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7

?INOEOOO NA?OeAAI-NOAeEIII? O??O?A?? AII OE?A?IE

E?EEOIIA Ieaen?e Aioiiiae/

OAeE 616.132.2-004.8-. 127-005.8./. 126.423-089

II?AeIAIIss ?OAI?*II? OAI?IAE NA?Oess C IAOIEIA??TH I?O?AEUeIIAI
EEAIAIA:

EE?I?EA, Ae?AAIINOEEA, O??O?A?*IA E?EOAAIIss

14.01.04. – na?oeaai-noaeeiia 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 ?inoeooo? na?oeaai-noaeeiii? o??o?a?? AII Oe?a?ie

Iaoeiaee ea??aiee:

eao?aao Aea?aeaaii? i?ai?? Oe?a?ie, aeieoi? iaaee/ieo iaoe, noa?oee
iaoeiaee ni?a?ia?oiee, O?noeaiei Aaneeue ?aaiiae/ (?inoeooo
na?oeaai-noaeeiii? o??o?a?? AII Oe?a?ie, a?aeae?e o??o?a?/ieo iaoiae?a
e?eoaaiiy ei?iia?ii? iaaeinoaoiino?, aieiaiee iaoeiaee ni?a?ia?oiee)

Io?oe?ei? iiiiaioe:

caneoaeaiee ae?y/ iaoee ? oaoi?ee Oe?a?ie, aeieoi? iaaee/ieo iaoe,
i?ioani?, I?eiiaiei Ieaenaiae? Naiaiiae/ (Caii??cueeee aea?aeaaiee
iaaee/iee oi?aa?neoao, caa?aeoaa/ eaoaae?e aini?oaeueii? o??o?a??,
eao?aao Aea?aeaaii? i?ai?? Oe?a?ie, aeieoi? iaaee/ieo iaoe, i?ioani?)

Neoa? Eaii?ae Eoee/, ?inoeooo na?oeaai-noaeeiii? o??o?a?? AII Oe?a?ie,
caa?aeoaa/ a?aeae?eii o??o?a?/ieo iaoiae?a e?eoaaiiy iaaooeo aaae na?oey

I?ia?aeia onoaiiaa:

?inoeooo ee?i?/ii? oa aenia?eiaioaeueii? o??o?a??, a?aeae?e o??o?a??
noaeei, AII Oe?a?ie, i. Ee?a.

Caoeno a?aeaoaeaoueny “28” aa?aniy 1999 ?. i 14.00 aiaeei? ia

can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae.26.555.01 ?inoeoooo
na?oeaai-noaeeiii? o??o?a?? AII Oe?a?ie (252110, i. Ee?a, oca?c I?ioan?a
ss?, 11)

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? ?inoeoooo
na?oeaai-noaeeiii? o??o?a?? AII Oe?a?ie (252110, i. Ee?a, oca?c I?ioan?a
ss?, 11)

Aaoi?aoa?ao ?ic?neaiee “ 27 ” /a?aiy 1999 ?.

A/aiee nae?aoa?

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

aeieoi? iaaee/ieo iaoe ?oaeaiei A.A.

Aeooaeuei?noue i?iaeaie. Ia no/aniiio aoai? aca?iica’ycie ?oai?/ii?
oai?iae na?oey (?ON) oa iaaooi? iaoieia?? i?o?aeueiiai eeaiaio (IE) ?
iaei??th c iaeneeaaei?oeo i?iaeai na?oeaai-noaeeiii? o??o?a?? o
aei?ineeo. Oe?iea ?iciianthaeaeaiiy a iiioeyoe?? oaeoi??a ?eceeo ?ON
coiiaeee ca?eueoaiiy e?eueeino? oai?eo, ye? iathoue ye ii?aeiaiiy
noaiicoth/iai aoa?ineea?ico a?ioeaaeo a?oa??e (AA) c iaaooeie
i?o?aeueieie aaaeaie (IA), oae ? aaaee? iaoai?/i? oneeaaeiaiiy
ceiye?niiai i?io?eaiiy ?ON o aeaeyae? iino?ioa?eoii? i?o?aeueii?
iaaeinoaoiino? (A?II), aiaa?ecie e?aiai oeoii/ea (EO). I?ioa aeai? i?i
/anoioo aeyaeaiiy aeaii? iaoieia?? o a?o/eciyi?e e?oa?aoo?? a?aenooi?.
Ii?aeiaiiy aeaio oai?ia – ?ON oa iaaooeo IA, eiaeia c yeeo ?
naiino?eiith iicieia?/iith iaeeieoeath, iaoiiaeei o?oaeiiu? a
nenoaiaoecaoe?? ee?i?/ieo oi?i aeyaeaiiy aeine?aeaeoaaii? iaoieia??.
Aaaeeea?noue aea/aiiy aeaiiai ieoaiiy iaa?ae’?iii ii?aeiaia c
iaa?oiooaaiiyi iieacaiue, no?ie?a oa ianyao o??o?a?/ieo ao?o/aiue.

A ?cieueiaai?e o??o?a?? IA iayai?noue noiooiuei? ?ON, iaiao?aei?noue
aeeiiaiiy ?aaaneoey??caoe?? i?iea?aea aai ei?aeoe?y III ei?aeth? c
aenieei iia?aoe?eiei ?eceeii. Aeeiiaiiy eeoa /anoeiai? ei?aeoe?? (aai
a?ioeaai?, aai i?o?aeueii? iaoieia??) iia’ycaii c iia??oaiiyi
aaciina?aaei?o oa a?aeaeaeaieo ?acoeueoao?a iia?aoe?e. ?acii c oei
ii?aeiaiiy ?aaaneoey??caoe?? i?iea?aea c o??o?a??th IA, ye o iao?e
e?a?i?, oae ? ca ei?aeiiii, noi?iaiaeaeo?oueny cia/iith aini?oaeueii?
eaoaeuei?noth, ui neeaaea? 10,0-48,0%. Iaae??oaieie caeeoathoueny
ieoaiiy iaoiaeeee iia?aoe??, ?io?aiia?aoe?eiiai caoenoo i?iea?aea,
ianyao oa aa??aio?a o??o?a?/ii? ei?aeoe??, i?iaiicoaaiiy ?acoeueoaoo
o??o?a?/iiai ao?o/aiiy.

Iaaaaeaiee ia?ae?e ieoaiue ie?aneea iaoo aeine?aeaeaiiy, yea iieyaaea o
?ic?iaoe? iioeiaeueii? iaoiaeeee iaeiiiiiaioii? ei?aeoe?? aaae
i?o?aeueiiai eeaiaia oa o?aaeaiue a?ioeaaeo a?oa??e.

O a?aeiia?aeiino? c iaoith aoee aecia/ai? ianooii? caaaeaiiy:

1. Aea/eoe /anoioo aeyaeaiiy ii?aeiaiue iaoieia?? i?o?aeueiiai eeaiaia
oa o?aaeaiue a?ioeaaeo a?oa??e.

2. I?iaanoe aiae?c aca?iica’yceo ?oai?/ii? oai?iae na?oey oa iaoieia??
i?o?aeueiiai eeaiaia c aecia/aiiyi iniiaieo oi?i ee?i?/iiai aeyaeaiiy
oaeiai ii?aeiaiiy.

3. Iaa?oiooaaoe iieacaiiy aei o??o?a?/iiai ao?o/aiiy aeey aeae?eaieo
ee?i?/ieo oi?i aeine?aeaeoaaii? iaoieia??.

4. ?ic?iaeoe iine?aeiai?noue o??o?a?/ieo ao?o/aiue ia i?o?aeueiiio
eeaiai? oa a?ioeaaeo a?oa??yo i?e iaeiiiiiaioi?e ei?aeoe?? ?o iaoieia??.

5. ?ic?iaeoe iaoaiaoe/i? iiaeae? i?iaiicoaaiiy ?acoeueoao?a o??o?a?/iiai
e?eoaaiiy ia i?aenoaa? aiae?co ia?aaeiia?aoe?eieo ee?i?/ieo
oa?aeoa?enoee.

6. Aecia/eoe ?io?aiia?aoe?ei? oaeoi?e ?eceeo iaeiiiiiaioii? ei?aeoe??
iaoieia?? i?o?aeueiiai eeaiaia oa o?aaeaiue a?ioeaaeo a?oa??e.

