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ȾɁ «Ⱦɧɿɩɪɨɩɟɬɪɨɜɫɶɤɚ ɦɟɞɢɱɧɚ ɚɤɚɞɟɦɿɹ ɆɈɁ ɍɤɪɚʀɧɢ» ɤɚɮɟɞɪɚ ɜɧɭɬɪɿɲɧɶɨʀ ɦɟɞɢɰɢɧɢ 2
(ɡɚɜ. – ɞ. ɦɟɞ. ɧ., ɩɪɨɮ. Ɉ.ȼ. Ʉɭɪɹɬɚ)
ɜɭɥ. Ⱦɡɟɪɠɢɧɫɶɤɨɝɨ, 9, Ⱦɧɿɩɪɨ, 49044, ɍɤɪɚʀɧɚ
SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine» Department of Internal Medicine 2
Dzerzhinsky str., 9, Dnipro, 49044, Ukraine e-mail: Filippova-dma@i.ua
Ʉɥɸɱɨɜɿɫɥɨɜɚɧɟɚɥɤɨɝɨɥɶɧɢɣɫɬɟɚɬɨɡ ɩɟɱɿɧɤɢ, ɨɠɢɪɿɧɧɹ, ɿɧɞɟɤɫ ɦɚɫɢ ɬɿɥɚ, ɩɟɪɟɤɢɫɧɟ ɨɤɢɫɧɟɧɧɹ ɥɿɩɿɞɿɜ, ɚɧɬɢɨɤɫɢɞɚɧɬɧɢɣ ɡɚɯɢɫɬ
.H\ZRUGVnonalcoholic steatosis, obesity, body mass index, lipid peroxidation, antioxidant protection
Ɋɟɮɟɪɚɬ ȼɡɚɢɦɨɫɜɹɡɢ ɦɟɠɞɭ ɧɟɚɥɤɨɝɨɥɶɧɵɦ ɫɬɟɚɬɨɡɨɦ ɩɟɱɟɧɢ ɚɧɬɪɨɩɨɦɟɬɪɢɱɟɫɤɢɦɢ ɩɨɤɚɡɚɬɟɥɹɦɢ ɢ ɧɚɪɭɲɟɧɢɹɦɢ ɜ ɩɪɨɰɟɫɫɚɯ ɩɟɪɟɤɢɫɧɨɝɨ ɨɤɢɫɥɟɧɢɹ ɥɢɩɢɞɨɜ ɢ ɚɧɬɢɨɤɫɢɞɚɧɬɧɨɣ ɡɚɳɢɬɵ ɭ ɛɨɥɶɧɵɯ ɫ ɩɪɢɡɧɚɤɚɦɢ ɨɠɢɪɟɧɢɹ ɎɢɥɢɩɩɨɜɚȺɘ ɐɟɥɶ ɪɚɛɨɬɵ: ɢɡɭɱɢɬɶ ɨɫɨɛɟɧɧɨɫɬɢ ɩɨɤɚɡɚɬɟɥɟɣ ɩɟɪɟɤɢɫɧɨɝɨ ɨɤɢɫɥɟɧɢɹ ɥɢɩɢɞɨɜ (ɉɈɅ) ɢ ɚɧɬɢɨɤɫɢɞɚɧɬɧɨɣ ɫɢɫɬɟɦɵ (ȺɈɋ) ɜ ɡɚɜɢɫɢɦɨɫɬɢ ɨɬ ɢɧɞɟɤɫɚ ɦɚɫɫɵ ɬɟɥɚ (ɂɆɌ) ɭ ɛɨɥɶɧɵɯ ɫ ɧɟɚɥɤɨɝɨɥɶɧɵɦ ɫɬɟɚɬɨɡɨɦ (ɇȺɋɉ) ɜ ɫɨɱɟɬɚɧɢɢ ɫ ɨɠɢɪɟɧɢɟɦ (Ɉɀ) ɢ ɩɚɬɨɥɨɝɢɟɣ ɛɢɥɢɚɪɧɨɝɨ ɬɪɚɤɬɚ (ȻɌ). Ɉɛɫɥɟɞɨɜɚɧɨ 100 ɛɨɥɶɧɵɯ ɫ ɇȺɋɉ ɜ ɫɨɱɟɬɚɧɢɢ ɫ Ɉɀ ɢ ɩɚɬɨɥɨɝɢɟɣ ȻɌ, ɭ ɤɨɬɨɪɵɯ ɜɨ ɜɪɟɦɹ ɫɨɧɨɝɪɚɮɢɱɟɫɤɨɝɨ ɢɥɢ ɦɨɪɮɨɥɨɝɢɱɟɫɤɨɝɨ ɢɫɫɥɟɞɨɜɚɧɢɹ ɛɢɨɩɬɚɬɚ ɩɟɱɟɧɢ ɛɵɥɢ ɜɵɹɜɥɟɧɵ ɩɪɢɡɧɚɤɢ ɫɬɟɚɬɨɡɚ ɩɟɱɟɧɢ. ɋɪɟɞɢ ɛɨɥɶɧɵɯ ɛɵɥɨ 19 ɦɭɠɱɢɧ ɢ 81 ɠɟɧɳɢɧɚ. ɋɪɟɞɧɢɣ ɜɨɡɪɚɫɬ ɩɚɰɢɟɧɬɨɜ – 53,67±1,11 ɝɨɞɚ. Ʉɨɧɬɪɨɥɶɧɚɹ ɝɪɭɩɩɚ ɫɨɫɬɨɹɥɚ ɢɡ 20 ɩɪɚɤɬɢɱɟɫɤɢ ɡɞɨɪɨɜɵɯ ɨɫɨɛ (ɉɁɈ). ɂɆɌ ɨɩɪɟɞɟɥɹɥɢ ɩɨ ɮɨɪɦɭɥɟ Ʉɟɬɥɟ. ȼ ɡɚɜɢɫɢɦɨɫɬɢ ɨɬ ɫɬɟɩɟɧɢ ɭɜɟɥɢɱɟɧɢɹ ɂɆɌ ɜɫɟ ɛɨɥɶɧɵɟ ɫ ɇȺɋɉ ɢ Ɉɀ ɛɵɥɢ ɪɚɫɩɪɟɞɟɥɟɧɵ ɧɚ ɬɪɢ ɝɪɭɩɩɵ: 1 ɝɪɭɩɩɚ – ɫ ɂɆɌ 25-29,9 ɤɝ/ɦ2 – ɢɡɛɵɬɨɱɧɚɹɦɚɫɫɚ ɬɟɥɚ; 2 ɝɪɭɩɩɚ – ɫɂɆɌ 30-34,9 ɤɝ/ɦ2 – Ɉɀ ȱɫɬɟɩɟɧɢ; 3 ɝɪɭɩɩɚ – ɫ ɂɆɌ 35-39,9 ɤɝ/ɦ2 – Ɉɀ II ɫɬɟɩɟɧɢ. ɋɨɫɬɨɹɧɢɟ ɫɢɫɬɟɦɵ ɉɈɅ ɨɰɟɧɢɜɚɥɢ ɩɨ ɤɨɧɰɟɧɬɪɚɰɢɢ
ɦɚɥɨ-ɧɨɜɨɝɨ ɞɢɚɥɶɞɟɝɢɞɚ ɜ ɩɥɚɡɦɟ ɤɪɨɜɢ ɢ ɷɪɢɬɪɨɰɢɬɚɯ ɢ ɫɨɞɟɪɠɚɧɢɸ ɩɪɨɦɟɠɭɬɨɱɧɵɯ ɩɪɨɞɭɤɬɨɜ ɉɈɅ ɜ ɞɜɭɯ ɮɚɡɚɯ ɥɢɩɢɞɧɨɝɨ ɷɤɫɬɪɚɤɬɚ – ɢɡɨɥɢɪɨɜɚɧɧɵɯ ɞɜɨɣɧɵɯ ɫɜɹɡɟɣ, ɞɢɟɧɨɜɵɯ ɤɨɧɴɸɝɚɬɨɜ, ɨɤɫɢɞɢɟɧɨɜɵɯ ɤɨɧɴɸɝɚɬɨɜ ɢ ɤɨɧɟɱɧɵɯ ɩɪɨɞɭɤɬɨɜ ɉɈɅ – ɲɢɮɮɨɜɵɯ ɨɫɧɨɜɚɧɢɣ. Ɏɚɤɬɨɪɵ ɚɧɬɢɨɤɫɢɞɚɧɬɧɨɣ ɡɚɳɢɬɵ ɨɰɟɧɢɜɚɥɢ ɩɨ ɚɤ -ɬɢɜɧɨɫɬɢ ɰɟɪɭɥɨɩɥɚɡɦɢɧɚ (ɐɉ), ɫɭɩɟɪɨɤɫɢɞɞɢɫɦɭɬɚɡɵ (ɋɈȾ) ɢ ɤɚɬɚɥɚɡɵ ɜ ɝɟɦɨɥɢɡɚɬɟ ɷɪɢɬɪɨɰɢɬɨɜ. ȼɫɟ ɩɨɤɚɡɚɬɟɥɢ ɉɈɅ ɛɵɥɢ ɚɤɬɢɜɢɪɨɜɚɧɵ ɜ ɞɜɭɯ ɮɚɡɚɯ ɥɢɩɢɞɧɨɝɨ ɷɤɫɬɪɚɤɬɚ (ɨɬ p<0,05 ɞɨ p<0,001 ɩɨ ɫɪɚɜɧɟɧɢɸ ɫ ɝɪɭɩɩɨɣ ɉɁɈ ɢ p<0,05 ɜ ɫɪɚɜɧɟɧɢɢ ɫ ɛɨɥɶɧɵɦɢ ɞɪɭɝɢɯ ɝɪɭɩɩ) ɢ ɡɚɜɢɫɟɥɢ ɨɬ ɭɜɟɥɢɱɟɧɢɹ ɂɆɌ. ɉɨɤɚɡɚɬɟɥɢ ȺɈɋ – ɋɈȾ ɢ ɤɚɬɚɥɚɡɚ ɜɨ ɜɫɟɯ ɝɪɭɩɩɚɯ ɇȺɋɉ ɩɪɚɤɬɢɱɟɫɤɢ ɧɟ ɨɬɥɢɱɚɥɢɫɶ ɨɬ ɩɚɪɚɦɟɬɪɨɜ ɉɁɈ ɢ ɧɟ ɡɚɜɢɫɟɥɢ ɨɬ ɭɜɟɥɢɱɟɧɢɹ ɂɆɌ. ɋɨ ɫɬɨɪɨɧɵ ɐɉ ɜɵɹɜɥɟɧɨ ɤɨɦɩɟɧɫɚɬɨɪɧɨɟ ɩɨɜɵɲɟɧɢɟ ɟɝɨ ɚɤɬɢɜɧɨɫɬɢ ɜ ɨɬɜɟɬ ɧɚ ɢɧɬɟɧɫɢɮɢɤɚɰɢɸ ɩɪɨɰɟɫɫɨɜ ɉɈɅ. ɍ ɛɨɥɶɧɵɯ ɫ ɇȺɋɉ ɜ ɫɨɱɟɬɚɧɢɢ ɫ Ɉɀ ɢ ɩɚɬɨɥɨɝɢɟɣ ȻɌ ɤɨɦɨɪɛɢɞɧɨɟ ɬɟɱɟɧɢɟ ɡɚɛɨɥɟɜɚɧɢɹ ɛɵɥɨ ɚɫɫɨɰɢɢɪɨɜɚɧɨ ɫ ɫɭɳɟɫɬɜɟɧɧɵɦɢ ɧɚɪɭɲɟɧɢɹɦɢ ɨɤɫɢɞɚɧɬɧɨ-ɚɧɬɢɨɤɫɢɞɚɧɬɧɨɝɨ ɪɚɜɧɨɜɟɫɢɹ, ɤɨɬɨɪɵɟ ɡɚɜɢɫɟɥɢ ɨɬ ɭɜɟɥɢɱɟɧɢɹ ɩɚɪɚɦɟɬɪɨɜ ɂɆɌ.
