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OA?EIANUeEEE AeA?AEAAIEE IAAeE*IEE OI?AA?NEOAO

E?AOIAEIAA IEAIA IEAA?AIA

OAeE:
616.127–008.1:616.12–005.4-073.432.19:616.132.2-089

OOIEOe?IIAEUeIEE NOAI I?IEA?AeA E?AIAI OEOII*EA O OAI?EO IA ?OAI?*IO
OAI?IAO NA?Oess AeI ? I?NEss AI?OI-EI?IIA?IIAI OOIOOAAIIss.

14.01.11 – ea?ae?ieia?y

AAOI?AOA?AO

aeena?oaoei? ia caeiaoooy iaoeiaiai

nooiaiy eaiaeeaeaoa iaaee/ieo iaoe

Oa?eia – 1999

Aeena?oaoei?th ? ?oeiien

?iaioa aeeiiaia o Oa?eianueeiio ?inoeooo? oaeineiiaeaiiy e?ea??a IIC
Oe?a?ie

oa Oa?e?anueeiio Oeaio?? na?oeaai-noaeeiii? o??o?a?? IIC Oe?a?ie

Iaoeiaee ea?iaiee – eaiaeeaeao iaaee/ieo iaoe, aeioeaio

Oonoaaeue Ieeiea
Oaaei?iae/,

Oa?e?anueeee
?inoeooo oaeineiiaeaiiy e?ea??a

IIC Oe?a?ie,
caaiaeoth/ee eaoaae?ith

ea?ae?ieia?? oa
ooieoe?iiaeueii? ae?aaiinoeee

Ioioeieii iiiiaioe: – aeieoi? iaaee/ieo iaoe, i?ioani?

Aieeia Aieiaeeie?
?aaiiae/,

?inoeooo oa?ai?? AII
Oe?a?ie,

caa?aeoth/ee
a?aeae?eii aoa?ineea?ico oa eiai

oneeaaeiaiue

– aeieoi? iaaee/ieo
iaoe

AEa??iia Ieaa
Eineiiae/,

Ee?anueea iaaee/ia
aeaaeai?y

i?neyaeeieiiii?
ina?oe ?i. I.E. Ooieea,

aeioeaio eaoaae?e
ea?ae?ieia??

? ooieoe?iiaeueii?
ae?aaiinoeee

I?ia?aeiee caeeaae ?inoeooo ea?ae?ieia?? ?i. aeaae.

I.Ae. No?aaeanea AII
Oe?a?ie,

i.Ee?a, a?aeae?e
aoa?ineea?ico oa

?oai?/ii? oai?iae
na?oey

Caoeno aeena?oaoei? aiaeaoaeaoueny “27” o?aaiy 1999 ?. i 13-30

aiaeei? ia caniaeaiii niaoeiaeiciaaii? a/aii? ?aaee Ae 64.600.04. i?e
Oa?eianueeiio aea?aeaaiiio iaaee/iiio oiiaa?neoao? ca aae?anith:

310022, i.Oa?eia, i?. Eai?ia, 4.

C aeena?oaoei?th iiaeia iciaeiieoeny a aiaeiioaoei Oa?eianueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo (310022, i.Oa?eia, i?. Eai?ia,4).

Aaoi?aoa?ao ?icineaii “26” ea?oiy 1999 ?.

A/aiee nae?aoa?

