{"id":9249,"date":"2020-04-23T04:32:36","date_gmt":"2020-04-23T01:32:36","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/hcg-total-hcgbeta\/"},"modified":"2026-02-19T00:15:01","modified_gmt":"2026-02-18T22:15:01","slug":"hcg-total-hcgbeta","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/hcg-total-hcgbeta\/","title":{"rendered":"\u041e\u0431\u0449\u0438\u0439 \u0425\u0427\u0413 (\u0425\u0413\u0427+\u0411\u0415\u0422\u0410)"},"content":{"rendered":"

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

Gonadotropina corionic\u0103 uman\u0103 (HCG), un hormon de natur\u0103 glicoproteic\u0103 produs \u00een mod normal de placent\u0103 \u015fi\u00a0\u00een mod aberant de unele tumori cu celule germinale, este alc\u0103tuit din dou\u0103 subunit\u0103\u0163i diferite: \u03b1 \u015fi \u03b2. Subunitatea \u03b1, constituit\u0103 din 92 aminoacizi, este identic\u0103 cu cea a hormonilor LH, FSH \u015fi TSH. Subunitatea \u03b2, ce con\u0163ine 145 aminoacizi, este specific\u0103 pentru HCG; deoarece testul are o sensibilitate \u00eenalt\u0103 pentru \u03b2-HCG nu exist\u0103 riscul unei reactivit\u0103\u0163i \u00eencruci\u015fate5<\/sup>.<\/p>\n

Cu ajutorul acestui test se poate confirma prezen\u0163a unei sarcini, la numai 6-10 zile de la implantarea ovulului fecundat2<\/sup>. Rolul biologic al HCG const\u0103 \u00een men\u0163inerea corpului luteal\u00a0\u00een cursul sarcinii; influen\u0163eaz\u0103 de asemenea produc\u0163ia de hormoni steroizi. Serul femeilor gravide con\u0163ine \u00een principal HCG intact. Concentra\u0163ia seric\u0103 \u015fi urinar\u0103 de HCG total cre\u015fte exponen\u0163ial\u00a0\u00een cursul sarcinii, dubl\u00e2ndu-se la aproximativ 40-48 ore, ating\u00e2nd un maximum\u00a0\u00een s\u0103pt\u0103m\u00e2nile 8-12. Produc\u0163ia hormonului scade progresiv\u00a0\u00een s\u0103pt\u0103m\u00e2nile 10-20 de sarcin\u0103, la valori de 1\/5-1\/20 din concentra\u0163ia maxim\u0103, dup\u0103 care r\u0103m\u00e2ne\u00a0\u00een platou p\u00e2n\u0103 la termen1<\/sup>.<\/p>\n

Anumite tumori slab diferen\u0163iate sau nediferen\u0163iate se asociaz\u0103 cu produc\u0163ie ectopic\u0103 de HCG. Printre acestea se numar\u0103: mola hidatiform\u0103, coriocarcinomul \u015fi tumorile testiculare cu celule germinale. In aceste forme de neoplazii HCG este produs de obicei de celulele sincitiotrofoblastice2<\/sup>.<\/p>\n

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

    \n
  1. Marker de sarcin\u0103<\/span>: diagnostic precoce de sarcin\u0103, estimarea v\u00e2rstei gesta\u0163ionale, depistarea sarcinilor ectopice (\u00eempreun\u0103 cu ecografia transvaginal\u0103) \u015fi a iminen\u0163ei de avort2;5<\/sup>.<\/li>\n
  2. Marker tumoral<\/span>: detectarea \u015fi monitorizarea tumorilor HCG secretante de origine placentar\u0103, ovarian\u0103 sau testicular\u0103; \u00een cazul tumorilor testiculare HCG se va determina \u00eempreun\u0103 cu AFP5<\/sup>.<\/li>\n<\/ol>\n

    Preg\u0103tire pacient <\/em><\/strong>- <\/em>\u00e0 jeun (pe nem\u00e2ncate) sau postprandial; pacientele vor men\u0163iona obligatoriu data ultimei menstrua\u0163ii sau v\u00e2rsta gesta\u0163ional\u0103 determinat\u0103 ecografic4<\/sup>.<\/p>\n

    Specimen recoltat <\/em><\/strong>- <\/em>\u0432\u0435\u043d\u043e\u0437\u043d\u0430\u044f \u043a\u0440\u043e\u0432\u044c4<\/sup>.<\/p>\n

    Recipient de recoltare <\/em><\/strong>- <\/em>vacutainer f\u0103r\u0103 anticoagulant, cu\/f\u0103r\u0103 gel separator4<\/sup>.<\/p>\n

    Prelucrare necesar\u0103 dup\u0103 recoltare <\/em><\/strong>- <\/em>se las\u0103 s\u00e2ngele s\u0103 coaguleze la temperatura camerei; se separ\u0103 serul prin centrifugare; se lucreaz\u0103 imediat; dac\u0103 acest lucru nu este posibil, serul se p\u0103streaz\u0103 la 2-8\u00b0C sau la -20\u00b0C4<\/sup>.<\/p>\n

    Volum prob\u0103<\/em><\/strong> \u2013 minim 1 mL ser4<\/sup>.<\/p>\n

    Cauze de respingere<\/em><\/strong> a probei<\/em><\/strong> \u2013 specimen intens hemolizat4<\/sup>.<\/p>\n

