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Transcript of ME')lYHAPO,l.lHblH OllI~IT 11 PE3YJfbTATbI · PDF fileDOKep"" Jleo . AKTOHOBII'I . KruI,llHuai...
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B T86nHUc 3 rrpencTaBneHO pacnpcneyCHHC HMDnaJITHpoB8HHblX
CTClfTOB HCXOnraquo H3 )ll1aMCTpa CTCHTa a TlIKJKC CpC)l1U1H )lHaMeTp CreUTOB B
KaJKlIOH 113 rpyn n
CJfD 0=139 (JOO Y)
MC 0=163 (100 Yo)
P
25 n () 30 (2 16) 39 (239) ns
275 MM n (Yo) 76 (547) 84 (515) lLS
30 MOl n W) 21 (1 5 1) 2S (153) ns
35 M~ n (~cl) 12 (86) 15 (92) ns
Cpermn lI)lllMeTp 101M 284plusmnO28 186plusmn034 ns
n t _- pIl1UItPI tteAO108epltw ~05 D - ICMlIIecrtO CT(if18
TaMH LIlt 3 COOTHoweHHe KOnHlCCTRlI 1 JUi8MeTpOB CTelnDB 8 lIIIYX rpynnll naJJMeIffOB
Cpe1Helt 3HalCHHe JUlliHbl IfMnJlaJiTKpOBaHUblX CTeHTOB B rpynnc 1
HCCKOJlbKO npeBblwaer aJ1aJ10f1i4Ublii nOKa3aTCnb 80 STOPOH rpynne
(p=O43) CTCIITOB nmtHOH MeHee 18 MM YCTllHOsnCHO 10CTOIlCPHO 60nbwe B
KOHTpoJlbHOH rpyun c naulfCHTOB (P=O027) CTeHTOB )lnIfHOR 60J10C 23 MM
10CTOBCPHO 60nhllle yc-r8HOBJICUO B pa60leH rpynuc (P=O035) (Ta6nKua 4)
em 0=1391100)
MC Il=HIJ (100 )
P
lt18 MM n () 22 (158) 46 (282) 0027 I
18-23MM n () 68 (489) 81 (497 ns I
gt23 101M n (Yo) 49 (353) 36(22 1) 0Q3 5
CpellWllVlHHa 101M 232plusmn31 208plusmn29 0043
DI - pauMIKt MtJlOCT06epHloi (gtO05) n - KOJIRICCTBO cretflO
Ta6ru1ll8 4 COOTHollleHHe KOIlHICCTB8 If 1lIllHJl CTeHTOB BJIlIYX rpynnax nlUilleHTOB
Bee nallfeUThr 6c3 HCK1110lemtJl noJl) 4 antf ~BoliAylQ
aHTItTpOM60UlmpIlYIQ 1C3arperaHTHYIO TepanHlO lacn nSUHCHTOB
11
IlOJl)lIfJlYl I1 HrH6 1nopbl IIblllla rm1KOnp OTCH HOBblX pellCllTOPOB
TpOM60IHTOB (Ta61lJ1U8 5)
r ynna I (CJJD) rfl~nna 2 (MC) P
n~1 12 (100 ) n~118 (100 )
AcnupHH (325 Mr 3a 48 Y3C(8) 112 ( 100) 118 ( 100) ns
T HeIl OOllpIIIlHHJJ (75 Mr M lUI 1a 48 4) 85 (76) 89 (75) ns
T HCIi Oll HPUwtHbl (300 Mr3a 15 4) 27 (24) 29 (25) ns
I1nrn6HTopbl Ubfl lla (1II11p8onep) 6 (5 3) 8 (68) ns
n s - PUlUtIlamp Jte1OCTO~HhI (PgtO05) n - aonUqecna nluuem-o
TaMHua S llC3arperaH1tllll nOllroioBK8 Kp0811 B lByx rpynnax naill1eHTOB
Herrocpe~CTBeHHbrH ycn ex amiddotl rHOrrJIacrHKH COCTaBHn 973 (109
naUHeHTOB 113 112) B nepBoil rpynne 11 966 (114 n8UHeHTOB 113 118) BO
Bropoil rpynnc (PgtO05) CMep TenJHblx HCXOllOB He 6bIJlO uOCTOBepHblX
Pa3JlHlHH 8 pa3BHTHIf OCJIO)KIICIIHM Me)KJlY rpYlm aMH He OTldC4CHO (PgtO05)
KJrHtrnlecKI1 3centlcentCKlHBHOH aHTHOnnaCTlltOOi 0P3HaJi3 y 91 (81l )
n auHellTa 8 ncpBOH rpynne Ii y 95 (806 ) nauHellTOB 80 STOPOH rpyrrne
(Pgt005) (Ta6mllla 6)
rpynna 1 0=112
rpyouI2 n=1I8
p
Ycnex rrpouel1Yp n () 109 (973) 114 (966) ns I
OcnolKnemUl B c-reHTHpOnalUloii aprepHH(TVF) n () 2 (18) 2 ( 17) ns I TpoM603 CTeHTa n () 2 (J 8) 2 ( 17) lLS
Kap)(HM bHble OCnO)f(HeHH~ (MACE) n () 1(09) 2 (1 7) ns
lWcjgtaPKT M HOKllPJla n (J 1 (09) 2 (17) ns
KopoHapHoe WYHTIlposaMHe n (Vo) - - -CMepTb n () - - -LJepe6po-aacK)mtpHble ocnollUicH1Ul n (Vo ) - -
-
-
ns - PlUJllltHa HtlOC1OBepIU (PgtO05~ n - I(OJIHiCCT1M) naWICHTOI
TaMHLl8 6 HcnocpeACTIlcHHble pe3ynbT8Tbl CTelrrl1p0SllHHJI B llByx fllyn nID(
OTIUlJletltlblC PeJYJlbT3TI1 crelfTllpOB3HHH
CpCJlHHH CPOK OTJlanCII lloro Ha6molleHUI 8 JlByX rpynnax 60JthHblX
COc-raBHn 132plusmn263 Mec no HCTCgeHl1H KOTOporo 6bJJ 11 BbJnOJllleHbl
1
HarpYJOlfHIgtIe n po6w C UeJb1O BWIBJJeHHII Hwe~U1H MHOKapIla Ii IT
nOllpo6u bie lJaHlihle 110 OTJlalJCHUblM CpOKllM Ha6mltgtlIeHH51 rrpeJlCTallneHbl II
Tn6nHue 7
rpyrma I (eTTfl) n=1l2 (l00 Yo)
rpynna 2 (Me) D118 (100 0)
p
CpenHHlI CPOK HR6moJreHHi Me( 136plusmn12 129plusmn23 as
MH$OPMallHll nOCl)nHWI no 6 01lbllblM n () 102 (91) 110 (932) ns
06cneJlOB1II0 HlI OTAWleuHOM )Tane n (Yo) 91 (812) 104 (88 1) 0048
KOlllpolhlllll Kr n () 82 (732) 89 (755 ) ])e3 clenokllpolI lI n (Yo) 89 (878) 78 (71) 0Q3
1 - pulHlfftlll lttaOCTOKpUW (pgtoOS) n - mrrn~ecno IWllteHTOJ
TaMUUI 7 KOllWICCTBCHHblC JlalHlIgttC OT1UlJleHIIOrO mUTa cc~eJlOBalII1R
IlposeL1eHHWI Kr BblllBKna pecrCH031J y 29 (137 ) nallHeHTOB
y p oSeH pecreHOJa CTaTHCTIfecKH m3QHMO 6bJ1 HIf)f(e B rpynne c
HMnnaHTIlpoBaRHblMH CJIfI B cpaBHeHMH C KOHTPOfhHoit rpyrrnoH
(PltOOO 1) B rpynne 1 OCHOBHWI 18crb pecTeH0301l nplfXOL1HTClI Ha
npoKcHMaJlbHOIH Kpae CTeHlHpoB8HHOro celMellTa B rpynne 2 pecTeH03
Pa3BIIJICli npeHMymecrncHHo B rpBHHUax CTCIIT3 B 06CI1X rpynnax
H3HMeHbWIUl laCTb pecTCHOJOB COCpeJlOTOlCHa y AHCTaJlbHOro KpM
(Ta6J1l1ua 8)
rpynna I (CJID) n=102 (100 1
rpynna 2 (MC) n1I0(JOO)
p
IgtHH3PHbl A
peCTIfI03
(Yo)
Beem 6 (59) 23 (209) lt0000 1
B f1JRlfHUIIX C1effT8 2 (21) 13(118) lt0000 1
npoKCan~Hbln Kpal 3 P 9) 7 (64) ltOOOJ
IHcTWlhliMn KpRn 1 (09) 3 (27) lt0001
nOTep npocse ra MM 052plusmnO45 1 04~58 lt0001
TpOM6oI creHTll (OImoolUl) n ( ) 4 (36) - lt0001
n porpeccHjXlSaKHe aTepoCl(J1qlO3a n (o) 18(1 76) - --shy-
15 (1 36) ns
1I L - pampUINkJl HetlOCtoaephI (PgtoOS)
Ta6J11tUa 8llallllwe KonHl leCT8eHl1oll rurmorpa4Jllll H3 OTl3IleHHOM ITane
13
B KaTelOplHI nalHellTOB C Ca p eCTeH03 I3 blllBJJ eH y 15 (13 1 Bcex
60fhHbiX C Ca) 60JrbH biX cpeaH KOTOPbl X upe06J1anaml n aUHeHTbl H3
BTOpO~ rpy nnbl ljaCToTa p a3BHTHI pecrcH03a CpelH lI aUHCHTOB C CJ B
nepsoH rpynne cocra BHn a 36 (2 n ar(l~eIlTa) a BO BTOPOH Ip ynne 1S2
(9 naUHeHTOs) (PltOOOI)
HaJl6oJIbWal laCTOTa pecreHo30B B o6clix rpynn ax B03HHKJJa S
MOPIPOnOr H-IecKH CJJOlKHhIX creHo3ax 13 OC06CHHOCUI THnax B2 H C B
Cil)-lae MopcentlonOnflecRH 60nee 6 n ar OnpIHITHoro ll1Ill creli i l1pOSalHul
CTeH03a m Da A pccreHo3a B r pynne om He OTMCCIIO (JlHarpaMMa 2)
~J
~ 6 emiddot~ 4~1 I enn~ middot( -~ 1- -2-shy
gt----J - liS ~ ~~ e 2 D9J -
~
T Tn Bl TnB2 T~n C
llarpa~ma 2 PacnpellCilcHIlC yaCTOThI pecrello3a B 3aSHCl1MOC1H OT MoptKgtnOrHYCCKOrO
TMHa ~ICXOllHOro CTe l103a 8 OTllaneHJ10M nepHOAC
Ha IlHarpaMMe 3 npocnClKlIB3eTCli 06paTH31l 3aBHCHMOCTb
YMcRbm cHHlI aCTO pecTCII03a C YSeJ1HIeHIiCM IlHaMeTpa creHntpyeMoH
apTepHIt B 05CKX rpynnax lJ aCTOTn peCTeHo33 M aKCHMaJlbHa cpeIlH apTepHH
MaJlOro L1HBMeTp a 13 llHaMerpe 35 MM 1aCTOTn pa3BHTHli PCCTCH03a He
BbICOKruJ L10CTOBCptlO He p a3Jl1fQae-rclI MeJIltilY rpy n n 3MH
10 -~
-cnn~ 1-- I ~-----shy~ ~ Me
-~ - -mo
1shy25 111 27SM 30~M 35 WJ
llllarpaMMIi 3 PaClipenel CH ItC ll3CTOTI1 pecreHOJ8 B JaBHCflMOCll1 OT IHalcTpa CTeHT8
14
npll a HaJlH3C Bntll1HHlI JIl1HHbl creHTa Ha 4acrory peCTeH03a o6pmuaeT
Ha ce6l1 BHHMaHHC npM3l1 3aBMCHMOCTb a 06CliX rpynnax B
creiITHpOB3lmbIX CelMCHTax Jllll1li010 6oICC 23 MM pccrCH03bl o6HapY)f(CHbl
B 3 paJa lalUe n pH IfMnJlaHTaUHH KaJlt CM TalC Ii MC B cpaBucHlHl C
KOPOTKHMH CTeH03aMH no 18 MM (IlHarpalMa 4)
0 shya
CI1I1 ~ e 4 t ~~ 2middot1~
e lt 8 amp - 23 gt 23
1Illarp8MMa 4 PacnpellCJICHHC 18ClUfbl pecrCH033 B 3aBliCHMOCTH OT )IJlHHIgt crelmL
KOppCJUIllHORHblii aHIllTH3 aHrHOI-prupHleCKHX peCTeH030B nOKa3aJ1
LITO B rpynne C HMnJlaRTHpoBaHHblMH ClITl KOppeJUlUHOHHaJI 33SHCHMOCTL
MC)f(Jy JlHaMCTpOM CTeHTHposaHHOM apTepl1H H laCTOTO~ PaJlIHTII$
pecreHo38 npaKTHlecKH OTC)TCTByeT (r=0220) B TO BpcMlI KaK B rpvnne
MC CymecTBye-1 IlOCraTOlllO BblCOKall o6paTHaJI 33BHCHMOCTI Mellltly
YJGl3aHHbIMH napaMCTpaMI1 (r=0792) TIp aH8JT113e 3aBHCHMOCTH MC)(JIJ )]J1HHOH HCXOJlHOro nopa)f(eHHlI H
1(3CTOTOil PaJBHTHIl pccrcHOJa B rpyrme C IlMIWaHTHponlUulblMH Me 6blJ1a
Bbl1UlneHa BblCOKaJI n0J10ll(HTeJ1bHaJI KOppelUI1U1lI (r=O819) B rpynnc C CJITI
TaJOKe c)llIecTsyer IltOppcnllUHOHltaJI CB1I3b MClKllY lJ1I1HOH HCXOJlHOrO
CTeH03a 11 tacTOTOH pecrCH03a OJlllaKO pacqen1 o1p3)f(aIOT secbMa
)MepeHHblH ee xapaKTcp (r=O306) Te C TOlKH 3PCHHlI PHCKft pa3BHTHlI
pecrcno30B JlnHIiB nOplllKCItHli JIl1 l1 CJITllle HrpaeT cYlUecTJleHHoH poJ1H KlIJlt
JIl1R M C rpaqlHIeCKRe MOJleJlJ1 LltOpperullij1H JlI13gtIerp3 11 lSCTOThl peCTCII03a
1lJIHHbl Ii laCTOTbl pec-reHo33 npenCTaBJ1eHbl Ha )]HSrpaMM3X 5 11 6
i ~i
[ rp nnu cnn 1 [ipyn Me r
LIllarpsMMiI 5 KoppeJUJUMOIiIUUI 3aSI1CUMOCTh MClIOlY IlJUIMC1pOM creHlllposalllloll
ap-repllll II 18CTOTO~ pS3BIITI1I1 pccreH038
j7PYiinacnn r - rpynna Me~I
T--rmiddotl bull i ~ bull
~ ag 11 +-+1-+--1
1lIIarpaMMa 6 KOppeIlRUIIOHJ11U138SHCKMOCTb MClKIIY J1JHIIIOH UCXOllloro nopiDKellHII Ii
~lICTOTolI Pa3BIITRJI pccreHOJa
B TelCHnC )OHlPOJIMIOro nepHo)]a peKOMeHllOBaHHOLO peJKHMa
JlBOHHOH aHTHarperaHTHOA Tcpamm rrpHlle~IIMJlHCb 90 (882 )
rrSUHCIlTOB H3 rpyIIIIhJ I H 93 (845 ) n3UHeHTll H3 rpynlThl 2 (Ta6nHl3 9)
rpymUlI rpynnl2 p n=l02 =110
~OAHasr alTlll arperalfTHtllI TepaJTHll n () 90 (882) 93(84 5) ns -
98 (96) 106 (964)Acml]lIlH 150 Mrcyr n ( ) ns
THeHonHplUlIIllt 1lVtIlTerullocn TepanHTI Idee 92plusmn21 2 44gt0 11 0032
7S MrcYT I n pHlUnl a1 n n (00) 90 (882) 93 (845) ns ~ -
n ~ -- pUIIlIllHIII ttcJlOCl1VDtpKtl (pgtoOS) n - OJIIJJ~ rnunetrTOIi
Ta6J11IUamp 9 PelKHM JlIlOi1HoR3lrmarpenIJITHoArepalll1H B IlByx rpyn nax n8UHeIITOR I
16
Ha OTJlaJJeHHOM nane LIOKa38BHbJH TPOM603 CTeHTI1poB8HHOro
ccrMCHTa 3altill1KCHpOBaH y 4 (39 ) 6oJJbBblx npl1 4eM 3 m nUICHTOB fibl111113
rpyrmbI C HMrrnallTI1p OBIlH HblMJ1 C JUl OTMeTHM 410 Cp eJlH nal~HeliTOB C
YpoM6030M B nepBoi rpy nne 2 113 3 n8lHCHTOB npCpS8JII1 )lBOHHYIO
aHTHarperaHTHYlo Tepanl1lO 110 p eKOMeHllOB8HHoro CpOK3 B r pynn e CJIT1
OTMeleHO 2 CJly4W1 a B rpy n n c MC 1 CJJylJaH BCKaPJll1aJlbHbIX OCJlO)l(lIeHHH
KOTOPblC Mbl CBJJ3hl BaCM C np HcMoM LIe3arperaliToB
3a Bp eMll I tafiJlIOneHHII YMepJIO 4 (3 9 ) fiOlTbBblX B rpynne I 11 4 (3 6
) B rpyn n e 2 B pa6olei rpynnc OTMClCHO nBC HClltapJlHBJIbHble CMepTH
060 6 uleH HbiC OT)laJIeHHble p e3YJlbTaTbI aHrHOnJlacrnKll npei4CTaBJIetlbl B
Ta6mlUe 10
rpYll1l8 I n-l02
rpynna 2 n110
p
be CTeHOKllPJUIH n () 89 (878) 78 (71) 003
AKnlO rpaltj IOC K llOKll3lIllllbill pecTe1l03 n () 6 (59) 23 (209) lt000 1
PeBacKY~HpH3aI~H Ieneaom creHroa (TLR) n () 5 (49) 20 ( 182) lt000 1
PeBac~mpIf3BUIlR Ho a w CTeH030B (TVR) n () 7 (69) 5 (46) 0044
K OpoRspHoe WYIITllpoeaJfHe n (0) ) (10) 2 (1 8) 0 5
T POM603 CTelrra n () 3 (29) 1 (09) lt0001
I1111lapKT MHOKllPllB n (0) 3 (29) 4 (36) nS
KapnHaJ1bHble OCn O)f(Hflrn (MACE) n () 6 (59) 7 (63) ns
He ~llpllIl2J1bHble ocnOllltHeH Ill 0 () 2 (19) 1 (09) 004
ClotepTb (BCCro) n () 4 (3 9) 4 (36) O S
HCKaPAtlaJI b trQJI CMCpTb n () 2 (1 9) 1 (09) 004 nl_- PIlJmO(I HeJlOcro8epkW (pgtOOS) D ~ KQnUIecno ITIWteHTO
TaMH 118 10 OtQaJlCHHbJCpe3YllhTlITbl CTeIffifPOBaJi HlI B JUlyx rpynnax naUI1CHT08
K ax CJlcuyeT H3 Ta6nHlbl 10 no 1laCTOTC P83BIITHlII1M Ii KaplLHaJI b ~LbX
OClJOlKH ellHH )lOCToBepHblx p 33JJHiHA M~ rpyn nBMIi He BblJJ B11eHO
OllHaKO n o IDeTOTe HcofixonJ1MOCTFI nOBTOp lloii p esaCK)IUIJlH38lHH
npOCJTe)l(HBaeTCII llOCTOBepHoe )BCJlHlJeHHe 0 rpyrrnc C HMTIJIaRTHpOBBH NblMH
Me
I
AHaJlH3 TaKOra BIDKHOro 1I0Ka3BHJHI K8K OeJonaCHOCTb CTCIITOB no
KPHlCPHJIM TpoM603a CTeBTa KOHCOPUIi)MB no AKaneMH4ecKI1 M
HCCJIellOB3llIUlM (ARC) nOKa3aJ1 ITO Aa p aHHHX 3Tanax pamHIIIH no
laCTOTe rpoM603B MeifltlY rpyrtlHlMH He 8bllwnCHO O)lHaKO liB OTllBJICHHOM
cpoKe 38$HKCHpOBaHO HecKonbKo 6omwcc 411CJlO )IOKll3aHHbIX TpoM6030A Il
ncpBolt rpynne XOTlI KOJlHIeCTBO 1l03MO)I(Hb1X TpoM6030B MCJtillY rpyrulaMH
He )lOCTHfJJO 3HBlHMOro Pa3JTRtfHll (rB6JJHI~a 11)
rpynna 1 n1 02
rpynna 2 nUO
p
PalllluA
TpoM60J (0-30t1l1eA)
Bcuo 2 (JIJ) 2 (18) nS uOKa3llllHbIA 2 (1 9 2 ( 18) n1
BepoATItbI Ii - - -1T0000IIHn
Tpo60J pO-365 JlleR)
B~ S (49) 307) 003
JlOKa3aJIHhIA 3 (29) 1(09) 003 I
Bepomu11l 1(09) 0046
BolMOll(Hbifi 2 (19) 1(09) os
ltPieBb nOlJUIHA
TJION60J (gt365 Ulei1)
BCUI (ID) - 0046
[lOtlta38Jillhl A - - - i
BepollTHwA I (1 0) - 0046
BOlMogtKHlgtrll - - -
UTOro l0MlirooB 8 (79) i (45) ltU0l n 5 - Pl1llU I 1VI Kcnoc-roeepIlW (pgtO05) n - fCQJUf4ecno nDWtt-I-1TOt
Tawmua 11 AHaJllt31JXlM6oJa C1CIITa no ARC nllllYX rpynnax 6oJlhHhll
~ nOMOllJhlO MeTO)lHJ(1i oneHKH BblKHOaeMOCTl1 no KanJlaHy-Majjepy
Mbl paCCIIHbIBBJII ofiJUYlO Bbl)KHBaeMOCTb BbnKHBaeMOCTb 6C3 nllKCJJhLX
KapnHaJIbHblX c06bIT11H (MACE) Ii Bbl)l(HOaeMOCTb 6C3 nOBTopHblX
pcsacryJlllpl13allHH (TLR) B TeleBlie 14 MCC$lUCB Ha6molleHHJI
npH aAaJIH3e o6wefi BblJlOlBaeMOCTH B nepHOll Ra6J1lolleHHll Be Obl1l0
BblllBJICHO 3f1a4HMblX p33JIHlHA B PIICKC CMepTH M~ IlB)MlI rpynnaMH
6 0JJbHblX KpHBbl e BbllKHBaeMOCTH 6C3 TlllKeJlblX Kap)lHaJJbllblX C06blTl~H
(cepnClHaJI CMepTb HM onepauHSl Kill) HMCJJH TeRlleHllHIO K paCXO)J(llCHHIO
nOCJJe 4 MCCSlUCB Ha6 J1IOncHHJI Ol1H aKO MC)I(Jly rpynnaMH C
11
18
IfMnnatiTIlpoaaHHblM Cfln H MC Pa3InI II1H no qaCrOTe BCTpelaeMOCTH
cOBoKynHoCTII lIe6naronpl111TllbiX KapuHaJIbHhlX OCJIO)KHCHH H BblllBnellO He
6 Mno (nHarpaMMa 6)
shy ~ ~ w
I n ~ I
1 _Uti~ J _em ~ C~ Iej u ---J i __ -lt --~- _ ---- -
u 1 r ----rshyr-c 1
)--- shy I I Ia n 1~~r1r amp e is 1~~ ~
06lJ1llJ BbJ)j(IIBBeMOCTh BbilKlIBlleMOCTh 6e3 KlIPlll aJI bHblX Oc10llmeHHH
llHarpa~ma 4 BbllRHOaeMOCTb nauHelITOS B lilYgt rpynnax no Kannatlymiddot MaAcpy
H a IlHarpaMMe 7 n p eucT8BJ1CHa BbLliOiBaeMOCTb B o6eRX rpyllnax fie3
Heo6xollHMOCTH nOBTOpH bX peBacK)J111pI13al1HH ueneBOro CTeH03a K pHBhle
BbI)KHBaeMOCTI1 P830lliJIHCb qepe3 3 MeOIua lla6Jl10lleHIDI (P=O06)
craTHCTHJeCKI1 3HatntMOe pacXO)fJlCHHe Me)KJO H3YlacMblMH rpynnam
3acentHKcHpoBaHo K 9 Mec$IUaM (PltOOO I) P IfCK cMeprn 6e3
