IAOe?IIAEUeIA AEAAeAI?ss IAOE OE?A?IE

?INOEOOO AENIA?EIAIOAEUeII? IAOIEIA??,

IIEIEIA?? ? ?AAe?IA?IEIA?? ?i. ?.?. EAAAOeUeEIAI

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

OE?A?INUeEEE IAOEIAI-AeINE?AeIEE ?INOEOOO

IIEIEIA?? OA ?AAe?IEIA??

EI?IA?I NA?A?E ?AI?IAE*

OAeE: 616.5– 006.61– 005.277.3–089

OEssOE IIE?AUAIIss ?ACOEUeOAO?A E?EOAAIIss CEIssE?NII? IAEAIIIE
OE??E E?IOe?AIE OA OOEOAA

14. 01. 07 – Iieieia?y

A A O I ? A O A ? A O

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

aeieoi?a iaaee/ieo iaoe

Ee?a – 1998

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia a Oe?a?inueeiio iaoeiai-aeine?aeiiio ?inoeooo? iieieia??
oa ?aae?ieia?? IIC Oe?a?ie.

Iaoeiaee eiinoeueoaio ( aeieoi? iaaee/ieo iaoe, i?ioani?

Oienoii’yoia Ai?eneaa Ienaio?eiae/,

Oe?a?inueeee iaoeiai-aeine?aeiee ?inoeooo

iieieia?? oa ?aae?ieia?? IIC Oe?a?ie, caa?aeoaa/ iaoeiai-aeine?aeiiai
a?aeae?eaiiy iooeei iii?ii-?ooiaiai aia?aoo.

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

Ai?iaeiaa Ethny ?aai?aia,

Oe?a?inueeee iaoeiai-aeine?aeiee ?inoeooo iieiei-a?? oa ?aae?ieia?? IIC
Oe?a?ie, caa?aeoth/a iaoeiai-aeine?aeiei a?aeae?eaiiyi iieia?iaeieia??;

aeieoi? iaaee/ieo iaoe, i?ioani?

Iyni?aeia Aeieo?i Aieiaeeie?iae/,

Ee?anueea iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe IIC Oe?a?ie ?i. I.E.
Ooieea, caa?aeoaa/ eaoaae?e iieieia??;

aeieoi? iaaee/ieo iaoe, i?ioani?

ss?ai/oe Ieaenaiae? sseiae/,

Iaoe?iiaeueiee iaaee/iee oi?aa?neoao ?i. I.I.Aiaiiieueoey IIC Oe?a?ie,
caa?aeoaa/ eaoaae?e iieieia??.

I?ia?aeia onoaiiaa ( Aeiiaoeueeee iaaee/iee oi?aa?neoao ?i. I.
Ai?ueeiai IIC Oe?a?ie, eaoaae?a iieieia??.

Caoeno a?aeaoaeaoueny (16( a?oaeiy 1998 ?. i 13 aiae 30 oa ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae.26.155.01 a ?inoeooo?
aenia?eiaioaeueii? iaoieia??, iieieia?? ? ?aae?ia?ieia?? ?i. ?.?.
Eaaaoeueeiai IAI Oe?a?ie (252022, Ee?a , aoe. Aaneeuee?anueea, 45).

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? ?inoeoooo
aenia?eiaioaeueii? iaoieia??, iieieia?? ? ?aae?ia?ieia?? ?i. ?.?.
Eaaaoeueeiai IAI Oe?a?ie.

Aaoi?aoa?ao ?ic?neaiee (11( eenoiiaaea 1998 ?.

A/aiee nae?aoa?

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

aeieoi? iaaee/ieo iaoe
Aa?aiaiei ?.A.

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue i?iaeaie. Iaeaiiia oe??e noaiiaeoue eeoa 1(3%
ceiye?nieo caoai?thaaiue ethaeeie. Aea e?euee?noue ethaeae o na?o?,
oai?eo ia iaeaiiaeanoiio, eiaeiiai ?ieo c?inoa? ia 5% (A.A.
Aieneiia e niaao., 1995). I?inoaaeaia aeeiai?ea ca?eueoaiiy iieaciee?a
caoai?thaaiino? ianaeaiiy a Oe?a?i?. E?euee?noue ethaeae, ye? caoai??ee
ia ceiye?nio iaeaiiio, c?inea c 1553 o 1989 ?. aei 1944 o 1996 ?. Oea
aei??aith? 3,0 ? 3,8 ia 100 000 ianaeaiiy e?a?ie (C.I. Oaaei?aiei oa
ni?aaao., 1997).

O??o?a?/ia aeaeaeaiiy iaeaiiaeanoiie oe??e caeeoa?oueny ?aeeiei
?aaeeeaeueiei iaoiaeii e?eoaaiiy (A. Barth et al., 1994). Iacaaaeath/e
ia iiaeeea?noue oe?ieiai e aaeanoe/iiai aeaeaeaiiy ia?aeiii? iooeeie,
iiaeaeueoee ?icaeoie caoai?thaaiiy i?e II(V ??aiyo ?iaac?? iooeeie ca
Eea?eii (97% iaoe??io?a, ye? aia?oa caa?oathoueny aei e?ea?y), i?aeoe/ii
iaieio/ee (M. Thorn et al., 1994).

Iieieiae iino?eii aaaeooue iiooe cania?a ? iaoiae?a, caaaeyee yeei
iiaeia aeinyaoe o?eaaeeo, noaa?eueieo oa?i?i?a ?ai?n?? (P. Wolkenstein
et al., 1995). Aeiiei? oey i?iaeaia ia ae??oaia ? ? ia’?eoii iiooeo (J.
Overgaard et al.,1995). Oe?ieee niaeo? ?nioth/eo iaoiae?a
i?io?eaeoeee ? e?eoaaiiy iaoanoac?a iaeaiiie oe??e ? ?o eiia?iaoe?e
caeaee ?ac aeiaiaeeoue, ye aeaeaea oey i?iaeaia a?ae inoaoi/iiai
ae??oaiiy (C. Balch et al., 1997).

?ooeii? caniae aeei?enoaiiy oaeeo aeia?a a?aeiieo iaoiae?a e?eoaaiiy
ceiye?nieo iooeei, ye i?iiaiaaa ? o?i?ioa?ai?y, ia iie?aueee ?acoeueoaoo
?aaeeeaeueieo iia?aoe?e (H. Voigt, 1988). A?eueo ia?aeiieea? aeai? aoee
io?eiai? i?e iiaeeo?eaoe?? o?i?ioa?ai?? naeaeoeaiei niiniaii aaaaeaiiy
oeeoinoaoee?a (H. Hoekstra et al., 1993). Cie?aia, caaaeath/e ia aaeeeo
a??ia?aei?noue o?aaeaiiy iaoanoacaie ?aa?iia?iiai e?ioaoe/iiai
eieaeoi?o, aeey iaeaiiie oe??e e?ioe?aie ? ooeoaa iaeaeioe?euei?oith ?
iaoiaeeea aiaeie?ioaoe/ii? oa?ai??. Oeae iai?yiie aei oeueiai /ano
eeoa?oueny aeooaeueiei, aea ia? aeoaea aaeeeo e?euee?noue ieoaiue, ui
iio?aaothoue ae??oaiiy .

I?ioa iaeoaeaiiy oai?eo ia ceiye?nio iaeaiiio oe??e iaiiaeeeai o?eueee
caaaeyee oaoi?/iiio oaeineiiaeaiith iaoiaeee. Ia?aeaeueii ?c ?ic?iaeith
oeyo?a aaaaeaiiy oeeoinoaoe/ieo i?aia?ao?a ?aeooue iiooee oa ai?iaaoe??
iiaeo i?ioeiooeeiieo cania?a (M. Mitchell et al., 1995).

Iaeiei ?c ia?niaeoeaieo iai?yi?a i?ioeiooeeiii? oa?ai?? ? aeei?enoaiiy
iiaeeo?eaoi??a a?ieia?/ieo a?aeiia?aeae, aai oeeoie?i?a (A.E. Ai?iioeiaa
e niaao., 1996; A.O.Aiceaiia e niaao., 1998). Ia aeoieo aaaaoueio
aeine?aeiee?a, a oeueiio aaeeeiio ?icae?e? iiaeo e?ea?nueeeo i?aia?ao?a
i?e iaeaiii? ia?aaaaa iaaea?oueny ?ioa?oa?iio (J Kirkwood et al.,
1996). Ia nueiaiaei? ia ?nio? /?oeeo oyaeaiue i?i eiie?aoi? oa?aiaaoe/i?
noaie aeeth/aiiy ?ioa?oa?iio a eiiieaenio oa?ai?th iaeaiiaeanoiie.

Ca’ycie aeine?aeaeaiue c iaoeiaeie i?ia?aiaie. ?iaioa aeeiiaia a ?aieao
ieaiiaeo IAe? a?aeae?eaiiy iooeei iii?ii-?ooiaiai aia?aoo Oe?a?inueeiai
iaoeiai-aeine?aeiiai ?inoeoooo iieieia?? ? ?aae?ieia?? (OIAe?I?) IIC
Oe?a?ie ca oaeeie iiia?aie aea?aeaaii? ?a?no?aoe??: ? 0194EI18647, ?
01.9.20000845 , ? 0186.0054737.

Iaoa ?iaioe. Ioe?ieoe aoaeoeai?noue no/anieo iaoiae?a e?eoaaiiy oai?eo
ia iaeaiiio oe??e e?ioe?aie oa ooeoaa, ?ic?iaeoe aoaeoeai? noaie
aae’thaai-oii? oa?ai??, ui caeaoi? iie?aueoe a?aeaeaeai? ?acoeueoaoe
?aaeeeaeueieo iia?aoe?e.

Caaea/? aeine?aeaeaiiy

1. Aea/eoe ?acoeueoaoe o??o?a?/iiai iaoiaeo e?eoaaiiy oai?eo ia
iaeaii-io oe??e e?ioe?aie ? ooeoaa ia ??cieo aoaiao i?ia?an??
caoai?thaaiiy. Anoaiiaeoe iine?aeiai?noue ?icaeoeo aeaii? ceiye?nii?
iooeeie ? aecia/eoe aieea noao?, a?eo iaoe??io?a ? eieae?caoe?? iooeeie
ia ia?aa?a iaoieia??, ui aea/a?oueny.

2. Ioe?ieoe aoaeoeai?noue iaoiaeeee aae’thaaioii? i?iiaiaai? oa?ai?? a
eii-a?iaoe?? c ?aaeeeaeueiith iia?aoe??th o oai?eo ia iaeaiiio oe??e
e?ioe?aie ? ooeoaa.

3. ?ic?iaeoe iaoiaeeeo i?io?eaeoe/ii? nenoaiii? o?i?ioa?ai?? ?
i?iaia-e?coaaoe ?acoeueoaoe ?? aeei?enoaiiy o oai?eo ia ceiye?nio
iaeaiiio oe??e e?ioe?aie ? ooeoaa.

4. ?ic?iaeoe eiia?iiaaiee iaoiae aae’thaaioii? nenoaiii? o?i?ioa?ai?? a
ii?aeiaii? c ianiaoeeo?/iei ?ioiiiiaeoeyoi?ii eaaii?cieii aeey e?eoaaiiy
oai?eo ia iaeaiiio oe??e e?ioe?aie ? ooeoaa.

5. ?ic?iaeoe iaoiaeeeo i?io?eaeoe/ii? niaoeeo?/ii? ?ioiioa?ai??
(aooi-aaeoeeiaoe??) i?e e?eoaaii? iiaoi?ieo oai?eo c ?aoeeaeeaieie
iaoanoacaie iaeaiiie oe??e a ?aa?iia?ieo e?ioaoe/ieo aoceao ? aecia/eoe
?? aoaeoeai?noue.

6. ?ic?iaeoe iaoiaeeeo naeaeoeaii? (aiaeie?ioaoe/ii?) aae’thaaioii?
o?i?i-oa?ai?? aeey e?eoaaiiy oai?eo ia iaeaiiio oe??e e?ioe?aie ?
ooeoaa. Aeaoe ioe?ieo ?acoeueoaoai aeei?enoaiiy ai?iaaaeaeaiiai
eiia?iiaaiiai iaoiaeo.

7. Ai?iaoaaoe ? cai?iaaaeeoe a?o/eciyiee ?aeiia?iaioiee (-((-?ioa?-oa?ii
(eaoa?ii) a noaiao eiia?iiaaiiai e?eoaaiiy oai?eo ia ceiye?nio iaeaiiio
oe??e. Aeaoe ioe?ieo iiaeeeainoyi iiaiai i?aia?aoo. ?ic?iaeoe iaoiaeeee
? noaie eiai aeei?enoaiiy i?e e?eoaaii? oai?eo ia iaeaiiio oe??e
e?ioe?aie ? ooeoaa.

8. Ia i?aenoaa? aiae?co io?eiaieo ?acoeueoao?a cai?iiiioaaoe iioeiaeuei?
noaie e?eoaaiiy oai?eo ia iaeaiiio oe??e e?ioe?aie ? ooeoaa a
caeaaeiino? a?ae noaae?? caoai?thaaiiy.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a. ?ic?iaeaii aoaeoeai?, iaoeiai
iaa?oioiaai? i?aeoiaee aei e?eoaaiiy oai?eo ia iaeaiiio oe??e e?ioe?aie
? ooeoaa, ye? aeicaieeee ca?eueoeoe oa?i?i ?ai?n?? caoai?thaaiiy ?
o?eaae?noue aeeooy iaoe??io?a (iieacieee 3- ? 5-??/iiai aeaeeaaiiy).

Anoaiiaeaii, ui aiaeie?ioaoe/ia o?i?ioa?ai?y iiaeiaaeo? oa?i?i aeeooy
oai?eo ? ?ai?n?? caoai?thaaiiy i?ney iia?aoe?e, aeeiiaieo c i?eaiaeo
ia?aeiii eieae?ciaaii? iaeaiiie oe??e.

