I?i?noa?noai ioi?iie caei?ia’y Oe?a?ie

Ee?anueea iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe ?i. I.E. Ooieea

Ni?ie?i TH??e Ieeieaeiae/

OAeE 616.832-004-056.24:615.835.3

Aaaaoaoeai? iieacieee

o oai?eo ia ?icn?yiee neea?ic

oa ?o aeeiai?ea ia aoaiao

a?ia?aa?e/ii? ienEaaiaoe??

14.01.15 — ia?aia? oai?iae

Aaoi?aoa?ao

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Ee?a — 1999 ?.

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia a Eoaainueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao? IIC
Oe?a?ie.

Iaoeiaee ea??aiee:

aeieoi? iaaee/ieo iaoe, i?ioani? Aecthaa Ieaenaiae? Ieeieaeiae/,
Eoaainueeee aea?aeaaiee iaaee/iee oi?aa?neoao IIC Oe?a?ie, eaoaae?a
ia?aiaeo oai?ia c iae?io??o?a??th oa eo?nii aeeoy/i? iaa?ieia??,
caa?aeoaa/ eaoaae?e.

Io?oe?ei? iiiiaioe:

/eai-ei?aniiiaeaio AII Oe?a?ie, aeieoi? iaaee/ieo iaoe, i?ioani? Ia/a?ao
?aaai?y Eaii?ae?aia, Ee?anueea iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe
?i. I.E. Ooieea IIC Oe?a?ie, eaoaae?a iaa?ieia?? oa ?aoeaenioa?ai??,
caa?aeoaa/ eaoaae?e;

aeieoi? iaaee/ieo iaoe, i?ioani? ?aoooaiei Noai?neaa Einoyioeiiae/,
Aeiiaoeueeee aea?aeaaiee iaaee/iee oi?aa?neoao IIC Oe?a?ie, oaeoeueoao
i?neyaeeieiiii? ina?oe, eaoaae?a aeeoy/i? ? caaaeueii? iaa?ieia?? c
eo?nii ?aoeaenioa?ai??, caa?aeoaa/ eaoaae?e.

I?ia?aeia onoaiiaa:

Iaoe?iiaeueiee iaaee/iee oi?aa?neoao ?i. I.I. Aiaiiieueoey IIC Oe?a?ie,
eaoaae?a ia?aiaeo oai?ia (i. Ee?a).

Caoeno a?aeaoaeaoueny «___» __________ 1999 ?. i ___ aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 26.613.01 i?e Ee?anuee?e
iaaee/i?e aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I.E. Ooieea IIC Oe?a?ie
ca aae?anith: 254112, Ee?a, aoe. Aei?iaiaeeoeueea, 9, aoae. ? 3.

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? Ee?anueei? iaaee/ii?
aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I.E. Ooieea IIC Oe?a?ie ca
aae?anith: 254112, Ee?a, aoe. Aei?iaiaeeoeueea, 9.

Aaoi?aoa?ao ?ic?neaiee «___» _________ 1999 ?.

A/aiee nae?aoa?

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

eaiae. iaae. iaoe, aeioeaio

I.?. ?iiaiaiei

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie. ?icn?yiee neea?ic (?N) ? iaei??th c iaea?eueo
neeaaeieo i?iaeai no/anii? iaa?ieia??. I?ia?aeia ?ieue ?ioiiiaoieia?/ieo
?aaeoe?e aecia/a? cia/aiiy ?ioiieo iaoiae?a e?eoaaiiy ?N. ?acii c oei
?ioii? iaoai?cie ia ? ?aeeieie a iaoiaaiac? caoai?thaaiiy, ui coiiaeth?
eiai iiaeaeueoa aea/aiiy ? ?ic?iaeo iiaeo iaoiae?a e?eoaaiiy (Aaoooaiei
N.E., 1991; Aeaieia O.E. e niaao., 1997; Caaaeeoei E.A. e niaao., 1997;
Nieieiaa E.E., 1997; ss?io I.I., 1997; Thompson A.J., Noseworthy J.H.,
1996).

?c ai?iaaaeaeaiiyi iiaeo e?euee?nieo iaoiae?a aeine?aeaeaiiy
aaaaoaoeaii? ia?aiai? nenoaie (AIN) c’yaeeeny a?aeiiino? i?i
iioe?ai?noue aaaaoaoeaii? iaoieia?? i?e ?N ? caoe?eaaeai?noue ye
naaiaioa?ieo, oae ? iaaenaaiaioa?ieo no?oeoo? (Eoia?oieaeo E.A., 1993;
Aeaieeia A.A., 1994; Diamond B.J. a.a., 1995; Linden D. e.a., 1995;
Frontoni M. a.a., 1996).

AIN ? nenoaiith iaea?eueo oaeaeeiai ?aaaoaaiiy ia aieea ??ciiiai?oieo
/eiiee?a, i?e oeueiio aaaaoaoeai? iaoai?cie ?aaoeyoe?? neoaeaoue
iniiaith aaeaioaoe?eii-i?enoinoaaeueieo ?aaeoe?e i?aai?cio (Aieyineee
A.A., 1995; Aaei A.I., 1998). Iioe?ai?noue ? iie?nenoaii?noue
aaaaoaoeaieo ?iceaae?a o oai?eo ia ?N iia’ycai? ia eeoa c eieae?caoe??th
aiaieu aeai??e?i?caoe??, aea ? c ineoiaaiiei oaeoi?ii ye ?aaeoe??th ia
aaaeeo oai?iao oa ?iaae?ae?caoe?th a iieiaeiio a?oe?. Ii?yae c ?ioiieie
c?ooaiiyie aiie na?ae/aoue i?i ii?ooaiiy aaeaino iae?i?ioiieo iaoai?ci?a
iaoiaaiaco caoai?thaaiiy ? i?ioean?a aaeaioaoe??-eiiiainaoe??
(Aoiaaeoeeeia Ae.O., 1993; Aonaa A.E., 1993; Iieiaeai E.A. e niaao.,
1997).

Aaeeea aa??aaaeuei?noue ee?i?/ieo, ?ioiieia?/ieo oa iaoaaie?/ieo
ia?aiao??a i?e ?N na?ae/aoue i?i ??ciee noai nenoai aiiainoaco o oai?eo
? cacia/athoue ia iaiao?aei?noue ?iaeea?aeoaeueiiai i?aeoiaeo aei aeai?o
iaoiaeo e?eoaaeueiiai aieeao (A?ie/oe N.I., 1994; Aecthaa A.I. e niaao.,
1995; Nieieiaa E.?. oa ni?aaao., 1997; Ooeaaeue A.A., 1998). Iniaeeaino?
aaaaoaoeaii? ?aaoeyoe?? o oai?eo ia ?N iiaeooue a?aeaeaaoe oe?
?iaeea?aeoaeuei? a?aei?iiino? aaeaioaoe?eii-i?enoinoaaeueieo iaoai?ci?a.

Ca a?eueo i?ae 25-??/io ?noi??th canoinoaaiiy a?ia?aa?e/ii? ieneaaiaoe??
(AAI) a e?eoaaii? ?N io?eiaii iaiaeiicia/i? ?acoeueoaoe. Aiae?c 14
ca?oa?aeieo aeine?aeaeaiue i?eca?a aei aeoiee i?i a?aenooi?noue aieeao
AAI ia oyaee?noue ? ia?aa?a ?N (Kleijnen J., Knipschild P., 1995). O
?yae? ?ioeo ?ia?o aaoi?e cacia/athoue ia iiceoeaiee oa?aiaaoe/iee aoaeo
canoinoaaiiy aa?ioa?ai?? i?e ?N (Eooeeee I.A., 1993; Aaneeueaa I.A. e
niaao., 1994; Eiaia A.I., 1994; Aoeiaiei A.I., 1996; Eiaenue O.I., Oi?/
I.I., 1997; Fisher B.H. e.a., 1983). ?acii c oei o an?o oeeo
aeine?aeaeaiiyo i?aea?? aeice a?ia?aa?e/iiai eenith ia a?aoiao?
?iaeea?aeoaeuei? iniaeeaino? ia?aa?ao caoai?thaaiiy.

Iiaeaeueoee aeieac aoaeoeaiino? AAI iia’ycothoue ?c ci?iith ?aaeei?a
aeicoaaiiy e?eoaaeueii? a?ia?ien?? c o?aooaaiiyi iniaeeainoae ia?aa?ao
?N (Eiaia A.I., 1994; Kleijnen J., Knipschild P., 1995). sse iiyniaiiy
i?e/ei a?aenooiino? aoaeoo AAI a /anoei? aeiaaee?a e?eoaaiiy ?N
cai?iiiiiaaii eiioeaioe?th ??cieo iaoai?ci?a ae?? e?eoaaeueii?
a?ia?ien?? i?e ?N (Ai?iaueaa E.I., Aecthaa A.I., 1996), yea iia’yco?
?icaeoie e?eoaaeueiiai aoaeoo ?c caa?aaeaiith ?aaeoeai?noth aaeaioeaieo
iaoai?ci?a ia aieea oaeiai iiooaeiiai aaeaioiaaio ye a?ia?aa?e/iee
eenaiue. ??cia ?aaeoeai?noue aei a?ia?ien?? iiaea coiiaethaaoe ??cio
aoaeoeai?noue aa?ioa?ai?? i?e e?eoaaii? oaeiai ??ciiiai?oiiai
caoai?thaaiiy ye ?N. I?e oeueiio iiaeeeaee ?icaeoie oiene/ii? ae?? AAI,
iia’ycaii? c iaaei??iith aeoeaaoe??th ia?aeenieo i?ioean?a ca
i?eai?/aiino? aaeaioaoe?eieo ?aaeoe?e uiaei ae?? a?ia?aa?e/iiai eenith.
Aaaaoaoeai? i?iyae oiene/iino? a?ia?ien?? aeieeathoue ?ai?oa niiaoe/ieo
? caeaaeaoue a?ae ?aaeeio aa?inaaino (Caeueoeiai A.E., Naeea?a A.E.,
1987).

Aaaaoaoeaia ?aaeoeai?noue aei a?ia?aa?e/iiai eenith a?aeaeaa? ieoo?a?
aaeaioeai? ?aaeoe?? ?aaoeyoi?ieo iaoai?ci?a, ye? ia?aaeothoue
no?oeoo?iei ? aeathoue iiaeeea?noue aeyaeoe ii/aoeia? iciaee iaoiaaiiiai
aoaeoo AAI. A?aoiaoth/e oea, aeine?aeaeaiiy noaio aaaaoaoeaii?
?aaoeyoe?? oa aaaaoaoeaii? ?aaeoeaiino? aei a?ia?ien?? ia aoaiao naaino
? eo?no AAI oyaey?oueny aeineoue aaaeeeaei aeey ?icoi?iiy e?eoaaeueieo
iaoai?ci?a AAI i?e ?N ? iioei?caoe?? e?eoaaiiy oai?eo.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. ?iaioa ?
o?aaiaioii iaoeiai? ?iaioe eaoaae?e ia?aiaeo oai?ia c iae?io??o?a??th oa
eo?nii aeeoy/i? iaa?ieia?? Eoaainueeiai aea?aeaaiiai iaaee/iiai
oi?aa?neoaoo “?iceaae aaaaoaoeaiiai aiiainoaco ? ii?ooaiiy aaaaoaoeaii?
?aaoeyoe?? i?e caoai?thaaiiyo ia?aiai? nenoaie”, ? aea?ae?a?no?aoe??
0198V005868.

