OA?E?ANUeEEE AeA?AEAAIEE IAAeE*IEE OI?AA?NEOAO

?AI?IA Einoyioei TH??eiae/

OAeE 616.127-005.8-036.11-02:616.151.5-085.27

NENOAIIEE O?IIAIE?CEN OA OA?AI?ss AIOEIENEAeAIOII “O??IAOAC?Ae?I” A
AINO?IIO IA??IAe? ?IOA?EOO I?IEA?AeA

14.01.11 — ea?ae?ieia?y

A a o i ? a o a ? a o

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Oa?e?a — 1999

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia a Aei?i?iiao?ianuee?e aea?aeaai?e iaaee/i?e aeaaeai??
IIC Oe?a?ie.

Iaoeiaee ea??aiee: aeaaeai?e AII Oe?a?ie, aeieoi? iaaee/ieo
iaoe,

i?ioani? Aecye Aai?a?e
A?eoi?iae/,

Aei?i?iiao?ianueea
aea?aeaaia iaaee/ia aeaaeai?y, ?aeoi?,

caa?aeoth/ee eaoaae?ith
aini?oaeueii? oa?ai?? ?2.

Io?oe?ei? iiiiaioe:

aeieoi? iaaee/ieo iaoe, i?ioani? Aieeia Aieiaeeie? ?aaiiae/, ?inoeooo
oa?ai?? AII Oe?a?ie (i.Oa?e?a), caa?aeoth/ee a?aeae?eii aoa?ineea?ico,

eaiaeeaeao iaaee/ieo iaoe, aeioeaio Oonoaaeue Ieeiea Oaaei?iae/,
Oa?e?anueeee ?inoeooo oaeineiiaeaiiy e?ea??a, caa?aeoth/ee eaoaae?ith
ea?ae?ieia??.

I?ia?aeia onoaiiaa:

Oe?a?inueeee iaoeiai-aeine?aeiee ?inoeooo ea?ae?ieia?? ?iai? aeaaeai?ea
I.Ae. No?aaeanea IIC Oe?a?ie (i.Ee?a), a?aeae?e ?aai?iaoe?? oa
?ioaineaii? oa?ai??.

Caoeno a?aeaoaeaoueny “ 22 ” ea?oiy 1999 ?. i 13-00 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 64.600.04 i?e Oa?e?anueeiio
aea?aeaaiiio iaaee/iiio oi?aa?neoao? ( 310022, i. Oa?e?a, i?. Eai?ia,
4.)

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? Oa?e?anueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo ( 310022, i. Oa?e?a, i?. Eai?ia,
4.)

Aaoi?aoa?ao ?ic?neaiee “ 11 “ aa?aciy 1999 ?.

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii?

?aaee, aeioeaio, e.i.i.
Ia/a?aiei E.?.

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue i?iaeaie. Ca?aeii c aeaieie Aieiaiiai oi?aae?iiy
noaoenoeee, nia?oi?noue a?ae aino?iai ?ioa?eoo i?iea?aea (A?I) a Oe?a?i?
o 1994 ?ioe? neeaaeaea 14 — 16%, a a 1996 ?ioe? c?inea aei 21%. Oi/a a
aeiiii?/ii ?icaeiaieo e?a?iao oe? iieacieee cia/ii ieae/a oa
neeaaeathoue a?ae 8 — 9% aei 11 — 12%, ?oai?/ia oai?iaa na?oey (?ON) oa
?ioa?eo i?iea?aeo (?I) caeeoathoueny i?ia?aeieie i?e/eiaie nia?o? na?aae
?ioeo caoai?thaaiue (T.J.Ryan et al, 1996). Oiio ?ioa?an aei ieoaiiy
e?eoaaiiy oa i?io?eaeoeee na?oeaai-noaeeiieo caoai?thaaiue a iei?oi?e
/an i?iaeiaaeo? ?inoe.

Aei iiyae aeie?a ?ioaineaii? oa?ai?? eaoaeuei?noue oai?eo c aino?ei
?ioa?eoii i?iea?aea aoea aeua 30%. Ai?iaaaeaeaiiy ia ii/aoeo 60-o ?ie?a
a i?aeoeeo oaeeo aeie?a oa cania?a aeao?a?eeyoe??, cae?eoiai ianaaeo
na?oey ? aaiiaeeiai?/iiai eiio?ieth aeicaieeei cieceoe eaoaeuei?noue aei
20%. A iiaeaeueoiio, canoinoaaiiy oa?iaeieia?/ieo cania?a, ui
caaacia/othoue aaiiaeeiai?/ia ?icaaioaaeaiiy i?iea?aeo — i?o?ao?a oa
b-aeieaoi??a, aeicaieeei cieceoe eaoaeuei?noue aei 15 — 20%. Oe?iea
aaeeaaiiy o?a?eiie?oe/ieo i?aia?ao?a iai?ee?ioe? 70-o ?ie?a noaei
?aaiethoe?eiith iiae??th a e?eoaaii? oai?eo ia A?I, ai aeinyaiooa
cieaeaiiy eaoaeueiino? ia?aaeueei an? ?nioth/? i?aeoiaee.

