OA?E?ANUeEEE AeA?AEAAIEE IAAeE*IEE OI?AA?NEOAO
Cae/aiei Ieueaa ?aaai?aia
OAeE
616.12008.46+616.124.2:/615.225.2:615.355
II??AIssEUeIA IAOAAIE?*IA OA AAIIAeEIAI?*IA AOAEOEAI?NOUe
?IA?A?OI??A AIA?IOAICEIIA?AOAI?THTH*IAI OA?IAIOO I?E AeENOOIEOe?? E?AIAI
OEOII*EA OA II?OOAIIssO NA?OeAAIAI ?EOIO
14.01.11 Ea?ae?ieia?y
Aaoi?aoa?ao aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy
eaiaeeaeaoa iaaee/ieo iaoe
Oa?e?a 1998
Aeena?oaoe??th ? ?oeiien
?iaioo aeeiiaii a Oa?e?anueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao?
IIC Oe?a?ie
Iaoeiaee ea??aiee: caneoaeaiee ae?y/ iaoee ? oaoi?ee Oe?a?ie,
aeieoi? iaaee/ieo iaoe, i?ioani?
Eaoiaoc ?aai E?iae?aoiae/,
Oa?e?anueeee aea?aeaaiee iaaee/iee
oi?aa?neoao,
caa?aeoaa/ eaoaae?e aioo??oi?o
oai?ia, EOE oa NI.
Io?oe?ei? iiiiaioe: aeieoi? iaaee/ieo iaoe, i?ioani?
Eiaaeueiaa Ieueaa Ieeiea?aia,
Oa?e?anueeee aea?aeaaiee iaaee/iee
oi?aa?neoao, caa?-
aeoaa/ eaoaae?e i?iiaaeaaoeee
aioo??oi?o oai-
?ia ? 1;
aeieoi? iaaee/ieo iaoe
I?eieaiei ?aaai sseiae/,
?inoeooo oa?ai?? AII Oe?a?ie,
canooiiee aee?aeoi?a
c iaoeiai? ?iaioe .
I?ia?aeia onoaiiaa: Oe?a?inueeee iaoeiai-aeine?aeiee ?inoeooo
ea?ae?ieia??
?i. aeaaeai?ea I.Ae. No?aaeanea,
i. Ee?a, a?aeae?eaiiy
aoa?ineea?ico oa o?ii?/ii? ?oai?/ii?
oai?iae na?oey.
Caoeno a?aeaoaeaoueny 11 ethoiai 1999 ?. i 13.30 aiaeei? ia can?aeaii?
niaoe?ae?ciaaii? a/aii? ?aaee Ae. 64.600.04 i?e Oa?e?anueeiio
aea?aeaaiiio iaaee/iiio oi?aa?neoao? ca aae?anith: 310022, i. Oa?e?a,
i?iniaeo Eai?ia,4.
C aeena?oaoe??th iiaeia iciaeiieoeny o a?ae?ioaoe? Oa?e?anueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo ( i. Oa?e?a, i?ini. Eai?ia,4).
Aaoi?aoa?ao ?ic?neaiee 9 n?/iy 1999 ?.
A/aiee nae?aoa? niaoe?ae?ciaaii? a/aii? ?aaee
eaiaeeaeao iaaee/ieo iaoe, aeioeaio .
Ia/a?aiei E. ?.
CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE.
Aeooaeueiinoue oaie. A inoaiii ?iee aeinyaiooi cia/ii oniioe a
aeiaaiinoeoei oa eieoaaiii ii?ooaiue ?eoio oa i?iaiaeiinoi na?oey.
