Особливості перебігу та лікування сепсису у хворих з гнійно-запальними процесами м’яких тканин: Автореф. дис… д-ра мед. наук / С.Д. Шаповал, Харк. д

OA?E?ANUeEEE AeA?AEAAIEE IAAeE*IEE OI?AA?NEOAO

OAIIAAE NA?A?E AeIEO?IAE*

OAeE-616-089.168.1-06-002.3+

616.94-08: 612.43/47+ 612/017

INIAEEAINO? IA?AA?AO OA E?EOAAIIss NAINENO

O OAI?EO C AI?EII-CAIAEUeIEIE I?IOeANAIE

I’ssEEO OEAIEI

14.01.03 – o??o?a?y

A a o i ? a o a ? a o

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

aeieoi?a iaaee/ieo iaoe

Oa?e?a – 1999

Aeena?oaoe?y ? ?oeiien.

?iaioa aeeiiaia o Caii??cueeiio aea?aeaaiiio ?inoeooo? oaeineiiaeaiiy
e?ea??a IIC Oe?a?ie.

Iaoeiaee eiinoeueoaio:

caneoaeaiee ae?y/iaoee ? oaoi?ee Oe?a?ie, aeieoi? iaaee/ieo iaoe,
i?ioani? Aeaoeaiei Ai?en Iaea?iae/, Oa?e?anueeee ?inoeooo oaeineiiaeaiiy
e?ea??a, caa?aeoth/ee eaoaae?ith o??o?a?? oa i?ieoieia??.

Io?oe?ei? iiiiaioe:

Eao?aao Aea?aeaaii? i?ai?? Oe?a?ie, aeieoi? iaaee/ieo iaoe, i?ioani?
Aaeeaioeueeee Ieeiea Ieeieaeiae/, Oa?e?anueeee ?inoeooo oaeineiiaeaiiy
e?ea??a, caa?aeoth/ee eaoaae?ith oi?aeiaaaeii?iaeueii? o??o?a??.

aeieoi? iaaee/ieo iaoe, i?ioani? Iai/e/ Aieiaeeie? ?aaiiae/, Ee?anueea
iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe, caa?aeoth/ee eaoaae?ith
o??o?a??, aieiaiee aaiaoieia Oe?a?ie.

caneoaeaiee ae?y/ iaoee ? oaoi?ee Oe?a?ie, aeieoi? iaaee/ieo iaoe,
i?ioani? Oeo??i A?eai??e A?eaae?eiae/, Caii??cueeee ?inoeooo
oaeineiiaeaiiy e?ea??a, caa?aeoth/ee eaoaae?ith aianoac?ieia??.

I?ia?aeia onoaiiaa: ?inoeooo ee?i?/ii? oa aenia?eiaioaeueii? o??o?a??
AII Oe?a?ie, a?aeae?e aianoac?ieia?? oa ?ioaineaii? oa?ai??.

Caoeno a?aeaoaeaoueny “23” aa?aniy 1999 ?. i 13.30 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae.64.600.01 i?e Oa?e?anueeiio
aea?aeaaiiio iaaee/iiio oi?aa?neoao? (310022, i.Oa?e?a, i?.Eai?ia, 4).

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? Oa?e?anueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo (310022, i.Oa?e?a, i?.Eai?ia, 4).

Aaoi?aoa?ao ?ic?neaiee “12” eeiiy 1999 ?.

A/aiee nae?aoa?

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

aeioeaio
Oaiueei I.I.

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie. Nainen a?aeiineoueny aei /enea iaea?eueo neeaaeieo
o??o?a?/ieo oa caaaeueiia?ieia?/ieo i?iaeai, iniiai? aniaeoe yei? ca
inoaii? ?iee i?aeaeaeeny ?noioiueiio ia?aaeyaeo. Iia? ?acoeueoaoe
ooiaeaiaioaeueieo oa ee?i?/ieo aeine?aeaeaiue iaoio?c?ieia?? naineno
na?ae/aoue, ui nenoaiia caiaeueia a?aeiia?aeue i?aai?cio ia ?ioaeoe?th ?
aieiaiei iaoiaaiaoe/iei iaoai?ciii ?icaeoeo naioe/iiai npioeeno
[TH.A.Iaeeiaoeue, 1997; A.O.Na?iei, 1997; I.A.A?thnia oa ni?aaao., 1998;
A.?.Aaeueoaiae oa ni?aaao., 1998; ?.A.A?tho?i oa ni?aaao., 1998; ?.I.
Oeaiae, 1998; R.C. Bone, 1994; A.D.Cumming, 1994; E.H.Farthamann et al.,
1994; U.Schoffel, 1994; D.C.Morrison et S.E. Bucklin, 1995 oa ?io?].

Iaeaaaeeea?oei aeinyaiaiiyi, ui ci?ieei anth eiioeaioe?th iaoiaaiaco
naineno, aoei a?aee?eooy a?oie aiaeiaaiieo iaae?aoi??a nenoaiii?
caiaeueii? ?aaeoe??, eaneaaeiee oa?aeoa? ae?? yeeo aecia/a? iniiai?
ee?i?/i? i?iyae naineno ? aaaea aei ?icaeoeo neiae?iio iie?i?aaiii?
iaaeinoaoiino? [I.I.Ayae?i, 1990; N.I.A?eioeueeee oa ni?aaao., 1998;
A.A.Ea?eia, 1998; R.L.Barron, 1993; P.E.Marik, 1993; M.Odenh, 1993;
D.Zhou et al., 1993; R.Belk,1994; R.Bone, 1994; A.D.Cumming, 1994;
C.J.Lowensteim et al., 1994; A.Salgado et al., 1994; J.Cohen, 1995;
A.S.Dofferhoff et al., 1995 oa ?io?].

Ca inoaii? 40-50 ?ie?a nooo?ai ci?ieany oa?aeoa? i?e?ioei?e i?e nainen?.
Aei aeei?enoaiiy aioea?ioee?a oe?ieiai niaeo?o ae?? caoaeieeaie naineno
/ano?oa aoee no?aioieiee ? noao?eieiee, aea c iiyaith oa oe?ieei
ee?i?/iei canoinoaaiiyi iiaeo iiooaei?o aioea?ioee?a ana a?eueoo ?ieue
noaea a?aoe iicieii?iaeueia a?aiiaaaoeaia ?ioaeoe?y — eeoeia? iaee/ee,
iaee/ee neiuei-caeaiiai aiith, i?ioae, eeaan??ea [A.A.Ai/i?eoa?e?, 1993;
?.Ae.Aeie?aeca oa ni?aaao., 1993; I.A.Ieaen??iei oa ni?aaao., 1995;
A.O.Na?iei oa ni?aaao., 1997; Ae.A.Iaea? oa ni?aaao., 1998; A.I.sseiaeaa
oa ni?aaao, 1998; E.F.Moffi et al., 1993; G.S. Ifokazu et al., 1996 oa
?io?].

C?inei ao?ieia?/ia cia/aiiy iaoa?iaiooth/eo a?aiiaaaoeaieo aaeoa-??e, a
oaeiae aiaa?iaieo ianii?iia?acoth/eo i?e?ii?aai?ci?a ?
aiaa?iaii-aa?iaieo anioe?aoe?e [TH.A.Oeaae?a oa ni?aaao., 1995;
A.I.Oeeaoeye, 1995; A.I.O?aioeocia oa ni?aaao. , 1998; V. Hamon-Poupinel
et al. , 1991; L. Verbist, 1991; R. I. Fass et al. , 1995]. O aeaiee /an
/anoioa a?aiiiceoeaiiai oa a?aiia-aaoeaiiai naineno i?eaeecii iaeiaeiaa
[R. C. Bone, 1994; Y. Cohen, 1995].

*anoioa aeiaaee?a naineno ia? oaiaeaioe?th aei c?inoaiiy
[I.I.Iae?-iianueeee oa ni?aaao., 1997; A.O.Na?iei 1997; A.A.Ai/i?eoa?e?
oa ni?aaao., 1998; A.I.Na?ooo?i oa ni?aaao., 1998; A.I.Farthamann et
al., 1994; D.C.Mor-rison et al., 1995; A.S.M.Dofferhold and Y. Buys,
1995], a iieaciee eaoaeueiino? caeeoa?oueny ae?ae aenieei. O ?a?ii?
ui?ieo ?a?no?o?oueny aei i?ai?eueeiia aeiaaee?a naineno; o I?ia//ei?
a?ae naineno ui??/ii aie?a? 75 000 oai?eo — no?eueee ae, ne?eueee a?ae
aino?iai ?ioa?eoo i?iea?aea. O NOA ui??/ii ?a?no?o?oueny 300 000
aeiaaee?a o?eueee a?aiiaaaoeaiiai naineno, eaoaeuei?noue i?e yeiio
neeaaea? 30-90% [Y.Kieffetal, 1993; C.V.Poole et al., 1993; R.Boun,
1994; D.L.Dunn, 1994; K.H.Lee et al., 1994; Y. Cohen, 1995 ].

Ia i?ioyc? inoaii?o ?ie?a iieaciee eaoaeueiino? i?e nainen?
caee-oa?oueny noaa?eueii aenieei, iacaaaeath/e ia ae?ae eiooiaia [
Y.A.Tuch-schmidt a C.E. Wecher, 1991; B.Kreter , 1992] ?ioaineaia
e?eoaaiiy c i?ecia-/aiiyi iia?oi?o aioei?e?iaieo i?aia?ao?a, eiiieaeniee
iii?oi?eia aaii-aeeiai?ee ? o?ainii?oo eenith, na?oeaai-eaaaiaao
?anonoeoooe?th c iaoaai-e?/iith i?aeo?eieith.

Iacaaeia?euei? ?acoeueoaoe e?eoaaiiy naineno aecia/athoue iaiao?aei?noue
yeiaeoaeaeoi? ee?i?/ii? ci?ie iniiaieo aeaiaio?a iaoeiai? eiioeaioe??
eiai iaoiaaiaco: anoaiiaeai? eeth/ia? eaiee nenoaiii? caiaeueii?
a?aeiia?ae? iiaeii? aooe aeei?enoai? a yeino? iiaeo ae?aaiinoe/ieo ?
i?iaiinoe/ieo e?eoa???a, a aaea io?eiai? iiiieeiiaeuei? aioeo?ea — aeey
aoaeoeaiiai i?eai?/oaaiiy iaae?aoi?iiai eaneaaeo oa iiia?aaeaeaiiy
iie?i?aaiii? iaaeinoaoiino? [?.?. Iia?eiaa oa ni?aaao., 1996; N.I.
Aeyioeaa, 1998; ?. I. ?aoaoi?eia oa ni?aaao., 1998; A.I. Oaii oa
ni?aaao., 1998; A.R. Exley et al., 1990; R.K. Greenman et al., 1991;
E.F. Manzyello, 1997].

Iaaeinoaoiuei aea/aia ee?i?/ia aoaeoeai?noue iiaeo iaoiae?a ?aiiuei?
ae?aaiinoeee naineno [N.O.Aaaiaiei oa ni?aaao., 1998; I.A.A?eiai?iaeiaa
oa ni?aaao., 1998; A.I.Oaii oa ni?aaao., 1998; E.I.Lee et al., 1993;
B.Valletet et al., 1993; C.Buck et al., 1994; Y.Stehgle a D. Dries, 1994
oa ?io?], a oaeiae ee?i?/ia cia/aiiy oaiiiaio o?aineieaoe?? aiaeioieneio
? aaeoa??e e??cue neeciaaoo eeoeiai? no?iee oa eiai aieea ia ?icaeoie
neiae?iio iie?i?aaiii? iaaeinoaoiino? [R.L.Zapoto-Sirvent a
I.F.Hansbrough, 1992; A.M.Munster et al., 1993; E.A.Deitch, 1994;
P.A.Van Leenwen et al., 1994 oa ?io?]. Iio?aao? aea/aiiy ee?i?/ia
cia/ei?noue ?aiiueiai athiaeueiiai (e??cue ciiae) oa?/oaaiiy c iaoith
i?io?eaeoeee oaiiiaio aaeoa??aeueii? o?aineieaoe?? oa iai?iaeaeaiiy
?ioiii? nenoaie eeoa/ieea a?ae o/ano? a iaae?aoi?iiio eaneaae?
caaaeueii? caiaeueii? ?aaeoe??.

Ia?oi/a?aiaith caaea/ath ? ee?i?/ia ioe?iea neiae?iio aiaeioieneeico o
oai?eo nainenii oa aeei?enoaiiy iaoiae?a aeaoieneeaoe?? aeey eiai
i?eai?/aiiy, canoiniaoth/e i?e oeueiio e??ieiina?aiaai? a?ini?aaioe
[I.I. Aaeeaioeueeee oa ni?aaao., 1994; I.A. Aa?ani?a oa ni?aaao., 1995,
1996, 1997; A.?. Iai/e/ oa ni?aaao., 1997; M. Pollack, 1992; U.
Kreimeier et al., 1993].

Iaaia a?aenoaaaiiy a iaeano? ee?i?/ieo aeine?aeaeaiue i?iaeaie naineno
a?ae ??aiy aeinyaiaiue iaoeiai-oai?aoe/iiai ieaio iio?aao? yeiaeoaeaeoi?
ei?aeoe??: naia iaaeinoaoi?noue ee?i?/iiai aea/aiiy naineno coiiaeth?
iecueeo aoaeoeai?noue eiai e?eoaaiiy [R. C. Bone, 1991].

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Aeena?oaoe?eia
?iaioa aeeiiaia a?aeiia?aeii aei ieaio IAe? Oa?e?anueeiai ?inoeoooo
oaeineiiaeaiiy e?ea??a ?acii ?c Ee?anueeei ?inoeoooii ee?i?/ii? oa
aenia?eiaioaeueii? o??o?a?? ca oaiith “?ic?iaea oa ai?iaaaeaeaiiy
e?ea?nueeeo cania?a oa iiaeo iaoiae?a i?io?eaeoeee ? e?eoaaiiy
ai?eii-naioe/ieo oneeaaeiaiue a aaaeii?iaeuei?e o??o?a??”,
1.02.04:046-93 (AEIO), a oaeiae ieaio IAe? Caii??cueeiai ?inoeoooo
oaeineiiaeaiiy e?ea??a (Aea?aeaaiee ?a?no? 0196V014757).

Iaoa aeine?aeaeaiiy — i?aeaeuaiiy aoaeoeaiino? ?ioaineaii? oa?ai??
oai?eo nainenii ia iniia? iiaeeaeaieo aeine?aeaeaiue
caoenii-i?enoinoaaeue-ieo ?aaeoe?e, eiiiainaoi?ieo iiaeeeainoae
i?aai?cio, ci?i eiai iae?i-aiaei-e?eiii?, aioeieneaeaioii? nenoai oa
?ioiiiai noaoono aeey ?oiuei? ni?yiiaaii? ei?aeoe?? a neeaae?
eiiieaeniiai e?eoaaiiy .

Caaea/? aeine?aeaeaiiy

1. O na?o? iiai? eiioeaioe?? iaoiaaiaco naineno eiiieaenii aea/eoe
oa?aeoa? oa ni?yiiaai?noue ?aaeoe?e iae?i-aiaeie?eiiie ?
aioeieneaeaioii? nenoai, a oaeiae ?ioiiiai noaoono i?aai?cio ia
ooeiaeaeoth/o ae?th neiae?iio nenoaiii? caiaeueii? a?aeiia?ae?.

2. Iioei?coaaoe aoai ?aiiuei? ae?aaiinoeee naineno c ioe?ieith
ii??a-iyeueii? ?ioi?iaoeaiino? iniiaieo ee?i?/ieo oa eaai?aoi?ieo
e?eoa???a.

3. Oe?eani?yiiaaii aea/eoe neiae?ii aiaeiaaiii? ?ioieneeaoe?? i?e
nainen? c iaa?oiooaaiiyi e?eoa???a (ia’?eoeaieo ia?ea??a) ioe?iee eiai
aaae oa aeeiai?/iiai eiio?ieth aoaeoeaiino? aeaoieneeaoe?eii? oa?ai??.

4. Iioei?coaaoe i?ia?aio ?ioaineaiiai e?eoaaiiy naineno oeyoii
oaeineiiaeaiiy aoai?a i?noeaaiai e?eoaaiiy ia?aeiiiai ai?eiiai
ina?aaeeo, a oaeiae caaaeueii? eiiieaenii? oa?ai?? c aeei?enoaiiyi iiaeo
a?iaaeaioiaai?a i?e?iaeiiai iioiaeaeaiiy (Ai?oei? oa ?i.), /eiiee?a
aeoeaaoe?? ianiaoeeo?/ii? aaeaioaoe?eii? a?aeiia?ae? (AEIE), a oaeiae
e??ieiina?aiaaieo a?ini?aaio?a (enaiiaaiaoioeeoe, nieaiioeeoe, ia?oocao
e??ieiina?aiaaieo o?aaiaio?a naea-c?iee, ee?oei o?iono) ? iaoiae?a
ni?yiiaaii? ei?aeoe?? ii?ooaiue iae?i-aiaeie?eiii?, aioeieneaeaioii?
nenoai oa ?ioiiiai noaoono i?aai?cio.

5. Aea/eoe ee?i?/io aoaeoeai?noue ?ic?iaeaii? i?ia?aie ?ioaineaiiai
e?eoaaiiy naineno c ai?iaaaeaeaiiyi iiaeo ?ic?iaie o ee?i?/io i?aeoeeo.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a. Aea/aii iaoai?cie oa iniiai?
/eiieee ooeiaeaeoth/i? ae?? neiae?iio nenoaiii? caiaeueii? a?aeiia?ae?
ia noai iae?i-aiaeie?eiii?, aioeieneaeaioii? nenoai oa ?ioiiiai noaoono
i?aai?cio. Aeiaaaeaii caeaaei?noue i?ae nooiaiai ii?ooaiue
iae?i-aiaeie?eiiiai oa ?ioiiiai noaoono oai?eo ? ni?yiiaai?noth ia?aa?ao
naioe/iiai i?ioeano. Anoaiiaeaii, ui i?iaiinoe/ii iani?eyoeeaeie
iciaeaie aeeiai?ee ia?aa?ao naineno aa?oi aaaaeaoe ??aaiue ei?oecieo ,
ui cieaeo?oueny i?ia?aneaii , ?c i?aeaeuaiiyi eiao?oe??ioa
“ei?oecie/?inoe?i” aeua 5 iae., i?aeaeuaiiy aeoea-iino? O3 oa O4 ia oii?
i?aeaeuaiiai ??aiy OOA, cieaeaiiy ?ioii?aaoethth/iai ?iaeaeno aei
1,0-1,2 iae. ? ieae/a.

O ?acoeueoao? aea/aiiy i?ioean?a ia?aeeniiai ieeneaiiy e?i?ae?a oa
ae-oeaiino? aioeieneaeaioii? nenoaie i?e nainen? aia?oa anoaiiaeaii, ui
i?e iaaaoeai?e aeeiai?oe? ia?aa?ao i?ioeano aeyaey?oueny c?inoaiiy on?o
aeine?aeaeoaaieo iieaciee?a aeoeaiino? i?ioean?a ia?ieneaeaoe?? ia oii?
i?eai?/oaaiiy ??aiy aioeieneaeaioieo ?aaeoe?e. I?iaiinoe/ii
iani?eyoeeaei e?eoa???i ? iieaciee iaaaeueiiai cieaeaiiy (iaae?iiy)
??aiy ia?aeiieo oa aoi?eiieo i?iaeoeo?a IIE, ui ia?aaeo? ?icaeoie
aaaeeeo ? /anoi iacai?ioieo oneeaaeiaiue (nai-oe/iee oie, neiae?ii III).

Aeyaeaii aenieee ??aaiue ei?aeyoe?? a ioe?ioe? aaae neiae?iio
aiaeioie-neeico i?e nainen? i?ae iieacieeaie ia?ea??a ?ioieneeaoe?? oa
iniiaieie eiai ee?i?/ieie ? eaai?aoi?ieie i?iyaaie (e?eoa??yie).
Iaa?oioiaaii aeioe?euei?noue canoinoaaiiy a eiiieaen? aeaoieneeaoe?eieo
caoiae?a i?e aaaeeiio (II oa III nooi?iue) aiaeioieneeic? aia?aoieo
iaoiae?a ni?aoe??, iniaeeai c aeei?enoaiiyi e??ieiina?aiaaieo
enaiiaaiaoioeeo?a, o?aaiaio?a enaiinaeac?iee ? ee?oei o?iono (??oaiiy
IAeOeIA ia aeaea/o iaoaio?a Oe?a?ie ia aeiao?ae ?97104998 a?ae 07.10.98
? ?97125767 a?ae 08.10.98)

Iiaeie a iaoeiaiio oa ee?i?/iiio ieai? ? ?ic?iaee c iioei?caoe??
i?ia?aie i?noeaaiai e?eoaaiiy ia?aeiiiai ? aoi?eiieo ai?eieo ina?aaee?a
i?e nainen?: iaa?oioiaaia aeioe?euei?noue iaeneiaeueiiai ?aaeeeae?cio
?oiueiai o??o?a?/iiai ii?aoethaaiiy c ianooiiei e?eoaaiiyi iiaeie
eiia?iiaaieie i?aia?aoaie ia a?ae?io?euei?e iniia?, ?ic?iaeaieie a
Oe?a?i?.

