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Функціональний стан зсідально-протизсідальної системи крові у хворих на гострий панкреатит: Автореф. дис… канд. мед. наук / А.С. Барвінська, Львів.

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EUeA?ANUeEEE AeA?AEAAIEE IAAeE*IEE OI?AA?NEOAO

ii. AeAIEEA Aaeeoeueeiai

Aa?aiinueea Aiia Noaiaiiaia

OAeE: 616.37 – 002 – 036.11 – 092: 612.115

Ooieoeiiiaeueiee noai cniaeaeueii-i?ioecniaeaeueii? nenoaie e?iai o
oai?eo ia aino?ee iaie?aaoeo

14.01.03 – O??O?A?ss

Aaoi?aoa?ao

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

EUeA?A – 1999

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia o Euea?anueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao?

ii. Aeaieea Aaeeoeueeiai I?i?noa?noaa
ioi?iie caei?ia’y Oe?a?ie

Iaoeiaee ea?iaiee – aeieoi? iaaee/ieo iaoe, i?ioani?

Iaea?
Aeieo?i A?naiiae/

i?ioani? eaoaae?e
oaeoeueoaonueei? oa caaaeueii?
o??o?a?? Euea?aueeiai aea?aeaaiiai iaaee/iiai

oi?aa?neoaoo ii. Aeaieea Aaeeoeueeiai

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

Ea/i?ianueeee Aiaaeai Aieiaeeie?iae/

caa.
a?aeae?eaiiy o??o?a?? oa ee?i?/ii? o?ainooc?ieia??

Euea?anueeiai iaoeiai-aeine?aeiiai ?inoeoooo

iaoieia?? e?ia? ? o?ainooc?eii? iaaeeoeeie


aeieoi? iaaee/eieo iaoe, i?ioani?,

cane.
aeiy/ iaoee Oe?a?ie

Oaa/oe Ieoaeei A?eai?i?ae/

caa.
eaoaae?e oieoaeueii? o??o?a??

?aaii-O?aie?anueei? aea?aeaaii? iaaee/ii? aeaaeai??

I?ia?aeia onoaiiaa – ?inoeooo ee?i?/ii?
oa aenia?eiaioaeueii? o??o?a??

AII
Oe?a?ie, a?aeae?e o??o?a?? i?aeoeoieiai?

caeice i aeia/ieo oeyoia

Caoeno aeena?oaoe?? a?aeaoaeaoueny “ 26 ” aa?aciy 1999 ?ieo i
13 00 aiaeei? ia can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 35.600.01.
o Euea?anueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao? ii. Aeaieea
Aaeeoeueeiai (290010, i. Euea?a, aoe. Iaea?nueea, 69).

C aeena?oaoe??th iiaeia iciaeiieoeny a iaoeia?e a?ae?ioaoe?
Euea?anueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo ii. Aeaieea
Aaeeoeueeiai (290000, i. Euea?a, aoe. N?/iaeo No??eueoe?a, 6).

Aaoi?aoa?ao ?ic?neaiee “ 20 ” ethoiai 1999 ?ieo.

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee
*oee?i N.I.

Caaaeueia oa?aeoa?enoeea ?iaioe

Aeooaeueiinoue oaie. Aino?ee iaie?aaoeo (AI) ca /anoioith aeieeiaiiy,
ao?ieia??th oa iaoiaaiacii, aaaeeinoth ee?i?/iiai ia?aa?ao, neeaaeiiuaie
ae?aaiinoeee ? iacaaeiaieueieie ?acoeueoaoaie e?eoaaiiy caeia? iaeia c
i?iaiaeieo i?noeue na?aae iecee no/anieo i?iaeai iaaiaeeeaaeii?
oi?o?ai?. sse na?ae/aoue aeai? e?oa?aoo?e AI caeia? o?aoth noiaeeio a
no?oeoo?? iaa?aeeeaaeieo aaaeii?iaeueieo iicieia?e [Caeoeaa A.O. e
niaao., 1991; Iaiei A.A. e niaao., 1993; Artaza Varasa T. et al., 1994].
A Oe?a?ii iieacieee caoai?thaaiino? ia AI iacia/ii ia?aaeuothoue
naioiai ?iaii e neeaaeathoue 4,0-4,2 aeiaaeeia ia 10 oeny/ ianaeaiiy
[Iiiiia?aiei A.I. ? ni?aaao., 1994].

Ia caaaeath/e ia iaaiee i?ia?an o ae?aaiinoeoe? oa e?eoaaii? AI, ?yae
aniaeo?a eiai iaoiaaiaco caeeoathoueny inoaoi/ii ia ?ice?eoeie. Aiaeoae
i?ia?aia e?eoaaeueii-oaeoe/ieo ae?e i?e oeie iaoieiai? iineoue
caeaa?eueoiai neiioiiaoe/iee oa?aeoa?. Oea ii?yae c ?ioeie
aeaoa?i?ioth/eie oaeoi?aie iicia/a?oueny ia iieacieeao eaoaeueiino?, yei
eieeaathoueny a iaaeao aiae 5,1-14,9 % caaaeii [Aeaee?ei A.I., 1990;
Banerjee A.K. et al., 1995; Lankisch P.G. et al., 1996] aei 80 % i?e
aeano?oeoeaieo oi?iao caoai?thaaiiy [Caeoeaa A.O. e niaao., 1991;
Oaeeiia N.A. e niaao., 1992; Aaa?eeaiei A.A. e niaao., 1996; Fagniez
P.L. et al., 1994; Padillo F.J. et al., 1995]. ?c iaaaaeaieo oaeo?a
neiaeo?, ui iiooe oeyo?a iieiioaiiy ?acoeueoao?a oi?o?ai/iiai e?eoaaiiy
AI ioneoue ??oiooaaoeny ia iiaeeaeaiiio aea/aiii eiai iaoiaaiaco.

