8 research outputs found
ΠΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΠ΅ ΡΡΠ°Π΅ΠΊΡΠΎΡΠΈΠΉ Π΄Π²ΠΈΠΆΡΡΠΈΡ ΡΡ ΠΏΡΡΠΌΠΎΠ»ΠΈΠ½Π΅ΠΉΠ½ΠΎ Π²ΠΎΠ·Π΄ΡΡΠ½ΡΡ ΡΠ΅Π»Π΅ΠΉ ΠΏΡΠΈ Π²ΡΠΎΡΠΈΡΠ½ΠΎΠΉ ΠΎΠ±ΡΠ°Π±ΠΎΡΠΊΠ΅ ΡΠ°Π΄ΠΈΠΎΠ»ΠΎΠΊΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ
Introduction. The primary functions of secondary processing of radar information are to detect and maintain the trajectories of air targets (AT). The AT trajectory detection can be characterised by the probability of detecting trajectory and average autocapture time. When the target moves, its distance from the radar station changes, leading to a change in the signal/noise ratio and the probability of detecting AT.Aim. To assess the impact of a change in the probability of detection of a straight and evenly moving target at consecutive time intervals of radar observation upon the characteristics of trajectory detection during secondary processing of radar information.Methods and materials. The research aim was achieved using the methods of mathematical statistics, including verification of statistical hypotheses, assessment of distribution parameters and theory of perturbations by small parameters. The ratio of the distance travelled by the AT during the review period to the target range at the initial moment of its detection was chosen as a perturbation parameter.Results. Analytical expressions were established for the probability of detecting a straight-moving AT and the probability of detecting the trajectory of its movement at interval multiples during the study period. The study illustrated the probability of detecting AT moving away from radar by means of consistent radar observations with reduced signal/noise ratios and angles between the velocity vector and the AT vector radius relative to the radar. The increase in AT speed which causes the z parameter to change from 0.01 to 0.07 reduces the probability of AT detection from 0.727 to 0.52 and leads to a corresponding change in the probability of detecting the trajectory. If the observation time is reduced by one time interval, the probability of detecting the trajectory is from 0.03 to 0.04β¦0.07 for signal/noise 40 ratio and from 0.06 to 0.08β¦0.11 for signal/noise 25 ratio (with the probability of false alarm 10β4 ).Conclusion. The resulting expressions allow for the calculation of directly moving AT trajectory detection, considering changes in the probability of detecting targets in successive time intervals of radar observations.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. ΠΡΠ½ΠΎΠ²Π½ΡΠΌΠΈ Π·Π°Π΄Π°ΡΠ°ΠΌΠΈ Π²ΡΠΎΡΠΈΡΠ½ΠΎΠΉ ΠΎΠ±ΡΠ°Π±ΠΎΡΠΊΠΈ ΡΠ°Π΄ΠΈΠΎΠ»ΠΎΠΊΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΡΠ²Π»ΡΡΡΡΡ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΠ΅ ΠΈ ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π΅Π½ΠΈΠ΅ ΡΡΠ°Π΅ΠΊΡΠΎΡΠΈΠΉ Π΄Π²ΠΈΠΆΠ΅Π½ΠΈΡ Π²ΠΎΠ·Π΄ΡΡΠ½ΡΡ
