”

”ɇɨɜɨɫɬɢɯɢɪɭɪɝɢɢ
ɋȿ. ɄȺɌɈɊɄɂɇ, Ƚȼ. əɊɈȼȿɇɄɈ, ɉɇ. Ɇɕɒȿɇɐȿȼ, əȼ. ɋɂɁɈɇȿɇɄɈ
ÎÑÎÁÅÍÍÎÑÒÈ ÁÈÎÌÅÕÀÍÈ×ÅÑÊÈÕ ÈÇÌÅÍÅÍÈÉ
ÎÏÎÐÍÎ-ÄÂÈÃÀÒÅËÜÍÎÉ ÑÈÑÒÅÌÛ ÏÐÈ ÕÐÎÍÈ×ÅÑÊÎÉ
ËÈÌÔÎÂÅÍÎÇÍÎÉ ÍÅÄÎÑÒÀÒÎ×ÍÎÑÒÈ ÍÈÆÍÈÕ ÊÎÍÅ×ÍÎÑÒÅÉ
ȽɈɍȼɉɈ «ɋɚɦɚɪɫɤɢɣɝɨɫɭɞɚɪɫɬɜɟɧɧɵɣɦɟɞɢɰɢɧɫɤɢɣɭɧɢɜɟɪɫɢɬɟɬɊɨɫɡɞɪɚɜɚ»,
ɊɨɫɫɢɣɫɤɚɹɎɟɞɟɪɚɰɢɹ
ɐɟɥɶ.ɍɥɭɱɲɟɧɢɟɮɭɧɤɰɢɨɧɚɥɶɧɨɣɞɢɚɝɧɨɫɬɢɤɢɩɪɢɯɪɨɧɢɱɟɫɤɨɣɥɢɦɮɨɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢɧɢɠɧɢɯɤɨɧɟɱɧɨɫɬɟɣɩɭɬɺɦɩɪɢɦɟɧɟɧɢɹɛɢɨɦɟɯɚɧɢɱɟɫɤɢɯɦɟɬɨɞɨɜɢɫɫɥɟɞɨɜɚɧɢɹ.
Ɇɚɬɟɪɢɚɥɢɦɟɬɨɞɵ. Ɉɛɫɥɟɞɨɜɚɧɨ 116 ɩɚɰɢɟɧɬɨɜɫɹɜɥɟɧɢɹɦɢɯɪɨɧɢɱɟɫɤɨɣɥɢɦɮɨɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢ (ɤɥɚɫɫɵɋ4-ɋ6 ɩɨɋȿȺɊ) ɢ 28 ɩɪɚɤɬɢɱɟɫɤɢɡɞɨɪɨɜɵɯɥɢɰ. ɉɪɨɜɨɞɢɥɢɤɥɢɧɢɱɟɫɤɢɣɚɧɚɥɢɡɞɜɢɠɟɧɢɹɧɚɚɩɩɚɪɚɬɧɨɩɪɨɝɪɚɦɦɧɨɦɤɨɦɩɥɟɤɫɟ «ɆȻɇȻɢɨɦɟɯɚɧɢɤɚ», ɜɤɥɸɱɚɸɳɢɣɩɨɞɨɦɟɬɪɢɸ, ɩɥɚɧɬɨɝɪɚɮɢɸ, ɷɥɟɤɬɪɨɦɢɨɝɪɚɮɢɸɢɝɨɧɢɨɦɟɬɪɢɸ.
Ɋɟɡɭɥɶɬɚɬɵ. ɍ 56% ɩɚɰɢɟɧɬɨɜɜɵɹɜɥɟɧɵɹɜɥɟɧɢɹɫɤɨɥɢɨɡɚ, ɭ 28% ɧɚɛɥɸɞɚɥɫɹɨɫɬɟɨɯɨɧɞɪɨɡ, ɚɪɬɪɨɡɨɚɪɬɪɢɬɞɢɚɝɧɨɫɬɢɪɨɜɚɧɜ 45% ɫɥɭɱɚɟɜ, ɪɚɡɥɢɱɧɵɟɧɚɪɭɲɟɧɢɹɤɨɧɮɢɝɭɪɚɰɢɢɫɬɨɩɜ
89% ɧɚɛɥɸɞɟɧɢɣ. ɇɚɢɛɨɥɟɟ ɜɵɪɚɠɟɧɧɚɹ ɩɚɬɨɥɨɝɢɹ ɨɩɨɪɧɨɞɜɢɝɚɬɟɥɶɧɨɣ ɫɢɫɬɟɦɵ ɨɬɦɟɱɟɧɚ ɜ
ɤɥɚɫɫɚɯɋ5-ɋ6. ɍɫɬɚɧɨɜɥɟɧɨ, ɱɬɨɜɤɥɚɫɫɚɯɋ4-ɋ6 ɪɚɡɜɢɜɚɟɬɫɹɮɭɧɤɰɢɨɧɚɥɶɧɚɹɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶ
ɧɢɠɧɢɯɤɨɧɟɱɧɨɫɬɟɣɫɩɚɬɨɥɨɝɢɟɣɥɨɤɨɦɨɬɨɪɧɨɣɮɭɧɤɰɢɢɝɨɥɟɧɨɫɬɨɩɧɵɯɫɭɫɬɚɜɨɜ.
Ɂɚɤɥɸɱɟɧɢɟ. Ɏɭɧɤɰɢɨɧɚɥɶɧɚɹɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶɢɫɬɚɬɨɞɢɧɚɦɢɱɟɫɤɢɟɧɚɪɭɲɟɧɢɹɭɩɚɰɢɟɧɬɨɜɫɯɪɨɧɢɱɟɫɤɨɣɥɢɦɮɨɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶɸɋ4-ɋ6 ɫɜɢɞɟɬɟɥɶɫɬɜɨɜɚɥɢɨɫɪɵɜɟɤɨɦɩɟɧɫɚɬɨɪɧɵɯɪɟɚɤɰɢɣɨɩɨɪɧɨɞɜɢɝɚɬɟɥɶɧɨɣɫɢɫɬɟɦɵ, ɱɬɨɧɟɨɛɯɨɞɢɦɨɭɱɢɬɵɜɚɬɶɩɪɢɩɪɨɜɟɞɟɧɢɢ
ɦɟɞɢɰɢɧɫɤɨɣɪɟɚɛɢɥɢɬɚɰɢɢ.
Ʉɥɸɱɟɜɵɟ ɫɥɨɜɚ: ɛɢɨɦɟɯɚɧɢɤɚ, ɯɪɨɧɢɱɟɫɤɚɹ ɥɢɦɮɨɜɟɧɨɡɧɚɹ ɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶ, ɫɬɚɬɨɞɢɧɚɦɢɱɟɫɤɢɟ ɧɚɪɭɲɟɧɢɹ
Objectives. Improvement of the functional diagnostics at chronic lymph-venous insufficiency of
the lower limbs using the biochemical methods of investigation.
Methods. 116 patients with lymph-venous insufficiency of C4-C6 classes (according to CEAP)
and 28 practically healthy people were examined. The clinical movement analysis was performed, applying
apparatus-software complex «MBN-Biomechanika» including podometrics, plantography,
electromyography and goniometry.
Results. Scoliosis was found out in 56% of the patients; in 28% osteochondrosis was observed;
arthrosis-arthritis was diagnosed in 45%; various disturbances of the foot configuration were seen in
89% of all investigations. The most obvious pathology of the skeletal system was noted in the classes C5C6. Functional insufficiency of the lower limbs with the locomotor function pathology of the talocrural
joint was established to develop in the classes C4-C6.
Conclusions. Functional insufficiency and static-dynamic disturbances in patients with chronic
lymph-venous insufficiency of C4-C6 testified to the failure of compensatory reactions of the skeletal
system that should be taken into consideration while carrying out medical rehabilitation.
Keywords: biomechanics, chronic lymph-venous insufficiency, static-dynamic disturbances
ɏɪɨɧɢɱɟɫɤɚɹɜɟɧɨɡɧɚɹɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶ
ɧɢɠɧɢɯ ɤɨɧɟɱɧɨɫɬɟɣ ɹɜɥɹɟɬɫɹ ɨɞɧɢɦ ɢɡ
ɫɚɦɵɯ ɪɚɫɩɪɨɫɬɪɚɧɺɧɧɵɯ ɯɢɪɭɪɝɢɱɟɫɤɢɯ
ɡɚɛɨɥɟɜɚɧɢɣ [1, 2]. ȼɩɚɬɨɥɨɝɢɱɟɫɤɢɣɩɪɨɰɟɫɫɜɨɜɥɟɤɚɸɬɫɹɜɟɧɨɡɧɚɹ, ɚɪɬɟɪɢɚɥɶɧɚɹ,
ɥɢɦɮɚɬɢɱɟɫɤɚɹɫɢɫɬɟɦɵ, ɩɨɪɚɠɚɟɬɫɹɦɢɤ50
ɪɨɰɢɪɤɭɥɹɬɨɪɧɨɟɪɭɫɥɨ [3, 4, 5]. ɋɧɢɠɚɟɬɫɹɬɨɧɭɫɢɷɮɮɟɤɬɢɜɧɨɫɬɶɪɚɛɨɬɵɢɤɪɨɧɨɠɧɵɯɦɵɲɰ, ɧɚɪɭɲɚɟɬɫɹɥɨɤɨɦɨɬɨɪɧɚɹɮɭɧɤɰɢɹɫɭɫɬɚɜɨɜɧɢɠɧɢɯɤɨɧɟɱɧɨɫɬɟɣ [6]. ȼ
ɬɨɠɟɜɪɟɦɹɨɛɳɟɩɪɢɧɹɬɵɟɦɟɬɨɞɵɞɢɚɝɧɨɫɬɢɤɢɫɭɳɟɫɬɜɟɧɧɨɧɟɜɥɢɹɸɬɧɚɨɰɟɧɤɭ
ʋ6x2010 iɬɨɦ 18
ɫɨɫɬɨɹɧɢɹ ɦɵɲɟɱɧɨɜɟɧɨɡɧɨɣ ɩɨɦɩɵ ɢ
ɫɬɚɬɨɞɢɧɚɦɢɱɟɫɤɨɣ ɮɭɧɤɰɢɢ ɧɢɠɧɢɯ ɤɨɧɟɱɧɨɫɬɟɣ [7]. ɇɟ ɨɛɪɚɳɚɟɬɫɹ ɞɨɥɠɧɨɝɨ
ɜɧɢɦɚɧɢɹ ɧɚ ɱɚɫɬɨɟ ɫɨɱɟɬɚɧɢɟ ɯɪɨɧɢɱɟɫɤɨɣɥɢɦɮɨɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢɢɧɚɪɭɲɟɧɢɣ ɨɩɨɪɧɨɞɜɢɝɚɬɟɥɶɧɨɝɨ ɚɩɩɚɪɚɬɚ
[8]. ȼɫɜɹɡɢɫɷɬɢɦ, ɪɚɡɜɢɜɚɸɳɚɹɫɹɮɭɧɤɰɢɨɧɚɥɶɧɚɹ ɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶ ɧɢɠɧɢɯ ɤɨɧɟɱɧɨɫɬɟɣɫɹɜɥɟɧɢɹɦɢɫɬɚɬɨɞɢɧɚɦɢɱɟɫɤɢɯ
ɧɚɪɭɲɟɧɢɣɢɢɯɜɥɢɹɧɢɟɧɚɬɟɱɟɧɢɟɡɚɛɨɥɟɜɚɧɢɹɧɭɠɞɚɸɬɫɹɜɞɚɥɶɧɟɣɲɟɦɢɡɭɱɟɧɢɢ.