I?iaiaeia cia/aiiy a ?icaeoeo AI iaeaaeeoue aeoeaaoe?? i?ioa?iac ?
e?iace [Gabryelewicz A. et al., 1993]. Oei oa?iaioe ia?aeiii
ooeiaeaeothoue aoeeia?i? ee?oeie, a ioaea ca?eueiythoue /eneaiii
iaae?aoi?e caiaeaiiy. Ca o/anoth o?iiaioeeo?a ? oaaioeeo?a
aiaeaoaa?oueny aeeth/aiiy a iaoieiai/iee i?ioean i?e?ioee?eoeyoi?iiai
?onea oa niieo/ii? oeaieie i?aeoeoieiai? caeice. Aeaye? aeine?aeieee
[Dominguez-Munoz J.E. et al., 1995] oa?aeoa?ecothoue AI, ye caiaeueia
caoai?thaaiiy c nenoaiiith a?aeiia?aeaeth, yea iieyaa? o aca?iiaei?
eaeeioeeo?a, aiaeioae?ioeeo?a, o?a?iaeano?a i ??cieo i?ioaie?oe/ieo
nenoai (eiaaoeyoe??, o?a?eiie?co, eae?e?a?iiai?, eiiieaiaioa?ii? oa
ii.). Oaeoe/ii aiieiai/iith noooth iaoiaaiaoe/iiai eaioethaa oeueiai
caoai?thaaiiy ? aiaeioieneeic, yeee na?aae iioiai aeanoaaieico?
?iaiiaaao i cn?aeaeueii-i?ioecn?aeaeueii? nenoaie e?ia?. Ii?ooaiiy
o?c?ieia?/iiai aaeaino i?ae i?ioeanaie cn?aeaiiy ? i?ioecn?aeaiiy ?
iaia“yceiaei eiiiiiaioii aiaeioieneeico aoaeue-yeiai aaiaco, a oiio
/ene?, i iaie?aaoiaaiiiai. sse aeaco? iecea aaoi??a [Iaaeianeee Ae.I.,
1987; Iaaeianueeee I.I. ? ni?aaao., 1997; Oeeei A.E. e niaao., 1997] ia
iaaiiio aoai? ia?aa?ao aeania oei ?iceaaee iiaeooue aecia/aoe
iani?eyoeeaee i?iaiic caoai?thaaiiy.

Ia caaaeath/e ia iaaaaeaia, aeioaia?ioiie noai ?ic?iaee i?iaeaie AI ia
aiaeiiaiaea? ?aaeueiei aeiiaai no/anii? iaaeeoeeie. Aeini, aieiaiee
iai?yiie aeineiaeaeaiue iaiaaeoaaany aea/aiiyi ciii
cniaeaeueii-i?ioecniaeaeueii? nenoaie e?iai i?e ie?aieo oi?iao AI
[Iaaeianeee Ae.I., 1987; Iao?ooiaa E.Ae., 1988; Eoeueyiia E.A. e
niaao., 1991; Eoiaeueoeaa A.E. e niaao., 1991; Iaaeianueeee I.I. ?
ni?aaao., 1997; Lasson A. et al., 1986; Gabryelewicz A. et al., 1993].
Iayai? ioae?eaoe?? iathoue caeaa?eueoiai o?aaiaioa?iee oa?aeoa? ? ia
aeathoue oe?e?niiai oyaeaiiy i?i oeae aniaeo iaoiaaiaco AI. O a?eueoino?
c ieo a?aenooi?e nenoaiaoeciaaiee i?aeo?ae aei aeeiai?ee caaaeaieo
ii?ooaiue a?aeiia?aeii aei ia?aa?ao caoai?thaaiiy, ia ?nio?
ae?aaiinoe/ii-i?iaiinoe/ieo i?ia?ai, ui aeeth/aee a aaiinoac?ieia?/i?
oanoe, ia ?ic?iaeaia e?eoaaeueii-oaeoe/ia i?ia?aia ae?e c o?aooaaiiyi
ii?ooaiue cniaeaeueii-i?ioecniaeaeueii? nenoaie e?iai.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Aeeiiaia
aeineiaeaeaiiy ? o?aaiaioii iaoeiai-aeineiaeii? ?iaioe eaoaae?e
caaaeueii? oi?o?ai? Eueaianueeiai aea?aeaaiiai iaaee/iiai oiiaa?neoaoo
ii. Aeaieea Aaeeoeueeiai (EAeIO) ?01930009040 ca oaiith: “?ic?iaea
aeiaaiinoe/ii? oa eieoaaeueii? oaeoeee i?e aino?iio iaie?aaoeoi,
iniiaaii? ia canoinoaaiii aeiaaiinoe/iiai aeai?eoio, iioeiaeueieo
oi?o?ai/ieo ao?o/aiue ia i?aaiao aieia?iiai o?aeoo i iiaeoeoieiai?
caeice, a oaeiae iaoiaeao ?aaiiia?ii? oa?aii?”.

