Діагностика ранніх стадій діабетичної нефропатії у дітей та підлітків, хворих на цукровий діабет: Автореф. дис… канд. мед. наук / О.А. Будрейко, Ін-

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?INOEOOO AIAeIE?EIIEIA?? OA IAI?IO ?A*IAEI

?i. A.I. Eii?na?aiea

AEAAeAI?? IAAeE*IEO IAOE OE?A?IE

AOAe?AEEI Ieaia Aiaoie??aia

OAeE 616.61:616.379-008.64-053.5/.6-07

Ae?AAIINOEEA ?AII?O NOAAe?E Ae?AAAOE*II?

IAO?IIAO?? O Ae?OAE OA I?AeE?OE?A, OAI?EO IA

OeOE?IAEE Ae?AAAO

14.01.14 – aiaeie?eiieia?y

AAOI?AOA?AO

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Ee?a — 1999

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia a Oe?a?inueeiio iaoeiai-aeine?aeiiio ?inoeooo? ioi?iie
caei?ia’y ae?oae oa i?aee?oe?a IIC Oe?a?ie, i. Oa?e?a.

Iaoeiaee ea??aiee – aeieoi? iaaee/ieo iaoe, i?ioani?

Nooe?e Ea?ena sseei?aia,
Oe?a?inueeee iaoeiai-

aeine?aeiee ?inoeooo ioi?iie
caei?ia’y ae?oae oa

i?aee?oe?a, aieiaiee iaoeiaee
ni?a?ia?oiee

a?aeae?eo aiaeie?eiieia??,
i.Oa?e?a.

Io?oe?ei? iiiiaioe:

aeieoi? iaaee/ieo iaoe, i?ioani?, aeaaeai?e ?o?iia Aiae??e Naiaiiae/,
?inoeooo aiaeie?eiieia?? oa iai?io ?a/iaei ?i. A.I. Eii?na?aiea,
caa?aeoaa/ a?aeae?eo ae?aaaoieia??, i. Ee?a

aeieoi? iaaee/ieo iaoe, i?ioani? Aiaeia? Iao?i Ieeieaeiae/,
Iaoe?iiaeueiee iaaee/iee oi?aa?neoao ?i. I.I. Aiaiiieueoey, caa?aeoaa/
eaoaae?e aiaeie?eiieia??, i. Ee?a

I?ia?aeia onoaiiaa: Oe?a?inueeee IAe? oa?iaeioa?ai?? aiaeie?eiieo
caoai?thaaiue, eaai?aoi??y iaoio?c?ieia??, i. Oa?e?a

Caoeno a?aeaoaeaoueny 26 aeiaoiy 1999 ?. i 13-30 aiaeei?

ia can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 26.558.01 c
aiaeie?eiieia?? a ?inoeooo? aiaeie?eiieia?? oa iai?io ?a/iaei ?i. A.I.
Eii?na?aiea AII Oe?a?ie (254114, i. Ee?a, aoe Aeoai?iaenueea, 69)

C aeena?oaoe??th iiaeia iciaeiieoeny o a?ae?ioaoe? ?inoeoooo
aiaeie?eiieia?? oa iai?io ?a/iaei ?i. A.I. Eii?na?aiea AII Oe?a?ie
(254114, i. Ee?a, aoe. Aeoai?iaenueea, 69).

Aaoi?aoa?ao ?ic?neaiee “ 24 ” aa?aniy 1999 ?.

A/aiee nae?aoa?

niaoe?ae?ciaaii? A/aii? ?aaee,

aeieoi? a?ieia?/ieo iaoe
E. I. Eaeeinueea

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue i?iaeaie. Oyaee?noue ia?aa?ao thaai?eueiiai oeoe?iaiai
ae?aaaoo, iaoiiaeaia ia o?eueee cia/iith aaniethoiith ?inoe?iiaith
iaaeinoaoi?noth, aea e eaa?euei?noth iaoaaie?/ieo iieaciee?a,
iniaeeainoyie ai?iiiaeueieo c?ooaiue o c?inoath/iio i?aai?ci?, aecia/a?
ia?nenoaioe?th iani?eyoeeaeo oaeoi??a (a?ia?ae?eai?y, a?ia?e?i?aeai?y,
i?aeaeuaiee ??aaiue oee?eoethth/eo ?ioiieo eiiieaen?a, niiaoio?iiiiai
ai?iiio oa ?i.), aieea yeeo ia noaeeiio no?ieo oa ia i?aaie acaaae?
iaieio/ee [A.N. ?o?iia ?c ni?aaao., 1998]. O ca’yceo c oeei aaaeeeaiai
cia/aiiy iaaoaa? ?ic?iaea nenoaie ?aiiuei? ae?aaiinoeee oa iii?oi?eiao
oneeaaeiaiue oeoe?iaiai ae?aaaoo o ae?oae oa i?aee?oe?a. Iniaeeaino?
oi?ioaaiiy ae?aaaoe/ii? iao?iiao??, ye iaeiiai c iaeoyaee?oeo
ae?aaaoe/ieo oneeaaeiaiue, o ae?oae oa i?aee?oe?a aea/ai? iaaeinoaoiuei,
oi/a caaaeuei? ieoaiiy ?? iaoiaaiaco oa ae?aaiinoeee o aei?ineeo aea/ai?
aeineoue ?aoaeueii [I.?.Aaeaaiee?i, 1994, I.A. Oanoaeiaa, 1995].

A inoaii? ?iee iaea?eueo ?ioi?iaoeaiei ?aii?i ae?aaiinoe/iei e?eoa???i
ae?aaaoe/ii? iao?iiao?? aaaaea?oueny aecia/aiiy i?e?iaeueaoi?io???
[Mogensen C.E., 1983, Parving H. H., 1989, Nianeaoeaaa A.A., 1990].
Ii?yae c oeei iaaia cia/aiiy ia? ioe?iea ?acoeueoao?a o?aaeeoe?eieo
iaoiae?a aeine?aeaeaiiy ooieoe?? ie?ie c o?aooaaiiyi i?e?iaeueaoi?io???,
a?aeiiino? i?i ??aaiue yei? o ae?oae oa i?aee?oe?a aeinoaoiuei
noia?a/eea? [R. Nomiyama, 1989, ?.I. ?eue?ia, 1992, E. Mathiesen, 1993].

A iiiaeeiieeo aeine?aeaeaiiyo, i?enay/aieo aea/aiith ooieoe?? ie?ie a
caeaaeiino? a?ae noaoaai? c??einoe, anoaiiaeaia caeaaei?noue
iao?iiaaae?? oa eeoai/eiai? a?ia?o?eueo?aoe?? a?ae o?eaaeino? ioaa?oaoo
[M.L. Lawson et al, 1994]. Ie?ai? aaoi?e iaaiai?ththoue i?eiouaiiy uiaei
aecia/aeueiiai cia/aiiy ianoaiiy ia??iaeo noaoaaiai ?icaeoeo aeey iiyae
i?e?iaeueaoi?io??? o i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao [M. Janner
et al, 1994, A.?. Neaion ?c ni?aaao.,1998].

Cia/ia ?ieue niaaeeiaeo oaeoi??a a iaoiaaiac? oeoe?iaiai ae?aaaoo
acaaae?, a oaeiae iiaeeeaa noeeuei?noue aei ?aiiueiai oi?ioaaiiy eiai
oneeaaeiaiue aeiaaathoue aeae?eaiiy a?oi oai?eo ?c i?aeaeuaiei ?eceeii
?o ?icaeoeo. A?aeiiino? i?i ca’ycie iaaieo aioeaai?a nenoaie HLA (human
leucocyte antigen) c oeoe?iaei ae?aaaoii oa c o?ii?/iith ie?eiaith
iaoieia??th [?.A. Aaoaiaa, 1990, A.I. Ae?aiiee, 1990, A.A. Iaiayi ?c
ni?aaao., 1991], ?ieue ?ioiieia?/ieo ii?ooaiue ye a iaoiaaiac?
oeoe?iaiai ae?aaaoo oa eiai oneeaaeiaiue, oae ? o?ii?/ieo caoai?thaaiue
ie?ie [I.O. Ea?iia ?c ni?aaao., 1986, I.I. Ceia?ia ?c ni?aaao., 1993,
I.?. Eaia?aa ?c ni?aaao., 1996], aeyaeai? iniaeeaino? no?oeoo?e ie?eiai?
oeaieie (e?euee?noue eeoai/e?a, a?aceea?noue no?iie eaiaeueoe?a aei
ai?iiiaeueiiai oa a?io?i?/iiai aieeao) aeicaieythoue i?eionoeoe
?nioaaiiy niaaeeiai? noeeueiino? aei o?aaeaiiy ie?ie o iaaieo a?oi
oai?eo ia oeoe?iaee ae?aaao [E.R. Seaquist, 1989, M. Marre, 1993], ye?
a?ae??ciythoueny ye ca aeanoeainoyie ie?eiaeo no?oeoo?, oae ? ca
oa?aeoa?ii ?ioiieia?/ii? ?aaeoeaiino? i?aai?cio acaaae?.

Iaaeinoaoi?noue a?aeiiinoae i?i iniaeeaino? oi?ioaaiiy oa /anoioo
ae?aaaoe/ii? iao?iiao?? o ae?oae oa i?aee?oe?a c o?aooaaiiyi
?acoeueoao?a no/anieo iaoiae?a ?? ?aiiuei? ae?aaiinoeee, iaiao?aei?noue
?icoe?aiiy oyaeaiue i?i ?ieue ?ioiieia?/ieo ? aaiaoe/ieo oaeoi??a a
o?aaeaii? ie?ie o oai?eo ia oeoe?iaee ae?aaao o aeeoy/iio oa
i?aee?oeiaiio a?oe? noaee i?aenoaaith aeey i?iaaaeaiey oeueiai
aeine?aeaeaiiy.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Aeine?aeaeaiiy
i?iaiaeeeinue a iaaeao iaoeiai-aeine?aeieoeueeeo ?ia?o “No/ani? aniaeoe
?aaa?e?oaoe?? ae?oae oa i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao, oa ?o
nioe?aeueia aaeaioaoe?y” (aeeiioaaeanue o 1994-1997 ?ieao) oa “I?iaiic
oi?ioaaiiy oneeaaeiaiue oeoe?iaiai ae?aaaoo o ae?oae ? i?aee?oe?a, oa ?o
i?io?eaeoeea”, yea aeeiio?oueny o a?aeae?e? aiaeie?eiieia??
Oe?a?inueeiai IAe? ioi?iie caei?ia’y ae?oae oa i?aee?oe?a c 1998 ?ieo.

Iaoa aeine?aeaeaiiy — oaeineiiaeaiiy ?aiiuei? ae?aaiinoeee ae?aaaoe/ii?
iao?iiao?? oa aecia/aiiy oaeoi??a ?eceeo ?icaeoeo oeueiai oneeaaeiaiiy o
ae?oae oa i?aee?oe?a.

Iniiai? caaaeaiiy aeine?aeaeaiiy:

1. Aea/eoe ?aii? iciaee o?aaeaiiy ie?ie o ae?oae oa i?aee?oe?a, oai?eo
ia oeoe?iaee ae?aaao, a caeaaeiino? a?ae /ano iai?oanoaoe??, o?eaaeino?,
nooiaiy eiiiainaoe?? caoai?thaaiiy, iayaiino? i?e?ioee?eoeyoi?ieo
ii?ooaiue, a oaeiae a?eo oa noao? oai?eo.

2. Aeaoe ?ioiieia?/io oa ?ioiiaaiaoe/io oa?aeoa?enoeeo oai?eo c ?aii?ie
iciaeaie ae?aaaoe/ii? iao?iiao??.

3. Aecia/eoe oaeoi?e ?eceeo ?icaeoeo ae?aaaoe/ii? iao?iiao?? o ae?oae oa
i?aee?oe?a.

4. ?ic?iaeoe aeai?eoi ae?aaiinoeee ae?aaaoe/ii? iao?iiao??, iaa?oiooaaoe
i?aeoiaee aei niinoa?aaeaiiy ca ae?oueie oa i?aee?oeaie c ?aii?ie
iciaeaie ae?aaaoe/ii? iao?iiao??.

Iaoeiaa iiaecia. O ae?oae oa i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao,
anoaiiaeaia aeniea /anoioa eaoaioieo ii?ooaiue ooieoe?? ie?ie, ui
ae?aaiinooaaeenue ye aeiee?i?/ia noaae?y ae?aaaoe/ii? iao?iiao??. Aia?oa
iieacai? ee?i?/i? iniaeeaino? ae?aaaoe/iiai o?aaeaiiy ie?ie o aeeoy/iio
oa i?aee?oeiaiio a?oe?:

— noeeuei?noue aei cieaeaiiy o?eueo?aoe?eii? ooieoe?? ie?ie o oai?eo
oe??? a?eiai? a?oie, ui noi?iaiaeaeo?oueny c?inoaiiyi aaee/eie oa
/anoioe i?e?iaeueaoi?io???;

— caeaaei?noue aeiaiaiai ?eoio i?e?iaeueaoi?io??? o ae?oae oa i?aee?oe?a
a?ae o?eaaeino? oa nooiaiy eiiiainaoe?? oeoe?iaiai ae?aaaoo;

— aieea iia??oaiiy eiiiainaoe?? aoaeaaiaeiiai iai?io ia cieaeaiiy ii?iao
i?e?ioee?eoeyoi?ieo ii?ooaiue, aeinoaoiueiai aeey iiyae
i?e?iaeueaoi?io???;

— ca’ycie ?icaeoeo ae?aaaoe/iiai o?aaeaiiy ie?ie o aeeoy/iio oa
i?aee?oeiaiio a?oe? c iai?oanoaoe??th oeoe?iaiai ae?aaaoo a iaai? a?eia?
ia??iaee (8-10 oa 11-13 ?ie?a), ye? ni?aiaaeathoue c /anii oi?ioaaiiy
?aiaeueieo ooieoe?e oa ii/aoeii ai?iiiaeueieo c?ooaiue ioaa?oaoiiai
ia??iaeo;

— ca’ycie oa?aeoa?o i?iya?a iciae ae?aaaoe/ii? iao?iiao?? c ia??iaeii
noaoaaiai ?icaeoeo oa caeaaei?noue ?o a?ae noao? oai?eo oa o?eaaeino?
oeoe?iaiai ae?aaaoo a?aeiinii ii/aoeo ioaa?oaoo: ia oe? o?eaaeino?
caoai?thaaiiy a?eueoa 5 ?ie?a neiioiie o?aaeaiiy ie?ie c’yaeyeenue eeoa
c ii/aoeii ioaa?oaoiiai ia??iaeo (i?aeaeuaiiy /anoioe
i?e?iaeueaoi?io???, iniaeeai o ae?a/ao, oa cieaeaiiy aaee/eie
eeoai/eiai? o?eueo?aoe?? iacaeaaeii a?ae noao?); o oai?eo c iaeith
o?eaae?noth oai?iae (iaioa 3 ?ie?a) oa?aeoa?enoeea iciae ae?aaaoe/ii?
iao?iiao?? a?ae??ciyeanue a caeaaeiino? a?ae noao? oa noaae??
ioaa?oaoiiai ia??iaeo ? aoea iniaeeai iani?eyoeeaith o ae?a/ao
(i?aeaeuaiiy /anoioe i?e?iaeueaoi?io??? o ?aiiueiio ioaa?oaoiiio a?oe?
oa cia/ia cieaeaiiy eeoai/eiai? o?eueo?aoe??? o i?ci?e ioaa?oaoiee
ia??iae);

— ca’ycie i?e?iaeueaoi?io??? ?c cieaeaiiyi e?eueeino? aeoeaieo
e?ioioeeo?a oa i?aeaeuaiiyi ??aith ee?oeiii? nainea?e?caoe??? (ca
?acoeueoaoaie niiioaiii? ?aaeoe?? aeanoo?ainoi?iaoe?? e?ioioeeo?a);

— iayai?noue iaaieo ?ioiiaaiaoe/ieo ia?ea??a ?aiiuei? iiyae
i?e?iaeueaoi?io??? (aioeaaie HLA-DR5, DR7, DR2, DR52 oa aaieioeie
DR5DR7 ? DR2DR5).

I?aeoe/ia cia/aiiy ?iaioe. Cai?iiiiiaai? iia? i?aeoiaee aei
niinoa?aaeaiiy ca ae?oueie oa i?aee?oeaie, oai?eie ia oeoe?iaee ae?aaao,
ye? ia?aaeaa/athoue:

— ?aaoey?iee eiio?ieue ia o?eueee noaio eiiiainaoe?? aoaeaaiaeiiai
iai?io, aea ? ooieoe?? ie?ie c iaia’yceiaei aecia/aiiyi
i?e?iaeueaoi?io??? oa eeoai/eiai? o?eueo?aoe??, a oiio /ene? ?o
aeiaiaiai ?eoio;

— iaia’yceiao ae?aaiinoeeo noaio i?e?ioee?eoeyoe??, cia/i? ii?ooaiiy
yei? ? oaeoi?ii ?eceeo oi?ioaaiiy ae?aaaoe/ii? iao?iiao?? o oai?eo
aeeoy/iai oa i?aee?oeiaiai a?eo, iaa?oue ca oiia caaeia?eueii?
eiiiainaoe?? aoaeaaiaeiiai iai?io ia iiiaio ianoaaeaiiy;

— aeeth/aiiy, ii iiaeeeaino?, a eiiieaen aeine?aeaeaiiy ae?oae oa
i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao, iaoiae?a aecia/aiiy oaiioeio
HLA oa ee?oeiiiai ?ioieoaoo;

— aeae?eaiiy a?oi iaoe??io?a c i?aeaeuaiei ?eceeii ?aiiueiai oi?ioaaiiy
o?aaeaiiy ie?ie c o?aooaaiiyi anoaiiaeaieo iani?eyoeeaeo oaeoi??a.

?ic?iaeaiee aeai?eoi ae?aaiinoeee ae?aaaoe/ii? iao?iiao??, aeei?enoaiiy
yeiai, iniaeeai o oai?eo c aeae?eaieo a?oi ?eceeo, aeicaiey?
oaeineiiaeeoe ae?aaiinoeeo oeueiai oyaeeiai oneeaaeiaiiy ia ?aii?o
noaae?yo, ui ia? cia/aiiy aeey i?aeoe/ii? ?iaioe ae?aaaoieia?a.

Aeaeea?aoe?y eiie?aoiiai iniaenoiai aianeo caeiaoaa/a. Aaoi?
aeena?oaoe?? naiino?eii cae?enithaaa ianoaaeaiiy, ee?i?ei-aaiaaeia?/ia
aeine?aeaeaiiy oa niinoa?aaeaiiy ae?oae oa i?aee?oe?a, oai?eo ia
oeoe?iaee ae?aaao, oaeineiiaeea iaoiaeeeo aeine?aeaeaiiy aeiaiaiai ?eoio
eeoai/eiai? o?eueo?aoe?? oa i?e?iaeueaoi?io??? o o?e /ania? ?ioa?aaee
(?aoe?iiae?caoi?nueea i?iiiceoe?y ? 10 a?ae 12.12.96.), a oaeiae noai?ea
aeai?eoi ae?aaiinoeee ae?aaaoe/ii? iao?iiao??. Aaoi?ii naiino?eii
i?iaaaeaia noaoenoe/ia ia?iaea iaea?aeaieo ?acoeueoao?a, ?o aiae?c oa
iaaiai?aiiy. ?acoeueoaoe ?ioiiaaiaoe/iiai aeine?aeaeaiiy oai?eo noaee
i?aenoaaith aeey ioi?ieaiiy aaoi?ii cayaee ia aeiao?ae “Niin?a
i?iaiicoaaiiy ae?aaaoe/ii? iao?iiao?? o ae?oae oa i?aee?oe?a, oai?eo ia
oeoe?iaee ae?aaao”. ?iaioo aeeiiaii ia aac? a?aeae?eaiiy
aiaeie?eiieia??, eaai?aoi??e iaaee/ii? aaiaoeee, ?ioiieia??, a?io?i??,
?aae?i?cioiiii? ae?aaiinoeee Oe?a?inueeiai ?inoeoooo ioi?iie caei?ia’y
ae?oae oa i?aee?oe?a, a oaeiae Aeeoy/iai oeaio?o ee?i?/ii? ?ioiieia??
i.Oa?eiaa.

Ai?iaaoe?y ?iaioe. ?acoeueoaoe aeine?aeaeaiiy aeiiia?aeaeenue ia
I?aeia?iaei?e iaoeiai-i?aeoe/i?e eiioa?aioe?? ii aeeoy/iio ae?aaaoo
(Ioua-Aiaeeoey, Ee?a, 1995), I?aeia?iaeieo Aeiyo Ae?aaaoo
(Aei?i?iiao?ianuee,1997), iaoeiai-i?aeoe/i?e eiioa?aioe??, i?enay/ai?e
75-??//th canioaaiiy Oe?a?inueeiai IAe? ioi?iie caei?ia’y ae?oae oa
i?aee?oe?a (Oa?e?a,1997), eiioa?aioe?yo iieiaeeo a/aieo Oe?a?inueeiai
IAe? ioi?iie caei?ia’y ae?oae oa i?aee?oe?a (Oa?e?a,1995,1997), ia
can?aeaii? Oa?e?anueeiai iaoeiai-iaaee/iiai oiaa?enoaa (Oa?e?a,1998).

Ioae?eaoe?? ?acoeueoao?a aeine?aeaeaiiy. Ca iaoa??aeaie aeena?oaoe??
iioae?eiaaii aeaaiaaeoeyoue ?ia?o, a oiio /ene? 4 noaoo? o oeaio?aeueieo
oaoiaeo aeo?iaeao, a oaeiae ca?a?no?iaaii 2 iiaiaaaaeaiiy.

No?oeoo?a oa ianya ?iaioe. Aeena?oaoe?y aeeeaaeaia ia 154 noi??ieao
ae?oeiaaiiai oaenoo oa i?noeoue anooi, iaeyae e?oa?aoo?e, ?icae?e,
i?enay/aiee iieno iaoa??aeo oa iaoiae?a aeine?aeaeaiiy, o?e ?icae?ee
aeanieo aeine?aeaeaiue, iaaiai?aiiy, aeniiaee oa i?aeoe/i?
?aeiiaiaeaoe??, nienie e?oa?aoo?e, a yeee oa?eoee 207 aeaea?ae (126 –
a?o/eciyieo oa e?a?i NIAe ? 81 – ?iicaiieo). Aeena?oaoeey ?ethno?iaaia
20 iaethieaie oa 20 oaaeeoeyie.

CI?NO ?IAIOE

Iaoiaee aeine?aeaeaiiy. I?ae iaaeyaeii ia?aaoaaei 162 oai?eo ia
oeoe?iaee ae?aaao o a?oe? a?ae 5 aei 18 ?ie?a. A eiiieaen aeine?aeaeaiiy
aoiaeeee ye o?aaeeoe?ei? ae?aaiinoe/i? oanoe oa iaoiaee ioe?iee nooiaiy
eiiiainaoe?? aoaeaaiaeiiai iai?io, oae ? aecia/aiiy ?aii?o iciae
o?aaeaiiy ie?ie o ae?oae oa i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao.

