{"id":9435,"date":"2020-04-23T03:37:55","date_gmt":"2020-04-23T00:37:55","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/gastrina\/"},"modified":"2025-02-07T09:09:34","modified_gmt":"2025-02-07T07:09:34","slug":"gastrina","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/gastrina\/","title":{"rendered":"\u0413\u0430\u0441\u0442\u0440\u0438\u043d"},"content":{"rendered":"

Informa\u0163ii generale \u015fi recomand\u0103ri pentru determinarea gastrinei<\/em><\/strong><\/span><\/p>\n

Gastrina este un hormon secretat de celulele G antrale \u015fi are rolul de a stimula produc\u0163ia de HCl gastric, motilitatea antral\u0103, secre\u0163ia de pepsin\u0103 \u015fi factor intrinsec.<\/span><\/p>\n

In circula\u0163ie gastrina este prezent\u0103 sub mai multe forme moleculare, cele mai importante fiind G-34 (\u201ebig gastrin\u201d) \u015fi G-14 (\u201eminigastrin\u201d)3<\/sup>. Valorile gastrinei prezint\u0103 varia\u0163ii circadiene \u015fi fluctua\u0163ii fiziologice \u00een raport cu mesele.<\/span><\/p>\n

Determinarea gastrinei de\u0163ine un rol important \u00een diagnosticul tumorilor Zollinger-Ellison (gastrinoame)\u00a0\u00een prezen\u0163a hiperacidit\u0103\u0163ii1<\/sup>.<\/span><\/p>\n

In condi\u0163ii \u00e0 jeun, la persoanele s\u0103n\u0103toase, nivelurile gastrinei circulante nu dep\u0103\u015fesc 100 pg\/mL, pe c\u00e2nd la cele cu sindrom Zollinger-Ellison sunt semnificativ crescute peste limita superioar\u0103 a normalului2<\/sup>.<\/span><\/p>\n

Tumorile neuroendocrine asociate cu sindromul Zollinger-Ellison sunt caracterizate prin hiperaciditate gastric\u0103 \u015fi ulcer gastro-duodenal; se pot asocia diareea \u015fi steatoreea. Nivelurile de gastrin\u0103 >500-600 pg\/mL la un pacient cu hiperaciditate gastric\u0103 bazal\u0103 indic\u0103 adesea prezen\u0163a unui gastrinom, de\u015fi aceste valori pot fi \u00eent\u00e2lnite \u015fi\u00a0\u00een unele cazuri de hiperplazie a celulelor G antrale. Un procent de 15-20% din pacien\u0163ii cu sindrom Zollinger-Ellison asociaz\u0103 \u015fi alte tumori endocrine cum ar fi: adenom paratiroidian, insulinoame, tumori hipofizare \u015fi suprarenaliene (sindrom Cushing), fiind \u00eencadrat\u00a0\u00een sindromul Werner (neoplazii endocrine multiple de tip I). Gastrinoamele sunt maligne\u00a0\u00een 62% din cazuri, iar 44 % din pacien\u0163i prezint\u0103 metastaze. De obicei gastrinoamele sunt localizate\u00a0\u00een pancreas, dar \u00ee\u015fi pot avea originea \u015fi la nivelul duodenului. Au fost descrise doar c\u00e2teva cazuri de gastrinoame cu localizare primar\u0103 la nivelul stomacului3<\/sup>.<\/span><\/p>\n

Niveluri crescute de gastrin\u0103 sunt \u00eent\u00e2lnite \u015fi \u00een alte condi\u0163ii patologice cum ar fi: anemia pernicioas\u0103 (nivelurile de gastrin\u0103 cresc propor\u0163ional cu gradul hipoacidit\u0103\u0163ii gastrice), obstruc\u0163ia piloric\u0103 cu distensie antral\u0103, dup\u0103 vagotomie precum \u015fi la unii pacien\u0163i cu boal\u0103 ulceroas\u0103 obi\u015fnuit\u0103.<\/span><\/p>\n