Niaoeiaeiciaaii? A/aii? ?aaee

Aeioeaio
E.?. Ia/a?aiei

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeueiinoue oaie. O??o?a?/ia ?aaaneoey?ecaoe?y i?iea?aea (? cie?aia
iia?aoe?y ai?oi-ei?iia?iiai ooiooaaiiy – AEO) iin?aea? aaaeeeaa i?noea
o ??oaii? i?iaeaie aoaeoeaii? aeiiiiiae oai?ei ia ?oai?/io oai?iao
na?oey (?ON), yea ? iniiaiith i?e/eiith aeieeiaiiy na?oeaai?
iaaeinoaoiino?, ?iaae?aeiino? oa nia?oiino? a on?o ?icaeiaieo e?a?iao
na?oo (Aia?ia A.A.,1996, Eieoia A.A.,1996, Iaea E.O.,1994, Iaoyaeaiei
A.C.,1997) . A?aoiaoth/e oea, a inoaii? ?iee aaeeea oaaaa
i?eae?ey?oueny ieoaiiyi, ui noinothoueny i?eioeei?a a?aeai?o iaoe??io?a
aeey o??o?a?/iiai e?eoaaiiy oa ioe?iee ?acoeueoao?a iia?aoe??. Iaei??th
c iaae??oaieo i?iaeai ? ?ic?iaea ia?iaaceaieo iieaciee?a
ooieoe?iiaeueiiai noaio i?iea?aea e?aiai oeoii/ea (EO) o oai?eo ia ?ON,
ye? a aeiiiiaaaee ia’?eoea?coaaoe aaaee?noue caoai?thaaiiy ia aoai?
ia?aaeiia?aoe?eiiai ianoaaeaiiy, oa ioe?ieoe a?aeaeaeai? ?acoeueoaoe
AEO.

?acoeueoaoe iia?aoe?? AEO caeaaeaoue a?ae eiioeiaaioo oai?eo, aaaeeino?
?oiuei? ee?i?/ii? neiioiiaoeee, oa?aeoa?o o?aaeaiiy ei?iia?iiai ?onea oa
ooieoe?iiaeueiiai noaio i?iea?aea EO (CASS Principal Investigators and
their Associates.Coronary Artery Surgery Study ,1983; Elvio N. et
al.,1997; Hamer A. et al.,1994). Caaaeath/e ia oea, o a?o/eciyi?e oa
?iicaii?e i?aeoeoe? e?eoaaiiy oai?eo ia ?ON aaeeeo oaaao i?eae?eythoue
ieoaiiyi i?eioeei?a a?aeai?o iaoe??io?a aeey o??o?a?/iiai e?eoaaiiy. A
ieioe? ?iee aoei i?iaaaeaii ?yae aaeeeeo i?aeia?iaeieo aeine?aeaeaiue
(The Veterans Administration Study, European Coronary Surgical Study,
Coronary Artery Surgery Study), ui aoee i?enay/ai? aea/aiith yeino?
aeeooy ea?ae?io??o?a?/ieo iaoe??io?a, aoa aeeiiaiee ii??aiyeueiee aiae?c
aoaeoeaiino? iaaeeeaiaioiciiai oa o??o?a?/iiai iaoiae?a e?eoaaiiy, a
oaeiae aea/aii aoaeoeai?noue ??ciiiai?oieo ?aaaneoey?ecoth/eo iia?aoe?e
oa ia?aaaae eiaeiiai c iaoiae?a a caeaaeiino? a?ae iniaeeainoae ia?aa?ao
caoai?thaaiiy (Eieoia A.A., 1996; Oo?eaei N.I.,1987; Ake A.,1992;
Laird-Meeter K.,1983; Peduzzi ?.,1998).

I?ia?aeieie oaeoi?aie, ui aecia/aee iieacaiiy oa ?acoeueoaoe
iia?aoeaiiai e?eoaaiiy o oeeo aeine?aeaeaiiyo aoee aeai?
ei?iia?iaaio?eeoeia?ao??, ye? a?aeia?aaeaee eieae?caoe?th e aaaee?noue
aoa?ineea?ioe/iiai o?aaeaiiy ei?iia?iiai ?onea, a oaeiae noai
nei?i/oaaeueii? ooieoe?? EO. Aoei aeieacaii, ui iecueea aeo?aeia
ooieoe?y EO, iciaeaie yei? ? ciie aneia?a?? oa i?aeaeuaiiy
e?ioeaai-ae?anoie?/iiai oeneo, ui aeyaeythoueny i?ae /an i?iaaaeaiiy
aaio?eeoeia?ao??, cia/ii aieeaathoue ia eaoaeuei?noue ea?ae?io??o?a?/ieo
oai?eo.

