I?I?NOA?NOAI IOI?IIE CAeI?IA’ss OE?A?IE

AeA?AEAAIA I?AeI?E?INOAI «OE?A?INUeEEE IAOEIAI- AeINE?AeIEE ?INOEOOO
II?NUeEI? IAAeEOeEIE»

IIACOI Iaaei Aiaoie?eiae/

OAeE 616.37- 002-036.11

IAAeE*IA OA I?IOAN?EIA ?AAA?E?OAOe?ss I?AOe?AIEE?A II?NUeEIAI
O?AINII?OO, ssE? NO?AAEAeATHOUe IA O?II?*IEE IAIE?AAOEO

14.01.34.-aa?aoe?eia, eini?/ia oa ii?nueea iaaeeoeeia

Aaoi?aoa?ao ia caeiaoooy iaoeiaiai

nooiaiy eaiaeeaeaoa iaaee/ieo iaoe

Iaeana- 1999

Aeena?oaoe??th ? ?oeiien

?iaioa aeeiiaia a Aea?aeaaiiio i?aei?e?inoa? «Oe?a?inueeee iaoeiai-
aeine?aeiee ?inoeooo ii?nueei? iaaeeoeeie ”, i. Iaeana

Iaoeiaee ea??aiee: Aeieoi? iaaee/ieo iaoe, aeioeaio

Caii?iae/aiei Ai?en Na?a?eiae/

aeioeaio eaoaae?e ii?nueei? iaaeeoeeie Iaeanueeiai aea?aeaaiiai
iaaee/iiai oi?aa?neoaoo

Io?oe?ei? iiiiaioe aeieoi? iaaee/ieo iaoe,

Ie/eoaeei Ieoaeei THoeiiae/

ea??aiee a?aeae?eo eaia?ineii?/ii? o??o?a?? ? oieae?o?aco Ee?anueeiai
?inoeoooo ee?i?/ii? oa aenia?eiaioaeueii? o??o?a?? AII Oe?a?ie

aeieoi? iaaee/ieo iaoe, noa?oee iaoeiaee ni?a?ia?oiee

E?niaae Aieiaeeie? Ieaenaiae?iae/

noa?oee iaoeiaee ni?a?ia?oiee AeI «Oe?a?inueeee iaoeiai- aeine?aeiee
?inoeooo ii?nueei? iaaeeoeeie»

I?ia?aeia onoaiiaa Oa?e?anueeee ?inoeooo oaeineiiaeaiiy e?ea??a IIC
Oe?a?ie

Caoeno a?aeaoaeaoueny “_19_ “ eaioiy 1999 ?. i__13___aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae.41.617.01 i?e Aea?aeaaiiio
i?aei?e?inoa? «Oe?a?inueeee iaoeiai-aeine?aeiee ?inoeooo ii?nueei?
iaaeeoeeie ” ca aae?anith: 270049, i.Iaeana, aoe. Noaeiiaoae?aia, 1.

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? Aea?aeaaiiai
i?aei?e?inoaa «Oe?a?inueeee iaoeiai-aeine?aeiee ?inoeooo ii?nueei?
iaaeeoeeie ”

Aaoi?aoa?ao ?ic?neaiee “16_”_aa?aciy_ 1999 ?.

A/aiee nae?aoa? niaoe?ae?ciaaii? a/aii? ?aaee,

ae.i.i., i?ioani? ?aiaoue?a I.I.

Aeooaeuei?noue i?iaeaie. I?iaeaia aeniei? caoai?thaaiino? ?
iniaeeainoae aeieeiaiiy oa e?eoaaiiy o?ii?/iiai iaie?aaoeoo (OI) iaaoaa?
a oiiaao ?iaioe ia ii?nueeiio o?ainii?o? aaaeeeaiai cia/aiiy. Cie?aia,
aeniea /anoioa caiaeaiiy i?aeoeoieiai? caeice (IC) aecia/a?oueny
niaoeeo?/ieie oiiaaie ?iaioe ii?ye?a, a?aceea?noth ia?aio?ie IC aei
no?aniaaiiiai aeeao [Eiaaiei A.A., 1995, 1997; Aieoaiei A.I., 1992;
Iaooaeuoaoei I.TH., 1992; Caii?iae/aiei A.N., 1998; Eaiaoueaa A.I.,
1998].

Iacaaaeath/e ia aeaye? oni?oe iaaeeeaiaioiciiai ? o??o?a?/iiai e?eoaaiiy
OI, inoaii?ie ?ieaie i?iaeaia ?ic?iaee aoaeoeaieo iaoiae?a e?eoaaiiy
oaeiai caoai?thaaiiy ? aeoaea aeaeaeith a?ae ?? ?ica’ycaiiy. Oea
iaoiiaeaii ye neeaaei?noth iaoiaaiaoe/ieo iaoai?ci?a ?icaeoeo OI,
iaaeinoaoiueith aoaeoeai?noth ?nioth/eo iaoiae?a e?eoaaiiy, oae ?
no??ieei c?inoaiiyi caoai?thaaiino? ia OI o oeea?e?ciaaieo e?a?iao, o
oiio /ene? e a Oe?a?i?. Ca aeaieie A.A.Oae?iiaa c? ni?aaao. (1998),
caoai?thaai?noue ia OI a Oe?a?i? ioe?ith?oueny o n?aaeiueiio
aaee/eiith, aeecueeith aei 1% a?ae on??? e?eueeino? ianaeaiiy, a
caoai?thaai?noue ia OI o ii?ye?a ? ua a?eueu aenieith — o 1,5- 2,5 ?aco
[E?niaae A.A., 1995].

E?eoaaiiy oai?eo ia OI ae??ciy?oueny neeaaei?noth, ? iaa?oue
canoinoaaiiy o??o?a?/ieo iaoiae?a ia iiaea aa?aiooaaoe iiaii?
eiiiainaoe?? o oai?eo oyaeeeo aieueiaeo a?ae/ooo?a ? caiia?aoe
ii?ooaiiyi c aieo oeoieiai- eeoeiaiai o?aeoo, oiaoi oae? oai?? caaaeaee
iio?aaothoue eiiieaeniiai e?eoaaiiy [Oae?iia A.A., 1997; Oka Y. et al.,
1993; Sameshima H. et al., 1993; Asseman C. et al., 1996; Norman J.G. et
al., 1996; Stephens F.O., 1997].

Iacaaeia?euei? ?acoeueoaoe uiaei e?eoaaiiy OI iiaeooue iiynithaaoenue ye
iaaeinoaoi?ie iiaeeeainoyie o??o?a?/ii? oaeoeee, ui canoiniao?oueny
nueiaiaei?, eiiieaenieie iaoiaeaie e?eoaaiiy, oae ? cia/iith i??ith
iane?aeeaie iaaeinoaoiueiai iaoiaaiaoe/iiai iaa?oiooaaiiy iaoiae?a
eiiieaeniiai e?eoaaiiy aeaiiai caoai?thaaiiy [Oae?iia A.A., 1997]. [Oka
Y. et al., 1993; Sameshima H. et al., 1993; Asseman C. et al., 1996;
Norman J.G. et al., 1996; Stephens F.O., 1997].

Ca aeaieie Caii?iae/aiea A.N. (1998), a oiiaao e?eoaaiiy OI aeoaea
aoaeoeaiei noiniaii caiia?aaiiy oneeaaeiaiiyi ?aiiueiai e a?aeaeaeaiiai
i?neyiia?aoe?eiiai ia??iae?a ? canoinoaaiiy eaca?iiai aei?ii?iaiiy
iecueei? ?ioaineaiino? ?io?a/a?aiiiai ae?aiaciio (EAI??Ae) ?
iaioieneo?e?io (IOO). I?e/iio ca oiia iaeii/aniiai aeei?enoaiiy
eiia?iaoe?? oeeo iaoiae?a a?aei?/a?oueny iioaioe?eiaaiee oa?aiaaoe/iee
aoaeo. Iaeiae o ?ac? oni?oiiai canoinoaaiiy oaeeo iaoiae?a o eiiieaeni?e
oa?ai?? aeeiai?ea ?aaa?e?oaoe?? oai?eo ? aeoaea iia?eueiith, cie?aia,
niinoa??aathoueny iniaeeaino? a?aeiinii ia?aeeniiai ieeneaiiy e?i?ae?a
(IIE). Iiaeia aaaaeaoe, ui aoaeoeai?noue canoinoaaiiy ?ic?iaeaiiai
eiiieaeno EAI??Ae +IOO ia? cia/i? ?aca?ae uiaei eiai iie?auaiiy,
iniaeeai yeui iiaa eaea i?i ei?aeoe?th o oai?eo i?ioean?a
a?eueii?aaeeeaeueiiai ieeneaiiy.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Aeena?oaoe?y
aeeiiaia a?aeiia?aeii aei ieaio iaoeiai-aeine?aeieo ?ia?o Aea?aeaaiiai
i?aei?e?inoaa «Oe?a?inueeee iaoeiai-aeine?aeiee ?inoeooo ii?nueei?
iaaeeoeeie” ? ? o?aaiaioii iaoeiai-aeine?aeii? oaie, ? aea?ae?a?no?aoe??
01.86.000.6102.

Iaoith ?iaioe aoea ?ic?iaea iaoiaaiaoe/ii iaa?oioiaaiiai eiiieaeniiai
e?eoaaiiy ii?ye?a, ui no?aaeaeathoue ia o?ii?/i? oi?ie iaie?aaoeoo, c
aeei?enoaiiyi o??o?a?/ieo, oa?iaeieia?/ieo ? o?c?ioa?aiaaoe/ieo
iaoiae?a, ei?eaoth/eo i?ioeane a?eueii?aaeeeaeueiiai ieeneaiiy oa
eieaaaiii?iaeoeoe??.