    Stabilitate prob\u0103 <\/em><\/strong>- <\/em>serul separat este stabil: 3 zile <\/em>la 2-8\u00b0C; 1 an <\/em>\u00a0la -20\u00b0C; nu decongela\u0163i\/recongela\u0163i4<\/sup>.<\/p>\n

    Metod\u0103 <\/em><\/strong>- imunochimic\u0103 cu detec\u0163ie prin electrochemiluminiscen\u0163\u0103 (ECLIA)<\/span>4<\/sup>.<\/p>\n

    Valori de referin\u0163\u0103\u00a0<\/em><\/strong>\u00a0<\/em><\/p>\n

    In absen\u0163a sarcinii<\/span>:<\/p>\n

    B\u0103rba\u0163i: < 2.6 mUI\/mL .<\/p>\n

    Femei: \u2013 premenopauz\u0103\u00a0\u00a0\u00a0\u00a0< 5.3 mUI\/mL;<\/p>\n

    \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u2013 postmenopauz\u0103\u00a0\u00a0\u00a0< 8.3 mUI\/mL.<\/p>\n

    In sarcin\u0103<\/span>: valorile se interpreteaz\u0103 \u00een func\u0163ie de v\u00e2rsta gesta\u0163ional\u0103 (s\u0103pt\u0103m\u00e2ni \u00eemplinite de sarcin\u0103 de la data ultimei menstrua\u0163ii)<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
    \n

    S\u0103pt\u0103m\u00e2na de sarcin\u0103<\/strong><\/p>\n<\/td>\n

    		\n
    Valori mediane<\/strong><\/div>\n
    HCG (mUI\/mL)<\/strong><\/div>\n<\/td>\n
    		\n
    Interval de referin\u0163\u0103<\/strong><\/div>\n
    HCG (mUI\/mL)<\/strong><\/div>\n<\/td>\n<\/tr>\n
    \n

    3<\/p>\n<\/td>\n

    		\n

    17.5<\/p>\n<\/td>\n

    		\n

    5.8-71.2<\/p>\n<\/td>\n<\/tr>\n

    \n

    4<\/p>\n<\/td>\n

    		\n

    141<\/p>\n<\/td>\n

    		\n

    9.5-750<\/p>\n<\/td>\n<\/tr>\n

    \n

    5<\/p>\n<\/td>\n

    		\n

    1398<\/p>\n<\/td>\n

    		\n

    217-7138<\/p>\n<\/td>\n<\/tr>\n

    \n

    6<\/p>\n<\/td>\n

    		\n

    3339<\/p>\n<\/td>\n

    		\n

    158-31.795<\/p>\n<\/td>\n<\/tr>\n

    \n

    7<\/p>\n<\/td>\n

    		\n

    39.759<\/p>\n<\/td>\n

    		\n

    3697-163.563<\/p>\n<\/td>\n<\/tr>\n

    \n

    8<\/p>\n<\/td>\n

    		\n

    90.084<\/p>\n<\/td>\n

    		\n

    32.065-149.571<\/p>\n<\/td>\n<\/tr>\n

    \n

    9<\/p>\n<\/td>\n

    		\n

    106.257<\/p>\n<\/td>\n

    		\n

    63.803-151.410<\/p>\n<\/td>\n<\/tr>\n

    \n

    10<\/p>\n<\/td>\n

    		\n

    85.172<\/p>\n<\/td>\n

    		\n

    46.509-186.977<\/p>\n<\/td>\n<\/tr>\n

    \n

    12<\/p>\n<\/td>\n

    		\n

    66.976<\/p>\n<\/td>\n

    		\n

    27.832-210.612<\/p>\n<\/td>\n<\/tr>\n

    \n

    14<\/p>\n<\/td>\n

    		\n

    34.440<\/p>\n<\/td>\n

    		\n

    13.950-62.530<\/p>\n<\/td>\n<\/tr>\n

    \n

    15<\/p>\n<\/td>\n

    		\n

    28.962<\/p>\n<\/td>\n

    		\n

    12.039-70.971<\/p>\n<\/td>\n<\/tr>\n

    \n

    16<\/p>\n<\/td>\n

    		\n

    23.930<\/p>\n<\/td>\n

    		\n

    9040-56.451<\/p>\n<\/td>\n<\/tr>\n

    \n

    17<\/p>\n<\/td>\n

    		\n

    20.860<\/p>\n<\/td>\n

    		\n

    8175-55.868<\/p>\n<\/td>\n<\/tr>\n

    \n

    18<\/p>\n<\/td>\n

    		\n

    19.817<\/p>\n<\/td>\n

    		\n

    8099-58.176<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    !Men\u0163iune: valorile mediane se refer\u0103 la o sarcin\u0103 unic\u0103; \u00een cazul sarcinilor multiple valorile sunt mult mai mari4;5<\/sup>.<\/p>\n

    Limita de detec\u0163ie<\/em><\/strong> \u2013 0.1 mUI\/mL4<\/sup>.<\/p>\n

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

    In iminen\u0163a de avort valorile HCG scad progresiv de la o determinare la alta. Dup\u0103 un chiuretaj complet timpul de \u00eenjum\u0103t\u0103\u0163ire al concentra\u0163iei serice de HCG este de 1 zi3<\/sup>.<\/p>\n

