Relationship between aneurism of ascending part of aorta and syndrome of connective tissue dysplasia

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6. Ɋɟɝɿɨɧɚɥɶɧɿ ɨɫɨɛɥɢɜɨɫɬɿ ɪɿɜɧɹ ɡɞɨɪɨɜ’ɹ ɧɚɪɨɞɭ

ɍɤɪɚʀɧɢ. Ⱥɧɚɥɿɬɢɱɧɨ-ɫɬɚɬɢɫɬɢɱɧɢɣ ɩɨɫɿɛɧɢɤ. – Ʉ., 2011. – 165 ɫ.

7. Event-related desynchronization reflects downre-gulation of intracortical inhibition in human primary motor cortex / M. Takemi [et al.] // J. Neurophysiol. – 2013. – Vol. 110, N 5. – P. 1158-1166.

8. Event-related potentials indicating impaired emo-tional attention in cerebellar stroke-a case study /

M. Adamaszek [et al.] // Neurosci. Lett. – 2013. – Vol. 548. – P. 206-211.

9. Hagelin C. The psychometric properties of the Swedish Hagelin Multidimensional Fatigue Inventory MFI – 20 in four different populations / C. Hagelin, Y. Wengstrem, S. Runesdotter // Acta Oncol. – 2007. – Vol. 46, N 1. – P. 97-104.

10. Za J. H. Biostatistical Analysis / J.H. Za. – Pren-tice Hall, 2010. – 944 p.

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1. Shkolnyk VM. [Asthenia is a marker of dynamics of cerebral disgemia] Plenum nevrolog. Kyiv. 2009;21. Ukrainian.

2. Gnezditskii VV. [Atlas about evoked potentials of brain]. PresSto. 2011;532. Russian.

3. Shkolnyk VM, et al. [Modification of method evaluating neuronal asthenia under cerebrovascular di-seases] Plenum nevrologov. Kyiv. 2009;20. Ukrainian.

4. Pogorelov OV. [Diagnostic criteria of visual evoked potentials after cerebral ischemic disorders due to cerebral atherosclerosis]. Medichni Perspectivi. 2010;15(2):1–4. Ukrainian.

5. Pogorelov OV. [Neuropsychological disorders in patients with hemispheric ischemic lesions and their dependences from neuronal state of brain stem and co-rtex] Medichni perpectivi. 2010;15(3):33–36. Ukrainian.

6. [Regional features of health level of people of Ukraine. Analytico-statistical textbook]. Kyiv. 2011;165. Ukrainian.

7. Takemi M. Event-related desynchronization reflects downregulation of intracortical inhibition in human primary motor cortex. J. Neurophysiol. 2013;110(5):1158–66.

8. Adamaszek M, et al. Event-related potentials indicating impaired emotional attention in cerebellar stroke-a case study. Neurosci. Lett. 2013;548:206–211.

9. Hagelin C, Wengstrem Y, Runesdotter S. The psychometric properties of the Swedish Hagelin Multi-dimensional Fatigue Inventory MFI – 20 in four different populations. Acta Oncol. 2007;46(1):97–104.

10. Za JH. Biostatistical Analysis. Prentice Hall. 2010;944.

ɋɬɚɬɬɹ ɧɚɞɿɣɲɥɚ ɞɨ ɪɟɞɚɤɰɿʀ

27.08.2014

ɍȾɄ 616.13-007.64:616.132:616-018.2-007.17-053

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ȼɿɧɧɢɰɶɤɢɣ ɧɚɰɿɨɧɚɥɶɧɢɣ ɦɟɞɢɱɧɢɣ ɭɧɿɜɟɪɫɢɬɟɬ ɿɦ.Ɇ.ȱ.ɉɢɪɨɝɨɜɚ

ɤɚɮɟɞɪɚ ɜɧɭɬɪɿɲɧɶɨʀ ɦɟɞɢɰɢɧɢ ʋ 1

ɜɭɥ.ɉɢɪɨɝɨɜɚ, 56, ȼɿɧɧɢɰɹ, 21000, ɍɤɪɚʀɧɚ

Vinnitsa National Medical University named after N.I. Pirogov Department of Internal Medicine N 1

Pirogova str., 56, Vinnitsa, 21000, Ukraine e-mail: kavacuk@yandex.ru

Ʉɥɸɱɨɜɿ ɫɥɨɜɚ:ɚɧɟɜɪɢɡɦɚ ɜɢɫɯɿɞɧɨɝɨ ɜɿɞɞɿɥɭ ɚɨɪɬɢ,ɩɪɢɱɢɧɧɿ ɮɚɤɬɨɪɢ,ɞɢɫɩɥɚɡɿɹ ɫɩɨɥɭɱɧɨʀ ɬɤɚɧɢɧɢ,ɿɲɟɦɿɱɧɚ

ɯɜɨɪɨɛɚ ɫɟɪɰɹ,ɝɿɩɟɪɬɨɧɿɱɧɚ ɯɜɨɪɨɛɚ

Key words:aneurism of ascending part of aorta, causal factors, dysplasia of connective tissue, ischemic heart disease, essential hypertension

Ɋɟɮɟɪɚɬ. ȼɡɚɢɦɨɫɜɹɡɶ ɚɧɟɜɪɢɡɦɵ ɜɨɫɯɨɞɹɳɟɝɨ ɨɬɞɟɥɚ ɚɨɪɬɵ ɫ ɫɢɧɞɪɨɦɨɦ ɫɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɨɣ

ɞɢɫɩɥɚɡɢɢ.Ɉɫɨɜɫɤɚɹ ɇ.ɘ.ȼ ɪɚɛɨɬɟ ɨɩɪɟɞɟɥɟɧɵ ɨɫɧɨɜɧɵɟ ɩɪɢɱɢɧɵ ɪɚɡɜɢɬɢɹ ɚɧɟɜɪɢɡɦɵ ɜɨɫɯɨɞɹɳɟɝɨ ɨɬɞɟɥɚ

(2)

ɚɫɫɨɰɢɢɪɨɜɚɧɧɵɯ ɫ ɜɨɡɪɚɫɬɨɦ ɮɚɤɬɨɪɨɜ ɪɢɫɤɚ ɚɧɟɜɪɢɡɦɵ ɛɵɥɨ ɨɛɫɥɟɞɨɜɚɧɨ 154 ɛɨɥɶɧɵɯ, ɫ ɧɚɥɢɱɢɟɦ

ɪɚɫɲɢɪɟɧɢɹ ɤɨɪɧɹ ɢ/ɢɥɢ ɜɨɫɯɨɞɹɳɟɣ ɚɨɪɬɵ ɛɨɥɟɟ 40 ɦɦ, ɩɨ ɞɚɧɧɵɦ ɷɯɨɤɚɪɞɢɨɝɪɚɮɢɱɟɫɤɨɝɨ ɢɫɫɥɟɞɨɜɚɧɢɹ.

Ȼɨɥɶɧɵɟ ɛɵɥɢ ɪɚɡɞɟɥɟɧɵ ɧɚ 4 ɤɚɬɟɝɨɪɢɢ ɩɨ ɜɨɡɪɚɫɬɭ: 18-29 ɥɟɬ, 30 – 44 ɝɨɞɚ, 45 – 59 ɥɟɬ, 60 - 74 ɝɨɞɚ.

ɂɫɩɨɥɶɡɨɜɚɧɧɵɟ ɢɧɫɬɪɭɦɟɧɬɚɥɶɧɵɟ ɦɟɬɨɞɵ ɨɛɫɥɟɞɨɜɚɧɢɹ: ɗɯɨɄȽ, ɗɄȽ, ɫɭɬɨɱɧɨɟ ɦɨɧɢɬɨɪɢɪɨɜɚɧɢɟ ɗɄȽ ɢ

ɚɪɬɟɪɢɚɥɶɧɨɝɨ ɞɚɜɥɟɧɢɹ,ɨɩɪɟɞɟɥɟɧɢɟ ɜɚɪɢɚɛɟɥɶɧɨɫɬɢ ɫɟɪɞɟɱɧɨɝɨ ɪɢɬɦɚ,ɍɁɂ ɜɧɭɬɪɟɧɧɢɯ ɨɪɝɚɧɨɜ. Cɢɧɞɪɨɦ

ɞɢɫɩɥɚɡɢɢ ɫɨɟɞɢɧɢɬɟɥɶɧɨɣ ɬɤɚɧɢ ɭɫɬɚɧɚɜɥɢɜɚɥɢ ɫɨɝɥɚɫɧɨ ɤɪɢɬɟɪɢɹɦ ɪɚɛɨɱɟɣ ɝɪɭɩɩɵ Ȼɪɢɬɚɧɫɤɨɝɨ Ɉɛɳɟɫɬɜɚ ɪɟɜɦɚɬɨɥɨɝɨɜ. ɋɢɧɞɪɨɦ ɝɢɩɟɪɦɨɛɢɥɶɧɨɫɬɢ ɫɭɫɬɚɜɨɜ ɨɩɪɟɞɟɥɹɥɢ ɫɨɝɥɚɫɧɨ Ȼɪɚɣɬɨɧɨɜɫɤɢɦ ɤɪɢɬɟɪɢɹɦ.

Ɉɛɪɚɛɨɬɤɭ ɞɚɧɧɵɯ ɩɪɨɜɨɞɢɥɢ ɦɟɬɨɞɚɦɢ ɜɚɪɢɚɰɢɨɧɧɨɣ ɫɬɚɬɢɫɬɢɤɢ ɜ ɩɪɨɝɪɚɦɦɟ StatSoft "Statistica" v.10.0.

ɍɫɬɚɧɨɜɥɟɧɨ,ɱɬɨ ɭ ɩɚɰɢɟɧɬɨɜ ɦɨɥɨɞɨɝɨ ɢ ɡɪɟɥɨɝɨ ɜɨɡɪɚɫɬɚ ɩɪɢɱɢɧɨɣ ɚɧɟɜɪɢɡɦɵ ɜɨɫɯɨɞɹɳɟɝɨ ɨɬɞɟɥɚ ɚɨɪɬɵ

ɱɚɳɟ ɜɫɟɝɨ ɹɜɥɹɟɬɫɹ ɫɢɧɞɪɨɦ ɫɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɨɣ ɞɢɫɩɥɚɡɢɢ. ɍ ɫɬɚɪɲɢɯ ɜɨɡɪɚɫɬɧɵɯ ɤɚɬɟɝɨɪɢɣ

ɩɪɟɢɦɭɳɟɫɬɜɟɧɧɨ ɞɢɚɝɧɨɫɬɢɪɭɸɬ ɚɧɟɜɪɢɡɦɭ ɜɨɫɯɨɞɹɳɟɣ ɚɨɪɬɵ, ɚɫɫɨɰɢɢɪɨɜɚɧɧɭɸ ɫ ɝɢɩɟɪɬɪɨɮɢɟɣ ɥɟɜɨɝɨ

ɠɟɥɭɞɨɱɤɚ ɢ ɭɦɟɧɶɲɟɧɢɟɦ ɫɨɤɪɚɬɢɬɟɥɶɧɨɣ ɮɭɧɤɰɢɢ ɫɟɪɞɰɚ.

Abstract. Relationship between aneurism of ascending part of aorta and syndrome of connective tissue dysplasia. Osovska N.Yu. The paper identifies the main reasons for the development of an aneurysm of the ascending aorta and predictors of its complications in patients of all ages. To determine the cause and age-associated risk factors for aneurysms there were examined 154 patients with the presence of the expansion of the root and / or ascending aorta of more than 40 mm, according to echocardiographic examination. Patients were divided into 4 categories by age: 18-29 years, 30-44 years 45-59 years 60-74 years. Instrumental methods of examination: echocardiography, ECG, ECG monitoring and blood pressure, heart rate variability, ultrasound of internal organs were used. Syndrome of connective tissue dysplasia was established according to the criteria of the working group of the British Society of Rheumatology. Joint hypermobility syndrome was determined according to the Brayton criteria. Statistical processing was carried out by methods of variation statistic program StatSoft "Statistica" v.10.0. It was established that in young and middle aged patients the cause of aneurysm of ascending aorta more often is connective tissue dysplasia syndrome. In older patients the main cause of aneurysm of ascending aorta is associated with left ventricular hypertrophy and decreased contractile function of the heart.

ɉɪɢɱɢɧɢ,ɹɤɿ ɩɪɢɡɜɨɞɹɬɶ ɞɨ ɩɚɬɨɥɨɝɿɱɧɢɯ ɡɦɿɧ ɚɪɬɟɪɿɚɥɶɧɨʀ ɫɬɿɧɤɢ, ɡɨɤɪɟɦɚ ɜɢɫɯɿɞɧɨʀ ɚɨɪɬɢ, ɡɧɚɱɧɨ ɪɿɡɧɹɬɶɫɹ ɡɚɥɟɠɧɨ ɜɿɞ ɜɿɤɭ ɩɚɰɿɽɧɬɿɜ. Ɏɚɤɬɨɪɢ, ɳɨ ɫɩɪɢɹɸɬɶ ɜɢɧɢɤɧɟɧɧɸ ɚɧɟɜɪɢɡɦɢ ɜɢɫɯɿɞɧɨɝɨ ɜɿɞɞɿɥɭ ɚɨɪɬɢ (ȺȼȼȺ)ɜ ɨɫɿɛ ɦɨɥɨɞɲɟ 50 ɪɨɤɿɜ, ɱɚɫɬɿɲɟ ɜɪɨɞɠɟɧɿ. ɐɟ ɞɢɫɩɥɚɡɿʀ ɫɩɨ -ɥɭɱɧɨʀ ɬɤɚɧɢɧɢ (ɧɚɩɪɢɤɥɚɞ, ɫɢɧɞɪɨɦ Ɇɚɪɮɚɧɚ), ɜɪɨɞɠɟɧɿ ɜɚɞɢ ɫɟɪɰɹ, ɤɨɚɪɤɬɚɰɿɹ ɚɨɪɬɢ, ɛɿɤɭ -ɫɩɿɞɚɥɶɧɢɣ (ɭ 7-14%) ɿ ɨɞɧɨɫɬɭɥɤɨɜɢɣ ɤɥɚɩɚɧ, ɨɛɬɹɠɟɧɢɣ ɫɿɦɟɣɧɢɣ ɚɧɚɦɧɟɡ ɩɨ ɚɧɟɜɪɢɡɦɿ ɚɨɪɬɢ, ɫɢɫɬɟɦɧɿ ɜɚɫɤɭɥɿɬɢ (ɨɫɨɛɥɢɜɨ ɱɚɫɬɨ ɝɪɚɧɭɥɟ -ɦɚɬɨɡɧɢɣ, ɝɿɝɚɧɬɨɤɥɿɬɢɧɧɢɣ ɚɪɬɟɪɿʀɬ), ɫɢɮɿɥɿɫ, ɯɿɦɿɱɧɿ ɣ ɬɨɤɫɢɱɧɿ ɞɿʀ ɬɨɳɨ [7, 9, 10]. ɍ ɩɚɰɿɽɧɬɿɜ ɫɬɚɪɲɟ 60 ɪɨɤɿɜ ɩɪɢɱɢɧɨɸ ȺȼȼȺ, ɹɤ ɩɪɚɜɢɥɨ, ɽ ɚɬɟɪɨɫɤɥɟɪɨɡ ɬɚ ɚɪɬɟɪɿɚɥɶɧɚ ɝɿɩɟɪɬɟɧɡɿɹ (ȺȽ). Ɋɢɡɢɤ ɭɫɤɥɚɞɧɟɧɨɝɨ ɩɟɪɟɛɿɝɭ ȺȼȼȺ ɡɛɿɥɶɲɭɽɬɶ -ɫɹ ɡ ɜɿɤɨɦ, ɧɚɹɜɧɿɫɬɸ ȺȽ, ɞɢɥɚɬɚɰɿʀ ɭɫɬɹ ɚɨɪɬɢ, ɝɿɩɟɪɥɿɩɿɞɟɦɿʀ,ɰɭɤɪɨɜɨɝɨ ɞɿɚɛɟɬɭ ɿ ɜ ɤɭɪɰɿɜ [7].