Deoarece aproximativ jum\u0103tate din pacien\u0163ii cu tumori Zollinger-Ellison au niveluri bazale de gastrin\u0103 <500 pg\/mL (care nu permit diferen\u0163ierea unui gastrinom de alte condi\u0163ii asociate cu hipergastrinemie), sunt adesea necesare proceduri de confirmare2<\/sup>. Acestea constau \u00een determinarea gatrinemiei \u00een urma administr\u0103rii unor substan\u0163e, secretina<\/em> oferind cea mai bun\u0103 acurate\u0163e a diagnosticului2<\/sup>. In mod normal administrarea intravenoas\u0103 de secretin\u0103 reduce secre\u0163ia de gastrin\u0103, dar la pacien\u0163ii cu gastrinom nivelurile serice de gastrin\u0103 \u00eenregistreaz\u0103 o cre\u015ftere paradoxal\u01032<\/sup>.<\/span><\/p>\n

Preg\u0103tire pacient <\/em><\/strong>-<\/em>obligatoriu \u00e0 jeun (pe nem\u00e2ncate) \u2013 ultima mas\u0103 \u00een urm\u0103 cu 12-14 ore<\/span>2<\/sup>.<\/span><\/p>\n

Specimen recoltat <\/em><\/strong>- <\/em>\u0432\u0435\u043d\u043e\u0437\u043d\u0430\u044f \u043a\u0440\u043e\u0432\u044c2<\/sup>.<\/span><\/p>\n

Recipient de recoltare <\/em><\/strong>- <\/em>vacutainer f\u0103r\u0103 anticoagulant, cu\/f\u0103r\u0103 gel separator2<\/sup><\/span><\/p>\n

Cantitate recoltat\u0103 <\/em><\/strong>-<\/em>minim 0.5 mL ser2<\/sup>.<\/span><\/p>\n

Cauze de respingere a probei<\/em><\/strong> \u2013 specimen intens hemolizat, icteric, lipemic sau contaminat bacterian; probe care nu au sosit la laborator congelate; nu sunt acceptate probe de plasm\u01032<\/sup>.<\/span><\/p>\n

Prelucrare necesar\u0103 dup\u0103 recoltare <\/em><\/strong>- <\/em>se separ\u0103 serul prin centrifugare cat mai repede dup\u0103 formarea complet\u0103 a coagulului; dac\u0103 proba nu poate fi analizat\u0103 imediat va fi congelat\u0103 la -20\u00b0C; probele recoltate \u00een afara sediilor laboratorului vor fi transportate\u00a0\u00een recipientul destinat probelor congelate2<\/sup>.<\/span><\/p>\n

Stabilitate prob\u0103 <\/em><\/strong>-<\/em>serul este stabil 1 lun\u0103<\/em> la -20\u00b0C; nu decongela\u0163i\/recongela\u0163i2<\/sup>.<\/span><\/p>\n

Metod\u0103 <\/i><\/b>- imunochimic\u0103 cu detec\u0163ie prin chemiluminiscen\u0163\u0103 (CLIA)<\/span>2<\/sup>.<\/span><\/p>\n

Valori de referin\u0163\u0103<\/span> <\/i><\/b><\/span>- <\/i>13-115 ng\/L2<\/sup>.<\/span><\/p>\n

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

Valori ale gastrinemiei bazale >1000 pg\/mL \u00een prezen\u0163a unei hiperacidita\u0163i gastrice (secre\u0163ie acid\u0103 bazal\u0103 >15 mmol\/h la un pacient cu ulcer gastro-duodenal care nu a suferit interven\u0163ie chirurgical\u0103) stabilesc cu certitudine diagnosticul de sindrom Zollinger-Ellison3<\/sup>.<\/span><\/p>\n

Cre\u015fteri ale gastrinei serice<\/strong> <\/span>sunt \u00eent\u00e2lnite \u015fi \u00een urm\u0103toarele condi\u0163ii clinice:<\/span><\/p>\n

\u2022 carcinom gastric (datorit\u0103 reducerii secre\u0163iei acide gastrice);<\/span><\/div>\n
\u2022 unele ulcere gastrice\u00a0\u015fi duodenale obi\u015fnuite;<\/span><\/div>\n
\u2022 anemie pernicioasa;<\/span><\/div>\n
\u2022 hiperplazia celulelor G antrale;<\/span><\/div>\n
\u2022 vagotomie f\u0103r\u0103 rezec\u0163ie gastric\u0103;<\/span><\/div>\n
\u2022 hiperparatiroidism;<\/span><\/div>\n
\u2022 obstruc\u0163ie piloric\u0103;<\/span><\/div>\n
\u2022 insuficien\u0163\u0103 renal\u0103 cronic\u0103 \u00een stadiu terminal (gastrina este metabolizat\u0103 de rinichi).<\/span><\/div>\n