$EVWUDFW 7KH LQWHUDFWLRQ EHWZHHQ QRQDOFRKROLF VWHDWRVLV DQWKURSRPHWULF LQGLFDWRUV DQG GLVWXUEDQFH RI OLSLG SHUR[LGDWLRQ DQG DQWLR[LGDQW GHIHQVH LQ SDWLHQWV ZLWK VLJQV RI REHVLW\ )LOLSSRYD$<XAim - to study charac-teristics of indicators of lipid peroxidation (LPO) and antioxidant system (AOS), depending on the body mass index (BMI) in patients with non-alcoholic steatosis (NASP) in combination with obesity (OB) and pathology of the biliary tract (BT). The study involved 100 patients with NASP in combination with OB and BT pathology, who at the time of sonographic and morphological study of liver biopsy presented signs of hepatic steatosis. Among the patients there were 19 men and 81 women. The average age of patients - (53,67 ± 1,11) years. The control group consisted of 20 practically healthy persons (PHP). BMI is determined by the formula Quetelet. Depending on the degree of BMI increase all patients with NASH and obesity were divided into three groups: 1 group – with BɆI 25-29,9 kg/m2–
ex-cessive body mass; 2 group – with BMI 30-34,9 kg/m2– obesity of I degree; 3 group – with BMI 35–39,9 kg/m2– obesity
and the content of lipid peroxidation intermediates in the two phases of the lipid extract – isolated double bonds, diene conjugates, oksidien conjugates and the final LPO products – schiff bases. Factors of antioxidant defense activity were assessed by ceruloplasmin (CP), superoxide dismutase (SOD) and catalase in erythrocyte hemolysate. All LPO indicators have been activated in the two phases of lipid extract (from p<0,05 to p<0,001 when compared with a group of PHP and p<0,05 as compared to other groups of patients) and depended on increasing BMI. Indicators of AOS – SOD and catalase in all NASP groups practically did not differ from PHP parameters and did not depend on the increase of BMI. From the CP side a compensatory increase in its activity in response to the intensification of LPO was revealed. In NASP patients in combination with OB and comorbid disorders of BT the course of the disease was associated with significant violations of the oxidant-antioxidant balance, which depended on increasing BMI parameters.
ɉɪɢɪɨɡɜɢɬɤɭɧɟɚɥɤɨɝɨɥɶɧɨʀɠɢɪɨɜɨʀɯɜɨɪɨɛɢ ɩɟɱɿɧɤɢ ɇȺɀɏɉ ɜ ɫɩɨɥɭɱɟɧɧɿ ɡ ɨɠɢɪɿɧɧɹɦ Ɉɀ ɡɧɚɱɧɭ ɪɨɥɶ ɜɿɞɿɝɪɚɸɬɶ ɩɪɨɰɟɫɢ ɚɤɬɢɜɚɰɿʀ ɩɟɪɟɤɢɫɧɨɝɨ ɨɤɢɫɧɟɧɧɹ ɥɿɩɿɞɿɜ ɉɈɅ ɿ ɡɦɿɧɢ ɜ ɡɚɯɢɫɧɿɣ ɚɧɬɢɨɤɫɢɞɚɧɬɧɿɣ ɫɢɫɬɟɦɿ ȺɈɋ > @ Ʉɨɦɨɪɛɿɞɧɚ ɩɚɬɨɥɨɝɿɹ ɹɤɚ ɮɨɪɦɭɽɬɶɫɹ ɡɧɚɱɧɨɸ ɦɿɪɨɸ ɽ ɪɟɡɭɥɶɬɚɬɨɦ ɨɤɫɢɞɚɬɢɜɧɨɝɨ ɫɬɪɟɫɭ >@ ɉɪɢɜɚɛɥɢɜɿɫɬɶ ɜɢɫɭɧɟɧɧɹ ɨɤɫɢɞɚɬɢɜɧɨɝɨ ɫɬɪɟɫɭ ɧɚ ɪɨɥɶ ɧɚɣɜɚɠɥɢɜɿɲɨɝɨ ɭɧɿɜɟɪɫɚɥɶɧɨɝɨ ɩɚɬɨɝɟ ɧɟɬɢɱɧɨɝɨɦɟɯɚɧɿɡɦɭɪɨɡɜɢɬɤɭɠɢɪɨɜɨʀɞɢɫɬɪɨɮɿʀ ɩɟɱɿɧɤɢ ɪɿɡɧɨʀ ɟɬɿɨɥɨɝɿʀ ɩɨɥɹɝɚɽ ɜ ɬɨɦɭ ɳɨ ɟɮɟɤɬɚɦɢɉɈɅɦɨɠɧɚɩɨɹɫɧɢɬɢɨɫɧɨɜɧɭɱɚɫɬɢɧɭ ɝɿɫɬɨɥɨɝɿɱɧɢɯ ɡɦɿɧ ɹɤɿ ɫɩɨɫɬɟɪɿɝɚɸɬɶɫɹ ɹɤ ɩɪɢ ɫɬɟɚɬɨɡɚɯɬɚɤɿɩɪɢɫɬɟɚɬɨɝɟɩɚɬɢɬɚɯ>@Ɋɨɡɜɢɬɨɤ ɧɟɚɥɤɨɝɨɥɶɧɨɝɨɫɬɟɚɬɨɡɭɇȺɋɉɜɫɩɨɥɭɱɟɧɧɿɡ Ɉɀ ɿ ɩɪɢ ɧɚɹɜɧɨɫɬɿ ɫɭɩɭɬɧɶɨʀ ɩɚɬɨɥɨɝɿʀ ɡ ɛɨɤɭ ɛɿɥɿɚɪɧɨɝɨ ɬɪɚɤɬɭ ȻɌ ɳɟ ɛɿɥɶɲɟ ɩɨɝɥɢɛɥɸɽ ɪɨɡɥɚɞɢɜɨɛɦɿɧɿɥɿɩɿɞɿɜɩɨɫɢɥɸɽɩɪɨɰɟɫɢɉɈɅɿ ɡɧɢɠɭɽ ɮɭɧɤɰɿʀ ɡɚɯɢɫɧɨʀ ȺɈɋ >@ ɇɚɞɦɿɪɧɟ ɧɚɤɨɩɢɱɟɧɧɹ ɩɪɨɞɭɤɬɿɜ ɉɈɅ ɜ ɨɪɝɚɧɿɡɦɿ ɩɪɢɡɜɨɞɢɬɶɞɨɡɦɿɧɢɫɬɪɭɤɬɭɪɧɨɮɭɧɤɰɿɨɧɚɥɶɧɨʀ ɨɪɝɚɧɿɡɚɰɿʀɦɟɦɛɪɚɧɡɚɩɚɥɟɧɧɹɞɢɫɬɪɨɮɿʀɮɭɧɤ ɰɿɨɧɚɥɶɧɢɯɩɨɪɭɲɟɧɶ>@
