I?i?noa?noai ioi?iie caei?ia’y Oe?a?ie
CAII??CUeEEE AeA?AEAAIEE IAAeE*IEE OI?AA?NEOAO
OEUAIEI ??eia Aaeaioei?aia
OAeE 616.1-008.6-072:616.12-008.
331.1:616.379-008.64
CIA*AIIss OOIEOe?IIAEUeIEO OA OA?IAEIEIA?*IEO I?IA A IOe?IOe? NOAIO
NA?OeAAI-NOAeEIII? NENOAIE O OAI?EO IA OeOE?IAEE Ae?AAAO OA A?OA??AEUeIO
A?IA?OAIC?TH
14.01.11 – ea?ae?ieia?y
Aaoi?aoa?ao aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy
eaiaeeaeaoa iaaee/ieo iaoe
Caii??aeaey – 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: aeieoi? iaaee/ieo iaoe,
i?ioani? Ia?oeaaa Oaoyia
Ieaen??aia,
Aei?i?iiao?ianueea aea?aeaaia
iaaee/ia aeaaeai?y,
caa?aeoaa/ eaoaae?e
oaeoeueoaonueei? oa?ai?? oa
aiaeie?eiieia??.
Io?oe?ei? iiiiaioe:
aeieoi? iaaee/ieo iaoe, i?ioani? Ooooae ?aai Ieoaeeiae/, Caii??cueeee
aea?aeaaiee ?inoeooo oaeineiiaeaiiy e?ea??a IIC Oe?a?ie, caa?aeoaa/
eaoaae?e oa?ai?? ? 2;
aeieoi? iaaee/ieo iaoe, i?ioani? Eiaaeue Na?a?e Ieeieaeiae/, ?inoeooo
oa?ai?? AII Oe?a?ie (i. Oa?e?a), caa?aeoaa/ a?aeae?eo
a?oa??aeueii? a?ia?oii??.
I?ia?aeia onoaiiaa:
?inoeooo ea?ae?ieia?? ?i. I.Ae.No?aaeanea AII Oe?a?ie, a?aeae?e
anaioe?aeueii? a?ia?oaic?? (i. Ee?a).
Caoeno aeena?oaoe?? a?aeaoaeaoueny “_ 26__”_____n?/iy____2000 ?ieo i
“__13 00 ” aiaeei? ia can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae
17.600.02 i?e Caii??cueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao? IIC
Oe?a?ie ca aae?anith: 69035, i. Caii??aeaey, i?. Iayeianueeiai, 26.
C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? Caii??cueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo ( 69035, i. Caii??aeaey,
i?. Iayeianueeiai, 26).
Aaoi?aoa?ao ?ic?neaiee “__25___” ____a?oaeiy_____ 1999 ?.
A/aiee nae?aoa?
niaoe?ae?ciaaii? a/aii? ?aaee
aeieoi? iaaee/ieo iaoe, i?ioani?
Aieioei I.A.
CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE
Aeooaeuei?noue oaie. Na?aae caoai?thaaiue na?oeaai-noaeeiii? nenoaie
ia?oa i?noea ii ?iciianthaeaeaiino? iin?aea? a?oa??aeueia a?ia?oaic?y,
yeo ?a?no?othoue, ca aeaieie AIIC (1996), o 10 – 20 % aei?ineiai
ianaeaiiy a?eueoino? e?a?i na?oo. Aei aea?aeaa c aenieith
?iciianthaeaeai?noth a?oa??aeueii? a?ia?oaic?? a?aeiineoueny ? Oe?a?ia,
a ye?e ca?a?no?iaaii iiiaae 5 iei. oai?eo (Ni??iiaa ?.I. oa ni?aaao.,
1997; Eiaaeaiei A.I. e niaao., 1999). No?eea i?aeaeuaiiy a?oa??aeueiiai
oeneo ni?e/eiy? ?inoeueo, na?oeaao iaaeinoaoi?noue, caoai?thaaiiy ie?ie,
?icoa?oaaiiy ai?oe, ??cei i?aeaeuo? ?ecee ?ioa?eoo i?iea?aea,
ieeethc?eieo caoai?thaaiue ia?eoa?e/ieo noaeei. A?oa??aeueia a?ia?oaic?y
? iaeiei c aieiaieo oaeoi??a eaoaeueiino? a?ae iniiaieo
na?oeaai-noaeeiieo caoai?thaaiue. Cia/ia /anoeia oneeaaeiaiue,
aeiiii?/i? caeoee, aenieee ??aaiue ?iaae?aeiino? oa nia?oiino?, c
iaeiiai aieo, oa ?nioth/? iiaeeeaino? oni?oiiai ei?eaoaaiiy i?aeaeuaiiai
??aiy a?oa??aeueiiai oeneo, c ae?oaiai aieo, coiiaeththoue
aeooaeuei?noue oe??? i?iaeaie.