C ii/aoeo 80-o ?ie?a o?iiaie?oe/ia oa?ai?y noaea cieioei noaiaea?oii
e?eoaaiiy oai?eo ia aino?ee ?ioa?eo i?iea?aeo (J.M. Nappi et al, 1995).

I?ioa, a no/ani?e i?aeoeoe? ia Oe?a?i? o?iiaie?cen i?iaiaeeoueny iaio 20
— 25% oai?eo, ui aini?oae?cothoueny c i?eaiaeo A?I, a oie /an ye ?oi?
/enei iiaeiii aooe ye i?i?ioi a 2 ?ace a?eueoa.

*anoeiai oea iiynith?oueny aenieith aa?o?noth o?iiaie?oe/ieo i?aia?ao?a.
C ?ioiai aieo — oea iiaithaaiiy ?icaeoeo oneeaaeiaiue o?iiaie?oe/ii?
oa?ai??, oaeeo ye e?iaioa/a, ?ao?iiaic oa ?aia?ooc?ei? a?eoi??. E??i
oiai, ?nioaaiiy iaaii? e?eueeino? ??cieo ii ae?? o?a?eiie?oe/ieo
i?aia?ao?a noaaeoue ia?aae e?ea?ai i?iaeaio aeai?o iaea?eueo aoaeoeaiiai
o?iiaie?oeea. I?aeia?iaei? aaaaoioeaio?ia? aeine?aeaeaiiy ia ni?iiiaeeny
aeaoe iaeiicia/ii? a?aeiia?ae? ia oea ieoaiiy (TIMI, 1987; GISSI-2,
1990; ISIS-3, 1992; GUSTO, 1993 oa ?i.).

Ii aeaiei E. M. Ohman oa ni?aaao. (1990) ?aiiy ?aieethc?y iiaea
cono??/aoeny o a?eueo, i?ae 20% oai?eo A?I i?ney ?aeaiae?caoe??
o?a?eiie?oe/ieie caniaaie oa anioe?th?oueny c aenieei ??aiai nia?oiino?.
I?e/eiaie oeueiai oneeaaeiaiiy ?: i?ieiaaoethth/ee aoaeo o?iiaie?oee?a
(B.E.Sobel, D.Collen, 1993), ui caeeoa?oueny oyaeeee ?aceaeoaeueiee
noaiic, coiiaeaiee aoa?ineea?ioe/iith aeyoeith aai ia iiai?noth
e?ciaaiei o?iiaii (E.J.Topol, 1993) oa iioeiaeaeaiiy noaeeiii? no?iee
i?ney e?ceno o?iiaa (C.Lendon et al, 1992).

E?iaioa/? — iaea?eueo niaoeeo?/i? oneeaaeiaiiy o?iiaie?oe/ii? oa?ai??. A
aeine?aeaeaiiyo ii ia?iaaceaii? ?aia?ooc?ei?e oa?ai?? i?e A?I aaii?aa??
cono??/aeeny a 2 — 5% aeiaaeeao (D.P.De Bono, R.S.More, 1992). A?eueo
70% — oea e?iaioa/? c i?noeue ioieoe?e noaeei, a cia/i?e a?eueoino?, ui
ia aeiaaathoue ia?a?eaaiiy oa?ai?? oa ?ioaineaiiai e?iaicoieiyth/iai
e?eoaaiiy (D.C.Sane et al, 1989). Iaea?eueo a??ciei oneeaaeiaiiyi
o?iiaie?ceno ? ?io?ae?ai?aeuei? e?iaioa/?, ui cono??/athoueny o 0,5-1%
aeiaaee?a, a caeaaeiino? a?ae aea?aiiai o?iiaie?oeea oa aioeeiaaoeyioii?
oa?ai?? (GISSI, TIMI-II, 1991).

Ciaiiy ci?i, ui a?aeaoaathoueny a nenoai? aaiinoaco i?ae aieeaii
o?iiaie?oe/ii? oa?ai?? aeicaieyoue i?aaeeueii i?iaanoe aeiaeaoeiao
aioeeiaaoeyioio oa?ai?th oa cia/ii cieceoe ?ecee aeieeiaiiy oeeo
oneeaaeiaiue. Na?aae /eiiee?a, aecia/ath/eo noai cn?aeaeueii? nenoaie,
?aieia?/i? aeanoeaino? a?athoue aaaeeeao ?ieue, a cia/iiio nooiai?
aieeaath/e ia i?ioeane o?iiaiooai?aiiy (I. N. Oo?eaei, 1990).

Oeoii/eia? oao?a?eoi??, c iaeiiai aieo, iiaeooue oneeaaeithaaoe ia?aa?a
iinoo?iiaie?oe/iiai ia??iaeo ?, iaa?oue, noai?thaaoe caa?ico aeey aeeooy
oai?iai. C ?ioiai aieo, iaio aaaee? a?eoi??, oae?, ye i?enei?aiee
?ae?iaaio?eeoey?iee ?eoi, neoaeaoue ia?iaaceaieie ia?ea?aie oni?oii?
?aia?ooc??. Oi/a aeai? iauiaeaai?o aeine?aeaeaiue iieacaee, ui
a?eueo?noue a?eoi?e, ianooiieo ca o?iiaie?oe/iith oa?ai??th a aino??e
oac? ?I ia ? ai? iaaacia/ieie (ca aeiyoeii o?a?eeyoe?? oeoii/e?a), ai?
ia?ea?aie ?aia?ooc??, iaeii iaaii — iayai?noue oeoii/eiai? oao?ea?ae??
oa o?a?eeyoe?? a ia?o? 24 aiaeeie ?I ca’ycaia c iiaaiei i?iaiicii
caoai?thaaiiy (D.C.Sane et al, 1995).

