Тhe features of severe community acquired pneumonia

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8. Parfɺnov VA. [Cognitive and emotional disorders in patients with hypertension]. Ukrainsky nevrologicheny Journal. 2006;1:47-52. Ukrainian.

9. Rebrovɚ O. [Statistical analysis of medical data. The use of the application package STATISTICA]. 2002;312.

10. Svischenko EP. [Detection and treatment of hypertension in Ukraine: reality and perspectives]. 2011;1:13-15. Ukrainian.

11. Yakhno NN. [Syndrome of mild cognitive disor-ders in vascular encephalopathy]. Journal nevropatolohyy and psyhyatryy. 2005;2:13-17. Russian.

12. Arima H. PROGRESS Collaborative Group. Lo-wer target blood pressures are safe and effective for the

pressure measured in the office, at home and during am-bulatory monitoring in general practice. J. Hum Hy-pertens. 2005;19:801–7.

14. Hypertension: management of hypertension in adults in primary care NICE/BHS. June 2006. www.nice.org.uk/CG034nice.org.uk/

15. Laurent S. European Network for non invasive investigation of large arteries. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2000;27:2588–605.

16. Mancia G. Assessment of long-term antihyperten-sive treatment by clinic an ambulatory blood pressure. Data from the ELSA Study. J. Hypertens. 2007;25:1087–94.

ɋɬɚɬɬɹ ɧɚɞɿɣɲɥɚ ɞɨ ɪɟɞɚɤɰɿʀ 27.01.2015

ɍȾɄ 616.24 – 002.1 – 036

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ȾɁ «Ⱦɧɿɩɪɨɩɟɬɪɨɜɫɶɤɚ ɦɟɞɢɱɧɚ ɚɤɚɞɟɦɿɹ ɆɈɁ ɍɤɪɚʀɧɢ» ɤɚɮɟɞɪɚ ɩɪɨɩɟɞɟɜɬɢɤɢ ɜɧɭɬɪɿɲɧɶɨʀ ɦɟɞɢɰɢɧɢ

(ɡɚɜ. – ɞ.ɦɟɞ.ɧ.,ɩɪɨɮ.Ɍ.Ⱥ.ɏɨɦɚɡɸɤ)

ɜɭɥ.Ⱦɡɟɪɠɢɧɫɶɤɨɝɨ, 9, Ⱦɧɿɩɪɨɩɟɬɪɨɜɫɶɤ, 49044, ɍɤɪɚʀɧɚ

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine» Department of Internal Medicine Propaedeutics

Dzerzhinsky str., 9, Dnipropetrovsk, 49044, Ukraine ɟ-mail:56466@rambler.ru

Ʉɥɸɱɨɜɿ ɫɥɨɜɚ:ɩɧɟɜɦɨɧɿɹ,ɬɹɠɤɚ ɧɟɝɨɫɩɿɬɚɥɶɧɚ ɩɧɟɜɦɨɧɿɹ,ɨɫɨɛɥɢɜɨɫɬɿ ɩɧɟɜɦɨɧɿʀ

Key words: pneumonia, severe community acquired pneumonia features of pneumonia

Ɋɟɮɟɪɚɬ. Ɉɫɨɛɟɧɧɨɫɬɢ ɤɥɢɧɢɱɟɫɤɨɝɨ ɬɟɱɟɧɢɹ ɬɹɠɟɥɨɣ ɧɟɝɨɫɩɢɬɚɥɶɧɨɣ ɩɧɟɜɦɨɧɢɢ. Ⱥɜɪɚɦɟɧɤɨ ɂ.ȼ.

ɂɫɯɨɞɹ ɢɡ ɞɚɧɧɵɯ ɩɪɨɫɩɟɤɬɢɜɧɨɝɨ ɚɧɚɥɢɡɚ ɡɚ ɝɨɞ ɧɚɛɥɸɞɟɧɢɹ,ɜ ɫɬɚɬɶɟ ɩɪɢɜɟɞɟɧɵ ɞɚɧɧɵɟ ɨɛ ɨɫɨɛɟɧɧɨɫɬɹɯ ɬɟɱɟɧɢɹ ɬɹɠɺɥɨɣ ɧɟɝɨɫɩɢɬɚɥɶɧɨɣ ɩɧɟɜɦɨɧɢɢ ɭ ɛɨɥɶɧɵɯ,ɧɚɯɨɞɢɜɲɢɯɫɹ ɧɚ ɫɬɚɰɢɨɧɚɪɧɨɦ ɥɟɱɟɧɢɢ ɜ ɨɬɞɟɥɟɧɢɢ ɩɭɥɶɦɨɧɨɥɨɝɢɢ (ɢɥɢ ɬɟɪɚɩɢɢ), ɚ ɬɚɤɠɟ ɨɬɞɟɥɟɧɢɢ ɪɟɚɧɢɦɚɰɢɢ ɢ ɢɧɬɟɧɫɢɜɧɨɣ ɬɟɪɚɩɢɢ ɬɪɟɯ ɤɥɢɧɢɱɟɫɤɢɯ ɛɨɥɶɧɢɰ ɝ.Ⱦɧɟɩɪɨɩɟɬɪɨɜɫɤɚ, ɚ ɢɦɟɧɧɨ ɄɁ «Ⱦɧɟɩɪɨɩɟɬɪɨɜɫɤɚɹ ɝɨɪɨɞɫɤɚɹ ɤɥɢɧɢɱɟɫɤɚɹ ɛɨɥɶɧɢɰɚ ʋ6», ɄɁ «Ⱦɧɟɩɪɨɩɟɬɪɨɜɫɤɚɹ ɝɨɪɨɞɫɤɚɹ ɤɥɢɧɢɱɟɫɤɚɹ ɛɨɥɶɧɢɰɚ ʋ2», ɄɁ «Ⱦɧɟɩɪɨɩɟɬɪɨɜɫɤɚɹ ɝɨɪɨɞɫɤɚɹ ɤɥɢɧɢɱɟɫɤɚɹ ɛɨɥɶɧɢɰɚ ʋ16», ɤɨɬɨɪɵɟ ɹɜɥɹɸɬɫɹ ɤɥɢɧɢɱɟɫɤɢɦɢ ɛɚɡɚɦɢ Ⱦɍ «Ⱦɧɟɩɪɨɩɟɬɪɨɜɫɤɚɹ ɦɟɞɢɰɢɧɫɤɚɹ ɚɤɚɞɟɦɢɹ ɆɁ ɍɤɪɚʀɧɢ». ɉɨɤɚɡɚɧɚ ɡɚɜɢɫɢɦɨɫɬɶ ɬɹɠɟɫɬɢ ɫɨɫɬɨɹɧɢɹ ɨɬ ɞɥɢɬɟɥɶɧɨɫɬɢ ɡɚɛɨɥɟɜɚɧɢɹ ɞɨ ɝɨɫɩɢɬɚɥɢɡɚɰɢɢ, ɨɫɨɛɟɧɧɨɫɬɢ ɫɟɡɨɧɧɨɫɬɢ ɡɚɛɨɥɟɜɚɟɦɨɫɬɢ. Ɋɚɫɫɦɨɬɪɟɧɨ ɜɥɢɹɧɢɟ ɞɵɯɚɬɟɥɶɧɨɣ ɝɢɦɧɚɫɬɢɤɢ ɧɚ ɬɟɱɟɧɢɟ ɡɚɛɨɥɟɜɚɧɢɹ. ɉɨɥɭɱɟɧɧɵɟ ɪɟɡɭɥɶɬɚɬɵ ɦɨɝɭɬ ɛɵɬɶ ɨɫɧɨɜɚɧɢɟɦ ɞɥɹ ɛɨɥɟɟ ɢɧɞɢɜɢɞɭɚɥɶɧɨɝɨ ɩɨɞɯɨɞɚ ɤ ɪɚɡɪɚɛɨɬɤɟ ɞɢɚɝɧɨɫɬɢɱɟɫɤɨɣ ɢ ɬɟɪɚɩɟɜɬɢɱɟɫɤɨɣ ɩɪɨɝɪɚɦɦɵ ɞɥɹ ɛɨɥɶɧɵɯ ɬɹɠɺɥɨɣ ɧɟɝɨɫɩɢɬɚɥɶɧɨɣ ɩɧɟɜɦɨɧɢɟɣ.

(2)

ɄɅȱɇȱɑɇȺ ɆȿȾɂɐɂɇȺ

department of the intensive care from three teaching hospitals in Dnepropetrovsk, namely "Dnipropetrovsk City Hospital ʋ6», "Dnipropetrovsk City Hospital ʋ2», "Dnipropetrovsk City Hospital ʋ16», which are the clinical ones of "Dnepropetrovsk Medical Academy of the Ministry of Health Ukraine". Dependence of the severity of the condition shown on duration of illness before admission, features of season character of disease. The effect of breathing exercises on the course of the disease. The results can be the basis for a more personal approach to the development of diagnostic and therapeutic programs for patients with severe community-acquired pneumonia.

Ɂɚɯɜɨɪɸɜɚɧɧɹ ɨɪɝɚɧɿɜ ɞɢɯɚɧɧɹ ɫɬɚɧɨɜɥɹɬɶ ɨɞɧɭ ɡ ɧɚɣɛɿɥɶɲ ɱɢɫɥɟɧɧɢɯ ɝɪɭɩ ɡɚɯɜɨɪɸɜɚɧɶ ɿ ɩɨɫɿɞɚɸɬɶ ɜɚɝɨɦɟ ɦɿɫɰɟ ɫɟɪɟɞ ɩɪɢɱɢɧ ɡɧɢɠɟɧɧɹ ɩɪɚɰɟɡɞɚɬɧɨɫɬɿ ɬɚ ɫɦɟɪɬɿ. Ɂɧɚɱɧɚ ɩɢɬɨɦɚ ɜɚɝɚ

ɫɟɪɟɞ ɯɜɨɪɨɛ ɨɪɝɚɧɿɜ ɞɢɯɚɧɧɹ (ɡɚ ɜɢɤɥɸɱɟɧɧɹɦ

ɝɨɫɬɪɢɯ ɪɟɫɩɿɪɚɬɨɪɧɢɯ ɿɧɮɟɤɰɿɣ) ɧɚɥɟɠɢɬɶ ɡɚ

-ɩɚɥɟɧɧɸ ɥɟɝɟɧɿɜ (ɛɿɥɶɲɟ 60 %) [1, 2, 9, 11].

