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Aeaaeai?y Iaaee/ieo Iaoe Oe?a?ie

?inoeooo ea?ae?ieia?? ?i. aeaae. I. Ae. No?aaeanea

Aoiueeiaa Aaeeia A?eoi??aia

OAeE: 616.12-008.46-036.12-085

Ii??aiyiiy ee?i?ei-oa?iaeiaeeiai?/ieo aoaeo?a ?ai?i?eea, oic?iii?eea oa
aiaeai?eea o oai?eo ?c o?ii?/iith na?oeaaith iaaeinoaoi?noth

14.01.11.-ea?ae?ieia?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? ea?ae?ieia?? ?i. aeaae.

I. Ae. No?aaeanea AII Oe?a?ie.

Iaoeiaee ea??aiee:

aeieoi? iaaee/ieo iaoe, i?ioani? Ai?iieia Eaii?ae Aai?a?eiae/,
caa?aeoaa/ a?aeae?eaiiy na?oeaai? iaaeinoaoiino? ?inoeoooo ea?ae?ieia??
?i. aeaae. I.Ae.No?aaeanea AII Oe?a?ie.

Io?oe?ei? iiiiaioe:

aeieoi? iaaee/ieo iaoe, i?ioani? Aaiaeao sseia Aa?aiiae/, aieiaiee
iaoeiaee ni?a?ia?oiee a?aeae?eo caeiaooeo aaae na?oey ?inoeoooo
na?oeaai-noaeeiii? o??o?a?? AII Oe?a?ie.

aeieoi? iaaee/ieo iaoe A?eoi?ia Ieaen?e Iaaeiae/, caa?aeoaa/
a?aeae?eaiiy ee?i?/ii? oa?iaeieia?? ?inoeoooo ea?ae?ieia?? ?i. aeaae.
I.Ae.No?aaeanea AII Oe?a?ie.

I?ia?aeia onoaiiaa: Aei?i?iiao?ianueea aea?aeaaia iaaee/ia aeaaeai?y IIC
Oe?a?ie, eaoaae?a oaeoeueoaonueei? oa?ai?? c eo?nii aiaeie?eiieia??.

Caoeno aeena?oaoe?? a?aeaoaeaoueny 25 o?aaiy i 12-00 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae. 26.616.01 i?e ?inoeooo?
ea?ae?ieia?? ?i. aeaae. I.Ae. No?aaeanea (252151, i. Ee?a, aoe.
Ia?iaeiiai Iiie/aiiy, 5).

C aeena?oaoe??th iiaeia iciaeiieoenue a iaoeia?e a?ae?ioaoe? ?inoeoooo
ea?ae?ieia?? ?i. aeaae. I.Ae. No?aaeanea (252151,

i. Ee?a, aoe. Ia?iaeiiai Iiie/aiiy, 5)

Aaoi?aoa?ao ?ic?neaiee “ 22 ” ea?oiy 1999?.

A/aiee nae?aoa? niaoe?ae?ciaaii?

a/aii? ?aaee Aeaye N. ?.

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie. Canoinoaaiiy ?ia?a?oi??a
aia?ioaicei-ia?aoai?thth/iai oa?iaioo (?AIO) aeey e?eoaaiiy ONI ?
a?aeiinii iiaei iai?yieii no/anii? ea?ae?ieia??, ii/aoie yeiio
iieeaaeaii a?eueo 10 ?ie?a oiio. Ia i?aenoaa? aeina?aeo aaaaoioeaio?iaeo
aeine?aeaeaiue ?AIO, aei aeiaaaeaieo aoaeo?a oeueiai eeano i?aia?ao?a o
oaeeo oai?eo a?aeiinyoue ia o?eueee ee?i?ei-ooieoe?iiaeueia iie?auaiiy
?o noaio, aea e iie?auaiiy ?o aeaeeaaiiy (CONSENSUS, 1987, the SOLVD
Inv. 1992).

