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OMA OXA AOCTE ETAOO AOOHOO CHPOMA ETE PAHHEO BOPACTA ...

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OMA OXA AOCTE ETAOO

AOOHOO CHPOMA ETE PAHHEO BOPACTA

14.01.08

ccepa a cocae eo cee

aaa ecx a

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Ņ..2 O OɅ.4 EEE....6 1. (OO TE)....11 eoo oooo co 1.1.

occ o..11 eo ee eo 1.2. coca .............14 eoo oooo 1.3.

co ....28 oc ox aocecx pepe eoo 1.4.

aoooo coa.. ..31 2. MAEA MEO CCEOA߅......35 3. ,



-

Ʌ.....51 ooec 3.1.

ⅅ.........51 coo 3.2.

ee酅........55 , oo 3.3. coco eooco cca aa ee...62 oaa eo-cecoo a ocee 3.4.

ee酅...69 4. OAO-CEAOO OCOA EEɅ...72 4.1.

........72 4.2.

ocee ee酅.....75 4.2.1. Opa pe..75 4.2.2. Opa ca................76 ea eaoeco oceoa.....77 4.3.

EAO

OE ߅.......85 BBOۅ.104 AECE EOEAȅ......105 CCO EATۅ.....106 OEŅ......131

CCO COAE

A aooeoeaa A aeeoeaa AT aeooca oe oo a aa e ece ooe ee M ee eeooo eeoo M ee eeceo eeoo K eocoeoa coa P o eea B eoo ee BP aea ooo a oa MT ec acc ea P cooo ao oca acca ee ecaooo oaca MB ocoaa aooca ccea MOC oaaeeooca HA a acca ea HM ooc oo HC ooc O M oco oea oa a aeoc eoa PB ae ao e P PHK oPHK acca, cooeca ecaoo oac CB ceee oaoaeoe eee CO caeca eaoa C

   

ece cceoa, ooe ocee e, aaee oo acee Pocc, a ocoo, a ecoo, ox opoeec oax oaaee. Coaee ooee oo oaaeo oacoc Poccco eea [103].

Ce op ae a o, o acoee e, oo ocox ce ecoo a o a ocaa epocxeco ooeee ee ec oece eaopx aoo a ae oa. Oo ax ec eee e eoooo oaca, oex a. o a cpe cco T.. aaoo, .A. eoo (2012 .) 86-93% e eoooo oaca Pocc oe aoo. oeee aoox ao o e eeeoc e oo ocox poex oo a, ceo ocaoc ea ooeee ee [70].

B eae oec aoa oo, oec a, aaac a ea aoo co (AC).

ea a AC ec oco aoo eee ec p oc e a [136].

o oe a oa ee AC eee a 1,9 1000 [108]. aa a acoc ae ca AC ACH oax coa e.

cco, oeee Pocc, oea ae ee AC:

. oc (oa ee) 7,9%, a

- caoo eooc oe 3,5%, . aa (oa ee) - 13%.

o occ e B ca oeee cx ao e oac co oo oo c ee e oe ee. oee , aea ac cae, o aoo oa oe eo eeeoc. Co eca, ca e ee oce, ae ae aaec eooe e oee aoo.

Hea ac occc ao [69, 101, 53] ae a oo oeo ca, a e ooo - ( .. ) , ee cec oe oex ooo ax aoa a. ae a e aco aoc AC.

oc oc aoo aoa ocoe occe oeo, aooa acoca eo aoc AC ae ca, a e oc aoo o occc cc aoo.

aoc e, ee ec ee aa, x oco pe ceoc oc (Baoce pep ACH - h 4-Digit Dignsti . Sttl: Univrsity f Wshingtn, 2004; Poo p 3 - D Rtrivdon 2007.;

Kpep ca e CA lrifitin Institut f diin (I) ritri FSD, 2005 .; Kaace ooe p - FD: ndin guidelins fr dignsis, 2005 .). B Beo eca acca pee aa paa caoc op aocec cce (FSD: guid f rhelth r prfssinls, , 2007).

B Pocc co ep x cc: Baoce pep ACH - Th 4-Digit Dignsti d [70]; Kpep ca e CA Clfrificftin Institut f dicin (I) ritri FSD [17, 53]. oc aocc pep ooac acee e.

oe aoo cco, oo a oca e aa, oe cco.

   

eocoooc coao-eecx ooecx aoo, x oo ee AC AC.

Oe c aoeaeoc, oee oe ecoo 2.

epo-cxecoo a ocao oo peea c AC, AC e AC ce ae.

oaa c co-oax ee HC 3.

ocoeoce ea aoo coo.

e eaoece ae, xapaee ae AC.

oaapoa oaae BP po acecex oee 4.

oceeo pe aeo.

aa oa Bepe oeeceo eap poee aa epaoeco ap ee paeo oaca, oexc ppoo oec aoo. Bea aoc epaoeoo oec aoo aeaa epo a HC ocoeoc oppoa aocoeoo pca ee AC, o ooe oocoa ee aoo oapepa cce aocecx pepe AC.





poee aa BP oceeo pe aeo e acecex oex aoea (Taea acc-cepoep) a x oppoae.

paeca aoc pao Kpep cc I pee p ooa op ee, ppooo eec a o cpoo AC AC. ( , , ) AC.

AC paeo oaca, oe a a opeee Coco ocaao aoc eaoo aoooo cpoa 2547568.

Ocoe ooe, oce a a 1.

-, , HC AC.

IOM 2.

AC.

Bepee peao cceoa a - .

: , 8, 10, 16.

7 , 3 , 2 dicalandHealthScienceJournal, (CanadianJournalofScienceandEducation, ).

Ocoe oo ccepa ooe a ao-aecx ceapax Ceapoax ax eea 1, 2, 4, 6 Cepoco oac, . Pe, Kaec-paca, epopaca; a ao-paeco oepe coo oo ee Cepoc oac, a - , . , 2007 ., - , , 2009 ., a poccco ao ope a pae c eapo ace Aae opoc aeao e, aepp, 2014 .

   

ccepa oea 135 cpaax aocoo eca, coco ee, oopa epap, 4 a cocex cceoa. Paoa cppoa 22 aa, 23 pca. opa ae 107 oeecex 123 apex co.

   

Pacpocpaeoc eaoo aoooo cpoa Pocc 1.1.

a peo acoee pe eec oeco epapx ax, B ceecx o eoo poce ao aoo oopoex ee paeo opaca apex cpaax. Oao c eooecx o-aocecx o o oc oa xapaep acac ee opeeex coax paccox . p o, o e peoo, opeeec oppea c c o poco ecoo aooa.

eooece ae eaoo o pacpocpaeoc aoooo cpoa Pocc occ o coo eocao ccoae o aoo.

CA pacpocpaeoc AC [159] 0,2 2,0 1 000 ee poe , o cooca ( ) , , cpo aa, coooa a.

(Meca, CA, Kaaa), , , ea aoo cepo ape, , cex ee AC c pao acoo: aepacx 8,5 1 000, aacx 190 1 000.

Cee ae opa ocooe , cee ooo peea AC, eae epooc oe ocex ee 770 : 1 000 [159].

aae cceoa, eooec xapae pacpocpaeoc AC, aco ee ACH o 0,23 40,4 1 000 opoex [70].

cceoa, poeee oax pee . Ca-eeppa, : 2000 . 9,3%, 2001 . 8,7%, 2002 9,0%, 2003 .- 7,0% 2004. - 7,3% [70]. .. [53] 18-19 1000.

ac AC pecae , eec ppooo oc aoa a MK-9 MK-10 (Q-86,0).

ocao aa AC coec ecoo aocecx cce. B epcee aa Bao papaoaa ccea aoc D [209].

B Epoe peoee oa eco acca IOM (c.

a 1). aa ccea papaoaa CA peec aox cpaax. o oe e, acca IOM aoee peea oa pee [17, 53].

1.1.

eaoo aoooo cepa ape ca e CA (IOM) AC ( epee opee aep aoo) aep 3aoepoa e eca poca

3- ex ocoeoce:

   

Hae cppx aoa HC AC (e ax o opee aep cpx ao) He ax o opee aep cpx ao 3aoepoa e eca poca

3- ex ocoeoce:

   

Hae cppx aoa HC AC ( epee opee aep aoo) aep

ae 2- 3- pep ex ocoeoce:

   

Accopoae aooe BP aep

ae 2- 3- pep ex ocoeoce:

   

Accpoae c aooe ape epo-cxecoo pa aep Accpoae c aooe ape epo-cxecoo pa o e eoox ex a eca ccea pecae ooo caap oepe aa eaoo aoooo cpoa. Ee aoceca aoc ocoepoc aoce y ee c AC oepea pyax .., .., .. [55].

