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Клініко-метаболічні особливості адаптації доношених новонароджених дітей з пневмонією і гіпоксично-ішемічною енцефалопатією: Автореф. дис… канд. мед

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?INOEOOO IAAe?AO???, AEOOA?NOAA OA A?IAEIEIA??

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

IEEEI’THE Aiia Ien??aia

OAeE: 616.-053.-35:[61.831-005+616.152.21]

EE?I?EI-IAOAAIE?*I? INIAEEAINO? AAeAIOAOe??

AeIIIOAIEO IIAIIA?IAeAEAIEO Ae?OAE C

IIAAIII??TH ? A?IIENE*II-?OAI?*IITH

AIOeAOAEIIAO??TH

14.01.10 – iaae?ao??y

AAOI?AOA?AO

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Ee?a – 1999

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia a ?aaii-O?aie?anuee?e aea?aeaai?e iaaee/i?e aeaaeai??
IIC Oe?a?ie.

Iaoeiaee ea??aiee:

aeieoi? iaaee/ieo iaoe, i?ioani? Aieinyiei ?iiaia Iao??aia,
?aaii-O?aie?anueea aea?aeaaia iaaee/ia aeaaeai?y IIC Oe?a?ie,
caa?aeoth/a eaoaae?e aeeoy/eo oai?ia

Io?oe?ei? iiiiaioe:

– aeieoi? iaaee/ieo iaoe, i?ioani?, caneoaeaiee ae?y/ iaoee ? oaoi?ee
Oe?a?ie Iiaeue/aiei Ethaeieea ?aai?aia, ?inoeooo iaae?ao???, aeooa?noaa
oa a?iaeieia?? AII Oe?a?ie, ea??aiee a?aeae?eaiiy aeeoa?aioe?eii?
ae?aaiinoeee, i?io?eaeoeee oa oa?ai?? caoai?thaaiue aioo??oi?o i?aai?a o
ae?oae

– aeieoi? iaaee/ieo iaoe, i?ioani? Oea/aiei Na?oeaia Eoci?i?/ia,
Euea?anueeee aea?aeaaiee iaaee/iee oi?aa?neoao ?i. Ae.Aaeeoeueeiai IIC
Oe?a?ie, i?ioani? eaoaae?e oaeoeueoaonueei? ? aini?oaeueii? iaae?ao???

I?ia?aeia onoaiiaa:

Ee?anueea iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe ?i.I.E.Ooieea IIC
Oe?a?ie, eaoaae?a iaiiaoieia??, i.Ee?a

Caoeno a?aeaoaeaoueny “ 25 ” n?/iy 2000 ?ieo i 1300 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 26.553.01 ii caoenoo
aeena?oaoe?e ia caeiaoooy iaoeiaiai nooiaiy aeieoi?a iaoe ca
niaoe?aeueiinoyie “Iaae?ao??y”, “Aeooa?noai ? a?iaeieia?y” i?e ?inoeooo?
iaae?ao???, aeooa?noaa oa a?iaeieia?? AII Oe?a?ie (04050, i.Ee?a,
aoe.Iaio?euenueeiai, 8).

C aeena?oaoe??th iiaeia iciaeiieoeny a a?ae?ioaoe? ?inoeoooo
iaae?ao???, aeooa?noaa ? a?iaeieia?? AII Oe?a?ie (04050, i.Ee?a, aoe.
Iaio?euenueeiai, 8)

Aaoi?aoa?ao ?ic?neaiee “ 27 ” eenoiiaaea 1999 ?ieo

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee
E.A. Eaaoi?ia

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue i?iaeaie. Na?aae i?e/ei ia?eiaoaeueii? nia?oiino? ?
iaoieia?? a iinoiaoaeueiiio ia??iae? ?icaeoeo aeeoeie a Oe?a?i? /?eueia
i?noea caeia? a?iien?y ieiaea ? ano?en?y iiaiia?iaeaeaiiai
(A.I.N?ae?euei?eia, N.I.E?eaiionoia, 1994).

Ca no/anieie oyaeaiiyie a a?iien?th ieiaea o?ainoi?io?oueny aoaeue-yea
iani?eyoeeaa i?io?eaiiy aaa?oiino? (I.I.Oaaaeia, 1995). Iaoyaeaiee
ia?aa?a aaa?oiino? ? iieia?a o iaoa??, ye a?aeiii, aeeeeea? ii?ooaiiy
an?o aeae?a iai?io ?a/iaei o ieiaea ? iiaiia?iaeaeaii? aeeoeie
(I.I.Eoe’yiiaa, E.?.Iiaeue/aiei, 1994, O.E.Ciaiainueea, 1993,
A.A.Iaae?eianueea, 1996), i?e oeueiio a eaioethc? iinoa?iiene/ieo
iioeiaeaeaiue iniaeeai aaaeeeaeie ? ?iceaaee aia?aaoe/iiai iaoaaie?cio.
Aeaci?aai?caoe?y iaoaaie?/ieo i?ioean?a noi?iaiaeaeo?oueny no?oeoo?ieie
ci?iaie a ee?oeiieo iaia?aiao ? iaaei??iei iinooieaiiyi a e?iaiiinia
?onei oa?iaio?a aia?aaoe/iiai iai?io ? ae?eie?co: e?aaoeie?iace ?
ea-eoaoaeaa?ae?iae?iaaiace (A.A-Eaaeaiei oa ni?aaaoi?e, 1993).

