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Гемодинамічні детермінанти оптимізації пролонгованої терапії в умовах формування ‘післяінфарктного серця’: Автореф. дис… канд. мед. наук / Р.Б. Чапл

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AEAAeAI?ss IAAeE*IEO IAOE OE?A?IE

?INOEOOO EA?Ae?IEIA??

?i. aeaae. I.Ae.NO?AAEANEA

*AIE?INUeEEE ?inoeneaa Ai?eniae/

OAeE:
616.127-005.4-071-072.7-08-039.35

AAIIAeEIAI?*I? AeAOA?I?IAIOE IIOEI?CAOe??

I?IEIIAIAAII? OA?AI?? A OIIAAO

OI?IOAAIIss

“I?NEss?IOA?EOIIAI NA?Oess”

14.01.11 – Ea?ae?ieia?y

AAOI?AOA?AO

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Ee?a – 1999

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia a Aoeiaeinuee?e aea?aeaai?e iaaee/i?e aeaaeai?? IIC
Oe?a?ie.

Iaoeiaee ea??aiee:

aeieoi? iaaee/ieo iaoe, i?ioani? Oauoe A?eoi? Ei?i?eiae/, caa?aeoaa/
eaoaae?e aini?oaeueii? oa?ai?? ?2 oa EOE Aoeiaeinueei? aea?aeaaii?
iaaee/ii? aeaaeai?? IIC Oe?a?ie (i.*a?i?aoe?).

Io?oe?ei? iiiiaioe:

aeieoi? iaaee/ieo iaoe, noa?oee iaoeiaee ni?a?ia?oiee Ooiaeia Aaeaioei
Ieaenaiae?iae/, ?inoeooo ea?ae?ieia?? ?i. aeaae. I.Ae.No?aaeanea AII
Oe?a?ie, caa?aeoaa/ a?aeae?eaiiy aino?iai ?ioa?eoo i?iea?aea oa
a?aeiiaethaaeueiiai e?eoaaiiy (i.Ee?a);

aeieoi? iaaee/ieo iaoe A?eiiiaeei Ieaenaiae? Aai?a?eiae/, Ee?anueea
iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe ?i.I.E.Ooi?ea IIC Oe?a?ie,
i?ia?aeiee iaoeiaee ni?a?ia?oiee i?iaeaiii? eaai?aoi??? aia?ia?ao?/ieo
oa aeaeo?io?c?ieia?/ieo aeine?aeaeaiue eaoaae?e ea?ae?ieia?? oa
ooieoe?iiaeueii? ae?aaiinoeee.

I?ia?aeia onoaiiaa:

Iaoe?iiaeueiee iaaee/iee oi?aa?neoao ?i. I.I.Aiaiiieueoey, eaoaae?a
oaeoeueoaonueei? oa?ai?? ?2, IIC Oe?a?ie, i. Ee?a.

Caoeno a?aeaoaeaoueny 22 /a?aiy 1999 ?. i 12 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 26.616.01 i?e ?inoeooo?
ea?ae?ieia?? ?i. aeaae. I.Ae.No?aaeanea AII Oe?a?ie, (252151 i.Ee?a
151, aoe. Ia?iaeiiai iiie/aiiy, 5).

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? ?inoeoooo
ea?ae?ieia?? ?i. aeaae. I.Ae.No?aaeanea AII Oe?a?ie, (252151 i.Ee?a
151, aoe. Ia?iaeiiai iiie/aiiy, 5).

Aaoi?aoa?ao ?ic?neaiee 18 o?aaiy 1999 ?ieo

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee
Aeaye N.?.

