Клініко-метаболічні особливості адаптації доношених новонароджених дітей з пневмонією і гіпоксично-ішемічною енцефалопатією: Автореф. дис… канд. мед

?INOEOOO IAAe?AO???, AEOOA?NOAA OA A?IAEIEIA??

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

IEEEI’THE Aiia Ien??aia

OAeE: 616.-053.-35:[61.831-005+616.152.21]

EE?I?EI-IAOAAIE?*I? INIAEEAINO? AAeAIOAOe??

AeIIIOAIEO IIAIIA?IAeAEAIEO Ae?OAE C

IIAAIII??TH ? A?IIENE*II-?OAI?*IITH

AIOeAOAEIIAO??TH

14.01.10 – iaae?ao??y

AAOI?AOA?AO

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Ee?a – 1999

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia a ?aaii-O?aie?anuee?e aea?aeaai?e iaaee/i?e aeaaeai??
IIC Oe?a?ie.

Iaoeiaee ea??aiee:

aeieoi? iaaee/ieo iaoe, i?ioani? Aieinyiei ?iiaia Iao??aia,
?aaii-O?aie?anueea aea?aeaaia iaaee/ia aeaaeai?y IIC Oe?a?ie,
caa?aeoth/a eaoaae?e aeeoy/eo oai?ia

Io?oe?ei? iiiiaioe:

— aeieoi? iaaee/ieo iaoe, i?ioani?, caneoaeaiee ae?y/ iaoee ? oaoi?ee
Oe?a?ie Iiaeue/aiei Ethaeieea ?aai?aia, ?inoeooo iaae?ao???, aeooa?noaa
oa a?iaeieia?? AII Oe?a?ie, ea??aiee a?aeae?eaiiy aeeoa?aioe?eii?
ae?aaiinoeee, i?io?eaeoeee oa oa?ai?? caoai?thaaiue aioo??oi?o i?aai?a o
ae?oae

— aeieoi? iaaee/ieo iaoe, i?ioani? Oea/aiei Na?oeaia Eoci?i?/ia,
Euea?anueeee aea?aeaaiee iaaee/iee oi?aa?neoao ?i. Ae.Aaeeoeueeiai IIC
Oe?a?ie, i?ioani? eaoaae?e oaeoeueoaonueei? ? aini?oaeueii? iaae?ao???

I?ia?aeia onoaiiaa:

Ee?anueea iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe ?i.I.E.Ooieea IIC
Oe?a?ie, eaoaae?a iaiiaoieia??, i.Ee?a

Caoeno a?aeaoaeaoueny “ 25 ” n?/iy 2000 ?ieo i 1300 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 26.553.01 ii caoenoo
aeena?oaoe?e ia caeiaoooy iaoeiaiai nooiaiy aeieoi?a iaoe ca
niaoe?aeueiinoyie “Iaae?ao??y”, “Aeooa?noai ? a?iaeieia?y” i?e ?inoeooo?
iaae?ao???, aeooa?noaa oa a?iaeieia?? AII Oe?a?ie (04050, i.Ee?a,
aoe.Iaio?euenueeiai, 8).

C aeena?oaoe??th iiaeia iciaeiieoeny a a?ae?ioaoe? ?inoeoooo
iaae?ao???, aeooa?noaa ? a?iaeieia?? AII Oe?a?ie (04050, i.Ee?a, aoe.
Iaio?euenueeiai, 8)

Aaoi?aoa?ao ?ic?neaiee “ 27 ” eenoiiaaea 1999 ?ieo

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee
E.A. Eaaoi?ia

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue i?iaeaie. Na?aae i?e/ei ia?eiaoaeueii? nia?oiino? ?
iaoieia?? a iinoiaoaeueiiio ia??iae? ?icaeoeo aeeoeie a Oe?a?i? /?eueia
i?noea caeia? a?iien?y ieiaea ? ano?en?y iiaiia?iaeaeaiiai
(A.I.N?ae?euei?eia, N.I.E?eaiionoia, 1994).

Ca no/anieie oyaeaiiyie a a?iien?th ieiaea o?ainoi?io?oueny aoaeue-yea
iani?eyoeeaa i?io?eaiiy aaa?oiino? (I.I.Oaaaeia, 1995). Iaoyaeaiee
ia?aa?a aaa?oiino? ? iieia?a o iaoa??, ye a?aeiii, aeeeeea? ii?ooaiiy
an?o aeae?a iai?io ?a/iaei o ieiaea ? iiaiia?iaeaeaii? aeeoeie
(I.I.Eoe’yiiaa, E.?.Iiaeue/aiei, 1994, O.E.Ciaiainueea, 1993,
A.A.Iaae?eianueea, 1996), i?e oeueiio a eaioethc? iinoa?iiene/ieo
iioeiaeaeaiue iniaeeai aaaeeeaeie ? ?iceaaee aia?aaoe/iiai iaoaaie?cio.
Aeaci?aai?caoe?y iaoaaie?/ieo i?ioean?a noi?iaiaeaeo?oueny no?oeoo?ieie
ci?iaie a ee?oeiieo iaia?aiao ? iaaei??iei iinooieaiiyi a e?iaiiinia
?onei oa?iaio?a aia?aaoe/iiai iai?io ? ae?eie?co: e?aaoeie?iace ?
ea-eoaoaeaa?ae?iae?iaaiace (A.A-Eaaeaiei oa ni?aaaoi?e, 1993).

Na?aae oneeaaeiaiue ia?eiaoaeueii? a?iien?? aeniea /anoea i?eiaaea? ia
oea?aa?aeueio iaoieia?th (I.?.Aaeaeoe, 1992). Ia oe?
a?iiene/ii-?oai?/ii? aioeaoaeiiao?? o iiaiia?iaeaeaieo iaethe?a ia??aeei
aeieea? caiaeaiiy eaaaiaai? oeaieie (?.i.aieinyiei, 1994,
A.?.Eeaiaianueeee 1995). ?icaeoeo iiaaiii?? ni?eythoue ? o?c?ieia?/i?
iniaeeaino? ?ioi?oaoo a iaiiaoaeueiiio a?oe?, eio?? iieyaathoue o
iaaeinoaoi?e c??eino? ee?oeiii? ? aoii?aeueii? eaiie ?ioi?oaoo ?
oaaioeeoico (N.E-Oea/aiei c? ni?aaaoi?., 1994, A.I.*a?ieoia,
?.?.Neoea?i, 1994). Iiaaiii?y a naith /a?ao iineeth? a?iiene/iee noai
iaiiaeyoe (A.I.Aeaiaioue?aa, 1995), a oneeaaeithth/ei oaeoi?ii i?e
oeueiio aenooia? ? neiae?ii aiaeiaaiii? ?ioieneeaoe??, yeee
noi?iaiaeaeo? caiaeuei? i?ioeane a i?aai?ci? (.?.Iaiiaa, 1997). Iniaeea?
o?oaeiiu? a i?aeoeoe? e?ea?y — iaiiaoieiaa iia’ycai? c oei, ui ee?i?/i?
i?iyae ia?eiaoaeueii? aioeaoaeiiao?? ? iiaaiii?? o iiaiia?iaeaeaieo
iaiiaeyo ? iiae?aieie (A.A.Ano??i c? ni?aaao., 1994), a /?oe? e?eoa???,
ye? a aeicaieeee aecia/eoe nooi?iue iinoa?iiene/iiai iioeiaeaeaiiy ?
nai?/anii ae?aaiinooaaoe i?e?aeiaiiy iiaaiii?/iiai i?ioeano aei
ia?eiaoaeueii? aioeaoaeiiao??, o iiaiia?iaeaeaieo ae?oae ia aeinoaoiuei
aecia/ai?. Oea iaaaoeaii iicia/a?oueny ia aoaeoeaiino? e?eoaaiiy oa
?aaa?e?oaoe?? aeacaiiai eiioeiaaioo iaiiaeyo.

Na?aae no/anieo iaoiaeee oa?iaeiei?aeoe?? iinoa?iiene/ieo noai?a o
iiaiia?iaeaeaieo ae?oae caneoaiao? oaaae canoinoaaiiy i?aia?ao?a
iaoaaie?/ii? ae??, ye?, ?aaoethth/e iai?ii? i?ioeane, i?aeaeuothoue
caaaeuei? a?aeiiai? ?aaeoe?? ? aeyaeythoue ianiaoeeo?/iee
?ioiiei?aaoth/ee aoaeo (I.A.Ai?aethaiaa, 1993).

Iaaaaeaia aecia/eei iaoo oa caaaeaiiy i?iaaaeaieo aeine?aeaeaiue.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, oaiaie, ieaiaie. I?aaenoaaeaia
i?aoey ? o?aaiaioii iaoeiai-aeine?aeii? ?iaioe «Ee?i?ei-iaoiaaiaoe/i?
iniaeeaino? i?ciueiai iaiiaoaeueiiai ia??iaeo o aeiiioaieo
iiaiia?iaeaeaieo ae?oae c ii?ooaiiyie aaeaioaoe?? a ia?o? aei? aeeooy»,
aeeiiaii? ia eaoaae?? iaae?ao??? ?aaii-O?aie?anueei? aea?aeaaii?
iaaee/ii? aeaaeai?? a ?aieao i?ia?aie «Ae?oe Oe?a?ie» (aioo??oiy
?a?no?aoe?y 01.10.03O.96I) oa /anoeiith iniiaiiai iaoeiaiai iai?yieo
aeaaeai?? «?ic?iaea iiaeo iaaee/ieo oaoiieia?e oa noaiaea?o?a yeino?
ae?aaiinoeee oa e?eoaaiiy iaeaaaeeea?oeo ia?ioaeoe?eieo caoai?thaaiue»,
yeee ?ic?iaey?oueny aeaaeai??th a iaaeao i?aeia?iaeii? ?ioaa?aeueii?
i?ia?aie NAII? — AIIC — Oe?a?ia (1995-2000).

Iaoa aeine?aeaeaiiy. Aaeineiiaeaiiy iaoiae?a ae?aaiinoeee oa i?aeaeuaiiy
aoaeoeaiino? e?eoaaiiy iiaiia?iaeaeaieo ae?oae c iiaaiii??th ?
a?iiene/ii-?oai?/iith aioeaoaeiiao??th.

Caaea/? aeine?aeaeaiiy:

1. Ioe?ieoe ee?i?/i? iniaeeaino? aaeaioaoe?? aeiiioaieo iiaiia?iaeaeaieo
ae?oae c a?iiene/ii-?oai?/iith aioeaoaeiiao??th ? c iiaaiii??th ia oe?
ia?eiaoaeueii? ai-oeaoaeiiao??.

2. Aea/eoe ??aaiue na?aaei?o iieaeoe a e?ia? iiaiia?iaeaeaieo c
a?iiene/ii-?oai?/iei o?aaeaiiyi iiceo ? c iiaaiii??th ia oe?
a?iiene/ii-?oai?/ii? aioeaoa-eiiao??.