ɐɟɥɶ ɢɫɫɥɟɞɨɜɚɧɢɹ – ɭɥɭɱɲɟɧɢɟɮɭɧɤɰɢɨɧɚɥɶɧɨɣɞɢɚɝɧɨɫɬɢɤɢɩɪɢɯɪɨɧɢɱɟɫɤɨɣ
ɥɢɦɮɨɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢɧɢɠɧɢɯ
ɤɨɧɟɱɧɨɫɬɟɣɩɭɬɺɦɤɨɦɩɥɟɤɫɧɨɝɨɩɪɢɦɟɧɟɧɢɹɤɥɢɧɢɱɟɫɤɢɯɛɢɨɦɟɯɚɧɢɱɟɫɤɢɯɦɟɬɨɞɨɜ
ɢɫɫɥɟɞɨɜɚɧɢɹ.
Ɇɚɬɟɪɢɚɥɢɦɟɬɨɞɵ
Ɉɛɫɥɟɞɨɜɚɧɨ 116 ɩɚɰɢɟɧɬɨɜɫɹɜɥɟɧɢɹɦɢɯɪɨɧɢɱɟɫɤɨɣɥɢɦɮɨɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢ (ɤɥɚɫɫɵɋ4-ɋ6 ɩɨɦɟɠɞɭɧɚɪɨɞɧɨɣ
ɤɥɚɫɫɢɮɢɤɚɰɢɢɋȿȺɊ): 67 ɱɟɥɨɜɟɤɫɋ4, 26
ɩɚɰɢɟɧɬɨɜɫɋ5 ɢ 23 ɱɟɥɨɜɟɤɚɫɋ6 ɤɥɢɧɢɱɟɫɤɢɦɢɤɥɚɫɫɚɦɢ. ɋɪɟɞɢ ɩɚɰɢɟɧɬɨɜ ɩɪɟɜɚɥɢɪɨɜɚɥɢɠɟɧɳɢɧɵ, ɱɬɨɫɨɨɬɜɟɬɫɬɜɨɜɚɥɨ 65% ɧɚɛɥɸɞɚɟɦɵɯ. ȼɨɡɪɚɫɬɨɛɫɥɟɞɨɜɚɧɧɵɯɜɚɪɶɢɪɨɜɚɥɨɬ 20 ɞɨ 83 ɥɟɬɢɜɫɪɟɞɧɟɦ ɫɨɫɬɚɜɢɥ 38,6±6,1 ɥɟɬ. ɉɨɞɚɜɥɹɸɳɟɟ
ɛɨɥɶɲɢɧɫɬɜɨ ɩɚɰɢɟɧɬɨɜ ɫɬɪɚɞɚɥɢ ɯɪɨɧɢɱɟɫɤɨɣɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶɸɨɬ 5 ɞɨ
15 ɥɟɬ. Ⱦɥɹ ɩɨɥɭɱɟɧɢɹɧɨɪɦɚɬɢɜɧɵɯ ɞɚɧɧɵɯɜɪɟɦɟɧɧɵɯ, ɤɢɧɟɦɚɬɢɱɟɫɤɢɯɢɞɢɧɚɦɢɱɟɫɤɢɯɩɚɪɚɦɟɬɪɨɜɧɨɪɦɚɥɶɧɨɣɩɨɯɨɞɤɢɢ
ɫɬɨɣɤɢɩɪɨɜɟɞɟɧɵɢɫɫɥɟɞɨɜɚɧɢɹɭ 28 ɩɪɚɤɬɢɱɟɫɤɢɡɞɨɪɨɜɵɯɥɢɰɜɜɨɡɪɚɫɬɟɨɬ 19 ɞɨ
45 ɥɟɬ.
ɋ ɰɟɥɶɸ ɤɨɦɩɥɟɤɫɧɨɝɨ ɨɛɫɥɟɞɨɜɚɧɢɹ
ɨɩɨɪɧɨɞɜɢɝɚɬɟɥɶɧɨɣ ɫɢɫɬɟɦ ɧɢɠɧɢɯ ɤɨɧɟɱɧɨɫɬɟɣɩɪɢɦɟɧɹɥɢɤɥɢɧɢɱɟɫɤɢɣɚɧɚɥɢɡ
ɞɜɢɠɟɧɢɹɧɚɚɩɩɚɪɚɬɧɨɩɪɨɝɪɚɦɦɧɨɦɤɨɦɩɥɟɤɫɟ «ɆȻɇȻɢɨɦɟɯɚɧɢɤɚ», ɤɨɬɨɪɵɣ
ɜɤɥɸɱɚɥɩɨɞɨɦɟɬɪɢɸ (ɢɡɦɟɪɟɧɢɟɜɪɟɦɟɧɧɵɯ ɯɚɪɚɤɬɟɪɢɫɬɢɤ ɲɚɝɚ), ɩɥɚɧɬɨɝɪɚɮɢɸ
ɞɢɚɝɧɨɫɬɢɤɚɤɨɧɮɢɝɭɪɚɰɢɢɫɬɨɩɵ), ɷɥɟɤɬɪɨɦɢɨɝɪɚɮɢɸ (ɢɫɫɥɟɞɨɜɚɧɢɟɛɢɨɷɥɟɤɬɪɢɱɟɫɤɨɣɚɤɬɢɜɧɨɫɬɢɦɵɲɰ) ɢɝɨɧɢɨɦɟɬɪɢɸ
ɢɡɦɟɪɟɧɢɟɢɪɟɝɢɫɬɪɚɰɢɹɥɨɤɨɦɨɰɢɣɫɭɫɬɚɜɨɜ). ɇɚɪɭɲɟɧɢɟɨɫɚɧɤɢ ɢɫɫɥɟɞɨɜɚɥɢɫɶ
ɩɪɨɟɤɰɢɨɧɧɵɦ ɦɟɬɨɞɨɦ ɤɨɦɩɶɸɬɟɪɧɨɣ
ɨɩɬɢɱɟɫɤɨɣɬɨɩɨɝɪɚɮɢɢ «Ʉɨɦɨɬ».
ɋɬɚɬɢɫɬɢɱɟɫɤɚɹ ɨɛɪɚɛɨɬɤɚɞɚɧɧɵɯɩɪɨɜɨɞɢɥɚɫɶ ɫ ɢɫɩɨɥɶɡɨɜɚɧɢɟɦ ɩɪɨɝɪɚɦɦ
EXCEL 6, STATISTICA (ɜɟɪɫɢɹ 6,0). ɉɨɥɭɱɟɧɧɵɟ ɰɢɮɪɨɜɵɟ ɡɧɚɱɟɧɢɹ ɩɨɞɨɦɟɬɪɢɢ,
ɝɨɧɢɨɦɟɬɪɢɢ ɢ ɷɥɟɤɬɪɨɦɢɨɝɪɚɮɢɢ ɩɪɟɞɫɬɚɜɥɟɧɵɜɮɨɪɦɚɬɟ «ɫɪɟɞɧɟɟɡɧɚɱɟɧɢɟ (Ɇ)
± ɨɲɢɛɤɚɫɪɟɞɧɟɝɨ (m)».
Ɋɟɡɭɥɶɬɚɬɵɢɨɛɫɭɠɞɟɧɢɟ
ɍɜɫɟɯɩɚɰɢɟɧɬɨɜ, ɜɯɨɞɢɜɲɢɯɜɞɚɧɧɨɟ
ɢɫɫɥɟɞɨɜɚɧɢɟ, ɛɵɥɚɨɬɦɟɱɟɧɚɫɨɩɭɬɫɬɜɭɸɳɚɹɩɚɬɨɥɨɝɢɹɨɩɨɪɧɨɞɜɢɝɚɬɟɥɶɧɨɣɫɢɫɬɟɦɵ. ɇɟɨɛɯɨɞɢɦɨ ɨɬɦɟɬɢɬɶ, ɱɬɨ ɨɧɚ ɧɚɛɥɸɞɚɥɚɫɶɭɩɚɰɢɟɧɬɨɜɫɚɤɬɢɜɧɵɦɢɬɪɨɮɢɱɟɫɤɢɦɢɪɚɫɫɬɪɨɣɫɬɜɚɦɢɧɢɠɧɢɯɤɨɧɟɱɧɨɫɬɟɣ, ɱɬɨɫɜɢɞɟɬɟɥɶɫɬɜɭɟɬɨɛɚɫɫɨɰɢɚɰɢɢ
ɨɛɳɟɣɞɢɫɩɥɚɡɢɢɢɯɪɨɧɢɱɟɫɤɨɣɜɟɧɨɡɧɨɣ
ɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢ. ɉɨɧɚɲɢɦɞɚɧɧɵɦ, ɭɨɛɫɥɟɞɨɜɚɧɧɵɯɩɚɰɢɟɧɬɨɜɫɯɪɨɧɢɱɟɫɤɨɣɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶɸ ɧɢɠɧɢɯɤɨɧɟɱɧɨɫɬɟɣ (ɤɥɚɫɫɵɋ4-ɋ6 ɩɨɋȿȺɊ) ɜ 56% ɜɵɹɜɥɹɥɢɫɶɩɪɢɡɧɚɤɢɫɤɨɥɢɨɡɚ (ɪɢɫ.). ȼ 28%
ɧɚɛɥɸɞɚɥɫɹ ɨɫɬɟɨɯɨɧɞɪɨɡ. Ɋɚɡɥɢɱɧɵɟ ɧɚɊɢɫ. ɋɨɩɭɬɫɬɜɭɸɳɚɹɩɚɬɨɥɨɝɢɹɨɩɨɪɧɨɞɜɢɝɚɬɟɥɶɧɨɣɫɢɫɬɟɦɵɭɩɚɰɢɟɧɬɨɜɫɯɪɨɧɢɱɟɫɤɨɣ
ɥɢɦɮɨɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶɸɧɢɠɧɢɯ
ɤɨɧɟɱɧɨɫɬɟɣ
%
100
80
89
60
40
20
56
45
28
0
ɋɤɨɥɢɨɡ
Ɉɫɬɟɨɯɨɧɞɪɨɡ
ɇɚɪɭɲɟɧɢɟɤɨɧɮɢɝɭɪɚɰɢɢɫɬɨɩ
Ⱥɪɬɪɨɡɨɚɪɬɪɢɬ
51
”ɇɨɜɨɫɬɢɯɢɪɭɪɝɢɢ
Ɍɚɛɥɢɰɚ 1
ȼɪɟɦɟɧɧɵɟɩɚɪɚɦɟɬɪɵɰɢɤɥɚɲɚɝɚɭɩɚɰɢɟɧɬɨɜ ɯɪɨɧɢɱɟɫɤɨɣɥɢɦɮɨɜɟɧɨɡɧɨɣ
ɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶɸɋ4 ɤɥɢɧɢɱɟɫɤɨɝɨɤɥɚɫɫɚ (ɩɨɋȿȺɊ) (n=67)
ɉɚɪɚɦɟɬɪɵɰɢɤɥɚɲɚɝɚ
ɉɨɤɚɡɚɬɟɥɢɡɞɨɪɨɜɵɯ
ɥɢɰ (Ɇ ± m)
ɐɢɤɥɲɚɝɚ
1,22±0,05
ɉɟɪɢɨɞɨɩɨɪɵ
62,27±0,48
ɉɟɪɢɨɞɩɟɪɟɧɨɫɚ
37,86±0,42
ɋɭɦɦɚɪɧɵɣɩɟɪɢɨɞ ɞɜɨɣɧɨɣɨɩɨɪɵ
26,49±1,36
ɉɟɪɜɵɣɩɟɪɢɨɞɞɜɨɣɧɨɣɨɩɨɪɵ
13,3±0,92
ȼɬɨɪɨɣɩɟɪɢɨɞɞɜɨɣɧɨɣɨɩɨɪɵ
13,18±0,91
ɉɟɪɢɨɞ ɨɞɢɧɨɱɧɨɣɨɩɨɪɵ
36,84±0,50
ɇɚɱɚɥɨɜɬɨɪɨɝɨ ɩɟɪɢɨɞɚ ɞɜɨɣɧɨɣɨɩɨɪɵ
49,74±0,33
ɉɪɢɦɟɱɚɧɢɟ: s – ɥɟɜɚɹɢ d – ɩɪɚɜɚɹɧɢɠɧɹɹɤɨɧɟɱɧɨɫɬɢ
ɪɭɲɟɧɢɹɤɨɧɮɢɝɭɪɚɰɢɢɫɬɨɩɛɵɥɢɨɬɦɟɱɟɧɵɜ 89% ɧɚɛɥɸɞɟɧɢɣ, ɚɹɜɥɟɧɢɹɚɪɬɪɨɡɨɚɪɬɪɢɬɚɞɢɚɝɧɨɫɬɢɪɨɜɚɥɢɫɶɜ 45% ɫɥɭɱɚɟɜ.