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie. ?oai?/ia oai?iaa na?oey (?ON), ?? aino?? oi?ie oa
iniaeeai aino?ee ?ioa?eo i?iea?aea (A?I) ia ii/aoeo iiaiai oeny/ie?ooy
i?iaeiaaeothoue caeeoaoeny iaei??th c iaea?eueo neeaaeieo i?iaeai
no/anii? ea?ae?ieia??, i?i ui na?ae/eoue ?iciiae?e ?ON a no?oeoo??
nia?oiino? a Oe?a?i?, yeee o 1997 ?ioe? neeaa 62,1%, a aeey
i?aoeacaeaoiiai a?eo – 55,8%; nia?oi?noue ca ia??iae 1992-1997 ?ie?a
c?inea ia 42,2%, iioe?ai?noue – ia 32,8%, caoai?thaai?noue – ia 21,3%
(A.I.Eiaaeaiei, A.I.Aei?iaie, 1998). Na?oeaai-noaeeii? caoai?thaaiiy
iin?aeathoue ia?oa i?noea na?aae ?ioi? iaoieia??, yea aieeaa? ia
o?eaae?noue oa ye?noue aeeooy ethaeeie ? i?iaeiaaeothoue caeeoaoeny
aieiaiith i?e/eiith ao?aoe i?aoeacaeaoiino? ? nia?oiino? ianaeaiiy a
a?eueoino? aeiiii?/ii ?icaeiooeo e?a?i ( A.I.Ia?oiiaiei,
1996;

TH.I.Ne?aiei e ae?., 1998; D.G.Julian, 1991).

sse na?ae/eoue aiae?c e?oa?aoo?e inoaii?o ?ie?a, a e?eoaaii? oai?eo ia
A?I aeinyaioo? iaai? oni?oe (caaaeyee nenoai? iaa?aeeeaaeii?
aini?oae?caoe??, i?io?eaeoeoe? a?eoi?e, ai?iaaaeaeaiith o?a?eiie?co),
oiae? ye a iioei?caoe?? e?eoaaiiy oai?eo a i?ney?ioa?eoiiio ia??iae? ?
oe?eee ?yae iaae??oaieo i?iaeai (E.O.Iaeay, 1997; I. A. Aoaianiaa,
1998; E.E.Neaaecaaneay e ae?., 1998; P.Silva et al., 1993; S.Heuper et
al., 1997). Eaoaeuei?noue a?ae ?I a Oe?a?i? caeeoa?oueny ia aenieiio
??ai? – 16-18% (E. O. Iaeay, ss. A. Aeueoi, 1998).

Aaeaeaaoia ? iaoiaaiaoe/ii iaa?oioiaaia e?eoaaiiy oai?eo c?
noaiiea?ae??th i?ney ?I aecia/a? ia o?eueee ye?noue ?o aeeooy, a e
iiaeeea?noue cieaeaiiy /anoioe ei?iia?ieo oneeaaeiaiue (E.E.Neaaecaaneay
e ae?., 1997; I.N.Nu/aa, 1997; I.?.Eooae, TH.TH.Ai?noe, 1998;
C.Buonnano et al., 1992; L.Bentivoglio et al., 1994).

A no/ani?e ea?ae?ieia?? aaaeeeao oaaao aeine?aeiee?a i?eaa?oa? i?iaeaia
noaa?e?caoe?? noaio oai?eo c aino?eie ei?iia?ieie neiae?iiaie
(A.A.Ooiaeia, 1994; E.A.Ai?iieia, 1998; G.A.Lanza et al., 1997).

