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<0,01) oa aeecueea aei a??ia?aeii? cai?ioiy caeaaei?noue i?ae ??a-iai i?iaanoa?iio oa ?aNI2 (t = 1,86) ? INI3- (t = 1,51). Oaeei /eiii, ciaioaiiy ai?noo i?iaanoa?iio a ne?iaaooe? e?ia? noi?iaiaeaeo?oueny ciaioaiiyi ?I oa ca?eue-oaiiyi INI3- , oiaoi ca?eueoaiiyi nooiaiy a?ia?eaii?? oa aeeoaeueiiai aoeeaeico. Caeaaeiino? i?ae eiioeaio?aoe??th i?iaanoa?iio oa iieacieeii AA ia niinoa-??aaeinue. Io?eiai? ?acoeueoaoe iaoiiaeththoue iaiao?aei?noue aea/aiiy iiaeeeaino? ca-noinoaaiiy i?iaanoa?iio c iaoith ei?aeoe?? a?ia?eaii?? oa aeeoaeueiiai aoeeaeico o oai?eo ?c o?ii?/iei eaaaiaaei na?oeai. AIEEA I?IAANOA?IIO IA AACIAEE NEEAAe, EENEIOII-INIIAIEE NOAI E?IA? OA IIEACIEEE EAAAIAAI? AAIOEEssOe?? O OAI?EO ?C O?II?*IEI EAAAIAAEI NA?OeAI Aecia/aiiy aeeiai?ee iieaciee?a aaciaiai neeaaeo, eeneioii-iniiaiiai noaio e?ia? oa eaaaiaai? aaioeeyoe?? i?ioyaii aeiae i?ney aaaaeaiiy i?iaanoa?iio (1,0 ie 2,5 % ?ic/eio aioo??oiueii’yciai) i?iaaaeaia o aeaio oai?eo ?c a?ia?eaii??th e?ia?. Aeine?aeaeaiiy i?iaaaeaii i?inoei ne?iei iaoiaeii ca ianooiiith iaoiaeeeith. I?ioyaii ia?oi? aeiae a 9 aiaeei ?aieo ?a?no?oaaee aeo?aei? iieacieee aaioeeyoe??, aaciaiai neeaaeo oa eeneioii-iniiaiiai noaio e?ia?, i?ney /iai oai?iio aaiaeeee aioo??oiueii’yciai 1,0 ie o?c?ieia?/iiai ?ic/eio. Ianooiio ?a?no?aoe?th iieaciee?a cae?enithaaee /a?ac 1, 3, 6 oa 24 aiaeeie. Ianooiiiai aeiy aeine?aeaeaiiy i?iaiaeeee a aiaeia?/iiio ii?yaeeo i?ney aaaaeaiiy i?iaanoa?iio. A ?acoeueoao? nooo?aiai aieeao i?iaanoa?iio ia aaciaee neeaae oa ?I e?ia? ia niinoa??aaeinue, a ca’yceo c /ei iiaeaeueo? aeine?aeaeaiiy i?iaiaeeeeny i?ioyaii oeaeiy c uiaeaiiei canoinoaaiiyi i?iaanoa?iio (ii 1,0 ie 2,5 % ?ic/eio) oa uiaeaiiith ?a?no?aoe??th iieaciee?a. Ianoaaeaii 6 oai?eo (/ieia?ee o a?oe? a?ae 47 aei 59 ?ie?a). O 4 ?c ieo aoa ae?aaiinoiaaiee o?ii?/iee iano?oeoeaiee a?iio?o, o 2 - ?ae?iiaoe/iee o?a?icoth/ee aeueaaie?o. I?e anooi? aei ee?i?ee EI II nooiaith niinoa??aaeanue a 4 aeiaaeeao, EI III nooiaith - a 2. O an?o oai?eo iaee i?noea iciaee cano?eii? iaaeinoaoiino? e?iaiia?ao o aaeeeiio eie?: II A noaae?? -o 5, II A noaae?? - o 1. I?e anooi? oai?ei i?ecia/aee e?eoaaiiy, yea aoei ni?yiiaaia ia e?ea?aeaoe?th caaino?aiiy o?ii?/iiai a?iio?oo oa i?iya?a na?oeaai? aeaeiiiainaoe??, i?ney /iai i?iaiaeeeanue i?aeo?eioth/a oa?ai?y (aioeaa?aaaioe, aaciaeeeaoaoi?e, i?e iaia-o?aeiino? - na/ia?ii? caniae). A?aea?? oai?eo aeey iiaeaeueoiai aeine?aeaeaiiy i?i-aiaeeany i?ney noaa?e?caoe?? noaio oa iieaciee?a aaciaiai neeaaeo e?ia? ia i?ioyc? ia iaioa, i?ae 2 oeaei?. I?ney canoinoaaiiy i?iaanoa?iio i?ioyaii 7 aei?a nooo?aa iiceoeaia ee?i?