Aea/aiiy o?eueo?aoe?eii? ooieoe?? ie?ie i?iaiaeeeinue oeyoii
iaeiie?aoiiai aecia/aiiy ee??aino aiaeiaaiiiai e?aaoei?io (aeey
e?euee?nii? ioe?iee), a oaeiae o i?ioean? aeine?aeaeaiiy aeiaiaiai ?eoio
eeoai/eiai? o?eueo?aoe?? (aeey ?? ye?nii? ioe?iee) – aecia/aiiy ??aith
e?aaoei?io o o?ueio ii?oe?yo na/?, c?a?aii? o /ania? ?ioa?aaee: 6-14
aiae. (I), 14-22 aiae. (II), 22-6 aiae. (III), a?aeiinii ??aiy
e?aaoei?io ne?iaaoee e?ia? o iaeiie?aoi?e i?ia? [A.N. ?o?iia, 1989].
Io?eiai? aaee/eie eeoai/eiai? o?eueo?aoe?? i?eaiaeeeenue aei
noaiaea?oii? iiaa?oi? o?ea (1,73i2). Aecia/aiiy i?e?iaeueaoi?io???
i?iaiaeeeinue ?ioiioa?iaioiei iaoiaeii o i?iaao na/?, c?a?aieo aii/?
(20-6 aiae.) oa i?ioyaii aeiae (caaaeueii? oa a ie?ai? /ania? ?ioa?aaee
— 6-14 aiae., 14-22 aiae., 22-6 aiae.). Aeey aeeeth/aiiy iiieeie a
?ioa?i?aoaoe?? io?eiaieo ?acoeueoao?a aeine?aeaeai? i?iae aeiaiai?
ii?oe?? na/? 20 caei?iaeo ae?oae oa i?aee?oe?a o a?oe? 6-18 ?ie?a
(2-e?aoii o eiaeiiai aeine?aeaeaiiai). 46 i?aee?oeai, oai?ei ia
oeoe?iaee ae?aaao, i?iaaaeaia ?aae?i?cioiiia ?aiia?ao?y c aeei?enoaiiyi
a?io?aio, iii?/aiiai 131I.

A i?ioean? aea/aiiy noaio i?e?ioee?eoeyoe?? nooi?iue ii?ooaiue ??
ioe?ithaaany ye?nii (I, II, III nooiaiy) oa e?euee?nii oeyoii ia/eneaiiy
caaaeueiiai eai?ey?ineii?/iiai ?iaeaena (CE?) c aeei?enoaiiyi iaoiaeo
aaeueii? ioe?iee eai?ey?ineii?/ieo ci?i [N.I.*oiae, 1997].

Aea/aiiy ee?oeiii? eaiee ?ioieoaoo i?iaiaeeeinue ia aac? eaai?aoi???
Aeeoy/iai oeaio?o ee?i?/ii? ?ioiieia?? i.Oa?eiaa oa aeeth/aei
?aeaioeo?eaoe?th A-e?ioioeeo?a a ?aaeoe?? AAN-?icaoeiooai?aiiy,
O-e?ioioeeo?a a ?aaeoe?? ?icaoeiooai?aiiy c a?eo?ioeeoaie aa?aia,
ie?aieo noaiiioeyoe?e O-e?ioioeeo?a (CD3+, CD4+, CD8+) c aeei?enoaiiyi
iiiieeiiaeueieo aioeo?e, ioe?ieo ?aaeoe?? aeanoo?ainoi?iaoe??
e?ioioeeo?a (?AOE), niiioaiii? oa ?iaeoeiaaii? o?oiaaiaaethoe-i?iii.

Ee?i?ei-aaiaaeia?/ia aeine?aeaeaiiy oai?eo aeeth/aei cae?aiiy ?iaeiaiaeo
oa iiaeaeueoee eiai aaiaaeia?/iee aiae?c. O 32 oai?eo i?iaaaeaii
aeine?aeaeaiiy aioeaai?a II eeano eiiieaeno HLA, yea cae?enithaaee o
i?ioean? aeeiiaiiy i?ieiiaiaaiiai aa??aioo i?e?ie?ioioeeoioiene/ii?
i?iae ii A-iiioeyoe?? e?ioioeeo?a c aeei?enoaiiyi ne?iaaoie oanoiaiaeae
Naieo-Iaoa?ao?cueeiai IAe? ia?aeeaaiiy e?ia? (ii eeano DR).

Noaoenoe/ia ia?iaea io?eiaieo ?acoeueoao?a cae?enithaaeanue ia IE IBM
PC c aeei?enoaiiyi iaeoie?a i?eeeaaeieo i?ia?ai “Fox-pro”,
“Statgraphics”. Aeey ioe?iee a??ia?aeiino? io?eiaieo ?acoeueoao?a
i?iaiaeeeinue ia/eneaiiy ia?aiao?e/ieo (Nouethaeaioa) oa
iaia?aiao?e/ieo (O?eeieniia-Iaiia-O?oi?) e?eoa???a, aecia/aiiy
eiao?oe??ioo ei??aeyoe?? (r) ? e?eoa??th caiaee (2).

?acoeueoaoe aeine?aeaeaiiy oa ?o iaaiai?aiiy. O a?eueoino? ianoaaeaieo
ae?oae oa i?aee?oe?a (93,2%) aeyaeaii oyaeeee ia?aa?a caoai?thaaiiy c
/anoith aeaeiiiainaoe??th aoaeaaiaeiiai iai?io, eaoiaoeeaeicii,
?icaeoeii ae?aaaoe/ieo oneeaaeiaiue.

I?ioa?io??y ca caaaeueieie aiae?caie na/? ae?aaiinoiaaia o 18,5% oai?eo,
a o. /. o 4,3% aeine?aeaeaieo oe? ci?ie iineee no?eeee oa?aeoa?.
Ee?i?/i? iciaee iao?ioe/iiai neiae?iio o aeaeyae? a?oa??aeueii?
a?ia?oaic??, eaaei? iaa?yeeino? iaee//y a?aei?/ai? o 2,5% oai?eo,
ia?aaaaeii i?aee?oeiaiai a?eo. O 7,4% oai?eo aeyaeyeanue a?ia?oaic?y
??ciiai nooiaiy, a o. /. cia/ia i?aeaeuaiiy a?oa??aeueiiai oeneo
(180-200/120-150 ii ?o. no.) — o i?aee?oe?a c iao?ioe/iei neiae?iiii.

I?ae /an aeine?aeaeaiiy i?e?iaeueaoi?io???, ye iaea?eueo ?ioi?iaoeaiiai
?aiiueiai neiioiio ae?aaaoe/ii? iao?iiao??, i?aeaeuaiee ?? ??aaiue
(a?eueoa 20 ia/e) ae?aaiinoiaaii o 34,6±3,7% ae?oae oa i?aee?oe?a,
oai?eo ia oeoe?iaee ae?aaao, i?e oeueiio iae?iaeueaoi?io??y (a?eueoa 400
ia/e) a?aei?/aeanue o 6,2±3,1%, a no?eea i?e?iaeueaoi?io??y — o 7,4±3,8%
oai?eo.

Aiae?c iieaciee?a i?e?iaeueaoi?io??? a?eueoa 20 ia/e (IAO) iieacaa
a??ia?aeia i?aeaeuaiiy ?? /anoioe oa na?aaeiuei? aaee/eie o
aeine?aeaeaieo ?c ca?eueoaiiyi o?eaaeino? caoai?thaaiiy (r=+0,447,
p<0,05), ui ii?aeioaaeinue ?c cieaeaiiyi o?eueo?aoe?eii? ooieoe?? ie?ie (oaaeeoey). Oaaeeoey Oa?aeoa?enoeea i?e?iaeueaoi?io??? oa eeoai/eiai? o?eueo?aoe?? o ae?oae oa i?aee?oe?a a caeaaeiino? a?ae o?eaaeino? oeoe?iaiai ae?aaaoo O?eaae?noue oeoe?iaiai ae?aaaoo, ?iee*anoioa IAOIAO, ia/eEO, ie/oa%±mM±mM±m<1, n=31 12,9±6,0 35,0±18,9 110,8±12,71-3, n=51 13,7±5,1 31,6±12,9 89,6±9,14-8, n=52 ** 51,9±6,9 * 93,1±19,7 * 77,8±5,5>8, n=28 **

