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Клініко-ехокардіографічна характеристика кардіопатії у підлітків, обумовленої малими структурними аномаліями серця: Автореф. дис… канд. мед. наук /

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

AAAAeAINUeEA OAOssIA NOAI?NEAA?AIA

OAeE 616.12-008-053.-6-07

EE?I?EI-AOIEA?Ae?IA?AO?*IA OA?AEOA?ENOEEA EA?Ae?IIAO?? O I?AeE?OE?A,

IAOIIAEAII? IAEEIE NO?OEOO?IEIE AIIIAE?ssIE NA?Oess

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 Oe?a?inueeiio iaoeiai-aeine?aeiiio ?inoeooo? ioi?iie
caei?ia’y ae?oae ? i?aee?oe?a IIC Oe?a?ie, i. Oa?e?a.

Iaoeiaee ea??aiee:

aeieoi? iaaee/ieo iaoe, i?ioani? Na?aia A?eoi??y Ieaenaiae??aia,
Oe?a?inueeee iaoeiai-aeine?aeiee ?inoeooo ioi?iie caei?ia’y ae?oae ?
i?aee?oe?a, i?ia?aeiee iaoeiaee ni?a?ia?oiee eaai?aoi???
ooieoe?iiaeueii? ae?aaiinoeee

Io?oe?ei? iiiiaioe:

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;

aeieoi? iaaee/ieo iaoe, i?ioani? Ino?iiieaoeue Naaae?e Naaae?eiae/
Aeiiaoeueeee aea?aeaaiee iaaee/iee oi?aa?neoao, caa?aeoth/ee eaoaae?ith
iaae?ao??? oaeoeueoaoo i?neyaeeieiiiiai iaa/aiiy.

I?ia?aeia onoaiiaa: Aei?i?iiao?ianueea aea?aeaaia iaaee/ia aeaaeai?y IIC
Oe?a?ie

Caoeno a?aeaoaeaoueny ”__26___” eenoiiaaea 1999 ?. i 12.30
aiaeei? ia can?aeaii? niaoe?ae?ciaaii? A/aii? ?aaee Ae.64.600.04 c
iaae?ao??? a Oa?e?anueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao? (310022,
i. Oa?e?a, i?. Eai?ia, 4: o.40-26-27)

C aeena?oaoe??th iiaeia iciaeiieoueny o a?ae?ioaoe? Oa?e?anueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo

Aaoi?aoa?ao ?ic?neaiee ”_19_” ___aeiaoiy___ 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. A no?oeoo?? caoai?thaaiue na?oey o ae?oae ?
i?aee?oe?a cia/io ieoiio aaao caeiathoue ea?ae?iiao?? iacaiaeueiiai
aaiaco, i?e?iaea eio?eo aei oeueiai /ano ua ia ?icoeo?iaaia iiai?noth. A
ca’yceo c oeei a iianyeaeaii?e i?aeoeoe? ia??aeei aeieea?
a?ia?ae?aaiinoeea i?e?iaeaeaieo ii?ie?a na?oey, ea?aeeo?a,
ea?ae?ii?iiao?e oa ?ioi? iaoieia??. I?ney oe?ieiai oi?iaaaeaeaiiy aei
ee?i?/ii? i?aeoeee oeueo?acaoeiaeo iaoiae?a aeine?aeaeaiiy noaei
iiaeeeaei aea/aiiy ii?oieia?? no?oeoo? na?oey, a oiio /ene? ? eiai iaeeo
no?oeoo?ieo aiiiae?e (INA), iieaciee?a ea?ae?iaaiiaeeiai?ee, oei?a
aaiioee?eoeyoe??, ui a cia/i?e i??? ?icoe?eei ae?aaiinoe/i? iiaeeeaino?
(A.I. Aieiniaaoeue, 1989; A.I. sseiae?a, A.?. Ia/a?aa, 1990; A.C.
I?eoiaeueei, A.N. Naiaoi?iaa, 1993; ?.A. Ianoeae ? ni?aaao., 1998;
O.Oakamoto, M. Nitta, 1991).