peBacKYMpH33UHIl n OCToBepHO HH)Ke B l Pynn e CJll1 ODHaKO KaK B rpyn n e
C IfMnnswH l poaaHHbIMH Cll n TaK 11 B rpyrrrre C HMnn8HTlfpoBaHHhlMH MC
OCTaerClillOCTaTOlHO HH3KHM
1 ----r
~~ R ur bull -- - - eM
---+- - ----i Me
q ~~~1 ~ ~ n - -+- t
I
-t- 1---11 -----j ~
o ~
UI Df JGl ~ t5f
BpetM IU6IW1JQlflIIIIII I AKII
lluarpaMMH 7 Bbl lKflBaeMOCTL 11~lie ll1UB BMYX rpynnax no K8I1JlilH) -MaAepy_
IY
06CY-dlICHUe pnyJJbrarOB
B HalliCM HCCJle10BaIHH llse cqJOPMHpoollHHble rpynn bl no
KnJtIlHlJeCKIIM xapaKTepliCTI1KaM 6hInH 1OCTOBepHo I1UCHTHIIthl 11
conOCT8BHMhl Ha 011l81leHHOM mme H86monell11$1 Mhl nonylliiTH
pe3YJlbT8ThI CXO)Kl1e C llalUlblMH nlnepaTypbl CTeTJelb peCTeH038 0 rpynnc C
CJlTl no c paBHC1i1flO C rpynnoH C MC OK31anaCb HJnKe C BhlCOKHM ypoBlleM
llOCTOoep HOCTIf (PltOOO 1) i-lMID18HTatlHII CJlIl naUHelltaM C BnepBble
BhlJJBneilHbIMII CTCH03aMH KopoHapHbTX apTCpHii YMeithwaCT PI1CK
aHrHOrpacentHleCKoro peCTeH03a B TCIeHHe 14 MecllUCO HB 15 no
CP8BIICHI-lJ) C MC
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B npCllCTaBl1ellHOH p a60Te n poseucH rny6 0 KHH BflanH3 MHpoBoro
OflblTa no n p HMeHcHHJO crellTOB C llCKftpCTBCHHbIM nOKp blTHCM H
MeTaJlJlHleCKHX CTCHTOB B JlC4eHHH nauHCHTOB C VlEe Ha pa3JlHll1blX
rpynnax n ruHlc HToB n ponellcl CpBBRlneJlbHbIH aHam13 nOKa33J-illH
3jJcjleKTHBIIOCTli IIcno cp eucTBeHHblx 11 OTnanellllbIX p e3YJlbTaTOB n pou e))Pbl
TJT6AIl C YC1atIOBKOH C I1T1 H MC AaHll3$ HaYlH3$ pa6 0Ta COJlep)fffT
pcmcHH c llK1)aJlbTlOH HaymiddotmoM 3a1lalH - ol1peueneuHc rrOKa3llIUlH K
MCrrOJlh30BBlUIIO P33JlH4H101X n mos CTeHTOB B leleHKM nat(HeHTOB
CTpanaIOIlJHX Pa3JHll1bIMI1 aHBTQMM4eCKHMH QJopMafM 8repoCKnepo3a KA
DPOBCl1ClllihlH HaY l HblH BfoIaJll13 n03BOJISlC1 yJlyllliliTb aJlrOpMTM
J1elCHFIli naUl1eHTOIl c HEC B o co 6eHHOCTIl C COI1)TCTByIOIlJHMH
cjIaKTOpaMH SJHHIIOlllHMH Ha ycnex 3HJlOSBCKYJlllPHblX BMeruaTeJlbCTB
v13YleHHe TeXHW-eCKHX H Me)lHl1HHCKHX CBORCTB KOpoHap ULlX CTeHTOB
1l03BOnHT 6011ee neranbHO npOf H03HPOBBTb HenocpellCTBeHHhtH ycnex
3cj1cj1CIITHSHOcrb li OTllaleHUblC pC3YJIhTaTbi npliMeneHHlI S oco6eHIIOCTH y
naUHeHToB C BbJCOKHM PHCKOM peCTeH03a ~hYleIlHhle OJ1IgtITHblltl nyrCM H Ha
npaKTHKC rrpCI1MYlllCCTSB H He)lOCT8TKH CTeHTOB C JlCKapCTBeHHhIM
nOKpblTliCM H CTeHTOB 6e3 n OKpblTl1l1 C03)laJOT npe)lnOCWJTlltH IlJU1 p a3pa60TKH
6 0nee cosepweHHblX M 3jgtcjICKTliBHblX KOHcrpYKUIlli KOPOJ18PHbIX
3HnonpoTe30B
Peanm3IHR pelynbT8ToB pa60Tbi
Pe3YJ1bTaTbI HCClleuo BaH Ifll BHellpeHbt S npaKTHKY nele6soshy
uHBrHOCTHleCKOH pa6 0ThI HLlCCX HM A I I 6aKYllCBa PAM H H MOryr
6hITh HCnOilb30Ballbl B lIpyrHx KapmIOJlOrHleCKHX H JltapJlHOx MpyprwJCCKJlX
neIlTpax
6
OClfOBlLJe nOJJOiKeHHSI BblHOCHMble lUI J8llHTy
1 CTeHThI C aHTIlI1pom UpCpantBHblM JlCKaPCTIlCHllblM nOKpbITHe1
yrleHbWalO1 sePOllTl IOCTb PCCTCIIOJa Ii DOBTOPHbIX BMeruaTeJ1bl-1 B
np nponliKCHHWX nOpaJKelllUIX CTCIfTHposaUHH oocYllon MalOro
IlHaMCTpa Ii y IlI1Ul-ICHTOB C caxapHblM )l)1a6cTOM no cpaBHcllHIO C
roJlOMCTan1HIecKHMH CrCIlTaMIi
2 B cnYlae HMflJlallTIUUHI TOJlOMeTaIJID1lCCKHX CTCHTOB Y naUlfCHTOB c
HIiJIltHM aUaTOMI1lCCKHM ~1 KJlIffiHlecJGM PCKOM pCCTCHOJa
BbllImBaeMOCTb 6C3 1l0BTOPHblX peBaCK)JllIpl13aQHA OCTaeTClI
llOCTaTOlHO BbIOOKOH
3 He BhUlBJleHO LOCTOSepHblX Pa3JIHIHH B 061UCH OTllaneHHOH
BbDKHnaeMOCTH 1aCTOTC pa3BHTH~ KapIlHaJlhHblX OCJIOiKHCHIJH 11
HHqapKTOB MIJOKaplla MCgtKllY HCnOJTh30BaHHCM CJITI II MC
4 TIpHMcueHlle CTeHTOB C aImmpoJlHcpepaTHSHbiM nOKpbITJ1CM -rpe6yeT
np0llOJliKHTeJlhRoro DplieMa llC3aTpCJ3IITHhIX npenapaTOB ITO
nOBblm8eT PIICK IlCKaplOlamllblX OCJIOlKHelUdi Ii HCKapJJliaJIbHhlX
cMepTcit
Anpo6aUffSI pa60Tbf
MaTeplfaJIbl JlHccepTaUHIl JJOJlOiKCHW UB 11-oH elKerollHoi1 HaYIHOH
CeCCHI-I HU CCX HM A H baKyJlCS8 (MOCKBa 2007 roll) Ha 12-oH
ClKCroJ]HOH HayttHoH C~UH Hll CCX HM A H baKYneBll (MOCKSa 2008
rOll) lIa 14-M Bcepoccll i1cKOM Cbe3lle cepJJelnO-COCYllliCThIX XHpyproB
(MocKaa 2008 ro)l) lIa COBMCCTIIOM JaccnaHfrn OTllenellHII XHpyprlflecKoro
JlCICHHlI OOICTaHHblX nOpa)f(CHHi1 KopollapHhlx H nepHqepHqCCKHX apTepl1H
OTlleneHH1I XHpypnllCCKOro JleqelUHl J1l)C If MaJlOHHB83f1Blloit XHpyprHIi
KopoHapHbIX ap1epKit na60p aTOpl1H peHTrClOOIpypJ1lCCKHX Ii
3 J1eKTpOltpH3HOnOrHICCKHX MeTO)lOB HccncllOBRIlIDI H llClCHHlI H anpo6alHIH
HOBeHWHX TexHonol1dl HI~ CCX HM AH EaKyJlCBa PAWl
7
nYMHKaUHIl no TCMC HCCJICJlOB3Umi
MaTcpH arthl Ii BbIBOlITgt pa60Tbl npencl1m JleHbl B 8 J1y 6 J1H KaU HlIx (4
CTaTbl1 S H3na HHH 1CIlTpanbHoH nelaTH 4 TC3l1ca)
C Tpytcrypa H 06beM lIl1cccpTamlH
JJHCCCPTauHoHHall pa60Ta H3J10 )f(CHa Ha 138 CTpaHH Uax
M a11ll1 HOnHCUoro TCKcra COCTOHT H3 BBelleHl1l1 4 mas JaxmoleHHll
Bb180)lOB rrpaKTI1 leCKlfX pcKoMCHlau mt H CIlHCKa U1Tcparyp bl
JJHCCCPTaUHII IlJI IOCTpHpoBaH8 26 Ta6nHU8MH 14 Il11arpaMMaMH If 12
PHCYHK8MH oH6nHorpa4lHIeCKHH YKa3aTeJ1b BKJJlOIae-r 202 HCTOlHI1Ka Jot3
IHlX 32 p a60TbJ OTeiCCTBClllibIX alHopos Ii 170 pa60T liHOCTpaHllblX aBTopoB
OCHOBHOE COUEP)J(AHltE PAliOThl
Me-rOJ(hf HCCJlea068UIUI
B CCM nalUlCHTaM B n OJl1iOM o 6beMc npoBOlllUloCb KOMnJleKCIIOC
HCHHB83HBHoe 06CJICllOIUlHHC BKJIIOIaBWCe B ce611 061UCKlU1tHIlCCKHC H
~ a60paTopH blC MCTOllbl I1 CCJ1CllOSIUIHlI 3Kr xorrrepoBCKOC
MOHHTOPIlPOBIUIHC (no nOK83aHHlIM) 3xoKr l nOKoe Ii C HarpY3Ko H n pH
Heo6xolHMOCTf1 BbIl10JIHlI aCb CUI-IHTHrpaqHlI wJoK8plla TIocJle
SblflOJTHeHHlI KOMllJleKCa IICHHB83HSHbI X DliarnOCTI-IIeCKUX npollellYP
60JlbHblM BhmOJlHIIJlaCb Kopo HaporpaltpHJI n p H HaJlHIHH aHespH3Mbl JDK (no
Iailll blM 3xoKr) B CO 1eTaHHH C nCBoH seIlTpI1 KYflorpaqHeii
KnKHHmiddotleCKaR Xap8KTepHCTliK8 nauneHTOB
B COOTBCTCTBHH C 3ana8MK HCCJIellOBaHHl 6blJlO 06CJlC)lOBaJlO 2 30
6orlbHbIX C HJ)C 113 HHX 168 ( 73 ) M)iKIH H 11 62 (27 ) )f(eHIllI1Hbl
B03paCT llallHeHTOB COCTaSHn 40 - 76 -lCT ( CpenHI1H s03paCT 589plusmn96 rolla)
TIauHeHTbl 6WlH P83llCJ1CHlgtl Ha lls e rpynnbl B n epB)lQ ( p a60tyiO)
rpynoy Boml lO 112 n aUHeHTOB KOTOPhlM B KA 6blnH J1MIIJlallTHpoBaJlbl
8
CTeHTbl C neKapcrBeHHblM nOKpblTHeM (311 nepJlon C 1mBap li 2005 r - M3pT
2007 r) BO STOPYIO (KOIITPOIlhHYIO) rpynny fiblIlO BKJU()LJeHO 118
IlRUHeHTOB KOTOPblM 6hIJm YCTaHOBnellbl f0J10MeTdJlJIliLJecKl1e MaTpHIHble
CTCHTbl (38 nCpHOJl c fgteBP8IU 2005 r - neKa6pb 2Q()6 r)
npoScpKa CTaTHCTlflJecKHX ntnOTe3 110 BeeM nOKa38TeIlIM
CBHLeTenbCTBYeT 0 BblCOKOM yposm OnHOponHOCTH JlBYX rpynn nRUHCHTOB
no $8K1opa1 pHcKa 0606JleIlHble n8BHble n o centalI-ropaM pHcKa B 06efix
rpyrmax npenCTaBllelibl H8 TafiJlHlte 1
rpynna I (CJlIT) rpynoa 2 (Me) pn3 118 (100 Ok)n=l12 (100 0)
55 Io IO511CT ns52711 23B031aCT lIeT
92 (78) nS 76 (678) M)K41ltHhI n () 39 (33) 35 (322) nsKypeKl1e n (~~)
71 (602) 67 (598) nsAPTCllHaT1bllWl nmeprelnlll n (Yo) 42 (356) ns i43 (384)AIICmlnllJeMIIII n () 37 (31 5)35 (312) CaxapttblR Jllla6eT n (0) ns I 39 (33) 36 (312) ns2l1llpelUte ~()
01 - piIlAHCKJI IteIlOCrtgtBeP1fW (PgtO05 n - ItOJfIJlfeCr8O nlUHeUTO
Ta(iJIllua I Xap8klepUCTHX3 JIBYX rpynn naUlfe~rroB no $alITOpal pllcKa
LVilfTenbHoCTb 3a60nellamtll H6C CpcnH nauJlCHTOB rpynnbl C CJITl
Kone6aTJaCb OT 4 MCCllIeB JlO 8 n eT s rpynnc c Me OT 2 MeC51l(eB no 6 llCT
nOlaBnJllOwce UfCJ10 nRUlietlTOB l0 BMcruaTenbCTB8 HMeno JUlIHIKY
CTellOKaplHH COOTBeTCTBYlOmylO n JI III lt1gtK OOUlee lHCJlO flaUHeHTOB (0
CH II lt1gtK OOCTaBl1JIO )03 (448 Yo) co CH III ltW - 116 (504 ) OT 06wero
1J1CJla naul1eHTOB BKJUOIeHHblX B I1CCJlenOBaIlHC ITo lt1gtK CTclloKapnHH 06e
rpynnM naUIiCHTOB B BblCOKOH CTCneHiI ODHOponHbI PH CTaTHCTIilCCKOH
06pa60TKc JlOCTOBepliblX P83JIHfHH BbUIBJleHO He 6b1J1o (PgtOOS) IToKa3aTeJlb
C2gtB JDK Konc68J1Cli OT 40 lO 62 (B cpcnHeM 473plusmn51 ) YMepefillO
CHKJ(CHlltul laquo 50 ) C2gtB JOK BbUlBlJCna y 37 (415 ) nRUHeHTOB B rpynne I
(s cpenHeM 456plusmn27 ) H Y 48 (407 ) naUi~eHTOB B rpynne 2 (B cperHleM
449plusmn51 ) (Pgt)05)
9
Auaruu JlBllllblX KopoHapol-pacJlHJJ
B pa6olfel1 rpY ll lIC y 11 2 naUHCHTOB BbJJUlJIeHO 132 CTeH038 KA B
KOImiddotrrponbHoH rpYU lle 157 CTCH030B Y 118 naJlHeHTOB LayxcocYLlHCTWC
n Op a)f(eHHll B KOH1pOJl bHOH rpynnc n aUHeHTOB BblllBnllJlHCb B cpeJlHeM B 18
p83 1aJi(C (P=O02) COoTHo lueHHe TImOB CTCH030B KA (no AHAACC) B
nBYX rpynnax n auHCWTOBlO BMewaTe1bCTBa orpIDKellO 118 nHarpaMMe 1
Pa60laquolR rpynne KOlfTpOl1bHeR rpynna
011lt
JIc
112 4Q~
P-(IoOl
l-oos
J(uarpaMM8 I COOTItOmellHC peHTJeIlMOpcentOnontleCKHlC TImOB creH0308 8 ll8YX
rpyrrnax nll1lHCIITOB (no ACeAHA)
Lam~ble KOJlI11CCTBeRBoro BHaJJI138 CTCtl030B KA no BMCUlaTCnbCTBa B
LlByX rpynnax nBUHCllTOB n penCHUiJ1CHbl B Ta61U~e 2
1
rlyuna] CJlU
rl)[IJI 2 Me p
PeljtepeHTHldil IIHaMeTp aptepHH 1M 274plusmnO48 2amp4plusmnO63 nS
npoTllJllCHllOCn CTeH03a MM 193plusmn81 4 J705t5 57 0045
Cre fleHh ItCXOJlloro CTCII03a 797plusmn98 84 5plusmn84 n s
n S - p HeJlOCTOUJgtIIJoI (PgtO05)
TaMHua 2 KOrrHlCCTBCHHLIIl aHarTll3 ItCXOllHbIX CTeH030B B JlByx rpyn nax nauIlCHTOB
HenOCpellClBeHHble PClYJlb18Tbl creHTUpOOaHlfH
n pe)l1naTaUl1l BbUJOJlUella B 369 BMew aTeJlhCTB (n=85) B cnyllUlx
Tpc6YIOll11X LOnOJ1HJlTeJIIHOrO CTCIiTa I1CnOJlb30BaJICR CTellT C
aHaJJo rHIHbl M nOKphITHe~ COOTHOUleHHe TIfIlOB YCTaHOBneHHbIX CTefiTOB
CJInMC COCTaB~lJlO 1117 B pa60lcH rpynne 112 nauweHTIlM co 132
CTeH03liMH HMnJlaJlTJ1 pOBaIlO 139 CHpOJlHMYC-BblllcnllIOLUJ1X CTCHTOB B
10
KOIl-rpOJlbHOM rpyrme 118 nauHCHl8M co 157 CTetf038MI1 HMnn8HTIlpos8HO
] 63 ronOMeTaJJJJWICCKHX C1CIITa
B T86nHUc 3 rrpencTaBneHO pacnpcneyCHHC HMDnaJITHpoB8HHblX
CTClfTOB HCXOnraquo H3 )ll1aMCTpa CTCHTa a TlIKJKC CpC)l1U1H )lHaMeTp CreUTOB B
KaJKlIOH 113 rpyn n
CJfD 0=139 (JOO Y)
MC 0=163 (100 Yo)
P
25 n () 30 (2 16) 39 (239) ns
275 MM n (Yo) 76 (547) 84 (515) lLS
30 MOl n W) 21 (1 5 1) 2S (153) ns
35 M~ n (~cl) 12 (86) 15 (92) ns
Cpermn lI)lllMeTp 101M 284plusmnO28 186plusmn034 ns
n t _- pIl1UItPI tteAO108epltw ~05 D - ICMlIIecrtO CT(if18
TaMH LIlt 3 COOTHoweHHe KOnHlCCTRlI 1 JUi8MeTpOB CTelnDB 8 lIIIYX rpynnll naJJMeIffOB
Cpe1Helt 3HalCHHe JUlliHbl IfMnJlaJiTKpOBaHUblX CTeHTOB B rpynnc 1
HCCKOJlbKO npeBblwaer aJ1aJ10f1i4Ublii nOKa3aTCnb 80 STOPOH rpynne
(p=O43) CTCIITOB nmtHOH MeHee 18 MM YCTllHOsnCHO 10CTOIlCPHO 60nbwe B
KOHTpoJlbHOH rpyun c naulfCHTOB (P=O027) CTeHTOB )lnIfHOR 60J10C 23 MM
10CTOBCPHO 60nhllle yc-r8HOBJICUO B pa60leH rpynuc (P=O035) (Ta6nKua 4)
em 0=1391100)
MC Il=HIJ (100 )
P
lt18 MM n () 22 (158) 46 (282) 0027 I
18-23MM n () 68 (489) 81 (497 ns I
gt23 101M n (Yo) 49 (353) 36(22 1) 0Q3 5
CpellWllVlHHa 101M 232plusmn31 208plusmn29 0043
DI - pauMIKt MtJlOCT06epHloi (gtO05) n - KOJIRICCTBO cretflO
Ta6ru1ll8 4 COOTHollleHHe KOIlHICCTB8 If 1lIllHJl CTeHTOB BJIlIYX rpynnax nlUilleHTOB
Bee nallfeUThr 6c3 HCK1110lemtJl noJl) 4 antf ~BoliAylQ
aHTItTpOM60UlmpIlYIQ 1C3arperaHTHYIO TepanHlO lacn nSUHCHTOB
11
IlOJl)lIfJlYl I1 HrH6 1nopbl IIblllla rm1KOnp OTCH HOBblX pellCllTOPOB
TpOM60IHTOB (Ta61lJ1U8 5)
r ynna I (CJJD) rfl~nna 2 (MC) P
n~1 12 (100 ) n~118 (100 )
AcnupHH (325 Mr 3a 48 Y3C(8) 112 ( 100) 118 ( 100) ns
T HeIl OOllpIIIlHHJJ (75 Mr M lUI 1a 48 4) 85 (76) 89 (75) ns
T HCIi Oll HPUwtHbl (300 Mr3a 15 4) 27 (24) 29 (25) ns
I1nrn6HTopbl Ubfl lla (1II11p8onep) 6 (5 3) 8 (68) ns
n s - PUlUtIlamp Jte1OCTO~HhI (PgtO05) n - aonUqecna nluuem-o
TaMHua S llC3arperaH1tllll nOllroioBK8 Kp0811 B lByx rpynnax naill1eHTOB
Herrocpe~CTBeHHbrH ycn ex amiddotl rHOrrJIacrHKH COCTaBHn 973 (109
naUHeHTOB 113 112) B nepBoil rpynne 11 966 (114 n8UHeHTOB 113 118) BO
Bropoil rpynnc (PgtO05) CMep TenJHblx HCXOllOB He 6bIJlO uOCTOBepHblX
Pa3JlHlHH 8 pa3BHTHIf OCJIO)KIICIIHM Me)KJlY rpYlm aMH He OTldC4CHO (PgtO05)
KJrHtrnlecKI1 3centlcentCKlHBHOH aHTHOnnaCTlltOOi 0P3HaJi3 y 91 (81l )
n auHellTa 8 ncpBOH rpynne Ii y 95 (806 ) nauHellTOB 80 STOPOH rpyrrne
(Pgt005) (Ta6mllla 6)
rpynna 1 0=112
rpyouI2 n=1I8
p
Ycnex rrpouel1Yp n () 109 (973) 114 (966) ns I
OcnolKnemUl B c-reHTHpOnalUloii aprepHH(TVF) n () 2 (18) 2 ( 17) ns I TpoM603 CTeHTa n () 2 (J 8) 2 ( 17) lLS
Kap)(HM bHble OCnO)f(HeHH~ (MACE) n () 1(09) 2 (1 7) ns
lWcjgtaPKT M HOKllPJla n (J 1 (09) 2 (17) ns
KopoHapHoe WYHTIlposaMHe n (Vo) - - -CMepTb n () - - -LJepe6po-aacK)mtpHble ocnollUicH1Ul n (Vo ) - -
-
-
ns - PlUJllltHa HtlOC1OBepIU (PgtO05~ n - I(OJIHiCCT1M) naWICHTOI
TaMHLl8 6 HcnocpeACTIlcHHble pe3ynbT8Tbl CTelrrl1p0SllHHJI B llByx fllyn nID(
OTIUlJletltlblC PeJYJlbT3TI1 crelfTllpOB3HHH
CpCJlHHH CPOK OTJlanCII lloro Ha6molleHUI 8 JlByX rpynnax 60JthHblX
COc-raBHn 132plusmn263 Mec no HCTCgeHl1H KOTOporo 6bJJ 11 BbJnOJllleHbl
1
HarpYJOlfHIgtIe n po6w C UeJb1O BWIBJJeHHII Hwe~U1H MHOKapIla Ii IT
nOllpo6u bie lJaHlihle 110 OTJlalJCHUblM CpOKllM Ha6mltgtlIeHH51 rrpeJlCTallneHbl II
Tn6nHue 7
rpyrma I (eTTfl) n=1l2 (l00 Yo)
rpynna 2 (Me) D118 (100 0)
p
CpenHHlI CPOK HR6moJreHHi Me( 136plusmn12 129plusmn23 as
MH$OPMallHll nOCl)nHWI no 6 01lbllblM n () 102 (91) 110 (932) ns
06cneJlOB1II0 HlI OTAWleuHOM )Tane n (Yo) 91 (812) 104 (88 1) 0048
KOlllpolhlllll Kr n () 82 (732) 89 (755 ) ])e3 clenokllpolI lI n (Yo) 89 (878) 78 (71) 0Q3
1 - pulHlfftlll lttaOCTOKpUW (pgtoOS) n - mrrn~ecno IWllteHTOJ
TaMUUI 7 KOllWICCTBCHHblC JlalHlIgttC OT1UlJleHIIOrO mUTa cc~eJlOBalII1R
IlposeL1eHHWI Kr BblllBKna pecrCH031J y 29 (137 ) nallHeHTOB
