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Ефективність застосування прогестерону в корекції гіперкапнії та дихального ацидозу у хворих із хронічним легеневим серцем: Автореф. дис… канд. мед.

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Aeaaeai?y iaaee/ieo iaoe Oe?a?ie

?inoeooo ooec?ao??? ? ioeueiiiieia?? ?i. O.A.ssiianueeiai

AAA??E Aeaia ss?ineaa?aia

OAeE 616.12-02-036.12.616.24:612.127.3-08:612:018

AOAEOEAI?NOUe CANOINOAAIIss I?IAANOA?IIO A EI?AEOe?? A?IA?EAII?? OA
AeEOAEUeIIAI AOeEAeICO 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 (aee?aeoi? – aeaaeai?e AII Oe?a?ie, aeieoi?
iaaee/ieo iaoe,

i?ioani? TH.?.Oauaiei)

IAOEIAEE EA??AIEE:

aeieoi? iaaee/ieo iaoe, i?ioani? Aaa?enthe Aieiaeeie? Einoyioeiiae/,
caa?aeoaa/ ee?i?ei-ooieoe?iiaeueiei a?aeae?eaiiyi ?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 IIC Oe?a?ie

aeieoi? iaaee/ieo iaoe, i?ioani? Eiiiieueiaa E?ae?y Oaaei??aia, i?ioani?
eaoaae?e aini?oaeueii? oa?ai?? ?1 Iaoe?iiaeueiiai iaaee/iiai
oi?aa?neoaoo

?i. I.I. Aiaiiieueoey

I?IA?AeIA ONOAIIAA: ?inoeooo oa?ai?? AII Oe?a?ie

Caoeno a?aeaoaeaoueny ” 26″ /a?aiy 1999 ?ieo i 1500 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae.26.522.01 i?e ?inoeooo?
ooec?ao??? ? ioeueiiiieia?? ?i. O.A.ssiianueeiai AII Oe?a?ie (252000, i.
Ee?a, INI-650, oca?c I?ioan?a ss?, 7).

C aeena?oaoe??th iiaeia iciaeiieoeny a a?ae?ioaoe? ?inoeoooo ooec?ao???
?

ioeueiiiieia?? ?i. O.A.ssiianueeiai AII Oe?a?ie (252000, i.Ee?a, oca?c
I?ioan?a ss?, 7).

Aaoi?aoa?ao ?ic?neaiee “25” o?aaiy 1999 ?ieo.

A/aiee nae?aoa?

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

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

AEOOAEUeI?NOUe OAIE. No/ania ai?aeai?ieia?/ia neooaoe?y a Oe?a?i?
oa?aeoa?eco?oueny nooo?aei ca?eueoaiiyi caoai?thaaiiino? oa
oai?iaeeaino? iana-eaiiy ooaa?eoeueicii ? ianiaoeeo?/ieie
caoai?thaaiiyie eaaaiue (TH.?.Oauaiei , 1997).

Aieiaiith i?e/eiith ?iaae?aeiino? oa nia?oiino? oai?eo o?ii?/ieie
caiaeue-ieie caoai?thaaiiyie eaaaiue ? ?icaeoie aeaeiiiainiaaiiai
o?ii?/iiai eaaaiaaiai na?oey (E.I.Caiioaaa, 1988; A.I.Neeueaano?ia ?
ni?aaao., 1990; E.E.Naoa?/oe, 1990; TH.I.Oeoia?aa ? ni?aaao., 1990;
E.Weitzenblum et al., 1981).

Eaaaiaaa na?oea ? /anoei oneeaaeiaiiyi o?ii?/iiai ooaa?eoeueico eaaaiue
(TH.A.Eoea/eianeee, 1981) oa iaei??th ?c i?ia?aeieo i?e/ei nia?o? oai?eo
(A.A.Eaeeie/aa, A.E.Aeiaei, 1989). I?e ?iciianthaeaeaieo oi?iao
o?ii?/iiai o?a?icii-eaaa?iiciiai ooaa?eoeueico eaaaiue eaaaiaai-na?oeaaa
iaaeinoaoi?noue niinoa??aa?oueny a na?aaeiueiio o 60 % oai?eo
(I.I.Eiaaeaiei, 1986).