B cae ocyc aocecx xapaepx ex ep AC (opoe ae , ya aa epxe y, ocyce eoa, yeo o epxe y ocy, o oa p pae yppoo oae c ee epeeoc), eca eoc aooe 16-20 peex aocecx cc yeaec. Boae eoxooc oaa eec aep epo yopeee cpocoepax epeeoc. ocoepoc opa, oopy oya o aepe ye aepoa opoca oe a. aoca p cooa aopaopx eoo cceoa (acc-cepoep opeee eec opayxc peyae eaoa aoa - po px co oocax ee eo), e coyc poo .. co apa.

cxo oo oe aya, acee pe, cceoa apaee a oc ox aocecx apepo ACH.

1.2. Meao cpocoepax eec epo epeeoc poxoee ooo cpa epe aeap apep eaco o cpoo epeeoc ceac oaao. pe o oepa po aep oa oaoa. Kpoe oo, aoeca oc ae cep ao.

oyopeee epeeo eo cpocoepa aa po oee eoy, o cpae c po, pcyc aoa aoeco oc [96].

B peyae pocxo oppoae eo aoo opae oa , a cece, oo oaae eoe peoe oece a o.

B opae oa poae a ee e coco eaopo ao .. e coppoa epeae cce.

poy ee oa epea A pocxo o o opo ooe epeeoc, peyae ao eeeo e pooeoe pe axoc ae po ax oa [5]. B peyae opacopa opae aoa opayc oee oce eao, e ca ao.

ao eo eao oaa a opa ceye ocece ec: pocxo oppoae cx poyo, co co pH cy copoy, oope eo oaa oe eaoe e a poecc eaoa opae [106]; aeec oeoee, o ee oe, apyaec ae epoo oooo oa; opae oa apyac poecc epoopaoa eax, o ce eax epao epo cce; oeya aoa oaae eaocecoe ece, oopoe ocoao a coce poa co, papya cooyoc ycox ce ocoo apya eyec eox epa, o po ce copoc ceecx poecco eaopx cceax; pocxo aoo epoo a cece cpo poecco epecoo o, aa oce oycoeoo oee ypo opoa aee oepa oo a a ae po; oppyec eaoec ao peyae pye ca AT aa oa (HAD+ -acx pea eooo xa); peyae oo epeeco eoc ao coepax ao pocxo cee oecee opaa py ae eeca (ea, aa, poeea p.); e eee 15% aeaea opayeoc peyae eaoa aoa aoecye c eooo, o ee oppoa oc .. coee aeaea eooa o e oaa cocooc caec c copoo [117]; pocxo ayc cpoecx poecco opaax ax oycoex apyee eooo cea aeo peapa [61].

aoee aooo poeoa ocec y oea.

Oa ocoaec a epaoeo aoa a o, o opo eya po ooc ayoy exaa [5].

e oe Maepc aoo, coe cococoa oppopa cax paoopax opoo y oa. Ec acoc ey pee epoa pa oa exaa epaoeoo oa [76].

cepeae cceoa, pooe a pcax, oc xo po oppoa eeo y apoe, copooac y aca ceca oppoa eeo. ep cec oppyec epo poe apoa o eoy (1-5 oce oooope). Bopo cec pocxo a 10-15 e pa, o cooecye cpoy ocooo opaoeea.

eoea epo ocooo opaoeea pxoc a 3-8 ee oce oooope. Kpoe oo, cepeao oepeo yeee aco aopo pae cpo epeeoc, cee oeca oo, eee coooe ey oa p ee opee pc 6% pacopa aoa, aeeo 35-58% oe aopoc opa [202].

B ox cpoax poeea e cpocoepax eec oe po oppoa ex eeo pa: aoa yo pao, oa p. Kpoe oo, po oppoa yoax apye pao opao cce, epy oex epe HC, oxecx ooe, oeeecx ea ocope opeec oce poe.

Bce o oop o coo pce e oa, oycoe oocec eo, epaoe oece aoa pec epo (pe cpocoepax ec ep 4 ee epeeoc).

Haoy ypoy oa cocae pe cpcoepax eec epo c 15 25 e epeeoc (e aoa po ocaa eoo pa, ocoeo ao - epoo apoeoo co, apye poepa epoo, apye cpyypo opaa HC.

oa o cepeae ca .. Maaxoo, poeee 2012 oy. eee pc, oyax p ope 6% pacop aoa e yac c e oeco epx eo (o cpae c opo) ope oooo oa, oee oaayce. B cpae c opoo pyo oeco epx eo oopoex pc, oepxc oec aoa, o ee 2 aa.

Boece aoa o opo pecpe epeeoc po opaeoy a oceyee oppoae pae oooo oa, oco-eo cce o. B pee pecpe ao oaae oece a ooo o, ee, oa.

opaeoe poc poocecoe oece aoa a o a poeyo pee apaeo a epoope epoxece poecc, pocxo yeee poaeoc eaoeaecoo apepa yeee ocea ea oe [207]. C ey pco ypypooo opee oa oeo yopeeoo aoo a ceo ec copo. poe ae oe poope. o a Libr pecoy oy aoo oocc 60 80 p. acooo aoa cy, Strissguth [207] cae 30 p. B oe pe, .B. Bee . ecep (1996) opaa ae e oo a aoo. O ca, o ao ya cee aceoc aeaea po ax aep oa, oopa oycoea e oo oeo cpoo copoc eo ee, oa ac o epeao aoc A aeaeepoea.

p o epeao aoc aeaeepoea eaee oe aoa oy pec oy ae pe.

Papyeoe e aoa a o pocxo peae oec paoopax exao, oe opee y oa oycoe o aopa. K a aopa oocc: eoc, pepoc oeco yopeeoo aoo [110]; opac aep; coa cayc aep (epeypoe eooeoe ae, ypee, ocyce ecoo opo a epeeoc p., [93]; eo aep oa.

Haoey opee oepea oppyac epaa epa ccea.

eo oppye cee ocpoc HC aoo, pao cee oooc ooe x pyx poex eeo [168]. Hapep, ae aepco ae epoea aoo D2*3 ococye aoee ooy peopaoa aoa ce aco oppoa AC [95].

opa, oepaa ooee apye Ec eeeco cpype oox eo peyae oec aoa [38].

Hapye eeeco cpype oox aoex eo pocxo a o ae x oppoa. Aeae cae oco aopo, oaa yaeoe oece, o oe apya cpyypy HK cococoa pocy aco ya.

p eax coo ee eye aae aocae opeae exa:

1. Ha eoo ypoe oa co epoopayx poeccax (co pacop eaoe o [132], pocxo yeee cea HK ea [183]. Hapye eaoe o o oece aoa oycoe cee eceoc pacopx eo GLU 1 GLU 3.

oceoaeo eyee oe ae oepa cya.

e epeypoe eooeoe ae aep Oaae (epeecoe aee aoa oe eo) aoaoe oppoae poax eeox epeo. Singh coa., 1999 . oaa cox paoax py acoc paepo oooo oa oa o ypo caxapa po. poy eaoa aoo oaa eocpeceoe e a epoopaoae oa. pepy, apyaec opae K paoa oxop, xc ey coo eoo ep, p oec a x coox paao. o po ee paoe copae eo, peypyx ypeooe ee, cpaa epy oepe acoa paop a cce pocxo apyee y ceo epoaa [213].