O ca’yceo ?c oaeaeeei ?icaeoeii oa oaeineiiaeaiiyi iaaee/ii? oaoi?ee a
inoaii? ?iee c’yaeeenue iia? iiaeeeaino? ae?aaiinoeee aaaeeino?
iaoieia?/iiai i?ioeano oa ooieoe?iiaeueiiai noaio na?oeaaiai i‘yca o
oai?eo ia ?ON. No/ani? oeueo?acaoeia? oa ?aae?iioee?aei? iaoiaee
aeine?aeaeaiiy aeicaieythoue ia o?eueee aeeaoa aea/aoe, aea e ci?ieoe
iaoiaeieia?/iee aniaeo i?aeoiaeo aei a?aeai?o iaoe??io?a aeey
o??o?a?/ii? ?aaaneoey??caoe?? oa ioe?iee ?acoeueoao?a iia?aoe??.
Caaaeyee ?i c’yaeeenue oae? iia? iiiyooy, ye ae?anoie?/ia e nenoie?/ia
aeenooieoe?y na?oey, ”a?aa?ioth/ee“ oa “i?eaieiioeeaee“ i?iea?ae
(Appleton N.,1988; Braunwald A. et al.,1986;1987). Ia?iaaceai?noue,
i?inoioa oa iaaeniea aa?o?noue oeueo?acaoeiaeo iaoiae?a aeine?aeaeaiiy,
iiaeeea?noue iaea?aeoaaoe iaiao?aeio ?ioi?iaoe?th a aeeiai?oe? c?iaeee
?o iacai?iieie ia o?eueee o niaoe?ae?ciaaieo ea?ae?io??o?a?/ieo oa
ea?ae?ieia?/ieo noaoe?iia?ao, aea e ia aoai? aiaoeaoi?iiai aeiaeyaeo ca
iaoe??ioaie o iie?ee?i?eao. Ne?ae, iaeiae, i?aee?aneeoe, ui iacaaaeath/e
ia aeinyaioo? oni?oe o ae?aaiinoeoe? oa o??o?a?/iiio e?eoaaii? oai?eo ia
?ON, aeaye? ieoaiiy caeeoathoueny ua iaaeinoaoiuei aea/aieie.

Ia noi?iiaai? ?aeei? iaoiaeieia?/i? i?aeoiaee aei ianoaaeaiiy oai?eo
ia?aae oa i?ney AEO, ye? a aeeth/aee iioeiaeueia ii?aeiaiiy “ cieioiai
noaiaea?oo” ea?ae?io??o?a?? – ei?iia?iaaio?eeoeia?ao?? oa ia?iaaceaieo
iaoiae?a (aoiea?ae?ia?ao?y, aeiiiea?-aoiea?ae?ia?ao?y,
no?an-aoiea?ae?ia?ao?y). Iaaeinoaoiuei aea/aieie ? ae?aaiinoe/i?
iiaeeeaino? iaaaioaaeoaaeueieo iaaeeeaiaioicieo i?ia o ii?aeiaii? c
oeueo?acaoeiaeie iaoiaeaie (no?an-aoiea?ae?ia?ao?y) aeey ia’?eoea?caoe??
nei?i/oaaeueii? ooieoe?? i?iea?aea EO ia?aae iia?aoe??th AEO. Aaeeeee
i?aeoe/iee ?ioa?an ia? aea/aiiy iniaeeainoae aieeao AEO ia ae?anoie?/io
ooieoe?th EO, ?? aeeiai?eo o a?aeaeaeai? no?iee i?ney iia?aoe??,
aca?iica’ycie ?c iniaeeainoyie ee?i?/iiai ia?aa?ao caoai?thaaiiy oa
noaiii nenoie?/ii? ooieoe?? EO. Iio?aaothoue ooi/iaiiy
aoiea?ae?ia?ao?/i? (AoiEA) oa aeiiiea?-aoiea?ae?ia?ao?/i?
(aeiiiea?-AoiEA) e?eoa???, ui aeicaieyee a ia’?eoeaii ioe?ithaaoe
ooieoe?iiaeueiee noai na?oeaaiai i’yca o a?aeaeaeai? no?iee i?ney AEO ?
cae?enithaaoe niaaeei?ii?noue i?ae ea?ae?io??o?a?/iith oa
ea?ae?ieia?/iith eaieaie e?eoaaiiy iaoe??io?a.

