{"id":9294,"date":"2020-04-23T03:33:54","date_gmt":"2020-04-23T00:33:54","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/virusul-rubeolei-anticorpi-igm\/"},"modified":"2026-02-19T00:04:13","modified_gmt":"2026-02-18T22:04:13","slug":"virusul-rubeolei-anticorpi-igm","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/virusul-rubeolei-anticorpi-igm\/","title":{"rendered":"\u0412\u0438\u0440\u0443\u0441 \u043a\u0440\u0430\u0441\u043d\u0443\u0445\u0438 \u2013 \u0430\u043d\u0442\u0438\u0442\u0435\u043b\u0430 IgM"},"content":{"rendered":"

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

Virusul rubeolei este\u00a0 un togavirus cu ARN monocatenar care determina una din infectiile exantematoase ale copilariei. Infectia se produce predominant in lunile de iarna si primavara, subiectii umani fiind singurele gazde cunoscute ale virusului. Modul de transmitere a bolii este direct si aerogen (prin secretii nazofaringiene). Perioada de incubatie este de 2-3 saptamani.<\/p>\n

Infectia are de obicei o evolutie benigna si este frecvent subclinica. In cazurile simptomatice, tabloul clinic include febra, eruptie maculo-papulara adesea discreta si de scurta durata, limfadenopatii, posibil coriza si conjunctivita. Adenopatia rubeolica (tipic in regiunea occipitala, retro- si submastoidiana, laterocervicala si submaxilara) constituie un semn constant al bolii, fiind adesea singura ei manifestare. Hemoleucograma indica de obicei neutropenie, iar in formula leucocitara este caracteristica aparitia de plasmocite si celule T\u00fcrk, a caror proportie poate ajunge la 5-19%. Infectia confera imunitate pe toata durata vietii1;7<\/sup>.<\/p>\n

Infectia cu virusul rubeolei are consecinte foarte grave in cazul in care este contractata in cursul primelor patru luni de sarcina. Daca gravida nu prezinta imunitate, exista un risc mare de afectare embriofetala. Rubeola congenitala determina aparitia unor defecte severe, multe dintre acestea fiind permanente, afectand dezvoltarea ulterioara: cataracta, surditate, hepatosplenomegalie, retard psihomotor, anomalii osoase, cardiopatii, neuropatii. Consecintele patologice asupra fatului si nou-nascutului depind de teratogenitatea virusului si de varsta gestationala la care s-a contractat infectia. Este unanim acceptat faptul ca riscul scade odata cu cresterea varstei gestationale; astfel riscul este maxim in cursul primelor doua luni de sarcina (40-60%) si scade progresiv in lunile patru si cinci (10-20%). Studiile au demonstrat faptul ca infectia fetala este rara dupa trimestrul II de sarcina1;2;4;7<\/sup>.<\/p>\n

In cursul infectiei acute, virusul infecteaza placenta si poate fi transmis la fat. Expunerea secundara la virus sau reinfectia se asociaza extrem de rar cu transmiterea intrauterina a virusului, indicand faptul ca imunitatea mamei (dobandita natural sau indusa prin vaccinare) confera protectie impotriva infectiei in utero<\/em>. Infectia primara a mamei poate avea urmatoarele consecinte: a) absenta infectiei la embrion; b) resorbtia embrionului (doar in cursul primelor saptamani de sarcina); c) avort spontan; d) moartea fatului in<\/em> utero<\/em>; e) infectia placentei fara afectarea fatului; f) afectarea concomitenta a placentei si fatului1;4<\/sup>.<\/p>\n

Testele serologice reprezinta un instrument important in diagnosticul si monitorizarea infectiei acute. Astfel, primul raspuns umoral la infectie este reprezentat de anticorpii specifici de tip IgM care sunt detectati in majoritatea cazurilor la cateva zile de la aparitia exantemului, atingand un maximum dupa 2-3 saptamani de la debut. Nivelurile IgM incep sa scada dupa 36-70 zile, fiind rar detectate dupa 180 zile (in cazuri izolate, pana la 1 an). Anticorpii specifici de tip IgG apar de obicei dupa aproximativ 1 saptamana de la generarea anticorpilor IgM; nivelul acestora creste rapid atingand un platou la 6-10 saptamani de la debutul bolii, dupa care scad progresiv la un titru (15-200 UI\/mL)\u00a0 care se mentine toata viata. Reinfectia, care este complet asimptomatica, este insotita de cresteri moderate ale anticorpilor IgG2;4;5<\/sup>.<\/p>\n

Introducerea vaccinului antirubeolic in 1969 a avut un impact major asupra numarului de infectii congenitale. Cu toate acestea continua sa apara epidemii de rubeola. Prevalenta femeilor neimunizate in randul populatiilor vaccinate este in jur de 1.8%, in timp ce la populatiile nevaccinate poate depasi 40%.<\/p>\n