Iniiai? caaaeaiiy aeine?aeaeaiiy aoee oaeeie:

aea/eoe noai IIE o oai?eo — ?ia?oiee?a ii?nueeiai o?ainii?oo, yeeo aoei
i?iiia?iaaii c i?eaiaeo OI, e iniaeeaino? aeaieo iieaciee?a o ?ac?
canoinoaaiiy o eiiieaeni?e oa?ai?? EE, a oaeiae eiia?iiaaiiai
canoinoaaiiy EE ? eiiieaeno IOO+EAI??Ae;

?ic?iaeoe aenia?eiaioaeueio iiaeaeue OI ia iniia? aeine?aeaeaiue
aeeiai?ee aeoeaiino? o?eineio, ai?eace, e?iace, ?ia?a?oi?a o?eineio, a
oaeiae a?aeo?ii?aeace, eenei? oinoaoace; ae?aciino? i?ioean?a IIE ?
aioeieneaeaioiiai caoenoo; ??ai?a ienei?ie?io e ienee?ceio o ieaci?
e?ia?; a oaeiae aieueiai? /ooeeaino? ia ??cieo oa?i?iao, ii/eiath/e c
iiiaioo oi?ioaaiiy aenia?eiaioaeueiiai iaie?aaoeoo, ca aeiiiiiaith
caii?iaeoaaiiy e nenoaiiiai canoinoaaiiy no?aioicioioeeio;

aea/eoe aoaeoeai?noue ie?aiiai ? ii?aeiaiiai canoinoaaiiy e?ii?ai?
eeneioe (EE), IOO ? EAI??Ae o oaa?ei ?c aenia?eiaioaeueiei OI;

aea/eoe iniaeeaino? ?ioiieia?/ii? ?aaeoeaiino?, iieaciee?a
ooieoe?iiaeueiiai noaio IC ? IIE o oai?eo ia OI a oiiaao o?aaeeoe?eii?
oa?ai?? ? eiiieaenii? oa?ai?? c aeei?enoaiiyi IOO ? EAI??Ae;

aeine?aeeoe aeeiai?eo ??aiy (-ienei?ie?io, (-ienee?ceio, aeoeaiino?
a?aeo?ii?aeace ? (-aetheiceaeac o ieaci? e?ia? oai?eo, ye? i?aeeyaaee
eiiieaeniiio e?eoaaiith c oaaaeaiiyi EE ye ie?aii, oae ? a eiiieaen? c
IOO ? EAI??Ae;

aea/eoe aoaeoeai?noue eiiieaeniiai e?eoaaiiy oai?eo ia OI ca ?o noaiii o
a?aeaeaeaiiio i?neyiia?aoe?eiiio ia??iae? e iieacieeaie ?ioiieia?/ii?
?aaeoeaiino?, IIE, noeioeueiaaii? aene?aoi?ii? oa ?ie?aoi?ii? ooieoe?e
IC ca oiiae aeeth/aiiy aei eiiieaeno e?eoaaeueieo caoiae?a o??o?a?/ii?
ei?aeoe?? caoai?thaaiiy, oaaaeaiiy EE ye ie?aii, oae ? a eiiieaen? c IOO
? EAI??Ae;

aea/eoe iniaeeaino? i?ioan?eii? ?aaa?e?oaoe?? ii?ye?a i?ney eiiieaeniiai
e?eoaaiiy OI.

Iaoeiaa iiaecia. Aia?oa aecia/aii, ui aiane?aeie ?icaeoeo
aenia?eiaioaeueiiai OI, yeee ni?e/eiy?oueny caii?iaeoaaiiyi oeaieie IC
oei?aoeeii ia oii? canoinoaaiiy no?aioicioioeeio, niinoa??aa?oueny oaea:
i?aeaeuaiiy ??ai?a o?eineio, ai?eace, e?iace, c?inoaiiy aeoeaiino?
a?oeao?ii?aeace, eenei? oinoaoace, ??ai?a ienei?ie?io e ienee?ceio a
ieaci? e?ia?, ?ioaineo?eaoe?y IIE, cieaeaiiy aioeieneaeaioiiai caoenoo,
a oaeiae ?icaeoie i?aeaeuaii? aieueiai? /ooeeaino? oaa?ei i?ioyaii
ainueie oeaei?a a?ae iiiaioo caii?iaeoaaiiy IC. Aeiaaaeaii, ui EE
ni?e/eiy? aeica-caeaaeiee aoaeo uiaei cieaeaiiy oa?iaioai??, iieaciee?a
IIE, aioeieneaeaioii? oa?iaioaoeaii? aeoeaiino? a?aeo?ii?aeace, eenei?
oanoaoace, (-ienei?ie?io, (-ienee?ceio. Aeyaeaii iineeaiiy aeacaieo
aoaeo?a EE i?ae aieeaii ?o ii?aeiaiiai canoinoaaiiy c IOO ? EAI??Ae.
Aeiaaaeaii, ui aieueiaee neiae?ii, oa?aeoa?iee aeey i?iya?a OI,
i?aeeyaa? ?noioi?e ?aaeoeoe?? ia a?aeaeaeaieo no?ieao o oai?eo, yeei
i?iaiaeeee eiiieaenia e?eoaaiiy c aeeth/aiiyi EE, ? ? a?eueo ae?aciei
i?e oaaaeaii? aei e?eoaaeueiiai eiiieaeno IOO ? EAI??Ae. A oiiaao
eiiieaeniiai e?eoaaiiy, yea i?noeoue canoinoaaiiy EE, IOO ? EAI??Ae,
?noioii iie?auothoueny a?aeaeaeai? ?acoeueoaoe e?eoaaiiy oai?eo ia OI,
caa??aa?oueny ooieoe?iiaeueia caeaoi?noue aecie?eiii? /anoeie IC, yea
aecia/a?oueny o oanoao noeioeyoe?? nae?aoe?? ?c nae?aoeiii ?
iaie?aicei?iii, caa??aa?oueny ?ie?aoi?ia ooieoe?y, yea aecia/a?oueny ye
ca iieacieeii aacaeueii? ?ie?aoe?? ?inoe?io, oae ? aetheaaiio.
Canoinoaaiiy EE o eiiieaen? caoiae?a aeey e?eoaaiiy oai?eo ia OI
caaacia/o? ia a?aeaeaeaiiio ia??iae? a?eueo ae?acio ii?iae?caoe?th
iieaciee?a ?ioiieia?/ii? ?aaeoeaiino?, a oaeiae iieaciee?a IIE ?
oa?iaioaoeaii? eaiee aioeieneaeaioii? nenoaie. Aeiaaaeaii, ui
aeeoa?aioe?eiaaiee i?aeo?ae uiaei aeai?o iia?aoe?e ae?aioaaiiy ?
?acaeoe?? IC aeicaiey? aeinyaoe aeia?eo ?acoeueoao?a e?eoaaiiy o 84,7%
oai?eo ? caaeia?eueieo- o 11,9%. Canoinoaaiiy EE ?noioii ni?ey?
iie?auaiith ia?aa?ao iaeaeeae/iai i?neyiia?aoe?eiiai ia??iaeo ?
i?ioan?eii? ?aaa?e?oaoe?? oai?eo ia a?aeaeaeaieo oa?i?iao i?ney
iia?aoe??.

I?aeoe/ia cia/aiiy io?eiaieo ?acoeueoao?a. Aeyaeaia aeniea
aoaeoeai?noue iaoiaaiaoe/ii iaa?oioiaaiiai eiiieaeniiai e?eoaaiiy ?
i?ioan?eii? ?aaa?e?oaoe?? ii?ye?a, ye? no?aaeaeathoue ia OI, aiane?aeie
aeeth/aiiy aei eiiieaeniiai e?eoaaiiy EE, yeo iaiao?aeii canoiniaoaaoe o
aeaeyae? aioo??oiueii’yciaeo oaaaeaiue ?c ?ic?aooieo 50 ia aea?/? ia
aeiao i?ioyaii 2 — 4-o oeaei?a. Ii?aeiaiiy EE ?c IOO, yeee oaiaeeoueny o
aeaeyae? aioo??oiueiaaiieo ?iooc?e ?c ?ic?aooieo 0,1 a ia 250 ie
?cioii?/iiai ?ic/eio iao??th oei?eaeo aei iia?aoeaiiai ao?o/aiiy ?
i?ioyaii 5-e aei?a i?ney iia?aoe??, ? ae?? EAI??Ae ia i?iaeoe?th IC aei
iia?aoe?? ? i?ioyaii o?ueio aei?a i?neyiia?aoe?eiiai ia??iaeo (aea?/? ia
aeaiue, o?eaae?noue naaino — 10 oa., aeiaaeeia oaee? — 0,89-0,95 iei)
ni?e/eiy? ae?acio iiceoeaio e?eoaaeueio ae?th. E??i oiai, cai?iiiiiaaia
iaoiaeeea e?eoaaiiy EE, IOO ? EAI??Ae iiaea canoiniaoaaoenue ye
naiino?eiee iaoiae oa?ai?? o oai?eo ia OI, ye? ia i?aeeyaathoue
o??o?a?/iiio e?eoaaiith.

?acoeueoaoe ?iaioe ai?iaaaeaeai? o ae?yeuei?noue o??o?a?/ieo
a?aeae?eaiue ?cia?euenueei? aanaeiiai?, ?ee?/?anueei?, Ieeiea?anueei?,
?ai?enueei?, E?e?enueei? ii?oiaeo e?ea?aiue.

Iniaenoee aianie aeena?oaioa. Aeena?oaio noi?ioethaaa iaoo, caaaeaiiy
aeine?aeaeaiiy, aeeiiaa aenia?eiaioaeuei? aeine?aeaeaiiy ? i?ia?a
eiiieaenia e?eoaaiiy oai?eo ia o?ii?/iee iaie?aaoeo, o oiio /ene? ?yae
o??o?a?/ieo ao?o/aiue ye iia?oth/ee o??o?a ? anenoaio, c?iaea aiae?c
io?eiaieo aeaieo ? noi?ioeuethaaa aeniiaee e i?aeoe/i? ?aeiiaiaeaoe??.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. ?acoeueoaoe aeine?aeaeaiue
aeieeaaeaii ia can?aeaii? Iaeanueeiai iaeaniiai iaoeiaiai oiaa?enoaa
o??o?a?a (1997), I- e i?aeia?iaei?e eiioa?aioe?? c ii?nueei? iaaeeoeeie
(Iaeana, 1997), Iaoeia?e eiioa?aioe??, i?enay/ai?e 80-??//th aeaae.
A.A.Oae?iiaa (Ee?a, 1998), noi?nieo can?aeaiiyo eaoaae? ii?nueei?
iaaeeoeeie, ii?iaeueii? ? iaoieia?/ii? o?c?ieia?? IAeIO (Iaeana, 1997,
1998, 1999).

Ioae?eaoe??. Ca iaoa??aeaie aeena?oaoe?? iioae?eiaaii 6 ?ia?o, ?c yeeo
5 — aeo?iaeuei? noaoo?.

No?oeoo?a e ianya aeena?oaoe??. Ci?no ?iaioe aeeeaaeaii ia 193 noi??ieao
iaoeiiieniiai oaenoo. Aeena?oaoe?y neeaaea?oueny c? anooio ? oanoe aeaa:
iaeyae e?oa?aoo?e — 1 aeaaa; iaoa??ae ? iaoiaee — 1 aeaaa; iniaeno?
aeine?aeaeaiiy — 3 aeaae; aeniiaee, i?aeoe/i? ?aeiiaiaeaoe??, iieaae/ee
e?oa?aoo?e. Oaeno ?ethno?iaaiee (?enoie?a — 17, oaaeeoeue — 21).
A?ae?ia?ao?y i?noeoue 122 aeaea?aea, iaae?oeiaaieo ee?eeeoeath, ? 134 —
?io? aeaea?aea.

CI?NO ?IAIOE

Iaoa??aee oa caniae aeine?aeaeaiiy. Aenia?eiaioaeuei? aeine?aeaeaiiy.
Niinoa?aaeaiiy n?oaaaeeeecy ca yiia o?oi?/iiai aecna?eiaioo ia 275
a?eeo uo?ao-caioeyo e?i?? A?coa? iacoth a?ae 180 aeo 320 a. O oaa?ei
ni?e/eiyee iiaeaeue OI oeyoii ioieiaeaeaiiy oeaieie IC oei?aoeeii o
ii?aeiaii? c oaaaeaiiyi no?aioicioioeeio [Oeeii?eiaa O.Ae., 1995]. Ca
eiio?ieue aoei acyoi iani?aaaeiueiiia?iaaieo uo??a.