Aaaeeeaei aniaeoii i?iaeaie ? iaiao?aei?noue aaeineiiaeaiiy iaoiae?a
?iaeea?aeoaeueiiai i?aeai?o iaaeeeaiaioicieo cania?a o oai?eo c
“i?ney?ioa?eoiei na?oeai” ia iniia? aea/aiiy ei?iia?iiai ?aca?ao oa
ooieoe?iiaeueiiai noaio i?iea?aea (A.I.Iaeei, E.A.Aeooei, 1996). ?aiiy
ia?eoea?caoe?y noaio oai?eo c i?ney?ioa?eoiei ea?ae?ineea?icii,
iioei?caoe?y i?ieiiaiaaii? iaaeeeaiaioicii? oa?ai??, i?iaiicoaaiiy
iiaeaeueoiai ia?aa?ao caoai?thaaiiy ?c canoinoaaiiyi io?eiaieo
?acoeueoao?a aeey aecia/aiiy a?oi i?aeaeuaiiai ?eceeo caeeoathoueny
aeooaeueieie ia aeaiiio aoai? ?icaeoeo no/anii? ea?ae?ieia??
(I.I.Na?aaethe, ?.I.Aaeaethe, 1996; A.A.Aia?ia e ae?., 1997; A. A.
Aecye e ae?., 1997; M.Radice et al., 1995). Canoinoaaiiy
/a?acno?aaio?aeii? aeaeo?iea?ae?inoeioeyoe?? (*NAN), aoiea?ae?ia?ao??
(AoiEA), aaeia?aiiao??? (AAI), Oieoa??anueeiai iii?oi?oaaiiy
aeaeo?iea?ae?ia?aie (OI AEA), aino?eo iaaeeeaiaioicieo oano?a aeathoue
ciiao ioe?ieoe ei?iia?iee ?aca?a ? ooieoe?iiaeueiee noai i?iea?aea
(E.Y.Iaeeiianeay e ae?., 1991; A.I.Nieiaueyi, 1998; A.Pozzati et al.,
1995). Iioei?caoe?y i?ieiiaiaaii? oa?ai?? o oai?eo c “i?ney?ioa?eoiei
na?oeai” ca aeiiiiiaith aino?eo iaaeeeaiaioicieo oano?a ia iniia? AoiEA
c ??cieie a?oiaie i?aia?ao?a, ia a?aei?io a?ae noaiaea?oieo noai
e?eoaaiiy, aeicaiey? ?iaeea?aeoae?coaaoe oa ia?eoea?coaaoe canoinoaaiiy
??ciiiai?oieo iaaeeeaiaio?a.

Caycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Aeena?oaoe?eia
?iaioa ? o?aaiaioii iaoeiai-aeine?aeii? ?iaioe eaoaae?e aini?oaeueii?
oa?ai?? ?2 oa EOE Aoeiaeinueei? aea?aeaaii? iaaee/ii? aeaaeai?? ia oaio
“Noai?aiiy ?aa?no?o aino?iai ?ioa?eoo i?iea?aea I?ai?/ii? Aoeiaeie c
aecia/aiiyi oee?eaae?aiieo ?eoi?a oa ee?i?ei-ooieoe?iiaeueieo
i?aaeeeoi??a ia?aa?ao aino?i? noaae??” (?a?no?aoe?eiee iiia? 01.97
V015.111).

Iaoa ? caaea/? aeine?aeaeaiiy. Aea/eoe ci?ie ei?iia?iiai ?aca?ao oa
noai aaiiaeeiai?ee o oai?eo c ??cieie aa??aioaie ia?aa?ao ?ON ia aoai?
i?neyaini?oaeueiiai e?eoaaiiy A?I a oiiaao ?icaeoeo i?ney?ioa?eoiiai
ea?ae?ineea?ico, aeine?aeeoe aaiiaeeiai?/i? aeaoa?i?iaioe iioei?caoe??
i?ieiiaiaaii? oa?ai??, ia?eoea?coaaoe oa ?iaeea?aeoae?coaaoe
canoinoaaiiy ??cieo a?oi iaaeeeaiaioicieo cania?a ia i?aenoaa? aino?eo
iaaeeeaiaioicieo oano?a ca ?acoeueoaoaie AoiEA.

Caaea/? aeine?aeaeaiiy:

1. Aea/eoe ei?iia?iee ?aca?a oa ooieoe?iiaeueiee noai i?iea?aea o oai?eo
c i?ney?ioa?eoiei ea?ae?ineea?icii ca aeaieie *NAN, AoiEA, AAI, OI AEA.

2. Aenia?eiaioaeueii iaa?oiooaaoe aeioe?euei?noue aeei?enoaiiy aino?eo
iaaeeeaiaioicieo oano?a c ??cieie a?oiaie i?aia?ao?a o oai?eo c
“i?ney?ioa?eoiei na?oeai” aeey iioei?caoe?? iiaeaeueoi? oa?ai??.

3. Ia?eoea?coaaoe ?iaeea?aeoaeueiee i?aea?? iaaeeeaiaioicieo cania?a o
aeaeyae? aeai?eoi?a ia iniia? aea/aiiy ci?i ei?iia?iiai ?aca?ao ?
ooieoe?iiaeueiiai noaio i?iea?aea ca aeaieie aino?eo iaaeeeaiaioicieo
oano?a.