Aia?oa aea/aia c iiceoeaiei ?acoeueoaoii ee?i?/ia aoaeoeai?noue no/anieo
a?iaaeaioiaai?a (i?aia?aoe “Aaineoii-40”, “Ai?oei?” oa ?io?) o
eiiieaeniiio e?eoaaii? oai?eo nainenii (??oaiiy IAeOeIA ia aeaea/o
iaoaioo Oe?a?ie ia aeiao?ae ?97115429 a?ae 12.10.98).

Anoaiiaeaii i?iaiinoe/io cia/ei?noue aea/aiiy iniiaieo iieaciee?a
aeo?aeiiai ?ioiiiai noaoono oai?eo nainenii, a oaeiae aeeiai?ee ?oiuei?
ci?ie a i?ioean? ?ioaineaii? oa?ai?? aeey ni?yiiaaii? ei?aeoe?? ye
aoii?aeueieo, oae ? ee?oeiieo ?ioiieia?/ieo ?aaeoe?e.

I?aaiii/i?noue oai?aoe/ieo iieiaeaiue, ui iaa?oioiaothoue
ia?niae-oeai?noue ?ic?iaeaii? i?ia?aie ?ioaineaiiai e?eoaaiiy naineno
i?aeoaa?aeaeaia iiceoeaiei aoaeoii ?? ee?i?/iiai aeei?enoaiiy, ui
caaacia/eei cieaeaiiy eaoaeueiino? oai?eo ?c 23,6 aei 17,4% oa
nei?i/aiiy oa?i?i?a ia?aaoaaiiy a noaoe?iia?? a 1,2 ?ace.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a

Ia i?aenoaa? ?acoeueoao?a i?iaaaeaieo aeine?aeaeaiue aeey oe?iei?
ee?i?/ii? i?aeoeee ?ic?iaeaia ?aoe?iiaeueia i?ia?aia eiiieaenii?
ae?aaiinoeee oa ?ioaineaiiai e?eoaaiiy naineno. Cai?iiiiiaai? aeey
nai?/anii? ae?aaiinoeee naineno aeinooii? aeey i?aeoe/ii? o??o?a??
ee?i?ei-eaai?aoi?i? iaoiaeeee, a oaeiae ?yae e?eoa???a (ia?ea??a), ui
ia’?eoeaii eeaneo?eothoue oai?eo ca nooiaiai aaae neiae?iio aiaeiaaiii?
?ioieneeaoe??. Aeae?eaiee ye aaaeeeaee o i?iaiinoe/iiio ieai? iieaciee
??aiy i?iaeoeo?a IIE (ia?aeiieo oa aoi?eiieo): ?oi? ??cea cieaeaiiy
caaaeaee ia?aaeo? ?icaeoeo aaaeeeo ? /anoi iacai?ioieo oneeaaeiaiue
naineno (naioe/iee oie, neiae?ii III).

Iioei?ciaaii aoai i?noeaaiai e?eoaaiiy ia?aeiiiai oa aoi?eiieo
ina?aaee?a ?ioaeoe?? c aeei?enoaiiyi iiaeo iaaeeeaiaioicieo cania?a o
oi?i? iac? ia a?ae?io?euei?e iniia?, ?ic?iaeaieo a Oe?a?i?.
Cai?iiiiiaaii noaie aii??e/ii? aioea?ioeeioa?ai?? ca oeiii “iiaea?eiiai”
?aaeeio aaaaeaiiy, aai iiiioa?ai??. Noaiaea?oiee eiiieaen
aeaoieneeaoe?eieo caoiae?a caaaa/aiee (i?e ?ioieneeaoe?eiiio neiae?ii?
II oa, iniaeeai, III nooiaith) aeei?enoaiiyi iaoiae?a aia?aoii? ni?aoe??
c aaaaeaiiyi o eiioo? (ni?aoe?eio eieiieo) aia?aoo e??ieiina?aiaaieo
aaiaoioeeo?a ? nieaiioeeo?a.

?ic?iaeaia noaia ?ioiioa?ai?? oai?eo nainenii, caniiaaia ia aiae?c?
iieaciee?a aioea?ioeeia?aie, aecia/a? iieacaiiy aei aeei?enoaiiy
cai?iii? oa ei?aaoth/i? ?ioiioa?ai?? , ia??aeei a niieo/aii? ?c
ni?aoe?eieie iaoiaeaie aeaoieneeaoe?? (aenieee ??aaiue Oe?E, aenieee
iieaciee ??aiy A-e?ioioeeo?a oa ?io?).

Ee?i?/ia ai?iaaoe?y ?ic?iaeaii? i?ia?aie ?ioaineaiiai e?eoaaiiy naineno,
yea i?iaaaeaia a ?yae? i?io?eueieo e?eoaaeueieo caeeaae?a, iieacaea ??
i?aeoe/io cia/ei?noue o iie?ioaii? ?acoeueoao?a e?eoaaiiy oai?eo
nainenii.

Ii?yae ?c ioae?eaoe?yie iaoa??ae?a aeena?oaoe?? o a?o/eciyieo aeo?iaeao
oa iaoeiaeo ca??ieeao, aeaeaiiyi iaoiaee/ieo ?aeiiaiaeaoe?e oa aenooi?a
ia ??ciiai ??aiy eai?oiao niaoe?ae?no?a, ?acoeueoaoe aeine?aeaeaiue
ai?iaaaeaeai? a i?aeoeeo ?iaioe i?nueeiai ai?eii-naioe/iiai oeaio?o
i.Caii??aeaey, iaeaniiai oeaio?o aeno?aiaeueii? iaaeeoeeie oa oaeaeei?
aeiiiiiae i.Caii??aeaey, aaaaoi-i?io?eueieo ee?i?/ieo e?ea?iyo ? 2, 3,
7, 9 i.Caii??aeaey, i. Iae?oiiiey, i. Aia?aiaea?a, e?ea?i? oaeaeei?
iaaee/ii? aeiiiiiae i.Aei?i?iiao?ianueea, 2 i?nueei? ee?i?/ii? e?ea?i?
i.Oa?eiaa.

Iaoa??aee aeine?aeaeaiue c ae?aaiinoeee oa e?eoaaiiy naineno
ai?iaaaeaeai? a iaa/aeueiee i?ioean ia eaoaae?ao o??o?a?? Caii??cueeiai
oa Oa?e?anueeiai ?inoeooo?a oaeineiiaeaiiy e?ea??a.

Iniaenoee aianie caeiaoaa/a. Ia i?aenoaa? aiae?co iaoa??ae?a e?oa?aoo?e
oa aeaieo iaoaioiiai iiooeo ii oai? aeine?aeaeaiiy aaoi?ii aoea
iaa?oioiaaia iaoa ?iaioe oa caaea/? aeine?aeaeaiiy. Aecia/aiiy iai?yie?a
aeine?aeaeaiiy, ca?? ? ii?aoethaaiiy oaeoe/iiai iaoa??aeo, ee?i?/i?
ianoaaeaiiy oa iiae?e oai?eo ia a?oie, aeeiiaiiy a?eueoi? /anoeie
ia?aeiieo ? iiaoi?ieo iia?aoeaieo ao?o/aiue, i?aeoe/ia aeine?aeaeaiiy
icia/aieo iieiaeaiue, iiaoaeiaa ia ?oi?e i?aenoaa? a?aeiia?aeieo
aeniiae?a oa ?aeiiaiaeaoe?e, i?aeaiooaaiiy ?oeiieno aeena?oaoe??
i?iaaaeai? aaoi?ii naiino?eii. Aeeiiaa noaoenoe/ia ii?aoethaaiiy
iaoa??aeo oa aiae?c ee?i?/ieo aeine?aeaeaiue, io?eiai? aeai? aeiiia?a ia
eiia?anao, eiioa?aioe?yo, oiaa?enoaao niaoe?ae?no?a. O eieaeoeaieo
ioae?eaoe?yo 80% ?aeae oa ?ic?iaie iaeaaeeoue aaoi?o.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iniiai? iieiaeaiiy aeena?oaoe?eii?
?iaioe iia?aeiieai?, iaaiai?ai? oa noaaeai? ia can?aeaiiyo i?aenoieiai?
iaoeiai? eiioa?aioe?? Caii??cueeiai ?inoeoooo oaeineiiaeaiiy e?ea??a
(1996, 1997, 1998), Caii??cueeiio iaeaniiio iaoeiaiio oiaa?enoa?
o??o?a?a oa o?ieia?a (1995), ni?eueiiio can?aeaii? i?nueeiai
iaoeiai-i?aeoe/iiai oiaa?enoaa o??o?a?a oa a?iaeieia?a (E?eaee ??a,
1996), II Iaoe?iiaeueiiio Eiia?an? aianoac?ieia?a Oe?a?ie (Oa?e?a,
1996), iaoeiai-i?aeoe/i?e eiioa?aioe?? “Ee?i?/i? ieoaiiy iaaeeoeeie”
(N?ioa?iiieue, 1997), Caii??cueeiio iaeaniiio iaoeiaiio oiaa?enoa?
aianoac?ieia?a-?aai?iaoieia?a (1998), i?aeiaeaniiio iaoeiaiio oiaa?enoa?
o??o?a?a (Caii??aeaey, 1998), Oa?e?anueeiio iaeaniiio iaoeiaiio
oiaa?enoa? o??o?a?a (1998), I?aeia?iaei?e eiioa?aioe?? “?aie ? ?aiiaa
?ioaeoe?y” (Iineaa, 1998).

Ioae?eaoe??. Ca iaoa??aeaie aeena?oaoe?? iioae?eiaaii 38 iaoeiaeo
i?aoeue, 1 iaoiaee/i? ?aeiiaiaeaoe??, 13 ?ia?o o oeaio?aeueieo iaaee/ieo
aeo?iaeao oa ca??ieeao, io?eiaii 3 ??oaiiy IAeOeIA ia aeaea/o iaoaio?a
Oe?a?ie ia aeiaoiaee.

No?oeoo?a aeena?oaoe??. Aeena?oaoe?eia ?iaioa aeeeaaeaia ia 250
noi??ieao iaoeiiieniiai oaenoo ? neeaaea?oueny ?c anooio, 2 ?icae?e?a
iaeyaeo e?oa?aoo?e, 5 ?icae?e?a aeanieo aeine?aeaeaiue, caeeth/aiiy,
aeniiae?a, i?aeoe/ieo ?aeiiaiaeaoe?e. A?ae?ia?ao?/iee iieaae/ee i?noeoue
448 iaeiaioaaiue ?ia?o, aeeth/ath/e 203 ?iicaiieo aaoi??a ianyaii 53
noi??iee. Aeena?oaoe?y ?ethno?iaaia 5 ?enoieaie ? 45 oaaeeoeyie, ye?
caeiathoue 22 noi??iee.

INIIAIEE CI?NO ?IAIOE

Iaoiaeieia?y, iaoa??aee oa iaoiaee aeine?aeaeaiue. Iaoiaeieia?y
ieaioaaiiy oa i?iaaaeaiiy ?iaioe aecia/eea ii?yaeie, ianya oa
iine?aeiai?noue ae??oaiiy iniiaieo caaea/ i?iaaaeaiiai ee?i?/iiai
aeine?aeaeaiiy, a oaeiae eiiieaeniee i?aeo?ae aei ioe?iee io?eiaieo
?acoeueoao?a. A?aeiia?aeii aei oeueiai ii/aoeiaei aoaiii aeine?aeaeaiiy
aoei iaoeiaa iaa?oiooaaiiy aeai?o e?eoa???a aeey oi?ioaaiiy
a?aeiia?aeaeueieo ii ee?i?/i?i oa?aeoa?enoeeai a?oi oai?eo — ye?
aeine?aeaeoaaeenue (iniiaia) oa eiio?ieueia, a oaeiae aecia/aiiy
iaea?eueo ?ioi?iaoeaieo iaoiae?a ?o aeine?aeaeaiiy oa eiio?ieth
aoaeoeaiino? e?eoaaiiy, ui caaacia/oaaei no/ani?e ??aaiue aeeiiaiiy
?iaioe a oe?eiio.

Ianooiiei aoaiii ?iaioe aoei iaeiie/aiiy iaoa??ae?a
ee?i?ei-eaai?aoi?iiai aeine?aeaeaiiy oai?eo nainenii, iiaeaeueoee aiae?c
yeeo aecia/ea cia/ei?noue ye ie?aieo neiioii?a, oae ? eaai?aoi?ieo
e?eoa???a, ae?aaeaii?noue yeeo aeicaieeea i?iaanoe eeaneo?eaoe?th oai?eo
ca oyaee?noth nai-oe/iiai i?ioeano. ?yae niaoe?aeueieo iaoiaeee aoee
canoiniaai? aeey iiaeeaea-iiai aea/aiiy ci?i oi?aaeyth/eo nenoai
i?aai?cio i?e nainen? – iae?i-aiaeie?eiii? oa ?ioiii?, ui aeicaieeei
iaa?oiooaaoe iia? iaoiaeeee iaoiaa-iaoe/ii? oa?ai?? a eiiieaeniiio
e?eoaaii? naineno o oai?eo iniiaii? a?oie.

Caeeth/iei aoaiii aeine?aeaeaiiy aoei i?iaaaeaiiy ii??aiyeueiiai
aiae?-co ?acoeueoao?a e?eoaaiiy, oiaoi aoaeoeai?noue aeei?enoaiiy
?ic?iaeaii? iaie ?ioaineaii? i?ia?aie e?eoaaiiy naineno oa eiai
oneeaaeiaieo oi?i.

Ee?i?/ia oa?aeoa?enoeea oai?eo. I?iaaaeaia eiiieaenia
(ee?i?ei-eaai?aoi?ia) aeine?aeaeaiiy 158 oai?eo nainenii, ui
ciaoiaeeeeny ia ianoa-aeaii? oa e?eoaaii? a i?nueeiio ai?eii-naioe/iiio
oeaio?? i. Caii??aeaey ca ia??iae c 1991 ii 1998 ?iee. Eiio?ieueio a?oio
neeaee 55 oai?eo, ui aoee aini?oae?ciaai? a noaoe?iia? ca ia??iae c 1991
ii 1994 ??, ianoaaeaiiy oa e?eoaaiiy 103 oai?eo iniiaii? a?oie
i?iaaaeaii i?ioyaii 1995-1998 ??.

Iniiaio /anoeio oai?eo ye iniiaii?, oae ? eiio?ieueii? a?oie neeaaeaee
iniae iieiaeiai oa na?aaeiueiai a?eo (71,9% oa 70,8% a?aeiia?aeii),
na?aaei?e a?e oai?eo aoa 48,3±1,1 ?. (48,1+0,9 ?.- o eiio?ieuei?e oa
48,5±1,4 ?.- a iniiai?e a?oi?). Na?aae oai?eo eiio?ieueii? a?oie
/ieia?ee neeaee 69,1%, a iniiai?e — 49,5%.

Oyaee?noue noaio oai?eo, ye? iinooiaee aei noaoe?iia?o, aoa o i?yii
i?i-ii?oe?ei?e caeaaeiino? a?ae no?ie?a aeieeiaiiy ia?oeo i?iya?a
naineno. A oe?eiio oyaeeee nainen ca?a?no?iaaii i?e aini?oae?caoe?? o
60% oai?eo, ye iniiaii?, oae ? eiio?ieueii? a?oie, a na?aaei? no?iee
iinooiath/eo o noaoe?iia? neeaee a?aeiia?aeii 6,2 oa 6,4 ae?a.

Noiooiy iaoieia?y niinoa??aaeanue i?eaeecii o 90% oai?eo, ye in-iiaii?,
oae ? eiio?ieueii? a?oie. A 11,4% aeiaaee?a iaee i?noea iciaee
aeaeii-iainaoe??, iniaeeai /anoi i?e oyaeeiio nainen?. Iae/ano?oa
cono??/aeenue ca-oai?thaaiiy na?oeaai-noaeeiii? nenoaie (40% a
eiio?ieuei?e oa 42,7% a iniiai?e a?oi?). A?aei?/aii c?inoaiiy (c 27,3%
aei 36,9%) /enea oai?eo ia oeoe?iaee ae?aaao, oa c?inoaiiy (c 18,2% aei
28,2%) /enea oai?eo a iniiai?e a?oi?, eiee nainen aeieeaa ia oii? aeaio
noiooi?o caoai?thaaiue (oeoe?iaee ae?aaao oa ?oai?/ia oai?iaa na?oey ?
o.i.).

On?i aini?oae?ciaaiei oai?ei aoei i?iaaaeaii eiiieaenia
ee?i?ei-eaai?aoi?ia aeine?aeaeaiiy, ni?yiiaaia ia iinoaiiaeo ae?aaiico
oa aecia/aiiy oyaeeino? noaio oai?iai nainenii. Oaoiieia?y ia?aeiiiai
ee?i?ei-eaai?aoi?-iiai aeine?aeaeaiiy oai?eo aoea noaiaea?oiith ?
aeeth/aea a naaa ioe?ieo noaio i?aai?a oa nenoai, ye a ieai?
ae?aaiinoeee naineno, oae ? aecia/aiiy oa?aeoa?o oa oyaeeino? noiooiuei?
iaoieia??.

Ia?aeiieie ai?eieie ina?aaeeaie i?e nainen? aoee a 90,9% aeiaaee?a o
eiio?ieuei?e oa a 95,1% a iniiai?e — oyaee? ai?ei? caoai?thaaiiy i’yeeo
oeaiei (oeaaiiie), /anoi i?ney o?eaaeiai (16,5% niinoa?aaeaiue — a?eueoa
aeaio oeaei?a), oa a a?eueoino? aeiaaee?a iaaeinoaoiueiai ?o i?noeaaiai
e?eoaaiiy (13,9% iaoe??io?a).

Aeey ae?aaiinoeee naineno c aecia/aiiyi oace (oi?ie) oeueiai
iaoieia?/iiai neiae?iio aeei?enoiaoaaee noaiaea?oi? ee?i?/i? e?eoa???
ioe?iee «aeo?aeiiai» noaio na?oeaai-noaeeiii?, eaaaiaai? oa ae?oaeo
nenoai i?aai?cio — a?ia?oa?i?th, oao?ea?ae?th, cieaeaiiy AO, caaeeoeo,
iaa?ieia?/i? neiioiie, eaeeioeeoic /e eaeeiiai?th, a oaeiae i?aeaeuaio
ao?aoo acioo, ye iciaeo a?ia?eaoaaie?cio. Aeyaeaia nooi?iue ii?ooaiue
ee?i?/iiai noaoono oai?iai, yea aoea ooi/iaia aeaieie eaai?aoi?iiai
eiio?ieth, aeicaieeea eeaneo?eoaaoe oyaee?noue naioe/iiai noaio (oi?io
naineno).

