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Патогенетичне обгрунтування етапного лікування дуоденальної виразки, асоційованої з Helicobacter pylori: Автореф. дис… канд. мед. наук / А.В. Ілько,

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

EE?ANUeEA IAAeE*IA AEAAeAI?ss

I?NEssAeEIEIIII? INA?OE ?I. I.E.OOIEEA

?eueei Aiae??e Aaneeueiae/

OAeE 616.33-002.44-06-08:615.838.97;681.3

IAOIAAIAOE*IA IAA?OIOOAAIIss AOAIIIAI E?EOAAIIss AeOIAeAIAEUeII?
AE?ACEE,

ANIOe?EIAAII? C HELICOBACTER PYLORI

14.01.02 – aioo??oi? oai?iae

Aaoi?aoa?ao

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Ee?a – 1999

Aeena?oaoe??th ? ?oeiien

?iaioa aeeiiaia a

Iaoeiaee ea??aiee:

Io?oe?ei? iiiiaioe:

I?ia?aeia onoaiiaa:Oaeai?iaenueeiio aea?aeaaiiio oi?aa?neoao?
I?i?noa?noai ina?oe Oe?a?ie

aeieoi? iaaee/ieo iaoe, i?ioani? *iiae ?aai Aaneeueiae/, caa?aeoaa/
eaoaae?e i?neyaeeieiiii? i?aeaioiaee e?ea??a Oaeai?iaenueeiai
aea?aeaaiiai oi?aa?neoaoo II Oe?a?ie

aeieoi? iaaee/ieo iaoe, i?ioani? Aaaei?ia E?ae?y sse?aia, i?ioani?
eaoaae?e n?iaeii? iaaeeoeeie Ee?anueei? iaaee/ii? aeaaeai??
i?neyaeeieiiii? ina?oe ?i. I.E.Ooieea IIC Oe?a?ie

aeieoi? iaaee/ieo iaoe, i?ioani? Iaeauoe Aiaoie?e Iao?iae/, i?ioani?
eaoaae?e aini?oaeueii? oa?ai?? ?2 Iaoe?iiaeueiiai iaaee/iiai
oi?aa?neoaoo ?i. I.I.Aiaiiieueoey IIC Oe?a?ie

?aaii-O?aie?anueea aea?aeaaia iaaee/ia aeaaeai?y IIC Oe?a?ie, eaoaae?a
i?iiaaeaaoeee aioo??oi?o caoai?thaaiue, i. ?aaii-O?aie?anuee

Caoeno a?aeaoaeaoueny “ 24 ” ethoiai 1999 ?. i 11.00 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? ?aaee Ae 26.613.01 i?e
Ee?anuee?e iaaee/i?e aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I.E.Ooieea IIC
Oe?a?ie (254112, i.Ee?a, aoe. Aei?iaiaeeoeueea, 9, aoae. ?3)

C aeena?oaoe??th iiaeia iciaeiieoeny a iaoeia?e a?ae?ioaoe? Ee?anueei?
iaaee/ii? aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I.E.Ooieea (254112,
i.Ee?a, aoe. Aei?iaiaeeoeueea,9)

Aaoi?aoa?ao ?ic?neaiee “ 22 ” n?/iy 1999 ?.

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee

eaiaeeaeao iaaee/ieo iaoe, aeioeaio
I. ?. ?iiaiaiei

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie. Oai?iae i?aaiia o?aaeaiiy caeiathoue iaeia c
i?iaiaeieo iinoeue ye ii /anoioi ?iaae?aeecaoe??, oae i ii iieacieeo
nia?oiinoi. Ia?aaeae?aceia? noaie (IAN) oa ae?acea aeaaiaaeoeyoeiaei?
eeoee (AAeIE) caeiathoue i?aaaethth/a iinoea a no?oeoo?i caoai?thaaiinoi
i?aaiia OEO. Ca aeaieie aaaaoi/eneaieo aaoi??a a aeiiii?/ii ?icaeiooeo
e?a?iao eeoa iaioe/iith ae?aceith (IA) ia i?ioyc? aeeooy oai??thoue a?ae
10 aei 20 a?aenioe?a anueiai aei?ineiai ianaeaiiy (I.ss.A?eai?ueaa e
niaao., 1993, E.E.Aeaaoy??aa, I.A.Oa?/aiei, 1995, Eiaeiia e niaao.,
1993). A Oe?a?i? /enei aeyaeaieo oai?eo ia iaioe/io ae?aceo ia?aaeuo? 4
i?eueeiie. O 1995 ?ioe? a iao?e e?a?i? c i?eaiaeo oeueiai caoai?thaaiiy
i?iiia?iaaii 29 oeny/ oai?eo ? eeoa o 36 a?aenioe?a c ieo aoea
oneeaaeiaia IA, oiae? ye 64 a?aenioee neeaee ieaiia? iia?aoe??
(A.A.Ia?aaea?ee e niaao., 1997). Caaaeueiia?aeiii, ui, a iniiaiiio,
iaioe/iith ae?aceith oai??thoue ethaee iieiaeiai oa na?aaeiueiai,
iaea?eueo i?aoeacaeaoiiai a?eo, ?, cae/aeii, ?iaae?aeecaoe?y
i?iiia?iaaieo oai?eo caeeoa?oueny iaei??th c iaeaeueo.