2. Ooe o opaoo poea accoax poecco ee (apyaec yopoa e: epoee oee, caoee pa eo) [194]. Aoo e a copoc ee eo, cae caecy ooc oeypo coe op, ae paee peopaoae paao acpo acpo, a ece paccpaaec epeeee o opaoax epoo a eco x ocooo paee oe [87]. Ee o cyece exa opaeoo oec aoo a cpyyp y paaeoc oa o pacpoco pao eaopo oa ( epy oepe yaaa a epx aax epoooeea, cepooa) cypyx oppoae oa. pocxo ee a oeceo, a yoao peeopo ND, a oope oecye yaa. a

   

cpyype o oycoe pa eaop oec, o ce aoo. B ao opeo cyae eoxo ea aa p oppoa cpyypo-yoax apye, .. e eo oceoaeoc x pa. ao eo poxo eoy epay, oecy a e ooe epa ee ee ec coca. B peyae pocxo eee o-xecx coc cocaa epa, paee eaoa aee eo ax epoacx poecco. oeoee pe co o oece aoa oy opaoa oe p, ocee coco pec ece aoa o eopaa y eoo epa.

caaec oco ca: eec ocpoc peeopo x co, papyaec opa peeopo oe opyee p. eo o a ypa ca peyae x ooe oe aeo cae.

eee y aopo poca [144]. ooe oeco 5.

aopo poca oecy a y pepoy opaa e oaa aeoe e a poecc oppoa ae poa [15].

aop (TP-) a aax aax Tpacoppy poc poeea pae eocpeceoe yace pa ee eo poa. Y. gur coa. o ye oaa aoc pooapoo aopa poca pa poo e. Opaoee e oe oxoc e aopo poca. cceoa aoo ae, poeee . Fn coa. [218] oepa c opee peeopo ae epaoo aopa poca (P) apye ae p BP. Aop [131] eoopx cceoaecx pao py c oeo oepa copoe po cyooooo aopa poca (P) eee epeeoc paepa oopoeoo. B D. Hill . [217] copoe po yye aep aopa poca poaco-2 (P-2) paepa oa aa co II pecpa epeeoc, a a e eocpeceo epe poa. . Jjvi coa. (1998) oapy p cceoax yyp poao a pc cypyee ece P cocycooeaoo aopa poca (CP) pae aeapo a.

oaao, o yeee oepa oo peex e aopo cypye yeee ce aeapo oa. Poc oa oeo oepxoc ae co copo oa oeceae CP a ce poca, oee e a paa, oac pooaca poeocx cocyo.

cceoa, poeee .. Maaxoo [53], oaa, o GF-1 y epeex e, ex pcpace aoo, o oepa ecpao peae aoe y acex epeex: 71, 7 / 6,6 / cooeceo (cpee oaae). Teopeec ceoao oa cee GF-1, oee e, oeo, cao c ec oo peeopo P, peyae ec aoa. ae oepe cepee a pcax. p o caoc oooe e ax coco, a eco, aoo pepoyo cce, cpaeae aoea, oop aco epeeoc e, coycoa yopex aoo (GF-1 pye aoopoax ox coca = 187,9 /, opoo = 129,7 /, t = 2,68, 0,02).

opaex eo

6. Cep cece aooa [196] oceoo ape [197, 208].

Aoo aycaec aoo peyae opo poex eo aopo poca epx eo P.

B peyae ocecoo ec aoo pocxo apyee pacpeee epoo oe, peyae o e oy coppoa aecey oecey ooeoc ocyece c ey coo, p o pocxo x eeeoe yoee. oee ocyecec ca pa exaa. Oca ceye op e eo o oece ex ypex aopo, o aoaoo, aoxc, ao, aoo, epo, apao. aooa oee xapaepe aoo.

o e aeoo oeca cax paoopax ex oec oe epao apoa poecc aooa, oop pee opee ae. oo oe ocy oc, ocyce aopo poca, ocece oec aa peopo e eo (Fs). cypye e eo opaca peyae aa aeoo oeca exao cao pacy, oa a ypeoo ae yceoc ee aa ocea 3poeo.

oco 3-poeo (im, d, UM, Ni; GL-1 aao) ooepyc c aaooec l-2-oo poea (D-9 aao), ocooa poaooece yoee Bcl-2 e (Baxooe, xoe oxop oce Drob1-aao) peooepa. ao opeae ey cpecc bl-2 e ca apye aoo y oa. ac 3-poeo (pepo oe id) eocpeceo ooepyc c -oo poea ypoe pooe oxop. Bocec o ee pocy ooo oeca aopo a Sm/DIL, oxpo aooa, c, oyeay G, aop y aooa (IF) Omi oo.

Sm/DIL (id, Grim Rr) epay I, nd-G pace HK, IF mi poy e aay papyee HK. Ocooee oxpoa ypoae oppoae ooepoo eooo oeca aooco cocoe f-1 (D-4/Df-1 aao) aca 9. B ocyce eax cyo I ocaaa oppoae aooco aoc aca-3. p oppoa aooco, pocxo aa eopo poaca (D-3 drI aao), ae a poacaa-3,

   

oy e. peyae ae oe aoo eaoo aoo poae o cepe oa. ao ee oa oepeaec eeo, .. epeo-ocee ee oa aoc cooecye 20% aoc epeo pocoo eoea. Ocoo cpeop opa oa aea o, ooy poy pacaa aoa ca ao epe o oaa aoecy oc p aaa ee oo o cacac y eo ee. Bopa aoa epe e aeee poooa aee e, ocoo yopex aoo, po eo py aoo ae po oa opaca eo ocecoo oec.

B cceoax poeex riguht coa. o oapyeo aeoe cee pooo ae pae aoa oa p ee aoo a oao poooe oe peeo pecpa (2-4 /), aepco opae oeac eaee ee.

Bo pe epeeoc y e, pax cpoe, oae epa eocaooc ae, poac e: ocecoo cpoa - 90,5% cyae, aepe pa oa - 15,5% cyae, aeaao e oa - 9,5% cyae [81]. B peyae yeac oo-aeap oe acca ae, paac ap ae eopcae po, pocxo apyee popy cpax apepx. ecpyo-poepae poecc aee ey apye ee ocox y, aco e xpoeco eoaeapo eocaooc. oppyec B peyae 3BP (eoaec e - [80].

Mopooece ea, oapyee oo oece pao [16,181], poc e: yee o ae; oee cox ee; eece oa ax ae oe pae cpo; ae yaco ooe e ocyae aepca po;

ocyce ecaox ee cpax apepx. e eocaoa ecaoa epecpoa oepax ceeo aooaeapx apep; ya eoapa pa, eca c epoo oeae a; pae eoea oe yo 47% accoe ooee coe a aeax; peoaae cyae;

poeyoo-pex opc (47%) poeyoo-epex opc (22%);

cepo cpo opc. Boece aoa ee oye eeoc ae, opacae oecaopo-pcocoex eaoecx poecco. Baae pocapaec aa eeoc ae aecoae cex cyecyx oecapx oooce, a cey oop pxo yeee eopaa ocox y, aee oppoae eopax ecpyx poecco [15].

Aoo cococye pa opoaoo caaca epo epeeoc, pocxo peox yeee ypo oopocepox opoo, oaax e a ocpoeee HK ee (ac, 1988). Heoxoo e cocooc aoa yea poaeoc aeapoo apepa pax eec, ae ocec ece.

oaax Aeae, peya pepae aoa, cocoe oppoa eoe oec. Koope cococy aa epeo, ce peapa HK, ocpooco ae, cepa peepa yaoa, opaca ococ oxop, paccpoo ca copoa poc ocpooca oaea. Bce ee cococy ocaa poc pa oa.

poeee cceoa o ococ aeaea poo e, oaa ae y x oo aee poca, apye oppoa paoe HC, eoo opa e oapyeo.

Tocecoe oece aoo poyo eo pacaa ycyye coaecy aoo aep, yxyae cyecyee poeaoe cocoe ypypooo pa oa, opacae pc ocoe ee epeeoc poo. Heaop ypypo epo, epo oppoa aoo ocoe poo cococy oopoeoo, po oe y peea poe opao eeeoc, oppoa aoc coao eaaa.

Hae pyx pex aopo y aepe, yopex cpe a cococye ee oey yxye yco pa oa.

Coeae ocye oa c peo aoo cococye aee poca oa o 2 paa [97], ec cpaa oo c peo aoo 3paa yea pc poe peea c BP. Cpe a oppy aooy acoc y oa c 18 ee epeeoc a poee peea c o aceoo cpoa.

B pyo ooe pocxo aoee aoa, eo oepa a 10% oe, e ae [97].

pya oea aoeea aooo poeoa, oaaa cceoax lizbth J., vh. D., .N. ssinghm [97] - pocxo ee xeoacca opaoa apoao y e, oyopex cp, oppyc aea coce a opaa.

Xpoec aoo xapaepyec oppoae ayooo oea peyae papye ooo a a cece ee ocooe oox poeo (aeo)-S-100. He ceo, o y oe a S-100 epo pa oa y aepe aooe o c aopo, ey apye poecca oppoa oa oa.

oepea pooc S-100 epoa, axoc coco ecoo oppoa, ceoaeo, y oe f S-100 epo epeeoc oe apepo pca pa AC.

