{"id":9242,"date":"2020-04-23T04:32:24","date_gmt":"2020-04-23T01:32:24","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/fosfor-seric\/"},"modified":"2026-02-19T01:15:31","modified_gmt":"2026-02-18T23:15:31","slug":"fosfor-seric","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/fosfor-seric\/","title":{"rendered":"\u0424\u043e\u0441\u0444\u043e\u0440 \u0432 \u043a\u0440\u043e\u0432\u0438"},"content":{"rendered":"

Sinonime <\/em><\/strong>- <\/em>fosfat seric, fosfor anorganic7<\/sup>.<\/p>\n

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

Dupa calciu, fosforul este cel mai abundent element mineral din organism, aflandu-se in orice tesut. Fosforul reprezinta 1% din greutatea corpului, ceea ce inseamna ca in organismul unui adult se gasesc cca. 600-700 g P sub forma de diversi fosfati anorganici si organici. Din aceasta cantitate 85% intra in constitutia scheletului, 6% in muschi, iar 9% in nervi si sange. Aproximativ 70% din fosforul din sange este prezent in forma organica, in principal fosfolipide, restul fiind fosfor anorganic, sub forma de ortofosfati (H2<\/sub>PO4<\/sub>-<\/sup>, HPO4<\/sub>2-<\/sup>), care rezulta din ionizarea secventiala a acidului fosforic7<\/sup>.<\/p>\n

Fosfatul este anionul intracelular principal; in celula, fosforul este in principal implicat sub forma de fosfor organic in metabolismul glucidic si lipidic sau este legat de proteine si doar o mica parte este prezenta ca ion fosfat7<\/sup>.<\/p>\n

Conditiile care faciliteaza legarea organica a fosforului implica transportul ionilor fosfati din spatiul extra- in cel intracelular; astfel eliberarea de insulina indusa de glucoza induce transportul glucozei si ionilor fosfati in celulele musculare si hepatice7<\/sup>.<\/p>\n

Fosforul intra in compozitia oaselor si a dintilor, este unul din constituentii acizilor nucleici, nucleoproteinelor, fosfolipidelor din membranele celulare; este de asemenea implicat in mentinerea echilibrului acido-bazic, in stocarea si transferul de energie1<\/sup>, in procese enzimatice, stimuleaza contractia musculara si este necesar pentru mentinerea\u00a0 activitatii neuronale3<\/sup>.<\/p>\n

Fosfatul este prezent in multe produse alimentare (carne, vegetale), absorbtia intestinala a fosforului depinzand linear de aportul de fosfat si numai o mica parte este absorbita activ, dependenta de 1,25(OH)2<\/sub>\u04133<\/sub> [mecanism care devine important in cazurile asociate cu nivel crescut de 1,25(OH)2<\/sub>\u04133<\/sub>]. Rinichii sunt principalii reglatori ai homeostaziei fosforului; aproximativ 80% din cantitatea filtrata glomerular este reabsorbita in tubii proximali si 10% in tubii distali. Fosfatul este transportat de doi cotransporteri Na+<\/sup>\/fosfat prin marginea in perie a membranei tubilor renali. PTH faciliteaza excretia renala a fosfatului prin inhibarea transportului Na-dependent. Alti hormoni joaca de asemenea un rol in reglarea transportului fosfatului: hormonul de crestere, IGF1, insulina, hormonii tiroidieni, 1,25(OH)2<\/sub>\u04133<\/sub> reduc excretia fosfatului; calcitonina, factorul natriuretic atrial, EGF, TGF-\u03b1, glucocorticoizii cresc efectul excretor7<\/sup>.<\/p>\n

Recomandari pentru determinarea fosforului seric <\/em><\/strong>\u2013 boli osoase, boli renale cronice, pacienti dializati, status posttiroidectomie, boli paratiroidiene, nefrolitiaza, alcoolism cronic, pacienti care necesita ingrijiri medicale intensive (nutritie parenterala, ventilatie mecanica), suspiciune de deficit de vitamina D (sindroame de malabsorbtie), slabiciune musculara7<\/sup>.<\/p>\n

Nivelurile de fosfor seric trebuie evaluate intotdeauna impreuna cu cele ale calciului, deoarece exista o relatie inversa intre cele 2 elemente: cresterea unuia din cei doi electroliti in sange determina cresterea excretiei urinare a celuilalt electrolit. Multe din cauzele care cresc nivelul calciului determina de asemenea scaderea nivelului fosforului1<\/sup>.<\/p>\n

Pregatire pacient <\/em><\/strong>-<\/em> \u00e0 jeun (pe nemancate).! Postprandial nivelul de fosfat seric creste5<\/sup>.<\/p>\n

Specimen recoltat <\/em><\/strong>- <\/em>sange venos; se va evita staza cu garoul5<\/sup>.\u00a0<\/em><\/strong><\/p>\n

Recipient de recoltare <\/em><\/strong>-<\/em> vacutainer fara anticoagulant cu\/fara gel separator5<\/sup>.<\/p>\n

Prelucrare necesara dupa recoltare <\/em><\/strong>- <\/em>se separa serul prin centrifugare5<\/sup>.<\/p>\n

Volum proba<\/em><\/strong> \u2013 minim 0.5 mL ser5<\/sup><\/p>\n

Cauze de respingere a probei <\/em><\/strong>-<\/em> specimen hemolizat5<\/sup>.<\/p>\n

Stabilitate proba <\/em><\/strong>- <\/em>serul separat este stabil 24 ore<\/em> la temperatura camerei; 7 zile<\/em> la 2-8\u00baC; 1 an<\/em> la -20\u00baC5<\/sup>.<\/p>\n