Iaoa ? caaea/? aeine?aeaeaiiy. Iaoith aeine?aeaeaiiy aoei anoaiiaeoe
a?aei?iiino? aaaaoaoeaii? ?aaeoeaiino? o oai?eo ia ?N i?ae /an
a?ia?aa?e/ii? ieneaaiaoe?? oa aecia/eoe ?o aca?iica’ycie c ee?i?/ieie
iniaeeainoyie caoai?thaaiiy. Aeey ?? aeinyaiaiiy iaiao?aeii aoei
ae??oeoe ne?aeoth/? caaea/?:

1.Aea/eoe ooieoe?iiaeueiee noai AIN o oai?eo ia ?N a caeaaeiino? a?ae
oyaeeino? noaio ? oa?aeoa?o ia?aa?ao caoai?thaaiiy.

2.Ioe?ieoe ci?ie ee?i?/iiai noaio, aaaaoaoeaieo oa ?ioiieia?/ieo
iieaciee?a o oai?eo ia ?N aiane?aeie ae?? AAI.

3.Aea/eoe aaaaoaoeai? ci?ie o oai?eo ia ?N i?ae /an naaino AAI ? ia
i?aenoaa? ee?i?ei-aeaeo?io?c?ieia?/ieo ni?anoaaeaiue aeae?eeoe ??ci?
oeie aaaaoaoeaii? ?aaeoeaiino? aei a?ia?ien??.

4.Aecia/eoe iayai?noue i?ia?niee?a iaoiaaiieo aoaeo?a AAI-oa?ai?? ca
aeaieie aeine?aeaeaiiy aaaaoaoeaieo iieaciee?a o oai?eo ia ?N i?ae /an
aa?inaaino.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a. Aia?oa ia i?aenoaa? ci?i
iieaciee?a iaoaiaoe/iiai aiae?co ?eoio na?oey (IA?N) i?ae /an naaino AAI
aecia/aii ??ci? oeie aaaaoaoeaii? ?aaeoeaiino? aei a?ia?ien?? o oai?eo
ia ?N ?c ??ciei nooiaiai ee?i?/ieo i?iya?a oai?iae.

Aeiaaaeaii caeaaei?noue aoaeoeaiino? AAI-oa?ai?? o eiiieaeniiio
e?eoaaii? oai?eo ia ?N a?ae ??cieoe? o noai? ?aaoeyoi?ieo iaoai?ci?a.

Aia?oa aeaii ioe?ieo aaaaoaoeaieo c?ooaiue i?ioyaii aa?inaaino o oai?eo
ia ?N ca aeaieie aiae?co iio?aeieo na?oeaaiai ?eoio.

Ia i?aenoaa? aeine?aeaeaiiy aeeiai?ee iieaciee?a aaaaoaoeaii? ?aaoeyoe??
o oai?eo ia ?N i?ae /an naain?a AAI aecia/ai? ia?ea?e i?ia?niee?a
iaoiaaiiiai aoaeoo a?ia?aa?e/iiai eenith. I?iaeaiiino?iaaii
aaeaeaaoi?noue iaoiaeo IA?N aeey aeyaeaiiy oa a?aeaa?oaiiy iaoiaaiii?
ae?? a?ia?ien??.

Aia?oa ?ic?iaeaii e?eoa??? oa iaoiaeeea ?iaeea?aeoaeueiiai i?aeoiaeo
aeey aecia/aiiy oaeoeee AAI-oa?ai?? o oai?eo ia ?N ia i?aenoaa?
aecia/aiiy ooieoe?iiaeueiiai noaio iaoai?ci?a ?aaoeyoe?? ?c aeiiiiiaith
iii?oi??iao iieaciee?a aaaaoaoeaiiai aiiainoaco i?ae /an aa?inaaino.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a. ?ic?iaeaia iaoiaeeea
aeei?enoiao?oueny ? iiaea aooe canoiniaaia aeey aecia/aiiy
ooieoe?iiaeueiiai noaio ?aaoeyoi?ieo nenoai oa ?iaeea?aeoaeueii?
/ooeeaino? aei a?ia?ien?? o oai?eo ia ?N i?ae /an naaino AAI (?aoe.
i?ii. ? 3159 a?ae 16.02.99 ?.) ? ai?iaaaeaeaia a iaa?ieia?/ieo
a?aeae?eaiiyo Eoaainueei? iaeanii? ee?i?/ii? e?ea?i? oa iaeanii?
aeeoy/i? ee?i?/ii? e?ea?i? i.Aeiiaoeuee, o a?aeae?eaii? aianoac?ieia?? c
iaeaoaie ?ioaineaii? oa?ai?? ? ien?aa?ioa?ai?? ?inoeoooo iaa?aeeeaaeii?
? a?aeiiaii? o??o?a?? AII Oe?a?ie, i?i ui ? aeoe ai?iaaaeaeaiiy.

Aeiaaaeaii aoaeoeai?noue IA?N a aecia/aii? i?ia?niee?a iaoiaaiiiai
aoaeoo a?ia?aa?e/iiai eenith ? i?iaiicoaaiiy aoaeoeaiino? AAI o
eiiieaeniiio e?eoaaii? ?N (?aoe. i?ii. ? 3158 a?ae 16.02.99 ?.).

Io?eiai? aeai? iiaeooue ni?eyoe ae?oa?aioe?eiiio i?aeoiaeo aei
i?ecia/aiiy ?aaeei?a ? aeai?o oaeoeee canoinoaaiiy AAI o oai?eo ia ?N oa
a?eueo aeeaieiio ?icoi?iith e?eoaaeueieo iaoai?ci?a AAI i?e ?N.

Iniaenoee aianie caeiaoaa/a. Iaa?? ee?i?/iiai iaoa??aeo oa ianoaaeaiiy
i?iaaaeaii naiino?eii. Aeine?aeaeaiiy iio?aeieo na?oeaaiai ?eoio
cae?enithaaeiny ca iaoiaeieia??th oa oaoiieia??th E.I. Ai?iaeiaa
(1996-1998). Noaoenoe/i? ?ic?aooiee c?iaeaii naiino?eii ia iniia?
noaoenoe/ieo i?ia?ai “EXCEL”, “STATISTICA” ? “STATGRAPHICS”.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. ?iaioa ai?iaiaaia ia can?aeaiiyo
eaoaae?e ia?aiaeo oai?ia c iae?io??o?a??th oa eo?nii aeeoy/i? iaa?ieia??
Eoaainueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo ? eaoaae?e caaaeueii?
oa aeeoy/i? iaa?ieia?? OII Aeiiaoeueeiai aea?aeaaiiai iaaee/iiai
oi?aa?neoaoo. Iniiai? ?acoeueoaoe ?iaioe aoei i?aaenoaaeaii ia
can?aeaii? Eoaainueeiai iaeaniiai oiaa?enoaa iaa?iiaoieia?a; ia
I?aeiaeani?e iaoeiai-i?aeoe/i?e eiioa?aioe?? aianoac?ieia?a ? o??o?a?a
“Aeno?aiaeueia iaaeeoeeia” (i. Eoaainuee); ia ?in?enuee?e
iaoeiai-i?aeoe/i?e eiioa?aioe?? “Nia?aiaiiua aniaeou
yeaeo?iiae?inoeioey-oeee e iiaua oaoiieiaee a iae?ioe?o?aee e
iaa?ieiaee” (i. Na?aoia); ia iaoeiai-i?aeoe/i?e eiioa?aioe?? “Iiaia a
iaoieiaee: oai?ey e i?aeoeea” (O/o “Iiaaa”, Naaanoiiieue — Noaiaoe —
Naaanoiiieue).

Ioae?eaoe??. Io?eiai? aeai? a?aeia?aaeaii a 13 ioae?eaoe?yo: 7
aeo?iaeueieo noaoae (5 — iniaeno?), 2 noaoo? o ca??ieeao iaoeiaeo
i?aoeue (1 — iniaenoa), 4 — oace eiioa?aioe?e.

Ianya oa no?oeoo?a aeena?oaoe??. Aeena?oaoe?th aeeeaaeaii ia 133
noi??ieao ae?oeiaaiiai oaenoo. Aiia neeaaea?oueny c? anooio, iaeyaeo
e?oa?aoo?e, caaaeueii? oa?aeoa?enoeee oai?eo, aeeeaaeaiiy iaoiae?a
aeine?aeaeaiiy, 3 ?icae?e?a aeanieo aeine?aeaeaiue, caeeth/ii? /anoeie,
aeniiae?a, nieneo e?oa?aoo?e (202 aeaea?aea). ?iaioa ?ethno?iaaia 39
oaaeeoeyie, 29 iaethieaie.

INIIAIEE CI?NO ?IAIOE

Iaoa??ae ? iaoiaee aeine?aeaeaiiy. Ianoaaeaii 105 oai?eo ?c aeinoia??iei
ae?aaiicii ?N ca e?eoa??yie Iica?a (Poser C. e.a., 1983). On? oai?? aoee
c oea?aa?ini?iaeueiith oi?iith ?N. Na?aaei?e a?e oai?eo neeaa 33,23±1,06
?ie?a; a?e aeaathoo — 27,52±1,05; o?eaae?noue oai?iae a na?aaeiueiio —
5,25±0,48 ?ie?a.

A ocaaaeueiai?e a?oi? ia?aaaaeaee oai?? c ?ai?ooth/ei oeiii ia?aa?ao (69
iaoe??io?a (65,71%); 32 /ieia?ee ? 37 ae?iie) ? a noaae?? caaino?aiiy
iaoieia?/iiai i?ioeano (45 oai?eo (42,86%); 21 oa 24 a?aeiia?aeii).
I?ia?aae??ioiee ia?aa?a a?aecia/aany o 36 oai?eo (34,29%) — 16 /ieia?e?a
? 20 ae?iie; ia?aeiii-i?ia?aae??ioiee oei — o 16 oai?eo (10 /ieia?e?a oa
6 ae?iie), aoi?eiii-i?ia?aae??ioiee — o 20 iaoe??io?a (6 ? 14
a?aeiia?aeii).

On? oai?? aoee iiae?eai? ia aea? a?oie, ye? a??ia?aeii ia ?ic??ciyeeny
ca na?aaei?i a?eii, o?eaae?noth oai?iae oa ca a?eii aeaathoo: ia?oo
a?oio neeaee 42 oai?eo, yeei i?ecia/aee aa?ioa?ai?th — a?ae 5 aei 10
naain?a; 2,0 aoa; 40 oaeeei ?cii?an?? — ia oii? eiiieaenii? oa?ai??
(aaciaeoeai? i?aia?aoe, iiio?iie, aeacaa?aaaioe, ?ioiio?iii? oa
iaoaaie?/i? caniae); ae?oao — 63 oai?eo, ye? io?eioaaee eeoa eiiieaenio
oa?ai?th. Aa?ioa?ai?th ae?noaee 19 /ieia?e?a (na?aaei?e a?e —
34,21±1,94; a?e aeaathoo — 31,21±2,13) ? 23 ae?iee (34,26±2,74 ?
28,00±2,28).

