?INOEOOO OOEC?AO??? ? IOEUeIIIIEIA??

?I. O.A. ssIIANUeEIAI

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

OAeE 616.72-002-022-056.3-092.19-07

Aeaeon Ia?oa Ai?en?aia

Oai?iaa ?aeoa?a: ?ioiieia?/i? iaoai?cie ?icaeoeo oa iniaeeaino?
ae?aaiinoeee

14.01.29. – ee?i?/ia ?ioiieia?y

Aaoi?aoa?ao

aeena?oaoe?? ia caeiaoooy

iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe

Ee?a– 1999

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia a Euea?anueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao? ?i.
Aeaieea Aaeeoeueeiai IIC Oe?a?ie.

Iaoeiaee ea??aiee:ae.i.i., aeioe. *ii’ye Aaeaioeia Aieiaeeie??aia,
Euea?anueeee aea?aeaaiee iaaee/iee oi?aa?neoao IIC Oe?a?ie, caa?aeoaa/
eaoaae?e ee?i?/ii? ?ioiieia?? oa aea?aieia??.Io?oe?ei? iiiiaioe:ae.i.i.,
i?io., *oiae Aiaoie?e Aiae??eiae/, Iaoeiaee oeaio? ?aae?aoe?eii?
iaaeeoeeie AII Oe?a?ie, caa?aeoaa/ a?aeae?eii ee?i?/ii? ?ioiieia??.

ae.i.i., i?io. Aaiaeaea ?ai? Ieoaeeiae/, Ee?anueea iaaee/ia aeaaeai?y
i?neyaeeieiiii? ina?oe ?i. I.E. Ooieea IIC Oe?a?ie, i?ioani?
eaoaae?e n?iaeii? iaaeeoeeie c eo?nii ee?i?/ii? ?ioiieia?? oa
aea?aieia??.

I?ia?aeia onoaiiaa: ?aaii-O?aie?anueea aea?aeaaia iaaee/ia aeaaeai?y IIC
Oe?a?ie,
eaoaae?a oaeoeueoaonueei? oa?ai??.

Caoeno a?aeaoaeaoueny “ 29 ” eenoiiaaea 1999 ?. i 14-00 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 26.552.01 i?e ?inoeooo?
ooec?ao??? ? ioeueiiiieia?? ?i. O.A. ssiianueeiai AII Oe?a?ie (03110, i.
Ee?a, INI – 03680, oca?c I?ioan?a y?, 7).

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? ?inoeoooo ooec?ao???
? ioeueiiiieia?? ?i. O.A. ssiianueeiai AII Oe?a?ie (i. Ee?a, oca?c
I?ioan?a y?, 7).

Aaoi?aoa?ao ?ic?neaiee “ 25 ” aeiaoiy 1999 ?.

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee Aaaioe?aa AE.A.

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie

A inoaii? ?iee i?iaeai? ao?ieia??, iaoiaaiaco oa e?eoaaiith oai?iae
?aeoa?a (O?) oa ?ioeo ?aaeoeaieo a?o?eo?a o na?o? iaaeathoue aeoaea
aaeeeiai cia/aiiy a i?aeoe/i?e iaaeeoeei? (Aaaaaaiaa A.?., 1995; Eiaaeaa
TH.I., 1997; Svenungson B., 1995). Anoaiiaeaii a 90-o ?ieao cia/iee ??no
/anoioe caoai?thaaiino? ia O? (Eiaaeaiei A.I., 1996; Granfors K., 1998).
A?aeiii, ui 40% oaeeo iaoe??io?a ia? iiaoi?i? aoaee O? i?ioyaii ?ieo, a
na?eici? nenoaii? oneeaaeiaiiy (ea?ae?ieia?/i?, iaa?ieia?/i?)
niinoa??aathoueny a 3% oai?eo, nia?oi?noue – o 1% (Graham R., 1996).
Chlamydia trachomatis ? iniiaiith i?e/eiith caoai?thaaiue, o /enei yeeo
aoiaeeoue ? O?, ui aaaeooue aei aeieeiaiiy ?aaeoeaieo a?o?eo?a,
o?iaai?oaeueieo caiaeueieo i?ioean?a, o?aoiie (Aaiaeaea ?.I., 1997;
Quinn T., 1996). Oai?iaa ?aeoa?a noi?iaiaeaeo?oueny o?ii?/iei caiaeueiei
i?ioeanii, i?e yeiio /anoi ia aaea?oueny eoeueoeaoaaoe oeai?ae?? c
aiaieua caiaeaiiy. E??i oiai, i?e O? oaeiae aeyaeythoue ? ??n?i??,
eaii?eiaaeoa???, naeueiiiaee, o?aaee, no?aioieiee, noao?eieiee,
i?eiieacie oa a??one. Aea ana ae oeai?ae?eia ?ioaeoe?y ? aeii?ioth/ith
i?e O? ? ca ??cieie aeaieie ae?aaiinoo?oueny a 36 – 50% (Ianiiiaa A.I.,
1997; Granfors K., 1997; Schumacher H, 1998). Iacaaaeath/e ia oa, ui
caniae ae?aaiinoeee ? oa?ai?? oeai?ae?e oaia? noaee a?eueo aoaeoeaieie,
?iciianthaeaeai?noue oa oneeaaeiaiiy a ?acoeueoao? ?o aeoeaaoe??
i?iaeiaaeothoue ca?eueooaaoenue. O ?icaeiaieo e?a?iao /anoea
caoai?thaaiino? ia oeai?ae?ic o a?oiao ?eceeo neeaaea? ca aeaieie ??cieo
aaoi??a a?ae 11% aei 30% (Agacfidan A., 1998). Ca?oiaa noaoenoeea
?a?no?o? ui??/ii 333 iei. iiaeo aeiaaee?a caoai?thaaiue, ye?
ia?aaeathoueny noaoaaei oeyoii, ?c ieo ia oeai?ae?ic i?eiaaea? 89 iei.
(AIIC, 1995). Oae, a Oe?a?i? e?euee?noue in?a c aeyaeaiei oeai?ae?icii
noaiii ia 1998 ??e noaiiaeea 24150 oai?eo, ui a 2,8 ?ace ca?eueoeeinue
ii??aiyii c 1994 ?ieii. C?icoi?ei, ui c?inoaiiy oeai?ae?ico aaaea aei
cia/ii? caoai?thaaiino? ethaeae iieiaeiai a?eo ia O?.

Oiio aeooaeuei?noue i?iaeaie O?, iniaeeai a inoaii? aeanyoee?ooy,
coiiaeaia ye iaaee/ieie, oae ? nioe?aeueieie i?e/eiaie. Nioe?aeueiee
aniaeo iia’ycaiee c oei, ui oai??thoue, a iniiaiiio, ethaee iieiaeiai,
i?aoeacaeaoiiai a?eo, ui aaaea aei oaeaeei? ?iaae?aeecaoe?? oa coiiaeth?
?icaeoie aacie?aeaey. Iaaee/iee aniaeo i?iaeaie iieyaa? o a?aenooiino?
/?oeeo oyaeaiue i?i ao?ieia?th caoai?thaaiiy, eiai iaoiaaiac.
Oa?aeoa?ii, ui i?e O? /anoi aeyaey?oueny ?aoeeaeeaoaaiiy,
iai?iaiiciaaiee ia?aa?a, a?aenooi?noue aoaeoeaieo iaoiae?a e?eoaaiiy.

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

Aeena?oaoe?y ? o?aaiaioii aea?aeaaii? iaoeiai-oaoi?/ii? i?ia?aie 02. 11
“Caoeno oa ?aaa?e?oaoe?y ?ioiii? nenoaie ianaeaiiy Oe?a?ie”. Aea?aeaaiee
?a?no?aoe?eiee iiia? – 2. 11/04102 – 97.

IAOA ? CAAAeAIIss IAOEIAIAI AeINE?AeAEAIIss

Iaoith ?iaioe aoei aea/aiiy ao?ieia?/ieo oaeoi??a oa ?ioiieo iaoai?ci?a
o ?icaeoeo O? oa ?o aca?iica’yce?a ?c ee?i?/ieie iniaeeainoyie O?.

Aeey aeinyaiaiiy iinoaaeaii? iaoe ae??ooaaeenue oae? caaaeaiiy:

1) anoaiiaeoe iniaeeaino? e?ioioeeoa?ieo, aioeo?eicaeaaeieo oa
ianiaoeeo?/ieo oaeoi??a ?ioiieia?/ii? ?aaeoeaiino? a oai?eo ia O?;

2) ii??aiyoe ?ioiieia?/i? iieacieee a oai?eo ia O? c iiceoeaiei oa
iaaaoeaiei HLA-B27 aaiioeiaie;

3) aeine?aeeoe i?noeaa? oa nenoaii? ia?ea?e ??cieo ?ioaeoe?e o oai?eo ia
O?;

4) ioe?ieoe oa?aeoa? ?ioiieia?/ieo ci?i o caeaaeiino? a?ae aeyaeaii?
?ioaeoe??, o?eaaeino?, ee?i?/ii? neiioiiaoeee, aeoeaiino? oa e?eoaaiiy
oai?eo ia O?.

IAA?OIOOAAIIss IAOEIAI? IIAECIE AeINE?AeAEAIIss, EIAI OAI?AOE*II? OA
I?AEOE*II? Oe?IIINO?