ΡΠ΅Π»Π΅ΠΉ (ΠΠ¦). ΠΡΠΈ ΡΡΠΎΠΌ ΠΏΡΠΎΡΠ΅ΡΡ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΡ ΡΡΠ°Π΅ΠΊΡΠΎΡΠΈΠΉ Π΄Π²ΠΈΠΆΠ΅Π½ΠΈΡ ΠΠ¦ ΠΏΡΠΈΠ½ΡΡΠΎ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΠΎΠ²Π°ΡΡ Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΡΠΌΠΈ ΠΈΡ
ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΡ ΠΈ ΡΡΠ΅Π΄Π½ΠΈΠΌ Π²ΡΠ΅ΠΌΠ΅Π½Π΅ΠΌ ΠΈΡ
Π°Π²ΡΠΎΠ·Π°Ρ
Π²Π°ΡΠ°. ΠΡΠΈ Π΄Π²ΠΈΠΆΠ΅Π½ΠΈΠΈ ΡΠ΅Π»ΠΈ Π΅Π΅ Π΄Π°Π»ΡΠ½ΠΎΡΡΡ ΠΎΡ ΡΠ°Π΄ΠΈΠΎΠ»ΠΎΠΊΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΡΡΠ°Π½ΡΠΈΠΈ (Π ΠΠ‘) ΠΈΠ·ΠΌΠ΅Π½ΡΠ΅ΡΡΡ, ΡΡΠΎ ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡ ΠΊ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡ ΡΠΈΠ³Π½Π°Π»/ΡΡΠΌ ΠΈ Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΡ ΠΠ¦.Π¦Π΅Π»Ρ ΡΠ°Π±ΠΎΡΡ. ΠΡΠ΅Π½ΠΊΠ° Π²Π»ΠΈΡΠ½ΠΈΡ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΡ ΠΏΡΡΠΌΠΎΠ»ΠΈΠ½Π΅ΠΉΠ½ΠΎ Π΄Π²ΠΈΠΆΡΡΠ΅ΠΉΡΡ ΡΠ΅Π»ΠΈ ΠΏΡΠΈ ΡΠ°Π΄ΠΈΠΎΠ»ΠΎΠΊΠ°ΡΠΈΠΎΠ½Π½ΡΡ
Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡΡ
Π½Π° Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΡ ΡΡΠ°Π΅ΠΊΡΠΎΡΠΈΠΈ Π΅Π΅ Π΄Π²ΠΈΠΆΠ΅Π½ΠΈΡ ΠΏΡΠΈ Π²ΡΠΎΡΠΈΡΠ½ΠΎΠΉ ΠΎΠ±ΡΠ°Π±ΠΎΡΠΊΠ΅ ΡΠ°Π΄ΠΈΠΎΠ»ΠΎΠΊΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ.ΠΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΏΠΎΠ»ΡΠ·ΡΡΡΡΡ ΠΌΠ΅ΡΠΎΠ΄Ρ ΠΌΠ°ΡΠ΅ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΡΠ°ΡΠΈΡΡΠΈΠΊΠΈ: ΠΏΡΠΎΠ²Π΅ΡΠΊΠ° ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π³ΠΈΠΏΠΎΡΠ΅Π·, ΠΎΡΠ΅Π½ΠΊΠ° ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΎΠ² ΡΠ°ΡΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠΉ ΠΈ ΡΠ΅ΠΎΡΠΈΡ Π²ΠΎΠ·ΠΌΡΡΠ΅Π½ΠΈΠΉ ΠΏΠΎ ΠΌΠ°Π»ΠΎΠΌΡ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΡ. Π ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ Π²ΠΎΠ·ΠΌΡΡΠ°ΡΡΠ΅Π³ΠΎ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠ° Π²ΡΠ±ΡΠ°Π½ΠΎ ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠ΅ ΡΠ°ΡΡΡΠΎΡΠ½ΠΈΡ, ΠΏΡΠΎΡ
ΠΎΠ΄ΠΈΠΌΠΎΠ³ΠΎ ΠΠ¦ Π·Π° ΠΏΠ΅ΡΠΈΠΎΠ΄ ΠΎΠ±Π·ΠΎΡΠ°, ΠΊ Π΄Π°Π»ΡΠ½ΠΎΡΡΠΈ ΡΠ΅Π»ΠΈ Π² Π½Π°ΡΠ°Π»ΡΠ½ΡΠΉ ΠΌΠΎΠΌΠ΅Π½Ρ Π΅Π΅ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΡ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠΎΠ»ΡΡΠ΅Π½Ρ Π°Π½Π°Π»ΠΈΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π²ΡΡΠ°ΠΆΠ΅Π½ΠΈΡ Π΄Π»Ρ Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΡ ΠΏΡΡΠΌΠΎΠ»ΠΈΠ½Π΅ΠΉΠ½ΠΎ Π΄Π²ΠΈΠΆΡΡΠ΅ΠΉΡΡ ΠΠ¦ ΠΈ Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΡ ΡΡΠ°Π΅ΠΊΡΠΎΡΠΈΠΈ Π΅Π΅ Π΄Π²ΠΈΠΆΠ΅Π½ΠΈΡ Π½Π° ΠΈΠ½ΡΠ΅ΡΠ²Π°Π»Π°Ρ
