{"id":10101,"date":"2020-04-23T03:56:36","date_gmt":"2020-04-23T00:56:36","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/eritropoietina\/"},"modified":"2025-02-07T09:08:45","modified_gmt":"2025-02-07T07:08:45","slug":"eritropoietina","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/eritropoietina\/","title":{"rendered":"\u042d\u0440\u0438\u0442\u0440\u043e\u043f\u043e\u044d\u0442\u0438\u043d"},"content":{"rendered":"

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

Eritropoietina (EPO), un hormon glicoproteic codificat de o gen\u0103 situat\u0103 pe bra\u0163ul lung al cromozomului 7 \u015fi secretat \u00een principal \u00een rinichi, intervine \u00een controlul eritropoiezei. \u00cen mod normal, nivelurile de eritropoietin\u0103 variaz\u0103 invers propor\u0163ional cu valoarea hematocritului. Hipoxia stimuleaz\u0103 eliberarea EPO, care la r\u00e2ndul s\u0103u induce produc\u0163ia de eritrocite la nivelul m\u0103duvei osoase. Valorile crescute ale num\u0103rului de eritrocite, hematocritului \u015fi hemoglobinei suprim\u0103 eliberarea EPO.<\/span><\/p>\n

EPO stimuleaz\u0103 proliferarea, cre\u015fterea \u015fi diferen\u0163ierea precursorilor eritroizi, av\u00e2nd drept consecin\u0163\u0103 cre\u015fterea num\u0103rului de eritrocite. EPO exercit\u0103 un efect dominant asupra unit\u0103\u0163ilor formatoare de colonii eritroide (CFU-E), pronormoblastilor \u015fi\u00a0eritrobla\u015ftilor bazofili4;5<\/sup>. Una din ac\u0163iunile cele mai spectaculoase ale EPO este capacitatea hormonului de a men\u0163ine viabilitatea acestor celule \u00een absen\u0163a oric\u0103rui efect asupra ciclului celular. Efectul asupra megacariocitelor este minor1;5<\/sup>.<\/span><\/p>\n

Celulele hematopoietice care r\u0103spund la EPO prezint\u0103 pe suprafa\u0163a lor receptori specifici pentru acest hormon (EPOR). Dup\u0103 legarea EPO de receptori urmeaz\u0103 un proces de fosforilare a tirozinei. Deoarece EPOR nu prezint\u0103 un domeniu al kinazei este nevoie s\u0103 se asocieze cu o tirozinkinaz\u0103 ce face parte din familia Janus kinazelor \u015fi este denumit\u0103 JAK2. O muta\u0163ie punctiform\u0103 (Val617Phe) la nivelul JAK2 conduce la activarea acesteia. Aceast\u0103 muta\u0163ie somatic\u0103 activatoare a fost depistat\u0103 la majoritatea pacien\u0163ilor cu policitemie vera \u015fi cu o frecven\u0163\u0103 mai mic\u0103 \u00een alte neoplazii mieloproliferative cronice1<\/sup>.<\/span><\/p>\n

Policitemia vera este o afec\u0163iune clonal\u0103 a celulei stem caracterizat\u0103 printr-o produc\u0163ie autonom\u0103 de celule hematopoietice. Cre\u015fterea masei eritrocitare are drept consecin\u0163\u0103 suprimarea compensatorie a nivelurilor EPO. Modific\u0103rile asociate cu policitemia vera includ: valori persistent crescute ale hemoglobinei (Hb >18.5 g\/dL la b\u0103rba\u0163i \u015fi \u00a0>16.5 g\/dL la femei), adesea \u00eenso\u0163ite de leucocitoz\u0103 \u015fi trombocitoz\u0103, splenomegalie, eritromelalgie, tromboze\u00a0\u00een teritorii neobi\u015fnuite4<\/sup>. Valorile sc\u0103zute ale eritropietinei serice constituie unul dintre criteriile minore de diagnostic al policitemiei vera6<\/sup>.<\/span><\/p>\n

Policitemiile secundare se pot datora unei cre\u015fteri a masei eritrocitare, adecvate sau inadecvate. Policitemiile secundare adecvate se dezvolt\u0103 ca urmare a unor condi\u0163ii asociate cu hipoxie cronic\u0103 (habitatul la altitudini mari sau bolile pulmonare). Produc\u0163ia EPO este ridicat\u0103 pentru a cre\u015fte compensator masa eritrocitar\u0103 \u015fi a \u00eencerca s\u0103 se livreze \u0163esuturilor o cantitate mai mare de oxigen. Policitemiile secundare inadecvate sunt determinate de o serie de tumori renale, hepatice, pulmonare sau cerebrale care secret\u0103 \u00een exces EPO sau molecule asem\u0103n\u0103toare acesteia4<\/sup>.<\/span><\/p>\n

Deoarece 80-90% din cantitatea de EPO este produs\u0103 la nivel renal, insuficien\u0163a renal\u0103 cronic\u0103 este \u00eenso\u0163it\u0103 de sc\u0103derea marcat\u0103 a produc\u0163iei de eritropoietin\u0103 cu anemie consecutiv\u0103. Ficatul poate sintetiza cantit\u0103\u0163i mici de EPO, astfel \u00eenc\u00e2t pacien\u0163ii anefrici prezint\u0103 o cantitate rezidual\u0103 de EPO produs\u0103 la nivel hepatic3;4<\/sup>.<\/span><\/p>\n