3. Aecia/eoe noai ee?oeiiiai oa aoii?aeueiiai ?ioi?oaoo o iaiiaeyo c
a?ii-ene/ii-?oai?/iei o?aaeaiiyi iiceo oa c iiaaiii??th ia oe?
a?iiene/ii-?oai?/ii? aioeaoaeiiao??.

4. Aea/eoe aeoeai?noue ieaciaoe/ieo oa?iaio?a aia?aaoe/iiai iai?io oa
ae?eie?co e?aaoeie?iace oa eaeoaoaeaa?ae?iaaiace o ae?oae c
a?iiene/ii-?oai?/iei o?aaeaiiyi aieiaiiai iiceo oa c iiaaiii??th ia oe?
a?iiene/ii-?oai?/ii? aioeaoaeiiao??.

5. Ii??aiyoe aeeiai?eo iieaciee?a aoii?aeueiiai oa ee?oeiiiai ?ioi?oaoo,
aeoeaiino? e?aaoeie?iace ? eaeoaoaeaa?ae?iaaiace ne?iaaoee e?ia? i?e
a?iiene/ii-?oai?/ieo o?aaeaiiyo aieiaiiai iiceo oa o ae?oae c
iiaaiii??th ia oe? a?iiene/ii-?oai?/ii? aioeaoaeiiao?? ia oii?
caaaeueiii?eeiyoiai e?eoaaiiy ? oa?ai?? c aeeth/aiiyi eiiiiceoo
iaoaaie?/ieo ei?aeoi??a: e?ii?ai? eeneioe, a?oai?i?a Aa ? Aa.

Iaoeiaa iiaecia ?iaioe. Aia?oa aeiaaaeaii, ui i?e ii?ooaii? i?ciuei?
iinoiaoaeueii? aaeaioaoe?? o ae?oae c a?iiene/ii-?oai?/iith
aioeaoaeiiao??th oa a?iiene/ii-?oai?/iith aioeaoaeiiao??th ? iiaaiii??th
iayaiee aiaeioieneeic ??ciiai nooiaiy oyaeeino? ca ee?i?/ieie iciaeaie
oa ci?iaie ai?noo na?aaei?o iieaeoe o e?ia?.

O iaiiaeyo c iiaaiii??th ia oe? a?iiene/ii-?oai?/ii? aioeaoaeiiao??
anoaiiaeaii aeinoia??i? ci?ie aeoeaiino? ne?iaaoeiaeo oa?iaio?a
e?aaoeie?iace ? eaeoaoaeaa?ae?iaaiace, iieacieee yeeo iiaeooue neoaeeoe
e?eoa???i oyaeeino? o?aaeaiiy oa aoaeoeaiino? e?eoaaiiy oai?eo iaiiaeyo.

Aia?oa iaa?oioiaaii iiaeeea?noue iioei?caoe?? aeoeaiino? aicei?a a
i?aai?ci? iiaiia?iaeaeaieo iaethe?a oeyoii canoinoaaiiy a eiiieaen?
e?eoaaiiy eiiiiceoo i?aia?ao?a iaoaaie?/ii? ae?? (e?ii?ai? eeneioe,
a?oai?i?a Aa ? Aa), aeiaaaeaii ?o iiceoeaiee aieea ia
ee?i?ei-iaoaaie?/io oa ?ioiieia?/io aaeaioaoe?th iiaiia?iaeaeaieo
iaethe?a c a?iiene/ii-?oai?/iei o?aaeaiiyi aieiaiiai iiceo oa c
iiaaiii??th ia oe? a?iiene/ii-?oai?/ii? aioeaoaeiiao??.

I?aeoe/ia cia/ei?noue ?iaioe. A ?acoeueoao? i?iaaaeaieo aeine?aeaeaiue
aeey ?aiiuei? ae?aaiinoeee ii?ooaiue iaoaaie?/ieo i?ioean?a o
iiaiia?iaeaeaieo ae?oae c a?iiene/ii-?oai?/iith aioeaoaeiiao??th ? c
iiaaiii??th ia oe? a?iiene/ii-?oai?/ii? aioeaoaeiiao?? cai?iiiiiaaii
aecia/aiiy a ne?iaaooe? e?ia? ??aiy na?aaei?o iieaeoe oa aeoeaiino?
ieaciaoe/ieo oa?iaio?a e?aaoeie?iace ? eaeoaoaeaa?ae?iaaiace.

Ia??oioiaaii oa ?ic?iaeaii iaoiae iioei?caoe?? iinoiaoaeueii?
ee?i?ei-iaoaaie?/ii?, ?ioiieia?/ii? aaeaioaoe?? iiaiia?iaeaeaieo
iaethe?a c a?iiene/ii-?oai?/iei o?aaeaiiyi iiceo oa c iiaaiii??th ia oe?
a?iiene/ii-?oai?/ii? aioeaoaeiiao?? oeyoii aeeth/aiiy a eiiieaen
e?eoaaiiy eiiiiceoo i?aia?ao?a iaoaaie?/ii? ae?? (e?ii?ai? eeneioe,
a?oai?i?a Aa ? Aa).

Ai?iaaaeaeaiiy ?acoeueoao?a aeine?aeaeaiiy o i?aeoeeo. ?acoeueoaoe
aeine?aeaeaiiy cai?iaaaeaeai? a i?aeoeeo ?iaioe ?aaii-O?aie?anueei?
iaeanii? ee?i?/ii? e?ea?i? oa ?aaii-O?aie?anueeiai iaeaniiai
ia?eiaoaeueiiai oeaio?o, ?aeiiieo e?ea?aiue ?aaii-O?aie?anueei? iaeano?
(I.Eieiiey, i.Aiai?iae/aie, i.Aeieeia).

Iniaenoee aianie caeiaoaa/a. I?e aeeiiaii? ?iaioe iniaenoi i?iaaaeaii
aeaoaeueiee ee?i?/iee aiae?c ia?aa?ao aioa-, ?io?a- oa iaiiaoaeueiiai
ia??iaeo ? ?acoeueoao?a a?io?i?/iiai oa ?ioiieia?/iiai ianoaaeaiiy o 114
iiaiia?iaeaeaieo ae?oae. Iaa?oioiaaii iaoiae iaoaaie?/ii? ei?aeoe?? o
iaiiaeyo c a?iiene/ii-?oai?/iith aioeaoaeiiao??th ? c iiaaiii??th ia oe?
a?iiene/ii-?oai?/ii? aioeaoaeiiao??. Aaoi?ii iniaenoi i?iaaaeaii
iaoaiaoe/io ia?iaeo io?eiaieo ?acoeueoao?a, ianoaaeaiiy ae?oae, iaienai?
an? ?icae?ee aeena?oaoe?? ? noi?ioeueiaai? aeniiaee oa i?aeoe/i?
?aeiiaiaeaoe??.

Ai?iaaoe?y ?iaioe. Iniiai? iieiaeaiiy ?iaioe aeiiia?aeaeenue ia iaoeia?e
eiioa?aioe?? ?aaii-O?aie?anueei? aea?aeaaii? iaaee/ii? aeaaeai?? IIC
Oe?a?ie ii cae?i/aieo iaoeiai-aeine?aeieo ?iaioao (1998), ia
iaoeiai-i?aeoe/i?e eiioa?aioe?? ?aaii-O?aie?anueei? Anioe?aoe??
iaae?ao??a (I.?aaii-O?aie?anuee, 1997), eo?nao i?aeaeuaiiy eaae?o?eaoe??
iaae?ao??a oa iaiiaoieia?a i?e ?aaii-O?aie?anuee?e aea?aeaai?e iaaee/i?e
aeaaeai?? (1998).

Ioae?eaoe?y ?acoeueoao?a aeine?aeaeaiue. Iniiai? iieiaeaiiy aeena?oaoe??
iioae?eiaaii o 4 ae?oeiaaieo a aeo?iaeao ?iaioao.

Ianya oa no?oeoo?a aeena?oaoe??. Aeena?oaoe?th aeeeaaeaii ia 152
noi??ieao ae?oeiaaiiai oaenoo. ?iaioa neeaaea?oueny c anooio, iaeyaeo
e?oa?aoo?e, 3 ?icae?e?a aeanieo niinoa?aaeaiue, aiae?co oa iaaiai?aiiy
io?eiaieo ?acoeueoao?a, aeniiae?a, i?aeoe/ieo ?aeiiaiaeaoe?e, nieneo
aeei?enoaieo e?oa?aoo?ieo aeaea?ae, yeee i?noeoue 218 aeaea?ae, c ieo
122 a?o/eciyieo ? 96 caei?aeiiieo, ye? caeiathoue 21 noi??ieo, ?iaioo
?ethno?iaaii 67 oaaeeoeyie ? 7 ?enoieaie, ye? caeiathoue 6 noi??iie.

CI?NO ?IAIOE

Iaoa??aee ? iaoiaee ianoaaeaiiy

Aeey ae??oaiiy iinoaaeaieo caaaeaiue ni?anoaaeaii ?acoeueoaoe
ee?i?ei-a?io?i?/iiai, ?ioiieia?/iiai oa ?ino?oiaioaeueiiai ianoaaeaiiy
114 aeiiioaieo iiaiia?iaeaeaieo ae?oae a?eii a?ae a aei 28 aei?a aeeooy,
ye? e?eoaaeenue o a?aeae?e? iaoieia?? iiaiia?iaeaeaieo ae?oae iaeanii?
ee?i?/ii? e?ea?i? I.?aaii-O?aie?anueea. C ieo o 73 iaethe?a
ae?aaiinoiaaii ia?eiaoaeueio aioeaoaeiiao?th, o 41 — iiaaiii?th ia oe?
a?iiene/ii-?oai?/ii? aioeaoaeiiao??. A?oio ii??aiyiiy neeaee 15
caei?iaeo aeiiioaieo iiaiia?iaeaeaieo, o yeeo ia?eiaoaeueiee ia??iae
i?io?eaa aac oneeaaeiaiue.

I?e ioe?ioe? noaio iaiiaeyo aeei?enoai? aeai? aeooa?nueeiai aiaiiaco
iaoiaeii aiae?co iaaee/ii? aeieoiaioaoe?? (ea?oe ?icaeoeo
iiaiia?iaeaeaiiai a iieiaiaiio aoaeeieo, aeienee c ?noi???
noaoe?iia?iiai oai?iai).

An?i ae?oyi i?iaaaeaia eiiieaenia ee?i?/ia ianoaaeaiiy. I?iaiaeeeanue
aeeiai?/ia ioe?iea iaa?ieia?/iiai ? niiaoe/iiai noaio. Oa?aeoa?enoeea
iaa?ieia?/iiai noaoono aeeth/aea ioe?ieo iice iiaiia?iaeaeaiiai,
i’yciaiai oiiono, a?iaeaeaieo ?aoeaen?a, iiaaae?iee, neooiaeo ? ?ooiaeo
?aaeoe?e. Nooi?iue oyaeeino? o?aaeaiiy aieiaiiai iiceo aecia/aee o
a?aeiia?aeiino? ? eeaneo?eaoe??th TH.A-sseoi?ia oa A.?-ssiiieuenueei?
(1979).