, ΠΊΡΠ°ΡΠ½ΡΡ
ΠΏΠ΅ΡΠΈΠΎΠ΄Ρ ΠΎΠ±Π·ΠΎΡΠ°. ΠΡΠΎΠΈΠ»Π»ΡΡΡΡΠΈΡΠΎΠ²Π°Π½ΠΎ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΠ΅ Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΡ ΠΠ¦, ΡΠ΄Π°Π»ΡΡΡΠ΅ΠΉΡΡ ΠΎΡ Π ΠΠ‘, ΠΏΡΠΈ ΠΏΠΎΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΡΠ°Π΄ΠΈΠΎΠ»ΠΎΠΊΠ°ΡΠΈΠΎΠ½Π½ΡΡ
Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡΡ
Ρ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΉ ΡΠΈΠ³Π½Π°Π»/ΡΡΠΌ ΠΈ ΡΠ³Π»Π° ΠΌΠ΅ΠΆΠ΄Ρ Π²Π΅ΠΊΡΠΎΡΠΎΠΌ ΡΠΊΠΎΡΠΎΡΡΠΈ ΠΈ ΡΠ°Π΄ΠΈΡΡΠΎΠΌ-Π²Π΅ΠΊΡΠΎΡΠΎΠΌ ΠΠ¦ ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎ Π ΠΠ‘. Π£Π²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ ΡΠΊΠΎΡΠΎΡΡΠΈ ΠΠ¦, Π²ΡΠ·ΡΠ²Π°ΡΡΠ΅Π΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠ° z Ρ 0.01 Π΄ΠΎ 0.07, ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡ ΠΊ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΡ Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΡ ΠΠ¦ Ρ 0.727 Π΄ΠΎ 0.52 ΠΈ ΠΊ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΡΡΡΠ΅ΠΌΡ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΡ ΡΡΠ°Π΅ΠΊΡΠΎΡΠΈΠΈ. ΠΡΠΈ ΡΠΎΠΊΡΠ°ΡΠ΅Π½ΠΈΠΈ Π²ΡΠ΅ΠΌΠ΅Π½ΠΈ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ Π½Π° ΠΎΠ΄ΠΈΠ½ Π²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΠΈΠ½ΡΠ΅ΡΠ²Π°Π» ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΠ΅ Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΡ ΡΡΠ°Π΅ΠΊΡΠΎΡΠΈΠΈ ΡΠΎΡΡΠ°Π²Π»ΡΠ΅Ρ ΠΎΡ 0.03 Π΄ΠΎ 0.04...0.07 Π΄Π»Ρ ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡ ΡΠΈΠ³Π½Π°Π»/ΡΡΠΌ 40 ΠΈ ΠΎΡ 0.06 Π΄ΠΎ 0.08...0.11 Π΄Π»Ρ ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡ ΡΠΈΠ³Π½Π°Π»/ΡΡΠΌ 25 (ΠΏΡΠΈ Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΠΈ Π»ΠΎΠΆΠ½ΠΎΠΉ ΡΡΠ΅Π²ΠΎΠ³ΠΈ 10β4 ).ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠΎΠ»ΡΡΠ΅Π½Π½ΡΠ΅ Π²ΡΡΠ°ΠΆΠ΅Π½ΠΈΡ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡΡ ΡΠ°ΡΡΡΠΈΡΡΠ²Π°ΡΡ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΡ ΡΡΠ°Π΅ΠΊΡΠΎΡΠΈΠΉ Π²ΠΎΠ·Π΄ΡΡΠ½ΡΡ
ΡΠ΅Π»Π΅ΠΉ, Π΄Π²ΠΈΠΆΡΡΠΈΡ
ΡΡ ΠΏΡΡΠΌΠΎΠ»ΠΈΠ½Π΅ΠΉΠ½ΠΎ, Ρ ΡΡΠ΅ΡΠΎΠΌ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΠ΅ΠΉ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΡ ΡΠ΅Π»Π΅ΠΉ Π² ΠΏΠΎΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΡΡ
Π²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
ΠΈΠ½ΡΠ΅ΡΠ²Π°Π»Π°Ρ
ΠΎΠ±Π·ΠΎΡΠ° ΡΠ°Π΄ΠΈΠΎΠ»ΠΎΠΊΠ°ΡΠΈΠΎΠ½Π½ΡΡ
Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠΉ
Detection of the Trajectories of Moving Rectilinearly Air Targets in the Secondary Processing of Radar Information