Metoda<\/em><\/strong> -<\/em> spectrofotometrica (colorimetrica)<\/span>5<\/sup><\/span>.<\/span><\/p>\n

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

Valori de referin\u0163\u0103<\/em><\/strong> \u2013 sunt \u00een functie de varsta\u00a0si sex5<\/sup>:<\/p>\n

Femei:<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
\u0412\u043e\u0437\u0440\u0430\u0441\u0442<\/em><\/strong><\/td>\nValori (mg\/dL)<\/em><\/strong><\/td>\n<\/tr>\n
<1 lun\u0103<\/td>\n4.3-7.7<\/td>\n<\/tr>\n
1-12 luni<\/td>\n3.7-6.5<\/td>\n<\/tr>\n
1-3 ani<\/td>\n3.4-6.0<\/td>\n<\/tr>\n
4-6 ani<\/td>\n3.2-5.5<\/td>\n<\/tr>\n
7-9 ani<\/td>\n3.1-5.5<\/td>\n<\/tr>\n
10-12 ani<\/td>\n3.3-5.3<\/td>\n<\/tr>\n
13-15 ani<\/td>\n2.8-4.8<\/td>\n<\/tr>\n
16-18 ani<\/td>\n2.5-4.8<\/td>\n<\/tr>\n
Adult<\/td>\n2.5-4.5<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Barbati:<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
\u0412\u043e\u0437\u0440\u0430\u0441\u0442<\/em><\/strong><\/td>\nValori (mg\/dL)<\/em><\/strong><\/td>\n<\/tr>\n
<1 lun\u0103<\/td>\n3.9-6.9<\/td>\n<\/tr>\n
1-12 luni<\/td>\n3.5-6.6<\/td>\n<\/tr>\n
1-3 ani<\/td>\n3.1-6.0<\/td>\n<\/tr>\n
4-6 ani<\/td>\n3.3-5.6<\/td>\n<\/tr>\n
7-9 ani<\/td>\n3.0-5.4<\/td>\n<\/tr>\n
10-12 ani<\/td>\n3.2-5.7<\/td>\n<\/tr>\n
13-15 ani<\/td>\n2.9-5.1<\/td>\n<\/tr>\n
16-18 ani<\/td>\n2.7-4.9<\/td>\n<\/tr>\n
Adult<\/td>\n2.5-4.5<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u00a0Factor de conversie: mg\/dL x 0.323 = mmol \/L<\/em><\/p>\n

Limita de detectie<\/em><\/strong> - <\/em>0.3 mg\/dL (0.1 mmol\/L)5<\/sup>.\u00a0<\/em><\/p>\n

Valori critice <\/em><\/strong>- <\/em>nivel scazut: < 1 mg\/<\/em>dL<\/strong>; nivel crescut: > 9 mg\/<\/em>dL<\/strong><\/p>\n

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

Cresteri<\/em><\/strong><\/p>\n<\/td>\n

\n

Scaderi<\/em><\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

\u2022 insuficienta renala acuta si cronica (cea mai frecventa cauza); \u2022 hipoparatiroidism; \u2022 pseudohipoparatiroidism; \u2022 hipervitaminoza D;<\/p>\n

\u2022 sindrom lapte-alcaline; \u2022 sindrom acut de liza tumorala, \u2022 sindrom de strivire; \u2022 acidoza metabolica;<\/p>\n

\u2022 cetoacidoza diabetica (inaintea inceperii tratamentului cu insulina); \u2022 majoritatea cazurilor de hipocalcemie; \u2022 metastaze osteolitice (unii pacienti);<\/p>\n

\u2022 fracturi osoase in curs de vindecare; \u2022 sarcoidoza;<\/p>\n

\u2022 acromegalie; \u2022 boala Adisson; \u2022 hipertiroidism1;4<\/sup>;7<\/sup>.<\/p>\n<\/td>\n

\n

\u2022 atleti de performanta, bodybuilding;<\/p>\n

\u2022 hiperparatiroidism primar; \u2022 carente de vitamina D (rahitism la copil si osteomalacie la adult);<\/p>\n

\u2022 cetoacidoza diabetica (rehidratarea si administrarea de insulina induc fluxul intracelular); \u2022hiperinsulinism; \u2022 alcoolism; \u2022 malabsorbtie, varsaturi si diaree severe; \u2022 reluarea aportului alimentar dupa o perioada de post; \u2022 tratament cu antiacide pe baza de hidroxid de aluminiu; \u2022 arsuri severe; \u2022 septicemie cu germeni Gram negativi; \u2022 hipercalcemie de diverse etiologii;<\/p>\n

\u2022 alcaloza respiratorie; \u2022 osteomalacie oncogenica hipofosfatemica; \u2022 hipofosfatemie familiala; \u2022 sindrom Fanconi; \u2022 hipercalciurie idiopatica1;4<\/sup>;7<\/sup>.<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

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

\u2022 Conditii fiziologice: in mod normal nivelurile de fosfor sunt crescute la copii; exista de asemenea variatii sezoniere (maxime in lunile mai-iunie, minime in lunile de iarna)4<\/sup> si circadiene (maxime dimineata si minime seara)1<\/sup> ale concentratiei de fosfor. Stres-ul creste nivelul seric al fosforului1<\/sup>.<\/p>\n

\u2022 Conditii patologice: unele persoane cu malnutritie severa pot prezenta hipofosfatemie; administrarea intravenoasa de glucoza si de fluide in exces, hiperalimentatia, dializa pot determina de asemenea hipofosfatemie1;6<\/sup>. Hipofosfatemia usoara este frecventa la pacientii spitalizati si este intalnita la 30% din pacientii chirurgicali7<\/sup>. Laxativele orale si clismele cu fosfat de sodiu cresc nivelul fosforului1<\/sup>. Trombocitoza se asociaza cu cresterea concentratiei fosforului7<\/sup>.<\/p>\n