Aia?oa anoaiiaeaia aoaeoeai?noue naeaeoeaiiai (aiaeie?ioaoe/iiai)
canoinoaaiiy ?aeiia?iaioiiai (-((-?ioa?oa?iio (eaoa?iio) oai?ei ia
iaeaiiio oe??e. ?ic?iaeaia iaoiaeeea ii?aeiaiiai aiaeie?ioaoe/iiai
aaaaeaiiy ?aeiia?iaioiiai ?ioa?oa?iio ? o?i?ii?aia?ao?a a noaiao
eiia?iiaaiiai e?eoaaiiy oai?eo ia iaeaiiio oe??e e?ioe?aie ? ooeoaa.
Aeiaaaeaia aoaeoeai?noue oeueiai i?io?eaeoe/iiai caniao i?ney iia?aoe?e,
aeeiiaieo c i?eaiaeo ia?aeiii eieae?ciaaii? iaeaiiie oe??e.

?ic?iaeaii aoaeoeaiee iaoiae aae’thaaioii? oa?ai?? e?eoaaiiy oai?eo c
iaoanoacaie iaeaiiie oe??e e?ioe?aie ? ooeoaa a ?aa?iia?ieo e?ioaoe/ieo
aoceao (ia?aaeiia?aoe?eia aiaeie?ioaoe/ia i?ioeiooeeiia oa?ai?y).

I?aeoe/ia cia/aiiy ? ai?iaaaeaeaiiy io?eiaieo ?acoeueoao?a. Ai?iaiaaii
oa cai?iaaaeaeaii aei oe?ieiai ee?i?/iiai aeei?enoaiiy a?o/eciyiee
?aeiia?iaioiee (-((-?ioa?oa?ii – eaoa?ii. ?ic?iaeaii noaie eiai
canoinoaaiiy o oai?eo ia iaeaiiio oe??e e?ioe?aie ? ooeoaa.

?ic?iaeaia noaia aae’thaaioii? aiaeie?ioaoe/ii? o?i?ioa?ai?? aeicaieeea
ia 11,0% ca?eueoeoe iieaciee 5-??/iiai aeaeeaaiiy oai?eo ia ia?aeiii
eieae?ciaaio iaeaiiio oe??e e?ioe?aie ? ooeoaa.

?ic?iaeaia noaia aae’thaaioii? aiaeie?ioaoe/ii? oa?ai?? c aeei?enoaiiyi
o?i?ii?aia?ao?a ? eaoa?iio ia 15,0% i?aeaeueea iieaciee 3-??/iiai
aeaeeaaiiy oai?eo ia ia?aeiii eieae?ciaaio iaeaiiio oe??e.

Ai?iaaaeaeaia noaia ia?aaeiia?aoe?eii? aiaeie?ioaoe/ii? i?ioeiooeeiii?
oa?ai?? (o?i?ioa?ai??, ?ioa?oa?iiioa?ai??) ia 19,0% iie?aueea iieaciee
3-??/iiai aeaeeaaiiy i?e e?eoaaii? ia?aeiieo oai?eo c iaoanoacaie
iaeaiiie oe??e a ?aa?iia?ieo e?ioaoe/ieo aoceao.

?ic?iaeaia noaia e?eoaaiiy (ia?aaeiia?aoe?eia aiaeie?ioaoe/ia aaaaeaiiy
eaoa?iio) oai?eo c ?aa?iia?ieie e?ioaoe/ieie iaoanoacaie oe??e ooeoaa,
ui aeieeaee i?ney aeaeaeaiiy ia?aeiii? iooeeie, ia 23,0% iie?ioeea
iieaciee 3-??/iiai aeaeeaaiiy iaoe??io?a i?ney e?ioaaeaiaeoii??.

Iaoa??aee aeena?oaoe?? aeeth/aii aei i?ia?aie iaa/aiiy e?ea??a ia
eaoaae?? iieieia?? Ee?anueei? iaaee/ii? aeaaeai?? i?neyaeeieiiii? ina?oe
IIC Oe?a?ie. ?acoeueoaoe ?iaioe aeeeaaeai? ia eaeoe?yo aeey e?ea??a, ye?
iaa/aeeny ia eo?nao ?ioi?iaoe?? ? noaaeoaaiiy o a?aeae?eaii? iooeei
iii?ii-?ooiaiai aia?aoo OIAe?I? IIC Oe?a?ie. ?acoeueoaoe aeine?aeaeaiiy
ai?iaaaeaeaii a i?aeoeeo iaaee/ieo caeeaae?a oeyoii aeaeaiiy iaoiaee/ieo
?aeiiaiaeaoe?e ? aeaio ?ioi?iaoe?eieo eeno?a, caoaa?aeaeaieo IIC
Oe?a?ie. ?ic?iaeai? iaoiaee e?eoaaiiy aeei?enoiaothoueny o a?aeae?eaii?
iooeei iii?ii-?ooiaiai aia?aoo OIAe?I? IIC Oe?a?ie ? o ??aiainueeiio
iaeaniiio iieieia?/iiio aeeniaina??.

Iniaenoee aianie caeiaoaa/a. Aaoi?ii iniaenoi ?ic?iaeai? oa ai?iaiaai?
an? iaoiaeeee aae’thaaioii? oa iaiaae’thaaioii? aiaeie?ioaoe/ii? oa?ai??
i?e e?eoaaii? oai?eo ia iaeaiiio oe??e e?ioe?aie ? ooeoaa. Caeiaoaa/ai
naiino?eii i?iaaaeaia aiaeie?ioaoe/ia oa?ai?y on?i 360 oai?ei, ye?
oa?eoee aei aeine?aeaeoaaieo a?oi.

Caeiaoaa/ai aeanii?o/ii aeeiiaii on? ee?i?/i? ?iaioe c oa?ai?? oai?eo ia
iaeaiiio oe??e iaoiaeii i?io?eaeoe/ii? aooiaaeoeeiaoe??.

Aaoi? aoa aeeiiaaoeai ?iaeea?aeoaeueieo caaaeaiue IAe? i?e ?ic?iaoe? ?
ai?iaaoe?? iaoiae?a aae’thaaioii? nenoaiii? o?i?ioa?ai??, eiia?iiaaii?
o?i?i- ? ?ioiioa?ai?? oai?eo ia iaeaiiio oe??e ? a?aa aaciina?aaeith
o/anoue a e?eoaaii? oaiaoe/ieo oai?eo, a oaeiae o noai?aii?
eiii’thoa?ieo aac aeaieo, ia?iaoe? a?o?aiiai iaoa??aeo ? aea/aii?
a?aeaeaeaieo ?acoeueoao?a e?eoaaiiy.

Ai?iaaoe?y ?iaioe. Iniiai? ?acoeueoaoe aeena?oaoe?? aoei aeeeaaeaii ?
iaaiai?aii ia Ananithciiio neiiic?oi? «Ee?i?ea oa e?eoaaiiy iaeaiiie
oe??e» (Na?aoia, 1990); ?? Ananithciiio neiiic?oi? «Iaoanoacoaaiiy
ceiye?nieo iooeei. Iia? i?aeoiaee» (Ee?a, 1991); can?aeaiiyo Iaoeiaiai
oiaa?enoaa iieieia?a i. Ee?aa ? Ee?anueei? iaeano? (Ee?a, 1992);
?anioae?eainuee?e iaoeiai-i?aeoe/i?e eiioa?aioe?? «Eaoa?ii a eeiii/iie
iaaeeoeeii» (??aia, 1995); IX c’?cae? iieieia?a Oe?a?ie (A?iieoey,
1995); ?anioae?eainuee?e iaoeiai-i?aeoe/i?e eiioa?aioe?? «O?i?ioa?ai?y a
eiiieaeniiio e?eoaaii? iieieia?/ieo oai?eo» (*a?i?aoe?, 1996);
?anioa-e?eainuee?e iaoeiai-i?aeoe/i?e eiioa?aioe?? «?ae ia Oe?a?i?:
ai?aeai?ieia?/i? ? i?aai?caoe?ei? aniaeoe i?iaeaie» (Ee?a, 1997);
?anioae?eainuee?e iaoeiai-i?aeoe/i?e eiioa?aioe?? «?ioiioa?ai?y i?e
e?eoaaii? ceiye?nieo iiaiooai?aiue» (Ee?a, 1998); ?anioae?eainuee?e
iaoeiai-i?aeoe/i?e eiioa-?aioe?? «Aeooaeuei? i?iaeaie ee?i?/ii?
oa?iaeieia??» (A?iieoey, 1998).

Ioae?eaoe?? ?acoeueoao?a aeine?aeaeaiue. Ca iaoa??aeaie aeena?oaoe??
iioae?eiaaii 39 iaoeiaeo i?aoeue, c ieo 20 noaoae a i?ia?aeieo oaoiaeo
aeaeaiiyo.

No?oeoo?a oa ianya aeena?oaoe??. Aeena?oaoe?y aeeeaaeaia oe?a?inueeith
iiaith ia 284 noi?. iaoeiiieno. Neeaaea?oueny c? anooio, iaeyaeo
e?oa?aoo?e, oanoe ?icae?e?a aeanieo aeine?aeaeaiue, caeeth/aiiy,
aeniiae?a oa nieneo e?oa?aoo?ieo aeaea?ae, aei yeiai aoiaeeoue 481
iaeiaioaaiiy, c ieo 195 ( ia oe?a?inuee?e ? ?in?enuee?e iiaao, 286 ( ia
aiae?enuee?e. Aeena?oaoe?y ?ethno?iaaia 82 oaaeeoeyie ? 18 ?enoieaie.

INIIAIEE CI?NO ?IAIOE

IA’?EO ? IAOIAeE AeINE?AeAEAIIss

?iaioo aeeiiaii ia i?aenoaa? niinoa?aaeaiue ca 1703 oai?eie ia iaeaiiio
oe??e e?ioe?aie ? ooeoaa, ye? e?eoaaeeny o a?aeae?eaii? iooeei
iii?ii-?ooiaiai aia?aoo OIAe?I? IIC Oe?a?ie.

I?iaiae?ciaaii ?acoeueoaoe e?eoaaiiy oai?eo ia ia?aeiii eieae?ciaaio
iaeaiiio oe??e e?ioe?aie ? ooeoaa (I noaae?y, ca eeaneo?eaoe??th Stehlin
oa ni?aaao. – T(1-4)NoMo), ia?aeiieo oai?eo ia iaeaiiio oe??e e?ioe?aie
? ooeoaa c iae?eiaaiith ia?aeiiith iooeeiith ? ?aa?iia?ieie
e?ioiaaiieie iaoanoacaie (III B noaae?y, ca eeaneo?eaoe??th Stehlin oa
ni?aaao. – any Tc N1Mo) ? iiaoi?ieo oai?eo,ye? caa?ioeeny aei ian c
ee?i?/ieie i?iyaaie ?aa?iia?ieo e?ioiaaiieo iaoanoac?a, ui aeieeaee
i?ney aeaeaeaiiy iaeaiii oe??e e?ioe?aie ? ooeoaa

( III B noaae?y, ca eeaneo?eaoe??th Stehlin oa ni?aaao. – Tx
rN1Mo).

Aeey e?eoaaiiy oai?eo aoee canoiniaai? oae? iaoiaee:

1. O??o?a?/iee iaoiae.

2. O??o?a?/iee iaoiae noeoiii c i?iiaiaaith oa?ai??th.

3. O??o?a?/iee iaoiae noeoiii c nenoaiiith o?i?ioa?ai??th.

4. ?aaeeeaeueia iia?aoe?y ? nenoaiia o?i?ioa?ai?y noeoiii c
ianiaoeeo?/-iith ?ioiioa?ai??th (eaaii?cie).

5. ?aa?iia?ia e?ioaaeaiaeoii?y ? niaoeeo?/ia ?ioiioa?ai?y
(aooiaae-oeeia).

6. O??o?a?/iee iaoiae noeoiii c aiaeie?ioaoe/iith o?i?ioa?ai??th.

7. O??o?a?/iee iaoiae noeoiii c aiaeie?ioaoe/iith
?ioa?oa?iii-oa?ai??th (eaoa?ii).

8. O??o?a?/iee iaoiae ? aiaeie?ioaoe/ia o?i?ioa?ai?y noeoiii c
aiaeie?i-oaoe/iith ?ioa?oa?iiioa?ai??th (eaoa?ii).

A ia?o? aeine?aei? a?oie (A1 ( A7) oa?eoee oai?? ia ia?aeiii
eieae?-ciaaio iaeaiiio oe??e. Oea iaoe??ioe, o eio?eo aoea
ae?aaiinoiaaia ceiye?nia iaeaiiia oe??e II(V ??ai?a i?iieeiaiiy iooeeie
a aea?io ca Eea?eii, aac ee?i?/ieo iciae iaoanoac?a.

A?oia A1 ( oai?? (901 iaoe??io, eiio?ieueia a?oia), e?eoaaiiy yeeo
iaiaaeoaaeiny aeaeaeaiiyi ia?aeiii? iooeeie.

A?oia A2 ( oai?ei (90 iaoe??io?a) i?iaiaeeeanue i?neyiia?aoe?eia
i?iia-iaaa oa?ai?y: ia i?neyiia?aoe?eiee ?oaaoeue eo?niaa aeica 55(60
A?, ia?aeaeueii iai?aaeeaiea aaiaoa?ai?y ciie ?aa?iia?iiai
e?ioieieaeoi?o eo?niaith aeicith 40 A?.