Introduction. The primary functions of secondary processing of radar information are to detect and maintain the trajectories of air targets (AT). The AT trajectory detection can be characterised by the probability of detecting trajectory and average autocapture time. When the target moves, its distance from the radar station changes, leading to a change in the signal/noise ratio and the probability of detecting AT.Aim. To assess the impact of a change in the probability of detection of a straight and evenly moving target at consecutive time intervals of radar observation upon the characteristics of trajectory detection during secondary processing of radar information.Methods and materials. The research aim was achieved using the methods of mathematical statistics, including verification of statistical hypotheses, assessment of distribution parameters and theory of perturbations by small parameters. The ratio of the distance travelled by the AT during the review period to the target range at the initial moment of its detection was chosen as a perturbation parameter.Results. Analytical expressions were established for the probability of detecting a straight-moving AT and the probability of detecting the trajectory of its movement at interval multiples during the study period. The study illustrated the probability of detecting AT moving away from radar by means of consistent radar observations with reduced signal/noise ratios and angles between the velocity vector and the AT vector radius relative to the radar. The increase in AT speed which causes the z parameter to change from 0.01 to 0.07 reduces the probability of AT detection from 0.727 to 0.52 and leads to a corresponding change in the probability of detecting the trajectory. If the observation time is reduced by one time interval, the probability of detecting the trajectory is from 0.03 to 0.04β¦0.07 for signal/noise 40 ratio and from 0.06 to 0.08β¦0.11 for signal/noise 25 ratio (with the probability of false alarm 10β4 ).Conclusion. The resulting expressions allow for the calculation of directly moving AT trajectory detection, considering changes in the probability of detecting targets in successive time intervals of radar observations
Π ΠΎΠ»Ρ Π½ΠΈΡΠΊΠΎΠ²ΠΎΡ Π΄ΠΈΡΡΡΠ½ΠΊΡΡΡ Ρ ΡΠΎΠ·Π²ΠΈΡΠΊΡ ΡΡΠΊΠ»Π°Π΄Π½Π΅Π½Ρ ΡΠΈΡΠΎΠ·Ρ ΠΏΠ΅ΡΡΠ½ΠΊΠΈ
