I?i?noa?noai ioi?iie caei?ia’y Oe?a?ie

Ee?anueea iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe

?i. I.E.Ooieea

E?aa/aiei Oaoyia Aai?a??aia

OAeE 616.344-002-031.84-08-039.73-089

IIOEI?CAOe?ss IIEACAIUe

AeI AEAI?O OAEOEEE E?EOAAIIss

OAI?IAE E?IIA OIIEI? ? OIANOI? EEOIE

14.01.03 — o??o?a?y

Aaoi?aoa?ao

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Ee?a – 1999

Aeena?oaoe??th ? ?oeiien

?iaioa aeeiiaia a Iaoe?iiaeueiiio iaaee/iiio oi?aa?neoao? ?i.
I.I.Aiaiiieueoey IIC Oe?a?ie (i.Ee?a).

Iaoeiaee ea??aiee:

Aeieoi? iaaee/ieo iaoe, i?ioani?

AAEOAEO?N THE?E A?EOI?IAE*,

caa?aeoaa/ eaoaae?e oaeoeueoaonueei? o??o?a?? ?1 Iaoe?iiaeueiiai
iaaee/iiai oi?aa?neoaoo ?i.I.I.Aiaiiieueoey IIC Oe?a?ie.

Io?oe?ei? iiiiaioe:

1. Aeieoi? iaaee/ieo iaoe, i?ioani?

?AAeC?OIANUeEEE AIAOIE?E IAAEIAE*,

caa?aeoaa/ eaoaae?e o??o?a?? oa ii?eiai? oai?iae Ee?anueei? iaaee/ii?
aeaaeai?? i?neyaeeieiiii? ina?oe ?i.I.E.Ooieea IIC Oe?a?ie.

2. Aeieoi? iaaee/ieo iaoe, noa?oee iaoeiaee ni?a?ia?oiee

EEEIOUe AIEIAeEIE? IIOO??EIAE*,

noa?oee iaoeiaee ni?a?ia?oiee a?aeae?eo aaaeii?iaeueii? iieieia??
Oe?a?inueeiai iaoeiai-aeine?aeiiai ?inoeoooo iieieia?? oa ?aae?ieia??
IIC Oe?a?ie.

I?ia?aeia onoaiiaa:

?inoeooo ee?i?/ii? oa aenia?eiaioaeueii? o??o?a?? AII Oe?a?ie, a?aeae?e
o??o?a?? oeoieiai-eeoeiaiai o?aeoo.

Caoeno a?aeaoaeaoueny 05.11.1999 ?ieo i14 aiaeei? ia can?aeaii?
niaoe?ae?ciaaii? a/aii? ?aaee Ae 26.613.02

i?e Ee?anuee?e iaaee/i?e aeaaeai?? i?neyaeeieiiii? ina?oe ?i.I.E.Ooieea.
(254112, i. Ee?a, aoe. Aei?iaiaeeoeueea, 9).

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? Ee?anueei? iaaee/ii?
aeaaeai?? i?neyaeeieiiii? ina?oe ?i.I.E.Ooieea.

(i.Ee?a, aoe. Aei?iaiaeeoeueea, 9).

Aaoi?aoa?ao ?ic?neaiee 05.10. 1999 ?ieo.

A/aiee nae?aoa?

niaoe?aeiciaaii? ?aaee,

e.i.i., aeioeaio
I.I. Aaicaeye

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie Aeooaeuei?noue i?iaeaie oai?iae E?iia (OE)
iaoiiaeaia ye iaaee/ieie, oae ? nioe?aeueieie oaeoi?aie.

Nioe?aeueiee aniaeo i?iaeaie iieyaa? o anac?inoath/iio ??ai? ia?aeiii?
caoai?thaaiino?, yea ui??/ii nyaa? 5-10 iiaeo aeiaaee?a ia 100000
ianaeaiiy (V.Binder,1995). I?e ia?aeiii? caoai?thaaiino? i?eiaaea? ia
ae?oao oa o?aoth aeaeaaee aeeooy, ioaea ? iaea?eueoa e?euee?noue
caoai??aoeo — iniae iieiaeiai, iaea?eueo i?aoeacaeaoiiai a?eo (P.R.
Eliot, 1992; J.Emmrich, 1998).

Iaaee/iee aniaeo i?iaeaie oa?aeoa?eco?oueny iaeiaea/aiei
ao?iiaoiaaiacii, oyaeeei iai?iaiiciaaiei ia?aa?aii, a?aenooi?noth
ia’?eoeaieo e?eoa???a ioe?iee noaio iaoe??io?a oa noa’?eoeai?noth o
aeai?? e?eoaaeueii? oaeoeee (G.D’Haens, 1998; A.Otley,1999).

Eiina?aaoeaia e?eoaaiiy OE iaeiaoaeoeaia. ?nioth/? caniae
iaaeeeaiaioicii? oa?ai?? ae?thoue eeoa ia ie?ai? eaiee iaoiaaiaco, a
?ecee ?o canoinoaaiiy ia??aeei ia?aaeuo? oa?aiaaoe/iee aoaeo (A.A.
A?eai?ueaaa, 1996; J.Scholmerich, 1997, M.Robinson, 1998).

O??o?a?/ia e?eoaaiiy ia?aaeeeaeueia uiaei naii? OE, a ? eeoa ?aca?aii
aeey e?eoaaiiy oneeaaeiaieo oa ?ao?aeoa?ieo aei iaaeeeaiaioicii? oa?ai??
oi?i caoai?thaaiiy (TH.A.Aaeoaeo?n, 1997; A.Gaudio,1998).
?iaae?aeecoth/ee oa?aeoa? iaoe?ieo ?acaeoe?e eeoe?aieea oa aeniea
/anoioa i?neyiia?aoe?eieo ?aoeeaeea?a (35% i?ioyaii ia?oiai ?ieo)
ciooothoue o??o?a?a aeaaaeaii i?aeoiaeeoe aei aeeiiaiiy iia?aoeaieo
ao?o/aiue. A oie aea naiee /an, caa?ica aeieeiaiiy iaaacia/ieo
oneeaaeiaiue ia aea? iiaeeeaino? caie?eaoe c o??o?a?/iei e?eoaaiiyi
(L.P.Frizelle,1996; M.G.W. Kettwel, 1997; TH.A.Aaeoaeo?n,1997).
Iaaecia/aieie ia oeae /an caeeoathoueny a?aeiini? iieacaiiy aei
ia?aeiieo iia?aoe?e, iioeiaeueiee oa?i?i oa niin?a ?o aeeiiaiiy
(B.Bohm,1995; TH.A.Aaeoaeoen,1997).

Aeeneon?eiei ? ieoaiiy aeeiiaiiy ia?aeiii-a?aeiiaieo iia?aoe?e i?e OE:
?aea? iaeiiiiiaioiiai a?aeiiaeaiiy aacia?a?aiino? eeoe?aieea, yea ni?ey?
iie?auaiith ooieoe?iiaeueieo ?acoeueoao?a e?eoaaiiy oa ?aaa?e?oaoe??
iia?iaaieo iaoe??io?a, eiieo?othoue c i?aaiaiiyi iiia?aaeeoe
i?neyiia?aoe?ei? oneeaaeiaiiy oa ?aoeeaeeae c aieo noi?iiaaiiai
aianoiiico. Ia’?eoeai? e?eoa??? a?aeai?o noiiiaaieo iaoe??io?a aei
?aeiino?oeoeaii-a?aeiiaieo iia?aoe?e ua e aein? /?oei ia aecia/ai?
(M.Hashemi, 1998, H.J.Buhr, 1998., T.Yamamoto, 1999).

Oaeei /eiii, iaea?eueo ia?niaeoeaiei iai?yieii ae??oaiiy i?iaeaie
e?eoaaiiy OE — caoai?thaaiiy, ao?ieia?y eio?iai ana ua caeeoa?oueny
iaaecia/aiith, ? ia’?eoea?caoe?y e?eoaaeueii? oaeoeee oa ?ic?iaea
aoaeoeaieo cania?a eiina?aaoeaii? oa?ai??, ye? a ni?eyee i?i?i?caoe??
iieacaiue aei o??o?a?/iiai e?eoaaiiy OE oa iie?auaiith eiai
?acoeueoao?a.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie Aeena?oaoe?eia
?iaioa ? o?aaiaioii iaoeiai-aeine?aeii? ?iaioe eaoaae?e oaeoeueoaonueei?
o??o?a?? ?1 Iaoe?iiaeueiiai iaaee/iiai oi?aa?neoaoo ?i.I.I.Aiaiiieueoey
“I?io?eaeoeea ? e?eoaaiiy ai?eii-naioe/ieo oneeaaeiaiue i?ney iia?aoe?e
ia i?aaiao /a?aaii? ii?iaeieie c iaoith i?aeaeuaiiy aoaeoeaiino?
e?eoaaiiy”, ? aea?ae?a?no?aoe?? 0194 E017979.