67,9±8,9 **

135,9±31,2 **

65,2±9,1 #* — p<0,05, ** - p<0,02 - a??ia?aei?noue a?aei?iiinoae a?aeiinii iieaciee?a a?oie oai?eo c o?eaae?noth oeoe?iaiai ae?aaaoo iaioa 1 ?ieo; # - p<0,05 a??ia?aei?noue a?aei?iiinoae a?aeiinii eiio?ieueieo iieaciee?a Aea/aiiy IAO o ae?oae oa i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao, a caeaaeiino? a?ae a?eo (iae.1) iieacaei, /oi na?aae oai?eo c iaeith o?eaae?noth oeoe?iaiai aeeaaaoo c iaea?eueoith /anoioith IAO ae?aaiinoiaaii o a?eia?e a?oi? 11-13 ?ie?a (28,6±6,1% ca o?eaaeino? oai?iae iaioa 3 ?ie?a oa 75,2±9.2% ca ?? o?eaaeino? 3-5 ?ie?a ii??aiyii c /anoioith IAO na?aae oai?eo o a?oe? iaioa 11 ?ie?a – 16,7±4,1% ? 42,9±10,1% a?aeiia?aeii), a oaeiae o i?aee?oe?a 16-18 ?ie?a, ui oai??thoue ia oeoe?iaee ae?aaao a?eueoa 5 ?ie?a (67,4±6,9% ii??aiyii c oeei iieacieeii o oai?eo iieiaeoiai a?eo - iaioa 11 ?ie?a (27,3±11,7%). picscalex100010009000003961f00000c00350000000000050000000902000000000500 00000102ffffff000400000004010d000400000002010200050000000c02100186010300 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ii??aiyii c i?aee?oeaie, ui oai??thoue ia oeoe?iaee ae?aaao iaioa 3 ?ie?a (17,4±8,1% oa 22,2±10,7% a?aeiia?aeii), oiae? ye o aeine?aeaeaieo 11-13 ?ie?a oa iieiaeoa aeyaeaii ca?eueoaiiy /anoioe IAO ca o?eaaeino? oeoe?iaiai ae?aaaoo 3-5 ?ie?a (75,2±9,2% ? 42,9±10,1% ii??aiyii c iieacieeaie a?aeiia?aeieo a?eiaeo a?oi oai?eo c o?eaae?noth oai?iae iaioa 3 ?ie?a 28,6±6,1% oa 16,7±4,1%), ui a?aeiia?aeaei ii/aoeo oai?iae o e?eoe/iee ia??iae aeey oi?ioaaiiy ?aiaeueieo ooieoe?e (7-8 ?ie?a), a oaeiae ni?aiaaeaei c ia??iaeii noaoaaiai ?icaeoeo. A?aeiia?aei? ?acoeueoaoe io?eiai? i?ae /an aea/aiiy a?eiaeo iniaeeainoae iai?oanoaoe?? oeoe?iaiai ae?aaaoo o ae?oae oa i?aee?oe?a c IAO: o oai?eo c ii/aoeii iaaeoae o a?oe? 8-10 ?ie?a aiia c’yaeyeanue /ano?oa i?e iaaaeee?e o?eaaeino? oai?iae (3-5 ?ie?a), a oie /an ye ca oiiae ?? ?aiiuei? iai?oanoaoe?? (aei 5 ?ie?a) oeae iaoieia?/iee neiioii /ano?oa aeyaeyany o oai?eo c aaeeeith o?eaae?noth caoai?thaaiiy. A?aoiaoth/e ca’ycie i?aeaeuaiiy /anoioe IAO c ioaa?oaoiei ia??iaeii, a oaeiae aeayeo ia?aaaao ?? na?aae ae?a/ao (38,1±7,8%) ii??aiyii c oeiioeyie (30,8±7,4%), i?iaaaeaiee aiae?c oeueiai iieacieea o oai?eo a caeaaeiino? a?ae noao? oa a?eo. Io?eiai? ?acoeueoaoe na?ae/aoue i?i iaai? a?aei?iiino? a oa?aeoa?? IAO o oai?eo ??cii? noao?, ui iaea?eueo iii?oii o ?aiiueiio ioaa?oaoiiio ia??iae?: o ae?a/ao 11-13 ?ie?a aeyaeaii cia/ia ca?eueoaiiy /anoioe IAO (48,0±10,2%), yea aeaui ciaioo?oueny o oai?eo 14-15 ?ie?a (37,5±12,5%) oa ciiao c?inoa? o a?eia?e a?oi?16-18 ?ie?a (50,0±10,9%, 2=8,14, p<0,1); o oeiioe?a, oai?eo ia oeoe?iaee ae?aaao, ia a?aei?io a?ae ae?a/ao, /anoioa IAO caeeoaeanue noaa?eueiith a i?aioaa?oaoiiio oa ?aiiueiio ioaa?oaoiiio a?oe? (a?ae 20,7±14,7% aei 24,0±9,4%) oa iii?oii ca?eueooaaeanue a a?oi? oai?eo 16-18 ?ie?a (56,5±10,6%, 2=11,39, p<0,05), oiaoi o i?ciueiio ioaa?oaoiiio a?oe?. Iiaeaeueoee aiae?c noaoaaeo a?aei?iiinoae IAO iieacaa, ui iacaeaaeii a?ae o?eaaeino? oeoe?iaiai ae?aaaoo, /anoioa IAO aoea aenieith na?aae ae?a/ao 11-13 ?ie?a, oiaoi o ?aiiueiio ioaa?oaoiiio a?oe?. Iaeiae o ae?a/ao, ui oai??ee iaioa 3 ?ie?a, IAO ae?aaiinooaaeanue ye ia ii/aoeo ioaa?oaoiiai ia??iaeo (35,7±4,2%), oae ? a i?aioaa?oaoiiio a?oe? (12,5±6,6%), a ii/eiath/e c o?eaaeino? caoai?thaaiiy a?eueoa 3 ?ie?a, /anoioa oeueiai iieacieea caeeoaeanue aenieith a on?o a?eiaeo a?oiao a?aeiia?aeii ia??iaeo noaoaaiai ?icaeoeo (a?ae 49,7±5,9 aei 69,6±5,4%, p<0,05). O oeiioe?a c o?eaae?noth oai?iae iaioa 5 ?ie?a IAO aeyaeaii a on? a?eia? ia??iaee, aea a a?oi? aeine?aeaeaieo, ye? oai??ee iaioa 3 ?ie?a - ?c noaa?eueii iaaenieith /anoioith (a?ae 8,3±4,3% aei 14,3±5,4%), a na?aae oeiioe?a, ui oai??ee ia oeoe?iaee ae?aaao a?ae 3 aei 5 ?ie?a, /anoioa IAO aeyaeeanue iaea?eueoith a a?oi? aeine?aeaeaieo i?aioaa?oaoiiai a?eo (11-13 ?ie?a) – 75,0±11,1%. Ia oe? o?eaaeino? oeoe?iaiai ae?aaaoo a?eueoa 5 ?ie?a IAO o oeiioe?a ae?aaiinooaaeanue eeoa o ioaa?oaoiiio a?oe?, iniaeeai a 16-18 ?ie?a (71,4±5,8%). Aeine?aeaeaiiy IAO a caeaaeiino? a?ae nooiaiy noaoaai? c??eino? i?aeoaa?aeeei io?eiai? ?acoeueoaoe: o oai?eo c o?eaae?noth oeoe?iaiai ae?aaaoo a?eueoa 5 ?ie?a aiia ae?aaiinooaaeany eeoa ca oiiae iayaiino? aoi?eiieo noaoaaeo iciae iacaeaaeii a?ae noao?; na?aae aeine?aeaeaieo c iaeith o?eaae?noth caoai?thaaiiy c iaea?eueoith /anoioith IAO aeyaeyeanue o ae?a/ao a ?aiiueiio ioaa?oaoiiio ia??iae?, a oaeiae o oeiioe?a o i?aioaa?oaoiiio ia??iae? ia oe? o?eaaeino? oai?iae 3-5 ?ie?a. I?iaaaeai? aeine?aeaeaiiy iieacaee, ui aeey iiyae IAO o ae?oae oa i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao, aaeeea cia/aiiy ia? nooi?iue i?e?ioee?eoeyoi?ieo ii?ooaiue (r=+0,418, p<0,05), ca oiiae aenieiai ??aiy yeeo ii?ooaiiy naeaeoeaiino? i?ioa?io??? iiaeeeaa ? ia oe? caaeia?eueii? eiiiainaoe?? oeoe?iaiai ae?aaaoo. I?e oeueiio ii??a i?e?ioee?eoeyoi?ieo ii?ooaiue aeey iiyae IAO o ae?oae oa i?aee?oe?a ?c iia??oaiiyi eiiiainaoe?? aoaeaaiaeiiai iai?io cieaeo?oueny: a?ae 21,3±1,8 aae?a caaaeueiiai eai?ey?ineii?/iiai ?iaeaena (CE?) o a?oi? oai?eo c ??aiai HbA1c<7% aei 16,2±2,1 aae?a (p<0,05) o a?oi? oai?eo ?c iacaaeia?eueiith eiiiainaoe??th aoaeaaiaeiiai iai?io oa HbA1c>9% (na?aae
iaoe??io?a c IAO).

Aiae?c aeiaiaiai ?eoio IAO iieacaa cia/aiiy aeine?aeaeaiiy na/? o ??ci?
/ania? ?ioa?aaee: o 29,4±4,7% aeiaaee?a IAO a?eueoa 20 ia/e ciaeaeaii o
aeaiieo oa i?/ieo ii?oe?yo na/?. Acaaae?, oa?aeoa? eieeaaiue
na?aaeiueiai ??aiy IAO ia i?ioyc? aeiae o oai?eo ?c ??ciith o?eaae?noth
oai?iae aoa iaiaeiaeiaee c ia?aaaaith a ?aieiaeo ii?oe?yo ia ii/aoeiaeo
aoaiao caoai?thaaiiy, a i?/ieo ii?oe?yo i?e na?aaei?e eiai o?eaaeino? oa
a aeaiiee ia??iae o ae?oae oa i?aee?oe?a, ui aeiaaee /an oai??thoue ia
oeoe?iaee ae?aaao.

?ioaineai?noue aeueaoi?io??? i?ioyaii aeiae iinooiiai cieaeoaaeanue a
aeaiiee ia??iae, aeinyaath/e i?i?ioio a i?/i? aiaeeie o oai?eo ?c
caaeia?eueiith eiiiainaoe??th oa iii??iith aeaeiiiainaoe??th
aoaeaaiaeiiai iai?io. I?aeaeuaiiy ??aiy HbA1c ii?aeioaaeinue, iaaiaee,
?c c?inoaiiyi i?ioyaii aeiae na?aaeiuei? aaee/eie aeueaoi?io???, yea
aeinyaaea iaeneiaeueieo cia/aiue a i?/iee /an.