y p oSeH pecreHOJa CTaTHCTIfecKH m3QHMO 6bJ1 HIf)f(e B rpynne c
HMnnaHTIlpoBaRHblMH CJIfI B cpaBHeHMH C KOHTPOfhHoit rpyrrnoH
(PltOOO 1) B rpynne 1 OCHOBHWI 18crb pecTeH0301l nplfXOL1HTClI Ha
npoKcHMaJlbHOIH Kpae CTeHlHpoB8HHOro celMellTa B rpynne 2 pecTeH03
Pa3BIIJICli npeHMymecrncHHo B rpBHHUax CTCIIT3 B 06CI1X rpynnax
H3HMeHbWIUl laCTb pecTCHOJOB COCpeJlOTOlCHa y AHCTaJlbHOro KpM
(Ta6J1l1ua 8)
rpynna I (CJID) n=102 (100 1
rpynna 2 (MC) n1I0(JOO)
p
IgtHH3PHbl A
peCTIfI03
(Yo)
Beem 6 (59) 23 (209) lt0000 1
B f1JRlfHUIIX C1effT8 2 (21) 13(118) lt0000 1
npoKCan~Hbln Kpal 3 P 9) 7 (64) ltOOOJ
IHcTWlhliMn KpRn 1 (09) 3 (27) lt0001
nOTep npocse ra MM 052plusmnO45 1 04~58 lt0001
TpOM6oI creHTll (OImoolUl) n ( ) 4 (36) - lt0001
n porpeccHjXlSaKHe aTepoCl(J1qlO3a n (o) 18(1 76) - --shy-
15 (1 36) ns
1I L - pampUINkJl HetlOCtoaephI (PgtoOS)
Ta6J11tUa 8llallllwe KonHl leCT8eHl1oll rurmorpa4Jllll H3 OTl3IleHHOM ITane
13
B KaTelOplHI nalHellTOB C Ca p eCTeH03 I3 blllBJJ eH y 15 (13 1 Bcex
60fhHbiX C Ca) 60JrbH biX cpeaH KOTOPbl X upe06J1anaml n aUHeHTbl H3
BTOpO~ rpy nnbl ljaCToTa p a3BHTHI pecrcH03a CpelH lI aUHCHTOB C CJ B
nepsoH rpynne cocra BHn a 36 (2 n ar(l~eIlTa) a BO BTOPOH Ip ynne 1S2
(9 naUHeHTOs) (PltOOOI)
HaJl6oJIbWal laCTOTa pecreHo30B B o6clix rpynn ax B03HHKJJa S
MOPIPOnOr H-IecKH CJJOlKHhIX creHo3ax 13 OC06CHHOCUI THnax B2 H C B
Cil)-lae MopcentlonOnflecRH 60nee 6 n ar OnpIHITHoro ll1Ill creli i l1pOSalHul
CTeH03a m Da A pccreHo3a B r pynne om He OTMCCIIO (JlHarpaMMa 2)
~J
~ 6 emiddot~ 4~1 I enn~ middot( -~ 1- -2-shy
gt----J - liS ~ ~~ e 2 D9J -
~
T Tn Bl TnB2 T~n C
llarpa~ma 2 PacnpellCilcHIlC yaCTOThI pecrello3a B 3aSHCl1MOC1H OT MoptKgtnOrHYCCKOrO
TMHa ~ICXOllHOro CTe l103a 8 OTllaneHJ10M nepHOAC
Ha IlHarpaMMe 3 npocnClKlIB3eTCli 06paTH31l 3aBHCHMOCTb
YMcRbm cHHlI aCTO pecTCII03a C YSeJ1HIeHIiCM IlHaMeTpa creHntpyeMoH
apTepHIt B 05CKX rpynnax lJ aCTOTn peCTeHo33 M aKCHMaJlbHa cpeIlH apTepHH
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OTJlH lHC 01 CTeIiTOB 6e3 nOKpbITHII
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7
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C Tpytcrypa H 06beM lIl1cccpTamlH
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M a11ll1 HOnHCUoro TCKcra COCTOHT H3 BBelleHl1l1 4 mas JaxmoleHHll
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JJHCCCPTaUHII IlJI IOCTpHpoBaH8 26 Ta6nHU8MH 14 Il11arpaMMaMH If 12
PHCYHK8MH oH6nHorpa4lHIeCKHH YKa3aTeJ1b BKJJlOIae-r 202 HCTOlHI1Ka Jot3
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MOHHTOPIlPOBIUIHC (no nOK83aHHlIM) 3xoKr l nOKoe Ii C HarpY3Ko H n pH
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SblflOJTHeHHlI KOMllJleKCa IICHHB83HSHbI X DliarnOCTI-IIeCKUX npollellYP
60JlbHblM BhmOJlHIIJlaCb Kopo HaporpaltpHJI n p H HaJlHIHH aHespH3Mbl JDK (no
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B COOTBCTCTBHH C 3ana8MK HCCJIellOBaHHl 6blJlO 06CJlC)lOBaJlO 2 30
6orlbHbIX C HJ)C 113 HHX 168 ( 73 ) M)iKIH H 11 62 (27 ) )f(eHIllI1Hbl
B03paCT llallHeHTOB COCTaSHn 40 - 76 -lCT ( CpenHI1H s03paCT 589plusmn96 rolla)
TIauHeHTbl 6WlH P83llCJ1CHlgtl Ha lls e rpynnbl B n epB)lQ ( p a60tyiO)
rpynoy Boml lO 112 n aUHeHTOB KOTOPhlM B KA 6blnH J1MIIJlallTHpoBaJlbl
8
CTeHTbl C neKapcrBeHHblM nOKpblTHeM (311 nepJlon C 1mBap li 2005 r - M3pT
2007 r) BO STOPYIO (KOIITPOIlhHYIO) rpynny fiblIlO BKJU()LJeHO 118
IlRUHeHTOB KOTOPblM 6hIJm YCTaHOBnellbl f0J10MeTdJlJIliLJecKl1e MaTpHIHble
CTCHTbl (38 nCpHOJl c fgteBP8IU 2005 r - neKa6pb 2Q()6 r)
npoScpKa CTaTHCTlflJecKHX ntnOTe3 110 BeeM nOKa38TeIlIM
CBHLeTenbCTBYeT 0 BblCOKOM yposm OnHOponHOCTH JlBYX rpynn nRUHCHTOB
no $8K1opa1 pHcKa 0606JleIlHble n8BHble n o centalI-ropaM pHcKa B 06efix
rpyrmax npenCTaBllelibl H8 TafiJlHlte 1
rpynna I (CJlIT) rpynoa 2 (Me) pn3 118 (100 Ok)n=l12 (100 0)
55 Io IO511CT ns52711 23B031aCT lIeT
92 (78) nS 76 (678) M)K41ltHhI n () 39 (33) 35 (322) nsKypeKl1e n (~~)
71 (602) 67 (598) nsAPTCllHaT1bllWl nmeprelnlll n (Yo) 42 (356) ns i43 (384)AIICmlnllJeMIIII n () 37 (31 5)35 (312) CaxapttblR Jllla6eT n (0) ns I 39 (33) 36 (312) ns2l1llpelUte ~()
01 - piIlAHCKJI IteIlOCrtgtBeP1fW (PgtO05 n - ItOJfIJlfeCr8O nlUHeUTO
Ta(iJIllua I Xap8klepUCTHX3 JIBYX rpynn naUlfe~rroB no $alITOpal pllcKa
LVilfTenbHoCTb 3a60nellamtll H6C CpcnH nauJlCHTOB rpynnbl C CJITl
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nOlaBnJllOwce UfCJ10 nRUlietlTOB l0 BMcruaTenbCTB8 HMeno JUlIHIKY
CTellOKaplHH COOTBeTCTBYlOmylO n JI III lt1gtK OOUlee lHCJlO flaUHeHTOB (0
CH II lt1gtK OOCTaBl1JIO )03 (448 Yo) co CH III ltW - 116 (504 ) OT 06wero
1J1CJla naul1eHTOB BKJUOIeHHblX B I1CCJlenOBaIlHC ITo lt1gtK CTclloKapnHH 06e
rpynnM naUIiCHTOB B BblCOKOH CTCneHiI ODHOponHbI PH CTaTHCTIilCCKOH
06pa60TKc JlOCTOBepliblX P83JIHfHH BbUIBJleHO He 6b1J1o (PgtOOS) IToKa3aTeJlb
C2gtB JDK Konc68J1Cli OT 40 lO 62 (B cpcnHeM 473plusmn51 ) YMepefillO
CHKJ(CHlltul laquo 50 ) C2gtB JOK BbUlBlJCna y 37 (415 ) nRUHeHTOB B rpynne I
(s cpenHeM 456plusmn27 ) H Y 48 (407 ) naUi~eHTOB B rpynne 2 (B cperHleM
449plusmn51 ) (Pgt)05)
9
Auaruu JlBllllblX KopoHapol-pacJlHJJ
B pa6olfel1 rpY ll lIC y 11 2 naUHCHTOB BbJJUlJIeHO 132 CTeH038 KA B
KOImiddotrrponbHoH rpYU lle 157 CTCH030B Y 118 naJlHeHTOB LayxcocYLlHCTWC
n Op a)f(eHHll B KOH1pOJl bHOH rpynnc n aUHeHTOB BblllBnllJlHCb B cpeJlHeM B 18
p83 1aJi(C (P=O02) COoTHo lueHHe TImOB CTCH030B KA (no AHAACC) B
nBYX rpynnax n auHCWTOBlO BMewaTe1bCTBa orpIDKellO 118 nHarpaMMe 1
Pa60laquolR rpynne KOlfTpOl1bHeR rpynna
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rpyrrnax nll1lHCIITOB (no ACeAHA)
Lam~ble KOJlI11CCTBeRBoro BHaJJI138 CTCtl030B KA no BMCUlaTCnbCTBa B
LlByX rpynnax nBUHCllTOB n penCHUiJ1CHbl B Ta61U~e 2
1
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rl)[IJI 2 Me p
PeljtepeHTHldil IIHaMeTp aptepHH 1M 274plusmnO48 2amp4plusmnO63 nS
npoTllJllCHllOCn CTeH03a MM 193plusmn81 4 J705t5 57 0045
Cre fleHh ItCXOJlloro CTCII03a 797plusmn98 84 5plusmn84 n s
n S - p HeJlOCTOUJgtIIJoI (PgtO05)
TaMHua 2 KOrrHlCCTBCHHLIIl aHarTll3 ItCXOllHbIX CTeH030B B JlByx rpyn nax nauIlCHTOB
HenOCpellClBeHHble PClYJlb18Tbl creHTUpOOaHlfH
n pe)l1naTaUl1l BbUJOJlUella B 369 BMew aTeJlhCTB (n=85) B cnyllUlx
Tpc6YIOll11X LOnOJ1HJlTeJIIHOrO CTCIiTa I1CnOJlb30BaJICR CTellT C
aHaJJo rHIHbl M nOKphITHe~ COOTHOUleHHe TIfIlOB YCTaHOBneHHbIX CTefiTOB
CJInMC COCTaB~lJlO 1117 B pa60lcH rpynne 112 nauweHTIlM co 132
CTeH03liMH HMnJlaJlTJ1 pOBaIlO 139 CHpOJlHMYC-BblllcnllIOLUJ1X CTCHTOB B
10
KOIl-rpOJlbHOM rpyrme 118 nauHCHl8M co 157 CTetf038MI1 HMnn8HTIlpos8HO
] 63 ronOMeTaJJJJWICCKHX C1CIITa
B T86nHUc 3 rrpencTaBneHO pacnpcneyCHHC HMDnaJITHpoB8HHblX
CTClfTOB HCXOnraquo H3 )ll1aMCTpa CTCHTa a TlIKJKC CpC)l1U1H )lHaMeTp CreUTOB B
KaJKlIOH 113 rpyn n
CJfD 0=139 (JOO Y)
MC 0=163 (100 Yo)
P
25 n () 30 (2 16) 39 (239) ns
275 MM n (Yo) 76 (547) 84 (515) lLS
30 MOl n W) 21 (1 5 1) 2S (153) ns
35 M~ n (~cl) 12 (86) 15 (92) ns
Cpermn lI)lllMeTp 101M 284plusmnO28 186plusmn034 ns
n t _- pIl1UItPI tteAO108epltw ~05 D - ICMlIIecrtO CT(if18
TaMH LIlt 3 COOTHoweHHe KOnHlCCTRlI 1 JUi8MeTpOB CTelnDB 8 lIIIYX rpynnll naJJMeIffOB
Cpe1Helt 3HalCHHe JUlliHbl IfMnJlaJiTKpOBaHUblX CTeHTOB B rpynnc 1
HCCKOJlbKO npeBblwaer aJ1aJ10f1i4Ublii nOKa3aTCnb 80 STOPOH rpynne
(p=O43) CTCIITOB nmtHOH MeHee 18 MM YCTllHOsnCHO 10CTOIlCPHO 60nbwe B
KOHTpoJlbHOH rpyun c naulfCHTOB (P=O027) CTeHTOB )lnIfHOR 60J10C 23 MM
10CTOBCPHO 60nhllle yc-r8HOBJICUO B pa60leH rpynuc (P=O035) (Ta6nKua 4)
em 0=1391100)
MC Il=HIJ (100 )
P
lt18 MM n () 22 (158) 46 (282) 0027 I
18-23MM n () 68 (489) 81 (497 ns I
gt23 101M n (Yo) 49 (353) 36(22 1) 0Q3 5
CpellWllVlHHa 101M 232plusmn31 208plusmn29 0043
DI - pauMIKt MtJlOCT06epHloi (gtO05) n - KOJIRICCTBO cretflO
Ta6ru1ll8 4 COOTHollleHHe KOIlHICCTB8 If 1lIllHJl CTeHTOB BJIlIYX rpynnax nlUilleHTOB
Bee nallfeUThr 6c3 HCK1110lemtJl noJl) 4 antf ~BoliAylQ
aHTItTpOM60UlmpIlYIQ 1C3arperaHTHYIO TepanHlO lacn nSUHCHTOB
11
IlOJl)lIfJlYl I1 HrH6 1nopbl IIblllla rm1KOnp OTCH HOBblX pellCllTOPOB
TpOM60IHTOB (Ta61lJ1U8 5)
r ynna I (CJJD) rfl~nna 2 (MC) P
n~1 12 (100 ) n~118 (100 )
AcnupHH (325 Mr 3a 48 Y3C(8) 112 ( 100) 118 ( 100) ns
T HeIl OOllpIIIlHHJJ (75 Mr M lUI 1a 48 4) 85 (76) 89 (75) ns
T HCIi Oll HPUwtHbl (300 Mr3a 15 4) 27 (24) 29 (25) ns
I1nrn6HTopbl Ubfl lla (1II11p8onep) 6 (5 3) 8 (68) ns
n s - PUlUtIlamp Jte1OCTO~HhI (PgtO05) n - aonUqecna nluuem-o
TaMHua S llC3arperaH1tllll nOllroioBK8 Kp0811 B lByx rpynnax naill1eHTOB
Herrocpe~CTBeHHbrH ycn ex amiddotl rHOrrJIacrHKH COCTaBHn 973 (109
naUHeHTOB 113 112) B nepBoil rpynne 11 966 (114 n8UHeHTOB 113 118) BO
Bropoil rpynnc (PgtO05) CMep TenJHblx HCXOllOB He 6bIJlO uOCTOBepHblX
Pa3JlHlHH 8 pa3BHTHIf OCJIO)KIICIIHM Me)KJlY rpYlm aMH He OTldC4CHO (PgtO05)
KJrHtrnlecKI1 3centlcentCKlHBHOH aHTHOnnaCTlltOOi 0P3HaJi3 y 91 (81l )
n auHellTa 8 ncpBOH rpynne Ii y 95 (806 ) nauHellTOB 80 STOPOH rpyrrne
(Pgt005) (Ta6mllla 6)
rpynna 1 0=112
rpyouI2 n=1I8
p
Ycnex rrpouel1Yp n () 109 (973) 114 (966) ns I
OcnolKnemUl B c-reHTHpOnalUloii aprepHH(TVF) n () 2 (18) 2 ( 17) ns I TpoM603 CTeHTa n () 2 (J 8) 2 ( 17) lLS
Kap)(HM bHble OCnO)f(HeHH~ (MACE) n () 1(09) 2 (1 7) ns
lWcjgtaPKT M HOKllPJla n (J 1 (09) 2 (17) ns
KopoHapHoe WYHTIlposaMHe n (Vo) - - -CMepTb n () - - -LJepe6po-aacK)mtpHble ocnollUicH1Ul n (Vo ) - -
-
-
ns - PlUJllltHa HtlOC1OBepIU (PgtO05~ n - I(OJIHiCCT1M) naWICHTOI
TaMHLl8 6 HcnocpeACTIlcHHble pe3ynbT8Tbl CTelrrl1p0SllHHJI B llByx fllyn nID(
OTIUlJletltlblC PeJYJlbT3TI1 crelfTllpOB3HHH
CpCJlHHH CPOK OTJlanCII lloro Ha6molleHUI 8 JlByX rpynnax 60JthHblX
COc-raBHn 132plusmn263 Mec no HCTCgeHl1H KOTOporo 6bJJ 11 BbJnOJllleHbl
1
HarpYJOlfHIgtIe n po6w C UeJb1O BWIBJJeHHII Hwe~U1H MHOKapIla Ii IT
nOllpo6u bie lJaHlihle 110 OTJlalJCHUblM CpOKllM Ha6mltgtlIeHH51 rrpeJlCTallneHbl II
Tn6nHue 7
rpyrma I (eTTfl) n=1l2 (l00 Yo)
rpynna 2 (Me) D118 (100 0)
p
CpenHHlI CPOK HR6moJreHHi Me( 136plusmn12 129plusmn23 as
MH$OPMallHll nOCl)nHWI no 6 01lbllblM n () 102 (91) 110 (932) ns
06cneJlOB1II0 HlI OTAWleuHOM )Tane n (Yo) 91 (812) 104 (88 1) 0048
KOlllpolhlllll Kr n () 82 (732) 89 (755 ) ])e3 clenokllpolI lI n (Yo) 89 (878) 78 (71) 0Q3
1 - pulHlfftlll lttaOCTOKpUW (pgtoOS) n - mrrn~ecno IWllteHTOJ
TaMUUI 7 KOllWICCTBCHHblC JlalHlIgttC OT1UlJleHIIOrO mUTa cc~eJlOBalII1R
IlposeL1eHHWI Kr BblllBKna pecrCH031J y 29 (137 ) nallHeHTOB
y p oSeH pecreHOJa CTaTHCTIfecKH m3QHMO 6bJ1 HIf)f(e B rpynne c
HMnnaHTIlpoBaRHblMH CJIfI B cpaBHeHMH C KOHTPOfhHoit rpyrrnoH
(PltOOO 1) B rpynne 1 OCHOBHWI 18crb pecTeH0301l nplfXOL1HTClI Ha
npoKcHMaJlbHOIH Kpae CTeHlHpoB8HHOro celMellTa B rpynne 2 pecTeH03
Pa3BIIJICli npeHMymecrncHHo B rpBHHUax CTCIIT3 B 06CI1X rpynnax
H3HMeHbWIUl laCTb pecTCHOJOB COCpeJlOTOlCHa y AHCTaJlbHOro KpM
(Ta6J1l1ua 8)
rpynna I (CJID) n=102 (100 1
rpynna 2 (MC) n1I0(JOO)
p
IgtHH3PHbl A
peCTIfI03
(Yo)
Beem 6 (59) 23 (209) lt0000 1
B f1JRlfHUIIX C1effT8 2 (21) 13(118) lt0000 1
npoKCan~Hbln Kpal 3 P 9) 7 (64) ltOOOJ
IHcTWlhliMn KpRn 1 (09) 3 (27) lt0001
nOTep npocse ra MM 052plusmnO45 1 04~58 lt0001
TpOM6oI creHTll (OImoolUl) n ( ) 4 (36) - lt0001
n porpeccHjXlSaKHe aTepoCl(J1qlO3a n (o) 18(1 76) - --shy-
15 (1 36) ns
1I L - pampUINkJl HetlOCtoaephI (PgtoOS)
Ta6J11tUa 8llallllwe KonHl leCT8eHl1oll rurmorpa4Jllll H3 OTl3IleHHOM ITane
13
B KaTelOplHI nalHellTOB C Ca p eCTeH03 I3 blllBJJ eH y 15 (13 1 Bcex
60fhHbiX C Ca) 60JrbH biX cpeaH KOTOPbl X upe06J1anaml n aUHeHTbl H3
BTOpO~ rpy nnbl ljaCToTa p a3BHTHI pecrcH03a CpelH lI aUHCHTOB C CJ B
nepsoH rpynne cocra BHn a 36 (2 n ar(l~eIlTa) a BO BTOPOH Ip ynne 1S2
(9 naUHeHTOs) (PltOOOI)
HaJl6oJIbWal laCTOTa pecreHo30B B o6clix rpynn ax B03HHKJJa S
MOPIPOnOr H-IecKH CJJOlKHhIX creHo3ax 13 OC06CHHOCUI THnax B2 H C B
Cil)-lae MopcentlonOnflecRH 60nee 6 n ar OnpIHITHoro ll1Ill creli i l1pOSalHul
CTeH03a m Da A pccreHo3a B r pynne om He OTMCCIIO (JlHarpaMMa 2)
~J
~ 6 emiddot~ 4~1 I enn~ middot( -~ 1- -2-shy
gt----J - liS ~ ~~ e 2 D9J -
~
T Tn Bl TnB2 T~n C
llarpa~ma 2 PacnpellCilcHIlC yaCTOThI pecrello3a B 3aSHCl1MOC1H OT MoptKgtnOrHYCCKOrO
TMHa ~ICXOllHOro CTe l103a 8 OTllaneHJ10M nepHOAC
Ha IlHarpaMMe 3 npocnClKlIB3eTCli 06paTH31l 3aBHCHMOCTb
YMcRbm cHHlI aCTO pecTCII03a C YSeJ1HIeHIiCM IlHaMeTpa creHntpyeMoH
apTepHIt B 05CKX rpynnax lJ aCTOTn peCTeHo33 M aKCHMaJlbHa cpeIlH apTepHH
MaJlOro L1HBMeTp a 13 llHaMerpe 35 MM 1aCTOTn pa3BHTHli PCCTCH03a He
BbICOKruJ L10CTOBCptlO He p a3Jl1fQae-rclI MeJIltilY rpy n n 3MH
10 -~
-cnn~ 1-- I ~-----shy~ ~ Me
-~ - -mo
1shy25 111 27SM 30~M 35 WJ
llllarpaMMIi 3 PaClipenel CH ItC ll3CTOTI1 pecreHOJ8 B JaBHCflMOCll1 OT IHalcTpa CTeHT8
14
npll a HaJlH3C Bntll1HHlI JIl1HHbl creHTa Ha 4acrory peCTeH03a o6pmuaeT
Ha ce6l1 BHHMaHHC npM3l1 3aBMCHMOCTb a 06CliX rpynnax B
creiITHpOB3lmbIX CelMCHTax Jllll1li010 6oICC 23 MM pccrCH03bl o6HapY)f(CHbl
B 3 paJa lalUe n pH IfMnJlaHTaUHH KaJlt CM TalC Ii MC B cpaBucHlHl C
KOPOTKHMH CTeH03aMH no 18 MM (IlHarpalMa 4)
0 shya
CI1I1 ~ e 4 t ~~ 2middot1~
e lt 8 amp - 23 gt 23
1Illarp8MMa 4 PacnpellCJICHHC 18ClUfbl pecrCH033 B 3aBliCHMOCTH OT )IJlHHIgt crelmL
