?INOEOOO OOEC?AO??? ? IOEUeIIIIEIA?? ?i. O.A. ssIIANUeEIAI

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

Aecthaeee ss?ineaa Ieaenaiae?iae/

OAeE: 616.12-02:616.24-085:612.115.3.001.5

AOAEOEAI?NOUe I?AIA?AOO OAEII A EI?AEOe?? NENOAIE AEEICAII?Ae?A O
OAI?EO C O?II?*IEI EAAAIAAEI NA?OeAI

14.01.27 — ioeueiiiieia?y

Aaoi?aoa?ao

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Ee?a – 1999 Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia a ?inoeooo? ooec?ao??? ? ioeueiiiieia?? ?i. O.A.
ssiianueeiai AII Oe?a?ie.

Iaoeiaee ea??aiee: aeieoi? iaaee/ieo iaoe ss/iee Aiaoie?e ?aaiiae/,
i?ia?aeiee iaoeiaee ni?a?ia?oiee ee?i?ei-ooieoe?iiaeueiiai a?aeae?eaiiy
?inoeoooo ooec?ao??? ? ioeueiiiieia?? ?i. O.A.ssiianueeiai AII Oe?a?ie

Io?oe?ei? iiiiaioe: aeieoi? iaaee/ieo iaoe, i?ioani? Ooaa Iaii?ea
Ieoaee?aia, i?ioani? eaoaae?e oa?ai?? ? ?aaiaoieia?? Ee?anueei?
iaaee/ii? aeaaeai?? i?neyaeeieiiii? ina?oe ?iai? I.E. Ooieea IIC
Oe?a?ie;

aeieoi? iaaee/ieo iaoe, i?ioani? Na?ioe?oeueeee Aiaoie?e Noai?neaaiae/,
caa?aeoth/ee eaoaae?ith aini?oaeueii? oa?ai?? N 2 Iaoe?iiaeueiiai
iaaee/iiai oi?aa?neoaoo ?iai? I.I. Aiaiiieueoey.

I?ia?aeia onoaiiaa: Euea?anueeee aea?aeaaiee iaaee/iee oi?aa?neoao ?i.
Aeaieea Aaeeoeueeiai.

Caoeno a?aeaoaeaoueny 1 eenoiiaaea 1999 ?. i 14 aiaeei? ia can?aeaii?
niaoe?ae?ciaaii? a/aii? ?aaee Ae 26.552.01 i?e ?inoeooo? ooec?ao??? ?
ioeueiiiieia?? ?i. O.A.ssiianueeiai AII Oe?a?ie (252110, i. Ee?a,
INI-680, oca?c I?ioan?a ss?, 7).

C aeena?oaoe??th iiaeia iciaeiieoenue a a?ae?ioaoe? ?inoeoooo ooec?ao???
? ioeueiiiieia?? ?i. O.A.ssiianueeiai AII Oe?a?ie (i. Ee?a, oca?c
I?ioan?a ss?, 7).

Aaoi?aoa?ao ?ic?neaiee 30 aa?aniy 1999 ?.

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee AE.A. Aaaioe?aa

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

AEOOAEUeI?NOUe OAIE. O?ii?/ia eaaaiaaa na?oea — iaea?eueo /anoa i?e/eia
nia?oiino? oai?eo ia o?ii?/i? caoai?thaaiiy eaaai?a (A.E. Aaa?enthe,
A.E. ss/iee, 1998). Ia a?aei?io a?ae cano?eii? iaaeinoaoiino?
e?iaiia?ao, iaoiiaeaii? caoai?thaaiiyie na?oey, aeaeiiiainiaaia o?ii?/ia
eaaaiaaa na?oea oa?aeoa?eco?oueny cia/ii a?eueo /anoith ?ao?aeoa?i?noth
aei o?aaeeoe?eieo iaoiae?a e?eoaaiiy, iniiao yeeo neeaaeathoue
na/ia?ii?, ?iio?iii? caniae, ?ia?a?oi?e aia?ioaicei-eiiaa?ooth/iai
oa?iaioo (E.E. Aieeiaa, TH.I. Ooaeiaa?ae, 1992). Oea iiynith?oueny
nooo?aeie a?aei?iiinoyie iaoai?ci?a ?icaeoeo cano?eii? iaaeinoaoiino?
e?iaiia?ao i?e caoai?thaaiiyo na?oey ? eaaai?a oa coiiaeth?
aeooaeuei?noue ?ic?iaee iiaeo i?aeoiae?a aei oa?iaeioa?ai?? oai?eo c
o?ii?/iei eaaaiaaei na?oeai.

A inoaii? ?iee a ea?ae?ieia??, ioeueiiiieia??, iao?ieia?? oa ?ioeo
aaeocyo iaaeeoeeie ao?oeeai ?icaeaathoueny iia? iaoeia? iai?yiee
aeine?aeaeaiue ii aea/aiith a?ieia?/ii? ?ie? (-3 iie?iaiane/aieo aee?ieo
eeneio (IIAEE). Oaaaa aei (-3 IIAEE ??cei ca?eueoeeanue ia ?oaaae? 70-o
– 80-o ?ie?a, eiee a ?acoeueoao? ai?aeai?ieia?/ieo aeine?aeaeaiue (J.
Dyerberg, H.O. Band, 1975, A. Hirai, 1987) aoei anoaiiaeaii, ui aeoaea
iecueeee ??aaiue na?oeaai-noaeeiieo caoai?thaaiue, o?iiaic?a oa
o?iiaiaiaie?e o aeeoae?a A?aieaiae??, i?eaa?aaeieo ?aeii?a ssiii??,
I?aea?eaiae?a ? ?yaeo ?ioeo e?a?i iia’ycaiee c i?aeaeuaiei aaeeaaiiyi
aaeeei? e?eueeino? ii?nueeeo aee??a c aenieei ai?noii aeeicaiaioa?iiai?
? aeieicaaaena?iiai? eeneio (AIE ? AeAE).

Aeae?, a ?acoeueoao? /eneaiieo aenia?eiaioaeueieo ? eaai?aoi?ieo
aeine?aeaeaiue (TH.E. Oauaiei, 1996, P. Singer, 1991) aoei anoaiiaeaii,
ui (-3 IIAEE ii?yae c a?iie?i?aeai?/iith ae??th ni?e/eiythoue
a?iioaiceaiee, aioeaa?aaaioiee ? i?ioecaiaeueiee aoaeoe, iaoai?ci yeeo
?aae?co?oueny /a?ac iiaeeo?eaoe?th iaoaaie?cio a?ao?aeiiiai? eeneioe
(AE) ca o/anoth AIE ? AeAE. (-3 IIAEE ? eiieo?aioieie aioaaii?noaie AE:
i?e iaaeoiaeaeaii? ?o a i?aai?ci ciaioo?oueny caaaeueiee ai?no AE, a
oaeiae cieaeo?oueny aeoeai?noue ?? iaoaaie?cio. Aiane?aeie oeueiai,
ciaioo?oueny i?iaeoeoe?y ?iaeoeoi??a caiaeaiiy e aa?aaaoe??
o?iiaioeeo?a, iaoaaie?o?a, ye? iathoue aacieiino?eeoi?io ae?th (M.B.
Engler, 1996, H.R. Knapp, 1991).

A Cao?aei?e ?a?ii?, NOA, ssiii?? oa a aeayeeo ?ioeo e?a?iao ca?ac
ae?iaey?oueny i?aia?ao MaxEPA e aiaeiae, ye? i?noyoue aei 30% (-3 IIAEE.
A ?in?? aeionea?oueny i?aia?ao Aeeiiie c oaeei naiei neeaaeii.

A ?inoeooo? ooec?ao??? ? ioeueiiiieia?? ?i. O.A. ssiianueeiai AII
Oe?a?ie ?ic?iaeaiee i?aia?ao Oaeii, yeee i?noeoue 45% (-3 IIAEE, oa ia?
aeica?e Oa?iaeieia?/iiai eii?oaoo IIC Oe?a?ie aeey ee?i?/iiai
canoinoaaiiy. I?aia?ao ia? ia?aaaae ia?aae MaxEPA ? Aeeiiieii ca ye?niei
neeaaeii, ine?eueee a iueiio iaioa IIAEE eeano (-6, ye? aenooiathoue
iioaioe?eieie eiieo?aioaie AIE ? AeAE a ?icaeoeo ?o oa?iaeieia?/iiai
aoaeoo.