Iaoeiaa iiaecia ?iaioe iieyaa? a oiio, ui aea/aii aca?iica’ycie O? c
??cieie ?ioaeoe?eieie anioe?aoe?yie, aia?oa cai?iiiiiaaii ?icai?iooo
ee?i?ei-eaai?aoi?io ?ioiieia?/io ioe?ieo aeoeaiino? O?, aeine?aeaeaii
aieea ?ioiieia?/ieo ee?oeiieo oa aoii?aeueieo iaoai?ci?a ia ?icaeoie O?,
aeyaeaii ei?aeyoe?? ?ioiieia?/ieo iieaciee?a c o?eaae?noth oai?iae,
ee?i?/ieie i?iyaaie oa c ao?ieia?/ieie oaeoi?aie, anoaiiaeaii
iniaeeaino? ?ioiieia?/ieo iieaciee?a o HLA-B27- iiceoeaieo oa
HLA-B27-iaaaoeaieo oai?eo ia O?.

I?aeoe/ia cia/aiiy ?iaioe

Aeey i?aeoe/ieo e?ea??a ii?aoeueiaai? iieiaeaiiy aeena?oaoe??
aeicaieythoue:

1. Iie?aueoe niaoeeo?/io ae?aaiinoeeo O?.

2. Aecia/eoe aeoeai?noue O? ia iniia? ee?i?/ieo oa ia?aee?i?/ieo
?ioiieia?/ieo iieaciee?a.

3. Iaa?oiooaaoe iaoiaaiaoe/io iaiao?aei?noue canoinoaaiiy
i?ioe?ioaeoe?eii? oa ?ioiio?iiii? oa?ai?? a oai?eo ia O? ia iniia?
?iaeea?aeoaeueiiai i?aeoiaeo.

?acoeueoaoe ?iaioe ai?iaaaeaeai? a oa?aiaaoe/iiio a?aeae?eaii?
Euea?anueei? iaeanii? ee?i?/ii? e?ea?i?, Euea?anueeiio iaeaniiio
ae?aaiinoe/iiio oeaio??, a ?aaiaoieia?/ieo a?aeae?eaiiyo Aieeinueei?
iaeanii? ee?i?/ii? e?ea?i? oa Eooeueei? i?nueei? ee?i?/ii? e?ea?i?.
Aeaeai? ?ioi?iaoe?ei? eenoe: “Iaoiae aecia/aiiy aeoeaiino? oai?iae
?aeoa?a” oa “Iaoiae oi?ioethaaiiy ae?aaiico oai?iae ?aeoa?a”.

Iniaenoee aianie caeiaoaa/a a ?ic?iaee aeena?oaoe??

Ee?i?/iee i?aea?? oai?eo, ee?i?ei-eaai?aoi?i? noaie ianoaaeaiue,
eiinoeueoaoe?ei? aeniiaee oa i?ecia/aiiy niaoeeo?/ii? oa?ai?? i?iaiaeeea
naiino?eii. E??i oiai, naiino?eii eo?oaaea a?eueo?noue noaoe?iia?ieo
oai?eo, ai?iaaaeaeoaaea i?aeoe/i? ?aeiiaiaeaoe?? aeena?oaoe?? a ?iaioo
a?aeae?eaiue. Aaeeeo aeiiiiiao a iaai?? ee?i?/iiai iaoa??aeo iaaeaee
i?io. Aeaianueeee A.I., ae.i.i. aeioe. Aa?aaaiiae/ I.I., Neiaiueea
I.TH., ca ui ?i ue?i aaey/ia.

?ioiieia?/i? aeine?aeaeaiiy i?iaiaeeeenue o eaai?aoi??yo a?aeae?eaiiy
o?ii?/iiai aaiiae?ae?co oa ia?anaaeee ie?ie Euea?anueei? iaeanii?
ee?i?/ii? e?ea?i?, Euea?anueeiai iaeaniiai ae?aaiinoe/iiai oeaio?o
(?ioiioa?iaioi? oa ?ioiio?i?/i?), Euea?anueei? iaeanii? niaoe?ae?ciaaii?
aeeoy/i? e?ea?i? (oeeoioethi?iiao?e/i?, ?ioiioa?iaioi?, ?ioiio?i?/i?).
Naiino?eii aecia/aea iayai?noue oeai?ae?eiiai aioeaaio ?ioiioa?iaioiei
iaoiaeii, a?aea o/anoue o aeine?aeaeaii? noaiiioeyoe?e e?ioioeeo?a
iaoiaeii i?ioi/ii? oeeoiiao??? ca aeiiiiiaith iiiieeiiaeueieo aioeo?e.
?ioiieia?/i? aeine?aeaeaiiy aaciina?aaeiuei aeeiioaaee e.i.i. Iao?oo
A.A., e.a.i., no.i.i. Aaa?eethe A.I., e?ea?? eaai?aioe Ii?ioianueea
C.N.,*o?anueea O.I., ca ui ue?i ?i aeyeoth.

On? oai?? aoee ianoaaeai? ia aac? eaoaae?e i/ieo oai?ia Euea?anueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo c iiaeaeueoei oeeoieia?/iei
aeine?aeaeaiiyi c?oe?yao c eii’thieoeae. I?e?ia?ieia?/i? aeine?aeaeaiiy
aeeiiai? ia aac? Euea?anueeiai IAe? ai?aeai?ieia?? oa a?a??ie, eaoaae?e
i?e?ia?ieia?? Euea?anueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo oa
Euea?anueeiai iaeaniiai ae?aaiinoe/iiai oeaio?o. Ca ni?eyiiy a
i?iaaaeaii? iaoiaeee ue?i aeyeoth ae.i.i., aeioe. Aeiia?aae I.?. oa
eieaeoeao eaai?aoi???.

Naiino?eii ii?aoeueiaoaaea aeei?enoaio e?oa?aoo?o, i?iaiaeeea
noaoenoe/i? aeine?aeaeaiiy, ?ic?iaeyea oaaeeoe? oa ?enoiee, aiae?coaaea
iaoa??ae.

On?i eieaaai, ye? aeiiiiaaaee iai? aeeiioaaoe ?iaioo, aeneiaethth naith
na?aea/io aaey/i?noue.

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

Iniiai? iieiaeaiiy aeena?oaoe?? neooaee oa iaaiai?thaaee ia can?aeaii?
iaeaniiai oa?aiaaoe/iiai (Euea?a, 1996) oa iooaeueiieia?/iiai oiaa?enoa
(Euea?a, 1995), ia can?aeaiiyo eaoaae? oieoaeueii? oa?ai?? (Euea?a,
1997) ? ee?i?/ii? ?ioiieia?? oa aea?aieia?? (Euea?a, 1999) Euea?anueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo. ?acoeueoaoe aeena?oaoe??
aeiiia?aeaeenue ia ianooiieo a?o/eciyieo ? ca?oa?aeieo c’?caeao oa
eiioa?aioe?yo: I?aeia?iaeiee Eiia?an iieiaeeo a/aieo oe?a?ioe?a
(?aaii-O?aie?anuee, 1995); 3-rd ?nternational congress on heart failure
– mechanisms and management (Geneva, Switzerland, 1995); VIII Zjazd
Polskego Towarzystwa Immunologicznego (Wroclaw, 1995); II Oe?a?inueea
iaoeiai-i?aeoe/ia eiioa?aioe?y c i?aeia?iaeiith o/anoth — Aeooaeuei?
i?iaeaie ee?i?/ii? ?ioiieia?? (Euea?a, 1996); OIV c’?cae oa?aiaao?a
Oe?a?ie (Ee?a, 1998); IUSTI European Congress 1998 on STDs and Genital
Dermatology (Goteborg, Sweden, 1998).

Ioae?eaoe??

?acoeueoaoe aeena?oaoe?? iioae?eiaai? a 12 ae?oeiaaieo aeaeaiiyo, ?c ieo
– 8 o iaoeiaeo iaaee/ieo a?o/eciyieo oa ca?oa?aeieo aeo?iaeao, 4 – a
iaoa??aeao oa oacao a?o/eciyieo oa ca?oa?aeieo eiioa?aioe?e. Aaoi?
aeionoeea aeaa ?ioi?iaoe?ei? eenoe.

Ianya oa no?oeoo?a aeena?oaoe??

Aeena?oaoe?eia ?iaioa neeaaea?oueny c? anooio, iaeyaeo e?oa?aoo?e, 5
?icae?e?a aeanieo aeine?aeaeaiue, aeniiae?a, i?aeoe/ieo ?aeiiaiaeaoe?e,
nieneo aeei?enoaii? e?oa?aoo?e. ?iaioa aeeeaaeaia ia 132 noi??ieao,
?ethno?iaaia 21 oaaeeoeyie, 17 ?enoieaie. Nienie e?oa?aoo?e ioiieth? 213
aeaea?ae.

INIIAIEE CI?NO

Iaoa??aee oa iaoiaee aeine?aeaeaiue

Iaie aoei i?iaaaeaii ee?i?ei-eaai?aoi?ia oa ?ino?oiaioaeueia ianoaaeaiiy
78 iaoe??io?a ?c O?, ye? caa?oaeenue ca iaaee/iith aeiiiiiaith a
Euea?anueeo iaeanio ee?i?/io e?ea?ith, 4-oo i?nueeo e?ea?ith i. Eueaiaa,
Euea?anueeee iaeaniee ae?aaiinoe/iee oeaio? oa a?enueeiaee oieoaeue o
ia??iae c 1993 ii 1998 ?.?. Na?aae ianoaaeaieo oai?eo aoei 63 /ieia?e?a
(81,8%) ? 15 ae?iie (18,2%). Ia?aaaaeia a?eueo?noue iaoe??io?a (62,8%)
iaea a?e a?ae 20 aei 40 ?ie?a, a o?eaae?noue caoai?thaaiiy a a?eueoino?
oai?eo (44,9%) noaiiaeea a?ae 12 aei 60 i?n. Caaaeueio eiio?ieueio a?oio
ca ?ioiieia?/ieie ia?aiao?aie neeaaeaee 30 caei?iaeo in?a a?aeiia?aeiiai
a?eo oa noao?.