ɍ ɤɪɚʀɧɚɯ ɩɿɫɥɹɪɚɞɹɧɫɶɤɨɝɨ ɩɪɨɫɬɨɪɭ ɯɜɨɪɨɛɢ ɨɪɝɚɧɿɜ ɞɢɯɚɧɧɹ ɩɨɫɿɞɚɸɬɶ ɩɟɪɲɟ ɦɿɫɰɟ ɡɚ ɡɚɯɜɨ

-ɪɸɜɚɧɿɫɬɸ ɣ ɩɨɲɢɪɟɧɿɫɬɸ [3, 6, 9]. ɉɪɨɬɹɝɨɦ

ɨɫɬɚɧɧɿɯ ɪɨɤɿɜ ɡɚɯɜɨɪɸɜɚɧɿɫɬɶ ɧɟɭɯɢɥɶɧɨ ɡɪɨɫɬɚ

-ɥɚ ɣ ɡɚɥɢɲɚɽɬɶɫɹ ɫɬɚɛɿɥɶɧɨ ɜɢɫɨɤɨɸ ɫɟɪɟɞ ɞɨ

-ɪɨɫɥɨɝɨ ɧɚɫɟɥɟɧɧɹ [1, 3, 4].

ȼ ɍɤɪɚʀɧɿ ɜ 2010 ɪ., ɡɚ ɞɚɧɢɦɢ ɨɮɿɰɿɣɧɨʀ ɫɬɚ

-ɬɢɫɬɢɤɢ, ɡɚɯɜɨɪɸɜɚɧɿɫɬɶ ɞɨɪɨɫɥɢɯ ɧɚ ɩɧɟɜɦɨɧɿɸ

ɫɬɚɧɨɜɢɥɚ 519,7 ɧɚ 100 ɬɢɫ. ɧɚɫɟɥɟɧɧɹ, ɚ

ɫɦɟɪɬɧɿɫɬɶ — 10,3 ɧɚ 100 ɬɢɫ. ɧɚɫɟɥɟɧɧɹ, ɬɨɛɬɨ

ɩɨɦɟɪɥɨ ɦɚɣɠɟ 2% ɡ ɬɢɯ, ɯɬɨ ɡɚɯɜɨɪɿɜ ɧɚ ɩɧɟɜ

-ɦɨɧɿɸ. Ɉɞɧɚɤ ɰɿ ɩɨɤɚɡɧɢɤɢ ɧɟ ɩɨɜɧɨɸ ɦɿɪɨɸ

ɜɿɞɨɛɪɚɠɚɸɬɶ ɪɿɜɟɧɶ ɫɩɪɚɜɠɧɶɨʀ ɡɚɯɜɨɪɸɜɚɧɨɫɬɿ ɿ ɫɦɟɪɬɧɨɫɬɿ Ɂɚ ɩɿɞɪɚɯɭɧɤɚɦɢ, ɭ ɧɚɲɿɣ ɤɪɚʀɧɿ

ɳɨɪɿɱɧɨ ɛɿɥɶɲɟ 1,5 ɦɥɧ ɥɸɞɟɣ ɜɿɤɨɦ ɩɨɧɚɞ 18

ɪɨɤɿɜ ɯɜɨɪɿɸɬɶ ɧɚ ɧɟɝɨɫɩɿɬɚɥɶɧɭ ɩɧɟɜɦɨɧɿɸ, ɳɨ

ɜɢɡɧɚɱɚɽ ɜɚɠɥɢɜɿɫɬɶ ɩɢɬɚɧɧɹ ɞɿɚɝɧɨɫɬɢɤɢ,

ɥɿɤɭɜɚɧɧɹ ɿ ɩɪɨɮɿɥɚɤɬɢɤɢ ɰɶɨɝɨ ɡɚɯɜɨɪɸɜɚɧɧɹ ɹɤ ɧɚɣɛɿɥɶɲ ɝɨɫɬɪɢɯ ɩɪɨɛɥɟɦ ɜɿɬɱɢɡɧɹɧɨʀ ɨɯɨɪɨɧɢ ɡɞɨɪɨɜ’ɹ [6].

Ɂ ɭɪɚɯɭɜɚɧɧɹɦ ɜɢɳɟɡɚɡɧɚɱɟɧɨɝɨ, ɦɟɬɨɸ

ɞɨɫɥɿɞɠɟɧɧɹ ɛɭɥɨ ɜɢɹɜɢɬɢ ɨɫɨɛɥɢɜɨɫɬɿ ɤɥɿɧɿɱ

-ɧɨɝɨ ɩɟɪɟɛɿɝɭ ɬɹɠɤɨʀ ɧɟɝɨɫɩɿɬɚɥɶɧɨʀ ɩɧɟɜɦɨɧɿʀ ɡɚɥɟɠɧɨ ɜɿɞ ɤɥɿɧɿɱɧɨʀ ɝɪɭɩɢ ɩɧɟɜɦɨɧɿʀ ɿ ɫɨ

-ɰɿɚɥɶɧɨ-ɞɟɦɨɝɪɚɮɿɱɧɢɯ ɯɚɪɚɤɬɟɪɢɫɬɢɤ.

ɆȺɌȿɊȱȺɅɂ ɌȺ ɆȿɌɈȾɂ ȾɈɋɅȱȾɀȿɇɖ ɍ ɞɨɫɥɿɞɠɟɧɧɹ ɛɭɥɨ ɜɤɥɸɱɟɧɨ 88 ɩɚɰɿɽɧɬɿɜ

ɜɿɤɨɦ ɜɿɞ 20 ɞɨ 82 ɪɨɤɿɜ, ɡ ɞɿɚɝɧɨɡɨɦ «ɇɟɝɨɫɩɿ

-ɬɚɥɶɧɚ ɩɧɟɜɦɨɧɿɹ, ɬɹɠɤɢɣ ɩɟɪɟɛɿɝ», ɹɤɿ ɡɧɚɯɨɞɢ

-ɥɢɫɶ ɧɚ ɫɬɚɰɿɨɧɚɪɧɨɦɭ ɥɿɤɭɜɚɧɧɿ ɜ ɬɟɪɚɩɟɜɬɢɱ

-ɧɢɯ (ɩɭɥɶɦɨɧɨɥɨɝɿɱɧɢɯ) ɜɿɞɞɿɥɟɧɧɹɯ ɬɚ ɜɿɞ

-ɞɿɥɟɧɧɹɯ ɿɧɬɟɧɫɢɜɧɨʀ ɬɟɪɚɩɿʀ ɬɚ ɪɟɚɧɿɦɚɰɿʀ ɬɪɶɨɯ ɤɥɿɧɿɱɧɢɯ ɥɿɤɚɪɟɧɶ ɦ.Ⱦɧɿɩɪɨɩɟɬɪɨɜɫɶɤɚ, ɚ ɫɚɦɟ

ɄɁ «Ⱦɧɿɩɪɨɩɟɬɪɨɜɫɶɤɚ ɦɿɫɶɤɚ ɤɥɿɧɿɱɧɚ ɥɿɤɚɪɧɹ

ʋ 6», ɄɁ «Ⱦɧɿɩɪɨɩɟɬɪɨɜɫɶɤɚ ɦɿɫɶɤɚ ɤɥɿɧɿɱɧɚ ɥɿ

-ɤɚɪɧɹ ʋ 2», ɄɁ «Ⱦɧɿɩɪɨɩɟɬɪɨɜɫɶɤɚ ɦɿɫɶɤɚ ɤɥɿɧɿɱ

-ɧɚ ɥɿɤɚɪɧɹ ʋ 16», ɹɤɿ ɽ ɤɥɿɧɿɱɧɢɦɢ ɛɚɡɚɦɢ ȾɁ «Ⱦɧɿ

-ɩɪɨɩɟɬɪɨɜɫɶɤɚ ɦɟɞɢɱɧɚ ɚɤɚɞɟɦɿɹ ɆɈɁ ɍɤɪɚʀɧɢ».

ɋɟɪɟɞɧɿɣ ɜɿɤ ɯɜɨɪɢɯ ɫɬɚɧɨɜɢɜ 47,6±1,7 ɪɨɤɭ;

ɱɨɥɨɜɿɤɿɜ ɛɭɥɨ 42 (47,7 %), ɠɿɧɨɤ – 46 (52,3 %).

Ʉɪɢɬɟɪɿɹɦɢ ɜɤɥɸɱɟɧɧɹ ɞɨ ɞɨɫɥɿɞɠɟɧɧɹ ɛɭɥɢ:

ɜɿɤ ɜɿɞ 18 ɞɨ 85 ɪɨɤɿɜ,ɜɿɞɩɨɜɿɞɧɿɫɬɶ ɫɢɦɩɬɨɦɿɜ ɬɚ

ɨɡɧɚɤ ɤɥɿɧɿɱɧɨɦɭ ɞɿɚɝɧɨɡɭ «ɇɟɝɨɫɩɿɬɚɥɶɧɚ ɩɧɟɜ

-ɦɨɧɿɹ, ɬɹɠɤɢɣ ɩɟɪɟɛɿɝ», ɧɚɹɜɧɿɫɬɶ ɪɟɡɭɥɶɬɚɬɿɜ

ɫɩɿɪɨɦɟɬɪɿʀ.

Ⱦɨ ɤɪɢɬɟɪɿʀɜ ɜɢɤɥɸɱɟɧɧɹ ɡ ɞɨɫɥɿɞɠɟɧɧɹ ɧɚ

-ɥɟɠɚɥɢ: ɧɚɹɜɧɿɫɬɶ ɨɡɧɚɤ ɬɹɠɤɨʀ ɫɭɩɭɬɧɶɨʀ ɩɚɬɨ

-ɥɨɝɿʀ ɿɧɲɢɯ ɨɪɝɚɧɿɜ ɿ ɫɢɫɬɟɦ, ɩɭɯɥɢɧɧɢɯ ɩɪɨ

-ɰɟɫɿɜ, ɹɤɿ ɿɫɬɨɬɧɨ ɦɨɠɭɬɶ ɜɩɥɢɧɭɬɢ ɧɚ ɪɟɡɭɥɶɬɚɬ

ɞɨɫɥɿɞɠɟɧɧɹ; ɡɦɿɧɚ ɤɥɿɧɿɱɧɨɝɨ ɞɿɚɝɧɨɡɭ ɧɚ

ɩɿɞɫɬɚɜɿ ɞɚɧɢɯ, ɨɬɪɢɦɚɧɢɯ ɩɿɞ ɱɚɫ ɩɪɨɜɟɞɟɧɧɹ

ɞɨɞɚɬɤɨɜɢɯ ɦɟɬɨɞɿɜ ɨɛɫɬɟɠɟɧɧɹ; ɜɿɞɦɨɜɚ ɩɚ

-ɰɿɽɧɬɿɜ ɜɿɞ ɭɱɚɫɬɿ ɡɚ ɛɭɞɶ-ɹɤɢɯ ɩɪɢɱɢɧ.

Ⱦɿɚɝɧɨɫɬɢɤɭ ɬɚ ɮɨɪɦɭɥɸɜɚɧɧɹ ɞɿɚɝɧɨɡɭ ɩɪɨ

-ɜɨɞɢɥɢ ɜɿɞɩɨɜɿɞɧɨ ɞɨ ɇɚɤɚɡɭ ɆɈɁ ɍɤɪɚʀɧɢ ʋ 128 ɜɿɞ 19 ɛɟɪɟɡɧɹ 2007 ɪɨɤɭ [8].

