ɄɅȱɇȱɑɇȺ ɆȿȾɂɐɂɇȺ
8. Burton GJ, Jauniaux E, Charnock-Jones DS. The influence of the intrauterine environment on human placental development. Int J Dev Biol. 2010;54(2–3):303–12.
9. Hargitai B, Marton T, Cox BM. Examination of the human placenta. Journal of Clinical Pathology. 2004;57:785-92.
10. Boers KE, Vijgen SM, Bijlenga D, van der Post JA, Bekedam DJ, Kwee A, van der Salm PC, van Pampus MG, Spaanderman ME, de Boer K, Duvekot JJ, Bremer HA, Ha-saart TH, Delemarre FM, Bloemenkamp KW, van Meir CA, Willekes C, Wijnen EJ, Rijken M, le Cessie S, Roumen FJ, Thornton JG, van Lith JM, Mol BW, Scherjon SA; DIGITAT study group. Induction versus expectant monito-ring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT). BMJ. 2010;21:341:c7087.
11. Mayhew TM. Turnover of human villous tropho-blast in normal pregnancy: what do we know and what do we need to know? Placenta. 2014;35(4):229-40.
12. Dunk C, Smith S, Hazan A, Whittle W, Jones RL. Promotion of angiogenesis by human endometrial lym-phocytes. Immunol Invest. 2008;7(5);583–610.
13. Burton GJ, Woods AW, Jauniaux E, Kingdom JC. Rheological and physiological consequences of conver-sion of the maternal spiral arteries for uteroplacental blood flow during human pregnancy. Placenta. 2009;30(6):473–82.
14. Fitzgerald B, Shannon P, Kingdom J, Keating S. Rounded intraplacental haematomas due to decidual vasculopathy have a distinctive morphology. J Clin Pathol. 2011;64(8):729–32.
15. Cooley SM, Donnelly JC, Walsh T, McMahon C, Gillan J, Geary MP. The impact of ultrasonographic pla-cental architecture on antenatal course, labor and delivery in a low-risk primigravid population. J Matern Fetal Neonatal Med. 2011;24(3):493-7.
ɋɬɚɬɬɹ ɧɚɞɿɣɲɥɚ ɞɨ ɪɟɞɚɤɰɿʀ 16.09.2014
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Ƚɨɪɨɞɫɤɨɣ ɚɥɥɟɪɝɨɥɨɝɢɱɟɫɤɢɣ ɰɟɧɬɪ Ⱦɧɟɩɪɨɩɟɬɪɨɜɫɤ, 49000, ɍɤɪɚɢɧɚ City Allergy Center
Dnipropetrovsk, 49044, Ukraine
Ʉɥɸɱɟɜɵɟ ɫɥɨɜɚ:ɫɵɩɶ,ɡɭɞ,ɤɪɚɩɢɜɧɢɰɚ,ɝɢɫɬɚɦɢɧ,ɞɢɫɛɢɨɡ,ɤɢɲɟɱɧɢɤ
Key words: rash, itching, urticaria, histamine, disbiosis, gut
Ɋɟɮɟɪɚɬ. Ⱦɢɧɚɦɿɤɚ ɪɿɜɧɹ ɝɿɫɬɚɦɢɧɭ ɭ ɯɜɨɪɢɯ ɧɚ ɯɪɨɧɿɱɧɭ ɤɪɨɩɢɜ’ɹɧɤɭ ɩɿɞ ɜɩɥɢɜɨɦ ɪɿɡɧɢɯ ɦɟɬɨɞɿɜ
ɥɿɤɭɜɚɧɧɹ.Ⱦɢɬɹɬɤɨɜɫɶɤɚ ȯ.Ɇ.ȼɢɜɱɚɥɚɫɶ ɟɮɟɤɬɢɜɧɿɫɬɶ ɪɿɡɧɢɯ ɤɨɦɩɥɟɤɫɿɜ ɥɿɤɭɜɚɧɧɹ ɯɜɨɪɢɯ ɧɚ ɯɪɨɧɿɱɧɭ ɤɪɨ
-ɩɢɜ’ɹɧɤɭ.ȼɫɿ ɯɜɨɪɿ ɛɭɥɢ ɪɨɡɩɨɞɿɥɟɧɿ ɧɚ 2 ɝɪɭɩɢ ɡɚɥɟɠɧɨ ɜɿɞ ɥɿɤɭɜɚɥɶɧɨʀ ɫɯɟɦɢ.ɍ ɫɬɚɬɬɿ ɩɨɤɚɡɚɧɚ ɞɢɧɚɦɿɤɚ ɪɿɜ
-ɧɹ ɝɿɫɬɚɦɿɧɭ ɭ ɩɥɚɡɦɿ ɤɪɨɜɿ,ɞɢɫɛɿɨɡɭ ɤɢɲɤɿɜɧɢɤɚ ɿ ɤɥɿɧɿɱɧɢɯ ɫɢɦɩɬɨɦɿɜ ɭ ɯɜɨɪɢɯ ɧɚ ɯɪɨɧɿɱɧɭ ɤɪɨɩɢɜ’ɹɧɤɭ ɩɿɞ
ɜɩɥɢɜɨɦ ɪɿɡɧɢɯ ɬɟɪɚɩɟɜɬɢɱɧɢɯ ɤɨɦɩɥɟɤɫɿɜ. ȼɢɹɜɥɟɧɨ ɤɨɪɟɥɹɰɿɣɧɢɣ ɡɜ’ɹɡɨɤ ɪɿɜɧɹ ɝɿɫɬɚɦɿɧɭ ɭ ɩɥɚɡɦɿ ɤɪɨɜɿ ɡ
ɦɟɬɨɞɚɦɢ ɥɿɤɭɜɚɧɧɹ.ȼɤɥɸɱɟɧɧɹ ɭ ɬɟɪɚɩɿɸ ɛɿɨɧɨɪɦɚ ɞɨɡɜɨɥɹɽ ɞɨɫɹɝɬɢ ɡɧɹɬɬɹ ɤɥɿɧɿɱɧɢɯ ɫɢɦɩɬɨɦɿɜ, ɡɧɢɡɢɬɢ
ɪɿɜɟɧɶ ɝɿɫɬɚɦɿɧɭ ɬɚ ɡɧɚɱɧɨ ɩɨɤɪɚɳɢɬɢ ɠɢɬɬɹ ɩɚɰɿɽɧɬɿɜ.
14/
Ɍɨɦ
XIX / 4
ɬɢɹ ɢ ɦɟɬɨɞɢɱɟɫɤɢɦ ɩɨɞɯɨɞɚɦ ɤ ɬɟɪɚɩɢɢ.
Ɉɫɧɨɜɧɨɣ ɤɥɢɧɢɱɟɫɤɢɣ ɫɢɦɩɬɨɦ – ɜɨɥɞɵɪɢ,
ɪɚɡɦɟɪɨɦ ɨɬ ɧɟɫɤɨɥɶɤɢɯ ɦɢɥɥɢɦɟɬɪɨɜ ɞɨ ɧɟɫɤɨɥɶɤɢɯ ɫɚɧɬɢɦɟɬɪɨɜ, ɱɟɬɤɨ ɜɵɪɚɠɟɧɧɵɟ,
ɜɨɡɜɵɲɚɸɳɢɟɫɹ ɧɚɞ ɩɨɜɟɪɯɧɨɫɬɶɸ ɤɨɠɢ,ɫɨɩɪɨ
-ɜɨɠɞɚɸɳɢɟɫɹ ɡɭɞɨɦ.