Sc\u0103deri ale gastrinei serice<\/strong><\/span> se \u00eenregistreaz\u0103 \u00een:<\/span><\/p>\n

\u2022 antrectomie cu vagotomie<\/span><\/div>\n
\u2022 hipotiroidie1<\/sup><\/span><\/div>\n

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

False cre\u015fteri ale gastrinei serice se \u00eent\u00e2lnesc la pacien\u0163ii care nu au respectat condi\u0163iile de ajunare (o mas\u0103 bogat\u0103 \u00een proteine induce cre\u015fteri semnificative), persoane v\u00e2rstnice, diabetici insulino-dependen\u0163i sau postgastroscopie.<\/span><\/p>\n

\u2022 Medicamente<\/span><\/p>\n

Cre\u015fteri:<\/span> blocan\u0163i de receptori H2, steroizi, preparate de calciu1<\/sup>.<\/span><\/p>\n

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

Anticorpii heterofili prezen\u0163i \u00een serul pacien\u0163ilor pot interac\u0163iona cu imunoglobulinele incluse\u00a0\u00een componentele kit-ului \u015fi da rezultate neconcludente2<\/sup>.<\/span><\/p>\n

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

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

1.\u00a0Frances Fischbach. Chemistry Studies. In A Manual of Laboratory and Diagnostic Tests.<\/i> Lippincott Williams & Wilkins, USA, 8 Ed., 2009, 393-394.<\/span><\/div>\n
2.\u00a0Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate. 2014. Ref Type: Catalog.<\/span><\/div>\n
3.\u00a0Laboratory Corporation of America. Directory of Services and Interpretive Guide. Gastrin, Serum. www.labcorp.com<\/a> 2014. Ref Type: Internet Communication.<\/span><\/div>","protected":false},"excerpt":{"rendered":"

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    \n
  • G-34\u00a0(\u0431\u043e\u043b\u044c\u0448\u043e\u0439\u00a0\u0433\u0430\u0441\u0442\u0440\u0438\u043d,\u00a0\u0431\u0438\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u0438\u00a0\u0430\u043a\u0442\u0438\u0432\u043d\u044b\u0439\u00a0\u043f\u0440\u0435\u0434\u0448\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u0438\u043a\u00a0\u0433\u0430\u0441\u0442\u0440\u0438\u043d\u0430,\u00a0\u043f\u0435\u0440\u0438\u043e\u0434\u00a0\u043f\u043e\u043b\u0443\u0440\u0430\u0441\u043f\u0430\u0434\u0430\u00a0—\u00a042\u00a0\u043c\u0438\u043d.),<\/li>\n
  • G-17\u00a0(\u043c\u0430\u043b\u044b\u0439\u00a0\u0433\u0430\u0441\u0442\u0440\u0438\u043d\u00a0– \u0437\u0440\u0435\u043b\u0430\u044f\u00a0\u0444\u043e\u0440\u043c\u0430\u00a0\u0433\u043e\u0440\u043c\u043e\u043d\u0430,\u00a0\u043f\u0435\u0440\u0438\u043e\u0434\u00a0\u043f\u043e\u043b\u0443\u0440\u0430\u0441\u043f\u0430\u0434\u0430 –\u00a05\u00a0\u043c\u0438\u043d.)\u00a0\u0438<\/li>\n
  • G-14\u00a0(\u043c\u0438\u043d\u0438-\u0433\u0430\u0441\u0442\u0440\u0438\u043d,\u00a0\u043f\u0435\u0440\u0438\u043e\u0434\u00a0\u043f\u043e\u043b\u0443\u0440\u0430\u0441\u043f\u0430\u0434\u0430\u00a0– 5\u00a0\u043c\u0438\u043d.),\u00a0\u0441\u043e\u0434\u0435\u0440\u0436\u0430\u0449\u0438\u0445\u00a0\u0432\u00a0\u0441\u0432\u043e\u0435\u0439\u00a0\u043c\u043e\u043b\u0435\u043a\u0443\u043b\u0435\u00a0\u0441\u043e\u043e\u0442\u0432\u0435\u0442\u0441\u0442\u0432\u0435\u043d\u043d\u043e\u00a034,\u00a017\u00a0\u0438\u00a014\u00a0\u0430\u043c\u0438\u043d\u043e\u043a\u0438\u0441\u043b\u043e\u0442\u043d\u044b\u0445\u00a0\u043e\u0441\u0442\u0430\u0442\u043a\u0430.<\/li>\n<\/ul>\n