7. Aecia/eoe iioeiaeueiee aa??aio ?io?aiia?aoe?eiiai caoenoo i?iea?aea
oa oaeineiiaeeoe iaoiaeeeo ea?ae?iieaa??.

8. Aea/eoe aaciina?aaei? oa a?aeaeaeai? ?acoeueoaoe iia?aoe?e oa
?ic?iaeoe ?aeiiaiaeaoe?? ii ?o iie?ioaiith.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie. Oaia aeena?oaoe?? aoea
caoaa?aeaeaia a/aiith ?aaeith ?inoeoooo na?oeaai-noaeeiii? o??o?a?? AII
Oe?a?ie 02.10.1995?., i?ioieie ? 12 oa ? o?aaiaioii eiiieaenii? oaie:
“Oaeineiiaeaiiy o??o?a?/iiai e?eoaaiiy oneeaaeiaieo oi?i iino?ioa?eoieo
aiaa?eci o oai?eo c ?oai?/iith oai?iaith na?oey” AE 96.01.073, ?
Aea?aeaaiiai ?a?no?o 0196.O001521.

Iaoeiaa iiaecia. Aecia/aia /anoioa aeyaeaiiy ii?aeiaiue ?ON oa iaoieia??
IE ia i?aenoaa? eiiieaeniiai ee?i?/iiai (1041 niinoa?aaeaiiy) oa
iaoieiaiaiaoii?/iiai (246 aooiin?e) aeine?aeaeaiiy. Aea/aiee
eaocaeueii-iaoiaaiaoe/iee aca?iica’ycie ?ON oa iaoieia?? IE. Aia?oa
aecia/ai? oa nenoaiaoeciaai? oi?ie ee?i?/ieo i?iya?a ii?aeiaiue ?ON oa
iaaooeo IA. Aia?oa a?aee?eoee oa aeieacaiee iaoiii?oic o?aaeaiue AA a
ee?i?oe? iaaooeo IA oa aia?oa cai?iiiiiaaia noaia iaoio?c?ieia?/iiai
iiyniaiiy oeueiai yaeua. Aea/aii iniiai? iaoiaaiaoe/i? iaoai?cie
iino?ioa?eoii? i?o?aeueii? iaaeinoaoiino?.

?ic?iaeaii iieacaiiy aei iaeiiiiiaioii? o??o?a?/ii? ei?aeoe?? aeae?eaieo
oi?i ee?i?/iiai ia?aa?ao aeine?aeaeoaaii? iaoieia??. Aecia/aiee
iaea?eueo ni?eyoeeaee aa??aio o??o?a?/ii? ei?aeoe?? i?o?aeueii? aaaee o
ii?aeiaii? c ?aaaneoey??caoe??th i?iea?aea.

Oaeineiiaeaia ? ai?iaaaeaeaia iaoiaeeea ?io?aiia?aoe?eiiai caoenoo
i?iea?aea. Aia?oa i?iaaaeaiee aeaoaeueiee aiae?c aoaeoeaiino?
??ciiiai?oieo aeae?a caoenoo i?iea?aea i?e iaeiiiiiaioi?e o??o?a?/i?e
ei?aeoe?? IA ? o?aaeaiue AA. a ?acoeueoao? yeiai cai?iiiiiaaiee
iioeiaeueiee aa??aio oaoi?ee ea?ae?iieaa??.

?ic?iaeai? iaoaiaoe/i? iiaeae? ?iaeea?aeoaeueiiai i?iaiicoaaiiy
?acoeueoaoo o??o?a?/iiai ao?o/aiiy, aecia/ai? i?iaiinoe/i? oaeoi?e
?eceeo aini?oaeueii? eaoaeueiino?. Iaoeiai iaa?oioiaai? caoiaee uiaei
i?aeaeuaiiy aoaeoeaiino? o??o?a?/iiai ao?o/aiiy ii iaeiiiiiaioi?e
ei?aeoe?? iaoieia?? IE ? o?aaeaiue AA.

I?aeoe/ia cia/ei?noue io?eiaieo ?acoeueoao?a. Aecia/ai? aeaiia?ao?/i?
iniaeeaino? a?oi oai?eo, ye? iathoue ii?aeiaiiy ?ON oa iaoieia?? IE.
Aeaia aeaoaeueia oa?aeoa?enoeea oi?i ee?i?/iiai i?iyao aeine?aeaeoaaii?
iaoieia??. Aea/aia ?ioi?iaoeai?noue ??cieo iaoiae?a ae?aaiinoeee
aeine?aeaeoaaii? iaoieia?? ? aecia/ai? iieacaiiy aei ei?iia?ia?ao?? a
ia?aaeiia?aoe?eiiio ia??iae?.

Aecia/ai? e iaa?oioiaai? iieacaiiy aei iaeiiiiiaioii? ei?aeoe??
o?aaeaiue AA ? iaoieia?? IE. ?ic?iaeaia iine?aeiai?noue aoai?a
o??o?a?/iiai ao?o/aiiy. Oaeineiiaeaia iaoiaeeea ?io?aiia?aoe?eiiai
caoenoo i?iea?aea ? aecia/aiee aeey i?aeoe/iiai canoinoaaiiy
iioeiaeueiee aa??aio oaoi?ee caoenoo i?iea?aea. Aecia/aiee iaea?eueo
ni?eyoeeaee aa??aio o??o?a?/ii? ei?aeoe?? aeine?aeaeoaaii? iaoieia??.
?aeaioeo?eiaai? i?iaiinoe/i? /eiieee ?eceeo aini?oaeueii? eaoaeueiino? ?
cai?iiiiiaaia iaoaiaoe/ia iiaeaeue i?iaiicoaaiiy ?acoeueoaoo
o??o?a?/iiai e?eoaaiiy.

?acoeueoaoe aeine?aeaeaiiy ai?iaaaeaeai? a i?aeoeeo ?inoeoooo
na?oeaai-noaeeiii? o??o?a?? AII Oe?a?ie, Aei?i?iiao?ianueeiai iaeaniiai
ae?aaiinoe/iiai oeaio?o. Io?eiaii iaoaio ia aeiao?ae ? 3769-O?? “Niin?a
iaoai?/ii? aiaea?aa?aeoii??” ? iiceoeaia ??oaiiy ca cayaeith ia aeiao?ae
? 970521 17/2154 “Niin?a o??o?a?/iiai e?eoaaiiy aiaa?eci na?oey” a?ae
07.05.97?. Iaoa??aee ?iaioe aeeth/ai? a iaoiaee/i? ?aeiiaiaeaoe?? IIC
Oe?a?ie “Caniae caoenoo i?iea?aea i?e neeaaeieo o??o?a?/ieo ao?o/aiiyo o
oai?eo c o?aaeaiiyi eeaiai?a oa a?ioeaaeo a?oa??e na?oey” (1994 ?.)

Iniaenoee aianie. Aeena?oaoe?y ? iniaenoith i?aoeath aaoi?a, yeee
aeeiiaa aiae?c ee?i?/iiai iaoa??aeo ia no/aniiio iaoeiaiio ??ai?. Aaoi?
aeine?aeaeoaaa iiaeeeaino? no/anieo iaoiae?a ae?aaiinoeee ? e?eoaaiiy
oai?eo, ye? iathoue ii?aeiaiiy ?ON ? iaoieia?? IE, iaa?oiooaaa, ?ic?iaea
? ai?iaaaeea o i?aeoee iioeiaeuei? aa??aioe ?io?aiia?aoe?eiiai caoenoo
i?iea?aea ? o??o?a?/ii? ei?aeoe?? aeine?aeaeoaaii? iaoieia??.
A?eueo?noue iia?aoe?e aeeiiaii i?e o/ano? aeena?oaioa. Aaoi?ii
i?iaaaeaia noaoenoe/ia ii?aoethaaiiy iaoa??aeo, oaenoiaa ? a?ao?/ia
ioi?ieaiiy ?acoeueoao?a.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iaoa??aee aeena?oaoe?? aeeeaaeai?
e

iaaiai?ai? ia ? Ananithciiio c’?cae? na?oeaai-noaeeiieo o??o?a?a
(Iineaa. 1990 ?.), IV c’?cae? ea?ae?ieia?a Oe?a?ie (Aei?i?iiao?ianuee,
1993), ? ? III Iaoeiaeo eiioa?aioe?yo anioe?aoe?? na?oeaai-noaeeiieo
o??o?a?a Oe?a?ie (Ee?a, 1993 ? 1995 ?.), III iaoeiai-i?aeoe/i?e
eiioa?aioe?? “Aeooaeuei? i?iaeaie aenia?eiaioaeueii? iaaeeoeeie” (Ee?a,
1999?.). Ca oaiith aeena?oaoe?? iioae?eiaaii 13 ?ia?o. Ioae?eaoe??
iiai?noth a?aeoai?ththoue ci?no aeine?aeaeaiue.

