{"id":10124,"date":"2020-04-23T03:57:19","date_gmt":"2020-04-23T00:57:19","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/iod-seric\/"},"modified":"2025-02-07T16:44:23","modified_gmt":"2025-02-07T14:44:23","slug":"iod-seric","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/iod-seric\/","title":{"rendered":"\u0419\u043e\u0434 \u0432 \u043a\u0440\u043e\u0432\u0438"},"content":{"rendered":"

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

Iodul se g\u0103se\u015fte \u00een natur\u0103 sub diferite forme: s\u0103ruri anorganice de sodiu \u015fi potasiu (ioduri \u015fi ioda\u0163i), iod diatomic anorganic (iod molecular sau I2<\/sub>) \u015fi iod monoatomic organic. Oceanele reprezint\u0103 principala surs\u0103 de iod; cantitatea mic\u0103 de iod depozitat\u0103 \u00een sol este rezultatul procesului de evaporare a apei oceanice6<\/sup>.<\/p>\n

Alimentele cele mai bogate \u00een iod sunt pe\u015ftele (macrou, hering, somon, p\u0103str\u0103v, somn), fructele de mare \u015fi algele marine. Unele vegetale, precum \u015fi apa potabil\u0103 constituie de asemenea o surs\u0103 de iod, dar con\u0163inutul\u00a0\u00een iod al acestora variaz\u0103 \u00een func\u0163ie de concentra\u0163ia acestui element\u00a0\u00een sol. Sarea iodat\u0103 poate fi o surs\u0103 dietetic\u0103 de iod foarte important\u0103, acolo unde este\u00a0\u00een mod curent accesibil\u0103. Laptele matern are un con\u0163inut crescut de iod, care poate asigura necesarul pentru sugarii alimenta\u0163i natural. Legume ca varza, conopida, napii \u015fi guliile con\u0163in\u00a0\u00een mod natural substan\u0163e (tiociana\u0163i si izotiociana\u0163i), care au o ac\u0163iune competitiv\u0103 cu iodul, pe care il deplaseaz\u0103 din combina\u0163iile lui \u00eempiedic\u00e2nd astfel acumularea iodului\u00a0\u00een tiroid\u0103. Pe de alt\u0103 parte, aceste legume con\u0163in goitrina, substan\u0163a care interfer\u0103 cu biosinteza hormonilor tiroidieni. Excesul de fluor din ap\u0103 \u015fi alimente poate favoriza caren\u0163a de iod, deoarece fluorul este mai reactiv dec\u00e2t iodul \u015fi intr\u0103 \u00een competi\u0163ie cu acesta. Concentra\u0163ia crescut\u0103 de calciu \u015fi magneziu, caracteristic\u00e2 apelor dure, diminueaz\u0103 absorb\u0163ia intestinal\u0103 a iodului2<\/sup>.<\/p>\n

Iodul molecular (I2<\/sub>) este absorbit intestinal prin difuziune facilitat\u0103, \u00een timp ce iodurile (I-<\/sup>) sunt absorbite prin intermediul unui transportor de tip simport Na+<\/sup>\/I situat la nivelul mucoasei gastrice.<\/p>\n

Iodul constituie un oligoelement esen\u0163ial necesar pentru func\u0163ionarea optim\u0103 a glandei tiroide \u015fi dezvoltarea neurologic\u0103 a f\u0103tului \u015fi copilului mic. Astfel, deficitul de iod este recunoscut ca fiind cauza cea mai obi\u015fnuit\u0103 de endocrinopatie (gu\u015fa \u015fi hipotiroidism primar), precum \u015fi de retard mental ce poate fi prevenit.<\/p>\n

