78 research outputs found
Determinants of Short-term Liabilities of Financially Distressed SME-s
The article studies the determinants of short-term liabilities of financially distressed small and medium-sized enterprises in Bulgaria. The research is based on data from the financial statements of one hundred non-financial enterprises in different industries in the period from 2014 to 2016, provided by the National Statistical Institute.
A company is defined as financially distressed if it cannot cover its short-term liabilities with its operating cash flow. By employing multiple regression analysis, we design a model, which shows the positive impact of the levels of net sales revenue, inventory, receivables from customers and suppliers and financial assets, and the negative impact of the ratio of current assets to total assets on the short-term debt of financially distressed SME-s
Survey of the Attitudes of Nursing Undergraduate Students towards Work with Children with Disabilities and Their Families
Introduction: The attitude to people with disabilities is the most crucial criterion for the maturity of a society. The development and implementation of policy on early childhood are a part of the values and policies of all EU countries, including Bulgaria, which necessitates the introduction of an integrated approach of institutions and society, as well as services based on intercector cooperation .The aim of the present survey is to study the attitudes and needs of nursing undergraduate students to provide integrated health and social services for children with disabilities and their families, as well as their inclusion in follow-up education and specialisation in the field of integrated care.Material and methods: the opinion of 150 undergraduate students of nursing at Varna Medical University and Veliko Tarnovo, Sumen and Sliven subsidiaries was polled July-September, 2020.Methods of the survey β an inquiry method, a statistical method for processing and analysis of information.Results and discussion: a considerable share of the future nurses say that they received information on the types of integrated health and social services over the course of their studies (96%). In terms of the nurseβs role in providing them, according to 62% of the students, her inclusion in the team would improve the quality of child care. Only one-third of the respondents say that they are ready to work in the field of integrated care (35.3%). More than half (59.3%) would like to participate in courses for follow-up education of specialists involved in the care of children with disabilities and their families.Conclusions: The results of the survey suggest that the students realise the need to include the nurse in the team for providing integrated care of children with disabilities and are aware of the need to to be included in the various forms of follow-up education, intended to improve the quality of the care provided
Survey of attitudes of nurse and midwife university students for provision of health and social services for children and families
