{"id":12094,"date":"2020-05-06T00:16:43","date_gmt":"2020-05-05T21:16:43","guid":{"rendered":"https:\/\/www.synevo.ro\/shop\/profil-boli-hepatice-autoimune-blot-ama-m2-m2-3e-sp100-pml-gp210-lkm-1-lc-1-sla-lp-ro-52\/"},"modified":"2025-07-01T07:57:14","modified_gmt":"2025-07-01T04:57:14","slug":"profil-boli-hepatice-autoimune-blot","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/profil-boli-hepatice-autoimune-blot\/","title":{"rendered":"\u041f\u0440\u043e\u0444\u0438\u043b\u044c \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u043e\u0433\u043e \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f \u043f\u0435\u0447\u0435\u043d\u0438 - \u0431\u043b\u043e\u0442"},"content":{"rendered":"<p>Anti-SLA au fost descri\u0219i \u00een 1987 ca fiind \u00eendrepta\u021bi \u00eempotriva\u00a0 unei proteine din citosol care se g\u0103se\u0219te \u00een concentra\u021bii crescute \u00een \u021besutul hepatic \u0219i renal. Anti-LP au fost descri\u0219i \u00eenaintea anti-SLA (1981), de c\u0103tre un grup diferit de cercet\u0103tori, ca av\u00e2nd reactivitate fa\u021b\u0103 de o protein\u0103 solubil\u0103 dintr-un lizat omogen de ficat \u0219i pancreas. Ulterior s-a demonstrat\u00a0 c\u0103 anti-SLA si anti-LP sunt\u00a0 identici (anti SLA\/LP) \u0219i c\u0103 antigenul \u021bint\u0103 este reprezentat de o protein\u0103 citosolic\u0103 de 50 kDa ce este implicat\u0103 \u00een biosinteza seleno-proteinelor (UGA-suppressor serine-tRNA-associated protein). Ace\u0219ti anticorpi sunt \u00eenalt specifici pentru AIH\u00a0 av\u00e2nd o prevalen\u021b\u0103 de 10-30%1;2;6.<\/p>\n<p>Anti-LC1 apar in AIH tip II, fiind detecta\u021bi la 50% din serurile LKM\u00a0 positive. Unii autori\u00a0 \u00eel asociaz\u0103 cu ANA \u0219i ASMA \u0219i \u00a0de asemenea cu\u00a0 hepatita cronic\u0103 cu virus C. Ei\u00a0 recunosc ca antigen \u021bint\u0103\u00a0 formiminotransferaza-ciclodeaminaza\u00a0 \u0219i se coreleaz\u0103 cu activitatea bolii2;6;7.<\/p>\n<p>Al\u021bi\u00a0 anticorpi care\u00a0 mai pot ap\u0103rea \u00een AIH sunt :<\/p>\n<p>p-ANCA atipici<br \/>\nanti-LKM3 (\u021binta antigenic\u0103 este reprezentat\u0103 de de uridin-difosfat glucuronoziltransferaza \u0219i sunt \u00eent\u00e2lni\u021bi la pacien\u021bi cu hepatit\u0103 cronic\u0103 D \u0219i AIH tip II)<br \/>\nanti-LKM2 (\u00eendrepta\u021bi \u00eempotriva CYP2C9 \u0219i asocia\u021bi cu\u00a0 hepatita\u00a0 la ticrynafen)<br \/>\nanti-receptor pentru asialoglicoproteine (ASGP-R, sunt \u00eent\u00e2lni\u021bi at\u00e2t la pacien\u021bi cu AIH c\u00e2t \u0219i cu hepatit\u0103 viral\u0103; se coreleaz\u0103 cu activitatea histologic\u0103)1.<\/p>\n<p>Diversitatea serologic\u0103\u00a0 a anticorpilor a condus la ipoteza c\u0103 AIH reprezint\u0103 un grup heterogen de boli. Aceast\u0103 ipotez\u0103 este sus\u021binut\u0103 de asocierea\u00a0 \u00een 10-18 % din cazuri a unui sindrom multiorganic (APECED) caracterizat prin candidiaz\u0103 mucocutanat\u0103 cronic\u0103, distrofie ectodermal\u0103 \u0219i distruc\u021bie tisular\u0103 autoimun\u0103 a diferitelor glande endocrine (hipoparatiroidism, insuficien\u021b\u0103 suprarenalian\u0103, hipogonadism)1;7.<\/p>\n<p>Ciroza\u00a0 biliar\u0103 primitiv\u0103 (PBC)\u00a0 apare \u00een 90% din cazuri la femei de v\u00e2rst\u0103 mijlocie. Inciden\u021ba bolii \u00een diferite regiuni ale lumii este de 4-31 cazuri \/1 million locuitori\/an. Clinic, pacien\u021bii prezint\u0103 fatigabilitate, prurit, artralgii, dureri abdominale, icter obstructiv intermitent. Patognomonici\u00a0 pentru aceast\u0103 afec\u021biune\u00a0 sunt anticorpii antimitocondriali (AMA) care \u00a0apar la 95% din pacien\u021bi. Ei sunt \u00eendrepta\u021bi asupra subunit\u0103\u021bii E2\u00a0 a complexului piruvat dehidrogenazei (PDC-E2). Acest \u00a0antigen\u00a0 este exprimat\u00a0 la nivel hepatic,\u00a0 \u00een jurul ductelor biliare, iar autoanticorpii vor duce la distruc\u021bia canaliculelor biliare cu colestaz\u0103 secundar\u0103. Diagnosticul PBC este luat \u00een considerare\u00a0 dac\u0103:<\/p>\n<p>1. testele\u00a0 de colestaz\u0103 sunt pozitive (ALP, GGT)<br \/>\n2. AMA sunt\u00a0\u00a0 pozitivi<br \/>\n3.\u00a0examenul histopatologic este sugestiv (colangit\u0103 cronic\u0103 non-supurativ\u0103\u00a0 cu distruc\u021bie progresiv\u0103\u00a0 a ductelor\u00a0 biliare\u00a0 \u0219i fibroz\u0103)<\/p>\n<p>Boala poate afecta at\u00e2t ficatul c\u00e2t \u0219i glandele cu func\u021bie exocrin\u0103 (glande salivare, lacrimale, pancreas). Titrurile AMA crescute\u00a0\u00a0 sus\u021bin diagnosticul de PBC \u0219i pot avea\u00a0 valoare predictiv\u0103 pentru dezvoltarea\u00a0 ulterioar\u0103 de PBC\u00a0 la pacien\u021bi cu simptome\u00a0 de\u00a0 colestaz\u0103. AMA mai pot fi detecta\u021bi \u0219i \u00een sindroame\u00a0 overlap PBC-AIH, scleroza sistemic\u0103 (6%) \u0219i sindromul\u00a0 Sj\u00f6gren1;4;5.