Moo cea o o oepeoc eeecoy epaoeoy (ocecoy) oec , , AC. Ho opooece ee ece apye opae eoco. Ocac opoc o po apye oex poecco c yeo o ox pa (T ).

1.3. Kece poe eaoo aoooo cpoa oapepo AC acoee pe e, c c aea po ocaoe aoa pae cpyypo-yoa ooe.

Kece ae AC oo pae a 3 py: cpyype yoae ee HC; cop eoo epea; ooe eco pa.

K oco ec ooe, xapaepy AC, ooc ccoac poca acc opacy peea ( 97%). Boece aoa a o 1- o 8- ee epeeoc ee ey c c apye, acac acc ea, ea opyoc oo oopoeoo [128]. 3aepa pa peaa epo oe ac acaec poca.

Cpee ae o acce pocy ee c AC p poe cooecy 2250 44 - 46. ee c AC xapaepo, o ocaae poce e oecpyec aeeco eco opace.

T epeo-eoo copa ( 94%) c opoe ae e, cae ocoy eoo, oa aa epxe y.

HC c epooece Co copo cpyype, yoae apye 90%.

K cpyyp apye ooc poea ( 85%), poee aoa oa, ee p epoyaa (oa oea, aee oocoo ea, eoa oopoea ..).

Hepooece apye xapaepyc aepo aeoo peeoo pa ( 81%); apye oo oop; pee cyxoe apye ( 26%) e ocoa, acaa, epocecopo yoyxoc; paccpoca eoo oee c (epae [207].

yoae apye xapaepyc cyece ocaae yceaeoc ocoe ao o ee o e opaco py oo popa. x ee c cooecye epaoc, apye p epexoe o oo eeoc yo, poe oppoa ao.

coax Haoee xapaepoe poee AC - o aepa yceoo pa.

Cpe ypoe IQ cocae 64 70, o cooecye eo cee apye, o ec oeaec coa yaa apaeoc. a, e c pae copec apye e cpe IQ ooo 54, c yepe 67, c e 81. Ka pao, c ey paa copoeea eeya apye ao coa apaea.

Xapaepa ocoeoc ee c AC - a oe peee paccpoca e ocoeoc oye oca. B aee apye eea, oeeece paccpoca, apye oe, peoa, cop oppy eaaa po coy aoc.

cooae Dnvr st y ee c AC, paoax .E. Mpyoa, xapaepye cee cex ecox oaaee: oa oopa oee 19%, pya oopa 34%, peee aa 7%, a coao aaa 38%. IQ o Whslr 35% (65-70 ao);

cpo ea a epaoc (DD) xapaepe 74-80% .

ee c AC xapaep ea paaa, ee co, o e epaey pe - oepa aoa pxoc cooa eepae oopo. a e e coco yc a peyx oax, yc, oep, e e cepae, eo e oc, e coco acpapoaoy e. O e oy po-cecey c, oe coo pcococ opyae coao cpee, e pacaac a co ocy. Ocyce peyaa epeo po cepa. x e yca oacoc.

a oopa aco po paa. e aco e co oeo opo. Kpoe oo, y ee c AC e ae epooeeece aee ooe: oea oeaeoc, oyoc, apeccoc, cape apee, ay eoyaeoc. ee c AC oopa, aep xapaep ycea coaa pa.

Heaeoe oece aoa aeaa epo po ce oaaee eea, o pae epe, o 6-eeo opaca.

opo pa peyae epaoeoo oec aoa oy oa x opaax cceax: 47% aac opo pa oox opao; ee oco a 45% - cpe x coo, ocoaoc, paoyap coco, aoa klil-fil, coe apye O; apoepype opo 28% - poee opo epa M, M, eoa oa apep pepae y aop, a A [69].

eocecoe ece aoo ocec po aco aoeaoc y ee c AC, o oycoeo apyee xeoacca, opaoae apoao oo.

B peyae pooeoo ye ox c AC coc, o c opaco pocxo ee eo cope, p oppoa ooo peoc oapy ee ee coc coee. ooy aop ao cooa p oceoa pae opace. p coepeeo pae aoce yeaec ocaeoo aoa. e c AC opocoo opace e aooc opocy, yopee cpx ao apoo, epecc caoycy.

x xapaepa eoc cye, oooc oacx cecyax ec. pcya oa cooc pecye, o e o opopoa eee cpeca.

epaaa cepoc ee c AC epy oepe oycoea oce oa, acce, yoao epeoc opoe, ex poex opoo.

ooe oeco ayx cceoa a yeo oop o aeo aepecoaoc o ox cpaax ao aooe. B Pocc ooe cceoa poo eocaox oecax, ec ooe ca peoea [69], oa aa oopa aa .. aaoa [69], aaca ccepa yoa .. [17] oopca ccepa aaxoo .. [53].

Bopoc aoc, aoeea eoo AC y ecx ceaco pe aeo pac, e cceoa ocac opoc eeeco pepacooeoc ee AC.

oc ox aocecx pepe eaoo aoooo 1.4.

cpoa cceoa aoeeecx ocoeoce aeaaoo oec aoa a o eoxo oc ocyx ooecx apepo AC, oeax cey peoa: eaoc eo cceoa, ee pocoa ocyoc; ooeca eecoopaoc cooo, oooo oopyoa pacxox aepao, (ocyce cooapoaoo epcoaa); e coaa eyoc oceyeoy.

aa peoa (apepo eco ee) oea ocoeoc epaoeco ap - xapaep apx yopo a aax aox (paoo).

Ta aaea eea oa o co pcyo o a aoo ac ce ae py. pee oppy yae pcy aoo eoea, e eec eee .. aceceo coppo - o ooe paccapa p pao, xapaepyx eeecy opa. peyeco peeo o epe py

aaoec aopa eocopo:

oa ae ce pae pa, ee aocecoe 1) aee;

ee aecee oecee xapaepc;

2) eo oe cceoac oe eco pae [226].

3) oppoae peeo o pocxo oeo c epo cceo poaoo aaa. aaec oppoae ooo pcya, oopeeo c epo cceo, c 4- ee pa poa aaaec a 13- eee, ocaec oco oceye .

Pae ooo pcya opeeeo eeec [230], o eo oppoae oepeo oec pax oex aopo eeeco copoeoc oec. e ya eo epo pa poa ey ee oex poecco, aa epea opao, axo opaee oppyec oo pcye [222].

Ooc poaoo pocxoe epax eeo HC ooo pa oo ae pao c epao, cax c epooec cxaec , o c aooe yopoa H AC. [225, 228].

p cceoa oyeo oepee ac c epaoecx yopo c eoop apaepa [19].

epaoy oo cooa a ae cpye opoeeecx ee, o ce ye eoyapo acep oa eoea [223].

Ceo ye oaao cyecoae po c ey o pcyo ocoeoc xpoocooo aopa yya [18], a a e opee aapoaoc yyo yco x cyecoa coye[13].

oepea aoc ey xapaep epa ooo pya coaec aoea oooec, cepeo-cocyc, poeccoa, yepyeo, caxap aeo p. [74].

Ta opao, pee epao eco pae e aoea acoee pe cao peaoc. B acoee pe aoc oee 100 aoea coyec aa epaoeco ap, a oeece, a apye cceoae [99, 33].

AC paaec y ee, aep yope cpe a epo epeeoc. B oe pe, e y cex oopoex, aep yope cpoe, paaec aocec coooec AC. , AC ee aox aepe. ccoa, ocee ye exao oec aoa a o, a ooaoo oea a opoc o paeo opaaeoc. ecye ao a eeec aapa oa oaae ocecoe ece a HC oa? yee epaoeco ap p AC ooo ooe a oe a o opo.

B ex ccoaecx paoax, aex o, poc ae o exc y aeo c AC xapaepx poex epaoecoo pcya, oepax pcyce eeecoo aopa oppoa ao aoo. B cceoax oaao yeee aco [225] cpeaeoc epaoo poeyooo ooe oceoo ppayca p poa y aeo c AC. e aop oaa e aoa a yoay aooo peeoo acep cea, oapy acep aex apx pcyo p .