4. I?iaiae?coaaoe ci?ie ei?iia?iiai ?aca?ao ? ooieoe?iiaeueiiai noaio
i?iea?aea a oiiaao o?eaaeiai canoinoaaiiy eiia?iiaaiiai
iaaeeeaiaioiciiai e?eoaaiiy c iiaeaeueoei aecia/aiiyi ii??aiyeueiiai
aoaeoo eiia?iaoe?? c aioo??oiueiaaiiei eaca?iei ii?ii?iaiiyi e?ia?
(EIE).

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a. Aia?oa aeei?enoaii
ee?i?ei-ae?aaiinoe/iee eiiieaen (aino?? iaaeeeaiaioici? oanoe, AoiEA,
*NAN, AAI, OI AEA) o oai?eo ia ?ON ia aoai? i?neyaini?oaeueiiai
e?eoaaiiy A?I a oiiaao ?icaeoeo i?ney?ioa?eoiiai ea?ae?ineea?ico c
iaoith ia?eoea?caoe?? ?aaeoeoe?? ei?iia?iiai ?aca?ao oa ci?i
ooieoe?iiaeueiiai noaio i?iea?aea aeey aecia/aiiy aaiiaeeiai?/ieo
aeaoa?i?iaio iioei?caoe?? i?ieiiaiaaii? oa?ai??. Ca aeaieie aino?eo
iaaeeeaiaioicieo oano?a i?ae /an AoiEA ?ic?iaeaia noaia
aeeoa?aioe?eiaaiiai canoinoaaiiy ??cieo a?oi iaaeeeaiaioicieo cania?a a
caeaaeiino? a?ae aieeao ia ooieoe?iiaeueiee noai i?iea?aea o oai?eo c
“i?ney?ioa?eoiei na?oeai”. I?iaaaeaii aiae?c aoaeoeaiino? canoinoaaiiy
iaea?eueo aaeeaaieo eiia?iaoe?e aioeaia?iaeueieo, aioe?oai?/ieo cania?a,
aeaia eiiieaenia ioe?iea aoaeoeaiino? ?o aieeao ia
ee?i?ei-ooieoe?iiaeuei? iieacieee, aecia/ai? ci?ie ?oai?caoe??
neiii?iiaioiaaiiai i?iea?aea a oiiaao no?an-oano?a oa Oieoa??anueeiai
iii?oi?eiao ia ?aiiueiio i?neyaini?oaeueiiio aoai? oi?ioaaiiy
i?ney?ioa?eoiiai ea?ae?ineea?ico oa a ii??aiyii? ia oii? o?eaaei?
iaaeeeaiaioicii? ei?aeoe?? (1 ??e).

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a. Ooi/iai? e?eoa??? aieeao
??cieo oaeoi??a ia ee?i?ei-ooieoe?iiaeuei? aeaoa?i?iaioe iaiaaeaiiy
ei?iia?iiai ?aca?ao o oai?eo ?ON. Aecia/ai? iniaeeaino? ei?iia?iiai
?aca?ao oa ooieoe?iiaeueiiai noaio i?iea?aea o oai?eo ?ON, ye?
iaaeoiaeyoue a iie?ee?i?eo c ?I i?ney ea?ae?ieia?/iiai a?aeae?eaiiy.
?ic?iaeai? aeai?eoie eiia?iiaaiiai i?ieiiaiaaiiai e?eoaaiiy c
ia?aaeaa/aiiyi ?o iiaeaeueoi? aoaeoeaiino? ia i?ioyc? ?ieo. Iaa?oioiaaia
aeioe?euei?noue aeei?enoaiiy aino?eo iaaeeeaiaioicieo oano?a aeey
ia?eoea?caoe?? canoinoaaiiy ??cieo a?oi iaaeeeaiaioicieo cania?a.
Ai?iaaaeaeaia ?iaeea?aeoae?caoe?y oa ia?eoea?caoe?y i?ecia/aiiy ??cieo
a?oi i?aia?ao?a c iiaeaeueoei i?iniaeoeaiei aecia/aiiyi ?o aoaeoeaiino?
a oiiaao i?ieiiaiaaii? oa?ai??. Iioei?ciaaia oa?ai?y oai?eo ia ?ON ia
aoai? i?neyaini?oaeueiiai e?eoaaiiy A?I a oiiaao ?icaeoeo
i?ney?ioa?eoiiai ea?ae?ineea?ico ia canaaeao aeei?enoaiiy
aioo??oiueiaaiiiai EIE.

