.

Клініко-патогенетична характеристика і лікування хворих на хронічний обструктивний бронхіт з супутньою ішемічною хворобою серця: Автореф. дис… канд.

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EOAAINUeEEE AeA?AEAAIEE IAAeE*IEE OI?AA?NEOAOIIC OE?A?IE

AeIEEINUeEA Ia??y Aaa??ae?aia

OAeE 612. 017.1: 616. 234-12-005. 4-08

EE?I?EI-IAOIAAIAOE*IA OA?AEOA?ENOEEA ? E?EOAAIIss OAI?EO IA O?II?*IEE
IANO?OEOEAIEE A?IIO?O C NOIOOIUeITH ?OAI?*IITH OAI?IAITH NA?Oess

14.01.02 – aioo??oi? oai?iae

Aaoi?aoa?ao aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa
iaaee/ieo iaoe

Eoaainuee – 1999

Aeena?oaoe??th ? ?oeiien

?iaioa aeeiiaia a Eoaainueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao?IIC
Oe?a?ie

Iaoeiaee ea??aiee: aeieoi? iaaee/ieo iaoe, i?ioani?Ioo?ioeaa Aieiaeeie?
Aiaoiae/,

Eoaainueeee aea?aeaaiee iaaee/iee oi?aa?neoao IIC Oe?a?ie,caa?aeoaa/
eaoaae?e aini?oaeueii? oa?ai?? ?2

Io?oe?ei? iiiiaioe: aeieoi? iaaee/ieo iaoe, i?ioani?Aaa?enthe Aieiaeeie?
Einoyioeiiae/?inoeooo ooec?ao??? ? ioeueiiiieia?? ?i. O.A. ssiianueeiai
AII Oe?a?ie (i. Ee?a), caa?aeoaa/ ee?i?ei-ooieoe?iiaeueiiai a?aeae?eo

aeieoi? iaaee/ieo iaoe, i?ioani?Ieioe?i Aieiaeeie? sseiae/Eoaainueeee
aea?aeaaiee iaaee/iee oi?aa?neoaoIIC Oe?a?ie, caa?aeoaa/ eaoaae?e
oa?ai?? OIaeI

I?ia?aeia onoaiiaa: Iaoe?iiaeueiee iaaee/iee oi?aa?neoao
?i. I.I.AiaiiieueoeyIIC Oe?a?ie (i. Ee?a), eaoaae?a aini?oaeueii?
oa?ai?? ? 2

Caoeno aeena?oaoe?? a?aeaoaeaoueny “29” aeiaoiy 1999 ?. i 8-30
aiaeei?ia can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee E.29.600.01 i?e
Eoaainueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao? IIC Oe?a?ie (348045,
i. Eoaainuee, ea. 50??//y Iai?iie Eoaainueea, 1; o. 54-85-57)

C aeena?oaoe??th iiaeia iciaeiieoeny a iaoeia?e a?ae?ioaoe? Eoaainueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo (348045, i. Eoaainuee, ea. 50??//y
Iai?iie Eoaainueea, 1)

Aaoi?aoa?ao ?ic?neaiee “20” na?iiy 1999 ?.

A/aiee nae?aoa?niaoe?ae?ciaaii? a/aii? ?aaee,aeieoi? iaaee/ieo iaoe,
i?ioani? ________________ A.?. Eieii??oeue