Renal dysfunction is defined as progressing renal failure against chronic and acute failure of a liver at insignificant or total absence of morphological changes in kidneys. Emergence of renal dysfunction at cirrhosis is an integral part of a natural course of the disease characterizing its weight. However the importance of renal dysfunction in development of complications of cirrhosis and its correction today fully are not defined.The aim of research. To estimate the role of renal dysfunction in development of complications of cirrhosis.Materials and methods. 70 patients with cirrhosis took part in the study. 34 patients were hospitalized with ascites resistant to the diuretics and 36 patients had bleeding from esophageal varices. 29 patients have died. Duration of supervision of patients was from 2-3 weeks to 1,5-2 years. All patients had numerous clinical, laboratory and instrumental researches. They included measurement of a daily diuresis, body weight, abdominal circumference. Laboratory researches included, in addition to standard, definition of a creatinine, sodium and potassium level in blood and urine, speeds of a glomerular filtration (GFR). Ultrasonic research (US) of abdominal organs with vessels of an abdominal cavity and renal arteries color duplex scan. Diameter of renal arteries, speed ofΒ blood-groove on them and an index of resistance of arteries were estimated. Data of instrumental and laboratory researches were compared with clinical characteristics of a course of a disease and existence of complications.Β Β Results. In 14 (39%) patients with bleeding and 28 (82%) with ascites before development of complications the negative water balance β decrease diuresis in comparison with amount of the drunk liquid was noted at the corresponding diuretic therapy that is an early clinical sign of development of renal dysfunction. At laboratory inspection in all patients before hospitalization the tendency to GFR decrease was noted. At an ultrasonic exam of renal arteries resistance index exceeded normal ranges (0,6-0,7) and was 0,95Β±0,03. In the absence of correction of renal dysfunction the unsatisfactory results of treatment consisting in frequent recurrence of bleeding and high mortality are noted.Β Conclusions. Clinical manifestation of renal dysfunction is the negative water balance; the laboratory β a tendency to speed of a glomerular filtration decrease; the tool β reduction of diameter of renal arteries, decrease in a volume blood-groove in them, increase in an index of resistance in process of transition from the disease not complicated to the complicated current that took place in 76% of patients. In 82% patients with ascites and 39% with bleeding from esophageal varices clinically significant renal dysfunction took place before development of complications. More than for 60% of patients with early recurrence of bleeding the gepatorenal syndrome was diagnosed. At all died patients hepato-renal insufficiency was noted.