ɍ ɬɟɩɟɪɿɲɧɿɣ ɱɚɫ ɧɟɡɜɚɠɚɸɱɢ ɧɚ ɡɧɚɱɧɭ ɤɿɥɶɤɿɫɬɶ ɞɨɫɥɿɞɠɟɧɶ ɩɪɢɫɜɹɱɟɧɢɯ ɜɢɜɱɟɧɧɸ ɩɪɨɛɥɟɦɢ ɚɤɬɢɜɚɰɿʀ ɩɪɨɰɟɫɿɜ ɉɈɅ ɬɚ ɩɪɢɝɧɿ ɱɟɧɧɸȺɈɋɩɪɢɫɬɟɚɬɨɡɿɩɟɱɿɧɤɢ>@ɡɚɥɢ ɲɚɸɬɶɫɹ ɧɟ ɞɨ ɤɿɧɰɹ ɡ¶ɹɫɨɜɚɧɢɦɢ ɦɟɯɚɧɿɡɦɢ ʀɯ ɜɡɚɽɦɨɡɜ¶ɹɡɤɭɿɡɧɚɞɥɢɲɤɨɜɨɸɦɚɫɨɸɬɿɥɚɇɆɌ ɿ Ɉɀ ɧɚ ɬɥɿ ɩɚɬɨɥɨɝɿʀ ȻɌ ɐɟ ɡɭɦɨɜɢɥɨ ɩɪɨɜɟ ɞɟɧɧɹɰɶɨɝɨɧɚɭɤɨɜɨɝɨɞɨɫɥɿɞɠɟɧɧɹɡɦɟɬɨɸɡ¶ɹ ɫɭɜɚɧɧɹɩɚɬɨɝɟɧɟɬɢɱɧɨʀɪɨɥɿɩɪɨɰɟɫɿɜɉɈɅɫɬɚ ɧɭ ɮɭɧɤɰɿɨɧɭɜɚɧɧɹ ɫɢɫɬɟɦɢ ȺɈɋ ɭ ɪɨɡɜɢɬɤɭ ɬɚ ɩɟɪɟɛɿɝɭɇȺɀɏɉɡɚɥɟɠɧɨɜɿɞɩɚɪɚɦɟɬɪɿɜȱɆɌ
Ɇɟɬɚ ɪɨɛɨɬɢ ± ɜɢɜɱɢɬɢ ɨɫɨɛɥɢɜɨɫɬɿ ɩɨ ɤɚɡɧɢɤɿɜɉɈɅɬɚȺɈɋɡɚɥɟɠɧɨɜɿɞȱɆɌɭɯɜɨɪɢɯ ɡɇȺɋɉɭɩɨɽɞɧɚɧɧɿɡɈɀɿɩɚɬɨɥɨɝɿɽɸȻɌ
ɆȺɌȿɊȱȺɅɂɌȺɆȿɌɈȾɂȾɈɋɅȱȾɀȿɇɖ
ɈɛɫɬɟɠɟɧɨɯɜɨɪɢɯɡɇȺɋɉɭɩɨɽɞɧɚɧɧɿɡ Ɉɀ ɿ ɩɚɬɨɥɨɝɿɽɸ ȻɌ ɹɤɿ ɩɟɪɟɛɭɜɚɥɢ ɧɚ ɫɬɚɰɿɨ ɧɚɪɧɨɦɭɥɿɤɭɜɚɧɧɿɜɤɥɿɧɿɰɿȾɍ©ȱɧɫɬɢɬɭɬɝɚɫɬɪɨ ɟɧɬɟɪɨɥɨɝɿʀ ɇȺɆɇ ɍɤɪɚʀɧɢª ɜ ɹɤɢɯ ɩɿɞ ɱɚɫ ɫɨɧɨɝɪɚɮɿɱɧɨɝɨɚɛɨɦɨɪɮɨɥɨɝɿɱɧɨɝɨɞɨɫɥɿɞɠɟɧɧɹ ɛɿɨɩɬɚɬɭ ɩɟɱɿɧɤɢ ɛɭɥɢ ɜɢɹɜɥɟɧɿ ɨɡɧɚɤɢ ɫɬɟɚɬɨɡɭ ɩɟɱɿɧɤɢ ɋɟɪɟɞ ɯɜɨɪɢɯ ɛɭɥɨ ɱɨɥɨɜɿɤɿɜ ɬɚ
ɠɿɧɤɚ ɋɟɪɟɞɧɿɣ ɜɿɤ ɩɚɰɿɽɧɬɿɜ ± ɪɨɤɭ Ʉɨɧɬɪɨɥɶɧɚ ɝɪɭɩɚ ɫɤɥɚɞɚɥɚɫɹ ɡ ɩɪɚɤ ɬɢɱɧɨ ɡɞɨɪɨɜɢɯ ɨɫɿɛ ɉɁɈ ȼɫɿ ɩɚɰɿɽɧɬɢ ɩɿɞɩɢ ɫɚɥɢɿɧɮɨɪɦɨɜɚɧɭɡɝɨɞɭɧɚɭɱɚɫɬɶɭɞɨɫɥɿɞɠɟɧɧɿ Ⱦɿɚɝɧɨɡ ɇȺɋɉ ɬɚ ɩɚɬɨɥɨɝɿʀ ȻɌ ɭɫɬɚɧɨɜɥɟɧɨ ɜɿɞɩɨɜɿɞɧɨ ɞɨ ɫɬɚɧɞɚɪɬɢɡɨɜɚɧɢɯ ɩɪɨɬɨɤɨɥɿɜ ɞɿɚɝɧɨɫɬɢɤɢɬɚɥɿɤɭɜɚɧɧɹɯɜɨɪɨɛɨɪɝɚɧɿɜɬɪɚɜɥɟɧ ɧɹ ɡɝɿɞɧɨ ɡ ɧɚɤɚɡɨɦ ɆɈɁ ɍɤɪɚʀɧɢ ʋ ɜɿɞ ɪ >@ ɆɄɏ ɧɚ ɩɿɞɫɬɚɜɿ ɞɚɧɢɯ ɚɧɚɦɧɟɡɭ ɤɥɿɧɿɱɧɨɝɨ ɬɚ ɿɧɫɬɪɭɦɟɧɬɚɥɶɧɨɝɨ ɭɥɶɬɪɚɡɜɭɤɨɜɟ ɞɨɫɥɿɞɠɟɧɧɹ ɨɪɝɚɧɿɜ ɱɟɪɟɜɧɨʀ ɩɨɪɨɠɧɢɧɢ ɿɧɬɪɚɨɩɟɪɚɰɿɣɧɚ ɩɭɧɤɰɿɣɧɚ ɛɿɨɩɫɿɹ ɩɟɱɿɧɤɢ ɨɛɫɬɟɠɟɧɧɹ ɡ ɨɛɨɜ¶ɹɡɤɨɜɢɦ ɭɪɚɯɭ ɜɚɧɧɹɦ ɞɚɧɢɯ ɡɚɝɚɥɶɧɨɩɪɢɣɧɹɬɢɯ ɛɿɨɯɿɦɿɱɧɢɯ ɩɨɤɚɡɧɢɤɿɜ
ɏɜɨɪɿɡɚɥɭɱɟɧɿɜɞɨɫɥɿɞɠɟɧɧɹɧɟɡɥɨɜɠɢɜɚɥɢ ɚɥɤɨɝɨɥɟɦ ɫɩɨɠɢɜɚɧɧɹ ɝ ɟɬɚɧɨɥɭɬɢɠɞɟɧɶ ɞɥɹ ɱɨɥɨɜɿɤɿɜ ɝ ɟɬɚɧɨɥɭɬɢɠɞɟɧɶ ɞɥɹ ɠɿɧɨɤ ɩɪɨɬɹɝɨɦɨɫɬɚɧɧɶɨɝɨɪɨɤɭȼɨɛɫɬɟɠɟɧɢɯɨɫɿɛɧɟ ɜɢɹɜɥɟɧɨ ɫɢɪɨɜɚɬɤɨɜɢɯ ɦɚɪɤɟɪɿɜ ɜɿɪɭɫɧɢɯ ɝɟɩɚ ɬɢɬɿɜȼɿɋ ɚɜɬɨɿɦɭɧɧɢɯɬɚɫɩɚɞɤɨɜɢɯɡɚɯɜɨɪɸ ɜɚɧɶɩɟɱɿɧɤɢ
ȼɫɿɦɩɚɰɿɽɧɬɚɦɩɪɨɜɨɞɢɥɢɩɨɝɥɢɛɥɟɧɟɚɧɬɪɨ ɩɨɦɟɬɪɢɱɧɟɨɛɫɬɟɠɟɧɧɹɧɚɬɳɟɡɜɚɠɭɜɚɥɢɜɢɦɿ ɪɸɜɚɥɢɡɪɿɫɬɯɜɨɪɨɝɨɜɢɡɧɚɱɚɥɢɨɛɽɦɬɚɥɿʀɈɌ ɿ ɨɛɽɦ ɫɬɟɝɨɧ Ɉɋ Ⱦɥɹ ɜɢɡɧɚɱɟɧɧɹ ɯɚɪɚɤɬɟɪɭ ɪɨɡɩɨɞɿɥɭ ɠɢɪɭ ɜ ɨɪɝɚɧɿɡɦɿ ɜɢɤɨɪɢɫɬɨɜɭɽɬɶɫɹ ɩɨɤɚɡɧɢɤ ɫɩɿɜɜɿɞɧɨɲɟɧɧɹ ɈɌ ɞɨ Ɉɋ ɈɌɈɋ Ɉɠɢɪɿɧɧɹɜɜɚɠɚɥɢɚɛɞɨɦɿɧɚɥɶɧɢɦɹɤɳɨɜɠɿɧɨɤ ɜɟɥɢɱɢɧɚɈɌɈɋ!ɭɱɨɥɨɜɿɤɿɜ!>@ ȱɆɌɜɢɡɧɚɱɚɥɢɡɚɮɨɪɦɭɥɨɸɄɟɬɥɟɁɚɥɟɠɧɨɜɿɞ ɫɬɭɩɟɧɹɡɛɿɥɶɲɟɧɧɹȱɆɌɜɫɿɯɜɨɪɿɡɇȺɋɉɬɚɈɀ ɛɭɥɢɪɨɡɩɨɞɿɥɟɧɿɧɚɬɪɢɝɪɭɩɢɝɪɭɩɚ±ɡȱɆɌ
ɤɝɦ ± ɇɆɌ ɝɪɭɩɚ ± ɡ ȱɆɌ
ɤɝɦ ± Ɉɀ ȱ ɫɬɭɩɟɧɹ ɝɪɭɩɚ ± ɡ ȱɆɌ
ɤɝɦ±Ɉɀȱȱɫɬɭɩɟɧɹ
ɋɬɚɧ ɫɢɫɬɟɦɢ ɉɈɅ ɨɰɿɧɸɜɚɥɢ ɡɚ ɤɨɧɰɟɧɬɪɚ ɰɿɽɸ ɦɚɥɨɧɨɜɨɝɨ ɞɿɚɥɶɞɟɝɿɞɭ ɆȾȺ ɜ ɩɥɚɡɦɿ ɤɪɨɜɿ ɬɚ ɟɪɢɬɪɨɰɢɬɚɯ ɿ ɜɦɿɫɬɭ ɩɪɨɦɿɠɧɢɯ ɩɪɨ ɞɭɤɬɿɜ ɉɈɅ ɆȾȺ ɜɢɡɧɚɱɚɥɢ ɡɚ ɿɧɬɟɧɫɢɜɧɿɫɬɸ ɡɚɛɚɪɜɥɟɧɧɹ ɬɪɢɦɟɬɢɥɨɜɨɝɨ ɤɨɦɩɥɟɤɫɭ ɹɤɢɣ ɭɬɜɨɪɸɽɬɶɫɹ ɜ ɤɢɫɥɨɦɭ ɫɟɪɟɞɨɜɢɳɿ ɩɪɢ ɪɟɚɝɭ ɜɚɧɧɿ ɆȾȺ ɡ ɬɿɨɛɚɪɛɿɬɭɪɨɜɨɸ ɤɢɫɥɨɬɨɸ >@ ȼɦɿɫɬ ɩɪɨɦɿɠɧɢɯ ɩɪɨɞɭɤɬɿɜ ɉɈɅ ɜɢɡɧɚɱɚɥɢ ɡɚ