    In sarcina ectopic\u0103 produc\u0163ia de HCG nu urmeaz\u0103 patern-ul dintr-o sarcin\u0103 normal\u0103 (dublarea valorilor se \u00eenregistreaz\u0103 mult mai lent, la >48 ore)4<\/sup>. Valorile anormale de HCG coroborate cu ecografia transvaginal\u0103 pot detecta multe sarcini ectopice \u00eenainte de ruperea lor5<\/sup>.<\/p>\n

    Cu excep\u0163ia c\u00e2torva cazuri, toate tumorile trofoblastice sintetizeaz\u0103 HCG. Ob\u0163inerea unor valori foarte crescute de HCG \u00een trimestrul I de sarcin\u0103 (>500000 mUI\/mL), care nu prezint\u0103 tendin\u0163a de regresie, sunt sugestive pentru mola hidatiform\u0103. Prezen\u0163a unui coriocarcinom poate fi suspectat\u0103 \u00een cazurile \u00een care se ob\u0163in valori crescute pentru HCG, asociate cu un raport free beta-HCG\/HCG total mai mare dec\u00e2t \u00een sarcina normal\u0103 sau \u00een mola hidatiform\u0103. Monitorizarea post-operatorie a HCG total este esen\u0163ial\u0103 pentru stabilirea atitudinii terapeutice ulterioare \u015fi reprezint\u0103 un important marker de prognostic.<\/p>\n

    Dup\u0103 evacuarea unei mole hidatiforme nivelul HCG trebuie s\u0103 ating\u0103 normalul \u00een 12 s\u0103pt\u0103m\u00e2ni, timpul de \u00eenjum\u0103t\u0103\u0163ire al concentra\u0163iei serice fiind mai mare dec\u00e2t \u00een condi\u0163ii fiziologice (aproximativ 4 zile). Persisten\u0163a valorilor crescute sau observarea unei tendin\u0163e de cre\u015ftere a valorilor indic\u0103 prezen\u0163a unui \u0163esut proliferant sau care a suferit o transformare malign\u0103. Modific\u0103rile HCG pot precede cu s\u0103pt\u0103m\u00e2ni sau luni apari\u0163ia manifest\u0103rilor clinice. Monitorizarea postoperatorie a HCG se face s\u0103pt\u0103m\u00e2nal\u00a0p\u00e2n\u0103 la normalizarea valorilor \u015fi \u00een urm\u0103toarele 3 s\u0103pt\u0103m\u00e2ni, dup\u0103 care se efectueaz\u0103 lunar o perioad\u0103 de 6 luni. Monitorizarea periodic\u0103 (efectuat\u0103 \u00een cazul unei remisiuni complete la 3-6 luni, o perioad\u0103 de 5 ani) este util\u0103 pentru depistarea precoce a recuren\u0163elor.<\/p>\n

    In cazul tumorilor testiculare cu celule germinale frecven\u0163a test\u0103rii HCG (\u00eempreun\u0103 cu AFP) este urm\u0103toarea: de dou\u0103 ori \u00eenaintea orhiectomiei; de trei ori\u00a0 \u00een prima s\u0103pt\u0103m\u00e2n\u0103, dup\u0103 orhiectomie sau limfadenectomie retroperitoneal\u0103; s\u0103pt\u0103m\u00e2nal\u00a0\u00een cursul chimioterapiei \u015fi iradierii p\u00e2n\u0103 la normalizarea valorilor. Dup\u0103 rezec\u0163ia chirurgical\u0103 complet\u0103 a tumorii, nivelurile HCG scad cu un timp de \u00eenjum\u0103t\u0103\u0163ire de 1-3 zile, aproape identic cu cel \u00eenregistrat\u00a0\u00een condi\u0163ii fiziologice. Dup\u0103 chimioterapie se poate produce o cre\u015ftere tranzitorie a markerului datorit\u0103 lizei tumorale. Persisten\u0163a nivelurilor crescute de HCG \u015fi\/sau AFP, dup\u0103 interven\u0163ia chirurgical\u0103, indic\u0103 faptul c\u0103 tumora nu este limitat\u0103 la testicul. Dup\u0103 ob\u0163inerea unei remisiuni complete, monitorizarea markerilor serici se efectueaz\u0103 lunar\u00a0\u00een primul an \u015fi la dou\u0103 luni\u00a0\u00een cursul celui de-al doilea \u015fi al treilea an3<\/sup>.<\/p>\n

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

    Concentra\u0163iile HCG \u00een sarcin\u0103 au varia\u0163ie individual\u0103 foarte mare, comparativ cu nivelurile altor hormoni. De aceea stabilirea cu acurate\u0163e a v\u00e2rstei gesta\u0163ionale nu se poate face pe baza unei singure determin\u0103ri HCG1;2<\/sup>.<\/p>\n

    Valorile HCG, ca \u015fi cele ale LH, cresc\u00a0\u00een perioada de menopauz\u0103, hipofiza fiind implicat\u0103 \u00een produc\u0163ia acestui hormon.<\/p>\n

    La unele femei aflate \u00een postmenopauz\u0103, cu insuficien\u0163\u0103 renal\u0103 ce necesit\u0103 dializ\u0103, pot fi detectate niveluri de HCG care dep\u0103\u015fesc de 10 ori valorile de referin\u0163\u0103,\u00a0\u00een absen\u0163a unei tumori HCG secretante. Acestea se datoreaz\u0103 sc\u0103derii elimin\u0103rii renale de HCG, cu producerea fiziologic\u0103 a acestui hormon\u00a0\u00een diverse \u0163esuturi (\u00een concentra\u0163ii mici)3<\/sup>.<\/p>\n

