f\u0440\u043e\u0442\u0435\u0438\u043d\u0443 C (APCR) \u0432\u0430\u0436\u043d\u0430 \u043f\u043e \u043d\u0435\u0441\u043a\u043e\u043b\u044c\u043a\u0438\u043c \u043f\u0440\u0438\u0447\u0438\u043d\u0430\u043c:<\/p>\n

      \n
    1. \u0418\u0441\u0442\u043e\u0440\u0438\u044f \u0442\u0440\u043e\u043c\u0431\u043e\u0437\u043e\u0432: \u041b\u044e\u0434\u0438 \u0441 \u043f\u0440\u043e\u0448\u043b\u044b\u043c \u043e\u043f\u044b\u0442\u043e\u043c \u0442\u0440\u043e\u043c\u0431\u043e\u0437\u043e\u0432, \u043e\u0441\u043e\u0431\u0435\u043d\u043d\u043e \u043c\u043e\u043b\u043e\u0434\u044b\u0435 \u043b\u044e\u0434\u0438 \u0438\u043b\u0438 \u0442\u0435, \u0443 \u043a\u043e\u0433\u043e \u043d\u0435\u0442 \u0434\u0440\u0443\u0433\u0438\u0445 \u043e\u0447\u0435\u0432\u0438\u0434\u043d\u044b\u0445 \u0444\u0430\u043a\u0442\u043e\u0440\u043e\u0432 \u0440\u0438\u0441\u043a\u0430, \u043c\u043e\u0433\u0443\u0442 \u0431\u044b\u0442\u044c \u043a\u0430\u043d\u0434\u0438\u0434\u0430\u0442\u0430\u043c\u0438 \u0434\u043b\u044f \u0442\u0435\u0441\u0442\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u044f \u043d\u0430 APCR.<\/li>\n
    2. \u041c\u0443\u0442\u0430\u0446\u0438\u044f \u0444\u0430\u043a\u0442\u043e\u0440\u0430 V Leiden: \u0412 \u0441\u043b\u0443\u0447\u0430\u0435 \u043f\u043e\u0434\u043e\u0437\u0440\u0435\u043d\u0438\u044f \u043d\u0430 \u043d\u0430\u043b\u0438\u0447\u0438\u0435 \u043c\u0443\u0442\u0430\u0446\u0438\u0438 \u0444\u0430\u043a\u0442\u043e\u0440\u0430 V Leiden, \u0442\u0435\u0441\u0442\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u0435 \u043d\u0430 APCR \u043c\u043e\u0436\u0435\u0442 \u043f\u043e\u043c\u043e\u0447\u044c \u043f\u043e\u0434\u0442\u0432\u0435\u0440\u0434\u0438\u0442\u044c \u0434\u0438\u0430\u0433\u043d\u043e\u0437. \u041c\u0443\u0442\u0430\u0446\u0438\u044f \u0444\u0430\u043a\u0442\u043e\u0440\u0430 V Leiden \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u043d\u0430\u0438\u0431\u043e\u043b\u0435\u0435 \u0447\u0430\u0441\u0442\u043e\u0439 \u043f\u0440\u0438\u0447\u0438\u043d\u043e\u0439 \u0433\u0435\u043d\u0435\u0442\u0438\u0447\u0435\u0441\u043a\u0438 \u043e\u0431\u0443\u0441\u043b\u043e\u0432\u043b\u0435\u043d\u043d\u043e\u0439 \u0442\u0440\u043e\u043c\u0431\u043e\u0444\u0438\u043b\u0438\u0438 \u0438 \u0430\u0441\u0441\u043e\u0446\u0438\u0438\u0440\u043e\u0432\u0430\u043d\u0430 \u0441 \u043f\u043e\u0432\u044b\u0448\u0435\u043d\u043d\u044b\u043c \u0440\u0438\u0441\u043a\u043e\u043c \u0432\u0435\u043d\u043e\u0437\u043d\u043e\u0433\u043e \u0442\u0440\u043e\u043c\u0431\u043e\u0437\u0430.
      \n\u0421\u0435\u043c\u0435\u0439\u043d\u0430\u044f \u0438\u0441\u0442\u043e\u0440\u0438\u044f \u0442\u0440\u043e\u043c\u0431\u043e\u0437\u043e\u0432: \u041b\u044e\u0434\u044f\u043c \u0441 \u0441\u0435\u043c\u0435\u0439\u043d\u043e\u0439 \u0438\u0441\u0442\u043e\u0440\u0438\u0435\u0439 \u0442\u0440\u043e\u043c\u0431\u043e\u0437\u043e\u0432, \u043e\u0441\u043e\u0431\u0435\u043d\u043d\u043e \u0435\u0441\u043b\u0438 \u0431\u043b\u0438\u0437\u043a\u0438\u0435 \u0440\u043e\u0434\u0441\u0442\u0432\u0435\u043d\u043d\u0438\u043a\u0438 \u0441\u0442\u0430\u043b\u043a\u0438\u0432\u0430\u043b\u0438\u0441\u044c \u0441 \u0442\u0440\u043e\u043c\u0431\u043e\u0437\u0430\u043c\u0438, \u0440\u0435\u043a\u043e\u043c\u0435\u043d\u0434\u0443\u0435\u0442\u0441\u044f \u0442\u0435\u0441\u0442\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u0435 \u043d\u0430 APCR \u0434\u043b\u044f \u0432\u044b\u044f\u0432\u043b\u0435\u043d\u0438\u044f \u043d\u0430\u0441\u043b\u0435\u0434\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u0445 \u0444\u0430\u043a\u0442\u043e\u0440\u043e\u0432 \u0440\u0438\u0441\u043a\u0430.<\/li>\n
    3. \u041f\u043e\u0432\u0442\u043e\u0440\u044f\u044e\u0449\u0438\u0435\u0441\u044f \u0441\u043f\u043e\u043d\u0442\u0430\u043d\u043d\u044b\u0435 \u0430\u0431\u043e\u0440\u0442\u044b: \u041e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0435 APCR \u043c\u043e\u0436\u0435\u0442 \u0431\u044b\u0442\u044c \u0440\u0435\u043a\u043e\u043c\u0435\u043d\u0434\u043e\u0432\u0430\u043d\u043e \u0436\u0435\u043d\u0449\u0438\u043d\u0430\u043c, \u0441\u0442\u043e\u043b\u043a\u043d\u0443\u0432\u0448\u0438\u043c\u0441\u044f \u0441 \u043f\u043e\u0432\u0442\u043e\u0440\u044f\u044e\u0449\u0438\u043c\u0438\u0441\u044f \u0441\u043f\u043e\u043d\u0442\u0430\u043d\u043d\u044b\u043c\u0438 \u0430\u0431\u043e\u0440\u0442\u0430\u043c\u0438, \u043f\u043e\u0441\u043a\u043e\u043b\u044c\u043a\u0443 \u0440\u0435\u0437\u0438\u0441\u0442\u0435\u043d\u0442\u043d\u043e\u0441\u0442\u044c \u043a \u0430\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e\u043c\u0443 \u043f\u0440\u043e\u0442\u0435\u0438\u043d\u0443 C \u043c\u043e\u0436\u0435\u0442 \u0431\u044b\u0442\u044c \u0441\u0432\u044f\u0437\u0430\u043d\u0430 \u0441 \u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u044f\u043c\u0438 \u0432\u0430\u0441\u043a\u0443\u043b\u044f\u0440\u043d\u043e\u0439 \u0446\u0438\u0440\u043a\u0443\u043b\u044f\u0446\u0438\u0438 \u0432 \u043f\u043b\u0430\u0446\u0435\u043d\u0442\u0435.<\/li>\n<\/ol>\n

      \u041f\u043e\u0434\u0433\u043e\u0442\u043e\u0432\u043a\u0430 \u043a \u0430\u043d\u0430\u043b\u0438\u0437\u0443<\/strong><\/p>\n

      \u041b\u044e\u0434\u044f\u043c, \u043a\u043e\u0442\u043e\u0440\u044b\u0435 \u043d\u0435 \u0438\u043c\u0435\u043b\u0438 \u0442\u0440\u043e\u043c\u0431\u043e\u0437, \u0441\u043f\u0435\u0446\u0438\u0430\u043b\u044c\u043d\u0430\u044f \u043f\u043e\u0434\u0433\u043e\u0442\u043e\u0432\u043a\u0430 \u043a \u0430\u043d\u0430\u043b\u0438\u0437\u0443 \u043d\u0430 \u0440\u0435\u0437\u0438\u0441\u0442\u0435\u043d\u0442\u043d\u043e\u0441\u0442\u044c \u043a \u0430\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e\u043c\u0443 \u043f\u0440\u043e\u0442\u0435\u0438\u043d\u0443 C (APCR) \u043d\u0435 \u0442\u0440\u0435\u0431\u0443\u0435\u0442\u0441\u044f. \u041e\u0434\u043d\u0430\u043a\u043e \u0440\u0435\u043a\u043e\u043c\u0435\u043d\u0434\u0443\u0435\u0442\u0441\u044f \u0438\u0437\u0431\u0435\u0433\u0430\u0442\u044c \u043f\u0440\u043e\u0445\u043e\u0436\u0434\u0435\u043d\u0438\u044f \u0430\u043d\u0430\u043b\u0438\u0437\u0430 \u0441\u0440\u0430\u0437\u0443 \u043f\u043e\u0441\u043b\u0435 \u043f\u0440\u0438\u0435\u043c\u0430 \u043f\u0438\u0449\u0438 \u0434\u043b\u044f \u043e\u0431\u0435\u0441\u043f\u0435\u0447\u0435\u043d\u0438\u044f \u0442\u043e\u0447\u043d\u043e\u0441\u0442\u0438 \u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u043e\u0432. \u0412 \u0442\u043e \u0436\u0435 \u0432\u0440\u0435\u043c\u044f, \u043b\u0438\u0446\u0430\u043c, \u043f\u0435\u0440\u0435\u043d\u0435\u0441\u0448\u0438\u043c \u0442\u0440\u043e\u043c\u0431\u043e\u0437, \u0441\u043b\u0435\u0434\u0443\u0435\u0442 \u043f\u043e\u0441\u043e\u0432\u0435\u0442\u043e\u0432\u0430\u0442\u044c\u0441\u044f \u0441\u043e \u0441\u0432\u043e\u0438\u043c \u0432\u0440\u0430\u0447\u043e\u043c \u043f\u0435\u0440\u0435\u0434 \u043f\u0440\u043e\u0432\u0435\u0434\u0435\u043d\u0438\u0435\u043c \u0430\u043d\u0430\u043b\u0438\u0437\u0430 \u043d\u0430 APCR. \u0412 \u044d\u0442\u0438\u0445 \u0441\u043b\u0443\u0447\u0430\u044f\u0445 \u0437\u0430\u0447\u0430\u0441\u0442\u0443\u044e \u0442\u0440\u0435\u0431\u0443\u0435\u0442\u0441\u044f \u0432\u0440\u0435\u043c\u0435\u043d\u043d\u043e \u043f\u0440\u0435\u043a\u0440\u0430\u0442\u0438\u0442\u044c \u043f\u0440\u0438\u0435\u043c \u0430\u043d\u0442\u0438\u043a\u043e\u0430\u0433\u0443\u043b\u044f\u043d\u0442\u043e\u0432 \u043f\u0435\u0440\u0435\u0434 \u0430\u043d\u0430\u043b\u0438\u0437\u043e\u043c, \u0447\u0442\u043e\u0431\u044b \u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u044b \u0431\u044b\u043b\u0438 \u043d\u0430\u0434\u0435\u0436\u043d\u044b\u043c\u0438.<\/p>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[952],"product_tag":[],"class_list":{"0":"post-10002","1":"product","2":"type-product","3":"status-publish","5":"product_cat-teste-de-trombofilie","7":"first","8":"instock","9":"sold-individually","10":"shipping-taxable","11":"purchasable","12":"product-type-simple"},"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product\/10002","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/comments?post=10002"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10002"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=10002"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=10002"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=10002"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}