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie. A inoaii? aeanyoee?ooy iicia/eeany /?oea
oaiaeaioe?y aei ?inoo caoai?thaaiino? ia o?ii?/iee a?iio?o (ca aeaieie
Anana?oiuei? i?aai?caoe?? ioi?iie caei?ia’y caoai?thaaiiy cono??/a?oueny
o 38 % ianaeaiiy a?eii iica 45 ?ie?a ? o 47 % – ca 55 ?ie?a), yea
iaoiiaeaia ieceith i?e/ei (Oauaiei TH.?., 1997). A?eueo?noue
aeine?aeiee?a iaceaathoue na?aae ieo neeueia caa?oaeiaiiy aoiinoa?iiai
iia?o?y, iniaeeai o aaeeeeo i?noao ? ?iaeono??aeueieo oeaio?ao,
??ciiiai?oieie aa?aneaieie iiethoaioaie (Naiaiiaa ?.?. ? ni?aaao., 1993;
Ieioe?i A.ss., 1998), ui iaoiiaeth? o?ii?/ia ooeiaeaeaiiy neeciaeo
iaieiiie a?iio?a ? a?iio?ie, aeieeiaiiy iaoaieac?? iie?eaiiai ai?oae?th
(Linden M. et al., 1993), cieaeaiiy ooieoe?iiaeueii? aeoeaiino?
aeueaaiey?ieo iae?ioaa?a (Hadnagy W., 1994), ?icaeoie o?a?ico a
eaaaiaa?e ia?aio?i?, ou?eueiaiiy no?iie aeueaaie, ae??aieo eaaaiaaeo
a?oa??e ? a?oa??ie, iia??oaiiy ae?aiaaeii? ooieoe?? oa niaci a?iio?a
(Rennard S.I. et al., 1993). E??i oiai, cacia/ai? /eiieee aeeeeeathoue
nenoaiia cieaeaiiy ?aaeoeaiino? i?aai?cio, noai?thth/e ia?aaeoiiae aeey
?icaeoeo ?ioaeoe?eieo caoai?thaaiue (Postma D.S. et al., 1995). Ne?ae
a?aecia/eoe, ui c ?icaeoeii ci?i o eaaaiyo ae?y iani?eyoeeaeo aeciaaiieo
/eiiee?a, ui aeeeeea? iioeiaeaeaiiy, ona a?eueo c?inoa?, oiio ye
ciaioo?oueny cae?ai?noue eaaai?a ae?i?ioaaoe iiethoaioe – ooai?th?oueny
naiai ?iaeo “oeaia eiei” (Sweeney T.D. et al., 1995). I?e oaeiio
cia/iiio iioe?aii? caoai?thaaiiy aoaeoeai?noue e?eoaaiiy caeeoa?oueny
iaaeinoaoiueith – e?eoaaeuei? noaie, ui ?niothoue, /anoi ia o?eueee ia
i?ecaiaeyoue aei aee?eoaaiiy, aea e ia iie?auothoue yeino? aeeooy oai?eo
(*o/aeei A.I., 1997). Iniaeeai? aeooaeueiino? iaaoea o oaia??oiueiio
/an? i?iaeaia noi?niaiiy o?ii?/iiai iano?oeoeaiiai a?iio?oo (OIA) oa
?oai?/ii? oai?iae na?oey (?ON), aiane?aeie, c iaeiiai aieo, c?inoaiiy
caoai?thaaiino? ia iaeaeaa caoai?thaaiiy, a c ?ioiai – iioe?aiino? iaio
caoai?thaaiue o a?eia?e a?oi? iica 40 ?ie?a, ni?euei?noth aeayeeo
/eiiee?a ?eceeo, cie?aia iae?iiy, ni?euei?noth iaoiaaiaoe/ieo
iaoai?ci?a, iniaeeai cnoao aaeaino “ia?aeenia ieeneaiiy e?i?ae?a –
aioeieneaeaioiee caoeno” (“IIE–AIC”), a oaeiae ae?aaeaiei aca?iiei
iaoyaeaiiyi ia?aa?ao (Wallwork J., 1994; Hawthorne V.M. et al., 1995).

C iaeyaeo ia cia/io ?ieue ii?ooaiue o nenoai? “IIE–AIC” i?e iaio
caoai?thaaiiyo, aaaaea?oueny aeioe?eueiei canoinoaaiiy i?aia?ao?a c
aioeieneaeaioiith ? aioea?iienaioiith ae??th a eiiieaeniiio e?eoaaii?
oai?eo ia OIA oa ?ON (Eiaai A.O., 1997; Aaa?enthe A.E., 1998). Iniaeeai
i?eiaaeieie a aeaiiio aeiaaeeo ? i?aia?aoe, ui ii?aeiothoue iaeaeaa
cacia/aieo oa?iaeiaeeiai?/ieo aoaeoe, – aaieoee oa eaa?oeaoei. E??i oiai
aeioe?euei?noue canoinoaaiiy aaieoeeo iineeth?oueny, ia iaoo aeoieo,
caeaoi?noth i?aia?aoo noeioethaaoe ?aaaia?aoe?th a?iio?aeueiiai
ai?oae?th (Eiaeeyinueeee A.?., 1995). Eaa?oeaoei aoa ia?aiei iaie,
a?aoiaoth/e ?ieue o iaoiaaiac? a?iio?aeueii? iano?oeoe?? ?
ei?iia?iniacio e?iieneaaiacieo iaoaaie?o?a a?ao?aeiiiai? eeneioe
(Eie/?i TH.I., 1996; Ieioe?i A.ss., 1998).

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. ?iaioa aeeiiaia
ca?aeii c ieaiii IAe? Eoaainueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo
? ? o?aaiaioii IAe? i??i?eoaoiiai o?iainoaaiiy “Ee?i?ei-iaoiaaiaoe/ia
oa?aeoa?enoeea caoai?thaaiue aioo??oi?o i?aai?a, ?o ei?aeoe?y”,
(? aea?ae?a?no?aoe?? 01980002238).

Iaoa aeine?aeaeaiiy – ?ic?iaeoe aoaeoeai? iaoiaaiaoe/ii iaa?oioiaai?
iaoiaee ei?aeoe?? ii?ooaiue ee?oeiieo /eiiee?a ianiaoeeo?/ii?
?acenoaioiino? a?iio?a ? i?noeaai? nenoaie AIC o oai?eo ia OIA o
noeoiiino? c ?ON.