No?oeoo?a oa ianya ?iaioe. Aeena?oaoe?y aeeeaaeaia ia 207 noi??ieao
iaoeiiieniiai oaenoo ? neeaaea?oueny c anooio, iaeyaeo e?oa?aoo?e (1
?icae.), aeanieo aeine?aeaeaiue (4 ?icae.), caeeth/ii? /anoeie,
aeniiae?a, i?aeoe/ieo ?aeiiaiaeaoe?e, nieneo c 189 aeei?enoaieo aeaea?ae
? aeiaeaoeo. ?iaioa ?ethno?iaaia 55 oaaeeoeyie oa 9 iaethieaie.

Iaoa??aee oa iaoiaee aeine?aeaeaiiy. A iniiao aeine?aeaeaiiy iieeaaeaiee
?ao?iniaeoeaiee aiae?c 1041 ei?iia?ia?ao?/iiai aeine?aeaeaiiy o oai?eo c
iaaooith iaoieia??th IE, aeeiiaieo a ?inoeooo? na?oeaai-noaeeiii?
o??o?a?? AII Oe?a?ie c 1988 ii 1998 ?iee.

E?eoa???i oi?ioaaiiy a?oie aeine?aeaeaiiy aoei ii?aeiaiiy aniiaeeiai?/ii
cia/eieo caoaeaiue AA (ia 50,0% ? a?eueoa i?ina?oo noaeeie) c
iaoieia??th IE, ye? iio?aaothoue o??o?a?/ii? ei?aeoe??. A?aeiia?aeii aei
aeaiiai e?eoa??th aoee nenoaiaoeciaai? aeai? 165 oai?eo. Ioaea caaaeueia
/anoioa aeyaeaiiy aeine?aeaeoaaii? iaoieia?? neeaea 15,9% (165 aeiaaee?a
c 1041 ei?iia?ia?ao?/iiai aeine?aeaeaiiy).

Oai?? iiae?eai? ia aea? a?oie. Ia?oa i?noeoue 137 (83,1%) aeiaaee?a, ye?
iathoue iacaeaaeia ii?aeiaiiy ?ON oa iaaooeo IA. Ae?oaa a?oia i?noeoue
28 (16,9%) aeiaaee?a, ye? iathoue III. Oa?aiaaoe/i? aniaeoe, ui
aeeth/athoue aeaiia?ao?/io oa?aeoa?enoeeo, ?iciianthaeaeai?noue oaeoi??a
?eceeo ?ON, oi?ie ee?i?/iiai i?iyao oa iniaeeaino? ia?aa?ao aea/ai?
ie?aii aeey eiaeii? c aeae?eaieo a?oi.

A eiiieaen ee?i?/iiai ianoaaeaiiy aoiaeeee o?aaeeoe?ei? aeine?aeaeaiiy
(nea?ae, aiaiiac, ?a?no?aoe?y oaeoi??a ?eceeo ?ON, aea/aiiy caaaeueiiai
noaio, AEA, AOIEA, AAI, ?aioaai?anueea ianoaaeaiiy a?oaeii? ii?iaeieie,
eaai?aoi?i? aeine?aeaeaiiy) ? niaoe?aeuei? aeine?aeaeaiiy
(eaoaoa?ecaoe?y ii?iaeiei na?oey ?c naeaeoeaiith ei?iia?ia?ao??th). O
i?ioean? aeine?aeaeaiiy aeeiioaaany aiae?c c aeei?enoaiiyi oaeeo
i?aaeiia?aoe?eieo iieaciee?a: ?EA iciaee a?ia?o?io?? e?aiai (AEO) oa
i?aaiai (AIO) oeoii/e?a na?oey, iayai?noue ieaioeeai? a?eoi?? (IA), a
oaeiae e?ioeaai-ae?anoie?/iee ?iaeaen (EAe?), e?ioeaai-nenoie?/iee
?iaeaen (EN?), oaea?iee ?iaeaen (O?), oaeeeiiee ia’?i na?oey (OIN),
na?oeaaee ?iaeaen (N?), o?aeoe?y aeaiaiiy EO (OA),
e?ioeaai-ae?anoie?/iee oene EO (EAeOeo), nenoie?/iee oene o eaaaiaa?e
a?oa??? (?ea), ea?ae?ioi?aeaeueiee ?iaeaen (EO?). Aeei?enoiaoaaeanue
caaaeueiii?eeiyoa eeaneo?eaoe?y aaiiaeeiai?/ieo aa??aio?a IA na?oey:
i?o?aeueiee noaiic (IN), eiia?iiaaia i?o?aeueia aaaea (EIA), i?o?aeueia
iaaeinoaoi?noue (II). ?acoeueoaoe ei?iia?ia?ao?/ieo aeine?aeaeaiue aoee
aiae?ciaai?, ? ?icoaooaaiiy a?ioeaaeo noaiic?a eean?o?eiaaii
a?aeiia?aeii iniiaiei ai?ea?ae?aeueiei a?oa??yi: ia?aaeiy i?aeoeoii/eiaa
(IIOA), iaeiath/a (0A), i?aaa (IAA) oa iniiaiee noiaao? e?ai? a?ioeaai?
a?oa??? (INEAA).

?ao?iniaeoeaiee aiae?c (1988-1990??.) naeoe?eieo aeaieo iiia?eeo (i^246)
i?ney i?ioacoaaiiy IE (IIE) aeicaieea aecia/eoe /anoioo a?ioeaaeo
o?aaeaiue oa c’ynoaaoe ?o aieea ia ?acoeueoaoe iia?aoe?e. Ii?oieia?/i?
aeine?aeaeaiiy i?iaiaeeeeny ia iae?ineii?/iiio oa i?e?ineii?/iiio ??aiyo
ia iniia? ?io?aiia?aoe?eiiai oa naeoe?eiiai iaoa??aeo.

O??o?a?/ia e?eoaaiiy aoei aeeiiaii a 83 (50,3%) aeiaaeeao.

Iaeiiiiiaioia ei?aeoe?y IA oa o?aaeaiue AA aeeiiaia o 45 (27,3%) oai?eo.
A?aeaeaeai? ?acoeueoaoe iia?aoe?e aea/ai? o 32 (97,0%) oai?eo, ui
aeienaeeny. No?iee a?aeaeaeaieo niinoa?aaeaiue neeaee a?ae 1,5 aei 11
?ie?a, o na?aaeiueiio 6,7 ± 0,4 ?.

*anoeiaa o??o?a?/ia ei?aeoe?y (aai eeoa IA, aai eeoa o?aaeaiue AA) aoea
aeeiiaia 38 (23,0%) oai?ei. ?ao?iniaeoeaiee aiae?c ?acoeueoao?a oeeo
iia?aoe?e a?aoiaoaaany aeey oi?ioaaiiy iieacaiue aei iaeiiiiiaioii?
ei?aeoe?? o?aaeaiue AA oa IA.

Iniiai? ?acoeueoaoe aeine?aeaeaiiy. Nenoaiaoeciaai? ca aeanyoe??/iee
ia??iae 165 niinoa?aaeaiue aoee iiae?eai? ca?aeii
eaocaeueii-iaoiaaiaoe/iiai i?eioeeio: ?ON ye iacaeaaeii ?nioth/a
oai?iaa, yea ii?aeio?oueny c iaaooeie IA — 137 (83,1%) aeiaaee?a c 165
niinoa?aaeaiue; oa ?ON, o aeiaaeeo ?? oneeaaeiaiiai ia?aa?ao, ye ?aeeia
e iniiaia i?e/eia iaaeinoaoiino? IE — 28 (16,9%) aeiaaee?a c 165
niinoa?aaeaiue.