Aeineiaeaeaiiy, ui i?iaiaeeeenue, aeaee ciiao anoaiiaeoe, ui ii?ooaiiy
?eoio o aieueoinoi aeiaaeeia aeieeathoue i?e i?aaii/ieo o?aaeaiiyo
na?oeaai-noaeeiii? nenoaie (Eooaeianueeee I.N.,1992-1993, Iaea E.O.,
Eaoiaoc ?. E., 1993, Iaco? I. A., 1995). Aeineoue /anoi ii?ooaiiy ?eoio
na?oey iathoue iinoea ia oiii aeenooieoei? eiaiai oeoii/ea o oai?eo ia
ioaii/io oai?iao na?oey (?ON), ui aieeaa? ia ia?aaia caoai?thaaiiy oa
eiai i?iaiic. (Aiiniaa I.I., Aia?ia A. I., AEa?i-iia I.E. 1995,
Podrid P.J., Fogel K. L., Fuchs T. S.,1992 ). Iae/anoioa i?e yaiie aai
eaoaioiie aeenooieoei? eiaiai oeoii/ea, ca aeaieie oieoa?ianueeiai
iiiioi?oaaiiy AEA, cono?i/a?oueny oeoieiaa aeno?a-nenoieiy (80%
aeiaaeeia) i ianoieea oeoii/eiaa oaoiea?aeiy (aieueo 40%
aeiaaeeia). (Aia?ia A. I., AEa??iia I. E. 1995, Eooaeianueeee I. N.,
1993 ).
Iiyaa oeoii/eiaeo ii?ooaiue ?eoio oa ?o a?aaeaoeiy a cia/iie ii?i
caeaaeaoue aiae ae?aaeaiinoi canoieieo yaeu i ooieoeiiiaeueiiai noaio
oai?eo ( Aiiniaa I.I., 1994, Parmley W. W., 1987). A ca’yceo c oeei
aaaeeeaa cia/aiiy ia? aeei?enoaiiy i?aia?aoia, ui ciaioothoue nooi?iue
aeenooieoei? na?oeaaiai i’yca. (Iia?eiaa E. N., A?aa?aeca A. A., 1990,
Neoiie N. I., Iaeeoei E. I., 1994).
Na?aae iaaeeeaiaioicieo caniaia, ui aeei?enoiaothoueny i?e
aeenooieoei? iiiea?aea, aaaeeeaa iinoea caeiathoue iiaiaioi?e
aiaiioaiceiia?aoai?thth/iai oa?iaioo (AIO) ( Ai?iieia E.A., ?yaaiei
Ae.A., 1994, Bielem E.C., Fagard R. H., 1992). Caiiaiaath/e aieeao
aiaiioaiceio ?? ia na?oea, iiaiaioi?e AIO ni?eythoue ciaioaiith
aiia?o?ioi? iiiea?aea, iie?auothoue iaoaaieici a na?oeaaiio i’yci,
ciaioothoue ei?iia?iniaci ( Rogers W., Johnstone D., 1994 ). E?ii oiai,
caaaeyee aaciaeeeaooth/ie aei? cieaeaiith ia?aae- oa iinoiaaaioaaeaiiy,
iiaiaioi?e AIO caiiaiaathoue i?ia?anoaaiith aeeeaoaoe?? eiaiai oeoii/ea,
ciaioothoue nooi?iue iaaeinoaoiinoi e?iaiiaiao ( ?yaaiei Ae. A., 1996,
Naeuaiei ?. I., 1995 ).
Aieea ia na?oea iiaiaioi?ia AIO caeienith?oueny ca aeiiiiiaith
iae?iaoii?aeueieo iaoaiiciia, oaeeo ye iiaeaeuaiiy aeoeaiinoi ?aiiio,
cieaeaiiy ?iaiy aeueaeinoa?iio, iiaeaeuaiiy ?iaiy a?aaeeeiiiio,
iineeaiiy neioaco i?inoaaeaiaeeiia. (Ieuea?inueea E. ?., Ii?iciaa O. ?.,
1993, N??aiei TH. I., 1994, Robertson J. S., 1993 ). Aeieeiaiiy
oeoii/eiaeo a?eoiie o oai?eo c o?iii/iith na?oeaaith iaaeinoaoiinoth
(ONI), ui cia/ii iia??oothoue i?iaiic aeey aeeooy, cae/aeii
caeienith?oueny ia oei iae?iaoii?aeueieo ii?ooaiue, ye? onoaathoueny
iiaiaioi?aie AIO ( Aia?ia A. I., AEa??iia I. E., 1995). Ana oea
aeicaiey? i?eioneaoe iiaeeeainoue aeei?enoaiiy iiaiaioi?ia AIO i?e
oeoii/eiaeo a?eoiiyo o oai?eo c aeenooieoei?th iiiea?aea ?iciiai aaiaca.