Ⱦɥɹ ɨɰɿɧɸɜɚɧɧɹ ɬɹɠɤɨɫɬɿ ɩɟɪɟɛɿɝɭ ɩɧɟɜɦɨɧɿʀ ɜɢɤɨɪɢɫɬɨɜɭɜɚɥɢɫɶ «ɦɚɥɿ» ɬɚ «ɜɟɥɢɤɿ» ɤɪɢɬɟɪɿʀ,

ɪɟɤɨɦɟɧɞɨɜɚɧɿ ɧɚɤɚɡɨɦ ʋ 128 ɆɈɁ ɍɤɪɚʀɧɢ ɡ

ɩɭɥɶɦɨɧɨɥɨɝɿʀ [8].

"Ɇɚɥɿ" ɤɪɢɬɟɪɿʀ ɬɹɠɤɨɝɨ ɩɟɪɟɛɿɝɭ ɩɧɟɜɦɨɧɿʀ:

ɱɚɫɬɨɬɚ ɞɢɯɚɧɧɹ 30 ɡɚ 1 ɯɜ.ɬɚ ɛɿɥɶɲɟ;ɩɨɪɭɲɟɧɧɹ

ɫɜɿɞɨɦɨɫɬɿ; SaO2 ɦɟɧɲɟ 90% (ɡɚ ɞɚɧɢɦɢ ɩɭɥɶ

-ɫɨɤɫɢɦɟɬɪɿʀ), ɩɚɪɰɿɚɥɶɧɚ ɧɚɩɪɭɝɚ ɤɢɫɧɸ ɜ ɚɪɬɟ

-ɪɿɚɥɶɧɿɣ ɤɪɨɜɿ (ɞɚɥɿ - PaO2) ɧɢɠɱɟ 60 ɦɦ ɪɬ.ɫɬ.;

ɫɢɫɬɨɥɿɱɧɢɣ ɚɪɬɟɪɿɚɥɶɧɢɣ ɬɢɫɤ ɧɢɠɱɟ

90ɦɦ.ɪɬ.ɫɬ.; ɞɜɨɛɿɱɧɟ ɚɛɨ ɩɨɥɿɞɨɥɶɨɜɟ ɭɪɚ

-ɠɟɧɧɹ ɥɟɝɟɧɶ, ɩɨɪɨɠɧɢɧɢ ɪɨɡɩɚɞɭ, ɩɥɟɜɪɚɥɶɧɢɣ

ɜɢɩɿɬ.

"ȼɟɥɢɤɿ"ɤɪɢɬɟɪɿʀ ɬɹɠɤɨɝɨ ɩɟɪɟɛɿɝɭ ɩɧɟɜɦɨɧɿʀ:

ɩɨɬɪɟɛɚ ɜ ɩɪɨɜɟɞɟɧɧɿ ɲɬɭɱɧɨʀ ɜɟɧɬɢɥɹɰɿʀ ɥɟɝɟɧɶ;

ɲɜɢɞɤɟ ɩɪɨɝɪɟɫɭɜɚɧɧɹ ɜɨɝɧɢɳɟɜɨ-ɿɧɮɿɥɶɬɪɚɬɢɜ

-ɧɢɯ ɡɦɿɧ ɭ ɥɟɝɟɧɹɯ – ɡɛɿɥɶɲɟɧɧɹ ɪɨɡɦɿɪɿɜ ɿɧ

-ɮɿɥɶɬɪɚɰɿʀ ɛɿɥɶɲɟ ɧɿɠ ɧɚ 50 % ɩɪɨɬɹɝɨɦ ɧɚɣ

-ɛɥɢɠɱɢɯ 2 ɞɿɛ; ɫɟɩɬɢɱɧɢɣ ɲɨɤ ɚɛɨ ɧɟɨɛɯɿɞɧɿɫɬɶ

ɜɜɟɞɟɧɧɹ ɜɚɡɨɩɪɟɫɨɪɧɢɯ ɩɪɟɩɚɪɚɬɿɜ ɩɪɨɬɹɝɨɦ 4

ɝɨɞ. ɬɚ ɛɿɥɶɲɟ; ɝɨɫɬɪɚ ɧɢɪɤɨɜɚ ɧɟɞɨɫɬɚɬɧɿɫɬɶ (ɤɿɥɶɤɿɫɬɶ ɫɟɱɿ ɦɟɧɲɟ 80 ɦɥ ɡɚ 4 ɝɨɞ., ɚɛɨ ɪɿɜɟɧɶ

ɤɪɟɚɬɢɧɿɧɭ ɜ ɫɢɪɨɜɚɬɰɿ ɤɪɨɜɿ ɜɢɳɟ 0,18 ɦɦɨɥɶ/ɥ,

ɚɛɨ ɤɨɧɰɟɧɬɪɚɰɿɹ ɚɡɨɬɭ ɫɟɱɨɜɢɧɢ ɜɢɳɟ 7 ɦɦɨɥɶ/ɥ (ɚɡɨɬ ɫɟɱɨɜɢɧɢ = ɫɟɱɨɜɢɧɚ (ɦɦɨɥɶ/ɥ) / 2,14) ɡɚ

ɜɿɞɫɭɬɧɨɫɬɿ ɯɪɨɧɿɱɧɨʀ ɧɢɪɤɨɜɨʀ ɧɟɞɨɫɬɚɬɧɨɫɬɿ.

ɉɪɨ ɬɹɠɤɢɣ ɩɟɪɟɛɿɝ ɩɧɟɜɦɨɧɿʀ ɫɜɿɞɱɢɬɶ ɧɚɹɜ

-ɧɿɫɬɶ ɭ ɯɜɨɪɢɯ ɧɟ ɦɟɧɲɟ ɞɜɨɯ "ɦɚɥɢɯ" ɚɛɨ

ɨɞɧɨɝɨ "ɜɟɥɢɤɨɝɨ"ɤɪɢɬɟɪɿɸ,ɤɨɠɟɧ ɡ ɹɤɢɯ ɞɨɫɬɨ

(3)

ɧɟɝɨɫɩɿɬɚɥɶɧɨɸ ɩɧɟɜɦɨɧɿɽɸ ɬɹɠɤɨɝɨ ɩɟɪɟɛɿɝɭ IV

ɤɥɿɧɿɱɧɨʀ ɝɪɭɩɢ, ɳɨ ɩɨɬɪɟɛɭɜɚɥɢ ɥɿɤɭɜɚɧɧɹ ɭ

ɜɿɞɞɿɥɟɧɧɿ ɪɟɚɧɿɦɚɰɿʀ ɬɚ ɿɧɬɟɧɫɢɜɧɨʀ ɬɟɪɚɩɿʀ, ɛɟɡ

ɜɪɚɯɭɜɚɧɧɹ ɨɛ’ɽɦɭ ɭɪɚɠɟɧɧɹ ɥɟɝɟɧɟɜɨʀ ɬɤɚɧɢɧɢ – 33ɩɚɰɿɽɧɬɢ.

2-ɚ ɝɪɭɩɚ – ɩɚɰɿɽɧɬɢ ɡ ɧɟɝɨɫɩɿɬɚɥɶɧɨɸ ɩɧɟɜ

-ɦɨɧɿɽɸ ɬɹɠɤɨɝɨ ɩɟɪɟɛɿɝɭ III ɤɥɿɧɿɱɧɨʀ ɝɪɭɩɢ ɡ

ɜɟɥɢɤɢɦ ɨɛɫɹɝɨɦ ɭɪɚɠɟɧɧɹ ɥɟɝɟɧɟɜɨʀ ɬɤɚɧɢɧɢ –

ɞɜɨɛɿɱɧɢɦ, ɨɞɧɨɛɿɱɧɢɦ ɫɭɛɬɨɬɚɥɶɧɢɦ ɚɛɨ ɨɞɧɨ

-ɛɿɱɧɢɦ ɦɚɫɢɜɧɢɦ ɩɨɥɿɫɟɝɦɟɧɬɚɪɧɢɦ ɭɪɚɠɟɧɧɹɦ ɥɟɝɟɧɶ, ɹɤɿ ɩɪɨɯɨɞɢɥɢ ɥɿɤɭɜɚɧɧɹ ɭ ɜɿɞɞɿɥɟɧɧɿ

ɬɟɪɚɩɿʀ/ɩɭɥɶɦɨɧɨɥɨɝɿʀ – 55 ɩɚɰɿɽɧɬɿɜ.

ɍɫɿɦ ɩɚɰɿɽɧɬɚɦ ɜɢɤɨɧɚɧɨ ɤɨɦɩɥɟɤɫ ɞɨɫɥɿɞ

-ɠɟɧɶ: ɡɚɝɚɥɶɧɨɤɥɿɧɿɱɧɿ (ɤɥɿɧɿɤɨ-ɚɧɚɦɧɟɫɬɢɱɧɿ,

ɮɿɡɢɤɚɥɶɧɿ, ɡɚɝɚɥɶɧɨɤɥɿɧɿɱɧɿ ɥɚɛɨɪɚɬɨɪɧɿ, ɛɚɤɬɟ

-ɪɿɨɥɨɝɿɱɧɿ), ɿɧɫɬɪɭɦɟɧɬɚɥɶɧɿ (ɪɟɧɬɝɟɧɨɝɪɚɮɿɹ ɨɪ

-ɝɚɧɿɜ ɝɪɭɞɧɨʀ ɩɨɪɨɠɧɢɧɢ ɜ 2-ɯ ɩɪɨɟɤɰɿɹɯ, ɤɨɦ

-ɩ’ɸɬɟɪɧɚ ɚɛɨ ɦɚɝɧɿɬɧɨ-ɪɟɡɨɧɚɧɫɧɚ ɬɨɦɨɝɪɚɮɿɹ ɡɚ

ɜɢɦɨɝɨɸ ɬɨɳɨ) ɬɚ ɫɩɟɰɿɚɥɶɧɿ (ɫɩɿɪɨɦɟɬɪɢɱɧɿ)

ɦɟɬɨɞɢ ɞɨɫɥɿɞɠɟɧɧɹ [7]. ɍɫɿɦ ɩɚɰɿɽɧɬɚɦ ɛɭɥɨ

ɡɚɩɪɨɩɨɧɨɜɚɧɨ ɞɨɞɚɬɤɨɜɨ ɞɨ ɨɫɧɨɜɧɨʀ ɬɟɪɚɩɿʀ ɜɤɥɸɱɢɬɢ ɤɨɦɩɥɟɤɫ ɜɩɪɚɜ ɫɩɟɰɿɚɥɶɧɨʀ ɞɢɯɚɥɶɧɨʀ ɝɿɦɧɚɫɬɢɤɢ ɡɚ ɫɢɫɬɟɦɨɸ «The art of living» ɬɚ

ɜɢɤɨɧɭɜɚɬɢ ɣɨɝɨ ɞɜɿɱɿ ɧɚ ɞɟɧɶ. Ȼɭɥɨ ɡɚɩɪɨɩɨ

-ɧɨɜɚɧɨ ɤɨɦɩɥɟɤɫ ɿɡ 3-ɯ ɜɩɪɚɜ, ɤɨɠɧɚ ɡ ɹɤɢɯ

ɜɿɞɩɨɜɿɞɚɽ ɩɨɤɪɚɳɟɧɧɸ ɪɨɛɨɬɢ ɩɟɜɧɨʀ ɞɿɥɹɧɤɢ ɭɦɨɜɧɨ ɩɨɞɿɥɟɧɢɯ ɧɚ 3 ɱɚɫɬɢɧɢ ɥɟɝɟɧɿɜ (ɜɟɪɯɿɜɤɢ,

ɫɟɪɟɞɧɿ ɫɟɝɦɟɧɬɢ,ɧɢɠɧɿ ɫɟɝɦɟɧɬɢ).