Iodul de\u0163ine un rol direct \u00een formarea hormonilor tiroidieni; la nivelul membranei bazolaterale a celulelor foliculului tiroidian se g\u0103se\u015fte transportorul de tip simport Na+<\/sup>\/I care sechestreaz\u0103 iodul din lichidul extracelular (I-<\/sup>) \u015fi a c\u0103rui activitate este controlat\u0103 de c\u0103tre tireotropin\u0103 (TSH). Aceast\u0103 protein\u0103 asigur\u0103 concentrarea iodului \u00een interiorul celulelor foliculare p\u00e2n\u0103 se ating niveluri de 20-40 ori mai mari dec\u00e2t cele prezente\u00a0\u00een s\u00e2nge. In continuare, I- <\/sup>este organificat (oxidat) la I2<\/sub> sub ac\u0163iunea tiroid-peroxidazei \u00a0(TPO) \u015fi \u00eencorporat \u00een molecula tiroglobulinei. In final rezult\u0103 hormonii tiroidieni tiroxin\u0103 (T4) \u015fi triiodotironin\u0103 (T3). Iodul reprezint\u0103 65% din greutatea molecular\u0103 a T4 \u015fi 59% din cea a T3.<\/p>\n

La adultul cu aport adecvat, aproximativ 15-20 mg de iod, reprezent\u00e2nd 30% din cantitatea total\u0103 din organism, sunt concentrate \u00een \u0163esutul \u015fi hormonii tiroidieni, iar restul de 70% este distribuit la nivelul glandelor mamare, ochilor, mucoasei gastrice, colului uterin \u015fi glandelor salivare. In celulele acestor \u0163esuturi iodul p\u0103trunde de asemenea printr-un transport de tip simport Na+<\/sup>\/I. Rolul \u0163esutului mamar de a concentra iodul este legat de func\u0163ionarea tiroidei nou-n\u0103scutului \u015fi \u00een consecin\u0163a de dezvoltarea cerebral\u0103 normal\u0103. In celelalte \u0163esuturi func\u0163ia sa r\u0103m\u00e2ne incomplet elucidat\u0103, unele studii demonstr\u00e2nd capacitatea de antioxidant a acestui oligoelement6<\/sup>.<\/p>\n

Doza zilnic\u0103 recomandat\u0103 de iod variaz\u0103 de la 150 \u00b5g\/zi pentru adul\u0163i la 290 \u00b5g\/zi pentru femeile care al\u0103pteaz\u0103. Cu toate acestea, glanda tiroid\u0103 nu are nevoie de mai mult de 70 \u00b5g\/zi pentru a sintetiza hormonii tiroidieni. Aceste nivele ridicate sunt necesare pentru optima func\u0163ionare a mucoasei gastrice, glandelor salivare, mucoasei bucale, timusului, epidermei, plexului coroid1<\/sup>.<\/p>\n

Deficitul de iod este frecvent \u00een \u0163\u0103rile\u00a0\u00een curs de dezvoltare \u015fi \u00een anumite p\u0103r\u0163i ale Europei \u015fi rar\u00a0\u00een zonele\u00a0\u00een care este utilizat\u0103 sarea iodat\u0103. Studii recente arat\u0103 c\u0103 lipsa iodului este un fapt comun\u00a0\u00een r\u00e2ndul femeilor adulte din SUA. Deficitul de iod se dezvolt\u0103 atunci cand aportul scade sub\u00a0 20 \u00b5g\/zi. Drept consecin\u0163\u0103 se produce m\u0103rirea de volum a glandei tiroide cu posibila apari\u0163ie de noduli multipli (gu\u015f\u0103 endemic\u0103). De obicei pacien\u0163ii r\u0103m\u00e2n eutiroidieni; dar, cu toate acestea, deficitul sever la adul\u0163i poate cauza hipotiroidism clinic manifest (mixedem endemic) ce poate determina la femei anovula\u0163ie, infertilitate, hipertensiune gesta\u0163ional\u0103, avort spontan\u00a0\u00een primul trimestru \u015fi moartea f\u0103tului in utero<\/em>.<\/p>\n

Manifest\u0103rile ap\u0103rute la copiii mici sunt rezultatul deficitului matern de iod. Astfel, deficitul matern sever determin\u0103 retard de cre\u015ftere, anomalii \u00een dezvoltarea creierului, malforma\u0163ii congenitale, iar la sugari produce cretinismul<\/em> caracterizat prin retard mental, surditate, dificult\u0103\u0163i de mers, deficit statural \u015fi, uneori, hipotiroidism. In concluzie, iodul constituie un element esen\u0163ial at\u00e2t \u00een cursul sarcinii c\u00e2t \u015fi\u00a0\u00een perioada lacta\u0163iei, pentru\u00a0 facilitarea dezvolt\u0103rii neurologice continue a copilului mic5;6<\/sup>.<\/p>\n