A inoaii? ?iee a ee?i?/io i?aeoeeo ai?iaaaeaeothoueny iia? ?AIO,
cie?aia oae? ye ?ai?i?ee (?), oic?iii?ee (O). Aeei?enoaiiy oeeo
i?aia?ao?a a?aeia?aaeaii a iaiaaeai?e e?eueeino? ioae?eaoe?e, iaea?eueo
cia/iith na?aae yeeo ? aeine?aeaeaiiy aoaeoeaiino? ? i?ney ?ioa?eoo
i?iea?aea (AIRE, 1993).

? ? i?ii?aia?aoii, yeee i?noeoue ea?aieneeueio a?oio, c aenieei
ia??iaeii iai?aaeaaaeaiiy, ui ia?aaeuo? aiaeia?/iee iieaciee eaioii?eea
ia 85% oa aiaeai?eea (A) ia 17%, ? c aeoaea iecueeith eiinoaioith
aeennioe?aoe?? ?ciia?iiai eiiieaena aicei-?ia?a?oi? – 640 oa (Buning P.,
1987).

A inoaii? ?iee oaaao aeine?aeiee?a i?eaa?oa? oaaao O, yeee aeae?eaiee a
ie?aiee i?aeeean ?AIO. Aei neeaaeo oeueiai i?aia?aoo aoiaeeoue iieaeoea
oinoi?ii? eeneioe, ? eiai ae?i?iaoe?y ia caeaaeeoue a?ae a?eo, ie?eiai?
oa ia/?ieiai? iaaeinoaoiino? (Grover G.A.,, Sleph P.G., Dzwonszyk S. et
al,1991, Zusman R.M., 1991).

Aei oaia??oiueiai /ano i?aeoe/ii ia i?iaaaeai? ni?anoaaeaiiy
ee?i?ei-oa?iaeiaeeiai?/ieo aoaeo?a aeuaiaaaaeaieo ?AIO c oaeeie o
“aoaeiiiiai” ?ia?a?oi?a o?eaaei? ae?? – A. Iaaeinoaoiuei aea/ai? aeaye?
aniaeoe oa?iaeiaeeiai?ee ?AIO. Iayai?noue aioeieneaeaioieo aeanoeainoae
?AIO, ye? c oai?aoe/ieo iiceoe?e iiaeooue aooe neeaaeiaeie niia?eueiaiiy
oaiio i?ia?anoaaiiy na?oeaai? iaaeinoaoiino?, o iiaeo ?AIO ? oa O
niaoe?aeueii ia aea/aeiny. A?aenooi? i?aeoe/i? ?aeiiaiaeaoe?? uiaei
aeei?enoaiiy ? oa O o oai?eo ?c nenoie?/iith cano?eiith na?oeaaith
iaaeinoaoi?noth.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Oaia
aeena?oaoe?eii? ?iaioe aeeiiaia o neeaae? iaoeiai-aeine?aeii? ?iaioe
a?aeae?e?a na?oeaai? iaaeinoaoiino? oa oai?ia i?iea?aeo ? aaae na?oey
?inoeoooo ea?ae?ieia?? ?i. aeaae. I.Ae. No?aaeanea “?ic?iaeoe iia?
iaoiaaiaoe/ii iaa?oioiaai? iaoiaee e?eoaaiiy oai?eo ?c ONI ??ciiai
aaiaco”, 1995-98 ??. OAeE 616.12-008. 46-036.12-037-985 EI (?
aea?ae?aa?no?aoe?? 0196 E 005233).

Iaoa ? caaaeaiiy aeine?aeaeaiiy. Iaoa ?iaioe – ioe?iea
ee?i?ei-oa?iaeiaeeiai?/ieo aoaeo?a iiaeo ?AIO – ? ? O o oai?eo ?c ONI,
iaoiiaeaiith nenoie?/iith aeenooieoe??th e?aiai oeoii/ea, ?ic?iaea
?aeiiaiaeaoe?e uiaei ?oiueiai i?aeoe/iiai canoinoaaiiy.

I?ae /an aeeiiaiiiy ?iaioe ae??ooaaeenue oae? caaaeaiiy:

1. Aea/eoe a ii??aiyeueiiio ieai? aieea ?, O ? A ia
ee?i?ei-ooieoe?iiaeueiee noai ? o?ce/io i?aoeacaeaoi?noue oai?eo ?c ONI.