( Aaeaieia TH. I., Aaa?a O. O., Ia?onaa A. TH., 1996 ).
Aea aei oeueiai /ano iaaeinoaoiuei aea/aia ieoaiiy i?i aieea
iiaiaioi?ia AIO ia iniiai? eaiee iaoiaaiaco a?eoiie o oai?eo c
aeenooieoei?th eiaiai oeoii/ea oa aac ia?, i?aeoe/ii aiaenooii aeai? i?i
ea?aeiiaaiiaeeiaii/ii i iaoaaiei/ii aoaeoe iiaiaioi?ia AIO i?e
ii?ooaiiyo na?oeaaiai ?eoio, ia aea/aii iiaeeeainoi niieo/aiiai
aeei?enoaiiy iiaiaioi?ia AIO, aioaaiiinoia ?aoeaioi?ia aiaiioaiceio II
i?e a?eoiiyo, iaaeinoaoiuei ?ic?iaeaii iaoiaee ia’?eoeaii? ioeiiee
aoaeoeaiinoi iiaiaioi?ia AIO i?e ii?ooaiiyo ?eoio ca aeiiiiiaith
iaiiaaceaieo iaoiaeia. Oaeei /eiii, aeine?aeaeaiiy a oe?e iaeano? ?
aeooaeueieie ? iiaeooue ni?eyoe iioei?caoe?? e?eoaaiiy oai?eo c
aeenooieoe??th e?aiai oeoii/ea oa a?eoi?yie.
Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie
?iaioa ? /anoeiith caaaeueii? eaoaae?aeueii? iaoeiai? oaie “
Iaoieiaiy na?oeaai-noaeeiii? nenoaie”, “Eeii?ei-aiio?i?/ii aniaeoe
aeiaaiinoeee oa eieoaaiiy ioaii/ii? oai?iae na?oey i?e niiaoe/ieo oa
aiaeie?eiieo caoai?thaaiiyo”, ? aea?ae. ?a?no?aoe?? 01950023462.
Iaoa ? caaea/? aeine?aeaeaiiy
Iaoith ?iaioe aoei iie?auaiiy e?eoaaiiy ii?ooaiue na?oeaaiai
?eoio o oai?eo c aeenooieoe??th e?aiai oeoii/ea ca aeiiiiiaith
aecia/aiiy ii?iaiyeueii? iaoaaiei/ii? oa aaiiaeeiaii/ii? aoaeoeaiinoi
iiaiaioi?ia AIO.
Aeey caeieniaiiy anoaiiaeaii? iaoe aeineiaeaeaiiy ieaioaaeiny ae?ioeoe
oae? caaea/i:
1. Aea/eoe eeii?/io aoaeoeaiinoue iiaiaioi?ia AIO i?e oeoii/eiaeo
a?eoiiyo o oai?eo c aeenooieoei?th eiaiai oeoii/ea.
2. Ioeiieoe iaoaaiei/io aoaeoeaiinoue iiaiaioi?ia AIO; ?o aieea ia
?aiii-aiaiioaicei-aeueaeinoa?iiiao nenoaio, iaiii aeaeo?ie?oia.
3. Aecia/eoe ae?aaeai?noue aieeao iiaiaioi?ia AIO ia
ea?aeiiaaiiaeeiaiieo o oai?eo c aeenooieoei?th eiaiai oeoii/ea oa
a?eoiiyie.
4. Ioeiieoe ae?aaeai?noue iaoaaiei/ieo aoaeoia iiaiaioi?ia AIO i?e
ii?ooaiiyo na?oeaaiai ?eoia ca aeiiiiiaith eaai?aoi?ieo oa iaiiaaceaieo
iino?oiaioaeueieo iaoiaeia aeineiaeaeaiiy.
5. Aea/eoe eieoaaeueii iiaeeeainoi eiiaiiiaaii? oa?aii? ii?ooaiue ?eoio
na?oey ca aeiiiiiaith iiaiaioi?ia AIO, aioaaii?noia ?aoeaioi?ia
aiaiioaiceio II.
6. Ca iaea?aeaieie ?acoeueoaoaie ?ic?iaeoe i?ia?aio ?aoeiiiaeueii?
oa?aii? o oai?eo c aeenooieoei?th eiaiai oeoii/ea oa a?eoiiyie.