I?eionea?oueny, ui aioeieneaeaioia oa?ai?y o??iaoac?ae?iii, caaaeyee
ciaioaiith nooiaiy ?aia?ooc?eiiai iioeiaeaeaiiy i?iea?aeo aeicaieeoue
cieceoe e?euee?noue oaoaeueieo oneeaaeiaiue a aino?iio ia??iae? ?I. E??i
oiai, iia?aeiieyeiny, ui o??iaoac?ae?i ciaioo? aaeaac?th oa aa?aaaoe?th
o?iiaioeeo?a o ethaeeie (C. Astarie-Dequeker et al, 1994).

A aeinooii?e e?oa?aoo?? ie ia cono??ee ?ia?o, ui noinothoueny aea/aiiy
o?ce/ieo oa?aeoa?enoee noaio e?ia? i?e nenoaiiiio o?iiaie?cen? o oai?eo
A?I ia oe? aioeieneaeaioii? oa?ai?? o??iaoac?ae?iii. Ana aeeeaaeaia aeua
aecia/a? aeioe?euei?noue aea/aiiy ee?i?/ii? aoaeoeaiino? o?iiaie?oee?a,
ui iaea?eueo oe?iei aeei?enoiaothoueny a Oe?a?i? — t-PA ? no?aioie?iace
ia oii? aaaaeaiiy o??iaoac?ae?io, a oaeiae noaio aaii?aieia?? oa
aioeieneaeaioii? aeoeaiino? o??iaoac?ae?io o oai?eo A?I i?e i?iaaaeaii?
nenoaiii? o?iiaie?oe/ii? oa?ai??.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Aeaia ?iaioa
aeeiioaaeany a ?aieao i?aeia?iaeiiai aaaaoioeaio?iaiai ?aiaeii?ciaaiiai
iiaea?eiiai ne?iiai ieaoeaai-eiio?ie??o?iiai aeine?aeaeaiiy ii
e?eoaaiith ?ioa?eoo i?iea?aeo EMIP-FR (European Myocardial Infarction
Project — Free Radicals) oa aaaaoioeaio?iaiai aeine?aeaeaiiy “Aeo?e?ca —
oa?aiaaoe/ia iciaeiieaiiy”.

Iaoa ? caaea/? aeine?aeaeaiiy. Ioe?iea ee?i?/ii? aoaeoeaiino?
no?aioie?iace ia oii? aioeieneaeaioii? oa?ai?? o??iaoac?ae?iii ?
oeaieiiiai aeoeaaoi?o ieaci?iiaaio, aecia/aiiy noaio ?aieia?/ieo oa
eiaaoeyoe?eieo aeanoeainoae e?ia? o oai?eo ia A?I i?e nenoaiiiio
o?iiaie?cen? i?ae /an aaaaeaiiy o??iaoac?ae?io aeey ?ic?iaee iieacaiue
aei eiai i?ecia/aiiy.

1. Ioe?ieoe ee?i?/io aoaeoeai?noue oeaieiiiai aeoeaaoi?o ieaci?iiaaio
(“Aeo?e?ca”) ? no?aioie?iace (“No?aioaca”) i?e i?iaaaeaii?
aioeieneaeaioii? oa?ai?? o??iaoac?ae?iii o oai?eo ia A?I.

2. Aea/eoe ci?ie iieaciee?a aaiinoaco oa ?aieia?/ieo aeanoeainoae e?ia?
o oai?eo ia aino?ee ?ioa?eo i?iea?aeo i?e nenoaiiiio o?iiaie?cen?.

3. Aea/eoe aieea o??iaoac?ae?io ia iniiai? iieacieee aaiinoaco ?
aeaee?noue e?ia? o oai?eo ia aino?ee ?ioa?eo i?iea?aeo.

4. Aecia/eoe aioeieneaeaioio aeoeai?noue o??iaoac?ae?io o oai?eo A?I ii
iieacieeai oai?ethi?ianoeaioe??.

5. ?ic?iaeoe ?aeiiaiaeaoe?? ii aeei?enoaiith aioeieneaeaioii? oa?ai?? o
oai?eo aino?ei ?ioa?eoii i?iea?aeo i?e nenoaiiiio o?iiaie?cen?.