E??i oiai, oai??, ui io?eioaaee AAI, aoee iiae?eai? ia aea? a?oie c
??ciith aoaeoeai?noth i?iaaaeaiiai e?eoaaiiy, ye? aeyaeeeny ??aieie.
Ia?oo a?oio neeaee oai?? c ee?i?/iei iie?ioaiiyi o aeaeyae? ciaioaiiy
iaa?ieia?/iiai aeao?oeeoo ? iiceoeaiith aeeiai?eith ca ?icoe?aiith
oeaeith nooiaith ?iaae?aeiino? Kurtzke (oeaea EDSS), ae?oao — oai?? c
a?aenooi?noth ci?i a ee?i?/i?e ea?oei?, c noa’?eoeaiei iie?ioaiiyi
naiiii/oooy aai c iacia/iei ?aa?anii iaa?ieia?/ieo neiioii?a aac
aeeiai?ee iieacieea EDSS.

Ee?i?/io ioe?ieo ooieoe?iiaeueiiai noaio i?iaiaeieeiaeo nenoai
i?iaiaeeee ca oeaeith iioeiaeaeaiue ooieoe?iiaeueieo nenoai Kurtzke
(oeaea FS) c ?ic?aooieii noia?iiai aaea iaa?ieia?/iiai aeao?oeeoo — NA
FS (Kurtzke J.F., 1961). Oyaee?noue noaio oai?eo aecia/aee ca oeaeith
EDSS (Weiner H., Ellison G.W., 1983). Nooi?iue oyaeeino? caoai?thaaiiy
ioe?ithaaee ca ?.A. Oi?aeoii oa ni?aaao. (1980).

Ee?i?/i? iciaee aaaaoaoeaii? aeenooieoe?? ia’?aeioaaeeny a
ineoiaaaaoaoeaiee neiae?ii (IAN) ? neiae?ii i?ia?anoth/i? aaaaoaoeaii?
iaaeinoaoiino? (IAI) (Aaei A.I., 1998). Aeey e?euee?nii? ioe?iee i?iya?a
IAN ? IAI ?ic?aoiaoaaee noia?iee aae (NA IAN ? NA IAI), yeee noaiiaea
niaith noio ee?i?/ieo iciae?a, eiaeiiio c ieo i?enaithaaee cia/aiiy a
iaeei aae (Eoia?oieaeo E.A., 1993).

Aeine?aeaeaiiy ooieoe?iiaeueiiai noaio AIN aeeth/aei aea/aiiy
aaaaoaoeaiiai oiiono, aaaaoaoeaii? ?aaeoeaiino? (A?) oa aaaaoaoeaiiai
caaacia/aiiy ae?yeueiino? (AC) (Nieiaueaaa A.Ae. e niaao., 1998) ?
i?iaiaeeeiny ca iaoiaeieia??th oa oaoiieia??th E.I. Ai?iaeiaa (1998),
yea aeeth/aea ne?aeoth/? aeiee:

1. Na?oeo?eiaaia i?ia?aia cai?o aeaieo oa iiia?aaeiueiai aiae?co
iio?aeieo na?oeaaiai ?eoio a ?aaeueiiio ianooaa? /ano ca aeai?eoiaie
?.I. Aa?anueeiai oa ni?aaao. (1984), yeo ?aae?ciaaii o aeaeyae?
«Iii?oi?ii? nenoaie aeey ?ioaineaii? oa?ai?? ? a?ia?aa?e/ii?
ieneaaiaoe??» (na?oeo?eao yeino? IIC Oe?a?ie a?ae 01.08.1995).

2. Iaoiaeeea ?ao?iniaeoeaii? ia?iaee aace aeaieo na?oeo?eiaaii?
i?ia?aie.

3. Iaoiaeeea iaeaoii? ia?iaee aeaieo aaaaoaoeaieo i?ia.

4. Iaoiaeeea a?coae?caoe?? ?acoeueoao?a aeine?aeaeaiiy
(ioeueo?ia?aiao?e/iee a?oiiaee noaoenoe/iee aiae?c aeeiai?/ieo ?yae?a
iio?aeieo IA?N).

5. Iaoiaeeea aeene?aoecaoe?? naaino AAI ia aoaie aeine?aeaeaiiy.

I?e oeueiio ?ic?aoiaoaaeeny 20 iieaciee?a IA?N, na?aae ieo: na?aaeiy
aaee/eia ea?ae?i?ioa?aaeo MedRR; aiie?ooaea iiaee AMo; aa??aoe?eiee
?iciao dRR; na?aaeiueieaaae?aoe/ia a?aeoeeaiiy SrQdr; aenoean Ex;
?iaeaen iai?oae ?aaoeyoi?ieo nenoai IndBc; eiao?oe?aio ei?aeyoe?? i?e
ia?oiio c?ooaii? aeeiai?/iiai ?yaeo ea?ae?i?ioa?aae?a AKF1; iiia?
ci?uaiiy, i?e yeiio eiao?oe?aio ei?aeyoe?? aeinyaa? cia/aiiy iaio ioey —
AKF0; iiooaei?noue oaeeue c ia??iaeii eieeaaiue 31-70 n — Max2; c
ia??iaeii 11-30 n — Max1; c ia??iaeii 3-10 n — MaxD (Ai?iaueaa E.I.,
1997).

Iieacieee aaaaoaoeaii? ?aaoeyoe?? ioe?ithaaee aei ? i?ney e?eoaaiiy, aei
? i?ney eiaeiiai naaino AAI. Aeine?aeaeaiiy A? aei a?ia?ien?? i?iaiaeeee
aaciina?aaeiuei i?ioyaii aa?inaaino, aeey ?? ioe?iee eiaeiee naain ca
iiae?o?eiaaiith oaoiieia??th E.I. Ai?iaeiaa (1997) aoei iiae?eaii ia 10
aoai?a: ia?aae naainii; 1-5 oaeeeie eiii?an??; 1-5, 6-10, 11-20, 21-30,
31-35, 36-40 oaeeeie ?cii?an??; 1-5 oaeeeie aeaeiii?an??; i?ney naaino.
Anueiai i?ioyaii 263 naain?a i?iaaaeaii 2629 aeine?aeaeaiue.

A? aeine?aeaeoaaee oaeiae ca aeiiiiiaith oeniaiiy ia ?aoeaeoi?i? ciie a
ieina?oeaa?e, n?iiea?ioeaei?e ? niey?i?e i?iaao (Nieiaueaaa A.Ae. e
niaao., 1998). Ca ?acoeueoaoaie o?ueio i?ia aeae?eyee in?a ?c
ia?aneiiaoe/iith, neiiaoe/iith ? ii?iaeueiith A? (Inueieiei O.A. e
niaao., 1991). Ia?iaeo aeaieo a INI ? ENI i?iaiaeeee ca Z. Servit
(1948).

Noai ia?aneiiaoe/iiai aoa?aioiiai oeyoo ioe?ithaaee ca ci?iith *NN i?ae
/an anoaaaiiy c ?ic?aooieii eiao?oe?aioa RR30:15 ? a i?ia? c aeeaieei
iia?eueiei aeeoaiiyi (6 ?ac?a o 1 oaeeeio) ?c aecia/aiiyi eiao?oe??ioa
RRmax/min (Nieiaueaaa A.Ae. e niaao., 1998). sse eiio?ieuei? aeai?
aeei?enoiaoaaee ?acoeueoaoe ianoaaeaiiy 30 oiiaii caei?iaeo in?a,
na?aaei?e a?e — 35,50±2,30 ?ie?a.

?ioiiee noaoon aeine?aeaeoaaee aei ? i?ney e?eoaaiiy. Ee?oeia? iieacieee
?ioi?oaoo aecia/aee ca aeiiiiiaith noaiaea?oieo iaoiaeee
?icaoeiooai?aiiy (*a?aaeaaa A.I. e niaao., 1980). Aecia/aiiy
?ioiiaeiaoe?i?a ne?iaaoee eean?a A, I ? G (IgA, IgM ? IgG) i?iaiaeeee
iaoiaeii ?aae?aeueii? ?ioiiaeeooc?? a aae? (Mancini G. a.a., 1965).
??aaiue oee?eoethth/eo ?ioiieo eiiieaen?a aecia/aee iaoiaeii
i?aoe?i?oaoe?? o 2%, 3,5% ? 6% ?ic/ei? iie?ao?e?iae?eieth (Digeon M.
e.a., 1977) a iiaeeo?eaoe?? O?ieiaa A.I. oa ni?aaao. (1986). sse
ii?iaoeai? aoei aeei?enoaii aeai? A.A. Aeoaiai? (1996).

?c aeiiiiiaith aaeaioiaaiiai iaoiaeo oea?oiaeo aeai??a Ethoa?a
i?iaiaeeee ioe?ieo iniaenoeo ineoio?c?ieia?/ieo iniaeeainoae c
?ic?aooieii iieaciee?a ineoinioe?aeueii? aaeaioaoe?? IIA, ?ioaineaiino?
o?eaiae I?O ? eiao?oe??ioa aaaaoaoeaiiai aaeaino EAA (Aeaacyi O.A. e
niaao., 1989; Nia/ee E.I., 1998).

Aeey ia?iaee io?eiaieo aeaieo aeei?enoiaoaaeenue ia?aiao?e/i? caniae
noaoenoeee c aecia/aiiyi e?eoa??th Nouethaeaioa (t). Aeey noaoenoe/iiai
aiae?co canoiniaoaaeenue noaiaea?oi? noaoenoe/i? i?ia?aie “EXCEL”,
“STATISTICA” ? “STATGRAPHICS”.

