{"id":9979,"date":"2020-04-23T03:52:58","date_gmt":"2020-04-23T00:52:58","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/25-oh-vitamina-d\/"},"modified":"2026-05-01T01:00:41","modified_gmt":"2026-04-30T22:00:41","slug":"25-oh-vitamina-d","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/25-oh-vitamina-d\/","title":{"rendered":"25-\u041e\u041d - \u0432\u0438\u0442\u0430\u043c\u0438\u043d D"},"content":{"rendered":"<p style=\"text-align: justify;\"><span style=\"color: #333333; font-size: 12pt;\"><strong><em>Informa\u0163<\/em><\/strong><strong><em>ii generale <\/em><\/strong><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">Vitaminele D sau calciferolii sunt sintetizate din provitamine prin clivajul inelului B din molecula sterolic\u0103 \u00een timpul expunerii la lumina solar\u0103. Cele mai importante vitamine D sunt vitamina D2 (ergocalciferol) \u015fi vitamina D3 (colecalciferol)<sup>3<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">Vitamina D2 este forma derivat\u0103 din plante (ergosterol sau provitamina D2). Vitamina D3 provine fie din alimente de origine animal\u0103 (\u00een special pe\u015ftele gras sau uleiul de pe\u015fte) sau suplimente nutri\u0163ionale, fie este sintetizat\u0103 la nivel cutanat din 7-dehidrocolesterol (provitamina D3) sub ac\u0163iunea radia\u0163iilor ultraviolete<sup>6<\/sup>. Rata de formare a vitaminei D depinde \u00een principal de durata \u015fi intensitatea expunerii. Folosirea cremelor de protec\u0163ie solar\u0103, chiar \u015fi cu un SPF de 15, reduce produc\u0163ia acestei vitamine cu 99.9%. Formarea cutanat\u0103 excesiv\u0103 este prevenit\u0103 prin conversia fotosensibil\u0103 a vitaminei D\u00a0\u00een tachisterol sau lumisterol. At\u00e2t vitamina D2 c\u00e2t \u015fi vitamina D3 nu au activitate biologic\u0103 semnificativ\u0103, de aceea este nevoie s\u0103 fie metabolizate\u00a0\u00een forme hormonal active<sup>2<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">Activarea are loc \u00een dou\u0103 etape, mai int\u00e2i la nivel hepatic \u015fi apoi la nivel renal. Vitamina D av\u00e2nd o structur\u0103 liposolubil\u0103 este transportat\u0103\u00a0\u00een circula\u0163ie sub forma unui complex cu o alfa1 globulin\u0103 specific\u0103 \u2013 proteina transportoare a vitaminei D (VDBP = vitamin D binding protein). La nivel hepatic vitamina D sufer\u0103 prima hidroxilare\u00a0pentru a forma 25-OH vitamina D (calcidiol), un metabolit cu activitate biologic\u0103 limitat\u0103<sup>6<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\"><span style=\"text-decoration: underline;\">25 hidroxivitamina D<\/span>, cu un timp de \u00eenjum\u0103t\u0103\u0163ire prelungit (2-3 s\u0103pt\u0103m\u00e2ni), constituie principalul rezervor circulant \u015fi cel mai bun indicator al statusului global al vitaminei D<sup>2<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">Mai mult de 95% din 25-OH vitamina D dozabil\u0103 \u00een ser este reprezentat\u0103 de 25-OH vitamina D3; 25-OH vitamina D2 cre\u015fte\u00a0\u00een ser la nivele m\u0103surabile doar la pacien\u0163ii care iau medica\u0163ie con\u0163in\u00e2nd vitamina D2<sup>6<\/sup>. Testul utilizat \u00een laboratorul nostru determin\u0103 25-OH vitamina D total\u0103<sup>1<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">Nivelul exact al 25-OH vitaminei D care reflect\u0103 o rezerv\u0103 optim\u0103 a organismului este necunoscut. Un deficit u\u015for sau moderat poate fi asociat cu osteoporoza sau hiperparatiroidism secundar. Deficitul sever conduce la insuficien\u0163a mineraliz\u0103rii \u0163esutului osos nou format (osteoidului), av\u00e2nd drept consecin\u0163\u0103 dezvoltarea rahitismului la copil \u015fi a osteomalaciei la adult. Deoarece se dezvolt\u0103 \u00een perioada de cre\u015ftere osoas\u0103, rahitismul are drept consecin\u0163\u0103 apari\u0163ia unor deforma\u0163ii osoase caracteristice. Modific\u0103rile testelor de laborator \u00een rahitism includ: hipocalcemie, hipofosfatemie, cre\u015fterea fosfatazei alcaline \u015fi a parathormonului. La adult deficitul de vitamina D este asociat cu dureri osoase \u015fi un risc crescut de fracturi.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">Consecin\u0163ele deficitului de vitamina D asupra altor organe dec\u00e2t osul nu sunt pe deplin \u00een\u0163elese, dar ar putea include o susceptibilitate crescut\u0103 fa\u0163\u0103 de infec\u0163ii, disconfort muscular, rezisten\u0163a la insulin\u0103, diabet zaharat de tip I, hipertensiune arterial\u0103, insuficien\u0163\u0103 cardiac\u0103, depresie, schizofrenie, autism, scleroz\u0103 multipl\u0103, sindrom nefrotic, risc crescut de preeclampsie \u015fi de afec\u0163iuni maligne: cancer de colon, prostat\u0103, san, ovar, limfom non-nonhodgkinian<sup>3;4;5<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">Cauzele unui nivel suboptim de 25-OH vitamina D includ:<\/span><\/p>\n<ul style=\"text-align: justify;\">\n<li><span style=\"font-size: 12pt;\">expunere insuficient\u0103 la soare;<\/span><\/li>\n<li><span style=\"font-size: 12pt;\">aport alimentar inadecvat;<\/span><\/li>\n<li><span style=\"font-size: 12pt;\">deficit de absorb\u0163ie a vitaminei D la nivel intestinal (ciroz\u0103 biliar\u0103, sindrom de intestin scurt, insuficien\u0163\u0103 pancreatic\u0103 exocrin\u0103, boala Crohn, fibroz\u0103 chistic\u0103, boala celiac\u0103);<\/span><\/li>\n<li><span style=\"font-size: 12pt;\">catabolizare crescut\u0103 a vitaminei D (tratament cu barbiturice \u015fi anticonvulsivante, hiperparatiroidism primar);<\/span><\/li>\n<li><span style=\"font-size: 12pt;\">pierderi crescute de vitamina D (sindrom nefrotic, dializ\u0103 peritoneal\u0103);<\/span><\/li>\n<li><span style=\"font-size: 12pt;\">reducerea activit\u0103\u0163ii 25-hidroxilazei hepatice secundara unor boli hepatice severe<sup>3<\/sup>.