IA a?aeiineoueny aei a?oie eeneioicaeaaeieo caoai?thaaiue, ? oiio iiaia
oa aaeaeaaoia ?ioi?iaoe?y i?i noai eeneioiooai?thth/i? ooieoe?? oeoieo
iaaecae/aeii aaaeeeaa aeey ?icoi?iiy iaoiaaiaco, i?iaiico, aeai?o
iaoiaeo e?eoaaiiy oa eiio?ieth ca eiai aoaeoeai?noth (TH.ss.Eay, 1987,
I.ss.A?eai?ueaa e niaao., 1988).

Eiii’thoa?iee aioo??oeoieiaee iii?oi?eia ?I (EAI?I) ? i?ia?aeiei
iaoiaeii ae?aaiinoeee IA, aea? ciiao aea/aoe i?ioeane
eeneioii?iaeoeoe?? (EI) oa eeneioiiaeo?aeicaoei? (EI) o oeoieo a
aeeiaiioei. Ii?yae c oei, aeei?enoaiiy oeueiai iaoiaeo aeicaiey?
ioeiithaaoe aoaeoeaiinoue eieoaaiiy oai?eo ia AAeIE oa IAN
oa?iaeieiai/ieie i?aia?aoaie, oiciioa?aiaaoe/ieie, eo?i?oieiai/ieie
iaoiaeaie, oiui.

Aae?eiaaeoa?ia ?ioaeoe?y – iaeaaaeeea?oee ao?ieia?/iee oaeoi? iaeaea
an?o iaiaaeeeaiaioicieo oeoieiaeo oa aeoiaeaiaeueieo ae?acie. A?eueoa 95
a?aenioe?a oai?eo ia AAeIE ? a?ey 90 a?aenioe?a oai?eo ia
iaiaaeeeaiaioicio aeia?iye?nio ae?aceo oeoieo iathoue oe? aaeoa???.
A?aaeeeaoe?y Helicobacter pylori (I?) i?eaiaeeoue ia eeoa aei
caaeeaeaiiy ae?acie, aea e iiia?aaeaeo? caaino?aiiy oai?iae (E.E.A?oei e
niaao., 1993, I.ss.A?eai?ueaa, 1996, ss.N.Oeeiia?iai e niaao., 1993).

Aea ii?yae c oeei, aaeeeo ?ieue o aeieeiaii? oeueiai caoai?thaaiiy
a?ae?a?a? aaiaoe/ia noeeuei?noue, yea aeia?a a?aeiia a ee?i?oe? ? iiaea
aooe ae?aaiinoiaaia ??cieie iaoiaeaie, a oiio /ene? aeei?enoiaoth/e
ineoieia?/i? oanoe (O.A.Aa?acei e niaao., 1976).

Ia nueiaiaei?oi?e aeaiue cai?iiiiiaaii iaiaei iaoiae?a eiiieaeniiai
e?eoaaiiy AAeIE. ?nio? aace?/ noai i?ioeaae?eiaaeoa?ii? oa?ai??, aea i?
iaeio c ieo ia iiaeia aaaaeaoe ?aeaaeueiith. Iaaooue a ee?i?oe?
aioo??oi?o oai?ia ia ciaeaeaoueny iiae?aiiai caoai?thaaiiy, i?e yeiio
aeei?enoiaoaaeinue ae a?ey 700 ??cieo iina?aaeiee?a oa niinia?a oa?ai??,
aea i?e oiio caeeoaeiny no?eueee a?eeo ieyi a?aeiinii oaeoeee aaaeaiiy,
aeioe?eueiino? aoaiiiai e?eoaaiiy. Ia aeeaey/enue ia oa, ui oi?ioeo
“iaia? I? – iaia? ae?acee” iiaeia ?aooaaoe aeiaaaeaiith, aaaaoi a
e?eoaaii? I?-anioe?eiaaii? IA caeeoa?oueny iayniei. Ia nueiaiaei? ia
?nio? noaie, yea a aeaaaea noia?aenioeiaee ?acoeueoao a?aaeeeaoe??
?ioaeoe?eiiai aaaioa, a c ?ioiai aieo anoaiiaeaii, ui i?eeii
aioenae?aoi?ieo i?aia?ao?a, ye? i?aeo?eiothoue ?I o ii?iaeiei? oeoieo
aeua 3 iae. ?I ia i?ioyc? 18 aiaeei ca aeiao, caaacia/o? caaeeaeaiiy
ae?acee ia i?ioyc? 4 oeaei?a o 100 a?aenioe?a oai?eo (D.W.Burget,
S.G.Chiverton et al., 1990). Oiio iiaeaeueoa aea/aiiy iaoiae?a e?eoaaiiy
caeeoa?oueny aeooaeueiei, ye ? ieoaiiy i?i no/ani? iaoiaee aoaeoeaiiai
eiio?ieth ca i?iaaaeaiiyi ae?i?iaoe?? eaii?eiaaeoa??ico.