Iaoeiaa iiaecia
A ?iaioi aia?oa aeine?aeaeaia eeii?/ia oa iaoaaie?/ia
aoaeoeaiinoue iiaiaioi?ia AIO o oai?eo c aeenooieoei?th eiaiai oeoii/ea
oa a?eoiiyie. Aeyaeaii iniaeeainoi iae?iaoii?aeueieo ii?ooaiue i?e
aeenooieoei? eiaiai oeoii/ea i a?eoiiyo, aecia/aii iaeaieueo
?aoeiiiaeueii oeyoe ei?aeoei? ca aeiiiiiaith iiaiaioi?ia AIO.
Aia?oa aea/aia iiaeeeainoue aeei?enoaiiy eaai?aoi?ieo i
iaiiaaceaieo iino?oiaioaeueieo iaoiaeia aeey ioeiiee aoaeoeaiinoi
oa?aii? iiaiaioi?aie AIO o oai?eo c aeinooieoei?th eiaiai oeoii/ea i
a?eoiiyie. Iieacaii, ui iiae aieeaii iaaeeeaiaioicii? oa?aii?
iiaiaioi?aie AIO o oai?eo c aeenooieoei?th eiaiai oeoii/ea ia oei
ii?iae?caoe?? iae?iaoii?aeueiiai noaoono i iieiioaiiy
ea?aeiiaaiiaeeiaii/ieo iieacieeia cia/ii cieaeo?oueny /anoioa
oeoii/eiaeo a?eoiie.
I?aeoe/ia cia/aiiy ?iaioe
I?aeoe/ia cia/aiiy ?acoeueoao?a aeineiaeaeaiue, ui aoee
i?iaaaeaii, iieyaa? o oiio, ui iieacaia aeioeieueiinoue i?ecia/aiiy
iiaiaioi?ia AIO oai?ei c ii?ooaiiyie na?oeaaiai ?eoio ia oei
aeenooieoei? iiiea?aea eiaiai oeoii/ea; anoaiiaeaii, ui iiaiaioi?e AIO
ni?eythoue ?aa?ani? aiia?o?ioi? eiaiai oeoii/ea, oiaoi iathoue
ea?aeii-i?ioaeoi?io aeith; aeieacaii, ui o oai?eo ia ioaii/io oai?iao
na?oey iiaiaioi?e AIO ciaioothoue nooi?iue na?oeaai? iaaeinoaoiinoi, ui
ni?ey? ciaioaiith /anoioe a?eoiie, cieaeaiith nooiaith ioaii? iiiea?aea
ia AEA, i?aeaeuaiith oiea?aioiino? aei o?ce/iiai iaaaioaaeaiiy ;
iieacaia aaaeeeainoue aeei?enoaiiy iaiiaaceaieo iaoiaeia aeineiaeaeaiiy
aoiea?aeiia?aoi?, oieoa?ianueeiai iiiioi?oaaiiy, i?ia c iaaaioaaeaiiyi
aeey ioeiiee aoaeoeaiinoi eieoaaiiy iiaiaioi?aie AIO oai?eo c
aeenooieoei?th eiaiai oeoii/ea i a?eoiiyie.
?acoeueoaoe aeineiaeaeaiue aeei?enoiaothoueny a ?iaioi
Aei?iaeii? eeiii/ii? eiea?ii ? 2 ( ea?aeiieiai/iiio oa iioa?eoiiio
aiaeaeieaiiyo); Oa?e?anueei? iaeanii? ee?i?/ii? e?ea?i?;
oa??oi??aeueiiio iaaee/iiio ia’?aeiaii? I?aeaeii?eiaecaanueeiai ?-io i.