O an?o iaoe??io?a cae?aany aaiaaeia?/iee aiaiiac ca ioeueiaei, ia?oei oa
ae?oaei ??aiai.

Oai?ei i?iaiaeeee oa?iia?ao?/i? aeine?aeaeaiiy ia aia?ao? “?aaeoaa – IO”
c eiii’thoa?iei aeiaeaoeii. I?ney aaciina?aaeiuei? a?coaeueii? ioe?iee
noaeia?a i?ae?aoiaoaaee /enei aoyaiaieo o caiaeueiee i?ioean noaeia?a oa
aecia/aee aaee/eio oa?iianeiao??? (??cieoey oaiia?aoo?e ciie
i?aeaeuaiiai aei?ii?iaiiy iaaeieeoi?ie oeaieiaie ? neiao?e/ieie
noaeiaaie).

Aeey anoaiiaeaiiy o?eaa?ieo oaeoi??a noaoaaeo o?aini?neaieo
caoai?thaaiue, ye? ? i?ia?aeieie /eiieeaie a aeieeiaii? oai?iae ?aeoa?a,
aoei aeei?enoaii ieceo aaeoa??ieia?/ieo, a??onieia?/ieo oa na?ieia?/ieo
iaoiae?a aeine?aeaeaiiy. Iaoa??aeii aeey aeyaeaiiy oeai?ae?e oa ?o
aioeaai?a a o?aaeaieo ee?oeiao aoee c?oe?yae c? neeciaeo iaieiiie
na/iaea?aeiiai eaiaeo, oeeee iaoee oa neeciaeo i/ae. Aeey aeyaeaiiy
oeeoiieaciaoe/ieo aeeth/aiue oeai?ae?e aeei?enoiaoaaee oa?aoaaiiy ca
iaoiaeii ?iiaiianueeiai-A?ice. Aeaoaeoe?th oeai?ae?eieo aioeaai?a
i?iaiaeeee ?ioiioa?iaioiei iaoiaeii ca aeiiiiiaith oano-nenoaie
“Surecell Chlamydia” (“Kodak”, Aiae?y), c iiiieeiiaeueieie aioeo?eaie,
niaoeeo?/ieie aei oeai?ae?eiiai LPS aioeaaio. Oeai?ae?ei? aioeo?ea eeano
IgG a ne?iaaoeao iaoe??io?a aecia/aee ca aeiiiiiaith iaai??a “Platelia
Chlamydia IgG“ (“Sanofi Paster Diagnostics”, O?aioe?y) ia iniia?
oaa?aeioaciaiai ?ioiioa?iaioiiai aiae?co oa a ?aaeoe?? iai?yii?
i?e?i?ioiioethi?anoeaioe??. ?ioiioa?iaioiei iaoiaeii oaeiae aeyaeyee
iayai?noue aioeaaio a??ona aa?iano 2 oeio iaai?aie “HerpELISA Ag”
(“Savyon Diagnostics Ltd.”, ?c?a?eue) oa iai?oaeai?noue ?ioi?oaoo aei
oeeoiiaaaeia??onii? ?ioaeoe?? ca ??aiai aioe-NIV IgG aioeo?e o
ne?iaaoeao oai?eo (“Roche”, Oaaeoea??y).

Ao?ieia?/io ?ieue eeoeiaeo iaoiaai?a (Yersinia enterocolitica, Shigella
flexneri, Shigella sonnei oa Salmonella) ioe?ithaaee ca iayai?noth
niaoeeo?/ieo aioeo?e o ne?iaaoeao oai?eo, ye? iaee a aiaiiac? ae?a?aeiee
neiae?ii, c a?aeiiaiaeieie aioeaaiieie a?eo?ioeeoa?ieie ae?aaiinoeeoiaie
a ?aaeoe?? iai?yii? aaiaaethoeiaoe?? (?IAA).

Aaeoa??aeueiee niaeo? caoaeiee?a iaaiiieieiaeo o?ao?eo?a (noao?eieiee,
no?aioieiee, eeoeiaa iaee/ea oa ?i.) anoaiiaethaaee, aeei?enoiaoth/e
caiaoaioiaaiee iaeii?aciaee i?eno??e “Diaslide” aeey aaeoa??ieia?/iiai
eoeueoeaoaaiiy iaoa??aeo, caa?aiiai c o?ao?e (“Savyon Diagnostics Ltd.”,
?c?a?eue).

Mycoplasma hominis oa Ureaplasma urealiticum aecia/aee oeyoii aianaiiy
iaoa??aeo c o?ao?e aai oea?a?eaeueiiai eaiaeo a o?ainii?oia na?aaeiaeua,
yea aoiaeeoue o neeaae oano-iaai?o “Mycoplasma DUO” (“Sanofi Pasteur”,
O?aioe?y).

Aeey ioe?iee ?ioiiiai noaoono ethaeeie aeei?enoiaoaaee iaoiaee,
?aeiiaiaeiaai? AIIC, aeey anoaiiaeaiiy ??aiy ? nooiaiy ii?ooaiiy ?ioiieo
ooieoe?e i?e aeec?aaoeyoi?ieo ?ioiiaeao?oeeoieo noaiao, aooi?ioiieo,
aea?a?/ieo oa ?ioaeoe?eieo oai?iaao, aeey i?iaiico i?io?eaiiy oa
eiio?ieth ca e?eoaaiiyi (Aai?ia A.I., 1990).

Aecia/aee oae? ee?oeii? ?ioiieia?/i? ia?aiao?e: oaaioeeoa?iee iieaciee,
“?aii?e” oa “i?ci?e” oaaioeeoic, ?iaeaen eiai aeoeaiino? (*a?iooaiei
E.O. ? ni?aaao., 1988), aaniethoio oa a?aeiinio e?euee?noue e?ioioeeo?a,
O-e?ioioeeoe (A-?OE), A-e?ioioeeoe (AAN-?OE), noaiiioeyoe?? e?ioioeeo?a
(Aa, O-, O-), a oaeiae ?iaeaene ?ioiii? a?aeiia?ae?: ?aaoeyoi?iee oa
aoaeoi?iee (*???ae??a A.I., 1976). Iaoiaeii i?ioi/ii? oeeoiiao???
aeyaeyee CD3+-, CD4+-, CD8+-, CD20+-, CD16+-e?ioioeeoe,
CD-HLA-B27+-ee?oeie. ?ioiioaiioeioaaiiy noaiiioeyoe?e e?ioioeeo?a
i?iaiaeeeiny ca aeiiiiiaith iaai?o a?aeiia?aeieo iiiieeiiaeueieo aioeo?e
(“Becton Dickenson”, NOA) oa iiiieeiiaeueieo aioeo?e aei aioeaaio
HLA-B27, i?/aieo oethi?anoea?i?cio?ioe?aiaoii (“One Lamba”, NOA).

Oee?eoethth/? ?ioii? eiiieaene aecia/aee iaoiaeii i?aoeei?oaoe?? a
iie?aoeeaiae?eie? (I=6000) c eiioeaio?aoe??th 2,75 % niaeo?ioioiiao?e/ii
(Ineiia N.A. ? ni?aaao., 1983). ?ioiiaeiaoe?ie eean?a I, G, A
aeine?aeaeoaaee iaoaeiiao?e/iei iaoiaeii o ne?iaaooe? e?ia? ca
noaiaea?oiith iaoiaeeeith c aeei?enoaiiyi iiiiniaoeeo?/ieo aioene?iaaoie
aei ?o iniiaieo eean?a, a eiiieaiaioa?io aeoeai?noue ne?iaaoee e?ia? —
oioieiei?eiao?e/ii (*a?iooaiei E.O. ? Eiainiaa E.N., 1981).

Iieacieee ianiaoeeo?/ii? ?acenoaioiino? aeeth/aee aecia/aiiy
N-?aaeoeaiiai i?ioa?io (N?I) — eaoaen oanoii, OIA — iaoiaeii
inaaeaeaiiy, i?ioa?iia?aie — iaoiaeii aeaeo?ioa?aco.

On? ianoaaeai? oai?? aoee ?icae?eai? ia oae? a?oie:

1) ca o?eaae?noth caoai?thaaiiy: aei 1 ?ieo – 22 oai?eo, 1 — 5 ?ie?a –
34 oai?eo, a?eueoa 5 ?ie?a – 21 oai?eo;

2) ca ia?aaaaeaiiyi o ee?i?oe? iaaieo neiae?ii?a O?: oao?aaea – 17
oai?eo, o??aaea – 38 oai?eo, iaiiaia O? – 23 oai?eo;

3) ca aeyaeaiiyi HLA-B27 aioeaaio ia ee?oeiao e?ia?: HLA-B27-iiceoeai? –
22 oai?eo, HLA-B27-iaaaoeai? – 30 oai?eo;

4) ca aieeaii e?eoaaiiy ia oai?eo O?: aei e?eoaaiiy – 58 oai?eo, i?ney
e?eoaaiiy – 58 oai?eo.

Oai?ei ia O? i?iaiaeeeanue ianooiia aaciaa oa?ai?y caeaaeii a?ae
ao?ieia?? O?. Aeaaaeoeyoueii oai?ei i?ecia/aee aioea?ioeee
oao?aoeeee?iiaiai ?yaeo i?ioyaii 1 i?nyoey. Iae?ie?aee canoiniaoaaee a
20 oai?eo i?ioyaii 3 i?nyoe?a, a iaoe??ioai c a??oniith ?ioaeoe??th,
e??i oiai, i?ecia/aee ??ci? aeaee aeueoa-?ioa?oa?ii?a. *anoeio oai?eo
(18 in?a), a iniiaiiio c aioa?ieie?oe/ieie i?iyaaie, e?eoaaee
naeacii??eaeaceiii. O oyaeeeo aeiaaeeao, eiee ia aeiiiiaaaea aaciaa
oa?ai?y a eiia?iaoe?? c ianoa?i?aeieie i?ioecaiaeueieie caniaaie, aei
e?eoaaiiy aeiaeaaaee ai?iiiaeuei? i?aia?aoe, a a iaeiiio — aeei?enoaii
oeeoinoaoeee.

