6 research outputs found
Influence of drinking regime on the plasma glucose level for patients with insulin-nondependent type 2 diabetes mellitus
Optimal drinking regime influences on the plasma glucose level in patients with insulin-nondependent type 2 diabetes mellitus with fixed water consumption deficiency during the diet maintaining and oral antihyperglycemic therapy has been assessed. 103 people: 21 men (20,4%) and 82 women (79,6%) took part in the research. The average age of the group was 64,7Β±3,2 (men β 61,1Β±1,01, women β 68,3Β±5,4). The research for each patient continued for 10 days, in the first 5 days we observed for the volume of the drunk water. If the deficiency of drunk water was found out the patients were offered to the lacking volume with warm boiled water. The deficiency of water for each patient was calculated by this formula: Β«42,9 (ml) Π₯ weight (kg) β the average patientβs volume of drunk water for 5 days (ml)Β». The deficiency of the volume of drunk water was 2101,3 in average R (range) [1902,9; 3119,3] ml. The optimal water regime in the group of patients with insulin-nondependent type 2 diabetes mellitus led to depression of the average glucose level of blood plasma. Also it helped to stabilize the glucose level during a day.Π ΡΠ°Π±ΠΎΡΠ΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΎΡΠ΅Π½ΠΊΠ° Π²Π»ΠΈΡΠ½ΠΈΡ ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΠΈΡΡΠ΅Π²ΠΎΠ³ΠΎ ΡΠ΅ΠΆΠΈΠΌΠ° Π½Π° ΡΡΠΎΠ²Π΅Π½Ρ Π³Π»ΡΠΊΠΎΠ·Ρ ΠΏΠ»Π°Π·ΠΌΡ ΠΊΡΠΎΠ²ΠΈ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΈΠ½ΡΡΠ»ΠΈΠ½ΠΎ-Π½Π΅Π·Π°Π²ΠΈΡΠΈΠΌΡΠΌ ΡΠ°Ρ
Π°ΡΠ½ΡΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠΌ 2 ΡΠΈΠΏΠ° Ρ ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½Π½ΡΠΌ Π΄Π΅ΡΠΈΡΠΈΡΠΎΠΌ ΠΏΠΎΡΡΠ΅Π±Π»Π΅Π½ΠΈΡ ΠΆΠΈΠ΄ΠΊΠΎΡΡΠΈ Π½Π° ΡΠΎΠ½Π΅ ΠΏΠΎΠ΄Π΄Π΅ΡΠΆΠ°Π½ΠΈΡ Π΄ΠΈΠ΅ΡΡ ΠΈ ΠΏΡΠΈΠ΅ΠΌΠ° Π³ΠΈΠΏΠΎΠ³Π»ΠΈΠΊΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΠΏΡΠΈΠ½ΡΠ»ΠΎ ΡΡΠ°ΡΡΠΈΠ΅ 103 ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ°: 21 ΠΌΡΠΆΡΠΈΠ½Π° (20,4%) ΠΈ 82 ΠΆΠ΅Π½ΡΠΈΠ½Ρ (79,6%). Π‘ΡΠ΅Π΄Π½ΠΈΠΉ Π²ΠΎΠ·ΡΠ°ΡΡ ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΠΌΠΎΠΉ Π³ΡΡΠΏΠΏΡ ΡΠΎΡΡΠ°Π²ΠΈΠ» 64,7Β±3,2 (ΠΌΡΠΆΡΠΈΠ½Ρ β 61,1Β±1,01; ΠΆΠ΅Π½ΡΠΈΠ½Ρ β 68,3Β±5,4). ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π΄Π»Ρ ΠΊΠ°ΠΆΠ΄ΠΎΠ³ΠΎ Π±ΠΎΠ»ΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΎΡΡ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ 10 Π΄Π½Π΅ΠΉ, Π·Π° ΠΏΠ΅ΡΠ²ΡΠ΅ 5 ΠΈΠ· ΠΊΠΎΡΠΎΡΡΡ
ΠΎΡΡΡΠ΅ΡΡΠ²Π»ΡΠ»ΠΎΡΡ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠ΅ Π·Π° ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎΠΌ ΠΏΠΎΡΡΠ΅Π±Π»ΡΠ΅ΠΌΠΎΠΉ ΠΆΠΈΠ΄ΠΊΠΎΡΡΠΈ, ΠΏΠΎΡΠ»Π΅, ΠΏΡΠΈ Π²ΡΡΠ²Π»Π΅Π½Π½ΠΎΠΌ Π΄Π΅ΡΠΈΡΠΈΡΠ΅, ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ ΠΏΠ΅ΡΠ΅Ρ
ΠΎΠ΄ΠΈΠ»ΠΈ Π½Π° ΡΡΠ°ΠΏ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π°, Π³Π΄Π΅ ΠΈΠΌ Π±ΡΠ»ΠΎ ΠΏΡΠ΅Π΄Π»ΠΎΠΆΠ΅Π½ΠΎ Π΄ΠΎΠ±ΠΈΡΠ°ΡΡ Π½Π΅Π΄ΠΎΡΡΠ°ΡΡΠΈΠΉ ΠΎΠ±ΡΠ΅ΠΌ ΡΠ΅ΠΏΠ»ΠΎΠΉ ΠΊΠΈΠΏΡΡΠ΅Π½ΠΎΠΉ Π²ΠΎΠ΄ΠΎΠΉ. ΡΠ°ΡΡΠ΅Ρ Π΄Π΅ΡΠΈΡΠΈΡΠ° ΠΏΠΎΡΡΠ΅Π±Π»Π΅Π½ΠΈΡ ΠΆΠΈΠ΄ΠΊΠΎΡΡΠΈ Π΄Π»Ρ ΠΊΠ°ΠΆΠ΄ΠΎΠ³ΠΎ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΠ»ΡΡ ΡΠ»Π΅Π΄ΡΡΡΠΈΠΌ ΠΎΠ±ΡΠ°Π·ΠΎΠΌ: Β«42,9 (ΠΌΠ») Π₯ ΠΌΠ°ΡΡΡ ΡΠ΅Π»Π° (ΠΊΠ³) β ΡΡΠ΅Π΄Π½ΠΈΠΉ ΠΎΠ±ΡΠ΅ΠΌ ΠΏΠΎΡΡΠ΅Π±Π»ΡΠ΅ΠΌΠΎΠΉ ΠΆΠΈΠ΄ΠΊΠΎΡΡΠΈ Ρ Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Π·Π° 5 Π΄Π½Π΅ΠΉ (ΠΌΠ»)Β». Π’Π°ΠΊΠΈΠΌ ΠΎΠ±ΡΠ°Π·ΠΎΠΌ, Π΄Π΅ΡΠΈΡΠΈΡ ΠΎΠ±ΡΠ΅ΠΌΠ° Π²ΡΠΏΠΈΠ²Π°Π΅ΠΌΠΎΠΉ ΠΆΠΈΠ΄ΠΊΠΎΡΡΠΈ Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ ΡΠΎΡΡΠ°Π²ΠΈΠ» 2101,3 R (ΡΠ°Π·ΠΌΠ°Ρ