A?oia A3 ( oai?? (38 iaoe??io?a) i?ney iia?aoe?? iaea?aeoaaee eo?ne
nenoaiii? o?i?ioa?ai??: o?noue eo?n?a i?ioyaii 2 ?ie?a c aeei?enoaiiyi
i?ini?aeeia, aeaeoeiii?oeeia ? dacarbazine.

A?oia A4 ( oai?ei (17 iaoe??io?a) i?ney iia?aoe?? i?iaiaeeeenue eo?ne
nenoaiii? o?i?ioa?ai?? (o?noue eo?n?a i?iaeiaae 2 ?ie?a c aeei?enoaiiyi
i?ini?aeeia ? aeaeoeiii?oeeia) noeoiii c ?ioiiiiaeoeyoi?ii eaaii?cieii
ii 150 ia per os aea?/? ia oeaeaeaiue, /ioe?ueiooeaeiaaee eo?n i?ney
eiaeii? o?i?ioa?ai??.

A?oia A5 ( oai?? (110 iaoe??io?a) i?ney iia?aoe?? io?eioaaee eo?n
yiaeie?ioaoe/ii? o?i?ioa?ai??: iaeei eo?n i?ioyaii oeaeiy. O?e
aaaaeaiiy /a?ac 48 aiae c aeei?enoaiiyi i?ini?aeeia, dacarbazine,
iaoio?aenaoa ? oeeeeioinoaia. Aea?? ia?eoa??eii? e?ioaoe/ii? noaeeie
aeey eaoaoa?ecaoe?? ia noii? /e eeno? i?iaiaeeany a noai??e caeaaeiino?
a?ae eieae?caoe?? aeaeaeaii? iooeeie.

A?oia A6 ( oai?? (45 iaoe??io?a) i?ney iia?aoe?? iaea?aeoaaee e?eoaaiiy
?aeiia?iaioiei (-((-?ioa?oa?iiii (eaoa?iiii): iaeei eo?n
yiaeie?i-oaoe/ii? oa?ai?? ( o?e aaaaeaiiy /a?ac 48 aiae ii 3·106 II. A
ianooiiiio ( 11 eo?n?a e?ioio?iiiiai aaaaeaiiy i?iaeiaae 1 ?ieo /a?ac
i?nyoeue. Eo?niaa aeica ( 4·106 II.

A?oia A7 ( oai?? (72 iaoe??ioa), yeei i?ney iia?aoe?? aiaeie?ioaoe/ii
aaiaeeee nii/aoeo o?i?ii?aia?ao (1-e oa 3-e aei?), a iio?i eaoa?ii (
6-e oa 7-e aei?). I?ioyaii ianooiiiai ?ieo oai?? io?eioaaee 11 eo?n?a
e?ioio?iiiiai aaaaeaiiy eaoa?iio oeaeiaaeie eo?naie /a?ac i?nyoeue.

Iiaeaeueo? aeine?aeaeaiiy aoee i?enay/ai? ?acoeueoaoai e?eoaaiiy oai?eo
ia iaeaiiio oe??e e?ioe?aie ? ooeoaa c III B ee?i?/iith noaae??th
caoai?thaaiiy, ca Stehlin oa ni?aaao.

Na?aae iaoe??io?a aeaii? a?oie ie aeae?eeee ia?aeiieo oai?eo, eio??
caa?ioeeny aei ee?i?ee c iae?eiaaiith ia?aeiiith iooeeiith ? iaoanoacaie
iaeaiiie a ?aa?iia?ieo e?ioaoe/ieo aoceao (any Tc N1Mi) ? iiaoi?ieo
iaoe??io?a c iaoanoacaie iaeaiiaeanoiie a ?aa?iia?ieo e?ioaoe/ieo
aoceao, ui aeieeaee i?ney aeaeaeaiiy ia?aeiii eieae?ciaaii? iaeaiiie
oe??e e?ioe?aie ? ooeoaa (Tx rN1Mi).

Aei a?oi A1 ( A4 ia?aeiieo oai?eo c ?aa?iia?ieie e?ioiaaiieie
iaoanoacaie oa?eoee oae? iaoe??ioe.

A?oia A1 ( oai?ei (205 iaoe??io?a, eiio?ieueia a?oia) c?iaeaia
?aaeeeaeueia iia?aoe?y.

A?oia A2 ( oai?ei (24 iaoe??ioa) i?ney o??o?a?/iiai e?eoaaiiy
i?iaiaeeeanue i?io?eaeoe/ia i?iiaiaaa oa?ai?y ciie ?aa?iia?iiai
e?ioieieaeoi?o: ia ciio aeaeaeaieo ?aa?iia?ieo e?ioaoe/ieo aoce?a eo?n
iai?aaeeaiei? aaiaoa?ai?? noia?iith aeicith 35(40 A?.

A?oia A3 ( oai?? (28 iaoe??io?a) ia?aaeiia?aoe?eii io?eioaaee a
ia?eoa??eio e?ioaoe/io noaeeio o?aaeaiiai e?ioaoe/iiai eieaeoi?o iaeei
oeaeiaaee eo?n o?i?ioa?ai??.

A?oia A4 ( oai?ei (19 iaoe??io?a) ia?aaeiia?aoe?eii aiaeie?ioaoe/ii
aaiaeeany eaoa?ii. Aoa i?iaaaeaiee iaeei eo?n ( o?e aaaaeaiiy /a?ac 48
aiae ii 3·106 II eaoa?iio ? i?ney iia?aoe?? – eo?ne e?ioio?iiiiai
aaaaeaiiy eaoa?iio: 11 eo?n?a e?ioio?iiiiai aaaaeaiiy oeaeiaaeie eo?naie
ii 4·106 II /a?ac i?nyoeue.

O a?oie N1 ( N5 oa?eoee iiaoi?i? oai?? ia iaeaiiio oe??e e?ioe?aie ?
ooeoao, ye? caa?ioeeny aei ee?i?ee c iaoanoacaie iaeaiiaeanoiie a
?aa?iia?ieo e?ioaoe/ieo aoceao, ui aeieeaee i?ney aeaeaeaiiy ia?aeiii?
iooeeie.

A?oia N1 ( oai?ei (435 iaoe??io?a , eiio?ieueia a?oia) i?iaiaeeeanue
eeoa ?aa?iia?ia e?ioaaeaiaeoii?y.

A?oia N2 ( oai?? (42 iaoe??ioa) ii?yae c o??o?a?/iei e?eoaaiiyi
io?eioaaee eo?ne i?neyiia?aoe?eii? aae’thaaioii? nenoaiii? o?i?ioa?ai??:
o?noue eo?n?a i?ioyaii 2 ?ie?a c aeei?enoaiiyi i?ini?aeeia,
aeaeoeiii?oeeia ? dacarbazine.

A?oia N3 ( oai?? (26 iaoe??io?a) i?ney iia?aoe?? iaea?aeoaaee
aaeoeeiaoe?th oa aeai?aciao ?aaaeoeeiaoe?th iooeeiiith aooiaaeoeeiith
(ca iaoiaeeeith Ae.A.Caooee oa ni?aaao., 1983).

A?oia N4 ( oai?ei (49 iaoe??io?a) i?iaiaeeany oeaeiaaee eo?n
ia?aaei-ia?aoe?eii? aiaeie?ioaoe/ii? o?i?ioa?ai??: o?e aaaaeaiiy
?ioa?aaeii 48 aiae.

A?oia N5 ( oai?ei (47 iaoe??io?a) ia?aaeiia?aoe?eii aiaeie?ioaoe/ii
aaiaeeany eaoa?ii: iaeei eo?n ( o?e aaaaeaiiy /a?ac 48 aiae ii 3·106 II
? i?ney iia?aoe?? – eo?ne e?ioio?iiiiai aaaaeaiiy eaoa?iio: 11 eo?n?a
e?ioio?iiiiai aaaaeaiiy oeaeiaaeie eo?naie ii 4·106 II /a?ac i?nyoeue.

Ca iniiai? (eiio?ieuei?) ?acoeueoaoe e?eoaaiiy aoee i?eeiyo? iieacieee a
a?oiao, a yeeo aeey e?eoaaiiy canoiniaoaaeeny eeoa ?aaeeeaeuei?
iia?aoe??. Oe? nai? aaeee? ca e?euee?noth niinoa?aaeaiue a?oie (A1, A1,
N1) aeei?enoiaoaaeeny oaeiae ? aeey aea/aiiy aieeao ie?aieo oaeoi??a ia
ia?aa?a caoai?thaaiiy.

Aeey aea/aiiy aaciina?aaei?o ?acoeueoao?a e?eoaaiiy ioe?ithaaeeny ci?ie
iieaciee?a caaaeueiiee?ie/ieo aiae?c?a, niinoa?aaeaiiy ca oai?eie.

C iaoith aea/aiiy aieeao eaoa?iio ia aeeiai?eo e?euee?niiai aaeaino
noeioeyoi??a e ?ia?a?oi??a ee?oeiii? i?ie?oa?aoe?? a ne?iaaooe? e?ia?
oai?eo iaie i?iaaaeaii oanooaaiiy ni?aa?aeiioaiiy iiceoeaieo ?
iaaaoeaieo oaeoi??a ?inoo (O?-oano ( A.E. Ai?iioeiaa e niaao., 1991) o
27 iaoe??io?a aeine?aeaeo?ii? a?oie (A6), o 17 oai?eo ia ia?aeiii
eieae?ciaaio iaeaiiio oe??e eiio?ieueii? a?oie (A1) ? o 16 i?aeoe/ii
caei?iaeo aeiii??a. Aea/aany aieea ne?iaaoee e?ia? oai?eo ia
i?ie?oa?aoeaio aeoeai?noue noniaic?eii? eoeueoo?e ee?oei iooeeie
e?ioina?eiie iaoethe?a in vitro.

Na?aae oai?eo a?oi A1, A3, A4 ? N3 c iaoith aieeao canoiniaaieo
aae’thaaioieo iaoiaeee ia ?ioiieia?/iee noai iaoe??io?a aea/aeany
aeeiai?ea ci?i iieaciee?a oanoo ?icaoeiooai?aiiy ? oanoo a?ia?/ooeeaino?
iia?eueiiai oeio ia AeIOA.

Aeey ioe?iee a?aeaeaeaieo ?acoeueoao?a cai?iaaaeaeaieo eiia?iiaaieo
iaoiae?a e?eoaaiiy aea/aeeny iieacieee ui??/ii? aeeiai?ee ?ai?n??
caoai?thaaiiy (recurrence-free survival) ? aeaeeaaiiy oai?eo (overall
survival).

Ia?iaea aeaieo i?iaiaeeeanue ia IAAI ?AI ca i?ia?aiith aea/aiiy
aoaeoeaiino? iaoiae?a e?eoaaiiy. Ca aeai?eoi ?ic?aooieo iieacieea
aeaeeaaiiy acyoi aeoo??aeueiee (aeeiai?/iee) iaoiae, i?eeiyoee AIIC ca
noaiaea?o. Oi?ioaaiiy aea??ie i?iaiaeeeiny ia i?aenoaa? iaoa??ae?a
eaioea?-?aa?no?o a?aeae?eaiiy iooeei iii?ii-?ooiaiai aia?aoo OIAe?I? IIC
Oe?a?ie c o?aooaaiiyi ??cieo i?iaiinoe/ieo ia?aiao??a (noaae?y, a?e oa
?i.), a oaeiae a caeaaeiino? a?ae aeeiai?ee i?iaaaeaiiai e?eoaaiiy (O.
Jensen et al., 1991; E.I. Aoeae, 1994).

?ACOEUeOAOE OA ?O IAAIAI?AIIss

A ia?oo /a?ao iaie aoee aea/ai? iiaeeeaino? ?aaeeeaeueieo iia?aoe?e i?e
e?eoaaii? ceiye?nii? iaeaiiie oe??e ? ?? iaoanoac?a a ?aa?iia?ieo
e?ioaoe/ieo aoceao.

I?e noaoenoe/i?e ia?iaoe? iaoa??aeo i?aeoaa?aeaeaii oaeo i?ei?eoaoiiai
iaoanoacoaaiiy iaeaiiie oe??e a ?aa?iia?i? e?ioaoe/i? aocee (L. Craig et
al., 1993).

I?ney ?aaeeeaeueiiai aeaeaeaiiy ia?aeiii eieae?ciaaii? iaeaiiie na?aae
eiio?ieueii? a?oie oai?eo A1, ui neeaaeaeany c 901 iaoe??ioa, o 709
(78,6% on??? a?oie) aeieeaee iaoanoace iooeeie. O 701 (98,8% na?aae
iaoe??io?a c ee?i?/ieie i?iyaaie iaoanoac?a) oai?iai a ia?oo /a?ao aoei
aeyaeaii o?aaeaiiy ?aa?iia?ieo e?ioaoe/ieo aoce?a.

Oa?i?i iiyae e?ioiaaiieo iaoanoac?a ciaoiaeeoueny a aeoaea oe?ieiio
ae?aiacii? ( a?ae 1 i?nyoey aei 20 ?ie?a. Aea i?inoaaeaia /?oea
caeiiii??i?noue: iniiaia /anoeia iaoanoac?a (640 oai?eo; 90,2%)
aeieea? a ia?o? 5 ?ie?a niinoa?aaeaiiy i?ney ?aaeeeaeueieo iia?aoe?e.

O?aaa aeacaoe ia oaeo aeineoue oaeaeeiai ?icaeoeo iaeaiiie oe??e.
I?ioyaii ?ieo i?ney ?aaeeeaeueii? iia?aoe?? c i?eaiaeo ia?aeiii
eieae?ciaaii? iaeaiiaeanoiie oe??e (noaae?y I) iaoanoace aeieeaee o 360
oai?eo, ui noaiiaeei 50,7% iaoe??io?a, o eio?eo aeyaeaii iaoanoace
iaeaiiie. Ioaea,

o eiaeiiai ae?oaiai oai?iai na?aae oeo, ooi caa?ioany c i?eaiaeo
?aoeeaeeao caoai?thaaiiy, iaoanoace aeieeaee i?iaeiaae ia?oeo 12
i?nyoe?a i?ney iia?aoe??.