?acoeueoaoe aeine?aeaeaiiy ii?aoeueiaoaaeeny ia IBM PC ca aeiiiiiaith
nenoaie ea?oaaiiy aacaie aeaieo FoxPro v.2.0 (MicroSoft, USA) ?
noaoenoe/ieo i?ia?ai InStat (“GraphPAD Software”, USA) oa STATISTICA v.
4.3 (“StatSoft”, USA). Aeey ii??aiyiiy ye?nieo iieaciee?a aeei?enoaii
oi/iee oano R.Fisher ? oano 2 aeey a?eueoeo oaaeeoeue, aeey ii??aiyiiy
ia?aiao?e/ieo iieaciee?a o ??cieo a?oi oai?eo iaia?iee t-oano, aeey
anoaiiaeaiiy ei?aeyoe?? ia?aiao?e/ieo e?eoa???a iaoiae e?i?eii?
?aa?an??, ?aiaiaeo e?eoa???a — iaoiae Kendall.

Iniiai? ?acoeueoaoe aeine?aeaeaiue

I?iaaaeai? i?ioyaii i’yoe ?ie?a ee?i?/i?, eaai?aoi?i? oa
?ino?oiaioaeuei? aeine?aeaeaiiy aeicaieeee aeae?eeoe 78 oai?eo, o yeeo
ae?aaiinoiaaii O? ia iniia? eeaneo?eaoe?eieo e?eoa???a Aia?eeainueei?
anioe?aoe?? ?aaiaoieia?a (1995). Aiae?c ee?i?/ieo niinoa?aaeaiue ca
oai?eie ia O? iieacaa, ui c ieo o 59 (75,6%) cono??/aeenue o?aaeaiiy
iii?ii-?ooiaiai aia?aoo: a 41% oai?eo aoei aeyaeaii a?o?eo, o 26% oai?eo
— iaeiia?/iee nae?i?ea?o, o 22% oai?eo — ao?eiaeai?o oa a 11% oai?eo —
i’yoeia? oii?e. O 61% oai?eo ia?aaaaeaee I oa II nooiai?
ooieoe?iiaeueii? iaaeinoaoiino? noaeia?a.

O 62 (80,5%) oai?eo aoei a?aei?/aii a aiaiiac? aai ia iiiaio
niinoa?aaeaiiy o?aaeaiiy na/inoaoaai? nenoaie, na?aae yeeo o?ao?eo aoa
ae?aaiinoiaaiee o 41 (66,1%) oai?iai, i?inoaoeo – o 17 (35,4%) oai?eo
/ieia?e?a, oeenoeo — o 9 (14,5%) oai?eo, aaeiaeneo — o 4 ae?iie (26,6
%).

I?e iooaeueiieia?/iiio ianoaaeaii? a 45,5% oai?eo aoei aeyaeaii
eii’thieoea?o, o 10,9 % — oaa?o, o 9,1% — ??eaeioeeee?o, a a iaeiiai
oai?iai, aiane?aeie oaeaeeiai i?ia?anoaaiiy caoai?thaaiiy, ianooieea
iiaia ao?aoa ci?o.

Aioa?ieie?o, yeee aeiee ca aeae?eueea oeaei?a ia?aae ii/aoeii
caoai?thaaiiy aai i?ney ii/aoeo oai?iae, niinoa??aaany a 26,3% oai?eo.

Oe??i? o?aaeaiiy i?e O? aoei aeyaeaii a 35 in?a (46,1%), ye?
i?iyaeyeenue ionooeueicieie, aaii?aa?/ieie aai aeaii?aa?/ieie
aeneiaiiyie, ea?aoiaea?i??th, a?ia?ea?aoicii oa e?eueoeaaei aaeai?oii. O
12,3% iaoe??io?a niinoa??aaany ae?aceiaee noiiaoeo.

Iao? aeai? a?aeiia?aeaee a?eueoino? ee?i?/ieo oa iaoeiaeo iia?aeiieaiue
?c i?eaiaeo O? (Lichtman S., 1995; Svenungson B., 1995). O oie aea /an
ee?i?/i? ?acoeueoaoe iaoeo niinoa?aaeaiue aeaui a?ae??ciythoueny a?ae
aeaieo Willkens R. et al. (1991). Oae, o iaoeo oai?eo noaeiaiaee
neiae?ii cono??/aany a 75,6%, na/inoaoaaee — 80,5 %, i/i? neiioiie —
45,5%, oe??i? i?iyae — 46,1%, aioa?aeuei? — 26,3%. Ca Willkens R. et
al., noaeiaiaee neiae?ii niinoa??aaany a 90 %, na/inoaoaaee — o 85%,
i/iee — 57%, oe??iee — 49%. Aeaye? ?ica?aeiino? a noaeiaiaiio ?
iooaeueiieia?/iiio neiae?iiao iiaeia iiynieoe aeineoue aeaoaeueieie
iaoeie ee?i?/ieie ianoaaeaiiyie noaeia?a, a oaeiae iniaeeaith
iaoiaeeeith aeine?aeaeaiiy i?aaio ci?o, cai?iiiiiaaiith eaoaae?ith
iooaeueiieia?? Euea?anueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo, ui
caaacia/eei iai a?eueoee a?aenioie a?aeiia?aeieo neiae?ii?a i?e O?.
Io?eiai? iaie ee?i?/i? ?acoeueoaoe a?ae??ciythoueny a?ae aeaieo Silveira
L. et al. (1993), ye? niinoa??aaee eii’thieoea?o eeoa a 29,8% oai?eo,
aeeco?e/i? yaeua – a 31,3% oa oe??i? o?aaeaiiy – a 9%. Oaeaeoa anueiai,
oeth a?aei?ii?noue iiaeia iiynieoe oei, ui a eaoaai??th “i/i? neiioiie”
ie aeeth/aee ia eeoa eii’thieoea?o, a e ??eo, ??eaeioeeee?o, oaa?o oa
ai?neea?eo, a a eaoaai??th “na/inoaoaa? i?iyae” — ia o?eueee aeeco?e/i?
yaeua, a e o?ao?eo, oeenoeo, i?inoaoeo, aaeai?o.

Oa?aeoa?ii, ui a a?eueoino? iaoe??io?a (50,1%) aoei aeyaeaii o??aaeo
oai?iae ?aeoa?a, oiae? ye oao?aaeo O? aoei ae?aaiinoiaaii a 21,7%, a
iaiiaio O? – a 28,2%. I?e aiae?c? ee?i?/ieo iieaciee?a caeaaeii a?ae
o?eaaeino? O?, neiae?iiaeueieo i?iya?a oa ae?? e?eoaaiiy aeyaeaii, ui c?
ca?eueoaiiyi o?eaaeino? caoai?thaaiiy c?inoa? e?euee?noue ee?i?/ieo
i?iya?a o?ao?eoo (?<0,05) oa o?aaeaiiy eeoe?aieea (P<0,05). Iooaeueiieia?/i? i?iyae ia?aaaaeii ae?aaiinooaaee i?e oao?aae? (P<0,001), ??aeoa – i?e o??aae? O? (P<0,05). Aeaoaeueiee aiae?c ee?i?/ieo aeaieo oa caaaeueii-eaai?aoi?ieo iieaciee?a aeicaieea noai?eoe nenoaio ioe?iee aeoeaiino? O? a aaeao, iniiaaio ia aecia/aii? aeoeaiino? i?ioeano ca iaoiaeii Aoia?na A. oa THoaiaeoa ss. (1985). O oeth nenoaio aoiaeyoue oae? ee?i?/i? oa eaai?aoi?i? aeai?: ?aieiaa neoo?noue, a?ia?ai?y noaeia?a, noaeiaiaee ?iaeaen, e?euee?noue i?eiooeeo noaeia?a, i/i?, o?iaai?oaeuei? neiioiie, ci?ie c? noi?iie oe??e, iieacieea OIA, ae?aaeaiino? N?I ? ??ai?a 2- aeiaoe?i?a (oaae. 1). Oaaeeoey 1 E?eoa??? ioe?iee aeoeaiino? oai?iae ?aeoa?a Aeaee e?eoa???aNooi?iue aeoeaiino?A?aenooiyI?i?i.Na?aaeiyAenieaIaeneiaeueia0 nooi?iue aei 2 aae?aI nooi?iue 3 – 10 aae?aII nooi?iue 11 – 20 aae?a??? nooi. 21 – 30 aae?aIV nooi?iue 30 ? a?eueoa aae?a?aieiaa neoo?noueiaia?aei 30 oa.30-60 oa.1 - 2 aiae.>2
aiae.Aaee01234A?ia?ai?y noaeia?aiaia?iacia/iaiii??iaAe?aaeaiacia/ii
ae?aaeaiaAaee01234Noaeiaiaee ?iaeaen,
aaee0-56-1415-2526-30>31Aaee0-11234E?euee?noue i?eiooeeo
noaeia?aiaia?12-45-7>8Aaee01234O?aaeaiiy
i/aeiaia?iacia/i?iii??i?Ae?aaeai?cia/ii ae?aaeai?Aaee01234O?iaai?oaeuei?
i?iyaeiaia?iacia/i?iii??i?Ae?aaeai?cia/ii ae?aaeai?Aaee01234Oe??i?
i?iyaeiaia?iacia/i?iii??i?Ae?aaeai?cia/ii ae?aaeai?Aaee01234OIA,
ii/aiae<1617-2021-4041-50>51Aaee0-11234N-?I-++++++++++Aaee012342-aeiaoe?
ieaei 10,0%aei 12,0%aei 14,0%aei 16,0%>16,0%Aaee01234

Ioe?iea oeeo iciae o aaeao aeaea i?aenoaae aeey a?eueo /?oeiai oa
?iaeea?aeoaeueiiai aecia/aiiy nooiaith aeoeaiino? O?: aei 2 aae?a –
a?aenooiy aeoeai?noue (0 nooi?iue), 3-10 — i?i?iaeueia ( I no.aeo.), 11
— 20 — na?aaeiy (II no. aeo.), 21 — 30 — aaeeea (III no. aeo.), 30 ?
a?eueoa — iaeneiaeueia (IV no. aeo.). Ia iniia? io?eiaieo ?acoeueoao?a
iaie aoee aeae?eai? oae? a?oie oai?eo caeaaeii a?ae aeoeaiino? O?: ia?oa
a?oia — I no. aeoeaiino? (25 oai?eo), ae?oaa a?oia — 29 oai?eo c II no.
aeoeaiino? oa o?aoy a?oia — 18 oai?eo c III-IV no. aeoeaiino?.