*anoioa aeyao aaiiaeeiai?/ii cia/eieo caoaeaiue AA o oai?eo c iaaooeie
IA ca ?acoeueoaoaie ei?iia?ia?ao?/ieo aeine?aeaeaiue neeaaea? 13,2% (137
aeiaaee?a c 1041 ei?iia?ia?ao??). Ii/aoie ae?aaiinooaaiiy a?ioeaaeo
o?aaeaiue i?eiaaea? ia 35-??/iee a?e o /ieia?e?a oa 46-??/iee o ae?iie.
Iaea?eueoa e?euee?noue oai?eo ia?aaoaa? o noa?oeo a?eiaeo a?oiao.

A ?acoeueoao? iaoieiaiaiaoii?/ieo aeine?aeaeaiue (i = 246, na?aaei?e a?e
-42,0 ± 0,3?.) aoa?ineea?ioe/i? o?aaeaiiy ??ciiai nooiaith ae?aaeaiino?
aoee aeyaeai? o 96 (39,0%) iiia?eeo (na?aaei?e a?e 46,6 ± 1,6?.), i?e
oeueiio aaiiaeeiai?/ii cia/ei? caoaeaiiy (>50,0%) aeyaeai? o 39 (16,0%)
iiia?eeo.

A?oia oai?eo c iacaeaaeiei ii?aeiaiiyi ?ON ? iaaooeo IA (na?aaei?e a?e
52,7 =ue 0,5?.) iaea oae? iniaeeaino?: ia?aaaaeaiiy in?a /ieia?/i? noao?
(73,0%), ni?aa?aeiioaiiy /ieia?ee / ae?iee neeaei 2,7 : 1; cia/ia
?iciianthaeaeai?noue oaeoi??a ?eceeo ?ON, iniaeeai a?oa??aeueii?
a?ia?oaic?? (AA) (33,6%); aeii?ioth/a ?ieue ?aaiaoecio o aaiac? IA
(94,9%), oa ye iane?aeie oeueiai ia?aaaaeaiiy IN (66,4%) na?aae
aaiiaeeiai?/ieo aa??aio?a IA; i?aaaethaaiiy oai?eo c ae?aaeaieie
noaae?yie IA, ye? iathoue cia/io o?eaae?noue ?nioaaiiy naii? aaaee (19,9
± 1,0 ?.); na?aaeiy e?euee?noue o?aaeaieo AA ia iaoe??ioa neeaea 1,65 ±
0,1; o a?eueoino? aeiaaee?a o?aaeaiiy AA iaee eaoaioiee ia?aa?a –
noaiiea?ae?y niinoa??aaeanue a 39,4% aeiaaee?a, aino?ee ?ioa?eo
i?iea?aea (A?I) o 5,1% aeiaaee?a, AEA- iciaee o?ii?/ii? a?ioeaai?
iaaeinoaoiino? (OAI) ?a?no?oaaeeny a 47,4% aeiaaee?a.

Aeey ianooiiiai aiae?co aoee aeae?eai? 2 i?aea?oie oai?eo, ye?
aecia/athoue iniiai? oi?ie ee?i?/iiai i?iyao iacaeaaeiiai ii?aeiaiiy ?ON
oa iaaooeo IA:

1. Oai??, ye? iathoue eeoa ee?i?/i? neiioiie o?aaeaiiy IE, neiioiiaoeea
?ON a?aenooiy — 83 (60,6%) aeiaaeee c 137 niinoa?aaeaiue.

2. Oai??, o yeeo iaeiaeiai iiaeai? neiioiie IA oa ?ON 54 (39,4%)
aeiaaee?a c 137 niinoa?aaeaiue.

Naia oaeee iiae?e oai?eo aoa iieeaaeaiee a iniiao aea/aiiy iniaeeainoae
i?iyao o?aaeaiue AA o oai?eo c IA, ?aeaioeo?eaoe?? oaeoi??a oa oiia, ui
aecia/athoue “i?iee” oa?aeoa? ia?aa?ao a?ioeaaeo noaiic?a. Ii??aiyeueiee
aiae?c ca ye?nieie oa e?euee?nieie ee?i?/ieie oa?aeoa?enoeeaie i?ae
i?aea?oiaie oai?eo aeicaieea c?iaeoe ianooii? aeniiaee:

1. I?aea?oia oai?eo c aacneiioiiiei ia?aa?aii a?ioeaaeo o?aaeaiue
oa?aeoa?eco?oueny a?eueoei nooiaiai ae?aaeaiino? IA, ui
i?aeoaa?aeaeo?oueny a??ia?aeii a?eueoith /anoioith ?a?no?aoe?? IA –
90,4% (? 50,0%) i?ina?oo
iaei?n? ? a?eueoa iniiaieo ai?ea?ae?aeueieo a?oa??e, iacaeaaeii a?ae
iayaiino? neiioiiaoeee ?ON.

2. Iayai?noue noi?iiaaii? IA.

Ne?ae aeacaoe, ui aeieeiaiiy IA, o?iiaico e?aiai ia?aaena?aey (EI),
eaeueoeeiico IE, eaaaiaai? a?ia?oaic??, iiyaa iciae aeaeiiiainaoe??
e?iaiia?ao aai noiooi? ci?ie e?euee?nieo iieaciee?a: EO? > 50,0, EN? >
50,0 ie/ea.i, EAe? > 120-150 ie/ea.i, EAeOeo > 12-15 ii ?o.no., OA ), IAA
– 19 (42,2%), INEAA – 5 (11,1%) aeiaaeeao. ?iciianthaeaeai?noue
a?ioeaaeo o?aaeaiue ioe?ithaaeanue a?aeiia?aeii caoaeaiiyi 1 AA – 20
(44,4%i), 2 AA – 17 (37,8%), C AA – 8 (17,8%) aeiaaee?a. Iieaciee
na?aaeiuei? e?eueeino? o?aaeaieo AA neeaa 1,8 ± 0,2.

?io?aiia?aoe?ei? aeai? oa o??o?a?/ia oaoi?ea aeeth/aee i?iaaaeaiiy
iiacaeiaaeiuei? noa?iioii??, aaia??i?caoe??, ?icae?eueii? eaitheyoe??
aa?oiuei? oa ieaeiuei? ii?iaeienoeo aai, aeno?aeii? ai?oe c ianooiiei
canoinoaaiiyi noaiaea?oii? oaoi?ee ooo/iiai e?iaiia?ao (OE). No?aoaa?y
caoenoo i?iea?aea aeeth/aea nenoaiio a?iioa?i?th (28 °N), i?noeaaa
ioieiaeaeaiiy i?iea?aea (12 °N) oa canoinoaaiiy 10 e?enoaei?aeiiai aai
e?ia’yiiai (ii Aaeaa?ao) ea?ae?iieaa?/ieo ?ic/ei?a o 28 (62,2%) oa 17
(37,8%) aeiaaeeao a?aeiia?aeii. ?ic/eie aaiaeeeenue eeoa aiona?aaeii o
16 (35,6%) aeiaaeeao, aeiaeaoeiai ?ao?ia?aaeia o 29 (64,4%) aeiaaeeao.

I?ieneiaeuei? aianoiiice c ai?oith aeeiioaaeenue oeyoii ?? e?aeiaiai
a?aeoeneaiiy aei OE; o aeiaaeeao ianoaa?eueii? aaiiaeeiai?ee aanue ianya
o??o?a?/ii? ei?aeoe?? i?iaiaeeany i?ae /an ea?ae?iieaa?/ii? coieiee
na?oey. Ii?yaeie o??o?a?/ieo iai?ioeyoe?e aoa ianooiiei: ?aa?c?y
ii?iaeieie EI ia i?aaeiao o?iia?a, aeeiiaiiy aeenoaeueieo aianoiiic?a c
AA, ei?aeoe?y IA, aa?iaoecaoe?y na?oey. IIE aoei aeeiiaii o 35 (77,8%)
aeiaaeeao. Iecueeii?io?euei? iaoai?/i? i?ioace aeei?enoiaoaaeeny o 33
(94,3% oai?eo, eoeueeia? i?ioace o 2 (5,5%) oai?eo. Eeaiaiicaa??aath/?
iia?aoe?? (ECI) aoee aeeiiai? a 10 (22,2%) aeiaaeeao; c ieo
-eii?no?ioii?? o 8 oai?eo oa oiaia ieanoeea IE o 2 oai?eo. Noiooi? AEO
aoei i?iaaaeaia o an?o aeiaaeeao oa iaei ianooii? aa??aioe: AEO – 1 o 21
(46,7%), AEO-2 o 17 (37,8%), AEO-3-4 o 7 (15,5%) oai?eo. Na?aaeiy
e?euee?noue aeeiiaieo aeenoaeueieo aianoiiic?a ia iaoe??ioa neeaea 1,9 ±
0,25. A yeino? o?ainieaioaio?a aeei?enoiaoaaeenue aooiaaie o 44 (97,8%)
aeiaaeeao oa aioo??oiy a?oaeia a?oa??y a 1 (2,2%) aeiaaeeo. Na?aaeiy
o?eaae?noue OE oa ia?aoeneaiiy ai?oe neeaee 146,8 ± 7,9 oa. oa 88,1 ±
5,6 oa. a?aeiia?aeii.

