.ɇ. Ɇɟɥɶɧɢɤɨɜ, Ⱥ.Ɉ. Ⱦɨɧɝɚɤ, ɋ.Ƚ. Ʉɪɢɜɨɳɟɤɨɜ, Ɋ.ɂ. Ⱥɣɡɦɚɧ ȼ

ɍȾɄ 612.13:612.213:612.273.2
ȼ.ɇ. Ɇɟɥɶɧɢɤɨɜ, Ⱥ.Ɉ. Ⱦɨɧɝɚɤ, ɋ.Ƚ. Ʉɪɢɜɨɳɟɤɨɜ, Ɋ.ɂ. Ⱥɣɡɦɚɧ
ɉɈɄȺɁȺɌȿɅɂ ȽȿɆɈȾɂɇȺɆɂɄɂ ɍ ɆɈɅɈȾɕɏ Ɇɍɀɑɂɇ
ɉɊɂ ȾȿɃɋɌȼɂɂ ȼɈȾɇɈɃ ɇȺȽɊɍɁɄɂ ȼ ɋɈɑȿɌȺɇɂɂ
ɋ ɄɊȺɌɄɈȼɊȿɆȿɇɇɈɃ ȽɂɉɈɄɋɂȿɃ
Ƚɍ ɇɂɂ ɮɢɡɢɨɥɨɝɢɢ ɋɈ ɊȺɆɇ, ɇɨɜɨɫɢɛɢɪɫɤ
ȽɈɍ ȼɉɈ ɇɨɜɨɫɢɛɢɪɫɤɢɣ ɝɨɫɭɞɚɪɫɬɜɟɧɧɵɣ ɩɟɞɚɝɨɝɢɱɟɫɤɢɣ ɭɧɢɜɟɪɫɢɬɟɬ
Ⱦɥɹ ɨɰɟɧɤɢ ɪɚɡɞɟɥɶɧɵɯ ɢ ɫɨɜɦɟɫɬɧɵɯ ɷɮɮɟɤɬɨɜ ɜɨɞɧɨɣ ɧɚɝɪɭɡɤɢ (ȼɇ) ɢ ɨɫɬɪɨɣ ɝɢɩɨɤɫɢɢ ɧɚ ɩɟɪɢɮɟɪɢɱɟɫɤɨɟ ɤɪɨɜɨɨɛɪɚɳɟɧɢɟ ɨɛɫɥɟɞɨɜɚɥɢɫɶ 27 ɦɨɥɨɞɵɯ ɦɭɠɱɢɧ ɜ ɩɨɤɨɟ
ɢ ɱɟɪɟɡ 60 ɦɢɧ ɩɨɫɥɟ ɩɟɪɨɪɚɥɶɧɨɣ ȼɇ (1% ɨɬ ɦɚɫɫɵ ɬɟɥɚ). ɇɚ ɞɪɭɝɨɣ ɞɟɧɶ ɷɬɨ ɜɨɡɞɟɣɫɬɜɢɟ ɫɨɱɟɬɚɥɨɫɶ ɫ ɝɢɩɨɤɫɢɱɟɫɤɨɣ ɩɪɨɛɨɣ, ɡɚɤɥɸɱɚɜɲɟɣɫɹ ɜ ɞɵɯɚɧɢɢ ɜɨɡɞɭɲɧɨɣ ɫɦɟɫɶɸ
ɫ 10 ɨɛ.% Ɉ2 ɜ ɬɟɱɟɧɢɟ 10 ɦɢɧ. ɋ ɩɨɦɨɳɶɸ ɨɤɤɥɸɡɢɨɧɧɨɣ ɩɥɟɬɢɡɦɨɝɪɚɮɢɢ ɢɡɦɟɪɹɥɢ
ɩɨɤɚɡɚɬɟɥɢ ɤɪɨɜɨɨɛɪɚɳɟɧɢɹ ɜ ɦɵɲɰɚɯ ɩɪɟɞɩɥɟɱɶɹ ɢ ɤɨɠɟ ɩɚɥɶɰɚ ɩɪɚɜɨɣ ɪɭɤɢ. ȼɇ ɫɚɦɚ
ɩɨ ɫɟɛɟ ɭɜɟɥɢɱɢɜɚɟɬ ɞɢɭɪɟɡ, ɜɟɧɨɡɧɵɣ ɪɟɡɟɪɜ ɦɵɲɰ ɢ ɫɧɢɠɚɟɬ ɑɋɋ, ɨɫɦɨɥɹɪɧɨɫɬɶ ɦɨɱɢ
ɢ ɚɪɬɟɪɢɚɥɶɧɵɣ ɤɪɨɜɨɬɨɤ ɜ ɤɨɠɟ. Ƚɢɩɨɤɫɢɹ ɩɨɬɟɧɰɢɪɭɟɬ ɜɵɡɜɚɧɧɵɟ ȼɇ ɢɡɦɟɧɟɧɢɹ
ɑɋɋ, ɨɫɦɨɥɹɪɧɨɫɬɢ, ɤɨɠɧɨɝɨ ɢ ɦɵɲɟɱɧɨɝɨ ɚɪɬɟɪɢɚɥɶɧɨɝɨ ɤɪɨɜɨɬɨɤɚ ɢ ɪɟɚɤɬɢɜɧɭɸ ɨɤɤɥɸɡɢɨɧɧɭɸ ɝɢɩɟɪɟɦɢɸ ɦɵɲɰ. Ⱦɟɥɚɟɬɫɹ ɡɚɤɥɸɱɟɧɢɟ, ɱɬɨ ɨɛɟ ɧɚɝɪɭɡɤɢ ɨɤɚɡɵɜɚɸɬ ɚɞɞɢɬɢɜɧɵɣ ɷɮɮɟɤɬ ɧɚ ɪɟɝɢɨɧɚɥɶɧɭɸ ɝɟɦɨɞɢɧɚɦɢɤɭ.
Ʉɥɸɱɟɜɵɟ ɫɥɨɜɚ: ɜɨɞɧɚɹ ɧɚɝɪɭɡɤɚ, ɝɢɩɨɤɫɢɹ, ɩɟɪɢɮɟɪɢɱɟɫɤɚɹ ɝɟɦɨɞɢɧɚɦɢɤɚ.
ȼ ɧɚɫɬɨɹɳɟɟ ɜɪɟɦɹ ɢɦɟɟɬɫɹ ɪɹɞ ɮɚɤɬɨɜ,
ɫɜɢɞɟɬɟɥɶɫɬɜɭɸɳɢɯ ɨ ɜɡɚɢɦɨɫɜɹɡɢ ɝɟɦɨɞɢɧɚɦɢɤɢ ɢ ɜɨɞɧɨ-ɫɨɥɟɜɨɝɨ ɨɛɦɟɧɚ ɤɚɤ ɜ ɢɧɬɚɤɬɧɨɦ
ɫɨɫɬɨɹɧɢɢ ɨɪɝɚɧɢɡɦɚ, ɬɚɤ ɢ ɩɪɢ ɪɚɡɥɢɱɧɵɯ ɷɤɫɩɟɪɢɦɟɧɬɚɥɶɧɵɯ ɜɨɡɞɟɣɫɬɜɢɹɯ. ȼ ɱɚɫɬɧɨɫɬɢ,
ɩɨɤɚɡɚɧɨ, ɱɬɨ ɝɢɩɟɪɝɢɞɪɚɬɚɰɢɹ ɜɵɡɵɜɚɟɬ ɛɪɚɞɢɤɚɪɞɢɸ, ɢɡɦɟɧɟɧɢɟ ɭɞɚɪɧɨɝɨ ɨɛɴɟɦɚ, ɩɨɧɢɠɟɧɢɟ ɬɨɧɭɫɚ ɩɟɪɢɮɟɪɢɱɟɫɤɢɯ ɫɨɫɭɞɨɜ [1, 2].
ɍɫɬɚɧɨɜɥɟɧɨ, ɱɬɨ ɩɨɫɥɟ ɜɨɞɧɨɣ ɧɚɝɪɭɡɤɢ ɚɤɬɢɜɧɨɫɬɶ ɪɟɧɢɧɚ, ɭɪɨɜɟɧɶ ɚɥɶɞɨɫɬɟɪɨɧɚ ɩɥɚɡɦɵ
ɜɨɡɪɚɫɬɚɸɬ [3], ɚ ɤɨɧɰɟɧɬɪɚɰɢɢ ɤɨɪɬɢɡɨɥɚ
ɢ ɋɌȽ ɭɦɟɧɶɲɚɸɬɫɹ [4].