) [1902,9; 3119,3] ΠΌΠ». ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΡΠΉ ΠΏΠΈΡΡΠ΅Π²ΠΎΠΉ ΡΠ΅ΠΆΠΈΠΌ Ρ ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΠΌΠΎΠΉ Π³ΡΡΠΏΠΏΡ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΈΠ½ΡΡΠ»ΠΈΠ½ΠΎΠ½Π΅Π·Π°Π²ΠΈΡΠΈΠΌΡΠΌ ΡΠ°Ρ
Π°ΡΠ½ΡΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠΌ 2 ΡΠΈΠΏΠ° ΠΏΡΠΈΠ²Π΅Π» ΠΊ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΡΡΠ΅Π΄Π½Π΅Π³ΠΎ ΡΡΠΎΠ²Π½Ρ Π³Π»ΡΠΊΠΎΠ·Ρ ΠΏΠ»Π°Π·ΠΌΡ ΠΊΡΠΎΠ²ΠΈ (Π½Π΅ΡΠΌΠΎΡΡΡ Π½Π° ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ°Π·Π»ΠΈΡΠΈΡ Π² ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½ΡΠ΅ ΠΏΠ΅ΡΠΈΠΎΠ΄Ρ, ΡΠ΅ΡΠΊΠΎ ΠΏΡΠΎΡΠ»Π΅ΠΆΠΈΠ²Π°Π΅ΡΡΡ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½Π°Ρ ΡΠ΅Π½Π΄Π΅Π½ΡΠΈΡ), Π° ΡΠ°ΠΊΠΆΠ΅ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ» ΡΡΠ°Π±ΠΈΠ»ΠΈΠ·ΠΈΡΠΎΠ²Π°ΡΡ Π΅Π³ΠΎ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ ΡΡΡΠΎΠΊ, ΠΈΠ·Π±Π΅Π³Π°Ρ Π·Π½Π°ΡΠΈΠΌΡΡ
ΠΏΠ΅ΡΠ΅ΠΏΠ°Π΄ΠΎΠ² ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ
Evaluation of the effectiveness of teipping technology in patients with impotence syndrome of the rotator cuff of the shoulder
The purpose of this study was to value efficiency kinesio taping by Kase et al in patients with shoulder impingement syndrome with support treatment. Patients (n = 100) from 30 to 69 years was divided for 2 groups by 50 patients each. The main goal of this study was to measure mobility arms, level of painful feeling and mental condition. Response to treatment was evaluated with the the Disability of Arm, Shoulder, and Hand (DASH) scale, visual analogue scale (VAS), SF-36 BP, SF-36 MH. Measures were assessed before treatment, after treatment and after 1 month. The DASH score of the kinesio taping group was statistically significantly lower after 1 week and 1 month as compared with the control group. So, Kinesio tape has been found to be more effective than the only standard therapy.Π ΡΠ°Π±ΠΎΡΠ΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΎΡΠ΅Π½ΠΊΠ° ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ ΡΠ΅ΠΉΠΏΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ΅ Kase et al. Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π±ΠΎΠ»Π΅Π²ΡΠΌ ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ Π½Π° ΡΠΎΠ½Π΅ ΠΈΠΌΠΏΠΈΠ΄ΠΆΠΌΠ΅Π½Ρ-ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° ΠΏΡΠΈ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠΈ Π°Π΄Π΅ΠΊΠ²Π°ΡΠ½ΠΎΠΉ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΠΏΡΠΈΠ½ΡΠ»ΠΎ ΡΡΠ°ΡΡΠΈΠ΅ 100 ΡΠ΅Π»ΠΎΠ²Π΅ΠΊ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ ΠΎΡ 30 Π΄ΠΎ 69 Π»Π΅Ρ (42 ΠΆΠ΅Π½ΡΠΈΠ½Ρ, 58 ΠΌΡΠΆΡΠΈΠ½), ΠΊΠΎΡΠΎΡΡΠ΅ Π±ΡΠ»ΠΈ ΡΠ°Π·Π΄Π΅Π»Π΅Π½Ρ Π½Π° Π³ΡΡΠΏΠΏΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΈ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ, ΠΏΠΎ 50 Π² ΠΊΠ°ΠΆΠ΄ΠΎΠΉ. Π‘ΡΡΡΡ ΠΌΠ΅ΡΠΎΠ΄Π° ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π±ΡΠ»Π° ΠΎΡΠ΅Π½ΠΊΠ° ΡΡΠ½ΠΊΡΠΈΠΎΠ½ΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π²Π΅ΡΡ
Π½Π΅ΠΉ ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΡΡΠΈ, ΡΡΠΎΠ²Π½Ρ ΡΡΠ±ΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡ
Π±ΠΎΠ»Π΅Π²ΡΡ
ΠΎΡΡΡΠ΅Π½ΠΈΠΉ ΠΈ ΠΏΡΠΈΡ
ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π΄ΠΎ ΠΈ ΠΏΠΎΡΠ»Π΅ Π»Π΅ΡΠ΅Π½ΠΈΡ, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠΏΡΡΡΡ 1 ΠΌΠ΅ΡΡΡ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΡΠΊΠ°Π» DASH, VAS, SF-36 BP, SF-36 MH. ΠΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π°, Π·Π½Π°ΡΠΈΠΌΡΠ΅ ΡΠ°Π·Π»ΠΈΡΠΈΡ Π³ΡΡΠΏΠΏΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΈ Π³ΡΡΠΏΠΏΡ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ Π±ΡΠ»ΠΈ Π²ΡΡΠ²Π»Π΅Π½Ρ ΠΏΠΎ ΡΠΊΠ°Π»Π΅ DASH ΡΠ΅ΡΠ΅Π· 1 Π½Π΅Π΄Π΅Π»Ρ ΠΈ ΡΠ΅ΡΠ΅Π· 1 ΠΌΠ΅ΡΡΡ ΠΏΠΎΡΠ»Π΅ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΠ΅ΠΉΠΏΠΎΠ². ΡΠ°ΠΊΠΈΠΌ ΠΎΠ±ΡΠ°Π·ΠΎΠΌ, ΡΠΊΠ°Π·Π°Π½Π½Π°Ρ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΡ ΡΠ΅ΠΉΠΏΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΈ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠΈ Π°Π΄Π΅ΠΊΠ²Π°ΡΠ½ΠΎΠΉ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΎΠΊΠ°Π·Π°Π»Π°ΡΡ Π±ΠΎΠ»Π΅Π΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½Π° Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ ΡΠΎ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΡΠΌΠΈ ΠΌΠ΅ΡΠΎΠ΄Π°ΠΌΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ, Π° ΠΈΠΌΠ΅Π½Π½ΠΎ, ΡΠΏΠΎΡΠΎΠ±ΡΡΠ²ΠΎΠ²Π°Π»Π° Π±ΠΎΠ»Π΅Π΅ Π±ΡΡΡΡΠΎΠΌΡ Π²ΠΎΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΡ ΡΡΠ½ΠΊΡΠΈΠΈ ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΡΡΠΈ, Π½ΠΎ Π½Π΅ ΠΎΠΊΠ°Π·ΡΠ²Π°Π»Π° Π²Π»ΠΈΡΠ½ΠΈΡ Π½Π° Π±ΠΎΠ»Π΅Π²ΠΎΠΉ ΡΠΈΠ½Π΄ΡΠΎΠΌ ΠΈ ΠΏΡΠΈΡ
ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²
RNase T1 mimicking artificial ribonuclease
Recently, artificial ribonucleases (aRNases)βconjugates of oligodeoxyribonucleotides and peptide (LR)4-G-amideβwere designed and assessed in terms of the activity and specificity of RNA cleavage. The conjugates were shown to cleave RNA at Pyr-A and GβX sequences. Variations of oligonucleotide length and sequence, peptide and linker structure led to the development of conjugates exhibiting GβX cleavage specificity only. The most efficient catalyst is built of nonadeoxyribonucleotide of unique sequence and peptide (LR)4-G-NH2 connected by the linker of three abasic deoxyribonucleotides (conjugate pep-9). Investigation of the cleavage specificity of conjugate pep-9 showed that the compound is the first single-stranded guanine-specific aRNase, which mimics RNase T1. Rate enhancement of RNA cleavage at GβX linkages catalysed by pep-9 is 108 compared to non-catalysed reaction, pep-9 cleaves these linkages only 105-fold less efficiently than RNase T1 (kcat_RNase T1/kcat_pep-9 = 105)
Cleavage of 5β²-P-labelled RNA-96 by and RNase T1 under various conditions
<p><b>Copyright information:</b></p><p>Taken from "RNase T1 mimicking artificial ribonuclease"</p><p></p><p>Nucleic Acids Research 2007;35(7):2356-2367.</p><p>Published online 27 Mar 2007</p><p>PMCID:PMC1874650.</p><p>Β© 2007 The Author(s)</p> Autoradiograph of 12% polyacrylamideβ8βM urea gel. Lanes Lβimidazole ladder. Lanes CβRNA incubated in the absence of cleaving agents for 8βh and 15βmin, respectively. reaction: [5β²-P]-RNA-96 was incubated in the presence of 10βΞΌM in buffers and at 37Β°C for 5β8βh. T1-reaction: [5β²-P]-RNA-96 was incubated in the presence of 3β5 U RNase T1 in buffer at 50Β°C and in buffers or at 37Β°C for 15βmin. Buffers are listed in the Materials and methods section. Incubation time, concentration of RNase T1 and experimental conditions are indicated in the top. Location of cleavage sites is shown on the left and right
ΠΡΠ΄Π°Π»Π΅Π½Π½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Ρ ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠ΅ΡΠ΅Π±ΡΠ°Π»ΡΠ½ΡΡ Π°Π½Π΅Π²ΡΠΈΠ·ΠΌ Π² ΠΎΡΡΡΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ ΠΊΡΠΎΠ²ΠΎΠΈΠ·Π»ΠΈΡΠ½ΠΈΡ