Aoaiia e?eoaaiiy oai?eo ia AAeIE, a oiio /ene? c aeei?enoaiiyi
i?ia?aeueieo aiae (IA), aea/aeiny aeineoue ?aoaeueii. Aeiaaaeaii
ni?eyoeeaee eeneioi?aaoethth/ee aieea aoaeaeeneeo a?ae?iea?aiiaoieo
iao???aeo IA (AAIIA) ia aieueoinoue oai?eo c iaoieiai?th
aano?iaeoiaeaiaeueii? ciie (I.O.Eaiae?e, I.I.Aaenae, E.I.Ee?oe/ oa
ni?aaao., 1996). Aea, ii?yae c oeei, cianii ia aea/aia ae?oaa noi?iia ?o
eieoaaeueieo iiaeeeainoae – aioe-I? ae?y. C ?ioiai aieo, aeeeeea?
?ioa?an aea/aiiy aeeiai?ee i?ioean?a eeneioii?iaeoeoe?? oa
eeneioiiaeo?ae?caoe?? a naiaoi?ieo caeeaaeao i?e ??cieo oa?i?iao
e?eoaaiiy.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. ?iaioa ?
/anoeiith iaoeiai? i?ia?aie eaoaae?e i?neyaeeieiiii? i?aeaioiaee e?ea??a
iaaee/iiai oaeoeueoaoo Oaeai?iaenueeiai aea?aeaaiiai oi?aa?neoaoo c
oaiaoeee: “Aea/aiiy no?oeoo?ii-ooieoe?iiaeueieo iniia oa iaoai?ci?a
iaoieia?/ieo oa eiiiainaoi?ieo ?aaeoe?e aano?iaeoiaeaiaeueii? nenoaie
na?aae ianaeaiiy Caea?iaooy a oe?eiio oa a ie?aieo iiioeyoe?yo, a oaeiae
i?e ?oai?/i?e oai?ia? na?oey“, iiia? aea?aeaaii? ?a?no?aoe??
0196U003256.

Iaoa ? caaea/? aeine?aeaeaiiy. I?iaanoe eiiieaenia aea/aiiy aoiieiai/ieo
oaeoi?ia oa iaoiaaiaoe/ieo iaoaiiciia ?icaeoeo AAeIE oa IAN, a naia:
?ieue I?-iioaeoei?, ?iceaaeia nenoaie
eeneioii?iaeoeoeiy-eeneioiiaeo?aeicaoeiy o oeoieo a ?icii oace
caoai?thaaiue ca aeiiiiiaith EAI?I, ineoieia?/ieo iniaeeainoae oai?eo,
oa ?ic?iaeoe iioeiaeueii iaoiaee aoaiiiai eieoaaiiy i eiio?ieth ca eiai
aoaeoeaiinoth. Cai?iiiioaaoe aeey oe?ieiai aeei?enoaiiy /?oeo
eiioeaioe?th aoaiiiai e?eoaaiiy oai?eo ia AAeIE.

Aeey ?aaeicaoei? oei?? iaoe aoee iinoaaeaii ianooii? caaea/?:

1. Aea/eoe nooiiiue iioieoaaiiy I? oai?eo ia AAeIE ia ??cieo aoaiao
e?eoaaiiy.

2. Aeineiaeeoe nooiiiue ii?ooaiiy i?ioeania eeneioiooai?aiiy oa
eeneioiiaeo?aeicaoei? o oeoieo oai?eo ia AAeIE ca aeiiiiiaith EAI?I ia
??cieo aoaiao e?eoaaiiy caoai?thaaiiy.

3. Aea/eoe oa?aeoa? ineoieia?/ieo iniaeeainoae oai?eo ia AAeIE.

4. Aeineiaeeoe oa ioeiieoe ?yae aioeaaeieiaaeoa?ieo noai c oi/ee ci?o
aoaeoeaiinoi, i?iyao ieie iiai/ieo aoaeoia oa aa?oinoi. Cai?iiiioaaoe
aei i?aeoe/iiai aeei?enoaiiy aenieiaoaeoeaio ei?ioeino?ieiao noaio
aioe-I? oa?aii?.