ɉɪɨɬɟ ɮɚɤɬɨɪɢ, ɳɨ ɚɫɨɰɿɣɨɜɚɧɿ ɡ ɧɟɭɫɤɥɚɞ-ɧɟɧɨɸ ɚɧɟɜɪɢɡɦɨɸ ɚɨɪɬɢ, ɨɫɨɛɥɢɜɨ ɭ ɦɨɥɨɞɢɯ ɥɸɞɟɣ,ɚ ɬɚɤɨɠ "ɦɚɪɤɟɪɢ"ɱɢ ɩɪɟɞɢɤɬɨɪɢ ɩɪɨɝɪɟ -ɫɭɸɱɨɝɨ ɚɛɨ ɭɫɤɥɚɞɧɟɧɨɝɨ ɩɟɪɟɛɿɝɭ ɚɧɟɜɪɢɡɦɢ ɚɨɪɬɢ,ɡɚ ɹɤɢɦɢ ɦɨɠɥɢɜɨ ɛɭɥɨ ɛ ɫɤɥɚɫɬɢ ɩɪɨɝɧɨɡ ɭ ɤɨɠɧɨɝɨ ɨɤɪɟɦɨɝɨ ɯɜɨɪɨɝɨ, ɡɚɥɢɲɚɸɬɶɫɹ ɞɢɫ -ɤɭɫɿɣɧɢɦ ɩɢɬɚɧɧɹɦ ɫɭɱɚɫɧɨʀ ɤɚɪɞɿɨɥɨɝɿʀ.

Ɍɨɦɭ ɦɟɬɨɸ ɞɨɫɥɿɞɠɟɧɧɹ ɫɬɚɥɨ ɜɢɡɧɚɱɟɧɧɹ ɨɫɧɨɜɧɢɯ ɩɪɢɱɢɧɧɢɯ ɬɚ ɚɫɨɰɿɣɨɜɚɧɢɯ ɮɚɤɬɨɪɿɜ ɪɨɡɜɢɬɤɭ ɚɧɟɜɪɢɡɦɢ ɜɢɫɯɿɞɧɨɝɨ ɜɿɞɞɿɥɭ ɚɨɪɬɢ ɬɚ ɩɪɟɞɢɤɬɨɪɿɜ ʀʀ ɭɫɤɥɚɞɧɟɧɶ ɭ ɩɚɰɿɽɧɬɿɜ ɪɿɡɧɨɝɨ ɜɿɤɭ.

ɆȺɌȿɊȱȺɅɂ ɌȺ ɆȿɌɈȾɂ ȾɈɋɅȱȾɀȿɇɖ Ⱦɥɹ ɜɢɡɧɚɱɟɧɧɹ ɩɪɢɱɢɧɧɢɯ ɬɚ ɚɫɨɰɿɣɨɜɚɧɢɯ ɡ ɜɿɤɨɦ ɮɚɤɬɨɪɿɜ ɪɢɡɢɤɭ ȺȼȼȺ ɛɭɥɨ ɨɛɫɬɟɠɟɧɨ 154 ɯɜɨɪɢɯ, ɡ ɧɚɹɜɧɿɫɬɸ ɪɨɡɲɢɪɟɧɧɹ ɤɨɪɟɧɹ ɬɚ ɚɛɨ ɜɢɫɯɿɞɧɨʀ ɚɨɪɬɢ ɛɿɥɶɲɟ 40 ɦɦ, ɡɚ ɞɚɧɢɦɢ ɟɯɨɤɚɪɞɿɨɝɪɚɮɿɱɧɨɝɨ ɞɨɫɥɿɞɠɟɧɧɹ. ɏɜɨɪɢɯ ɛɭɥɨ ɪɨɡɩɨɞɿɥɟɧɨ ɧɚ ɤɚɬɟɝɨɪɿʀ ɡɝɿɞɧɨ ɡ ɜɿɤɨɜɨɸ ɤɥɚɫɢ-ɮɿɤɚɰɿɽɸ ȼɈɓɁ 1963 ɪ.: 18-29 ɪɨɤɿɜ – ɦɨɥɨɞɢɣ ɜɿɤ (N=39), 30-44 ɪɨɤɢ – ɡɪɿɥɢɣ ɜɿɤ (N=38), 45-59 ɪɨɤɿɜ – ɫɟɪɟɞɧɿɣ ɜɿɤ (N=40), 60-74 ɪɨɤɢ – ɩɨ -ɯɢɥɢɣ ɜɿɤ (N=37). ɉɚɰɿɽɧɬɿɜ ɫɬɚɪɟɱɨɝɨ ɜɿɤɭ ɬɚ ɞɨɜɝɨɠɢɬɟɥɿɜ ɭ ɞɨɫɥɿɞɠɟɧɧɹ ɜɤɥɸɱɟɧɨ ɧɟ ɛɭɥɨ ɱɟɪɟɡ ɜɿɞɫɭɬɧɿɫɬɶ ɞɨɫɬɚɬɧɶɨʀ ɤɿɥɶɤɨɫɬɿ ɫɩɨɫɬɟɪɟ -ɠɟɧɶ ɬɚ ɣɦɨɜɿɪɧɿɫɬɶ ɞɨɦɿɧɭɜɚɧɧɹ ɜ ɰɿɣ ɤɚɬɟɝɨɪɿʀ ɫɚɦɟ ɚɬɟɪɨɫɤɥɟɪɨɬɢɱɧɨ ɡɭɦɨɜɥɟɧɨʀ ɚɧɟɜɪɢɡɦɢ ɡɿ ɜɫɿɦɚ ɚɫɨɰɿɣɨɜɚɧɢɦɢ ɡ ɚɬɟɪɨɫɤɥɟɪɨɡɨɦ ɮɚɤ -ɬɨɪɚɦɢ.

Ɍɪɚɞɢɰɿɣɧɢɦɢ ɦɟɬɨɞɚɦɢ ɿɧɫɬɪɭɦɟɧɬɚɥɶɧɨɝɨ ɨɛɫɬɟɠɟɧɧɹ ɯɜɨɪɢɯ ɛɭɥɢ ȿɯɨɄȽ, ȿɄȽ, ɞɨɛɨɜɟ ɦɨɧɿɬɨɪɭɜɚɧɧɹ ȿɄȽ (ȾɆȿɄȽ) ɬɚ ɚɪɬɟɪɿɚɥɶɧɨɝɨ ɬɢɫɤɭ, ɜɢɡɧɚɱɟɧɧɹ ɜɚɪɿɚɛɟɥɶɧɨɫɬɿ ɫɟɪɰɟɜɨɝɨ ɪɢɬ -ɦɭ (ȼɋɊ).

ȼɿɞɛɿɪɤɨɜɟ ɭɥɶɬɪɚɡɜɭɤɨɜɟ ɞɨɫɥɿɞɠɟɧɧɹ ɜ ɨɞ-ɧɨɜɢɦɿɪɧɨɦɭ ɬɚ ɞɜɨɜɢɦɿɪɧɨɦɭ ɪɟɠɢɦɚɯ ɡ ɤɨɥɶɨ-ɪɨɜɨɸ, ɿɦɩɭɥɶɫɧɨɸ ɬɚ ɩɨɫɬɿɣɧɨɯɜɢɥɶɨɜɨɸ ɞɨɩ -ɩɥɟɪɨɝɪɚɮɿɽɸ ɩɪɨɜɨɞɢɥɢ ɟɯɨɤɚɪɞɿɨɝɪɚɮɨɦ ɆyLab 25 (ȱɬɚɥɿɹ)ɡɚ ɦɟɬɨɞɢɤɨɸ Ʉɨɜɚɥɟɧɤɨ ȼ.Ɇ. [4].

(3)

ɡɚ ɞɨɩɨɦɨɝɨɸ ɫɢɫɬɟɦɢ ɚɧɚɥɿɡɭ ȼɊɋ “HRV”, ɹɤɚ ɜɯɨɞɢɬɶ ɞɨ ɫɤɥɚɞɭ ɰɢɯ ɯɨɥɬɟɪɿɜɫɶɤɢɯ ɫɢɫɬɟɦ. ȼɢɜɱɚɥɢ ɱɚɫɨɜɿ ɣ ɱɚɫɬɨɬɧɿ ɩɨɤɚɡɧɢɤɢ ȼɊɋ: ɫɬɚɧɞɚɪɬɧɟ ɜɿɞɯɢɥɟɧɧɹ NN ɿɧɬɟɪɜɚɥɭ (SDNN), % ɫɭɫɿɞɧɿɯ NN ɿɧɬɟɪɜɚɥɿɜ, ɪɿɡɧɢɰɹ ɦɿɠ ɹɤɢɦɢ ɩɟɪɟɜɢɳɭɽ 50 ɦɫ (pNN50%), ɤɜɚɞɪɚɬɧɢɣ ɤɨɪɿɧɶ ɫɭɦɢ ɤɜɚɞɪɚɬɿɜ ɪɿɡɧɢɰɶ ɬɪɢɜɚɥɨɫɬɿ ɫɭɫɿɞɧɿɯ ɿɧɬɟɪɜɚɥɿɜ NN (RMSSD), ɩɨɬɭɠɧɿɫɬɶ ɭ ɞɿɚɩɚɡɨɧɿ ɧɢɡɶɤɢɯ (0,04-0,15 Ƚɰ) (LF) ɬɚ ɜɢɫɨɤɢɯ (0,15-0,4 Ƚɰ) (HF) ɱɚɫɬɨɬ, ɜɿɞɧɨɲɟɧɧɹ LF ɞɨ HF (LF/HF).

Cɢɧɞɪɨɦ ɞɢɫɩɥɚɡɿʀ ɫɩɨɥɭɱɧɨʀ ɬɤɚɧɢɧɢ (ȾɋɌ) ɜɫɬɚɧɨɜɥɸɜɚɥɢ ɡɝɿɞɧɨ ɡ ɤɪɢɬɟɪɿɹɦɢ ɪɨɛɨɱɨʀ ɝɪɭ -ɩɢ Ȼɪɢɬɚɧɫɶɤɨɝɨ Ɍɨɜɚɪɢɫɬɜɚ Ɋɟɜɦɚɬɨɥɨɝɿɜ [2]. ɋɢɧɞɪɨɦ ɝɿɩɟɪɦɨɛɿɥɶɧɨɫɬɿ ɫɭɝɥɨɛɿɜ ɜɢɡɧɚɱɚɥɢ ɡɝɿɞɧɨ ɡ Ȼɪɚɣɬɨɧɿɜɫɶɤɢɦɢ ɤɪɢɬɟɪɿɹɦɢ [2].

Ɂɚ ɞɨɩɨɦɨɝɨɸ ɍɁȾ ɜɧɭɬɪɿɲɧɿɯ ɨɪɝɚɧɿɜ ɜɢɡɧɚ -ɱɚɥɢ ɧɚɹɜɧɿɫɬɶ ɞɢɫɤɿɧɟɡɿʀ ɠɨɜɱɧɨɝɨ ɦɿɯɭɪɚ, ɧɟɮ -ɪɨɩɬɨɡɭ, ɩɨɞɜɨɽɧɧɹ, ɝɿɩɨɩɥɚɡɿʀ ɧɢɪɨɤ, ɩɿɞɤɨɜɨ -ɩɨɞɿɛɧɨʀ ɧɢɪɤɢ, ɚɫɢɦɟɬɪɿʀ ɪɨɡɦɿɪɿɜ ɧɢɪɨɤ ɡɚ ɦɟɬɨɞɢɤɨɸ Ɇɿɬɶɤɨɜɚ ȼ.ȼ. [5].

ɋɬɚɬɢɫɬɢɱɧɭ ɨɛɪɨɛɤɭ ɩɪɨɜɨɞɢɥɢ ɦɟɬɨɞɚɦɢ ɜɚɪɿɚɰɿɣɧɨʀ ɫɬɚɬɢɫɬɢɤɢ ɜ ɩɪɨɝɪɚɦɿ StatSoft „Sta-tistica” v.10.0 ɡɝɿɞɧɨ ɡ ɪɟɤɨɦɟɧɞɚɰɿɹɦɢ Ɋɟɛɪɨ-ɜɚ Ɉ.ɘ. [6].