Ai?iaaaeaeaiiy ?acoeueoao?a aeine?aeaeaiiy a i?aeoeeo. ?acoeueoaoe
aeine?aeaeaiiy aeei?enoiaothoueny i?ae /an aeeeaaeaiiy ia eaoaae?ao
aini?oaeueii? oa?ai?? Aoeiaeinueei? aea?aeaaii? iaaee/ii? aeaaeai?? oa
i?aeoe/i?e ?iaio? a?aeae?eaiue *a?i?aaoeueeiai iaeaniiai
ea?ae?iaeeniaina?o, 1 oa 3 i?nueeeo e?ea?aiue i. *a?i?aoe?, ui
i?aeoaa?aeaeaii aeoaie ai?iaaaeaeaiiy.

Iniaenoee aianie caeiaoaa/a. Iniaenoee aianie aaoi?a a io?eiaii?
iaoeiaeo ?acoeueoao?a ? iniiaiei ? iieyaa? o aeai?? iai?yieo ? iaoiae?a
aeine?aeaeaiiy, aeaoa?i?iaoe?? eiioeiaaioo aiae?co?ieo a?oi,
oi?ioethaaii? iaoe oa caaaeaiue aeine?aeaeaiiy, a i?iaaaeaii? anueiai
ia?io ee?i?/ieo, ?ino?oiaioaeueieo oa eaai?aoi?ieo ianoaaeaiue, a
aiae?c?, ocaaaeueiaii? oa noaoenoe/i?e ia?iaoe? io?eiaieo ?acoeueoao?a a
i?aeaioiaoe? iaoeiaeo aeaieo aei ioae?eaoe??. Aeniiaee oa i?aeoe/i?
?aeiiaiaeaoe?? noi?ioeueiaai? aaoi?ii ?acii c iaoeiaei ea??aieeii.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iniiai? iieiaeaiiy ?iaioe aoee
iaaiai?ai? ia i?aeeaoaae?aeueiiio can?aeaii? oa?aiaaoe/ieo eaoaae?
Aoeiaeinueei? iaaee/ii? aeaaeai??, can?aeaii? oiaa?enoaa oa?aiaao?a
*a?i?aaoeueei? iaeano?, eiioa?aioe?yo Aoeiaeinueei? iaaee/ii? aeaaeai??,
iaoeia?e eiioa?aioe?? iieiaeeo a/aieo iaaeee?a ?aaii-O?aie?anueei?
iaaee/ii? aeaaeai?? (1997), XIV c?cae? oa?aiaao?a Oe?a?ie (Ee?a, 22-25
aa?aniy 1998), Ieaioi? ea?ae?ieia?a Oe?a?ie, i?enay/aiiio iaiyo?
aeaeaoieo a?o/eciyieo a/aieo i?ioani??a A.E.I?oiueiaa, I.E.A?eoethea,
I.A.Aaaooa (Ee?a, 11-13 eenoiiaaea 1998).

Ai?iaaoe?y aeena?oaoe?? aoea i?iaaaeaia ia ni?eueiiio can?aeaii?
eaoaae?e aini?oaeueii? oa?ai?? ?2 oa EOE, iaoeiai? eii?n?? Aoeiaeinueei?
aea?aeaaii? iaaee/ii? aeaaeai??, *a?i?aaoeueeiai iaeaniiai oiaa?enoaa
ea?ae?ieia?a 29.12.1998 ?ieo. ?iaioo ai?iaiaaii ia iaoeiai-i?aeoe/i?e
eiioa?aioe?? a?aeae?eo ?aai?iaoe?? oa ?ioaineaii? oa?ai??, a?aeae?eaiiy
aino?iai ?ioa?eoo i?iea?aea oa a?aeiiaethaaeueiiai e?eoaaiiy,
a?aeae?eaiiy a?eoi?e na?oey oa eaai?aoi??? aenia?aiaioaeueii?
ea?ae?ieia?? Oe?a?inueeiai iaoeiai-aeine?aeiiai ?inoeoooo ea?ae?ieia??
?i. aeaae. I.Ae.No?aaeanea 18.02.1999 ?ieo.