\u2022 Medicamente<\/p>\n

Cresteri<\/strong><\/span>: steroizi anabolizanti, androgeni, blocanti beta adrenergici (acebutolol, pindolol), eritropoietina, ergocalciferol, furosemid, hormon de crestere, hidrocloratiazida, meticilina (nefrotoxicitate), fosfati, etidronat de sodiu, tetraciclina (nefrotoxicitate), tacrolimus, vitamina D2<\/sup>.<\/p>\n

Scaderi<\/strong><\/span>: acetazolamida, albuterol, antiacide care contin aluminiu, aminoacizi, anestezice, calcitonina, carbamazepin, epinefrina, estramustin, estrogeni, glucocorticoizi, hidroclorotiazida (tratament prelungit), ifosfamida, insulina, izoniazida, contraceptive orale, fenitoina, sucralfat2<\/sup>.<\/p>\n

\u2022 Interferente analitice<\/p>\n

Hemoliza poate determina valori fals crescute1;5<\/sup>.\u00a0<\/strong><\/p>\n

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

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

1. Frances Fischbach. Pulmonary Function, ANGs and Electrolyte Studies. In A Manual of Laboratory and Diagnostic Tests. Lippincott Williams & Wilkins, USA, 8 Ed., 2009, 999-1001.<\/span><\/p>\n

2. Frances Fischbach. Effects of the Drugs on Laboratory Tests. In A Manual of Laboratory and Diagnostic Tests. Lippincott Williams & Wilkins, USA, 8 Ed., 2009, 1247.<\/span><\/p>\n

3. Iulian Mincu, Aurora Popescu, C.Ionescu Tirgoviste. Elemente de biochimie si fiziologie a nutritiei, 1985.<\/span><\/p>\n

4. Jacques Wallach. Analizele de sange. In Interpretarea testelor de diagnostic. Editura Stiintelor Medicale, Romania, 7 Ed., 2001, 76-78.<\/span><\/p>\n

5. Laborator Synevo. Referintele specifice tehnologiei de lucru utilizate 2015. Ref Type: Catalog.<\/span><\/p>\n

6. Laboratory Corporation of America. Directory of Services and Interpretive Guide. Phosphorus, Serum. www.labcorp.com 2015. Ref Type: Internet Communication.<\/span><\/p>\n

7. Lothar Thomas. Bone and Mineral Metabolism. In Clinical Laboratory Diagnostics-Use and Assessment of Clinical Laboratory Results. TH-Books Verlagsgesellschaft mbH, Frankfurt \/Main, Germany, 1 Ed., 1998, 241-244.<\/span><\/p>","protected":false},"excerpt":{"rendered":"