An? ae?oe iaeyioo? niaoe?ae?noaie, niinoa??aaeenue iooaeueiieiaii ?
iaa?iiaoieiaii.

I?iaiaeeeanue aeaeo?iea?ae?ia?ao?y ia aia?ao? «Ceaeo?iea?aeeia?ao CE
1O-ICI» a o?ueio noaiaea?oieo oa a?oaeieo a?aeaaaeaiiyo, a oaeiae
oeueo?acaoeiaa neaioaaiiy aieiaiiai iiceo ? na?oey ia aia?ao? «A?ina 880
— 630» aeao/eeaie naeoi?iiai neaioaaiiy 5,0 ? 7,5iAoe. 43 ae?oyi
i?iaaaeaii ?aioaaiieia?/ia ianoaaeaiiy.

Ia 2-3 ? ia 9-10 aeaiue i?ney iinooieaiiy aei noaoe?iia?o i?iaiaeeeinue
eaai?aoi?ia ianoaaeaiiy, ni?yiiaaia ia ooi/iaiiy oa?iaioaoeaiiai oa
?ioiiiai noaoono i?aai?cio aeeoeie ? aecia/aiiy o ne?iaaooe? e?ia? ??aiy
na?aaei?o iieaeoe.

Aeoeai?noue e?aaoeie?iace (EE) ? eaeoaoaeaa?ae?iaaiace (EAeA) aecia/aee
ia a?io?i?/iiio aiae?caoi?? «8?a1 ?ao 1904 ??ec» c aeiiiiiaith
oano-nenoai ? iaoiaeeee o??ie (NOA).

Eiioeaio?aoe?y ne?iaaoeiaeo ?ioiiaeiaoe?i?a eean?a I, I ? A aecia/aeanue
iaoiaeii ?aae?aeueii? ?ioiiaeeooc?? (Iain?i? I., 1965). Iieacieee
ee?oeiii? eaiee ?ioi?oaoo aecia/aeenue iaeii/aniei aeyaeaiiyi
A-?icaoeiooai?thth/eo (A-?OE), iaaaioaaeaieo eiiieaiaioii
A-?icaoeiooai?thth/eo ee?oei (AAN-?OE) oa ioeaaeo ee?oei (Iaia?ay E?.,
1974), a oaeiae oaio?e?i/ooeeaeo (OO*-?OE) oa oaio?e?i?ace-noaioieo — A
— ?icaoeiooai?thth/eo e?ioioeeo?a (OO?-?OE).

??aaiue na?aaei?o iieaeoe (?NI) aecia/aiee niaeo?ioioiiao?e/iei
iaoiaeii. Nooiai? oyaeeino? aiaeioieneeico aeyaeyeenue ca
cai?iiiiiaaiith A.A.I?oaeueniiii ? I-I.Iaaee?iaith (1991) noaiith.

A eiiieaeniiio e?eoaaii? iiaiia?iaeaeaieo ae?oae c iiaaiii??th ia oe?
a?ii-ene/ii-?oai?/ii? aioeaoaeiiao?? (A?A) ? c ia?eiaoaeueiith
aioeaoaeiiao??th canoiniaaii eiiiiceo iaoaaie?/ieo ei?aeoi??a: e?ii?aa
eeneioa ? a?oai?ie Aa, Aa. Aeaia eiia?ioaaiiy iaoaaie?/ieo ei?aeoi??a
cai?iiiiiaaia A?aoiooaeiii A.?. (1987) ia i?aenoaa? oe?eani?yiiaaieo
aenia?eiaio?a. Aeei?enoaii ii?aeiaia aei i’yciaa aaaaeaiiy 0,5% ?ic/eio
e?ii?ai? eeneioe a aeic? 1o§/e?7aeiao ia i?ioyc? 15 aei?a c ii/a?aiaei
aaaaeaiiyi /a?ac aeaiue 1% ?ic/eio ?eaioeaa?i-iiiiioeeaioeaeo a aeiaia?e
aeic? 8 oa/aeiao ? i??eaeienaeueoinoaoo a aeic? 50 o§/aeiao.

A caeaaeiino? a?ae iaoiaeo oa?ai?? ae?oe iiae?eai? ia 4 iaeii??aei? ca
iniiaiei ae?aaiicii, oyaee?noth noaio ? ianith o?ea a?oie. Aei ia?oi?
(19 iaethe?a) ? ae?oai? (27 ae?oae) a?oie aa?eoee ae?oe c iiaaiii??th ia
oii? A?A. O?aoth (27 iiaiia?iaeaeaieo) ? /aoaa?oo (14 iaiiaeyo) neeaee
ae?oe c A?A aac iiaaiii??.

Iaiiaeyoai 1-i? ? ???-i? a?oi aei eiiieaeno e?eoaaiiy aeeth/ai?
i?aia?aoe iaoaaie?/ii? ae??. Ae?oe I-i? ? ?O-i? a?oi i?ioiaeeee eo?n
noaiaea?oiiai e?eoaaiiy. Aoaeoeai?noue oa?ai?? ioe?ithaaeanue ca
aeeiai?eith ee?i?/ieo, a?io?i?/ieo oa ?ioiieia?/ieo iieaciee?a

Noaoenoe/ia ia?iaea i?iaaaeaia iaoiaeii aa??aoe?eii? noaoenoeee c
aeei?enoaiiyi e?eoa??th Nouethaeaioa

Iniiai? ?acoeueoaoe aeine?aeaeaiue oa ?o iaaiai?aiiy

I?iaaaeai? aeine?aeaeaiiy aeyaeee, ui a?eueo?noue ae?oae ia?iaeeeenue o
iaoa??a iioeiaeueiiai aeey ?ai?iaeoeoe?? a?eo — 22-24 ?iee. A?eueoa
iieiaeie iaiiaeyo (54,4%) ia?iaeeeenue a?ae ia?oi? aaa?oiino? ? iieia?a,
iaeaea o?aoeia (30,7%) — a?ae ae?oaeo iieia?a, a?ae o?ao?o iieia?a ?
a?eueoa ia?iaeeeenue 14,8% ae?oae.

Na?aae oaeoi??a ia?eiaoaeueiiai ?eceeo a?iien?? o ieiae?a ?
iiaiia?iaeaeaieo ae?oae o 63,2% aeiaaee?a aeyaeaia aiai?y aaa?oiino?, o
42,9% — aanoice, o 21,1% — ae-no?aaai?oaeueia iaoieia?y o iaoa??. O
a?eueoino? aeiaaee?a (67,9%) a?aei?/aia ii?aeiaiiy aioa- oa
?io?aiaoaeueieo oaeoi??a ?eceeo a?iien??. I?ae /an iieia?a o 42,1%
aeiaaee?a niinoa??aaeanue ano?en?y ieiaea, o 37,4% neaa?noue iieiaiai?
ae?yeueiino? ?c canoinoaaiiyi ?iaeinoeioeyoe??, o 20,2% — no??ie?
iieiae, o 21,0% — o?eaaeee (a?eueoa 6 aiae.) aacaiaeiee ia??iae. O 54,8%
niinoa?aaeaiue aeyaeai? 3 ? a?eueoa oaeoi??a ?eceeo. Ii??aiyiiy oaeoi??a
ia?eiaoaeueiiai ?eceeo o iaethe?a c iiaaiii??th ia oe? A?A ? c A?A
aeyaeei, ui o iaiiaeyo c iiaaiii??th /ano?oa niinoa??aaeenue ano?en?y a
iieiaao (51,2% i?ioe 36,9% o ae?oae c A?A), ani??aoe?eiee neiae?ii ?
neiae?ii aeeoaeueieo ?iceaae?a (34,1% i?ioe 9,6%), i?iaaaeaiiy
?ioaineaii? oa?ai?? a ?iaecae? ?c canoinoaaiiyi OAE (21,9% i?ioe 19,4%).

Ia i?e?iaeiiio aiaeoaaii? ciaoiaeeeenue 84,2% iaethe?a, 7,9% — ia
ci?oaiiio, 7,1% — ia ooo/iiio. A noaoe?iia? 24 aeeoeie iinooieee c?
noaiii na?aaeiuei? oyaeeino?, 62-c oyaeeei, 28 — ?c ae?ae oyaeeei
noaiii.

Oa?aeoa?iith iciaeith iinoiaoaeueii? aaeaioaoe?? iiaiia?iaeaeaii?
aeeoeie neoaeeoue aeeiai?ea iane o?ea. I?e aiae?c? io?eiaieo
?acoeueoao?a aeyaeeinue, ui a na?aaeiueiio iana o?ea o iiaiia?iaeaeaieo
noaiiaeea 3403,a±30,9a, ui a?aeiia?aea? na?aae-iueinoaoenoe/iei
iieacieeai ? ? iioeiaeueiith aeey iiaeaeueoiai ?icaeoeo.

Oyaee?noue noaio i?e iinooieaii? nooo?ai aieeaaea ia a?aenioie ao?aoe
iane o?ea, yeee o iaiiaeyo c? noaiii na?aaeiuei? oyaeeino? neeaaeaa
7,6±0,3%, a?aeiia?aeii o ae?oae c oyaeeei ? ae?ae oyaeeei noaiii —
10,2+0,7% oa 12,7±1,6%. I?e iinooieaii? ia a?aei?/aii ?icoiaeaeaiue o
nooiaiyo ao?aoe iane o?ea o iaiiaeyo c iiaaiii??th ia oe? A?A ? o
iiaiia?iaeaeaieo c A?A (a?aeiia?aeii 10,7±1,3% ? 9,4+0,8%). Aea
a?aeiiaeaiiy iane o?ea o ae?oae c iiaaiii??th ia oe? A?A ianooiaei ia
aea? aeiae i?ci?oa, i?ae o ae?oae c A?A, ui iiaea na?ae/eoe i?i a?eueo
aeeaie? c?ooaiiy iaoaaie?/ieo i?ioean?a, cie?aia ieanoe/ieo, oa
aeao?oeeo iae?ia?a?a.

O a?eueo ye iieiaeie iiaiia?iaeaeaieo (55,3%) a iieiaiaiio aoaeeieo
cao?eniaaii neiae?ii i?eai?/aiiy OeIN. I?e iinooieaii? aei noaoe?iia?o
ae?oaiai aoaio aeoiaeaeoaaiiy /anoea oeueiai neiae?iio ciaioeeanue aei
41,6%, ui ?icoe?iaii iaie ca ni?eyoeeao ianoaaeio. A i?ciueiio
iaiiaoaeueiiio ia??iae? aeaui ca?eueoeeanue /anoea neiae?iio
iae?i-?aoeaeoi?ii? caoaeeeaino? (32,9% i?ioe 28,1%), caoa ciaioeeanue
aeiey a?ia?oaic?eii-a?ae?ioeaoaeueiiai neiae?iio (3,5% i?ioe 7,0%).