Luand in considerare datele prezentate reiese importanta efectuarii screening-ului\u00a0 pentru determinarea statusului imun matern. Deoarece vaccinul antirubeolic este contraindicat la femeile\u00a0 gravide (risc teoretic, deoarece nu s-a demonstrat teratogenitatea virusului atenuat continut in vaccin) si la cele care pot deveni gravide in urmatoarea luna dupa vaccinare, se recomanda ca screening-ul sa fie efectuat inainte de conceptie, iar femeile neimunizate sa poata beneficia de vaccin1;2<\/sup>.<\/p>\n

Pregatire pacient<\/em><\/strong> \u2013 testele nu necesita o pregatire prealabila4<\/sup>.<\/p>\n

Specimen recoltat <\/em><\/strong>\u2013 sange venos4<\/sup>.<\/p>\n

Recipient de recoltare <\/em><\/strong>\u2013 vacutainer fara anticoagulant cu\/fara gel separator4<\/sup>.<\/p>\n

Prelucrare necesara dupa recoltare <\/em><\/strong>\u2013 se separa serul prin centrifugare4<\/sup>.<\/p>\n

Volum proba <\/em><\/strong>\u2013 minim 1mL ser (pentru determinarea ambelor tipuri de anticorpi)4<\/sup>.<\/p>\n

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

Stabilitate proba <\/em><\/strong>\u2013 serul separat este stabil cateva ore la temperatura camerei 18-30\u00baC; cateva zile la 2-8\u00baC\u00a0; perioada mai indelungata la \u201320\u00baC. Centrifugati specimenele decongelate si utilizati supernatantul. Evitati congelare\/decongelare repetata4<\/sup>.<\/p>\n

Metode<\/em><\/strong><\/p>\n

\u00cen laboratorul Synevo sunt utilizate urm\u0103toarele metode de lucru:<\/p>\n

    \n
  1. imunochimic\u0103 cu detec\u0163ie prin electrochemiluminiscen\u0163\u0103 (ECLIA)<\/span><\/li>\n
  2. imunochimic\u0103 prin tehnica ELFA (enzyme-linked immunofluorescence assay)<\/span> (doar pentru anticorpii IgM)4<\/sup>.<\/li>\n<\/ol>\n

    Valori de referin\u0163\u0103 <\/em><\/strong>-.difer\u0103 \u00een func\u0163ie de metoda de lucru4<\/sup>.<\/p>\n

    Rubeola IgG<\/span><\/strong><\/p>\n

    ECLIA<\/span><\/p>\n

    <10 UI\/mL:\u00a0\u00a0 Negativ<\/p>\n

    >=10 UI\/mL: Pozitiv.<\/p>\n

    Rubeola IgM<\/span><\/strong><\/p>\n

    1. ECLIA<\/span><\/p>\n

    <0.80 Index\u00a0\u00a0\u00a0\u00a0\u00a0 : Negativ<\/p>\n

    0.80 \u2013 1: Index:\u00a0\u00a0 Echivoc<\/p>\n

    \u22651 Index:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Pozitiv.<\/p>\n

    2. ELFA<\/span><\/p>\n

    <0.80 Index\u00a0\u00a0\u00a0\u00a0\u00a0 :\u00a0\u00a0\u00a0\u00a0 Negativ<\/p>\n

    0.80 \u2013 1.2: Index:\u00a0\u00a0 Echivoc<\/p>\n

    \u22651.2 Index:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0Pozitiv.<\/p>\n

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

    Determinarea statusului imun:<\/span><\/p>\n

    Rubeola IgG :<\/p>\n

    \u043e\u0442\u0440\u0438\u0446\u0430\u0442\u0435\u043b\u044c\u043d\u044b\u0439<\/em> \u2013 imunitate absenta; in cazul pacientelor gravide se va repeta recoltarea pentru determinarea anticorpilor IgG in saptamanile 16-18 de sarcina, chiar in absenta unei expuneri cunoscute la virusul rubeolei3;6<\/sup>;<\/p>\n

    echivoc<\/em> \u2013 se recomanda repetarea determinarii dupa o saptamana;<\/p>\n

    \u043f\u043e\u043b\u043e\u0436\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u0439 <\/em>\u2013 indica infectie in antecedente\/vaccinare\/infectie recenta. Se recomanda efectuarea anti-rubeola IgM din acelasi ser; obtinerea unui rezultat negativ confirma infectia in antecedente si prezenta statusului imun3;4;6<\/sup>.<\/p>\n

    Diagnosticul infectiei recente<\/span><\/p>\n

    O crestere de doua ori a nivelului anticorpilor IgG in seruri perechi obtinute la interval de 14-21 zile confirma infectia recenta.<\/p>\n

