.

Характеристика та оцінка функціональних серцевих шумів у дітей: Автореф. дис… канд. мед. наук / О.О. Панфілова, Харк. держ. мед. ун-т. — Х., 1999. —

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OA?E?ANUeEEE AeA?AEAAIEE IAAeE*IEE

OI?AA?NEOAO

IAIO?EIAA IEAIA IEAENAIAe??AIA

OAeE: 616.12-008.2-072.7-053.2

OA?AEOA?ENOEEA OA IOe?IEA

OOIEOe?IIAEUeIEO NA?OeAAEO OOI?A O Ae?OAE

14.01.10 – iaae?ao??y

AAOI?AOA?AO

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Oa?e?a – 1999

Aeena?oaoe??th ? ?oeiien

?iaioa aeeiiaia a Oa?e?anueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao? IIC
Oe?a?ie

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

Noea/iaa Aaiia ?aai?aia,

Oa?e?anueeee aea?aeaaiee
iaaee/iee oi?aa?neoao,

i?ioani? eaoaae?e
oaeoeueoaonueei? iaae?ao??? c

iaaee/iith aaiaoeeith.

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

Ino?iiieaoeue Naaae?e
Naaae?eiae/,

Aeiiaoeueeee aea?aeaaiee
iaaee/iee oi?aa?neoao,

caa?aeoaa/ eaoaae?e
iaae?ao??? oaeoeueoaoo

i?neyaeeieiiiiai iaa/aiiy,

– aeieoi? iaaee/ieo iaoe

Aiaiao Ethaeieea Oaaein??aia,

Oe?a?inueeee iaoeiai-aeine?aeiee
?inoeooo ioi?iie

caei?ia’y ae?oae oa i?aee?oe?a,
i.Oa?e?a, noa?oee

iaoeiaee ni?a?ia?oiee,

ea??aiee a?aeae?eo iaoieia?? i?aee?oe?a.

I?ia?aeiee caeeaae: Aei?i?iiao?ianueea aea?aeaaia iaaee/ia aeaaeai?y,

eaoaae?a aini?oaeueii? iaae?ao???
? 2 ? iaiiaoieia?? OII.

Caoeno aeena?oaoe?? a?aeaoaeaoueny “ 11 ” aa?aciy 1999 ?ieo i
1330 aiaeei? ia can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 64.600.04
i?e Oa?e?anueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao? ca aae?anith:
310022, i.Oa?e?a, i?. Eai?ia, 4.

C aeena?oaoe??th iiaeia iciaeiieoeny a a?ae?ioaoe? Oa?e?anueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo (310022, i.Oa?e?a, i?. Eai?ia, 4)

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

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee,

eaiaeeaeao iaaee/ieo iaoe, aeioeaio
E.?.Ia/a?aiei

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie.

Aei oeueiai /ano caoai?thaaiiy na?oeaai-noaeeiii? nenoaie ? iaei??th c
aeooaeueieo iaaee/ieo i?iaeai. ?? aaaeeea?noue iaoiiaeaia iianthaeiei
c?inoaiiyi na?oeaai-noaeeiii? iaoieia??, yea ia??aeei, ii/aaoenue o
aeeoy/iio a?oe?, noa? aeaea?aeii oyaeeeo caoai?thaaiue o aei?ineeo
(Aiae?ouaiei ?.A., E?anianueea I.A., 1990; I?eoiaeueei A.N., 1993;
Stamler S. et al., 1993). Oiio, ii?yae c oaeineiiaeaiiyi ae?aaiinoeee ?
e?eoaaiiy, aeooaeueieie ? ieoaiiy i?io?eaeoeee oyaeeeo oi?i
ea?ae?aeueii? iaoieia?? ye o aei?ineeo, oae ? o ae?oae (Neaeaeueieeia
A.I., 1993; Aiaaoe?ueiaa ?.A. c ni?aaao. 1997).

O i?aeoe/i?e ae?yeueiino? e?ea??a-iaae?ao??a aeineoue /anoi (o 30 – 60%
ae?oae) cono??/athoueny nenoie?/i? ooie iac?icoi?ei? aaiace, ye?
aeeeeeathoue aaeee? o?oaeiiu? a nai?e o?aeoiaoe?, ai i?e
caaaeueiii?eeiyoeo ee?i?/ieo oa ?ino?oiaioaeueieo aeine?aeaeaiiyo (AEA,
OEA) ia caaaeaee oaea?oueny ?icoeo?oaaoe ?o i?e/eio. Oae? ooie caeaaia
iienoaaeeny a e?oa?aoo?? ye ooieoe?iiaeuei?, aeoeeaeaioaeuei?,
iac?icoi?ei? aaiace (Ineieeiaa I.E., 1977, 1988; Iiue/ I.N. oa ?i.,
1986; Aiae?ouaiei ?.A., E?anianueea I.A., 1990). Caoe?eaaeai?noue aei
ieo ia ciaioo?oueny, ui, i/aaeaeii, ? iineoaeeei i?aenoaaith aeey
aeae?eaiiy ?oa?eee ““Aeia?iye?ni?” na?oeaa? ooie oa o?, ui ia
ni?e/eiythoue oo?aioe (ooieoe?iiaeuei? na?oeaa? ooie) ” (R01.0) a IEC
AIC O ia?aaeyaeo.

