{"id":9278,"date":"2020-04-23T04:33:27","date_gmt":"2020-04-23T01:33:27","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/nt-probnp\/"},"modified":"2026-02-19T00:09:40","modified_gmt":"2026-02-18T22:09:40","slug":"nt-probnp","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/nt-probnp\/","title":{"rendered":"\u041c\u043e\u0437\u0433\u043e\u0432\u043e\u0439 \u043d\u0430\u0442\u0440\u0438\u0439\u0443\u0440\u0435\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0439 \u043f\u0435\u043f\u0442\u0438\u0434 (NT-proBNP)"},"content":{"rendered":"<div style=\"text-align: justify;\">\n<p><strong><em>Informa<\/em><\/strong><strong><em>\u0163<\/em><\/strong><strong><em>ii generale \u015fi recomand\u0103ri pentru determinarea NT-proBNP<\/em><\/strong><\/p>\n<p>Insuficien\u0163a cardiac\u0103 (IC) poate fi definit\u0103 ca anomalia structurii cardiace sau disfunc\u0163ia care duce la insuficien\u0163a inimii de a furniza oxigen la o rat\u0103 propor\u0163ional\u0103 cu cerin\u0163ele \u0163esuturilor metabolizante, \u00een ciuda presiunii normale de umplere (sau doar cu costul unei presiuni de umplere ridicate).<\/p>\n<p>Inciden\u0163a sa este \u00een continu\u0103 cre\u015ftere at\u00e2t \u00een \u0163\u0103rile din Europa c\u00e2t \u015fi \u00een Statele Unite ale Americii, constituind\u00a0 cauza cea mai frecvent\u0103 de spitalizare a persoanelor v\u00e2rstnice.<\/p>\n<p>Diagnosticul de insuficien\u0163\u0103 cardiac\u0103 \u00een stadiu precoce este greu de stabilit deoarece simptome cum ar fi dispneea, fatigabilitatea \u015fi edemele declive sunt destul de nespecifice. Diagnosticul devine \u015fi mai dificil la persoanele v\u00e2rstnice sau obeze. Pentru stabilirea diagnosticului se recurge adesea la investiga\u0163ii imagistice, ecografia cardiac\u0103 fiind cea mai folosit\u0103 metod\u0103. \u0162in\u00e2nd cont de faptul c\u0103 este o boal\u0103 progresiv\u0103, cu c\u00e2t diagnosticul este stabilit mai precoce, cu at\u00e2t mai mult se reduce riscul complica\u0163iilor \u015fi al mortalit\u0103\u0163ii<sup>1<\/sup>.<\/p>\n<p>Din acest motiv, s-a sim\u0163it nevoia s\u0103 se depisteze markeri serici care s\u0103 se coreleze \u00eentr-un mod adecvat cu prognosticul bolii.<\/p>\n<p>Semnifica\u0163ia clinic\u0103 a peptidelor natriuretice a fost de mult timp demonstrat\u0103. Acestea reprezint\u0103 familie de molecule ce include ANP (peptid natriuretic de tip A sau atrial), BNP (peptid natriuretic de tip B sau cerebral) \u0219i CNP (peptid natriuretic de tip C) cu rol \u00een men\u021binerea homeostaziei circulatorii. ANP \u015fi BNP prin propriet\u0103\u0163ile lor natriuretice, diuretice c\u00e2t \u015fi de antagoni\u015fti ai sistemului renin\u0103-angiotensin\u0103-aldosteron influen\u0163eaz\u0103 balan\u0163a hidro-electrolitic\u0103 din organism. ANP este eliberat rapid \u00een circula\u021bie \u00een timp ce BNP este sintetizat sub forma unor precursori (pre-proBNP \u0219i pro-BNP) \u0219i eliberat din miocardul ventricular \u00een circula\u021bie ca urmare a stresului parietal prelungit.<\/p>\n<p>Pro-BNP ce con\u021bine 108 aminoacizi este clivat \u00eentr-o form\u0103 biologic activ\u0103\u00a0\u2013 BNP (77-108) \u2013 \u015fi \u00eentr-un fragment inactiv\u00a0\u2013 NT-proBNP (1-76)<sup>2<\/sup>.<\/p>\n<p>S-a constatat c\u0103 nivelurile serice ale BNP (\u015fi respectiv ale NT-proBNP) se coreleaz\u0103 foarte bine cu severitatea disfunc\u0163iei ventriculare st\u00e2ngi \u0219i respectiv cu clasele NYHA (New York Heart Association) \u00een care sunt \u00eencadra\u021bi pacien\u021bii cu IC pe baza simptomatologiei clinice<sup>3<\/sup>.<\/p>\n<p>Terminologia tipic\u0103 pentru descrierea IC se bazeaz\u0103 pe m\u0103surarea frac\u021biei de ejec\u021bie a ventricului st\u00e2ng (FEVS). Ghidul Societ\u0103\u021bii Europene de Cardiologie (ESC) 2016 a redefinit entit\u0103\u021bile ce apar\u021bin IC, incluz\u00e2nd \u0219i valorile serice ale peptidelor natriuretice:<\/p>\n<ul>\n<li><strong>IC cu frac\u021bie de ejec\u021bie (FE) p\u0103strat\u0103<\/strong> \u2013 sunt prezente simptome \u00b1 semne caracteristice de IC dar FEVS \u2265 50 %; exist\u0103 dovada obiectiv\u0103 de boal\u0103 structural\u0103 a cordului (hipertrofie VS\/dilatare atriu st\u00e2ng, AS \u015fi\/sau disfunc\u0163ie diastolic\u0103) iar nivelurile pepetidelor natriuretice sunt crescute (BNP&gt;35 pg\/ml \u0219i\/sau NT-proBNP&gt;125 pg\/mL)<\/li>\n<li><strong>IC cu FE sc\u0103zut\u0103 <\/strong>\u2013 sunt prezente simptome \u00b1 semne caracteristice de IC \u00eempreun\u0103 cu FEVS &lt; 40 %<\/li>\n<li><strong>IC cu FE \u00een \u201ezona gri\u201c (mid-range) <\/strong>\u2013 sunt prezente simptome \u00b1 semne caracteristice de IC cu FEVS 40-49%; exist\u0103 dovada obiectiv\u0103 de boal\u0103 structural\u0103 a cordului (hipertrofie VS\/dilatare atriu st\u00e2ng, AS \u015fi\/sau disfunc\u0163ie diastolic\u0103) iar nivelurile pepetidelor natriuretice sunt crescute (BNP&gt;35 pg\/ml \u0219i\/sau NT-proBNP&gt;125 pg\/mL); pacien\u021bii au cel mai probabil o disfunc\u021bie sistolic\u0103 u\u0219oar\u0103<sup>4<\/sup>.