Ea?ae?ieiae Iueth-Ei?enueei? anioe?aoe?? aeae?eythoue neiae?ii
aeenieac?? niieo/ii? oeaieie na?oey. Oey i?iaeaia ii/aea iaea?eueo
?ioaineaii ?ic?iaeyoeny a iaae?ao??? ia i?ioyc? inoaiiueiai aeanyoe??//y
( I.I. Ii?iciaa, 1990; I.?. No?aoie, 1992; ss.?. Eec?eia; 1993).
Anoaiiaeaii, ui INA na?oey aeeth/athoue aaa?aioi? oi?aee (AO),
aeecii?o?ci eeaiaiieo, i?aeeeaiaiieo no?oeoo? ? iaa?no?aeueieo noaeei,
?o ?ae?iiaoe/ia caoaeaiiy, na?iiiiae?aieee aeaei i?aeoeoii/eiai?
ia?aai?iaeee, ia??aeei a niieo/aii? c nenoaiiith aeenieac??th niieo/ii?
oeaieie (A.N. Naiaoi?iaa, 1994; I.N. Eooaeianueeee, 1997; C.C. Barett et
al., 1991). Ea?ae?iiao??, iaoiiaeai? oe??th iaoieia??th, /anoi
noi?iaiaeaeothoueny ??cieie ii?ooaiiyie ?eoio ? i?ia?aeiino? na?oey,
ci?iith ea?ae?iaaiiaeeiai?ee ( O.A. A?caooe?ia, A.A.Eoci?oeia, 1995;
A.I. Eiaaeueiaa, 1995; I.Ae. Ino?ioiiaa, 1996).

O i?aee?oe?a aeaia i?iaeaia oaeoe/ii ia aea/aia. sse a?aeiii, oeae
ia??iae noaoaaiai aeic??aaiiy oa?aeoa?eco?oueny ?yaeii
aiaoiii-o?c?ieia?/ieo iniaeeainoae iae?iaoii?aeueii? ?aaoeyoe??,
eaa?euei?noth aaaaoaoeaii? ia?aiai? nenoaie, ?ioaineaiith ai?iiiaeueiith
ia?aaoaeiaith, oaeaeeei c?inoaiiyi, nai???aei?noth ii?oino?oeoo?e
na?oey, ui iaoiiaeth? /anoioo ??ciiiai?oieo ieioueo ?iceaae?a a nenoai?
e?iaiia?ao ? ia??aeei cieaeaiiy ?? aaeaioaoe?eieo iiaeeeainoae. Iiaeia
aaaeaoe, ui ea?ae?iiao?y, iaoiiaeaia INA, a ia??iae? noaoaaiai
aeic??aaiiy ia? nai? iniaeeaino? ? i?io?ea? c a?eueo na?eicieie
ii?ooaiiyie ae?yeueiino? na?oey a ii??aiyii? c aeeoy/ei a?eii.