Ɂɚɝɚɥɶɧɿ ɩɪɚɜɢɥɚ ɞɢɯɚɧɧɹ – ɞɢɯɚɥɶɧɢɣ ɚɤɬ

ɩɪɨɜɨɞɢɦɨ ɡɚ ɬɚɤɢɦɢ ɩɪɚɜɢɥɚɦɢ:

x ɜɞɢɯ ɩɨɜɢɧɟɧ ɛɭɬɢ ɦ'ɹɤɢɦ, ɩɥɚɜɧɢɦ, ɚɥɟ

ɞɨɫɢɬɶ ɫɢɥɶɧɢɦ; ɱɟɪɟɡ ɧɿɫ ɜɬɹɝɭɜɚɬɢ ɩɨɜɿɬɪɹ

ɩɨɬɪɿɛɧɨ ɲɭɦɧɨ ɣ ɚɤɬɢɜɧɨ, ɧɿɛɢ ɜɿɞɱɭɜɚɸɱɢ

ɩɨɬɿɤ ɩɨɜɿɬɪɹ;

x ɜɢɞɢɯɚɬɢ ɩɨɬɪɿɛɧɨ ɱɟɪɟɡ ɪɨɬ ɩɨɜɿɥɶɧɨ ɿ ɩɥɚɜɧɨ; ɩɨɜɿɬɪɹ ɩɨɜɢɧɧɟ ɜɢɯɨɞɢɬɢ ɛɟɡɩɟɪɟɲ

-ɤɨɞɧɨ ɿ ɜɿɥɶɧɨ;

x ɜɞɢɯ ɜɢɤɨɧɭɽɬɶɫɹ ɨɞɧɨɱɚɫɧɨ ɡ ɪɭɯɨɦ;

x ɜɩɪɚɜɢ ɦɨɠɧɚ ɜɢɤɨɧɭɜɚɬɢ ɫɬɨɹɱɢ ɚɛɨ ɫɢɞɹɱɢ ɧɚ ɬɜɟɪɞɿɣ ɩɨɜɟɪɯɧɿ ɡɚɥɟɠɧɨ ɜɿɞ ɫɬɚɧɭ ɿ ɫɬɭɩɟɧɹ ɬɹɠɤɨɫɬɿ ɡɚɯɜɨɪɸɜɚɧɧɹ;

x ɪɢɬɦ ɞɢɯɚɧɧɹ ɧɟɨɛɯɿɞɧɨ ɩɿɞɬɪɢɦɭɜɚɬɢ ɪɚɯɭɧɤɨɦ,ɜɿɞɩɨɜɿɞɧɢɦ ɪɢɬɦɭ ɦɚɪɲɨɜɨɝɨ ɤɪɨɤɭ;

x ɩɨɫɥɿɞɨɜɧɿɫɬɶ ɞɢɯɚɧɧɹ ɜɿɞɩɨɜɿɞɧɨ ɞɨ ɪɚɯɭɧɤɭ ɦɚɽ ɛɭɬɢ ɬɚɤɚ: ɧɚ 4 ɪɚɯɭɧɤɢ – ɜɞɢɯ, ɧɚ

ɧɚɫɬɭɩɧɿ 4 ɪɚɯɭɧɤɢ – ɡɚɬɪɢɦɤɚ ɞɢɯɚɧɧɹ, ɧɚ 6

ɪɚɯɭɧɤɿɜ – ɜɢɞɢɯ, ɧɚ ɧɚɫɬɭɩɧɿ 2 ɪɚɯɭɧɤɢ – ɡɚ

-ɬɪɢɦɤɚ ɞɢɯɚɧɧɹ.

1 ɜɩɪɚɜɚ (ɞɥɹ ɩɨɤɪɚɳɟɧɧɹ ɪɨɛɨɬɢ «ɧɢɠɧɶɨʀ

ɱɚɫɬɢɧɢ ɥɟɝɟɧɿɜ»): ɉɨɱɚɬɤɨɜɟ ɩɨɥɨɠɟɧɧɹ:ɫɬɨɹ

-ɱɢ ɧɨɝɢ - ɧɚ ɲɢɪɢɧɿ ɩɥɟɱɟɣ, ɚɛɨ ɫɢɞɹɱɢ ɧɚ

ɬɜɟɪɞɿɣ ɩɨɜɟɪɯɧɿ, ɪɭɤɢ ɧɚ ɩɨɹɫɿ, ɜɫɿ ɦ'ɹɡɢ

ɪɨɡɫɥɚɛɥɟɧɿ. ȼɢɤɨɧɚɧɧɹ:ɜɞɢɯ ɩɿɞ ɪɚɯɭɧɨɤ ɱɟɪɟɡ

- ɜɢɞɢɯ ɱɟɪɟɡ ɪɨɬ ɡ ɨɞɧɨɱɚɫɧɢɦ ɜɿɞɜɟɞɟɧɧɹɦ

ɥɿɤɬɶɨɜɢɯ ɫɭɝɥɨɛɿɜ ɜɩɟɪɟɞ ɡ ɨɤɪɭɝɥɟɧɧɹɦ ɫɩɢɧɢ

(ɧɚɱɟ ɪɭɯ ɤɪɢɥ ɦɟɬɟɥɢɤɚ).Ɂɪɨɛɢɬɢ 6-8 ɪɚɡɿɜ.

2 ɜɩɪɚɜɚ (ɞɥɹ ɩɨɤɪɚɳɟɧɧɹ ɪɨɛɨɬɢ «ɫɟɪɟɞɧɶɨʀ

ɬɜɟɪɞɿɣ ɩɨɜɟɪɯɧɿ, ɜɟɥɢɤɿ ɩɚɥɶɰɿ ɪɭɤ ɭ ɩɚɯɜɨɜɿ

ɡɚɩɚɞɢɧɢ, 4 ɩɚɥɶɰɿ ɪɭɤ ɧɚ ɝɪɭɞɧɢɯ ɦ’ɹɡɚɯ ɩɨ

ɧɚɩɪɚɜɥɟɧɧɸ ɞɨ ɝɪɭɞɢɧɢ, ɜɫɿ ɦ'ɹɡɢ ɪɨɡɫɥɚɛɥɟɧɿ.

ȼɢɤɨɧɚɧɧɹ: ɜɞɢɯ ɩɿɞ ɪɚɯɭɧɨɤ ɱɟɪɟɡ ɧɿɫ ɡ

ɨɞɧɨɱɚɫɧɢɦ ɜɿɞɜɟɞɟɧɧɹɦ ɥɿɤɬɶɨɜɢɯ ɫɭɝɥɨɛɿɜ ɧɚɡɚɞ ɿ ɨɤɪɭɝɥɟɧɧɹɦ ɝɪɭɞɧɨʀ ɤɥɿɬɤɢ ɜɩɟɪɟɞ;ɩɨɬɿɦ - ɜɢɞɢɯ ɱɟɪɟɡ ɪɨɬ ɡ ɨɞɧɨɱɚɫɧɢɦ ɜɿɞɜɟɞɟɧɧɹɦ

ɥɿɤɬɶɨɜɢɯ ɫɭɝɥɨɛɿɜ ɜɩɟɪɟɞ ɡ ɨɤɪɭɝɥɟɧɧɹɦ ɫɩɢɧɢ

(ɧɚɱɟ ɪɭɯ ɤɪɢɥ ɦɟɬɟɥɢɤɚ).ȼɢɤɨɧɚɬɢ 6-8 ɩɨɜɬɨɪɿɜ.

3 ɜɩɪɚɜɚ (ɞɥɹ ɩɨɤɪɚɳɟɧɧɹ ɪɨɛɨɬɢ «ɜɟɪɯɧɶɨʀ

ɬɜɟɪɞɿɣ ɩɨɜɟɪɯɧɿ, ɞɨɥɨɧɿ ɫɯɪɟɳɟɧɿ ɧɚ 7 ɲɢɣɧɨɦɭ

ɯɪɟɛɰɿ, ɜɫɿ ɦ'ɹɡɢ ɪɨɡɫɥɚɛɥɟɧɿ. ȼɢɤɨɧɚɧɧɹ: ɜɞɢɯ

ɩɿɞ ɪɚɯɭɧɨɤ ɱɟɪɟɡ ɧɿɫ ɡ ɨɞɧɨɱɚɫɧɢɦ ɜɿɞɜɟɞɟɧɧɹɦ ɥɿɤɬɶɨɜɢɯ ɫɭɝɥɨɛɿɜ ɧɚɡɚɞ ɿ ɨɤɪɭɝɥɟɧɧɹɦ ɝɪɭɞɧɨʀ ɤɥɿɬɤɢ ɜɩɟɪɟɞ; ɩɨɬɿɦ - ɜɢɞɢɯ ɱɟɪɟɡ ɪɨɬ ɡ ɨɞɧɨ

-ɱɚɫɧɢɦ ɜɿɞɜɟɞɟɧɧɹɦ ɥɿɤɬɶɨɜɢɯ ɫɭɝɥɨɛɿɜ ɜɩɟɪɟɞ ɡ ɨɤɪɭɝɥɟɧɧɹɦ ɫɩɢɧɢ (ɧɚɱɟ ɪɭɯ ɤɪɢɥ ɦɟɬɟɥɢɤɚ).

ȼɢɤɨɧɚɬɢ 6-8 ɩɨɜɬɨɪɿɜ.