Iieacieee a?aeaeaeaieo ?acoeueoao?a iia?aoe?e, aeeiiaieo o a?aeae?eaii?
iooeei iii?ii-?ooiaiai aia?aoo OIAe?I? IIC Oe?a?ie c i?eaiaeo ia?aeiii
eieae?ciaaii? iaeaiiie oe??e, aoee oaeeie: 3 ?iee i?ney iia?aoe??
i?iaeeei 67,7 ( 1,5% oai?eo, 5 ?ie?a ( 53,5 ( 1,6%, 10 ?ie?a ( 41,6
( 1,6%.

Na?aae oai?eo ia ia?aeiii eieae?ciaaio iaeaiiio oe??e 3- oa 5-??/ia
aeaeeaaiiy /ieia?e?a aei??aithaaei 63,2 ( 2,6 oa 49,4 ( 7,4%
a?aeiia?aeii. O ae?iie o? ae nai? iieacieee noaiiaeee a?aeiia?aeii 70,4
( 1,9 oa 59,1 ( 2,0%. I?e ii??aiyii? oeeo oa?aeoa?enoee anoaiiaeaii
noaoenoe/ii a??ia?aeio ia?aaaao iaio iieaciee?a aeaeeaaiiy na?aae
ae?iie (P<0,05). I?e eieae?caoe?? iooeeie ia oe??? ooeoaa 3- oa 5-??/ia aeaeeaaiiy nyaaei 61,7 ( 2,6 oa 46,5 ( 2,6% a?aeiia?aeii. I?e eieae?caoe?? iaeaiiie ia oe??? e?ioe?aie o? ae nai? iieacieee aei??aithaaee 71,5 ( 1,9 oa 57,9 ( 2,1% (P<0,05). A caeaaeiino? a?ae a?eo iaoe??io?a 3- oa 5-??/ia aeaeeaaiiy ci?ithaaeinue oaeei /eiii. A a?oi? oai?eo, a?e yeeo aoa a?eueoa 15 ?ie?a ? ia ia?aaeuoaaa 40, 3-??/ia aeaeeaaiiy noaiiaeei 68,9 ( 2,5%, 5-??/ia ( 56,2 ( 2,7%. O oai?eo a?eii a?ae 41 aei 60 ?ie?a 3-??/ia aeaeeaaiiy aei??aithaaei 68,1 ( 2,3%, 5-??/ia ( 54,2 ( 2,5%. O oai?eo a?eii a?eueoa 60 ?ie?a 3-??/ia aeaeeaaiiy noaiiaeei 63,9 ( 3,6%, 5-??/ia ( 46,5 ( 3,5%. I?e ii??aiyii? cacia/aieo aeua iieaciee?a anoaiiaeaia no?eea oaiaeaioe?y iia??oaiiy i?iaiico o oai?eo, a?e yeeo ia?aaeuea 60 ?ie?a, a oie /an ye iieacieee aeaeeaaiiy iaoe??io?a aeaio ?ioeo a?oi aoee i?aeoe/ii iaeiaeiaeie. Noaoenoe/ii a??ia?aeio ??cieoeth ca?a?no?iaaii eeoa i?e ii??aiyii? 5-??/iiai aeaeeaaiiy oai?eo ia?oi? ? o?aouei? a?eiaeo a?oi (P<0,05). ?acoeueoaoe o??o?a?/iiai e?eoaaiiy iaoe??io?a c e?ioiaaiieie iaoanoacaie iaeaiiie aoee ua a??oeie. Iieacieee 3- oa 5-??/iiai aeaeeaaiiy ia?aeiieo oai?eo (a?oia A1 ( any Tc N1Mo) c III B noaae??th caoai?thaaiiy aei??aithaaee a?aeiia?aeii 41,3 ( 3,4 ? 30,6 + 3,2%. I?e aea/aii? iane?aee?a e?eoaaiiy oai?eo c iaoanoacaie iaeaiiie oe??e e?ioe?aie ? ooeoaa a ?aa?iia?ieo e?ioaoe/ieo aoceao aoea anoaiiaeaia oaea caeiiii??i?noue: oa?i?ie aeeooy oai?eo i?ney ?aaeeeaeueieo e?ioaaeaiaeoii?e ia caeaaeeee a?ae oiai, /e i?enooiy ia iiiaio iia?aoe?? ia?aeiia iooeeia aai ?? aoei aeaeaeaii aei iiyae ?aa?iia?ieo e?ioiaaiieo iaoanoac?a. Iieaciee 3-??/iiai aeaeeaaiiy o ia?aeiieo oai?eo a noaae?? III B (a?oia A1 – any Tc N1Mo) i?ney o??o?a?/iiai e?eoaaiiy noaiiaea 41,3 ( 3,4%. Oie aea iieaciee i?ney ?aa?iia?ii? e?ioaaeaiaeoii?? o iaoe??io?a c iaoanoacai, ui aeieeaee i?ney aeaeaeaiiy iooeeie (a?oia N1 – Tx rN1Mo), aei??aithaaa 36,7 ( 2,3%. Oeeo?e 5-??/iiai aeaeeaaiiy nyaaee 30,6 ( 3,2% oa 30,0 ( 2,1% a?aeiia?aeii. A?aenooi?noue nooo?ai? ?ica?aeiino? iieaciee?a a?aeaeaeaieo iane?aee?a cao?eniaaia ? i?e ii??aiyeueiiio aiae?c? ?acoeueoao?a iia?aoe?e a caeaaeiino? a?ae noao? oai?eo ? eieae?caoe?? ia?aeiii? iooeeie (a?oie A1 ? N1). Iaeiae o?aaa aeacaoe, ui aeeiai?ea ?ai?n?? caoai?thaaiiy i?ney e?ioaaeaiaeoii?e aoea a?eueo ni?eyoeeaith o iiaoi?ieo oai?eo. ??e i?ney iia?aoe?? aac iciae iaoanoac?a i?iaeeei 39,5 ( 3,4% oai?eo c neio?iiieie e?ioiaaiieie iaoanoacaie (a?oia A1 ( any Tc N1Mo), o iiaoi?ieo oai?eo (a?oia N1 ( Tx rN1Mo) oeae iieaciee aei??aithaaa 54,0 ( 2,3% (P<0,05). A?eueo?noue aaoi??a, ye? caeiaeeny ii??aiyiiyi iienaieo iieaciee?a, noaa?aeaeothoue, ui ?acoeueoaoe e?ioaaeaiaeoii?e a??o? o ia?aeiieo oai?eo. Oae, A.?. Aaaia? c ni?aaaoi?aie (1996) ia i?aenoaa? aeaniiai iaoa??aeo anoa-iiaea, ui o 192 ia?aeiieo oai?eo c neio?iiieie e?ioiaaiieie iaoanoacaie iieaciee 5-??/iiai aeaeeaaiiy noaiiaea 25,0%, o 127 iiaoi?ieo iaoe??io?a, eio?? e?eoaaeeny c i?eaiaeo e?ioiaaiieo iaoanoac?a, ui aeieeaee i?ney aeaeaeaiiy ia?aeiii? iooeeie, 5 ?ie?a i?ney e?ioaaeaiaeoii?? i?iaeeei 35,4%. ?acoeueoaoe iaoeo aeine?aeaeaiue ca?aathoueny c? aeacaieie aeaieie eeoa /anoeiai. A ?iaio? noaoenoe/ii a??ia?aeii anoaiiaeaii, ui ia?aa?a iaeaiiie oe??e o ia?aeiieo oai?eo c iaoanoacaie a ?aa?iia?ieo e?ioaoe/ieo aoceao a?eueo aa?aneaiee ? iaoanoace i?ney iia?aoe?? aeieeathoue /ano?oa, i?ae i?ney e?ioaaeaiaeoii?e o iiaoi?ieo oai?eo, a oa?i?ie aeeooy ye ia?aeiieo oai?eo a noaae?? III B, oae ? iaoe??io?a, ye? caa?ioeeny aei ian c ee?i?/ieie i?iyaaie iaoanoac?a a ?aa?iia?ieo e?ioaoe/ieo aoceao i?ney aeaeaeaiiy ia?aeiii? iooeeie, aoee iaeiaeiaeie. Oaeei /eiii, iaia'yceiaee aoai ?icaeoeo ceiye?nii? iaeaiiie oe??e e?ioe?aie ? ooeoaa ( iai?oanoaoe?y ?aa?iia?ieo e?ioiaaiieo iaoanoac?a ( ? ? oi?aa?naeueiith aeii?ioth/ith i?iaiinoe/iith iciaeith, nai???aeiith /aniaith (e?aieith a?aee?eo( aeey oai?iai. I?e aea/aii? iiaeeeainoae o??o?a?/iiai iaoiaeo e?eoaaiiy aoea anoaiiaeaia ua iaeia caeiiii??i?noue. Aeyaeaia noaoenoe/ii a??ia?aeia caeaaei?noue iieacieea aeaeeaaiiy i?ney e?ioaaeaiaeoii?e o iiaoi?ieo oai?eo a?ae eieae?caoe?? ia?aeiii? iooeeie, ui aoea aeaeaeaia ?ai?oa. I?ney e?ioaaeaiaeoii?e 3 ?iee i?iaeeei 28,7 ( 3,4% oai?eo, ye? e?eoaa-eeny c i?eaiaeo e?ioiaaiieo iaoanoac?a iaeaiiie oe??e ooeoaa ? 42,4 ( 3,0% iaoe??io?a, eio?? aoee i?iiia?iaai? c i?eaiaeo ?aa?iia?ieo iaoanoac?a iaeaii-ie oe??e e?ioe?aie. Iieacieee 5-??/iiai aeaeeaaiiy aei??aithaaee 23,3 ( 3,2 oa 34,6 ( 2,9% a?aeiia?aeii (a iaio aeiaaeeao cao?eniaaia noaoenoe/ii a??ia?aeia ??cieoey; P<0,05). I?e aeine?aeaeaii? aieeao oaeoi?o eieae?caoe?? iooeeie o ia?aeiieo oai?eo a noaae?? III B c neio?iiiei o?aaeaiiyi e?ioaoe/ieo aoce?a oaea caeaaei?noue aoea iaa??ia?aeiith. Aaniethoii ?aeaioe/i? ?acoeueoaoe io?eiaii i?e ii??aiyeuei?e ioe?ioe? iieaciee?a aeeiai?ee ?ai?n?? caoai?thaaiiy a caeaaeiino? a?ae eieae?caoe?? ia?aeiii? iooeeie a iaio a?oiao. sseee iaoai?ci iaoanoacoaaiiy ceiye?nieo iooeei, cie?aia iaeaiiaeanoiie oe??e( *ei iiaeia iiynieoe oaeo nooo?ao ??cieoeth a /an? iiyae iaoanoac?a o oai?eo i?ney aeaeaeaiiy ia?aeiii? iooeeie (a iaoiio aeine?aeaeaii? a?ae 1 i?nyoey aei 20 ?ie?a)( ?nio? a?iioaca oae caaieo eaoaioieo iaoanoac?a. I?eionea?oueny, ui aiaiee (ai?a?aioe( iiaeooue ?nioaaoe aeineoue aeiaaee /an aac aieiaii? iciaee iooeeie ( iiae?eo ee?oei ( ? i?aeo?eioaaoe eeoa naith aeeoo?caeaoi?noue. A?aenooi?noue iaoai?ci?a i?e?iaeiueiai aiiioico (cai?ia?aiiaaii? nia?o?) a aaiii? iiaiooai?aiiy i?eaiaeeoue aei oiai, ui iiae?aiee noai noaee?i?/ieo iaoanoac?a iiaea o?eaaoe i?ioyaii anueiai oa?i?io aeeooy iae?ii?aai?cio (I.?.Eoae?yaoeaa oa ni?aaao., 1996). ?acoeueoaoe ni?ia aieeiooe ia noaee?i?/i? iaoanoace o oai?eo ia ceiye?nio iaeaiiio oe??e iaie ioe?ithaaeenue ca aeiiiiiaith aea/aiiy iieaciee?a aeaeeaaiiy oai?eo a aeine?aeaeo?ieo a?oiao. A ia?oo /a?ao ie ioe?ithaaee a?aeaeaeai? ?acoeueoaoe iaoe??io?a ia ia?aeiii eieae?ciaaio iaeaiiio oe??e (1 noaae?y ( O(1-4) NoMo), aiie i?aaenoaaeai? a oaae. 1 ? 2. C iaoith iie?auaiiy ?acoeueoao?a ?aaeeeaeueieo iia?aoe?e ia ii/aoeo aeine?aeaeaiiy aoea canoiniaaia i?iiaiaaa oa?ai?y. I?e ii??aiyii? ?acoeueoao?a aeei?enoaiiy oeueiai iaoiaeo c eiio?ieai ia ca?a?no?iaaii nooo?ai? ??cieoe? iieaciee?a ye aeeiai?ee ?ai?n?? caoai?thaaiiy, oae ? aeaeeaaiiy. Iiynieoe oea iiaeia ianaiia?aae caaaeueiiaeciaiith ?aae?i?acenoaioi?noth ee?oei iaeaiiaeanoiie (A.I. Eoae?yaoeaa, 1996), a oaeiae iaiaaeaieie iiaeeeainoyie i?iiaiaai? oa?ai?? a /an? ? a cii? ?? aieeao. I?e aea/aii? iane?aee?a e?eoaaiiy aeyaeeiny oaeiae, ui i?io?eaeoe/ia nenoaiia o?i?ioa?ai?y noaoenoe/ii a??ia?aeii iia??oeea a?aeaeaeai? ?acoeueoaoe ?aaeeeaeueieo iia?aoe?e: iieaciee 3-??/iiai aeaeeaaiiy ia 22,6% ? 5-??/iiai ia 18,4% aoa iaioee ca eiio?ieueiee (P<0,05). Ia iaoo aeoieo, i?e/eio iaaaea/ /anoeiai iiyniththoue iieacieee ?ioiieia?/iiai noaoono iaoe??io?a. I?e i?iaaaeaii? o?i?ioa?ai?? o oai?eo (a?oia A3) ca?a?no?iaaii a??ia?aeia cieaeaiiy iieaciee?a oano?a, ui aea/aeeny (?aaeoe?y a?ia?/ooeeaino? iia?eueiiai oeio ia AeIOA ? ?aaeoe?y niiioaiiiai ?icaoeiooai?aiiy), a oie /an ye a eiio?ieuei?e a?oi? (A4) ia iii?/aii aoaeue-yeeo nooo?aeo ci?i aaee/ei oano?a, ye? aeine?aeaeoaaeeny. Ioaea, iiaeii aeiionoeoe ?iia??i?noue iaei?aeoiiai aieeao canoiniaaii? o?i?ioa?ai?? ia ?ioiieia?/iee aiiainoac iaoe??io?a. Oaaeeoey 1 Aeeiai?ea ?ai?n?e o oai?eo ia ia?aeiii eieae?ciaaio iaeaiiio oe??e a caeaaeiino? a?ae canoiniaaiiai iaoiaeo e?eoaaiiy (M( m) Iaoiae e?eoaaiiy A?oia oai?eo E?euee?noue oai?eo A?aenioie oai?eo, ye? i?iaeeee aac iaoanoac?a 1 ??e 2 ?iee 3 ?iee 4 ?iee 5 ?ie?a O??o?a?/iee A1 901 59,9(1,6 45,7(1,7 ( < 38,7(1,6 ^ 31,3(1,6 ( 29,0(1,6 ! O??o?a?/iee + i?iiaiaaa oa?ai?y A2 90 66,3(5,0 48,3(5,0 43,5(5,2 35,9(5,0 29,0(1,6 O??o?a?/iee + o?i?ioa?ai?y A3 38 52,5(8,1 39,3(7,9 27,7(7,4 21,9(6,9 18,4(6,9 ( O??o?a?/iee + o?i?ioa?ai?y + eaaii?cie A4 17 64,7(11,5 52,9(12,1 46,7(12,1 46,7(12,1 46,7(12,1 ( O??o?a?/iee + aiaeie?ioaoe/-ia o?i?ioa?ai?y A5 110 68,8(4,4 58,5(4,0 < 50,7(4,7 ^ 48,5(4,7 ( 45,6(4,7 ! O??o?a?/iee + aiaeie?ioaoe/ia?ioa?oa?iiioa-?ai?y A6 45 71,1(6,7 60,5(7,2 ( 49,3(7,4 Niinoa?aaeaiiy o?eaa? O??o?a?/iee + aiaeie?ioaoe/ia o?i?ioa?ai?y + ?ioa?oa?iiioa-?ai?y A7 72 65,8(5,5 45,2(5,8 44,6(5,8 Niinoa?aaeaiiy o?eaa? Onueiai : 1273 I?ei?oea. ??cieoey i?ae iicia/aieie iieacieeaie noaoenoe/ii a??ia?aeia ( ( < ^ ( ! ( P<0,05). Oaaeeoey 2 Ii??aiyeueia ioe?iea iieaciee?a aeaeeaaiiy oai?eo ia ia?aeiii eieae?ciaaio iaeaiiio oe??e e?ioe?aie ? ooeoaa a caeaaeiino? a?ae canoiniaaiiai iaoiaeo e?eoaaiiy (M( m) Iaoiae e?eoaaiiy A?oia oai?eo E?euee?noue oai?eo Aeaeeaaiiy, % 3 ?iee 5 ?ie?a O??o?a?/iee A1 901 67,7(1,5 ( 53,5(1,6 ! O??o?a?/iee + i?iiaiaaa oa?ai?y A2 90 68,3(4,9 52,9(5,5 O??o?a?/iee + o?i?ioa?ai?y A3 38 45,1(8,0 < ( 35,1(7,7 O??o?a?/iee + o?i?ioa?ai?y + eaaii?cie A4 17 58,0(12,0 51,5(12,3 O??o?a?