{"id":9315,"date":"2020-04-23T03:34:30","date_gmt":"2020-04-23T00:34:30","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/timp-de-tromboplastina-partiala-activat-aptt\/"},"modified":"2026-02-19T01:40:03","modified_gmt":"2026-02-18T23:40:03","slug":"timp-de-tromboplastina-partiala-activat-aptt","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/timp-de-tromboplastina-partiala-activat-aptt\/","title":{"rendered":"\u0410\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e\u0435 \u0447\u0430\u0441\u0442\u0438\u0447\u043d\u043e\u0435 \u0442\u0440\u043e\u043c\u0431\u043e\u043f\u043b\u0430\u0441\u0442\u0438\u043d\u043e\u0432\u043e\u0435 \u0432\u0440\u0435\u043c\u044f (\u0410\u0427\u0422\u0412)"},"content":{"rendered":"

\u041e\u0431\u0449\u0430\u044f \u0438\u043d\u0444\u043e\u0440\u043c\u0430\u0446\u0438\u044f<\/em><\/strong>\u00a0<\/em><\/span><\/p>\n

aPTT<\/strong> este un test func\u0163ional care evalueaz\u0103 \u201ccalea intrinsec\u0103\u201d (prekalicreina, kininogenul cu greutate molecular\u0103 mare \u2013 HK, factorii XII, XI, IX, VIII)\u00a0 \u015fi \u201ccomun\u0103\u201d a coagul\u0103rii (factorii X, V, II, I)1;2<\/sup>.<\/span><\/p>\n

In vivo<\/em>, sistemul de contact este implicat atunci c\u00e2nd s\u00e2ngele interac\u0163ioneaz\u0103 cu o suprafa\u0163\u0103 str\u0103in\u0103, cum ar fi bypass-ul cardiopulmonar. Zimogenul FXII, prima protein\u0103 a seriei, se leag\u0103 la suprafe\u0163e \u00eenc\u0103rcate negativ (kaolin, dextran sulfat, sulfatide), determin\u00e2nd autoactivarea \u015fi ac\u0163iunea asupra substratelor, prekalikreina \u015fi FXI, cu formarea de kalikreina \u015fi FXIa. Kalikreina cliveaz\u0103 HK cu eliberarea bradikininei \u015fi kininogenului kinin-free (HK activat).<\/span><\/p>\n

In vitro<\/em>, activarea este realizat\u0103 prin ad\u0103ugarea unei a\u015fa-numite \u201ctromboplastine par\u0163iale\u201d, compus\u0103 doar din fosfolipide (nu con\u0163ine partea proteic\u0103, respectiv factorul tisular, ca \u00een \u201ctromboplastina complet\u0103\u201d utilizat\u0103 pentru ini\u0163ierea coagul\u0103rii \u00een PT) \u015fi a unui activator de suprafa\u0163\u0103, silic\u0103, care furnizeaz\u0103 suprafa\u0163a \u00eenc\u0103rcat\u0103 negativ pentru activarea c\u0103ii de contact a coagul\u0103rii1<\/sup>. Apoi se adaug\u0103 clorura de calciu \u015fi se m\u0103soara timpul, exprimat \u00een secunde, p\u00e2n\u0103 la formarea cheagului4,5<\/sup>.<\/span><\/p>\n

Speciali\u015ftii de laborator, care au dezvoltat testul PTT, au dat denumirea de \u201ccale intrinsec\u0103\u201d cascadei de reac\u0163ii declan\u015fate \u00een PTT, pe baza percep\u0163iei gre\u015fite, c\u0103 coagularea este ini\u0163iat\u0103 f\u0103r\u0103 ad\u0103ugarea nici unui factor extern. In fapt, un factor extern este implicat\u00a0\u00een ini\u0163ierea coagul\u0103rii\u00a0\u00een PTT, respectiv suprafa\u0163a de sticl\u0103 \u00eenc\u0103rcat\u0103 negativ a tubului de reac\u0163ie. Aceast\u0103 activare \u201cde contact\u201d poate fi poten\u0163at\u0103 prin ad\u0103ugarea de particule, ca silic\u0103, kaolin, acid elagic,\u00a0\u00een ceea ce ne referim\u00a0\u00een prezent ca testul de tromboplastin\u0103 par\u0163ial\u0103 \u201cactivat\u201d. Activarea de contact este un truc utilizat de speciali\u015ftii de laborator pentru a stabili func\u0163ionalitatea c\u00e2torva factori importan\u0163i ai c\u0103ii intrinseci \u00eentr-un tub de testare6<\/sup>.<\/span><\/p>\n