    Un rezultat pozitiv pentru anticorpii IgM este de asemenea sugestiv pentru infectia recenta, dar instituirea masurilor clinice nu trebuie sa se faca pe baza unei singure determinari1<\/sup>.<\/p>\n

    In laboratorul Synevo, un rezultat pozitiv pentru anti-rubeola IgM este confirmat prin doua metode iar aceasta mentiune apare pe buletinul final de rezultate4<\/sup>.<\/p>\n

    Diagnosticul infectiei congenitale<\/span><\/p>\n

    Deoarece serul copiilor normali contine anticorpi IgG transferati pasiv de la mama, diagnosticul de rubeola congenitala se stabileste pe evidentierea anticorpilor IgM. Acestia sunt depistati in 100% din cazuri in primele 5 luni de la nastere (in majoritate cazurilor in primele 3 luni). Frecventa acestora scade dupa cum urmeaza: 60% la varsta de 6-12 luni, 40% la varsta de 12-18 luni; rar detectabili dupa varsta de 18 luni2<\/sup>.<\/p>\n

    Monitorizarea post-vaccinala<\/span><\/p>\n

    Anticorpii IgM apar la 80% din pacientii vaccinati in primele 3 saptamani de la vaccinare4<\/sup>.Anticorpii IgG sunt de regula detectati la 4-6 saptamani de la data vaccinarii si persista toata viata2<\/sup>.<\/p>\n

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

    Absen\u0163a anticorpilor IgM la na\u015ftere nu exclude diagnosticul de rubeol\u0103 congenital\u0103.<\/p>\n

    Rubeola neonatal\u0103, este o condi\u0163ie clinic\u0103 rar\u0103, dar trebuie luat\u0103 \u00een considerare dac\u0103 anticorpii IgM nu se pozitiveaz\u0103 \u00een perioada postnatal\u0103 imediat\u0103, ci mai t\u00e2rziu.<\/p>\n

    Rezultate fals pozitive pentru rubeola IgM pot s\u0103 apar\u0103 dup\u0103 mononucleoza infec\u0163ioas\u0103, infec\u0163ii cu parvovirus B19 \u015fi posibil alte infec\u0163ii\u00a0 cu virusuri de tip herpetic.<\/p>\n

    Reac\u0163ii fals pozitive pentru rubeola IgM au fost raportate \u015fi la gravide, datorate unor reac\u0163ii \u00eencruci\u015fate cu alte virusuri (CMV, rujeolic)4<\/sup>.\u00a0\u00a0<\/span><\/p>\n

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

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

    1. Ann M.Gronowski. Prenatal Screening and Diagnosis of Congenital Infections. In Handbook of Clinical Laboratory Testing During Pregnancy. Totowa, NJ: Humana Press ed. 2004; 264-266.<\/span><\/p>\n

    2. Felicity T.Cutts, et.al. Guidelines for Surveillance of Congenital Rubella Syndrome and Rubella. www.who.int\/pdf\/ 2000. Ref Type: Internet Communication<\/span><\/p>\n

    3. Hans W.Doerr.Viral Diseases. In Clinical Laboratory Diagnostics-Use and Assessment of Clinical Laboratory Results. Lothar Thomas. TH-Books Verlagsgesellschaft mbH, Frankfurt \/Main, Germany,1 ed. 1998, 1253-1254.<\/span><\/p>\n

    4. Laborator Synevo. Referintele specifice tehnologiei de lucru utilizate 2010. Ref Type: Catalog<\/span><\/p>\n

    5. Laboratory Corporation of America.Directory of Services and Interpretive Guide. Rubella Antibodies IgM. www.labcorp.com 2010. Ref Type: Internet Communication<\/span><\/p>\n

    6. Lothar Thomas. Prenatal monitoring. In Clinical Laboratory Diagnostics-Use and Assessment of Clinical Laboratory Results. TH-Books Verlagsgesellschaft mbH, Frankfurt \/Main, Germany,1 ed. 1998;1117.<\/span><\/p>\n

    7. Marin Voiculescu. Rubeola. In Boli infectioase-clinica si epidemiologie. Editura Medicala, Romania ed. 1981, 516-525.<\/span><\/p>","protected":false},"excerpt":{"rendered":"