KOppCJUIllHORHblii aHIllTH3 aHrHOI-prupHleCKHX peCTeH030B nOKa3aJ1
LITO B rpynne C HMnJlaRTHpoBaHHblMH ClITl KOppeJUlUHOHHaJI 33SHCHMOCTL
MC)f(Jy JlHaMCTpOM CTeHTHposaHHOM apTepl1H H laCTOTO~ PaJlIHTII$
pecreHo38 npaKTHlecKH OTC)TCTByeT (r=0220) B TO BpcMlI KaK B rpvnne
MC CymecTBye-1 IlOCraTOlllO BblCOKall o6paTHaJI 33BHCHMOCTI Mellltly
YJGl3aHHbIMH napaMCTpaMI1 (r=0792) TIp aH8JT113e 3aBHCHMOCTH MC)(JIJ )]J1HHOH HCXOJlHOro nopa)f(eHHlI H
1(3CTOTOil PaJBHTHIl pccrcHOJa B rpyrme C IlMIWaHTHponlUulblMH Me 6blJ1a
Bbl1UlneHa BblCOKaJI n0J10ll(HTeJ1bHaJI KOppelUI1U1lI (r=O819) B rpynnc C CJITI
TaJOKe c)llIecTsyer IltOppcnllUHOHltaJI CB1I3b MClKllY lJ1I1HOH HCXOJlHOrO
CTeH03a 11 tacTOTOH pecrCH03a OJlllaKO pacqen1 o1p3)f(aIOT secbMa
)MepeHHblH ee xapaKTcp (r=O306) Te C TOlKH 3PCHHlI PHCKft pa3BHTHlI
pecrcno30B JlnHIiB nOplllKCItHli JIl1 l1 CJITllle HrpaeT cYlUecTJleHHoH poJ1H KlIJlt
JIl1R M C rpaqlHIeCKRe MOJleJlJ1 LltOpperullij1H JlI13gtIerp3 11 lSCTOThl peCTCII03a
1lJIHHbl Ii laCTOTbl pec-reHo33 npenCTaBJ1eHbl Ha )]HSrpaMM3X 5 11 6
i ~i
[ rp nnu cnn 1 [ipyn Me r
LIllarpsMMiI 5 KoppeJUJUMOIiIUUI 3aSI1CUMOCTh MClIOlY IlJUIMC1pOM creHlllposalllloll
ap-repllll II 18CTOTO~ pS3BIITI1I1 pccreH038
j7PYiinacnn r - rpynna Me~I
T--rmiddotl bull i ~ bull
~ ag 11 +-+1-+--1
1lIIarpaMMa 6 KOppeIlRUIIOHJ11U138SHCKMOCTb MClKIIY J1JHIIIOH UCXOllloro nopiDKellHII Ii
~lICTOTolI Pa3BIITRJI pccreHOJa
B TelCHnC )OHlPOJIMIOro nepHo)]a peKOMeHllOBaHHOLO peJKHMa
JlBOHHOH aHTHarperaHTHOA Tcpamm rrpHlle~IIMJlHCb 90 (882 )
rrSUHCIlTOB H3 rpyIIIIhJ I H 93 (845 ) n3UHeHTll H3 rpynlThl 2 (Ta6nHl3 9)
rpymUlI rpynnl2 p n=l02 =110
~OAHasr alTlll arperalfTHtllI TepaJTHll n () 90 (882) 93(84 5) ns -
98 (96) 106 (964)Acml]lIlH 150 Mrcyr n ( ) ns
THeHonHplUlIIllt 1lVtIlTerullocn TepanHTI Idee 92plusmn21 2 44gt0 11 0032
7S MrcYT I n pHlUnl a1 n n (00) 90 (882) 93 (845) ns ~ -
n ~ -- pUIIlIllHIII ttcJlOCl1VDtpKtl (pgtoOS) n - OJIIJJ~ rnunetrTOIi
Ta6J11IUamp 9 PelKHM JlIlOi1HoR3lrmarpenIJITHoArepalll1H B IlByx rpyn nax n8UHeIITOR I
16
Ha OTJlaJJeHHOM nane LIOKa38BHbJH TPOM603 CTeHTI1poB8HHOro
ccrMCHTa 3altill1KCHpOBaH y 4 (39 ) 6oJJbBblx npl1 4eM 3 m nUICHTOB fibl111113
rpyrmbI C HMrrnallTI1p OBIlH HblMJ1 C JUl OTMeTHM 410 Cp eJlH nal~HeliTOB C
YpoM6030M B nepBoi rpy nne 2 113 3 n8lHCHTOB npCpS8JII1 )lBOHHYIO
aHTHarperaHTHYlo Tepanl1lO 110 p eKOMeHllOB8HHoro CpOK3 B r pynn e CJIT1
OTMeleHO 2 CJly4W1 a B rpy n n c MC 1 CJJylJaH BCKaPJll1aJlbHbIX OCJlO)l(lIeHHH
KOTOPblC Mbl CBJJ3hl BaCM C np HcMoM LIe3arperaliToB
3a Bp eMll I tafiJlIOneHHII YMepJIO 4 (3 9 ) fiOlTbBblX B rpynne I 11 4 (3 6
) B rpyn n e 2 B pa6olei rpynnc OTMClCHO nBC HClltapJlHBJIbHble CMepTH
060 6 uleH HbiC OT)laJIeHHble p e3YJlbTaTbI aHrHOnJlacrnKll npei4CTaBJIetlbl B
Ta6mlUe 10
rpYll1l8 I n-l02
rpynna 2 n110
p
be CTeHOKllPJUIH n () 89 (878) 78 (71) 003
AKnlO rpaltj IOC K llOKll3lIllllbill pecTe1l03 n () 6 (59) 23 (209) lt000 1
PeBacKY~HpH3aI~H Ieneaom creHroa (TLR) n () 5 (49) 20 ( 182) lt000 1
PeBac~mpIf3BUIlR Ho a w CTeH030B (TVR) n () 7 (69) 5 (46) 0044
K OpoRspHoe WYIITllpoeaJfHe n (0) ) (10) 2 (1 8) 0 5
T POM603 CTelrra n () 3 (29) 1 (09) lt0001
I1111lapKT MHOKllPllB n (0) 3 (29) 4 (36) nS
KapnHaJ1bHble OCn O)f(Hflrn (MACE) n () 6 (59) 7 (63) ns
He ~llpllIl2J1bHble ocnOllltHeH Ill 0 () 2 (19) 1 (09) 004
ClotepTb (BCCro) n () 4 (3 9) 4 (36) O S
HCKaPAtlaJI b trQJI CMCpTb n () 2 (1 9) 1 (09) 004 nl_- PIlJmO(I HeJlOcro8epkW (pgtOOS) D ~ KQnUIecno ITIWteHTO
TaMH 118 10 OtQaJlCHHbJCpe3YllhTlITbl CTeIffifPOBaJi HlI B JUlyx rpynnax naUI1CHT08
K ax CJlcuyeT H3 Ta6nHlbl 10 no 1laCTOTC P83BIITHlII1M Ii KaplLHaJI b ~LbX
OClJOlKH ellHH )lOCToBepHblx p 33JJHiHA M~ rpyn nBMIi He BblJJ B11eHO
OllHaKO n o IDeTOTe HcofixonJ1MOCTFI nOBTOp lloii p esaCK)IUIJlH38lHH
npOCJTe)l(HBaeTCII llOCTOBepHoe )BCJlHlJeHHe 0 rpyrrnc C HMTIJIaRTHpOBBH NblMH
Me
I
AHaJlH3 TaKOra BIDKHOro 1I0Ka3BHJHI K8K OeJonaCHOCTb CTCIITOB no
KPHlCPHJIM TpoM603a CTeBTa KOHCOPUIi)MB no AKaneMH4ecKI1 M
HCCJIellOB3llIUlM (ARC) nOKa3aJ1 ITO Aa p aHHHX 3Tanax pamHIIIH no
laCTOTe rpoM603B MeifltlY rpyrtlHlMH He 8bllwnCHO O)lHaKO liB OTllBJICHHOM
cpoKe 38$HKCHpOBaHO HecKonbKo 6omwcc 411CJlO )IOKll3aHHbIX TpoM6030A Il
ncpBolt rpynne XOTlI KOJlHIeCTBO 1l03MO)I(Hb1X TpoM6030B MCJtillY rpyrulaMH
He )lOCTHfJJO 3HBlHMOro Pa3JTRtfHll (rB6JJHI~a 11)
rpynna 1 n1 02
rpynna 2 nUO
p
PalllluA
TpoM60J (0-30t1l1eA)
Bcuo 2 (JIJ) 2 (18) nS uOKa3llllHbIA 2 (1 9 2 ( 18) n1
BepoATItbI Ii - - -1T0000IIHn
Tpo60J pO-365 JlleR)
B~ S (49) 307) 003
JlOKa3aJIHhIA 3 (29) 1(09) 003 I
Bepomu11l 1(09) 0046
BolMOll(Hbifi 2 (19) 1(09) os
ltPieBb nOlJUIHA
TJION60J (gt365 Ulei1)
BCUI (ID) - 0046
[lOtlta38Jillhl A - - - i
BepollTHwA I (1 0) - 0046
BOlMogtKHlgtrll - - -
UTOro l0MlirooB 8 (79) i (45) ltU0l n 5 - Pl1llU I 1VI Kcnoc-roeepIlW (pgtO05) n - fCQJUf4ecno nDWtt-I-1TOt
Tawmua 11 AHaJllt31JXlM6oJa C1CIITa no ARC nllllYX rpynnax 6oJlhHhll
~ nOMOllJhlO MeTO)lHJ(1i oneHKH BblKHOaeMOCTl1 no KanJlaHy-Majjepy
Mbl paCCIIHbIBBJII ofiJUYlO Bbl)KHBaeMOCTb BbnKHBaeMOCTb 6C3 nllKCJJhLX
KapnHaJIbHblX c06bIT11H (MACE) Ii Bbl)l(HOaeMOCTb 6C3 nOBTopHblX
pcsacryJlllpl13allHH (TLR) B TeleBlie 14 MCC$lUCB Ha6molleHHJI
npH aAaJIH3e o6wefi BblJlOlBaeMOCTH B nepHOll Ra6J1lolleHHll Be Obl1l0
BblllBJICHO 3f1a4HMblX p33JIHlHA B PIICKC CMepTH M~ IlB)MlI rpynnaMH
6 0JJbHblX KpHBbl e BbllKHBaeMOCTH 6C3 TlllKeJlblX Kap)lHaJJbllblX C06blTl~H
(cepnClHaJI CMepTb HM onepauHSl Kill) HMCJJH TeRlleHllHIO K paCXO)J(llCHHIO
nOCJJe 4 MCCSlUCB Ha6 J1IOncHHJI Ol1H aKO MC)I(Jly rpynnaMH C
11
18
IfMnnatiTIlpoaaHHblM Cfln H MC Pa3InI II1H no qaCrOTe BCTpelaeMOCTH
cOBoKynHoCTII lIe6naronpl111TllbiX KapuHaJIbHhlX OCJIO)KHCHH H BblllBnellO He
6 Mno (nHarpaMMa 6)
shy ~ ~ w
I n ~ I
1 _Uti~ J _em ~ C~ Iej u ---J i __ -lt --~- _ ---- -
u 1 r ----rshyr-c 1
)--- shy I I Ia n 1~~r1r amp e is 1~~ ~
06lJ1llJ BbJ)j(IIBBeMOCTh BbilKlIBlleMOCTh 6e3 KlIPlll aJI bHblX Oc10llmeHHH
llHarpa~ma 4 BbllRHOaeMOCTb nauHelITOS B lilYgt rpynnax no Kannatlymiddot MaAcpy
H a IlHarpaMMe 7 n p eucT8BJ1CHa BbLliOiBaeMOCTb B o6eRX rpyllnax fie3
Heo6xollHMOCTH nOBTOpH bX peBacK)J111pI13al1HH ueneBOro CTeH03a K pHBhle
BbI)KHBaeMOCTI1 P830lliJIHCb qepe3 3 MeOIua lla6Jl10lleHIDI (P=O06)
craTHCTHJeCKI1 3HatntMOe pacXO)fJlCHHe Me)KJO H3YlacMblMH rpynnam
3acentHKcHpoBaHo K 9 Mec$IUaM (PltOOO I) P IfCK cMeprn 6e3
peBacKYMpH33UHIl n OCToBepHO HH)Ke B l Pynn e CJll1 ODHaKO KaK B rpyn n e
C IfMnnswH l poaaHHbIMH Cll n TaK 11 B rpyrrrre C HMnn8HTlfpoBaHHhlMH MC
OCTaerClillOCTaTOlHO HH3KHM
1 ----r
~~ R ur bull -- - - eM
---+- - ----i Me
q ~~~1 ~ ~ n - -+- t
I
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o ~
UI Df JGl ~ t5f
BpetM IU6IW1JQlflIIIIII I AKII
lluarpaMMH 7 Bbl lKflBaeMOCTL 11~lie ll1UB BMYX rpynnax no K8I1JlilH) -MaAepy_
IY
06CY-dlICHUe pnyJJbrarOB
B HalliCM HCCJle10BaIHH llse cqJOPMHpoollHHble rpynn bl no
KnJtIlHlJeCKIIM xapaKTepliCTI1KaM 6hInH 1OCTOBepHo I1UCHTHIIthl 11
conOCT8BHMhl Ha 011l81leHHOM mme H86monell11$1 Mhl nonylliiTH
pe3YJlbT8ThI CXO)Kl1e C llalUlblMH nlnepaTypbl CTeTJelb peCTeH038 0 rpynnc C
CJlTl no c paBHC1i1flO C rpynnoH C MC OK31anaCb HJnKe C BhlCOKHM ypoBlleM
llOCTOoep HOCTIf (PltOOO 1) i-lMID18HTatlHII CJlIl naUHelltaM C BnepBble
BhlJJBneilHbIMII CTCH03aMH KopoHapHbTX apTCpHii YMeithwaCT PI1CK
aHrHOrpacentHleCKoro peCTeH03a B TCIeHHe 14 MecllUCO HB 15 no
CP8BIICHI-lJ) C MC
npoBeueH-Hoe HCCJlellOB3RHC nOKa3aI10 ITO f18H60Ilbwee 1lt0JtHlecTllO
CTCHTOII YCTaH8BJ1KB3erCII B apTepHI lll3MeipOM no 30 MM a IaCTOTa
pecreHoJa MaKCHM3JlhHa HMellHO B 3TOM I1I1TepBaJle KUJm6pa
KOPPeJ1l1UHOHHblH aWlJIH3 3aBHCHMOCTH 1aCTOTbl pecreH03a OT JII3Merpa
CTellTHpyeMoH aprepHH H llJUfHbl nOp3)KeHHoro YIaCTKa n03BOMer CYAHTb 0
npemlyruecrnc CJln ncpcn MC C TO)(l 3peHlfJl pHcKa Pa3BHTlfjl
PecreH030B AHruierp apTeplili 11 l1IHHa nOp3)KeHIDI lJlII creHToB C
8HTHnpoJ11lltigtepaTBBHblM nOKpblTHCM lie Hrpaer CYUlCCTBCHHOK pOJln B
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Pa60laquolR rpynne KOlfTpOl1bHeR rpynna
011lt
JIc
112 4Q~
P-(IoOl
l-oos
J(uarpaMM8 I COOTItOmellHC peHTJeIlMOpcentOnontleCKHlC TImOB creH0308 8 ll8YX
rpyrrnax nll1lHCIITOB (no ACeAHA)
Lam~ble KOJlI11CCTBeRBoro BHaJJI138 CTCtl030B KA no BMCUlaTCnbCTBa B
LlByX rpynnax nBUHCllTOB n penCHUiJ1CHbl B Ta61U~e 2
1
rlyuna] CJlU
rl)[IJI 2 Me p
PeljtepeHTHldil IIHaMeTp aptepHH 1M 274plusmnO48 2amp4plusmnO63 nS
npoTllJllCHllOCn CTeH03a MM 193plusmn81 4 J705t5 57 0045
Cre fleHh ItCXOJlloro CTCII03a 797plusmn98 84 5plusmn84 n s
n S - p HeJlOCTOUJgtIIJoI (PgtO05)
TaMHua 2 KOrrHlCCTBCHHLIIl aHarTll3 ItCXOllHbIX CTeH030B B JlByx rpyn nax nauIlCHTOB
HenOCpellClBeHHble PClYJlb18Tbl creHTUpOOaHlfH
n pe)l1naTaUl1l BbUJOJlUella B 369 BMew aTeJlhCTB (n=85) B cnyllUlx
Tpc6YIOll11X LOnOJ1HJlTeJIIHOrO CTCIiTa I1CnOJlb30BaJICR CTellT C
aHaJJo rHIHbl M nOKphITHe~ COOTHOUleHHe TIfIlOB YCTaHOBneHHbIX CTefiTOB
CJInMC COCTaB~lJlO 1117 B pa60lcH rpynne 112 nauweHTIlM co 132
CTeH03liMH HMnJlaJlTJ1 pOBaIlO 139 CHpOJlHMYC-BblllcnllIOLUJ1X CTCHTOB B
10
KOIl-rpOJlbHOM rpyrme 118 nauHCHl8M co 157 CTetf038MI1 HMnn8HTIlpos8HO
] 63 ronOMeTaJJJJWICCKHX C1CIITa
B T86nHUc 3 rrpencTaBneHO pacnpcneyCHHC HMDnaJITHpoB8HHblX
CTClfTOB HCXOnraquo H3 )ll1aMCTpa CTCHTa a TlIKJKC CpC)l1U1H )lHaMeTp CreUTOB B
KaJKlIOH 113 rpyn n
CJfD 0=139 (JOO Y)
MC 0=163 (100 Yo)
P
25 n () 30 (2 16) 39 (239) ns
275 MM n (Yo) 76 (547) 84 (515) lLS
30 MOl n W) 21 (1 5 1) 2S (153) ns
35 M~ n (~cl) 12 (86) 15 (92) ns
Cpermn lI)lllMeTp 101M 284plusmnO28 186plusmn034 ns
n t _- pIl1UItPI tteAO108epltw ~05 D - ICMlIIecrtO CT(if18
TaMH LIlt 3 COOTHoweHHe KOnHlCCTRlI 1 JUi8MeTpOB CTelnDB 8 lIIIYX rpynnll naJJMeIffOB
Cpe1Helt 3HalCHHe JUlliHbl IfMnJlaJiTKpOBaHUblX CTeHTOB B rpynnc 1
HCCKOJlbKO npeBblwaer aJ1aJ10f1i4Ublii nOKa3aTCnb 80 STOPOH rpynne
(p=O43) CTCIITOB nmtHOH MeHee 18 MM YCTllHOsnCHO 10CTOIlCPHO 60nbwe B
KOHTpoJlbHOH rpyun c naulfCHTOB (P=O027) CTeHTOB )lnIfHOR 60J10C 23 MM
10CTOBCPHO 60nhllle yc-r8HOBJICUO B pa60leH rpynuc (P=O035) (Ta6nKua 4)
em 0=1391100)
MC Il=HIJ (100 )
P
lt18 MM n () 22 (158) 46 (282) 0027 I
18-23MM n () 68 (489) 81 (497 ns I
gt23 101M n (Yo) 49 (353) 36(22 1) 0Q3 5
CpellWllVlHHa 101M 232plusmn31 208plusmn29 0043
DI - pauMIKt MtJlOCT06epHloi (gtO05) n - KOJIRICCTBO cretflO
Ta6ru1ll8 4 COOTHollleHHe KOIlHICCTB8 If 1lIllHJl CTeHTOB BJIlIYX rpynnax nlUilleHTOB
Bee nallfeUThr 6c3 HCK1110lemtJl noJl) 4 antf ~BoliAylQ
aHTItTpOM60UlmpIlYIQ 1C3arperaHTHYIO TepanHlO lacn nSUHCHTOB
11
IlOJl)lIfJlYl I1 HrH6 1nopbl IIblllla rm1KOnp OTCH HOBblX pellCllTOPOB
TpOM60IHTOB (Ta61lJ1U8 5)
r ynna I (CJJD) rfl~nna 2 (MC) P
n~1 12 (100 ) n~118 (100 )
AcnupHH (325 Mr 3a 48 Y3C(8) 112 ( 100) 118 ( 100) ns
T HeIl OOllpIIIlHHJJ (75 Mr M lUI 1a 48 4) 85 (76) 89 (75) ns
T HCIi Oll HPUwtHbl (300 Mr3a 15 4) 27 (24) 29 (25) ns
I1nrn6HTopbl Ubfl lla (1II11p8onep) 6 (5 3) 8 (68) ns
n s - PUlUtIlamp Jte1OCTO~HhI (PgtO05) n - aonUqecna nluuem-o
TaMHua S llC3arperaH1tllll nOllroioBK8 Kp0811 B lByx rpynnax naill1eHTOB
Herrocpe~CTBeHHbrH ycn ex amiddotl rHOrrJIacrHKH COCTaBHn 973 (109
naUHeHTOB 113 112) B nepBoil rpynne 11 966 (114 n8UHeHTOB 113 118) BO
Bropoil rpynnc (PgtO05) CMep TenJHblx HCXOllOB He 6bIJlO uOCTOBepHblX
Pa3JlHlHH 8 pa3BHTHIf OCJIO)KIICIIHM Me)KJlY rpYlm aMH He OTldC4CHO (PgtO05)
KJrHtrnlecKI1 3centlcentCKlHBHOH aHTHOnnaCTlltOOi 0P3HaJi3 y 91 (81l )
n auHellTa 8 ncpBOH rpynne Ii y 95 (806 ) nauHellTOB 80 STOPOH rpyrrne
(Pgt005) (Ta6mllla 6)
rpynna 1 0=112
rpyouI2 n=1I8
p
Ycnex rrpouel1Yp n () 109 (973) 114 (966) ns I
OcnolKnemUl B c-reHTHpOnalUloii aprepHH(TVF) n () 2 (18) 2 ( 17) ns I TpoM603 CTeHTa n () 2 (J 8) 2 ( 17) lLS
Kap)(HM bHble OCnO)f(HeHH~ (MACE) n () 1(09) 2 (1 7) ns
lWcjgtaPKT M HOKllPJla n (J 1 (09) 2 (17) ns
KopoHapHoe WYHTIlposaMHe n (Vo) - - -CMepTb n () - - -LJepe6po-aacK)mtpHble ocnollUicH1Ul n (Vo ) - -
-
-
ns - PlUJllltHa HtlOC1OBepIU (PgtO05~ n - I(OJIHiCCT1M) naWICHTOI
TaMHLl8 6 HcnocpeACTIlcHHble pe3ynbT8Tbl CTelrrl1p0SllHHJI B llByx fllyn nID(
OTIUlJletltlblC PeJYJlbT3TI1 crelfTllpOB3HHH
CpCJlHHH CPOK OTJlanCII lloro Ha6molleHUI 8 JlByX rpynnax 60JthHblX
COc-raBHn 132plusmn263 Mec no HCTCgeHl1H KOTOporo 6bJJ 11 BbJnOJllleHbl
1
HarpYJOlfHIgtIe n po6w C UeJb1O BWIBJJeHHII Hwe~U1H MHOKapIla Ii IT
nOllpo6u bie lJaHlihle 110 OTJlalJCHUblM CpOKllM Ha6mltgtlIeHH51 rrpeJlCTallneHbl II
Tn6nHue 7
rpyrma I (eTTfl) n=1l2 (l00 Yo)
rpynna 2 (Me) D118 (100 0)
p
CpenHHlI CPOK HR6moJreHHi Me( 136plusmn12 129plusmn23 as
MH$OPMallHll nOCl)nHWI no 6 01lbllblM n () 102 (91) 110 (932) ns
06cneJlOB1II0 HlI OTAWleuHOM )Tane n (Yo) 91 (812) 104 (88 1) 0048
KOlllpolhlllll Kr n () 82 (732) 89 (755 ) ])e3 clenokllpolI lI n (Yo) 89 (878) 78 (71) 0Q3
1 - pulHlfftlll lttaOCTOKpUW (pgtoOS) n - mrrn~ecno IWllteHTOJ
TaMUUI 7 KOllWICCTBCHHblC JlalHlIgttC OT1UlJleHIIOrO mUTa cc~eJlOBalII1R
IlposeL1eHHWI Kr BblllBKna pecrCH031J y 29 (137 ) nallHeHTOB
y p oSeH pecreHOJa CTaTHCTIfecKH m3QHMO 6bJ1 HIf)f(e B rpynne c
HMnnaHTIlpoBaRHblMH CJIfI B cpaBHeHMH C KOHTPOfhHoit rpyrrnoH
(PltOOO 1) B rpynne 1 OCHOBHWI 18crb pecTeH0301l nplfXOL1HTClI Ha