Aea/aiiy ia?oe?aeueieo ooieoe?e ie?ie iieacaei, ui o ae?oae oa
i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao, ii?ooaiiy o?eueo?aoe?eii?
ooieoe?? cono??/athoueny aeineoue /anoi – o 71,0±4,2% aeine?aeaeaieo,
ia?aaaaeii o aeaeyae? cieaeaiiy eeoai/eiai? o?eueo?aoe?? (o 54,9±3,9%
aeine?aeaeaieo). A?ia?o?eueo?aoe?y ae?aaiinoiaaia o 16,1±2,9% oai?eo.
I?e oeueiio c?inoaiiy o?eaaeino? oeoe?iaiai ae?aaaoo o ae?oae oa
i?aee?oe?a noi?iaiaeaeoaaeinue i?aeaeuaiiyi /anoioe iecueeeo (iaioa 80
ie/oa) iieaciee?a eeoai/eiai? o?eueo?aoe?? (a?ae 41,9±11,1% o ia?oee ??e
oai?iae aei 67,8±7,0% i?e o?eaaeino? oeoe?iaiai ae?aaaoo a?eueoa 8
?ie?a, pO<0,1). Aiae?c iieaciee?a eeoai/eiai? o?eueo?aoe?? (EO) iieacaa cieaeaiiy ?? na?aaeiuei? aaee/eie o i?ioean? ca?eueoaiiy o?eaaeino? oeoe?iaiai ae?aaaoo (oaaeeoey). Aeine?aeaeaiiy aeyaeei a?aei?iiino? o oa?aeoa?? ci?i EO a caeaaeiino? a?ae o?eaaeino? oai?iae o oai?eo ??cii? noao? (iae.2). Io?eiai? ?acoeueoaoe iieacaee, ui ia ii/aoeiaeo aoaiao caoai?thaaiiy EO i?aeoe/ii iaeiaeiaa o oeiioe?a (97,3±18,7 ie/oa) oa ae?a/ao (95,1±20,7 ie/iei). A i?ioean? c?inoaiiy o?eaaeino? oeoe?iaiai ae?aaaoo EO o ae?a/ao iii?oii cieaeo?oueny (52,7±5,1 ie/oa) ia a?aei?io a?ae oeiioe?a, o yeeo oeae iieaciee ?noioii ia ci?ith?oueny (82,3±8,9 ie/iei). Acaaae? iaoieia?/i? ci?ie EO o oeiioe?a cono??/aeenue c iaioith /anoioith (65,3±4,7%) ii??aiyii c ae?a/aoaie (76,2±4,5%, p<0,1). picscalex100010009000003200c00000c00180000000000050000000902000000000500 00000102ffffff000400000004010d000400000002010200050000000c021101be010300 00001e00040000002701ffff030000001e00040000002701ffff050000000b0200000000 030000001e00050000000102ffffff000500000009020000000015000000fb02f3ff0000 00000000bc02000000cc0000001254696d6573204e657720526f6d616e00cc0004000000 2d010000040000002d010000040000002d010000040000002d010000040000002d010000 040000002d010000040000002d010000040000002d010000040000002d01000004000000 2d010000040000002d010000040000002d010000040000002d010000040000002d010000 040000002d010000040000002d010000040000002d010000040000002d01000004000000 2d010000040000002d010000040000002d010000040000002d010000040000002d010000 040000002d010000040000002d01000015000000fb02efff000000000000bc02000000cc 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040000002d01030005000000090280808000050000000102808080000400000004010d00 04000000020102000e000000240305005d01ca005e01940064018e006201c3005d01ca00 040000002d010500050000000102ffffff000e000000240305004801c700490192005e01 94005d01ca004801c700040000002d010800040000002d010900050000000102bfbfbf00 0e000000240305005e01940064018e004f018c00490192005e019400040000002d010100 040000002d010100040000002d010400040000002d010500040000002d01020004000000 2701ffff030000001e00040000002d010100040000002d010900040000002d0106000500 00000102bfbfbf0005000000090280808000070000001604af0062018f00480105000000 090200000000050000000102ffffff000400000004010d0004000000020101000a000000 320a96004c0102000000232309000900040000002d010100040000002d01040004000000 2d010500040000002d010200040000002701ffff030000001e00040000002d0101000400 00002d010900040000002d010600050000000102ffffff00050000000902000000000700 000016040b01b80106000600040000002d01080004000000f0010900040000002d010400 04000000f001060009000000fa02000001000000000000002200040000002d0106000500 00001402b20075000400000004010d0004000000020101000500000013021f006f000500 00001402b2007500050000001302b2007200050000001402960074000500000013029600 710005000000140279007300050000001302790070000500000014025b00720005000000 13025b006f000500000014023d0071000500000013023d006e000500000014021f006f00 0500000013021f006c00040000002d01000009000000320aab0069000100000030000700 0a000000320a8f006100020000003330070007000a000000320a72006000020000003630 070007000a000000320a54005f00020000003930070007000c000000320a360057000300 0000313230000700070007000c000000320a180055000300000031353000070007000700 040000002d010000040000002d010000040000002d010000040000002d01000004000000 2d010400040000002d010200040000002701ffff030000001e00040000002d0100000400 00002d010600050000000102ffffff000500000009020000000007000000160481005400 46000b000400000004010d0004000000020101000d000000320a4b000e000b000000caeb f3e1eef7eaeee2e020000d000000320a5c000f000b000000f4e8ebfcf2f0e0f6b3ff2000 0a000000320a6d001f0005000000eceb2ff5e200040000002d010000040000002d010400 040000002d010200040000002701ffff030000001e00040000002d010000040000002d01 0600050000000102ffffff00050000000902000000000700000016040b01b80106000600 040000002d010000040000002d010000040000002d010400040000002d01020004000000 2701ffff030000001e00040000002d010000040000002d010600050000000102ffffff00 0500000009020000000007000000160404013101eb0063000400000004010d0004000000 0201010018000000320af000660022000000d2f0e8e2e0ebb3f1f2fc20f6f3eaf0eee2ee e3ee20e4b3e0e1e5f2f32c20f0eeeae8040000002d010000040000002d01040004000000 2d010200040000002701ffff030000001e00040000002d010000040000002d0106000500 00000102ffffff00050000000902000000000700000016040b01b8010600060004000000 2d010400040000002d010200040000002701ffff030000001e00040000002d0100000400 00002d010600050000000102ffffff00050000000902000000000700000016041101be01 00000000040000002d010400040000002d010200040000002701ffff030000001e000400 00002d010000040000002d010600050000000102ffffff00050000000902000000000700 000016041101be0100000000040000002d01040004000000f0010600040000002701ffff 050000000c021101be01030000001e00050000000102ffffff0005000000090200000000 040000002701ffff050000000b0200000000030000001e00050000000102ffffff000500 0000090200000000040000002701ffff03000000000000000000 Iae.2 Eeoai/eiaa o?eueo?aoe?y o ae?oae oa i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao, a caeaaeiino? a?ae noao? oa o?eaaeino? oeoe?iaiai ae?aaaoo (*- p<0,05, ** - p<0,02, a??ia?aei?noue a?aeiinii iieaciee?a ae?a/ao; # - p<0,05, ## - p<0,02, a??ia?aei?noue a?aeiinii ii?iaoeaieo iieaciee?a) Anoaiiaeaia oaeiae caeaaei?noue ii?ooaiue o?eueo?aoe?eii? ooieoe?? ie?ie a?ae o?eaaeino? oeoe?iaiai ae?aaaoo a?aeiinii ii/aoeo ia??iaeo noaoaaiai ?icaeoeo. Ca oiiae o?eaaeino? oai?iae a?eueoa 5 ?ie?a iaoieia?/i? ci?ie EO c’yaeyeenue o oai?eo o ?aiiueiio ioaa?oaoiiio a?oe?, ia?aaaaeii o aeaeyae? cieaeaiiy oeueiai iieacieea iacaeaaeii a?ae noao?. Ia oe? iaei? o?eaaeino? oeoe?iaiai ae?aaaoo iieacieee EO o oeiioe?a oa ae?a/ao cia/ii a?ae??ciyeenue oa iaee i?ioeeaaeiee oa?aeoa? a caeaaeiino? a?ae a?eo: ia iiiaio caaa?oaiiy ia??iaeo noaoaaiai ?icaeoeo EO o ae?a/ao cia/ii cieaeoaaeanue, a o thiae?a aeyaeyeanue a?ia?o?eueo?aoe?y. Oaeei /eiii, o ae?a/ao oa oeiioe?a, oai?eo ia oeoe?iaee ae?aaao, ci?ie o?eueo?aoe?eii? ooieoe?? ie?ie iaee ??ciiiai?aaeaiee oa?aeoa? ?, iiaeeeai, iia’ycai? c ??cieie no?ieaie ii/aoeo ioaa?oaoiiai ia??iaeo oa iniaeeainoyie eiai ai?iiiaeueii? oa?aeoa?enoeee a caeaaeiino? a?ae noao?. ?acoeueoaoe aeine?aeaeaiiy eieeaaiue aaee/eie EO ia i?ioyc? aeiae ocaiaeaeothoueny c e?oa?aoo?ieie aeaieie i?i oa?aeoa? ii?ooaiue ?? aeiaiaiai ?eoio o oai?eo ia oeoe?iaee ae?aaao [A.N.?o?iia,1989]: ?c c?inoaiiyi o?eaaeino? caoai?thaaiiy o ae?oae oa i?aee?oe?a nii/aoeo c’yaeyeanue ?iaa?n?y aeiaiaiai ?eoio EO, a iiaeaeueoiio a?i iaaoaaa iiiioiiiiai oa?aeoa?o. Cia/ia aeaeiiiainaoe?y oeoe?iaiai ae?aaaoo o ae?oae oa i?aee?oe?a c aenieeie iieacieeaie HbA1c a?ae??ciyeenue ye ?iaa?n??th, oae ? iiiioiii?noth aeiaiaiai ?eoio EO. Na?aae iaoiae?a aeine?aeaeaiiy ooieoe?? ie?ie aeineoue oe?iei aeei?enoiao?ueny ?aae?i?cioiiia ?aiia?ao?y, iaoieia?/i? ci?ie yei? aoee aea/ai? ?ai?oa o ae?oae, oai?eo ia oeoe?iaee ae?aaao [I.O.Aic?aiia, 1972, A.?.Aaaeeeaea?a,1982]. A oeueiio aeine?aeaeaii? i?ae /an aeeiiaiiy ?aae?i?cioiiii? ?aiia?ao?? ii?ooaiiy aeyaeai? o 78,3±6,4 % i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao, ia?aaaaeii o aeaeyae? iaoieia?