Ioae?eaoe??. Ca iaoa??aeaie aeena?oaoe?? iaae?oeiaaii 8 iaoeiaeo ?ia?o,
?c ieo 4 o aeaeyae? noaoae a iaoeiaeo aeo?iaeao, ui aeciai? AAE Oe?a?ie
oa 4 oac?a.

No?oeoo?a aeena?oaoe??. Iniiaiee oaeno aeena?oaoe?? aeeeaaeaii ia 142
noi??ieao, neeaaea?oueny c? anooio, iaeyaeo e?oa?aoo?e, ?icae?eo
Iaoa??ae ? iaoiaee, o?ueio ?icae?e?a ca ?acoeueoaoaie aeanieo
aeine?aeaeaiue, i?aenoieo, aeniiae?a, i?aeoe/ieo ?aeiiaiaeaoe?e, nieneo
aeei?enoaieo aeaea?ae, yeee i?noeoue 396 e?oa?aoo?ieo iaeiaioaaiue.
Aeena?oaoe?y ?ethno?iaaia 24 ?enoieaie oa 39 oaaeeoeyie.

INIIAIEE CI?NO ?IAIOE

Ee?i?/ia oa?aeoa?enoeea oai?eo oa iaoiaeieia?y aeine?aeaeaiiy.

?iaioa aaco?oueny ia ianoaaeaii? 168 ea?ae?ieia?/ieo iaoe??io?a, ui
iaae?eoee a iie?ee?i?eo ia aoai? i?neyaini?oaeueiiai e?eoaaiiy. Iniiaio
a?oio neeaee 79 oai?eo c ia?aianaiei A?I, ye? cae?i/eee noaoe?iia?iee
aoai e?eoaaiiy ? a oa?i?i 2 i?nyoe? a?ae ii/aoeo ?I aoee ia?aaaaeai? ia
iie?ee?i?/ia e?eoaaiiy oa niinoa?aaeaiiy. Na?aae 79 oai?eo c ia?aianaiei
A?I o 36 (45,6%) aoa ca?a?no?iaaiee o?ainio?aeueiee iae?ic i?iea?aea, ua
o 14 (17,7%) – aaeeeiaiaieuaaee ? o 29 (36,7%) – ae??aiiaiaieuaaee. A
ia?aa?ao ?ON o 36 oai?eo c ia?aianaiei o?ainio?aeueiei A?I aeii?ioaaee
nea?ae a?aeiia?aeii aei noaiiea?ae?? iai?oaeaiiy II OE a 7 (19,4%)
aeiaaeeao, noaiiea?ae?? iai?oaeaiiy III OE oa niieith – a 29 (80,6%); o
14 iaoe??io?a c aaeeeiaiaieuaaei A?I noaiiea?ae?y iai?oaeaiiy II OE
cao?eniaaia a 6 (42,9%) aeiaaeeao, noaiiea?ae?y iai?oaeaiiy III OE oa
niieith – a 8 (57,1%); o 29 oai?eo c ae??aiiaiaieuaaei A?I noaiiea?ae?y
iai?oaeaiiy II OE ?a?no?oaaeanue a 4 (13,8%) aeiaaeeao, noaiiea?ae?y
iai?oaeaiiy III OE oa niieith – a 25 (86,2%).

A?oia ni?anoaaeaiiy neeaaeaeany c 89 iaoe??io?a, o yeeo a 24 (27,0%)
aeiaaeeao ae?aaiinoiaaia ?ON o aeaeyae? noaiiea?ae?? iai?oaeaiiy II OE,
a 31 (34,8%) – noaiiea?ae?? iai?oaeaiiy III OE, a 34 (38,2%) –
noaiiea?ae?? iai?oaeaiiy II OE aai III OE ? niieith.