A?aoiaoth/e aaeeea cia/aiiy ii?ooaiue iaoaaie?cio AE a iaoiaaiac?
iaaeinoaoiino? e?iaiia?ao o oai?eo c caoai?thaaiiyie eaaai?a (Cristman
B.W., 1992; Adatia I. et al., 1993), iaaaaeai? aeua aeai?, c iaoi? oi/ee
ci?o, aenooiathoue ia?aaeoiiaith aeey aea/aiiy aoaeoeaiino? canoinoaaiiy
(-3 IIAEE a e?eoaaii? oai?eo c o?ii?/iei eaaaiaaei na?oeai.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie oa oaiaie. Iaoa??aee
aeena?oaoe?eii? ?iaioe ? o?aaiaioii ieaiiai? IAe? ?inoeoooo A.98.02
“?ic?iaeoe oaoiieia?th canoinoaaiiy iiaiai e?ea?nueeiai i?aia?aoo Oaeii
a eiiieaeniiio e?eoaaii? oai?eo c o?ii?/iei eaaaiaaei na?oeai”. ?
aea?ae?a?no?aoe?? 0198U000753.

Iaoa aeine?aeaeaiiy. Aea/eoe aieea iiaiai e?ea?nueeiai i?aia?aoo Oaeii
ia iieacieee nenoaie aeeicaii?ae?a ? aecia/eoe iiaeeeaino? eiai
canoinoaaiiy o oai?eo c o?ii?/iei eaaaiaaei na?oeai.

Caaea*? aeine?aeaeaiiy

Aea/eoe in vitro aieea Oaeiio ia iieacieee nenoaie aeeicaii?ae?a o
oai?eo c o?ii?/iei eaaaiaaei na?oeai.

Aea/eoe aieea Oaeiio ia ai?no iaoaaie?o?a AE o oai?eo c o?ii?/iei
eaaaiaaei na?oeai a ee?i?/ieo oiiaao.

Aecia/eoe aoaeoeai?noue ei?aeoe?? nenoaie aeeicaii?ae?a i?e aeei?enoaii?
Oaeiio a e?eoaaii? oai?eo c o?ii?/iei eaaaiaaei na?oeai ia iniia?
ioe?iee noaio ea?ae?i-?ani??aoi?ii? nenoaie.

Iaoeiaa iiaecia IAeA?AEAIEO ?ACOEUeOAO?A. Aea/aiee aieea ?ic?iaeaiiai ca
i?ea?iaeueiith oaoiieia??th (iaoaio Oe?a?ie ? 7180A, IIE-5 A 61E35/60
a?ae 16.03.1995 ?.) iiaiai e?ea?nueeiai i?aia?aoo Oaeii ia iieacieee
nenoaie aeeicaii?ae?a o oai?eo c o?ii?/iei eaaaiaaei na?oeai a i?iaao in
vitro e a ee?i?/ieo oiiaao.

Anoaiiaeaii, ui Oaeii, ye eiieo?aioiee aioaaii?no AE, aeeeeea? ciaioaiiy
i?iaeoeoe?? ?iaeoeoi??a caiaeaiiy ? aa?aaaoe?? o?iiaioeeo?a, a oaeiae ??
iaoaaie?o?a, ye? ni?e/eiythoue a?iioi- oa aacieiino?eeoi?io ae?th. Oea
neeaaea? iniiao aeey canoinoaaiiy Oaeiio o oai?eo c o?ii?/iei eaaaiaaei
na?oeai.

A ?acoeueoao? e?eoaaiiy i?aia?aoii ca?a?no?iaaia iiceoeaia aeeiai?ea
ee?i?/ieo iieaciee?a noaio oai?eo a ii?aeiaii? c iie?auaiiyi
ooieoe?iiaeueieo iieaciee?a ea?ae?i-?ani??aoi?ii? nenoaie.

Canoinoaaiiy (-3 IIAEE o oai?eo c o?ii?/iei eaaaiaaei na?oeai ?
i?eioeeiiai iiaei i?aeoiaeii o oa?iaeioa?ai?? iaaeinoaoiino? e?iaiia?ao
i?e caoai?thaaiiyo eaaai?a.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a. ?ic?iaeaii iaoiaeeeo
aea/aiiy aieeao Oaeiio ia noai nenoaie aeeicaii?ae?a in vitro, yea iiaea
aooe aeei?enoaia a iaoeiai-aeine?aeieo ?iaioao ii aea/aiith aieeao iiaeo
e?ea?nueeeo cania?a ia iaoaaie?ci AE.

Aeeiiaia ?iaioa ? o?aaiaioii i?ia?aie iaoeiaeo aeine?aeaeaiue ii
?ic?iaoe? i?aia?aoo Oaeii, yeee i?eeiyoee aei ae?iaieoeoaa AO
«Ee?anueeee a?oai?iiee caaiae».

Ai?iaaaeaeaiiy a i?aeoeeo ?aeiiaiaeaoe?e ii canoinoaaiith Oaeiio i?e
o?ii?/iiio eaaaiaaiio na?oe? aoaea ni?eyoe i?aeaeuaiith aoaeoeaiino?
e?eoaaiiy oai?eo, ca?eueoaiith o?eaaeino? ?o aeeooy.

?acoeueoaoe ?iaioe ai?iaaaeaeai? a ?inoeooo? ooec?ao??? ? ioeueiiiieia??
?i. O.A. ssiianueeiai AII Oe?a?ie, ee?i?/i?e e?ea?i? iaooiia?a?iaii?
i?iieneiaino? Oe?a?ie IIC Oe?a?ie, OeEE ?30 I?inueeiai ?aeiio i. Ee?aa.

INIAENOEE AIANIE CAeIAOAA*A. Iniaenoee aianie iieyaa? o ?ic?iaoe? an?o
iaoeiaeo ?acoeueoao?a. Ee?i?/i? oa ?ino?oiaioaeuei? aeine?aeaeaiiy aoee
i?iaaaeai? ca aaciina?aaeiueith iniaenoith o/anoth aaoi?a. An? oai??
ciaoiaeeeenue i?ae iniaenoei niinoa?aaeaiiyi aeena?oaioa. Naiino?eii
i?iaaaeaiee aiae?c aenia?eiaioaeueieo ? ee?i?/ieo aeaieo, noaoenoe/ia
ia?iaea iaoa??aeo. Aeneiaeth?ii ue?o iiaeyeo caa?aeoaa/o eaai?aoi???th
?aae?i?cioiiieo iaoiae?a aeine?aeaeaiiy ?inoeoooo ea?ae?ieia?? ?i. I.Ae.
No?aaeanea ae.i.i. N.TH. Naaeoeueeiio ca ni?eyiiy o aeeiiaii?
?aae?i-?ioiieia?/ieo aeine?aeaeaiue.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iniiai? iieiaeaiiy aeena?oaoe??
aeieeaaeai? ia II c’?cae? ooec?ao??a ? ioeueiiiieia?a Oe?a?ie (Ee?a,
1998), 8 iaoe?iiaeueiiio eiia?an? c caoai?thaaiue i?aai?a aeeoaiiy
(Iineaa, 1998), iaoeia?e eiioa?aioe?? a ?inoeooo? ooec?ao??? ?
ioeueiiiieia?? ?i. O.A. ssiianueeiai AII Oe?a?ie (1999).

Ioae?eaoe??. Ii iaoa??aeai aeine?aeaeaiiy iioae?eiaaii 9 ?ia?o, a oiio
/ene? 5 noaoae a i?ia?aeieo aeo?iaeao, ?aeiiaiaeiaaieo AAE Oe?a?ie.

Ianya oa no?oeoo?a aeena?oaoe??. Aeena?oaoe?y aeeeaaeaia ia 124
noi??ieao ae?oeiaaiiai oaenoo, i?i?ethno?iaaia 10 ?enoieaie, i?noeoue 11
oaaeeoeue. Neeaaea?oueny ?c anooio, iaeyaeo e?oa?aoo?e, aeaio ?icae?e?a
aeanieo aeine?aeaeaiue, caeeth/aiiy, aeniiae?a, i?aeoe/ieo
?aeiiaiaeaoe?e, ia?ae?eo e?oa?aoo?e, yeee iae?/o? 194 aeaea?aea.

CI?NO ?IAIOE

IAOA??AEE ? IAOIAeE AeINE?AeAEAIUe.

Ianoaaeaii 84 oai?eo a?eii a?ae 19 aei 74 ?ie?a ?c caoai?thaaiiyie
a?iioi-eaaaiaai? nenoaie ??ciiiai?oiiai oa?aeoa?o (/ieia?e?a – 57,
ae?iie – 27). ?iciiae?e oai?eo a caeaaeiino? a?ae iicieia?/ieo oi?i
iaaaaeaiee a oaaeeoe? 1.

Ae?aaiic caoai?thaaiiy anoaiiaethaaany ia iniia? aeaieo ee?i?/iiai,
?aioaaiieia?/iiai iaoiae?a, aeaeo?iea?ae?ia?ao??, aoiea?ae?ia?ao??,
aeine?aeaeaiiy ooieoe?? ciai?oiueiai aeeoaiiy, a oaeiae eaai?aoi?ieo
iaoiae?a.