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

    Pot produce interferen\u0163e cu unele componente ale kit-ului \u015fi conduce la rezultate neconcludente urm\u0103toarele:<\/p>\n

    \u2013 tratamentul cu biotin\u0103 \u00een doze mari (>5 mg\/zi); de aceea se recomand\u0103 ca recoltarea de s\u00e2nge s\u0103 se fac\u0103 dup\u0103 minimum 8 ore de la ultima administrare;<\/div>\n
    \u2013 titrurile foarte crescute de anticorpi anti-streptavidina \u015fi anti-ruteniu;<\/div>\n
    \u2013 anticorpii monoclonali proveni\u0163i de la \u015foarece administra\u0163i la unii pacien\u0163i \u00een scop diagnostic sau terapeutic4<\/sup>.<\/div>\n

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

    1. Ann M.Gronowski. Human Chorionic Gonadotropin. In Handbook of Clinical Laboratory Testing During Pregnancy. Humana Press, USA, Ed. 2004, 19-22.<\/span><\/div>\n
    2. Frances Fischbach. Chemistry studies. In A Manual of Laboratory and Diagnostic Tests. Lippincott Williams & Wilkins, USA, 8 Ed., 2009, 400-402.<\/span><\/div>\n
    3. Klaus Mann, Rudolf Hormann. hCG (Human Chorionic Gonadotropin). In Clinical Laboratory Diagnostics-Use and Assessment of Clinical Laboratory Results. Lothar Thomas. TH-Books Verlagsgesellschaft mbH, Frankfurt \/Main, Germany, 1 Ed.,1998; 971-974.<\/span><\/div>\n
    4. Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate 2010. Ref Type: Catalog<\/span><\/div>\n
    5. Laboratory Corporation of America. Directory of Services and Interpretive Guide. Human Chorionic Gonadotropin (hCG), Beta Subunit, Serum. www.labcorp.com 2010. Ref Type: Internet Communication.<\/span><\/div>","protected":false},"excerpt":{"rendered":"

    \u0425\u043e\u0440\u0438\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u0439 \u0433\u043e\u043d\u0430\u0434\u043e\u0442\u0440\u043e\u043f\u0438\u043d \u2013 \u044d\u0442\u043e \u0433\u043e\u0440\u043c\u043e\u043d, \u0432\u044b\u0440\u0430\u0431\u0430\u0442\u044b\u0432\u0430\u0435\u043c\u044b\u0439 \u0432\u043d\u0435\u0448\u043d\u0435\u0439 \u043e\u0431\u043e\u043b\u043e\u0447\u043d\u043e\u0439 \u0437\u0430\u0440\u043e\u0434\u044b\u0448\u0430, \u0438 \u0432 \u043d\u043e\u0440\u043c\u0435 \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u044f\u0435\u0442\u0441\u044f \u0432 \u043a\u0440\u043e\u0432\u0438 \u0438 \u043c\u043e\u0447\u0435 \u0436\u0435\u043d\u0449\u0438\u043d\u044b \u0442\u043e\u043b\u044c\u043a\u043e \u043f\u0440\u0438 \u043d\u0430\u0441\u0442\u0443\u043f\u043b\u0435\u043d\u0438\u0438 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438.<\/p>\n

    \u0425\u043e\u0440\u0438\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u0439 \u0433\u043e\u043d\u0430\u0434\u043e\u0442\u0440\u043e\u043f\u0438\u043d \u0441\u043e\u0441\u0442\u043e\u0438\u0442 \u0438\u0437 \u0434\u0432\u0443\u0445 \u0441\u0443\u0431\u044a\u0435\u0434\u0438\u043d\u0438\u0446 \u2013 \u0430\u043b\u044c\u0444\u0430 \u0438 \u0431\u0435\u0442\u0430. \u0411\u0435\u0442\u0430-\u0441\u0443\u0431\u044a\u0435\u0434\u0438\u043d\u0438\u0446\u0430 (\u03b2-\u0425\u0413\u0427), \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u0443\u044e\u0449\u0430\u044f\u0441\u044f \u0434\u043b\u044f \u0438\u043c\u043c\u0443\u043d\u043e\u043c\u0435\u0442\u0440\u0438\u0447\u0435\u0441\u043a\u043e\u0433\u043e \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u044f \u0433\u043e\u0440\u043c\u043e\u043d\u0430 – \u0443\u043d\u0438\u043a\u0430\u043b\u044c\u043d\u0430. \u0414\u043b\u044f \u043d\u0430\u0431\u043b\u044e\u0434\u0435\u043d\u0438\u044f \u0437\u0430 \u0442\u0435\u0447\u0435\u043d\u0438\u0435\u043c \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u0443\u044e\u0442 \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0435 \u0431\u0435\u0442\u0430-\u0441\u0443\u0431\u044a\u0435\u0434\u0438\u043d\u0438\u0446\u044b \u0425\u0413\u0427. \u0423\u0440\u043e\u0432\u0435\u043d\u044c \u0431\u0435\u0442\u0430-\u0425\u0413\u0427 \u043a\u0440\u043e\u0432\u0438 \u0443\u0436\u0435 \u043d\u0430 6 – 8 \u0434\u0435\u043d\u044c \u043f\u043e\u0441\u043b\u0435 \u0437\u0430\u0447\u0430\u0442\u0438\u044f \u043f\u043e\u0437\u0432\u043e\u043b\u044f\u0435\u0442 \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u0440\u043e\u0432\u0430\u0442\u044c \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u044c (\u043a\u043e\u043d\u0446\u0435\u043d\u0442\u0440\u0430\u0446\u0438\u044f \u03b2-\u0425\u0413\u0427 \u0432 \u043c\u043e\u0447\u0435 \u0434\u043e\u0441\u0442\u0438\u0433\u0430\u0435\u0442 \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u0447\u0435\u0441\u043a\u043e\u0433\u043e \u0443\u0440\u043e\u0432\u043d\u044f \u043d\u0430 1 – 2 \u0434\u043d\u044f \u043f\u043e\u0437\u0436\u0435, \u0447\u0435\u043c \u0432 \u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0435 \u043a\u0440\u043e\u0432\u0438).<\/p>\n