/ia aeeiai?ea (ciaioaiiy caaeooe oa oeeaiico) niinoa??aaeanue o 2 ?c 6 oai?eo. Ae?aci? ci?ie aaciaiai neeaaeo e?ia? (ciaioaiiy nooiaiy a?ia?eaii?? oa a?iienai??) aeyaeyeenue a na?aaeiueiio /a?ac 5 ae?a a?ae ii/aoeo e?eoaaiiy i?iaanoa?iiii. Ii?yae ?c ciaioaiiyi ?aNI2 niinoa??aaeinue ca?eueoaiiy ?I e?ia?, ui aeacoaaei ia ciaioaiiy nooiaiy aeeoaeueiiai aoeeaeico. Noaoenoe/iee aiae?c iieaciee?a, ui aoa i?iaaaeaiee iaoiaeii ioe?iee ??cieoeue ni?anoaaeaieo na?aaei?o aaee/ei, na?ae/eoue i?i a??ia?aeia ciaioaiiy ?aNI2 /a?ac oeaeaeaiue a?ae ii/aoeo e?eoaaiiy (-5,9 + 1,64; t = 3,598). A i?ioean? e?eoaaiiy niinoa??aaeanue oaiaeaioe?y aei ca?eueoaiiy VC, FEV1, MEF25 oa PEF, iaeiae ci?ie iieaciee?a aoee noaoenoe/ii iaa??ia?aeieie. Aeeiai?ea iieaciee?a ?aaeeio aeeoaiiy a i?ioean? e?eoaaiiy i?iaanoa?iiii i?ioyaii 7 aei?a oaeiae aoea ianooo?aith. Iaea i?noea oaiaeaioe?y aei ca?eueoaiiy aeeoaeueiiai ia’?io oa ciaioaiiy /anoioe aeeoaiiy. Oaeei /eiii, ii/aoeia? i?iyae oa?iaeiaeeiai?/iiai aoaeoo i?iaanoa?iio ia aaciaee neeaae oa ?I e?ia? a?aecia/athoueny a e?ioe? oeaeiy a?ae ii/aoeo e?eoaaiiy. Iiaeaeueoa aea/aiiy aieeao i?aia?aoo aoei cae?eniaii i?ioyaii 3-oeaeiaaiai eo?no e?eoaaiiy. Ianoaaeaii 28 oai?eo (/ieia?ee o a?oe? a?ae 33 aei 70 ?ie?a). ?c ieo o?ii?/iee a?iio?o aoa ae?aaiinoiaaiee o 19 oai?eo, ?ae?iiaoe/iee aeueaaie?o - o 4, e?noicia a?iiieac?y eaaaiue - o 2, oi?aeiae?ao?aaiaeueia oi?ia o?ii?/iiai eaaaiaaiai na?oey - o 2, neiae?ii I?ea?ea - o 1. I?e anooi? aei ee?i?ee EI II nooiaith niinoa??aaeanue a 16 aeiaaeeao, EI III nooiaith - a 12. O an?o oai?eo iaee i?noea iciaee cano?eii? iaaeinoaoiino? e?iaiia?ao : II A noaae?? - o 19, II A noaae?? - o 9. Ia??ai? ?c e?eoaaiiyi iniiaiiai caoai?thaaiiy an? oai?? io?eioaaee oa?ai?th, yea aoea ni?yiiaaia ia ciaioaiiy nooiaiy na?oeaai? aeaeiiiainaoe?? (na/ia?ii? caniae, no?ioaioei, aaciaeeeaoaoi?e, i?aia?aoe eae?th, aioeaa?aaaioe). 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 oa iieaciee?a aaciaiai neeaaeo e?ia? ia i?ioyc? ia iaioa, i?ae 2 oeaei?. A oaaeeoe? 2 iaaaaeai? iieacieee aaciaiai neeaaeo oa ?I e?ia? a i?ioean? aacen-ii? (i?aeo?eioth/i?) oa?ai??. sse aeaeii ?c iaaaaeaieo aeaieo, iieacieee aaciaiai neeaaeo oa ?I e?ia? a i?i-oean? aacenii? oa?ai?? aoee noaa?eueieie, ui aeaei i?aenoaae aaaaeaoe ?o eiio-?ieueieie o aea/aii? oa?iaeiaeeiai?/ii? ae?? i?iaanoa?iio. Ne?ae caoaaaeeoe, ui neeaae aacenii? oa?ai?? aoa iaci?iiei i?ioyaii onueiai ia??iaeo e?eoaaiiy i?iaanoa?iiii Oaaeeoey 2 - Iieacieee aaciaiai neeaaeo oa ?I e?ia? a i?ioean? aacenii? oa?ai?? (M + m, n = 28) IieacieeAeo?aei?