ɉɪɨɝɪɚɦɚ ɞɨɫɥɿɞɠɟɧɧɹ ɛɭɥɚ ɪɨɡɪɨɛɥɟɧɚ, ɜɢ

-ɯɨɞɹɱɢ ɡ ɩɨɫɬɚɜɥɟɧɨʀ ɦɟɬɢ ɬɚ ɡɚɜɞɚɧɶ ɪɨɛɨɬɢ ɡ ɜɢɤɨɪɢɫɬɚɧɧɹɦ ɫɢɫɬɟɦɧɨɝɨ ɩɿɞɯɨɞɭ ɬɚ ɤɨɦɩɥɟɤɫɭ ɞɨɫɥɿɞɠɟɧɶ, ɡ ɭɪɚɯɭɜɚɧɧɹɦ ɨɫɧɨɜɧɢɯ ɩɨɥɨɠɟɧɶ GɋP ICH ɿ Ƚɟɥɶɫɿɧɫɶɤɨʀ ɞɟɤɥɚɪɚɰɿʀ ɡ ɛɿɨɟɬɢɤɢ [ɏɟɥɶɫɢɧɫɤɚɹ ɞɟɤɥɚɪɚɰɢɹ ɜɫɟɦɢɪɧɨɣ ɚɫɫɨɰɢɚɰɢɢ

ɜɪɚɱɟɣ, 1964]. ɉɪɨɜɟɞɟɧɟ ɞɨɫɥɿɞɠɟɧɧɹ ɛɭɥɨ ɩɨɜ

-ɧɿɫɬɸ ɞɨɛɪɨɜɿɥɶɧɢɦ – ɭɫɿ ɩɚɰɿɽɧɬɢ ɛɭɥɢ ɞɟɬɚɥɶɧɨ

ɩɪɨɿɧɮɨɪɦɨɜɚɧɿ ɩɪɨ ɣɨɝɨ ɦɟɬɭ,ɡɚɜɞɚɧɧɹ, ɫɬɪɨɤɢ

ɜɢɤɨɧɚɧɧɹ, ɞɚɥɢ ɫɜɨɸ ɡɝɨɞɭ ɧɚ ɩɪɨɜɟɞɟɧɧɹ

ɨɛɫɬɟɠɟɧɧɹ ɬɚ ɥɿɤɭɜɚɧɧɹ ɬɚ ɩɨɝɨɞɢɥɢɫɶ ɡ ɬɢɦ,ɳɨ

ɭɡɚɝɚɥɶɧɟɧɿ ɪɟɡɭɥɶɬɚɬɢ ɞɨɫɥɿɞɠɟɧɧɹ ɦɨɠɭɬɶ ɛɭɬɢ ɨɩɭɛɥɿɤɨɜɚɧɿ, ɨɛɝɨɜɨɪɸɜɚɬɢɫɶ ɞɨɫɥɿɞɧɢɤɚɦɢ ɡɿ

ɡɛɟɪɟɠɟɧɧɹɦ ɤɨɧɮɿɞɟɧɰɿɣɧɨɫɬɿ ɳɨɞɨ ɨɫɨɛɢɫɬɢɯ ɞɚɧɢɯ.

ɋɬɚɬɢɫɬɢɱɧɚ ɨɛɪɨɛɤɚ ɪɟɡɭɥɶɬɚɬɿɜ ɩɪɨɜɨɞɢɥɚɫɶ ɡ ɜɢɤɨɪɢɫɬɚɧɧɹɦ ɩɚɤɟɬɭ ɩɪɨɝɪɚɦ STATISTICA v.6.1®. Ⱦɚɧɿ ɩɪɟɞɫɬɚɜɥɟɧɿ ɭ ɜɢɝɥɹɞɿ ɫɟɪɟɞɧɿɯ (Ɇ±m), ɜɿɞɧɨɫɧɢɯ ɜɟɥɢɱɢɧ (n, %), ɤɨɟɮɿɰɿɽɧɬɿɜ

ɪɚɧɝɨɜɨʀ ɤɨɪɟɥɹɰɿʀ ɋɩɿɪɦɟɧɚ (r). Ⱦɥɹ ɨɰɿɧɤɢ ɞɨ

-ɫɬɨɜɿɪɧɨɫɬɿ ɜɿɞɦɿɧɧɨɫɬɟɣ ɫɟɪɟɞɧɿɯ ɜɟɥɢɱɢɧ ɡɚɫɬɨ

-ɫɨɜɭɜɚɥɢɫɶ ɤɪɢɬɟɪɿʀ ɋɬɶɸɞɟɧɬɚ ɞɥɹ ɡɚɥɟɠɧɢɯ ɿ ɧɟɡɚɥɟɠɧɢɯ ɜɢɛɿɪɨɤ, ɞɥɹ ɜɿɞɧɨɫɧɢɯ – ɤɪɢɬɟɪɿɣ

ɏɿ-ɤɜɚɞɪɚɬ ɉɿɪɫɨɧɚ (F2) [5, 10].

ɊȿɁɍɅɖɌȺɌɂ ɌȺ Ȳɏ ɈȻȽɈȼɈɊȿɇɇə

Ⱥɧɚɥɿɡ ɜɿɤɨ-ɫɬɚɬɟɜɢɯ ɯɚɪɚɤɬɟɪɢɫɬɢɤ ɯɜɨɪɢɯ ɧɚ

(4)

ɄɅȱɇȱɑɇȺ ɆȿȾɂɐɂɇȺ

ɜɫɬɚɧɨɜɢɬɢ ɞɨɫɬɨɜɿɪɧɿ ɪɨɡɛɿɠɧɨɫɬɿ ɦɿɠ ɜɢɞɿɥɟ

-ɧɢɦɢ ɤɥɿɧɿɱ-ɧɢɦɢ ɝɪɭɩɚɦɢ (ɬɚɛɥ. 1). ȼɢɹɜɥɟɧɨ,

ɳɨ ɫɟɪɟɞ ɯɜɨɪɢɯ, ɹɤɿ ɡɧɚɯɨɞɢɥɢɫɶ ɭ ɜɿɞɞɿɥɟɧɧɿ

ɪɟɚɧɿɦɚɰɿʀ ɬɚ ɿɧɬɟɧɫɢɜɧɨʀ ɬɟɪɚɩɿʀ, ɩɟɪɟɜɚɠɚɥɢ

ɱɨɥɨɜɿɤɢ ɿ ɩɚɰɿɽɧɬɢ ɫɬɚɪɲɨɝɨ ɜɿɤɭ (p < 0,05 ɦɿɠ

ɝɪɭɩɚɦɢ). ȼɨɞɧɨɱɚɫ, ɝɪɭɩɢ ɛɭɥɢ ɫɬɚɬɢɫɬɢɱɧɨ

ɩɨɪɿɜɧɹɧɢɦɢ ɡɚ ɤɿɥɶɤɿɫɬɸ ɤɭɪɰɿɜ (30,3% ɿ 21,8%

ɭ 1-ɣ ɿ 2-ɣ ɝɪɭɩɿ ɜɿɞɩɨɜɿɞɧɨ, p = 0,374) ɿ ɩɚɰɿɽɧɬɿɜ

ɡ ɧɚɞɥɢɲɤɨɜɨɸ ɦɚɫɨɸ ɬɿɥɚ ɬɚ ɨɠɢɪɿɧɧɹɦ (69,7%

ɿ 54,5%, p = 0,160).

Ɍ ɚ ɛ ɥ ɢ ɰ ɹ 1

ɋɨɰɿɚɥɶɧɨ

-

ɞɟɦɨɝɪɚɮɿɱɧɿ ɯɚɪɚɤɬɟɪɢɫɬɢɤɢ ɯɜɨɪɢɯ ɧɚ ɬɹɠɤɭ ɧɟɝɨɫɩɿɬɚɥɶɧɭ ɩɧɟɜɦɨɧɿɸ

ɉɨɤɚɡɧɢɤɢ _{(n = 88)}ȼɫɶɨɝɨ 1-_{(n = 33)}ɚ ɝɪɭɩɚ 2-_{(n = 55)}ɚ ɝɪɭɩɚ (ɪ)ɦɿɠ ɝɪɭɩɚɦɢ

ȼɿɤ,ɪɨɤɢ (M±m) 47,6±1,7 51,4±2,3 45,2±2,1 0,050

ɋɬɚɬɶ ɱɨɥɨɜɿɤɢ

ɠɿɧɤɢ 42 (47,7%) 46 (52,3%)

21 (63,6%) 12 (36,4%)

21 (38,2%)

34 (61,8%) 0,021

Ʉɭɪɰɿ 22 (25,0%) 10 (30,3%) 12 (21,8%) 0,374

ɍ ɯɜɨɪɢɯ 1-ʀ ɝɪɭɩɢ ɱɚɫɬɿɲɟ ɛɭɥɨ ɞɿɚɝɧɨ

-ɫɬɨɜɚɧɨ ɩɨɥɿɫɟɝɦɟɧɬɚɪɧɭ ɚɛɨ ɫɭɛɬɨɬɚɥɶɧɭ ɩɧɟɜ

-ɦɨɧɿɸ (45,5% ɩɪɨɬɢ 23,6%, ɪ = 0,033) ɡ ɞɜɨɛɿɱ

-ɧɢɦ ɭɪɚɠɟɧɧɹɦ ɥɟɝɟɧɶ (51,5% ɩɪɨɬɢ 38,2%, p = 0,222), ɳɨ ɫɭɩɪɨɜɨɞɠɭɜɚɥɨɫɹ ɥɟɝɟɧɟɜɨɸ ɧɟ

-ɞɨɫɬɚɬɧɿɫɬɸ ȱȱ ɿ Iȱȱ ɫɬɭɩɟɧɹ (78,8% ɩɪɨɬɢ 38,2%,

ɪ < 0,001). ɉɪɢɱɨɦɭ ɬɹɠɤɢɣ ɫɬɭɩɿɧɶ ɥɟɝɟɧɟɜɨʀ

ɧɟɞɨɫɬɚɬɧɨɫɬɿ ɦɚɣɠɟ ɜɞɜɿɱɿ ɱɚɫɬɿɲɟ ɜɿɞɡɧɚɱɚɜɫɹ ɭ ɱɨɥɨɜɿɤɿɜ, ɧɿɠ ɭ ɠɿɧɨɤ – 69,0% ɩɪɨɬɢ 39,1% (ɪ = 0,005).

ɋɭɩɭɬɧɸ ɩɚɬɨɥɨɝɿɸ,ɩɟɪɟɜɚɠɧɨ ɡɚɯɜɨɪɸɜɚɧɧɹ

ɫɢɫɬɟɦɢ ɤɪɨɜɨɨɛɿɝɭ ɿ ɬɪɚɜɥɟɧɧɹ ɜ ɨɫɿɛ ɫɬɚɪɲɨɝɨ ɜɿɤɭ, ɦɚɥɢ 38 (43,2%) ɯɜɨɪɢɯ ɧɚ ɬɹɠɤɭ ɧɟɝɨɫɩɿ

-ɬɚɥɶɧɭ ɩɧɟɜɦɨɧɿɸ.