Oaeei /eiii, aea/aiiy ooieoe?iiaeueiiai noaio i?iea?aea EO o oai?eo ia
?ON ia aoai? ia?aaeiia?aoe?eiiai ianoaaeaiiy oa i?ney AEO , a oaeiae
?ic?iaea iiaeo i?aeoiae?a aei ia’?eoea?caoe?? eiai ooieoe?? ca
aeiiiiiaith oeueo?acaoeiaeo iaoiae?a ? aeineoue aeooaeueiith oa
aaaeeeaith caaea/ath.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Aea?aiee
iai?yiie aeine?aeaeaiue iia’ycaiee c iaoeiaith ae?yeuei?noth e aoiaeeoue
aei oaiaoe/iiai ieaio eaoaae?e ea?ae?ieia?? oa ooieoe?iiaeueii?
ae?aaiinoeee Oa?e?anueeiai ?inoeoooo oaeineiiaeaiiy e?ea??a ye o?aaiaio
iaoeiai-aeine?aeii? ?iaioe – ?a?no?. ? 0198U002291-“Oaeineiiaeaiiy
iaoiae?a ia?iaaceaii? ae?aaiinoeee oa e?eoaaiiy oai?eo ia ?ON i?ney
?ioa?eoo i?iea?aea”.

Iaoa ? caaaeaiiy aeineiaeaeaiiy. Iaoa ?iaioe – oaeineiiaeaiiy
ia?iaaceaii? ae?aaiinoeee ooieoe?iiaeueiiai noaio i?iea?aea EO o oai?eo
ia ?ON aei ? i?ney iia?aoe?? ai?oi-ei?iia?iiai ooiooaaiiy oa aecia/aiiy
ae?aaiinoe/ieo iiaeeeainoae oeueo?acaoeiaeo iaoiae?a aeine?aeaeaiiy
na?oey uiaei onoaiiaeaiiy oyaeeino? caoai?thaaiiy, i?iaiicoaaiiy ?eceeo
oa ioe?iee aoaeoeaiino? o??o?a?/ii? ?aaaneoey?ecaoe?? i?iea?aea.

A?aeiia?aeii aei iinoaaeaii? iaoe aoei aecia/aii oae? caaaeaiiy:

1. Anoaiiaeoe iniiai? AoiEA e aeiiiea?-AoiEA iieacieee nenoie?/ii?
ooieoe?? i?iea?aea e?aiai oeoii/ea, ye? a?aeia?aaeathoue oyaee?noue ?ON
e iiaeooue aeei?enoaoeny ia aoai? a?aeai?o oai?eo ia o??o?a?/io
?aaaneoey?ecaoe?th i?iea?aea, a oaeiae aeicaieythoue ia’?eoea?coaaoe
noai aioo??oiueina?oeaai? aaiiaeeiai?ee oa iniaeeaino? ee?i?/iiai
ia?aa?ao a?aeaeaeaiiai i?neyiia?aoe?eiiai ia??iaeo.

2. C’ynoaaoe aieea o??o?a?/ii? ?aaaneoey?ecaoe?? i?iea?aea ia nenoie?/io
ooieoe?th e?aiai oeoii/ea a caeaaeiino? a?ae ?? aeo?aeiiai ??aiy.