*a?ac 2 oeaei?t?I7,353 + 0,00577,349 + 0,00540,510PaCO2, ii ?o.no.55,8 + 0,7456,4 + 0,860,529PaO2, ii ?o.no.55,0 + 1,5254,1 + 1,680,397 Aeine?aeaeaiiy aaciaiai neeaaeo oa eeneioii-iniiaiiai noaio e?ia?, iieaciee?a eaaaiaai? aaioeeyoe?? i?iaaaeai? aaciina?aaeiuei ia?aae i?ecia/aiiyi i?iaanoa?iio (ii 1,0 ie 2,5 % ?ic/eio uiaeaiii) oa /a?ac 1, 2 ? 3 oeaei? e?eoaaiiy. O an?o oai?eo i?ney e?eoaaiiy niinoa??aaany iiceoeaiee ee?i?/iee aoaeo - ciaioaiiy caaeooe, oeeaiico, iie?auaiiy aeo?eaaeino? i?e o?ce/ieo iaaaioaaeai-iyo. Ne?ae iaeiae cacia/eoe, ui iiae?aia ee?i?/ia ioe?iea aoaeoeaiino? e?eoaaiiy ? aeineoue noa’?eoeaiith, a ca’yceo c /ei a iniia? aea/aiiy oa?iaeiaeeiai?/ii? ae?? i?iaanoa?iio aoa aiae?c aeeiai?ee a?ia?eaii??, a?iienai??, iieaciee?a eeneioii-iniiaiiai noaio e?ia? oa eaaaiaai? aaioeeyoe??. ?acoeueoaoe aea/aiiy aaciaiai neeaaeo oa eeneioii-iniiaiiai noaio e?ia? a i?ioean? e?eoaaiiy i?iaanoa?iiii iaaaaeai? a oaaeeoe? 3. sse aeaeii ?c oaaeeoe?, aeo?aei? iieacieee (a ia??iae noaa?e?caoe?? ia?aae i?ecia-/aiiyi i?iaanoa?iio) na?ae/eee i?i iayai?noue o oai?eo iaeiiiainiaaiiai aeeoaeue-iiai aoeeaeico (ciaioaiiy ?I, ca?eueoaiiy AA oa ?aNI2), a oaeiae ia??ai? ?c cia/iith a?ia?eaii??th niinoa??aaeenue iciaee iii??ii? a?oa??aeueii? a?iienai?? (ciaioaiiy ?aI2 ? I2 sat.). A i?ioeann? e?eoaaiiy i?iaanoa?iiii iaei i?noea nooo?aa cieaeaiiy ??aiy a?-ia?eaii?? oa ciaioaiiy nooiaiy aeeoaeueiiai aoeeaeico. Aeeiai?ea ??aiy a?iienai?? aoea iaio nooo?aith. Aieea i?aia?aoo ia aaciaee neeaae oa eeneioii-iniiaiee noai e?ia? i?iya-eyany aaea /a?ac 1 oeaeaeaiue a?ae ii/aoeo e?eoaaiiy, iaeiae iaea?eueo cia/ia aeeiai?ea niinoa??aaeanue /a?ac 2 oeaei?, i?ney /iai ci?ie iieaciee?a aoee iacia/ieie. Ae-o?aei? iieacieee e?eai? iio?e-ia’?i oi?niaaiiai aeaeioo na?ae/eee i?i cia/i? ci?ie aaioeeyoe?eii? ooieoe?? eaaaiue ci?oaiiai aaiaco. A i?ioean? e?eoaaiiy niinoa??aaeanue aeayea oaiaeaioe?y aei iie?auaiiy iieaciee?a a?iio?aeueii? i?io?aeiino?. Ia??ai? c oeei iaei i?noea a??ia?aeia ca?eueoaiiy VC, ui, iiaeeeai, iia’ycaii ?c iie?auaiiyi ooieoe?iiaeueiiai noaio aeeoaeueieo i’yc?a. Oiaoi, nooo?aa ca?eueoaiiy VC i?e iacia/ieo ci?iao iieaciee?a a?iio?aeueii? i?io?aeiino? ? nei??oa iane?aeeii iie?auaiiy aaciaiai neeaaeo oa eeneioii-iniiaiiai noaio e?ia? (caaaeyee aeayeei ?ioei oaeoi?ai), i?ae eiai i?e/eiith. Canoinoaaiiy i?iaanoa?iio ni?eyei ci?iai ?aaeeio aeeoaiiy – i?ioyaii e?eoaaiiy niinoa??aaeinue a??ia?aeia ca?eueoaiiy VT ? ciaioaiiy BF, i?e oeueiio oaeeeiiee ia’?i aeeoaiiy caeeoaany i?aeoe/ii aac ci?i (oaaeeoey 4). sseui a?aooaaoe, ui aaee/eia aiaoii?