<\/p>\n<p>Al\u021bi\u00a0 autoanticorpi\u00a0 specifici\u00a0 PBC sunt:<\/p>\n<p>Anti-gp210\u00a0\u00a0\u00a0\u00a0recunosc un antigen de 210 kDa \u00a0al membranei\u00a0 nucleare \u0219i apar la 10-47% din pacien\u021bii cu PBC.<\/p>\n<p>Anti-Sp100 apar\u00a0 la \u00a020% din pacien\u021bii cu PBC \u00a0\u0219i sunt \u00eendrepta\u021bi \u00eempotriva\u00a0\u00a0 unor structuri \u00a0numite corpi nucleari (\u201cnuclear\u00a0 dots\u201d) care \u00een imunofluorescen\u021ba indirect\u0103 prezint\u0103 un aspect punctat \u0219i care au fost pu\u0219i \u00een eviden\u021b\u0103 pentru prima dat\u0103 \u00een\u00a0 nucleii celulelor maligne. Ace\u0219ti corpi nucleari\u00a0 ce con\u021bin fibre non-cromatiniene\u00a0\u00a0 reprezint\u0103 un complex alc\u0103tuit din urm\u0103toarele componente: antigenul sp100, antigenul PML (promyelocytic leukemia factor), LYSP 100, NDP55 \u0219i NDP 53.<\/p>\n<p>Anti-NUP62 (Nucleoporina p62)\u00a0 apar \u00een\u00a0 32% din cazurile de PBC.<\/p>\n<p>Mai pu\u021bin specifici pentru PBC sunt anticorpii anti receptor lamin B \u0219i anti-ciclin\u0103 A.<\/p>\n<p>\u00cen tabelul de mai jos este men\u021bionat\u0103 sensibilitatea \u0219i specificitatea diverselor tipuri de autoanticorpi pentru PBC:<\/p>\n<table class=\"wp-block-table w-100\" border=\"1\" width=\"624\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"96\"><span style=\"font-size: 10pt;\"><strong>\u00a0<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"72\"><span style=\"font-size: 10pt;\"><strong>AMA M2<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"60\"><span style=\"font-size: 10pt;\"><strong>M2-3E<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"62\"><span style=\"font-size: 10pt;\"><strong>SP100<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"59\"><span style=\"font-size: 10pt;\"><strong>PML<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"95\"><span style=\"font-size: 10pt;\"><strong>SP100\/PML<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"72\"><span style=\"font-size: 10pt;\"><strong>GP210<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"108\"><span style=\"font-size: 10pt;\"><strong>TOTAL<\/strong><\/span><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"96\"><span style=\"font-size: 10pt;\"><strong>Sensibilitate<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"72\"><span style=\"font-size: 10pt;\"><strong>81%<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"60\"><span style=\"font-size: 10pt;\"><strong>86%<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"62\"><span style=\"font-size: 10pt;\"><strong>21%<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"59\"><span style=\"font-size: 10pt;\"><strong>13%<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"95\"><span style=\"font-size: 10pt;\"><strong>24%<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"72\"><span style=\"font-size: 10pt;\"><strong>26%<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"108\"><span style=\"font-size: 10pt;\"><strong>94%<\/strong><\/span><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"96\"><span style=\"font-size: 10pt;\"><strong>Specificitate<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"72\"><span style=\"font-size: 10pt;\"><strong>100%<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"60\"><span style=\"font-size: 10pt;\"><strong>100%<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"62\"><span style=\"font-size: 10pt;\"><strong>100%<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"59\"><span style=\"font-size: 10pt;\"><strong>100%<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"95\"><span style=\"font-size: 10pt;\"><strong>100%<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"72\"><span style=\"font-size: 10pt;\"><strong>100%<\/strong><\/span><\/td>\n<td valign=\"top\" width=\"108\"><span style=\"font-size: 10pt;\"><strong>99%<\/strong><\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"font-size: small;\">\u00a0<\/span>Tratamentul PBC\u00a0 impune reducerea colestazei \u0219i \u00eembun\u0103t\u0103\u021birea\u00a0 func\u021biei hepatice; const\u0103 \u00een administrarea de acid ursodeoxicolic \u0219i colestiramin\u0103. \u00cen cazuri severe este indicat transplantul hepatic1;3;6.<\/p>\n<p>O situa\u021bie aparte este reprezentat\u0103 de\u00a0 sindroamele overlap PBC-AIH \u00een care anticorpii AMA \u00a0se asociaz\u0103\u00a0 cu \u00a0cei din AIH (10-20% din cazuri). Aceste sindroame pot coexista de la \u00eenceput (PBC-AIH) sau PBC poate progresa\u00a0 c\u0103tre AIH. Identificarea sindroamelor overlap este foarte important\u0103 datorit\u0103 eficacit\u0103\u021bii dovedite a tratamentului corticosteroid. Pentru diagnosticul sindroamelor overlap AIH-PBC\u00a0 au fost elaborate criteriile Paris5:<\/p>\n<table class=\"wp-block-table w-100\" style=\"width: 742px; height: 202px;\" border=\"1\" width=\"742\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"288\">\n<p align=\"center\"><span style=\"font-size: 10pt;\"><strong>Criterii pentru PBC<\/strong><\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"336\">\n<p