Iaoa ? caaea/? aeine?aeaeaiiy Iniiaiith iaoith aeine?aeaeaiiy ?
iie?ioaiiy ?acoeueoao?a e?eoaaiiy OE oiiei? ? oianoi? eeoie oeyoii
canoinoaaiiy iioei?ciaaii? e?eoaaeueii? oaeoeee, yea a ni?eyea
i?i?i?caoe?? iieacaiue aei o??o?a?/iiai e?eoaaiiy, ca?eueoaiith a
caaaeuei?e no?oeoo?? iia?aoeaieo ao?o/aiue /anoee ia?aeiii-a?aeiiaieo oa
i?aaiicaa??aath/eo iia?aoe?e, cieaeaiith /anoioe i?neyiia?aoe?eieo
oneeaaeiaiue oa ?aoeeaeea?a, iie?ioaiith ?acoeueoao?a iaaee/ii? oa
nioe?aeueii? ?aaa?e?oaoe?? iia?iaaieo iaoe??io?a.

Aeey aeinyaiaiiy iinoaaeaii? iaoe iaiao?aeii aoei ae??oeoe oae? caaea/?:

1. Aea/eoe oa ioe?ieoe i?e/eie iacaaeia?eueieo ?acoeueoao?a
eiina?aaoeaiiai ? o??o?a?/iiai e?eoaaiiy OE oa aecia/eoe iiaeeea? oeyoe
?o iie?auaiiy.

2. Ii?aoethaaoe e?eoaaeueio oaeoeeo, yea a ni?eyea i?i?i?caoe??
iieacaiue aei ia?aeiieo iia?aoe?e oa iie?ioaiith ?acoeueoao?a
o??o?a?/iiai e?eoaaiiy OE.

3. Aeine?aeeoe aoaeoeai?noue aoaeanii?aeo — i?aia?aoo c a?oie eieaeueii
ae?th/eo aetheiei?oeei?ae?a aeey e?eoaaiiy aeoeaii? OE oiiei? ? oianoi?
eeoie, aecia/eoe iioeiaeueio oa?aiaaoe/io aeico i?aia?aoa oa /?oe?
iieacaiiy aei eiai canoinoaaiiy.

4. Aecia/eoe ia’?eoeai? e?eoa??? ioe?iee aoaeoeaiino? iaaeeeaiaioicii?
oa?ai??, iioeiaeueiee oa?i?i oa a?aeiini? iieacaiiy aeey ia?aoiaeo a?ae
eiina?aaoeaiiai aei iia?aoeaiiai e?eoaaiiy o aeiaaeeao ?ao?aeoa?ieo aei
iaaeeeaiaioicii? oa?ai?? oa oneeaaeiaieo oi?i OE.

5. Aecia/eoe iioeiaeuei? niiniae iia?aoeaieo ao?o/aiue oa i?noea
eaia?ineii?/ieo oaoiieia?e a o??o?a?/iiio e?eoaaii? OE oiiei? ? oianoi?
eeoie.

6. Aecia/eoe ia’?eoeai? e?eoa??? a?aeai?o noiiiaaieo iaoe??io?a c OE aei
aeeiiaiiy aoi?eiii-a?aeiiaieo iia?aoe?e oa iiaeeea? oeyoe ?icoe?aiiy
iieacaiue aei ieo.

7. Ioe?ieoe ?acoeueoaoe ?ic?iaeaii? e?eoaaeueii? oaeoeee oa ?? aieea ia
iie?ioaiiy ?acoeueoao?a o??o?a?/iiai e?eoaaiiy OE.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a Aia?oa aecia/aii iioeiaeuei?
oa?aiaaoe/i? aeice oa /?oe? iieacaiiy aei canoinoaaiiy ia?i?aeueieo oi?i
aoaeanii?aeo, aeiaaaeaii eiai aenieo aoaeoeai?noue oa aacia/i?noue aeey
e?eoaaiiy aeoeaii? OE oiiei? ? oianoi? eeoie.

Aecia/aii ia’?eoeai? e?eoa??? ioe?iee noaio iaoe??io?a, aoaeoeaiino?
iaaeeeaiaioicii? oa?ai?? oa aeai?o iiaeaeueoi? e?eoaaeueii? oaeoeee.

Ca aeiiiiiaith ?ic?iaeaii? i?eioeeiiai iiai? e?eoaaeueii? oaeoeee
aeiaaaeaii iaiao?aei?noue canoinoaaiiy a ia?aaeiia?aoe?ei?e i?aeaioiaoe?
no/anieo i?aia?ao?a aacenii? oa?ai?? oa aeeiiaiiy iia?aoeaieo ao?o/aiue
ia ?aii?o aoaiao caoai?thaaiiy, ui ni?ey? iie?ioaiith ?acoeueoao?a
o??o?a?/iiai e?eoaaiiy OE.

Aecia/aii a?aeiini? iieacaiiy aei ia?aeiieo iia?aoe?e i?e OE oiiei? ?
oianoi? eeoie, iioeiaeuei? oa?i?ie oa niiniae ?o aeeiiaiiy,
aaciina?aaei?i a?aeia?aaeaiiyi /iai ? iie?auaiiy ?acoeueoao?a iaaee/ii?
oa nioe?aeueii? ?aaa?e?oaoe?? iia?iaaieo iaoe??io?a.

Aeciaii, ui e?euee?noue ?eainoiiieo aeii?iaeiaiue ? iaeiei c ia’?eoeaieo
e?eoa???a a?aeai?o noiiiaaieo iaoe??io?a c OE aei aeeiiaiiy
aoi?eiii-a?aeiiaieo iia?aoe?e oa aia?oa cai?iiiiiaaii oeyoe ?icoe?aiiy
iieacaiue aei ieo.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a Aeiaaaeaia a ?acoeueoao?
aeine?aeaeaiue aeniea aoaeoeai?noue aoaeanii?aeo, aecia/ai? iioeiaeuei?
oa?aiaaoe/i? aeice ? iieacaiiy aei eiai canoinoaaiiy aeathoue
iiaeeea?noue aeeth/eoe i?aia?ao aei iaaaaaoiai a?naiaeo cania?a aacenii?
oa?ai?? OE oiiei? ? oianoi? eeoie.

Canoinoaaiiy ?iaeaeno Aanoa aeey ioe?iee noaio iaoe??io?a oa
aoaeoeaiino? iaaeeeaiaioicii? oa?ai?? aeicaiey? ia’?eoea?coaaoe
e?eoaaeueio oaeoeeo i?e OE.

Ia’?i oiieieeoeiaeo aeae?eaiue o noiiiaaieo iaoe??io?a c OE aia?oa
aeciaii iaeiei c ia’?eoeaieo e?eoa???a a?aeai?o aei
?aeiino?oeoeaii-a?aeiiaieo iia?aoe?e, a ciaioaiiy ?o e?eueeino? i?e
canoinoaaii? aoaeanii?aeo — iaeiei c iiaeeeaeo oeyo?a ?icoe?aiiy
iieacaiue aei aoi?eiii-a?aeiiaieo iia?aoeaieo ao?o/aiue.

Canoinoaaiiy ?ic?iaeaii? e?eoaaeueii? oaeoeee aeicaiey? iie?ioeoe
?acoeueoaoe e?eoaaiiy OE, aaciina?aaei?i a?aeia?aaeaiiyi /iai ?
i?i?i?caoe?y iieacaiue aei o??o?a?/iiai e?eoaaiiy, ca?eueoaiiy a
caaaeuei?e nooeoo?? iia?aoeaieo ao?o/aiue /anoee aeiiiiieo ?acaeoe?e
eeoe?aieea, ia?aeiii-a?aeiiaieo oa no?ieoa?caa??aath/eo iia?aoe?e,
cieaeaiiy /anoioe i?neyiia?aoe?eieo oneeaaeiaiue ? ?aoeeaeea?a,
nei?i/aiiy oa?i?i?a iaaee/ii? oa nioe?aeueii? ?aaa?e?oaoe?? iia?iaaieo
iaoe??io?a.

?ic?iaeaio e?eoaaeueio oaeoeeo ai?iaaaeaeaii a i?aeoeeo I?ieoieia?/iiai
oeaio?o oa i?ieoieia?/ieo a?aeae?eaiue Oe?a?ie. Iaoa??aee
aeena?oaoe?eii? ?iaioe aeei?enoiaothoueny i?ae /an i?iaaaeaiiy
i?aeoe/ieo caiyoue oa eaeoe?e ia eaoaae?? oaeoeueoaonueei? o??o?a?? ?1
Iaoe?iiaeueiiai iaaee/iiai oi?aa?neoaoo ?i.I.I.Aiaieiiueoey IIC Oe?a?ie.

Iniaenoee aianie aeena?oaioa Ee?i?/i? aeine?aeaeaiiy i?iaaaeai?
aaoi?eith naiino?eii ia aac? eaoaae?e oaeoeueoaonueei? o??o?a?? ?1 IIO
oa I?ieoieia?/iiai oeaio?o Oe?a?ie. I?ioieiee ee?i?/ieo aeine?aeaeaiue
?ic?iaeai? aaoi?eith o ni?ai?aoe? c eiiiai??th c ee?i?/ieo
aeine?aeaeaiue Euro Bio-Pharm (I?ia//eia). Eaai?aoi?i? aeine?aeaeaiiy
i?iaaaeai? ca o/anoth aaoi?ee a eaai?aoi??? EIEE ?18 (caa. eaai?aoi???th
e.i.i. A.?.Aaeea?) oa ?inoeooo? eaai?aoi?ii? iaaeeoeeie (i.Oaeaeaeaa?a,
I?ia//eia).