Bolile inflamatorii cronice, procesele maligne, rejetul grefelor \u015fi traumatismele grave duc probabil la o inhibi\u0163ie a produc\u0163iei de eritropoetin\u0103 prin citokine (IL-1,TNF\u03b1), \u00eens\u0103 anemia din cadrul acestor afec\u0163iuni este rezultatul unor fenomene multifactoriale3<\/sup>.<\/span><\/p>\n

\u00cen 1989 a fost introdus tratamentul cu eritropoietin\u0103 uman\u0103 recombinat\u0103; pacien\u0163ii candida\u0163i pentru aceast\u0103 terapie sunt cei cu insuficien\u0163\u0103 renal\u0103 cronic\u0103, precum \u015fi cei cu anemii de diverse cauze: chimioterapie, SIDA \u015fi unele afec\u0163iuni hematologice4<\/sup>.<\/span><\/p>\n

Motivul pentru care EPO este pe lista dopajului \u00een sportul de performan\u0163\u0103 este cre\u015fterea volumului sanguin, a eritrocitelor \u015fi hemoglobinei pentru a cre\u015fte capacitatea de transport a oxigenului. Astfel, o cre\u015ftere a hemoglobinei cu 0.3 g\/dL are ca urmare o cre\u015ftere a capacit\u0103\u0163ii de efort cu 1%. Folosirea EPO poate fi dificil de dovedit deoarece forma sintetic\u0103 nu se deosebe\u015fte de cea natural\u0103. Pot fi trase concluzii\u00a0\u00een mod indirect, prin modific\u0103rile hemoglobinei, hematocritului, feritinei \u015fi receptorului pentru transferin\u01033<\/sup>.<\/span><\/p>\n

Recomand\u0103ri pentru determinarea \u00a0eritropietinei serice<\/em><\/strong><\/span><\/p>\n

\u2022\u00a0<\/strong>Diferen\u0163ierea policitemiei primare (vera) de cea secundar\u0103 \u2022<\/strong> Identificarea candida\u0163ilor la terapia cu EPO uman\u0103 recombinat\u0103 \u2022 <\/strong>Investigarea unei anemii normocitare de cauz\u0103 neclar\u0103<\/span><\/div>\n
\u2022<\/strong> Evaluarea pacien\u0163ilor afla\u0163i sub tratament cu EPO la care se constat\u0103 un r\u0103spuns hematopoietic inadecvat \u2022 <\/strong>Monitorizarea pacien\u0163ilor cu tumori EPO-secretante3;4<\/sup>.<\/span><\/div>\n

Preg\u0103tire pacient <\/em><\/strong>\u2013 \u00e0 jeun (pe nem\u00e2ncate)3<\/sup>.<\/span><\/p>\n

Specimen recoltat<\/em><\/strong> - <\/em>\u0432\u0435\u043d\u043e\u0437\u043d\u0430\u044f \u043a\u0440\u043e\u0432\u044c3<\/sup>.<\/span><\/p>\n

Recipient de recoltare <\/em><\/strong>\u2013 vacutainer f\u0103r\u0103 anticoagulant cu\/f\u0103r\u0103 gel separator3<\/sup>.<\/span><\/p>\n

Prelucrare necesar\u0103 dup\u0103 recoltare <\/em><\/strong>\u2013 se separ\u0103 serul prin centrifugare3<\/sup>.<\/span><\/p>\n

Volum prob\u0103<\/em><\/strong> \u2013 minim 0.5 mL ser3<\/sup>.<\/span><\/p>\n

Stabilitate prob\u0103 <\/em><\/strong>\u2013 serul separat este stabil 7 zile<\/em> la 2-8\u00b0C; timp \u00eendelungat<\/em> la -20\u00b0C3<\/sup>.<\/span><\/p>\n

Metod\u0103 <\/em><\/strong>- imunochimic\u0103 cu detec\u0163ie prin chemiluminiscen\u0163\u0103 (CLIA)<\/span>3<\/sup>.<\/span><\/p>\n

Valori de referin\u0163\u0103 <\/em><\/strong>-<\/em> 4.3-29 UI\/L3<\/sup>.<\/span><\/p>\n