Ɉɩɢɫɚɧɵ ɨɫɨɛɟɧɧɨɫɬɢ ɪɟɝɢɨɧɚɥɶɧɨɣ ɝɟɦɨɞɢɧɚɦɢɤɢ ɢ ɜɨɞɧɨ-ɫɨɥɟɜɨɝɨ ɨɛɦɟɧɚ ɜ ɭɫɥɨɜɢɹɯ
ɧɟɞɨɫɬɚɬɤɚ ɤɢɫɥɨɪɨɞɚ. Ɍɚɤ, ɤɪɚɬɤɨɜɪɟɦɟɧɧɚɹ
ɧɨɪɦɨɛɚɪɢɱɟɫɤɚɹ ɝɢɩɨɤɫɢɹ ɩɨɜɵɲɚɟɬ ɱɚɫɬɨɬɭ
ɫɟɪɞɟɱɧɵɯ ɫɨɤɪɚɳɟɧɢɣ (ɑɋɋ), ɫɧɢɠɚɟɬ ɚɪɬɟɪɢɚɥɶɧɵɣ ɤɪɨɜɨɬɨɤ ɦɵɲɰ ɢ ɤɨɠɢ ɩɪɟɞɩɥɟɱɶɹ
ɢ ɧɟɡɧɚɱɢɬɟɥɶɧɨ ɭɦɟɧɶɲɚɟɬ ɪɟɚɤɬɢɜɧɭɸ ɝɢɩɟɪɟɦɢɸ ɜ ɧɢɯ, ɜɨɡɧɢɤɚɸɳɭɸ ɜ ɨɬɜɟɬ ɧɚ ɩɟɪɟɠɚɬɢɟ ɫɨɫɭɞɨɜ ɤɨɧɟɱɧɨɫɬɢ. ɗɬɢ ɫɞɜɢɝɢ ɬɪɚɤɬɭɸɬɫɹ ɤɚɤ ɫɥɟɞɫɬɜɢɟ ɜɚɡɨɤɨɧɫɬɪɢɤɰɢɢ ɜ ɦɹɝɤɢɯ
ɬɤɚɧɹɯ ɤɨɧɟɱɧɨɫɬɟɣ ɩɪɢ ɝɢɩɨɤɫɟɦɢɢ ɜ ɫɨɫɬɨɹɧɢɢ ɩɨɤɨɹ ɢ ɩɟɪɟɪɚɫɩɪɟɞɟɥɟɧɢɹ ɤɪɨɜɨɬɨɤɚ
ɜ ɩɨɥɶɡɭ ɠɢɡɧɟɧɧɨ ɜɚɠɧɵɯ ɨɪɝɚɧɨɜ — ɝɨɥɨɜɧɨɝɨ ɦɨɡɝɚ, ɫɟɪɞɰɚ, ɩɟɱɟɧɢ [5].
ɋɥɚɛɚɹ ɢɥɢ ɭɦɟɪɟɧɧɚɹ ɨɫɬɪɚɹ ɜɵɫɨɬɧɚɹ ɝɢɩɨɤɫɢɹ ɜɵɡɵɜɚɟɬ ɩɨɥɢɭɪɢɸ [6], ɭɦɟɧɶɲɚɟɬ ɨɛɴɟɦ ɩɥɚɡɦɵ ɤɪɨɜɢ ɢ ɤɨɧɰɟɧɬɪɚɰɢɸ ɧɚɬɪɢɣɭɪɟɬɢ¡fiÀÀ“Õ‹ –Œ —¿ÃÕ, ʋ 3 (125), 2007 „.
ɱɟɫɤɨɝɨ ɩɟɩɬɢɞɚ [7]. ɉɨ ɞɪɭɝɢɦ ɞɚɧɧɵɦ, ɛɨɥɟɟ
ɜɵɪɚɠɟɧɧɚɹ ɢ ɞɥɢɬɟɥɶɧɚɹ ɝɢɩɨɤɫɟɦɢɹ ɩɪɢɜɨɞɢɬ
ɤ ɨɥɢɝɭɪɢɢ [8], ɡɚɞɟɪɠɤɟ ɜɨɞɵ ɜ ɨɪɝɚɧɢɡɦɟ [9]
ɢ ɨɬɟɤɚɦ [10]. Ʉɪɚɬɤɨɜɪɟɦɟɧɧɨ ɩɨɜɵɲɚɟɬɫɹ ɷɤɫɤɪɟɰɢɹ ɚɧɬɢɞɢɭɪɟɬɢɱɟɫɤɨɝɨ ɝɨɪɦɨɧɚ [11] ɢ ɫɧɢɠɚɸɬɫɹ ɚɤɬɢɜɧɨɫɬɶ ɪɟɧɢɧɚ ɢ ɤɨɧɰɟɧɬɪɚɰɢɹ ɚɥɶɞɨɫɬɟɪɨɧɚ ɜ ɤɪɨɜɢ [12].
Ɉɬɦɟɱɚɟɬɫɹ ɜɵɪɚɠɟɧɧɚɹ ɢɧɞɢɜɢɞɭɚɥɶɧɚɹ
ɢɡɦɟɧɱɢɜɨɫɬɶ ɝɢɩɨɤɫɢɱɟɫɤɢɯ ɷɮɮɟɤɬɨɜ, ɩɪɨɹɜɥɹɸɳɚɹɫɹ ɜ ɜɚɪɢɚɬɢɜɧɨɫɬɢ ɧɟ ɬɨɥɶɤɨ ɜɟɥɢɱɢɧɵ,
ɧɨ ɢ ɡɧɚɤɚ ɪɟɚɤɰɢɣ ɫɨ ɫɬɨɪɨɧɵ ɜɨɞɧɨ-ɫɨɥɟɜɨɝɨ
ɨɛɦɟɧɚ ɜ ɡɚɜɢɫɢɦɨɫɬɢ ɨɬ ɫɬɟɩɟɧɢ ɝɢɩɟɪɤɚɩɧɢɢ
[13], ɞɵɯɚɬɟɥɶɧɨɝɨ ɚɥɤɚɥɨɡɚ [6] ɢ ɨɬ ɬɨɝɨ, ɫɤɥɨɧɟɧ ɢɥɢ ɭɫɬɨɣɱɢɜ ɬɨɬ ɢɥɢ ɢɧɨɣ ɫɭɛɴɟɤɬ ɤ ɪɚɡɜɢɬɢɸ ɝɨɪɧɨɣ ɛɨɥɟɡɧɢ [9].
ȿɫɥɢ ɪɚɡɞɟɥɶɧɵɟ ɷɮɮɟɤɬɵ ɝɢɩɨɤɫɢɢ ɢ ɝɢɩɟɪɜɨɥɟɦɢɢ ɨɩɢɫɚɧɵ, ɬɨ ɢɯ ɫɨɜɦɟɫɬɧɨɟ ɞɟɣɫɬɜɢɟ ɧɚ ɝɟɦɨɞɢɧɚɦɢɤɭ ɨɫɬɚɟɬɫɹ ɧɟɢɡɭɱɟɧɧɵɦ.
ɉɨɷɬɨɦɭ ɩɪɟɞɫɬɚɜɥɹɥɨ ɢɧɬɟɪɟɫ ɜɵɹɫɧɢɬɶ ɨɫɨɛɟɧɧɨɫɬɢ ɫɨɱɟɬɚɧɧɨɝɨ ɜɥɢɹɧɢɹ ɷɬɢɯ ɞɜɭɯ ɮɚɤɬɨɪɨɜ ɧɚ ɩɨɤɚɡɚɬɟɥɢ ɰɟɧɬɪɚɥɶɧɨɝɨ ɢ ɩɟɪɢɮɟɪɢɱɟɫɤɨɝɨ ɤɪɨɜɨɨɛɪɚɳɟɧɢɹ ɢ ɬɚɤɢɦ ɨɛɪɚɡɨɦ ɨɬɜɟɬɢɬɶ ɧɚ ɜɨɩɪɨɫ, ɦɨɠɧɨ ɥɢ ɭɦɟɧɶɲɢɬɶ ɝɟɦɨɞɢɧɚɦɢɱɟɫɤɢɟ ɩɪɨɹɜɥɟɧɢɹ ɝɢɩɨɤɫɢɢ, ɪɟɝɭɥɢɪɭɹ
ɩɢɬɶɟɜɨɟ ɩɨɜɟɞɟɧɢɟ. ɉɪɨɜɟɪɹɟɦɚɹ ɪɚɛɨɱɚɹ ɝɢɩɨɬɟɡɚ ɡɚɤɥɸɱɚɥɚɫɶ ɜ ɬɨɦ, ɱɬɨ ɜɨɞɧɚɹ ɧɚɝɪɭɡɤɚ
ɢ ɫɜɹɡɚɧɧɚɹ ɫ ɧɟɣ ɝɢɩɟɪɝɢɞɪɚɬɚɰɢɹ ɭɫɬɪɚɧɹɟɬ
ɜɵɡɜɚɧɧɨɟ ɝɢɩɨɤɫɢɟɣ ɭɦɟɧɶɲɟɧɢɟ ɤɪɨɜɨɬɨɤɚ
ɜ ɩɟɪɢɮɟɪɢɱɟɫɤɢɯ ɬɤɚɧɹɯ.