2. Ii??aiyoe aieea aeuacacia/aieo i?aia?ao?a ia iieacieee ooieoe??
e?aiai oeoii/ea ? aeaye? ia?aiao?e aaiiaeeiai?ee o oai?eo ?c o?ii?/iith
nenoie?/iith na?oeaaith iaaeinoaoi?noth.

3. Aecia/eoe aeeiai?eo aeiaiaiai ai?noo eaoaoieai?i?a o na/?, iieaciee?a
no?oeoo?ii-ooieoe?iiaeueiiai noaio iaia?ai a?eo?ioeeo?a, ia?aeeniiai
ieenethaaiiy e?i?ae?a (IIE), aeoeaiino? AIO o ne?iaaooe? e?ia? i?ae
aieeaii ?, O a c?noaaeaii? c A.

4. Ia i?aenoaa? ocaaaeueiaiiy io?eiaieo aeaieo iaa?oiooaaoe ? ?ic?iaeoe
?aeiiaiaeaoe?? ii canoinoaaiith ? ? O o oai?eo ?c ONI.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a. A ?acoeueoao? i?iaaaeaiiai
aeine?aeaeaiiy aia?oa anoaiiaeaii:

– a?eueo ae?acia i?aeaeuaiiy o?ce/ii? i?aoeacaeaoiino? oa iie?auaiiy
aaiiaeeiai?/iiai caaacia/aiiy o?ce/iiai iaaaioaaeaiiy o oai?eo ?c ONI
i?ae aieeaii A a ii??aiyii? ?c O oa ?.

– a?eueo ae?aciee ni?eyoeeaee aieea O ia iieacieee nenoie?/ii? ooieoe??
e?aiai oeoii/ea ii??aiyiii c A oa ? o oai?eo ?c ONI;

– aioeieneaeaioio oa iioei?coth/o no?oeoo?ii-ooieoe?iiaeueiee noai
iaia?ai ae?th ?.

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

Iaa?oioiaaia iaiao?aei?noue canoinoaaiiy A aeey e?eoaaiiy oai?eo ?c ONI
??-??? ooieoe?iiaeueieo eean?a (OE) (a?aeiia?aeii aei e?eoa???a NYHA)
caaaeyee eiai a?eueo ae?aciiio ni?eyoeeaiio aieeao ia o?ce/io
i?aoeacaeaoi?noue ? aaiiaeeiai?/ia caaacia/aiiy o?ce/iiai iaaaioaaeaiiy
oaeeo oai?eo o ii??aiyii? ?c O ? ?.

Iaeneiaeueiee aieea ia ?aiiaeaethaaiiy EO o iaoe??io?a ?c ae?aaeaiith
aeenooieoe??th i?iea?aeo aa?oi i/?eoaaoe a?ae O a ii??aiyii? ?c A ? ?.

I?e eaai?aoi?ii aeiaaaeai?e aeoeaaoe?? i?ioean?a e?iiia?ieneaeaoe??
iaa?oioiaaia iaio?aei?noue i?ecia/aiiy oai?ei ?c ONI ? ye i?aia?aoo, ui
/eieoue aioeieneaeaioio ae?th ? iie?auo? no?oeoo?ii-ooieoe?iiaeueiee
noai ee?oeiieo iaia?ai.

Cai?iiiiiaai? ?aeiiaiaeaoe?? uiaei i?ecia/aiiy aea/aieo ?AIO oai?ei ?c
o?ii?/iith na?oeaaith iaaeinoaoi?noth cai?iaaaeaeai? a i?aeoeeo ?iaioe
iie?ee?i?/iiai a?aeae?eaiiy ?inoeoooo ea?ae?ieia?? ?i. aeaae.
I.Ae.No?aaeanea, ui i?aeoaa?aeaeo?oueny a?aeiia?aeiei aeoii i?i
ai?iaaaeaeaiiy. Aeniiaee ? ?acoeueoaoe ?iaioe aoee aeei?enoai? i?e
noai?aii? iaoiaee/ieo ?aeiiaiaeaoe?e ii e?eoaaiith oai?eo ?c
aeeeyoaoe?eiith ea?ae?ii?iiao??th.

