ºðºì²ÜÆ äºî²Î²Ü вزÈê²ð²ÜÆ ¶Æî²Î²Ü îºÔºÎ²¶Æð Ó×ÅÍÛÅ ÇÀÏÈÑÊÈ ÅÐÅÂÀÍÑÊÎÃÎ ÃÎÑÓÄÀÐÑÒÂÅÍ ÍÎÃÎ ÓÍÈÂÅÐ ÑÈÒÅÒÀ ´Ý³Ï³Ý ·ÇïáõÃÛáõÝÝ»ñ 2, 2007 Åñòåñòâåííûå íàó êè ƥ njǒ Ǐ ǒ LJnj ǣ ɍȾɄ: 612.8±591.18 Ɋ. ɋ. ȺɊɍɌɘɇəɇ ɊɈɅɖ ɅȺɌȿɊȺɅɖɇɈȽɈ ɆȺɆɂɅɅəɊɇɈȽɈ əȾɊȺ ȽɂɉɈɌȺɅȺɆɍɋȺ ȼ ɊȿȽɍɅəɐɂɂ ȾɕɏȺɇɂə ɉɊɂ ȽɂɉɈɄɋɂɂ ɂɡɭɱɟɧɨ ɜɥɢɹɧɢɟ ɥɚɬɟɪɚɥɶɧɨɝɨ ɦɚɦɢɥɥɹɪɧɨɝɨ (LM) ɹɞɪɚ ɝɢɩɨɬɚɥɚɦɭɫɚ ɧɚ ɢɦɩɭɥɶɫɧɭɸ ɚɤɬɢɜɧɨɫɬɶ ɞɵɯɚɬɟɥɶɧɵɯ ɧɟɣɪɨɧɨɜ ɩɪɨɞɨɥɝɨɜɚɬɨɝɨ ɦɨɡɚ. ȼ ɭɫɥɨɜɢɹɯ ɧɨɪɦɚɥɶɧɨɝɨ ɚɬɦɨɫɮɟɪɧɨɝɨ ɞɚɜɥɟɧɢɹ ɷɥɟɤɬɪɢɱɟɫɤɨɟ ɪɚɡɞɪɚɠɟɧɢɟ LM ɹɞɪɚ ɝɢɩɨɬɚɥɚɦɭɫɚ ɨɤɚɡɵɜɚɥɨ ɩɪɟɢɦɭɳɟɫɬɜɟɧɧɨ ɚɤɬɢɜɢɪɭɸɳɟɟ ɜɥɢɹɧɢɟ. ɇɚ « ɜɵɫɨɬɟ» 4–5 ɬɵɫ. ɦ ɧɚ ɮɨɧɟ ɝɢɩɨɤɫɢɱɟɫɤɨɣ ɚɤɬɢɜɚɰɢɢ ɪɚɡɞɪɚɠɟɧɢɟ LM ɹɞɪɚ ɧɟ ɨɤɚɡɵɜɚɥɨ ɯɚɪɚɤɬɟɪɧɨɝɨ ɜɥɢɹɧɢɹ. ȼɨ ɜɬɨɪɨɣ ɮɚɡɟ ɝɢɩɨɤɫɢɢ (7,5–8 ɬɵɫ. ɦ) ɧɚɛɥɸɞɚɥɨɫɶ ɭɝɧɟɬɟɧɢɟ ɚɤɬɢɜɧɨɫɬɢ ɧɟɪɜɧɵɯ ɟɞɢɧɢɰ. ɇɚ ɬɚɤɨɦ ɭɝɧɟɬɟɧɧɨɦ ɮɨɧɟ ɜɨɡɛɭɠɞɚɸɳɟɟ ɜɥɢɹɧɢɟ LM ɹɞɪɚ ɝɢɩɨɬɚɥɚɦɭɫɚ ɛɵɥɨ ɛɨɥɟɟ ɜɵɪɚɠɟɧɧɵɦ. ȼ ɜɟ ɞ ɟ ɧ ɢɟ . ɉɪɨɛɥɟɦɚ ɝɢɩɨɤɫɢɱɟɫɤɢɯ ɫɨɫɬɨɹɧɢɣ ɨɪɝɚɧɢɡɦɚ ɛɵɥɚ ɢ ɨɫɬɚɟɬɫɹ ɨɞɧɨɣ ɢɡ ɚɤɬɭɚɥɶɧɵɯ ɜ ɛɢɨɥɨɝɢɢ ɢ ɦɟɞɢɰɢɧɟ ɜɜɢɞɭ ɬɨɝɨ, ɱɬɨ ɞɚɠɟ ɡɞɨɪɨɜɵɣ ɨɪɝɚɧɢɡɦ ɱɟɥɨɜɟɤɚ ɢ ɠɢɜɨɬɧɨɝɨ ɜ ɡɚɜɢɫɢɦɨɫɬɢ ɨɬ ɭɫɥɨɜɢɣ ɨɛɢɬɚɧɢɹ, ɢɧɬɟɧɫɢɜɧɨɫɬɢ ɟɝɨ ɞɟɹɬɟɥɶɧɨɫɬɢ ɩɨɫɬɨɹɧɧɨ ɫɬɚɥɤɢɜɚɟɬɫɹ ɫ ɤɢɫɥɨɪɨɞɧɨɣ ɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶɸ. ȼ ɭɫɥɨɜɢɹɯ ɝɢɩɨɤɫɢɢ ɫɨɯɪɚɧɟɧɢɟ ɝɚɡɨɜɨɝɨ ɝɨɦɟɨɫɬɚɡɚ ɨɪɝɚɧɢɡɦɚ ɩɪɨɢɫɯɨɞɢɬ ɩɨɫɪɟɞɫɬɜɨɦ ɜɡɚɢɦɨɞɟɣɫɬɜɢɹ ɛɭɥɶɛɚɪɧɨɝɨ ɞɵɯɚɬɟɥɶɧɨɝɨ ɰɟɧɬɪɚ ɢ ɫɭɩɪɚɛɭɥɶɛɚɪɧɵɯ ɨɛɪɚɡɨɜɚɧɢɣ. ɇɚɪɹɞɭ ɫ ɞɪɭɝɢɦɢ ɫɭɩɪɚɛɭɥɶɛɚɪɧɵɦɢ ɥɢɦɛɢɱɟɫɤɢɦɢ ɫɬɪɭɤɬɭɪɚɦɢ, ɝɢɩɨɬɚɥɚɦɭɫ ɤɚɤ ɜɵɫɲɢɣ ɰɟɧɬɪ ɜɟɝɟɬɚɬɢɜɧɨɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ ɨɤɚɡɵɜɚɟɬ ɦɨɳɧɨɟ ɪɟɝɭɥɢɪɭɸɳɟɟ ɜɥɢɹɧɢɟ ɧɚ ɜɫɟ ɠɢɡɧɟɧɧɨ ɜɚɠɧɵɟ ɮɭɧɤɰɢɢ ɨɪɝɚɧɢɡɦɚ, ɜ ɬɨɦ ɱɢɫɥɟ ɢ ɧɚ ɞɵɯɚɧɢɟ [1–3]. Ɉɞɧɚɤɨ, ɧɟɫɦɨɬɪɹ ɧɚ ɜɚɠɧɨɫɬɶ ɝɢɩɨɬɚɥɚɦɢɱɟɫɤɨɝɨ ɭɪɨɜɧɹ ɪɟɝɭɥɹɰɢɢ ɜɢɫɰɟɪɚɥɶɧɵɯ ɫɢɫɬɟɦ, ɞɨ ɧɚɫɬɨɹɳɟɝɨ ɜɪɟɦɟɧɢ ɩɨɱɬɢ ɨɬɫɭɬɫɬɜɭɸɬ ɷɤɫɩɟɪɢɦɟɧɬɚɥɶɧɵɟ ɪɚɛɨɬɵ ɩɨ ɢɡɭɱɟɧɢɸ ɪɨɥɢ ɨɞɧɨɝɨ ɢɡ ɜɚɠɧɟɣɲɢɯ ɹɞɟɪ ɝɢɩɨɬɚɥɚɦɭɫɚ – ɥɚɬɟɪɚɥɶɧɨɝɨ ɦɚɦɢɥɥɹɪɧɨɝɨ (LM) ɹɞɪɚ – ɜ ɪɟɝɭɥɹɰɢɢ ɞɵɯɚɧɢɹ ɜ ɭɫɥɨɜɢɹɯ ɝɢɩɨɤɫɢɢ. ȼ ɫɜɹɡɢ ɫ ɷɬɢɦ ɰɟɥɶɸ ɧɚɲɟɣ ɪɚɛɨɬɵ ɹɜɢɥɨɫɶ ɢɡɭɱɟɧɢɟ ɪɟɚɤɰɢɣ ɞɵɯɚɬɟɥɶɧɵɯ ɧɟɣɪɨɧɨɜ ɩɪɨɞɨɥɝɨɜɚɬɨɝɨ ɦɨɡɝɚ ɢ ɞɵɯɚɧɢɹ ɧɚ ɷɥɟɤɬɪɢɱɟɫɤɨɟ ɪɚɡɞɪɚɠɟɧɢɟ LM ɹɞɪɚ ɜ ɞɢɧɚɦɢɤɟ ɝɢɩɨɤɫɢɱɟɫɤɨɝɨ ɜɨɡɞɟɣɫɬɜɢɹ. Ɇɟ ɬɨɞɢɤɚ ɢɫɫɥɟɞɨɜɚɧɢɣ. ɂɫɫɥɟɞɨɜɚɧɢɹ ɩɪɨɜɨɞɢɥɢɫɶ ɧɚ ɛɟɥɵɯ ɤɪɵɫɚɯ, ɧɚɪɤɨɬɢɡɢɪɨɜɚɧɧɵɯ ɫɦɟɫɶɸ ɯɥɨɪɨɥɨɡɵ ɢ ɧɟɦɛɭɬɚɥɚ (30 ɢ 10 ɦɝ/ɤɝ 109 ɫɨɨɬɜɟɬɫɬɜɟɧɧɨ, ɜɧɭɬɪɢɛɪɸɲɢɧɧɨ). LM ɹɞɪɨ ɝɢɩɨɬɚɥɚɦɭɫɚ ɪɚɡɞɪɚɠɚɥɢ ɛɢɩɨɥɹɪɧɵɦɢ ɤɨɧɫɬɚɧɬɚɧɨɜɵɦɢ ɷɥɟɤɬɪɨɞɚɦɢ (ɦɟɠɷɥɟɤɬɪɨɞɧɨɟ ɪɚɫɫɬɨɹɧɢɟ 0,2–0,3 ɦɦ), ɨɪɢɟɧɬɢɪɨɜɚɧɧɵɦɢ ɜ ɫɨɨɬɜɟɬɫɬɜɭɸɳɭɸ ɫɬɪɭɤɬɭɪɭ ɩɨ ɤɨɨɪɞɢɧɚɬɚɦ ɫɬɟɪɟɨɬɚɤɫɢɱɟɫɤɨɝɨ ɚɬɥɚɫɚ [4]: AP (+4,52), L (± 0,2), V (9,2). Ⱦɥɹ ɪɚɡɞɪɚɠɟɧɢɹ ɭɤɚɡɚɧɧɨɣ ɫɬɪɭɤɬɭɪɵ ɩɨɞɚɜɚɥɢ ɩɪɹɦɨɭɝɨɥɶɧɵɟ ɢɦɩɭɥɶɫɵ ɬɨɤɚ ɞɥɢɬɟɥɶɧɨɫɬɶɸ 0,1–0,3 ɦ, ɱɚɫɬɨɬɨɣ 80–100 Ƚɰ ɜ ɬɟɱɟɧɢɟ 3–10 ɫ. Ɍ ɨɤ ɫɬɢɦɭɥɹɰɢɢ ɫɨɫɬɚɜɥɹɥ 100–200 ɦɤȺ. Ⱦɥɹ ɨɬɜɟɞɟɧɢɹ ɚɤɬɢɜɧɨɫɬɢ ɪɟɫɩɢɪɚɬɨɪɧɵɯ ɧɟɣɪɨɧɨɜ ɩɨɫɥɟ ɱɚɫɬɢɱɧɨɝɨ ɭɞɚɥɟɧɢɹ ɦɨɡɠɟɱɤɚ (ɦɟɬɨɞɨɦ ɨɬɫɚɫɵɜɚɧɢɹ) ɦɢɤɪɨɷɥɟɤɬɪɨɞ ɨɩɭɫɤɚɥɢ ɜ ɨɛɥɚɫɬɶ ɡɚɞɜɢɠɤɢ (obex) ɩɪɨɞɨɥɝɨɜɚɬɨɝɨ ɦɨɡɝɚ. Ⱦɥɹ ɢɞɟɧɬɢɮɢɤɚɰɢɢ ɢɧɫɩɢɪɚɬɨɪɧɵɯ (ɂɇ) ɢ ɷɤɫɩɢɪɚɬɨɪɧɵɯ (ɗɇ) ɧɟɣɪɨɧɨɜ ɩɪɨɢɡɜɨɞɢɥɢ ɨɞɧɨɜɪɟɦɟɧɧɭɸ ɪɟɝɢɫɬɪɚɰɢɸ ɞɵɯɚɧɢɹ ɩɨɫɪɟɞɫɬɜɨɦ ɭɝɨɥɶɧɨɝɨ ɞɚɬɱɢɤɚ. ɗɤɫɬɪɚɤɥɟɬɨɱɧɭɸ ɪɟɝɢɫɬɪɚɰɢɸ ɞɵɯɚɬɟɥɶɧɵɯ ɧɟɣɪɨɧɨɜ ɩɪɨɢɡɜɨɞɢɥɢ ɜ ɨɫɧɨɜɧɨɦ ɢɡ ɜɟɧɬɪɚɥɶɧɨɣ ɡɨɧɵ ɞɵɯɚɬɟɥɶɧɨɝɨ ɰɟɧɬɪɚ ɩɪɨɞɨɥɝɨɜɚɬɨɝɨ ɦɨɡɝɚ ɫɬɟɤɥɹɧɧɵɦɢ ɦɢɤɪɨɷɥɟɤɬɪɨɞɚɦɢ, ɡɚɩɨɥɧɟɧɧɵɦɢ 4 Ɇ ɪɚɫɬɜɨɪɨɦ NaCl (ɞɢɚɦɟɬɪ ɤɨɧɱɢɤɚ 1,5–2 ɦɤɦ, ɫɨɩɪɨɬɢɜɥɟɧɢɟ 3–5 MɈɦ). ɗɤɫɩɟɪɢɦɟɧɬɵ ɩɪɨɜɨɞɢɥɢ ɜ ɞɢɧɚɦɢɤɟ ɝɢɩɨɤɫɢɱɟɫɤɨɝɨ ɜɨɡɞɟɣɫɬɜɢɹ. Ⱦɥɹ ɷɬɨɝɨ ɠɢɜɨɬɧɨɟ, ɡɚɮɢɤɫɢɪɨɜɚɧɧɨɟ ɜ ɫɬɟɪɟɨɬɚɤɫɢɱɟɫɤɨɦ ɩɪɢɛɨɪɟ, ɩɨɦɟɳɚɥɢ ɜ ɛɚɪɨɤɚɦɟɪɭ ɞɥɹ «ɩɨɞɴɟɦɚ». Ɋɟɝɢɫɬɪɚɰɢɸ ɢɡɭɱɚɟɦɵɯ ɩɨɤɚɡɚɬɟɥɟɣ ɩɪɨɢɡɜɨɞɢɥɢ ɞɨ «ɩɨɞɴɟɦɚ» ɠɢɜɨɬɧɨɝɨ, ɬ.ɟ. ɜ ɭɫɥɨɜɢɹɯ ɧɨɪɦɨɤɫɢɢ (pO2 =142 ɦɦ ɪɬ. ɫɬ.), ɧɚ «ɜɵɫɨɬɟ» 4–5 ɬɵɫ. ɦ (pO2 =109–85 ɦɦ ɪɬ. ɫɬ.) ɢ 7,5–8 ɬɵɫ. ɦ (pO2 =64– 58 ɦɦ ɪɬ. ɫɬ.), ɚ ɬɚɤɠɟ ɩɨɫɥɟ «ɫɩɭɫɤɚ», ɜ ɭɫɥɨɜɢɹɯ ɧɨɪɦɚɥɶɧɨɝɨ ɚɬɦɨɫɮɟɪɧɨɝɨ ɞɚɜɥɟɧɢɹ, ɞɨ ɢ ɫɪɚɡɭ ɩɨɫɥɟ ɪɚɡɞɪɚɠɟɧɢɹ ɦɚɦɢɥɥɹɪɧɨɝɨ ɹɞɪɚ. «ɉɨɞɴɟɦ» ɢ «ɫɩɭɫɤ» ɠɢɜɨɬɧɨɝɨ ɜ ɛɚɪɨɤɚɦɟɪɟ ɨɫɭɳɟɫɬɜɢɥɢ ɫɨ ɫɤɨɪɨɫɬɶɸ 15–20 ɦ/ɫ. ɉɨɫɥɟ ɷɤɫɩɟɪɢɦɟɧɬɚ ɩɪɨɜɨɞɢɥɢ ɷɥɟɤɬɪɨɤɨɚɝɭɥɹɰɢɸ ɬɨɱɟɤ ɪɚɡɞɪɚɠɟɧɢɹ ɞɥɹ ɩɨɫɥɟɞɭɸɳɟɝɨ ɝɢɫɬɨɥɨɝɢɱɟɫɤɨɝɨ ɤɨɧɬɪɨɥɹ. ɉɨ ɨɤɨɧɱɚɧɢɢ ɨɩɵɬɨɜ ɞɥɹ ɷɜɬɚɧɚɡɢɢ ɜɧɭɬɪɢɛɪɸɲɢɧɧɨ ɜɜɨɞɢɥɢ ɬɟ ɠɟ ɧɚɪɤɨɬɢɱɟɫɤɢɟ ɜɟɳɟɫɬɜɚ ɫ ɩɪɟɜɵɲɟɧɢɟɦ ɞɨɡɵ ɜ 3 ɪɚɡɚ. Ɋɟɝɢɫɬɪɚɰɢɹ ɩɪɨɢɡɜɨɞɢɥɚɫɶ ɫ ɩɨɦɨɳɶɸ ɩɪɨɝɪɚɦɦɵ, ɨɛɟɫɩɟɱɢɜɚɸɳɟɣ ɜ ɪɟɠɢɦɟ on-line ɫɟɥɟɤɰɢɸ ɫɩɚɣɤɨɜ ɩɨɫɪɟɞɫɬɜɨɦ ɚɦɩɥɢɬɭɞɧɨɣ ɞɢɫɤɪɢɦɢɧɚɰɢɢ. ɋɬɪɨɢɥɢɫɶ ɩɪɟɞ- ɢ ɩɨɫɬɫɬɢɦɭɥɶɧɵɟ ɝɢɫɬɨɝɪɚɦɦɵ ɦɟɠɫɩɚɣɤɨɜɵɯ ɢɧɬɟɪɜɚɥɨɜ, ɚ ɬɚɤɠɟ ɝɪɚɮɢɤɢ ɫɤɨɥɶɡɹɳɟɣ ɱɚɫɬɨɬɵ. ɉɪɢ ɷɬɨɦ ɫɨ ɫɞɜɢɝɨɦ ɜ ɫɪɟɞɧɟɦ ɜ 70 ɦɫ ɪɚɫɫɱɢɬɵɜɚɥɚɫɶ ɱɚɫɬɨɬɚ ɪɚɡɪɹɞɚ ɧɟɣɪɨɧɨɜ ɜ ɢɧɬɟɪɜɚɥɟ 120–150 ɦɫ. ɇɚ ɨɫɧɨɜɚɧɢɢ ɜɵɱɢɫɥɟɧɧɵɯ ɞɥɹ ɮɨɧɨɜɨɣ ɚɤɬɢɜɧɨɫɬɢ ɫɪɟɞɧɟɣ ɱɚɫɬɨɬɵ (Ɇ) ɢ ɫɬɚɧɞɚɪɬɧɨɝɨ ɨɬɤɥɨɧɟɧɢɹ (SD) ɨɩɪɟɞɟɥɹɥɫɹ ɞɢɚɩɚɡɨɧ ɱɚɫɬɨɬ Ɇ±2SD, ɨɬɧɨɫɢɬɟɥɶɧɨ ɤɨɬɨɪɨɝɨ ɜɵɹɜɥɹɥɢɫɶ ɩɟɪɢɨɞɵ ɩɨɫɬɬɟɬɚɧɢɱɟɫɤɨɣ ɚɤɬɢɜɚɰɢɢ ɢ (ɢɥɢ) ɞɟɩɪɟɫɫɢɢ. Ɏɚɡɵ ɬɨɪɦɨɠɟɧɢɹ ɢ ɚɤɬɢɜɚɰɢɢ ɫɨɨɬɜɟɬɫɬɜɨɜɚɥɢ ɬɟɦ ɜɪɟɦɟɧɧɵɦ ɨɬɪɟɡɤɚɦ, ɤɨɝɞɚ ɜɟɥɢɱɢɧɚ ɝɢɫɬɨɝɪɚɦɦ ɛɵɥɚ ɛɨɥɶɲɟ ɢɥɢ ɦɟɧɶɲɟ ɜɵɱɢɫɥɟɧɧɨɝɨ ɫɪɟɞɧɟɝɨ ɡɧɚɱɟɧɢɹ ɮɨɧɨɜɨɣ ɚɤɬɢɜɧɨɫɬɢ (Ɇ±2SD). ȼ ɫɥɭɱɚɟ, ɤɨɝɞɚ 2SD ɩɪɟɜɵɲɚɥ Ɇ, ɭɪɨɜɟɧɶ ɬɨɪɦɨɠɟɧɢɹ ɨɩɪɟɞɟɥɹɥɫɹ ɩɨ ɧɭɥɟɜɨɣ ɥɢɧɢɢ. Ɉɬɤɥɨɧɟɧɢɹ ɫɪɟɞɧɟɣ ɜɟɥɢɱɢɧɵ ɜɵɱɢɫɥɹɥɢɫɶ ɩɨ ɋɬɶɸɞɟɧɬɭ (p<0,05). Ɋɟ ɡɭɥɶɬɚɬɵ ɢɫɫɥɟ ɞɨɜɚɧɢɹ ɢ ɨɛɫɭɠɞɟ ɧɢɟ . ɉɨ ɯɚɪɚɤɬɟɪɭ ɪɟɚɤɰɢɢ ɧɚ ɪɚɡɞɪɚɠɟɧɢɟ LM ɹɞɪɚ ɪɟɫɩɢɪɚɬɨɪɧɵɟ ɧɟɣɪɨɧɵ ɦɨɠɧɨ ɪɚɡɞɟɥɢɬɶ ɧɚ ɬɪɢ ɝɪɭɩɩɵ: 1 – ɚɤɬɢɜɢɪɨɜɚɜɲɢɟɫɹ (ɫɬɢɦɭɥɹɰɢɹ ɩɪɢɜɟɥɚ ɤ ɩɨɜɵɲɟɧɢɸ ɢɦɩɭɥɶɫɧɨɣ ɚɤɬɢɜɧɨɫɬɢ), 2 – ɬɨɪɦɨɡɢɜɲɢɟɫɹ (ɫɬɢɦɭɥɹɰɢɹ ɩɪɢɜɟɥɚ ɤ ɩɨɧɢɠɟɧɢɸ ɢɦɩɭɥɶɫɧɨɣ ɚɤɬɢɜɧɨɫɬɢ), 3 – ɚɪɟɚɤɬɢɜɧɵɟ ɧɟɣɪɨɧɵ (ɧɟ ɩɪɨɹɜɢɜɲɢɟ ɧɢɤɚɤɨɣ 110 ɪɟɚɤɰɢɢ ɧɚ ɪɚɡɞɪɚɠɟɧɢɟ). Ʉ ɬɨɣ ɢɥɢ ɢɧɨɣ ɝɪɭɩɩɟ ɨɬɧɨɫɢɥɢ ɧɟɣɪɨɧɵ, ɭ ɤɨɬɨɪɵɯ ɷɮɮɟɤɬɵ ɪɚɡɞɪɚɠɟɧɢɹ ɛɵɥɢ ɨɛɪɚɬɢɦɵɦɢ ɩɪɢ ɩɪɟɤɪɚɳɟɧɢɢ ɪɚɡɞɪɚɠɟɧɢɹ ɢ ɜɨɫɩɪɨɢɡɜɨɞɢɦɵɦɢ ɩɪɢ ɩɨɜɬɨɪɧɨɦ ɪɚɡɞɪɚɠɟɧɢɢ. Ɉɬɜɟɬɧɚɹ ɪɟɚɤɰɢɹ ɧɟɣɪɨɧɨɜ ɧɚ ɪɚɡɞɪɚɠɟɧɢɟ LM ɹɞɪɚ ɨɩɪɟɞɟɥɹɥɚɫɶ ɩɨ ɤɨɥɢɱɟɫɬɜɭ ɚɤɬɢɜɢɪɨɜɚɜɲɢɯɫɹ ɢ ɬɨɪɦɨɡɢɜɲɢɯɫɹ ɧɟɣɪɨɧɨɜ, ɚ ɬɚɤɠɟ ɩɨ ɫɬɟɩɟɧɢ ɢɡɦɟɧɟɧɢɹ ɢɯ ɚɤɬɢɜɧɨɫɬɢ. ȼɧɚɱɚɥɟ ɪɟɝɢɫɬɪɚɰɢɹ ɞɵɯɚɬɟɥɶɧɵɯ ɧɟɣɪɨɧɨɜ ɧɚ ɪɚɡɞɪɚɠɟɧɢɟ LɆ ɹɞɪɚ ɩɪɨɢɡɜɨɞɢɥɚɫɶ ɜ ɭɫɥɨɜɢɹɯ ɧɨɪɦɨɤɫɢɢ, ɬ.ɟ. ɞɨ «ɩɨɞɴɟɦɚ» ɠɢɜɨɬɧɨɝɨ, ɱɬɨ ɩɨɫɥɭɠɢɥɨ ɤɨɧɬɪɨɥɟɦ ɞɥɹ ɨɩɵɬɨɜ, ɩɪɨɜɨɞɢɦɵɯ ɩɪɢ ɜɨɡɞɟɣɫɬɜɢɢ ɨɫɬɪɨɣ ɝɢɩɨɤɫɢɢ. ȼ ɭɫɥɨɜɢɹɯ ɧɨɪɦɨɤɫɢɢ ɪɚɡɞɪɚɠɟɧɢɟ LM ɹɞɪɚ ɨɤɚɡɵɜɚɥɨ ɩɪɟɢɦɭɳɟɫɬɜɟɧɧɨ ɜɨɡɛɭɠɞɚɸɳɟɟ ɜɥɢɹɧɢɟ ɧɚ ɢɦɩɭɥɶɫɧɭɸ ɚɤɬɢɜɧɨɫɬɶ ɞɵɯɚɬɟɥɶɧɵɯ ɧɟɣɪɨɧɨɜ ɢ ɧɚ ɞɵɯɚɧɢɟ ɜ ɰɟɥɨɦ. Ɍ ɚɤ, ɢɡ 48 ɗɇ ɚɤɬɢɜɢɪɨɜɚɥɢɫɶ 30 (62,5%), ɬɨɪɦɨɡɢɥɢɫɶ 16 (33,3%), ɚ ɨɫɬɚɥɶɧɵɟ ɧɟɣɪɨɧɵ ɨɤɚɡɚɥɢɫɶ ɚɪɟɚɤɬɢɜɧɵɦɢ (ɫɦ. ɬɚɛɥ.). ɉɪɢ ɷɬɨɦ ɛɵɥɨ ɭɫɬɚɧɨɜɥɟɧɨ, ɱɬɨ ɱɚɫɬɨɬɚ ɪɚɡɪɹɞɚ ɚɤɬɢɜɢɪɨɜɚɜɲɢɯɫɹ ɧɟɣɪɨɧɨɜ ɞɨ ɪɚɡɞɪɚɠɟɧɢɹ ɫɨɫɬɚɜɥɹɥɚ 21,56 ɢɦɩ./ɫ, ɚ ɩɨɫɥɟ ɪɚɡɞɪɚɠɟɧɢɹ ɭɜɟɥɢɱɢɜɚɥɚɫɶ ɞɨ 28 ɢɦɩ./ɫ, ɬ.