Iaea?eueo iani?eyoeeaei i?iaiicii aeey aeeooy oa?aeoa?eco?oueny a?oia
oai-?eo ?c o?ii?/iei eaaaiaaei na?oeai, yea oneeaaeieeinue ?icaeoeii
a?ia?eaii?? (Medical Research Council Working Party, 1981; S.Al-Damluji,
1988). O oeeo oai?eo o?aaeeoe?eia e?eoaaiiy, ui aeeth/a?
ieneaaiioa?ai?th, ye i?aaeei, ? iaeiaoae-oeaiei (T.Evans, 1983).

Ioneiaeie iaoai?ciaie ?icaeoeo a?ia?eaii?? i?e caoai?thaaiiyo eaaaiue ?
iano?oeoeai? oa ?ano?eeoeai? ?iceaaee eaaaiaai? aaioeeyoe??
(A.I.Ceeueaa?, 1989). Iii??iiai nooiaiy a?ia?eaii?y ? iiaeeeaith eeoa o
aeiaaeeao, eiee oe? ?iceaaee ia-thoue cai?ioi?e oa?aeoa?. O oai?eo ?c
cia/ieie i?aai?/ieie ci?iaie eaaaiue o?eaa-ea i?aeaeuaiiy iai?oae
aoaeaeeneiai aaco a e?ia? i?eaiaeeoue aei ao?aoe /ooeeaino?
oeaio?aeueieo oaii?aoeaioi??a aei aoaeaeeneiai aaco, ui iaoiiaeth?
iineeaiiy aeue-aaiey?ii? aaioeeyoe?? oa ye iane?aeie – iiaeaeueoa
i?ia?anoaaiiy a?ia?eaii??. ?aeeiei niiniaii ?? ei?aeoe?? o oe???
eaoaai??? oai?eo ? noeioeyoe?y eaaaiaai? aaioeeyoe??.

Iaeiei ?c aoaeoeaieo iaoiae?a ai?ioueae ?c a?iiaaioeeyoe??th aeueaaie ?
aeaeo?inoeioeyoe?y ae?ao?aaie (A.TH.Iaiaeiaa oa ni?aaao., 1986). Iaeiae
iiceoea-iee aoaeo a?ae aeaeo?inoeioeyoe?? niinoa??aa?oueny eeoa i?ae /an
i?iaaaeaiiy naain?a, a ca’yceo c /ei iaoiae canoiniao?oueny aieiaiei
/eiii i?e aino??e aeeoaeuei?e iaaeinoaoiino? a o??o?a?/i?e i?aeoeoe?
(A.E.I?eeiae oa ni?aaao., 1982; 1983; A.I.Aa-neeueaa, A.N.Iiaaaaeia,
1990). O e?eoaaii? oai?eo ?c o?ii?/iith a?ia?eaii??th iaiao?aei? iaoiaee
oa caniae, ye? caaacia/othoue o?eaaeo noeioeyoe?th eaaaiaai?
aaioeeyoe??.

Ua a 1905 ?ioe? M.P.Fitzgerald oa J.S.Haldane a?aecia/eee a?aei?iiino?
a ia-i?oc? aoaeaeeneiai aaco a aeueaaiey?iiio iia?o?? o /ieia?e?a oa
ae?iie (o ae?iie oeae iieaciee aoa aeuei o na?aaeiueiio ia 8 ii
?o.no.). Iai?oaa aoaeaeeneiai aaco a aeueaaiey?iiio iia?o?? nooo?ai
cieaeo?oueny i?ae /an aaa?oiino? (R.L.Goodland et al., 1954), a oaeiae
i?ae /an ae?oai? oace iaino?oaeueiiai oeeeeo (R.L.Goodland,
W.T.Pommerenke, 1952), ui aeicaieeei i?eionoeoe iayai?noue o ai?iiia
aeiaoiai o?ea noeioethth/iai aieeao ia eaaaiaao aaioeeyoe?th. C /anii
oey aeanoea?noue i?iaanoa?iio aoea i?aeoaa?aeaeaia i?e aeine?aeaeaii?
caei?iaeo /ieia?e?a-aeia?iaieueoe?a ? oai?eo ? o?ii?/ieie iano?oeoeaieie
caoai?thaaiiyie eaaaiue (F.D.Sutton et al., 1975; J.B.Skatrud,
J.A.Dempsey, 1983; S.Al-Damluji, 1986).