Aaoi?eith naiino?eii i?iaaaeaii iaoaioiee iiooe, aiae?c e?oa?aoo?e,
noaoenoe/io ia?iaeo iaea?aeaieo ?acoeueoao?a, iaienaii an? ?icae?ee
aeena?oaoe??, noi?ioethaaii aeniiaee oa i?aeoe/i? ?aeiiaiaeaoe??.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe?? Iniiai? iieiaeaiiy aeena?oaoe?eii?
?iaioe aeeeaaeai? oa iaaiai?ai? ia 3-e i?aeia?iaei?e eiioa?aioe??
“I?iaeaiu ?aaaeeeoaoeee i?ieoieiae/aneeo aieueiuo” (Aeoaane, 21-22 iay
1998a.), Falk Symposium “New Aspects in Hepatology and Gastroenterology”
(Tbilisi/Tiflis, May 29-30, 1998), Polisn-Belorussian-Ukrainian Falk
Symposium “New Concepts on Etiopathogenesis and Treatment of
Inflammatory Bowel Disease” (Warsaw/Poland, September 10-11, 1999).

Ioae?eaoe?? Ca iaoa??aeaie aeena?oaoe?? iioae?eiaaii 6 iaoeiaeo ?ia?o:
3 — o oaoiaeo a?o/eciyieo aeo?iaeao, 3 — o iaoa??aeao i?aeia?iaeieo
neiiic?oi?a oa eiioa?aioe??.

No?oeoo?a oa ia’?i aeena?oaoe?? Iniiaiee oaeno aeena?oaoe?? aeeeaaeaiee
oe?a?inueeith iiaith ia 118 noi??ieao iaoeiiieniiai oaenoo ?
neeaaea?oueny ?c anooio, i’yoe ?icae?e?a (iaeyaeo e?oa?aoo?e, ?icae?eo c
iienii iaoa??aeo oa iaoiae?a aeine?aeaeaiiy, o?ueio ?icae?e?a aeanieo
aeine?aeaeaiue), caeeth/aiiy, aeniiae?a, i?aeoe/ieo ?aeiiaiaeaoe?e,
nieneo aeei?enoaii? e?oa?aoo?e oa o?ueio aeiaeaoe?a. ?iaioa ?ethno?iaaia
29 oaaeeoeyie oa 19 ?enoieaie. Nienie e?oa?aoo?e neeaaea?oueny c 436
aeaea?ae: 31 — ?iaioe a?o/eciyieo aaoi??a, 405 — ?iaioe ca?oa?aeieo
aaoi??a.

INIIAIEE CI?NO ?IAIOE

Oa?aeoa?enoeea oai?eo ? iaoiaee aeine?aeaeaiiy A iniiao ?iaioe
iieeaaeaii ?acoeueoaoe e?eoaaiiy 222 iaoe??io?a c OE oiiei? ? oianoi?
eeoie, ye? ia?aaoaaee ia e?eoaaii? a ee?i?oe? eaoaae?e oaeoeueoaonueei?
o??o?a?? ?1 IIO c 1991 ii 1998 ??. (8 ?ie?a).

Aeey aeinyaiaiiy iaoe oa ae??oaiiy caaea/ aeine?aeaeaiiy aeeiiaiiy
aeena?oaoe?eii? ?iaioe aoei ?iciiae?eaii ia aeaa aoaie. Ia ia?oiio aoai?
aeine?aeaeaiiy ia a?o?aiiio iaoa??ae? ee?i?ee aea/aii ?acoeueoaoe
e?eoaaiiy 113 iaoe??io?a c OE ca ia??iae 1991-1994??., aecia/aii i?e/eie
iacaaeia?eueieo ?acoeueoao?a e?eoaaiiy oa iiaeeea? oeyoe ?o iie?auaiiy.
Ia ae?oaiio aoai?, a?aooaaaoe an? iaaeie?ee e?eoaaeueii? oaeoeee
1991-1994??., ?ic?iaeaii i?eioeeiiai a?aei?iio oaeoeeo e?eoaaiiy ?
iieeaaeaii ?? a iniiao e?eoaaiiy 109 iaoe??io?a c OE a 1995-1998 ??.
Oaeei /eiii, aoei aeae?eaii 2 a?oie iaoe??io?a: eiio?ieueia
(1991-1994??.) — 113 in?a oa aeine?aeaeoaaia (1995-1998??.) — 109 in?a.

Iaeaea? a?oie aoee ?ai?acaioaoeaieie ca a?eiaei, noaoaaei neeaaeii oa
iniiaieie ee?i?/ieie oa?aeoa?enoeeaie caoai?thaaiiy. I?eioeeiiai
a?aei?iieie uiaei ieo aoee e?eoaaeueia oaeoeea oa oa?aeoa?
iaaeeeaiaioicii? oa?ai??.