Deficien\u0163a sau inhibi\u0163ia HK, prekalikreinei sau factorilor XII, XI, IX \u015fi VIII determin\u0103 prelungirea aPTT cu PT normal, \u00een timp ce deficien\u0163e ale factorilor \u201cc\u0103ii comune\u201d a coagul\u0103rii (X, V, II, fibrinogen) pot prelungi at\u00e2t aPTT c\u00e2t \u015fi PT.<\/span><\/p>\n

aPTT nu este influen\u0163at de deficien\u0163e ale FVII sau FXIII7<\/sup>.<\/span><\/p>\n

Recomand\u0103ri pentru efectuarea testului<\/em><\/strong><\/span><\/p>\n

\u2013 Detectarea deficien\u0163elor congenitale sau dob\u00e2ndite ale factorilor de coagulare men\u0163iona\u0163i mai sus; suspiciunea de hemofilie sau boala von Willebrand.<\/span><\/p>\n

Observa\u0163ii: deficitul de factor XII, prekalikreina sau HK nu se \u00eenso\u0163e\u015fte clinic de manifest\u0103ri hemoragice. Pe de alt\u0103 parte, aproximativ 95% din sindroamele hemoragice congenitale se \u00eenso\u0163esc de prelungirea aPTT.<\/span><\/p>\n

\u2013 Monitorizarea tratamentului cu heparin\u0103 nefrac\u0163ionat\u0103 \u015fi inhibitori trombinici (hirudin, argatroban);<\/span><\/p>\n

\u2013 Suspectarea prezen\u0163ei de inhibitori factor-specifici sau nespecifici ai coagul\u0103rii (ex. anticoagulant lupic).<\/span><\/p>\n

Observa\u0163ie: prezen\u0163a anticoagulan\u0163ilor lupici se asociaz\u0103 cu tendin\u0163a clinic\u0103 spre tromboz\u0103 \u015fi nu cu hemoragie.<\/span><\/p>\n

\u2013 Evaluarea preoperatorie a riscului hemoragic1,7<\/sup>.<\/span><\/p>\n

Preg\u0103tire pacient<\/em><\/strong> - <\/em>\u00e0 jeun (pe nem\u00e2ncate)4<\/sup>.<\/span><\/p>\n

In heparinoterapie, proba se recolteaz\u0103 cu o or\u0103 \u00eenainte de urm\u0103toarea administrare. Nu se recolteaz\u0103 proba de pe un cateter heparinizat2<\/sup>.<\/span><\/p>\n

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

Recipient de recoltare<\/em><\/strong> \u2013 vacutainer cu citrat de Na 0.105M (raport citrat de sodiu \u2013 s\u00e2nge=1\/9).<\/span><\/p>\n

Presiunea realizat\u0103 de garou trebuie s\u0103 fie \u00eentre valoarea presiunii sistolice \u015fi cea a presiunii diastolice \u015fi nu trebuie s\u0103 dep\u0103\u015feasc\u0103 1 minut. Dac\u0103 punc\u0163ia venoas\u0103 a e\u015fuat, o nou\u0103 tentativ\u0103 pe aceea\u015fi ven\u0103 nu se poate face dec\u00e2t dup\u0103 10 minute4<\/sup>.<\/span><\/p>\n

Cantitate recoltat\u0103<\/em><\/strong> \u2013 c\u00e2t permite vacuumul; pentru a preveni coagularea par\u0163ial\u0103 a probei se va asigura amestecul corect al s\u00e2ngelui cu anticoagulantul, prin 5-6 mi\u015fc\u0103ri bl\u00e2nde de inversiune a tubului4<\/sup>.<\/span><\/p>\n

Cauze de respingere a probei<\/em><\/strong> - <\/em>vacutainer care nu este plin (cel pu\u0163in 90%); proba intens hemolizat\u0103, coagulat\u0103 sau recoltat\u0103 \u00een alt tub dec\u00e2t cu citrat4,5<\/sup>.<\/span><\/p>\n

Prelucrare necesar\u0103 dup\u0103 recoltare <\/em><\/strong>\u2013 proba va fi centrifugat\u0103 15 minute la 2500g4<\/sup>.<\/span><\/p>\n

Stabilitate prob\u0103<\/em><\/strong> \u2013 proba este stabil\u0103 4 ore<\/em> la temperatura camerei (stabilitatea se reduce la 2 ore \u00een cazul pacien\u0163ilor afla\u0163i sub heparinoterapie); plasma separat\u0103 este stabil\u0103 3 s\u0103pt\u0103m\u00e2ni<\/em> la \u2013 20\u00baC; >1 an<\/em> la \u201370\u00baC4<\/sup>.<\/span><\/p>\n