A ca`yceo c ia/eneaii?noth a?aeiiinoae a e?oa?aoo?? c aeaii? i?iaeaie o
i?aee?oe?a, ?? aaeeeith aeooaeuei?noth ?icii/aoi iaoa aeine?aeaeaiiy,
aaaeeeaa c ae?aaiinoe/ieo iiceoe?e, ioe?iee aaeaioaoe?? aei o?ce/ieo
iaaaioaaeaiue, ?aaa?e?oaoe?? oeueiai eiioeiaaioo. E??i oiai, oeacaia
i?iaeaia ia? nioe?aeueia cia/aiiy, iniaeeai o thiae?a i?e i?ecia? aei
a?i??. Ana oea aecia/a? ?? aeooaeuei?noue. A?aeiia?aeii aei
i?aeia?iaeii? noaoenoe/ii? eeaneo?eaoe?? oai?ia Aeanyoiai ia?aaeyaeo
(IEO-10), i?eeiyoith Anaiaea?th AIIC a 1992 ?ioe?, INA na?oey a?aeianai?
aei XVII eeano, yeee aeeth/a? aeie “I?e?iaeaeai? aaaee ?icaeoeo nenoaie
e?iaiia?ao” (Q20-Q28). Aeey ni?iuaiiy oa?i?iieia?? ? c?o/iino? ie
aeei?enoaee oaeee ?iai/ee oa?i?i ye “aeenieanoe/ia ea?ae?iiao?y” (AeE)
a?aeiinii aei oe??? iaoieia??.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Aeena?oaoe?y
aeeiiaia a ?aieao iaoeiai-aeine?aeii? ?iaioe IAe? ICAeI ia oaio
”I?iaiicoaaiiy ia?aa?ao na?oeaai-noaeeiieo ii?ooaiue o i?aee?oe?a,
iaoiiaeaiiy i?aeoiae?a aei ?o ?aaa?e?oaoe??” (? aea?ae?a?no?aoe??
0196U002916) a iaaeao ?anioae?eainueei? i?iaeaie “Ioi?iia caei?ia’y
ae?oae oe?eueiiai a?eo oa i?aee?oe?a”.

Iaoa aeine?aeaeaiiy. Oaeineiiaeaiiy iaoiae?a ae?aaiinoeee ea?ae?iiao??,
iaoiiaeaii? INA na?oey, o i?aee?oe?a ca aeiiiiiaith
ee?i?ei-?ino?oiaioaeueieo iaoiae?a aeine?aeaeaiiy ? iaa?oiooaaiiy ?o
aeeniaina?iiai niinoa?aaeaiiy.

Iniiai? caaea/? aeine?aeaeaiiy:

– aeaoe ee?i?/io oa?aeoa?enoeeo i?aee?oe?a c AeE c o?aooaaiiyi aeaieo
aiaiiaco ? noeai aeecaia??iaaiaco niieo/ii? oeaieie;

– onoaiiaeoe ii?oieia?/i? iniaeeaino? INA ca aeaieie aoiea?ae?ia?ao??;

– ioe?ieoe noai ea?ae?iaaiiaeeiai?ee, oeaio?aeueii? aaiiaeeiai?ee o
i?aee?oe?a c AeE, ?ieue INA, ?o niieo/aiue a aeieeiaii? ??cieo
ea?ae?aeueieo ii?ooaiue;

– ioa?aeoa?ecoaaoe ooieoe?iiaeueiee noai na?oey o i?aee?oe?a c AeE a
niieith ? a i?ioean? o?ce/iiai iaaaioaaeaiiy ( ca aeaieie
?ino?oiaioaeueieo iieaciee?a ), i?iaanoe eaoaiianoe/ia niinoa?aaeaiiy, a
oaeiae iaa?oiooaaoe iaiao?aei?noue ?o aeeniaina?ecaoe??.

Iaoeiaa iiaecia. Aia?oa o i?aee?oe?a c INA na?oey anoaiiaeai?
iniaeeaino? ea?ae?aeueii? iaoieia?? ? iaa?oioiaai? i?aeoiaee aei ?o
aeeniaina?iiai niinoa?aaeaiiy.

Iieacaii, ui INA iaoiiaeththoue ?icaeoie aeenieanoe/ii? ea?ae?iiao??,
yea noi?iaiaeaeothoueny iaaieie ee?i?/ieie i?iyaaie, ia??aeei a
ii?aeiaii? c ??cieie aeno?aea?ae?aeueieie noeaiaie aeenieac?? niieo/ii?
oeaieie.

Onoaiiaeai? /anoioa, oa?aeoa? INA na?oey o i?aee?oe?a. Aia?oa ioe?iaii o
ieo noai ea?ae?iaaiiaeeiai?ee ca aeaieie aoiea?ae?ia?ao?? c o?aooaaiiyi
a?eo, noao? iaoe??io?a a ii??aiyii? ?c caei?iaeie iaeiie?oeaie.