Ee?i?ei-o?c?ieia?/ia oa?aeoa?enoeea oai?eo ia ?N. A ocaaaeueiai?e a?oi?
oai?eo ia ?N ?c ??ciei oeiii ia?aa?ao ? c ??ciith noaae??th
caoai?thaaiiy ca aeaieie IA?N aeyaeaii iii??ia ia?aaaaeaiiy oiiono
neiiaoe/ii? ia?aiai? nenoaie (AMo — 55,30±1,89; p<0,05 c eiio?ieai) ? iaaeinoaoi?noue naaiaioa?ieo neiiaoe/ieo (Max1 - 13,30±0,63) oa ia?aneiiaoe/ieo (MaxD - 15,79±1,30) iaoai?ci?a ?aaoeyoe?? ia oii? aeoeaaoe?? oea?aa?aeueieo a?aio?iiieo nenoai (Max2 - 19,46±1,08) ?c eaaeith iai?oaith oeaio?aeueiiai eiioo?o ?aaoeyoe?? (IndBc - 290,05±32,55; p<0,01; AKF1 - 0,62±0,02), ui a?aeaeeiny o a??ia?aeii ??ciiio uiaei eiio?ieueii? a?oie noia?iiio aoaeo? ?aaoeyoe?? ca iieacieeii MedRR (p<0,05). NA FS i?e oeueiio neeaea 10,21±0,33; EDSS - 4,12±0,14; nooi?iue oyaeeino? a na?aaeiueiio - 2,40±0,08. Ee?i?/i? i?iyae aaaaoaoeaii? aeenooieoe?? niinoa??aaeeny o 54% oai?eo (o 65% ae?iie ? o 42% /ieia?e?a) o aeaeyae? IAN, o 82% oai?eo (o 83% ae?iie ? o 82% /ieia?e?a) aeyaeyeeny neiioiie IAI. A?eueo ae?aaeaia iai?oaa oeaio?aeueiiai eiioo?o ?aaoeyoe?? (IndBc - 309,21±36,43; p<0,001 c eiio?ieai; AKF0 - 9,13±0,97) ? aeaui a?eueo ae?aaeaia neiiaoeeioii?y (AMo - 57,19±2,59; p<0,05 c eiio?ieai) o ae?iie niieo/aeany c iineaaeaiiyi aaoiiiiiiai eiioo?o (dRR - 179,67±14,09; SrQdr - 33,90±2,68) ? iaaeinoaoi?noth naaiaioa?ieo aieea?a (Max1 - 11,92±0,76, p<0,05 c /ieia?eaie ? eiio?ieai; MaxD - 15,44±1,83), ui a?aeaeeiny o a??ia?aeii ??cieo (p<0,05) c a?oiith /ieia?e?a na?aaeiueiio ??ai? aiiainoaooaaiiy ? ee?i?/ieo i?iya?a aaaaoaoeaii? aeenooieoe??: MedRR neeaa a?aeiia?aeii 815,00±19,20 (p<0,05 c eiio?ieai) ? 873,88±21,41 (p<0,05 i?ae a?oiaie); NA IAN - 3,07±0,31 e 2,07±0,32; NA IAI - 3,02±0,30 e 2,15±0,28. Nooi?iue iaa?ieia?/iiai aeao?oeeoo oaeiae aoea a?eueo ae?aaeaiith a in?a ae?ii/i? noao?, aieiaiei /eiii, ca ?aooiie i?aaaethaaiiy i??ai?aeieo, eii?aeeiaoe?eieo ? oaciaeo ?iceaae?a: NA FS - 10,31±0,41; EDSS - 4,23±0,17; o a?oi? /ieia?e?a - 10,09±0,54 e 4,00±0,24 a?aeiia?aeii. Iaea?eueo ae?aaeai? ci?ie a noai? AIN aeyaeeeny o oai?eo ?c i?ia?aae??ioiei ia?aa?aii ?N o aeaeyae? naiiai cia/iiai i?aeaeuaiiy neiiaoe/iiai oiiono (AMo - 60,41±3,38; p<0,01 c eiio?ieai) c iaea?eueoei i?eai?/aiiyi oiiono aaaona (dRR - 169,88±18,80; SrQdr - 31,99±3,99; MaxD - 13,71±2,29) ? c iaea?eueoei nooiaiai neiiaoe/ii? aa?i?aoeaioi?ii? iaaeinoaoiino? (Max1 - 11,79±0,92; p<0,05 c eiio?ieueiith a?oiith). I?e oeueiio aeyaeyeiny ia?aiai?oaeaiiy nenoai aaeaioaoe?? oa aeniaaeaiiy ?aca?a?a aaoiiiiiiai eiioo?o (o niieith IndBc - 317,06±40,70; p<0,01 c eiio?ieai; AKF1 - 0,62±0,04; AKF0 - 9,13±1,20; MedRR - 846,56±24,67; a i?oii?ia? IndBc - 324,94±55,45; p<0,001 c eiio?ieai; AKF1 - 0,92±0,01; AKF0 - 11,41±1,92; dRR - 167,00±15,64; p<0,001). Ia oeueiio oii? aeyaeeany a?aeiinii iecueea aeoeai?noue iaaenaaiaioa?iiai ??aiy ?aaoeyoe?? (Max2 - 16,42±1,66), a i?oii?ia? aeaiee iieaciee aoa iaeiaioei c on?o a?oi - 25,68±2,73, (p<0,001 c eiio?ieai), ye ? iiooaei?noue oaeeue aeniei/anoioiiai ae?aiaciio - 8,18±1,28 (p<0,001), ui aeicaiey? aeoiaoe i?i aeniaaeaiiy ?aaoeyoi?ieo iaoai?ci?a aaeaioaoe?? a aeai?e a?oi? oai?eo. IAI i?e oeueiio aoea iaea?eueo cia/iith - 3,33±0,38 (p<0,05 c a?oiith c ?ai?ooth/ei ia?aa?aii). Oai?? c i?ia?aae??ioiei oeiii ia?aa?ao a?ae??ciyeeny a?eueoei nooiaiai ae?aaeaiino? i??ai?aeiiai ? aoaeoe/iiai neiae?iio (p<0,001 c a?oiith c ?ai?ooth/ei ia?aa?aii), ii?ooaiue a naini?i?e noa?? oa ooieoe?e oaciaeo i?aai?a, ui a?aeaeaaeiny ? aeinoia??ii a?eueoeie iieacieeaie EDSS oa NA FS (5,11±0,22 e 12,31±0,59) o oe?e a?oi? oai?eo o ii??aiyii? c oai?eie c ?ai?ooth/ei ia?aa?aii iaoieia?/iiai i?ioeano (3,58±0,15 e 9,02±0,37; p<0,001). Iaea?eueo aeniea aeoeai?noue oea?aa?aeueieo a?aio?iiieo nenoai i?ae /an caaino?aiiy i?e ?ai?ooth/iio oei? ia?aa?ao (Max2 - 22,27±1,89; p<0,05 o ii??aiyii? c i?ia?aae??ioiei ia?aa?aii) na?ae/eoue i?i iaeneiaeueio iai?oaeai?noue aaeaioeaii-eiiiainaoe?eieo ?aaeoe?e o oeae ia??iae oai?iae. Iaea?eueoee nooi?iue i?aeaeuaiiy aeoeaiino? iaaenaaiaioa?ieo (Max2 - 34,62±4,22; p<0,01 c eiio?ieai) ? naaiaioa?ieo iaoai?ci?a ?aaoeyoe?? (Max1 - 22,55±1,97; p<0,05 ? MaxD - 12,01±1,18; p<0,05) a i?oii?ia? o oe?e a?oi? ia oii? iaeiaioi? iai?oae ?aaoeyoi?ieo nenoai (IndBc - 241,72±37,17; p<0,001) cacia/a? ia aaeaeaaoio aeoeaaoe?th aaeaioaoe?eii-i?enoinoaaeueieo ?aaeoe?e a ia??iae caaino?aiiy iaoieia?/iiai i?ioeano oa caa?aaeaiiy ?aaoeyoi?ieo iaoai?ci?a. Aiae?c iio?aeieo na?oeaaiai ?eoio iieacaa i?aeneeaiiy neiiaoeeioii??, iaaeinoaoiino? aa?i?aoeaioi?ieo oa aaaaeueieo aieea?a ? oeaio?ae?caoe?? i?ioean?a oi?aae?iiy ii i??? ca?eueoaiiy nooiaiy oyaeeino? noaio oai?eo ia ?N oa o?eaaeino? oai?iae. Aieea AAI ia ee?i?/iee noai, ?ioiieia?/i?, ineoio?c?ieia?/i? oa aaaaoaoeai? iieacieee o oai?eo ia ?N. Canoinoaaiiy AAI-oa?ai?? i?ecaaei aei ciaioaiiy iaa?ieia?/iiai aeao?oeeoo o 50% oai?eo ?c cieaeaiiyi EDSS c 3,60±0,25 aei 2,93±0,24 ? NA FS c 8,86±0,57 aei 6,81±0,56 (p<0,05). A?eueoith i??ith cae?enithaaeiny ciaioaiiy ae?aaeaiino? eii?aeeiaoe?eieo, oaciaeo, i??ai?aeieo ? naini?ieo ?iceaae?a. O 26% oai?eo ?aa?an iaa?ieia?/ii? neiioiiaoeee noi?iaiaeaeoaaany ciaioaiiyi NA FS ca iaci?iiiai EDSS; o 17% aeiaaee?a iaoe??ioe cacia/aee ia iie?auaiiy caaaeueiiai noaio, ciaioaiiy oyaeeino? ? ii?i?iiy a e?ioe?aeao, oeoaiiy i?e oiae?ii?, a?aei?/aee iie?ioaiiy na/iaeioneaiiy, ciaioaiiy aoiiethaaiino?, iie?auaiiy ci?o, ao?i cia/aiiy EDSS ? NA FS o ieo caeeoaeeny iiia?aaei?ie; o 7% oai?eo ci?i o noai? ia niinoa??aaeiny. A oe?eiio aeeth/aiiy AAI o eiiieaen e?eoaaeueieo caoiae?a i?eaiaeeei aei a?eueo cia/iiai ?aa?ano iaa?ieia?/iiai aeao?oeeoo (NA FS ciaioeeanue c 10,88±0,58 aei 9,52±0,64; EDSS - c 4,51±0,25 aei 4,19±0,27) o ii??aiyii? ?c a?oiith aac canoinoaaiiy aa?ioa?ai?? (a?aeiia?aeii 9,71±0,39 ? 9,19±0,41; 3,84±0,16 ? 3,66±0,17; p<0,05 i?ae a?oiaie), oi/ o ia?oeo iaa?ieia?/i? ?iceaaee aoee a?eueo ae?aaeaieie. O ii??aiyii? c a?oiith, ui ia iaea?aeoaaea AAI, o oai?eo i?ney eo?no aa?ioa?ai?? a?aeaoaaeiny a?eueo ae?aaeaia ciaioaiiy ee?i?/ieo i?iya?a IAN (2,02±0,28 ? 0,95±0,18; p<0,01) ? IAI (2,64±0,35 ? 1,74±0,31). Oai?? c iiceoeaiei aoaeoii AAI ia?a?nii oa?aeoa?ecoaaeeny a?eueoith NA IAN, neiioiie IAI aoee a?eueoa i?aaenoaaeai? a a?oi? c a?aenooi?noth ci?i o iaa?ieia?/iiio noaoon?. Aeinyaiaiiy ee?i?/iiai aoaeoo noi?iaiaeaeoaaeiny a??ia?aeiei (p<0,05) ciaioaiiyi noia?ieo i?iya?a IAN (2,67±0,47 ? 1,19±0,36) ? IAI (2,14±1,10 ? 