Metoda<\/em><\/strong> - coagulometric\u0103<\/span>4<\/sup>.<\/span><\/p>\n

Exprimarea rezultatelor<\/em><\/strong> \u2013 \u00een secunde; domeniul m\u0103surabil: 20-240s4<\/sup>.<\/span><\/p>\n

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

\u00a0- normal<\/span>: <40s<\/span><\/p>\n

- interval terapeutic<\/span>: \u00een cursul heparinoterapiei: 1.5-2.5 ori<\/strong> valoarea nivelului de control.<\/span><\/p>\n

Heparina administrat\u0103 intravenos poten\u0163eaz\u0103 efectul inhibitor al antitrombinei asupra factorilor XII, XI, IX, X \u015fi II (efectul se exercit\u0103 mai ales asupra factorilor Xa \u015fi a trombinei). Efectul anticoagulant apare imediat. Deoarece timpul de \u00eenjum\u0103t\u0103\u0163ire al heparinei este de 3 ore, proba de s\u00e2nge pentru aPTT se recolteaz\u0103 la 3 ore dup\u0103 sau cu o or\u0103 \u00eenainte de administrarea heparinei1,2<\/sup>.<\/span><\/p>\n

Valori critice<\/em><\/strong> - <\/em>aPTT >70s (risc de s\u00e2ngerare spontan\u0103)2<\/sup>.<\/span><\/p>\n

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

Prelungirea aPTT<\/span><\/em>: toate deficitele congenitale ale c\u0103ii intrinseci (inclusiv hemofilia A \u015fi B, boala von Willebrand), tratament cu heparin\u0103 nefrac\u0163ionat\u0103, inhibitori trombinici (hirudin, argatroban), streptokinaza, urokinaza, tratament cu anticoagulante orale, deficit de vitamina K, malnutri\u0163ie, hipofibrinogenemie, afec\u0163iuni hepatice, CID, prezen\u0163a produ\u015filor de degradare a fibrinei, prezen\u0163a anticoagulantilor circulan\u0163i factor-specifici (sunt observa\u0163i cel mai adesea la 5-10% din pacien\u0163ii cu hemofilie ca anti-factor VIII sau anti-factor IX; de asemenea Ac anti-FVIII pot ap\u0103rea la v\u00e2rstnici sau\u00a0\u00een sarcin\u01035<\/sup>) sau nespecifici \u2013 anticoagulan\u0163ii lupici (primari sau secundari \u00een: LES \u015fi alte boli autoimune, boli maligne, ca reac\u0163ie la medicamente, dup\u0103 transfuzii multiple, \u00een tuberculoz\u0103, glomerulonefrita cronic\u0103).<\/span><\/p>\n

Rezultatele aPTT se coroboreaz\u0103 cu\u00a0valorile PT2<\/sup>:<\/span><\/p>\n

- PT normal cu aPTT prelungit<\/span>: sugereaz\u0103 deficitul HK, prekalikreinei sau unuia din factorii VIII, IX, XI \u015fi\/sau XII.<\/span><\/p>\n

- PT prelungit cu aPTT normal:<\/span> sugereaz\u0103 un posibil deficit de factor VII. FVII av\u00e2nd un timp de \u00eenjum\u0103t\u0103\u0163ire scurt comparativ cu factorii dependen\u0163i de vitamina K ai c\u0103ii intrinseci, deficien\u0163ele nutri\u0163ionale sau terapeutice ale factorilor dependen\u0163i de vitamina K pot determina uneori PT prelungit cu aPTT normal5,6<\/sup>.<\/span><\/p>\n

- PT \u015fi aPTT prelungite:<\/span> sugereaz\u0103 deficitul unuia din factorii I, II, V sau X.<\/span><\/p>\n

Scurtarea aPTT<\/span><\/em>: poate ap\u0103rea \u00een cazul unor nivele crescute ale unui singur factor, cel mai adesea FVIII8<\/sup>, \u00een neoplasme diseminate (mai pu\u0163in c\u00e2nd este afectat ficatul), imediat dup\u0103 o hemoragie acut\u0103,\u00a0\u00een stadiile ini\u0163iale ale CID1,2<\/sup>.<\/span><\/p>\n

In timp ce valori prelungite ale aPTT sugereaz\u0103 o boal\u0103 hemoragic\u0103, un aPTT scurtat s-a dovedit a fi un predictor independent pentru un risc crescut de deces, tromboz\u0103, hemoragie \u015fi morbiditate8<\/sup>.<\/span><\/p>\n

