{"id":10104,"date":"2020-04-23T03:56:41","date_gmt":"2020-04-23T00:56:41","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/proinsulina-intacta\/"},"modified":"2025-02-07T09:12:38","modified_gmt":"2025-02-07T07:12:38","slug":"proinsulina-intacta","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/proinsulina-intacta\/","title":{"rendered":"\u0418\u043d\u0442\u0430\u043a\u0442\u043d\u044b\u0439 \u043f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d"},"content":{"rendered":"

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

Proinsulina, un polipeptid de 86 aminoacizi, este hormonul precursor al insulinei, produsa in celulele beta ale insulelor Langerhans. Proinsulina este sintetizata in reticulul endoplasmatic, unde pun\u0163ile sale disulfidice sunt oxidate6<\/sup>. Este apoi transportata la aparatul Golgi si depozitata in veziculele secretorii unde este procesata de o serie de proteaze pentru a forma insulina matura. Peptidul C este extras din centrul secven\u0163ei de proinsulina; celelalte doua capete (lanturile A si B ) raman legate prin pun\u0163i disulfidice1<\/sup>. Proteazele care scindeaza molecula de proinsulina sunt prohormonconvertaze (PC1\/3 si PC2) si carboxipeptidaza E3<\/sup>. Doar 1-3% din proinsulina este secretata intacta5<\/sup>.<\/p>\n

Proinsulina, care are o activitate biologica scazuta (aproximativ 10% din cea a insulinei) este forma majora de stocare a insulinei. In mod normal, doar mici cantita\u0163i de proinsulina intra in circula\u0163ie. Deoarece proinsulina are un timp de injumata\u0163ire mai mare decat al insulinei, concentra\u0163iile circulatorii de proinsulina reprezinta 5-30% din concentra\u0163iile de insulina, cu propor\u0163ii relativ mai mari postprandial si la pacien\u0163ii cu rezisten\u0163a la insulina sau diabet zaharat tip 2 precoce. Proinsulina se poate lega la receptorii pentru insulina5<\/sup>.<\/p>\n

Concentra\u0163ii mari de proinsulina au fost asociate cu tumori ale celulelor beta pancreatice benigne sau maligne si tumori panceatice asociate cu sindromul neoplaziilor endocrine multiple MEN1. Majoritatea pacien\u0163ilor cu tumori de celule beta au concentra\u0163ii crescute de insulina, peptid C si proinsulina, dar ocazional doar proinsulina este crescuta3<\/sup>. In ciuda activita\u0163ii biologice scazute, proinsulina poate creste suficient pentru a produce hipoglicemie. Diagnosticul poate fi dificil daca tumorile sunt mici sau secreta doar episodic insulina. Administrarea drogurilor hipoglicemiante (de ex. sulfonilureice) sau injec\u0163iile cu insulina pot mima un insulinom. Hipersecre\u0163ia de insulina din insulinom duce la eliberarea unui numar crescut de granule secretorii imature cu proinsulina incomplet procesata, ducand la concentra\u0163ii ridicate serice\/plasmatice de proinsulina5<\/sup>.<\/p>\n

Au fost raportate de asemenea mutatii in molecula de proinsulina care afecteaza eficienta clivajului enzimatic si metabolismul proinsulinei. Aceste mutatii pot conduce la nivel crescut de proinsulina, dar nu sunt insotite de diabet sau alte anomalii hormonale.<\/p>\n

Diabetul zaharat de tip 2 este caracterizat printr-o rezistenta la insulina determinata genetic si o secretie pancreatica necorespunzatoare. Studiile clinice (IRIS II) au identificat proinsulina intacta drept marker inalt specific pentru rezistenta la insulina<\/strong>. In cazul necesitatii crescute, celulele beta pancreatice produc intr-o prima faza insulina suficienta, prin desprinderea peptidului C din proinsulina intacta. Daca rezistenta la insulina creste, capacitatea de clivare este depasita. Se produce cresterea proinsulinei si a produsilor partiali de clivare din plasma. Acest model de secretie se pastreaza si in cazul insuficientei secundare a celulelor beta.<\/p>\n