5. Aeineiaeeoe eeneioi?aaoethth/o oa aioeaaeieiaaeoa?io aeanoeainoi
AAIIA na?aaeiuei? i?ia?ae?caoe?? oeio “Iieyia Eaaniaa” ia
naiaoi?ii-eo?i?oiiio aoaii eieoaaiiy c a?aooaaiiyi ?icieo oa?iiiia
aaeueiaieiai/ii? oa?aii?.

6.Iaa?oiooaaoe oa ai?iaaaeeoe iiao iaoiaeeeo i?eeiio AAIIA o oai?eo ia
AAeIE, ia?aa??eoe ?? aoaeoeai?noue.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a.

1. Iiaeeaeaii aea/aia ?ieue Helicobacter pylori o aeieeiaii? AAeIE ia
aoaiao e?eoaaiiy.

2. Aea/aiee o aeeiai?oe? noai oeoieiai? eeneioii?iaeoeoe?? oa
eeneioiiaeo?ae?caoe?? oai?eo ia AAeIE i?ae /an noaoe?iia?iiai oa
naiaoi?ii-eo?i?oiiai aoai?a e?eoaaiiy.

3. Anoaiiaeaii ?nioaaiiy ianiaoeeo?/ieo ?iceaae?a ineoieia?/iiai noaio
o oai?eo ia AAeIE.

4. Aeine?aeaeai? oa cai?iiiiiaai? aeey oe?ieiai aeei?enoaiiy iia?
iaoiaeeee i?ioeaae?eiaaeoa?ii? oa?ai??.

5. Aea/aia oa ai?iaiaaia iiaa iaoiaeeea ieoiiai e?eoaaiiy AAIIA
na?aaeiuei? i?ia?ae?caoe?? oai?eo ia AAeIE oa ia IAN. Ioe?iaia
aioeaae?eiaaeoa?ia ?ieue IA “Iieyia Eaaniaa”.

6. Iaa?oioiaaii iaiao?aei?noue aoaiiiai e?eoaaiiy oai?eo ia AAeIE.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a.

Iaoa??aee aeena?oaoe?? aeei?enoiaothoueny a eaeoe?eiiio eo?n? oa ia
i?aeoe/ieo caiyooyo eaoaae?aie i?neyaeeieiiii? i?aeaioiaee e?ea??a,
aini?oaeueii? oa?ai?? oa i?iiaaeaaoeee aioo??oi?o oai?ia
Oaeai?iaenueeiai aea?aeaaiiai oi?aa?neoaoo, eaoaae?ith aini?oaeueii?
oa?ai?? ? ee?i?/ii? oa?iaeieia?? Aoeiaeinueei? aea?aeaaii? iaaee/ii?
aeaaeai??.

Ca iaoa??aeaie aeena?oaoe?eii? ?iaioe ?ic?iaeai? aea?
?aoe?iiae?caoi?nuee? i?iiiceoe?? (a ni?aaaoi?noa?): “Niin?a e?eoaaiiy
ae?aceiai? oai?iae aeaaiaaeoeyoeiaei? eeoee” (iina?ae/aiiy ? 351 a?ae
03.12.96), “Niin?a ae?aaiinoeee aeoiaeaii-aano?aeueiiai ?aoetheno”
(iina?ae/aiiy ? 352 a?ae 03.12.96). Aeai? niiniae ai?iaaaeaeai? a
i?aeoeeo aano?iaioa?ieia?/iiai a?aeae?eaiiy OeIEE i.Oaeai?iaea,
oa?aiaaoe/iiai a?aeae?eaiiy a?aeae?eeiai? e?ea?i? no. Oaeai?iae, IAI
“?aaa?e?oaoe?y” i.Oaeai?iae, naiaoi??th aano?iaioa?ieia?/iiai i?io?eth
“Niiy/ia Caea?iaooy” oa aano?iaioa?ieia?/iiai a?aeae?eaiiy 1-? i?nueei?
e?ea?i? i.*a?i?aoe?. ?acoeueoaoe ai?iaaaeaeaiiy a i?aeoeeo aeiaiaeyoue
?o aenieo aoaeoeai?noue oa i?aeoe/io oe?ii?noue.