align=\"center\"><span style=\"font-size: 10pt;\"><strong>Criterii pentru AIH<\/strong><\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"text-align: center;\" valign=\"top\" width=\"288\"><span style=\"font-size: 10pt;\">1. Activitatea fosfatezei alcaline \u00een ser \u2265 2x limita \u00a0superioar\u0103 a normalului sau\u00a0activitatea GGT \u00een ser \u2265 5x<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"336\"><span style=\"font-size: 10pt;\">Activitatea ALT \u00een ser \u00a0\u2265 5x limita superioar\u0103 a normalului<\/span><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"288\"><span style=\"font-size: 10pt;\">2. AMA pozitivi<\/span><\/td>\n<td valign=\"top\" width=\"336\"><span style=\"font-size: 10pt;\">Nivelul IgG \u00een ser \u2265 2x limita superioar\u0103 a normalului sau ASMA pozitivi<\/span><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"288\"><span style=\"font-size: 10pt;\">3. Biopsie hepatic\u0103 ce indic\u0103 leziuni floride \u00a0\u00a0 de ducte biliare<\/span><\/td>\n<td valign=\"top\" width=\"336\"><span style=\"font-size: 10pt;\">Biopsie hepatic\u0103 ce indic\u0103 \u201cpiecemeal necrosis\u201d moderat\u0103\/sever\u0103 periportal\u0103 sau periseptal\u0103<\/span><\/td>\n<\/tr>\n<tr>\n<td style=\"text-align: left;\" colspan=\"2\" valign=\"top\" width=\"624\"><span style=\"font-size: 10pt;\"><strong>Pentru dg. de sindrom overlap PBC-AIH sunt necesare cel pu\u021bin 2 din cele 3 criterii acceptate pentru pentru fiecare condi\u021bie.<\/strong><\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Colangita sclerozant\u0103\u00a0 primitiv\u0103 (PSC) apare cu o inciden\u021b\u0103 de\u00a0 4 cazuri la 100 000 locuitori\/an. Tabloul clinic este dominat de simptomele \u0219i semnele de colestaz\u0103. Diagnosticul\u00a0 se bazeaz\u0103 pe\u00a0 modific\u0103rile testelor de laborator, examenul histologic \u0219i \u00a0colangiopancreatografia\u00a0 endoscopic\u0103 retrograd\u0103 (ERCP). Sunt afecta\u021bi \u00een principal b\u0103rba\u021bii iar \u00een 50% din cazuri se asociaz\u0103\u00a0 \u0219i colita ulceroas\u0103. Autoanticorpii identifica\u021bi \u00een aceast\u0103\u00a0 afec\u021biune\u00a0 sunt\u00a0 p-ANCA cu aspect atipic \u00een imunofluorescen\u021ba indirect\u0103, \u00eendrepta\u021bi impotriva antigenelor: catepsin\u0103 G, lactoferin\u0103, catalaz\u0103, alfa-enolaz\u0103. Ace\u0219tia\u00a0 pot ap\u0103rea\u00a0 ocazional \u0219i\u00a0 \u00een AIH\u00a0 \u0219i\u00a0 PBC1;4.<\/p>\n<p>Recomand\u0103ri &#8211;\u00a0 pacien\u021bi cu suspiciune clinic\u0103 de boli hepatice autoimune1.<\/p>\n<p>Preg\u0103tire pacient &#8211; \u00e0 jeun (pe nem\u00e2ncate) sau postprandial (dup\u0103 mese)7.<\/p>\n<p>Specimen recoltat &#8211; s\u00e2nge venos7.<\/p>\n<p>Recipient de recoltare &#8211; vacutainer f\u0103r\u0103 anticoagulant cu\/f\u0103r\u0103 gel separator7.<\/p>\n<p>Prelucrare necesar\u0103 dup\u0103 recoltare &#8211; se separ\u0103 serul prin centrifugare7.<\/p>\n<p>Volum prob\u0103 &#8211; minim 1 mL ser7.<\/p>\n<p>Cauze de respingere a probei:<\/p>\n<p>\u2022 specimen hemolizat;<br \/>\n\u2022 specimen icteric, lipemic;<br \/>\n\u2022 specimen contaminat bacterian7.<\/p>\n<p>Stabilitate prob\u0103 &#8211; serul separat este stabil 14 zile la 2-8\u00baC \u0219i timp \u00eendelungat la -20\u00baC. Nu decongela\u021bi\/recongela\u021bi6.<\/p>\n<p>Metod\u0103 &#8211; imunoblot. Testul utilizeaz\u0103 9 antigene native \u0219i recombinate purificate, care sunt fixate\u00a0 \u00een cip-uri paralele pe membrana unui strip. Antigenele sunt reprezentate, \u00een ordinea fix\u0103rii pe strip, de:<\/p>\n<p>&#8211; AMA M2: antigen nativ purificat<br \/>\n&#8211; M2-3E (BPO): antigen recombinat ce cuprinde domeniile imunogenice ale subunit\u0103\u021biii E2<br \/>\n&#8211; Sp100: antigen recombinat<br \/>\n&#8211; PML: antigen recombinat<br \/>\n&#8211; GP210: antigen recombinat<br \/>\n&#8211; LKM1: antigen recombinat<br \/>\n&#8211; LC-1: antigen recombinat<br \/>\n&#8211; SLA\/LP: antigen recombinat<br \/>\n&#8211; Ro 52: antigen recombinat<\/p>\n<p>\u00centr-o prim\u0103 etap\u0103 strip-ul \u00eenc\u0103rcat cu antigenele purificate este incubat \u00eempreun\u0103 cu serul diluat al pacientului. Dac\u0103 \u00een ser sunt prezen\u021bi anticorpi specifici ace\u0219tia se vor lega de antigenele corespunz\u0103toare de pe strip. Dup\u0103 o etap\u0103 de sp\u0103lare, strip-ul este incubat cu un conjugat anti-IgG uman marcat cu fosfataza alcalin\u0103. Conjugatul se va ata\u0219a la por\u021biunea IgG a complexului antigen-anticorp. Dup\u0103 \u00eendep\u0103rtarea prin sp\u0103lare a conjugatului nelegat se adaug\u0103 solu\u021bia de colorare (substratul enzimei) \u2013 un sistem de detec\u021bie enzimatic\u0103 colorimetric\u0103 . Dac\u0103 este prezent conjugatul legat reac\u021bia enzimatic\u0103 va genera un produs colorat albastru-\u00eenchis la nivelul benzilor ocupate de anticorpi specifici. Astfel, benzile vizualizate la nivelul stripului sunt rezultatul leg\u0103rii\u00a0 anticorpilor specifici de antigenele individuale de la nivelul strip-ului.