Ia iniia? aeaieo e?oa?aoo?e oa aeaniiai ee?i?/iiai aeina?aeo iaie aeey
oi?o?eaoe?? ioe?iee oyaeeino? naioe/iiai neiae?iio (nainen, oyaeeee
nainen, naioe/iee oie, neiae?ii III), aoea ?ic?iaeaia iiaeeo?eiaaia
?iai/a eeaneo?eaoe?y naineno (oaae.1 ), ee?i?ei-eaai?aoi?i?
iieacieee yei? a?aeiia?aeathoue

Oaaeeoey 1

?iai/a eeaneo?eaoe?y oyaeeino? naineno ca noaiaea?oieie
ee?i?ei-eaai?aoi?ieie e?eoa??yie

Aeine?aeaeoaaiee iieacieeOyaee?noue naioe/iiai ia??iaeoNainenOyaeeee
nainenNaioe/iee oieOaiia?aoo?a o?eaA?ia?oa?i?y >38°NA?ia?oa?i?y c
iciiaii, ??aeei a?iioa?i?yA?ia?oa?i?y*anoioa na?oeaaeo nei?i/aiue*ano?oa
–iii??ia oao?ea?ae?y >90 oae./oa.Oao?ea?ae?y aei 120 oae./oa.Oao?ea?ae?y
a?eueoa 120 oae./oa., *anoioa aeeoaiiyCaaeeoea >20/oa. (?ani??aoi?iee
aeeaeic)Ea?oeia ?AeNAe (eiiiainiaaiee ci?oaiee aoeeaeic)Ea?oeia ?AeNAe
(aeaeiiiainiaaiee ci?oaiee aoeeaeic)??aaiue AOA?oa??aeueia a?iioaic?y (
AO <100 ii. ?o. no.)A?oa??aeueia a?iioaic?y ( AO <90 ii. ?o. no. ?c caa?aaeaiiyi ?aaeoe?? ia iiiiaiaiiy IOeE)A?oa??aeueia a?iioaic?y ? oie, ?ao?aeoa?i? aei ia'?iiiai iaaaioaaeaiiyIaa?ieia?/iee noaoonAe?ao?aeea?noue, caoi?iiaeai?noue, i?-aea?? (??aeei)Nieooai?noue na?aeiiino?, niieea?noue, i?- aea?? (??aeei)Nooii?, eiiaOoieoe?? ia/?ieeIii??ii ii?ooai? (a?e??oa?iai?y <60 iiieue/e)Ae?aaeai? ii?ooaiiy (a?e??oa?iai?y >60
iiieue/e, a?iii?ioa?iai?y)Aeaeiiiainiaai? ii?ooaiiy on?o
ooieoe?eIieacieee aaiia?aie*enei eaeeioeeo?a /ano?oa >13-15000/iee,
??aeoa <3500/iee*enei eaeeioeeo?a >15-30000/iee aai (ana /ano?oa)
<3000/ieeEaeeiiai?y. Aiai?y. O?iiaioeeoiiai?yAetheica e?ia?A?ia?ae?eai?y (cae/ii o ae?aaaoee?a)A?iiae?eai?y /ano?oaA?iiae?eai?y a?aaeaoe?? e?eoa???a ii?ooaiiai aiiainoaco a noaiaea?oeciaaieo no/anieo eeaneo?eaoe?yo naineno. Aeei?enoaiiy oe??? eeaneo?eaoe?? a ee?i?/i?e ?iaio? cia/ii ni?iuoaaei oa ?iaeei oaeaeoei i?ioean ae?aaiinoe/iiai iiooeo. Ae?aaiinoe/ia i?ia?aia ianoaaeaiiy oai?eo iniiaii? a?oie aoea ?icoe?aia ca ?aooiie canoinoaaiiy ?yaeo niaoe?aeueieo iaoiae?a aeine?aeaeaiiy, ui aeicaieeei, a?aeiia?aeii aei no/anieo aeiia, o?aeoiaeo neiae?iio naineno aacoaaoe ia ee?i?ei-iaoio?c?ieia?/iiio eiai ae?aaiic?, aaeoa??ieia?/iiio oa ?ioiieia?/iiio ae?aaiic?. Iaoiaee eaai?aoi?iiai aeine?aeaeaiiy. Noaiaea?oi? eaai?aoi?i? aeine?ae-aeaiiy - caaaeueiee aiae?c e?ia? oa na/?, ??aaiue aetheice e?ia?, a?io?i?/i? aeine?aeaeaiiy ooieoe?? ia/?iee, ie?ie, aecia/aiiy ??aiy caaaeueiiai a?eea e?ia? oa a?eeiaiai niaeo?o ne?iaaoee, iieaciee?a cai?ooth/i? oa i?ioecai?ooth/i? nenoai - aeeiioaaeenue caaaeueiii?eeiyoieie eeane/ieie iaoiaeaie, ye? aeeeaaeai? a "Oi?o?eiaaieo" i?ia?aiao aeine?aeaeaiue. Aace e?ia? oa eeneioii-eoaeiee aaeain aecia/aee o eai?ey?i?e a?oa??ae?ciaai?e e?ia? ca aeiiiiiaith aaciaiae?caoi?o "Eiiiaeo-1" o??ie AVL-List (Aano??y). Aeey aecia/aiiy ??aiy INII aeei?enoiaoaaee ne?ei?iaiaee iaoiae, cai?iiiiiaaiee I. ? Aaa???eyi oa ni?aaao., (1981). Aeine?aeaeaiiy i?iaiaeeeiny ia niaeo?ioioiiao?? (NO-24, N?N?) i?e aeiaaeei? oaee? 254 ii. ?ioiia ?aaeoeai?noue oai?eo nainenii ioe?ithaaeanue oeyoii aea/aiiy ?yaeo iieaciee?a ca iaoiaeeeaie, ye? aeeeaaeai? a iaoiaee/ieo ?aeiiaiaeaoe?yo "Oieoeoee?iaaiiua eiioiieiae/aneea iaoiaeu ianeaaeiaaiey aieueiuo ia noaoeeiia?iii e aiaoeaoi?iii yoaiao ea/aiey" (1981). Aeine?aeaeaiiy i?iaaaeaii a aeeiai?oe? - i?e anooi? aei noaoe?iia?o, ia 7-8, 12-16 oa 25-30 aeiao, a i?e iaiao?aeiino? - ? o a?eueo ?aii? /e i?ci?o? no?iee. Aea/aee aaniethoiee oa i?ioeaioiee ai?no e?ioioeeo?a o e?ia?, e?euee?noue O - e?ioioeeo?a ii ?aaeoe?? niiioaiiiai ?icaoeiooai?thaaiiy (A-?IE), ai?no A - e?ioioeeo?a ?c aeiiiii-aith ?aaeoe?? AAN - ?icaoeiooai?thaaiiy (AAN-?IE). Aecia/aee ai?no Oa e?i-oioeeo?a (aeoeai?), Oh - ? Os - e?ioioeeo?a (oaio?e?i - ?acenoaioieo oa oaio?e?i - /ooeeaeo), a oaeiae eiao?oe??io noi?an?? (Oh/Os); e??i oeueiai aeine?aeaeoaaee ioeueia? e?ioioeeoe. ?ioiiaeiaoe?ie eean?a G, A, I, aea/aee iaoiaeii ?aae?aeueii? ?ioiiaeeooc?? ia aaa?? ii Iai/?i? (1965). ?c iieaciee?a ianiaoeeo?/iiai ?ioi?oaoo aea/aee oaaioeeoa?io aeoeai?noue iaeo?io?e?a (INO - oano, oaaioeeoa?ia /enei), aeoeai?noue eiiieaiaioo, a oaeiae oee?eoethth/? ?ioii? eiiieaene. Noai ai?iiiaeueiiai aiiainoaco oai?eo nainenii aeine?aeaeoaaee ?aae?i?ioiieie iaoiaeaie. I?i noai a?iio?ca?ii-oe?ai?aeii? nenoaie noaeeee ii ?acoeueoaoai aeine?aeaeaiiy oe?aio?iiiiai ai?iiio a?iio?co (OOA), o?eeiae-oe?iieio (O3), oe?ieneio (O4). Aeey oeeo aeine?aeaeaiue aeei?enoiaoaaeenue iaai?e o??ie AOE-IALLING-RIDO, I?ia//eia (OOA) oa o??ie OII EAIO, A?ei?onue (O3, O4). Aecia/aiiy ei?oecieo oa ?inoe?io i?iaiaeeeenue ?c aeiiiiiaith ?aae?i?ioiieo iaoiae?a ?c aeei?enoaiiyi noaiaea?oieo iaai??a ?aaeoea?a, cacia/aieo aeua. Aeey aei??thaaiiy ?aae?iaeoeaiino? aeei?enoiaoaaee neaioth/ee aaiia-e?/eeueiee ae?iaieoeoaa o??ie LEA (Oaaoe?y). I?ioeane ia?aeeniiai ieeneaiiy e?i?ae?a (IIE) aeine?aeaeoaaee oeyoii aea/aiiy ia?aeiieo ? aoi?eiieo i?iaeoeo?a ia?ieneaeaoe?? oa iaeiiiaiai ae?aeueaeaa?aeo. Caaaeuei? e?i?aee aeine?aeaeoaaeenue ?c aeei?enoaiiyi noaiaea?oieo iaai??a ae?iaieoeoaa o??ie "Lachema" (*aoineiaa//eia). Iioe/ia aonoeia eiiieaeno aei??thaaeanue ia niaeo?ioioiiao?? (NO-46, N?N?). Aeoeai?noue aioeieneaeaioieo i?ioean?a a i?aai?ci? aeine?aeaeoaaeenue aecia/aiiyi a?oai?i?a A ? A iaoiaeii Ohompson o iiaeeo?eaoe?? ?.O.*a?iy-oneaia (1987); a?oai?io N - iaoiaeii Farmer S.G. a iiaeeo?eaoe?? O.?.Ea??ii? oa ni?aaao., (1987): aeoeai?noue eaoaeace - iaoiaeii I.A.Ei?iethe oa ni?aaao., (1988); aecia/aiiy oea?oeiieaci?io - oi?o?eiaaiei iaoiaeii ?aa?ea a iiaeeo?eaoe?? N.A.Aanooaeaaa oa A.O.Eieaa (1976). Eiiieaen aaeoa??ieia?/ieo aeine?aeaeaiue neeaaeaany ?c i?e?ia?ieia?/iiai aea/aiiy ?ai a aeeiai?oe? (oa?aeoa? i?e?ioei?e, nooi?iue ?? /ooeeaino? aei aeoeaieo i?aia?ao?a, ??aaiue i?e?iaii? caa?oaeiaiino? ?ai) oa aaeoa??ieia?/ieo aiae?c?a ia aaiieoeueoo?o. ?aeaioeo?eaoe?y i?e?ioei?e aoea noaiaea?oiith. Ioe?iea ?? /ooeeaino? aei aioeaaeoa??aeueieo i?aia?ao?a i?iaiaeeeanue aeni?an-iaoiaeii, cai?iiiiiaaiei I.O.Eaia?aei oa A.I.Aauoeii (1975), ui aeicai-eyei io?eiaoe a?aeiia?aeue /a?ac 4 aiaeeie. I?aaeeuei?noue a?aeiia?ae? eiio?i-ethaaee ?acoeueoaoaie aecia/aiiy /ooeeaino? ca aeiiiiiaith noaiaea?oieo ia-oiaeee /a?ac 24-48 aiaeei. Aeey ioe?iee ??aiy i?e?iaii? caa?oaeiaiino? oeaiei i?iaiaeeee a?iin?th e?ath oa aeia ?aie c iine?aeiaiei iin?aii oa ae?iuoaaiiyi ?aiiai? i?e?ioei?e, i?ae?aooieii eieii?e oa i?ae?aooieii e?eueeino? i?e?ia-ieo inia?a ia 1a oeaieie (I.?.Eoc?i oa ni?aaao., 1980). Iaea?aeai? a oeeo?iaiio ae?ac? ?acoeueoaoe ia?iaeai? iaia?aiao?e/ieie iaoiaeaie "O? - eaaae?ao" ca aeiiiiiaith nenoaie i?ia?ai aeey aiae?co aeaieo SOAOGRA?I?NS, ?ic?iaeaieo o??iith STSN ?NC., USA. ?acoeueoaoe i?iaa-aeaieo aeine?aeaeaiue ia?iaeyeeny ia IAEI oeio ?AI ?S/1 ia i?ia?aiiiio caaania/aii? o??ie "I?naisift" ?c aeei?inoaiiyi iaeaoo i?ia?ai WINWIRD oa SOAO?E. ?ACOEUeOAOE AEANIEO AeINE?AeAEAIUe Ae?aaiinoeea naineno. Ci?ie ia?aiai? nenoaie i?e anooi? aei noaoe?iia?o o oai?eo nainenii iineee iie?ii?oiee oa?aeoa?: caaaeueia iacaeoaeaiiy oa neaae?noue a?aecia/aee on? oai??, 89,1% iaoe??io?a oo?aoaaa aieiaiee a?eue, a?eueo 82% oai?eo nea?aeeeeny ia ?iceaae nio. Ne?ae cacia/eoe, ui anoai?/ia neiioiiaoeea o oai?eo, ye? aeaeoaeaee, caeeoaeany aae aei aeienee. Oaiia?aoo?a o?ea aeua 38 N ca?a?no?iaaia a 71% niinoa?aaeaiue. E?euee?noue na?oeaaeo nei?i/aiue aei 90 oaea??a ia oaeeeio o oai?eo ye eiio?ieueii?, oae ? iniiaii? a?oi ca?a?no?iaaii c iaeiaeiaith /anoioith (16,4% oa 16,5%). Oao?ea?ae?y aei 120 oae/ oa. aoea a?aecia/aia a?aeiia?aeii a 63,6% oa 69,7% niinoa?aaeaiue ? ia?aaeuoaaea 120 oaea??a - o 21,9% oai?eo eiio?ieueii? oa o 23,3% iniiaii? a?oi. Ia?aeaeueii c oyaee?noth caaaeueiiai noaio c?inoaea caaeeoea (/anoioa iiaeeoo a?eueo 20 o oaeeeio), ui iaea i?noea a 72% oai?eo, noai yeeo ?icoe?-ithaaany ye na?aaeiuei? aaae (ia?oa i?aea?oia), oa a 88% iaoe??io?a ?c aaaeeei caaaeueiei noaiii (ae?oaa i?aea?oia). Aiaeia?/ii ci?ithaaany aaciaee neeaae e?ia?, ui coiiaeaii, c iaeiiai aieo, a?eueo ae?aaeaiei aiai?/iei neiae?iiii i?e aaaeeiio caaaeueiiio noai?, c ?ioiai aieo - ae?aaeaiith a?iien??th. Oea na?ae/eoue i?i oa, ui a?iien?y aeieea? /a?ac iiyao ae?eyiie eaaai?a i?aeoe/ii iaaaioeeth?ieo, aea ia?-ooco?ieo, ui o naith /a?ao aaaea aei ooioo aaiicii? e?ia? a a?oa??aeueia ?onei. I?e a?eueo eaaeiio ia?aa?ao naineno aeyaeaia oaiaeaioe?y aei ?icaeoeo aoeeaeico, oiae? ye oyaee? oi?ie oai?iae, ye i?aaeei, oa?aeoa?ecoaaeeny aeea-eicii ?c iaaeeeoeii aooa?ii? iniiae (AA). Aiai?/iee neiae?ii (e?euee?noue a?eo?ioeeo?a iaioa 3,0o1012 /e, aa-iiaeia?i iaioa 100 a/e) oa?aeoa?iee aeey iaio i?aea?oi ? aoa ca?a?no?iaaiee a?eueoa, i?ae o 80% niinoa?aaeaiue. I?e oeueiio a?eueo ae?aaeaiei a?i aoa o oai?eo ?c aaaeeei caaaeueiei noaiii. sse o eiio?ieuei?e, oae ? a iniiai?e a?oiao, a?aeiia?aeii a 90 oa 93% oai?eo, a?aecia/aiee eaeeioeeoic (a?eueo 12,0o109 /e) ?c cnoaii eaeeioi?ioee ae?ai. Aea yeui aaaee?noue noaio ia a?aeaeaaeany ia e?eueeino? eaeeioeeo?a (?>0,05), oi neeaae eaeeioi?ioee na?ae/ea i?i
oa, ui yaea?iee cnoa o oai?eo c aaaeeei caaaeueiei noaiii a?eueo
ae?aaeaiee (?<0,01), i?ae o oai?eo ia?oi? i?aea?oie. Oaeaee?noue in?aeaiiy a?eo?ioeeo?a iiiaae 60 ii/aiae o oai?eo ?c aaaeeei ia?aa?aii caoai?thaaiiy, ye eiio?ieueii?, oae ? iniiaii? a?oi niinoa??aaeany a 2,7 ?aca /ano?oa, i?ae o oai?eo ia?oi? i?aea?oie. Ci?ie a na/? oa?aeoa?ecoaaeeny i?ioa?io???th, ca?eueoaiiyi e?eueeino? eaeeioeeo?a oa iaci?iieo a?eo?ioeeo?a, iiyaith a?ae?iiaeo oeee?iae??a. ??aaiue e?aaoei?io a??ia?aeii (? < 0,001) ia?aaeuoaaa ii?iaeuei? iieacieee a iaio a?oiao ? ia?inoaa ia?aeaeueii aaaeeino? i?io?eaiiy caoai?thaaiiy. ssaeua oiene/iiai aaiaoeoo a oai?eo ?c aaaeeei ia?aa?aii caoai-?thaaiiy a 1,3 ?aca ia?aaeuoaaee iieacieee oai?eo ia?oi? i?aea?oie. Aiaeia?/i? aeai? io?eiai? i?e aeine?aeaeaii? caaaeueiiai a?eea oa eiai aeueaoi?iiaeo ? aeiaoe?iiaeo o?aeoe?e. A?ia?eiaaoeyoe?eiee neiae?ii aoa oa?aeoa?iee aeey iaio i?aea?oi ? iaoiiaethaaany, ianaiia?aae, ca?eueoaiiyi eiioeaio?aoe?? o?a??iiaaio, o oie /an, ye i?aeaeuaiee ??aaiue a?eueiiai aaia?eio na?ae/ea i?i ??ceo aeoeaaoe?th i?ioecai?ooth/i? nenoaie. Aaeoa??ieia?/ia aeine?aeaeaiiy ?ai oai?eo nainenii i?noeei a nia? ?aeaioeo?eaoe?th caoaeieea, eiai /ooeea?noue aei aioeaaeoa??aeueieo i?aia?ao?a, a oaeiae e?euee?nio oa?aeoa?enoeeo. I?e?ia?ieia?/iee eiio?ieue ia?aeiieo ai?eieo ina?aaee?a i?e nainen?, i?iaaaeaiee iino?eii ia i?ioyc? 1991-1998 ??., iieacaa, ui ca oeae ia??iae aeieeee ?noioi? ci?ie a i?e?iaiiio iaecaae? ?ai: aen?thaai?noue noao?eieie?a o iiiieoeueoo?? ciaioeeany c 42,3% (1991 ?.) aei 26,8% (1998 ?.), a a?ai(-) i?e?ioei?a c?inea c 37,9% (1992 ?.) aei 55,4% (1998 ?.); iniaeeai iii?oiei aoa c??no aen?thaai?no? iaee/ie neiuei-caeaiiai aiith (o 1,5 ?aca). Ia nueiaiaei? ianaiai?iiy ?ai a?ai (+) ? a?ai (-) i?e?ioei?ith cono??/a?oueny c iaeiaeiaith /anoioith (?en. 1). picscalex100010009000003c309000008002d0000000000050000000902000000000500 00000102ffffff000500000004010d00000005000000020102000000050000000c02ec00 f500030000001e00040000002701ffff030000001e00040000002701ffff050000000b02 00000000030000001e00050000000102ffffff0005000000090200000000040000002701 ffff030000001e00050000000102ffffff0005000000090200000000070000001604ec00 f50000000000040000002701ffff030000001e00050000000102ffffff00050000000902 00000000070000001604ec00f50000000000040000002701ffff030000001e0005000000 0102ffffff0005000000090200000000070000001604e800f1000400040008000000fa02 00000100000000000000040000002d01000007000000fc0200008080ff00000004000000 2d010100050000000902ffffff000500000001028080ff000500000004010d0000000500 00000201020000000b0000001a089b00cb007a001f00d100d5001b001f0007000000fc02 0000802060000000040000002d01020004000000f0010100050000000102802060000b00 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Ia??iae 1995-1998 ??. ?en1 Aeeiai?ea a ao?ieia?/i?e no?oeoo?? ai?eii? o??o?a?/ii? ?ioaeoe?? ia aen?thaai?noue i?e?ioei?e ?c ?ai oai?eo nainenii: 1 – noao?eieiee; 2 – noao?eieiee a anioe?aoe?yo; 3 – no?aioieiee; 4 – iaee/ee neiuei-caeaiiai aiith; 5 – eeoa/ia iaee/ea; 6 – i?ioae; 7 – eie?ii?oi? aaeoa???; 8 – anioe?aoe?? a?aiiaaaoaaieo i?e?ii?aai?ci?a. Aaeoa???i?y i?e nainen? aeyaeaia a 78,2% oai?eo eiio?ieueii? oa 76,7% – iniiaii? a?oi. Ii??aiyii /ano?oa i?e iiceoeaieo iin?aao aaiieoeueoo?e a e?ia? oai?eo nainenii aeyaeythoueny noao?eieiee, i?ioa aen?aa?i?noue ?o cieceeany c 43,7% (eiio?ieueia a?oia) aei 36,9% (iniiaia a?oia), i?e oeueiio c?inei /enei aeyaeaiue o e?ia? a?ai (-) aaeoa??e. Oe? caoaeieee, ye iieacaee ?acoeueoaoe aeine?aeaeaiue, iathoue a?eueo ae?aaeaio iie?aioea?ioeei?acenoaioi?noue, i?ae noao?eieiee (?en. 2). 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0f0009900f2009700f3009600f6009400f8009300f9009200fb008f00fc008e00fc00740 007000000fc020000802060000000040000002d01040004000000f001020005000000090 2ffffff00050000000102802060007c00000024033c00fc007400fb007500f9007800f80 07900f6007a00f3007c00f2007d00f0007f00ed008000ea008200e8008300e4008400e20 08500df008600db008800d9008900d6008900d1008b00ce008b00cb008c00c6008d00c30 08e00c0008e00bb008f00b8008f00b4009000af009000ac009000a8009100a30091009f0 091009c0091009700910093009100900090008b0090008700900084008f007f008f007c0 08e0078008e0073008d0070008c006d008b0069008a0066008900630089005f0087005c0 086005a0085005600840053008300510082004e0080004c007f004a007d0047007c00450 07a009e006600fc00740008000000fa0200000000000000000000040000002d010200070 00000fc020000ffffff000000040000002d010500040000002d010100040000002701fff f030000001e00040000002d010000040000002d010400040000002d01030005000000010 280206000050000000902ffffff00070000001604e7003d0100000000040000002d01020 0040000002d010500040000002d010100040000002701ffff030000001e00040000002d0 10000040000002d010400040000002d01030005000000010280206000050000000902fff fff00070000001604e7003d0100000000040000002d010000040000002d0100000400000 02d010200040000002d010500040000002d010100040000002701ffff030000001e00040 000002d010000040000002d010400040000002d010300050000000102802060000500000 00902ffffff000700000016045e003a014200fc000500000009020000000005000000010 2ffffff000500000004010d0000000500000002010100000010000000320a47000001060 0000032332c333025090009000400090009000e00040000002d010000040000002d01020 0040000002d010500040000002d010100040000002701ffff030000001e00040000002d0 10000040000002d010400040000002d010300050000000102ffffff00050000000902000 00000070000001604e7003d0100000000040000002d010000040000002d0100000400000 02d010200040000002d010500040000002d010100040000002701ffff030000001e00040 000002d010000040000002d010400040000002d010300050000000102ffffff000500000 0090200000000070000001604c600ce00aa0090000500000004010d00000005000000020 10100000010000000320aaf0094000600000033362c393025090009000400090009000e0 0040000002d010000040000002d010200040000002d010500040000002d0101000400000 02701ffff030000001e00040000002d010000040000002d010400040000002d010300050 000000102ffffff0005000000090200000000070000001604e7003d01000000000400000 02d010000040000002d010000040000002d010200040000002d010500040000002d01010 0040000002701ffff030000001e00040000002d010000040000002d010400040000002d0 10300050000000102ffffff00050000000902000000000700000016045400490038000b0 00500000004010d0000000500000002010100000010000000320a3d000f0006000000333 42c393025090009000400090009000e00040000002d010000040000002d0102000400000 02d010500040000002d010100040000002701ffff030000001e00040000002d010000040 000002d010400040000002d010300050000000102ffffff0005000000090200000000070 000001604e7003d0100000000040000002d010000040000002d010000040000002d01020 0040000002d010500040000002d010100040000002701ffff030000001e00040000002d0 10000040000002d010400040000002d010300050000000102ffffff00050000000902000 000000700000016043e00ec002200b7000500000004010d0000000500000002010100000 00f000000320a2700bb0005000000342c3930250009000400090009000e00040000002d0 10000040000002d010200040000002d010500040000002d010100040000002701ffff030 000001e00040000002d010000040000002d010400040000002d010300050000000102fff fff0005000000090200000000070000001604e7003d010000000007000000fc020000000 000000000040000002d01060004000000f0010400040000002d01020004000000f001030 00500000004010d0000002d000000f700000314000000000080000000008000008080000 0000080008000800000808000c0c0c000c0dcc000a6caf000fffbf000a0a0a4008080800 0ff00000000ff0000ffff00000000ff00ff00ff0000ffff00ffffff00040000003402030 007000000fc020100000000000000040000002d01040008000000fa02050001000000000 00000040000002d010700070000001b047000f6004800b100040000002d0106000400000 02d010200040000002d010700040000002d0104000500000009020000000005000000010 2ffffff00040000002d0106000700000016046e00f1004900b500040000002d010000040 000002d0100000500000004010d0000000500000002010100000008000000320a5200ce0 0010000003107040000002701ffff030000001e00050000000102ffffff0005000000090 200000000070000001604e7003d0100000000040000002d010200040000002d010600040 000002d010400040000002d010700070000001b049900c40062008100040000002d01060 0040000002d010200040000002d010700040000002d01040005000000090200000000050 000000102ffffff00040000002d0106000700000016049700bf0063008500040000002d0 10000040000002d0100000500000004010d0000000500000002010100000008000000320 a74009d00010000003207040000002701ffff030000001e00050000000102ffffff00050 00000090200000000070000001604e7003d0100000000040000002d010200040000002d0 10600040000002d010400040000002d010700070000001b047000960047005a000400000 02d010600040000002d010200040000002d010700040000002d010400050000000902000 00000050000000102ffffff00040000002d0106000700000016046e00910048005e00040 000002d010000040000002d0100000500000004010d00000005000000020101000000080 00000320a52007300010000003307040000002701ffff030000001e00050000000102fff fff0005000000090200000000070000001604e7003d0100000000040000002d010200040 000002d010600040000002d010400040000002d010700070000001b046e00be0032009c0 0040000002d010600040000002d010200040000002d010700040000002d0104000500000 0090200000000050000000102ffffff00040000002d0106000700000016046c00b900330 0a000040000002d010000040000002d0100000500000004010d000000050000000201010 0000008000000320a4600a800010000003407040000002701ffff030000001e000500000 00102ffffff0005000000090200000000070000001604e7003d0100000000040000002d0 10200040000002d01060005000000090200000000050000000102ffffff00040000002d0 10600040000002701ffff050000000c02e7003d01030000001e00050000000102ffffff0 005000000090200000000040000002701ffff050000000b0200000000030000001e00050 000000102ffffff0005000000090200000000040000002701ffff0300000000000000000 0Ia??iae 1991-1994??. Ia??iae 1995-1998??. ?en 2 Aeaeiaee neeaae i?e?ioei?e, aeae?eaiee ?c e?ia? I?e?ii?aai?cie: 1 – c??no ia io?eiaii; 2 – a?aiiiceoeai?; 3 – a?aiiaaaoaai?; 4 – anii?iaaii?. O ia?aaaaeiiio (96%) /ene? niinoa?aaeaiue, ye na?aae oai?eo iniiaii?, oae ? eiio?ieueii? a?oie, ?icaeoie naineno ca?a?no?iaaii ia “oii?” ianeaieo (aaeeeeo ? aeeaieeo) oa iiaaii naiiaaieo ia?aeiieo ai?eieo ina?aaee?a ?c aenieei ??aiai i?e?iaii? caa?oaeiaiiino? oeaiei. Ia niinoa??aaeiny aeiaaee?a ?icaeoeo naineno o oai?eo, i?e?iaia caa?oaeiai?noue ai?eieo ?ai o yeeo aoea ieae/a 102-3 i?e?iaieo o?e ia 1 a oeaieie. ?acoeueoao i?iaaaeaiiai ii??aiyeueiiai aiae?co oai?eo eiio?ieueii? oa iniiaii? a?oi ca a?eiaeie iieacieeaie, oa?aeoa?ii caiaeueiiai i?ioeano, ae?aciino? neiae?iio ?ioieneeaoe??, ee?i?ei-eaai?aoi?ieie iieacieeaie ? noiooiuei? iaoieia?? na?ae/eee i?i oa, ui aeai? a?oie ii??aiyeuei?. I?iaaaeaiee ca e?eoa??yie no/anii? eeaneo?eaoe?? naineno aiae?c aeiaaee?a caoai?thaaiiy, i?aeoaa?aeaeo? oaeo iaeiaeiai? /anoioe ee?i?/ieo oi?i a iaio a?oiao: o eiio?ieuei?e a?oi? (55 oai?eo) oeiiaa ea?oeia naineno ca?a?no?iaaia a 22 oai?eo, a iniiai?e (103 oai?eo) - o 43 niinoa?aaeaiiyo. Oyaeeee nainen - a?aeiia?aeii a 33 ? 60 oai?eo, c ieo: naioe/iee oie - 4 o eiio?ieuei?e oa 7 - a iniiai?e a?oiao; neiae?ii III - o 5 oa 8 oai?eo . O aea/aii? iaoiaaiaco ?icaeoeo naineno aaaeeeaa cia/aiiy ia? aeine?aeaeaiiy ai?iiiaeueieo oa a?iaeoeaieo ?a/iaei, ?ioiieia?/ieo ? iaoaaie?/ieo iieaciee?a, ine?eueee aeicaiey? ioiieoe aieiai? eaiee ?aaoeyoi?ieo nenoai i?aai?cio, ui cae?eniththoue iaoaaie?/io aaeaioaoe?th ca oe?? iaoieia??. C iaoith iioei?caoe?? e?eoaaeueii? i?ia?aie aea/ai? iaaeinoaoiuei a?aeii? ia?aiao?e iae?i-aiaeie?eiii? oa aioeieneaeaioii? nenoai, ia?aeeniiai ieeneaiiy e?i?ae?a ? ?ioiiiai noaoono o oai?eo nainenii. Aea/aiiy iniiaieo ai?iii?a ia?eoa???ii? eaiee aaeaioaoe?eii? nenoaie ei?oecieo oa ?inoe?io iieacaei, ui ai?no ?o o e?ia? o oai?eo nainenii ci?ith-?oueny a caeaaeiino? a?ae aaae noaio ia iiiaio ianoaaeaiiy. Oae, i?e iaaeoiaeaeaii? aei noaoe?iia?o ??aaiue ei?oecieo aoa a 1,6 ?aca aeua ii?ie, ui na?ae/eoue i?i aeoeaaoe?th aetheiei?oeei?aeii? ooieoe?? iaaeie?iee?a. I?ioa a o?aoeie iaoe??io?a ??aaiue ei?oecieo ia aeoiaeea ca iaae? o?c?ieia?/ii? ii?ie, ui a oiiaao ?aaeoe?? o?eaiae aa?oi ?icaeyaeaoe ye iciaeo c?eao eiiiainaoi?ieo iiaeeeainoae i?aai?cio. I?aeaeuaiiy ??aiy ei?oecieo o aeaeoaeaeeo oai?eo ia 7-8 aeiao i?neyiia?aoe?eiiai ia??iaeo aa?oi ?icaeyaeaoe ye iayai?noue eiiiainaoi?iiai ?aca?ao caoenieo nee i?aai?cio oa i?i a?aenooi?noue oaeiai o aeiaaeeao eaoaeueiiai e?ioey. Iii??ia i?aeaeuaiiy ei?oecieo ia iiiaio ee?i?/iiai aeaeoaeaiiy na?ae/eoue i?i oa, ui ?aaa?e?oaoe?eiee ia??iae aei iiiaioo aeienee ia cae?i/o?oueny, a aaeaioaoe?eii-eiiiainaoi?i? iiaeeeaino? i?aai?cio ciaoiaeyoueny a noaae?? ?acenoaioiino?. O 63,6% iiia?eeo oai?eo a?aecia/aiee iecueeee ??aaiue ei?oecieo, ui a?aeiia?aeaei noaae?? aeniaaeaiiy. ??aaiue ?inoe?io a e?ia? oai?eo nainenii aei e?eoaaiiy i?aeaeuoaaany a 3 ?ace, ui aa?oi o?aeooaaoe ye aaeaeaaoio ?aaeoe?th i?aai?cio ia ca?eueoaiiy ai?noo ei?oecieo oa "oo?eiaiiy" aetheice e?ia? a iaaeao o?ceieia?/ii? ii?ie. Ia 7-8 aeiao o aeaeoaeaeeo oai?eo aeeiai?ea ?inoe?io ia caciaaaea ci?i, o oie /an ye o iiia?eeo oai?eo ia oii? iecueeiai ??aiy ei?oecieo a 38,9% niinoa?aaeaiue a?aecia/aia iiaeaeueoa ca?eueoaiiy ?inoe?io a e?ia? (?<0,001), ui iaoiiaethaaei aeniaaeaiiy aoaeaaiaeieo ?aca?a?a ? ianoaiiy oace aeniaaeaiiy. Ia 12-16 aeiao ??aaiue ?inoe?io o aeaeoaeaeeo oai?eo cieaeoaaany ia 28,7% (?<0,001), ui ia? aaeaioaoe?eia cia/aiiy, ine?eueee i?e oeueiio i?aeae-uo?oueny /ooeea?noue oeaiei aei ae?? aetheiei?oeei?ae?a. O a?oi? iiia?eeo oai?eo ??aaiue ?inoe?io oaeiae cieaeoaaany, aea a??ia?aeii (?<0,01) ia?aaeuoaaa iieacieee aeaeoaeaeeo iaoe??io?a. Ia 25-30 aeiao ??aaiue ?inoe?io ia ia?aaeuoaaa iieaciee caei?iaeo in?a, ui na?ae/eei i?i ia?ao?ae i?aai?cio ia ?ioee ??aaiue ?aaoeyoe??, a?eueo iuaae-eeaee oa a?eueo aeioe?eueiee. O oeueiio iieyaa? a?ieia?/ia aeioe?euei?noue cieaeaiiy ??aiy ?inoe?io (oaae. 2). Aei e?eoaaiiy eiao?oe??io ni?aa?aeiioaiiy ei?oecieo aei ?inoe?io o oai- Oaaeeoey 2 Aeeiai?ea iieaciee?a ??aiy ei?oecieo oa ?inoe?io o oai?eo nainenii (M±m) A?oiie oai?eo Aaee/eia iieaciee?a Eiio?ieueia a?oia i=30No?iee aeine?aeaeaiiyI?e anooi?7-8 aeiaa12-16 aeiaa25-30 aeiaaEi?oecie, iiieue/e528,028,6 Aeaeoaeae? (i=85)858,432,7* (i=79)921,754,8* (i=73)813,341,2* (i=64)734,836,7* (i=52)Iiia?e? (i=18)24,93,7* (i=17)36,2 4,1** (i=13)31,73,9** (i=11)14,3 2,4** (i=9)?inoe?i, ieaae/ie8,50,7Aeaeoaeae? (i=85)25,63,4* (i=79)24,82,7* (i=73)17,22,2* (i=64)8,90,9* (i=52)Iiia?e? (i=18)863,647,3* (i=17)612,4 68,7** (i=13)623,958,2** (i=11)437,2 71,5* (i=9) I?ei?oee: 1.*- ?<0,05 o ii??aiyii? ?c ii?iaeueieie cia/aiiyie. 2.**- oa ae ?c iieacieeaie aeaeoaeaeeo. ?eo nainenii ca?eueooaaany a 2,3 ?ace aac aeinoia??ieo ?icoiaeaeaiue (?>0,05) o a?oi? aeaeoaeaeeo ? iiia?eeo. O i?ioean? e?eoaaiiy o
aeaeoaeaeeo oai?eo eiao?oe??io cieaeoaaany ? ia 25-30 aeiao ia
ia?aaeuoaaa ii?iaeuei? aaee/eie. Oaea ci?ia eiao?oe??ioo aeiaiaeeoue, ui
i?e nainen? a noai? aaeaioaoe?eieo i?ioean?a aeieeathoue cia/i? ci?ie. C
oace o?eaiae, oa?aeoa?ii? aeey ??aiy oeaio?aeueieo iaoai?ci?a
?aaoeyoe??, aiie ia?aoiaeyoue o ae?oao oaco – ?acenoaioiino? ia ??ai?
ia?eoa?e/ieo iaoai?ci?a caaacia/aiiy caaaeueiiai aaeaioaoe?eiiai
neiae?iio.