159
Ɇɟɥɶɧɢɤɨɜ ȼ.ɇ. ɉɨɤɚɡɚɬɟɥɢ ɝɟɦɨɞɢɧɚɦɢɤɢ ɭ ɦɨɥɨɞɵɯ ɦɭɠɱɢɧ ɩɪɢ ɞɟɣɫɬɜɢɢ ɜɨɞɧɨɣ ɧɚɝɪɭɡɤɢ
ɜ ɫɨɱɟɬɚɧɢɢ ɫ ɤɪɚɬɤɨɜɪɟɦɟɧɧɨɣ ɝɢɩɨɤɫɢɟɣ / ɫ. 159-162
Ɉɛɴɟɤɬɵ ɢ ɦɟɬɨɞɵ
Ɉɛɫɥɟɞɨɜɚɧɵ 27 ɡɞɨɪɨɜɵɯ ɦɨɥɨɞɵɯ ɦɭɠɱɢɧ-ɫɬɭɞɟɧɬɨɜ 18-25 ɥɟɬ ɫ ɢɧɞɟɤɫɨɦ ɦɚɫɫɵ ɬɟɥɚ
22,1±0,5 ɤɝ/ɦ2. ɉɟɪɜɵɣ ɜɚɪɢɚɧɬ ɷɤɫɩɟɪɢɦɟɧɬɚ
ɛɵɥ ɫɥɟɞɭɸɳɢɣ. ɉɨɫɥɟ 30-ɦɢɧɭɬɧɨɣ ɚɞɚɩɬɚɰɢɢ
ɤ ɬɟɦɩɟɪɚɬɭɪɧɵɦ ɭɫɥɨɜɢɹɦ ɩɨɦɟɳɟɧɢɹ (25qɋ)
ɢɫɩɵɬɭɟɦɵɟ ɜ ɭɬɪɟɧɧɢɟ ɱɚɫɵ ɧɚɬɨɳɚɤ ɜɵɩɢɜɚɥɢ
600-900 ɦɥ ɤɢɩɹɱɟɧɨɣ ɜɨɞɵ (1% ɨɬ ɦɚɫɫɵ ɬɟɥɚ)
ɤɨɦɧɚɬɧɨɣ ɬɟɦɩɟɪɚɬɭɪɵ ɜ ɬɟɱɟɧɢɟ 1- 2 ɦɢɧ.
ȼ ɢɫɯɨɞɧɨɦ ɫɨɫɬɨɹɧɢɢ ɢ ɱɟɪɟɡ 60 ɦɢɧ ɢɡɦɟɪɹɥɢ ɑɋɋ ɧɚ ɚɜɬɨɦɚɬɢɱɟɫɤɨɦ ɩɭɥɶɫɨɤɫɢɦɟɬɪɟ
«Palco 305» (ɋɒȺ), ɫɢɫɬɨɥɢɱɟɫɤɨɟ (ȺȾɋ)
ɢ ɞɢɚɫɬɨɥɢɱɟɫɤɨɟ (ȺȾȾ) ɚɪɬɟɪɢɚɥɶɧɨɟ ɞɚɜɥɟɧɢɟ ɧɚ ɥɟɜɨɣ ɪɭɤɟ ɫ ɩɨɦɨɳɶɸ ɩɪɢɛɨɪɚ «Blood
Pressure Monitor» (Meditech, ɋɒȺ), ɩɨɤɚɡɚɬɟɥɢ
ɩɟɪɢɮɟɪɢɱɟɫɤɨɝɨ ɤɪɨɜɨɨɛɪɚɳɟɧɢɹ ɧɚ ɩɪɚɜɨɦ
ɩɪɟɞɩɥɟɱɶɟ ɧɚ ɜɟɧɨɡɧɨ-ɨɤɤɥɸɡɢɨɧɧɨɦ ɩɥɟɬɢɡɦɨɝɪɚɮɟ «Periquant 3500» (Ƚɟɪɦɚɧɢɹ) ɩɪɢ ɪɚɫɩɨɥɨɠɟɧɢɢ ɦɚɧɠɟɬɵ ɧɚ ɩɥɟɱɟ. ɉɪɢ ɜɬɨɪɨɦ ɜɚɪɢɚɧɬɟ ɷɤɫɩɟɪɢɦɟɧɬɚ ɨɛɫɥɟɞɭɟɦɵɟ ɫɪɚɡɭ ɩɨɫɥɟ
ɜɨɞɧɨɣ ɧɚɝɪɭɡɤɢ ɜ ɬɟɱɟɧɢɟ 10 ɦɢɧ ɞɵɲɚɥɢ ɜɨɡɞɭɲɧɨɣ ɫɦɟɫɶɸ, ɫɨɞɟɪɠɚɳɟɣ 10 ɨɛ.% Ɉ2,
ɜ ɧɨɪɦɨɛɚɪɢɱɟɫɤɢɯ ɭɫɥɨɜɢɹɯ. ɑɟɪɟɡ 50 ɦɢɧ
(60 ɦɢɧ ɩɨɫɥɟ ɜɨɞɧɨɣ ɧɚɝɪɭɡɤɢ) ɩɨɜɬɨɪɧɨ ɢɡɦɟɪɹɥɢɫɶ ɩɨɤɚɡɚɬɟɥɢ ɝɟɦɨɞɢɧɚɦɢɤɢ. Ɉɫɦɨɥɹɪɧɨɫɬɶ ɦɨɱɢ ɨɩɪɟɞɟɥɹɥɢ ɦɟɬɨɞɨɦ ɤɪɢɨɫɤɨɩɢɢ
ɧɚ ɩɪɢɛɨɪɟ ɆɌ-5 (Ɋɨɫɫɢɹ).
ɑɚɫɨɜɨɣ ɢɧɬɟɪɜɚɥ ɛɵɥ ɜɵɛɪɚɧ ɞɥɹ ɷɤɫɩɟɪɢɦɟɧɬɚ ɤɚɤ ɩɟɪɢɨɞ, ɜ ɤɨɧɰɟ ɤɨɬɨɪɨɝɨ ɧɚɛɥɸɞɚɸɬɫɹ ɧɚɢɛɨɥɟɟ ɜɵɪɚɠɟɧɧɵɟ ɢɡɦɟɧɟɧɢɹ ɜɨɞɧɨɫɨɥɟɜɨɝɨ ɛɚɥɚɧɫɚ [13]. Ɍɚɤ, ɩɪɟɞɜɚɪɢɬɟɥɶɧɨɟ
ɞɢɧɚɦɢɱɟɫɤɨɟ ɨɛɫɥɟɞɨɜɚɧɢɟ 47 ɢɫɩɵɬɭɟɦɵɯ ɞɨ
ɢ ɱɟɪɟɡ 30, 60, 90 ɢ 120 ɦɢɧ ɩɨɫɥɟ 1%-ɧɨɣ ɜɨɞɧɨɣ ɧɚɝɪɭɡɤɢ ɩɨɤɚɡɚɥɨ, ɱɬɨ ɞɢɭɪɟɡ ɢ ɨɫɦɨɥɹɪɧɨɫɬɶ ɦɨɱɢ ɫɨɫɬɚɜɥɹɥɢ, ɫɨɨɬɜɟɬɫɬɜɟɧɧɨ, 1,1,
5,8, 12,3, 10,5, 4,3 ɦɥ/ɦɢɧ ɢ 856, 716, 142, 177,
378 ɦɨɫɦ/ɥ. ȼɵɛɪɚɧɧɨɟ ɝɢɩɨɤɫɢɱɟɫɤɨɟ ɜɨɡɞɟɣɫɬɜɢɟ ɱɟɪɟɡ 10 ɦɢɧ ɫɧɢɠɚɥɨ ɭɪɨɜɟɧɶ ɫɚɬɭɪɚɰɢɢ
ɝɟɦɨɝɥɨɛɢɧɚ ɤɢɫɥɨɪɨɞɨɦ ɜ ɤɪɨɜɹɧɨɦ ɪɭɫɥɟ ɩɨɞɭɲɟɱɤɢ ɩɚɥɶɰɚ ɪɭɤɢ ɞɨ 81,2±1,3% (ɪ < 0,001
ɩɨ ɫɪɚɜɧɟɧɢɸ ɫ ɮɨɧɨɜɵɦ ɢɡɦɟɪɟɧɢɟɦ).
