<<

. 2
( 2 .)




aia?aea auei 25, a a a?oiia eiiaeie?iaaiiie oa?aiee – 40.


NEOE?EIOI
/ Aiai?y ia yooaeoeaiinoe eiiaeie?iaaiiie aioeaa?aaaioiie oa?a-

iee ai aoi?e?iie i?ioeeaeoeea eoaie?aneiai einoeuoa aoa?io?iiaioe-

?aneie i?e?iau, neaaoao oiiiyioou aeie?eaaiie, iaoaieci aaenoaey
(, )
(. ) eioi?iai naycai n iiauoaieai niaa??aiey a o?iiaioeoao o–AIO e
( ) o–AIO, iaania?eaa?ueo aioeaa?aaaoeiiiia aaenoaea i?aia?aoa (?en.
( )
1).
22% ±2 Aoi?ia Aa?iiaeneia enneaaiaaiea ii aoi?e?iie i?ioeeaeoeea
0,0 0,5 1,0 1,5 2,0 eoaie?aneiai einoeuoa (ESPS–2), i?iaaaaiiia ia 6602 aieuiuo, ia?a-

ianoeo eoaie?aneee einoeuo eee o?aiceoi?io? aoaeo, e a eioi?ii o?e
Antithrombotic Trialists’ Collaboration. BMJ 2002; 324: 71–86.
aa?eaioa oa?aiee – ANE (50 ia/nooee), aeie?eaaiie a aeaa ?aoa?ae?i-
aaiiie oi?iu (400 ia a nooee) e eiiaeiaoey ANE (50 ia/nooee) e aeie-
?en. 2. Aeeyiea aioeaa?aaaioia ia ?anoioo eioa?eoa,
einoeuoa e ninoaenoie nia?oe o aieuiuo aunieiai ?enea ?eaaiiea (400 ia a nooee) – auee n?aaiaiu n ieaoaai, iaia?o?eei i?a-
eiouanoai eiiaeiaoee ANE n aeie?eaaiieii ii n?aaiaie? n iiiioa-


436 13, 7, 2005
oOaeCOa a aOaAeeiCe
?aieae ANE. Nie?aiea I? einoeuoa a a?oiia ANE ninoaaeei 21%, a a i?eaia.
N oi?ee c?aiey iaaeoeiu aieacaoaeunoa iaeaieaa eco?aiu aaia-
a?oiia ANE+aeie?eaaiie – 41% [29].
?eiu, nouanoao?uea eeou a eiuaeoeiiiie oi?ia. Iao?aeoeiie?iaai-
A ?aeiiaiaaoeyo 2004 aiaa [22,30] ii aoi?e?iie i?ioeeaeoeea
eoaie?aneiai einoeuoa aoa?io?iiaioe?aneie i?e?iau oeacaii i aic- iue aaia?ei e aai ieceiiieaeoey?iua o?aeoee yaey?ony iai?yiuie
ii?iinoe o?ao aa?eaioia ia?aea oa?aiee: eiaeaeoi?aie o?iiaeia, oae eae aey inouanoaeaiey aioeeiaaoeyioiie
– ANE a aicao io 50 ai 325 ia; ooieoee ei io?ai eioaeoi? aioeo?iiaei III. Iao?aeoeiie?iaaiiue aa-
– eiiaeiaoey 25 ia ANE n iaaeaiiiaunaiai?aa?uaeny oi?iie ia?ei a iaeiaeiaie noaiaie niiniaai eiaeae?iaaou e o?iiaei, e Oa oa-
aeie?eaaiiea a aica 200 ia; eoi? (iineaaiee a eaneaaa eiaaoeyoee ?aniiei?ai auoa, iiyoiio aai
– eeiieaia?ae a aica 75 ia a nooee. eiaeae?iaaiea i?eaiaeo e oiaiuoaie? ia?aciaaiey o?iiaeia). Iecei-
Oai ia iaiaa o aieuiuo ni n?aaiei e aunieei ?eneii aaii??aae- iieaeoey?iua o?aeoee ec–ca iaiuoeo ?acia?ia iieaeoeu i?aeioua-