Oa?eiaa: 12-e eiea?ii, 25-e eeii?/iie eiea?ii oa ?ioeo e?eoaaeueieo
caeeaaeao i. Oa?eiaa. Ai?iaaaeaeaiiy ?acoeueoao?a aeine?aeaeaiiy o
ee?i?/io i?aeoeeo aeicaiey? i?aeae-ueoe aoaeoeai?noue e?eoaaiiy,
iie?ioeoe noai o aeinoaoiuei aaaeeiai eiio?iaaioo oai?eo, ciaioeoe
o?eaae?noue ia?aaoaaiiy a noaoe?iia??. Iaoa??aee aeena?oaoe??
aeei?enoiaothoueny a iaa/aeueii-iaaeaaia?/iiio i?ioean? ia eaoaae??
aioo??oi?o oai?ia, EOE oa NI Oa?e?anueeiai aea?aeaaiiai iaaee/iiai
oi?aa?neoaoo.
Iniaenoee aianie caeiaoaa/a
Naiinoieii cae?enithaaea iiaeai? oa ianoaaeaiiy oaiaoe/ieo oai?eo
c aeei?enoaiiyi eeiiiei-iino?oiaioaeueieo oa eaai?aoi?ieo iaoiaeia,
?ic?iaeyea i?ia?aie aeeoa?aioeieiaaiiai eieoaaiiy iaoei?ioia. Ieaio-
aaea iaoo, caaea/i aeineiaeaeaiiy oa caeienithaaea eiio?ieue ca
aoaeoeaiinoth eieoaaiiy. I?iaiaeeea noaoenoe/io ia?iaeo io?eiaieo
?acoeueoaoia oa ?o aiaeic, ioi?ieyea aeena?oaoeieio ?iaioo.
Ai?iaaoe?y ?acoeueoao?a ?iaioe
Iaoa?iaee aeena?oaoeieii? ?iaioe aoee aeieeaaeaii i iaaiai?aii
ia iaoeiai-i?aeoe/ieo eiioa?aioeiyo iieiaeeo a/aieo iaaeeeia ( Oa?eia,
1996, 1997) ; caniaeaiii iaaee/iiai iaoeiaiai oiaa?enoaa (Oa?eia,1997);
iaoeiai-i?aeoe/iie eiioa?aioei? , i?enay/aiie i?iaeaiai caeicie/ii?
iaaeeoeeie ( Oa?eia, 1997 ); III-io Iiaeia?iaeiiio eiia?ani ii
aeaeo?inoeioeyoei? i eeii?/iie aeaeo?ioiciieiai? na?oey (
Ea?aeiinoii-98, Naieo-Iaoa?ao?a, 1998 ); OIV c’?cae? oa?aiaao?a Oe?a?ie
( Ee?a, 1998 ); II- e Oe?a?inuee?e iaoeia?e eiioa?aioe?? c
i?aeia?iaeiith o/anoth “Aeooaeuei? i?iaeaie ee?i?/ii? oa?iaeieia??” (
A?iieoey, 1998).
Ioae?eaoe??
Ca oaiith aeena?oaoe?? iioae?eiaaii 8 ?ia?o a iaoeiaeo
aeaeaiiyo, c
ieo 4 noaoo?, 4 oace aeiiia?aeae.
No?oeoo?a oa ianya aeena?oaoe??
?iaioa aeeeaaeaia ia 130 noi??ieao iaoeiiieniiai oaenoo, i?noeoue
5 oaaeeoeue, 11 iaethie?a ? neeaaea?oueny ?c anooio, 2-o aeaa iaeyaeo
e?oa?aoo?e, 7-? aeaa aeanieo niinoa?aaeaiue, iaaiai?aiiy ?acoeueoao?a
aeine?aeaeaiiy, aeniiae?a, i?aeoe/ieo ?aeiiaiaeaoe?e, ia?ae?eo
aeei?e-noaii? e?oa?aoo?e. Nienie aeei?enoaieo aeaea?ae i?noeoue 278
?ia?o, c ieo 93 aaoi??a e?a?i NIAe, 185 ?iicaiieo aaoi??a.
Ciino ?iaioe
Iaoa?iaee i iaoiaee
Ianoaaeaii 128 oai?eo ia ioaii/io oai?iao na?oey ( ION) c
aeenooieoei?th eiaiai oeoii/ea, a oiio /enei 109 /ieiaieia (85,2%) i 19
aeiiie (14,8%) o aioei aiae 43 aei 71 ?ieo. Eiio?ieueio a?oio neeaee 36
i?aeoe/ii caei?iaeo inia aiaeiai/iiai aieo oa noaoi.