?ioiieia?/i? iaoiaee aeine?aeaeaiiy Aeey aecia/aiiy ooieoe?oiaeueioao
coaio O-cecoaie e?ioooeeo?a aea/aee cnaoeeo?/i? ee?oeii? ?aaeoe??
a?na?/ooeeaino? in vitro. Cie?aia, c oe??th iaoith aea/aee ?aaeoe?th
aaeueioaaiiy i?eeeiaiiy ee?oei (?AIE), ?aaeoe?th aeanoo?ainoi?iaoe??
e?ioioeeo?a (?AOE), ?aaeoe?th cnaoeeo?/iiao ?ocaoeoooai?aiiy (A-?OE,
I-?OE), a oaeiae ?aaeoe?th aaeueioaaiiy i?a?aoe?? e?ioioeeo?a (?AIE)
[Aoaa?a??oe I.A. c? ni?aaao., 1990; 1991]. ?ioioaeoaoe?ie eeac?a A, M ?
G aecia/aeeny o?iiaoia?ao?/iei iaooaeoi [Iao?ia ?.A., 1991].

Oa?aeoa?enoeea oa?iaioaoeaieo ? iaoaaie?/ieo ci?i. sse niaoeeo?/iee
iieaciee aeieeiaiiy ? ?icaeoeo iaie?aaoeoo o ieaci? e?ia? aecia/aee
aeoeai?noue o?eineio ca A?eaiaa?ii — Oaoa?ieeii; ?ia?a?oi?a o?eineio —
ca Oaaa?aaeii o iiaeeo?eaoe?? Oaoa?ieeiaa; aeueoa-ai?eace — ca iaoiaeii
Ea?aaay. Aeine?aeaeaiiy ai?noo caaaeueiiai oieanoa?eio i?iaaaeeee ca
iaoiaeii ?eueea; oieanoa?eio, e?iii?ioa?ae?a aeniei? aonoeie — ca
iaoiaeii Aaaey i?ney aaia?ei-ia?aaioeaai? i?aoeei?oaoe?? ? inaaeaeoaaiiy
ne?iaaoee aiii?ioa?i-aaoaai?nieo e?iii?ioa?ae?a; o?eae?oea?eaee oa
caaaeuei? e?i?aee — ca aeiiiiiaith ae?aaiinoe/ieo iaai??a o??ie «Eaoaia»
(*ao?y); a oaeiae cae?enithaaee aeaeo?io?aoe/iee ?iciiae?e
e?iii?ioa?ae?a o aae? aaa?ice [Ci?uee?ia A.A. c? ni?aaao., 1997].

Aeoeai?noue a?aeo?ii?aeace aecia/aee ca noaiaea?oiei iaoiaeii [Aca?aiie
E.N., Aaia?aeia E.E., 1994], b- ienei?ie?io ? b- ienee?ceio — ca
i?ia?ae?eiiaei iaoiaeii [Anao?ai? A.N., 1956], aeoeai?noue b-
aetheiceaeac — ca iaoiaeeeith Borooach K. et al., (1961), aeoeai?noue
eenei? oinoaoace — ca noaiaea?oiei iaoiaeii [Aca?aiie E.N., Aaia?aeia
E.E., 1994].

Aecia/aiiy ??aiy iaeiiiaiai ae?aeueaeaa?aeo (IAeA) i?iaaaeeee ca
aeiiiiiaith o?iaa?a?oo?iai? eeneioe [E.Ae.Noaeueiay, O.A.Aa?eoaeee,
1977]. O ieaci? e?ia? ? a a?eo?ioeeoao aecia/aee aeoeai?noue
aeooao?iiia??ieneaeace (AOI), aeooao?ii?aaeoeoace (A?), eaoaeace, a
oaeiae noia?ieneaeaeeniooace (NIAe) a a?eo?ioeeoao [Ooaaeiaa A.I.,
Aioiiiaa O.A., 1997]. Ca eiio?ieue a?aee a?aeiia?aei? iieacieee
i?aeoe/ii caei?iaeo in?a aiaeia?/iiai a?eo.

Ee?i?/i? niinoa?aaeaiiy ? eiiieaenia oa?ai?y. O o??o?a?/iiio
a?aeae?eaii? *i?iiii?nueei? oeaio?aeueii? aanaeiiai? ee?i?/ii? e?ea?i?
ia aiaeiiio o?ainii?o? ca ia??iae c 1987 ii 1998 ??. c i?eaiaeo OI
i?iaaaeaia e?eoaaiiy 127 oai?eo- i?aoe?aiee?a ii?nueeiai o?ainii?oo, a
oiio /ene? 83 ae?iie oa 44 /ieia?e?a, ?ao?iniaeoeaiee aiae?c
aaciina?aaei?o oa a?aeaeaeaieo ?acoeueoao?a o??o?a?/iiai ?
eiina?aaoeaiiai e?eoaaiiy yeeo noaiiaeoue iniiao aeaiiai aeine?aeaeaiiy.
Na?aaei?e a?e oai?eo noaiiaea 43,7(5,1 ?ie?a.

Ae?aaiinoeea cae?enithaaeany ia i?aenoaa? eiiieaeniiai ianoaaeaiiy
oai?eo c aeei?enoaiiyi iaoiae?a oeueo?acaoeiaiai, ?aioaaiieiii’thoa?iiai
aeine?aeaeaiue, eaia?ineii??, iaoiaeo aeenoaioe?eii? ?aae?aoe?eii?
ae?aaiinoe/ii? oaieiiao???, aia?ia?ao?? IC, aiaeineii?/ii? ?ao?ia?aaeii?
oieaia?ia?ao??, a oaeiae ee?i?ei- eaai?aoi?ieo aeaieo.

Oaaaeaiiy EE (o?ieoiaa eeneioa, ASTA Medica AG, I?ia//eia) cae?enithaaee
aeicaie a?ae 10 aei 50 ia/ea, a/i, aea?/? ia aeiao. Aeey eaca?ioa?ai??
aeei?enoiaoaaany eaca?iee aia?ao ia a?nai?ae? aae?th “Oci?” c aeo?aeiith
iiooaei?noth 3 Ao ?iioeueniiai ?aaeeio ae?? (300 Aoe), aaia?oth/ee oaee?
aeiaaeeiith 0,89 — 0,95 iei; o?eaae?noue naaino noaiiaeea 10 oa. IOO
(“o?aioae”, Oaano) canoiniaoaaee uiaeiaiai aioo??oiueiaaiii ii 0,1 a ia
250 ie ?cioii?/iiai ?ic/eio Na CL.

Noaoecoe/ia oa?iaea ?acyeueoao?a aeine?aeaeaiue i?iaaaeeeanue ?c
canoinoaaiiyi caaaeueiii?eeiyoeo o iaaeeeo-a?oeoa?/ieo aeine?aeaeaiiyo
na?aiao?e/ieo ? iana?aiao?e/ieo iaooae?a coaoecoe/ioao aiae?co
[Nanaoeeaa Ae., 1968; Ayaea? A.A., Aaieei A.A., 1973; ss.Ay?ao e ae?.,
1991] ia eoin’thoa?? IBM PC/AT ca aeiiiiiaith n?oa?ai coaoecoe/ioao
aiae?co.

1. Aenia?eiaioaeueia iaa?oiooaaiiy eiiieaeniiai iaoiaeo e?eoaaiiy OI.
Aeey iiaeaethaaiiy OI aoea aeei?enoaia iaoiaeeea eiia?iiaaii? ae??
no?aioicioioeeiii, o?iiiei aei ia?aio?ie IC, ?c caii?iaeoaaiiyi oeaieie
IC [Oeeii?eiaa O.Ae., 1996].

*a?ac 24 aiae. i?ney caii?iaeoaaiiy oeaieie IC o uo??a niinoa??aaeinue
c?inoaiiy aeoeaiino? o?eineio a e?ia? o 8,6 ?aco ii??aiyii c eiio?ieai
(P<0,001), a i?e eiia?ioaai? c? no?aioicioioeeiii- o 9,2 ?aco (P<0,001). ??aaiue ?ia?a?oi?a o?eineio a oeae ia??iae ciaiooaaany a?aeiia?aeii ia 37 ? 46% (P<0,001). Aeoeai?noue ai?eace c?inoaea o 2,9 ? 3,5 ?aco (P<0,001), a aeoeai?noue e?iace- o 2,35 ? 3,1 ?aco (P<0,001). A a?oi? oaa?ei c iaei??th oieiaeiaith ae??th /a?ac 8 oeaei?a a?aeaoaaeany ii?iae?caoe?y oa?iaioiiai neeaaeo e?ia?, oei/anii ye ia oii? canoinoaaiiy no?aioicioioeeio aeoeai?noue o?eineio ia?aaeuoaaea a?aeiia?aeiee iieaciee o eiio?ie? a 3,6 ?aco, ai?eace- a 3 ?ace ? e?iace- ? 2,5 ?aco (P<0,001), ??aaiue ?ia?a?oi?a o?eineio aoa ieae/ei a?ae eiio?ieueiiai cia/aiiy ia 25% (P<0,01). *a?ac 12 oeaei?a aeoeai?noue o?eineio caeeoaeany i?aeaeuaiith o 2,3 ?aco, ai?eace- a 2,4 ?aco, e?iace- a 1,8 ?aco (P<0,01), a ??aaiue ?ia?a?oi?a o?eineio aoa cieaeaiei ia 20% (P<0,05). Ia oii? canoinoaaiiy EE (25,0 ia/ea) aeoeai?noue o?eineio, ai?eace ? e?iace o ieaci? e?ia? aoea a?eueoa a?ae oaei? o eiio?ie? a?aeiia?aeii ia 70%, 65% (P<0,01) ? 50% (P<0,05). I?ae aieeaii EE aeicith (50,0 ia/ea) aeine?aeaeoaai? iieacieee ia a?ae??ciyeenue a?ae eiio?ieth (P>0,05).

I?ae aieeaii 7-aeaiieo oaaaeaiue IOO (20,0 ia/ea) o oaa?ei ia 8-io
oeaei? iieacieee aeoeaiino? o?eineio a 3,2 ?aco, ai?eace ? e?iace a 2,8
? 2,3 ?aco ia?aaeuoaaee oae? o eiio?ie? (P<0,001). Aeoeai?noue ?ia?a?oi?a o?eineio aoea iaioith ia 30% (P<0,01). I?ae aieeaii aeai?aciaeo uiaeiaiaeo naain?a (10 oa.) EAI??Ae (3 aeiae) aeoeai?noue o?eineio, ai?eace ? e?iace a e?ia? oaa?ei aoea a?eueoith a?ae oaei? o eiio?ie? a?aeiia?aeii o 3,5; 3,0 ? 2,4 ?aco (P<0,001), oei/anii ye aeoeai?noue ?ia?a?oi?a o?eineio aoea ieae/ith ia 25% (P<0,01). Ii?aeiaia canoinoaaiiy IOO (20,0 ia/ea) ? EAI??Ae (10 -oa.) a oiiaao aenia?eiaioaeueiiai OI aeiaaei, ui aeoeai?noue o?eineio aoea a?eueoith, i?ae o eiio?ie?, ia 40% (P<0,05), ai?eace ? e?iace - ia 20 ? 14% (P>0,05), aeoeai?noue ?ia?a?oi?a o?eineio aoea iaioith, i?ae o eiio?ie?,
ia 16% (P>0,05). I?ae aieeaii EAI??Ae (10- oa.), IOO (20,0 ia/ea) ia
oii? i?ny/iiai oaaaeaiiy EE (10,0 ia/ea) on? aeine?aeaeoaai? iieacieee
ia a?ae??ciyeenue a?ae oaeeo o a?oi? iani?aaaeiueiiia?iaaieo oaa?ei
(P>0,05).