?aneeo inei?iaiee oeacaii ia oaeaniia?aciinou i?eiaiaiey ANE a ai- noaaiii eiaeae?o?o Oa oaeoi?, o.a. aaenoao?o ia noaaee, i?aaoanoao?-
cao io 50 ai 100 ia. O aieuiuo n aeea?aeae e ANE aeuoa?iaoeaie yaey- uae o?iiaeiiia?aciaaie?. Oiaiuoaiea ?acia?ia iieaeoeu aaia?eia
aony eeiieaia?ae. i?eaaei e oeo?oaie? aeiainooiiinoe i?e iiaei?iii aaaaaiee, ainoe-
Oioaeinu au iia?a?eioou, ?oi n oi?ee c?aiey iaaeoeiu aieaca- aa?uae o ieceiiieaeoey?iuo aaia?eiia 90% a ioee?ea io 30% o iao-
oaeunoa iniiaaiee ?aeiiaiaiaaou eiiaeiaoe? ?aoa?ae?iaaiiie oi?iu ?aeoeiie?iaaiiiai aaia?eia. Oi?ioay aeiainooiiinou ieceiiieaeo-
aeie?eaaiiea n ANE aey aieuiuo n eoaie?aneie aieaciu? na?aoa iao. ey?iuo aaia?eiia iicaieyao ?ann?eoaou aico n o?aoii iannu oaea e, (a
Yoa iiceoey iaoea naia io?a?aiea a eiinainona yenia?oia ii aioe- ioee?ea io iao?aeoeiie?iaaiiiai aaia?eia) ia o?aaoao eiio?iey iiea-
o?iiaioeoa?iui i?aia?aoai, iioaeeeiaaiiii a 2004 aiao [22]. caoaey A?OA i?e iiaai?a aicu. N oi?ee c?aiey iaaeoeiu aieacaoaeunoa
yooaeoeaiinou aaia?eia i?e aoa?io?iiaica aieacaia eeou o aieuiuo n
AIU„OIEOU? IIb/IIIa ?A?AOUO?O‚ U?OI·O?EUO‚ IEN aac iiauaia ST ia YEA, iiyoiio iiaei?iua eiuaeoee ieceiiiea-
Eiiao i?ioeiai noieaoey iciaiaiiaaeny ?anoeo?iaeie iaoaiec- eoey?iuo aaia?eiia (yiienaia?ei, aaeoaia?ei, iaa?iia?ei) eee aioo?e-
iia aa?aaaoee o?iiaioeoia ia iieaeoey?iii o?iaia. Oeiaeuiue yoai aaiiay eioocey iao?aeoeiie?iaaiiiai aaia?eia iia eiio?ieai A?OA
aa?aaaoee o?iiaioeoia i?aanoaaeyao niaie oi?ie?iaaiea iinoeeia aoiayo a ia?a?aiu iaycaoaeuiuo i?aia?aoia i?e ea?aiee aaiiiai ninoi-
ia?ao aeoeae?iaaiiuie ?aoaioi?aie IIb/IIIa o?iiaioeoia ca n?ao aaaa- yiey [31]. Neaaoao ioiaoeou, ?oi iacia?aiea iao?aeoeiie?iaaiiiai aa-
ceaiuo iieaeoe (oea?eiiaai, oaeoi? Aeeeaa?aiaa). Yoio iaoaieci ia?eia n?eoaaony iaycaoaeuiui i?e i?iaaaaiee o?iiaieeoe?aneie oa-
iaeiaeia i?e anao aicii?iuo noeioeyoeyo o?iiaioeoia, iiyoiio aei- ?aiee n iiiiuu? oeaiaaiai aeoeaaoi?a ieacieiiaaia, oae eae niiniano-
ee?iaaiea ooieoee IIb/IIIa ?aoaioi?ia o?iiaioeoia i?aanoaaeyeinu ia?- aoao ainnoaiiaeaie? i?ioiaeiinoe eioa?eo–naycaiiie a?oa?ee.