O iiia?eeo oai?eo eiao?oe??io ni?aa?aeiioaiiy ei?oecieo aei ?inoe?io
eieeaaany a iaaeao a?ae 2,2 aei 7,4 iaeeieoe?, ui na?ae/eei i?i
a?aenooi?noue ?aca?ao eiiiainaoi?ieo iiaeeeainoae i?aai?cio oa ii?ooaiiy
aia?aicaaacia-/aiiy aaeaioaoe?eieo i?ioean?a o oac? aeniaaeaiiy.

Anoaiiaeaii, ui aeoeaaoe?y oe?aio?iiii? ooieoe?? a?iio?co, yea
niinoa-??aaeanue, iineea i?enoinoaaeueiee oa?aeoa? ? aoea iia’ycaia c
aia?aaoe/iei caaacia/aiiyi niaoeeo?/ieo oa ianiaoeeo?/ieo aaeaioaoe?eieo
?aaeoe?e i?aai?c-io. O aeaeoaeaeeo ? iiia?eeo oai?eo o aeeiai?oe?
aeine?aeaeaiiy aeinoia??ieo ?icoiaeaeaiue a ??ai? OOA ia aeyaeaii
(?>0,05). I?ioa, o 27,8% iiia?eeo a?aecia/aii ae?ae iecueeee ??aaiue
OOA, ui na?ae/eoue i?i iiaia ii?ooaiiy ai?iiiaeueiiai aiiainoaco.

Aei e?eoaaiiy ??aaiue O3 ? O4 o oai?eo nainenii o 1,2 —
1,3 ?aca (? <0,001) ia?aaeuoaaei aiaeia?/i? iieacieee caei?iaeo in?a. I?ioa, o 10,7% oai?eo ??aaiue O3 ? a 9,7% O4 ia aeoiaeea ca iaae? o?c?i-eia?/ii? ii?ie, a a 22,3% ??aaiue o?eeiaeoe?iieio oa o 24,3% ??aaiue oe?ieneio aoee cieaeaieie. Ine?eueee aca?iia?aeiineie i?ae oeaio?ii oa ia?eoa???th a aiaeie?eii?e nenoai? aaco?oueny ia i?eioeei? ?aoeei?ieiino?, oi on? o?ceieia?/i? oa aaeaioa-oe?ei? ci?ie a nenoai? a?iio?c-ueoiaeaeia caeica iiaeooue i?io?eaoe o?eueee a i?ioeeaaeieo iai?yieao. Oiio i?aeaeuaiiy ??aiy O3 ? O4 na?ae/eoue i?i aeieaaeo iaaaoeaiiai cai?ioiueiai ca'yceo ?, oaeei /eiii, i?i ii?ooaiiy ai?iiiaeue-iiai aiiainoaco. Ia 7-8 aeiao i?neyiia?aoe?eiiai ia??iaeo ye o aeaeoaeaeeo, oae ? a iiia?eeo oai?eo ??aaiue O3 ? O4 i?iaeiaaeoaaa caeeoaoeny a??ia?aeii i?aeaeuaiei (?<0,001), aea ia ia?aaeuoaaa aiaeia?/i? iieacieee aei e?eoaaiiy (?>0,05). I/aaeaeii, o aeaiiio aeiaaeeo, a?ia?oe?ieneiai?y ia
? ?acoeueoaoii ca?eueoaiiy oe?ai?aeii? aeoeaiino?, a ? iane?aeeii ci?ie
ni?iiiaeiino? oe?ieneica’yco-th/eo aeiaoe?i?a ?c ieacie.

I?e aeieeiaii? oneeaaeiaiue oa eaoaeueiiio e?ioe? eieeaaiiy ??ai?a O3 ?
O4 c?oooaaeeny o a?e ieaeiuei? iaae? ii?ie ? neeaaeaee 74,8% oa 79,2%.
Oai?eo ?c a?ia?ooieoe??th ia niinoa??aaeinue.

Ia 25-30 aeiao ??aaiue O3 ? O4 ia aeoiaeea ca iaae? iieaciee?a aa?oiuei?
o?c?ieia?/ii? ii?ie, i?ioa iiaii? ii?iae?caoe?? iieaciee?a ia
a?aeaoaaeiny, ui aeacoaaei ia iaiao?aei?noue i?iaeiaaeaiiy e?eoaaeueieo
caoiae?a (oaae. 3).

A?aoiaoth/e, ui a?eueii-?aaeeeaeueia ieeneaiiy e?i?ae?a ? iaeiei c
iniia-

Oaaeeoey 3

Aeeiai?ea iieaciee?a ??aiy oe?aio?iiiiai ai?iiio a?iio?co,
o?eeiaeoe?iieio oa oe?ieneio o oai?eo nainenii (Mm)

A?oie

oai?eo

Aaee/eia iieaciee?a Eiio?ieueia a?oia

i=30No?iee aeine?aeaeaiiyI?e anooi?7-8 aeiaa12-16 aeiaa25-30 aeiaaOOA,

ieiA/e1,828,6 Aeaeoaeae?

(i=85)2,110,12*

(i=79)2,120,17*

(i=73)2,090,23*

(i=64)1,920,43*

(i=52)Iiia?e?

(i=18)2,060,23*

(i=17)2,14 0,32*

(i=13)2,160,47*

(i=11)1,67 0,54**

(i=9)O3,

iiieue/e1,720,21 Aeaeoaeae?

(i=85)2,130,14*

(i=79)2,130,27*

(i=73)1,960,13*

(i=64)1,780,18

(i=52)Iiia?e?

(i=18)2,110,34*

(i=17)2,14 0,36*

(i=13)1,680,41*

(i=11)1,64 0,32**

(i=9)O4,

iiieue/e110,011,2Aeaeoaeae?

(i=85)153,112,3*

(i=79)156,316,4*

(i=73)126,318,4*

(i=64)116,217,7

(i=52)Iiia?e?

(i=18)154,211,8*

(i=17)156,8 21,2*

(i=13)104,17,8**

(i=11)96,7 12,3**

(i=9) I?ei?oee:

1.*- ?<0,05 o ii??aiyii? ?c ii?iaeueieie cia/aiiyie. 2.**- oa ae ?c iieacieeaie aeaeoaeaeeo. ieo ioneiaeo /eiiee?a i?ioeano ooeiaeaeaiiy ee?oeie, a eiai noai o oai?eo nainenii ina?oeaii iaaeinoaoiuei oa noia?a/eeai, i?iaaaeaia aeine?aeaeaiiy i?ioean?a IIE o 103 oai?eo nainenii oa 27 o caei?iaeo in?a. Aea/aeany e?eue-e?noue caaaeueieo e?i?ae?a e?ia?, ??aaiue ia?aeiieo i?iaeoeo?a ia?aieeneaiiy a?ae?iia?aeen?a e?i?ae?a, oaeaee?noue ?aaeoe?? ia?ieneaeaoe?? oa ??aaiue aoi?eiieo i?iaeoeo?a IIE - iaeiiiaiai ae?aeueaeaa?aeo ? oeooiaeo iniia. E?euee?noue caaaeueieo e?i?ae?a o oai?eo nainenii aei e?eoaaiiy oa o aeeiai?oe? e?eoaaiiy aoei cia/ii cieaeaii (?<0,001), ui na?ae/eoue i?i cia/ia ii?ooaiiy ee?oeiiiai iaoaaie?cio oa ??cea cieaeaiiy ooieoe?iiaeueii? aeoeaiino? eaeeioeeo?a. O aeiaaeeao eaoaeueiiai e?ioey e?euee?noue CE noaoenoe/ii a??ia?aeii ia ci?ithaaeiny (?>0,05), ui
aeaco? ia a?aeiinio noaa?euei?noue e?i?aeii? nenoaie oa iaiao?aei?noue
aeinoaoiuei o?eaaeiai /aniaiai oaeoi?o, uia a?aeaoeeny iacai?ioi? ci?ie
a nenoai? a?eeiai-e?i?aeieo eiiieaen?a.