Iaeiae aei iei?oiueiai /ano ia aea/aiee iiaeeeaee aca?iica’ycie i?ae
ai?noii i?iaanoa?iio a ne?iaaooe? e?ia? oa nooiaiai a?ia?eaii?? oa
aeeoaeueiiai aoeeaeico. A?eueo?noue ?ia?o i?iaaaeai? aac a?aooaaiiy
aeeiai?ee aaciaiai neeaaeo e?ia?, oiaoi a aeinoaoi?e i??? ia aecia/ai?
iiaeeeaino? canoinoaaiiy i?iaanoa?iio a ei?aeoe?? a?ia?eaii?? o oai?eo
?c o?ii?/iei eaaaiaaei na?oeai.

CA’ssCIE ?IAIOE C IAOEIAEIE I?IA?AIAIE, IEAIAIE OA OAIAIE

?iaioa ? o?aaiaioii eiiieaenii? oaie IE. 91.62 “ Aea/eoe ?ieue
niaae-ei?iii iaoiiaeaieo aeaoaeo?a nenoaie cn?aeaiiy e?ia?, aaeaino
aeeicaii?ae?a oa aeenai?iiiaeueieo ?iceaae?a a ?icaeoeo aeniei?
eaaaiaai? a?ia?oaic??” ee?i?ei-ooieoe?iiaeueiiai a?aeae?eaiiy ?inoeoooo
ooec?ao??? ? ioeueiiiieia?? ?i. O.A.ssiianueeiai AII Oe?a?ie.

IAOA AeINE?AeAEAIIss. Aea/eoe aoaeoeai?noue canoinoaaiiy i?iaanoa?iio a
ei?aeoe?? a?ia?eaii?? oa aeeoaeueiiai aoeeaeico o oai?eo ?c o?ii?/iei
eaaaiaaei na?oeai.

CAAAeAIIss AeINE?AeAEAIIss

1. Aea/eoe caeaaei?noue i?ae ai?noii i?iaanoa?iio o ne?iaaooe? e?ia? oa
nooia-iai a?ia?eaii?? ? aeeoaeueiiai aoeeaeico o oai?eo ?c o?ii?/iei
eaaaiaaei na?oeai.

2. Aeine?aeeoe aieea i?iaanoa?iio ia aaciaee neeaae oa
eeneioii-iniiaiee noai e?ia? oa aecia/eoe iiaeeeaino? i?aia?aoo a
ei?aeoe?? a?ia?eaii?? oa aeeoaeueiiai aoeeaeico.

3. Aecia/eoe iiaeeea? iaoai?cie eiai aieeao ia noai
aaioeeyoe?eii? ooieoe?? eaaaiue ? iieacieee ?aaeeio aeeoaiiy.

4. Aea/eoe ii/aoie i?iya?a oa?iaeiaeeiai?/iiai aoaeoo i?iaanoa?iio oa
no?iee eiai iaeneiaeueii? ae?? c iaoith ia?aiiy iioeiaeueii? noaie
canoinoaaiiy i?aia?aoo a eiiieaeniiio e?eoaaii? oai?eo.

IAOEIAA IIAECIA ?IAIOE

Aia?oa aea/aia ei?aeyoe?eia caeaaei?noue i?ae ai?noii i?iaanoa?iio a
ne?i-

aaooe? e?ia? oa nooiaiai a?ia?eaii?? oa aeeoaeueiiai aoeeaeico o oai?eo
?c o?ii?/iei eaaaiaaei na?oeai.

Io?eiai? iia? aeai? uiaei aieeao i?iaanoa?iio ia aaciaee neeaae ?
eeneioii-iniiaiee noai e?ia?, ui na?ae/aoue i?i iiaeeeaino? eiai
canoinoaaiiy a ei?aeoe?? a?-ia?eaii?? oa aeeoaeueiiai aoeeaeico.

Ia iniia? aeine?aeaeaiiy aieeao i?iaanoa?iio ia noai aaioeeyoe?eii?
ooieoe?? eaaaiue, iieacieee ?aaeeio aeeoaiiy aecia/aiee iaea?eueo
a??ia?aeiee iaoai?ci ae?? i?aia?aoo – iineeaiiy eaaaiaai? aaioeeyoe?? ca
?aooiie ca?eueoaiiy aeeaeie oa ciaioaiiy /anoioe aeeoaiiy, /anoee
ia?oaiai i?inoi?o a caaaeueiiio ianyc? aai-oeeyoe??.