ȼɿɞɨɦɨ, ɳɨ ɬɹɠɤɿɫɬɶ ɩɟɪɟɛɿɝɭ ɬɚ ɧɚɫɥɿɞɤɢ

ɬɹɠɤɨʀ ɧɟɝɨɫɩɿɬɚɥɶɧɨʀ ɩɧɟɜɦɨɧɿʀ ɡɚɥɟɠɚɬɶ ɜɿɞ ɫɬɪɨɤɿɜ ɝɨɫɩɿɬɚɥɿɡɚɰɿʀ.ɉɚɰɿɽɧɬɢ,ɹɤɿ ɛɪɚɥɢ ɭɱɚɫɬɶ

ɭ ɞɨɫɥɿɞɠɟɧɧɿ, ɛɭɥɢ ɝɨɫɩɿɬɚɥɿɡɨɜɚɧɿ ɜ ɫɬɪɨɤɢ ɜɿɞ 1 ɞɨ 28 ɞɧɿɜ ɡ ɦɨɦɟɧɬɭ ɩɨɱɚɬɤɭ ɡɚɯɜɨɪɸɜɚɧɧɹ, ɜ

ɫɟɪɟɞɧɶɨɦɭ ɱɟɪɟɡ 7,0±0,49 ɞɧɹ,ɜ ɬɨɦɭ ɱɢɫɥɿ ɭ 1-ɣ

ɝɪɭɩɿ – ɱɟɪɟɡ 6,15±0,55 ɞɧɹ, ɭ 2-ɣ – ɱɟɪɟɡ 7,51±0,70 ɞɧɹ (ɪ = 0,180).

ɍ ɩɟɪɲɿ 3 ɞɧɿ ɡɚɯɜɨɪɸɜɚɧɧɹ ɝɨɫɩɿɬɚɥɿɡɨɜɚɧɨ 17,0% ɯɜɨɪɢɯ,ɧɚ 4-7 ɞɟɧɶ – 55,7%, ɧɚ 8-13 ɞɟɧɶ – 15,9%, ɩɿɫɥɹ 2 ɬɢɠɧɿɜ ɜɿɞ ɜɢɧɢɤɧɟɧɧɹ ɩɟɪɲɢɯ

ɫɢɦɩɬɨɦɿɜ ɡɚɯɜɨɪɸɜɚɧɧɹ – 11,4 % ɩɚɰɿɽɧɬɿɜ. ɉɪɢ

ɰɶɨɦɭ 11 (12,5%) ɩɚɰɿɽɧɬɿɜ ɦɚɥɢ ɫɭɦɧɿɜɢ ɳɨɞɨ

ɫɬɪɨɤɭ ɩɨɱɚɬɤɭ ɡɚɯɜɨɪɸɜɚɧɧɹ ɿ ɧɚɡɜɚɥɢ ɨɪɿɽɧ

-ɬɨɜɧɿ ɫɬɪɨɤɢ ɡ ɪɨɡɛɿɝɨɦ ɭ 3-4 ɞɧɿ. ɋɥɿɞ ɜɿɞɡɧɚ

-ɱɢɬɢ, ɳɨ ɩɟɪɟɜɚɠɧɚ ɛɿɥɶɲɿɫɬɶ ɩɚɰɿɽɧɬɿɜ (ɩɨɧɚɞ 70%) ɡɚɣɦɚɽɬɶɫɹ ɫɚɦɨɥɿɤɭɜɚɧɧɹɦ ɡɚ ɩɨɪɚɞɚɦɢ

ɡɧɚɣɨɦɢɯ ɱɢ ɮɚɪɦɚɰɟɜɬɿɜ.

ɋɬɪɨɤɢ ɬɪɢɜɚɥɨɫɬɿ ɡɚɯɜɨɪɸɜɚɧɧɹ ɞɨ ɝɨɫɩɿ

-ɬɚɥɿɡɚɰɿʀ ɩɨ ɝɪɭɩɚɯ ɩɪɟɞɫɬɚɜɥɟɧɿ ɧɚ ɪɢɫɭɧɤɭ 1.

1-ɚ ɝɪɭɩɚ

1-3 ɞɧɿ; 24,2%

4-7 ɞɧɿɜ; 51,5% 8-13 ɞɧɿɜ;

18,2%

14ɿ ɛɿɥɶɲɟ;

6,1%

2-ɚ ɝɪɭɩɚ

1-3 ɞɧɿ; 12,8%

4-7 ɞɧɿɜ; 58,2% 8-13 ɞɧɿɜ;

14,5%

14ɿ ɛɿɥɶɲɟ;

14,5%

(5)

ɥɿɡɚɰɿʀ (r = - 0,22, ɪ < 0,05). ȼɫɬɚɧɨɜɥɟɧɨ, ɳɨ

ɦɚɤɫɢɦɚɥɶɧɢɣ ɪɿɜɟɧɶ ɝɨɫɩɿɬɚɥɿɡɚɰɿʀ ɯɜɨɪɢɯ ɧɚ ɬɹɠɤɭ ɧɟɝɨɫɩɿɬɚɥɶɧɭ ɩɧɟɜɦɨɧɿɸ ɭ ɜɿɞɞɿɥɟɧɧɹ ɪɟɚɧɿɦɚɰɿʀ ɬɚ ɿɧɬɟɧɫɢɜɧɨʀ ɬɟɪɚɩɿʀ ɫɩɨɫɬɟɪɿɝɚɽɬɶɫɹ

ɨɞɧɨɦɭ ɜɢɩɚɞɤɭ).ɉɚɰɿɽɧɬɢ 2-ʀ ɝɪɭɩɢ ɦɚɥɢ ɦɚɤɫɢ

-ɦɚɥɶɧɭ ɤɿɥɶɤɿɫɬɶ ɝɨɫɩɿɬɚɥɿɡɚɰɿʀ ɡ ɞɿɚɝɧɨɡɨɦ ɬɹɠɤɚ ɧɟɝɨɫɩɿɬɚɥɶɧɚ ɩɧɟɜɦɨɧɿɹ ɭ ɝɪɭɞɧɿ (20,0 %) ɬɚ

ɥɸɬɨɦɭ (20,0%) (ɪɢɫ. 2).

0% 5% 10% 15% 20% 25%

ɫɿɱɟɧɶ

ɥɸɬɢɣ

ɛɟɪɟɡɟɧɶ

ɤɜɿɬɟɧɶ

ɬɪɚɜɟɧɶ

ɱɟɪɜɟɧɶ ɥɢɩɟɧɶ

ɫɟɪɩɟɧɶ ɜɟɪɟɫɟɧɶ ɠɨɜɬɟɧɶ

ɥɢɫɬɨɩɚɞ ɝɪɭɞɟɧɶ

1-ɚ ɝɪɭɩɚ 2-ɚ ɝɪɭɩɚ

Ɋɢɫ. 2. ɋɟɡɨɧɧɿɫɬɶ ɝɨɫɩɿɬɚɥɿɡɚɰɿʀ ɯɜɨɪɢɯ ɤɥɿɧɿɱɧɢɯ ɝɪɭɩ

ɋɟɪɟɞɧɿɣ ɬɟɪɦɿɧ ɬɪɢɜɚɥɨɫɬɿ ɝɨɫɩɿɬɚɥɿɡɚɰɿʀ ɫɬɚ

-ɧɨɜɢɜ 21,3±0,6 ɞɧɹ. ɉɪɢɱɨɦɭ ɩɚɰɿɽɧɬɢ 1-ʀ ɝɪɭɩɢ

ɡɧɚɯɨɞɢɥɢɫɶ ɭ ɥɿɤɚɪɧɿ ɜ ɫɟɪɟɞɧɶɨɦɭ ɧɚ 4 ɞɧɿ ɞɨɜ

-ɲɟ (23,9±1,0) ɞɧɹ, ɧɿɠ ɯɜɨɪɿ 2-ʀ ɝɪɭɩɢ (19,9±0,6

ɞɧɹ, ɪ < 0,001). ɋɟɪɟɞɧɿɣ ɬɟɪɦɿɧ ɩɟɪɟɛɭɜɚɧɧɹ ɭ

ɜɿɞɞɿɥɟɧɧɿ ɪɟɚɧɿɦɚɰɿʀ ɬɚ ɿɧɬɟɧɫɢɜɧɨʀ ɬɟɪɚɩɿʀ ɩɚ

-ɰɿɽɧɬɿɜ 1-ʀ ɝɪɭɩɢ ɫɬɚɧɨɜɢɜ 4,52±0,76 ɞɧɹ.

Ⱥɧɚɥɿɡ ɞɢɧɚɦɿɤɢ ɫɤɚɪɝ ɬɚ ɤɥɿɧɿɤɨ-ɥɚɛɨɪɚɬɨɪɧɢɯ

ɩɨɤɚɡɧɢɤɿɜ ɭ ɯɜɨɪɢɯ ɧɚ ɬɹɠɤɭ ɧɟɝɨɫɩɿɬɚɥɶɧɭ ɩɧɟɜɦɨɧɿɸ ɧɚ ɬɥɿ ɬɟɪɚɩɿʀ (ɬɚɛɥ. 2) ɩɨɤɚɡɚɜ, ɳɨ

ɩɚɰɿɽɧɬɢ 1-ʀ ɝɪɭɩɢ ɞɨɫɬɨɜɿɪɧɨ ɱɚɫɬɿɲɟ ɫɤɚɪɠɢɥɢɫɶ

ɧɚ ɡɚɞɢɲɤɭ ɹɤ ɧɚ ɦɨɦɟɧɬ ɝɨɫɩɿɬɚɥɿɡɚɰɿʀ (69,7%

ɩɪɨɬɢ 36,4%, ɪ = 0,002), ɬɚɤ ɿ ɱɟɪɟɡ 10 ɞɿɛ ɜɿɞ

ɩɨɱɚɬɤɭ ɥɿɤɭɜɚɧɧɹ (33,3% ɩɪɨɬɢ 12,7%, ɪ = 0,020).

Ɍ ɚ ɛ ɥ ɢ ɰ ɹ 2

Ⱦɢɧɚɦɿɤɚ ɫɤɚɪɝ ɬɚ ɞɚɧɢɯ ɨɛɫɬɟɠɟɧɧɹ ɯɜɨɪɢɯ ɧɚ ɬɹɠɤɭ ɧɟɝɨɫɩɿɬɚɥɶɧɭ ɩɧɟɜɦɨɧɿɸ

1-ɚ ɝɪɭɩɚ (n = 33) 2-ɚ ɝɪɭɩɚ (n = 55)

ɉɨɤɚɡɧɢɤɢ

ɩɨɱɚɬɨɤ ɱɟɪɟɡ 10 ɞɿɛ ɩɨɱɚɬɨɤ ɱɟɪɟɡ 10 ɞɿɛ

Ɂɚɞɢɲɤɚ 23 (69,7%) 11 (33,3%) 20 (36,4%)* 7 (12,7%)*

Ɂɚɝɚɥɶɧɚ ɫɥɚɛɤɿɫɬɶ 24 (72,7%) 11 (33,3% 40 (72,7%) 11 (20,0%)

Ʉɚɲɟɥɶ 28 (84,8%) 25 (75,8%) 41 (74,5%) 28 (50,9%)*

Ɇɨɤɪɨɬɢɧɧɹ: 20 (60,6%) 16 (48,5%) 35 (63,6%) 21 (38,2%)

ɫɥɢɡɨɜɟ 6 (18,2%) 10 (30,3%) 12 (21,8%) 14 (25,5%)

ɫɥɢɡɨɜɨ-ɝɧɿɣɧɟ 14 (42,4%) 6 (18,2%) 23 (41,8%) 7 (12,7%)