Oaea aaeueia nenoaia aeaea iiaeeea?noue ?ic?iaeoe /?oe? e?eoa???, ye? a
oa?aeoa?ecoaaee nooi?iue aeoeaiino? O? aeey ia’?eoeaiiai aecia/aiiy
ee?i?/iiai noaoono iaoe??io?a. O iiaeaeueoiio aiia aeicaieeea
?aaeaiaiooaaoe ?ioaineai?noue oa o?eaae?noue aaciai? oa?ai??, a oaeiae
ioe?ieoe ?? aoaeoeai?noue.

A inoaii? ?iee aeoeaii aea/athoueny i?e/eie O?. O ca’yceo c oeei ie
iaiaaaeenue ioe?ieoe oeyoii niaoeeo?/ieo ?ioiieia?/ieo oa
i?e?ia?ieia?/ieo ianoaaeaiue /anoioo aeyaeaiiy oeai?ae?eii? oa ?ioeo
?ioaeoe?e ye i?e/eiieo oaeoi??a O? a ianoaaeaieo iaie oai?eo. Oae, ca
aeiiiiiaith ?ioiioa?iaioiiai iaoiaeo ie aeyaeee LPS-niaoeeo?/iee
oeai?ae?eiee aioeaai o 38% oai?eo ia O?, a aenie? ??ai? niaoeeo?/ieo
aioeoeai?ae?eieo aioeo?e o ne?iaaoeao e?ia? oai?eo ca aeiiiiiaith
?ioiioethi?anoeaioiiai oa ?ioiioa?iaioiiai iaoiae?a — o 58% oai?eo.

I?e oeeoieia?/iiio ianoaaeaii? a iaoe??io?a aeyaeaii ??ci? anioe?eiaai?
?ioaeoe?? ii?yae c oeai?ae?eiith: Neisseria gonorrhoea — a 9%,
Trichomonas vaginalis – 16%, Ureaplasma urealiticum – 22% oa Mycoplasma
hominis — 3%. Oiiaii-iaoiaaii? i?e?ii?aai?cie na/inoaoaaiai o?aeoo
oai?eo, aen?yi? a iaoiaaiieo e?eueeinoyo (oeo? 1000 EOI/ie): no?aioieiee
(17%), noao?eieiee (15%), E.coli (8%) oa Candida albicans (10%). O 34%
oai?eo caoai?thaaiiy noi?iaiaeaeoaaeinue na?ieia?/iith ?aaeoeaaoe??th
aa?iaoe/ii? ?ioaeoe?? c aenieei ??aiai niaoeeo?/ieo IgG (i?e/iio a 18%
oai?eo oea aoei i?aeoaa?aeaeaii iiceoeaieie aioeaaiieie ciao?aeeaie a
c?oe?yaao o?ao?e oa oea?a?eaeueiiai eaiaeo). Anioe?aoe?y oeai?ae?eii?
?ioaeoe?? c aa?iaoe/iith a??oniith aoea aeyaeaia a 47%. E??i oiai, a 10
oai?eo (8%) ?c neiae?iiii aioa?ieie?oo a aiaiiac? aoei aen?yii
Salmonella enteritidis, Shigella sonne?, Shigella flexneri ? ??n?i??.
Io?eiai? aeai? iaei /ei a?ae??ciythoueny a?ae iia?aeiieaiue Svenungson
B. at al. (1995). A?i niinoa??aaa aneiioiiaoe/i? o?eaa?i? ?ioaeoe?? a
10-25% oai?eo ?c iinoaioa?e/iith O? oa aei 40% — c iinoaaia?e/iith O?.
Io?eiai? iaie ?acoeueoaoe ni?aiaaeathoue ?c aeaieie Silveira L. et al.
(1993) a oiio, ui oai?? ia O? c oeai?ae?eiith ?ioaeoe??th iathoue
oyae/ee ia?aa?a oa oaeaeoo o?ii?caoe?th iaoieia?/iiai i?ioeano. Oai?? c
iayai?noth oeai?ae?eieo aioeaai?a oa i?aeaeuaieo ??ai?a aioeo?e nooo?ai
ia a?ae??ciyeenue ca a?eii, o?eaae?noth caoai?thaaiiy, e?euee?noth
o?aaeaieo noaeia?a, aeoeai?noth oai?iae oa ca ee?i?/ieie i?iyaaie ?
ianiaoeeo?/ieie iieacieeaie caiaeaiiy a?ae oai?eo c
aioa?iaaeoa??aeueieie ?ioaeoe?yie.

Aeii?ioth/eie iaoai?ciaie a ?icaeoeo O? ? ?ioiicaeaaei? i?ioeane:
?ioiiaaiaoe/i?, ?ioiicaiaeuei? oa aooi?ioii?, ye? aai noai?ththoue
ni?eyoeeaee a?oio aeey iai?oanoaoe?? niaoeeo?/ii? ?ioaeoe??, aai ?
ai?oaiiiaiii aieeao ?ioaeoe?e ia ?ioiio nenoaio oai?iai.