Ɉɫɧɨɜɧɵɦɢ ɩɪɨɹɜɥɟɧɢɹɦɢ ɡɚɛɨɥɟɜɚɧɢɹɭɩɚɰɢɟɧɬɨɜɋ4 ɤɥɚɫɫɚɛɵɥɢɪɚɫɲɢɪɟɧɢɟɢɬɪɚɧɫɮɨɪɦɚɰɢɹɩɨɜɟɪɯɧɨɫɬɧɵɯɜɟɧ,
ɨɬɟɤɧɢɠɧɢɯɤɨɧɟɱɧɨɫɬɟɣɢɩɨɹɜɥɟɧɢɟɬɪɨɮɢɱɟɫɤɢɯɢɡɦɟɧɟɧɢɣɜɜɢɞɟɩɢɝɦɟɧɬɚɰɢɢ,
ɥɢɩɨɞɟɪɦɚɬɨɫɤɥɟɪɨɡɚɜ ɧɢɠɧɟɣɬɪɟɬɢɝɨɥɟɧɢ.
ɉɪɢ ɩɪɨɜɟɞɟɧɢɢ ɷɥɟɤɬɪɨɦɢɨɝɪɚɮɢɢ
ɧɚɦɢɡɚɮɢɤɫɢɪɨɜɚɧɨɫɧɢɠɟɧɢɟɩɨɤɚɡɚɬɟɥɟɣ
ɚɦɩɥɢɬɭɞɵɉȾȿ (ɩɨɬɟɧɰɢɚɥɞɜɢɝɚɬɟɥɶɧɵɯ
ɟɞɢɧɢɰ) ɢɤɪɨɧɨɠɧɨɣ ɦɵɲɰɵ ɩɨ ɫɪɚɜɧɟɧɢɸɫɞɚɧɧɵɦɢɩɪɚɤɬɢɱɟɫɤɢɡɞɨɪɨɜɵɯɥɢɰ
ɞɨ 1,18±0,06 mV (p<0,05). ɉɨɤɚɡɚɬɟɥɶɉȾȿ
ɩɟɪɟɞɧɟɣ ɛɟɪɰɨɜɨɣ ɦɵɲɰɵ ɬɚɤɠɟ ɫɭɳɟɫɬɜɟɧɧɨ ɧɢɠɟ ɧɨɪɦɵ – 1,92±0,12 mV
(p<0,05). ɉɨɥɭɱɟɧɧɵɟɪɟɡɭɥɶɬɚɬɵɫɨɩɨɫɬɚɜɢɦɵ ɫ ɞɚɧɧɵɦɢ ɞɪɭɝɢɯ ɚɜɬɨɪɨɜ [9, 10].
ɂɫɫɥɟɞɨɜɚɧɢɟ ɜɪɟɦɟɧɧɵɯ ɯɚɪɚɤɬɟɪɢɫɬɢɤ
ɜɵɹɜɢɥɨ, ɱɬɨɞɥɢɬɟɥɶɧɨɫɬɶɰɢɤɥɚɲɚɝɚɩɪɢ
ɋ4 ɩɪɟɜɵɲɚɥɚɫɪɟɞɧɢɟɩɨɤɚɡɚɬɟɥɢɭɩɪɚɤɬɢɱɟɫɤɢɡɞɨɪɨɜɵɯɥɢɰ (p<0,05) (ɬɚɛɥɢɰɚ 1).
ɇɚɛɥɸɞɚɥɚɫɶɚɫɢɦɦɟɬɪɢɹɫɭɦɟɧɶɲɟɧɢɟɦ ɞɥɢɬɟɥɶɧɨɫɬɢ ɰɢɤɥɚ ɲɚɝɚ ɧɚ ɫɬɨɪɨɧɟ
ɩɨɪɚɠɟɧɢɹ. ɉɟɪɢɨɞɩɟɪɟɧɨɫɚɡɞɨɪɨɜɨɣɤɨɧɟɱɧɨɫɬɢɛɵɥɞɨɫɬɨɜɟɪɧɨɧɢɠɟ ɧɨɪɦɵ, ɚ
ɩɟɪɢɨɞɨɩɨɪɵ – ɛɨɥɶɲɟ (p<0,05). ɍɜɟɥɢɱɢɜɚɥɚɫɶɞɥɢɬɟɥɶɧɨɫɬɶɫɭɦɦɚɪɧɨɝɨɩɟɪɢɨɞɚ
ɞɜɨɣɧɨɣɨɩɨɪɵɧɚɤɨɧɟɱɧɨɫɬɢɫɬɪɨɮɢɱɟɫ52
ɉɨɤɚɡɚɬɟɥɢɩɚɰɢɟɧɬɨɜ
ɋ4 ɤɥɚɫɫɚ (Ɇ ± m)
s
d
1,48±0,02
1,56±0,06
62,16±1,08
63,46±2,18
37,62±2,03
33,12±1,09
29,11±2,02
26,74±1,05
14,02±1,07
14,6±2,06
14,64±1,63
12,82±2,11
35,82±1,08
36,43±2,06
48,92±0,04
49,78±0,05
ɤɢɦɢ ɪɚɫɫɬɪɨɣɫɬɜɚɦɢ. ɉɪɨɫɬɪɚɧɫɬɜɟɧɧɵɟ
ɩɨɤɚɡɚɬɟɥɢɫɤɨɪɨɫɬɢɢɱɚɫɬɨɬɵɲɚɝɚɭɩɚɰɢɟɧɬɨɜ ɫɋ4 ɤɥɢɧɢɱɟɫɤɢɦɤɥɚɫɫɨɦ ɛɵɥɢ
ɫɧɢɠɟɧɵ ɢ ɧɚɯɨɞɢɥɢɫɶ ɜ ɩɪɟɞɟɥɚɯ
76,8±2,01 ɢ 96,3±4,1 ɲɚɝɦɢɧɫɨɨɬɜɟɬɫɬɜɟɧɧɨ (p<0,05). ɉɪɨɫɬɪɚɧɫɬɜɟɧɧɵɟɯɚɪɚɤɬɟɪɢɫɬɢɤɢɲɚɝɚɛɵɥɢɫɥɟɞɭɸɳɢɟ: ɞɥɢɧɚɲɚɝɚ –
62,5±2,1 ɫɦ (ɩɨ ɪɚɠɺɧɧɚɹ ɫɬɨɪɨɧɚ) ɢ
59,8±0,3 ɫɦ (ɢɧɬɚɤɬɧɚɹɫɬɨɪɨɧɚ), ɛɚɡɚɲɚɝɚ
– 7,9±2,01 ɫɦ, ɭɝɨɥ ɪɚɡɜɨɪɨɬɚ – 9,5±2,8°
ɩɪɚɜɨɣɢ 8,6±1,2° ɥɟɜɨɣɫɬɨɩ. Ɍɚɤɢɦɨɛɪɚɡɨɦ, ɭ ɩɚɰɢɟɧɬɨɜ ɋ4-ɤɥɚɫɫɚ ɞɥɢɧɚ ɲɚɝɚ
ɭɦɟɧɶɲɚɥɚɫɶɩɨ ɫɪɚɜɧɟɧɢɸɫɧɨɪɦɨɣ, ɧɨ
ɧɚɩɨɪɚɠɺɧɧɨɣɫɬɨɪɨɧɟɨɧɚɛɨɥɶɲɟ, ɱɟɦɧɚ
ɡɞɨɪɨɜɨɣ (p<0,05). ɂɦɟɥɚɫɶ ɬɟɧɞɟɧɰɢɹ ɤ
ɭɜɟɥɢɱɟɧɢɸɛɚɡɵɲɚɝɚɢɭɦɟɧɶɲɟɧɢɸɭɝɥɚ
ɪɚɡɜɨɪɨɬɚɧɚɩɨɪɚɠɺɧɧɨɣɤɨɧɟɱɧɨɫɬɢ.
Ʉɢɧɟɦɚɬɢɤɚɞɜɢɠɟɧɢɣɤɪɭɩɧɵɯɫɭɫɬɚɜɨɜɧɢɠɧɢɯɤɨɧɟɱɧɨɫɬɟɣɢɡɦɟɧɹɥɚɫɶɜɫɬɨɪɨɧɭɭɦɟɪɟɧɧɨɝɨɫɧɢɠɟɧɢɹɚɦɩɥɢɬɭɞɞɜɢɠɟɧɢɹ ɩɪɢ ɜɵɪɚɠɟɧɧɵɯ ɨɬɺɱɧɨɦ ɢ ɛɨɥɟɜɨɦ ɫɢɧɞɪɨɦɚɯ, ɢɧɞɭɪɚɬɢɜɧɨɦ ɩɪɨɰɟɫɫɟ.
Ⱥɦɩɥɢɬɭɞɚ ɨɫɧɨɜɧɨɝɨɦɚɯɨɜɨɝɨ ɫɝɢɛɚɧɢɹ
ɤɨɥɟɧɧɨɝɨɫɭɫɬɚɜɚɄ3 ɦɟɧɶɲɟɧɚɛɨɥɶɧɨɣɤɨɧɟɱɧɨɫɬɢ (56,8±2,62°) (p<0,05). Ⱥɧɚɥɨɝɢɱɧɚɹɡɚɤɨɧɨɦɟɪɧɨɫɬɶɜɵɹɜɥɹɥɚɫɶɞɥɹɚɦɩɥɢɬɭɞɵ Ƚ3 ɩɨɞɨɲɜɟɧɧɨɟ ɫɝɢɛɚɧɢɟ ɝɨɥɟɧɨɫɬɨɩɧɨɝɨɫɭɫɬɚɜɚɩɪɢɨɬɪɵɜɟɫɬɨɩɵɨɬɨɩɨɪɵ). ɇɚ ɫɬɨɪɨɧɟ ɩɨɪɚɠɺɧɧɨɣ ɤɨɧɟɱɧɨɫɬɢ
ɨɧɚɫɧɢɠɚɥɚɫɶ (Ƚ3 = - 12,43±2,19) (p<0,05).