O uo??a ?c OI /a?ac 8 oeaei?a ??ai? IAeA o ieaci? ? a a?eo?ioeeoao aoee
aeueie a?ae eiio?ieueieo cia/aiue a?aeiia?aeii o 3,17 ? 4,62 ?aco
(P<0,001). Aeoeai?noue AOI o ieaci? ? a a?eo?ioeeoao oaeiae ia?aaeuoaaea eiio?ieuei? cia/aiiy o 2,64 ? 4,0 ?ace, a A? - o 3,2 ? 1,69 ?aco (P<0,001). Aeoeai?noue eaoaeace ? NIAe a?eo?ioeeo?a caeeoaeeny ieae/eie a?ae eiio?ieueieo cia/aiue a?aeiia?aeii ia 26 ? 30% (P<0,05). Aei??yi? ia 8-io oeaei? ??ai? IAeA o ieaci? e a?eo?ioeeoao ia oii? i?ny/iiai canoinoaaiiy EE (25,0 ia/ea) ia?aaeuoaaee a?aeiia?aei? cia/aiiy o eiio?ie? a 1,8 (P<0,01) ? 1,64 ?aco (P<0,05), aeoeai?noue AO? o ieaci? e?ia? ia a?ae??ciyeanue, a a a?eo?ioeeoao aoea aeuith ia 35% (P<0,05), i?ae o eiio?ie?. Aeoeai?noue A?, eaoaeace ? NIAe ia a?ae??ciyeanue a?ae eiio?ieth (P>0,05). A oiiaao ii?aeiaiiai
canoinoaaiiy IOO (20,0 ia/ea) ? EAI??Ae (10-oa.) ??ai? IAeA o ieaci? ? a
a?eo?ioeeoao ia?aaeuoaaee a?aeiia?aei? iieacieee o eiio?ie? a 2,4 ? 3,0
?ace (P<0,01). Aeoeai?noue AOI o ieaci? ? a a?eo?ioeeoao oaeiae ia?aaeuoaaea ??aaiue eiio?ieth- o 1,8 ? 2,9 ?aco, a aeoeai?noue A? - o 2,48 ? 1,5 ?aco (P<0,01). Ca oaeeo oiia aeoeai?noue NIAe a?eo?ioeeo?a caeeoaeany iaioith a?ae oaei? o eiio?ie? ia 20% (P<0,05). Aiaeia?/ia ae?y IOO ? EAI??Ae ia oaa?ei ia oii? i?ny/iiai canoinoaaiiy EE (10,0 ia/ea) i?eaiaeeea aei ii?iae?caoe?? on?o aeine?aeaeoaaieo iieaciee?a (P>0,05).

EE (10,0 ia/ea) a oiiaao OI (8-e oeaeaeaiue) cieaeoaaea ??aaiue b-
ienei?ie?io, b- ienee?ceio, aeoeai?noue a?aeo?ii?aeace ? eenei?
oinoaoace o ii??aiyii? c eiio?ieai a?aeiia?aeii ia 70 ? 60% (P<0,01), o 2,2 ?aco (P<0,001) ? ia 80% (P<0,01). I?ae aieeaii ii?aeiaiiai canoinoaaiiy IOO (20,0 ia/ea) ? EAI??Ae (10-oa.) ??ai? b-ienei?ie?io ? b-ienee?ceio ia?aaeuoaaee a?aeiia?aei? iieacieee o eiio?ie? ia 30 ? 40% (P<0,05), aeoeai?noue a?aeo?ii?aeace aoea aeuith ia 10%, a eenei? oinoaoace- ia 23% (P>0,05).

A oiiaao aieeao IOO (20,0 ia/ea), EAI??Ae (10-oa.) ia oii? i?ny/iiai
canoinoaaiiy EE (10,0 ia/ea) a?aei?/aeany i?aeoe/ii iiaia ii?iae?caoe?y
c aieo an?o aeine?aeaeoaaieo iieaciee?a (P>0,05).

I?ae aieeaii EE aeicith 10,0 ia/ea ?ioaineai?noue aieueiaeo ?aaeoe?e,
ye? aeieeaee o uo??a o a?aeiia?aeue ia cauaieaiiy oainoa, ia?aaeuoaaea
oaeo o eiio?ie? ia 80% (P<0,01), aeicith 25,0 ia/ea- ia 50% (P<0,05). I?e ii?aeiaiiio canoinoaaii? IOO (20,0 ia/ea) ? EAI??Ae (10-oa.) ?ioaineai?noue ?aaeoe?e ia aieueiaee iiae?aciee caeeoaeany aeuith ia 40%, i?ae o uo??a eiio?ieueii? a?oie (P<0,05). Ii?aeiaia canoinoaaiiy IOO (20,0 ia/ea), EAI??Ae (10- oa) ia oii? oaaaeaiey EE (10,0 ia/ea, i?ioyaii i?nyoey) noi?iaiaeaeoaaeiny iiaiith ii?iae?caoe??th aieueiai? /ooeeaino? oaa?ei (P>0,05).

Oaeei /eiii, iaaaaeai? ?acoeueoaoe na?ae/aoue i?i oa, ui EE iineeth?
oa?aiaaoe/io ae?th IOO, EAI??Ae noiniaii oa?iaioaoeaieo ii?ooaiue, a
oaeiae aieueiai? /ooeeaino? o uo??a ?c OI.

2. Aaciina?aaei? ?acoeueoaoe ??ciiiai?oieo iaoiae?a o??o?a?/iiai ?
eiiieaeniiai e?eoaaiiy oai?eo ia OI

Ianoaaeaii 127 oai?eo — ii?ye?a ?c ??cieie oi?iaie OI a?eii a?ae 25 aei
53 ?ie?a, ye? iaee noaae ieaaaiiy ia noaeiao a?ae 2 aei 25 ?ie?a. ?c ieo
69 iaoe??io?a io?eiaee eiiieaenia o??o?a?/ia e?eoaaiiy, ?ioei aoei
i?iaaaeaia eiiieaenia eiina?aaoeaia e?eoaaiiy c canoinoaaiiyi EE o
ii?aeiaii? ?c IOO ? EAI??Ae. Eiio?ieueio a?oio neeaaeaee 32 oai?eo, yeei
i?iaiaeeany eo?n o?aaeeoe?eiiai e?eoaaiiy.

O 12 oai?eo aoei cae?eniaia aioo??oi? ae?aioaaiiy aeno?aia?aio?iaoicieo
e?no IC, yea aeeiioaaee oeyoii oi?ioaaiiy oe?ieiai a?/ea e?noe c oiieith
eeoeith ia a?aeeeth/ai?e iaoe? ca iaoiaeii ?o aai aeiaa?e iaoe? ca
A?aoiii ? “caaeooeith” i?ea?aeii? iaoe? ca A.A.Oae?iiaei, noi?iiaaiiai o
ieaeiueiio iiethn? e?noe. Oeenoiaano?inoii?th ? oeenoiaeoiaeaiinoii?th
cae?eniaii a?aeiia?aeii o 14 e 13 oai?eo. O?nooei?thiinoii?y ia
ao?a/aiiio ae?aiaae? c a?aeeeth/aiith ca ?o iaoeath oiiei? eeoee aoea
aeeiiaia o 2 oai?eo. Iicaeiaaeith iaie?aaoi?thiinoii?th i?iaaaeaii o 17
oai?eo.

?c 58 oai?eo, yeei aoee aeeiiai? iia?aoe?? aioo??oiueiai ae?aioaaiiy,
i?neyiia?aoe?ei? oneeaaeiaiiy niinoa??aaeenue o 5 in?a. ?c ieo iiia?ee
aeaa iaoe??ioe: iaeei — i?ney oeenoiaano?inoii?? ? iaeei — i?ney
o?nooei?thiinoii??.

I?ieneiaeueia ?acaeoe?y IC (IAe?) ca Wippl-A.A.Oae?iiaei o
pilorus-caa??aath/iio aa??aio? aoea aeeiiaia o 3 oai?eo. Aeenoaeueia
?acaeoe?y IC cae?eniaia o 8 oai?eo.

I?ney IAe? ? aeenoaeueii? ?acaeoe?? IC i?neyiia?aoe?ei? oneeaaeiaiiy
?icaeaaeenue o aeaio oai?eo: a iaeiiio aeiaaeeo niinoa??aaeinue
aeieeiaiiy e?ainoi?iiiueiai i?aeae?ao?aaiaeueiiai aanoeano, a o ae?oaiai
oai?iai i?ney aeenoaeueii? ?acaeoe?? IC ?icaeioany ia?eoii?o, yeee
cae?i/eany eaoaeueiei e?ioeai. Oaeei /eiii, eaoaeuei?noue o oe?eiio
noaiiaeea 4,3%.