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

\u2013 aPTT depinde de v\u00e2rsta pacientului: la nou-n\u0103scu\u0163i limita superioar\u0103 a aPTT este prelungit\u0103 p\u00e2n\u0103 la 55s \u015fi scade treptat la nivelul de la adul\u0163i p\u00e2n\u0103 la v\u00e2rsta de 6 luni5<\/sup>; valori prelungite ale aPTT la copiii s\u0103n\u0103to\u015fi se datoreaz\u0103 unei combina\u0163ii de reduceri u\u015foare ale mai multor proteine coagulante. La v\u00e2rstnici aPTT poate fi scurtat.<\/span><\/p>\n

\u2013 Plasma hemolizat\u0103 scurteaz\u0103 aPTT la pacien\u0163ii nehepariniza\u0163i, dar nu \u015fi la cei hepariniza\u0163i.<\/span><\/p>\n

\u2013 La pacien\u0163ii hepariniza\u0163i, centrifugarea \u015fi separarea plasmei trebuie f\u0103cute c\u00e2t mai repede (\u00eentr-o or\u0103) pentru a evita pe c\u00e2t posibil inactivarea heparinei de c\u0103tre trombocite4<\/sup>.<\/span><\/p>\n

\u2013 Valori ale hematocritului foarte mari sau foarte mici, vacutainere recoltate insuficient, prin modificarea raportului s\u00e2nge-citrat pot interfera cu testul.<\/span><\/p>\n

\u2013 Recoltarea probei pe cateter venos central\u00a0 pe care a fost administrat\u0103 solu\u0163ie hiperton\u0103 de NaCl va prelungi PT \u015fi aPTT.<\/span><\/p>\n

\u2013 Probele intens lipemice pot interfera cu mecanismul analizorului de detec\u0163ie a form\u0103rii cheagului7<\/sup>.<\/span><\/p>\n

\u2013 aPTT poate s\u0103 nu fie prelungit \u00een deficien\u0163e individuale ale factorilor de coagulare, dec\u00e2t dac\u0103 nivelul acestora scade sub 15-45%,\u00a0\u00een func\u0163ie de factor, pe c\u00e2nd deficien\u0163e mai pu\u0163in importante ale factorilor de coagulare, dar combinate (deficien\u0163e multiple) pot prelungi aPTT. De asemenea aPTT este mai sensibil la deficien\u0163e ale factorilor c\u0103ii intrinseci (\u00een special ale FVIII \u015fi IX) dec\u00e2t ale factorilor c\u0103ii comune5,8<\/sup>.<\/span><\/p>\n

\u2013 aPTT-LA este mai sensibil pentru screening-ul anticoagulantului lupic la pacien\u0163ii cu istoric de tromboz\u01035<\/sup>.<\/span><\/p>\n

\u2013 Nivele crescute ale FVIII, ca \u00een reac\u0163iile de faz\u0103 acut\u0103 sau boli inflamatorii cronice, pot scurta aPTT sau normaliza rezultate u\u015for crescute ale aPTT (de ex.\u00a0\u00een deficientele u\u015foare ale FIX \u015fi FXI)3,5,7,8<\/sup>.<\/span><\/p>\n

\u2013 At\u00e2t \u00een cazul PT c\u00e2t \u015fi aPTT este util ca rezultatele u\u015for modificate s\u0103 fie repetate pe probe proaspete; varia\u0163iile intrapersonale\u00a0\u00een timp pot fi de 6-12%.3<\/sup><\/span><\/p>\n

\u2013 Un num\u0103r mare de condi\u0163ii pot complica utilizarea aPTT \u00een monitorizarea heparinoterapiei. Un prim grup este reprezentat de factorii care influen\u0163eaz\u0103 biodisponibilitatea heparinei: v\u00e2rsta inaintat\u0103, obezitatea, modific\u0103ri ale proteinelor care leag\u0103 heparina, boli hepatice, renale, rezisten\u0163a la heparin\u0103. Al doilea grup de factori ii include pe cei care altereaz\u0103 r\u0103spunsul\u00a0\u00een func\u0163ie de doza al aPTT la heparin\u0103, cum ar fi nivelele crescute de FVIII sau fibrinogen, nivelele sc\u0103zute de antitrombin\u0103 sau reducerile u\u015foare ale mai multor factori de coagulare (cum se \u00eent\u00e2mpl\u0103\u00a0\u00een stadiile precoce ale coagulopatiei de consum sau la debutul terapiei cu anticoagulante orale). In final trebuie considera\u0163i acei factori care prelungesc aPTT\u00a0\u00een absen\u0163a heparinei: lupusul anticoagulant, deficien\u0163e ale factorilor de contact. In aceste cazuri ar fi mai util testul de heparin\u0103 anti-FXa pentru monitorizarea heparinoterapiei5<\/sup>.<\/span><\/p>\n