Determinarea nivelului de iod serve\u015fte ca indicator important al aportului alimentar adecvat de iod, dar \u015fi al supra\u00eenc\u0103rc\u0103rii, ce poate ap\u0103rea\u00a0\u00een cursul terapiei cu diverse medicamente, cum ar fi amiodarona4<\/sup>.<\/p>\n

Toxicitatea cronic\u0103 se poate dezvolta atunci c\u00e2nd aportul de iod dep\u0103\u015fe\u015fte 1,1 mg\/zi. Majoritatea persoanelor care inger\u0103 cantit\u0103\u0163i mari de iod r\u0103m\u00e2n eutiroidiene; unele persoane \u00eens\u0103, \u00een special cele care anterior au fost deficitare, dezvolt\u0103 hipertiroidie. In mod paradoxal, captarea excesiv\u0103 de iod de c\u0103tre tiroid\u0103 poate inhiba sinteza hormonilor tiroidieni (efectul Wolff-Chaikoff). Astfel, toxicitatea poate provoca\u00a0\u00een cele din urma gu\u015f\u0103, hipotiroidism sau mixedem. Cantit\u0103\u0163i foarte mari de iod pot produce un gust metalic, hipersaliva\u0163ie, irita\u0163ie gastrointestinal\u0103, precum \u015fi leziuni acneiforme. La pacien\u0163ii expu\u015fi la cantit\u0103\u0163i mari de substan\u0163e radiologice de contrast sau diverse medicamente ce con\u0163in iod este necesar s\u0103 se monitorizeze func\u0163ia tiroidian\u01035<\/sup>.<\/p>\n

Recomand\u0103ri pentru determinarea iodului<\/em><\/strong><\/p>\n

\u2013 determinarea statusului iodului \u00een organism;<\/div>\n
\u2013 monitorizarea nivelului de iod la persoanele c\u0103rora li se administreaz\u0103 medicamente care con\u0163in iod;<\/div>\n
\u2013 monitorizarea ratei de excre\u0163ie a iodului ca indicator al terapiei zilnice de substituVie4;6<\/sup>.<\/div>\n

Preg\u0103tire pacient<\/em><\/strong> \u2013 nu este necesar\u0103 o preg\u0103tire special\u01033<\/sup>.<\/p>\n

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

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

Prelucrare necesar\u0103 dup\u0103 recoltare<\/em><\/strong> \u2013 se separ\u0103 serul prin centrifugare; probele se men\u0163in la 2-8\u00b0C p\u00e2n\u0103 \u00een momentul lucrului3<\/sup>.<\/p>\n

Cantitate recoltat\u0103 <\/em><\/strong>\u2013 2 mL ser3<\/sup>.<\/p>\n

Stabilitate prob\u0103 <\/em><\/strong>\u2013 serul separat\u00a0este stabil 7 zile\u00a0<\/em>la 2-8\u00b0C3<\/sup>.<\/p>\n

Metod\u0103<\/em><\/strong> - plasm\u0103 cuplat\u0103 inductiv cu spectrometrie de mas\u0103 (ICP\/MS)3<\/sup><\/span>.<\/p>\n

Valori de referin\u0163\u0103 \u015f<\/em><\/strong>i interpretarea rezultatelor<\/em><\/strong><\/p>\n

Iod seric: 46-70 \u03bcg\/L<\/p>\n

Valori >460 \u00b5g\/zi pot indica un exces determinat de un regim alimentar necorespunz\u0103tor, dar cel mai frecvent sugereaz\u0103 expunerea recent\u0103 la substan\u0163e de contrast sau administrare de medicamente pe baz\u0103 de iod.<\/div>\n
Valori serice cuprinse \u00eentre 80 \u015fi 250 \u00b5g\/L se \u00eenregistreaz\u0103 \u00een hipertiroidie. Nivele plasmatice > 250 \u00b5g\/L pot indica o supra\u00eenc\u0103rcare cu iod.<\/div>\n
Pacien\u0163ii c\u0103rora li s-au administrat substan\u0163e de contrast sau medicamente pe baz\u0103 de iod (amiodarona), vor prezenta valori serice \u015fi urinare crescute3;4;6<\/sup>.<\/div>\n