<\/p>\n<p>Pe fiecare strip\u00a0 exist\u0103 o band\u0103 de control intern. Apari\u021bia unei reac\u021bii de culoare intense la acest nivel certific\u0103 faptul c\u0103 toate etapele testului imunoblot au fost executate corect7.<\/p>\n<p>Valori de referin\u021b\u0103 \u00a0\u0219i interpretarea rezultatelor<\/p>\n<p>Interpretarea definitiv\u0103 a rezultatelor testului se face cu ajutorul unui software (dup\u0103 scanarea strip-urilor) care \u00een func\u021bie de intensitatea semnalului, acord\u0103 un punctaj pentru fiecare band\u0103 a strip-ului, astfel:<\/p>\n<table class=\"wp-block-table w-100\" border=\"1\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"156\"><strong><span style=\"font-size: small;\">EVALUARE SEMNAL<\/span><\/strong><\/td>\n<td valign=\"top\" width=\"168\"><strong><span style=\"font-size: small;\">INTENSITATE\u00a0 SEMNAL<\/span><\/strong><\/td>\n<td colspan=\"2\" valign=\"top\" width=\"259\"><strong><span style=\"font-size: small;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 REZULTAT<\/span><\/strong><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"156\"><span style=\"font-size: small;\">\u00a0 F\u0103r\u0103\u00a0 band\u0103 <\/span><\/td>\n<td valign=\"top\" width=\"168\"><span style=\"font-size: small;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 0-5<\/span><\/td>\n<td valign=\"top\" width=\"114\"><span style=\"font-size: small;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/td>\n<td valign=\"top\" width=\"145\"><span style=\"font-size: small;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 NEGATIV<\/span><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"156\"><span style=\"font-size: small;\">\u00a0Band\u0103 slab\u0103<\/span><\/td>\n<td valign=\"top\" width=\"168\"><span style=\"font-size: small;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 6-10\u00a0\u00a0\u00a0 <\/span><\/td>\n<td valign=\"top\" width=\"114\"><span style=\"font-size: small;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 (+)<\/span><\/td>\n<td valign=\"top\" width=\"145\"><span style=\"font-size: small;\">\u00a0\u00a0\u00a0\u00a0\u00a0 ECHIVOC<\/span><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"156\"><span style=\"font-size: small;\">Band\u0103 medie-intens\u0103<\/span><\/td>\n<td valign=\"top\" width=\"168\"><span style=\"font-size: small;\">\u00a0\u00a0 11-25 sau 26-50<\/span><\/td>\n<td valign=\"top\" width=\"114\"><span style=\"font-size: small;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 +,++<\/span><\/td>\n<td valign=\"top\" width=\"145\"><span style=\"font-size: small;\">\u00a0\u00a0\u00a0\u00a0\u00a0 POZITIV<\/span><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"156\"><span style=\"font-size: small;\">Band\u0103 foarte intens\u0103<\/span><\/td>\n<td valign=\"top\" width=\"168\"><span style=\"font-size: small;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 &gt;50<\/span><\/td>\n<td valign=\"top\" width=\"114\"><span style=\"font-size: small;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 +++<\/span><\/td>\n<td valign=\"top\" width=\"145\"><span style=\"font-size: small;\">\u00a0\u00a0\u00a0\u00a0 INTENS POZITIV<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<div><\/div>\n<p>\u00cen final este calculat\u0103 suma\u00a0 punctelor acordate \u0219i se va genera rezultatul testului.<br \/>\nUn rezultat pozitiv confirm\u0103 prezen\u021ba anticorpilor specifici .<br \/>\nUn rezultat echivoc indic\u0103 faptul c\u0103 prezen\u021ba auto- anticorpilor\u00a0 este incert\u0103; \u00een func\u021bie de contextul clinic al pacientului testul va fi repetat la un interval de 1-2 luni.<br \/>\nUn rezultat negativ indic\u0103 absen\u021ba auto-anticorpilor specifici.<\/p>\n<p>Valori de referin\u021b\u0103<\/p>\n<p>Anti-AMA M2: negativ<br \/>\nAnti-M2-3E: negativ<br \/>\nAnti-sp100: negativ<br \/>\nAnti-PML: negativ<br \/>\nAnti-gpP210: negativ<br \/>\nAnti-LKM 1: negativ<br \/>\nAnti-LC1: negativ<br \/>\nAnti-SLA\/LP: negativ<br \/>\nAnti-Ro 52: negativ7<\/p>\n<p>\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<\/p>\n<p>1.\u00a0 \u00a0A. J. Czaja. Autoantibodies as prognostic markers in autoimmune liver disease. In\u00a0 Digestive Diseases and Sciences, vol.\u00a055,\u00a0 no. 8, pp. 2144\u20132161, 2010.<br \/>\n2.\u00a0\u00a0 Ashima Makol et al. Autoimmune Hepatitis: A Review of Current Diagnosis and Treatment. In Hepatitis Research and\u00a0Treatment, volume 2011 (2011).<br \/>\n3.\u00a0\u00a0 Christian P. Strassburg. Autoantibodies and Autoantigens in Autoimmune Hepatitis. In Semin Liver Dis. 2002\u00a0Nov;22(4):339-52.<br \/>\n4.\u00a0\u00a0 D.P. Bogdanos. Autoimmune liver serology: current diagnostic and clinical challenges. In World\u00a0Journal of Gastroenterology, 2008, 14(21):3374-87.<br \/>\n5.