/iiai ia?oaiai i?inoi?o o aei?inei? ethaeeie noaiiaeoue o na?aaeiueiio 150 ie, oi eiai /anoea a caaaeueiiio ia’?i? aaioeeyoe?? a i?ioean? e?eoaaiiy ciaioeeanue ?c 21,9 % aei 18,9 %. Ia aeeeth/aii, ui iiceoeaiee aieea i?iaanoa?iio ia aaciaee neeaae oa eeneioii-iniiaiee noai e?ia? iiaea aooe iaoiiaeaiee oaeiae ? ?ioeie iaoai?ciaie, iaeiae noeioeyoe?y aeeoaiiy oa i?aeaeuaiiy aoaeoeaiino? aaioeeyoe?? ca ?aooiie ciaioaiiy /anoee ia?oaiai i?inoi?o a ?? caaaeueiiio ianyc? ? i/aaeaeieie. I?aenoiiaoth/e io?eiai? aeai?, iiaeia i?eeoe aei aeniiaeo, ui canoinoaaiiy i?iaanoa?iio a eiiieaeniiio e?eoaaii? oai?eo c o?ii?/iei eaaaiaaei na?oeai ni?ey? nooo?aiio ciaioaiith nooiaiy a?ia?eaii??, aeeoaeueiiai aoeeaeico oa (aeaui a iaio?e i???) a?iienai??. Iaea?eueo a??ia?aeiei iaoai?ciii cacia/aiiai aoaeoo i?a- ia?aoo ? noeioethth/ee aieea ia aeeoaeueiee oeaio?, a?aeiiaeaiiy eiai /ooeeaino? aei aeaiieeno aoaea?iaeo. I?e oeueiio niinoa??aa?oueny ca?eueoaiiy aeeoaeueiiai ia’?io c aeayeei ciaioaiiyi /anoioe aeeoaiiy, ui iaoiiaeth? ciaioaiiy /anoee ia?oaiai i?inoi?o a caaaeueiiio ianyc? eaaaiaai? aaioeeyoe??. A i?ioeann? e?eoaaiiy i?iaanoa?iiii niinoa??aa?oueny oaiaeaioe?y aei iie?auaiiy a?iio?aeueii? i?io?aeiino? oa a??ia?aeiiai ca?eueoaiiy aeeoo?ai? ?iiino? eaaaiue. Aieea i?iaanoa?iio ia aaciaee neeaae oa eeneioii-iniiaiee noai e?ia? i?i-yaey?oueny aaea /a?ac 1 oeaeaeaiue a?ae ii/aoeo e?eoaaiiy, iaeiae iaea?eueo cia/ia aeeiai?ea niinoa??aa?oueny /a?ac 2 oeaei?, i?ney /iai ia? i?noea a?aeiinia noaa?e?caoe?y iieaciee?a. Io?eiai? aeai? aeicaieythoue ?aeiiaiaeoaaoe canoinoaaiiy i?iaanoa?iio i?e a?ia?eaii?? o oai?eo c o?ii?/iei eaaaiaaei na?oeai.Oaaeeoey 3 - Ci?ie aaciaiai neeaaeo oa eeneioii-iniiaiiai noaio e?ia? a i?ioean? e?eoaaiiy i?iaanoa?iiii ia i?ioyc? 3 oeaei?a (M + m, n = 28) Iieaciee1 aeo?aei?2 /a?ac 1 oeaeaeaiue3 /a?ac 2 oeaei?4 /a?ac 3 oeaei??pH7,349+0,00547,352+0,00577,362+0,0607,360+0,0061PaCO2 (ii.?o.no.)56,4+0,8652,3+0,7049,7+0,6548,2+0,58P1-2,3,4<0,001 P2-3<0,05 P2-4<0,001BE (iiieue/e)3,1+0,472,0+0,500,9+0,61-0,2+0,59P1-3<0,01 P1-4<0,001 P2-4<0,01BE ecf. (iiieue/e)5,5+0,453,8+0,562,5+0,60-0,1+0,57P1-2<0,05 P1-3,4<0,001 P2-3,4<0,001BB (iiieue/e)50,9+0,6250,0+0,5748,8+0,6147,7+0,60P1-3<0,05 P1-4<0,001 P2-4<0,01HCO3- (iiieue/e)31,3+0,4129,3+0,4527,2+0,4725,1+0,50P1-2,3,4<0,001 P2-3,4<0,001 P3-4<0,001SB (iiieue/e)25,8+0,4025,1+0,4223,5+0,4023,3+0,39P1-3,4<0,001 P2-3,4<0,01PaO2 (ii ?o.no.)54,1+1,6858,8+1,4156,6+1,5456,8+1,23P1-2<0,05O2 sat. (%)85,0+1,1487,9+0,6987,0+0,7687,1+0,73P1-2<0,05 Oaaeeoey 4 - Aeeiai?ea iieaciee?a ?aaeeio aeeoaiiy a i?ioean? e?eoaaiiy i?iaanoa?iiii i?ioyaii 3 oeaei?a (M + m, n = 28) Iieaciee (% a?ae iaeaaei.)1 aeo?aei?2 /a?ac 1 oeaeaeaiue3 /a?ac 2 oeaei?4 /a?ac 3 oeaei??VT (e)0,699+ 0,02930,739+ 0,03630,782+ 0,02900,795+ 0,0335P1-3 < 0,05 BF (ca 1 oa.)23,1+ 1,1621,3+ 1,2220,1+ 1,0919,3+ 1,05P1-4 < 0,05MV (e/oa.)15,8+ 0,6315,5+ 0,5215,4+ 0,6715,3+ 0,68 AENIIAEE 1. O oai?eo ?c o?ii?