ɄɅȱɇȱɑɇȺ
ɆȿȾɂɐɂɇȺ
ɦɨɧɨɯɪɨɦɚɬɢɱɧɨɝɨ ɫɜɿɬɨɜɨɝɨ ɩɨɬɨɤɭ ɜ ɭɥɶɬɪɚ ɮɿɨɥɟɬɨɜɿɣɞɿɥɹɧɰɿɫɩɟɤɬɪɭɡɪɨɡɩɨɞɿɥɨɦɪɟɽɫɬɪɚ ɰɿʀ ɥɿɩɿɞɧɨɝɨ ɟɤɫɬɪɚɤɬɭ ɤɪɨɜɿ ɜ ɝɟɩɬɚɧɨɜɿɣ ɬɚ ɿɡɨɩɪɨɩɚɧɨɥɶɧɿɣ ɮɪɚɤɰɿʀ >@ Ɍɚɤɢɣ ɩɿɞɯɿɞ ɞɨɡɜɨɥɹɽɡɞɿɣɫɧɢɬɢɞɢɮɟɪɟɧɰɿɣɨɜɚɧɟɜɢɡɧɚɱɟɧɧɹ
ɟɮɿɪɧɨɩɨɜ¶ɹɡɚɧɢɯ ɩɪɨɞɭɤɬɿɜ ɩɟɪɨɤɫɢɞɚɰɿʀ
ɮɨɫɮɨɥɿɩɿɞɿɜ ɭɬɪɢɦɚɧɢɯ ɜ ɿɡɨɩɪɨɩɚɧɨɥɶɧɿɣ ɮɚɡɿ ɬɚ ɧɟɟɬɟɪɢɮɿɤɨɜɚɧɢɯ ɿɧɬɟɪɦɟɞɿɚɬɿɜ ɩɟɪɨɤɫɢɞɚɰɿʀ ɠɢɪɧɢɯ ɤɢɫɥɨɬ ɟɤɫɬɪɚɝɨɜɚɧɢɯ ɝɟɩɬɚɧɨɜɨɸ ɮɚ ɡɨɸ Ɉɩɬɢɱɧɭ ɮɚɡɭ ɟɤɫɬɪɚɝɨɜɚɧɢɯ ɥɿɩɿɞɿɜ ɤɪɨɜɿ ɜɢɦɿɪɹɥɢɧɚɋɎɩɪɢɞɨɜɠɢɧɿɯɜɢɥɿɧɦɳɨ ɜɿɞɨɛɪɚɠɚɽɤɨɧɰɟɧɬɪɚɰɿɸɿɡɨɥɶɨɜɚɧɢɯɩɨɞɜɿɣɧɢɯ ɡɜ¶ɹɡɤɿɜ ȱɉɁ ɭ ɧɟɧɚɫɢɱɟɧɢɯ ɥɿɩɿɞɚɯ ɹɤɿ ɽ ɫɭɛɫɬɪɚɬɚɦɢ ɉɈɅ ȼɦɿɫɬ ɞɿɽɧɨɜɢɯ ɤɨɧ¶ɸɝɚɬɿɜ ȾɄ ɜɢɡɧɚɱɚɥɢ ɩɪɢ ɞɨɜɠɢɧɿ ɯɜɢɥɿ ɧɦ ɨɤɫɨɞɿɽɧɨɜɢɯ ɤɨɧ¶ɸɝɚɬɿɜ ɈȾɄ ± ɩɪɢ ɧɦ ɿ ɩɪɢ ɞɨɜɠɢɧɿ ɯɜɢɥɿ ɧɦ ± ɲɢɮɨɜɿ ɨɫɧɨɜɢ ɒɈ±ɤɿɧɰɟɜɿɩɪɨɞɭɤɬɢɉɈɅ
Ⱦɥɹ ɯɚɪɚɤɬɟɪɢɫɬɢɤɢ ɫɬɚɧɭ ɚɧɬɢɨɤɫɢɞɚɧɬɧɨʀ ɫɢɫɬɟɦɢɩɿɞɤɨɧɬɪɨɥɟɦɹɤɨʀɡɧɚɯɨɞɹɬɶɫɹɩɪɨɰɟɫɢ ɜɿɥɶɧɨɪɚɞɢɤɚɥɶɧɨɝɨɨɤɢɫɧɟɧɧɹɜɢɤɨɪɢɫɬɨɜɭɜɚɥɢ ɩɪɨɫɬɢɣɬɚɲɜɢɞɤɢɣɦɟɬɨɞɜɢɡɧɚɱɟɧɧɹɡɚɝɚɥɶɧɨʀ ɚɧɬɢɨɤɫɢɞɚɧɬɧɨʀ ɚɤɬɢɜɧɨɫɬɿ Ɏɚɤɬɨɪɢ ɚɧɬɢɨɤɫɢ ɞɚɧɬɧɨɝɨ ɡɚɯɢɫɬɭ ɨɰɿɧɸɜɚɥɢ ɡɚ ɚɤɬɢɜɧɿɫɬɸ ɰɟ ɪɭɥɨɩɥɚɡɦɿɧɭ ɫɭɩɟɪɨɤɫɢɞɞɢɫɦɭɬɚɡɢ ɋɈȾ ɬɚ ɤɚɬɚɥɚɡɢ ɜ ɝɟɦɨɥɿɡɚɬɿ ɟɪɢɬɪɨɰɢɬɿɜ Ⱥɤɬɢɜɧɿɫɬɶ ɐɉɭɫɢɪɨɜɚɬɰɿɤɪɨɜɿɜɢɡɧɚɱɚɥɢɦɨɞɢɮɿɤɨɜɚɧɢɦ ɦɟɬɨɞɨɦɊɟɜɿɧɚ>@
Ⱦɥɹ ɞɿɚɝɧɨɫɬɢɤɢ ɫɬɟɚɬɨɡɭ ɩɟɱɿɧɤɢ ɜɢɤɨ ɪɢɫɬɨɜɭɜɚɥɢɭɥɶɬɪɚɡɜɭɤɨɜɢɣɦɟɬɨɞɞɨɫɥɿɞɠɟɧɧɹ ɹɤɢɣɞɚɽɡɦɨɝɭɧɟɥɢɲɟɨɰɿɧɢɬɢɫɬɚɧɩɟɱɿɧɤɢɚɣ ɜɢɹɜɢɬɢɜɿɞɯɢɥɟɧɧɹɡɛɨɤɭȻɌɫɭɞɢɧɩɟɱɿɧɤɢɬɚ ɩɿɞɲɥɭɧɤɨɜɨʀ ɡɚɥɨɡɢ ɡɚ ɞɨɩɨɦɨɝɨɸ ɫɨɧɨɝɪɚ ɮɿɱɧɨʀ ɫɢɫɬɟɦɢ ɥɿɧɿɣɧɨɝɨ ɫɤɚɧɭɜɚɧɧɹ ɜ ɪɟɚɥɶɧɨ ɦɭ ɦɚɫɲɬɚɛɿ ɱɚɫɭ 6RQRVFRSH ± ɮɿɪɦɢ .UDQ FEKOHUȾɨɫɥɿɞɠɟɧɧɹɩɪɨɜɨɞɢɥɨɫɹɧɚɬɳɟȺɧɚɥɿɡ ɫɬɪɭɤɬɭɪɧɢɯ ɡɦɿɧ ɨɪɝɚɧɿɜ ɬɪɚɜɥɟɧɧɹ ɦɿɫɬɢɜ ɨɰɿɧɤɭ ɪɨɡɦɿɪɿɜ ɤɨɧɬɭɪɿɜ ɚɤɭɫɬɢɱɧɨʀ ɫɬɪɭɤɬɭɪɢ ɣ ɟɯɨɝɟɧɧɨɫɬɿ ɩɟɱɿɧɤɢ ɿ ɩɿɞɲɥɭɧɤɨɜɨʀ ɡɚɥɨɡɢ ɫɬɚɧɭ ɛɿɥɿɚɪɧɨʀ ɫɢɫɬɟɦɢ ɡɚ ɡɚɝɚɥɶɧɨɩɪɢɣɧɹɬɢɦ ɦɟɬɨɞɨɦ>@
ɋɬɭɩɿɧɶ ɫɬɟɚɬɨɡɭ ɩɟɱɿɧɤɢ ɜɫɬɚɧɨɜɥɸɜɚɥɢ ɡɚ ɞɚɧɢɦɢɭɥɶɬɪɚɡɜɭɤɨɜɨɝɨɞɨɫɥɿɞɠɟɧɧɹ
ɫɬɭɩɿɧɶ , ± ɧɟɡɧɚɱɧɟ ɞɢɮɭɡɧɟ ɩɿɞɜɢɳɟɧɧɹ ɟɯɨɝɟɧɧɨɫɬɿɩɚɪɟɧɯɿɦɢɩɟɱɿɧɤɢɧɨɪɦɚɥɶɧɚɜɿɡɭɚ ɥɿɡɚɰɿɹɜɧɭɬɪɿɲɧɶɨɩɟɱɿɧɤɨɜɢɯɫɭɞɢɧɿɞɿɚɮɪɚɝɦɢ ɫɬɭɩɿɧɶ ,, ± ɩɨɦɿɪɧɟ ɞɢɮɭɡɧɟ ɩɿɞɜɢɳɟɧɧɹ ɟɯɨɝɟɧɧɨɫɬɿ ɩɚɪɟɧɯɿɦɢ ɩɟɱɿɧɤɢ ɧɟɡɧɚɱɧɟ ɩɨɪɭ ɲɟɧɧɹɜɿɡɭɚɥɿɡɚɰɿʀɜɧɭɬɪɿɲɧɶɨɩɟɱɿɧɤɨɜɢɯɫɭɞɢɧɿ ɞɿɚɮɪɚɝɦɢ
ɫɬɭɩɿɧɶ ,,, ± ɜɢɪɚɠɟɧɟ ɞɢɮɭɡɧɟ ɩɿɞɜɢɳɟɧɧɹ ɟɯɨɝɟɧɧɨɫɬɿ ɩɚɪɟɧɯɿɦɢ ɩɟɱɿɧɤɢ ɜɿɡɭɚɥɿɡɚɰɿɹ ɜɧɭɬɪɿɲɧɶɨɩɟɱɿɧɤɨɜɢɯ ɫɭɞɢɧ ɞɿɚɮɪɚɝɦɢ ɬɚ ɡɚɞɧɶɨʀ ɱɚɫɬɢɧɢ ɩɪɚɜɨʀ ɱɚɫɬɤɢ ɡɧɚɱɧɨ ɩɨɪɭɲɟɧɚ ɚɛɨɜɡɚɝɚɥɿɜɿɞɫɭɬɧɹ
Ⱦɥɹ ɜɟɪɢɮɿɤɚɰɿʀ ɞɿɚɝɧɨɡɭ ɜ ɯɜɨɪɢɯ ɛɭɥɚ ɜɢɤɨɧɚɧɚ ɿɧɬɪɚɨɩɟɪɚɰɿɣɧɚ ɛɿɨɩɫɿɹ ɩɟɱɿɧɤɢ ɡ ɩɨɞɚɥɶɲɢɦ ɜɢɜɱɟɧɧɹɦ ʀʀ ɝɿɫɬɨɫɬɪɭɤɬɭɪɢ Ⱦɥɹ ɝɿɫɬɨɥɨɝɿɱɧɨɝɨ ɞɨɫɥɿɞɠɟɧɧɹ ɡɪɿɡɢ ɡɚɛɚɪɜɥɸɜɚɥɢ ɝɟɦɚɬɨɤɫɢɥɿɧɨɦ ɿ ɟɨɡɢɧɨɦ ɡɚ ɦɟɬɨɞɢɤɨɸ Ɇɚɥ ɥɨɪɿɋɥɿɧɱɟɧɤɨ ɋɬɚɧ ɝɿɫɬɨɫɬɪɭɤɬɭɪɢ ɩɟɱɿɧɤɢ ɨɰɿɧɸɜɚɥɢɧɚɩɿɜɤɿɥɶɤɿɫɧɨɜɫɢɫɬɟɦɿɫɬɭɩɟɧɿɜ± ɜɿɞɫɭɬɧɹ ± ɧɟɡɧɚɱɧɚ ± ɩɨɦɿɪɧɚ ± ɜɢɪɚɠɟɧɚ ɬɢɩ ɯɨɥɟɫɬɚɡɭ ɫɬɭɩɿɧɶ ɯɪɨɧɿɱɧɨɝɨɡɚɩɚɥɟɧɧɹɫɬɭɩɿɧɶɛɿɥɤɨɜɨʀɠɢɪɨɜɨʀ ɬɚɜɭɝɥɟɜɨɞɧɨʀɞɢɫɬɪɨɮɿʀȽɿɫɬɨɥɨɝɿɱɧɿɩɪɟɩɚɪɚɬɢ ɜɢɜɱɚɥɢ ɡɚ ɞɨɩɨɦɨɝɨɸ ɫɜɿɬɥɨɜɨɝɨ ɦɿɤɪɨɫɤɨɩɚ ©ɅɘɆȺɆ±ɂª