O ieaci? e?ia? oai?eo ia OI aei iia?aoe?? iaei i?noea c?inoaiiy
eiioeaio?aoe?? iaeiiiaiai ae?aeueaeaa?aeo (IAeA; ia 70%) ? ae??iiaeo
eii’thaao?a (AeE; o 2,.2 ?aco). E??i oiai, o ieaci? e?ia? oaeiae
cieaeoaaany ai?no ye caaaeueiiai aeooao?iio, oae ? eiai a?aeiiaeaii?
oi?ie (a?aeiia?aeii ia 40 ? 26,6%), aioeieneaeaoieo oa?iaio?a: NIAe (ia
37%), aeooao?iiia?ieneaeace (o 1,8 ?aco) ? aeooao?ii?aaeoeoace (ia 36%)
(P<0,001). O e?ia? oai?eo, ye? ia?aianee iia?aoeaia ao?o/aiiy ? yeei aoea i?iaaaeaia caaaeueiii?eeiyoa oa?ai?y, caa??aaeinue ae?acia c?inoaiiy IAeA (a 1,5 ?aco) ? AeE (a 1,6 ?aco) (P<0,001). Iaei i?noea oaeiae cieaeaiiy ??aiy aeooao?iio (ia 29-42%), aeoeaiino? NIAe (ia 29%) (P<0,05), aeooao?iiia?ieneaeace (ia 37%) ? aeooao?ii?aaeoeoace (ia 29%) (P<0,001). Iane?aeeii canoinoaaiiy o eiiieaeniiio e?eoaaii? IOO (aeai?aciaa aioo??oiueiaaiia oaaaeaiiy IOO (ii 0,2 a), ai?no o e?ia? oai?eo IAeA ? AeE aoa ia 22% (P<0,01) ? 26% (P<0,05) a?eueoei, i?ae aei iia?aoe??. Ca oaeeo oiia a?aei?/aeiny oaeiae cieaeaiiy (ia 24%) eiioeaio?aoe?? caaaeueiiai aeooao?iio (P<0,05). Iieacieee aeoeaiino? NIAe ? aeooao?iiia?ieneaeace cieceeenue ia 15%, a aeooao?ii?aaeoeoace - ia 21% (P<0,05) (P<0,05). I?ae aieeaii EAI??Ae ?a?no?oaaeinue cia/ia (ia 25%) cieaeaiiy eiioeaio?aoe?? IAeA (P<0,05) ? a?aei?/aeany oaiaeaioe?y aei cieaeaiiy eiioeaio?aoe?? AeE (P>0.05). Aecia/aaeiny i?aeaeuaiiy (ia 25%)
eiioeaio?aoe?? caaaeueiiai aeooao?iio, a oaeiae (ia 31%) aeoeaiino? NIAe
(P<0,05). Aiane?aeie ii?aeiaiiai canoinoaaiiy IOO ? EAI??Ae o oai?eo ia OI, yeei aoei i?iaaaeaia iia?aoeaia ao?o/aiiy, ??ai? IAeA ? AeE caeeoaeeny a?eueoeie a?ae eiio?ieth a?aeiia?aeii ia 21 ? 30% (P<0,05). Eiioeaio?aoe?y caaaeueiiai aeooao?iio cieceeany ia 28% (P<0.05). E??i oiai, caa?oa? ia naaa oaaao ?noioia cieaeaiiy eiioeaio?aoe?? NIAe (ia 13%) (P<0,05), aeooao?iiia?ieneaeace (ia 14%) (p<0,05) ? aeooao?ii?aaeoeoace (ia 17%) (P<0,01). Ca oiiae canoinoaaiiy e?ii?ai? eeneioe (50,0 ia/ea, a/i, aea?/? ia aeiao i?ioyaii 2-3 oeaei?a) a?aei?/aeiny cieaeaiiy eiioeaio?aoe?? ye IAeA (ia 29%) (P<0,01), oae ? AeE (ia 35%) (P<0,05) o ii??aiyii? c iieacieeaie aei ii/aoeo e?eoaaiiy. Aoei a?aei?/aia oaeiae c?inoaiiy eiioeaio?aoe?? caaaeueiiai aeooao?iio ? eiai o?aeoe?e ia 44, 50 ? 21% a?aeiia?aeii (P<0.05). Aeoeai?noue NIAe c?inea ia 40%, a a?aeiia?aei? iieacieee aeooao?iiia?ieneaeace ? aeooao?ii?aaeoeoace - ia 20 ? 32% a?aeiia?aeii (P<0.05). A iiaeaeueoiio iaie aoei i?iaaaeaia aiaeia?/ia aeine?aeaeaiiy aieeao e?ii?ai? eeneioe, IOO ? EAI??Ae ia iiecieee IIE ? AIN o e?ia? oai?eo ia OI. Canoinoaaiiy aeaiiai eiiieaeno i?eaiaeeei aei cieaeaiiy ??aiy IAeA (ia 28%) ? AeE (ia 27%) (P<0,05) o ii??aiyii? c a?aeiia?aeieie iieacieeaie aei ii/aoeo e?eoaaiiy. Aoei a?aei?/aia oaeiae c?inoaiiy eiioeaio?aoe?? caaaeueiiai aeooao?iio ? eiai o?aeoe?e ia 35, 39 ? 22% a?aeiia?aeii (P<0.05). Aeoeai?noue NIAe c?inea ia 23% (P<0.01), a a?aeiia?aei? iieacieee aeooao?iiia?ieneaeace ? aeooao?ii?aaeoeoace - ia 18 ? 20% a?aeiia?aeii (P<0.05). O ?ac? aeei?enoaiiy a e?eoaaeueiieo eiiieaen? ?ioeo aioeieneaeaio?a - a?oai?io A (100 ia/aeiao, a/i)- ia niinoa??aaeiny ci?i ai?noo IAeA ? AeE o ii??aiyii? c ?o ??aiai aei ii/aoeo e?eoaaiiy (7 oai?eo). Eiioeaio?aoe?y caaaeueiiai aeooao?iio c?inea ia 14% (P>0,05),
aeoeai?noue aeooao?iiia?ieneaeace — ia 4,6% ? aeooao?ii?aaeoeoace — ia
5,5% (P>0,05). Canoinoaaiiy a?oai?io A o eiiieaen? c IOO ? EAI??Ae ia
i?eaiaeeei aei c?inoaiiy e?eoaaeueiiai aoaeoo, yeee a?aei?/aany i?e
ii?aeiaiiio canoinoaaii? IOO ? EAI??Ae.