1,10±0,32). A ?acoeueoao? eo?no AAI o oai?eo ia ?N niinoa??aaeiny ciaioaiiy aeoeaiino? oea?aa?aeueieo a?aio?iiieo ooai?aiue, iineeaiiy aieea?a naaiaioa?ii? aa?i?aoeaioi?ii? eaiee ? cieaeaiiy iai?oae ?aaoeyoi?ieo nenoai. I?ioa i?e oeueiio a?aecia/aeiny iineaaeaiiy aeoeaiino? aaoiiiiiiai eiioo?o ? ciaioaiiy ia?aneiiaoe/ieo aieea?a, ui ? iani?eyoeeaeie c?ooaiiyie ? oaeee oaeo iiaea na?ae/eoe i?i iaiaeii??aei?noue aeaii? a?oie oai?eo ca oeeie iieacieeaie. Ci?ie ia?aiao??a IA?N a ?acoeueoao? a?ia?iene/iiai aieeao aeyaeeeny ??cieie a caeaaeiino? a?ae noao?, ia?aa?ao ? noaae?? caoai?thaaiiy (oaae.). O ae?iie a?aecia/aeiny cieaeaiiy ae?aaeaiino? neiiaoeeioii??, iai?oae ?aaoeyoi?ieo nenoai ? nooiaiy aeoeaiino? iaaenaaiaioa?ieo iaoai?ci?a ?aaoeyoe?? aaaaoaoeaiiai oiiono, ?acii c oei neiiaoe/iee oiion caeeoaany a??ia?aeii aeuei (p<0,05), i?ae a a?oi? /ieia?e?a, o yeeo caa??aaany aenieee ??aaiue aeoeaiino? oea?aa?aeueieo a?aio?iiieo no?oeoo? i?e c?inoaii? iai?oae ?aaoeyoi?ieo iaoai?ci?a c ae?aaeaiei aeii?ioaaiiyi oeaio?aeueiiai eiioo?o ?aaoeyoe??, aeinyaioaoei aeinoia??ii? a?aeciaee (p<0,01) a?ae iieaciee?a a?oie ae?iie i?ney AAI. I?e oeueiio o ae?iie a?aei?/aeiny e?aua a?aeiiaeaiiy eii?aeeiaoe?eieo ii?ooaiue (p<0,05), i?ae o /ieia?e?a, oi/ ia?a?nii ?iceaaee eii?aeeiaoe?? o ieo aoee a?eueo ae?aaeaieie. O oai?eo c i?ia?aae??ioiei ia?aa?aii ?N a ?acoeueoao? eo?no aa?ioa?ai?? a?aecia/aeiny iiaeeaeaiiy ?nioth/i? aaaaeueii? iaaeinoaoiino? oa i?aeneeaiiy oeaio?ae?caoe?? i?ioean?a oi?aae?iiy a ii?aeiaii? c ?ea?aei?noth iieaciee?a aeoeaiino? oea?aa?aeueieo a?aio?iiieo ? neiiaoe/ieo aa?i?aoeaioi?ieo ooai?aiue, ui na?ae/eoue i?i aeniaaeaiiy aaeaioaoe?eieo iaoai?ci?a i?e i?ia?anoaaii? iaoieia?/iiai i?ioeano i?e ?N. Nooi?iue ciaioaiiy iaa?ieia?/iiai aeao?oeeoo i?e oeueiio aoa iacia/iee: NA FS ciaioeeany c 13,07±1,05 aei 12,14±1,12; o oie /an ye o a?oi? c ?ai?ooth/ei ia?aa?aii - c 9,17±0,56 aei 7,42±0,58 (p<0,05), a EDSS - n 3,65±0,23 aei 3,13±0,22. Ciaioaiiy ae?aaeaiino? ee?i?/ieo i?iya?a IAN o inoaii?o oaeiae aoei a?eueo cia/iei (p<0,01). A ?acoeueoao? a?ia?iene/iiai aieeao o oai?eo c ?ai?ooth/ei oeiii ia?aa?ao cieaeoaaeany aeoeai?noue iaaenaaiaioa?ieo no?oeoo?, ui a?aeaeeiny o ciaioaii? iai?oaeaiino? ?aaoeyoi?ieo iaoai?ci?a oa aieeao oeaio?aeueiiai eiioo?o ?aaoeyoe?? ? aoei a?eueo oa?aeoa?ii aeey noaae?? caaino?aiiy. A noaae?? ?ai?n?? a?aecia/aeiny i?aeneeaiiy neiiaoeeioii?? ia oii? iacia/iiai iineaaeaiiy naaiaioa?ieo neiiaoe/ieo, ii?iae?caoe?? ia?aneiiaoe/ieo aieea?a oa cieaeaiiy aeoeaiino? oea?aa?aeueieo a?aio?iiieo nenoai, ui noi?iaiaeaeoaaeiny aeayeei i?aeaeuaiiyi iai?oae i?ioean?a ?aaoeyoe??, i?ioa iieacieee aaoiei?aeyoe?eiiai aiae?co ci?ithaaeeny a i?ioeeaaeieo iai?yieao. Ineoio?c?ieia?/i? iieacieee a ?acoeueoao? eo?no AAI a??ia?aeieo ci?i ia caciaee, i?ioa iiaeia a?aecia/eoe, ui a a?oi? c ee?i?/iei iie?ioaiiyi caa??aaeany ia?a?nia ia?aaaaa o?ioio?iiieo i?ioean?a; o oai?eo c a?aenooi?noth aeeiai?ee EDSS aecia/aeany noeeuei?noue aei i?aeneeaiiy ia?a?nii ?nioth/iai a?aio?iiiiai ?aaaoaaiiy. Cia/ia ca?eueoaiiy aaee/eie I?O ? cieaeaiiy ??aiy IIA aeaco?, iaaii, ia aeoeai?noue oa aaeaeaaoi?noue aaeaioeaieo ?aaeoe?e o a?oi? oai?eo c iiceoeaiith aeeiai?eith iaa?ieia?/iiai noaoono; o oai?eo c a?aenooi?noth ?aa?ano iaa?ieia?/iiai aeao?oeeoo I?O iaa oaiaeaioe?th aei ciaioaiiy, a IIA c?inoaa a iacia/iiio nooiai?, ui iiaea a?aeaeaaoe ?ia?oi?noue ?aaoeyoi?ieo iaoai?ci?a. Ciaioaiiy aaee/eie eiao?oe?aioa RR30:15 c 1,01±0,02 (p<0,001 c eiio?ieai) aei 0,98±0,03 (p<0,001) i?ney eo?no aa?ioa?ai?? na?ae/eoue i?i i?aeneeaiiy aaaaeueii? iaaeinoaoiino? oa iiaea cacia/aoe ia iai?oaeai?noue ? aeniaaeaiiy naaiaioa?ieo ia?aneiiaoe/ieo iaoai?ci?a i?e aieea? a?ia?aa?e/iiai eenith. ?acii c oei aeaiee oaeo iiaea na?ae/eoe i?i iaiaeii??aei?noue aeaii? a?oie ca oeei iieacieeii. Aiae?c eiai aeeiai?ee a caeaaeiino? a?ae aoaeoeaiino? AAI iieacaa ca?eueoaiiy cia/aiiy RR30:15 o oai?eo ?c iiceoeaiith aeeiai?eith EDSS c 1,00±0,04 (p<0,001) aei 1,04±0,05 (p<0,05) ? ciaioaiiy c 1,02±0,03 (p<0,001) aei 0,94±0,03 (p<0,001) - o a?oi? c a?aenooi?noth ee?i?/iiai iie?ioaiiy, ui aiai?eoue i?i ??ciee ooieoe?iiaeueiee noai ia?aneiiaoe/iiai aoa?aioiiai oeyoo a oeeo a?oiao. Aeine?aeaeaiiy ci?i aaaaoaoeaieo oa ?ioiieia?/ieo iieaciee?a o oai?eo ia ?N a caeaaeiino? a?ae ee?i?/ii? aoaeoeaiino? AAI iieacaei ??ciee noai ?aaoeyoi?ieo iaoai?ci?a o a?oiao ?c ??ciei nooiaiai ?aa?ano iaa?ieia?/iiai aeao?oeeoo. A?aenooi?noue ee?i?/iiai aoaeoo i?ney eo?no AAI ei?aethaaea c ?ea?aei?noth ?ioiieia?/ieo ? aaaaoaoeaieo iieaciee?a, ui na?ae/eoue i?i i?eai?/aiiy aaeaioaoe?eii-eiiiainaoe?eieo iaoai?ci?a i?aai?cio a oe?e a?oi?. I?e oeueiio caa??aaany aenieee ??aaiue neiiaoeeioii?? (p<0,05 c eiio?ieai) ? oea?aa?aeueii? a?aio?iiii? aeoeaiino? oa iaaeinoaoi?noue - aa?i?aoeaioi?ii? eaiee ?aaoeyoe??, niinoa??aaeiny iiaeeaeaiiy aaaonii? iaaeinoaoiino? (p<0,01 c eiio?ieai) oa i?aeneeaiiy iai?oaeaiino? ?aaoeyoi?ieo i?ioean?a. A?aeiinii iecueeee ??aaiue A-e?ioioeeo?a (15,88±1,62%; aaniethoia e?euee?noue - 0,25±0,05o109/e), oaio?e?i/ooeeaeo O-e?ioioeeo?a (15,38±1,86%; 0,08±0,02) oa IgG (12,88±0,58 a/e) ? a?aenooi?noue ?oiuei? aeeiai?ee a ?acoeueoao? a?ia?iene/iiai aieeao cacia/aei ia aeniaaeaiiy ?ioii?aaoeyoi?ieo iaoai?ci?a a a?oi? c a?aenooi?noth ee?i?/iiai iie?ioaiiy, ui i?aeoaa?aeaeoaaeiny caa?aaeaiiyi i?ney e?eoaaiiy aeai?an?? oaio?e?i?ac?noaioieo O-e?ioioeeo?a o oeeo oai?eo (13,13±1,92%; 0,19±0,04). Ciaioaiiy iaa?ieia?/iiai aeao?oeeoo c? cieaeaiiyi EDSS a na?aaeiueiio ia 0,67 aaea noi?iaiaeaeoaaei cieaeaiiy aeoeaiino? iaaenaaiaioa?ieo ?aaoeyoi?ieo iaoai?ci?a, ii?iae?caoe?y aieea?a naaiaioa?iiai neiiaoe/iiai ? ia?aneiiaoe/iiai ??ai?a ?aaoeyoe?? aaaaoaoeaiiai oiiono, ca?eueoaiiy ??aiy IgG (c 11,73±0,60 aei 13,44±0,31; p<0,05) ? aaniethoii? e?eueeino? noaiiioeyoe?e O-e?ioioeeo?a c noi?ani?iith aeoeai?noth, ui noi?iaiaeaeoaaeiny ciaioaiiyi iai?oae ?aaoeyoi?ieo iaoai?ci?a ? a?aeaeaa? caa?aaeaiiy i?ioean?a aaeaioaoe??-eiiiainaoe?? a aeai?e a?oi? oai?eo. Aaaaoaoeai? c?ooaiiy o oai?eo ia ?N ia aoaiao naaino AAI. Aeine?aeaeaiiy iieaciee?a IA?N i?ae /an naaino AAI aeyaeei oa?aeoa?i? c?ooaiiy ia?aiao??a aaaaoaoeaiiai aiiainoaco i?ioyaii aa?inaaino a caeaaeiino? a?ae ia??iaeo naaino oa /ano aeniiceoe??. Aeai? ci?ie aaaaoaoeaii? ?aaoeyoe?? na?ae/aoue i?i ?icaeoie ia?ao?aeieo i?ioean?a ? noaiiaeaiiy ?ioeo ??ai?a ooieoe?iioaaiiy ?aaoeyoi?ieo iaoai?ci?a. A ia?o? i’youe oaeeei eiii?an?? anoaiiaeaii ?noioio iai?oao iaoai?ci?a aaaaoaoeaii? ?aaoeyoe??. Ia aoaiao ?cii?an?? niinoa??aaeiny ciaioaiiy aieea?a oeaio?aeueiiai eiioo?o ?aaoeyoe?? oa ia?ao?ae nenoaie ia a?eueo iecueeee ? aeiiii?/iee ??aaiue ooieoe?iioaaiiy c ia?aaaaith aaoiiiiiiai eiioo?o ia aoaiao ?cii?an??. I?e aiae?c? aeeiai?ee ci?i iaea?eueo cia/oueo iio?aeieo IA?N i?ae /an naaino AAI aeyaeai? ?ai?oa iaa?aeii? aeinoia??i? noaoenoe/i? aeai? i?i ??ci? c?ooaiiy aaaaoaoeaii? ?aaoeyoe?? a ??cieo ee?i?