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°èêöèè. α®á»© èíòå°å± ï°å¤±òàâ«ÿþò ýôôåêò» á«®êà- ê®íöåíò°àöèè âíóò°èê«åò®·í®ã® êà«üöèÿ. ‚ ¤àíí®¬ à±ïå-
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öèåâ»å êàíà«» “ ï°å®á«à¤àþò íà ï°èí®±ÿùèµ à°òå°è®«àµ öèå⻵ êàíà«®â L“òèïà ¤èã褰®ïè°è¤èí®â®ã® °ÿ¤à. ’àê
ï°åïà°àò ଫ®¤èïèí ±íè¦àåò ï®â°å¦¤åíèå ê«åò®ê, íà-
[6], ÁÊÊ ï°å¤®òâ°àùàþò èµ â৮ê®í±ò°èêöèþ, èí¤óöè°®-
âàííóþ í®°ýïèíåô°èí®¬, ýí¤®òå«èí®¬ è àíãè®òåí§èí®¬ “ á«þ¤à嬮å ï°è àòå°®ãåíå§å, íèâå«è°óÿ ⮧¤å©±òâèå «è-
II, â ò® â°å¬ÿ êàê ±ó¦åíèå â»í®±ÿùèµ à°òå°è®«, ⻧âàí- ï®ï°®òå褮â íè§ê®© ï«®òí®±òè [12]. Ï®±«å¤íèå è±±«å¤®-
í®å òå¬è ¦å àãåíòà¬è, íå ﮤ¤àåò±ÿ ⮧¤å©±òâèþ ÁÊÊ [7]. âàíèÿ òàê¦å ï®êà§à«è, ·ò® ãèïå°ã«èêå¬èÿ, ê®ò®°àÿ ï°å-
Îíè òàê¦å ï°åïÿò±òâóþò °åàá±®°áöèè íàò°èÿ, êàê °åàê- ¤®ï°å¤å«ÿåò ⮧íèêí®âåíèå °åòèí®“, íå©°®“ è íåô°®ïà-
öèè íà ±íè¦åíèå ò®êà ê°®âè ·å°å§ ï®·êè [5]. Ýò® êà·å±òâ® òèè ó ᮫üí»µ ±àµà°í»¬ ¤èàáåò®¬, ⻧»âàåò óâå«è·åíèå
µà°àêòå°è§óåò á«®êàò®°» êà«üöèå⻵ êàíà«®â, êàê êà«üöèÿ â öèò®§®«å. ‚ ýò®¬ à±ïåêòå èíòå°å±í»¬è ï°å¤-
ï°åïà°àò», ®±®áåíí® ï®¤µ®¤ÿùèå ¤«ÿ íà§íà·åíèÿ ±òàâ«ÿþò±ÿ ¤àíí»å ýê±ïå°è¬åíòà«üí»µ °àá®ò ® ±ï®±®á-
·óâ±òâèòå«üí»¬ ê ±®«è ïàöèåíòà¬, â ﮫü§ó ·åã® ±âè- í®±òè ଫ®¤èïèíà ±òàáè«è§è°®âàòü òå·åíèå ¤èàáåòà [13].
¤åòå«ü±òâóþò ¤àíí»å ®á à¤åêâàòí®¬ ±íè¦åíèè à°òå°è- „âà °àí¤®¬è§è°®âàíí»µ è±ï»òàíèÿ íà ïàöèåíòൠ±
à«üí®ã® ¤àâ«åíèÿ è¬åíí® ó ¤àíí®© êàòåã®°èè ᮫üí»µ [8]. µ°®íè·å±êè¬è §à᮫åâàíèÿ¬è ï®·åê ﮤòâå°¤è«è, ·ò®
Á®«üøàÿ àíòèãèïå°òåí§èâíàÿ àêòèâí®±òü àíòàã®íè±ò®â ÁÊÊ ¬åíåå ýôôåêòèâí» â ï°å¤®òâ°àùåíèè ï°®ã°å±±è°®-
êà«üöèÿ ó ·óâ±òâèòå«üí»µ ê ±®«è ïàöèåíò®â ¬®¦åò á»òü âàíèÿ ï®·å·í»µ §à᮫åâàíè©, ·å¬ èíãèáèò®°» °åíèí“àí-
ãè®òåí§èí®â®© ±è±ò嬻. ȱ±«å¤®âàíèå AASK ừ® ï°®-
òàê¦å ⻧âàíà èµ ®±®á»¬è ýôôåêòà¬è íà ï®·êè, à ò®·-
íåå, ±ï®±®áí®±òüþ ï°å¤®òâ°àùàòü ¬à±±è°®âàíí®å ï®±òó- âå¤åí® ¤«ÿ ±°àâíåíèÿ ýôôåêò®â ò°åµ °à§í»µ ã°óïï ï°å-