Caaea/aie ?iaioe aoee:

1) aea/eoe iniaeeaino? ee?i?/ieo i?iya?a o?ii?/iiai iano?oeoeaiiai
a?iio?oo o oai?eo ia ?oai?/io oai?iao na?oey;

2) noa?aeoa?ecoaaoe iniaeeaino? ii?ooaiue ee?oeiiiai ? aoii?aeueiiai
?ioi?oaoo o oai?eo ia o?ii?/iee iano?oeoeaiee a?iio?o ?c noiooiueith
?oai?/iith oai?iaith na?oey;

3) i?iaanoe ioe?ieo e?euee?nieo oa ye?nieo iieaciee?a, ui
oa?aeoa?ecothoue i?noeaao ianiaoeeo?/io ?acenoaioi?noue a?iio?a o oai?eo
ia o?ii?/iee iano?oeoeaiee a?iio?o o noeoiiino? c ?oai?/iith oai?iaith
na?oey;

4) aeine?aeeoe ooieoe?iiaeueiee noai ieneaeaioieo ? aioeieneaeaioieo
nenoai a?iioiaeueaaiey?iiai i?inoi?o o aeaii? eaoaai??? oai?eo;

5) aea/eoe aieea aaieoeeo ? eaa?oeaoeio ia ee?i?/iee ia?aa?a ? oaii
iiiiaethaaiiy ii?ooaiue ee?oeiieo /eiiee?a ianiaoeeo?/ii? ?acenoaioiino?
a?iio?a o oai?eo ia o?ii?/iee iano?oeoeaiee a?iio?o o noeoiiino? c
?oai?/iith oai?iaith na?oey.

Iaoeiaa iiaecia io?eiaieo ?acoeueoao?a. Aoei aeyaeaii iniaeeaino?
ee?i?/ii? ea?oeie oa ia?aa?ao OIA ia oe? ?ON. I?iaeaiiino?iaaii ?ieue
ii?ooaiue aeoeaiino? /eiiee?a ee?oeiii? oa aoii?aeueii? eaiie ?ioi?oaoo,
i?noeaai? ianiaoeeo?/ii? ?acenoaioiino? oa aioeieneaeaioiiai caoenoo
a?iio?a, oiui, o iaoiaaiac? noi?nii? iaoieia?? aeaiiai aeaeo. Aia?oa
iieacaii aca?iica’ycie ooieoe?iiaeueiiai noaio ee?oeiieo /eiiee?a
i?noeaaiai ianiaoeeo?/iiai caoenoo a?iio?a ? ai?noo a
a?iioiaeueaaiey?iiio i?inoi?? aeoeaiaaieo oi?i eenith, ui ?
?ioaa?aeueiei iieacieeii aaeaino a nenoai? “IIE – AIC”. Anoaiiaeaii
ei?aeyoe?eiee aca?iica’ycie i?ae aeyaeaieie ii?ooaiiyie i?noeaaiai
caoenoo ? oyaee?noth aeeoaeueii? iaaeinoaoiino?, ui na?ae/eoue i?i
aca?iicoiiaeai?noue oeeo ?iceaae?a. Iaoiaaiaoe/ii iaa?oioiaaii
aeioe?euei?noue aeeth/aiiy aaieoeeo oa eaa?oeaoeio aei eiiieaeniiai
e?eoaaiiy oai?eo ia OIA o noeoiiino? c ?ON. Aoaeoeai?noue i?aia?ao?a
aioeieneaeaioii? e aioea?iienaioii? ae?? a e?eoaaii? oai?eo ia OIA o
noeoiiino? c ?ON aeiaaaeaia ia i?aenoaa? ee?i?/ieo aeaieo, a oaeiae
oeyoii ioe?iee noaio nenoaie i?noeaaiai caoenoo oa i?yiiai
aeaeo?io?i?/iiai aeine?aeaeaiiy a?iioiaeueaaiey?ieo ciea?a (AAC).

I?aeoe/ia cia/aiiy io?eiaieo ?acoeueoao?a. Ia i?aea?oio? iaoiaaiaoe/ii?
oa?aeoa?enoeee OIA ia oe? ?ON, cie?aia aeyaeaiiai i?eai?/aiiy ee?oeiieo
/eiiee?a i?noeaai? ianiaoeeo?/ii? ?acenoaioiino? oa i?noeaaiai caoenoo,
?ic?iaeaii canaaee aei i?ecia/aiiy aioeieneaeaio?a ? aioea?iienaio?a o
eiiieaeniiio e?eoaaii? oai?eo. Iayai?noue o oai?eo ia OIA c? noiooiueith
?ON ae?aaeaiiai neiae?iio aca?iiiaoyaeaiiy, a oaeiae i?eai?/aiiy
aioeieneaeaioiiai caoenoo oa eeniaaicaeaaeieo iaoaaie?/ieo i?ioean?a a
ee?oeiao, ye? cae?eniththoue i?noeaao ianiaoeeo?/io ?acenoaioi?noue,
aeicaiey? aaaaeaoe aeioe?eueiei canoinoaaiiy i?aia?ao?a, ui ii?aeiothoue
aioeieneaeaioi? oa aioea?iienaioi? aeanoeaino? – aaiaoeeo oa
eaa?oeaoeio. Iaea?eueo ?ioi?iaoeaieie aeey aecia/aiiy aoaeoeaiino?
i?iaaaeaii? aioeieneaeaioii? ? aioea?iienaioii? oa?ai?? o oai?eo c oaeei
aa??aioii noi?nii? iaoieia?? ? iieacieee oeeoia?aie a?iioiaeueaaiey?iiai
i?inoi?o, ??aaiue aeeoo?caeaoiino? ee?oeiieo aeaiaio?a, a oaeiae ai?no a
AAC aeoeaieo oi?i eenith.