Iaei??th c iaea?eueo aeooaeueieo i?iaeai ee?i?/ii? iaaeeoeeie
caeeoa?oueny oaeiae oeoe?iaee ae?aaao. Oea iaoiiaeaii eiai cia/iei
iioe?aiiyi, ?aii?i ?icaeoeii oyaeeeo oneeaaeiaiue, ui i?ecaiaeyoue aei
iia??oaiiy yeino? aeeooy, aenieei ??aiai eaoaeueiino?, iaaeinoaoiueith
iiaiioith oyaeaiue i?i ao?ieia?th oa iaoiaaiaoe/i? iaoai?cie
caoai?thaaiiy (Aeaaeia E.E. e niaao., 1994; Aoeiia A.N., 1996).
Ca?aeii c ai?aeai?ieia?/ieie aeine?aeaeaiiyie, iioe?ai?noue oeoe?iaiai
ae?aaaoo iaaieiii ca?eueoo?oueny a on?o e?a?iao na?oo, neeaaeath/e a
i?iieneiai ?icaeiaieo ?aa?iiao a na?aaeiueiio 1,5 – 4 % ianaeaiiy (
Aoeiia A.N. e niaao., 1991; Aaeaaieeei I.E., 1993; Olefsky J.M., Sherwin
R.S., 1985).
Noaeeii? oneeaaeiaiiy ? iniiaiith i?e/eiith ?iaae?aeiino? oa
i?aeaeuaiiy nia?oiino? i?e oeoe?iaiio ae?aaao?. Iniaeeaa i?noea na?aae
caoai?thaaiue na?oeaai-noaeeiii? nenoaie ye i?e ?inoe?icaeaaeiiio, oae
? i?e ?inoe?iiacaeaaeiiio oeoe?iaiio ae?aaao? caeia? a?oa??aeueia
a?ia?oaic?y, /anoioa yei? o oai?eo ia ae?aaao a 1,5 – 2 ?ace ? a?eueoa
ia?aaeuo? iioe?ai?noue a?oa??aeueii? a?ia?oaic?? na?aae ianaeaiiy a
oe?eiio (Aeaaeia E.E. e niaao., 1996; Kingston S.M., Barry G., 1988).
I?iaeaia a?oa??aeueii? a?ia?oaic?? i?e oeoe?iaiio ae?aaao? a inoaii?
?iee ana oe?oa i?eaa?oa? oaaao aeine?aeiee?a. Aea/athoueny oiie?
a?io?i?/i? oa iae?iaoii?aeuei? iaoai?cie, ui aa?ooue o/anoue a ??
?icaeoeo oa noaiiaeaii?; anoaiiaeaia ?ieue aiaeioae?aeueii?
aeenooieoe??, aeoeaaoe?? i?ioean?a ia?aeeniiai ieeneaiiy e?i?ae?a a ??
i?ia?anoaaii?; i?aeoaa?aeaeaii cia/aiiy i?aeaeuaiiai a?oa??aeueiiai
oeneo a i?ia?anoaaii? ae?aaaoe/ii? iao?iiao??; i?iaeiaaeothoue aea/aoeny
aaiiaeeiai?/i? aniaeoe noaio na?oeaai-noaeeiii? nenoaie i?e
a?oa??aeuei?e a?ia?oaic?? (Eieiiieneay I.A. e niaao., 1989.; E?ooeeiaa
A.A., 1990; Coaeiaa N.O. e niaao., 1991; Oanoaeiaa I.A., Aeaaeia E.E.,
1993; Aoeiia A.N., 1996; Nieieia A.E., Cae/eeiaa I.N., 1996;
Feldt-Rassmussen B. et al., 1987; DCCT, 1993; Nonose N. at al., 1993).