<\/li>\n<\/ul>\n<p><strong>UTILITATEA CLINIC\u0102 A MARKER-ULUI NT-proBNP <\/strong><\/p>\n<ol>\n<li><u> Recomand\u0103ri ESC<\/u><\/li>\n<\/ol>\n<p>Ghidul ESC recomand\u0103 peptidele natriuretice, inclusiv NT-proBNP, ca test ini\u021bial pentru excluderea IC la pacien\u021bi cu dispnee, care se prezint\u0103 fie \u00een condi\u021bii de urgen\u021b\u0103, fie \u00een ambulator. Scopul este de a :<\/p>\n<p>\u2013 a evita consulta\u0163iile la cardiolog \u015fi ecografiile cardiace a pacien\u0163ilor cu simptome sugestive, dar f\u0103r\u0103 IC;<\/p>\n<p>\u2013 evita tratamentul nenecesar \u00een cazul pacien\u0163ilor suspecta\u0163i de IC dar av\u00e2nd o patologie non-cardiac\u0103<sup>4<\/sup>.<\/p>\n<ol>\n<li><em><u>Evaluarea pacien\u021bilor cu dispnee \u00een condi\u021bii de urgen\u021b\u0103<\/u><\/em><\/li>\n<\/ol>\n<p>\u25a0 Excluderea IC<\/p>\n<p>Concentra\u021biile\u00a0 NT-proBNP &lt; 300 pg\/mL prezint\u0103 o valoare predictiv\u0103 negativ\u0103 de 99% pentru excluderea IC congestive la toate grupele de v\u00e2rst\u0103<\/p>\n<p>\u25a0 Identificarea IC \u2013 valorile cut-off sunt \u00een func\u021bie de v\u00e2rst\u0103 \u0219i de prezen\u021ba\/absen\u021ba bolii cronice de rinichi (<em>engl. Chronic Kidney Disease, CKD<\/em>)<\/p>\n<p>&lt; 50 ani: NT-proBNP &gt; 450 pg\/mL (f\u0103r\u0103 CKD); &gt; 1200 pg\/mL (CKD)<\/p>\n<p>50-75 ani: NT-proBNP &gt; 900 pg\/mL (f\u0103r\u0103 CKD); &gt; 4502 pg\/mL (CKD)<\/p>\n<p>&gt;75 ani: NT-proBNP &gt; 1800 pg\/mL (f\u0103r\u0103 CKD).<\/p>\n<ol start=\"2\">\n<li>2<em>. <u>Evaluarea pacien\u021bilor cu dispnee \u00een condi\u021bii de ambulator<\/u><\/em><\/li>\n<\/ol>\n<p>Ghidul ESC recomand\u0103 s\u0103 se utilizeze o valoare cut-off diferit\u0103 fa\u021b\u0103 de condi\u021biile de urgen\u021b\u0103. Astfel, vaaloarea cut-off\u00a0 NT-proBNP 125 pg\/mL prezint\u0103 urm\u0103toarele caracteristici de performan\u021b\u0103 pentru detec\u021bia disfunc\u021biei sistolice a ventriculului st\u00e2ng:<\/p>\n<p>\u2013 sensibilitate 97%, specificitate 46%<\/p>\n<p>\u2013 valoare predictiv\u0103 pozitiv\u0103\u00a0 15%<\/p>\n<p>\u2013 valoare predictiv\u0103 negativ\u0103 99%<sup>4<\/sup>.<\/p>\n<ol>\n<li><u>Valoarea prognostic\u0103 a NT-proBNP \u00een IC cronic\u0103<\/u><\/li>\n<\/ol>\n<ul>\n<li>Valorile NT-proBNP crescute se coreleaz\u0103 cu severitatea IC bazat\u0103 pe clasificarea NYHA<sup>3<\/sup>;<\/li>\n<li>Studiul Copenhagen Hospital Heart Failure (2004) : valorile NT-proBNP au valoare predictiv\u0103 privind mortalitatea la 1 an<sup>5<\/sup>;<\/li>\n<li>La pacien\u021bii spitaliza\u021bi NT-proBNP are valoare predictiv\u0103 privind mortalitatea \u0219i\/sau reinternarea \u00een spital<sup>6<\/sup>;<\/li>\n<li>Valorile NT-proBNP + ecocardiografia Doppler \u00eembun\u0103t\u0103\u021besc stratificarea \u00een func\u021bie de risc a pacien\u021bilor cu IC cronic\u0103<sup>7<\/sup>.<\/li>\n<\/ul>\n<ol>\n<li><u>NT-proBNP \u00een monitorizarea \u0219i evaluarea tratamentului IC cronice<\/u><\/li>\n<\/ol>\n<ul>\n<li>De\u0219i studiile clinice au avut design-uri diferite \u0219i au urm\u0103rit \u021binte diferite \u00een ceea ce prive\u0219te peptidele natriuretice la categoriile variate de pacien\u021bi cu IC, utilizarea BNP\/NT-proBNP \u00een ghidarea tratamentului farmacologic \u00een IC cronic\u0103 pare s\u0103 fie asociat\u0103 cu reducerea mortalit\u0103\u021bii \u0219i a num\u0103rului de spitaliz\u0103ri, \u00een special la pacien\u021bii &lt; 75 ani, cu FEVS sc\u0103zut\u0103<sup>8<\/sup>.<\/li>\n<li>Studiile \u00een desf\u0103\u0219urare vor aduce date noi privind modul \u00een care determin\u0103rile NT-proBNP ar putea ajuta la individualizarea tratamentului \u00een IC cronic\u0103 dincolo de recomand\u0103rile standard din ghiduri<sup>9<\/sup>.<\/li>\n<\/ul>\n<ol>\n<li><u>Alte aplica\u021bii clinice ale NT-proBNP<\/u><\/li>\n<li><em><u>Stratificarea \u00een func\u021bie de risc a pacien\u021bilor cu sindrom coronarian acut<\/u><\/em><\/li>\n<\/ol>\n<p>\u25a0 Valorile NT-proBNP crescute\u00a0 \u00een faza subacut\u0103 constituie indicator puternic al mortalit\u0103\u021bii pe<\/p>\n<p>termen lung, \u00een special la pacien\u021bii f\u0103r\u0103 semne de IC<sup>10<\/sup>.<\/p>\n<p>\u25a0 La pacien\u021bii cu valori bazale NT-proBNP crescute lipsa unui declin rapid (&gt; 250 pg\/mL)\u00a0 dup\u0103<\/p>\n<p>48 h este asociat\u0103 cu risc \u00eenalt de evenimente cardiace pe termen scurt<sup>11<\/sup>.<\/p>\n<ol start=\"2\">\n<li><em><u>Evaluarea prognosticului la pacien\u021bii cu embolie pulmonar\u0103<\/u><\/em><\/li>\n<\/ol>\n<p>O valoare bazal\u0103 NT-proBNP &lt; 1000 pg\/mL are o valoare predictiv\u0103 negativ\u0103 95% privind complica\u021biile \u0219i 100% privind mortalitatea<sup>12<\/sup>.<\/p>\n<ol start=\"3\">\n<li><em><u>Screening-ul disfunc\u0163iilor ventriculare asimptomatice la pacien\u0163ii cu risc crescut<\/u><\/em> (hipertensivi, diabetici)<sup>13<\/sup>.<\/li>\n<li><em><u>Detectarea disfunc\u021biei VS la pacien\u0163ii cu bron\u015fit\u0103 cronic\u0103 acutizat\u0103<\/u><\/em> cu o sensibilitate 94.4% \u015fi specificitate 68.2% la un cut-off de 935 pg\/mL<sup>14<\/sup>.