Valori ridicate ale proinsulinei si produsului de clivare des-31,32-proinsulina se coreleaza cu un risc crescut de ateroscleroza. Nivelurile crescute de proinsulina si de produsi nespecifici de degradare ai acesteia cauzeaza o inhibitie a fibrinolizei in plasma. In cazul dezvoltarii unui infarct liza trombilor este impiedicata.<\/p>\n

Se discuta despre rezistenta la insulina ca fiind implicata in patogeneza sindromului de ovar polichistic. Rezistenta la insulina duce in mod compensator la o eliberare crescuta de insulina. Rezulta hiperinsulinemie care accentueaza hiperandrogenia\u00a0 existenta. Nivelurile scazute de SHBG (insulina suprima sinteza SHBG in ficat) ar putea reprezenta primul indiciu al unei rezistente la insulina si in cazul suspiciunii ar trebui dozata proinsulina2<\/sup>.<\/p>\n

Recomandari pentru determinarea proinsulinei <\/em><\/strong>\u2013 evaluarea pacientilor cu hipoglicemii \u00e0 jeun5;6<\/sup>; evaluarea rezistentei la insulina si stabilirea deciziei terapeutice in diabetul zaharat tip 21<\/sup>.<\/p>\n

Pregatire pacient <\/em><\/strong>- <\/em>\u00e0 jeun (pe nemancate) \u2013 minim 12 ore2<\/sup>.<\/p>\n

Specimen recoltat <\/em><\/strong>- <\/em>sange venos2<\/sup>.<\/p>\n

Recipient de recoltare <\/em><\/strong>- <\/em>vacutainer ce contine EDTA ca anticoagulant2<\/sup>.<\/p>\n

Prelucrare necesara dupa recoltare <\/em><\/strong>- <\/em>se separa rapid plasma prin centrifugare; se congeleaza proba cat se poate de repede2<\/sup>.<\/p>\n

Volum proba<\/em><\/strong> \u2013 minim 0.5 mL plasma2<\/sup>.<\/p>\n

Cauze de respingere<\/em><\/strong> a probei <\/em><\/strong>\u2013 specimen intens hemolizat2<\/sup>.<\/p>\n

Stabilitate proba <\/em><\/strong>- <\/em>plasma separata este stabila 3 luni<\/em> la -20\u00b0C; nu decongelati\/recongelati2<\/sup>.<\/p>\n

Metoda <\/em><\/strong>- ELISA<\/span>2<\/sup>.<\/p>\n

Valori de referinta <\/em><\/strong><\/p>\n

Pacienti normoponderali, \u00e1 jeun\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<7.31 pmol\/L<\/p>\n

Insulinodependenti, \u00e1 jeun\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <16.01 pmol\/L<\/p>\n

Insulinodependenti, postprandial\u00a0\u00a0\u00a0\u00a0\u00a0<63.27 pmol\/L2<\/sup>.<\/p>\n

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

Peste 80% din pacientii cu insulinom au concentratii de proinsulina peste limita superioara a intervalului de referinta. Sensibilitatea si specificitatea pentru diagnosticul de insulinom in cursul hipoglicemiei este aproximativ 75%, respectiv aproape de 100% la un cut-off de 20 pmol\/L. O sensibilitate mai mare (>95%) poate fi atinsa la un cut-off de 5 pmol\/L.<\/p>\n

Valori mult crescute de proinsulina apar la pacientii cu deficit de PC1\/3. Acestia prezinta defecte in procesarea multor peptide hormonale si sufera de diabet, insuficienta adrenala, infertilitate si obezitate. Au un nivel scazut, uneori nedetectabil, de insulina si nivel semnificativ crescut de proinsulina, care creste si mai mult dupa ingestia de alimente. Acesti pacienti prezinta si alte anomalii hormonale, inclusiv deficit de cortizol (din cauza lipsei procesarii pro-opiomelanocortinei in ACTH)4;5;6<\/sup>.<\/p>\n