Ɋɟɡɭɥɶɬɚɬɢ ɛɭɥɢ ɩɪɟɞɫɬɚɜɥɟɧɿ: 1) ɤɿɥɶɤɿɫɧɿ ɜɟɥɢɱɢɧɢ – ɭ ɜɢɝɥɹɞɿ ɦɟɞɿɚɧɢ ɣ ɿɧɬɟɪɤɜɚɪ -ɬɢɥɶɧɨɝɨ ɪɨɡɦɚɯɭ (25 ɿ 75 ɩɪɨɰɟɧɬɢɥɿ) ɿ 2) ɜɿɞ -ɧɨɫɧɿ ɜɟɥɢɱɢɧɢ - ɭ ɜɢɝɥɹɞɿ ɜɿɞɫɨɬɤɿɜ (%). ɉɨɪɿɜɧɹɧɧɹ ɜɿɞɧɨɫɧɢɯ ɜɟɥɢɱɢɧ ɩɪɨɜɨɞɢɥɢ ɡɚ ɞɨ -ɩɨɦɨɝɨɸ ɤɪɢɬɟɪɿɸ F2_, _{ɤɿɥɶɤɿɫɧɢɯ ɜɟɥɢɱɢɧ ɧɟɡɚ}

-ɥɟɠɧɢɯ ɜɢɛɨɪɨɤ - ɡɚ ɦɟɞɿɚɧɧɢɦ ɤɪɢɬɟɪɿɽɦ ɿ ɡɜ’ɹɡɚɧɢɯ ɜɢɛɨɪɨɤ (ɜɢɛɿɪɤɢ ɞɨ ɿ ɩɿɫɥɹ ɫɩɨɫɬɟ -ɪɟɠɟɧɧɹ) – ɡɚ ɤɪɢɬɟɪɿɽɦ ȼɿɥɤɨɤɫɨɧɚ. Ⱦɥɹ ɜɢɡ -ɧɚɱɟɧɧɹ ɡɜ’ɹɡɤɭ ɦɿɠ ɩɚɪɚɦɟɬɪɚɦɢ ɛɭɜ ɜɢɤɨ -ɪɢɫɬɚɧɢɣ ɧɟɩɚɪɚɦɟɬɪɢɱɧɢɣ ɤɨɪɟɥɹɰɿɣɧɢɣ ɪɚɧ -ɝɨɜɢɣ ɚɧɚɥɿɡ ɋɩɿɪɦɟɧɚ.

Ɂ ɦɟɬɨɸ ɨɰɿɧɤɢ ɫɢɥɢ ɜɩɥɢɜɭ ɨɤɪɟɦɢɯ ɧɟɡɚ -ɥɟɠɧɢɯ ɩɪɟɞɢɤɬɨɪɿɜ ɧɚ ɞɢɧɚɦɿɤɭ ȿɯɨɄȽ-ɩɨɤɚɡ -ɧɢɤɿɜ ɬɚ ɞɥɹ ɜɢɹɜɥɟɧɧɹ ɱɢɧ-ɧɢɤɿɜ, ɚɫɨɰɿɣɨɜɚɧɢɯ ɡ ɚɧɟɜɪɢɡɦɨɸ ɜɢɫɯɿɞɧɨʀ ɚɨɪɬɢ ɜ ɪɿɡɧɢɯ ɜɿɤɨɜɢɯ ɝɪɭɩɚɯ, ɜɢɤɨɪɢɫɬɚɧɚ ɦɧɨɠɢɧɧɚ ɥɿɧɿɣɧɚ ɪɟɝɪɟɫɿɹ (ɦɨɞɭɥɶ “Multiple Regression). ȱɧɮɨɪɦɚɬɢɜɧɿɫɬɶ ɪɟɝɪɟɫɿɣɧɨɝɨ ɚɧɚɥɿɡɭ ɨɰɿɧɸɜɚɥɚɫɶ ɡɚ ɞɨɩɨɦɨɝɨɸ ɪɨɡɪɚɯɭɧɤɭ ɤɨɟɮɿɰɿɽɧɬɭ ɦɧɨɠɢɧɧɨʀ ɪɟɝɪɟɫɿʀ (ɤɨɟ-ɮɿɰɿɽɧɬɭ ɞɟɬɟɪɦɿɧɚɰɿʀ - RI), ɚɞɟɤɜɚɬɧɿɫɬɶ - ɡɚ ɞɨɩɨɦɨɝɨɸ ɚɧɚɥɿɡɭ ɡɚɥɢɲɤɿɜ (Residual Analysis) ɿɡ ɪɨɡɪɚɯɭɧɤɨɦ ɮɚɤɬɢɱɧɨɝɨ ɬɚ ɤɪɢɬɢɱɧɨɝɨ (df) ɡɧɚɱɟɧɧɹ ɤɪɢɬɟɪɿɸ Ɏɿɲɟɪɚ (F-ɤɪɢɬɟɪɿɸ) ɿ ɪɿɜɧɹ ɡɧɚɱɭɳɨɫɬɿ (ɪ).Ⱦɥɹ ɫɬɚɬɢɫɬɢɱɧɨʀ ɯɚɪɚɤɬɟɪɢɫɬɢɤɢ ɨɤɪɟɦɢɯ ɱɢɧɧɢɤɿɜ (ɧɟɡɚɥɟɠɧɢɯ ɩɪɟɞɢɤɬɨɪɿɜ) ɜɢɤɨɪɢɫɬɨɜɭɜɚɥɢ ɛɟɬɚ-ɤɨɟɮɿɰɿɽɧɬ (ȼȿɌȺ), ɹɤɢɣ ɩɨɤɚɡɭɜɚɜ ɫɢɥɭ ɜɩɥɢɜɭ ɱɢɧɧɢɤɚ ɧɚ ɜɢɯɿɞɧɢɣ ɩɚɪɚɦɟɬɪ ɬɚ ɯɚɪɚɤɬɟɪ ɰɶɨɝɨ ɜɩɥɢɜɭ (ɩɨɡɢɬɢɜɧɢɣ ȼȿɌȺ ɫɜɿɞɱɢɜ ɩɪɨ ɩɪɹɦɢɣ ɿ ɧɟɝɚɬɢɜɧɢɣ – ɩɪɨ ɡɜɨɪɨɬɧɿɣ ɡɜ'ɹɡɨɤ). Ɋɨɡɪɚɯɭɧɨɤ ɤɪɢɬɢɱɧɢɯ ɜɟɥɢ

-ɱɢɧ ɨɤɪɟɦɢɯ ɩɪɟɞɢɤɬɨɪɿɜ ɩɪɨɜɨɞɢɥɢ ɡɚ ɮɨɪ -ɦɭɥɨɸ Ⱥɧɬɨɦɨɧɨɜɚ Ɇ.ɘ. [1].

ɊȿɁɍɅɖɌȺɌɂ ɌȺ Ȳɏ ɈȻȽɈȼɈɊȿɇɇə

ɇɟɩɪɹɦɢɦɢ ɤɪɢɬɟɪɿɹɦɢ,ɳɨ ɫɜɿɞɱɚɬɶ ɩɪɨ ɞɢɫ -ɩɥɚɫɬɢɱɧɢɣ ɝɟɧɟɡ ɚɧɟɜɪɢɡɦɢ ɚɨɪɬɢ, ɦɨɠɭɬɶ ɛɭɬɢ ɜɥɚɫɬɢɜɿ ɰɿɣ ɩɚɬɨɥɨɝɿʀ ɮɟɧɨɬɢɩɿɱɧɿ ɬɚ ɚɧɬɪɨ -ɩɨɦɟɬɪɢɱɧɿ ɮɟɧɨɦɟɧɢ. ȼɢɹɜɥɟɧɧɹ ɰɢɯ ɯɚɪɚɤɬɟ -ɪɢɫɬɢɤ ɦɨɠɟ ɡ ɜɟɥɢɤɨɸ ɱɚɫɬɤɨɸ ɣɦɨɜɿɪɧɨɫɬɿ ɫɜɿɞɱɢɬɢ ɩɪɨ ɦɨɠɥɢɜɿɫɬɶ ɜɢɧɢɤɧɟɧɧɹ ȺȼȼȺ ɬɚ ʀʀ ɡɜ'ɹɡɨɤ ɡ ɞɢɫɩɥɚɫɬɢɱɧɢɦɢ ɩɪɨɰɟɫɚɦɢ ɜ ɫɩɨɥɭɱɧɿɣ ɬɤɚɧɢɧɿ.

ȼɪɚɯɨɜɭɸɱɢ ɱɢɫɥɟɧɧɿɫɬɶ ɮɟɧɨɬɢɩɿɱɧɢɯ ɿ ɚɧ-ɬɪɨɩɨɦɟɬɪɢɱɧɢɯ ɨɡɧɚɤ ȾɋɌ, ɦɢ ɩɪɨɚɧɚɥɿɡɭɜɚɥɢ ɬɿ,ɳɨ ɧɚɣɛɿɥɶɲ ɱɚɫɬɨ ɡɭɫɬɪɿɱɚɸɬɶɫɹ ɿ ɽ ɧɚɣɛɿɥɶɲ ɫɩɟɰɢɮɿɱɧɢɦɢ.

ȼɫɬɚɧɨɜɥɟɧɨ, ɳɨ ɡ ɚɧɬɪɨɩɨɦɟɬɪɢɱɧɢɯ ɨɡɧɚɤ ɧɚɣɱɚɫɬɿɲɟ ɜ ɝɪɭɩɿ ɩɚɰɿɽɧɬɿɜ ɡ ɪɨɡɲɢɪɟɧɧɹɦ ɚɨɪɬɢ, ɚɫɨɰɿɣɨɜɚɧɨʀ ɡ ȾɋɌ, ɡɭɫɬɪɿɱɚɥɢɫɹ ɩɨɪɭ -ɲɟɧɧɹ ɩɨɫɬɚɜɢ, ɫɤɨɥɿɨɡ, ɚɫɬɟɧɿɱɧɢɣ ɬɢɩ ɫɬɚɬɭɪɢ, ɞɟɮɿɰɢɬ ɜɚɝɢ,ɝɿɩɨɬɪɨɮɿɹ ɦ'ɹɡɿɜ,ɞɟɮɨɪɦɚɰɿɹ ɝɪɭɞ -ɧɨʀ ɤɥɿɬɤɢ. ɍ ɬɨɣ ɠɟ ɱɚɫ ɭ ɩɚɰɿɽɧɬɿɜ ɡɪɿɥɨɝɨ ɬɚ ɩɨɯɢɥɨɝɨ ɜɿɤɭ ɰɿ ɚɧɬɪɨɩɨɦɟɬɪɢɱɧɿ ɨɡɧɚɤɢ ɛɭɥɢ ɧɚɹɜɧɿ ɧɚɛɚɝɚɬɨ ɪɿɞɲɟ (ɬɚɛɥ. 1).

ɑɚɫɬɢɦɢ ɿ ɫɩɟɰɢɮɿɱɧɢɦɢ ɮɟɧɨɬɢɩɿɱɧɢɦɢ ɨɡ -ɧɚɤɚɦɢ (ɬɚɛɥ.2) ɛɭɥɢ ɞɿɚɝɨɧɚɥɶɧɚ ɛɨɪɨɡɟɧɤɚ ɧɚ ɦɨɱɰɿ ɜɭɯɚ,ɝɿɩɟɪɦɨɛɿɥɶɧɿɫɬɶ ɫɭɝɥɨɛɿɜ,ɩɿɞɜɢɳɟɧɚ ɪɨɡɬɹɠɧɿɫɬɶ ɲɤɿɪɢ, ɚɧɨɦɚɥɿʀ ɪɭɤ, ɫɢɦɩɬɨɦɢ ɜɟ -ɥɢɤɨɝɨ ɩɚɥɶɰɹ ɿ ɡɚɩ'ɹɫɬɹ. ȼɟɥɶɦɢ ɫɩɟɰɢɮɿɱɧɢɦ ɤɪɢɬɟɪɿɽɦ ɜɢɹɜɢɜɫɹ ɩɿɞɜɢɜɢɯ ɤɪɢɲɬɚɥɢɤɚ, ɩɪɚɤ-ɬɢɱɧɨ ɜɿɞɫɭɬɧɿɣ ɭ ɩɚɰɿɽɧɬɿɜ ɛɟɡ ɞɢɫɩɥɚɡɿʀ ɋɌ. Ⱦɟɳɨ ɪɿɞɲɟ, ɚɥɟ ɞɨɫɬɨɜɿɪɧɨ ɱɚɫɬɿɲɟ, ɧɿɠ ɭ ɩɚɰɿɽɧɬɿɜ ɡ ɚɧɟɜɪɢɡɦɨɸ ɚɨɪɬɢ ɛɟɡ ȾɋɌ, ɫɩɨɫɬɟ -ɪɿɝɚɥɢɫɹ ɬɚɤɿ ɨɡɧɚɤɢ, ɹɤ ɜɢɤɪɢɜɥɟɧɧɹ ɧɨɫɨɜɨʀ ɩɟɪɟɝɨɪɨɞɤɢ,ɩɥɨɫɤɨɫɬɨɩɿɫɬɶ,ɦɿɨɩɿɹ,ɜɚɪɢɤɨɡ ɜɟɧ ɧɢɠɧɿɯ ɤɿɧɰɿɜɨɤ.