Ⱦɨɫɬɨɜɟɪɧɨɫɬɶ ɪɚɡɥɢɱɢɣ ɧɨɪɦɚɥɶɧɨ ɪɚɫɩɪɟɞɟɥɟɧɧɵɯ ɜɟɥɢɱɢɧ ɨɰɟɧɢɜɚɥɚɫɶ ɫ ɩɨɦɨɳɶɸ
ɩɚɪɧɨɝɨ Ɍ-ɤɪɢɬɟɪɢɹ, ɜ ɞɪɭɝɢɯ ɫɥɭɱɚɹɯ — ɧɟɩɚɪɚɦɟɬɪɢɱɟɫɤɨɝɨ ɤɪɢɬɟɪɢɹ ȼɢɥɤɨɤɫɨɧɚ ɞɥɹ ɡɚɜɢɫɢɦɵɯ ɩɟɪɟɦɟɧɧɵɯ. Ƚɪɚɧɢɱɧɵɦ ɫɬɚɬɢɫɬɢɱɟɫɤɢɦ ɭɪɨɜɧɟɦ ɡɧɚɱɢɦɨɫɬɢ ɞɥɹ ɨɬɤɥɨɧɟɧɢɹ ɧɭɥɟɜɨɣ ɝɢɩɨɬɟɡɵ ɨɛ ɨɬɫɭɬɫɬɜɢɢ ɪɚɡɥɢɱɢɣ ɩɪɢɧɢɦɚɥɫɹ ɩɨɪɨɝ p ” 0,05. ȼɫɟ ɜɟɥɢɱɢɧɵ ɜɵɪɚɠɟɧɵ
ɤɚɤ ɫɪɟɞɧɟɟ ± ɫɬɚɧɞɚɪɬɧɚɹ ɨɲɢɛɤɚ ɫɪɟɞɧɟɝɨ
ɡɧɚɱɟɧɢɹ (M±m).
ɋɩɢɫɨɤ ɷɤɫɩɟɪɢɦɟɧɬɚɥɶɧɵɯ ɩɪɨɰɟɞɭɪ ɢ ɫɯɟɦɚ ɨɩɵɬɚ ɨɞɨɛɪɟɧɵ ɛɢɨɷɬɢɱɟɫɤɢɦ ɤɨɦɢɬɟɬɨɦ
160
ɂɧɫɬɢɬɭɬɚ ɮɢɡɢɨɥɨɝɢɢ ɋɈ ɊȺɆɇ. Ɉɬ ɢɫɩɵɬɭɟɦɵɯ ɩɨɥɭɱɟɧɨ ɢɧɮɨɪɦɢɪɨɜɚɧɧɨɟ ɫɨɝɥɚɫɢɟ
ɭɱɚɫɬɜɨɜɚɬɶ ɜ ɷɤɫɩɟɪɢɦɟɧɬɟ.
Ɋɟɡɭɥɶɬɚɬɵ ɢ ɨɛɫɭɠɞɟɧɢɟ
ɑɟɪɟɡ 60 ɦɢɧ ɩɨɫɥɟ ɜɨɞɧɨɣ ɧɚɝɪɭɡɤɢ ɜɵɞɟɥɟɧɢɟ ɦɨɱɢ ɭɜɟɥɢɱɢɜɚɟɬɫɹ ɩɪɢ ɫɨɨɬɜɟɬɫɬɜɭɸɳɟɦ ɫɧɢɠɟɧɢɢ ɨɫɦɨɥɹɪɧɨɫɬɢ. ɋɢɫɬɟɦɧɨɟ ȺȾ,
ɧɟɫɦɨɬɪɹ ɧɚ ɜɨɡɦɨɠɧɭɸ ɝɢɩɟɪɜɨɥɟɦɢɸ, ɫɨɯɪɚɧɹɟɬɫɹ ɫɬɚɛɢɥɶɧɵɦ ɡɚ ɫɱɟɬ ɭɦɟɧɶɲɟɧɢɹ ɑɋɋ
[1, 2]. ɇɚ ɮɨɧɟ ɧɟɢɡɦɟɧɧɨɝɨ ɚɪɬɟɪɢɚɥɶɧɨɝɨ ɤɪɨɜɨɬɨɤɚ ɜ ɦɵɲɰɚɯ ɜɨɡɪɚɫɬɚɟɬ ɜɟɧɨɡɧɵɣ ɪɟɡɟɪɜ
(+14%) ɢɥɢ ɤɨɥɢɱɟɫɬɜɨ ɤɪɨɜɢ ɜ ɜɟɧɨɡɧɨɦ ɪɭɫɥɟ
ɦɵɲɰ ɩɪɟɞɩɥɟɱɶɹ, ɜɟɪɨɹɬɧɨ, ɜ ɪɟɡɭɥɶɬɚɬɟ ɭɝɧɟɬɟɧɢɹ ɫɟɤɪɟɰɢɢ ɜɚɡɨɩɪɟɫɫɢɧɚ ɢ ɧɚɫɬɭɩɚɸɳɟɣ
ɞɢɥɹɬɚɰɢɢ ɩɟɪɢɮɟɪɢɱɟɫɤɢɯ ɜɟɧ ɜ ɭɫɥɨɜɢɹɯ ɝɢɩɟɪɝɢɞɪɚɬɚɰɢɢ [14]. Ɉɞɧɚɤɨ ɤɨɠɧɵɣ ɚɪɬɟɪɢɚɥɶɧɵɣ ɤɪɨɜɨɬɨɤ ɫɭɳɟɫɬɜɟɧɧɨ ɫɧɢɠɚɟɬɫɹ
(–44%) ɩɪɢ ɧɟɢɡɦɟɧɧɨɦ ɜɟɧɨɡɧɨɦ ɪɟɡɟɪɜɟ, ɜɟɧɨɡɧɨɦ ɨɬɬɨɤɟ ɢ ɨɤɤɥɸɡɢɨɧɧɨɣ ɝɢɩɟɪɟɦɢɢ.
ȼ ɭɫɥɨɜɢɹɯ ɝɢɩɟɪɜɨɥɟɦɢɢ ɢ ɩɪɢ ɤɨɦɧɚɬɧɨɣ
ɬɟɦɩɟɪɚɬɭɪɟ, ɤɨɝɞɚ ɱɪɟɫɤɨɠɧɵɟ ɩɨɬɟɪɢ ɜɨɞɵ
ɦɢɧɢɦɚɥɶɧɵ, ɷɬɨ ɦɨɠɟɬ ɫɩɨɫɨɛɫɬɜɨɜɚɬɶ ɩɨɞɞɟɪɠɚɧɢɸ ɜɵɫɨɤɨɝɨ ɤɪɨɜɨɬɨɤɚ ɜ ɦɚɝɢɫɬɪɚɥɶɧɵɯ
ɢ ɩɨɱɟɱɧɵɯ ɫɨɫɭɞɚɯ, ɭɫɤɨɪɟɧɧɨɣ ɮɢɥɶɬɪɚɰɢɢ
ɢ ɜɨɫɫɬɚɧɨɜɥɟɧɢɸ ɨɫɦɨɬɢɱɟɫɤɨɝɨ ɝɨɦɟɨɫɬɚɡɚ.
Ʉɪɚɬɤɨɜɪɟɦɟɧɧɚɹ ɝɢɩɨɤɫɢɹ, ɫɨɱɟɬɚɸɳɚɹɫɹ
ɫ ɜɨɞɧɨɣ ɧɚɝɪɭɡɤɨɣ, ɩɪɢɜɨɞɢɬ ɤ ɛɨɥɟɟ ɜɵɪɚɠɟɧɧɨɦɭ ɫɧɢɠɟɧɢɸ ɨɫɦɨɥɹɪɧɨɫɬɢ ɦɨɱɢ ɩɪɢ
ɧɟɢɡɦɟɧɟɧɧɨɦ ɭɪɨɜɧɟ ɞɢɭɪɟɡɚ, ɱɬɨ ɦɨɠɟɬ ɫɜɢɞɟɬɟɥɶɫɬɜɨɜɚɬɶ ɨɛ ɭɦɟɧɶɲɟɧɢɢ ɷɤɫɤɪɟɰɢɢ ɨɫɦɨɬɢɱɟɫɤɢ ɚɤɬɢɜɧɵɯ ɜɟɳɟɫɬɜ ɢ ɜɟɪɨɹɬɧɭɸ ɡɚɞɟɪɠɤɭ ɫɨɥɟɣ. ɗɬɨɬ ɦɟɯɚɧɢɡɦ ɨɬɜɟɱɚɟɬ ɡɚ ɪɟɬɟɧɰɢɸ ɜɨɞɵ ɜ ɨɪɝɚɧɢɡɦɟ ɢ ɩɪɨɢɫɯɨɠɞɟɧɢɟ
ɨɬɟɤɨɜ ɜ ɝɢɩɨɤɫɢɱɟɫɤɢɯ ɭɫɥɨɜɢɹɯ [9].