Ii?yae c caaaeueieie caeiiii??iinoyie ci?i aoiea?ae?ia?ao?/ieo
iieaciee?a o i?aee?oe?a c AeE ? caei?iaeo a ca’yceo c ?o c?inoaiiyi
aeyaeai? iniaeeaino? ea?ae?iaaiiaeeiai?ee oa ia?aaaaeaiiy
a?iie?iaoe/iiai oeio aaiioee?eoeyoe?? i?e iayaiino? INA na?oey.

Aecia/aia aaeeea /anoioa ci?i a?iaeaeo?e/ii? ? iaoai?/ii? aeoeaiino?
i?iea?aea o i?aee?oe?a c AeE, onoaiiaeai? iaaaoeai? oaeoi?e, ye?
aieeaathoue ia aeieeiaiiy ii?ooaiue ?eoio, ae?anoie?/ii? ooieoe?? e?aiai
oeoii/ea, ui ?icoe?th? oyaeaiiy i?i iaoiaaiac ?iceaae?a
ea?ae?iaaiiaeeiai?ee.

Ia i?aenoaa? eaoaiianoe/ieo niinoa?aaeaiue ia i?ioyc? 1, 5-2 ?ie?a o
a?eueoino? i?aee?oe?a aeyaeaia noaa?euei?noue iieaciee?a
?ino?oiaioaeueieo iaoiae?a aeine?aeaeaiue na?oey, o /anoeie – ?o
iia??oaiiy, iniaeeai aaeaioaoe?? aei o?ce/ieo iaaaioaaeaiue.

I?aeoe/ia cia/aiiy ?iaioe. Iaea?aeai? ?acoeueoaoe ni?yiiaai? ia
iie?ioaiiy ae?aaiinoeee AeE o i?aee?oe?a. Ii?iaoeae aoiea?ae?ia?ao?/ieo
iieaciee?a o iaoe??io?a 12-17 ?ie?a c o?aooaaiiyi a?eo, noao? iiaeooue
aeei?enoiaoaaoeny a i?aeoeoe? i?e aeine?aeaeaii? caei?iaeo ? c ??ciith
iaoieia??th.

Aeae?eai? iniiai? ee?i?/i?, ?ino?oiaioaeuei? iieacieee ? aoaie ?o
i?iaaaeaiiy aeey aeyaeaiiy INA na?oey, ioe?iee eiai ooieoe?iiaeueiiai
noaio. Aeieacaia iaiao?aei?noue aeeniaina?iiai niinoa?aaeaiiy ca
i?aee?oeaie c AeE o ea?ae?ieiaa c iaa?oioiaaiiyi e?aoiino?
aeine?aeaeaiue ? i?aeoiae?a aei icaei?iaeaiiy.

Iaoiaee ae?aaiinoeee AeE o i?aee?oe?a ? ii?iaoeae aoiea?ae?ia?ao?/ieo
iieaciee?a o caei?iaeo oi?iaaaeaeai? a iie?ee?i?oe? ? ee?i?oe?
Oe?a?inueeiai IAe? ICAeI, iaeanieo ee?i?/ieo e?ea?aiue ? 1, 2, a oaeiae
ia eaoaae?? oa?ai?? i?aee?oeiaiai a?eo Oa?e?anueeiai ?inoeoooo
oaeineiiaeaiiy e?ea??a a eaeoe?eiiio iaoa??ae?. Aeae?eai? aoaie
i?iaaaeaiiy ee?i?ei-?ino?oiaioaeueieo aeine?aeaeaiue INA aeicaieyee
iie?ioeoe ae?aaiinoeeo ea?ae?aeueieo ii?ooaiue, nai?/aniiio i?iaaaeaiith
aeeniaina?iiai iaaeyaeo ca iaoe??ioaie.