<\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">Deficitul de vitamina D este mult mai frecvent dec\u00e2t se credea p\u00e2n\u0103 acum, \u00een special\u00a0\u00een r\u00e2ndul adolescen\u0163ilor, femeilor \u015fi v\u00e2rstnicilor. Astfel, numeroase studii au ar\u0103tat c\u0103 mai mult de 50% dintre v\u00e2rstnicii institu\u0163ionaliza\u0163i \u015fi de asemenea un procent similar de femei care urmeaz\u0103 tratament pentru osteoporoz\u0103 prezint\u0103 nivele inadecvate de vitamina D. De asemenea persoanele care locuiesc\u00a0\u00een regiunile din latitudinea nordic\u0103, cele cu tenul de culoare \u00eenchis\u0103 datorit\u0103 unui con\u0163inut crescut de melanin\u0103, cele care datorit\u0103 unor obiceiuri religioase \u00ee\u015fi limiteaz\u0103 expunerea la soare, pacien\u0163ii obezi sau cu boli cronice severe, nou-n\u0103scu\u0163ii din mame cu deficit asociaz\u0103 un risc crescut de a dezvolta deficit de vitamina D<sup>2;4<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">Tratamentul deficitului de vitamina D const\u0103 \u00een administrarea urm\u0103toarelor preparate:<\/span><\/p>\n<div style=\"text-align: justify; padding-left: 30px;\"><span style=\"font-size: 12pt;\">\u2013 colecalciferol (vitamina D3); administrarea zilnic\u0103 timp de 3 luni a 1000 UI determin\u0103 o cre\u015ftere cu 10 ng\/mL a nivelului seric de 25-OH vitamina D;<\/span><\/div>\n<div style=\"text-align: justify; padding-left: 30px;\"><span style=\"font-size: 12pt;\">\u2013 ergocalciferol (vitamina D2); administrat sub forma unor capsule de 50 000 UI<sup>5<\/sup>.<\/span><\/div>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">In compara\u0163ie cu prevalen\u0163a crescut\u0103 a deficitului de vitamina D, hipervitaminoza D este rar\u0103 \u015fi este depistat\u0103 numai \u00een cazurile de expunere prelungit\u0103 la doze mari de vitamina D. Aceast\u0103 condi\u0163ie se caracterizeaz\u0103 clinic prin anorexie, grea\u0163\u0103, v\u0103rs\u0103turi, diaree, hipotonie, nefrolitiaz\u0103, tulbur\u0103ri de ritm cardiac, iar ca modific\u0103ri ale testelor de laborator se \u00eenregistreaz\u0103 hipercalcemie \u015fi hiperfosfatemie severe, precum \u015fi valori sc\u0103zute ale parathormonului<sup>4;5<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #333333; font-size: 12pt;\"><strong><em>Recomand\u0103<\/em><\/strong><strong><em>ri pentru determinarea 25-0H vitaminei D<\/em><\/strong><\/span><\/p>\n<div style=\"text-align: justify; padding-left: 30px;\"><span style=\"font-size: 12pt;\">\u2013 diagnosticul deficitului de vitamina D;<\/span><\/div>\n<div style=\"text-align: justify; padding-left: 30px;\"><span style=\"font-size: 12pt;\">\u2013 diagnosticul diferen\u0163ial al cauzelor de rahitism \u015fi osteomalacie;<\/span><\/div>\n<div style=\"text-align: justify; padding-left: 30px;\"><span style=\"font-size: 12pt;\">\u2013 monitorizarea terapiei de substitu\u0163ie cu vitamina D;<\/span><\/div>\n<div style=\"text-align: justify; padding-left: 30px;\"><span style=\"font-size: 12pt;\">\u2013 diagnosticul hipervitaminozei D<sup>4<\/sup>.<\/span><\/div>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\"><span style=\"color: #333333;\"><strong><em>Specimen recoltat <\/em><\/strong><\/span><em>- <\/em>\u0432\u0435\u043d\u043e\u0437\u043d\u0430\u044f \u043a\u0440\u043e\u0432\u044c<sup>1<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\"><span style=\"color: #333333;\"><strong><em>Recipient de recoltare <\/em><\/strong><\/span><em>- <\/em>vacutainer f\u0103r\u0103 anticoagulant, cu\/f\u0103r\u0103 gel separator<sup>1<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\"><span style=\"color: #333333;\"><strong><em>Prelucrare necesar\u0103 dup\u0103 recoltare<\/em><\/strong> <\/span>\u2013 se separ\u0103 serul prin centrifugare<sup>1<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\"><span style=\"color: #333333;\"><strong><em>Volum prob\u0103<\/em><\/strong> <\/span>\u2013 minim 1 mL ser<sup>1<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #333333; font-size: 12pt;\"><strong><em>Cauze de respingere<\/em><\/strong> <strong><em>a probei<\/em><\/strong><\/span><\/p>\n<div style=\"text-align: justify; padding-left: 30px;\"><span style=\"font-size: 12pt;\">\u2022 specimen hemolizat<\/span><\/div>\n<div style=\"text-align: justify; padding-left: 30px;\"><span style=\"font-size: 12pt;\">\u2022 specimen icteric, lipemic<\/span><\/div>\n<div style=\"text-align: justify; padding-left: 30px;\"><span style=\"font-size: 12pt;\">\u2022 specimen contaminat bacterian<sup>1<\/sup>.<\/span><\/div>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\"><span style=\"color: #000000;\"><span style=\"color: #333333;\"><b><i>Stabilitate prob\u0103 <\/i><\/b><\/span><i>-<b> <\/b><\/i><\/span>serul separat este stabil <i>5 zile<\/i> \u00a0la 2-8\u00baC si <i>timp \u00eendelungat<\/i> la -20\u00baC. Nu decongela\u0163i\/recongela\u0163i<sup>1<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\"><span style=\"color: #333333;\"><b><i>Metod\u0103<\/i><\/b><b><i> <\/i><\/b><\/span>- <span style=\"text-decoration: underline;\">metoda imunochimic\u0103 cu detec\u0163ie prin electrochemiluminiscen\u0163\u0103<\/span>; este m\u0103surat\u0103 vitamina D total\u0103 (vitamina D3, vitamina D2 \u015fi al\u0163i metaboli\u0163i hidroxila\u0163i ai vitaminei D)<sup>1<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #333333; font-size: 12pt;\"><b><i>Valori de referin\u0163\u0103<\/i><\/b> <\/span><\/p>\n<div