Ȼɿɥɶ ɭ ɝɪɭɞɧɿɣ ɤɥɿɬɰɿ 19 (57,6%) 7 (21,2%) 24 (43,6%) 5 (9,1%)

Ʌɢɯɨɦɚɧɤɚ 30 (90,9%) – 51 (92,7%) –

ɋɟɪɟɞɧɹ ɬɟɦɩɟɪɚɬɭɪɚ ɬɿɥɚ, °ɋ. 38,3±0,1 36,7±0,1 38,0±0,1 36,5±0,1

Ɍɪɢɜɚɥɿɫɬɶ ɥɢɯɨɦɚɧɤɢ,ɞɧɿ 4,23±0,48 – 2,94±0,28* –

ɑȾ 25,9±0,5 19,8±0,3 21,2±0,3** 19,2±0,2

Sa 86,9±1,1 96,3±0,4 95,8±0,3** 97,7±0,1**

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ɄɅȱɇȱɑɇȺ ɆȿȾɂɐɂɇȺ

ȱɧɲɨɸ ɩɪɨɜɿɞɧɨɸ ɫɤɚɪɝɨɸ ɛɭɜ ɤɚɲɟɥɶ. Ⱥɥɟ

ɹɤɳɨ ɧɚ ɩɨɱɚɬɤɭ ɡɚɯɜɨɪɸɜɚɧɧɹ ɜɿɞɫɨɬɨɤ ɫɤɚɪɝ ɧɚ ɤɚɲɟɥɶ ɛɭɜ ɩɨɪɿɜɧɹɧɢɦ ɜ ɨɛɨɯ ɝɪɭɩɚɯ (84,8%

ɩɪɨɬɢ 74,5%, ɪ = 0,255), ɬɨ ɱɟɪɟɡ 10 ɞɿɛ ɜɿɞ ɩɨ

-ɱɚɬɤɭ ɥɿɤɭɜɚɧɧɹ ɤɚɲɟɥɶ ɡɛɟɪɿɝɫɹ ɭ 75,8% ɿ 50,9%

ɩɚɰɿɽɧɬɿɜ 1-ʀ ɿ 2-ʀ ɝɪɭɩɢ ɜɿɞɩɨɜɿɞɧɨ (ɪ = 0,021). ɐɟ

ɬɚɤɨɠ ɩɿɞɬɜɟɪɞɠɭɽɬɶɫɹ ɧɚɹɜɧɿɫɬɸ ɩɪɹɦɨɝɨ ɤɨɪɟɥɹɰɿɣɧɨɝɨ ɡɜ’ɹɡɤɭ ɦɿɠ ɜɢɪɚɠɟɧɿɫɬɸ ɤɚɲɥɸ

ɬɚ ɬɹɠɤɿɫɬɸ ɡɚɯɜɨɪɸɜɚɧɧɹ ɿ, ɹɤ ɧɚɫɥɿɞɨɤ, ɦɿɫɰɟɦ

ɝɨɫɩɿɬɚɥɿɡɚɰɿʀ (r = 0,25, p < 0,05).

Ʌɢɯɨɦɚɧɤɚ ɧɚ ɦɨɦɟɧɬ ɝɨɫɩɿɬɚɥɿɡɚɰɿʀ ɜɿɞɡɧɚ

-ɱɚɥɚɫɶ ɭ ɛɿɥɶɲɨɫɬɿ ɩɚɰɿɽɧɬɿɜ ɨɛɨɯ ɝɪɭɩ (90,9% ɿ 92,7%), ɩɪɨɬɟ ɭ ɯɜɨɪɢɯ 1-ʀ ɝɪɭɩɢ ɜɨɧɚ ɫɭɩɪɨ

-ɜɨɞɠɭɜɚɥɚɫɶ ɩɿɞɜɢɳɟɧɧɹɦ ɬɟɦɩɟɪɚɬɭɪɢ ɞɨ ɮɟɛɪɢɥɶɧɢɯ ɿ ɩɿɪɟɬɢɱɧɢɯ ɡɧɚɱɟɧɶ (72,7%), ɬɪɢ

-ɜɚɸɱɢ ɜ ɫɟɪɟɞɧɶɨɦɭ 4,23±0,48 ɞɧɹ.Ⱦɥɹ ɯɜɨɪɢɯ

2-ʀ ɝɪɭɩɢ ɛɭɥɚ ɯɚɪɚɤɬɟɪɧɨɸ ɫɭɛɮɟɛɪɢɥɶɧɚ ɥɢɯɨ

-ɦɚɧɤɚ (40,0%) ɡ ɬɪɢɜɚɥɿɫɬɸ 2,94±0,28 ɞɧɹ (ɪ = 0,015). ɉɪɢ ɰɶɨɦɭ ɡɧɚɱɧɟ ɩɿɞɜɢɳɟɧɧɹ ɬɟɦ

-ɩɟɪɚɬɭɪɢ ɡɞɟɛɿɥɶɲɨɝɨ ɜɿɞɡɧɚɱɚɥɨɫɶ ɭ ɦɨɥɨɞɢɯ ɩɚɰɿɽɧɬɿɜ (r = -0,21, p < 0,05).

Ɂɚ ɞɚɧɢɦɢ ɫɩɿɪɨɦɟɬɪɢɱɧɨɝɨ ɞɨɫɥɿɞɠɟɧɧɹ, ɭ 93,9% ɩɚɰɿɽɧɬɿɜ 1-ʀ ɝɪɭɩɢ ɿ 65,5% ɩɚɰɿɽɧɬɿɜ 2-ʀ

ɝɪɭɩɢ ɜɢɹɜɥɟɧɨ ɩɨɪɭɲɟɧɧɹ ɜɟɧɬɢɥɹɰɿɣɧɨʀ ɮɭɧɤ

-ɰɿʀ ɥɟɝɟɧɶ (ɪ = 0,002 ɦɿɠ ɝɪɭɩɚɦɢ).ɉɪɢ ɰɶɨɦɭ, ɜ 54,5% ɿ 40,0% ɜɢɩɚɞɤɿɜ ɩɨɪɭɲɟɧɧɹ ɜɿɞɩɨɜɿɞɚɥɢ

ɪɟɫɬɪɢɤɬɢɜɧɨɦɭ ɬɢɩɭ,ɜ 39,4% ɿ 25,5% – ɨɛɫɬɪɭɤ

-ɬɢɜɧɨɦɭ.

ɍ ɞɢɧɚɦɿɰɿ ɥɿɤɭɜɚɧɧɹ ɜ ɨɛɨɯ ɤɥɿɧɿɱɧɢɯ ɝɪɭɩɚɯ ɜɿɞɡɧɚɱɚɜɫɹ ɪɟɝɪɟɫ ɨɫɧɨɜɧɨʀ ɤɥɿɧɿɱɧɨʀ ɫɢɦɩɬɨɦɚ

-ɬɢɤɢ ɡɚɯɜɨɪɸɜɚɧɧɹ (p < 0,05), ɡɚ ɜɢɤɥɸɱɟɧɧɹɦ

ɫɤɚɪɝ ɧɚ ɤɚɲɟɥɶ ɭ ɯɜɨɪɢɯ 1-ʀ ɝɪɭɩɢ,ɹɤɢɣ ɡɛɟɪɿɝɫɹ

ɭ 75,8% ɩɚɰɿɽɧɬɿɜ. ɍ ɩɚɰɿɽɧɬɿɜ, ɹɤɿ ɜɢɤɨɧɭɜɚɥɢ

ɜɩɪɚɜɢ ɞɢɯɚɥɶɧɨʀ ɝɿɦɧɚɫɬɢɤɢ, ɜɿɞɡɧɚɱɚɥɨɫɶ ɫɭɬ

-ɬɽɜɟ (p < 0,001) ɡɧɢɠɟɧɧɹ ɱɚɫɬɨɬɢ ɞɢɯɚɧɧɹ (ɧɚ 23,6% ɿ 9,4% ɜ 1-ɣ ɿ 2-ɣ ɝɪɭɩɚɯ)ɬɚ ɑɋɋ (ɧɚ 21,4%

ɿ 13,9%), ɩɨɤɪɚɳɟɧɧɹ ɫɚɬɭɪɚɰɿʀ (ɧɚ 10,8% ɿ 2,0%).

ɇɚ ɩɨɱɚɬɤɭ ɞɨɫɥɿɞɠɟɧɧɹ ɫɚɦɨɨɰɿɧɤɚ ɬɹɠɤɨɫɬɿ ɫɜɨɝɨ ɫɬɚɧɭ ɡɚ 5-ɬɢ ɛɚɥɶɧɨɸ ɲɤɚɥɨɸ (1 – ɞɭɠɟ

ɩɨɝɚɧɨ, 5 – ɞɭɠɟ ɞɨɛɪɟ) ɫɬɚɧɨɜɢɥɚ ɜ ɫɟɪɟɞɧɶɨɦɭ 1,45±0,36 ɛɚɥɚ ɬɚ 1,72±0,41 ɛɚɥɚ ɜɿɞɩɨɜɿɞɧɨ ɭ 1-ɣ

ɬɚ 2-ɣ ɝɪɭɩɚɯ (ɪ = 0,650 ɦɿɠ ɝɪɭɩɚɦɢ).ɍ ɞɢɧɚɦɿɰɿ

ɥɿɤɭɜɚɧɧɹ ɡ ɜɤɥɸɱɟɧɧɹɦ ɜɩɪɚɜ ɞɢɯɚɥɶɧɨʀ ɝɿɦ

-ɧɚɫɬɢɤɢ ɜɿɞɡɧɚɱɟɧɨ ɞɨɫɬɨɜɿɪɧɟ (p < 0,001) ɩɨɤɪɚ

-ɳɟɧɧɹ ɫɬɚɧɭ ɬɚ ɩɿɞɜɢ-ɳɟɧɧɹ ɪɿɜɧɹ ɫɚɦɨɨɰɿɧɤɢ ɣɨɝɨ ɬɹɠɤɨɫɬɿ ɞɨ 3,85±0,4 ɬɚ 3,92±0,36 ɛɚɥɚ ɜɿɞ

-ɩɨɜɿɞɧɨ ɩɨ ɝɪɭɩɚɯ.

ȼɂɋɇɈȼɄɂ

1. Ɇɚɤɫɢɦɚɥɶɧɚ ɤɿɥɶɤɿɫɬɶ ɯɜɨɪɢɯ ɧɚ ɬɹɠɤɭ

ɧɟɝɨɫɩɿɬɚɥɶɧɭ ɩɧɟɜɦɨɧɿɸ ɝɨɫɩɿɬɚɥɿɡɭɽɬɶɫɹ ɧɚ 4-7

ɞɨɛɭ ɜɿɞ ɩɨɱɚɬɤɭ ɡɚɯɜɨɪɸɜɚɧɧɹ. ɍ ɫɟɪɟɞɧɶɨɦɭ

ɱɟɪɟɡ 7,0±0,49 ɞɧɹ, ɜ ɬɨɦɭ ɱɢɫɥɿ ɭ 1-ɣ ɝɪɭɩɿ –

ɱɟɪɟɡ 6,15±0,55 ɞɧɹ, ɭ 2-ɣ – ɱɟɪɟɡ 7,51±0,70 ɞɧɹ (ɪ = 0,180).