Ia iniaeeao oaaao caneoaiaoaaee iia?iaai? iaoe??ioe iaio a?oi, oiio ui
oea aoee iaoe??ioe c oeie oi?iaie OE, iaaeeeaiaioicia oa?i?y yeeo
aeyaeeanue iaeioaeoeaiith. Eiaeia c a?oi aoea ?iciiae?eaia ia aea?
i?aea?oie a caeaaeiino? a?ae canoiniaaiiai e?eoaaiiy — eiina?aaoeaiiai
/e iia?aoeaiiai. Ii??aiyiiy ni?aa?aeiioaiiy iia?iaaieo oa iaiia?iaaieo
iaoe??io?a iaio a?oi iieacaei, ui a eiio?ieuei?e a?oi? iia?iaaieo
iaoe??io?a aoei aeinoia??ii a?eueoa, i?ae a aeine?aeaeoaai?e: 37,174,55%
i?ioe 22,023,97%, P<0,05 (oaae.1). Oaaeeoey 1. Ni?aa?aeiioaiy iia?iaaieo ? iaiia?iaaieo iaoe??io?a a eiio?ieuei?e oa aeine?aeaeoaai?e a?oiao Eaoaai??? iaoe??io?aEiio?ieueia a?oia (n=113)Aeine?aeaeoaaia a?oia (n=109) ?aan.% mpaan.% mpIaiia?iaai?7162,83 4,558577,98 3,97< 0,05Iia?iaai?4237,17 4,552422,02 3,97< 0,05ANUeIAI113100109100 Iniiaieie i?e/eiaie iacaaeia?eueieo ?acoeueoao?a e?eoaaiiy iaoe??io?a eiio?ieueii? a?oie, a?aoiaoth/e ?? ?ai?acaioaoeai?noue c aeine?aeaeoaaiith, ie aaaaea?ii: iaaeinoaoith aoaeoeai?noue eiina?aaoeaiiai e?eoaaiiy (iniiaiei i?aia?aoii aacenii? oa?ai?? aoa noeueoanaeacei); a?aenooi?noue ia’?eoeaieo e?eoa???a ioe?iee noaio iaoe??io?a oa aoaeoeaiino? iaaeeeaiaioicii? oa?ai??; canoinoaaiiy o??o?a?/iiai e?eoaaiiy ia i?ci?o aoaiao caoai?thaaiiy; iaaeinoaoith ia?aaeiia?aoe?eio i?aeaioiaeo; ia?aaaaeaiiy a caaaeuei?e no?oeoo?? iia?aoeaieo ao?o/aiue iaoe?ieo ?acaeoe?e eeoe?aieea oa iia?aoe?e, aeeiiaieo ca aaniethoieie iieacaiiyie. Iniiai? oeyoe iie?auaiiy ?acoeueoao?a e?eoaaiiy OE ie aaa/aee a ii?aoethaaii? e?eoaaeueii? oaeoeee, yea iieyaaea a ia’?eoeai?e ioe?ioe? noaio iaoe??io?a ? aoaeoeaiino? e?eoaaiiy oa canoinoaaii? aoaeoeaieo eiina?aaoeaieo niinia?a e?eoaaiiy, e ni?eyea i?i?i?caoe?? iieacaiue aei o??o?a?/ieo ao?o/aiue, ca?eueoaiith a caaaeuei?e no?oeoo?? iia?aoeaieo ao?o/aiue e?eueeino? i?aaiicaa??aath/eo ia?aeiii-a?aeiiaieo iia?aoe?e, iie?ioaiith ?acoeueoao?a iaaee/ii? ? nioe?aeueii? ?aaa?e?oaoe?? iia?iaaieo iaoe??io?a. A?aeiii, ui iaea?eueo aoaeoeaiei caniaii eiina?aaoeaiiai e?eoaaiiy aeoeaii? OE eeoe?aieea ? nenoaii? aetheiei?oeei?aee, aea oyaee?noue noa?i?aeicaeaaeieo iia?/ieo neiioii?a, ui aeieeathoue i?e ?o canoinoaaii?, ia??aeei ia?aaeuo? oa?aiaaoe/io ei?enoue ? no?eio? oe?iea aeei?enoaiiy oeeo i?aia?ao?a. O a?aeiia?aeiino? c oeei, aeey iaaeeeaiaioiciiai e?eoaaiiy aeoeaii? OE oiiei? ? oianoi? eeoie c iaoith iie?auaiiy eiai ?acoeueoao?a, iaie aoei ia?aii noai?aiee iai?ee?ioe? 80-o ??. eieaeueii ae?th/ee aetheiei?oeei?ae aoaeanii?ae, yeeo aaea i?ieoia aaeeeo e?euee?noue aenia?eiaioaeueieo oa ia?o? oace ee?i?/ieo aeine?aeaeaiue a NOA oa e?a?iao ?a?iie. Aea/aiiy oa?iaeieia?/ieo aeanoeainoae i?aia?aoo iieacaei, ui ia a?aei?io a?ae nenoaiieo noa?i?ae?a a?i ia? aenieo eieaeueio oa iecueeo nenoaiio aeoeai?noue, yea iaoiiaeaia aenieith nii??aeiai?noth i?aia?aoo c aetheiei?oeei?aeieie ?aoeaioi?aie, aeia?ith ?ic/eii?noth a aiae?, i?i?iaeueiith caaaeueiith aani?aoe??th oa 90-95%-th o?ainoi?iaoe??th i?ney ia?oiai i?ioiaeaeaiiy /a?ac ia/?ieo. Aeey e?eoaaiiy OE aoee ?ic?iaeai? ia?i?aeuei? oi?ie aoaeanii?aeo o aeaeyae? no?eeeo aei ae?? oeoieiaiai nieo eainoe c ?I-iiaeeo?eiaaiei aea?eueiaiiyi iaiaaeaii? e?eueeino? aeoeaiiai ?ia?aae??ioa aaciina?aaeiuei a oiie?e ? oiano?e eeoeao. ?acoeueoaoe ee?i?/ieo aeine?aeaeaiue oeeo oi?i aoaeanii?aeo i?iaeaiiino?oaaee eiai aoaeoeai?noue ? aacia/i?noue oa aeiaaee, ui a?i ? ia?niaeoeaiei “i?aia?aoii-eaiaeeaeaoii” aeey e?eoaaiiy eeoeiaeo oi?i OE. Aea iioeiaeueia oa?aiaaoe/ia aeica oa /?oe? iieacaiiy aei canoinoaaiiy aoaeanii?aea ia aeaieo aoaiao aeine?aeaeaiue aecia/ai? ia aoee. C oe??th iaoith iaie aoei i?iaaaeaii iiaea?eia ne?ia ?aiaeii?ciaa ii??aiyeueia ee?i?/ia aeine?aeaeaiiy aoaeoeaiino? oa aacia/iino? 3ia, 9ia oa 18ia aoaeanii?aeo a eainoeao i?ioe eainoe ieaoeaai. Aeine?aeaeaiiy i?iaiaeeeenue o ni?ai?aoe? c eiiiai??th c ee?i?/ieo aeine?aeaeaiiue Euro Bio-Pharm (I?ia//eia). Aei aeine?aeaeaiiy aoei caeo/aii 35 iaoe??io?a a?eii a?ae 18 aei 60 ?ie?a c aeoeaiith OE eaaeiai ? na?aaeiueiai nooiaith oyaeeino? (150350) oa eieae?caoe??th i?ioeano a oa?i?iaeueiiio
a?aeae?e? eeoaiai? eeoee, oiano?e eeooe? oa cii? oiiei-oianoieeoeiaiai
aianoiiico. O eiaeiiai c iaoe??io?a aeine?aeaeaiiy o?eaaei 777 aei?a.
Aeey ia’?eoeaii? ioe?iee noaio iaoe??io?a oa aoaeoeaiino? e?eoaaiiy
canoiniaoaaee aeniei?ioi?iaoeaio nenoaio aaaaoioaeoi?iiai aiae?co —
?iaeaen Aanoa, yeee ? caaaeueii i?eeiyoiei ee?i?/ii cia/ouei ia?aiao?ii
? aeei?enoiao?oueny o an?o eiio?ieueiaaieo ee?i?/ieo aeine?aeaeaiiyo,
i?ena’y/aieo OE. Ciaioaiiy ?iaeaeno Aanoa i?ioyaii e?eoaaiiy ia 60 iae.
oa a?eueoa aaaaea?oueny ?iaeeeaoi?ii ?aa?an?? caaino?aiiy OE, a ?iaeaen
Aanoa<150iae. na?ae/eoue i?i ia?aaoaaiiy iaoe??ioa a oac? ?ai?n??. Aoaeoeai?noue oa aacia/i?noue canoinoaaiiy aoaeanii?aeo ioe?ithaaee ca ?acoeueoaoaie caaa?oaiiai e?eoaaiiy aeey eiaeii? aeice i?aia?aoo ? ii??aithaaeenue c ieaoeaai. Iioeiaeueiith oa?aiaaoe/iith aeicith aaaaeaeanue iaeieae/a aeica aoaeanii?aeo, aoaeoeai?noue yei? noaoenoe/ii aeinoia??ii a?ae??ciyeanue a?ae aoaeoeaiino? ieaoeaai. Ia?aeiiei ia?aiao?ii aoaeoeaiino? aoaeanii?aeo aaaaeaeanue ee?i?/ia ?ai?n?y OE, aecia/aia ca ?iaeaenii Aanoa. Aoi?eiieie ia?aiao?aie aoaeoeaiino? aoaeanii?aeo aoee: 1) aeeiai?ea ci?i i?ioyaii e?eoaaiiy ?iaeaeno Aanoa oa iniiaieo ee?i?/ieo neiioii?a caoai?thaaiiy (e?eueeino? ianoi?iiaaieo aeii?iaeiaiue ia aeiao, ?ioaineaiino? aaaeii?iaeueiiai aieth, caaaeueiiai naiiii/oooy); 2) na?aaei?e /an ianoaiiy ee?i?/ii? ?ai?n??; 3) oa?aiaaoe/ia ei?enoue (ciaioaiiy ?iaeaeno Aanoa, i?i?ioi, ia 60iae. o ii??aiyii? c ii/aoeiaei). Aacia/i?noue canoinoaaiiy aoaeanii?aeo aiae?coaaeanue i?ioyaii e?eoaaiiy oeyoii iii?oi?eiao aeieeiaiiy iia?/ieo aoaeo?a ? ci?i iieaciee?a ne?iaaoeiaiai ei?oecieo. E??i oiai, aeey aecia/aiiy a?iio?ca?ii-aae?aiaeiai? ooieoe?? aei ii/aoeo ? i?ney caaa?oaiiy e?eoaaiiy an?i iaoe??ioai i?iaiaeeee ei?oeeio?ii?inoeioethth/ee oano. ?acoeueoaoe aeine?aeaeaiiy oa ?o iaaiai?aiiy ?acoeueoaoe aeine?aeaeaiiy aeiaaee, ui iioeiaeueiith aeicith ia?i?aeueieo oi?i aoaeanii?aeo aeey e?eoaaiiy aeoeaii? OE oiiei? ? oianoi? eeoie ? 9ia ia aeiao (o?e/? ia aeaiue ii 3ia). A a?oi? 9ia aoaeanii?aeo: · ??aaiue ee?i?/ii? ?ai?n?? noaiiaea 62,58,2% i?ioe 20,06,8% a a?oi? ieaoeaai (?<0,01); · na?aaei?e ?iaeaen Aanoa ciaioeany ia 47,1% i?ioe 6,6%, a a?oi? ieaoeaai (?<0,01); · na?aaeiy aeiaiaa e?euee?noue ianoi?iiaaieo aeii?iaeiaiue ciaioeeanue ia 37,58,2% i?ioe 7,94,6% a a?oi? ieaoeaai (?<0,01); · ?ioaineai?noue aaaeii?iaeueiiai aieth ciaioeeanue ia 40,35,9% i?ioe 6,84,3% a a?oi? ieaoeaai (?<0,01); · caaaeueia naiiii/oooy iie?ioeeinue ia 35,48,1%, a oie /an ye a a?oi? ieaoeaai iia??oeeinue ia 12,05,5% (?<0,01). *an ianoaiiy ee?i?/ii? ?ai?n?? oaeiae aoa iaeei?iooei a a?oi? 9ia aoaeanii?aeo: aaea /a?ac 2 oeaei? i?ney ii/aoeo e?eoaaiiy ee?i?/io ?ai?n?th aoei aeinyaiooi o 50,08,5% iaoe??io?a i?ioe 10,05,1% iaoe??io?a a?oie ieaoeaai (?<0,05). Oa?aiaaoe/ia ei?enoue a?ae canoinoaaiiy 9ia aoaeanii?aeo neeaaeaea 75,07,3% i?ioe 10,05,1% a a?oi? ieaoeaai (?<0,01). Aaaeeeaeie i?iaiinoe/ieie iieacieeaie aeyaeeeny aecia/ai? ca ?iaeaenii Aanoa /an ianoaiiy ee?i?/ii? ?ai?n?? oa oa?aiaaoe/ia ei?enoue, a iaea?eueo /ooeeaeie ia?ea?aie ?aa?an?? OE oa aoaeoeaiino? e?eoaaiiy - iniiai? ee?i?/i? neiioiie caoai?thaaiiy, eiao?oe??io ei?aeyoe?? eio?eo c ?iaeaenii Aanoa a aeiaei?e c oa?aiaaoe/ieo a?oi ia aoa ieae/ei 0,82. Iniiai? eaai?aoi?i? iieacieee aeoeaiino? caiaeaiiy N-?aaeoeaiee i?ioa?i oa oaeaee?noue in?aeaiiy a?eo?ioeeo?a aeyaeeenue iaei?ioi?iaoeaieie aeey ioe?iee aoaeoeaiino? e?eoaaiiy (eiao?oe??io ei?aeyoe?? c ?iaeaenii Aanoa ia ia?aaeuoaaa 0,41). ?acoeueoaoe aeine?aeaeaiue aacia/iino? aoaeanii?aeo iieacaee, ui canoinoaaiiy i?aia?aoo a aeic? 9ia ia aeiao ia i?ecaiaeeoue aei na?eiciiai ii?ooaiiy a?iio?ca?ii-aae?aiaeiai? ooieoe??. *anoioa aeieeiaiiy noa?i?aeicaeaaeieo iia?/ieo neiioii?a a a?oi? 9ia aoaeanii?aeo noaoenoe/ii aeinoia??ii ia a?ae??ciyeanue a?ae a?oie ieaoeaai (37,56,3% i?ioe 30,07,9%, ?>0,05), a oei/aniaa cieaeaiiy ??aiy
aacaeueiiai ei?oecieo ia?aaoaaei a iaaeao i?eionoeieo aaee/ei ? iaei
aaeaioaoe?eiee oa?aeoa?. I?ney cae?i/aiiy aeine?aeaeaiiy na?aaei?e
??aaiue aacaeueiiai ei?oecieo ia a?ae??ciyany a?ae ii/aoeiaiai ? aoa
ieae/ei eeoa ia 3,9%.