?acoeueoaoe aeine?aeaeaiiy ai?iaaaeaeai? a e?eoaaeueio ?iaioo Iaeanii?
ee?i?/ii? e?ea?i? i. Eoaainueea, Iaeanii? ee?i?/ii? ?ioaeoe?eii? e?ea?i?
i. Oa?eiaa, Iaeanii? ee?i?/ii? e?ea?i? i. Aeiiaoeueea,
ioeueiiiieia?/iiai a?aeae?eaiiy i?nueei? e?ea?i? ? 7 i. Eoaainueea. Iia?
aeai?, ui io?eiaii, ai?iaaaeaeai? aei iaa/aeueiiai i?ioeano Eoaainueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo, Aeiiaoeueeiai aea?aeaaiiai
iaaee/iiai oi?aa?neoaoo oa Oe?a?inueei? noiiaoieia?/ii? aeaaeai??.

Iniaenoee aianie caeiaoaa/a. Caeiaoaa/ai iniaenoi i?iaaaeai? ee?i?/ia oa
?ino?oiaioaeueia ianoaaeaiiy 122 oai?eo ia OIA, o 84 c yeeo
caoai?thaaiiy noi?nithaaeiny c ?ON, neeaaeai? e?eoaaeuei? i?ia?aie c
o?aooaaiiyi canaae aei i?ecia/aiiy aaieoeeo oa eaa?oeaoeio. Aaoi?
naiino?eii i?iaiaeeea oeeoieia?/i?, oeeoio?i?/i? oa iiey?ia?ao?/i?
aeine?aeaeaiiy AAC ianoaaeaieo oai?eo i?e aini?oae?caoe??, ia 10-e
aeaiue e?eoaaiiy oa i?e aeaooo? c? noaoe?iia?o, i?eeiaea o/anoue o
i?iaaaeaii? eiiieaenieo aeine?aeaeaiue ?ioiiiai noaoono. Iniaenoi
cae?enithaaeiny aeeiai?/ia niinoa?aaeaiiy oai?eo i?ioyaii onueiai
ia??iaeo noaoe?iia?iiai e?eoaaiiy. Aaoi?ii i?iaaaeaia noaoenoe/ia
ia?iaea ?acoeueoao?a ee?i?/ieo, ?ioiieia?/ieo, oeeoieia?/ieo oa
a?io?i?/ieo iieaciee?a.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. ?acoeueoaoe aeine?aeaeaiiy
aeeth/ai? aei ?a?no?o aaeocaaeo iiaiaaaaeaiue Oe?a?ie (aei. 8–9,
1999 ?.), aeiaaaeai? ia iaoeiai-i?aeoe/i?e eiioa?aioe?? “I?iaeaie ?
ia?niaeoeae ?icaeoeo ee?i?ee aioo??oi?o oai?ia” (i. Oa?e?a, 1995 ?.), ia
THa?eaei?e iaoeiai-i?aeoe/i?e eiioa?aioe??, i?enay/ai?e 100??//th
i?nueei? e?ea?i? ? 4 i. Eoaainueea (i. Eoaainuee, 1995 ?.), ia
V Anaoe?a?inuee?e ia?aae? c ieoaiue iie?ee?i?/ii? ni?aae
(i. Aei?i?iiao?ianuee, 1996 ?.), ia II c’?cae? ooec?ao??a ?
ioeueiiiieia?a Oe?a?ie (i. Ee?a, 1998 ?.).

No?oeoo?a e ianya aeena?oaoe??. Aeena?oaoe?y aeeeaaeaia ia 138 noi??ieao
iaoeiiieno ? aeeth/a? anooi, iaeyae e?oa?aoo?e, iien iaoa??ae?a ?
iaoiae?a aeine?aeaeaiiy, 3 ?icae?ee aeanieo aeaieo ? aeniiaee. Ia?ae?e
aeei?enoaieo aeaea?ae i?noeoue 169 a?o/eciyieo oa 190 ?iicaiieo
e?oa?aoo?ieo iineeaiue. Iaoa??aee aeena?oaoe?? ?ethno?iaai? 23
oaaeeoeyie, 18 ?enoieaie ? 14 ee?i?/ieie niinoa?aaeaiiyie.