style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">Caren\u0163a:\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u2264 20 ng\/mL<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">Nivel insuficient:\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 21-29 ng\/mL<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">Nivel optim:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 30-55.5 ng\/mL<\/span><\/div>\n<div style=\"text-align: justify;\"><\/div>\n<div style=\"text-align: justify;\"><span style=\"color: #000000; font-size: 12pt;\"><i>Factor de conversie: 1 ng\/mL = 2.496 nmo\/L<\/i><sup>1<\/sup><\/span><\/div>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\"><span style=\"color: #333333;\"><b><i>Limita de detec\u0163ie<\/i><\/b><\/span> \u2013 4 ng\/mL<sup>1<\/sup><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #333333; font-size: 12pt;\"><strong><em>Interpretarea rezultatelor<\/em><\/strong><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">Nivelul seric de 25-OH vitamina D reflect\u0103 ingestia de vitamina D din alimenta\u0163ie \u015fi sinteza cutanat\u0103 din provitamine sub influen\u0163a razelor ultraviolete; este influen\u0163at de v\u00e2rst\u0103, sex, ras\u0103 \u015fi loca\u0163ie geografic\u0103. De asemenea nivelul de 25-OH vitamina D poate avea varia\u0163ii sezoniere (valorile din sezonul rece pot fi cu 40-50% mai sc\u0103zute dec\u00e2t cele din sezonul cald datorit\u0103 reducerii expunerii la radia\u0163iile ultraviolete). Concentra\u0163iile metaboli\u0163ilor vitaminei D sunt crescute in timpul sarcinii.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">Cunoa\u015fterea factorilor de influen\u0163\u0103 a condus la stabilirea unor valori \u201cnormale\u201d \u00een func\u0163ie de sezon, pe e\u015fantioane de popula\u0163ie din anumite zone geografice. Abordarea men\u0163ionat\u0103 furnizeaz\u0103 un \u201cinterval de referin\u0163\u0103\u201c \u00eens\u0103 acesta nu se suprapune cu intervalul optim pentru starea de s\u0103n\u0103tate dac\u0103 de fapt un procent semnificativ din popula\u0163ia de referin\u0163\u0103 este deficitar in vitamina D. De mai mare utilitate\u00a0\u00een practica clinic\u0103 ar putea fi <span style=\"text-decoration: underline;\">valoarea prag pentru un status nutri\u0163ional adecvat<\/span>, sub care un individ poate fi considerat ca av\u00e2nd deficit de vitamina D. C\u00e2\u0163iva cercet\u0103tori preocupa\u0163i de aceast\u0103 problem\u0103 au \u00eencercat s\u0103 stabileasc\u0103 o corela\u0163ie \u00eentre concentra\u0163iile serice de 25-OH vitamina D \u015fi cele ale altor markeri biologici, cum ar fi calciul \u015fi parathormonul<sup>2;6<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">De\u015fi nu exist\u0103 un consens asupra valorilor optime de 25-OH vitamina D, majoritatea speciali\u015ftilor define\u015fte deficitul de vitamina D printr-un nivel seric &lt;20 ng\/mL (50 nmol\/L). Valorile &lt;10 ng\/mL indic\u0103 un deficit sever. In urma studiilor efectuate s-a constatat c\u0103 absorb\u0163ia intestinal\u0103 a calciului cre\u015fte cu 45-65% \u00een cazul \u00een care se ob\u0163ine o cre\u015ftere a nivelului seric de 25-OH vitamina D de la 20 la 32 ng\/mL (de la 50 la 80 nmol\/L). Din acest motiv valorile cuprinse \u00eentre 20 \u015fi 29 ng\/mL pot fi considerate ca un indicator de insuficien\u0163\u0103 relativ\u0103 a vitaminei D, \u00een timp ce un nivel &gt;30 ng\/mL este adecvat at\u00e2t pentru absorb\u0163ia intestinal\u0103 optim\u0103 a calciului (ce men\u0163ine echilibrul mineral osos) c\u00e2t \u015fi pentru corectarea hiperparatiroidismului secundar. Pentru a se atinge valorile optime aportul zilnic de vitamina D trebuie s\u0103 fie de minimum 800 UI (mai mare dec\u00e2t recomand\u0103rile actuale).<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">Intoxica\u0163ia cu vitamina D se observ\u0103 de obicei la valori serice ale 25-OH vitaminei D &gt;150 ng\/mL (374 nmol\/L)<sup>5<\/sup>. Determinarea nivelului de 25-OH vitamina D este util\u0103 pentru diagnosticul diferen\u0163ial cu afec\u0163iunile granulomatoase, \u00een special sarcoidoza, \u00een care pacien\u0163ii prezint\u0103 de asemenea hipercalcemie, hiperfosfatemie \u015fi un nivel redus de PTH (prin conversia ectopic\u0103 a 25-OH vitaminei D \u00een 1,25-(OH)<sub>2<\/sub> vitamina D), \u00eens\u0103 valorile 25-OH vitaminei D sunt mult mai mici dec\u00e2t\u00a0\u00een hipervitaminoza D<sup>4<\/sup>.<em>\u00a0<\/em><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #333333; font-size: 12pt;\"><strong><em>Limite \u015fi interferen\u0163e<\/em><\/strong><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">Ob\u0163inerea unor valori &gt;10 ng\/mL de 25-OH vitamina D \u00een prezen\u0163a unui tablou clinic sugestiv pentru deficitul de vitamina D impune determinarea 1,25-(OH)<sub>2<\/sub> vitamina D \u00eempreun\u0103 cu testarea func\u0163iei renale<sup>4<\/sup>.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">\u00a0<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 10pt;\"><strong>\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f:<\/strong><\/span><\/p>\n<div style=\"text-align: justify;\"><span style=\"font-size: 12pt;\">1. <span style=\"font-size: 10pt;\">Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate 2012. Ref Type: Catalog.<\/span><\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: 10pt;\">2. Laboratory Corporation of America. Directory of Services and Interpretive Guide. Vitamin D, 25Hydroxy. www.labcorp.com 2010. Ref Type: Internet Communication.