A inoaii? ?iee, caaaeyee iioe?aiiio ai?iaaaeaeaiith a i?aeoeeo ioi?iie
caei?ia’y no/anii? oeueo?acaoeiai? ae?aaiinoe/ii? aia?aoo?e, aaeaeiny
c’ynoaaoe i?e/eio aeieeiaiiy aaaaoueio ooieoe?iiaeueieo na?oeaaeo ooi?a.
Na?aae ieo cia/io /anoeio neeaaeathoue iae? no?oeoo?i? aiiiae?? na?oey,
ye? ?yaeii aaoi??a o?aeoothoueny ye ia?aeii? aai aeenieanoe/i?
ea?ae?iiao?? (I?eoiaeueei A.N., Naiaoi?iaa A.N., 1994; Aiaiao E.O, oa
?i., 1997). Onoaiiaeaii, ui ?yae i?e/ei, oae?, ye aino?? ? o?ii?/i?
?ioaeoe??, ?ao?o, o?ii?/i? ?iceaaee aeeaeaiiy, aea?aice, aaaaoinoaeeii?
aeenoii??, aiaeie?eii? caoai?thaaiiy oa ?io?, iiaeooue i?eaanoe aei
?icaeoeo aoi?eiieo ea?ae?iiao?e (Naiaoi?iaa A.N., 1994, 1997). Ca
aeaieie aeuaaeacaieo aaoi??a, aiie nooo?ai aieeaathoue ia aaiiaeeiai?/i?
iieacieee. A aeine?aeaeaiiy ooieoe?iiaeueii? aaeaioaoe?? na?oey o ae?oae
c i?ieaa??oaaiiyi i?o?aeueiiai eeaiaio (I.I.Ii?iciaa, 1990),
aaaaoinoaeeiiith aeenoii??th, ooieoe?iiaeueieie ea?ae?iiao?yie (Iia?eiaa
A.I., 1986; Iiieoe?i I.I., 1997), i?iea?ae?iaeeno?io??th (Ino?iiieaoeue
N.N. c ni?aaao., 1991; Aia?ia A.A., Aaoiaeiaa I.A., 1994) anoaiiaeee o
25-40% c ieo cieaeaiiy oiea?aioiino? aei o?ce/iiai iaaaioaaeaiiy.

?yaeii aaoi??a (*a?aeiaoeue A.?., Eiiae?aoue?a A.A., 1993) aeiaaaeaiee
/?oeee ca’ycie i?ae caa?oaeiai?noth ?aeiia iaoeaiiy ? /anoioith
aeiiicieia?/-ieo ci?i na?oeaai-noaeeiii? nenoaie. Onoaiiaeaii, ui 50%
ae?oae, ui iaoeathoue a caa?oaeiaieo i?iieneiaeie a?aeoiaeaie ?aeiiao,
iathoue a?aeoeeaiiy a ?? noai? (Eaaaaeueeiaa N.?. c ni?aaao., 1991). Ca
?iee, ui ieioee i?ney aaa??? ia *AAN, a?aecia/a?oueny cia/ia c?inoaiiy
ooieoe?iiaeueieo ci?i a ?? ae?yeueiino? o ae?oae o aeaeyae?
iae?ioee?eoeyoi?ii? aeenoii??, ooieoe?iiaeueieo ea?ae?iiao?e, ye?, ca
aeaieie e?oa?aoo?e (Iia?eiaa A.I., 1991; Anoaoiaa E.I. c ni?aaa., 1991;
Noaiaiiaa ?.?. c ni?aaao., 1991, Ei??i?a I.I. c ni?aaao., 1997),
aeyaeythoueny o 40-85,5% ae?oae, aaaeoeiaaieo c 30-e?eiiao?iai? ciie
AAN.

C o?aooaaiiyi ci?iaieo oyaeaiue i?i oae caai? ooieoe?iiaeuei? na?oeaa?
ooie ?nioth/a eeaneo?eaoe?y ?o o ae?oae ia a?aeiia?aea? no/aniei aeiiaai
iaae?ao?e/ii? i?aeoeee. A e?oa?aoo?? a?aeo? ?ia?o, i?enay/aieo
aaaaoiieaiiaiio aeine?aeaeaiith noaio ? aaeaioaoe?eieo iiaeeeainoae
na?oeaai-noaeeiii? nenoaie o oeeo ae?oae, aeeth/ath/e aeine?aeaeaiiy
aaaaoaoeaiiai aiiainoaco, iaaaioaaeoaaeueieo i?ia ? iieaciee?a iai?io
niieo/ii? oeaieie, iaia? /?oeeo aeac?aie, ye iiynithaaoe noaie, ui
iaoiiaeththoue ?o aeieeiaiiy. Iaaeinoaoiuei ?ia?o c aea/aiiy ?oiuei?
?ie? a ?icaeoeo na?oeaai-noaeeiii? iaoieia?? a ianooii? ia??iaee aeeooy.
Ia a?aei?aoeueiaaia ?aeeia i?ia?aia ianoaaeaiiy, iaaeyaeo ca oeeie
ae?oueie ? i?iaaaeaiiy o ieo iaa?oioiaaiiai eiiieaeno
e?eoaaeueii-i?io?eaeoe/ieo caoiae?a, ui ? iineoaeeei i?aenoaaith aeey
cae?eniaiiai iaie aeine?aeaeaiiy.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie.