npoKcHMaJlbHOIH Kpae CTeHlHpoB8HHOro celMellTa B rpynne 2 pecTeH03
Pa3BIIJICli npeHMymecrncHHo B rpBHHUax CTCIIT3 B 06CI1X rpynnax
H3HMeHbWIUl laCTb pecTCHOJOB COCpeJlOTOlCHa y AHCTaJlbHOro KpM
(Ta6J1l1ua 8)
rpynna I (CJID) n=102 (100 1
rpynna 2 (MC) n1I0(JOO)
p
IgtHH3PHbl A
peCTIfI03
(Yo)
Beem 6 (59) 23 (209) lt0000 1
B f1JRlfHUIIX C1effT8 2 (21) 13(118) lt0000 1
npoKCan~Hbln Kpal 3 P 9) 7 (64) ltOOOJ
IHcTWlhliMn KpRn 1 (09) 3 (27) lt0001
nOTep npocse ra MM 052plusmnO45 1 04~58 lt0001
TpOM6oI creHTll (OImoolUl) n ( ) 4 (36) - lt0001
n porpeccHjXlSaKHe aTepoCl(J1qlO3a n (o) 18(1 76) - --shy-
15 (1 36) ns
1I L - pampUINkJl HetlOCtoaephI (PgtoOS)
Ta6J11tUa 8llallllwe KonHl leCT8eHl1oll rurmorpa4Jllll H3 OTl3IleHHOM ITane
13
B KaTelOplHI nalHellTOB C Ca p eCTeH03 I3 blllBJJ eH y 15 (13 1 Bcex
60fhHbiX C Ca) 60JrbH biX cpeaH KOTOPbl X upe06J1anaml n aUHeHTbl H3
BTOpO~ rpy nnbl ljaCToTa p a3BHTHI pecrcH03a CpelH lI aUHCHTOB C CJ B
nepsoH rpynne cocra BHn a 36 (2 n ar(l~eIlTa) a BO BTOPOH Ip ynne 1S2
(9 naUHeHTOs) (PltOOOI)
HaJl6oJIbWal laCTOTa pecreHo30B B o6clix rpynn ax B03HHKJJa S
MOPIPOnOr H-IecKH CJJOlKHhIX creHo3ax 13 OC06CHHOCUI THnax B2 H C B
Cil)-lae MopcentlonOnflecRH 60nee 6 n ar OnpIHITHoro ll1Ill creli i l1pOSalHul
CTeH03a m Da A pccreHo3a B r pynne om He OTMCCIIO (JlHarpaMMa 2)
~J
~ 6 emiddot~ 4~1 I enn~ middot( -~ 1- -2-shy
gt----J - liS ~ ~~ e 2 D9J -
~
T Tn Bl TnB2 T~n C
llarpa~ma 2 PacnpellCilcHIlC yaCTOThI pecrello3a B 3aSHCl1MOC1H OT MoptKgtnOrHYCCKOrO
TMHa ~ICXOllHOro CTe l103a 8 OTllaneHJ10M nepHOAC
Ha IlHarpaMMe 3 npocnClKlIB3eTCli 06paTH31l 3aBHCHMOCTb
YMcRbm cHHlI aCTO pecTCII03a C YSeJ1HIeHIiCM IlHaMeTpa creHntpyeMoH
apTepHIt B 05CKX rpynnax lJ aCTOTn peCTeHo33 M aKCHMaJlbHa cpeIlH apTepHH
MaJlOro L1HBMeTp a 13 llHaMerpe 35 MM 1aCTOTn pa3BHTHli PCCTCH03a He
BbICOKruJ L10CTOBCptlO He p a3Jl1fQae-rclI MeJIltilY rpy n n 3MH
10 -~
-cnn~ 1-- I ~-----shy~ ~ Me
-~ - -mo
1shy25 111 27SM 30~M 35 WJ
llllarpaMMIi 3 PaClipenel CH ItC ll3CTOTI1 pecreHOJ8 B JaBHCflMOCll1 OT IHalcTpa CTeHT8
14
npll a HaJlH3C Bntll1HHlI JIl1HHbl creHTa Ha 4acrory peCTeH03a o6pmuaeT
Ha ce6l1 BHHMaHHC npM3l1 3aBMCHMOCTb a 06CliX rpynnax B
creiITHpOB3lmbIX CelMCHTax Jllll1li010 6oICC 23 MM pccrCH03bl o6HapY)f(CHbl
B 3 paJa lalUe n pH IfMnJlaHTaUHH KaJlt CM TalC Ii MC B cpaBucHlHl C
KOPOTKHMH CTeH03aMH no 18 MM (IlHarpalMa 4)
0 shya
CI1I1 ~ e 4 t ~~ 2middot1~
e lt 8 amp - 23 gt 23
1Illarp8MMa 4 PacnpellCJICHHC 18ClUfbl pecrCH033 B 3aBliCHMOCTH OT )IJlHHIgt crelmL
KOppCJUIllHORHblii aHIllTH3 aHrHOI-prupHleCKHX peCTeH030B nOKa3aJ1
LITO B rpynne C HMnJlaRTHpoBaHHblMH ClITl KOppeJUlUHOHHaJI 33SHCHMOCTL
MC)f(Jy JlHaMCTpOM CTeHTHposaHHOM apTepl1H H laCTOTO~ PaJlIHTII$
pecreHo38 npaKTHlecKH OTC)TCTByeT (r=0220) B TO BpcMlI KaK B rpvnne
MC CymecTBye-1 IlOCraTOlllO BblCOKall o6paTHaJI 33BHCHMOCTI Mellltly
YJGl3aHHbIMH napaMCTpaMI1 (r=0792) TIp aH8JT113e 3aBHCHMOCTH MC)(JIJ )]J1HHOH HCXOJlHOro nopa)f(eHHlI H
1(3CTOTOil PaJBHTHIl pccrcHOJa B rpyrme C IlMIWaHTHponlUulblMH Me 6blJ1a
Bbl1UlneHa BblCOKaJI n0J10ll(HTeJ1bHaJI KOppelUI1U1lI (r=O819) B rpynnc C CJITI
TaJOKe c)llIecTsyer IltOppcnllUHOHltaJI CB1I3b MClKllY lJ1I1HOH HCXOJlHOrO
CTeH03a 11 tacTOTOH pecrCH03a OJlllaKO pacqen1 o1p3)f(aIOT secbMa
)MepeHHblH ee xapaKTcp (r=O306) Te C TOlKH 3PCHHlI PHCKft pa3BHTHlI
pecrcno30B JlnHIiB nOplllKCItHli JIl1 l1 CJITllle HrpaeT cYlUecTJleHHoH poJ1H KlIJlt
JIl1R M C rpaqlHIeCKRe MOJleJlJ1 LltOpperullij1H JlI13gtIerp3 11 lSCTOThl peCTCII03a
1lJIHHbl Ii laCTOTbl pec-reHo33 npenCTaBJ1eHbl Ha )]HSrpaMM3X 5 11 6
i ~i
[ rp nnu cnn 1 [ipyn Me r
LIllarpsMMiI 5 KoppeJUJUMOIiIUUI 3aSI1CUMOCTh MClIOlY IlJUIMC1pOM creHlllposalllloll
ap-repllll II 18CTOTO~ pS3BIITI1I1 pccreH038
j7PYiinacnn r - rpynna Me~I
T--rmiddotl bull i ~ bull
~ ag 11 +-+1-+--1
1lIIarpaMMa 6 KOppeIlRUIIOHJ11U138SHCKMOCTb MClKIIY J1JHIIIOH UCXOllloro nopiDKellHII Ii
~lICTOTolI Pa3BIITRJI pccreHOJa
B TelCHnC )OHlPOJIMIOro nepHo)]a peKOMeHllOBaHHOLO peJKHMa
JlBOHHOH aHTHarperaHTHOA Tcpamm rrpHlle~IIMJlHCb 90 (882 )
rrSUHCIlTOB H3 rpyIIIIhJ I H 93 (845 ) n3UHeHTll H3 rpynlThl 2 (Ta6nHl3 9)
rpymUlI rpynnl2 p n=l02 =110
~OAHasr alTlll arperalfTHtllI TepaJTHll n () 90 (882) 93(84 5) ns -
98 (96) 106 (964)Acml]lIlH 150 Mrcyr n ( ) ns
THeHonHplUlIIllt 1lVtIlTerullocn TepanHTI Idee 92plusmn21 2 44gt0 11 0032
7S MrcYT I n pHlUnl a1 n n (00) 90 (882) 93 (845) ns ~ -
n ~ -- pUIIlIllHIII ttcJlOCl1VDtpKtl (pgtoOS) n - OJIIJJ~ rnunetrTOIi
Ta6J11IUamp 9 PelKHM JlIlOi1HoR3lrmarpenIJITHoArepalll1H B IlByx rpyn nax n8UHeIITOR I
16
Ha OTJlaJJeHHOM nane LIOKa38BHbJH TPOM603 CTeHTI1poB8HHOro
ccrMCHTa 3altill1KCHpOBaH y 4 (39 ) 6oJJbBblx npl1 4eM 3 m nUICHTOB fibl111113
rpyrmbI C HMrrnallTI1p OBIlH HblMJ1 C JUl OTMeTHM 410 Cp eJlH nal~HeliTOB C
YpoM6030M B nepBoi rpy nne 2 113 3 n8lHCHTOB npCpS8JII1 )lBOHHYIO
aHTHarperaHTHYlo Tepanl1lO 110 p eKOMeHllOB8HHoro CpOK3 B r pynn e CJIT1
OTMeleHO 2 CJly4W1 a B rpy n n c MC 1 CJJylJaH BCKaPJll1aJlbHbIX OCJlO)l(lIeHHH
KOTOPblC Mbl CBJJ3hl BaCM C np HcMoM LIe3arperaliToB
3a Bp eMll I tafiJlIOneHHII YMepJIO 4 (3 9 ) fiOlTbBblX B rpynne I 11 4 (3 6
) B rpyn n e 2 B pa6olei rpynnc OTMClCHO nBC HClltapJlHBJIbHble CMepTH
060 6 uleH HbiC OT)laJIeHHble p e3YJlbTaTbI aHrHOnJlacrnKll npei4CTaBJIetlbl B
Ta6mlUe 10
rpYll1l8 I n-l02
rpynna 2 n110
p
be CTeHOKllPJUIH n () 89 (878) 78 (71) 003
AKnlO rpaltj IOC K llOKll3lIllllbill pecTe1l03 n () 6 (59) 23 (209) lt000 1
PeBacKY~HpH3aI~H Ieneaom creHroa (TLR) n () 5 (49) 20 ( 182) lt000 1
PeBac~mpIf3BUIlR Ho a w CTeH030B (TVR) n () 7 (69) 5 (46) 0044
K OpoRspHoe WYIITllpoeaJfHe n (0) ) (10) 2 (1 8) 0 5
T POM603 CTelrra n () 3 (29) 1 (09) lt0001
I1111lapKT MHOKllPllB n (0) 3 (29) 4 (36) nS
KapnHaJ1bHble OCn O)f(Hflrn (MACE) n () 6 (59) 7 (63) ns
He ~llpllIl2J1bHble ocnOllltHeH Ill 0 () 2 (19) 1 (09) 004
ClotepTb (BCCro) n () 4 (3 9) 4 (36) O S
HCKaPAtlaJI b trQJI CMCpTb n () 2 (1 9) 1 (09) 004 nl_- PIlJmO(I HeJlOcro8epkW (pgtOOS) D ~ KQnUIecno ITIWteHTO
TaMH 118 10 OtQaJlCHHbJCpe3YllhTlITbl CTeIffifPOBaJi HlI B JUlyx rpynnax naUI1CHT08
K ax CJlcuyeT H3 Ta6nHlbl 10 no 1laCTOTC P83BIITHlII1M Ii KaplLHaJI b ~LbX
OClJOlKH ellHH )lOCToBepHblx p 33JJHiHA M~ rpyn nBMIi He BblJJ B11eHO
OllHaKO n o IDeTOTe HcofixonJ1MOCTFI nOBTOp lloii p esaCK)IUIJlH38lHH
npOCJTe)l(HBaeTCII llOCTOBepHoe )BCJlHlJeHHe 0 rpyrrnc C HMTIJIaRTHpOBBH NblMH
Me
I
AHaJlH3 TaKOra BIDKHOro 1I0Ka3BHJHI K8K OeJonaCHOCTb CTCIITOB no
KPHlCPHJIM TpoM603a CTeBTa KOHCOPUIi)MB no AKaneMH4ecKI1 M
HCCJIellOB3llIUlM (ARC) nOKa3aJ1 ITO Aa p aHHHX 3Tanax pamHIIIH no
laCTOTe rpoM603B MeifltlY rpyrtlHlMH He 8bllwnCHO O)lHaKO liB OTllBJICHHOM
cpoKe 38$HKCHpOBaHO HecKonbKo 6omwcc 411CJlO )IOKll3aHHbIX TpoM6030A Il
ncpBolt rpynne XOTlI KOJlHIeCTBO 1l03MO)I(Hb1X TpoM6030B MCJtillY rpyrulaMH
He )lOCTHfJJO 3HBlHMOro Pa3JTRtfHll (rB6JJHI~a 11)
rpynna 1 n1 02
rpynna 2 nUO
p
PalllluA
TpoM60J (0-30t1l1eA)
Bcuo 2 (JIJ) 2 (18) nS uOKa3llllHbIA 2 (1 9 2 ( 18) n1
BepoATItbI Ii - - -1T0000IIHn
Tpo60J pO-365 JlleR)
B~ S (49) 307) 003
JlOKa3aJIHhIA 3 (29) 1(09) 003 I
Bepomu11l 1(09) 0046
BolMOll(Hbifi 2 (19) 1(09) os
ltPieBb nOlJUIHA
TJION60J (gt365 Ulei1)
BCUI (ID) - 0046
[lOtlta38Jillhl A - - - i
BepollTHwA I (1 0) - 0046
BOlMogtKHlgtrll - - -
UTOro l0MlirooB 8 (79) i (45) ltU0l n 5 - Pl1llU I 1VI Kcnoc-roeepIlW (pgtO05) n - fCQJUf4ecno nDWtt-I-1TOt
Tawmua 11 AHaJllt31JXlM6oJa C1CIITa no ARC nllllYX rpynnax 6oJlhHhll
~ nOMOllJhlO MeTO)lHJ(1i oneHKH BblKHOaeMOCTl1 no KanJlaHy-Majjepy
Mbl paCCIIHbIBBJII ofiJUYlO Bbl)KHBaeMOCTb BbnKHBaeMOCTb 6C3 nllKCJJhLX
KapnHaJIbHblX c06bIT11H (MACE) Ii Bbl)l(HOaeMOCTb 6C3 nOBTopHblX
pcsacryJlllpl13allHH (TLR) B TeleBlie 14 MCC$lUCB Ha6molleHHJI
npH aAaJIH3e o6wefi BblJlOlBaeMOCTH B nepHOll Ra6J1lolleHHll Be Obl1l0
BblllBJICHO 3f1a4HMblX p33JIHlHA B PIICKC CMepTH M~ IlB)MlI rpynnaMH
6 0JJbHblX KpHBbl e BbllKHBaeMOCTH 6C3 TlllKeJlblX Kap)lHaJJbllblX C06blTl~H
(cepnClHaJI CMepTb HM onepauHSl Kill) HMCJJH TeRlleHllHIO K paCXO)J(llCHHIO
nOCJJe 4 MCCSlUCB Ha6 J1IOncHHJI Ol1H aKO MC)I(Jly rpynnaMH C
11
18
IfMnnatiTIlpoaaHHblM Cfln H MC Pa3InI II1H no qaCrOTe BCTpelaeMOCTH
cOBoKynHoCTII lIe6naronpl111TllbiX KapuHaJIbHhlX OCJIO)KHCHH H BblllBnellO He
6 Mno (nHarpaMMa 6)
shy ~ ~ w
I n ~ I
1 _Uti~ J _em ~ C~ Iej u ---J i __ -lt --~- _ ---- -
u 1 r ----rshyr-c 1
)--- shy I I Ia n 1~~r1r amp e is 1~~ ~
06lJ1llJ BbJ)j(IIBBeMOCTh BbilKlIBlleMOCTh 6e3 KlIPlll aJI bHblX Oc10llmeHHH
llHarpa~ma 4 BbllRHOaeMOCTb nauHelITOS B lilYgt rpynnax no Kannatlymiddot MaAcpy
H a IlHarpaMMe 7 n p eucT8BJ1CHa BbLliOiBaeMOCTb B o6eRX rpyllnax fie3
Heo6xollHMOCTH nOBTOpH bX peBacK)J111pI13al1HH ueneBOro CTeH03a K pHBhle
BbI)KHBaeMOCTI1 P830lliJIHCb qepe3 3 MeOIua lla6Jl10lleHIDI (P=O06)
craTHCTHJeCKI1 3HatntMOe pacXO)fJlCHHe Me)KJO H3YlacMblMH rpynnam
3acentHKcHpoBaHo K 9 Mec$IUaM (PltOOO I) P IfCK cMeprn 6e3
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roJ10McnIl1H-ICCKHMH CTCHTaMH B oco6eHHoCTH npn npoNl)JellllblX
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pecreHo33 nplleMIlCMblc pe3YJllT3Tbi MOryl 6b1Tb nOJJytel-lbl npH
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3 npIMcHeHHe CTeIITOB C JJCK8pctBeHHblM nOKpbmtCM He OKa3bl8aer
3HaHlMOfO nOnO)I(ITCJibHoro 3Q1Q1elCTa Ha 06IlY1O Bbl)(HBaCMOCTb
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5 B Cll)IBC HMnilBHTBlHH CTeHTa C n eKapCTBeHl l blM n OKpbITHeM Bpa4 II
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JlCTaJlbHbLX IICXO)lOB CBSlJaHHblX C npl1CMOM oemrpcraHTIlblX nOl lHoueHlloA llBOHIIOH 8HTHTpoM60LUlTspHo i1 TepanHH H eCnl1
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3 B03MO)KTIOCTb HMIlJJ8HT8LIHH CTeHTll 6e3 JlCKapcTBclmoro 1l0KpblTHIi 3 AcauOB DA MeJKl(YHapolHbIH OTIblT npHMeHCIiH5I middot CTeHTOB
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4 iloCile HMTIilaHTaWHI nOKp blTOrO JleKapCTBoM CTeIlTa JlBoiffiaJJ - N6 - C 11middot-16
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OnepaTHBliblX BMewaTeJlbCTB Ii mo6 blX Hll Ll X COCTOSlHHA NQ6 - C 3- 9
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24
5 4HrorHmc HA JltpcentCK1HBlIOCTb KopollapHoH aHrHOnnaCTHKH C
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6 tIHrOlYlQ3C HA H aw onblT no npl1MeHCHHIO CTeHTOB C Jl eKapCTBcHHbIMH
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NQ3 - C 116
7 ])oKep HlI JlA PC3yfJhTaTbl 3HllOB8CKYJllIPHOro JIeqeHI1Ji C
I1CllOJl b30BaH l1eM CTCHTOB C aHTIlllpOnHcent epaTHBHblM nOKpblTHCM Y
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8 lJ lirOrHll3C llA B JIHSIHHC Mera6 oJIH4 ecKoro CJoIHnpoMa Ha PC3YJlbTaTbl
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11M AH oaKYIlesa PA MH - 2008 - T9 - NQ6 - C 207
8
CTeHTbl C neKapcrBeHHblM nOKpblTHeM (311 nepJlon C 1mBap li 2005 r - M3pT
2007 r) BO STOPYIO (KOIITPOIlhHYIO) rpynny fiblIlO BKJU()LJeHO 118
IlRUHeHTOB KOTOPblM 6hIJm YCTaHOBnellbl f0J10MeTdJlJIliLJecKl1e MaTpHIHble
CTCHTbl (38 nCpHOJl c fgteBP8IU 2005 r - neKa6pb 2Q()6 r)
npoScpKa CTaTHCTlflJecKHX ntnOTe3 110 BeeM nOKa38TeIlIM
CBHLeTenbCTBYeT 0 BblCOKOM yposm OnHOponHOCTH JlBYX rpynn nRUHCHTOB
no $8K1opa1 pHcKa 0606JleIlHble n8BHble n o centalI-ropaM pHcKa B 06efix
rpyrmax npenCTaBllelibl H8 TafiJlHlte 1
rpynna I (CJlIT) rpynoa 2 (Me) pn3 118 (100 Ok)n=l12 (100 0)
55 Io IO511CT ns52711 23B031aCT lIeT
92 (78) nS 76 (678) M)K41ltHhI n () 39 (33) 35 (322) nsKypeKl1e n (~~)
71 (602) 67 (598) nsAPTCllHaT1bllWl nmeprelnlll n (Yo) 42 (356) ns i43 (384)AIICmlnllJeMIIII n () 37 (31 5)35 (312) CaxapttblR Jllla6eT n (0) ns I 39 (33) 36 (312) ns2l1llpelUte ~()
01 - piIlAHCKJI IteIlOCrtgtBeP1fW (PgtO05 n - ItOJfIJlfeCr8O nlUHeUTO
Ta(iJIllua I Xap8klepUCTHX3 JIBYX rpynn naUlfe~rroB no $alITOpal pllcKa
LVilfTenbHoCTb 3a60nellamtll H6C CpcnH nauJlCHTOB rpynnbl C CJITl
Kone6aTJaCb OT 4 MCCllIeB JlO 8 n eT s rpynnc c Me OT 2 MeC51l(eB no 6 llCT
nOlaBnJllOwce UfCJ10 nRUlietlTOB l0 BMcruaTenbCTB8 HMeno JUlIHIKY
CTellOKaplHH COOTBeTCTBYlOmylO n JI III lt1gtK OOUlee lHCJlO flaUHeHTOB (0
CH II lt1gtK OOCTaBl1JIO )03 (448 Yo) co CH III ltW - 116 (504 ) OT 06wero
1J1CJla naul1eHTOB BKJUOIeHHblX B I1CCJlenOBaIlHC ITo lt1gtK CTclloKapnHH 06e
rpynnM naUIiCHTOB B BblCOKOH CTCneHiI ODHOponHbI PH CTaTHCTIilCCKOH
06pa60TKc JlOCTOBepliblX P83JIHfHH BbUIBJleHO He 6b1J1o (PgtOOS) IToKa3aTeJlb
C2gtB JDK Konc68J1Cli OT 40 lO 62 (B cpcnHeM 473plusmn51 ) YMepefillO
CHKJ(CHlltul laquo 50 ) C2gtB JOK BbUlBlJCna y 37 (415 ) nRUHeHTOB B rpynne I
(s cpenHeM 456plusmn27 ) H Y 48 (407 ) naUi~eHTOB B rpynne 2 (B cperHleM
449plusmn51 ) (Pgt)05)
9
Auaruu JlBllllblX KopoHapol-pacJlHJJ
B pa6olfel1 rpY ll lIC y 11 2 naUHCHTOB BbJJUlJIeHO 132 CTeH038 KA B
KOImiddotrrponbHoH rpYU lle 157 CTCH030B Y 118 naJlHeHTOB LayxcocYLlHCTWC
n Op a)f(eHHll B KOH1pOJl bHOH rpynnc n aUHeHTOB BblllBnllJlHCb B cpeJlHeM B 18
p83 1aJi(C (P=O02) COoTHo lueHHe TImOB CTCH030B KA (no AHAACC) B
nBYX rpynnax n auHCWTOBlO BMewaTe1bCTBa orpIDKellO 118 nHarpaMMe 1
Pa60laquolR rpynne KOlfTpOl1bHeR rpynna
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rpyrrnax nll1lHCIITOB (no ACeAHA)