    \u042d\u0442\u043e\u0442 \u0430\u043d\u0430\u043b\u0438\u0437 \u043f\u043e\u0437\u0432\u043e\u043b\u044f\u0435\u0442 \u0432\u044b\u044f\u0432\u0438\u0442\u044c \u0432 \u043a\u0440\u043e\u0432\u0438 \u0430\u043d\u0442\u0438\u0442\u0435\u043b\u0430 \u043a \u043a\u0440\u0430\u0441\u043d\u0443\u0445\u0435. \u041e\u043d\u0438 \u0432\u044b\u0440\u0430\u0431\u0430\u0442\u044b\u0432\u0430\u044e\u0442\u0441\u044f \u0432 \u043e\u0442\u0432\u0435\u0442 \u043d\u0430 \u0437\u0430\u0440\u0430\u0436\u0435\u043d\u0438\u0435 \u0432\u0438\u0440\u0443\u0441\u043e\u043c. \u0415\u0441\u0442\u044c \u0434\u0432\u0430 \u0442\u0438\u043f\u0430 \u0430\u043d\u0442\u0438\u0442\u0435\u043b: IgM \u0438 IgG. \u0412 \u043f\u0435\u0440\u0432\u0443\u044e \u043e\u0447\u0435\u0440\u0435\u0434\u044c \u043f\u043e\u0441\u043b\u0435 \u0438\u043d\u0444\u0438\u0446\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u044f \u043f\u043e\u044f\u0432\u043b\u044f\u044e\u0442\u0441\u044f IgM. \u0423\u0440\u043e\u0432\u0435\u043d\u044c \u044d\u0442\u043e\u0433\u043e \u0431\u0435\u043b\u043a\u0430 \u0432 \u043a\u0440\u043e\u0432\u0438 \u043f\u043e\u0441\u0442\u0435\u043f\u0435\u043d\u043d\u043e \u043f\u043e\u0432\u044b\u0448\u0430\u0435\u0442\u0441\u044f \u0438 \u0434\u043e\u0441\u0442\u0438\u0433\u0430\u0435\u0442 \u043f\u0438\u043a\u0430 \u0447\u0435\u0440\u0435\u0437 7-10 \u0434\u043d\u0435\u0439 \u043f\u043e\u0441\u043b\u0435 \u0437\u0430\u0440\u0430\u0436\u0435\u043d\u0438\u044f, \u0437\u0430\u0442\u0435\u043c \u0432 \u0431\u043b\u0438\u0436\u0430\u0439\u0448\u0438\u0435 \u043d\u0435\u0441\u043a\u043e\u043b\u044c\u043a\u043e \u043d\u0435\u0434\u0435\u043b\u044c \u043f\u0440\u043e\u0438\u0441\u0445\u043e\u0434\u0438\u0442 \u0435\u0433\u043e \u0441\u043d\u0438\u0436\u0435\u043d\u0438\u0435. \u0418\u0441\u043a\u043b\u044e\u0447\u0435\u043d\u0438\u0435\u043c \u044f\u0432\u043b\u044f\u044e\u0442\u0441\u044f \u0438\u043d\u0444\u0438\u0446\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u044b\u0435 \u043d\u043e\u0432\u043e\u0440\u043e\u0436\u0434\u0451\u043d\u043d\u044b\u0435, \u0443 \u043a\u043e\u0442\u043e\u0440\u044b\u0445 \u0430\u043d\u0442\u0438\u0442\u0435\u043b\u0430 IgM \u043c\u043e\u0433\u0443\u0442 \u0431\u044b\u0442\u044c \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0435\u043d\u044b \u043d\u0430 \u043f\u0440\u043e\u0442\u044f\u0436\u0435\u043d\u0438\u0438 \u0435\u0449\u0435 \u043d\u0435\u0441\u043a\u043e\u043b\u044c\u043a\u0438\u0445 \u043c\u0435\u0441\u044f\u0446\u0435\u0432, \u0438\u043d\u043e\u0433\u0434\u0430 \u0433\u043e\u0434\u0430.<\/p>\n

    \u041d\u0430\u043b\u0438\u0447\u0438\u0435 \u0430\u043d\u0442\u0438\u0442\u0435\u043b IgM \u043c\u043e\u0436\u0435\u0442 \u0441\u0432\u0438\u0434\u0435\u0442\u0435\u043b\u044c\u0441\u0442\u0432\u043e\u0432\u0430\u0442\u044c \u043e\u0431 \u043e\u0441\u0442\u0440\u043e\u0439 \u0438\u043d\u0444\u0435\u043a\u0446\u0438\u0438.<\/p>\n

    \u0412\u0438\u0440\u0443\u0441 \u043a\u0440\u0430\u0441\u043d\u0443\u0445\u0438 \u043e\u0431\u044b\u0447\u043d\u043e \u043f\u0440\u043e\u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u0432 \u043b\u0435\u0433\u043a\u043e\u0439 \u0444\u043e\u0440\u043c\u0435 \u0438 \u0441\u043e\u043f\u0440\u043e\u0432\u043e\u0436\u0434\u0430\u0435\u0442\u0441\u044f \u043c\u0435\u043b\u043a\u043e\u0439 \u043a\u0440\u0430\u0441\u043d\u043e\u0439 \u0441\u044b\u043f\u044c\u044e, \u043a\u043e\u0442\u043e\u0440\u0430\u044f \u0432\u043e\u0437\u043d\u0438\u043a\u0430\u0435\u0442 \u043d\u0430 \u043b\u0438\u0446\u0435 \u0438 \u0448\u0435\u0435, \u0430 \u0437\u0430\u0442\u0435\u043c \u0441\u043f\u0443\u0441\u043a\u0430\u0435\u0442\u0441\u044f \u043d\u0430 \u0442\u0443\u043b\u043e\u0432\u0438\u0449\u0435 \u0438 \u043a\u043e\u043d\u0435\u0447\u043d\u043e\u0441\u0442\u0438, \u043f\u0440\u0435\u0436\u0434\u0435 \u0447\u0435\u043c \u0438\u0441\u0447\u0435\u0437\u043d\u0443\u0442\u044c \u0447\u0435\u0440\u0435\u0437 \u043d\u0435\u0441\u043a\u043e\u043b\u044c\u043a\u043e \u0434\u043d\u0435\u0439.<\/p>\n