Β ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Π° ΡΡΠ½ΠΊΡΠΈΡ ΠΏΠΎΡΠ΅ΠΊ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ ΠΊΠΎΠΌΠΏΠ΅Π½ΡΠΈΡΠΎΠ²Π°Π½Π½ΡΠΌ ΠΈ Π΄Π΅ΠΊΠΎΠΌΠΏΠ΅Π½ΡΠΈΡΠΎΠ²Π°Π½Π½ΡΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΠΈΡΡΠΎΠ·Π° ΠΏΠ΅ΡΠ΅Π½ΠΈ. ΠΠ°Π½Π° ΠΎΡΠ΅Π½ΠΊΠ° ΡΠΎΠ»ΠΈ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠΉ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠΈ Π² ΡΠ°Π·Π²ΠΈΡΠΈΠΈ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ ΡΠΈΡΡΠΎΠ·Π°.ΠΠΎΡΠ»ΡΠ΄ΠΈΠ»ΠΈ ΡΡΠ½ΠΊΡΡΡ Π½ΠΈΡΠΎΠΊ Ρ Ρ
Π²ΠΎΡΠΈΡ
ΡΠ· ΠΊΠΎΠΌΠΏΠ΅Π½ΡΠΎΠ²Π°Π½ΠΈΠΌ Ρ Π΄Π΅ΠΊΠΎΠΌΠΏΠ΅Π½ΡΠΎΠ²Π°Π½ΠΈΠΌ ΠΏΠ΅ΡΠ΅Π±ΡΠ³ΠΎΠΌ ΡΠΈΡΠΎΠ·Ρ ΠΏΠ΅ΡΡΠ½ΠΊΠΈ. ΠΠ΄ΡΠΉΡΠ½ΠΈΠ»ΠΈ ΠΎΡΡΠ½ΡΠ²Π°Π½Π½Ρ ΡΠΎΠ»Ρ Π½ΠΈΡΠΊΠΎΠ²ΠΎΡ Π΄ΠΈΡΡΡΠ½ΠΊΡΡΡ Ρ ΡΠΎΠ·Π²ΠΈΡΠΊΡ ΡΡΠΊΠ»Π°Π΄Π½Π΅Π½Ρ ΡΠΈΡΠΎΠ·Ρ
ΠΠΎΡΠ΅ΠΊΡΡΡ Π½ΠΈΡΠΊΠΎΠ²ΠΎΡ Π΄ΠΈΡΡΡΠ½ΠΊΡΡΡ Ρ Ρ Π²ΠΎΡΠΈΡ ΡΠ· Π΄Π΅ΠΊΠΎΠΌΠΏΠ΅Π½ΡΠΎΠ²Π°Π½ΠΈΠΌ ΠΏΠ΅ΡΠ΅Π±ΡΠ³ΠΎΠΌ ΡΠΈΡΠΎΠ·Ρ ΠΏΠ΅ΡΡΠ½ΠΊΠΈ
Aim. Elaboration of the uniform tactical installations concerning questions of rational therapy of patients with renal dysfunction in cirrhosis and its complicationsΒ is actual.Methods and results. Effectiveness of the treatment of 48 patients with renal dysfunction was studied. As basis therapy terlipressin (Remestip)Β and albumin were used. It was established that treatment of renal dysfunction improves survival rate of patients and allows to extend terms of complications development.Conclusion. It testifies the influence of correction of renal dysfunction in patients with decompensative course of cirrhosis on duration and quality of their life.Β Β ΠΠΊΡΡΠ°Π»ΡΠ½Π° Π²ΡΡΠ°Π±ΠΎΡΠΊΠ° Π΅Π΄ΠΈΠ½ΡΡ
ΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΡΡΠ°Π½ΠΎΠ²ΠΎΠΊ, ΠΊΠ°ΡΠ°ΡΡΠΈΡ
ΡΡ Π²ΠΎΠΏΡΠΎΡΠΎΠ² ΡΠ°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠΉ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠ΅ΠΉ ΠΏΡΠΈ ΡΠΈΡΡΠΎΠ·Π΅ ΠΏΠ΅ΡΠ΅Π½ΠΈ ΠΈ Π΅Π³ΠΎ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡΡ
. Π‘ ΡΠ΅Π»ΡΡ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠΎΠ»ΠΈ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠΉ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠΈ ΠΏΡΠΈ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡΡ
ΡΠΈΡΡΠΎΠ·Π° ΠΏΠ΅ΡΠ΅Π½ΠΈ ΠΈΠ·ΡΡΠ΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π»Π΅ΡΠ΅Π½ΠΈΡ 48 Π±ΠΎΠ»ΡΠ½ΡΡ
, ΠΊΠΎΡΠΎΡΡΠΌ Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡΠ΅Π»ΡΠ½ΠΎ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΡ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠΉ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠΈ. Π ΠΎΡΠ½ΠΎΠ²Π΅ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ β Π½Π°Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ ΡΠ΅ΡΠ»ΠΈΠΏΡΠ΅ΡΡΠΈΠ½Π° ΠΈ Π°Π»ΡΠ±ΡΠΌΠΈΠ½Π°, ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΊΠΎΡΠΎΡΡΡ
ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 70%. Π£ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠΉ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠΈ ΡΠ»ΡΡΡΠ°Π΅Ρ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΈ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΡΠ΄Π»ΠΈΠ½ΠΈΡΡ ΡΡΠΎΠΊΠΈ ΠΌΠ΅ΠΆΠ΄Ρ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π°ΠΌΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ. ΠΡΠΎ ΡΠ²ΠΈΠ΄Π΅ΡΠ΅Π»ΡΡΡΠ²ΡΠ΅Ρ ΠΎ Π·Π½Π°ΡΠΈΠΌΠΎΡΡΠΈ ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΠΈ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠΉ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠΈ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ Π΄Π΅ΠΊΠΎΠΌΠΏΠ΅Π½ΡΠΈΡΠΎΠ²Π°Π½Π½ΡΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΠΈΡΡΠΎΠ·Π° ΠΏΠ΅ΡΠ΅Π½ΠΈ Π½Π° ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎ ΠΈΡ
ΠΆΠΈΠ·Π½ΠΈ.Β ΠΠΊΡΡΠ°Π»ΡΠ½ΠΈΠΌ Ρ Π½Π°ΠΏΡΠ°ΡΡΠ²Π°Π½Π½Ρ ΡΠ΄ΠΈΠ½ΠΈΡ
ΡΠ°ΠΊΡΠΈΡΠ½ΠΈΡ
ΡΡΡΠ°Π½ΠΎΠ²ΠΎΠΊ, ΡΠΎ ΡΡΠΎΡΡΡΡΡΡΡ ΠΏΠΈΡΠ°Π½Ρ ΡΠ°ΡΡΠΎΠ½Π°Π»ΡΠ½ΠΎΡ ΡΠ΅ΡΠ°ΠΏΡΡ Ρ
Π²ΠΎΡΠΈΡ
ΡΠ· Π½ΠΈΡΠΊΠΎΠ²ΠΎΡ Π΄ΠΈΡΡΡΠ½ΠΊΡΡΡΡ ΠΏΡΠΈ ΡΠΈΡΠΎΠ·Ρ ΠΏΠ΅ΡΡΠ½ΠΊΠΈ ΡΠ° ΠΉΠΎΠ³ΠΎ ΡΡΠΊΠ»Π°Π΄Π½Π΅Π½Π½ΡΡ
. Π ΠΌΠ΅ΡΠΎΡ ΠΎΡΡΠ½ΠΊΠΈ ΡΠΎΠ»Ρ Π½ΠΈΡΠΊΠΎΠ²ΠΎΡ Π΄ΠΈΡΡΡΠ½ΠΊΡΡΡ ΠΏΡΠΈ ΡΡΠΊΠ»Π°Π΄Π½Π΅Π½Π½ΡΡ
ΡΠΈΡΠΎΠ·Ρ ΠΏΠ΅ΡΡΠ½ΠΊΠΈ Π²ΠΈΠ²ΡΠΈΠ»ΠΈ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΈ Π»ΡΠΊΡΠ²Π°Π½Π½Ρ 48 Ρ
Π²ΠΎΡΠΈΡ
, ΡΠΊΠΈΠΌ Π΄ΠΎΠ΄Π°ΡΠΊΠΎΠ²ΠΎ Π²ΠΈΠΊΠΎΠ½Π°Π»ΠΈ ΠΊΠΎΡΠ΅ΠΊΡΡΡ Π½ΠΈΡΠΊΠΎΠ²ΠΎΡ Π΄ΠΈΡΡΡΠ½ΠΊΡΡΡ. ΠΡΠ½ΠΎΠ²ΠΎΡ ΡΠ΅ΡΠ°ΠΏΡΡ Π±ΡΠ»ΠΎ ΠΏΡΠΈΠ·Π½Π°ΡΠ΅Π½Π½Ρ ΡΠ΅ΡΠ»ΡΠΏΡΠ΅ΡΠΈΠ½Ρ ΠΉ Π°Π»ΡΠ±ΡΠΌΡΠ½Ρ, ΡΡ
Π΅ΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡΡΡ ΡΡΠ°Π½ΠΎΠ²ΠΈΠ»Π° 70%. ΠΠΈΠ·Π½Π°ΡΠΈΠ»ΠΈ, ΡΠΎ Π»ΡΠΊΡΠ²Π°Π½Π½Ρ Π½ΠΈΡΠΊΠΎΠ²ΠΎΡ Π΄ΠΈΡΡΡΠ½ΠΊΡΡΡ ΠΏΠΎΠ»ΡΠΏΡΡΡ Π²ΠΈΠΆΠΈΠ²Π°Π½ΡΡΡΡ ΠΏΠ°ΡΡΡΠ½ΡΡΠ² Ρ Π΄Π°Ρ ΠΌΠΎΠΆΠ»ΠΈΠ²ΡΡΡΡ ΠΏΠΎΠ΄ΠΎΠ²ΠΆΠΈΡΠΈ ΡΡΡΠΎΠΊΠΈ ΠΌΡΠΆ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π°ΠΌΠΈ ΡΠΎΠ·Π²ΠΈΡΠΊΡ ΡΡΠΊΠ»Π°Π΄Π½Π΅Π½Ρ. Π¦Π΅ ΡΠ²ΡΠ΄ΡΠΈΡΡ ΠΏΡΠΎ Π·Π½Π°ΡΠ΅Π½Π½Ρ ΠΊΠΎΡΠ΅ΠΊΡΡΡ Π½ΠΈΡΠΊΠΎΠ²ΠΎΡ Π΄ΠΈΡΡΡΠ½ΠΊΡΡΡ Ρ Ρ
Π²ΠΎΡΠΈΡ
ΡΠ· Π΄Π΅ΠΊΠΎΠΌΠΏΠ΅Π½ΡΠΎΠ²Π°Π½ΠΈΠΌ ΠΏΠ΅ΡΠ΅Π±ΡΠ³ΠΎΠΌ ΡΠΈΡΠΎΠ·Ρ ΠΏΠ΅ΡΡΠ½ΠΊΠΈ Π½Π° ΡΡΠΈΠ²Π°Π»ΡΡΡΡ Ρ ΡΠΊΡΡΡΡ ΡΡ
Π½ΡΠΎΠ³ΠΎ ΠΆΠΈΡΡΡ
Correction of renal dysfunction in patients with the decompensated course of cirrhosis
Aim. Elaboration of the uniform tactical installations concerning questions of rational therapy of patients with renal dysfunction in cirrhosis and its complications is actual.