The influence of the consequences of aneurysmal subarachnoid hemorrhage on the human body in the long-term period has been insufficiently studied. Most studies indicate a high risk of developing cognitive impairment. Until now, there is no unified algorithm for the management of patients with aneurysmal subarachnoid hemorrhage, who need long-term comprehensive rehabilitation and supervision of specialists in various fields.Aim of study. To study the influence of the nature, severity, features of the clinical manifestation of aneurysmal subarachnoid hemorrhage, as well as the choice of the method of intervention in the acute period of the disease on the long-term results of treatment of aneurysms.Material and methods. In the presented study, the observation group included 74 patients who were operated on in the emergency neurosurgery department of the N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health Department from 2013 to 2019 in the acute period of subarachnoid hemorrhage (during the first 14 days after the rupture of the cerebral aneurysm). The average age of patients at the time of surgery was 47 [Me=46; min=27; max=76] years old. The ruptured aneurysm was turned off from the bloodstream by one of the following methods: microsurgical intervention with the application of a clip to the aneurysm neck (50 (67,6%) patients), the simultaneous open intervention of aneurysm clipping, and the formation of an extra-intracranial micro anastomosis from the side of the aneurysm access (8 (10,8%) patients), endovascular exclusion of the cerebral aneurysm from the bloodstream (16 (21,6%) patients). On average, after 2,4 [Me=2,5; min=1; max=6] years, patients were invited for a clinical and neurological examination, which included testing according to the Modified Rankin Scale (MRS), the Bartel Index questionnaire, the Mini-Mental Status Scale (MMSS), and the Hospital Anxiety and Depression Scale (HADS). We analysed the changes in the professional activity and habitual lifestyle of patients, as well as the influence of the most common risk factors: arterial hypertension, diabetes mellitus, smoking, on long-term outcomes.Results. In the long-term period of surgical treatment of cerebral aneurysms, on average after 2,4 [Me=2,5; min=1; max=6] years after subarachnoid hemorrhage, 30 (40,5%) patients scored 0 points on the Modified Rankin Scale, 27 (36,5%) patients β 1 point, 6 (8,1%) patients β 2 points, in 6 (8,1%) patients β 3 points, in 4 (5,4%) patients β 4 points and in 1 (1,4%) patient β 5 points. A significant dependence of the degree of disability according to the modified Rankin scale in the long-term period of subarachnoid hemorrhage on the severity of the patientβs condition at discharge from the hospital was revealed according to the Glasgow Outcome Scale (p<0,001). The patientβs age at the time of rupture of the aneurysm independently influenced cognitive functions and the ability to self-care in the long-term period. With an increase in age by 1 year, the score on the short scale of mental status and on the Bartel questionnaire decreased by 0,08 (p=0,03) and by 0,3 (p=0,04), respectively. With the simultaneous presence of intracerebral hemorrhage and the severity of subarachnoid hemorrhage corresponding to grade III according to the Fisher classification, the likelihood of developing anxiety and depressive mental disorders according to the hospital scale of anxiety and depression increased significantly (p><0,01). The development of intracerebral hematoma with aneurysmal hemorrhage contributed to the appearance of hypertension (p><0,05). Conclusion The revealed disorders that persist for several years after the intervention indicate the need for long-term follow-up of patients who underwent intervention for subarachnoid hemorrhage, the development of