I?e ii??aiyii? no?oeoo?e iaa?ieia?/ieo neiae?ii?a o ae?oae c iiaaiii??th
ia oe? A?A ? o ae?oae c A?A aeyaeaii, ui o iaiiaeyo c iiaaiii??th ia oe?
A?A /ano?oa cono??/a?oueny neiae?ii i?eai?/aiiy OeIN (53,7% i?ioe
34,2%). Ia aeeeth/aii, ui i?e iiaaiii?? ia oe? A?A a?eueoeie ? nooi?iue
a?iien??, ?iceaaee aioo??ee?oeiiiai iaoaaie?cio ? a?eueo ae?aaeaiee
aiaeioieneeic, ? oea i?eaiaeeoue aei iineeaiiy iaa?ieia?/ii?
neiioiiaoeee.

A oe?eiio cia/ii? ??cieoe? a ci?iao i’yciaiai oiiono oa oiiaieo
?aoeaen?a o ae?oae c iiaaiii??th ia oe? A?A ? o iaethe?a c A?A ia
a?aei?/aii.

O 12,5% iaiiaeyo c i?iyaaie iiaaiii?? niinoa??aaeinue i?aeaeuaiiy
oaiia?aoo?e o?ea, o 70,7% — cieaeaiiy aiaoeoo. O 41,5% aeiaaee?a
cao?eniaaia coieiea a iaae?aii? iane o?ea. O 64,8% aeyaeai? ii?ooaiiy
nio, o 65,9% — caeoooy aeeaioa, o 56,1% — aethaioa ? c?eaoaaiiy.. Cia/ia
/anoeia iiaiia?iaeaeaieo c iiaaiii??th iinooieea c iciaeaie ii?ooaiiy
i?e?ioee?eoeyoe??. A 60,9% iaethe?a aoea iayaia ae?ae?noue oe??ieo
iie?ea?a ?c n??oaaoei a?aeo?ieii, 78,2% — iaee iineeaiee noaeeiiee
?enoiie, o 95,1% iaiiaeyo aeyaeaii ia?ei?aeueiee oa ae?ioe?aiic.
A?eueo?noue c iaaaaeaieo neiioii?a a ia??iae? iiaiia?iaeaeaiino? iiaea
aeieeaoe ? i?e iiaaiii??, ? i?e A?A.

Caiaaeaiiy iiaeaoeeaeo i?noeue a?oaeii? ee?oee aeyaeaia o 87,8% ae?oae,
neiioii ai/eiiiae?aii? a?oaeii? ee?oee iaa i?noea o 17,1% ae?oae c
iiaaiii??th ia oe? A?A.

O 19,5% iaiiaeyo c iiaaiii??th ia oe? A?A i?e ia?eon?? niinoa??aaeinue
aei?a/aiiy ia?eooiaaiiai caoeo, o 39,0% — oeiiai?o c aei?i/aiei
a?aeo?ieii, o 41,5% ae?oae — ei?iaeiaee caoe. Aoneoeueoaoeaii o 68,3%
iaethe?a aeyaeaii ineaaeaia, o o?aoeie — 31,7% — aei?noea aeeoaiiy, o
46% i?ineooiaoaaeanue e?ai?oaoe?y, o 65,9% iaiiaeyo — aieia? eieaeuei?
ae??aiii?oo?oeaa? o?eie.

Iaaaaeaia na?ae/eoue, ui o iiaiia?iaeaeaieo ae?oae i?e iiaaiii?? ia oe?
IA o?-ceeaeuei? aeai? ? a?aeieie ? iaaeinoaoiuei ?ioi?iaoeaieie. Ia
ia?oee ieai aenooia? iaa?ieia?/ia neiioiiaoeea ? ?iceaaee
i?e?ioee?eoeyoe??. Oea aeiaaa? aecia/aiiy a?eueo /?oeeo e?eoa???a
ae?aaiinoeee.

Na?aae oneeaaeiaiue iiaaiii?? caa?oa? oaaao, ui o iaeaea iieiaeie ae?oae
(51,2%) cao?eniaaii aeeoaeueio iaaeinoaoi?noue ??-iai nooiaiy, a?eueo ye
o o?aoeie (34,2%) — ea?ae?i-?ani??aoi?iee neiae?ii oa ?ioaeoe?eiee
oieneeic ? nooiaiy — o 36,6%. Ia oneeaaeiaia oi?ia iiaaiii?? a?aei?/aia
o 21,9% aeiaaee?a.

?aioaaiieia?/ia ianoaaeaiiy aeyaeei iciaee iaeiia?/ii? aiaieuaai?
a?iioiiiaaiii?? o 32 (78,0%), aeaia?/ii? aiaieuaai? a?iioiiiaaiii?? — o
6 (14,6%), ?i-oa?noeoe?aeueii?» iiaaiii?? — o 3 (7,3%) iaiiaeyo.

I?iaaaeaia aoieieaoe?y na?oey o 4-o ae?oae c iiaaiii??th ia oe? A?A
cana?ae/eea a?aee?eooy iaaeueiiai ioai?o. A iaei??? aeeoeie aei 10-ai
aeiy ia?aaoaaiiy a noaoe?iia?? a?aeaoeinue cae?eooy iaaeueiiai a?eia
A?aee?eoa iaaeueia a?eii iiaeia ?icoe?ithaaoe ye ia?nenoaioe?th
oaoaeueii? eiioi?eaoe?? o a?aeiia?aeue ia a?iien?th O an?o 4-o iaiiaeyo
a aiaiiac? a?aei?/aia ano?en?y a iieiaao, o 2-o — ?ani??aoi?iee
aeeno?an-neiae?ii.

Aeaeo?iea?ae?ia?ao?/ia ianoaaeaiiy aeyaeei iciaee a?iien?? i?iea?aeo o 7
iaethe?a, c ieo o?i? — c iiaaiii??th ia oe? A?A.

I?e i?iaaaeaii? iooaeueiineii?? ia 2-3 aeaiue ia?aaoaaiiy a noaoe?iia??
o 42 iiaiia?iaeaeaieo (36,8%) aeyaeaii aia?iiao?th, o o?ueio (2,6%
ae?oae) niinoa??aaeenue e?iaiaeeeae a n?oe?aeo.

I?e aiae?c? iieaciee?a aaiia?aie o iiaiia?iaeaeaieo c A?A ii??aiyii c
ae?oueie c iiaaiii??th ia oe? A?A aeyaeaiee a?eueoee a?aenioie
e?ioioeeo?a (53,6% i?ioe 42,8%). A eaeeia?ai? ae?oae c iiaaiii??th ia
oe? A?A a?aei?/aia iaeaea iaeiaeiaa e?euee?noue iaeo?io?e?a ?
e?ioioeeo?a, o ae?oae c A?A iaa i?noea e?ioioeeoic.

??aaiue caaaeueiiai a?eeo a e?ia? ae?oae c iiaaiii??th ia oe? A?A ? o
iiaiia?iaeaeaieo c IA aoa a iaaeao ii?ie, aea o an?o ae?oae a?aei?/aia
oaiaeaioe?y aei cieaeaiiy aeiaoe?iiai? o?aeoe??.

O 19 ae?oae (14 iaiiaeyo c A?A ? 5 — c iiaaiii??th ia oe? A?A)
cao?eniaaia iai?yia a?ia?a?e??oa?iai?y na?aaeiueiai nooiaiy.

Nooi?iue aiaeioieneeico aecia/aee ii ??aith na?aaei?o iieaeoe a
ne?iaaooe? e?ia? Anoaiiaeaii, ui o ae?oae c iiaaiii??th ia oe? A?A
??aaiue na?aaei?o iieaeoe o e?ia? aoa a 2,3 ?ace aeuei, i?ae o iaiiaeyo
c A?A.

O 34,2% iaiiaeyo c A?A aiaeioieneeic aoa a?aenooi?i, o 65,8% iaethe?a
cao?eniaaii aiaeioieneeic ? nooiaiy.

Aiaeioieneeic ??cieo nooiai?a oyaeeino? niinoa??aaany o an?o ae?oae c
iiaaiii??th ia oe? A?A. I?e/iio o 75,6% aeiaaee?a oea aoa aiaeioieneeic
??-??? nooiai?a, ui na?ae/eoue i?i i?e?aeiaiiy o ieo aiaeioieneeico
?ioaeoe?eiiai aaiaco (?enoiie 1).

Iayai?noue neiae?iio aiaeiaaiii? ?ioieneeaoe?? ? nooiaiy o iaethe?a c IA
iiaeiia aeeeeeaoe iniaeeao oaaao, ine?eueee oae? ae?oe, aiane?aeie
ineaaeaiiy nenoai naii?aaoeyoe??, caa?iceea? ii iiaeeeaino? i?e?aeiaiiy
aei iniiaiiai iaoieia?/iiai i?ioeano ai?eii-caiaeueieo oneeaaeiaiue.

Ca ?acoeueoaoaie iaoiai aeine?aeaeaiiy i?i i?e?aeiaiiy aei A?A caiaeaiiy
eaaaiue na?ae/eoue iiyaa aiaeioieneeico ??-??? nooiai?a.

O an?o ianoaaeaieo ae?oae aeyaeaii cieaeaiiy ai?noo ?ioiiaeiaoe?io I a
ne?iaaooe? e?ia?. Ii??aiyiiy iieaciee?a eiioeaio?aoe?? ?ioiiaeiaoe?i?a o
ae?oae c A?A ? c iiaaiii??th ia oe? A?A ia aeyaeei noaoenoe/ia cia/eieo
a?aei?iiinoae. I?e/eiith cieaeaiiy ai?noo ?@ I i/aaeaeii ? a?iien?y,
aeeeeeaia iath ?oeiaoe?y oeaiei ? iineeaia anei?eyoe?y ?§ I.