Methods and results. Effectiveness of the treatment of 48 patients with renal dysfunction was studied. As basis therapy terlipressin (Remestip) and albumin were used. It was established that treatment of renal dysfunction improves survival rate of patients and allows to extend terms of complications development.
Conclusion. It testifies the influence of correction of renal dysfunction in patients with decompensative course of cirrhosis on duration and quality of their life
Role of renal dysfunction in development of cirrhosis complications
Renal dysfunction is defined as progressing renal failure against chronic and acute failure of a liver at insignificant or total absence of morphological changes in kidneys. Emergence of renal dysfunction at cirrhosis is an integral part of a natural course of the disease characterizing its weight. However the importance of renal dysfunction in development of complications of cirrhosis and its correction today fully are not defined.
The aim of research. To estimate the role of renal dysfunction in development of complications of cirrhosis.
Materials and methods. 70 patients with cirrhosis took part in the study. 34 patients were hospitalized with ascites resistant to the diuretics and 36 patients had bleeding from esophageal varices. 29 patients have died. Duration of supervision of patients was from 2-3 weeks to 1,5-2 years. All patients had numerous clinical, laboratory and instrumental researches. They included measurement of a daily diuresis, body weight, abdominal circumference. Laboratory researches included, in addition to standard, definition of a creatinine, sodium and potassium level in blood and urine, speeds of a glomerular filtration (GFR). Ultrasonic research (US) of abdominal organs with vessels of an abdominal cavity and renal arteries color duplex scan. Diameter of renal arteries, speed of blood-groove on them and an index of resistance of arteries were estimated. Data of instrumental and laboratory researches were compared with clinical characteristics of a course of a disease and existence of complications.
Results. In 14 (39%) patients with bleeding and 28 (82%) with ascites before development of complications the negative water balance β decrease diuresis in comparison with amount of the drunk liquid was noted at the corresponding diuretic therapy that is an early clinical sign of development of renal dysfunction. At laboratory inspection in all patients before hospitalization the tendency to GFR decrease was noted. At an ultrasonic exam of renal arteries resistance index exceeded normal ranges (0,6-0,7) and was 0,95Β±0,03. In the absence of correction of renal dysfunction the unsatisfactory results of treatment consisting in frequent recurrence of bleeding and high mortality are noted.
Conclusions. Clinical manifestation of renal dysfunction is the negative water balance; the laboratory β a tendency to speed of a glomerular filtration decrease; the tool β reduction of diameter of renal arteries, decrease in a volume blood-groove in them, increase in an index of resistance in process of transition from the disease not complicated to the complicated current that took place in 76% of patients. In 82% patients with ascites and 39% with bleeding from esophageal varices clinically significant renal dysfunction took place before development of complications. More than for 60% of patients with early recurrence of bleeding the gepatorenal syndrome was diagnosed. At all died patients hepato-renal insufficiency was noted