I?e aecia/aii? nooiaith eaaaiaai? iaaeinoaoiino? oa noaae??
iaaeinoaoiino? e?iaiia?ao aeei?enoiaoaaee e?eoa??? ee?i?/ieo
eeaneo?eaoe?e A.A. Aeaiai oa I.Ae. No?aaeanea — A.O. Aaneeaiei. Eaaaiaaa
iaaeinoaoi?noue I nooiaith niinoa??aaeanue o 18 oai?eo, II nooiaith — o
58, III nooiaith — o 8. Cano?eia iaaeinoaoi?noue e?iaiia?ao iaea i?noea
a 40 aeiaaeeao: IIA — o 31 oai?iai, IIA — o 9.

Oaaeeoey 1

?iciiae?e oai?eo a caeaaeiino? a?ae oa?aeoa?o caoai?thaaiiy

Iicieia?/ia oi?ia E?euee?noue oai?eo

aan. %

O?ii?/iee iano?oeoeaiee a?iio?o 33 39,3

O?a?icii-eaaa?iiciee ooaa?eoeueic eaaai?a 13 15,5

Aeenai?iiaaiee ooaa?eoeueic eaaai?a 9 10,7

Aii??ia ieaa?e 6 7,1

Iiaaiii?y 5 6,0

Ia?aeiia eaaaiaaa a?ia?oaic?y 5 6,0

?ae?iiaoe/iee o?a?icoth/ee aeueaaie?o 5 6,0

O?ii?/ia iinoaiaie?/ia eaaaiaaa a?ia?oaic?y 4 4,8

A?iioiaeoaoe/ia oai?iaa 3 3,6

Oi?aei-ae?ao?aaiaeueia oi?ia OEN 1 1,2

Anueiai 84 100

C iaoith aea/aiiy aieeao Oaeiio ia iaoaaie?ci a?ao?aeiiiai? eeneioe in
vitro iaie ?ic?iaeaia ianooiia iaoiaeeea.

C?acee e?ia? (ii 10 ie) iii?uaee o aea? ieanoeeia? i?ia??ee c 0,5 ie
3,8% ?ic/eio oeeo?aoo iao??th ? 0,95 ie 4% ?ic/eio
aoeeaiae?ai?ioao?aaoeaoaoo. A iaeio c i?ia??ie aeiaeaaaee 0,2 ie Oaeiio,
ui a?aeiia?aeaei na?aaei?e oa?aiaaoe/i?e aeic? i?aia?aoo. I?ney
?ieoaaoe?? ia i?ioyc? 30 oaeeei iiaeaeueoee iaoaaie?ci IIAEE coieiyee
oeyoii aeiaeaaaiiy ani?cieo (0,05 ie 10% ?ic/eio), e?ia oeaio?eooaoaaee,
a io?eiaio ieacio iaaaeii caii?iaeoaaee i?e oaiia?aoo?? -400C.

Aecia/aiiy ai?noo 6-eaoi-i?inoaaeaiaeeio F1( (IAF1() — noaa?eueiiai
iaoaaie?oo i?inoaoeeee?io (IA?2) — ? o?iiaienaio B2 (TxB2) —
noaa?eueiiai iaoaaie?oo o?iiaienaio A2 (TxA2), a oaeiae
noeueo?aeieaeeio?e?i?a 4 na??? (EOC4/D4/E4) i?iaiaeeee
?aae?i?ioiieia?/iei iaoiaeii c aeei?enoaiiyi ??A-iaai??a o??ie
«Amersham» (Aaeeeia?eoai?y) ia ?aae?iiao?? «Aaiia-12» a eaai?aoi???
?aae?i?cioiiieo iaoiae?a aeine?aeaeaiue Oe?a?inueeiai IAe? ea?ae?ieia??
?i. I.Ae. No?aaeanea (ea??aiee — ae.i.i. Naaeoeueeee N.TH.).

C?acee e?ia? aeey aea/aiiy aieeao eo?niaiai e?eoaaiiy Oaeiiii ia
iieacieee nenoaie aeeicaii?ae?a cae?aee ca aiaeia?/iith iaoiaeeeith (ia
a?aei?io a?ae i?ia in vitro ani?cie aeiaeaaaee aaciina?aaeiuei i?ney
iaae?aiiy e?ia?).

Aea/aiiy aaioeeyoe?eii? ooieoe?? eaaai?a i?iaiaeeee ca aeiiiiiaith
iaoiaeo ?a?no?aoe?? ? aiae?co e?eai? iio?e-ia’?i oi?niaaiiai aeaeeoo c
aeei?enoaiiyi aia?aoo «Pneumoscreen II» ae?iaieoeoaa eiiiai?? «Erich
Jaeger» (I?ia//eia). I?iaiaeeee aiae?c oaeeo iieaciee?a: aeeoo?aa
?ii?noue eaaaiue (VC), oi?niaaia aeeoo?aa ?ii?noue eaaaiue (FVC), ia’?i
oi?niaaiiai aeaeeoo ca ia?oo naeoiaeo (FEV1), ?iaeaen O?ooii (FEV1/VC),
ieoo?a? oaeaeeino? iioieo ia ??aiyo 25% FVC (MEF25), 50% FVC (MEF50),
75% FVC (MEF75), i?eiaa oaeaee?noue aeaeeoo (PEF). Aiae?coaaee cia/aiiy
aei??thaaieo iieaciee?a o a?aenioeao aei iaeaaeieo aaee/ei.

Aoiea?ae?ia?ao?/ia aeine?aeaeaiiy i?iaaaeaii c aeei?enoaiiyi
aoiea?ae?ia?aoo «Irex-Meridian» ae?iaieoeoaa eiiiai?? «Johnson&Johnson»
(NOA).

Aecia/aiiy ia’?i?a i?aaiai oeoii/eo i?iaiaeeee ia iniia? aiae?co
i?oiaiiaeueieo c??c?a, io?eiaieo c aa?o?aeiaiai aeinooio, c
aeei?enoaiiyi ??aiyiiy Neiiniia. Ia iniia? io?eiaieo aeaieo
?ic?aoiaoaaee ianooii? iieacieee: e?ioeaaee ae?anoie?/iee ia’?i
oeoii/e?a (EAeI, ie); a?aeiioaiiy EAeI aei ieiu? iiaa?oi? o?ea (EAeI/S,
ie/i2), e?ioeaaee nenoie?/iee ia’?i (ENI, ie); a?aeiioaiiy ENI aei ieiu?
o?ea (ENI/S, ie/i2), o?aeoe?th aeaiaiiy (OA, %), oaea?iee ?iaeaen (O?,
ie/i2), na?oeaaee ?iaeaen (N?, e/oa(i2), iieaciee a?aeiioaiiy
ae?anoie?/ieo ia’?i?a i?aaiai oa e?aiai oeoii/e?a (EAeIIO/EAeIEO) ?
iieaciee a?aeiioaiiy nenoie?/ieo ia’?i?a oeoii/e?a (ENIIO/ENIEO),
nenoie?/iee oene a eaaaiaa?e a?oa??? (NOEA). Aeine?aeaeaiiy ooieoe??
ciai?oiueiai aeeoaiiy oa aoiea?ae?ia?ao?th i?iaiaeeee a?ae?aco i?ney
e?ea?aeaoe?? yaeu aeaeiiiainaoe?? e?iaiia?ao oa ia?aaaaeaiiy oai?eo ia
i?aeo?eioth/o oa?ai?th, ia?aae i?ecia/aiiyi Oaeiio (/a?ac 7 aei?a i?ney
ia?oiai aeine?aeaeaiiy) oa i?ney cae?i/aiiy eo?no oa?ai?? Oaeiiii (/a?ac
4 oeaei? i?ney ae?oaiai aeine?aeaeaiiy). A?aenooi?noue aeinoia??ieo
a?aei?iiinoae iieaciee?a ea?ae?i-?ani??aoi?ii? nenoaie i?ioyaii 7 aei?a,
ye? ia?aaeoaaee i?ecia/aiith Oaeiio, na?ae/eea i?i noaa?e?caoe?th
ooieoe?iiaeueieo ia?aiao??a aeeoaiiy oa e?iaiia?ao, a oaeiae i?i
aeinyaiaiiy iaeneiaeueiiai aoaeoo o?aaeeoe?eii? oa?ai??. A ca’yceo c
oeei, ioe?iea aoaeoeaiino? Oaeiio a e?eoaaii? oai?eo c o?ii?/iei
eaaaiaaei na?oeai i?iaiaeeeany oeyoii ii??aiyiiy iieaciee?a ooieoe??
ciai?oiueiai aeeoaiiy oa aaiiaeeiai?ee iaeiai eiea e?iaiia?ao aei
ii/aoeo oa?ai?? oa i?ney caaa?oaiiy 4-oeaeiaaiai eo?no e?eoaaiiy
Oaeiiii. Eiio?ieai a aeine?aeaeaii? aenooiaa noai oai?eo ia aoai?
i?ecia/aiiy i?aeo?eioth/i? iaaeeeaiaioicii? oa?ai?? aac Oaeiio.

