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Функціональні зміни серцево-судинної системи у хворих на гломерулонефрит і пієлонефрит, які перебувають на програмному гемодіалізі, та шляхи їх корекц

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12

I?I?NOA?NOAI IOI?IIE CAeI?IAss OE?A?IE

E?EINUeEEE AeA?AEAAIEE IAAeE*IEE OI?AA?NEOAO

?i. N.?. AAI?A??ANUeEIAI

OAeE 616.12+616.611-002-61.002.3-089

AAN?EAN Eiinoaio?iin

OOIEOe?IIAEUeI? CI?IE NA?OeAAI-NOAeEIII? NENOAIE O OAI?EO IA
AEIIA?OEIIAO?EO ? I??EIIAO?EO, ssE? IA?AAOAATHOUe IA I?IA?AIIIIO
AAIIAe?AE?C?, OA OEssOE ?O EI?AEOe??

14.01.02- aioo??oi? oai?iae

AAOI?AOA?AO

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

N?ioa?iiieue 1999

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiia a E?einueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao? ?i.
N.?. Aai?a??anueeiai.

Iaoeiaee ea??aiee: aeieoi? iaaee/ieo iaoe, i?ioani?

E?oo?eia Na?a?e Ieeieaeiae/, E?einueeee aea?aeaaiee iaaee/iee
oi?aa?neoao ?i. N.?. Aai?a??anueeiai, caa?aeoaa/ eaoaae?e i?iiaaeaaoeee
aioo??oi?o oai?ia

Io?oe?ei? iiiiaioe: aeieoi? iaaee/ieo iaoe, i?ioani?

Nae?aaiiaa Enai?y Oaaei??aia, E?einueeee aea?aeaaiee iaaee/iee
oi?aa?neoao ?i. N. ?. Aai?a??anueeiai, eaoaae?a oaeoeueoaonueei? oa?ai??
?1

aeieoi? iaaee/ieo iaoe, i?ioani?

Nai?aeioeueea AEaiia Aeieo??aia, Oa?e?anueeee aea?aeaaiee iaaee/iee
oi?aa?neoao, caa?aeoaa/ eaoaae?e i?iiaaeaaoeee aioo??oi?o oai?ia

I?ia?aeia i?aai?caoe?y:

Iaoe?iiaeueiee iaaee/iee oi?aa?neoao ?i. I.I. Aiaiiieueoey.

Caoeno a?aeaoaeaoueny “16” eenoiiaaea 1999 ?ieo i 14aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee E 52.600.01 i?e E?einueeiio
aea?aeaaiiio iaaee/iiio oi?aa?neoao? ?i. N.?. Aai?a??anueeiai (333006,
i. N?ioa?iiieue, aoe. Eai?ia 5/7)

C aeena?oaoe??th iiaeia iciaeiieoeny a a?ae?ioaoe? E?einueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo ?i. N.?. Aai?a??anueeiai (333006,
i. N?ioa?iiieue, aoe. Eai?ia, 5/7).

Aaoi?aoa?ao ?ic?neaiee “9” aeiaoiy 1999?.

A/aiee nae?aoa? niaoe?ae?ciaaii?

a/aii? ?aaee, aeieoi? iaaee/ieo iaoe ,

i?ioani? I.O.
Iaco?aoeue

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie. O?ii?/ia ie?eiaa iaaeinoaoi?noue (OII) ?
iane?aeeii aaaaoueio caoai?thaaiue ie?ie [N.E. ?yaia, 1997]. *anoi
a?aei?/a?oueny ?icaeoie OII a in?a iieiaeiai a?eo, ui ? i?e/eiith
?iaae?aeecaoe?? ? nia?o? oai?eo. I?e oeueiio, yeui i?e e?eoaaii? oai?iae
ie?ie oni?oe aeoaea ne?iii?, oi a oa?ai?? ie?eiai? iaaeinoaoiino?
a?aei?/ai? a?eueo? aeinyaiaiiy. Oa?ai?y OII ?iciiae?ey?oueny ia o?e
aaeee? aoaie eiina?aaoeaiee, aeoeaiee ? o??o?a?/iee aai
o?ainieaioaoe?eiee.

Iaea?eueoa iioe?aiiy o na?o? io?eiaea ae?ae?cia oa?ai?y. Noai
na?oeaainoaeeiii? nenoaie aecia/a? i?iaiic oa iane?aeee e?eoaaiiy
a?eueoa i?ae o iieiaeie oai?eo, ye? ia?aaoaathoue ia e?eoaaii?
i?ia?aiiei aaiiae?ae?cii, a oaeiae a cia/iiio nooiai? aeaeeaaiiy
?aoe?i??io?a ie?eiaiai o?ainieaioaoo, iniaeeai o aeiaaeeo ia?anaaeee
ie?ee iaoe??ioai c ae?aaaoe/iith iao?iiao??th [N.E. ?yaia, TH.E.
Iaoi/ei, 1997].