<\/li>\n<\/ol>\n<p><strong>AVANTAJELE TEST\u0102RII NT-proBNP versus BNP <\/strong><\/p>\n<ul>\n<li>timp de \u00eenjum\u0103t\u0103\u021bire 1-2 h (NT-proBNP) vs 20 min (BNP);<\/li>\n<li>stabilitate crescut\u0103 \u00een plasm\u0103; fluctua\u021bii diurne reduse;<\/li>\n<li>deoarece NT-proBNP nu este un hormon activ acesta nu este \u00eendep\u0103rtat din circula\u021bie prin mecanisme biologice, astfel c\u0103 prezint\u0103 niveluri stabile mai mari \u00een circula\u021bie vs BNP;<\/li>\n<li>BNP este metabolizat de endopeptidaza neutr\u0103 (neprilizin) astfel c\u0103 tratamentul IC cu o combina\u021bie de inhibitor de neprilizin (sacubitril) \u0219i un blocant de receptor angiotensinic (valsartan) influen\u021beaz\u0103 nivelurile sale \u00een s\u00e2nge dar nu \u0219i pe cele NT-proBNP<sup>15<\/sup>.<\/li>\n<\/ul>\n<p><strong><em>Preg\u0103tire pacient <\/em><\/strong>\u2013 nu este necesar\u0103 o preg\u0103tire special\u0103<sup>16<\/sup>.<\/p>\n<p><strong><em>Specimen recoltat <\/em><\/strong>\u2013 s\u00e2nge venos<sup>16<\/sup>.<\/p>\n<p><strong><em>Recipient de recoltare <\/em><\/strong>\u2013 vacutainer f\u0103r\u0103 anticoagulant, cu\/f\u0103r\u0103 gel separator<sup>16<\/sup>.<\/p>\n<p><strong><em>Prelucrare necesar\u0103 dup\u0103 recoltare <\/em><\/strong>\u2013 se separ\u0103 serul prin centrifugare<sup>16<\/sup>.<\/p>\n<p><strong><em>Volum prob\u0103 <\/em><\/strong>\u2013 minim 0.5 mL ser<sup>16<\/sup>.<\/p>\n<p><strong><em>Cauze de respingere a probei<\/em><\/strong> \u2013 specimen hemolizat<sup>16<\/sup>.<\/p>\n<p><strong>Stabilitate prob\u0103<\/strong> - <em>3 zile<\/em> la 20-25\u00baC; <em>6 zile<\/em> la 2-8\u00baC; 12 luni la -20\u00baC<sup>16<\/sup>.<\/p>\n<p><strong><em>Metod\u0103 <\/em><\/strong><em>- <\/em><u>imunochimic\u0103 cu detec\u0163ie prin electrochemiluminiscen\u0163\u0103<\/u> (ECLIA)<sup>2<\/sup>. Kit-ul utilizat \u00een laboratorul Synevo con\u0163ine 2 anticorpi policlonali care recunosc epitopi localiza\u0163i \u00een por\u0163iunea N-terminal\u0103 (1-76) a BNP<sup>16<\/sup>.<\/p>\n<p><strong><em>Valori de referin\u0163\u0103<\/em><\/strong><sup>16<\/sup>.<\/p>\n<p><u>Valori de referin\u021b\u0103 \u00een popula\u021bia general\u0103 \u00een func\u021bie de v\u00e2rst\u0103 \u0219i sex (pg\/mL)<\/u><\/p>\n<table class=\"wp-block-table w-100\">\n<tbody>\n<tr>\n<td width=\"197\"><strong>Grupa de v\u00e2rst\u0103<\/strong><\/td>\n<td width=\"197\"><strong>Sex masculin<\/strong><\/td>\n<td width=\"197\"><strong>Sex feminin<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"197\">0-11 luni<\/td>\n<td width=\"197\">Nu au fost stabilite<\/td>\n<td width=\"197\">Nu au fost stabilite<\/td>\n<\/tr>\n<tr>\n<td width=\"197\">1-3 ani<\/td>\n<td width=\"197\">&lt; 320<\/td>\n<td width=\"197\">&lt; 320<\/td>\n<\/tr>\n<tr>\n<td width=\"197\">4-6 ani<\/td>\n<td width=\"197\">&lt;190<\/td>\n<td width=\"197\">&lt;190<\/td>\n<\/tr>\n<tr>\n<td width=\"197\">7-9 ani<\/td>\n<td width=\"197\">&lt;145<\/td>\n<td width=\"197\">&lt;145<\/td>\n<\/tr>\n<tr>\n<td width=\"197\">10 ani<\/td>\n<td width=\"197\">&lt;112<\/td>\n<td width=\"197\">&lt;112<\/td>\n<\/tr>\n<tr>\n<td width=\"197\">11 ani<\/td>\n<td width=\"197\">&lt;317<\/td>\n<td width=\"197\">&lt;317<\/td>\n<\/tr>\n<tr>\n<td width=\"197\">12 ani<\/td>\n<td width=\"197\">&lt;186<\/td>\n<td width=\"197\">&lt;186<\/td>\n<\/tr>\n<tr>\n<td width=\"197\">13 ani<\/td>\n<td width=\"197\">&lt;370<\/td>\n<td width=\"197\">&lt;370<\/td>\n<\/tr>\n<tr>\n<td width=\"197\">14 ani<\/td>\n<td width=\"197\">&lt;363<\/td>\n<td width=\"197\">&lt;363<\/td>\n<\/tr>\n<tr>\n<td width=\"197\">15 ani<\/td>\n<td width=\"197\">&lt;217<\/td>\n<td width=\"197\">&lt;217<\/td>\n<\/tr>\n<tr>\n<td width=\"197\">16 ani<\/td>\n<td width=\"197\">&lt;206<\/td>\n<td width=\"197\">&lt;206<\/td>\n<\/tr>\n<tr>\n<td width=\"197\">17 ani<\/td>\n<td width=\"197\">&lt;135<\/td>\n<td width=\"197\">&lt;135<\/td>\n<\/tr>\n<tr>\n<td width=\"197\">18 ani<\/td>\n<td width=\"197\">&lt;115<\/td>\n<td width=\"197\">&lt;115<\/td>\n<\/tr>\n<tr>\n<td width=\"197\">18-44 ani<\/td>\n<td width=\"197\">&lt;86<\/td>\n<td width=\"197\">&lt;130<\/td>\n<\/tr>\n<tr>\n<td width=\"197\">45-54 ani<\/td>\n<td width=\"197\">&lt;121<\/td>\n<td width=\"197\">&lt;249<\/td>\n<\/tr>\n<tr>\n<td width=\"197\">55-64 ani<\/td>\n<td width=\"197\">&lt;210<\/td>\n<td width=\"197\">&lt;287<\/td>\n<\/tr>\n<tr>\n<td width=\"197\">65-74 ani<\/td>\n<td width=\"197\">&lt;376<\/td>\n<td width=\"197\">&lt;301<\/td>\n<\/tr>\n<tr>\n<td width=\"197\">\u2265 75 ani<\/td>\n<td width=\"197\">&lt;486<\/td>\n<td width=\"197\">&lt;738<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Cut-off clinic<\/strong> pentru disfunc\u0163ia cardiac\u0103: 125 pg\/mL<\/p>\n<p><strong><u>Corela\u021bii NT-proBNP cu clasele NYHA (pentru pacien\u021bii diagnostica\u021bi cu insuficien\u021b\u0103 cardiac\u0103 cronic\u0103)<\/u><\/strong><\/p>\n<p>NYHA I: \u00a0\u00a033-3410 pg\/mL<\/p>\n<p>NYHA II: 103-6567 pg\/mL<\/p>\n<p>NYHA III: 126-10449 pg\/mL<\/p>\n<p>NYHA IV: 148-12188\u00a0\u00a0 pg\/mL<\/p>\n<p>Factori de conversie:\u00a0\u00a0 pmol\/L x 8.457 = pg\/mL\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 pg\/mL x 0.118 = pmol\/L.<\/p>\n<p><strong><em>Limita de detec\u0163ie<\/em><\/strong> \u2013 5 pg\/mL (0.6 pmol\/L)<sup>16<\/sup>.