/iee + aiaeie?ioaoe/ia o?i?ioa?ai?y A5 110 75,2(4,0 < 64,9(4,5 ! O??o?a?/iee + aiaeie?ioaoe/ia ?ioa?oa?iiioa?ai?y A6 45 74,3(6,5 ( Niinoa?aaeai-iy o?eaa? O??o?a?/iee + aiaeie?ioaoe/ia o?i?ioa?ai?y + ?ioa?oa?iiioa?ai?y A7 72 83,3(4,4 ( Niinoa?aaeai-iy o?eaa? Onueiai : 1273 I?ei?oea. ??cieoey i?ae iicia/aieie iieacieeaie noaoenoe/ii a??ia?aeia (( < ( ! P<0,05). Iaoa i?eiouaiiy aeineoue ia?aeiieeai i?aeoaa?aeeee ?acoeueoaoe e?eoaaiiy oai?eo, o yeeo ia?aeaeueii ?c canoinoaaiiyi oeeee?a o?i?ioa?ai?? aeei?enoiaoaaany ?ioiiiiaeoeyoi? eaaii?cie (a?oia A4). O oeeo iaoe??io?a a?aei?/aia noaa?e?caoe?y iieaciee?a ?ioiieia?/ieo oano?a, a a?aeaeaeai? ?acoeueoaoe aoee e?aueie ca oae? ae nai? o a?oi? A3: aac iciae ?aoeeaeeao caoai?thaaiiy a a?oi? A3 5 ?ie?a i?iaeeei 18,4 ( 6,9%, a a?oi? A4 ( 46,7 ( 12,1%. Iieacieee aeaeeaaiiy oai?eo aeine?aeaeoaaii? a?oie eeoa iaaeeceeeny aei eiio?ieueieo aaee/ei. I?e/eie, ui i?ecaaee aei oaeeo iane?aee?a, c iaoi? oi/ee ci?o, oae?. Ii-ia?oa, o?i?ioa?ai?y i?eai?/oaaea ooieoe?th aaiiiiaco: o iaoe??io?a a?oie A3 (38 oai?eo) o 16 (42%) cao?eniaaii cieaeaiiy iieaciee?a eaeeioeeo?a e?ia? aei iii?oee, ieae/i? ca 3·109/e, ui, iaaii, iiaei i?eaanoe aei ci?i iieaciee?a ?ioiieia?/ieo oano?a. Ii-ae?oaa, caaaeath/e ia iiceoe?th a?iioace eaoaioiiai iaoanoaco, iiaeeeaino? aaeue’thaaioii? nenoaiii? o?i?ioa?ai?? ae?ae iaiaaeai?, ai ?nioaaiiy aenieeo ae??caeaoieo eiioeaio?aoe?e oeeoinoaoee?a aeineoue iae? a /an?. Oaeei /eiii, iaaaoeaiee aieea aeei?enoaiiy noaie nenoaiii? o?i?ioa?ai?? ia aeeeeea? noii?ao, a ?? ae?y ia iooeeiio ee?oeio i?iaeaiaoe/ia. Ie aiaaieeeny, ui ae??oeoe i?iaeaio i?io?eaeoeee ?icaeoeo iaoanoac?a iaeaiiie oe??e iaiiaeeeai ca aeiiiiiaith ?ooeiieo iaoiaeee. Aeey oiai uia ni?e/eieoe iaiai?ioi? i?ioeane a yae?ao ee?oei noaee?i?/iiai iaoanoaco, yeee i?aeoe/ii ia ia? noinoie?a c ioi/oth/eie oeaieiaie, o?aaa "aeeoiaoe" ee?oeie ceiye?nii? iooeeie o aeniei eiioeaio?iaaiiio ?ic/ei? oeeoinoaoeea. Aeey iaeaiiie oe??e e?ioe?aie ? ooeoaa oaeei iaoiaeii aeai?o ? aiaeie?ioaoe/ia o?i?ioa?ai?y, ai aeii?ioth/ei oeyoii ?iciianthaeaeaiiy iaeaiiie oe??e ia ii/aoeiaeo oacao ?icaeoeo caoai?thaaiiy ? e?ioiaaiiee. A i?ioean? aeine?aeaeaiiy a ee?i?oe? ai?iaaaeaeaia iaoiaeeea eaoaoa?ecaoe?? ia?eoa??eieo e?ioaoe/ieo noaeei (eeno? ? noiie a caeaaeiino? a?ae eieae?caoe?? iooeeie). I?e ii??aiyeueiiio aiae?c? a?aeaeaeaieo ?acoeueoao?a i?neyiia?a-oe?eiiai aeei?enoaiiy aiaeie?ioaoe/ii? o?i?ioa?ai?? (a?oia A5) io?eiaii noaoenoe/ii a??ia?aeia i?aeaeuaiiy oa?i?i?a ?ai?n?? caoai?thaaiiy: a?aenioie oai?eo, ye? niinoa??aaeeny aac iciae iaoanoac?a i?ioyaii 5 ?ie?a, a??ia?aeii ia?aaeuoaaa eiio?ieuei? iieacieee (a?oia A1); 5-??/ia aeaeeaaiiy oai?eo i?ney aiaeie?ioaoe/ii? oa?ai?? a??ia?aeii ia 11% aoei a?eueoei ca eiio?ieue (P<0,05). Ioaea, aiane?aeie aaaaoi??/ieo aeine?aeaeaiue aoei aecia/aii niin?a, yeee aeicaiey? a aeinoaoiuei aaeeeiio a?aenioeo aeiaaee?a iie?aueoe ?acoeueoaoe ?aaeeeaeueieo iia?aoe?e o oai?eo ia ia?aeiii eieae?ciaaio iaeaiiio oe??e e?ioe?aie ? ooeoaa. Caaaeaiiyi ianooiiiai aoaio aeine?aeaeaiiy noaa iiooe iiaeeeainoae i?aeaeuaiiy aoaeoeaiino? aiaeie?ioaoe/ii? oa?ai?? i?e e?eoaaii? oai?eo ia iaeaiiaeanoiio oe??e. sse cacia/aii ?ai?oa, a i?aeoe/i?e iieieia?? i?e e?eoaaii? ceiye?nii? iaeaiiie aeineoue aaeeea ia?aaaaa iaaea?oueny ?ioa?oa?iio. Aeey aea/aiiy iiaeeeainoae ?aeiia?iaioiiai (-((-?ioa?oa?iio a noaiao eiia?iiaaiiai e?eoaaiiy oai?eo ia iaeaiiio oe??e ie aeei?enoiaoaaee iiaee a?o/eciyiee i?aia?ao ( eaoa?ii ( a iaaeao i?ia?aie IIC Oe?a?ie uiaei eiai ee?i?/iiai ?nieoo. I?aia?ao io?eiaii a ?inoeooo? iieaeoey?ii? a?ieia?? ? aaiaoeee IAI Oe?a?ie. I?ney an?o oac aeiee?i?/ieo aeine?aeaeaiue o 1990 ?. aoei ?icii/aoi aei?iaoaaiiy eaoa?iio a ee?i?oe?. A?aeae?eaiiy iooeei iii?ii-?ooiaiai aia?aoo OIAe?I? IIC Oe?a?ie oa?eoei aei caeeaae?a, ia aac? yeeo i?iaiaeeeany ai?iaaoe?y iiaiai ?aeiia?iaioiiai ?ioa?oa?iio. A ?acoeueoao? caaeia?eueieo ee?i?/ieo aei?iaoaaiue o 1995 ?. Oa?iaeieia?/iee eii?oao IIC Oe?a?ie aeaa aeica?e ia i?iieneiaa aeaioiaeaiiy eaoa?iio ? eiai ?aae?caoe?th a aioa/i?e ia?aae?. A aoai? ee?i?/iiai ai?iaaaeaeaiiy iiaiai i?aia?aoo ? iaaia caneoaa aaoi?a. I?e aea/aii? aaciina?aaei?o ?acoeueoao?a aeei?enoaiiy eaoa?iio /?oei cao?eniaaia aeanoea?noue ne?iaaoee e?ia? iaoe??io?a, ye? io?eioaaee ?aeiia?iaioiee ?ioa?oa?ii, no?eioaaoe i?ie?oa?aoe?th eoeueoo?e ee?oei iooeeie e?ioina?eiie iaoethe?a in vitro. A oie aea /an o oai?eo, e?eoaaiiy yeeo iaiaaeoaaeiny eeoa aeaeaeaiiyi iooeei, aiia aoea iaae?aciith. Noaoenoe/ii a??ia?aeia ??cieoey i?ae iieacieeaie O?-oanoo aeine?aeaeo?ii? a?oie A6 ? eiio?ieai A1 cao?eniaaia ia 3, 9, 12-e i?nyoe? i?ney iia?aoe??. Ii??aithth/e a?aeaeaeai? ?acoeueoaoe aeei?enoaiiy eaoa?iio, anoaiiaeaii ianooiia: a) iieacieee aeeiai?ee ?ai?n?? caoai?thaaiiy aoee e?aueie a a?oi? A6 ii??aiyii c eiio?ieai (a?aenioie oai?eo, ye? i?iaeeee 2 ?iee i?ney iia?aoe?? aac ee?i?/ieo iciae iaoanoac?a a a?oi? A6, a??ia?aeii ia 14,8% ia?aaeuea eiio?ieueiee iieaciee). Aeeiai?ea ?ai?n?? caoai?thaaiiy a a?oi? A6 iaeaea ia a?ae??ciyeany a?ae ?acoeueoao?a canoinoaaiiy aae’thaaioii? aiaeie?ioaoe/ii? o?i?ioa?ai?? a a?oi? A5; a) i?e aea/aii? iieaciee?a 3-??/iiai aeaeeaaiiy aoei anoaiiaeaii, ui ?acoeueoao e?eoaaiiy oai?eo a?oie A6 iaa??ia?aeii ia?aaeuea eiio?ieue ? iaaeeceany aei iieaciee?a a?oie A5 (iaoe??io?a, o yeeo aoea canoiniaaia aiaeie?ioaoe/ia o?i?ioa?ai?y). Noaoenoe/ii cia/ia ia?aaeuaiiy 3-??/iiai aeaeeaaiiy aei eiio?ieth (ia 25,7%) aoei cao?eniaaii o oai?eo /ieia?e?a. Iieaciee 3-??/iiai aeaeeaaiiy /ieia?e?a eiio?ieueii? a?oie aei??aithaaa 63,2 ( 2,6%, a na?aae iaoe??io?a /ieia?/i? noao? aiae?co?ii? a?oie ( 88,9 ( 9,0%. Ioaea, io?eiai? aenia?eiaioaeuei? ?acoeueoaoe aeiaaee i?enooi?noue aioei?ie?oa?aoeaii? aeoeaiino? eaoa?iio i?e ia?aioa?aeueiiio eiai aaaaeaii? oai?ei ia iaeaiiio oe??e. I?iaaaeai? ee?i?/i? aeine?aeaeaiiy aeyaeee aoaeoeai?noue naiino?eiiai aae'thaaioiiai aeei?enoaiiy eaoa?iio a noaiao e?eoaaiiy oai?eo ia iaeaiiio oe??e e?ioe?aie ? ooeoaa. Ia i?aenoaa? ii??aiyeueiiai aiae?co iaea?aeaieo aeaieo iiaeia aiai?eoe i?i oa, ui i?ioeiooeeiia aoaeoeai?noue aiaeie?ioaoe/iiai aeei?enoaiiy eaoa?iio i?e iaeaiii? oe??e ia iinooia?oueny ?acoeueoaoai canoinoaaiiy aiaeie?ioaoe/ii? o?i?ioa?ai??. Iaaaaeai? aeai? aeicaieythoue i?eionoeoe, ui eiia?iiaaia canoinoaaiiy aiaeie?ioaoe/iiai aaaaeaiiy o?i?ii?aia?ao?a ? eaoa?iio o oai?eo ia ia?aeiii eieae?ciaaio iaeaiiio oe??e e?ioe?aie ? ooeoaa iiaeiii i?eaanoe aei iie?ioaiiy a?aeaeaeaieo iane?aee?a ?aaeeeaeueieo iia?aoe?e, ? ie cai?iiiioaaee oaeo noaio o ianooiii? a?oie oai?eo. Aiae?coth/e iieacieee 3-??/iiai aeaeeaaiiy anoaiiaeaii, ui ?acoeueoao aeei?enoaiiy icia/aii? eiia?iaoe?? aoa iaee?auei. sseui aae’thaaioia aiaeie?ioaoe/ia o?i?ioa?ai?y oa ?ioa?oa?iiioa?ai?y ie?aii eeoa iicia/eee i?aeaeuaiiy a?aenioeo oai?eo, ye? ia?aaeeee 3 ?iee i?ney iia?aoe?? (a?oie A5 ? A6), oi ?ic?iaeaiee iaie eiia?iiaaiee iaoiae (a?oia A7) aeicaieea a??ia?aeii ia 15,4% ia?aaeueoe eiio?ieueiee iieaciee 3-??/iiai aeaeeaaiiy (oaae. 2). Iniaeeai iaiaae?eeea? ?acoeueoaoe io?eiai? i?e canoinoaaii? ?ic?iaeaii? iaie noaie eiia?iiaaiiai e?eoaaiiy oai?eo ae?ii/i? noao? oa iaoe??io?a, oai?eo ia iaeaiiio oe??e e?ioe?aie. Iieaciee 3-??/iiai aeaeeaaiiy iaoe??ioie aeine?aeaeoaaii? a?oie noaiiaea 92,8%, oai?eo ia iaeaiiio oe??e e?ioe?aie ( 93,8%. Aeae? iaie aoa i?iaaaeaiee aiae?c ?acoeueoao?a e?eoaaiiy oai?eo ia iaeaiiio oe??e e?ioe?aie ? ooeoaa c neio?iiiei o?aaeaiiyi ?aa?iia?ieo e?ioaoe/ieo aoce?a (oaae. 3 ? 4). sse a iiia?aaeiueiio aeiaaeeo o oai?eo ia ia?aeiii eieae?ciaaio iaeaiiio (a?oia A2), oae ? o ia?aeiieo iaoe??io?a c III B noaae??th caoai?thaaiiy (a?oia A2), i?iiaiaaa oa?ai?y ia ci?ieea ?acoeueoao?a o??o?a?/iiai e?eoaaiiy. Oai?ei a?oie A3 aoea i?iaaaeaia aiaeie?ioaoe/ia o?i?ioa?ai?y, yea, a?aoiaoth/e oaoi?/io iaiiaeeea?noue i?neyiia?aoe?eii? ?aa?iia?ii? aiaeie?ioaoe/ii? o?i?ioa?ai??, aoea aeeiiaia iaia?aaeiaei? iia?aoe??. Iaa?oiooaaiiyi aeey i?iaaaeaiiy aeaii? oa?ai?? aoei oa, ui iia?aoe?eia iiea, a yeiio i?aoeth? o??o?a i?ae /an aeaeaeaiiy iooeeie ? ?? e?ioiaaiieo iaoanoac?a, aeineoue iaiaaeaia. ?iia??ii, ui a ciiao, iaaeinyaeieo aeey o??o?aa, eeoathoueny iaoanoaoe/i? aiaiee. Ia?aaeiia?aoe?eia aiaeie?ioaoe/ia o?i?ioa?ai?y aieeaa? ia oae? i?e?iiaoanoace. I?e ii??aiyii? a?aeaeaeaieo ?acoeueoao?a iaie ia iaea?aeaii noaoenoe/ii cia/oui? ??cieoe? ia ei?enoue aeei?enoaiiy aiaeie?ioaoe/ii? o?i?ioa?ai?? o aea/a?ii? eaoaai??? oai?eo. Iaeiae i?inoaaeaia no?eea oaiaeaioe?y ia?aaeuaiiy iieaciee?a aeaeeaaiiy aeine?aeaeoaaii? a?oie (A3) ii??aiyii c eiio?ieueieie aeaieie. O?aaa aeacaoe, ui iieaciee 5-??/iiai aeaeeaaiiy oai?eo a?oie, a ye?e i?iaiaeeeany aiaeie?ioaoe/ia oa?ai?y, a??ia?aeii ia?aaeuea oae? ae e?eoa- Oaaeeoey 3 Aeeiai?ea ?ai?n?e o ia?aeiieo oai?eo ia iaeaiiio oe??e c neio?iiieie iaoanoacaie a ?aa?iia?ieo e?ioaoe/ieo aoceao a caeaaeiino? a?ae canoiniaaiiai iaoiaeo e?eoaaiiy (M ( m) Iaoiae e?eoaaiiy A?oia oai?eo E?euee?noue oai?eo A?aenioie oai?eo, ye? i?iaeeee aac iaoanoac?a 1 ??e 2 ?iee 3 ?iee 4 ?iee 5 ?ie?a O??o?a?/iee A1 205 39,5(3,4 26,5(3,0 21,6(2,8 19,6(2,7 18,0(2,6 O??o?a?/iee + i?iiaiaaa oa?ai?y A2 24 56,5(10,3 28,4(9,6 5,7(5,4 5,7(5,4 5,7(5,4 Aiaeie?ioaoe/ia o?i?ioa?ai?y + o??o?a?/iee A3 28 50,0(9,6 39,3(9,4 31,7(8,8 26,8(8,5 20,1(7,7 Aiaeie?ioaoe/ia ?ioa?oa?iiioa-?ai?y + o??o?a?/iee A4 19 28,2(10,6 28,2(10,6 28,2(10,6 Niinoa?aaeaiiy o?eaa? Onueiai : 1273 I?ei?oea. ??cieoey i?ae iieacieeaie noaoenoe/ii iaa??ia?aeia (P>0,05).