(4)

Ɍ ɚ ɛ ɥ ɢ ɰ ɹ 1 ɑɚɫɬɨɬɚ ɚɧɬɪɨɩɨɦɟɬɪɢɱɧɢɯ ɨɡɧɚɤ ɞɢɫɩɥɚɡɿʀ ɋɌ ɭ ɯɜɨɪɢɯ

ɡ ȺȼȼȺ ɜ ɪɿɡɧɢɯ ɜɿɤɨɜɢɯ ɝɪɭɩɚɯ

ɉɨɤɚɡɧɢɤɢ Ƚɪɭɩɚ 1 _(n=39) Ƚɪɭɩɚ 2 _(n=38) Ƚɪɭɩɚ 3 _(n=40) Ƚɪɭɩɚ 4 _(n=37)

Ⱥɫɬɟɧɿɤ 20 (51,3%) 9 (23,7%) 7 (17,5%) 5 (13,5%)

Ɋ1-2=0,012, ɪ1-3=0,002, ɪ1-4<0,0001

ɇɨɪɦɨɫɬɟɧɿɤ 18 (46,2%) 23 (60,5%) 20 (50,0%) 18 (48,6%)

Ƚɿɩɟɪɫɬɟɧɿɤ 0 (0) 6 (15,8%) 13 (32,5%) 14 (37,8%)

Ɋ1-2=0,010, ɪ1-3<0,0001, ɪ1-4<0,0001, p2-4=0,031

Ⱦɟɮɿɰɢɬ ɜɚɝɢ ɬɿɥɚ 29 (74,4%) 24 (63,2%) 3 (7,5%) 0 (0)

Ɋ1-3<0,0001, ɪ1-4<0,0001, ɪ2-3<0,0001, p2-4<0,0001

ɉɨɪɭɲɟɧɧɹ ɩɨɫɬɚɜɢ 31 (79,5%) 31 (81,6%) 11 (27,5%) 0 (0)

Ɋ1-3<0,0001, ɪ1-4<0,0001, ɪ2-3<0,0001, p2-4<0,0001, ɪ3-4=0,001

Ƚɿɩɟɪɦɨɛɿɥɶɧɿɫɬɶ ɫɭɝɥɨɛɿɜ 28 (71,8%) 36 (94,7%) 11 (27,5%) 4 (10,8%)

Ɋ1-2=0,007, Ɋ1-3<0,0001, ɪ1-4<0,0001, ɪ2-3<0,0001, p2-4<0,0001

Ƚɿɩɨɬɪɨɮɿɹ ɦɹɡɿɜ 22 (56,4%) 23 (60,5%) 9 (22,5%) 0 (0)

Ɋ1-3=0,002, ɪ1-4<0,0001, ɪ2-3=0,001, p2-4<0,0001, ɪ3-4=0,002

Ⱦɟɮɨɪɦɚɰɿɹ ɝɪ.ɤɥɿɬɤɢ 22 (56,4%) 22 (57,9%) 6 (15,0%) 3 (8,1%)

Ɋ1-3<0,0001, ɪ1-4<0,0001, ɪ2-3<0,0001, p2-4<0,0001

ɋɤɨɥɿɨɡ 30 (76,9%) 29 (76,3%) 13 (32,5%) 7 (18,9%)

Ɋ1-3<0,0001, ɪ1-4<0,0001, ɪ2-3<0,0001, p2-4<0,0001

ɋɭɞɢɧɧɿ ɩɨɪɭɲɟɧɧɹ ɜ ɤɿɧɰɿɜɤɚɯ, ɳɨ ɜɢɹɜ -ɥɹɸɬɶɫɹ ɫɢɧɞɪɨɦɨɦ Ɋɟɣɧɨ ɿ ɛɨɥɶɨɜɢɦɢ ɜɿɞ -ɱɭɬɬɹɦɢ ɡɚ ɞɢɡɟɫɬɟɬɢɱɧɢɦ ɬɢɩɨɦ, ɬɚɤɨɠ ɛɭɥɢ ɜɢɹɜɥɟɧɿ ɩɪɢɛɥɢɡɧɨ ɡ ɨɞɧɚɤɨɜɨɸ ɱɚɫɬɨɬɨɸ ɜ ɬɪɶɨɯ ɩɟɪɲɢɯ ɝɪɭɩɚɯ ɿ ɧɟɞɨɫɬɨɜɿɪɧɨ ɦɟɧɲɨɸ – ɭ ɯɜɨɪɢɯ ɩɨɯɢɥɨɝɨ ɜɿɤɭ,ɞɟ ɚɬɟɪɨɫɤɥɟɪɨɬɢɱɧɿ ɡɦɿɧɢ ɫɭɞɢɧ ɩɟɪɟɜɚɠɚɥɢ ɧɚɞ ɩɨɪɭɲɟɧɧɹɦ ɦɿɤɪɨ -ɰɢɪɤɭɥɹɬɨɪɧɨɝɨ ɪɭɫɥɚ(ɬɚɛɥ. 3).

ȼɪɨɞɠɟɧɿ ɞɟɮɟɤɬɢ ɮɿɛɪɢɥɨɝɟɧɟɡɭ ɫɩɪɢɹɸɬɶ ɮɨɪɦɭɜɚɧɧɸ ɪɿɡɧɢɯ ɜɚɪɿɚɧɬɿɜ ɩɚɬɨɥɨɝɿʀ ɧɢɪɨɤ ɿ ɫɟɱɨɜɢɜɿɞɧɢɯ ɲɥɹɯɿɜ [6]. ȼɪɨɞɠɟɧɿ ɚɧɨɦɚɥɿʀ

ɧɢɪɨɤ ɪɿɡɧɨɝɨ ɪɨɞɭ (ɩɿɞɤɨɜɨɩɨɞɿɛɧɚ ɧɢɪɤɚ,

ɩɨɞɜɨɽɧɧɹ ɧɢɪɤɢ, ɝɿɩɨɩɥɚɡɿɹ, ɚɫɢɦɟɬɪɿɹ ɪɨɡɦɿɪɿɜ

ɧɢɪɨɤ) ɫɩɨɫɬɟɪɿɝɚɥɢɫɹ ɱɚɫɬɿɲɟ ɭ ɦɨɥɨɞɲɢɯ

ɩɚɰɿɽɧɬɿɜ ɡ ȺȼȼȺ (ɬɚɛɥ.3). Ɍɚɤɨɠ ɭ ɩɚɰɿɽɧɬɿɜ ɡ

ȾɋɌ ɡɧɚɱɧɨ ɱɚɫɬɿɲɟ ɫɩɨɫɬɟɪɿɝɚɜɫɹ ɧɟɮɪɨɩɬɨɡ,

ɳɨ ɦɨɝɥɨ ɛɭɬɢ ɩɨɜ'ɹɡɚɧɨ ɡɿ ɫɩɨɥɭɱɧɨɬɤɚɧɢɧɧɢɦɢ

ɞɟɮɟɤɬɚɦɢ ɡɜ'ɹɡɤɨɜɨɝɨ ɚɩɚɪɚɬɭ ɧɢɪɤɢ. ȼɜɚɠɚ

-ɽɬɶɫɹ, ɳɨ ɱɚɫɬɨɬɚ ɭɪɚɠɟɧɧɹ ɜɟɪɯɧɿɯ ɫɟɱɨɜɢɯ

(5)

Ɍ ɚ ɛ ɥ ɢ ɰ ɹ 2 ɑɚɫɬɨɬɚ ɮɟɧɨɬɢɩɿɱɧɢɯ ɨɡɧɚɤ ɞɢɫɩɥɚɡɿʀ ɋɌ ɭ ɯɜɨɪɢɯ ɡ ȺȼȼȺ ɜ ɪɿɡɧɢɯ ɜɿɤɨɜɢɯ ɝɪɭɩɚɯ

ɉɨɤɚɡɧɢɤɢ Ƚɪɭɩɚ 1 _(n=39) Ƚɪɭɩɚ 2 _(n=38) Ƚɪɭɩɚ 3 _(n=40) Ƚɪɭɩɚ 4 _(n=37)

Ɉɫɨɛɥɢɜɨɫɬɿ ɲɤɿɪɢ 31 (79,5%) 35 (92,1%) 8 (20,0%) 3 (8,1%)

Ɋ1-3<0,0001, ɪ1-4<0,0001, ɪ2-3<0,0001, p2-4<0,0001

ɉɿɞɜɢɳɟɧɚ ɪɨɡɬɹɠɧɿɫɬɶ ɲɤɿɪɢ 31 (79,5%) 34 (89,5%) 7 (17,5%) 6 (16,2%)

Ɋ1-3<0,0001, ɪ1-4<0,0001, ɪ2-3<0,0001, p2-4<0,0001

Ⱥɧɨɦɚɥɿɹ ɪɭɤ 31 (79,5%) 35 (92,1%) 7 (17,5%) 5 (13,5%)

Ɋ1-3<0,0001, ɪ1-4<0,0001, ɪ2-3<0,0001, p2-4<0,0001

Ɉɡɧɚɤɚ ɡɚɩ’ɹɫɬɤɚ 27 (69,2%) 30 (78,9%) 8 (20,0%) 0 (0)

Ɋ1-3<0,0001, ɪ1-4<0,0001, ɪ2-3<0,0001, p2-4<0,0001, ɪ3-4=0,004

Ɉɡɧɚɤɚ ɜɟɥɢɤɨɝɨ ɩɚɥɶɰɹ 30 (76,9%) 32 (84,2%) 5 (12,5%) 4 (10,8%)

Ɋ1-3<0,0001, ɪ1-4<0,0001, ɪ2-3<0,0001, p2-4<0,0001

ɉɥɨɫɤɨɫɬɨɩɿɫɬɶ 21 (53,8%) 24 (63,2%) 6 (15,0%) 4 (10,8%)

Ɋ1-3<0,0001, ɪ1-4<0,0001, ɪ2-3<0,0001, p2-4<0,0001

ȼɚɪɢɤɨɡ 16 (41,0%) 19 (50,0%) 9 (22,5%) 6 (16,2%)

ɪ1-4=0,017, ɪ2-3=0,011, p2-4=0,002

ȼɢɤɪɢɜɥɟɧɧɹ ɧɨɫɨɜɨʀ ɩɟɪɟɝɨɪɨɞɤɢ 23 (59,0%) 22 (57,9%) 5 (12,5%) 6 (16,2%)

Ɋ1-3<0,0001, ɪ1-4<0,0001, ɪ2-3<0,0001, p2-4<0,0001

Ɇɿɨɩɿɹ 16 (41,0%) 22 (57,9%) 3 (7,5%) 5 (13,5%)

Ɋ1-3<0,0001, ɪ1-4=0,007, ɪ2-3<0,0001, p2-4<0,0001

ɉɿɞɜɢɜɢɯ ɤɪɢɲɬɚɥɢɤɚ 17 (43,6%) 13 (34,2%) 3 (7,5%) 0 (0)

Ɋ1-3<0,0001, ɪ1-4<0,0001, ɪ2-3=0,003, p2-4<0,0001

Ʉɚɪɿɽɫ 19 (48,7%) 18 (47,4%) 10 (25,0%) 12 (32,4%)

Ɋ1-3=0,029, ɪ2-3=0,040

Ⱦɿɚɝɨɧɚɥɶɧɚ ɛɨɪɨɡɟɧɤɚ ɧɚ ɦɨɱɰɿ ɜɭɯɚ 32 (82,1%) 31 (81,6%) 6 (15,0%) 6 (16,2%)

(6)

Ɂɧɚɱɧɚ ɱɚɫɬɨɬɚ ɜɢɹɜɥɟɧɧɹ ɨɡɧɚɤ ȾɋɌ ɭ ɯɜɨɪɢɯ ɡ ȺȼȼȺ ɦɨɥɨɞɨɝɨ ɜɿɤɭ ɞɚɽ ɩɿɞɫɬɚɜɭɩɪɢɩɭɫɤɚɬɢ ɭ ɩɚɰɿɽɧɬɿɜ ɡ ɧɚɹɜɧɿɫɬɸ ɬɚɤɨʀ ɫɢɦɩɬɨɦɚɬɢɤɢ ɦɨɠɥɢɜɿɫɬɶ ɪɨɡɜɢɬɤɭ ȺȼȼȺ ɿ ɜɢɡɧɚɱɚɽ ɧɟɨɛɯɿɞ

-ɧɿɫɬɶ ɩɪɨɜɟɞɟɧɧɹ ɞɨɞɚɬɤɨɜɨɝɨ ɭɥɶɬɪɚɡɜɭɤɨɜɨɝɨ ɞɨɫɥɿɞɠɟɧɧɹ ɫɟɪɰɹ ɿ ɚɨɪɬɢ.

ȼɿɞɨɦɨ, ɳɨ ɮɟɧɨɬɢɩɿɱɧɿ ɣ ɩɨɥɿɨɪɝɚɧɧɿ ɡɦɿɧɢ ɩɪɢ ɧɚɹɜɧɨɫɬɿ ɦɚɥɢɯ ɫɬɪɭɤɬɭɪɧɢɯ ɫɟɪɰɟɜɢɯ ɚɧɨɦɚɥɿɣ (ɩɪɨɥɚɩɫ ɦɿɬɪɚɥɶɧɨɝɨ ɤɥɚɩɚɧɚ, ɚɧɨ -ɦɚɥɶɧɿ ɯɨɪɞɢ ɬɚ ʀɯ ɩɨɽɞɧɚɧɧɹ),ɡɭɦɨɜɥɟɧɢɯ ȾɋɌ, (ɫɢɧɞɪɨɦ Ɇɚɪɮɚɧɚ, ɦɚɪɮɚɧɨɩɨɞɿɛɧɢɣ ɫɢɧɞɪɨɦ), ɫɭɩɪɨɜɨɞɠɭɸɬɶɫɹ ɞɢɫɮɭɧɤɰɿɽɸ ɜɟɝɟɬɚɬɢɜɧɨʀ ɧɟɪɜɨɜɨʀ ɫɢɫɬɟɦɢ, ɳɨ ɜɢɡɧɚɱɚɽ ɪɿɡɧɨɦɚɧɿɬɧɿɫɬɶ ɤɥɿɧɿɱɧɢɯ ɫɢɦɩɬɨɦɿɜ [2, 9].

ȱɧɮɨɪɦɚɬɢɜɧɢɦ ɤɪɢɬɟɪɿɽɦ, ɳɨ ɜɿɞɨɛɪɚɠɚɽ ɫɬɚɧ ɜɟɝɟɬɚɬɢɜɧɨʀ ɧɟɪɜɨɜɨʀ ɫɢɫɬɟɦɢ, ɽ ɜɚɪɿɚ -ɛɟɥɶɧɿɫɬɶ ɫɟɪɰɟɜɨɝɨ ɪɢɬɦɭ. Ⱦɥɹ ɹɤɿɫɧɨʀ ɬɚ ɤɿɥɶɤɿɫɧɨʀ ɨɰɿɧɤɢ ɫɬɚɧɭ ɚɜɬɨɧɨɦɧɨʀ ɧɟɪɜɨɜɨʀ ɫɢɫɬɟɦɢ, ɡɦɿɧɢ ɹɤɨʀ ɛɭɥɢ ɬɚɤ ɹɫɤɪɚɜɨ ɩɪɟɞ -ɫɬɚɜɥɟɧɿ ɤɥɿɧɿɤɨɸ ɩɚɰɿɽɧɬɿɜ ɩɟɪɟɜɚɠɧɨ 1-2 ɝɪɭɩ, ɧɚɦɢ ɩɪɨɜɟɞɟɧɨ ɜɢɡɧɚɱɟɧɧɹ ɜ ɩɨɪɿɜɧɹɥɶɧɨɦɭ ɚɫɩɟɤɬɿ ɞɨɛɨɜɨʀ ȼɋɊ. Ɂɜɚɠɚɸɱɢ ɧɚ ɬɟ, ɳɨ ɡɚɝɚɥɶɧɨɩɪɢɣɧɹɬɿ ɧɨɪɦɢ ɩɨɤɚɡɧɢɤɿɜ ɰɶɨɝɨ ɚɧɚ -ɥɿɡɭ ɡɧɚɱɧɨ ɜɚɪɿɸɸɬɶ, ɩɪɢɜ'ɹɡɚɧɿ ɹɤ ɞɨ ɜɿɤɭ,ɬɚɤ ɿ ɞɨ ɫɟɪɰɟɜɨ-ɫɭɞɢɧɧɨʀ ɩɚɬɨɥɨɝɿʀ, ɧɚɦɢ ɛɭɥɨ ɩɪɨ -ɚɧɚɥɿɡɨɜɚɧɨ ɤɨɧɬɪɨɥɶɧɭ ɝɪɭɩɭ, ɳɨ ɫɤɥɚɥɚɫɹ ɡɿ ɡɞɨɪɨɜɢɯ ɨɫɿɛ 23-53 ɪɨɤɿɜ.