<\/p>\n<p><strong><em>Interpretarea rezultatelor<\/em><\/strong><\/p>\n<p>Valori &gt;125 pg\/mL pot indica disfunc\u0163ie cardiac\u0103 \u015fi un risc crescut de complica\u0163ii cardiace (infarct miocardic, insuficien\u0163\u0103 cardiac\u0103, moarte subit\u0103)<sup>16<\/sup>.<\/p>\n<p><strong><em>Limite \u015fi interferen\u0163e<\/em><\/strong><\/p>\n<p>Valorile ob\u0163inute pentru NT-proBNP trebuie interpretate \u00een corela\u0163ie cu datele clinice ale pacientului \u015fi alte investiga\u0163ii paraclinice.<\/p>\n<p>Se pot ob\u021bine valori fals crescute la persoanele obeze.<\/p>\n<p>Valori moderat crescute de NT-proBNP se pot \u00eenregistra \u00een \u00een boli pulmonare cronice cu disfunc\u021bie de ventricul drept.<\/p>\n<p>Valorile NT-proBNP trebuie interpretate cu precau\u021bie \u00een cazul unei rate de filtrare glomerular\u0103<\/p>\n<p>(RFG) &lt; 60 mL\/min<sup>17<\/sup>.<\/p>\n<ul>\n<li>Interferen\u0163e analitice<\/li>\n<\/ul>\n<p>Pot produce interferen\u0163e cu unele componente ale kit-ului \u015fi conduce la rezultate neconcludente urm\u0103toarele:<\/p>\n<p>\u2013 tratamentul cu biotin\u0103 \u00een doze mari (&gt;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;<\/p>\n<p>\u2013 titrurile foarte crescute de anticorpi anti-streptavidin\u0103 \u015fi anti-ruteniu<sup>16<\/sup>.<\/p>\n<p><em>\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<\/em><\/p>\n<ol>\n<li style=\"text-align: left;\">Ghidul ESC de diagnostic \u015fi tratament al insuficien\u021bei cardiace acute \u015fi cronice 2012. Grupul de Lucru pentru Diagnosticul \u015fi Tratamentul Insuficien\u021bei Cardiace Acute \u015fi Cronice 2012 al Societ\u0103\u0163ii Europene de Cardiologie. Elaborat \u00een colaborare cu Asocia\u0163ia pentru Insuficien\u0163\u0103 Cardiac\u0103 (HFA) a ESC. Romanian Journal of Cardiology\u00a0 Vol. 23, No. 3, 2013.<\/li>\n<li style=\"text-align: left;\">Clerico A, Passino C, Franzini M, et al. Cardiac biomarker testing in the clinical labratory: Where do we stand?General overview of themethodology with special emphasis on natriuretic peptides. Clin Chimica Acta 2015;443:17-24.<\/li>\n<li style=\"text-align: left;\">Januzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients The International Collaborative of NT-proBNP Study Euro Heart Journ 2006;27(3):330-337.<\/li>\n<li style=\"text-align: left;\">Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, Falk V, Gonz\u00e1lez-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GM,\u00a0 \u00a0 Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P; Authors\/Task Force Members; Document Reviewers. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016 Aug;18(8):891-975.<\/li>\n<li style=\"text-align: left;\">Kirk V, Bay M, Parner J, Krogsgaard K, Herzog TM, Boesgaard S, Hassager C, Nielsen OW, Aldershvile J, Nielsen H. N-terminal proBNP and mortality in hospitalised patients with heart failure and preserved vs. reduced systolic function: data from the prospective Copenhagen Hospital Heart Failure Study (CHHF). Eur J Heart Fail. 2004 Mar 15;6(3):335-41.<\/li>\n<li style=\"text-align: left;\">Bettencourt P, Azevedo A, Pimenta J, Fri\u00f5es F, Ferreira S, Ferreira A. N-terminal-pro-brain natriuretic peptide predicts outcome after hospital discharge in heart failure patients. Circulation. 2004 Oct 12;110(15):2168-74.<\/li>\n<li style=\"text-align: left;\">Bruch C, Rothenburger M, Gotzmann M, Sindermann J, Scheld HH, Breithardt G, Wichter T. Risk stratification in chronic heart failure: independent and incremental prognostic value of echocardiography and brain natriuretic peptide and its N-terminal fragment. J Am Soc Echocardiogr. 2006 May;19(5):522-8.<\/li>\n<li style=\"text-align: left;\">Bayes-Genis A, Lup\u00f3n J, Jaffe AS. Can Natriuretic Peptides be Used to Guide Therapy? EJIFCC. 2016 Aug 1;27(3):208-16.<\/li>\n<li style=\"text-align: left;\">Francis GS, Felker GM, Tang WH. A Test in Context: Critical Evaluation of Natriuretic Peptide Testing in Heart Failure. J Am Coll Cardiol. 2016 Jan 26;67(3):330-7.<\/li>\n<li style=\"text-align: left;\">Omland T, Persson A, Ng L, O\u2019Brien R, Karlsson T, Herlitz J, Hartford M, Caidahl K. N-terminal pro-B-type natriuretic peptide and long-term mortality in acute coronary syndromes. Circulation. 2002 Dec3;106(23):2913-8<\/li>\n<li>Heeschen C, Hamm CW, Mitrovic V, Lantelme NH, White HD; Platelet Receptor Inhibition in Ischemic Syndrome Management (PRISM) Investigators. N-terminal pro-B-type natriuretic peptide levels for dynamic risk stratification of patients with acute coronary syndromes. Circulation. 2004 Nov 16;110(20):3206-12.<\/li>\n<li>Binder L, Pieske B, Olschewski M, Geibel A, Klostermann B, Reiner C, Konstantinides S. N-terminal pro-brain natriuretic peptide or troponin testing followed by echocardiography for risk stratification of acute pulmonary embolism. Circulation. 2005 Sep 13;112(11):1573-9.<\/li>\n<li>Luers C, Wachter R, Kleta S, Uhlir M, Koschack J, Scherer M, Binder L, Herrmann-Lingen C, Zapf A, Kulle B, Kochen MM, Pieske B. Natriuretic peptides in the detection of preclinical diastolic or systolic dysfunction. Clin Res Cardiol. 2010 Apr;99(4):217-26.<\/li>\n<li>Wang QP, Cao XZ, Wang XD, Gu J, Wen LM, Mao LM, Shan PN, Tang AG. Utility of NT-proBNP for identifying LV failure in patients with acute exacerbation of chronic bronchitis. PLoS One. 2013;8(1):e52553.<\/li>\n<li>Stokes NR, Dietz BW, Liang JJ. Cardiopulmonary laboratory biomarkers in the evaluation of acute dyspnea. Open Access Emerg Med. 2016 May 17;8:35-45.<\/li>\n<li>Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate. 2017. Ref Type: Catalog.<\/li>\n<li>Semenov AG, Katrukha AG. Analytical Issues with Natriuretic Peptides \u2013 has this been Overly Simplified? EJIFCC. 2016 Aug 1;27(3):189-207<\/li>\n<\/ol>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>\u041c\u043e\u0437\u0433\u043e\u0432\u043e\u0439 \u043d\u0430\u0442\u0440\u0438\u0439\u0443\u0440\u0435\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0439 \u043f\u0435\u043f\u0442\u0438\u0434 (BNP) &#8211; \u043c\u0430\u0440\u043a\u0435\u0440 \u0441\u0435\u0440\u0434\u0435\u0447\u043d\u043e\u0439 \u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u0438. BNP \u0441\u0438\u043d\u0442\u0435\u0437\u0438\u0440\u0443\u0435\u0442\u0441\u044f \u0438 \u0432\u044b\u0434\u0435\u043b\u044f\u0435\u0442\u0441\u044f \u0432 \u043a\u0440\u043e\u0432\u043e\u0442\u043e\u043a \u0432 \u043e\u0442\u0432\u0435\u0442 \u043d\u0430 \u043e\u0431\u044a\u0451\u043c\u043d\u0443\u044e \u043f\u0435\u0440\u0435\u0433\u0440\u0443\u0437\u043a\u0443 \u0438\u043b\u0438 \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u044f, \u0432\u044b\u0437\u044b\u0432\u0430\u044e\u0449\u0438\u0435 \u0440\u0430\u0441\u0442\u044f\u0436\u0435\u043d\u0438\u0435 \u0436\u0435\u043b\u0443\u0434\u043e\u0447\u043a\u0430 \u0441\u0435\u0440\u0434\u0446\u0430, \u0441 \u0446\u0435\u043b\u044c\u044e \u043a\u043e\u043d\u0442\u0440\u043e\u043b\u044f \u0436\u0438\u0434\u043a\u043e\u0441\u0442\u043d\u043e\u0433\u043e \u0438 \u044d\u043b\u0435\u043a\u0442\u0440\u043e\u043b\u0438\u0442\u043d\u043e\u0433\u043e \u0433\u043e\u043c\u0435\u043e\u0441\u0442\u0430\u0437\u0430 \u043f\u0443\u0442\u0451\u043c \u0432\u0437\u0430\u0438\u043c\u043e\u0434\u0435\u0439\u0441\u0442\u0432\u0438\u044f \u0441 \u0441\u0438\u0441\u0442\u0435\u043c\u043e\u0439 \u0440\u0435\u043d\u0438\u043d-\u0430\u043d\u0433\u0438\u043e\u0442\u0435\u043d\u0437\u0438\u043d-\u0430\u043b\u044c\u0434\u043e\u0441\u0442\u0435\u0440\u043e\u043d.<\/p>\n<p>\u0423\u0440\u043e\u0432\u0435\u043d\u044c BNP \u043f\u043e\u0432\u044b\u0448\u0435\u043d \u0443 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u0432 \u0441 \u0434\u0438\u0441\u0444\u0443\u043d\u043a\u0446\u0438\u0435\u0439 \u043b\u0435\u0432\u043e\u0433\u043e \u0436\u0435\u043b\u0443\u0434\u043e\u0447\u043a\u0430. \u041f\u0440\u0438 \u044d\u0442\u043e\u043c \u0441\u043e\u0434\u0435\u0440\u0436\u0430\u043d\u0438\u0435 BNP \u0432 \u043f\u043b\u0430\u0437\u043c\u0435 \u043a\u0440\u043e\u0432\u0438 \u0434\u043e\u0441\u0442\u043e\u0432\u0435\u0440\u043d\u043e \u043a\u043e\u0440\u0440\u0435\u043b\u0438\u0440\u0443\u0435\u0442 \u0441 \u0444\u0443\u043d\u043a\u0446\u0438\u043e\u043d\u0430\u043b\u044c\u043d\u044b\u043c\u0438 \u043a\u043b\u0430\u0441\u0441\u0430\u043c\u0438 \u0445\u0440\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u043e\u0439 \u0441\u0435\u0440\u0434\u0435\u0447\u043d\u043e\u0439 \u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u0438 (\u043f\u043e \u043a\u043b\u0430\u0441\u0441\u0438\u0444\u0438\u043a\u0430\u0446\u0438\u0438 \u041d\u044c\u044e-\u0419\u043e\u0440\u043a\u0441\u043a\u043e\u0439 \u0430\u0441\u0441\u043e\u0446\u0438\u0430\u0446\u0438\u0438 \u043f\u043e \u0438\u0437\u0443\u0447\u0435\u043d\u0438\u044e \u0441\u0435\u0440\u0434\u0435\u0447\u043d\u044b\u0445 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0439). \u041e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0435 \u0443\u0440\u043e\u0432\u043d\u044f BNP \u0432 \u043f\u043b\u0430\u0437\u043c\u0435 \u043a\u0440\u043e\u0432\u0438 \u043f\u043e\u043c\u043e\u0433\u0430\u0435\u0442 \u043e\u0446\u0435\u043d\u0438\u0442\u044c \u0441\u0442\u0435\u043f\u0435\u043d\u044c \u0442\u044f\u0436\u0435\u0441\u0442\u0438 \u0445\u0440\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u043e\u0439 \u0441\u0435\u0440\u0434\u0435\u0447\u043d\u043e\u0439 \u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u0438, \u043f\u0440\u043e\u0433\u043d\u043e\u0437\u0438\u0440\u043e\u0432\u0430\u0442\u044c \u0434\u0430\u043b\u044c\u043d\u0435\u0439\u0448\u0435\u0435 \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u0435 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f, \u0430 \u0442\u0430\u043a\u0436\u0435 \u043e\u0446\u0435\u043d\u0438\u0432\u0430\u0442\u044c \u044d\u0444\u0444\u0435\u043a\u0442 \u043f\u0440\u043e\u0432\u043e\u0434\u0438\u043c\u043e\u0439 \u0442\u0435\u0440\u0430\u043f\u0438\u0438.