Aiae?c ?acoeueoao?a ee?i?/iiai aeine?aeaeaiiy aoaeanii?aeo aeicaieea
aecia/eoe /?oe? iieacaiiy aei eiai canoinoaaiiy.

1. Eieae?caoe?y caiaeueii-?io?eueo?aoeaieo ci?i o oa?i?iaeueiiio
a?aeae?e? eeoaiai? eeoee, o i?aa?e iieiaei? iaiaeiai? eeoee oa a cii?
oiiei-oianoieeoeiaeo aianoiiic?a. O aeiaaeeao o?aaeaiiy ?ioeo a?aeae?e?a
oianoi? eeoee aoaeoeai?noue aeiaeii? c aeic aoaeanii?aeo ia aoea
aeinoaoiueith.

2. Oi?ie OE oiiei? ? oianoi? eeoie, ia?aa?a yeeo ia oneeaaeiaiee
iicaeeoeiaeie i?iyaaie oa caiaeueieie ?io?eueo?aoaie a /a?aai?e
ii?iaeiei?.

Aoaeoeai?noue 3ia aoaeanii?aeo aeey e?eoaaiiy aeoeaii? OE oiiei? oa
oianoi? eeoee aeyaeeanue iaaeinoaoiueith. Aoaeoeai?noue 18ia
aoaeanii?aeo noaoenoe/ii aeinoia??ii ia a?ae??ciyeanue a?ae aoaeoeaiino?
9ia aoaeacii?aeo, aea /anoioa noa?i?aeicaeaaeieo iia?/ieo neiioii?a aoei
aeuith — 62,5±8,2% i?ioe 37,5±6,3%, P<0,05. Aeey e?eoaaiiy i?ieoeo?a, i?ieoineaii?aeeo?a, e?aia?/ieo a?aioeaiaoicieo eie?o?a aoaeoeaieie aeyaeeenue ?aeoaeuei? oi?ie i?aia?ao?a ianaeaceio, a o aeiaaeeao oioaeueieo eie?o?a - eiia?iaoe?y ?aeoaeueieo oa ia?i?aeueieo oi?i oeeo i?aia?ao?a a aeic? ia iaio?e i?ae 4a ia aeiao. Aoaeoeai?noue i?aia?ao?a ianaeaceio aeia?a aea/aia, aacia/i?noue ?o canoinoaaiiy aeiaaaeaia ? ia iio?aao? aeaoaeueiiai ?icaeyaeo. Ia oeae /an oaeiae a?aeiii, ui ia?i?aeuei? oi?ie aoaeanii?aeo ? aoaeoeaiei ? aeey e?eoaaiiy noiiiaaieo iaoe??io?a c OE. Aeey aea/aiiy aoaeoeaiino? i?aia?aoo o oe??? eaoaai??? oai?eo iaie aoei i?iaaaeaii iiaea?eia ne?ia ?aiaeii?ciaaia ii??aiyeueia ee?i?/ia aeine?aeaeaiiy 3ia, 6ia oa 9ia aoaeanii?aeo a a?oi? noiiiaaieo iaoe??io?a (30 in?a), yeei ?ai?oa aoee aeeiiai? iaoe?i? ?acaeoe?? eeoe?aieea c i?eaiaeo OE. ?acoeueoaoe aeine?aeaeaiue aeiaaee, ui i?ae aieeaii aoaeanii?aeo i?aeaeuo?oueny aniieooaaiiy ??aeeie a oa?i?iaeueieo a?aeae?eao oiiei? eeoee ? ciaioo?oueny e?euee?noue ?eainoiiieo aeii?iaeiaiue ca ?aooiie ?o caouaiiy: ciaioaiiy e?eueeino? ??aeeeo aeii?iaeiaiue oa ca?eueoaiiy e?eueeino? eaoaiiae?aieo ? noi?iiaaieo aeii?iaeiaiue. ?acoeueoaoe iaeiioeaeiaaiai e?eoaaiiy aoee oaeeie: · ciaioaiiy e?euee?no? ?eainoiiieo aeii?iaeiaiue ia 20% ? a?eueoa (ia?aeiiee ia?aiao? aoaeoeaiino? aeey aeaiiai aeine?aeaeaiiy) ca?a?no?iaaii o 40,08,8% iaoe??io?a a?oie 3ia aoaeanii?aeo, o 36,48,8% iaoe??io?a a?oie 6ia aoaeanii?aeo oa o 33,38,6% iaoe??io?a a?oie 9ia aoaeanii?aeo; · na?aaeiy e?euee?noue ?eainoiiieo aeae?eaiue ciaioeeanue ia 15,66,6% a a?oi? 3ia aoaeanii?aeo, ia 18,97,1% - a a?oi? 6ia aoaeanii?aeo oa ia 17,46,9% - a a?oi? 9ia aoaeanii?aeo. Canoinoaaiiy an?o aeic aoaeanii?aeo oaeiae ni?eyei noaa?e?caoe?? ooieoe?? na/iaea?aeii? nenoaie, yea iaea?eueoa o?aaeaia o noiiiaaieo iaoe??io?a: /anoioa na/iaeioneaiiy ca?eueoeeanue ia 11,82%, ??aaiue na/iaeie a ne?iaaooe? e?ia? cieceany ia 4,57%, a ??aaiue e?aaoei?io - ia 10,62%. Ioaea, ?acoeueoaoe i?iaaaeaiiai aeine?aeaeaiiy aeaiiino?othoue aenieo aoaeoeai?noue aoaeanii?aeo o noiiiaaieo iaoe??io?a c OE ? aeicaieythoue canoiniaoaaoe i?aia?ao ia eeoa a eiiieaeniiio e?eoaaii? iinoeieaeoii?/iiai neiae?iio, a e aeey i?aeaioiaee iaoe??io?a aei ?aeiino?oeoeaii-a?aeiiaieo iia?aoe?e, ?icoe?thth/e oei naiei iieacaiiy aei ?o aeeiiaiiy. A?aenooi?noue aeinoia??ii? ??cieoe? i?ae aoaeoeai?noth aeine?aeaeoaaieo aeic aoaeanii?aeo aeicaiey? ?aeiiaiaeoaaoe aeey e?eoaaiiy noiiiaaieo iaoe??io?a i?i?iaeueio aeico - 3ia ia aeiao ?, oei naiei, iie?ioeoe ni?aa?aeiioaiiy “ei?enoue-?ecee” canoinoaaiiy i?aia?aoo, ui iniaeeai aaaeeeai i?e i?aeaioiaoe? aei iia?aoeaieo ao?o/aiue. ?acoeueoaoe i?iaaaeaieo aeine?aeaeaiue ie aeei?enoaee aeey iioei?caoe?? e?eoaaeueii? oaeoeee OE oiiei? ? oianoi? eeoie, iniiaieie neeaaeiaeie yei? aoee: 1) ia’?eoeaia ioe?iea noaio iaoe??io?a oa aoaeoeaiino? iaaeeeaiaioicii? oa?ai?? ca aeiiiiiaith ?iaeaeno Aanoa; 2) iaia’yceiaa canoinoaaiiy a eiiieaeniiio e?eoaaii? OE oa ia?aaeiia?aoe?ei?e i?aeaioiaoe? aenieiaoaeoeaieo cania?a aacenii? oa?ai?? - i?aia?ao?a aoaeanii?aeo oa ianaeaceio; 3) canoinoaaiiy o??o?a?/iiai e?eoaaiiy ia ?aii?o aoaiao caoai?thaaiiy, eiee eeoe?aiee ua ia c?oeiiaaiee aaaaoueia ?aoeeaeeaaie OE, a a ?ioeo i?aaiao ? nenoaiao ia noaeeny iacai?ioi? ci?ie; 4) aeeiiaiiy iia?aoeaieo ao?o/aiue i?ney aeinyaiaiiy iaoe??ioii ee?i?/ii? ?ai?n??, a o aeiaaeeao, eiee oea iaiiaeeeai, i?ney noaa?e?caoe??? iniiaieo ee?i?/ieo ? eaai?aoi?ieo neiioii?a caoai?thaaiiy. Iniiaiith iciaeith iiceoeaii? aeeiai?ee OE ? iie?auaiiy ee?i?/ieo neiioii?a caoai?thaaiiy, a iniiaiei ia’?eoeaiei e?eoa???i - ciaioaiiy ?iaeaeno Aanoa i?i?ioi ia 60 iae. Iani?eyoeeaeie i?iaiinoe/ieie iciaeaie aeey i?iaaaeaiiy eiina?aaoeaii? oa?ai?? ? e?eoa??yie aeai?o o??o?a?/iiai e?eoaaiiy ?: a?aenooi?noue aoaeoo a?ae iaaeeeaiaioicii? oa?ai?? i?ioyaii 15-21 ae?a (ie??i aino?eo oi?i OE) oa oi?ie OE, ui ia?aa?aathoue c ooai?aiiyi caiaeueieo ?io?eueo?ao?a a /a?aai?e ii?iaeiei? oa iicaeeoeiaeie i?iyaaie. AEiaeai ?c canoiniaaieo i?aia?ao?a o oeeo aeiaaeeao ia aoa aoaeoeaiei. Ioe?ieo ?ic?iaeaii? e?eoaaeueii? oaeoeee i?iaaaeaii oeyoii ii??aiyiiy ?acoeueoao?a e?eoaaiiy iaoe??io?a eiio?ieueii? oa aeine?aeaeoaaii? a?oi. Aeio?eiaiiy iniiaieo i?eioeei?a iioei?ciaaii? e?eoaaeueii? oaeoeee aeicaieeei iai ia 15,2% (c 37,2% aei 22,0%) i?i?i?coaaoe iieacaiiy aei o??o?a?