Niveluri crescute de proinsulina indica un stadiu avansat de epuizare a celulelor beta pancreatice si reprezinta un marker cu specificitate inalta pentru rezistenta la insulina. Poate fi utilizat ca marker arbitrar pentru stabilirea deciziei terapeutice in diabetul zaharat de tip 2: medicamente care stimuleaza secretia de insulina (insulinsecretagoge), substante care cresc sensibilitatea tesuturilor la insulina (sensibilizatori ai insulinei) sau insulinoterapie1<\/sup>.<\/p>\n

Limite si interferente<\/em><\/strong><\/p>\n

Interpretarea valorilor proinsulinei la pacientii cu hipoglicemie trebuie facuta in contextul bolii si impreuna cu alte rezultate (de exemplu insulina,peptid C)4<\/sup>.<\/div>\n
Valori crescute de proinsulina se obtin si la pacientii cu insuficienta renala cronica,ciroza,hipertiroidism3<\/sup>.<\/div>\n

\u00a0<\/span><\/p>\n

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

1. Andreas Pf\u00fctzner, Thomas Kunt, Cloth Hohberg, Agnes Mondok, Sabine Pahler, Thomas Konrad, Georg L\u00fcben, Thomas Forst. Fasting Intact Proinsulin Is a Highly Specific Predictor Of Insulin Resistance in Type 2 Diabetes. In Diabetes Care, December 2003.<\/span><\/div>\n
2. Laborator Synevo. Referintele specifice tehnologiei de lucru utilizate. 2010. Ref Type: Catalog.<\/span><\/div>\n
3. Laboratory Corporation of America. Directory of Services and Interpretive Guide. Proinsulin www.labcorp.com 2010. Ref Type: Internet Communication.<\/span><\/div>\n
4. Lothar Thomas. Insulin, C-peptide, proinsulin. In Clinical Laboratory Diagnostics-Use and Assessment of Clinical Laboratory Results. TH-Books Verlagsgesellschaft mbH, Frankfurt \/Main, Germany, 1 Ed., 1998 153-154.<\/span><\/div>\n
5. Mayo Clinic\/Mayo Medical Laboratories. Test Catalogs and Guides C-peptide www.mayomedicallaboratories.com. Ref Type:Internet Communication.<\/span><\/div>\n
6. Richard A. McPherson,Matthew R.Pincus. Henry\u201ds clinical diagnosis and management by laboratory methods,Ed., 2007, 185-189.<\/span><\/div>","protected":false},"excerpt":{"rendered":"

\u0418\u043d\u0442\u0430\u043a\u0442\u043d\u044b\u0439 \u043f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d \u0441\u0438\u043d\u0442\u0435\u0437\u0438\u0440\u0443\u0435\u0442\u0441\u044f \u0432 \u03b2-\u043a\u043b\u0435\u0442\u043a\u0430\u0445 \u043f\u043e\u0434\u0436\u0435\u043b\u0443\u0434\u043e\u0447\u043d\u043e\u0439 \u0436\u0435\u043b\u0435\u0437\u044b \u0438 \u0442\u0430\u043a\u0438\u043c \u043e\u0431\u0440\u0430\u0437\u043e\u043c \u0441\u043e\u0437\u0434\u0430\u0435\u0442\u0441\u044f \u0437\u0430\u043f\u0430\u0441 \u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0430. \u0424\u0430\u043a\u0442\u0438\u0447\u0435\u0441\u043a\u0438 \u044d\u0442\u043e \u043c\u043e\u043b\u0435\u043a\u0443\u043b\u0430-\u043f\u0440\u0435\u0434\u0448\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u0438\u043a \u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0430, \u043a\u043e\u0442\u043e\u0440\u0430\u044f, \u0432 \u0441\u0432\u043e\u044e \u043e\u0447\u0435\u0440\u0435\u0434\u044c, \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u0432\u0430\u0436\u043d\u0435\u0439\u0448\u0438\u043c \u0440\u0435\u0433\u0443\u043b\u044f\u0442\u043e\u0440\u043e\u043c \u0443\u0433\u043b\u0435\u0432\u043e\u0434\u043d\u043e\u0433\u043e \u043e\u0431\u043c\u0435\u043d\u0430 \u0438 \u043e\u0431\u0435\u0441\u043f\u0435\u0447\u0438\u0432\u0430\u0435\u0442 \u0443\u0441\u0432\u043e\u0435\u043d\u0438\u0435 \u043a\u043b\u0435\u0442\u043a\u0430\u043c\u0438 \u0433\u043b\u044e\u043a\u043e\u0437\u044b.<\/p>\n