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\u043a\u0440\u043e\u0432\u0438 \u043d\u0430 50-150% (\u043c\u0430\u043a\u0441\u0438\u043c\u0430\u043b\u044c\u043d\u044b\u0439 \u0443\u0440\u043e\u0432\u0435\u043d\u044c \u0433\u043e\u0440\u043c\u043e\u043d\u0430 \u0432 \u043a\u0440\u043e\u0432\u0438 \u0434\u043e\u0441\u0442\u0438\u0433\u0430\u0435\u0442\u0441\u044f \u043f\u0440\u0438 \u044d\u0442\u043e\u043c \u0447\u0435\u0440\u0435\u0437 15-40 \u043c\u0438\u043d.). \u041f\u0435\u0440\u0438\u043e\u0434 \u043f\u043e\u043b\u0443\u0440\u0430\u0441\u043f\u0430\u0434\u0430 \u0433\u0430\u0441\u0442\u0440\u0438\u043d\u0430 – \u043e\u043a\u043e\u043b\u043e 8 \u043c\u0438\u043d. \u0418\u0437 \u043a\u0440\u043e\u0432\u0438 \u043e\u043d \u0432\u044b\u0432\u043e\u0434\u0438\u0442\u0441\u044f \u043f\u043e\u0447\u043a\u0430\u043c\u0438, \u0433\u0434\u0435 \u043f\u043e\u0441\u043b\u0435 \u0444\u0438\u043b\u044c\u0442\u0440\u0430\u0446\u0438\u0438 \u0438 \u0440\u0435\u0437\u043e\u0440\u0431\u0446\u0438\u0438 \u0440\u0430\u0441\u0449\u0435\u043f\u043b\u044f\u0435\u0442\u0441\u044f. \u0421\u0435\u043a\u0440\u0435\u0446\u0438\u044e \u0433\u0430\u0441\u0442\u0440\u0438\u043d\u0430 \u0441\u0442\u0438\u043c\u0443\u043b\u0438\u0440\u0443\u0435\u0442 \u0441\u043d\u0438\u0436\u0435\u043d\u0438\u0435 \u043a\u043e\u043d\u0446\u0435\u043d\u0442\u0440\u0430\u0446\u0438\u0438 \u0441\u043e\u043b\u044f\u043d\u043e\u0439 \u043a\u0438\u0441\u043b\u043e\u0442\u044b. \u0412 \u043d\u043e\u0440\u043c\u0435 HCl \u0438\u043d\u0433\u0438\u0431\u0438\u0440\u0443\u0435\u0442 \u0441\u0435\u043a\u0440\u0435\u0446\u0438\u044e \u0433\u0430\u0441\u0442\u0440\u0438\u043d\u0430 – \u0432 \u0443\u0441\u043b\u043e\u0432\u0438\u044f\u0445, \u043a\u043e\u0433\u0434\u0430 \u0432 \u0436\u0435\u043b\u0443\u0434\u043a\u0435 \u0441\u043e\u0434\u0435\u0440\u0436\u0438\u0442\u0441\u044f \u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0435 \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u043e \u043a\u0438\u0441\u043b\u043e\u0442\u044b, \u0433\u0430\u0441\u0442\u0440\u0438\u043d \u043d\u0435 \u0441\u0435\u043a\u0440\u0435\u0442\u0438\u0440\u0443\u0435\u0442\u0441\u044f. \u041d\u0435 \u0432\u0441\u0435\u0433\u0434\u0430 \u0433\u0438\u043f\u0435\u0440\u043f\u0440\u043e\u0434\u0443\u043a\u0446\u0438\u044f \u0433\u0430\u0441\u0442\u0440\u0438\u043d\u0430 \u0441\u043e\u043f\u0440\u043e\u0432\u043e\u0436\u0434\u0430\u0435\u0442\u0441\u044f \u0433\u0438\u043f\u0435\u0440\u0441\u0435\u043a\u0440\u0435\u0446\u0438\u0435\u0439 HCl. \u0413\u0438\u043f\u0435\u0440\u0433\u0430\u0441\u0442\u0440\u0438\u043d\u0435\u043c\u0438\u044f \u0431\u0435\u0437 \u0433\u0438\u043f\u0435\u0440\u0441\u0435\u043a\u0440\u0435\u0446\u0438\u0438 HCl \u0438\u043c\u0435\u0435\u0442 \u043c\u0435\u0441\u0442\u043e \u043f\u0440\u0438 \u0442\u0430\u043a\u0438\u0445 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f\u0445, \u043a\u0430\u043a \u043f\u0435\u0440\u043d\u0438\u0446\u0438\u043e\u0437\u043d\u0430\u044f \u0430\u043d\u0435\u043c\u0438\u044f, \u0430\u0442\u0440\u043e\u0444\u0438\u0447\u0435\u0441\u043a\u0438\u0435 \u0433\u0430\u0441\u0442\u0440\u0438\u0442\u044b, \u0432\u0438\u0442\u0438\u043b\u0438\u0433\u043e. \u0418\u043d\u0442\u0435\u0440\u043f\u0440\u0435\u0442\u0430\u0446\u0438\u044f \u043f\u043e\u0432\u044b\u0448\u0435\u043d\u043d\u044b\u0445 \u0443\u0440\u043e\u0432\u043d\u0435\u0439 \u0433\u0430\u0441\u0442\u0440\u0438\u043d\u0430 \u0442\u0440\u0435\u0431\u0443\u0435\u0442 \u0438\u043d\u0444\u043e\u0440\u043c\u0430\u0446\u0438\u0438 \u043e \u0441\u0435\u043a\u0440\u0435\u0446\u0438\u0438 HCl \u0436\u0435\u043b\u0443\u0434\u043a\u043e\u043c.<\/p>\n