O iao?e ?iaio? aeoeaiooaaeany oaaaa ia ioe?ioe? e?ioioeeoa?ieo
?ioiieia?/ieo iieaciee?a oai?eo ia O?, ?o ei?aeyoe?? c o?eaae?noth,
ee?i?/ieie i?iyaaie oa aeoeai?noth i?ioeano. Anoaiiaeaii, ui a oai?eo ia
O? ca?eueoo?oueny /enei CD22+-e?ioioeeo?a (?<0,001), iineaaeththoueny ?aaoeyoi?i? (?<0,01) oa aoaeoi?i? (?<0,001) iaoai?cie. Oae? ci?ie iaea?eueo oa?aeoa?i? aeey oai?eo ia O? c aeyaeaieie oeai?ae?eieie ia?ea?aie (iniaeeai a eiia?iaoe?? c a??onaie). E?euee?noue CD4+-e?ioioeeo?a ia? oaiaeaioe?th aei cieaeaiiy (?<0,05). I?e o?eaaeino? oai?iae a?eueoa 5 ?ie?a ia?inoa? /enei CD8+-e?ioioeeo?a (?<0,05). Oai?? c ??cieie ee?i?/ieie i?iyaaie (neiae?iiaie) nooo?ai ia a?ae??ciythoueny iaeiei a?ae iaeiiai ca e?ioioeeoa?ieie ?ioiieia?/ieie iieacieeaie. Iaea?eueo? ee?oeii? ?ioiieia?/i? c?ooaiiy aeyaeaii a oai?eo c III-IV no. aeoeaiino? O?. C? ca?eueoaiiyi nooiaiy aeoeaiino? O? a?aei?/a?oueny c?inoaiiy caaaeueiiai /enea CD22+-e?ioioeeo?a (?<0,01) oa CD8+-e?ioioeeo?a (P<0,05). Aiae?c ei?aeyoe?e i?ae e?ioioeeoa?ieie ?ioiieia?/ieie iieacieeaie iieacaa, ui iaea?eueoa aca?iicoiiaeai?noue ? i?ae ?aaoeyoi?ieie oa aoaeoi?ieie ?ioiieie ?iaeaenaie (r=0,72), ui noai?th? an? ni?eyoeea? oiiae ye aeey aeoeaaoe?? oiiaiiiaoiaaiii? oei?e (o?aaieacie, no?aioieiee, noao?eieiee), oae ? aeey i?e?aeiaiiy iaoiaaiieo i?e?ii?aai?ci?a. Iniaeeaino? ci?i e?ioioeeoa?iiai ioeo a oai?eo ia O?, c iaeiiai aieo, noai?ththoue ni?eyoeeaee a?oio aeey aeoeaaoe?? ?ioaeoe?eieo i?ioean?a, a c ?ioiai – ? aacith aeey ?icaeoeo aeec?aaoeyoe?? ?ioiii? a?aeiia?ae? oa iai?oanoaoe?? aooi?ioiiaa?an??. Oea i?aeoaa?aeaeo?oueny aeaieie, io?eiaieie iaie ca aeiiiiiaith iaoaeiiao?e/iiai aiae?co ??ai?a ?ioiiaeiaoe?i?a ? aecia/aiiy eiioeaio?aoe?? Oe?E. O oai?eo ia O? anoaiiaeaii i?aeaeuaiiy ??aiy Oe?E (P<0,001) ia oe? c?inoaiiy eiioeaio?aoe?? IgG (P<0,05) ? IgI (P<0,001). A?ia??ioiiaeiaoe?iai?y G oa a?ia??ioiieiiieaenai?y niinoa??aathoueny a oai?eo ?c ??cieie ao?ieia?/ieie oaeoi?aie oa iaea?eueoa aiie ae?aaeai? i?e O? oeai?ae?eii-a??onii? ao?ieia??. Aiaeii/an ??aaiue IgA ? i?aeaeuaiei o oai?eo ia O? eeoeiai? ao?ieia?? (P<0,05), a oeai?ae?eii-a??onii? ao?ieia?? – cieaeaiei (P<0,001) o ii??aiyii? c? caei?iaeie iniaaie. I?e oao?aae? O? ??aaiue na?aaei?o Oe?E ieae/ee (P<0,05) ii??aiyii c a?oiaie oai?eo, ye? iaee ?io? ee?i?/i? neiae?iie O?, ui iiaeia iiynieoe, iaaooue, a?eueo aeoeaiith o?enaoe??th Oe?E ia oeaieiao-i?oaiyo o oai?eo oe??? a?oie. Anoaiiaeaii, ui c? ca?eueoaiiyi e?eueeino? ?aoeeaeea?a O? c?inoa? ??aaiue IgA (r=0,96; ?<0,001), a i?aeaeuaiiy eiioeaio?aoe?? IgG ei?aeth? c? ciaioaiiyi oaaioeeoa?iiai /enea (r=0,68; ?<0,05). Oe? oaeoe iiaeia oa?aeoa?ecoaaoe iineeaiiyi aooiaa?aneaieo iaoai?ci?a. Iai?yi? i?iyae aooiaa?aneaieo iioeiaeaeaiue noaeia?a oa noaeei o oai?eo ia O? aoei aeyaeaii ca aeiiiiiaith oa?iia?ao?/ieo aeine?aeaeaiue, ye? aeicaieeee a?coaeueii ioe?ieoe nooi?iue ae?aaeaiino? oa oa?aeoa? ci?i o aiaieu? caiaeaiiy, a oaeiae o ioi/oth/eo oeaieiao. I?e oa?iia?ao?/iiio ianoaaeaii? 27 oai?eo iaie aoei anoaiiaeaii neiioii “oa?iiaiiooaoe??” e?ioe?aie o 10 iaoe??io?a, ui na?ae/eoue i?i ci?ie a i?e?ioee?eoeyoi?iiio ?one? noaeei iiae?aii neiae?iio ?aeii. Oe?eaai, ui ee?i?/ii i? a iaeiiai oai?iai ia aoei nea?a, ye? a na?ae/eee i?i ii?ooaiiy i?e?ioee?eoeyoe??. Neiioii “oa?iiaiiooaoe??” e?ioe?aie ia aoa iia’ycaiee i? c o?eaae?noth, i? c aeoeai?noth oa ao?ieia??th caoai?thaaiiy, oi/a e iaea i?noea ??cieoey i?e ii??aiyii? neiioiio “oa?iiaiiooaoe??” e?ioe?aie o oai?eo c o??aaeith oa oao?aaeith O? (P < 0,05). O e?oa?aoo?? oaeiae a?aeii? oaeoe ?icaeoeo caiaeueieo iioeiaeaeaiue noaeei i?e ?aaeoeaieo a?o?eoao. Ca aeaieie Ei?ioa?aa O.A. ? ni?aaao. (1991) oa Boehni U. et al. (1997) aaneoe?oe a oai?eo ia ?aaeoeai? a?o?eoe noi?iaiaeaeoaaeenue a?aeeeaaeaiiyi aeaiiceo?a N3-eiiiiiaioa eiiieaiaioo ? IgM o noaeeiao. Magro C.M. et al. (1995) i?iaaee ?ioiia?noieia?/i? ianoaaeaiiy o?aaeaieo ae?eyiie oe??e o?ueio oai?eo ?c O?, a yeeo oaeiae aoei a?aei?/aii a?aeeeaaeaiiy IgG, IgM, C3 oa oeai?ae?eiiai HSP 60 - aioeaaio a no?ieao noaeei. Aeyaeaii iaai? caeiiii??iino? na?aae iieaciee?a ianiaoeeo?/ieo aoii?aeueieo oaeoi??a ?acenoaioiino? oai?eo ia O?. O ieo cao?eniaaii ca?eueoaiiy ??ai?a 2 - (P<0,001), - (P<0,001) aeiaoe?i?a oa oaaioeeoa?iiai iieacieea (P<0,001) ia oe? ca?eueoaiiy OIA (P<0,001) a ii??aiyii? c? caei?iaeie iniaaie. Oe? ci?ie na?ae/aoue i?i cia/i? ?ioiieiiiainaoi?i? iaoai?cie, ye? aeeth/athoueny ca oiia O?. Aiie, i?ioa, iiaeooue aooe oaeiae ? iioeiaeaeoth/eie oaeoi?aie, iniaeeai i?e caoyaeiiio ia?aa?c? oai?iae. *ei o?eaae?oa oai?iaa, oei ?noioi?oa i?aeaeuaiiy ??ai?a eiiieaiaioa?ii? aeoeaiino? ne?iaaoee e?ia? (P<0,001), 2- (P<0,001) ? - aeiaoe?i?a (P<0,001) oa OIA (P<0,001), oiae? ye aeoeai?noue oai?iae aoea iia’ycaia o?eueee c OIA (P<0,001). Aoa i?iaaaeaiee aiae?c caeaaeiino? ?ioiieia?/ieo iieaciee?a o oai?eo ia O? c a?aooaaiiyi aeyaeaiiy aioeaaio HLA-B27 ia ee?oeiao ianoaaeaieo (oaae. 2). Oae, aoei a?aei?/aii, ui a oai?eo c iiceoeaiei HLA-B27 aaiioeiii niinoa??aa?oueny ciaioaiiy aaniethoieo oa a?aeiinieo iieaciee?a ND3+-e?ioioeeo?a (P<0,05), aaniethoieo ND4+-e?ioioeeo?a (P<0,05) oa ca?eueoaiiy /enea ND22+-e?ioioeeo?a (P<0,05). E??i oiai, a HLA-B27-iiceoeaieo iaoe??io?a ia O? a?aei?/aii oaeiae cieaeaiiy aaniethoii? e?eueeino? CD3+- (P<0,05), CD22+- (P<0,05), CD4+- (P<0,05) oa ND8+-e?ioioeeo?a ia oe? ca?eueoaiiy a?aeiiniiai /enea 0-e?ioioeeo?a (P<0,01) ii??aiyii c HLA-B27-iaaaoeaieie iaoe??ioaie. O oai?eo, o yeeo O? iia’ycaia c aioeaaiii a?noinoi?niino? HLA-B27, c?inoathoue ??ai? ?ioiiaeiaoe?i?a eean?a I (P<0,05) oa G (P<0,01) ? eiioeaio?aoe?y na?aaei?o Oe?E (P<0,001) ii??aiyii c? caei?iaeie, a ??aaiue IgA, iaaiaee, ciaioo?oueny (P<0,01), ii??aiyii c HLA-B27-iaaaoeaieie oai?eie. O HLA-B27-iiceoeaieo iaoe??io?a c O? niinoa??aaeiny ciaioaiiy oaaioeeoa?iiai iieacieea (P<0,001), c?inoaiiy “?aiiueiai” oaaioeeoa?iiai /enea (P<0,001) oa cieaeaiiy eiiieaiaioa?ii? aeoeaiino? ne?iaaoee e?ia? (P<0,01), ii??aiyii c? caei?iaeie iniaaie. I?ae niaith oe? aea? a?oie oai?eo ia a?ae??ciyeenue ca iieacieeaie ianiaoeeo?/ii? ?acenoaioiino?. Aaaeeeai cacia/eoe, ui on? 22 oai?eo c aeyaeaiei aioeaaiii a?noinoi?niino? HLA-B27 iaee iiceoeai? oeai?ae?ei? ia?ea?e. Oa?aeoa?ii, ui a a?eueoino? oai?eo ia aoei anoaiiaeaii oneeaaeiaii? niaaeeiaino? ca ioeueiaei, ia?oei oa ae?oaei ??aiai aaiaaeia?/iiai aiaiiaco. Ana ae o 7 oai?eo niinoa??aaeeny a ?iaeei? ?aaiaoieia?/i? caoai?thaaiiy. Aieea e?eoaaiiy a oai?eo ia O? aeyaeany iiceoeaiei ye ia ee?i?eo, oae ? ia ?ioiieia?/i? iieacieee, oiaoi aeoea?coaaeeny oaaioeeoa?i? iaoai?cie, cieceeenue ??ai? Oe?E ? IgG, oi/a aiie ? ia aa?ioeenue aei ii?ie. Ii?iae?coaaeanue eeoa eiioeaio?aoe?y IgA a e?ia?. Iaeiae, e?ioioeeoa?iicaeaaei? iaoai?cie oa?aeoa?ecoaaeeny iiaeeaeaiiyi aeec?aaoeyoe?? aiane?aeie i?iaaaeaiiai e?eoaaiiy. Oiio a?aoiaoth/e iie?ao?ieia?/i?noue, ??cio aaiaoe/io noeeuei?noue oa caeaaeiee a?ae ia? oei ?ioiieia?