Iniaenoee aianie caeiaoaa/a. Aaoi? aeena?oaoe?? naiino?eii ioe?ithaaa
noai i?aee?oe?a ? i?iaaaeea ?o aeeiai?/ia niinoa?aaeaiiy, iaoiaee
ooieoe?iiaeueii? ae?aaiinoeee na?oeaai-noaeeiii? nenoaie, a oiio /ene?
aoiea?ae?ia?ao?th, aeiiie??aoiea?ae?ia?ao?th, aiae?coaaa ? iaaiai?thaaa
?acoeueoaoe aeine?aeaeaiue, ?iaea ?? noaoenoe/io ia?iaeo ? ioi?ieaiiy.

Ai?iaaoe?y ?iaioe. ?acoeueoaoe aeine?aeaeaiue aeiiia?aeaeenue ?
iaaiai?thaaeeny ia iaoeiai-i?aeoe/ieo eiioa?aioe?yo “Nia?aiaiiua iaoiaeu
oeueo?acaoeiaie aeeaaiinoeee” (Oa?e?a, 1996), iieiaeeo a/aieo (Oa?e?a,
1995, 1996), a oaeiae i?enay/ai?e 75-??//th Oe?a?inueeiai IAe? ICAeI
(Oa?e?a, 1997), ia II Iaoe?iiaeueiiio eiia?an? ?aaiaoieia?a (Ee?a,
1997), ia can?aeaii? Oa?e?anueeiai iaoeiaiai iaaee/iiai oiaa?enoaa
e?ea??a c ooieoe?iiaeueii? ae?aaiinoeee (1997).

Ioae?eaoe??. Ca iaoa??aeaie aeena?oaoe?? iioae?eiaaii 9 ?ia?o, c ieo 5
noaoae – a oeaio?aeueieo aeo?iaeao, 1 noaooy – a ca??ieeo iaoeiaeo
i?aoeue, 3 oace aeiiia?aeae a iaoa??aeao eiia?ano ? eiioa?aioe?e.

No?oeoo?a oa ianya ?iaioe. Iaoa??aee aeena?oaoe?? aeeeaaeai? ia 136
noi??ieao iaoeiiieniiai oaenoo. Aiia ia? anooi, iaeyae e?oa?aoo?e,
?icae?e c iaoa??ae?a, iaoiae?a aeine?aeaeaiiy, /ioe?e ?icae?ee aeanieo
aeine?aeaeaiue, cae?i/aiiy, aeniiaee, i?aeoe/i? ?aeiiaiaeaoe?? oa
ia?ae?e e?oa?aoo?e, yeee aeeth/a? 204 aeaea?aea, a oiio /ene? 129
a?o/eciyieo ? 75 ?iicaiieo, ui neeaaea? 28 noi??iie. A aeena?oaoe??
i?eaaaeaii 21 oaaeeoeth, 37 iaethie?a, ui noaiiaeoue 30 noi??iie.

CI?NO ?IAIOE

Ia’?i ? iaoiaee aeine?aeaeaiiy. I?ae iaaeyaeii ciaoiaeeeeny 215
i?aee?oe?a 12-17 ?ie?a c INA na?oey, ?c ieo – 85 a aeeiai?oe? /a?ac 1,
5-2 ?iee; a?oio ii??aiyiiy neeaee 70 caei?iaeo iaeiie?oe?a aeey
iaea?aeaiiy ii?iaoea?a aoiea?ae?ia?ao?/ieo iieaciee?a. Ii?yae c
caaaeueiiee?i?/ieie iaoiaeaie aeine?aeaeaiue, i?iaaaeeee
aeaeo?iea?ae?ia?ao?th (AEA) a niieith, oiiiea?ae?ia?ao?th (OEA),
?aae?iaeaeo?iea?ae?ia?ao?th c aaeia?aiiao???th, oano PWC 170,
aoiea?ae?ia?ao?th (AoiEa) a I- ? A – ?aaeeiao ia aia?ao? “Sonoline-SL1”
o??ie “Siemens” (O?A), aeiiie??aoiea?ae?ia?ao?th (AeAoiEa) c
aeei?enoaiiyi ?iioeueniiai ? eieuei?iaiai ea?oe?oaaiiy ia aia?ao?
“Logic-500” o??ie “General Electric”.