    \u041d\u0430\u0438\u0431\u043e\u043b\u0435\u0435 \u0432\u0430\u0436\u043d\u044b\u043c \u043a\u043b\u0438\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u043c \u0430\u0441\u043f\u0435\u043a\u0442\u043e\u043c \u043f\u0440\u0438\u043c\u0435\u043d\u0435\u043d\u0438\u044f \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u044f \u0433\u0430\u0441\u0442\u0440\u0438\u043d\u0430 \u044f\u0432\u043b\u044f\u044e\u0442\u0441\u044f \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0430 \u0438 \u043a\u043e\u043d\u0442\u0440\u043e\u043b\u044c \u043b\u0435\u0447\u0435\u043d\u0438\u044f \u0441\u0438\u043d\u0434\u0440\u043e\u043c\u0430 \u0417\u043e\u043b\u043b\u0438\u043d\u0433\u0435\u0440\u0430-\u042d\u043b\u043b\u0438\u0441\u043e\u043d\u0430, \u0438\u043b\u0438 \u0433\u0430\u0441\u0442\u0440\u0438\u043d\u043e\u043c\u044b. \u0414\u0430\u043d\u043d\u044b\u0439 \u0442\u0435\u0441\u0442 \u043f\u043e\u0437\u0432\u043e\u043b\u044f\u0435\u0442 \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u044f\u0442\u044c \u0432\u0441\u0435 \u0444\u043e\u0440\u043c\u044b \u0433\u0430\u0441\u0442\u0440\u0438\u043d\u0430 (\u0441 \u0431\u043e\u043b\u044c\u0448\u0435\u0439 \u0441\u043f\u0435\u0446\u0438\u0444\u0438\u0447\u043d\u043e\u0441\u0442\u044c\u044e \u043f\u043e \u043e\u0442\u043d\u043e\u0448\u0435\u043d\u0438\u044e \u043a G-17). \u042d\u0442\u043e \u0438\u0433\u0440\u0430\u0435\u0442 \u0432\u0430\u0436\u043d\u0443\u044e \u0440\u043e\u043b\u044c, \u0442\u0430\u043a \u043a\u0430\u043a \u043d\u0435\u043a\u043e\u0442\u043e\u0440\u044b\u0435 \u0433\u0430\u0441\u0442\u0440\u0438\u043d\u043e\u043c\u044b \u0441\u043f\u043e\u0441\u043e\u0431\u043d\u044b \u0441\u0435\u043a\u0440\u0435\u0442\u0438\u0440\u043e\u0432\u0430\u0442\u044c \u0440\u0430\u0437\u043b\u0438\u0447\u043d\u044b\u0435 \u0444\u043e\u0440\u043c\u044b \u0433\u0430\u0441\u0442\u0440\u0438\u043d\u0430.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n
    \u041f\u043e\u043a\u0430\u0437\u0430\u0442\u0435\u043b\u044c<\/b><\/td>\n\u0425\u0430\u0440\u0430\u043a\u0442\u0435\u0440\u0438\u0441\u0442\u0438\u043a\u0430<\/b><\/td>\n<\/tr>\n
    \u041c\u0430\u0442\u0435\u0440\u0438\u0430\u043b<\/b><\/td>\n\u0412\u0435\u043d\u043e\u0437\u043d\u0430\u044f\u00a0\u043a\u0440\u043e\u0432\u044c<\/td>\n<\/tr>\n