Iai?yiua aioeeiaaoeyiou (IAEA) eee aioaaiienou aeoaieia E
niaeoeaiui iai?aaeaieai aioeo?iiaioeoa?iie oa?aiee (?en. 1). Aeiee-
?iaaiea IIb/IIIa ?aoaioi?ia o?iiaioeoia ii?ii inouanoaeou n iiiiuu? yaey?ony aaeinoaaiiuie ia naaiaiyoiee aaiu oaaeaoe?iaaiiuie i?aia-
niaoeoe?aneeo aioeoae eee n iiiiuu? iaioeaia eee iaeeeo iieaeoe, ?aoaie, einaaiii oiaiuoa?ueie ia?aciaaiea o?iiaeia. Iaoaieci aae-
niaa??aueo ecaanoio? iineaaiaaoaeuiinou aieiieeneio, niiniaio? noaey IAEA naycai n oaiaoaieai ia?aciaaiey a ia?aie ?aou?ao aeoaiei
«ociaou» ?aoaioi?, naycaouny n iei e i?aiyonoaiaaou aa?aaaoee o?iiai- E–caaeneiuo oaeoi?ia naa?ouaaiey e?iae: II, VII, IX e X, ?oi a eiia?iii
oeoia. eoiaa i?eaiaeo e oiaiuoaie? ia?aciaaiey o?iiaeia. naa?ouaaiey e?iae.
Enoi?ey i?eiaiaiey eiaeaeoi?ia IIb/IIIa ?aoaioi?ia o?iiaioeoia Aioaaiienou aeoaieia E, iiieii oeacaiiuo ooieoee, ia?aie?eaa?o ea?-
ia?aeanu n eniieuciaaiey eo i?e ??anei?iuo ei?iia?iuo aiaoaoaeuno- aieneee?iaaiea i?ioaeiia N e S e oai naiui ieacuaa?o aeeyiea ia
aao e o aieuiuo n ino?ui ei?iia?iui neia?iiii. ?acia?u iaiie noa- ooieoe? i?ioeainaa?ouaa?uae nenoaiu. Iaeaieaa oe?iei i?eiaiy?ony
oue ia iicaiey?o iia?iaii ?anneacaou ia aioeo?iiaioe?aneie oa?aiee i?iecaiaiua eoia?eia – aa?oa?ei, aoaiieoia?ie, ?oi naycaii n aieuoae
anao oi?i aoa?io?iiaica, iiyoiio a ioiioaiee ino?iai ei?iia?iiai i?aaneacoaiinou? e noaaeeuiinou? aaenoaey. Oa?aiey IAEA o?aaoao ?a-
neia?iia aac iiauaia ST ia YEA ia?aie?einy eeou e?aoeei ?ac?ia aoey?iiai eiio?iey i?io?iiaeia n ?an?aoii Ia?aoia?iaiiai Ii?iaee-
?aeiiaiaaoee ia?aoia?iaiuo e Ana?inneeneiai iaoeiiaeuiiai iaua- ciaaiiiai ioiioaiey (III). Oa?aiaaoe?aneea cia?aiey III iaoiayony a
noaa ea?aeieiaia, oeacuaa?uei, ?oi aiaaaeaiea eiaeaeoi?ia IIb/IIIa ?a- aeaiaciia io 2,0 ai 3,0, i?e yoii ainoeaaaony iioeiaeuiia niioiioaiea
oaioi?ia e oa?aiee ANE e aaia?eiaie i?e ino?ii ei?iia?iii neia?iia yooaeoeaiinoe e aaciianiinoe.
aac iiauaia ST ia YEA oeo?oaao enoiau yiaiaaneoey?iuo aiaoa- Ecaanoiu ?acoeuoaou iyoe enneaaiaaiee, a eioi?uo eco?aeanu yo-
oaeunoa ia ei?iia?iuo a?oa?eyo. Iiyoiio aioaaiienou IIb/IIIa ?aoaioi?ia oaeoeaiinou aa?oa?eia (III=2,0–3,0) o aieuiuo, ia?aianoeo IEN:
ASPECT–2 [32], APRICOT–2 [33], OASIS–2 [34], WARIS II [35] e CHAMP
o?iiaioeoia (aaneeneiaa, yioeoeaaoea, oe?ioeaai) neaaoao aiaaaeou e
ANE e aaia?eio o aieuiuo, iiaaa?aaaiuo ??anei?iui ei?iia?iui aia- [36]. ?aou?a ec iyoe oiiiyioouo enneaaiaaiee iieacaee, ?oi aiaaaeaiea
oaoaeunoaai (i?e yoii iie iiaoo auou iacia?aiu iaiin?aanoaaiii ia- aa?oa?eia (oaeaaia III 2,0–2,5) e 80 ia ANE oiaiuoaao ?anoioo na?-
?aa aiaoaoaeunoaii). aa?ii–ninoaenouo yieciaia (ASPECT, OASIS–2, WARIS–II) e oiaiuoaao
Ec ecaanoiuo aioaaiienoia IIb/IIIa ?aoaioi?ia eeou yioeoeaaoea ?ene ?aieee?cee eioa?eo–naycaiiie a?oa?ee (APRICOT–2). Enneaaiaa-
eee oe?ioeaai ?aeiiaiaoaony aiaaaeou e ANE e ieceiiieaeoey?iiio iea CHAMP, aee??eaoaa aieaa 5000 aieuiuo, ia?aianoeo eioa?eo ie-
eee iao?aeoeiie?iaaiiiio aaia?eio o aieuiuo n nio?aiy?uaeny, ia- iea?aa, ia iaia?o?eei i?aeiouanoa io aiaaaeaiey aa?oa?eia e ANE,
niio?y ia i?eeaaaaiua oneeey, eoaieae, i?e i?iyaeaieyo aunieiai ?e- iaiaei n?aaiaa III, io?a?a?uaa eioaineaiinou aioeeiaaoeyoee, a
nea e iaaicii?iinoe ?aaaneoey?ecaoee ieiea?aa. aaiiii enneaaiaaiee auei 1,8 i?ioea cia?aiey 2,2 a aeeceii ii aecae-
io enneaaiaaiee WARIS–II, 2001, ?oi iiaei neacaouny ia ?acoeuoaoao en-
e?AO?U?, ‚IE???EA I IOI IO„UI??EE neaaiaaiey.