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LlByX rpynnax nBUHCllTOB n penCHUiJ1CHbl B Ta61U~e 2
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npoTllJllCHllOCn CTeH03a MM 193plusmn81 4 J705t5 57 0045
Cre fleHh ItCXOJlloro CTCII03a 797plusmn98 84 5plusmn84 n s
n S - p HeJlOCTOUJgtIIJoI (PgtO05)
TaMHua 2 KOrrHlCCTBCHHLIIl aHarTll3 ItCXOllHbIX CTeH030B B JlByx rpyn nax nauIlCHTOB
HenOCpellClBeHHble PClYJlb18Tbl creHTUpOOaHlfH
n pe)l1naTaUl1l BbUJOJlUella B 369 BMew aTeJlhCTB (n=85) B cnyllUlx
Tpc6YIOll11X LOnOJ1HJlTeJIIHOrO CTCIiTa I1CnOJlb30BaJICR CTellT C
aHaJJo rHIHbl M nOKphITHe~ COOTHOUleHHe TIfIlOB YCTaHOBneHHbIX CTefiTOB
CJInMC COCTaB~lJlO 1117 B pa60lcH rpynne 112 nauweHTIlM co 132
CTeH03liMH HMnJlaJlTJ1 pOBaIlO 139 CHpOJlHMYC-BblllcnllIOLUJ1X CTCHTOB B
10
KOIl-rpOJlbHOM rpyrme 118 nauHCHl8M co 157 CTetf038MI1 HMnn8HTIlpos8HO
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CTClfTOB HCXOnraquo H3 )ll1aMCTpa CTCHTa a TlIKJKC CpC)l1U1H )lHaMeTp CreUTOB B
KaJKlIOH 113 rpyn n
CJfD 0=139 (JOO Y)
MC 0=163 (100 Yo)
P
25 n () 30 (2 16) 39 (239) ns
275 MM n (Yo) 76 (547) 84 (515) lLS
30 MOl n W) 21 (1 5 1) 2S (153) ns
35 M~ n (~cl) 12 (86) 15 (92) ns
Cpermn lI)lllMeTp 101M 284plusmnO28 186plusmn034 ns
n t _- pIl1UItPI tteAO108epltw ~05 D - ICMlIIecrtO CT(if18
TaMH LIlt 3 COOTHoweHHe KOnHlCCTRlI 1 JUi8MeTpOB CTelnDB 8 lIIIYX rpynnll naJJMeIffOB
Cpe1Helt 3HalCHHe JUlliHbl IfMnJlaJiTKpOBaHUblX CTeHTOB B rpynnc 1
HCCKOJlbKO npeBblwaer aJ1aJ10f1i4Ublii nOKa3aTCnb 80 STOPOH rpynne
(p=O43) CTCIITOB nmtHOH MeHee 18 MM YCTllHOsnCHO 10CTOIlCPHO 60nbwe B
KOHTpoJlbHOH rpyun c naulfCHTOB (P=O027) CTeHTOB )lnIfHOR 60J10C 23 MM
10CTOBCPHO 60nhllle yc-r8HOBJICUO B pa60leH rpynuc (P=O035) (Ta6nKua 4)
em 0=1391100)
MC Il=HIJ (100 )
P
lt18 MM n () 22 (158) 46 (282) 0027 I
18-23MM n () 68 (489) 81 (497 ns I
gt23 101M n (Yo) 49 (353) 36(22 1) 0Q3 5
CpellWllVlHHa 101M 232plusmn31 208plusmn29 0043
DI - pauMIKt MtJlOCT06epHloi (gtO05) n - KOJIRICCTBO cretflO
Ta6ru1ll8 4 COOTHollleHHe KOIlHICCTB8 If 1lIllHJl CTeHTOB BJIlIYX rpynnax nlUilleHTOB
Bee nallfeUThr 6c3 HCK1110lemtJl noJl) 4 antf ~BoliAylQ
aHTItTpOM60UlmpIlYIQ 1C3arperaHTHYIO TepanHlO lacn nSUHCHTOB
11
IlOJl)lIfJlYl I1 HrH6 1nopbl IIblllla rm1KOnp OTCH HOBblX pellCllTOPOB
TpOM60IHTOB (Ta61lJ1U8 5)
r ynna I (CJJD) rfl~nna 2 (MC) P
n~1 12 (100 ) n~118 (100 )
AcnupHH (325 Mr 3a 48 Y3C(8) 112 ( 100) 118 ( 100) ns
T HeIl OOllpIIIlHHJJ (75 Mr M lUI 1a 48 4) 85 (76) 89 (75) ns
T HCIi Oll HPUwtHbl (300 Mr3a 15 4) 27 (24) 29 (25) ns
I1nrn6HTopbl Ubfl lla (1II11p8onep) 6 (5 3) 8 (68) ns
n s - PUlUtIlamp Jte1OCTO~HhI (PgtO05) n - aonUqecna nluuem-o
TaMHua S llC3arperaH1tllll nOllroioBK8 Kp0811 B lByx rpynnax naill1eHTOB
Herrocpe~CTBeHHbrH ycn ex amiddotl rHOrrJIacrHKH COCTaBHn 973 (109
naUHeHTOB 113 112) B nepBoil rpynne 11 966 (114 n8UHeHTOB 113 118) BO
Bropoil rpynnc (PgtO05) CMep TenJHblx HCXOllOB He 6bIJlO uOCTOBepHblX
Pa3JlHlHH 8 pa3BHTHIf OCJIO)KIICIIHM Me)KJlY rpYlm aMH He OTldC4CHO (PgtO05)
KJrHtrnlecKI1 3centlcentCKlHBHOH aHTHOnnaCTlltOOi 0P3HaJi3 y 91 (81l )
n auHellTa 8 ncpBOH rpynne Ii y 95 (806 ) nauHellTOB 80 STOPOH rpyrrne
(Pgt005) (Ta6mllla 6)
rpynna 1 0=112
rpyouI2 n=1I8
p
Ycnex rrpouel1Yp n () 109 (973) 114 (966) ns I
OcnolKnemUl B c-reHTHpOnalUloii aprepHH(TVF) n () 2 (18) 2 ( 17) ns I TpoM603 CTeHTa n () 2 (J 8) 2 ( 17) lLS
Kap)(HM bHble OCnO)f(HeHH~ (MACE) n () 1(09) 2 (1 7) ns
lWcjgtaPKT M HOKllPJla n (J 1 (09) 2 (17) ns
KopoHapHoe WYHTIlposaMHe n (Vo) - - -CMepTb n () - - -LJepe6po-aacK)mtpHble ocnollUicH1Ul n (Vo ) - -
-
-
ns - PlUJllltHa HtlOC1OBepIU (PgtO05~ n - I(OJIHiCCT1M) naWICHTOI
TaMHLl8 6 HcnocpeACTIlcHHble pe3ynbT8Tbl CTelrrl1p0SllHHJI B llByx fllyn nID(
OTIUlJletltlblC PeJYJlbT3TI1 crelfTllpOB3HHH
CpCJlHHH CPOK OTJlanCII lloro Ha6molleHUI 8 JlByX rpynnax 60JthHblX
COc-raBHn 132plusmn263 Mec no HCTCgeHl1H KOTOporo 6bJJ 11 BbJnOJllleHbl
1
HarpYJOlfHIgtIe n po6w C UeJb1O BWIBJJeHHII Hwe~U1H MHOKapIla Ii IT
nOllpo6u bie lJaHlihle 110 OTJlalJCHUblM CpOKllM Ha6mltgtlIeHH51 rrpeJlCTallneHbl II
Tn6nHue 7
rpyrma I (eTTfl) n=1l2 (l00 Yo)
rpynna 2 (Me) D118 (100 0)
p
CpenHHlI CPOK HR6moJreHHi Me( 136plusmn12 129plusmn23 as
MH$OPMallHll nOCl)nHWI no 6 01lbllblM n () 102 (91) 110 (932) ns
06cneJlOB1II0 HlI OTAWleuHOM )Tane n (Yo) 91 (812) 104 (88 1) 0048
KOlllpolhlllll Kr n () 82 (732) 89 (755 ) ])e3 clenokllpolI lI n (Yo) 89 (878) 78 (71) 0Q3
1 - pulHlfftlll lttaOCTOKpUW (pgtoOS) n - mrrn~ecno IWllteHTOJ
TaMUUI 7 KOllWICCTBCHHblC JlalHlIgttC OT1UlJleHIIOrO mUTa cc~eJlOBalII1R
IlposeL1eHHWI Kr BblllBKna pecrCH031J y 29 (137 ) nallHeHTOB
y p oSeH pecreHOJa CTaTHCTIfecKH m3QHMO 6bJ1 HIf)f(e B rpynne c
HMnnaHTIlpoBaRHblMH CJIfI B cpaBHeHMH C KOHTPOfhHoit rpyrrnoH
(PltOOO 1) B rpynne 1 OCHOBHWI 18crb pecTeH0301l nplfXOL1HTClI Ha
npoKcHMaJlbHOIH Kpae CTeHlHpoB8HHOro celMellTa B rpynne 2 pecTeH03
Pa3BIIJICli npeHMymecrncHHo B rpBHHUax CTCIIT3 B 06CI1X rpynnax
H3HMeHbWIUl laCTb pecTCHOJOB COCpeJlOTOlCHa y AHCTaJlbHOro KpM
(Ta6J1l1ua 8)
rpynna I (CJID) n=102 (100 1
rpynna 2 (MC) n1I0(JOO)
p
IgtHH3PHbl A
peCTIfI03
(Yo)
Beem 6 (59) 23 (209) lt0000 1
B f1JRlfHUIIX C1effT8 2 (21) 13(118) lt0000 1
npoKCan~Hbln Kpal 3 P 9) 7 (64) ltOOOJ
IHcTWlhliMn KpRn 1 (09) 3 (27) lt0001
nOTep npocse ra MM 052plusmnO45 1 04~58 lt0001
TpOM6oI creHTll (OImoolUl) n ( ) 4 (36) - lt0001
n porpeccHjXlSaKHe aTepoCl(J1qlO3a n (o) 18(1 76) - --shy-
15 (1 36) ns
1I L - pampUINkJl HetlOCtoaephI (PgtoOS)
Ta6J11tUa 8llallllwe KonHl leCT8eHl1oll rurmorpa4Jllll H3 OTl3IleHHOM ITane
13
B KaTelOplHI nalHellTOB C Ca p eCTeH03 I3 blllBJJ eH y 15 (13 1 Bcex
60fhHbiX C Ca) 60JrbH biX cpeaH KOTOPbl X upe06J1anaml n aUHeHTbl H3
BTOpO~ rpy nnbl ljaCToTa p a3BHTHI pecrcH03a CpelH lI aUHCHTOB C CJ B
nepsoH rpynne cocra BHn a 36 (2 n ar(l~eIlTa) a BO BTOPOH Ip ynne 1S2
(9 naUHeHTOs) (PltOOOI)
HaJl6oJIbWal laCTOTa pecreHo30B B o6clix rpynn ax B03HHKJJa S
MOPIPOnOr H-IecKH CJJOlKHhIX creHo3ax 13 OC06CHHOCUI THnax B2 H C B
Cil)-lae MopcentlonOnflecRH 60nee 6 n ar OnpIHITHoro ll1Ill creli i l1pOSalHul
CTeH03a m Da A pccreHo3a B r pynne om He OTMCCIIO (JlHarpaMMa 2)
~J
~ 6 emiddot~ 4~1 I enn~ middot( -~ 1- -2-shy
gt----J - liS ~ ~~ e 2 D9J -
~
T Tn Bl TnB2 T~n C
llarpa~ma 2 PacnpellCilcHIlC yaCTOThI pecrello3a B 3aSHCl1MOC1H OT MoptKgtnOrHYCCKOrO
TMHa ~ICXOllHOro CTe l103a 8 OTllaneHJ10M nepHOAC
Ha IlHarpaMMe 3 npocnClKlIB3eTCli 06paTH31l 3aBHCHMOCTb
YMcRbm cHHlI aCTO pecTCII03a C YSeJ1HIeHIiCM IlHaMeTpa creHntpyeMoH
apTepHIt B 05CKX rpynnax lJ aCTOTn peCTeHo33 M aKCHMaJlbHa cpeIlH apTepHH
MaJlOro L1HBMeTp a 13 llHaMerpe 35 MM 1aCTOTn pa3BHTHli PCCTCH03a He
BbICOKruJ L10CTOBCptlO He p a3Jl1fQae-rclI MeJIltilY rpy n n 3MH
10 -~
-cnn~ 1-- I ~-----shy~ ~ Me
-~ - -mo
1shy25 111 27SM 30~M 35 WJ
llllarpaMMIi 3 PaClipenel CH ItC ll3CTOTI1 pecreHOJ8 B JaBHCflMOCll1 OT IHalcTpa CTeHT8
14
npll a HaJlH3C Bntll1HHlI JIl1HHbl creHTa Ha 4acrory peCTeH03a o6pmuaeT
Ha ce6l1 BHHMaHHC npM3l1 3aBMCHMOCTb a 06CliX rpynnax B
creiITHpOB3lmbIX CelMCHTax Jllll1li010 6oICC 23 MM pccrCH03bl o6HapY)f(CHbl
B 3 paJa lalUe n pH IfMnJlaHTaUHH KaJlt CM TalC Ii MC B cpaBucHlHl C
KOPOTKHMH CTeH03aMH no 18 MM (IlHarpalMa 4)
0 shya
CI1I1 ~ e 4 t ~~ 2middot1~
e lt 8 amp - 23 gt 23
1Illarp8MMa 4 PacnpellCJICHHC 18ClUfbl pecrCH033 B 3aBliCHMOCTH OT )IJlHHIgt crelmL
KOppCJUIllHORHblii aHIllTH3 aHrHOI-prupHleCKHX peCTeH030B nOKa3aJ1
LITO B rpynne C HMnJlaRTHpoBaHHblMH ClITl KOppeJUlUHOHHaJI 33SHCHMOCTL
MC)f(Jy JlHaMCTpOM CTeHTHposaHHOM apTepl1H H laCTOTO~ PaJlIHTII$
pecreHo38 npaKTHlecKH OTC)TCTByeT (r=0220) B TO BpcMlI KaK B rpvnne
MC CymecTBye-1 IlOCraTOlllO BblCOKall o6paTHaJI 33BHCHMOCTI Mellltly
YJGl3aHHbIMH napaMCTpaMI1 (r=0792) TIp aH8JT113e 3aBHCHMOCTH MC)(JIJ )]J1HHOH HCXOJlHOro nopa)f(eHHlI H
1(3CTOTOil PaJBHTHIl pccrcHOJa B rpyrme C IlMIWaHTHponlUulblMH Me 6blJ1a
Bbl1UlneHa BblCOKaJI n0J10ll(HTeJ1bHaJI KOppelUI1U1lI (r=O819) B rpynnc C CJITI
TaJOKe c)llIecTsyer IltOppcnllUHOHltaJI CB1I3b MClKllY lJ1I1HOH HCXOJlHOrO
CTeH03a 11 tacTOTOH pecrCH03a OJlllaKO pacqen1 o1p3)f(aIOT secbMa
)MepeHHblH ee xapaKTcp (r=O306) Te C TOlKH 3PCHHlI PHCKft pa3BHTHlI
pecrcno30B JlnHIiB nOplllKCItHli JIl1 l1 CJITllle HrpaeT cYlUecTJleHHoH poJ1H KlIJlt
JIl1R M C rpaqlHIeCKRe MOJleJlJ1 LltOpperullij1H JlI13gtIerp3 11 lSCTOThl peCTCII03a
1lJIHHbl Ii laCTOTbl pec-reHo33 npenCTaBJ1eHbl Ha )]HSrpaMM3X 5 11 6
i ~i
[ rp nnu cnn 1 [ipyn Me r
LIllarpsMMiI 5 KoppeJUJUMOIiIUUI 3aSI1CUMOCTh MClIOlY IlJUIMC1pOM creHlllposalllloll
ap-repllll II 18CTOTO~ pS3BIITI1I1 pccreH038
j7PYiinacnn r - rpynna Me~I
T--rmiddotl bull i ~ bull
~ ag 11 +-+1-+--1
1lIIarpaMMa 6 KOppeIlRUIIOHJ11U138SHCKMOCTb MClKIIY J1JHIIIOH UCXOllloro nopiDKellHII Ii
~lICTOTolI Pa3BIITRJI pccreHOJa
B TelCHnC )OHlPOJIMIOro nepHo)]a peKOMeHllOBaHHOLO peJKHMa
JlBOHHOH aHTHarperaHTHOA Tcpamm rrpHlle~IIMJlHCb 90 (882 )
rrSUHCIlTOB H3 rpyIIIIhJ I H 93 (845 ) n3UHeHTll H3 rpynlThl 2 (Ta6nHl3 9)
rpymUlI rpynnl2 p n=l02 =110
~OAHasr alTlll arperalfTHtllI TepaJTHll n () 90 (882) 93(84 5) ns -
98 (96) 106 (964)Acml]lIlH 150 Mrcyr n ( ) ns
THeHonHplUlIIllt 1lVtIlTerullocn TepanHTI Idee 92plusmn21 2 44gt0 11 0032
7S MrcYT I n pHlUnl a1 n n (00) 90 (882) 93 (845) ns ~ -
n ~ -- pUIIlIllHIII ttcJlOCl1VDtpKtl (pgtoOS) n - OJIIJJ~ rnunetrTOIi
Ta6J11IUamp 9 PelKHM JlIlOi1HoR3lrmarpenIJITHoArepalll1H B IlByx rpyn nax n8UHeIITOR I
16
Ha OTJlaJJeHHOM nane LIOKa38BHbJH TPOM603 CTeHTI1poB8HHOro
ccrMCHTa 3altill1KCHpOBaH y 4 (39 ) 6oJJbBblx npl1 4eM 3 m nUICHTOB fibl111113
rpyrmbI C HMrrnallTI1p OBIlH HblMJ1 C JUl OTMeTHM 410 Cp eJlH nal~HeliTOB C
YpoM6030M B nepBoi rpy nne 2 113 3 n8lHCHTOB npCpS8JII1 )lBOHHYIO
aHTHarperaHTHYlo Tepanl1lO 110 p eKOMeHllOB8HHoro CpOK3 B r pynn e CJIT1
OTMeleHO 2 CJly4W1 a B rpy n n c MC 1 CJJylJaH BCKaPJll1aJlbHbIX OCJlO)l(lIeHHH
KOTOPblC Mbl CBJJ3hl BaCM C np HcMoM LIe3arperaliToB
3a Bp eMll I tafiJlIOneHHII YMepJIO 4 (3 9 ) fiOlTbBblX B rpynne I 11 4 (3 6
) B rpyn n e 2 B pa6olei rpynnc OTMClCHO nBC HClltapJlHBJIbHble CMepTH
060 6 uleH HbiC OT)laJIeHHble p e3YJlbTaTbI aHrHOnJlacrnKll npei4CTaBJIetlbl B
Ta6mlUe 10
rpYll1l8 I n-l02
rpynna 2 n110
p
be CTeHOKllPJUIH n () 89 (878) 78 (71) 003
AKnlO rpaltj IOC K llOKll3lIllllbill pecTe1l03 n () 6 (59) 23 (209) lt000 1
PeBacKY~HpH3aI~H Ieneaom creHroa (TLR) n () 5 (49) 20 ( 182) lt000 1
PeBac~mpIf3BUIlR Ho a w CTeH030B (TVR) n () 7 (69) 5 (46) 0044
K OpoRspHoe WYIITllpoeaJfHe n (0) ) (10) 2 (1 8) 0 5
T POM603 CTelrra n () 3 (29) 1 (09) lt0001
I1111lapKT MHOKllPllB n (0) 3 (29) 4 (36) nS
KapnHaJ1bHble OCn O)f(Hflrn (MACE) n () 6 (59) 7 (63) ns
He ~llpllIl2J1bHble ocnOllltHeH Ill 0 () 2 (19) 1 (09) 004
ClotepTb (BCCro) n () 4 (3 9) 4 (36) O S
HCKaPAtlaJI b trQJI CMCpTb n () 2 (1 9) 1 (09) 004 nl_- PIlJmO(I HeJlOcro8epkW (pgtOOS) D ~ KQnUIecno ITIWteHTO
TaMH 118 10 OtQaJlCHHbJCpe3YllhTlITbl CTeIffifPOBaJi HlI B JUlyx rpynnax naUI1CHT08
K ax CJlcuyeT H3 Ta6nHlbl 10 no 1laCTOTC P83BIITHlII1M Ii KaplLHaJI b ~LbX
OClJOlKH ellHH )lOCToBepHblx p 33JJHiHA M~ rpyn nBMIi He BblJJ B11eHO
OllHaKO n o IDeTOTe HcofixonJ1MOCTFI nOBTOp lloii p esaCK)IUIJlH38lHH
npOCJTe)l(HBaeTCII llOCTOBepHoe )BCJlHlJeHHe 0 rpyrrnc C HMTIJIaRTHpOBBH NblMH
Me
I
AHaJlH3 TaKOra BIDKHOro 1I0Ka3BHJHI K8K OeJonaCHOCTb CTCIITOB no
KPHlCPHJIM TpoM603a CTeBTa KOHCOPUIi)MB no AKaneMH4ecKI1 M
HCCJIellOB3llIUlM (ARC) nOKa3aJ1 ITO Aa p aHHHX 3Tanax pamHIIIH no
laCTOTe rpoM603B MeifltlY rpyrtlHlMH He 8bllwnCHO O)lHaKO liB OTllBJICHHOM
cpoKe 38$HKCHpOBaHO HecKonbKo 6omwcc 411CJlO )IOKll3aHHbIX TpoM6030A Il
ncpBolt rpynne XOTlI KOJlHIeCTBO 1l03MO)I(Hb1X TpoM6030B MCJtillY rpyrulaMH
He )lOCTHfJJO 3HBlHMOro Pa3JTRtfHll (rB6JJHI~a 11)
rpynna 1 n1 02
rpynna 2 nUO
p
PalllluA
TpoM60J (0-30t1l1eA)
Bcuo 2 (JIJ) 2 (18) nS uOKa3llllHbIA 2 (1 9 2 ( 18) n1
BepoATItbI Ii - - -1T0000IIHn
Tpo60J pO-365 JlleR)
B~ S (49) 307) 003
JlOKa3aJIHhIA 3 (29) 1(09) 003 I
Bepomu11l 1(09) 0046
BolMOll(Hbifi 2 (19) 1(09) os
ltPieBb nOlJUIHA
TJION60J (gt365 Ulei1)
BCUI (ID) - 0046
[lOtlta38Jillhl A - - - i
BepollTHwA I (1 0) - 0046
BOlMogtKHlgtrll - - -
UTOro l0MlirooB 8 (79) i (45) ltU0l n 5 - Pl1llU I 1VI Kcnoc-roeepIlW (pgtO05) n - fCQJUf4ecno nDWtt-I-1TOt
Tawmua 11 AHaJllt31JXlM6oJa C1CIITa no ARC nllllYX rpynnax 6oJlhHhll
~ nOMOllJhlO MeTO)lHJ(1i oneHKH BblKHOaeMOCTl1 no KanJlaHy-Majjepy
Mbl paCCIIHbIBBJII ofiJUYlO Bbl)KHBaeMOCTb BbnKHBaeMOCTb 6C3 nllKCJJhLX
KapnHaJIbHblX c06bIT11H (MACE) Ii Bbl)l(HOaeMOCTb 6C3 nOBTopHblX
pcsacryJlllpl13allHH (TLR) B TeleBlie 14 MCC$lUCB Ha6molleHHJI
npH aAaJIH3e o6wefi BblJlOlBaeMOCTH B nepHOll Ra6J1lolleHHll Be Obl1l0
BblllBJICHO 3f1a4HMblX p33JIHlHA B PIICKC CMepTH M~ IlB)MlI rpynnaMH
6 0JJbHblX KpHBbl e BbllKHBaeMOCTH 6C3 TlllKeJlblX Kap)lHaJJbllblX C06blTl~H
(cepnClHaJI CMepTb HM onepauHSl Kill) HMCJJH TeRlleHllHIO K paCXO)J(llCHHIO
nOCJJe 4 MCCSlUCB Ha6 J1IOncHHJI Ol1H aKO MC)I(Jly rpynnaMH C
11
18
IfMnnatiTIlpoaaHHblM Cfln H MC Pa3InI II1H no qaCrOTe BCTpelaeMOCTH
cOBoKynHoCTII lIe6naronpl111TllbiX KapuHaJIbHhlX OCJIO)KHCHH H BblllBnellO He
6 Mno (nHarpaMMa 6)