Aeine?aeaeaiiy aa?aaaoe?eii? ni?iiiaeiino? o?iiaioeeo?a i?iaiaeeee
ca?aeii oi?o?eiaaieo ?aeiiaiaeaoe?e aei aa?aaiiao?a «Chrono-log»
(Eaiaaea).

Iaoiaeeea aeine?aeaeaiiy iieyaaea a ianooiiiio. A ieanoeeia? i?ia??ee c
3,8% ?ic/eiii oeeo?aoo iao??th caae?aee 5,0 ie e?ia?, i?ney /iai iaeio
na??th i?ia??ie caeeoaee ye eiio?ieueio, a a ae?oao aeiaeaaaee 0,1 ie
Oaeiio. Aeine?aeaeaiiy i?iaiaeeee i?ney ia??iaeo 2-o aiaeeiii?
?ieoaaoe?? c aeei?enoaiiyi noaiaea?oieo iaai??a ?iaeoeoi??a aa?aaaoe??
o?iiaioeeo?a.

A yeino? iciae a?ia?aa?aaaoe?? o?iiaioeeo?a o a?aeiia?aeue ia ?iaeoeoi?
aa?aaaoe?? AAeO a aeic? 1 ieiieue/e ?icaeyaeaee a?aenooi?noue oace
aeacaa?aaaoe?? ia e?ea?e, i?e oeueiio iieaciee aa?aaaoe?? (A)
aei??aithaaa noia?iiio ?iaeaeno aa?aaaoe?? o?iiaioeeo?a (N?AO). Iiyao
ae?oai? oaee? aa?aaaoe?? (aaee/eia N?AO ia?aaaaea? A) ?icoe?ithaaee ye
??cei ae?aaeaio a?ia?aa?aaaoe?th o?iiaioeeo?a. Aeey aee?eooy
a??ia?aeiiai ii?ooaiiy aa?aaaoe?eii? ooieoe?? o?iiaioeeo?a i?e io?eiaii?
ii?iaeueii? e?eai? ia aeico ?iaeoeoi?a 1 ieiieue/e aeei?enoiaoaaee AAeO
a aeic? 5 ieiieue/e.

?acoeueoaoe aeine?aeaeaiue ia?iaeai? o?aaeeoe?eiei iaoiaeii aa??aoe?eii?
noaoenoeee ? iaoiaeii ioe?iee ??cieoe? niieo/aieo na?aaei?o aaee/ei.

Aieea i?aia?aoo Oaeii ia ai?no a e?ia? aeeicaii?ae?a o oai?eo c
o?ii?/iei eaaaiaaei na?oeai

C iaoith i?aeoaa?aeaeaiiy iiaeeeaino? ei?aeoe?? nenoaie aeeicaii?ae?a ca
aeiiiiiaith iiaiai e?ea?nueeiai i?aia?aoo Oaeii iaie aoea ?ic?iaeaia
iaoiaeeea i?iaaaeaiiy aeine?aeaeaiue in vitro. A aeinooii?e e?oa?aoo??
ie ia ciaeoee iia?aeiieaiue noiniaii aea/aiiy aieeao ??cieo ?a/iaei ia
iaoaaie?ci AE in vitro, oi/a a?ieia?/i? i?ioeane, a oiio /ene? e
iaoaaie?ci AE, i?iaeiaaeo?oueny aeayeee /an i?ney acyooy e?ia? a
i?ia??eo.

Ie aaaaeaee, ui i?ney aeiaeaaaiiy a e?ia Oaeiio /anoeia oeeeeiieneaaiace
oa e?iieneaaiace aoaea aeo?a/aia ia ia?a?iaeo AIE ? AeAE, a ca’yceo c
/ei iaoaaie?ci AE oiia?eueieoueny ?, ye iane?aeie, ciaioeoueny
i?iaeoeoe?y ?? iaoaaie?o?a — TxA2, IAI2, EO 4 na???.

Caa?? e?ia? i?iaaaeaiee o 12 oai?eo c o?ii?/iei eaaaiaaei na?oeai (10
/ieia?e?a ? 2 ae?iee) a?eii a?ae 28 aei 74 ?ie?a. C ieo o 5 oai?eo aoa
ae?aaiinoiaaiee o?ii?/iee iano?oeoeaiee a?iio?o, o 4 — aeenai?iiaaiee, a
o 2 — o?a?icii-eaaa?iiciee ooaa?eoeueic eaaai?a, o 1 — o?ii?/ia
iinoaiaie?/ia eaaaiaaa a?ia?oaic?y.

Eaaaiaaa iaaeinoaoi?noue II nooiaith aoea i?enooiy o 10 oai?eo, III
nooiaith — o 2. Iciaee cano?eii? iaaeinoaoiino? e?iaiia?ao iaee i?noea a
8 aeiaaeeao (IIA noaae?? — a 6, IIA noaae?? — a 2).

Io?eiai? ?acoeueoaoe i?aaenoaaeai? a oaaeeoe? 2. Ii?yae ?c ciaioaiiyi
ai?noo noeueo?aeieaeeio?e?i?a (a na?aaeiueiio a 3 ?ace), a i?iaao c
Oaeiiii niinoa??aaeiny ??cea c?inoaiiy (a?eueo i?ae o 5 ?ac?a) ai?noo
iaoaaie?oo IAI2 — 6-eaoi-IAF1( ? aeayea ca?eueoaiiy eiioeaio?aoe??
iaoaaie?oo TxA2 — TxB2. I?e oeueiio ni?aa?aeiioaiiy 6-eaoi-IAF1(/TxB2
nooo?ai ca?eueoeeinue ia ei?enoue iaoaaie?oo i?inoaoeeee?io.

Oaaeeoey 2

Aieea i?aia?aoo Oaeii in vitro ia ai?no a e?ia? ?yaeo aeeicaii?ae?a
(M(m, n=12)