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\u0424\u043e\u0441\u0444\u043e\u0440 \u0443\u0447\u0430\u0441\u0442\u0432\u0443\u0435\u0442 \u0432 \u043e\u0431\u0440\u0430\u0437\u043e\u0432\u0430\u043d\u0438\u0438 \u043d\u0443\u043a\u043b\u0435\u0438\u043d\u043e\u0432\u044b\u0445 \u043a\u0438\u0441\u043b\u043e\u0442, \u043d\u0443\u043a\u043b\u0435\u043e\u0442\u0438\u0434\u043e\u0432, \u0444\u043e\u0441\u0444\u043e\u043b\u0438\u043f\u0438\u0434\u043e\u0432 \u0438 \u0434\u0440\u0443\u0433\u0438\u0445 \u0441\u043e\u0435\u0434\u0438\u043d\u0435\u043d\u0438\u0439, \u0443\u0447\u0430\u0441\u0442\u0432\u0443\u0435\u0442 \u0432 \u0437\u0430\u043f\u0430\u0441\u0430\u043d\u0438\u0438 \u0438 \u043f\u0435\u0440\u0435\u0434\u0430\u0447\u0435 \u044d\u043d\u0435\u0440\u0433\u0438\u0438, \u0432 \u0444\u0435\u0440\u043c\u0435\u043d\u0442\u0430\u0442\u0438\u0432\u043d\u044b\u0445 \u043f\u0440\u043e\u0446\u0435\u0441\u0441\u0430\u0445, \u0441\u0442\u0438\u043c\u0443\u043b\u0438\u0440\u0443\u0435\u0442 \u0441\u043e\u043a\u0440\u0430\u0449\u0435\u043d\u0438\u0435 \u043c\u044b\u0448\u0446 \u0438 \u043d\u0435\u043e\u0431\u0445\u043e\u0434\u0438\u043c \u0434\u043b\u044f \u043f\u043e\u0434\u0434\u0435\u0440\u0436\u0430\u043d\u0438\u044f \u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u0438 \u043d\u0435\u0439\u0440\u043e\u043d\u043e\u0432. \u041a\u043e\u043d\u0446\u0435\u043d\u0442\u0440\u0430\u0446\u0438\u044f \u0444\u043e\u0441\u0444\u043e\u0440\u0430 \u043d\u0438\u0436\u0435 0,3 \u043c\u043c\u043e\u043b\u044c\/\u043b \u0432\u0435\u0434\u0435\u0442 \u043a \u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u044e \u044d\u043d\u0435\u0440\u0433\u0435\u0442\u0438\u0447\u0435\u0441\u043a\u043e\u0433\u043e \u043e\u0431\u043c\u0435\u043d\u0430 \u043a\u043b\u0435\u0442\u043e\u043a. \u0424\u043e\u0441\u0444\u043e\u0440 \u0441\u043e\u0441\u0442\u0430\u0432\u043b\u044f\u0435\u0442 1% \u043e\u0442 \u043c\u0430\u0441\u0441\u044b \u0442\u0435\u043b\u0430, \u0438\u0437 \u044d\u0442\u043e\u0439 \u0441\u0443\u043c\u043c\u044b 85% \u0432\u0445\u043e\u0434\u0438\u0442 \u0432 \u0441\u043e\u0441\u0442\u0430\u0432 \u0441\u043a\u0435\u043b\u0435\u0442\u0430, 6% — \u0432 \u043c\u044b\u0448\u0446\u044b \u0438 9% – \u043d\u0435\u0440\u0432\u044b \u0438 \u043a\u0440\u043e\u0432\u044c. \u041e\u0441\u043d\u043e\u0432\u043d\u044b\u0435 \u0440\u0435\u0433\u0443\u043b\u0438\u0440\u0443\u044e\u0449\u0438\u0435 \u0444\u043e\u0441\u0444\u043e\u0440\u043d\u044b\u0439 \u043e\u0431\u043c\u0435\u043d \u0444\u0430\u043a\u0442\u043e\u0440\u044b: \u043f\u0430\u0440\u0430\u0442\u0433\u043e\u0440\u043c\u043e\u043d (\u0441\u043d\u0438\u0436\u0430\u0435\u0442 \u0443\u0440\u043e\u0432\u0435\u043d\u044c \u0444\u043e\u0441\u0444\u043e\u0440\u0430 \u043f\u043e\u0441\u0440\u0435\u0434\u0441\u0442\u0432\u043e\u043c \u0430\u043a\u0442\u0438\u0432\u0430\u0446\u0438\u0438 \u0435\u0433\u043e \u0432\u044b\u0432\u0435\u0434\u0435\u043d\u0438\u044f \u043f\u043e\u0447\u043a\u0430\u043c\u0438); 1,25(\u041e\u041d)2D (\u043f\u043e\u0432\u044b\u0448\u0430\u0435\u0442 \u0443\u0440\u043e\u0432\u0435\u043d\u044c \u0444\u043e\u0441\u0444\u043e\u0440\u0430 \u043f\u043e\u0441\u0440\u0435\u0434\u0441\u0442\u0432\u043e\u043c \u0430\u043a\u0442\u0438\u0432\u0430\u0446\u0438\u0438 \u0432\u0441\u0430\u0441\u044b\u0432\u0430\u043d\u0438\u044f \u0444\u043e\u0441\u0444\u0430\u0442\u043e\u0432 \u0432 \u043a\u0438\u0448\u0435\u0447\u043d\u0438\u043a\u0435); \u043a\u0430\u043b\u044c\u0446\u0438\u0442\u043e\u043d\u0438\u043d (\u0433\u0438\u043f\u043e\u0444\u043e\u0441\u0444\u0430\u0442\u0435\u043c\u0438\u0447\u0435\u0441\u043a\u043e\u0435 \u0434\u0435\u0439\u0441\u0442\u0432\u0438\u0435); \u0438\u043d\u0441\u0443\u043b\u0438\u043d (\u0441\u043d\u0438\u0436\u0430\u0435\u0442 \u0443\u0440\u043e\u0432\u0435\u043d\u044c \u0444\u043e\u0441\u0444\u043e\u0440\u0430 \u043f\u0443\u0442\u0435\u043c \u0441\u0442\u0438\u043c\u0443\u043b\u044f\u0446\u0438\u0438 \u043f\u0435\u0440\u0435\u043d\u043e\u0441\u0430 \u0444\u043e\u0441\u0444\u0430\u0442\u0430 \u0432 \u043a\u043b\u0435\u0442\u043a\u0438); \u043f\u043e\u0441\u0442\u0443\u043f\u043b\u0435\u043d\u0438\u0435 \u0444\u043e\u0441\u0444\u0430\u0442\u0430 \u0441 \u043f\u0438\u0449\u0435\u0439 \u0438 \u0432\u044b\u0432\u0435\u0434\u0435\u043d\u0438\u0435 \u0435\u0433\u043e \u043f\u043e\u0447\u043a\u0430\u043c\u0438 (\u043e\u043a\u043e\u043b\u043e 80% \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0430, \u043f\u0440\u043e\u0448\u0435\u0434\u0448\u0435\u0433\u043e \u043a\u043b\u0443\u0431\u043e\u0447\u043a\u043e\u0432\u0443\u044e \u0444\u0438\u043b\u044c\u0442\u0440\u0430\u0446\u0438\u044e, \u043f\u043e\u0433\u043b\u043e\u0449\u0430\u0435\u0442\u0441\u044f \u0432 \u043f\u0440\u043e\u043a\u0441\u0438\u043c\u0430\u043b\u044c\u043d\u044b\u0445 \u043e\u0442\u0434\u0435\u043b\u0430\u0445 \u043a\u0430\u043d\u0430\u043b\u044c\u0446\u0435\u0432 \u0438 10% – \u0432 \u0434\u0438\u0441\u0442\u0430\u043b\u044c\u043d\u044b\u0445 \u043e\u0442\u0434\u0435\u043b\u0430\u0445 \u043a\u0430\u043d\u0430\u043b\u044c\u0446\u0435\u0432).<\/p>\n