Aeine?aeaeaiiy i?iaaaeeeenue a iie?ee?i?oe?, ee?i?oe? ? eaai?aoi???
ooieoe?iiaeueii? ae?aaiinoeee Oe?a?inueeiai IAe? ioi?iie caei?ia’y
ae?oae ? i?aee?oe?a ca eiai ieaiii IAe? a iaaeao ?anioae?eainueei?
i?iaeaie “Ioi?iia caei?ia’y ae?oae oe?eueiiai a?eo ? i?aee?oe?a”.

?acoeueoaoe aeine?aeaeaiue oa ?o iaaiai?aiiy. ?acoeueoaoe aeine?aeaeaiue
iieacaee, ui o i?aee?oe?a c AeE a aiaiiac? ia??aeei niinoa??aaeeny ??ci?
iani?eyoeea? oaeoi?e, ye? iiaee ni?aaeyoe iaaaoeaiee aieea ia i?aai?ci :
oneeaaeiaiee ia?aa?a aaa?oiino?, a iniiaiiio ia?oi? ?? iieiaeie, ?
iieia?a o iaoa??, ano?en?y iiaiia?iaeaeaieo ? ?ioa iaoieia?y oeueiai
ia??iaeo (44,6±3,4 %), aenieee ?ioaeoe?eiee ?iaeaen, iiaoi?i?
?ani??aoi?i? caoai?thaaiiy (44,7±3,4 %). A?eueoa, i?ae o iieiaeie
iaoe??io?a (58,7±3,4 %) niinoa??aaeeny aeene?iac?? aeia/iaeae?eaii?
nenoaie, o?ii?/iee oieaoeenoeo ? aano?iaeoiaeai?o a noaae?? ?ai?n??,
ii?ooaiiy iaa??aeueii-iaino?oaeueiiai oeeeeo o ae?a/ao (21,4±5,4 %),
aaaaoi-noaeeiia aeenoii?y (12,1±2,2 %), a iaeeie/ieo aeiaaeeao –
aeeniaoaaie?/ia iao?iiao?y. O iieiaeie aeine?aeaeaieo aeyaeaia niaaeeiaa
iaoyaeaiiy ?c caoai?thaaiue na?oeaai-noaeeiii? ? niieo/iioeaieiii?
nenoai o aeecueeeo ?iaee/?a.

A?eueo?noue i?aee?oe?a (75,3±2,9 %) i?aae’yaeyee ea?ae?aeuei? ?
caaaeueiiiaa?ioe/i? nea?ae. Iaea?eueo /anoeie a ?o no?oeoo?? aoee
ea?ae?aea?? (91,3±2,2 %), caaeeoea i?e o?ce/iiio iaaaioaaeaii? (37,0±3,8
%) ? iiaaia eiai ia?aiini?noue (51,8±3,9 %), na?oeaaeooy (21,6±3,2 %).

AeE aeyaeyeany o iaoe??io?a ia??aeei aeiaaeeiai (21,9±2,8 %) a ca’yceo c
iayai?noth ooio a na?oe?, ii?ooaiue eiai ?eoio, a oaeiae i?e i?aeic?? ia
ii?ie, ea?aeeo (4,6±1,4 %) aai ?ioo iaoieia?th (16,3±2,5 %), ui
na?ae/eoue i?i iaai? ae?aaiinoe/i? o?oaeiiu? ? a?aenooi?noue /?oeeo
e?eoa???a.