Na?aae oneeaaeiaiue ia?eiaoaeueii? a?iien?? aeniea /anoea i?eiaaea? ia
oea?aa?aeueio iaoieia?th (I.?.Aaeaeoe, 1992). Ia oe?
a?iiene/ii-?oai?/ii? aioeaoaeiiao?? o iiaiia?iaeaeaieo iaethe?a ia??aeei
aeieea? caiaeaiiy eaaaiaai? oeaieie (?.i.aieinyiei, 1994,
A.?.Eeaiaianueeee 1995). ?icaeoeo iiaaiii?? ni?eythoue ? o?c?ieia?/i?
iniaeeaino? ?ioi?oaoo a iaiiaoaeueiiio a?oe?, eio?? iieyaathoue o
iaaeinoaoi?e c??eino? ee?oeiii? ? aoii?aeueii? eaiie ?ioi?oaoo ?
oaaioeeoico (N.E-Oea/aiei c? ni?aaaoi?., 1994, A.I.*a?ieoia,
?.?.Neoea?i, 1994). Iiaaiii?y a naith /a?ao iineeth? a?iiene/iee noai
iaiiaeyoe (A.I.Aeaiaioue?aa, 1995), a oneeaaeithth/ei oaeoi?ii i?e
oeueiio aenooia? ? neiae?ii aiaeiaaiii? ?ioieneeaoe??, yeee
noi?iaiaeaeo? caiaeuei? i?ioeane a i?aai?ci? (.?.Iaiiaa, 1997). Iniaeea?
o?oaeiiu? a i?aeoeoe? e?ea?y – iaiiaoieiaa iia’ycai? c oei, ui ee?i?/i?
i?iyae ia?eiaoaeueii? aioeaoaeiiao?? ? iiaaiii?? o iiaiia?iaeaeaieo
iaiiaeyo ? iiae?aieie (A.A.Ano??i c? ni?aaao., 1994), a /?oe? e?eoa???,
ye? a aeicaieeee aecia/eoe nooi?iue iinoa?iiene/iiai iioeiaeaeaiiy ?
nai?/anii ae?aaiinooaaoe i?e?aeiaiiy iiaaiii?/iiai i?ioeano aei
ia?eiaoaeueii? aioeaoaeiiao??, o iiaiia?iaeaeaieo ae?oae ia aeinoaoiuei
aecia/ai?. Oea iaaaoeaii iicia/a?oueny ia aoaeoeaiino? e?eoaaiiy oa
?aaa?e?oaoe?? aeacaiiai eiioeiaaioo iaiiaeyo.

Na?aae no/anieo iaoiaeee oa?iaeiei?aeoe?? iinoa?iiene/ieo noai?a o
iiaiia?iaeaeaieo ae?oae caneoaiao? oaaae canoinoaaiiy i?aia?ao?a
iaoaaie?/ii? ae??, ye?, ?aaoethth/e iai?ii? i?ioeane, i?aeaeuothoue
caaaeuei? a?aeiiai? ?aaeoe?? ? aeyaeythoue ianiaoeeo?/iee
?ioiiei?aaoth/ee aoaeo (I.A.Ai?aethaiaa, 1993).

Iaaaaeaia aecia/eei iaoo oa caaaeaiiy i?iaaaeaieo aeine?aeaeaiue.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, oaiaie, ieaiaie. I?aaenoaaeaia
i?aoey ? o?aaiaioii iaoeiai-aeine?aeii? ?iaioe “Ee?i?ei-iaoiaaiaoe/i?
iniaeeaino? i?ciueiai iaiiaoaeueiiai ia??iaeo o aeiiioaieo
iiaiia?iaeaeaieo ae?oae c ii?ooaiiyie aaeaioaoe?? a ia?o? aei? aeeooy”,
aeeiiaii? ia eaoaae?? iaae?ao??? ?aaii-O?aie?anueei? aea?aeaaii?
iaaee/ii? aeaaeai?? a ?aieao i?ia?aie “Ae?oe Oe?a?ie” (aioo??oiy
?a?no?aoe?y 01.10.03O.96I) oa /anoeiith iniiaiiai iaoeiaiai iai?yieo
aeaaeai?? “?ic?iaea iiaeo iaaee/ieo oaoiieia?e oa noaiaea?o?a yeino?
ae?aaiinoeee oa e?eoaaiiy iaeaaaeeea?oeo ia?ioaeoe?eieo caoai?thaaiue”,
yeee ?ic?iaey?oueny aeaaeai??th a iaaeao i?aeia?iaeii? ?ioaa?aeueii?
i?ia?aie NAII? – AIIC – Oe?a?ia (1995-2000).

Iaoa aeine?aeaeaiiy. Aaeineiiaeaiiy iaoiae?a ae?aaiinoeee oa i?aeaeuaiiy
aoaeoeaiino? e?eoaaiiy iiaiia?iaeaeaieo ae?oae c iiaaiii??th ?
a?iiene/ii-?oai?/iith aioeaoaeiiao??th.

Caaea/? aeine?aeaeaiiy:

1. Ioe?ieoe ee?i?/i? iniaeeaino? aaeaioaoe?? aeiiioaieo iiaiia?iaeaeaieo
ae?oae c a?iiene/ii-?oai?/iith aioeaoaeiiao??th ? c iiaaiii??th ia oe?
ia?eiaoaeueii? ai-oeaoaeiiao??.

2. Aea/eoe ??aaiue na?aaei?o iieaeoe a e?ia? iiaiia?iaeaeaieo c
a?iiene/ii-?oai?/iei o?aaeaiiyi iiceo ? c iiaaiii??th ia oe?
a?iiene/ii-?oai?/ii? aioeaoa-eiiao??.