\u2013 aPTT nu se folose\u015fte pentru monitorizarea tratamentului cu heparin\u0103 cu greutate molecular\u0103 mic\u0103 care ac\u0163ioneaz\u0103 \u00een principal asupra factorului Xa.<\/span><\/p>\n

\u2013 aPTT este mai pu\u0163in influen\u0163at de produ\u015fii de degradare ai fibrinogenului sau fibrinei dec\u00e2t TT.<\/span><\/p>\n

\u2013 Interferen\u0163e medicamentoase: administrarea concomitent\u0103 de penicilin\u0103, anistreplaza, clorpromazina, acid valproic pot prelungi aPTT1,2<\/sup>.<\/span><\/p>\n

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

    \n
  1. \n
    Dati F, Wagner C. \u201cHemostasis\u201d, Lothar Thomas`<\/em> Clinical Laboratory Diagnostics<\/em>, 1st<\/sup> ed, Frankfurt, Germany,1998, 602-604.<\/span><\/div>\n<\/li>\n
  2. \n
    Fischbach F, \u201cBlood Studies. Hematology and Coagulation\u201d, A Manual of Laboratory and Diagnostic Test, <\/em>8th<\/sup> ed, Philadelphia, 2009, 161-163.<\/span><\/div>\n<\/li>\n
  3. \n
    Kitchen S, Makris M, \u201cLaboratory Tests of Hemostasis\u201d, Practical Hemostasis and Thrombosis,<\/em> O\u2019Shaughnessy D, Makris M, Lillicrap D eds, Blackwell Publishing, 2008, 11-14<\/span><\/div>\n<\/li>\n
  4. \n
    Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate, Ref Type: Catalog.<\/span><\/div>\n<\/li>\n
  5. \n
    Laboratory Corporation of America. Directory of Services and Interpretive Guide. Partial thromboplastin Time, Activated. labcorp.com<\/a>. 2015. Ref Type: Internet Communication.<\/span><\/div>\n<\/li>\n
  6. \n
  7. \n
  8. \n
    <\/div>\n
    Rodgers G, \u201cDiagnostic Approach to the Bleeding Disorders\u201d, Wintrobe`s Clinical Hematology, <\/em>Greer J, Foerster J, Lukens J, Rodgers G, Pareskevas F, Glader B, 11th<\/sup> ed, Lippincott Williams & Wilkins, 2004, 1518-19.<\/span><\/div>\n<\/li>\n<\/ol>\n

    \u00a0<\/span><\/p>","protected":false},"excerpt":{"rendered":"

    \u0410\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e\u0435 \u0447\u0430\u0441\u0442\u0438\u0447\u043d\u043e\u0435 \u0442\u0440\u043e\u043c\u0431\u043e\u043f\u043b\u0430\u0441\u0442\u0438\u043d\u043e\u0432\u043e\u0435 \u0432\u0440\u0435\u043c\u044f (\u0410\u0427\u0422\u0412) \u0445\u0430\u0440\u0430\u043a\u0442\u0435\u0440\u0438\u0437\u0443\u0435\u0442 \u0432\u043d\u0443\u0442\u0440\u0435\u043d\u043d\u0438\u0439 \u043f\u0443\u0442\u044c \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u043d\u0438\u044f \u043a\u0440\u043e\u0432\u0438. \u0410\u0427\u0422\u0412 \u043f\u0440\u0435\u0434\u0441\u0442\u0430\u0432\u043b\u044f\u0435\u0442 \u0441\u043e\u0431\u043e\u0439 \u0432\u0440\u0435\u043c\u044f, \u0437\u0430 \u043a\u043e\u0442\u043e\u0440\u043e\u0435 \u0444\u043e\u0440\u043c\u0438\u0440\u0443\u0435\u0442\u0441\u044f \u0441\u0433\u0443\u0441\u0442\u043e\u043a \u0432 \u043e\u0431\u0440\u0430\u0437\u0446\u0435 \u043f\u043b\u0430\u0437\u043c\u044b \u043a\u0440\u043e\u0432\u0438, \u043f\u043e\u0441\u043b\u0435 \u0434\u043e\u0431\u0430\u0432\u043b\u0435\u043d\u0438\u044f \u043a \u043d\u0435\u0439 \u0441\u043f\u0435\u0446\u0438\u0430\u043b\u044c\u043d\u044b\u0445 \u0430\u043a\u0442\u0438\u0432\u0430\u0442\u043e\u0440\u043e\u0432 \u044d\u0442\u043e\u0433\u043e \u043f\u0440\u043e\u0446\u0435\u0441\u0441\u0430. \u0422\u0430\u043a\u0438\u043c \u043e\u0431\u0440\u0430\u0437\u043e\u043c \u043e\u0446\u0435\u043d\u0438\u0432\u0430\u0435\u0442\u0441\u044f \u0441\u0442\u0435\u043f\u0435\u043d\u044c \u0432\u043e\u0437\u0434\u0435\u0439\u0441\u0442\u0432\u0438\u044f \u0444\u0430\u043a\u0442\u043e\u0440\u043e\u0432 \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u043d\u0438\u044f \u043a\u0440\u043e\u0432\u0438 \u043d\u0430 \u043e\u0431\u0440\u0430\u0437\u043e\u0432\u0430\u043d\u0438\u0435 \u0442\u0440\u043e\u043c\u0431\u0430.<\/p>\n