Iaoiaaiac aoa?io?iiaica o?aaoao aicaaenoaey e ia eaneaa eiaao- Iniiaiay i?iaeaia i?e oa?aiee IAEA – aaii??aae?aneea inei?ia-
eyoee n oaeu? eiaeae?iaaiey ia?aciaaiey eee eiaeoeaaoee ee??aaiai iey, eo ?anoioa o aieuiuo, iieo?a?ueo eiiaeie?iaaiio? oa?aie? a
oa?iaioa naa?ouaaiey e?iae – o?iiaeia, ?oi iniaaiii aa?ii o aieuiuo n?aaiai a aaa ?aca auoa. Oai ia iaiaa i?e eniieuciaaiee oia?aiiie
n ia?anoa?uei o?iiaicii ei?iia?iie a?oa?ee. A ioee?ea io aioeo?ii- aioeeiaaoeyoee (oaeaaia III 2,0–3,0), ?anoioa na?uaciuo aaii??aaee
aioeoa?iuo i?aia?aoia a?naiae n?aanoa, aeey?ueo ia eaneaa, i?aanoa- ia noieu auniea, eae a aieaa ?aiieo enneaaiaaieyo n aunieie noaiaiu?
aeai ne?iiiaa. Iniaaiii yoi eanaaony i?aia?aoia n ia?i?aeuiui iooai aioeeiaaoeyoee. A enneaaiaaiee WARIS–II a a?oiia ANE iia ninoaaeea


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4. Falk E et al. Circulation 1995;92:657–71
0,15% ca aia, a a?oiia ANE + aa?oa?ei (III=2,2) – 0,52% ca aia, a en-
5. Robbi L & Libby P. Ann N Y Acad Sci 2001;947:167–79.
neaaiaaiee CHAMP, (2002) ?anoioa na?uaciuo aaii??aaee niioaaonoaai- 6. Tedgui A, Mallat, Z Arch Mal Coeur Vaiss 2003;96(6):671–5
7. The World Health Report 2002, WHO Geneva, 2002
ii - 0,72 e 1,28 ia/100 ?aeiaae ca aia. Aua iaiie i?iaeaiie, inei?iy-
8. Peeters A et al. Eur Heart J 2002; 23(6): 458–66
?uae oa?aie? IAEA, yaeyaony iaiaoiaeiinou ?aaoey?iiai eiio?iey
9. Hankey GJ, Warlow C. Lancet 1999; 354: 1457–63)
III, a oae?a iaiaoiaeiinou ia?aie?aiey ?yaa ieuaauo i?iaoeoia, ia-
10. Kannel WB. J. Cardiovascular Risk 1994; 1:333–339;
aeeaiaioiciuo i?aia?aoia e aeeiaiey. Ana yoi nie?aao i?eaa??aiiinou
11. Wilterdink et al., Arch Neurol 1992;49:857–863
aieuiuo oa?aiee IAEA. 12. Criqui et al., N. Engl. J. Med. 1992; 326:381–386
13. Adult Treatment Panel II National Cholesterol Education Program Circulation 1994;
Ii nia?aiaiiui i?aanoaaeaieyi, iniiaaiiui ia i?eioeiao iaae-
89:1333–1435
oeiu aieacaoaeunoa, iai?yiua aioeeiaaoeyiou yaey?ony i?aia?aoa-
14. Coccheri S. Eur Heart J 1998; 19(suppl): P1268
ie auai?a aey i?ioeeaeoeee einoeuoa i?e ia?oaoaeuiie a?eoiee.