??? ioe?iee a a?oi? oai?eo, eio?ei aei iia?aoe?? aeiaeaaaeany i?iiaiaaa
oa?ai?y (a?oia A2).

Inoaiiy aeine?aeaeoaaia a?oia (A4) ia?aeiieo oai?eo ia iaeaiiio oe??e c
neio?iiiei o?aaeaiiyi ?aa?iia?ieo e?ioaoe/ieo aoce?a neeaaeaeany c
iaoe??io?a, ye? io?eioaaee eaoa?ii.

Aiae?coth/e iieacieee a?aeaeaeaieo ?acoeueoao?a iiaeia aeneiaeoeny eeoa
i?i iayai?noue oaiaeaioe?? iie?auaiiy iieaciee?a 3-??/iiai aeaeeaaiiy
ii??aiyii c eiio?ieueieie aeaieie (noaoenoe/ii a??ia?aeio ??cieoeth ia
io?eiaii). O?aaa aeacaoe, ui ye a iiia?aaeiueiio aeine?aeaeaii? (oai?? ?
noaae?? caoai?thaaiiy, a?oie A5 ? A6), oae ? a aeaiiio (a?oie A3 ? A4),
iane?aeee aeei?enoaiiy eaoa?iio aoee noiaeeie c ?acoeueoaoaie
aiaeie?ioaoe/ii? o?i?ioa?ai??.

Oaaeeoey 4

Ii??aiyeueia ioe?iea iieaciee?a aeaeeaaiiy ia?aeiieo oai?eo ia
iaeaiiio oe??e c neio?iiieie iaoanoacaie a ?aa?iia?ieo
e?ioa-oe/ieo aoceao a caeaaeiino? a?ae canoiniaaiiai iaoiaeo
e?eoaaiiy

(M ( m)