Ine?eueee CE ? iniiaiei noano?aoii i?ioean?a ia?ieneaeaoe??, oi
ciai-oaiiy ?oiuei? e?eueeino? iia?/ii na?ae/eoue i?i ?ioaineo?eaoe?th
i?ioean?a IIE — AIN.

Ii??aiyeueia aeine?aeaeaiiy ia?aeiieo i?iaeoeo?a IIE iieacaei, ui ye
aei, oae ? a i?ioean? e?eoaaiiy ? cia/ia aeoeaaoe?y ?aaeoe??
ia?ieneaeaoe??. O?eueee aei ia??iaeo noaa?e?caoe?? caoai?thaaiiy, ia
12-16 aeiao, a?aecia/aeiny /?oea cie-aeaiiy ?ioaineaiino? ?aaeoe?? IIE
(?<0,01). I?e oeueiio oaii ii?iae?caoe?? oaeaeeino? ?aaeoe?? IIE caeaaeaa a?ae ianyao iia?aoeaiiai ao?o/aiiy oa i?in-oyaeiino? ia?aeiiiai ai?eiiai ina?aaeeo. Aea/aiiy aoi?eiieo i?iaeoeo?a ia?ieneaeaoe?? - iaeiiiaiai ae?aeueaea-a?aeo oa oeooiaeo iniia iieacaei, ui iaeiie/aiiy aoi?eiieo i?iaeoeo?a IIE ca?eueoo?oueny aae aei noaa?e?caoe?? caoai?thaaiiy ? iia?eueii ciaioo?oueny a i??o aeaeoaeaiiy. Aeyaeaii /?oeee aca?iica'ycie i?ae oyaee?noth naioe/iiai i?ioeano ? eieeaaiiyi on?o aeine?aeaeoaaieo i?iaeoeo?a IIE: niinoa??aaeiny i?aeaeuaiiy eiioeaio?aoe?? ia?aeiieo oa aoi?eiieo i?iaeoeo?a o ia??iae i?ia?anoaaiiy ca-oai?thaaiiy, oaiaeaioe?y aei ii?iae?caoe?? a ia??iae noaa?e?caoe?? i?ioeano, iaae?iiy ??aiy an?o aeine?aeaeoaaieo ?ia?aae??io?a i?e ?icaeoeo naioe/iiai oieo ? eaoaeueiiai e?ioey. O?eaea ia?inoaiiy eiioeaio?aoe?? ia?aeiieo oa aoi?eiieo i?iaeoeo?a IIE a?aecia/aee i?e i?ia?aae??ioiiio ia?aa?ao caoai?thaaiiy, iaaaeaei i?ae?-a?ai?e aioeaaeoa??aeuei?e oa?ai??, aai i?e iaaeinoaoi?e naiaoe?? ia?aeiiiai ina?aaeeo. O iiia?eeo oai?eo aeyaeaia oaea caeiiii??i?noue: aenieee ??aaiue ia?aeiieo oa aoi?eiieo i?iaeoeo?a IIE, ui caa??aa?oueny aeineoue o?eaaeee /an, ii/eiaa i?ioyaii 1-2 aeiae oaeaeei cieaeoaaoeny aei ii?iaeueiiai, a iio?i ? aei iaoieia?/ii iecueeiai. ?ioaineaia cieaeaiiy eiioeaio?aoe?? i?iaeoeo?a IIE, ye i?aaeei, na?ae/eei i?i aeeaie? iaicai?ioi? aeano?oeoeai? i?ioeane a?ieia?/ieo iaia?ai, ?icaeoie aaeoa??aeueiiai oieo (oaae. 4). Aioeieneaeaioia nenoaia ni?ey? aaeueioaaiith i?ioean?a aooiieen-eaiiy oa caaacia/o? noae?noue iecueeiai ??aiy ?aaeeeae?a o ee?oei?. I?iaaaeaii aeine?aeaeaiiy i?yiiai oa?iaioaoeaiiai aioeieenethaa/a - eaoaeace, aiaei-?ic/eiiiai aioeieenethaa/a - anei?a?iiai? eeneioe, aee?i?ic/eiaieo aioeieenethaa/?a - a?oai?i?a A ? A, i?aeueai?uoth/iai a?eeo - oea?oeiieaci?io. Aiae?c ?acoeueoao?a aeine?aeaeaiiy iieaco?, ui o oai?eo nainenii aei e?eoaaiiy a?aecia/a?oueny i?eai?/aiiy oa?iaioaoeaiiai aioeieeneaiiy, ui i?aeoaa?aeaeo?oueny cieaeaiiyi caaaeueiiai ??aiy eaoaeace a 2,1 ?aca, a?oai?io N - o 2 ?aca, a?oai?i?a A ? A a 1,4 ?aca. O i?ioean? e?eoaaiiy aeine?aeaeoaai? ?ia?aae??ioe o aeaeoaeaeeo oai?eo iinooiiai ca?eueooaaeeny ? ia 25-30 aeiao aeoeai?noue eaoaeace oa ??aaiue anei?a?iiai? eeneioe neeaaeaee a?aeiia?aeii 80,9% oa 87,6% a?ae ii?ie, a ??aaiue a?oai?i?a A ? A ii?iae?coaaany. Aeoeai?noue oea?oeiieaci?io o aeaeoaeaeeo oai?eo aei e?eoaaiiy a 1,8 ?ace aoea aeua ii?ie, cieaeoaaeany a i?ioean? e?eoaaiiy ? aei iiiaioo ee?i?/iiai aeaeoaeaiiy neeaaeaea 67,7% a?ae ii?iaeueieo aaee/ei, ui na?ae/eoue i?i iayai?noue i?eoiaaii? aeeoaeueii? iaaeinoaoiino? oa aoei na?aeeii eiiiainaoi?ii? ?aaeoe?? ia i?eai?/aiiy ieenieo i?ioean?a. I?e ?icaeoeo naioe/iiai oieo oa o aeiaaeeao eaoaeueiiai e?ioey iieacieee aioeieneaeaioii? nenoaie i?aeoe/ii ia aecia/aeeny, ui aeacoaaei ia iaea?iaaiee i?ioean ia?ieneaeaoe?? (oaae. 5). ?acoeueoaoe ii??aiyeueiiai aeine?aeaeaiiy nenoaie IIE - AIN ? ioe?iee ?? ooieoe?iiaeueiiai noaio o oai?eo nainenii na?ae/aoue i?i i?eai?/aiiy aeoeaiino? aioeieneaeaioii? nenoaie oa ?ioaineo?eaoe?? o ieo i?ioean?a ia?aieeneaiiy e?i?ae?a. Oe? ci?ie ? iaoiaaiaoe/iith iniiaith /eneaiieo oneeaaeiaiue Oaaeeoey 4 Aeeiai?ea i?ioean?a ia?ieneaeaoe?? o oai?eo nainenii () Aeine?aeaeo-aaiee iieaciee Eiio?ieue i=27No?iee aeine?aeaeaiiyI?e anooi?7-8 aeiaa12-16 aeiaa25-30 aeiaaAeaeoaeae? i=82Iiia?e? i=16Aeaeoaeae? i=73Iiia?e? i=11Aeaeoaeae? i=64Iiia?e? i=10Aeaeoaeae? i=53Iiia?e? i=6AIE233 a ie3,51±0,246,27±0,73*8,12±1,02**8,52±1,32*10,61±1,23**5,46±0,68*12,12±2, 31**4,21±0,32*9,32±2,63**AIE233 ia 1ia e?i?ae?a1,03±0,022,28±0,24*3,12±0,41**2,47±0,21*3,43±0,52**2,17±0,43*3,4 3±0,26**1,08±0,143,21±0,32**AIE273 a ie0,65±0,071,58±0,42*1,76±0,37**1,78±0,53*1,94±0,73**1,53±0,32*1,86±0,43 **0,70±0,161,79±0,62**CE a a/e6,65±0,414,24±0,52*3,27±0,41**3,63±0,41*3,28±0,37**3,19±0,39*3,18±0,2 9*3,93±0,32*3,02±0,19**IAeA, ieiieue/e10,45±0,4218,57±0,54*23,18±1,63**26,22±1,33*35,53±1,17**15,43±1 ,03*32,12±0,96**12,54±0,43*20,62±2,24**OI, oiia.iae.7,20±0,8215,47±1,73*19,32±1,42**22,39±1,45*23,12±1,18*11,56±0,6 2*20,39±0,87**9,32±0,87*17,62±1,34** I?ei?oee: 1.*- ?<0,05 o ii??aiyii? ?c ii?iaeueieie cia/aiiyie. 2.**- oa ae ?c iieacieeaie aeaeoaeaeeo.? iio?aaothoue i?iaaaeaiiy niaoe?aeueieo ei?aeoe?eieo e?eoaaeueieo oa i?io?eaeoe/ieo caoiae?a. C'yniaoaaiiy noaio ?ioiiiai noaoono iaiao?aeii ia o?eueee aeey ?ico-i?iiy caeiiii??iino? ?icaeoeo naineno, aea ? aeey iiaeeeaino? ?ic?iaee e?eoa???a i?iaiinoe/ii iani?eyoeeaiai i?neyiia?aoe?eiiai ia??iaeo oa eiai oneeaaeiaiue. A?aeaeath/e ia?aeiio ?ieue i?ioeanai naii?aaoeyoe?? ?ioiii? nenoaie, iaiao?aeii a?aecia/eoe, ui ia ??ai? oe?e?niiai i?aai?cio ooieoe?iiaeueia aeoeai?noue iiioeyoe?e e?ioi?aeieo ee?oei ciaoiaeeoueny i?ae iino?eiei aieeaii iae?i-aoii?aeueieo, aiaeie?eiieo /eiiee?a, a oaeiae noaio ee?oeiieo a?iiaia?ai. Iaie aea/ai? iniiai? iieacieee ee?oeiiiai ? aoii?aeueiiai ?ioi?oaoo, a oaeiae ianiaoeeo?/i? iieacieee ?acenoaioiino? i?aai?cio. Aea/aiiy ?ioiieia?/iiai iii?oi?eiao aeicaieeei iai aeae?eeoe a caeaaeiino? a?ae aeyaeaieo ii?ooaiue o?e a?oie. Ia?oa a?oia, iae/eneaii?oa - 74,6% oai?eo, ?c noi?aneaiei oeiii ?ioiii? a?aeiia?ae?. Iiia?ei 14 oai?eo, eaoaeuei?noue neeaea 18,2%. Ae?oaa a?oia iiaeaia oai?eie c ??aiii??ii aeoeaiaaiei oeiii ?ioiii? a?aeiia?ae?. Aeaiee oei a?aecia/aiee o 11,6% niinoa?aaeaiue. Eaoaeueiino? a ae?oa?e a?oi? oai?eo ia aoei. Oai?? c? ci?oaiei oeiii ?ioiiiai noaoono neeaee o?aoth a?oio - 13,6% niinoa?aaeaiue. I?e oeueiio a?aecia/aii ii?iaeueiee aai noi?aneaiee aoii?aeueiee ?ioi?oao ? aeoeaaoe?y aeayeeo iieaciee?a ee?oeiii? eaiee i?e ii?iaeueiiio aai cieaeaiiio ??ai? eiiieaiaioo. Oe? ci?ie na?ae/eee i?i nainea?e?caoe?th O-ee?oeiieo iiioeyoe?e aioeaaiii ? ?icaeoeo aooi?ioieo i?ioean?a. Eaoaeuei?noue o o?ao?e a?oi? neeaea 28,6% (oaae.6). ?acoeueoaoe aeine?aeaeaiiy ee?oeiii? ? aoii?aeueii? eaiie ?ioi?oaoo ?acii ?c iieacieeaie ianiaoeeo?/ii? ?acenoaioiino? i?aai?cio i?e nainen? aOaaeeoey 5 Aeeiai?ea ??aiy aioeieneaeaio?a o oai?eo nainenii (M±m) Aeine?aeaeoaa-iee iieaciee Eiio?ieue i=27No?iee aeine?aeaeaiiyI?e anooi?7-8 aeiaa12-16 aeiaa25-30 aeiaaAeaeoaeae? i=82Iiia?e? i=16Aeaeoaeae? i=73Iiia?e? i=11Aeaeoaeae? i=64Iiia?e? i=10Aeaeoaeae? i=53Iiia?e? i=6EO, ieao/e26,66±1,9114,72±1,74*10,12±1,08**16,65±1,09*9,34±0,82**17,36±1,41* 9,35±0,67**22,64±0,89*8,16±1,03**A?o. N, ieiieue/e83,46±3,1846,21±2,48*42,32±2,14**48,76±2,33*42,84±1,96**63,34±3 ,12*48,34±2,16**74,32±2,23*44,12±2,08**A?o. A, ieiieue/e2,39±0,161,87±0,43*1,89±0,51*1,84±0,21*1,83±0,17*1,86±0,22*1,79 ±0,33**2,36±0,161,81±0,42**A?o. A, ieiieue/e18,79±0,7315,35±0,48*12,13±0,27**13,34±0,64*11,83±0,48*15,66±0, 54*11,32±0,21**18,56±0,7610,12±0,36**OeI, ieiieue/e1,24±0,052,21±0,24*2,20±0,43*2,28±0,49*2,29±0,64*2,11±0,65*2,27 ±0,35**1,39±0,16*2,15±0,46** I?ei?oee: 1.*- ?<0,05 o ii??aiyii? ?c ii?iaeueieie cia/aiiyie. 2.**- oa ae ?c iieacieeaie aeaeoaeaeeo. Oaaeeoey 6 ?iciiae?e oai?eo ca oyaee?noth naineno oa ?acoeueoaoai ?ioaineaii? oa?ai?? a caeaaeiino? a?ae oeio ?oiueai ?ioiiiai noaoono Oei ?ioiiiai noaoono (i=103)Oi?ia (oace) naioe/iiai neiae?iioNainenOyaeeee nainenNaioe/iee oieNeiae?ii III Caaaeueiee % eaoaeueiino?*enei oai?eoIiia?-ei*enei oai?eoIiia?-ei*enei oai?eoIiia?-ei*enei oai?eoIiia?-eiNoi?anea-iee i=77 30 1 34 2 6 5 7 6 18,2??aiii??ii aeoeaiaaiee i=1210-2-----0Ci?oaiee c iciaeaie aooi?ioiieo ?aaeoe?e i=143-92111128,6Anueiai431 (2,3%)454 (8,9%)76 (85,7%)87 (87,5%)17,4 % caeaaeiino? a?ae oeio ?ioiiiai noaoono oai?eo iiaeai? a oaae. 7 oa 8. O iiia?eeo oai?eo aiceiaoe/ia aeoeai?noue iaeo?io?e?a i?ia?aneaii cieaeoaaeany, ui aeaco? ia aeniaaeaiiy ?oi?o oaaioeeoa?ieo ooieoe?e. Ca?eueoaiiy iieaciee?a oaaioeeoico a aeeiai?oe? e?eoaaiiy o aeaeoaeaeeo oai?eo ? i?iaiinoe/ii ni?eyoeeaith iciaeith, o oie /an ye ??cea cieaeaiiy oaaioeeoa?iiai /enea o iiia?eeo na?ae/eei i?i iacaeaoi?noue oaaioeeo?a ia?aaa?thaaoe caoiieai? i?e?iae. A?aeiia?aeii aei oeeo ?ic?iaie iioei?ciaaia i?ia?aia ?ioaineaiiai e?eoaaiiy oai?eo nainenii iniiaii? a?oie, ui aeeth/a?: ii?aoethaaiiy ia?aeiiiai ina?aaeeo ?ioaeoe??; ?aoe?iiaeueio aioea?ioeei- Oaaeeoey 7 Iieacieee ee?oeiiiai ?ioi?oaoo i?e nainen? a caeaaeiino? a?ae oeio ?ioiiiai noaoono oai?eo Oei ?ioiiiai noaoonoNo?iee aeine?aeaeaiiyAeine?aeaeoaaiee iieaciee a?aeiinii ii?ie (N)O-e?ioioeeoeTaThTsTh/TsI-e?ioioeeoeNoi?aneaiee (i=77) Eaoaeuei?noue – 18,2%Aei e?eoaaiiyCieaeai?Cieaeai?Cieaeai?Cieaeai?Cieaeai?Ii?iaA aeeiai?oe? - aeaeoaeae?I?aeaeuai?I?aeaeuai?I?aeaeuai?I?aeaeuai?I?aeaeuai?Aeayea i?aeaeuaiiy- iiia?e?Aac aeeiai?eeCieaeai?Cieaeai?I?aeaeuai?I?aeaeuai???cea i?aeaeuaiiyIane?aeie - aeaeoaeae?Ii?iaIi?iaIi?iaIi?iaIi?iaAeaui i?aeaeuai?- iiia?e???cei cieaeai???cei cieaeai???cei cieaeai???cei i?aeaeuai???cei i?aeaeuai???cei i?aeaeuai???aiii??ii aeoeaiaaiee (i=12) Eaoaeuei?noue – IAei e?eoaaiiyIi?iaIi?iaIi?iaIi?iaIi?iaIi?iaA aeeiai?oe? - aeaeoaeae?*aniaa cieaeaiiy*aniaa cieaeaiiyIi?iaIi?iaIi?iaAeae?eueea i?aeaeuai?Iane?aeie - aeaeoaeae? Ii?iaIi?iaIi?iaIi?iaIi?iaAeaui i?aeaeuai?Ci?oaiee c ?icaeoeii aooi?ioiieo i?ioean?a (i=14) Eaoaeuei?noue – 28,6 %Aei e?eoaaiiyI?aeaeuai?I?aeaeuai?I?aeaeuai?Aeae?eueea aeua ii?ieAeae?eueea ieae/a ii?ieIi?iaA aeeiai?oe? - aeaeoaeae?Ieaaia cieaeaiiyIeaaia cieaeaiiyIeaaia i?aeaeuaiiyAac aeeiai?eeIeaaia cieaeaiiyAeayea i?aeaeuaiiy- iiia?e???cea cieaeaiiy??cea cieaeaiiy??cea cieaeaiiyI?aeaeuaii?Cieaeaii???cea i?aeaeuaiiyIane?aeie - aeaeoaeae???cea cieaeaiiy (42% io N)??cea cieaeaiiy (89% io N)??cea cieaeaiiy (82% io N)Ii?iaAeae?eueea ieae/a ii?ieIii??ii i?aeaeuai?- iiia?e???cea cieaeaiiy (42% io N)??cea cieaeaiiy (51% io N)??cea cieaeaiiy (53% io N)??cea i?aeaeuaiiy??cea cieaeaiiy (iaioa 1,0-1,2)??cea i?aeaeuaiiyOaaeeoey 8 Iieacieee aoii?aeueiiai ?ioieoaoo oa ianiaoeeo?/ii? ?acenoaioiino? i?aai?cio i?e nainen? a caeaaeiino? a?ae oeio ?ioiiiai noaoono oai?eo Oei ?ioiiiai noaoonoNo?iee aeine?aeaeaiiyAeine?aeaeoaaiee iieaciee a?aeiinii ii?ie (N)A-e?ioi-oeeoeIg GIg MIg AOe?EEiiieaiaioINO-oanoOaaioeeoa?ia /eneiNoi?aneaiee (i=77) Eaoaeuei?noue – 18,2%Aei e?eoaaiiyCieaeai?Cieaeai?Cieaeai?Cieaeai?Cieaeai?Cieaeai?I?aeuaii a 4 ?aceCieaeaiiA aeeiai?oe? - aeaeoaeae?I?aeaeuai?Iinooiiaee c??noIinooiiaee c??noIinooiiaee c??noCieaeai?I?aeaeuai?Cieaeai?Eaaea cieaeaiiy- iiia?e?CieaeaiiyIiaeaeueoa cieaeaiiyIiaeaeueoa cieaeaiiyIiaeaeueoa cieaeaiiyI?aeaeuai?Cieaeai? Cieaeai???cea cieaeaiiyIane?aeie - aeaeoaeae?Ii?iaAeecueei aei N (82%)Aeecueei aei N (90%)Aeecueei aei N (93%)Aeecueei aei N (92%)Aeecueei aei N (93%)I?aeaeuaii a 2 ?ace a?ae NAeecueei aei N (83%)- iiia?e?I?aeaeuai???cei cieaeai? (43% io N)??cei cieaeai? (44% io N)??cei cieaeai? (46% io N)??cei i?aeaeuai???cea cieaeaiiy (a 2 ?aca)Cieaeaii (ia 30% a?ae N)Cieaeaii (73% io N)??aiii??ii aeoeaiaaiee (i=12) Eaoaeuei?noue – IAei e?eoaaiiyAeae?eueea cieaeai?Ii?iaIi?iaIi?iaEaaeue i?aeaeuai?Cieaeai?I?aeaeuaii a 2 ?aceIi?iaA aeeiai?oe? - aeaeoaeae?I?aeaeuai?I?aeaeuai?Aac aeeiai?eeAac aeeiai?eeIi?iaAeua N ia 30%Cieaeai?Eaaeue cieaeaiiIane?aeie - aeaeoaeae?Ii?iaI?aeaeuai?Ii?iaIi?iaIi?iaI?aeaeuai?Ii?iaEaaeue cieaeaiiCi?oaiee c ?icaeoeii aooi?ioieo i?ioean?a (i=14) Eaoaeuei?noue – 28,6 %Aei e?eoaaiiyCieaeai?Ii?iaIi?iaIi?iaI?aeaeuai?Cieaeai?Eaaeue i?aeaeuaiiEaaeue i?aeaeuaiiA aeeiai?oe? - aeaeoaeae?Aeayea i?aeaeuaiiyAeayea cieaeaiiyAeayea cieaeaiiyIi?iaCieaeaiiyIaeaea aac aeeiai?eeAeecueeee aei NEaaea cieaeaiiy- iiia?e?Cieaeai???cea cieaeaiiy??cea cieaeaiiy??cea cieaeaiiyI?aeaeuai?CieaeaiiyCieaeaiiy??cea cieaeaiiyIane?aeie - aeaeoaeae?Aeayea cieaeaiiyCieaeai? (72%)Aeecueeee aei ii?ieIi?iaAeae?eueea cieaeai?Cieaeai? (81% io N)Ii?iaAeae?eueea cieaeaii- iiia?e???cei cieaeai???cei cieaeai? (43% a?ae N)??cei cieaeai???cei cieaeai?(49% a?ae N)??cei cieaeai? (26% a?ae N)??cei cieaeai? (47% a?ae N)??cei cieaeai? (a 2 ?ace a?ae N)??cei cieaeaii oa?ai?th; i?eaeooaiiy aiaeioieneeico; ni?yiiaaio ?ioiiei?aeoe?th. Aeeiioaaia a oa?i?iiaiio ii?yaeeo o??o?a?/ia ii?aoethaaiiy ai?eiiai ina?aaeeo aoei ii/aoeiaei ? iaia'yceiaei aoaiii e?eoaaiiy naineno. O??o?a?/ia ii?aoethaaiiy ia?aeiiiai ai?eiiai ina?aaeeo o oai?eo iniiaii? a?oie cae?enithaaee ii oeio eiai ?aaeeeaeueiiai aen?/aiiy; aen?/aiee eiiaeiia?ao i?noea o nia? ia o?eueee yaii iaaeeoo?caeaoi?, aea ? ia?aa?ioe/i? oeaieie. E?eoa??yie "iaae?eii?" aeeoo?caeaoiino? oeaiei aoee iayai?noue eai?ey?ii? e?iaioa/?, yne?aaee eie?? oeaiei oa aa?ia nei?i/aiiy i'yciaeo aieieii o a?aeiia?aeue ia o?aaio. Aeina?ae na?ae/eoue, ui caeeoaiiy a ?ai? "oiiaii" aeeoo?caeaoieo oeaiei i?e nainen? /ano?oa ca ana aaaea aei oi?ioaaiiy iiaoi?ieo iae?ic?a, ui noeioeththoue i?ioeane NNAI. C iaoith i?aeaeuaiiy ?aaeeeae?cio o??o?a?/iiai ii?aoethaaiiy ai?eiiai ina?aaeeo eiai (ii aecia/aieo iieacaiiyo) aeiiiaithaaee ii?ii?iaiiyi ?aie ?icn?yiei i?iiaiai NI2 - eaca?a. Oaea eiia?iiaaia iaoiaeeea o??o?a?/iiai e?eoaaiiy ai?eiiai ina?aaeeo aeeiiaia a 35,9% niinoa?aaeaiue, aea aoea oaa?aea aiaaiai?noue o iiaiiio ?aaeeeae?ci? ao?o/aiiy (oaae.9). Oaaeeoey 9 Aoaeoeai?noue i?noeaaiai e?eoaaiiy ai?eiiai ina?aaeeo i?e nainen? E?eoa??? ioe?iee e?eoaaiiyIaoiaeeea i?noeaaiai e?eoaaiiy Noaiaea?oia i=55 Iiaeeo?eiaaia i=66Aeiiiaiaia canoinoaaiiyi NI2-eaca?a i=37I?noeaa? Iaiao?aei?noue a iiaoi?ieo iae?aeoii?yo 21,8% 10,6% 5,4%Na?aaei? no?iee iiyae a?aioeyoe?e12-14 aeiaa9-11 aeiaa6-8 aeiaaNa?aaei? no?iee ?aia?aoe?? ?aie*21-25 aeiaa16-20 aeiaa14-16 aeiaaIaeeaaeaiiy aoi?e/ieo oa?a9,1%12,1%16,2%Caaaeuei? Ciaioaiiy a?ia?oa?i?? 23,6% 27,3% 37,8%Ciaioaiiy oao?ea?ae??30,9%36,4%43,2%Caaaeueia ee?i?/ia iie?a-uaiiy 50,9% 60,6% 67,6%I?ei?oea. O oeo aeiaaeeao, eiee ia ?aio aoi?e/i? oae ia iaeeaaeoaaeeny (aooiaea?iaoiieanoeea). Ianooiia e?eoaaiiy noi?iiaaieo ii?aoethaaiiyi ?ai cae?enithaaee i?ae iia’yceith c aeei?enoaiiyi eiia?iiaaieo e?ea?nueeeo i?aia?ao?a ia a?ae-?io?euei?e iniia?. Aea?? i?aia?aoo aeey i?noeaaiai e?eoaaiiy caeaaeaa a?ae oa?aeoa?o ?aiiai? i?e?ioei?e: - i?e a?aiiiceoeai?e i?e?ioei?? oa i?ney ?aaeeeaeueii? naiaoe?? ai?eiiai ina?aaeeo aeei?enoiaoaaeeny iac? Eaainei aai Eaaii?eieue; - i?e a?aiiaaaoeai?e i?e?ioei?? oa ?aaeeeaeueiiio aen?/aii? - iacue Ae?ien?eieue aai Eiaeii??iiiao iacue; - i?e aiaa?iai?e ?ioaeoe?? a ?ai? - iac? Iao?iea?i aai I?oaoeeae; - i?e i?e?iaii-i?eicieo anioe?aoe?yo - iacue I??ai?noeia. O oeo aeiaaeeao, yeui o??o?a?/ia ii?aoethaaiiy ai?eiiai ina?aaeeo ca oeo aai ?ioeo i?e/ei ia aoei ciiae aeeiiaoe ?aaeeeaeueii, aeey ianooiiiai e?eoaaiiy ai?eii? ?aie aeei?enoiaoaaee iacue Ioeio?eiie-I, ui i?noeoue o nai?e a?ae?io?euei?e iniia? eieaaaiaco (i?ioaaca-N), aioea?ioee oe?ieiai niaeo?o ae?? (ioeienaoeei) ? i?noeaaee aianoaoee o?eiaea?i. Aeia?a ca?aeiiaiaeoaaee naaa ni?aaioi? oeaieie “Aei?i?i-2” oa “Ea?iaia”. Caaaeueia ?ioaineaia e?eoaaiiy naineno neeaaea?oueny c? ni?yiiaaii? aioea?ioeeioa?ai??, ia’?iii? i?aeo?eioth/i? oa?ai?? oa ?ioiioa?ai??. Ianya i?ae-o?eioth/i? oa?ai?? i?noeoue o nia? eiiieaenio oee?eoeyoi?io i?aeo?eieo, ?an-i??aoi?io i?aeo?eieo, caniae oa iaoiaee i?eaeooaiiy ?aaeoe?e caiaeueii? a?aeiia?ae? (iaoiaee aeaoieneeaoe??, iaioieneo?e?i), a oaeiae eiiieaen caoiae?a aeey i?io?eaeoeee ? iai?aaeyth/iai e?eoaaiiy ii?oi-ooieoe?iiaeueieo ii?ooaiue i?aai?a-i?oaiae. Aioea?ioeeioa?ai?y ? ia?oi/a?aiaith eaieith caaaeueiiai ?ioainea-iiai e?eoaaiiy naineno; aei ia? i?enooiaee a?ae?aco i?ney caaacia/aiiy aaiiciiai aeinooio, oiaoi ua a ia??iae eiio?ieth o?ceieia?/ieo ia?aiao??a oai?iai, aei iaea?aeaiiy ?acoeueoao?a aaeoa??ieia?/iiai aeine?aeaeaiiy. Aii??e/ia e?eoaaiiy aioea?ioeeaie, ii/aoa aei aeae?eaiiy oa ?aeaioeo?eaoe?? eoeueoo?e caoaeieea ?ioaeoe??, ? iaeaaaeeea?oei /eiieeii oni?oiiai e?eoaaiiy naineno, iniaeeai a oai?eo ?c ii?ooaiiyi ?ioi?oaoo. A aeaiee /an aei?aaaeo? naaa o e?eoaaeuei?e aoaeoeaiino? iaoiaeeea aioea?ioeeioa?ai??, eiee iaeii?aciai aaaaeaia aeiaiaa aeica ai?iiae?eiceaeo niieo/a?oueny c aeiaaino?ieiai ae?th/eie oeaoaeinii?eiaie III aaia?aoe??. I?e i?ecia/aii? aioea?ioee?a i?e aaaeeiio nainen? iio??aii oaeiae a?aoiaoaaoe ?oith ?iaeoeooth/o ni?iiiaei?noue aei oieneiiooai?aiiy: canoi-noaaiiy ianeaii? iie?aioea?ioeeioa?ai?? aaaea aei i?aeaeuaiiy ??aiy aiaeioie-neeico, ui ee?i?/ii aeyaey?oueny o oi?i? aaaeeiai eieaino. Oiio ?aeeii ?aaeueiei oeyoii i?io?eaeoeee oeeo oneeaaeiaiue aoei aeey ian i?ecia/aiiy oai?ei iniiaii? a?oie o aeiaaeeao oyaeeiai naineno o??iaio aai iiaea?eiiai ?aaeeio aioea?ioeeioa?ai?? c iiaei iieie?iiyi aioea?ioee?a. Iiaea?eiee ?aaeei aioea?ioeeioa?ai?? i?iaaaeaiee o 20 oai?eo eiio-?ieueii? oa 76 iaoe??io?a iniiaii? a?oie (aeania - o 36,4 ? 73,8% niinoa?aaeaiue). Aea yeui a oai?eo eiio?ieueii? a?oie iio??eiee ?aaeei aioea?ioeeioa?ai?? canoiniaaiee a ?ioeo 63,6% oai?eo, oi a iniiai?e a?oi? aeiaaee?a canoinoaaiiy iio??eiiai ?aaeeio ia aoei. Iiiioa?ai?y o??iaiii canoiniaaia iaie i?e e?eoaaii? oyaeeiai naineno a 27(26,2%) oai?eo iniiaii? a?oie. Anoaiiaeaii, ui canoinoaaiiy o??iaio caaacia/o? e?auee ee?i?/iee ?acoeueoao ii iniiaiei aeine?aeaeoaaiei iieac-ieeai. E??i oiai, canoinoaaiiy aioea?ioeeioa?ai?? a oai?eo iniiaii? a?oie caaacia/oaaei a?eueo ae?aaeaiee e?eoaaeueiee aoaeo iaa?oue a oiiaao c?inei? aioea?ioeeino?eeino? i?e?ii?aai?ci?a (?en.3). I?iaaaeaiiy ?ioeo iai?yie?a a ?ioaineai?e oa?ai?? naineno cae?enith-aaeiny c iiceoe?e noaa?e?caoe?? aiiainoaco oa aeio?eiaiiyi ?yaeo iaia'yceiaeo i?eioeei?a: - Ea?iaaia ii?iioa?i?y - aeinyaoe cieaeaiiy oaiia?aoo?ii? ?aaeoe?? ieae/a 38? N aai ?? i?aeeiio aeua 35,5? N; - A?aeiiaeaiiy aaciiai?io (i?e iieacaiiyo - ?AE), e?ea?aeaoe?y a?oa??aeueii? a?iien?? (FiO2>40%) oa a?aeiiaeaiiy a?ae?iea?aiiaoiiai
aooa?a e?ia? (INI3>24 iiieue/e);