Interpretarea rezultatelor<\/em><\/strong><\/span><\/p>\n

\u00cen policitemia vera valorile EPO sunt sc\u0103zute sau la limita inferioar\u0103 a intervalului de referin\u0163\u0103, \u00een timp ce \u00een formele secundare sunt crescute.<\/span><\/div>\n
La pacien\u0163ii cu anemie asociat\u0103 insuficien\u0163ei renale cronice se \u00eent\u00e2lnesc valori \u00a0EPO foarte sc\u0103zute\u00a0\u00een raport cu gradul anemiei, care se datoreaz\u0103 incapacit\u0103\u0163ii rinichiului afectat de a produce eritropoetin\u0103. De asemenea, crizele de rejet la pacien\u0163ii cu transplant renal sunt \u00eenso\u0163ite de sc\u0103derea eritropoietinei3<\/sup>.<\/span><\/div>\n
La pacien\u0163ii cu anemii feriprive, talasemii sau insuficien\u0163\u0103 medular\u0103 se \u00eenregistreaz\u0103 valori EPO crescute4<\/sup>.<\/span><\/div>\n
Valori ridicate ale eritropoetinei pot fi cauzate de tumori renale produc\u0103toare de EPO sau care blocheaz\u0103 fluxul sanguin local produc\u00e2nd hipoxie, f\u0103r\u0103 a exista o anemie sau hipoxie general\u01033<\/sup>.<\/span><\/div>\n
Pacien\u0163ii care prezint\u0103 un r\u0103spuns slab sau absent la tratamentul cu eritropietin\u0103 \u015fi la care nivelele EPO serice sunt normale sau chiar crescute pot avea alte cauze nerecunoscute de anemie. Dac\u0103 \u00eens\u0103 nu poate fi identificat nici un alt factor, se va lua\u00a0\u00een considerare posibilitatea dezvolt\u0103rii de anticorpi anti-EPO. Aceast\u0103 condi\u0163ie poate avea consecin\u0163e clinice grave cu riscul apari\u0163iei aplaziei medulare de serie ro\u015fie4<\/sup>.<\/span><\/div>\n

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

Unii pacien\u0163i cu policitemia vera prezint\u0103 niveluri serice normale de eritropoietin\u0103.<\/span><\/div>\n
Acest test nu permite distinc\u0163ia \u00eentre EPO endogen\u0103 \u015fi cea administrat\u0103 exogen4<\/sup>.<\/span><\/div>\n

\u2022 Medicamente<\/span><\/p>\n

Sc\u0103deri<\/span>:<\/strong> acetazolamid\u0103, amfotericina B, cisplatin, enalapril, furosemid, teofilina.<\/span><\/p>\n

Crester<\/span>i:<\/strong> steroizi anabolizan\u0163i, daunorubicin, eritropietin\u0103, fluoximesteron, hidroxiurea, teofilin\u0103, zidovudina.\u00a0<\/em><\/span><\/p>\n

\u2022 Interferen\u0163e analitice<\/span><\/p>\n

Anticorpii heterofili prezen\u0163i \u00een serul pacien\u0163ilor pot interac\u0163iona cu imunoglobulinele incluse\u00a0\u00een componentele din kit alter\u00e2nd rezultatele3<\/sup>.<\/span><\/p>\n

\u00a0<\/span>\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f:<\/strong><\/span><\/p>\n

1. Emmanuel N. Dessypriss, Stephen T Sawyer. Erytropoiesis. In Wintrobe\u2019s Clinical Hematology, Lippincot Williams & Wilkins, 12th Edition, 2009, 118-121.<\/span><\/span><\/div>\n
2. Frances Fischbach. Effects of the Most Commonly Used Drugs on Frequently Ordered Laboratory Tests. In A Manual of Laboratory and Diagnostic Tests. Lippincott Williams & Wilkins, USA, 8 ed. 2009, 1237.<\/span><\/div>\n
3. Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate 2012. Ref Type: Catalog<\/span><\/div>\n
4. Mayo Clinic\/Mayo Medical Laboratories. Test Catalog. Erythropoietin (EPO), Serum. www.mayomedicallaboratories.com<\/a>\u00a0 Ref Type: Internet Communication.<\/span><\/div>\n
5. Sharad Mathur, Kateherine Schexneider, Rober E. Huchinson. Hematopoiesis. In Henry\u2019s Clinical Diagnosis and Management by Laboratory Methods.Sauders Elsevier 21-Ed 2007, 486.<\/span><\/div>\n
6. WHO 2008 Classification of Chronic Myeloid Neoplasms.<\/span><\/div>","protected":false},"excerpt":{"rendered":"