A?ia?oaiceaiee neiae?ii oneeaaeithaaa ia?aa?a ?ON a 61 (36,3%)
aeiaaeeao. Na?oeaaa iaaeinoaoi?noue (NI) aecia/aia ia ??ai? NI I no a 22
(13,1%) aeiaaeeao, NI IIA no – a 146 (86,9%) oai?eo. Iaoe??ioe c NI III
no a ianoaaeaiiy ia aeeth/aeeny.

Na?aaei?e a?e iaoe??io?a, ye? ia?aianee ae??aiiaiaieuaaee ?I, aeyaeany
aeaui aeuei (62,11,9 ?ie?a) a ii??aiyii? c oai?eie, ye? ia?aianee
o?ainio?aeueiee ?I (59,81,7 ?ie?a, ?>0,2), oa ua a?eueo aeuei, i?ae o
oai?eo, c ia?aianaiei aaeeeiaiaieuaaee ?I (53,62,9 ?ie?a, ?? ???en.1 I?ioeaioi? ci?ie OA a oiiaao aino?iai iaaeeeaiaioiciiai oanoo c aeei?enoaiiyi i?o?iae?oea?eio (IA), iaceaeaio (Iac), aa?aiai?eo (Aa?), i?oaaeei?io (I?o), eaioii?eeo (Eaio), aeeaieneio (Aeea) a a?oiao oai?eo, ye? ia?aianee ?I ??cii? aaee/eie. A iiaeaeueoiio ianoaaeai? oai??, ye? iaea?aeoaaee i?ieiiaiaai? i?o?aoe ? ani??ei, aoee ?icae?eai? ia o?noue a?oi i?ieiiaiaaiiai aeiaeaoeiaiai e?eoaaiiy (I a?oia - iaceaeai; II - i?oaaeei?i, eaioii?ee; III - iaceaeai, eaioii?ee; IV - aa?aiai?e, eaioii?ee; V - i?oaaeei?i, aeeaienei; VI - i?oaaeei?i) ? i?aeaeai? aiae?co aoaeoeaiino? canoiniaaii? oa?ai?? a oiiaao aino?iai iaaeeeaiaioiciiai oanoa a oeeo a?oiao. I?iaaaeai? aino?? iaaeeeaiaioici? oanoe iieacaee, ui iaeneiaeueia ca?eueoaiiy OA ?a?no?oaaeinue i?e aaeeaaii? eaioii?eeo (4,9-11,6%) ia ae?oaiio i?noe? i?oaaeei?i (4,6-7,4%), aeae? iine?aeiaii - i?o?iae?oea?ei (2,7-6,9%), iaceaeai (2,8-5,4%), aa?aiai?e (1,5-5,2%), aeeaienei (1,7-5,1%). Aino?? iaaeeeaiaioici? oanoe c aa?aiai?eii ? aeeaieneiii ia i?eaaee aei nooo?aeo iie?auaiue aaiiaeeiai?/ieo iieaciee?a, a o oai?eo, yeei a iiaeaeueoiio aoei cai?iiiiiaaii i?oaaeei?i, aeeaienei aai i?oaaeei?i - aa?aiai?e a aino?iio oano? iaa?oue cieaeoaaa OA (0,8%; 1,5%) oai?ei, yeei a iiaeaeueoiio i?ecia/aee i?oaaeei?i, - aeeaienei oaae cieaeoaaa ?? (1,1%). Oaeei /eiii, ?acoeueoaoe aino?iai iaaeeeaiaioiciiai oanoo c aaeeaaiiyi aioeaia?iaeueieo oa aaiiaeeiai?/ii cia/oueo i?aia?ao?a aeicaiey? a iiaeaeueoiio i?iaiicoaaoe ?o aoaeoeai?noue oa ?ic?iaeoe noaie ? aeai?eoie iaaeeeaiaioicii? ei?aeoe?? o oai?eo c “i?ney?ioa?eoiei na?oeai”. Eiia?iiaaia iaaeeeaiaioicia e?eoaaiiy, yea aeeth/aei e??i aacenieo i?o?ao?a ? ani??eio - aa?aiai?e, eaioii?ee; i?oaaeei?i, eaioii?ee; iaceaeai, eaioii?ee; i?oaaeei?i, aeeaienei, iaea?aeoaaee oai??, a yeeo a?aei?