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

\u041f\u0440\u0438 \u0440\u0430\u0445\u0438\u0442\u0435 \u0443 \u0434\u0435\u0442\u0435\u0439 \u044d\u0442\u043e \u0441\u043e\u043e\u0442\u043d\u043e\u0448\u0435\u043d\u0438\u0435 \u043f\u043e\u0432\u044b\u0448\u0430\u0435\u0442\u0441\u044f \u0434\u043e 3 \u0438 \u0431\u043e\u043b\u0435\u0435.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\u041f\u043e\u043a\u0430\u0437\u0430\u0442\u0435\u043b\u044c<\/b><\/td>\n\u0425\u0430\u0440\u0430\u043a\u0442\u0435\u0440\u0438\u0441\u0442\u0438\u043a\u0430<\/b><\/td>\n<\/tr>\n
\u041c\u0430\u0442\u0435\u0440\u0438\u0430\u043b<\/b><\/td>\n\u0412\u0435\u043d\u043e\u0437\u043d\u0430\u044f\u00a0\u043a\u0440\u043e\u0432\u044c<\/td>\n<\/tr>\n
\u041f\u0440\u0430\u0432\u0438\u043b\u0430\u00a0\u043f\u043e\u0434\u0433\u043e\u0442\u043e\u0432\u043a\u0438\u00a0\u043f\u0430\u0446\u0438\u0435\u043d\u0442\u0430<\/b><\/td>\n\u0421\u0442\u0430\u043d\u0434\u0430\u0440\u0442\u043d\u044b\u0435<\/td>\n<\/tr>\n
\u0422\u0440\u0430\u043d\u0441\u043f\u043e\u0440\u0442\u043d\u0430\u044f\u00a0\u0441\u0440\u0435\u0434\u0430,\u00a0\u043f\u0440\u043e\u0431\u0438\u0440\u043a\u0430<\/b><\/td>\n\u0412\u0430\u043a\u0443\u0442\u0430\u0439\u043d\u0435\u0440\u00a0\u0441\/\u0431\u0435\u0437\u00a0\u0430\u043d\u0442\u0438\u043a\u043e\u0430\u0433\u0443\u043b\u044f\u043d\u0442\u0430\u00a0\u0441\/\u0431\u0435\u0437\u00a0\u0433\u0435\u043b\u0435\u0432\u043e\u0439\u00a0\u0444\u0430\u0437\u044b<\/td>\n<\/tr>\n
\u041f\u0440\u0430\u0432\u0438\u043b\u0430\u00a0\u0438\u00a0\u0443\u0441\u043b\u043e\u0432\u0438\u044f\u00a0\u0442\u0440\u0430\u043d\u0441\u043f\u043e\u0440\u0442\u0438\u0440\u043e\u0432\u043a\u0438,\u00a0\u0441\u0442\u0430\u0431\u0438\u043b\u044c\u043d\u043e\u0441\u0442\u044c\u00a0\u043f\u0440\u043e\u0431\u044b<\/b><\/td>\n\u0421\u0442\u0430\u043d\u0434\u0430\u0440\u0442\u043d\u044b\u0435<\/td>\n<\/tr>\n
\u041c\u0435\u0442\u043e\u0434\u00a0\u0442\u0435\u0441\u0442\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u044f<\/b><\/td>\n\u0421\u043f\u0435\u043a\u0442\u0440\u043e\u0444\u043e\u0442\u043e\u043c\u0435\u0442\u0440\u0438\u0447\u0435\u0441\u043a\u0438\u0439<\/td>\n<\/tr>\n
<\/td>\n<\/td>\n<\/tr>\n
 <\/p>\n

 <\/td>\n<\/tr>\n

<\/td>\n<\/td>\n<\/tr>\n
\u0418\u043d\u0442\u0435\u0440\u0444\u0435\u0440\u0438\u0440\u0443\u044e\u0449\u0438\u0435\u00a0\u0444\u0430\u043a\u0442\u043e\u0440\u044b.\u00a0\u041c\u0435\u0434\u0438\u043a\u0430\u043c\u0435\u043d\u0442\u044b<\/b><\/td>\n<\/tr>\n
\u041f\u043e\u0432\u044b\u0448\u0430\u044e\u0442<\/b><\/td>\n\u0421\u043d\u0438\u0436\u0430\u044e\u0442<\/b><\/td>\n<\/tr>\n
\u0421\u043e\u043c\u0430\u0442\u043e\u0442\u0440\u043e\u043f\u043d\u044b\u0439\u00a0\u0433\u043e\u0440\u043c\u043e\u043d,\u00a0\u0430\u043d\u0434\u0440\u043e\u0433\u0435\u043d\u044b,\u00a0\u044d\u0441\u0442\u0440\u043e\u0433\u0435\u043d\u044b,<\/p>\n

\u0430\u043d\u0430\u0431\u043e\u043b\u0438\u0447\u0435\u0441\u043a\u0438\u0435\u00a0\u0441\u0442\u0435\u0440\u043e\u0438\u0434\u044b,\u00a0\u0444\u043e\u0441\u0444\u0430\u0442\u044b,\u00a0\u0432\u0438\u0442\u0430\u043c\u0438\u043d\u00a0D,\u00a0\u0431\u0435\u0442\u0430-\u0430\u0434\u0440\u0435\u043d\u043e\u0431\u043b\u043e\u043a\u0430\u0442\u043e\u0440\u044b,\u00a0\u0433\u0438\u0434\u0440\u043e\u0445\u043b\u043e\u0440\u0442\u0438\u0430\u0437\u0438\u0434,\u00a0\u0442\u0435\u0442\u0440\u0430\u0446\u0438\u043a\u043b\u0438\u043d,<\/p>\n

\u0444\u0443\u0440\u043e\u0441\u0435\u043c\u0438\u0434,\u00a0\u0446\u0438\u0442\u043e\u0441\u0442\u0430\u0442\u0438\u043a\u0438<\/td>\n