Iaoa i caaea/i aeineiaeaeaiiy. Iaoa – iieiioaiiy ?acoeueoao?a
oi?o?ai/iiai e?eoaaiiy aino?iai iaie?aaoeoo oeyoii iioeiicaoei?
aeiaaiinoe/ieo oa eieoaaeueii-oaeoe/ieo i?ia?ai ia iiaenoaai aea/aiiy
ooieoe?iiaeueieo ciii cn?aeaeueii-i?ioecn?aeaeueii? nenoaie e?ia?.

Caaea/i aeineiaeaeaiiy:

1. Aecia/eoe ca iaoieiaiaiaoiii/ieie iaoa?iaeaie ieoiio aaao
o?iiaiaaii?aai/ieo oneeaaeiaiue i?e AI oa ?o aieea ia iacaaeiaieueii
aeneiaee eieoaaiiy.

2. C’ynoaaoe aeeiaiieo ooieoeiiiaeueieo ciii
cn?aeaeueii-i?ioecn?aeaeueii? nenoaie e?ia? caeaaeii a?ae oi?ie oa
ia??iae?a ee?i?/iiai ia?aa?ao AI.

3. Ioeiieoe ae?aaiinoe/io ?ioi?iaoeai?noue aaiinoac?ieia?/ieo oano?a i?e
AI, ?ici?aoethaaoe oa aaeineiiaeeoe iaoiaee ae?aaiinoeee ii?ooaiue
cn?aeaeueii-i?ioecn?aeaeueii? nenoaie e?ia?.

4. Iioeiicoaaoe i?eioeeiiai e?eoaaeueii-oaeoe/ii i?ia?aie aeey oai?eo
iaa?yeiaith oa aeano?oeoeaiith oi?iaie AI c o?aooaaiiyi iaoiaaiaoe/ieo
iaoai?ci?a ii?ooaiue aaiinoaco. ?ic?iaeoe noaie iioaineaii? oa?aii? i?e
noaeeiii/ieo ii?ooaiiyo cniaeaeueii-i?ioecniaeaeueii? nenoaie e?iai.

5. C“ynoaaoe aieea iia?aoe?eii? o?aaie ia o?a?eiie?oe/io aeoeai?noue
e?ia? o ??ci? ia??iaee eeiii/iiai ia?aaiao iaie?aiiae?ico, ii?aoethaaoe
iioeiaeuei? canaaee ?o i?ioieaeoeee oa aei- i iineyiia?aoeieii?
ei?aeoei?.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoaoia. Aia?oa nenoaiaoeciaaii
iaoieiaiaiaoii?/ii iciaee ii?ooaiue cniaeaeueii-i?ioecniaeaeueii?
nenoaie i?e ??cieo oi?iao AI aiaeiiaiaeii aei ee?i?/iiai ia?aa?ao
caoai?thaaiiy, noaa?aeaeaii aca?iica’ycie ?o eaai?aoi?ieo, eeiii/ieo i
iaoieiaiaiaoiii/ieo i?iyaia. Cai?iiiiiaaii i?eioeei noaeeiii/ii?
aa?eoieaoei? ii?ooaiue aaiinoaco. Aaeineiiaeaii aeiaaiinoeeo ii?ooaiue
cniaeaeueii-i?ioecniaeaeueii? nenoaie e?iai. C“yniaaii aeeiaiieo anio
eaiie aaiinoaco i?e iaa?yeiaiio iaie?aaoeoi; eiinoaoiaaii, ui i?e oeie
oi?ii caoai?thaaiiy iathoue iinoea ii?ooaiiy
cniaeaeueii-i?ioecniaeaeueii? nenoaie e?iai, a oiio /enei AeAC-neiae?ii.
Ie?aneaii ii?ooaiiy eiaeii? c eaiie aaiinoaco aiaeiiaiaeii aei ia?iiaeia
eeiii/iiai ia?aaiao iaie?aiiae?ico, a oaeiae aeeiaiieo oeeo ciii o
ia?iiae aiieii-naioe/ieo oneeaaeiaiue. Iioeiiciaaii i?ia?aio
eieoaaeueii-oaeoe/ieo aeie. Aia?oa c“yniaaii aieea iia?aoe?eii? o?aaie
ia o?a?eiie?oe/io aeoeai?noue e?ia? o ??ci? ia??iaee iaie?aiiae?ico ?
?ic?iaeaii iioeiaeueii canaaee ?o i?ioieaeoeee oa aei – i
i?neyiia?aoe?eii? ?ioaineaii? oa?ai??.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoaoia. Iaoeia? iieiaeaiiy oa
aeniiaee aeena?oaoe?eii? ?iaioe aaeaioiaaii aeey ai?iaaaeaeaiiy oa
canoinoaaiiy a i?aeoe/iie ioi?iii caei?ia’y.