Ɉɫɬɪɚɹ ɝɢɩɨɤɫɢɱɟɫɤɚɹ ɝɢɩɨɤɫɢɹ, ɩɪɢ ɤɨɬɨɪɨɣ ɫɨɝɥɚɫɧɨ ɯɪɟɫɬɨɦɚɬɢɣɧɵɦ ɩɪɟɞɫɬɚɜɥɟɧɢɹɦ
ɧɚɛɥɸɞɚɟɬɫɹ ɭɱɚɳɟɧɢɟ ɩɭɥɶɫɚ ɤɚɤ ɫɪɨɱɧɵɣ
ɪɟɮɥɟɤɬɨɪɧɵɣ ɨɬɜɟɬ [12], ɬɟɦ ɧɟ ɦɟɧɟɟ, ɧɟ ɢɡɦɟɧɢɥɚ ɨɬɪɢɰɚɬɟɥɶɧɭɸ ɪɟɚɤɰɢɸ ɫɨ ɫɬɨɪɨɧɵ
ɑɋɋ ɧɚ ɜɨɞɧɭɸ ɧɚɝɪɭɡɤɭ. Ɍɨ ɟɫɬɶ, ɝɢɩɨɤɫɟɦɢɹ
ɩɪɢ ɬɟɫɬɢɪɨɜɚɧɢɢ ɱɟɪɟɡ 50 ɦɢɧ ɧɟ ɫɦɨɝɥɚ ɤɨɦɩɟɧɫɢɪɨɜɚɬɶ ɛɪɚɞɢɤɚɪɞɢɱɟɫɤɢɣ ɷɮɮɟɤɬ ɝɢɩɟɪɜɨɥɟɦɢɢ. ȼ ɬɨ ɠɟ ɜɪɟɦɹ ɩɪɨɹɜɢɥɚɫɶ ɬɟɧɞɟɧɰɢɹ
ɤ ɭɜɟɥɢɱɟɧɢɸ ȺȾ, ɤɚɤ ɫɢɫɬɨɥɢɱɟɫɤɨɝɨ, ɬɚɤ
ɢ ɞɢɚɫɬɨɥɢɱɟɫɤɨɝɨ (p < 0,1), ɱɬɨ ɨɩɢɫɚɧɨ ɜ ɦɧɨɝɨɱɢɫɥɟɧɧɵɯ ɪɚɛɨɬɚɯ [15, 16] ɢ ɫɱɢɬɚɟɬɫɹ, ɜ ɱɚɫɬɧɨɫɬɢ, ɫɥɟɞɫɬɜɢɟɦ ɜɨɡɪɚɫɬɚɧɢɹ ɭɪɨɜɧɟɣ ɚɞɪɟɧɚɥɢɧɚ ɢ ɧɨɪɚɞɪɟɧɚɥɢɧɚ ɜ ɩɥɚɡɦɟ ɤɪɨɜɢ ɩɪɢ
ɝɢɩɨɤɫɢɢ [17].
ȼ ɨɬɜɟɬ ɧɚ ɫɨɱɟɬɚɧɧɨɟ ɞɟɣɫɬɜɢɟ ɜɨɞɧɨɣ ɧɚɝɪɭɡɤɢ ɢ ɝɢɩɨɤɫɢɢ ɱɟɪɟɡ 50-60 ɦɢɧ ɩɨɫɥɟ ɜɨɡɞɟɣɫɬɜɢɣ ɢɡɦɟɧɢɥɢɫɶ ɩɨɤɚɡɚɬɟɥɢ ɦɵɲɟɱɧɨɣ
ɝɟɦɨɞɢɧɚɦɢɤɢ. ɉɪɢ ɫɧɢɠɟɧɧɨɦ ɚɪɬɟɪɢɚɥɶɧɨɦ
¡fiÀÀ“Õ‹ –Œ —¿ÃÕ, ʋ 3 (125), 2007 „.
Ɇɟɥɶɧɢɤɨɜ ȼ.ɇ. ɉɨɤɚɡɚɬɟɥɢ ɝɟɦɨɞɢɧɚɦɢɤɢ ɭ ɦɨɥɨɞɵɯ ɦɭɠɱɢɧ ɩɪɢ ɞɟɣɫɬɜɢɢ ɜɨɞɧɨɣ ɧɚɝɪɭɡɤɢ
ɜ ɫɨɱɟɬɚɧɢɢ ɫ ɤɪɚɬɤɨɜɪɟɦɟɧɧɨɣ ɝɢɩɨɤɫɢɟɣ / ɫ. 159-162
Ɍɚɛɥɢɰɚ
ɉɨɤɚɡɚɬɟɥɢ ɜɵɞɟɥɢɬɟɥɶɧɨɣ ɮɭɧɤɰɢɢ ɩɨɱɟɤ ɢ ɝɟɦɨɞɢɧɚɦɢɤɢ ɭ ɡɞɨɪɨɜɵɯ ɦɨɥɨɞɵɯ ɦɭɠɱɢɧ
ɩɪɢ ɜɨɞɧɨɣ ɧɚɝɪɭɡɤɟ ɜ ɫɨɱɟɬɚɧɢɢ ɫ ɨɫɬɪɵɦ ɝɢɩɨɤɫɢɱɟɫɤɢɦ ɜɨɡɞɟɣɫɬɜɢɟɦ
ɉɨɤɚɡɚɬɟɥɶ
Ⱦɢɭɪɟɡ, ɦɥ/ɦɢɧ
Ɉɫɦɨɥɹɪɧɨɫɬɶ ɦɨɱɢ, ɦɨɫɦ/ɥ
ɑɋɋ, ɭɞ./ɦɢɧ
ȺȾɋ, ɦɦ ɪɬ. ɫɬ.
ȺȾȾ, ɦɦ ɪɬ. ɫɬ.
Ⱥɪɬɟɪɢɚɥɶɧɵɣ ɤɪɨɜɨɬɨɤ ɦɵɲɟɱɧɵɣ, ɦɥ/100 ɦɥ*ɦɢɧ
Ⱥɪɬɟɪɢɚɥɶɧɵɣ ɤɪɨɜɨɬɨɤ ɤɨɠɧɵɣ, ɦɥ/100 ɦɥ*ɦɢɧ
ȼɟɧɨɡɧɵɣ ɪɟɡɟɪɜ ɦɵɲɟɱɧɵɣ,
ɦɥ/100 ɦɥ*ɦɢɧ
ȼɟɧɨɡɧɵɣ ɪɟɡɟɪɜ ɤɨɠɧɵɣ,
ɦɥ/100 ɦɥ*ɦɢɧ
ȼɟɧɨɡɧɵɣ ɨɬɬɨɤ ɦɵɲɟɱɧɵɣ,
ɦɥ/100 ɦɥ*ɦɢɧ
ȼɟɧɨɡɧɵɣ ɨɬɬɨɤ ɤɨɠɧɵɣ,
ɦɥ/100 ɦɥ*ɦɢɧ
Ɋɟɚɤɬɢɜɧɚɹ ɝɢɩɟɪɟɦɢɹ ɦɵɲɟɱɧɚɹ, ɦɥ/100 ɦɥ*ɦɢɧ
Ɋɟɚɤɬɢɜɧɚɹ ɝɢɩɟɪɟɦɢɹ ɤɨɠɧɚɹ,
ɦɥ/100 ɦɥ*ɦɢɧ
ȼɨɞɧɚɹ ɧɚɝɪɭɡɤɚ
ȼɨɞɧɚɹ ɧɚɝɪɭɡɤɚ + ɝɢɩɨɤɫɢɹ
0 ɦɢɧ
60 ɦɢɧ
Ɋɚɡɧɨɫɬɶ
0 ɦɢɧ
60 ɦɢɧ
Ɋɚɡɧɨɫɬɶ
1,0r0,1
894r36
64,3r1,7
121,1r2,1
71,4r1,7
2,23r0,17
11,8r1,0
128r7,8
59,5r1,7
120,0r2,0
70,1r2,1
2,10r0,18
10,8r1,1 ***
–766r35 ***
–4,8r1,5 **
–1,1r1,1
–1,3r1,1
–0,13r0,19
1,0r0,1
940r57
62,3r2,3
118,3r2,7
69,4r2,1
2,44r0,39
9,8r1,9
104r11
56,2r2,6
118,2r1,9
72,3r1,9
1,92r0,21
8,8r1,9 ***
–836r51*** ^
–6,08r1,88 **
–0,1r1,1
2,9r1,9
–0,52r0,25 * ^
0,93r0,15
0,52r0,07
–0,41r0,13 **
1,12r0,19
0,38r0,10
–0,74r0,18 *** ^
2,45r0,12
2,79r0,13
0,35r0,13 *
2,47r0,13
2,62r0,12
0,15r0,13
1,06r0,10
1,15r0,09
0,10r0,11
1,03r0,13
0,93r0,10
–0,09r0,09
52,9r2,3
57,0r3,2
4,1r3,4
49,9r3,9
56,3r4,7
6,4r2,8 *
30,4r4,0
28,0r3,3
–2,3r3,3
23,2r3,0
17,4r2,5
–5,8r1,4 **
12,7r1,2
12,7r1,4
0,0r1,3
9,0r1,2
11,8r1,0
2,8r1,0 * ^^
7,13r0,77
6,60r0,70
–0,53r0,62
5,37r0,58
4,76r0,95
–0,61r0,88
ɉɪɢɦɟɱɚɧɢɹ. Ⱦɨɫɬɨɜɟɪɧɨɫɬɶ ɪɚɡɥɢɱɢɹ ɫ ɫɨɨɬɜɟɬɫɬɜɭɸɳɢɦ ɮɨɧɨɜɵɦ ɭɪɨɜɧɟɦ: * p < 0,05, ** p < 0,01, *** p < 0,001;
ɞɨɫɬɨɜɟɪɧɨɫɬɶ ɪɚɡɥɢɱɢɹ ɦɟɠɞɭ ɧɚɝɪɭɡɤɚɦɢ: ^ p < 0,05, ^^ p < 0,01.