Iaoiae

e?eoaaiiy

A?oia oai?eo E?euee?noue oai?eo Aeaeeaaiiy, %

3-??/ia 5-??/ia

O??o?a?/iee

A1

205

41,3(3,4

(

30,6(3,2

O??o?a?/iee + i?iiaiaaa oa?ai?y

A2

24

35,0(10,4

15,0(7,9

< Aiaeie?ioaoe/ia o?i?ioa?ai?y + o??o?a?/iee A3 28 59,1(9,4 41,9(9,4 < Aiaeie?ioaoe/ia ?ioa?oa?iiioa?a-i?y + o??o?a?/iee A4 19 61,9(11,4 Niinoa?aaeaiiy o?eaa? Aiaeie?ioaoe/ia oa?ai?y + o??o?a?/iee A3+A4 47 60,3(7,1 * Niinoa?aaeaiiy o?eaa? Onueiai: 276 I?ei?oea. ??cieoey i?ae iicia/aieie iieacieeaie noaoenoe/ii a??ia?aeia (( < P<0,05). Oaeei /eiii, i?e noaoenoe/iiio aiae?c? 3-??/iiai aeaeeaaiiy ia?aeiieo oai?eo a noaae?? III B yaii i?inoaaeo?oueny ia?aaaaa i?iaiico aeey iaoe??io?a, o yeeo canoiniaoaaeany ia?aaeiia?aoe?eia i?ioeiooeeiia aiaeie?i-oaoe/ia oa?ai?y, aea noaoenoe/ii cia/io ??cieoeth ia ei?enoue eiaeii? ?c aeine?aeaeoaaieo a?oi oai?eo ie ia io?eiaee aiane?aeie ii??aiyii iaaaeeei? e?eueeino? niinoa?aaeaiue. Uia aecia/eoeny, /e ? acaaae? aeioe?euei?noue cai?iaaaeaeaiiy iaoiaeo aiaeie?ioaoe/ii? i?ioeiooeeiii? oa?ai?? i?e e?eoaaii? ?aa?iia?ieo e?ioiaaiieo iaoanoac?a iaeaiiie oe??e, o aea/a?ii? eaoaai??? oai?eo i?iaaaeaii ianooiiee iaoaiaoe/iee aiae?c. A i?ioean? ia?iaee aeaieo aoea noai?aia ?iai/a a?oia, ui ia'?aeiaea iaoe??io?a, yeei canoiniaoaaee iaoiaee ia?aaeiia?aoe?eii? aiaeie?ioaoe/ii? o?i?i- oa ?ioa?oa?iiioa?ai?? (a?oia A3 + A4). A?aenioee oai?eo, ye? ia?aaeeee 3 ?iee i?ney iia?aoe??, a oeeo aeaio a?oiao, ye ie aaea cacia/aee, i?aeoe/ii ia a?ae??ciyeeny ? noaiiaeee 59,1 oa 61,9% a?aeiia?aeii. I?e ii??aiyii? iieaciee?a a?aeaeaeaieo ?acoeueoao?a e?eoaaiiy oai?eo ia'?aeiaii? a?oie (a?oia A3 + A4 a oaae.4) c eiio?ieueiith (a?oia A1) aecia/aii a??ia?aeia i?aeaeuaiiy 3-??/iiai aeaeeaaiiy (ia 21,0% a?aeiinii a?aeiia?aeiiai eiio?ieueiiai iieacieea; P<0,05). O?ao?e, inoaii?e o?aaiaio ?iaioe, i?enay/aiee aea/aiith iiaeeeainoae e?eoaaiiy oai?eo a ??? A noaae??, ye? caa?ioeeny aei ee?i?ee c iciaeaie iaoanoac?a iaeaiiie oe??e a ?aa?iia?ieo e?ioaoe/ieo aoceao, ui aeieeee i?ney aeaeaeaiiy ia?aeiii? iooeeie (oaae. 5 ? 6). Anoaiiaeaii, ui aeei?enoaiiy aae’thaaioii? nenoaiii? o?i?ioa?ai?? ye i?io?eaeoe/iiai eiiiiiaioo i?ney ?aaeeeaeueiiai aeaeaeaiiy ?aa?iia?ieo e?ioiaaiieo iaoanoac?a iaeaiiie oe??e, ia iie?aueei a?aeaeaeaieo iane?aee?a iia?aoe?e (a?oia N2). Ianooiiei e?ieii iaoiai aeine?aeaeaiiy aoea ni?iaa iie?ioeoe ?acoeueoaoe e?eoaaiiy ?aa?iia?ieo e?ioiaaiieo iaoanoac?a ca aeiiiiiaith niaoeeo?/ii? ?ioiioa?ai?? – aooiaaeoeeie. Ii??aiyeueia ioe?iea a?aeaeaeaieo ?acoeueoao?a iieacaea aacia?niaeoeai?noue canoiniaaii? iaoiaeeee aae’thaaioii? i?ioeiooeeiii? aooi?ioi?caoe?? o oai?eo a?oie N3. Aooiaaeoeeia ia iiaeiaoaea oa?i?i aeeooy oai?eo i?ney e?ioaaeaiaeoii?e. ?iia??ii, ui o iaoe??io?a, ye? iiaoi?ii caa?ioeeny aei iieieiaa c i?eaiaeo iiyae iaoanoac?a iaeaiiie a e?ioaoe/ieo aoceao, ? nooo?a? ii?ooaiiy ooieoe?? ?ioiieia?/iiai aiiainoaco, ? io?eiaoe o oeueiio aeiaaeeo aaeaeaaoio ?aaeoe?th ia aaeoeeio aeineoue aaaeei, a iiaea ? cian?i iaiiaeeeai. I?e aea/aii? iieaciee?a ?aaeoe?? ?icaoeiooai?aiiy aeine?aeaeoaaieo iaoe??io?a (a?oia N3) iai ia aaeaeiny cao?enoaaoe ci?i, iia'ycaieo ?c aaaaeaiiyi aooiaaeoeeie. I?e aea/aii? iane?aee?a e?eoaaiiy iiaoi?ieo oai?eo c e?ioiaaiieie iaoanoacaie iaeaiiie oe??e a a?oi? N4 aeyaeeiny, ui ia?aaeiia?aoe?eia aiaeie?ioaoe/ia o?i?ioa?ai?y ia aieeaa? ia a?aeaeaeai? ?acoeueoaoe e?ioaaeaiaeoii?e (oaae. 5 ? 6). Ia i?aenoaa? ii??aiyeueiiai aiae?co ?acoeueoao?a anoaiiaeaii, ui ia?aaeiia?aoe?eia aiaeie?ioaoe/ia ?ioa?oa?iiioa?ai?y (a?oia N5) oaeiae ia ci?ieea a?aeaeaeaieo iane?aee?a ?aaeeeaeueieo e?ioaaeaiaeoii?e o iiaoi?ieo Oaaeeoey 5 Iieacieee aeeiai?ee ?ai?n?e i?ney e?ioaaeaiaeoii?e o iiaoi?ieo oai?eo c iaoanoacaie iaeaiiie a ?aa?iia?ieo e?ioaoe/ieo aoceao a caeaaeiino? a?ae canoiniaaiiai iaoiaeo e?eoaaiiy (M ( m) Iaoiae e?eoaaiiy A?oia oai?eo E?euee?noue oai?eo A?aenioie oai?eo, ye? i?iaeeee aac iaoanoac?a 1 ??e 2 ?iee 3 ?iee 4 ?iee 5 ?ie?a O??o?a?/iee N1 435 54,0(2,4 * 33,2(2,2 27,0(2,1 23,8(2,0 23,8(2,0 O??o?a?/iee + i?iiaiaaa oa?ai?y N2 42 43,9(7,6 32,0(7,1 16,0(5,6 16,0(5,6 16,0(5,6 O??o?a?/iee + aooiaaeoeeia N3 26 34,0(9,4 * 20,4(8,0 20,4(8,0 20,4(8,0 20,4(8,0 Aiaeie?ioaoe/ia o?i?ioa?ai?y + o??o?a?/iee N4 49 52,0(7,1 38,2(6,9 31,0(6,6 20,8(5,7 20,8(5,7 Aiaeie?ioaoe/ia ?ioa?oa?iiioa-?ai?y + o??o?-a?/iee N5 47 56,7(7,2 29,6(6,6 29,6(6,6 Niinoa?aaeaiiy o?eaa? Onueiai : 599 I?ei?oea. ??cieoey i?ae iicia/aieie iieacieeaie noaoenoe/ii a??ia?aeia (* P<0,05). oai?eo a noaae?? III B. ? ana ae ?ioa?oa?iiioa?ai?y ia? iaai? ia?niaeoeae o aeai?e eaoaai??? oai?eo. Iaie aaea i?aee?anethaaany oaeo caeaaeiino? ?acoeueoao?a ?aa?iia?ii? e?ioaaeaiaeoii?? o iiaoi?ieo oai?eo a?ae eieae?caoe?? ia?aeiii?, ?ai?o aeaeaeaii? iooeeie. I?e ii??aiyii? iieaciee?a aeaeeaaiiy oai?eo c iaoanoacaie a ?aa?iia?ieo e?ioaoe/ieo aoceao ceiye?nii? iaeaiiie oe??e ooeoaa anoaiiaeaii, ui ?ioa?oa?iiioa?ai?y noaoenoe/ii a??ia?aeii iie?aueea iieaciee 3-??/iiai aeaeeaaiiy i?ney aeaeaeaiiy e?ioaoe/ieo aoce?a: eiio?ieueia a?oia ( 28,7 ( 3,4%, aeine?aeaeoaaia ( 51,9 ( 10,1% (P<0,05) a?aeiia?aeii. O? ae nai? iieacieee o oai?eo c iaoanoacaie oe??e e?ioe?aie aei??aithaaee 42,4 ( 3,0% ? 37,4 ( 10,5% a?aeiia?aeii. Oaaeeoey 6 Ii??aiyeueia ioe?iea iieaciee?a aeaeeaaiiy iiaoi?ieo oai?eo c iaoanoacaie iaeaiiie oe??e a ?aa?iia?ieo e?ioaoe/ieo aoceao a caeaaeiino? a?ae canoiniaaiiai iaoiaeo e?eoaaiiy (M ( m) Iaoiae e?eoaaiiy A?oia oai?eo E?euee?noue oai?eo A?aenioie oai?eo, ye? i?iaeeee aac iaoanoac?a i?ney e?ioaaeaiaeoii?? 3 ?iee 5 ?ie?a O??o?a?/iee N1 435 36,7(2,3 30,0(2,1 O??o?a?/iee + o?i?ioa?ai?y N2 42 34,4(7,3 25,8(6,7 O??o?a?/iee + aooiaaeoeeiaoe?y N3 26 21,5(8,2 ( < 21,5(8,2 Aiaeie?ioaoe/ia o?i?ioa?ai?y + o??o?a?/iee N4 49 44,4(7,1 ( 29,8(6,5 Aiaeie?ioaoe/ia ?ioa?oa?iiioa?a-i?y + o??o?a?/iee N5 47 44,3(7,2 < Niinoa?aaeaiiy o?eaa? Onueiai : 599 I?ei?oea. ??cieoey i?ae iicia/aieie iieacieeaie noaoenoe/ii a??ia?aeia ((< ?<0,05). Oaeei /eiii, i?aeaiaey/e i?aenoiie i?iaaaeaieo aeine?aeaeaiue, iiaeia noaa?aeaeoaaoe, ui a ?acoeueoao? o?eaaeiai aaaaoi??/iiai iiooeo na?aae ?nioth/iai aaeeeiai a?naiaeo i?ioeiooeeiieo cania?a aoei ciaeaeaii iioeiaeueio noaio eiia?iiaaiiai e?eoaaiiy oai?eo ia ia?aeiii eieae?ciaaio iaeaiiio oe??e e?ioe?aie ? ooeoaa oa iae?aneaii ia?niaeoeaiee oeyo ae??oaiiy i?iaeaie e?eoaaiiy iaoanoac?a iaeaiiie oe??e a ?aa?iia?ieo e?ioaoe/ieo aoceao. Aeneiaethth ue?o iiaeyeo i?ia?aeiiio iaoeiaiio ni?a?ia?oieeo a?aeae?eo a?ieia?? iooeeiii? ee?oeie ?inoeoooo aenia?eiaioaeueii? iaoieia??, iieieia?? ? ?aae?ia?ieia?? ?i. ?.?. Eaaaoeueeiai IAI Oe?a?ie, aeieoi?o a?ieia?/ieo iaoe Ai?iioeia?e Aae? Eaii?ae?ai? ca eiinoeueoaoeaio aeiiiiiao, yeo iaea?aeoaaa i?ioyaii aeeiiaiiy aeaii? ?iaioe. A E N I I A E E 1. Aiane?aeie aiae?co ?acoeueoao?a o??o?a?/iiai e?eoaaiiy 901 oai?iai ia ia?aeiii eieae?ciaaio iaeaiiio oe??e e?ioe?aie ? ooeoaa anoaiiaeaii, ui i?ney aeaeaeaiiy iooeeie o 78% oai?eo niinoa??aa?oueny iiaeaeueoee ?icaeoie caoai?thaaiiy a a?eueoino? aeiaaee?a (90,2%) a oa?i?ie aei 5 ?ie?a i?ney iia?aoe??. O 50% iaoe??io?a iaoanoace aeieeathoue a ia?oee ??e niinoa?aaeaiiy. 2. Anoaiiaeaii, ui i?ney aeaeaeaiiy ia?aeiii? iooeeie o oai?eo ia iaeaiiio oe??e e?ioe?aie ? ooeoaa o 99,2% aeiaaee?a iiaeaeueoiai ?icaeoeo caoai?thaaiiy iaoanoace c'yaeythoueny a ia?oo /a?ao a ?aa?iia?ieo e?ioaoe/ieo aoceao. 3. Iai?oanoaoe?y ?aa?iia?ieo e?ioiaaiieo iaoanoac?a iaeaiiaeanoiie ? naiino?eiith aeii?ioth/ith i?iaiinoe/iith iciaeith. ?acoeueoaoe o??o?a?/iiai e?eoaaiiy ?aa?iia?ieo e?ioiaaiieo iaoanoac?a iaeaiiie oe??e e?ioe?aie ? ooeoaa aoee iaeiaeiaeie ye o iiaoi?ieo oai?eo, o eio?eo aeaeaeyeeny iaoanoace, ui aeieeaee i?ney o??o?a?/iiai e?eoaaiiy ia?aeiii? iaeaiiie, oae ? o ia?aeiieo oai?eo, ye? caa?ioeeny aei ee?i?ee c iciaeaie ?aa?iia?ieo e?ioiaaiieo iaoanoac?a ? iae?eiaaiith ia?aeiiith iooeeiith. 4. Noaoue ? a?e iaoe??io?a, a oaeiae eieae?caoe?y iooeeie aieeaathoue ia ia?aa?a caoai?thaaiiy o oai?eo ia iaeaiiio oe??e. Iieaciee 5-??/iiai aeaeeaaiiy /ieia?e?a aoa ia 10% iaioee, i?ae o ae?iie, 5-??/ia aeaeeaaiiy oai?eo ia iaeaiiio oe??e e?ioe?aie ( ia 11% a?eueoa, /ei o iaoe??io?a c iaeaiiiith oe??e ooeoaa. A?e, a?eueoee ca 60 ?ie?a, – iani?eyoeeaee oaeoi? i?e ia?aeiii eieae?ciaai?e iaeaiii? oe??e e?ioe?aie ? ooeoaa. 5. Anoaiiaeaia caeaaei?noue oa?i?i?a aeeooy iiaoi?ieo oai?eo c iaoan-oacaie iaeaiiie oe??e a ?aa?iia?ieo e?ioaoe/ieo aoceao (Tx rN1Mo) a?ae eieae?caoe?? ia?aeiii? iooeeie, yea aoea aeaeaeaia ?ai?oa. 5-??/ia aeaeeaaiiy i?ney e?ioaaeaiaeoii?e o iaoe??io?a c iaoanoacaie iaeaiiie oe??e e?ioe?aie ia 11% ia?aaeuoaaei oie naiee iieaciee oai?eo, ye? e?eoaaeeny c i?eaiaeo iaoanoac?a iaeaiiie oe??e ooeoaa. 6. Aeei?enoaiiy canoiniaaieo o?aaeeoe?eieo aae'thaaioieo iaoiaeee i?iia-iaai? ? o?i?ioa?ai?? ia iie?aueei ?acoeueoao?a o??o?a?/iiai e?eoaaiiy oai?eo ia iaeaiiio oe??e e?ioe?aie ? ooeoaa. 