/ieo ci?i iieaciee?a ia??iaeo aeinyaiaiiy iaeneioio aeoeaiino? (Tiaen) oa ia??iaeo iai?aaeaaaeaiiy a?io?aio ?c ie?ie (T1/2). I?e oeueiio aeaeiiiainaoe?y oeoe?iaiai ae?aaaoo o i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao, noi?iaiaeaeoaaeinue nei?i/aiiyi Tiaen, a oaeiae cao?eieith aeaaaeaiiy ?aae?ii?aia?aoo o oai?eo ?c cia/iei nooiaiai ii?ooaiue aoaeaaiaeiiai iai?io. E??i oeueiai, anoaiiaeaii, ui o ae?a/ao 15-18 ?ie?a iii??ii cieaeaia na?aaeiy aaee/eia Tiaen (1,85±0,15 oa) ii??aiyii c thiaeaie (2,26±0,32 oa, p<0,05), a T1/2 o ae?a/ao, iaaiaee, aeiaoee (7,53±0,65 oa), i?ae o thiae?a (6,01±0,47 oa, p<0,05). Aeyaeai? noaoaa? a?aei?iiino? ?aae?i?cioiiieo ?aiia?ai o i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao, i/aaeaeii, iiaeooue aooe iiyniai? iniaeeainoyie ooieoe?? ie?ie a oiiaao ioaa?oaoiiai ia??iaeo. A i?ioean? aeine?aeaeaiiy ia aeyaeaii ei??aeyoe?? ?aiia?ao?/ieo iieaciee?a c IAO, ui, a?aoiaoth/e no/ani? oyaeaiiy i?i ?ioi?iaoeai?noue IAO aeey ae?aaiinoeee ?aii?o noaae?e ae?aaaoe/ii? iao?iiao??, ia aeicaiey? aaaaeaoe ?acoeueoaoe ?aae?i?cioiiii? ?aiia?ao?? iaae?eiith i?aenoaaith aeey ae?aaiinoeee oeueiai oneeaaeiaiiy o ae?oae oa i?aee?oe?a. Ioe?iea ?ioiieia?/iiai noaoono ae?oae oa i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao, iieacaea, ui aaaeeee ia?aa?a caoai?thaaiiy c ?icaeoeii aeaio oa a?eueoa oneeaaeiaiue /ano?oa aeyaeyany o ae?oae oa i?aee?oe?a ia oe? cieaeaiiy e?eueeino? aeoeaieo e?ioioeeo?a, i?aeaeuaiiy ?AOE, cieaeaiiy CD3+ ? CD4+ oa i?aeaeuaiiy e?eueeino? CD8+ (a ia?o? ?iee caoai?thaaiiy). Ooieoe?iiaeueia aeoeai?noue e?ioioeeo?a ia ii/aoeo oeoe?iaiai ae?aaaoo o ae?oae oa i?aee?oe?a oa?aeoa?ecoaaeanue i?aeaeuaiiyi ee?oeiii? nainea?e?caoe?? (ca ?acoeueoaoaie niiioaiii? ?AOE), yea iinooiiai cieaeoaaeanue a i?ioean? c?inoaiiy o?eaaeino? caoai?thaaiiy (r= 0,478, p<0,05). Ii?yae c oeei ?iaeoeiaaia ooieoe?iiaeueia aeoeai?noue e?ioioeeo?a (?AOE c o?oiaaiaaethoei?iii) o oai?eo aoea iaaeinoaoiueith iaa?oue o ii/aoeiaee (iaioa 3 ?ie?a) ia??iae oai?iae (54,7±5,2% ii??aiyii c ii?iith 70,0±6,4%, p<0,05) ? oaeiae iinooiiai cieaeoaaeanue (r= 0,434, p<0,05) ?c c?inoaiiyi o?eaaeino? oeoe?iaiai ae?aaaoo. Aiae?c ?ioiieia?/ieo iieaciee?a a caeaaeiino? a?ae iayaiino? iciae ae?aaaoe/ii? iao?iiao?? aeyaea a??ia?aeia cieaeaiiy e?eueeino? aeoeaieo e?ioioeeo?a (r= 0,469, p<0,05) oa i?aeaeuaiiy niiioaiii? ?AOE (r=+0,543, p<0,05) o aeine?aeaeoaaieo ae?oae oa i?aee?oe?a c IAO, ii??aiyii c a?oiith oai?eo c ii?iaeueieie iieacieeaie aeueaoi?io???, iacaeaaeii a?ae o?eaaeino? caoai?thaaiiy. Io?eiai? ?acoeueoaoe i?aeoaa?aeaeothoue aca?iica’ycie ?ioiieia?/ieo ii?ooaiue c oi?ioaaiiyi ae?aaaoe/ii? iao?iiao?? o ae?oae oa i?aee?oe?a, a i?aeaeuaiiy ?AOE oa cieaeaiiy e?eueeino? aeoeaieo e?ioioeeo?a iiaea aenooiaoe ?ioiieia?/iei oaeoi?ii ?eceeo ?aiiueiai ?icaeoeo oeueiai oneeaaeiaiiy. Ii??aiyiee aiae?c a?oi oai?eo ia oeoe?iaee ae?aaao a caeaaeiino? a?ae niaaeeiai? iaoyaeaiino? ii oe?e oai?ia? aeaco? ia iaaiee aieea aeacaiiai oaeoi?o ia oi?ioaaiiy ae?aaaoe/ii? iao?iiao?? o ae?oae oa i?aee?oe?a. O aeine?aeaeoaaieo c iaoyaeaiith niaaeeia?noth ii oeoe?iaiio ae?aaaoo a?aei?/aii c?inoaiiy IAO, yea noi?iaaeaeoaaeinue cieaeaiiyi EO i?ae aieeaii iii??ii? aeaeiiiainaoe?? aoaeaaiaeiiai iai?io. A a?oi? oai?eo c iaiaoyaeaiith niaaeeia?noth ii oeoe?iaiio ae?aaaoo aeaeiiiainaoe?y caoai?thaaiiy noi?iaiaeaeoaaeanue a?ia?o?eueo?aoe??th aac iii?oiiai aieeao ia nooi?iue IAO. Cieaeaiiy o?eueo?aoe?eii? ooieoe?? ie?ie ?c c?inoaiiyi o?eaaeino? oai?iae a?aei?/aeinue o ae?oae oa i?aee?oe?a iacaeaaeii a?ae iayaiino? niaaeeiai? iaoyaeaiino? ii oeoe?iaiio ae?aaaoo. ?ioiiaaiaoe/ia aeine?aeaeaiiy ae?oae oa i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao, aeicaieeei aeae?eeoe HLA-aioeaaie, iayai?noue yeeo o oaiioei? iaea iaaaoeaia cia/aiiy uiaei oi?ioaaiiy ae?aaaoe/ii? iao?iiao??:DR5, DR7, ui aeyaeyeenue aeineoue /anoi, a oaeiae DR2, DR52, DQ1, /anoioa yeeo o aeine?aeaeaieo aoea iaaaeeeith. ??aaiue IAO o oai?eo, ye? iaee aeacai? aioeaaie, aoa cia/ii aeuee (223,0±65,3ia/e, 144,5±51,1ia/e, 178,3±10,8ia/e, 153,1±56,2ia/e oa 161,6±50,4ia/e a?aeiia?aeii, p<0,05), ? ae?aaiinoiaaia aiia ia oe? iaioi? o?eaaeino? oai?iae (6-7 ?ie?a), i?ae o ae?oae oa i?aee?oe?a c ?ioeie aioeaaiaie (50,1±27,3ia/e aeey DR3, 64,6±24,2ia/e aeey DR4, 39,5±13,5ia/e aeey DR6 i?e na?aaei?e o?eaaeino? oeoe?iaiai ae?aaaoo 9-12 ?ie?a). Iayai?noue o aeine?aeaeaieo ae?oae oa i?aee?oe?a aaieioei?a DR5DR7 ? DR2DR5 noi?iaiaeaeoaaeanue a?eueo aenieeie iieacieeaie na?aaeiuei? aaee/eie IAO (270,7±45,7 ia/e, p<0,05 oa 178,3±36,4 ia/e, p<0,05 a?aeiia?aeii) o noi?iaiae? iecueeiai ??aiy EO (43,5±18,0 ie/oa oa 69,8±16,2 ie/oa a?aeiia?aeii) ii??aiyii c oai?eie, o yeeo ae?aaiinoiaaii aaieioei DR3DR4 (118,6±40,0 ia/e oa 82,6±9,1 ie/oa, p<0,1).Io?eiai? ?acoeueoaoe ocaiaeaeothoueny c e?oa?aoo?ieie aeaieie i?i i?aeaeuaio /anoioo aioeaai?a DR2, DR5 ? DR7 o oai?eo c aaaeeei ia?aa?aii o?ii?/ieo caoai?thaaiue ie?ie oa na?ae/aoue, i/aaeaeii, i?i i?aeaeuaio o?aceea?noue ie?ie oai?eo-iin??a aeacaieo aioeaai?a uiaei aieeao iaoieia?/ieo oaeoi??a (iaoaaie?/ieo, ?ioiieia?/ieo, ai?iiiaeueieo). Ocaaaeueithth/e aeuaaeeeaaeaia, iiaeia noaa?aeaeoaaoe, ui o ae?oae oa i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao, iacaaaeath/e ia iaae?aci?noue ee?i?/ii? neiioiiaoeee ae?aaaoe/ii? iao?iiao??, aeineoue /anoi aeyaeythoueny iciaee, ye? aaaaeathoueny ia oeae /an ?ioi?iaoeaieie e?eoa??yie ae?aaaoe/iiai o?aaeaiiy ie?ie: i?e?iaeueaoi?io??y, ii?ooaiiy eeoai/eiai? o?eueo?aoe??. Ii?yae ?c iacaaeia?eueiith eiiiainaoe??th oai?iae, iaea?eueo a??ia?aeieie oaeoi?aie ?eceeo iiyae oeeo iaoieia?/ieo neiioii?a o oai?eo aeeoy/iai oa i?aee?oeiaiai a?eo ? aaeeea o?eaae?noue oeoe?iaiai ae?aaaoo, ii/aoie caoai?thaaiiy o a?oe? 8-10 ?ie?a, ia??iae noaoaaiai ?icaeoeo (iniaeeai o ae?a/ao), cia/i? i?e?ioee?eoeyoi?i? ii?ooaiiy, a oaeiae iaoyaeaia niaaeeia?noue ii oeoe?iaiio ae?aaaoo. Iaaio iaaaoeaio ?ieue o ?aiiueiio oi?ioaaii? ae?aaaoe/ii? iao?iiao?? a?athoue iayai?noue o oaiioei? oai?eo ia oeoe?iaee ae?aaao aeacaieo aeua ?ioiiaaiaoe/ieo ia?ea??a, a oaeiae i?aeaeuaiiy niiioaiii? ?aaeoe?? aeanoo?ainoi?iaoe?? e?ioioeeo?a oa cieaeaiiy e?eueeino? aeoeaieo e?ioioeeo?a. C o?aooaaiiyi aeuaaeacaieo oaeoi??a ?eceeo aoa noai?aiee aeai?eoi iinoaiiaee ae?aaiico ae?aaaoe/ii? iao?iiao??, ui a oiiaao ?iaioe i?aeoe/iiai e?ea?y aeicaiey? ?icoe?eoe iiaeeeaino? ?? ?aiiuei? ae?aaiinoeee, nai?/aniiai ii/aoeo e?eoaaeueieo caoiae?a ? iiia?aaeaeaiiy ?icaeoeo oa i?ia?anoaaiiy oeueiai oneeaaeiaiiy. Oaeei /eiii, oyaee?noue ae?aaaoe/iiai o?aaeaiiy ie?ie oa aeineoue aaeeea ?iciianthaeaeai?noue eiai eaoaioieo noaae?e o ae?oae oa i?aee?oe?a aeiaaathoue ?aoaeueiiai aeine?aeaeaiiy o ieo ?aiaeueieo ooieoe?e c iaia’yceiaei aecia/aiiiyi ?aii?o ae?aaiinoe/ieo neiioii?a ae?aaaoe/ii? iao?iiao??, iniaeeai o oai?eo c i?aeaeuaiei ?eceeii ?? oi?ioaaiiy. AENIIAEE 1. O ae?oae oa i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao, c aenieith /anoioith aeyaeythoueny ?aii? iciaee ae?aaaoe/ii? iao?iiao?? (i?e?iaeueaoi?io??y a?eueoa 20 ia/e o 34,6%, cieaeaiiy eeoai/eiai? o?eueo?aoe?? o 54,9%, a?ia?o?eueo?aoe?y – o 16,1% oai?eo), ui aeicaiey? ae?aaiinooaaoe o ieo I-IV noaae?? oeueiai oneeaaeiaiiy (ii C.E.Mogensen). 2. *anoioa oa nooi?iue i?e?iaeueaoi?io???, iaea?eueo ?ioi?iaoeaiiai e?eoa??th ae?aaaoe/ii? iao?iiao??, i?aeaeuo?oueny o ae?oae oa i?aee?oe?a ?c ca?eueoaiiyi o?eaaeino? oeoe?iaiai ae?aaaoo oa c?inoaiiyi nooiaiy ii?ooaiue i?e?ioee?eoeyoe??. I?e oeueiio ii??a i?e?ioee?eoeyoi?ieo ii?ooaiue aeey iiyae i?e?iaeueaoi?io??? o ae?oae oa i?aee?oe?a ?c iia??oaiiyi eiiiainaoe?? aoaeaaiaeiiai iai?io cieaeo?oueny. Aeiaiaee ?eoi i?e?iaeueaoi?io??? caeaaeeoue a?ae o?eaaeino? oeoe?iaiai ae?aaaoo oa eiai eiiiainaoe??. 