The chances for human health are closely related to the conditions under which they are born and they live. The deinstitutionalization of children up to 18 years includes activities for providing community living for every child by establishing a system of services and measures ensuring the prevention of abandonment.Aim: The aim of this study is to identify the factors influencing career choices and the willingness of nurses and midwives to provide health and social services for prevention of abandonment of children, supporting families of children with medical risk in the family environment.Material and Methods: For the purpose of this study we examined the opinion of 40 nurse and midwife university students enrolled for the school year 2015/2016 in the branch campus - Veliko Tarnovo, with mean age of 28.7 years. Documentary method, a 9-item questionnaire and graphical analysis are used.Results and discussion: The data from this survey shows that 37.7% of respondents chose this profession because they would have a successful future realization. The choice of profession of all of the nurses is the first desire and less than half (40%) of midwives have made their first career choice. Sixty percent of all students say they would work with children with disabilities, 63% of them are partly familiar with the problems of families who raise children with disabilities.Conclusions: Based on the motivated professional choice and the positive attitude of students to the problems of children at risk and in implementation of the strategic documents, it is necessary to update the programme of studies in clinical practice and to introduce an optional subject `Early childhood intervention` in the programme of studies
Integrated Health And Social Services For Chilren With Disabilities: A Challenge For The Nurse
One of the most crucial criteria for the mechanism and maturity of society is its attitude to children and adults with disabilities. The development and implementation of the policies on early childhood are part of the values and policies of all EU countries, including Bulgaria.The aim of the present study is to research and analyse the nurseβs role in the multidisciplinary team in providing integrated health and social services to children with disabilities, as well as in providing professional assistance in a domestic environment.Materials and methods: the opinions of sixty three specialists working in seven social services for children with disabilities in Veliko Turnovo and Svishtov municipalities, and twenty five parents of children with disabilities were polled. Sociological, documentary and statistical methods were used, as well as graphical analysis. The inquiry card has nineteen questions. The questionnaire for parents includes seven open questions.Results and discussion: the data of the poll suggest that 94% of the specialists consider the inclusion of the nurse in the multidisciplinary team to be a guarantee of the service quality. The respondents expect the nurse to have above all skills for teamwork, flexibility, and an aptitude