Ɉɛɳɢɣ ɩɚɬɨɝɟɧɟɬɢɱɟɫɤɢɣ ɦɟɯɚɧɢɡɦ ɤɪɚɩɢɜ
-ɧɢɰɵ – ɧɚɪɭɲɟɧɢɟ ɩɪɨɧɢɰɚɟɦɨɫɬɢ ɦɢɤɪɨɰɢɪɤɭ
-ɥɹɬɨɪɧɨɝɨ ɪɭɫɥɚ ɫ ɩɨɫɥɟɞɭɸɳɢɦ ɦɟɫɬɧɵɦ ɨɬɟɤɨɦ.
Ⱥɤɬɭɚɥɶɧɨɫɬɶ ɤɪɚɩɢɜɧɢɰɵ ɨɩɪɟɞɟɥɹɟɬɫɹ ɫɥɟ
-ɞɭɸɳɢɦɢ ɮɚɤɬɨɪɚɦɢ: -ɪɚɫɩɪɨɫɬɪɚɧɟɧɧɨɫɬɶɸ;
-ɧɟɨɛɯɨɞɢɦɨɫɬɶɸ ɲɢɪɨɤɨɝɨ ɤɨɦɩɥɟɤɫɚ ɞɢɚ
-ɝɧɨɫɬɢɱɟɫɤɢɯ ɦɟɪɨɩɪɢɹɬɢɣ ɩɪɢ ɯɪɨɧɢɱɟɫɤɨɦ ɬɟɱɟɧɢɢ;
- ɧɚɥɢɱɢɟɦ ɡɧɚɱɢɬɟɥɶɧɨɣ ɝɪɭɩɩɵ ɛɨɥɶɧɵɯ, ɭ
ɤɨɬɨɪɵɯ ɧɟ ɨɩɪɟɞɟɥɟɧɚ ɷɬɢɨɥɨɝɢɹ ɡɚɛɨɥɟɜɚɧɢɹ; -ɞɥɢɬɟɥɶɧɵɦ ɩɪɢɦɟɧɟɧɢɟɦ (ɩɨɪɨɣ ɩɨɫɬɨɹɧ
-ɧɵɦ) ɥɟɤɚɪɫɬɜɟɧɧɵɯ ɫɪɟɞɫɬɜ (ɚɧɬɢɝɢɫɬɚɦɢɧɧɵɯ,
ɤɨɪɬɢɤɨɫɬɟɪɨɢɞɨɜ ɢ ɞɪ.) ɩɪɢ ɯɪɨɧɢɱɟɫɤɨɣ
ɤɪɚɩɢɜɧɢɰɟ.
ɫɧɢɠɟɧɢɟ ɜ ɫɜɹɡɢ ɫ ɧɚɪɭɲɟɧɢɟɦ ɫɧɚ, ɜɹɥɨɫɬɶɸ,
ɢɫɤɚɠɟɧɧɨɣ ɷɦɨɰɢɨɧɚɥɶɧɨɣ ɪɟɚɤɬɢɜɧɨɫɬɶɸ. ɉɪɢ
ɷɬɨɦ ɫɬɟɩɟɧɶ ɭɯɭɞɲɟɧɢɹ ɤɚɱɟɫɬɜɚ ɠɢɡɧɢ ɭ ɛɨɥɶɧɵɯ ɤɪɚɩɢɜɧɢɰɟɣ ɫɨɩɨɫɬɚɜɢɦɚ ɫ ɬɚɤɨɣ ɩɪɢ ɢɲɟɦɢɱɟɫɤɨɣ ɛɨɥɟɡɧɢ ɫɟɪɞɰɚ (Greaves M.W., Sabroe R.A.) ɢ ɫɚɯɚɪɧɨɦ ɞɢɚɛɟɬɟ.
ɉɨ ɞɚɧɧɵɦ ɪɚɡɧɵɯ ɚɜɬɨɪɨɜ, ɤɪɚɩɢɜɧɢɰɟɣ
ɫɬɪɚɞɚɟɬ ɨɬ 15,5 ɞɨ 31% ɧɚɫɟɥɟɧɢɹ,ɯɨɬɹ ɛɵ ɪɚɡ ɜ
ɠɢɡɧɢ ɨɧɚ ɜɨɡɧɢɤɚɟɬ ɭ 10-20% ɧɚɫɟɥɟɧɢɹ (Ɏɟ
-ɞɟɧɤɨ ȿ.ɋ., 2000).
Ʉɥɢɧɢɱɟɫɤɚɹ ɤɥɚɫɫɢɮɢɤɚɰɢɹ ɤɪɚɩɢɜɧɢɰɵ ɩɪɟɞɩɨɥɚɝɚɟɬ ɟɟ ɪɚɡɞɟɥɟɧɢɟ ɩɨ ɫɥɟɞɭɸɳɢɦ ɤɪɢɬɟɪɢɹɦ:
1)ɞɥɢɬɟɥɶɧɨɫɬɶ ɡɚɛɨɥɟɜɚɧɢɹ (ɨɫɬɪɚɹ – ɧɟ
ɛɨɥɟɟ 6 ɧɟɞɟɥɶ,ɯɪɨɧɢɱɟɫɤɚɹ – ɛɨɥɟɟ 6 ɧɟɞɟɥɶ); 2)ɩɚɬɨɝɟɧɟɬɢɱɟɫɤɢɟ ɦɟɯɚɧɢɡɦɵ (ɢɦɦɭɧɨɥɨ
-ɝɢɱɟɫɤɚɹ ɢɥɢ ɚɥɥɟɪ-ɝɢɱɟɫɤɚɹ, ɚɧɚɮɢɥɚɤɬɢɱɟɫɤɚɹ
ɢɥɢ ɩɫɟɜɞɨɚɥɥɟɪɝɢɱɟɫɤɚɹ, ɮɢɡɢɱɟɫɤɚɹ, ɧɚɫɥɟɞ
-ɫɬɜɟɧɧɚɹ,ɞɪɭɝɢɟ ɜɢɞɵ).
Ⱦɢɮɮɟɪɟɧɰɢɚɥɶɧɚɹ ɞɢɚɝɧɨɫɬɢɤɚ ɚɥɥɟɪɝɢɱɟɫ
-ɤɨɣ ɢ ɩɫɟɜɞɨɚɥɥɟɪɝɢɱɟɫ-ɤɨɣ ɤɪɚɩɢɜɧɢɰɵ ɩɪɟɞ
-ɫɬɚɜɥɟɧɚ ɜ ɬɚɛɥɢɰɟ 1.