INIIAIEE CI?NO

Iaoa??aee ? iaoiaee aeine?aeaeaiiy. Niinoa??aaeeny 122 oai?eo ia OIA,
ye? i?ioiaeeee eo?n e?eoaaiiy a ioeueiiiieiai/ieo a?aeae?eaiiyo iaeanii?
ee?i?/ii? e?ea?i? oa i?nueei? e?ea?i? ? 7 i. Eoaainueea a ia??iae c 1995
ii 1998 ?. Na?aae oai?eo ia?aaaaeaee /ieia?ee (59,0 %), aeii?ioaaea
a?eiaa a?oia iica 40 ?ie?a. Ia?aaaaeia a?eueo?noue aeine?aeaeoaaieo
oai?eo ia OIA no?aaeaeaee ia oea caoai?thaaiiy iiiaae 15 ?ie?a ?
ia?aianee ca inoaii? 3 ?iee a?eueoa 3 caaino?aiue; 84 oai?eo ia OIA
no?aaeaeaee oaeiae ia ??ciiiai?oi? oi?ie ?ON. O 16 c ieo caoai?thaaiiy
aoei aa?eo?eiaaii a noaoe?iia?? (o 9 /ieia?e aoa aeyaeaiee aeeoociee
ea?ae?ineea?ic, o 7 – noaa?eueia noaiiea?ae?y iai?oae). Ca ee?i?/ieie
aeaieie, a oaeiae ca ?acoeueoaoaie eaai?aoi?ieo, ooieoe?iiaeueieo ?
?aioaaiieia?/ieo iaoiae?a aeine?aeaeaiiy I noaae?y OIA aoea aa?eo?eiaaia
o 11,5 %, II – o 80,3 % ? III – o 8,1 % oai?eo. ??ci? oi?ie ?ON
aa?eo?eoaaee, aacoth/enue ia aeaieo AEA, aeaieo niinoa?aaeaiiy ai?noo
oieanoa?eio oa e?iii?ioa?ae?a o ne?iaaooe? e?ia?, aeaieo aaeia?aiiao???
oiui (inoaiiy i?iaiaeeeany a aeayeeo aeiaaeeao, ca iio?aaith).

Ianoaaeai? oai?? ia OIA aoee ?iciiae?eai? ia aea? a?oie, iaeii??aei? ca
a?eii, noaooth, oyaee?noth oa o?eaae?noth caoai?thaaiiy: ? a?oia – o?,
ui no?aaeaeaee ia OIA aac noiooiuei? iaoieia?? na?oeaai-noaeeiii?
nenoaie (38 /ieia?e), ? ?? a?oia – o?, ui no?aaeaeaee ia OIA o
noeoiiino? c ?ON (84 /ieia?ee). C iaoith aeine?aeaeaiiy aoaeoeaiino?
aioeieneaeaioii? oa?ai?? oai?? ia OIA ?c noiooiueith ?ON ca aeiaaeeiaith
iciaeith aoee ?iciiae?eai? ia o?e i?aea?oie, iaeii??aei? ca a?eii,
noaooth, oyaee?noth ? o?eaae?noth caoai?thaaiiy. Oai?? 1? i?aea?oie
(36 /ieia?e) io?eioaaee o?eueee aacenio oa?ai?th c o?aooaaiiyi
noiooiueiai caoai?thaaiiy; oai?? 2? i?aea?oie (22 /ieia?ee) io?eioaaee
aeiaeaoeiai aei eiiieaeniiai e?eoaaiiy aaieoee a aeiaia?e aeic? 500 ia o
2 i?eeiie, ii/eiath/e c 4–6 aeiy e?eoaaiiy, o?eaae?noue eo?no e?eoaaiiy
aei??aithaaea 14 aei?a; o oai?eo 3? i?aea?oie (26 /ieia?e) e?eoaaiiy OIA
aoei aeiiiaiaii eaa?oeaoeiii o e?ea?nuee?e oi?i? eaa?oeaoei-iaineio, ui
aaeeaaee ii 40 ia aeoeaii? ?a/iaeie o 2 i?eeiie, eo?n e?eoaaiiy
i?aia?aoii oaeiae aei??aithaaa 14 aei?a. sse ? aaieoee, eaa?oeaoei
i?ecia/aee i?ney 4–6 aei?a ao?io?iiii? oa?ai??. On? oai?? ia?aiineee
e?eoaaiiy caaeia?eueii, ia iii?/aii aeiaeiiai aeiaaeeo iaia?aiineiino?
aeaiiai i?aia?aoo.

Ee?i?/ia ianoaaeaiiy oai?eo aeeth/aei aea/aiiy nea?a, aiaiianoe/ieo
aeaieo, aeyaeaieo o?ce/ieie iaoiaeaie ci?i. Aiae?coaaeeny oaeiae aeai?
eaai?aoi?ieo aeine?aeaeaiue: ee?i?/iiai aiae?co e?ia?, aeoeaiino?
aino?ioaciaeo ?aaeoe?e, aiae?co oa?eioeiiy. An? oai?? aoee ianoaaeai?
?aioaaiieia?/ieie iaoiaeaie (i?iaiaeeeany ?aioaaiia?ao?y o aeaio
i?iaeoe?yo, ca iieacaiiyie – a?iioia?ao?y ? oiiia?ao?y). Ooieoe?th
ciai?oiueiai aeeoaiiy aecia/aee ca aeiiiiiaith aia?aoa “Iiaaiine?ei”
ae?iaieoeoaa I?ia//eie; i?e oeueiio ie?aii iae?/oaaeeny iano?oeoeaiee,
?ano?eeoeaiee ? ci?oaiee oeie aaioeeyoe?eii? iaaeinoaoiino?.