\u0411\u043e\u043b\u044c\u0448\u0430\u044f \u0447\u0430\u0441\u0442\u044c \u0441\u0438\u043d\u0442\u0435\u0437\u0438\u0440\u0443\u0435\u043c\u043e\u0433\u043e \u043f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0430 \u0440\u0430\u0441\u0449\u0435\u043f\u043b\u044f\u0435\u0442\u0441\u044f \u043d\u0430 \u0438\u043d\u0441\u0443\u043b\u0438\u043d \u0438 \u0421-\u043f\u0435\u043f\u0442\u0438\u0434, \u043a\u043e\u0442\u043e\u0440\u044b\u0435 \u0441\u0435\u043a\u0440\u0435\u0442\u0438\u0440\u0443\u044e\u0442\u0441\u044f \u0432 \u043a\u0440\u043e\u0432\u044c \u0432 \u0440\u0430\u0432\u043d\u044b\u0445 \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0430\u0445. \u041e\u043a\u043e\u043b\u043e 15% \u043f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0430 \u043f\u043e\u0441\u0442\u0443\u043f\u0430\u0435\u0442 \u0432 \u043a\u0440\u043e\u0432\u044c \u0432 \u043d\u0435\u0438\u0437\u043c\u0435\u043d\u0435\u043d\u043d\u043e\u043c \u0432\u0438\u0434\u0435. \u041f\u043e\u0434\u043e\u0431\u043d\u043e \u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0443 \u0438 \u0421-\u043f\u0435\u043f\u0442\u0438\u0434\u0443, \u043f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d \u043a\u0440\u043e\u0432\u0438 \u043e\u0442\u0440\u0430\u0436\u0430\u0435\u0442 \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u0435 \u03b2-\u043a\u043b\u0435\u0442\u043e\u043a \u043f\u043e\u0434\u0436\u0435\u043b\u0443\u0434\u043e\u0447\u043d\u043e\u0439 \u0436\u0435\u043b\u0435\u0437\u044b. \u0418\u0437\u043c\u0435\u0440\u0435\u043d\u0438\u0435 \u0443\u0440\u043e\u0432\u043d\u044f \u043f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0430 \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u0443\u0435\u0442\u0441\u044f \u043f\u0440\u0438 \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0435 \u03b2-\u043a\u043b\u0435\u0442\u043e\u0447\u043d\u044b\u0445 \u043e\u043f\u0443\u0445\u043e\u043b\u0435\u0439 \u043f\u043e\u0434\u0436\u0435\u043b\u0443\u0434\u043e\u0447\u043d\u043e\u0439 \u0436\u0435\u043b\u0435\u0437\u044b (\u0438\u043d\u0441\u0443\u043b\u0438\u043d\u043e\u043c\u044b). \u0412 \u0431\u043e\u043b\u044c\u0448\u0438\u043d\u0441\u0442\u0432\u0435 \u0438\u043d\u0441\u0443\u043b\u0438\u043d\u043e\u043c \u043d\u0430\u0431\u043b\u044e\u0434\u0430\u0435\u0442\u0441\u044f \u043f\u043e\u0432\u044b\u0448\u0435\u043d\u0438\u0435 \u043a\u043e\u043d\u0446\u0435\u043d\u0442\u0440\u0430\u0446\u0438\u0438 \u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0430, \u0421-\u043f\u0435\u043f\u0442\u0438\u0434\u0430 \u0438 \u043f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0430, \u043d\u043e \u0432 \u0440\u0435\u0434\u043a\u0438\u0445 \u0441\u043b\u0443\u0447\u0430\u044f\u0445 \u043c\u043e\u0436\u0435\u0442 \u043d\u0430\u0431\u043b\u044e\u0434\u0430\u0442\u044c\u0441\u044f \u0442\u043e\u043b\u044c\u043a\u043e \u043f\u043e\u0432\u044b\u0448\u0435\u043d\u0438\u0435 \u0443\u0440\u043e\u0432\u043d\u044f \u043f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0430.<\/p>\n