I?AEOE*IA CIA*AIIss ?ACOEUeOAO?A ?IAIOE, AI?IAAAeAEAIIss A I?AEOEEO

A ?acoeueoao? i?iaaaeaieo aeine?aeaeaiue ?ic?iaeaia iaa?oiooaaiiy aeey
canoino-aaiiy i?iaanoa?iio c iaoith ei?aeoe?? a?ia?eaii?? oa
aeeoaeueiiai aoeeaeico o oai?eo ?c o?ii?/iei eaaaiaaei na?oeai.

Aea/aiee ii/aoie i?iya?a oa?iaeiaeeiai?/iiai aoaeoo i?iaanoa?iio oa
no?iee eiai iaeneiaeueiiai aoaeoo, a ?acoeueoao? aecia/aia iioeiaeueia
noaia ca-noinoaaiiy i?aia?aoo a eiiieaeniiio e?eoaaii?.

Ai?iaaaeaeaiiy ?acoeueoao?a a i?aeoeeo aoaea ni?eyoe i?aeaeuaiith
aoaeoea-iino? e?eoaaiiy oai?eo ?c o?ii?/iei eaaaiaaei na?oeai, ?icaeoie
yeiai oneeaae-ieany a?ia?eaii??th oa aeeoaeueiei aoeeaeicii.

?acoeueoaoe ?iaioe ai?iaaaeaeai? a ee?i?eao ?inoeoooo ooec?ao??? ?
ioeueiiii-eia?? ?i. O.A.ssiianueeiai AII Oe?a?ie, Ee?i?/i?e e?ea?i?
iaooiia?a?iaii? i?i-ieneiaino? Oe?a?ie, ee?i?/i?e e?ea?i? ? 30
I?inueeiai ?aeiio i. Ee?aa.

AI?IAAOe?ss ?IAIOE

Iniiai? iieiaeaiiy aeena?oaoe?? aena?oeai? ia 7 Iaoe?iiaeueiiio eiia?an?
ii

oai?iaai i?aai?a aeeoaiiy (Iineaa, 1997), iaoeiai-i?aeoe/ieo
eiioa?aioe?yo ?in-oeoooo ooec?ao??? ? ioeueiiiieia?? ?i.
O.A.ssiianueeiai AII Oe?a?ie (1996, 1997).

IOAE?EAOe??. Ca iaoa??aeaie aeena?oaoe?? iioae?eiaaii 5 iaoeiaeo ?ia?o.

EIIE?AOIEE INIAENOEE AIANIE AeENA?OAIOA

Iniaenoee aianie iieyaa? a ?ic?iaoe? an?o iaoeiaeo iieiaeaiue
aeena?oaoe??. Aaoi? i?eeiyea aaciina?aaeith o/anoue a ieaioaaii? aoai?a
?iaioe, i?iaaaeaii? ee?i?/ieo oa ?ino?oiaioaeueieo aeine?aeaeaiue. Ca??
aeaieo, ia?iaea ia?aeiii? aeieo-iaioaoe?? oa iaoa??aeo, noaoenoe/ia
ia?iaea ?acoeueoao?a, ?o ?ioa?i?aoaoe?y iiai?noth aeiiiai? iniaenoi
aeena?oaioii.

IANssA ? NO?OEOO?A AeENA?OAOe??

?iaioa aeeeaaeaia ia 122 noi??ieao, i?noeoue 12 oaaeeoeue, 15 iaethie?a,
neeaaea?oueny ?c anooio, iaeyaeo e?oa?aoo?e, aeaae “Iaoa??ae ? iaoiaee
aeine?aeaeaiue”, aeaio aeaa aeanieo aeine?aeaeaiue, caaa?oaiiy,
aeniiae?a, i?aeoe/ieo ?aeiiaiaeaoe?e, iieaae/eea 214 e?oa?aoo?ieo
aeaea?ae.

CI?NO ?IAIOE

IAOA??AE ? IAOIAeE AeINE?AeAEAIIUe. Aeey ae??oaiiy aecia/aii? iaoe ?
caaaeaiue ianoaaeaii 62 oai?eo (/ieia?ee o a?oe? a?ae 39 aei 70 ?ie?a)
caoai?thaaiiyie a?iioieaaaiaai? nenoaie ??ciiai oa?ae-oa?o. ?iciiae?e
oai?eo a caeaaeiino? a?ae iicieia?/ii? iaeaaeiino? iaaaaeaiee o oaaeeoe?
1.