ï«åíèå êà«üöèÿ â ê«åòêè, ±òè¬ó«è°ó嬮å öå«»¬ °ÿ¤®¬ ïà°àò®â íà ï°®ã°å±±è°®âàíèå ï®·å·í»µ §à᮫åâàíè© ó
ï°å±±®°í»µ àãåíò®â. „®êà§àíí»¬ ÿâ«ÿåò±ÿ ôàêò ÿâí®© àô°®“à¬å°èêàíöåâ ± ê«èíè·å±êè¬ ¤èàãí®§®¬ «ãèïå°òåí-

414 РУССК˜™ М•”˜¦˜НСК˜™ –УРНАЛ ТОМ 13, „– 7, 2005
§èâí»© ã«®¬å°ó«®±ê«å°®§» [14]. Τíà ã°óïïà ﮫó·à«à á«®êàò®°» êà«üöèå⻵ êàíà«®â (ଫ®¤èïèí), ¤°óãàÿ “ èíãèáè-
ò®°» àíãè®òåí§èíï°åâ°àùàþùåã® ôå°¬åíòà (èÀÏ”), ò°åòüÿ “ β“á«®êàò®°». —à±òü è±±«å¤®âàíèÿ ó ïàöèåíò®â ± òå°à-
ïèå© à¬«®¤èïèí®¬ á»«à ¤®±°®·í® §àâå°øåíà 觓§à ᮫åå à¤åêâàòí»µ °å§ó«üòàò®â ó ï°èíè¬àâøèµ èíãèáèò®°» ÀÏ”.
‚à¦í® ®ò¬åòèòü, ·ò®, ±ê®°åå â±åã®, ®±í®âí»¬ ïàò®ãåíåòè·å±êè¬ ¬åµàí觬®¬, «å¦àùå¬ â ®±í®âå ¤àíí®ã® ôà°¬àꮫ®-
ãè·å±ê®ã® ýôôåêòà, ÿâ«ÿåò±ÿ ±®±ó¤®°à±øè°ÿþùåå ¤å©±òâèå ÁÊÊ íà ï°èí®±ÿùèå à°òå°è®«» â ï°®òèâ®âå± á®«åå ýô-
ôåêòèâí®© â৮¤è«àòàöèè â»í®±ÿùèµ à°òå°è®« èíãèáèò®°à¬è ÀÏ”. Êàê ±«å¤±òâèå ýò®ã® ¬èê°®öè°êó«ÿò®°í®ã® ®ò«è-
·èÿ, ÁÊÊ ±íè¦àþò âíóò°èê«óá®·ê®â®å ¤àâ«åíèå ¬åíåå ýôôåêòèâí®, ·å¬ èíãèáèò®°» ÀÏ” è«è á«®êàò®°» °åöåïò®°®â
àíãè®òåí§èíà (ÁÀÐ). Τíàê® °à§«è·èå ừ® §à¬åòí® «èøü ó íå᮫üø®© ¤®«è ïàöèåíò®â ± ï°®òåèíó°èå© â»øå 220 ¬ã/ã
ê°åàòèíèíà, â ò® â°å¬ÿ êàê ó ïàöèåíò®â ± ¬åíüøå© ï°®òåèíó°èå© °à§íèöà â ®±í®âí®¬ íå á»«à §à¬åòíà [14].
‚ ê«èíè·å±ê®¬ è±±«å¤®âàíèè IDNT ó ïàöèåíò®â ± ¤èàáåò®¬ 2 òèïà, ï°®òåèíó°èå© è µ°®íè·å±êè¬ §à᮫åâàíèå¬ ïå-
·åíè, ï°èíè¬àâøèµ à¬«®¤èïèí è«è ï«àöåá®, ừà ᮫üøàÿ âå°®ÿòí®±òü ï°®ã°å±±è°®âàíèÿ §à᮫åâàíèÿ ï®·åê, ·å¬ ó
ïàöèåíò®â, ï°èíè¬àâøèµ è°áå±à°òàí. Í屬®ò°ÿ íà ò®, ·ò® è°áå±à°òàí ⻧»âૠ᮫åå ﮧèòèâí»å ýôôåêò» ï°è òå°-
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°à§íèö» ¬å¦¤ó ýòè¬è ¤âó¬ÿ ï°åïà°àòà¬è â ó°®âíå ±¬å°òí®±òè ®ò «þỵ ï°è·èí è ±®·åòàíí®¬ ±å°¤å·í®“±®±ó¤è±ò®¬
ï®êà§àòå«å ±¬å°òí®±òè [15]. „«ÿ ±°àâíåíèÿ: â è±ï»òàíèè «Àíòèãèïå°òåí§èâí®© è «èï褮ï®íè¦àþùå© òå°àïèè ï®
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