Aeaeai? (o ni?aaaoi?noa?) iaoiaee/i? ?aeiiaiaeaoe?? “O?iie/aneee
aano?eo. Nia?aiaiiua i?aaenoaaeaiey i eeanneoeeaoeee, yoeiiaoiaaiaca,
eeeieea e ea/aiee” (Oaeai?iae,1997), ye? ai?iaaaeaeai? a
e?eoaaeueii-i?io?eaeoe/ieo caeeaaeao i.Oaeai?iaea, i?i ui na?ae/aoue
a?aeiia?aei? aeoe.

Iniaenoee aianie caeiaoaa/a. Aianie aaoi?a a io?eiai? ?acoeueoaoe ?
iniiaiei ? iieyaa? o aeai?? ia’?io ? iaoiae?a aeine?aeaeaiiy, a
iinoaiiaoe? iaoe oa oi?ioethaaii? caaaeaiue, a i?iaaaeaii? ee?i?/ieo,
?ino?oiaioaeueieo oa niaoe?aeueieo eaai?aoi?ieo aeine?aeaeaiue, a
aiae?c? oa ocaaaeueiaii? ?acoeueoao?a ?iaioe, iaa?oiooaaii? iaoiae?a
e?eoaaiiy, i?aeaioiaoe? iaoeiaeo iaoa??ae?a aei ae?oeo.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. ?acoeueoaoe aeena?oaoe?eii?
?iaioe, ii i??? ?o io?eiaiiy oa aiae?co, aeiiia?aeaeeny oa
iaaiai?thaaeeny ia i?aenoieiaeo iaoeiai-i?aeoe/ieo eiioa?aioe?yo
i?ioani?nueei-aeeeaaeaoeueeiai neeaaeo Oaeai?iaenueeiai aea?aeaaiiai
oi?aa?neoaoo o ethoiio 1996, 1997 oa 1998 ?ie?a, ia Ieaioi? i?aae?iiy
Oe?a?inueeiai iaoeiaiai oiaa?enoaa aa?iioieia?a (*a?i?aoe?, 18-20
aa?aniy 1996 ?ieo), neiiiceoi? “Aeooaeuei? ieoaiiy ?aaa?e?oaoe??
aano?iaioa?ieia?/ieo oai?eo” (i. *a?i?aoe?, 17-18 ea?oiy 1996 ?ieo),
i?aeia?iaei?e eiioa?aioe??, i?enay/ai?e 20- ??//th Oaeai?iaenueei?
a?aeae?eeiai? e?ea?i? “Aeooaeuei? i?iaeaie ianeoaiaoaaiiy i?aoethth/eo
ia cae?cie/iiio o?ainii?o?” (i.Oaeai?iae, 12-14 /a?aiy 1996 ?ieo),
i?aenaiaoi?iiio caiyoo? e?ea??a ia’?aeiaiiy “Caea?iaoeo?i?o” o
eenoiiaae? 1997 ?ieo, Ainueiiio i?aeia?iaeiiio eiia?an? ?ioaeoe?eieo
oai?ia (i.Ainoii, ooao Iana/onaon, NOA, 15-18 o?aaiy 1998 ?ieo) oa XIV
c’?cae? oa?aiaao?a Oe?a?ie (i. Ee?a, 22-25 aa?aniy, 1998 ?ieo).

Aeena?oaoe?y ai?iaiaaia 17 aa?aniy 1998 ?ieo ia ni?eueiiio can?aeaii?
eaoaae? i?neyaeeieiiii? i?aeaioiaee e?ea??a, aini?oaeueii? oa?ai?? oa
i?iiaaeaaoeee aioo??oi?o oai?ia iaaee/iiai oaeoeueoaoo Oaeaeo i?e
i?enooiino? ni?a?ia?oiee?a oa?aiaaoe/iiai a?aeae?eaiiy Oaeai?iaenueei?
a?aeae?eeiai? e?ea?i?.

Ioae?eaoe??. Ca iaoa??aeaie aeena?oaoe?? iioae?eiaaii 12 iaoeiaeo
i?aoeue, c ieo: 5 – o iaoeiaeo aeo?iaeao, 1 – o iaoeiaiio ca??ieeo, 6 –
o iaoa??aeao neiiiceoi?a oa eiia?an?a, a oiio /ene? aeaio, ye?
i?iaiaeeeeny ca ei?aeiiii.

No?oeoo?a aeena?oaoe??. Aeena?oaoe?y aeeeaaeaia ia 132 noi??ieao
iaoeiiieno, aeeth/a? 25 oaaeeoeue oa 18 ?enoie?a. ?iaioa iiaoaeiaaia ca
caaaeueiii?eeiyoei ieaiii ? neeaaea?oueny ?c anooio, 6 ?icae?e?a, a oiio
/ene? ?acoeueoao?a aeanieo aeine?aeaeaiue, caeeth/aiiy, aeniiae?a,
i?aeoe/ieo ?aeiiaiaeaoe?e, nieneo aeei?enoaieo aeaea?ae, yeeo
ia?aoiao?oueny o ?iaio? 285, c ieo 121 a?o/eciyieo (a oiio /ene? ?
?in?enueeiiiaieo) oa 164 ca?oa?aeieo aaoi??a, a oaeiae aeiaeaoe?a.