Ca oiiae canoinoaaiiy IOO aeicith 0,1 a a?aei?/aeiny cieaeaiiy ai?noo
(-ienei?ie?io: eiai ??aaiue noaiiaea 10,7±0.9 ieiieue/e, a aeicith 0,2 a
— aei 7.9 ± 0.8 ieiieue/e, ui oaeiae aoei aeinoia??ii iaioei, i?ae o
eiio?ie? (P<0.05). I?e /an canoinoaaiiy EAI??Ae (o?eaae?noue aeniiceoe?? 10 oa.) ia ae?eyieo i?iaeoe?? IC, a naia ia ?? ia?aaeith i/a?aaeiio no?ieo, ?a?no?oaaeiny cieaeaiiy ??aiy (-ienei?ie?io aei 11,4±1,0 ieiieue/e (P>0,05), oei/anii /an ye a?eueo o?eaaea ae?y (30 oa.)
ni?e/eiyea ciaioaiiy ai?noo ai?iieeneioe aei 9,0±0,7 ieiieue/e (P<0,05). Ii?aeiaia canoinoaaiiy IOO (0,1 a) ?c EAI??Ae (10- oa. naaine) noi?iaiaeaeoaaeinue cieaeaiiyi ??aiy ai?iieeneioe aei 8,4±0,8 ieiieue/e (P<0,05). Iiae?ai? ci?ie a?aeaoaaeeny c ai?noii (-ienee?ceio a ieaci? e?ia? oai?eo ia OI. Ca oiiae ae?? e?ii?ai? eeneioe aeicaie ye 10, oae ? 25 ia ai?no aeine?aeaeoaaieo ai?iieeneio, oi/a ? cieaeoaaany o ii??aiyii? c oaeeie iieacieeaie o oai?eo ia OI aei ii/aoeo eiiieaeniiai e?eoaaiiy, iaeiae ?noioii ia a?ae??ciyany a?ae a?aeiia?aeieo cia/aiue (P>0,05). I?ae
aieeaii e?ii?ai? eeneioe aeicith 50,0 ia ??aaiue ienei?ie?io ciaiooaaany
aei 9,3±1,0 ieiieue/e, a ienee?ceio — aei 10,0±1,1 ieiieue/e (P<0,05). I?ae aieeaii e?ii?ai? eeneioe aeicith 25 ia, IOO - 0,1 a ? 10- oa. naain?a EAI??Ae niinoa??aaeiny ae?acia cieaeaiiy ??ai?a (-ienei?ie?io ? (-ienee?ceio a?aeiia?aeii aei 5,7±0,6 ? 6,3±0,7 ieiieue/e (P<0,05). A oiiaao ?icaeoeo OI o oai?eo, ye? iaee iieacaiiy aeey iia?aoeaiiai ao?o/aiiy, a?aeaoaaeiny c?inoaiiy aeoeaiino? oa?iaioo - aei 675,0±36,3 II/ie (P<0,05). Canoinoaaiiy e?ii?ai? eeneioe aeicith 25 ? 50 ia noi?iaiaeaeoaaeiny cia/iei cieaeaiiyi ??aiy aeine?aeaeoaaiiai oa?iaioo o ii??aiyii? c oaeei o a?oi? oai?eo ia OI aac e?eoaaiiy (P<0,05). Iaeiae aaee/eia aeoeaiino? oa?iaioo caeeoaeany a?eueoith a?ae oaei? o i?aeoe/ii caei?iaeo in?a (P<0,05). Aeaui iaio ae?acio ae?th ni?e/eiyee naaine EAI??Ae (10-oa.). I?ae aieeaii ii?aeiaiiai canoinoaaiiy e?ii?ai? eeneioe (25 ia), EAI??Ae (10 - oa. naaine) ? IOO (0,1 a) aaee/eia aeoeaiino? a?aeo?ii?aeace noaiiaeea 315,6±22,4 II/ie, ui aoei aeinoia??ii iaioei, i?ae o a?oiao niinoa?aaeaiiy, aea cae?enithaaee ie?aia canoinoaaiiy aeine?aeaeoaaieo /eiiee?a, aea ia?aaeuoaaea a?aeiia?aeiee iieaciee o a?oi? i?aeoe/ii caei?iaeo (P<0,05). Aecia/aiiy aeoeaiino? (-aetheiceaeac aeiaaei, ui c on?o aeine?aeaeoaaieo oa?iaio?a iaea?eueo ae?acieie aoee ci?ie aeoeaiino? N-aoeaoee-(-aetheicai?i?aeace. I?e oeueiio aaee/eia aeoeaiino? aeaiiai oa?iaioo o i?aeoe/ii caei?iaeo noaiiaeea 1,14±0,6 oi.i./ie ? ca oiia ?icaeoeo OI c?inoaea aei 5,2±0,9 oi.i./ie (P<0,05). I?ae aieeaii e?ii?ai? eeneioe (50 ia) niinoa??aaeinue cieaeaiiy aeoeaiino? aeine?aeaeoaaiiai oa?iaioo aei 2,7±0,9 oi.i./ie, ui ia a?ae??ciyeiny a?ae a?aeiia?aeieo aeaieo o i?aeoe/ii caei?iaeo ? o oai?eo ia OI, yeei ia i?iaaaeeeiny eiiieaenia e?eoaaiiy (P>0.05). Canoinoaaiiy EAI??Ae (10-
oa. naaine) ? IOO (0,1 a) ia ci?ithaaei ??aiy aeoeaiino?
N-aoeaoee-(-aetheicai?i?aeace, yeee noaiiaea 4,7±1,0 oi.i./ie (P>0,05).
Ii?aeiaia canoinoaaiiy e?ii?ai? eeneioe (25 ia), IOO (0,1 a) ? EAI??Ae
(10 — oa. naaine) i?ecaiaeeei aei cieaeaiiy ??aiy aeoeaiino?
N-aoeaoee-(-aetheicai?i?aeace, ui noaiiaea 1,8±0,7 oi.i./ie ? aoa
aeinoia??ii iaioei o ii??aiyii? c oaeei o oai?eo ia OI aac e?eoaaeueieo
ae?e (P<0,05). 3. A?aeaeaeai? ?acoeueoaoe eiiieaeniiai e?eoaaiiy OI Ie?aiei caaaeaiiyi ?iaioe aoei aea/aiiy a?aeaeaeaieo ?acoeueoao?a (a?ae 5 i?nyoe?a aei 5 ?ie?a c iiiaioo i?iaaaeaiiy iia?aoeaiiai e?eoaaiiy) eiiieaeniiai e?eoaaiiy oai?eo ia OI. I?e oeueiio aoei ianoaaeaii 59 oai?eo. ?c 59 oai?eo, o yeeo aoee aea/ai? a?aeaeaeai? ?acoeueoaoe o??o?a?/iiai e?eoaaiiy OI, 48 iaoe??io?a aoee i?ney iia?aoe?e aioo??oiueiai ae?aioaaiiy ? 11 - i?ney ?acaeoe?e IC. Aeia?ee ?acoeueoao niinoa??aaany o 50 oai?eo (84,7%), caaeia?eueiee – o 7 (11,9%) ? iacaaeia?eueiee – o 2 oai?eo (3,4%). On?i oai?ei, o yeeo niinoa??aaany iacaaeia?eueiee ?acoeueoao i?ney iia?aoeaiiai e?eoaaiiy, aoea aeeiiaia iia?aoe?y aioo??oiueiai ae?aioaaiiy. A iaeiiai oai?iai (i?ney aano?i- ? aeoiaeaiioeenoinoii??) ?a?no?oaaany ?aoeeaeea e?noe IC, yeee iio?aaoaaa iiaiai iia?aoeaiiai ao?o/aiiy. Ne?ae a?aei?oeoe, ui o a?oi? c aeia?ei ?acoeueoaoii 90% a?ae on?o iaoe??io?a io?eiaee eiiieaenia e?eoaaiiy ?c canoinoaaiiyi e?ii?ai? eeneioe, a oaeiae IOO ? EAI??Ae. O a?oi? iaoe??io?a, yeei i?iaaaeeeiny o?aaeeoe?eia e?eoaaiiy, o a?aeaeaeaiiio i?neyiia?aoe?eiiio ia??iae? ee?i?/ia neiioiiaoeea aoea aeinoaoiuei aa??aaaeueiith. I?e oeueiio o 19 oai?eo (59,4%) a?aei?/aii ?icaeoie i?enooiiiiae?aieo aie?a o aa?oi?e iieiaei? aeeaioa: a ai?aano??? (34%), i?aaiio ? e?aiio i?ae?aaa?’yo (25,4%). Eiiae? niinoa??aaeenue aieiaei? aie? (o 34,5%), ye? ia??aeei aeieeaee o i?/iee ia??iae /ano (19,8%). O?eaae?noue aieueiaiai neiae?iio aoea ??ciith ? o?eaaea a?ae 0,5 aei 3-5 aiae. o a?eueoino? (39,6%) iaoe??io?a, ?iiae? (o 22,7%) - 6- 8 aiae., a a aeayeeo oai?eo- e?eueea ae?a. O 33% oai?eo a?aei?/aeeny ae?acia cieaeaiiy aiaoeoo, ioaeioa, ia??iaee/ii aeieeath/a aethaaiiy ia aenio? aieueiaiai iaiaaeo, a?ae?eaoaaiiy ? ia/?y, caii?e, ??aeea aeii?iaeiaiiy eaeo i?ae /an caaino?aiiy oai?iae (21 %); o o?aoeie iaoe??io?a ?a?no?oaaeiny cieaeaiiy iane o?ea (?iiae? ia 9-14 ea). Aeine?aeaeaiiy ciai?oiuei? nae?aoe?? IC aoei i?iaaaeaia o 20 iaoe??io?a ia a?aeaeaeaieo no?ieao i?ney canoinoaaiiy ?ic?iaeaiiai e?eoaaeueiiai eiiieaeno. Aeey noeioeyoe?? nae?aoi?ii? aeoeaiino? aeei?enoiaoaaeinue oaaaeaiiy nae?aoeio (1 IAe/ea) ? iaie?aicei?io (1 IAe/ea). Aeine?aeaeaiiy aeacaieo oei?a nae?aoe?? nieo IC o oai?eo, yeei i?iaaaeeee eiiieaenia e?eoaaiiy ca ?ic?iaeaiei iaoiaeii, aeyaeei, ui oa oeeo oiia cia/iith i??ith ci?ithaaeinue ?o ni?aa?aeiioaiiy (Oaae.1.). A aeaieo oiiaao aecia/aeinue i?aaaethaaiiy a?ia?nae?aoi?ieo a?aeiia?aeae (aei 77,8%), ui na?ae/eei i?i aeia?ee ooieoe?iiaeueiee noai ia?aio?ie IC. Aaaeeeaei oaeiae aoei e oa, ui ca aeaieo oiia na?aaeiy e?euee?noue io?eioaaiiai nieo aoea cia/ii a?eueoith, i?ae o aeiaaeeo noeioeyoe?? o oai?eo, yeei i?iaaaeeee o?aaeeoe?eia e?eoaaiiy, (870,5(25,6 ie) (P<0,05 o ii??aiyii? c iieacieeii o a?oi? oai?eo, ui io?eioaaee o?aaeeoe?eia e?eoaaiiy). Ia a?eueo ae?acia caa??aaiiy a oe?eino? ooieoe?iiaeueiiai noaio ia?aio?ie IC aeacoaaei oaeiae yaia cieaeaiiy e?eueeino? a?iinae?aoi?ieo a?aeiia?aeae, ye? a aeai?e a?oi? noaiiaeee 18,5% (P<0,025). Oaaeeoey 1 Oeie nae?aoi?ieo a?aeiia?aeae ia noeioeyoe?th nae?aoeiii ? iaie?aicei?iii a caeaaeiino? a?ae oa?aeoa?o iiia?aaeiueiai e?eoaaiiy oai?eo ia OI. Oa?aeoa? nae?aoi?ii? a?aeiia?ae? O?aaeeoe?eia e?eoaaiiy (n=32) E?eoaaiiy ca ?ic?iaeaiith iaoiaeeeith (n=27) A?ia?nae?aoi?iee 11(34,4%) 21(77,8%)* A?iinae?aoi?iee 17(53,1%) 5(18,5%)* Iaoo?aoeaiee 1(3,1%) -(0) A?ia?aeoeaiee 3(9,4%) 1(3,7%) I?ei?oea: *- P<0,025 (oi/iee e?eoa??e O?oa?a aeey /aoe?eiieueii? oaaeeoe?). Oaeei /eiii, ia a?aeaeaeaiiio ia??iae? i?ney oaaaeaiiy aei e?eoaaeueiiai eiiieaeno EE a?aei?/a?oueny a?eueoa ooieoe?iiaeueia caa?aaeaiiy a oe?eino? aecie?eiii? /anoeie IC. Aaaeeeaei aoaeoii uiaei oaaaeaiiy aei e?eoaaeueiiai eiiieaeno EE aoei oaeiae cieaeaiiy ae?aciino? aieueiaiai neiae?iio: o a?oi? oai?eo, yeei canoiniaoaaee a eiiieaeniiio e?eoaaii? IOO ? EAI??Ae, aieueiaee neiae?ii a?aei?/aany o 40,0% niinoa?aaeaiue, oei/anii ye o oai?eo, yeei canoiniaoaaee IOO, EAI??Ae ? EE, - o 3,7% (P<0,025). Ona?aaeiai? ?acoeueoaoe uiaei aecia/aiiy aeoeaiino? oa?iaio?a o ieaci? e?ia? o oai?eo ia OI, ye? i?aeeyaaee ??ciei aeaeai eiiieaeniiai e?eoaaiiy, iaaaaeai? o Oaae. 2. I?ney i?iaaaeaiiy o?aaeeoe?eiiai eiiieaeniiai e?eoaaiiy o oai?eo aecia/aany aenieee ai?no o?eineio (ia 56,2% a?eueoee, i?ae o i?aeoe/ii caei?iaeo in?a) (?<0,05), iecueeee ??aaiue ?ia?a?oi?a o?eineio, yeee noaiiaea 69,1% o ii??aiyii? ?c eiio?ieai (P<0,001), a oaeiae aenieee ??aaiue ai?eace (ia 52,5% a?eueoee, i?ae o eiio?ie?) (?<0,01). Oaeiae a?eueo aenieei, i?ae o eiio?ie?, aoa ??aaiue e?iace (ia 39,9%) (?<0,05). I?e i?iaaaeaii? eiiieaeniiai e?eoaaiiy ?c canoinoaaiiyi eiiieaeno IOO+EAI??Ae aeoeai?noue o?eineio ia a?ae??ciyeanue a?ae eiio?ieueiiai cia/aiiy (?>
0,05), ?ia?a?oi?a o?eineio — caeeoaeanue a?eueo iecueeith, i?ae o
eiio?ie? (ia 13,9%) (?<0,01), aeoeai?noue ai?eace oaeiae aoea a?eueo aenieith, i?ae o a?oi? eiio?ieueieo niinoa?aaeaiue (ia 45,6%) (?<0,01), aeoeai?noue e?iace iacia/ii ia?aaeuoaaea eiio?ieueia cia/aiiy (ia 13,7%) (P>0,05). O ?ac? e?eoaaiiy ?c canoinoaaiiyi EE aeine?aeaeoaai? iieacieee
ia a?ae??ciyeenue a?ae eiio?ieueieo cia/aiue (Oaae. 2).

Oaaeeoey 2

Ci?ie oa?iaioaoeaii? aeoeaiino? ieacie e?ia? o oai?eo ia OI a oiiaao
eiiieaeniiai e?eoaaiiy

Eiio?ieue (i?aeoe/ii caei?ia?)

(n=16)

OI

(n=12) OI+ eiiieaenia

o?aaeeoe?eia

e?eoaaiiy

(n=15) OI+e?ii?aa eeneioa+ IOO+EAI??Ae

(n=27)