Iaoeiaa iiaecia. I?iaaaeaia ii??aiyeueia ioe?iea ee?i?/ii? aoaeoeaiino?
aeaio o?iiaie?oe/ieo i?aia?ao?a, ui iaea?eueo oe?iei canoiniaothoueny a
Oe?a?i? — t-PA ? no?aioie?iace i?e i?iaaaeaii? aioeieneaeaioii? oa?ai??
o??iaoac?ae?iii a aino??e noaae?? ?I. Iieacaii, ui i?e aaaaeaii? t-PA
a?aeaoaa?oueny a?eueo aeneiaeaia cieaeaiiy eaoaeueiino?, iie?auo?oueny
ia?aa?a caoai?thaaiiy oa iiceoeaia aeeiai?ea ia AEA, i?ae i?e aaaaeaii?
no?aioie?iace a ii?aeiaii? c aioeieneaeaioiith oa?ai??th. Iaeiae,
i?ecia/aiiy t-PA noi?iaiaeaeo?oueny i?aeaeuaiei ?eceeii ?icaeoeo cia/ieo
aaii?aa?/ieo oneeaaeiaiue (4,2%) oa AV-aeieaae an?o nooiai?a (6,3%), a
oie /an ye, i?e aeei?enoaii? no?aioie?iace oaeeo oneeaaeiaiue ia
niinoa??aaeiny. O??iaoac?ae?i aeae?eueea iie?auo? ee?i?/iee ia?aa?a
caoai?thaaiiy, aea ?noioii ia aieeaa? ia eaoaeuei?noue oai?eo c A?I.

I?iaaaeaia eiiieaenia ioe?iea ?aieia?/ieo aeanoeainoae e?ia? i?e
nenoaiiiio o?iiaie?cen? o oai?eo A?I ia oe? aioeieneaeaioii? oa?ai??
i?aia?aoii o??iaoac?ae?i, ui ?ai?oa canoiniaoaaany o?eueee i?e o?ii?/ieo
oi?iao ?ON. Aeyaeaia iia??oaiiy ?aieia?/ieo aeanoeainoae e?ia? aei
e?ioey ia?oi? aeiae i?ney o?iiaie?oe/ii? oa?ai?? o anueiio ae?aiacii?,
iaea?eueo aeneiaeaia a noaeeiao iaeiai ? na?aaeiueiai eae?a?o. Aaaaeaiiy
o??iaoac?ae?io ia aeyaey? nooo?aiai aieeao ia aeeiai?eo ?aieia?/ieo
aeanoeainoae e?ia? o oai?eo, yeei i?iaiaeeany o?iiaie?cen.

E??i oiai, ii aeaiei a?neiceiao??? aia?oa iieacaii, ui ie??i
aioeieneaeaioii? ae??, o??iaoac?ae?i aieiae?? ? aeayeeie
aioeaa?aaaoe?eieie aeanoeainoyie, iie?auoth/e ?aieia?/i? aeanoeaino?
e?ia? o oai?eo c A?I a oiiaao a?aenooiino? o?iiaie?oe/ii? oa?ai??.

I?iaaaeai? aeine?aeaeaiiy aioeieneaeaioii? aeoeaiino? o??iaoac?ae?io
caniaii aecia/aiiy ?ioaineaiino? iiiaaeneaaeiai aei?ii?ithaaiiy na?oea
a?ieia?/iei noano?aoii (oai?ethi?i?noeaioe??) i?aeoaa?aeeee
ni?iiiaei?noue i?aia?aoo oeiaethaaoe a?euei? ?aaeeeaee, ui
ooai?ththoueny i?e aino??e ?oai?? i?iea?aeo.

An? aeuaiaaaaeai? iieiaeaiiy aeiinyoueny ia caoeno aeena?oaoe??.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a. ?acoeueoaoe eiiieaeniiai
aeine?aeaeaiiy ?aieia?/ieo aeanoeainoae e?ia? iioe?youe ee?i?/i?
oyaeaiiy i?i noai aaiinoaco oa iiaeeeaino? aioeieneaeaioii? oa?ai??
o??iaoac?ae?iii a aino??e oac? ?I i?e i?iaaaeaii? nenoaiiiai
o?iiaie?ceno.

I?iaaaeai? aeine?aeaeaiiy iieacothoue, ui an?o oai?eo c A?I, ui
aini?oae?cothoueny a niaoe?ae?ciaai? a?aeae?eaiiy, iaiao?aeii
?icaeyaeaoe ia i?aaeiao iiaeeeaino? i?iaaaeaiiy ?i o?iiaie?oe/ii?
oa?ai?? (OEO). Nenoaiiee o?iiaie?cen iiaeiai i?iaiaeeoeny a iaea?eueo
?aii? oa?i?ie aeieeiaiiy caoai?thaaiiy (a ia?o? 6 aiaeei a?ae iiiaioo
iiyae ia?oeo neiioii?a ?I). Aaaaeaiiy t-PA a?eueo ia?aaaaeia, i?ae
no?aioie?iace iacaeaaeii a?ae ii?aeiaiiy c aioeieneaeaioiith oa?ai??th
o??iaoac?ae?iii.