for working with children with disabilities (81%), to be familiar with the specific nature of social work (55%), to train parents and provide mobile services (56%). More than half of the parents want to get professional assistance in a domestic environment.Conclusion: the integrated services for children with disabilities are of great significance for the child, the family and the community. They help children achieve better results, defend human rights, support the families. Joining the forces of all institutions of the health and social area is a major factor in the success and development of integrated health and social services
The role of health professionals from children and school health care in the implementation of the child componentβ βHealthy children in healthy families` of the Cindi program
βΠΠ΄ΡΠ°Π²ΠΈ Π΄Π΅ΡΠ° Π² Π·Π΄ΡΠ°Π²ΠΈ ΡΠ΅ΠΌΠ΅ΠΉΡΡΠ²Π°` Π΅ Π΄Π΅ΡΡΠΊΠ°ΡΠ° ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½ΡΠ° Π½Π° ΠΏΡΠΎΠ³ΡΠ°ΠΌΠ° Π‘ΠΠΠΠ, ΠΊΠΎΡΡΠΎ ΡΠ΅ ΡΠ΅Π°Π»ΠΈΠ·ΠΈΡΠ° Π² Π·ΠΎΠ½Π° ΠΠ΅Π»ΠΈΠΊΠΎ Π’ΡΡΠ½ΠΎΠ²ΠΎ ΠΎΡ 2008 Π³ΠΎΠ΄ΠΈΠ½Π°. ΠΡΠΎΠ³ΡΠ°ΠΌΠ°ΡΠ° ΠΏΡΠ΅Π΄Π»Π°Π³Π° ΡΠ°ΠΌΠΊΠ° Π·Π° ΠΏΠΎΠ»ΠΈΡΠΈΠΊΠ° ΠΈ ΡΡΡΠ°ΡΠ΅Π³ΠΈΡ Π² ΠΎΠ±Π»Π°ΡΡΡΠ° Π½Π° ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ°ΡΠ° Π½Π° Ρ
ΡΠΎΠ½ΠΈΡΠ½ΠΈΡΠ΅ Π½Π΅Π·Π°ΡΠ°Π·Π½ΠΈ Π±ΠΎΠ»Π΅ΡΡΠΈ ΠΏΡΠΈ Π΄Π΅ΡΠ°ΡΠ° ΠΈ ΡΠ΅ ΠΎΡΡΡΠ΅ΡΡΠ²ΡΠ²Π° ΡΡΠ΅Π· Π΄Π΅ΠΉΠ½ΠΎΡΡΠΈ Π·Π° ΠΏΡΠΎΠΌΠΎΡΠΈΡ Π½Π° Π·Π΄ΡΠ°Π²Π΅ΡΠΎ, ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ° Π½Π° Π±ΠΎΠ»Π΅ΡΡΠΈΡΠ΅ ΠΈ ΠΏΡΠΎΠΌΡΠ½Π° Π½Π°ΡΠΈΠ½Π° Π½Π° ΠΆΠΈΠ²ΠΎΡ Ρ ΡΡΠ°ΡΡΠΈΠ΅ΡΠΎ Π½Π° Π΄Π΅ΡΠ° ΠΈ ΡΠ΅Ρ
Π½ΠΈΡΠ΅ ΡΠ΅ΠΌΠ΅ΠΉΡΡΠ²Π°.Π¦Π΅Π»ΡΠ° Π½Π° Π½Π°ΡΡΠΎΡΡΠΎΡΠΎ ΠΏΡΠΎΡΡΠ²Π°Π½Π΅ Π΅ Π΄Π° ΡΠ΅ Π°ΠΊΡΠ΅Π½ΡΠΈΡΠ° Π²ΡΡΡ
Ρ ΡΠΎΠ»ΡΡΠ° Π½Π° Π·Π΄ΡΠ°Π²Π½ΠΈΡΠ΅ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΠΈ ΠΎΡ Π΄Π΅ΡΡΠΊΠΎΡΠΎ ΠΈ ΡΡΠΈΠ»ΠΈΡΠ½ΠΎ Π·Π΄ΡΠ°Π²Π΅ΠΎΠΏΠ°Π·Π²Π°Π½Π΅ Π² ΠΎΡΠΈΠ³ΡΡΡΠ²Π°Π½Π΅ Π½Π° ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΎΠ½Π½ΠΎ-ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°ΡΠ΅Π»Π½ΠΈ ΠΈ Π·Π΄ΡΠ°Π²Π½ΠΎ-ΠΊΠΎΠ½ΡΡΠ»ΡΠ°ΡΠΈΠ²Π½ΠΈ ΡΡΠ»ΡΠ³ΠΈ Π½Π° ΡΡΠ΅Π½ΠΈΡΠΈΡΠ΅ Π·Π° ΠΈΠ·Π³ΡΠ°ΠΆΠ΄Π°Π½Π΅ Π½Π° ΠΆΠΈΠ·Π½Π΅Π½ΠΎ Π²Π°ΠΆΠ½ΠΈ ΡΠΌΠ΅Π½ΠΈΡ Π·Π° ΠΎΡΠ³ΠΎΠ²ΠΎΡΠ½ΠΎ Π·Π΄ΡΠ°Π²ΠΎΡΠ»ΠΎΠ²Π½ΠΎ ΠΏΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅.ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ: ΠΠ° ΡΠ΅Π»ΡΠ° Π½Π° Π½Π°ΡΡΠΎΡΡΠΎ ΡΠΎ ΠΈΠ·ΡΠ»Π΅Π΄Π²Π°Π½Π΅ Π±Π΅ ΠΏΡΠΎΡΡΠ΅Π½ΠΎ ΠΌΠ½Π΅Π½ΠΈΠ΅ΡΠΎ Π½Π° 46 Π·Π΄ΡΠ°Π²Π½ΠΈ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΠΈ ΠΎΡ ΠΎΠ±ΡΠΈΠ½Π° ΠΠ΅Π»ΠΈΠΊΠΎ Π’ΡΡΠ½ΠΎΠ²ΠΎ Π½Π° ΡΡΠ΅Π΄Π½Π° Π²ΡΠ·ΡΠ°ΡΡ 48,7 Π³ΠΎΠ΄ΠΈΠ½ΠΈ. ΠΠ·ΠΏΠΎΠ»Π·Π²Π°Π½ΠΈ ΡΠ° Π΄ΠΎΠΊΡΠΌΠ΅Π½ΡΠ°Π»Π΅Π½ ΠΌΠ΅ΡΠΎΠ΄, Π°Π½ΠΊΠ΅ΡΠ½ΠΎ ΡΠΎΡΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎ ΠΏΡΠΎΡΡΠ²Π°Π½Π΅ Ρ 8 Π²ΡΠΏΡΠΎΡΠ° ΠΈ Π³ΡΠ°ΡΠΈΡΠ΅Π½ Π°Π½Π°Π»ΠΈΠ·.Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ ΠΈ ΠΎΠ±ΡΡΠΆΠ΄Π°Π½Π΅: ΠΠ°Π½Π½ΠΈΡΠ΅ ΠΎΡ ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»Π½ΠΈΡ Π°Π½Π°Π»ΠΈΠ· Π½Π° ΡΠ΅Π·ΡΠ»ΡΠ°ΡΠΈΡΠ΅ ΠΎΡ ΠΈΠ·ΡΠ»Π΅Π΄Π²Π°Π½ΠΈΡΡΠ° Π·Π° Π½ΠΎΡΠΈΡΠ΅Π»ΡΡΠ²ΠΎ Π½Π° ΠΎΡΠ½ΠΎΠ²Π½ΠΈΡΠ΅ ΡΠ°ΠΊΡΠΎΡΠΈ Π½Π° ΡΠΈΡΠΊΠ° Π·Π° Π·Π΄ΡΠ°Π²Π΅ΡΠΎ Π½Π° ΡΡΠ΅Π½ΠΈΡΠΈΡΠ΅ Π½Π° Π²ΡΠ·ΡΠ°ΡΡ ΠΎΡ 14 Π΄ΠΎ 18 Π³ΠΎΠ΄ΠΈΠ½ΠΈ Π²ΡΠ² ΠΠ΅Π»ΠΈΠΊΠΎ Π’ΡΡΠ½ΠΎΠ²ΠΎ ΠΏΠΎΠΊΠ°Π·Π²Π°Ρ, ΡΠ΅ ΡΠ° Π½Π°ΡΡΡΠΏΠΈΠ»ΠΈ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»Π½ΠΈ ΠΏΡΠΎΠΌΠ΅Π½ΠΈ Π² ΠΏΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ΡΠΎ Π·Π° Π·Π΄ΡΠ°Π²Π΅, Π½ΠΎ Π΅Π΄Π½ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎ Ρ ΡΠΎΠ²Π° ΡΠ΅ ΠΎΡΡΠΈΡΠ°Ρ ΠΈ ΡΠ΅ΡΠΈΠΎΠ·Π½ΠΈ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠΈ ΠΊΠ°ΡΠΎ ΠΏΠΎΠ²ΠΈΡΠ΅Π½ΠΎ ΠΊΡΡΠ²Π½ΠΎ Π½Π°Π»ΡΠ³Π°Π½Π΅ ΠΈ Π½Π°Π΄Π½ΠΎΡΠΌΠ΅Π½ΠΎ ΡΠ΅Π³Π»ΠΎ.ΠΠ·Π²ΠΎΠ΄ΠΈ: Π£ΡΠΏΠ΅ΡΠ½ΠΎΡΠΎ ΡΠ΅Π°Π»ΠΈΠ·ΠΈΡΠ°Π½Π΅ Π½Π° ΠΏΡΠΎΠ³ΡΠ°ΠΌΠ°ΡΠ° βΠΠ΄ΡΠ°Π²ΠΈ Π΄Π΅ΡΠ° Π² Π·Π΄ΡΠ°Π²ΠΈ ΡΠ΅ΠΌΠ΅ΠΉΡΡΠ²Π°` Ρ ΡΡΠ°ΡΡΠΈΠ΅ΡΠΎ Π½Π° Π·Π΄ΡΠ°Π²Π½ΠΈΡΠ΅ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΠΈ ΠΎΡ Π΄Π΅ΡΡΠΊΠΎΡΠΎ ΠΈ ΡΡΠΈΠ»ΠΈΡΠ½ΠΎ Π·Π΄ΡΠ°Π²Π΅ΠΎΠΏΠ°Π·Π²Π°Π½Π΅, ΠΏΠΎΠ΄ΠΊΡΠ΅ΠΏΠ΅Π½ΠΈ ΠΎΡ ΠΎΠ±ΡΠ΅ΡΡΠ²Π΅Π½ΠΈ ΡΡΡΡΠΊΡΡΡΠΈ ΠΈ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ, Π΄ΠΎΠΊΠ°Π·Π²Π°, ΡΠ΅ Π½Π°ΠΌΠ°Π»ΡΠ²Π° Π½ΠΈΠ²ΠΎΡΠΎ Π½Π° ΡΠ°ΠΊΡΠΎΡΠΈΡΠ΅ Π½Π° ΡΠΈΡΠΊΠ° Π·Π° Π·Π΄ΡΠ°Π²Π΅ΡΠΎ ΡΡΠ΅Π΄ ΡΡΠ°ΡΠΈΡΠ΅, ΠΊΠΎΠ΅ΡΠΎ Π±ΠΈ Π½Π°ΠΌΠ°Π»ΠΈΠ»ΠΎ ΡΠΈΡΠΊΠ° ΠΎΡ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ Π½Π° Ρ
ΡΠΎΠ½ΠΈΡΠ½ΠΈΡΠ΅ Π½Π΅Π·Π°ΡΠ°Π·Π½ΠΈ Π±ΠΎΠ»Π΅ΡΡΠΈ Π² Π·ΡΡΠ»Π° Π²ΡΠ·ΡΠ°ΡΡ.βHealthy Children in Healthy Families` is a child component of the CINDI program, which was implemented in the area of Veliko Tarnovo in 2008. The program provided a policy and strategy framework in the prevention of chronic non-communicable diseases in children. It was implemented through health promotion activities, disease prevention and lifestyle changes involving children and their families.The aim of this study is to highlight the role of health professionals from child and school health care in providing information, education, and health consultation services to the students about building up vital skills for responsible health behavior.Materials and Methods: For the purpose of this study the opinion of 46 health professionals from the municipality of Veliko Turnovo at an average age of 48.7 years was sought. We have used a documentary method, a questionnaire survey of 8 questions and a graphical analysis.Results and Discussion: The data from the comparative analysis of the survey results for carrier of the main risk factors for the health of the students aged from 14 to 18 years in Veliko Tarnovo showed that there have been positive changes in health behaviors, but at the same time serious problems such as high blood pressure and overweight were reported.Conclusions: The successful implementation of the program βHealthy Children in Healthy Families` with the participation of health professionals from children and school health care, supported by public structures and organizations, proved that reducing the level of health risk factors among students would also reduce the risk of developing chronic non-communicable diseases among adults
Improper nutrition and diseases in pre-school children
For healthy generation it is healthy and orderly development from early childhood. It needs proper
nutrition, proper care and personal hygiene. Early childhood is the most vulnerable period in the development stage
of man.