INIIAIEE CI?NO ?IAIOE

Iaoa??aee ? iaoiaee aeine?aeaeaiue. Aeey ae?ioaiiy iinoaaeaieo caaea/
iaie aoei ianoaaeaii 159 oaiaoe/ieo oai?eo. C ieo – 125 oai?eo ia AAeIE,
a oiio /enei 95 o oaci caaino?aiiy, 30 o oaci ?aiini?; 34 oai?eo ia OA
A, a oiio /enei 18 a oaci caaino?aiiy, 16 a oaci ?aiini?. Aeineiaeaeaiiy
95 oai?eo ia AAeIE oa 18 oai?eo OA A o oaci caaino?aiiy i?iaiaeeeiny o
oa?aiaaoe/iiio oa iieieeiii/iiio aiaeaeieaiiyo aiaeaeieeiai? eeiii/ii?
eiea?ii no.Oaeai?iae oa aano?iaioa?ieiai/iiio aiaeaeieaiii OeIEE
i.Oaeai?iaea, 30 oai?eo ia AAeIE, 16 oai?eo OA A o oaci ?aiini? – o
aaciaiio naiaoi?i? aano?iaioa?ieiai/iiai i?ioieth “Niiy/ia Caea?iaooy”.
Ianoaaeaiiy aeeiioaaeeny ca ia?iiae 1996-1998 ??.

A yeinoi eiio?ieueii? a?oie aeei?enoaii 44 i?aeoe/ii caei?ia? iniae, a
oaeiae 33 oai?eo ia a?iioiaeueio anoio oa o?iii/iee a?iioio o oaci
?aiini?, yei i?ioiaeeee eieoaaiiy o IAI ”?aaaieioaoeiy” i.Oaeai?iae.

Aeai?eoi ae?aaiinoeee IA oa OA A ii/eiaany c ae?aaiico “Aeeniain?y”,
yeee i?ney aeei?enoaiiy ee?i?ei-?ino?oiaioaeueieo iaoiae?a
o?ainoi?ioaaany o a?aeiia?aeio iicieia?/io iaeeieoeth. Ia iiiaio
caaa?oaiiy iaienaiiy ?iaioe ie ei?enooaaeeny eeaneo?eaoe??th IA,
iaeneiaeueii aaeaioiaaiith aei IEO O ia?aaeyaeo (E.E. Aeaaoy??aa,
I.A.Oa?/aiei, 1995; A.A.Ia?aaea??e, 1997). Oaeei /eiii, a iao?e ?iaio?
iaioe/ia ae?acea – oea neiii?i ae?aceiai? oai?iae.

Uiaei OA, iaie aeei?enoiaoaaeany oae caaia N?aeiaenueea eeaneo?eaoe?y
1990 ?ieo, a c 1996 ?ieo ie a?aoiaoaaee oaeiae ?aeiiaiaeaoe?? ?iai/i?
O’thnoiinueei? a?oie (E.E.A?oei, 1997).

Aoaii?noue aeine?aeaeaiiy caaacia/oaaeany ?o i?iaaaeaiiyi a
aiaoeaoi?ii-noaoe?iia?ieo oa naiaoi?ii-eo?i?oieo oiiaao.

Aecia/aiiy I?-iioaeoei? i?iaiaeeeiny ca aeiiiiiaith a?noieia?/iiai
iaoiaeo, o?aaciiai oanoo c aeei?enoaiiyi na?aaeiaeua Caena oa iaoiaeo
oaapaeioaciiai iiyiioapiaioiiai aiaeico (iaai? ImmunoComb II,
ae?iaieoeoaa ?c?a?eth).

Aeine?aeaeaiiy EI oa EI ooieoei? oeoieo aeeiioaaeeny aia?aoaie
“Oiiaa?naeueiee iiiiii? AA – 74” c iaai?ii aeaieaiaeueieo ciiaeia
?.TH.E?ia?a oa AA 1Ae-01 c aeaieaiaeueieie ciiaeaie IA-?I-2. Aea/aiiy
i?/ii? nae?aoe?? oeoieo i?iaiaeeee ca aeiiiiiaith EAI?I
(A.I.*a?iia?iaee, 1989). Aeey oeueiai iaie aeei?enoaiee eiiieaen, yeee
aeeth/aa iaeiie/oaa/ ?I-iao?e/ii? ?ioi?iaoe??, eiii’thoa?, a?aeiia?aeio
i?ia?aio c aeiiii?aeieie aeaiaioaie nenoaie, ?I-i?e?iciiaeaie oa ?ioeie
i?eno?iyie. Aaoiiaoe/ia ?a?no?aoe?y ?I ia i?ioyc? ii/? i?iaiaeeeany c
?ioa?aaeii a 16 naeoiae. Aeey ooieoeiiioaaiiy eiiieaeno ie
aeei?enoiaoaaee ia?niiaeueio AII oeio ?AI ?N AO/OO – 486 c ia?eoa?i?th
(aeenieae, eeaaiaoo?a, i?eioa?).