individual programs for physical and psychological rehabilitation, and clinical examination of persons at high risk. Keywords: subarachnoid hemorrhage, aneurysm, follow-up, low-flow bypass, endovascular intervention>Λ 0,001). The patientβs age at the time of rupture of the aneurysm independently influenced cognitive functions and the ability to self-care in the long-term period. With an increase in age by 1 year, the score on the short scale of mental status and on the Bartel questionnaire decreased by 0,08 (p=0,03) and by 0,3 (p=0,04), respectively. With the simultaneous presence of intracerebral hemorrhage and the severity of subarachnoid hemorrhage corresponding to grade III according to the Fisher classification, the likelihood of developing anxiety and depressive mental disorders according to the hospital scale of anxiety and depression increased significantly (pΛ 0,01). The development of intracerebral hematoma with aneurysmal hemorrhage contributed to the appearance of hypertension (p<0,05). Conclusion The revealed disorders that persist for several years after the intervention indicate the need for long-term follow-up of patients who underwent intervention for subarachnoid hemorrhage, the development of individual programs for physical and psychological rehabilitation, and clinical examination of persons at high risk. Keywords: subarachnoid hemorrhage, aneurysm, follow-up, low-flow bypass, endovascular intervention>Λ 0,01). The development of intracerebral hematoma with aneurysmal hemorrhage contributed to the appearance of hypertension (pΛ 0,05).Conclusion. The revealed disorders that persist for several years after the intervention indicate the need for long-term follow-up of patients who underwent intervention for subarachnoid hemorrhage, the development of individual programs for physical and psychological rehabilitation, and clinical examination of persons at high risk.Β ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. ΠΠ»ΠΈΡΠ½ΠΈΠ΅ ΠΏΠΎΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠΉ Π°Π½Π΅Π²ΡΠΈΠ·ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΡΠ±Π°ΡΠ°Ρ
Π½ΠΎΠΈΠ΄Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²ΠΎΠΈΠ·Π»ΠΈΡΠ½ΠΈΡ (Π‘ΠΠ) Π½Π° ΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌ ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ° Π² ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ ΠΈΠ·ΡΡΠ΅Π½ΠΎ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²Π° ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΡΠΊΠ°Π·ΡΠ²Π°ΡΡ Π½Π° Π²ΡΡΠΎΠΊΠΈΠΉ ΡΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ. ΠΠΎ Π½Π°ΡΡΠΎΡΡΠ΅Π³ΠΎ Π²ΡΠ΅ΠΌΠ΅Π½ΠΈ ΠΎΡΡΡΡΡΡΠ²ΡΠ΅Ρ Π΅Π΄ΠΈΠ½ΡΠΉ Π°Π»Π³ΠΎΡΠΈΡΠΌ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΏΠ΅ΡΠ΅Π½Π΅ΡΡΠΈΡ
Π°Π½Π΅Π²ΡΠΈΠ·ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π‘ΠΠ, ΠΊΠΎΡΠΎΡΡΠ΅ Π½ΡΠΆΠ΄Π°ΡΡΡΡ Π² Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠΉ ΡΠ΅Π°Π±ΠΈΠ»ΠΈΡΠ°ΡΠΈΠΈ ΠΈ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠΈ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΠΎΠ² ΡΠ°Π·Π½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠΈΠ»Ρ.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. ΠΠ·ΡΡΠΈΡΡ Π²Π»ΠΈΡΠ½ΠΈΠ΅ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ°, ΡΡΠΆΠ΅ΡΡΠΈ, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠ΅ΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΡ Π°Π½Π΅Π²ΡΠΈΠ·ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π‘ΠΠ, Π° ΡΠ°ΠΊΠΆΠ΅ Π²ΡΠ±ΠΎΡΠ° ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠΈ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π° Π² ΠΎΡΡΡΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π½Π° ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π»Π΅ΡΠ΅Π½ΠΈΡ Π°Π½Π΅Π²ΡΠΈΠ·ΠΌ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π½ΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ Π² Π³ΡΡΠΏΠΏΡ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ Π²ΠΎΡΠ»ΠΈ 74 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°, ΠΎΠΏΠ΅ΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