Ⱦɥɹ ɫɬɚɬɢɫɬɢɱɧɨɝɨ ɚɧɚɥɿɡɭ ɞɚɧɢɯ ɜɢɤɨ ɪɢɫɬɨɜɭɜɚɥɢ ɥɿɰɟɧɡɿɣɧɭ ɩɪɨɝɪɚɦɭ 67$7,67,&$ Ɂ ɭɪɚɯɭɜɚɧɧɹɦ ɡɚɤɨɧɭ ɪɨɡɩɨɞɿɥɭ ɤɿɥɶɤɿɫɧɿ ɩɨɤɚɡɧɢɤɢ ɧɚɜɟɞɟɧɿ ɭ ɜɢɝɥɹɞɿ ɫɟɪɟɞɧɶɨɝɨ ɡɧɚ ɱɟɧɧɹɬɚɫɬɚɧɞɚɪɬɧɨʀɩɨɯɢɛɤɢɫɟɪɟɞɧɶɨɝɨɆP ɚɛɨ ɦɟɞɿɚɧɢ ɬɚ ɿɧɬɟɪɤɜɚɪɬɢɥɶɧɨɝɨ ɪɨɡɦɚɯɭ Ɇɟ >@Ⱦɥɹɩɨɪɿɜɧɹɧɧɹɫɟɪɟɞɧɿɯɩɨɤɚɡɧɢɤɿɜ ɭɜɫɿɯɩɿɞɝɪɭɩɚɯɜɢɤɨɪɢɫɬɨɜɭɜɚɥɢɩɚɪɚɦɟɬɪɢɱɧɿɿ ɧɟɩɚɪɚɦɟɬɪɢɱɧɿ ɤɪɢɬɟɪɿʀ ɋɬɶɸɞɟɧɬɚ Ɇɚɧɧɚ ɍʀɬɧɿ ɨɞɧɨɮɚɤɬɨɪɧɢɣ ɞɢɫɩɟɪɫɿɣɧɢɣ ɚɧɚɥɿɡ $129$ ɚɛɨ ɤɪɢɬɟɪɿɣ Ʉɪɚɫɤɟɥɚɍɨɥɥɿɫɚ ɞɥɹ ɜɿɞɧɨɫɧɢɯ ɩɨɤɚɡɧɢɤɿɜ ± ɤɪɢɬɟɪɿɣ ɏɿɤɜɚɞɪɚɬ
ɉɿɪɫɨɧɚFȾɥɹɨɰɿɧɤɢɜɡɚɽɦɨɡɜ¶ɹɡɤɭɦɿɠɨɡɧɚ
ɤɚɦɢ ɜɢɤɨɧɭɜɚɜɫɹ ɤɨɪɟɥɹɰɿɣɧɢɣ ɚɧɚɥɿɡ ɡ ɪɨɡ ɪɚɯɭɧɤɨɦ ɤɨɟɮɿɰɿɽɧɬɿɜ ɪɚɧɝɨɜɨʀ ɤɨɪɟɥɹɰɿʀ
ɋɩɿɪɦɟɧɚUV
ɊȿɁɍɅɖɌȺɌɂɌȺȲɏɈȻȽɈȼɈɊȿɇɇə
Ⱥɧɚɥɿɡɭɸɱɢ ɩɨɤɚɡɧɢɤɢ ɨɤɢɫɧɸɜɚɥɶɧɨɝɨ ɝɨ ɦɟɨɫɬɚɡɭ ɛɭɥɢ ɡɚɮɿɤɫɨɜɚɧɿ ɿɫɬɨɬɧɿ ɡɦɿɧɢ ɜ ɩɨ ɤɚɡɧɢɤɚɯ ɫɢɫɬɟɦɢ ɉɈɅ ɬɚ ȺɈɋ ɭ ɩɚɰɿɽɧɬɿɜ ɡ ɇȺɀɏɉ ɭ ɩɨɽɞɧɚɧɧɿ ɡ Ɉɀ ɹɤɿ ɡɧɚɱɧɨɸ ɦɿɪɨɸ ɡɚɥɟɠɚɥɢɜɿɞȱɆɌɬɚɛɥɉɨɤɚɡɧɢɤɢɉɈɅɛɭɥɢ ɚɤɬɢɜɨɜɚɧɿɜɨɛɨɯɮɚɡɚɯɥɿɩɿɞɧɨɝɨɟɤɫɬɪɚɤɬɭ
ɌɚɤɪɿɜɟɧɶȾɄɭɝɟɩɬɚɧɨɜɭɮɚɡɭɭɯɜɨɪɢɯɩɪɢ
ȱɆɌɤɝɦɩɟɪɟɜɢɳɭɜɚɜɩɨɤɚɡɧɢɤɢɉɁɈɭ
ɪɚɡɭɪɚɬɚɤɨɠɩɨɤɚɡɧɢɤɢɯɜɨɪɢɯɩɪɢ
ȱɆɌɤɝɦɬɚɤɝɦɭɬɚɪɚɡɭ
ɪɿɜɟɧɶ ȱɉɁ ɜɿɪɨɝɿɞɧɨ ɩɟɪɟɜɢɳɭɜɚɜ ɩɨɤɚɡɧɢɤɢ ɉɁɈ ɪ ɡ ɧɚɣɜɢɳɢɦɢ ɩɚɪɚɦɟɬɪɚɦɢ ɩɪɢ ȱɆɌ ɡɿ ɡɛɿɥɶɲɟɧɧɹɦ ɜ ɪɚɡɭ ɩɨɪɿɜɧɹɧɨ ɡ ɝɪɭɩɚɦɢ ɯɜɨɪɢɯ ɡ ȱɆɌ ɬɚ ȱɆɌ ɪ ɩɪɢ ɜɫɿɯ ɩɨɪɿɜɧɹɧɧɹɯ ȼ ɿɡɨɩɪɨɩɚɧɨɥɶɧɭ ɮɚɡɭ ɥɿɩɿɞɧɨɝɨ ɟɤɫɬɪɚɤɬɭ ɩɨ ɜɿɞɧɨɲɟɧɧɸ ɞɨ ȱɉɁ ɫɩɨɫɬɟɪɿɝɚɥɢɫɹ ɚɧɚɥɨɝɿɱɧɿ ɜɿɪɨɝɿɞɧɿ ɞɚɧɿ ɡ ɦɚɤɫɢɦɚɥɶɧɢɦ ɡɛɿɥɶɲɟɧɧɹɦ ɜ ɪɚɡɭ ɜ ɝɪɭɩɿ ɯɜɨɪɢɯ ɡ ȱɆɌ ɳɨɞɨ ɉɁɈ ɪ ɬɚ ɧɚ ɿ ɜɿɞɩɨɜɿɞɧɨ ɜɿɞɧɨɫɧɨ ɯɜɨɪɢɯ ɡ ȱɆɌ ɪ ɬɚ ȱɆɌ ɪ ɉɨɞɿɛɧɿ ɡɦɿɧɢ ɡ ɛɿɥɶɲ ɡɧɚɱɭɳɢɦɢ ɜɿɪɨɝɿɞɧɢɦɢ ɩɨɤɚɡɧɢ ɤɚɦɢ ɤɿɧɰɟɜɢɯ ɩɪɨɞɭɤɬɿɜ ɉɈɅ ± ɒɈ ɫɩɨɫɬɟɪɿ
ɝɚɥɢɫɹ ɜ ɿɡɨɩɪɨɩɚɧɨɥɶɧɭ ɮɚɡɭ ɩɪɢ ȱɆɌ
ɤɝɦ ɫɟɪɟɞɧɿ ɩɨɤɚɡɧɢɤɢ ɜ ɪɚɡɿɜ ɩɟɪɟɜɢ
ɳɭɜɚɥɢɡɧɚɱɟɧɧɹɉɁɈɪɬɚɜɪɚɡɭ± ɩɨɤɚɡɧɢɤɢ ɯɜɨɪɢɯ ɡ ȱɆɌ ɬɚ ȱɆɌ ɪ ȼɬɨɪɢɧɧɿ ɩɪɨɞɭɤɬɢ ɉɈɅ ± ɆȾȺ ɭ ɩɥɚɡɦɿ ɬɚ ɟɪɢɬɪɨɰɢɬɚɯ ɬɚɤɨɠ ɛɭɥɢ ɩɿɞɜɢɳɟɧɿ ɜ ɩɚɰɿɽɧɬɿɜɡȱɆɌ±ɭɩɥɚɡɦɿɜɪɚɡɭɜɟɪɢ ɬɪɨɰɢɬɚɯ ± ɭ ɪɚɡɭ ɩɨ ɜɿɞɧɨɲɟɧɧɸ ɞɨ ɉɁɈ ɪ ȼɿɪɨɝɿɞɧɿ ɜɿɞɦɿɧɧɨɫɬɿ ɰɢɯ ɩɨɤɚɡɧɢɤɿɜ ɬɚɤɨɠ ɫɩɨɫɬɟɪɿɝɚɥɢɫɹ ɳɨɞɨ ɯɜɨɪɢɯ ɡ ȱɆɌ ɬɚ
ȱɆɌɡɩɿɞɜɢɳɟɧɧɹɦɭɩɥɚɡɦɿɧɚɿ
ɜɿɞɩɨɜɿɞɧɨ ɜ ɟɪɢɬɪɨɰɢɬɚɯ ± ɧɚ ɿ ɪɩɪɢɜɫɿɯɩɨɪɿɜɧɹɧɧɹɯ
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ɆȾȺɩɥɚɡɧɦɨɥɶɦɥ
ss
ɆȾȺɟɪɢɬɧɦɨɥɶɦɥ
ss
ɋɈȾɭɦɨɞ
ɄɚɬɚɥɚɡɚɦɤɆɯɜɦɝɇɜ
ɐɟɪɭɥɨɩɥɚɡɦɿɧɦɝɦɥ
s
ɉ ɪ ɢ ɦ ɿ ɬ ɤ ɢ ±S±SɩɨɪɿɜɧɹɧɨɡɝɪɭɩɨɸɉɁɈ±S±SɩɨɪɿɜɧɹɧɨɡɜɿɞɩɨɜɿɞɧɨɸɝɪɭɩɨɸɯɜɨɪɢɯɡȱɆɌ
s ± Sss ± S ɩɨɪɿɜɧɹɧɨ ɡ ɜɿɞɩɨɜɿɞɧɨɸ ɝɪɭɩɨɸ ɯɜɨɪɢɯ ɡ ȱɆɌ ɪ)ɪɧ ± ɪɿɜɟɧɶ ɡɧɚɱɭɳɨɫɬɿ ɜɿɞɦɿɧɧɨɫɬɟɣ
ɄɅȱɇȱɑɇȺ
ɆȿȾɂɐɂɇȺ
Ɍɚɤɢɦ ɱɢɧɨɦ ɞɟɬɚɥɶɧɢɣ ɪɨɡɝɥɹɞ ɩɨɤɚɡɧɢɤɿɜ ɨɤɢɫɧɸɜɚɥɶɧɨɝɨ ɝɨɦɟɨɫɬɚɡɭ ɞɟɦɨɧɫɬɪɭɜɚɜ ɱɿɬɤɭ ɡɚɥɟɠɧɿɫɬɶ ɞɨɫɥɿɞɠɭɜɚɧɢɯ ɡɧɚɱɟɧɶ ɜɿɞ ɩɚɪɚ ɦɟɬɪɿɜ ɦɚɫɢ ɬɿɥɚ ɡ ɦɚɤɫɢɦɚɥɶɧɢɦ ɡɛɿɥɶɲɟɧɧɹɦ ɩɪɢɈɀȱɬɚȱȱɫɬɭɩɟɧɹɩɨɜɿɞɧɨɲɟɧɧɸɞɨɉɁɈɬɚ ɯɜɨɪɢɯɡɇɆɌɜɿɞɪɞɨɪ