/aeanue iaea?eueo ae?aaeaia ea?oeia ?oai?caoe?? i?iea?aea. Oai??, ye? iaea?aeoaaee iaceaeai oa i?oaaeei?i, aoee a?eueo ni?eyoeeaith a?oiith. Oai??, ye? io?eioaaee i?oaaeei?i, eaioii?ee; i?oaaeei?i, aeeaienei; iaceaeai, eaioii?ee; aa?aiai?e, eaioii?ee, iaee iaea?eueo iani?eyoeea? aeo?aei? a?aeoeeaiiy ia?iieo iieaciee?a ? nei?ioeeai? ooieoe?? i?iea?aea. Oai??, yeei i?ney ianoaaeaiiy aoei i?ecia/aii i?oaaeei?i, aeeaienei; i?oaaeei?i, eaioii?ee; aa?aiai?e, eaioii?ee; iaceaeai, eaioii?ee, iaee iaeiaioo oiea?aioi?noue aei o?ce/iiai iaaaioaaeaiiy i?e AAI. Iaeneiaeueia ?aaeoeoe?y ei?iia?iiai ?aca?ao c o?aooaaiiyi /anoioe i?eieiaiiy noeioeyoe?? aei e?eoaaiiy a?aei?/aeanue o oai?eo, ye? a iiaeaeueoiio i?eeiaee i?oaaeei?i, aeeaienei; i?oaaeei?i, eaioii?ee; iaceaeai, eaioii?ee; aa?aiai?e, eaioii?ee. ?acoeueoaoe OI AEA na?ae/aoue, ui A?I aei e?eoaaiiy /ano?oa ?a?no?oaaeanue o oai?eo, yeei aoei i?ecia/aii aa?aiai?e, eaioii?ee; iaceaeai, eaioii?ee; i?oaaeei?i, eaioii?ee. AA?I iaea?eueoa a?aei?/aeanue o oai?eo, ye? i?ney ianoaaeaiiy iaea?aeoaaee i?oaaeei?i, aeeaienei; aa?aiai?e, eaioii?ee; i?oaaeei?i, eaioii?ee. ?iia??i?noue aeieeiaiiy OA aei i?ecia/aiiai e?eoaaiiy aoea aeaui a?eueoa o oai?eo, ye? i?eeiaee i?oaaeei?i, eaioii?ee; iaceaeai, eaioii?ee; iaceaeai (oaae. 1). Oaaeeoey 1 Aeeiai?ea aeo?aeieo ooieoe?iiaeueieo iieaciee?a o ianoaaeaieo oai?eo ?ON, yeei e??i aacenii? oa?ai?? aoei i?ecia/aii iaceaeai (I a?oia), i?oaaeei?i, eaioii?ee (II), iaceaeai, eaioii?ee (III), aa?aiai?e, eaioii?ee (IV), i?oaaeei?i, aeeaienei (V), i?oaaeei?i (VI) A?oieIIIIIIIVVVIEAeI (ie)170,22,9*202,15,6195,84,2192,44,1200,15,2180,311,2ENI (ie)88,53,3*122,95,7117,34,1115,50,8122,55,098,013,6OA (%)48,21,2*39,81,440,41,040,51,139,01,847,43,2*AAI (Ao)109,38,3*58,83,8*69,13,5*59,63,5*50,02,188,813,5*% AAI74,98,947,28,6*51,86,1*48,48,2*42,77,3*68,317,6*NAN (?ii/oa)141,33,6*122,61,1124,42,0125,42,5120,01,0136,76,1*A?I OI (%)20,88,3*58,88,463,27,867,67,722,29,8*28,617,1*AA?I OI (%)20,88,3*50,08,636,87,851,48,255,611,722,95,8*OA OI (%)79,24,691,24,984,21,267,611,272,29,657,118,7I?ei?oea. * ?

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