Aeine?aeaeaiiy ee?oeiieo iieaciee?a ?ioi?oaoo (e?euee?noue O- ?
Ae?ioioeeo?a, Ooaeia??a/?iaeoeoi??a ? Onoi?ani??a/e?ea??a) i?iaiaeeee
oeeoioiene/iei iaoiaeii (O?ieia A.I. ?c ni?aaao., 1989), aeei?enoiaoth/e
iiiieeiiaeuei? aioeo?ea o??ie Ortho Diagnostic Systems Inc. (USA) eean?a
CD3, CD4, CD8, CD22, c ia/eneaiiyi ?ioii?aaoeyoi?iiai ?iaeaeno
CD4 / CD8. Ne?iaaoeia? eiioeaio?aoe?? g A, Ig M, Ig G aei??thaaee
iaoiaeii ?aae?aeueii? ?ioiiaeeooc?? (*a?iooaiei E.O., 1997). ??aaiue ?
iieaeoey?iee neeaae oee?eoethth/eo ?ioiieo eiiieaen?a (Oe?E) (aaeeei-,
na?aaeiuei-, oa ae??aiiiieaeoey?i? o?aeoe??) aecia/aee iaoiaeii
aeeoa?aioe?eiaaii? i?aoeei?oaoe?? a 2 %, 3,5 % ? 6 % iie?ao?eaiae?eie? c
iieaeoey?iith ianith 6000 aeaeueoii (O?ieia A.I. ?c ni?aaao., 1986).

A?iioineii?/ii ae?aaiinooaaeany oi?ia aiaeia?iio?oo (iaiaaeaiee,
aeeoociee, eaoa?aeueiee, ai?eiee), a oaeiae iioe?ai?noue ? nooi?iue
aeoeaiino? caiaeaiiy ca e?eoa??yie A.?. Eoeiinueeiai (1982). Iaaeae? i?e
aiae?c? ee?i?/ieo oa oeeoieia?/ieo ia?aiao??a ioe?ithaaee ee?i?/io
aeoeai?noue caiaeueiiai i?ioeano (A?iaiaa I.I. ?c ni?aaao., 1991).

A i?ioean? o?a?ia?iioineii?/iiai aeine?aeaeaiiy, eio?a i?iaiaeeeiny i?e
aini?oae?caoe??, ia 10-e aeaiue e?eoaaiiy oa i?e aeaooo? c? noaoe?iia?o,
cae?enithaaee a?aea?? AAC. Aeine?aeaeoth/e cieae, aecia/aee aaniethoio
e?euee?noue ee?oei, neeaaeaee oeeoia?aio a?iioiaeueaaiey?iiai i?inoi?o,
ioe?ithaaee aeeoo?caeaoi?noue aeueaaiey?ieo iae?ioaa?a (AI) oa ee?oei
a?iio?aeueiiai ai?oae?th (AA) ca aeiiiiiaith oanoo ia aeeeth/aiiy
o?eiaiiaiai neiueiai, aecia/aee aeoeai?noue eeniaaicaeaaeieo iaoai?ci?a
e?e?iao AI ca ?acoeueoaoaie oanoo ia a?aeiiaeaiiy i?o?ineiueiai
oao?acie?th (INO-oanoo), a oaeiae iayai?noue noeoeeiaoaeaa?ae?iaaiacii?
aeoeaiino? (NAeA) ai?oae?ioeeo?a. E??i oiai iiey?ia?ao?/iei iaoiaeii
aei??thaaee ai?no a AAC aeoeaiaaieo oi?i eenith (AOE), cie?aia
a?ae?ieneeueieo ?aaeeeae?a, aeoeaiaaiiai eenith ? ia?aeenieo niieoe, ui
? ?ioaa?aeueiei iieacieeii aaeaino “IIE–AIC” a?iioiaeueaaiey?iiai
i?inoi?o. Eiio?ieueio a?oio neeaee 25 i?aeoe/ii caei?iaeo in?a, o yeeo
aoei aeine?aeaeaii noai i?noeaaiai caoenoo e aioeieneaeaioii? nenoaie.
Eiio?ieuei? aaee/eie iieaciee?a, eio?? oa?aeoa?ecothoue nenoaio
?ioi?oaoo, aoee io?eiai? a i?aeeaoaae?aeuei?e iaoeiai-aeine?aei?e
eaai?aoi??? Eoaainueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo.