15. aOI?O‚ A.a., eI?AIIO O.e. a?EOIO„E? 2004 11, OU?.39–44.
Yoi oaaaeoaeuii i?iaaiiino?e?iaaii a iyoe enneaaiaaieyo e iiaoaa?-
16. Komarov, Panchenko E. et al., Eur Heart J,2002,v23,pp 1309–16)
?aaii a eo iaoa–aiaeeca. Nie?aiea ioiineoaeuiiai ?enea einoeuoa i?e 17. Grundy SM et al. Circulation 1999; 100: 1481–92
18. Smith SC et al. Circulation 2000; 101: 111–16
eniieuciaaiee aa?oa?eia ii n?aaiaie? n ieaoaai ninoaaeyao 60% [30],
19. Haffner SM et al. N Engl J Med 1998; 339: 229–34
i?e ?anoioa aaii??aaee – 0,3% a aia a a?oiia aa?oa?eia e 0,1% a aia a
20. Kuller LH et al. Arterioscler Throm Vasc Biol 2000; 20: 823–29
a?oiia ieaoaai.
21. Antithrombotic Trialists’ Collaboration. Collaborative meta–analysis of randomised
I?eai aa?oa?eia ii?ao auou ?aeiiaiaiaai aieuiui n ia?oa-
trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in
oaeuiie a?eoieae, iaoeaioai, ia?aianoei eioa?eo ieiea?aa, inei?- high risk patients. BMJ 2002; 324:: 71–86.
22. Expert Consensus Document on the use of antiplatelet agents. The Task Force on the
ieaoeeny ?acaeoeai aiaa?eciu e iaee?eai a iae oeiooe?o?uaai
use of antiplatelet agents in patients with atherosclerotic cardiovascular disease of the
o?iiaa, eeoai n a?i?aaiiuie o?iiaioeeeyie e i?eciaeaie o?iiaica,
European Society of Cardiology. Eur. Heart J. 2004; 25:166–81.
a oae?a aieuiui n ni?aoaieai a?oa?eaeuiuo e aaiiciuo o?iiaicia.
23. Eikelboom J.W., et al.. Circulation 2002; 105: 1650–5.
Ia?niaeoeaiui a ioiioaiee i?ioeeaeoeee aoa?io?iiaioe?aneeo
24. CAPRIE Steering Committee. A randomized, blinded trial of clopidogrel versus aspirin
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25. Yusuf S, et al. N Engl J Med 2001; 345:: 494–502.
ninoieo a oii, ?oi ia naaiaiyoiee aaiu yoi aaeinoaaiiue ia?i?aeuiue
26. Bertrand M, et al. Circulation 2000;102:624–629.
eiaeaeoi? o?iiaeia. Eneiaeaaao?ai auno?i ananuaaaony ec ?aeoai?-
27. Mehta SR, et al. Lancet 2001; 358:: 527–33.
ii–eeoa?iiai o?aeoa e i?aa?auaaony a iaeaaao?ai, eioi?ue eiaeae?oao
28. Steinhubl S, et al. JAMA, 2002;288: 2411 – 2420
aeoeaiue oaio? o?iiaeia. Iaeaaao?ai eiieo?aioii e ia?aoeii naycuaa-
29. Diener HC, et al. J Neurol Sci 1996; 143: 1–13.
aony n aeoeaiui oaio?ii o?iiaeia e iaania?eaaao aai eiaeae?iaaiea e 30. The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy, CHEST
2004; 126:234S–264S, 483S–511S, 513S–548S,576S–599S.
aucuaaaio? o?iiaeiii aeoeaaoe? ee??aauo oaeoi?ia naa?ouaaiey e?i-
31. aA?AIEA OOU?O„O IO?OI?IO„O OEI?OI ·AA OUOEIE? OO?AIO‚ OA„IAIU ST I
ae e o?iiaioeoia. Eiay iaaieuoo? iieaeoey?io? ianno, iaeaaao?ai ii-
uaE. eOOOEEOIEA ?AIOIAI?EE. e?EIOEAIEA I EU?IIU I?EOIO„E? 10, 2001 „O.