— Onoiaiiy a?oa??aeueii? a?iioaic??:

?en. 3. Noaie aioea?ioeeioa?ai??, ye? canoiniaoaaeeny i?e e?eoaaii?
naineno

o oai?eo eiio?ieueii? (E.) oa iniiaii? (I.) a?oi.-i?e a?ia?aeeiai?/iiio
neiae?ii? — ii?aae?aiae?i — 0,12 iea/ea/oa;

-i?e a?iiaeeiai?/iiio neiae?ii? — aeiiai?i — 4-6 iea/ea/oa;

— A?aeiiaeaiiy iai?oae ianyao e?ia? oa e?ea?aeaoe?y a?iiaieai??
?iooc?eii-o?ainooc?eiith oa?ai??th c caaacia/aiiyi ??aiy OeAO 70-90 ii
aiaeyi.no.

I?ecia/aiiy iaioieneo?e?io oai?ei nainenii aaaaeaee iaia’yceiaei ia
o?eueee ye i?aia?aoo, ui iie?auo? ?aieia?/i? iieacieee, aea ye caniaa,
ui iie?auo? na?oeaaee aeeeae, iineaaeth? nooi?iue ooeiaeaeaiiy eaaai?a,
iie?auo? iai?oao ?aI2 oa noaa?e?coth/ee ee?oeii? iaia?aie. E??i oiai,
iaioieneo?e?i ?ia?ao? i?iaeoeoe?th oeeoie?i?a, iayaieo o iaaeeeoeia?e
e?eueeino?.

Aiaeiaaiia ?ioieneeaoe?y o oai?eo nainenii i?iyaeyeany a?eueo-iaio
ae?aaeaiei ?ioieneeaoe?eiei neiae?iiii. Ae?iaeyth/ei /eiieeii
aiaei-oieneeico i?e ai?eii-caiaeueieo caoai?thaaiiyo i’yeeo oeaiei ?
?iciaae oeaiei, ui i?ecaiaeeoue aei iaeiie/aiiy i?iaeoeo?a aooie?co,
ia?aaaaeaiiy eaoaaie?/ieo i?ioean?a iaae aiaaie?/ieie, ui aaaea aei
iaeiie/aiiy i?ii?aeieo oa e?ioeaaeo i?iaeoeo?a ii?iaeueiiai iai?io,
aeaeiiiainaoe?y aoii?aeueieo ?aaoeyoi?ieo nenoai ?c iaeiie/aiiyi o
oiene/ieo eiioeaio?aoe?yo ?oi?o aoaeoi?ieo eiiiiiaio?a.

O caeaaeiino? a?ae oyaeeino? ii?ooaiue oa ae?aciino?
eiiiainaoi?ii-i?enoinoaaeueieo ?aaeoe?e neiae?ii aiaeiaaiii?
?ioieneeaoe?? ?icae?eaiee ia o?e nooiaiy: I nooi?iue — eiiiainaoe??, I
— noaeiiiainaoe??, O — aeaeiiiainaoe??.

O yeino? ia’?eoeaieo ia?ea??a aiaeioieneeico, ii?yae ?c aeeiai?/ieie
iieacieeaie ee?i?ee, aeei?enoiaoaaee ??aaiue iaioeae?a na?aaeiuei?
iiea-eoey?ii? iane (INII), eaeeioeeoa?iee ?iaeaen ?ioieneeaoe?? (E??),
aeoeai?noue a?eueii-?aaeeeaeueiiai ieenethaaiiy (IAeA, EO),
oee?eoethth/? ?ioii? eiii-eaene (Oe?E), eiao?oe??io noi?an?? (Oh /Os).

O caeaaeiino? a?ae aeo?aeieo ?ici???a cacia/aieo oano?a oa ee?i?/ieo
aeaieo i?iaiaeeany oie aai ?ioee ianya aeaoieneeaoe?eii? oa?ai??.

I?e ?ioieneeaoe?eiiio neiae?ii? I nooiaiy, ui niinoa??aaany a 34,9%
oai?eo, caoai?thaaiiy i?io?eaei ni?eyoeeai. Ci?ia aiiainoaco oa
iaoa-aie?cio eaaei ei?aaoaaeanue ?io?aei?ii?aeueieie iaoiaeaie:
aaii?iooc?eia aeaoieneeaoe?y (oaaaeaiiy i?aia?ao?a iie?a?i?ei??ie?aeiio,
aeueaoi?io c iiia-?aaeiueith aaiiaeeethoe??th oa oi?niaaiei ae?o?acii),
aioa?ini?aoe?y. Canoi-noaaiiy cae/aeieo iaoiae?a oa?ai?? aoei
aoaeoeaiei, on? iaoe??ioe aeea?.

I?e ?N I nooiaiy, ui iaa i?noea a 17(39,5%) oai?eo nainenii oa a 28
(46,7%) — oyaeeei nainenii (o oiio /ene? ?c naioe/iei oieii — 2 ? 3
oai?eo ?c III), ?io?aei?ii?aeuei? iaoiaee aeaoieneeaoe?? aeiiiaithaaeeny
aeno?a-ei?ii?aeueieie. Iieacaiiyie aei canoinoaaiiy aeno?aei?ii?aeueieo
iaoiae?a aeaoieneeaoe?? aoee: iaaoaeoeai?noue eiina?aaoeaii? oa?ai??,
i?ia?anoth/a aino?a ia/?ieiai-ie?eiaa iaaeinoaoi?noue c? ca?eueoaiiyi o
e?ia? ai?noo oie-ne/ieo iaoaaie?o?a, oiene/i? i?iyae c aieo
oeaio?aeueii? ia?aiai? nenoaie.

Onueiai aeno?aei?ii?aeuei? iaoiaee aeaoieneeaoe?? canoiniaai? a 57,8%
aeiaaee?a (o 4 iaoe??io?a — aea?/?). Eaoaeuei?noue neeaea 13,3%.

Ne?ae cacia/eoe, ui a i?ioean? e?eoaaiiy ?icoiaeaeaiiy a iieacieeao
ia?ea??a ?ioieneeaoe?? o aeaeoaeaeeo oa iiia?eeo oai?eo aoee noaoenoe/ii
aeinoia??i? (P<0,01). Ei?aeoe?y aiaeioieneeico O nooiaith, ui niinoa??aaany a 22 oai?eo (21,4%) iniiaii? a?oie, aoea iaiiaeeeaa aac aeno?aei?ii?aeueieo iaoiae?a aeaoieneeaoe??. Ia caaaeath/e ia i?iaaaeaiiy caoiae?a aeoeaii? aeaoieneeaoe??, eaoaeuei?noue aei??aithaaea 54,5%. Iiia?ei 12 oai?eo oyaeeei nainenii, o oiio /ene? ii 5 oai?eo ?c naioe/iei oieii oa III. Ne?ae cacia/eoe, ui ia caaaeath/e ia aeoeaio aeaoieneeaoe?eio oa?ai?th o oai?eo nainenii ?c ?N I-O nooiaiy aeiaeiee ?c ia'?eoeaieo ia?ea??a aiaeioieneeico ia 25-30 aeiao i?neyiia?aoe?eiiai ia??iaeo ia ii?iae?coaaany, ui na?ae/eoue i?i iaiao?aei?noue i?iaeiaaeaiiy ?aaa?e?oaoe?eiiai ia??iaeo. Aea/aiiy eiao?oe??ioa ei?aeyoe?? i?ae aeine?aeaeoaaieie ia?ea?aie ?ioieneeaoe?? ? aeayeeie ee?i?/ieie oa eaai?aoi?ieie iieacieeaie na?ae/eoue i?i oa, ui ?nio? i?yia ei?aeyoe?y i?ae ??aiai INII, E??, IAeA, Oe?E oa iaa?iaia o?nia ei?aeyoe?y c i?iyaii na?aeiiino?, aeoeai?noth EO, eiao?oe??ioii noi?an?? ?c aenieei nooiaiai aeinoia??iino?. Aeoiaey/e c io?eiaieo aeaieo, aeaoieneeaoe?eio oa?ai?th oai?ei nainenii cae?enithaaee ia’?iii, ia?aaeaa/ath/e aieea ia ia?aeiiee ina?aaeie, ??aee? na?aaeiaeua (e?ia, e?ioo), iineeaiiy (i?e ii?ooaii?) aai cai?io (i?e aeaeiiiainaoe?? ooieoe?? iniiaieo i?aai?a aeaoieneeaoe??) ?io?a- oa aeno?a-ei?ii?aeueieie iaoiaeaie (oaae.10). Iiaiioe?iia oa?/oaaiiy oai?eo nainenii aaaaeaee iaeaaaeeea?oei eiiiiiaioii ?ioaineaii? oa?ai??. Iaa?oue ia caaaeath/e ia oe?ae aaaeeee noai oai?eo, iaoiaeii aeai?o aaaaeaee aioa?aeueia oa?/oaaiiy. O yeino? aeiaeaoeiaiai oa?/oaaiiy iaie aia?oa canoiniaaii iaoo-?aeueiee aenieia?eeiaee i?iaeoeo "Aaineoii-40", ui i?noeoue a?eee, aee?e, aoaeaaiaee, a?n?i iacai?iieo ai?iieeneio, o?noue iniiaieo a?oai?i?a oa i'youe i?ia?aeueieo ?a/iaei. Ia?aae oei, ye i?ecia/aoe ?ioiio?iii? i?aia?aoe, iaiao?aeii oyaeoe ??aaiue iieiiee ?ioiiiai iaoai?cio oa oa?aeoa? iaiao?aeiiai ?aaoethth/iai aieeao. Aa?oi iai'yoaoe, ui ?ioiio?iii? i?aia?aoe, ye i?aaeei, ia aiee-aathoue ia iaci?ii? ?ioiieia?/i? iieacieee. Niaoe?aeueio ?ioiio oa?ai?th oai?ei nainenii i?iaiaeeee o?eueee i?e iayaiino? aeaieo ?ioiia?aie. E??i ianiaoeeo?/ieo oa niaoeeo?/ieo ?ioiii?aia?ao?a aeey i?aeaeuaiiy aaeaioaoe?eieo oa eiiiainaoi?ieo ooieoe?e i?aai?cio, ae?yeueiino? iae?i-aiaeie?eiii? oa ?ioiii? nenoai, canoiniaoaaee ianoiyieo ?c ei?ai?a ao?iaoe?? io?io?ii? ? a?ieiae/ii aeoeaiee i?iaeoeo “Ai?oei?”. Iaea?eueo aoaeoeaieie iaoiaeaie, ui noeioeththoue ?ioiio a?aeiia?aeue ? aioo??oiueinoaeeiia eaca?ia ii?ii?iaiiy e?ia?, i?aeeeth/aiiy e??ieiina?-aiaaieo o?aaiaio?a enaiinaeac?iee, aeei?enoaiiy ia?oocaoo e?ieiina?-aiaaieo o?aaiaio?a naeac?iee oa e??ieiina?aiaaieo ee?oei oeiono, ui aoee canoiniaai? iaie a?aeiia?aeii a 61, 9, 8 ? 9 oai?eo nainenii. Ne?ae cacia/eoe, ui ia?a?aoiaai? aeua iaoiaee iathoue ia o?eueee ?ioiiiiaeoethth/ee aoaeo, aea ? aeaoieneeaoe?eio ae?th, i?i ui na?ae/aoue ia'?eoeai? ia?ea?e ?ioie-neeaoe??. Ia caaaeath/e ia oa, ui oai?? nainenii eiio?ieueii? oa iniiaii? a?oi ii ii??aithaaieo ia?aiao?ao aoee ?ai?acaioaoeaieie, o ?acoeueoao? niieo/aiiy ae-oeaiiai? o??o?a?/ii? oaeoeee oa oe?eani?yiiaaii? aaaaoieiiiiiaioii? ?ioai-neaii? oa?ai?? eaoaeuei?noue o ae?oa?e a?oi? cieceeany c 23,6 aei 17,4%, a na?aaei?e e?aeei-aeaiue ciaioeany a 1,2 ?aca. AENIIAEE 1. I?iaaaeaiee aiae?c ?icaeoeo, ia?aa?ao oa e?ioeaaeo ?acoeueoao?a naineno a 158 oai?eo (103- iniiaia ? 55- eiio?ieueia a?oie) iieacaa, ui ?icaeoie oeueiai neiae?iio /ano?oa a?aecia/a?oueny a in?a iieiaeiai oa na?aaeiueiai a?eo (76%), iaoyaeaieo (o 90% niinoa?aaeaiue) ??ciiai ?iaeo noiooiueith iaoieia??th (o 75% ?c ieo aeo?aeii aeyaeaiee noi?aneaiee oei ?ioiiiai noaoono), iayai?noue ianeaiiai oa iiaaii e?eiaaiiai ai?eiiai ina?aaeeo c aenieei (>105 i?e?iaieo o?e ia 1 a
oeaieie) ??aiai i?e?iaiiai ian?iai?iiy oeaiei.