Aeena?oaoe?eia ?iaioa iia’ycaia c iaoeiaith i?iaeaiith Oa?e?anueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo ca o/anoth eaoaae? iaae?ao?e/iiai
i?ioeeth ca oaiith “Ae?aaiinoeea, aeeniaina?ecaoe?y ? ?aaa?e?oaoe?y
ae?oae c ea?ae?aeueiith oa ?ani??aoi?iith iaoieia??th” (? aea?aeaaii?
?a?no?aoe?? 01940038041) ? ? o?aaiaioii IAe? eaoaae?e oaeoeueoaonueei?
iaae?ao??? c iaaee/iith aaiaoeeith “Iioei?caoe?y no/anieo i?aeoiae?a aei
ae?aaiinoeee, e?eoaaiiy ? ?aaa?e?oaoe?? a?iioieaaaiaaeo ? ea?ae?aeueieo
caoai?thaaiue o ae?oae, ui iaoeathoue a aeieia?/ii iani?eyoeeaiio
?aa?ii?”.

Iaoa ? caaea/? aeine?aeaeaiiy.

Oaeineiiaeeoe ?aiith ae?aaiinoeeo ci?i na?oeaai-noaeeiii? nenoaie o
ae?oae c ooieoe?iiaeueieie na?oeaaeie ooiaie, aecia/eoe aeaye? iaoai?cie
?oiueiai oi?ioaaiiy ? iaa?oiooaaoe aeey oaeeo ae?oae aoaeoeai? iaoiaee
i?io?eaeoeee ? e?eoaaiiy.

A?aeiia?aeii aei iinoaaeaii? iaoe aoee aecia/ai? ianooii? caaea/?:

1. Aea/eoe noai na?oeaai-noaeeiii? nenoaie o ae?oae c ooieoe?iiaeueieie
na?oeaaeie ooiaie ca ee?i?ei-aiaiianoe/ieie aeaieie, ?acoeueoaoaie
?ino?oiaioaeueieo aeine?aeaeaiue, a oiio /ene? iaaaioaaeoaaeueieo i?ia,
a?io?i?/ieo aeine?aeaeaiue ? aaaaoaoeaiiai noaoono.

2. Anoaiiaeoe iniiai? iaoai?cie, ui ni?eythoue oi?ioaaiith
ooieoe?iiaeueieo na?oeaaeo ooi?a.

3. Aea/eoe noai iai?io i?iaeoeo?a niieo/ii? oeaieie ? aeayeeo iieaciee?a
ee?oeiiiai ?ioi?oaoo o ae?oae c i?e?iaiiiae?yie na?oey.

4. ?ic?iaeoe noaio-i?ia?aio ianoaaeaiiy ? aeai?eoi aeyaeaiiy a?oi ?eceeo
uiaei ?icaeoeo ??cieo aa??aio?a na?oeaai-noaeeiii? iaoieia?? o ae?oae c
ooieoe?iiaeueieie na?oeaaeie ooiaie, iaa?oiooaaoe aeey ieo eiiieaen
e?eoaaeueii-i?io?eaeoe/ieo caoiae?a.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a.

O ia?aaaaeii? a?eueoino? ianoaaeaieo ae?oae c ooieoe?iiaeueieie
na?oea-aeie ooiaie (89,5%) aeyaeai? iani?eyoeea? oaeoi?e, ui aoee
i?aenoaaith aeey ?icaeoeo yaieo ? i?eoiaaieo ii?ooaiue o
na?oeaai-noaeeii?e nenoai?.

Onoaiiaeai? iniiai? iaoai?cie oi?ioaaiiy ooieoe?iiaeueieo na?oeaaeo
ooi?a, yeeie aeyaeeeny iai?iii-o?io?/i? ii?ooaiiy ? aaaaoaoeaiee
aeenaaeain, eio?? iaoiiaeee ci?ie nei?i/oaaeueii?, ianinii? ooieoe??
i?iea?aeo, a oaeiae aaeaioaoe?eii-eiiiainaoi?ieo iaoai?ci?a
na?oeaai-noaeeiii? nenoaie, ui i?aeoaa?aeaeaii aeinoia??ieie
ei?aeyoe?eieie ca’yceaie i?ae iayai?noth nenoie?/iiai ooio ? i?iyaaie
oeacaieo ci?i.

Aia?oa anoaiiaeai? aeinoia??i? ci?ie iniiaieo iieaciee?a iai?io
niieo/ii? oeaieie o ae?oae c i?e?iaiiiae?yie na?oey. Aeieacaiee oeyoii
ei?aeyoe?eiiai aiae?co aieea aeeaeie ii?ooaiiai niieo/ii-oeaieiiiai
iai?io ia nooi?iue i?iyao ci?i a na?oeaai-noaeeii?e nenoai?. O ae?oae c
i?e?iaiiiae?yie na?oey i?ae iieacieeaie ee?oeiiiai ?ioi?oaoo ? iai?io
niieo/ii? oeaieie onoaiiaeai? aeinoia??i? ei?aeyoe?ei? ca’ycee, ui ?
i?aeoaa?aeaeaiiyi ii?ooaiiy o ieo caoenii? ooieoe?? niieo/ii? oeaieie.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a.