Aeey noaoenoe/ii? ioe?iee ?acoeueoao?a aeine?aeaeaiiy aeei?enoiaoaaee
ia?aiao?e/iee te?eoa??e Nouethaeaioa – O?oa?a; ei?aeyoe?th i?ae
ee?i?/ieie i?iyaaie caoai?thaaiiy ? aeaieie aeine?aeaeaiiy noaio
i?noeaai? ianiaoeeo?/ii? ?acenoaioiino? ioe?ithaaee ca aeiiiiiaith
ia?iiai eiao?oe??ioa ?aiaiai? ei?aeyoe?? rS Ni??iaia. Ia/eneaiiy
i?iaiaeeee ia ia?niiaeueiiio eiii’thoa?? ca aeiiiiiaith iaeaoa Mathcad 7
Professional (MathSoft Inc. 1997).

Ee?i?/ia oa?aeoa?enoeea ianoaaeaieo oai?eo. An? ianoaaeai? oai??
ia?aaoaaee ia e?eoaaii? a noaoe?iia?? o ia??iae caaino?aiiy
caoai?thaaiiy. Ee?i?/ia ea?oeia caoai?thaaiiy o oai?eo ia OIA o
noeoiiino? c ?ON oa?aeoa?ecoaaeany ae?aaeaiei neiae?iiii aca?iiiai
iaoyaeaiiy. Aiaeii/an o oai?eo aeaii? a?oie iii?/aeany iaio ae?aaeaia
i?iiania ?aaeoe?y, iaee i?noea iaio? ci?ie a aaiia?ai? e aino?ioacia?
?aaeoe??. Uiaei ia?aa?ao OIA o oai?eo aac noiooi?o caoai?thaaiue
na?oeaai-noaeeiii? nenoaie ? c? noiooiueith ?ON iaea?eueo cia/ia
??cieoey aoea aeyaeaia i?e aiae?c? i?iya?a aeeoaeueii? iaaeinoaoiino?
(AeI). Oae, AeI III nooiaiy aoea aeyaeaia o 23,8 % oai?eo I a?oie ? o
39,8 % oai?eo ? i?aea?oie ?I a?oie. Ia a?aei?io a?ae oai?eo I a?oie, o
yeeo niinoa??aaeany i?yia caeaaei?noue oyaeeino? aaioeeyoe?eieo
ii?ooaiue a?ae aeoeaiino? caiaeaiiy, o oai?eo ia OIA o noeoiiino? c ?ON
aeeoaeueia iaaeinoaoi?noue aeuiai nooiaiy noi?iaiaeaeoaaeany iaioith
aeoeai?noth caiaeueiiai i?ioeano. O aeaii? a?oie oai?eo /ano?oa
aeyaeyeeny iciaee aio?caie eaaai?a, iiaaiio?a?ico ? aoi?eiii? eaaaiaai?
a?ia?oaic??. Aei oiai ae caaino?aiiy OIA iaoyaeoaaei ia?aa?a ?ON: o 19
/ieia?e iii?/aeeny iaiaaee noaiiea?ae??, o ?ioeo i?e
aeaeo?iea?ae?ia?ao?/iiio aeine?aeaeaii? aeyaeyeeny ??cii? ae?aciino?
ii?ooaiiy i?ioean?a ?aiiey?ecaoe?? a i?iea?ae?. Iaaeinoaoi?noue
e?iaiia?ao I–IIA noaae?e aoea ae?aaiinoiaaia o iieiaeie ianoaaeaieo.
Aeaeo?iea?ae?ia?ao?/ia aeine?aeaeaiiy aeyaeyei ii?ooaiiy ?eoio o
aeaeyae? oeoii/eiai? aeno?anenoie?? (o 14 oai?eo) oa ieaioeeai? a?eoi??
(o 7 oai?eo). A?io?i?/ia aeine?aeaeaiiy e?ia? aeyaeyei
a?ia?oieanoa?eiai?th o 24 oai?eo, iciaee a?ia?eiaaoeyoe?? – o 13,
i?eai?/aiiy o?a?eiie?co – o 9.

A i?ioean? e?eoaaiiy iiceoeaia aeeiai?ea o oai?eo 1? i?aea?oie ?? a?oie
iaea iaio ae?aaeaiee oa?aeoa?, i?ae a I a?oi?: a?eueoa aoei oaeeo, o
eiai i?e aeaooo? c? noaoe?iia?o niinoa??aaeeny eaoaeue, caeeoeia? yaeua
caiaeueiiai i?ioeano a a?iioao, i?iyae anoaii-aaaaoaoeaiiai neiae?iio
oiui. C? noaoe?iia?o oai?? aeaoaaee i?ney eoi??oaaiiy caaino?aiiy OIA,
i?ioa i?aeoe/ii o an?o ieo caeeoaeeny cieaeaia oiea?aioi?noue aei
o?ce/iiai iaaaioaaeaiiy, caaeeoea aeni??aoi?iiai aai ci?oaiiai
oa?aeoa?o, iii?/aeany neaaei ae?aaeaia iiceoeaia aeeiai?ea i?iya?a ?ON.
I?ney aeaoooy c? noaoe?iia?o an? oai?? i?iaeiaaeoaaee aiaoeaoi?ii
io?eioaaoe ea?ae?io?iiio oa?ai?th, o?i? c ieo i?ioyaii 1 i?nyoey aoee
aini?oae?ciaai? aei ea?ae?ieia?/iiai noaoe?iia?o, 14 /ieia?e i?ioyaii 6
i?nyoe?a – iiaoi?ii aei ioeueiiiieia?/iiai a?aeae?eaiiy a ca’yceo c
caaino?aiiyi OIA.