Ia??oioiaaii aeioe?euei?noue o?aeooaaiiy ii?ooaiue
cniaeaeueii-i?ioecniaeaeueii? nenoaie e?iai ye iaeiiai c i?iaiaeieo
iaoiaaiaoe/ieo iaoaiiciia AI. Ie?aneaii ieceo ae?aaiinoe/ieo e?eoa???a
ii?ooaiue cniaeaeueii-i?ioecniaeaeueii? nenoaie e?iai; aecia/aii
iioeiaeueiee aeiaaiinoe/iee eiiieaen aeey noaeeiii/ii? aa?eoieaoei?
oei?? iaoieiai?, ui nooo?ai i?aeaeuo? aoaeoeai?noue ae?aaiinoeee
ii?ooaiue aaiinoaco (iina?ae/aiiy ia ?aoe?iiae?caoi?nueeo i?iiiceoe?th ?
610, aeaeaia 10.10.1991 ?. A??Aii aiaeaeieo ioi?iie caei?ia’y
Eueaianueeiai iaeaeeiieiio; iinaiae/aiiy ia ?aoeiiiaeicaoi?nueeo
i?iiiceoeith ? 708, aeaeaia 15.07.1997 ?. A?IAii aieiaiiai oi?aaeiiiy
ioi?iie caei?ia’y Eueaianueei? iaeaea?aeaaeiiiino?aoei?). Aaeineiiaeaii
niinia eieoaaiiy AeAC-neiae?iio o oai?eo ia AI (iina?ae/aiiy ia
?aoe?iiae?caoi?nueeo i?iiiceoe?th ? 707, aeaeaia 15.07.1997 ?. A??Aii
aieiaiiai oi?aaeiiiy ioi?iie caei?ia’y Eueaianueei?
iaeaea?aeaaeiiiino?aoei?). Aaeineiiaeaii niinia aioeo?iiaioe/ii?
oa?aii? a eiiieaeniiio eieoaaiii AI (iina?ae/aiiy ia
?aoe?iiae?caoi?nueeo i?iiiceoe?th ? 706, aeaeaia 15.07.1997 ?. A??Aii
aieiaiiai oi?aaeiiiy ioi?iie caei?ia’y Eueaianueei?
iaeaea?aeaaeiiiino?aoei?). Aiaeiiaiaeii aei aeyaeaieo aiaeoeeaiue o
oia?eiieioe/iie aeoeaiinoi e?iai o ?icii ia?iiaee eeiii/iiai ia?aaiao
caoai?thaaiiy iioeiiciaaii aei – i iineyiia?aoeieio iioaineaio oa?aiith.

?acoeueoaoe aeine?aeaeaiue c iiceoeaiei aoaeoii ai?iaaaeaeaii o
i?aeoe/io aeiyeueiinoue o??o?a?/ieo, ?aaiiiaoeieieo i aeiaaiinoe/ieo
a?aeae?eia Euea?anueei? i?nueei? ee?i?/ii? e?ea?i? oaeaeei? iaaee/ii?
aeiiiiiae (EIEEOIAe), A?iieoeueei? i?nueei? ee?i?/ii? e?ea?ii,
Oo?eianueei? oeaio?aeueii? ?aeiiii? eiea?ii, *a?aiiia?aaenueei?
oeaio?aeueii? iinueei? eiea?ii.

Iniiai? iaoeiai iieiaeaiiy aeena?oaoe?? aeeth/ai? a iaoa??aee eaeoeie oa
i?aeoe/ieo caiyoue c eiea?yie-iioa?iaie oa eo?naioaie ia eaoaae?ao
o??o?a?? oa eeiii/ii? eaai?aoi?ii? aeiaaiinoeee oaeoeueoaoo
iineyaeeieiiii? inaioe EAeIO.

Ca iaoa??aeaie aeine?aeaeaiue aeaeaii 2 ?ioi?iaoe?ei? eenoe IIC
Oe?a?ie, io?eiaii 4 iina?ae/aiiy ia ?aoe?iiae?caoi?nuee? i?iiiceoe??.

Iniaenoee aianie caeiaoaa/a. Iniaenoee aianie aaoi?a iieyaa? a ioeiioei
aeooaeueiinoi oa no/aniiai noaio aea/aiiy i?iaeaie; aeai?i oa
ii?aoethaaiii iaoiaeee aeine?aeaeaiiy; oi?ioaaiii ee?i?/ieo a?oi
iaoe??io?a, aiaeici oa ocaaaeueiaiii io?eiaieo ?acoeueoaoia;
oi?ioethaaiii aeniiaeia oa iaoeiaeo iieiaeaiue aeena?oaoei?. Oni
aaiinoaciieiai/ii ianoaaeaiiy oai?eo i?iaaaeaii aeena?oaioii naiinoieii,
?aooa – ca o/anoth i?aeoe/ieo e?ea??a, i?aoe?aiee?a ? aeiiii?aeieo
i?ae?icae?e?a EAeIO oa EIEEOIAe. Ni?aaaoi?noai ?ioeo aeine?aeiee?a o 10
c 22 iaoeiaeo ?ia?o, iioae?eiaaieo ca iaoa??aeaie aeena?oaoe??,
a?aeaeca?eaeth? ?o eiinoeueoaoeaio aeiiiiiao oa ni?ao/anoue o
ae?aaiinoe/ii-e?eoaaeueiiio i?ioean?.