\u041f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d \u043e\u0431\u043b\u0430\u0434\u0430\u0435\u0442 \u0433\u043e\u0440\u0430\u0437\u0434\u043e \u043c\u0435\u043d\u044c\u0448\u0435\u0439 \u0431\u0438\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u043e\u0439 \u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u044c\u044e (\u043f\u0440\u0438\u043c\u0435\u0440\u043d\u043e 1:10) \u0438 \u0431\u043e\u043b\u0435\u0435 \u0434\u043b\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u043c \u043f\u0435\u0440\u0438\u043e\u0434\u043e\u043c \u043f\u043e\u043b\u0443\u0432\u044b\u0432\u0435\u0434\u0435\u043d\u0438\u044f (\u043f\u0440\u0438\u043c\u0435\u0440\u043d\u043e 3:1), \u0447\u0435\u043c \u0438\u043d\u0441\u0443\u043b\u0438\u043d. \u041d\u0435\u0441\u043c\u043e\u0442\u0440\u044f \u043d\u0430 \u043d\u0438\u0437\u043a\u0443\u044e \u0431\u0438\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u0443\u044e \u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u044c \u043f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0430, \u0438\u0437\u043e\u043b\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e\u0435 \u043f\u043e\u0432\u044b\u0448\u0435\u043d\u0438\u0435 \u0435\u0433\u043e \u0443\u0440\u043e\u0432\u043d\u044f \u043c\u043e\u0436\u0435\u0442 \u043f\u0440\u0438\u0432\u0435\u0441\u0442\u0438 \u043a \u0433\u0438\u043f\u043e\u0433\u043b\u0438\u043a\u0435\u043c\u0438\u0447\u0435\u0441\u043a\u0438\u043c \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u044f\u043c, \u0432 \u0437\u043b\u043e\u043a\u0430\u0447\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u043e \u0442\u0440\u0430\u043d\u0441\u0444\u043e\u0440\u043c\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u044b\u0445 \u03b2-\u043a\u043b\u0435\u0442\u043a\u0430\u0445 \u0441\u043e\u043e\u0442\u043d\u043e\u0448\u0435\u043d\u0438\u0435 \u0441\u0438\u043d\u0442\u0435\u0437\u0438\u0440\u0443\u0435\u043c\u044b\u0445 \u0433\u043e\u0440\u043c\u043e\u043d\u043e\u0432 \u0441\u043c\u0435\u0449\u0435\u043d\u043e \u043a \u043f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0443. \u041f\u0440\u0438 \u0438\u043d\u0441\u0443\u043b\u0438\u043d\u043e\u043c\u0430\u0445 \u0441\u043e\u043e\u0442\u043d\u043e\u0448\u0435\u043d\u0438\u0435 \u043f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d\/\u0438\u043d\u0441\u0443\u043b\u0438\u043d \u0441\u043e\u0441\u0442\u0430\u0432\u043b\u044f\u0435\u0442 \u0431\u043e\u043b\u0435\u0435 25%, \u0438\u043d\u043e\u0433\u0434\u0430 \u0434\u043e 90%. \u041f\u043e\u0432\u044b\u0448\u0435\u043d\u043d\u044b\u0435 \u043a\u043e\u043d\u0446\u0435\u043d\u0442\u0440\u0430\u0446\u0438\u0438 \u043f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0430 \u043c\u043e\u0433\u0443\u0442 \u043d\u0430\u0431\u043b\u044e\u0434\u0430\u0442\u044c\u0441\u044f \u0443 \u0431\u043e\u043b\u044c\u043d\u044b\u0445 \u0441 \u043f\u043e\u0447\u0435\u0447\u043d\u043e\u0439 \u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u044c\u044e, \u0446\u0438\u0440\u0440\u043e\u0437\u043e\u043c \u043f\u0435\u0447\u0435\u043d\u0438, \u0433\u0438\u043f\u0435\u0440\u0442\u0438\u0440\u0435\u043e\u0437\u043e\u043c.<\/p>\n