3. Aecia/eoe ae?aaiinoe/io oe?ii?noue iaaeeeaiaioicii?
no?an-aoiea?ae?ia?ao?? c aeiaooai?iii oa ao?ii?iii o aeyaeaii? oyaeeino?
oa eieae?caoe?? ?oai?/iiai o?aaeaiiy i?iea?aea e?aiai oeoii/ea i?e ?ON.

4. Iaa?oiooaaoe aeioe?euei?noue aeei?enoaiiy no?an-aoiea?ae?ia?ao?? c
iecueeeie aeicaie aeiaooai?io ye iaoiaeo a?aeai?o iaoe??io?a ia
iia?aoe?th ai?oi-ei?iia?iiai ooiooaaiiy oa i?iaiicoaaiiy ??
?acoeueoao?a.

5. C’ynoaaoe aieea ai?oi-ei?iia?iiai ooiooaaiiy ia ae?anoie?/io
ooieoe?th e?aiai oeoii/ea oa oaeoi?e, a?ae yeeo caeaaeeoue nooi?iue ??
iie?auaiiy i?ney iia?aoe??.

6. Aecia/eoe iniiai? ci?ie iieaciee?a ae?anoie?/ii? ooieoe?? e?aiai
oeoii/ea, ye? a?aeia?aaeathoue ooieoe?iiaeueiee noai na?oeaaiai i’yca oa
oa?aeoa? ia?aa?ao ?ON o a?aeaeaeai? no?iee i?ney o??o?a?/ii?
?aaaneoey?ecaoe??.

Iaoeiaa iiaecia ?iaioe. A ?acoeueoao? aea/aiiy aeeiai?ee
nenoie?/ii? oa ae?anoie?/ii? ooieoe?? i?iea?aea EO o oai?eo ia ?ON aei e
i?ney iia?aoe?? AEO anoaiiaeaii iniiai? AoiEA oa aeiiiea?-AoiEA
iieacieee, ye? aeicaieythoue ia’?eoea?coaaoe aaaee?noue ee?i?/ii?
neiioiiaoeee oa o?aaeaiiy a?ioeaaiai ?onea o oai?eo ia ?ON, a oaeiae
iniaeeaino? ia?aa?ao a?aeaeaeaiiai ia??iaeo i?ney AEO. Aeyaeaii aenieo
ae?aaiinoe/io oe?ii?noue cai?iiiiiaaii? iiaeeo?eaoe?? iaoiaeo
no?an-AoiEA c aeiaooai?iii oa ao?ii?iii aeey ioe?iee nooiaiy oyaeeino?
e eieae?caoe?? ?oai?/iiai o?aaeaiiy i?iea?aea EO o oai?eo ia ?ON.
C’yniaaii ae?aaiinoe/i? iiaeeeaino? no?an-AoiEA c iecueeeie aeicaie
aeiaooai?io ye iaeiiai c iaoiae?a a?aeai?o oai?eo ia o??o?a?/io
?aaaneoey?ecaoe?th i?iea?aea oa i?iaiicoaaiiy ?acoeueoao?a AEO.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a. Cai?iiiiiaaii eiiieaeniee
i?aeo?ae aei ioe?iee ooieoe?iiaeueiiai noaio i?iea?aea EO o oai?eo ia
?ON c aeei?enoaiiyi oeueo?acaoeiaeo iaoiae?a aeine?aeaeaiiy; aecia/aii
iniiai? AoiEA oa aeiiiea?-AoiEA e?eoa??? aaaeeino? iaoieia?/iiai
iioeano, ui iiaeiii ni?eyoe aeae?eaiith a?oi iaoe??io?a, ye?
iio?aaothoue o??o?a?/iiai e?eoaaiiy. Iaa?oioiaaii iaiao?aei?noue
oe?ieiai aeei?enoaiiy iaaeeeaiaioicii? no?an-AoiEA o oai?eo ia ?ON c
iaoith aeyaeaiiy oyaeeino? e eieae?caoe?? ?oai?? na?oeaaiai i’yca, a
oaeiae aeey aeyaeaiiy aeeoo?caeaoiueiai i?iea?aea, yeee iio?aao?
o??o?a?/ii? ?aaaneoey?ecaoe??. Aecia/aii iniiai? iieacieee, ye?
a?aeia?aaeathoue aeeiai?eo nenoie?/ii? oa ae?anoie?/ii? ooieoe?? EO ?
iiaeooue aooe aeei?enoai? i?ae /an aeeiai?/iiai aeiaeyaeo ca iaoe??ioaie
i?ney AEO.