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

Un nivel seric crescut de gadoliniu interfer\u0103 cu testele la metale, de aceea \u00een cazul \u00een care au fost administrate substan\u0163e de contrast cu gadoliniu, recoltarea trebuie am\u00e2nat\u0103 cel pu\u0163in 48 de ore.<\/div>\n
Dezinfectan\u0163ii care con\u0163in iod (cum ar fi Betadina) nu trebuie utiliza\u0163i la locul de punc\u0163ie venoas\u01034<\/sup>.<\/div>\n

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

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

1. Brown-Grant, K. Extrathyroidal iodide concentrating mechanisms. In Physiol Rev. , 1961, 41: 189.<\/span><\/div>\n
2. Florentina Moldovanu. Micromineralele \u2013 nutrien\u0163i esen\u0163iali pentru s\u0103n\u0103tatea copilului. In Medicina Modern\u0103, Vol. XII \u2013 Nr. 7 (iulie 2005).<\/span><\/div>\n
3. Laborator Synevo. Referin\u0163e specifice tehnologiei de lucru utilizate 2010. Ref Type: Catalog.<\/span><\/div>\n
4. Mayo Clinic, Mayo Medical Laboratories. Test Catalog. Iodine, Serum. Iodine, Urine. www.mayomedicallaboratories.com. Ref Type: Internet Communication.<\/span><\/div>\n
5. The Merck Manuals for Healthcare Professional. Iodine. Ref Type: Internet Communication http:\/\/www.merck.com\/mmpe\/sec01\/ch005\/ch005e.html.<\/span><\/div>\n
6. Patrick L. Iodine: deficiency and therapeutic considerations. In Altern Med Rev, 2008, 13: 116.<\/span><\/div>","protected":false},"excerpt":{"rendered":"

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

\u0419\u043e\u0434 \u043f\u0440\u0438\u0441\u0443\u0442\u0441\u0442\u0432\u0443\u0435\u0442 \u0432 \u0432\u044b\u0441\u043e\u043a\u0438\u0445 \u043a\u043e\u043d\u0446\u0435\u043d\u0442\u0440\u0430\u0446\u0438\u044f\u0445 \u0432 \u043c\u043e\u0440\u0441\u043a\u043e\u0439 \u0432\u043e\u0434\u0435 \u0438 \u043c\u043e\u0440\u0435\u043f\u0440\u043e\u0434\u0443\u043a\u0442\u0430\u0445. \u041d\u0435\u043a\u043e\u0442\u043e\u0440\u044b\u0435 \u0432\u0430\u0440\u0438\u0430\u043d\u0442\u044b \u0444\u0430\u0441\u0442\u0444\u0443\u0434\u0430 \u043c\u043e\u0433\u0443\u0442 \u0441\u043e\u0434\u0435\u0440\u0436\u0430\u0442\u044c \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u043e \u0439\u043e\u0434\u0430, \u043f\u0440\u0435\u0432\u044b\u0448\u0430\u044e\u0449\u0435\u0435 \u0435\u0433\u043e \u0441\u0443\u0442\u043e\u0447\u043d\u0443\u044e \u043d\u043e\u0440\u043c\u0443. \u0418\u0441\u043a\u0443\u0441\u0441\u0442\u0432\u0435\u043d\u043d\u043e\u0435 \u0434\u043e\u0431\u0430\u0432\u043b\u0435\u043d\u0438\u0435 \u0434\u0430\u043d\u043d\u043e\u0433\u043e \u043c\u0438\u043a\u0440\u043e\u044d\u043b\u0435\u043c\u0435\u043d\u0442\u0430 \u0432 \u043f\u0438\u0449\u0443 (\u0439\u043e\u0434\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u0430\u044f \u0441\u043e\u043b\u044c, \u0439\u043e\u0434\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e\u0435 \u043c\u0430\u0441\u043b\u043e) \u0448\u0438\u0440\u043e\u043a\u043e \u043f\u0440\u0438\u043c\u0435\u043d\u044f\u044e\u0442 \u0434\u043b\u044f \u043f\u0440\u043e\u0444\u0438\u043b\u0430\u043a\u0442\u0438\u043a\u0438 \u0438 \u043b\u0435\u0447\u0435\u043d\u0438\u044f \u0439\u043e\u0434\u0434\u0435\u0444\u0444\u0438\u0446\u0438\u0442\u043d\u044b\u0445 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0439 \u0449\u0438\u0442\u043e\u0432\u0438\u0434\u043d\u043e\u0439 \u0436\u0435\u043b\u0435\u0437\u044b. \u041f\u0440\u0435\u043f\u0430\u0440\u0430\u0442\u044b, \u0441\u043e\u0434\u0435\u0440\u0436\u0430\u0449\u0438\u0435 \u0439\u043e\u0434, \u043f\u0440\u0438\u043c\u0435\u043d\u044f\u044e\u0442 \u0434\u043b\u044f \u0443\u043c\u0435\u043d\u044c\u0448\u0435\u043d\u0438\u044f \u043d\u0430\u043a\u043e\u043f\u043b\u0435\u043d\u0438\u044f \u0440\u0430\u0434\u0438\u043e\u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0433\u043e \u0439\u043e\u0434\u0430.<\/p>\n