\u0410\u0434\u0440\u0435\u043d\u0430\u043b\u0438\u043d,\u00a0\u0430\u043b\u044e\u043c\u0438\u043d\u0438\u0439\u0441\u043e\u0434\u0435\u0440\u0436\u0430\u0449\u0438\u0435\u00a0\u0430\u043d\u0442\u0430\u0446\u0438\u0434\u044b,\u00a0\u0430\u043d\u0435\u0441\u0442\u0435\u0442\u0438\u043a\u0438,\u00a0\u0433\u043b\u044e\u043a\u043e\u0437\u0430,<\/p>\n

\u0433\u043b\u044e\u043a\u043e\u043a\u043e\u0440\u0442\u0438\u043a\u043e\u0438\u0434\u044b, \u0438\u0437\u043e\u043d\u0438\u0430\u0437\u0438\u0434,\u00a0\u043f\u0440\u0438\u00a0\u043f\u0440\u043e\u0434\u043e\u043b\u0436\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u043c\u00a0\u043f\u0440\u0438\u043c\u0435\u043d\u0435\u043d\u0438\u0438\u00a0—\u00a0\u0433\u0438\u0434\u0440\u043e\u0445\u043b\u043e\u0440\u0442\u0438\u0430\u0437\u0438\u0434,\u00a0\u0438\u043d\u0441\u0443\u043b\u0438\u043d,\u00a0\u043f\u0435\u0440\u043e\u0440\u0430\u043b\u044c\u043d\u044b\u0435\u00a0\u043a\u043e\u043d\u0442\u0440\u0430\u0446\u0435\u043f\u0442\u0438\u0432\u044b,\u00a0\u0441\u0443\u043a\u0440\u0430\u043b\u044c\u0444\u0430\u0442,<\/p>\n

\u0438\u043d\u0444\u0443\u0437\u0438\u0438\u00a0\u0433\u043b\u044e\u043a\u043e\u0437\u044b,\u00a0\u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0430,\u00a0\u043a\u0430\u0442\u0435\u0445\u043e\u043b\u0430\u043c\u0438\u043d\u043e\u0432<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n\n\n\n\n
\u041f\u043e\u043a\u0430\u0437\u0430\u043d\u0438\u044f\u00a0\u043a\u00a0\u043d\u0430\u0437\u043d\u0430\u0447\u0435\u043d\u0438\u044e<\/b><\/td>\n<\/tr>\n
\u00b7\u00a0\u0417\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f\u00a0\u043a\u043e\u0441\u0442\u0435\u0439,\u00a0\u0442\u0440\u0430\u0432\u043c\u044b,\u00a0\u0440\u0430\u0445\u0438\u0442\u00a0\u0443\u00a0\u0434\u0435\u0442\u0435\u0439;<\/p>\n

\u00b7\u00a0\u043e\u0441\u0442\u0440\u044b\u0435\u00a0\u0438\u00a0\u0445\u0440\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u0435\u00a0\u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f\u00a0\u043f\u043e\u0447\u0435\u043a,\u00a0\u043f\u0430\u0446\u0438\u0435\u043d\u0442\u044b,\u00a0\u043d\u0430\u0445\u043e\u0434\u044f\u0449\u0438\u0435\u0441\u044f\u00a0\u043d\u0430\u00a0\u0434\u0438\u0430\u043b\u0438\u0437\u0435;<\/p>\n

\u00b7\u00a0\u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u044f\u00a0\u043f\u043e\u0441\u043b\u0435\u00a0\u0442\u0438\u0440\u0435\u043e\u0438\u0434\u044d\u043a\u0442\u043e\u043c\u0438\u0438,\u00a0\u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f\u00a0\u043f\u0430\u0440\u0430\u0449\u0438\u0442\u043e\u0432\u0438\u0434\u043d\u044b\u0445\u00a0\u0436\u0435\u043b\u0435\u0437;<\/p>\n

\u00b7\u00a0\u0445\u0440\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u0439\u00a0\u0430\u043b\u043a\u043e\u0433\u043e\u043b\u0438\u0437\u043c;<\/p>\n

\u00b7\u00a0\u043f\u0430\u0446\u0438\u0435\u043d\u0442\u044b,\u00a0\u043a\u043e\u0442\u043e\u0440\u044b\u0435\u00a0\u0442\u0440\u0435\u0431\u0443\u044e\u0442\u00a0\u0438\u043d\u0442\u0435\u043d\u0441\u0438\u0432\u043d\u043e\u0433\u043e\u00a0\u043c\u0435\u0434\u0438\u0446\u0438\u043d\u0441\u043a\u043e\u0433\u043e\u00a0\u043b\u0435\u0447\u0435\u043d\u0438\u044f\u00a0(\u0438\u043d\u0444\u0443\u0437\u0438\u043e\u043d\u043d\u0430\u044f\u00a0\u0442\u0435\u0440\u0430\u043f\u0438\u044f,\u00a0\u043f\u0430\u0440\u0435\u043d\u0442\u0435\u0440\u0430\u043b\u044c\u043d\u043e\u0435\u00a0\u043f\u0438\u0442\u0430\u043d\u0438\u0435,<\/p>\n

\u043c\u0435\u0445\u0430\u043d\u0438\u0447\u0435\u0441\u043a\u0430\u044f\u00a0\u0432\u0435\u043d\u0442\u0438\u043b\u044f\u0446\u0438\u044f);<\/p>\n

\u00b7\u00a0\u0433\u0438\u043f\u043e-,\u00a0\u0433\u0438\u043f\u0435\u0440\u0432\u0438\u0442\u0430\u043c\u0438\u043d\u043e\u0437\u00a0\u0414<\/td>\n<\/tr>\n