    \u041f\u0440\u043e\u0434\u043e\u043b\u0436\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u0441\u0442\u044c \u0410\u0427\u0422\u0412 \u0437\u0430\u0432\u0438\u0441\u0438\u0442 \u043e\u0442 \u0443\u0440\u043e\u0432\u043d\u044f \u0432\u044b\u0441\u043e\u043a\u043e\u043c\u043e\u043b\u0435\u043a\u0443\u043b\u044f\u0440\u043d\u043e\u0433\u043e \u043a\u0438\u043d\u0438\u043d\u043e\u0433\u0435\u043d\u0430, \u043f\u0440\u0435\u043a\u0430\u043b\u043b\u0438\u043a\u0440\u0435\u0438\u043d\u0430 \u0438 \u0444\u0430\u043a\u0442\u043e\u0440\u043e\u0432 \u0441\u0432\u0435\u0440\u0442\u044b\u0432\u0430\u043d\u0438\u044f XII, XI, VIII \u0438 \u043c\u0435\u043d\u0435\u0435 \u0447\u0443\u0432\u0441\u0442\u0432\u0438\u0442\u0435\u043b\u044c\u043d\u043e \u043f\u0440\u0438 \u0438\u0437\u043c\u0435\u043d\u0435\u043d\u0438\u044f\u0445 \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0430 \u0444\u0430\u043a\u0442\u043e\u0440\u043e\u0432 X, V, \u043f\u0440\u043e\u0442\u0440\u043e\u043c\u0431\u0438\u043d\u0430 \u0438 \u0444\u0438\u0431\u0440\u0438\u043d\u043e\u0433\u0435\u043d\u0430. \u0410\u0427\u0422\u0412 \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u044f\u044e\u0442 \u043f\u043e \u0434\u043b\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u0441\u0442\u0438 \u043e\u0431\u0440\u0430\u0437\u043e\u0432\u0430\u043d\u0438\u044f \u043a\u0440\u043e\u0432\u044f\u043d\u043e\u0433\u043e \u0441\u0433\u0443\u0441\u0442\u043a\u0430 \u043f\u043e\u0441\u043b\u0435 \u0434\u043e\u0431\u0430\u0432\u043b\u0435\u043d\u0438\u044f \u0432 \u043f\u0440\u043e\u0431\u0443 \u043a\u0440\u043e\u0432\u0438 \u043a\u0430\u043b\u044c\u0446\u0438\u044f \u0438 \u043f\u0430\u0440\u0446\u0438\u0430\u043b\u044c\u043d\u043e\u0433\u043e \u0442\u0440\u043e\u043c\u0431\u043e\u043f\u043b\u0430\u0441\u0442\u0438\u043d\u0430. \u0423\u0432\u0435\u043b\u0438\u0447\u0435\u043d\u0438\u0435 \u0434\u043b\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u0441\u0442\u0438 \u0410\u0427\u0422\u0412 \u0441\u0432\u044f\u0437\u0430\u043d\u043e \u0441 \u043f\u043e\u0432\u044b\u0448\u0435\u043d\u043d\u044b\u043c \u0440\u0438\u0441\u043a\u043e\u043c \u043a\u0440\u043e\u0432\u043e\u0442\u0435\u0447\u0435\u043d\u0438\u0439, \u0443\u043c\u0435\u043d\u044c\u0448\u0435\u043d\u0438\u0435 \u2013 \u0441 \u0442\u0440\u043e\u043c\u0431\u043e\u0437\u043e\u043c. \u0414\u0430\u043d\u043d\u044b\u0439 \u043f\u043e\u043a\u0430\u0437\u0430\u0442\u0435\u043b\u044c \u043e\u0442\u0434\u0435\u043b\u044c\u043d\u043e \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u0443\u044e\u0442 \u0434\u043b\u044f \u043a\u043e\u043d\u0442\u0440\u043e\u043b\u044f \u0442\u0435\u0440\u0430\u043f\u0438\u0438 \u043f\u0440\u044f\u043c\u044b\u043c\u0438 \u0430\u043d\u0442\u0438\u043a\u043e\u0430\u0433\u0443\u043b\u044f\u043d\u0442\u0430\u043c\u0438 (\u0433\u0435\u043f\u0430\u0440\u0438\u043d\u043e\u043c).<\/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?<\/p>\n