<\/p>\n<p>\u041d\u0430\u0442\u0440\u0438\u0439\u0443\u0440\u0435\u0442\u0438\u0447\u0435\u0441\u043a\u043e\u0433\u043e \u0433\u043e\u0440\u043c\u043e\u043d\u0430 (\u0412-\u0442\u0438\u043f\u0430) N-\u043a\u043e\u043d\u0446\u0435\u0432\u043e\u0439 \u043f\u043e\u043b\u0438\u043f\u0435\u043f\u0442\u0438\u0434 (NT-proBNP) &#8212; \u043c\u043e\u0437\u0433\u043e\u0432\u043e\u0439 \u043d\u0430\u0442\u0440\u0438\u0439\u0443\u0440\u0435\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0439 \u043f\u0435\u043f\u0442\u0438\u0434 (BNP) &#8211; \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u0443\u0435\u0442\u0441\u044f \u0434\u043b\u044f \u043f\u0435\u0440\u0432\u0438\u0447\u043d\u043e\u0439 \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0438 \u0438 \u043f\u0440\u043e\u0433\u043d\u043e\u0437\u0430 \u0442\u0435\u0447\u0435\u043d\u0438\u044f \u0441\u0435\u0440\u0434\u0435\u0447\u043d\u043e\u0439 \u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u0438, \u043c\u043e\u043d\u0438\u0442\u043e\u0440\u0438\u043d\u0433\u0430 \u043b\u0435\u0447\u0435\u043d\u0438\u044f. \u041d\u0430\u0442\u0440\u0438\u0439\u0443\u0440\u0435\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0439 \u043f\u0435\u043f\u0442\u0438\u0434 B-\u0442\u0438\u043f\u0430 &#8211; \u0432\u0430\u0437\u043e\u0430\u043a\u0442\u0438\u0432\u043d\u044b\u0439 \u0433\u043e\u0440\u043c\u043e\u043d. \u041e\u043d \u0441\u0438\u043d\u0442\u0435\u0437\u0438\u0440\u0443\u0435\u0442\u0441\u044f \u0432 \u043a\u043b\u0435\u0442\u043a\u0430\u0445 \u043c\u0438\u043e\u043a\u0430\u0440\u0434\u0430, \u043e\u0442\u043a\u0443\u0434\u0430 \u0432\u044b\u0441\u0432\u043e\u0431\u043e\u0436\u0434\u0430\u0435\u0442\u0441\u044f \u0432 \u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u0435 \u0440\u0430\u0441\u0442\u044f\u0436\u0435\u043d\u0438\u044f \u0441\u0442\u0435\u043d\u043a\u0438 \u0436\u0435\u043b\u0443\u0434\u043e\u0447\u043a\u0430. \u041f\u043e\u0432\u044b\u0448\u0435\u043d\u0438\u0435 \u0443\u0440\u043e\u0432\u043d\u044f \u043d\u0430\u0442\u0440\u0438\u0439\u0443\u0440\u0435\u0442\u0438\u0447\u0435\u0441\u043a\u043e\u0433\u043e \u0433\u043e\u0440\u043c\u043e\u043d\u0430 \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u043f\u0440\u0435\u0434\u0432\u0435\u0441\u0442\u043d\u0438\u043a\u043e\u043c \u0440\u0435\u0430\u043b\u0438\u0437\u0430\u0446\u0438\u0438 \u043d\u0435\u0431\u043b\u0430\u0433\u043e\u043f\u0440\u0438\u044f\u0442\u043d\u043e\u0433\u043e \u043f\u0440\u043e\u0433\u043d\u043e\u0437\u0430 \u0443 \u0431\u043e\u043b\u044c\u043d\u044b\u0445 \u0441 \u0441\u0435\u0440\u0434\u0435\u0447\u043d\u043e\u0439 \u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u044c\u044e \u043b\u044e\u0431\u043e\u0439 \u044d\u0442\u0438\u043e\u043b\u043e\u0433\u0438\u0438.<\/p>\n<table>\n<tbody>\n<tr>\n<td colspan=\"2\" width=\"262\"><b>\u041f\u043e\u043a\u0430\u0437\u0430\u0442\u0435\u043b\u044c<\/b><\/td>\n<td width=\"361\"><b>\u0425\u0430\u0440\u0430\u043a\u0442\u0435\u0440\u0438\u0441\u0442\u0438\u043a\u0430<\/b><\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\" width=\"262\"><b>\u041c\u0430\u0442\u0435\u0440\u0438\u0430\u043b<\/b><\/td>\n<td width=\"361\">\u0412\u0435\u043d\u043e\u0437\u043d\u0430\u044f\u00a0\u043a\u0440\u043e\u0432\u044c<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\" width=\"262\"><b>\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<td width=\"361\">\u0421\u0442\u0430\u043d\u0434\u0430\u0440\u0442\u043d\u044b\u0435<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\" width=\"262\"><b>\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<td width=\"361\">\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<tr>\n<td colspan=\"2\" width=\"262\"><b>\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<td width=\"361\">\u0421\u0442\u0430\u043d\u0434\u0430\u0440\u0442\u043d\u044b\u0435<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\" width=\"262\"><b>\u041c\u0435\u0442\u043e\u0434\u00a0\u0442\u0435\u0441\u0442\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u044f<\/b><\/td>\n<td width=\"361\">\u0418\u043c\u043c\u0443\u043d\u043e\u0445\u0438\u043c\u0438\u0447\u0435\u0441\u043a\u0438\u0439\u00a0\u0441\u00a0\u044d\u043b\u0435\u043a\u0442\u0440\u043e\u0445\u0435\u043c\u0438\u043b\u044e\u043c\u0438\u043d\u0435\u0441\u0446\u0435\u043d\u0442\u043d\u043e\u0439\u00a0\u0434\u0435\u0442\u0435\u043a\u0446\u0438\u0435\u0439\u00a0(ECLIA)<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\" width=\"262\"><\/td>\n<td width=\"361\"><\/td>\n<\/tr>\n<tr>\n<td colspan=\"3\" width=\"623\"><b>\u0420\u0435\u0444\u0435\u0440\u0435\u043d\u0442\u043d\u044b\u0435\u00a0\u0437\u043d\u0430\u0447\u0435\u043d\u0438\u044f,<\/b><b>\u00a0\u043f\u0433\/\u043c\u043b<\/b><\/p>\n<p><b>\u0416\u0435\u043d\u0449\u0438\u043d\u044b<\/b>.\u00a018-44\u00a0\u0433\u043e\u0434\u0430:\u00a0\u0434\u043e\u00a0130,0;\u00a045-54\u00a0\u0433\u043e\u0434\u0430:\u00a0\u0434\u043e\u00a0249,0;\u00a055-64\u00a0\u0433\u043e\u0434\u0430:\u00a0\u0434\u043e\u00a0287,0;<\/p>\n<p>65-74\u00a0\u0433\u043e\u0434\u0430:\u00a0\u0434\u043e\u00a0301,0.\u00a0\u0421\u0442\u0430\u0440\u0448\u0435\u00a075\u00a0\u043b\u0435\u0442:\u00a0\u0434\u043e\u00a0738,0.<\/p>\n<p><b>\u041c\u0443\u0436\u0447\u0438\u043d\u044b<\/b>.\u00a018-44\u00a0\u0433\u043e\u0434\u0430:\u00a0\u0434\u043e\u00a085,8;\u00a045-54\u00a0\u0433\u043e\u0434\u0430:\u00a0\u0434\u043e\u00a0121,0;\u00a055-64\u00a0\u0433\u043e\u0434\u0430:\u00a0\u0434\u043e\u00a0210,0;\u00a065-74\u00a0\u0433\u043e\u0434\u0430:\u00a0\u0434\u043e\u00a0376,0.