Noai oai?eo ioeiithaaany ia iiaenoaai aeaieo
eeiiiei-ooieoeiiiaeueiiai ianoaaeaiiy, ui ioiiethaaei ?acoeueoaoe
oiceeaeueieo, oa?aiaaoe/iiai, aiioiii/ieo oa iino?oiaioaeueieo
aeineiaeaeaiue.
Iaoei?ioe ianoaaeoaaeeny a?aioei, iaoua, iiney 20-30 oaeeei
aiae-ii/eieo. O anio oai?eo i?iaiaeeee caai? e?iai c vena cubitalis aeey
aiioiii/ieo aiaeicia. A e?iai aeineiaeaeoaaeeny iieacieee noaio
?aiiiaiaiioaiceiaeueaeinoa?iiiai? nenoaie (RAS), eiioeaio?aoeiy
aeaeo?ie?oia. Aeiaaiinoeeo a?eoiie oa aa?ioieaoeith oa?aeoa?o ii?ooaiue
?eoio i?iaiaeeee ia iniiai AEA-aeineiaeaeaiiy. Aeiaiaa iiiioi?oaaiiy AEA
cae?enithaaee ca aeiiiiiaith nenoaie aeey aeeiaii/ii?
aeaeo?iea?aeiia?aoi? “Eaioa-IO.”
Aiaeicoth/e AEA, iiae?aoiaoaaee eieueeinoue aeno?anenoie ca
eiaeio aiaeeio ?a?no?aoei? i ca 24 aiaeeie. I?e ioeiioei
i?ioeaia?eoii/ieo aoaeoia i?aia?aoia aecia/aee aiaenioie cieaeaiiy /enea
aeno?aneoie i?e aeiaiaiio eiio?iei.
Oeueo?acaoeiaa aeineiaeaeaiiy aeeiioaaee ia aia?aoi a
aeaiii?iiio oa I-?aaeeii c ?iai/ith /anoioith oeueo?acaoea 3iAoe i
eooii neaioaaiiy 80` c ia?anoa?iaeueii? oa aiieaeueii? iiceoei? ca
noaiaea?oiith iaoiaeeeith. Aeey ioeiiee noaio ea?aeiiaaiiaeeiaiiee
aecia/aeeny oaei iieacieee: eioeaaee aeianoiei/iee ?ici?? eiaiai
oeoii/ea (EAe?), eiioeaaee nenoiei/iee ?ici?? eiaiai oeoii/ea (EN?),
nooi?iue nei?i/aiiy ia?aaeiuei-caaeiueiai ?icii?o eiaiai oeoii/ea a
nenoieo (% (S), eiioeaaee aeianoie?/iee ia’?i eiaiai oeoii/ea
(EAeI), eiioeaaee nenoiei/iee ia’?i eiaiai oeoii/ea (ENI), oaea?iee
ia’?i (OI), o?aeoeith aeeeaeo (OA), oaeaeeinoue oee?eoey?iiai nei?i/aiiy
aieieii iiiea?aea (V cf), iano iiiea?aea eiaiai oeoii/ea (IIEO ).
Oao?aiiey?ia a?oaeia ?aia?aoiy i?iaiaeeeany ca aeiiiiiaith
i?eno?ith ?IA2-02 ca caaaeueiii?eeiyoith iaoiaeeeith. Aiaeicoth/e
?ai-a?aiio, aecia/aee oaei iieacieee: oaea?iee ia’?i (OI) oa oaeeeiiee
ia’?i (OI) na?oey , caaaeueiee ia?eoa?i/iee noaeeiiee iii? (CINI).
Aaeia?aiiao?iy i?iaiaeeeany ia i?eno?i? “Niiain-Aeaia”.
Canoiniaoaaeany iaoiaeeea c na?i?th iaaaioaaeaiue ic nooiii/anoei
caieueoaiiyi iiooaeiinoi. O?eaaeinoue eiaeiiai ianooiiiai nooiaiy
iaaaioaaeaiiy – 3 oaeeeie; ii/aoeiaa iaaaioaaeaiiy 25 Ao, ia eiaeiiio
ianooiiiio nooiaii iioaineaiinoue iaaaioaaeaiiy caieueooaaeanue ia 25
Ao. A ii/aoeiaiio noaii oa a eiioei eiaeiiai nooiaiy iaaaioaaeaiiy
aecia/aany a?oa?iaeueiee oene (AO), caienoaaeany AEA a 12
caaaeueiii?eeiyoeo aiaeaaaeaiiyo.