?ao i?iieeaou a naonoie e eiaeae?iaaou eae naiaiaiue, oae e naycaiiue n
32. van Es RF ASPECT (Anticoagulants in the Secondary Prevention of Events in Coronary
oea?eiii o?iiaei. Ai 80 % iaeaaao?aia auaiaeony ii?eai, ii ia iaoa-
Thrombosis–2) Presented at the 22nd Congress of the European Society of Cardiology,
aieece?oaony a ia?aie, ia naycuaaaony n aaeeaie ieaciu. Eaea?noa, September 2000, Amsterdam, The Netherlands
33. Brouwer M. APRICOT–2 (Antithrombotics in the Prevention of Reocclusion in
aeey?ueo ia iaoaaieeci eneiaeaaao?aia/ iaeaaao?aia, ia iaia?o?aii.
COronary Thrombolysis). Presented at the 22nd Congress of the European Society of
Nenoaia oeoio?iia ?450 ia o?anoaoao a iaoaaieecia eneiaeaaao?aia,
Cardiology, September 2000, Amsterdam, The Netherlands
iiyoiio ieuaaua i?iaoeou e eaea?noaa, acaeiiaaenoao?uea n aa?oa?e-
34. The Organization to Assess Strategies for Ischemic Syndromes (OASIS) investiga-
iii, ia ieacuaa?o aaenoaey ia iaoaaieeci eneiaeaaao?aia. Noaaeeuiia
tors. Effects of long–term, moderate–intensity oral anticoagulation in addition to aspirin
e i?aaneacoaiia aaenoaea eneiaeaaao?aia aaao aicii?iinou eniieuci- in unstable angina. J Am Coll Cardiol 2001;37:475–84.
35 Arnesen H. WARIS–II (Warfarin–Aspirin Re–Infarction Study) Presented at the 23d
aaou aai a oeene?iaaiiie aica aac ?aaoey?iiai eiio?iey eiaaoeyoeiiiuo
Congress of the European Society of Cardiology, September 2001, Stockholm, Sweden
iieacaoaeae. Nouanoaoao oaaeaoe?iaaiiay oi?ia eneiaeaaao?aia e eiu-
36. L.D.Fiore, et al. Primary Results of the CHAMP Study. Circulation.2002;105:557–563.
aeoeiiiay oi?ia iaeaaao?aia aey iiaei?iuo eiuaeoee.
Ia?aua iaiaaa?eaa?uea ?acoeuoaou a ioiioaiee eniieuciaaiey
eneiaeaaao?aia aey i?ioeeaeoeee aoa?io?iiaica auee iieo?aiu a en-
neaaiaaiee ESTEEM, (2003) iieacaaoai, ?oi aiaaaeaiea eneiaeaaao?a-
ia e ANE o aieuiuo, ia?aianoeo eioa?eo ieiea?aa, ia 24% nie?aao
noiia?io? ?anoioo nia?oe, eioa?eoa ieiea?aa e ?ao?aeoa?iie eoa-
iee.
Yooaeoeaiinou eneiaeaaao?aia a ioiioaiee i?ioeeaeoeee einoeu-
oa e aai aaciianiinou o aieuiuo ia?oaoaeuiie a?eoieae n?aaieaaeanu n
aa?oa?eiii a aaoo e?oiiiianooaaiuo enneaaiaaieyo SPORTIF III e V, ei-
oi?ua i?iaaiiino?e?iaaee, ?oi eneiaeaaao?ai a aica 36 ia aaa ?aca a
aaiu yeaeaaeaioai aa?oa?eio (III 2,0–3,0).
Oai ia iaiaa, ana enneaaiaaiey ii eco?aie? eneiaeaaao?aia io-
iaoeee, ?oi o 6% aieuiuo ni 2–ai ii 6–e ianyou io ia?aea ea?aiey io-
ia?aaony o?iae?aoiia iiauoaiea o?iaiy o?ainaieiac e?iae, i?e?eia
eioi?iai, eae e aicii?iinou iia?a?aa?uaai aaenoaey i?aia?aoa ia ia-
Iniiaiua iai?aaeaiey aioeo?iiaioe?aneie oa?aiee
?aiu, o?aao?o ooi?iaiey.


aEUA?UU?
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