Ɍ ɚ ɛ ɥ ɢ ɰ ɚ 1
Ʉɥɢɧɢɤɨ-ɚɧɚɦɧɟɫɬɢɱɟɫɤɢɟ ɨɫɨɛɟɧɧɨɫɬɢ ɚɥɥɟɪɝɢɱɟɫɤɨɣ ɢ ɩɫɟɜɞɨɚɥɥɟɪɝɢɱɟɫɤɨɣ ɤɪɚɩɢɜɧɢɰɵ
ɗɬɢɨɥɨɝɢɱɟɫɤɢɣ ɮɚɤɬɨɪ
Ⱥɥɥɟɪɝɢɱɟɫɤɚɹ ɥɟɤɚɪɫɬɜɟɧɧɚɹ,
ɩɵɥɶɰɟɜɚɹ,ɛɵɬɨɜɚɹ,ɩɢɳɟɜɚɹ,
ɢɧɫɟɤɬɧɚɹ ɚɥɥɟɪɝɢɢ
ɉɫɟɜɞɨɚɥɥɟɪɝɢɱɟɫɤɚɹ,
ɦɟɞɢɤɚɦɟɧɬɨɡɧɚɹ,ɩɢɳɚ,ɯɨɥɨɞ,ɫɬɪɟɫɫ,
ɹɞɨɫɥɸɧɧɵɟ ɧɚɫɟɤɨɦɵɟ,ɮɢɡɢɱɟɫɤɢɟ
ɧɚɝɪɭɡɤɢ
ȼɪɟɦɹ ɪɚɡɜɢɬɢɹ ɪɟɚɤɰɢɢ ɨɬ ɧɟɫɤɨɥɶɤɢɯ ɦɢɧɭɬ ɞɨ 6-12 ɱɚɫ. ɨɬ ɧɟɫɤɨɥɶɤɢɯ ɦɢɧɭɬ ɞɨ 72 ɱɚɫ.
Ɂɚɜɢɫɢɦɨɫɬɶ ɨɬ ɞɨɡɵ ɧɟɬ ɞɚ
Ɉɬɫɭɬɫɬɜɢɟ ɩɟɪɢɨɞɚ ɫɟɧɫɢɛɢɥɢɡɚɰɢɢ ɧɟɬ ɞɚ ȼɨɫɩɪɨɢɡɜɨɞɢɦɨɫɬɶ ɞɚɧɧɵɦ ɢɥɢ ɫɯɨɞɧɵɦ
ɚɥɥɟɪɝɟɧɨɦ ɜɫɟɝɞɚ ɢɧɨɝɞɚ
Ⱥɥɥɟɪɝɨɥɨɝɢɱɟɫɤɢɣ ɫɟɦɟɣɧɵɣ ɚɧɚɦɧɟɡ ɩɨɥɨɠɢɬɟɥɶɧɵɣ ɨɬɪɢɰɚɬɟɥɶɧɵɣ Ⱥɥɥɟɪɝɨɥɨɝɢɱɟɫɤɢɣ ɫɟɦɟɣɧɵɣ ɚɧɚɦɧɟɡ
ɥɢɱɧɵɣ ɩɨɥɨɠɢɬɟɥɶɧɵɣ ɨɬɪɢɰɚɬɟɥɶɧɵɣ
ɋɨɩɭɬɫɬɜɭɸɳɢɟ ɡɚɛɨɥɟɜɚɧɢɹ ɚɬɨɩɢɱɟɫɤɢɟ ɛɨɥɟɡɧɢ ɡɚɛɨɥɟɜɚɧɢɹ ɀɄɌɷɧɞɨɤɪɢɧɧɨɣ ɫɢɫɬɟɦ,ɝɟɩɚɬɨɛɢɥɥɢɚɪɧɨɣ,
ɋɪɟɞɢ ɷɬɢɨɥɨɝɢɱɟɫɤɢɯ ɮɚɤɬɨɪɨɜ ɩɫɟɜɞɨɚɥ
-ɥɟɪɝɢɱɟɫɤɨɣ ɤɪɚɩɢɜɧɢɰɵ ɨɫɨɛɨɝɨ ɜɧɢɦɚɧɢɹ ɡɚ
-ɫɥɭɠɢɜɚɟɬ ɩɚɬɨɥɨɝɢɹ ɠɟɥɭɞɨɱɧɨ-ɤɢɲɟɱɧɨɝɨ
ɬɪɚɤɬɚ (ɀɄɌ) ɢ ɝɟɩɚɬɨɛɢɥɥɢɚɪɧɨɣ ɫɢɫɬɟɦɵ (ȽȻɋ), ɩɪɢɜɨɞɹɳɚɹ ɤ ɧɚɪɭɲɟɧɢɸ ɪɚɫɳɟɩɥɟɧɢɹ
ɩɢɳɟɜɨɝɨ ɤɨɦɤɚ ɞɨ ɤɨɧɟɱɧɵɯ ɚɦɢɧɨɤɢɫɥɨɬ.
ɉɨɷɬɨɦɭ ɜɤɥɸɱɟɧɢɟ ɜ ɬɟɪɚɩɢɸ ɩɪɟɩɚɪɚɬɨɜ,ɭɥɭɱ
-ɲɚɸɳɢɯ ɮɭɧɤɰɢɸ ɬɨɝɨ ɢɥɢ ɢɧɨɝɨ ɨɪɝɚɧɚ ɀɄɌ ɢ ȽȻɋ, ɱɪɟɡɜɵɱɚɣɧɨ ɜɚɠɧɨ ɢ ɢɦɟɟɬ ɩɚɬɨɝɟɧɟɬɢ
-ɱɟɫɤɨɟ ɡɧɚɱɟɧɢɟ.
Ɉɫɨɛɨɟ ɡɧɚɱɟɧɢɟ ɜ ɝɟɧɟɡɟ ɤɪɚɩɢɜɧɢɰɵ ɢɦɟɟɬ ɞɢɫɛɢɨɡ ɤɢɲɟɱɧɢɤɚ – ɢɡɦɟɧɟɧɢɟ ɤɨɥɢɱɟɫɬɜɟɧ
-ɧɨɝɨ ɢ ɤɚɱɟɫɬɜɟɧ-ɧɨɝɨ ɫɨɫɬɚɜɚ ɦɢɤɪɨɮɥɨɪɵ ɜ ɨɬɜɟɬ ɧɚ ɥɸɛɨɣ ɫɬɪɟɫɫ ɨɪɝɚɧɢɡɦɚ, ɩɪɢɟɦ ɦɟɞɢ
-ɤɚɦɟɧɬɨɜ ɢ ɞɪ. ɉɪɢ ɞɢɫɛɢɨɡɟ ɤɢɲɟɱɧɢɤɚ ɭɦɟɧɶ
-ɲɚɟɬɫɹ ɨɛɪɚɡɨɜɚɧɢɟ ɝɢɫɬɚɦɢɧɚɡɵ, ɤɨɬɨɪɚɹ ɢɧ
-ɚɤɬɢɜɢɪɭɟɬ ɝɢɫɬɚɦɢɧ.