\u0423\u0440\u043e\u0432\u043d\u0438 \u043f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0430 \u043c\u043e\u0433\u0443\u0442 \u043e\u0437\u043da\u0447\u0430\u0435\u0442\u0435\u043b\u044c\u043d\u043e \u043f\u043e\u0432\u044b\u0448\u0430\u0442\u044c\u0441\u044f \u043f\u0440\u0438 \u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0435 \u043a\u043e\u043d\u0432\u0435\u0440\u0442\u0430\u0437\u044b PC1\/3. \u041f\u0440\u0438 \u044d\u0442\u043e\u043c \u043d\u0430\u0440\u0443\u0448\u0430\u0435\u0442\u0441\u044f \u043c\u0435\u0442\u0430\u0431\u043e\u043b\u0438\u0437\u043c \u043f\u0435\u043f\u0442\u0438\u0434\u043d\u044b\u0445 \u0433\u043e\u0440\u043c\u043e\u043d\u043e\u0432. \u041b\u044e\u0434\u044f\u043c \u0441 \u0434\u0435\u0444\u0438\u0446\u0438\u0442\u043e\u043c \u044d\u0442\u043e\u0433\u043e \u0444\u0435\u0440\u043c\u0435\u043d\u0442\u0430, \u043d\u0435\u0437\u0430\u0432\u0438\u0441\u0438\u043c\u043e \u043e\u0442 \u0440\u0430\u0441\u044b, \u0441\u0432\u043e\u0439\u0441\u0442\u0432\u0435\u043d\u043d\u044b \u0440\u044b\u0436\u0438\u0435 \u0432\u043e\u043b\u043e\u0441\u044b, \u043e\u0436\u0438\u0440\u0435\u043d\u0438\u0435, \u0431\u0435\u0441\u043f\u043b\u043e\u0434\u0438\u0435, \u043d\u0430\u0434\u043f\u043e\u0447\u0435\u0447\u043d\u0438\u043a\u043e\u0432\u0430\u044f \u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u044c, \u0441\u043d\u0438\u0436\u0435\u043d\u0438\u0435 \u0441\u043e\u0434\u0435\u0440\u0436\u0430\u043d\u0438\u044f \u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0430 \u0432 \u043a\u0440\u043e\u0432\u0438, \u0434\u0435\u0444\u0438\u0446\u0438\u0442 \u043a\u043e\u0440\u0442\u0438\u0437\u043e\u043b\u0430.<\/p>\n

\u041a\u043e\u0433\u0434\u0430 \u043d\u0443\u0436\u043d\u043e \u0441\u0434\u0430\u0432\u0430\u0442\u044c \u0430\u043d\u0430\u043b\u0438\u0437 \u043d\u0430 \u043f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d?<\/p>\n