2. ȼɢɹɜɥɟɧɨ ɡɚɥɟɠɧɿɫɬɶ ɬɹɠɤɨɫɬɿ ɩɟɪɟɛɿɝɭ ɧɟ

-ɝɨɫɩɿɬɚɥɶɧɨʀ ɩɧɟɜɦɨɧɿʀ ɜɿɞ ɫɟɡɨɧɭ ɝɨɫɩɿɬɚɥɿɡɚɰɿʀ

(r = -0,22, ɪ < 0,05). Ɇɚɤɫɢɦɚɥɶɧɢɣ ɪɿɜɟɧɶ ɝɨɫɩɿ

-ɬɚɥɿɡɚɰɿʀ ɡ ɬɹɠɤɨɸ ɧɟɝɨɫɩɿɬɚɥɶɧɨɸ ɩɧɟɜɦɨɧɿɽɸ ɭ ɜɿɞɞɿɥɟɧɧɹ ɪɟɚɧɿɦɚɰɿʀ ɬɚ ɿɧɬɟɧɫɢɜɧɨʀ ɬɟɪɚɩɿʀ ɫɩɨɫɬɟɪɿɝɚɽɬɶɫɹ ɭ ɫɿɱɧɿ (21,2%) ɬɚ ɛɟɪɟɡɧɿ (21,2%). ɉɚɰɿɽɧɬɢ 2-ʀ ɝɪɭɩɢ ɦɚɥɢ ɦɚɤɫɢɦɚɥɶɧɢɣ

ɪɿɜɟɧɶ ɝɨɫɩɿɬɚɥɿɡɚɰɿʀ ɡ ɬɹɠɤɨɸ ɧɟɝɨɫɩɿɬɚɥɶɧɨɸ ɩɧɟɜɦɨɧɿɽɸ ɭ ɝɪɭɞɧɿ (20,0%) ɬɚ ɥɸɬɨɦɭ (20,0%). 3. Ɍɪɢɜɚɥɿɫɬɶ ɝɨɫɩɿɬɚɥɿɡɚɰɿʀ ɩɚɰɿɽɧɬɿɜ 1-ʀ ɝɪɭɩɢ

ɞɨɫɬɨɜɿɪɧɨ ɞɨɜɲɟ, ɧɿɠ ɭ ɯɜɨɪɢɯ 2-ʀ ɝɪɭɩɢ (ɪ < 0,001).

4. ȼɫɬɚɧɨɜɥɟɧɨ ɧɚɹɜɧɿɫɬɶ ɩɪɹɦɨɝɨ ɤɨɪɟɥɹɰɿɣ

-ɧɨɝɨ ɡɜ’ɹɡɤɭ ɦɿɠ ɜɢɪɚɠɟɧɿɫɬɸ ɫɤɚɪɝ ɬɚ ɬɹɠɤɿɫɬɸ

ɡɚɯɜɨɪɸɜɚɧɧɹ ɿ,ɹɤ ɧɚɫɥɿɞɨɤ, ɧɟɨɛɯɿɞɧɿɫɬɸ ɝɨɫɩɿ

-ɬɚɥɿɡɚɰɿʀ ɭ ɜɿɞɞɿɥɟɧɧɹ ɪɟɚɧɿɦɚɰɿʀ ɬɚ ɿɧɬɟɧɫɢɜɧɨʀ ɬɟɪɚɩɿʀ (r = 0,25, p < 0,05).

5. ɍ ɩɚɰɿɽɧɬɿɜ,ɹɤɿ ɜɢɤɨɧɭɜɚɥɢ ɜɩɪɚɜɢ ɞɢɯɚɥɶ

-ɧɨʀ ɝɿɦɧɚɫɬɢɤɢ, ɜɿɞɡɧɚɱɚɥɨɫɶ ɫɭɬɬɽɜɨ (p < 0,001)

ɲɜɢɞɲɟ ɩɨɤɪɚɳɟɧɧɹ ɨɫɧɨɜɧɨʀ ɤɥɿɧɿɱɧɨʀ ɫɢɦɩɬɨ

-ɦɚɬɢɤɢ ɬɚ ɩɨɥɿɩɲɟɧɧɹ ɫɚɦɨɨɰɿɧɤɢ ɬɹɠɤɨɫɬɿ ɫɬɚɧɭ.

ɋ

ɉ

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ɋ

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Ʌ

ȱ

Ɍ

ȿ

Ɋ

Ⱥ

Ɍ

ɍ

Ɋ

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1. Ⱥɜɞɟɟɜ ɋ.ɇ.ɉɧɟɜɦɨɧɢɹ ɩɪɢ ɝɪɢɩɩɟ / ɋ.ɇ. Ⱥɜ-ɞɟɟɜ // ɊɆɀ. – 2000. – Ɍ. 8, ʋ 13-14. – ɋ. 545-547.

2. Ⱥɜɞɟɟɜ ɋ.ɇ. Ɍɹɠɟɥɚɹ ɜɧɟɛɨɥɶɧɢɱɧɚɹ ɩɧɟɜɦɨ-ɧɢɹ / ɋ.ɇ. Ⱥɜɞɟɟɜ, Ⱥ.Ƚ. ɑɭɱɚɥɢɧ // ɊɆɀ. – 2001. – Ɍ. 9., ʋ 5. – ɋ. 77-91.

3. Ⱥɧɬɨɧɤɢɧɚ ȼ.Ɏ. Ɉɫɬɪɵɟ ɩɧɟɜɦɨɧɢɢ (ɩɨ ɦɚɬɟ-ɪɢɚɥɚɦ ɩɚɬɨɥɨɝɨɚɧɚɬɨɦɢɱɟɫɤɨɝɨ ɨɬɞɟɥɟɧɢɹ ɛɨɥɶɧɢɰɵ ɫɤɨɪɨɣ ɦɟɞɢɰɢɧɫɤɨɣ ɩɨɦɨɳɢ ɢɦ. H.A. ɋɟɦɚɲɤɨ ɡɚ 1996-98 ɝ.ɝ.) / ȼ.Ɏ.Ⱥɧɬɨɧɤɢɧɚ, Ⱥ.ɂ.Ȼɨɧɞɚɪɟɧɤɨ, ȼ.Ɇ.ɋɬɪɟɥɟɰɤɢɣ // ȼɟɫɬɧɢɤ ɧɨɜɵɯ ɦɟɞ.ɬɟɯɧɨɥɨɝɢɣ. – 2000. – ʋ 3-4. – ɋ. 72-73.

4. Ƚɟɥɶɰɟɪ Ȼ.ɂ. Ɉɰɟɧɤɚ ɷɮɮɟɤɬɢɜɧɨɫɬɢ ɤɪɢɬɟ-ɪɢɟɜ ɝɨɫɩɢɬɚɥɢɡɚɰɢɢ ɩɪɢ ɜɧɟɛɨɥɶɧɢɱɧɨɣ ɩɧɟɜɦɨɧɢɢ / Ȼ.ɂ.Ƚɟɥɶɰɟɪ, JI.B. Ʉɭɤɨɥɶ // ȼɟɫɬɧɢɤ ɧɨɜɵɯ ɦɟɞ. ɬɟɯɧɨɥɨɝɢɣ. – 2002. – Ɍ 9, ʋ 4. – ɋ. 52-54.

5. Ʌɚɩɚɱ ɋ.ɇ., ɋɬɚɬɢɫɬɢɱɟɫɤɢɟ ɦɟɬɨɞɵ ɜ ɦɟɞɢɤɨ-ɛɢɨɥɨɝɢɱɟɫɤɢɯ ɢɫɫɥɟɞɨɜɚɧɢɹɯ ɫ ɢɫɩɨɥɶɡɨɜɚɧɢɟɦ Exel /ɋ.ɇ.Ʌɚɩɚɱ,Ⱥ.ȼ.Ƚɭɛɟɧɤɨ,ɉ.ɇ.Ȼɚɛɢɱ – Ʉ.:Ɇɨɪɢɨɧ, 2000. – 320 ɫ.

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7. ɉɟɪɰɟɜɚ Ɍ.Ⱥ. Ɉɫɧɨɜɵ ɢɡɭɱɟɧɢɹ ɜɟɧɬɢɥɹɰɢɨɧ -ɧɨɣ ɮɭɧɤɰɢɢ ɥɟɝɤɢɯ:ɤɥɢɧɢɤɨ-ɞɢɚɝɧɨɫɬɢɱɟɫɤɨɟ ɩɨɫɨɛɢɟ:ɦɟɬɨɞ.ɩɨɫɨɛ.ɞɥɹ ɜɪɚɱɟɣ ɢ ɫɬɭɞ.ɦɟɞ.ɜɭɡɨɜ / Ɍ.Ⱥ.ɉɟɪɰɟɜɚ, Ʌ.ɂ.Ʉɨɧɨɩɤɢɧɚ // Ⱦɧɟɩɪɨɩɟɬɪɨɜɫɤ: ȺɊɌ_ɉɊȿɋɋ, 2008. – 66 ɫ.

8. ɉɪɨ ɭɬɜɟɪɠɞɟɧɢɟ ɢɧɫɬɪɭɤɰɢɣ ɨɛ ɨɤɚɡɚɧɢɢ ɩɨɦɨɳɢ ɛɨɥɶɧɵɦ ɬɭɛɟɪɤɭɥɟɡɨɦ ɢ ɧɟɫɩɟɰɢɮɢɱɟɫɤɢɦɢ ɡɚɛɨɥɟɜɚɧɢɹɦɢ ɥɺɝɤɢɯ: ɉɪɢɤɚɡ Ɇɢɧɡɞɪɚɜɚ ɍɤɪɚɢɧɵ ʋ 128 ɨɬ 19 ɦɚɪɬɚ 2007 ɝ. – Ʉ., 2007.

–ɋ. 26-32.

10. Ɋɟɛɪɨɜɚ Ɉ.ɘ. ɋɬɚɬɢɫɬɢɱɟɫɤɢɣ ɚɧɚɥɢɡ ɦɟɞɢ -ɰɢɧɫɤɢɯ ɞɚɧɧɵɯ. ɉɪɢɦɟɧɟɧɢɟ ɩɚɤɟɬɚ ɩɪɢɤɥɚɞɧɢɯ ɩɪɨɝɪɚɦɦ STATISTICA. – Ɇ.: Ɇɟɞɢɚɋɮɟɪɚ, 2002. – 312 ɫ.

11. Robert C. The Continui ng Challenge of Lower Respiratory Tract Infections / C. Robert, Jr. Moellering // Clin. Infect. Dis. – 2002. – Vol. 34. – P.1-2.

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