\u042d\u0440\u0438\u0442\u0440\u043e\u043f\u043e\u044d\u0442\u0438\u043d \u2013 \u0433\u043e\u0440\u043c\u043e\u043d, \u0432 \u043e\u0441\u043d\u043e\u0432\u043d\u043e\u043c \u043f\u0440\u043e\u0438\u0437\u0432\u043e\u0434\u044f\u0449\u0438\u0439\u0441\u044f \u0432 \u043f\u043e\u0447\u043a\u0430\u0445. \u041e\u043d \u0432\u044b\u0441\u0432\u043e\u0431\u043e\u0436\u0434\u0430\u0435\u0442\u0441\u044f \u0432 \u043a\u0440\u043e\u0432\u043e\u0442\u043e\u043a \u0432 \u043e\u0442\u0432\u0435\u0442 \u043d\u0430 \u043a\u0438\u0441\u043b\u043e\u0440\u043e\u0434\u043d\u043e\u0435 \u0433\u043e\u043b\u043e\u0434\u0430\u043d\u0438\u0435 (\u0433\u0438\u043f\u043e\u043a\u0441\u0438\u044e). \u042d\u0440\u0438\u0442\u0440\u043e\u043f\u043e\u044d\u0442\u0438\u043d \u043f\u043e\u043f\u0430\u0434\u0430\u0435\u0442 \u0432 \u043a\u043e\u0441\u0442\u043d\u044b\u0439 \u043c\u043e\u0437\u0433, \u0433\u0434\u0435 \u043d\u0430\u0447\u0438\u043d\u0430\u0435\u0442 \u0441\u0442\u0438\u043c\u0443\u043b\u0438\u0440\u043e\u0432\u0430\u0442\u044c \u043f\u0440\u0435\u0432\u0440\u0430\u0449\u0435\u043d\u0438\u0435 \u0441\u0442\u0432\u043e\u043b\u043e\u0432\u044b\u0445 \u043a\u043b\u0435\u0442\u043e\u043a \u0432 \u044d\u0440\u0438\u0442\u0440\u043e\u0446\u0438\u0442\u044b. \u042d\u0440\u0438\u0442\u0440\u043e\u0446\u0438\u0442\u044b \u0441\u043e\u0434\u0435\u0440\u0436\u0430\u0442 \u0433\u0435\u043c\u043e\u0433\u043b\u043e\u0431\u0438\u043d \u2013 \u0431\u0435\u043b\u043e\u043a, \u043a\u043e\u0442\u043e\u0440\u044b\u0439 \u0441\u043f\u043e\u0441\u043e\u0431\u0435\u043d \u043f\u0435\u0440\u0435\u043d\u043e\u0441\u0438\u0442\u044c \u043a\u0438\u0441\u043b\u043e\u0440\u043e\u0434 \u043e\u0442 \u043b\u0435\u0433\u043a\u0438\u0445 \u043a \u043e\u0440\u0433\u0430\u043d\u0430\u043c \u0438 \u0442\u043a\u0430\u043d\u044f\u043c. \u0412 \u043d\u043e\u0440\u043c\u0435 \u0441\u0440\u043e\u043a \u0436\u0438\u0437\u043d\u0438 \u044d\u0440\u0438\u0442\u0440\u043e\u0446\u0438\u0442\u043e\u0432 \u0441\u043e\u0441\u0442\u0430\u0432\u043b\u044f\u0435\u0442 \u043e\u043a\u043e\u043b\u043e 120 \u0434\u043d\u0435\u0439, \u043e\u043d\u0438 \u0438\u043c\u0435\u044e\u0442 \u043e\u0434\u0438\u043d\u0430\u043a\u043e\u0432\u044b\u0435 \u0440\u0430\u0437\u043c\u0435\u0440\u044b \u0438 \u0444\u043e\u0440\u043c\u0443.<\/p>\n

\u041e\u0440\u0433\u0430\u043d\u0438\u0437\u043c \u0441\u0442\u0430\u0440\u0430\u0435\u0442\u0441\u044f \u043f\u043e\u0434\u0434\u0435\u0440\u0436\u0438\u0432\u0430\u0442\u044c \u043f\u0440\u0438\u043c\u0435\u0440\u043d\u043e \u043e\u0434\u0438\u043d\u0430\u043a\u043e\u0432\u043e\u0435 \u0447\u0438\u0441\u043b\u043e \u0446\u0438\u0440\u043a\u0443\u043b\u0438\u0440\u0443\u044e\u0449\u0438\u0445 \u044d\u0440\u0438\u0442\u0440\u043e\u0446\u0438\u0442\u043e\u0432. \u041f\u0440\u0438 \u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u0438 \u0431\u0430\u043b\u0430\u043d\u0441\u0430 \u043c\u0435\u0436\u0434\u0443 \u043e\u0431\u0440\u0430\u0437\u043e\u0432\u0430\u043d\u0438\u0435\u043c \u0438 \u0440\u0430\u0437\u0440\u0443\u0448\u0435\u043d\u0438\u0435\u043c \u044d\u0440\u0438\u0442\u0440\u043e\u0446\u0438\u0442\u043e\u0432 \u0440\u0430\u0437\u0432\u0438\u0432\u0430\u0435\u0442\u0441\u044f \u0430\u043d\u0435\u043c\u0438\u044f. \u0415\u0441\u043b\u0438 \u0432 \u043a\u043e\u0441\u0442\u043d\u043e\u043c \u043c\u043e\u0437\u0433\u0435 \u043e\u0431\u0440\u0430\u0437\u0443\u0435\u0442\u0441\u044f \u0441\u043b\u0438\u0448\u043a\u043e\u043c \u043c\u0430\u043b\u043e \u044d\u0440\u0438\u0442\u0440\u043e\u0446\u0438\u0442\u043e\u0432 \u043b\u0438\u0431\u043e \u0441\u043b\u0438\u0448\u043a\u043e\u043c \u043c\u043d\u043e\u0433\u043e \u0442\u0435\u0440\u044f\u0435\u0442\u0441\u044f \u0438\u0437-\u0437\u0430 \u043a\u0440\u043e\u0432\u043e\u043f\u043e\u0442\u0435\u0440\u0438 \u0438\u043b\u0438 \u0440\u0430\u0437\u0440\u0443\u0448\u0435\u043d\u0438\u044f (\u0433\u0435\u043c\u043e\u043b\u0438\u0437\u0430), \u0432\u044b\u0437\u0432\u0430\u043d\u043d\u043e\u0433\u043e \u043d\u0435\u043d\u043e\u0440\u043c\u0430\u043b\u044c\u043d\u044b\u043c\u0438 \u0440\u0430\u0437\u043c\u0435\u0440\u0430\u043c\u0438, \u0444\u043e\u0440\u043c\u043e\u0439, \u0444\u0443\u043d\u043a\u0446\u0438\u0435\u0439 \u044d\u0440\u0438\u0442\u0440\u043e\u0446\u0438\u0442\u043e\u0432 \u0438\u043b\u0438 \u0434\u0440\u0443\u0433\u0438\u043c\u0438 \u043f\u0440\u0438\u0447\u0438\u043d\u0430\u043c\u0438, \u0442\u043e \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u043e \u043f\u0435\u0440\u0435\u043d\u043e\u0441\u0438\u043c\u043e\u0433\u043e \u043a \u043e\u0440\u0433\u0430\u043d\u0430\u043c \u043a\u0438\u0441\u043b\u043e\u0440\u043e\u0434\u0430 \u0443\u043c\u0435\u043d\u044c\u0448\u0430\u0435\u0442\u0441\u044f. \u0412 \u043e\u0442\u0432\u0435\u0442 \u043d\u0430 \u044d\u0442\u043e \u043f\u043e\u0447\u043a\u043e\u0439 \u0432\u044b\u0440\u0430\u0431\u0430\u0442\u044b\u0432\u0430\u0435\u0442\u0441\u044f \u044d\u0440\u0438\u0442\u0440\u043e\u043f\u043e\u044d\u0442\u0438\u043d, \u043a\u043e\u0442\u043e\u0440\u044b\u0439 \u0437\u0430\u0442\u0435\u043c \u043a\u0440\u043e\u0432\u044c\u044e \u0434\u043e\u0441\u0442\u0430\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u0432 \u043a\u043e\u0441\u0442\u043d\u044b\u0439 \u043c\u043e\u0437\u0433, \u0433\u0434\u0435 \u0441\u0442\u0438\u043c\u0443\u043b\u0438\u0440\u0443\u0435\u0442 \u043e\u0431\u0440\u0430\u0437\u043e\u0432\u0430\u043d\u0438\u0435 \u044d\u0440\u0438\u0442\u0440\u043e\u0446\u0438\u0442\u043e\u0432.<\/p>\n