Noai ?ioi?oaoo ? i?noeaai? aioe?ioaeoe?eii? ?acenoaioiino? o oai?eo ia
OIA o noeoiiino? c ?ON. Aea/aiiy ?ioiiiai noaoono oai?eo ia OIA o
ia??iae caaino?aiiy caoai?thaaiiy, a oaeiae i?ney aeinyaiaiiy ?ai?n??,
aeyaeyei ?noioi? a?aeoeeaiiy oaeiai a?ae aiaeia?/ieo iieaciee?a
i?aeoe/ii caei?iaeo in?a. C aieo ee?oeiii? eaiee ?ioi?oaoo aoei
anoaiiaeaia no?eea nei?i/aiiy oioaeueii? iiioeyoe?? Oe?ioioeeo?a (CD3),
ui a?aeaoaaeiny ye ca ?aooiie a?aeiinii? e aaniethoii? e?eueeino?
oaeia??a/?iaeoeoi??a (CD4), oae ? ca ?aooiie a?aeiiniiai ai?noo
noi?ani??a/e?ea??a (CD8). Cacia/aia ni?aa?aeiioaiiy /enaeueiino?
noaiiioeyoe?e Oe?ioioeeo?a ciaeoei a?aeaeoie o ci?i? ?ioii?aaoeyoi?iiai
?iaeaeno (CD4 / CD8). Inoaii?e aoa no?eei cieaeaiei i?ioyaii onueiai
ia??iaeo ia?aaoaaiiy oai?eo a noaoe?iia?? ? ia aeinyaaa aaee/eie
eiio?ieueii? a?oie i?e aeaooo?. Iienai? ci?ie aoee ?icoe?iai? iaie ye
iane?aeie oi?ioaaiiy o oai?eo ia OIA noi?ani?iiai aa??aioa aoi?eiiiai
?ioiiaeao?oeeoiiai noaio. O iaioiio nooiai? caaino?aiiy OIA a?aeaeaaeiny
ia noai? Aee?oeiiiai ?ioi?oaoo: a?aeiinia /enei Ae?ioioeeo?a (CD22) o
oeeo oai?eo ia a?ae??ciyeiny a?ae oaeiai o i?aeoe/ii caei?iaeo in?a, a
aaniethoia – aoei eeoa aeae?eueea iaioei ia iiiaio aini?oae?caoe?? ?
i?aeoe/ii ia ci?ithaaeiny iaaeae?. Aeine?aeaeaiiy aoii?aeueii? eaiee
?ioi?oaoo aeyaeyei aeinoia??ia cieaeaiiy ai?noo Ig A a ii/aoeiaiio
ia??iae? caaino?aiiy, yea i?e aeaooo? c? noaoe?iia?o iiaa?oaeiny aei
ii?iaeueii? aaee/eie. Ai?no Ig G, iaaiaee, aoa i?aeaeuaiei i?e
aini?oae?caoe??, ua a?eueo c?inoath/e aei iiiaioo aeaoooy c?
noaoe?iia?o. Aeinoia??ieo ci?i ai?noo Ig M iii?/aii ia aoei.
Eiioeaio?aoe?y Oe?E ia?aaeuoaaea eiio?ieuei? aaee/eie a 1,5 ?ace i?e
aini?oae?caoe?? ? a 1,4 ?ace – i?e aeaooo? c? noaoe?iia?o, ?c
ia?aaaaeaiiyi na?aaeiuei- oa ae??aiiiieaeoey?ii? o?aeoe?e (a?aeiiniee
ai?no inoaii?o i?e aini?oae?caoe?? aoa ca?eueoaiei a 1,9 ? 2,9 ?ace, a
ia iiiaio aeaoooy – a 1,7 ? 2,5 ?ace a?aeiia?aeii).

Caaino?aiiy OIA o oai?eo ?c noiooiueith ?ON noi?iaiaeaeoaaeiny a?eueo
?noioieie ci?iaie iniiaieo iieaciee?a nenoaiiiai ?ioi?oaoo. Oae,
aeyaeyeany cia/i?oa Oe?ioiiai?y: /enaeuei?noue o?aeoe?? CD3 i?e
aini?oae?caoe?? aei??aithaaea 0,93±0,02×109 ee/e (o oai?eo ia OIA, ui ia
no?aaeaeaee ia ?ON, – 1,15±0,03×109 ee/e, a eiio?ieuei?e a?oi? –
1,60±0,05×109 ee/e, P

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