Iniaenoee aianie caeiaoaa/a. Aianie aaoi?a a io?eiai? ?acoeueoaoe ?
iniiaiei ? iieyaa? o aeai?? ia’?io oa iaoiae?a aeine?aeaeaiiy,
anoaiiaeaii? iaoe oa caaaeaiue, i?iaaaeaii? eo?aoe?? oa ee?i?/ieo
aeine?aeaeaiue oai?eo. Aaoi? iniaenoi aeeiioaaea aoiea?ae?ia?ao?th
(AOIEA) oa aaeia?aiiao??th (AAI), ioe?ieea io?eiai? ?acoeueoaoe, i?iaaea
ocaaaeueiaiiy oa noaoenoe/io ia?iaeo ?acoeueoao?a, i?aeaiooaaea iaoeia?
aeai? aei ioae?eaoe??, ioi?ieea aeena?oaoe?eio ?iaioo.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iniiai? iieiaeaiiy aeena?oaoe??
aoee i?aaenoaaeai? ia iaoeiai-i?aeoe/i?e eiioa?aioe?? “Aeooaeuei?
ieoaiiy ee?i?/ii? oa?iaeioa?ai??” (Oa?e?a, eenoiiaae 1996),
i?aenoieia?e nan?? ?inoeoooo ea?ae?ieia?? ?i. aeaae. I.Ae.No?aaeanea
(Ee?a, ethoee 1999).

Ai?iaaoe?y aeena?oaoe?? a?aeaoeany 30 a?oaeiy 1998?.ia ni?eueiiio
can?aeaii? a?aeae?eaiue na?oeaai? iaaeinoaoiino? oa aaae na?oey ? oai?ia
i?iea?aeo ?inoeoooo ea?ae?ieia?? ?i. I.Ae. No?aaeanea.

Ioae?eaoe??. Ca iaoa??aeaie aeena?oaoe?? iioae?eiaaii o?e aeo?iaeuei?
noaoo? o oaoiaeo aeaeaiiyo ? o?e oace.

No?oeoo?a aeena?oaoe??. Aeena?oaoe?y neeaaea?oueny ?c anooio, 5
?icae?e?a, aeniiae?a oa nieneo e?oa?aoo?e, ui i?noeoue 161 aeaea?aeo.
Aeena?oaoe?eio ?iaioo aeeiiaii ia 112 noi??ieao iaoeiiieniiai oaenoo,
?ethno?iaaii 48 oaaeeoeyie oa 4 iaethieaie.

INIIAIEE CI?NO ?IAIOE

Ee?i?/ia oa?aeoa?enoeea oai?eo. Iniiao aeaii? ?iaioe noaiiaeyoue
?acoeueoaoe ianoaaeaiiy 88 oai?eo c o?aeoe??th aeeeaeo (OA)
e?aiai oeoii/ea (EO) 0,05).

E?eoaaiiy ?AIO ii/eiaee c iaeiie?aoieo ni?iaieo aeic: 1,25 ia aeey ?,
2,5 ia aeey O ? 2,5 aeey A ?c ianooiiei oeo?oaaiiyi aei iaeneiaeueii
ee?i?/ii noa?iii?. Na?aaei? aeiaia? aeice neeaee aeey ? – (4,44+0,28)
ia, O – (6,65+0,54) ia ? (4,82+0,18) ia aeey A.

I?aea?? iioeiaeueii? aeice i?aia?ao?a cae?enithaaany ia i?aenoaa?
?aeiiaiaeaoe?e o??i – ae?iaiee?a a?aeiia?aeieo ?AIO ? a?aeiia?aeaa
caaaeueiii?eeiyoei ?aeiiaiaeaoe?yi uiaei ?oiueiai ee?i?/iiai
aeei?enoaiiy.