\u0418\u043d\u0442\u0435\u0440\u043f\u0440\u0435\u0442\u0430\u0446\u0438\u044f\u00a0\u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u043e\u0432<\/b><\/td>\n<\/tr>\n
\u041f\u043e\u0432\u044b\u0448\u0435\u043d\u0438\u0435\u00a0\u0443\u0440\u043e\u0432\u043d\u044f<\/b><\/td>\n\u0421\u043d\u0438\u0436\u0435\u043d\u0438\u0435\u00a0\u0443\u0440\u043e\u0432\u043d\u044f<\/b><\/td>\n<\/tr>\n
\u00b7\u00a0\u041d\u0435\u0437\u0430\u0432\u0435\u0440\u0448\u0435\u043d\u043d\u044b\u0439\u00a0\u043e\u0441\u0442\u0435\u043e\u043f\u043e\u0440\u043e\u0437;<\/p>\n

\u00b7\u00a0\u041e\u041f\u041d,\u00a0\u0425\u041f\u041d;<\/p>\n

\u00b7\u00a0\u043d\u0435\u043e\u043f\u043b\u0430\u0441\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0435\u00a0\u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f\u00a0(\u043b\u0435\u0439\u043a\u043e\u0437\u044b,\u00a0\u043b\u0438\u043c\u0444\u043e\u043c\u0430);<\/p>\n

\u00b7\u00a0\u043e\u0441\u0442\u0435\u043e\u043b\u0438\u0437\u00a0(\u043c\u0435\u0442\u0430\u0441\u0442\u0430\u0437\u044b\u00a0\u0432\u00a0\u043a\u043e\u0441\u0442\u0438);<\/p>\n

\u00b7\u00a0\u0441\u0430\u0440\u043a\u043e\u0438\u0434\u043e\u0437;<\/p>\n

\u00b7\u00a0\u0433\u0438\u043f\u043e\u043f\u0430\u0440\u0430\u0442\u0438\u0440\u0435\u043e\u0437,\u00a0\u043f\u0441\u0435\u0432\u0434\u043e\u0433\u0438\u043f\u043e\u043f\u0430\u0440\u0430\u0442\u0438\u0440\u0435\u043e\u0437,\u00a0\u0433\u0438\u043f\u0435\u0440\u0442\u0438\u0440\u0435\u043e\u0437;<\/p>\n

\u00b7\u00a0\u043a\u0435\u0442\u043e\u0430\u0446\u0438\u0434\u043e\u0437\u00a0\u043f\u0440\u0438\u00a0\u0441\u0430\u0445\u0430\u0440\u043d\u043e\u043c\u00a0\u0434\u0438\u0430\u0431\u0435\u0442\u0435,\u00a0\u043b\u0430\u043a\u0442\u043e\u0430\u0446\u0438\u0434\u043e\u0437,\u00a0\u0440\u0435\u0441\u043f\u0438\u0440\u0430\u0442\u043e\u0440\u043d\u044b\u0439\u00a0\u0430\u0446\u0438\u0434\u043e\u0437;<\/p>\n

\u00b7\u00a0\u0433\u0438\u043f\u0435\u0440\u0432\u0438\u0442\u0430\u043c\u0438\u043d\u043e\u0437\u00a0D;<\/p>\n

\u00b7\u00a0\u0430\u043a\u0440\u043e\u043c\u0435\u0433\u0430\u043b\u0438\u044f;<\/p>\n

\u00b7\u00a0\u043f\u043e\u0440\u0442\u0430\u043b\u044c\u043d\u044b\u0439\u00a0\u0446\u0438\u0440\u0440\u043e\u0437;<\/p>\n

\u00b7\u00a0\u0437\u0430\u0436\u0438\u0432\u043b\u0435\u043d\u0438\u0435\u00a0\u043f\u0435\u0440\u0435\u043b\u043e\u043c\u043e\u0432\u00a0\u043a\u043e\u0441\u0442\u0435\u0439\u00a0(\u043e\u0431\u0440\u0430\u0437\u043e\u0432\u0430\u043d\u0438\u0435\u00a0\u043a\u043e\u0441\u0442\u043d\u043e\u0439\u00a0\u00ab\u043c\u043e\u0437\u043e\u043b\u0438\u00bb);<\/p>\n

\u00b7\u00a0\u0442\u043e\u043a\u0441\u0438\u043a\u043e\u0437\u00a0\u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u044b\u0445;<\/p>\n

\u00b7\u00a0\u0441\u043f\u0430\u0437\u043c\u043e\u0444\u0438\u043b\u0438\u044f;<\/p>\n

\u00b7\u00a0\u0443\u0441\u0438\u043b\u0435\u043d\u043d\u0430\u044f\u00a0\u043c\u044b\u0448\u0435\u0447\u043d\u0430\u044f\u00a0\u043d\u0430\u0433\u0440\u0443\u0437\u043a\u0430;<\/p>\n

\u00b7\u00a0\u043f\u0435\u0440\u0435\u0434\u043e\u0437\u0438\u0440\u043e\u0432\u043a\u0430\u00a0\u0423\u0424-\u043e\u0431\u043b\u0443\u0447\u0435\u043d\u0438\u044f<\/td>\n

\u00b7\u00a0\u041d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u0435\u00a0\u0432\u0441\u0430\u0441\u044b\u0432\u0430\u043d\u0438\u044f\u00a0\u0432\u00a0\u043a\u0438\u0448\u0435\u0447\u043d\u0438\u043a\u0435\u00a0(\u0434\u0435\u0444\u0438\u0446\u0438\u0442\u00a0\u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430\u00a0\u0414<\/p>\n

,\u00a0\u043c\u0430\u043b\u044c\u0430\u0431\u0441\u043e\u0440\u0431\u0446\u0438\u044f,\u00a0\u0445\u0440\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u0439\u00a0\u0430\u043b\u043a\u043e\u0433\u043e\u043b\u0438\u0437\u043c,\u00a0\u0433\u043e\u043b\u043e\u0434\u0430\u043d\u0438\u0435,\u00a0\u0441\u0442\u0435\u0430\u0442\u043e\u0440\u0435\u044f);<\/p>\n