Aiae?c iieaciee?a ee?oeiiiai ?ioi?oaoo o an?o ianoaaeaieo iaiiaeyo
aeyaea cieaeaiiy /anoee iiioeyoe?? A-?OE ? AAN-?OE ? c?inoaiiy a?aenioeo
ioeaaeo ee?oei. A?aei?/aii aeenaaeain i?ae oaio?e?i/ooeeaeie ?
oaio?e?i?acenoaioieie O-e?ioioeeoaie c? cieaeaiiyi iieacieea
ni?aa?aeiioaiiy OO?-?OE / OO*-?OE o iaethe?a c iiaaiii??th ia oe? A?A —
aei 1,63%, o ae?oae c A?A aei — 1,44%. *anoea A-?OE o ae?oae c
iiaaiii??th ia oe? A?A noaiiaeea 36,5±2,4% i?ioe 43,5±2,5% o iaiiaeyo c
A?A (?<0,05), AAN-?OE a?aeiia?aeii 15,6±1,9% i?ioe 18,26±2,1% (?>0,05) ?
ioeaaeo ee?oei — 38,1±1,1% o ae?oae c iiaaiii??th i?ioe 31,4±2,5% o
iaethe?a c IA (?<0,05). C iaaaaeaieo aeaieo aeieeaa?, ui o iaiiaeyo c iiaaiii??th ia oe? A?A ? ieae/ith aeiey A-?OE - e?ioioeeo?a ? aeuith - /anoea ioeaaeo ee?oei. I?iaaaeaia iaie aiceiiae?aaiinoeea aeyaeea i?aeaeuaiiy aeoeaiino? ne?iaaoeiaeo e?aaoeie?iace ? eaeoaoaeaa?ae?iaaiace ? a a?oi? ae?oae c A?A, ? o ae?oae c iiaaiii??th ia oe? A?A. Aeoeai?noue EE o ae?oae c iiaaiii??th ia oe? A?A i?aeaeueeanue aei 89,6±3,2iea1/e (i?e aeoeaiino? 20,9+2,3ie:a1/e o caei?iaeo iaiiaeyo), o iaethe?a c A?A - aei 57,7±3,8iea1/e. Aeoeai?noue EAeA o ae?oae c iiaaiii??th ia oe? A?A i?aeaeueeanue aei 163,6±1,9iea1/e i?ioe 47,3±3,9iea1/e o caei?iaeo iaiiaeyo, a o iaeyo c A?A aeoeai?noue ieaciaoe/ii? EAeA aoea iaioith ? aei??aithaaea 115,7±4,2iea1/e. A?aeiii, ui ci?ie iaoaaie?cio a i?aai?ci? ? iaeiiiai?aaeaieie o an?o oeaieiao, a a?ia?oa?iaioai?y ? iaae?eiei e?eoa???i noaio aia?aaoe/iiai iai?io ? ooeiaeaeaiiy ee?oeiii? iaia?aie. Aeai? iaoeo aeine?aeaeaiue cana?ae/eee i?aeaeuaiiy aeoeaiino? EE o ae?oae c iiaaiii??th ia oe? A?A a 4,3 ?ace, o iiaiia?iaeaeaieo c A?A - a 2,8 ?ace, aeoeaiino? EAeA - a?aeiia?aeii a 3,5 ?ace, ? a 2,4 ?ace a?aeiinii iieaciee?a caei?iaeo iaiiaeyo. Oaeei /eiii, ??aaiue oa?iaioai?? o ae?oae c iiaaiii??th ia oe? A?A aoa aeinoia??ii aeuei, i?ae o ae?oae c A?A. Ca iaoeie aeaieie, ? o ae?oae c iiaaiii??th ia oe? AAA, ? a iaiiaeyo c A?A aeoeai?noue aicei?a c?inoaea ?c c?inoaiiyi oyaeeino? noaio aeeoeie (?<0,05). O iaethe?a c iiaaiii??th ia oe? A?A aeoeai?noue EE ? EAeA i?e na?aaeiueiio nooiai? oyaeeino? aeeoeie noaiiaeea 78,4±1,1iea?/I ? 148,6±3,IieaOe, i?e oyaeeiio a?aeiia?aeii 85,1±1,3iea1/e ? 154,3±2,8iea1/e, i?e ae?ae oyaeeiio - 96,5±3,7ieaOe ? 167,5±2,7iea1/e. O iaiiaeyo c IA c? noaiii na?aaeiuei? oyaeeino? EE ? EAeA aoee a?aeiia?aeii 49,7±3,0iea1/e ? 98,3±2,1ieaOe, c oyaeeei noaiii - 53,9±1,8 iea?/e, c ae?ae oyaeeei -58,5±2,2i1aa/e ? 119,4±3,7iea1/e. Oaeei /eiii, ca ?acoeueoaoaie iaoeo aeine?aeaeaiue, aaee/eia aeoeaiino? e?aa-oeie?iace ? eaeoaoaeaa?ae?iaaiace iiaea neoaeeoe /ooeeaei oanoii oyaeeino? iinoa?-iiene/ieo ci?i a i?aai?ci?. Aeyaeai? ci?ie aeoeaiino? EE ? EAeA, ??aiy na?aaei?o iieaeoe a ne?iaaooe? e?ia?, aoii?aeueii? ? ee?oeiii? eaiie ?ioi?oaoo o iiaiia?iaeaeaieo iaiiaeyo c iiaaiii??th ia oe? IA ? c IA, ia iaoo aeoieo, ? i?iyaii caaaeueieo ianiaoeeo?/ieo aaeaioeaieo ?aaeoe?e o a?aeiia?aeue ia a?iiene/ia iiae?aciaiiy. A?aei?/ai? o iaiiaeyo c iiaaiii??th ia oe? IA iciaee ?ioiiaeai?an?? (cieaeaiiy ai?noo ne?iaaoeiaiai ?§0, ciaioaiiy /anoee A-?OE ? AAN-?OE e?ioioeeo?a, aeenaaeain i?ae OO*-?OE ? OO?-?OE e?ioioeeoaie) iaaiaeyoue ia aeoieo i?i aoi?eiiee oa?aeoa? iiaaiii??. Oaeeo ci?i ca aeaieie Ocoiiai? A.I. c? ni?aaaoi?aie (1996) i?e ia?aeiieo iiaaiii?yo ia a?aei?/aii. Aoi?eii?noue iiaaiii?? ia oe? iinoa?iiene/iiai o?aaeaiiy aeiaaa? ie?aii? e?eoaaeueii? oaeoeee. E?ea?aeaoe?y i?e/ei, a naia - iane?aee?a a?iien??, ye? ni?iaieoaaee ?icaeoie aoi?eiii? iiaaiii??, iiaea ni?eyoe a?eueo oaeaeoiio iaeoaeaiith. O a?aeiia?aeue ia a?iien?th a i?aai?ci? aeoea?cothoueny eiiiainaoi?i? iaoai?cie aaeaioaoe?? ee?oeie. Iaeiei c oaeeo iaoai?ci?a ? iioei?caoe?y o?ainai?iaciiai oeeeeo ieeneaiiy noano?ao?a, oiio canoinoaaiiy e?i?ooth/eo iaoaaie?o?a o?ainai?iaciiai oeeeeo, yeeie ? e?ii?aa eeneioa, a?oai?ie Aa ? A<„ iiaea i?aeaeuoaaoe aoaeo i?ioe-a?iiene/ii? oa?ai??. Ia'?eoeaio ioe?ieo ?ioaineaiino? iai?iieo i?ioean?a o iiaiia?iaeaeaieo iaiiaeyo aeaiiino?o? na?aaeiueiaeiaiaee i?e??no iane o?ea. O ae?oae c iiaaiii??th ia oe? IA, eio?? io?eioaaee aei noaiaea?oii? oa?ai?? e?ii?ao eeneioo, a?oai?ie Aae ? Aa, a?i aeinya ??aiy 18,7±2,0a, oiae?, ye o ae?oae ?c o?aaeeoe?eiei e?eoaaiiyi - 13,5±1,2a (?<0,05). O iaethe?a c ia?eiaoaeueiith aioeaoaeiiao??th ia oe? i?ioaeoi?ii? oa?ai?? na?aaeiueiaeiaiaee i?e??no iane o?ea oaeiae aoa a?eueoee, i?ae o iiaiia?iaeaeaieo, ye? io?eioaaee aacenia e?eoaaiiy, a?aeiia?aeii - 24,7±0,8a i?ioe 16,3±1,2a. O iiaiia?iaeaeaieo, ye? io?eioaaee 'eiiiiceo iaoaaie?/ieo ei?aeoi??a, oaeaeoa ii?iae?coaaeenue o ii??aiyii? c ae?oueie c? noaiaea?oiith oa?ai??th nii ? aiaoeo (ia 2 aeiae ?ai?oa), cieeaee aeeniaioe/i? yaeua (ia 4 aeiae oaeaeoa), ?iceaaee i?e?ioee?eoeyoe?? (ia 3 aeiae ?ai?oa), iaoieia?/i? aoneoeueoaoeai? oaiiiaie (ia 2 aeiae ?ai?oa). Ia oii? iaoaaie?/ii? ei?aeoe?? o iaethe?a c iiaaiii??th ia oe? IA oaeaeoa ianooiaei ee?i?/ia iie?auaiiy (ia 7,3 aeiae i?ioe 4,8 aeiae o iaiiaeyo c aaceniith oa?ai??th) ? noaa?e?caoe?y niiaoe/iiai noaoono (a?aeiia?aeii 11,2 aeiae i?ioe 6,4 aeiae). O ae?oae 1-i? a?oie c iiaaiii??th ia oe? ia?eiaoaeueii? aioeaoaeiiao?? i?ae aieeaii i?ioaeoi?ii? oa?ai?? ia 6 aei?a oaeaeoa a?aeiiaethaaany ?aoeaen ?ia?iniia, ia 3 aei? - ?aoeaen Ii?i ? ?aoeaene iii?e oa aaoiiaoe/ii? oiaee, i?ae o ae?oae ?c o?aaeeoe?eiei iaoiaeii e?eoaaiiy. Aea o iaiiaeyo c a?iiene/ii-?oai?/iith aioeaoaeiiao??th iaie ia a?aei?/aii aeinoia??ii? ??cieoe? o a?aeiiaeaii? aacoiiaieo ?aoeaen?a a caeaaeiino? a?ae iaoiae?a e?eoaaiiy. Oea aeicaiey? i?eionoeoe, ui aoaeoeai?noue iaoaaie?/ieo ei?aeoi??a o a?aeiiaeaii? a?iaeaeaieo ?aoeaen?a o iiaiia?iaeaeaieo c iiaaiii??th ia oe? IA iieyaa? a oaeaeeiio onoiaii? aiaeioieneeico, yeee o oeeo ae?oae iiaeeaethaaa iaa?ieia?/i? ci?ie. Ia 9-TH aeaiue ia?aaoaaiiy a noaoe?iia?? o an?o ianoaaeaieo iaiiaeyo ??aaiue na?aaei?o iieaeoe a e?ia? cieceany aei a?aieoeue ii?ie, o iiaiia?iaeaeaieo c A?A - aei 0,232±0,1oi.iae., o ae?oae c iiaaiii??th ia oe? A?A - aei 0,258±0,1oi.iae. Noaoenoe/ia cia/eii? ??cieoe? ?NI a e?ia? o iaiiaeyo a caeaaeiino? a?ae iaoiaeo e?eoaaiiy i?ae a?oiaie iaie ia a?aei?/aii. O 94,5% ae?oae c A?A ? o 90,2% iaiiaeyo c iiaaiii??th ia oe? A?A ia 10 aeaiue ia?aaoaaiiy a noaoe?iia?? i?e i?iaaaeai? iiaoi?ieo caaaeueieo aiae?c?a e?ia? aeyaeaii i?aeaeuaiiy a?aenioeo e?ioioeeo?a ? cieaeaiiy iiiioeeo?a. Iae?iniiia?ao?