ɋɨ ɫɬɨɪɨɧɵ ɞɢɧɚɦɢɱɟɫɤɨɣ ɮɭɧɤɰɢɢ
ʋ6x2010 iɬɨɦ 18
ɧɢɠɧɢɯɤɨɧɟɱɧɨɫɬɟɣɨɛɧɚɪɭɠɢɜɚɥɨɫɶɫɧɢɠɟɧɢɟɞɢɚɩɚɡɨɧɚɩɟɪɟɦɟɧɧɵɯɞɢɧɚɦɢɱɟɫɤɢɯɧɚɝɪɭɡɨɤɞɨ 20% ɨɬɩɨɤɚɡɚɬɟɥɟɣɭɩɪɚɤɬɢɱɟɫɤɢɡɞɨɪɨɜɵɯɥɢɰ (p<0,05). Ɉɫɧɨɜɧɚɹ
ɫɬɨɣɤɚɯɚɪɚɤɬɟɪɢɡɨɜɚɥɚɫɶɫɧɢɠɟɧɢɟɦɫɬɚɛɢɥɶɧɨɫɬɢɢɭɦɟɪɟɧɧɵɦɫɦɟɳɟɧɢɟɦɰɟɧɬɪɚɞɚɜɥɟɧɢɹɜɨɮɪɨɧɬɚɥɶɧɨɣɢ, ɜɦɟɧɶɲɟɣ
ɫɬɟɩɟɧɢ, ɜɫɚɝɢɬɬɚɥɶɧɨɣɩɥɨɫɤɨɫɬɢ. Ʉɪɨɦɟ
ɬɨɝɨ, ɯɚɪɚɤɬɟɪɧɵɦ ɫɢɦɩɬɨɦɨɦ ɹɜɥɹɥɚɫɶ
ɚɫɢɦɦɟɬɪɢɹ ɩɨɤɚɡɚɬɟɥɟɣ ɩɨɪɚɠɺɧɧɨɣ ɢ
ɢɧɬɚɤɬɧɨɣɤɨɧɟɱɧɨɫɬɟɣɩɪɢɨɞɧɨɫɬɨɪɨɧɧɟɣ
ɩɚɬɨɥɨɝɢɢ. Ʉɨɷɮɮɢɰɢɟɧɬɚɫɢɦɦɟɬɪɢɢɛɵɥ
ɜɚɪɢɚɛɟɥɟɧɢɫɨɫɬɚɜɥɹɥɨɬ 1% ɞɨ 8%. ɇɨɪɦɚɥɶɧɨɟ ɫɨɨɬɧɨɲɟɧɢɟ ɩɟɪɢɨɞɨɜ ɨɩɨɪɵ ɢ
ɩɟɪɟɧɨɫɚ ɧɚ ɤɨɧɟɱɧɨɫɬɢ ɫ ɹɜɥɟɧɢɹɦɢ ɋ4
ɫɜɢɞɟɬɟɥɶɫɬɜɨɜɚɥɨɨɬɨɦ, ɱɬɨɟɣɨɛɟɫɩɟɱɢɜɚɥɫɹɪɟɠɢɦ, ɩɪɢɛɥɢɠɺɧɧɵɣɤɧɨɪɦɚɥɶɧɨɦɭ, ɡɚ ɫɱɺɬ ɮɭɧɤɰɢɨɧɚɥɶɧɨɝɨ ɧɚɩɪɹɠɟɧɢɹ
ɡɞɨɪɨɜɨɣɤɨɧɟɱɧɨɫɬɢ. ɍɦɟɧɶɲɟɧɢɟɭɝɥɚɪɚɡɜɨɪɨɬɚɫɬɨɩɵ, ɛɨɥɟɟɜɵɪɚɠɟɧɧɨɟɧɚɤɨɧɟɱɧɨɫɬɢ ɫ ɹɜɥɟɧɢɹɦɢ ɬɪɨɮɢɱɟɫɤɢɯ ɪɚɫɫɬɪɨɣɫɬɜ, ɫɜɢɞɟɬɟɥɶɫɬɜɨɜɚɥɨ ɨɮɪɨɧɬɚɥɢɡɚɰɢɢɨɫɢɞɜɢɠɟɧɢɣɝɨɥɟɧɨɫɬɨɩɧɨɝɨɫɭɫɬɚɜɚ ɢ ɮɭɧɤɰɢɨɧɚɥɶɧɨɣ ɢɦɦɨɛɢɥɢɡɚɰɢɢ
ɫɭɫɬɚɜɨɜɫɬɨɩɵ. ɗɬɨɫɨɝɥɚɫɭɟɬɫɹɫɞɚɧɧɵɦɢɷɥɟɤɬɪɨɦɢɨɝɪɚɮɢɢɢɫɜɢɞɟɬɟɥɶɫɬɜɭɟɬɨ
ɫɧɢɠɟɧɢɢɮɭɧɤɰɢɨɧɚɥɶɧɨɣɚɤɬɢɜɧɨɫɬɢɡɚɞɧɟɣɝɪɭɩɩɵɦɵɲɰɩɨɪɚɠɺɧɧɨɣ ɤɨɧɟɱɧɨɫɬɢ. Ɍɚɤɢɦɨɛɪɚɡɨɦ, ɭɩɚɰɢɟɧɬɨɜɫɋ4 ɤɥɢɧɢɱɟɫɤɢɦɤɥɚɫɫɨɦɢɦɟɥɚɫɶɮɭɧɤɰɢɨɧɚɥɶɧɚɹ
ɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶ ɧɢɠɧɢɯ ɤɨɧɟɱɧɨɫɬɟɣ.
ȼɵɹɜɥɟɧɧɵɟɜɫɭɫɬɚɜɚɯɧɢɠɧɢɯɤɨɧɟɱɧɨɫɬɟɣɭɩɚɰɢɟɧɬɨɜɋ4 ɤɥɚɫɫɚɢɡɦɟɧɟɧɢɹɤɢɧɟɦɚɬɢɤɢ ɹɜɥɹɸɬɫɹ ɩɪɨɹɜɥɟɧɢɟɦ ɬɚɤɨɝɨ
ɤɨɦɩɟɧɫɚɬɨɪɧɨɝɨɦɟɯɚɧɢɡɦɚ, ɤɚɤɮɭɧɤɰɢɨɧɚɥɶɧɨɟɤɨɩɢɪɨɜɚɧɢɟ. ɍɦɟɧɶɲɟɧɢɟɚɦɩɥɢɬɭɞ – ɪɟɡɭɥɶɬɚɬ ɫɧɢɠɟɧɢɹ ɬɟɦɩɚ ɢ ɞɥɢɧɵ
ɲɚɝɚ, ɬɨɟɫɬɶɡɚɦɟɞɥɟɧɢɹɯɨɞɶɛɵ.
ɉɨɫɥɟɞɨɜɚɬɟɥɶɧɨɫɬɶɧɨɪɦɚɥɶɧɨɝɨɩɟɪɟɤɚɬɚɫɬɨɩɵ «ɩɹɬɤɚ – V, ɩɥɸɫɧɟɜɚɹ – ȱ, ɩɥɸɫɧɟɜɚɹ – ɧɨɫɨɤ» ɛɵɥɚɱɚɳɟɫɨɯɪɚɧɟɧɚɫɨɛɟɢɯɫɬɨɪɨɧ. ɇɨ, ɩɪɢɷɬɨɦ, ɧɚɱɢɧɚɸɬɢɡɦɟɧɹɬɶɫɹɮɚɡɵɩɟɪɟɤɚɬɨɜ. Ɉɬɦɟɱɚɥɨɫɶɞɨɫɬɨɜɟɪɧɨɟɭɦɟɧɶɲɟɧɢɟɜɪɟɦɟɧɢɩɟɪɟɤɚɬɚɱɟɪɟɡɧɨɫɨɤɞɨ 18,2±1,3 ɩɪɢɩɨɤɚɡɚɬɟɥɟɭɩɪɚɤ-
ɬɢɱɟɫɤɢɡɞɨɪɨɜɵɯɥɢɰɜɩɪɟɞɟɥɚɯ 22,1±0,6
(p<0,05), ɩɪɨɥɨɧɝɢɪɨɜɚɧɢɟɩɟɪɟɤɚɬɚɱɟɪɟɡ
ɝɨɥɟɧɨɫɬɨɩɧɵɣ ɫɭɫɬɚɜ ɜ ɩɟɪɢɨɞ ɨɩɨɪɵ ɫ
ɨɛɟɢɯ ɫɬɨɪɨɧ, ɛɵɥɨ ɩɪɟɢɦɭɳɟɫɬɜɟɧɧɨ ɧɚ
ɩɚɬɨɥɨɝɢɱɟɫɤɢ ɢɡɦɟɧɟɧɧɨɣ ɤɨɧɟɱɧɨɫɬɢ –
33,6±1,4 ɢ 32,8±2,3, ɫɨɨɬɜɟɬɫɬɜɟɧɧɨ, ɩɪɢ
ɧɨɪɦɟ – 32,5±0,4. Ɏɢɤɫɢɪɨɜɚɥɨɫɶɫɬɚɬɢɫɬɢɱɟɫɤɢɞɨɫɬɨɜɟɪɧɨɟ (p<0,05) ɭɜɟɥɢɱɟɧɢɟ
ɜɪɟɦɟɧɢ ɩɟɪɟɤɚɬɚ ɱɟɪɟɡ ɩɹɬɤɭ ɞɥɹ ɨɛɟɢɯ
ɧɢɠɧɢɯɤɨɧɟɱɧɨɫɬɟɣ – 11,3±3,2 ɢ 9,5±0,8,
ɛɨɥɶɲɟɧɚɫɬɨɪɨɧɟɩɨɪɚɠɟɧɢɹɩɪɢɧɨɪɦɟ –
8,9±0,3. ɍɜɟɥɢɱɟɧɢɟɜɪɟɦɟɧɢɩɟɪɟɤɚɬɚɱɟɪɟɡɩɹɬɤɭɫɜɢɞɟɬɟɥɶɫɬɜɨɜɚɥɨɨɞɢɫɮɭɧɤɰɢɢ
ɝɨɥɟɧɨɫɬɨɩɧɨɝɨɫɭɫɬɚɜɚ. ɋɢɦɦɟɬɪɢɱɧɨɫɬɶ
ɷɬɨɝɨɫɢɦɩɬɨɦɚɫɜɢɞɟɬɟɥɶɫɬɜɨɜɚɥɚɨɤɨɩɢɪɨɜɚɧɢɢ ɡɞɨɪɨɜɨɣ ɤɨɧɟɱɧɨɫɬɶɸ ɮɭɧɤɰɢɢ
ɩɨɪɚɠɺɧɧɨɣɞɥɹɭɦɟɧɶɲɟɧɢɹɮɭɧɤɰɢɨɧɚɥɶɧɨɣ ɚɫɢɦɦɟɬɪɢɢ. ɉɪɨɥɨɧɝɢɪɨɜɚɧɢɟ ɩɟɪɟɤɚɬɚɱɟɪɟɡɧɨɫɨɤɡɚɱɚɫɬɭɸɩɪɢɜɨɞɢɬɤɭɫɢɥɟɧɢɸɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢ, ɬɚɤɤɚɤ
ɹɜɥɹɟɬɫɹɫɥɟɞɫɬɜɢɟɦɛɨɥɟɜɨɝɨɫɢɧɞɪɨɦɚɢ
ɫɥɚɛɨɫɬɢɡɚɞɧɟɣɝɪɭɩɩɵɦɵɲɰɝɨɥɟɧɢ, ɢɝɪɚɸɳɢɯɜɚɠɧɭɸɪɨɥɶɜɨɫɭɳɟɫɬɜɥɟɧɢɢɜɟɧɨɡɧɨɝɨɜɨɡɜɪɚɬɚ.
ɉɨɥɭɱɟɧɧɵɟ ɞɚɧɧɵɟ ɫɜɢɞɟɬɟɥɶɫɬɜɭɸɬ
ɨ ɜɵɪɚɠɟɧɧɨɣ ɮɭɧɤɰɢɨɧɚɥɶɧɨɣ ɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢ ɩɨɪɚɠɺɧɧɨɣ ɤɨɧɟɱɧɨɫɬɢ ɢ ɜɨɡɪɨɫɲɟɣɮɭɧɤɰɢɨɧɚɥɶɧɨɣɧɚɝɪɭɡɤɟɧɚɢɧɬɚɤɬɧɭɸ ɧɨɝɭ, ɚ ɩɪɨɝɪɟɫɫɢɪɭɸɳɟɟ ɫɧɢɠɟɧɢɟ
ɷɥɟɤɬɪɨɦɢɨɝɪɚɮɢɱɟɫɤɨɣ ɚɤɬɢɜɧɨɫɬɢ ɦɵɲɟɱɧɨɝɨɚɩɩɚɪɚɬɚ – ɨɫɧɢɠɟɧɢɢɫɨɤɪɚɬɢɬɟɥɶɧɨɣɫɩɨɫɨɛɧɨɫɬɢɢɤɪɨɧɨɠɧɵɯɦɵɲɰ ɢ
ɷɮɮɟɤɬɢɜɧɨɫɬɢɪɚɛɨɬɵ ɦɵɲɟɱɧɨɜɟɧɨɡɧɨɣ
ɩɨɦɩɵ.