Oaeoi?aie, ui coiiaeththoue /anoioo oneeaaeiaiue c aieo
na?oeaainoaeeiii? nenoaie, ? a?ia?oaic?y, ii?ooaiiy aeaeo?ie?oiiai ?
aiaeiiai aaeaino c ?aaoey?iith a?ia?a?ae?aoaoe??th oa aaeaioeaieie
eieeaaiiyie ?ici???a na?oey, iaoaaie?cio e?i?ae?a oa aoaeaaiae?a, ye?
aeeeeeathoue i?enei?aiee ?icaeoie aoa?ineea?ico, iayai?noue o oai?eo
aiai?? ? iino?eiiai ?icaeoeo ia?eea?aeo ? o.ae. [GEHC,1988]. Iacaeaaeiei
oaeoi?ii ?eceeo, ye a caaaeuei?e iiioeyoe??, oae ? o oai?eo ia
aaiiae?ae?c?, aaaaea?oueny oaeiae a?ia?o?io?y e?aiai oeoii/ea, a
?icaeoeo yeiai aiinyoue aianie aiai?y ? a?ia?oaic?y [I.N. Aaeionia e
niaao., 1988; I.I. Aeaaeeie?iaa e niaao., 1990; Sothern R.B. et al.,
1995; Wollert K.C. et al., 1994].

I?i iiaeeeaee caycie iaoieia?? ie?ie c i?aeaeuaiiyi a?oa??aeueiiai oeneo
iiaeia caeeth/eoe ua ?c ia?oiai iia?aeiieaiiy Bright (1836), a yeiio
aeacoaaeiny ia a?ia?o?io?th na?oey aac ci?i noaeei. A?eueo /?oei oea
ieoaiiy ?ic?iaeaia o i?aoeyo F.Volhard et Th Fahr (1914), ye? aeae?eeee
noaeeii? o?aaeaiiy ie?ie a ie?aio ?oa?eeo. Oaea a inoaii? 50 60 ?ie?a
aoea /?oei noi?iiaaia eiioeaioe?y i?i ?ieue ie?ie o iaoiaaiac?
a?oa??aeueii? a?ia?oii??, yea i?ecia? ca ie?eith ye i?ani?io, oae ?
aeai?ani?io ooieoe?th.

Ia nueiaiaeiyoi?e aeaiue iaea?eueoee ?ioa?an i?aaenoaaey? caycie i?ae
?ai?i-aia?ioaicei-aeueaeinoa?iiiaith nenoaiith (?AAN) ? a?ieia?/ieie
aeoeaieie ?a/iaeiaie, ye? aeae?eythoueny ?c ia?aaena?aey oae iaceaa?ieo
ao??iiaioeae?a. Iaeei ?c oeeo iaioeae?a oea iao??eo?aoe/iee iaioeae
(IOI) 28-ai?ii-eeneioiee iaioeae, yeee i?noeoueny a a?aioeao i?ioeeo?a
ia?aaena?aey o aeaeyae? i?iai?iiio [Fontana F. et al., 1997]. IOI
i?aaenoaaey? niaith iiaooi?e iao??eo?aoe/iee ? noaeeiii?icoe?thth/ee
aaaio, a oaeiae ? ?ia?a?oi?ii i?iaeoeoe?? aeueaeinoa?iio [Schenk G. et
al., 1985].

Ii?ooaiiy e?i?aeiiai iai?io aeyaeythoue iaeaea o 100% oai?eo c OII.
A?eueo?noue aeine?aeiee?a aaaaeathoue, ui o?ai?/ia aeene?iii?ioa?aeai?y
ni?ey? i?enei?aiiio ?icaeoeo aoa?ineea?ico, yeee eaaeeoue a iniia?
aeieeiaiiy eaoaeueieo na?oeaai noaeeiieo oneeaaeiaiue o oai?eo ia
aaiiae?ae?c? [Handbook of dialysis, 1988; Valek A., 1989].

?c aeuaaeeeaaeiaiiai aeo?ea? aeooaeuei?noue caaea/?, yea iieyaa? a
oiio, ui ieoaiiy i?iaaaeaiiy aaiiae?ae?co ? ei?aeoe?y oneeaaeiaiue, yea
aeieea? i?ae /an naaino aaiiae?ae?co, iio?aaothoue iiaeaeueoiai
aea/aiiy.