Iaae? a?aeiiniiai na?oeaaiai i?eooieaiiy o an?o i?aee?oe?a ciaoiaeeeeny
a?aeiinii a?eiai? ii?ie, o a?eueoino? c ieo (80,0±2,7 %) i?ineooiaoaaany
nenoie?/iee ooi ia aa?o?aoe? ? a oi/oe? Aioe?ia-A?aa, c ieo o 21,5±3,1 %
– a?i aoa a?oaoaaoiai oaia?o, aeiaaio?eaaeee, ca oa?aeoa?enoeeith
iaaeeaeaany aei i?aai?/iiai. A iaeeie/ieo aeiaaeeao (5,6±1,8 %)
a?aecia/aany ei?ioeee ae?anoie?/iee ooi c eieae?caoe??th a i?iaeoe??
ai?oe. Iaeaea o iieiaeie i?aee?oe?a niinoa??aaeeny i?eaeooaiiy oii?a
na?oey, o o?aoeie – nenoie?/i? aeno?aoiie.

Iaeneiaeueiee ? i?i?iaeueiee a?oa??aeueiee oene ca I.C. Ei?ioeiaei o
a?eueoino? iaoe??io?a aoa ii?iaeueiei, ?iiae? (12,1±2,2 %) cono??/aeiny
iaaaeeea (10-20 ii) neooaoe?eia i?aeaeuaiiy aai cieaeaiiy eiai
nenoie?/iiai iieacieea.

Oae ye aeaoaeo niieo/ii? oeaieie yaey?oueny aaia?ae?ciaaiei, o
i?aee?oe?a c AeE ia??aeei aoee iciaee ?? “neaaeino?” c aieo oe??e, i/ae,
iii?ii-?ooiaiai aia?aoa. Aiie i?iyaeyeeny noeoii?noth oaiioei?/ieo iciae
i?aai?cio, ye? a?aeia?aaeaee i?e?iaeaeai? iniaeeaino? ?? aoaeiae. Oae,
iaeaea o iieiaeie aeine?aeaeaieo i?e iaeyae? niinoa??aaeeny ??ci? noeaie
aeecaia??iaaiaco niieo/ii? oeaieie. Iaea?eueo /anoi cono??/aeeny
:anoai?/ia eiinoeoooe?y, neie?ioe/ia iinoaaa, i?aeaeuaia ?icoyae?iiy
oe??e, /eneaii? ?iaeeiee, aiiiae?? aa?oi?o ? ieaei?o e?ioe?aie,
a?ia?iia?euei?noue noaeia?a.

Ia i?aenoaa? oeueo?acaoeiaiai neaioaaiiy iaea?eueo /anoi cono??/aeeny
ianooii? aa??aioe INA: a ii?iaeieiao, /ano?oa a e?aiio oeoii/eo,
iaeeie/i? (52,1±3,4 %) aai iiiaeeii? (27,4±3,0 %) AO, a i?noeyo
a?aeoiaeaeaiiy eio?eo ia??aeei (43,3±3,8 %) aoea eieaeueia a?ia?o?io?y
i?iea?aea; ?ae?iiaoe/iee i?ieain i?o?aeueiiai eeaiaia I-II nooiaith
aecia/aany o 58,1±3,4 %, iiiaeeiia i?ieaaoaaiiy eeaiai?a – o 38,1±3,3 %
iaoe??io?a. I?ieaaoaaiiy o?eeoni?aeaeueiiai (11,2±2,2 %), eaaaiaaiai
(29,3±3,1 %) oa ai?oaeueiiai (7,4±1,8 %) eeaiai?a cono??/aeiny ??aeoa,
i?ae i?o?aeueiiai. ?o ae?aaiinoeea ia??aeei oo?oaeithaaeany a ca’yceo c
aiaoii?/iei ?ici?uaiiyi, iaeiae aeei?enoaiiy AeAoiEa c aeyaeaiiyi
?aao?a?oaoe?? ia oeeo eeaiaiao aeiiiiaaaei ae??oaiith oaei? caaea/?. A
iaeeie/ieo aeiaaeeao i?e oeueo?acaoeiaiio neaioaaii? ciaoiaeeee oae? INA
ye /ioe?ueionooe/aoee ai?oaeueiee eeaiai (2,3±1,0 %) ? ca?iiiiae?aiee
aeaei i?aeoeoii/eiai? ia?aai?iaeee.