Ne?ae a?aei?oeoe, ui e?eoaaiiy a?oa??aeueii? a?ia?oaic?? i?e oeoe?iaiio
ae?aaao? ? aeaeaei ia ae??oaiith i?iaeaiith. Iacaaaeath/e ia oa, ui
e?ea? aieiae?? aeineoue oe?ieei aeai?ii aioea?ia?oaiceaieo cania?a,
i?aia?aoe, ui aaeeaathoueny aei iei?oiueiai /ano, ia caaaeaee
aoaeoeai?, iathoue aaaaoi iia?/ieo ae?e (Aeaca? A.A., Aeyaeaii
iniaeeaino? eiiiainaoi?ii-i?enoinoaaeueieo ?aaeoe?e na?oeaai-noaeeiii?
nenoaie o a?aeiia?aeue ia ooieoe?iiaeuei? iaaaioaaeoaaeuei? i?iae c
ia?ai?iith iieiaeaiiy o?ea o i?inoi?? o oai?eo ia ??ci? oeie oeoe?iaiai
ae?aaaoo oa a?oa??aeueii? a?ia?oaic??. Anoaiiaeaia ?ioi?iaoeai?noue
ianeaii? i?oinoaoe/ii? oa aioei?oinoaoe/ii? i?ia a ioe?ioe?
?aaeoeaiino? aia?aoa e?iaiia?ao o oeeo eaoaai??e oai?eo. Aia?oa
cae?eniaii ii??aiyeueia aeine?aeaeaiiy aaiiaeeiai?/ieo aoaeo?a eaiioaio
oa aaeaa?cooaio o oai?eo ia oeoe?iaee ae?aaao i?e noi?niiio i?iaaaeaii?
aino?iai oa?iaeieia?/iiai oanoo oa ooieoe?iiaeueieo iaaaioaaeoaaeueieo
i?ia. Anoaiiaeaii a?aei?iiino? aaiiaeeiai?/ii? a?aeiia?ae? ia
iaeii?aciaee i?eeii eaiioaio oa aaeaa?cooaio o oai?eo ia ??ci? oeie
oeoe?iaiai ae?aaaoo, ye? no?aaeaeathoue ia a?ia?oii?/io oai?iao ?
neiioiiaoe/io a?oa??aeueio a?ia?oaic?th. Iieacaii iaiaeiicia/iee aieea
oeeo i?aia?ao?a ia eiiiainaoi?i? ?aaeoe?? na?oeaai-noaeeiii? nenoaie o
oai?eo ia oeoe?iaee ae?aaao.
I?aeoe/ia oe?ii?noue ?iaioe. Canoinoaaiiy eiiieaenii? iaoiaeeee
aeine?aeaeaiiy na?oeaai-noaeeiii? nenoaie ia i?aenoaa?
?aiiie?ea?ae?ia?ao?/iiai iaoiaeo c aeei?enoaiiyi iaaaioaaeoaaeueieo i?ia
aeicaieeei i?iaanoe aeeaiea ??ciia?/ia aea/aiiy ooieoe?iiaeueiiai noaio
nenoaie e?iaiia?ao o oai?eo ia oeoe?iaee ae?aaao, aeyaeoe iniaeeaino?
aaiiaeeiai?ee, oa?aeoa?i? aeey oai?eo ia ae?aaao I oa II oei?a ?
a?oa??aeueio a?ia?oaic?th ??ciiai aaiaco. Iieacaia ?ioi?iaoeai?noue
ooieoe?iiaeueieo i?ia ?c ci?iith iieiaeaiiy o?ea a ioe?ioe? ?aaeoeaiino?
na?oeaai-noaeeiii? nenoaie oa aeiaaaeaia aeioe?euei?noue aeeth/aiiy
ianeaii? i?oinoaoe/ii? oa aioei?oinoaoe/ii? i?ia a eiiieaen ianoaaeaiiy
oai?eo ia ae?aaao, iniaeeai ia oe? a?oa??aeueii? a?ia?oaic??.