ɤɪɨɜɨɬɨɤɟ (–21%) ɜɨɡɪɨɫɥɢ ɜɟɧɨɡɧɵɣ ɨɬɬɨɤ
(+13%) ɢ, ɤɚɤ ɫɥɟɞɫɬɜɢɟ, ɨɤɤɥɸɡɢɨɧɧɚɹ ɝɢɩɟɪɟɦɢɹ (+31%), ɱɬɨ ɫɜɢɞɟɬɟɥɶɫɬɜɭɟɬ ɨɛ ɭɜɟɥɢɱɟɧɢɢ
ɤɨɥɢɱɟɫɬɜɚ ɤɪɨɜɢ ɜ ɜɟɧɨɡɧɨɦ ɪɭɫɥɟ ɦɭɫɤɭɥɚɬɭɪɵ ɤɨɧɟɱɧɨɫɬɢ ɜ ɫɨɫɬɨɹɧɢɢ ɮɢɡɢɱɟɫɤɨɝɨ ɩɨɤɨɹ.
ɇɚ ɷɬɨ ɠɟ ɭɤɚɡɵɜɚɟɬ ɢ ɜɨɡɪɚɫɬɚɧɢɟ ɜɟɧɨɡɧɨɝɨ
ɪɟɡɟɪɜɚ (+6%), ɧɟ ɞɨɫɬɢɝɲɟɟ ɝɪɚɧɢɱɧɨɝɨ ɭɪɨɜɧɹ
ɡɧɚɱɢɦɨɫɬɢ ɢɡ-ɡɚ ɜɵɫɨɤɨɣ ɜɚɪɢɚɛɟɥɶɧɨɫɬɢ ɩɨɤɚɡɚɬɟɥɹ. ɇɚ ɮɨɧɟ ɛɨɥɟɟ ɜɵɪɚɠɟɧɧɨɝɨ ɫɧɢɠɟɧɢɹ ɤɨɠɧɨɝɨ ɚɪɬɟɪɢɚɥɶɧɨɝɨ ɤɪɨɜɨɬɨɤɚ (–67%)
ɜ ɫɪɚɜɧɟɧɢɢ ɫ ɩɟɪɜɵɦ ɜɚɪɢɚɧɬɨɦ ɷɤɫɩɟɪɢɦɟɧɬɚ
(–44%) ɨɛɫɥɟɞɨɜɚɧɢɹ ɭɦɟɧɶɲɢɥɫɹ ɢ ɜɟɧɨɡɧɵɣ
ɨɬɬɨɤ (–25%, ɪ < 0,01), ɱɬɨ ɦɨɠɧɨ ɬɪɚɤɬɨɜɚɬɶ
ɤɚɤ ɨɝɪɚɧɢɱɟɧɢɟ ɤɪɨɜɨɨɛɪɚɳɟɧɢɹ ɜ ɩɨɤɪɨɜɧɨɣ
ɬɤɚɧɢ ɩɨɞ ɜɥɢɹɧɢɟɦ ɨɛɟɢɯ ɧɚɝɪɭɡɨɤ. ɉɪɢ ɨɞɧɨɧɚɩɪɚɜɥɟɧɧɵɯ ɫɞɜɢɝɚɯ ɜ ɚɪɬɟɪɢɚɥɶɧɨɦ ɤɪɨɜɨɬɨɤɟ ɜ ɦɵɲɰɚɯ ɢ ɤɨɠɟ ɢɡɦɟɧɟɧɢɹ ɫɨ ɫɬɨɪɨɧɵ
ɝɟɦɨɞɢɧɚɦɢɤɢ ɜ ɜɟɧɨɡɧɨɦ ɪɭɫɥɟ ɛɵɥɢ ɩɪɨɬɢɜɨɩɨɥɨɠɧɵ: ɜɨɡɪɚɫɬɚɧɢɟ ɜɟɧɨɡɧɨɝɨ ɨɬɬɨɤɚ ɢ ɝɢɩɟɪɟɦɢɢ ɜ ɦɵɲɰɚɯ ɫɨɱɟɬɚɟɬɫɹ ɫ ɭɦɟɧɶɲɟɧɢɟɦ
ɷɬɢɯ ɩɨɤɚɡɚɬɟɥɟɣ ɜ ɩɨɤɪɨɜɧɨɣ ɬɤɚɧɢ, ɱɬɨ ɬɪɟɛɭɟɬ ɞɚɥɶɧɟɣɲɟɝɨ ɢɡɭɱɟɧɢɹ.
ɇɟɫɦɨɬɪɹ ɧɚ ɬɨ, ɱɬɨ ɜɫɟ ɥɸɞɢ ɜ ɧɨɪɦɚɥɶɧɵɯ
ɭɫɥɨɜɢɹɯ ɞɵɲɚɬ ɜɨɡɞɭɯɨɦ ɫ ɩɪɢɛɥɢɡɢɬɟɥɶɧɨ
ɨɞɢɧɚɤɨɜɵɦ ɫɨɞɟɪɠɚɧɢɟɦ ɤɢɫɥɨɪɨɞɚ, ɪɟɚɤɰɢɹ
ɨɪɝɚɧɢɡɦɨɜ ɧɚ ɟɝɨ ɞɟɮɢɰɢɬ ɩɨɤɚɡɵɜɚɟɬ ɜɵɪɚɠɟɧɧɭɸ ɢɧɞɢɜɢɞɭɚɥɶɧɭɸ ɜɚɪɢɚɛɟɥɶɧɨɫɬɶ, ɩɪɨ¡fiÀÀ“Õ‹ –Œ —¿ÃÕ, ʋ 3 (125), 2007 „.
ɹɜɥɹɸɳɭɸɫɹ ɤɚɤ ɜ ɨɬɧɨɲɟɧɢɢ ɩɚɪɚɦɟɬɪɨɜ ɜɨɞɧɨ-ɫɨɥɟɜɨɝɨ ɝɨɦɟɨɫɬɚɡɚ [6], ɬɚɤ ɢ ɩɟɪɢɮɟɪɢɱɟɫɤɨɣ ɝɟɦɨɞɢɧɚɦɢɤɢ [5]. ȼ ɞɚɧɧɨɦ ɷɤɫɩɟɪɢɦɟɧɬɟ
ɪɚɡɧɨɫɬɶ ɦɟɠɞɭ 60-ɦɢɧɭɬɧɵɦ ɢ ɢɫɯɨɞɧɵɦ
ɭɪɨɜɧɹɦɢ ɤɨɥɟɛɚɥɚɫɶ ɭ ɪɚɡɧɵɯ ɫɭɛɴɟɤɬɨɜ ɨɬ
–514 ɦɨɫɦ/ɥ ɞɨ –983 ɦɨɫɦ/ɥ ɞɥɹ ɨɫɦɨɥɹɪɧɨɫɬɢ
ɦɨɱɢ (ɤɨɷɮɮɢɰɢɟɧɬ ɜɚɪɢɚɰɢɢ 18%), ɨɬ
–15 ɭɞ./ɦɢɧ ɞɨ +6 ɭɞ./ɦɢɧ ɞɥɹ ɩɭɥɶɫɚ (107%),
ɨɬ –12 ɦɦ ɪɬ. ɫɬ. ɞɨ +19 ɦɦ ɪɬ. ɫɬ. ɞɥɹ ȺȾɋ
(207%). ɋɬɨɥɶ ɠɟ ɜɚɪɢɚɛɟɥɶɧɨɣ ɛɵɥɚ ɢ ɪɟɚɤɰɢɹ
ɩɨɤɚɡɚɬɟɥɟɣ ɩɟɪɢɮɟɪɢɱɟɫɤɨɝɨ ɤɪɨɜɨɨɛɪɚɳɟɧɢɹ.
ɉɪɢɱɢɧɚ ɷɬɨɝɨ ɤɪɨɟɬɫɹ ɜ ɡɧɚɱɢɬɟɥɶɧɨ ɪɚɡɥɢɱɚɸɳɟɣɫɹ ɢɧɞɢɜɢɞɭɚɥɶɧɨɣ ɱɭɜɫɬɜɢɬɟɥɶɧɨɫɬɢ
ɤ ɧɟɞɨɫɬɚɬɤɭ ɤɢɫɥɨɪɨɞɚ ɤɚɤ ɩɟɪɢɮɟɪɢɱɟɫɤɢɯ
ɬɤɚɧɟɣ, ɮɨɪɦɢɪɭɸɳɢɯ ɡɚɩɪɨɫ ɧɚ ɤɢɫɥɨɪɨɞɧɨɟ
ɨɛɟɫɩɟɱɟɧɢɟ, ɬɚɤ ɢ ɰɟɧɬɪɨɜ ɪɟɝɭɥɹɰɢɢ ɞɵɯɚɧɢɹ
ɢ ɤɪɨɜɨɨɛɪɚɳɟɧɢɹ [9].