      \n
    1. \u0414\u043b\u044f \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0438 \u0433\u0435\u043c\u043e\u0444\u0438\u043b\u0438\u0438.<\/li>\n
    2. \u0412 \u0446\u0435\u043b\u044f\u0445 \u043a\u043e\u043d\u0442\u0440\u043e\u043b\u044f \u0437\u0430 \u0433\u0435\u043f\u0430\u0440\u0438\u043d-\u0430\u043d\u0442\u0438\u043a\u043e\u0430\u0433\u0443\u043b\u044f\u043d\u0442\u043d\u043e\u0439 \u0442\u0435\u0440\u0430\u043f\u0438\u0435\u0439.<\/li>\n
    3. \u0414\u043b\u044f \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0438 \u0433\u043b\u0443\u0431\u043e\u043a\u043e\u0439 \u0433\u0438\u043f\u043e\u0444\u0438\u0431\u0440\u0438\u043d\u043e\u0433\u0435\u043d\u0435\u043c\u0438\u0438, \u0434\u0438\u0441\u0444\u0438\u0431\u0440\u0438\u043d\u043e\u0433\u0435\u043d\u0435\u043c\u0438\u0438 \u0438 \u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u0439 \u043f\u043e\u043b\u0438\u043c\u0435\u0440\u0438\u0437\u0430\u0446\u0438\u0438 \u0444\u0438\u0431\u0440\u0438\u043d-\u043c\u043e\u043d\u043e\u043c\u0435\u0440\u043e\u0432.<\/li>\n
    4. \u0427\u0442\u043e\u0431\u044b \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0438\u0442\u044c \u043f\u0440\u0435\u0434\u0440\u0430\u0441\u043f\u043e\u043b\u043e\u0436\u0435\u043d\u043d\u043e\u0441\u0442\u044c \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u0430 \u043a \u043a\u0440\u043e\u0432\u043e\u0442\u0435\u0447\u0435\u043d\u0438\u044f\u043c (\u0432 \u043a\u043e\u043c\u043f\u043b\u0435\u043a\u0441\u0435 \u043f\u0440\u0435\u0434\u043e\u043f\u0435\u0440\u0430\u0446\u0438\u043e\u043d\u043d\u044b\u0445 \u043f\u0440\u043e\u0446\u0435\u0434\u0443\u0440).<\/li>\n<\/ol>\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?<\/p>\n