/ieo a?oiao. Oea iniaeeai /?oei aeyaeyeiny ca aeaieie dRR, SrQdr, AKF1, IndBc oa MaxD ? noaei i?aenoaaith aeey aeae?eaiiy ii?iaeueii? a?oiiai? ?aaeoeaiino? aei e?eoaaeueii? a?ia?ien??, yea a?aeaeaa? aaeaeaaoi?noue ?aaeoe?e aaeaioaoe??, ui aeieeathoue i?e aieea? a?ia?aa?e/iiai eenith oa iia’ycai? c aeoeaaoe??th ieenethaaeueii-aioeieneaeaioieo i?ioean?a, ? cieaeaii?, ui na?ae/eoue i?i i?eai?/aiiy aaeaioaoe?eii-eiiiainaoe?eieo iaoai?ci?a ? ii?ooaiiy aaeaino ieenethaaeueii-aioeieneaeaioieo nenoai a i?aai?ci?. I?e oeueiio a a?oiao c ??ciith A? iieacieee IA?N i?ae /an aa?inaaino cia/ii ia ?ic??ciyeeny. Iaio ni?eyoeea? ci?ie aaaaoaoeaii? ?aaoeyoe?? o oai?eo c a?eueoith oyaee?noth noaio, i?ia?aae??ioiei ia?aa?aii ? iecueeith aoaeoeai?noth AAI, ui ae?aceeiny a ?ea?aeiino? aeeiai?ee iieaciee?a dRR, SrQdr, AKF1 ? MaxD, cacia/athoue ia iia??oaiiy aaeaioeaieo iaoai?ci?a a i?ioean? a?ia?ien?? ?, ye iane?aeie, ia cieaeaiiy ?acenoaioiino? i?aai?cio aei a?ia?ien??. Iaea?eueo iani?eyoeeaee oa?aeoa? ci?i iieaciee?a IA?N aecia/aany o oai?eo c aoi?eiii-i?ia?aae??ioiei oeiii ia?aa?ao ?N (?en. 1), o yeeo iaeaea ia niinoa??aaeiny i?aeneeaiiy aaaaeueieo naaiaioa?ieo aieea?a, a nooi?iue oeaio?ae?caoe?? i?ioean?a ?aaoeyoe?? ia i?ioyc? an?o aoai?a aa?inaaino ia?aaeuoaaa ia?a?niee. ?en. 1. Aeeiai?ea iieaciee?a IA?N o oai?eo c ?ai?ooth/ei (1), ia?aeiii-i?ia?aae??ioiei (2) ? aoi?eiii-i?ia?aae??ioiei (3) ia?aa?aii ?N i?ae /an AAI. I?e ?iciiae?e? oai?eo ?c aeiiiiiaith eeanoa?iiai aiae?co ia aea? a?oie c aeinoia??ii ??ciei nooiaiai iaa?ieia?/iiai aeao?oeeoo (EDSS - 3,48±0,24 ? 5,43±0,33; NA FS - 8,46±0,61 ? 13,25±0,72 a?aeiia?aeii; p<0,001) io?eiaii cia/i? a?aei?iiino? a ci?i? aaaaoaoeaieo iieaciee?a i?ioyaii naaino AAI. Oea iiynith? iaiaeiicia/i? ?acoeueoaoe aa?ioa?ai?? o aaaeeeo oai?eo (2-e eeanoa?) ? aeaiiino?o? caeaaei?noue aoaeoo AAI a?ae aeice a?ia?ien?? oa ?iaeea?aeoaeueii? /ooeeaino? aei a?ia?aa?e/iiai eenith. Iaea?eueo cia/oueie a ia??iae ?cii?an?? aeyaeeeny ca?eueoaiiy dRR, SrQdr, MaxD oa cieaeaiiy AKF1 ? IndBc, a?eueo ae?aaeai? o oai?eo ?c iaioei nooiaiai iaa?ieia?/iiai aeao?oeeoo, c ?ai?ooth/ei oeiii ia?aa?ao ? c aeinyaiaiiyi ee?i?/iiai iie?ioaiiy. Cia/ia aa??aaaeuei?noue aeeiai?ee aeaieo iieaciee?a i?ae /an aa?inaaino na?ae/eoue i?i ??ciee noai ?aaoeyoi?ieo iaoai?ci?a o aeae?eaieo a?oiao, ui aecia/a? ii?iaeueiee ? cieaeaiee oeie ?aaeoeaiino? aei a?ia?ien??, iaea?eueo /?oei ae?aaeai? o oi?eo c ??ciith aoaeoeai?noth e?eoaaiiy (?en. 2). ?en. 2. Ci?ie iieaciee?a IA?N ia aoaiao naaino AAI o oai?eo ia ?N c iiceoeaiith aeeiai?eith EDSS (1) oa aac ee?i?/iiai iie?ioaiiy (2). ?c cae?i/aiiyi naaino aeai? iieacieee a oeeo a?oiao caeeoaeeny ia aeinyaiooiio ??ai?, a oie /an ye o oai?eo ?c a?eueoith oyaee?noth noaio, i?ia?aae??ioiei ia?aa?aii ? iecueeith aoaeoeai?noth AAI - iaee oaiaeaioe?th aei iiaa?iaiiy aei ia?a?niiai ??aiy ? iaa?oue ia?aaeuoaaee eiai (AKF1), ui iiaeia iia’ycaoe c ?nioth/ith iaoiaaiiith ae??th a?ia?aa?e/iiai eenith. Aaea i?e ii??aiyii? aeeiai?ee ci?i aaaaoaoeaii? ?aaoeyoe?? ia i?ci?o aoaiao ?cii?an?? (6-8 aoaie) iiaeia aeyaeoe iani?eyoeea? c?ooaiiy iieaciee?a AKF1 ? MaxD o aeaeyae? iineeaiiy nooiaiy oeaio?ae?caoe?? ?aaoeyoi?ieo i?ioean?a oa aeniaaeaiiy naaiaioa?iiai ia?aneiiaoe/iiai ??aiy ?aaoeyoe?? na?oeaaiai ?eoio, ui a?aeaeaa? ii/aoeia? iciaee iaoiaaiieo aoaeo?a a?ia?ien??. Oaeei /eiii, io?eiai? ?acoeueoaoe na?ae/aoue i?i ??cio i?ieea?noue neeaaeiaeo aaaaoaoeaiiai aiiainoaco o oai?eo ia ?N i?e ae?? iaeiaeiai? aeice a?ia?aa?e/iiai eenith a caeaaeiino? a?ae oyaeeino? caoai?thaaiiy ? oeio ia?aa?ao iaoieia?/iiai i?ioeano. Iniaeeaino? aaaaoaoeaii? ?aaeoeaiino? aei e?eoaaeueii? a?ia?ien?? aeicaieythoue noaeeoe i?i ooieoe?iiaeueiee noai ?aaoeyoi?ieo iaoai?ci?a ? oa?aeoa?ecothoue, iaaii, aaeain ieenethaaeueieo oa aioeieneaeaioieo nenoai oai?iai. Aecia/aiiy ?aaeoeaiino? aei a?ia?aa?e/iiai eenith ni?ey? ?iaeea?aeoae?caoe?? oaeoeee canoinoaaiiy AAI: ?ea?aei?noue iieaciee?a IA?N i?ae /an aa?inaaino cacia/a? ia iani?iiiaei?noue aaeaioeaieo iaoai?ci?a ? ia iani?eyoeeaee i?iaiic aa?ioa?ai?? i?e aeai?e aeic? a?ia?ien??. ?acii c oei aeyaeai? a?aei?iiino? a aeeiai?oe? iio?aeieo na?oeaaiai ?eoio ia aoaiao aa?inaaino o oai?eo ia ?N c ??ciith aoaeoeai?noth e?eoaaiiy ? aeieacii caeaaeiino? aoaeoo e?eoaaeueii? a?ia?ien?? i?e ?N a?ae ooieoe?iiaeueiiai noaio ?aaoeyoi?ieo iaoai?ci?a, ui aecia/a? aaeaeaaoi?noue aaeaioeaii-eiiiainaoe?eieo i?ioean?a i?ae /an AAI. A?aoiaoth/e, ui aaaaoaoeai? ii?ooaiiy i?ae /an ae?? a?ia?aa?e/iiai eeniy ia?aaeothoue niiaoe/iei (Caeueoeiai A.E., Naeea?a A.E., 1987), c iaoith iioei?caoe?? aeicoaaiiy e?eoaaeueii? a?ia?ien?? iaiao?aeiee eiio?ieue aaaaoaoeaii? ?aaeoeaiino? aaciina?aaeiuei i?ae /an aa?ioa?ai?? aeey caiia?aaiiy iani?eyoeeaeo ?aaeoe?e AAI. AENIIAEE 1.Aaaaoaoeaia aeenooieoe?y a?aeaeaa? cieaeaiiy aaeaioaoe?eii-i?enoinoaaeueieo iiaeeeainoae o oai?eo ia ?N: ?c i?ia?anoaaiiyi caoai?thaaiiy oa ca?eueoaiiyi oyaeeino? noaio a?aeaoaa?oueny i?aeneeaiiy naaiaioa?ii? neiiaoe/ii? oa ia?aneiiaoe/ii? iaaeinoaoiino? ia oii? cia/ii? ooieoe?iiaeueii? iai?oae oeaio?aeueieo ?aaoeyoi?ieo iaoai?ci?a. 2.Ee?i?/iee aoaeo AAI o oai?eo ia ?N ei?aeth? ?c ciaioaiiyi aeoeaiino? oea?aa?aeueieo a?aio?iiieo nenoai ? cieaeaiiyi iai?oae ?aaoeyoi?ieo iaoai?ci?a ia oii? ii?iae?caoe?? naaiaioa?iiai neiiaoe/iiai ? ia?aneiiaoe/iiai ??ai?a ?aaoeyoe??. 3.Oai?? c a?aenooi?noth ee?i?/iiai iie?ioaiiy oa?aeoa?ecothoueny ?ea?aei?noth aeeiai?ee ?ioiieia?/ieo iieaciee?a ? aeeiai?ee iaaenaaiaioa?ieo ? aa?i?aoeaioi?ieo aieea?a, iiaeeaeaiiyi aaaaeueii? iaaeinoaoiino? oa iai?oaeaiino? ?aaoeyoi?ieo i?ioean?a a ?acoeueoao? eo?no aa?ioa?ai??, ui na?ae/eoue i?i i?eai?/aiiy ?aaoeyoi?ieo iaoai?ci?a. 4.Aeyaeaii aeaa oeie ?aaeoeaiino? aei e?eoaaeueii? a?ia?ien?? i?ae /an aa?inaaino: ii?iaeueia ?aaeoeai?noue a?aeaeaa? aaeaeaaoio aeoeaaoe?th aaeaioaoe?eii-i?enoinoaaeueieo iaoai?ci?a, ui caaacia/o? aoaeoeaiee e?eoaaeueiee ?acoeueoao; cieaeaia - na?ae/eoue i?i i?eai?/aiiy i?ioean?a aaeaioaoe??-eiiiainaoe??, ui ia?aoeiaeaeo? aeinyaiaiith e?eoaaeueiiai aoaeoo AAI. 5.I?e aieea? a?ia?aa?e/iiai eenith iathoue i?noea ye e?eoaaeuei?, oae ? iaoiaaii? aoaeoe. Aeinyaiaiiy e?eoaaeueiiai aoaeoo noi?iaiaeaeo?oueny cieaeaiiyi neiiaoeeioii??, nooiaiy iai?oaeaiino? ?aaoeyoi?ieo nenoai ? aieeao oeaio?aeueieo iaoai?ci?a ?aaoeyoe?? i?e iineeaii? aeoeaiino? aa?i?aoeaioi?ii? oa aaaaeueii? eaiie aaaaoaoeaii? ?aaoeyoe?? i?ae /an naaino AAI. 6.Iaoiaaiia ae?y a?ia?ien?? i?e iaeiaeia?e aeic? AAI i?iyaey?oueny ?ai?oa o oai?eo c? cieaeaiith ?aaeoeai?noth aei eenith ? aeeeeea? i?aeaeuaiiy nooiaiy oeaio?ae?caoe?? ?aaoeyoi?ieo iaoai?ci?a ?c aeniaaeaiiyi naaiaioa?iiai ia?aneiiaoe/iiai ??aiy aaaaoaoeaii? ?aaoeyoe?? i?ae /an aa?inaaino. 