    \u0425\u0413\u0427 \u043e\u043a\u0430\u0437\u044b\u0432\u0430\u0435\u0442 \u043c\u043d\u043e\u0433\u043e\u0441\u0442\u043e\u0440\u043e\u043d\u043d\u0435\u0435 \u0432\u043e\u0437\u0434\u0435\u0439\u0441\u0442\u0432\u0438\u0435 \u043d\u0430 \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0439: \u0432\u043b\u0438\u044f\u0435\u0442 \u043d\u0430 \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u0435 \u044d\u043c\u0431\u0440\u0438\u043e\u043d\u0430 \u0438 \u043f\u043b\u043e\u0434\u0430, \u0441\u0442\u0438\u043c\u0443\u043b\u0438\u0440\u0443\u0435\u0442 \u0441\u0438\u043d\u0442\u0435\u0437 \u044d\u0441\u0442\u0440\u043e\u0433\u0435\u043d\u043e\u0432 \u0438 \u0430\u043d\u0434\u0440\u043e\u0433\u0435\u043d\u043e\u0432 \u043a\u043b\u0435\u0442\u043a\u0430\u043c\u0438 \u044f\u0438\u0447\u043d\u0438\u043a\u043e\u0432, \u0441\u043f\u043e\u0441\u043e\u0431\u0441\u0442\u0432\u0443\u0435\u0442 \u0444\u0443\u043d\u043a\u0446\u0438\u043e\u043d\u0430\u043b\u044c\u043d\u043e\u0439 \u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u0438 \u0445\u043e\u0440\u0438\u043e\u043d\u0430 \u0438 \u043f\u043b\u0430\u0446\u0435\u043d\u0442\u044b, \u043e\u0431\u0435\u0441\u043f\u0435\u0447\u0438\u0432\u0430\u0435\u0442 \u0431\u043b\u0430\u0433\u043e\u043f\u043e\u043b\u0443\u0447\u043d\u043e\u0435 \u043f\u0440\u043e\u0442\u0435\u043a\u0430\u043d\u0438\u0435 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438.<\/p>\n

    \u0412\u0432\u0435\u0434\u0435\u043d\u0438\u0435 \u0425\u0413\u0427 \u0432 \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c \u043d\u0435\u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u044b\u0445 \u0441\u0442\u0438\u043c\u0443\u043b\u0438\u0440\u0443\u0435\u0442 \u043e\u0432\u0443\u043b\u044f\u0446\u0438\u044e \u0438 \u0441\u0438\u043d\u0442\u0435\u0437 \u043f\u043e\u043b\u043e\u0432\u044b\u0445 \u0433\u043e\u0440\u043c\u043e\u043d\u043e\u0432, \u043d\u0435\u043e\u0431\u0445\u043e\u0434\u0438\u043c\u044b\u0445 \u0434\u043b\u044f \u0437\u0430\u0447\u0430\u0442\u0438\u044f. \u0423 \u043c\u0443\u0436\u0447\u0438\u043d \u044d\u0442\u043e\u0442 \u0433\u043e\u0440\u043c\u043e\u043d \u0443\u0441\u0438\u043b\u0438\u0432\u0430\u0435\u0442 \u043e\u0431\u0440\u0430\u0437\u043e\u0432\u0430\u043d\u0438\u0435 \u0441\u0435\u043c\u0435\u043d\u043d\u043e\u0439 \u0436\u0438\u0434\u043a\u043e\u0441\u0442\u0438, \u0430\u043a\u0442\u0438\u0432\u0438\u0437\u0438\u0440\u0443\u0435\u0442 \u0432\u044b\u0440\u0430\u0431\u043e\u0442\u043a\u0443 \u0433\u043e\u043d\u0430\u0434\u043e\u0441\u0442\u0435\u0440\u043e\u0438\u0434\u043e\u0432.<\/p>\n