Ɍ ɚ ɛ ɥ ɢ ɰ ɹ 3 ɑɚɫɬɨɬɚ ɨɡɧɚɤ ɞɢɫɩɥɚɡɿʀ ɋɌ ɡɚ ɞɚɧɢɦɢ ɞɨɞɚɬɤɨɜɢɯ ɞɨɫɥɿɞɠɟɧɶ

ɭ ɯɜɨɪɢɯ ɡ ȺȼȼȺ ɜ ɪɿɡɧɢɯ ɜɿɤɨɜɢɯ ɝɪɭɩɚɯ

Ʉɥɿɧɿɱɧɿ ɣ ɿɧɫɬɪɭɦɟɧɬɚɥɶɧɿ ɩɨɤɚɡɧɢɤɢ Ƚɪɭɩɚ 1 _(n=39) Ƚɪɭɩɚ 2 _(n=38) Ƚɪɭɩɚ 3 _(n=40) Ƚɪɭɩɚ 4 _(n=37)

ɍɁȾ ɧɢɪɨɤ,ɚɫɢɦɟɬɪɿɹ ɪɨɡɦɿɪɿɜ 16 (41,0%) 15 (39,5%) 9 (22,5%) 3 (8,1%)

ɪ1-4=0,001, p2-4=0,001

ɍɁȾ ɧɢɪɨɤ,ɨɞɧɨɛɿɱɧɢɣ ɩɬɨɡ 7 (17,9%) 10 (26,3%) 3 (7,5%) 7 (18,9%)

ɍɁȾ ɧɢɪɨɤ,ɞɜɨɛɿɱɧɢɣ ɩɬɨɡ 8 (20,5%) 4 (10,5%) 4 (10,0%) 0 (0)

ɪ1-4=0,004, ɪ2-4=0,043, p3-4=0,048

ɍɁȾ ɧɢɪɨɤ,ɨɞɧɨɛɿɱɧɚ ɝɿɩɨɩɥɚɡɿɹ 3 (7,7%) 3 (7,9%) 4 (10,0%) 1 (2,7%)

ɍɁȾ ɧɢɪɨɤ,ɩɿɞɤɨɜɨɩɨɞɿɛɧɚ ɧɢɪɤɚ 6 (15,4%) 4 (10,5%) 1 (2,5%) 1 (2,7%)

Ɋ1-3=0,044

ɍɁȾ ɧɢɪɨɤ,ɩɨɞɜɨɽɧɧɹ ɧɢɪɨɤ 1 (2,6%) 1 (2,6%) 0 (0) 0 (0)

Ⱦɨɩɩɥɟɪ ɜɟɧ ɧɿɝ,ɏȼɇ ȱ ɫɬɭɩɟɧɹ 9 (23,1%) 8 (21,1%) 5 (12,5%) 8 (21,6%)

Ⱦɨɩɩɥɟɪ ɜɟɧ ɧɿɝ,ɏȼɇ ȱȱ ɫɬɭɩɟɧɹ 10 (25,6%) 4 (10,5%) 2 (5,0%) 3 (8,1%)

Ɋ1-3=0,011, ɪ1-4=0,042

Ⱦɨɩɩɥɟɪ ɜɟɧ ɧɿɝ,ɏȼɇ ȱȱȱ ɫɬɭɩɟɧɹ 2 (5,1%) 0 (0) 1 (2,5%) 0 (0)

ɉɪɨɛɚ Ʉɨɧɱɚɥɨɜɫɶɤɨɝɨ 8 (20,5%) 7 (18,4%) 7 (17,5%) 3 (8,1%)

Ɋ1-3=0,043, ɪ1-4=0,002, ɪ2-3=0,045, ɪ2-4=0,002

ɋɢɧɞɪɨɦ Ɋɟɣɧɨ 4 (10,3%) 4 (10,5%) 3 (7,5%) 1 (2,7%)

(7)

Ⱥɧɚɥɿɡ ɜɚɪɿɚɛɟɥɶɧɨɫɬɿ ɫɟɪɰɟɜɨɝɨ ɪɢɬɦɭ ɭ ɯɜɨɪɢɯ ɡ ȺȼȼȺ ɜɢɹɜɢɜ ɞɟɹɤɿ ɜɿɞɦɿɧɧɨɫɬɿ ɩɨ -ɤɚɡɧɢɤɿɜ ɭ ɝɪɭɩɚɯ ɦɨɥɨɞɨɝɨ ɣ ɫɟɪɟɞɧɶɨɝɨ ɜɿɤɭ ɩɪɢ ɩɨɪɿɜɧɹɧɧɿ ɡɿ ɫɬɚɪɲɢɦɢ ɜɿɤɨɜɢɦɢ ɝɪɭɩɚɦɢ (ɬɚɛɥ.4).

ɉɪɢ ɚɧɚɥɿɡɿ ȼɋɊ (ɬɚɛɥ. 4.) ɭ ɩɚɰɿɽɧɬɿɜ ɡ ɩɟɪɟɜɚɠɧɨ ɞɢɫɩɥɚɫɬɢɱɧɢɦ ɝɟɧɟɡɨɦ ɚɧɟɜɪɢɡɦɢ (1-2ɝɪɭɩɢ) ɜɿɞɦɿɱɟɧɨ ɡɦɟɧɲɟɧɧɹ ɩɨɤɚɡɧɢɤɚ SDNN, ɳɨ ɯɚɪɚɤɬɟɪɢɡɭɽ ɫɭɦɚɪɧɭ ɜɚɪɿɚɛɟɥɶɧɿɫɬɶ ɫɟɪ -ɰɟɜɨɝɨ ɪɢɬɦɭ, ɧɚ 27% ɿ pNN50, ɹɤɢɣ ɜɿɞɨɛɪɚɠɚɽ ɚɤɬɢɜɧɿɫɬɶ ɩɚɪɚɫɢɦɩɚɬɢɱɧɨʀ ɥɚɧɤɢ ɜɟɝɟɬɚɬɢɜɧɨʀ ɪɟɝɭɥɹɰɿʀ, ɧɚ 31% ɩɨɪɿɜɧɹɧɨ ɡɿ ɡɞɨɪɨɜɢɦɢ ɨɫɨ -ɛɚɦɢ (ɪ<0,05),ɚ ɬɚɤɨɠ ɡɛɿɥɶɲɟɧɧɹ ɩɨɤɚɡɧɢɤɚ,ɳɨ ɯɚɪɚɤɬɟɪɢɡɭɽ ɧɢɡɶɤɿ ɱɚɫɬɨɬɢ (LFɪ), ɧɚ 13-21%, ɡɦɟɧɲɟɧɧɹ ɩɨɤɚɡɧɢɤɚ HFɪ – ɤɪɢɬɟɪɿɸ ɬɨɧɭɫɭ ɩɚɪɚɫɢɦɩɚɬɢɱɧɨʀ ɧɟɪɜɨɜɨʀ ɫɢɫɬɟɦɢ ɧɚ 13-14% ɿ ɜɿɞɩɨɜɿɞɧɨ ɡɛɿɥɶɲɟɧɧɹ ɜɿɞɧɨɲɟɧɧɹ LF/HF (ɪ<0,01) ɧɚ 32-44%, ɳɨ ɦɨɝɥɨ ɫɜɿɞɱɢɬɢ ɩɪɨ ɧɚɹɜɧɿɫɬɶ ɜɿɞɱɭɬɧɨʀ ɝɿɩɟɪɫɢɦɩɚɬɢɤɨɬɨɧɿʀ. Ɉɞɧɚɤ

ɭ ɜɫɿɯ ɝɪɭɩɚɯ ɨɛɫɬɟɠɟɧɢɯ ɩɚɰɿɽɧɬɿɜ ɡ ȺȼȼȺ,

ɚɫɨɰɿɣɨɜɚɧɨʀ ɡ ȾɋɌ, ɡɚ ɞɚɧɢɦɢ ȼɊɋ, ɛɭɥɢ

ɩɚɰɿɽɧɬɢ, ɭ ɹɤɢɯ ɡɛɟɪɿɝɚɽɬɶɫɹ ɚɛɨ ɧɚɜɿɬɶ ɡɛɿɥɶ

-ɲɭɽɬɶɫɹ ɬɨɧɭɫ ɩɚɪɚɫɢɦɩɚɬɢɱɧɨʀ ɇɋ ɩɪɢ ɧɨɪ

-ɦɚɥɶɧɨɦɭ ɚɛɨ ɧɟɡɧɚɱɧɨ ɡɛɿɥɶɲɟɧɨɦɭ ɬɨɧɭɫɿ ɫɢɦɩɚɬɢɱɧɨʀ ɇɋ.ɐɟɣ ɬɨɧɭɫ ɦɨɠɧɚ ɪɨɡɝɥɹɞɚɬɢ ɹɤ

ɤɨɦɩɟɧɫɚɬɨɪɧɢɣ ɦɟɯɚɧɿɡɦ ɞɥɹ ɩɿɞɬɪɢɦɤɢ ɜɟ

-ɝɟɬɚɬɢɜɧɨɝɨ ɛɚɥɚɧɫɭ ɧɚ ɜɢɳɨɦɭ ɪɿɜɧɿ ɚɤɬɢɜɧɨɫɬɿ ɚɜɬɨɧɨɦɧɨʀ ɧɟɪɜɨɜɨʀ ɫɢɫɬɟɦɢ ɿ ɹɤ ɮɚɤɬɨɪ, ɳɨ

ɜɢɡɧɚɱɚɽ ɨɫɨɛɥɢɜɨɫɬɿ ɩɿɞɯɨɞɭ ɞɨ ɩɪɢɡɧɚɱɟɧɧɹ ɥɿɤɭɜɚɥɶɧɨ-ɩɪɨɮɿɥɚɤɬɢɱɧɢɯ ɡɚɯɨɞɿɜ.

Ɂɦɿɧɢ ɩɨɤɚɡɧɢɤɿɜ ȼɊɋ ɭ ɝɪɭɩɿ ɯɜɨɪɢɯ ɡ ȺȼȼȺ, ɜɢɧɢɤɧɟɧɧɹ ɹɤɨʀ ɡɭɦɨɜɥɟɧɨ ɝɿɩɟɪɬɨɧɿɱɧɨɸ ɯɜɨ -ɪɨɛɨɸ ɚɛɨ ɚɬɟɪɨɫɤɥɟɪɨɡɨɦ, ɫɭɬɬɽɜɨ ɧɟ ɜɿɞɪɿɡ -ɧɹɥɢɫɹ ɜɿɞ ɩɨɤɚɡɧɢɤɿɜ ɯɜɨɪɢɯ ɡ ȾɋɌ, ɨɞɧɚɤ ɜɿɞɦɿɱɚɥɚɫɹ ɛɿɥɶɲ ɜɢɪɚɠɟɧɚ ɬɟɧɞɟɧɰɿɹ ɞɨ ɚɤ -ɬɢɜɚɰɿʀ ɫɢɦɩɚɬɢɱɧɨʀ ɿ ɡɧɢɠɟɧɧɹ ɬɨɧɭɫɭ ɩɚɪɚ -ɫɢɦɩɚɬɢɱɧɨʀ ɧɟɪɜɨɜɨʀ ɫɢɫɬɟɦɢ, ɩɪɨ ɳɨ ɫɜɿɞɱɢɬɶ ɞɨɫɬɨɜɿɪɧɟ ɡɛɿɥɶɲɟɧɧɹ ɩɨɤɚɡɧɢɤɚ LFp ɿ ɩɨɦɿɪɧɟ ɡɦɟɧɲɟɧɧɹ ɬɚɤɢɯ ɱɢɧɧɢɤɿɜ,ɹɤ pNN50% ɿ HFp ɩɪɢ ɡɦɟɧɲɟɧɧɿ ɩɨɤɚɡɧɢɤɚ ɫɭɦɚɪɧɨʀ ȼɋɊ (SDNN) [7].

Ɍ ɚ ɛ ɥ ɢ ɰ ɹ 4 ɉɨɤɚɡɧɢɤɢ ɜɚɪɿɚɛɟɥɶɧɨɫɬɿ ɫɟɪɰɟɜɨɝɨ ɪɢɬɦɭ ɭ ɯɜɨɪɢɯ ɡ ȺȼȼȺ ɜ ɪɿɡɧɢɯ ɜɿɤɨɜɢɯ ɝɪɭɩɚɯ

ɉɨɤɚɡɧɢɤ Ʉɨɧɬɪɨɥɶ (n=30) Ƚɪɭɩɚ 1(n=39) Ƚɪɭɩɚ 2(n=38) Ƚɪɭɩɚ 3(n=40) Ƚɪɭɩɚ 4(n=37)

SDNN, ɦɫ 59,5 (55,5; 69,0) 43 (40; 46) 43 (39; 46) 40 (36; 44) 38 (36; 44)

ɪ1,2,3,4<0,0001, ɪ1-3<0,0001, ɪ1-4<0,0001, ɪ2-3<0,0001, p2-4<0,0001

LFp,ɦɫ2 _{(1139,3; 1187,3)}1167,5 _{( (1290; 1390)}1317 _{(1310; 1450)}1415 _{(1350; 1470)}1420 _{(1350; 1450)}1420

ɪ1,2,3,4<0,0001, ɪ1-2=0,012, ɪ1-3=-0,002, ɪ1-4=0,004

RNSSD, ɦɫ 49,5 (46,3; 53,8) 36 (35; 41) 38 (34; 40) 38 (35; 40) 38 (36; 40)

ɪ1,2,3,4<0,0001

HFp, ɦɫ2 _{612,5(609,3; 635,5)} _{533(500; 567)} _{525 (511; 540)} _{522 (511; 549)} _{516 (509; 540)}

ɪ1,2,3,4<0,0001

pNN50,% 45,5(39,5; 49,0) 31 (29; 33) 32 (28; 34) 30 (28; 34) 29 (28; 34)

ɪ1,2,3,4<0,0001

LF/HF 1,90 (1,83; 1,93) 2,5 (2,3; 2,8) 2,7 (2,4; 2,8) 2,7 (2,4; 2,9) 2,7 (2,5; 2,8)

Ɍɚɤɢɦ ɱɢɧɨɦ, ɭ ɯɜɨɪɢɯ ɡ ȺȼȼȺ ɫɩɨɫɬɟ -ɪɿɝɚɥɨɫɶ ɩɨɪɭɲɟɧɧɹ ɜɟɝɟɬɚɬɢɜɧɨɝɨ ɛɚɥɚɧɫɭ,ɩɟɪɟ -ɜɚɠɧɨ ɜ ɛɿɤ ɝɿɩɟɪɫɢɦɩɚɬɢɤɨɬɨɧɿʀ. ɍ ɜɢɧɢɤɧɟɧɧɿ

(8)

ɜɟɝɟɬɨɫɭɞɢɧɧɚ ɞɢɫɬɨɧɿɹ, ɚɫɨɰɿɣɨɜɚɧɚ ɬɚ ɭɫɩɚɞ -ɤɨɜɚɧɚ ɡ ȾɋɌ.ɍ ɯɜɨɪɢɯ ɫɬɚɪɲɢɯ ɜɿɤɨɜɢɯ ɝɪɭɩ,ɞɟ ɨɫɧɨɜɧɢɦ ɮɚɤɬɨɪɨɦ ȺȼȼȺ ɛɭɥɢ ɚɪɬɟɪɿɚɥɶɧɚ ɝɿɩɟɪɬɟɧɡɿɹ ɬɚ ɚɬɟɪɨɫɤɥɟɪɨɡ, ɡɦɿɧɢ ɜɟɝɟɬɚɬɢɜɧɨɝɨ ɛɚɥɚɧɫɭ ɚɫɨɰɿɸɜɚɥɢɫɹ ɡ ɨɪɝɚɧɿɱɧɨɸ ɩɚɬɨɥɨɝɿɽɸ ɫɟɪɰɟɜɨ-ɫɭɞɢɧɧɨʀ ɫɢɫɬɟɦɢ.