\u0411\u043e\u043b\u044c\u0448\u0430\u044f \u0447\u0430\u0441\u0442\u044c \u043f\u043e\u0441\u0442\u0443\u043f\u0430\u044e\u0449\u0435\u0433\u043e \u0441 \u043f\u0438\u0449\u0435\u0439 \u0439\u043e\u0434\u0430, \u0432 \u043a\u043e\u043d\u0435\u0447\u043d\u043e\u043c \u0441\u0447\u0435\u0442\u0435, \u0432\u044b\u0432\u043e\u0434\u0438\u0442\u0441\u044f \u043f\u043e\u0447\u043a\u0430\u043c\u0438, \u043f\u043e\u044d\u0442\u043e\u043c\u0443 \u0435\u0433\u043e \u044d\u043a\u0441\u043a\u0440\u0435\u0446\u0438\u044f \u0441 \u043c\u043e\u0447\u043e\u0439 \u0441\u043b\u0443\u0436\u0438\u0442 \u0445\u043e\u0440\u043e\u0448\u0438\u043c \u043c\u0430\u0440\u043a\u0435\u0440\u043e\u043c \u0443\u0440\u043e\u0432\u043d\u044f \u043d\u0435\u0434\u0430\u0432\u043d\u0435\u0433\u043e \u043f\u043e\u0442\u0440\u0435\u0431\u043b\u0435\u043d\u0438\u044f \u0439\u043e\u0434\u0430. \u041d\u043e \u0443\u0440\u043e\u0432\u0435\u043d\u044c \u0434\u0430\u043d\u043d\u043e\u0433\u043e \u044d\u043b\u0435\u043c\u0435\u043d\u0442\u0430 \u0432 \u043c\u043e\u0447\u0435 \u0443 \u043a\u043e\u043d\u043a\u0440\u0435\u0442\u043d\u043e\u0433\u043e \u0447\u0435\u043b\u043e\u0432\u0435\u043a\u0430 \u043c\u043e\u0436\u0435\u0442 \u0448\u0438\u0440\u043e\u043a\u043e \u0432\u0430\u0440\u044c\u0438\u0440\u043e\u0432\u0430\u0442\u044c \u0434\u0430\u0436\u0435 \u0432 \u0442\u0435\u0447\u0435\u043d\u0438\u0435 \u043e\u0434\u043d\u043e\u0433\u043e \u0434\u043d\u044f. \u041f\u043e\u044d\u0442\u043e\u043c\u0443 \u0441\u0430\u043c \u043f\u043e \u0441\u0435\u0431\u0435 \u044d\u0442\u043e\u0442 \u043f\u043e\u043a\u0430\u0437\u0430\u0442\u0435\u043b\u044c \u043d\u0435 \u0441\u043b\u0443\u0436\u0438\u0442 \u043e\u0441\u043d\u043e\u0432\u043e\u0439 \u0434\u043b\u044f \u043e\u0446\u0435\u043d\u043a\u0438 \u043e\u0431\u0435\u0441\u043f\u0435\u0447\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u0447\u0435\u043b\u043e\u0432\u0435\u043a\u0430 \u0439\u043e\u0434\u043e\u043c, \u0434\u043b\u044f \u044d\u0442\u043e\u0433\u043e \u043d\u0443\u0436\u0435\u043d \u043e\u0441\u043c\u043e\u0442\u0440 \u043a\u043b\u0438\u043d\u0438\u0446\u0438\u0441\u0442\u0430, \u043e\u0446\u0435\u043d\u043a\u0430 \u0440\u0430\u0437\u043c\u0435\u0440\u043e\u0432 \u0449\u0438\u0442\u043e\u0432\u0438\u0434\u043d\u043e\u0439 \u0436\u0435\u043b\u0435\u0437\u044b, \u043f\u0440\u0438 \u043d\u0435\u043e\u0431\u0445\u043e\u0434\u0438\u043c\u043e\u0441\u0442\u0438 \u2212 \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u043e\u0432\u0430\u043d\u0438\u0435 \u043b\u0430\u0431\u043e\u0440\u0430\u0442\u043e\u0440\u043d\u044b\u0445 \u0442\u0435\u0441\u0442\u043e\u0432, \u043e\u0442\u0440\u0430\u0436\u0430\u044e\u0449\u0438\u0445 \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u0435 \u0449\u0438\u0442\u043e\u0432\u0438\u0434\u043d\u043e\u0439 \u0436\u0435\u043b\u0435\u0437\u044b.<\/p>\n