/ia ianoaaeaiiy /a?ac 10 aei?a e?eoaaiiy cana?ae/eei ciaioaiiy /anoee ae?oae c iineeaiith ioeuenaoe??th (73,8% i?ioe 98,3%) O 34,2% iaiiaeyo aeyaeai? eenoe noaeeiieo nieao?iue, a i?e iinooieaii? aei noaoe?iia?o eenoe aeyaeeenue o?eueee o 21,1% ae?oae, ui iiaeia ?icoe?ieoe ye aeaeeio iciaeo i?aai?caoe?? e?iaiaeeea?a o noaeeii? nieao?iiy. A iaei??? aeeoeie c a?ia?oaic?eii-a?ae?ioeaoaeueiei neiae?iiii ii?iae?coaaeenue ?ici??e oeoii/e?a, o ?aooe aeaio noaa?e?coaaeanue aaio??eoeiiaaae?y. A?aei?noue iiceoeaieo ci?i ca ea?oeiith iae?i-niiia?ao?? e aiae?co aacoiiaii? ae?yeueiino? o iaethe?a c A?A ia oe? e?eoaaiiy iiynith?oueny ia iaoo aeoieo oei, ui OeIN ? noaa?eueiith a oeeoie?iaoe/iiio a?aeiioaii? nenoaiith c? niia?eueiaieie i?ioeanaie ?aaaia?aoe?? A caaaeueiiio, ca iaoeie niinoa?aaeaiiyie, ee?i?/ii o?eniaaia iie?auaiiy ? noaa?e?caoe?y iaa?ieia?/iiai noaoono o iaiiaeyo c A?A ianooia? ia oe? i?ioaeoi?ii? oa?ai?? ia 2,5 aeiae oaeaeoa. O iaethe?a c iiaaiii??th ia oii? A?A iie?auaiiy iaa?ieia?/iiai noaoono a ? a?oi? a?aei?/aii oaeaeoa ia 2 aeiae, noaa?e?caoe?th - ia 3,5 aeiae oaeaeoa, i?ae o I a?oi? c? noaiaea?oiith oa?ai??th. Canoinoaaiiy eiiieaeno i?ioaeoi?ii? oa?ai?? aeicaieeei nei?ioeoe oa?i?i ia?aaoaaiiy a noaoe?iia?? o ae?oae c IA ia aea? aeiae, o iaiiaeyo c iiaaiii??th ia oe? A?A - ia 5 ae?a. Iaie ia a?aei?/aii ?noioieo ci?i ??aiy ne?iaaoeiaeo ?ioiiaeiaoe?i?a an?o eean?a i?ae aieeaii iaoaaie?/ieo ei?aeoi??a o iaethe?a c iiaaiii??th ia oe? IA. O oie /an o ae?oae c IA niinoa??aaeinue c?inoaiiy eiioeaio?aoe?? ?§0 ne?iaaoee e?ia? a I? a?oi? ae?oae, oiaoi o oeo, ui io?eioaaee iaoaaie?/ia cei?aaiaaio oa?ai?th - 9,12±0,2a/e ia 10 aeaiue e?eoaaiiy i?ioe 6,0±0,4a/e i?e iinooieaii?. A?aenooi?noue ci?ie ai?noo ?§0 o ae?oae c iiaaiii??th ia oe? IA a aeeiai?oe? e?eoaaiiy iiaeia iiynieoe ?o ?ioaineaiei niiaeeaaiiyi aeey ?iaeoeaaoe?? aioeaaiieo iiae?aciee?a. Ca iaoeie aeaieie o iaethe?a c iiaaiii??th ? a ia?o?e, ? a ae?oa?e a?oi? nooo?ai ca?eueoeeenue /anoee A-?OE, AAN-?OE ? OO?-?OE, ciaioeeanue aeiey OO*-?OE ? ioeaaeo ee?oei. I?ae aieeaii i?ioaeoi?ii? oa?ai?? i?e ii??aiyii? iieaciee?a ee?oeiii? eaiee ?ioi?oaoo i?ae 1-ith ? ??-ith a?oiith a?aei?/ai? aeinoia??i? a?aei?iiino? i?ae iieacieeaie iiioeyoe?e A-?OE, AAN-?OE, ioeaaeo ee?oei ? ni?aa?aeiioaiiy OO?-?OE / OO*-?OE. A?aenioie A-?OE o ae?oae 1-i? a?oie i?aeiyany aei 51,4+2,4% i?ioe 46,7+2,9% o iaiiaeyo [1-i? a?oie, aiaeia?/ii /anoea AAN-?OE o ae?oae 1-i? a?oie neeaea 25,9±1,8% i?ioe 20,9±1,5%, a?aeiinia aaee/eia ioeaaeo ee?oei cieceeanue o ia?o?e a?oi? aei 16,2+2,2%, o ae?oa?e - aei 25,2+2,6%. Ni?aa?aeiioaiiy OO?-?OE / OO*-?OE a ia?o?e a?oi? neeaei - 4,4±0,2, a ??-e - 2,9±0,1 (?enoiie 2). A?aeiii, ui aei iiioeyoe?e A-?OE ? AAN-?OE i?e aeei?enoaii? oanoo ?icao-eiooai?aiiy iio?aieythoue, ye i?aaeei iaoaaie?/ia aeoeai? e?ioioeeoe ia a?aei?io a?ae ioeaaeo ee?oei. Noaiiioeyoe?y OO?-?OE e?ioioeeo?a ? iaea?eueo /ooeeaith aei aoaeue-yeeo no?ani?ieo aieea?a, a iniiaiiio ca ?o ?aooiie a?aeaoaa?oueny ci?ia ni?aa?aeiioaiiy i?ae OO?-?OE ? OO*-?OE, iieaciee yeiai oaeiae aieiae?? aenieith /ooeea?noth aei an?o ci?i a i?aai?ci? Eiai c?inoaiiy ?icoe?iaii iaie, ye ni?eyoeeaee neiioii aaeaioaaaeueiino? ?ioiii? nenoaie, oae ye ? c?inoaiiy a?aeiinieo aaee/ei A-?OE ? AAN-?OE Iaea?eueoa, ca ?acoeueoaoaie iaoeo niinoa?aaeaiue, c?inea oeeo?a ni?aa?aeiioaiiy OO?-?OE / OO*-?OE o iiaiia?iaeaeaieo c iiaaiii??th ia oe? A?A c oyaeeei ? na?aaeiueioyaeeei noaiii, a?aeiia?aeii 4,3±0,2 ? 4,7±0,2 i?ioe 2,4±0,1 o ae?oae c e?aei? oyaeeei noaiii O iaethe?a c A?A oaeiae a?aei?/aia c?inoaiiy i?ioeaioiiai ai?noo iiioeyoe?e A-?OE, OO?-?OE, OO*-?OE, oeeo?e ni?aa?aeiioaiiy OO?-?OE / OO*-?OE ? ciaioaiiy ioeaaeo ee?oei ? a III, ? a IV a?oiao O ae?oae c iaoaaie?/iith ei?aeoe??th a oa?ai?? o ii??aiyii? c ae?oueie c o?aaeeoe?eiei e?eoaaiiyi niinoa??aaeinue a?eueo ?noioia c?inoaiiy iiioeyoe?e A-?OE, OO?-?OE ? AAN-?OE (?enoiie 3) Ni?aa?aeiioaiiy OO?-?OE / OO*-?OE a a?oi? ae?oae c A?A ?c iaoaaie?/iith ei?aeoe??th aeinyaaei a i?ioean? e?eoaaiiy oeeo?e 6,7 i?ioe 5,4 o ae?oae c aaceniith oa?ai??th. Iniaeeai nooo?a? caaaeai? ci?ie aeyaeai? o ae?oae c A?A c? noaiii na?aaeiuei? oyaeeino?, i?ae aieeaii iaoaaie?/ieo ei?aeoi??a, o ieo aea cao?eniaaia iaeaeua ni?aa?aeiioaiiy OO?-?OE / OO*-?OE - 7,4. Ii??aiyiiy aieeao i?ioaeoi?ii? oa?ai?? o ae?oae c A?A ? o iaiiaeyo c iiaaiii??th ia oe? A?A ia iieacieee ee?oeiii? eaiee ?ioi?oaoo aeyaeei, ui a inoaii?o iai?aaeai?noue ci?i aoea ?aeaioe/iith, aea ae?aaeaia a iaio?e i??? (?enoiie 2 ? 3). I?ae aieeaii i?iaaaeaiiai e?eoaaiiy o an?o a?oiao ae?oae a?aei?/aia ii?iae?caoe?y iieaciee?a EE ? EAeA, aea a a?oi? iaiiaeyo c iaoaaie?/iith ei?aeoe??th oe? ci?ie ianooiathoue oaeaeoa. A ia?o?e a?oi? a i?ioean? e?eoaaiiy aeoeai?noue EE cieceeanue aei 15,2±1,6iea1/e i?ioe 19,4±2,1iea1/e, aeoeai?noue EAeA a?aeiia?aeii aei 4a,9±2,7iea1/e i?ioe 67,8±1,4iea1/e (?<0,05) o iaethe?a ??-i? a?oie. ?aeaioe/i? iieacieee cao?eniaai? ? o iiaiia?iaeaeaieo c A?A. A ???-e a?oi? i?e canoinoaaiiy i?aia?ao?a iaoaaie?/ii? ae?? aeoeai?noue EE noaiiaeea 11,4±1,2iea1/e i?ioe 21,4±2,1 iea?/e a AO-e a?oi? c aaceniith oa?ai??th. Aeoeai?noue EAeA a ???-e a?oi? aeinyaea oeeo?e 32,4±2,3i1na1/e i?ioe 58,2±2,5iea1/e (?<0,05). Ne?ae a?aei?oeoe, ui aeoeai?noue EAeA a II ? IV a?oi? iaiiaeyo c aaceniith oa?ai??th ia aeinyaea ??aiy caei?iaeo ae?oae, ia a?aei?io a?ae ae?oae, ye? io?eioaaee i?aia?aoe i?ioaeoi?ii? ae??. Ii??aiyiiy iieaciee?a aeoeaiino? aicei?a o ae?oae c iiaaiii??th ia oe? A?A ? o ae?oae c A?A aeyaeei, ui a inoaii?o cieaeaiiy aeoeaiino? EE ? EAeA a?aeaoaa?oueny ia oe? i?ioaeoi?ii? oa?ai?? ?ioaineai?oa. Ca ioe?ieith aeeiai?ee iieaciee?a oa?iaioaoeaiiai noaoono o ianoaaeaieo iaiiaeyo iiaeia c?iaeoe aeniiaie, ui o ae?oae c i?neya?iiene/ieie oneeaaeiaiiyie eiiieaenia iaoaaie?/ia ei?aeoe?y ni?ey? iiaeieaiith aia?aaoe/ii? aioo??ee?oeiii? e?ece oa ii?iae?caoe?? no?oeoo?ii-ooieoe?iiaeueiiai noaio ee?oeiieo iaia?ai. Canoinoaaiiy eiiiiceoo iaoaaie?/ieo ei?aeoi??a o neeaae? e?ii?ai? eeneioe, a?oai?i?a Ac ? Aa aeoea?co? neioaoe/i? i?ioeane, ui ciaioo? eaoaaie?/io iai?aaeai?noue iai?io ?a/iaei i?e iaoieia??. Aeyaeai? ci?ie aeoeaiino? EE ? EAeA aeicaieythoue aeei?enoiaoaaoe ?o, c o?aooaaiiyi cia/eiino? oeeo oa?iaio?a a aia?aicaaacia/aii? i?aai?cio, ye e?eoa??e nooiaiy iinoa?iiene/iiai o?aaeaiiy i?aai?cio aeeoeie ? aoaeoeaiino? oa?ai?? ?c canoinoaaiiyi i?aia?ao?a iaoaaie?/ii? ae??. Cai?iiiiiaaia oa?ai?y o ae?oae c iiaaiii??th ia oe? A?A aeyaey? ianiaoeeo?