3. Oa?aeoa?enoeea i?e?iaeueaoi?io??? o ae?oae oa i?aee?oe?a caeaaeeoue a?ae nooiaiy noaoaai? c??eino? oai?eo ??cii? noao?: ca oiiae o?eaaeino? oai?iae a?eueoa 5 ?ie?a i?e?iaeueaoi?io??y ae?aaiinoo?oueny o oai?eo eeoa c ii/aoeiaeie i?iyaaie ioaa?oaoiiai ia??iaeo, iniaeeai o ae?a/ao (O 50% aeiaaee?a). O oai?eo c iaeith o?eaae?noth oeoe?iaiai ae?aaaoo (a?ae 3 aei 5 ?ie?a) i?e?iaeueaoi?io??y ae?aaiinoo?oueny c i?aeaeuaiith /anoioith o i?aioaa?oaoiiio ia??iae? o oeiioe?a oa ia i?ioyc? onueiai ioaa?oaoiiai ia??iaeo o ae?a/ao. Ia ii/aoeiaeo aoaiao oai?iae i?aeaeuaiiy /anoioe i?e?iaeueaoi?io??? aeyaeyeinue o ?aiiueiio ioaa?oaoiiio ia??iae? o ae?a/ao. 4. Ii?ooaiiy o?eueo?aoe?eii? ooieoe?? ie?ie o ae?oae oa i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao, oa?aeoa?ecothoueny ia?aaaaeii cieaeaiiyi eeoai/eiai? o?eueo?aoe??, yea i?ia?ano? ?c ca?eueoaiiyi o?eaaeino? caoai?thaaiiy oa noi?iaiaeaeo?oueny c?inoaiiyi i?e?iaeueaoi?io???. 5. O oai?eo c iaeith o?eaae?noth oeoe?iaiai ae?aaaoo iieacieee o?eueo?aoe?eii? ooieoe?? ie?ie a ia??iae noaoaaiai ?icaeoeo a?ae??ciythoueny a caeaaeiino? a?ae noao? - cieaeaiiy eeoai/eiai? o?eueo?aoe?? ia ii/aoeo ioaa?oaoo oa a?ia?o?eueo?aoe?y ia caaa?oaeueiiio eiai aoai? o oeiioe?a, cia/ia cieaeaiiy oeueiai iieacieea o ae?a/ao i?ciueiai ioaa?oaoiiai a?eo. Ii/aoie ia??iaeo noaoaaiai ?icaeoeo o oai?eo c o?eaae?noth oeoe?iaiai ae?aaaoo a?eueoa 5 ?ie?a oa?aeoa?eco?oueny cieaeaiiyi o?eueo?aoe?eii? ooieoe?? ie?ie iacaeaaeii a?ae noao?. 6. Iaoieia?/i? ci?ie ?aiia?ao?/ieo iieaciee?a ia caeaaeaoue a?ae iayaiino? i?e?iaeueaoi?io???, ui ia aeicaiey? aeei?enoiaoaaoe iaoiae ?aae?i?cioiiii? ?aiia?ao?? aeey ae?aaiinoeee ?aii?o noaae?e ae?aaaoe/iiai o?aaeaiiy ie?ie o ae?oae oa i?aee?oe?a. 7. Ii/aoeiaee ia??iae oeoe?iaiai aeeaaaoo o ae?oae oa i?aee?oe?a (o?eaae?noue iaioa 3 ?ie?a), iniaeeai o oai?eo c ?aii?ie noaae?yie ae?aaaoe/ii? iao?iiao??, ui ae?aaiinoothoueny ca iayai?noth, nooiaiai oa noaa?euei?noth i?e?iaeueaoi?io???, oa?aeoa?eco?oueny caaaeueiei i?aeaeuaiiyi ee?oeiii? nainea?e?caoe?? (c?inoaiiy niiioaiii? ?aaeoe?? aeanoo?ainoi?iaoe?? e?ioioeeo?a) oa cieaeaiiyi e?eueeino? aeoeaieo e?ioioeeo?a; ?c ca?eueoaiiyi o?eaaeino? oeoe?iaiai ae?aaaoo ??aaiue ee?oeiii? nainea?e?caoe?? o oai?eo acaaae? cieaeo?oueny, a oie /an ye ca iayaiino? i?e?iaeueaoi?io??? a?i caeeoa?oueny aenieei ? noi?iaiaeaeo?oueny cieaeaiiyi ?iaeoeiaaii? ooieoe?iiaeueii? aeoeaiino? e?ioioeeo?a (cieaeaiiy ?aaeoe?? aeanoo?ainoi?iaoe?? e?ioioeeo?a c o?oiaaiaaethoei?iii) oa cieaeaiiyi e?eueeino? aeoeaieo e?ioioeeo?a, iaio iii?oiei ii??aiyii c oai?eie aac i?e?iaeueaoi?io???. 8. Iiyaa i?e?iaeueaoi?io??? o ae?oae oa i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao, o?nii iia’ycaia c iayai?noth a oaiioei? HLA-aioeaai?a: DR5, DR7, DR2, DR52, DQ1, iniaeeai aaieioei?a DR5DR7 ? DR2 DR5. 9. Ii?yae ?c aacoiiaiei aieeaii iacaaeia?eueii? eiiiainaoe?? aoaeaaiaeiiai iai?io ia oi?ioaaiiy ae?aaaoe/ii? iao?iiao??, oaeoi?aie ?eceeo ?? ?icaeoeo o ae?oae oa i?aee?oe?a iiaeia aaaaeaoe aaeeeo o?eaae?noue caoai?thaaiiy, iai?oanoaoe?th o a?oe? 8-10 ?ie?a, ioaa?oaoiee ia??iae (iniaeeai o ae?a/ao), cia/i? i?e?ioee?eoeyoi?i? ii?ooaiiy, iaoyaeaio niaaeeia?noue ii oeoe?iaiio ae?aaaoo, cieaeaiiy e?eueeino? aeoeaieo e?ioioeeo?a, i?aeaeuaiiy niiioaiii? ?aaeoe?? aeanoo?ainoi?iaoe?? e?ioioeeo?a, a oaeiae iayai?noue aeuaaeacaieo ?ioiiaaiaoe/ieo ia?ea??a. I?AEOE*I? ?AEIIAIAeAOe?? 1. Ae?aaiinoeea ?aii?o noaae?e ae?aaaoe/iiai o?aaeaiiy ie?ie o ae?oae oa i?aee?oe?a iiaeiia i?iaiaeeoeny ia i?aenoaa? eiiieaeniiai ee?i?ei-eaai?aoi?iiai aeine?aeaeaiiy c iaia’yceiaei aecia/aiiyi i?e?iaeueaoi?io??? oa eeoai/eiai? o?eueo?aoe??, a oiio /ene? ?o aeiaiaiai ?eoio c iiaeaeueoei aeeoa?aioe?eiaaiei ae?aaiicii ae?aaaoe/ii? iao?iiao?? c ?ioith iiaeeeaith iaoieia??th (ye ?aiaeueiith, oae ? aeno?a?aiaeueiith). Ii?yae c oeei, ae?oyi oa i?aee?oeai, oai?ei ia oeoe?iaee ae?aaao, ?aeiiaiaeiaaii i?iaaaeaiiy, ii-iiaeeeaino?, ?ioiieia?/iiai oa ?ioiiaaiaoe/iiai aeine?aeaeaiiy c iaoith aeyaeaiiy iciae, iani?eyoeeaeo uiaei oi?ioaaiiy ae?aaaoe/ii? iao?iiao??. 2. Aeeiai?/ia niinoa?aaeaiiy ae?oae oa i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao, aeiaaa? aeae?eaiiy a?oi ?eceeo ?aiiueiai ?icaeoeo ae?aaaoe/ii? iao?iiao?? c o?aooaaiiyi aeyaeaieo iani?eyoeeaeo oaeoi??a (aaeeea o?eaae?noue caoai?thaaiiy, ia??iae ioaa?oaoo, cia/i? i?e?ioee?eoeyoi?i? ii?ooaiiy, iaa?oue ia oe? caaeia?eueii? eiiiainaoe?? aoaeaaiaeiiai iai?io, cieaeaiiy e?eueeino? aeoeaieo e?ioioeeo?a, i?aeaeuaiiy ?AOE, a oaeiae iaoyaeaia niaaeeia?noue ii oeoe?iaiio ae?aaaoo, iayai?noue o oaiioei? aioeaai?a DR5, DR7, DR2, DR52, DQ1, iniaeeai aaieioei?a DR5DR7 ? DR2DR5) c iaoith a?eueo ?aoaeueiiai ianoaaeaiiy oai?eo oeeo a?oi oa nai?/aniiai i?ecia/aiiy i?ioaeoeaii? oa?ai??. 3. Ae?oe oa i?aee?oee, o yeeo iai?oanoaoe?y oeoe?iaiai ae?aaaoo ni?aiaaea? c a?eii, e?eoe/iei uiaei oi?ioaaiiy ?aiaeueieo ooieoe?e (8-10 ?ie?a), aeiaaathoue ?aoaeueiiai aeine?aeaeaiiy ooieoe?? ie?ie c iaia’yceiaei aecia/aiiyi i?e?iaeueaoi?io??? oa eeoai/eiai? o?eueo?aoe??, ii/eiath/e c ia?oeo ?ie?a caoai?thaaiiy, iniaeeai ca oiiae ii/aoeo ioaa?oaoiiai ia??iaeo. Ooieoe?iiaeueiee noai ie?ie o i?aee?oe?a ?c cia/iith o?eaae?noth oai?iae oaeiae iio?aao? iniaeeaiai eiio?ieth a ia??iae noaoaaiai ?icaeoeo. Eiiiainaoe?y oeoe?iaiai ae?aaaoo o oeeo oai?eo iiaeiia i?aeo?eioaaoeny ia iaeneiaeueii iiaeeeaiio ??ai?. IA?AE?E IOAE?EAOe?E CA OAIITH AeENA?OAOe?? 1. Oaeineiiaeaiiy iaoiae?a e?eoaaiiy oneeaaeiaiue oeoe?iaiai ae?aaaoo o ae?oae oa i?aee?oe?a/ E.ss.Nooe?e, I.A.O?e?iiaa, E.Ae. I?e?o?ia, N.I. *oiae, I.A.Aoae?aeei// Iaae?ao??y, aeooa?noai oa a?iaeieia?y. – 1997. - ?6. – N.47-49. 2. E.A.Nooeee, A.A.Aoae?aeei. Aeeaaaoe/aneay iao?iiaoey e aa iniaaiiinoe o aeaoae e iiae?inoeia// Iaaeaeoia?iaeiue iaaeeoeeineee aeo?iae. – 1998. - ?2. – N.86-90. 3. I.A.Aoae?aeei. ?aae?i?cioiiia ?aiia?ao?y o ae?aaiinoeoe? ii?ooaiue ooieoe?? ie?ie o i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao//Oe?a?inueeee ?aae?ieia?/iee aeo?iae. – 1998. - ?3. – N. 287-290. 4. Iiaua iiaeoiaeu e i?aaiecaoeee i?ioeanna ea/aiey aeaoae e iiae?inoeia, aieueiuo naoa?iui aeeaaaoii/ E.A.Nooeee, I.A.Oeeeiiiaa, E.Ae.Ieeeoeia, N.A. *oiae, A.A.Aoae?aeei, A.A. Ieoaeeiaa// Aiaeie?eiieia?y. – 1998. - ?2. – N.36-39. 5. A.A.Aoae?aeei. Nia?aiaiiua iaoiaeu ?aiiae aeeaaiinoeee ia?ooaiey ooieoeee ii/ae o aeaoae e iiae?inoeia, aieueiuo naoa?iui aeeaaaoii/Aeooaeueiua i?iaeaiu aeaoneie e iiae?inoeiaie yiaeie?eiieiaee: Oac.aeiee. - Oa?ueeia, 1995. – N.36-37. 6. A.A.Aoae?aeei. Ia?ooaiea ooieoeee ii/ae o aeaoae e iiae?inoeia, aieueiuo naoa?iui aeeaaaoii, a oneiaeyo niaoeeaeece?iaaiiie aeiiacee-eioa?iaoa//Iaoa?. Iaaeae. iao/ii-i?aeo.eiioa?. ii aeeaaaoo: Oac.aeiee. – Eeaa, Ioua-Aiaeeoea, 1996. 7. A.A.Aoae?aeei. Cia/aiea eee?aina e?aaoeieia e iee?iaeueaoieio?ee a ?aiiae aeeaaiinoeea ia?ooaiey ooieoeee ii/ae i?e naoa?iii aeeaaaoa o aeaoae e iiae?inoeia//Iaaeeoeeia - naaiaeiy e caao?a. - Aui. 2. - Oa?ueeia, 1997. – N.83-84. 8. A.A.Aoae?aeei. Iiaua iiaeoiaeu e aeeaaiinoeea ia?ooaiee ooieoeee ii/ae o aeaoae e iiae?inoeia, aieueiuo naoa?iui aeeaaaoii//Iaoa?. iao/ii-i?aeo. eiioa?., iinayuaiiie 75-eaoeth Oe?IEEICAeI:Oac.aeiee. – Oa?ueeia, 1997. – N. 76-77. 9. A.A.Aoae?aeei.Ia?ooaiea nooi/iiai ?eoia eeoai/eiaie oeeueo?aoeee o iiae?inoeia, aieueiuo naoa?iui aeeaaaoii// Iaaeaeoia?iaeiua Aeie Aeeaaaoa a Oe?aeia: Oac. aeiee. - Aeiai?iiao?iane, 1997. – N.63-64. 10. E.A. Nooe?e, A.A.Aoae?aeei. Yooaeoeaiinoue ea/aiey aeeaaaoe/aneie iao?iiaoee o aeaoae e iiae?inoeia// Iaaeaeoia?iaeiua Aeie Aeeaaaoa a Oe?aeia: Oac. aeiee. - Aeiai?iiao?iane, 1998. – N.113-115. 