    \u041a\u0440\u0430\u0441\u043d\u0443\u0445\u0430 \u043f\u0435\u0440\u0435\u0434\u0430\u0435\u0442\u0441\u044f \u0432\u043e\u0437\u0434\u0443\u0448\u043d\u043e-\u043a\u0430\u043f\u0435\u043b\u044c\u043d\u044b\u043c \u043f\u0443\u0442\u0435\u043c \u0438 \u043c\u043e\u0436\u0435\u0442 \u0438\u043c\u0435\u0442\u044c \u0442\u0430\u043a\u0438\u0435 \u0441\u0438\u043c\u043f\u0442\u043e\u043c\u044b, \u043a\u0430\u043a \u043f\u043e\u0432\u044b\u0448\u0435\u043d\u043d\u0430\u044f \u0442\u0435\u043c\u043f\u0435\u0440\u0430\u0442\u0443\u0440\u0430, \u0443\u0432\u0435\u043b\u0438\u0447\u0435\u043d\u0438\u0435 \u043b\u0438\u043c\u0444\u0430\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0445 \u0443\u0437\u043b\u043e\u0432, \u043d\u0430\u0441\u043c\u043e\u0440\u043a, \u043f\u043e\u043a\u0440\u0430\u0441\u043d\u0435\u043d\u0438\u0435 \u0433\u043b\u0430\u0437 \u0438 \u0431\u043e\u043b\u0438 \u0432 \u0441\u0443\u0441\u0442\u0430\u0432\u0430\u0445. \u041f\u0440\u0438\u0447\u0435\u043c \u0441\u0438\u043c\u043f\u0442\u043e\u043c\u044b \u044d\u0442\u0438 \u043c\u043e\u0433\u0443\u0442 \u0431\u044b\u0442\u044c \u043d\u0430\u0441\u0442\u043e\u043b\u044c\u043a\u043e \u043d\u0435\u0437\u043d\u0430\u0447\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u043c\u0438, \u043e\u0441\u043e\u0431\u0435\u043d\u043d\u043e \u0443 \u0434\u0435\u0442\u0435\u0439, \u0447\u0442\u043e \u043d\u0435 \u0432\u043e\u0441\u043f\u0440\u0438\u043d\u0438\u043c\u0430\u044e\u0442\u0441\u044f \u043a\u0430\u043a \u0432\u0438\u0440\u0443\u0441\u043d\u043e\u0435 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0435. \u0423 \u0431\u043e\u043b\u044c\u0448\u0438\u043d\u0441\u0442\u0432\u0430 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u0432 \u043a\u0440\u0430\u0441\u043d\u0443\u0445\u0430 \u043f\u0440\u043e\u0445\u043e\u0434\u0438\u0442 \u0432 \u0442\u0435\u0447\u0435\u043d\u0438\u0435 \u043d\u0435\u0441\u043a\u043e\u043b\u044c\u043a\u0438\u0445 \u0434\u043d\u0435\u0439 \u0431\u0435\u0437 \u043a\u0430\u043a\u043e\u0433\u043e-\u043b\u0438\u0431\u043e \u043b\u0435\u0447\u0435\u043d\u0438\u044f \u0438 \u043d\u0435 \u0432\u044b\u0437\u044b\u0432\u0430\u0435\u0442 \u0434\u0430\u043b\u044c\u043d\u0435\u0439\u0448\u0438\u0445 \u043f\u0440\u043e\u0431\u043b\u0435\u043c \u0441\u043e \u0437\u0434\u043e\u0440\u043e\u0432\u044c\u0435\u043c. \u0413\u043b\u0430\u0432\u043d\u043e\u0439 \u043e\u043f\u0430\u0441\u043d\u043e\u0441\u0442\u044c\u044e \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u043a\u043e\u043d\u0442\u0430\u043a\u0442 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0439 \u0436\u0435\u043d\u0449\u0438\u043d\u044b \u0441 \u0432\u0438\u0440\u0443\u0441\u043e\u043c \u043a\u0440\u0430\u0441\u043d\u0443\u0445\u0438 \u0432 \u043f\u0435\u0440\u0432\u044b\u0439 \u0440\u0430\u0437 \u0432 \u0442\u0435\u0447\u0435\u043d\u0438\u0435 \u043f\u0435\u0440\u0432\u043e\u0433\u043e \u0442\u0440\u0438\u043c\u0435\u0441\u0442\u0440\u0430 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u2013 \u0440\u0430\u0437\u0432\u0438\u0432\u0430\u044e\u0449\u0438\u0439\u0441\u044f \u043f\u043b\u043e\u0434 \u043d\u0430\u0438\u0431\u043e\u043b\u0435\u0435 \u0443\u044f\u0437\u0432\u0438\u043c \u0434\u043b\u044f \u043a\u0440\u0430\u0441\u043d\u0443\u0445\u0438 \u0438\u043c\u0435\u043d\u043d\u043e \u0432 \u044d\u0442\u043e \u0432\u0440\u0435\u043c\u044f. \u0415\u0441\u043b\u0438 \u0432\u0438\u0440\u0443\u0441 \u043f\u0435\u0440\u0435\u0434\u0430\u0441\u0442\u0441\u044f \u043e\u0442 \u043c\u0430\u0442\u0435\u0440\u0438 \u043f\u043b\u043e\u0434\u0443, \u0442\u043e \u043e\u043d \u043c\u043e\u0436\u0435\u0442 \u043f\u043e\u0441\u043b\u0443\u0436\u0438\u0442\u044c \u043f\u0440\u0438\u0447\u0438\u043d\u043e\u0439 \u0432\u044b\u043a\u0438\u0434\u044b\u0448\u0430, \u0440\u043e\u0436\u0434\u0435\u043d\u0438\u044f \u043c\u0435\u0440\u0442\u0432\u043e\u0433\u043e \u043f\u043b\u043e\u0434\u0430 \u0438\/\u0438\u043b\u0438 \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u044f \u0441\u0438\u043d\u0434\u0440\u043e\u043c\u0430 \u0432\u0440\u043e\u0436\u0434\u0451\u043d\u043d\u043e\u0439 \u043a\u0440\u0430\u0441\u043d\u0443\u0445\u0438 (\u0421\u0412\u041a) \u2013 \u0433\u0440\u0443\u043f\u043f\u044b \u0441\u0435\u0440\u044c\u0435\u0437\u043d\u044b\u0445 \u043f\u043e\u0440\u043e\u043a\u043e\u0432 \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u044f, \u043a\u043e\u0442\u043e\u0440\u044b\u0435 \u0441\u043f\u043e\u0441\u043e\u0431\u043d\u044b \u0432\u044b\u0437\u044b\u0432\u0430\u0442\u044c \u0437\u0430\u0434\u0435\u0440\u0436\u043a\u0443 \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u044f, \u0443\u043c\u0441\u0442\u0432\u0435\u043d\u043d\u0443\u044e \u043e\u0442\u0441\u0442\u0430\u043b\u043e\u0441\u0442\u044c, \u0433\u043b\u0443\u0445\u043e\u0442\u0443, \u043a\u0430\u0442\u0430\u0440\u0430\u043a\u0442\u0443, \u043c\u0438\u043a\u0440\u043e\u0446\u0435\u0444\u0430\u043b\u0438\u044e, \u043f\u0440\u043e\u0431\u043b\u0435\u043c\u044b \u0441 \u043f\u0435\u0447\u0435\u043d\u044c\u044e \u0438 \u043f\u043e\u0440\u043e\u043a\u0438 \u0441\u0435\u0440\u0434\u0446\u0430.<\/p>\n