Iieaciee

(ia/ie) I?iaa aac Oaeiio I?iaa c Oaeiiii P ( iieacieea p

6-eaoi-IAF1( 39,5(8,9 227,2(32,8 <0,001 +187,7(36,6 <0,001 TxB2 220,9(9,0 275,7(15,1 <0,05 +54,8(18,9 <0,05 6-eaoi-IAF1(/ TxB2 0,18(0,05 0,87(0,13 <0,001 +0,69(0,15 <0,001 EOC4 /D4/ E4 397,8(31,7 118,1(23,7 <0,001 -279,7(44,2 <0,001 O 24 oai?eo c o?ii?/iei eaaaiaaei na?oeai aoei i?iaaaeaii aea/aiiy noaio nenoaie aeeicaii?ae?a aei e i?ney 4-oeaeiaaiai eo?no e?eoaaiiy Oaeiiii. I?aia?ao a aeic? 4,0 a ia aeiao i?ecia/aany oai?ei i?ney e?ea?aeaoe?? yaeu aeaeiiiainaoe?? e?iaiia?ao ia oii? i?aeo?eioth/i? oa?ai?? e?eaie, ui ia aieeaathoue ia iaoaaie?ci AE. C?acee e?ia? aeey aecia/aiiy ai?noo TxB2, 6-eaoi-IAF1( oa EOB4/C4/D4 ?aae?i?ioiiei iaoiaeii caae?aee aaciina?aaeiuei ia?aae oa a?ae?aco i?ney cae?i/aiiy eo?no e?eoaaiiy Oaeiiii. Aeo?aei? ??ai? i?inoaii?ae?a ii??aithaaeeny c oaeeie o caei?iaeo aeia?iaieueoe?a, ye? neeaee eiio?ieueio a?oio. Iaie aoei anoaiiaeaii, ui o oai?eo c o?ii?/iei eaaaiaaei na?oeai a?aeaoaa?oueny i?aeaeuaiiy eiioeaio?aoe?e i?iaeoeo?a oeeeeiieneaaiaciiai oa e?iieneaaiaciiai oeyo?a ia?aoai?aiiy AE (oaaeeoey 3). Oaaeeoey 3 Aeeiai?ea iieaciee?a nenoaie aeeicaii?ae?a a i?ioean? e?eoaaiiy Oaeiiii Iieaciee (ia/ie) 1 Eiio?ieueia a?oia (n=12) A?oia oai?eo (n=24) t ( iieacieea 2 aei e?eoaaiiy 3 i?ney e?eoaaiiy 6-eaoi-IAF1( 18,3(1,5 63,6(11,1 49,4(7,1 t1-2=4,044* t1-3=4,286* t2-3=1,077 -14,2(7,5 t=1,893 TxB2 185,5(10,8 193,4(17,7 177,4(15,6 t1-2=0,381 t1-3=0,411 t2-3=0,678 -16,0(18,5 t=0,866 EO C4/D4/E4 221,5(17,2 294,8(44,4 209,8(25,6 t1-2=1,539 t1-3=0,379 t2-3=1,659 -85,0(42,0 t=2,021* I?ei?oea: * – a?aei?iiino? noaoenoe/ii aeinoia??i?. Aoaeoeai?noue canoinoaaiiy Oaeiio a ei?aeoe?? ii?ooaiue ea?ae?i-?ani??aoi?ii? nenoaie O oai?eo c o?ii?/iei eaaaiaaei na?oeai Aea/aiiy aoaeoeaiino? canoinoaaiiy Oaeiio a ei?aeoe?? ea?ae?i-?ani??aoi?ii? nenoaie i?iaiaeeee i?ney e?ea?aeaoe?? aai caaaeaiiy aei i?i?iaeueiiai ??aiy aeoeaiino? caiaeueiiai i?ioeano a a?iioi-eaaaiaa?e nenoai?. Oai?? o?ii?/iei a?iio?oii ciaoiaeeeeny a oac? ?ai?n?? caoai?thaaiiy, oai?? ia ooaa?eoeueic eaaai?a aeeth/aeeny a a?oio aeine?aeaeoaaieo i?ney 3-4 i?nyoe?a aeoeaii? o?i?ioa?ai??. O aeiaaeeao aeaeiiiainaoe?? e?iaiia?ao i?ecia/aee na/ia?ii? caniae (oo?inai?ae, aeea?ae?ioei?o?aceae, aoae?eiiaa eeneioa), ?iio?iii? (no?ioaioei), ia?eoa?e/i? aaciaeeeaoaoi?e (neaeiioa?i, i?o?aoe). E?eoaaiiy Oaeiiii a aeic? 4,0 a ia aeiao ?icii/eiaee i?ney e?ea?aeaoe?? ee?i?/ieo i?iya?a aeaeiiiainaoe?? na?oeaai? ae?yeueiino? e aeinyaiaiiy noaa?e?caoe?? ooieoe?iiaeueiiai noaio ea?ae?i-?ani??aoi?ii? nenoaie ia oii? i?aeo?eioth/i? oa?ai?? na/ia?iieie oa ia?eoa?e/ieie aaciaeeeaoaoi?aie (i?e iaiao?aeiino?). Noaa?e?caoe?y noaio ea?ae?i-?ani??aoi?ii? nenoaie aecia/aeanue ca a?aenooi?noth aeinoia??ii? aeeiai?ee oaeeo iieaciee?a ye VC, FVC, FEV1, EAeI, ENI ? OA i?aaiai oeoii/ea, NOEA ia ii/aoeo oa iai?ee?ioe? 7-aeaiiiai aooa?iiai ia??iaeo i?ae e?ea?aeaoe??th i?iya?a aeaeiiiainaoe?? e?iaiia?ao oa iiiaioii i?ecia/aiiy Oaeiio. Ianoaaeaii 33 oai?eo c o?ii?/ieie caoai?thaaiiyie eaaai?a, ye? noi?iaiaeaeoaaeeny ?icaeoeii o?ii?/iiai eaaaiaaiai na?oey (/ieia?ee — 22, ae?iee — 11) a?eii a?ae 19 aei 74 ?ie?a. O 12 iaoe??io?a aoa ae?aaiinoiaaiee o?ii?/iee iano?oeoeaiee a?iio?o, o 7 — o?a?icii-eaaa?iiciee ooaa?eoeueic eaaai?a, o 3 — aeenai?iiaaiee ooaa?eoeueic eaaai?a, o 5 — ia?aeiia eaaaiaaa a?ia?oaic?y, o 3 — o?ii?/ia iinoaiaie?/ia eaaaiaaa a?ia?oaic?y, o 1 — a?iioiaeoaoe/ia oai?iaa, o 1 — ?ae?iiaoe/iee o?a?icoth/ee aeueaaie?o, o 1 — oi?aei-ae?ao?aaiaeueia oi?ia o?ii?/iiai eaaaiaaiai na?oey. Eaaaiaaa iaaeinoaoi?noue I nooiaith niinoa??aaeanue o 6 oai?eo, II nooiaith — o 25, III nooiaith — o 2. Iciaee cano?eii? iaaeinoaoiino? e?iaiia?ao iaee i?noea a 16 aeiaaeeao (IIA noaae?? — a 11, IIA noaae?? — a 5). Aeo?aei? iieacieee ooieoe?? ciai?oiueiai aeeoaiiy na?ae/eee i?i iayai?noue iii??ieo aaioeeyoe?eieo ii?ooaiue, ia?aaaaeii ca iano?oeoeaiei oeiii, ui i?iyaeyeiny a cieaeaii? oaeeo iieaciee?a ye FVC, FEV1, MEF25-75, PEF. A ca’yceo ?c aaeeeeie eieeaaiiyie aa??aoe?eiiai ?yaeo aeaieo iieaciee?a, aeinoia??ieo a?aei?iiinoae ca aeaieie o?aaeeoe?eii? aa??aoe?eii? noaoenoeee i?ae aeo?aeieie oa e?ioeaaeie iieacieeaie e?eai? iio?e-ia’?i aeyaeaii ia aoei. Canoiniaaiee iaie iaoiae ii??aiyiiy niieo/aieo na?aaei?o aaee/ei aeicaieea i?aaethaaoe iaiaeii??aei?noue aeo?aeieo iieaciee?a. Ia iniia? canoinoaaiiy oe??? iaoiaeeee io?eiaii aeinoia??ia ca?eueoaiiy iieaciee?a VC, FVC, FEV1, MEF75 e aeecueea aei aeinoia??iiai ci?ia PEF. Iieacieee FEV1/VC, MEF75 oa MEF50 caeeoeeeny ia aeo?aeiiio ??ai?. Aoiea?ae?ia?ao?/iei iaoiaeii aea/aee ooieoe?iiaeuei? iieacieee e?aiai oa i?aaiai a?aeae?e?a na?oey, a oaeiae ?ic?aoiaoaaee nenoie?/iee oene a eaaaiaa?e a?oa???. Aeo?aei? iieacieee e?aiai oeoii/ea iaeaea ia a?ae??ciyeeny a?ae ii?iaeueieo. I?ney i?iaaaeaiiai e?eoaaiiy nooo?aeo ci?i aeine?aeaeoaaieo ia?aiao??a aeyaeaii ia aoei. A?aei?/aia iaaaeeea ca?eueoaiiy o?aeoe?? aeaiaiiy e?aiai oeoii/ea. ?acoeueoaoe aoiea?ae?ia?ao?? i?aaiai oeoii/ea na?oey na?ae/eee i?i iayai?noue o oai?eo ae?aaeaii? aeeeaoaoe?? ii?iaeieie i?aaiai oeoii/ea, ui i?iyaeyeiny ca?eueoaiiyi e?ioeaaeo nenoie?/iiai ? ae?anoie?/iiai ia’?i?a oeoii/ea; niinoa??aaeiny ia?aaaaeaiiy ia’?iieo ia?aiao??a ii?iaeieie i?aaiai oeoii/ea iaae aiaeia?/ieie iieacieeaie e?aiai (EAeIIO/EAeIEO ? ENIIO/ENIEO > 1). Aeinoia??ii aoea cieaeaia OA. ?acii c
oei, ie niinoa??aaee ca?eueoaiiy iieaciee?a na?oeaaiai aeeeaeo ye
?acoeueoao eiiiainaoi?ii? a?ia?o?io?? na?oey o a?aeiia?aeue ia
a?iien?th.

I?ney e?eoaaiiy Oaeiiii ciaioeeeny ae?anoie?/iee oa nenoie?/iee ia’?ie
i?aaiai oeoii/ea. Ia ciaioaiiy aeeeaoaoe?? i?aaiai oeoii/ea aeacothoue
oaeiae ciaioaiiy a?aeiinieo iieaciee?a: EAeIIO/EAeIEO ? ENIIO/ENIEO.

Aoei oaeiae a?aei?/aii iie?auaiiy nei?ioeeai? ooieoe?? i?iea?aeo i?aaiai
oeoii/eo, i?i ui na?ae/eei aeinoia??ia c?inoaiiy OA. Aaee/eia oaeeeiiiai
ia’?io e?iaiia?ao caa??aaeany ia aeo?aeiiio ??ai?.