    \u041f\u0440\u0430\u0432\u0438\u043b\u0430\u00a0\u043f\u043e\u0434\u0433\u043e\u0442\u043e\u0432\u043a\u0438\u00a0\u043f\u0430\u0446\u0438\u0435\u043d\u0442\u0430<\/b><\/td>\n\u0421\u0442\u0430\u043d\u0434\u0430\u0440\u0442\u043d\u044b\u0435<\/td>\n<\/tr>\n
    \u0422\u0440\u0430\u043d\u0441\u043f\u043e\u0440\u0442\u043d\u0430\u044f\u00a0\u0441\u0440\u0435\u0434\u0430,\u00a0\u043f\u0440\u043e\u0431\u0438\u0440\u043a\u0430<\/b><\/td>\n\u0412\u0430\u043a\u0443\u0442\u0430\u0439\u043d\u0435\u0440\u00a0\u0441\/\u0431\u0435\u0437\u00a0\u0430\u043d\u0442\u0438\u043a\u043e\u0430\u0433\u0443\u043b\u044f\u043d\u0442\u0430\u00a0\u0441\/\u0431\u0435\u0437\u00a0\u0433\u0435\u043b\u0435\u0432\u043e\u0439\u00a0\u0444\u0430\u0437\u044b<\/td>\n<\/tr>\n
    \u041f\u0440\u0430\u0432\u0438\u043b\u0430\u00a0\u0438\u00a0\u0443\u0441\u043b\u043e\u0432\u0438\u044f\u00a0\u0442\u0440\u0430\u043d\u0441\u043f\u043e\u0440\u0442\u0438\u0440\u043e\u0432\u043a\u0438,\u00a0\u0441\u0442\u0430\u0431\u0438\u043b\u044c\u043d\u043e\u0441\u0442\u044c\u00a0\u043f\u0440\u043e\u0431\u044b<\/b><\/td>\n\u0421\u0442\u0430\u043d\u0434\u0430\u0440\u0442\u043d\u044b\u0435<\/td>\n<\/tr>\n
    \u041c\u0435\u0442\u043e\u0434\u00a0\u0442\u0435\u0441\u0442\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u044f<\/b><\/td>\n\u0418\u043c\u043c\u0443\u043d\u043e\u0445\u0438\u043c\u0438\u0447\u0435\u0441\u043a\u0438\u0439\u00a0\u0441\u00a0\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\u00a0CLIA<\/td>\n<\/tr>\n
    <\/td>\n<\/td>\n<\/tr>\n
    \u0420\u0435\u0444\u0435\u0440\u0435\u043d\u0442\u043d\u044b\u0435\u00a0\u0437\u043d\u0430\u0447\u0435\u043d\u0438\u044f,<\/b>\u00a0\u043f\u0433\/\u043c\u043b<\/b><\/td>\n13,0-115,0<\/td>\n<\/tr>\n
    \u0418\u043d\u0442\u0435\u0440\u0444\u0435\u0440\u0438\u0440\u0443\u044e\u0449\u0438\u0435\u00a0\u0444\u0430\u043a\u0442\u043e\u0440\u044b.\u00a0\u041c\u0435\u0434\u0438\u043a\u0430\u043c\u0435\u043d\u0442\u044b\u00a0<\/b><\/td>\n<\/tr>\n
    \u041f\u043e\u0432\u044b\u0448\u0430\u044e\u0442<\/b><\/td>\n\u0421\u043d\u0438\u0436\u0430\u044e\u0442<\/b><\/td>\n<\/tr>\n
    \u0410\u043c\u0438\u043d\u043e\u043a\u0438\u0441\u043b\u043e\u0442\u044b\u00a0(\u043f\u0435\u0440\u043e\u0440\u0430\u043b\u044c\u043d\u044b\u0439\u00a0\u043f\u0440\u0438\u0451\u043c),\u00a0\u043a\u0430\u0440\u0431\u043e\u043d\u0430\u0442\u00a0\u043a\u0430\u043b\u044c\u0446\u0438\u044f\u00a0(\u043f\u0435\u0440\u043e\u0440\u0430\u043b\u044c\u043d\u044b\u0439\u00a0\u043f\u0440\u0438\u0451\u043c),<\/p>\n