\u00b7\u00a0\u043e\u0441\u0442\u0435\u043e\u043c\u0430\u043b\u044f\u0446\u0438\u044f,\u00a0\u0440\u0430\u0445\u0438\u0442\u00a0\u0443\u00a0\u0434\u0435\u0442\u0435\u0439;<\/p>\n

\u00b7\u00a0\u043f\u043e\u0432\u044b\u0448\u0435\u043d\u0430\u044f\u00a0\u044d\u043a\u0441\u043a\u0440\u0435\u0446\u0438\u044f\u00a0\u0441\u00a0\u043c\u043e\u0447\u043e\u0439\u00a0(\u0433\u0438\u043f\u0435\u0440\u043f\u0430\u0440\u0430\u0442\u0438\u0440\u0435\u043e\u0437,\u00a0\u0431\u043e\u043b\u0435\u0437\u043d\u0438\u00a0\u043f\u043e\u0447\u0435\u0447\u043d\u044b\u0445\u00a0\u043a\u0430\u043d\u0430\u043b\u044c\u0446\u0435\u0432,<\/p>\n

\u0443\u0432\u0435\u043b\u0438\u0447\u0435\u043d\u0438\u0435\u00a0\u041e\u0426\u041a,\u00a0\u043f\u0440\u0438\u0435\u043c\u00a0\u0434\u0438\u0443\u0440\u0435\u0442\u0438\u043a\u043e\u0432,<\/p>\n

\u0434\u0438\u0443\u0440\u0435\u0442\u0438\u0447\u0435\u0441\u043a\u0430\u044f\u00a0\u0444\u0430\u0437\u0430\u00a0\u043e\u0441\u0442\u0440\u043e\u0433\u043e\u00a0\u0442\u0443\u0431\u0443\u043b\u044f\u0440\u043d\u043e\u0433\u043e\u00a0\u043d\u0435\u043a\u0440\u043e\u0437\u0430\u00a0\u043f\u043e\u0441\u043b\u0435\u00a0\u0442\u0440\u0430\u043d\u0441\u043f\u043b\u0430\u043d\u0442\u0430\u0446\u0438\u0438\u00a0\u043f\u043e\u0447\u043a\u0438);<\/p>\n

\u00b7\u00a0\u0440\u0435\u0441\u043f\u0438\u0440\u0430\u0442\u043e\u0440\u043d\u044b\u0439\u00a0\u0430\u043b\u043a\u0430\u043b\u043e\u0437;<\/p>\n

\u00b7\u00a0\u0442\u044f\u0436\u0435\u043b\u044b\u0435\u00a0\u043e\u0436\u043e\u0433\u0438;<\/p>\n

\u00b7\u00a0\u0433\u0438\u043f\u0435\u0440\u0438\u043d\u0441\u0443\u043b\u0438\u043d\u0435\u043c\u0438\u044f\u00a0(\u043f\u0440\u0438\u00a0\u043b\u0435\u0447\u0435\u043d\u0438\u0438\u00a0\u0441\u0430\u0445\u0430\u0440\u043d\u043e\u0433\u043e\u00a0\u0434\u0438\u0430\u0431\u0435\u0442\u0430);<\/p>\n

\u00b7\u00a0\u0433\u0438\u043f\u0435\u0440\u0432\u0435\u043d\u0442\u0438\u043b\u044f\u0446\u0438\u044f\u00a0(\u043f\u0440\u0438\u00a0\u0441\u0435\u043f\u0441\u0438\u0441\u0435,\u00a0\u0438\u043d\u0442\u043e\u043a\u0441\u0438\u043a\u0430\u0446\u0438\u0438,\u00a0\u043f\u0430\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u0445\u00a0\u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u044f\u0445);<\/p>\n

\u00b7\u00a0\u0437\u043b\u043e\u043a\u0430\u0447\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u0435\u00a0\u043e\u043f\u0443\u0445\u043e\u043b\u0438;<\/p>\n

\u00b7\u00a0\u0441\u0438\u043d\u0434\u0440\u043e\u043c\u00a0\u00ab\u0433\u043e\u043b\u043e\u0434\u043d\u043e\u0439\u00a0\u043a\u043e\u0441\u0442\u0438\u00bb\u00a0(\u043c\u0435\u0442\u0430\u0441\u0442\u0430\u0437\u044b\u00a0\u0440\u0430\u043a\u0430\u00a0\u043f\u0440\u0435\u0434\u0441\u0442\u0430\u0442\u0435\u043b\u044c\u043d\u043e\u0439\u00a0\u0436\u0435\u043b\u0435\u0437\u044b\u00a0\u0432\u00a0\u043a\u043e\u0441\u0442\u0438<\/p>\n

,\u00a0\u043f\u0435\u0440\u0438\u043e\u0434\u00a0\u043f\u043e\u0441\u043b\u0435\u00a0\u043f\u0430\u0440\u0430\u0442\u0438\u0440\u0435\u043e\u0438\u0434\u044d\u043a\u0442\u043e\u043c\u0438\u0438,\u00a0\u043d\u0430\u0447\u0430\u043b\u043e\u00a0\u043b\u0435\u0447\u0435\u043d\u0438\u044f\u00a0\u0440\u0430\u0445\u0438\u0442\u0430\u00a0\u0438\u043b\u0438\u00a0\u043e\u0441\u0442\u0435\u043e\u043c\u0430\u043b\u044f\u0446\u0438\u0438);<\/p>\n

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