2. Aaaaoi??/iee i?e?ia?ieia?/iee eiio?ieue ia?aeiiiai ai?eiiai
ina-?aaeeo o oai?eo nainenii aeyaea cieaeaiiy aen?aa?iino? noao?eieie?a
o iiii-eoeueoo?? c 42,3% (1991 ?.) aei 26,8% (1998 ?.) ? c??no
aen?thaaiino? a?ai (-) i?e?ioei?e c 37,2% (1992 ?.) aei 55,4% (1998 ?.);
iniaeeai iii?oiei aoa c??no aen?thaaiino? iaee/ie neiuei-caeaiiai aiith
(o 1,4 ?aca); ?noioiuei (o 1,5 ?aca) c?inea aen?thaai?noue i?e?iaieo
anioe?aoe?e.

3. Nai?/ania ae?aaiinoeea naineno aaco?oueny ia aiae?c? ?yaeo ee?i?ei-
eaai?aoi?ieo e?eoa???a (a?ia?- aai a?iioa?i?y, caaeeoea, oao?ea?ae?y,
cieaeaiiy AO oa ?io?), a?aaeaoe?? yeeo o e?euee?niiio a?aeiioaii?
aeicaieythoue aecia/eoe oi?ie (noaae??) oa/?? i?ioeano.

4. Aecia/aii ?ioi?iaoeai? iieacieee eiio?ieth aoaeoeaiino? e?eoaaiiy
neiae?iio naineno; aei i?iaiinoe/ii iani?eyoeeaeo a?aeiinyoueny:

— cieaeaiiy iai?oae ?I2;

— i?aeaeuaiiy (aeua 5 iae.) eiao?oe??ioo ei?oecie/?inoe?i;

— ??cea cieaeaiiy i?iaeoeo?a IIE (ia?aeiieo oa aoi?eiieo);

— i?aeaeuaiiy aeoeaiino? O3 ? O4 ia oii? i?aeaeuaiiai ??aiy OOA;

— i?ia?anoth/a ca?eueoaiiy e?eueeino? I-e?ioioeeo?a;

— cieaeaiiy ?ioii?aaoethth/iai ?iaeaeno aei 1,0-1,2 iae. ? ieae/a.

5. Aeo?aeiee (aei ii/aoeo e?eoaaiiy) oei ?ioiiiai noaoono i?aai?cio
oai?eo nainenii ?noioiuei aieeaa? ia aoaeoeai?noue i?iaaaeaii? oa?ai??
oa ?acoeueoaoe e?eoaaiiy: o 74,8% oai?eo aeyaeaii noi?aneaiee oei
?ioii-eia?/ieo ?aaeoe?e (eaoaeuei?noue- 18,2%), o 13,6%- ci?oaiee oei,
oneeaaeiaiee ?icaeoeii aooi?ioiieo ?aaeoe?e (eaoaeuei?noue- 28,6% ) ? a
11,6% oai?eo — ??aiii??ii aeoeaiaaiee oei ?ioiiiai noaoono (eaoaeueieo
aeiaaee?a ia aoei).

6. Ia’?eoeaieie ia?ea?aie aaae NA? ? iieacieee INII, E??, IAeA, EO,
Oe?E, aeeiai?ea yeeo aeicaiey? noaeeoe i?i aoaeoeai?noue i?iaaaeaii?
oa?a-i?? oa i?iaiicoaaoe iane?aeie caoai?thaaiiy: onoaiiaeaii i?yiee
ei?aey-oeaiee ca’ycie i?ae ??aiai INNI, E??, IAeA, Oe?E ?c
ee?i?ei-eaai?aoi?ieie iieacieeaie ioe?iee aaae oai?iai nainenii oa
iaa?iaiith o?niith ei?aeyoe??th c i?iyaii na?aeiiino?, aeoeai?noth EO,
eiao?oe??ioii noi?an?? c aenieei nooia-iai aeinoia??iino?.

7. E?eoaaiiy naineno i?noeoue o nia? ?aaeeeaeueia o??o?a?/ia
ii?aoethaai-iy ai?eiiai ina?aaeeo ?ioaeoe?? oa caaaeueii? ?ioaineaii?
oa?ai??, iniiaieie aeaiaioaie yei? ? aioea?ioeeioa?ai?y, i?aeo?eioth/a
oa?ai?y oa ?ioiioa?ai?y; i?aeoaa?aeaeaia aeioe?euei?noue iiiioa?ai??
o??iaiii o ii??aiyii? “iiaea?eiiai” aai “iio??eiiai” ?aaeeio
canoinoaaiiy aioea?ioee?a.

8. Ai?iaaaeaeaiiy aeanieo ?ic?iaie o i?ia?aio e?eoaaiiy oai?eo nai-nenii
o aeaeyae? aeoeaiiai i?noeaaiai e?eoaaiiy ia?aeiiiai ina?aaeeo
(aaaa-oieiiiiiaioi? iac? ia a?ae?io?euei?e iniia? c o?aooaaiiyi aeaeo
i?e?iaiiai caoaeieea), ?ioaineo?eaoe?th eiiieaeno aeaoieneeaoe?eieo
caoiae?a (ieaciaoa?ac, aaiini?aoe?y c aeei?enoaiiyi e??ieiina?aiaaieo
enaiiaaiaoioeeo?a, nieaii-oeeo?a, ia?oocaoo e??ieiina?aiaaieo o?aaiaio?a
enaiinaeac?iee oa ee?oei oeiono), ni?yiiaaia ?ioiiei?aeoe?y oa iaoiaee
ianiaoeeo?/ii? aeoeaaoe?? ?ioii-aaiaco (AEIE, a?ieia?/ii aeoeaiee
i?iaeoeo “Ai?oei?”, ianoiyiea ?c ei?ai?a ao?iioe?? io?io?ii?), ?aii?
aioa?aeueia oa?/oaaiiy c aeei?enoaiiyi aeniei-a?eeiaiai i?iaeoeoo
“Aaineoii-40” aeicaieeei nei?ioeoe iieaciee eaoaeue-iino? c 23,7 aei
17,4% oa cieceoe na?aaei? ia?aaoaaiiy a noaoe?iia?? a 1,2 ?aca.

I?AEOE*I? ?AEIIAIAeAOe??

1. O??o?a?/ia ii?aoethaaiiy ia?aeiiiai ai?eiiai ina?aaeeo o oai?eo
nainenii ne?ae cae?enithaaoe ca oeiii eiai ?aaeeeaeueiiai aen?/aiiy,
a?aeaeaeaiee eiiaeiia?ao iiaeiai i?noeoe a nia? ia o?eueee yaii
iaaeeoo?caeaoi?, aea ? ia?aa?ioe/i? oeaieie.

2. C iaoith i?aeaeuaiiy ?aaeeeae?cio o??o?a?/iiai ii?aoethaaiiy
ai?e-iiai ina?aaeeo aeioe?eueii ii?ii?iaiiy ?aie ?icn?yiei i?iiaiai NI2
— eaca?a.

3. Aaeoa??aeueia ae?aaiinoeea ia?aeiieo ai?eieo ina?aaee?a i?e nainen?
iiaeiia neeaaeaoenue c ?aeaioeo?eaoe?? i?e?ioei?e, ??aiy i?e?iaii?
caa?oaeiaiino? oeaiei oa /ooeeaino? caoaeiee?a caoai?thaaiiy aei
aioeaaeoa??aeueieo i?aia?ao?a.

4. Aaeoa??aeueiee iin?a e?ia? ia aaiieoeueoo?o iiaeiai i?iaiaeeoenue
iaia’yceiai, aaaaoi?aciai oa a ??ciee /an aeiae.

5. E?eoaaiiy noi?iiaaieo ia?iaeith ?ai iaiao?aeii cae?enithaaoe i?ae
iia’yceith ?c aeei?enoaiiyi iacae ia a?ae?io?euei?e iniia?. Aea??
i?aia?aoo aeey i?noeaaiai e?eoaaiiy iiaeiai aooe oaeei: i?e a?ai (+)
i?e?ioei?? — iac? Eaainei oa Eaaii?eieue; i?e a?ai (-) oei?? — iacue
Ae?ien?eieue aai Eiaei-i??iiiao iacue; i?e aiaa?iai?e ?ioaeoe?? a ?ai? —
iac? Iao?iea?i aai I?oaoeeae; i?e i?e?iaii-i?eicieo anioe?aoe?yo — iacue
I??ai?noeia.

6. ?aoe?iiaeueia aioea?ioeeioa?ai?y, ii iiaeeeaino?, iiaeiia aooe
iiiiaaiiith.

7. Aei aa??o?eaoe?? caoaeieea ?ioaeoe?? iiaeeeaa i?iaaaeaiiy
«iiaea?eiiai» ?aaeeio aioeaaeoa??aeueii? oa?ai??. I?aia?aoaie aeai?o
iiaeii? aooe oeaoa-einii?eie ???-IY iieie?iiy a niieo/aii? ?c no/anieie
ai?iiae?eiceaeaie aai ooi?o?iieiie c iio?aeieie iao?ii?aeacieo.

8. Inoaoi/iee aea?? aioeaaeoa??aeueieo i?aia?ao?a iiaeiai
cae?enithaa-oeny o?eueee ca aeaieie aaeoa??ieia?/ii? ae?aaiinoeee c
o?aooaaiiyi ?ioii-eia?/iiai noaoono oai?iai.

9. Aeey ia’?eoeaii? ioe?iee neiae?iio aiaeiaaiii? ?ioieneeaoe?? i?e
nai-nen? aa?oi aeei?enoiaoaaoe E??, INII, Oe?E — ye iaea?eueo
?ioi?iaoeai? oa aeinooii? iaoiaee aeine?aeaeaiiy, ui ia iio?aaothoue
niaoe?aeueii? eiooiaii? aia?aoo?e.

10. E??i cae/aeieo iaoiae?a aeaoieneeaoe?? (ieaciaoa?ac, aaiini?aoe?y)
i?e oyaeeiio aiaeioieneeic? o oai?eo nain?nii ne?ae a?aeaeaaaoe ia?aaaao
iaoiaeai a?ini?aoe?? (e??ieiina?aiaai? enaiiaaiaoioeeoe, nieaiioeeoe).

11. I?iaaaeaiiy aioeieneaeaioii? oa?ai?? oai?ei nainenii iiaeiii
a?aeaoaaoeny a iaia’yceiaiio ii?yaeeo. I?aia?aoaie aeai?o iiaeii? aooe
iai-oieneo?e?i, a?oai?ie N ? A, ?ia?a?oi?e iaoaaie?o?a a?ao?aeiiiai?
eeneioe — ?aoi?ioai oa ?iaeiiaoaoeei o noaiaea?oieo aeicoaaiiyo.

12. I?e i?ecia/aii? ?ioiiiiaeoeyoi??a aa?oi a?aeaeaaaoe ia?aaaao
?in-eeiiei aaeaioiaaiai — Ianoiyioe? ao?iaoe?? io?io?ii? e Ai?oei?o —
aeniei-aoaeoeaiei a?o/eciyiei i?aia?aoai, ui ia aei?iai eiooothoue.
?ioiio?iiia e?eoaaiiy iaiao?aeii eiio?iethaaoe aoaiieie ?ioiia?aiaie.

13. O nenoai? eiiieaeniiai e?eoaaiiy iaiao?aeii aeei?enoiaoaaoe AEIE, ui
caaacia/o? ia o?eueee iiceoeaiee aieea ia iieacieee ee?oeiiiai oa
aoii?aeueiiai eaiie ?ioi?oaoo, aea ia? oaeiae aeaoieneeaoe?eiee aoaeo.

14. O ia?o? aei? i?ney iia?aoeaieo ao?o/aiue oai?? nainenii iiaeii?
ciaoiaeeoeny o a?aeae?eaii? ?ioaineaii? oa?ai?? oa ?aai?iaoe??, a a
iiaeaeueoiio — o niaoe?ae?ciaaieo iaeaoao a?aeae?eaiiy.

15. Aeioe?eueia eiioeaio?aoe?y oai?eo nainenii o niaoe?ae?ciaaieo
ai?eii-naioe/ieo a?aeae?eaiiyo (oeaio?ao), o??o?ae yeeo iathoue aeina?ae
?iaioe oa aiei-ae?thoue a?naiaeii iia?aoeaieo ao?o/aiue i?e ai?ei?e
iaoieia??.

NIENIE IIOAE?EIAAIEO I?AOeUe CA OAIITH AeENA?OAOe??

1. Oaiiaae N.Ae. Nainen o aieueiuo n aeano?oeoeaiui ianoeoii // Eeei.
oe?o?aey.–1993.-?1.– N.60-61.

2. Oaiiaae N.Ae. Aeoeaiia oe?o?ae/aneia ea/aiea iaeeino?eaeeaeueiie
eioaeoeee iyaeeo oeaiae. // Ee?i.o??o?aey. –1996.– ?5.– N. 8-9.

3. Oaiiaae N.Ae. I?eiaiaiea e?eieiina?ae?iaaiiuo enaiiaaiaoioeeoia o
aieueiuo nainenii // I?iaeaiu e?eiaeieiaee. –1997. – ?4. – N.50-54.

4. Oaiiaae N.Ae. Iieacaoaee ia?aeeniiai ieeneaiey eeieaeia e eiiiiiaioia
aioeieneaeaioiie nenoaiu i?e nainena // A?a/aaiay i?aeoeea.– 1997. –
?5-6. – N. 26-28.

5. Oaiiaae N.Ae. Ia?aeeniia ieneeaiea eeieaeia e ninoiyiea
aioeiene-aeaioiie nenoaiu i?e nainena o aieueiuo n
aiieii-ainiaeeoaeueiuie i?ioeannaie iyaeeo oeaiae // Ee?i.
o??o?a?y.-–1998. – ?11.– N. 15-16.

6. Oaiiaae N.Ae. Iieacaoaee aeiioeca?ii-oe?aieaeiie nenoaiu o aieueiuo
nainenii //I?iaeaiu, aeinoeaeaiey e ia?niaeoeau ?acaeoey
iaaeeei-aeieiae/aneeo iaoe e i?aeoe/aneiai cae?aaiio?aiaiey: O?oaeu
E?uineiai iaaeeoeeineiai oieaa?neoaoa ei. N. E. Aai?aeaaneiai. – 1998. –
o. 134, /anoue ?. – N.253-257.

7. Eniieueciaaiea yoeiaoeae io?io?iie o aieueiuo nainenii //I?iaeaiu,
aeinoeaeaiey e ia?niaeoeau ?acaeoey iaaeeei-aeieiae/aneeo iaoe e
i?aeoe/aneiai cae?aaiio?aiaiey: O?oaeu E?uineiai iaaeeoeeineiai
oieaa?neoaoa ei. N. E. Aai?aeaaneiai. – 1998. – o. 134, /anoue ?. –
N.246-252. A niaao., I.A. O?eaooiie, E.E. Naaii, A.N. Ia/ooaaa, A.I.
Ia?ouithe, E.A. Aaneeaaneay, TH.I. Iioo?a (Aaoi?ii i?iaaaeai iaai?
eeeie/aneiai iaoa?eaea, aiaeec e ia?aaioea ?acoeueoaoia enneaaeiaaiey).

8. Oaiiaae N. Ae. Eiioiieiae/aneay aeeaaiinoeea nainena //A?a/aaiay
i?aeoeea. – 1999. — ? 1. – N.58-60.

9. Oaiiaae N. Ae. I?eiaiaiea e?eieiina?ae?iaaiiuo eeaoie oeiona o
aieueiuo nainenii //I?iaeaiu e?eiaeieiaee. – 1999. — ?1. – N.61-62.

10. Oaiiaae N. Ae. Eioaineaiay oa?aiey aieueiuo n aiieii-iae?ioe/aneeie
ii?aaeaieyie ieaeieo eiia/iinoae i?e naoa?iii aeeaaaoa //A?niee
A?iieoeueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo. – 1999. – aei. 3, ?
1. – N.130-131.

11. Oaiiaae N. Ae. Eeeieei-eaai?aoi?iay aeeaaiinoeea nainena
//Aeooaeuei? ieoaiiy oa?iaoeaaoe/ii? oa iaaee/ii? iaoee oa i?aeoeee: Ca.
iaoe. noaoae.- Caii??aeaey, 1999. – aei. ???. – N.292-300.

12. Aioeaaeoa?eaeueiay oa?aiey nainena //Aeooaeuei? ieoaiiy
oa?iaoeaaoe/ii? oa iaaee/ii? iaoee oa i?aeoeee: Ca. iaoe. noaoae.-
Caii??aeaey, 1999. – aei. ???. – N.313-319. A niaao., A.A. ss?aoei, A.N.
Ia/ooaaa, I.A. O?eaooiie, E.E. Naaii, E.A. Aaneeaaneay, A.A. Ia?ouithe
(Aaoi? i?eieiae o/anoea a iaai?a eeeie/aneiai iaoa?eaea, ioi?ieaiee
noaouee).

13. Oaiiaae N. Ae. Nia?aiaiiua iiaeoiaeu e i?iaeaia oe?o?ae/aneiai
nainena //A?niee i?iaeai a?ieia?? ? iaaeeoeeie. – Iieoaaa, 1999. — ? 7.
– N.105-111.

14. Oaiiaae N. Ae. Ea/aiea nainena o aieueiuo n aiieii-ainiaeeoaeueiuie
caaieaaaieyie iyaeeo oeaiae: Iaoiae. ?aeiiaiaeaoeee. – Caii??aeaey,
1998. – 15n.

15. Oaiiaae N. Ae. Niin?a e?eoaaiiy aino?iai naineno // ??oaiiy IAeOeIA
ia aeaea/o iaoaioo Oe?a?ie ia aeiao?ae ?97104998 a?ae 07.10.98.

16. Oaiiaae N. Ae. Niin?a e?eoaaiiy naineno // ??oaiiy IAeOeIA ia
aeaea/o iaoaioo Oe?a?ie ia aeiao?ae ?97125767 a?ae 08.10.98. O ni?aaao.,
I.I.Noaaioa. (I?eeiaa o/anoue o ee?i?/iiio canoinoaaii? niiniao
e?eoaaiiy naineno, aiae?c? ?acoeueoao?a oa ioi?ieaii? cayaee ia
aeiao?ae).

17. Oaiiaae N. Ae. Niin?a e?eoaaiiy ai?eii-caiaeueieo caoai?thaaiue
i’yeeo oeaiei // ??oaiiy IAeOeIA ia aeaea/o iaoaioo Oe?a?ie ia aeiao?ae
?97115429 a?ae 12.10.98.