Ɂ ɦɟɬɨɸ ɡ'ɹɫɭɜɚɧɧɹ ɡɜ'ɹɡɤɭ ɦɿɠ ɜɿɤɨɦ, ɧɚɹɜ

-ɧɿɫɬɸ ȺȼȼȺ ɣ ɨɡɧɚɤɚɦɢ ɫɩɨɥɭɱɧɨɬɤɚɧɢɧɧɨʀ ɞɢɫɩɥɚɡɿʀ, ɦɢ ɩɪɨɜɟɥɢ ɤɨɪɟɥɹɰɿɣɧɢɣ ɚɧɚɥɿɡ ɡ

ɜɢɤɨɪɢɫɬɚɧɧɹɦ ɤɨɟɮɿɰɿɽɧɬɚ ɋɩɿɪɦɟɧɚ. ɍ ɦɚɬ

-ɪɢɰɸ ɛɭɥɢ ɜɤɥɸɱɟɧɿ 24 ɩɨɤɚɡɧɢɤɢ (ɬɚɛɥ. 5).

Ɍ ɚ ɛ ɥ ɢ ɰ ɹ 5 ȼɡɚɽɦɨɡɜ’ɹɡɨɤ ɦɿɠ ɜɿɤɨɦ ɩɚɰɿɽɧɬɿɜ ɡ ɚɧɟɜɪɢɡɦɨɸ ɚɨɪɬɢ ɣ ɚɧɬɪɨɩɨɦɟɬɪɢɱɧɢɦɢ

ɩɨɤɚɡɧɢɤɚɦɢ ɬɚ ɨɡɧɚɤɚɦɢ ɫɩɨɥɭɱɧɨɬɤɚɧɢɧɧɨʀ ɞɢɫɩɥɚɡɿʀ

Ɋɚir of Variables

(n=154) S pearmen (R) T (N-2) p-value

ȼɚɝɚ,ɤɝ 0,38 4,99 0,000002

Ɂɪɿɫɬ,ɫɦ -0,35 -4,65 0,000007

Ʉɨɪɿɧɶ ɚɨɪɬɢ,ɦɦ -0,52 -7,49 0,000000

Ⱥɨɪɬɚ ɜɢɫɯɿɞɧɚ,ɦɦ 0,66 11,03 0,000000

ɋɬɭɩɿɧɶ ɩɪɨɥɚɩɫɭ ɦɿɬɪɚɥɶɧɨɝɨ ɤɥɚɩɚɧɭ -0,60 -9,16 0,000000 ɋɬɭɩɿɧɶ ɦɿɬɪɚɥɶɧɨʀ ɪɟɝɭɪɝɿɬɚɰɿʀ -0,28 -3,64 0,0003 ɋɬɭɩɿɧɶ ɚɨɪɬɚɥɶɧɨʀ ɪɟɝɭɪɝɿɬɚɰɿʀ -0,39 -5,18 0,000001

ɋɢɧɞɪɨɦ Ɇɚɪɮɚɧɚ -0,23 -2,89 0,004

Ⱥɫɬɟɧɿɱɧɢɣ ɬɢɩ -0,33 -4,34 0,00003

Ƚɿɩɟɪɫɬɟɧɿɱɧɢɣ ɬɢɩ 0,37 4,94 0,000002

Ⱦɟɮɿɰɢɬ ɜɚɝɢ -0,63 -10,21 0,000000

ɉɨɪɭɲɟɧɧɹ ɩɨɫɬɚɜɢ -0,64 -10,27 0,000000

Ƚɿɩɟɪɦɨɛɿɥɶɧɿɫɬɶ ɫɭɝɥɨɛɿɜ -0,55 -8,15 0,000000

Ƚɿɩɨɬɪɨɮɿɹ ɦɹɡɿɜ -0,46 -6,47 0,000000

Ⱦɟɮɨɪɦɚɰɿɹ ɝɪ.ɤɥɿɬɤɢ -0,45 -6,26 0,000000

ɋɤɨɥɿɨɡ -0,48 -6,82 0,000000

Ɉɫɨɛɥɢɜɨɫɬɿ ɲɤɿɪɢ -0,58 -8,94 0,000000

ɉɿɞɜɢɳɟɧɚ ɪɨɡɬɹɝ.ɲɤɿɪɢ -0,56 -8,45 0,000000

Ⱥɧɨɦɚɥɿɹ ɪɭɤ -0,58 -8,78 0,000000

Ɉɡɧɚɤɚ ɡɚɩɹɫɬɤɚ -0,58 -8,79 0,000000

Ɉɡɧɚɤɚ ɜɟɥɢɤɨɝɨ ɩɚɥɶɰɹ -0,59 -9,12 0,000000

ɉɥɨɫɤɨɫɬɨɩɿɫɬɶ -0,40 -5,45 0,000000

ȼɚɪɢɤɨɡɧɟ ɪɨɡɲɢɪɟɧɧɹ ɜɟɧ ɧɿɝ -0,26 -3,26 0,001 Ⱦɨɩɩɥɟɪ ɜɟɧ ɧɿɝ:ɫɬɚɞɿɹ ɏȼɇ -0,20 -2,57 0,010 ȼɢɤɪɢɜɥɟɧɧɹ ɧɨɫɨɜɨʀ ɩɟɪɟɝɨɪɨɞɤɢ -0,39 -5,26 0,000000

Ɇɿɨɩɿɹ -0,31 -4,10 0,00006

ɉɿɞɜɢɜɢɯ ɤɪɢɲɬɚɥɢɤɚ -0,43 -5,90 0,000000

Ƚɿɩɨɦɚɫɬɿɹ ɭ ɠɿɧɨɤ -0,18 -2,36 0,019

Ʉɚɪɿɽɫ -0,18 -2,27 0,024

Ⱦɿɚɝɨɧɚɥɶɧɚ ɛɨɪɨɡɟɧɤɚ ɜɭɯɚ -0,56 -8,46 0,000000

ɑɋɋ -0,37 -4,96 0,000002

ɍɁȾ ɚɫɢɦɟɬɪɿɹ ɪɨɡɦɿɪɿɜ ɧɢɪɨɤ -0,27 -3,57 0,0004 ɍɁȾ ɞɜɨɛɿɱɧɢɣ ɩɬɨɡ ɧɢɪɨɤ -0,23 -2,97 0,003

(9)

əɤ ɜɢɞɧɨ ɡ ɞɚɧɢɯ ɬɚɛɥɢɰɿ 5, ɞɨɫɢɬɶ ɜɢɫɨɤɢɣ

ɫɬɭɩɿɧɶ ɡɜ'ɹɡɤɭ (Rsp > 0,50) ɛɭɜ ɜɫɬɚɧɨɜɥɟɧɢɣ

ɦɿɠ ɜɿɤɨɦ ɩɚɰɿɽɧɬɿɜ ɿ ɫɬɭɩɟɧɟɦ ɪɨɡɲɢɪɟɧɧɹ ɜɢɫɯɿɞɧɨɝɨ ɜɿɞɞɿɥɭ ɚɨɪɬɢ, ɩɨɪɭɲɟɧɧɹɦ ɩɨɫɬɚɜɢ,

ɞɟɮɿɰɢɬɨɦ ɦɚɫɢ ɬɿɥɚ, ɫɬɭɩɟɧɟɦ ɩɪɨɥɚɩɫɭ ɦɿɬ

-ɪɚɥɶɧɨɝɨ ɤɥɚɩɚɧɚ,ɫɢɦɩɬɨɦɚɦɢ ɜɟɥɢɤɨɝɨ ɩɚɥɶɰɹ ɿ

ɡɚɩ'ɹɫɬɹ, ɚɧɨɦɚɥɿɽɸ ɪɭɤ, ɩɿɞɜɢɳɟɧɨɸ ɪɨɡɬɹɠ

-ɧɿɫɬɸ ɲɤɿɪɢ, ɞɿɚɝɨɧɚɥɶɧɨɸ ɛɨɪɨɡɟɧɤɨɸ ɜɭɯɚ,

ɝɿɩɟɪɦɨɛɿɥɶɧɿɫɬɸ ɫɭɝɥɨɛɿɜ, ɲɢɪɢɧɨɸ ɤɨɪɟɧɹ

ɚɨɪɬɢ (ɪɨɡɩɨɞɿɥ ɩɨɤɚɡɧɢɤɿɜ ɡɚ ɫɬɭɩɟɧɟɦ ɡɦɟɧ

-ɲɟɧɧɹ ɤɨɟɮɿɰɿɽɧɬɚ ɋɩɿɪɦɟɧɚ).

Ɇɨɠɧɚ ɜɜɚɠɚɬɢ, ɳɨ ɜ ɪɿɡɧɢɯ ɜɿɤɨɜɢɯ ɝɪɭɩɚɯ

ɨɡɧɚɤɢ, ɹɤɿ ɚɫɨɰɿɸɸɬɶɫɹ ɡ ɚɧɟɜɪɢɡɦɨɸ ɚɨɪɬɢ,

ɛɭɞɭɬɶ ɜɿɞɪɿɡɧɹɬɢɫɹ. Ⱦɥɹ ɭɬɨɱɧɟɧɧɹ ɫɢɥɢ ɜɩɥɢɜɭ

ɪɿɡɧɢɯ ɨɡɧɚɤ ɦɢ ɩɪɨɜɟɥɢ ɦɧɨɠɢɧɧɢɣ ɥɿɧɿɣɧɢɣ

ɪɟɝɪɟɫɿɣɧɢɣ ɚɧɚɥɿɡ (ɦɨɞɭɥɶ "MultipleRegression).

Ⱦɥɹ ɫɬɚɬɢɫɬɢɱɧɨʀ ɯɚɪɚɤɬɟɪɢɫɬɢɤɢ ɨɤɪɟɦɢɯ ɱɢɧɧɢɤɿɜ (ɧɟɡɚɥɟɠɧɢɯ ɩɪɟɞɢɤɬɨɪɿɜ) ɜɢɤɨɪɢɫ -ɬɨɜɭɜɚɥɢ ɛɟɬɚ-ɤɨɟɮɿɰɿɽɧɬ (ȼȿɌȺ),ɹɤɢɣ ɩɨɤɚɡɭɜɚɜ ɫɢɥɭ ɜɩɥɢɜɭ ɱɢɧɧɢɤɚ ɧɚ ɜɢɯɿɞɧɢɣ ɩɚɪɚɦɟɬɪ ɬɚ ɯɚɪɚɤɬɟɪ ɰɶɨɝɨ ɜɩɥɢɜɭ (ɩɨɡɢɬɢɜɧɢɣ ȼȿɌȺ ɫɜɿɞ -ɱɢɜ ɩɪɨ ɩɪɹɦɢɣ ɿ ɧɟɝɚɬɢɜɧɢɣ – ɩɪɨ ɡɜɨɪɨɬɧɿɣ ɡɜ'ɹɡɨɤ).

ȼɢɜɱɟɧɧɹ ɚɫɨɰɿɚɬɢɜɧɨɝɨ ɡɜ'ɹɡɤɭ ɧɚɹɜɧɨɫɬɿ

ɚɧɟɜɪɢɡɦɢ ɚɨɪɬɢ ɡ ɨɡɧɚɤɚɦɢ ɫɩɨɥɭɱɧɨɬɤɚɧɢɧɧɨʀ ɞɢɫɩɥɚɡɿʀ ɿ ɤɪɢɬɟɪɿɹɦɢ ɫɬɪɭɤɬɭɪɧɨ-ɮɭɧɤɰɿɨɧɚɥɶ

-ɧɨɝɨ ɫɬɚɧɭ ɦɿɨɤɚɪɞɚ ɡ ɨɰɿɧɤɨɸ ʀɯ ɜɧɟɫɤɭ ɿ ɜɢɞɿ

-ɥɟɧɧɹ ɧɚɣɛɿɥɶɲ ɿɧɮɨɪɦɚɬɢɜɧɢɯ ɩɨɤɚɡɧɢɤɿɜ ɧɚɦɢ ɩɪɨɜɟɞɟɧɨ ɜ ɪɿɡɧɢɯ ɜɿɤɨɜɢɯ ɝɪɭɩɚɯ (ɬɚɛɥɢɰɿ 6-9).