/iei eaaaiaaei na?oeai niinoa??aa?oueny cai?ioiy ca-eaaei?noue i?ae ??aiai ai?noo i?iaanoa?iio o ne?iaaooe? e?ia? oa nooiaiai a?ia?eai-i?? ? aeeoaeueiiai aoeeaeico. 2. Canoinoaaiiy i?iaanoa?iio a eiiieaeniiio e?eoaaii? oai?eo ?c o?ii?/iei eaaaiaaei na?oeai, oneeaaeiaiei ?icaeoeii a?ia?eaii??, ni?ey? ciaioaiith nooiaith caaeooe, oeeaiico, iie?auaiith aeo?eaaeino? i?e o?ce/ieo iaaaioaaeaiiyo. 3. A i?ioean? e?eoaaiiy i?iaanoa?iiii ia? i?noea nooo?aa cieaeaiiy ??aiy a?ia?eaii?? oa ciaioaiiy nooiaith aeeoaeueiiai aoeeaeico. Aieea i?aia?aoo ia aaciaee neeaae oa eeneioii-iniiaiee noai e?ia? i?iyaey?oueny /a?ac 1 oeaeaeaiue a?ae ii/aoeo e?eoaaiiy, aeinyaath/e iaeneioio i?ioyaii 2 oeaei?a, i?ney /iai ia? i?noea noaa?e?caoe?y iieaciee?a. 4. I?iaanoa?ii ia cae?enith? nooo?aiai aieeao ia iieacieee a?iio?aeueii? i?io?aeiino?, a i?ioean? eiai canoinoaaiiy niinoa??aa?oueny aeayea ca?eueoaiiy aeeoo?-ai? ?iiino? eaaai?a. 5. A iaoai?ci? iiceoeaiiai aieeao i?iaanoa?iio ia aaciaee neeaae oa een-eioii-iniiaiee noai e?ia? aaaeeeaa cia/aiiy ia? eiai noeioethth/ee aoaeo ia ea-aaiaao aaioeeyoe?th ?c ca?eueoaiiyi aeeaeie oa ciaioaiiyi /anoioe aeeoaiiy, /anoee ia?oaiai i?inoi?o a caaaeueiiio ia’?i? aaioeeyoe??. I?AEOE*I? ?AEIIAIAeAOe?? C iaoith ei?aeoe?? a?ia?eaii?? oa aeeoaeueiiai aoeeaeico o oai?eo c o?ii?/iei eaaaiaaei na?oeai ?aeiiaiaeo?oueny canoinoaaiiy a eiiieaeniiio e?eoaaii? noeio-eyoi?a eaaaiaai? aaioeeyoe?? i?iaanoa?iio. I?aia?ao canoiniao?oueny a aeic? 1,0 ie 2,5 % ?ic/eio aioo??oiueii’yciai uiaeaiii i?ioyaii o?ueio oeaei?a. Nienie iioae?eiaaieo aaoi?ii i?aoeue ca oaiith aeena?oaoe?? 1. Iaoaieciu ?acaeoey e aiciiaeiinoe ei??aeoeee aeia?eaiiee o aieueiuo n o?iie/aneei eaai/iui na?aeoeai/ A.E. Aaa?enthe, Ae.ss. Aaa?ee, I.A. Ii?iciaa, A.E. ss/iee // Oe?a?inueeee ioeueiiiieia?/iee aeo?iae.-1996.- ?3.-N.39-42. 2. Yooaeoeaiinoue i?eiaiaiey i?iaanoa?iia a eiiieaena ea/aiey aieueiuo n o?iie/aneei eaai/iui na?aeoeai / A.E. Aaa?enthe, I.A. Ii?iciaa, Ae.ss. Aaa?ee, O.A. ssoieoea // Oe?a?inueeee ea?ae?ieia?/iee aeo?iae.-1996.-?3.- N.187. 3. Aaa?ee Ae.ss. Yooaeoeaiinoue i?iaanoa?iia a ei??aeoeee aeia?eaiiee o aieueiuo n o?iie/aneei eaai/iui na?aeoeai // Oe?a?inueeee ioeueiiiieia?/iee aeo?iae.-1997.-?4.-N.60-61. 4. Aaa?ee Ae.ss. I?eiaiaiea i?iaanoa?iia a ei??aeoeee aeia?eaiiee o aieue-iuo n o?iie/aneei eaai/iui na?aeoeai // 7 iaoe.eiia?ann ii aieaciyi i?a. aeuoaiey. Oac.aeiee.