ɉɨɜɵɲɟɧɧɨɟ ɫɨɞɟɪɠɚɧɢɟ ɝɢɫɬɚɦɢɧɚ ɜ ɩɥɚɡɦɟ ɤɪɨɜɢ ɢ ɬɤɚɧɟɜɨɣ ɠɢɞɤɨɫɬɢ ɜɫɥɟɞɫɬɜɢɟ ɜɵɫɜɨ
-ɛɨɠɞɟɧɢɹ ɟɝɨ ɢɡ ɬɭɱɧɵɯ ɤɥɟɬɨɤ ɢ ɛɚɡɨɮɢɥɨɜ,
ɤɨɬɨɪɨɟ ɦɨɠɟɬ ɛɵɬɶ ɜɵɡɜɚɧɨ ɤɚɤ ɢ JgE
ɡɚɜɢɫɢɦɵɦɢ ɪɟɚɤɰɢɹɦɢ, ɬɚɤ ɢ ɩɫɟɜɞɨɚɥɥɟɪɝɢ
-ɱɟɫɤɢɦɢ ɦɟɯɚɧɢɡɦɚɦɢ, ɨɛɟɫɩɟɱɢɜɚɟɬ ɫɢɦɩɬɨɦɵ
ɄɅȱɇȱɑɇȺ ɆȿȾɂɐɂɇȺ
ɪɟɰɟɩɬɨɪɚɦ ɨɛɟɫɩɟɱɢɜɚɟɬ ɩɨɜɵɲɟɧɢɟ ɩɪɨɧɢ
-ɰɚɟɦɨɫɬɢ ɫɨɫɭɞɨɜ, ɤɨɬɨɪɨɟ ɩɪɢɜɨɞɢɬ ɤ ɨɛɪɚ
-ɡɨɜɚɧɢɸ ɜɨɥɞɵɪɹ, ɚ ɬɚɤɠɟ ɨɛɟɫɩɟɱɢɜɚɟɬ ɡɭɞ,
ɡɧɚɱɢɬɟɥɶɧɨ ɭɯɭɞɲɚɸɳɢɣ ɤɚɱɟɫɬɜɨ ɠɢɡɧɢ ɛɨɥɶɧɵɯ.
ȼ ɫɜɹɡɢ ɫ ɜɵɲɟɢɡɥɨɠɟɧɧɵɦ, ɰɟɥɶɸ ɧɚɫɬɨɹ
-ɳɟɝɨ ɢɫɫɥɟɞɨɜɚɧɢɹ ɛɵɥɨ ɢɡɭɱɟɧɢɟ ɜɥɢɹɧɢɹ ɪɚɡɥɢɱɧɵɯ ɦɟɬɨɞɨɜ ɥɟɱɟɧɢɹ ɧɚ ɞɢɧɚɦɢɤɭ ɭɪɨɜɧɹ ɝɢɫɬɚɦɢɧɚ ɜ ɩɥɚɡɦɟ ɤɪɨɜɢ ɭ ɛɨɥɶɧɵɯ ɯɪɨɧɢ
-ɱɟɫɤɨɣ ɩɫɟɜɞɨɚɥɥɟɪɝɢ-ɱɟɫɤɨɣ ɤɪɚɩɢɜɧɢɰɟɣ.
ɆȺɌȿɊɂȺɅɕ ɂ ɆȿɌɈȾɕ ɂɋɋɅȿȾɈȼȺɇɂə ɉɨɞ ɧɚɲɢɦ ɧɚɛɥɸɞɟɧɢɟɦ ɧɚɯɨɞɢɥɢɫɶ 28
ɛɨɥɶɧɵɯ ɯɪɨɧɢɱɟɫɤɨɣ ɤɪɚɩɢɜɧɢɰɟɣ ɜ ɜɨɡɪɚɫɬɟ ɨɬ
18 ɞɨ 65 ɥɟɬ (ɫɪɟɞɧɢɣ ɜɨɡɪɚɫɬ 44,1±2,7 ɝɨɞɚ),ɢɡ
ɧɢɯ ɦɭɠɱɢɧ - 7 (25,0%), ɠɟɧɳɢɧ - 21 (75,0%).
ɂɫɫɥɟɞɨɜɚɧɢɟ ɩɪɨɜɨɞɢɥɨɫɶ ɜ ɞɢɡɚɣɧɟ ɩɚɪɚɥ
-ɥɟɥɶɧɵɯ ɝɪɭɩɩ.ȼɫɟ ɩɚɰɢɟɧɬɵ ɛɵɥɢ ɪɚɡɞɟɥɟɧɵ ɧɚ
ɞɜɟ ɤɥɢɧɢɱɟɫɤɢɟ ɝɪɭɩɩɵ ɜ ɡɚɜɢɫɢɦɨɫɬɢ ɨɬ ɫɯɟɦɵ ɥɟɱɟɧɢɹ:
1 ɝɪɭɩɩɚ (ɨɫɧɨɜɧɚɹ) – 16 ɛɨɥɶɧɵɯ, ɤɨɬɨɪɵɟ
ɩɨɥɭɱɚɥɢ ɚɧɬɢɝɢɫɬɚɦɢɧɧɵɟ ɩɪɟɩɚɪɚɬɵ ɩɨɫɥɟɞ
-ɧɟɣ ɝɟɧɟɪɚɰɢɢ (ɛɥɨɤɚɬɨɪɵ ɇ1-ɝɢɫɬɚɦɢɧɧɵɯ ɪɟ
-ɰɟɩɬɨɪɨɜ (ɞɟɡɥɨɪɚɬɚɞɢɧ ɜ ɞɨɡɟ 5 ɦɝ 1 ɬɚɛ.ɭɬɪɨɦ)),
ɦɨɧɬɟɥɭɤɚɫɬ ɧɚɬɪɢɹ 10 ɦɝ 1 ɬɚɛ. ɜɟɱɟɪɨɦ (ɚɧɬɢ
-ɥɟɣɤɨɬɪɢɟɧɨɜɵɣ ɩɪɟɩɚɪɚɬ), ɛɢɨɧɨɪɦ, ɫɨɞɟɪ
-ɠɚɳɢɣ ɥɢɝɧɢɧ ɚɤɬɢɜɢɪɨɜɚɧɧɵɣ, ɥɚɤɬɭɥɨɡɭ ɢ
ɰɟɥɥɸɥɨɡɭ ɦɢɤɪɨɤɪɢɫɬɚɥɥɢɱɟɫɤɭɸ. Ɂɚ ɫɱɟɬ ɥɢɝ
-ɧɢɧɚ ɢ ɰɟɥɥɸɥɨɡɵ ɩɪɟɩɚɪɚɬ ɢɦɟɟɬ ɜɵɫɨɤɭɸ ɫɨɪɛɰɢɨɧɧɭɸ ɚɤɬɢɜɧɨɫɬɶ, ɤɨɬɨɪɚɹ ɩɨɡɜɨɥɹɟɬ
ɫɜɹɡɵɜɚɬɶ ɢ ɜɵɜɨɞɢɬɶ ɢɡ ɩɪɨɫɜɟɬɚ ɀɄɌ ɩɚɬɨ
-ɝɟɧɧɵɟ ɛɚɤɬɟɪɢɢ, ɩɪɨɞɭɤɬɵ ɢɯ ɪɚɫɩɚɞɚ, ɚ ɬɚɤɠɟ
ɷɧɞɨ- ɢ ɷɤɡɨɬɨɤɫɢɧɵ. Ʌɚɤɬɭɥɨɡɚ ɹɜɥɹɟɬɫɹ ɫɢɧɬɟ
-ɬɢɱɟɫɤɢɦ ɞɢɫɚɯɚɪɢɞɨɦ, ɛɟɡ ɢɡɦɟɧɟɧɢɣ ɩɪɨɯɨɞɢɬ
ɱɟɪɟɡ ɀɄɌ ɞɨ ɬɨɥɫɬɨɝɨ ɤɢɲɟɱɧɢɤɚ, ɫɬɢɦɭɥɢɪɭɟɬ
ɪɚɡɜɢɬɢɟ ɛɢɮɢɞɨ- ɢ ɥɚɤɬɨɛɚɤɬɟɪɢɣ, ɬɟɦ ɫɚɦɵɦ
ɫɩɨɫɨɛɫɬɜɭɹ ɧɨɪɦɚɥɢɡɚɰɢɢ ɨɛɦɟɧɚ ɛɟɥɤɨɜ, ɠɢ
-ɪɨɜ, ɭɝɥɟɜɨɞɨɜ, ɭɫɜɨɟɧɢɸ ɜɢɬɚɦɢɧɨɜ, ɦɢɤɪɨ- ɢ
ɦɚɤɪɨɷɥɟɦɟɧɬɨɜ, ɚ ɬɚɤɠɟ ɩɪɢɧɢɦɚɟɬ ɭɱɚɫɬɢɟ ɜ
ɫɬɢɦɭɥɹɰɢɢ ɧɟɫɩɟɰɢɮɢɱɟɫɤɨɝɨ ɢɦɦɭɧɢɬɟɬɚ.