\u00a0\u00a0 Edith Kuiper. Primary billiary cirrhosis: Diagnostic and Therapeutic Aspects. Erasmus University Medical Centre\u00a0Rotterdam.<br \/>\n6.\u00a0 Kalliopi Zachou, et al. Autoantibodies and autoantigens in autoimmune hepatitis: important tools in clinical\u00a0practice. In Journal of Autoimmune Diseases, 2004, 2: 1740-1757.<br \/>\n7.\u00a0\u00a0 Laborator Synevo. Referin\u021bele specifice tehnologiei de lucru utilizate 2012. Ref Type: Catalog.<\/p>","protected":false},"excerpt":{"rendered":"<p>\u0410\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u044b\u0435 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f \u043f\u0435\u0447\u0435\u043d\u0438 \u043e\u0442\u043d\u043e\u0441\u044f\u0442\u0441\u044f \u043a \u0433\u0440\u0443\u043f\u043f\u0435 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0439, \u043f\u0440\u0438 \u043a\u043e\u0442\u043e\u0440\u044b\u0445 \u0432 \u0431\u0438\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u0438\u0445 \u0436\u0438\u0434\u043a\u043e\u0441\u0442\u044f\u0445 \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0438\u0432\u0430\u044e\u0442\u0441\u044f \u0430\u0443\u0442\u043e\u0430\u043d\u0442\u0438\u0442\u0435\u043b\u0430, \u043d\u0430\u043f\u0440\u0430\u0432\u043b\u0435\u043d\u043d\u044b\u0435 \u043a \u0440\u0430\u0437\u043b\u0438\u0447\u043d\u044b\u043c \u043a\u043e\u043c\u043f\u043e\u043d\u0435\u043d\u0442\u0430\u043c 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\u0431\u0438\u043b\u0438\u0430\u0440\u043d\u044b\u0439 \u0446\u0438\u0440\u0440\u043e\u0437 \u0438 \u043f\u0435\u0440\u0432\u0438\u0447\u043d\u044b\u0439 \u0441\u043a\u043b\u0435\u0440\u043e\u0437\u0438\u0440\u0443\u044e\u0449\u0438\u0439 \u0445\u043e\u043b\u0430\u043d\u0433\u0438\u0442) \u0438 &#8220;\u043f\u0435\u0440\u0435\u043a\u0440\u0435\u0441\u0442\u043d\u044b\u0439&#8221; \u0441\u0438\u043d\u0434\u0440\u043e\u043c. \u0410\u0443\u0442\u043e\u0430\u043d\u0442\u0438\u0442\u0435\u043b\u0430 \u044f\u0432\u043b\u044f\u044e\u0442\u0441\u044f \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u043c\u0438 \u043b\u0430\u0431\u043e\u0440\u0430\u0442\u043e\u0440\u043d\u044b\u043c\u0438 \u043a\u0440\u0438\u0442\u0435\u0440\u0438\u044f\u043c\u0438 \u0434\u0430\u043d\u043d\u044b\u0445 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0439.<\/p>\n<p>\u0410\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u044b\u0439 \u0433\u0435\u043f\u0430\u0442\u0438\u0442 (\u0410\u0418\u0413) \u2013 \u044d\u0442\u043e \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u043e\u0435 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0435 \u043f\u0435\u0447\u0435\u043d\u0438, \u043f\u0440\u043e\u044f\u0432\u043b\u044f\u044e\u0449\u0435\u0435\u0441\u044f \u0441\u043b\u0430\u0431\u043e\u0441\u0442\u044c\u044e, \u0443\u0442\u043e\u043c\u043b\u044f\u0435\u043c\u043e\u0441\u0442\u044c\u044e, \u043c\u044b\u0448\u0435\u0447\u043d\u044b\u043c\u0438 \u0438 \u0441\u0443\u0441\u0442\u0430\u0432\u043d\u044b\u043c\u0438 \u0431\u043e\u043b\u044f\u043c\u0438, \u043f\u0435\u0440\u0438\u043e\u0434\u0438\u0447\u0435\u0441\u043a\u0438\u043c \u043f\u043e\u0432\u044b\u0448\u0435\u043d\u0438\u0435\u043c \u0442\u0435\u043c\u043f\u0435\u0440\u0430\u0442\u0443\u0440\u044b \u0442\u0435\u043b\u0430. \u0418\u0437\u043c\u0435\u043d\u0435\u043d\u0438\u044f \u043b\u0430\u0431\u043e\u0440\u0430\u0442\u043e\u0440\u043d\u044b\u0445 \u0434\u0430\u043d\u043d\u044b\u0445, \u0445\u0430\u0440\u0430\u043a\u0442\u0435\u0440\u043d\u044b\u0435 \u0434\u043b\u044f \u0410\u0418\u0413, \u0432\u043a\u043b\u044e\u0447\u0430\u044e\u0442 \u0432 \u0441\u0435\u0431\u044f \u043f\u043e\u0432\u044b\u0448\u0435\u043d\u0438\u0435 \u0443\u0440\u043e\u0432\u043d\u044f \u0433\u0430\u043c\u043c\u0430-\u0433\u043b\u043e\u0431\u0443\u043b\u0438\u043d\u043e\u0432 \u0438\u043b\u0438 \u0438\u043c\u043c\u0443\u043d\u043e\u0433\u043b\u043e\u0431\u0443\u043b\u0438\u043d\u0430 G (IgG), \u0430 \u0442\u0430\u043a\u0436\u0435 \u043f\u043e\u044f\u0432\u043b\u0435\u043d\u0438\u0435 \u0432 \u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0435 \u043a\u0440\u043e\u0432\u0438 \u0430\u0443\u0442\u043e\u0430\u043d\u0442\u0438\u0442\u0435\u043b.<\/p>\n<p>\u0410\u043d\u0442\u0438\u0442\u0435\u043b\u0430 \u043a \u043c\u0438\u043a\u0440\u043e\u0441\u043e\u043c\u0430\u043b\u044c\u043d\u043e\u0439 \u0444\u0440\u0430\u043a\u0446\u0438\u0438 \u043f\u0435\u0447\u0435\u043d\u0438 \u0438 \u043f\u043e\u0447\u0435\u043a (\u0430\u043d\u0442\u0438-LKM, \u043e\u0442 \u0430\u043d\u0433\u043b. anti-liver kidney microsomal) \u043f\u0440\u0435\u0434\u0441\u0442\u0430\u0432\u043b\u044f\u044e\u0442 \u0441\u043e\u0431\u043e\u0439 \u0433\u0435\u0442\u0435\u0440\u043e\u0433\u0435\u043d\u043d\u0443\u044e \u0433\u0440\u0443\u043f\u043f\u0443 \u0430\u0443\u0442\u043e\u0430\u043d\u0442\u0438\u0442\u0435\u043b, \u0432\u0437\u0430\u0438\u043c\u043e\u0434\u0435\u0439\u0441\u0442\u0432\u0443\u044e\u0449\u0438\u0445 \u0441 \u0444\u0435\u0440\u043c\u0435\u043d\u0442\u0430\u043c\u0438 \u043c\u0438\u043a\u0440\u043e\u0441\u043e\u043c\u0430\u043b\u044c\u043d\u043e\u0439 \u0441\u0438\u0441\u0442\u0435\u043c\u044b \u043e\u043a\u0438\u0441\u043b\u0435\u043d\u0438\u044f \u043f\u0435\u0447\u0435\u043d\u0438 \u0438 \u043f\u043e\u0447\u0435\u043a. \u0420\u0430\u0437\u043b\u0438\u0447\u0430\u044e\u0442 \u043d\u0435\u0441\u043a\u043e\u043b\u044c\u043a\u043e \u0432\u0430\u0440\u0438\u0430\u043d\u0442\u043e\u0432 \u044d\u0442\u0438\u0445 \u0430\u043d\u0442\u0438\u0442\u0435\u043b. \u0410\u043d\u0442\u0438-LKM-1 \u0432\u0437\u0430\u0438\u043c\u043e\u0434\u0435\u0439\u0441\u0442\u0432\u0443\u044e\u0442 \u0441 \u0444\u0435\u0440\u043c\u0435\u043d\u0442\u043e\u043c \u0446\u0438\u0442\u043e\u0445\u0440\u043e\u043c\u043e\u043a\u0441\u0438\u0434\u0430\u0437\u043e\u0439 CYP 2D6. \u0410\u043d\u0442\u0438\u0442\u0435\u043b\u0430 \u043a LKM-1 \u0432\u0441\u0442\u0440\u0435\u0447\u0430\u044e\u0442\u0441\u044f \u0443 15 % \u0431\u043e\u043b\u044c\u043d\u044b\u0445 \u0410\u0418\u0413, \u0432 \u0447\u0430\u0441\u0442\u043d\u043e\u0441\u0442\u0438 \u0443 \u0431\u043e\u043b\u044c\u043d\u044b\u0445 \u0410\u0418\u0413 2-\u0433\u043e \u0442\u0438\u043f\u0430 (90 %). \u042d\u0442\u043e\u0442 \u0432\u0430\u0440\u0438\u0430\u043d\u0442 \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u043e\u0433\u043e \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430 \u043d\u0430\u0438\u0431\u043e\u043b\u0435\u0435 \u0445\u0430\u0440\u0430\u043a\u0442\u0435\u0440\u0435\u043d \u0434\u043b\u044f \u0434\u0435\u0442\u0435\u0439, \u0447\u0430\u0449\u0435 \u0432\u0441\u0442\u0440\u0435\u0447\u0430\u0435\u0442\u0441\u044f \u0443 \u0434\u0435\u0432\u043e\u0447\u0435\u043a, \u0447\u0435\u043c \u0443 \u043c\u0430\u043b\u044c\u0447\u0438\u043a\u043e\u0432, \u0438 \u0438\u043c\u0435\u0435\u0442 \u043d\u0430\u0438\u043c\u0435\u043d\u0435\u0435 \u0431\u043b\u0430\u0433\u043e\u043f\u0440\u0438\u044f\u0442\u043d\u044b\u0439 \u043f\u0440\u043e\u0433\u043d\u043e\u0437 \u043f\u043e \u0441\u0440\u0430\u0432\u043d\u0435\u043d\u0438\u044e \u0441 \u0410\u0418\u0413 1-\u0433\u043e \u0438 3-\u0433\u043e \u0442\u0438\u043f\u043e\u0432. \u0422\u0430\u043a\u0436\u0435 \u0430\u043d\u0442\u0438-LKM-1 \u0432\u044b\u044f\u0432\u043b\u044f\u044e\u0442\u0441\u044f \u0432 \u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0435 \u043a\u0440\u043e\u0432\u0438 \u0431\u043e\u043b\u044c\u043d\u044b\u0445 (\u043e\u043a\u043e\u043b\u043e 5 %) \u0441 \u0432\u0438\u0440\u0443\u0441\u043d\u044b\u043c \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u043e\u043c \u0421. \u0421\u043b\u0435\u0434\u0443\u0435\u0442 \u043e\u0442\u043c\u0435\u0442\u0438\u0442\u044c, \u0447\u0442\u043e \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0435\u043d\u0438\u0435 \u0430\u043d\u0442\u0438\u0442\u0435\u043b \u043a LKM \u043d\u0435 \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u0430\u0431\u0441\u043e\u043b\u044e\u0442\u043d\u044b\u043c \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u043c \u043a\u0440\u0438\u0442\u0435\u0440\u0438\u0435\u043c \u0410\u0418\u0413, \u0440\u0430\u0432\u043d\u043e \u043a\u0430\u043a \u0438 \u043e\u0442\u0440\u0438\u0446\u0430\u0442\u0435\u043b\u044c\u043d\u044b\u0439 \u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442 \u043d\u0430 \u0434\u0430\u043d\u043d\u044b\u0435 \u0430\u0443\u0442\u043e\u0430\u043d\u0442\u0438\u0442\u0435\u043b\u0430 \u043d\u0435 \u043f\u043e\u0437\u0432\u043e\u043b\u044f\u0435\u0442 \u0438\u0441\u043a\u043b\u044e\u0447\u0438\u0442\u044c \u0434\u0430\u043d\u043d\u044b\u0439 \u0434\u0438\u0430\u0433\u043d\u043e\u0437. \u0421\u043b\u0435\u0434\u0443\u0435\u0442 \u043f\u0440\u043e\u0432\u043e\u0434\u0438\u0442\u044c \u043a\u043e\u043c\u043f\u043b\u0435\u043a\u0441\u043d\u043e\u0435 \u043e\u0431\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u0432 \u0438 \u0438\u0441\u043a\u043b\u044e\u0447\u0430\u0442\u044c \u0432\u0441\u0435 \u0432\u043e\u0437\u043c\u043e\u0436\u043d\u044b\u0435 \u0438\u043d\u044b\u0435 \u043f\u0440\u0438\u0447\u0438\u043d\u044b \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430. \u0423\u0440\u043e\u0432\u0435\u043d\u044c \u0430\u043d\u0442\u0438\u0442\u0435\u043b \u043a LKM \u043c\u043e\u0436\u0435\u0442 \u0441\u043d\u0438\u0436\u0430\u0442\u044c\u0441\u044f \u043f\u0440\u0438 \u043b\u0435\u0447\u0435\u043d\u0438\u0438 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f, \u0447\u0442\u043e \u043f\u043e\u0437\u0432\u043e\u043b\u044f\u0435\u0442 \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u043e\u0432\u0430\u0442\u044c \u044d\u0442\u043e\u0442 \u043f\u0430\u0440\u0430\u043c\u0435\u0442\u0440 \u0434\u043b\u044f \u043e\u0446\u0435\u043d\u043a\u0438 \u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u0438 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f.