\u0418\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435 \u0443\u0440\u043e\u0432\u043d\u044f \u0439\u043e\u0434\u0430 \u0432 \u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0435 \u043c\u043e\u0436\u0435\u0442 \u0431\u044b\u0442\u044c \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u043e\u0432\u0430\u043d\u043e \u0432 \u043a\u0430\u0447\u0435\u0441\u0442\u0432\u0435 \u043f\u043e\u043a\u0430\u0437\u0430\u0442\u0435\u043b\u044f \u0430\u0434\u0435\u043a\u0432\u0430\u0442\u043d\u043e\u0433\u043e \u043f\u043e\u0442\u0440\u0435\u0431\u043b\u0435\u043d\u0438\u044f \u0438\u043b\u0438 \u043f\u0435\u0440\u0435\u0433\u0440\u0443\u0437\u043a\u0438 \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c\u0430 \u0439\u043e\u0434\u043e\u043c, \u0432 \u043e\u0441\u043e\u0431\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u043f\u0440\u0438 \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u043e\u0432\u0430\u043d\u0438\u0438 \u0439\u043e\u0434\u0441\u043e\u0434\u0435\u0440\u0436\u0430\u0449\u0438\u0445 \u043b\u0435\u043a\u0430\u0440\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u0445 \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442\u043e\u0432 (\u043d\u0430\u043f\u0440\u0438\u043c\u0435\u0440, \u0430\u043c\u0438\u043e\u0434\u0430\u0440\u043e\u043d\u0430).<\/p>\n