        \n
      1. \u0415\u0441\u043b\u0438 \u0443 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u0430 \u043a\u0440\u043e\u0432\u043e\u0442\u0435\u0447\u0435\u043d\u0438\u0435 \u0438\u043b\u0438 \u043a\u0440\u043e\u0432\u043e\u043f\u043e\u0434\u0442\u0435\u043a \u043d\u0435\u0438\u0437\u0432\u0435\u0441\u0442\u043d\u043e\u0433\u043e \u043f\u0440\u043e\u0438\u0441\u0445\u043e\u0436\u0434\u0435\u043d\u0438\u044f, \u0442\u0440\u043e\u043c\u0431\u043e\u044d\u043c\u0431\u043e\u043b\u0438\u0437\u043c \u0438\u043b\u0438 \u0440\u0430\u0441\u0441\u0435\u044f\u043d\u043d\u0430\u044f \u0432\u043d\u0443\u0442\u0440\u0438\u0441\u043e\u0441\u0443\u0434\u0438\u0441\u0442\u0430\u044f \u043a\u043e\u0430\u0433\u0443\u043b\u044f\u0446\u0438\u044f, \u043a\u043e\u0442\u043e\u0440\u0430\u044f \u043c\u043e\u0436\u0435\u0442 \u0432\u044b\u0437\u0432\u0430\u0442\u044c \u0438 \u043a\u0440\u043e\u0432\u043e\u0442\u0435\u0447\u0435\u043d\u0438\u0435, \u0438 \u043e\u0431\u0440\u0430\u0437\u043e\u0432\u0430\u043d\u0438\u0435 \u0442\u0440\u043e\u043c\u0431\u043e\u0432.<\/li>\n
      2. \u041f\u0440\u0438 \u043f\u0440\u043e\u0432\u0435\u0434\u0435\u043d\u0438\u0438 \u0433\u0435\u043f\u0430\u0440\u0438\u043d\u043e\u0432\u043e\u0439 \u0442\u0435\u0440\u0430\u043f\u0438\u0438 \u0438\u043b\u0438 \u043f\u0440\u0438 \u043f\u0435\u0440\u0435\u0432\u043e\u0434\u0435 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u0430 \u0441 \u0433\u0435\u043f\u0430\u0440\u0438\u043d\u043e\u0432\u043e\u0439 \u0442\u0435\u0440\u0430\u043f\u0438\u0438 \u043d\u0430 \u0434\u043b\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u0435 \u043b\u0435\u0447\u0435\u043d\u0438\u0435 \u0441 \u043f\u0440\u0438\u043c\u0435\u043d\u0435\u043d\u0438\u0435\u043c \u0432\u0430\u0440\u0444\u0430\u0440\u0438\u043d\u0430.<\/li>\n
      3. \u0412 \u043a\u043e\u043c\u043f\u043b\u0435\u043a\u0441\u0435 \u0434\u043e\u043e\u043f\u0435\u0440\u0430\u0446\u0438\u043e\u043d\u043d\u043e\u0433\u043e \u043e\u0431\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f \u043d\u0430 \u0432\u044b\u044f\u0432\u043b\u0435\u043d\u0438\u0435 \u0441\u043a\u043b\u043e\u043d\u043d\u043e\u0441\u0442\u0438 \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c\u0430 \u043a \u043a\u0440\u043e\u0432\u043e\u0442\u0435\u0447\u0435\u043d\u0438\u044f\u043c, \u043e\u0441\u043e\u0431\u0435\u043d\u043d\u043e \u0435\u0441\u043b\u0438 \u043f\u0440\u0435\u0434\u043f\u043e\u043b\u0430\u0433\u0430\u0435\u043c\u0430\u044f \u043e\u043f\u0435\u0440\u0430\u0446\u0438\u044f \u0441\u0432\u044f\u0437\u0430\u043d\u0430 \u0441 \u0431\u043e\u043b\u044c\u0448\u043e\u0439 \u043f\u043e\u0442\u0435\u0440\u0435\u0439 \u043a\u0440\u043e\u0432\u0438 \u0438\u043b\u0438 \u0432 \u043a\u043b\u0438\u043d\u0438\u0447\u0435\u0441\u043a\u043e\u0439 \u0438\u0441\u0442\u043e\u0440\u0438\u0438 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u0430 \u0443\u043a\u0430\u0437\u0430\u043d\u044b \u0431\u043e\u043b\u0435\u0435 \u0440\u0430\u043d\u043d\u0438\u0435 \u043a\u0440\u043e\u0432\u043e\u0442\u0435\u0447\u0435\u043d\u0438\u044f.<\/li>\n
      4. \u041f\u0440\u0438 \u043b\u0435\u0447\u0435\u043d\u0438\u0438 \u0438\u043d\u0444\u0430\u0440\u043a\u0442\u0430 \u043c\u0438\u043e\u043a\u0430\u0440\u0434\u0430.<\/li>\n<\/ol>\n

        \u041a\u0430\u043a \u043f\u0440\u0430\u0432\u0438\u043b\u044c\u043d\u043e \u043f\u043e\u0434\u0433\u043e\u0442\u043e\u0432\u0438\u0442\u044c\u0441\u044f \u043a \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044e?<\/p>\n

        \u041d\u0435 \u043f\u0440\u0438\u043d\u0438\u043c\u0430\u0442\u044c \u043f\u0438\u0449\u0443 \u0432 \u0442\u0435\u0447\u0435\u043d\u0438\u0435 12 \u0447\u0430\u0441\u043e\u0432 \u043f\u0435\u0440\u0435\u0434 \u0430\u043d\u0430\u043b\u0438\u0437\u043e\u043c.
        \n\u0418\u0441\u043a\u043b\u044e\u0447\u0438\u0442\u044c \u0444\u0438\u0437\u0438\u0447\u0435\u0441\u043a\u043e\u0435 \u0438 \u044d\u043c\u043e\u0446\u0438\u043e\u043d\u0430\u043b\u044c\u043d\u043e\u0435 \u043f\u0435\u0440\u0435\u043d\u0430\u043f\u0440\u044f\u0436\u0435\u043d\u0438\u0435 \u0437\u0430 30 \u043c\u0438\u043d\u0443\u0442 \u0434\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f.
        \n\u041d\u0435 \u043a\u0443\u0440\u0438\u0442\u044c \u0432 \u0442\u0435\u0447\u0435\u043d\u0438\u0435 30 \u043c\u0438\u043d\u0443\u0442 \u0434\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f.<\/p>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[951],"product_tag":[],"class_list":{"0":"post-9315","1":"product","2":"type-product","3":"status-publish","5":"product_cat-teste-de-hemostaza","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\/9315","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=9315"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=9315"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=9315"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=9315"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=9315"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}