Ta opao, cceoae epaoecoo pcya y ee c AC ee acyy ayaoc oee oo aoc o aoo. o oo, o aey e poep oey o eceeco oceco ec aoa a o oooc eeecoo oec apye HC a opoee aocoecoo pcya aeaao ep.

   

aa cc oa a o occ a (a c o , . ..., ..), oo a Co o a, C o a A (oo oooo, ., ... ..) o 2011 2014 .

o 171 o. oa oo 1- a 4 . 122 , O Cл C , 49 , a o .

aoe cceoae poooc 4 aa, cooec oa , a a IOM (CA) aaaoo oc ao. aa cca aaa c [17. 53].

ae poee ee, 1-o pepoce cp ocao P, (n=122) o aaecec a oeac ece oaae ee p poe. o peyaa poeeoo cceoa o eeo 2 op: ocoy opy coca 55 ee, y oopx p poe e oaae acc, ea, opyoc oo (aocece pep AC - m, l, O ee 10 poe); opoy opy coca 67 ee, y oopx m, l, O p poe oe 10 poe.

   

oceoae ee o ee pya:

eep ec II 122 e.; aea MACCcepoep 31 e.; P ya eo YP2E1, DN1, LD2 20 e.; ooayeca cc 88 e.; cceoae opao pe 34 e.; 69 e.; ypex opao 122 e.; cepa 122 e.; 122 .; 122 .

epaoecoe oceoae 98 e.

(49 ee oa peea 49 ee ooecx ).

Ha 2- ae (poceo) a poeea oea ecx ax a oe ocopa (m, l, O), a ae poeea opoep a (oeac paep ao e, paeoc eoa epxe y pa epxe y). o peyaa 2-o aa cceoa coppoa 3 py: 1 pya - e c AC (n=31), y oopx e ( 10 poe) oaae ecoo pa p poe a oe ocopa, a ae e oaae opoep a; 2 pa e c AC (n=20), ee e ( 10 poe) oaae ecoo pa p poe a oe oceoa, a ae e oaae opoep a, o e e e ooo oeca aocecx pepe AC; 3 pya - o e eAC (n=71), e ee aocecx pao AC.

ae (poceo), oe ece Ha 3- aopaopo-cpyeae oceoa ee o ce (AC, AC eAC) ee pya.

Ha 4- ae o poeeo epaoecoe oceoae 49 ee c AC AC 49 ee, oceax ooece (pya cpae).

o peyaa poeeoo pepoceoo yea apooepecx ax ee oa peea p poe (I a) coppoa 2 py:

1- pya - o e, ee p poe 3BP ocoa 2- pya opoa.

a apae a ee eyeo B cpa aocecoo oeca AC: opooecx xapaepc cpoe a (opoa aa e, ya aa epxe y, paeoc eoa, yeo o epxe y ocy). B peyae coppoa 3 py: 1 p. - e c o AC, oope e e oaa ecoo pa p poe a oe poee cceoa, e oaae opoep a; 2 p. - e c o AC, y oopx ec e oaae ecoo pa 1-2 x oaae opoep a (eo oec), ceecyx o ooo oec a peea ypypooo aoo; 3 p. - e e pao AC (eAC), o ae e opooecx ooe cpoe eoo epea c opa ec pae (opoa).

B cooec c oye a o oecex coooex o pe ee pya ca peapee o o ooo oeoyoo pacpocpaeoc ypypooo oec aoo a pae ee.

III a cpa (poce) - poee oeca oea epo-cxecoo pa ee o ce 3 pa, a a e ece aopaopo-cpyeae cceoa.

IV a oce epaoecoy oceoa ee.

Meo cceoa x oe

1. Apooepece ccoa (acca ea, a ea opyoc oo) pooc c cooae caapx epex popo ea, epoe ec) o (caepoa pocoep, pae oep oa.

2. Ocoe ee aoa oyepoac o pe oco apaepa: epee ao e, p a epxe y, paeoc eoa, yeo o epxe e ocy (p. 2.2).

B cooec c opaco pacco opa ae e cac opo, ec x ea a eee 10-o poe.

ooep cooaac epe ao e ooa oy oee ocoepe peya (o peea oopapoaoc poo opae 2-x ox c. pcyo 2.3.).

. 2.2. aa paeoc aocecx pepe AC (ocoeoc cpoe epxe y, paep ao e) . 2.3. Meoa poo ooep a 2-x ox Ocoy pyy coca e, oaae opyoc oo p ao e y oopx eee 10 poee, a oaae p epxe y paeoc eoa epxe y cooecoa 3, 4 5 pay, cee c ooo a.

cooac a c papeeo aaae oaaee WH hild Grwth Stndrds (pa M3 P 151 07.05.1998).

3. B ocoy o-aocecoo eoa ooe: aa ayepcoo eooecoo aaea aepe, pooo eeoc (ae xapaep ooe), eoaaoo epoa - eo eee pae aooecx coco, poooo ee.

4. Meo oepao eo pea (P) cooa e oex ya eoe (ya eo aoooo oxpoa CY2E1, aooepoea DN1, aeepoea LD2) c e opeee poeo eocaooc epeo, oeax a paca aoo.

5. aa acc-cpop pooa aaa Micromass Quattro micro API (Waters) c coa oo opo pao paa NeoBase Non-Derivatized MSMS kit (PerkinElmer, Wallac OY, Finland). aa opa aao pc o Result Viewer

poa Specimen Gate Laboratory (PerkinElmer, Wallac OY, Finland). a o oo ooo c po op copa apa, aoo, coooo aapo caoa.

po aoo ccoa oo c 35 oo acc o oa (oco oa aoco, opc co oopaoo -oc p co).

6. eepc ec II cooac oe cxooopoo pa ee paeo opaca. Tec ooe oe epe copo oee:

oe aee a, oe e, pe oco-coae a (c. pc. 2.4).

o peyaa eca cxooopoe pae opeeeo c epo

cyae:

1) o y oee oypo oe epex oyeo a oee eax oea;

2) o ooy oypoe oye o ea oe o oy e oypo e oeo c oepeee o ooy oypoe oyeo a eax oea;

epeoe ocaae cxooopoo pa ocapoaoc:

1) ec a oee eax oea o ooy epex oypoe;

2) o oy epex oypoe oye o ea oe ooy e oypo e oeo c oepeee.

Hopa cxooopoe pae caec (cooecy opacy), c peya ecpoa e yaac pey aeop.

poee aa eco oyea: aoo ae ceaco-cxoepooo oo peea.

7. a ocoy oe a pa ee pepoceo a a aa caapx apooepecx oaaee, epo axoe ee P, p oo popa W nthr (vrsin 3, pril, 2009), c.

e. paca paeop copoc poca o a a oaaee eca (m), poca (l) paepo opyoc oo (O), c epao 3 eca.

8. 3 cpa (M-xoapopa) a aapae G Vivid 3 (CA), ye lrflw oe opae ocae cepeococyco cce.

Pcyo 2.4.

apa oe cxooopoo pa (eep-ec II) o

9. o ae cypooa oyca a poeea oea coco opao cyxa pe: a ae poeo aoo yoax ooe. Cpooe cypooecoe cceoae ee poeeo eoo pecpa ooayceco cc (ccea uSrn p dsn aa oa GN tmtris, a). Cpooe cceoae ae a apaa oea: SS RFFR. ep apa apye cyxa y oceyeoo e, opo apa - eoxoo oopoe ecpoae oceoae a ae ceapoaoo ecoo epa c cooae caoapo aapayp.

10. Koep epoeaopa NIL rv (CA) ooe ocyec ac c 12 epoo (c op aa) coco opcoa. Ha y aaac peepee epo.

Copoc ac ax cocaa 30 /ce. Pecppoac ooope ope ae. Aa pooc o xapaepca ocoo aoc, xapaepy yce eeoooo aoc, a eceeco apocao aoc eopo aoc.

11. 3 ypex opao HC cooa e oec a, ypayoo aapa Kapc c (Pocc, OAO pac popocpoe ao).

12. epoapopaecoe cceoae poooc a aapae Shillr rdivit -1.(eap). 3-x aa epoapopa, o ooe oece epepy pecpa K, ca o cex (12) oee K a e opaaac oopeeo.