Ɉɫɧɨɜɧɵɦɢ ɩɪɨɹɜɥɟɧɢɹɦɢ ɡɚɛɨɥɟɜɚɧɢɹɭɩɚɰɢɟɧɬɨɜɋ5 ɤɥɚɫɫɚ, ɩɨɦɢɦɨɜɚɪɢɤɨɡɧɨɣɬɪɚɧɫɮɨɪɦɚɰɢɢɜɟɧɢɨɬɺɤɚɤɨɧɟɱɧɨɫɬɟɣ, ɛɵɥɢɹɪɤɨɜɵɪɚɠɟɧɧɵɟɬɪɨɮɢɱɟɫɤɢɟɪɚɫɫɬɪɨɣɫɬɜɚ, ɨɯɜɚɬɵɜɚɸɳɢɟɛɨɥɶɲɭɸ
ɱɚɫɬɶɝɨɥɟɧɢɢɷɩɢɬɟɥɢɡɢɪɨɜɚɧɧɚɹɬɪɨɮɢɱɟɫɤɚɹɹɡɜɚ. Ⱦɥɹɤɥɢɧɢɱɟɫɤɨɣɤɚɪɬɢɧɵɋ5
ɤɥɚɫɫɚɯɪɨɧɢɱɟɫɤɨɣɥɢɦɮɨɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢɛɵɥɚɯɚɪɚɤɬɟɪɧɚɪɟɡɤɨɜɵɪɚɠɟɧɧɚɹɮɭɧɤɰɢɨɧɚɥɶɧɚɹɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶɧɢɠɧɢɯ ɤɨɧɟɱɧɨɫɬɟɣɫɨ ɡɧɚɱɢɬɟɥɶɧɵɦɢ ɧɚɪɭ53
”ɇɨɜɨɫɬɢɯɢɪɭɪɝɢɢ
Ɍɚɛɥɢɰɚ 2
Ʉɨɥɢɱɟɫɬɜɟɧɧɵɟɩɨɤɚɡɚɬɟɥɢɚɦɩɥɢɬɭɞɵɩɨɬɟɧɰɢɚɥɨɜɞɜɢɝɚɬɟɥɶɧɵɯɟɞɢɧɢɰ
ɜ mV) ɦɵɲɰɝɨɥɟɧɢɭɩɪɚɤɬɢɱɟɫɤɢɡɞɨɪɨɜɵɯɥɢɰɢɩɚɰɢɟɧɬɨɜɋ4-ɋ5 ɤɥɢɧɢɱɟɫɤɢɯ
ɤɥɚɫɫɨɜɯɪɨɧɢɱɟɫɤɨɣɥɢɦɮɨɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢ
Ƚɪɭɩɩɵɨɛɫɥɟɞɭɟɦɵɯ
n
ɉɪɚɤɬɢɱɟɫɤɢɡɞɨɪɨɜɵɟɥɢɰɚ
Ȼɨɥɶɧɵɟɋ4 ɤɥɚɫɫɚ
Ȼɨɥɶɧɵɟɋ5 ɤɥɚɫɫɚ
28
67
26
Ɉɛɴɟɤɬɢɫɫɥɟɞɨɜɚɧɢɹ
ɂɤɪɨɧɨɠɧɚɹɦɵɲɰɚ
Ȼɟɪɰɨɜɚɹɦɵɲɰɚ
Ⱥɦɩɥɢɬɭɞɚ
Ɇ±m
Ⱥɦɩɥɢɬɭɞɚ
M±m
0,4 – 4,5
1,3 ± 0,13
0,5 – 15,0
3,18 ± 0,34
0,18 – 2,1
1,18 ± 0,06
0,3 – 4,5
1,92 ± 0,12
0,12 – 1,6
0,86 ± 0,02
0,18 – 2,5
1,34 ± 0,17
ɲɟɧɢɹɦɢɢɯɫɬɚɬɨɞɢɧɚɦɢɱɟɫɤɨɣɮɭɧɤɰɢɢ.
ɉɪɢɷɥɟɤɬɪɨɦɢɨɝɪɚɮɢɱɟɫɤɨɦɢɫɫɥɟɞɨɜɚɧɢɢ ɛɵɥɨ ɡɚɮɢɤɫɢɪɨɜɚɧɨ ɡɧɚɱɢɬɟɥɶɧɨɟ
ɫɧɢɠɟɧɢɟɩɨɤɚɡɚɬɟɥɟɣɚɦɩɥɢɬɭɞɵɉȾȿɢɤɪɨɧɨɠɧɨɣɦɵɲɰɵɩɨɫɪɚɜɧɟɧɢɸɫɞɚɧɧɵɦɢɩɪɚɤɬɢɱɟɫɤɢɡɞɨɪɨɜɵɯɥɢɰɢɋ4 ɤɥɚɫɫɨɦɞɨ 0,86±0,02 mV (p<0,05). ɉɨɤɚɡɚɬɟɥɶ
ɉȾȿɩɟɪɟɞɧɟɣɛɟɪɰɨɜɨɣɦɵɲɰɵɬɚɤɠɟɛɵɥ
ɫɭɳɟɫɬɜɟɧɧɨɧɢɠɟɧɨɪɦɵ – 1,34±0,17 mV
(p<0,05). ɗɬɨ ɨɫɨɛɟɧɧɨ ɩɪɨɹɜɥɹɥɨɫɶ ɩɪɢ
ɪɚɫɩɪɨɫɬɪɚɧɟɧɢɢɢɧɞɭɪɚɬɢɜɧɵɯɩɪɨɰɟɫɫɨɜ
ɜɨɛɥɚɫɬɢɥɨɞɵɠɟɤ. Ⱦɜɢɠɟɧɢɹɜɝɨɥɟɧɨɫɬɨɩɧɨɦɫɭɫɬɚɜɟɛɵɥɢɨɝɪɚɧɢɱɟɧɵɢɧɟɪɟɞɤɨɫɨɩɪɨɜɨɠɞɚɥɢɫɶɜɵɪɚɠɟɧɧɵɦɛɨɥɟɜɵɦ
ɫɢɧɞɪɨɦɨɦ (ɬɚɛɥɢɰɚ 2).
ɂɫɫɥɟɞɨɜɚɧɢɟɜɪɟɦɟɧɧɵɯɯɚɪɚɤɬɟɪɢɫɬɢɤɩɨɤɚɡɚɥɨ, ɱɬɨɞɥɢɬɟɥɶɧɨɫɬɶɰɢɤɥɚɲɚɝɚ
ɭɩɚɰɢɟɧɬɨɜɫɤɥɚɫɫɨɦɋ5 ɩɪɟɜɵɲɚɥɚɫɪɟɞɧɢɟɩɨɤɚɡɚɬɟɥɢɭɩɪɚɤɬɢɱɟɫɤɢɡɞɨɪɨɜɵɯɥɢɰ
ɢɭɩɚɰɢɟɧɬɨɜɤɥɢɧɢɱɟɫɤɨɝɨɤɥɚɫɫɚɋ4. ɇɚɛɥɸɞɚɥɚɫɶɚɫɢɦɦɟɬɪɢɹɫɭɦɟɧɶɲɟɧɢɟɦɞɥɢɬɟɥɶɧɨɫɬɢɰɢɤɥɚɲɚɝɚɧɚɫɬɨɪɨɧɟɩɨɪɚɠɟɧɢɹ. ɉɟɪɢɨɞɩɟɪɟɧɨɫɚɡɞɨɪɨɜɨɣɤɨɧɟɱɧɨɫɬɢɛɵɥɞɨɫɬɨɜɟɪɧɨɧɢɠɟɧɨɪɦɵ, ɚɩɟɪɢɨɞ
ɨɩɨɪɵ – ɛɨɥɶɲɟ (p<0,05). ɍɜɟɥɢɱɢɜɚɥɚɫɶ
ɞɥɢɬɟɥɶɧɨɫɬɶɫɭɦɦɚɪɧɨɝɨɩɟɪɢɨɞɚɞɜɨɣɧɨɣ
ɨɩɨɪɵɧɚɤɨɧɟɱɧɨɫɬɢɫɬɪɨɮɢɱɟɫɤɢɦɢɪɚɫɫɬɪɨɣɫɬɜɚɦɢ. Ɉɬɧɨɫɢɬɟɥɶɧɚɹɞɥɢɬɟɥɶɧɨɫɬɶ
ɩɟɪɜɨɝɨ ɩɟɪɢɨɞɚ ɞɜɨɣɧɨɣ ɨɩɨɪɵ ɤɚɤ ɞɥɹ
ɛɨɥɶɧɨɣ, ɬɚɤɢɞɥɹɢɧɬɚɤɬɧɨɣɤɨɧɟɱɧɨɫɬɢ
ɡɧɚɱɢɬɟɥɶɧɨɛɨɥɶɲɟɧɨɪɦɵ (p<0,05). ȼɬɨɪɨɣɩɟɪɢɨɞɞɜɨɣɧɨɣɨɩɨɪɵɛɵɥɭɜɟɥɢɱɟɧ
ɧɚɫɬɨɪɨɧɟɩɨɪɚɠɟɧɢɹ. ɉɪɨɫɬɪɚɧɫɬɜɟɧɧɵɟ
ɩɨɤɚɡɚɬɟɥɢɫɤɨɪɨɫɬɢɢɱɚɫɬɨɬɵɲɚɝɚɭɩɚɰɢɟɧɬɨɜɫɋ5 ɤɥɚɫɫɨɦɛɵɥɢɫɧɢɠɟɧɵɢɧɚ54
ɯɨɞɢɥɢɫɶɜɩɪɟɞɟɥɚɯ 68,2±1,05 ɢ 86,1±2,1
ɲɚɝɦɢɧ, ɫɨɨɬɜɟɬɫɬɜɟɧɧɨ (p<0,05). ɉɪɨɫɬɪɚɧɫɬɜɟɧɧɵɟɯɚɪɚɤɬɟɪɢɫɬɢɤɢɲɚɝɚɞɚɧɧɨɣ
ɝɪɭɩɩɵɩɚɰɢɟɧɬɨɜɛɵɥɢɫɥɟɞɭɸɳɢɟ: ɞɥɢɧɚɲɚɝɚ – 58,3±1,4 ɫɦ (ɩɨɪɚɠɟɧɧɚɹɫɬɨɪɨɧɚ) ɢ 59,8±0,3 ɫɦ (ɢɧɬɚɤɬɧɚɹɫɬɨɪɨɧɚ), ɛɚɡɚ
ɲɚɝɚ – 8,5±1,04 ɫɦ, ɭɝɨɥɪɚɡɜɨɪɨɬɚ – 8,5±2,8°
ɩɪɚɜɨɣɢ 7,6±1,2° ɥɟɜɨɣɫɬɨɩ. Ɍɚɤɢɦɨɛɪɚɡɨɦ, ɭ ɩɚɰɢɟɧɬɨɜ ɤɥɚɫɫɚ ɋ5 ɞɥɢɧɚ ɲɚɝɚ
ɭɦɟɧɶɲɢɥɚɫɶɩɨɫɪɚɜɧɟɧɢɸɫɧɨɪɦɨɣɢɧɚ
ɩɨɪɚɠɟɧɧɨɣɫɬɨɪɨɧɟɨɧɚɛɵɥɚɛɨɥɶɲɟ, ɱɟɦ
ɧɚɡɞɨɪɨɜɨɣ. ɂɦɟɥɚɫɶɬɟɧɞɟɧɰɢɹɤɭɜɟɥɢɱɟɧɢɸɛɚɡɵɲɚɝɚɢɭɦɟɧɶɲɟɧɢɸɭɝɥɚɪɚɡɜɨɪɨɬɚɧɚɩɨɪɚɠɟɧɧɨɣɤɨɧɟɱɧɨɫɬɢ. Ʉɢɧɟɦɚɬɢɤɚɞɜɢɠɟɧɢɣɫɭɫɬɚɜɨɜɧɢɠɧɢɯɤɨɧɟɱɧɨɫɬɟɣ ɢɡɦɟɧɹɥɚɫɶ ɜ ɫɬɨɪɨɧɭ ɫɧɢɠɟɧɢɹ
ɚɦɩɥɢɬɭɞ ɞɜɢɠɟɧɢɹ ɡɚ ɫɱɟɬ ɜɵɪɚɠɟɧɧɵɯ
ɨɬɟɤɨɜɩɪɢɫɨɩɭɬɫɬɜɭɸɳɟɦɩɨɪɚɠɟɧɢɢɥɢɦɮɚɬɢɱɟɫɤɨɣɫɢɫɬɟɦɵ, ɛɨɥɟɜɨɦɫɢɧɞɪɨɦɟ, ɚ
ɬɚɤɠɟɬɪɨɮɢɱɟɫɤɢɯɩɪɨɰɟɫɫɚɯ, ɩɪɢɜɨɞɹɳɢɯ
ɤɞɟɮɨɪɦɚɰɢɢɝɨɥɟɧɢɢɝɨɥɟɧɨɫɬɨɩɧɨɝɨɫɭɫɬɚɜɚ. Ɉɬɦɟɱɚɥɚɫɶ ɫɧɢɠɟɧɢɟ ɚɦɩɥɢɬɭɞɵ
ɥɨɤɨɦɨɰɢɣ ɜ ɬɚɡɨɛɟɞɪɟɧɧɨɦ ɢ, ɛɨɥɟɟɜɵɪɚɠɟɧɧɨɟ, ɜɤɨɥɟɧɧɨɦɫɭɫɬɚɜɚɯ. Ⱥɦɩɥɢɬɭɞɵɫɝɢɛɚɧɢɹɜɬɚɡɨɛɟɞɪɟɧɧɨɦ ɫɭɫɬɚɜɟɫɨɫɬɚɜɢɥɢ: Ɍ0 = 25,7±2,01° ɢ Ɍ2 – 7,6±1,25°.