    \u0414\u043b\u044f \u0447\u0435\u0433\u043e \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u0443\u0435\u0442\u0441\u044f \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435?<\/strong><\/p>\n

      \n
    • \u0414\u043b\u044f \u043f\u043e\u0434\u0442\u0432\u0435\u0440\u0436\u0434\u0435\u043d\u0438\u044f \u043d\u0430\u043b\u0438\u0447\u0438\u044f \u0438\u043c\u043c\u0443\u043d\u0438\u0442\u0435\u0442\u0430 \u043a \u0432\u0438\u0440\u0443\u0441\u0443 \u043a\u0440\u0430\u0441\u043d\u0443\u0445\u0438.<\/li>\n
    • \u0414\u043b\u044f \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0435\u043d\u0438\u044f \u0442\u0435\u043a\u0443\u0449\u0438\u0445 \u0438\u043b\u0438 \u043f\u0435\u0440\u0435\u043d\u0435\u0441\u0435\u043d\u043d\u044b\u0445 \u0438\u043d\u0444\u0435\u043a\u0446\u0438\u0439.<\/li>\n
    • \u0414\u043b\u044f \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u044f \u0442\u0435\u0445, \u043a\u0442\u043e \u043d\u0438\u043a\u043e\u0433\u0434\u0430 \u043d\u0435 \u043f\u043e\u0434\u0432\u0435\u0440\u0433\u0430\u043b\u0441\u044f \u0432\u043e\u0437\u0434\u0435\u0439\u0441\u0442\u0432\u0438\u044e \u0432\u0438\u0440\u0443\u0441\u0430, \u0438 \u0442\u0435\u0445, \u043a\u0442\u043e \u043d\u0435 \u0431\u044b\u043b \u0432\u0430\u043a\u0446\u0438\u043d\u0438\u0440\u043e\u0432\u0430\u043d.<\/li>\n
    • \u0427\u0442\u043e\u0431\u044b \u0443\u0431\u0435\u0434\u0438\u0442\u044c\u0441\u044f \u0432 \u043d\u0430\u043b\u0438\u0447\u0438\u0438 \u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0433\u043e \u0434\u043b\u044f \u0437\u0430\u0449\u0438\u0442\u044b \u043e\u0442 \u0438\u043d\u0444\u0435\u043a\u0446\u0438\u0438 \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0430 (\u0442\u0438\u0442\u0440\u0430) \u0430\u043d\u0442\u0438\u0442\u0435\u043b \u043f\u0440\u043e\u0442\u0438\u0432 \u043a\u0440\u0430\u0441\u043d\u0443\u0445\u0438 \u0443 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u044b\u0445 \u0436\u0435\u043d\u0449\u0438\u043d \u0438 \u0443 \u0442\u0435\u0445, \u043a\u0442\u043e \u043f\u043b\u0430\u043d\u0438\u0440\u0443\u0435\u0442 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u044c.<\/li>\n<\/ul>\n

      \u041a\u043e\u0433\u0434\u0430 \u043d\u0430\u0437\u043d\u0430\u0447\u0430\u0435\u0442\u0441\u044f \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435?<\/strong><\/p>\n