Ai?iaaoeiy ?acoeueoaoia aeena?oaoei?. ?acoeueoaoe aeine?aeaeaiiy ?
iniiai? iieiaeaiiy aeena?oaoe?? aena?oeai? o aeiiia?aeyo ia can?aeaiiyo
eaoaae?e caaaeueii? oi?o?ai? (1993-1997 ??.), eaoaae?e oaeoeueoaonueei?
i caaaeueii? o??o?a?? c eo?nii i?ieoieiai? (1997-1998 ??.),
iaoeiai-i?aeoe/iie eiioa?aioei? niiai?aoeiaieeia niaoeiaeiciaaii?
aaaaoii?ioieueii? eeiii/ii? eiea?ii oaeaeei? iaaee/ii? aeiiiiiae c
iaaiaee 10-?i//y aiaee?eooy (Eueaia, 1992), OOOVI iiaenoieiaie
nooaeaionueeie iaoeiaie eiioa?aioei? c o/anoth iieiaeeo a/aieo
(Oa?iiiieue, 1993), ?anioaeieainueeie iaa/aeueii-iaoiaee/iie iaoeiaie
eiioa?aioei? caaiaeoaa/ia eaoaae? caaaeueii? oi?o?ai? iaaee/ieo aocia
Oe?a?ie (*a?iiaoei, 1995), Oaeuee-neiiicioii ? 92 “Iiai iai?yiee o
aaiaoieiai?” (?iniy, 1996), thaieaeiie iaoeiai-i?aeoe/i?e eiioa?aioe??
“No/ani? aniaeoe iaa?aeeeaaeii? iaaee/ii? aeiiiiiae”, i?enay/ai?e
25-??//th noai?aiiy EIEEOIAe (Euea?a, 1997), Oaeuee-neiiicioii “Iiai
iai?yiee o aeiaaiinoeoei oa eieoaaiii caoai?thaaiue ia/iiee i oianoi?
eeoee” (Eueaia, 1997).

Ioae?eaoe??. Ca iaoa??aeaie aeena?oaoe?? iioae?eiaaii 22 ae?oeiaaii
i?aoei (a o./. 5 – o oi?ii noaooae a iaoeiaeo aeo?iaeao, 6 – a ?iaioao o
cai?ieeao iaoeiaeo i?aoeue, 11 – o iaoa??aeao ? oacao eiioa?aioe?e),
aeaa ?ioi?iaoe?ei? eenoe.

No?oeoo?a ? ianya aeena?oaoe??. Aeena?oaoe?y neeaaea?oueny c? anooio,
oanoe ?icae?e?a, aeniiae?a, nieneo aeei?enoaieo e?oa?aoo?ieo aeaea?ae
? aeiaeaoeo c eii?yie aeo?a ai?iaaaeaeaiiy. Iiaiee ianya aeena?oaoe??
neeaaea? 213 noi??iie. ?enoiee (10), oaaeeoe? (43), aeienee c ?noi??e
oai?ia (4), aeiaeaoie c eii?yie aeo?a ai?iaaaeaeaiiy (1) oa nienie
aeei?enoaieo e?oa?aoo?ieo aeaea?ae (303) caeiathoue 82 noi??iee.

INIIAIEE CI?NO ?IAIOE

Iaoa??ae ? iaoiaee aeine?aeaeaiiy

Ee?i?/iee iaoa??ae neeaee 272 iniae, na?aae yeeo: 122 – a?oia
?ao?iniaeoeaiiai aiaeico (ca iaoa?iaeaie iaoieiaiaiaoiii/iiai aiaeaeieo
EIEEOIAe), 130 – i?iniaeoeaii ianoaaeaii oai?i ia AI i 20 – caei?ia?
ethaee. Aeine?aeaeaiiy i?iaiaeeeeny ai?iaeiaae 1992-1996 ??. ? aeeth/aee
aiae?oe/io ioe?ieo oa noaoenoe/ia ii?aoethaaiiy ee?i?/ieo aeaieo,
?acoeueoao?a o?ceeaeueieo oa ?icieo aeiiiiiaeieo
(caaaeueii-eaai?aoi?ieo, a?io?i?/ieo, iaoiii?oieia?/ieo,
?ino?oiaioaeueieo) ianoaaeaiue. Ee?i?ei-ii?oieia?/ii oi?ie AI
eeaneoieoaaee caiaeii Oaeeiiaa N.A. ? ni?aaao. (1990). Aeey ?iciiaeieo
ee?i?/iiai ia?aa?ao AI ca ia?iiaeaie aeei?enoaee eeaneoieaoeith
Naaaeueaaa A.N. (1986). Nenoaiaoecaoeith oneeaaeiaiue AI caeienieee ca
aoiiiaoiaaiaoe/ieie i?eioeeiaie Oeeeia A.E. ? ni?aaao. (1994).
Aaiinoaciieiai/ii oace AeAC-neiae?iio oa?aeoa?ecoaaee caiaeii c
iaoiaee/ieie ?aeiiaiaeaoeiyie Caoa?i? E.A. oa niiaaao. (1988).
Iieacieee cn?aeaeueii-i?ioecniaeaeueii? nenoaie e?ia? aea/aee oeyoii
ii??aiyeueii? ioe?iee ?acoeueoao?a “o?aaeeoe?eii?” eiaaoeia?aie (?iaaiue
oia?eiiaaio, aeoeaiaaiee /an ?aeaeueoeeoieaoei?, i?io?iiaiiiaee /an,
i?io?iiaiiiaee iiaeaen, oiea?aioiinoue ieacie aei aaia?eio, ?iaaiue
oia?eiiaaio A) ? ?ici?aoeueiaaii? o eeiiioei ?icoe?aii? aaiinoac?ia?aie:
aaoieiaaoeyoe?eiee oano ca Berkarda A. et al. (1965) a iiaeeo?eaoe??
Aa?eaaaia E.C. (1972), ?aaiiaa ?.I. (1977); ia?aeiaaoeyoe?ei? oanoe
[a-iaooieiao i?iao ca Commine I., Lyons A. (1948), Aaeoaea A.I. ?
ni?aaao. (1980), aoaiieiao i?iao ca Godal H.C. et al. (1971) a
iiaeeo?eaoe?? Eu/aaa A.A. (1975), i?ioai?i-noeueoaoio i?iao ca
Latallo Z. et al. (1971) a iiaeeo?eaoe?? Eu/aaa A.A. (1975)]; ??aaiue
i?iaeoeo?a aeaa?aaeaoe?? o?a?eio ? o?a?eiiaaio; ??aaiue o?a?eiiaaio ca
?ooaa?a ?.A. (1961); aeoeaiaaiee /an ?aeaeueoeeo?eaoe?? ca
Bergerhof I., Roka L. (1954); /an e?ceno aoaeiaoe?i?a ca Kowalski A. et
al. (1954) a iiaeeo?eaoe?? Aaeoaea A.I., Aa?eaaai E.C. (1980); aaiiciee
aaiaoie?eo; /an cn?aeaiiy e?ia? ca Ei-Aaeo, ?ao?aeoe?y e?ia’yiiai
caonoea ? niiioaiiee o?a?eiie?c ca ?aaiiaei ?.I. (1983).