\u041d\u0430 \u043f\u0440\u043e\u0438\u0437\u0432\u043e\u0434\u0441\u0442\u0432\u043e \u044d\u0440\u0438\u0442\u0440\u043e\u0446\u0438\u0442\u043e\u0432 \u0432\u043b\u0438\u044f\u0435\u0442 \u0440\u0430\u0431\u043e\u0442\u0430 \u043a\u043e\u0441\u0442\u043d\u043e\u0433\u043e \u043c\u043e\u0437\u0433\u0430, \u0443\u043f\u043e\u0442\u0440\u0435\u0431\u043b\u0435\u043d\u0438\u0435 \u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0433\u043e \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0430 \u0436\u0435\u043b\u0435\u0437\u0430, \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 B12<\/sub>\u00a0\u0438 \u0444\u043e\u043b\u0438\u0435\u0432\u043e\u0439 \u043a\u0438\u0441\u043b\u043e\u0442\u044b \u0441 \u043f\u0438\u0449\u0435\u0439, \u0430 \u0442\u0430\u043a\u0436\u0435 \u043e\u0431\u0440\u0430\u0437\u043e\u0432\u0430\u043d\u0438\u0435 \u044d\u0440\u0438\u0442\u0440\u043e\u043f\u043e\u044d\u0442\u0438\u043d\u0430 \u0438 \u0441\u043f\u043e\u0441\u043e\u0431\u043d\u043e\u0441\u0442\u044c \u043a\u043e\u0441\u0442\u043d\u043e\u0433\u043e \u043c\u043e\u0437\u0433\u0430 \u043e\u0442\u0432\u0435\u0447\u0430\u0442\u044c \u043d\u0430 \u0441\u043e\u043e\u0442\u0432\u0435\u0442\u0441\u0442\u0432\u0443\u044e\u0449\u0438\u0435 \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0430 \u044d\u0442\u043e\u0433\u043e \u0433\u043e\u0440\u043c\u043e\u043d\u0430.<\/p>\n