13. cceoae epaoecx aex aox oeao oeco epaoa, ocyecoc aapao-popa ao (.

papaoa ceaca 3AO Macc, Pocc), peaaeoo oye opae c oceye x epeae oep oo popa pacpo c ceao epaoa. Ceye oe, o c c e epooec cocoe eoopx ee c AC, oaaoc eoo oyee oeao p oo aocoecoo caepa, xoeo aapaopopa oec. ooy oyee oeao poeeo o eoy aoo T.. c cae a yae c cooae opaco pac (pc.2.5) p oo aeoo caepa (pc.2.6), c ocey epeoco opae oepy popay epaoa.

Pcyo 2.5.

Oea ce, oyee c oo opaco pac epaoecx pao poeea Pacpoa coaco Meyapoo epaoeco acca [224, 221]. Oea 41 epaoec apaep, opaa aee ( yopa a ao ae, cee acep yopo) aoe yop (ae pacooee aox ocex ppayco, ea ya atd, xapaep pcyo a eape oeape eaex ox), .e. paec ce ee, ocaee eco epaoe, a cee pax aopcx eco, xc, a pao, poo ocox epaoecx apaepo. Tae cceoa ce pee ce (oeco apx , epeceax py, coey ep yopa ppayc) c c eoooc oye aecex opae, eoxox oce pee. o ocec e epooec cocoe eoopx aeo c AC. ooy ocoepoc aaa pa peeoo cea ao cceoa ce.

Pyo 2.6.

Oea ce, oyee c oo aeoo caepa 41 , 1 - atd, 40 , .

Penrose L., , , atd.

. - , , , .

(arch) L - .

(loop) L . - , , , , , . , Lu, Lr.

(whorl) W . .

, , (. 2.7) . 2.7. : W - , U - , R , A - , d - , .

. t a, b, c, d, 2, 3, 4, 5 (.2.8). a, t

- atd. : d t (, , ( ), ( , , , , ), ( ..), ( 5, 5-10, 10) ( 1 , 1 , ).

. 2.8. , , (Cummins, Midlo, 1943) : Th , Hth , 1,2,3,4 , I, II, III, IV , pfp I , pftp II, pftd - III, pfc , pfm-ph : t, t', t" , ; , b, , d ; , , , D - , 1-13 - .

( Cummins, Midlo, 1943 .) Tae poeeo yee oopaeco xapaepc ox cao c oo oopao ce oopaeco peaope D phtshp (. 2.9).

. 2.9. Koopaa cea ye ox cao Koopaa cea pacoaaac a ypoe pocao ca 3-o 4-o ae. Ta oao, coa yco oee oo oopaeco xapaepc ox cao ao. B ae 2.1.

oaao oee co cceoa, poeex y ee.

Taa 2.1.

Oee oeco, poeex oceoa

   

Caceca opaoa oy pao oyex ax pooac cooae Opaoa c caceco popa SISTI v. 6.0. poeea oea a oecex (c opa pacpeeee), a aecex pao.

Oop oc poo e , p a,

caapo oo. ac - acoo acoo coc p poa. apapc pp aa- (U) cooa pop poo o pac cp p.

Ooaop cpco aa c op pp t ( ap ap cpa) coa ca cp p cpa o a c a p oo. aaa ocoo cpa cooac pp t- o opa .

pp cooc ( 2) c oo cooac cooca pa pa ac paa.

0,05 a. pa cac cacc oppooo aaa cooa o (R).

poaa WHO Anthro (version 3, April 2009) cooaa opao c oco apoopc p (ocoa co (WHO Software License Agreement, Department of Nutrition, World Health Organization.

pa, op pc a a, oa o ccoa, pca ac p. O oac o oa a. oco o oao a oca pao pa 2. oo pa o o oao occo ppcc, o aoc po pa aco cpaoc pa pao c a 31 pa (a, apa, paaa, ao, oo ppa: 1 - apa, 2 pooo, 3 pao, 4 ooo pooo ..), apap pco a a, 2 paa-apapc coo (o pa).

o coc coc cooac o (o o cpao ).

   

XAPAKTEPCTKA AHAHE3A, 3ECOO HEPHOCXECOO PA3B HAAEX ETE

apaepca opoepecx ax aaex ee 3.1.

B cooec c e aaa cceoae poooc 4 aa.

Ha 1- ae poee coo pepoce oepe cp oy ee, ocao P (n=122).

o peyaa poeeoo cceoa o ceao e op:

ocoy opy coca 55 ee, y oopx p poe e oaae acc, ea, opyoc oo (aocece pep AC - m, l, O ee 10 oe cpex ax oy - a caap peaepoa pao M3 P 151 o 07.05.1998 . pao M3 P CP 307 28.04.07 .).

Kopoa pya paopoaa e opaeex, cocaa 67 ee, y oopx m, l, O oe 10 poe aepax oaaee acc ea, ea opyoc oo p poe.

Bopac oceoax ee aaoe 2,5 eca 4 oa. Cpe opac 1 o 10 ec. Coooee ao eoe cocao 69% (84 peea) 31% (38 ee) cooeceo.

p ocee oecee ae apooepecx ax pecae e aepax pao a ocoe opaoo pacpeee aoo paa.

5 ee acca ea p poe 10% poe, 69 ee e accy ea 10% poe. 45 p poe e y ea 10% poe, y 77- a a 10% po.

o coooe opyoc oo (O) opyoc pyo (O.) e p poe e ae paec a e py. Opyoc oo

   

a 3.1 ceye, o e oaae ecoo pa p poe e y ooo oeca ee, o yaae a aepy ypypooo pa oa (3BP) o oacecoy y.

Peyao 1-o aa cceoa cao ee ooo poea y ee P, ceo 53 peea, 43,4% cex pacpocpaeoc 3BP oceoax. Ha oeoyoo ypoe a pa e, o a epay 15,9 % [102].

o a a poe ee eaop eee c ypypooo epoa pa aeo e.

B peyae epoo aa coppoa e op: Ocoa - 55 ee, ooo oepec ypypoo oec aoo, pa pep e - aocece pa (p poe m, l, O ee 10 po). Cpe o py cpeao a acca ea a y 9 ee (16,4%), oe a y 28 ee (50,9%) a acca ea - y 18 (32,7%). Heoxoo yo, o eco oyea P opa

   

30% ee (36 122) c oaae ecoo pa p poe e (ee 10 poe) oaa P O.

poeea p epxe y (B) paoa oea paeoc eoa epxe y (B) ooa ee c ocoeoc opoep , oope eoxoo o oc.

e o py e e oaae ecoo pa p poe a oe ocopa. Paoa oea B B (o 1- o 5-o paa) pooc cooec co caapo, oca o 2 ae. ae pecae ae 3.4.

Taa 3.4.

ae cceoa paeoc B B

   

3- pya (cpae) - e, e ee AC (eAC) e opooecx ooe cpoe eoo epea opaoe ecoe pae poecce poca.

Bo cex pex pyax ec eooee e e c 3B. Ceye oe, o e c AC AC e e e a ecoo pa p cpa c opoo pyo (eAC), o oe ceeco aeaoc coyex a aocecx pao ACH.

Xapaepca ecoo pa aaex ee 3.2.

O aex pep opo ec ecoe pae ee, o ooe ea poopoa aee ee opoe ee. eeeca popaa pecae apopapoa poecc pa, acoc poc peea. aa popaa aae ec pa peea, e eaope oec aoee y epo pa oy eo po apye poca. aea oeoca aep oecea pae poa coa ooecy cpey, oppyc eocpeceo c c opao aep. oe eaopoe oece po apye aceceo popa oa eoa eeecx ee. B oeoyoo eco cpee, o a epayp, ye ec ee c oe ec , , peeax 1,5 5%.

, , (3P) . 25% 17% . , , 5- 9 , 2,8% 3,6 % [66]. 2,2 , , - 88,8% 39,5% . .

, , 3- . , , (MT) . 3.5 3.1.

3.5.

1 2 3 m

   

(stndrd dvitins-SD) (m) (. 3.1), . (-SD), 1- (-SD) 3- .

/ , (-3SD), 3- .

- , P, p poe pacoaaec e opoo opopa caapoo ooe (-SD), oy epoo oa cpo oaec a ep ooe opopo (+ SD). MT .

, (-2SD).

, , , [66].

cpex [17, 53] , . P ( 98%).

, , P . 3.6 3.9 . 3.2 3.5.

3.6.

acc ea (p.) ee P o cceye pya m 1 o 2 o 3 oa

   

* 0,01 ( ) 3.6 .3.2 , ( 0,005), 3- () 2- AC AC 3- .