?ACOEUeOAOE AeINEIAeAEAIUe

Iaoiii?oieiai/iee noano?ao ii?ooaiue cniaeaeueii-i?ioecniaeaeueii?
nenoaie e?iai o oai?eo ia AI. Ii?oieiai/ii i?iyae ii?ooaiiy
cniaeaeueii-i?ioecniaeaeueii? nenoaie e?iai aeyaeee o 80 (65,6 %)
iiia?eeo. I?e ni?iai ?o aiaeico caiaeii c i?eeiyoeie eeaneoieaoeiyie
/anoeia i?iyaia aeoiaeeea iica iaaei o?aaeeoeieieo e?eoa?i?a aiaeai?o.
Oea coiiaeei iaiaoiaeiinoue ?ic?iaee aeanii? nenoaiaoecaoei? ii?ooaiue
cniaeaeueii-i?ioecniaeaeueii? nenoaie e?iai aeey oai?eo ia AI, yea
ia?aaeaa/aea ie?aneaiiy o?iiaioe/iiai, aaii?aa?/iiai i
o?iiaiaaii?aa?/iiai neiae?iiia. Ii?oieiai/ieie iciaeaie o?iiaioe/iiai
neiae?iio aecia/aii o?iiaice, o?iiaiaiaie?? oa o?iiaioeaa?oe;
aaii?aa?/iiai – e?iaioa/? oa e?iaiaeeeae. Ca oiiae iaeii/aniiai
aeyaeaiiy iciae o?iiaioe/iiai ? aaii?aa?/iiai neiae?ii?a noaa?aeaeoaaee
o?iiaiaaii?aai/iee neiae?ii: aeania AeAC-neiae?ii (ca aiaeiieie
aaniethoieie iciaeaie oa iae?ineii?/ieie ci?iaie) /e neiae?ii
iie?eiaaoeyoe?eieo ii?ooaiue (i?e aiaenooiinoi aaniethoieo e?eoa???a
AeAC-neiae?iio, aea iayaiinoi iaeii/anii o?iiaioe/ieo oa aaii?aa?/ieo
i?iyaia).

C o?aooaaiiyi iaaaaeaiiai ?iciiaeieo o?iiaioe/iee neiae?ii noaa?aeaeaii
o 13 (10,7 %) oai?eo, aaii?aai/iee neiae?ii – o 35 (28,6 %),
o?iiaiaaii?aai/iee neiae?ii – o 32 (26,2 %). Ia aeyaeaii caeaaeiinoi
iiae eeiiiei-ii?oieiai/iith oi?iith AI oa neiae?iiaie ii?ooaiiy
cniaeaeueii-i?ioecniaeaeueii? nenoaie e?iai. Oiaoi i?e eiaeiie c
eeiiiei-ii?oieiai/ieo oi?i AI (iaa?yeiaiio iaie?aaoeoi, aaii?aai/iiio,
aee?iaiio i ciioaiiio iaie?aiiae?ici, aiieiiio iaie?aaoeoi) /anoea
ii?ooaiue aaiinoaco aoea iaeaea iaeiaeiaith ((2 0,05).