Ʉɨɦɩɥɟɤɫɧɨɟ ɜɥɢɹɧɢɟ ɤɨɦɩɨɧɟɧɬɨɜ ɩɪɟɩɚɪɚɬɚ ɫɩɨɫɨɛɫɬɜɭɟɬ ɮɨɪɦɢɪɨɜɚɧɢɸ ɧɨɪɦɚɥɶɧɨɣ ɦɢɤɪɨ
-ɮɥɨɪɵ, ɨɛɪɚɡɨɜɚɧɢɸ ɝɢɫɬɚɦɢɧɚɡɵ, ɱɬɨ ɩɪɢɜɨɞɢɬ
ɤ ɭɦɟɧɶɲɟɧɢɸ ɤɨɠɧɵɯ ɫɢɦɩɬɨɦɨɜ.
2 ɝɪɭɩɩɚ (ɤɨɧɬɪɨɥɶɧɚɹ) – 12 ɛɨɥɶɧɵɯ ɯɪɨ
-ɧɢɱɟɫɤɨɣ ɤɪɚɩɢɜɧɢɰɟɣ,ɤɨɬɨɪɵɟ ɩɨɥɭɱɚɥɢ ɬɨɥɶɤɨ
ɚɧɬɢɝɢɫɬɚɦɢɧɧɵɟ ɩɪɟɩɚɪɚɬɵ ɜ ɫɨɱɟɬɚɧɢɢ ɫ ɦɨ
-ɞɢɮɢɤɚɬɨɪɚɦɢ ɥɟɣɤɨɬɪɢɟɧɨɜ. Ɉɛɟ ɝɪɭɩɩɵ ɛɵɥɢ
ɫɨɩɨɫɬɚɜɢɦɵɦɢ ɩɨ ɜɨɡɪɚɫɬɭ ɢ ɩɨɥɭ ɩɚɰɢɟɧɬɨɜ
(p>0,05).
ɍɪɨɜɟɧɶ ɝɢɫɬɚɦɢɧɚ ɢɡɭɱɚɥɢ ɜ ɥɚɛɨɪɚɬɨɪɢɢ
VIC-MEDIK (ɥɢɰɟɧɡɢɹ ɆɁ ɍɤɪɚɢɧɵ ȺȽ
ʋ ʋ 602777 ɨɬ 04.08.2011) ɢɦɦɭɧɨɮɟɪɦɟɧɬɧɵɦ
ɦɟɬɨɞɨɦ ɨɩɪɟɞɟɥɟɧɢɹ ɝɢɫɬɚɦɢɧɚ ɜ ɗȾɌȺ ɩɥɚɡɦɟ
(Elisa),ɞɨ ɧɚɱɚɥɚ ɥɟɱɟɧɢɹ ɢ ɱɟɪɟɡ 3 ɧɟɞɟɥɢ ɩɨɫɥɟ
ɨɤɨɧɱɚɧɢɹ ɤɭɪɫɚ ɬɟɪɚɩɢɢ.
ɋɬɚɬɢɫɬɢɱɟɫɤɚɹ ɨɛɪɚɛɨɬɤɚ ɪɟɡɭɥɶɬɚɬɨɜ ɢɫɫɥɟ
-ɞɨɜɚɧɢɹ ɩɪɨɜɨɞɢɥɚɫɶ ɫ ɢɫɩɨɥɶɡɨɜɚɧɢɟɦ ɩɚɤɟɬɚ ɩɪɨɝɪɚɦɦ Statistica v6.1®. Ⱦɚɧɧɵɟ ɩɪɟɞɫɬɚɜɥɟɧɵ
ɜ ɜɢɞɟ ɤɨɥɢɱɟɫɬɜɚ ɧɚɛɥɸɞɟɧɢɣ (n), ɫɪɟɞɧɟɝɨ
ɚɪɢɮɦɟɬɢɱɟɫɤɨɝɨ ɢ ɟɝɨ ɫɬɚɧɞɚɪɬɧɨɣ ɨɲɢɛɤɢ
(Ɇ±m), 95% ɞɨɜɟɪɢɬɟɥɶɧɨɝɨ ɢɧɬɟɪɜɚɥɚ (95% CI),
ɭɪɨɜɧɹ ɫɬɚɬɢɫɬɢɱɟɫɤɨɣ ɡɧɚɱɢɦɨɫɬɢ (ɪ), ɤɨɷɮ
-ɮɢɰɢɟɧɬɚ ɤɨɪɪɟɥɹɰɢɢ ɋɩɢɪɦɟɧɚ (r). Ⱦɥɹ ɫɪɚɜ
-ɧɟɧɢɹ ɫɪɟɞɧɢɯ ɫɬɚɬɢɫɬɢɱɟɫɤɢɯ ɯɚɪɚɤɬɟɪɢɫɬɢɤ ɜ ɞɢɧɚɦɢɤɟ ɢ ɜ ɪɚɡɧɵɯ ɝɪɭɩɩɚɯ ɧɚɛɥɸɞɟɧɢɹ ɩɪɢɦɟɧɹɥɫɹ ɫɨɨɬɜɟɬɫɬɜɭɸɳɢɣ ɤɪɢɬɟɪɢɣ ɋɬɶɸ
-ɞɟɧɬɚ (ɞɥɹ ɡɚɜɢɫɢɦɵɯ ɢ ɧɟɡɚɜɢɫɢɦɵɯ ɜɵɛɨɪɨɤ),
ɞɥɹ ɨɬɧɨɫɢɬɟɥɶɧɵɯ ɩɨɤɚɡɚɬɟɥɟɣ – ɤɪɢɬɟɪɢɢ Ɇɚɤ
-ɇɟɦɚɪɚ ɢ ɏɢ-ɤɜɚɞɪɚɬ ɉɢɪɫɨɧɚ (F2).