\u0412\u044b\u0440\u0430\u0431\u043e\u0442\u043a\u0430 \u044d\u0440\u0438\u0442\u0440\u043e\u043f\u043e\u044d\u0442\u0438\u043d\u0430 \u0437\u0430\u0432\u0438\u0441\u0438\u0442 \u043e\u0442 \u0441\u0442\u0435\u043f\u0435\u043d\u0438 \u0442\u044f\u0436\u0435\u0441\u0442\u0438 \u043a\u0438\u0441\u043b\u043e\u0440\u043e\u0434\u043d\u043e\u0433\u043e \u0433\u043e\u043b\u043e\u0434\u0430\u043d\u0438\u044f \u0438 \u043e\u0442 \u0441\u043f\u043e\u0441\u043e\u0431\u043d\u043e\u0441\u0442\u0438 \u043f\u043e\u0447\u0435\u043a \u043f\u0440\u043e\u0438\u0437\u0432\u043e\u0434\u0438\u0442\u044c \u0433\u043e\u0440\u043c\u043e\u043d. \u041e\u043d \u0430\u043a\u0442\u0438\u0432\u0435\u043d \u0432 \u043a\u0440\u043e\u0432\u0438 \u043d\u0435\u043f\u0440\u043e\u0434\u043e\u043b\u0436\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u0435 \u0432\u0440\u0435\u043c\u044f, \u0430 \u0437\u0430\u0442\u0435\u043c \u0432\u044b\u0432\u043e\u0434\u0438\u0442\u0441\u044f \u0441 \u043c\u043e\u0447\u043e\u0439. \u041a\u0430\u043a \u0442\u043e\u043b\u044c\u043a\u043e \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u043e \u044d\u0440\u0438\u0442\u0440\u043e\u0446\u0438\u0442\u043e\u0432 \u043f\u043e\u0441\u043b\u0435 \u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0430 \u043f\u043e\u0432\u044b\u0448\u0430\u0435\u0442\u0441\u044f, \u043f\u043e\u0447\u043a\u0438 \u043d\u0430\u0447\u0438\u043d\u0430\u044e\u0442 \u0432\u044b\u0440\u0430\u0431\u0430\u0442\u044b\u0432\u0430\u0442\u044c \u043c\u0435\u043d\u044c\u0448\u0435 \u044d\u0440\u0438\u0442\u0440\u043e\u043f\u043e\u044d\u0442\u0438\u043d\u0430. \u041e\u0434\u043d\u0430\u043a\u043e \u0435\u0441\u043b\u0438 \u043e\u043d\u0438 \u043f\u043e\u0432\u0440\u0435\u0436\u0434\u0435\u043d\u044b \u0438\/\u0438\u043b\u0438 \u043d\u0435 \u043c\u043e\u0433\u0443\u0442 \u0441\u043e\u0437\u0434\u0430\u0432\u0430\u0442\u044c \u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0435 \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u043e \u044d\u0440\u0438\u0442\u0440\u043e\u043f\u043e\u044d\u0442\u0438\u043d\u0430 \u0438\u043b\u0438 \u0435\u0441\u043b\u0438 \u043a\u043e\u0441\u0442\u043d\u044b\u0439 \u043c\u043e\u0437\u0433 \u043d\u0435 \u0440\u0435\u0430\u0433\u0438\u0440\u0443\u0435\u0442 \u0430\u0434\u0435\u043a\u0432\u0430\u0442\u043d\u043e \u043d\u0430 \u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0435 \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u043e \u044d\u0440\u0438\u0442\u0440\u043e\u043f\u043e\u044d\u0442\u0438\u043d\u0430, \u0442\u043e \u043c\u043e\u0436\u0435\u0442 \u0440\u0430\u0437\u0432\u0438\u0442\u044c\u0441\u044f \u0430\u043d\u0435\u043c\u0438\u044f.<\/p>\n

\u041f\u0440\u0438 \u043e\u0431\u0440\u0430\u0437\u043e\u0432\u0430\u043d\u0438\u0438 \u0434\u043e\u0431\u0440\u043e\u043a\u0430\u0447\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u0445 \u0438\u043b\u0438 \u0437\u043b\u043e\u043a\u0430\u0447\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u0445 \u043e\u043f\u0443\u0445\u043e\u043b\u0435\u0439 \u043f\u043e\u0447\u0435\u043a (\u0438\u043b\u0438 \u0434\u0440\u0443\u0433\u0438\u0445 \u043e\u0440\u0433\u0430\u043d\u043e\u0432) \u043f\u0440\u043e\u0438\u0437\u0432\u043e\u0434\u0438\u0442\u0441\u044f \u0447\u0440\u0435\u0437\u043c\u0435\u0440\u043d\u043e\u0435 \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u043e \u044d\u0440\u0438\u0442\u0440\u043e\u043f\u043e\u044d\u0442\u0438\u043d\u0430, \u0438\u0437-\u0437\u0430 \u0447\u0435\u0433\u043e \u0432\u043e\u0437\u043d\u0438\u043a\u0430\u0435\u0442 \u0441\u043b\u0438\u0448\u043a\u043e\u043c \u043c\u043d\u043e\u0433\u043e \u044d\u0440\u0438\u0442\u0440\u043e\u0446\u0438\u0442\u043e\u0432 \u2013 \u0440\u0430\u0437\u0432\u0438\u0432\u0430\u0435\u0442\u0441\u044f \u043f\u043e\u043b\u0438\u0446\u0438\u0442\u0435\u043c\u0438\u044f. \u042d\u0442\u043e \u043f\u0440\u0438\u0432\u043e\u0434\u0438\u0442 \u043a \u0443\u0432\u0435\u043b\u0438\u0447\u0435\u043d\u0438\u044e \u0446\u0438\u0440\u043a\u0443\u043b\u0438\u0440\u0443\u044e\u0449\u0435\u0433\u043e \u043e\u0431\u044a\u0435\u043c\u0430 \u043a\u0440\u043e\u0432\u0438, \u043f\u043e\u0432\u044b\u0448\u0435\u043d\u0438\u044e \u0435\u0435 \u0432\u044f\u0437\u043a\u043e\u0441\u0442\u0438 \u0438 \u0430\u0440\u0442\u0435\u0440\u0438\u0430\u043b\u044c\u043d\u043e\u0433\u043e \u0434\u0430\u0432\u043b\u0435\u043d\u0438\u044f.<\/p>\n

\u0414\u043b\u044f \u0447\u0435\u0433\u043e \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u0443\u0435\u0442\u0441\u044f \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435?<\/strong><\/p>\n