Onoaiiaeai? ? ?aeiiaiaeiaai? a i?aeoeeo e?eoa??? ae?aaiinoeee
aaaaoaoeaieo aeenooieoe?e ? iai?iii-o?io?/ieo ii?ooaiue o i?iea?ae? ca
iieacieeaie ee?i?/ieo, ?ino?oiaioaeueieo, aaiiaeeiai?/ieo, a?io?i?/ieo
aeine?aeaeaiue, a oaeiae aecia/aiiy aaaaoaoeaiiai noaoono ?
oiea?aioiino? aei o?ce/iiai iaaaioaaeaiiy. Aeey aeyaeaiiy yaieo ?
ne?eoeo ci?i o noai? na?oeaai-noaeeiii? nenoaie o ae?oae c
ooieoe?iiaeueieie na?oeaaeie ooiaie cai?iiiiiaaia ?aoe?iiaeueia noaia ?o
ianoaaeaiiy, a oaeiae aeai?eoi iiooeo na?aae ieo a?oi ?eceeo uiaei
?icaeoeo ??cieo aa??aio?a a?eueo oyaeei? na?oeaai-noaeeiii? iaoieia?? a
ianooii? ia??iaee aeeooy. O a?eueoino? ianoaaeaieo ae?oae aeiaaaeaia
ni?iiiaei?noue iinoaiiaee ee?i?/iiai ae?aaiico o aeaeyae?
i?iea?ae?iaeeno?io?? ??cii? aaiace, aaaaoaoeaii? aeenooieoe?? ??ciiai
oeio oa ?o ii?aeiaiiy. C iaoith caiia?aaiiy i?ia?anoaaiiy onoaiiaeaieo
yaieo ? i?eoiaaieo ci?i cai?iiiiiaaia noaia aeeniaina?iiai iaaeyaeo ?
ei?aeoe?? iaoiaaiaoe/ieie caniaaie oa?ai?? ia ??cieo aoaiao
niinoa?aaeaiiy, ui ciaeoei a?aeia?aaeaiiy o aeaio ?ioi?iaoe?eieo eenoao.

Iaoiaeeee, i?ia?aie ianoaaeaiiy oa ?aaa?e?oaoe?? ae?oae c
ooieoe?iiaeueieie na?oeaaeie ooiaie ai?iaaaeaeai? a i?aeoeeo ?iaioe
iaeanii? aeeoy/i? ee?i?/ii? e?ea?i? ? 1, aeeoy/eo i?nueeeo e?ea?aiue ?
16, 19, 24 i. Oa?eiaa, a oaeiae aeeoy/eo i?nueeeo iie?ee?i?e ? 1, 15, 16
i. Oa?eiaa. Oi?ie ai?iaaaeaeaiiy: iaa/aiiy iaoiaeeeai, eiinoeueoaoe??,
?ioi?iaoe?ei? eenoe. Caeiaoo? oai?aoe/i? oa i?aeoe/i? aeai?
aeei?enoiaothoueny a iaaeaaia?/iiio i?ioean? eaoaae?e oaeoeueoaonueei?
iaae?ao??? c iaaee/iith aaiaoeeith OAeIO.

Iniaenoee aianie caeiaoaa/a.

Aaoi?ii iniaenoi i?iaiaeeany a?aea?? ? ee?i?/ia ianoaaeaiiy 171 aeeoeie
c ooieoe?iiaeueieie na?oeaaeie ooiaie ? 40 ae?oae eiio?ieueii? a?oie.
Aaoi? naiino?eii i?iaiaeeea AoiEA c i?ae?aooaaiiyi iieaciee?a
oeaio?aeueii? aaiiaeeiai?ee, AAI c aiae?cii oiea?aioiino? aei o?ce/iiai
iaaaioaaeaiiy, aeine?aeaeaiiy aaaaoaoeaiiai noaoono, ?icoeo?iaeo AEA oa
OEA o an?o ianoaaeaieo ae?oae. Aaoi? iniaenoi i?iaaea aiae?c iaea?aeaieo
aeaieo, noi?ioethaaea aeniiaee ? iniiai? iieiaeaiiy, aeianai? ia caoeno,
i?aeaiooaaea i?aeoe/i? ?aeiiaiaeaoe?? uiaei ianoaaeaiiy, ei?aeoe??
aaaaoaoeaieo ? iai?iii-o?io?/ieo ii?ooaiue o ae?oae c ooieoe?iiaeueieie
na?oeaaeie ooiaie.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??.