ɊȿɁɍɅɖɌȺɌɕ ɂ ɂɏ ɈȻɋɍɀȾȿɇɂȿ
Ⱦɢɧɚɦɢɤɚ ɝɢɫɬɚɦɢɧɚ ɜ ɩɥɚɡɦɟ ɤɪɨɜɢ ɭ ɩɚɰɢɟɧɬɨɜ ɞɜɭɯ ɝɪɭɩɩ ɩɪɟɞɫɬɚɜɥɟɧɚ ɜ ɬɚɛɥɢɰɟ 2,
ɢɡ ɤɨɬɨɪɨɣ ɜɢɞɧɨ, ɱɬɨ ɫɭɳɟɫɬɜɟɧɧɨɟ (ɪ<0,001)
ɫɧɢɠɟɧɢɟ ɭɪɨɜɧɹ ɝɢɫɬɚɦɢɧɚ ɜ ɫɵɜɨɪɨɬɤɟ ɤɪɨɜɢ ɨɬɦɟɱɚɥɨɫɶ ɜ ɨɫɧɨɜɧɨɣ ɝɪɭɩɩɟ ɩɚɰɢɟɧɬɨɜ, ɩɨɥɭ
-ɱɚɜɲɢɯ ɜ ɤɨɦɩɥɟɤɫɟ ɇ1-ɛɥɨɤɚɬɨɪɵ, ɚɧɬɢɥɟɣ
-ɤɨɬɪɢɟɧɨɜɵɟ ɩɪɟɩɚɪɚɬɵ ɢ ɛɢɨɧɨɪɦ. ɉɨɞ ɜɥɢɹ
-ɧɢɟɦ ɥɟɱɟɧɢɹ ɜɵɪɚɛɨɬɤɚ ɦɟɞɢɚɬɨɪɚ ɧɨɪɦɚɥɢ
-ɡɨɜɚɥɚɫɶ ɭ 14 (87,5%) ɛɨɥɶɧɵɯ, ɚ ɫɪɟɞɧɢɣ ɭɪɨ
-ɜɟɧɶ ɝɢɫɬɚɦɢɧɚ ɭ ɩɚɰɢɟɧɬɨɜ ɝɪɭɩɩɵ ɫɧɢɡɢɥɫɹ ɜ
3,9ɪɚɡɚ.
Ɍ ɚ ɛ ɥ ɢ ɰ ɚ 2
Ⱦɢɧɚɦɢɤɚ ɭɪɨɜɧɹ ɝɢɫɬɚɦɢɧɚ ɜ ɫɵɜɨɪɨɬɤɟ ɤɪɨɜɢ ɩɪɢ ɪɚɡɧɵɯ ɫɯɟɦɚɯ ɥɟɱɟɧɢɹ ɛɨɥɶɧɵɯ ɯɪɨɧɢɱɟɫɤɨɣ ɤɪɚɩɢɜɧɢɰɟɣ
Ɉɫɧɨɜɧɚɹ ɝɪɭɩɩɚ (n=16) Ʉɨɧɬɪɨɥɶɧɚɹ ɝɪɭɩɩɚ (n=12)
ɉɨɤɚɡɚɬɟɥɶ
ɞɨ ɧɚɱɚɥɚ ɥɟɱɟɧɢɹ ɩɨɫɥɟ ɥɟɱɟɧɢɹ ɞɨ ɧɚɱɚɥɚ ɥɟɱɟɧɢɹ ɩɨɫɥɟ ɥɟɱɟɧɢɹ ɋɪɟɞɧɢɣ ɭɪɨɜɟɧɶ (M±m), ɧɝ/ɦɥ 2,21±0,24 0,56±0,08
ɪ<0,001*
1,70±0,31 1,62±0,33
ɪ>0,05*
Ʉɨɥɢɱɟɫɬɜɨ ɩɚɰɢɟɧɬɨɜ ɫ ɩɨɤɚɡɚɬɟɥɟɦ ɜ ɩɪɟɞɟɥɚɯ ɧɨɪɦɵ (ɚɛɫ., %)
1 (6,3%) 14 (87,5%)
ɪ<0,002**
3 (25,0%) 5 (41,7%)
ɪ>0,05**
14/
Ɍɨɦ
XIX / 4
ɫɵɜɨɪɨɬɤɟ ɤɪɨɜɢ ɜ ɞɢɧɚɦɢɤɟ ɥɟɱɟɧɢɹ ɤɨɦɩɥɟɤ
-ɫɨɦ ɇ1-ɛɥɨɤɚɬɨɪɵ + ɚɧɬɢɥɟɣɤɨɬɪɢɟɧɵ ɧɟ ɨɬɦɟ
-ɱɚɥɨɫɶ (ɪ>0,05).ɉɪɨɞɭɤɰɢɹ ɝɢɫɬɚɦɢɧɚ ɫɧɢɡɢɥɚɫɶ
ɞɨ ɧɨɪɦɚɥɶɧɵɯ ɡɧɚɱɟɧɢɣ ɬɨɥɶɤɨ ɭ 5 ɩɚɰɢɟɧɬɨɜ (41,7%), ɜ ɨɫɬɚɥɶɧɵɯ ɫɥɭɱɚɹɯ ɭɪɨɜɟɧɶ ɦɟɞɢɚɬɨɪɚ
ɧɟɡɧɚɱɢɬɟɥɶɧɨ ɜɵɪɨɫ.
ɋɪɚɜɧɢɬɟɥɶɧɵɣ ɚɧɚɥɢɡ ɜɥɢɹɧɢɹ ɪɚɡɥɢɱɧɵɯ ɫɯɟɦ ɥɟɱɟɧɢɹ ɧɚ ɞɢɧɚɦɢɤɭ ɭɪɨɜɧɹ ɝɢɫɬɚɦɢɧɚ ɜ
(r = 0,79; ɪ<0,001) ɬɟɦɩɨɜ ɫɧɢɠɟɧɢɹ ɩɪɨɞɭɤɰɢɢ
ɦɟɞɢɚɬɨɪɚ ɩɨɫɥɟ ɥɟɱɟɧɢɹ ɫ ɤɨɦɩɥɟɤɫɨɦ ɥɟɱɟɛɧɵɯ ɦɟɪɨɩɪɢɹɬɢɣ (ɜɤɥɸɱɟɧɢɟ ɜ ɬɟɪɚɩɢɸ ɛɢɨɧɨɪɦɚ).
ɉɪɢ ɫɬɚɬɢɫɬɢɱɟɫɤɢ ɫɨɩɨɫɬɚɜɢɦɵɯ ɢɫɯɨɞɧɵɯ ɭɪɨɜɧɹɯ ɝɢɫɬɚɦɢɧɚ ɭ ɩɚɰɢɟɧɬɨɜ ɨɛɟɢɯ ɝɪɭɩɩ
(ɪ>0,05) ɱɟɪɟɡ 3 ɧɟɞɟɥɢ ɩɨɫɥɟ ɨɤɨɧɱɚɧɢɹ ɤɭɪɫɚ
ɬɟɪɚɩɢɢ ɪɚɡɥɢɱɢɹ ɫɬɚɥɢ ɞɨɫɬɨɜɟɪɧɵɦɢ ɫ ɪ<0,01 (ɪɢɫ.).