Aini?oaeueia eaoaeuei?noue neeaea o aeiaaeeao ia?aeiieo o??o?a?/ieo
ao?o/aiue (n = 31), aeeeth/ath/e oai?eo c III – 16,1% (oaae. 1), i?e
iiaoi?ieo ao?o/aiiyo (n = 8) – 50,0%, i?e ei?aeoe?? III (n == 6) –
50,0%. Aeey an??? aeine?aeaeoaaii? a?oie (n = 45) aini?oaeueia
eaoaeuei?noue neeaea 26,6% (12 iiia?eeo). I?e/eiaie nia?o? aoee:
eeaiaiiiacaeaaei? o aeaio aeiaaeeao (o?iiaic i?ioaco, i?ioaciee
aiaeiea?aeeo); na?oeaa? eeaiaiiiacaeaaei? a naie aeiaaeeao – I?I (n =
6), a?eoi?y (n — 1); iana?oeaa? eeaiaiiiacaeaaei? o o?ueio aeiaaeeao –
iiceia? oneeaaeiaiiy (n = 2), aino?a aeeoaeueia iaaeinoaoi?noue, (n =
1).

Oaaeeoey 1

Aini?oaeueia eaoaeuei?noue i?e ia?aeiieo o??o?a?/ieo ao?o/aiiyo

Aa??aio o??o?a?/ii? ei?aeoe??E?euee?noue oai?eoAini?oaeueia
eaoaeuei?nouen%IIE + AEO – 1 – 325520,0ECI + AEO – 1 –
360-Anueiai31516,1

Iiaeaeueoa aeine?aeaeaiiy aoei ni?yiiaaia ia ?aeaioeo?eaoe?th
i?iaiinoe/ieo oaeoi??a ?eceeo aini?oaeueii? eaoaeueiino? oa
iioei?caoe?th i?ioeano o??o?a?/iiai e?eoaaiiy. Ii??aiyeueiee aiae?c ca
e?euee?nieie oa?aeoa?enoeeai i?ae a?oiaie oai?eo, ye? aeaeeee oa ye?
iiia?ee, iieacaa, ui iiia?e? iaoe??ioe iaee a??ia?aeii a?eueoa cia/aiiy
EO? (? = 0,027) oa EN? (? = 0,049), a oaeiae o ieo niinoa??aaeanue
oaiaeaioe?y aei a?eueo aenieeo cia/aiue ?ea (? = 0,055), aeui?
na?aaeiuei? e?eueeino? o?aaeaieo AA (? = 0,058), oa a?eueo iecueeeo
cia/aiue OA (? = 0,064).

Ia i?aenoaa? io?eiaieo aeaieo aeey iaeiioaeoi?iiai aiae?co aoee
aecia/ai? a?aie/i? cia/aiiy aeey ianooiieo iieaciee?a: EO? – 55,0, EN? –
50 ie/ea.i, ?ea – 55 ii ?o.no., e?euee?noue o?aaeaieo AA – 2,0, OA –
53,0%.

A ?acoeueoao? i?iaaaeaiiai iaeiioaeoi?iiai aiae?co aoa aeyaeaiee ?yae
ia?aaeiia?aoe?eieo oa?aeoa?enoee, ui iacaeaaeii aieeaaee ia ?acoeueoao
o??o?a?/iiai e?eoaaiiy: noaae?y OIE (? ). Iaea?eueo /anoith i?e/eiith i?o?aeueii?
?aao?a?oaoe?? ? aeeeaoaoe?y o?a?iciiai e?eueoey IE (64,3%). Aecia/aiiy
ooieoe?iiaeueiiai oeio iino?ioa?eoii? II oa ioe?iea ?? ae?aaeaiino?
iiaeii? i?iaiaeeoeny eiiieaenii ia i?aenoaa? aeaieo AOIEA oa
aaio?eeoeia?ao?/ieo aeine?aeaeaiue.

3. Iaeiiiiiaioia ei?aeoe?y iaoieia?? IE oa o?aaeaiue AA iieacaia o
aeiaaeeao ii?aeiaiiy coi?iiaaii? IA oa aaiiaeeiai?/ii cia/eieo caoaeaiue
AA (>50,0% i?ina?oo noaeeie). A aeiiiaiaiiy aei ?aaaneoey?ecaoe??
i?iea?aea ei?aeoe?y III iieacaia i?e ?aao?a?oaoe?? ia IE 2+ oa a?eueoa.

4. Eeaiaiicaa??aath/ee aa??aio ei?aeoe?? IA ? iioeiaeueiei aeey
ii?aeiaiiy c ?aaaneoey?ecaoe??th i?iea?aea. O aeiaaeeao iaiao?aeiino?
i?ioacoaaiiy IE aeioe?eueia caa?aaeaiiy eiai i?aeeeaiaiieo no?oeoo?.

5. Caoeno i?iea?aea iiaeiai i?iaiaeeoeny a oiiaao nenoaiii? a?iioa?i??
(28 °N), i?noeaaiai ioieiaeaeaiiy i?iea?aea (10-12 °N) c canoinoaaiiyi
oieiaeiai? ea?ae?iieaa??. Iacaeaaeii a?ae oeyoo aaaaeaiiy
e?enoaei?aeiiai ea?ae?iieaa?/iiai ?ic/eio aoaeoeai?noue eiai
cieaeo?oueny i?e iayaiino? e?eoe/ieo caoaeaiue a?eie EAA oa a?ia?o?io??
EO .Iioeiaeueiei aa??aioii oaoi?ee ea?ae?iieaa?? ? canoinoaaiiy
e?ia’yiiai ea?ae?iieaa?/iiai ?ic/eio c eiia?ioaaiiyi oeyo?a eiai
aaaaeaiiy.

6. An? oai?? i?ney ei?aeoe?? ii?aeiaiiy o?aaeaiue AA oa iaoieia?? IE
iio?aaothoue aeiaaio?eaaeiai aeeniaina?iiai niinoa?aaeaiiy o
a?aeaeaeaiiio ia??iae?.

Nienie iioae?eiaaiieo i?aoeue ca oaiith aeena?oaoe??

1. Oe?o?ae/aneia ea/aiea eoaie/aneie aieacie na?aeoea, ni/aoathuaeny n
ii?aaeaieai eeaiaiiiai aiia?aoa na?aeoea // A?oaeiay e
na?aea/ii-ninoaeenoay oe?o?aey. — 1991. — ?9. — N. 15-19. (ni?aaaoi?e
O?noeaiei A.E., Eiuoia A .A., Neaa/aiei A.I., Oo?eaei N.I.).

2. Aiaa?eciaoe/aneia ii?aaeaiea noaiea eaaie aaia/iie a?oa?ee //
Oe?a?inueeee ea?ae?ieia?/iee aeo?iae. — 1997. — ? 5-6. — N. 54-57.
(ni?aaaoi?e O?noeaiei A.E., Ieeeiaiei I.I., Aecaoiaaa E.N., Caoa?iaa
A.I., Ianoaiei A.A.).

3. Niaa?oainoaiaaiea oe?o?ae/aneiai ea/aiey iinoeioa?eoiie aiaa?eciu
eaaiai aeaeoaei/ea // Oe?a?inueeee ea?ae?ieia?/iee aeo?iae. — 1999. —
?1. — N. 37-41. (ni?aaaoi?e O?noeaiei A.E., Ieeeiaiei I.I., Aaa?eaeyi
A.A., Ianoaiei A.A., Aaoeyaa A.I., Caoa?iaa A.I., Aea?aeo A.E.).