7.I?ecia/aiiy aa?ioa?ai?? ? aecia/aiiy ?aaeei?a aeicoaaiiy a?ia?aa?e/iiai eenith i?e e?eoaaii? ?N iiaeiii aooe ?iaeea?aeoaeueiei ? a?aoiaoaaoe caa?aaeai?noue aaeaioeaii-eiiiainaoe?eieo iaoai?ci?a: o aeiaaeeo aeniaaeaiiy ?aaeoe?e aaeaioaoe?? o a?aeiioaii? aei e?eoaaeueii? a?ia?ien?? canoinoaaiiy aeaii? aeice AAI ia i?ecaiaeeoue aei ciaioaiiy iaa?ieia?/iiai aeao?oeeoo. I?aeoe/i? ?aeiiaiaeaoe?? 1.Aeey aecia/aiiy oaeoeee canoinoaaiiy AAI i?e ?N ?aeiiaiaeo?oueny ?c aeiiiiiaith ?ic?iaeaii? iaoiaeeee a?aoiaoaaoe ?iaeea?aeoaeueiee noai aaeaioeaii-i?enoinoaaeueieo iaoai?ci?a, yeee aecia/a?oueny iniaeeainoyie aaaaoaoeaii? ?aaeoeaiino? aei e?eoaaeueii? a?ia?ien?? i?ae /an aa?inaaino. 2.AAI-oa?ai?th iaea?eueo aoaeoeaii i?ecia/aoe oai?ei ia ?N a noaae?? ?ai?n?? i?e ?ai?ooth/iio oei? ia?aa?ao caoai?thaaiiy. A ?ioeo aeiaaeeao aeey i?aeaeuaiiy aoaeoeaiino? e?eoaaiiy iaiao?aeii cae?enithaaoe i?aea?? aeice a?ia?aa?e/iiai eenith ? ?aaeeio AAI ia i?aenoaa? aiae?co aaaaoaoeaieo c?ooaiue i?ae /an aa?inaaino ca aeaieie IA?N. 3.A ?ac? a?aenooiino? ciaioaiiy aieea?a oeaio?aeueieo iaoai?ci?a oi?aae?iiy na?oeaaei ?eoiii ? iineeaiiy aieea?a naaiaioa?iiai ia?aneiiaoe/iiai ??aiy ?aaoeyoe?? i?ae /an naaino AAI, yea na?ae/eoue i?i i?eai?/aiiy aaeaioaoe?eieo ?aaeoe?e i?aai?cio, ?aeiiaiaeo?oueny i?iaiaeeoe ei?aeoe?th aa?ioa?aiaaoe/iiai ?aaeeio ? canoiniaoaaoe a?eueo iecueeo aeico a?ia?aa?e/iiai eenith. 4.I?ioeeaaeia ni?yiiaai?noue ii/aoeiaeo ni?eyoeeaeo ci?i iieaciee?a IA?N, ye? a?aeaeaathoue aieea oeaio?aeueieo ? aaaaeueieo ?aaoeyoi?ieo iaoai?ci?a, iia’ycaia c aeyaii iaoiaaiii? ae?? a?ia?ien?? ? na?ae/eoue i?i aeniaaeaiiy iaoai?ci?a aaeaioaoe??, ui aeiaaa? ci?ie ?aaeeio AAI. NIENIE I?AOeUe, IIOAE?EIAAIEO CA OAIITH AeENA?OAOe?? 1.Ai?iaueaa E.I., Aecthaa A.I., Ni?ieei TH.I. Eciaiaiey aaaaoaoeaiie ?aaoeyoeee o aieueiuo ?annayiiui neea?icii ai a?aiy aeia?aa?e/aneie ieneaaiaoeee // E?ea?nueea ni?aaa. - 1998. - ? 7. - N. 85-88. 2.Ni?ieei TH.I. Acaeiinaycue aaaaoaoeaiuo ia?ooaiee e oyaeanoe oa/aiey ?annayiiiai neea?ica // Oe?a?inueeee iaaee/iee aeueiaiao. - 1998. - O. 1, ? 4. - N. 51-53. 3.Ni?ie?i TH.I. Ni?yiiaai?noue aaaaoaoeaieo ?aaeoe?e o oai?eo ia ?icn?yiee neea?ic i?ae aieeaii oa?aiaaoe/ieo ae?e // Oe?a?inueeee iaaee/iee aeueiaiao. - 1999. - O. 2, ? 1. - N. 137-140. 4.Ni?ie?i TH.I. Aaaaoaoeaia ?aaeoeai?noue o oai?eo ia ?icn?yiee neea?ic // A?niee A?iieoeueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo. - 1999. - O. 3, ? 1. - N. 118-119. 5.Ni?ie?i TH.I. Iae?i?ioii? caeiiii??iino? aoaeoeaiino? AAI i?e ?icn?yiiio neea?ic? // Iaoeiaee a?niee Oaeai?iaenueeiai oi?aa?neoaoo, na??y “Iaaeeoeeia”. - 1999. - Aei. 7. - N. 167-170. 6.Ni?ie?i TH.I. Aaaaoaoeai? iaoai?cie a aeaatho? ?icn?yiiai neea?ico // Aoeiaeinueeee iaaee/iee a?niee. - 1999. - O. 3, ?1. - N. 107-111. 7.Ai?iaueaa E.I., Aecthaa A.I., Ni?ieei TH.I. Aaaaoaoeaiay ?aaeoeaiinoue o aieueiuo ?annayiiui neea?icii ia yoaiao naainia AAI // Oe?a?inueeee iaaee/iee aeueiaiao. - 1999. - O. 2, ? 2. - N. 41-44. 8.Ni?ieei TH.I. Aeeyiea AAI ia eiioiiue noaoon aieueiuo ?annayiiui neea?icii // Aeooaeuei? i?iaeaie aeooa?noaa ? a?iaeieia??, ee?i?/ii? ?ioiieia?? oa iaaee/ii? aaiaoeee. Ca. iaoe. i?. Aei. 3. - Ee?a - Eoaainuee. - 1999. - N. 221-228. 9.Ni?ieei TH.I., Aecthaa A.I. Ia?aiao?u aaaaoaoeaiiai aiiainoaca o aieueiuo ?annayiiui neea?icii // “Iaaeeei-a?ieia?/i? i?iaeaie i?iieneiaiai ?aa?iio”. Ca. iaoe. no. a/aieo Eoaainueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo. Aei. 1. - Eoaainuee: Aeoaeeia. - 1997. - N. 183-186. 10.Ni?ieei TH.I. I?e/eiu ?acee/iie yooaeoeaiinoe eioaineaiie oa?aiee ?annayiiiai neea?ica iaoiaeii AAI // “Yeno?aiaeueiay iaaeeoeeia. Nia?aiaiiua eiioeaioeee aianoaceieiae/aneie e oe?o?ae/aneie iiiiue”. Iaoa?eaeu Iaaeiaeanoiie iao/ii-i?aeoe/. eiio. aianoaceieiaia e oe?o?aia. - Eoaaine. - 1998. - N. 203-205. 11.Ai?iaueaa E.I., Aecthaa A.I., Ni?ieei TH.I. Iiaay oaoiieiaey aeeiaie/aneie ioeaiee aaaaoaoeaiie ?aaeoeaiinoe e ?acenoaioiinoe // “Nia?aiaiiua aniaeou yeaeo?iiae?inoeioeyoeee e iiaua oaoiieiaee a iae?ioe?o?aee e iaa?ieiaee”. Na. o?. ?inneeneie iao/ii-i?aeoe/. eiio., iina. 50-eaoeth eeeieee iae?ioe?o?aee Na?aoianeiai IEEOI. - Na?aoia. - 1998. - N. 148-150. 12.Ai?iaueaa E.I., Aecthaa A.I., Ni?ieei TH.I. I?e/eiu ?acee/iie yooaeoeaiinoe AAI i?e ?annayiiii neea?ica // “Nia?aiaiiua aniaeou yeaeo?iiae?inoeioeyoeee e iiaua oaoiieiaee a iae?ioe?o?aee e iaa?ieiaee”. Na. o?. ?inneeneie iao/ii-i?aeoe/. eiio., iina. 50-eaoeth eeeieee iae?ioe?o?aee Na?aoianeiai IEEOI. - Na?aoia. - 1998. - N. 180-182. 13.Aecthaa A.I., Ai?iaueaa E.I., Ni?ieei TH.I. Aaaaoaoeaiay iaoieiaey o aieueiuo ?annayiiui neea?icii iiae aeeyieai AAI-oa?aiee // “Iiaia a iaoieiaee: oai?ey e i?aeoeea”. Iaoa?eaeu iao/ii-i?aeoe/. eiio. 29.03 - 04.04.1999 a. - O/o “Iiaaa”, Naaanoiiieue - Noaiaoe - Naaanoiiieue. - 1999. - N. 15-17. AIIOAOe?ss Ni?ie?i TH.I. - Aaaaoaoeai? iieacieee o oai?eo ia ?icn?yiee neea?ic oa ?o aeeiai?ea ia aoaiao a?ia?aa?e/ii? ieneaaiaoe??. - ?oeiien. Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe ca niaoe?aeuei?noth 14.01.15 - ia?aia? oai?iae. - Ee?anueea iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe ?i. I.E. Ooieea IIC Oe?a?ie, Ee?a, 1999. Aeine?aeaeaii aaaaoaoeaio ?aaoeyoe?th o oai?eo ia ?icn?yiee neea?ic (?N) i?ioyaii eo?no oa naaino a?ia?aa?e/ii? ieneaaiaoe?? (AAI). Iieacaii ciaioaiiy aeoeaiino? oea?aa?aeueieo a?aio?iiieo nenoai ? cieaeaiiy iai?oae ?aaoeyoi?ieo iaoai?ci?a ia oii? ii?iae?caoe?? naaiaioa?iiai ??aiy ?aaoeyoe?? o oai?eo c ee?i?/iith aoaeoeai?noth AAI ca ?icoe?aiith oeaeith nooiaith ?iaae?aeiino? Kurtzke (EDSS). O oai?eo c a?aenooi?noth ee?i?/iiai iie?ioaiiy a?aecia/aeany ?ea?aei?noue aeeiai?ee ?ioiieia?/ieo iieaciee?a oa aeeiai?ee iaaenaaiaioa?ieo ? aa?i?aoeaioi?ieo aieea?a, iiaeeaeaiiy aaaaeueii? iaaeinoaoiino? oa iai?oaeaiino? ?aaoeyoi?ieo i?ioean?a, ui na?ae/eoue i?i i?eai?/aiiy ?aaoeyoi?ieo iaoai?ci?a. Aeyaeaii aeaa oeie ?aaeoeaiino? aei e?eoaaeueii? a?ia?ien?? i?ae /an aa?inaaino o oai?eo ia ?N: ii?iaeueia ?aaeoeai?noue a?aeia?aaeo? aaeaeaaoio aeoeaaoe?th aaeaioaoe?eii-i?enoinoaaeueieo iaoai?ci?a, ui caaacia/o? aoaeoeaiee e?eoaaeueiee ?acoeueoao; cieaeaia - na?ae/eoue i?i i?eai?/aiiy i?ioean?a aaeaioaoe??