    \n
  1. \u0414\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0430 \u0433\u0438\u043f\u043e\u0433\u043b\u0438\u043a\u0435\u043c\u0438\u0447\u0435\u0441\u043a\u0438\u0445 \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u0439;<\/li>\n
  2. \u041f\u043e\u0434\u043e\u0437\u0440\u0435\u043d\u0438\u0435 \u043d\u0430 \u0438\u043d\u0441\u0443\u043b\u0438\u043d\u043e\u043c\u0443;<\/li>\n
  3. \u041e\u0446\u0435\u043d\u043a\u0430 \u0444\u0443\u043d\u043a\u0446\u0438\u043e\u043d\u0430\u043b\u044c\u043d\u043e\u0433\u043e \u0441\u0442\u0430\u0442\u0443\u0441\u0430 \u0431\u0435\u0442\u0430-\u043a\u043b\u0435\u0442\u043e\u043a \u043f\u043e\u0434\u0436\u0435\u043b\u0443\u0434\u043e\u0447\u043d\u043e\u0439 \u0436\u0435\u043b\u0435\u0437\u044b;<\/li>\n
  4. \u041f\u043e\u0434\u043e\u0437\u0440\u0435\u043d\u0438\u0435 \u043d\u0430 \u0434\u0435\u0444\u0438\u0446\u0438\u0442 \u043a\u043e\u043d\u0432\u0435\u0440\u0442\u0430\u0437\u044b PC 1\/3;<\/li>\n
  5. \u041e\u0446\u0435\u043d\u043a\u0430 \u0438\u043d\u0441\u0443\u043b\u0438\u043d\u043e\u0440\u0435\u0437\u0438\u0441\u0442\u0435\u043d\u0442\u043d\u043e\u0441\u0442\u0438 \u0438 \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0435 \u0442\u0435\u0440\u0430\u043f\u0435\u0432\u0442\u0438\u0447\u0435\u0441\u043a\u043e\u0433\u043e \u0440\u0435\u0448\u0435\u043d\u0438\u044f \u043f\u0440\u0438 \u0434\u0438\u0430\u0431\u0435\u0442\u0435 2 \u0442\u0438\u043f\u0430.<\/li>\n<\/ol>\n

    \u041a\u0430\u043a \u043f\u043e\u0434\u0433\u043e\u0442\u043e\u0432\u0438\u0442\u044c\u0441\u044f \u043a \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044e? \u0422\u0435\u0441\u0442 \u043d\u0435\u043e\u0431\u0445\u043e\u0434\u0438\u043c\u043e \u043f\u0440\u043e\u0432\u043e\u0434\u0438\u0442\u044c \u043d\u0430\u0442\u043e\u0449\u0430\u043a<\/p>\n

    \u041c\u0430\u0442\u0435\u0440\u0438\u0430\u043b \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f \u0412\u0435\u043d\u043e\u0437\u043d\u0430\u044f \u043a\u0440\u043e\u0432\u044c<\/p>\n

    \u0412\u043e\u0437\u043c\u043e\u0436\u043d\u0430\u044f \u0438\u043d\u0442\u0435\u0440\u043f\u0440\u0435\u0442\u0430\u0446\u0438\u044f \u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u043e\u0432<\/p>\n

    \u041f\u043e\u0432\u044b\u0448\u0435\u043d\u043d\u044b\u0439 \u0443\u0440\u043e\u0432\u0435\u043d\u044c \u043f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0430:<\/p>\n

      \n
    • \u0438\u043d\u0441\u0443\u043b\u0438\u043d\u043e\u043c\u0430;<\/li>\n
    • \u0414\u0435\u0444\u0438\u0446\u0438\u0442 \u043a\u043e\u043d\u0432\u0435\u0440\u0442\u0430\u0437\u044b PC1\/3;<\/li>\n
    • \u0421\u0430\u0445\u0430\u0440\u043d\u044b\u0439 \u0434\u0438\u0430\u0431\u0435\u0442 2 \u0442\u0438\u043f\u0430;<\/li>\n
    • \u0421\u0435\u043c\u0435\u0439\u043d\u0430\u044f \u0433\u0438\u043f\u0435\u0440\u043f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0435\u043c\u0438\u044f;<\/li>\n
    • \u0418\u043d\u0441\u0443\u043b\u0438\u043d\u043f\u0440\u043e\u0434\u0443\u0446\u0438\u0440\u0443\u044e\u0449\u0438\u0435 \u043e\u043f\u0443\u0445\u043e\u043b\u0438;<\/li>\n
    • \u0425\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;<\/li>\n
    • \u0413\u0438\u043f\u0435\u0440\u0442\u0438\u0440\u0435\u043e\u0437;<\/li>\n
    • \u0446\u0438\u0440\u0440\u043e\u0437 \u043f\u0435\u0447\u0435\u043d\u0438;<\/li>\n
    • \u0422\u044f\u0436\u0435\u043b\u0430\u044f \u0433\u0438\u043f\u043e\u0433\u043b\u0438\u043a\u0435\u043c\u0438\u0447\u0435\u0441\u043a\u0430\u044f \u0433\u0438\u043f\u0435\u0440\u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0435\u043c\u0438\u044f<\/li>\n<\/ul>\n