        \n
      • \u0415\u0441\u043b\u0438 \u043d\u0435\u043e\u0431\u0445\u043e\u0434\u0438\u043c\u0430 \u043f\u0440\u043e\u0432\u0435\u0440\u043a\u0430 \u0438\u043c\u043c\u0443\u043d\u0438\u0442\u0435\u0442\u0430 \u043f\u0440\u043e\u0442\u0438\u0432 \u043a\u0440\u0430\u0441\u043d\u0443\u0445\u0438.<\/li>\n
      • \u041a\u043e\u0433\u0434\u0430 \u0443 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0439 \u0436\u0435\u043d\u0449\u0438\u043d\u044b \u0432\u044b\u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u043b\u0438\u0445\u043e\u0440\u0430\u0434\u043a\u0430 \u0438 \u0441\u044b\u043f\u044c \u0438\/\u0438\u043b\u0438 \u0434\u0440\u0443\u0433\u0438\u0435 \u0441\u0438\u043c\u043f\u0442\u043e\u043c\u044b, \u0445\u0430\u0440\u0430\u043a\u0442\u0435\u0440\u043d\u044b\u0435 \u0434\u043b\u044f \u043a\u0440\u0430\u0441\u043d\u0443\u0445\u0438. \u041f\u043e\u0441\u043a\u043e\u043b\u044c\u043a\u0443 \u043c\u043d\u043e\u0433\u0438\u0435 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f \u043c\u043e\u0433\u0443\u0442 \u0432\u044b\u0437\u044b\u0432\u0430\u0442\u044c \u0441\u0445\u043e\u0434\u043d\u044b\u0435 \u0441\u0438\u043c\u043f\u0442\u043e\u043c\u044b, \u0432\u0440\u0430\u0447 \u0434\u043e\u043b\u0436\u0435\u043d \u043d\u0430\u0437\u043d\u0430\u0447\u0438\u0442\u044c \u0442\u0435 \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f, \u043a\u043e\u0442\u043e\u0440\u044b\u0435 \u043f\u043e\u043c\u043e\u0433\u0443\u0442 \u043f\u043e\u0434\u0442\u0432\u0435\u0440\u0434\u0438\u0442\u044c \u0438\u043c\u0435\u043d\u043d\u043e \u044d\u0442\u043e\u0442 \u0434\u0438\u0430\u0433\u043d\u043e\u0437.<\/li>\n
      • \u0415\u0441\u043b\u0438 \u0443 \u043c\u043b\u0430\u0434\u0435\u043d\u0446\u0430 \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0438\u0432\u0430\u044e\u0442\u0441\u044f \u0432\u0440\u043e\u0436\u0434\u0451\u043d\u043d\u044b\u0435 \u043f\u043e\u0440\u043e\u043a\u0438 \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u044f (\u043f\u043e\u0442\u0435\u0440\u044f \u0441\u043b\u0443\u0445\u0430, \u0441\u0435\u0440\u0434\u0435\u0447\u043d\u043e-\u0441\u043e\u0441\u0443\u0434\u0438\u0441\u0442\u044b\u0435 \u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u044f, \u043a\u0430\u0442\u0430\u0440\u0430\u043a\u0442\u0430, \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f \u0446\u0435\u043d\u0442\u0440\u0430\u043b\u044c\u043d\u043e\u0439 \u043d\u0435\u0440\u0432\u043d\u043e\u0439 \u0441\u0438\u0441\u0442\u0435\u043c\u044b), \u043a\u043e\u0442\u043e\u0440\u044b\u0435 \u043c\u043e\u0433\u0443\u0442 \u0431\u044b\u0442\u044c \u0441\u0432\u044f\u0437\u0430\u043d\u044b \u0441 \u0421\u0412\u041a, \u0438\u043b\u0438 \u0435\u0441\u043b\u0438 \u0443 \u0435\u0433\u043e \u043c\u0430\u0442\u0435\u0440\u0438 \u0432\u043e \u0432\u0440\u0435\u043c\u044f \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u0431\u044b\u043b\u0430 \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u0440\u043e\u0432\u0430\u043d\u0430 \u043a\u0440\u0430\u0441\u043d\u0443\u0445\u0430.<\/li>\n