/iee ?ioiiei?aaoth/ee aoaeo ia ee?oeiio oa aoii?aeueio eaiee ?ioi?oaoo, ii?iae?coth/e ooieoe?iioaaiiy aoaeoeaieo eaiie ?ioi?oaoo. I?ecia/aiiy i?aia?ao?a i?ioaeoi?ii? ae?? i?eaiaeeei aei a?eueo a??aiiaaaeaiiai ia?aa?ao i?ciuei? iinoiaoaeueii? aaeaioaoe??. O ae?oae c ia?eiaoaeueiith aioeaoaeiia-o??th oa A?A ? iiaaiii??th oaeaeoa ianooiaei iie?auaiiy ? noaa?e?caoe?y niiaoe/iiai oa iaa?ieia?/iiai noaoono, nei?ioeeenue oa?i?ie ia?aaoaaiiy a noaoe?iia??. Iia?/ieo aoaeo?a a?ae canoinoaaiiy iaoaaie?/ieo i?ioaeoi??a iaie ia a?aei?/aii. Oea aeicaiey? ?aeiiaiaeoaaoe ai?iaaaeaeaiiy eiiieaeno i?aia?ao?a iaoaaie?/ii? ae?? (e?-ii?ai? eeneioe, a?oai?i?a Aa ? Aa) a e?eoaaiiy iiaiia?iaeaeaieo ae?oae c A1A ? iiaaiii??th ia oe? A?A. AENIIAEE 1. O iiaiia?iaeaeaieo aeiiioaieo ae?oae c iiaaiii??th ia oe? a?iiene/ii-?oai?/ii? aioeaoaeiiao?? ? c a?iiene/ii-?oai?/iei iioeiaeaeaiiyi iiceo ia? i?noea ii?ooaiiy ee?i?/iiai ia?aa?ao i?ciuei? iinoiaoaeueii? aaeaioaoe?? o aeaeyae? o?io?/ieo ?iceaae?a, ci?i ?ooiaeo ? iiaaae?ieiaeo ?aaeoe?e, a?iaeaeaieo ?aoeaen?a, i'yciaiai oiiono. 2. Anoaiiaeaii i?eai?/aiiy aoii?aeueii? oa ee?oeiii? eaiee ?ioi?oaoo o aeaeyae? ciaioaiiy /anoee iiioeyoe?? A-?OE, OO?-?OE ? AAN-?OE - e?ioioeeo?a, cieaeaiiy eiioeaio?aoe?? ne?iaaoeiaeo ?ioiiaeiaoe?i?a eeano I. Ii?ooaiiy i?i-oe?ioaeoe?eiiai caoenoo i?aai?cio o iiaiia?iaeaeaieo ae?oae c a?iiene/ii - ?oai?/iith aioeaoaeiiao??th ? ni?eyoeeaith iniiaith aeey ?icaeoeo aoi?eiii? iiaaiii??. 3. O ae?oae c iiaaiii??th ia oe? a?iiene/ii-?oai?/ii? aioeaoaeiiao?? niinoa??aa?oueny a?eueo ae?aaeaiee noai aiaeioieneeico, i?ae o iaethe?a c ia?eiaoaeueiith aioeaoaeiiao??th, ui i?iyaey?oueny aeuith eiioeaio?aoe??th na?aaei?o iieaeoe a ne?iaaooe? e?ia?. Aecia/aiiy ai?noo na?aaei?o iieaeoe iiaea aooe e?eoa???i ?icaeoeo caiaeaiiy eaaaiue ia oii? a?iiene/ii-?oai?/ii? aioeaoaeiiao??. 4. O iiaiia?iaeaeaieo iaiiaeyo, oai?eo ia iiaaiii?th ia oe? ia?eiaoaeueii? aioeaoaeiiao?? ? ia a?iiene/ii-?oai?/io aioeaoaeiiao?th, aeyaeaia i?aeaeuaia aeoeai?noue ieaciaoe/ieo oa?iaio?a e?aaoeie?iace oa eaeoaoaeaa?ae?iaaiace. Ci?ie aeoeaiino? aicei?a caeaaeaoue a?ae oyaeeino? i?ioeano ? iiaeooue neoaeeoe ia?ea?ii nooiaiy iinoa?iiene/iioi ooeiaeaeaiiy. 5. Eiiieaenia oa?ai?y c aeeth/aiiyi i?aia?ao?a i?ioaeoi?ii? ae?? (e?ii?ai? eeneioe, a?oai?i?a Aae ? Aa) ni?ey? e?au?e iaoaaie?/i?e aaeaioaoe??, cieaeoth/e aeoeai?noue ne?iaaoeiaeo e?aaoeie?iace oa eaeoaoaeaa?ae?iaaiace, aeyaeyth/e ianiaoeeo?/iee ?ioiiei?aaoth/ee aoaeo ia ee?oeiio oa aoii?aeueio eaieo ?ioi?oaoo, iiceoeaii aieeaa? ia noaa?e?caoe?th niiaoe/iiai oa iaa?ieia?/iiai noaoono. I?AEOE*I? ?AEIIAIAeAOe?? 1. Aeey nai?/anii? ae?aaiinoeee oa aecia/aiiy nooiaiy iinoa?iiene/iiai o?aaeaiiy aeeoy/iai i?aai?cio o iiaiia?iaeaeaieo ae?oae c ia?eiaoaeueiith aioeaoaeiiao??th ? c iiaaiii??th ia oe? a?iiene/ii-?oai?/ii? aioeaoaeiiao?? ?aeiiaiaeo?oueny aecia/aiiy ai?noo na?aaei?o iieaeoe, aeoeaiino? e?aaoeie?iace ? eaeoaoaeaa?ae?iaaiace ne?iaaoee e?ia?. 2. A eiiieaen e?eoaaiiy iaiiaeyoai c iiaaiii??th ia oe? a?iiene/ii-?oai?/ii? aioeaoaeiiao?? ? c a?iiene/ii-?oai?/iith aioeaoaeiiao??th i?iiiio?oueny aeeth/aoe eiiiiceo i?aia?ao?a i?ioaeoi?ii? ae?? (o neeaae? e?ii?ai? eeneioe ? a?oai?i?a Aa ? Aa). ?aeiiaiaeo?oueny ii?aeiaia aei i'yciaa aaaaeaiiy 0,5% ?ic/eio e?ii?ai? eeneioe a aeic? 1 o/ea/aeiao ia i?ioyc? 15 aei?a c ii/a?aiaei aaaaeaiiyi /a?ac aeaiue 1% ?ic/eio ?eaioeaa?iiiiiioeeaioeaeo c aeiaiaith aeicith 8 o§/aeiao ? i??e-aeienaeueoinoaoo a aeic? 50 o§/aeiao. Nienie iaoeiaeo i?aoeue, iioae?eiaaieo ca oaiith aeena?oaoe??. 1. Oa?iaioe aia?aaoe/iiai iai?io ? ??aaiue na?aaei?o iieaeoe o iiaiia?iaeaeaieo ae?oae i?e ia?eiaoaeueieo o?aaeaiiyo aieiaiiai iiceo oa ?ani??aoi?iiai aia?aoo a?iiene/iiai aaiaco // Aaeeoeueeee e?ea?nueeee a?niee. - 1997. - O. 4, 14. -N. 48-50. 2. Iniaeeaino? aaeaioaoe?eiiai neiae?iio o iiaiia?iaeaeaieo iaiiaeyo i?ney ia?eiaoaeueiiai a?iiene/iiai no?ano // Aaeeoeueeee e?ea?nueeee a?niee. -1998. - O. 5, ?3. - N. 64-65. 3. Iaoiaaiaoe/i? aniaeoe ?icaeoeo iiaaiii?? iiaiia?iaeaeaii? aeeoeie ia oe? a?iiene/ii-?oai?/iiai ooeiaeaeaiiy oeaio?aeueii? ia?aiai? nenoaie // Aaeeoeueeee e?ea?nueeee a?niee. - 1998. - O. 5, ?3. - N. 65-66. 4. Iaoiae iaoaaie?/ii? ei?aeoe?? o e?eoaaii? aeiiioaieo iiaiia?iaeaeaieo ae?oae c a?iiene/ii-?oai?/iith aioeaoaeiiao??th // A?niee i?iaeai a?ieia?? ? iaaeeoeeie. - 1999. - ?14. -N.108-112. AIIOAOe?ss Ieeei'the A.I. Ee?i?ei - iaoaaie?/i? iniaeeaino? aaeaioaoe?? aeiiioaieo iiaiia?iaeaeaieo ae?oae c iiaaiii??th ? a?iiene/ii-?oai?/iith aioeaoaeiiao??th.- ?oeiien. Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe ca niaoe?aeuei?noth 14.01.10. - iaae?ao??y. - ?inoeooo iaae?ao???, aeooa?noaa oa a?iaeieia?? AII Oe?a?ie, Ee?a, 1999. Aeine?aeaeaiiy i?iaiaeeeenue o 114 aeiiioaieo iiaiia?iaeaeaieo ae?oae, o 73 c yeeo ae?aaiinoiaaii a?iiene/ii-?oai?/io aioeaoaeiiao?th, o 41 — iiaaiii?th ia oe? ia?eiaoaeueii? aioeaoaeiiao??. A?oio ii??aiyiiy neeaee 15 caei?iaeo aeiiioaieo iiaiia?iaeaeaieo iaethe?a. An?i ae?oyi i?iaaaeaii eiiieaenia ee?i?/ia, eaai?aoi?ia (a?io?i?/ia), ?ioiieia?/ia oa ?ino?oiaioaeueia ianoaaeaiiy, aecia/aii oaeoi?e ia?eiaoaeueiiai ?eceeo ii ?icaeoeo a?iien?? ieiaea ? ano?en?? iiaiia?iaeaeaiiai. O an?o ae?oae aeyaeai? ee?i?/i? ?iceaaee i?ciuei? iinoiaoaeueii? aaeaioaoe??: ii?ooaiiy i?e?inoo iane o?ea, ci?ie ?ooiaeo ?aaeoe?e, a?iaeaeaieo ?aoeaen?a, i'yciaiai oiiono. Anoaiiaeaii i?aeaeuaiiy ai?noo na?aaei?o iieaeoe a ne?iaaooe? e?ia?, aeoeaiino? ieaciaoe/ieo e?aaoeie?iace ? eaeoaoaeaa?ae?iaaiace, i?eai?/aiiy aoii?aeueii? ? ee?oeiii? eaiee ?ioi?oaoo. ??aaiue na?aaei?o iieaeoe ? a?eueo aenieei o ae?oae c iiaaiii??th ia oe? ia?e-iaoaeueii? aioeaoaeiiao??, i?ae o iaiiaeyo c a?iiene/ii-?oai?/iith aioeaoaeiiao??th, ui aeicaiey? aeei?enoiaoaaoe oeae iieaciee a yeino? e?eoa??th i?e?aeiaiiy caiaeaiiy eaaaiue aei a?iiene/ii-?oai?/ii? aioeaoaeiiao??. Ci?ie c aieo ?ioiii? nenoaie iieyaathoue o ciaioaii? /anoee A-?OE, OO?-?OE ? AAN-?OE e?ioioeeo?a, cieaeaii? eiioeaio?aoe?? ne?iaaoeiaeo ?ioiiaeiaoe?i?a eeano I. Aeiaaaeaii, ui ii?ooaiiy i?ioe?ioaeoe?eiiai caoenoo o iiaiia?iaeaeaieo c ia?eiaoaeueiith aioeaoaeiiao??th ? ni?eyoeeaith iniiaith aeey ?icaeoeo aoi?eiii? iiaaiii??. O an?o ianoaaeaieo iaethe?a aeyaeaia i?aeaeuaia aeoeai?noue ieaciaoe/ieo oa?iaio?a e?aaoeie?iace oa eaeoaoaeaa?ae?iaaiace. Ci?ie aeoeaiino? aicei?a caeaaeaoue a?ae oyaeeino? i?ioeano ? ? /ooeeaeie ia?ea?aie nooiaiy iinoa?iiene/iiai ooeiaeaeaiiy. A eiiieaen e?eoaaiiy iaiiaeyoai c ia?eiaoaeueieie i?neya?iiene/ieie oneaaeiaiiyie aaaaeaii eiiiiceo i?aia?ao?a i?ioaeoi?ii? ae??: e?ii?ao eeneioo c a?oai?iaie Aae ? Aa. Iaoaaie?