/ii? a?aeiia?ae?, aaciaa e?eoaaiiy a oai?eo ia O? ? iaiaeiioeiiei ? iio?aao? ?iaeea?aeoaeueiiai i?aeoiaeo oa i?aeai?o i?aia?ao?a. Oaeei /eiii, io?eiai? ?acoeueoaoe aeathoue i?aenoaao eiinoaooaaoe iaai? ao?ieia?/i? oa ?ioiiiaoiaaiaoe/i? iniaeeaino? O?, ye? aieeaathoue ia ?? ee?i?eo, ia?aa?a, a oaeiae iiaeooue aooe aacith aeey aecia/aiiy iaoiaaiaoe/ii? oa?ai?? oa oaeoeee aaaeaiiy oai?eo ia O?. O aeieeiaii? O? aeii?ioth/a i?noea iaeaaeeoue oeai?ae?ei?e ?ioaeoe??, yea iniaeeai iaoiaaiii i?iyaey? naaa a eiia?iaoe?? c a??onaie i?inoiai aa?iano 2 oeio oa oeeoiiaaaeia??onaie. Ci?ie ?ioiii? nenoaie oai?eo ia O? oa?aeoa?ecothoueny iineaaeaiiyi aeni?an?? ia?ea??a a?eueoino? aeae?a e?ioioeeo?a, iniaeeai a HLA-B27-iiceoeaieo oai?eo, c?inoaiiyi /enea ?ioiiaeiaoe?iii?iaeoeoth/eo ee?oei oa aeec?aaoeyoi?ieie iaoai?ciaie, ye? noai?ththoue ni?eyoeea? oiiae aeey ?ioiiaooiaa?an??. Aiie ia caeaaeaoue a?ae a?eo oai?eo, aea iineeththoueny c aeoeai?noth oa o?eaae?noth O?. ?acoeueoaoe aeathoue iiaeeea?noue aiai?eoe i?i aeoeaio o/anoue ?ioiii? nenoaie a ?icaeoeo O?. O aaiaoe/ii noeeueieo ?iaeea?aeooi?a (HLA-B27 - iiceoeaieo) i?e O? aeec?aaoeyoi?i? ci?ie ?ioiii? a?aeiia?ae? ? ni?eyoeeaith iniiaith aeey aeoeaaoe?? aioo??oiueiee?oeiieo ?ioaeoe?e, ui a iiaeaeueoiio iiaea i?iaieoaaoe aooi?ioiio aa?an?th aei ioi/oth/eo oeaiei. Oaaeeoey 2 Ii??aiyeueia oa?aeoa?enoeea ?ioiiiicaeaaeieo iieaciee?a oai?eo ia oai?iao ?aeoa?a c HLA-B27-iiceoeaiei oa iaaaoeaiei aaiioeiii oa caei?iaeo in?a (Im) Oai?? ia O?Iieacieee Caei?ia? iniae (n=30)HLA-B27- iiceoeai? (n=22)HLA-B27- Iaaaoeai? (n=30)CD22+- e?ioioeeoe%15,02,6420,52,09*26,02,67*^109/e0,240,02 0,370,020,520,06*^CD3+- e?ioioeeoe%61,16,8752,72,28*57,52,61109/e0,980,04 0,730,5*0,860,060- e?ioioeeoe%23,93,20 26,81,6416,52,69*^109/e0,380,030,370,050,340,06CD4+-e?ioioeeoe%45,72,05 37,52,39*34,72,07*109/e0,740,08 0,420,06*0,70 ,06^CD8+-e?ioioeeoe%15,81,52 19,52,78*18,71,62*109/e0,250,01 0,220,050,390,06*CD4+/CD8+ (??)2,890,24 1,920,43*1,850,13*IgA a/e2,550,181,590,44*3,850,18^IgG a/e12,210,37 16,81,09*14,40,97^IgM a/e1,150,03 2,420,24*1,450,14^Oe?E (na?aaei?)Iaeeieoe? iio. aono.57,032,62 221,150,1*124,657,9*^ I?ei?oee: * - a??ia?aei?noue i?e ii??aiyii? iieaciee?a c a?oiith caei?iaeo in?a ^ - a??ia?aei?noue i?e ii??aiyii? iieaciee?a c a?oiith HLA-B27 iiceoeaieo oai?eo ia O? AENIIAEE 1. Oai?iaa ?aeoa?a noi?iaiaeaeo?oueny ci?iaie ?ioiicaeaaeieo i?ioean?a, ye? oa?aeoa?ecothoueny aeec?aaoeyoe??th ee?oeiieo ? aoii?aeueieo oaeoi??a ?ioiii? nenoaie oa iiaeeaeaiiyi ?o o oai?eo c HLA-B27 aaiioeiii. 2. O oai?eo c aeyaeaiei HLA-B27 aioeaaiii anoaiiaeaii cieaeaiiy iiioeyoe?e e?ioioeeo?a ia oe? ca?eueoaiiy e?eueeino? ?ioiiaeiaoe?iii?iaeoeoth/eo ee?oei, ??ai?a IgG oa IgI, a oaeiae a?eueo ae?aaeaia a?ia??ioiieiiieaenai?y ii??aiyii c oai?eie, a yeeo oeae aioeaai a?aenooi?e. 3. Ao?ieia?/iei oaeoi?ii oai?iae ?aeoa?a iae/ano?oa aenooia? oeai?ae?eia ?ioaeoe?y (38%), yea anioe?th?oueny c aa?iaoe/ieie a??onaie (47%), a oaeiae aioa?iaaeoa??aeuei? caoaeieee (20%). 4. O oai?eo c? ci?oaiith oeai?ae?eii-a??oniith ?ioaeoe??th aeyaeaii ca?eueoaiiy e?eueeino? ?aoeeaeea?a oai?iae ?aeoa?a, a oaeiae ?noioia iineaaeaiiy a ieo “?aiiueiai” oa “i?ciueiai” oaaioeeoa?iiai /enea. 5. Ia iniia? eiiieaenii? nenoaie ioe?iee aeoeaiino? iaoieia?/iiai i?ioeano aeyaeaii ia?aaaaeaiiy ? – ?? nooiai?a aeoeaiino? oai?iae ?aeoa?a, ui noi?iaiaeaeo?oueny ia?inoaiiyi e?eueeino? neaai?aoeaioi?ieo e?ioioeeo?a oa ??aiy IgM. 6. C? ca?eueoaiiyi o?eaaeino? oai?iae (iniaeeai i?ney 5-oe ?ie?a), cia/ii c?inoa? /enei CD22+-e?ioioeeo?a o oai?eo ia oai?iao ?aeoa?a. 7. I?ae aieeaii aaciaiai e?eoaaiiy c ?iaeea?aeoaeueiei i?aeoiaeii o oai?eo ia oai?iao ?aeoa?a anoaiiaeaii ciaioaiiy eiioeaio?aoe?? IgM oa na?aaei?o Oe?E o e?ia? c aeoeaaoe??th oaaioeeoico ii?yae c iiaeeaeaiiyi aeec?aaoeyoi?ieo e?ioioeeoa?iicaeaaeieo iaoai?ci?a. Nienie iniiaieo i?aoeue, iioae?eiaaieo ca oaiith aeena?oaoe?? 1. Aeaeon I. A., AEa??iia I.E., Iaaeaoeaae/ I.I. O?aaeaiiy na?oey i?e oai?ia? ?aeoa?a // E?ea?nueea ni?aaa. – 1995. -N 9-10. – C. 168 – 169. 2. Aeaeon I. A., Aeaianueeee A.I. I?iaeaia e?eoaaiiy oai?iae ?aeoa?a // Acta Medica Leopoliensia. – 1995. – N 1. – C. 73 – 75. 3. Aeaeon I. A., *ii’ye A. A., Aeaianueeee A. I. Nenoaia ioe?iee aeoeaiino? oai?iae ?aeoa?a // Aeooaeuei? i?iaeaie ee?i?/ii? ?ioiieia?? oa aea?aieia??. - 1996. – N 1.- N. 115 - 118. 4. Aeaeon I. A.,*ii’ye A. A., Aeaianueeee A. I. Aei ieoaiiy ae?aaiico oa eeaneo?eaoe?? oai?iae ?aeoa?a // Aaeeoeueeee e?ea?nueeee a?niee. - 1997.- O.4, N 2.- N. 14 - 16. 5. Aeaeon I. A. Aei ieoaiiy e?eoaaiiy ?aaeoeaieo a?o?eo?a // Aeooaeuei? i?iaeaie ee?i?/ii? ?ioiieia?? oa aea?aieia??. – 1997. – N 2. - N. 79 - 87. 6. Aeaeon I.A. Iniaeeaino? ci?i e?ioioeeoiiina?aaeeiaaieo i?ioean?a o oai?eo ia oai?iao ?aeoa?a oeai?ae?eii? ao?ieia?? // Aeooaeuei? i?iaeaie ee?i?/ii? ?ioiieia?? oa aea?aieia??. – Euea?a. – 1998. – ? 3. – C. 78 – 84. 7. Dzhus M.B., Vyhovsky V.P. Reiter’s syndrome and heart failure // 3-rd international congress on heart failure–mechanisms and management. – Geneva (Switzerland). -1995. - P. 61. 8. Dzhus M.B., Brodyk O.V., Chopyak V.V.Vira association in patients with Reiter’s disease // Polish Journal of Immunology.- 1995. – Vol. 20, N 3. – P. 211. 9. Bridyk O.V., Chopyak V.V., Porochovska Z.S., Dzhus M.B. Nall-mediated processes as prognostic factor of clinical development of myocardial reinfarction // Polish Journal of Immunology.- 1995. – Vol. 20, N 3. – P.189 10. Aeaeon I.A. Aieea naeacii??eaeaceio ia ia?aa?a oai?iae ?aeoa?a // Aeooaeuei? ieoaiiy iaaeeoeeie. Oace aeiiia?aeae I?aeia?iaeiiai Eiia?ano Iieiaeeo A/aieo Oe?a?ioe?a. - ?aaii-O?aie?anuee: 1995.- N. 80 – 81. 11. Dzhus M.B., Chopyak V.V. Microbiological and immunological aspects of Reiter’s disease // IUSTI European Congress 1998 on STDs and Genital Dermatology. - Goteborg (Sweden). – 1998. – P. 51. 12. Aeaeon I.A., *ii’ye A.A., Aeaianueeee A.I., Aa?aaaiiae/ I.I. Naeacii??eaeacei a eiiieaeni?e oa?ai?? oai?iae ?aeoa?a // Iaoa??aee OIV c’?caeo oa?aiaao?a Oe?a?ie. - Ee?a, 1998. – C. 294 – 295. Aeaeon I.A. Oai?iaa ?aeoa?a: ?ioiieia?/i? iaoai?cie ?icaeoeo oa iniaeeaino? ae?aaiinoeee. – ?oeiien. Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe ca niaoe?aeuei?noth 14.01.29. – ee?i?/ia ?ioiieia?y. – ?inoeooo ooec?ao??? ? ioeueiiiieia?? ?i. O.A.ssiianueeiai AII Oe?a?ie, Ee?a, 1999. Aeena?oaoe?th i?enay/aii ieoaiiyi ao?ieia?? oa ?ioiiaaiaco oai?iae ?aeoa?a. O ?iaio? cai?iiiiiaaia ee?i?ei-?ioiieia?