Caien iieacieeia i?/ii? nae?aoe?? oeoieo i?iaiaeeee c 23.00. aei
06.00., a a naiaoi?ieo oiiaao – aei 07.00, oiio ui ia oeueiio aoai?
aea/aeany oaeiae aioaoeeaeia ae?y iaeii?aciaiai i?eeiio 200 ie IA
“Iieyia Eaaniaa”.

Aeineiaeaeaiiy ineoieia?/ieo iniaeeainoae oai?eo i?iaiaeeee ca
aeiiiiiaith Iiiianionueeiai aieaoiiai oanoo (II?? – Minnesota
Multiphasic Personality Inventory). Io?eiaiee a ?acoeueoaoi
aeineiaeaeaiue oeeo?iaee iaoa?iae ia?iaeaiee c aeei?enoaiiyi
noaiaea?oieo noaoenoe/ieo iaoiaeia ic ciaoiaeaeaiiyi na?aaeiuei?
aaee/eie (I), na?aaeiuei? iioeaee na?aaeiuei? aaee/eie (m), iieaciee?a
?iia??iino? Nouethaeaioa (t) oa ai?iaiaeiinoi (?).

Iniiai? ?acoeueoaoe aeine?aeaeaiiy. ??aaiue ?io?eoaaiiy I? i?aeoe/ii
caei?iaeo in?a neeaa 37,5%, o oai?eo ia aeoiaeaiaeueio ae?aceo
I?-?ioaeoe?th ciaoiaeeee a 92,3%. Na?aaeiie iieaciee eiioeaio?aoe??
aio-I? Ig G o eiio?ieueii? a?oie noaiiaea 53,3 iae/ie, a o oai?eo ia
AAeIE – 65,1 iae/ie. Eiioeaio?aoe?y aioeo?e aei I? o oai?eo ia AAeIE ia
aoea a??ia?aeii aeuith a ii??aiyii? c caei?iaeie iniaaie ? ia iiaea
aeei?enoiaoaaoeny ye aeeoa?aioe?eiee ae?aaiinoe/iee oano.

I?e aea/aii? aoaeoeaiino? ?yaeo iaaeeeaiaioicieo noai c oi/ee ci?o
aeiiiiaoei? I?, /anoioe ?oaoethaaiiy ae?acee /a?ac o?e oeaei?,
ae?aaeaiino? iia?/ieo aoaeo?a oa aa?oino?, ca iaoeie aeaieie,
iaeaoaeoeai?oeie noaiaie a ieai? a?aaeeeaoei? I?-iioaeoei? aoee
eiiaiiaoei? aiieneoeeeiio (500 ia 4 ?ace ia aeaiue), caioaeo (150 ia 2
?ace ia aeaiue) oa aea-iieo (120 ia 4 ?ace ia aeaiue), ye? oai?? ia
AAeIE i?eeiaee ia i?ioyc? 14 aeiia; aea-iieo (120 ia 4 ?ace ia aeaiue),
oao?aoeeeeiio (500 ia 4 ?ace ia aeaiue) oa iao?iiiaeacieo (250 ia 3
?ace) – 14 aeiia; aea-iieo (120 ia 4 ?ace ia aeaiue), aiieneoeeeiio (500
ia 4 ?ace ia aeaiue) oa iao?iiiaeacieo (250 ia 3 ?ace ia aeaiue) – 14
aeiia; iiai?acieo (40 ia 1 ?ac ia aeaiue), yeee i?eeiaee i?ioyaii
oeaeiy, aceo?iiioeeio (c 5 aeiy ii 500 ia 1 ?ac ia aeaiue) oa
iao?iiiaeacieo (c 5 aeiy 500 ia 3 ?ace ia aeaiue), ye? i?eeiaee ia
i?ioyci 3 aeiia.

Ne?ae ie?aii i?aee?aneeoe, ui ye eeane/ia, oae ? cai?iiiiiaaia iaie
noaia c iiai?acieii, aceo?ii?oeeiii oa iao?ii?aeacieii, e??i oeueiai, ?
e aeiiiii/ii aeaiaeieie. O?ioe aieueoee (87,5% i?ioe 83,3%)
a?aaeeeaoeieiee aoaeo iaei cai?iiiiiaaia ei?ioeino?ieiaa i?ecia/aiiy
iiai?acieo, aceo?ii?oeeio oa iao?ii?aeacieo, ? oey eiia?iaoe?oey ?
c?o/iith o aeei?enoaii? oai?eie.