Ⱥɦɩɥɢɬɭɞɵɥɨɤɨɦɨɰɢɣɤɨɥɟɧɧɨɝɨɫɭɫɬɚɜɚ
ɫɨɨɬɜɟɬɫɬɜɨɜɚɥɢ: Ʉ1 = 14,1±5,2° ɢ Ʉ3 =
48,3±3,6°. Ȼɨɥɟɟ ɡɧɚɱɢɬɟɥɶɧɨ ɜɵɪɚɠɟɧɨ
ɫɧɢɠɟɧɢɟɥɨɤɨɦɨɰɢɣɝɨɥɟɧɨɫɬɨɩɧɨɝɨɫɭɫɬɚɜɚ, ɨɫɨɛɟɧɧɨɧɚɫɬɨɪɨɧɟɩɨɪɚɠɟɧɧɨɣɤɨɧɟɱɧɨɫɬɢȽ3 = - 10,3±1,09 (p<0,05).
ȼɵɹɜɥɹɟɦɚɹɨɬɱɟɬɥɢɜɚɹɮɭɧɤɰɢɨɧɚɥɶɧɚɹ ɚɫɢɦɦɟɬɪɢɹ ɧɚ ɭɪɨɜɧɟ ɥɨɤɨɦɨɰɢɣ ɜɨ
ɜɫɟɯɫɭɫɬɚɜɚɯɧɢɠɧɢɯɤɨɧɟɱɧɨɫɬɟɣɫɜɢɞɟ-
ʋ6x2010 iɬɨɦ 18
Ɍɚɛɥɢɰɚ 3
ȼɪɟɦɟɧɧɵɟɩɚɪɚɦɟɬɪɵɰɢɤɥɚɲɚɝɚɭɩɚɰɢɟɧɬɨɜ (n=26) ɫɯɪɨɧɢɱɟɫɤɨɣ
ɥɢɦɮɨɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶɸɋ5 ɤɥɢɧɢɱɟɫɤɨɝɨɤɥɚɫɫɚ (ɩɨɋȿȺɊ)
ɉɚɪɚɦɟɬɪɵɰɢɤɥɚɲɚɝɚ
ɉɨɤɚɡɚɬɟɥɢɡɞɨɪɨɜɵɯ
ɥɢɰ (Ɇ ± m)
ɐɢɤɥɲɚɝɚ
1,22±0,05
ɉɟɪɢɨɞɨɩɨɪɵ
62,27±0,48
ɉɟɪɢɨɞɩɟɪɟɧɨɫɚ
37,86±0,42
ɋɭɦɦɚɪɧɵɣɩɟɪɢɨɞ ɞɜɨɣɧɨɣɨɩɨɪɵ
26,49±1,36
ɉɟɪɜɵɣɩɟɪɢɨɞɞɜɨɣɧɨɣɨɩɨɪɵ
13,3±0,92
ȼɬɨɪɨɣɩɟɪɢɨɞɞɜɨɣɧɨɣɨɩɨɪɵ
13,18±0,91
ɉɟɪɢɨɞ ɨɞɢɧɨɱɧɨɣɨɩɨɪɵ
36,84±0,50
ɇɚɱɚɥɨɜɬɨɪɨɝɨ ɩɟɪɢɨɞɚ ɞɜɨɣɧɨɣɨɩɨɪɵ
49,74±0,33
ɉɪɢɦɟɱɚɧɢɟ: s – ɥɟɜɚɹɢ d – ɩɪɚɜɚɹɧɢɠɧɹɹɤɨɧɟɱɧɨɫɬɢ
ɬɟɥɶɫɬɜɭɟɬɨɮɭɧɤɰɢɨɧɚɥɶɧɨɦɢɫɬɨɳɟɧɢɢ
ɭɠɟɧɟɬɨɥɶɤɨɩɨɪɚɠɺɧɧɨɣɤɨɧɟɱɧɨɫɬɢ, ɧɨ
ɢɡɞɨɪɨɜɨɣ. Ⱦɥɹɨɫɧɨɜɧɨɣɫɬɨɣɤɢɯɚɪɚɤɬɟɪɧɨ ɫɧɢɠɟɧɢɟ ɫɬɚɛɢɥɶɧɨɫɬɢ ɢ ɫɦɟɳɟɧɢɟ
ɰɟɧɬɪɚɞɚɜɥɟɧɢɹɜɨɮɪɨɧɬɚɥɶɧɨɣɢɫɚɝɢɬɬɚɥɶɧɨɣ ɩɥɨɫɤɨɫɬɹɯ. Ʉɨɷɮɮɢɰɢɟɧɬ ɚɫɢɦɦɟɬɪɢɢɛɵɥɨɬ 8% ɞɨ 11%. ɂɦɟɥɚɫɶɜɵɪɚɠɟɧɧɚɹɧɟɭɫɬɨɣɱɢɜɨɫɬɶɩɨɯɨɞɤɢ.
ɉɨɥɭɱɟɧɧɵɟɪɟɡɭɥɶɬɚɬɵɫɜɢɞɟɬɟɥɶɫɬɜɭɸɬɨɡɧɚɱɢɬɟɥɶɧɵɯɢɡɦɟɧɟɧɢɹɯɫɬɪɭɤɬɭɪɵ
ɲɚɝɚɭɠɟɧɚɨɛɟɢɯɤɨɧɟɱɧɨɫɬɹɯ, ɩɪɢɛɨɥɶɲɟɣɜɵɪɚɠɟɧɧɨɫɬɢɧɚɤɨɧɟɱɧɨɫɬɢɫɹɜɥɟɧɢɹɦɢɋ5 ɯɪɨɧɢɱɟɫɤɨɣɥɢɦɮɨɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢ (ɬɚɛɥɢɰɚ 3). Ⱦɢɫɛɚɥɚɧɫɫɨɨɬɧɨɲɟɧɢɣɩɟɪɢɨɞɨɜɨɩɨɪɵɢɩɟɪɟɧɨɫɚɧɚ
ɩɨɪɚɠɺɧɧɨɣɤɨɧɟɱɧɨɫɬɢɫɜɢɞɟɬɟɥɶɫɬɜɨɜɚɥ
ɨɬɨɦ, ɱɬɨɟɣɭɠɟɧɟɨɛɟɫɩɟɱɢɜɚɥɫɹɪɟɠɢɦ,
ɩɪɢɛɥɢɠɺɧɧɵɣɤɧɨɪɦɚɥɶɧɨɦɭɡɚɫɱɺɬɮɭɧɤɰɢɨɧɚɥɶɧɨɝɨɧɚɩɪɹɠɟɧɢɹɡɞɨɪɨɜɨɣɤɨɧɟɱɧɨɫɬɢ. ɍɜɟɥɢɱɟɧɢɟ ɩɟɪɢɨɞɚ ɨɞɢɧɨɱɧɨɣ
ɨɩɨɪɵ ɧɚ ɛɨɥɶɧɭɸ ɤɨɧɟɱɧɨɫɬɶ ɨɡɧɚɱɚɥɨ
ɢɫɬɨɳɟɧɢɟɟɫɬɟɫɬɜɟɧɧɵɯɤɨɦɩɟɧɫɚɬɨɪɧɵɯ
ɜɨɡɦɨɠɧɨɫɬɟɣɨɪɝɚɧɢɡɦɚɩɚɰɢɟɧɬɚ. Ɂɧɚɱɢɬɟɥɶɧɚɹɫɬɟɩɟɧɶɚɫɢɦɦɟɬɪɢɢɹɜɥɹɥɚɫɶɩɪɢɡɧɚɤɨɦ ɢɫɬɨɳɟɧɢɹ ɜɧɭɬɪɟɧɧɢɯ ɪɟɡɟɪɜɨɜ,
ɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢɨɩɨɪɧɨɣɮɭɧɤɰɢɢɨɞɧɨɣ
ɢɡɤɨɧɟɱɧɨɫɬɟɣ.
ɍɦɟɧɶɲɟɧɢɟɭɝɥɚɪɚɡɜɨɪɨɬɚɫɬɨɩɵ, ɛɨɥɟɟɜɵɪɚɠɟɧɧɨɟɧɚɤɨɧɟɱɧɨɫɬɢɫɹɜɥɟɧɢɹɦɢ ɬɪɨɮɢɱɟɫɤɢɯ ɪɚɫɫɬɪɨɣɫɬɜ, ɫɜɢɞɟɬɟɥɶɫɬɜɨɜɚɥɨ ɨ ɞɚɥɶɧɟɣɲɟɣ ɮɭɧɤɰɢɨɧɚɥɶɧɨɣ
ɉɨɤɚɡɚɬɟɥɢɩɚɰɢɟɧɬɨɜɋ5
ɤɥɚɫɫɚ (Ɇ ± m)
s
d
1,52±0,12
1,59±1,23
62,16±1,08
63,46±2,18
36,89±2,03
34,25±1,28
29,11±2,02
26,74±1,05
14,02±1,07
14,6±2,06
14,58±1,03
12,78±1,07
37,82±1,45
36,92±1,04
51,36±2,13
49,16±0,04
ɢɦɦɨɛɢɥɢɡɚɰɢɢɫɭɫɬɚɜɨɜɫɬɨɩɵ. ȼɪɟɦɟɧɧɵɟɢɩɪɨɫɬɪɚɧɫɬɜɟɧɧɵɟɩɚɪɚɦɟɬɪɵɯɚɪɚɤɬɟɪɢɡɭɸɬɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶɤɨɦɩɟɧɫɚɬɨɪɧɵɯ
ɪɚɡɝɪɭɡɨɱɧɵɯ ɪɟɚɤɰɢɣɨɩɨɪɧɨɞɜɢɝɚɬɟɥɶɧɨɣɫɢɫɬɟɦɵɫɰɟɥɶɸɭɦɟɧɶɲɟɧɢɹɮɭɧɤɰɢɨɧɚɥɶɧɵɯɧɚɝɪɭɡɨɤɧɚɩɨɪɚɠɺɧɧɭɸɤɨɧɟɱɧɨɫɬɶ. ȼɨɜɪɟɦɟɧɧɨɣɩɨɫɥɟɞɨɜɚɬɟɥɶɧɨɫɬɢ
ɩɟɪɟɤɚɬɨɜ ɫɬɨɩɵ ɭɫɢɥɢɜɚɥɫɹ ɞɢɫɛɚɥɚɧɫ.