Aeei?enoaiiy cai?iiiiiaaii? iaoiaeeee no?an-AoiEA ianoaaeaiiy, a
oaeiae eiiieaeniiai aea/aiiy nenoie?/ii? oa ae?anoie?/ii? ooieoe?? EO o
ea?ae?io??o?a?/ieo oai?eo ia ?ON ca aeiiiiiaith iaoiae?a AoiEA oa
aeiiiea?-AoiEA aena?oeth?oueny o eaeoe?eieo eo?nao ia eaoaae??
ea?ae?ieia?? oa ooieoe?iiaeueii? ae?aaiinoeee Oa?e?anueeiai ?inoeoooo
oaeineiiaeaiiy e?ea??a. Eiiieaen ae?aaiinoe/ieo oeueo?acaoeiaeo
e?eoa???a oyaeeino? ee?i?ei-ii?oieia?/iiai ia?aa?ao caoai?thaaiiy
ai?iaaaeaeaii a i?aeoe/io ?iaioo a?aeae?eaiue ooieoe?iiaeueii?
ae?aaiinoeee Oa?e?anueeiai Oeaio?o na?oeaai-noaeeiii? o??o?a?? IIC
Oe?a?ie, IN* OCOAe ?2 i. Oa?eiaa, Oa?e?anueeiai iaoeiai-aeine?aeiiai
?inoeoooo caaaeueii? oa iaa?aeeeaaeii? o??o?a?? IIC Oe?a?ie, ?inoeoooo
oa?ai?? AII Oe?a?ie, ?inoeoooo ea?ae?ieia?? ?i. aeaae. I.Ae. No?aaeanea
AII Oe?a?ie, ?inoeoooo na?oeaai-noaeeiii? o??o?a?? AII Oe?a?ie, ui
ni?eyei i?aeaeuaiith yeino? ianoaaeaiiy oai?eo ia ?oai?/io oai?iao
na?oey.

Iniaenoee aianie caeiaoaa/a. Aaoi?ii iniaenoi i?iaaaeaii ee?i?/ia
oa ?ino?oiaioaeueia ianoaaeaiiy oai?eo, ui iinooiaee aeey o??o?a?/iiai
e?eoaaiiy ?ON o Oa?e?anueeee Oeaio? na?oeaai-noaeeiii? o??o?a??, a
oaeiae aeeniaina?iee iaaeyae ca iaoe??ioaie, ye? ia?aianee iia?aoe?th
AEO. Aaoi?ii aoa oaeineiiaeaiee i?ioieie i?iaaaeaiiy no?an-AoiEA
ianoaaeaiiy, i?iaaaeaii noaoenoe/io ia?iaeo ?acoeueoao?a aeine?aeaeaiiy,
iioae?eiaaii iaeyaeia? oa i?ea?iaeuei? noaoo?, ioi?ieaia aeena?oaoe?eia
?iaioa e aaoi?aoa?ao.

Aaoi? aeneiaeth? aeeaieo iiaeyeo ea??aieoeoao Oa?e?anueeiai Oeaio?o
na?oeaai-noaeeiii? o??o?a?? ? iniaenoi eiai aee?aeoi?ia? – aeieoi?o
iaaee/ieo iaoe, i?ioani?o I.E. Aieiaeinth ca aaeeeo oai?aoe/io e
i?aeoe/io aeiiiiiao i?ae /an i?iaaaeaiiy aeine?aeaeaiiy.