    \u041d\u0430 \u0440\u0430\u043d\u043d\u0438\u0445 \u0441\u0440\u043e\u043a\u0430\u0445 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u0438 \u0434\u043e 2-\u0433\u043e \u0442\u0440\u0438\u043c\u0435\u0441\u0442\u0440\u0430 \u03b2-\u0425\u0413\u0427 \u043f\u043e\u0434\u0434\u0435\u0440\u0436\u0438\u0432\u0430\u0435\u0442 \u043f\u0440\u043e\u0434\u0443\u043a\u0446\u0438\u044e \u043d\u0435\u043e\u0431\u0445\u043e\u0434\u0438\u043c\u044b\u0445 \u0434\u043b\u044f \u0441\u043e\u0445\u0440\u0430\u043d\u0435\u043d\u0438\u044f \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u0433\u043e\u0440\u043c\u043e\u043d\u043e\u0432, \u0430 \u0443 \u043f\u043b\u043e\u0434\u043e\u0432 \u043c\u0443\u0436\u0441\u043a\u043e\u0433\u043e \u043f\u043e\u043b\u0430 \u0441\u0442\u0438\u043c\u0443\u043b\u0438\u0440\u0443\u0435\u0442 \u043a\u043b\u0435\u0442\u043a\u0438, \u043e\u0442\u0432\u0435\u0447\u0430\u044e\u0449\u0438\u0435 \u0437\u0430 \u0444\u043e\u0440\u043c\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u0435 \u0438 \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u0435 \u043c\u0443\u0436\u0441\u043a\u043e\u0439 \u043f\u043e\u043b\u043e\u0432\u043e\u0439 \u0441\u0438\u0441\u0442\u0435\u043c\u044b.<\/p>\n

    \u041f\u043e\u043a\u0430\u0437\u0430\u043d\u0438\u044f \u0434\u043b\u044f \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u044f \u0443\u0440\u043e\u0432\u043d\u044f \u0425\u0413\u0427 \u0443 \u0436\u0435\u043d\u0449\u0438\u043d<\/p>\n

      \n
    1. \u041e\u0442\u0441\u0443\u0442\u0441\u0442\u0432\u0438\u0435 \u043c\u0435\u043d\u0441\u0442\u0440\u0443\u0430\u0446\u0438\u0439 (\u0430\u043c\u0435\u043d\u043e\u0440\u0435\u044f).<\/li>\n
    2. \u0418\u0441\u043a\u043b\u044e\u0447\u0435\u043d\u0438\u0435\/\u043f\u043e\u0434\u0442\u0432\u0435\u0440\u0436\u0434\u0435\u043d\u0438\u0435 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438, \u0432 \u0442\u043e\u043c \u0447\u0438\u0441\u043b\u0435 \u044d\u043a\u0442\u043e\u043f\u0438\u0447\u0435\u0441\u043a\u043e\u0439 (\u0432\u043d\u0435\u043c\u0430\u0442\u043e\u0447\u043d\u043e\u0439).<\/li>\n
    3. \u0414\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0430 \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u044f \u043f\u043b\u043e\u0434\u0430 \u043d\u0430 \u0440\u0430\u0437\u043d\u044b\u0445 \u0441\u0440\u043e\u043a\u0430\u0445 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438.<\/li>\n
    4. \u041e\u0446\u0435\u043d\u043a\u0430 \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u044f \u043f\u043b\u0430\u0446\u0435\u043d\u0442\u044b \u043d\u0430 \u0440\u0430\u0437\u043d\u044b\u0445 \u0441\u0440\u043e\u043a\u0430\u0445 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438.<\/li>\n
    5. \u0414\u0438\u043d\u0430\u043c\u0438\u0447\u0435\u0441\u043a\u043e\u0435 \u043d\u0430\u0431\u043b\u044e\u0434\u0435\u043d\u0438\u0435 \u0437\u0430 \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u0435\u043c \u043f\u043b\u043e\u0434\u0430 \u0432\u043e \u0432\u0440\u0435\u043c\u044f \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438, \u0432 \u0442\u043e\u043c \u0447\u0438\u0441\u043b\u0435 \u0432 \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0435 \u043f\u043e\u0440\u043e\u043a\u043e\u0432 \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u044f.<\/li>\n
    6. \u041f\u043e\u0434\u043e\u0437\u0440\u0435\u043d\u0438\u0435 \u043d\u0430 \u043d\u0430\u043b\u0438\u0447\u0438\u0435 \u043e\u043f\u0443\u0445\u043e\u043b\u0435\u0432\u044b\u0445 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0439 \u043f\u043e\u043b\u043e\u0432\u043e\u0439 \u0441\u0438\u0441\u0442\u0435\u043c\u044b, \u0442\u0430\u043a\u0438\u0445 \u043a\u0430\u043a \u043f\u0443\u0437\u044b\u0440\u043d\u044b\u0439 \u0437\u0430\u043d\u043e\u0441 (\u0440\u0435\u0434\u043a\u0430\u044f \u043f\u0430\u0442\u043e\u043b\u043e\u0433\u0438\u044f \u043f\u043b\u043e\u0434\u043d\u043e\u0433\u043e \u044f\u0439\u0446\u0430, \u043f\u0440\u0438 \u043a\u043e\u0442\u043e\u0440\u043e\u0439 \u0432\u043c\u0435\u0441\u0442\u043e \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u044f \u044d\u043c\u0431\u0440\u0438\u043e\u043d\u0430 \u043f\u0440\u043e\u0438\u0441\u0445\u043e\u0434\u0438\u0442 \u0440\u0430\u0437\u0440\u0430\u0441\u0442\u0430\u043d\u0438\u0435 \u0432\u043e\u0440\u0441\u0438\u043d \u0445\u043e\u0440\u0438\u043e\u043d\u0430), \u0445\u043e\u0440\u0438\u043e\u043d\u044d\u043f\u0438\u0442\u0435\u043b\u0438\u043e\u043c\u0430 (\u0437\u043b\u043e\u043a\u0430\u0447\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u0430\u044f \u043e\u043f\u0443\u0445\u043e\u043b\u044c, \u0440\u0430\u0437\u0432\u0438\u0432\u0430\u044e\u0449\u0430\u044f\u0441\u044f \u0438\u0437 \u044d\u043f\u0438\u0442\u0435\u043b\u0438\u044f \u0432\u043e\u0440\u0441\u0438\u043d \u043f\u043b\u043e\u0434\u043d\u043e\u0433\u043e \u044f\u0439\u0446\u0430).<\/li>\n
    7. \u041f\u0440\u043e\u0432\u0435\u0434\u0435\u043d\u0438\u0435 \u0438\u0441\u043a\u0443\u0441\u0441\u0442\u0432\u0435\u043d\u043d\u043e\u0433\u043e \u043f\u0440\u0435\u0440\u044b\u0432\u0430\u043d\u0438\u044f \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438.<\/li>\n<\/ol>\n