Noai (RAS) ioeiithaaany ca aeiiiiiaith ?aaeiiiioiieo iaoiaeia
aeineiaeaeaiiy: ?iaiy aeueaeinoa?iio (A), aiaiioaiceio I (AI),
aiaiioai-ceio II (AII) a ieacii e?iai, aeoeaiinoi ?aiiio ieacie e?iai
(A?I) c aeei?enoaiiyi noaiaea?oieo EIO iaai?ia. Eiioeaio?aoeith
aeaeo?ie?oia a ieacii e?iai aecia/aee ca aeiiiiiaith iaoiaea iieoi’yii?
oioiiao?i? ia iieoi’yiiio aiaeicaoi?i IAAE-2.
Noaoenoe/ia ia?iaea ?acoeueoaoia i?iaiaeeeany ca
caaaeueiii?eeiyoei iaoiaeii aa?iaoeieii? noaoenoeee (I.Aaeei,
Ae.Naiaoei?a) ia ?N ?AI.
?acoeueoaoe aeineiaeaeaiiy oa ?o aiaeic
I?e aeineiaeaeaiii eeii?/ii? aoaeoeaiinoi IAIO ianoaaeaii 64
oai?eo ia ION c aeenooieoei?th eiaiai oeoii/ea (EO) oa ii?ooaiiyie
na?oeaaiai ?eoio (IN?). Ooieoeiiiaeueii iiaeeeainoi iaoei?ioia c
o?iii/iith na?oeaaith iaaeinoaoiinoth (ONI), caiaeii ic eeaneoieaoei?th
Iueth-Ei?enueei? Anioeiaoe?? na?oey (NYHA), aoee oaeeie: I OE-o 26
oai?eo; II OE-o 25 oai?eo; III-IV OE o 13 oai?eo. Ca aeaieie
oieoa?ianueeiai iiiioi?oaaiiy AEA, caiaeii c nenoaiith a?aaeaoeie OA ii
A. Lawn, oai?i aoee ?iciiaeieaii oaeei /eiii: 1a?aaeaoei? – o 21; 2
a?aaeaoei?- o 23; 3 i 4 a?aaeaoei? – o 20 oai?eo. I?ioyaii 12 oeaeiia
oai?ei i?ecia/aee ?aiioae a aeici 2,5-20ia ia aeiao. Ia oiii oa?aii?
niinoa?iaaeany iiceoeaia eeii?/ia aeeiaiiea o 53 iaoei?ioia ( 82,8%). O
oeeo oai?eo aiaecia/aeiny ciaioaiiy caaeeoee, iaa?yeia, canoieieo yaeu a
eaaaiyo, iie?auaiiy aeeiiaiiy cae/aeieo iianyeaeaiieo oice/ieo
iaaaioaaeaiue. Iai?eeiioei eieoaaiiy ooieoeiiiaeueii iiaeeeainoi onio
iaoei?ioia aiaeiiaiaeaee I-II OE . Ii?yae c iie?auaiiyi oice/ieo
iiaeeeainoae o 19 (35,8%) oai?eo niinoa?iaaeiny ciaioaiiy eieueeinoi OA
c 6898(933 aei 4012(569 ia aeiao. I?e iayai ia?ieo OA, ianoieei?
oeoii/eiai? oaoiea?aei? (oai?i III-IV OE) IAIO ni?eyee ?o ii?iaeoaaiith
o 9 oai?eo (45%).
Oaeei /eiii, i?ecia/aiiy ?aiioaeo ia oiii noaiaea?oii? oa?aii?
i?ecaiaeeoue aei iie?auaiiy ooieoeiiiaeueieo iiaeeeainoae
na?oeaai-noaeeiii? nenoaie o aieueoinoi iaoei?ioia, ni?ey? ia?aoiaeo ONI
a ieae/ee ooieoeiiiaeueiee eean (NYHA) . Ii ii?i iie?auaiiy ooieoei?
iiiea?aea niinoa?iaa?oueny ciaioaiiy eieueeinoi OA.