ɟ. ɧɚ 29,8%. ɍ ɬɨɪɦɨɡɢɜɲɢɯɫɹ ɗɇ ɭɦɟɧɶɲɟɧɢɟ ɱɚɫɬɨɬɵ ɪɚɡɪɹɞɚ ɫɨɫɬɚɜɥɹɥɨ ɨɬ 25 ɞɨ 19,03 ɢɦɩ./ɫ, ɬ.ɟ. 23,88% (ɪɢɫ. 1). Ɋɢɫ. 1. ɉɪɟɞ- ɢ ɩɨɫɬɫɬɢɦɭɥɶɧɵɟ ɯɚɪɚɤɬɟɪɢɫɬɢɤɢ ɢɦɩɭɥɶɫɧɨɝɨ ɩɨɬɨɤɚ ɷɤɫɩɢɪɚɬɨɪɧɨɝɨ ɧɟɣɪɨɧɚ ɞɵɯɚɬɟɥɶɧɨɝɨ ɰɟɧɬɪɚ ɩɪɨɞɨɥɝɨɜɚɬɨɝɨ ɦɨɡɝɚ ɩɪɢ ɪɚɡɞɪɚɠɟɧɢɢ LM ɹɞɪɚ ɝɢɩɨɬɚɥɚɦɭɫɚ ɜ ɧɨɪɦɟ. Ɂɞɟɫɶ ɢ ɧɚ ɫɥɟɞɭɸɳɢɯ ɪɢɫɭɧɤɚɯ ɩɨɤɚɡɚɧɚ ɧɚɢɛɨɥɟɟ ɞɢɧɚɦɢɱɧɚɹ ɱɚɫɬɶ ɷɤɫɩɟɪɢɦɟɧɬɚ: 1 – ɞɨ ɫɬɢɦɭɥɹɰɢɢ, 2 – ɜɨ ɜɪɟɦɹ (A – ɧɚɱɚɥɨ, Ȼ – ɤɨɧɟɰ ɫɬɢɦɭɥɹɰɢɢ), ɢ 3 – ɩɨɫɥɟ ɫɬɢɦɭɥɹɰɢɢ. I – ɧɟɣɪɨɧɚɥɶɧɚɹ ɚɤɬɢɜɧɨɫɬɶ ɫ ɪɟɝɢɫɬɪɚɰɢɟɣ ɜɧɟɲɧɟɝɨ ɞɵɯɚɧɢɹ (ɜɟɪɯɧɹɹ ɤɪɢɜɚɹ). II – ɤɪɢɜɚɹ ɫɤɨɥɶɡɹɳɟɣ ɱɚɫɬɨɬɵ ɚɤɬɢɜɧɨɫɬɢ ɧɟɣɪɨɧɨɜ; ɩɨ ɨɫɢ ɚɛɫɰɢɫɫ – ɱɚɫɬɨɬɚ ɢɦɩɭɥɶɫɚɰɢɢ, ɩɨ ɨɫɢ ɨɪɞɢɧɚɬ – ɜɪɟɦɹ (ɫɩɥɨɲɧɚɹ ɥɢɧɢɹ ɨɬɧɨɫɢɬɫɹ ɤ ɫɪɟɞɧɟɣ ɱɚɫɬɨɬɟ (M), ɩɭɧɤɬɢɪɧɚɹ ɥɢɧɢɹ – ɤ ɭɪɨɜɧɸ + 2SD). III – ɤɭɦɭɥɹɬɢɜɧɚɹ ɤɪɢɜɚɹ ɫɩɚɣɤɨɜɨɣ ɚɤɬɢɜɧɨɫɬɢ, ɤɨɬɨɪɚɹ ɞɚɟɬɫɹ ɞɥɹ ɧɚɝɥɹɞɧɨɣ ɨɰɟɧɤɢ ɩɟɪɢɨɞɨɜ ɚɤɬɢɜɚɰɢɢ ɢ ɬɨɪɦɨɠɟɧɢɹ ɩɨ ɢɡɦɟɧɟɧɢɸ ɭɝɥɚ ɧɚɤɥɨɧɚ ɩɨɫɬɫɬɢɦɭɥɶɧɨɣ ɤɪɢɜɨɣ (3) ɩɨ ɨɬɧɨɲɟɧɢɸ ɤ ɮɨɧɨɜɨɣ ɤɪɢɜɨɣ (1). ɉɨ ɨɫɢ ɚɛɫɰɢɫɫ – ɜɪɟɦɹ, ɩɨ ɨɫɢ ɨɪɞɢɧɚɬ – ɫɭɦɦɚɰɢɹ ɫɩɚɣɤɨɜ ɩɨɫɥɟ ɫɬɢɦɭɥɹɰɢɢ. IV – ɫɩɚɣɤɨɜɚɹ ɚɤɬɢɜɧɨɫɬɶ ɜ ɪɟɚɥɶɧɨɦ ɜɪɟɦɟɧɢ. 111 Ɋɟɚɤɰɢɹ ɂɇ ɧɚ ɪɚɡɞɪɚɠɟɧɢɟ ɬɨɝɨ ɠɟ ɹɞɪɚ ɝɢɩɨɬɚɥɚɦɭɫɚ ɛɵɥɚ ɫɥɟɞɭɸɳɟɣ: ɢɡ 32 ɂɇ 21 ɭɜɟɥɢɱɢɥɢ ɫɪɟɞɧɸɸ ɱɚɫɬɨɬɭ ɪɚɡɪɹɞɚ ɨɬ 23,04 ɞɨ 30,00 ɢɦɩ./ɫ (ɧɚ 30,2%), ɚ 9 ɬɨɪɦɨɡɢɜɲɢɯɫɹ ɧɟɣɪɨɧɨɜ ɭɦɟɧɶɲɢɥɢ ɫɪɟɞɧɸɸ ɱɚɫɬɨɬɭ ɢɦɩɭɥɶɫɚɰɢɢ ɨɬ 26,26 ɞɨ 20,03 ɢɦɩ./ɫ, ɬ. ɟ. ɧɚ 23,7%. ȼɥɢɹɧɢɟ ɪɚɡɞɪɚɠɟɧɢɹ ɥɚɬɟɪɚɥɶɧɨɝɨ ɦɚɦɢɥɥɹɪɧɨɝɨ ɹɞɪɚ ɝɢɩɨɬɚɥɚɦɭɫɚ ɧɚ ɞɵɯɚɬɟɥɶɧɵɟ ɧɟɣɪɨɧɵ ɩɪɨɞɨɥɝɨɜɚɬɨɝɨ ɦɨɡɝɚ ɜ ɭɫɥɨɜɢɹɯ ɝɢɩɨɤɫɢɢ ɍɫɥɨɜɢɹ ɨɩɵɬɚ Ɉɛɳɟɟ ɤɨɥ-ɜɨ ɧɟɣɪɨɧɨɜ ɧɨɪɦɚ 4–5 ɬɵɫ. ɦ 7,5–8 ɬɵɫ. ɦ «ɫɩɭɫɤ» 48 (100%) 35 (73%) 28 (58%) 45 (94%) ɧɨɪɦɚ 4–5 ɬɵɫ. ɦ 7,5–8 ɬɵɫ. ɦ «ɫɩɭɫɤ» 32 (100%) 28 (88%) 19 (59,4%) 30 (94%) Ⱥɤɬɢɜɢɪɨɜɚɜɲɢɟɫɹ Ɍɨɪɦɨɡɢɜɲɢɟɫɹ ɧɟɣɪɨɧɵ ɧɟɣɪɨɧɵ ɗɤɫɩɢɪɚɬɨɪɧɵɟ ɧɟɣɪɨɧɵ 30 (62,5%) 16 (33,3%) 20 (57,14%) 12 (34,3%) 17 (60,7%) 9 (32,14%) 25 (55,6%) 17 (37,7%) ɂɧɫɩɢɪɚɬɨɪɧɵɟ ɧɟɣɪɨɧɵ 21 (65,6%) 9 (28,13%) 17 (60,7%) 10 (35,7%) 12 (63,16%) 6 (31,6%) 18 (60%) 9 (30%) Ⱥɪɟɚɤɬɢɜɧɵɟ ɧɟɣɪɨɧɵ 2 (4,2%) 3 (8,57%) 2 (7,14%) 3 (6,66%) 2 (6,25%) 1 (3,57%) 1 (5,26%) 3 (10%) ɉɨɫɥɟ ɭɫɬɚɧɨɜɥɟɧɢɹ ɢɫɯɨɞɧɵɯ ɞɚɧɧɵɯ ɪɟɝɢɫɬɪɚɰɢɹ ɬɟɯ ɠɟ ɪɟɫɩɢɪɚɬɨɪɧɵɯ ɧɟɣɪɨɧɨɜ ɧɚ ɬɚɤɨɟ ɠɟ ɪɚɡɞɪɚɠɟɧɢɟ LM ɹɞɪɚ ɝɢɩɨɬɚɥɚɦɭɫɚ ɩɪɨɞɨɥɠɚɥɨɫɶ ɩɪɢ ɜɨɡɞɟɣɫɬɜɢɢ ɝɢɩɨɤɫɢɢ. Ɋɢɫ. 2. ɉɪɟɞ- ɢ ɩɨɫɬɫɬɢɦɭɥɶɧɵɟ ɯɚɪɚɤɬɟɪɢɫɬɢɤɢ ɢɦɩɭɥɶɫɧɨɝɨ ɩɨɬɨɤɚ ɷɤɫɩɢɪɚɬɨɪɧɨɝɨ ɧɟɣɪɨɧɚ ɞɵɯɚɬɟɥɶɧɨɝɨ ɰɟɧɬɪɚ ɩɪɨɞɨɥɝɨɜɚɬɨɝɨ ɦɨɡɝɚ ɩɪɢ ɪɚɡɞɪɚɠɟɧɢɢ LM ɹɞɪɚ ɝɢɩɨɬɚɥɚɦɭɫɚ ɜ ɭɫɥɨɜɢɹɯ ɩɟɪɜɨɣ ɫɬɚɞɢɢ ɝɢɩɨɤɫɢɢ (4–5 ɬɵɫ. ɦ). ȼ ɧɚɱɚɥɶɧɨɣ ɮɚɡɟ ɝɢɩɨɤɫɢɢ (4–5 ɬɵɫ. ɦ) ɢɦɩɭɥɶɫɧɚɹ ɚɤɬɢɜɧɨɫɬɶ ɜɫɟɯ ɮɭɧɤɰɢɨɧɢɪɭɸɳɢɯ ɧɟɣɪɨɧɨɜ ɜ ɪɟɡɭɥɶɬɚɬɟ ɝɢɩɨɤɫɢɱɟɫɤɨɝɨ ɜɨɡɞɟɣɫɬɜɢɹ ɛɵɥɚ 112 ɧɟɫɤɨɥɶɤɨ ɭɜɟɥɢɱɟɧɚ. ɇɚ ɬɚɤɨɦ ɨɛɥɟɝɱɟɧɧɨɦ ɮɨɧɟ ɪɚɡɞɪɚɠɟɧɢɟ LM ɹɞɪɚ ɜɵɡɵɜɚɥɨ ɭ ɚɤɬɢɜɢɪɨɜɚɜɲɢɯɫɹ ɗɇ ɭɜɟɥɢɱɟɧɢɟ ɫɪɟɞɧɟɣ ɱɚɫɬɨɬɵ ɢɦɩɭɥɶɫɚɰɢɢ ɧɚ 18,7%, ɚ ɭ ɬɨɪɦɨɡɢɜɲɢɯɫɹ – ɭɦɟɧɶɲɟɧɢɟ ɫɪɟɞɧɟɣ ɱɚɫɬɨɬɵ ɧɚ 20,39%. Ɋɟɚɤɰɢɹ ɂɇ ɫɨɨɬɜɟɬɫɬɜɟɧɧɨ ɫɨɫɬɚɜɥɹɥɚ 23,27 ɢ 19,56%. ȼ ɷɬɨɬ ɩɟɪɢɨɞ ɩɚɪɚɥɥɟɥɶɧɨ ɫ ɝɢɩɨɤɫɢɱɟɫɤɨɣ ɚɤɬɢɜɚɰɢɟɣ ɢɦɩɭɥɶɫɧɨɝɨ ɪɚɡɪɹɞɚ ɧɟɣɪɨɧɨɜ ɛɵɥɨ ɡɚɪɟɝɢɫɬɪɢɪɨɜɚɧɨ ɢ ɭɱɚɳɟɧɢɟ ɞɵɯɚɧɢɹ. ɇɚ ɷɬɨɦ ɮɨɧɟ ɷɮɮɟɤɬ ɪɚɡɞɪɚɠɟɧɢɹ LM ɹɞɪɚ ɛɵɥ ɦɟɧɟɟ ɜɵɪɚɠɟɧɧɵɦ (ɪɢɫ. 2). ȼɨ ɜɬɨɪɨɣ ɮɚɡɟ ɝɢɩɨɤɫɢɱɟɫɤɨɝɨ ɜɨɡɞɟɣɫɬɜɢɹ (7,5–8 ɬɵɫ. ɦ) ɢɡɦɟɧɟɧɢɟ ɢɦɩɭɥɶɫɧɨɣ ɚɤɬɢɜɧɨɫɬɢ ɞɵɯɚɬɟɥɶɧɵɯ ɧɟɣɪɨɧɨɜ ɜɵɪɚɠɚɥɨɫɶ ɜ ɭɦɟɧɶɲɟɧɢɢ ɤɨɥɢɱɟɫɬɜɚ ɢɦɩɭɥɶɫɨɜ ɜ ɡɚɥɩɟ, ɚ ɜ ɪɹɞɟ ɫɥɭɱɚɟɜ – ɜ ɩɨɥɧɨɦ ɭɝɧɟɬɟɧɢɢ ɢɯ ɚɤɬɢɜɧɨɫɬɢ. ɉɪɢ ɷɬɨɦ ɩɪɨɞɨɥɠɚɥɢ ɨɫɬɚɜɚɬɶɫɹ ɚɤɬɢɜɧɵɦɢ ɜɫɟɝɨ 28 ɗɇ ɢ 19 ɂɇ (ɫɦ. ɬɚɛɥɢɰɭ). Ɋɟɚɤɰɢɹ ɷɬɢɯ ɧɟɣɪɨɧɨɜ ɧɚ ɪɚɡɞɪɚɠɟɧɢɟ LM ɹɞɪɚ ɝɢɩɨɬɚɥɚɦɭɫɚ ɫɥɟɞɭɸɳɚɹ: ɭ ɚɤɬɢɜɢɪɨɜɚɜɲɢɯɫɹ ɗɇ ɧɚɛɥɸɞɚɥɨɫɶ ɭɜɟɥɢɱɟɧɢɟ ɢɦɩɭɥɶɫɧɨɣ ɚɤɬɢɜɧɨɫɬɢ ɧɚ 23%, ɚ ɭ ɬɨɪɦɨɡɢɜɲɢɯɫɹ – ɭɦɟɧɶɲɟɧɢɟ ɧɚ 21,29%. ɑɚɫɬɨɬɚ ɪɚɡɪɹɞɚ ɚɤɬɢɜɢɪɨɜɚɜɲɢɯɫɹ ɂɇ ɩɨɫɥɟ ɪɚɡɞɪɚɠɟɧɢɹ ɭɜɟɥɢɱɢɥɚɫɶ ɧɚ 25%, ɚ ɭ ɬɨɪɦɨɡɢɜɲɢɯɫɹ – ɭɦɟɧɶɲɢɥɚɫɶ ɧɚ 20,54% (ɪɢɫ. 3). ɗɬɢ ɞɚɧɧɵɟ ɩɨɤɚɡɵɜɚɸɬ, ɱɬɨ ɜ ɭɫɥɨɜɢɹɯ ɬɹɠɟɥɨɣ ɝɢɩɨɤɫɢɢ LM ɹɞɪɨ ɨɤɚɡɵɜɚɟɬ ɩɪɟɢɦɭɳɟɫɬɜɟɧɧɨ ɚɤɬɢɜɢɪɭɸɳɟɟ ɜɥɢɹɧɢɟ. Ɋɢɫ. 3. ɉɪɟɞ- ɢ ɩɨɫɬɫɬɢɦɭɥɶɧɵɟ ɯɚɪɚɤɬɟɪɢɫɬɢɤɢ ɢɦɩɭɥɶɫɧɨɝɨ ɩɨɬɨɤɚ ɷɤɫɩɢɪɚɬɨɪɧɨɝɨ ɧɟɣɪɨɧɚ ɞɵɯɚɬɟɥɶɧɨɝɨ ɰɟɧɬɪɚ ɩɪɨɞɨɥɝɨɜɚɬɨɝɨ ɦɨɡɝɚ ɩɪɢ ɪɚɡɞɪɚɠɟɧɢɢ LM ɹɞɪɚ ɝɢɩɨɬɚɥɚɦɭɫɚ ɜ ɭɫɥɨɜɢɹɯ ɜɬɨɪɨɣ ɫɬɚɞɢɢ ɝɢɩɨɤɫɢɢ (7,5–8 ɬɵɫ. ɦ). ɋɩɭɫɬɹ 10–15 ɦɢɧ ɩɨɫɥɟ ɜɨɡɜɪɚɳɟɧɢɹ ɠɢɜɨɬɧɨɝɨ ɜ ɭɫɥɨɜɢɹ ɧɨɪɦɚɥɶɧɨɝɨ ɚɬɦɨɫɮɟɪɧɨɝɨ ɞɚɜɥɟɧɢɹ ɩɪɨɢɫɯɨɞɢɥɨ ɩɨɫɬɟɩɟɧɧɨɟ ɜɨɫɫɬɚɧɨɜɥɟɧɢɟ ɤɚɤ ɢɫɯɨɞɧɨɣ ɢɦɩɭɥɶɫɧɨɣ ɚɤɬɢɜɧɨɫɬɢ ɧɟɣɪɨɧɨɜ ɢ ɞɵɯɚɧɢɹ, ɬɚɤ ɢ ɪɟɚɤɰɢɢ ɢɯ ɧɚ ɪɚɡɞɪɚɠɟɧɢɟ (ɪɢɫ. 4). 