Ƚɢɩɨɬɟɡɚ ɨ ɪɚɡɧɨɧɚɩɪɚɜɥɟɧɧɨɦ ɜɥɢɹɧɢɢ ɝɢɩɨɤɫɢɢ ɢ ɜɨɞɧɨɣ ɧɚɝɪɭɡɤɢ ɧɚ ɩɟɪɢɮɟɪɢɱɟɫɤɨɟ
ɤɪɨɜɨɨɛɪɚɳɟɧɢɟ ɧɟ ɩɨɞɬɜɟɪɞɢɥɚɫɶ. Ɉɧɚ ɛɵɥɚ
ɨɫɧɨɜɚɧɚ, ɜɨ-ɩɟɪɜɵɯ, ɧɚ ɧɚɲɢɯ ɷɦɩɢɪɢɱɟɫɤɢɯ
ɞɚɧɧɵɯ ɨ ɫɧɢɠɟɧɢɢ ɚɪɬɟɪɢɚɥɶɧɨɝɨ ɤɪɨɜɨɬɨɤɚ
ɩɨɞ ɞɟɣɫɬɜɢɟɦ ɝɢɩɨɤɫɢɢ [5], ɚ ɜɨ-ɜɬɨɪɵɯ,
ɧɚ ɞɨɩɭɳɟɧɢɢ ɨ ɝɢɩɟɪɝɢɞɪɚɬɚɰɢɢ ɤɨɠɢ ɢ ɩɨɩɟɪɟɱɧɨ-ɩɨɥɨɫɚɬɨɣ ɦɭɫɤɭɥɚɬɭɪɵ ɤɨɧɟɱɧɨɫɬɟɣ
ɢ ɜɨɡɦɨɠɧɨɦ ɜɨɡɪɚɫɬɚɧɢɢ ɝɟɦɨɞɢɧɚɦɢɤɢ ɜ ɧɢɯ
ɩɪɢ ɜɨɞɧɨɣ ɧɚɝɪɭɡɤɟ [1, 2]. Ɉɤɚɡɚɥɨɫɶ, ɱɬɨ ɭɦɟ161
Ɇɟɥɶɧɢɤɨɜ ȼ.ɇ. ɉɨɤɚɡɚɬɟɥɢ ɝɟɦɨɞɢɧɚɦɢɤɢ ɭ ɦɨɥɨɞɵɯ ɦɭɠɱɢɧ ɩɪɢ ɞɟɣɫɬɜɢɢ ɜɨɞɧɨɣ ɧɚɝɪɭɡɤɢ
ɜ ɫɨɱɟɬɚɧɢɢ ɫ ɤɪɚɬɤɨɜɪɟɦɟɧɧɨɣ ɝɢɩɨɤɫɢɟɣ / ɫ. 159-162
ɪɟɧɧɚɹ ɝɢɩɟɪɜɨɥɟɦɢɹ, ɩɨɞɨɛɧɨ ɨɫɬɪɨɣ ɝɢɩɨɤɫɢɢ, ɭɦɟɧɶɲɚɟɬ ɚɪɬɟɪɢɚɥɶɧɵɣ ɤɪɨɜɨɬɨɤ
ɜ ɦɵɲɰɚɯ (ɪ < 0,1) ɢ ɤɨɠɟ (ɪ < 0,01), ɱɬɨ ɫɧɢɠɚɟɬ ɩɪɢɬɨɤ ɪɚɡɛɚɜɥɟɧɧɨɣ ɤɪɨɜɢ, ɤɭɩɢɪɭɟɬ ɩɚɞɟɧɢɟ ɨɫɦɨɬɢɱɟɫɤɨɝɨ ɞɚɜɥɟɧɢɹ ɜ ɦɟɠɤɥɟɬɨɱɧɨɣ
ɠɢɞɤɨɫɬɢ ɩɟɪɢɮɟɪɢɱɟɫɤɢɯ ɬɤɚɧɟɣ ɢ ɩɪɟɞɨɬɜɪɚɳɚɟɬ ɜɵɦɵɜɚɧɢɟ ɢɨɧɨɜ ɢɡ ɤɥɟɬɨɤ. Ɉɫɦɨɬɢɱɟɫɤɨɟ ɞɚɜɥɟɧɢɟ ɜ ɦɟɠɤɥɟɬɨɱɧɨɣ ɠɢɞɤɨɫɬɢ —
ɷɬɨ ɛɨɥɟɟ ɜɚɠɧɵɣ ɝɨɦɟɨɫɬɚɬɢɱɟɫɤɢɣ ɫɢɫɬɟɦɨɨɛɪɚɡɭɸɳɢɣ ɮɚɤɬɨɪ, ɱɟɦ ɨɛɴɟɦ ɤɪɨɜɢ [3].
ȼɵɜɨɞɵ, ɜɵɬɟɤɚɸɳɢɟ ɢɡ ɩɨɥɭɱɟɧɧɨɝɨ ɦɚɬɟɪɢɚɥɚ, ɡɚɤɥɸɱɚɸɬɫɹ ɜ ɬɨɦ, ɱɬɨ ɤɪɚɬɤɨɜɪɟɦɟɧɧɚɹ
ɨɫɬɪɚɹ ɝɢɩɨɤɫɢɹ ɢ ɷɤɡɨɝɟɧɧɚɹ ɝɢɩɟɪɜɨɥɟɦɢɹ
ɨɤɚɡɵɜɚɸɬ ɚɞɞɢɬɢɜɧɵɣ ɷɮɮɟɤɬ, ɫɧɢɠɚɹ ɨɫɦɨɥɹɪɧɨɫɬɶ ɦɨɱɢ, ɑɋɋ, ɚɪɬɟɪɢɚɥɶɧɵɣ ɤɪɨɜɨɬɨɤ
ɜ ɩɟɪɢɮɟɪɢɱɟɫɤɢɯ ɬɤɚɧɹɯ ɜɟɪɯɧɟɣ ɤɨɧɟɱɧɨɫɬɢ,
ɭɜɟɥɢɱɢɜɚɹ ɜɟɧɨɡɧɵɣ ɨɬɬɨɤ ɨɬ ɦɵɲɰ ɢ ɨɤɤɥɸɡɢɨɧɧɭɸ ɝɢɩɟɪɟɦɢɸ. ɗɬɢ ɞɚɧɧɵɟ ɩɨɡɜɨɥɹɸɬ
ɞɚɬɶ ɫɥɟɞɭɸɳɢɣ ɨɬɜɟɬ ɧɚ ɜɨɩɪɨɫ, ɫɮɨɪɦɭɥɢɪɨɜɚɧɧɵɣ ɜɨ ɜɜɟɞɟɧɢɢ: ɤɪɚɬɤɨɜɪɟɦɟɧɧɚɹ ɨɫɬɪɚɹ
ɝɢɩɨɤɫɢɹ ɢ ɜɨɞɧɚɹ ɧɚɝɪɭɡɤɚ ɜ ɫɨɱɟɬɚɧɢɢ ɨɤɚɡɵɜɚɸɬ ɫɢɧɟɪɝɢɱɧɨɟ ɜɨɡɞɟɣɫɬɜɢɟ ɧɚ ɮɭɧɤɰɢɢ ɩɨɱɟɤ. ɍɜɟɥɢɱɟɧɧɨɟ ɩɨɬɪɟɛɥɟɧɢɟ ɜɨɞɵ ɧɟ ɤɭɩɢɪɭɟɬ ɷɮɮɟɤɬɵ ɝɢɩɨɤɫɢɢ ɧɚ ɩɟɪɢɮɟɪɢɱɟɫɤɨɟ ɤɪɨɜɨɨɛɪɚɳɟɧɢɟ.
AN INFLUENCE OF WATER LOAD WITH
AND WITHOUT SHORT-TERM ACUTE
NORMOBARIC HYPOXIA UPON
PERIPHERAL BLOOD FLOW IN YOUNG
MEN
V.N. Melnikov, A.O. Dongak, S.G. Krivoschekov,
R.I. Aizman
To evaluate separate and joint effects of a water
load (WL) and acute hypoxia on the peripheral
blood flow in the forearm we examined 27 men,
aged 18-25 years, on two consecutive days at rest
and 60 min after the oral WL (1% of body weight,
first day) combined with the normobaric hypoxia
(10% O2 for 10 min immediately after the WL,
second day). The WL per se increases urine
volume and muscle venous capacity and decreases
heart rate, urine osmolarity and cutaneous arterial
flow. Hypoxia potentiates changes caused by WL
in urine osmolarity, heart rate, cutaneous and
muscle arterial flow and muscle reactive
hyperemia. It is concluded that both loads cause a
sinergetic effect on the regional blood flow.