3. Aecia/eoe noai ee?oeiiiai oa aoii?aeueiiai ?ioi?oaoo o iaiiaeyo c
a?ii-ene/ii-?oai?/iei o?aaeaiiyi iiceo oa c iiaaiii??th ia oe?
a?iiene/ii-?oai?/ii? aioeaoaeiiao??.

4. Aea/eoe aeoeai?noue ieaciaoe/ieo oa?iaio?a aia?aaoe/iiai iai?io oa
ae?eie?co e?aaoeie?iace oa eaeoaoaeaa?ae?iaaiace o ae?oae c
a?iiene/ii-?oai?/iei o?aaeaiiyi aieiaiiai iiceo oa c iiaaiii??th ia oe?
a?iiene/ii-?oai?/ii? aioeaoaeiiao??.

5. Ii??aiyoe aeeiai?eo iieaciee?a aoii?aeueiiai oa ee?oeiiiai ?ioi?oaoo,
aeoeaiino? e?aaoeie?iace ? eaeoaoaeaa?ae?iaaiace ne?iaaoee e?ia? i?e
a?iiene/ii-?oai?/ieo o?aaeaiiyo aieiaiiai iiceo oa o ae?oae c
iiaaiii??th ia oe? a?iiene/ii-?oai?/ii? aioeaoaeiiao?? ia oii?
caaaeueiii?eeiyoiai e?eoaaiiy ? oa?ai?? c aeeth/aiiyi eiiiiceoo
iaoaaie?/ieo ei?aeoi??a: e?ii?ai? eeneioe, a?oai?i?a Aa ? Aa.

Iaoeiaa iiaecia ?iaioe. Aia?oa aeiaaaeaii, ui i?e ii?ooaii? i?ciuei?
iinoiaoaeueii? aaeaioaoe?? o ae?oae c a?iiene/ii-?oai?/iith
aioeaoaeiiao??th oa a?iiene/ii-?oai?/iith aioeaoaeiiao??th ? iiaaiii??th
iayaiee aiaeioieneeic ??ciiai nooiaiy oyaeeino? ca ee?i?/ieie iciaeaie
oa ci?iaie ai?noo na?aaei?o iieaeoe o e?ia?.

O iaiiaeyo c iiaaiii??th ia oe? a?iiene/ii-?oai?/ii? aioeaoaeiiao??
anoaiiaeaii aeinoia??i? ci?ie aeoeaiino? ne?iaaoeiaeo oa?iaio?a
e?aaoeie?iace ? eaeoaoaeaa?ae?iaaiace, iieacieee yeeo iiaeooue neoaeeoe
e?eoa???i oyaeeino? o?aaeaiiy oa aoaeoeaiino? e?eoaaiiy oai?eo iaiiaeyo.

Aia?oa iaa?oioiaaii iiaeeea?noue iioei?caoe?? aeoeaiino? aicei?a a
i?aai?ci? iiaiia?iaeaeaieo iaethe?a oeyoii canoinoaaiiy a eiiieaen?
e?eoaaiiy eiiiiceoo i?aia?ao?a iaoaaie?/ii? ae?? (e?ii?ai? eeneioe,
a?oai?i?a Aa ? Aa), aeiaaaeaii ?o iiceoeaiee aieea ia
ee?i?ei-iaoaaie?/io oa ?ioiieia?/io aaeaioaoe?th iiaiia?iaeaeaieo
iaethe?a c a?iiene/ii-?oai?/iei o?aaeaiiyi aieiaiiai iiceo oa c
iiaaiii??th ia oe? a?iiene/ii-?oai?/ii? aioeaoaeiiao??.

I?aeoe/ia cia/ei?noue ?iaioe. A ?acoeueoao? i?iaaaeaieo aeine?aeaeaiue
aeey ?aiiuei? ae?aaiinoeee ii?ooaiue iaoaaie?/ieo i?ioean?a o
iiaiia?iaeaeaieo ae?oae c a?iiene/ii-?oai?/iith aioeaoaeiiao??th ? c
iiaaiii??th ia oe? a?iiene/ii-?oai?/ii? aioeaoaeiiao?? cai?iiiiiaaii
aecia/aiiy a ne?iaaooe? e?ia? ??aiy na?aaei?o iieaeoe oa aeoeaiino?
ieaciaoe/ieo oa?iaio?a e?aaoeie?iace ? eaeoaoaeaa?ae?iaaiace.

Ia??oioiaaii oa ?ic?iaeaii iaoiae iioei?caoe?? iinoiaoaeueii?
ee?i?ei-iaoaaie?/ii?, ?ioiieia?/ii? aaeaioaoe?? iiaiia?iaeaeaieo
iaethe?a c a?iiene/ii-?oai?/iei o?aaeaiiyi iiceo oa c iiaaiii??th ia oe?
a?iiene/ii-?oai?/ii? aioeaoaeiiao?? oeyoii aeeth/aiiy a eiiieaen
e?eoaaiiy eiiiiceoo i?aia?ao?a iaoaaie?/ii? ae?? (e?ii?ai? eeneioe,
a?oai?i?a Aa ? Aa).

Ai?iaaaeaeaiiy ?acoeueoao?a aeine?aeaeaiiy o i?aeoeeo. ?acoeueoaoe
aeine?aeaeaiiy cai?iaaaeaeai? a i?aeoeeo ?iaioe ?aaii-O?aie?anueei?
iaeanii? ee?i?/ii? e?ea?i? oa ?aaii-O?aie?anueeiai iaeaniiai
ia?eiaoaeueiiai oeaio?o, ?aeiiieo e?ea?aiue ?aaii-O?aie?anueei? iaeano?
(I.Eieiiey, i.Aiai?iae/aie, i.Aeieeia).