    \u0445\u043b\u043e\u0440\u0438\u0434\u00a0\u043a\u0430\u043b\u044c\u0446\u0438\u044f\u00a0\u0432\u043d\u0443\u0442\u0440\u0438\u0432\u0435\u043d\u043d\u043e,\u00a0\u043a\u0430\u0442\u0435\u0445\u043e\u043b\u0430\u043c\u0438\u043d\u044b,\u00a0\u0446\u0438\u043c\u0435\u0442\u0438\u0434\u0438\u043d\u00a0(\u0441\u0442\u0438\u043c\u0443\u043b\u044f\u0446\u0438\u044f\u00a0\u043f\u0438\u0449\u0435\u0439),<\/p>\n

    \u0438\u043d\u0441\u0443\u043b\u0438\u043d,\u00a0\u043e\u043c\u0435\u043f\u0440\u0430\u0437\u043e\u043b<\/td>\n

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    \u041f\u043e\u043a\u0430\u0437\u0430\u043d\u0438\u044f\u00a0\u043a\u00a0\u043d\u0430\u0437\u043d\u0430\u0447\u0435\u043d\u0438\u044e<\/b><\/td>\n<\/tr>\n
    \u00b7\u00a0\u0414\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0430\u00a0\u0438\u00a0\u043a\u043e\u043d\u0442\u0440\u043e\u043b\u044c\u00a0\u043b\u0435\u0447\u0435\u043d\u0438\u044f\u00a0\u0441\u0438\u043d\u0434\u0440\u043e\u043c\u0430\u00a0\u0417\u043e\u043b\u043b\u0438\u043d\u0433\u0435\u0440\u0430-\u042d\u043b\u043b\u0438\u0441\u043e\u043d\u0430\u00a0(\u0433\u0430\u0441\u0442\u0440\u0438\u043d\u043e\u043c\u044b);<\/p>\n

    \u00b7\u00a0\u0440\u0430\u043a\u00a0\u0436\u0435\u043b\u0443\u0434\u043a\u0430;<\/p>\n

    \u00b7\u00a0\u043f\u0435\u0440\u043d\u0438\u0446\u0438\u043e\u0437\u043d\u0430\u044f\u00a0\u0430\u043d\u0435\u043c\u0438\u044f;<\/p>\n

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

    \u00b7\u00a0\u0440\u0430\u043a\u00a0\u0436\u0435\u043b\u0443\u0434\u043a\u0430;<\/p>\n

    \u00b7\u00a0\u044f\u0437\u0432\u0430\u00a0\u0436\u0435\u043b\u0443\u0434\u043a\u0430<\/td>\n

    		\u00b7\u00a0\u0410\u043d\u0442\u0440\u044d\u043a\u0442\u043e\u043c\u0438\u044f\u00a0\u0441\u00a0\u0432\u0430\u0433\u043e\u0442\u043e\u043c\u0438\u0435\u0439;<\/p>\n

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