/iiai e?eoaaiiy, iaa?oue o aeiaaeeao oyaeeeo oa ?iciianthaeaeaieo oi?i caoai?thaaiiy, a?aeeeanoe aeeiiaiiy ?iaae?aeecoth/iai iia?aoeaiiai ao?o/aiiy, aeath/e iiaeeea?noue iaoe??ioai iieiaeiai a?eo aeeiiaoe nai? nioe?aeuei? ooieoe?? (cae?i/eoe ina?oo, iaea?aeaoe i?ioan?th, noai?eoe n?i’th). Aea iaa?oue canoinoaaiiy no/anieo aenieiaoaeoeaieo iaaeeeaiaioicieo cania?a ia caaaeaee aeicaiey? noaa?e?coaaoe ia?aa?a OE ? a?aeiiaeoenue a?ae o??o?a?/iiai e?eoaaiiy oeueiai oyaeeiai ?ae?iiaoe/iiai caoai?thaaiiy. O aeiaaeeao iaieio/ino? aeeiiaiiy iia?aoeaiiai ao?o/aiiy, canoinoaaiiy iioei?ciaaii? e?eoaaeueii? oaeoeee aeaei iiaeeea?noue ci?ieoe o??o?a?/io oaeoeeo ?, oei naiei, cia/ii iie?ioeoe ?acoeueoaoe o??o?a?/iiai e?eoaaiiy OE (oaa.2). Oaaeeoey 2. ?acoeueoaoe o??o?a?/iiai e?eoaaiiy oai?iae E?iia oiiei? ? oianoi? eeoie Iniiai? iieacieeeEiio?ieueia a?oia (n = 113)Aeine?aeaeoaaia a?oia (n = 109) ??cieoey ?Aeiiiii? ?acaeoe?? eeoe?aieea 4,8% 37,5% 32,7% < 0,05A?aeiiai? iia?aoe??:· ia?aeiii-a?aeiiai?0%45,8%7,14%54,1%47,0%< 0,05· aoi?eiii-a?aeiiai?7,14%8,33%No?ieoa?icaa??aath/? iaoe?i? ?acaeoe?? eeoe?aieea 33,3% 41,7% 8,4% < 0,05I?neyiia?aoe?ei?:· oneeaaeiaiiy47,6%20,8%26,8%< 0,05· ?aoeeaeeae23,8%16,6% 7,2%> 0,05· eaoaeuei?noue19,1%4,2%14,9%< 0,05· ia?aaoaaiiy iaoe??io?a a noaoe?iia?? 21,2 ae?a 10,2 ae?a 11ae?a < 0,05 A caaaeuei?e nooeoo?? iia?aoeaieo ao?o/aiue aeine?aeaeoaaii? a?oie a ii??aiyii? c eiio?ieueiith /anoea aeiiiiieo ?acaeoe?e eeoe?aieea ca?eueoeeanue c 4,83,3% aei 37,59,9%, ia?aeiii-a?aeiiaieo iia?aoe?e - c 0% aei 45,810,2%, iaoe?ieo ?acaeoe?e eeoe?aieea c? caa?aaeaiiyi caieeath/iai aia?aoo i?yii? eeoee - c 33,37,3% aei 41,710,1%, iia?aoeaieo ao?o/aiue, aeeiiaieo ca a?aeiinieie iieacaiiyie c 40,57,5% aei 62,57,5%. A o??o?a?/iiio e?eoaaii? iaoneeaaeiaieo oi?i OE aoee canoiniaai? eaia?ineii?/i? oaoiieia??. Aaciina?aaei?ie ?acoeueoaoaie canoinoaaiiy iioei?ciaaii? e?eoaaeueii? oaeoeee aoei: ciaioaiiy e?eueeino? i?neyiia?aoe?eieo oneeaaeiaiue c 47,67,7% aei 20,88,3%, i?neyiia?aoe?eii? eaoaeueiino? c 19,16,0% aei 4,24,1% oa nei?i/aiiy oa?i?io i?neyiia?aoe?eiiai ia?aaoaaiiy iaoe??io?a o noaoe?iia?? ia 11 ae?a. Iniiaiee iieaciee aoaeoeaiino? o??o?a?/iiai e?eoaaiiy OE - /anoioa i?neyiia?aoe?eieo ?aoeeaeea?a ciaioeeanue c 23,86,6% aei 16,67,6%. ? oi/a oey ??cieoey ia aoea noaoenoe/ii aeinoia??iith, /?oea oaiaeaioe?y aei cieaeaiiy /anoioe ?aoeeaeea?a i?ine?aeeiao?oueny, iniaeeai caaaeath/e ia cia/ii a?eueoo e?eueeinoue ia?aeiii-a?aeiiaieo i?aaiicaa??aath/eo iia?aoe?e, ye? aoee aeeiiai? a aeine?aeaeoaai?e a?oi?. sse iieaco? iao aeina?ae oa ?acoeueoaoe i?iaaaeaieo aeine?aeaeaiue, iioeiaeueiei niiniaii o??o?a?/iiai e?eoaaiiy OE oiiei? ? oianoi? eeoie ? iaeiiaoaii? aeiiiii? ?acaeoe?? eeoe?aieea c ia?aeiiei a?aeiiaeaiiyi eiai aacia?a?aiino?. Aei eieaeoii?e ne?ae aaeaaaoenue eeoa o aeiaaeeao ?ao?aeoa?ieo aei iaaeeeaiaioicii? oa?ai?? oioaeueieo eie?o?a. Aeeiiaiiy ia?aeiii-a?aeiiaieo iia?aoe?e ni?eyei ia eeoa iie?ioaiith ?acoeueoao?a iaaee/ii? ?aaa?e?oaoe?? iia?iaaieo iaoe??io?a, a, ui ia iaio aaaeeeai, ? ?o iiai?e nioe?aeuei?e ?aaa?e?oaoe??. AEiaeai c iaoe??io?a, eio?ei aoee aeeiiai? iaeiiiiiaioi? iia?aoeai? ao?o/aiiy, ia aeeoia ia iain?th ii eae?oeoao, ia ci?iea i?ioan?th, ui aeicaieeei ?i caa?aaoe aeiiii?/io iacaeaaei?noue ? ia iia??oeei ye?noue ?oiueiai aeeooy. Oa?i?i nioe?aeueii? ?aaa?e?oaoe?? o aeaii? eaoaai??? iaoe??io?a noaiiaea 30,57,12 aei?a i?ioe 10,22,5 i?nyoe?a a eiio?ieuei?e a?oi?, aea ia?aeiii-a?aeiiai? iia?aoe?? acaaae? ia aeeiioaaeenue. Oaeei /eiii, iaaooee iaie aeina?ae canoinoaaiiy iioei?ciaaii? e?eoaaeueii? oaeoeee aeicaiey? iie?ioeoe ?acoeueoaoe e?eoaaiiy OE ? ?aeiiaiaeoaaoe ?? oe?iea ai?iaaaeaeaiy a ee?i?/io i?aeoeeo eieii?ieoieia?a, o??o?a?a oa aano?iaioa?ieia?a. AENIIAEE 1. No/aniee noai i?iaeaie e?eoaaiiy OE oa?aeoa?eco?oueny iaeiaea/ai?noth ao?iiaoiaaiaco, a?aenooi?noth ia’?eoeaieo e?eoa???a ioe?iee noaio iaoe??io?a, iaaeinoaoiueith aoaeoeai?noth ?nioth/eo cania?a iaaeeeaiaioicii? oa?ai??, ia?aaeeeaeuei?noth o??o?a?/iiai e?eoaaiiy oa iaaecia/ai?noth iioeiaeueiiai oa?i?io ? niiniao eiai aeeiiaiiy, ia?aaaaeaiiyi a caaaeuei?e no?oeoo?? iia?aoeaieo ao?o/aiue iaoe?ieo ?acaeoe?e eeoe?aieea. 2. Canoinoaaiiy a ee?i?/i?e i?aeoeoe? ?iaeaeno Aanoa aeicaiey? ia’?eoeaii ioe?ithaaoe noai iaoe??ioa oa aoaeoeai?noue iaaeeeaiaioicii? oa?ai??, iioei?coaaoe e?eoaaeueio oaeoeeo OE. 3. Aoaeanii?ae a aeiaia?e aeic? 9 ia ? aenieiaoaeoeaiei (aoaeoeai?noue 62,58,18%) ? aacia/iei i?aia?aoii aeey e?eoaaiiy iaoneeaaeiaieo oi?i aeoeaii? OE oa?i?iaeueiiai a?aeae?eo eeoaiai? eeoee, i?aai? iieiaeie oianoi? eeoee oa ?aoeeaeea?a a cii? oiiei-oianoieeoeiaeo aianoiiic?a. 4. Ia?i?aeuei? oi?ie aoaeanii?aeo a aeic? 3ia ia aeiao ciaioothoue ia’?i oiieieeoeiaeo aeii?iaeiaiue o noiiiaaieo iaoe??io?a ca ?aooiie ?o caouaiiy, ? oei naiei ni?eythoue ?icoe?aiith iieacaiue aei ?aeiino?oeoeaii-a?aeiiaieo iia?aoe?e. 5. Aeei?enoaiiy no/anieo iaaeeeaiaioicieo cania?a (i?aia?ao?a ianaeaceio oa aoaeanii?aeo) aeey e?eoaaiiy aeoeaii? OE oiiei? ? oianoi? eeoie aeicaiey? i?i?i?coaaoe iieacaiiy aei o??o?a?