Iaoa aeaiiai aeine?aeaeaiiy: aeyaeaiiy iiaeo caeiiii??iinoae aeayeeo
iieaciee?a ooieoe?iiaeueiiai noaio na?oeaainoaeeiii? nenoaie a ie?aieo
a?oi oai?eo, ye? ia?aaoaathoue ia i?ia?aiiiio aaiiae?ae?c?, ? ?ic?iaeoe
niiniae ei?aeoe?? ?o ci?i.

Aeey ?aae?caoe?? aeaii? iaoe iaie iinoaaeai? oae? iniiai? caaea/?:

1. aea/eoe ai?iiiaeueio ooieoe?th na?oey ia iniia? aeae?eaiiy
iao??eo?aoe/iiai iaioeaeo a oiiaao i?iaaaeaiiy aaiiae?ae?co ? i?ae
aieeaii e?ea?nueeeo i?aia?ao?a;

2. aeaoe ioe?ieo ci?i ?ai?i aia?ioaiceiiiai? nenoaie i?ae /an
aaiiae?ae?co ? a i?aeae?ae?ciiio ia??iae?, oa i?e canoinoaaii?
e?ea?nueeeo ?a/iaei ?c ??cieo a?oi;

3. ooi/ieoe aca?iicaycie ?ai?iaia?ioaiceiaeueaeinoa?iiiai? nenoaie oa
iao??eo?aoe/iiai iaioeaeo o oai?eo ia i?ioyc? ?o e?eoaaiiy ia
i?ia?aiiiio aaiiae?ae?c?;

4. aea/eoe ii?oieia?/i? iniaeeaino? ea?ae?ioeeo?a o oai?eo ia aoi?eiio
a?ia?oii?th oa a?oa??aeueio a?ia?oii?th iaie?eiaiai aaiaco;

5. ooi/ieoe aieea aaiiae?ae?co ia oeaio?aeueio ? ia?eoa?e/io
aaiiaeeiai?eo ia i?aenoaa? ci?i ia?oe?aeueiiai oeneo eenith, ci?i
iieaciee?a ?aia?aie oa oeueo?acaoeiaiai aeine?aeaeaiiy na?oey.

Iaoeiaa iiaecia aeine?aeaeaiue caeeth/a?oueny a oiio, ui iaea?aeai? iia?
aeai? i?i a?aei?iiino? noaio ?ai?iaia?ioaiceiaeueaeinoa?iiiai? nenoaie o
oai?eo ia o?ii?/iee aeiia?oeiiao?eo ? i??eiiao?eo, ye? ia?aaoaathoue ia
i?ia?aiiiio aaiiae?ae?c?. Iieacai? ??ci? noaie ea?ae?ioeeo?a o oai?eo,
ui no?aaeaeathoue anaioe?aeueiith oa aoi?eiiith , ie?eiaiai aaiaco,
a?oa??aeueiith a?ia?oaic??th. Oae? iniaeeaino? i?ioeaaeo?e aaiiae?ae?co,
ye cieaeaiiy ia?oe?aeueiiai oeneo eenith, oi?ioaaiiy aaiiciiai canoith,
ni?ey? oi?ioaaiith na?oeaai? iaaeinoaoiino?, oeaieiii? ? ee?oeiii?
a?iien??. ?acii c oeeie ci?iaie aeyaeaii i?aeaeuaiiy ooieoe??
ueoiaeaeii? caeice o oai?eo ie?eiaith iaoieia??th c o?ii?/iith ie?eiaith
iaaeinoaoi?noth a oa?i?iaeuei?e noaae??. Iieacaia ?aoe?iiaeuei?noue
a?iioaiceaii? oa?ai?? c iaoith noaa?e?caoe?? oa eiio?iethaaiiy
a?oa??aeueiiai oeneo i?ae /an i?ioeaaeo?e aaiiae?ae?co ? a
i?aeae?ae?ciiio ia??iae?.