Ɍ ɚ ɛ ɥ ɢ ɰ ɹ 6 Ⱥɫɨɰɿɚɬɢɜɧɢɣ ɡɜ'ɹɡɨɤ ɚɧɟɜɪɢɡɦɢ ɜɢɫɯɿɞɧɨʀ ɚɨɪɬɢ ɡ ɨɡɧɚɤɚɦɢ ɫɩɨɥɭɱɧɨɬɤɚɧɢɧɧɨʀ ɞɢɫɩɥɚɡɿʀɿ ɫɬɪɭɤɬɭɪɧɨ-ɮɭɧɤɰɿɨɧɚɥɶɧɨɝɨ ɫɬɚɧɭ ɥɿɜɨɝɨ ɲɥɭɧɨɱɤɚ ɜ 1-ɣ ɜɿɤɨɜɿɣ ɝɪɭɩɿ

ɇɟɡɚɥɟɠɧɿ ɱɢɧɧɢɤɢ BETA p-level _{ɜɩɥɢɜɭ (%)}ɋɢɥɚ Ʉɪɢɬɢɱɧɚ_{ɜɟɥɢɱɢɧɚ}

ɋɬɭɩɿɧɶ ɩɪɨɥɚɩɫɭ ɆɄ 0,52 0,00000 46 2

ɇɚɹɜɧɿɫɬɶ ɞɟɮɿɰɢɬɭ ɦɚɫɢ ɬɿɥɚ 0,12 0,028 11 - ɇɚɹɜɧɿɫɬɶ ɞɨɞɚɬɤɨɜɨʀ ɯɨɪɞɢ Ʌɒ 0,22 0,003 19

-Ⱦɿɚɝɨɧɚɥɶɧɚ ɛɨɪɨɡɧɚ ɦɨɱɤɢ ɜɭɯɚ 0,19 0,015 17 - ɋɬɚɞɿɹ ɯɪɨɧɿɱɧɨʀ ɜɟɧɨɡɧɨʀ ɧɟɞɨɫɬɚɬɧɨɫɬɿ

ɡɚ ɞɚɧɢɦɢ ɞɨɩɩɥɟɪ-ȿɯɨɄȽ 0,09 0,05 7 1

ɉ ɪ ɢ ɦ ɿ ɬ ɤ ɚ. ȱɧɮɨɪɦɚɬɢɜɧɿɫɬɶ ɪɟɝɪɟɫɿɣɧɨɝɨ ɚɧɚɥɿɡɭ ɨɰɿɧɸɜɚɥɢ ɡɚ ɞɨɩɨɦɨɝɨɸ ɪɨɡɪɚɯɭɧɤɭ ɤɨɟɮɿɰɿɽɧɬɭ ɦɧɨɠɢɧɧɨʀ ɪɟɝɪɟɫɿʀ(ɤɨɟɮɿɰɿɽɧɬɭ

ɞɟɬɟɪɦɿɧɚɰɿʀ - RI),ɚɞɟɤɜɚɬɧɿɫɬɶ - ɡɚ ɞɨɩɨɦɨɝɨɸ ɚɧɚɥɿɡɭ ɡɚɥɢɲɤɿɜ(ResidualAnalysis)ɿɡ ɪɨɡɪɚɯɭɧɤɨɦ ɮɚɤɬɢɱɧɨɝɨ ɡɧɚɱɟɧɧɹ ɤɪɢɬɟɪɿɸ Ɏɿɲɟɪɚ (F-ɤɪɢɬɟɪɿɸ)ɿ ɪɿɜɧɹ ɡɧɚɱɭɳɨɫɬɿ(ɪ-level) – RI = 0,69; F(4,15)=30,30, p<0,00000, Std.errrorofestimate – 0,32.

əɤ ɜɢɞɧɨ ɡ ɞɚɧɢɯ ɬɚɛɥɢɰɿ 6, ɭ ɩɚɰɿɽɧɬɿɜ ɦɨɥɨɞɨɝɨ ɜɿɤɭ ɱɢɧɧɢɤɚɦɢ, ɳɨ ɜɩɥɢɜɚɸɬɶ ɧɚ ɜɢɧɢɤɧɟɧɧɹ ɚɧɟɜɪɢɡɦɢ ɚɨɪɬɢ,ɛɭɥɢ ɞɢɫɩɥɚɫɬɢɱɧɿ ɩɪɨɰɟɫɢ ɫɩɨɥɭɱɧɨʀ ɬɤɚɧɢɧɢ ɿ ɜ ɩɟɪɲɭ ɱɟɪɝɭ ɫɬɪɭɤɬɭɪ ɫɟɪɰɹ - ɜɢɪɚɠɟɧɿɫɬɶ ɩɪɨɥɚɩɫɭ ɦɿɬɪɚɥɶ -ɧɨɝɨ ɤɥɚɩɚɧɚ ɿ ɧɚɹɜɧɿɫɬɶ ɞɨɞɚɬɤɨɜɢɯ ɯɨɪɞ Ʌɒ. ɉɟɜɧɟ ɡɧɚɱɟɧɧɹ ɦɚɥɢ ɩɪɨɹɜɢ ɫɢɫɬɟɦɧɨʀ ɫɩɨɥɭɱ -ɧɨɬɤɚɧɢɧɧɨʀ ɞɢɫɩɥɚɡɿʀ, ɚ ɫɚɦɟ:ɞɿɚɝɨɧɚɥɶɧɚ ɛɨɪɨ -ɡɟɧɤɚ ɦɨɱɤɢ ɜɭɯɚ, ɞɟɮɿɰɢɬ ɦɚɫɢ ɬɿɥɚ ɿ ɫɬɚɞɿɹ ɯɪɨɧɿɱɧɨʀ ɜɟɧɨɡɧɨʀ ɧɟɞɨɫɬɚɬɧɨɫɬɿ. Ɉɫɤɿɥɶɤɢ ɫɬɪɭɤɬɭɪɧɿ ɡɦɿɧɢ ɦɿɨɤɚɪɞɚ ɜ ɨɫɿɛ ɰɿɽʀ ɜɿɤɨɜɨʀ

ɝɪɭɩɢ ɛɭɥɢ ɦɚɥɨ ɜɢɪɚɠɟɧɿ, ɫɢɥɚ ʀɯ ɜɩɥɢɜɭ ɧɚ ɜɢɧɢɤɧɟɧɧɹ ȺȼȼȺ ɛɭɥɚ ɧɟɡɧɚɱɧɨɸ ɿ ɬɨɦɭ ɧɟ ɡɧɚɣɲɥɚ ɜɿɞɨɛɪɚɠɟɧɧɹ ɜ ɬɚɛɥɢɰɿ.

ɍ ɞɪɭɝɿɣ ɜɿɤɨɜɿɣ ɝɪɭɩɿ ɡɦɟɧɲɭɽɬɶɫɹ ɫɢɥɚ ɜɩɥɢɜɭ ɫɟɪɰɟɜɨʀ ɫɩɨɥɭɱɧɨɬɤɚɧɢɧɧɨʀ ɞɢɫɩɥɚɡɿʀ, ɡɛɟɪɿɝɚɽɬɶɫɹ ɪɨɥɶ ɫɢɫɬɟɦɧɨʀ ɞɢɫɩɥɚɡɿʀ, ɩɪɨ ɳɨ ɫɜɿɞɱɢɜ ɚɫɨɰɿɚɬɢɜɧɢɣ ɡɜ'ɹɡɨɤ ȺȼȼȺ ɡ ɝɿɩɟɪ -ɦɨɛɿɥɶɧɿɫɬɸ ɫɭɝɥɨɛɿɜ, ɨɫɨɛɥɢɜɨɫɬɹɦɢ ɲɤɿɪɢ, ʀʀ ɩɿɞɜɢɳɟɧɨɸ ɪɨɡɬɹɠɧɿɫɬɸ, ɧɚɹɜɧɿɫɬɸ ɦɿɨɩɿʀ. Ɉɞ -ɧɚɤ ɭ ɰɿɣ ɝɪɭɩɿ ɩɨɱɢɧɚɽ ɩɪɨɝɥɹɞɚɬɢɫɹ ɡɜ'ɹɡɨɤ ȺȼȼȺ ɡ ɦɚɫɨɸ ɦɿɨɤɚɪɞɚ Ʌɒ (ɬɚɛɥ. 7).

Ɍ ɚ ɛ ɥ ɢ ɰ ɹ 7 Ⱥɫɨɰɿɚɬɢɜɧɢɣ ɡɜ'ɹɡɨɤ ɚɧɟɜɪɢɡɦɢ ɜɢɫɯɿɞɧɨʀ ɚɨɪɬɢ ɡ ɨɡɧɚɤɚɦɢ ɫɩɨɥɭɱɧɨɬɤɚɧɢɧɧɨʀ ɞɢɫɩɥɚɡɿʀ ɬɚ ɫɬɪɭɤɬɭɪɧɨ-ɮɭɧɤɰɿɨɧɚɥɶɧɨɝɨ ɫɬɚɧɭ ɥɿɜɨɝɨ ɲɥɭɧɨɱɤɚ ɜ 2-ɣ ɜɿɤɨɜɿɣ ɝɪɭɩɿ

ɇɟɡɚɥɟɠɧɿ ɱɢɧɧɢɤɢ BETA p-level _{ɜɩɥɢɜɭ (%)}ɋɢɥɚ Ʉɪɢɬɢɱɧɚ_{ɜɟɥɢɱɢɧɚ}

ɇɚɹɜɧɿɫɬɶ ɝɿɩɟɪɦɨɛɿɥɶɧɨɫɬɿ ɫɭɝɥɨɛɿɜ 0,21 0,016 21 - ɇɚɹɜɧɿɫɬɶ ɲɤɿɪɧɢɯ ɨɡɧɚɤ (ɨɫɨɛɥɢɜɿɫɬɶ ɲɤɿɪɢ) 0,18 0,048 18 -

ɉɿɞɜɢɳɟɧɚ ɪɨɡɬɹɠɢɦɿɫɬɶ ɲɤɿɪɢ 0,21 0,016 21 -

ɇɚɹɜɧɿɫɬɶ ɦɿɨɩɿʀ 0,17 0,015 17 -

ȼɟɥɢɱɢɧɚ ɆɆɅɒ ɜ ɝ -0,21 0,001 21 <235

(10)

ȼ ɨɫɿɛ ɫɟɪɟɞɧɶɨɝɨ ɜɿɤɭ (3-ɬɹ ɝɪɭɩɚ) ɧɚɣɛɿɥɶ

-ɲɨɸ ɫɢɥɨɸ ɜɩɥɢɜɭ ɧɚ ɜɢɧɢɤɧɟɧɧɹ ȺȺ ɦɚɥɢ ɩɨ

-ɤɚɡɧɢɤɢ ɫɬɪɭɤɬɭɪɧɨɝɨ ɫɬɚɧɭ ɦɿɨɤɚɪɞɚ: ɫɬɭɩɿɧɶ

ɚɨɪɬɚɥɶɧɨɝɨ ɫɬɟɧɨɡɭ, ɬɨɜɳɢɧɚ ɦɿɠɲɥɭɧɨɱɤɨɜɨʀ

ɩɟɪɟɝɨɪɨɞɤɢ, ɜɿɞɧɨɫɧɚ ɬɨɜɳɢɧɚ ɫɬɿɧɨɤ Ʌɒ

(ɬɚɛɥ. 8).

Ɍ ɚ ɛ ɥ ɢ ɰ ɹ 8 Ⱥɫɨɰɿɚɬɢɜɧɢɣ ɡɜ'ɹɡɨɤ ɚɧɟɜɪɢɡɦɢ ɜɢɫɯɿɞɧɨʀ ɚɨɪɬɢ ɡ ɨɡɧɚɤɚɦɢ ɫɩɨɥɭɱɧɨɬɤɚɧɢɧɧɨʀ ɞɢɫɩɥɚɡɿʀ ɿ ɫɬɪɭɤɬɭɪɧɨ-ɮɭɧɤɰɿɨɧɚɥɶɧɨɝɨ ɫɬɚɧɭ ɥɿɜɨɝɨ ɲɥɭɧɨɱɤɚ ɜ 3-ɣ ɜɿɤɨɜɿɣ ɝɪɭɩɿ

ɇɟɡɚɥɟɠɧɿ ɱɢɧɧɢɤɢ BETA p-level _{ɜɩɥɢɜɭ (%)}ɋɢɥɚ Ʉɪɢɬɢɱɧɚ ɜɟɥɢɱɢɧɚ

ɋɬɭɩɿɧɶ ɚɨɪɬɚɥɶɧɨɝɨ ɫɬɟɧɨɡɭ 0,29 0,0001 40 1

ɌɆɒɉ ɜ ɦɦ 0,22 0,003 30 >10

ȼɌɋ 0,22 0,003 30 > 0,37

ɉ ɪ ɢ ɦ ɿ ɬ ɤ ɢ: RI = 0,44; F(3,15)=12,19, p<0,00000, Std.errorofestimate – 0,40.

ȼ ɨɫɿɛ ɩɨɯɢɥɨɝɨ ɜɿɤɭ, ɬɚɤ ɫɚɦɨ ɹɤ ɿ ɜ ɩɨɩɟ

-ɪɟɞɧɿɣ ɝɪɭɩɿ, ɧɚɣɛɿɥɶɲɨɸ ɛɭɥɚ ɫɢɥɚ ɜɩɥɢɜɭ

ɫɬɪɭɤɬɭɪɧɢɯ ɩɨɤɚɡɧɢɤɿɜ, ɨɞɧɚɤ ɞɨɫɢɬɶ ɜɟɥɢɤɭ

ɫɢɥɭ ɜɩɥɢɜɭ ɧɚɛɭɜɚɽ ɩɨɤɚɡɧɢɤ ɮɭɧɤɰɿɨɧɚɥɶɧɨɝɨ ɫɬɚɧɭ ɦɿɨɤɚɪɞɚ - Ɏȼ Ʌɒ (ɬɚɛɥ. 9).