4. Aiaeec iaiin?aaenoaaiiuo ?acoeueoaoia iaeiiiiiaioiie ei??aeoeee
i?eia?aoaiiuo ii?ieia ieo?aeueiiai eeaiaia e ii?aaeaiee ei?iia?iuo
a?oa?ee // Na?oeaai-noaeeiia o??o?a?y. Ui??/iee iaoeiaeo i?aoeue
anioe?aoe?? na?oeaai-noaeeiieo o??o?a?a Oe?a?ie. — 1999. — Aeione 7. —
N. 146-150.

5. Iao. 21566 Oe?a?ia, IEA A61A17/00. Niin?a iaoai?/ii? aiaea?oa?aeoii??
/ Aea?aeaaia iaoaioia a?aeiinoai Oe?a?ie. — ?97052116; Cayae. 07.05.97;
Iioae. 30.04.98; Athe. ?2 -3 n. (ni?aaaoi?e O?noeaiei A.?., Ieeeiaiei
I.I., Iaeno?aiei Ae.I., Aaa???eyi A.A., Neaa/aiei I.I., Eoi/einueeee
I.A.).

6. Oe?o?ae/aneia ea/aiea eoaie/aneie aieacie na?aeoea, ineiaeiaiiie
niioonoaothuei ii?aaeaieai eeaiaiiiai aiia?aoa na?aeoea // Oacenu
aeieeaaeia ? Ananithciiai nueacaea na?aea/ii-ninoaeenouo oe?o?aia. —
Iineaa. — 1990. — N. 132-133. (ni?aaaoi?e O?noeaiei A.E., Eiuoia A.A.,
Eo/a?ia TH.A., Neaa/aiei A.I., Oo?eaei N.I.).

7. O??o?a?/ia e?eoaaiiy ?aaiaoe/ieo aaae na?oey, ye? ii?aeiothoueny c
iioeiaeaeaiiyi a?ioeaaeo a?oa??e // Oace aeiiia?aeae ? eiia?ano
?aaiaoieia?a Oe?a?ie. — Ee?a. — 1993. — N. 131. (ni?aaaoi?e O?noeaiei
A.?., Neaa/aiei 0.11.).

8. O??o?a?/ia e?eoaaiiy ii?aeiaii? iaoieia?? a?ioeaaeo a?oa??e, eeaiai?a
oa ?ioeo caoai?thaaiue na?oey // Oace aeiiia?aeae ? iaoeiai?
eiioa?aioe?? anioe?aoe?? na?oeaai-noaeeiieo o??o?a?a Oe?a?ie. — Ee?a. —
1993. — N. 100. (ni?aaaoi?e O?noeaiei A.?., Neaa/aiei I.I.).

9. ?aaiaoe/i? aaaee na?oey, ye? ii?aeiothoueny c ?oai?/iith oai?iaith.
*anoioa aeiaaee?a, aeina?ae o??o?a?/iiai e?eoaaiiy // Oace aeiiia?aeae
IV c’?cae ea?ae?ieia?a Oe?a?ie. — Ee?a. — 1993. — N. 100. (ni?aaoi?e
Neaa/aiei I.I., I?oaeeee ?.?.).

10. *anoioa aeaaioneeo e ineiaeiaiiuo oi?i aiaa?eci eaaiai aeaeoaei/ea.
Iaiin?aaenoaaiiua ?acoeueoaou iia?aoeee. I?e/eie eaoaeueiinoe // Oace
aeiiia?aeae III iaoeiai? eiioa?aioe?? anioe?aoe?? na?oeaai-noaeeiieo
o??o?a?a Oe?a?ie. — Ee?a. — 1995. — N.140. (ni?aaaoi?e O?noeaiei A.E.,
Ieeeiaiei I.I.).

11. Iniaaiiinoe caueou ieiea?aea i?e iia?aoeeyo iaeiiiiiaioiie
ei??aeoeee eeaiaiiuo e ei?iia?iuo ii?aaeaiee // Oace aeiiia?aeae III
iaoeiai? eiioa?aioe?? anioe?aoe?? na?oeaai-noaeeiieo o??o?a?a Oe?a?ie. —
Ee?a. — 1995. —N. 139. (ni?aaaoi?e O?noeaiei A.E., Neaa/aiei A.I.,
Iaeno?aiei Ae.I., Ieeeiaiei I.I.).

12. Eiiaeie?iaaiiay eeaiaiiay e ei?iia?iay oe?o?aey // Oacenu aeieeaaeia
III Ana?inneeneiai nueacaea na?aea/ii-ninoaeenouo oe?o?aia. — Iineaa.:
A?oaeiay e na?aea/ii-ninoaeenoay oe?o?aey. — 1996. —?6. — N. 269.
(ni?aaaoi?e Eiuoia A .A., O?noeaiei A.E., Neaa/aiei A.I.).

13. Oe?o?ae/aneia ea/aiea i?eia?aoaiiuo ii?ieia, ineiaeiaiiuo
eoaie/aneie aieaciueth na?aeoea // Aeooaeuei? i?iaeaie
iaie?aaoiaaiaoia?e?a?ii? oa noaeeiii? o??o?a??: Ca??iee ?ia?o iaoeiai?
eiioa?aioe??, i?enay/aii? 80-??//th c aeiy ia?iaeaeaiiy aeaaeai?ea 0.0.
Oae?iiaa. — Ee?a. — 1998. — N. 240. (ni?aaaoi?e Eiuoia A.A., O?noeaiei
A.E., Neaa/aiei A.I.).

14. Niin?a o??o?a?/iiai e?eoaaiiy aiaa?ecie na?oey // Iiceoeaia ??oaiiy
i?i aeaea/o iaoaioo Oe?a?ie ia aeiao?ae. — ? 97052117; Cayae. 07.05.97.
(ni?aaaoi?e Ieeeiaiei I.I., O?noeaiei A.?., Iaeno?aiei Ae.I., Aaa???eyi
A.A., Neaa/aiei I.I., Eoi/einueeee I.A.).

15. Caniae caoenoo i?iea?aea i?e neeaaeieo o??o?a?/ieo ao?o/aiiyo o
oai?eo c o?aaeaiiyi eeaiai?a oa a?ioeaaeo a?oa??e na?oey // Iaoiaee/i?
?aeiiaiaeaoe??; IIC Oe?a?ie, ?OeIIO. — Ee?a. — 1994. — 24 n. (ni?aaaoi?e
O?noeaiei A.?., E?aa/aiei ?.I., I?oaeeee ?.?., Ei?ieue ?.I., Neaa/aiei
I.I.).

Aiioaoe?y

E?eeoiia I.A. Ii?aeiaiiy ?oai?/ii? oai?iae na?oey c iaoieia??th
i?o?aeueeiai eeaiaia: ee?i?ea, ae?aaiinoeea, o??o?a?/ia e?eoaaiiy. —
?oeiien.

Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe
ca niaoe?aeuei?noth 14.01.04 — na?oeaai-noaeeiia o??o?a?y. ?inoeooo
na?oeaai-noaeeiii? o??o?a?? AII Oe?a?ie, i. Ee?a, 1999 ?.

Aeena?oaoe?th i?enay/aii i?iaeaiai ee?i?/iiai i?iyao, ae?aaiinoeoe? oa
o??o?a?/iiai e?eoaaiiy ii?aeiaiiy ?oai?/ii? oai?iae na?oey c iaoieia??th
i?o?aeueiiai eeaiaia.

Naeaeoeaia ei?iia?ia?ao?y aoea aeeiiaia 1041 oai?iio -? iaoieia??th
i?o?aeueiiai eeaiaia. Cia/ei? caoaeaiiy a?ioeaaeo a?oa??e (ia 50,0% ?
a?eueoa i?ina?oo noaeeie) aoee aeyaeai? o 165 (15,9%) oai?eo. Iacaeaaeia
ii?aeiaiiy ?oai?/ii? oai?iae na?oey oa iaaooeo i?o?aeueieo aaae
ae?aaiinoiaaii o 137 (13,2%) oai?eo. Aacneiioiiiee ia?aa?a a?ioeaaeo
o?aaeaiue niinoa??aaany o 83 (60,6%) oai?eo. *anoioa iino?ioa?eoii?
i?o?aeueii? iaaeinoaoiino? noaiiaeea 28 (2,7%) aeiaaee?a. Aea/aii
aca?iica’ycie ?oai?/ii? oai?iae na?oey ? iaoieia?? i?o?aeueiiai eeaiaia,
/anoioo aeyaeaiiy oaeiai ii?aeiaiiy oa iniaeeaino? ee?i?/iiai i?iyao.