/iiai e?eoaaiiy ia 15,15% (c 37,174,55% aei 22,023,97%) iaa?oue o aeiaaeeao oyaeeeo oa ?iciianthaeaeaieo oi?i caoai?thaaiiy. 6. Iioeiaeueiee oa?i?i, iaiao?aeiee aeey ioe?iee aoaeoeaiino? iaaeeeaiaioicii? oa?ai?? noaiiaeoue 15-21 aei?a. A?aeiinieie iieacaiiyie aei o??o?a?/iai e?eoaaiiy ? ?ao?aeoa?i? aei an?o aeae?a eiina?aaoeaii? oa?ai?? ?io?eueo?aoeai? oa oneeaaeiai? iicaeeoeiaeie i?iyaaie oi?ie OE. 7. I?e o??o?a?/iiio e?eoaaii? OE oiiei? ? oianoi? eeoie iaiao?aeii canoiniaoaaoe iioei?ciaaio e?eoaaeueio oaeoeeo, yea aeeth/a?: 1)i?iaaaeaiiy a aeiiia?aoe?eiiio ia??iae? aaeaeaaoiiai iaaeeeaiaioiciiai e?eoaaiiy c iaia’yceiaei canoinoaaiiyi i?aia?ao?a aoaeanii?aeo oa/aai ianaeaceio; 2)aeeiiaiiy iia?aoeaieo ao?o/aiue i?ney aeinyaiaiiy iaoe??ioii ee?i?/ii? ?ai?n??, a o aeiaaeeao, eiee oea iaiiaeeeai, i?ney noaa?e?caoe?? iniiaieo ee?i?/ieo oa eaai?aoi?i?o neiioii?a OE; 3)canoinoaaiiy o??o?a?/iiai e?eoaaiiy ia ?aii?o aoaiao caoai?thaaiiy. 8. Aeio?eiaiiy iniiaieo i?eioeei?a iioei?ciaaii? e?eoaaeueii? oaeoeee aeicaiey? iie?ioeoe ?acoeueoaoe o??o?a?/iiai e?eoaaiiy OE: 1) ca?eueoeoe a caaaeuei?e no?oeoo?? iia?aoeaieo ao?o/aiue /anoeo aeiiiiieo ?acaeoe?e eeoe?aieea c 4,83,3% aei 37,59,9%, no?ieoa?icaa??aath/eo iaoe?ieo ?acaeoe?e eeoe?aieea c 33,3%7,3% aei 41,710,1%, ia?aeiii-a?aeiiaieo iia?aoe?e c 0% aei 45,810,2%; 2) cieceoe /anoioo i?neyiia?aoe?eieo oneaaeiaiue c 47,67,7% aei 20,88,3%, i?neyiia?aoe?eieo ?aoeeaeea?a c 23,86,6% aei 16,67,6%, i?neyiia?aoe?eio eaoaeuei?noue c 19,16,1% aei 4,24,1%, 3) nei?ioeoe oa?i?i i?neyiia?aoe?eiiai ia?aaoaaiiy iaoe??io?a a noaoe?iia?? ia 11 ae?a, iie?ioeoe iieacieee iaaee/ii? oa nioe?aeueii? ?aaa?e?oaoe?? iia?iaaieo oai?eo. NIENIE IIOAE?EIAAIEO I?AOeUe CA OAIITH AeENA?OAOe?? 1. E?aa/aiei O.A. Aeena?ioe/i? ci?ie i?e?ioei?e oianoi? eeoee o iaoe??io?a c oai?iaith E?iia // Ee?i?/ia o??o?a?y. - 1998. - ?8. - N.25-26. 2. E?aa/aiei O.A. Aieaciue E?iia: e?eoa?ee ii?aaeaeaiey aeoeaiinoe, noaiaie oyaeanoe e i?iaiica // Oe?a?inueeee iaaee/iee /aniien. - 1998. - ?6(8). - N.10-15. 3. E?aa/aiei O.A. No/ani? aniaeoe e?eoaaiiy oai?iae E?iia // E?ee Oe?a?ie. - 1999. - ?10. - N.51-52. 4. E?aa/aiei O.A. Iee?iaeioeaiic oienoie eeoee o iaoeeaioia n aieaciueth E?iia //Iaoa?eaeu 3-e iaaeaeoia? eiio. “I?iaeaiu ?aaaeeeoaoeee i?ieoieiae/aneeo aieueiuo”. Ii.:Aaei?onneee oeaio? iao/. iaae. eioi?iaoeee IC ?A, 1998. - N.104-105. 5. M.Kucher, Y.Baltaitis, S.Sheveluk, M.Kryvoruk, T.Kravchenko The role of laparoscopic techniques in the treatment of inflammatory bowell disease (IBD) // Falk Symposium “New Aspects in Hepatology and Gastroenterology”. - Tbilisi/Tiflis (Georgia). - 1998. - P.151. 6. T.Kravchenko. Crohn’s Disease: The role of Modern Medicine in the Improvement of Surgical Results // Polisn-Belorussian-Ukrainian Falk Symposium “New Concepts on Etiopathogenesis and Treatment of Inflammatory Bowel Disease”. - Warsaw (Poland). - 1999. - P.67. AIIOAOe?ss E?aa/aiei O.A. Iioei?caoe?y iieacaiue aei aeai?o oaeoeee e?eoaaiiy oai?iae E?iia oiiei? ? oianoi? eeoie. Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe ca niaoe?aeuei?noth 14.01.03 - o??o?a?y. - Ee?anueea iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe ?i.I.E.Ooieea IIC Oe?a?ie, Ee?a, 1999. Aeena?oaoe?y i?enay/ia i?iaeai? e?eoaaiiy oai?iae E?iia oiiei? ? oianoi? eeoie. A ?iaio? ii?aoeueiaaia oaeoeea e?eoaaiiy oai?iae E?iia, aea/aia aoaeoeai?noue i?aia?ao?a aoaeanii?aeo. I?iaeaiiino?iaaii, ui canoinoaaiiy aenieiaoaeoeaieo i?aia?ao?a aacenii? oa?ai?? aeey e?eoaaiiy oai?iae E?iia ni?ey? i?i?i?caoe?? iieacaiue aei iia?aoeaiiai e?eoaaiiy, a aeei?enoaiiy ?iaeaeno Aanoa - ia’?eoea?caoe?? e?eoaaeueii? oaeoeee. Canoinoaaiiy a ee?i?/i?e i?aeoeoe? ?ic?iaeaii? oaeoeee e?eoaaiiy aeicaieeei iie?aueoe ?acoeueoaoe o??o?a?/iiai e?eoaaiiy: ca?eueoeoe /anoeo aeiiiiieo ?acaeoe?e eeoe?aieea, ia?aeiii-a?aeiiaieo ? no?ieoa?icaa??aath/eo iia?aoe?e, cieceoe /anoioo i?neyiia?aoe?eieo oneeaaeiaiue, ?aoeeaeea?a oa eaoaeueiino?, iie?ioeoe ?acoeueoaoe nioe?aeueii? ?aaa?e?oaoe?? iia?iaaieo iaoe??io?a. Aecia/ai? a?aeiini? iieacaiiy aei ia?aeiieo iia?aoe?e oa iioeiaeuei? no?iee ?o aeeiiaiiy. Iieacaii, ui iioeiaeueiei niiniaii o??o?a?/iiai e?eoaaiiy oai?iae E?iia ? iaeiiiiiaioi? i?aaiicaa??aath/? iia?aoe??. Eeth/ia? neiaa: oai?iaa E?iia, ?iaeaen Aanoa, aoaeanii?ae, o??o?a?/ia e?eoaaiiy. SUMMARY T.G. Kravchenko. The optimization of indications for the choice of medical management of small and large bowel Crohn's disease. A dissertation prepared to fulfill the requirements for the scientific degree of candidate of medical sciences, speciality 14.01.03 - surgery. P.L.Shupik Kiev Medical Academy for Postgraduate Education, Ministry of Health of Ukraine, Kyiv, 1999. The dissertation is devoted to the problem of curing Crohn's disease of the small and large bowel. The purpose of this research was to study the effectiveness of various forms of budesonide, and propose a medical management for treating Crohn's disease. It was shown that the use of highly effective medicine for treating Crohn's disease minimizes the indications for surgery, and use of the CDAI leads to the optimal choice of medical approach. The use of this medicines