\u00a0\u0421\u0442\u0430\u0440\u0448\u0435\u00a075\u00a0\u043b\u0435\u0442:\u00a0\u0434\u043e\u00a0486,0<\/td>\n<\/tr>\n<tr>\n<td width=\"252\"><b>\u041a\u043e\u044d\u0444\u0444\u0438\u0446\u0438\u0435\u043d\u0442\u00a0\u043f\u0435\u0440\u0435\u0440\u0430\u0441\u0447\u0435\u0442\u0430<\/b><\/td>\n<td colspan=\"2\" width=\"370\">\u043f\u043c\u043e\u043b\u044c\/\u043b\u00a0\u0445\u00a08,457\u00a0=\u00a0\u043f\u0433\/\u043c\u043b;\u00a0\u043f\u0433\/\u043c\u043b\u00a0\u0445\u00a00,118\u00a0=\u00a0\u043f\u043c\u043e\u043b\u044c\/\u043b<\/td>\n<\/tr>\n<tr>\n<td colspan=\"3\" width=\"623\"><b>\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<tr>\n<td colspan=\"3\" width=\"623\">\u041f\u043e\u043b\u0443\u0447\u0435\u043d\u043d\u044b\u0435\u00a0\u0437\u043d\u0430\u0447\u0435\u043d\u0438\u044f\u00a0\u0434\u043b\u044f\u00a0\u043d\u0430\u0442\u0440\u0438\u0439\u0443\u0440\u0435\u0442\u0438\u0447\u0435\u0441\u043a\u043e\u0433\u043e\u00a0\u0433\u043e\u0440\u043c\u043e\u043d\u0430\u00a0(\u0412\u00a0\u0442\u0438\u043f\u0430)\u00a0N-\u043a\u043e\u043d\u0446\u0435\u0432\u043e\u0433\u043e\u00a0\u043f\u043e\u043b\u0438\u043f\u0435\u043f\u0442\u0438\u0434\u0430\u00a0(NT-proBNP)\u00a0\u0434\u043e\u043b\u0436\u043d\u044b\u00a0\u0438\u043d\u0442\u0435\u0440\u043f\u0440\u0435\u0442\u0438\u0440\u043e\u0432\u0430\u0442\u044c\u0441\u044f\u00a0\u0432\u00a0\u0441\u043e\u0447\u0435\u0442\u0430\u043d\u0438\u0438\u00a0\u0441\u00a0\u043a\u043b\u0438\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u043c\u0438\u00a0\u0434\u0430\u043d\u043d\u044b\u043c\u0438\u00a0\u0438\u00a0\u0434\u0430\u043d\u043d\u044b\u043c\u0438\u00a0\u0434\u0440\u0443\u0433\u0438\u0445\u00a0\u043b\u0430\u0431\u043e\u0440\u0430\u0442\u043e\u0440\u043d\u044b\u0445\u00a0\u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0439<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table>\n<tbody>\n<tr>\n<td width=\"623\"><b>\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<tr>\n<td width=\"623\">\u00b7\u00a0\u0414\u0438\u0444\u0444\u0435\u0440\u0435\u043d\u0446\u0438\u0430\u043b\u044c\u043d\u0430\u044f\u00a0\u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0430\u00a0\u043c\u0435\u0436\u0434\u0443\u00a0\u0441\u0435\u0440\u0434\u0435\u0447\u043d\u044b\u043c\u0438\u00a0\u0438\u00a0\u043b\u0451\u0433\u043e\u0447\u043d\u044b\u043c\u0438\u00a0\u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f\u043c\u0438;<\/p>\n<p>\u00b7\u00a0\u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0430\u00a0\u0441\u0435\u0440\u0434\u0435\u0447\u043d\u043e\u0439\u00a0\u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u0438\u00a0\u043d\u0430\u00a0\u0440\u0430\u043d\u043d\u0438\u0445\u00a0\u0434\u043e\u043a\u043b\u0438\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u0445\u00a0\u0441\u0442\u0430\u0434\u0438\u044f\u0445,<\/p>\n<p>\u043e\u0446\u0435\u043d\u043a\u0430\u00a0\u0441\u0442\u0435\u043f\u0435\u043d\u0438\u00a0\u0442\u044f\u0436\u0435\u0441\u0442\u0438\u00a0\u0441\u0435\u0440\u0434\u0435\u0447\u043d\u043e\u0439\u00a0\u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u0438,\u00a0\u043e\u0446\u0435\u043d\u043a\u0430\u00a0\u044d\u0444\u0444\u0435\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u0438\u00a0\u043f\u0440\u043e\u0432\u043e\u0434\u0438\u043c\u043e\u0439\u00a0\u0442\u0435\u0440\u0430\u043f\u0438\u0438;<\/p>\n<p>\u00b7\u00a0\u0434\u0438\u0441\u043f\u0430\u043d\u0441\u0435\u0440\u0438\u0437\u0430\u0446\u0438\u044f\u00a0\u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u0432\u00a0\u0441\u00a0\u0432\u044b\u0441\u043e\u043a\u0438\u043c\u00a0\u0440\u0438\u0441\u043a\u043e\u043c\u00a0\u043d\u0435\u0431\u043b\u0430\u0433\u043e\u043f\u0440\u0438\u044f\u0442\u043d\u043e\u0433\u043e\u00a0\u0438\u0441\u0445\u043e\u0434\u0430<\/td>\n<\/tr>\n<tr>\n<td width=\"623\"><b>\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<tr>\n<td width=\"623\">\u00b7\u00a0NT-proBNP\u00a0\u043c\u0435\u043d\u044c\u0448\u0435\u00a0125\u00a0\u043f\u0433\/\u043c\u043b\u00a0&#8212;\u00a0\u0440\u0430\u0437\u0432\u0438\u0442\u0438\u0435\u00a0\u0441\u0435\u0440\u0434\u0435\u0447\u043d\u043e\u0439\u00a0\u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u0438\u00a0\u043c\u0430\u043b\u043e\u0432\u0435\u0440\u043e\u044f\u0442\u043d\u043e\u00a0\u0438\u00a0\u0442\u0430\u043a\u0438\u0435\u00a0\u0443\u0440\u043e\u0432\u043d\u0438\u00a0\u0443\u0441\u043b\u043e\u0432\u043d\u043e\u00a0\u043f\u0440\u0438\u043d\u044f\u0442\u044b<\/p>\n<p>\u043a\u0430\u043a\u00a0\u00ab\u043d\u043e\u0440\u043c\u0430\u043b\u044c\u043d\u044b\u0435\u00bb\u00a0\u0432\u00a0\u0444\u0443\u043d\u043a\u0446\u0438\u0438\u00a0\u0441\u0435\u0440\u0434\u0446\u0430\u00a0\u0438\u00a0\u043c\u043e\u0433\u0443\u0442\u00a0\u0431\u044b\u0442\u044c\u00a0\u0438\u0441\u043a\u043b\u044e\u0447\u0435\u043d\u044b\u00a0\u0441\u00a0\u0432\u044b\u0441\u043e\u043a\u043e\u0439\u00a0\u0432\u0435\u0440\u043e\u044f\u0442\u043d\u043e\u0441\u0442\u044c\u044e.<\/p>\n<p>\u00b7\u00a0NT-proBNP\u00a0\u0432\u044b\u0448\u0435\u00a0125\u00a0\u043f\u0433\/\u043c\u043b\u00a0&#8212;\u00a0\u0440\u0430\u0437\u0432\u0438\u0442\u0438\u0435\u00a0\u0441\u0435\u0440\u0434\u0435\u0447\u043d\u043e\u0439\u00a0\u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u0438\u00a0\u0432\u043f\u043e\u043b\u043d\u0435\u00a0\u0432\u0435\u0440\u043e\u044f\u0442\u043d\u043e.