18. Eiiieaeniia ea/aiea ?aceeoiai aiieiiai ia?eoiieoa a oa?ieiaeueiie
noaaeee // Ee?i. o??o?a?y. –1996. –? 2 -3. –N.58. A niaao., A.A.
ss?aoei, I.E. Iiiia, I.I. *a?oaieia, E.E. Iioaiiaa, A.I. Ai?iaaoe (Aaoi?
i?eieiae o/anoea a aiaeeca ?acoeueoaoia ea/aiey).

19. Oaiiaae N.Ae. Iieacieee aiaeiaaiii? ?ioieneeaoe?? oa ia?aeeniiai
ieeneaiiy e?i?ae?a o oai?eo c oyaeeith o?aceiaith ?ioieneeaoe??th,
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20. Oaiiaae N.Ae. Eiiieaenia e?eoaaiiy ai?eii-iae?ioe/ieo o?aaeaiue
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21. Cia/aiiy aaeoa??ieia?/iiai aeine?aeaeaiiy i?e e?eoaaii? oai?eo c
ai?eieie caoai?thaaiiyie i’yeeo oeaiei //Iaoa??aee V ?anioae?eainueei?
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I.A. O?eaooiee (Aaoi? i?eeiaa o/anoue o iaai?? oa aiae?c? ee?i?/iiai
iaoa??aeo).

22. Aeina?ae eiiieaeniiai e?eoaaiiy o??o?a?/iiai naineno // Iaoa??aee 2
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noaoo?).

23. Oaiiaae N.Ae. Cia/aiiy ?ioiieia?/iiai eiio?ieth i?e nainen? //
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24. Oaiiaae N.Ae. Canoinoaaiiy ai?oei?o oa ao?iaoe?? io?io?iai? ye
?ioiiiiaeoeyoi??a o oai?eo c aaaeeith o?aceiaith ?ioieneeaoe??th //
Iaoa??aee Y ?anioae?eainueei? o/. iaoiae. eiio. caa. eao. caaaeueii?
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25. Oaiiaae N.Ae. I?e/eie eaoaeueiino? i?e o??o?a?/iiio nainen?
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26. Oaiiaae N.Ae. ?ioiieia?/iee noaoon o oai?eo c ai?eii-caiaeueieie
i?ioeanaie i’yeeo oeaiei // Aeooaeueiua aii?inu iaaeeoeeiu e aeieiaee:
Na.noaoae. – Aeiai?iiao?iane, 1997. – aui.9, N.158.

27. Oaiiaae N.Ae. Ii??aiyeueia oa?aeoa?enoeea oai?eo c oyaeeith
o?aceiaith ?ioieneeaoe??th oa nainenii o /aniaiio aniaeo? // Iaoeia?
i?aoe? CAe?OE, i?enay/ai? 70-??/iiio tha?eath ?inoeoooo. – Caii??aeaey,
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28. Oaiiaae N.Ae. Aaeoa??ieia?/ia aeine?aeaeaiiy ?ai o /aniaiio aniaeo?
// Aeooaeueiua aii?inu iaaeeoeeiu e aeieiaee: Na.noaoae. –
Aeiai?iiao?iane, 1997. – aui.9, N.145-146.

29. Oaiiaae N.Ae. Eaoaeueiinoue i?e nainena o aieueiuo n
aiieii-ainiaeeoaeueiuie i?ioeannaie iyaeeo oeaiae // Aii?inu eeeie/aneie
iaaeeoeeiu: Iaoa?eaeu iao/.-i?aeo. eiio. oe?o?aia, iinayuaiiie
100-eaoiaio thaeeath i?io. A.E.Caoa?iaa. – Neioa?iiieue, 1997. – N.182.

30. Oaiiaae N.Ae. Aeoeaiua iaoiaeu aeaoieneeaoeee i?e nainena o
aieueiuo n aiieii-ainiaeeoaeueiuie i?ioeannaie iyaeeo oeaiae // Iia?
oaoiieia?? a o??o?a??. Iaoa??aee i?aeia?.iaoe.eiio. “Aeooaeuei? ieoaiiy
no/anii? o??o?a??”, i?enay/aii? 100-??//th c aeiy ia?iaeaeaiiy
i?io.Oaaeeioey I.A., — Oaeai?iae, 1997. – N.206.

31. Oaiiaae N.Ae., Aieeiaa O. Ae. Eiioiieiae/aneea aniaeou
oe?o?ae/aneiai nainena o aieueiuo iieeiie ia?eiiaieae // Iiaua
oaoiieiaee a oe?o?aee. Na.iao/.o?oae., iinayuaiiuo 75-eaoeth
eao.oe?o?aee Eeaaneie iaaeeoe. aeaaeaiee iineaaeeie. ia?aciaaiey IC
Oe?aeiu. E.: 1997. – N. 178. (Iaai? e aiaeec eeeie/aneiai iaoa?eaea,
iaienaiea oacenia).

32. Oaiiaae N.Ae. Ei??aeoeey ia?ooaiee ia?aeeniiai ieeneaiey eeieaeia e
aioeieneaeaioiie nenoaiu i?e nainena o aieueiuo n
aiieii-ainiaee-oaeueiuie i?ioeannaie iyaeeo oeaiae // Aeooaeuei?
i?iaeaie iaie?aaoi-aaiaoia?e?a?ii? oa noaeeiii? o??o?a??:
3a.?ia?o.iaoe.eiio., i?enay/aii? 80-??//th aeaae. I.I.Oae?iiaa. – E.:
Ee?i.o??o?a?y. – 1998. – N.405-406.

33. Oaiiaae N.Ae. Iaeioi?ua aniaeou eiioiieiaee nainena // ?
Iaoe?iiaeue-iee Eiia?an Oe?a?ie c ?ioiieia??, aea?aieia?? oa
?ioii?aaa?e?oaoe??: 3a. oac. – Aeoooa, E?ei, 1998. – N.163-164.

34. Oaiiaae N.Ae. Niaea?aeaiea ei?oeciea e einoeeia o aieueiuo n
aiieii-ainiaeeoaeueiuie caaieaaaieyie iyaeeo oeaiae // ?? Eiia?an
o??o?a?a Oe?a?ie: 3a. iaoe. ?ia?o. – Ee?a; Aeiiaoeuee: Ee?i. o??o?a?y. –
1998. – N.82-83.

35. Oaiiaae N.Ae. Yeno?aei?ii?aeueiua iaoiaeu aeaoieneeaoeee o aieueiuo
nainenii // ?? Eiia?an o??o?a?a Oe?a?ie: 3a.iaoe.?ia?o. – Ee?a;
Aeiiaoeuee: Ee?i.o??o?a?y. – 1998. – N.83-84.

36. Oaiiaae N.Ae. Ei??aeoeey ia/aii/iie iaaeinoaoi/iinoe o aieueiuo
nainenii // Aiiaeu oe?o?ae/aneie aaiaoieiaee. – 1998, o.3, ?3. – N.330.

37. Aeaoeaiei A. I., Oaiiaae N.Ae. Iaoiaaiaoe/aneea iniiau oi?ie?iaaiey
ea/aaiie i?ia?aiiu i?e nainena //Iaoa?eaeu iaaeaeoia?.eiio. “?aiu e
?aiaaay eioaeoeey”. – I.: 1998. – N.158-159. (Aaoi? i?eieiae o/anoea a
iiaeaioiaea noaouee).

38. Oaiiaae N.Ae. Au?aaeaiiinoue yiaeioieneeica i?e nainena e aai
ei??aeoeey // Iaoa?eaeu iaaeaeoia?.eiio. “?aiu e ?aiaaay eioaeoeey”. –
I.: 1998. – N.186-187.

AIIOAOe?ss

Oaiiaae Na?a?e Aeieo?iae/ “Iniaeeaino? ia?aa?ao oa e?eoaaiiy naineno a
oai?eo ?c ai?eii-caiaeueieie i?ioeanaie i’yeeo oeaiei”. ?oeiien.
Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy aeieoi?a iaaee/ieo iaoe ca
nia-oe?aeuei?noth 14.01.03 – o??o?a?y. Caii??cueeee aea?aeaaiee ?inoeooo
oaeinei-iaeaiiy e?ea??a, i. Caii??aeaey, 1999.

Caoeua?oueny aeena?oaoe?eia ?iaioa, o ye?e cai?iiiiiaaia
iaoeiai-iaa?oioiaaia I?ia?aia i?aeaeuaiiy aoaeoeaiino? oa?ai?? oai?eo
nainenii. Aeey ?? i?aeoe/ii? ?aae?caoe??, a ?acoeueoao? i?iaaaeaieo
ee?i?/ieo aeine?aeaeaiue, aea/ai? oa?aeoa? oa ni?yiiaai?noue ?aaeoe?e
iae?i-aiaeie?eiii?, aioeiene-aeaioii? nenoai, a oaeiae ?ioiiiai noaoono
ia iioeiaeaeoth/o ae?th neiae?iio nenoaiii? caiaeueii? a?aeiia?ae?.
Iaeii/anii c oeei iioei?ciaaii aoai ?aiiuei? ae?aaiinoeee naineno c
ioe?ieith ii??aiyeueii? ?ioi?iaoeaiino? iniiaieo ee?-i?/ieo oa
eaai?aoi?ieo e?eoa???a. Iaa?oioiaaii e?eoa??? (ia’?eoeai? ia?ea-?e)
ioe?iee aaae neiae?iio aiaeiaaiii? ?ioieneeaoe?? i?e nainen? oa
aeeiai?/-iiio eiio?ieth aoaeoeaiino? aeaoieneeaoe?eii? oa?ai??.
Iioei?ciaaia i?ia?a-ia ?ioaineaiiai e?eoaaiiy naineno oeyoii
oaeineiiaeaiiy aoai?a i?noeaaiai e?eoaaiiy ia?aeiiiai ai?eiiai
ina?aaeeo, a oaeiae caaaeueii? eiiieaenii? oa?ai?? c aeei?enoaiiyi iiaeo
a?iaaeaioiaai?a, oaeoi??a ianiaoeeo?/ii? aaeai-oaoe?eii? a?aeiia?ae? oa
e??ieiina?aiaaieo a?ini?aaio?a.

Aea/aiiy ee?i?/ii? aoaeoeaiino? ?ic?iaeaii? i?ia?aie ?ioaineaiiai
e?eoaaiiy naineno c oi?iaaaeaeaiiyi iiaeo ?ic?iaie o ee?i?/io i?aeoeeo
ii-eacaei ?oith aenieo aoaeoeai?noue: caaacia/eei cieaeaiiy eaoaeueiino?
oai?eo c 23,6 aei 17,4% oa nei?i/aiiy oa?i?i?a ia?aaoaaiiy a noaoe?iia??
a 1,2 ?aca.

Eeth/ia? neiaa: nainen, ai?eii-caiaeuei? caoai?thaaiiy,
i?e?ioei?a, iae?i-aiaeie?eiia, aioeieneaeaioia nenoaie, ia?aeenia
ieeneaiiy e?i?ae?a, ?ioiiee noaoon, aioeaaeoa??aeueia oa?ai?y,
aeaoieneeaoe?y, ei?aeoe?y.

AIIIOAOeEss

Oaiiaae Na?aae Aeieo?eaae/ “Iniaaiiinoe oa/aiey e ea/aiey nainena o
aieueiuo n aiieii-ainiaeeoaeueiuie i?ioeannaie iyaeeo oeaiae”.
?oeiienue. Aeenna?oaoeey ia nieneaiea o/aiie noaiaie aeieoi?a
iaaeeoeeineeo iaoe ii niaoeeaeueiinoe 14.01.03 – oe?o?aey. Caii?iaeneee
ainoaea?noaaiiue einoeooo oniaa?oainoaiaaiey a?a/ae, a. Caii?iaeuea,
1999.

Caueuaaony aeenna?oaoeeiiiay ?aaioa, a eioi?ie i?aaeeiaeaia
iao/ii-iainiiaaiiay I?ia?aiia iiauoaiey yooaeoeaiinoe oa?aiee aieueiuo
nainenii. Aeey aa i?aeoe/aneie ?aaeecaoeee a ?acoeueoaoa i?iaaaeaiiuo
eeeie/aneeo enneaaeiaaiee eco/aii oa?aeoa? e iai?aaeaiiinoue ?aaeoeee
iae?i-yiaeie?eiiie e aioeieneaeaioiie nenoai, a oaeaea eiioiiiai noaoona
ia iia?aaeaeathuaa aeaenoaea neiae?iia nenoaiiiai ainiaeeoaeueiiai
ioaaoa. Iaeiia?aiaiii n yoei iioeiece?iaai yoai ?aiiae aeeaaiinoeee
nainena n ioeaieie n?aaieoaeueiie eioi?iaoeaiinoe iniiaiuo eeeie/aneeo e
eaai?aoi?iuo e?eoa?eaa.

Ia iniiaaiee nianoaaiiiai eeeie/aneiai iiuoa aeey oieoeoee?iaaiiie
ioeaiee noaiaie oyaeanoe naioe/aneiai neiae?iia (nainen, oyaeaeue
nainen, naioe/aneee oie, neiae?ii III) auea ?ac?aaioaia
iiaeeoeoee?iaaiiay ?aai/ay eeanneoeeaoeey nainena, eeeieei-eaai?aoi?iua
iieacaoaee eioi?ie, niioaaonoaotho a?aaeaoeee e?eoa?eaa ia?ooaiiiai
aiiainoaca a noaiaea?oeciaaiiuo nia?aiaiiuo eeanneoeeaoeeyo nainena.
Eniieueciaaiea yoie eeanneoeeaoeee a eeeie/aneie ?aaioa nouanoaaiii
oi?inoeei e onei?eei i?ioeann aeeaaiinoe/aneiai iienea.

Aeeaaiinoe/aneay i?ia?aiia ianeaaeiaaiey aieueiuo nainenii auea
?anoe?aia ca n/ao i?eiaiaiey ?yaea niaoeeaeueiuo iaoiaeia enneaaeiaaiey,
/oi iicaieeei niioaaonoaaiii nia?aiaiiui o?aaiaaieyi o?aeoiaeo neiae?iia
nainena aace?iaaoue ia eeeieei-iaoioeceieiae/aneii aai aeeaaiica,
aaeoa?eieiae/aneii aeeaaiica e eiioiieiae/aneii aeeaaiica.

Iainiiaaiu e?eoa?ee (iauaeoeaiua ia?ea?u) ioeaiee oyaeanoe neiae?iia
yiaeiaaiiie eioieneeaoeee i?e nainena e aeeiaie/aneiai eiio?iey
yooaeoeaiinoe aeaoieneeaoeeiiiie oa?aiee. Aiaeec aeaiiuo eeeie/aneiai
ianeaaeiaaiey e eeeieei-aeioeie/aneeo iieacaoaeae, iieo/aiiuo i?e
aeeiaie/aneii iaaethaeaiee, naeaeaoaeuenoaoao ia io/aoeeaie au?aaeaiiie
caaeneiinoe iaaeaeo niaea?aeaieai eco/aaiuo ia?ea?ia eioieneeaoeee e
noaiaiueth au?aaeaiiinoe yaeaiee yiaeioieneeica. I?iaaaeaiiue
ei??aeyoeeiiiue aiaeec iicaieyao ooaa?aeaeaoue, /oi aicieeiiaaieth
yiaeiaaiiie eioieneeaoeee niinianoaoao oeaiue iaoioeie/aneeo e
iaoiii?oieiae/aneeo ?aaeoeee, auoiaeyueo ca ?aiee anoanoaaiiiai eiio?iey
ni noi?iiu i?aaiecia e aeeth/athueony a ii?i/iue e?oa acaeiiiai
iioaioee?iaaiey.

Onoaiiaeaii, /oi enoiaeiue (aei ia/aea ea/aiey) oei eiioiiiai noaoona
i?aaiecia aieueiuo nainenii nouanoaaiii aeeyao ia yooaeoeaiinoue
i?iaiaeeiie oa?aiee e enoiaeu ea/aiey: o 74,8% aieueiuo iaia?oaeai
noi?anneaiue oei eiioiieiae/aneeo ?aaeoeee (eaoaeueiinoue- 18,2%), o
13,6%- niaoaiiue oei, ineiaeiaiiue ?acaeoeai aooieiioiiuo ?aaeoeee
(eaoaeueiinoue- 28,6% ) e o 11,6% aieueiuo — ?aaiiia?ii aeoeae?iaaiiue
oei eiioiiiai noaoona (eaoaeueiuo enoiaeia ia auei).

Iioeiece?iaaia i?ia?aiia eioaineaiiai ea/aiey nainena iooai
niaa?oainoaiaaiey yoaiia ianoiiai ea/aiey ia?ae/iiai aiieiiai i/aaa, a
oaeaea iauae eiiieaeniie oa?aiee n eniieueciaaieai iiauo
aeiaaeaioiaaiia, oaeoi?ia ianiaoeeoe/aneiai aaeaioaoeeiiiiai ioaaoa, e
e?eieiina?ae-?iaaiiuo aeini?aaioia.

Ii?aaeaeaiu eioi?iaoeaiua iieacaoaee eiio?iey yooaeoeaiinoe ea/aiey
neiae?iia nainena; e i?iaiinoe/anee iaaeaaii?eyoiui ioiinyony: nieaeaiea
iai?yaeaiey ?I2; iiauoaiea (auoa 5 aae.) eiyooeoeeaioa ei?oecie /
einoeei; ?aceia nieaeaiea i?iaeoeoia IIE (ia?ae/iuo e aoi?e/iuo);
iiauoaiea aeoeaiinoe O3 e O4 ia oiia iiauoaiiiai o?iaiy OOA;
i?ia?anne?othuaa oaaee/aiea eiee/anoaa I-eeioioeeoia; nieaeaiea
eiioii?aaoee?othuaai eiaeaena aei 1,0-1,2 aae. e ieaea.

Aiaae?aiea nianoaaiiuo ?ac?aaioie a i?ia?aiio ea/aiey aieueiuo nainenii
a aeaea aeoeaiiai ianoiiai ea/aiey ia?ae/iiai i/aaa (iiiai-eiiiiiaioiua
iace ia aeae?ioeeueiie iniiaa n o/aoii aeaea iee?iaiiai aicaoaeeoaey),
eioaineoeeaoeee eiiieaena aeaoieneeaoeeiiiuo ia?ii?eyoee (ieaciaoa?ac,
aaiini?aoeee n eniieueciaaieai e?eieiina?ae?iaaiiuo enaiiaaiaoioeeoia,
nieaiioeeoia, ia?oocaoa e?eieiina?ae?iaaiiuo o?aaiaioia enaiinaeacaiee e
eeaoie oeiona), iai?aaeaiiie eiioiiei??aeoeee e iaoiaeia
ianiaoeeoe/aneie aeoeaaoeee eiioiiaaiaca (AEIE, aeieiae/anee aeoeaiue
i?iaeoeo “Aieoei?”, ianoieea ec ei?iae yoeiioeae io?io?iie), ?aiiaai
yioa?aeueiiai ieoaiey n eniieueciaaieai aunieiaaeeiaiai i?iaeoeoa
“Aaineoii-40” iicaieeei nie?aoeoue iieacaoaeue eaoaeueiinoe n 23,7 aei
17,4% e nieceoue n?aaeiaa i?aauaaiea a noaoeeiia?a a 1,2 ?aca.

Eeth/aaua neiaa: nainen, aiieii-ainiaeeoaeueiua caaieaaaiey,
iee?i-oei?a, iae?i-yiaeie?eiiay, aioeieneaeaioiay nenoaiu, ia?aeeniia
ieeneaiea eeieaeia, eiioiiue noaoon, aioeaaeoa?eaeueiay oa?aiey,
aeaoieneeaoeey, ei?-?aeoeey.

ANNOTATION

Shapovalov, Sergei Dmitriyevich «Peculiarities of the course and
treatment of sepsis of patients having pyo-inflammatory process of soft
tissues». Manuscript. Thesis on the competition of scientific degree of
the Doctor of Medical Sciences on the speciality 14.01.03 — surgery.
Zaporizhia advanced training institute for doctors, city of Zaporizhia,
1999.

The thesis is defended in which scientifically substantiated program of
increasing efficiency of therapy of patients having sepsis, has been put
forward. For its practical realization in the result of the conducted
clinical examination, the nature and direction of neuro-endocrine and
antioxidation systems as well as the immune status to the injurious
effect of the systemic inflammatory response syndrome have been studied.
Simultaneously the stage of early sepsis diagnosis and estimation of
comparative imformativeness of the basic clinical and laboratory
criteria, has been optimized. The criteria (objective markers) of the
degree of endogenous intoxication syndrome during sepsis and dynamic
control ofdetoxication therapy efficiency have been grounded. The
program of intensive sepsis treatment by way of improvement of stages of
the local treatment of the primary suppurative focus as well as general
complex therapy with application of new bioadaptgens, factors of
non-specific adaptation response and cryoconserved biosorbents have been
optimized.

The study of the clinical efficiency of the developed program of
intensive sepsis treatment with the introduction of new developments
into the clinical practice have proved its high efficiency: secured
decrease of patients’ lethality from 23,6 to 17,4% and reduction of the
term of staying in hospital by 1,2.

Key words: sepsis, pyo-inflammatory disease, microflora,
neuro-endocrine, antioxidation systems, peroxidal oxidation oflipids,
immune status, antibac-teriological therapy, detoxication, correction.

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