Π² ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠΈ Π½Π΅ΠΎΡΠ»ΠΎΠΆΠ½ΠΎΠΉ Π½Π΅ΠΉΡΠΎΡ
ΠΈΡΡΡΠ³ΠΈΠΈ ΠΠΠ Π‘Π ΠΈΠΌ. Π.Π. Π‘ΠΊΠ»ΠΈΡΠΎΡΠΎΠ²ΡΠΊΠΎΠ³ΠΎ Ρ 2013 ΠΏΠΎ 2019 Π³. Π² ΠΎΡΡΡΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ Π‘ΠΠ (Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ ΠΏΠ΅ΡΠ²ΡΡ
14 ΡΡΡΠΎΠΊ ΠΏΠΎΡΠ»Π΅ ΡΠ°Π·ΡΡΠ²Π° ΡΠ΅ΡΠ΅Π±ΡΠ°Π»ΡΠ½ΠΎΠΉ Π°Π½Π΅Π²ΡΠΈΠ·ΠΌΡ). Π‘ΡΠ΅Π΄Π½ΠΈΠΉ Π²ΠΎΠ·ΡΠ°ΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π½Π° ΠΌΠΎΠΌΠ΅Π½Ρ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ» 47 [Me=46; min=27; max=76] Π»Π΅Ρ. ΠΡΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅ ΡΠ°Π·ΠΎΡΠ²Π°Π²ΡΠ΅ΠΉΡΡ Π°Π½Π΅Π²ΡΠΈΠ·ΠΌΡ ΠΈΠ· ΠΊΡΠΎΠ²ΠΎΡΠΎΠΊΠ° ΠΎΡΡΡΠ΅ΡΡΠ²Π»ΡΠ»ΠΎΡΡ ΠΎΠ΄Π½ΠΈΠΌ ΠΈΠ· ΡΠ»Π΅Π΄ΡΡΡΠΈΡ
ΡΠΏΠΎΡΠΎΠ±ΠΎΠ²: ΠΌΠΈΠΊΡΠΎΡ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²ΠΎ Ρ Π½Π°Π»ΠΎΠΆΠ΅Π½ΠΈΠ΅ΠΌ ΠΊΠ»ΠΈΠΏΡΡ Π½Π° ΡΠ΅ΠΉΠΊΡ Π°Π½Π΅Π²ΡΠΈΠ·ΠΌΡ (50 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (67,6%)), ΡΠΈΠΌΡΠ»ΡΡΠ°Π½Π½ΠΎΠ΅ ΠΎΡΠΊΡΡΡΠΎΠ΅ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²ΠΎ ΠΊΠ»ΠΈΠΏΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π°Π½Π΅Π²ΡΠΈΠ·ΠΌΡ ΠΈ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΡΠΊΡΡΡΠ°-ΠΈΠ½ΡΡΠ°ΠΊΡΠ°Π½ΠΈΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΌΠΈΠΊΡΠΎΠ°Π½Π°ΡΡΠΎΠΌΠΎΠ·Π° ΡΠΎ ΡΡΠΎΡΠΎΠ½Ρ Π΄ΠΎΡΡΡΠΏΠ° ΠΊ Π°Π½Π΅Π²ΡΠΈΠ·ΠΌΠ΅ (8 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (10,8%)), ΡΠ½Π΄ΠΎΠ²Π°ΡΠΊΡΠ»ΡΡΠ½ΠΎΠ΅ Π²ΡΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅ ΡΠ΅ΡΠ΅Π±ΡΠ°Π»ΡΠ½ΠΎΠΉ Π°Π½Π΅Π²ΡΠΈΠ·ΠΌΡ ΠΈΠ· ΠΊΡΠΎΠ²ΠΎΡΠΎΠΊΠ° (16 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (21,6%)). Π ΡΡΠ΅Π΄Π½Π΅ΠΌ ΡΠ΅ΡΠ΅Π· 2,4 [Me=2,5; min=1; max=6] Π³ΠΎΠ΄Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΏΡΠΈΠ³Π»Π°ΡΠ°Π»ΠΈ Π½Π° ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅, ΠΊΠΎΡΠΎΡΠΎΠ΅ Π²ΠΊΠ»ΡΡΠ°Π»ΠΎ ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΠΎ ΠΌΠΎΠ΄ΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΡΠΊΠ°Π»Π΅ Π ΡΠ½ΠΊΠΈΠ½Π° (mRs), ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊΡ ΠΠ½Π΄Π΅ΠΊΡ ΠΠ°ΡΡΠ΅Π», ΠΊΡΠ°ΡΠΊΠΎΠΉ ΡΠΊΠ°Π»Π΅ ΠΏΡΠΈΡ
ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΡΠ°ΡΡΡΠ° (MMSE), Π³ΠΎΡΠΏΠΈΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π»Π΅ ΡΡΠ΅Π²ΠΎΠ³ΠΈ ΠΈ Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΠΈ (HADS). ΠΠ½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π»ΠΈ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠΉ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΠΈ ΠΏΡΠΈΠ²ΡΡΠ½ΠΎΠ³ΠΎ ΡΠΊΠ»Π°Π΄Π° ΠΆΠΈΠ·Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², Π° ΡΠ°ΠΊΠΆΠ΅ Π²Π»ΠΈΡΠ½ΠΈΠ΅ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΡΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ°: Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΡΠ΅Π½Π·ΠΈΠΈ, ΡΠ°Ρ
Π°ΡΠ½ΠΎΠ³ΠΎ Π΄ΠΈΠ°Π±Π΅ΡΠ° ΠΈ ΠΊΡΡΠ΅Π½ΠΈΡ Π½Π° ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΡΠ΅ ΠΈΡΡ
ΠΎΠ΄Ρ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠ΅ΡΠ΅Π±ΡΠ°Π»ΡΠ½ΡΡ