/ia nenoaia ioe?iee aeoeaiino? oai?iae ?aeoa?a. Anoaiiaeaii, ui iae/ano?oeie o?eaa?ieie oaeoi?aie oai?iae ?aeoa?a aenooiathoue oeai?ae?eia ?ioaeoe?y, yea anioe?th?oueny c aa?iaoe/ieie a??onaie, a oaeiae aioa?iaaeoa??aeuei? caoaeieee. Oai?iaa ?aeoa?a noi?iaiaeaeo?oueny ci?iaie ?ioiicaeaaeieo i?ioean?a, ye? oa?aeoa?ecothoueny aeec?aaoeyoe??th ee?oeiieo ? aoii?aeueieo oaeoi??a ?ioiii? nenoaie. O oai?eo c aeyaeaiei HLA-B27 aaiioeiii oe? ci?ie iniaeeai ae?aaeai? ? noi?iaiaeaeothoueny cieaeaiiyi iniiaieo iiioeyoe?e e?ioioeeo?a ia oe? ca?eueoaiiy ?ioii?aaoeyoi?iiai ?iaeaeno, ??ai?a IgG oa IgI, a oaeiae a?eueo ae?aaeaiith a?ia??ioiieiiieaenai??th. Iniiai? ?acoeueoaoe i?aoe? ciaeoee ai?iaaaeaeaiiy a i?aeoe/io iaaeeoeeio, iie?iooth/e ae?aaiinoeeo oa eiio?ieue ca e?eoaaiiyi oai?eo ia oai?iao ?aeoa?a. Eeth/ia? neiaa: oai?iaa ?aeoa?a, ao?ieia?y,?ioiiiaoiaaiac, HLA-B27. Aeaeon I.A. Aieaciue ?aeoa?a: eiioiieiae/aneea iaoaieciu ?acaeoey e iniaaiiinoe aeeaaiinoeee. – ?oeiienue. Aeenca?oaoeey ia nieneaiea o/aiie noaiaie eaiaeeaeaoa iaaeeoeeineeo iaoe ii niaoeeaeueiinoe 14.01.29. – eeeie/aneay eiioiieiaey. – Einoeooo ooeceao?ee e ioeueiiiieiaee ei. O.A. ssiianeiai AII Oe?aeiu, Eeaa, 1999. Aeenna?oaoeey iinayuaia aii?inai yoeieiaee e eiioiiaaiaca aieacie ?aeoa?a. A ?aaioa i?aaeeiaeaia eeeieei-eiioiieiae/aneay nenoaia ioeaiee aeoeaiinoe aieacie ?aeoa?a. Auyaeaii, /oi naiuie /anouie o?eaa?iuie oaeoi?aie aieacie ?aeoa?a aunooiatho oeaieaeeeiay eioaeoeey, anioeee?othuay n aa?iaoe/aneeie ae?onaie, a oaeaea yioa?iaaeoa?eaeueiua aicaoaeeoaee. Aieaciue ?aeoa?a nii?iaiaeaeaaony eciaiaieyie eiioiicaaeneiuo i?ioeannia, oa?aeoa?ecothueony aeec?aaoeyoeeae eeaoi/iuo e aoii?aeueiuo oaeoi?ia eiioiiie nenoaiu e oneeaieai yoeo eciaiaiee o aieueiuo n HLA-B27 aaiioeiii. Eiioiia?aiiu aieueiuo n auyaeaiiui HLA-B27 aioeaaiii oa?aeoa?ecothony nieaeaieai iniiaiuo iiioeyoeee eeioioeeoia ia oiia oaaee/aiey eiioii?aaoeyoi?iiai eiaeaena, o?iaiae IgG e IgI, a oaeaea aieaa au?aaeaiie aeia?eiioiieiiieaenaieae ii n?aaiaieth n aieueiuie, o eioi?uo yoio aioeaai ionoonoaoao. Iniiaiua ?acoeueoaou ?aaiou iaoee aiaae?aiea a i?aeoe/aneoth iaaeeoeeio, oeo/oay aeeaaiinoeeo e eiio?ieue ea/aiey iaoeeaioia n aieaciueth ?aeoa?a. Eeth/aaua neiaa: aieaciue ?aeoa?a, yoeieiaey, eiioiiiaoiaaiac, HLA-B27. Dzhus M.B. Reiter’s Disease: immunological mechanism of development and diagnosis peculiarities. – Manuscript. Thesis for the degree of philosophy doctor by specialization 14.01.29 – clinical immunology. – Institute of Phthisiology and Pulmonology n.a. F.G.Yanovsky, Ukrainian Academy of Medical Sciences, Kyiv, 1999. The dissertation is devoted to the problems of etiology and immunogenesis of Reiter’s disease. We carried out clinical, immunological and microbiological observation of 78 patients with RD in order to find out the influence of etiological agens, genetic factors, duration, activity and different clinical symptoms of illness on the immune responce. Cytological, immune-fluorescent and direct monoclonal-based ensyme immunoassay methods were used for detection of chlamydial and virus infection. Clinico-immunological approach in diagnosis of Reiter’s disease activity was worked out. The most frequent triggering agents of Reiter’s disease were Chlamydia trachomatis, which often associated with HVS II and enterobacterial infection. In 59 (75,6%) patients was diagnosed arthritis disorders: in 41% - oligo-articular, asymmetric arthritis, in 26% - clinical and X-ray features of sacroiliitis, in 22% - tendon inflammation and in 11% - heel pain. Extraarticular manifestations included mucocutaneous symptoms in 46,1%, ocular inflammation (conjunctivitis – 45,5%, uveitis – 10,9%, iridocyclitis – 9,1%), urethral disorders in 80,5% (urethritis – 66,1%, prostatitis – 35,4% males, cystitis – 14,5%, adnecsitis 26,6% females) and enterocolitis in 26,3%. Majority of patients (50,1%) had complete Reiter’s disease. Tetrad was diagnosed in 21,7% of cases and uncompleted Reiter’s disease – in 28,2%. We used thermography in order to estimate the degree of local inflammation. The symptom of “thermoamputation” was found out accidentally in 10 patients which testify the microcirculatory disorders. The reasons of vasculitis are on the one hand – the result of vessel’s spasm and on the other hand – result of the undergone inflammation in the vessel’s wall. It is known that such vessel injuries are accompanied by C3 compliment and IgM depositions. The mechanism of the development of vasculitis during Reiter’s disease is probably immune complexes with HSP60 and LPS in their structure. Immunedependent processes (immune inflammation, genetic and autoimmune processes) are the dominant in the development of Reiter’s disease. The disregulation of the cell and humoral immunity is frequent, especially in the HLA-B27 – positive patients. This make convinient conditions for manifestation of the specific infections, or it may be the epiphenomena of the infectious influence on the patient`s immune system. Reduction of the main lymphocytic populations and increasing of immunoregylatory index, IgG, IgA levels and immune complexes were estimated in the HLA-B27 – positive patients versus HLA-B27 – negative patients. It was also estimated that patients with Reiter’s disease had higher levels of 1-, 2-, -globulin, more active phagocytosis and quicker ESR versus the group of healthy volunteers. Most patients with arthritis triggered by Chlamydia and virus had complete Reiter’s disease (triad). They also had more severe disease and more frequent relapses. These patients had more expresed immunological changes (weakening of lymphocyte`s membrane reception, strengthening of dysregulation of immune answer, hyperimmunecomplexemia) that may lead to autoimmune agression. Patients with complete Reiter’s disease had lower level of the medium CIC (P<0,05) in comparison to the patients with tetrad or uncompleted Reiter’s disease. Rising of IgA (r=0,96; P<0,001) level correlates with quantity of Reiter’s disease relapses, and ascending of IgG (r=0,68; P<0,05) level – with phagocytosis depressing which is the evidence of autoagression strengthening. The activization of phagocytosis, CIC and IgG depressing were recognized after the course of specific treatment although they did not normalized. At the same time lymphocytic depended mechanisms characterized by deepening of the disregulation due to the treatment. Taking to the consideration polyetiology of Reiter’s disease, different genetic inclinations and depended immune answer, the basic treatment of patients with Reiter’s disease must be individual. The acute clinical picture of the arthritic component of Reiter’s disease is similar regardless of the specific infecting organisms, suggesting that the diverse bacterial species involved possess some common arthritogenic factor that – by interacting with as yet unknown host factor, e.g. HLA-B27 class 1 MHC determinant – can initiate a pathogenic process leading to the development of Reiter's disease. The main results of the work have been installed into practical medicine, improving diagnosis and treatment control of patients with Reiter’s disease. Key words: Reiter’s disease, etiology, immunopathogenesis, HLA-B27.

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