Noi?nia canoinoaaiiy aino?iai oa?iaeieia?/iiai oanoo, ianeaii?
i?oinoaoe/ii? oa aioei?oinoaoe/ii? i?ia aeicaieeei, ii?yae c aea/aiiyi
aaiiaeeiai?/ieo aniaeo?a ae?? aioea?ia?oaiceaieo i?aia?ao?a eaiioaio ?
aaeaa?cooaio, ioe?ieoe ?o aieea ia noaeeiio ?aaeoeai?noue ?
eiiiainaoi?ii-i?enoinoaaeuei? ?aaeoe?? na?oeaai-noaeeiii? nenoaie o
oai?eo c ??cieie oeiaie ae?aaaoo ? a?oa??aeueii? a?ia?oaic??.
Aeyaeai? iniaeeaino? aaiiaeeiai?/ii? a?aeiia?ae? ia iaeii?aciaee i?eeii
aeacaieo i?aia?ao?a o oai?eo ia oeoe?iaee ae?aaao I oa II oei?a c
a?ia?oaiceaiei neiae?iiii ??ciiai iioiaeaeaiiy iiaeooue aooe
canoiniaai? aeey aeeoa?aioe?eiaaiiai aeiai?o a?iioaiceaii? oa?ai?? o
aeaii? eaoaai??? oai?eo.
?acoeueoaoe aeine?aeaeaiue ao?eaii a i?aeoeeo ?iaioe
aiaeie?eiieia?/iiai ? ea?ae?ieia?/iiai a?aeae?eaiue i?nueei? ee?i?/ii?
e?ea?i? ? 9, oa?aiaaoe/iiai a?aeae?eaiiy i?nueei? ee?i?/ii? e?ea?i? ? 6
i.Aei?i?iiao?ianueea. Iaoa??aee ?iaioe aeei?enoiaothoueny a iaa/aeueiiio
i?ioean? eaoaae?e oaeoeueoaonueei? oa?ai?? oa aiaeie?eiieia??
Aei?i?iiao?ianueei? aea?aeaaii? iaaee/ii? aeaaeai??.
Iniaenoee aianie caeiaoaa/a. Aaoi?ii ia?niiaeueii i?iaiae?ciaaia
iaoeiaa e?oa?aoo?a c aea?aii? oaiaoeee, i?iaaaeaiee ?ioi?iaoe?eiee
iiooe. Aeanii?o/ii i?iaaaeaii ianoaaeaiiy oai?eo ca?aeii c i?ia?aiith
aeine?aeaeaiiy. ?icoeo?iaea aeaieo ooieoe?iiaeueieo aeine?aeaeaiue, ?o
ia?aeiia ia?iaea, oi?ioaaiiy a?oi ? noaoenoe/ia ia?iaea ?acoeueoao?a
aeine?aeaeaiue ia ia?niiaeueiiio eiii’thoa?? i?iaaaeai? aaoi?ii
ia?niiaeueii. Naiino?eii iaienaii iaeyae e?oa?aoo?e, i?iaaaeaii aiae?c
io?eiaieo ?acoeueoao?a, noi?ioeueiaaii aeniiaee ? i?aeoe/i?
?aeiiaiaeaoe??, ui aeieeaathoue c ?acoeueoao?a aeaiiai aeine?aeaeaiiy.
Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iniiai? iieiaeaiiy aeena?oaoe??
aoee i?aaenoaaeai? ia IV c’?cae? ea?ae?ieia?a Oe?a?ie
(Aei?i?iiao?ianuee, 1993), OVI iaeani?e iaoeiai-i?aeoe/i?e eiioa?aioe??
c no/anieo ieoaiue ee?i?/ii? aiaeie?eiieia?? (A?iieoey, 1993), ia
iaoeiai-i?aeoe/ieo eiioa?aioe?yo “Aeeaaao – i?iaeaia iaua/aeiaa/aneay”
(Aei?i?iiao?ianuee, 1997, 1998, 1999), V ?in?enueeiio iaoe?iiaeueiiio
eiia?an? “*aeiaae e eaea?noai” (Iineaa, 1998), iaoeiaeo nan?yo
Aei?i?iiao?ianueeiai iaaee/iiai ?inoeoooo a 1993 – 1994 ?.?. Ai?iaaoe?y
aeena?oaoe?? a?aeaoeany 13 ea?oiy 1999 ?. ia ?icoe?aiiio can?aeaii?
eaoaae?e oaeoeueoaonueei? oa?ai?? oa aiaeie?eiieia?? Aei?i?iiao?ianueei?
aea?aeaaii? iaaee/ii? aeaaeai??.
Ioae?eaoe??. Ca oaiith aeena?oaoe?? iioae?eiaaii 11 iaoeiaeo ?ia?o (4 c
ieo – a oeaio?aeueieo aeo?iaeao). 8 ?ia?o i?aeaioiaeai? a ni?aaaoi?noa?,
3 – naiino?eii.
Ianya ? no?oeoo?a ?iaioe. Aeena?oaoe?y aeeeaaeaia ia 162 noi??ieao,
neeaaea?oueny c anooio, iaeyaeo e?oa?aoo?e, 4 ?icae?e?a aeanieo
aeine?aeaeaiue, iaaiai?aiiy io?eiaieo ?acoeueoao?a, aeniiae?a,
i?aeoe/ieo ?aeiiaiaeaoe?e. ?iaioa ?ethno?iaaia 34 oaaeeoeyie, ui
noaiiaeoue 25 noi??iie. A?ae?ia?ao?y i?noeoue 196 ?ia?o ee?eeeoeath ? 71
– eaoeiith, ui neeaaea? 27 noi??iie.
INIIAIA *ANOEIA
Ee?i?/ia oa?aeoa?enoeea oai?eo. Ianoaaeaii 166 oai?eo ia oeoe?iaee
ae?aaao a?eii a?ae 17 aei 65 ?ie?a, eio?? ciaoiaeeeeny ia e?eoaaii? a
aiaeie?eiieia?/iiio a?aeae?eaii? 9 i?nueei? ee?i?/ii? e?ea?i? i.
Aei?i?iiao?ianueea. C ieo 117 oai?eo ia ?inoe?icaeaaeiee oeoe?iaee
ae?aaao, 49 oai?eo ia ?inoe?iiacaeaaeiee oeoe?iaee ae?aaao. Na?aae
oai?eo ia ?inoe?icaeaaeiee oeoe?iaee ae?aaao o 39 in?a ia a?aei?/aeinue
i?aeaeuaiiy a?oa??aeueiiai oeneo i? a aiaiiac?, i? ca ia??iae e?eoaaiiy
a noaoe?iia?? (na?aaei?e a?e a a?oi? 37,2 ± 1,8 ?ie?a, na?aaeiy
o?eaae?noue ae?aaaoo – 11,46 ± 1,23 ?ie?a, na?aaei?e ??aaiue
nenoie?/iiai a?oa??aeueiiai oeneo 124,9 ± 2,01 ii ?o.no.,
ae?anoie?/iiai a?oa??aeueiiai oeneo – 80,64 ± 1,2 ii ?o.no.), o 25 in?a
ae?aaiinoiaaia a?ia?oii?/ia oai?iaa II noaae?? (na?aaei?e a?e 50,44 ±
1,5 ?ie?a, na?aaeiy o?eaae?noue ae?aaaoo – 17,04 ± 1,22 ?ie?a, na?aaeiy
o?eaae?noue a?oa??aeueii? a?ia?oaic?? – 13,32 ± 3,45 ?iee, na?aaei?e
??aaiue nenoie?/iiai a?oa??aeueiiai oeneo – 169,54 ( 3,09 ii ?o.no,
ae?anoie?/iiai – 96,08 ( 0,77 ii ?o.no.), o 53 in?a ae?aaiinoiaaia
neiioiiaoe/ia a?oa??aeueia a?ia?oaic?y aiane?aeie ae?aaaoe/ii?
iao?iiao?? (na?aaei?e a?e 40,39 ± 1,80 ?ie?a, na?aaeiy o?eaae?noue
oeoe?iaiai ae?aaaoo – 16,32 ± 1,00 ??e, na?aaeiy o?eaae?noue a?ia?oaic??