Iaoa??aee aeena?oaoe?? aeiiia?aeaeeny ? iaaiai?thaaeeny ia i?nuee?e
tha?eaei?e iaoeiai-i?aeoe/i?e eiioa?aioe?? aeeoy/eo e?ea??a, i?enay/ai?e
10-??//th eaoaae?e aeeoy/eo oai?ia ? 2 OI? (Oa?e?a, 1994 ?.), ia
i?nuee?e tha?eaei?e iaoeiai-i?aeoe/i?e eiioa?aioe??, i?enay/ai?e
50-??//th eaoaae?e aeeoy/eo ?ioaeoe?eieo oai?ia OAeIO (Oa?e?a, 1995 ?.),
ia V (Oa?e?a, 1997) oa VII (Oa?e?a, 1998 ?.) i?nueeeo
iaoeiai-i?aeoe/ieo eiioa?aioe?yo e?ea??a-iaae?ao??a, ia can?aeaii?
Oa?e?anueeiai iaoeiaiai iaaee/iiai oiaa?enoaa (1996 ?.). ?iaioa i?ieoea
ai?iaaoe?th ia i?aeeaoaae?aeueiiio can?aeaii? eaoaae? aeeoy/eo oai?ia,
i?iiaaeaaoeee aeeoy/eo oai?ia, oaeoeueoaonueei? iaae?ao??? c iaaee/iith
aaiaoeeith, aini?oaeueii? iaae?ao???, aeeoy/eo ?ioaeoe?eieo oai?ia OAeIO
(ea?oaiue, 1998 ?.)

Ioae?eaoe??.

Ca oaiith aeena?oaoe?? iioae?eiaaii 6 ae?oeiaaieo ?ia?o, c ieo 4 noaoo?
– a iaaee/ieo aeo?iaeao, 2 – o ca??eao iaoeiaeo i?aoeue.

No?oeoo?a oa ianya aeena?oaoe??.

Aeena?oaoe?eia ?iaioa aeeeaaeaia ia 219 noi??ieao iaoeiiieniiai oaenoo ?
neeaaea?oueny ?c anooio, iaeyaeo e?oa?aoo?e, 5 ?icae?e?a aeanieo
aeine?aeaeaiue, ocaaaeueiaiiy iaea?aeaieo ?acoeueoao?a, aeniiae?a,
i?aeoe/ieo ?aeiiaiaeaoe?e, nieneo e?oa?aoo?e, yeee i?noeoue 252
e?oa?aoo?ieo aeaea?aea. ?iaioa ?ethno?iaaia 40 iaethieaie oa 37
oaaeeoeyie, ye? ia?eiathoue 44 noi??iee.

CI?NO ?IAIOE

Iaoa??ae ? iaoiaee aeine?aeaeaiiy.

Aeine?aeaeaiiy i?iaiaeeeeny a aeaa aoaie. Ia ia?oiio aoai?
aoiea?ae?ia?ao?/ii aoei ianoaaeaii 635 ae?oae a?eii a?ae 1 i?nyoey aei
15 ?ie?a c iaoith ?ice?eooy i?e/ei iayaiino? o ieo nenoie?/ieo ooi?a. O
a?eueoino? c ieo – 425 (67%) – aoee aeyaeai? ??ciiiai?oi? ci?ie a
na?oe?, na?aae yeeo ia?aaaaeaee (o 75%) iae? no?oeoo?i? aiiiae?? na?oey,
o ?ioeo (25%) ciaeaeai? ci?ie e?iaoeee, a?eoi??, ea?aeeoe, o?iaeaeai?
aaaee na?oey.

Ia ae?oaiio aoai? c iaaeyaeo aoee aeeeth/ai? ea?aeeoe, o?iaeaeai? aaaee
na?oey, aino?? ?ioaeoe?ei? caoai?thaaiiy, aeeooci? caoai?thaaiiy
niieo/ii? oeaieie. ?c ?aooe ae?oae oeyoii aeiaaeeiaiai aeai?o aeey
iiaeeaeaiiai ianoaaeaiiy aoea a?ae?a?aia 171 aeeoeia a?eii a?ae 3 aei 15
?ie?a.

Na?aae ianoaaeaieo aoee ye iino?ei? iaoeaioe? aeieia?/ii iani?eyoeeaiai
aiane?aeie oaoiiaaiiiai caa?oaeiaiiy I?aeaeii?e?aecaanueeiai ?aeiio
i.Oa?eiaa (100 ae?oae), oae ? ae?oe c n?iae, ui iino?aaeaeaee a?ae
aaa??? ia *AAN (71 aeeoeia) ? ui iaoeathoue ia ?iaainueeiio aeeeianea?,
yeee ? aeieia?/ii a?aeiinii “/enoei”. Eiio?ieueio a?oio neeaee 40
i?aeoe/ii caei?iaeo ae?oae oiai ae a?eo aac iayaiino? a ieo ooi?a o
na?oe? ? ci?i ia AoiEA.

Iaoiaeeee ianoaaeaiiy, e??i caaaeueiiee?i?/ieo, aeeth/aee ?yae
?ino?oiaioaeueieo, a?io?i?/ieo, ?ioiieia?/ieo aeine?aeaeaiue, a oaeiae
aecia/aiiy aaaaoaoeaiiai noaoono ? oiea?aioiino? aei o?ce/iiai
iaaaioaaeaiiy.