Aeacaia aeeiai?ea iieaciee?a oeueo?acaoeiaiai aeine?aeaeaiiy i?aaiai
oeoii/ea iaea?eueo a??ia?aeii coiiaeaia cieaeaiiyi oeneo a eaaaiaa?e
a?oa??? ? ciaioaiiyi a?ia?ooieoe?? i?aaeo a?aeae?e?a na?oey. Oea
i?aeoaa?aeaeo?oueny ?acoeueoaoaie ?ic?aooieo aaee/eie nenoie?/iiai oeneo
a eaaaiaa?e a?oa???, ye? aoee aei ii/aoeo oa i?ney e?eoaaiiy Oaeiiii.
Oae ciaioaiiy NOEA noaiiaeei (7,9(1,3) ii ?oooiiai noiai/eea.

C iaoith i?aeoaa?aeaeaiiy aioeaa?aaaioii? ae?? Oaeiio ni?eueii c O.O.
Naeaciaiei ? I.A. Ii?iciaith iaie aoei i?iaaaeaii aeine?aeaeaiiy aieeao
Oaeiio ia aa?aaaoe?eio ni?iiiaei?noue o?iiaioeeo?a in vitro.

A c?aceao e?ia? 39 oai?eo c o?ii?/ieie caiaeueieie caoai?thaaiiyie
eaaai?a aea/aee aa?aaaoe?eio aeoeai?noue o?iiaioeeo?a ? ii??aithaaee ??
c oaeith a i?iaao e?ia? i?ney ?ieoaaoe?? c Oaeiiii. O 76,9% oai?eo aoea
ca?a?no?iaaia a?ia?aa?aaaoe?y o?iiaioeeo?a. A 9 aeiaaeeao (23,1%)
niinoa??aaeenue ii?iaeuei? e?ea? aa?aaaoe?? o?iiaioeeo?a. A i?iaao c
Oaeiiii a 84,8% aeiaaee?a a?aei?/aii ciaioaiiy aa?aaaoe?eii?
ni?iiiaeiino? o?iiaioeeo?a (o oai?eo c a?ia?aa?aaaoe??th — aei noaio
ii?ii- ? a?iiaa?aaaoe??, o oai?eo c ii?iaeueiith aa?aaaoe?eiith
ooieoe??th o?iiaioeeo?a — aei noaio a?iiaa?aaaoe??).

I?aeaiaey/e i?aenoiie i?iaaaeaiei aeine?aeaeaiiyi, iiaeia
noaa?aeaeoaaoe, ui Oaeii, ciaoiaey/enue a eiieo?aioieo aca?iia?aeiineiao
c iniiaiei noano?aoii aeey neioaco aeeicaii?ae?a — AE, i?ecaiaeeoue aei
ciaioaiiy i?iaeoeoe?? i?inoaoeeee?io, o?iiaienaio ae?oai? na??? oa
eaeeio?e?i?a /aoaa?oi? na???. Aiane?aeie niaoeeo?/ii? ?ia?a?oe??
e?iieneaaiaciiai oeyoo eiiaa?n?? AE in vitro Oaeii ni?e/eiy? ciaioaiiy
neioaco eaeeio?e?i?a 4 na???. Aiaeii/an, caaaeyee ca?eueoaiith
e?eueeino? noano?aoo aeey oeeeeiieneaaiace ca?eueoo?oueny i?iaeoeoe?y
i?inoaaeaiaeei?a c ia?aaaaeaiiyi i?inoaoeeee?io. Nenoaiiee aieea (-3
IIAEE i?iyaey?oueny ciaioaiiyi i?iaeoeoe?? an?o iaoaaie?o?a AE.

O oai?eo c o?ii?/iei eaaaiaaei na?oeai ei?aeoe?y nenoaie aeeicaii?ae?a
ca aeiiiiiaith Oaeiio aeeeeea? iie?auaiiy ee?i?/iiai ia?aa?ao
caoai?thaaiiy, a oaeiae iiceoeai? ci?ie aeayeeo iieaciee?a
ea?ae?i-?ani??aoi?ii? nenoaie: c?inoa? a?iio?aeueia i?io?aei?noue,
ciaioothoueny ia’?ii? ?ici??e i?aaiai oeoii/ea oa ia?aaena?aey, ui
iaoiiaeaii ciaioaiiyi nenoie?/iiai oeneo a eaaaiaa?e a?oa??? oa
ciaioaiiyi caaaeueiiai iii?o eaaaiaaeo noaeei. Ie?aii ne?ae cacia/eoe
ae?aaeaio aioeaa?aaaioio ae?th Oaeiio, yea i?aeoaa?aeaeaia
aeine?aeaeaiiyie in vitro: ciaioaiiy aa?aaaoe?eii? ni?iiiaeiino?
o?iiaioeeo?a ? aaaeeeaith neeaaeiaith iie?auaiiy i?ioeano
i?e?ioee?eoeyoe?? a eaaaiyo.

Aeniiaee

Oaeii in vitro aeeeeea? i?eai?/aiiy e?iieneaaiaciiai oeyoo iaoaaie?cio
a?ao?aeiiiai? eeneioe ?c ciaioaiiyi i?iaeoeoe?? eaeeio?e?i?a 4 na???,
ui, a naith /a?ao, coiiaeth? aeoeaaoe?th oeeeeiieneaaiaciiai oeyoo ?c
ci?iith aaeaino i?inoaoeeee?i-o?iiaienaiiai? nenoaie a a?e ia?aaaaeaiiy
i?inoaoeeee?io.

A ?acoeueoao? canoinoaaiiy Oaeiio a ee?i?/ieo oiiaao niinoa??aa?oueny
ciaioaiiy aeoeaiino? iaio eaiie iaoaaie?cio a?ao?aeiiiai? eeneioe, ui
coiiaeaii ia eeoa i?yiith ae??th i?aia?aoo ia oa?iaioe ia?aoai?aiiy
a?ao?aeiiiai? eeneioe, a e ciaioaiiyi ?? caaaeueiiai ai?noo o
oinoie?i?aeao ee?oeiieo iaia?ai i?e o?eaaeiio canoinoaaii? eiieo?aioieo
(-3 iie?iaiane/aieo aee?ieo eeneio.

Ciaioaiiy i?ae ae??th Oaeiio ai?noo iaoaaie?o?a a?ao?aeiiiai? eeneioe,
ye? iathoue a?iioi- ? aacieiino?eeoi?i? aeanoeaino?, a oaeiae
?iaeoeoi??a caiaeaiiy oa aa?aaaoe?? o?iiaioeeo?a, aenooia? oai?aoe/iith
iniiaith aeey canoinoaaiiy Oaeiio a e?eoaaii? oai?eo c o?ii?/iei
eaaaiaaei na?oeai.

I?ecia/aiiy Oaeiio oai?ei c o?ii?/iei eaaaiaaei na?oeai a aeic? 4,0 a ia
aeiao ia i?ioyc? 4 oeaei?a coiiaeth? iie?auaiiy iieaciee?a a?iio?aeueii?
i?io?aeiino?, ciaioaiiy nooiaith eaaaiaai? a?ia?oaic??, aeeeaoaoe??
i?aaiai oeoii/ea, iie?auaiiy nei?ioeeai? ooieoe?? i?iea?aeo. Iaei??th c
i?e/ei ciaioaiiy eaaaiaai-a?oa??aeueiiai iii?o ? aieea Oaeiio ia noai
i?e?ioee?eoeyoe?? ca ?aooiie ii?iae?caoe?? aa?aaaoe?eii? ooieoe??
o?iiaioeeo?a.

Iiceoeaia aeeiai?ea ee?i?/iiai noaio oai?eo a ii?aeiaii? c iie?auaiiyi
ooieoe?iiaeueieo iieaciee?a ea?ae?i-?ani??aoi?ii? nenoaie, a oaeiae
a?aenooi?noue iia?/ieo aoaeo?a aeicaieythoue ?aeiiaiaeoaaoe canoinoaaiiy
Oaeiio a e?eoaaii? oai?eo c o?ii?/iei eaaaiaaei na?oeai.

I?aeoe/i? ?aeiiaiaeaoe??

C iaoith iie?auaiiy aaioeeyoe?eii? ooieoe?? eaaai?a ? aaiiaeeiai?ee
iaeiai eiea e?iaiia?ao a e?eoaaii? oai?eo c o?ii?/iei eaaaiaaei na?oeai
?aeiiaiaeo?oueny canoinoaaiiy i?aia?aoo Oaeii a aeic? 1,0 a (2 eainoee)
4 ?ace ia aeaiue per os i?ney ?ae? i?ioyaii 4 oeaei?a.