Iniaenoee aianie caeiaoaa/a. I?e aeeiiaii? ?iaioe iniaenoi i?iaaaeaii
aeaoaeueiee ee?i?/iee aiae?c ia?aa?ao aioa-, ?io?a- oa iaiiaoaeueiiai
ia??iaeo ? ?acoeueoao?a a?io?i?/iiai oa ?ioiieia?/iiai ianoaaeaiiy o 114
iiaiia?iaeaeaieo ae?oae. Iaa?oioiaaii iaoiae iaoaaie?/ii? ei?aeoe?? o
iaiiaeyo c a?iiene/ii-?oai?/iith aioeaoaeiiao??th ? c iiaaiii??th ia oe?
a?iiene/ii-?oai?/ii? aioeaoaeiiao??. Aaoi?ii iniaenoi i?iaaaeaii
iaoaiaoe/io ia?iaeo io?eiaieo ?acoeueoao?a, ianoaaeaiiy ae?oae, iaienai?
an? ?icae?ee aeena?oaoe?? ? noi?ioeueiaai? aeniiaee oa i?aeoe/i?
?aeiiaiaeaoe??.

Ai?iaaoe?y ?iaioe. Iniiai? iieiaeaiiy ?iaioe aeiiia?aeaeenue ia iaoeia?e
eiioa?aioe?? ?aaii-O?aie?anueei? aea?aeaaii? iaaee/ii? aeaaeai?? IIC
Oe?a?ie ii cae?i/aieo iaoeiai-aeine?aeieo ?iaioao (1998), ia
iaoeiai-i?aeoe/i?e eiioa?aioe?? ?aaii-O?aie?anueei? Anioe?aoe??
iaae?ao??a (I.?aaii-O?aie?anuee, 1997), eo?nao i?aeaeuaiiy eaae?o?eaoe??
iaae?ao??a oa iaiiaoieia?a i?e ?aaii-O?aie?anuee?e aea?aeaai?e iaaee/i?e
aeaaeai?? (1998).

Ioae?eaoe?y ?acoeueoao?a aeine?aeaeaiue. Iniiai? iieiaeaiiy aeena?oaoe??
iioae?eiaaii o 4 ae?oeiaaieo a aeo?iaeao ?iaioao.

Ianya oa no?oeoo?a aeena?oaoe??. Aeena?oaoe?th aeeeaaeaii ia 152
noi??ieao ae?oeiaaiiai oaenoo. ?iaioa neeaaea?oueny c anooio, iaeyaeo
e?oa?aoo?e, 3 ?icae?e?a aeanieo niinoa?aaeaiue, aiae?co oa iaaiai?aiiy
io?eiaieo ?acoeueoao?a, aeniiae?a, i?aeoe/ieo ?aeiiaiaeaoe?e, nieneo
aeei?enoaieo e?oa?aoo?ieo aeaea?ae, yeee i?noeoue 218 aeaea?ae, c ieo
122 a?o/eciyieo ? 96 caei?aeiiieo, ye? caeiathoue 21 noi??ieo, ?iaioo
?ethno?iaaii 67 oaaeeoeyie ? 7 ?enoieaie, ye? caeiathoue 6 noi??iie.

CI?NO ?IAIOE

Iaoa??aee ? iaoiaee ianoaaeaiiy

Aeey ae??oaiiy iinoaaeaieo caaaeaiue ni?anoaaeaii ?acoeueoaoe
ee?i?ei-a?io?i?/iiai, ?ioiieia?/iiai oa ?ino?oiaioaeueiiai ianoaaeaiiy
114 aeiiioaieo iiaiia?iaeaeaieo ae?oae a?eii a?ae a aei 28 aei?a aeeooy,
ye? e?eoaaeenue o a?aeae?e? iaoieia?? iiaiia?iaeaeaieo ae?oae iaeanii?
ee?i?/ii? e?ea?i? I.?aaii-O?aie?anueea. C ieo o 73 iaethe?a
ae?aaiinoiaaii ia?eiaoaeueio aioeaoaeiiao?th, o 41 – iiaaiii?th ia oe?
a?iiene/ii-?oai?/ii? aioeaoaeiiao??. A?oio ii??aiyiiy neeaee 15
caei?iaeo aeiiioaieo iiaiia?iaeaeaieo, o yeeo ia?eiaoaeueiee ia??iae
i?io?eaa aac oneeaaeiaiue.

I?e ioe?ioe? noaio iaiiaeyo aeei?enoai? aeai? aeooa?nueeiai aiaiiaco
iaoiaeii aiae?co iaaee/ii? aeieoiaioaoe?? (ea?oe ?icaeoeo
iiaiia?iaeaeaiiai a iieiaiaiio aoaeeieo, aeienee c ?noi???
noaoe?iia?iiai oai?iai).

An?i ae?oyi i?iaaaeaia eiiieaenia ee?i?/ia ianoaaeaiiy. I?iaiaeeeanue
aeeiai?/ia ioe?iea iaa?ieia?/iiai ? niiaoe/iiai noaio. Oa?aeoa?enoeea
iaa?ieia?/iiai noaoono aeeth/aea ioe?ieo iice iiaiia?iaeaeaiiai,
i’yciaiai oiiono, a?iaeaeaieo ?aoeaen?a, iiaaae?iee, neooiaeo ? ?ooiaeo
?aaeoe?e. Nooi?iue oyaeeino? o?aaeaiiy aieiaiiai iiceo aecia/aee o
a?aeiia?aeiino? ? eeaneo?eaoe??th TH.A-sseoi?ia oa A.?-ssiiieuenueei?
(1979).