Π°Π½Π΅Π²ΡΠΈΠ·ΠΌ, Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ ΡΠ΅ΡΠ΅Π· 2,4 [Me=2,5; min=1; max=6] Π³ΠΎΠ΄Π° ΠΏΠΎΡΠ»Π΅ ΠΏΠ΅ΡΠ΅Π½Π΅ΡΠ΅Π½Π½ΠΎΠ³ΠΎ Π‘ΠΠ, Ρ 30 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (40,5%) Π½Π°Π±ΡΠ°Π½ΠΎ 0 Π±Π°Π»Π»ΠΎΠ² ΠΏΠΎ ΠΌΠΎΠ΄ΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΡΠΊΠ°Π»Π΅ Π ΡΠ½ΠΊΠΈΠ½Π°, Ρ 27 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (36,5%) β 1 Π±Π°Π»Π», Ρ 6 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (8,1%) β 2 Π±Π°Π»Π»Π°, Ρ 6 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (8,1%) β 3 Π±Π°Π»Π»Π°, Ρ 4 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (5,4%) β 4 Π±Π°Π»Π»Π° ΠΈ Ρ 1 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° (1,4%) β 5 Π±Π°Π»Π»ΠΎΠ². ΠΡΡΠ²Π»Π΅Π½Π° ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠ°Ρ Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΡ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΠΈΠ½Π²Π°Π»ΠΈΠ΄Π½ΠΎΡΡΠΈ ΠΏΠΎ mRs Π² ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ Π‘ΠΠ ΠΎΡ ΡΡΠΆΠ΅ΡΡΠΈ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° ΠΏΡΠΈ Π²ΡΠΏΠΈΡΠΊΠ΅ ΠΈΠ· ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ° ΠΏΠΎ ΡΠΊΠ°Π»Π΅ ΠΈΡΡ
ΠΎΠ΄ΠΎΠ² ΠΠ»Π°Π·Π³ΠΎ (p<0,001). ΠΠΎΠ·ΡΠ°ΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Π½Π° ΠΌΠΎΠΌΠ΅Π½Ρ ΡΠ°Π·ΡΡΠ²Π° Π°Π½Π΅Π²ΡΠΈΠ·ΠΌΡ Π½Π΅Π·Π°Π²ΠΈΡΠΈΠΌΠΎ Π²Π»ΠΈΡΠ» Π½Π° ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΠ΅ ΡΡΠ½ΠΊΡΠΈΠΈ ΠΈ Π½Π° ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΡ ΠΊ ΡΠ°ΠΌΠΎΠΎΠ±ΡΠ»ΡΠΆΠΈΠ²Π°Π½ΠΈΡ Π² ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅. ΠΡΠΈ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠΈ Π²ΠΎΠ·ΡΠ°ΡΡΠ° Π½Π° 1 Π³ΠΎΠ΄ Π±Π°Π»Π» ΠΏΠΎ ΠΊΡΠ°ΡΠΊΠΎΠΉ ΡΠΊΠ°Π»Π΅ ΠΏΡΠΈΡ
ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΡΠ°ΡΡΡΠ° ΠΈ ΠΏΠΎ ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊΡ ΠΠ½Π΄Π΅ΠΊΡ ΠΠ°ΡΡΠ΅Π» ΡΠΌΠ΅Π½ΡΡΠ°Π»ΡΡ Π½Π° 0,08 (p=0,03) ΠΈ Π½Π° 0,3 (p=0,04) ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ. ΠΡΠΈ ΠΎΠ΄Π½ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΌ Π½Π°Π»ΠΈΡΠΈΠΈ Π²Π½ΡΡΡΠΈΠΌΠΎΠ·Π³ΠΎΠ²ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²ΠΎΠΈΠ·Π»ΠΈΡΠ½ΠΈΡ ΠΈ ΡΡΠΆΠ΅ΡΡΠΈ ΡΠ‘ΠΠ, ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΡΡΡΠ΅ΠΉ III ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΠΏΠΎ ΠΊΠ»Π°ΡΡΠΈΡΠΈΠΊΠ°ΡΠΈΠΈ Fisher, Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΡΠ΅Π²ΠΎΠΆΠ½ΡΡ
ΠΈ Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΠ²Π½ΡΡ
ΠΏΡΠΈΡ
ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ°ΡΡΡΡΠΎΠΉΡΡΠ² ΠΏΠΎ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π»Π΅ ΡΡΠ΅Π²ΠΎΠ³ΠΈ ΠΈ Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΠΈ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ, ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΠ°Π»Π° (p><0,01). Π Π°Π·Π²ΠΈΡΠΈΠ΅ Π²Π½ΡΡΡΠΈΠΌΠΎΠ·Π³ΠΎΠ²ΠΎΠΉ Π³Π΅ΠΌΠ°ΡΠΎΠΌΡ ΠΏΡΠΈ Π°Π½Π΅Π²ΡΠΈΠ·ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΌ ΠΊΡΠΎΠ²ΠΎΠΈΠ·Π»ΠΈΡΠ½ΠΈΠΈ ΡΠΏΠΎΡΠΎΠ±ΡΡΠ²ΠΎΠ²Π°Π»ΠΎ ΠΏΠΎΡΠ²Π»Π΅Π½ΠΈΡ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ (p><0,05, ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎ). ΠΠ«ΠΠΠ ΠΡΡΠ²Π»Π΅Π½Π½ΡΠ΅ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ, ΡΠΎΡ
ΡΠ°Π½ΡΡΡΠΈΠ΅ΡΡ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΈΡ
Π»Π΅Ρ ΠΏΠΎΡΠ»Π΅ ΠΏΠ΅ΡΠ΅Π½Π΅ΡΠ΅Π½Π½ΠΎΠ³ΠΎ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π°, ΡΠΊΠ°Π·ΡΠ²Π°ΡΡ Π½Π° Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΡ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΏΠ΅ΡΠ΅Π½Π΅ΡΡΠΈΡ
Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²ΠΎ ΠΏΠΎ ΠΏΠΎΠ²ΠΎΠ΄Ρ ΡΡΠ±Π°ΡΠ°Ρ