A ?iaio? oa iniia? ianoaaeaiiy 83 (50,3%) iia?iaaieo oai?eo, ye? iaee
ii?aeiaiiy ?oai?/ii? oai?iae na?oey c iaoieia??th i?o?aeueiith eeaiaia,
i?iiiio?oueny eiiieaeniee i?aeo?ae aei o??o?a?/iiai e?eoaaiiy oa
i?io?eaeoeee ?io?aiia?aoe?eieo oneeaaeiaiue.

Iaeiiiiiaioia ei?aeoe?y a?ioeaaeo o?aaeaiue oa i?o?aeueieo aaae aeeiiaia
o 45 (27,3%) oai?eo. Aiae?c ?acoeueoao?a iia?aoe?e aeicaieea aecia/eoe
iioeiaeuei? aa??aioe o??o?a?/ii? ei?aeoe?? oa oaoi?ee caoenoo i?iea?aea.
Aea/ai? aaciina?aaei? e a?aeaeaeai? ?acoeueoaoe ii?aeiaiiy o??o?a??
i?o?aeueiiai eeaiaia c ?aaaneoey?ecai??e i?iea?aea.

Eeth/ia? neiaa: ?oai?/ia oai?iaa na?oey, i?o?aeueia aaaea na?oey,
eiia?iiaaia i?o?aeueia oa ei?iia?ia o??o?a?y.

Abstract

Krikunov A.A. The coexistance of ischemic heart desease and mitral
valvulopathy: clinical manifestation, diagnostics, surgical management.-
Manuscript.

The thesis is to obtain a scientific degree of the candidate of medical
sciences on the speciality 14.01.04 – cardiovascular surgery. – The
Institute of Cardiovascular Surgery of the Academy of Medical Sciences
of Ukraine, Kyiv, 1999.

The dissertation is devoted to the problems of clinical manifestations,
diagnostics possibilities and surgical treatment of patients with
coexistence of ischemic heart disease and mitral valvulopathy.

Selective coronary angiography was performed in 1041 patients with
mitral valvulopathy. Significant coronary stenosis (> 50,0%) was found
in 165 (15,9%) cases. Coronary artery disease associated with mitral
valve disease of non-ischemic origin was demonstrated in 137 (13,2%)
cases. Asymptomatic coronary artery disease was present in 83 (60,6%)
cases. The incidence of significant ischemic mitral incompetence was in
28 (2,7%) cases. The relationship between coronary damage and mitral
valvulopathy, the incidence of this association and clinical
presentations were described.

The complex approach to surgical treatment and prophylaxis of
intraoperative complications was developed on the base of operative
management of 83 (50,3%) patients with coexistance of ischemic heart
desease and mitral valvulopathy.

The total of 45 (27,3%) patients underwent mitral valve surgery combined
with coronary artery bypass grafting. The method of combined surgery and
technique of myocardial protection were improved. Early and late results
of the combined mitral valve and coronary surgery were studied.

Key words: ischemic heart disease, mitral valve disease, combined mitral
valve and coronary surgery.

Aiiioaoeey

E?eeoiia A.A. Ni/aoaiea eoaie/aneie aieacie na?aeoea n iaoieiaeae
ieo?aeueiiai eeaiaia: eeeieea, aeeaaiinoeea, oe?o?ae/aneia ea/aiea. –
?oeiienue.

Aeenna?oaoeey ia nieneaiea iao/iie noaiaie eaiaeeaeaoa iaaeeoeeineeo
iaoe ii niaoeeaeueiinoe 14.01.04 – na?aea/ii-ninoaeenoay oe?o?aey.
Einoeooo na?aea/ii-ninoaeenoie oe?o?aee AII Oe?aeiu, a. Eeaa, 1999 a.

A iniiao enneaaeiaaiee iieiaeai ?ao?iniaeoeaiue aiaeec 1041
ei?iia?ia?aoe/aneiai enneaaeiaaiey o aieueiuo n i?eia?aoaiiie iaoieiaeae
ieo?aeueiiai eeaiaia (IE), auiieiaiiuo a ENNO AII Oe?aeiu n 01.01.88 ii
01.01.98 aa. E?eoa?eai oi?ie?iaaiey a?oiiu enneaaeiaaiey yaeeinue
ni/aoaiea aaiiaeeiaie/aneeo cia/eiuo noaeaiee ei?iia?iuo a?oa?ee (EA) ia
50,0% e aieaa i?inaaoa ninoaea iaoieiaeae IE, o?aaothuei oe?o?ae/aneie
ei??aeoeee. Niaeanii yoiio e?eoa?eth auee nenoaiaoece?iaaiu aeaiiua 165
aieueiuo, eioi?ua e yaeeenue iauaeoii i?iaiaeeiiai enneaaeiaaiey.
Neaaeiaaoaeueii, iauay /anoioa auyaeaiey eco/aaiie iaoieiaee ii aeaiiui
ei?iia?ia?aoe/aneeo enneaaeiaaiee ninoaaeea 15,9% (165 neo/aaa ia 1041
ei?iia?ia?aoeth).

I?ioeann iacaaeneiiai ?acaeoey EAN e i?eia?aoaiiuo ieo?aeueiuo ii?ieia
(II) iaaethaeaaony o 137 (13,2%) aieueiuo (n?aaeiee aic?ano 52,70,5 a).
I?e yoii, ia/aei aeeaaiinoe?iaaiey ii?aaeaiee EA i?eoiaeeony ia aic?ano
35 eao o ioae/ei e 46 eao o aeaiuei n oaaee/aieai /anoiou a noa?oeo
aic?anoiuo a?oiiao. ?ao?iniaeoeaiue aiaeec iaoaieiai-aiaoiie/aneeo
enneaaeiaaiee 246 oia?oeo iinea i?ioace?iaaiey ieo?aeueiiai eeaiaia
(IIE) iieacae, /oi aaiiaeeiaie/anee cia/eiua aoa?ineea?ioe/aneea
eciaiaiey EA iaaethaeaeenue a 16,0% neo/aaa (n?aaeiee aic?ano 47,51,6
e).

Iinoeioa?eoiay ieo?aeueiay iaaeinoaoi/iinoue i?e ei?iia?ia?aoe/aneeo
enneaaeiaaieyo auyaeaia o 28 (2,7%) aieueiuo (n?aaeiee aic?ano 49,01,8
e).

Aeey a?oiiu aieueiuo n iacaaeneiui ni/aoaieai EAN e i?eia?aoaiiuo II
ii?aaeaeaiu oi?iu eeeie/aneiai i?iyaeaiey iaoieiaee. Iaeaieaa /anoi
iaaethaeaaony aanneiioiiiay “iaiay” oi?ia oa/aiey ii?aaeaiee EA (60,6%).
Oa?aeoa?iui aeey aeaiiie oi?iu yaeyaony ioaeneie iie (69,9%), iaee/ea
oaeoi?ia ?enea EAN (41,0%), iniaaiii a?oa?eaeueiie aeia?oaicee (37,7%).
O/eouaay cia/eoaeueioth /anoioo aanneiioiiiiai oa/aiey ii?aaeaiey EA,
anai aieueiui n i?eia?aoaiiui II, iacaaeneii io iaee/ey neiioiiia EAN, a
eiiieaen i?aaeiia?aoeeiiiiai ianeaaeiaaiey aeieaeia aeeth/aoueny
naeaeoeaiay ei?iia?ia?aoey, ia/eiay n aic?anoa 35 eao o ioae/ei e 46 eao
o aeaiuei. Aoi?ay oi?ia iaaethaeaaony a 39,4% neo/aaa e oa?aeoa?ecoaony
i?iyaeaieai eeeie/aneeo neiioiiia eae EAN, oae e II.

A i?ioeanna enneaaeiaaiey aeieacaii, /oi i?e/eiie iaoiii?oica ii?aaeaiee
EA ia oiia nouanoaothuaai II yaeyaony noaiaiue aaiiaeeiaie/aneie
iaa?ocee eaaiai aeaeoaei/ea, eioi?ay caaeneo io au?aaeaiiinoe ii?iea IE.