ȼɨɞɧɨɱɚɫɩɨɤɚɡɧɢɤɢɫɢɫɬɟɦɢȺɈɋ±ɋɈȾɬɚ ɤɚɬɚɥɚɡɚ ɜ ɭɫɿɯ ɝɪɭɩɚɯ ɇȺɋɉ ɩɪɚɤɬɢɱɧɨ ɧɟ ɜɿɞɪɿɡɧɹɥɢɫɹ ɜɿɞ ɩɚɪɚɦɟɬɪɿɜ ɉɁɈ ɬɚ ɧɟ ɦɚɥɢ ɜɿɪɨɝɿɞɧɨʀɡɚɥɟɠɧɨɫɬɿɜɿɞɡɛɿɥɶɲɟɧɧɹɩɨɤɚɡɧɢɤɿɜ ȱɆɌ Ɉɞɧɚɤ ɡ ɛɨɤɭ ɧɟɤɥɿɬɢɧɧɨɝɨ ɚɧɬɢɨɤɫɢɞɚɧɬɚ ɰɟɪɭɥɨɩɥɚɡɦɿɧɭ ɜɢɹɜɥɟɧɟ ɜɿɞɩɨɜɿɞɧɟ ɤɨɦɩɟɧ ɫɚɬɨɪɧɟɩɿɞɜɢɳɟɧɧɹɣɨɝɨɚɤɬɢɜɧɨɫɬɿɭɜɿɞɩɨɜɿɞɶ ɧɚ ɿɧɬɟɧɫɢɮɿɤɚɰɿɸ ɩɪɨɰɟɫɿɜ ɉɈɅ Ɍɚɤ ɫɟɪɟɞɧɿ ɩɨɤɚɡɧɢɤɢ ɰɟɪɭɥɨɩɥɚɡɦɿɧɭ ɜ ɭɫɿɯ ɝɪɭɩɚɯ ɜɿɪɨ ɝɿɞɧɨ ɜɿɞɪɿɡɧɹɥɢɫɹ ɜɿɞ ɩɨɤɚɡɧɢɤɿɜ ɉɁɈ ɡɛɿɥɶ ɲɟɧɧɹ ɜ ɪɚɡɭ ɪ ɬɚ ɛɭɥɢ ɦɚɤɫɢ ɦɚɥɶɧɢɦɢ ɩɪɢ ȱɆɌ ɪ ɩɨɪɿɜɧɹɧɨ ɡ ɝɪɭɩɚɦɢ ȱɆɌ ɿ ȱɆɌ ɉɿɞɜɢɳɟɧɧɹ ɚɤɬɢɜ ɧɨɫɬɿ ɮɟɪɦɟɧɬɭ ɚɧɬɢɨɤɫɢɞɚɧɬɧɨɝɨ ɡɚɯɢɫɬɭ ± ɰɟɪɭɥɨɩɥɚɡɦɿɧɭ ɧɟɨɛɯɿɞɧɨɝɨ ɞɥɹ ɡɚɯɢɫɬɭ ɛɿɨɥɨ ɝɿɱɧɢɯ ɦɟɦɛɪɚɧ ɭɲɤɨɞɠɟɧɢɯ ɤɥɿɬɢɧ ɜɿɞ ɞɿʀ ɩɟ ɪɟɤɢɫɿɜɦɨɠɟɪɨɡɝɥɹɞɚɬɢɫɹɹɤɩɨɡɢɬɢɜɧɚɩɪɨɝɧɨ ɫɬɢɱɧɚɨɡɧɚɤɚ
ȼɢɳɟɜɤɚɡɚɧɿ ɜɿɪɨɝɿɞɧɿ ɡɚɥɟɠɧɨɫɬɿ ɩɨɤɚɡɧɢɤɿɜ ɨɤɢɫɧɸɜɚɥɶɧɨɝɨɝɨɦɟɨɫɬɚɡɭɭɯɜɨɪɢɯɡɇȺɋɉɭ ɩɨɽɞɧɚɧɧɿ ɡ Ɉɀ ɬɚ ɩɚɬɨɥɨɝɿɽɸ ȻɌ ɜɿɞ ȱɆɌ ɩɿɞ ɬɜɟɪɞɠɟɧɿ ɿ ɞɚɧɢɦɢ ɤɨɪɟɥɹɰɿɣɧɨɝɨ ɚɧɚɥɿɡɭ ɹɤɿ ɜɤɚɡɭɜɚɥɢ ɳɨ ɩɿɞɜɢɳɟɧɧɹ ȱɆɌ ɩɪɢɡɜɨɞɢɥɨ ɞɨ ɡɪɨɫɬɚɧɧɹ ɪɿɜɧɿɜ ȾɄ ɜ ɝɟɩɬɚɧɨɜɭ ɬɚ ɿɡɨɩɪɨɩɚ
ɧɨɥɶɧɭɮɚɡɭɥɿɩɿɞɧɨɝɨɟɤɫɬɪɚɤɬɭUV ɪ
ɿ UV ɪ ɈȾɄ UV ɪ ɿ
UV ɪȱɉɁUV ɪɿUV
ɪ ɒɈ UV ɪ ɿ UV
ɪɚɬɚɤɨɠɜɦɿɫɬɭɆȾȺɭɩɥɚɡɦɿUV
ɪ ɬɚ ɜ ɟɪɢɬɪɨɰɢɬɚɯ UV ɪ ɿ
ɩɿɞɜɢɳɟɧɧɹ ɤɨɦɩɨɧɟɧɬɭ ȺɈɋ ± ɰɟɪɭɥɨɩɥɚɡɦɿɧɭ
UV ɪ
ɍ ɩɨɞɚɥɶɲɨɦɭ ɡ ɭɪɚɯɭɜɚɧɧɹɦ ɜɢɹɜɥɟɧɨʀ ɡɚ ɥɟɠɧɨɫɬɿɩɨɤɚɡɧɢɤɿɜɜɿɞɩɚɪɚɦɟɬɪɿɜȱɆɌɭɤɨɠ ɧɿɣɝɪɭɩɿɛɭɥɨɩɪɨɚɧɚɥɿɡɨɜɚɧɨɱɚɫɬɨɬɭɜɢɹɜɥɟɧɧɹ ɜɿɞɯɢɥɟɧɶ ɩɨɤɚɡɧɢɤɿɜ ɉɈɅ ɬɚ ȺɈɋ ɜɿɞ ɧɨɪɦɢ ɭ ɯɜɨɪɢɯɡɇȺɋɉɭɩɨɽɞɧɚɧɧɿɡɈɀ
Ⱥɧɚɥɿɡ ɜɦɿɫɬɭ ɩɪɨɞɭɤɬɿɜ ɉɈɅ ɭ ɯɜɨɪɢɯ ɡ ɇȺɋɉɬɚɛɥɜɢɹɜɢɜɡɧɚɱɧɟɩɿɞɜɢɳɟɧɧɹȾɄɜ ɿɡɨɩɪɨɩɚɧɨɥɶɧɿɣɮɚɡɿɥɿɩɿɞɧɨɝɨɟɤɫɬɪɚɤɬɭɜɛɿɥɶ
ɲɨɫɬɿɯɜɨɪɢɯɡȱɆɌɤɝɦɬɚɭ
ɡȱɆɌɤɝɦɩɨɜɿɞɧɨɲɟɧɧɸɞɨ
ɯɜɨɪɢɯ ɡ ȱɆɌ ɤɝɦɪ
ɩɪɢ ɜɫɿɯ ɩɨɪɿɜɧɹɧɧɹɯ ɇɨɪɦɚɥɶɧɿ ɡɧɚɱɟɧɧɹ ȾɄ ɫɩɨɫɬɟɪɿɝɚɥɢɫɹ ɥɢɲɟ ɜ ɡ ȱɆɌ
ɤɝɦ ɩɪɨɬɢ ɯɜɨɪɢɯ ɡ ȱɆɌ
ɤɝɦɪ
ȺɧɚɥɨɝɿɱɧɿɡɦɿɧɢɡɩɿɞɜɢɳɟɧɧɹɦɪɿɜɧɹɈȾɄɜ ɝɟɩɬɚɧɨɜɭ ɮɚɡɭ ɥɿɩɿɞɧɨɝɨ ɟɤɫɬɪɚɤɬɭ ɬɚɤɨɠ ɮɿɤɫɭɜɚɥɢɫɹ ɭ ɯɜɨɪɢɯ ɡ ȱɆɌ ± ɭ ɩɪɨɬɢ ɯɜɨɪɢɯ ɡ ȱɆɌ ɪ Ɂɧɚ ɱɟɧɧɹ ɈȾɄ ɭ ɦɟɠɚɯ ɧɨɪɦɢ ɛɭɥɢ ɜ ɡ ȱɆɌɩɪɨɬɢɡȱɆɌɪȱɉɁ ɛɭɥɢɜɿɪɨɝɿɞɧɨɩɿɞɜɢɳɟɧɢɦɢɜɨɛɨɯɮɚɡɚɯɥɿɩɿɞ ɧɨɝɨɟɤɫɬɪɚɤɬɭɜɩɚɰɿɽɧɬɿɜɡȱɆɌɩɨɪɿɜɧɹɧɨɡ ɝɪɭɩɨɸȱɆɌ±ɜɿɞɩɨɜɿɞɧɿɫɩɿɜɜɿɞɧɨɲɟɧɧɹɫɬɚ ɧɨɜɢɥɢɩɪɨɬɢɪɜɝɟɩɬɚɧɨɜɭ ɮɚɡɭ ɿ ɩɪɨɬɢ ɪ ɜ ɿɡɨɩɪɨɩɚ ɧɨɥɶɧɭɮɚɡɭ
ȼɿɪɨɝɿɞɧɟ ɩɿɞɜɢɳɟɧɧɹ ɪɿɜɧɹ ɒɈ ɜ ɝɟɩɬɚɧɨɜɭ ɮɚɡɭ ɥɿɩɿɞɧɨɝɨ ɟɤɫɬɪɚɤɬɭ ɜɿɞɡɧɚɱɚɥɨɫɶ ɭ ɯɜɨɪɢɯ ɩɪɢ ȱɆɌ ɩɨ ɜɿɞɧɨɲɟɧɧɸ ɥɢɲɟɞɨɩɚɰɿɽɧɬɚɡȱɆɌɭɬɨɣɱɚɫɹɤ ɜ ɿɡɨɩɪɨɩɚɧɨɥɶɧɭ ɮɚɡɭ ɩɿɞɜɢɳɟɧɿ ɡɧɚɱɟɧɧɹ ɮɿɤɫɭɜɚɥɢɫɹ ɭ ɡ ȱɆɌ ɩɪɨɬɢ ɯɜɨɪɢɯ ɡ ȱɆɌ ɪ ɩɪɢ ɜɫɿɯ ɩɨɪɿɜɧɹɧɧɹɯ ȼɦɿɫɬ ɜɬɨɪɢɧɧɨɝɨ ɩɪɨɞɭɤɬɭ ɉɈɅ ɆȾȺ ɭ ɩɥɚɡɦɿ ɤɪɨɜɿ ɛɭɜ ɩɿɞɜɢɳɟɧɢɦ ɭ ɯɜɨɪɢɯ ɡ ȱɆɌ ɜ ɟɪɢɬɪɨɰɢɬɚɯ ± ɭ ɳɨɜɤɚɡɭɽɧɚɡɧɚɱɧɟɧɚɤɨɩɢɱɟɧɧɹɰɶɨɝɨ ɬɨɤɫɢɱɧɨɝɨ ɩɪɨɞɭɤɬɭ ɭ ɯɜɨɪɢɯ ɡ Ɉɀ ȱȱ ɫɬɭɩɟɧɹ
ɩɨɜɿɞɧɨɲɟɧɧɸɞɨɩɚɰɿɽɧɬɿɜɡɇɆɌɪ
Ⱥɧɚɥɿɡ ɱɚɫɬɨɬɢ ɜɢɹɜɥɟɧɧɹ ɜɿɞɯɢɥɟɧɶ ɩɨ ɤɚɡɧɢɤɿɜ ȺɈɋ ɜɿɞ ɧɨɪɦɢ ɭ ɯɜɨɪɢɯ ɡ ɇȺɋɉ ɭ ɩɨɽɞɧɚɧɧɿɡɈɀɡɚɥɟɠɧɨɜɿɞȱɆɌɪɢɫɩɨɤɚɡɚɜ ɳɨ ɡɦɿɧɚ ɩɪɨɞɭɤɬɿɜ ȺɈɋ í ɋɈȾ ɤɚɬɚɥɚɡɢ ɬɚ ɰɟɪɭɥɨɩɥɚɡɦɿɧɭ ɭ ɯɜɨɪɢɯ ɡ ɝɪɭɩ ɇȺɋɉ ɛɭɥɚ ɪɿɡɧɨɫɩɪɹɦɨɜɚɧɨɸ ɬɚ ɜɿɪɨɝɿɞɧɨ ɧɟ ɡɚɥɟɠɚɥɚ ɜɿɞ ȱɆɌ
Ɂ ɭɪɚɯɭɜɚɧɧɹɦ ɬɚɤɢɯ ɪɟɡɭɥɶɬɚɬɿɜ ɩɪɨɨɤɫɢ ɞɚɧɬɧɨʀɥɚɧɤɢɨɤɢɫɧɨɝɨɝɨɦɟɨɫɬɚɡɭɩɪɟɞɫɬɚɜɥɹɽ ɿɧɬɟɪɟɫɜɢɜɱɟɧɧɹɤɨɦɩɨɧɟɧɬɿɜɿɬɢɩɿɜɪɟɚɝɭɜɚɧɧɹ ȺɈɋɈɫɤɿɥɶɤɢɋɈȾɤɚɬɚɥɚɡɚɬɚɰɟɪɭɥɨɩɥɚɡɦɿɧ ɽɨɫɧɨɜɧɢɦɢɜɡɚɽɦɨɩɨɜɹɡɚɧɢɦɢɥɚɧɤɚɦɢȺɈɋʀɯ ɪɨɡɝɥɹɞ ɪɨɡɪɿɡɧɟɧɨ ɣ ɨɤɪɟɦɨ ɦɨɠɟ ɞɚɬɢ ɩɨ ɦɢɥɤɨɜɿ ɪɟɡɭɥɶɬɚɬɢ ɿ ɩɪɟɞɫɬɚɜɥɹɽɬɶɫɹ ɧɚɦ ɧɟ ɤɨɪɟɤɬɧɢɦ Ɂ ɭɪɚɯɭɜɚɧɧɹɦ ɩɪɢɧɰɢɩɨɜɨ ɪɿɡɧɨɝɨ ɯɚɪɚɤɬɟɪɭ ʀɯ ɡɦɿɧ ɭ ɯɜɨɪɢɯ ɧɚ ɇȺɀɏɉ ɜɢɜɱɟɧɿ ɬɢɩɢ ɪɟɚɝɭɜɚɧɧɹ ɚɧɬɢɨɤɫɢɞɚɧɬɧɨɝɨ ɡɚɯɢɫɬɭ ȺɈɁɧɚɚɤɬɢɜɚɰɿɸɩɪɨɰɟɫɿɜɥɿɩɨɩɟɪɨɤɫɢɞɚɰɿʀɡɚ ɫɩɿɜɜɿɞɧɨɲɟɧɧɹɦɦɿɠɰɢɦɢɤɨɦɩɨɧɟɧɬɚɦɢȺɈɋ Ⱥɧɚɥɿɡ ɨɬɪɢɦɚɧɢɯ ɞɚɧɢɯ ɞɨɡɜɨɥɢɜ ɜɢɞɿɥɢɬɢ ɩɪɢ