Iaoiaee aeine?aeaeaiiy. Ii?yae c ?aoaeueiei ee?i?/iei ianoaaeaiiyi an?i
oai?ei i?iaiaeeee ?ino?oiaioaeuei? ? eaai?aoi?i? iaoiaee aeine?aeaeaiiy.
Ioe?ieo aioo??oiueina?oeaai? aaiiaeeiai?ee cae?enithaaee ca aeiiiiiaith
AoiEA a I- oa A-?aaeeiao ia aia?aoao “Biomedica” (?oae?y) ca
caaaeueiii?eeiyoith iaoiaeeeith (O?eea? E., Ineiia I.A., 1993).

Ca aeiiiiiaith AoiEA ia/enethaaee e?ioeaai-nenoie?/iee ?ici?? EO,
e?ioeaai-ae?anoie?/iee ?ici?? EO, ia?aaeiuei-caaei?e ?ici?? e?aiai
ia?aaena?aey (EI). Io?eiai? ?ici??e ii?iaeieie EO aeei?enoiaoaaee aeey
?ic?aooieo oaeeo iieaciee?a, ye e?ioeaai-nenoie?/iee ia’?i (ENI) ?
e?ioeaai-ae?anoie?/iee ia’?i (EAeI) EO ii oi?ioe? L.Teicholtz.

O?aeoe?th aeeeaeo (OA) EO aecia/aee ii oi?ioe?:

OA=(EAeI-ENI)/EAeIo100%, (1)

aea

OA – o?aeoe?y aeeeaeo e?aiai oeoii/ea;

EAeI – e?ioeaai-nenoie?/iee ia’?i;

ENI – e?ioeaai-ae?anoie?/iee ia’?i.

Aecia/aiiy oiea?aioiino? aei o?ce/iiai iaaaioaaeaiiy i?iaiaeeee ca
aeiiiiiaith aaeia?aiiao?e/iiai oanoo ia aaeia?aiiao?? “Simens-Elema”
(I?ia//eia) o neaey/iio iieiaeaii?. Aeei?enoiaoaaany iaoiae
aacia?a?aii-c?inoath/iai iaaaioaaeaiiy. Ii/aoeiaa iiooaei?noue
iaaaioaaeaiiy anoaiiaethaaeanue ia 20 AO ? iio?i iiaoaiii ca?eueooaaeany
ia 20 AO. *an iaaeaethaaiiy eiaeiiai aoaio noaiiaea 4 oa. Oanooaaiiy
i?iaiaeeeiny aei aeinyaiaiiy noaiaeneiaeueii? /anoioe na?oeaaeo
nei?i/aiue (*NN) aai ae aei iiyae ae?aaeaii? caaeooe /e iioeo eeiii/ieo
iciae, ui e?i?ooaaee iiaeaeueoa i?iaeiaaeaiiy i?iae. I?ae /an
aeine?aeaeaiiy aecia/aeeny oae? iieacieee: nenoie?/iee a?oa??aeueiee
oene (AOn), *NN, iiaea?eiee aeiaooie (IAe) (aeiaooie *NN ia AOn) a noai?
niieith, ia ?aeaioe/iiio (?ae) ? ia ii?iaiaiio (ii??a) ??aiyo
iaaaioaaeaiiy, /an iaaeaethaaiiy a oaeeeiao (t). Ca aeaieie AAI oaeiae
aecia/aee iieacieee ianyao aeeiiaii? ?iaioe (A) oa aaiiaeeiai?/ii?
aa?oino? ?iaioe (AA?) ii oi?ioeai:

A=Wo6oTo9,81, (2)

aea

W – iiooaei?noue iaaaioaaeaiiy, yea aeeiioaaee iaoe??ioe i?ae /an
AAI-oanoo, a Ao;

t – o?eaae?noue aeeiiaiiy AAI oanoo a oa.,

AA?=IAeii??a-IAe o noai? niieith/A, (3)

 aea

IAeii??a – iiaea?eiee aeiaooie ia ii?iaiaiio iaaaioaaeaii? AAI-oanoo a
oi.iae.;

IAe – iiaea?eiee aeiaooie o noai? niieith a oi. iae.

A – caaaeueiee ianya aeeiiaii? ?iaioe, a eAeae.