    \n
  • \u0427\u0442\u043e\u0431\u044b \u043e\u0442\u043b\u0438\u0447\u0438\u0442\u044c \u0434\u0440\u0443\u0433 \u043e\u0442 \u0434\u0440\u0443\u0433\u0430 \u0440\u0430\u0437\u043b\u0438\u0447\u043d\u044b\u0435 \u0432\u0438\u0434\u044b \u0430\u043d\u0435\u043c\u0438\u0439 \u0438 \u0443\u0437\u043d\u0430\u0442\u044c, \u043d\u0430\u0441\u043a\u043e\u043b\u044c\u043a\u043e \u0443\u0440\u043e\u0432\u0435\u043d\u044c \u044d\u0440\u0438\u0442\u0440\u043e\u043f\u043e\u044d\u0442\u0438\u043d\u0430 \u0441\u043e\u043e\u0442\u0432\u0435\u0442\u0441\u0442\u0432\u0443\u0435\u0442 \u0441\u0442\u0435\u043f\u0435\u043d\u0438 \u0432\u044b\u0440\u0430\u0436\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u0430\u043d\u0435\u043c\u0438\u0438. \u041d\u0435\u043e\u0431\u0445\u043e\u0434\u0438\u043c\u043e\u0441\u0442\u044c \u0432 \u0434\u0430\u043d\u043d\u043e\u043c \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0438, \u043a\u0430\u043a \u043f\u0440\u0430\u0432\u0438\u043b\u043e, \u043e\u0431\u0443\u0441\u043b\u043e\u0432\u043b\u0435\u043d\u0430 \u043a\u0430\u043a\u0438\u043c\u0438-\u0442\u043e \u043e\u0442\u043a\u043b\u043e\u043d\u0435\u043d\u0438\u044f\u043c\u0438 \u0432 \u043e\u0431\u0449\u0435\u043c \u0430\u043d\u0430\u043b\u0438\u0437\u0435 \u043a\u0440\u043e\u0432\u0438, \u043a\u043e\u0442\u043e\u0440\u044b\u0439 \u0432\u043a\u043b\u044e\u0447\u0430\u0435\u0442 \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0435 \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0430 \u044d\u0440\u0438\u0442\u0440\u043e\u0446\u0438\u0442\u043e\u0432, \u0433\u0435\u043c\u043e\u0433\u043b\u043e\u0431\u0438\u043d\u0430, \u0433\u0435\u043c\u0430\u0442\u043e\u043a\u0440\u0438\u0442\u0430, \u0440\u0435\u0442\u0438\u043a\u0443\u043b\u043e\u0446\u0438\u0442\u043e\u0432. \u0420\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u044b \u0442\u0430\u043a\u043e\u0433\u043e \u0430\u043d\u0430\u043b\u0438\u0437\u0430 \u043f\u043e\u0437\u0432\u043e\u043b\u044f\u044e\u0442 \u043f\u043e\u0434\u0442\u0432\u0435\u0440\u0434\u0438\u0442\u044c \u0434\u0438\u0430\u0433\u043d\u043e\u0437 “\u0430\u043d\u0435\u043c\u0438\u044f”, \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0438\u0442\u044c \u0441\u0442\u0435\u043f\u0435\u043d\u044c \u0435\u0435 \u0442\u044f\u0436\u0435\u0441\u0442\u0438 \u0438 \u0432\u044b\u0437\u0432\u0430\u0432\u0448\u0443\u044e \u0435\u0435 \u043f\u0440\u0438\u0447\u0438\u043d\u0443.<\/li>\n
  • \u0427\u0442\u043e\u0431\u044b \u0443\u0437\u043d\u0430\u0442\u044c, \u043d\u0435 \u0432\u044b\u0437\u0432\u0430\u043d\u0430 \u043b\u0438 \u0430\u043d\u0435\u043c\u0438\u044f \u043d\u0435\u0445\u0432\u0430\u0442\u043a\u043e\u0439 \u044d\u0440\u0438\u0442\u0440\u043e\u043f\u043e\u044d\u0442\u0438\u043d\u0430 \u0438\u043b\u0438 \u043d\u0435 \u0443\u0441\u0443\u0433\u0443\u0431\u043b\u044f\u0435\u0442 \u043b\u0438 \u044d\u0442\u0430 \u043d\u0435\u0445\u0432\u0430\u0442\u043a\u0430 \u0438\u043c\u0435\u044e\u0449\u0443\u044e\u0441\u044f \u0430\u043d\u0435\u043c\u0438\u044e \u0434\u0440\u0443\u0433\u043e\u0433\u043e \u043f\u0440\u043e\u0438\u0441\u0445\u043e\u0436\u0434\u0435\u043d\u0438\u044f.<\/li>\n
  • \u0427\u0442\u043e\u0431\u044b \u043e\u0446\u0435\u043d\u0438\u0442\u044c \u0441\u043f\u043e\u0441\u043e\u0431\u043d\u043e\u0441\u0442\u044c \u043f\u043e\u0447\u0435\u043a \u0432\u044b\u0440\u0430\u0431\u0430\u0442\u044b\u0432\u0430\u0442\u044c \u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u044b\u0435 \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0430 \u044d\u0440\u0438\u0442\u0440\u043e\u043f\u043e\u044d\u0442\u0438\u043d\u0430 \u0443 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u0432 \u0441 \u0445\u0440\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u043e\u0439 \u043f\u043e\u0447\u0435\u0447\u043d\u043e\u0439 \u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u044c\u044e.<\/li>\n
  • \u0414\u043b\u044f \u0432\u044b\u044f\u0441\u043d\u0435\u043d\u0438\u044f, \u043d\u0435 \u0432\u044b\u0437\u0432\u0430\u043d\u0430 \u043b\u0438 \u043f\u043e\u043b\u0438\u0446\u0438\u0442\u0435\u043c\u0438\u044f \u0438\u0437\u0431\u044b\u0442\u043e\u0447\u043d\u043e\u0439 \u043f\u0440\u043e\u0434\u0443\u043a\u0446\u0438\u0435\u0439 \u044d\u0440\u0438\u0442\u0440\u043e\u043f\u043e\u044d\u0442\u0438\u043d\u0430.<\/li>\n<\/ul>\n