      \u041f\u043e\u0432\u044b\u0448\u0435\u043d\u043d\u044b\u0435 \u0443\u0440\u043e\u0432\u043d\u0438 \u043f\u0440\u043e\u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0430 \u0443\u043a\u0430\u0437\u044b\u0432\u0430\u044e\u0442 \u043d\u0430 \u0434\u0430\u043b\u0435\u043a\u043e \u0438\u0434\u0443\u0449\u0435\u0435 \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u0435 \u0438\u0441\u0442\u043e\u0449\u0435\u043d\u0438\u044f \u0431\u0435\u0442\u0430-\u043a\u043b\u0435\u0442\u043e\u043a \u043f\u043e\u0434\u0436\u0435\u043b\u0443\u0434\u043e\u0447\u043d\u043e\u0439 \u0436\u0435\u043b\u0435\u0437\u044b \u0438 \u043f\u0440\u0435\u0434\u0441\u0442\u0430\u0432\u043b\u044f\u044e\u0442 \u0441\u043e\u0431\u043e\u0439 \u0432\u044b\u0441\u043e\u043a\u043e\u0441\u043f\u0435\u0446\u0438\u0444\u0438\u0447\u043d\u044b\u0439 \u043c\u0430\u0440\u043a\u0435\u0440 \u0438\u043d\u0441\u0443\u043b\u0438\u043d\u043e\u0440\u0435\u0437\u0438\u0441\u0442\u0435\u043d\u0442\u043d\u043e\u0441\u0442\u0438.<\/p>\n

      \u0415\u0433\u043e \u043c\u043e\u0436\u043d\u043e \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u043e\u0432\u0430\u0442\u044c \u0432 \u043a\u0430\u0447\u0435\u0441\u0442\u0432\u0435 \u043c\u0430\u0440\u043a\u0435\u0440\u0430 \u0432\u044b\u0431\u043e\u0440\u0430 \u0442\u0435\u0440\u0430\u043f\u0438\u0438 \u0441\u0430\u0445\u0430\u0440\u043d\u043e\u0433\u043e \u0434\u0438\u0430\u0431\u0435\u0442\u0430 2 \u0442\u0438\u043f\u0430: \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442\u044b, \u0441\u0442\u0438\u043c\u0443\u043b\u0438\u0440\u0443\u044e\u0449\u0438\u0435 \u0441\u0435\u043a\u0440\u0435\u0446\u0438\u044e \u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0430, \u0432\u0435\u0449\u0435\u0441\u0442\u0432\u0430, \u043f\u043e\u0432\u044b\u0448\u0430\u044e\u0449\u0438\u0435 \u0447\u0443\u0432\u0441\u0442\u0432\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u0441\u0442\u044c \u0442\u043a\u0430\u043d\u0435\u0439 \u043a \u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0443 (\u0441\u0435\u043d\u0441\u0438\u0431\u0438\u043b\u0438\u0437\u0430\u0442\u043e\u0440\u044b \u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0430), \u0438\u043b\u0438 \u0438\u043d\u0441\u0443\u043b\u0438\u043d\u043e\u0442\u0435\u0440\u0430\u043f\u0438\u044f.<\/p>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[912,911],"product_tag":[],"class_list":{"0":"post-10104","1":"product","2":"type-product","3":"status-publish","5":"product_cat-hormoni-de-glicoreglare","6":"product_cat-markeri-endocrini","8":"first","9":"instock","10":"sold-individually","11":"shipping-taxable","12":"purchasable","13":"product-type-simple"},"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product\/10104","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=10104"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10104"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=10104"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=10104"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=10104"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}