Oai?ei c A?I, yeei i?iaiaeeeany nenoaiia o?iiaie?oe/ia oa?ai?y iieacaia
aeiaeaoeiaa aioeeiaaoeyioia oa?ai?y c iaoith iiia?aaeaeaiiy ?icaeoeo
?aieeethc?? ?ioa?eocaeaaeii? ei?iia?ii? a?oa???. Canoinoaaiiy
aioo??oiueiaaiii? ?iooc?? 16 ie aioeieneaeaioa o??iaoac?ae?i ia i?ioyc?
48 aiaeei i?e nenoaiiiio o?iiaie?cen? aeicaiey? ciaioeoe ia 8%
e?euee?noue ?aoeeaeea?a aieth/iai neiae?iia ? ia 13% i?iya?a na?oeaai?
iaaeinoaoiino?, iiia?aaeeoe ?icaeoie ?aoeeaeeae?oaaiiy ?I oa o?a?eeyoe?e
oeoii/e?a. Ca a?aenooi?noth OEO o??iaoac?ae?i oaeiae cia/ii ciaioo?
/anoioo iiyae o?a?eeyoe?e oeoii/e?a (ia 50%) oa ia?aoeiaeaeo? ?icaeoeo
ea?ae?iaaiiiai oieo.

Cai?iiiiiaai? a aeena?oaoe?? iaoiaee e?eoaaiiy ai?iaaaeaeai? a i?aeoeeo
a?aeae?eaiiy ?aai?iaoe?? oa ?ioa?eoiiai a?aeae?eaiiy ?2 ee?i?/iiai
ia’?aeiaiiy oaeaeei? iaaee/ii? aeiiiiiae i. Aei?i?iiao?ianueea,
a?aeae?eaiiy ea?ae?i?aai?iaoe?? i?nueei? e?ea?i? oaeaeei? iaaee/ii?
aeiiiiiae i. Aei?i?iaeca?aeeinueea, ui aeicaieeei cieceoe eaoaeuei?noue
oa e?aeei-aeaiue a icia/aieo e?eoaaeueieo onoaiiaao.

Iniaenoee aianie caeiaoaa/a. Aaoi? i?aai?coaaa oa i?ia?a ?aiaeii?ciaaia
iiaea?eii-ne?ia ieaoeaai eiio?ieueiaaia aeine?aeaeaiiy, iniaenoi
i?iaiaeea ee?i?/ia ianoaaeaiiy oa e?eoaaiiy o?iiaie?oe/ieie i?aia?aoaie
? aioeieneaeaioii o??iaoac?ae?i oai?eo ia A?I, ioe?ithaaa ee?i?/io
aoaeoeai?noue ??ciiiai?oieo o?iiaie?oee?a oa ?oi?e aieea ia ?icaeoie
oneeaaeiaiue ? eaoaeuei?noue, a a ianooiiiio i?iaiaeea ee?i?/ia
niinoa?aaeaiiy ca oai?eie i?ioyaii 12 i?nyoe?a i?ney aeienee c
noaoe?iia?o; aea/aa aioeieneaeaioio aeoeai?noue o??iaoac?ae?io oa
?aieia?/i? aeanoeaino? e?ia? oai?eo, yeei i?iaiaeeany nenoaiiee
o?iiaie?c?n. Oaeiae, aaoi? iniaenoi i?iaiaeea noaoenoe/io ia?iaeo
iaea?aeaiiai iaoa??aeo, ?ic?iaeya i?aeoe/i? ?aeiiaiaeaoe?? ii e?eoaaiith
oai?eo ia A?I, a?aa iniaenoo o/anoue o aenooiao oa ioae?eaoe?yo ii oai?
aeena?oaoe?? oa ?? ioi?ieaii?.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iniiai? iieiaeaiiy aeena?oaoe??
aeeeaaeai? ia III I?aeia?iaei?e eiioa?aioe?? “O?aioe?y oa Oe?a?ia,
iaoeiai-i?aeoe/iee aeina?ae o eiioaeno? ae?aeiao iaoe?iiaeueieo
eoeueoo?” (Aei?i?iiao?ianuee, 1996), tha?eaei?e iaoeiai-i?aeoe/i?e
eiioa?aioe??, i?enay/ai?e 75-??//th eaoaae?e oa?ai?? 1 Ee?anueei?
iaaee/ii? aeaaeai?? i?neyaeeieiiii? ina?oe (Ee?a, 1996), oeieao
ea?ae?ieiaa (Ee?a, 1996,97), iaoeiai-i?aeoe/i?e eiioa?aioe?? “No/ani?
i?iaeaie ea?ae?ieia?? oa ?aaiaoieia??” (Ee?a, 1998). Ai?iaaoe?y
aeena?oaoe?? a?aeaoeanue 8 aeiaoiy 1998 ?ieo ia ni?eueiiio can?aeaii?
eaoaae? oa?aiaaoe/iiai i?io?eth Aei?i?iiao?ianueei? iaaee/ii? aeaaeai??.

Ioae?eaoe??. Ca iaoa??aeaie aeena?oaoe?? iioae?eiaaii 6 ?ia?o, c ieo 3 —
o oeaio?aeueieo aeo?iaeao.

Ianya oa no?oeoo?a aeena?oaoe??. Iaoa??aee aeena?oaoe?? aeeeaaeai? ia
122 noi??ieao iaoeiiieno oa neeaaeathoueny ?c aaaaeaiiy, iaeyaeo
e?oa?aoo?e, oa?aeoa?enoeee ianoaaeaieo oai?eo oa iaoiae?a
aeine?aeaeaiiy, o?ueio ?icae?e?a iniaenoeo aeine?aeaeaiue, iaaiai?aiiy,
aeniiae?a, i?aeoe/ieo ?aeiiaiaeaoe?e oa iieacieea e?oa?aoo?e.