- Iineaa, 1997.- ?640. 5. Ei??aeoeey ?aaeeia aaioeeyoeee a ea/aiee aieueiuo n o?iie/aneie aeuoa-oaeueiie iaaeinoaoi/iinoueth / A.E. Aaa?enthe, A.E. ss/iee, O.A. ssoieoea, Ae.ss. Aaa?ee, AE.A. Iooeaiei // Oe?a?inueeee ioeueiiiieia?/iee aeo?iae.- 1999.- ?1.- N.13-17. Aaa??e Ae.ss. 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.-?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, 1998. Aeena?oaoe?y i?enay/aia aea/aiith iiaeeeainoae ei?aeoe?? a?ia?eaii?? oa aeeoaeueiiai aoeeaeico o oai?eo c o?ii?/iei eaaaiaaei na?oeai ca aeiiiiiaith i?i-aanoa?iio. A ?acoeueoao? anoaiiaeaiee iiceoeaiee aieea i?aia?aoo ia aaciaee neeaae oa eeneioii-iniiaiee noai e?ia?, yeee i?iyaey?oueny /a?ac 1 oeaeaeaiue a?ae ii/aoeo e?eoaaiiy, aeinyaath/e iaeneioio /a?ac 2 oeaeiy, i?ney /iai niinoa??aa-?oueny noaa?e?caoe?y iieaciee?a. A iaoai?ci? ae?? i?iaanoa?iio ia? cia/aiiy eiai noe-ioethth/ee aoaeo ia eaaaiaao aaioeeyoe?th ?c ca?eueoaiiyi aeeaeie oa ciaioaiiyi /anoioe aeeoaiiy oa /anoee ia?oaiai i?inoi?o a caaaeueiiio ia’?i? aaioeeyoe??. Canoinoaaiiy i?iaanoa?iio ni?ey? ciaioaiith nooiaiy caaeooe, oeeaiico, iie?auaiith aeo?eaaeino? i?e o?ce/ieo iaaaioaaeaiiyo. Eeth/ia? neiaa: o?ii?/ia eaaaiaaa na?oea, a?ia?eaii?y e?ia?, i?iaanoa?ii. Bagriy D.Ya. Efficacy of progesterone in management of hypercapnia and respiratory acidosis in cor pulmonale patients.- Manuscript. Theses for a candidate's degree in specialty 14.01.27 - Pulmonology.-Yanovsky Institute of Phthisiology and Pulmonology of Academy of Sciences of Ukraine, Kyiv, 1988. The dissertation is dedicated to the management of hypercapnia and respiratory acidosis using progesterone in cor pulmonale patients. The positive effect of progesterone on blood gas composition and acid-base system develops 1 week after initiation of therapy, achieving its maximum in 2 weeks. Then the stable level of physiological indices is usually observed. The pharmacodynamics of progesterone comprises stimulation of pulmonary ventilation - an increase of tidal volume, and reduction of respiration rate and dead space. The administration of progesterone promotes the decrease of dyspnea, cyanosis and increases the exercise tolerance. Key words: cor pulmonale; hypercapnia; progesterone. Aaa?ee Ae.ss. Yooaeoeaiinoue i?eiaiaiey i?iaanoa?iia a ei??aeoeee aeia?eaiiee e aeuoaoaeueiiai aoeeaeica o aieueiuo n o?iie/aneei eaai/iui na?aeoeai.- ?oeiienue. 