Oaaeeoey 1 – ?iciiae?e oai?eo a caeaaeiino? a?ae oa?aeoa?o
caoai?thaaiiy

Oa?aeoa? caoai?thaaiiy E?euee?noue oai?eoaan.%O?ii?/iee iano?oeoeaiee
a?iio?o4572,6O?a?icoth/ee aeueaaie?o914,5E?noicia a?iiieac?y
eaaaiue46,5E?oineie?ic23,2Neiae?ii I?ea?ea11,6A?iioiaeoaoe/ia
oai?iaa11,6Anueiai62100,0

A?eueo?noue ianoaaeaieo (45) neeaee oai?? o?ii?/iei iano?oeoeaiei
a?iio?-oii. Ne?ae cacia/eoe, ui o?ii?/iee iano?oeoeaiee a?iio?o ye
noiooi? caoai-?thaaiiy niinoa??aaany i?aeoe/ii o an?o oai?eo ?c ?ioeie
iicieia?/ieie oi?iaie. Oai?? ciaoiaeeeenue ia ianoaaeaii? oa e?eoaaii? a
ee?i?ei-ooie-oe?iiaeueiiio a?aeae?eaii? ?inoeoooo, ?icoaoiaaiiio ia aac?
?anioae?eainueei? ee?i?/ii? e?ea?i? iaooiia?a?iaii? i?iieneiaino?
Oe?a?ie.

Ae?aaiic caoai?thaaiiy anoaiiaethaaee ia iniia? aeaieo ee?i?/iiai,
?aioaaii-eia?/iiai iaoiae?a, iieaciee?a ooieoe?? ciai?oiueiai aeeoaiiy,
aeaeo?iea?ae?ia?ao??,

aoiea?ae?ia?ao?? oa eaai?aoi?ieo aeine?aeaeaiue, i?e iaiao?aeiino? –
a?iioieia?/iiai oa ?ioeo iaoiae?a aeine?aeaeaiiy.

I?e aecia/aii? nooiaiy eaaaiaai? iaaeinoaoiino? (EI) oa noaae??
iaaeinoaoiino? e?iaiia?ao (IE) aeei?enoiaoaaee e?eoa??? ee?i?/ieo
eeaneo?eaoe?e I.A.Aeaiai oa I.Ae.No?aaeanea-A.O.Aaneeaiea.

EI II nooiaith niinoa??aaeanue o 37 oai?eo, EI III nooiaith – o 25.

O an?o oai?eo iaea i?noea cano?eia iaaeinoaoi?noue e?iaiia?ao: IE II A
noaae?? – o 42, IE II A noaae?? – o 20.

?acii c e?eoaaiiyi iniiaiiai caoai?thaaiiy an?i oai?ei i?iaiaeeeanue
oa?ai?y, ui iaea ia iao? ciaioaiiy nooiaith na?oeaai? aeaeiiiainaoe??
(na/ia?ii? caniae, no?ioaioei, ia?eoa??ei? aaciaeeeaoaoi?e, i?aia?aoe
eae?th, aioeaa?aaai-oe). I?ecia/aiith i?iaanoa?iio ia?aaeoaaa ia??iae
i?aeo?eioth/i? oa?ai??, i?e oeueiio a?aea?? oai?eo i?iaiaeeany i?e
noaa?e?caoe?? noaio ? iieaciee?a aaciaiai neeaaeo e?ia? ia i?ioyc? ia
iaio, i?ae 2 oeaei?. Noaa?euei? i?ioyaii aacenii? oa?ai?? iieacieee
aaciaiai neeaaeo ? eeneioii-iniiaiiai noaio e?ia?, ?aaeeio aeeoaiiy oa
aaioeeyoe?eii? ooieoe?? eaaaiue aaaaeaee eiio?ieueieie i?e aea/aii?
oa?iaeiaee-iai?/ii? ae?? i?iaanoa?iio.