?iaioa i?i?ethno?iaaia 20 oaaeeoeyie, 4 iaethieaie, ianya yeeo anoaiiaea
12 noi??iie. A?ae?ia?ao?/iee iieaciee e?oa?aoo?e i?noeoue 206 aeaea?ae
(22 noi??iee).

CI?NO ?IAIOE

Ee?i?/ia oa?aeoa?enoeea oai?eo. Aeey ae??oaiiy iinoaaeaieo caaaeaiue aoa
ianoaaeaiee 161 oai?ee c A?I, ui iinooiea a noaoe?iia? a ia?oo aeiao
caoai?thaaiiy. Na?aaei?e a?e aeeth/aieo a aeine?aeaeaiiy oai?eo neeaa
57,4 ± 10,7 ?ieo. Na?aae ieo aoei 130 /ieia?e?a oa 31 ae?iea. Ae?aaiic
A?I noaaeany ia i?aenoaa? e?eoa???a, cai?iiiiiaaieo AIIC, ? i?eioneaa
iayai?noue ee?i?/ii? ea?oeie caoai?thaaiiy, aeeiai?eo YEA a
aeaaiaaeoeyoe noaiaea?oieo a?aeaaaeaiiyo, a oaeiae i?aeaeuaiiy
aeoeaiino? o?ainai?iac, e?aaoeioinoie?iace, ci?ie ee?i?/iiai aiae?co
e?ia?. Na?aae in?a, ui ianoaaeeeeny, iaae?eoee a noaoe?iia? a oa/?th
ia?oeo o?ueio aiaeei a?ae ii/aoeo caoai?thaaiiy 26 oai?eo (16,1%), a
ia??iae a?ae o?ueio aei oanoe aiaeei — 74 oai?eo (46%), a?ae oanoe aei
aeaaiaaeoeyoe aiaeei — 41 oai?ee (25,5%), a a?ae aeaaiaaeoeyoe aei
aeaaaeoeyoe /ioe?ueio aiaeei a?ae ii/aoeo caoai?thaaiiy — 20 oai?eo
(12,4%).

Ee?i?/iee noai ianoaaeaieo oai?eo ioe?ithaaany ii iayaiino?
iaeoi??iaaiiai ia aeioieoaeueiiio aoai? caa?oaeieiiiai aieth, ui
ia?aaeo? o?a?eeyoe?? oeoii/e?a, iaa?yeo eaaaiue, ea?ae?iaaiiiai oieo,
??aith a?oa??aeueiiai oeneo oa /anoioe na?oeaaeo nei?i/aiue. Oaeiae, o
aeeth/aieo a aeine?aeaeaiiy oai?eo a?aoiaoaaeany eieae?caoe?y ii?acee.

A caeaaeiino? a?ae cae?enithaaii? oa?ai?? an? oai?? aoee
iiae?eai? ia o?e a?oie: I a?oia — oai??, ui iaea?aeoaaee a yeino?
o?iiaie?oeea no?aioie?iaco (SK), II a?oia — oai??, yeei o?iiaie?cen
i?iaiaeeany ca aeiiiiiaith oeaieiiiai aeoeaaoi?o ieaci?iiaaia (t-PA) ?,
a III a?oio (NT) a?eoee oai??, yeei o?iiaie?oe/ia oa?ai?y ia
i?iaiaeeeany cian?i. Ana?aaeei? ia?oi? ? o?aouei? a?oi aeae?eyeeny
i?aea?oie oai?eo ui iaea?aeoaaee (i?aea?oia A) ? ui ia iaea?aeoaaee
(i?aea?oiia A) aioeieneaeaioio oa?ai?th o??iaoac?ae?iii.

Iaoiaee aeine?aeaeaiiy. Aeey ioe?iee ?oai?/ieo oa iae?ioe/ieo i?ioean?a,
i?io?eath/eo a i?iea?ae? i?ney o?iiaie?ceno aeei?enoiaoaaeanue aeeiai?ea
a?aeoeeaiiy naaiaioo ST a?ae ?ciaeaeo?e/ii? in? ia aeaeo?iea?ae?ia?ai?,
aei??thaaia /a?ac 1 ii a?ae oi/ee J a iaeiiio iaea?eueo ?ioi?iaoeaiiio
a?aeaaaeaii?. ?aa?no?aoe?y aeaeo?iea?ae?ia?aie i?iaiaeeeanue i?e
aini?oae?caoe?? oai?iai, a iio?i /a?ac 3, 24 oa /a?ac 3 aiaeeie i?ney
cae?i/aiiy aaaaeaiiy o??iaoac?ae?io aai ieaoeaai.

Noai aaii?aieia?/ieo iieaciee?a ioe?ithaaany ii ?acoeueoaoao
aeine?aeaeaiiy aeeiai?/ii? aeaeeino? e?ia? (AeAE), ui aecia/aeanue ia
?ioaoe?eiiio a?neiceiao?? “?aioano-2” c aeei?enoaiiyi oeee?iae?iaiai
aei??thaaeueiiai aeaoooaaiiy i?e oaeaeeinoyo c?ooaiiy (486,0 n-1, 218,7
n-1, 145,8 n-1, 121,5 n-1, 81,0 n-1, 72,9 n-1, 46,8 n-1), iiaeaethth/eo
??ciiiai?oi? ae?eueieoe? noaeeiiiai ?onyaa.