An? ae?oe iaeyioo? niaoe?ae?noaie, niinoa??aaeenue iooaeueiieiaii ?
iaa?iiaoieiaii.

I?iaiaeeeanue aeaeo?iea?ae?ia?ao?y ia aia?ao? “Ceaeo?iea?aeeia?ao CE
1O-ICI” a o?ueio noaiaea?oieo oa a?oaeieo a?aeaaaeaiiyo, a oaeiae
oeueo?acaoeiaa neaioaaiiy aieiaiiai iiceo ? na?oey ia aia?ao? “A?ina 880
– 630” aeao/eeaie naeoi?iiai neaioaaiiy 5,0 ? 7,5iAoe. 43 ae?oyi
i?iaaaeaii ?aioaaiieia?/ia ianoaaeaiiy.

Ia 2-3 ? ia 9-10 aeaiue i?ney iinooieaiiy aei noaoe?iia?o i?iaiaeeeinue
eaai?aoi?ia ianoaaeaiiy, ni?yiiaaia ia ooi/iaiiy oa?iaioaoeaiiai oa
?ioiiiai noaoono i?aai?cio aeeoeie ? aecia/aiiy o ne?iaaooe? e?ia? ??aiy
na?aaei?o iieaeoe.

Aeoeai?noue e?aaoeie?iace (EE) ? eaeoaoaeaa?ae?iaaiace (EAeA) aecia/aee
ia a?io?i?/iiio aiae?caoi?? “8?a1 ?ao 1904 ??ec” c aeiiiiiaith
oano-nenoai ? iaoiaeeee o??ie (NOA).

Eiioeaio?aoe?y ne?iaaoeiaeo ?ioiiaeiaoe?i?a eean?a I, I ? A aecia/aeanue
iaoiaeii ?aae?aeueii? ?ioiiaeeooc?? (Iain?i? I., 1965). Iieacieee
ee?oeiii? eaiee ?ioi?oaoo aecia/aeenue iaeii/aniei aeyaeaiiyi
A-?icaoeiooai?thth/eo (A-?OE), iaaaioaaeaieo eiiieaiaioii
A-?icaoeiooai?thth/eo ee?oei (AAN-?OE) oa ioeaaeo ee?oei (Iaia?ay E?.,
1974), a oaeiae oaio?e?i/ooeeaeo (OO*-?OE) oa oaio?e?i?ace-noaioieo – A
– ?icaoeiooai?thth/eo e?ioioeeo?a (OO?-?OE).

??aaiue na?aaei?o iieaeoe (?NI) aecia/aiee niaeo?ioioiiao?e/iei
iaoiaeii. Nooiai? oyaeeino? aiaeioieneeico aeyaeyeenue ca
cai?iiiiiaaiith A.A.I?oaeueniiii ? I-I.Iaaee?iaith (1991) noaiith.

A eiiieaeniiio e?eoaaii? iiaiia?iaeaeaieo ae?oae c iiaaiii??th ia oe?
a?ii-ene/ii-?oai?/ii? aioeaoaeiiao?? (A?A) ? c ia?eiaoaeueiith
aioeaoaeiiao??th canoiniaaii eiiiiceo iaoaaie?/ieo ei?aeoi??a: e?ii?aa
eeneioa ? a?oai?ie Aa, Aa. Aeaia eiia?ioaaiiy iaoaaie?/ieo ei?aeoi??a
cai?iiiiiaaia A?aoiooaeiii A.?. (1987) ia i?aenoaa? oe?eani?yiiaaieo
aenia?eiaio?a. Aeei?enoaii ii?aeiaia aei i’yciaa aaaaeaiiy 0,5% ?ic/eio
e?ii?ai? eeneioe a aeic? 1o§/e?7aeiao ia i?ioyc? 15 aei?a c ii/a?aiaei
aaaaeaiiyi /a?ac aeaiue 1% ?ic/eio ?eaioeaa?i-iiiiioeeaioeaeo a aeiaia?e
aeic? 8 oa/aeiao ? i??eaeienaeueoinoaoo a aeic? 50 o§/aeiao.

A caeaaeiino? a?ae iaoiaeo oa?ai?? ae?oe iiae?eai? ia 4 iaeii??aei? ca
iniiaiei ae?aaiicii, oyaee?noth noaio ? ianith o?ea a?oie. Aei ia?oi?
(19 iaethe?a) ? ae?oai? (27 ae?oae) a?oie aa?eoee ae?oe c iiaaiii??th ia
oii? A?A. O?aoth (27 iiaiia?iaeaeaieo) ? /aoaa?oo (14 iaiiaeyo) neeaee
ae?oe c A?A aac iiaaiii??.