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?oaoeey iinayuaia eco/aieth aiciiaeiinoae ei??aeoeee aeia?eaiiee e aeuoaoaeueiiai aoeeaeica o aieueiuo n o?iie/aneei eaai/iui na?aeoeai n iiiiuueth i?iaanoa?iia. I?aaeiinueeie auiieiaiey ?aaiou yaeeenue aeaiiua eeoa?aoo?u i noeioee?othuai aeeyiee ai?iiia aeaeoiai oaea ia eaai/ioth aaioeeyoeeth. I?iaaaeaii eco/aiea ei??aeyoeeiiiuo caaeneiinoae o?iaiy aeia?eaiiee e aeuoaoaeueiiai aoeeaeica io eiioeaio?aoeee a e?iae i?iaanoa?iia o aieueiuo n o?iie-/aneei eaai/iui na?aeoeai. Ii?aaeaeaiea niaea?aeaiey i?iaanoa?iia a nuai?ioea e?iae inouanoaeyee ?aaeeieiioiieiae/aneei iaoiaeii. I?e ei??aeyoeeiiiii aiaeeca auyaeaia i?yiay caaeneiinoue iaaeaeo o?iaiai i?iaanoa?iia e ?I e?iae (p<0,01) e aeeceay e aeinoiaa?iie ia?aoiay caaeneiinoue iaaeaeo o?iaiai i?iaanoa-?iia e iai?yaeaieai oaeaeeneiai aaca, a oaeaea enoeiiui aeea?aiiaoii e?iae. Oaeei ia?acii, oiaiueoaiea niaea?aeaiey i?iaanoa?iia a nuai?ioea e?iae nii?i-aiaeaeaaony oaaee/aieai noaiaie aeia?eaiiee e aeuoaoaeueiiai aoeeaeica. Iieo/aiiua aeaiiua iaoneiaeee iaiaoiaeeiinoue eco/aiey aiciiaeiinoae i?eiaiaiey i?iaanoa?iia n oeaeueth ei??aeoeee aeia?eaiiee e aeuoaoaeueiiai aoeeaeica o aieueiuo n o?iie/aneei eaai/iui na?aeoeai. Eco/aiea aeeiaieee iieacaoaeae aaciaiai ninoaaa, eeneioii-iniiaiiai ninoiyiey e?iae e eaai/iie aaioeeyoeee ia i?ioyaeaiee nooie iinea aaaaeaiey i?iaanoa?iia (1,0 ie 2,5 % ?anoai?a aioo?eiuoa/ii) i?iaaaeaii o aeaoo aieueiuo i?inoui neaiui iaoiaeii. A ia?aua nooee a 9 /ania oo?a ?aaeno?e?iaaee enoiaeiua iieacaoaee, iinea /aai aieueiiio aaiaeeee aioo?eiuoa/ii 1 ie oeceieiae/aneiai ?anoai?a. Iineaaeothuoth ?aaeno?aoeeth iieacaoaeae inouanoaeyee /a?ac 1, 3, 6 e 24 /ana. Ia neaaeothuee aeaiue enneaaeiaaiey i?iaiaeeee a aiaeiae/iii ii?yaeea iinea aaaaeaiey i?iaanoa?iia. Nouanoaaiiiai aeeyiey i?iaanoa?iia ia aaciaue ninoaa e eeneioii-iniiaiia ninoiyiea e?iae ia iaaethaeaeinue, a nayce n /ai aeaeueiaeoea enneaaeiaaiey i?iaiaeeee ia i?ioyaeaiee iaaeaee n aaeaaeiaaiui aaaaeaieai i?iaanoa?iia (ii 1,0 ie 2,5 % ?anoai?a) e aaeaaeiaaiie ?aaeno?aoeeae iieacaoaeae. Ianeaaeiaaii 6 aieueiuo. I?e iinooieaiee a eeeieeo aieueiui iacia/aee ea/aiea, iai?aaeaiiia ia eeeaeaeaoeeth iaino?aiey o?iie/aneiai a?iioeoa e i?ec-iaeia na?aea/iie aeaeiiiainaoeee, iinea /aai i?iaiaeeeanue iiaeaea?aeeaathuay oa?a-iey (aioeaa?aaaiou, aaciaeeeaoaoi?u, i?e iaiaoiaeeiinoe – ii/aaiiiua n?aaenoaa). Ioai? aieueiuo aeey aeaeueiaeoaai enneaaeiaaiey i?iaiaeeeny iinea noaaeeecaoeee ninoiyiey e iieacaoaeae aaciaiai ninoaaa e?iae ia i?ioyaeaiee ia iaiaa /ai 2 iaaeaee. Iinea i?eiaiaiey i?iaanoa?iia a oa/aiea 7 nooie nouanoaaiiay iieiaee-oaeueiay eeeie/aneay aeeiaieea (oiaiueoaiea iaeuoee e oeeaiica) iaaethaeaeanue o 2 ec 6 aieueiuo. Au?aaeaiiua