Ai?iaaoeiy ?acoeueoaoia aeena?oaoei?. ?acoeueoaoe ?iaioe
iiaiaeiieaii ? iaaiai?aii ia III I?aeia?iaei?e eiioa?aioe?? c
No?an-aoiea?ae?ia?ao?? (Oei?aioe?y, ?oae?y,1998 ?.), ?anioae?eainueeeo
iaoeiai-i?aeoe/ieo eiioa?aioe?yo o Oa?eia? (1997 ?.), V Eiia?ano
ea?ae?ieia?a Oe?a?ie (Ee?a, 1997), V Iaoeia?e eiioa?aioe??
na?oeaai-noaeeiieo o??o?a?a Oe?a?ie (Ee?a, 1997).

Ioaeieaoei?. Ca iaoa?iaeaie aeena?oaoei? aeaeaii 5 iaoeiaeo noaoae, 6
oac aeiiia?aeae ia iaoeiaeo eiioa?aioe?yo oa ioi?ieaii 1 iaoaio ia
aeiao?ae, ca?a?no?iaaiee a Oe?a?i?.

No?oeoo?a oa ianya aeena?oaoe??. Aeena?oaoeiy aeeeaaeaia ia 177
noi?iieao iaoeiiieniiai oaenoo. Neeaaea?oueny c? anooio, 3
i?ae?icae?e?a iaeyaeo eioa?aoo?e, 8 i?ae?icae?e?a aeanieo
aeine?aeaeaiue, iaaiai?aiiy caeiaooeo ?acoeueoao?a, aeniiaeia,
i?aeoe/ieo ?aeiiaiaeaoeie, aeiaeaoe?a (ia 2 noi??ieao) oa nieneo
e?oa?aoo?e. ?iaioa iethno?iaaia 24 iaethieaie oa 34 oaaeeoeyie, ui
neeaaea? 28 noi??iie. Aei aiaeiia?aoi? aoiaeyoue 46 i?aoeue
oe?a?inueeeo ? ?in?enueeeo oa 116 caei?aeiiieo aaoi?ia, ui neeaaea? 19
noi??iie.

CI?NO ?IAIOE

Iaoa??ae ? iaoiaee aeine?aeaeaiiy. Ianoaaeaii 70 oai?eo ia ?ON (68
/ieia?e?a oa 2 ae?iee), a?eii a?ae 28 aei 63 ?ie?a (na?aaei?e a?e- 47,7
6,2 ?.), yeei o 1991-1998 ??. aoei i?iaaaeii iia?aoe?th AEO a
Oa?e?anueeiio Oeaio?? na?oeaai-noaeeiii? o??o?a??. Na?aae ieo 7 oai?eo
ia?aianee ?aaaneoey?ecaoe?th i?iea?aea o 1991-1993 ??., ?ioeo 63 – aoei
iine?aeiaii i?iiia?iaaii c aa?aniy 1994 ii aa?anaiue 1998 ?. Na?aaeiy
o?eaae?noue caoai?thaaiiy ia iiiaio ia?aeiiiai ianoaaeaiiy noaiiaeea 4,6
3,7 ?., na?aaei?e no?ie aeiaeyaeo ca iaoe??ioaie i?ney iia?aoe?? AEO
noaiiaea 3,2 1,4 ?. A aeine?aeaeaiiy ia aeeth/aee oai?eo c oyaeeeie
o?aaeaiiyie eeaiaiiiai aia?aoo na?oey, i?ioeiieacaiiyie aei i?iaaaeaiiy
ei?iia?iaia?ia?ao?? (EAA), a oaeiae iaoe??io?a, o yeeo aoei ia iiaeeeai
io?eiaoe ye?niiai cia?aaeaiiy na?oey i?ae /an AoiEA ianoaaeaiiy.

Ia?aae iia?aoe??th ianoaa?eueio noaiiea?ae?th aoei ca?a?no?iaaii o 9
in?a, ?io? iaee noaa?eueio noaiiea?ae?th II-IV ooieoe?iiaeueieo eean?a
(OE). ?ioa?eo i?iea?aea (?I) ?c coaoeai Q aoa a aiaiiac? o 35
ianoaaeaieo, c ?icaeoeii o?ii?/ii? aiaa?ecie na?oey o 8 aeiaaeeao. 58
oai?eo iaee iciaee na?oeaai? iaaeinoaoiino? (NI) I-III ooieoe?iiaeueieo
eean?a (OE) ca eeaneo?eaoe??th Iueth-Ei?enueei? ea?ae?ieia?/ii?
anioe?aoe?? (NYHA). Ca ?acoeueoaoaie EAA 14 in?a iaee o?aaeaiiy 1
ei?iia?ii? a?oa??? (EA), 17- 2 EA ? 39 – o?aaeaiiy 3 aieiaieo EA oa
?oi?o a?eie.

On?o iaoe??io?a aoei ?iciiae?eaii ia 2 a?oie. Iniiaiei e?eoa???i aoea
iayai?noue aai a?aenooi?noue ia iiiaio iaaeoiaeaeaiiy aei
ea?ae?io??o?a?/iiai noaoe?iia?o iciae ciaioaiiy nei?i/oaaeueii? ooieoe??
EO ca aeaieie AoiEA. Aei ia?oi? a?oie iaae?eoei 48 iaoe??io?a aac yaieo
iciae nenoie?/ii? aeenooieoe?? EO (NAeOEO) e iieacieeii o?aeoe?? aeeeaeo
(OA EO) 50%. Ae?oao a?oio neeaee 22 oai?eo, ui iaee iciaee ciaioaiiy
nei?ioiino? i?iea?aea EO oa OA EO0,1), ee?i?/ia neiioiiaoeea aoea a?eueo ae?aciith o
oai?eo c a?oie II, ?c iciaeaie NAeOEO (OA0,1). Oae? ci?ie
aoee i?e/eiith a??ia?aeiiai cieaeaiiy o?aeoe?? nei?ioiino? EO – ON
(p0,05), ui iiaeia iiynieoe a?aenooi?noth aeeeaoaoe?? EO o
niie?eiiio noai?. Oaeee oei aaiiaeeiai?/ii? a?aeiia?ae? ia aaaaeaiiy
iecueeeo aeic neiiaoii?iaoeea aoa ?icoe?iaiee ye iciaea iayaiino? o
oai?eo aeeoo?caeaoiueiai i?iea?aea, iio?aaoth/iai ?aaaneoey?ecaoe??.

O ae?oa?e a?oi? iiceoeaii? aeeiai?ee nei?i/oaaeueii? ooieoe?? EO
aeyaeaii ia aoei. A?eueo oiai, o /anoeie iaoe??io?a aoei cao?eniaaii
cieaeaiiy eiai ooieoe?iiaeueii? aeoeaiino?, /oi i?iyaeeiny ciaioaiiyi OA
EO (p0,1). Oaeo aeeiai?eo
ia’?iieo iieaciee?a ne?ae aoei /aeaoe, ine?eueee a aeai?e a?oi?
iaoe??io?a ia aoei cao?eniaaii aeo?aeii? aeeeaoaoe?? EO, a iii??ia
cieaeaiiy OA EO iiynithaaeiny iayai?noth aeaa?ioth/iai i?iea?aea,
ooieoe?y yeiai aoea a?aeiiaeaia oeyoii AEO. A aeai?e a?oi? aeyaeaii
iie?auaiiy AoiEA ia?aiao??a oeaio?aeueii? aaiiaeeiai?ee – OI (p

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