Improper diet and disease in children from pre-school age are a problem for both children and parents. It is therefore
important to undertake measures for proper nutrition and prevention of diseases.
Described as improper diet affects children from pre-school age. Incorret diet destroys children and causes various
diseases.
"Health comes through the mouth" - that means as you usually eat, so our body to function and so will place our
metabolism. Only with a balanced diet will achieve the desired goal of a better life and better quality.
Keywords: improper nutrition, pre-school children, disease prevention
ΠΠ΅ΠΊΠΎΡ Π΅ΠΌΠΏΠ°Π³Π»ΠΈΡΠ»ΠΎΠ·ΠΈΠ½ - ΡΡΠΈ Π²ΠΎ Π΅Π΄Π½ΠΎ
ΠΠΌΠΏΠ°Π³Π»ΠΈΡΠ»ΠΎΠ·ΠΈΠ½ Π΅ Π²ΠΈΡΠΎΠΊΠΎΡΠ΅Π»Π΅ΠΊΡΠΈΠ²Π΅Π½ Π°Π½ΡΠΈΡ
ΠΈΠΏΠ΅ΡΠ³Π»ΠΈΠΊΠ΅ΠΌΠΈΡΠ΅Π½ Π°Π³Π΅Π½Ρ ΠΊΠΎΡ ΠΏΡΠΈΠΏΠ°ΡΠ° Π²ΠΎ ΠΊΠ»Π°ΡΠ°ΡΠ° Π½Π° Π»Π΅ΠΊΠΎΠ²ΠΈ Π½Π°ΡΠ΅ΡΠ΅Π½ΠΈ ΠΈΠ½Ρ
ΠΈΠ±ΠΈΡΠΎΡΠΈ Π½Π° Π½Π°ΡΡΠΈΡΠΌ-Π³Π»ΠΈΠΊΠΎΠ·Π° ΠΊΠΎ-ΡΡΠ°Π½ΡΠΏΠΎΡΡΠ΅Ρ 2 (SGLT-2). ΠΡΠ΅ΠΊΡ ΠΈΠ½Ρ