shy ~ ~ w
I n ~ I
1 _Uti~ J _em ~ C~ Iej u ---J i __ -lt --~- _ ---- -
u 1 r ----rshyr-c 1
)--- shy I I Ia n 1~~r1r amp e is 1~~ ~
06lJ1llJ BbJ)j(IIBBeMOCTh BbilKlIBlleMOCTh 6e3 KlIPlll aJI bHblX Oc10llmeHHH
llHarpa~ma 4 BbllRHOaeMOCTb nauHelITOS B lilYgt rpynnax no Kannatlymiddot MaAcpy
H a IlHarpaMMe 7 n p eucT8BJ1CHa BbLliOiBaeMOCTb B o6eRX rpyllnax fie3
Heo6xollHMOCTH nOBTOpH bX peBacK)J111pI13al1HH ueneBOro CTeH03a K pHBhle
BbI)KHBaeMOCTI1 P830lliJIHCb qepe3 3 MeOIua lla6Jl10lleHIDI (P=O06)
craTHCTHJeCKI1 3HatntMOe pacXO)fJlCHHe Me)KJO H3YlacMblMH rpynnam
3acentHKcHpoBaHo K 9 Mec$IUaM (PltOOO I) P IfCK cMeprn 6e3
peBacKYMpH33UHIl n OCToBepHO HH)Ke B l Pynn e CJll1 ODHaKO KaK B rpyn n e
C IfMnnswH l poaaHHbIMH Cll n TaK 11 B rpyrrrre C HMnn8HTlfpoBaHHhlMH MC
OCTaerClillOCTaTOlHO HH3KHM
1 ----r
~~ R ur bull -- - - eM
---+- - ----i Me
q ~~~1 ~ ~ n - -+- t
I
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BpetM IU6IW1JQlflIIIIII I AKII
lluarpaMMH 7 Bbl lKflBaeMOCTL 11~lie ll1UB BMYX rpynnax no K8I1JlilH) -MaAepy_
IY
06CY-dlICHUe pnyJJbrarOB
B HalliCM HCCJle10BaIHH llse cqJOPMHpoollHHble rpynn bl no
KnJtIlHlJeCKIIM xapaKTepliCTI1KaM 6hInH 1OCTOBepHo I1UCHTHIIthl 11
conOCT8BHMhl Ha 011l81leHHOM mme H86monell11$1 Mhl nonylliiTH
pe3YJlbT8ThI CXO)Kl1e C llalUlblMH nlnepaTypbl CTeTJelb peCTeH038 0 rpynnc C
CJlTl no c paBHC1i1flO C rpynnoH C MC OK31anaCb HJnKe C BhlCOKHM ypoBlleM
llOCTOoep HOCTIf (PltOOO 1) i-lMID18HTatlHII CJlIl naUHelltaM C BnepBble
BhlJJBneilHbIMII CTCH03aMH KopoHapHbTX apTCpHii YMeithwaCT PI1CK
aHrHOrpacentHleCKoro peCTeH03a B TCIeHHe 14 MecllUCO HB 15 no
CP8BIICHI-lJ) C MC
npoBeueH-Hoe HCCJlellOB3RHC nOKa3aI10 ITO f18H60Ilbwee 1lt0JtHlecTllO
CTCHTOII YCTaH8BJ1KB3erCII B apTepHI lll3MeipOM no 30 MM a IaCTOTa
pecreHoJa MaKCHM3JlhHa HMellHO B 3TOM I1I1TepBaJle KUJm6pa
KOPPeJ1l1UHOHHblH aWlJIH3 3aBHCHMOCTH 1aCTOTbl pecreH03a OT JII3Merpa
CTellTHpyeMoH aprepHH H llJUfHbl nOp3)KeHHoro YIaCTKa n03BOMer CYAHTb 0
npemlyruecrnc CJln ncpcn MC C TO)(l 3peHlfJl pHcKa Pa3BHTlfjl
PecreH030B AHruierp apTeplili 11 l1IHHa nOp3)KeHIDI lJlII creHToB C
8HTHnpoJ11lltigtepaTBBHblM nOKpblTHCM lie Hrpaer CYUlCCTBCHHOK pOJln B
OTJlH lHC 01 CTeIiTOB 6e3 nOKpbITHII
B UCJlOM I1CCne)lOB8HRe nOKa33JlO npeHMYUleCTBo eM npll
CTeHTHPOBJlJIHIi cnO)(HIgtlX creHo30B B TO BpCMII K8Ilt Clm
npCnTIOlTiITellbHCe AJUI npocentKJ181ltTI1KH pec-ren030B npH MOPltigt0J10rHIecKH
CJl0)KHblX Ii rrpoTII)KeHHbIX nopwteeHtd Ii B BpTepHliX M8110ro KaJlH6pa Y
nBl(I-IeHTOB C HH3KfiM BHaTOMHIeCXI1M I-lJIH KJIHHHIecKHM PHCKOM
npHCMJleMble pe3ynbtaTbI MOryT GMTb nonyleHbl II rrpH HMnJ18RTaul1~i
HenOKpbfTblX MeraJIJlHIecKHX CTeHTOB Mhl nOJJaraeM ITO B03MOlKHOCTb
If CIlOnbJOBafllfll HenOKpblTOro neKapCTBOM CTe~lTa 06113aTCJlbHO CJJellye-r
p acCMOTpC1b B KruKllOM KOHKpeTHOM cnylBe
20
l hlCJ10 p ClTC1I030B CpellM 6 0 51HT) C)J CTamCTHlCCKH )lOC1OBCPHO
60Jlb We B r pYTlne B KOTOPOH I1MnmlHTIlpOBaJ1HCh Me (PltOOOl)
D OJ1YleHllbl e )laHHble CBH)lerCJlbCTBYKlT B n OJlb3Y IIpHMeHeHH~ cfln B
OTIIO WCHHH naUl~eHTOB c-rpauruOWH) cn 1l0CKOJTbry HX L(KTOCTanI4ccKHH
3 ltpQleKT HaH60JTee aKryaIleH n p M 3H)lOTeJlHaIlbHOH Jll1cQlYH KlI1I1 KOTOp8JI
Bblpa)(CUa y 3TOH pac npoc-rpaHCHlIOH KaTerop aH 60Jl bHbIX
H ame HcencnOBaliI1C nOKa3bIBaCT ITO n p HMCHCHHC CJID He JlaeT
KaKHX ml60 npCHMyruecrn B laCTOTe pa3BKTHli 11M H CMCPTIWCTI1
( KapllHaJlbHOH H UelltapllHaJ1bHOH) fionce leM 1epe3 r Oll n o cnc HMnnaHTBlUtH
HCCMOTP~ Ha TO ITO cfln HMCIOT HH3KHH PHCK pecrCH0 3a 11 TLR
D PHMCHCIIHC Cml B Hawei1 npaKTHKC He aCCOLlHHpyercll co 3Hall1MOA
pa3HI1L(CH B ofiU-IeH ctlepTHOCTI1 liO CB1I3ruw c YBeJlH4eHHeM HCKapllHaJ1bHblX
OCIlO)KI-ICI-lltll H leraJlbllblX HCXOllOB no cpaBHCHHIO c MC KOTOPblC Mbl
CBl3blBaCM c n pHCMOM JlC3arpCrallTOB npHMCHCHHC CJITl He OKa3blBaer
3Ha4HMoro nonmKHTeJJbHOro 3Q1Q1 eKTa Ha 06myJO BbDKI1BaeMOCTb H p 33BHTHC
KpHTflleCKHX KapllHaJ1bHblX OCJIO)(HCHHH n o cpaBHeHluo C MC 06ulM I1 PHCK
CMCPTl-l Ii KOM6HH ~fJlO BaHHbIH PHCK CMCp1H H 11M npaKTI14CCKH HJleHTHfHbl
)1) 1l1 llayx rpynn 6on bHblx lTO 11 0DTBep)l(JlaeTC~ C n OMOmblO KpHBblX
Bbl)(HBaeMOCTH In lByX HCCnCllyeMblx rpynn 3a n epHon Ha6nlOlleHlHI B 14
MCClIu eB MelKl) naLlHCHTaMH C liMnmlliTHpoaaHHbl1 CJITI H MC I-Ie
BblliBneHO lOCTOBepHblx pa3J1HiHI1 B 06mCM pHCKe CMepTH nocne
3H1l0BaCKYAApHoro nCleHlUI H5C
TIo laCTOTC TpoM603a B PaHHCM nocneonepatJHOHHOM nep HOtlC
p a3nH1HH Me)(Jly r pynnaMH He ltl a6nKlDaJ10Cb Bec enYla~l TpoM603a 6blJlH
3HrHOrpaQlH4eCKil llOKa3aHbl CnYCTli ron n ocne CTeHTHpoB8HHll IHCJlO
TPOM6030B B rpynne CJID JlOCTl-l f JIO CTaTHCTH 4ecKJ1 3HalHMO 50JTbWCl1
BCJUI-HlHbl TlO cpaaHellHTO C rpynno H C MC H a HHTepB3Jle llO rolla 3101
21
IIOKa33TeJIh npeBaJlHpyeT 38 CleT llOKa33HHbiX 1pOM6030B a Ha HHTepBa1lC
BpeMCHl 60nbWC rolla Ja C4er BCPOllTRb1X (npcnnonaraeMblx) 1pOM6030B
C YlCTOM C)llleCTByKllJ-IllX TPYllHOcTell S onpelleJeHHl1 rpoM603a
CTeHTa nOKa3aTenCM 6e30naCHOCTH ItMOJlru-rrallHl1 CTeHTa llOn)(r-ra 61gtITb
43CTOTa CMCp1ROCTH Ii liM 1CM Mbi H PYKOBOllCTBOB3JJHCb B03MOiKHO
3l1rHorpafJH4ccKoc AOlt33aTeJlbCTBO 6b1no 6bl 60nee npelMCTllbIM 1eM
aHaJlH3 lHen8 cMep1ci1 II MM nOTOMY 410 pa3JII1-U1e B laCTOre 1pOM603a B
IIauCM HccnenOBllIIIH1 MO)(CT Olltll3aThCli enYlaliHbIM TpYIDlO ncpeoueHKTb
npH 3TOM POJIL llBoihlOH aJ-lTltarperru-nHOH TepanHH npH HMflIlaH18LU111 cm KOTOPYlO Heo5XO)HfMO npo1l0Jl)(HTb Ha lIeonpeLlenellllOC SpeMlI HO 6oJlbLDCC
4CM 12 MCCSU-CB
BbIBO~hl
1 HMnJlaHTatJHlI CTCHTOB C anTHnponmpepanmRblMR cBOHCTsaMH C
BTlepOblC BbUlBJleHRblMH CTeR03aMH KoponaplihlX ap1cpHA YMeHblll8eT
PHCK aHTliorpaQlHiCCKoro peCTeH033 H BCpollTliOCTb nOBTOpHblX
pCBacryJUlpR3aUHH lcnCBOro CTCll03a no cpaSHeHHIO C
roJ10McnIl1H-ICCKHMH CTCHTaMH B oco6eHHoCTH npn npoNl)JellllblX
nOpIDkCHH1IX cTclfTnpoBaHHH CQcyuOB MaJlOro llHBMeTpa H ) naUliCHTOB
c caxapHblM llUa6eroM
2 Y naUHCHTOB C HH3KHM 8RamMHlecKHM RIlH KnHHHltJCCKHM PHCKOM
pecreHo33 nplleMIlCMblc pe3YJllT3Tbi MOryl 6b1Tb nOJJytel-lbl npH
HMnIlaHTaIHH HeOOlC11 blX MeraJIJ1M-ICCKnX CTeHTOB nOCKOJIbKY
BbDKHB3eMOCTb 6el nOBTOpRblX peaaCK)JIKpH3aUHII B 3TOM CJJylae
ocaercSI JlOCTa1middot04HO BblCOKOit
3 npIMcHeHHe CTeIITOB C JJCK8pctBeHHblM nOKpbmtCM He OKa3bl8aer
3HaHlMOfO nOnO)I(ITCJibHoro 3Q1Q1elCTa Ha 06IlY1O Bbl)(HBaCMOCTb
lacTOTy pa3BflTl1l kapJlHamHblX OCIlOiKHCHI1H H HUQlapKTOB MHOKapJla
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22
5 B Cll)IBC HMnilBHTBlHH CTeHTa C n eKapCTBeHl l blM n OKpbITHeM Bpa4 II
HO yaelJlfHiB8cr BepOSlTHOCTb UeKapLlHaJl bHblX OCJlO)l(HeHHH H llOcryllilOH ltjlopMe uOIJ)Kell 06cY)ll1Tb C n a LlHeHTOM B0 3MO)l(llOCTb
JlCTaJlbHbLX IICXO)lOB CBSlJaHHblX C npl1CMOM oemrpcraHTIlblX nOl lHoueHlloA llBOHIIOH 8HTHTpoM60LUlTspHo i1 TepanHH H eCnl1
npcnapa103 no cpBBlleHHIO C MCrEUIJlH leCKllMH CTCHTaM I1 O)KHJlBClCSI lTO OOJIbHoia no JII06blM npHlWHal npeJKl(eBpeMCIlHO
4 J1cnOJlb30BBHl1e CTeHTOB C aHTlmponMltjlcpaTHBHL1M n OKp blTJiel CBSl391l0 npeKpBnn rrpHeM KJIOnHlorpenl1 )10 lOJOKflO paccMaTpHSBTbCSI KaK
C n OBbfw eHHblM PI1CKOM n03)JlIero TpoMfio 38 npH lIecofimooeHI1H cepbe3HblH apryMcHT B noJJh3) OTKlI3a OT npHMcllellHH CTCHTa
p CJl(HMa JlBOHHOi1 aUTHarperrunHoH TepanHH no c paBHelHlO C BbllCJISlloLUero nel(8pc1 Btl
r OIJOMCTarJJIH 4ecKHMH CTeHTaMH
CUHCOK paliOT onyliJ1UKOBalfHblX no Tete IlHCCepTaQuH
fiPAKTHqECKHEPEKOMEHDAUHH 1 liOKCPHJI 11A nepCnCKTHBbl rrplIMeHeHHJr p8CT80pHMbIX CTefITOB B
1 J1cnOJlb30BaHHC CTemos C nCKapCTBeHHbIM lloKpbrrHeM 1cneco06p83HO neqemrn a-repDCKnepoTHleCKHX 3afi011eBallldi COCYlOB ]lA 60KepHli
y o T06paHHbix 60nbllblx C BblCOKHM PHCKOM PCCTCR03a s laCTHocru X llIeHoom MB ABanHaJlH IiP MaprnpocIIH 3A fyceHlloB
npH MoptjlonOfl1lecKH Hc6naronpHSlTHblX nmax CTCH030B PH aA ACMOB HA QlfrorHJl3e I 61On HllCC X HM AH PaKynes8
CTeHTJ1p0BaHHH cocynoB llHaMerpoM Mcnce 35 MM HnH nnHHoH fionee PAMH-2007 - T8 - HM - C 95- 101
23 MM a TaK)l(e y 60JlbllblX C conyrCTByloLUHM caxapliMM nHafiClOM 2 J)OKCPIiIi JIA PC3YJlbTaThI 3HJlOBacKYnllpHoro lIClCHH$l c 2 Dnll llOCTl1iKeHJUt OTITHMaTlbHbIX HcnocpenCTBeHHblx 11 OTllanCIiHbIX HCnOJTb30aaUHeM CTeHTOB C awmrrpoJllltjlepaTHBHblM nOKpbITHCM Y
p e3yn 6TaToB CICJl)CT YlIeJUlTb oco60e BHHMaHHC npasHlIbHo MY n01l6o py 60nblfblx mneMHIecKoH 601leJHbIO cepJlua C OiKHpeHHe 11A PoKepHll
THJ l a creHTa cro p83MCPa a TaOl(e TeXHHKe cTeHTHpoBaJHlll lTo6 bl M A KaxHTcnaWBHJlU HA lhiror Hl3C )1A AcanoB HIO CwaCD II
MaKCHMEUlbHO y nyqWHTh 3aBHCJllUJle OT ollepaTOpa PC3YJlh TaTbl fpYWiall CCpnC4110-COCYllHCTaII XlIPYPfHJI - 2008 -N2 - C 14-18
3 B03MO)KTIOCTb HMIlJJ8HT8LIHH CTeHTll 6e3 JlCKapcTBclmoro 1l0KpblTHIi 3 AcauOB DA MeJKl(YHapolHbIH OTIblT npHMeHCIiH5I middot CTeHTOB
0 6$l3aTeJlbHO cncLlyeT paccMoTpCTIgt B Ka)I(JlOM KOHKpe1HOM clIyqae c C aHTHnpOilMlpepaTHllHW1H c 80iiCTBaMH (0630p mneparypbl)
YlCTOM Bcex aHrHorpaltjlH leCIOIX H KITlUllI lecKHX naHHblX I uA AcanOB I PIOn HIJCCX HM AH l)axyncBa PAMI-I - 2008 - T9
4 iloCile HMTIilaHTaWHI nOKp blTOrO JleKapCTBoM CTeIlTa JlBoiffiaJJ - N6 - C 11middot-16
aHTHTpOM601KTaPHWI repanHSl JlOJDICHa npOBOIDITbCSI He MeHee 12 41HTOfHJ3e HA BlJHlIllHe MeTa6oJTHfecKOro cHHJpoMa Ha peJynbTaTbI
MecJUCB HO n ocnc TLUaTCJlbllOrO B3seWlIDaHHll ce 3centltjlCKTHBHOCTH H crcHTHpoBaRlofIJ KOpollaplihlX apTepHH BA lIHrorHlJ3C
plfcKa c yqCTOM BCPOllTHOcnt KpDSOTClCHHH nOBbl wcHHOH MA KaKI1TCJlaUJBHnH KB KnIOmHIltOB A M 3aKYT )JW C aMYHilOBa
l)BCTBI1TCJlbHOcnl K acn Hpl1HY liilH KJlO~orpcmo B03MO)KHblX )1A AC3JJOB II Pion HLJC CX 101M AH 6ru-yneB3 PAMH - 2008 - T9 shy
OnepaTHBliblX BMewaTeJlbCTB Ii mo6 blX Hll Ll X COCTOSlHHA NQ6 - C 3- 9
o6YCJIOBJlelfHbfX HapYLlJe~IHeM HMMYHROfi CHCTeMbT
24
5 4HrorHmc HA JltpcentCK1HBlIOCTb KopollapHoH aHrHOnnaCTHKH C
HCnOJIb30BaIlHe)1 CTeHTOB C UI1TOCTaTH1CCKlt)1 IlOKphlTHeM H CTCHTOB 6C3
1l0KPblTW HA LJHromn3c )J A ACaDOB II )IO~~ HUCCX
HM A H 6ayrteBa PAMH - 2007 - T8 - NQ3 - C 11 2
6 tIHrOlYlQ3C HA H aw onblT no npl1MeHCHHIO CTeHTOB C Jl eKapCTBcHHbIMH
CBOHCTBao1H H roJl0MeTIlJIn H4eCKRX CTeHTOB HA llHrorHll3c
nA ACMOS 1 61OJI HUCCX HM AB IiaxyneBa PAM H - 2008 - T9 shy
NQ3 - C 116
7 ])oKep HlI JlA PC3yfJhTaTbl 3HllOB8CKYJllIPHOro JIeqeHI1Ji C
I1CllOJl b30BaH l1eM CTCHTOB C aHTIlllpOnHcent epaTHBHblM nOKpblTHCM Y
6 0JlbHbiX MEC C o)J(HpeHHeM I JIA 6oKepHlI MA KaKI1TenaUlBHJlH
)JA A canoB MlO CHraeB HA LJ llrorHQ3e II 01OJI HllCCX
HM A H EaK)neBa PAM H - 2008 - T9 - NQ3 - C 114
8 lJ lirOrHll3C llA B JIHSIHHC Mera6 oJIH4 ecKoro CJoIHnpoMa Ha PC3YJlbTaTbl
CTeHTl1poBaHI111 KopoHapHblx apTepldi CTeIHaMH C IHTOCTaTH y eC1ltHM
Jl eKapCTBellHblM nOKpbfTHeM I HA lll-lror Hll3e MB K nmiIUIKOD
rUO CJiraeB MA KaxHTenaI1J8HllH )JA A CMOB II EIOJI HlJCCX
11M AH oaKYIlesa PA MH - 2008 - T9 - NQ6 - C 207
10
KOIl-rpOJlbHOM rpyrme 118 nauHCHl8M co 157 CTetf038MI1 HMnn8HTIlpos8HO
] 63 ronOMeTaJJJJWICCKHX C1CIITa
B T86nHUc 3 rrpencTaBneHO pacnpcneyCHHC HMDnaJITHpoB8HHblX
CTClfTOB HCXOnraquo H3 )ll1aMCTpa CTCHTa a TlIKJKC CpC)l1U1H )lHaMeTp CreUTOB B
KaJKlIOH 113 rpyn n
CJfD 0=139 (JOO Y)
MC 0=163 (100 Yo)
P
25 n () 30 (2 16) 39 (239) ns
275 MM n (Yo) 76 (547) 84 (515) lLS
30 MOl n W) 21 (1 5 1) 2S (153) ns
35 M~ n (~cl) 12 (86) 15 (92) ns
Cpermn lI)lllMeTp 101M 284plusmnO28 186plusmn034 ns
n t _- pIl1UItPI tteAO108epltw ~05 D - ICMlIIecrtO CT(if18
TaMH LIlt 3 COOTHoweHHe KOnHlCCTRlI 1 JUi8MeTpOB CTelnDB 8 lIIIYX rpynnll naJJMeIffOB
Cpe1Helt 3HalCHHe JUlliHbl IfMnJlaJiTKpOBaHUblX CTeHTOB B rpynnc 1
HCCKOJlbKO npeBblwaer aJ1aJ10f1i4Ublii nOKa3aTCnb 80 STOPOH rpynne
(p=O43) CTCIITOB nmtHOH MeHee 18 MM YCTllHOsnCHO 10CTOIlCPHO 60nbwe B
KOHTpoJlbHOH rpyun c naulfCHTOB (P=O027) CTeHTOB )lnIfHOR 60J10C 23 MM
10CTOBCPHO 60nhllle yc-r8HOBJICUO B pa60leH rpynuc (P=O035) (Ta6nKua 4)
em 0=1391100)
MC Il=HIJ (100 )
P
lt18 MM n () 22 (158) 46 (282) 0027 I
18-23MM n () 68 (489) 81 (497 ns I
gt23 101M n (Yo) 49 (353) 36(22 1) 0Q3 5
CpellWllVlHHa 101M 232plusmn31 208plusmn29 0043
DI - pauMIKt MtJlOCT06epHloi (gtO05) n - KOJIRICCTBO cretflO
Ta6ru1ll8 4 COOTHollleHHe KOIlHICCTB8 If 1lIllHJl CTeHTOB BJIlIYX rpynnax nlUilleHTOB
Bee nallfeUThr 6c3 HCK1110lemtJl noJl) 4 antf ~BoliAylQ
aHTItTpOM60UlmpIlYIQ 1C3arperaHTHYIO TepanHlO lacn nSUHCHTOB
11
IlOJl)lIfJlYl I1 HrH6 1nopbl IIblllla rm1KOnp OTCH HOBblX pellCllTOPOB
TpOM60IHTOB (Ta61lJ1U8 5)
r ynna I (CJJD) rfl~nna 2 (MC) P
n~1 12 (100 ) n~118 (100 )
AcnupHH (325 Mr 3a 48 Y3C(8) 112 ( 100) 118 ( 100) ns
T HeIl OOllpIIIlHHJJ (75 Mr M lUI 1a 48 4) 85 (76) 89 (75) ns
T HCIi Oll HPUwtHbl (300 Mr3a 15 4) 27 (24) 29 (25) ns
I1nrn6HTopbl Ubfl lla (1II11p8onep) 6 (5 3) 8 (68) ns
n s - PUlUtIlamp Jte1OCTO~HhI (PgtO05) n - aonUqecna nluuem-o
TaMHua S llC3arperaH1tllll nOllroioBK8 Kp0811 B lByx rpynnax naill1eHTOB
Herrocpe~CTBeHHbrH ycn ex amiddotl rHOrrJIacrHKH COCTaBHn 973 (109
naUHeHTOB 113 112) B nepBoil rpynne 11 966 (114 n8UHeHTOB 113 118) BO
Bropoil rpynnc (PgtO05) CMep TenJHblx HCXOllOB He 6bIJlO uOCTOBepHblX
Pa3JlHlHH 8 pa3BHTHIf OCJIO)KIICIIHM Me)KJlY rpYlm aMH He OTldC4CHO (PgtO05)
KJrHtrnlecKI1 3centlcentCKlHBHOH aHTHOnnaCTlltOOi 0P3HaJi3 y 91 (81l )