<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: 10pt;\">3. Lothar Thomas. Bone and Mineral Metabolism. In Clinical Laboratory Diagnostics-Use and Assessment of Clinical Laboratory Results. TH- Books Verlagsgesellschaft mbH, Frankfurt \/Main, Germany, 1 Ed., 1998; 221-225; 254-255.<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: 10pt;\">4. Mayo Clinic. Mayo Medical Laboratories. Test Catalog: 25-Hydroxyvitamin D2 and D3, Serum. <a href=\"http:\/\/www.mayomedicallaboratories.com\" rel=\"nofollow noopener\" target=\"_blank\">www.mayomedicallaboratories.com<\/a>. Ref Type: Internet Communication.<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: 10pt;\">5. Michael F. Holick. Vitamin D Deficiency. In The New England Journal of Medicine, volume 357:266-281, July, 2007.<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: 10pt;\">6. Richard A. Mc.Pherson, Mattew R. Pincus. Biochemical markers of bone metabolism. In Henry\u00b4S.Clinical Diagnosis and Management By Laboratory Methods, Ed.Saunders, 2007, 175-176.<\/span><\/div>","protected":false},"excerpt":{"rendered":"<p>\u0412\u0438\u0442\u0430\u043c\u0438\u043d D \u2013 \u0436\u0438\u0440\u043e\u0440\u0430\u0441\u0442\u0432\u043e\u0440\u0438\u043c\u043e\u0435 \u0432\u0435\u0449\u0435\u0441\u0442\u0432\u043e, \u043d\u0435\u043e\u0431\u0445\u043e\u0434\u0438\u043c\u043e\u0435 \u0434\u043b\u044f \u043f\u043e\u0434\u0434\u0435\u0440\u0436\u0430\u043d\u0438\u044f \u0432 \u043a\u0440\u043e\u0432\u0438 \u0443\u0440\u043e\u0432\u043d\u044f \u043a\u0430\u043b\u044c\u0446\u0438\u044f, \u0444\u043e\u0441\u0444\u043e\u0440\u0430 \u0438 \u043c\u0430\u0433\u043d\u0438\u044f. \u041f\u043e \u0441\u0432\u043e\u0435\u043c\u0443 \u0434\u0435\u0439\u0441\u0442\u0432\u0438\u044e \u043e\u043d \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u0433\u043e\u0440\u043c\u043e\u043d\u043e\u043c \u0438 \u0430\u043d\u0442\u0438\u0440\u0430\u0445\u0438\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u043c \u0444\u0430\u043a\u0442\u043e\u0440\u043e\u043c. \u0421\u0443\u0449\u0435\u0441\u0442\u0432\u0443\u0435\u0442 \u043d\u0435\u0441\u043a\u043e\u043b\u044c\u043a\u043e \u0444\u043e\u0440\u043c \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D, \u043a\u043e\u0442\u043e\u0440\u044b\u0435 \u043c\u043e\u0436\u043d\u043e \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0438\u0442\u044c \u0432 \u043a\u0440\u043e\u0432\u0438: 25-\u0433\u0438\u0434\u0440\u043e\u043a\u0441\u0438\u0432\u0438\u0442\u0430\u043c\u0438\u043d D [25(OH)D] \u0438 1,25-\u0434\u0438\u0433\u0438\u0434\u0440\u043e\u043a\u0441\u0438\u0432\u0438\u0442\u0430\u043c\u0438\u043d D [1,25(OH)(2)D]. 25-\u0433\u0438\u0434\u0440\u043e\u043a\u0441\u0438\u0432\u0438\u0442\u0430\u043c\u0438\u043d D \u2013 \u043e\u0441\u043d\u043e\u0432\u043d\u0430\u044f \u043d\u0435\u0430\u043a\u0442\u0438\u0432\u043d\u0430\u044f \u0444\u043e\u0440\u043c\u0430 \u0433\u043e\u0440\u043c\u043e\u043d\u0430, \u0441\u043e\u0434\u0435\u0440\u0436\u0430\u0449\u0435\u0433\u043e\u0441\u044f \u0432 \u043a\u0440\u043e\u0432\u0438, \u043f\u0440\u0435\u0434\u0448\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u0438\u043a \u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0433\u043e \u0433\u043e\u0440\u043c\u043e\u043d\u0430 1,25-\u0434\u0438\u0433\u0438\u0434\u0440\u043e\u043a\u0441\u0438\u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D. \u0414\u043b\u044f \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u044f \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0430 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D \u043e\u0431\u044b\u0447\u043d\u043e \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u0443\u0435\u0442\u0441\u044f 25-\u0433\u0438\u0434\u0440\u043e\u043a\u0441\u0438\u0432\u0438\u0442\u0430\u043c\u0438\u043d D \u0438\u0437-\u0437\u0430 \u0435\u0433\u043e \u0432\u044b\u0441\u043e\u043a\u043e\u0439 \u043a\u043e\u043d\u0446\u0435\u043d\u0442\u0440\u0430\u0446\u0438\u0438 \u0438 \u0434\u043b\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u0433\u043e \u043f\u0435\u0440\u0438\u043e\u0434\u0430 \u043f\u043e\u043b\u0443\u0440\u0430\u0441\u043f\u0430\u0434\u0430.<\/p>\n<p>\u041f\u043e \u043f\u0440\u043e\u0438\u0441\u0445\u043e\u0436\u0434\u0435\u043d\u0438\u044e \u0432\u0438\u0442\u0430\u043c\u0438\u043d D \u0431\u044b\u0432\u0430\u0435\u0442 \u0434\u0432\u0443\u0445 \u0442\u0438\u043f\u043e\u0432: \u044d\u043d\u0434\u043e\u0433\u0435\u043d\u043d\u044b\u0439 (\u0445\u043e\u043b\u0435\u043a\u0430\u043b\u044c\u0446\u0438\u0444\u0435\u0440\u043e\u043b), \u043a\u043e\u0442\u043e\u0440\u044b\u0439 \u043e\u0431\u0440\u0430\u0437\u0443\u0435\u0442\u0441\u044f \u0432 \u043a\u043e\u0436\u0435 \u043f\u043e\u0434 \u0432\u043b\u0438\u044f\u043d\u0438\u0435\u043c \u0441\u043e\u043b\u043d\u0435\u0447\u043d\u044b\u0445 \u043b\u0443\u0447\u0435\u0439, \u0438 \u044d\u043a\u0437\u043e\u0433\u0435\u043d\u043d\u043d\u044b\u0439 (\u044d\u0440\u0433\u043e\u043a\u0430\u043b\u044c\u0446\u0438\u0444\u0435\u0440\u043e\u043b), \u043a\u043e\u0442\u043e\u0440\u044b\u0439 \u043f\u043e\u0441\u0442\u0443\u043f\u0430\u0435\u0442 \u0432 \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c \u0432\u043c\u0435\u0441\u0442\u0435 \u0441 \u043f\u0438\u0449\u0435\u0439. \u041f\u0438\u0449\u0435\u0432\u044b\u0435 \u0438\u0441\u0442\u043e\u0447\u043d\u0438\u043a\u0438 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D: \u0436\u0438\u0440\u043d\u0430\u044f \u0440\u044b\u0431\u0430 (\u043d\u0430\u043f\u0440\u0438\u043c\u0435\u0440, \u043b\u043e\u0441\u043e\u0441\u044c, \u0441\u043a\u0443\u043c\u0431\u0440\u0438\u044f), \u0440\u044b\u0431\u0438\u0439 \u0436\u0438\u0440. \u0412 \u043e\u0441\u043d\u043e\u0432\u043d\u043e\u043c \u0432\u0438\u0442\u0430\u043c\u0438\u043d D \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u043f\u0440\u043e\u0434\u0443\u043a\u0442\u043e\u043c \u043f\u0440\u0435\u0432\u0440\u0430\u0449\u0435\u043d\u0438\u044f 7-\u0434\u0435\u0433\u0438\u0434\u0440\u043e\u0445\u043e\u043b\u0435\u0441\u0442\u0435\u0440\u043e\u043b\u0430, \u043e\u0431\u0440\u0430\u0437\u0443\u044e\u0449\u0435\u0433\u043e\u0441\u044f \u0432 \u043a\u043e\u0436\u0435 \u043f\u043e\u0434 \u0432\u043e\u0437\u0434\u0435\u0439\u0441\u0442\u0432\u0438\u0435\u043c \u0443\u043b\u044c\u0442\u0440\u0430\u0444\u0438\u043e\u043b\u0435\u0442\u043e\u0432\u043e\u0433\u043e \u0438\u0437\u043b\u0443\u0447\u0435\u043d\u0438\u044f \u0441 \u0434\u043b\u0438\u043d\u043e\u0439 \u0432\u043e\u043b\u043d\u044b 290-315 \u043d\u043c. \u0421\u0438\u043d\u0442\u0435\u0437 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D \u0437\u0430\u0432\u0438\u0441\u0438\u0442 \u043e\u0442 \u0434\u043b\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u0441\u0442\u0438 \u0432\u043e\u0437\u0434\u0435\u0439\u0441\u0442\u0432\u0438\u044f \u0438 \u0438\u043d\u0442\u0435\u043d\u0441\u0438\u0432\u043d\u043e\u0441\u0442\u0438 \u0438\u0437\u043b\u0443\u0447\u0435\u043d\u0438\u044f. \u041f\u0435\u0440\u0435\u0438\u0437\u0431\u044b\u0442\u043a\u0430 \u043a\u0430\u043b\u044c\u0446\u0438\u0444\u0435\u0440\u043e\u043b\u0430 \u043f\u0440\u0438 \u044d\u0442\u043e\u043c \u043d\u0435 \u0432\u043e\u0437\u043d\u0438\u043a\u0430\u0435\u0442, \u0442\u0430\u043a \u043a\u0430\u043a \u0441\u0443\u0449\u0435\u0441\u0442\u0432\u0443\u044e\u0442 \u0444\u043e\u0442\u043e\u0447\u0443\u0432\u0441\u0442\u0432\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u0435 \u0437\u0430\u0449\u0438\u0442\u043d\u044b\u0435 \u043c\u0435\u0445\u0430\u043d\u0438\u0437\u043c\u044b, \u043a\u043e\u0442\u043e\u0440\u044b\u0435 \u043c\u0435\u0442\u0430\u0431\u043e\u043b\u0438\u0437\u0438\u0440\u0443\u044e\u0442 \u043b\u0438\u0448\u043d\u0438\u0439 \u0432\u0438\u0442\u0430\u043c\u0438\u043d D \u0432 \u0442\u0430\u0445\u0438\u0441\u0442\u0435\u0440\u043e\u043b \u0438 \u043b\u044e\u043c\u0438\u0441\u0442\u0435\u0440\u043e\u043b. \u0412 \u043f\u0435\u0447\u0435\u043d\u0438 \u0432\u0438\u0442\u0430\u043c\u0438\u043d D \u043f\u0440\u0435\u0432\u0440\u0430\u0449\u0430\u0435\u0442\u0441\u044f \u0432 25-\u0433\u0438\u0434\u0440\u043e\u043a\u0441\u0438\u043a\u0430\u043b\u044c\u0446\u0438\u0444\u0435\u0440\u043e\u043b, \u043a\u043e\u0442\u043e\u0440\u044b\u0439 \u0438 \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u043e\u0441\u043d\u043e\u0432\u043d\u044b\u043c \u043b\u0430\u0431\u043e\u0440\u0430\u0442\u043e\u0440\u043d\u044b\u043c \u043f\u043e\u043a\u0430\u0437\u0430\u0442\u0435\u043b\u0435\u043c \u0443\u0440\u043e\u0432\u043d\u044f \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D \u0432 \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c\u0435. \u0412 \u043a\u0440\u043e\u0432\u0438 \u0434\u0430\u043d\u043d\u0430\u044f \u0444\u043e\u0440\u043c\u0430 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 \u0442\u0440\u0430\u043d\u0441\u043f\u043e\u0440\u0442\u0438\u0440\u0443\u0435\u0442\u0441\u044f \u0432 \u043a\u043e\u043c\u043f\u043b\u0435\u043a\u0441\u0435 \u0441 \u0431\u0435\u043b\u043a\u043e\u043c. \u0412 \u043f\u043e\u0447\u043a\u0430\u0445 25-\u041e\u041d-D \u043f\u0440\u0435\u0432\u0440\u0430\u0449\u0430\u0435\u0442\u0441\u044f \u0432 \u0431\u0438\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u0438 \u0430\u043a\u0442\u0438\u0432\u043d\u0443\u044e \u0444\u043e\u0440\u043c\u0443 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D \u2013 1,25-\u0434\u0438\u0433\u0438\u0434\u0440\u043e\u043a\u0441\u0438\u043a\u0430\u043b\u044c\u0446\u0438\u0444\u0435\u0440\u043e\u043b (1,25-\u041e\u041d(2)-D), \u043a\u043e\u0442\u043e\u0440\u044b\u0439 \u0441\u0442\u0438\u043c\u0443\u043b\u0438\u0440\u0443\u0435\u0442 \u0432\u0441\u0430\u0441\u044b\u0432\u0430\u043d\u0438\u0435 \u043a\u0430\u043b\u044c\u0446\u0438\u044f \u0432 \u043a\u0438\u0448\u0435\u0447\u043d\u0438\u043a\u0435 \u0438 \u0440\u0435\u0430\u0431\u0441\u043e\u0440\u0431\u0446\u0438\u044e \u043a\u0430\u043b\u044c\u0446\u0438\u044f \u0438 \u0444\u043e\u0441\u0444\u043e\u0440\u0430 \u0432 \u043f\u043e\u0447\u043a\u0430\u0445.<\/p>\n<p>\u041f\u0440\u0438 \u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0435 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D \u0443\u0440\u043e\u0432\u0435\u043d\u044c \u043a\u0430\u043b\u044c\u0446\u0438\u044f \u043a\u043e\u043c\u043f\u0435\u043d\u0441\u0438\u0440\u0443\u0435\u0442\u0441\u044f \u0437\u0430 \u0441\u0447\u0435\u0442 \u0435\u0433\u043e \u043c\u043e\u0431\u0438\u043b\u0438\u0437\u0430\u0446\u0438\u0438 \u0438\u0437 \u043a\u043e\u0441\u0442\u043d\u043e\u0439 \u0442\u043a\u0430\u043d\u0438, \u0447\u0442\u043e \u043c\u043e\u0436\u0435\u0442 \u043f\u0440\u0438\u0432\u0435\u0441\u0442\u0438 \u043a \u043e\u0441\u0442\u0435\u043e\u043c\u0430\u043b\u044f\u0446\u0438\u0438, \u0440\u0430\u0445\u0438\u0442\u0443 \u0443 \u0434\u0435\u0442\u0435\u0439 \u0438 \u043e\u0441\u0442\u0435\u043e\u043f\u043e\u0440\u043e\u0437\u0443 \u0443 \u0432\u0437\u0440\u043e\u0441\u043b\u044b\u0445. \u041f\u043e \u0434\u0430\u043d\u043d\u044b\u043c \u043d\u0435\u043a\u043e\u0442\u043e\u0440\u044b\u0445 \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0439, \u0434\u0435\u0444\u0438\u0446\u0438\u0442 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D \u0442\u0430\u043a\u0436\u0435 \u0430\u0441\u0441\u043e\u0446\u0438\u0438\u0440\u043e\u0432\u0430\u043d \u0441 \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u044b\u043c\u0438 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f\u043c\u0438, \u0440\u0430\u043a\u043e\u043c \u043f\u0440\u043e\u0441\u0442\u0430\u0442\u044b, \u0440\u0430\u043a\u043e\u043c \u043c\u043e\u043b\u043e\u0447\u043d\u044b\u0445 \u0436\u0435\u043b\u0435\u0437, \u0440\u0430\u043a\u043e\u043c \u0442\u043e\u043b\u0441\u0442\u043e\u0439 \u043a\u0438\u0448\u043a\u0438, \u0433\u0438\u043f\u0435\u0440\u0442\u043e\u043d\u0438\u0435\u0439, \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f\u043c\u0438 \u0441\u0435\u0440\u0434\u0446\u0430, \u043c\u043d\u043e\u0436\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u043c \u0441\u043a\u043b\u0435\u0440\u043e\u0437\u043e\u043c, \u0441\u0430\u0445\u0430\u0440\u043d\u044b\u043c \u0434\u0438\u0430\u0431\u0435\u0442\u043e\u043c 1-\u0433\u043e \u0442\u0438\u043f\u0430. \u0420\u0438\u0441\u043a \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u044f \u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0430 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D \u0432\u044b\u0441\u043e\u043a\u0438\u0439 \u0443 \u043b\u044e\u0434\u0435\u0439 \u0441 \u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u044f\u043c\u0438 \u0432\u0441\u0430\u0441\u044b\u0432\u0430\u043d\u0438\u044f \u043f\u0438\u0442\u0430\u0442\u0435\u043b\u044c\u043d\u044b\u0445 \u0432\u0435\u0449\u0435\u0441\u0442\u0432 \u0432 \u043a\u0438\u0448\u0435\u0447\u043d\u0438\u043a\u0435 (\u043d\u0430\u043f\u0440\u0438\u043c\u0435\u0440, \u043f\u0440\u0438 \u0431\u043e\u043b\u0435\u0437\u043d\u0438 \u041a\u0440\u043e\u043d\u0430, \u0432\u043d\u0435\u0448\u043d\u0435\u0441\u0435\u043a\u0440\u0435\u0442\u043e\u0447\u043d\u043e\u0439 \u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u0438 \u043f\u043e\u0434\u0436\u0435\u043b\u0443\u0434\u043e\u0447\u043d\u043e\u0439 \u0436\u0435\u043b\u0435\u0437\u044b, \u043c\u0443\u043a\u043e\u0432\u0438\u0441\u0446\u0438\u0434\u043e\u0437\u0435, \u0446\u0435\u043b\u0438\u0430\u043a\u0438\u0438, \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u0439 \u043f\u043e\u0441\u043b\u0435 \u0440\u0435\u0437\u0435\u043a\u0446\u0438\u0438 \u0436\u0435\u043b\u0443\u0434\u043a\u0430 \u0438 \u043a\u0438\u0448\u0435\u0447\u043d\u0438\u043a\u0430), \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f\u043c\u0438 \u043f\u0435\u0447\u0435\u043d\u0438, \u043d\u0435\u0444\u0440\u043e\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u043c \u0441\u0438\u043d\u0434\u0440\u043e\u043c\u043e\u043c. \u041f\u043e\u0436\u0438\u043b\u044b\u0435 \u043b\u044e\u0434\u0438, \u0436\u0438\u0442\u0435\u043b\u0438 \u0441\u0435\u0432\u0435\u0440\u043d\u044b\u0445 \u0448\u0438\u0440\u043e\u0442 \u0438 \u043b\u044e\u0434\u0438, \u0438\u0437\u0431\u0435\u0433\u0430\u044e\u0449\u0438\u0435 \u0441\u043e\u043b\u043d\u0435\u0447\u043d\u043e\u0433\u043e \u0441\u0432\u0435\u0442\u0430, \u0442\u0430\u043a\u0436\u0435 \u0441\u0442\u0440\u0430\u0434\u0430\u044e\u0442 \u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043a\u043e\u043c \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D. \u041f\u043e\u044d\u0442\u043e\u043c\u0443 \u043d\u0435\u0440\u0435\u0434\u043a\u043e \u0434\u0435\u0442\u044f\u043c \u0438 \u0432\u0437\u0440\u043e\u0441\u043b\u044b\u043c \u0441 \u0440\u0438\u0441\u043a\u043e\u043c \u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0430 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D \u043d\u0430\u0437\u043d\u0430\u0447\u0430\u044e\u0442 \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442\u044b \u0441 \u044d\u0440\u0433\u043e- \u0438\u043b\u0438 \u0445\u043e\u043b\u0435\u043a\u0430\u043b\u044c\u0446\u0438\u0444\u0435\u0440\u043e\u043b\u043e\u043c.<\/p>\n<p>\u041e\u0434\u043d\u0430\u043a\u043e \u0447\u0440\u0435\u0437\u043c\u0435\u0440\u043d\u043e\u0435 \u0443\u043f\u043e\u0442\u0440\u0435\u0431\u043b\u0435\u043d\u0438\u0435 \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442\u043e\u0432 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D \u0438\u043c\u0435\u0435\u0442 \u043d\u0435\u0433\u0430\u0442\u0438\u0432\u043d\u044b\u0435 \u043f\u043e\u0441\u043b\u0435\u0434\u0441\u0442\u0432\u0438\u044f. \u0415\u0433\u043e \u0438\u0437\u0431\u044b\u0442\u043e\u043a \u0442\u043e\u043a\u0441\u0438\u0447\u0435\u043d, \u043c\u043e\u0436\u0435\u0442 \u0432\u044b\u0437\u0432\u0430\u0442\u044c \u0442\u043e\u0448\u043d\u043e\u0442\u0443, \u0440\u0432\u043e\u0442\u0443, \u0437\u0430\u0434\u0435\u0440\u0436\u043a\u0443 \u0440\u043e\u0441\u0442\u0430 \u0438 \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u044f, \u043f\u043e\u0432\u0440\u0435\u0436\u0434\u0435\u043d\u0438\u0435 \u043f\u043e\u0447\u0435\u043a, \u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u0435 \u043e\u0431\u043c\u0435\u043d\u0430 \u043a\u0430\u043b\u044c\u0446\u0438\u044f \u0438 \u0440\u0430\u0431\u043e\u0442\u044b \u0438\u043c\u043c\u0443\u043d\u043d\u043e\u0439 \u0441\u0438\u0441\u0442\u0435\u043c\u044b. \u0412 \u0441\u0432\u044f\u0437\u0438 \u0441 \u044d\u0442\u0438\u043c \u0432\u0430\u0436\u0435\u043d \u043a\u043e\u043d\u0442\u0440\u043e\u043b\u044c \u0443\u0440\u043e\u0432\u043d\u044f \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D \u0432 \u043a\u0440\u043e\u0432\u0438, \u0441\u0432\u043e\u0435\u0432\u0440\u0435\u043c\u0435\u043d\u043d\u0430\u044f \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0430 \u0435\u0433\u043e \u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0430 \u0438\u043b\u0438 \u043f\u0435\u0440\u0435\u0438\u0437\u0431\u044b\u0442\u043a\u0430.<\/p>\n<p><strong>\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<p>\u0414\u043b\u044f \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0438 \u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0430 \u0438\u043b\u0438 \u0438\u0437\u0431\u044b\u0442\u043a\u0430 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D.