?a?no?aoe?y AEA ? OEA cae?enithaaeany an?i ae?oyi ia 6-eaiaeueiiio
aeaeo?iea?ae?ia?ao? “6-NEK” ae?iaieoeoaa I?ia//eie ? OEA-01 a?o/eciyiiai
ae?iaieoeoaa ca caaaeueiii?eeiyoeie iaoiaeeeaie. I?e oeueiio, ii?yae c
?ioeie iieacieeaie, cia/ia oaaaa i?eae?eyeanue aiae?co ia?aaena?aeiueiai
? e?ioeaai? /anoeie oeoii/eiaiai eiiieaen?a, i?ae?aooaaiith ?iaeaena
Iae?oca.

AAI i?iaaaeaia 112 ae?oyi o a?oe? 8-15 ?ie?a a iieiaeaii? “neaey/e” ia
aaeia?aiiao?? AA 05 “?eoi” (i. Ee?a). ?a?no?aoe?y AEA i?iaiaeeeany a 12
noaiaea?oieo a?aeaaaeaiiyo o niiei?, ia aenio? iaaaioaaeaiiy ? a
aeeiai?oe? ?anoeoooe??. Aeei?enoiaoaaee iaoiaeeeo nooiaiaaiai,
aacia?a?aii ia?anoath/iai iaaaioaaeaiiy, ii/aoeiaa iiooaei?noue yeiai
noaiiaeea 6 eAi/(oa.ea) c iine?aeiaiei i?aeaeuaiiyi eiai ia 3
eAi/(oa.ea) eiaei? o?e oaeeeie aei aeinyaiaiiy noaiaeneiaeueiiai. Eiaeio
oaeeeio i?iae, a oaeiae ia 3-e, 5-e, 7-e oaeeeiao a?aeiiaethaaeueiiai
ia??iaeo ?a?no?oaaee AO, *NN, /anoioo aeeoaiiy. Ca ?acoeueoaoaie
i?iaaaeaiiai iaaaioaaeoaaeueiiai oanoo aecia/aee o?ce/io
i?aoeacaeaoi?noue, oiea?aioi?noue aei o?ce/iiai iaaaioaaeaiiy,
ioe?ithaaee ?aaeoe?th aaiiaeeiai?ee ia aeeiiaio ?iaioo, o?eaae?noue
a?aeiiaethaaeueiiai ia??iaeo.

Aoiea?ae?ia?ao?/i? aeine?aeaeaiiy a I- ? A-?aaeeiao aeeiioaaeeny an?i
ae?oyi ia oeueo?acaoeiaiio aia?ao? “Sonoline SL-1” o??ie “Siemens”
(I?ia//eia) c /anoioith aeao/eea 3,5 iAoe ca caaaeueiii?eeiyoeie
iaoiaeeeaie. I?e ianoaaeaii? ioe?ithaaeeny ii?oiooieoe?ei? ia?aiao?e
na?oey ? aaeeeeo noaeei, ?ic?aoiaoaaeeny iieacieee oeaio?aeueii?
aaiiaeeiai?ee (OI, %dS, OA, N?) ca aeiiiiiaith aeai?eoio Simpson
(iaoiae aeene?a).

Aeine?aeaeaiiy aaaaoaoeaiiai noaoono aeeth/aei aecia/aiiy aeo?aeiiai
aaaaoaoeaiiai oiiono, aaaaoaoeaii? ?aaeoeaiino? ? aaaaoaoeaiiai
caaacia/aiiy ae?yeueiino?. Aeo?aeiee aaaaoaoeaiee oiion aecia/aee ca
oaaeeoeath Aaeia (1981), aeaieie AEA ? ?icoe?ithaaee eiai ye aeoii?/iee
(ii?iioii?/iee), aaaioii?/iee, neiiaoeeioii?/iee aai aeenoii?/iee
(ci?oaiee aa??aio). C iaoith aeine?aeaeaiiy aaaaoaoeaii? ?aaeoeaiino?
aeei?enoiaoaaeeny o?ce/i? oanoe: i?noeaaee aea?iia?ao?ci, ieina?oeaaee
?aoeaen Aoia?a, neiiea?ioeaeiee ?aoeaen *a?iaea, ca ?acoeueoaoaie yeeo
aeae?eyee ii?iaeueio, a?ia?neiiaoeeioii?/io ? aneiiaoeeioii?/io
?aaeoeai?noue. Aeine?aeaeaiiy aaaaoaoeaiiai caaacia/aiiy ae?yeueiino?
cae?enithaaeiny ca aeiiiiiaith ee?iii?oinoaoe/ii? i?iae, ca
?acoeueoaoaie yei? aeae?eyee aeinoaoi? caaacia/aiiy (ii?iaeueiee
aa??aio) ? 5 iaoieia?/ieo aa??aio?a: c iaaei??iei aeeth/aiiyi
neiiaoeei-aae?aiaeiai? nenoaie (a?ia?neiiaoeeioii?/iee) ? c
iaaeinoaoiueith ?? ooieoe??th (aneiiaoeeioii?/iee, a?ia?ae?anoie?/iee,
neiiaoeeianoai?/iee ? anoaiineiiaoe/iee).