Ʌɢɬɟɪɚɬɭɪɚ
1. Ⱥɣɡɦɚɧ Ɋ.ɂ. ȼɨɡɪɚɫɬɧɵɟ ɨɫɨɛɟɧɧɨɫɬɢ ɝɟɦɨɞɢɧɚɦɢɤɢ ɭ ɱɟɥɨɜɟɤɚ ɧɚ ɫɬɢɦɭɥɹɰɢɸ ɨɫɦɨɪɟɝɭɥɢɪɭɸɳɟɣ ɫɢɫɬɟɦɵ / Ɋ.ɂ. Ⱥɣɡɦɚɧ, Ɉ.ɇ. ɉɟɬɪɨɜɚ, ɂ.Ɉ. Ɍɭɩɢɰɵɧ // Ɏɢɡɢɨɥ. ɱɟɥ. – 1988. – Ɍ. 14. – ʋ 4. – ɋ. 647-651.
162
2. Ɋɨɣɮɦɚɧ Ɇ.Ⱦ. ɂɡɦɟɧɟɧɢɹ ɝɟɦɨɞɢɧɚɦɢɤɢ ɩɨɫɥɟ
ɜɨɞɧɨɣ ɧɚɝɪɭɡɤɢ ɭ ɱɟɥɨɜɟɤɚ // Ɇ.Ⱦ. Ɋɨɣɮɦɚɧ, Ⱥ.ə. Ɍɟɪɧɟɪ
// VII ȼɫɟɫɨɸɡɧɚɹ ɤɨɧɮɟɪɟɧɰɢɹ ɩɨ ɮɢɡɢɨɥɨɝɢɢ ɩɨɱɟɤ ɢ
ɜɨɞɧɨ-ɫɨɥɟɜɨɝɨ
ɨɛɦɟɧɚ,
ɩɨɫɜɹɳɟɧɧɚɹ
90-ɥɟɬɢɸ
Ⱥ.Ƚ. Ƚɢɧɟɰɢɧɫɤɨɝɨ. Ɍɟɡɢɫɵ ɞɨɤɥ. – 1985. – ɋ. 235.
3. Ⱥɣɡɦɚɧ Ɋ.ɂ. Ɋɟɚɤɰɢɹ ɩɨɱɟɤ ɩɨɞɪɨɫɬɤɨɜ ɧɚ ɜɨɞɧɵɟ
ɢ ɫɨɥɟɜɵɟ ɧɚɝɪɭɡɤɢ / Ɋ.ɂ. Ⱥɣɡɦɚɧ, Ɉ.ɇ. ɉɟɬɪɨɜɚ // ȼɨɡɪɚɫɬɧɵɟ ɨɫɨɛɟɧɧɨɫɬɢ ɮɨɪɦɢɪɨɜɚɧɢɹ ɦɨɪɮɨɥɨɝɢɢ ɢ ɮɢɡɢɨɥɨɝɢɢ ɩɨɱɤɢ ɱɟɥɨɜɟɤɚ. ɋɛ. ɧɚɭɱ. ɬɪ. ɇȽɉɂ. – 1981. – ɋ.81-89.
4. Ɍɟɪɧɟɪ Ⱥ.ə. Ɋɟɚɤɰɢɹ ɷɧɞɨɤɪɢɧɧɨɣ ɫɢɫɬɟɦɵ ɧɚ
ɜɨɞɧɨ-ɫɨɥɟɜɵɟ ɧɚɝɪɭɡɤɢ ɭ ɥɸɞɟɣ / Ⱥ.ə. Ɍɟɪɧɟɪ // VII ȼɫɟɫɨɸɡɧɚɹ ɤɨɧɮɟɪɟɧɰɢɹ ɩɨ ɮɢɡɢɨɥɨɝɢɢ ɩɨɱɟɤ ɢ ɜɨɞɧɨɫɨɥɟɜɨɝɨ ɨɛɦɟɧɚ, ɩɨɫɜɹɳɟɧɧɚɹ 90-ɥɟɬɢɸ Ⱥ.Ƚ. Ƚɢɧɟɰɢɧɫɤɨɝɨ. Ɍɟɡɢɫɵ ɞɨɤɥ. – 1985. – ɋ.217.
5. Ⱦɢɜɟɪɬ ȼ.ɗ. ȼɥɢɹɧɢɟ ɨɫɬɪɨɣ ɧɨɪɦɨɛɚɪɢɱɟɫɤɨɣ
ɝɢɩɨɤɫɢɱɟɫɤɨɣ ɧɚɝɪɭɡɤɢ ɧɚ ɪɟɝɢɨɧɚɪɧɨɟ ɤɪɨɜɨɫɧɚɛɠɟɧɢɟ
ɜɟɪɯɧɟɣ ɤɨɧɟɱɧɨɫɬɢ / ȼ.ɗ Ⱦɢɜɟɪɬ, Ɍ.Ƚ. Ʉɨɦɥɹɝɢɧɚ,
ɋ.Ƚ. Ʉɪɢɜɨɳɟɤɨɜ // Ɏɢɡɢɨɥ. ɱɟɥ. – 2004. – Ɍ. 30. – ʋ 6. –
ɋ. 51-56.
6. Hildebrandt W. Diuretic effect of hypoxia, hypocapnia, and hyperpnea in humans: relations to hormones and O2
hemosensitivity / W. Hildebrandt // J. Appl. Physiol. – 2000. –
Vol. 88. – P. 599-610.
7. Operation Everest III: role of plasma volume expansion on O2max during prolonged high altitude exposure /
P. Robach, M. Dechaux, S. Jarrot, et al. // Appl. Physiol. –
2000. – Vol. 89. – P. 29-37.
8. Effects of acute hypoxia on renal and endocrine
function at rest and during graded exercise in hydrated subjects / N.V. Olsen, I.L. Kanstrup, J.P. Richalet, et al. // J. Appl.
Physiol. – 1992. – Vol. 73. – P. 2036-2043.
9. Early fluid retension and severe acute mountain
sickness / J.A. Loeppky, M.V. Icenogle, D. Maes, et al. // J.
Appl. Physiol. – 2005. – Vol. 98. – P. 591-597.
10. Evidence against an increase in capillary permeability in subjects exposed to high altitude / G.R. Kleger,
P. Bartsch, P. Vock, et al. // J. Appl. Physiol. – 1996. –
Vol. 81. – P. 1917-1923.
11. Antidiuretic hormone responses to eucapnic hypoxia
in humans / J.R. Claybaugh, C.E. Wade, A.K. Sato, et al. //
J. Appl. Physiol. – 1982. – Vol. 53. – P. 815-823.
12. Lawrence D.L. Effect of hypoxia on atrial natriuretic
factor and aldosterone regulation in humans / D.L. Lawrens,
J.B. Skatrud and Y. Shenker // Am. J. Physiol. Endocrinol.
Metab. – 1990. – Vol. 258. – P. E243-E248.
13. ȼɨɡɪɚɫɬɧɵɟ ɨɫɨɛɟɧɧɨɫɬɢ ɜɨɞɧɨ-ɫɨɥɟɜɨɝɨ ɨɛɦɟɧɚ ɢ
ɜɥɢɹɧɢɟ ɧɚ ɧɢɯ ɧɟɤɨɬɨɪɵɯ ɮɚɤɬɨɪɨɜ ɫɪɟɞɵ / Ɋ.ɂ. Ⱥɣɡɦɚɧ,
ɇ.ȿ. Ʉɚɥɦɵɤɨɜɚ, ɋ.Ⱥ. Ȼɨɪɢɫɨɜɚ, ɂ.ɉ. ɋɥɢɧɶɤɨɜɚ // Ɏɨɪɦɢɪɨɜɚɧɢɟ ɦɟɯɚɧɢɡɦɨɜ ɪɟɝɭɥɹɰɢɢ ɜɨɞɧɨ-ɫɨɥɟɜɨɝɨ ɨɛɦɟɧɚ
ɜ ɩɪɨɰɟɫɫɟ ɨɧɬɨɝɟɧɟɡɚ. ɇɨɜɨɫɢɛɢɪɫɤ, 1979. – ɋ.18-37.
14. Systemic and regional hemodinamic effects of endogenious vasopressin stimulation in rats / F. Charocopos,
P. Hatzinikolaou, W.G. North, H. Gavras // Am. J. Physiol.
Heart Circ. Physiol. – 1982. – Vol. 243. – P. H560-H565.
15. Kanstrup I.L. Blood pressure and plasma catecholamines in acute and prolonged hypoxia: effects of local hypothermia / I.L. Kanstrup // J. Appl. Physiol. – 1999. – Vol. 87. –
P. 2053-2058.
16. Bestle M.H. Prolonged hypobaric hypoxemia attenuates vasopressin secretion and renal response to osmostimulation in men / M.H. Bestle, N.V. Olsen, T.D. Poulsen // J. Appl.
Physiol. – 2002. – Vol. 92. – P. 1911-1922.
17. Effect of hypoxia on renin secretion and renal renin
gene expression / B.K. Kramer, T. Ritthaler, F. Schweda, et al.
// Kidney Int. – 1998. – Vol. 54. – S155-S158.
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