A ?acoeueoao? i?iaaaeaiiai noaoe?iia?iiai e?eoaaiiy o a?eueoino? oai?eo
ia AAeIE cieeea iniiaia neiioiiaoeea. Aieueiaee neiae?ii caeeoaany /a?ac
o?e oeaei? i?ney ii/aoeo oa?ai?? o 13% in?a, c ieo o 4, ui io?eioaaee
ieaoeaai, ia??iaee/i? a?ae?eaeea eeneei – o 35%, ia/?y o 11% oa cae?aie
o 30% oai?eo ia aeoiaeaiaeueio ae?aceo (i?e iinooieaii? a?aeiia?aeii o
92,6%, 43%, 48,4% oa 53,7% oai?eo).

I?iyae iia?/ieo aoaeo?a aeine?aeaeoaaieo iaaeeeaiaioicieo noai aoee
i?i?iaeueieie ? aeyaeai? o 9 ?c 77 oai?eo (11,7%).

I?e aea/aii? i?ioean?a EI oa EI o eiio?ieuei?e a?oi? in?a na?aaei?e
iieaciee ?I oiea oeoieo noaiiaea 1,6424+0,062 iae. ?I, a a aio?aeuei?e
/anoei? – 4,6092+0,357 iae. ??aaiue EI ciaoiaeeany a iaaeao
ii?iaoeeaeiino?, a EI, oiaoi ??cieoey i?ae iieacieeii ?I o o?e? oa
aio?aeuei?e /anoei? oeoieo, noaiiaeea 2,9668.

Na?aaei?e iieaciee ?I o o?e? oeoieo oai?eo ia AAeIE o oac? caaino?aiiy
noaiiaea 1,2642+0,060, o oai?eo ia OA A o oac? caaino?aiiy –
1,3744+0,077 iae. ?I. Oiaoi, a iaeaeaio a?oiao iieacieee ?I o?ea oeoieo
iiaeia ioa?aeoa?ecoaaoe, ye iii??ii a?ia?aoeeaei?. sse o oai?eo ia
AAeIE, oae ? OA A io?eiai? iieacieee ?I o?ea oeoieo a??ia?aeii
a?ae??ciyeeny a?ae aiaeia?/ieo eiio?ieueii? a?oie (? 0,2 oa > 0,6 a?aeiia?aeii).

Iieacieee ?I o o?e? oeoieo oai?eo ia AAeIE o oac? ?ai?n?? noaiiaeee
1,3792+0,089 iae. ?I. C ?ioiai aieo, o oai?eo ia OA A o oac? ?ai?n?? oe?
iieacieee aoee 1,3571+0,145 iae. ?I. A aio?aeueiiio a?aeae?e? oeoieo
aiie noaiiaeee a?aeiia?aeii 3,9950+0,235 oa 3,2928+0,318 iae. ?I.

I?e ii??aiyii? aeaieo iieaciee?a c aiaeia?/ieie eiio?ieueii? a?oie
anoaiiaeaii, ui o iaio aeineiaeaeoaaieo eiioeiaaio?a oai?eo inioaaea
a??ia?aeia ??cieoey iieaciee?a ?I o?ea oeoieo oa aio?aeueiiai a?aeae?eo
ye a oaci caaino?aiiy, oae ? ?ai?n??. C ?ioiai aieo, ia ciaeaeaii
a??ia?aeieo ciii i?ae iieacieeaie EI oeeo a?oi oai?eo o ??cieo oacao
caoai?thaaiue iaa?oue /a?ac 3-7 i?nyoe?a i?ney caaino?aiiy (? > 0,2 oa >
0,3 a?aeiia?aeii). Oe?eaai, ui a??ia?aei? ci?ie ciaeaeai? aeey
iieaciee?a ?I a aio?aeueiiio a?aeae?e? oeoieo (? 0,05). C ?ioiai aieo,
aiia ?nioaaea o na?aaeiueia?oiiaeo cia/aiiyo i?/ieo iieaciee?a ?I o?ea
oeoieo oai?eo ia AAeIE ye o oac? ?ai?n??, oae o oac? caaino?aiiy, i?e
ii??aiyii? c eiio?ieueiith a?oiith a ia?o?e iieiaei? ii/?. A oac?
?ai?n?? oey ??cieoey niinoa??aaeany ia i?ii?aeeo /ano a?ae 23.00 aei
00.20 (?

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