ɇȺɋɉ ɱɨɬɢɪɢ ɜɚɪɿɚɧɬɢ ɫɩɿɜɜɿɞɧɨɲɟɧɧɹ
Ɍ ɚ ɛ ɥ ɢ ɰ ɹ 2
ɑɚɫɬɨɬɚɜɢɹɜɥɟɧɧɹɜɿɞɯɢɥɟɧɶɩɨɤɚɡɧɢɤɿɜɉɈɅɜɿɞɧɨɪɦɢɭɯɜɨɪɢɯɧɚɧɟɚɥɤɨɝɨɥɶɧɢɣ ɫɬɟɚɬɨɡɩɟɱɿɧɤɢɭɩɨɽɞɧɚɧɧɿɡɨɠɢɪɿɧɧɹɦɡɚɥɟɠɧɨɜɿɞȱɆɌɚɛɫ
ɇȺɋɉQ
ȱɆɌ
ɤɝɦQ ɤɝɦȱɆɌQ ɤɝɦȱɆɌQ ɉɨɤɚɡɧɢɤɢ Ɏɚɡɢ
ɧɨɪɦɚ ɩɿɞɜɢɳɟɧɧɹ ɡɧɢɠɟɧɧɹ ɧɨɪɦɚ ɩɿɞɜɢɳɟɧɧɹ ɡɧɢɠɟɧɧɹ ɧɨɪɦɚ ɩɿɞɜɢɳɟɧɧɹ ɡɧɢɠɟɧɧɹ ɪȤ
D ±
ȾɄɜɨɞɦɥ
E
± ±
D
± ± ±
ɈȾɄɜɨɞɦɥ
E
D
±
ȱɉɁɜɨɞɦɥ
E
± ±
D
± ± ±
ɒɈɜɨɞɦɥ
E
± ± ±
ɆȾȺɩɥɚɡɧɦɨɥɶɦɥ
±
ɆȾȺɟɪɢɬɧɦɨɥɶɦɥ
±
ɉ ɪ ɢ ɦ ɿ ɬ ɤ ɢ ɪȤ±ɪɿɜɟɧɶɡɧɚɱɭɳɨɫɬɿɜɿɞɦɿɧɧɨɫɬɟɣɩɨɤɚɡɧɢɤɿɜɦɿɠɝɪɭɩɚɦɢɜɰɿɥɨɦɭɡɚɤɪɢɬɟɪɿɽɦȤ±Sɩɨɪɿɜɧɹɧɨɡɜɿɞɩɨɜɿɞɧɨɸ
ɝɪɭɩɨɸɯɜɨɪɢɯɡȱɆɌɤɝɦ
ȼɢɯɨɞɹɱɢ ɡ ɧɚɜɟɞɟɧɢɯ ɭ ɬɚɛɥɢɰɿ ɞɚɧɢɯ ɭ ɯɜɨɪɢɯ ɡ ɇȺɋɉ ɭ ɩɨɽɞɧɚɧɧɿ ɡ Ɉɀ ɿ ɩɚɬɨɥɨɝɿɽɸ ȻɌ ɧɟɡɚɥɟɠɧɨ ɜɿɞ ȱɆɌ ɱɚɫɬɿɲɟ ɮɿɤɫɭɜɚɥɢɫɹ ɤɨɦɩɟɧɫɚɬɨɪɧɢɣ ɬɢɩ ɪɟɚɝɭɜɚɧɧɹ ȺɈɁ ɡ ɩɿɞ ɜɢɳɟɧɧɹɦ ɭɫɿɯ ɩɚɪɚɦɟɬɪɿɜ ɫɢɫɬɟɦɢ ȺɈɁ ɬɚ
ɫɭɛɤɨɦɩɟɧɫɚɬɨɪɧɢɣɬɢɩɪɟɚɝɭɜɚɧɧɹɤɨɥɢɨɞɢɧɡ
ɩɨɤɚɡɧɢɤɿɜ ɫɢɫɬɟɦɢ ȺɈɁ ɩɿɞɜɢɳɟɧɨ ɿɧɲɢɣ ɡɧɢɠɟɧɨ Ɍɚɤ ȱ ɬɢɩ ɤɨɦɩɟɧɫɚɬɨɪɧɢɣ ɫɩɨɫɬɟ ɪɿɝɚɜɫɹ ɩɪɢɛɥɢɡɧɨ ɡ ɨɞɧɚɤɨɜɨɸ ɱɚɫɬɨɬɨɸ ɩɪɢ ȱɆɌ ± ɭ ɩɪɢ ȱɆɌ ± ɭ ɩɪɢȱɆɌ±ɜ
ɄɅȱɇȱɑɇȺ
ɆȿȾɂɐɂɇȺ
ɉɿɞɜɢɳɟɧɧɹ
ɇɨɪɦɚ
Ɂɧɢɠɟɧɧɹ
ȱɆɌ ȱɆɌ ȱɆɌ ȱɆɌ ȱɆɌ ȱɆɌ ȱɆɌ ȱɆɌ ȱɆɌ
ɋɈȾɄɚɬɚɥɚɡɚɐɟɪɭɥɨɩɥɚɡɦɿɧ
ɊɨɡɩɨɞɿɥɡɦɿɧɩɨɤɚɡɧɢɤɿɜȺɈɋɩɨɪɿɜɧɹɧɨɡɧɨɪɦɨɸɭɯɜɨɪɢɯ
ɧɚɧɟɚɥɤɨɝɨɥɶɧɢɣɫɬɟɚɬɨɡɩɟɱɿɧɤɢɜɩɨɽɞɧɚɧɧɿɡɨɠɢɪɿɧɧɹɦɡɚɥɟɠɧɨɜɿɞȱɆɌ
Ɉɬɠɟ ɭ ɯɜɨɪɢɯ ɡ ɇȺɀɏɉ ɩɟɪɟɜɚɠɚɥɢ ɩɚɬɨ ɥɨɝɿɱɧɿ ɬɢɩɢ ɪɟɚɝɭɜɚɧɧɹ ȺɈɁ ɤɨɦɩɟɧɫɚɬɨɪɧɢɣ ɫɭɛɤɨɦɩɟɧɫɚɬɨɪɧɢɣ ɞɟɤɨɦɩɟɧɫɚɬɨɪɧɢɣ ɧɚ ɬɥɿ ɩɿɞɜɢɳɟɧɨʀ ɚɤɬɢɜɧɨɫɬɿ ɩɪɨɰɟɫɿɜ ɥɿɩɨɩɟɪɨɤ ɫɢɞɚɰɿʀ ɋɭɛɤɨɦɩɟɧɫɚɬɨɪɧɢɣ ɬɢɩ ɪɟɚɝɭɜɚɧɧɹ ɦɨɠɥɢɜɨɪɨɡɝɥɹɞɚɬɢɹɤɩɨɝɪɚɧɢɱɧɢɣɬɨɛɬɨɹɤɢɣ ɩɪɢɡɜɨɞɢɬɶ ɞɨ ɩɚɬɨɥɨɝɿɱɧɢɯ ɡɦɿɧ ɭ ɪɚɡɿ ɣɨɝɨ ɬɪɢɜɚɥɨɝɨ ɿ ɩɪɨɝɪɟɫɭɸɱɨɝɨ ɩɟɪɟɛɿɝɭ Ɍɚɤɢɦ ɱɢ ɧɨɦ ɜ ɨɛɫɬɟɠɟɧɢɯ ɯɜɨɪɢɯ ɩɪɚɤɬɢɱɧɨ ɜ ɭɫɿɯ
ɤɥɿɧɿɱɧɢɯɜɢɩɚɞɤɚɯɭɝɪɭɩɚɯɇȺɋɉɪɨɡɜɢɜɚɽɬɶɫɹ ɜɿɞɧɨɫɧɚ ɚɛɨ ɚɛɫɨɥɸɬɧɚ ɚɧɬɢɨɤɫɢɞɚɧɬɧɚ ɧɟɞɨ ɫɬɚɬɧɿɫɬɶ ɡ ɜɢɫɧɚɠɟɧɧɹɦ ʀʀ ɨɤɪɟɦɢɯ ɥɚɧɨɤ ɡɨɤɪɟɦɚ ɋɈȾ ɤɚɬɚɥɚɡɢ ɿ ɰɟɪɭɥɨɩɥɚɡɦɿɧɭ ȼɿɞ ɧɨɫɧɚɚɧɬɢɨɤɫɢɞɚɧɬɧɚɧɟɞɨɫɬɚɬɧɿɫɬɶɩɪɨɹɜɥɹɽɬɶ ɫɹ ɡɧɢɠɟɧɧɹɦ ɚɤɬɢɜɧɨɫɬɿ ɨɞɧɿɽʀ ɡ ɥɚɧɨɤ ȺɈɁ ± ɋɈȾɤɚɬɚɥɚɡɢɚɛɨɰɟɪɭɥɨɩɥɚɡɦɿɧɭɚɛɫɨɥɸɬɧɚ± ɡɧɢɠɟɧɧɹɦɭɫɿɯʀʀɤɨɦɩɨɧɟɧɬɿɜ
Ɍ ɚ ɛ ɥ ɢ ɰ ɹ 3
ɌɢɩɢɪɟɚɝɭɜɚɧɧɹȺɈɁɭɩɚɰɿɽɧɬɿɜɩɪɢɧɟɚɥɤɨɝɨɥɶɧɨɦɭɫɬɟɚɬɨɡɿɜɩɨɽɞɧɚɧɧɿɡ ɨɠɢɪɿɧɧɹɦɿɫɭɩɭɬɧɶɨɸɩɚɬɨɥɨɝɿɽɸɛɿɥɿɚɪɧɨɝɨɬɪɚɤɬɭɚɛɫ
ɉɨɤɚɡɧɢɤɢ ɤɝɦȱɆɌ Q
ȱɆɌ ɤɝɦ
Q
ȱɆɌ ɤɝɦ
Q ɪȤ
ɬɢɩɩɨɤɚɡɧɢɤɢɜɦɟɠɚɯɧɨɪɦɢ
ɬɢɩɤɨɦɩɟɧɫɚɬɨɪɧɢɣĹɋɈȾĹɄȺɌĹɐɉ
ɬɢɩɫɭɛɤɨɦɩɟɧɫɚɬɨɪɧɢɣĹĻɋɈȾĹĻɄȺɌĹĻɐɉ
ɬɢɩɞɟɤɨɦɩɟɧɫɚɬɨɪɧɢɣĻɋɈȾĻɄȺɌĻɐɉ ±
±
ȼɂɋɇɈȼɄɂ
ɍ ɯɜɨɪɢɯ ɡ ɇȺɋɉ ɭ ɩɨɽɞɧɚɧɧɿ ɡ Ɉɀ ɿ ɩɚ
ɬɨɥɨɝɿɽɸ ȻɌ ɤɨɦɨɪɛɿɞɧɢɣ ɩɟɪɟɛɿɝ ɡɚɯɜɨɪɸɜɚɧɧɹ ɛɭɥɨ ɚɫɨɰɿɣɨɜɚɧɨ ɡ ɫɭɬɬɽɜɢɦɢ ɩɨɪɭɲɟɧɧɹɦɢ ɨɤ ɫɢɞɚɧɬɧɨɚɧɬɢɨɤɫɢɞɚɧɬɧɨʀɪɿɜɧɨɜɚɝɢ
ȼɫɬɚɧɨɜɥɟɧɨ ɳɨ ɜɢɪɚɠɟɧɿɫɬɶ ɡɚɡɧɚɱɟɧɢɯ
ɡɦɿɧ ɭ ɫɢɫɬɟɦɿ ɉɈɅ ɬɚ ȺɈɋ ɭ ɤɨɠɧɿɣ ɡ ɨɛɫɬɟ ɠɟɧɢɯ ɝɪɭɩ ɧɟɨɞɧɚɤɨɜɚ ɿ ɡɚɥɟɠɢɬɶ ɜɿɞ ɫɬɭɩɟɧɹ ȱɆɌɭɯɜɨɪɢɯɡɝɪɭɩɇȺɋɉɭɩɨɽɞɧɚɧɧɿɡɈɀɿ ɩɚɬɨɥɨɝɿɽɸ ȻɌ Ɂɪɨɫɬɚɧɧɹ ɫɬɭɩɟɧɹ ȱɆɌ ɫɩɪɢɹɽ ɛɿɥɶɲɨɦɭ ɩɨɝɥɢɛɥɟɧɧɸ ɩɪɨɰɟɫɿɜ ɥɿɩɨɩɟɪɨɤɫɢ ɞɚɰɿʀɬɚɩɪɢɝɧɿɱɟɧɧɸɩɚɪɚɦɟɬɪɿɜȺɈɋɩɪɚɤɬɢɱɧɨ ɜɭɫɿɯɝɪɭɩɚɯɫɩɨɫɬɟɪɟɠɟɧɧɹɇȺɋɉ