Ca ?acoeueoaoaie aiaeico iioeeaeaioiinoi ii?ooaiue
cniaeaeueii-i?ioecniaeaeueii? nenoaie e?iai noiniaii ia?iiaeia
eeiii/iiai ia?aaiao AI noaa?aeaeaii c?inoaiiy /anoioe oneeaaeiaiue a
ii?o aaainoaaiiy i?ioeano. O ia?oiio ia?iiaei oai?iae ii?ooaiiy
aaiinoaco eiinoaoiaaii a 6 (42,9 %) iaoei?ioia, o ae?oaiio – a
33 (63,5 %), o o?aoueiio – a 41 (73,2 %). Iii?e ?icio /anoeo ii?ooaiue
aaiinoaco a eiaeiee c ia?iiaeia caoai?thaaiiy noaa?aeaeaii oaeiae i
?iciee oa?aeoa? oeeo ciii. O aieueoinoi iiia?eeo (57,1 %) o ia?oiio
ia?iiaei o?iiaiaaii?aai/ieo oneeaaeiaiue ia aoei. Oeae oaiiiai iiaeia
iiynieoe ?aiiueith iiioeiaoei?th iaoiaaiaoe/iiai eaioethaa ii?ooaiue
aaiinoaco (a ia?oiio ia?iiaei oai?iae). O ae?oaiio ia?iiaei aeiiiioaaa
o?iiaiaaii?aai/iee neiae?ii ((2=8,5; p 10

I?ieiaaoeyioia aeoeaiinoue ( ((( (( ( ( N N N

Aioeeiaaoeyioia aeoeaiinoue ( ( ( ( ( ( ( (

Oia?eiieioe/ia aeoeaiinoue N ( (( (( (( N N N

Cniaeaeueii-i?ioecniaeaeueia nenoaia e?iai i?e aeano?oeoeaiie oi?ii AI.
I?e aeano?oeoeaiie oi?ii AI ii?ooaiiy cniaeaeueii-i?ioecniaeaeueii?
nenoaie e?iai noaa?aeaeaii o 72 (90 %) oai?eo; c ieo o 59 (73,8 %) –
eaai?aoi?ii iciaee AeAC-neiae?iio. A eiaeiee c ia?iiaeia iaie?aiiae?ico
niinoa?iaaeeny iaaii caeiiiii?iinoi ii?ooaiue
cniaeaeueii-i?ioecniaeaeueii? nenoaie e?iai. Oae, i?ieiaaoeyioia
aeoeaiinoue aoea iaeneiaeueii iiaeaeuaiith a ia?oee ia?iiae
iaie?aiiae?ico i iinooiiai ciaiooaaeany aae aei i?eaii/aiiy ia noaaei?
iiciio i?iyaia o?aoueiai ia?iiaeo caoai?thaaiiy. Aiaeii/an
oia?eiieioe/ia aeoeaiinoue aoea ?icei cieaeaiith a ia?oee i ae?oaee
ia?iiaee, oiaei ye o o?aoueiio ia?iiaei oai?iae aiaeaoaaeany
ii?iaeicaoeiy ?? iieacieeia. Aiaeiai/ii aei ia?aaiao iaa?yeiai? oi?ie AI
aioeeiaaoeyioia aeoeaiinoue aoea cieaeaiith (oaae.2).

Oaaeeoey 2

Aeeiaiiea ii?ooaiue cniaeaeueii-i?ioecniaeaeueii? nenoaie e?iai o oai?eo
aeano?oeoeaiith oi?iith AI

Ia?iiaee caoai?thaaiiy I II IIIa IIIa aeienea

I?ieiaaoeyioia aeoeaiinoue ((( (( ( ( N

Aioeeiaaoeyioia aeoeaiinoue ( ( ( ( (

Oia?eiieioe/ia aeoeaiinoue (( ( N N (

C iaeyaeo ia aiaeiii aeaii i?i aieea iia?aoeieii? o?aaie, oa?iaioaii? oa
aioeoa?iaioieo i?aia?aoia ia oia?eiieioe/io aeoeaiinoue e?iai iaeiei ic
caaaeaiue aeineiaeaeaiiy aoei aea/aiiy aieeao iia?aoeieii? o?aaie oa
aioei?ioaac ia oia?eiieioe/io aeoeaiinoue e?iai o ?icii ia?iiaee
iaie?aiiae?ico. O ca’ceo c oei, ui /anoeii iaoe??io?a ia i?iaiaeeeany
aioeoa?iaioia oa?ai?y, ie ii??aiyee o?a?eiie?oe/io aeoeai?noue e?ia? o
ieo (i?aea?oia A – 36 (45 %) inia), oa o oai?eo (iiaea?oia A – 44 (55 %)
inia), yei io?eioaaee caaaeaia e?eoaaiiy.

O iaoe??io?a iiaea?oie A aeyaeaii aeoeaiaaiee oia?eiieic ai?iaeiaae
onueiai ia?aaiao caoai?thaaiiy. O oai?eo iiaea?oie A iia?aoeieia o?aaia
ia aeeeeeaea aiaeoeeaiiy oia?eiieioe/ii? aeoeaiinoi, ui iiaeia iiynieoe
aieeaii ?ia?a?oi??a i?ioaac (oaae.3).