Iaiiaeyoai 1-i? ? ???-i? a?oi aei eiiieaeno e?eoaaiiy aeeth/ai?
i?aia?aoe iaoaaie?/ii? ae??. Ae?oe I-i? ? ?O-i? a?oi i?ioiaeeee eo?n
noaiaea?oiiai e?eoaaiiy. Aoaeoeai?noue oa?ai?? ioe?ithaaeanue ca
aeeiai?eith ee?i?/ieo, a?io?i?/ieo oa ?ioiieia?/ieo iieaciee?a

Noaoenoe/ia ia?iaea i?iaaaeaia iaoiaeii aa??aoe?eii? noaoenoeee c
aeei?enoaiiyi e?eoa??th Nouethaeaioa

Iniiai? ?acoeueoaoe aeine?aeaeaiue oa ?o iaaiai?aiiy

I?iaaaeai? aeine?aeaeaiiy aeyaeee, ui a?eueo?noue ae?oae ia?iaeeeenue o
iaoa??a iioeiaeueiiai aeey ?ai?iaeoeoe?? a?eo – 22-24 ?iee. A?eueoa
iieiaeie iaiiaeyo (54,4%) ia?iaeeeenue a?ae ia?oi? aaa?oiino? ? iieia?a,
iaeaea o?aoeia (30,7%) – a?ae ae?oaeo iieia?a, a?ae o?ao?o iieia?a ?
a?eueoa ia?iaeeeenue 14,8% ae?oae.

Na?aae oaeoi??a ia?eiaoaeueiiai ?eceeo a?iien?? o ieiae?a ?
iiaiia?iaeaeaieo ae?oae o 63,2% aeiaaee?a aeyaeaia aiai?y aaa?oiino?, o
42,9% – aanoice, o 21,1% – ae-no?aaai?oaeueia iaoieia?y o iaoa??. O
a?eueoino? aeiaaee?a (67,9%) a?aei?/aia ii?aeiaiiy aioa- oa
?io?aiaoaeueieo oaeoi??a ?eceeo a?iien??. I?ae /an iieia?a o 42,1%
aeiaaee?a niinoa??aaeanue ano?en?y ieiaea, o 37,4% neaa?noue iieiaiai?
ae?yeueiino? ?c canoinoaaiiyi ?iaeinoeioeyoe??, o 20,2% – no??ie?
iieiae, o 21,0% – o?eaaeee (a?eueoa 6 aiae.) aacaiaeiee ia??iae. O 54,8%
niinoa?aaeaiue aeyaeai? 3 ? a?eueoa oaeoi??a ?eceeo. Ii??aiyiiy oaeoi??a
ia?eiaoaeueiiai ?eceeo o iaethe?a c iiaaiii??th ia oe? A?A ? c A?A
aeyaeei, ui o iaiiaeyo c iiaaiii??th /ano?oa niinoa??aaeenue ano?en?y a
iieiaao (51,2% i?ioe 36,9% o ae?oae c A?A), ani??aoe?eiee neiae?ii ?
neiae?ii aeeoaeueieo ?iceaae?a (34,1% i?ioe 9,6%), i?iaaaeaiiy
?ioaineaii? oa?ai?? a ?iaecae? ?c canoinoaaiiyi OAE (21,9% i?ioe 19,4%).

Ia i?e?iaeiiio aiaeoaaii? ciaoiaeeeenue 84,2% iaethe?a, 7,9% – ia
ci?oaiiio, 7,1% – ia ooo/iiio. A noaoe?iia? 24 aeeoeie iinooieee c?
noaiii na?aaeiuei? oyaeeino?, 62-c oyaeeei, 28 – ?c ae?ae oyaeeei
noaiii.

Oa?aeoa?iith iciaeith iinoiaoaeueii? aaeaioaoe?? iiaiia?iaeaeaii?
aeeoeie neoaeeoue aeeiai?ea iane o?ea. I?e aiae?c? io?eiaieo
?acoeueoao?a aeyaeeinue, ui a na?aaeiueiio iana o?ea o iiaiia?iaeaeaieo
noaiiaeea 3403,a±30,9a, ui a?aeiia?aea? na?aae-iueinoaoenoe/iei
iieacieeai ? ? iioeiaeueiith aeey iiaeaeueoiai ?icaeoeo.

Oyaee?noue noaio i?e iinooieaii? nooo?ai aieeaaea ia a?aenioie ao?aoe
iane o?ea, yeee o iaiiaeyo c? noaiii na?aaeiuei? oyaeeino? neeaaeaa
7,6±0,3%, a?aeiia?aeii o ae?oae c oyaeeei ? ae?ae oyaeeei noaiii –
10,2+0,7% oa 12,7±1,6%. I?e iinooieaii? ia a?aei?/aii ?icoiaeaeaiue o
nooiaiyo ao?aoe iane o?ea o iaiiaeyo c iiaaiii??th ia oe? A?A ? o
iiaiia?iaeaeaieo c A?A (a?aeiia?aeii 10,7±1,3% ? 9,4+0,8%). Aea
a?aeiiaeaiiy iane o?ea o ae?oae c iiaaiii??th ia oe? A?A ianooiaei ia
aea? aeiae i?ci?oa, i?ae o ae?oae c A?A, ui iiaea na?ae/eoe i?i a?eueo
aeeaie? c?ooaiiy iaoaaie?/ieo i?ioean?a, cie?aia ieanoe/ieo, oa
aeao?oeeo iae?ia?a?a.

O a?eueo ye iieiaeie iiaiia?iaeaeaieo (55,3%) a iieiaiaiio aoaeeieo
cao?eniaaii neiae?ii i?eai?/aiiy OeIN. I?e iinooieaii? aei noaoe?iia?o
ae?oaiai aoaio aeoiaeaeoaaiiy /anoea oeueiai neiae?iio ciaioeeanue aei
41,6%, ui ?icoe?iaii iaie ca ni?eyoeeao ianoaaeio. A i?ciueiio
iaiiaoaeueiiio ia??iae? aeaui ca?eueoeeanue /anoea neiae?iio
iae?i-?aoeaeoi?ii? caoaeeeaino? (32,9% i?ioe 28,1%), caoa ciaioeeanue
aeiey a?ia?oaic?eii-a?ae?ioeaoaeueiiai neiae?iio (3,5% i?ioe 7,0%).