eciaiaiey aaciaiai ninoaaa e?iae (oiaiueoaiea noa-iaie aeia?eaiiee e aeiienaiee) auyaeyeenue a n?aaeiai /a?ac 5 aeiae io ia/aea ea-/aiey i?iaanoa?iiii. Ia?yaeo n oiaiueoaieai iai?yaeaiey a e?iae oaeaeeneiai aaca iaaethaeaeinue oaaee/aiea ?I e?iae, /oi oeacuaaei ia oiaiueoaiea noaiaie aeuoaoaeueiiai aoeeaeica. A i?ioeanna ea/aiey iaaethaeaeanue oaiaeaioeey e oaaee/aieth aeeciaiiie ai-einoe eaaeeo, iauaia oi?ne?iaaiiiai auaeioa ca ia?aoth naeoiaeo, ieeiaie nei-?inoe auaeioa, aic?anoaieth aeuoaoaeueiiai iauaia e oiaiueoaieth /anoiou aeuoaiey. Oaeei ia?acii, ia/aeueiua i?iyaeaiey oa?iaeiaeeiaie/aneiai yooaeoa i?iaanoa?iia ia aaciaue ninoaa e ?I e?iae ioia/athony /a?ac iaaeaeth io ia/aea ea/aiey. Aeaeueiaeoaa eco/aiea aeeyiey i?aia?aoa i?iaiaeeeinue ia i?ioyaeaiee o?aoiaaeaeueiiai eo?na ea/aiey. I?e iinooieaiee a eeeieeo aieueiui i?iaiaeeeinue ea/aiea iniiaiiai caai-eaaaiey e oa?aiey, iai?aaeaiiay ia oiaiueoaiea noaiaie na?aea/iie aeaeiiiai-naoeee. Iinea noaaeeecaoeee ninoiyiey iacia/aeanue iiaeaea?aeeaathuay oa?aiey ia ia?eiae ia iaiaa 2 iaaeaeue aei iacia/aiey i?iaanoa?iia. Enneaaeiaaiea aaciaiai ninoaaa e eeneioii-iniiaiiai ninoiyiey e?iae, iieacaoaeae eaai/iie aaioeeyoeee i?iaaaeaiu iaiin?aaenoaaiii ia?aae iacia/aieai i?iaanoa?iia e /a?ac 1, 2 e 3 iaaeaee ea/aiey. O anao aieueiuo iinea ea/aiey iaaethaeaeny iieiaeeoaeueiue eeeie/aneee yo-oaeo – oiaiueoaiea iaeuoee, oeeaiica, oeo/oaiea ia?aiineiinoe oece/aneeo ia-a?ocie. Enoiaeiua (a ia?eiae noaaeeecaoeee) iieacaoaee aaciaiai ninoaaa e eeneioii-iniiaiiai ninoiyiey e?iae naeaeaoaeuenoaiaaee i iaee/ee o aieueiuo au?aaeaiiie aeia?eaiiee, oia?aiiie aeiienaiee, iaeiiiaine?iaaiiiai aeuoaoaeueiiai aoeeaeica. A i?ioeanna ea/aiey i?iaanoa?iiii eiaei ianoi nouanoaaiiia nieaeaiea o?iaiy aeia?eaiiee e oiaiueoaiea noaiaie aeuoaoaeueiiai aoeeaeica. Aeeiaieea o?iaiy aeiienaiee auea iaiaa au?aaeaiiie. Aeeyiea i?aia?aoa i?iyaeyeinue oaea /a?ac 1 iaaeaeth io ia/aea ea/aiey, iaeiaei iaeaieaa au?aaeaiiay aeeiaieea iaaethaeaeanue /a?ac 2 iaaeaee, iinea /aai eciaiaiey iieacaoaeae auee iacia/eoaeueiuie. I?eiaiaiea i?iaanoa?iia niinianoaiaaei eciaiaieth ?aaeeia aeuoaiey – oaaee/aieth aeuoaoaeueiiai iauaia e oiaiueoaieth /anoiou aeuoaiey, /oi iaoneiaeei oiaiueoaiea aeiee ia?oaiai i?ino?ainoaa a iauai iauaia eaai/iie aaioeeyoeee. Iineaaeiaa naeaeaoaeuenoaoao i noeioee?othuai aeeyiee i?aia?aoa ia aeuoaoaeueiue oeaio?, /oi a cia/eoaeueiie ia?a iauyniyao aai ei??eae?othuaa aeaenoaea ia aaciaue ninoaa e?iae. Eeth/aaua neiaa: o?iie/aneia eaai/iia na?aeoea, aeia?eaiiey e?iae, i?iaan-oa?ii.

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