n auHellTa 8 ncpBOH rpynne Ii y 95 (806 ) nauHellTOB 80 STOPOH rpyrrne
(Pgt005) (Ta6mllla 6)
rpynna 1 0=112
rpyouI2 n=1I8
p
Ycnex rrpouel1Yp n () 109 (973) 114 (966) ns I
OcnolKnemUl B c-reHTHpOnalUloii aprepHH(TVF) n () 2 (18) 2 ( 17) ns I TpoM603 CTeHTa n () 2 (J 8) 2 ( 17) lLS
Kap)(HM bHble OCnO)f(HeHH~ (MACE) n () 1(09) 2 (1 7) ns
lWcjgtaPKT M HOKllPJla n (J 1 (09) 2 (17) ns
KopoHapHoe WYHTIlposaMHe n (Vo) - - -CMepTb n () - - -LJepe6po-aacK)mtpHble ocnollUicH1Ul n (Vo ) - -
-
-
ns - PlUJllltHa HtlOC1OBepIU (PgtO05~ n - I(OJIHiCCT1M) naWICHTOI
TaMHLl8 6 HcnocpeACTIlcHHble pe3ynbT8Tbl CTelrrl1p0SllHHJI B llByx fllyn nID(
OTIUlJletltlblC PeJYJlbT3TI1 crelfTllpOB3HHH
CpCJlHHH CPOK OTJlanCII lloro Ha6molleHUI 8 JlByX rpynnax 60JthHblX
COc-raBHn 132plusmn263 Mec no HCTCgeHl1H KOTOporo 6bJJ 11 BbJnOJllleHbl
1
HarpYJOlfHIgtIe n po6w C UeJb1O BWIBJJeHHII Hwe~U1H MHOKapIla Ii IT
nOllpo6u bie lJaHlihle 110 OTJlalJCHUblM CpOKllM Ha6mltgtlIeHH51 rrpeJlCTallneHbl II
Tn6nHue 7
rpyrma I (eTTfl) n=1l2 (l00 Yo)
rpynna 2 (Me) D118 (100 0)
p
CpenHHlI CPOK HR6moJreHHi Me( 136plusmn12 129plusmn23 as
MH$OPMallHll nOCl)nHWI no 6 01lbllblM n () 102 (91) 110 (932) ns
06cneJlOB1II0 HlI OTAWleuHOM )Tane n (Yo) 91 (812) 104 (88 1) 0048
KOlllpolhlllll Kr n () 82 (732) 89 (755 ) ])e3 clenokllpolI lI n (Yo) 89 (878) 78 (71) 0Q3
1 - pulHlfftlll lttaOCTOKpUW (pgtoOS) n - mrrn~ecno IWllteHTOJ
TaMUUI 7 KOllWICCTBCHHblC JlalHlIgttC OT1UlJleHIIOrO mUTa cc~eJlOBalII1R
IlposeL1eHHWI Kr BblllBKna pecrCH031J y 29 (137 ) nallHeHTOB
y p oSeH pecreHOJa CTaTHCTIfecKH m3QHMO 6bJ1 HIf)f(e B rpynne c
HMnnaHTIlpoBaRHblMH CJIfI B cpaBHeHMH C KOHTPOfhHoit rpyrrnoH
(PltOOO 1) B rpynne 1 OCHOBHWI 18crb pecTeH0301l nplfXOL1HTClI Ha
npoKcHMaJlbHOIH Kpae CTeHlHpoB8HHOro celMellTa B rpynne 2 pecTeH03
Pa3BIIJICli npeHMymecrncHHo B rpBHHUax CTCIIT3 B 06CI1X rpynnax
H3HMeHbWIUl laCTb pecTCHOJOB COCpeJlOTOlCHa y AHCTaJlbHOro KpM
(Ta6J1l1ua 8)
rpynna I (CJID) n=102 (100 1
rpynna 2 (MC) n1I0(JOO)
p
IgtHH3PHbl A
peCTIfI03
(Yo)
Beem 6 (59) 23 (209) lt0000 1
B f1JRlfHUIIX C1effT8 2 (21) 13(118) lt0000 1
npoKCan~Hbln Kpal 3 P 9) 7 (64) ltOOOJ
IHcTWlhliMn KpRn 1 (09) 3 (27) lt0001
nOTep npocse ra MM 052plusmnO45 1 04~58 lt0001
TpOM6oI creHTll (OImoolUl) n ( ) 4 (36) - lt0001
n porpeccHjXlSaKHe aTepoCl(J1qlO3a n (o) 18(1 76) - --shy-
15 (1 36) ns
1I L - pampUINkJl HetlOCtoaephI (PgtoOS)
Ta6J11tUa 8llallllwe KonHl leCT8eHl1oll rurmorpa4Jllll H3 OTl3IleHHOM ITane
13
B KaTelOplHI nalHellTOB C Ca p eCTeH03 I3 blllBJJ eH y 15 (13 1 Bcex
60fhHbiX C Ca) 60JrbH biX cpeaH KOTOPbl X upe06J1anaml n aUHeHTbl H3
BTOpO~ rpy nnbl ljaCToTa p a3BHTHI pecrcH03a CpelH lI aUHCHTOB C CJ B
nepsoH rpynne cocra BHn a 36 (2 n ar(l~eIlTa) a BO BTOPOH Ip ynne 1S2
(9 naUHeHTOs) (PltOOOI)
HaJl6oJIbWal laCTOTa pecreHo30B B o6clix rpynn ax B03HHKJJa S
MOPIPOnOr H-IecKH CJJOlKHhIX creHo3ax 13 OC06CHHOCUI THnax B2 H C B
Cil)-lae MopcentlonOnflecRH 60nee 6 n ar OnpIHITHoro ll1Ill creli i l1pOSalHul
CTeH03a m Da A pccreHo3a B r pynne om He OTMCCIIO (JlHarpaMMa 2)
~J
~ 6 emiddot~ 4~1 I enn~ middot( -~ 1- -2-shy
gt----J - liS ~ ~~ e 2 D9J -
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OTJlH lHC 01 CTeIiTOB 6e3 nOKpbITHII
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CTeHTHPOBJlJIHIi cnO)(HIgtlX creHo30B B TO BpCMII K8Ilt Clm
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22
5 B Cll)IBC HMnilBHTBlHH CTeHTa C n eKapCTBeHl l blM n OKpbITHeM Bpa4 II
HO yaelJlfHiB8cr BepOSlTHOCTb UeKapLlHaJl bHblX OCJlO)l(HeHHH H llOcryllilOH ltjlopMe uOIJ)Kell 06cY)ll1Tb C n a LlHeHTOM B0 3MO)l(llOCTb
JlCTaJlbHbLX IICXO)lOB CBSlJaHHblX C npl1CMOM oemrpcraHTIlblX nOl lHoueHlloA llBOHIIOH 8HTHTpoM60LUlTspHo i1 TepanHH H eCnl1
npcnapa103 no cpBBlleHHIO C MCrEUIJlH leCKllMH CTCHTaM I1 O)KHJlBClCSI lTO OOJIbHoia no JII06blM npHlWHal npeJKl(eBpeMCIlHO
4 J1cnOJlb30BBHl1e CTeHTOB C aHTlmponMltjlcpaTHBHL1M n OKp blTJiel CBSl391l0 npeKpBnn rrpHeM KJIOnHlorpenl1 )10 lOJOKflO paccMaTpHSBTbCSI KaK
C n OBbfw eHHblM PI1CKOM n03)JlIero TpoMfio 38 npH lIecofimooeHI1H cepbe3HblH apryMcHT B noJJh3) OTKlI3a OT npHMcllellHH CTCHTa
p CJl(HMa JlBOHHOi1 aUTHarperrunHoH TepanHH no c paBHelHlO C BbllCJISlloLUero nel(8pc1 Btl
r OIJOMCTarJJIH 4ecKHMH CTeHTaMH
CUHCOK paliOT onyliJ1UKOBalfHblX no Tete IlHCCepTaQuH
fiPAKTHqECKHEPEKOMEHDAUHH 1 liOKCPHJI 11A nepCnCKTHBbl rrplIMeHeHHJr p8CT80pHMbIX CTefITOB B
1 J1cnOJlb30BaHHC CTemos C nCKapCTBeHHbIM lloKpbrrHeM 1cneco06p83HO neqemrn a-repDCKnepoTHleCKHX 3afi011eBallldi COCYlOB ]lA 60KepHli
y o T06paHHbix 60nbllblx C BblCOKHM PHCKOM PCCTCR03a s laCTHocru X llIeHoom MB ABanHaJlH IiP MaprnpocIIH 3A fyceHlloB
npH MoptjlonOfl1lecKH Hc6naronpHSlTHblX nmax CTCH030B PH aA ACMOB HA QlfrorHJl3e I 61On HllCC X HM AH PaKynes8
CTeHTJ1p0BaHHH cocynoB llHaMerpoM Mcnce 35 MM HnH nnHHoH fionee PAMH-2007 - T8 - HM - C 95- 101
23 MM a TaK)l(e y 60JlbllblX C conyrCTByloLUHM caxapliMM nHafiClOM 2 J)OKCPIiIi JIA PC3YJlbTaThI 3HJlOBacKYnllpHoro lIClCHH$l c 2 Dnll llOCTl1iKeHJUt OTITHMaTlbHbIX HcnocpenCTBeHHblx 11 OTllanCIiHbIX HCnOJTb30aaUHeM CTeHTOB C awmrrpoJllltjlepaTHBHblM nOKpbITHCM Y
p e3yn 6TaToB CICJl)CT YlIeJUlTb oco60e BHHMaHHC npasHlIbHo MY n01l6o py 60nblfblx mneMHIecKoH 601leJHbIO cepJlua C OiKHpeHHe 11A PoKepHll
THJ l a creHTa cro p83MCPa a TaOl(e TeXHHKe cTeHTHpoBaJHlll lTo6 bl M A KaxHTcnaWBHJlU HA lhiror Hl3C )1A AcanoB HIO CwaCD II
MaKCHMEUlbHO y nyqWHTh 3aBHCJllUJle OT ollepaTOpa PC3YJlh TaTbl fpYWiall CCpnC4110-COCYllHCTaII XlIPYPfHJI - 2008 -N2 - C 14-18
3 B03MO)KTIOCTb HMIlJJ8HT8LIHH CTeHTll 6e3 JlCKapcTBclmoro 1l0KpblTHIi 3 AcauOB DA MeJKl(YHapolHbIH OTIblT npHMeHCIiH5I middot CTeHTOB
0 6$l3aTeJlbHO cncLlyeT paccMoTpCTIgt B Ka)I(JlOM KOHKpe1HOM clIyqae c C aHTHnpOilMlpepaTHllHW1H c 80iiCTBaMH (0630p mneparypbl)
YlCTOM Bcex aHrHorpaltjlH leCIOIX H KITlUllI lecKHX naHHblX I uA AcanOB I PIOn HIJCCX HM AH l)axyncBa PAMI-I - 2008 - T9
4 iloCile HMTIilaHTaWHI nOKp blTOrO JleKapCTBoM CTeIlTa JlBoiffiaJJ - N6 - C 11middot-16
aHTHTpOM601KTaPHWI repanHSl JlOJDICHa npOBOIDITbCSI He MeHee 12 41HTOfHJ3e HA BlJHlIllHe MeTa6oJTHfecKOro cHHJpoMa Ha peJynbTaTbI
MecJUCB HO n ocnc TLUaTCJlbllOrO B3seWlIDaHHll ce 3centltjlCKTHBHOCTH H crcHTHpoBaRlofIJ KOpollaplihlX apTepHH BA lIHrorHlJ3C
plfcKa c yqCTOM BCPOllTHOcnt KpDSOTClCHHH nOBbl wcHHOH MA KaKI1TCJlaUJBHnH KB KnIOmHIltOB A M 3aKYT )JW C aMYHilOBa
l)BCTBI1TCJlbHOcnl K acn Hpl1HY liilH KJlO~orpcmo B03MO)KHblX )1A AC3JJOB II Pion HLJC CX 101M AH 6ru-yneB3 PAMH - 2008 - T9 shy
OnepaTHBliblX BMewaTeJlbCTB Ii mo6 blX Hll Ll X COCTOSlHHA NQ6 - C 3- 9
o6YCJIOBJlelfHbfX HapYLlJe~IHeM HMMYHROfi CHCTeMbT
24
5 4HrorHmc HA JltpcentCK1HBlIOCTb KopollapHoH aHrHOnnaCTHKH C
HCnOJIb30BaIlHe)1 CTeHTOB C UI1TOCTaTH1CCKlt)1 IlOKphlTHeM H CTCHTOB 6C3
1l0KPblTW HA LJHromn3c )J A ACaDOB II )IO~~ HUCCX
HM A H 6ayrteBa PAMH - 2007 - T8 - NQ3 - C 11 2
6 tIHrOlYlQ3C HA H aw onblT no npl1MeHCHHIO CTeHTOB C Jl eKapCTBcHHbIMH
CBOHCTBao1H H roJl0MeTIlJIn H4eCKRX CTeHTOB HA llHrorHll3c
nA ACMOS 1 61OJI HUCCX HM AB IiaxyneBa PAM H - 2008 - T9 shy
NQ3 - C 116
7 ])oKep HlI JlA PC3yfJhTaTbl 3HllOB8CKYJllIPHOro JIeqeHI1Ji C
I1CllOJl b30BaH l1eM CTCHTOB C aHTIlllpOnHcent epaTHBHblM nOKpblTHCM Y
6 0JlbHbiX MEC C o)J(HpeHHeM I JIA 6oKepHlI MA KaKI1TenaUlBHJlH
)JA A canoB MlO CHraeB HA LJ llrorHQ3e II 01OJI HllCCX
HM A H EaK)neBa PAM H - 2008 - T9 - NQ3 - C 114
8 lJ lirOrHll3C llA B JIHSIHHC Mera6 oJIH4 ecKoro CJoIHnpoMa Ha PC3YJlbTaTbl
CTeHTl1poBaHI111 KopoHapHblx apTepldi CTeIHaMH C IHTOCTaTH y eC1ltHM
Jl eKapCTBellHblM nOKpbfTHeM I HA lll-lror Hll3e MB K nmiIUIKOD
rUO CJiraeB MA KaxHTenaI1J8HllH )JA A CMOB II EIOJI HlJCCX
11M AH oaKYIlesa PA MH - 2008 - T9 - NQ6 - C 207
___I
22
5 B Cll)IBC HMnilBHTBlHH CTeHTa C n eKapCTBeHl l blM n OKpbITHeM Bpa4 II
HO yaelJlfHiB8cr BepOSlTHOCTb UeKapLlHaJl bHblX OCJlO)l(HeHHH H llOcryllilOH ltjlopMe uOIJ)Kell 06cY)ll1Tb C n a LlHeHTOM B0 3MO)l(llOCTb
JlCTaJlbHbLX IICXO)lOB CBSlJaHHblX C npl1CMOM oemrpcraHTIlblX nOl lHoueHlloA llBOHIIOH 8HTHTpoM60LUlTspHo i1 TepanHH H eCnl1
npcnapa103 no cpBBlleHHIO C MCrEUIJlH leCKllMH CTCHTaM I1 O)KHJlBClCSI lTO OOJIbHoia no JII06blM npHlWHal npeJKl(eBpeMCIlHO
4 J1cnOJlb30BBHl1e CTeHTOB C aHTlmponMltjlcpaTHBHL1M n OKp blTJiel CBSl391l0 npeKpBnn rrpHeM KJIOnHlorpenl1 )10 lOJOKflO paccMaTpHSBTbCSI KaK
C n OBbfw eHHblM PI1CKOM n03)JlIero TpoMfio 38 npH lIecofimooeHI1H cepbe3HblH apryMcHT B noJJh3) OTKlI3a OT npHMcllellHH CTCHTa
p CJl(HMa JlBOHHOi1 aUTHarperrunHoH TepanHH no c paBHelHlO C BbllCJISlloLUero nel(8pc1 Btl
r OIJOMCTarJJIH 4ecKHMH CTeHTaMH
CUHCOK paliOT onyliJ1UKOBalfHblX no Tete IlHCCepTaQuH
fiPAKTHqECKHEPEKOMEHDAUHH 1 liOKCPHJI 11A nepCnCKTHBbl rrplIMeHeHHJr p8CT80pHMbIX CTefITOB B
1 J1cnOJlb30BaHHC CTemos C nCKapCTBeHHbIM lloKpbrrHeM 1cneco06p83HO neqemrn a-repDCKnepoTHleCKHX 3afi011eBallldi COCYlOB ]lA 60KepHli
y o T06paHHbix 60nbllblx C BblCOKHM PHCKOM PCCTCR03a s laCTHocru X llIeHoom MB ABanHaJlH IiP MaprnpocIIH 3A fyceHlloB
npH MoptjlonOfl1lecKH Hc6naronpHSlTHblX nmax CTCH030B PH aA ACMOB HA QlfrorHJl3e I 61On HllCC X HM AH PaKynes8
CTeHTJ1p0BaHHH cocynoB llHaMerpoM Mcnce 35 MM HnH nnHHoH fionee PAMH-2007 - T8 - HM - C 95- 101
23 MM a TaK)l(e y 60JlbllblX C conyrCTByloLUHM caxapliMM nHafiClOM 2 J)OKCPIiIi JIA PC3YJlbTaThI 3HJlOBacKYnllpHoro lIClCHH$l c 2 Dnll llOCTl1iKeHJUt OTITHMaTlbHbIX HcnocpenCTBeHHblx 11 OTllanCIiHbIX HCnOJTb30aaUHeM CTeHTOB C awmrrpoJllltjlepaTHBHblM nOKpbITHCM Y
p e3yn 6TaToB CICJl)CT YlIeJUlTb oco60e BHHMaHHC npasHlIbHo MY n01l6o py 60nblfblx mneMHIecKoH 601leJHbIO cepJlua C OiKHpeHHe 11A PoKepHll
THJ l a creHTa cro p83MCPa a TaOl(e TeXHHKe cTeHTHpoBaJHlll lTo6 bl M A KaxHTcnaWBHJlU HA lhiror Hl3C )1A AcanoB HIO CwaCD II
MaKCHMEUlbHO y nyqWHTh 3aBHCJllUJle OT ollepaTOpa PC3YJlh TaTbl fpYWiall CCpnC4110-COCYllHCTaII XlIPYPfHJI - 2008 -N2 - C 14-18
3 B03MO)KTIOCTb HMIlJJ8HT8LIHH CTeHTll 6e3 JlCKapcTBclmoro 1l0KpblTHIi 3 AcauOB DA MeJKl(YHapolHbIH OTIblT npHMeHCIiH5I middot CTeHTOB
0 6$l3aTeJlbHO cncLlyeT paccMoTpCTIgt B Ka)I(JlOM KOHKpe1HOM clIyqae c C aHTHnpOilMlpepaTHllHW1H c 80iiCTBaMH (0630p mneparypbl)
YlCTOM Bcex aHrHorpaltjlH leCIOIX H KITlUllI lecKHX naHHblX I uA AcanOB I PIOn HIJCCX HM AH l)axyncBa PAMI-I - 2008 - T9
4 iloCile HMTIilaHTaWHI nOKp blTOrO JleKapCTBoM CTeIlTa JlBoiffiaJJ - N6 - C 11middot-16
aHTHTpOM601KTaPHWI repanHSl JlOJDICHa npOBOIDITbCSI He MeHee 12 41HTOfHJ3e HA BlJHlIllHe MeTa6oJTHfecKOro cHHJpoMa Ha peJynbTaTbI
MecJUCB HO n ocnc TLUaTCJlbllOrO B3seWlIDaHHll ce 3centltjlCKTHBHOCTH H crcHTHpoBaRlofIJ KOpollaplihlX apTepHH BA lIHrorHlJ3C
plfcKa c yqCTOM BCPOllTHOcnt KpDSOTClCHHH nOBbl wcHHOH MA KaKI1TCJlaUJBHnH KB KnIOmHIltOB A M 3aKYT )JW C aMYHilOBa
l)BCTBI1TCJlbHOcnl K acn Hpl1HY liilH KJlO~orpcmo B03MO)KHblX )1A AC3JJOB II Pion HLJC CX 101M AH 6ru-yneB3 PAMH - 2008 - T9 shy
OnepaTHBliblX BMewaTeJlbCTB Ii mo6 blX Hll Ll X COCTOSlHHA NQ6 - C 3- 9
o6YCJIOBJlelfHbfX HapYLlJe~IHeM HMMYHROfi CHCTeMbT
24
5 4HrorHmc HA JltpcentCK1HBlIOCTb KopollapHoH aHrHOnnaCTHKH C
HCnOJIb30BaIlHe)1 CTeHTOB C UI1TOCTaTH1CCKlt)1 IlOKphlTHeM H CTCHTOB 6C3
1l0KPblTW HA LJHromn3c )J A ACaDOB II )IO~~ HUCCX
HM A H 6ayrteBa PAMH - 2007 - T8 - NQ3 - C 11 2
6 tIHrOlYlQ3C HA H aw onblT no npl1MeHCHHIO CTeHTOB C Jl eKapCTBcHHbIMH
CBOHCTBao1H H roJl0MeTIlJIn H4eCKRX CTeHTOB HA llHrorHll3c
nA ACMOS 1 61OJI HUCCX HM AB IiaxyneBa PAM H - 2008 - T9 shy
NQ3 - C 116
7 ])oKep HlI JlA PC3yfJhTaTbl 3HllOB8CKYJllIPHOro JIeqeHI1Ji C
I1CllOJl b30BaH l1eM CTCHTOB C aHTIlllpOnHcent epaTHBHblM nOKpblTHCM Y
6 0JlbHbiX MEC C o)J(HpeHHeM I JIA 6oKepHlI MA KaKI1TenaUlBHJlH
)JA A canoB MlO CHraeB HA LJ llrorHQ3e II 01OJI HllCCX
HM A H EaK)neBa PAM H - 2008 - T9 - NQ3 - C 114
8 lJ lirOrHll3C llA B JIHSIHHC Mera6 oJIH4 ecKoro CJoIHnpoMa Ha PC3YJlbTaTbl
CTeHTl1poBaHI111 KopoHapHblx apTepldi CTeIHaMH C IHTOCTaTH y eC1ltHM
Jl eKapCTBellHblM nOKpbfTHeM I HA lll-lror Hll3e MB K nmiIUIKOD
rUO CJiraeB MA KaxHTenaI1J8HllH )JA A CMOB II EIOJI HlJCCX
11M AH oaKYIlesa PA MH - 2008 - T9 - NQ6 - C 207
24
5 4HrorHmc HA JltpcentCK1HBlIOCTb KopollapHoH aHrHOnnaCTHKH C
HCnOJIb30BaIlHe)1 CTeHTOB C UI1TOCTaTH1CCKlt)1 IlOKphlTHeM H CTCHTOB 6C3
1l0KPblTW HA LJHromn3c )J A ACaDOB II )IO~~ HUCCX
HM A H 6ayrteBa PAMH - 2007 - T8 - NQ3 - C 11 2
6 tIHrOlYlQ3C HA H aw onblT no npl1MeHCHHIO CTeHTOB C Jl eKapCTBcHHbIMH
CBOHCTBao1H H roJl0MeTIlJIn H4eCKRX CTeHTOB HA llHrorHll3c
nA ACMOS 1 61OJI HUCCX HM AB IiaxyneBa PAM H - 2008 - T9 shy
NQ3 - C 116
7 ])oKep HlI JlA PC3yfJhTaTbl 3HllOB8CKYJllIPHOro JIeqeHI1Ji C
I1CllOJl b30BaH l1eM CTCHTOB C aHTIlllpOnHcent epaTHBHblM nOKpblTHCM Y
6 0JlbHbiX MEC C o)J(HpeHHeM I JIA 6oKepHlI MA KaKI1TenaUlBHJlH
)JA A canoB MlO CHraeB HA LJ llrorHQ3e II 01OJI HllCCX
HM A H EaK)neBa PAM H - 2008 - T9 - NQ3 - C 114
8 lJ lirOrHll3C llA B JIHSIHHC Mera6 oJIH4 ecKoro CJoIHnpoMa Ha PC3YJlbTaTbl
CTeHTl1poBaHI111 KopoHapHblx apTepldi CTeIHaMH C IHTOCTaTH y eC1ltHM
Jl eKapCTBellHblM nOKpbfTHeM I HA lll-lror Hll3e MB K nmiIUIKOD
rUO CJiraeB MA KaxHTenaI1J8HllH )JA A CMOB II EIOJI HlJCCX
11M AH oaKYIlesa PA MH - 2008 - T9 - NQ6 - C 207