Aea/aiiy aaioeeyoe?eii? ooieoe?? eaaaiue i?iaiaeeeinue ca aeaieie
eiii’thoa?-ii? ia?iaee ni??ia?aie, e?eai? iio?e-ia’?i oi?niaaiiai
aeaeioo, aeaieo caaaeueii? ieaoeciia?ao?? o?ea c aeei?enoaiiyi aia?aoo
“Bodytest” o??ie “Erich Jager” (O?I).

Aiae?coaaee ianooii? iieacieee: aeeoaeueiee ia’?i (VT, e), /anoioo
aeeoaiiy (BF, ca 1 oa.), oaeeeiiee ia’?i aeeoaiiy (MV, e/ oa.,),
aeeoo?ao aii?noue eaaaiue (VC max.), oi?niaaio aeeoo?ao ?ii?noue eaaaiue
(FVC ex), ia’?i oi?niaaiiai aeaeioo ca 1 naeoiaeo (FEV1), eiao?oe??io
O?ooii (FEV1 / VC max.), ieoo?a? iaeneiaeuei? oaeae-eino? aeaeioo ia
??ai? 25 % FVC ex (MEF25), 50 % FVC ex (MEF50 ), 75 % FVC ex (MEF 75),
i?eiao oaeaee?noue aeaeioo (PEF). An? iieacieee, ca aeiyoeii VT, BF ?
MV aoee i?eaaaeai? a i?ioeaioia a?aeiioaiiy aei iaeaaeieo aaee/ei
(ca?aeii P.Kristujeck et al. – caaaeueia ieaoeciia?ao?y o?ea, ca
Eeaiaioii ?.O. ?c ni?a?ia?o. (1984) – ni??ia?ao?y oa e?eaa iio?e-ia’?i
oi?niaaiiai aeaeioo).

Aecia/aiiy aaciaiai neeaaeo oa eeneioii-iniiaiiai noaio e?ia? i?iaiaeeee
i?e?iiaoiaeii ia aaoiiaoe/iiio aiae?caoi?? “AVL-945” o??ie “AVL”.

?ic?aoiaoaaee ianooii? iieacieee: eiioeaio?aoe?th ?ii?a aiaeith (?I),
iai?oao aoaeaeeneioe (?aNI2 , ii ?o.no.), aooa?i? iniiae (AA,
iiieue.e-1 ), iaaeeeoie aooa?ieo iniia (AA, iiieue.e-1), ?noeiee
a?ea?aiiao e?ia? (AA, iiieue.e-1), iai?oao eenith (?aI2, ii ?o.no.),
iane/aiiy e?ia? eeniai (I2, sat.,%).

O 26 oai?eo i?iaaaeaia aecia/aiiy eiioeaio?aoe?? i?iaanoa?iio o
ne?iaaooe? e?ia? ?aae?i?ioiieia?/iei iaoiaeii ia eaoaae?? ?aae?ieia??
Ee?anueei? aeaaeai?? i?ney-aeeieiiii? ina?oe ?c aeei?enoaiiyi
noaiaea?oieo iaai??a o??ie “Cea-Ire- Sorin” (O?aioe?y) ia aia?ao?
“Mark-3” (NOA).

?acoeueoaoe i?iaaaeaieo aeine?aeaeaiue ia?iaeai? iaoiaeii ei?aeyoe?eiiai
aia-e?co, aa??aoe?eii? noaoenoeee, iaoiaeii ioe?iee ??cieoeue
ni?anoaaeaieo na?aaei?o aaee-/ei ia eiii’thoa?? “Cardio-200”.

AI?NO I?IAANOA?IIO A NE?IAAOOe? E?IA? OA EIAI EI?AEssOe?ss C ??AIAI
A?IA?EAII?? OA AeEOAEUeIIAI AOeEAeICO

A?ia?eaii?y ? i?e/eiith ?icaeoeo aeeoaeueiiai aoeeaeico. I?aeaeuaiiy
iai?oae aoaeaeeneiai aaco a a?oa??aeuei?e e?ia? i?eaiaeeoue nii/aoeo aei
cieaeaiiy a?aeii-oaiiy INI3- /?aNI2 oa ciaioaiiy ?I (Aiaiiieia A.I. oa
ni?aaao., 1979; West J., 1988). Ca?eueoaiiy ?aNI2 iiaeiii
noi?iaiaeaeoaaoeny e aeayeei i?aeaeuaiiyi ai?noo a?ea?aiiao?a a ca’yceo
c aeenioe?aoe??th aoa?eueii? eeneioe, yea ooai?th?oueny i?e iaaeeeoeo
NI2. Iaeiae, iacaaaeath/e ia oea, a?aeiioaiiy INI3- / ?aNI2
cieaeo?oueny.