<\/p>\n<p>\u00b7\u00a0\u0423\u0440\u043e\u0432\u043d\u0438\u00a0NT-proBNP\u00a0\u0432\u044b\u0448\u0435\u00a0125\u00a0\u043f\u0433\/\u043c\u043b\u00a0&#8212;\u00a0\u043c\u043e\u0433\u0443\u0442\u00a0\u043e\u0442\u0440\u0430\u0436\u0430\u0442\u044c\u00a0\u043d\u0430\u043b\u0438\u0447\u0438\u0435\u00a0\u0438\u043b\u0438\u00a0\u0440\u0430\u0437\u0432\u0438\u0442\u0438\u0435\u00a0\u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u0439\u00a0\u0444\u0443\u043d\u043a\u0446\u0438\u0438\u00a0\u0441\u0435\u0440\u0434\u0446\u0430\u00a0\u0438\u00a0\u0430\u0441\u0441\u043e\u0446\u0438\u0438\u0440\u043e\u0432\u0430\u0442\u044c\u0441\u044f<\/p>\n<p>\u0441\u00a0\u043f\u043e\u0432\u044b\u0448\u0435\u043d\u043d\u044b\u043c\u00a0\u0440\u0438\u0441\u043a\u043e\u043c\u00a0\u0441\u0435\u0440\u0434\u0435\u0447\u043d\u044b\u0445\u00a0\u043e\u0441\u043b\u043e\u0436\u043d\u0435\u043d\u0438\u0439.<\/p>\n<p>\u00b7\u00a0\u041f\u043e\u0432\u044b\u0448\u0435\u043d\u0438\u0435\u00a0\u0443\u0440\u043e\u0432\u043d\u044f\u00a0NT-proBNP\u00a0\u0432\u044b\u0448\u0435\u00a0250\u00a0\u043f\u0433\/\u043c\u043b\u00a0\u0443\u00a0\u0431\u043e\u043b\u044c\u043d\u044b\u0445\u00a0\u0441\u00a0\u043e\u0441\u0442\u0440\u044b\u043c\u00a0\u043a\u043e\u0440\u043e\u043d\u0430\u0440\u043d\u044b\u043c\u00a0\u0441\u0438\u043d\u0434\u0440\u043e\u043c\u043e\u043c\u00a0\u0431\u0435\u0437\u00a0\u043f\u043e\u0434\u044a\u0435\u043c\u0430\u00a0\u0441\u0435\u0433\u043c\u0435\u043d\u0442\u0430\u00a0ST\u00a0\u043d\u0430\u00a0\u042d\u041a\u0413\u00a0\u043f\u0440\u0438\u00a0\u0434\u0438\u043d\u0430\u043c\u0438\u0447\u0435\u0441\u043a\u043e\u043c<\/p>\n<p>\u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0438\u00a0\u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f\u00a0\u043f\u0440\u0435\u0434\u0438\u043a\u0442\u043e\u0440\u043e\u043c\u00a0\u0432\u044b\u0441\u043e\u043a\u043e\u0439\u00a0\u0441\u043c\u0435\u0440\u0442\u043d\u043e\u0441\u0442\u0438\u00a0\u0438\u00a0\u0438\u043d\u0444\u0430\u0440\u043a\u0442\u0430\u00a0\u043c\u0438\u043e\u043a\u0430\u0440\u0434\u0430\u00a0\u0432\u00a0\u0442\u0435\u0447\u0435\u043d\u0438\u0435\u00a06\u00a0\u043c\u0435\u0441\u044f\u0446\u0435\u0432.<\/p>\n<p>\u00b7\u00a0NT-proBNP\u00a0\u043c\u043e\u0436\u0435\u0442\u00a0\u043f\u0440\u0438\u043c\u0435\u043d\u044f\u0442\u044c\u0441\u044f\u00a0\u0434\u043b\u044f\u00a0\u043f\u043e\u0434\u0431\u043e\u0440\u0430\u00a0\u0438\u00a0\u043c\u043e\u043d\u0438\u0442\u043e\u0440\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u044f\u00a0\u0442\u0435\u0440\u0430\u043f\u0438\u0438\u00a0\u0443\u00a0\u0431\u043e\u043b\u044c\u043d\u044b\u0445\u00a0\u0441\u00a0\u0441\u0435\u0440\u0434\u0435\u0447\u043d\u043e\u0439\u00a0\u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u044c\u044e.\u00a0\u0423\u0440\u043e\u0432\u043d\u0438\u00a0NT-proBNP\u00a0\u0432\u00a0\u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0435\u00a0\u0438\u043b\u0438\u00a0\u043f\u043b\u0430\u0437\u043c\u0435\u00a0\u043c\u043e\u0433\u0443\u0442\u00a0\u0431\u044b\u0442\u044c\u00a0\u0441\u043d\u0438\u0436\u0435\u043d\u044b\u00a0\u043f\u0440\u0438\u00a0\u043d\u0430\u0437\u043d\u0430\u0447\u0435\u043d\u0438\u0438\u00a0\u0438\u043d\u0442\u0435\u043d\u0441\u0438\u0432\u043d\u043e\u0439\u00a0\u043b\u0435\u043a\u0430\u0440\u0441\u0442\u0432\u0435\u043d\u043d\u043e\u0439\u00a0\u0442\u0435\u0440\u0430\u043f\u0438\u0438\u00a0\u0443\u00a0\u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u0432<\/p>\n<p>\u0441\u00a0\u0441\u0435\u0440\u0434\u0435\u0447\u043d\u043e\u0439\u00a0\u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u044c\u044e.\u00a0\u041b\u0435\u043a\u0430\u0440\u0441\u0442\u0432\u0435\u043d\u043d\u0430\u044f\u00a0\u0442\u0435\u0440\u0430\u043f\u0438\u044f,\u00a0\u043f\u043e\u0434\u043e\u0431\u0440\u0430\u043d\u043d\u0430\u044f\u00a0\u043f\u043e\u00a0\u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u0430\u043c\u00a0\u0443\u0440\u043e\u0432\u043d\u044f\u00a0NT-proBNP,\u00a0\u0443\u043c\u0435\u043d\u044c\u0448\u0430\u0435\u0442\u00a0\u043e\u0431\u0449\u0435\u0435\u00a0\u0447\u0438\u0441\u043b\u043e\u00a0\u0441\u0435\u0440\u0434\u0435\u0447\u043d\u043e-\u0441\u043e\u0441\u0443\u0434\u0438\u0441\u0442\u044b\u0445\u00a0\u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0439\u00a0\u0438\u00a0\u0443\u0441\u043b\u043e\u0432\u043d\u043e\u00a0\u00ab\u043e\u0442\u043e\u0434\u0432\u0438\u0433\u0430\u0435\u0442\u00bb\u00a0\u0432\u0440\u0435\u043c\u044f\u00a0\u043f\u0435\u0440\u0432\u043e\u0433\u043e\u00a0\u043e\u0431\u0440\u0430\u0449\u0435\u043d\u0438\u044f\u00a0\u043f\u0430\u0446\u0438\u0435\u043d\u0442\u0430\u00a0\u043a\u00a0\u0432\u0440\u0430\u0447\u0443\u00a0\u0438\u00a0\u043d\u0430\u0437\u043d\u0430\u0447\u0435\u043d\u0438\u0435\u00a0\u0438\u043d\u0442\u0435\u043d\u0441\u0438\u0432\u043d\u043e\u0433\u043e\u00a0\u043b\u0435\u0447\u0435\u043d\u0438\u044f<\/td>\n<\/tr>\n<\/tbody>\n<\/table>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[925],"product_tag":[],"class_list":{"0":"post-9278","1":"product","2":"type-product","3":"status-publish","5":"product_cat-markeri-cardiaci","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\/9278","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=9278"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=9278"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=9278"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=9278"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=9278"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}