113 Ɋɟɡɭɥɶɬɚɬɵ ɩɪɟɞɫɬɚɜɥɟɧɧɵɯ ɞɚɧɧɵɯ ɫɜɢɞɟɬɟɥɶɫɬɜɭɸɬ, ɱɬɨ LM ɹɞɪɨ ɝɢɩɨɬɚɥɚɦɭɫɚ ɨɤɚɡɵɜɚɟɬ ɫɭɳɟɫɬɜɟɧɧɨɟ ɜɥɢɹɧɢɟ ɧɚ ɚɤɬɢɜɧɨɫɬɶ ɧɟɣɪɨɧɨɜ ɞɵɯɚɬɟɥɶɧɨɝɨ ɰɟɧɬɪɚ ɩɪɨɞɨɥɝɨɜɚɬɨɝɨ ɦɨɡɝɚ ɢ ɧɚ ɜɧɟɲɧɟɟ ɞɵɯɚɧɢɟ ɤɚɤ ɩɪɢ ɧɨɪɦɨɤɫɢɢ, ɬɚɤ ɢ ɜ ɞɢɧɚɦɢɤɟ ɝɢɩɨɤɫɢɱɟɫɤɨɝɨ ɜɨɡɞɟɣɫɬɜɢɹ. Ɉɧɨ ɧɚɩɪɚɜɥɟɧɨ ɧɚ ɨɛɟɫɩɟɱɟɧɢɟ ɫɨɨɬɜɟɬɫɬɜɭɸɳɢɯ ɜɟɝɟɬɚɬɢɜɧɵɯ ɪɟɮɥɟɤɫɨɜ ɢ ɨɛɳɟɝɨ ɤɢɫɥɨɪɨɞɧɨɝɨ ɝɨɦɟɨɫɬɚɡɚ ɩɪɢ ɝɢɩɨɤɫɢɢ. ȼ ɧɚɲɢɯ ɨɩɵɬɚɯ ɧɚɛɥɸɞɚɥɚɫɶ ɜɵɫɨɤɚɹ ɪɟɚɤɬɢɜɧɨɫɬɶ ɧɟɣɪɨɧɨɜ ɞɵɯɚɬɟɥɶɧɨɝɨ ɰɟɧɬɪɚ ɩɪɢ ɷɥɟɤɬɪɨɫɬɢɦɭɥɹɰɢɢ LM ɹɞɪɚ, ɱɬɨ ɫɜɢɞɟɬɟɥɶɫɬɜɭɟɬ ɨ ɬɟɫɧɨɣ ɫɜɹɡɢ ɝɢɩɨɬɚɥɚɦɭɫɚ ɫ ɞɵɯɚɬɟɥɶɧɵɦ ɰɟɧɬɪɨɦ ɩɪɨɞɨɥɝɨɜɚɬɨɝɨ ɦɨɡɝɚ [5, 6]. Ɋɢɫ. 4. ɉɪɟɞ- ɢ ɩɨɫɬɫɬɢɦɭɥɶɧɵɟ ɯɚɪɚɤɬɟɪɢɫɬɢɤɢ ɢɦɩɭɥɶɫɧɨɝɨ ɩɨɬɨɤɚ ɷɤɫɩɢɪɚɬɨɪɧɨɝɨ ɧɟɣɪɨɧɚ ɞɵɯɚɬɟɥɶɧɨɝɨ ɰɟɧɬɪɚ ɩɪɨɞɨɥɝɨɜɚɬɨɝɨ ɦɨɡɝɚ ɩɪɢ ɪɚɡɞɪɚɠɟɧɢɢ LM ɹɞɪɚ ɝɢɩɨɬɚɥɚɦɭɫɚ ɩɨɫɥɟ «ɫɩɭɫɤɚ» . ȼ ɭɫɥɨɜɢɹɯ ɩɨɧɢɠɟɧɧɨɝɨ pO2 ɩɪɨɢɫɯɨɞɹɬ ɡɚɦɟɬɧɵɟ ɢɡɦɟɧɟɧɢɹ ɜɨ ɜɡɚɢɦɨɨɬɧɨɲɟɧɢɹɯ ɦɟɠɞɭ ɫɬɪɭɤɬɭɪɚɦɢ ɥɢɦɛɢɱɟɫɤɨɣ ɫɢɫɬɟɦɵ, ɜ ɱɚɫɬɧɨɫɬɢ ɝɢɩɨɬɚɥɚɦɭɫɚ ɢ ɞɵɯɚɬɟɥɶɧɨɝɨ ɰɟɧɬɪɚ ɩɪɨɞɨɥɝɨɜɚɬɨɝɨ ɦɨɡɝɚ. Ƚɥɭɛɨɤɢɣ ɚɧɚɥɢɡ ɷɬɢɯ ɜɡɚɢɦɨɨɬɧɨɲɟɧɢɣ, ɨɫɨɛɟɧɧɨ ɜ ɞɢɧɚɦɢɤɟ ɝɢɩɨɤɫɢɱɟɫɤɨɝɨ ɜɨɡɞɟɣɫɬɜɢɹ, ɢɦɟɟɬ ɜɚɠɧɨɟ ɬɟɨɪɟɬɢɱɟɫɤɨɟ ɢ ɩɪɚɤɬɢɱɟɫɤɨɟ ɡɧɚɱɟɧɢɟ. Ɍ ɚɤ, ɩɪɢ «ɩɨɞɴɟɦɟ» ɠɢɜɨɬɧɨɝɨ ɛɵɥɢ ɜɵɞɟɥɟɧɵ ɞɜɟ ɮɚ ɡɵ: ɩɟɪɜɚɹ – ɧɚ «ɜɵɫɨɬɟ» 4–5 ɬɵɫ. ɦ, ɤɨɝɞɚ ɧɚɫɬɭɩɚɥɨ ɩɨɜɵɲɟɧɢɟ ɚɤɬɢɜɧɨɫɬɢ ɞɵɯɚɬɟɥɶɧɵɯ ɧɟɣɪɨɧɨɜ, ɨɛɭɫɥɨɜɥɟɧɧɨɟ ɤɚɤ ɪɟɮɥɟɤɬɨɪɧɵɦ, ɬɚɤ ɢ ɧɟɩɨɫɪɟɞɫɬɜɟɧɧɵɦ ɜɨɡɞɟɣɫɬɜɢɟɦ ɩɨɧɢɠɟɧɧɨɝɨ pO2 ɧɚ ɧɟɪɜɧɵɟ ɤɥɟɬɤɢ, ɚ ɬɚɤɠɟ ɞɟɩɨɥɹɪɢɡɚɰɢɟɣ ɢɯ ɦɟɦɛɪɚɧɵ [7, 8]. ȼɬɨɪɚɹ ɮɚɡɚ ɧɚɫɬɭɩɚɥɚ ɩɪɢ ɭɜɟɥɢɱɟɧɢɢ «ɜɵɫɨɬɵ» ɞɨ 7,5–8 ɬɵɫ. ɦ, ɤɨɝɞɚ, ɧɚɨɛɨɪɨɬ, ɩɪɨɢɫɯɨɞɢɥɨ ɭɝɧɟɬɟɧɢɟ ɚɤɬɢɜɧɨɫɬɢ ɧɟɣɪɨɧɨɜ. ɗɬɨ ɹɜɥɹɟɬɫɹ ɪɟɡɭɥɶɬɚɬɨɦ ɧɚɪɭɲɟɧɢɹ ɫɬɪɭɤɬɭɪɧɨ-ɮɭɧɤɰɢɨɧɚɥɶɧɨɣ ɨɪɝɚɧɢɡɚɰɢɢ ɤɥɟɬɨɱɧɵɯ 114 ɦɟɦɛɪɚɧ, ɚ ɬɚɤɠɟ ɪɚɡɜɢɬɢɟɦ ɤɥɟɬɨɱɧɨɝɨ ɚɰɢɞɨɡɚ ɢ ɭɜɟɥɢɱɟɧɢɟɦ ȽȺɆɄ ɜ ɦɨɡɝɭ [7, 9]. ɉɪɢ ɢɡɭɱɟɧɢɢ ɪɟɚɤɰɢɣ ɞɵɯɚɬɟɥɶɧɵɯ ɧɟɣɪɨɧɨɜ ɩɪɨɞɨɥɝɨɜɚɬɨɝɨ ɦɨɡɝɚ ɧɚ ɪɚɡɞɪɚɠɟɧɢɟ LM ɹɞɪɚ ɝɢɩɨɬɚɥɚɦɭɫɚ ɜ ɭɫɥɨɜɢɹɯ ɧɨɪɦɚɥɶɧɨɝɨ ɚɬɦɨɫɮɟɪɧɨɝɨ ɞɚɜɥɟɧɢɹ ɛɵɥɨ ɡɚɪɟɝɢɫɬɪɢɪɨɜɚɧɨ ɤɚɤ ɭɜɟɥɢɱɟɧɢɟ, ɬɚɤ ɢ ɭɦɟɧɶɲɟɧɢɟ ɱɚɫɬɨɬɵ ɪɚɡɪɹɞɚ ɧɟɣɪɨɧɨɜ, ɱɬɨ ɨɬɦɟɱɚɥɨɫɶ ɬɚɤɠɟ ɭ ɚɜɬɨɪɨɜ [2, 10], ɨɞɧɚɤɨ ɚɤɬɢɜɢɪɨɜɚɜɲɢɯɫɹ ɧɟɣɪɨɧɨɜ ɛɵɥɨ ɛɨɥɶɲɟ, ɱɟɦ ɧɟɣɪɨɧɨɜ, ɨɬɜɟɱɚɜɲɢɯ ɩɨɥɧɵɦ ɢɥɢ ɱɚɫɬɢɱɧɵɦ ɬɨɪɦɨɠɟɧɢɟɦ. ɋɥɨɠɧɨɫɬɶ ɢ ɧɟɨɞɧɨɡɧɚɱɧɨɫɬɶ ɜɥɢɹɧɢɹ LM ɹɞɪɚ ɧɚ ɞɵɯɚɬɟɥɶɧɵɟ ɧɟɣɪɨɧɵ ɦɨɠɧɨ ɨɛɴɹɫɧɢɬɶ ɬɟɦ, ɱɬɨ ɜ ɪɚɡɞɪɚɠɚɟɦɨɦ ɹɞɪɟ ɞɢɮɮɭɡɧɨ ɪɚɫɫɟɹɧɵ ɤɚɤ ɚɤɬɢɜɢɪɭɸɳɢɟɫɹ, ɬɚɤ ɢ ɬɨɪɦɨɡɢɜɲɢɟɫɹ ɧɟɣɪɨɧɵ ɫ ɜɵɪɚɠɟɧɧɵɦ ɩɪɟɨɛɥɚɞɚɧɢɟɦ ɬɟɯ ɢɥɢ ɞɪɭɝɢɯ [10]. ȼɥɢɹɧɢɟ LM ɹɞɪɚ ɝɢɩɨɬɚɥɚɦɭɫɚ ɧɚ ɮɭɧɤɰɢɨɧɚɥɶɧɨɟ ɫɨɫɬɨɹɧɢɟ ɧɟɣɪɨɧɨɜ ɞɵɯɚɬɟɥɶɧɨɝɨ ɰɟɧɬɪɚ ɦɨɠɟɬ ɨɫɭɳɟɫɬɜɥɹɬɶɫɹ ɤɚɤ ɡɚ ɫɱɟɬ ɤɨɧɜɟɪɝɟɧɰɢɢ ɢɯ ɷɮɮɟɪɟɧɬɧɵɯ ɩɪɨɟɤɰɢɣ ɧɚ ɭɪɨɜɧɟ ɫɬɜɨɥɚ ɦɨɡɝɚ, ɚɦɢɝɞɚɥɵ, ɬɚɤ ɢ ɩɨɫɪɟɞɫɬɜɨɦ ɩɪɹɦɵɯ ɫɜɹɡɟɣ ɫ ɹɞɪɚɦɢ ɩɪɨɞɨɥɝɨɜɚɬɨɝɨ ɦɨɡɝɚ [1, 11, 12]. ȼ ɧɚɱɚɥɶɧɨɣ ɮɚɡɟ ɝɢɩɨɤɫɢɱɟɫɤɨɝɨ ɜɨɡɞɟɣɫɬɜɢɹ (4–5 ɬɵɫ. ɦ) ɧɚ ɮɨɧɟ ɝɢɩɨɤɫɢɱɟɫɤɨɣ ɚɤɬɢɜɚɰɢɢ ɢɦɩɭɥɶɫɧɨɝɨ ɪɚɡɪɹɞɚ ɧɟɣɪɨɧɨɜ ɨɛɥɟɝɱɚɸɳɢɣ ɷɮɮɟɤɬ ɪɚɡɞɪɚɠɟɧɢɹ LM ɹɞɪɚ ɩɪɨɹɜɥɹɥɫɹ ɫɥɚɛɨ. ȼɨɡɦɨɠɧɨ, ɧɚ ɷɬɨɣ ɜɵɫɨɬɟ ɧɟɣɪɨɧɵ, ɛɭɞɭɱɢ ɜɨɡɛɭɠɞɟɧɧɵɦɢ ɝɢɩɨɤɫɢɱɟɫɤɢɦ ɜɨɡɞɟɣɫɬɜɢɟɦ, ɩɨɞɜɟɪɝɚɸɬɫɹ ɫɥɚɛɨɦɭ ɦɨɞɭɥɢɪɭɸɳɟɦɭ ɜɥɢɹɧɢɸ LM ɹɞɪɚ ɝɢɩɨɬɚɥɚɦɭɫɚ. Ɉɞɧɚɤɨ ɦɨɠɧɨ ɩɪɟɞɩɨɥɨɠɢɬɶ ɬɚɤɠɟ, ɱɬɨ ɧɚ ɷɬɨɣ ɜɵɫɨɬɟ ɩɪɨɢɫɯɨɞɢɬ ɩɨɜɵɲɟɧɢɟ ɚɤɬɢɜɧɨɫɬɢ ɤɨɪɤɨɜɵɯ ɷɥɟɦɟɧɬɨɜ [13, 14], ɩɪɢɜɨɞɹɳɟɟ ɤ ɨɫɥɚɛɥɟɧɢɸ ɞɟɣɫɬɜɢɹ LM ɹɞɪɚ. ȼɨ ɜɬɨɪɨɣ ɮɚɡɟ ɝɢɩɨɤɫɢɢ (7,5–8 ɬɵɫ. ɦ), ɧɚɨɛɨɪɨɬ, ɨɫɬɪɚɹ ɧɟɯɜɚɬɤɚ ɤɢɫɥɨɪɨɞɚ ɩɪɢɜɨɞɢɬ ɤ ɪɟɡɤɨɦɭ ɭɝɧɟɬɟɧɢɸ ɢɦɩɭɥɶɫɧɨɣ ɚɤɬɢɜɧɨɫɬɢ ɧɟɣɪɨɧɨɜ ɜɫɟɯ ɫɬɪɭɤɬɭɪ ɐɇɋ, ɜ ɬɨɦ ɱɢɫɥɟ ɢ ɩɪɨɞɨɥɝɨɜɚɬɨɝɨ ɦɨɡɝɚ. Ɉɱɟɜɢɞɧɨ, ɷɬɨ ɨɛɴɹɫɧɹɟɬɫɹ ɬɟɦ, ɱɬɨ ɧɚ ɛɨɥɶɲɢɯ ɜɵɫɨɬɚɯ ɤɨɪɚ ɛɨɥɶɲɢɯ ɩɨɥɭɲɚɪɢɣ ɨɬɤɥɸɱɚɟɬɫɹ ɪɚɧɶɲɟ ɞɪɭɝɢɯ ɫɬɪɭɤɬɭɪ ɦɨɡɝɚ, ɩɪɢ ɷɬɨɦ ɝɢɩɨɬɚɥɚɦɭɫ (ɜ ɬɨɦ ɱɢɫɥɟ LM ɹɞɪɨ) ɜɵɫɜɨɛɨɠɞɚɟɬɫɹ ɢɡ ɩɨɞ ɬɨɧɢɱɟɫɤɨɝɨ ɬɨɪɦɨɡɧɨɝɨ ɜɥɢɹɧɢɹ ɤɨɪɵ, ɭɫɢɥɢɜɚɹ ɤɨɧɬɪɨɥɶ ɚɤɬɢɜɧɨɫɬɢ ɧɟɣɪɨɧɨɜ ɞɵɯɚɬɟɥɶɧɨɝɨ ɰɟɧɬɪɚ ɢ ɨɛɟɫɩɟɱɢɜɚɹ ɤɢɫɥɨɪɨɞɧɵɣ ɝɨɦɟɨɫɬɚɡ ɨɪɝɚɧɢɡɦɚ. ȼɫɟ ɷɬɨ ɭɤɚɡɵɜɚɟɬ ɧɚ ɬɨ, ɱɬɨ ɜ ɪɟɝɭɥɹɰɢɢ ɞɵɯɚɧɢɹ ɪɟɲɚɸɳɢɦ ɹɜɥɹɟɬɫɹ ɧɟ ɨɞɢɧ ɭɪɨɜɟɧɶ ɪɟɝɭɥɹɰɢɢ, ɚ ɢɯ ɜɡɚɢɦɨɞɟɣɫɬɜɢɟ. Ɍ ɨɥɶɤɨ ɬɚɤɚɹ ɢɧɬɟɝɪɚɰɢɹ ɤɨɪɤɨɜɵɯ ɢ ɩɨɞɤɨɪɤɨɜɵɯ, ɰɟɧɬɪɚɥɶɧɵɯ ɢ ɩɟɪɢɮɟɪɢɱɟɫɤɢɯ, ɚɤɬɢɜɢɪɭɸɳɢɯ ɢ ɬɨɪɦɨɡɹɳɢɯ ɦɟɯɚɧɢɡɦɨɜ ɦɨɠɟɬ ɨɛɟɫɩɟɱɢɬɶ ɧɚɢɛɨɥɟɟ ɫɨɜɟɪɲɟɧɧɨɟ ɢ ɧɚɞɟɠɧɨɟ ɩɪɢɫɩɨɫɨɛɥɟɧɢɟ ɨɪɝɚɧɢɡɦɚ ɤ ɩɨɫɬɨɹɧɧɨ ɦɟɧɹɸɳɢɦɫɹ ɭɫɥɨɜɢɹɦ ɩɨɬɪɟɛɥɟɧɢɹ ɤɢɫɥɨɪɨɞɚ. Ʉɚɮɟɞɪɚ ɮɢɡɢɨɥɨɝɢɢ ɱɟɥɨɜɟɤɚ ɢ ɠɢɜɨɬɧɵɯ ɉɨɫɬɭɩɢɥɚ 20.12.2006 Ʌ ɂ Ɍȿ Ɋ ȺɌ ɍɊ Ⱥ 1. Ȼɚɤɥɚɜɚɞɠɹɧ Ɉ.Ƚ. ɇɟɣɪɨɧɧɚɹ ɨɪɝɚɧɢɡɚɰɢɹ ɝɢɩɨɬɚɥɚɦɨ-ɜɢɫɰɟɪɚɥɶɧɨɣ ɪɟɮɥɟɤɬɨɪɧɨɣ ɞɭɝɢ. Ʌ.: ɇɚɭɤɚ, 1988, 86ɫ. 2. ȼ ɚɥɶɞɦɚɧ Ⱥ.ȼ . ɇɟɣɪɨɮɚɪɦɚɤɨɥɨɝɢɹ ɩɪɨɰɟɫɫɨɜ ɰɟɧɬɪɚɥɶɧɨɝɨ ɪɟɝɭɥɢɪɨɜɚɧɢɹ. Ʌ., 1969, 595 ɫ. 3. Ɍɤɚɱɟɧɤɨ Ȼ.ɂ. ɇɨɪɦɚɥɶɧɚɹ ɮɢɡɢɨɥɨɝɢɹ ɱɟɥɨɜɟɤɚ. Ɇ.: Ɇɟɞɢɰɢɧɚ, 2005, 900 ɫ. 4. Paxinos G ., Watson Ch. The Rat Brain in Stereotaxic Coordinates. N-Y.: Academic Press, 1986. 