Ⱦɨ ɥɟɱɟɧɢɹ
1,62 1,70
0,56 2,21
0 0,5 1 1,5 2 2,5 3
ɉɨɫɥɟ ɥɟɱɟɧɢɹ
ɧɝ
/
ɦɥ
Ʉɨɧɬɪɨɥɶɧɚɹ ɝɪɭɩɩɚ Ɉɫɧɨɜɧɚɹ ɝɪɭɩɩɚ
p<0,01 p>0,05
Ⱦɢɧɚɦɢɤɚ ɫɪɟɞɧɟɝɨ ɭɪɨɜɧɹ (Ɇ, 95% CI) ɝɢɫɬɚɦɢɧɚ ɜ ɫɵɜɨɪɨɬɤɟ ɤɪɨɜɢ
ɛɨɥɶɧɵɯ ɯɪɨɧɢɱɟɫɤɨɣ ɤɪɚɩɢɜɧɢɰɟɣ ɩɪɢ ɪɚɡɧɵɯ ɫɯɟɦɚɯ ɥɟɱɟɧɢɹ
ȼɕȼɈȾɕ
1. Ⱦɥɹ ɞɨɫɬɢɠɟɧɢɹ ɤɥɢɧɢɱɟɫɤɨɝɨ ɷɮɮɟɤɬɚ ɭ
ɛɨɥɶɧɵɯ ɯɪɨɧɢɱɟɫɤɨɣ ɤɪɚɩɢɜɧɢɰɟɣ ɧɟɨɛɯɨɞɢɦɨ ɧɚɡɧɚɱɚɬɶ ɬɟɪɚɩɟɜɬɢɱɟɫɤɢɣ ɤɨɦɩɥɟɤɫ, ɤɨɬɨɪɵɣ
ɜɥɢɹɟɬ ɧɚ ɜɫɟ ɦɟɯɚɧɢɡɦɵ ɫɧɢɠɟɧɢɹ ɭɪɨɜɧɹ ɝɢɫɬɚɦɢɧɚ ɜ ɩɥɚɡɦɟ ɤɪɨɜɢ.
2. ȼɤɥɸɱɟɧɢɟ ɜ ɤɨɦɩɥɟɤɫ ɥɟɱɟɧɢɹ ɛɢɨɧɨɪɦɚ
ɩɨɡɜɨɥɹɟɬ ɫɭɳɟɫɬɜɟɧɧɨ ɫɧɢɡɢɬɶ ɭɪɨɜɟɧɶ ɝɢɫɬɚ
-ɦɢɧɚ ɜ ɩɥɚɡɦɟ ɤɪɨɜɢ ɩɨ ɫɪɚɜɧɟɧɢɸ ɫ ɧɚɡɧɚ
-ɱɟɧɢɟɦ ɬɨɥɶɤɨ ɇ1-ɛɥɨɤɚɬɨɪɨɜ ɢ ɥɟɣɤɨɬɪɢɟɧɨɜɵɯ
ɩɪɟɩɚɪɚɬɨɜ, ɱɬɨ ɩɨɞɬɜɟɪɠɞɟɧɨ ɜɵɹɜɥɟɧɧɨɣ ɤɨɪ
-ɪɟɥɹɰɢɨɧɧɨɣ ɫɜɹɡɶɸ (r = 0,79) ɦɟɠɞɭ ɞɢɧɚɦɢɤɨɣ
ɩɪɨɞɭɤɰɢɢ ɝɨɪɦɨɧɚ ɢ ɦɟɬɨɞɚɦɢ ɥɟɱɟɧɢɹ.
ɋ
ɋɉ
ɉɂ
ɂɋ
ɋɈ
ɈɄ
Ʉ
Ʌɂ
Ʌ
ɂ
Ɍȿ
Ɍ
ȿɊ
ɊȺ
ȺɌ
Ɍɍ
ɍɊ
Ɋɕ
ɕ
1. Ƚɨɪɹɱɤɢɧɚ Ʌ.Ⱥ.Ɉɫɬɪɚɹ ɢ ɯɪɨɧɢɱɟɫɤɚɹɤɪɚɩɢɜ-ɧɢɰɚ, ɢ ɚɧɝɢɨɧɟɜɪɨɬɢɱɟɫɤɢɣ ɨɬɟɤ: ɭɱɟɛ. ɩɨɫɨɛɢɟ / Ʌ.Ⱥ.Ƚɨɪɹɱɤɢɧɚ, ɇ.Ɇ.ɇɟɧɚɲɟɜɚ, ȿ.ɘ.Ȼɨɪɡɨɜɚ. – Ɇ., 2003. – 47 ɫ.
2. Ʉɥɢɧɢɱɟɫɤɚɹ ɚɥɥɟɪɝɨɥɨɝɢɹ ɢ ɢɦɦɭɧɧɨɥɨɝɢɹ. Ɋɭɤɨɜɨɞɫɬɜɨ ɞɥɹ ɩɪɚɤɬɢɤɭɸɳɢɯ ɜɪɚɱɟɣ / ɩɨɞ ɨɛɳɟɣ ɪɟɞ.Ƚɨɪɹɱɤɢɧɨɣ Ʌ.Ⱥ.ɢ Ʉɚɲɤɢɧɚ Ʉ.ɉ. – Ɇ.:Ɇɢɤɥɨɲ, 2009. – 432 ɫ.
3. ɉɚɬɬɟɪɫɨɧ Ɋ.Ⱥɥɥɟɪɝɢɱɟɫɤɢɟ ɛɨɥɟɡɧɢ. Ⱦɢɚɝɧɨ-ɫɬɢɤɚ ɢ ɥɟɱɟɧɢɟ / Ɋ.ɉɚɬɬɟɪɫɨɧ, Ʌ.Ʉ.Ƚɪɷɦɦɭ, ɉ.Ⱥ.Ƚɪɢɧɛɟɪɝɭ. – Ɇ.: ȽɗɈɌȺɊ – Ɇɟɞɢɚ, 2000. – 733 ɫ.
4. C1 inhibitor deficiency: consensus document / British Society for Immunology, Clinical and Experimen-tal Immunology. – 2005. – 139. – Ɋ. 379-394.
5. Charlesworth E.N. Urticaria and angioederma: a clinical spectrum / E.N. Charlesworth // Ann. Allergy Asthma Immunol. – 1996. – Vol. 76, N 6. – P. 484-495.
6. Koplan A. Urticaria and angioderma / A. Koplan // Allergy. Principles and Practice Ed.by E. Middleton, Ch E Reed, E.F. Ellis [et al.]. – 5th ed. – St.lonis: Mosby_ Year Book, Inc. 1998. – P. 1104-1122.
ɄɅȱɇȱɑɇȺ ɆȿȾɂɐɂɇȺ
R
R
E
E
F
F
E
E
R
R
E
E
N
N
C
C
E
E
S
S
1. Goryachkina LA, Nenasheva NM, Borzova EYu. [Acute and chronic urticaria and angioedema]. Tutorial. Ɇ., 2003; 47. Russian.
2. [Clinical Allergy and Immunology]. Guidelines for clinicians. Under the general editorship of Goryach-kina L, KashGoryach-kina KP. Ɇ., Miklosh; 2009. Russian.
3. Roy Patterson, Leslim K Gremmu, Pol A Grinbergu. [Allergic diseases. Diagnosis and treatment]. Geotar meditsiny. Moskva. 2000;313-412. Russian.