C iaoith aeeoa?aioe?eii? ae?aaiinoeee c caiaeueieie caoai?thaaiiyie
na?oeaai-noaeeiii? nenoaie aecia/aeeny aino?ioacia? iieacieee
(ae?eii?ioa?aee, n??iioei?ae), a oaeiae caaaeueiee a?eie ? eiai o?aeoe??
a ne?iaaooe? e?ia? ca caaaeueiii?eeiyoeie iaoiaeeeaie.

Ae?oyi c iaeeie no?oeoo?ieie aiiiae?yie na?oey i?iaiaeeeiny aecia/aiiy
ai?noo a ne?iaaooe? e?ia? caaaeueieo ae?eicai?iiae?eai?a (AAA)
i?oeeiiaei iaoiaeii oa ?o o?aeoe?e (Ooa?i I.?. c ni?aaao., a.n. ?
960626), ??aaiue aene?aoe?? c na/ath ae?eicai?iiae?eai?a ca
Ia?eo?’?aith ?.O. (1969) oa ien?i?ie?io (II) ca iaoiaeeeith E?aeue A.A.
? Ooioeaai? E.I. (1968).

??aaiue O- ? A-e?ioioeeo?a ia?eoa??eii? e?ia? aecia/aany iaoiaeii
?icaoeiooai?thaaiiy ca Jondal M. (1972). Ooieoe?iiaeueia aeoeai?noue
iaeo?io?e?a ioe?ithaaeany ca ?acoeueoaoaie ?aaeoe?? a?aeiiaethaaiiy
i?o?ineiueiai oao?acie?th, ui iinoaaeaia iaoiaeii A?eniaia I.?. ?
Iayinueeiai A.I. (1979). ??aaiue e?ciniiaeueieo eao?iiieo a?ee?a
aecia/aany ca iaoiaeii I.A.Ooae/a c aeei?enoaiiyi a?iioaiieiaiai
neiueiai, aeoeai?noue i??eiia?ieneaeace – ca iaoiaeii A?aoaia-Eiiey.

), na?aaeiy iiieeea na?aaeiuei? a?eoiaoe/ii? (m), e?eoa??e No’thaeaioa
(t), ?iia??i?noue iiieeee (?), eiao?oe?aio ei?aeyoe?? (r) ca
caaaeueiii?eeiyoeie iaoiaeeeaie.

?acoeueoaoe aeine?aeaeaiue.

I?ae /an aeine?aeaeaiiy aoei anoaiiaeaii, ui ooieoe?iiaeuei? na?oeaa?
ooie o a?eueoino? (89,5%) ianoaaeaieo ae?oae aeyaeyeeny ia
iani?eyoeeaiio i?aii?a?aeiiio oii?, ca iayaiino? iaoyaeaiiai
aeooa?nueeiai aiaiiaco (56,7%), iani?eyoeeai? niaaeeiaino? uiaei
na?oeaai-noaeeiieo caoai?thaaiue (31%), ui, i/aaeaeii, e iaoiiaeei o ieo
ci?ie a na?oeaai-noaeeii?e nenoai?.

3,8%.

O a?eueoino? ianoaaeaieo (82,9%) aeyaeai? aeinoia??i? ci?ie iieaciee?a
ae?yeueiino? aaaaoaoeaiiai a?aeae?eo ia?aiai? nenoaie. Oae, o 27,1%
onoaiiaeaia aaaaoaoeaia aeenooieoe?y ca aaaioii?/iei oeiii, ui na?ae/eea
i?i iaaeinoaoith aeoeai?noue neiiaoe/iiai a?aeae?eo AIN. A oie aea /an
aenieee nooi?iue iai?oae eiiiainaoi?ii-i?enoinoaaeueieo ?aaeoe?e i?ea?a
aei oi?ioaaiiy o 22,5% ae?oae aaaaoaoeaii? aeenooieoe?? ii
neiiaoeeioii?/iiio oeio. O 33,3% ae?oae ??ciini?yiiaai? iieacieee
aeo?aeiiai aaaaoaoeaiiai oiiono, aaaaoaoeaii? ?aaeoeaiino? ?
caaacia/aiiy ae?yeueiino? na?ae/eee i?i ae?aaeaiee aeenaaeain a
ae?yeueiino? AIN, ? aaaaoaoeaio aeenooieoe?th o ieo ?icoe?ithaaee ii
ci?oaiiio oeio.

Onoaiiaeai? na?aaei? ei?aeyoe?ei? ca’ycee i?ae iayai?noth nenoie?/iiai
ooio ? i?iyaaie AAe ??cieo oei?a, a oaeiae i?ae eiai iayai?noth ?
ci?iaie iai?iii-o?io?/iiai oa?aeoa?o ia AEA (r=0,41 – r=0,51), ui aeaco?
ia ?o ?ieue o oi?ioaaii? na?oeaaeo ooi?a.

Iaea?eueo ?ioi?iaoeaiei ? oe?iiei iaoiaeii a ?ice?eoo? i?e/ei ooi?a a
na?oe? o ae?oae yaeeany aeaii??ia aoiea?ae?ia?ao?y. Ca aeiiiiiaith
oeueiai iaoiaeo o a?eueoino? ianoaaeaieo (70,2%) iaie aeyaeai? iae?
no?oeoo?i? aiiiae?? na?oey, na?aae yeeo i?ieaa??oaaiiy eeaiai?a (? ? ??
nooiaith) noaiiaeee 36,8%, aiiiaeuei? oi?aee a ii?iaeieiao oeoii/e?a
na?oey – 15,8% ? ii?aeiai? aiiiae?? – 17,6%. O 29,8% no?oeoo?ieo
aiiiae?e ia aoei ciaeaeaii. Oea ? aeaei i?aenoaao aeey ?iciiae?eo an?o
ianoaaeaieo ae?oae ia 2 a?oie: c IAN oa aac IAN.