/i? ei?aeoi?e ni?eythoue a?eueo a??aiiaaaeaiiio ia?aa?aia? i?ciuei? aaeaioaoe??, cieaeaiith aeoeaiino? ieaciaoe/ieo e?aaoeie?iace ? eaeoaoaeaa?ae?iaaiace, ni?aaeythoue ianiaoeeo?/iee ?ioiiei?aaoth/ee aoaeo. Eeth/ia? neiaa: iiaiia?iaeaeai?, a?iiene/ii-?oai?/ia aioeaoaeiiao?y, e?aaoeie?iaca, eaeoaoaeaa?ae?iaaiaca, iaoaaie?/ia ei?aeoe?y AIIIOAOeEss Ieeeithe A.I. Eeeieei-iaoaaiee/aneea iniaaiiinoe aaeaioaoeee aeiiioaiiuo iiai?iaeaeaiiuo aeaoae n iiaaiiieae e aeiiene/anee-eoaie/aneie yioeaoaeiiaoeae. — ?oeiienue. Aeenna?oaoeey ia nieneaiea iao/iie noaiaie eaiaeeaeaoa iaaeeoeeineeo iaoe ii niaoeeaeueiinoe 14.01.10. - iaaeeao?ey. - Einoeooo iaaeeao?ee, aeooa?noaa e aeiaeieiaee AII Oe?aeiu, Eeaa, 1999. Enneaaeiaaiey i?iaiaeeeenue a 114 aeiiioaiiuo iiai?iaeaeaiiuo aeaoae, a 73 ec eioi?uo aeeaaiinoe?iaaia aeiiene/anee-eoaie/aneay yioeaoaeiiaoey, a 41 ?aaaiea - iiaaiiiey ia oiia ia?eiaoaeueiie yioeaoaeiiaoee. A?oiio n?aaiaiey ninoaaeee 15 caei?iauo aeiiioaiiuo iaeuoae. Anai aeaoyi i?iecaaaeaii eiiieaeniia eeeie/aneia, eaai?aoi?iia (aeioeie/aneia) ianeaaeiaaiea, ii?aaeaeaiu oaeoi?u ia?eiaoaeueiiai ?enea ?acaeoey aeiienee ieiaea e anoeenee iiai?iaeaeaiiiai. I?e iinooieaiee a noaoeeiia? e ia 9-10 aeaiue ea/aiey i?iaiaeeeinue eco/aiea eiioiiiai, oa?iaioaoeaiiai noaoona e ii?aaeaeaiea o?iaiy n?aaeieo iieaeoe a nuai?ioea e?iae. N?aaiaiea oaeoi?ia ia?eiaoaeueiiai ?enea o iaeuoae n iiaaiiieae ia oiia ia?eaoaeueiie yioeaoaeiiaoee e n aeiiene/anee-eoaie/aneie yioeaoaeiiaoee auyaeei, /oi o aeaoae n iiaaiiieae /aua iaia?oaeeaaaony a aiaiiaca anoeeney a ?iaeao, anie?aoeeiiiue e ?anie?aoi?iue aeeno?ann-neiae?ii. Ai anao aeaoae auyaeaiu eeeie/aneea i?eciaee ?anno?ienoaa iicaeiae aaeaioaoeee: ia?ooaiea i?eaaaee aana, eciaiaiea aeaeaaoaeueiuo ?aaeoeee, iuoa/iiai oiiona, a?iaeaeaiiuo ?aoeaenia. Onoaiiaeaii iiauoaiea eiioeaio?aoeee n?aaeieo iieaeoe a nuai?ioea e?iae, aeoeaiinoe ieaciaoe/iuo e?aaoeieeiacu e eaeoaoaeaaeae?iaaiacu, oaiaoaiea aoii?aeueiiai e eeaoi/iiai caaia eiioieoaoa. O?iaaiue n?aaeieo iieaeoe aieaa aunie o iaeuoae n iiaaiiieae ia oiia ia-?eiaoaeueiie yioeaoaeiiaoee, /ai o ieaaeaioeaa n aeiiene/anee-eoaie/aneie yioeaoaeiiaoeae, /oi iicaieyao eniieueciaaoue yoio iieacaoaeue a ea/anoaa e?eoa?ey i?eniaaeeiaiey ainiaeaiey eaaeeo e aeiiene/anee-eoaie/aneie yioeaoaeiiaoee. A ianeaaeiaaiiuo iaeuoae auyaeaia iiauoaiiay aeoeaiinoue ieaciaoe/iuo oa?iaioia e?aaoeieeiacu e eaeoaoaeaaeae?iaaiacu. Eciaiaiey aeoeaiinoe yiceiia caaenyo io oyaeanoe i?ioeanna e yaeythony /oanoaeoaeueiuie ia?ea?aie noaiaie iinoaeiiene/aneiai ii?aaeaiey i?aaiecia. Eciaiaiey ni noi?iiu eiioiiie nenoaiu ninoiyo a oiaiueoaiee aeiee A-?IE, OO?-?IE e AAN-?IE eeioioeeoia, nieaeaiee niaea?aeaiey nuai?ioi/iuo eiioiiaeiaoeeiia eeanna G. Aeiaaaeaii, /oi ia?ooaiea i?ioeaieioaeoeeiiiie caueou a iiai?iaeaeaiiuo n ia?eiaoaeueiie yioeaoaeiiaoeae niinianoaoao ?acaeoeth aoi?e/iie iiaaiiiee. Aoi?e/iinoue iiaaiiiee ia oiia iinoaeiiene/aneiai ii?aaeaiey aieiaiiai iicaa ii?aaeaeyao iniaaiiinoue oa?aiaaoe/aneie oaeoeee, eioi?ay i?aaeiieaaaao ei??aae?iaaiea iineaaenoaee aeiienee. Auyaeaiiua eciaiaiey aeoeaiinoe ieaciaoe/iuo oa?iaioia, o?iaiy n?aaeieo iieaeoe, aoii?aeueiiai e eeaoi/iiai caaia eiioieoaoa a ianeaaeiaaiiuo aeaoae yaeythony i?iyaeaieai ianiaoeeoe/aneeo aaeaioeaiuo ?aaeoeee a ioaao ia aeiiene/aneia ?acae?aaeaiea. A eiiieaen ea/aiey ieaaeaioeai n ia?eiaoaeueiuie iinoaeiiene/aneeie ineiaeiaieyie aaaaeai eiiiiceo i?aia?aoia i?ioaeoi?iiai aeaenoaey: eeiiaaay eeneioa n aeoaieiaie A2 e A6. Iaoaaiee/aneea ei??aeoi?u niinianoaotho aieaa o?aaiiaaoaiiiio oa/aieth iicaeiae aaeaioaoeee, nieaeaieth aeoeaiinoe ieaciaoe/iuo e?aaoeieeiacu e eaeoaoaeaaeae?iaaiacu, ieacuaatho ianiaoeeoe/aneee eiioiiei??aae?othuee yooaeo. Eeth/aaua neiaa: iiai?iaeaeaiiua, aeiiene/anee-eoaie/aneay yioeaoaeiiaoey, iiaaiiiey, e?aaoeieeiaca, eaeoaoaeaaeae?iaaiaca, iaoaaiee/aneay ei??aeoeey. ANNOTATION Pilypyuk A.M. Peculiarities of clinical-metabolic adaptation of new boms who underwent a pneumonia and a hypoxia - ischemic encephalopathy. - Manuscript. Dissertation for the academic degree of candidate of medical sciences by speciality 14.01.10 - pediatrics. - The Institute of Pediatrics, Obstetrics and Gynecology of Academy of Medical Science of Ukraine, Kyie, 1999. The examinations of 114 newboms were made, where 73 patients with hypoxia-ischemic encephalopathy and 41 with a pneumonia on a background of perinatal encephalopathy. A group of comparison was consisted of 15-s healthy newborns. Complex clinic-metabolic, biochemical and immunologic observation of newboms was made and facts of perinatal risk was found. Clinic derangement of late adaptation: breach of process of misbalance of body mass, achange of motor reactions, congenital reflexes muscular tension. It was set up an araisement of middlemolecules's substance an activity of plasmatic creatine kinase, lactate dehydrogenase, depression ofhumoral and cellular links of immunity. The level of middle molecules for children is highest with pneumonia on a background of perinatal encephalopathy then of new-boms with hypoxia-ischemic encephalopathy what helps to use the indicator of serving a criterion of joining pneumonia to hypoxia-ischemic encephalopathy. Changes from the side of immune system mean the less of part E-RUK, TFR-RUK and EAC-RUK lymphocytes, lowering of concentration of immune serum globulin of class G. It was proved that an infringement on anti - infectious defendense of new-boms with perinatal encephalopathy is a common base for developing of second pneumonia. A highest activity of plasmatic ferment of creatine kinase and lactate dehydrogenase was founded in new-boms. The changes of enzymes activity depend upon critically process. The following complex of treatment for new-boms with perinatal after hypoxemia complication is used: a complex of protective preparations: lipoic acid with vitamins 82 and Aa. Metabolic correctors dwells to more favorable process of late adaptation, less activity of plasmatic creatine kinase and lactate dehydrogenase, dwells to nonspecific planned immunization effect. Key words: newbom, hypoxic-ichemic encephalopathy, pneumonia, creatine kinase,lactatdehydrogenase, metabolic correctors

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