      \u041f\u043e\u043a\u0430\u0437\u0430\u043d\u0438\u044f \u0434\u043b\u044f \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u044f \u0443\u0440\u043e\u0432\u043d\u044f \u0425\u0413\u0427 \u0443 \u043c\u0443\u0436\u0447\u0438\u043d:<\/p>\n

      \u041d\u0430\u043b\u0438\u0447\u0438\u0435 \u043f\u043e\u0434\u043e\u0437\u0440\u0435\u043d\u0438\u0439 \u043d\u0430 \u043e\u043f\u0443\u0445\u043e\u043b\u0438 \u044f\u0438\u0447\u0435\u043a.<\/p>\n

      \u041f\u0440\u0430\u0432\u0438\u043b\u0430 \u043f\u043e\u0434\u0433\u043e\u0442\u043e\u0432\u043a\u0438 \u043a \u0441\u0434\u0430\u0447\u0435 \u0430\u043d\u0430\u043b\u0438\u0437\u0430 \u043a\u0440\u043e\u0432\u0438 \u043d\u0435\u0441\u043f\u0435\u0446\u0438\u0444\u0438\u0447\u043d\u044b: \u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e \u043d\u0430\u043a\u0430\u043d\u0443\u043d\u0435 \u043f\u0440\u043e\u0446\u0435\u0434\u0443\u0440\u044b \u0432\u043e\u0437\u0434\u0435\u0440\u0436\u0430\u0442\u044c\u0441\u044f \u043e\u0442 \u043a\u0443\u0440\u0435\u043d\u0438\u044f \u0438 \u0443\u043f\u043e\u0442\u0440\u0435\u0431\u043b\u0435\u043d\u0438\u044f \u0430\u043b\u043a\u043e\u0433\u043e\u043b\u044f, \u043e\u0433\u0440\u0430\u043d\u0438\u0447\u0438\u0442\u044c \u0441\u0442\u0440\u0435\u0441\u0441\u043e\u0432\u044b\u0435 \u0432\u043e\u0437\u0434\u0435\u0439\u0441\u0442\u0432\u0438\u044f \u0438 \u0438\u043d\u0442\u0435\u043d\u0441\u0438\u0432\u043d\u0443\u044e \u0444\u0438\u0437\u0438\u0447\u0435\u0441\u043a\u0443\u044e \u043d\u0430\u0433\u0440\u0443\u0437\u043a\u0443 \u0432 \u0442\u0435\u0447\u0435\u043d\u0438\u0435 \u043d\u0435\u0434\u0435\u043b\u0438; \u0441\u0434\u0430\u0447\u0430 \u043a\u0440\u043e\u0432\u0438 \u043f\u0440\u043e\u0432\u043e\u0434\u0438\u0442\u0441\u044f \u043d\u0430\u0442\u043e\u0449\u0430\u043a.<\/p>\n

      \u041e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0435 \u0425\u0413\u0427 \u0432 \u043a\u0440\u043e\u0432\u0438 \u0432\u043e\u0437\u043c\u043e\u0436\u043d\u043e \u0443\u0436\u0435 \u043d\u0430 6-8-\u0439 \u0434\u0435\u043d\u044c \u043f\u043e\u0441\u043b\u0435 \u0437\u0430\u0447\u0430\u0442\u0438\u044f. \u041f\u0440\u0438\u043c\u0435\u043d\u0435\u043d\u0438\u0435 \u043c\u043e\u0447\u0435\u0432\u044b\u0445 \u0442\u0435\u0441\u0442-\u0441\u0438\u0441\u0442\u0435\u043c (\u044d\u043a\u0441\u043f\u0440\u0435\u0441\u0441-\u0442\u0435\u0441\u0442\u043e\u0432 \u043d\u0430 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u044c) \u0431\u0443\u0434\u0435\u0442 \u0438\u043d\u0444\u043e\u0440\u043c\u0430\u0442\u0438\u0432\u043d\u044b\u043c, \u043d\u0430\u0447\u0438\u043d\u0430\u044f \u0441 7-\u0433\u043e \u0434\u043d\u044f \u043f\u043e\u0441\u043b\u0435 \u043e\u043f\u043b\u043e\u0434\u043e\u0442\u0432\u043e\u0440\u0435\u043d\u0438\u044f \u044f\u0439\u0446\u0435\u043a\u043b\u0435\u0442\u043a\u0438. \u0414\u043b\u044f \u043f\u043e\u0434\u0442\u0432\u0435\u0440\u0436\u0434\u0435\u043d\u0438\u044f \u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u0430 \u0440\u0435\u043a\u043e\u043c\u0435\u043d\u0434\u0443\u0435\u0442\u0441\u044f \u043f\u043e\u0432\u0442\u043e\u0440\u043d\u043e\u0435 \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0435 \u0443\u0440\u043e\u0432\u043d\u044f \u0433\u043e\u0440\u043c\u043e\u043d\u0430 \u0447\u0435\u0440\u0435\u0437 \u043d\u0435\u0441\u043a\u043e\u043b\u044c\u043a\u043e \u0434\u043d\u0435\u0439 \u043f\u043e\u0441\u043b\u0435 \u043f\u0435\u0440\u0432\u043e\u0433\u043e \u0430\u043d\u0430\u043b\u0438\u0437\u0430.<\/p>\n