in clinical practice led to an improvement in the surgical results: increased the part of segmental bowel resections, primary restorative and sphincter-saving operations, reduced the frequency of post-operative complications, relapses, and mortality, and improved the results of the social rehabilitation of post-surgery patients. The indications and the optimal time for elective surgery were clearly determined. It was shown that the optimal method of Crohn's disease surgical treatment is organ-preserving primary-restorative operations that reduce the level of overall trauma. Key words: Nrohn's disease, NDAI, budesonide, surgery. AIIIOAOeEss E?aa/aiei O.A. Iioeiecaoeey iieacaiee e auai?o ea/aaiie oaeoeee aieacie E?iia oiieie e oienoie eeoie. Aeenna?oaoeey ia nieneaiea iao/iie noaiaie eaiaeeaeaoa iaaeeoeeineeo iaoe ii niaoeeaeueiinoe 14.01.03 - oe?o?aey. - Eeaaneay iaaeeoeeineay aeaaeaiey iineaaeeieiiiiai ia?aciaaiey ei.I.E.Ooieea IC Oe?aeiu, Eeaa, 1999. Aeenna?oaoeey iinayuaia i?iaeaia ea/aiey aieacie E?iia oiieie e oienoie eeoee, a /anoiinoe, iieneo iooae oeo/oaiey ?acoeueoaoia oe?o?ae/aneiai ea/aiey caaieaaaiey. A iniiao aeenna?oaoeeiiiie ?aaiou iiaeeiaeaiu ?acoeueoaou eeeie/aneiai iaaethaeaiey ca 222-iy aieueiuie, ?acaeaeaiiuie ia 2 a?oiiu - eiio?ieueioth (113 iaoeeaioia) e enneaaeoaioth (109 iaoeeaioia). I?eioeeieaeueii ioee/iuie a aeaoo a?oiao auee ea/aaiay oaeoeea e i?aia?aou aaceniie oa?aiee: a eiio?ieueiie a?oiia auai? ea/aaiie oaeoeee aue noauaeoeaiei, a ea/anoaa iniiaiiai i?aia?aoa aaceniie oa?aiee eniieueciaaee noeueoanaeacei; aeey iaaeeeaiaioiciiai ea/aiey iaoeeaioia enneaaeoaiie a?oiu eniieueciaaee i?aia?aou ianaeaceia e aoaeaniieaea, auai? ea/aaiie oaeoeee aue iniiaai ia iauaeoeaiie ioeaiea ninoiyiey iaoeeaioia i?e iiiiue eiaeaena Aanoa. A aeenna?oaoeee ?ac?aaioaia iioeiece?iaaiiay ea/aaiay oaeoeea i?e aieacie E?iia e eco/aia yooaeoeaiinoue ia?i?aeueiuo oi?i eieaeueii aeaenoaothuaai aetheiei?oeeieaea aoaeaniieaea. ?acoeueoaou i?iaaaeaiuo enneaaeiaaiee i?iaeaiiino?e?iaaee, /oi ia?i?aeueiua oi?iu aoaeaniieaea a aeica 9ia a nooee yaeythony yooaeoeaiuie aeey ea/aiey aeoeaiie aieacie E?iia oiieie e oienoie eeoee, a nieaeaiea o?iaiy nuai?ioi/iiai ei?oeciea i?e aai i?eiaiaiee iaoiaeeony a i?aaeaeao aeiionoeiuo aaee/ei e eiaao aaeaioaoeeiiiuo oa?aeoa?. ?ac?aaioaia iioeiece?iaaiiay ea/aaiay oaeoeee, iniiaiuie ninoaaeythueie eioi?ie auee: 1)iauaeoeaiay ioeaiea ninoiyiey iaoeeaioia e aoaeoeaiinoe i?iaiaeeiiai ea/aiey i?e iiiiue eiaeaena Aanoa; 2)i?eiaiaiea a eiiieaeniii eiina?aaoeaiii ea/aiee e i?aaeiia?aoeeiiiie iiaeaioiaea yooaeoeaiuo i?aia?aoia aaceniie oa?aiee; 3)ia?aoiae e oe?o?ae/aneiio ea/aieth ia ?aiieo yoaiao caaieaaaiey; 4)auiieiaiea iia?aoeaiuo aiaoaoaeuenoa iinea aeinoeaeaiey iaoeeaioii eeeie/aneie ?aiennee, a a neo/ayo, eiaaea yoi iaaiciiaeii - iinea noaaeeecaoeee iniiaiiuo eeeie/aneeo e eaai?aoi?iuo neiioiiia aieacie E?iia. Iniiaiuie iieacaoaeyie iieiaeeoaeueiie aeeiaieee aieacie E?iia i?eciaii oeo/oaiea eeeie/aneeo neiioiiia caaieaaaiey, a iauaeoeaiui io?aaeaieai eeeie/aneiai oeo/oaiey oa/aiey aieacie - oiaiueoaiea eiaeaena Aanoa, ieieioi, ia 60 aae. I?iaiinoe/anee iaaeaaii?eyoiuie i?eciaeaie aeey i?iaaaeaiey iaaeeeaiaioiciiai ea/aiey e e?eoa?eyie aeey auai?a aeoeaiie oe?o?ae/aneie oaeoeee yaeythony: ionoonoaea yooaeoa io iaaeeeaiaioiciie oa?aiee ia i?ioyaeaiee 15-21 aeiy; onoie/eaua ei anai aeaeai eiina?aaoeaiie oa?aiee eioeeueo?aoeaiua e ineiaeiaiiua aiaeeoa/iuie i?iyaeaieyie oi?iu aieacie E?iia oiieie e oienoie eeoie. Ioeaieo ?ac?aaioaiiie ea/aaiie oaeoeee i?iaaaeaii iooai niiinoaaeaiey ?acoeueoaoia ea/aiey iaoeeaioia enneaaeoaiie e eiio?ieueiie a?oii. I?eiaiaiea a enneaaeoaiie a?oiia iioeiece?iaaiiie ea/aaiie oaeoeee iicaieeei cia/eoaeueii oeo/oeoue, ii n?aaiaieth n eiio?ieueiie a?oiiie, ?acoeueoaou ea/aiey aieacie E?iia: 1)ia 15,15% ieieiece?iaaoue iieacaiey e oe?o?ae/aneiio ea/aieth aeaaea i?e oyaeaeuo e ?aniino?aiaiiuo oi?iao caaieaaaiey: 2)nouanoaaiii eciaieoue oe?o?ae/aneoth oaeoeeo: oaaee/eoue eiee/anoai naaiaioa?iuo ?acaeoeee eeoa/ieea ia 32,7%, ia?ae/ii-ainnoaiiaeoaeueiuo iia?aoeee - ia 45,8%, noeieoa?inio?aiythueo iia?aoeee - ia 8,38%, i?eiaieoue a oe?o?ae/aneii ea/aiee aieacie E?iia eaia?ineiie/aneea oaoiieiaee. Iaiin?aaenoaaiiui ?acoeueoaoii i?eiaiaiey oniaa?oainoaiaaiiie oe?o?ae/aneie oaeoeee auei nieaeaiea /anoiou iineaiia?aoeeiiiuo ineiaeiaiee ia 26,8%, iineaiia?aoeeiiiuo ?aoeeaeeaia - ia 7,2%, iineaiia?aoeeiiiie eaoaeueiinoe - ia 14,9%. ?acoeueoaou enneaaeiaaiee iieacaee, /oi iioeiaeueiui niiniaii oe?o?ae/aneiai ea/aiey aieacie E?iia yaeythony yeiiiiiua ?acaeoeee eeoa/ieea n ia?ae/iui ainnoaiiaeaieai aai iai?e?uaiinoe, a e eieyeoiieyi neaaeoao i?eaaaaoue oieueei i?e ?ao?aeoa?iuo e iaaeeeaiaioiciie oa?aiee oioaeueiuo eieeoao. Auiieiaiea ia?ae/ii-ainnoaiiaeoaeueiuo iia?aoeee niinianoaiaaei oeo/oaieth ?acoeueoaoia ia oieueei iaaeeoeeineie, ii, e nioeeaeueiie ?aaaeeeoaoeee iia?e?iaaiuo iaoeeaioia, ainnoaiiaeaieth eo o?oaeiniiniaiinoe e yeiiiie/aneie iacaaeneiinoe. Eeth/aaua neiaa: aieaciue E?iia, eiaeaen Aanoa, aoaeaniieae, oe?o?ae/aneia ea/aiea.

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