Ie??i oeueiai, iiina?aaeiaaio ?ioi?iaoe?th i?i a?eueii-?aaeeeaeuei?
i?ioeane, ui iino?eii i?io?eathoue a ee?oeiieo iaia?aiao, ie
iaea?aeoaaee aei??ii ?ioaineaiino? iiiaaeneaaeiai aei?ii?ithaaiiy na?oea
caniaii a?ioai?ethi?ianoeaioe??.

Noaoenoe/ia ia?iaea io?eiaieo ?acoeueoao?a i?iaiaeeeany ca aeiiiiiaith
i?ea?iaeueieo i?eeeaaeieo noaoenoe/ieo i?ia?ai “Microsoft Excel” ?
“Prophet” aeey “Windows” ia AII oeio IBM PC/AT. Aeinoia??i?noue
iane?aee?a ioe?ithaaeanue ca aeiiiiiaith e?eoa??y Nocthaeaioa —
aeinoia??ieie aaaaeaee a?aei?ie i?e ? < 0,05. ?ACOEUeOAOE AeINE?AeAEAIIss Ioe?ieo ee?i?/ii? aoaeoeaiino? t-PA ? no?aioie?iace i?e i?iaaaeaii? aioeieneaeaioii? oa?ai?? i?iaiaeeee ii /anoio? aeieeiaiiy oneeaaeiaiue aino?iai ia??iaeo ?I (oaae. 1). Aaaaeaiiy t-PA aeicaieeei ciaioeoe e?euee?noue aeiaaee?a ?aoeeaeeae?oaaiiy aieth/iai neiae?iia, ui aeiaaaei i?ecia/aiiy ia?eioe/ieo aiaeueaaoee?a, ia 8,3% (? < 0,05) a ii??aiyii? c oai?eie, o yeeo a yeino? o?iiaie?oeea aeei?enoiaoaaeany no?aioie?iaca ? ia 13,9% (p < 0, 05) a ii??aiyii? c oeie iaoe??ioaie, yeei o?iiaie?cen ia i?iaiaeeany. Aeiaeaoeiaa aioeieneaeaioia oa?ai?y o??iaoac?ae?iii cieceea a?aenioie ?aoeeaeeae?oaaiiy aia?iicieo i?enooi?a ia 8,4% (? < 0,05) a I-e a?oi? oai?eo, iaeiae a III a?oi? oaeeo aeiaaee?a aoei a?eueoa ia oii? aaaaeaiiy o??iaoac?ae?io. Oaaeeoey 1. *anoioa ?icaeoeo oneeaaeiaiue ia aini?oaeueiiio aoai?. Iieaciee I a?oia II III a?oia % A A Anueiai a?oia A A Anueiai ?aoeeaeea aieth 33,3 41,7 37,5 29,2 53,1 33,3 43,1 ?aoeeaeea ?I 0 4,2 2,1 2,1 6,3 3,0 4,6 O?a?eeyoe?y oeoii/e?a 0 8,3 4,2 0 3,1 6,1 4,6 Anenoie?y 8,3 4,2 6,25 2,1 3,1 3,0 3,1 AV-aeieaaee (an? nooiai?) 0 0 0 6,3 3,1 3,0 3,1 Cia/i? aaii?aa?? 0 0 0 4,2 0 0 0 Iae? aaii?aa?? 20,8 25,0 22,9 6,3 0 3 1,5 NI I 70,8 66,7 68,8 70,8 62,5 66,7 64,6 (KILLIP) II 16,7 29,2 22,9 29,2 28,1 30,3 29,2 III 4,2 4,2 4,2 0 9,4 0 4,6 IV 0 0 0 0 0 3,0 1,5 E?euee?noue ?aoeeaeea?a ?I aoea ia iaeiiio ??ai? a a?oiao oai?eo, yeei i?iaiaeeeany OEO ? a?eueo, i?ae a aeaa ?ace iaioa ca III a?oio. I?e aeei?enoaii? o??iaoac?ae?io a ii?aeiaii? c no?aioie?iacith aeiaaee?a ?aoeeaeeae?oaaiiy ?I ia niinoa??aaeiny, aea o oai?eo, yeei o?iiaie?cen ia i?iaiaeeany, ia oii? aaaaeaiiy o??iaoac?ae?io ?aoeeaeeae ?I niinoa??aaeeny ia 3,3% a?eueoa, i?ae a a?oi? ieaoeaai (III-A a?oia). Iaeiei c ia?ea??a ui ianoaea ?aia?ooc?y i?iea?aeo ?, oae caai?, ?aia?ooc?ei? a?eoi??. I?eioneaeiny, ui o??iaoac?ae?i aeicaieeoue ciaioeoe nia?oi?noue ca ?aooiie iiia?aaeaeaiiy ?icaeoeo oaoaeueiiai i?iyao ?aia?ooc?eiiai neiae?iio - o?a?eeyoe?? oeoii/e?a (OO). A iaoiio aeine?aeaeaii? OO ia niinoa??aaeany o oai?eo, yeei aaiaeeany t-PA oa no?aioie?iaca ?acii ?c o??iaoac?ae?iii, a oie /an, ye i?e aaaaeaii? o?eueee no?aioie?iace oea ii?ooaiiy ?eoio cono??/aeiny o 8,3% oai?eo. A a?oi? oai?eo, aea o?iiaie?cen ia i?iaiaeeany, aaaaeaiiy o??iaoac?ae?io aeicaieeei oaeiae a??ia?aeii cieceoe ??aaiue OO. AV-aeieaaee ??cieo nooiai?a iae/ano?oa cono??/aeeny i?e aeei?enoaii? t-PA (6,3%) ? o oai?eo aac o?iiaie?ceno (3,1%). A??ia?aeii? ??cieoe? i?ae i?aea?oiaie III a?oie ia aoei, a cia/i? aaii?aa?? aoee cao?eniaai? o?eueee o oai?eo, ui io?eiaee t-PA (4,2%). Iaai?ioe, iae? aaii?aa?? cia/ii /ano?oa niinoa??aaeeny i?e aaaaeaii? no?aioie?iace, i?ae t-PA (22,9% ? 6,3% a?aeiia?aeii). Oea coiiaeaia iaiao?aei?noth o?eaaei? (48 aiaeei) ?iooc?? o??iaoac?ae?io. A??ia?aeii? ??cieoe? o i?aea?oiao ia a?aecia/aia. I?iyae iii??ii? na?oeaai? iaaeinoaoiino? (NI) (ii eeaneo?eaoe?? KILLIP - 2-e eean) ciaioeeeny ia 12,5% (? < 0,05) i?e ii?aeiaii? no?aioie?iace ?c o??iaoac?ae?iii. I?e ?cieueiaaiiio canoinoaaii? o??iaoac?ae?io niinoa??aaeany oaiaeaioe?y aei ciaioaiiy i?iya?a NI. I?e aeei?enoaii? t-PA o oai?eo ia aoei a?aecia/aia oaeeo oneeaaeiaiue ?I, ye iaa?yeo eaaaiue oa ea?ae?iaaiiiai oieo (KILLIP-3, 4). Aeai? i?i aieea o??iaoac?ae?io ia ?icaeoie aaaeeeo nooiai?a NI ia oe? o?iiaie?oe/ii? oa?ai?? oa aac ia? iaa??ia?aei?. A?ao?/ia cia?aaeaiiy aeeiai?ee naaiaioo ST i?e i?iaaaeaii? o?iiaie?oe/ii? oa aioeieneaeaioii? oa?ai?? i?aaenoaaeaii ia iaethieao 1, 2. Ca?aeii io?eiaiei ?acoeueoaoai, a ia?o? 3 aiaeeie i?ney ii/aoeo oa?ai?? c aeei?enoaiiyi t-PA cieaeaiiy naaiaioo ST a?aeaoaaeiny ia 4% oaeaeoa, i?ae i?e no?aioie?iac? ? ia 22% oaeaeoa, i?ae o oai?eo aac o?iiaie?ceno (p < 0,05). O??iaoac?ae?i aeicaieea i?enei?eoe aeai?an?th ST ia 6% i?e o?iiaie?oe/ii? oa?ai?? (p < 0,05) ? ia 27% - a?aenooi?noth o?iiaie?ceno (p > 0,05).