A iniia? ia?aeiiiai ?ae?iiaoe/iiai i?ieaaoaaiiy eeaiai?a eaaeeoue, ye
a?aeiii, i?eniiaoicia o?ainoi?iaoe?y nooeie, iaoiiaeaia i?ie?o??aoe??th
aoa/aoi? ciie, iaeiieaiiyi eeneeo ioeiiie?naoa??ae?a oa o?aaiaioaoe??th
eieaaaiiaeo aieieii. Ia??aeei i?eniiaoicia aeaaaia?aoe?y iioe?thaaeany ?
ia oi?aeaeueiee aia?ao. Eiee iaeii/anii ci?ithaaeany no?oeoo?a nooeie ?
ca’yci/iiai aia?aoa, oi aeeaeia i?ieaaoaaiiy i?o?aeueiiai eeaiaia
iaaeeaeoaaeany aei II nooiaiy. E aoiea?ae?ia?ao?/iei iciaeai
i?eniiaoicii? aeaaaia?aoe?? a?aeiinyoue “?icieo?noue”, “eoaeeao?noue”
nooeie, ia??aeei c aaeeeiiiae?aieie iaeeaaeaiiyie ia ?o a?eueieo e?ayo (
O. Takamoto at al., 1991). *enei, ?ici?uaiiy ? niieo/aiiy INA na?oey
aecia/athoue, i/aaeaeii, iniaeeaino? ooieoe?iioaaiiy na?oeaai-noaeeiii?
nenoaie o oaeeo i?aee?oe?a.

Aeey ia’?eoeaii? ioe?iee noaio nenoaie e?iaiia?ao o iaoe??io?a c AeE ?
nooiaith a?aeoeeaiue iieaciee?a a?ae ii?iaeueieo aecia/ai? ii?iaoeae
AoiEa-ia?aiao??a o i?aeoe/ii caei?iaeo iaeiie?oie (70), ye? noai?eee
eiio?ieueio a?oio c o?aooaaiiyi noaoaaeo ? a?eiaeo iniaeeainoae. I?e
aiae?c? aeaieo onoaiiaeaii, ui ii?oiiao?e/i? iieacieee na?oey iaee /?oeo
a?eiao a?aaeaoe?th. Oae, o 12-14 – ? 15-17 – ??/ieo nenoie?/iee
(?0,05).Iaeaea o iieiaeie aeine?aeaeaieo (43,3±3,8
%) a i?noeyo a?aeoiaeaeaiiy oi?ae niinoa??aaeany eieaeueia a?ia?o?io?y
i?iea?aea, aea iiaee oi?ioaaoeny ina?aaeee aeoii?/ii? aeoeaiino?. I?e
ii??aiyii? ii?oiooieoe?iiaeueieo iieaciee?a na?oey o i?aee?oe?a c AeE c
ii?ooaiiyie ?eoio ? aac ieo a?aei?/aia iaaia ??cieoey.

A a?oi? c ?iceaaeaie ?eoio onoaiiaeaii a??ia?aeia ?icoe?aiiy aeo?aeiiai
o?aeoo i?aaiai oeoii/ea, e?aiai ia?aaena?aey, nenoie?/iiai,
ae?anoie?/iiai ae?aiao??a ? ia’?i?a e?aiai oeoii/ea ia oii? cieaeaiiy
iieaciee?a ianinii? ooieoe?? (oaea?iiai ia’?io, o?aeoe?? aeeeaeo ) ?
nei?i/oaaeueii? ni?iiiaeiino? (nenoie?/iiai i?e?inoo ae?aiao?a,
oaeaeeino? oee?eoey?iiai oei?i/aiiy aieieii i?iea?aea). O iaoe??io?a c
ii?ooaiiyie ?eoio iieaciee iaieey?ii? o?aeoe?? aoa cia/ii aeua
(p0,05), a a?iie?iaoe/iee oei
ia?aaaaeaa o iaoe??io?a c AeE (18,6±4,6 % ? 31,2±3,2 %, p

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