\u0418\u0437\u0431\u044b\u0442\u043e\u043a \u044d\u043b\u0435\u043c\u0435\u043d\u0442\u0430 (\u0432\u0441\u043b\u0435\u0434\u0441\u0442\u0432\u0438\u0435 \u043d\u0435\u043a\u043e\u043d\u0442\u0440\u043e\u043b\u0438\u0440\u0443\u0435\u043c\u043e\u0433\u043e \u0443\u043f\u043e\u0442\u0440\u0435\u0431\u043b\u0435\u043d\u0438\u044f \u0441\u043e\u043e\u0442\u0432\u0435\u0442\u0441\u0442\u0432\u0443\u044e\u0449\u0438\u0445 \u043f\u0438\u0449\u0435\u0432\u044b\u0445 \u0434\u043e\u0431\u0430\u0432\u043e\u043a \u0438 \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442\u043e\u0432 \u0439\u043e\u0434\u0430), \u043a\u0430\u043a \u0438 \u0435\u0433\u043e \u0434\u0435\u0444\u0438\u0446\u0438\u0442 \u043c\u043e\u0433\u0443\u0442 \u0431\u044b\u0442\u044c \u043e\u043f\u0430\u0441\u043d\u044b \u0434\u043b\u044f \u0437\u0434\u043e\u0440\u043e\u0432\u044c\u044f. \u041d\u0435 \u0438\u0441\u043a\u043b\u044e\u0447\u0435\u043d\u043e, \u0447\u0442\u043e \u0432 \u0432\u044b\u0441\u043e\u043a\u0438\u0445 \u043a\u043e\u043d\u0446\u0435\u043d\u0442\u0440\u0430\u0446\u0438\u044f\u0445 \u0439\u043e\u0434 \u043f\u0440\u043e\u044f\u0432\u043b\u044f\u0435\u0442 \u0442\u043e\u043a\u0441\u0438\u0447\u043d\u043e\u0441\u0442\u044c, \u043f\u0440\u0438\u0432\u043e\u0434\u0438\u0442 \u043a \u043f\u0430\u0442\u043e\u043b\u043e\u0433\u0438\u0438 \u0449\u0438\u0442\u043e\u0432\u0438\u0434\u043d\u043e\u0439 \u0436\u0435\u043b\u0435\u0437\u044b, \u043f\u043e\u0440\u0430\u0436\u0435\u043d\u0438\u044f\u043c \u043a\u043e\u0436\u0438 \u0438 \u0434\u044b\u0445\u0430\u0442\u0435\u043b\u044c\u043d\u044b\u0445 \u043f\u0443\u0442\u0435\u0439, \u043e\u0449\u0443\u0449\u0435\u043d\u0438\u044e \u0443\u0441\u0442\u0430\u043b\u043e\u0441\u0442\u0438, \u0441\u043b\u0430\u0431\u043e\u0441\u0442\u0438, \u0434\u0435\u043f\u0440\u0435\u0441\u0441\u0438\u0438, \u043e\u043a\u0430\u0437\u044b\u0432\u0430\u0435\u0442 \u0442\u0435\u0440\u0430\u0442\u043e\u0433\u0435\u043d\u043d\u043e\u0435 \u0434\u0435\u0439\u0441\u0442\u0432\u0438\u0435 \u043d\u0430 \u043f\u043b\u043e\u0434.<\/p>\n

\u0412\u0437\u044f\u0442\u0438\u0435 \u043a\u0440\u043e\u0432\u0438 \u043f\u0440\u0435\u0434\u043f\u043e\u0447\u0442\u0438\u0442\u0435\u043b\u044c\u043d\u043e \u043f\u0440\u043e\u0432\u043e\u0434\u0438\u0442\u044c \u0443\u0442\u0440\u043e\u043c \u043d\u0430\u0442\u043e\u0449\u0430\u043a, \u043f\u043e\u0441\u043b\u0435 8-14 \u0447\u0430\u0441\u043e\u0432 \u043d\u043e\u0447\u043d\u043e\u0433\u043e \u043f\u0435\u0440\u0438\u043e\u0434\u0430 \u0433\u043e\u043b\u043e\u0434\u0430\u043d\u0438\u044f (\u0432\u043e\u0434\u0443 \u043f\u0438\u0442\u044c \u043c\u043e\u0436\u043d\u043e), \u0434\u043e\u043f\u0443\u0441\u0442\u0438\u043c\u043e \u0434\u043d\u0435\u043c \u0447\u0435\u0440\u0435\u0437 4 \u0447\u0430\u0441\u0430 \u043f\u043e\u0441\u043b\u0435 \u043b\u0435\u0433\u043a\u043e\u0433\u043e \u043f\u0440\u0438\u0435\u043c\u0430 \u043f\u0438\u0449\u0438.<\/p>\n

\u0412 \u043a\u0430\u043a\u0438\u0445 \u0441\u043b\u0443\u0447\u0430\u044f\u0445 \u043f\u0440\u043e\u0432\u043e\u0434\u044f\u0442 \u0430\u043d\u0430\u043b\u0438\u0437 \u043d\u0430 \u0419\u043e\u0434 \u0432 \u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0435:<\/p>\n

    \n
  • \u0432\u044b\u044f\u0432\u043b\u0435\u043d\u0438\u0435 \u0438\u0437\u0431\u044b\u0442\u043e\u0447\u043d\u043e\u0433\u043e \u043f\u043e\u0441\u0442\u0443\u043f\u043b\u0435\u043d\u0438\u044f \u0439\u043e\u0434\u0430 \u0432 \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c;<\/li>\n
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