– 8,78 ± 2,23 ?ie?a, na?aaei?e ??aaiue nenoie?/iiai a?oa??aeueiiai oeneo
– 164,82 ± 3,2 ii ?o.no, na?aaei?e ??aaiue ae?anoie?/iiai oeneo –
96,04 ± 1,28 ii.?o.no.). Na?aae oai?eo ia ?inoe?iiacaeaaeiee oeoe?iaee
ae?aaao o 15 in?a i?aeaeuai? oeeo?e a?oa??aeueiiai oeneo ia
?a?no?oaaeenue (na?aaei?e a?e – 55,43 ± 2,84 ?iee, na?aaeiy o?eaae?noue
ae?aaaoo – 11,29 ± 1,99 ?ie?a, na?aaei?e ??aaiue nenoie?/iiai
a?oa??aeueiiai oeneo – 131,71 ± 3,3 ii ?o.no. ? ae?anoie?/iiai – 79,43
± 2,47 ii ?o. no), o 34 in?a ae?aaiinoiaaia a?ia?oii?/ia oai?iaa II
noaae?? (na?aaei?e a?e – 55,32 ± 0,90 ?ie?a, na?aaeiy o?eaae?noue
oeoe?iaiai ae?aaaoo – 12,38 ±
Ia?aeiia aeine?aeaeaiiy oeaio?aeueii? aaiiaeeiai?ee i?iaiaeeeiny a
ia?o? 2 – 3 aeiae ia?aaoaaiiy oai?iai a noaoe?iia??, i?ney
iiia?aaeiueiai ianoaaeaiiy ? aeeeth/aiiy aioea?ia?oaiceaieo cania?a. A
oie aea aeaiue i?iaiaeeeinue iiaoi?ia ianoaaeaiiy a oiiaao aino?iai
oa?iaeieia?/iiai oanoo /a?ac 1,5 – 2 aiaeeie i?ney i?eeiio eaiioaio
(o??ia “A??noieue Iae??n”, NOA) a aeic? 25 ia aai aaeaa?cooaio (o??ia
“AVD”, Aa?iai?y) a aeic? 1 ia.
?acoeueoaoe ?iaioe aoee ia?iaeai? ca caaaeueiii?eeiyoeie iaoiaeeeaie
aa??aoe?eii? noaoenoeee (Ia?eia A.I., 1969; Eaaiia TH.E., Iiai?aethe
I.I., 1990) ca aeiiiiiaith aeaeo?iiieo oaaeeoeue “Microsoft Excel – 7.0”
c aeei?enoaiiyi ia?niiaeueiiai eiii’thoa?a IAII IBM 486.
?ACOEUeOAOE AeINE?AeAEAIIss, ?O AIAE?C OA IAAIAI?AIIss
Aea/aiiy iieaciee?a aaiiaeeiai?ee o oai?eo ia oeoe?iaee ae?aaao
aeicaieeei anoaiiaeoe iaai? caeiiii??i? ii?ooaiiy nei?i/oaaeueii?
ooieoe?? na?oey, ia?eoa?e/iiai iii?o noaeei, aia?aaoe/ieo aeo?ao
i?iea?aea caeaaeii a?ae oeio ae?aaaoo ? iayaiino? a?oa??aeueii?
a?ia?oaic??.
Aiae?c iieaciee?a ia’?iiiai e?iaioieo (OI, OIE, O?, N?) aeyaea
cieaeaiiy ?o cia/aiue o an?o oai?eo a ii??aiyii? c eiio?ieai (?
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