115 5. Ⱦɨɪɨɲɟɧɤɨ ɇ.Ɂ., Ɇɚɣɫɤɢɣ ȼ .Ⱥ., Ʉɚɪɰɟɜɚ Ⱥ.Ƚ. – Ⱦɨɤɥ. Ⱥɇ ɋɋɋɊ, 1985, ɬ. 282, ʋ 1, ɫ. 232–236. 6. Saper C.B ., Swanson L.W., Cowan W.M. – J. Co mpar. Neurol., 1976, v. 169, p. 409–442. 7. 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Ⱥɤɨɩɹɧ ɇ.ɋ., Ȼɚɤɥ ɚɜɚɞɠɹɧ Ɉ.Ƚ., Ʉɚɪɚɩɟɬɹɧ Ɇ.Ⱥ. – Ɏɢɡɢɨɥ. ɠɭɪɧ. ɋɋɋɊ ɢɦ. ɂ.Ɇ. ɋɟɱɟɧɨɜɚ, 1982, LXVIII, ʋ 5, ɫ. 576–581. è. ê. вðàôÂÚàôÜ Ú²Ü ÂÂì²Ìܲø²ÔòÆ ä²ÚزÜܺðàôØ ºÜ²îºê²ÂØ´Æ Ø²ØÆÈÚ²ð زðØÜÆ ÎàÔØܲÚÆÜ ÎàðÆ¼Æ ¸ºðÀ ÞÜâ²èàôÂÚ²Ü Î²ð¶²ìàðØ²Ü ¶àðÌÀܲòàôØ ² Ù÷á÷ áõÙ àõëáõÙݳëÇñí»É ¿ »Ýóï»ë³ÃÙµÇ ÏáÕÙݳ ÛÇÝ Ù³ÙÇÉÛ³ñ (ÎØ) ÏáñÇ½Ç ³½¹»óáõÃÛáõÝÁ »ñϳñ³íáõÝ áõÕ»ÕÇ ßÝã³é³Ï³Ý Ý»ÛñáÝÝ»ñÇ ÇÙåáõÉë³ÛÇÝ ³ÏïÇíáõÃÛ³Ý íñ³ ÝáñÙ³ÛáõÙ ¨ ÃÃí³ÍݳÛÇÝ ³Ýµ³í³ ñ³ñáõÃÛ³Ý å³ÛÙ³ÝÝ»ñáõÙ: ØÃÝáÉáñï³ÛÇÝ ×ÝßÙ³Ý µÝ³Ï³ÝáÝ å³ÛÙ³ÝÝ»ñáõÙ »Ýóï»ë³ ÃÙµÇ ÎØ ÏáñÇ½Ç ¿É»Ïïñ³ËóÝáõÙÁ ÃáÕ»É ¿ ³é³í»É³å»ë ³ÏïÇí³óÝáÕ ³½¹»óáõÃÛáõÝ: 4 5 ѳ½. Ù « µ³ñÓñáõÃ۳ݻ ¹»åùáõÙ ÑÇåûùëÇÏ ³ÏïÇí ýáÝÇ íñ³ ÎØ ÏáñÇ½Ç Ëó ÝáõÙÁ ãÇ ÃáÕ»É µÝáñáß ³½¹»óáõÃÛáõÝ:  Ãí³Íݳù³ ÕóÇ »ñÏñáñ¹ ÷áõÉáõÙ` 7,5 8 ѳ½. Ù « µ³ñÓñáõÃ۳ݻ íñ³ ¹Çïí»É ¿ ÝÛ³ñ¹³ÛÇÝ µçÇç Ý»ñÇ ³ÏïÇíáõÃÛ³ Ý ³ÝÏáõÙ: ÜÙ³Ý ×Ýßí³Í ýáÝÇ íñ³ ÎØ ÏáñÇ½Ç ¹ñ¹áÕ ³½¹»óáõÃÛáõÝÁ »Õ»É ¿ ³é³í»É ³ñï³Ñ³Ûïí³Í: R. S. ARUTUNYAN T HE ROLE OF THE NUCLEUS LAT ERALIS MAMILLARIS OF T HE HYPOT HALAMUS IN RESPIRAT ORY NEURONS IN HYPOXIA CONDITIONS Su m m a r y In the normal as well as in the oxygen deficiency conditions research has been made to study the influence of irritation of lateral mamillary (LM) nucleus of the hypothalamus on impulse activity of respiratory neurons of medulla oblongata. In conditions of normal atmospheric pressure the electrical stimulation of the LM nucleus has had mainly activiting influence. In the initial phase, on 4–5 thousand meter altitude, activation of frequent discharge of neurons occurred. In this situation stimulation of the LM induced uncharacteristic reactions of those neurons. In the second phase (7,5–8 thousand meters) on the reduction of the impulse activity of neurons, stimulation LM nucleus of hypothalamus was more accentuated than in conditions of normoxia. 116