A ianooiio aeiao oaiie cieaeaiiy naaiaioo ST aoee iaeiaeiaeie a on?o
a?oiao, iaeiae i?e ii?aeiaii? no?aioie?iace c o??iaoac?ae?iii oeae
iieaciee aoa iaea?eueoei — 39% (p < 0,05). Iae.1. Aeeiai?ea naaiaioo ST i?e i?iaaaeaii? o?iiaie?oe/ii? oa?ai??. *a?ac 3 aiaeeie i?ney cae?i/aiiy aaaaeaiiy o??iaoac?ae?io-ieaoeaai naaiaio ST i?iaeiaaeoaaa cieaeoaaoeny a on?o a?oiao, a i?e ?cieueiaaiiio aaaaeaii? aioeieneaeaioo niinoa??aaany a??ia?aeiee i?aeeii naaiaioo ST ia 23,5% aac ?ioeo i?iya?a ?aieethc?? ei?iia?ii? a?oa???. Oaea “i?ia” ?aoeeaeea??oth/a ?oai?y i?iea?aeo iia'ycaia c i?aeneeaiiyi ooai?aiiy a?eueieo ?aaeeeae?a i?ney cae?i/aiiy ae?? o??iaoac?ae?io (r = 0,89), iiaoi?iei iaae?iiyi aeoeaiino? aioeieneaeaioii? nenoaie (r = 0,68), c?inoaiiyi ??aiy (r = 0,76) ? i?enei?aiiyi i?ioean?a ia?aeeniiai ieeneaiiy e?i?ae?a (r = 0,75). The significant oscillations of indexes of blood reologic properties after streptokinase introduction, connected to

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