Aeey aeineiaeaeaiiy aieeao IAIO ia RAS ianoaaeaii 84 oai?eo ia
ION c aeenooieoei?th EO oa a?eoiiyie. Eieoaaiiy ?aiioaeii i?iaiaeeee
aiaee?eoei caniaii, aac i?ecia/aiiy ieaoeaai, i?e aaeaeaaoiie
aaiiaeeiaii/iie ?aaeoei? o aiaeiiaiaeue ia i?iaio aeico 2,5ia .
O?eaaeinoue eieoaaiiy neeaea 8 oeaeiia. 1-o eiio?ieueio a?oio neeaee 16
oai?eo ia ION c ONI I-II OE aac ii?ooaiue na?oeaaiai ?eoio; 2-o
-34oai?eo ia ION c ONI I-II OE oa OA 1-ai eeano (B.Lawn); 3-th a?oio
neeaee 31 iaoei?io, II OE c OA 2-ai eeano (B.Lawn); 4-o a?oio neeaee 19
oai?eo, III OE,
OA 2-3 eeania. Iieacieee ?iaiy A?I, AII, ALD iaaaaeaii a
oaaeeoei 1.
Oaaeeoey 1
??aaiue aeoeaiino? ?ai?io ieacie, aeueaeinoa?iio, aia?ioaiceio II, ai?no
aeaeo?ie?o?a eae?y ? iao??y a ieaci? e?ia? a aeeiai?oe? e?eoaaiiy
?ai?oaeii
Iieacieee
Noaae?? niinoa?aaeai-iy A?oie oai?eo
1-a
a?oia 2-a
a?oia 3-a
a?oia 4-a a?oia
Aeoeai?noue ?ai?io ieacie (A?I),
ia/ie//-1
Aei e?eoaaiiy 3.58(0.9 4.19(1.05 5.72(1.16 8.06(1.19
P>0.05 P>0.05 P0.05 P10.05 P>0.05 P>0.05
I?ney
e?eoaaiiy 197.4(23.1 202.3(33.8 181.9(25.8 123.4(15.9
P1>0.05 P1>0.05 P10.05 P>0.05 P>0.05
I?ney
e?eoaaiiy 10.86(1.82 11.03(2.1 12.11(1.9 13.8(2.2
P1>0.05 P1>0.05 P1>0.05
P20.05 P>0.05 P>0.05
I?ney
e?eoaaiiy 131.6(2.1 142.9(3.84 130.1(2.86 128.8(1.96
P1>0.05 P1>0.05 P1>0.05
P2>0.05 P2>0.05 P2>0.05 P2>0.05
Eae?e,
iiieue/e
Aei e?eoaaiiy 4.03(0.29 4.11(0.18 3.46(0.31 3.21(0.10
P>0.05 P>0.05 P0.05 P1>0.05 P1>0.05
P2>0.05 P2>0.05 P2>0.05 P20.05
EN?, ni 4.24(0.18 3.7(0.16 0.05
ENI, ni( 79.4(2.0 59.8(1.95 0.05
OA, % 44.2(2.0 52.33(3.4 0.05
*anoioa OA ia aeiao 648(94 405(72 0.05
ENI, ni3 123.16(11.40 81.3(8.9 0.05
OA, % 40.3(1.6 49.40(2.3 0.05
*anoioa OA ia aeiao 10508(938 6095(827 0.05
EN?, ni 5.28(0.30 4.5(0.10 0.05
ENI, ni3 129.3(10.6 97.5(9.8 0.05
OI, ni3 65.8(3.5 69.6(3.8 >0.05
OA, % 34.6(1.98 41.57(2.13 0.05
*anoioa OA ia aeiao 11901(1011 7228(986 Iieacieee Cia/aiiy iieaciee?a P Aei e?eoaaiiy I?ney e?eoaaiiy AOn, ii ?o.no. 138.8(3.6 129.1(3.0 0.05
OIAEIn ii 12.9(1.1 10.1(0.8 0.05
EAeI, ni3 142.0(6.1 129.0(5.9 >0.05
ENI, ni3 74.6(4.8 55.2(3.4
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