Ci?ie iieaciee?a oeaio?aeueii? aaiiaeeiai?ee onoaiiaeai? o 57,3% ae?oae.
O 42,1% aiie aoee cieaeaieie, a o 15,2% – i?aeaeuaieie. O /anoeie
(15,8%) ciaeaeaia iii??ia aeeeyoaoe?y e?aiai oeoii/eo, yea
noi?iaiaeaeoaaeany a?eueo ae?aaeaieie ci?iaie eiai ianinii? ooieoe??,
aaaaoaoeaiiai noaoono, iieaciee?a AEA, ui a?aeia?aaeathoue iaoaaie?/i?
ii?ooaiiy a i?iea?ae?.

Oeyoii ei?aeyoe?eiiai aiae?co onoaiiaeaiee nooo?aee aieea (r=0,34 –
r=0,53) oiiono neiiaoe/iiai a?aeae?eo AIN ia iieacieee oeaio?aeueii?
aaiiaeeiai?ee. A iaea?eueo cia/i? (? I?ei?oee: AAe – aaaaoaoeaia aeenooieoe?y, A?C – aino?? ?ani??aoi?i? caoai?thaaiiy, OEO – oeoieiai-eeoeiaee o?aeo. ?en. 1. Noaia-ia?ae?e iniiaieo ci?i na?oeaai-noaeeiii? nenoaie o ae?oae c ooieoe?iiaeueieie na?oeaaeie ooiaie NEA?AE INIAEEAINO? AIAIIACO ?ICEAAeE AIN: OEI, CAAACIA*AIIss AeAI? AEA AOIEA: IA?AIAO?E IIEACIEEE AAIIAeEIAI?EE AAI A?OIE ?ECEEO I?ei?oee: IOeAe – iae?i-oee?eoeyoi?ia aeenoii?y, ?ON – ?oai?/ia oai?iaa na?oey, AO – a?ia?oii?/ia oai?iaa. ?en. 2. Aeai?eoi aeyaeaiiy a?oi ?eceeo uiaei ?icaeoeo ??cieo aa??aio?a na?oeaai-noaeeiii? iaoieia?? na?aae ae?oae c ooieoe?iiaeueieie na?oeaaeie ooiaie (neeaaeaiee ia i?aenoaa? ianoaaeaiiy 112 ae?oae o a?oe? 8-15 ?ie?a) AENIIAEE 1. Onoaiiaeaii, ui ooieoe?iiaeuei? na?oeaa? ooie o ianoaaeaieo ae?oae – iaoeaioe?a i?iieneiaiai ?aeiio i. Oa?eiaa, aeieeathoue ia iani?eyoeeaiio i?aii?a?aeiiio oii? (o 89,5%), i?e ?icaeoeo aeacaaeaioaoe?eiiai neiae?iio (o 82,9%), ye? i?ecaiaeyoue aei ii?ooaiiy nei?i/oaaeueii? ? ianinii? ooieoe?? i?iea?aea (o 57,3%) ? cieaeaiiy oiea?aioiino? aei o?ce/iiai iaaaioaaeaiiy (o 85,7%), ui aeiaaa? canoinoaaiiy e?eoaaeueii-i?io?eaeoe/ieo caoiae?a c iaoith caiia?aaiiy i?ia?anoaaiith aeyaeaieo ci?i. 2. I?ae iayai?noth ooieoe?iiaeueiiai na?oeaaiai ooio ? iieacieeaie ??cieo oei?a aaaaoaoeaii? aeenooieoe??, a oaeiae i?ae eiai iayai?noth ? iieacieeaie ci?iaieo ooieoe?e na?oeaai-noaeeiii? nenoaie onoaiiaeai? aeinoia??i? ei?aeyoe?ei? ca’ycee (r=0,41 – r=0,51), ui aeaco? ia ?oith ?ieue o oi?ioaaii? ooieoe?iiaeueieo na?oeaaeo ooi?a. 3. Iciaeaie ii?ooaii? iai?iii-o?io?/ii? ? ?eoi?/ii? ae?yeueiino? na?oey ? aeyaeai? aeinoia??i? ci?ie a ?yae? iieaciee?a ee?i?/ieo, aaiiaeeiai?/ieo ? a?io?i?/ieo aeine?aeaeaiue, a oaeiae ii?ooaiiy aaaaoaoeaiiai aiiainoaco e oiea?aioiino? aei o?ce/iiai iaaaioaaeaiiy. 4. Aeyaeai? ci?ie iniiaieo iieaciee?a iai?io niieo/ii? oeaieie ? ee?oeiiiai ?ioi?oaoo o ae?oae c i?e?iaiiiae?yie na?oey, ui aeinoia??ii (?

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