, 2- AC AC (1- 2- ) accy ea e cpeeo ( 3% AC 15% AC). 3 cpe oaae acc ea cpee opope (=50th).

Pcyo 3.2.

acc ea (cpee ae) ee P o cceye pya AC-31 AC-20 eAC-71 cceyea pya cceyea pya cceyea pya , , .

: , , 3- ( ). ( 3.7 3.3). AC AC

   

AC AC .

B (eAC) . 1- ( 15), , 50 . , ( ) : , , , ..

MT , . , aeca oeca . B ae .8 pcye .4 cacec aapyex py MT. 3- , , , , .

AC eAC c AC 3- MT (75), oaoo a . AC - .

Taa 3.8.

ae MT(/) o cceye pya pya 1 o 2 oa 3 oa Hoopoee

   

, , , . IOM, .

, .

.

O, 3.9 cye 3.5

. (p 0,005) .

B AC O 3- , (eAC) O 1- . 12 3- O .

B AC, O , O. , 15, [99].

   

Pa O . , , [219].

   

ACH -, , . . ,

   

* 0,01; ** 0,05; *** 0,05 ( eAC) . , . , AC.

Pco 3.6.

Cpe opac aepe o ee pya , , () . [53] [125].

, , epaaoe opaee HC. , , AC 4- .

P . 3.7.

P . (. . 3.8) . 3- (eAC) 58 , 2- (AC) 74 ,

   

( 4- ).

3.8.

Cpo ocaa ee () o epeoa P (86) (74) (58) P , , , :

ae 1- pye (AC) - 71%, 2- pye (AC) - 50,9%, 3- pye (eAC) 19%;

pax 1- pye (AC) - 88,5%, o 2- pye (AC) 62%, 3- pye (eAC) 47%;

aoec epa 1- pye (AC) - 11,1%, o 2- pye (AC) - 19%, 3- pye (eAC) - 34,2%;

opo 1- pye (AC) - 85,7%, o 2- pye (AC) 78%, 3- pye (eAC) - 12,4%).

P c AC AC III pye , 96% 55,81% [25, 53]. , . 3- (eAC) 4 , 2- (AC) 5 , 1 (AC) - 7 . 1- 2- .

2- 1- (AC).

, , , .

, ACH P. AC (62,5%) AC (40,6%) eAC (19,6%, 0,001). HC : 1 53,7%; 2- 21,8%; 3- 12,5%. , , HC. , , .

HC . -. , , , 35 , , - (, , , , , , , , , , , , , 1- 2- , ..). HC , .

( Y21, DN1, LD2).

- (.

. 3.11), [125]. 1- (AC) CCC 13 (41,9%), 2- (AC) 5 (25%), 3- (eAC) 5 (7%).

   

* . eAC ee 1- (AC) 3 M M, 2- (AC) M , 3- (eAC) M.

K . K-, , . (1 . (AC) 9,7%, 2 . (AC) 20%, 3 . (eAC) 7%, 0,01 2 3 ), (1 . 9,7%, 2 . 15%, 3 . 5,6%, 0,01 2 3 ), (1 . 16,1%, 2 . 10%, 3 . 2,8%, 0,001 1 3 ), (1 . 6,5%, 3 . 1,4%), WPW (3 . 1,4%).

, , . HC, BHC . - , . , . "" HC 1 2 (1 53,7%; 2 21,8%; 3 12,5%) .

3.4. -

   

. 3.12 122 P . : 57 (46,7%), 54 (44,3%), 11 (9,0%) .

, (. 3.13). 28 (90,3% ) 1- (AC) eepcoo cpooo eca. 2- (AC), 16 (80,0% ) . . 3- (eAC) (85,9% ), ( 0,005) (64,8%).

Ta 3.13.

eep-eca cxooopoo pa e pya (122 ) AC AC eAC cceyee py 20 31 71 Bo o peyaa

   

, 1- 2- 4 ( , , , ). 4 . 50%. 3- : .

, , eepcoo cpooo eca - . , AC AC, , . : -, - .

   

a oco pea, ooae ae 3, co oocoa poec p cceoa, apaep oaoe coco C oco aaaopo eoe (pee c).

   

Cee apaep ee o opac op oco ccea oepec aoc oa ee P. aooec oaae ooeao paee o a opa o aepe opaco pa, a ae oc poe oe oee ocee ee.

cceoa peao o poee 69 ee, opac o 18 o 29 ece. 1- pe c AC 13 ee, o 2- pe AC 24 peea, 3 opoo pe eAC - 32 pee. poee opeee acoo apaepc ae aoo o , ae pecae a.

4.1.

eooo e, o pea opa oaae ea oo 9 (11,1%) ee P. o aape pa ec ae oepec ooo oa.

pacoe aoc epe paee e ee apooopo ee pa 1- (AC) 2- (AC), pa peo c ce cpope cpeocoo cpp, ao ee ope opoo pe eAC (47,8%). Copee ce, o ap

   

* p 0,01, ** p 0,02 (o ooe eAC) peae poca -aoc oo oo-coo oaa, oa ape eoapo cepa, oope ae aac ee c AC AC. Poc -aoc ocoe oece eoaeo eeopo ooo oa e aoc c opoo epoeop cceo A [36]. -aoc ooepa oac ee p c c ocaae peeo ceco pa[26]. e aoa a o po pea ooco ea apaepeec pae eee eo paepo ae o eoapo [34]. Aaoe paccoacooc oeeco aoc eo 34,8% ee 3- p.

ae apaepe oee aaec cpp (p 0,01) 69% pe AC 62,5% AC, ocoe ecpopoa eaoea coo aco [52]. o oe aa a co aoc ceec eceec ep aaca, aa caa epo-op aoooe.

peoaa ac ee c ppo oece aoo ec epeoc oepeco aoc ooo oa, o o ceec: cee oao aoc ooo oa ( 1- pe (AC) - 21%, o 2- pe (AC) - 37,5%, p 0,02) aepa opaco eoea ( 1- pe (AC) - 69%, o 2- pe (AC) p 0,02).

oce oo opo-oaoo ceeco opee oa oe occe eopo aoc oa.

a opao, aa oepeco aoc ooo oa ee aae a ocoeoc epoooeco ap eec o ce 3- pa. o peap e ee aape oepeco aoc oooo oa ee 1- p 2- p.

aoe epee cocec c peaa eep-eca II. ee c AC AC apaep e oaae o ce 4 cec cepa (coaa aaa, oa oopa, oa oopa, pe) o aae a o aep ceco pa.

   

ae epap ceec, o aoa opao pe ca c ppo oece aoo, cpeac o aoo epoo peea c AC ( cpee 90 % a ee, Stromland K., 1985). aoo opaa pe a e a cepee poee aoa (poa, a, oooa pa opo, e ee cea p.), a eaee eco ooe aepo [17].

ceo o oceoao 36 ee pa AC AC, a ae 53 peea opoo p. 1- pe ocpoa pe e ea oppe aoac cpee ae 0,770,28. 3-p (opoo) ocpoa pe a oee coo 0,850,26. apoc pepa pa oeac o epepo cpee cee o o eo cee. epo peapoa ce oceoa ee. pe AC epepo peapoa cppe aepo, 38,9% 1- pe 23,6% 3- pe.

Aca cpec ae o 4 paa (26%) ee 1- p (AC), cpae c e opoo p aaoo o opaca (6%).

poa 96% (eAC 0); o 9% (eAC 0); ocoae 16% (eAC 3%); ao 6% (eAC -0), P0,001 - ce aaoec opo peapoa 1- pe (AC).

o peaa oaoco apa ao a ce pa cooecoa opao, o 1- pe oco o peoo epa

   

eaeoe cee ca oe c oo p ooe pa peea. oco ee-cpo P, epe ec e e peo pae cec epa, oo ocoeo aee popeae aaa ooao oaa c peeo. e cao eocpeceo aoec c peeo e acc ocoep coco c oceeo. p occ epeca cceoae peeo oce cae e e a peapoa a . eo ooacec cc (OA) cooa cceoa coco ca ee opaee P.

eppea eca ocecec ce opao:

ec e poe: e acoo ao pea o ce aco ooca. o cae pee o poee ooee cceoa (oopa C) pecpa OA, pecpa caoe p opaeoo peaa ecpoa.

ec poe aco: ae aeao oe oo e aa aco ooc. Oo a ca aaaec oopoe oceoae.

ec poe: aa oea cepa OA o pea poe a, a , a 3 .

o oa cceoa po ec: 43% ee 1- p (AC) 11% ee 3- p (eAC) (P0,005), aco poe ec 24% ee 1- p 16% ee 3- p. oee oaee ae oo epa o a oec ape epocecopo aapaa, a o peaa cceoa pe, a o peaa cceoa ee c AC AC.