11. Iniaaiiinoe ?aiia?aiiu o iiae?inoeia, aieueiuo naoa?iui aeeaaaoii/ E.A.Nooeee, A.A.Aoae?aeei, N.O.*a?aaaoiaa // I?iaeaiu aeaoneie yiaeie?eiieiaee: Iaoa?.O?aoueaai iaaeaeoia?iaeiiai neiiiceoia eiiiaiee Iiai Ii?aeene. - E?ui,1998. – N.13. 12. Aaoiiaoece?iaaiiue iiieoi?eia aieueiuo naoa?iui aeeaaaoii aeaoae e iiae?inoeia/ E.A.Nooeee, I.A.Oeeeiiiaa, E.Ae.Ieeeoeia, A.A.Aoae?aeei, N.A.*oiae// I?iaeaiu aeaoneie yiaeie?eiieiaee: Iaoa?.O?aoueaai iaaeaeoia?iaeiiai neiiiceoia eiiiaiee Iiai Ii?aeene. - E?ui,1998. – N.14-15. AIIOAOe?ss Aoae?aeei I.A. Ae?aaiinoeea ?aii?o noaae?e ae?aaaoe/ii? iao?iiao?? o ae?oae oa i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao. –?oeiien. Aeena?oaoe?y ia caeiaoooy a/aiiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe ii niaoe?aeueiino? 14.01.14 – aiaeie?eiieia?y, ?inoeooo aiaeie?eiieia?? oa iai?io ?a/iaei ?i. A.I. Eii?na?aiea AII Oe?a?ie, Ee?a, 1999. Aeena?oaoe?eia ?iaioa i?enay/aia aea/aiith ?aii?o iciae ae?aaaoe/ii? iao?iiao?? o ae?oae oa i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao. Iiaeaii oa?aeoa?enoeeo i?e?iaeueaoi?io??? oa eeoai/eiai? o?eueo?aoe?? o thieo oai?eo ia oeoe?iaee ae?aaao, anoaiiaeaii cieaeaiiy o?eueo?aoe?eii? ooieoe?? ie?ie, yea noi?iaiaeaeoaaeinue c?inoaiiyi i?e?iaeueaoi?io??? ?c ca?eueoaiiyi o?eaaeino? o ieo oeoe?iaiai ae?aaaoo, iieacaia cia/aiiy ii/aoeo ioaa?oaoiiai ia??iaeo aeey iiyae ?aii?o ae?aaiinoe/ieo neiioii?a ae?aaaoe/ii? iao?iiao??, iniaeeai iii?oia o ae?a/ao. I?aeoaa?aeaeaiee aca?iica’ycie ii?ooaiue o ee?oeii?e eaioe? ?ioi?oaoo, cie?aia cieaeaiiy e?eueeino? aeoeaieo e?ioioeeo?a oa i?aeaeuaiiy ?AOE, c iiyaith i?e?iaeueaoi?io??? o ae?oae oa i?aee?oe?a, oai?eo ia oeoe?iaee ae?aaao, anoaiiaeai? ?ioiiaaiaoe/i? ia?ea?e ?aiiueiai ?icaeoeo o ieo ae?aaaoe/ii? iao?iiao??. Ia i?aenoaa? io?eiaieo ?acoeueoao?a aeae?eai? oaeoi?e ?eceeo ?aiiueiai ?icaeoeo ae?aaaoe/ii? iao?iiao?? o aeeoy/iio ? i?aee?oeiaiio a?oe? oa ?ic?iaeaiee aeai?eoi ?? ae?aaiinoeee. Eeth/ia? neiaa: ae?oe, i?aee?oee, oeoe?iaee ae?aaao, ae?aaaoe/ia iao?iiao?y, i?e?iaeueaoi?io??y, eeoai/eiaa o?eueo?aoe?y, ee?oeiiee ?ioi?oao, HLA-aioeaaie. AIIIOAOeEss Aoae?aeei A.A. Aeeaaiinoeea ?aiieo noaaeee aeeaaaoe/aneie iao?iiaoee o aeaoae e iiae?inoeia, aieueiuo naoa?iui aeeaaaoii.- ?oeiienue. Aeenna?oaoeey ia nieneaiea o/aiie noaiaie eaiaeeaeaoa iaaeeoeeineeo iaoe ii niaoeeaeueiinoe 14.01.14 – yiaeie?eiieiaey, Einoeooo yiaeie?eiieiaee e iaiaia aauanoa ei. A.I. Eiienna?aiei AII Oe?aeiu, Eeaa, 1999. Aeenna?oaoeeiiiay ?aaioa iinayuaia eco/aieth ?aiieo noaaeee aeeaaaoe/aneie iao?iiaoee o aeaoae e iiae?inoeia, aieueiuo naoa?iui aeeaaaoii. Onoaiiaeaii, /oi o yoie a?oiiu aieueiuo naoa?iui aeeaaaoii, ianiio?y ia ionoonoaea oa?aeoa?iuo i?iyaeaiee aeeaaaoe/aneiai ii?aaeaiey ii/ae, n aeinoaoi/ii aunieie /anoioie auyaeythony i?eciaee, n/eoathueany a ianoiyuaa a?aiy eioi?iaoeaiuie e?eoa?eyie aeeaaaoe/aneie iao?iiaoee (iee?iaeueaoieio?ey, ia?ooaiey eeoai/eiaie oeeueo?aoeee). Aeaia oa?aeoa?enoeea iee?iaeueaoieio?ee e eeoai/eiaie oeeueo?aoeee, a oii /enea eo nooi/iiai ?eoia, o aeaoae e iiae?inoeia, aieueiuo naoa?iui aeeaaaoii, onoaiiaeaii nieaeaiea oeeueo?aoeeiiiie ooieoeee ii/ae, nii?iaiaeaeathuaany ia?anoaieai iee?iaeueaoieio?ee n oaaee/aieai o ieo aeeeoaeueiinoe naoa?iiai aeeaaaoa, iieacaii cia/aiea ianooieaiey ioaa?oaoiiai ia?eiaea aeey iiyaeaiey ?aiieo aeeaaiinoe/aneeo neiioiiia aeeaaaoe/aneie iao?iiaoee, iniaaiii o aeaai/ae. Onoaiiaeaia acaeiinaycue ia/aea caaieaaaiey a ii?aaeaeaiiua aic?anoiua ia?eiaeu (8-10 eao) n ?aiiei iiyaeaieai iee?iaeueaoieio?ee ia oiia naoa?iiai aeeaaaoa a iiae?inoeiaii aic?anoa. Iieacaia ?ieue iee?ioee?eoeyoi?iuo ia?ooaiee o aeaoae e iiae?inoeia, aieueiuo naoa?iui aeeaaaoii, a oi?ie?iaaiee o ieo ?aiieo noaaeee aeeaaaoe/aneie iao?iiaoee. I?e yoii onoaiiaeaii nieaeaiea ii?iaa ia?ooaiee iee?ioee?eoeyoeee aeey iiyaeaiey iee?iaeueaoieio?ee n ia?anoaieai aeaeiiiainaoeee oaeaaiaeiiai iaiaia. Eco/aiu iieacaoaee ?aaeeiecioiiiie ?aiia?aoee o iiae?inoeia, aieueiuo naoa?iui aeeaaaoii, a caaeneiinoe io aeeeoaeueiinoe, noaiaie eiiiainaoeee naoa?iiai aeeaaaoa, iiea aieueiuo, a oaeaea iaee/ey iee?iaeueaoieio?ee. Auyaeaiiua ia?ooaiey i?aaenoaaeaiu, a iniiaiii, oei?i/aieai ia?eiaea aeinoeaeaiey iaeneioia aeoeaiinoe e caiaaeeaieai auaaaeaiey ?aaeeii?aia?aoa. Iiaeoaa?aeaeaia acaeiinaycue ia?ooaiee a eeaoi/iii caaia eiioieoaoa, a /anoiinoe nieaeaiey /enea aeoeaiuo eeioioeeoia e iiauoaiey ?AOE, n iiyaeaieai iee?iaeueaoieio?ee o aeaoae e iiae?inoeia, aieueiuo naoa?iui aeeaaaoii, onoaiiaeaiu eiioiiaaiaoe/aneea ia?ea?u ?aiiaai ?acaeoey o ieo aeeaaaoe/aneie iao?iiaoee, a /anoiinoe, aeieacaia iaaaoeaiay ?ieue HLA-aioeaaiia DR5, DR7, DR2, DR52, DQ1, iniaaiii aaieioeiia DR5DR7 e DR2DR5. I?e yoii oa?aeoa? oi?ie?iaaiey aeeaaaoe/aneiai ii?aaeaiey ii/ae a ii?aaeaeaiiie noaiaie caaeneo io iaee/ey ianeaaenoaaiiie ioyaiuaiiinoe ii naoa?iiio aeeaaaoo. Ia iniiaaiee iieo/aiiuo ?acoeueoaoia auaeaeaiu oaeoi?u ?enea ?aiiaai ?acaeoey aeeaaaoe/aneie iao?iiaoee a aeaoneii e iiae?inoeiaii aic?anoa, n?aaee eioi?uo auaeaeaiu aieueoay aeeeoaeueiinoue naoa?iiai aeeaaaoa, ia/aei caaieaaaiey a aic?anoa 8-10 eao, ia?eiae iieiaiai nic?aaaiey, cia/eoaeueiua ia?ooaiey iee?ioee?eoeyoeee, nieaeaiea /enea aeoeaiuo eaeeioeeoia, oaaee/aiea ?AOE, ioyaiuaiiay ianeaaenoaaiiinoue ii naoa?iiio aeeaaaoo, iaee/ea a oaiioeia aieueiuo naoa?iui aeeaaaoii HLA –aioeaaiia DR5, DR7, DR2, DR52, DQ1, iniaaiii aaieioeiia DR5 DR7 e DR2 DR5. A i?ioeanna auiieiaiey ?aaiou ?ac?aaioai aeai?eoi aeeaaiinoeee aeeaaaoe/aneie iao?iiaoee. Eeth/aaua neiaa: aeaoe, iiae?inoee, naoa?iue aeeaaao, aeeaaaoe/aneay iao?iiaoey, iee?iaeueaoieio?ey, eeoai/eiaay oeeueo?aoeey, eeaoi/iue eiioieoao, HLA-aioeaaiu. ABSTRACT Budreyko A.A. Diagnostics of early stages of diabetic nephropathy at children and adolescents suffering with diabetes mellitus.- Manuscript. Thesis for a candidate’s degree of medical sciences by speciality 14.01.14 - endocrinology.- V.P.Komissarenko Institute of Endocrinology and Metabolism of Ukrainian Academy of Medical Sciences, Kiyiv, 1999. The work is devoted to the studying of early symptoms of diabetic nephropathy at children and adolescents suffering with diabetes mellitus. The description of microalbuminuria and glomerular filtration at young patients with diabetes mellitus is given, the decrease of kidneys filtration function accompanying by increase of microalbuminuria with increase of diabetes mellitus duration at children and adolescents is established, the significance of pubescence for appearance of early diagnostic symptoms of diabetic nephropathy is shown. The interrelation of infringements in the cellular unit of immunity, in particular the decrease of number of active lymphocytes and increase of LBTR, with appearance of microalbuminuria at children and adolescents suffering with diabetes mellitus is confirmed. Immunogenetic markers of early development of diabetic nephropathy are allocated . On the basis of the received results the factors of risk of early development of diabetic nephropathy in children’s and adolescent age are allocated, and the algorithm of its diagnostics is developed. Key words: children, adolescents, diabetes mellitus, diabetic nephropathy, microalbuminuria, glomerular filtration, cellular immunity, HLA-antigens. NIENIE NEI?I*AIUe CE? – caaaeueiee eai?ey?ineii?/iee ?iaeaen; EO – eeoai/eiaa o?eueo?aoe?y; IAO – i?e?iaeueaoi?io??y a?eueoa 20 ia/e; ?AOE – ?aaeoe?y aeanoo?ainoi?iaoe?? e?ioioeeo?a; HbA1c – ae?eiceeueiaaiee aaiiaeia?i; HLA - human leucocyte antigen (eiiieaen aioeaai?a a?noinoi?niino? ethaeeie).

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