O?einei

(iiieue/n.e.) 26,9(4,3

41,6( 5,6* 38,7( 5,2 30,0( 4,2

?ia?a?oi? o?eineio

(ieiieue/n.e.) 10,2( 0,3

7,2(0,3*** 8,9( 0,3** 9,7( 0,4

Ai?eaca

(a//.e.) 869,2( 73,2 1330,5( 123,6** 1278,4( 113,4** 965,5( 72,6

E?iaca

(ieiieue/n.e.) 565,3( 62,8 792,6( 81,7* 650,2( 73,4 550,3( 54,5

I?ei?oea: *-P<0,05; **-P<0,01; ***-P<0,001 o ii??aiyii? c iieacieeaie o a?oi? i?aeoe/ii caei?iaeo in?a. Ii??aiyeueiee aiae?c iieaciee?a noaio O- ? A-nenoai ?ioi?oaoo aeyaea a?aenooi?noue ci?i ?ioiieia?/ieo iieaciee?a o i?ioean? o?aaeeoe?eiiai e?eoaaiiy. A a?oi? oai?eo, e?eoaaiiy yeeo cae?enithaaeiny c aeei?enoaiiyi IOO ? EAI??Ae, ae??n ??aaiue caaaeueii? iiioeyoe?? O-Eo (a?ae 38,2 ± 3,1 aei 57,6 ±2,6, ?<0,01), ? cieceany ?iaeaen ni?aa?aeiioaiiy caaaeueieo iiioeyoe?e A/O. Aiane?aeie canoinoaaiiy EE, IOO ? EAI??Ae a?aei?/aeinue ia o?eueee c?inoaiiy O-Eo (a?ae 42,6 ± 2,7 % aei 67,3 ± 2,2 %; ? < 0,01), aea e iaaia aeoeaaoe?y iiioeyoe?? A-nenoaie c i?aeaeuaiiyi iieacieea A-Eo (a?ae 17,5 ± 1,4 % aei 26,7 ± 1,5 % ; ? < 0,01). Aeyaeyeinue oaeiae cieaeaiiy ??ai?a oee?eoethth/eo ?ioiieo eiiieaen?a: a?ae 12,4 ± 1,1 aei 6,1 ± 1,3 aeey OeEE-315 (? < 0,001) ? a?ae 7,9 ± 2,2 aei 3,9 ± 0,8 aeey OeEE-400 (? < 0,01). Aeine?aeaeaiiy a?io?i?/ieo iieaciee?a IIE o e?ia? oai?eo ia a?aeaeaeaiiio ia??iae? aeiaaei, ui a oiiaao o?aaeeoe?eiiai e?eoaaiiy ?a?no?oaaeinue oaea: cieaeaiiy caaaeueiiai oieanoa?eio a 5,5 ?aco o ii??aiyii? c ??aiai aeaiiai iieacieea aei ii/aoeo eiiieaeniiai e?eoaaiiy (P<0,001); cieaeaiiy ??aiy aaoa-e?iii?ioa?i?a - o 1,5 ?aco (P<0,001); cieaeaiiy ia?aeenii? ?acenoaioiino? a?eo?ioeeo?a - o 1,52 ?aco (P<0,05). Oei /anii ?a?no?oaaeiny ia?noioia c?inoaiiy ??aiy IAeA - ia 12% (P>0,05), a oaeiae aeinoia??ia o ii??aiyii? c ??aiai aei ii/aoeo
eiiieaeniiai e?eoaaiiy i?aeaeuaiiy aeoeaiino? eaoaeace (ia 15%),
oea?oeiieaci?io (ia 25%) ? NIAe ( ia 14%). I?ae aieeaii eiiieaeniiai
e?eoaaiiy oai?eo c oaaaeaiiyi eiiieaeno IOO+EAI??Ae a?aei?/aeinue
?noioia cieaeaiiy ??aiy oieanoa?eio- ia 37% o ii??aiyii? c eiai ??aiai
aei ii/aoeo e?eoaaiiy (P<0.001); ciaioaiiy aaoa-e?iii?ioa?i?a ia 11%, ui ia a?ae??ciyeiny a?ae ai?noo aeaieo niieoe aei ii/aoeo e?eoaaiiy; oei/anii ye cieaeaiiy ai?noo IAeA aoei ?noioiei (ia 42%; P<0,05). O ?acoeueoao? i?iaaaeaiiai e?eoaaiiy ia 33% cieceeenue iieacieee ia?aeenii? ?acenoaioiino? a?eo?ioeeo?a e ?noioii c?inea aeoeai?noue eaoaeace- ia 14%, oea?oeiieaci?io - ia 40% ? NIAe - ia 54% (P<0,001). I?ae aieeaii eiiieaeno EE+IOO+EAI??Ae ?noioii cieceeany eiioeaio?aoe?y caaaeueiiai oieanoa?eio (ia 43%; P<0,001), (-e?iii?ioa?i?a (ia 28%) ? IAeA (ia 70%), ii?iae?coaaany iieaciee ia?aeenii? ?acenoaioiino? a?eo?ioeeo?a, ia 20% c?inea aeoeai?noue eaoaeace, a 1,44 ?aco i?aeaeueany ai?no aiaeiaaiiiai oea?oeiieaci?io (P<0,01), ia 60% c?inea aeoeai?noue NIAe (P<0.01). Ca?aeii iieaciee?a i?ioan?eii? ?aaa?e?oaoe?? i?ae aieeaii o?aaeeoe?eii? oa?ai?? oi?io? ?acoeueoaoe niinoa??aaeenue a 35,2%, caaeia?euei?- 42,6%, oa iacaaeia?euei?- a 22,2%, a oie /an ye i?e aeei?enoaii? ?ic?iaeaiiai eiiieaeniiai iaoiaeo oe? iieacieee neeaee a?aeiia?aeii 84,7%, 11,9% oa 3,4%. I?e oeueiio aei aeeiiaiiy nai?o i?ioan?eieo iaiayce?a i?enooieee 91% oai?eo, yeei i?iaiaeeee e?eoaaiiy ca ?ic?iaeaiei iaoiaeii, a oie /an ye a a?oi? c o?aaeeoe?eiei e?eoaaiiyi- 69%. AENIIAEE ?icaeoie aenia?eiaioaeueiiai iaie?aaoeoo, ?iaeoeiaaiiai caii?iaeoaaiiyi oeaieie IC ia oii? nenoaiiiai canoinoaaiiy no?aioicioioeeio, oa?aeoa?eco?oueny oaeei: o?eaaeith oa?iaioaoe??th (8 oeaei?a a?ae iiiaioo caii?iaeoaaiiy IC); i?aeaeuaiiyi aeoeaiino? a?oeao?ii?aeace, eenei? oinoaoace, ??ai?a b-ienei?ie?io ? b-ienee?ceio a ieaci? e?ia?; ?ioaineo?eaoe??th IIE; cieaeaiiyi aioeieneaeaioiiai caoenoo, a oaeiae ?icaeoeii i?aeaeuaii? aieueiai? /ooeeaino? oaa?ei, ui iiaeia ?icaeyaeaoe ye iiaeaeue OI. EE ni?e/eiy? aeica- caeaaeiee aoaeo cieaeaiiy oa?iaioai??, iieaciee?a IIE, aioeieneaeaioii? oa?iaioaoeaii? aeoeaiino? a?aeo?ii?aeace, eenei? oanoaoace, (-ienei?ie?io, (-ienee?ceio aae aei aoaeo?a iiaiiai aeieoaaiiy ii?ooaiue i?ae aieeaii aeniei? aeice e?ii?ai? eeneioe (50,0 ia/ea). Oeacai? aoaeoe EE iineeththoueny i?ae aieeaii eiai ii?aeiaiiai canoinoaaiiy c IOO ? EAI??Ae. Aieueiaee neiae?ii, ui ? oa?aeoa?iei aeey i?iya?a OI, i?aeeyaa? ?noioi?e ?aaeoeoe?? ia a?aeaeaeaiiio ia??iae? o oai?eo, yeei i?iaiaeeee eiiieaenia e?eoaaiiy c aeeth/aiiyi EE. Aeaiee aoaeo EE ? a?eueo ae?aciei o ii??aiyii? c aoaeoii ii?aeiaiiai canoinoaaiiy IOO ? EAI??Ae, a oaaaeaiiy aei e?eoaaeueiiai eiiieaeno IOO ? EAI??Ae iineeth? ae?th EE. Aeoiaey/e c ?acoeueoao?a aeine?aeaeaiiy aoaeo?a noeioeueiaaii? nae?aoe?? IC, iiaeia ae?eoe aeniiaeo, ui a oiiaao eiiieaeniiai e?eoaaiiy, yea i?noeoue canoinoaaiiy EE, IOO ? EAI??Ae, ?noioii iie?auothoueny a?aeaeaeai? ?acoeueoaoe e?eoaaiiy oai?eo ia OI, caa??aa?oueny ooieoe?iiaeueia caeaoi?noue aecie?eiii? /anoeie IC, yea aecia/a?oueny o oanoao noeioeyoe?? nae?aoe?? c nae?aoeiii ? iaie?aicei?iii. Ii??aiyiiy aoaeoeaiino? ?ic?iaeaiiai e?eoaaeueiiai eiiieaeno (EE, IOO+EAI??Ae) ?c ?ai?oa ?ic?iaeaiei eiiieaeniei iaoiaeii e?eoaaiiy, yeee i?noeoue o?eueee IOO ? EAI??Ae, aeiaaei eiai aaeeeo aoaeoeai?noue a?aeiinii caa?aaeaiiy o oe?eino? aiaeie?eiii? ooieoe?? IC ia a?aeaeaeaiiio ia??iae? OI ye ca iieacieeii aacaeueii? ?ie?aoe?? ?inoe?io, oae ? aetheaaiio. Canoinoaaiiy EE o eiiieaen? e?eoaaeueieo caoiae?a o oai?eo ia OI caaacia/o? ia a?aeaeaeaiiio ia??iae? ii?iae?caoe?th iieaciee?a ?ioiieia?/ii? ?aaeoeaiino?: noaio O- ee?oeiii? eaiee ?ioi?oaoo, oee?eoethth/eo ?ioiieo eiiieaen?a, a oaeiae iieaciee?a IIE ? oa?iaioaoeaii? eaiee aioeieneaeaioii? nenoaie. Aeeoa?aioe?eiaaiee i?aeo?ae aei aeai?o iia?aoe?e ae?aioaaiiy ? ?acaeoe?? IC aeicaiey? aeinyaoe aeia?eo ?acoeueoao?a e?eoaaiiy o 84,7% ? caaeia?eueieo- o 11,9%. Aeei?enoaiiy EE nooo?ai aieeaa? ia ni?eyoeeaee ia?aa?a ye iaaee/ii?, oae ? i?ioan?eii? ?aaa?e?oaoe?? ii?ye?a, ye? i?enooiathoue aei ?iaioe ca niaoe?aeuei?noth ia noaeiao o no?iee a?ae 3 aei 12 i?nyoe?a c iiiaioo i?iaaaeaiiy eiiieaeniiai e?eoaaiiy. I?AEOE*I? ?AEIIAIAeAOe?? C iaoith iaea?eo aoaeoeaiiai i?iaaaeaiiy eiiieaeniiai e?eoaaiiy ii?ye?a, ye? no?aaeaeathoue ia OI, iaiao?aeii aei eiiieaeno e?eoaaeueieo caoiae?a aeeth/eoe EE, yeo ne?ae canoiniaoaaoe o aeaeyae? aeaio- /ioe?eoeaeiaaiai eo?no aioo??oiueii’yciaeo ?i’?eoe?e ?c ?ic?aooieo ii 50 ia aea?/? ia aeiao. Ca oiiae canoinoaaiiy EE ca aeacaiith noaiith c?inoa? oa?aiaaoe/ia aoaeoeai?noue canoinoaaiiy eiiieaeno IOO+EAI??Ae (a?aeiia?aeii ii 0,1 a i?ioyaii 5 aei. aioo??oiueiaaiii ? o?eaeiaiaa ii?ii?iaiiy i?iaeoe?? IC aea?/? ia aeaiue ii 10 oa. ca aeiiiiiaith aia?aoa "Oci?" c aeo?aeiith iiooaei?noth 3 Ao, 300 Aoe, aeiaaeeiith oaee? 0,89- 0,95 iei). Aeaiee iaoiae iiaea aooe canoiniaaiei a oiiaao ii?nueeiai ?aeno. NIENIE I?AOeUe, IIOAE?EIAAIEO CA OAIITH AeENA?OAOe?? Aeei?enoaiiy iaioieneo?e?io aeey e?eoaaiiy aenia?eiaioaeueiiai iaie?aiiae?ico//AEo?iae Aeaaeai?? Iaaee/ieo iaoe.- 1998.- O.4,?3.- N. 530- 538 (a ni?aaao. c Eiaaieii A.I., Caii?iae/aieii A.N., Oaiae?ith I.A., Aiaeeaanueeei E.N.). Oa/aiea iineaiia?aoeeiiiiai ia?eiaea o aieueiuo o?iie/aneei iaie?aaoeoii a oneiaeyo i?eiaiaiey iaioieneoeeeeia e eio?ae?aniiai eaca?iiai eceo/aiey ieceie eioaineaiinoe//A?niee ii?nueei? iaaeeoeeie.- 1998.- ?2.- N. 25-27. ?ae iiaeaeaeoaei/iie aeaeacu: aiciiaeiinoe ?aaeeeaeueiiai ea/aiey a ioaeaeaiee iauaoe?o?ae/aneiai i?ioeey//Aiiaeu oe?o?ae/aneie aaiaoieiaee.