Aieueiua n o?iie/aneie iinoeioa?eoiie ieo?aeueiie iaaeinoaoi/iinoueth
(n?aaeiee aic?ano 49,01,6 a.) oa?aeoa?ecothony i?aiaeaaeaieai aiaa?eci
eaaiai aeaeoaei/ea (53,6%), o?aoninoaeenouo ii?aaeaiee EA (53,4%) i?e
cia/eoaeueiie /anoioa noaeaiee iniiaiiai noaiea EEA (14,3%),
iaiaeii?iaeiinoueth iaoaieciia aicieeiiaaiey ?aao?aeoaoeee ia IE.
Iaeaieaa /anoie i?e/eiie o?iie/aneie iinoeioa?eoiie ieo?aeueiie
iaaeinoaoi/iinoe yaeyaony aeeeaoaoeey oea?iciiai eieueoea IE (64,3%).

I?e iaeii n?iea nouanoaiaaiey naiie iaoieiaee IE (2,9 0,6 a.)
ioia/athony io/aoeeaua i?eciaee i?ia?anne?iaaiey ieiea?aeiie
iaaeinoaoi/iinoe, ia /oi oeacuaatho oaaee/aiea iauaiia e nieaeaiea
nie?aoeiinoe EAE, oaaee/aiea cia/aiee eiia/ii-aeeanoiee/aneiai aeaaeaiey
a aai iieinoe. Aeaiiua eciaiaiey yaeythony neaaenoaeai noiie?iaaiey
aeaoo iaaaoeaiuo oaeoi?ia iinoeioa?eoiuo eciaiaiee ieiea?aea e iauaiiie
ia?aa?ocee EAE aneaaenoaea ?aao?aeoaoeee ia IE.

Oi?ie?iaaiea iieacaiee e iaeiiiiiaioiie oe?o?ae/aneie ei??aeoeee
ii?aaeaiee EA II i?iaiaeeeinue n o/aoii iaoaeiaeaoai?aiiuo ?acoeueoaoia
/anoe/iie ei??aeoeee (eee oieueei eeaiaiiie, eee oieueei ei?iia?iie),
aunieiai ?enea iiaoi?iuo oe?o?ae/aneeo aiaoaoaeuenoa e ieceie
ioaeaeaiiie auaeeaaaiinoe a neo/ayo anoanoaaiiiai oa/aiey eco/aaiie
iaoieiaee. Niioonoaothuea ieo?aeueiui iioieai oia?aiiua noaeaiey EA
(50,0%) ia o?aaotho oe?o?ae/aneie ei??aeoeee. Noaiice?iaaiea i?inaaoa EA
ia 50,0% e aieaa, iacaaeneii io aai eeeie/aneiai i?iyaeaiey, o?aaoao
aeiiieieoaeueiie ?aaaneoeyoeee ieiea?aea. Iia?aoeeyie auai?a i?e
ni/aoaiee noaiica IE n aaiiaeeiaie/anee cia/eiuie noaeaieyie EA
yaeythony i?iaaaeaieai ?aioaaiyiaeiaaneoey?iie aeeeaoaoeee e ei?iia?iie
aiaeiieanoeee. Iieacaieai e oe?o?ae/aneie ei??aeoeee iinoeioa?eoiie
ieo?aeueiie iaaeinoaoi/iinoe neoaeeo ?aao?aeoaoeey ia IE 2+ e aieaa.

Ni/aoaiea oe?o?aee IE n ai?oi-ei?iia?iui ooioe?iaaieai (AEO) auei
auiieiaii 45 aieueiui (n?aaeiee aic?ano 51,9 1,1 a.). IIE auei
auiieiaii a 35 (77,8%) neo/ayo, eeaiaiinio?aiythuea iia?aoeee a 10
(22,2%) neo/ayo. Niioonoaothuay ?aaaneoeyoeey ieiea?aea auea auiieiaia
ai anao neo/ayo e eiaea neaaeothuea aa?eaiou: AEO – 1 o 21 (46,7%), AEO
– 2 o 17 (37,8%), AEO – 3 o 7 (15,5%) aieueiuo. A ea/anoaa
o?ainoeaioaioia i?eiaiyeenue aooiaaiu a 44 (97,8%) neo/ayo e aioo?aiiyy
a?oaeiay a?oa?ey a iaeiii (2,2%) neo/aa. N?aaeiaa eiee/anoai auiieiaiiuo
aeenoaeueiuo aianoiiicia ia iaoeeaioa ninoaaeei 1,9 0,25. N?aaeiyy
aeeeoaeueiinoue ia?aaeaoey ai?ou e eneonoaaiiiai e?iaiia?auaiey auee
88,1 5,6 iei. E 146,8 7,9 iei. Niioaaonoaaiii. Ainieoaeueiay
eaoaeueiinoue a neo/ayo ia?ae/iuo oe?o?ae/aneeo aiaoaoaeuenoa, eneeth/ay
iinoeioa?eoioth yoeieiaeth II, ninoaaeea 16,1%.

Aeey anae a?oiiu iia?e?iaaiiuo aieueiuo ia iniiaaiee aiaeeca
i?aaeiia?aoeeiiiuo eeeie/aneeo oa?aeoa?enoee auee eaeaioeoeoee?iaaiu
neaaeothuea i?iaiinoe/aneea oaeoi?u ?enea ainieoaeueiie eaoaeueiinoe:
noaaeey o?iie/aneie iaaeinoaoi/iinoe e?iaiia?auaiey: iiaoi?iinoue
oe?o?ae/aneiai aiaoaoaeuenoaa, eiee/anoai ii?aaeaiiuo EA, aeia?oaicey a
eaai/iie a?oa?ee.

Aiaeec ieo?aiia?aoeeiiiuo aeaiiuo ii?aaeaeee oeaeaniia?aciinoue
ia?aii/a?aaeiiai i?iaaaeaiey ?aaaneoey?ecaoeee ieiea?aea n iineaaeothuae
ei??aeoeeae II, eniieuecoy ii aiciiaeiinoe eeaiiinio?aiythuea iaoiaeeee.
A neo/ayo iaiaoiaeeiinoe i?ioace?iaaiey IE aeaeaoaeueii nio?aiyoue ai
iiaeeeaiaiiua no?oeoo?u. Ni/aoaiea eeaiaiiinio?aiythuae ei??aeoeee II n
iieiie ?aaaneoey?ecaoeeae ieiea?aea a ciiao e?iainiaaaeaiey eaaie EA
aeaeatho aieaa aa?iyoiui aeaaii?eyoiue enoiae oe?o?ae/aneiai ea/aiey.

N?aaieoaeueiue aiaeec yooaeoeaiinoe ?acee/iuo aa?eaioia caueou ieiea?aea
iieacae, /oi iacaaeneii io iooe aaaaeaiey e?enoaeeieaeiiai
ea?aeeiieaae/aneiai ?anoai?a yooaeoeaiinoue aai nieaeaaony i?e iaee/ee
e?eoe/aneeo noaeaiee aaoaae eaaie EA e aeia?o?ioee ieiea?aea eaaiai
aeaeoaei/ea. Iioeiaeueiui aa?eaioii oaoieee ea?aeeiieaaee yaeyaony
i?eiaiaiea e?iayiiai ea?aeeiieaae/aneiai ?anoai?a n eiiaeie?iaaieai
iooae aai aaaaeaiey.

Ioaeaeaiiua ?acoeueoaou naeaeaoaeuenoaotho ia yooaeoeaiinoe
iaeiiiiiaioiie ei??aeoeee ii?aaeaiee EA e iaoieiaee IE. Auaeeaaaiinoue e
5 aiaeo iinea iia?aoeee ninoaaeea 62,7%, e 7 aiaeo – 60,0% e e 10 –
57,8% (n o/aoii ainieoaeueiie eaoaeueiinoe). A aieaa aunieee
ooieoeeiiaeueiue eeann ia?aoee 59,3% aieueiuo.

Eeth/aaua neiaa: eoaie/aneay aieaciue na?aeoea, ieo?aeueiue ii?ie,
ni/aoaiea oe?o?aee ieo?aeueiiai eeaiaia e ?aaaneoey?ecaoeee ieiea?aea.

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