Ɍ ɚ ɛ ɥ ɢ ɰ ɹ 9 Ⱥɫɨɰɿɚɬɢɜɧɢɣ ɡɜ'ɹɡɨɤ ɚɧɟɜɪɢɡɦɢ ɜɢɫɯɿɞɧɨʀ ɚɨɪɬɢ ɡ ɨɡɧɚɤɚɦɢ ɫɩɨɥɭɱɧɨɬɤɚɧɢɧɧɨʀ

ɞɢɫɩɥɚɡɿʀ ɿ ɫɬɪɭɤɬɭɪɧɨ-ɮɭɧɤɰɿɨɧɚɥɶɧɨɝɨ ɫɬɚɧɭ Ʌɒ ɜ 4-ɣ ɜɿɤɨɜɿɣ ɝɪɭɩɿ

ɇɟɡɚɥɟɠɧɿ ɱɢɧɧɢɤɢ BETA p-level _{ɜɩɥɢɜɭ (%)}ɋɢɥɚ Ʉɪɢɬɢɱɧɚ ɜɟɥɢɱɢɧɚ

ɋɬɭɩɿɧɶ ɦɿɬɪɚɥɶɧɨʀ ɪɟɝɭɪɝɿɬɚɰɿʀ 0,10 0,05 11 > 1

Ɇɚɫɚ ɦɿɨɤɚɪɞɚ Ʌɒ ɜ ɝ 0,17 0,019 19 > 270

Ⱥɨɪɬɚ ɜɢɫɯɿɞɧɚ ɜ ɦɦ 0,43 0,00000 47 > 47 Ɏɪɚɤɰɿɹ ɜɢɤɢɞɭ ɜ % -0,21 0,007 23 < 46

ɉ ɪ ɢ ɦ ɿ ɬ ɤ ɢ: RI = 0,57; F(3,15)=19,21, p<0,00000, Std. ɟrrorofestimate – 0,37.

ȼɂɋɇɈȼɄɂ

1. Ɋɿɡɧɿ ɜɿɤɨɜɿ ɝɪɭɩɢ ɜɿɞɪɿɡɧɹɸɬɶɫɹ ɡɚ ɫɢɥɨɸ ɜɩɥɢɜɭ ɪɿɡɧɢɯ ɮɚɤɬɨɪɿɜ ɧɚ ɧɚɹɜɧɿɫɬɶ ȺȼȼȺ. Ɇɧɨɠɢɧɧɢɣ ɪɟɝɪɟɫɿɣɧɢɣ ɚɧɚɥɿɡ ɩɿɞɬɜɟɪɞɢɜ,ɳɨ ɭ ɩɚɰɿɽɧɬɿɜ ɦɨɥɨɞɨɝɨ ɜɿɤɭ ɧɚɹɜɧɿɫɬɶ ȺȺ ɚɫɨɰɿɸɽɬɶ-ɫɹ ɡ ɜɢɪɚɠɟɧɿɫɬɸ ɫɟɪɰɟɜɨʀ ɬɚ ɫɢɫɬɟɦɧɨʀ ɫɩɨ-ɥɭɱɧɨɬɤɚɧɢɧɧɨʀ ɞɢɫɩɥɚɡɿʀ.ɍ ɯɜɨɪɢɯ ɞɪɭɝɨʀ ɝɪɭɩɢ ɡɛɟɪɿɝɚɽɬɶɫɹ ɪɨɥɶ ɫɢɫɬɟɦɧɢɯ ɫɩɨɥɭɱɧɨɬɤɚɧɢɧɧɢɯ ɞɢɫɩɥɚɫɬɢɱɧɢɯ ɡɦɿɧ, ɨɞɧɚɤ ɩɨɱɢɧɚɽ ɜɿɞɿɝɪɚɜɚɬɢ ɿɫɬɨɬɧɭ ɪɨɥɶ ɿ ȽɅɒ ɡ ɤɪɢɬɢɱɧɨɸ ɜɟɥɢɱɢɧɨɸ ɦɿɨɤɚɪɞɚ ɜ 235 ɝ.ɍ ɯɜɨɪɢɯ 3-ʀ ɝɪɭɩɢ ɡɪɨɫɬɚɽ ɪɨɥɶ ɝɿɩɟɪɬɪɨɮɿʀ Ʌɒ, ɩɪɨ ɳɨ ɫɜɿɞɱɢɬɶ ɚɫɨɰɿɚɰɿɹ ɡɿ ɡɛɿɥɶɲɟɧɧɹɦ ɌɆɒɉ ɿ ȼɌɋ.Ⱥɫɨɰɿɚɰɿɹ ɚɧɟɜɪɢɡɦɢ ɚɨɪɬɢ ɡɿ ɫɬɪɭɤɬɭɪɧɢɦɢ ɿ ɮɭɧɤɰɿɨɧɚɥɶɧɢɦɢ ɡɦɿ -ɧɚɦɢ ɦɿɨɤɚɪɞɚ ɧɚɣɱɿɬɤɿɲɟ ɜɢɪɚɠɟɧɚ ɭ ɥɿɬɧɿɯ ɩɚɰɿɽɧɬɿɜ.

2. ȼɫɬɚɧɨɜɥɟɧɨ ɞɨɫɢɬɶ ɜɢɫɨɤɢɣ ɫɬɭɩɿɧɶ ɡɜ'ɹɡɤɭ (R>0,50) ɦɿɠ ɜɿɤɨɦ ɩɚɰɿɽɧɬɿɜ ɿ ɫɬɭɩɟɧɟɦ ɪɨɡ -ɲɢɪɟɧɧɹ ɜɢɫɯɿɞɧɨɝɨ ɜɿɞɞɿɥɭ ɚɨɪɬɢ, ɚ ɬɚɤɨɠ ɡ

ɬɚɤɢɦɢ ɨɡɧɚɤɚɦɢ ɫɩɨɥɭɱɧɨɬɤɚɧɢɧɧɨʀ ɞɢɫɩɥɚɡɿʀ, ɹɤ ɩɨɪɭɲɟɧɧɹ ɩɨɫɬɚɜɢ, ɞɟɮɿɰɢɬ ɦɚɫɢ ɬɿɥɚ, ɫɬɭ -ɩɿɧɶ ɩɪɨɥɚɩɫɭ ɦɿɬɪɚɥɶɧɨɝɨ ɤɥɚɩɚɧɚ, ɫɢɦɩɬɨɦɢ ɜɟɥɢɤɨɝɨ ɩɚɥɶɰɹ ɿ ɡɚɩ'ɹɫɬɹ, ɚɧɨɦɚɥɿɹ ɪɭɤ, ɩɿɞ-ɜɢɳɟɧɚ ɪɨɡɬɹɠɧɿɫɬɶ ɲɤɿɪɢ, ɞɿɚɝɨɧɚɥɶɧɚ ɛɨɪɨ-ɡɟɧɤɚ ɜɭɯɚ,ɝɿɩɟɪɦɨɛɿɥɶɧɿɫɬɶ ɫɭɝɥɨɛɿɜ.

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ɜɿɤɭ, ɩɨɪɹɞ ɿɡ ɜɩɥɢɜɨɦ ȾɋɌ, ɡɛɿɥɶɲɭɽɬɶɫɹ ɫɢɥɚ ɜɩɥɢɜɭ ɝɿɩɟɪɬɪɨɮɿʀ Ʌɒ ɡ ɤɪɢɬɢɱɧɨɸ ɜɟɥɢɱɢɧɨɸ ɦɚɫɢ ɦɿɨɤɚɪɞɚ ɜ 235 ɝɪɚɦɿɜ. Ⱥɫɨɰɿɚɰɿɹ ɫɬɪɭɤ

-ɬɭɪɧɢɯ ɿ ɮɭɧɤɰɿɨɧɚɥɶɧɢɯ ɡɦɿɧ ɦɿɨɤɚɪɞɚ ɬɚ ɚɧɟɜɪɢɡɦɢ ɚɨɪɬɢ ɧɚɣɛɿɥɶɲ ɱɿɬɤɨ ɜɢɪɚɠɟɧɚ ɭ ɩɚɰɿɽɧɬɿɜ ɥɿɬɧɶɨɝɨ ɜɿɤɭ.

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1. Ⱥɧɬɨɦɨɧɨɜ Ɇ.ɘ. Ɋɚɫɱɟɬ ɩɨɪɨɝɨɜɵɯ (ɤɪɢɬɢ

-ɱɟɫɤɢɯ)ɭɪɨɜɧɟɣ ɞɟɣɫɬɜɭɸɳɢɯ ɭɱɟɬɧɵɯ ɮɚɤɬɨɪɨɜ ɞɥɹ

ɪɚɡɥɢɱɧɨɝɨ ɬɢɩɚ ɞɚɧɧɵɯ, ɩɨɥɭɱɟɧɧɵɯ ɜ ɝɢɝɢɟɧɢɱɟɫ

-ɤɢɯ ɢɫɫɥɟɞɨɜɚɧɢɹɯ / Ɇ.ɘ.Ⱥɧɬɨɦɨɧɨɜ // Ƚɢɝɢɟɧɚ ɧɚɫɟ

-ɥɟɧɧɵɯ ɩɭɧɤɬɨɜ. – 2004.- ʋ43.- ɋ. 573-579.

2. Ȼɨɧɞɚɪɟɧɤɨ ɂ.ɉ. Ɇɚɥɵɟ ɚɧɨɦɚɥɢɢ ɫɟɪɞɰɚ ɜ

ɞɢɚɝɧɨɫɬɢɤɟ ɜɪɨɠɞɟɧɧɨɣ ɞɢɫɩɥɚɡɢɢ ɫɨɟɞɢɧɢɬɟɥɶɧɨɣ ɬɤɚɧɢ / ɂ.ɉ. Ȼɨɧɞɚɪɟɧɤɨ // ɍɤɪ. ɤɚɪɞɿɨɥ. ɠɭɪɧɚɥ. – 2004. – ʋ3. – ɋ. 66–69.

3. ɂɧɡɟɥɶ Ɍ.ɇ.Ⱦɢɚɝɧɨɫɬɢɱɟɫɤɨɟ ɡɧɚɱɟɧɢɟ ɫɩɟɰɢ

-ɮɢɱɟɫɤɢɯ ɝɟɧɨɬɢɩɢɱɟɫɤɢɯ ɦɚɪɤɟɪɨɜ ɚɧɨɦɚɥɢɣ ɪɚɡɜɢ

-ɬɢɹ ɩɨɱɟɤ, ɚɫɫɨɰɢɢɪɨɜɚɧɧɵɯ ɫ ɫɢɧɞɪɨɦɨɦ ɞɢɫɩɥɚɡɢɢ

ɫɨɟɞɢɧɢɬɟɥɶɧɨɣ ɬɤɚɧɢ / Ɍ.ɇ. ɂɧɡɟɥɶ, Ʌ.Ɇ. Ƚɚɝɥɨɟɜɚ,

ɋ.ȼ.Ʉɨɜɚɥɶɫɤɢɣ // ɍɪɨɥɨɝɢɹ – 2000. – ʋ 3. – ɋ. 8–9. 4. Ʉɥɿɧɿɱɧɟ ɡɚɫɬɨɫɭɜɚɧɧɹ ɟɯɨɤɚɪɞɿɨɝɪɚɮɿʀ // Ɋɟɤɨ

-ɦɟɧɞɚɰɿʀ ɪɨɛɨɱɨʀ ɝɪɭɩɢ ɡ ɮɭɧɤɰɿɨɧɚɥɶɧɨʀ ɞɿɚɝɧɨɫɬɢɤɢ ɤɚɪɞɿɨɥɨɝɿɜ ɍɤɪɚɿɧɢ ɿ ɍɤɪɚɿɧɫɶɤɨʀ ɚɫɨɰɿɚɰɿʀ ɮɚɯɿɜɰɿɜ ɡ ɟɯɨɤɚɪɞɿɨɝɪɚɮɿʀ / ȼ.Ɇ.Ʉɨɜɚɥɟɧɤɨ, ɘ.Ⱥ.ȱɜɚɧɿɜ,

Ɉ.Ɉ.Ʉɪɚɯɦɚɥɨɜɚ [ɬɚ ɿɧ.]. – Ʌɶɜɿɜ, 2010. – 100 ɫ. 5. ɉɪɚɤɬɢɱɟɫɤɨɟ ɪɭɤɨɜɨɞɫɬɜɨ ɩɨ ɭɥɶɬɪɚɡɜɭɤɨɜɨɣ

ɞɢɚɝɧɨɫɬɢɤɟ.Ɉɛɳɚɹ ɭɥɶɬɪɚɡɜɭɤɨɜɚɹ ɞɢɚɝɧɨɫɬɢɤɚ: [ɜ 5-ɬɢ ɬ.]. – ɂɡɞ. 2-ɟ. / ɩɨɞ ɪɟɞ. ȼ.ȼ. Ɇɢɬɶɤɨɜɚ. – Ɇ.:

ȼɂȾȺɊ, 2011. – 720 ɫ.

6. Ɋɟɛɪɨɜɚ Ɉ.ɘ. ɋɬɚɬɢɫɬɢɱɟɫɤɢɣ ɚɧɚɥɢɡ ɦɟɞɢ

-ɰɢɧɫɤɢɯ ɞɚɧɧɵɯ. ɉɪɢɦɟɧɟɧɢɟ ɩɚɤɟɬɚ ɩɪɢɤɥɚɞɧɢɯ

ɩɪɨɝɪɚɦɦ STATISTICA / Ɉ.ɘ.Ɋɟɛɪɨɜɚ. – Ɇ.:

Ɇɟɞɢɚɋɮɟɪɚ, 2006. – 312 ɫ.

7. European Society of Hypertension Working Group on Blood Pressure Monitoring. Practice guidelines of the European Society of Hypertension for clinic, ambulatory and self blood pressure measurement / E. O'Brien, R. Asmar, L. Beilin [et al.] // J. Hypertens. – 2005. – Vol. 23. – Ɋ. 697–701.

8. Graham R. The British Society for Rheumatology Special Interest Group on Heritable Disoders of Con-nective Tissue. Criteria for the Benign Joint Hyper-mobility Syndrome. The Revised (Brighton 1998) Criteria for the Diagnosis of the BJHS / R. Graham, H. Bird, A. Child // J. Rheumatol. – 2000. – Vol. 27. – P. 1777–1779. 9. Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease ACCF/AHA/ AATS/ACR/ASA/SCA/SCAI/SIR/ STS/SVM // J. Amer. College Cardiology. – 2010. – Vol. 55, Issue 14. – P. 27-129.

10. Keane M.G. Medical Management of Marfan Syndrome / M.G. Keane, R.E. Pyeritz // Circulation. – 2008. – Vol. 117 – P. 2802-2813.

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8. Graham R. The British Society for Rheumatology Special Interest Group on Heritable Disoders of Connec-tive Tissue. Criteria for the Benign Joint Hypermobility Syndrome. The Revised (Brighton 1998) Criteria for the Diagnosis of the BJHS / R. Graham, H. Bird, A. Child . J. Rheumatol. 2000;27:1777–9.

9. Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease ACCF/AHA/ AATS/ACR/ASA/SCA/SCAI/SIR/ STS/SVM // Journal of the American College of Cardiology, Volume 55, Issue 14, 6 April 2010;27-129.

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