I?e ii??aiyii? no?oeoo?e iaa?ieia?/ieo neiae?ii?a o ae?oae c iiaaiii??th
ia oe? A?A ? o ae?oae c A?A aeyaeaii, ui o iaiiaeyo c iiaaiii??th ia oe?
A?A /ano?oa cono??/a?oueny neiae?ii i?eai?/aiiy OeIN (53,7% i?ioe
34,2%). Ia aeeeth/aii, ui i?e iiaaiii?? ia oe? A?A a?eueoeie ? nooi?iue
a?iien??, ?iceaaee aioo??ee?oeiiiai iaoaaie?cio ? a?eueo ae?aaeaiee
aiaeioieneeic, ? oea i?eaiaeeoue aei iineeaiiy iaa?ieia?/ii?
neiioiiaoeee.

A oe?eiio cia/ii? ??cieoe? a ci?iao i’yciaiai oiiono oa oiiaieo
?aoeaen?a o ae?oae c iiaaiii??th ia oe? A?A ? o iaethe?a c A?A ia
a?aei?/aii.

O 12,5% iaiiaeyo c i?iyaaie iiaaiii?? niinoa??aaeinue i?aeaeuaiiy
oaiia?aoo?e o?ea, o 70,7% – cieaeaiiy aiaoeoo. O 41,5% aeiaaee?a
cao?eniaaia coieiea a iaae?aii? iane o?ea. O 64,8% aeyaeai? ii?ooaiiy
nio, o 65,9% – caeoooy aeeaioa, o 56,1% – aethaioa ? c?eaoaaiiy.. Cia/ia
/anoeia iiaiia?iaeaeaieo c iiaaiii??th iinooieea c iciaeaie ii?ooaiiy
i?e?ioee?eoeyoe??. A 60,9% iaethe?a aoea iayaia ae?ae?noue oe??ieo
iie?ea?a ?c n??oaaoei a?aeo?ieii, 78,2% – iaee iineeaiee noaeeiiee
?enoiie, o 95,1% iaiiaeyo aeyaeaii ia?ei?aeueiee oa ae?ioe?aiic.
A?eueo?noue c iaaaaeaieo neiioii?a a ia??iae? iiaiia?iaeaeaiino? iiaea
aeieeaoe ? i?e iiaaiii??, ? i?e A?A.

Caiaaeaiiy iiaeaoeeaeo i?noeue a?oaeii? ee?oee aeyaeaia o 87,8% ae?oae,
neiioii ai/eiiiae?aii? a?oaeii? ee?oee iaa i?noea o 17,1% ae?oae c
iiaaiii??th ia oe? A?A.

O 19,5% iaiiaeyo c iiaaiii??th ia oe? A?A i?e ia?eon?? niinoa??aaeinue
aei?a/aiiy ia?eooiaaiiai caoeo, o 39,0% – oeiiai?o c aei?i/aiei
a?aeo?ieii, o 41,5% ae?oae – ei?iaeiaee caoe. Aoneoeueoaoeaii o 68,3%
iaethe?a aeyaeaii ineaaeaia, o o?aoeie – 31,7% – aei?noea aeeoaiiy, o
46% i?ineooiaoaaeanue e?ai?oaoe?y, o 65,9% iaiiaeyo – aieia? eieaeuei?
ae??aiii?oo?oeaa? o?eie.

Iaaaaeaia na?ae/eoue, ui o iiaiia?iaeaeaieo ae?oae i?e iiaaiii?? ia oe?
IA o?-ceeaeuei? aeai? ? a?aeieie ? iaaeinoaoiuei ?ioi?iaoeaieie. Ia
ia?oee ieai aenooia? iaa?ieia?/ia neiioiiaoeea ? ?iceaaee
i?e?ioee?eoeyoe??. Oea aeiaaa? aecia/aiiy a?eueo /?oeeo e?eoa???a
ae?aaiinoeee.

Na?aae oneeaaeiaiue iiaaiii?? caa?oa? oaaao, ui o iaeaea iieiaeie ae?oae
(51,2%) cao?eniaaii aeeoaeueio iaaeinoaoi?noue ??-iai nooiaiy, a?eueo ye
o o?aoeie (34,2%) – ea?ae?i-?ani??aoi?iee neiae?ii oa ?ioaeoe?eiee
oieneeic ? nooiaiy – o 36,6%. Ia oneeaaeiaia oi?ia iiaaiii?? a?aei?/aia
o 21,9% aeiaaee?a.

?aioaaiieia?/ia ianoaaeaiiy aeyaeei iciaee iaeiia?/ii? aiaieuaai?
a?iioiiiaaiii?? o 32 (78,0%), aeaia?/ii? aiaieuaai? a?iioiiiaaiii?? – o
6 (14,6%), ?i-oa?noeoe?aeueii?” iiaaiii?? – o 3 (7,3%) iaiiaeyo.

I?iaaaeaia aoieieaoe?y na?oey o 4-o ae?oae c iiaaiii??th ia oe? A?A
cana?ae/eea a?aee?eooy iaaeueiiai ioai?o. A iaei??? aeeoeie aei 10-ai
aeiy ia?aaoaaiiy a noaoe?iia?? a?aeaoeinue cae?eooy iaaeueiiai a?eia
A?aee?eoa iaaeueia a?eii iiaeia ?icoe?ithaaoe ye ia?nenoaioe?th
oaoaeueii? eiioi?eaoe?? o a?aeiia?aeue ia a?iien?th O an?o 4-o iaiiaeyo
a aiaiiac? a?aei?/aia ano?en?y a iieiaao, o 2-o – ?ani??aoi?iee
aeeno?an-neiae?ii.