7. Canoiniaaia iaoiaeeea aooiaaeoeeiaoe?? ia i?aeaeueea iieaciee?a a?ae-aeaeaieo ?acoeueoao?a iia?aoe?e o iiaoi?ieo oai?eo c iaoanoacaie iaeaiiie oe??e e?ioe?aie ? ooeoaa a ?aa?iia?ieo e?ioaoe/ieo aoceao. 8. Anoaiiaeaii, ui caaaeyee ai?iaaaeaeaiith i?neyiia?aoe?eii? aiaeie?i-oaoe/ii? o?i?ioa?ai?? aaeaeiny ia 11% i?aeaeueoe iieaciee 5-??/iiai aeaeeaaiiy oai?eo ia ia?aeiii eieae?ciaaio iaeaiiio oe??e e?ioe?aie ? ooeoaa. 9. ?aeiia?iaoiee (-((-?ioa?oa?ii (eaoa?ii) caeaoiee naiino?eii iie?a-uoaaoe a?aeaeaeai? ?acoeueoaoe ?aaeeeaeueieo iia?aoe?e o oai?eo ia iaeaiiio oe??e e?ioe?aie ? ooeoaa. Aeiiiaiaiiy ?aaeeeaeueieo iia?aoe?e aiaeie?ioao?/iei aaaaeaiiyi eaoa?iio a??ia?aeii ia 15% i?aeaeueei iieaciee aeai??/iiai aac?aoeeaeeaiiai aeaeeaaiiy oai?eo ia ia?aeiii eieae?ciaaio iaeaiiio oe??e. Caaaeyee aeei?enoaiith eaoa?iio ye i?io?eaeoe/iiai caniao aaeaeiny ia 23% i?aeaeueoe iieaciee 3-??/iiai aeaeeaaiiy iiaoi?ieo oai?eo c ?aa?iia?ieie e?ioiaaiieie iaoanoacaie iaeaiiie oe??e ooeoaa. 10. Ia?aaeiia?aoe?eia aiaeie?ioaoe/ia i?ioeiooeeiia oa?ai?y (o?i?i-oa?ai?y, eaoa?iiioa?ai?y) ia 19% i?aeaeueea 3-??/ia aeaeeaaiiy i?ney ?aaeeeaeueieo iia?aoe?e o ia?aeiieo oai?eo c iaoanoacaie iaeaiiie oe??e e?ioe?aie ? ooeoaa a ?aa?iia?ieo e?ioaoe/ieo aoceao. 11. Iaoiaeii aeai?o e?eoaaiiy oai?eo ia ia?aeiii eieae?ciaaio iaeaiiio oe??e e?ioe?aie ? ooeoaa ? eiiieaenia oa?ai?y, ui aeeth/a? a naaa o??o?a?/ia aeaeaeaiiy iooeeie oa i?neyiia?aoe?eia eiia?iiaaia aiaeie?ioa-oe/ia aaaaeaiiy o?i?ii?aia?ao?a ? eaoa?iio. Canoinoaaiiy ?ic?iaeaii? aae'thaaioii? iaoiaeeee aeicaieeei a??ia?aeii ia 15% i?aeaeueoe iieaciee 3-??/iiai aeaeeaaiiy iaoe??io?a. NIENIE INIIAIEO IIOAE?EIAAIEO IAOEIAEO I?AOeUe CA OAIITH AeENA?OAOe?? 1. Iineaiei I.Ae., Ei?iaei N.E., Iaeaneeia E.A., Eaiaoe A.Ae., Oienoiiyoia A.A. Niiniaiinoue eeaoie iaeaiiiu eiaee /aeiaaea aeeeoaeueii nio?aiyoueny in vitro //Yenia?ei. iieieiaey. ( 1988. ( N4. ( N. 34(36. 2. Iaeaneeia E.A., Ei?iaei N.E., Aaieia E.I., Oienoiiyoia A.A. 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Ei?iaei N.E., Oienoiiyoia A.A., Iaeeaaoe A.TH., Aeaaeeia A.A., I?ioeaiei A.A. Eioa?oa?iiioa?aiey a ea/aiee ceiea/anoaaiiie iaeaiiiu eiaee eiia/iinoae e ooeiaeua // Iaoa??aee iaoe.-i?aeo. eiio. (?ioiioa?ai?y i?e e?eoaaii? ceiye?nieo iiaiooai?aiue(, Ee?a, 1–2 aeiao. 1998 ?. ( Ee?a, 1998. – N. 62(65. 36. Ai?iioeiaa A.E., Ei?ia?i N.?., AEeeue/oe A.?. Aeina?ae canoinoaaiiy a?o/eciyiiai ?aeiia?iaioiiai (-((-?io?aoa?iio – eaoa?iio a iieieia?/i?e ee?i?oe? // Oace aeii. iaoe.-i?aeo. eiio. (Aeooaeuei? i?iaeaie ee?i?/ii? oa?iaeieia??(, A?iieoey, 6(8 aeiao. 1998 ?.– A?iieoey, 1998. – N. 210–211. 37. Ei?ia?i N.?., Oienoii'yoia A.I. Eiia?iiaaia e?eoaaiiy ceiye?noii? iaeaiiie oe??e e?ioe?aie ? ooeoaa : Iaoiae. ?aeiiaiaeaoe??. – Ee?a, 1996. – 9 n. 38. Oienoiiyoia A.A., Aecthaei I.ss,. Eiiiaaeaiei A.O, Aaneethe A.I., Eino?uaa E.I, Eaaoiaoe E.O, ?aaeeioniaa N.O., Oeiceineay A.O, *a?iaiei I.Ae, Ei?iaei N.E. // Eioi?i. ienueii. – Aui.3 ii i?iaeaia "Ceiea/anoaaiiua iiaiia?aciaaiey". Eiiaeie?iaaiiia ea/aiea na?eii iyaeeo oeaiae e iaeaiiiu eiaee. – Eeaa , 1987. – 2 n. 39.Oienoiiyoia A.A., Ei?iaei N.E., Aaneethe A.I., Iaeaneeia E.A. Eiiaeie?iaaiiia ea/aiea iaeaiiiu eiaee eiia/iinoae e ooeiaeua n eniieueciaaieai yiaeieeioaoe/a/aneie iieeoeieioa?aiee // Eioi?i. ienueii. – Aui.2 ii i?iaeaia "Ceiea/anoaaiiua iiaiia?aciaaiey". – Eeaa, 1988. – 2 n. Ei?ia?i N.?. "Oeyoe iie?auaiiy ?acoeueoao?a e?eoaaiiy ceiye?nii? iaeaiiie oe??e e?ioe?aie ? ooeoaa". – ?oeiien. Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy aeieoi?a iaaee/ieo iaoe ca niaoe?aeuei?noth 14.01.07 – iieieia?y. – ?inoeooo aenia?eiaioaeueii? iaoieia??, iieieia?? ? ?aae?ia?ieia?? ?i. ?.?.Eaaaoeueeiai IAI Oe?a?ie, Oe?a?inueeee iaoeiai-aeine?aeiee ?inoeooo iieieia?? oa ?aae?ieia?? IIC Oe?a?ie, Ee?a, 1998. Aeena?oaoe?y i?enay/aia i?iaeai? ae??oaiiy neeaaeiiai caaaeaiiy – iie?auaiith ?acoeueoao?a ?aaeeeaeueieo iia?aoe?e o oai?eo ia iaeaiiio oe??e e?ioe?aie ? ooeoaa. O 1703 iaoe??io?a c ae?aaiicii iaeaiiia oe??e e?ioe?aie ? ooeoaa a ??cieo noaae?yo caoai?thaaiiy aoei aeei?enoaii a?n?i noai e?eoaaiiy, ye? aeeth/aee a naaa iia?aoe?th ? i?io?eaeoe/i? caoiaee: i?iiaiaaa oa?ai?y, nenoaiia o?i?ioa?ai?y, ?ioiioa?ai?y, aiaeie?ioaoe/ia o?i?ioa?ai?y ? ?ioa?oa?iiioa?ai?y. I?e ii??aiyeueiiio aiae?c? iaea?aeaieo ?acoeueoao?a anoaiiaeaii, ui canoiniaai? noaie i?iiaiaai? oa?ai??, nenoaiii? o?i?ioa?ai??, nenoaiii? o?i?ioa?ai?? a ii?aeiaii? c ?ioiiiiaeoeyoi?ii eaaii?cieii, a oaeiae ai?iaaaeaeaia iaoiaeeea aooiaaeoeeiaoe?? ia i?eaaee aei i?aeaeuaiiy a?aeaeaeaieo ?acoeueoao?a iia?aoe?e. O oai?eo c iaoanoacaie iaeaiiie oe??e e?ioe?aie ? ooeoaa a ?aa?iia?ieo e?ioaoe/ieo aoceao a?aeiinii ia?niaeoeaiei ? aeeth/aiiy a noaie eiia?iiaaiiiai e?eoaaiiy ?aeiia?iaioiiai (-((-?ioa?oa?iio (eaoa?iio). I?neyiia?aoe?eia aiaeie?ioaoe/ia o?i?ioa?ai?y a??ia?aeii i?aeaeueea iieacieee aeaeeaaiiy oai?eo ia ia?aeiii eieae?ciaaio iaeaiiio oe??e. Iae?acoeueoaoeai?oith iaoiaeeeith i?neyiia?aoe?eii? i?io?eaeoeee iaoanoac?a o oai?eo ia ia?aeiii eieae?ciaaio iaeaiiaeanoiio aeyaeeany eiia?iiaaia aiaeie?ioaoe/ia o?i?i- oa ?ioa?oa?iiioa?ai?y. Eeth/ia? neiaa: iaeaiiia oe??e, iaoanoace, ?aeiia?iaioiee (-((- ?ioa?oa?ii. Ei?iaei N.E. " Iooe oeo/oaiey ?acoeueoaoia ea/aiey ceiea/anoaaiiie iaeaiiie eiaee eiia/iinoae e ooeiaeua". – ?oeiienue. Aeenna?oaoeey ia nieneaiea o/aiie noaiaie aeieoi?a iaaeeoeeineeo iaoe ii niaoeeaeueiinoe 14.01.07 – iieieiaey. – Einoeooo yenia?eiaioaeueiie iaoi-eiaee, iieieiaee e ?aaeeiaeieiaee ei. ?.A.Eaaaoeeiai IAI Oe?aeiu, Oe?aeineee iao/ii-enneaaeiaaoaeueneee einoeooo iieieiaee e ?aaeeieiaee IOC Oe?aeiu, Eeaa, 1998. Aeenna?oaoeey iinayuaia i?iaeaia ?aoaiey neiaeiie caaea/e – oeo/-oaieth ?acoeueoaoia ?aaeeeaeueiuo iia?aoeee o aieueiuo iaeaiiiie eiaee eiia/iinoae e ooeiaeua. O 1703 iaoeeaioia n aeeaaiicii iaeaiiia eiaee eiia/iinoae e ooeiaeua a ?aciuo noaaeeyo caaieaaaiey auei i?eiaiaii ainaiue noai ea/aiey, eioi?ua aeeth/aee a naay iia?aoeeth e i?ioe-eaeoe/aneea ia?ii?eyoey: eo/aaay oa?aiey, nenoaiiay oeieioa?aiey, eiioiioa?aiey, yiaeieeioaoe/aneay oeieioa?aiey e eioa?oa?iiioa?aiey. I?e n?aaieoaeueiii aiaeeca iieo/aiiuo ?acoeueoaoia ieacaeinue, /oi i?eiaiaiiua noaiu eo/aaie oa?aiee, nenoaiiie oeieioa?aiee, nenoaiiie oeieioa?aiee a eiiaeiaoeee n eiioiiiiaeoeyoi?ii eaaiiecieii, a oaeaea i?eiaiaiiay iaoiaeeea aooiaaeoeeiaoeee ia i?eaaee e oeo/oaieth ioaeaeaiiuo ?acoeueoaoia iia?aoeee. O aieueiuo n iaoanoacaie iaeaiiiu eiaeu eiia/iinoae e ooeiaeua a ?aaeiia?iuo eeioaoe/aneeo oceao ioiineoaeueii ia?niaeoeaiui yaeyaony aeeth/aiea a noaiu eiiaeie?iaaiiiai ea/aiey ?aeiiaeiaioiiai (-((-eioa?oa?iia (eaoa?iia). Iineaiia?aoeeiiiay yiaei-eeioaoe/aneay oeieioa?aiey aeinoiaa?ii iiauneea iieacaoaee aeaeeaaaiinoe aieueiuo n ia?ae/ii ia?aie/aiiie iaeaiiiie eiaee. Naiie ?acoeueoaoeaiie iaoiaeeeie iineaiia?aoeeiiiie i?ioeeaeoeee iaoanoacia o aieueiuo n ia?ae/ii ia?aie/aiiie iaeaiiaeanoiiie ieacaeanue eiiaeiaoeey yiaeieeioaoe/aneie oeiei- e eioa?oa?iiioa?aiee. Eeth/aaua neiaa: iaeaiiia eiaee, iaoanoacu, ?aeiiaeiaioiue (-((- eioa?oa?ii. Korovin S.I. (The ways to improve the results of treatment of skin melanoma of extremities and trunk( – Manuscript. Thesis for degree of doctor medical sciences on speciality 14.01.07. – oncology. R.E.Kavetsky Institute for Experimental Pathology, Oncology and Radiobiology of NAS of Ukraine, Ukrainian Reseach Institute of Oncology and Radiology Ministry of Health Care of Ukraine, Kyiv, 1998. The thesis is devoted to solution of the elaborate problem – to improve the results of radical operation in patients with skin melanoma of extremities and trunk. 1703 patients with the different stages of skin melanoma of extremities and trunk were treated using 8 protocols of treatment including surgical and prevention measures: radiotherapy, systemic chemotherapy, immunotherapy, endolymphatic chemotherapy and interferonotherapy. The comparative analysis of obtained results revealed that using radiotherapy, systemic chemotherapy, systemic chemotherapy combined with immunomodulator levamizol and also using the method of autovaccine did not lead to improve the distant results of surgery. (-((-Interferon in complex treatment of patients with skin melanoma of extremities and trunk with metastasis to regional lymph nodes is relatively perspective method. Postoperative endolymphatic chemotherapy reliably improved the survival index of patients with primary circumscribed skin melanoma. The combination of endolymphatic chemo- and interferonotherapy for patients with primary circumscribed melanoblastoma was evidently noted as the most pronounced effect for postoperative prevention of metastasis. Key words: skin melanoma, metastasis, recombinant (-((-interferon. PAGE 20

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