-eiiiainaoe??, ui ia?aoeiaeaeo? aeinyaiaiith e?eoaaeueiiai aoaeoo AAI. Eeth/ia? neiaa: aaeaioaoe?y, a?ia?aa?e/ia ieneaaiaoe?y, aaaaoaoeaia ia?aiaa nenoaia, aa??aaaeuei?noue na?oeaaiai ?eoio, ?aaeoeai?noue, ?icn?yiee neea?ic. ANNOTATION Sorokin Yu.N. - Vegetative parameters in patients with multiple sclerosis and their changes at stages of a hyperbaric oxygenation. - Manuscript. Thesis for the Candidate of Medical Sciences degree by speciality 14.01.15 - nervous diseases. - Kyiv Medical Academy of Post-Graduated Education named after P. Shupyk, Health Ministry of Ukraine, Kyiv, 1999. The vegetative regulation in the patients with multiple sclerosis (MS) is investigated during a rate and session of the hyperbaric oxygenation (HBO). The reduction of activity of cerebral ergotrope systems and voltage reduction of regulation mechanisms on a background of normalization of a segmental level of a regulation in the patients with clinical efficiency of the HBO on the Expanded Disability Status Scale Kurtzke (EDSS) is shown. The rigidity of changes of immunological parameters and changes suprasegmental and baroreflex influences, deepening of vagal insufficiency and intensity of regulation processes was marked in the patients with absence of clinical improvement, that testifies to an oppression of regulation mechanisms. Two types of the reactivity to a medical hyperbaric oxygen are revealed in the patients with MS during a baroseance such as: the normal reactivity reflects adequate activation of mechanisms of adaptation and compensation ensuring effective medical result; reduced reactivity testifies to an oppression of processes of adaptation-indemnification interfering to achievement of medical effect of the HBO. Key words: adaptation, vegetative nervous system, heart rate variability, hyperbaric oxygenation, multiple sclerosis, reactivity. AIIIOAOeEss Ni?ieei TH.I. Aaaaoaoeaiua iieacaoaee o aieueiuo ?annayiiui neea?icii e eo aeeiaieea ia yoaiao aeia?aa?e/aneie ieneaaiaoeee. - ?oeiienue. Aeenna?oaoeey ia nieneaiea o/aiie noaiaie eaiaeeaeaoa iaaeeoeeineeo iaoe ii niaoeeaeueiinoe 14.01.15 - ia?aiua aieacie. - Eeaaneay iaaeeoeeineay aeaaeaiey iineaaeeieiiiiai ia?aciaaiey ei. I.E. Ooieea IC Oe?aeiu, Eeaa, 1999. Ianeaaeiaaiu 105 aieueiuo ?annayiiui neea?icii (?N) n ?acee/iui oeiii oa/aiey e noaaeeae caaieaaaiey. Onoaiiaeaia iaaeinoaoi/iinoue naaiaioa?iuo neiiaoe/aneeo e ia?aneiiaoe/aneeo iaoaieciia ?aaoeyoeee ia oiia aeoeaaoeee oea?aa?aeueiuo y?aio?iiiuo ia?aciaaiee e iai?yaeaiey ?aaoeyoi?iuo nenoai, /oi io?aaeaao nieaeaiea aaeaioaoeeiiii-i?eniiniaeoaeueiuo aiciiaeiinoae i?e ?N. Iaeaieaa cia/eoaeueiay noaiaiue neiiaoeeioiiee, iai?yaeaiey i?ioeannia ?aaoeyoeee, oaiaoaiey oiiona aaaona e aa?i?aoeaioi?iie iaaeinoaoi/iinoe auyaeaia o aieueiuo n i?ia?aaeeaioiui oeiii oa/aiey ?N. O aieueiuo n ?aieooe?othuei oa/aieai ?N ?aaoeyoi?iua iaoaieciu ieacaeenue aieaa nio?aiiuie. Aiaeec aa?eaaaeueiinoe na?aea/iiai ?eoia iieacae oneeaiea neiiaoeeioiiee, iaaeinoaoi/iinoe aa?i?aoeaioi?iuo e aaaaeueiuo aeeyiee e oeaio?aeecaoeee i?ioeannia oi?aaeaiey ii ia?a oaaee/aiey noaiaie oyaeanoe ninoiyiey aieueiuo ?N e aeeeoaeueiinoe caaieaaaiey. Enneaaeiaaia aaaaoaoeaiay ?aaoeyoeey o aieueiuo ?N ia i?ioyaeaiee eo?na e naaina aeia?aa?e/aneie ieneaaiaoeee (AAI). O aieueiuo n i?ia?aaeeaioiui oa/aieai ?N a ?acoeueoaoa eo?na aa?ioa?aiee i?ienoiaeeei oaeoaeaiea eiaaoaeny aaaaeueiie iaaeinoaoi/iinoe e oneeaiea oeaio?aeecaoeee i?ioeannia oi?aaeaiey a ni/aoaiee n ?eaeaeiinoueth iieacaoaeae aeoeaiinoe oea?aa?aeueiuo y?aio?iiiuo e neiiaoe/aneeo aa?i?aoeaioi?iuo ia?aciaaiee, /oi naeaeaoaeuenoaoao ia enoiuaiee aaeaioaoeeiiiuo iaoaieciia i?e i?ia?anne?iaaiee iaoieiae/aneiai i?ioeanna i?e ?N. ?aciiiai?aaeaiiay aeeiaieea ia?aiao?ia aaaaoaoeaiiai aiiainoaca o aieueiuo n ?acee/iie noaaeeae i?e ?aieooe?othuai oeia oa/aiey ?N oeacuaaao ia iaiaeii?iaeiinoue ninoiyiey ?aaoeyoi?iuo iaoaieciia a aeaiiie a?oiia. Iieacaii oiaiueoaiea aeoeaiinoe oea?aa?aeueiuo y?aio?iiiuo nenoai e nieaeaiea iai?yaeaiey ?aaoeyoi?iuo iaoaieciia ia oiia ii?iaeecaoeee naaiaioa?iiai o?iaiy ?aaoeyoeee o aieueiuo n eeeie/aneie yooaeoeaiinoueth AAI ii ?anoe?aiiie oeaea noaiaie eiaaeeaeiinoe Kurtzke (EDSS). Aieueiua n ionoonoaeai eeeie/aneiai oeo/oaiey oa?aeoa?eciaaeenue ?eaeaeiinoueth aeeiaieee eiioiieiae/aneeo iieacaoaeae e aeeiaieee iaaenaaiaioa?iuo e aa?i?aoeaioi?iuo aeeyiee, oaeoaeaieai aaaaeueiie iaaeinoaoi/iinoe e oneeaieai iai?yaeaiiinoe ?aaoeyoi?iuo i?ioeannia, /oi naeaeaoaeuenoaoao ia oaiaoaiee ?aaoeyoi?iuo iaoaieciia. Ai a?aiy aa?inaaina o aieueiuo ?N i?ienoiaeeei nieaeaiea neiiaoeeioiiee e noaiaie iai?yaeaiey ?aaoeyoi?iuo nenoai i?e oneeaiee aeoeaiinoe aa?i?aoeaioi?iuo e aaaaeueiuo iaoaieciia ?aaoeyoeee e aeoeaaoeee oea?aa?aeueiuo y?aio?iiiuo no?oeoo?. Ia?aoiae nenoaiu ia aieaa ieceee e yeiiiie/iue o?iaaiue ooieoeeiie?iaaiey ia yoaiao ecii?annee nii?iaiaeaeaeny aeaoeaio?aeecaoeeae i?ioeannia oi?aaeaiey na?aea/iui ?eoiii. Ia i?ioyaeaiee naaina AAI iaaethaeaeenue ?acee/ey a aeeiaieea iieacaoaeae aaaaoaoeaiie ?aaoeyoeee a caaeneiinoe io iiea, oa/aiey, noaaeee iaoieiae/aneiai i?ioeanna, noaiaie iaa?ieiae/aneiai aeaoeoeeoa, oyaeanoe ninoiyiey e yooaeoeaiinoe i?iaaaeaiiiai ea/aiey, /oi aeieacuaaao nouanoaiaaiea ?acee/ee a ninoiyiee ?aaoeyoi?iuo iaoaieciia a oeacaiiuo a?oiiao aieueiuo. Iaeiaiaa aeaaii?eyoiua eciaiaiey aaaaoaoeaiie ?aaoeyoeee ioia/aeenue o iaoeeaioia n aoi?e/ii-i?ia?aaeeaioiui oa/aieai ?N, o eioi?uo ia i?ienoiaeeei oneeaiea aaaaeueiuo aeeyiee, a noaiaiue oeaio?aeecaoeee i?ioeannia ?aaoeyoeee ia i?ioyaeaiee anao yoaiia aa?inaaina i?aauoaea enoiaeiue, /oi io?aaeaao ianinoiyoaeueiinoue aaeaioaoeeiiiuo iaoaieciia. Auyaeaiu aeaa oeia ?aaeoeaiinoe e ea/aaiie aeia?ienee ai a?aiy aa?inaaina o aieueiuo ?N: ii?iaeueiay ?aaeoeaiinoue io?aaeaao aaeaeaaoioth aeoeaaoeeth aaeaioaoeeiiii-i?eniiniaeoaeueiuo iaoaieciia, iaania/eaathuoth yooaeoeaiue ea/aaiue ?acoeueoao; nieaeaiiay - naeaeaoaeuenoaoao ia oaiaoaiee i?ioeannia aaeaioaoeee-eiiiainaoeee, i?aiyonoaothuai aeinoeaeaieth ea/aaiiai yooaeoa AAI. Iieacaiu aaaaoaoeaiua i?iyaeaiey iaoiaaiiiai yooaeoa aeia?aa?e/aneiai eenei?iaea o aieueiuo ?N ai a?aiy naaina AAI a aeaea iiauoaiey noaiaie oeaio?aeecaoeee ?aaoeyoi?iuo i?ioeannia e oaiaoaiey aeoeaiinoe naaiaioa?iiai ia?aneiiaoe/aneiai o?iaiy ?aaoeyoeee na?aea/iiai ?eoia, eioi?ua aicieeatho ?aiueoa o aieueiuo n eia?oiinoueth ?aaoeyoi?iuo i?ioeannia e oeacuaatho ia enoiuaiea aaeaioaoeeiiiuo iaoaieciia. Aeieacaia iaiaoiaeeiinoue iiieoi?eiaa iieacaoaeae aaaaoaoeaiiai aiiainoaca o aieueiuo ?N ai a?aiy aa?inaaina aeey iioeiecaoeee ea/aaiiai ?aaeeia e ii?aaeaeaiey i?aaeaanoieeia iaoiaaiiuo yooaeoia aeia?aa?e/aneiai eenei?iaea. I?aaeeiaeaii ii?aaeaeaiea ooieoeeiiaeueiiai ninoiyiey ?aaoeyoi?iuo iaoaieciia, i?iaaaeaiea ei??aeoeee aeice?iaaiey aeia?aa?e/aneiai eenei?iaea e i?iaiice?iaaiea yooaeoeaiinoe AAI-oa?aiee ia iniiaa ?aaeoeaiinoe e ea/aaiie aeia?ienee ai a?aiy aa?inaaina. Eeth/aaua neiaa: aaeaioaoeey, aeia?aa?e/aneay ieneaaiaoeey, aaaaoaoeaiay ia?aiay nenoaia, aa?eaaaeueiinoue na?aea/iiai ?eoia, ?aaeoeaiinoue, ?annayiiue neea?ic. PAGE PAGE 1

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