Aeyaeaia caeiiiii?iinoue ia??oiooaaea aeioeieueiinoue aiaeiiaiaeii?
ei?aeoei? ii?ooaiue oia?eiieico aioeoa?iaioieie i?aia?aoaie iiney
iia?aoei? a ae?oaiio oa o?aoueiio ia?iiaeao caoai?thaaiiy. Aiaeii/an o
ia?iiae oienaii?, eiee oia?eiieioe/ia nenoaia i?eaii/o?oueny niiioaiii,
i?ecia/aiiy caaaeaieo iaaeeeaiaioicieo na?aaeieeia iiaea ni?e/eieoe
o?iiaioe/ii oneeaaeiaiiy. Oea aecia/a? iaia“yceiaei eiiiiiaioii
aeiaaiinoe/ii-eieoaaeueieo caoiaeia uiaeaiiee eaai?aoi?iee eiio?ieue
aeoeaiinoi oia?eiieico.

Oaaeeoey 3

Aieea iia?aoeieii? o?aaie oa aioeoa?iaioii? oa?aii? ia oia?eiieioe/io
aeoeaiinoue e?iai o ?icii ia?iiaee iaie?aiiae?ico

Ia?iiaee Oia?eiieioe/ia aeoeaiinoue

Iiaea?oia A Iiaea?oia A

Aei iia?aoei? Iiney iia?aoei? Aei iia?aoei? Iiney iia?aoei?

I (( N (( (

II ( ( ( (

III N (( (( ((

Iioi?iaoeaiinoue aaiinoaciieiai/ieo oanoia. Aeey ioeiiee iioi?iaoeaiinoi
aaiinoaciieiai/ieo oanoia o oai?eo ia AI ia/enethaaee ?o caaaeueio
/ooeeainoue, niaoeeoi/iinoue oa aeiaaiinoe/io aoaeoeaiinoue, ie?aii
?ic?aoiaoth/e cacia/aii iieacieee uiaei a?oi iaoei?ioia c iaa?yeiaith
oa aeano?oeoeaiith oi?iith caoai?thaaiiy. Io?eiaii ?acoeueoaoe
ii?iaithaaee c aeaieie aiaeiai/ieo ianoaaeaiue 13 oai?eo c iioith
aaaeiiiiaeueiith iaoieiai?th.

“O?aaeeoeieia eiaaoeia?aia” aeyaeeany i?eaeaoiith oieueee aeey
iaaaoeaii? naeaeoei?, oiaoi aeey caia?a/aiiy yaeu aiia?eiaaoeyoei? /e
aiiieiaaoeyoei?. Caaaeii oeae aeiaaiinoe/iee eiiieaen aeyaeany
iecueeiiioi?iaoeaiei.

Caaeiaieueio aeiaaiinoe/io aoaeoeaiinoue (84,5-91,0 %) o aieueoinoi
eeiii/ieo aeiaaeeia iaee oanoe ?icoe?aii? aaiinoaciia?aie. A?aoiaoth/e
iieacieee /ooeeainoi (*) oa niaoeeoi/iinoi (N) eiaeiiai c ieo, iniiao
aeiaaiinoeee ii?ooaiue cniaeaeueii-i?ioecniaeaeueii? nenoaie e?iai o
oai?eo c AI iiaeiii neeaaeaoe: aaoieiaaoeyoeieiee oano (* – 65,7-83,3
%; N – 76,9-100,0 %), /an Ei-Aaeoa (*=82,3 %; N=76,9 %), aeoeaiaaiee
/an ?aeaeueoeeoieaoei? (*=80,8 %; N=84,6 %), eieueeinoue oia?eiiaaio
(*=91,7 %; N=30,8 %), aeoeaiinoue aioeo?iiaiio III (*=84,8 %; N=84,6 %),
eicen aoaeiaoeiiia (*=86,1 %; N=76,9 %), aeey caia?a/aiiy
AeAC-neiae?iio – ia?aeiaaoeyoeieii oanoe (* – 37,1-51,4 %; N – 84,6-92,3
%) oa ?iaaiue IAeO (*=54,5 %; N=84,6 %).

AeAC-neiae?ii o oai?eo ia AI. Aeeiaiiea eaai?aoi?ieo iciae
AeAC-neiae?iio iaea i?eoaiaiio aoaiiinoue. Oae, eaai?aoi?ii eiinoaoiaaia
i?e iinooieaiii aiia?eiaaoeyoeieia oaca AeAC-neiae?iio caa?iaaeany o
iiaeaeueoiio o eiaeiiai /aoaa?oiai iaoei?ioa, o iieiaeie oai?eo c oei??
a?oie iieacieee aaiinoaco ii?iaeicoaaeeny. Noaa?aeaeaiiy
aaeiaaoeyoeieii? oa aiiieiaaoeyoeieii? oace AeAC-neiae?iio i?e
ainiioaeicaoei? aoei iani?eyoeeaith i?iaiinoe/iith iciaeith,
ii?iaeicaoeiy iieacieeia aiaeaoaaeany eeoa o 14-30 % oai?eo.

O 34 (45,3 %) c 75 oai?eo c eaai?aoi?ii eiinoaoiaaiei AeAC-neiae?iiii
aeyaeaii eeiii/ii i?iyae ii?ooaiue cniaeaeueii-i?ioecniaeaeueii?
nenoaie. Aiaeii/an a a?oii c eaai?aoi?ii caia?a/aiei AeAC-neiae?iiii
caaaeaii eeiii/ii neiioiie noaa?aeaeaii eeoa o 2 (3,6 %) c 55 iaoei?ioia
((2 = 25,5; ?

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