Π½ΠΎΠΈΠ΄Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²ΠΎΠΈΠ·Π»ΠΈΡΠ½ΠΈΡ, ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΡ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΡΠ½ΡΡ
ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌ ΡΠΈΠ·ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈ ΠΏΡΠΈΡ
ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅Π°Π±ΠΈΠ»ΠΈΡΠ°ΡΠΈΠΈ, Π΄ΠΈΡΠΏΠ°Π½ΡΠ΅ΡΠΈΠ·Π°ΡΠΈΠΈ Π»ΠΈΡ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ. ΠΠ»ΡΡΠ΅Π²ΡΠ΅ ΡΠ»ΠΎΠ²Π°: ΡΡΠ±Π°ΡΠ°Ρ
Π½ΠΎΠΈΠ΄Π°Π»ΡΠ½ΠΎΠ΅ ΠΊΡΠΎΠ²ΠΎΠΈΠ·Π»ΠΈΡΠ½ΠΈΠ΅, Π°Π½Π΅Π²ΡΠΈΠ·ΠΌΠ°, ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ, ΡΠΊΡΡΡΠ°-ΠΈΠ½ΡΡΠ°ΠΊΡΠ°Π½ΠΈΠ°Π»ΡΠ½ΡΠΉ ΠΌΠΈΠΊΡΠΎΠ°Π½Π°ΡΡΠΎΠΌΠΎΠ·, ΡΠ½Π΄ΠΎΠ²Π°ΡΠΊΡΠ»ΡΡΠ½ΠΎΠ΅ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²ΠΎ>Λ 0,001). ΠΠΎΠ·ΡΠ°ΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Π½Π° ΠΌΠΎΠΌΠ΅Π½Ρ ΡΠ°Π·ΡΡΠ²Π° Π°Π½Π΅Π²ΡΠΈΠ·ΠΌΡ Π½Π΅Π·Π°Π²ΠΈΡΠΈΠΌΠΎ Π²Π»ΠΈΡΠ» Π½Π° ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΠ΅ ΡΡΠ½ΠΊΡΠΈΠΈ ΠΈ Π½Π° ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΡ ΠΊ ΡΠ°ΠΌΠΎΠΎΠ±ΡΠ»ΡΠΆΠΈΠ²Π°Π½ΠΈΡ Π² ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅. ΠΡΠΈ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠΈ Π²ΠΎΠ·ΡΠ°ΡΡΠ° Π½Π° 1 Π³ΠΎΠ΄ Π±Π°Π»Π» ΠΏΠΎ ΠΊΡΠ°ΡΠΊΠΎΠΉ ΡΠΊΠ°Π»Π΅ ΠΏΡΠΈΡ
ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΡΠ°ΡΡΡΠ° ΠΈ ΠΏΠΎ ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊΡ ΠΠ½Π΄Π΅ΠΊΡ ΠΠ°ΡΡΠ΅Π» ΡΠΌΠ΅Π½ΡΡΠ°Π»ΡΡ Π½Π° 0,08 (p=0,03) ΠΈ Π½Π° 0,3 (p=0,04) ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ. ΠΡΠΈ ΠΎΠ΄Π½ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΌ Π½Π°Π»ΠΈΡΠΈΠΈ Π²Π½ΡΡΡΠΈΠΌΠΎΠ·Π³ΠΎΠ²ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²ΠΎΠΈΠ·Π»ΠΈΡΠ½ΠΈΡ ΠΈ ΡΡΠΆΠ΅ΡΡΠΈ ΡΠ‘ΠΠ, ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΡΡΡΠ΅ΠΉ III ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΠΏΠΎ ΠΊΠ»Π°ΡΡΠΈΡΠΈΠΊΠ°ΡΠΈΠΈ Fisher, Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΡΠ΅Π²ΠΎΠΆΠ½ΡΡ
ΠΈ Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΠ²Π½ΡΡ
ΠΏΡΠΈΡ
ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ°ΡΡΡΡΠΎΠΉΡΡΠ² ΠΏΠΎ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π»Π΅ ΡΡΠ΅Π²ΠΎΠ³ΠΈ ΠΈ Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΠΈ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ, ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΠ°Π»Π° (p<0,01). Π Π°Π·Π²ΠΈΡΠΈΠ΅ Π²Π½ΡΡΡΠΈΠΌΠΎΠ·Π³ΠΎΠ²ΠΎΠΉ Π³Π΅ΠΌΠ°ΡΠΎΠΌΡ ΠΏΡΠΈ Π°Π½Π΅Π²ΡΠΈΠ·ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΌ ΠΊΡΠΎΠ²ΠΎΠΈΠ·Π»ΠΈΡΠ½ΠΈΠΈ ΡΠΏΠΎΡΠΎΠ±ΡΡΠ²ΠΎΠ²Π°Π»ΠΎ ΠΏΠΎΡΠ²Π»Π΅Π½ΠΈΡ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ (p>Λ 0,05, ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎ).ΠΡΠ²ΠΎΠ΄. ΠΡΡΠ²Π»Π΅Π½Π½ΡΠ΅ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ, ΡΠΎΡ
ΡΠ°Π½ΡΡΡΠΈΠ΅ΡΡ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΈΡ
Π»Π΅Ρ ΠΏΠΎΡΠ»Π΅ ΠΏΠ΅ΡΠ΅Π½Π΅ΡΠ΅Π½Π½ΠΎΠ³ΠΎ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π°, ΡΠΊΠ°Π·ΡΠ²Π°ΡΡ Π½Π° Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΡ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΏΠ΅ΡΠ΅Π½Π΅ΡΡΠΈΡ
Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²ΠΎ ΠΏΠΎ ΠΏΠΎΠ²ΠΎΠ΄Ρ ΡΡΠ±Π°ΡΠ°Ρ
Π½ΠΎΠΈΠ΄Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²ΠΎΠΈΠ·Π»ΠΈΡΠ½ΠΈΡ, ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΡ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΡΠ½ΡΡ
ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌ ΡΠΈΠ·ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈ ΠΏΡΠΈΡ
ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅Π°Π±ΠΈΠ»ΠΈΡΠ°ΡΠΈΠΈ, Π΄ΠΈΡΠΏΠ°Π½ΡΠ΅ΡΠΈΠ·Π°ΡΠΈΠΈ Π»ΠΈΡ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ.