{"id":10008,"date":"2020-04-23T03:53:48","date_gmt":"2020-04-23T00:53:48","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/factor-viii\/"},"modified":"2025-02-04T16:29:27","modified_gmt":"2025-02-04T14:29:27","slug":"factor-viii","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/factor-viii\/","title":{"rendered":"\u0424\u0430\u043a\u0442\u043e\u0440 \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u043d\u0438\u044f \u043a\u0440\u043e\u0432\u0438 VIII"},"content":{"rendered":"<p style=\"text-align: justify;\"><span style=\"font-size: medium;\"><strong><em>Informa\u0163ii generale \u015fi recomand\u0103ri privind efectuarea testului<\/em><\/strong><strong>\u00a0<\/strong><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\">Factorul VIII (factorul antihemofilic A) este un procofactor nonenzimatic sintetizat \u00een principal\u00a0\u00een hepatocite, care circul\u0103 \u00een plasm\u0103 legat de factorul von Willebrand (vWF) \u00eentr-un raport de 1 molecul\u0103 de FVIII la 50 molecule vWF<sup>1;2<\/sup>. Ini\u0163ial s-a considerat c\u0103 FVIII \u015fi vWF reprezint\u0103 o singur\u0103 entitate \u015fi primele comunic\u0103ri legate de FVIII se refereau de fapt la diverse aspecte ale structurii \u015fi func\u0163iei vWF.<\/span><\/p>\n<div style=\"text-align: justify;\"><span style=\"font-size: medium;\">Proteina factorului VIII este denumit\u0103 FVIII antigen (FVIII:Ag), \u00een timp ce func\u0163ia sa procoagulant\u0103 este desemnat\u0103 ca FVIII coagulant (FVIII:C).<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: medium;\">Factorul vWF regleaz\u0103 concentra\u0163ia plasmatic\u0103 a factorului VIII \u015fi o stabilizeaz\u0103 \u00een sensul c\u0103 \u00eei prelunge\u015fte timpul de \u00eenjum\u0103t\u0103\u0163ire la 8 \u2013 12 ore.<\/span><\/div>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\">Procofactorul FVIII este activat printr-un proces de clivare de c\u0103tre \u03b1-trombina pentru a genera cofactorul FVIIIa<sup>2<\/sup>. La r\u00e2ndul s\u0103u, cofactorul FVIIIa se leag\u0103 de enzima FIXa (o serin-proteaz\u0103) \u00een prezen\u0163a ionilor de calciu\u00a0 \u015fi formeaz\u0103 complexul intrinsec al tenazei, omolog cu cel al protrombinazei. Conform modelului actual al coagul\u0103rii, acest complex intervine\u00a0\u00een etapa a doua (de propagare), fiind activatorul major al factorului X (de 50 ori mai activ dec\u00e2t complexul factor VIIa-factor tisular). Astfel, peste 90% din cantitatea total\u0103 de FXa este produs\u0103 de c\u0103tre complexul tenazei<sup>1;7<\/sup>.<\/span><\/p>\n<div style=\"text-align: justify;\"><span style=\"font-size: medium;\">De\u015fi FVIIIa este inactivat proteolitic de c\u0103tre un num\u0103r de enzime, disocierea spontana constituie principalul mecanism reglator al func\u0163iei cofactorului<sup>2<\/sup>.<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: medium;\">Gena pentru FVIII este localizat\u0103 pe bra\u0163ul lung al cromozomului X \u015fi este una dintre cele mai mari gene, reprezent\u00e2nd 0.1% din \u00eentregul cromozom X<sup>7<\/sup>.<\/span><\/div>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\">Hemofilia A sau hemofilia clasic\u0103 este consecin\u0163a deficitului congenital de factor VIII. Dup\u0103 boala von Willebrand constituie cea mai frecvent\u0103 diatez\u0103 hemoragic\u0103 ereditar\u0103 (aproximativ 1 caz la 5000 na\u015fteri de fe\u0163i de sex masculin). Hemofilia A este responsabil\u0103 de 85% din toate cazurile de hemofilie \u015fi are o transmitere autozomal-recesiv\u0103\u00a0 legat\u0103 de cromozomul X<sup>4<\/sup>. Gena factorului VIII poate prezenta anomalii multiple \u00een secven\u0163\u0103 nucleotidelor, \u00eens\u0103 defectul genetic cel mai obi\u015fnuit, responsabil de aproximativ 45% din cazurile de hemofilie A sever\u0103, este <em>inversia intronului 22<\/em>. Ca urmare a acestui defect rezult\u0103 o protein\u0103 care nu prezint\u0103 o activitate imunologic\u0103 sau func\u0163ional\u0103. Alte defecte \u00eent\u00e2lnite sunt muta\u0163ii punctiforme, dele\u0163ii \u015fi muta\u0163ii missens<sup>6<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\">Majoritatea cazurilor de boal\u0103 se dezvolt\u0103 la b\u0103ie\u0163ii ale c\u0103ror mame sunt purt\u0103toare ale defectului genetic (heterozigote). Astfel, femeile purt\u0103toare transmit boala la 50% dintre b\u0103ie\u0163i \u015fi tara genetic\u0103 la 50% dintre fete<sup>5<\/sup>. Aceste femei prezint\u0103 rareori s\u00e2nger\u0103ri excesive. \u00cen schimb femeile cu sindrom Turner (cariotip X0) pot fi simptomatice, la fel ca \u015fi persoanele de sex feminin purt\u0103toare care prezint\u0103 un grad crescut de lionizare (inactivarea unui cromozom X)<sup>6<\/sup>.<\/span><\/p>\n<div style=\"text-align: justify;\"><span style=\"font-size: medium;\">Diagnosticul de hemofilie se poate stabili\u00a0 prenatal prin analiza ADN-ului fetal ob\u0163inut din vilozit\u0103\u0163ile choriale \u00een s\u0103pt\u0103m\u00e2nile 11-12 de sarcin\u0103 sau prin amniocentez\u0103 \u00een s\u0103pt\u0103m\u00e2na 16<sup>5;6<\/sup>.<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: medium;\">Toate femeile care sunt posibil purt\u0103toare ale defectului trebuie testate genetic \u00een scopul identific\u0103rii muta\u0163iei familiale \u015fi pentru management-ul corect al sarcinilor viitoare<sup>6<\/sup>.<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: medium;\">Aproximativ 30% din cazurile de deficit de factor VIII apar la sexul masculin ca urmare a unor muta\u0163ii <em>de novo<\/em> (spontane, \u00een absen\u0163a oric\u0103rui istoric familial).<\/span><\/div>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\">\u00cen func\u0163ie de severitatea sindromului hemoragipar sunt descrise 3 forme clinice de hemofilie A:<\/span><\/p>\n<div style=\"text-align: justify; padding-left: 30px;\"><span style=\"font-size: medium;\"><em>\u25cf\u00a0 sever\u0103<\/em>: hemoragiile apar spontan (nivel FVIII &lt;1%);<\/span><\/div>\n<div style=\"text-align: justify; padding-left: 30px;\"><span style=\"font-size: medium;\"><em>\u25cf\u00a0 medie<\/em>: hemoragiile apar dup\u0103 traumatisme minore (nivel de factor VIII: 1-5%);<\/span><\/div>\n<div style=\"text-align: justify; padding-left: 30px;\"><span style=\"font-size: medium;\"><em>\u25cf\u00a0 u\u015foar\u0103<\/em>: hemoragiile apar dup\u0103 traumatisme mari \u015fi interven\u0163ii chirurgicale (nivel de factor VIII:\u00a05-40%)<sup>4;5<\/sup>.<\/span><\/div>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\">Tabloul clinic al bolii este dominat de hemoragii profunde care apar \u00een prima copil\u0103rie. Uneori copiii cu hemofilie sever\u0103 sunt depista\u0163i\u00a0\u00een perioada neonatal\u0103 datorit\u0103 s\u00e2nger\u0103rii excesive dup\u0103 circumcizie sau ca urmare a necrozei cordonului ombilical. Hemartozele reprezint\u0103 cele mai frecvente manifest\u0103ri hemoragice (60%), \u00eens\u0103 acestea nu apar de regul\u0103 dec\u00e2t\u00a0\u00een momentul\u00a0\u00een care copilul \u00eencepe s\u0103 mearg\u0103. Hemoragiile intraarticulare repetate conduc la fenomene degenerative cu limitarea mobilit\u0103\u0163ii articulare \u015fi hipotrofii musculare adiacente. Hematoamele musculare apar adesea la locurile de injec\u0163ie;\u00a0\u00een 1-2% din cazuri, hematoamele recidivante se pot organiza \u015fi \u00eencapsula form\u00e2nd pseudotumori. Hemoragiile digestive apar \u00een circa 10% din cazuri \u015fi tind s\u0103 fie provocate mai degrab\u0103 de leziuni anatomice dec\u00e2t de tulburarea de coagulare. Hematuria este precipitat\u0103 de efort, traumatisme, coexisten\u0163a litiazei renale, infec\u0163ii urinare, tratament cu AINS. Hemoragia cerebral\u0103, ap\u0103rut\u0103 spontan sau dup\u0103 traumatisme, reprezint\u0103 cea mai obi\u015fnuit\u0103 cauz\u0103 de deces a pacien\u0163ilor hemofilici<sup>4;5;6<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\">Tendin\u0163a hemoragic\u0103 se men\u0163ine pe tot parcursul vie\u0163ii. Evolu\u0163ia are loc \u00een puseuri hemoragice ce alterneaz\u0103 cu perioade de via\u0163\u0103 normal\u0103; frecven\u0163a puseurilor este variabil\u0103 de la caz la caz \u015fi scade odat\u0103 cu\u00a0 \u00eenaintarea\u00a0\u00een v\u00e2rst\u0103, prin evitarea traumatismelor declan\u015fatoare de s\u00e2nger\u0103ri<sup>5<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\">Pacien\u0163ii cu hemofilie A care primesc tratament substitutiv pot dezvolta inhibitori ai factorului VIII ca urmare a producerii de aloanticorpi. Exist\u0103 \u015fi cazuri rare de hemofilie A dob\u00e2ndit\u0103 prin apari\u0163ia de autoanticorpi anti-FVIII dup\u0103 o sarcin\u0103 sau \u00een cadrul unor afec\u0163iuni autoimune la v\u00e2rstnici. Ace\u015fti pacien\u0163i prezint\u0103 manifest\u0103ri clinice similare celor din forma congenital\u0103 sever\u0103<sup>4<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\">Diagnosticul bolii este sus\u0163inut de tabloul clinic \u015fi de datele de laborator. Timpul de tromboplastin\u0103 par\u0163ial\u0103 activat (APTT) este mult alungit \u015fi se corecteaz\u0103 dup\u0103 administrarea de plasm\u0103 normal\u0103, \u00een timp ce timpul de protrombin\u0103, timpul de trombin\u0103 \u015fi timpul de s\u00e2ngerare sunt normale. Determinarea specific\u0103 a activit\u0103\u0163ii FVIII \u2013 % din normal \u2013 stabile\u015fte diagnosticul de hemofilie A \u015fi forma clinic\u0103 (sever\u0103, medie, u\u015foar\u0103)<sup>5<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\"><strong><em>Preg\u0103tire pacient<\/em><\/strong> <em>- <\/em>\u00e0 jeun (pe nem\u00e2ncate)<sup>3<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\"><strong><em>Specimen recoltat<\/em><\/strong> <em>- <\/em>\u0432\u0435\u043d\u043e\u0437\u043d\u0430\u044f \u043a\u0440\u043e\u0432\u044c<sup>3<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\"><strong><em>Recipient de recoltare<\/em><\/strong> \u2013 vacutainer cu citrat de Na 0.105M (raport citrat de sodiu \u2013 s\u00e2nge=1\/9). Presiunea realizat\u0103 de garou trebuie s\u0103 fie \u00eentre valoarea presiunii sistolice \u015fi cea a presiunii diastolice \u015fi nu trebuie s\u0103 dep\u0103\u015feasc\u0103 1 minut. Dac\u0103 punc\u0163ia venoas\u0103 a e\u015fuat, o nou\u0103 tentativ\u0103 pe aceea\u015fi ven\u0103 nu se poate face dec\u00e2t dup\u0103 10 minute<sup>3<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\"><strong><em>Cantitate recoltat\u0103<\/em><\/strong> \u2013 c\u00e2t permite vacuumul; pentru a preveni coagularea par\u0163ial\u0103 a probei se va asigura amestecul corect al s\u00e2ngelui cu anticoagulantul, prin mi\u015fc\u0103ri de inversiune a tubului<sup>3<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\"><strong><em>Prelucrare necesar\u0103 dup\u0103 recoltare <\/em><\/strong>\u2013 proba va fi centrifugat\u0103 15 minute la 2500g, urmat\u0103 imediat de separarea plasmei \u015fi congelarea acesteia; probele recoltate \u00een afara laboratorului vor fi transportate\u00a0\u00een recipientul destinat probelor congelate<sup>3<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\"><strong><em>Cauze de respingere a probei<\/em><\/strong> <em>- <\/em>vacutainer care nu este plin; proba de s\u00e2nge hemolizat\u0103 sau coagulat\u0103; plasma care nu a ajuns congelat\u0103 la laborator<sup>3<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\"><strong><em>Stabilitate prob\u0103<\/em><\/strong> \u2013 plasma separat\u0103 este stabil\u0103 <em>4 ore<\/em> la temperatura camerei; <em>3 s\u0103pt\u0103m\u00e2ni<\/em> la\u00a0 \u2013 20\u00baC; <em>&gt;1 an<\/em> la \u2013 70\u00baC<sup>3<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\"><strong><em>Metod\u0103 <\/em><\/strong>- <span style=\"text-decoration: underline;\">coagulometric\u0103<\/span> (const\u0103 \u00een m\u0103surarea timpului de coagulare a probei de investigat\u00a0\u00een prezen\u0163a cefalinei + activator \u015fi a unei plasme care con\u0163ine\u00a0\u00een exces to\u0163i factorii plasmatici ai coagul\u0103rii cu excep\u0163ia factorului VIII<sup>3<\/sup>).<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\"><strong><em>Valori de referin\u0163\u0103 <\/em><\/strong>\u2013 50-150%<sup>3<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\"><strong><em>Interpretarea rezultatelor<\/em><\/strong><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\">Gradul de severitate a hemofiliei este condi\u0163ionat de nivelul plasmatic al factorului deficient, respectiv de gradul de inhibi\u0163ie al genei produc\u0103toare. In cadrul acelea\u015fi familii exprimarea clinic\u0103 la diferi\u0163i membrii afecta\u0163i este variabil\u0103; aceasta \u0163ine de varia\u0163ia individual\u0103, \u00een cadrul c\u0103reia rezisten\u0163a vascular\u0103, num\u0103rul de trombocite \u015fi nivelul celorlal\u0163i factori ai coagul\u0103rii de\u0163in un rol important. Clinic ace\u015fti bolnavi se prezint\u0103 diferit, dar la examenul de laborator sunt depista\u0163i cu acela\u015fi nivel de deficien\u0163\u0103<sup>5<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\">Majoritatea pacien\u0163ilor cu boala von Willebrand prezint\u0103 niveluri sc\u0103zute de factor VIII deoarece vWF este \u201ccarrier-ul\u201d plasmatic al factorului VIII. Pacien\u0163ii cu boala von Willebrand tip 2N (Normandy), care mimeaz\u0103 clinic hemofilia A form\u0103 u\u015foar\u0103, vor avea o activitate a cofactorului pentru ristocetin\u0103 \u015fi un nivel de antigen vWF normale sau u\u015for sc\u0103zute asociate cu niveluri reduse de factor VIII, ca urmare a deficien\u0163ei de legare a FVIII de varianta de molecul\u0103 vWF.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\">Un sindrom de deficit combinat de FVIII \u015fi FV a fost descris la peste 60 de familii din zona bazinului mediteraneean.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\">Niveluri crescute de FVIII sunt \u00eenregistrate la na\u015ftere \u015fi \u00een cursul sarcinii. FVIII reprezint\u0103 un reactant de faz\u0103 acut\u0103 ale c\u0103rui nivele cresc \u00een cursul perioadelor de stress acut, postoperator \u015fi \u00een condi\u0163ii inflamatorii. Valori crescute mai pot fi \u00eent\u00e2lnite \u015fi ca urmare a efortului fizic sus\u0163inut, dup\u0103 administrarea unor medicamente: epinefrin\u0103, DDAVP, preparate cu estrogeni \u00een scop contraceptiv sau pentru tratamentul hormonal substitutiv sau \u00een unele afec\u0163iuni: anemii hemolitice, tromboz\u0103 venoas\u0103 profund\u0103, infarct miocardic, diabet zaharat, afec\u0163iuni hepatice \u015fi renale, leucemii, carcinoame.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\">Persisten\u0163a unor valori crescute ale activit\u0103\u0163ii FVIII (&gt;150%) cre\u015fte de cel pu\u0163in 5 ori riscul de tromboz\u0103\u00a0 venoas\u0103 \u015fi este asociat\u0103 de asemenea cu risc crescut de recuren\u0163\u0103 a bolii tromboembolice. Riscul se <\/span><span style=\"font-size: medium;\">m\u0103re\u015fte propor\u0163ional cu gradul de activitate a FVIII. Astfel, valori &gt;150% sunt \u00eent\u00e2lnite la 20-25% dintre pacien\u0163ii cu tromboz\u0103 venoas\u0103 sau tromboembolism,\u00a0\u00een absen\u0163a unor cauze cunoscute de cre\u015ftere a FVIII<sup>4<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\"><strong><em>Limite \u015fi interferen\u0163e<\/em><\/strong><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\">Determinarea activit\u0103\u0163ii factorului VIII nu trebuie utilizat\u0103 pentru depistarea femeilor purt\u0103toare ale tarei hemofilice \u2013 pentru aceste cazuri sunt indicate teste genetice. \u00cen prezen\u0163a inhibitorilor precum \u015fi a anticoagulantului lupic se pot ob\u0163ine valori fals sc\u0103zute ale activit\u0103\u0163ii factorului VIII<sup>4<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: medium;\">\u00a0<\/span><\/p>\n<p style=\"text-align: justify;\"><strong><span style=\"font-size: small;\">\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<\/span><\/strong><\/p>\n<div style=\"text-align: justify;\"><span style=\"font-size: small;\">1. Denise O\u2019 Shaughnessy, Michael Makris, David Lilicrap. Basic principles underlying coagulation system. In Practical hemostasis and Thrombosis, Blackwell Publishing, 2008, 4-6.<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: small;\">2. Kathleen Brummel-Ziedins, et al. Blood Coagulation and Fibrinolysis. In Wintrobe\u2019s Clinical Hematology, Lippincot Williams &amp; Wilkins, 12th Edition, 2009, 550-552.<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: small;\">3. Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate 2010. Ref Type: Catalog.<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: small;\">4. Laboratory Corporation of America. Directory of Services and Interpretive Guide. Factor VIII Activity. <\/span><a href=\"http:\/\/www.labcorp.com\" rel=\"nofollow noopener\" target=\"_blank\"><span style=\"font-size: small;\">www.labcorp.com<\/span><\/a><span style=\"font-size: small;\"> 2010. Ref Type: Internet Communication.<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: small;\">5. Radu P\u0103un. Tratat de medicin\u0103 intern\u0103. Hematologie. Partea II. Ed. Medical\u0103 1999, 779-854.<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: small;\">6. Rhona M. Maclean, Michael Makris. Hemophilia A and B. In Practical hemostasis and Thrombosis, Blackwell Publishing, 2008, 41-45.<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: small;\">7. Richard A. McPetersen, Matthew R. Pincus. Coagulation and Fibrinolysis. In Clinical diagnosis and management by laboratory methods. 2007, 729-743.<\/span><\/div>","protected":false},"excerpt":{"rendered":"<p>\u0424\u0430\u043a\u0442\u043e\u0440 \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u043d\u0438\u044f \u043a\u0440\u043e\u0432\u0438 VIII \u2014 \u0432\u0430\u0436\u043d\u044b\u0439 \u043a\u043e\u043c\u043f\u043e\u043d\u0435\u043d\u0442 \u043a\u0430\u0441\u043a\u0430\u0434\u0430 \u0441\u0438\u0441\u0442\u0435\u043c\u044b \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u043d\u0438\u044f \u043a\u0440\u043e\u0432\u0438. \u0422\u043e\u0447\u043d\u043e\u0435 \u043c\u0435\u0441\u0442\u043e \u043e\u0431\u0440\u0430\u0437\u043e\u0432\u0430\u043d\u0438\u044f \u0444\u0430\u043a\u0442\u043e\u0440\u0430 VIII \u043d\u0435\u0438\u0437\u0432\u0435\u0441\u0442\u043d\u043e, \u043e\u0434\u043d\u0430\u043a\u043e \u0434\u0430\u043d\u043d\u044b\u0435 \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0439 \u0443\u043a\u0430\u0437\u044b\u0432\u0430\u044e\u0442 \u043d\u0430 \u0442\u043e, \u0447\u0442\u043e \u0433\u043b\u0430\u0432\u043d\u044b\u043c \u0438\u0441\u0442\u043e\u0447\u043d\u0438\u043a\u043e\u043c \u0435\u0433\u043e \u0441\u0438\u043d\u0442\u0435\u0437\u0430 \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u043f\u0435\u0447\u0435\u043d\u044c.<\/p>\n<p>\u041d\u043e\u0432\u0435\u0439\u0448\u0438\u0435 \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f in vivo \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u044f\u044e\u0442 \u044d\u043d\u0434\u043e\u0442\u0435\u043b\u0438\u0439 \u0441\u043e\u0441\u0443\u0434\u043e\u0432 (\u0432\u043d\u0443\u0442\u0440\u0435\u043d\u043d\u044f\u044f \u0432\u044b\u0441\u0442\u0438\u043b\u043a\u0430 \u0441\u043e\u0441\u0443\u0434\u043e\u0432) \u0438 \u043c\u0435\u0433\u0430\u043a\u0430\u0440\u0438\u043e\u0446\u0438\u0442\u044b \u043a\u0430\u043a \u0431\u043e\u043b\u0435\u0435 \u0442\u043e\u0447\u043d\u043e\u0435 \u043c\u0435\u0441\u0442\u043e \u043e\u0431\u0440\u0430\u0437\u043e\u0432\u0430\u043d\u0438\u0435 \u0434\u0430\u043d\u043d\u043e\u0433\u043e \u0431\u0435\u043b\u043a\u0430. \u0422\u0430\u043a\u0430\u044f \u0433\u0438\u043f\u043e\u0442\u0435\u0437\u0430 \u043e\u0431\u0443\u0441\u043b\u043e\u0432\u043b\u0435\u043d\u0430 \u0442\u0435\u043c, \u0447\u0442\u043e \u0443\u0440\u043e\u0432\u0435\u043d\u044c \u0444\u0430\u043a\u0442\u043e\u0440\u0430 \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u043d\u0438\u044f \u043a\u0440\u043e\u0432\u0438 VIII \u0440\u0435\u0437\u043a\u043e \u0432\u044b\u0440\u0430\u0441\u0442\u0430\u0435\u0442 \u043f\u0440\u0438 \u0442\u044f\u0436\u0435\u043b\u044b\u0445 \u043f\u043e\u0432\u0440\u0435\u0436\u0434\u0435\u043d\u0438\u044f\u0445 \u043a\u043b\u0435\u0442\u043e\u043a \u043f\u0435\u0447\u0435\u043d\u0438. \u0421\u043b\u0435\u0434\u043e\u0432\u0430\u0442\u0435\u043b\u044c\u043d\u043e, \u0438\u0441\u0442\u043e\u0447\u043d\u0438\u043a\u043e\u043c \u0444\u0430\u043a\u0442\u043e\u0440\u0430 VIII \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f, \u043f\u043e-\u0432\u0438\u0434\u0438\u043c\u043e\u043c\u0443, \u043d\u0435 \u043f\u0435\u0447\u0435\u043d\u043e\u0447\u043d\u0430\u044f \u043f\u0430\u0440\u0435\u043d\u0445\u0438\u043c\u0430 (\u0433\u043b\u0430\u0432\u043d\u0430\u044f \u0444\u0443\u043d\u043a\u0446\u0438\u043e\u043d\u0438\u0440\u0443\u044e\u0449\u0430\u044f \u0442\u043a\u0430\u043d\u044c \u0442\u0430\u043a\u0438\u0445 \u043e\u0440\u0433\u0430\u043d\u043e\u0432 \u043a\u0430\u043a \u043f\u0435\u0447\u0435\u043d\u044c, \u043f\u043e\u0447\u043a\u0438, \u0441\u0435\u043b\u0435\u0437\u0435\u043d\u043a\u0430).<\/p>\n<p>\u0424\u0430\u043a\u0442\u043e\u0440 \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u043d\u0438\u044f VIII \u0432 \u043f\u043b\u0430\u0437\u043c\u0435 \u043a\u0440\u043e\u0432\u0438 \u043f\u0440\u0435\u0434\u0441\u0442\u0430\u0432\u043b\u0435\u043d \u0432 \u0432\u0438\u0434\u0435 \u0441\u0435\u0440\u0438\u0438 \u0444\u043e\u0440\u043c \u0438 \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0438\u0432\u0430\u0435\u0442\u0441\u044f \u0432 \u043a\u043e\u043d\u0446\u0435\u043d\u0442\u0440\u0430\u0446\u0438\u0438 0,1-0,2 \u043c\u043a\u0433\/\u043c\u043b. \u041f\u0440\u0430\u043a\u0442\u0438\u0447\u0435\u0441\u043a\u0438 \u0432\u0435\u0441\u044c \u0444\u0430\u043a\u0442\u043e\u0440 VIII \u0432 \u043f\u043b\u0430\u0437\u043c\u0435 \u043d\u0430\u0445\u043e\u0434\u0438\u0442\u0441\u044f \u0432 \u0441\u0432\u044f\u0437\u0430\u043d\u043d\u043e\u043c \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u0438 \u0441 \u0444\u0430\u043a\u0442\u043e\u0440\u043e\u043c \u0444\u043e\u043d \u0412\u0438\u043b\u043b\u0435\u0431\u0440\u0430\u043d\u0434\u0430, \u043a\u043e\u0442\u043e\u0440\u044b\u0439 \u0441\u0442\u0430\u0431\u0438\u043b\u0438\u0437\u0438\u0440\u0443\u0435\u0442 \u0438 \u0437\u0430\u0449\u0438\u0449\u0430\u0435\u0442 \u0444\u0430\u043a\u0442\u043e\u0440 \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u043d\u0438\u044f VIII \u0432 \u043a\u0440\u043e\u0432\u043e\u0442\u043e\u043a\u0435 \u043e\u0442 \u0440\u0430\u0437\u0440\u0443\u0448\u0435\u043d\u0438\u044f \u043f\u0440\u043e\u0442\u0435\u0430\u0437\u0430\u043c\u0438.<\/p>\n<p>\u0424\u0443\u043d\u043a\u0446\u0438\u043e\u043d\u0430\u043b\u044c\u043d\u0430\u044f \u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u044c \u0444\u0430\u043a\u0442\u043e\u0440\u0430 \u043a\u0440\u043e\u0432\u0438 VIII \u0437\u0430\u043a\u043b\u044e\u0447\u0430\u0435\u0442\u0441\u044f \u0432 \u043e\u0431\u0435\u0441\u043f\u0435\u0447\u0435\u043d\u0438\u0438 \u0432\u043d\u0443\u0442\u0440\u0435\u043d\u043d\u0435\u0433\u043e \u043c\u0435\u0445\u0430\u043d\u0438\u0437\u043c\u0430 \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u043d\u0438\u044f \u043a\u0440\u043e\u0432\u0438. \u0410\u043d\u0442\u0438\u0433\u0435\u043c\u043e\u0444\u0438\u043b\u0438\u0447\u0435\u0441\u043a\u0438\u0439 \u0444\u0430\u043a\u0442\u043e\u0440 \u043f\u0440\u0438 \u0443\u0447\u0430\u0441\u0442\u0438\u0438 \u0438\u043e\u043d\u043e\u0432 \u043a\u0430\u043b\u044c\u0446\u0438\u044f \u043e\u0431\u0440\u0430\u0437\u0443\u0435\u0442 \u043a\u043e\u043c\u043f\u043b\u0435\u043a\u0441 \u0441 \u0444\u0430\u043a\u0442\u043e\u0440\u043e\u043c \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u043d\u0438\u044f IX, \u0447\u0442\u043e \u0432\u043f\u043e\u0441\u043b\u0435\u0434\u0441\u0442\u0432\u0438\u0438 \u0430\u043a\u0442\u0438\u0432\u0438\u0440\u0443\u0435\u0442 \u0444\u0430\u043a\u0442\u043e\u0440 \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u043d\u0438\u044f \u043a\u0440\u043e\u0432\u0438 X. \u0422\u0430\u043a\u043e\u0439 \u043f\u0440\u043e\u0446\u0435\u0441\u0441 \u043e\u0431\u0435\u0441\u043f\u0435\u0447\u0438\u0432\u0430\u0435\u0442 \u043f\u0440\u0435\u043e\u0431\u0440\u0430\u0437\u043e\u0432\u0430\u043d\u0438\u0435 \u043f\u0440\u043e\u0442\u0440\u043e\u043c\u0431\u0438\u043d\u0430 \u0432 \u0442\u0440\u043e\u043c\u0431\u0438\u043d, \u043a\u043e\u0442\u043e\u0440\u044b\u0439, \u0432 \u0441\u0432\u043e\u044e \u043e\u0447\u0435\u0440\u0435\u0434\u044c, \u0437\u0430\u0432\u0435\u0440\u0448\u0430\u0435\u0442 \u043f\u0440\u0435\u0432\u0440\u0430\u0449\u0435\u043d\u0438\u0435 \u0444\u0438\u0431\u0440\u0438\u043d\u043e\u0433\u0435\u043d\u0430 \u0432 \u0444\u0438\u0431\u0440\u0438\u043d \u2014 \u0433\u043b\u0430\u0432\u043d\u043e\u0435 \u0441\u043e\u0441\u0442\u0430\u0432\u043b\u044f\u044e\u0449\u0435\u0435 \u043a\u0440\u043e\u0432\u044f\u043d\u043e\u0433\u043e \u0441\u0433\u0443\u0441\u0442\u043a\u0430.<\/p>\n<p>\u041d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u043a \u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u0438 \u0444\u0430\u043a\u0442\u043e\u0440\u0430 \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u0435\u043c\u043e\u0441\u0442\u0438 \u043a\u0440\u043e\u0432\u0438 VIII \u0432\u044b\u0437\u044b\u0432\u0430\u0435\u0442 \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u0435 \u0433\u0435\u043c\u043e\u0444\u0438\u043b\u0438\u0438 \u0410 \u2014 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f, \u0441\u0446\u0435\u043f\u043b\u0435\u043d\u043d\u043e\u0433\u043e \u0441 \u043f\u043e\u043b\u043e\u043c (\u043d\u0430\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435 \u0433\u0435\u043d\u0430, \u043d\u0430\u0445\u043e\u0434\u044f\u0449\u0435\u0433\u043e\u0441\u044f \u0432 \u043f\u043e\u043b\u043e\u0432\u044b\u0445 \u0445\u0440\u043e\u043c\u043e\u0441\u043e\u043c\u0430\u0445) \u0438 \u043f\u0440\u043e\u044f\u0432\u043b\u044f\u044e\u0449\u0435\u0433\u043e\u0441\u044f \u043a\u043e\u043c\u043f\u043b\u0435\u043a\u0441\u043e\u043c \u0432\u043d\u0443\u0442\u0440\u0435\u043d\u043d\u0438\u0445 \u0438 \u0432\u043d\u0435\u0448\u043d\u0438\u0445 \u043a\u0440\u043e\u0432\u043e\u0442\u0435\u0447\u0435\u043d\u0438\u0439.<\/p>\n<p>\u0414\u043b\u044f \u0433\u0435\u043d\u0435\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0445 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0439 \u0441 \u0442\u0430\u043a\u0438\u043c \u0432\u0438\u0434\u043e\u043c \u043d\u0430\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f \u0445\u0430\u0440\u0430\u043a\u0442\u0435\u0440\u043d\u044b\u043c \u043f\u0440\u0438\u0437\u043d\u0430\u043a\u043e\u043c \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u043f\u0440\u0435\u0438\u043c\u0443\u0449\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u043e\u0435 \u043f\u0440\u043e\u044f\u0432\u043b\u0435\u043d\u0438\u0435 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f \u0443 \u043c\u0443\u0436\u0447\u0438\u043d, \u0432 \u0442\u043e \u0432\u0440\u0435\u043c\u044f \u043a\u0430\u043a \u0436\u0435\u043d\u0449\u0438\u043d\u044b \u044f\u0432\u043b\u044f\u044e\u0442\u0441\u044f \u043b\u0438\u0448\u044c \u043d\u043e\u0441\u0438\u0442\u0435\u043b\u044c\u043d\u0438\u0446\u0430\u043c\u0438 \u0434\u0435\u0444\u0435\u043a\u0442\u043d\u043e\u0433\u043e \u0433\u0435\u043d\u0430. \u0427\u0430\u0441\u0442\u043e\u0442\u0430 \u0432\u0441\u0442\u0440\u0435\u0447\u0430\u0435\u043c\u043e\u0441\u0442\u0438 \u0433\u0435\u043c\u043e\u0444\u0438\u043b\u0438\u0438 \u0410 \u0443 \u043c\u0443\u0436\u0447\u0438\u043d 14:100000 \u0447\u0435\u043b\u043e\u0432\u0435\u043a. \u041b\u0438\u0448\u044c \u0435\u0434\u0438\u043d\u0438\u0447\u043d\u044b\u0435 \u0441\u043b\u0443\u0447\u0430\u0438 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f \u0432\u043e\u0437\u043c\u043e\u0436\u043d\u044b \u0441\u0440\u0435\u0434\u0438 \u0436\u0435\u043d\u0441\u043a\u043e\u0433\u043e \u043f\u043e\u043b\u0430.<\/p>\n<p>\u0423\u0440\u043e\u0432\u0435\u043d\u044c \u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0430 \u0444\u0430\u043a\u0442\u043e\u0440\u0430 \u043a\u0440\u043e\u0432\u0438 VIII \u043c\u043e\u0436\u0435\u0442 \u0431\u044b\u0442\u044c \u0440\u0430\u0437\u043b\u0438\u0447\u043d\u044b\u043c, \u0447\u0442\u043e \u043f\u043e\u0437\u0432\u043e\u043b\u044f\u0435\u0442 \u0432\u044b\u0434\u0435\u043b\u044f\u0442\u044c \u0442\u044f\u0436\u0435\u043b\u0443\u044e, \u0441\u0440\u0435\u0434\u043d\u044e\u044e \u0438 \u043b\u0435\u0433\u043a\u0443\u044e \u0444\u043e\u0440\u043c\u044b \u0433\u0435\u043c\u043e\u0444\u0438\u043b\u0438\u0438. \u041f\u0440\u0438 \u0442\u044f\u0436\u0435\u043b\u043e\u0439 \u0444\u043e\u0440\u043c\u0435 \u0432 \u043f\u043b\u0430\u0437\u043c\u0435 \u043a\u0440\u043e\u0432\u0438 \u0431\u043e\u043b\u044c\u043d\u044b\u0445 \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0438\u0432\u0430\u0435\u0442\u0441\u044f \u043d\u0435 \u0431\u043e\u043b\u0435\u0435 1 % \u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0433\u043e \u0444\u0430\u043a\u0442\u043e\u0440\u0430, \u0442.\u0435. 1 \u0435\u0434\u0438\u043d\u0438\u0446\u0430 \u0444\u0430\u043a\u0442\u043e\u0440\u0430 \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u0435\u043c\u043e\u0441\u0442\u0438 \u043a\u0440\u043e\u0432\u0438 VIII \u043d\u0430 1 \u0434\u043b \u043a\u0440\u043e\u0432\u0438. \u0422\u0430\u043a\u043e\u0435 \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u0435 \u043f\u0440\u043e\u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u0447\u0430\u0441\u0442\u044b\u043c\u0438 \u0438 \u043c\u0430\u0441\u0441\u0438\u0432\u043d\u044b\u043c\u0438 \u043a\u0440\u043e\u0432\u043e\u0438\u0437\u043b\u0438\u044f\u043d\u0438\u044f\u043c\u0438 \u0434\u0430\u0436\u0435 \u043f\u0440\u0438 \u043d\u0435\u0431\u043e\u043b\u044c\u0448\u0438\u0445 \u0438 \u043d\u0435\u0437\u0430\u043c\u0435\u0442\u043d\u044b\u0445 \u0442\u0440\u0430\u0432\u043c\u0430\u0445. \u041e\u0441\u043e\u0431\u0435\u043d\u043d\u043e \u0441\u0438\u043b\u044c\u043d\u044b\u0435 \u043a\u0440\u043e\u0432\u043e\u0438\u0437\u043b\u0438\u044f\u043d\u0438\u044f \u043f\u0440\u043e\u0438\u0441\u0445\u043e\u0434\u044f\u0442 \u0432 \u0441\u0443\u0441\u0442\u0430\u0432\u044b \u0438 \u043c\u044b\u0448\u0446\u044b.<\/p>\n<p>\u0421\u0440\u0435\u0434\u043d\u044f\u044f \u0441\u0442\u0435\u043f\u0435\u043d\u044c \u0442\u044f\u0436\u0435\u0441\u0442\u0438 \u0433\u0435\u043c\u043e\u0444\u0438\u043b\u0438\u0438 \u0410 \u043f\u0440\u0435\u0434\u043f\u043e\u043b\u0430\u0433\u0430\u0435\u0442 \u043d\u0430\u043b\u0438\u0447\u0438\u0435 \u0444\u0430\u043a\u0442\u043e\u0440\u0430 VIII \u0432 \u043e\u0431\u044a\u0435\u043c\u0435 \u043e\u0442 2 \u0434\u043e 4 \u0435\u0434\/\u0434\u043b \u0432 \u043f\u043b\u0430\u0437\u043c\u0435 \u043a\u0440\u043e\u0432\u0438. \u041a\u0440\u043e\u0432\u043e\u0442\u0435\u0447\u0435\u043d\u0438\u044f \u0443 \u0442\u0430\u043a\u0438\u0445 \u0431\u043e\u043b\u044c\u043d\u044b\u0445 \u0432\u043e\u0437\u043d\u0438\u043a\u0430\u044e\u0442 \u043f\u0440\u0438 \u0441\u0440\u0435\u0434\u043d\u0435 \u0442\u044f\u0436\u0435\u043b\u044b\u0445 \u0442\u0440\u0430\u0432\u043c\u0430\u0445.<\/p>\n<p>\u0423 \u0431\u043e\u043b\u044c\u043d\u044b\u0445 \u043b\u0435\u0433\u043a\u043e\u0439 \u0444\u043e\u0440\u043c\u043e\u0439 \u0433\u0435\u043c\u043e\u0444\u0438\u043b\u0438\u0438 \u0432 \u043f\u043b\u0430\u0437\u043c\u0435 \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0438\u0432\u0430\u044e\u0442 \u043e\u0442 5 \u0434\u043e 30 \u0435\u0434\/\u0434\u043b \u0444\u0430\u043a\u0442\u043e\u0440\u0430 VIII. \u041a\u0440\u043e\u0432\u043e\u0442\u0435\u0447\u0435\u043d\u0438\u044f \u0432\u043e\u0437\u043d\u0438\u043a\u0430\u044e\u0442 \u043f\u0440\u0438 \u043e\u0431\u0448\u0438\u0440\u043d\u044b\u0445 \u0442\u0440\u0430\u0432\u043c\u0430\u0445, \u0440\u043e\u0434\u0430\u0445, \u0445\u0438\u0440\u0443\u0440\u0433\u0438\u0447\u0435\u0441\u043a\u0438\u0445 \u043f\u043e\u0441\u043e\u0431\u0438\u044f\u0445. \u041d\u043e\u0440\u043c\u0430 \u0441\u043e\u0434\u0435\u0440\u0436\u0430\u043d\u0438\u044f \u0444\u0430\u043a\u0442\u043e\u0440\u0430 VIII \u0432 \u043a\u0440\u043e\u0432\u0438 \u2014 \u043e\u0442 50 \u0434\u043e 180 \u0435\u0434\/\u0434\u043b.<\/p>\n<p>\u0414\u043b\u044f \u0444\u0430\u043a\u0442\u043e\u0440\u0430 \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u043d\u0438\u044f \u043a\u0440\u043e\u0432\u0438 VIII \u043e\u043f\u0438\u0441\u0430\u043d\u0430 \u043f\u0440\u0438\u043e\u0431\u0440\u0435\u0442\u0435\u043d\u043d\u0430\u044f \u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u044c, \u043a\u0430\u043a \u0440\u0435\u0434\u043a\u043e\u0435 \u0438 \u043a\u0440\u0430\u0439\u043d\u0435 \u0442\u044f\u0436\u0435\u043b\u043e\u0435 \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043e\u0435 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0435. \u0422\u0430\u043a\u043e\u0439 \u0440\u0430\u0441\u0441\u0442\u0440\u043e\u0439\u0441\u0442\u0432\u043e \u0440\u0430\u0437\u0432\u0438\u0432\u0430\u0435\u0442\u0441\u044f \u0432 \u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u0435 \u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u0435 \u0444\u0443\u043d\u043a\u0446\u0438\u043e\u043d\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u044f \u0441\u043e\u0431\u0441\u0442\u0432\u0435\u043d\u043d\u043e\u0439 \u0438\u043c\u043c\u0443\u043d\u043d\u043e\u0439 \u0441\u0438\u0441\u0442\u0435\u043c\u044b \u0447\u0435\u043b\u043e\u0432\u0435\u043a\u0430, \u0447\u0442\u043e \u043f\u0440\u043e\u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u043e\u0431\u0440\u0430\u0437\u043e\u0432\u0430\u043d\u0438\u0435\u043c \u0430\u043d\u0442\u0438\u0442\u0435\u043b \u043a \u0444\u0430\u043a\u0442\u043e\u0440\u0443 VIII.<\/p>\n<p>\u0414\u0430\u043d\u043d\u043e\u0435 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0435 \u043c\u043e\u0436\u0435\u0442 \u043d\u0430\u0431\u043b\u044e\u0434\u0430\u0442\u044c\u0441\u044f \u043a\u0430\u043a \u0443 \u043c\u0443\u0436\u0447\u0438\u043d, \u0442\u0430\u043a \u0438 \u0443 \u0436\u0435\u043d\u0449\u0438\u043d \u0438 \u043f\u0440\u043e\u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u0442\u044f\u0436\u0435\u043b\u044b\u043c\u0438 \u043a\u0440\u043e\u0432\u043e\u0442\u0435\u0447\u0435\u043d\u0438\u044f\u043c\u0438. \u0414\u0430\u043d\u043d\u044b\u0435 \u043f\u043e\u0441\u043b\u0435\u0434\u043d\u0438\u0445 \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0439 \u0441\u043e\u043e\u0431\u0449\u0430\u044e\u0442 \u043e \u0432\u043e\u0437\u043c\u043e\u0436\u043d\u043e\u0439 \u0441\u0432\u044f\u0437\u0438 \u044d\u0442\u043e\u0433\u043e \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u044f \u0441 \u0434\u0440\u0443\u0433\u0438\u043c\u0438 \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u044b\u043c\u0438 \u0440\u0430\u0441\u0441\u0442\u0440\u043e\u0439\u0441\u0442\u0432\u0430\u043c\u0438 (\u0441\u0438\u0441\u0442\u0435\u043c\u043d\u0430\u044f \u043a\u0440\u0430\u0441\u043d\u0430\u044f \u0432\u043e\u043b\u0447\u0430\u043d\u043a\u0430, \u0440\u0435\u0432\u043c\u0430\u0442\u043e\u0438\u0434\u043d\u044b\u0439 \u0430\u0440\u0442\u0440\u0438\u0442, \u043d\u0435\u0441\u043f\u0435\u0446\u0438\u0444\u0438\u0447\u0435\u0441\u043a\u0438\u0439 \u044f\u0437\u0432\u0435\u043d\u043d\u044b\u0439 \u043a\u043e\u043b\u0438\u0442 \u0438 \u0442.\u0434.), \u0437\u043b\u043e\u043a\u0430\u0447\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u043c\u0438 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f\u043c\u0438, \u043f\u0440\u0438\u043c\u0435\u043d\u0435\u043d\u0438\u0435\u043c \u043d\u0435\u043a\u043e\u0442\u043e\u0440\u044b\u0445 \u043b\u0435\u043a\u0430\u0440\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u0445 \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442\u043e\u0432.<\/p>\n<p>\u0421\u043e\u0434\u0435\u0440\u0436\u0430\u043d\u0438\u0435 \u0444\u0430\u043a\u0442\u043e\u0440\u0430 VIII \u0443 \u0437\u0434\u043e\u0440\u043e\u0432\u044b\u0445 \u043b\u0438\u0446 \u0431\u044b\u0441\u0442\u0440\u043e \u0432\u043e\u0437\u0440\u0430\u0441\u0442\u0430\u0435\u0442 \u043f\u0440\u0438 \u0444\u0438\u0437\u0438\u0447\u0435\u0441\u043a\u0438\u0445 \u0443\u0441\u0438\u043b\u0438\u044f\u0445, \u0441\u0442\u0440\u0435\u0441\u0441\u043e\u0440\u043d\u044b\u0445 \u0432\u043e\u0437\u0434\u0435\u0439\u0441\u0442\u0432\u0438\u044f\u0445 \u0438\u043b\u0438 \u0432\u0432\u0435\u0434\u0435\u043d\u0438\u0438 \u0430\u0434\u0440\u0435\u043d\u0430\u043b\u0438\u043d\u0430. \u042d\u0442\u043e \u044f\u0432\u043b\u0435\u043d\u0438\u0435 \u043f\u0440\u0435\u0445\u043e\u0434\u044f\u0449\u0435\u0435 \u0438 \u0441\u0447\u0438\u0442\u0430\u044e\u0442, \u0447\u0442\u043e \u043e\u043d\u043e \u0441\u0432\u044f\u0437\u0430\u043d\u043e \u0441 \u0432\u044b\u0441\u0432\u043e\u0431\u043e\u0436\u0434\u0435\u043d\u0438\u0435\u043c \u0444\u0430\u043a\u0442\u043e\u0440\u0430 VIII \u0438\u0437 \u0437\u0430\u043f\u0430\u0441\u043e\u0432. \u0423\u0440\u043e\u0432\u0435\u043d\u044c \u0444\u0430\u043a\u0442\u043e\u0440\u0430 VIII \u0432\u043e\u0437\u0440\u0430\u0441\u0442\u0430\u0435\u0442 \u0442\u0430\u043a\u0436\u0435 \u043f\u0440\u0438 \u0440\u0430\u0437\u043b\u0438\u0447\u043d\u044b\u0445 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f\u0445, \u0442\u0430\u043a\u0438\u0445 \u043a\u0430\u043a \u043e\u043f\u0443\u0445\u043e\u043b\u0438, \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u044b\u0435 \u043f\u0440\u043e\u0446\u0435\u0441\u0441\u044b, \u0446\u0438\u0440\u0440\u043e\u0437 \u043f\u0435\u0447\u0435\u043d\u0438 \u0438 \u044d\u043d\u0434\u043e\u043a\u0440\u0438\u043d\u043d\u044b\u0435 \u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u044f.<\/p>\n<p><strong>\u041f\u043e\u0434\u0433\u043e\u0442\u043e\u0432\u043a\u0430 \u043a \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044e<\/strong><\/p>\n<ul>\n<li>\u041a\u0440\u043e\u0432\u044c \u0441\u0434\u0430\u044e\u0442 \u0443\u0442\u0440\u043e\u043c \u043d\u0430\u0442\u043e\u0449\u0430\u043a \u2014 \u043f\u043e\u0441\u043b\u0435 \u043f\u043e\u0441\u043b\u0435\u0434\u043d\u0435\u0433\u043e \u043f\u0440\u0438\u0435\u043c\u0430 \u043f\u0438\u0449\u0438 \u0434\u043e\u043b\u0436\u043d\u043e \u043f\u0440\u043e\u0439\u0442\u0438 \u043a\u0430\u043a \u043c\u0438\u043d\u0438\u043c\u0443\u043c 8 \u0447\u0430\u0441\u043e\u0432. \u0412\u0435\u0447\u0435\u0440\u043e\u043c \u043d\u0430\u043a\u0430\u043d\u0443\u043d\u0435 \u043f\u043e\u0443\u0436\u0438\u043d\u0430\u0439\u0442\u0435 \u043b\u0435\u0433\u043a\u043e\u0439 \u043d\u0435\u0436\u0438\u0440\u043d\u043e\u0439 \u043f\u0438\u0449\u0435\u0439.<\/li>\n<li>\u0417\u0430 2 \u0447\u0430\u0441\u0430 \u0434\u043e \u0441\u0434\u0430\u0447\u0438 \u043a\u0440\u043e\u0432\u0438 \u043d\u0430 \u0430\u043d\u0430\u043b\u0438\u0437 \u043d\u0435\u043b\u044c\u0437\u044f \u043a\u0443\u0440\u0438\u0442\u044c, \u043f\u0438\u0442\u044c \u043a\u043e\u0444\u0435 \u0438 \u0447\u0430\u0439, \u0430 \u0442\u0430\u043a\u0436\u0435 \u0444\u0440\u0443\u043a\u0442\u043e\u0432\u044b\u0435 \u0441\u043e\u043a\u0438. \u0414\u043e\u043f\u0443\u0441\u0442\u0438\u043c\u043e \u0443\u043f\u043e\u0442\u0440\u0435\u0431\u043b\u0435\u043d\u0438\u0435 \u043d\u0435\u0431\u043e\u043b\u044c\u0448\u043e\u0433\u043e \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0430 \u043d\u0435\u0433\u0430\u0437\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e\u0439 \u0432\u043e\u0434\u044b \u2014 \u043d\u0435 \u0441\u043b\u0430\u0434\u043a\u043e\u0439, \u043d\u0435 \u0441\u043e\u043b\u0435\u043d\u043e\u0439, \u043d\u0435 \u043c\u0438\u043d\u0435\u0440\u0430\u043b\u044c\u043d\u043e\u0439.<\/li>\n<li>\u0412 \u0442\u0435\u0447\u0435\u043d\u0438\u0435 24 \u0447\u0430\u0441\u043e\u0432 \u0434\u043e \u0430\u043d\u0430\u043b\u0438\u0437\u0430 \u043a\u0440\u043e\u0432\u0438 \u043d\u0435\u043b\u044c\u0437\u044f \u0443\u043f\u043e\u0442\u0440\u0435\u0431\u043b\u044f\u0442\u044c \u0430\u043b\u043a\u043e\u0433\u043e\u043b\u044c. \u0422\u0430\u043a\u0436\u0435, \u043f\u043e \u0441\u043e\u0433\u043b\u0430\u0441\u043e\u0432\u0430\u043d\u0438\u044e \u0441 \u043b\u0435\u0447\u0430\u0449\u0438\u043c \u0432\u0440\u0430\u0447\u043e\u043c, \u043d\u0435\u043e\u0431\u0445\u043e\u0434\u0438\u043c\u043e \u043e\u0442\u043c\u0435\u043d\u0438\u0442\u044c \u043f\u0440\u0438\u0435\u043c \u043b\u0435\u043a\u0430\u0440\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u0445 \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442\u043e\u0432.<\/li>\n<li>\u0417\u0430 \u0447\u0430\u0441 \u0434\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f \u0438\u0437\u0431\u0435\u0433\u0430\u0439\u0442\u0435 \u043f\u0441\u0438\u0445\u043e\u044d\u043c\u043e\u0446\u0438\u043e\u043d\u0430\u043b\u044c\u043d\u043e\u0433\u043e \u043d\u0430\u043f\u0440\u044f\u0436\u0435\u043d\u0438\u044f, \u0444\u0438\u0437\u0438\u0447\u0435\u0441\u043a\u043e\u0433\u043e \u043d\u0430\u043f\u0440\u044f\u0436\u0435\u043d\u0438\u044f, \u0442\u0430\u043a\u043e\u0433\u043e \u043a\u0430\u043a \u0431\u044b\u0441\u0442\u0440\u044b\u0439 \u043f\u043e\u0434\u044a\u0435\u043c \u043f\u043e \u043b\u0435\u0441\u0442\u043d\u0438\u0446\u0435, \u0431\u0435\u0433. \u0416\u0435\u043b\u0430\u0442\u0435\u043b\u044c\u043d\u043e \u043f\u0440\u0438\u0439\u0442\u0438 \u0432 \u043e\u0442\u0434\u0435\u043b\u0435\u043d\u0438\u0435 \u043b\u0430\u0431\u043e\u0440\u0430\u0442\u043e\u0440\u0438\u0438 \u0437\u0430\u0431\u043b\u0430\u0433\u043e\u0432\u0440\u0435\u043c\u0435\u043d\u043d\u043e \u0438 \u0432 \u0442\u0435\u0447\u0435\u043d\u0438\u0435 10-15 \u043c\u0438\u043d\u0443\u0442 \u0434\u043e \u0441\u0434\u0430\u0447\u0438 \u043a\u0440\u043e\u0432\u0438 \u0441\u043f\u043e\u043a\u043e\u0439\u043d\u043e \u043f\u043e\u0441\u0438\u0434\u0435\u0442\u044c.<\/li>\n<li>\u041d\u0435 \u0441\u0434\u0430\u0432\u0430\u0439\u0442\u0435 \u043a\u0440\u043e\u0432\u044c \u0441\u0440\u0430\u0437\u0443 \u043f\u043e\u0441\u043b\u0435 \u0444\u0438\u0437\u0438\u043e\u0442\u0435\u0440\u0430\u043f\u0435\u0432\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0445 \u043f\u0440\u043e\u0446\u0435\u0434\u0443\u0440, \u043c\u0430\u0441\u0441\u0430\u0436\u0430 \u0438 \u0438\u043d\u0441\u0442\u0440\u0443\u043c\u0435\u043d\u0442\u0430\u043b\u044c\u043d\u044b\u0445 \u043e\u0431\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0439, \u0442\u0430\u043a\u0438\u0445 \u043a\u0430\u043a \u0423\u0417\u0418 \u0438 \u0440\u0435\u043d\u0442\u0433\u0435\u043d, \u0432 \u0442\u0435\u0447\u0435\u043d\u0438\u0435 5-7 \u0434\u043d\u0435\u0439.<\/li>\n<\/ul>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[951],"product_tag":[],"class_list":{"0":"post-10008","1":"product","2":"type-product","3":"status-publish","5":"product_cat-teste-de-hemostaza","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\/10008","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=10008"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10008"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=10008"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=10008"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=10008"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}