Eaai?aoi?ia ianoaaeaiiy neeaaeaeiny ?c caaaeueiiee?i?/ieo, a?io?i?/ieo
(eiio?iethaaeenue ai?no aeaeo?ie?o?a (E+, Na+), ??aaiue e?aaoei?io
e?ia?) ? niaoe?aeueieo iaoiae?a aeine?aeaeaiiy. O eaai?aoi??? ee?i?/ii?
a?io?i?? OIAe? (ea??aiee i?io. E.N. Io?oa?yi) aecia/aeeny iieacieee IIE
ii iaoiaeo Noaeueii?, ooieoe?iiaeueiiai noaio iaia?ai a?eo?ioeeo?a ia
a?io?i?/iiio aiae?caoi?? Ciba Corning (Aiae?y), ??ai?a eaoaoieai?i?a o
aeiaia?e e?eueeino? na/? ii iaoiaeo Iaoe?ii?. Aeine?aeaeaiiy aeoeaiino?
AIO o ne?iaaooe? e?ia? i?iaaaeeeinue ca iaoiaeeeith Fridlend E. ia
oethi?eiao?? o??ie O?oa/?.

Ia oii? i?eeiio ?AIO o 7 oai?eo aeieeee iia?/i? aoaeoe, ui e?i?ooaaee
iiaeaeueoa e?eoaaiiy: i?e canoinoaaii? ? a 1 /ieia?ea (3,57%) – eaoaeue,
o 1 iaoe??ioa (3,57%) – a?eue a ae?eyioe? na?oey, o 1 oai?iai (3,57%)
a?aecia/aeiny i?aeaeuaiiy AO, i?e i?eeii? O – o 1 oai?iai (3,70%)
c’yaeeeny iai?e?ii? a?ae/oooy a ae?eyioe? na?oey, ui noi?iaiaeaeoaaeeny
oeoii/eiaith aeno?anenoie??th, i?e i?eeii? A – o 2 iaoe??io?a (6,06%)
ia?aaeuaiiy ii?iaeueii? eiioeaio?aoe?? e?aaoei?io a ieaci? e?ia? oa o 1
/ieia?ea (3,03%) – oe??ia aeneiea. Oe? oai?? ia aoee aeeth/ai? a
aeine?aeaeaiiy.

?acoeueoaoe aeine?aeaeaiue ia?iaeai? ca aeiiiiiaith iaoiae?a
aa??aoe?eii? noaoenoeee c aeei?enoaiiyi iaeaoa i?eeeaaeieo noaoenoe/ieo
i?ia?ai “Stat4win”. Ioe?iea a??ia?aeiino? ci?i iieaciee?a i?ae aieeaii
i?aia?ao?a a eiaei?e c a?oi cae?enithaaeany ca aeiiiiiaith iaoiaeo
niieo/aieo aa??aio (O?aao A.TH, 1975), a ioe?iea a??ia?aeiino?
a?aei?iiinoae aaniethoieo i?e?ino?a iieaciee?a i?ae ??cieie a?oiaie – ca
aeiiiiiaith iaoiaeo ii??aiyiiy na?aaei?o (O?aao A.TH, 1975).

?acoeueoaoe aeanieo aeineiaeaeaiue, ?o iaaiai?aiiy.

I?ecia/aiiy ?AIO ni?eyei aeinoia??iiio iie?auaiith iieaciee?a
aioo??oiueina?oeaai? aaiiaeeiai?ee. A on?o a?oiao oai?eo
a?aei?/aia aeinoia??ia ciaioaiiy ia?aaeiuei-caaeiueiai ?ici??o EI
i?ney 2 ? i?ney 8 oeaei?a aeine?aeaeaiiy. Aiae?c aaniethoieo aaee/ei
i?e?ino?a ?ici??o EI ca 8 oeaeiaaee ia??iae i?eeiio ?AIO o ii??aiyii? c
aeo?aeieie aaee/eiaie (DEI) iieacaa, ui inoaii?e i?ae aieeaii O
ciaiooaaany a a?eueo?e i???, i?ae i?ae aieeaii A ? ?, i?e/iio aeai?
?icoiaeaeaiiy aeinyaaee nooiaiy aeinoia??iino? noiniaii A (?

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