<\/p>\n<p>\u0410\u043d\u0442\u0438\u0442\u0435\u043b\u0430 \u043a \u0446\u0438\u0442\u043e\u0437\u043e\u043b\u044c\u043d\u043e\u043c\u0443\u00a0\u0430\u043d\u0442\u0438\u0433\u0435\u043d\u0443 1-\u0433\u043e \u0442\u0438\u043f\u0430 (LC-1) \u0438 \u0430\u043d\u0442\u0438\u0442\u0435\u043b\u0430 \u043a \u0440\u0430\u0441\u0442\u0432\u043e\u0440\u0438\u043c\u043e\u043c\u0443 \u0430\u043d\u0442\u0438\u0433\u0435\u043d\u0443 \u043f\u0435\u0447\u0435\u043d\u0438\/\u043f\u043e\u0434\u0436\u0435\u043b\u0443\u0434\u043e\u0447\u043d\u043e\u0439 \u0436\u0435\u043b\u0435\u0437\u044b (SLA\/LP) \u0442\u0430\u043a\u0436\u0435 \u044f\u0432\u043b\u044f\u044e\u0442\u0441\u044f \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u043c\u0438 \u043c\u0430\u0440\u043a\u0435\u0440\u0430\u043c\u0438 \u0410\u0418\u0413. \u041e\u043d\u0438 \u043e\u0442\u043d\u043e\u0441\u044f\u0442\u0441\u044f \u043a \u043b\u0430\u0431\u043e\u0440\u0430\u0442\u043e\u0440\u043d\u044b\u043c \u043f\u043e\u043a\u0430\u0437\u0430\u0442\u0435\u043b\u044f\u043c \u0432\u0442\u043e\u0440\u043e\u0439 \u043b\u0438\u043d\u0438\u0438 \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0438, \u043a\u043e\u0433\u0434\u0430 \u043d\u0435 \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0438\u0432\u0430\u044e\u0442\u0441\u044f \u0430\u043d\u0442\u0438\u0442\u0435\u043b\u0430 \u043f\u0435\u0440\u0432\u043e\u0439 \u043b\u0438\u043d\u0438\u0438: \u0430\u043d\u0442\u0438\u0442\u0435\u043b\u0430 \u043a \u0433\u043b\u0430\u0434\u043a\u0438\u043c \u043c\u044b\u0448\u0446\u0430\u043c, \u0430\u043d\u0442\u0438\u043d\u0443\u043a\u043b\u0435\u0430\u0440\u043d\u044b\u0435 \u0430\u043d\u0442\u0438\u0442\u0435\u043b\u0430 \u0438 \u0430\u043d\u0442\u0438\u0442\u0435\u043b\u0430 \u043a LKM-1.<\/p>\n<p>\u0410\u043d\u0442\u0438\u0442\u0435\u043b\u0430 \u043a LC-1 \u043d\u0430\u043f\u0440\u0430\u0432\u043b\u0435\u043d\u044b \u043a \u0441\u043f\u0435\u0446\u0438\u0444\u0438\u0447\u0435\u0441\u043a\u043e\u043c\u0443 \u043c\u0435\u0442\u0430\u0431\u043e\u043b\u0438\u0447\u0435\u0441\u043a\u043e\u043c\u0443 \u0444\u0435\u0440\u043c\u0435\u043d\u0442\u0443 \u043f\u0435\u0447\u0435\u043d\u0438 \u2013 \u0444\u043e\u0440\u043c\u0438\u043c\u0438\u043d\u043e\u0442\u0440\u0430\u043d\u0441\u0444\u0435\u0440\u0430\u0437\u0435 \u0446\u0438\u043a\u043b\u043e\u0434\u0435\u0430\u043c\u0438\u043d\u0430\u0437\u0435. \u041e\u043d\u0438 \u0432\u0441\u0442\u0440\u0435\u0447\u0430\u044e\u0442\u0441\u044f \u0443 25-40 % \u0431\u043e\u043b\u044c\u043d\u044b\u0445 \u043f\u0440\u0438 LKM-1\u2013\u043f\u043e\u043b\u043e\u0436\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u043c \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u043e\u043c \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0435 2-\u0433\u043e \u0442\u0438\u043f\u0430. \u0418\u0437\u043e\u043b\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e \u0430\u043d\u0442\u0438-LC-1 \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0438\u0432\u0430\u044e\u0442\u0441\u044f \u0432 10 % \u0441\u043b\u0443\u0447\u0430\u0435\u0432 \u0434\u0430\u043d\u043d\u043e\u0433\u043e \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f. \u0414\u0430\u043d\u043d\u044b\u0439 \u0442\u0438\u043f \u0430\u0443\u0442\u043e\u0430\u043d\u0442\u0438\u0442\u0435\u043b \u043f\u0440\u0430\u043a\u0442\u0438\u0447\u0435\u0441\u043a\u0438 \u043d\u0435 \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0438\u0432\u0430\u0435\u0442\u0441\u044f \u043f\u0440\u0438 \u0432\u0438\u0440\u0443\u0441\u043d\u043e\u043c \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0435 \u0421 \u0438 \u0410\u0418\u0413 1-\u0433\u043e \u0442\u0438\u043f\u0430.<\/p>\n<p>\u0410\u043d\u0442\u0438\u0442\u0435\u043b\u0430 \u043a SLA\/LP \u0441\u0432\u044f\u0437\u044b\u0432\u0430\u044e\u0442\u0441\u044f \u0446\u0438\u0442\u043e\u0437\u043e\u043b\u044c\u043d\u044b\u043c \u0431\u0435\u043b\u043a\u043e\u043c-\u0444\u0435\u0440\u043c\u0435\u043d\u0442\u043e\u043c, \u0441\u043e\u0434\u0435\u0440\u0436\u0430\u0449\u0438\u043c \u0441\u0435\u043b\u0435\u043d\u043e\u0446\u0438\u0441\u0442\u0435\u0438\u043d \u0432 \u043f\u0435\u043f\u0442\u0438\u0434\u043d\u044b\u0445 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\u043d\u0430\u0441\u043b\u0435\u0434\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u0445 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0439 \u043f\u0435\u0447\u0435\u043d\u0438.<\/li>\n<\/ul>\n<p><strong>\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<ul>\n<li>\u041f\u0440\u0438 \u043d\u0430\u043b\u0438\u0447\u0438\u0438 \u0441\u0438\u043c\u043f\u0442\u043e\u043c\u043e\u0432 \u043e\u0441\u0442\u0440\u043e\u0433\u043e \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430: \u0431\u043e\u043b\u0438 \u0432 \u043f\u0440\u0430\u0432\u043e\u043c \u043f\u043e\u0434\u0440\u0435\u0431\u0435\u0440\u044c\u0435, \u0436\u0435\u043b\u0442\u0443\u0445\u0435 \u043a\u043e\u0436\u043d\u044b\u0445 \u043f\u043e\u043a\u0440\u043e\u0432\u043e\u0432 \u0438 \u0432\u0438\u0434\u0438\u043c\u044b\u0445 \u0441\u043b\u0438\u0437\u0438\u0441\u0442\u044b\u0445, \u043b\u0438\u0445\u043e\u0440\u0430\u0434\u043a\u0435;<\/li>\n<li>\u043f\u0440\u0438 \u043d\u0430\u043b\u0438\u0447\u0438\u0438 \u0441\u0438\u043c\u043f\u0442\u043e\u043c\u043e\u0432 \u0445\u0440\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u043e\u0433\u043e \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430: \u0441\u043b\u0430\u0431\u043e\u0441\u0442\u0438, \u043f\u043e\u0442\u0435\u0440\u0435 \u0432\u0435\u0441\u0430, \u0430\u043d\u043e\u0440\u0435\u043a\u0441\u0438\u0438, \u0436\u0435\u043b\u0442\u0443\u0445\u0430 \u0432 \u0430\u043d\u0430\u043c\u043d\u0435\u0437\u0435, \u0443\u043c\u0435\u0440\u0435\u043d\u043d\u044b\u0439 \u043a\u043e\u0436\u043d\u044b\u0439 \u0437\u0443\u0434, \u043a\u0440\u043e\u0432\u043e\u0442\u043e\u0447\u0438\u0432\u043e\u0441\u0442\u044c \u0434\u0435\u0441\u0435\u043d, \u043d\u043e\u0441\u043e\u0432\u044b\u0435 \u043a\u0440\u043e\u0432\u043e\u0442\u0435\u0447\u0435\u043d\u0438\u044f, \u0430\u0440\u0442\u0440\u0430\u043b\u0433\u0438\u0438, \u043c\u0438\u0430\u043b\u0433\u0438\u0438;<\/li>\n<li>\u043f\u0440\u0438 \u043d\u0430\u043b\u0438\u0447\u0438\u0438 \u0441\u0438\u043c\u043f\u0442\u043e\u043c\u043e\u0432 \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u043e\u0433\u043e \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430: \u0430\u0440\u0442\u0440\u0430\u043b\u0433\u0438\u0438, \u043c\u0438\u0430\u043b\u0433\u0438\u0438, \u0443\u043c\u0435\u0440\u0435\u043d\u043d\u044b\u0435 \u0431\u043e\u043b\u0438 \u0432 \u0436\u0438\u0432\u043e\u0442\u0435, \u0431\u043e\u043b\u0438 \u0432 \u0433\u0440\u0443\u0434\u043d\u043e\u0439 \u043a\u043b\u0435\u0442\u043a\u0435, \u0430\u043c\u0435\u043d\u043e\u0440\u0435\u044f, \u0433\u0438\u0440\u0441\u0443\u0442\u0438\u0437\u043c;<\/li>\n<li>\u043f\u0440\u0438 \u043d\u0430\u043b\u0438\u0447\u0438\u0438 \u0441\u0438\u043c\u043f\u0442\u043e\u043c\u043e\u0432 \u043f\u0435\u0440\u0432\u0438\u0447\u043d\u043e\u0433\u043e \u0431\u0438\u043b\u0438\u0430\u0440\u043d\u043e\u0433\u043e \u0446\u0438\u0440\u0440\u043e\u0437\u0430: \u0443\u0442\u043e\u043c\u043b\u044f\u0435\u043c\u043e\u0441\u0442\u044c, \u0441\u043b\u0430\u0431\u043e\u0441\u0442\u044c, \u043a\u043e\u0436\u043d\u044b\u0439 \u0437\u0443\u0434, \u0436\u0435\u043b\u0442\u0443\u0445\u0430, \u0433\u0435\u043f\u0430\u0442\u043e\u043c\u0435\u0433\u0430\u043b\u0438\u044f, \u0441\u043f\u043b\u0435\u043d\u043e\u043c\u0435\u0433\u0430\u043b\u0438\u044f, \u0443\u0432\u0435\u043b\u0438\u0447\u0435\u043d\u0438\u0435 \u0443\u0440\u043e\u0432\u043d\u0435\u0439 \u0410\u041b\u0422, \u0410\u0421\u0422, \u0449\u0435\u043b\u043e\u0447\u043d\u043e\u0439 \u0444\u043e\u0441\u0444\u0430\u0442\u0430\u0437\u044b \u0432 \u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0435 \u043a\u0440\u043e\u0432\u0438;<\/li>\n<li>\u043f\u0440\u0438 \u0443\u0432\u0435\u043b\u0438\u0447\u0435\u043d\u0438\u0438 \u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u0438 \u043f\u0435\u0447\u0435\u043d\u043e\u0447\u043d\u044b\u0445 \u0444\u0435\u0440\u043c\u0435\u043d\u0442\u043e\u0432: \u0410\u041b\u0422, \u0410\u0421\u0422, \u0449\u0435\u043b\u043e\u0447\u043d\u043e\u0439 \u0444\u043e\u0441\u0444\u0430\u0442\u0430\u0437\u044b, \u0433\u0430\u043c\u043c\u0430-\u0433\u043b\u044e\u0442\u0430\u043c\u0438\u043b\u0442\u0440\u0430\u043d\u043f\u0435\u043f\u0442\u0438\u0434\u0430\u0437\u044b;<\/li>\n<li>\u043f\u0440\u0438 \u043d\u0430\u043b\u0438\u0447\u0438\u0438 \u0434\u0440\u0443\u0433\u043e\u0433\u043e \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u043e\u0433\u043e \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f \u0438 \u043f\u043e\u0434\u043e\u0437\u0440\u0435\u043d\u0438\u0438 \u043d\u0430 \u0441\u043e\u0447\u0435\u0442\u0430\u043d\u0438\u0435 \u043d\u0435\u0441\u043a\u043e\u043b\u044c\u043a\u0438\u0445 \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u044b\u0445 \u043f\u0430\u0442\u043e\u043b\u043e\u0433\u0438\u0439, \u043d\u0430\u043b\u0438\u0447\u0438\u0438 &#8220;\u043f\u0435\u0440\u0435\u043a\u0440\u0435\u0441\u0442\u043d\u044b\u0445&#8221; \u0441\u0438\u043d\u0434\u0440\u043e\u043c\u043e\u0432.<\/li>\n<\/ul>\n<p><strong id=\"subj3\" class=\"subj-header\">\u041a\u0430\u043a \u043f\u0440\u0430\u0432\u0438\u043b\u044c\u043d\u043e \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?<\/strong><\/p>\n<ul>\n<li>\u041d\u0435 \u043a\u0443\u0440\u0438\u0442\u044c \u0432 \u0442\u0435\u0447\u0435\u043d\u0438\u0435 30 \u043c\u0438\u043d\u0443\u0442 \u0434\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f.<\/li>\n<\/ul>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[931],"product_tag":[],"class_list":{"0":"post-12094","1":"product","2":"type-product","3":"status-publish","5":"product_cat-markeri-pentru-afectiuni-hepatice-si-gastrointestinale-autoimune","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\/12094","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=12094"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=12094"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=12094"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=12094"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=12094"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}