Ⱥɧɚɥɿɡɨɬɪɢɦɚɧɢɯɞɚɧɢɯɞɨɡɜɨɥɢɜɜɢɞɿɥɢɬɢ
ɩɪɢ ɤɨɦɨɪɛɿɞɧɨɦɭ ɩɟɪɟɛɿɝɭ ɇȺɋɉ ɱɨɬɢɪɢ ɜɚ ɪɿɚɧɬɢ ɪɟɚɝɭɜɚɧɧɹ ȺɈɁ ɍ ɩɚɰɿɽɧɬɿɜ ɡ ɇȺɋɉ ɭ ɩɨɽɞɧɚɧɧɿɡɈɀɿɩɚɬɨɥɨɝɿɽɸȻɌɧɟɡɚɥɟɠɧɨɜɿɞ
ȱɆɌɱɚɫɬɿɲɟɮɿɤɫɭɜɚɥɢɫɹɤɨɦɩɟɧɫɚɬɨɪɧɢɣ ɬɚ ɫɭɛɤɨɦɩɟɧɫɚɬɨɪɧɢɣ ɬɢɩɢ ɪɟɚɝɭɜɚɧɧɹ ȺɈɁ
Ɂɚ ɪɟɡɭɥɶɬɚɬɚɦɢ ɤɨɪɟɥɹɰɿɣɧɨɝɨ ɚɧɚɥɿɡɭ
ɜɫɬɚɧɨɜɥɟɧɿ ɜɿɪɨɝɿɞɧɿ ɩɪɹɦɿ ɡɜ¶ɹɡɤɢ ɫɥɚɛɤɨʀ ɿ ɫɟɪɟɞɧɶɨʀ ɫɢɥɢ ɦɿɠ ɨɫɧɨɜɧɢɦɢ ɩɨɤɚɡɧɢɤɚɦɢ ɨɤɢɫɧɸɜɚɥɶɧɨɝɨɝɨɦɟɨɫɬɚɡɭȾɄɈȾɄȱɉɁɒɈ ɆȾȺɜɨɛɢɞɜɿɮɚɡɢɥɿɩɿɞɧɨɝɨɟɤɫɬɪɚɤɬɭɿɦɚɫɨɸ ɬɿɥɚ ɯɜɨɪɢɯ ɡ ɇȺɋɉ UV ɜɿɞ ɞɨ ɡ
ɪɪ
ɉɟɪɫɩɟɤɬɢɜɚ ɩɨɞɚɥɶɲɢɯ ɞɨɫɥɿɞɠɟɧɶ Ⱦɨ
ɫɥɿɞɠɟɧɧɹ ɩɚɪɚɦɟɬɪɿɜ ɉɈɅ ɬɚ ȺɈɁ ɭ ɯɜɨɪɢɯ ɡ ɧɟɚɥɤɨɝɨɥɶɧɢɦ ɫɬɟɚɬɨɝɟɩɚɬɢɬɨɦ ɭ ɩɨɽɞɧɚɧɧɿ ɡ Ɉɀ ɡɚɥɟɠɧɨ ɜɿɞ ɩɨɤɚɡɧɢɤɿɜ ȱɆɌ ɬɚ ɧɚɹɜɧɨɫɬɿ ɫɭɩɭɬɧɶɨʀɩɚɬɨɥɨɝɿʀɡɛɨɤɭȻɌ
ɋ
ɋ
ɉ
ɉ
ɂ
ɂ
ɋ
ɋ
Ɉ
Ɉ
Ʉ
Ʉ
Ʌ
Ʌ
ȱ
ȱ
Ɍ
Ɍ
ȿ
ȿ
Ɋ
Ɋ
Ⱥ
Ⱥ
Ɍ
Ɍ
ɍ
ɍ
Ɋ
Ɋ
ɂ
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ɋɨɩɨɫɬɚɜɥɟɧɢɟ ɪɚɡɥɢɱɧɵɯ ɩɨɞɯɨɞɨɜ ɤ ɨɩɪɟ ɞɟɥɟɧɢɸ ɩɪɨɞɭɤɬɨɜ ɉɈɅ ɜ ɝɟɩɬɚɧɢɡɨɩɪɨɩɚɧɨɥɶɧɵɯ ɷɤɫɬɪɚɤɬɚɯɤɪɨɜɢɂȺȼɨɥɱɟɝɨɪɫɤɢɣɎȽɇɚɥɢɦɨɜ ȻȽ əɪɨɜɢɧɫɤɢɣ >ɢ ɞɪ@ ȼɨɩɪɨɫɵ ɦɟɞ ɯɢɦɢɢ ± ±ʋ±ɋ
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ȺɈ «Ɋɟɫɩɭɛɥɢɤɚɧɫɤɢɣ ɫɩɟɰɢɚɥɢɡɢɪɨɜɚɧɧɵɣ ɰɟɧɬɪ ɯɢɪɭɪɝɢɢ ɢɦ ɚɤɚɞ. ȼ. ȼɚɯɢɞɨɜɚ» ɭɥ. Ʉɢɱɢɤ ɯɚɥɤɚ ɣɭɥɢ, 10, Ɍɚɲɤɟɧɬ, 100000, ɍɡɛɟɤɢɫɬɚɧ
Stock Company «Republican Specialized Surgery Center named after academician V.Vakhidov» Kichik khalka yuli str., 10, Tashkent city, 100000, Uzbekistan
e-mail: anvar76@list.ru
Ʉɥɸɱɟɜɵɟɫɥɨɜɚ ɜɟɧɬɪɚɥɶɧɵɟ ɝɪɵɠɢ, ɩɪɨɬɟɡɧɚɹ ɩɥɚɫɬɢɤɚ, ɤɨɠɧɨ-ɩɪɨɬɟɡɧɵɟ ɫɜɢɳɢ, ɯɢɪɭɪɝɢɱɟɫɤɨɟ ɥɟɱɟɧɢɟ, ɚɡɨɬɧɵɣ ɢ ɭɝɥɟɤɢɫɥɨɬɧɵɣ ɥɚɡɟɪ
.H\ZRUGV ventral hernia, alloplastics, skin-prosthetic fistula, surgical treatment, nitrogen and carbon dioxide laser
Ɋɟɮɟɪɚɬ ɏɪɨɧɿɱɧɚ ɩɚɪɚɩɪɨɬɟɡɧɚ ɿɧɮɟɤɰɿɹ ɩɿɫɥɹ ɚɥɨɝɟɪɧɿɨɩɥɚɫɬɢɤɢ Ʉɚɥɿɲɘȱ ȺɦɟɬɨɜɅɁ ɒɚɸɫɭɩɨɜȺɊɃɿɝɿɬɚɥɿɽɜɋɏɄɚɛɭɥɨɜɆɄ ɉɪɨɬɟɡɧɚ ɩɥɚɫɬɢɤɚ ɝɪɢɠ ɲɢɪɨɤɨ ɩɨɲɢɪɟɧɚ, ɨɞɧɚɤ ʀʀ ɫɭɩɪɨ-ɜɨɞɠɭɽ ɝɨɫɬɪɟ ɿ ɯɪɨɧɿɱɧɟ ɡɚɩɚɥɟɧɧɹ, ɹɤɟ ɪɨɡɜɢɜɚɽɬɶɫɹ ɧɚɜɤɨɥɨ ɿɦɩɥɚɧɬɚɬɭ. ɍ ɬɚɤɿɣ ɫɢɬɭɚɰɿʀ ɧɟɨɛɯɿɞɧɨ ɜɢɪɿɲɭɜɚɬɢ ɩɢɬɚɧɧɹ: ɜɢɞɚɥɹɬɢ ɚɛɨ ɡɛɟɪɟɝɬɢ ɫɿɬɤɭ. Ɇɢ ɫɩɨɫɬɟɪɿɝɚɥɢ 11 ɩɚɰɿɽɧɬɿɜ ɡɿ ɫɮɨɪɦɨɜɚɧɢɦɢ ɲɤɿɪɧɨ-ɩɪɨɬɟɡɧɢɦɢ ɫɜɢɳɚɦɢ, ɿɫɧɭɸɱɢɦɢ ɜɿɞ 1 ɪɨɤɭ ɞɨ 6 ɪɨɤɿɜ. ɉɪɨɜɨɞɢɥɢ ɫɚɧɚɰɿɸ ɫɜɢɳɿɜ ɿ ɨɩɪɨɦɿɧɟɧɧɹ ɭɥɶɬɪɚ-ɮɿɨɥɟɬɨɜɢɦɚɡɨɬɧɢɦɥɚɡɟɪɨɦ, ɹɤɢɣɦɚɽɛɚɤɬɟɪɿɨɰɢɞɧɢɣɟɮɟɤɬ (Pn - 2,5 -5 ɦȼɬ; t=2 ɯɜ.; W- 1,5-3 Ⱦɠ/ɫɦ2). 10 ɩɚɰɿɽɧɬɿɜ ɩɪɨɨɩɟɪɨɜɚɧɨ. ɍ ɞɜɨɯ ɜɢɩɚɞɤɚɯ ɛɭɥɨ ɜɢɤɨɧɚɧɨ ɜɢɫɿɱɟɧɧɹ ɞɿɥɹɧɤɢ ɩɪɨɬɟɡɚ ɜ ɦɟɠɚɯ ɣɨɝɨ ɿɧɬɟɝɪɨɜɚɧɨʀ ɱɚɫɬɢɧɢ. ɍ ɜɨɫɶɦɢ ɛɭɥɨ ɜɢɤɨɧɚɧɨ ɩɨɜɧɟ ɜɢɞɚɥɟɧɧɹ ɿɦɩɥɚɧɬɚɬɿɜ ɡ ɲɢɪɨɤɨɸ ɞɢɡɫɟɤɰɿɽɸ ɿɧɮɿɤɨɜɚɧɢɯ ɬɤɚɧɢɧ. Ɋɟɩɪɨɬɟɡɭɜɚɧɧɹ ɜɢɤɨɧɚɧɨ ɱɨɬɢɪɶɨɦ ɯɜɨɪɢɦ. ɇɚ ɟɬɚɩɚɯ ɨɩɟɪɚɰɿʀ ɬɚɤɨɠ ɜɢɤɨɪɢɫɬɚɧɨ ɜɭɝɥɟɤɢɫɥɨɬɧɢɣ ɥɚɡɟɪ ɞɥɹ ɨɩɪɨɦɿɧɟɧɧɹ ɨɩɟɪɚɰɿɣɧɨʀ ɪɚɧɢ (ɞɨɜɠɢɧɚ ɯɜɢɥɿ 10,6 ɦɤɦ, ɩɨɬɭɠɧɿɫɬɶ ɜɢɩɪɨɦɿɧɸɜɚɧɧɹ 25 ȼɬ, ɟɤɫɩɨɡɢɰɿɹ ɧɚ 1 ɫɦ2 ɪɚɧɨɜɨʀ ɩɨɜɟɪɯɧɿ ɩɪɨɬɹɝɨɦ 1 ɫɟɤ.). Ɂ ɞɟɫɹɬɢ ɨɩɟɪɨɜɚɧɢɯ ɩɚɰɿɽɧɬɿɜ ɡ ɯɪɨɧɿɱɧɨɸ ɩɚɪɚɩɪɨɬɟɡɧɨɸ ɿɧɮɟɤɰɿɽɸ