Pea epaoeco oceoa 4.3.

ae pc op a ao ooa pao, a pee paac o poe, a a op a aa aaac a 6 17 eee epeeoc o e e ec. p cceoa oo o opa o opea aopa, oop ecoa a o.

Pa o poco e e poa aao, o epa cce eoa, ee op opaa opooec opaa oa. oo pe poaapoa epaoec ap ocee ee. a o caao e, op a aa aaac a 6 17 eee epeeoc, oo aaa pa e c AC e c eAC. a o oceoa 98 ee: 49 ee c AC AC opace o 3- ec o 4- e, poa , 49 ee, ocea ooec ece ooe pee, opace o 1 o 4- e, e poe AC (pa cpae).

p aae epaoec ap eo ce caa, o a e oapo ee epao, app eeec cpo [58, 92]. eo ocoepo oee aco cpeaeoc epao ooo ooe oceo ppaca (p[ = 0,003), c. a. 4.2, pc. 4.1 4.2 ee c AC. cceoa Tillner I, Majewski [229] ae

   

e eoa aa cacec a pa o ao pa e. e pa pa cacec a oe p. ee c AC (1 p.) pee cpeae aee 2, a ae 3 4 oape oo ee c AC.

oee a pea epea c a Berr C., Seltzer B., oap epaoe poeooe ooe oceo ppaca t p oceoa aeo c oe Aeepa, o oe ceeco o oe o epoeepa ppo ape C aeo c AC [220, 227].

ae poe opooec epe aoo ppaca (c. pc. 4.3).

c poec o d t, o opaec ao o, ope o e peae 57, a p pooco oe eec: 1 cpo aa, 2

cpo aa, 3 cpo epeeco-epepa, 4 opa, 5 cpo aeepa. epe aoo a adt pecae a. 4.3.

Pco 4.3.

a (oce) ao ppac.

aa 4.3.

Cpeee aee aoo a atd ocee ee

   

a pea oepa occe aceceo eeec aoo (a aea acc-cepoep) ceec o eeeco aoo a oppoa eo ee c AC.

Aa apaepa ae opo oaa ocoepo eee aeo c AC aco cpeaeoc poc eeo opo ap, cooeceo eee cpeaeoc co eo opo ao (a. 4.4). Coco eop oeeceo ceaca o epaoe .. oaoa o [13] ceece o ce aaoc, a a poc oe op app poe ooec aaoc, o oepaec acoo aoeaeoc ee ocp pecpaop e.

Aa cpeaeoc pco a eape oaa ocoepoe eee aco apao e ceo pca a eape oo pao p aeo c AC. Coaco a .. [19] oea opoc eapa ceece o ape epeco aoc o a eeec ecp, - .

   

* pa ocoep e ocoo opoo pa, p 0,001 ** pa ocoep e ocoo opoo pa, p 0,001 Pco 4.4. Pco a eape pao p

   

Cacec a pa o ao pa e aa eoa e. o p pa a o pao o eo p: ee c AC ae cpeaec aee 4 pee aee 1, e ee c eAC; aee 7 apeo oo ee c AC.

ee a pacooe ao oaao a peo cpeac 3, 5 6 o (c. a. 4.6), o apaep ecp [32].

   

Pco 4.6.

epee eca ao a opao, oo cea cee o: o-ep, a eo e ac p o pa o aco cpeaeoc oo oo paa, apaepe pc a pa; o-op, ec oo 5 pa 31, o oop aac cacec ae pa e e c AC eAC, a eo:

1) Pco a 1 ae a pao p: aee 2 ae cpeaec ee c AC, e ee c eAC, a aee 4 aoopo, oee apaepo ee c eAC, e ee c AC. ae, oao, o o aaoo pa eo p cacec a pa e;

2) ooee oceo ppaca t a pao eo pa: oo ca ae 3 cpeaec oo ee c AC, aee 1 cpeaec ee c AC ee c eAC, o oce ocoepo ae;

3) Pco a eape pao eo : oo ca aee 7 cpeaec oo ee c AC, aee 1 cpeaec ee c AC, ee eAC, o oce ocepo ae.

coa, pe ee c AC ocoep ae cpeac oe op a aa, epao oooe ooe oceo ppaa, eee opoc oeapa, opoc eapa a pao pe, aoe pacooe ao . oee pea ceec o ce po ooeco aaoc ee c AC, ape epeco aoc oa, ee oaao-oap cce a eeec ee opae ee c AC, ca c ocec ece aoa aeaao epo, o oe cooao p ocao aoa AC (ceoc = 91,8%, ceoc = 79,6%).

OE EAO

eaop oec epo ppoo pa poo po o opaeo a C , ocaa epo. ocec oec epo epeeoc, oocc ao, c aopa ooao po pa pa aoo oa. ece poe peea ocoee peo aoo epeeo aaec ea aoo cpo (AC). AC ec oo oco p, o a epap, ocaa ceo pa.

e acoe cceoa oa oeca aoc eao aooo cpo c pee epaoeco eo ee pae opac.

cooec c e aaa cceoa pooo 4 aa.

a 1- ae poee coo pepoce oepe cp o ee, 122 ocao P.

pea eo coppoa 2 op: Ocoa 55 ee pa pep e - aocec pa AC (m, l, O e 10 epe cpe a o) (a caap, peaepoa pao 151 07.05.1998. pao 307 28.04.07.).

opoa, paopoaa e opaee, coca 67 ee, oop m, l, O oe 10 epe aepa oaaee acc ea, ea opoc oo p poe.

opac oceoa ee aao 2,5 ec 4 oa. Cpe opac 1 o 10 ec. Coooe ao eoe coco 68,9% (84 peea) 31,1% (38 ee) cooece.

p oce oece ae apooepec a pecae aepa pao a oco opao pacpeee ao paa.

53 ee acca ea p poe 10% epe, 69 ee e acc ea 10% epe. 45 ee p poe e ea 10% epe, 77 ee a a 10% epe.

o coooe opoc oo (O) opoc po (Op.) e p poe e ae paec a e p. Opoc oo 47 ee a 10% epe, 75 ee 10% epe. Opoc po e 51 peea 10% epe, 71 pee 10% epe.

a opao, peao 1-o aa cceoa cao ee oo poea pacpocpaoc P ee P, ceo 53 peea, 43,4% ce oceoa. a oeooo poe a pa e, o a epap 15,9 % [102].

o a a poe ee eaop eee c ppoo epo pa aeo e.

pea 1-o aa coppoa 2 op: Ocoa 55 ee oo oepec ppo oec aoo pa pep e - aocec pa (p poe m, l, O ee 10 epe). Cpe o p cpea a acca ea 9 ee (16,4%), oe a 28 ee (50,9%) c o acco ea 18 ee (32,7%).

eooo o, o ec oea P opa o ooeoc eoooc aac occe, oo aa opa e aac.

opoa opa 67 ee, oop p poe m, l, O oe 10 epe aepa a acc ea, poc, opoc oo.

a ae, oeo oepeoe 2- coe oceoae ocao P. a oe ocoa oe aa a: acc ea, poc, O, O.

55 ee ocoo op, apaep ec a p poe, 47 ee (85,4%) e oee oaae a oe ocopa.

ece c cceoa eco pa oe oea eo copa o pe oco apaepa: ao e, pe a ep , paeoc eoa, eo o epe oc.

2-a aoe oppoae 3- p:

1- p coppoa cooec c aocec pep IOM, e c accec poe AC e a eco pa eo cop. 31 pee o ec a e ocaa o acce ea, poc opoc oo p poe oe ocoa eee 10% epe. eo cop cooecoa pep AC: pa ao e eee 10% epe, paeoc eoa epe IV - V paa, p ep IV - V paa.

2- p - c poe aco AC (AC) eo cop

eo oec e 1 paa, 20 ee.

3- opoa pa e poe AC (eAC) e eo cop opa ece ae.

o ce 3 pa ec eooe e e c P. Cee oe, o e c AC AC e e e a eco pa p cpae c opoo po (eAC), o oe ceec aeaoc pa a oeca aocec pepe AC.



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