I?aeoe/ia cia/aiiy ?acoeueoao?a aeine?aeaeaiiy. Aeyaeai? a?aei?iiino?
noaio ?ai?iaia?ioaiceiaeueaeinoa?iiiai? nenoaie oa iao??eo?aoe/iiai
iaioeaeo o oai?eo ia o?ii?/iee aeiia?oeiiao?eo ? i??eiiao?eo a
oa?i?iaeuei?e noaae?? ie?eiai? iaaeinoaoiino? aeicaieeee ei?aeooaaoe
ia?aiao?e i?iaaaeaiiy naaino aaiiae?ae?co o oeeo oai?eo. A?aeiiaeaiiy
aaeaeaaoii? a?iioaiceaii? oa?ai?? o aeaeyae? ?iaeea?aeoaeueiiai aeai?o
e?ea?nueeeo i?aia?ao?a ?c a?oi ?ia?a?oi??a aia?ioaiceiia?aoai?thth/iai
oa?iaioo ? naeaeoeaieo 1aae?aiiaeieaoi??a, iie?ioo? naain aaiiae?ae?co
oa oiia?eueith? i?ia?anoaaiiy ie?eiai? ? na?oeaai? iaaeinoaoiino?.
Onoaiiaeaia iaiao?aei?noue canoinoaaiiy aioeieneaeaioii? oa?ai?? c
iaoith aeaoieneeaoe?? ? i?aeaeuaiiy /ooeeaino? i?aai?cio oai?iai aei
ae?? noa?i?aeieo i?aia?ao?a oa iiaeiaaeaiiy no?ie?a ?ai?n??.

Iniaenoa o/anoue aaoi?a a ?ic?iaoe? iniiaieo iieiaeaiue aeena?oaoe??.
?iaioa aeeiiaia ia eaoaae?? i?iiaaeaaoeee aioo??oi?o oai?ia E?einueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo ?i. N.?. Aai?a??anueeiai
(caa?aeoaa/ aeieoi? iaaee/ieo iaoe, i?ioani? N.I. E?oo?eia) ia aac? ? ?
?? oa?aiaaoe/ieo ? ea?ae?ieia?/iiio a?aeae?eaiiyo 7-i? i?nueei? e?ea?i?
oa o a?aeae?eaii? o?ii?/iiai aaiiae?ae?co ?EE ?i. I.I. Naiaoea.

Ianoaaeaiiy oai?eo ?c canoinoaaiiyi iniiaieo iaoiae?a aeine?aeaeaiiy,
noaoenoe/ia ia?iaea ?acoeueoao?a aeine?aeaeaiiy oa ?o aiae?c, iaienaiiy
?iaioe aeeiiai? aaoi?ii naiino?eii.

?acoeueoaoe ?iaioe ai?iaaaeaeai? a i?aeoeeo o a?aeae?eaii? o?ii?/iiai
aaiiae?ae?co ?EE ?i. I.I. Naiaoea.

Ai?iaaoe?y iaoa??ae?a aeena?oaoe??. ?acoeueoaoe aeine?aeaeaiiy
aeiiia?aeaeeny oa iaaiai?thaaeeny ia can?aeaii? E?einueeiai iaoeiaiai
oiaa?enoaa oa?aiaao?a (1998, 1999).

Ioae?eaoe??. Ca iaoa??aeaie aeena?oaoe?? iioae?eiaaii 4 iaoeia? i?aoe?
oa iaeia ?aoe?iiae?caoi?nueea i?iiiceoe?y.

No?oeoo?a oa ianya aeena?oaoe??. Aeena?oaoe?y neeaaea?oueny c? anooio,
iaeyaeo e?oa?aoo?e, ?icae?eo “Iaoiaee aeine?aeaeaiiy ? ee?i?/ia
oa?aeoa?enoeea oai?eo”, ?icae?eo ?c iyoe i?ae?icae?e?a, a yeiio
iaaaaeai? ?acoeueoaoe aieeao aaiiae?ae?co ia noai na?oeaai noaeeiii?
nenoaie, ?icae?eo ?c aeaio i?ae?icae?e?a, a yeiio iaaaaeai? ?acoeueoaoe
aieeao e?ea?nueeeo i?aia?ao?a ia ?ai?iaia?ioaiceiio nenoaio oa
iao??eo?aoe/iee iaioeae, caeeth/aiiy, aeniiae?a, i?aeoe/ieo
?aeiiaiaeaoe?e, nieneo e?oa?aoo?e, yeee aeeth/a? 228 aeaea?ae.
Aeena?oaoe?y aeeeaaeaia ia 104 noi??ieao (aac iieaae/eea e?oa?aoo?e),
?ethno?iaaia 30 ?enoieaie, 12 oaaeeoeyie.