Aeaeo?iea?ae?ia?ao?/ia ianoaaeaiiy aeyaeei iciaee a?iien?? i?iea?aeo o 7
iaethe?a, c ieo o?i? – c iiaaiii??th ia oe? A?A.

I?e i?iaaaeaii? iooaeueiineii?? ia 2-3 aeaiue ia?aaoaaiiy a noaoe?iia??
o 42 iiaiia?iaeaeaieo (36,8%) aeyaeaii aia?iiao?th, o o?ueio (2,6%
ae?oae) niinoa??aaeenue e?iaiaeeeae a n?oe?aeo.

I?e aiae?c? iieaciee?a aaiia?aie o iiaiia?iaeaeaieo c A?A ii??aiyii c
ae?oueie c iiaaiii??th ia oe? A?A aeyaeaiee a?eueoee a?aenioie
e?ioioeeo?a (53,6% i?ioe 42,8%). A eaeeia?ai? ae?oae c iiaaiii??th ia
oe? A?A a?aei?/aia iaeaea iaeiaeiaa e?euee?noue iaeo?io?e?a ?
e?ioioeeo?a, o ae?oae c A?A iaa i?noea e?ioioeeoic.

??aaiue caaaeueiiai a?eeo a e?ia? ae?oae c iiaaiii??th ia oe? A?A ? o
iiaiia?iaeaeaieo c IA aoa a iaaeao ii?ie, aea o an?o ae?oae a?aei?/aia
oaiaeaioe?y aei cieaeaiiy aeiaoe?iiai? o?aeoe??.

O 19 ae?oae (14 iaiiaeyo c A?A ? 5 – c iiaaiii??th ia oe? A?A)
cao?eniaaia iai?yia a?ia?a?e??oa?iai?y na?aaeiueiai nooiaiy.

Nooi?iue aiaeioieneeico aecia/aee ii ??aith na?aaei?o iieaeoe a
ne?iaaooe? e?ia? Anoaiiaeaii, ui o ae?oae c iiaaiii??th ia oe? A?A
??aaiue na?aaei?o iieaeoe o e?ia? aoa a 2,3 ?ace aeuei, i?ae o iaiiaeyo
c A?A.

O 34,2% iaiiaeyo c A?A aiaeioieneeic aoa a?aenooi?i, o 65,8% iaethe?a
cao?eniaaii aiaeioieneeic ? nooiaiy.

Aiaeioieneeic ??cieo nooiai?a oyaeeino? niinoa??aaany o an?o ae?oae c
iiaaiii??th ia oe? A?A. I?e/iio o 75,6% aeiaaee?a oea aoa aiaeioieneeic
??-??? nooiai?a, ui na?ae/eoue i?i i?e?aeiaiiy o ieo aiaeioieneeico
?ioaeoe?eiiai aaiaco (?enoiie 1).

Iayai?noue neiae?iio aiaeiaaiii? ?ioieneeaoe?? ? nooiaiy o iaethe?a c IA
iiaeiia aeeeeeaoe iniaeeao oaaao, ine?eueee oae? ae?oe, aiane?aeie
ineaaeaiiy nenoai naii?aaoeyoe??, caa?iceea? ii iiaeeeaino? i?e?aeiaiiy
aei iniiaiiai iaoieia?/iiai i?ioeano ai?eii-caiaeueieo oneeaaeiaiue.

Ca ?acoeueoaoaie iaoiai aeine?aeaeaiiy i?i i?e?aeiaiiy aei A?A caiaeaiiy
eaaaiue na?ae/eoue iiyaa aiaeioieneeico ??-??? nooiai?a.

O an?o ianoaaeaieo ae?oae aeyaeaii cieaeaiiy ai?noo ?ioiiaeiaoe?io I a
ne?iaaooe? e?ia?. Ii??aiyiiy iieaciee?a eiioeaio?aoe?? ?ioiiaeiaoe?i?a o
ae?oae c A?A ? c iiaaiii??th ia oe? A?A ia aeyaeei noaoenoe/ia cia/eieo
a?aei?iiinoae. I?e/eiith cieaeaiiy ai?noo [email protected] I i/aaeaeii ? a?iien?y,
aeeeeeaia iath ?oeiaoe?y oeaiei ? iineeaia anei?eyoe?y ?§ I.

Aiae?c iieaciee?a ee?oeiiiai ?ioi?oaoo o an?o ianoaaeaieo iaiiaeyo
aeyaea cieaeaiiy /anoee iiioeyoe?? A-?OE ? AAN-?OE ? c?inoaiiy a?aenioeo
ioeaaeo ee?oei. A?aei?/aii aeenaaeain i?ae oaio?e?i/ooeeaeie ?
oaio?e?i?acenoaioieie O-e?ioioeeoaie c? cieaeaiiyi iieacieea
ni?aa?aeiioaiiy OO?-?OE / OO*-?OE o iaethe?a c iiaaiii??th ia oe? A?A –
aei 1,63%, o ae?oae c A?A aei – 1,44%. *anoea A-?OE o ae?oae c
iiaaiii??th ia oe? A?A noaiiaeea 36,5±2,4% i?ioe 43,5±2,5% o iaiiaeyo c
A?A (?0,05) ?
ioeaaeo ee?oei – 38,1±1,1% o ae?oae c iiaaiii??th i?ioe 31,4±2,5% o
iaethe?a c IA (?

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