I?e no?eeiio aeeoaeueiiio aoeeaeic? ianooia? eiiiainaoi?ia cao?eiea
INI3- a ie?eao. I?e oeueiio iai?oaa aoaeaeeneiai aaco a ee?oeiao
ie?eiaeo eaiaeueoe?a ca?eueoo?oueny e aiie aeae?eythoue a?eueoo
e?euee?noue ?ii?a aiaeith, oiaoi a?eueo eeneo na/o. I?ioiie i?e oeueiio
aeaiaeyoueny o aeaeyae? I2?I4+ aai NH4+, a ?iie INI3-
?aa?ani?aothoueny. A ?acoeueoao? i?aeaeuo?oueny ai?no INI3- a
ne?iaaooe?, ? a?aeii-oaiiy INI3-/ ?aNI2 aa?oa?oueny aei ii?iaeueiiai
??aiy (noai eiiiainiaaiiai aee-oaeueiiai aoeeaeico). Ie?ee eeoa ?iiae?
caeaoi? iiai?noth eiiiainoaaoe aoeeaeic, oiio ?I cae/aeii ia
iiaa?oa?oueny aei ii?iaeueiiai ??aiy. Nooi?iue ie?eiai? eiiiainaoe??
ioe?iththoue ca oaeei iieacieeii, ye iaaeeeoie aooa?ieo iniia (AA). A
oiiaao eiiiainaoe?? AA i?aeaeuo?oueny, i?e aeaeiiiainiaaiiio aoeeaeic?
aa?oa?oueny aei aeo?aeiiai noaio (West J., 1988).

Oaeei /eiii, iaea?eueo ?ioi?iaoeaieie iieacieeaie a?ia?eaii?? oa
aeeoaeue-iiai aoeeaeico ? ?aNI2. ?I, INI3- oa AA.

Iaeiei ?c aieiaieo caaaeaiue oe??? ?iaioe aoei aea/aiiy iiaeeeaeo
ei?aeyoe?e-ieo caeaaeiinoae i?ae ai?noii a e?ia? i?iaanoa?iio oa ??aiai
a?ia?eaii?? ? aeeoaeue-iiai aoeeaeico o oai?eo ?c o?ii?/iei eaaaiaaei
na?oeai.

Ianoaaeaii 26 oai?eo (/ieia?ee o a?oe? a?ae 43 aei 64 ?ie?a). ?c ieo
o?ii?/iee iano?oeoeaiee a?iio?o aoei ae?aaiinoiaaii o 20, o?a?icoth/ee
aeueaaie?o -o 3, e?noicio a?iiieac?th eaaaiue – o 2, a?iioiaeoaoe/io
oai?iao – o 1.

An? oai?? i?e anooi? aei noaoe?iia?o iaee ee?i?/i? iciaee eaaaiaai?
iaaeinoao-iino? oa cano?eii? iaaeinoaoiino? e?iaiia?ao: EI II nooiaith
niinoa??aaeanue o 15 aeiaaeeao, EI III nooiaith – a 11; IE II A noaae??
– a 16, IE II A noaae?? – a 10.

A?ia?eaii?y a ia??iae ianoaaeaiiy iaea i?noea o 18 iaoe??io?a, o 8 –
iieaciee ?aNI2 aoa ieae/ei ca 45 ii ?o.no.

Ai?no i?iaanoa?iio a e?ia? eieeaaany a aeineoue oe?ieeo iaaeao (a?ae 0,1
aei 4,9 iiieue/e), ui a?aeiia?aea? a?aeiiinoyi e?oa?aoo?e (I?eaueiaa
I.I. oa ni?aaao., 1984) i?i nooo?a? ?iaeea?aeoaeuei? a?aei?iiino?
cia/aiue oeueiai iieacieea ia o?eueee na?aae oai?eo, aea e na?aae
caei?iaeo in?a.

I?e ei?aeyoe?eiiio aiae?c? a?aecia/aia i?yia caeaaei?noue i?ae ??aiai
i?iaan-oa?iio oa ?I e?ia? (P

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