Iaoiaeeea aea/aiiy aieeao Oaeiio ia noai nenoaie aeeicaii?ae?a in vitro,
yea aeeth/a? aeiaeaaaiiy ?ia?a?oi?a iaoaaie?/iiai ia?aoai?aiiy
a?ao?aeiiiai? eeneioe i?ney 30-oaeeeiii? ?ieoaaoe?? e?ia? c i?aia?aoii,
iiaea aooe aeei?enoaia a iaoeiai-aeine?aeieo ?iaioao ii aea/aiith aieeao
iiaeo e?ea?nueeeo cania?a ia iaoaaie?ci a?ao?aeiiiai? eeneioe.

NIENIE ?IA?O, IAAe?OEIAAIEO CA OAIITH AeENA?OAOe??

Iiaaa-3 IIAEE. Iiaue eaea?noaaiiue i?aia?ao Oaeii /Oauaiei TH.E.,
Aaa?enthe A.E., ss/iee A.E., Ii?iciaa I.A., Eauaiei N.E., Ii?neay I.Ae.,
ssoieoea O.A., Naeaciaiei O.O. Inaae/oe O.A., Eaaeai E.I., E?oaeiaa
E.O., Ianu?iaa I.O., Aecthaeee ss.A./ Iiae ?aae. TH.E. Oauaiei, A. E.
Aaa?enthea. — Eeaa, 1996. — 126 n.

Aaa?enthe A.E., ss/iee A.E., Eauaiei N.E., Ii?iciaa I.A., Aii/a? A.A.,
Aecthaeee ss.A. Aeeyiea i?aia?aoa Oaeii ia iaoaaieeci a?aoeaeiiiaie
eeneiou o aieueiuo n o?iie/aneei eaai/iui na?aeoeai // Oe?a?inueeee
ioeueiiiieia?/iee aeo?iae. — 1998.- ?4. — N. 35-37.

Eauaiei N.E., Ii?iciaa I.A., Aii/a? A.A., Aecthaeee ss.A. Aeeyiea
i?aia?aoa Oaeii in vitro ia niaea?aeaiea a e?iae yeeicaiieaeia o
aieueiuo n o?iie/aneei eaai/iui na?aeoeai // Oe?a?inueeee
ioeueiiiieia?/iee aeo?iae. — 1998. — ? 3. — N. 31-33.

Ii?iciaa I.A., Ianu?iaa I.O., Naeaciaiei O.O., Aecthaeee ss.A.
Ia?niaeoeau i?eiaiaiey iiaaa-3 iieeiaianuuaiiuo aee?iuo eeneio i?e
caaieaaaieyo eaaeeo e aoa?ineea?ica // A?a/aaiay i?aeoeea. — 1997. —
?6. — N. 22-25.

Aecthaeee ss.A. Iiaaa-3 iieeiaianuuaiiua aee?iua eeneiou e ninoiyiea
nenoaiu yeeicaiieaeia o aieueiuo n caaieaaaieyie eaaeeo// Oe?a?inueeee
ioeueiiiieia?/iee aeo?iae. — 1997. — ? 3. — N. 67-70.

Aaa?enthe A.E., Ii?iciaa I.A., Eauaiei N.E., Ii?neay I.Ae„ ssoieoea
O.A., Aecthaeee ss.A. Yooaeoeaiinoue i?eiaiaiey i?aia?aoa Oaeii a
ea/aiee aieueiuo o?iie/aneei a?iioeoii a ni/aoaiee n aoa?iaaiiie
aeeneeiii?ioaeaeaieae // Oacenu 7-ai Iaoeeiiaeueiiai eiia?anna ii
aieaciyi i?aaiia aeuoaiey. — Iineaa. — 1995.-N. 394

Eauaiei N.E., Ii?iciaa I.A., ssoieoea O.A., Aecthaeee ss.A. Iiaaa-3
iieeiaianuuaiiua aee?iua eeneiou a ei??aeoeee o?iiaioeeoa?iiai caaia
aaiinoaca i?e caaieaaaieyo eaaeeo // Oacenu 8-ai Iaoeeiiaeueiiai
Eiia?anna ii aieaciyi i?aaiia aeuoaiey.- Iineaa. — 1998. — N. 225.

Eauaiei N.?., Aecthaeee ss.I. Iiaaa-3 iie?iaiane/ai? aee?i? eeneioe ye
aioaaii?noe a?ao?aeiiiai? eeneioe o ei?aeoe?? o?iiaioeeoa?ii? eaiee
aaiinoaco i?e caoai?thaaii? eaaaiue // II c’?cae ooec?ao??a ?
ioeueiiiieia?a Oe?a?ie: Iaoa?. iaoe. i?aoeue. — Ee?a. — 1998 — N. 189.

Aaa?enthe A.E., ss/iee A.?., Eauaiei N.?., Ii?iciaa I.A., Aecthaeee
ss.I. Ia?niaeoeau i?eiaiaiey iiaaa-3 iieeiaianuuaiiuo aee?iuo eeneio a
iaaeeoeeia // Oa?iaeieia?/iee a?niee. — 1999. — ?3. — N. 39-41.

Aecthaeee ss.I. Aoaeoeai?noue i?aia?aoo Oaeii a ei?aeoe?? nenoaie
aeeicaii?ae?a o oai?eo c o?ii?/iei eaaaiaaei na?oeai. — ?oeiien.

Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe
ca niaoe?aeuei?noth 14.01.27 — ioeueiiiieia?y. — ?inoeooo ooec?ao??? ?
ioeueiiiieia?? ?i. O.A.ssiianueeiai AII Oe?a?ie, Ee?a, 1999.

?iaioa i?enay/aia aea/aiith aieeao iiaiai e?ea?nueeiai i?aia?aoo Oaeii,
yeee i?noeoue 45% (-3 iie?iaiane/aieo aee?ieo eeneio, ia nenoaio
aeeicaii?ae?a, aa?aaaoe?eio ni?iiiaei?noue o?iiaioeeo?a oa ?yae
iieaciee?a ea?ae?i-?ani??aoi?ii? nenoaie o oai?eo c o?ii?/iei eaaaiaaei
na?oeai. A i?iaao in vitro anoaiiaeaii ca?eueoaiiy neioaco i?iaeoeo?a
5-oeeeeiieneaaiace oa ciaioaiiy ai?noo eaeeio?e?i?a. Oa?ai?y
aeine?aeaeoaaieo oai?eo Oaeiiii ia i?ioyc? 4 oeaei?a i?eaiaeeea aei
nooo?aiai i?eai?/aiiy neioaco iaoaaie?o?a a?ao?aeiiiai? eeneioe. Oea
i?iyaeyeiny iie?auaiiyi ooieoe?iiaeueieo iieaciee?a eaaaiaai?
aaiiaeeiai?ee ? ciai?oiueiai aeeoaiiy, a oaeiae ciaioaiiyi aa?aaaoe??
o?iiaioeeo?a.

Eeth/ia? neiaa: o?ii?/ia eaaaiaaa na?oea, aeeicaii?aee, (-3
iie?iaiane/ai? aee?i? eeneioe, Oaeii.

Dzyublik Ya.A. Efficacy of medicine Tecom in correction of eicosanoid
system in cor pulmonale patients. – Manuscript.

Thesis for a degree of Candidate of Medical Sciences in specialty
14.01.27 – pulmonology. Institute of phthisiatry and pulmonology named
after F.G. Yanovsky, AMS Ukraine, Kiev, 1999.

There have been studied the efficacy of medicine Tecom, containing 45%
of (-3 polyunsaturated fatty acids, on eicosanoid system, platelet
aggregation and several heart-lung parameters in cor pulmonale patients.
The promotion of 5-cyclooxygenase product synthesis together with
decrease of leukotrienes content has been revealed. The 4-week therapy
with Tecom led to significant inhibition of arachidonic acid metabolite
production. This resulted in improvement of some pulmonary hemodynamic
and ventilatory indices, and decrease of platelet aggregation.

Key words: cor pulmonale, eicosanoids, (-3 polyunsaturated fatty acids,
Tecom.

Aecthaeee ss.A. Yooaeoeaiinoue i?aia?aoa Oaeii a ei??aeoeee nenoaiu
yeeicaiieaeia o aieueiuo n o?iie/aneei eaai/iui na?aeoeai.

Aeenna?oaoeey ia nieneaiea o/aiie noaiaie eaiaeeaeaoa iaaeeoeeineeo
iaoe ii niaoeeaeueiinoe 14.01.27 — ioeueiiiieiaey.- Einoeooo ooeceao?ee
e ioeueiiiieiaee ei. O.A. ssiianeiai AII Oe?aeiu, Eeaa, 1999.