    \u041a\u043e\u0433\u0434\u0430 \u043d\u0430\u0437\u043d\u0430\u0447\u0430\u0435\u0442\u0441\u044f \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435?<\/strong><\/p>\n

      \n
    • \u041a\u043e\u0433\u0434\u0430 \u0430\u043d\u0435\u043c\u0438\u044f \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u0430 \u043d\u0435 \u043e\u0431\u044a\u044f\u0441\u043d\u044f\u0435\u0442\u0441\u044f \u0434\u0435\u0444\u0438\u0446\u0438\u0442\u043e\u043c \u0436\u0435\u043b\u0435\u0437\u0430, \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 B12\u00a0<\/sub>\u0438\u043b\u0438 \u0444\u043e\u043b\u0438\u0435\u0432\u043e\u0439 \u043a\u0438\u0441\u043b\u043e\u0442\u044b, \u0433\u0435\u043c\u043e\u043b\u0438\u0437\u043e\u043c \u043b\u0438\u0431\u043e \u043a\u0440\u043e\u0432\u043e\u043f\u043e\u0442\u0435\u0440\u0435\u0439.<\/li>\n
    • \u041a\u043e\u0433\u0434\u0430 \u044d\u0440\u0438\u0442\u0440\u043e\u0446\u0438\u0442\u044b, \u0433\u0435\u043c\u043e\u0433\u043b\u043e\u0431\u0438\u043d \u0438 \u0433\u0435\u043c\u0430\u0442\u043e\u043a\u0440\u0438\u0442 \u0441\u043d\u0438\u0436\u0435\u043d\u044b, \u0430 \u0440\u0435\u0442\u0438\u043a\u0443\u043b\u043e\u0446\u0438\u0442\u044b \u0432 \u043d\u043e\u0440\u043c\u0435 \u0438\u043b\u0438 \u043d\u0438\u0436\u0435 \u0435\u0435.<\/li>\n
    • \u041f\u0440\u0438 \u043d\u0435\u043e\u0431\u0445\u043e\u0434\u0438\u043c\u043e\u0441\u0442\u0438 \u0440\u0430\u0437\u0433\u0440\u0430\u043d\u0438\u0447\u0438\u0442\u044c \u043f\u0440\u0438\u0447\u0438\u043d\u044b \u0430\u043d\u0435\u043c\u0438\u0438 \u2013 \u0443\u0433\u043d\u0435\u0442\u0435\u043d\u0438\u0435 \u0444\u0443\u043d\u043a\u0446\u0438\u0438 \u043a\u043e\u0441\u0442\u043d\u043e\u0433\u043e \u043c\u043e\u0437\u0433\u0430 \u0438 \u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u043a \u044d\u0440\u0438\u0442\u0440\u043e\u043f\u043e\u044d\u0442\u0438\u043d\u0430.<\/li>\n
    • \u041a\u043e\u0433\u0434\u0430 \u043d\u0443\u0436\u043d\u043e \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0438\u0442\u044c, \u043d\u0430\u0441\u043a\u043e\u043b\u044c\u043a\u043e \u0445\u0440\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u0430\u044f \u043f\u043e\u0447\u0435\u0447\u043d\u0430\u044f \u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u044c \u0432\u043b\u0438\u044f\u0435\u0442 \u043d\u0430 \u0443\u0440\u043e\u0432\u0435\u043d\u044c \u044d\u0440\u0438\u0442\u0440\u043e\u043f\u043e\u044d\u0442\u0438\u043d\u0430.<\/li>\n
    • \u041f\u0440\u0438 \u043d\u0435\u043e\u0431\u0445\u043e\u0434\u0438\u043c\u043e\u0441\u0442\u0438 \u0443\u0431\u0435\u0434\u0438\u0442\u044c\u0441\u044f, \u0447\u0442\u043e \u043f\u043e\u043b\u0438\u0446\u0438\u0442\u0435\u043c\u0438\u044f \u043d\u0435 \u0432\u044b\u0437\u0432\u0430\u043d\u0430 \u0438\u0437\u0431\u044b\u0442\u043e\u0447\u043d\u044b\u043c \u043f\u0440\u043e\u0438\u0437\u0432\u043e\u0434\u0441\u0442\u0432\u043e\u043c \u044d\u0440\u0438\u0442\u0440\u043e\u043f\u043e\u044d\u0442\u0438\u043d\u0430.<\/li>\n<\/ul>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[926],"product_tag":[],"class_list":{"0":"post-10101","1":"product","2":"type-product","3":"status-publish","5":"product_cat-markeri-anemie","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\/10101","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=10101"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10101"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=10101"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=10101"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=10101"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}