      \u041f\u0440\u0438\u0447\u0438\u043d\u044b, \u0432\u0435\u0434\u0443\u0449\u0438\u0435 \u043a \u0432\u044b\u0441\u043e\u043a\u043e\u043c\u0443 \u0443\u0440\u043e\u0432\u043d\u044e \u03b2-\u0425\u0413\u0427<\/p>\n

        \n
      • \u041c\u043d\u043e\u0433\u043e\u043f\u043b\u043e\u0434\u043d\u0430\u044f \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u044c.<\/li>\n
      • \u041d\u0435\u0432\u0435\u0440\u043d\u043e \u0443\u0441\u0442\u0430\u043d\u043e\u0432\u043b\u0435\u043d\u043d\u044b\u0435 \u0441\u0440\u043e\u043a\u0438 \u043d\u0430\u0441\u0442\u0443\u043f\u043b\u0435\u043d\u0438\u044f \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438.<\/li>\n
      • \u041f\u0430\u0442\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u0438 \u043f\u0440\u043e\u0442\u0435\u043a\u0430\u044e\u0449\u0430\u044f \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u044c: \u043f\u043e\u044f\u0432\u043b\u0435\u043d\u0438\u0435 \u043e\u0442\u0435\u043a\u043e\u0432, \u043f\u043e\u0432\u044b\u0448\u0435\u043d\u0438\u0435 \u0430\u0440\u0442\u0435\u0440\u0438\u0430\u043b\u044c\u043d\u043e\u0433\u043e \u0434\u0430\u0432\u043b\u0435\u043d\u0438\u044f, \u043f\u043e\u0442\u0435\u0440\u044f \u0431\u0435\u043b\u043a\u0430 \u0441 \u043c\u043e\u0447\u043e\u0439 (\u0433\u0435\u0441\u0442\u043e\u0437), \u0441\u0443\u0434\u043e\u0440\u043e\u0433\u0438 (\u044d\u043a\u043b\u0430\u043c\u043f\u0441\u0438\u044f), \u0442\u043e\u043a\u0441\u0438\u043a\u043e\u0437.<\/li>\n
      • \u041d\u0430\u043b\u0438\u0447\u0438\u0435 \u0443 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0439 \u0445\u0440\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u0445 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0439 (\u043d\u0430\u043f\u0440\u0438\u043c\u0435\u0440, \u0441\u0430\u0445\u0430\u0440\u043d\u043e\u0433\u043e \u0434\u0438\u0430\u0431\u0435\u0442\u0430).<\/li>\n
      • \u041c\u043d\u043e\u0436\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u0435 \u043f\u043e\u0440\u043e\u043a\u0438 \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u044f \u043f\u043b\u043e\u0434\u0430 (\u0432 \u0442\u0430\u043a\u043e\u0439 \u0441\u0438\u0442\u0443\u0430\u0446\u0438\u0438 \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u0443\u0435\u0442\u0441\u044f \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0435 \u0443\u0440\u043e\u0432\u043d\u044f \u03b2-\u0425\u0413\u0427 \u0441\u043e\u0432\u043c\u0435\u0441\u0442\u043d\u043e \u0441 \u0434\u0440\u0443\u0433\u0438\u043c\u0438 \u043f\u043e\u043a\u0430\u0437\u0430\u0442\u0435\u043b\u044f\u043c\u0438, \u0442\u0430\u043a \u043d\u0430\u0437\u044b\u0432\u0430\u0435\u043c\u044b\u0439 \u00ab\u0442\u0440\u043e\u0439\u043d\u043e\u0439 \u0442\u0435\u0441\u0442\u00bb.<\/li>\n<\/ul>\n

        \u042d\u0442\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435 \u043f\u0440\u0438\u043c\u0435\u043d\u044f\u044e\u0442 \u0432 \u043a\u0430\u0447\u0435\u0441\u0442\u0432\u0435 \u0441\u043a\u0440\u0438\u043d\u0438\u043d\u0433\u043e\u0432\u043e\u0433\u043e, \u0430 \u043d\u0435 \u0434\u043b\u044f \u043f\u043e\u0441\u0442\u0430\u043d\u043e\u0432\u043a\u0438 \u0434\u0438\u0430\u0433\u043d\u043e\u0437\u0430.).<\/p>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[911,915],"product_tag":[],"class_list":{"0":"post-9249","1":"product","2":"type-product","3":"status-publish","5":"product_cat-markeri-endocrini","6":"product_cat-markeri-pentru-sarcina-normala-patologica","8":"first","9":"instock","10":"sold-individually","11":"shipping-taxable","12":"purchasable","13":"product-type-simple"},"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product\/9249","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=9249"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=9249"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=9249"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=9249"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=9249"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}