<br \/>\n\u0414\u043b\u044f \u0432\u044b\u044f\u0432\u043b\u0435\u043d\u0438\u044f \u043f\u0440\u0438\u0447\u0438\u043d \u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u044f \u043e\u0431\u043c\u0435\u043d\u0430 \u043a\u0430\u043b\u044c\u0446\u0438\u044f, \u043f\u0430\u0442\u043e\u043b\u043e\u0433\u0438\u0438 \u043a\u043e\u0441\u0442\u043d\u043e\u0439 \u0442\u043a\u0430\u043d\u0438.<br \/>\n\u0414\u043b\u044f \u043a\u043e\u043d\u0442\u0440\u043e\u043b\u044f \u0437\u0430 \u044d\u0444\u0444\u0435\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u044c\u044e \u043b\u0435\u0447\u0435\u043d\u0438\u044f \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442\u0430\u043c\u0438 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D \u0438 \u043a\u043e\u0440\u0440\u0435\u043a\u0446\u0438\u0438 \u0434\u043e\u0437\u044b.<\/p>\n<p><strong>\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<p>\u041f\u0440\u0438 \u0441\u0438\u043c\u043f\u0442\u043e\u043c\u0430\u0445 \u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0430 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D, \u0442\u0430\u043a\u0438\u0445 \u043a\u0430\u043a \u0438\u0441\u043a\u0440\u0438\u0432\u043b\u0435\u043d\u0438\u0435 \u043a\u043e\u0441\u0442\u0435\u0439 \u0443 \u0434\u0435\u0442\u0435\u0439 (\u0440\u0430\u0445\u0438\u0442) \u0438 \u0441\u043b\u0430\u0431\u043e\u0441\u0442\u044c, \u0440\u0430\u0437\u043c\u044f\u0433\u0447\u0435\u043d\u0438\u0435 \u0438 \u043b\u043e\u043c\u043a\u043e\u0441\u0442\u044c \u043a\u043e\u0441\u0442\u0435\u0439 \u0443 \u0432\u0437\u0440\u043e\u0441\u043b\u044b\u0445 (\u043e\u0441\u0442\u0435\u043e\u043c\u0430\u043b\u044f\u0446\u0438\u044f).<br \/>\n\u041f\u0440\u0438 \u043a\u043e\u043c\u043f\u043b\u0435\u043a\u0441\u043d\u043e\u0439 \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0435 \u043a\u0430\u043b\u044c\u0446\u0438\u0435\u0432\u043e\u0433\u043e \u043e\u0431\u043c\u0435\u043d\u0430.<br \/>\n\u041f\u0440\u0438 \u043d\u0438\u0437\u043a\u043e\u043c \u0443\u0440\u043e\u0432\u043d\u0435 \u043a\u0430\u043b\u044c\u0446\u0438\u044f \u0432 \u043a\u0440\u043e\u0432\u0438 \u0438 \u0438\u0437\u043c\u0435\u043d\u0435\u043d\u0438\u0438 \u0443\u0440\u043e\u0432\u043d\u044f \u043f\u0430\u0440\u0430\u0442\u0433\u043e\u0440\u043c\u043e\u043d\u0430.<br \/>\n\u041f\u0435\u0440\u0435\u0434 \u043d\u0430\u0447\u0430\u043b\u043e\u043c \u043b\u0435\u0447\u0435\u043d\u0438\u044f \u043e\u0441\u0442\u0435\u043e\u043f\u043e\u0440\u043e\u0437\u0430 (\u043d\u0435\u043a\u043e\u0442\u043e\u0440\u044b\u0435 \u0441\u043e\u0432\u0440\u0435\u043c\u0435\u043d\u043d\u044b\u0435 \u043b\u0435\u043a\u0430\u0440\u0441\u0442\u0432\u0430 \u043e\u0442 \u043e\u0441\u0442\u0435\u043e\u043f\u043e\u0440\u043e\u0437\u0430 \u0441\u043e\u0434\u0435\u0440\u0436\u0430\u0442 \u0440\u0435\u043a\u043e\u043c\u0435\u043d\u0434\u043e\u0432\u0430\u043d\u043d\u0443\u044e \u0434\u043e\u0437\u0443 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D).<br \/>\n\u041f\u0440\u0438 \u0441\u0438\u043d\u0434\u0440\u043e\u043c\u0435 \u043c\u0430\u043b\u044c\u0430\u0431\u0441\u043e\u0440\u0431\u0446\u0438\u0438 (\u043d\u0430 \u0444\u043e\u043d\u0435 \u043c\u0443\u043a\u043e\u0432\u0438\u0441\u0446\u0438\u0434\u043e\u0437\u0430, \u0431\u043e\u043b\u0435\u0437\u043d\u0438 \u041a\u0440\u043e\u043d\u0430, \u0446\u0435\u043b\u0438\u0430\u043a\u0438\u0438).<br \/>\n\u0412\u043e \u0432\u0440\u0435\u043c\u044f \u043b\u0435\u0447\u0435\u043d\u0438\u044f \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442\u0430\u043c\u0438, \u0441\u043e\u0434\u0435\u0440\u0436\u0430\u0449\u0438\u043c\u0438 \u0432\u0438\u0442\u0430\u043c\u0438\u043d D.<\/p>\n<p><strong>\u0427\u0442\u043e \u043e\u0437\u043d\u0430\u0447\u0430\u044e\u0442 \u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u044b?<\/strong><\/p>\n<p>\u0420\u0435\u0444\u0435\u0440\u0435\u043d\u0441\u043d\u044b\u0435 \u0437\u043d\u0430\u0447\u0435\u043d\u0438\u044f:* 30 \u2013 100 \u043d\u0433\/\u043c\u043b.<\/p>\n<p>* \u0420\u0435\u0444\u0435\u0440\u0435\u043d\u0441\u043d\u044b\u0435 \u0437\u043d\u0430\u0447\u0435\u043d\u0438\u044f \u0440\u0430\u0437\u043b\u0438\u0447\u0430\u044e\u0442\u0441\u044f \u0434\u043b\u044f \u043d\u0435\u043a\u043e\u0442\u043e\u0440\u044b\u0445 \u0440\u0435\u0433\u0438\u043e\u043d\u043e\u0432 \u0438\u0437-\u0437\u0430 \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u043e\u0432\u0430\u043d\u0438\u044f \u0440\u0430\u0437\u043b\u0438\u0447\u043d\u044b\u0445 \u0442\u0435\u0441\u0442-\u0441\u0438\u0441\u0442\u0435\u043c \u0434\u043b\u044f \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f.<\/p>\n<p>\u041f\u0440\u0438\u0447\u0438\u043d\u044b \u043f\u043e\u043d\u0438\u0436\u0435\u043d\u043d\u043e\u0433\u043e \u0443\u0440\u043e\u0432\u043d\u044f 25-\u0433\u0438\u0434\u0440\u043e\u043a\u0441\u0438\u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D:<\/p>\n<p>\u043d\u0435\u0445\u0432\u0430\u0442\u043a\u0430 \u0441\u043e\u043b\u043d\u0435\u0447\u043d\u043e\u0433\u043e \u0441\u0432\u0435\u0442\u0430;<br \/>\n\u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0435 \u043f\u043e\u0442\u0440\u0435\u0431\u043b\u0435\u043d\u0438\u0435 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D \u0441 \u043f\u0438\u0449\u0435\u0439;<br \/>\n\u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u0435 \u0432\u0441\u0430\u0441\u044b\u0432\u0430\u043d\u0438\u044f \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D \u0438\u0437 \u043a\u0438\u0448\u0435\u0447\u043d\u0438\u043a\u0430 \u043f\u0440\u0438 \u0441\u0438\u043d\u0434\u0440\u043e\u043c\u0435 \u043c\u0430\u043b\u044c\u0430\u0431\u0441\u043e\u0440\u0431\u0446\u0438\u0438;<br \/>\n\u043d\u0435\u0444\u0440\u043e\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0439 \u0441\u0438\u043d\u0434\u0440\u043e\u043c (\u0432 \u0441\u0432\u044f\u0437\u0438 \u0441 \u043f\u043e\u0432\u044b\u0448\u0435\u043d\u043d\u043e\u0439 \u043f\u043e\u0442\u0435\u0440\u0435\u0439 \u0436\u0438\u0434\u043a\u043e\u0441\u0442\u0438 \u0438 \u0431\u0435\u043b\u043a\u0430);<br \/>\n\u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f \u043f\u0435\u0447\u0435\u043d\u0438 (\u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u0435 \u043e\u0434\u043d\u043e\u0433\u043e \u0438\u0437 \u044d\u0442\u0430\u043f\u043e\u0432 \u043c\u0435\u0442\u0430\u0431\u043e\u043b\u0438\u0437\u043c\u0430 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D);<br \/>\n\u043f\u0440\u0438\u0435\u043c \u043d\u0435\u043a\u043e\u0442\u043e\u0440\u044b\u0445 \u043b\u0435\u043a\u0430\u0440\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u0445 \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442\u043e\u0432 (\u043d\u0430\u043f\u0440\u0438\u043c\u0435\u0440, \u0444\u0435\u043d\u0438\u0442\u043e\u0438\u043d\u0430, \u043a\u043e\u0442\u043e\u0440\u044b\u0439 \u0432\u043b\u0438\u044f\u0435\u0442 \u043d\u0430 \u0441\u043f\u043e\u0441\u043e\u0431\u043d\u043e\u0441\u0442\u044c \u043f\u0435\u0447\u0435\u043d\u0438 \u043f\u0440\u043e\u0438\u0437\u0432\u043e\u0434\u0438\u0442\u044c 25-\u0433\u0438\u0434\u0440\u043e\u043a\u0441\u0438\u0432\u0438\u0442\u0430\u043c\u0438\u043d D).<\/p>\n<p>\u041f\u043e\u0432\u044b\u0448\u0435\u043d\u043d\u044b\u0439 \u0443\u0440\u043e\u0432\u0435\u043d\u044c 25-\u0433\u0438\u0434\u0440\u043e\u043a\u0441\u0438\u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D:<\/p>\n<p>\u0447\u0440\u0435\u0437\u043c\u0435\u0440\u043d\u043e\u0435 \u0443\u043f\u043e\u0442\u0440\u0435\u0431\u043b\u0435\u043d\u0438\u0435 \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442\u043e\u0432, \u0441\u043e\u0434\u0435\u0440\u0436\u0430\u0449\u0438\u0445 \u0432\u0438\u0442\u0430\u043c\u0438\u043d D.<\/p>\n<p>\u0427\u0442\u043e \u043c\u043e\u0436\u0435\u0442 \u0432\u043b\u0438\u044f\u0442\u044c \u043d\u0430 \u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442?<\/p>\n<p>\u041b\u0435\u043a\u0430\u0440\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u0435 \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442\u044b, \u0441\u043d\u0438\u0436\u0430\u044e\u0449\u0438\u0435 \u0443\u0440\u043e\u0432\u0435\u043d\u044c 25-\u0433\u0438\u0434\u0440\u043e\u043a\u0441\u0438\u043a\u0430\u043b\u044c\u0446\u0438\u0444\u0435\u0440\u043e\u043b\u0430 \u0432 \u043a\u0440\u043e\u0432\u0438: \u0444\u0435\u043d\u0438\u0442\u043e\u0438\u043d, \u0444\u0435\u043d\u043e\u0431\u0430\u0440\u0431\u0438\u0442\u0430\u043b, \u0440\u0438\u0444\u0430\u043c\u043f\u0438\u0446\u0438\u043d, \u043f\u0435\u0440\u043e\u0440\u0430\u043b\u044c\u043d\u044b\u0435 \u0430\u043d\u0442\u0438\u043a\u043e\u0430\u0433\u0443\u043b\u044f\u043d\u0442\u044b.<br \/>\n\u0411\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u044c.<\/p>\n<p>\u0412\u0430\u0436\u043d\u044b\u0435 \u0437\u0430\u043c\u0435\u0447\u0430\u043d\u0438\u044f<\/p>\n<p>\u0412\u044b\u0441\u043e\u043a\u0438\u0435 \u043a\u043e\u043d\u0446\u0435\u043d\u0442\u0440\u0430\u0446\u0438\u0438 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D \u0438 \u043a\u0430\u043b\u044c\u0446\u0438\u044f \u043c\u043e\u0433\u0443\u0442 \u043f\u0440\u0438\u0432\u0435\u0441\u0442\u0438 \u043a \u043a\u0430\u043b\u044c\u0446\u0438\u043d\u043e\u0437\u0443 \u0438 \u043f\u043e\u0432\u0440\u0435\u0436\u0434\u0435\u043d\u0438\u044e \u043e\u0440\u0433\u0430\u043d\u043e\u0432, \u043e\u0441\u043e\u0431\u0435\u043d\u043d\u043e \u043f\u043e\u0447\u0435\u043a \u0438 \u043a\u0440\u043e\u0432\u0435\u043d\u043e\u0441\u043d\u044b\u0445 \u0441\u043e\u0441\u0443\u0434\u043e\u0432.<br \/>\n\u0423\u0440\u043e\u0432\u043d\u0438 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D, \u043a\u0430\u043b\u044c\u0446\u0438\u044f, \u0444\u043e\u0441\u0444\u043e\u0440\u0430 \u0438 \u043f\u0430\u0440\u0430\u0442\u0438\u0440\u0435\u043e\u0438\u0434\u043d\u043e\u0433\u043e \u0433\u043e\u0440\u043c\u043e\u043d\u0430 \u0442\u0435\u0441\u043d\u043e \u0441\u0432\u044f\u0437\u0430\u043d\u044b. \u0422\u0430\u043a, \u043f\u0440\u0438 \u0438\u0437\u0431\u044b\u0442\u043a\u0435 \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D \u0438 \u043a\u0430\u043b\u044c\u0446\u0438\u044f \u0441\u043d\u0438\u0436\u0430\u0435\u0442\u0441\u044f \u0441\u0438\u043d\u0442\u0435\u0437 \u043f\u0430\u0440\u0430\u0442\u0433\u043e\u0440\u043c\u043e\u043d\u0430.<br \/>\n\u0412\u043e \u0432\u0440\u0435\u043c\u044f \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u043c\u0435\u0442\u0430\u0431\u043e\u043b\u0438\u0437\u043c \u0432\u0438\u0442\u0430\u043c\u0438\u043d\u0430 D \u043a\u043e\u043d\u0442\u0440\u043e\u043b\u0438\u0440\u0443\u0435\u0442\u0441\u044f \u043f\u0440\u043e\u043b\u0430\u043a\u0442\u0438\u043d\u043e\u043c \u0438 \u0441\u043e\u043c\u0430\u0442\u043e\u0442\u0440\u043e\u043f\u043d\u044b\u043c \u0433\u043e\u0440\u043c\u043e\u043d\u043e\u043c.<\/p>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[927],"product_tag":[],"class_list":{"0":"post-9979","1":"product","2":"type-product","3":"status-publish","5":"product_cat-markeri-ososi","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\/9979","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=9979"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=9979"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=9979"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=9979"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=9979"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}