ȼɪɟɦɹɩɟɪɟɤɚɬɚɱɟɪɟɡɧɨɫɨɤɫɧɢɠɚɥɨɫɶɞɨ
16,2±1,3 ɫɟɤɩɪɢɩɨɤɚɡɚɬɟɥɟɭɩɪɚɤɬɢɱɟɫɤɢ
ɡɞɨɪɨɜɵɯ ɥɢɰ ɜ ɩɪɟɞɟɥɚɯ 22,1±0,6 ɫɟɤ
(p<0,05). Ɉɬɦɟɱɚɥɨɫɶɩɪɨɥɨɧɝɢɪɨɜɚɧɢɟɩɟɪɟɤɚɬɚɱɟɪɟɡɝɨɥɟɧɨɫɬɨɩɧɵɣɫɭɫɬɚɜɜɩɟɪɢɨɞɨɩɨɪɵɫɨɛɟɢɯɫɬɨɪɨɧ, ɩɪɟɢɦɭɳɟɫɬɜɟɧɧɨɧɚɩɚɬɨɥɨɝɢɱɟɫɤɢɢɡɦɟɧɟɧɧɨɣɤɨɧɟɱɧɨɫɬɢ – 35,2±1,9 ɫɟɤɢ 33,6±1,3 ɫɟɤ, ɫɨɨɬɜɟɬɫɬɜɟɧɧɨ, ɩɪɢ ɧɨɪɦɟ – 32,5±0,4 ɫɟɤ. ɍɞɥɢɧɟɧɢɟɩɪɨɞɨɥɠɢɬɟɥɶɧɨɫɬɢɩɟɪɟɤɚɬɚɱɟɪɟɡ
ɝɨɥɟɧɨɫɬɨɩɧɵɟɫɭɫɬɚɜɵɭɜɟɥɢɱɢɜɚɥɨɪɢɫɤ
ɜɨɡɧɢɤɧɨɜɟɧɢɹɢɯɚɪɬɪɨɡɚ. Ɏɢɤɫɢɪɨɜɚɥɨɫɶ
ɫɬɚɬɢɫɬɢɱɟɫɤɢɞɨɫɬɨɜɟɪɧɨɟ (p<0,05) ɭɜɟɥɢɱɟɧɢɟ ɜɪɟɦɟɧɢ ɩɟɪɟɤɚɬɚ ɱɟɪɟɡ ɩɹɬɤɭ ɞɥɹ
ɨɛɟɢɯɧɢɠɧɢɯɤɨɧɟɱɧɨɫɬɟɣ – 11,3±3,2 ɫɟɤ
ɢ 9,5±0,8 ɫɟɤ, ɛɨɥɶɲɟɧɚɫɬɨɪɨɧɟɩɨɪɚɠɟɧɢɹ ɩɪɢ ɧɨɪɦɟ – 8,9±0,3 ɫɟɤ. ɍɜɟɥɢɱɟɧɢɟ
ɜɪɟɦɟɧɢ ɩɟɪɟɤɚɬɚ ɱɟɪɟɡ ɩɹɬɤɭ ɫɜɢɞɟɬɟɥɶɫɬɜɭɟɬɨɞɢɫɮɭɧɤɰɢɢɝɨɥɟɧɨɫɬɨɩɧɨɝɨɫɭɫɬɚɜɚ. ɋɢɦɦɟɬɪɢɱɧɨɫɬɶɷɬɨɝɨɫɢɦɩɬɨɦɚɭɤɚɡɵɜɚɟɬ ɧɚ ɮɭɧɤɰɢɨɧɚɥɶɧɨɟ ɤɨɩɢɪɨɜɚɧɢɟ
ɡɞɨɪɨɜɨɣɤɨɧɟɱɧɨɫɬɶɸɮɭɧɤɰɢɢɩɨɪɚɠɺɧɧɨɣ.
ɉɨɥɭɱɟɧɧɵɟɞɚɧɧɵɟɤɨɧɫɬɚɬɢɪɭɸɬɪɚɡ55
”ɇɨɜɨɫɬɢɯɢɪɭɪɝɢɢ
ɜɢɬɢɟɜɵɪɚɠɟɧɧɨɣɮɭɧɤɰɢɨɧɚɥɶɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢɧɟɬɨɥɶɤɨɩɨɪɚɠɺɧɧɨɣɤɨɧɟɱɧɨɫɬɢ, ɧɨ ɢ ɡɞɨɪɨɜɨɣ. ȿɫɥɢ ɩɨɤɚɡɚɬɟɥɢ
ɛɨɥɶɧɨɣɤɨɧɟɱɧɨɫɬɢɧɚɱɢɧɚɸɬɞɢɜɟɪɝɢɪɨɜɚɬɶɨɬɧɨɪɦɵ, ɷɬɨɨɡɧɚɱɚɟɬɫɪɵɜɤɨɦɩɟɧɫɚɬɨɪɧɵɯɜɨɡɦɨɠɧɨɫɬɟɣɢɩɟɪɟɯɨɞɩɚɬɨɥɨɝɢɱɟɫɤɨɝɨɩɪɨɰɟɫɫɚɧɚɤɚɱɟɫɬɜɟɧɧɨɢɧɨɣ, ɛɨɥɟɟɧɟɛɥɚɝɨɩɪɢɹɬɧɵɣɞɥɹɩɚɰɢɟɧɬɚɭɪɨɜɟɧɶ.
Ɉɫɧɨɜɧɵɦɢ ɩɪɨɹɜɥɟɧɢɹɦɢ ɡɚɛɨɥɟɜɚɧɢɹɭɩɚɰɢɟɧɬɨɜɋ6 ɤɥɚɫɫɚɛɵɥɢɨɬɤɪɵɬɵɟ
ɜɟɧɨɡɧɵɟɬɪɨɮɢɱɟɫɤɢɟɹɡɜɵ, ɩɥɨɳɚɞɶɤɨɬɨɪɵɯɫɨɫɬɚɜɥɹɥɚɨɬ 5 ɞɨ 200 ɫɦ2. ȼɪɟɦɹɨɬ
ɦɨɦɟɧɬɚɩɨɹɜɥɟɧɢɹɫɢɦɩɬɨɦɨɜɯɪɨɧɢɱɟɫɤɨɣɥɢɦɮɨɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢɧɢɠɧɢɯɤɨɧɟɱɧɨɫɬɟɣɞɨɩɨɹɜɥɟɧɢɹɩɟɪɜɨɣɬɪɨɮɢɱɟɫɤɨɣɹɡɜɵɭɨɛɫɥɟɞɨɜɚɧɧɵɯɫɨɫɬɚɜɢɥɨ
9,2±1,32 ɝɨɞɚ. ɍ 20% ɩɚɰɢɟɧɬɨɜɩɪɢ ɪɚɫɩɪɨɫɬɪɚɧɟɧɢɢɬɪɨɮɢɱɟɫɤɨɣɹɡɜɵɧɚɩɟɪɟɞɧɸɸɩɨɜɟɪɯɧɨɫɬɶɝɨɥɟɧɢɪɚɡɜɢɜɚɥɫɹɨɫɫɢɮɢɰɢɪɭɸɳɢɣɩɟɪɢɨɫɬɢɬɫɨɱɚɝɚɦɢɨɫɬɟɨɫɤɥɟɪɨɡɚ, ɜɨɜɥɟɱɟɧɢɟɦɦɵɲɰ, ɫɭɯɨɠɢɥɢɣ,
ɧɚɞɤɨɫɬɧɢɰɵɢɤɨɫɬɟɣ. Ɏɨɪɦɢɪɨɜɚɥɫɹɬɚɤ
ɧɚɡɵɜɚɟɦɵɣ compartment-ɫɢɧɞɪɨɦ, ɪɟɡɤɨ
ɨɝɪɚɧɢɱɢɜɚɸɳɢɣ ɩɨɞɜɢɠɧɨɫɬɶ ɝɨɥɟɧɨɫɬɨɩɧɨɝɨ ɫɭɫɬɚɜɚ ɢ ɡɧɚɱɢɬɟɥɶɧɨ ɭɯɭɞɲɚɸɳɢɣɪɚɛɨɬɭɦɵɲɟɱɧɨɜɟɧɨɡɧɨɣɩɨɦɩɵ. ɍ
45% ɩɚɰɢɟɧɬɨɜɨɩɢɫɚɧɧɵɟɢɡɦɟɧɟɧɢɹɩɪɢɜɟɥɢɤɚɪɬɪɨɡɭɝɨɥɟɧɨɫɬɨɩɧɨɝɨɫɭɫɬɚɜɚ, ɚɭ
12 ɛɨɥɶɧɵɯ – ɤɟɝɨɤɨɧɬɪɚɤɬɭɪɟ. ɍɷɬɢɯɩɚɰɢɟɧɬɨɜ ɫɬɚɬɨɞɢɧɚɦɢɱɟɫɤɢɟ ɧɚɪɭɲɟɧɢɹ
ɛɵɥɢɛɨɥɟɟɜɵɪɚɠɟɧɧɵɦɢ. Ɉɬɦɟɱɟɧɨ ɩɨɫɬɟɩɟɧɧɨɟ ɫɧɢɠɟɧɢɟ ɧɟ ɬɨɥɶɤɨ ɪɟɚɤɰɢɢ
ɨɩɨɪɵ, ɧɨɢɚɦɩɥɢɬɭɞɵɥɨɤɨɦɨɰɢɢɫɭɫɬɚɜɨɜ, ɩɪɢɱɺɦɧɟɬɨɥɶɤɨɝɨɥɟɧɨɫɬɨɩɧɵɯ, ɧɨ
ɢɤɨɥɟɧɧɵɯ, ɚɩɪɢɞɚɥɶɧɟɣɲɟɦɩɪɨɝɪɟɫɫɢɪɨɜɚɧɢɢɢɬɚɡɨɛɟɞɪɟɧɧɵɯ. Ɉɬɦɟɱɟɧɨɬɚɤɠɟ ɢɫɬɨɳɟɧɢɟ ɮɭɧɤɰɢɨɧɚɥɶɧɵɯ ɪɟɡɟɪɜɨɜ
ɡɞɨɪɨɜɨɣ ɤɨɧɟɱɧɨɫɬɢ. ɗɥɟɤɬɪɨɦɢɨɝɪɚɮɢɱɟɫɤɢɟɩɨɤɚɡɚɬɟɥɢɢɞɚɧɧɵɟɤɥɢɧɢɱɟɫɤɨɝɨ
ɚɧɚɥɢɡɚ ɞɜɢɠɟɧɢɹ ɩɪɢ ɞɚɧɧɨɦ ɤɥɚɫɫɟ ɜɟɧɨɡɧɨɣ ɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢ ɛɵɥɢ ɬɚɤɢɟ ɠɟ,
ɤɚɤɢɜɤɥɚɫɫɟɋ5. ɇɨɩɪɢɩɟɪɟɯɨɞɟɬɪɨɮɢɱɟɫɤɨɝɨɹɡɜɟɧɧɨɝɨɩɪɨɰɟɫɫɚɧɚɩɟɪɟɞɧɸɸ
ɩɨɜɟɪɯɧɨɫɬɶɝɨɥɟɧɢɢɝɨɥɟɧɨɫɬɨɩɧɵɣɫɭɫɬɚɜɫɪɚɡɜɢɬɢɟɦɩɟɪɢɨɫɬɢɬɚ, ɩɨɜɪɟɠɞɟɧɢ56
ɟɦɫɭɫɬɚɜɧɨɣɤɚɩɫɭɥɵɢɫɭɯɨɠɢɥɢɣ, ɪɟɡɤɢɦ
ɨɝɪɚɧɢɱɟɧɢɟɦɟɝɨɩɨɞɜɢɠɧɨɫɬɢɨɧɢɡɚɦɟɬɧɨɭɯɭɞɲɚɥɢɫɶ.