      • \u0422\u0430\u043a \u043a\u0430\u043a \u0432\u044b\u0440\u0430\u0431\u043e\u0442\u043a\u0430 \u0430\u043d\u0442\u0438\u0442\u0435\u043b IgM \u043a \u043a\u0440\u0430\u0441\u043d\u0443\u0445\u0435 \u0437\u0430\u043d\u0438\u043c\u0430\u0435\u0442 \u043d\u0435\u043a\u043e\u0442\u043e\u0440\u043e\u0435 \u0432\u0440\u0435\u043c\u044f \u043f\u043e\u0441\u043b\u0435 \u0437\u0430\u0440\u0430\u0436\u0435\u043d\u0438\u044f, \u0430\u043d\u0430\u043b\u0438\u0437\u044b \u043c\u043e\u0433\u0443\u0442 \u043d\u0430\u0437\u043d\u0430\u0447\u0438\u0442\u044c \u043f\u043e\u0432\u0442\u043e\u0440\u043d\u043e \u0447\u0435\u0440\u0435\u0437 2-3 \u043d\u0435\u0434\u0435\u043b\u0438, \u0447\u0442\u043e\u0431\u044b \u043f\u043e\u0441\u043c\u043e\u0442\u0440\u0435\u0442\u044c, \u0432\u044b\u044f\u0432\u044f\u0442\u0441\u044f \u043b\u0438 \u0430\u043d\u0442\u0438\u0442\u0435\u043b\u0430 (\u0435\u0441\u043b\u0438 \u043e\u043d\u0438 \u0438\u0437\u043d\u0430\u0447\u0430\u043b\u044c\u043d\u043e \u043e\u0442\u0441\u0443\u0442\u0441\u0442\u0432\u043e\u0432\u0430\u043b\u0438), \u0438\u043b\u0438 \u043e\u0446\u0435\u043d\u0438\u0442\u044c, \u0440\u0430\u0441\u0442\u0435\u0442 \u0438\u043b\u0438 \u0441\u043d\u0438\u0436\u0430\u0435\u0442\u0441\u044f \u0438\u0445 \u0443\u0440\u043e\u0432\u0435\u043d\u044c \u0441\u043e \u0432\u0440\u0435\u043c\u0435\u043d\u0435\u043c.<\/li>\n<\/ul>\n
        \u0421\u043f\u0435\u0446\u0438\u0430\u043b\u044c\u043d\u043e\u0439 \u043f\u043e\u0434\u0433\u043e\u0442\u043e\u0432\u043a\u0438 \u043d\u0435 \u0442\u0440\u0435\u0431\u0443\u0435\u0442\u0441\u044f. \u0420\u0435\u043a\u043e\u043c\u0435\u043d\u0434\u0443\u0435\u0442\u0441\u044f \u0432\u0437\u044f\u0442\u0438\u0435 \u043a\u0440\u043e\u0432\u0438 \u043d\u0435 \u0440\u0430\u043d\u0435\u0435 \u0447\u0435\u043c \u0447\u0435\u0440\u0435\u0437 4 \u0447\u0430\u0441\u0430 \u043f\u043e\u0441\u043b\u0435 \u043f\u043e\u0441\u043b\u0435\u0434\u043d\u0435\u0433\u043e \u043f\u0440\u0438\u0435\u043c\u0430 \u043f\u0438\u0449\u0438.<\/div>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[961],"product_tag":[],"class_list":{"0":"post-9294","1":"product","2":"type-product","3":"status-publish","5":"product_cat-serologie-boli-infectioase","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\/9294","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=9294"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=9294"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=9294"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=9294"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=9294"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}