Aeenna?oaoeeiiiay ?aaioa iinayuaia eco/aieth aeeyiey Oaeiia ia
iaoaaieeci yeeicaiieaeia, ninoiyiea ea?aeei-?anie?aoi?iie nenoaiu e
aa?aaaoeeiiioth niiniaiinoue o?iiaioeeoia. N oeaeueth eco/aiey aeeyiey
Oaeiia ia iaoaaieeci a?aoeaeiiiaie eeneiou iaie i?iaaaeaii i?eaeiaeueiia
enneaaeiaaiea in vitro. Onoaiiaeaii, /oi iiae aeeyieai i?aia?aoa
ioia/aaony oiaiueoaiea niaea?aeaiey noeueoeaeieaeeio?eaiia (a n?aaeiai a
3 ?aca), aic?anoaiea (aieaa /ai a 5 ?ac) eiioeaio?aoeee noaaeeueiiai
iaoaaieeoa i?inoaoeeeeeia (IAI2) — 6-eaoi-i?inoaaeaiaeeia F1(
(6-eaoi-IAF1(), a oaeaea iaeioi?ia oaaee/aiea eiioeaio?aoeee iaoaaieeoa
o?iiaienaia A2 (TxA2) — o?iiaienaia A2 (TxB2). I?e yoii niioiioaiea
6-eaoi-IAF1(/TxB2 nouanoaaiii oaaee/eeinue a iieueco i?inoaoeeeeeia.

O 24 aieueiuo n o?iie/aneei eaai/iui na?aeoeai i?iaaaeaii eco/aiea
ninoiyiey nenoaiu yeeicaiieaeia aei e iinea 4-iaaeaeueiiai eo?na ea/aiey
Oaeiiii. I?aia?ao a aeica 4,0 a a nooee iacia/aeny aieueiui iinea
eeeaeaeaoeee yaeaiee aeaeiiiainaoeee e?iaiia?auaiey ia oiia
iiaeaea?aeeaathuae oa?aiee. Auei onoaiiaeaii, /oi o aieueiuo n
o?iie/aneei eaai/iui na?aeoeai i?ienoiaeeo oaaee/aiea niaea?aeaiey
i?iaeoeoia eae oeeeeiieneaaiaciiai, oae e eeiieneaaiaciiai iooae
i?aia?aciaaiey a?aoeaeiiiaie eeneiou.

Aeeiaieea iieacaoaeae ea?aeei-?anie?aoi?iie nenoaiu i?e eo?niaii ea/aiee
Oaeiiii eco/aia o 33 aieueiuo o?iie/aneeie caaieaaaieyie eaaeeo,
nii?iaiaeaeaaoeony ?acaeoeai o?iie/aneiai eaai/iiai na?aeoea. Enoiaeiua
iieacaoaee ooieoeee aiaoiaai aeuoaiey naeaeaoaeuenoaiaaee i iaee/ee
oia?aiiuo aaioeeyoeeiiiuo ia?ooaiee, i?aeiouanoaaiii ii iano?oeoeaiiio
oeio. Iinea oa?aiee Oaeiiii iieo/aii aeinoiaa?iia oaaee/aiea iieacaoaeae
aeeciaiiie aieinoe eaaeeo (VC), oi?ne?iaaiiie aeeciaiiie aieinoe eaaeeo
(FVC), iauaia oi?ne?iaaiiiai auaeioa ca ia?aoth naeoiaeo (FEV1),
iaiiaaiiie iauaiiie nei?inoe ia o?iaia 75% aeeciaiiie aieinoe eaaeeo
(MEF75) e aeeceia e aeinoiaa?iiio eciaiaiea ieeiaie nei?inoe auaeioa
(PEF). Iieacaoaee FEV1/VC, MEF75 e MEF50 inoaaaeenue ia enoiaeiii
o?iaia.

?acoeueoaou yoiea?aeeia?aoee i?aaiai aeaeoaei/ea na?aeoea
naeaeaoaeuenoaiaaee i iaee/ee o aieueiuo au?aaeaiiie aeeeaoaoeee iieinoe
i?aaiai aeaeoaei/ea, eioi?ay i?iyaeyeanue oaaee/aieai eiia/iuo
nenoiee/aneiai e aeeanoiee/aneiai iauaiia; iaaethaeaeinue i?aiaeaaeaiea
iauaiiuo ia?aiao?ia (eiia/ii-aeeanoiee/aneiai iauaia — EAeI;
eiia/ii-nenoiee/aneiai iauaia — ENI) iieinoe i?aaiai aeaeoaei/ea iaae
aiaeiae/iuie iieacaoaeyie iieinoe eaaiai aeaeoaei/ea (EAeIIAE/EAeIEAE e
ENIIAE/ENIEAE > 1). Aeinoiaa?ii auea nieaeaia o?aeoeey ecaiaiey (OE).
Iinea ea/aiey Oaeiiii oiaiueoeeenue aeeanoiee/aneee e nenoiee/aneee
iauaiu i?aaiai aeaeoaei/ea. Ia oiaiueoaiea aeeeaoaoeee i?aaiai
aeaeoaei/ea oeacuaatho oaeaea oiaiueoaiea ioiineoaeueiuo iieacaoaeae:
EAeIIAE/EAeIEAE e ENIIAE/ENIEAE.

Auei oaeaea ioia/aii oeo/oaiea nie?aoeoaeueiie ooieoeee ieiea?aea
i?aaiai aeaeoaei/ea, i /ai naeaeaoaeuenoaiaaei aeinoiaa?iia aic?anoaiea
OE. Aaee/eia ieiooiiai iauaia e?iaiia?auaiey nio?aiyeanue ia enoiaeiii
o?iaia.

Oeacaiiay aeeiaieea iieacaoaeae oeueo?acaoeiaiai enneaaeiaaiey i?aaiai
aeaeoaei/ea iaeaieaa aeinoiaa?ii iaoneiaeaia nieaeaieai aeaaeaiey a
eaai/iie a?oa?ee e oiaiueoaieai aeia?ooieoeee i?aauo ioaeaeia na?aeoea.
Yoi iiaeoaa?aeaeaaony ?acoeueoaoaie ?an/aoa aaee/eiu nenoiee/aneiai
aeaaeaiey a eaai/iie a?oa?ee a i?ioeanna ea/aiey Oaeiiii. Oae,
oiaiueoaiea nenoiee/aneiai aeaaeaiey a i?aaii aeaeoaei/ea ninoaaeei
(7,9(1,3) ii ?oooiiai noieaa.

A ia?acoeao e?iae 39 aieueiuo n o?iie/aneeie ainiaeeoaeueiuie
caaieaaaieyie eaaeeo eco/aee aa?aaaoeeiiioth niiniaiinoue o?iiaioeeoia e
n?aaieaaee aa n oaeie a i?iaao e?iae iinea eieoaaoeee n Oaeiiii. O 76,9%
aieueiuo auea ca?aaeno?e?iaaia aeia?aa?aaaoeey o?iiaioeeoia. A 9 neo/ayo
(23,1%) iaaethaeaeenue ii?iaeueiua e?eaua aa?aaaoeee o?iiaioeeoia. A
i?iaao n Oaeiiii a 84,8% neo/aaa ioia/aii oiaiueoaiea aa?aaaoeeiiiie
niiniaiinoe o?iiaioeeoia (o aieueiuo n aeia?aa?aaaoeeae — aei ninoiyiey
ii?ii- e aeiiaa?aaaoeee, o aieueiuo n ii?iaeueiie aa?aaaoeeiiiie
ooieoeeae o?iiaioeeo?a — aei ninoiyiey aeiiaa?aaaoeee).

?acoeueoaou i?iaaaeaiiuo enneaaeiaaiee iicaieytho caeeth/eoue, /oi o
aieueiuo n o?iie/aneei eaai/iui na?aeoeai ei??aeoeey Oaeiiii nenoaiu
yeeicaiieaeia aucuaaao oeo/oaiea eeeie/aneiai oa/aiey caaieaaaiey, a
oaeaea i?eaiaeeo e iieiaeeoaeueiui eciaiaieyi iaeioi?uo iieacaoaeae
ea?aeei-?anie?aoi?iie nenoaiu: oeo/oaaony a?iioeaeueiay i?ioiaeeiinoue,
oiaiueoathony iauaiiua ?acia?u i?aaiai aeaeoaei/ea e i?aaena?aeey, /oi
iaoneiaeaii oiaiueoaieai nenoiee/aneiai aeaaeaiey a eaai/iie a?oa?ee e
oiaiueoaieai iauaai nii?ioeaeaiey eaai/iuo ninoaeia. Ioaeaeueii neaaeoao
ioiaoeoue au?aaeaiiia aioeaa?aaaioiia aeaenoaea Oaeiia, i?iyaeythuaany
oiaiueoaieai aa?aaaoeeiiiie niiniaiinoe o?iiaioeeoia.

Eeth/aaua neiaa: o?iie/aneia eaai/iia na?aeoea, yeeicaiieaeu, (-3
iieeiaianuuaiiua aee?iua eeneiou, Oaeii.

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