Ɂɚɤɥɸɱɟɧɢɟ
ɉɪɨɜɟɞɺɧɧɨɟɤɥɢɧɢɤɨɮɭɧɤɰɢɨɧɚɥɶɧɨɟ
ɨɛɫɥɟɞɨɜɚɧɢɟ ɩɚɰɢɟɧɬɨɜ ɫ ɋ4-ɋ6 ɤɥɚɫɫɚɦɢɯɪɨɧɢɱɟɫɤɨɣɥɢɦɮɨɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢ ɧɢɠɧɢɯ ɤɨɧɟɱɧɨɫɬɟɣ ɜɵɹɜɢɥɨ
ɪɟɡɤɨɟɫɧɢɠɟɧɢɟɮɭɧɤɰɢɢɦɵɲɟɱɧɨɜɟɧɨɡɧɨɣɩɨɦɩɵ. Ɋɚɡɜɢɜɚɸɳɢɟɫɹɜɦɵɲɰɚɯɞɢɫɬɪɨɮɢɱɟɫɤɢɟɢɡɦɟɧɟɧɢɹ, ɡɧɚɱɢɬɟɥɶɧɨɭɯɭɞɲɚɸɬɬɟɱɟɧɢɟɡɚɛɨɥɟɜɚɧɢɹ, ɩɪɢɜɨɞɹɤɮɭɧɤɰɢɨɧɚɥɶɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢ, ɫɬɚɬɨɞɢɧɚɦɢɱɟɫɤɢɦ ɧɚɪɭɲɟɧɢɹɦ ɢ ɩɚɬɨɥɨɝɢɱɟɫɤɨɣ
ɯɨɞɶɛɟ. ȼɵɹɜɥɹɟɦɵɟɭɩɚɰɢɟɧɬɨɜɮɭɧɤɰɢɨɧɚɥɶɧɚɹɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶɢɫɬɚɬɨɞɢɧɚɦɢɱɟɫɤɢɟɧɚɪɭɲɟɧɢɹɫɜɢɞɟɬɟɥɶɫɬɜɭɸɬɨɫɪɵɜɟɤɨɦɩɟɧɫɚɬɨɪɧɵɯɪɟɚɤɰɢɣɨɩɨɪɧɨɞɜɢɝɚɬɟɥɶɧɨɣɫɢɫɬɟɦɵɩɪɢɋ5-ɋ6 ɤɥɢɧɢɱɟɫɤɢɯ
ɤɥɚɫɫɚɯɯɪɨɧɢɱɟɫɤɨɣɥɢɦɮɨɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢ, ɱɬɨ ɧɟɨɛɯɨɞɢɦɨ ɭɱɢɬɵɜɚɬɶ
ɩɪɢɩɪɨɜɟɞɟɧɢɢɦɟɞɢɰɢɧɫɤɨɣɪɟɚɛɢɥɢɬɚɰɢɢ.
ɅɂɌȿɊȺɌɍɊȺ
1. Jeanneret-Gris-Iseli, C. 50 years of phlebology /
C. Jeanneret-Gris-Iseli, K. Burnand // XVȱ World
Congress of the Union Internationale de Phlebologie:
e-abstract book. – Monaco, 2009. – P. 2-3.
2. Ɏɥɟɛɨɥɨɝɢɹ: ɪɭɤɨɜɨɞɫɬɜɨɞɥɹɜɪɚɱɟɣ / ȼ. ɋ. ɋɚɜɟɥɶɟɜ [ɢɞɪ.]; ɩɨɞɪɟɞ. ȼ. ɋ. ɋɚɜɟɥɶɟɜɚ. – Ɇ.: Ɇɟɞɢɰɢɧɚ, 2001. – 664 ɫ.
3. Ʉɨɫɢɧɟɰ, Ⱥ. ɇ. ȼɚɪɢɤɨɡɧɚɹɛɨɥɟɡɧɶ / ɇ. Ⱥ. Ʉɨɫɢɧɟɰ, ɋ. Ⱥ. ɋɭɲɤɨɜ. – ȼɢɬɟɛɫɤ: ȼȽɆɍ, 2009. – 415 ɫ.
4. Bergan, J. J. Chronic venous disease / J. J. Bergan,
G. W. Schmid-Schonbein, P. D. Coleridge-Smith //
Minerva Cardioangiol. – 2007. – Vol. 55, N 4. – P. 459-476.
5. Risk factor and underlying mechanisms for venous
stasis syndrome: a population-based case-control
study / A. A. Ashrani [et al.] // Vasc. Med. – 2009. – Vol.
14, N 4. – P. 339-349.
6. əɪɨɜɟɧɤɨ, Ƚ. ȼ. Ɋɨɥɶɛɢɨɦɟɯɚɧɢɱɟɫɤɢɯɢɫɫɥɟɞɨɜɚɧɢɣɩɪɢɯɪɨɧɢɱɟɫɤɨɣɥɢɦɮɨɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢɧɢɠɧɢɯɤɨɧɟɱɧɨɫɬɟɣ / Ƚ. ȼ. əɪɨɜɟɧɤɨ, ɋ. ȿ. Ʉɚɬɨɪɤɢɧ, ɉ. ɇ. Ɇɵɲɟɧɰɟɜ // ɇɨɜɨɫɬɢɯɢɪɭɪɝɢɢ. –
2010. – ʋ 2. – ɋ. 56-63.
7. ɀɭɤɨɜ, Ȼ. ɇ. ɂɧɧɨɜɚɰɢɨɧɧɵɟɬɟɯɧɨɥɨɝɢɢɜɞɢɚɝɧɨɫɬɢɤɟ, ɥɟɱɟɧɢɢɢɦɟɞɢɰɢɧɫɤɨɣɪɟɚɛɢɥɢɬɚɰɢɢɛɨɥɶ-
ʋ6x2010 iɬɨɦ 18
ɧɵɯɯɪɨɧɢɱɟɫɤɨɣɜɟɧɨɡɧɨɣɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶɸɧɢɠɧɢɯɤɨɧɟɱɧɨɫɬɟɣ / Ȼ. ɇ. ɀɭɤɨɜ, ɋ. ȿ. Ʉɚɬɨɪɤɢɧ. – ɋɚɦɚɪɚ: ɋɚɦ. ɨɬɞ. Ʌɢɬɮɨɧɞɚ, 2010. – 383 ɫ.
8. ɀɭɤɨɜ, Ȼ. ɇ. Ɇɟɞɢɰɢɧɫɤɚɹɪɟɚɛɢɥɢɬɚɰɢɹɛɨɥɶɧɵɯ
ɯɪɨɧɢɱɟɫɤɨɣ ɜɟɧɨɡɧɨɣ ɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶɸ ɧɢɠɧɢɯ
ɤɨɧɟɱɧɨɫɬɟɣ: ɭɱɟɛɧɨɟɩɨɫɨɛɢɟ / Ȼ. ɇ. ɀɭɤɨɜ, ɋ. ȿ.
Ʉɚɬɨɪɤɢɧ, ə. ȼ. ɋɢɡɨɧɟɧɤɨ; ȽɈɍȼɉɈ «ɋɚɦɚɪ. Ƚɨɫ.
Ɇɟɞ. ɍɧɬ». – ɋɚɦɚɪɚ: ɋɚɦɚɪ. ɨɬɞ. Ʌɢɬɮɨɧɞɚ, 2009. –
164 ɫ.
9. Ȼɚɬɵɲɟɜɚ, Ɍ. Ɍ. ɋɨɜɪɟɦɟɧɧɵɟɬɟɯɧɨɥɨɝɢɢɞɢɚɝɧɨɫɬɢɤɢɢɪɟɚɛɢɥɢɬɚɰɢɢɜɧɟɜɪɨɥɨɝɢɢɢɨɪɬɨɩɟɞɢɢ /
Ɍ. Ɍ. Ȼɚɬɵɲɟɜɚ, Ⱦ. ȼ. ɋɤɜɨɪɰɨɜ, Ⱥ. ɂ. Ɍɪɭɯɚɧɨɜ. – Ɇ.:
Ɇɟɞɢɤɚ, 2005. – 256 ɫ.
10. ɋɤɜɨɪɰɨɜ, Ⱦ. ȼ. Ⱦɢɚɝɧɨɫɬɢɤɚɞɜɢɝɚɬɟɥɶɧɨɣɩɚɬɨɥɨɝɢɢɢɧɫɬɪɭɦɟɧɬɚɥɶɧɵɦɢɦɟɬɨɞɚɦɢ: ɚɧɚɥɢɡɩɨɯɨɞɤɢ, ɫɬɚɛɢɥɨɦɟɬɪɢɹ / Ⱦ. ȼ. ɋɤɜɨɪɰɨɜ, Ɍ. Ɇ. Ⱥɧɞɪɟɟɜɚ.
– Ɇ., 2007. – 640 ɫ.
Àäðåñ äëÿ êîððåñïîíäåíöèè
443087, Ðîññèéñêàÿ Ôåäåðàöèÿ,
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ÓÂÀÆÀÅÌÛÅ ÊÎËËÅÃÈ!
IV ɄɨɧɝɪɟɫɫɆɨɫɤɨɜɫɤɢɯɯɢɪɭɪɝɨɜɫɨɫɬɨɢɬɫɹɜɝ. Ɇɨɫɤɜɟ
19-20 ɦɚɹ 2011 ɝ. ɜɡɞɚɧɢɢɉɪɚɜɢɬɟɥɶɫɬɜɚɆɨɫɤɜɵ
ɐɟɥɶɩɪɨɜɟɞɟɧɢɹ:ɜɫɟɫɬɨɪɨɧɧɟɨɛɫɭɞɢɬɶɩɪɨɛɥɟɦɵɧɟɨɬɥɨɠɧɨɣɢɫɩɟɰɢɚɥɢɡɢɪɨɜɚɧɧɨɣɯɢɪɭɪɝɢɱɟɫɤɨɣɩɨɦɨɳɢɜɝɨɪɨɞɟɆɨɫɤɜɟɢɞɪɭɝɢɯɤɪɭɩɧɵɯɝɨɪɨɞɚɯ; ɨɛɨɡɧɚɱɢɬɶɚɤɬɭɚɥɶɧɵɟɧɚɩɪɚɜɥɟɧɢɹɪɚɡɜɢɬɢɹɟɞɢɧɨɣɬɟɯɧɨɥɨɝɢɢɢɩɭɬɢɫɨɜɟɪɲɟɧɫɬɜɨɜɚɧɢɹɯɢɪɭɪɝɢɱɟɫɤɨɣɩɨɦɨɳɢ; ɞɨɜɟɫɬɢɢɧɮɨɪɦɚɰɢɸɨɧɨɜɟɣɲɢɯɦɟɞɢɰɢɧɫɤɢɯɬɟɯɧɨɥɨɝɢɹɯɢɞɨɫɬɢɠɟɧɢɹɯɜ ɞɚɧɧɵɯɨɛɥɚɫɬɹɯɞɨɩɪɚɤɬɢɤɭɸɳɢɯɜɪɚɱɟɣɢɫɩɟɰɢɚɥɢɫɬɨɜ.
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