4. C1 inhibitor deficiency: consensus document // 2005 British Society for Immunology, Clinical and Ex-perimental Immunology, 139;379-94.
5. Charlesworth EN. Urticaria and angioederma: a clinical spectrum. Ann Allergy Asthma Immunol. 1996;76(6):484-95.
6. Koplan A. Urticaria and angioderma. Allergy. Principles and Practice. Ed. by E. Middleton, Ch E Reed, E.F. Ellis et al. 5th ed. «Mosby_Year Book, Inc.» St.lonis, 1998;1104-22.
7. Rebecca S. Grucnalla Cinical assessment of drug-induced disease Lancet. 2000;356:1505-11.
ɋɬɚɬɬɹ ɧɚɞɿɣɲɥɚ ɞɨ ɪɟɞɚɤɰɿʀ 21.08.2014
ɍȾɄ 616.831:616.8-009.86-07-08
Ɉ.ȼ.ɉɨɝɨɪɽɥɨɜ
Ɉɋ
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Ɋɇ
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ȾɁ «Ⱦɧɿɩɪɨɩɟɬɪɨɜɫɶɤɚ ɦɟɞɢɱɧɚ ɚɤɚɞɟɦɿɹ ɆɈɁ ɍɤɪɚʀɧɢ»
ɤɚɮɟɞɪɚ ɧɟɜɪɨɥɨɝɿʀ ɬɚ ɨɮɬɚɥɶɦɨɥɨɝɿʀ
(ɡɚɜ. – ɞ.ɦɟɞ.ɧ.Ɉ.ȼ.ɉɨɝɨɪɽɥɨɜ)
ɩɥ.ɀɨɜɬɧɟɜɚ, 14, Ⱦɧɿɩɪɨɩɟɬɪɨɜɫɶɤ, 49044, ɍɤɪɚʀɧɚ
SE "Dnipropetrovsk medical academy of Health Ministry of Ukraine" Department of neurology and ophthalmology
Zhovtneva sq., 14, Dnipropetrovsk, 49044, Ukraine e-mail: [email protected]
Ʉɥɸɱɨɜɿ ɫɥɨɜɚ:ɧɟɣɪɨɧɚɥɶɧɚ ɚɫɬɟɧɿɹ,ɡɨɪɨɜɿ ɜɢɤɥɢɤɚɧɿ ɩɨɬɟɧɰɿɚɥɢ,ɤɥɿɧɿɱɧɚ ɲɤɚɥɚ ɚɫɬɟɧɿʀ,ɰɟɪɟɛɪɨɜɚɫɤɭɥɹɪɧɿ
ɡɚɯɜɨɪɸɜɚɧɧɹ
Key words: neural asthenia, visual evoked potentials, clinical asthenia scale, cerebrovascular diseases
Ɋɟɮɟɪɚɬ. Ɉɫɨɛɟɧɧɨɫɬɢ ɤɥɢɧɢɤɢ ɢ ɞɢɚɝɧɨɫɬɢɤɢ ɚɫɬɟɧɢɱɟɫɤɢɯ ɫɨɫɬɨɹɧɢɣ ɩɪɢ ɰɟɪɟɛɪɨɜɚɫɤɭɥɹɪɧɵɯ
ɡɚɛɨɥɟɜɚɧɢɹɯ.ɉɨɝɨɪɟɥɨɜ Ⱥ.ȼ.ɉɪɨɜɟɞɟɧɨ ɢɫɫɥɟɞɨɜɚɧɢɟ 68 ɩɚɰɢɟɧɬɨɜ ɫ ɯɪɨɧɢɱɟɫɤɢɦɢ ɧɚɪɭɲɟɧɢɹɦɢ ɦɨɡɝɨɜɨɝɨ
ɤɪɨɜɨɨɛɪɚɳɟɧɢɹ (ɏɇɆɄ), ɤɨɬɨɪɵɟ ɩɟɪɟɧɨɫɢɥɢ ɥɚɤɭɧɚɪɧɵɟ ɢɲɟɦɢɱɟɫɤɢɟ ɢɧɮɚɪɤɬɵ ɦɨɡɝɚ. ɍɫɬɚɧɨɜɥɟɧɨ, ɱɬɨ
ɩɚɰɢɟɧɬɵ ɫ ɏɇɆɄ ɨɫɨɡɧɚɸɬ ɚɫɬɟɧɢɸ ɜ 57,35% ɫɥɭɱɚɟɜ, ɩɪɢ ɰɟɥɟɜɨɦ ɢɫɫɥɟɞɨɜɚɧɢɢ ɚɫɬɟɧɢɹ ɜɵɹɜɥɹɟɬɫɹ ɛɟɡ
ɢɫɤɥɸɱɟɧɢɣ. ȼɵɹɜɥɟɧɚ ɤɨɪɪɟɥɹɰɢɹ (ɦɤȼ) ɤɨɦɩɨɧɟɧɬɚ P3-N3 ɡɪɢɬɟɥɶɧɨɝɨ ɜɵɡɜɚɧɧɨɝɨ ɩɨɬɟɧɰɢɚɥɚ ɫ ɤɥɢɧɢ
-ɱɟɫɤɢɦɢ ɩɪɨɹɜɥɟɧɢɹɦɢ ɚɫɬɟɧɢɢ (r=0,41), ɨɰɟɧɟɧɧɵɦɢ ɩɨ ɤɥɢɧɢɱɟɫɤɨɣ ɲɤɚɥɟ ɚɫɬɟɧɢɢ MFI-20. ɋɞɟɥɚɧɨ ɡɚɤɥɸ
-ɱɟɧɢɟ, ɱɬɨ ɩɪɢ ɨɬɫɭɬɫɬɜɢɹ ɞɪɭɝɢɯ ɮɚɤɬɨɪɨɜ ɚɫɬɟɧɢɢ ɩɨɤɚɡɚɬɟɥɢ ɚɦɩɥɢɬɭɞ ɞɥɢɧɧɨɥɚɬɟɧɬɧɨɣ ɮɚɡɵ
ɜɵɡɜɚɧɧɨɝɨ ɨɬɜɟɬɚ (P3-N3) ɭ ɛɨɥɶɧɵɯ ɫ ɰɟɪɟɛɪɨɜɚɫɤɭɥɹɪɧɵɦɢ ɡɚɛɨɥɟɜɚɧɢɹɦɢ ɦɨɝɭɬ ɛɵɬɶ ɤɪɢɬɟɪɢɟɦ ɬɚɤ
ɧɚɡɵɜɚɟɦɨɣ «ɧɟɣɪɨɧɚɥɶɧɨɣ ɚɫɬɟɧɢɢ», ɨɩɪɟɞɟɥɹɬɶ ɞɢɧɚɦɢɤɭ ɪɚɡɜɢɬɢɹ ɡɚɛɨɥɟɜɚɧɢɹ ɢ ɩɨɬɪɟɛɧɨɫɬɶ ɜ ɩɚɬɨ
-ɝɟɧɟɬɢɱɟɫɤɨɣ ɧɚɩɪɚɜɥɟɧɧɨɫɬɢ ɥɟɱɟɛɧɵɯ ɞɟɣɫɬɜɢɣ.