CI?NO AeINE?AeAEAIIss

Iaoa??aee ? iaoiaee aeine?aeaeaiiy. Aeey aeinyaiaiiy aeaii? iaoe ?
iinoaaeaieo caaea/ aoei ianoaaeaii 25 i?aeoe/ii caei?iaeo ethaeae, 20
oai?eo ia a?ia?oii?/io oai?iao ?? noaae?? (AO), 20 oai?eo a?ia?oii?/iith
oi?iith o?ii?/iiai aeiia?oeiiao?eoo (OAI) aac o?ii?/ii? ie?eiai?
iaaeinoaoiino?, 20 oai?eo a?ia?oii?/iith oi?iith o?ii?/iiai i??eiiao?eoo
(O?II) aac o?ii?/ii? ie?eiai? iaaeinoaoiino?, 33 oai?eo ia o?ii?/iee
aeiia?oeiiao?eo c o?ii?/iith ie?eiaith iaaeinoaoi?noth (OII) ??A???A
noaae?? ? 22 oai?eo ia o?ii?/iee i??eiiao?eo c o?ii?/iith ie?eiaith
iaaeinoaoi?noth ??A???A noaae??. Aeey aecia/aiiy oi?ie aeiia?oeiiao?eoo
? i??eiiao?eoo oa noaae?? o?ii?/ii? ie?eiai? iaaeinoaoiino?
aeei?enoiaoaaeany eeaneo?eaoe?y N.?. ?yaiaa. On? oai?? c o?ii?/iith
ie?eiaith iaaeinoaoi?noth ia?aaoaaee ia i?ia?aiiiio aaiiae?ae?c?.

?aae?i?ioiiei niiniaii aecia/aeeny o oai?eo eiioeaio?aoe?y
aeueaeinoa?iio (Aeueae), aia?ioaiceio ? (Aia ?), aeoeai?noue ?ai?io
ieacie (A?I) iao??eo?aoe/iiai iaioeaeo (IOI), ai?iii?a ueoiaeaeii?
caeice O3 ? O4.

Oai?ei ia aaiiae?ae?c? ia ii/aoeo ? a e?ioe? naaino aecia/aeeny
eiioeaio?aoe?? iao??th, eae?th, na/iaeie ? e?aaoei?io.

On?i oai?ei ia i?ia?aiiiio aaiiae?ae?c? i?iaiaeeeany aoiea?ae?ia?ao?y.

Ia i?aenoaa? iaea?aeaieo aaciaeo oa?aeoa?enoee aecia/aeeny ?ic?aooieia?
?iaeaene: e?ioeaaiae?anoie?/iiai ia?io e?aiai oeoii/ea (?EAeI), ?iaeaen
e?ioeaaiai nenoie?/iiai ia?io e?aiai oeoii/ea (?ENI), ?iaeaen iane
i?iea?aea e?aiai oeoii/ea (?IIEO).

E??i aoiea?ae?ia?ao?? aecia/aeeny ?aia?ao?/iee ?iaeaen, a?aeiioaiiy
ae?anoie?/ii? aei nenoie?/ii? oaee?, yea a?aeia?aaea? ni?aa?aeiioaiiy
a?oa??aeueiiai ? aaiiciiai e?iaioieo, a?aeiioaiiy, yea oa?aeoa?eco?
aaee/eio ia?eoa?e/iiai iii?o; iaeneiaeueia oaeaee?noue e?iaaiaiiaiaiiy,
yea oa?aeoa?eco? noai nei?ioeeai? ooieoe?? i?iea?aea, oaeaee?noue
e?iaaiaiiaiaiiy e?oiieo a?eie a?oa??e.

Uia ioe?ieoe nooiai? iane/aiiy e?ia? eeniai, ie aecia/aee ia?oe?aeueiee
oene eenith a ia?eoa?e/i?e e?ia? ia ieneaaiiiao?? o??ie
“Radiometer”Aeai?y.

On?i oai?ei c o?ii?/iith ie?eiaith iaaeinoaoi?noth (OII) aaeany
ae?ae?cia ea?oi/ea. Aei naaino aaiiae?ae?co o?enoaaeany ii/aoeiaa aaaa.
I?ae /an i?iaaaeaiiy aaiiae?ae?co o?enoaaeeny oeeo?e nenoie?/iiai ?
ae?anoie?/iiai a?oa??aeueiiai oeneo, ioeuen eiaei? 30 ? i?aia?aoe, ye?
aaiaeeeeny i?ae /an i?ioeaaeo?e. I?ney naaino a?aei?/aeany e?ioeaaa
aaaa oai?iai.

I?e ia?iaoe? iaea?aeaieo ?acoeueoao?a aoee canoiniaai? iaoiaee
aa??aoe?eii? noaoenoeee c aecia/aiiyi ??aiy cia/ouino? a?aei?iiinoae ca
e?eoa???i Wilcoxon ? aeinoia??iino? a?aei?iiinoae (?), aa?o/e ca
aeinoia??iee ??aaiue cia/aiiy, ii/eiath/e c ?

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