- 1998.- O.3,?3.- N.222- 223 (a niaao. n Caii?iae/aiei A.N., Oeoeia(i A.E., Ai?aoiia(i A.A., Ai?iaeaaa(i E.A.). Canoinoaaiiy aioeieneaeaio?a o i?aoe?aiee?a ii?nueeiai o?ainii?oo, iia?iaaieo c i?eaiaeo o?ii?/iiai iaie?aaoeoo//A?niee ii?nueei? iaaeeoeeie.- 1999.- ?1.- N. 33. Aeei?enoaiiy e?ii?ai? eeneioe (EE) oa iaioieneo?e?io (IOO) a i?neyiia?aoe?eiiio ia??iae? o i?aoe?aiee?a ii?nueeiai o?ainii?oo, oai?eo ia o?ii?/iee iaie?aaoeo (OI)//A?niee ii?nueei? iaaeeoeeie.- 1999.- ?1.- N. (a ni?aaao. c Caii?iae/aieii A.N.) Oe?o?ae/aneay oaeoeea i?e iaie?aiiae?ica//A na. iao/iuo ?aaio "II-e Eiia?an o??o?a?a Oe?a?ie".- Ee?a- Aeiiaoeuee, Aeae. "Ee?i?/ia o??o?a?y".- 1998.- N.112- 113 (a niaao. n Caii?iae/aiei A.N., Oeoeia(i A.E., Iaoiaiei A.A., Ai?aoiia(i A.A., Ieuaiei A.A.). AIIOAOe?? Iiacoi I.A. Iaaeeoeeineay e i?ioanneiiaeueiay ?aaaeeeoaoeey ?aaioieeia ii?neiai o?ainii?oa, eioi?ua no?aaeatho o?iie/aneei iaie?aaoeoii.- ?oeiienue. Aeenna?oaoeey ia nieneaiea o/aiie noaiaie eaiaeeaeaoa iaaeeoeeineeo iaoe ii niaoeeaeueiinoe 14.01.34- aaeaoeeiiiay, einie/aneay e ii?neay iaaeeoeeia.- Ainoaea?noaaiiia i?aaei?eyoea "Oe?aeineee iao/ii- enneaaeiaaoaeueneee einoeooo ii?neie iaaeeoeeiu". Enneaaeiaaiea iinayuaii i?iaeaia iaoiaaiaoe/aneiai iainiiaaiey iiaeoiaeia e eiiieaeniiio ea/aieth OI o ?aaioieeia ii?neiai o?ainii?oa. A oneiaeyo o?iie/aneiai yenia?eiaioa iieacaii oi?ie?iaaiea o?iie/aneiai yieeaioiaaiaca i?e ni/aoaiiii i?eiaiaiee caii?aaeeaaiey oeaie aeaeacu e aaaaeaiee no?aioicioioeeia, ieacuaathuaai oiene/aneee yooaeo a ioiioaiee oeaie IAE. A aeaiiuo oneiaeyo ia ainueiie iaaeaea n iiiaioa aicaeaenoaee o aeeaioiuo ioia/aeenue i?iyaeaiey, oa?aeoa?iua aeey OI: aunieay aeoeaiinoue o?eineia, aieeacu, eeiacu, ieceee o?iaaiue eiaeaeoi?a o?eineia, iiauoaiea eioaineaiinoe ia?aeeniuo i?ioeannia, aunieay aieaaay /oanoaeoaeueiinoue. A oneiaeyo aeaiiie iiaeaee auei iieacaii, /oi EE e IOO ieacuaatho aeica- caeaeneiia oa?aaiaaoe/aneia aeaenoaea, a EEIEEAe i?e n?aaeiae aeeeoaeueiinoe naaina (30 iei) oaeaea aucuaaao nieaeaiea oa?iaioaiee. Ni/aoaiea EE n eiiieaenii IOO+ EEIEEAe nii?iaiaeaeaaony iieiie eiiiainaoeeae iaoieiae/aneeo i?iyaeaiee. Iioaioee?iaaiea oa?aiaaoe/aneeo yooaeoia iiae aeeyieai EE ioia/aeinue oaeaea a ioiioaiee iiauoaiiuo a nayce n OI iieacaoaeae ia?aeeniiai ieeneaiey eeieaeia, b-ienei?ieeia e b-ieneeeceia, aeaeo?iieaeacu, eeneie oinoaoacu, a oaeaea aieaaiai neiae?iia. A ?aaioa i?aaenoaaeaiu ?acoeueoaou ianeaaeiaaii 127 aieueiuo - ii?yeia no?aaeathueo OI, ec eioi?uo 69 iaoeeaioia iieo/eee eiiieaeniia oe?o?ae/aneia ea/aiea, inoaeueiui auei i?iaaaeaii eiiieaeniia eiina?aaoeaiia ea/aiea n i?eiaiaieai EE a ni/aoaiee n IOO e EEIEEAe. Eiio?ieueioth a?oiio ninoaaeee 32 aieueiuo, iieo/eaoeo eo?n o?aaeeoeeiiiiai ea/aiey. I?eiaiaiea EE, IOO e EEIEEAe i?eaiaeeei e nieaeaieth o?iaiy IAeA e AeE a n?aaiaiee n niioaaonoaothueie iieacaoaeyie aei ia/aea ea/aiey. Auei ioia/aii oaeaea oaaee/aiea eiioeaio?aoeee iauaai aeooaoeiia e aai o?aeoeee, aeoeaiinoe NIAe, iieacaoaeae aeooaoeiiia?ieneaeacu e aeooaoeii?aaeoeoacu. Aeeth/aiea a eiiieaen aeoaieia A (100 ia/nooee) ia nii?iaiaeaeaeinue oneeaieai oa?aiaaoe/aneiai aeaenoaey eiiieaena IOO+ EEIEEAe. Iiae aeeyieai EE (25 ia), IOO - 0,1 a e 10- iei naainia EEIEEAe iaaethaeaeinue au?aaeaiiia nieaeaiea o?iaiy (-ienei?ieeia e (-ieneeeceia. E?iia yoiai, iiae aeeyieai ?ac?aaioaiiiai ea/aaiiai eiiieaena iaaethaeaeanue ii?iaeecaoeey aeoeaiinoe aeaeo?iieaeacu, N-aoeaoee-(-aetheicaieieaeacu. A oneiaeyo i?eiaiaiey ?ac?aaioaiiiai iaoiaea ea/aiey OI oi?ioee ?acoeueoao iaaethaeaeny o 50 aieueiuo (84,7%), oaeiaeaoai?eoaeueiue –o 7 (11,9%) e iaoaeiaeaoai?eoaeueiue – o 2 aieueiuo (3,4%). A oneiaeyo i?eiaiaiey aeaiiiai eiiieaena a ioaeaeaiiii ia?eiaea ioia/aeanue au?aaeaiiay ii?iaeecaoeey iieacaoaeae eiioiieiae/aneie ?aaeoeaiinoe (O- e A- eeioioeeoa?iie nenoaiu), iieacaoaeae noeioee?iaaiiie nae?aoeee (nae?aoei, iaie?aiceiei), o?iaiy iaie?aaoe/aneeo oa?iaioia a e?iae iaoeeaioia, a oaeaea iieacaoaeae IIE. Oaeei ia?acii, eiiieaeniay ioeaiee ?acoeueoaoia i?eiaiaiey EE iieacuaaao aa aunieoth yooaeoeaiinoue o aieueiuo OI- ?aaioieeia aiaeiiai o?ainii?oa. Eeth/aaua neiaa: o?iie/aneee iaie?aaoeo, ii?neie o?ainii?o, eeiiaaay eeneioa, iaioieneoeeeei, eio?ae?aniia eaca?iia eceo/aiea ieceie eioaineaiinoe. Iiacoi I.A. Iaaee/ia oa i?ioan?eia ?aaa?e?oaoe?y i?aoe?aiee?a ii?nueeiai o?ainii?oo, ye? no?aaeaeathoue ia o?ii?/iee iaie?aaoeo.- ?oeiien. Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe ca niaoe?aeuei?noth 14.01.34- aa?aoe?eia, eini?/ia oa ii?nueea iaaeeoeeia.- Aea?aeaaia i?aei?e?inoai "Oe?a?inueeee iaoeiai- aeine?aeiee ?inoeooo ii?nueei? iaaeeoeeie". Caaaeaiiyi aeine?aeaeaiiy aoeia aecia/aiiy aoaeoeaiino? canoinoaaiiy e?ii?ai? eeneioe o eiiieaeniiio e?eoaaii? ii?yeua- oai?eo ia OI. Ca oiia aenia?eiaioo ia iiaeae? OI o uo??a, ui a?aeoai?thaaeanue oeyoii caii?iaeaiiy oeaieie caeice ia oii? canoinoaaiiy no?aioicioioeeio aeiaaaeaii iie?auaiiy ia?aa?ao caoai?thaaiiy ye iuae aieeaii naiino?eiiai canoinoaaiiy EE, oae ? i?e ?? eiiieaeniiio aeei?enoaii? c IOO oa E?I??Ae. O ii?ye?a- oai?eo ia OI, ye? io?eiaee o??o?a?/ia e?eoaaiiy (69 in?a), oa eiiieaenia eiina?aaoeaia e?eoaaiiy (57 in?a) anoaiiaeaii a?eueoo aoaeoeai?noue o canoinoaaiiy ?ic?iaeaiiai e?eoaaeueiiai eiiieaeno o a?aeiioaii? aei ii?iae?caoe?? iieaciee?a IIE, oa?iaioaoeaii? aeoeaiino? e?ia? (o?einei, ai?eaca, e?iaca, ?ia?a?oi? o?eineio), a?aeo?ii?aeaca, aetheiceaeace, ??aiy ienei?ie?io oa ienee?ceio. I?inoaaeai? o a?aeaeaeaiiio ia??iae? (a?ae 5 i?nyoe?a aei 5 ?ie?a) ?acoeueoaoe cana?ae/eee oaeiae ae?acio oa?aiaaoe/io aoaeoeai?noue- ca?aeii iieaciee?a oa?iaioaoeaii? aeoeaiino? e?ia?, ?ioiieia?/ii? ?aaeoeaiino?. Eeth/ia? neiaa: o?ii?/iee iaie?aaoeo, ii?nueeee o?ainii?o, e?ii?aa eeneioa, iaioieneo?e?i, ?io?a/a?aiia eaca?ia aei?ii?ithaaiiy iecueei? ?ioaineaiino?. Povzun P.A. Medical and professional rehabilitation of sailors who suffer from chronic pancreatitis.- Manuscript. Thesis for a candidate's degree by speciality 14.01.34- air- fly, marine and space medicine.- Governmental structure "Ukrainian Research Institute of Marine Medicine". The efficacy of lipoic acid in complex treatment of sailors suffered from cnronic pancreatitis was determined. Under condition of experimental modeling of chronic pancreatitis in rats via frozening of pancreatic tissue with the preliminar administration of streptozotocin the improvement of the pathological disease development both in case of lipoic acid and it’s coadminsitration with pentoxyphillin and infrared laser irradiation of low intenisty was shown. In sailors who were treated surgically (69 patients) and those who were not operated on (57 patients) the more pronounced efficacy of worked complex method of treatment was shown with regard to processes of peroxidation, enzymatic activity of blood (tripsin, amylasem lipase, inhibitor of tripsin), hyaluronidase, glucosidase, level of oxyproline and oxylisine. During the postponed period (from 5 months up to 5 years) the pronounced therapeutic efficacy was evident with regard to enzymatic activity of blood abd immunological activity. Key words: chronic pancreatit, marine transport, lipoic acid, pentoxyphillin, infrared laser irradiation of low intensity. PAGE 3 PAGE 3

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