ΠΈΠ±ΠΈΡΠΈΡΠ° Π½Π° SGLT-2, Π΅ΠΌΠΏΠ°Π³Π»ΠΈΡΠ»ΠΎΠ·ΠΈΠ½ΠΎΡ ΡΠ° Π½Π°ΠΌΠ°Π»ΡΠ²Π° Π±ΡΠ±ΡΠ΅ΠΆΠ½Π°ΡΠ° ΡΠ΅Π°ΠΏΡΠΎΡΠΏΡΠΈΡΠ° Π½Π° Π³Π»ΠΈΠΊΠΎΠ·Π° ΠΈ ΡΠ° Π·Π³ΠΎΠ»Π΅ΠΌΡΠ²Π° ΡΡΠΈΠ½Π°ΡΠ½Π°ΡΠ° Π΅ΠΊΡΠΊΡΠ΅ΡΠΈΡΠ° Π½Π° Π³Π»ΠΈΠΊΠΎΠ·Π°ΡΠ°. ΠΠ»Π°Π²Π½Π° ΠΈΠ½Π΄ΠΈΠΊΠ°ΡΠΈΡΠ° Π·Π° Π΅ΠΌΠΏΠ°Π³Π»ΠΈΡΠ»ΠΎΠ·ΠΈΠ½ Π΅ ΡΡΠ΅ΡΠΌΠ°Π½ Π½Π° Π΄ΠΈΡΠ°Π±Π΅ΡΠ΅Ρ ΠΌΠ΅Π»ΠΈΡΡΡ ΡΠΈΠΏ 2, Π½Π°ΠΌΠ°Π»ΡΠ²Π°ΡΡΠΈ ΡΠ° ΠΏΠΎΡΡΠΏΡΠ°Π½Π΄ΠΈΡΠ°Π»Π½Π°ΡΠ° ΠΈ Π³Π»ΠΈΠΊΠ΅ΠΌΠΈΡΠ°ΡΠ° Π½Π° Π³Π»Π°Π΄Π½ΠΎ, Π²ΠΎ ΠΌΠΎΠ½ΠΎΡΠ΅ΡΠ°ΠΏΠΈΡΠ° ΠΈΠ»ΠΈ ΡΠΎ Π΄ΡΡΠ³ΠΈ Ρ
ΠΈΠΏΠΎΠ³Π»ΠΈΠΊΠ΅ΠΌΠΈΡΠ½ΠΈ Π»Π΅ΠΊΠΎΠ²ΠΈ. ΠΠΎΡΠ°Π΄ΠΈ ΠΎΡΠΈΠ³ΠΈΠ½Π°Π»Π½ΠΈΠΎΡ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·Π°ΠΌ Π½Π° Π΄Π΅ΡΡΡΠ²ΠΎ, ΠΈΠ½Π΄ΠΈΠΊΠ°ΡΠΈΠΈΡΠ΅ ΡΠ΅ ΠΏΡΠΎΡΠΈΡΠΈΡΠ° ΠΈ ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ ΠΊΠΎΠ½Π³Π΅ΡΡΠΈΠ²Π½Π° ΡΡΡΠ΅Π²Π° ΡΠ»Π°Π±ΠΎΡΡ ΠΈ Π±ΡΠ±ΡΠ΅ΠΆΠ½Π° ΡΠ»Π°Π±ΠΎΡΡ, Π½Π΅Π·Π°Π²ΠΈΡΠ½ΠΎ ΠΎΠ΄ ΠΏΡΠΈΡΡΡΡΠ²ΠΎΡΠΎ Π½Π° Π΄ΠΈΡΠ°Π±Π΅ΡΠ΅Ρ ΠΌΠ΅Π»ΠΈΡΡΡ ΡΠΈΠΏ 2 (EMPA-REG, EMPEROR-Reduced, EMPEROR-Preserved). Π‘ΡΡΠ΄ΠΈΡΠ°ΡΠ° EMPEROR-Reduced Π΄ΠΎΠΊΠ°ΠΆΠ° Π΄Π΅ΠΊΠ° ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ ΡΡΡΠ΅Π²Π° ΡΠ»Π°Π±ΠΎΡΡ ΡΠΎ Π½Π°ΠΌΠ°Π»Π΅Π½Π° Π΅ΠΆΠ΅ΠΊΡΠΈΠΎΠ½Π° ΡΡΠ°ΠΊΡΠΈΡΠ°, Π΅ΠΌΠΏΠ°Π³Π»ΠΈΡΠ»ΠΎΠ·ΠΈΠ½ΠΎΡ Π³ΠΎ Π½Π°ΠΌΠ°Π»ΡΠ²Π° ΡΠΈΠ·ΠΈΠΊΠΎΡ ΠΎΠ΄ ΠΊΠ°ΡΠ΄ΠΈΠΎΠ²Π°ΡΠΊΡΠ»Π°ΡΠ½Π° ΡΠΌΡΡ, ΡΠΈΠ·ΠΈΠΊΠΎΡ ΠΎΠ΄ Π΄Π΅ΠΊΠΎΠΌΠΏΠ΅Π½Π·Π°ΡΠΈΠΈ ΠΈ Π±ΡΠΎΡ Π½Π° Ρ
ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΠΈ Π³ΠΎ Π·Π°Π±Π°Π²ΡΠ²Π° Π²Π»ΠΎΡΡΠ²Π°ΡΠ΅ΡΠΎ Π½Π° Π±ΡΠ±ΡΠ΅ΠΆΠ½Π°ΡΠ° ΡΡΠ½ΠΊΡΠΈΡΠ°. Π’ΠΎΡ Π΅ Π΅Π΄ΠΈΠ½ΡΡΠ²Π΅Π½ΠΈΠΎΡ Π΄ΠΎΠΊΠ°ΠΆΠ°Π½ Π»Π΅ΠΊ Π·Π° ΡΡΡΠ΅Π²Π° ΡΠ»Π°Π±ΠΎΡΡ ΡΠΎ ΡΠΎΡΡΠ²Π°Π½Π° Π΅ΠΆΠ΅ΠΊΡΠΈΠΎΠ½Π° ΡΡΠ°ΠΊΡΠΈΡΠ° (EMPEROR-Preserved). Π‘ΡΡΠ΄ΠΈΠΈΡΠ΅ EMPA-TROPISM ΠΈ SUGAR-DM-HF ΠΏΠΎΠΊΠ°ΠΆΠ°Π° Π΅ΡΠ΅ΠΊΡ Π½Π° Π΅ΠΌΠΏΠ°Π³Π»ΠΈΡΠ»ΠΎΠ·ΠΈΠ½ΠΎΡ Π²ΡΠ· ΠΌΠΎΡΡΠΎΠ»ΠΎΡΠΊΠΈΡΠ΅ ΠΏΡΠΎΠΌΠ΅Π½ΠΈ Π½Π° Π»Π΅Π²Π°ΡΠ° ΠΊΠΎΠΌΠΎΡΠ°. ΠΠ²ΡΠΎΠΏΡΠΊΠΈΡΠ΅ ΠΏΡΠ΅ΠΏΠΎΡΠ°ΠΊΠΈ Π·Π° ΡΡΡΠ΅Π²Π° ΡΠ»Π°Π±ΠΎΡΡ ΠΎΠ΄ 2021 Π³ΠΎΠ΄ΠΈΠ½Π°, ΠΎΡΠΈΡΠΈΡΠ°Π»Π½ΠΎ Π³ΠΎ Π²ΠΊΠ»ΡΡΠΈΡΠ° Π΅ΠΌΠΏΠ°Π³Π»ΠΈΡΠ»ΠΎΠ·ΠΈΠ½ΠΎΡ, Π·Π°Π΅Π΄Π½ΠΎ ΡΠΎ Π΄ΡΡΠ³ΠΈΡΠ΅ ΠΈΠ½Ρ
ΠΈΠ±ΠΈΡΠΎΡΠΈ Π½Π° SGLT-2, Π²ΠΎ ΡΡΠ΅ΡΠΌΠ°Π½ΠΎΡ Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ ΡΡΡΠ΅Π²Π° ΡΠ»Π°Π±ΠΎΡΡ, Π½Π΅Π·Π°Π²ΠΈΡΠ½ΠΎ ΠΎΠ΄ ΠΏΡΠΈΡΡΡΡΠ²ΠΎΡΠΎ Π½Π° Π΄ΠΈΡΠ°Π±Π΅ΡΠ΅Ρ ΠΌΠ΅Π»ΠΈΡΡΡ ΠΈ Π΅ΠΆΠ΅ΠΊΡΠΈΠΎΠ½Π° ΡΡΠ°ΠΊΡΠΈΡΠ° (Π½ΠΈΠ²ΠΎ Π½Π° Π΄ΠΎΠΊΠ°Π·: Π, ΠΊΠ»Π°ΡΠ° I). Π’ΡΠ΅ΡΠ°ΡΠ° ΠΈΠ½Π΄ΠΈΠΊΠ°ΡΠΈΡΠ° Π½Π° Π΅ΠΌΠΏΠ°Π³Π»ΠΈΡΠ»ΠΎΠ·ΠΈΠ½ΠΎΡ Π΅ ΡΠ΅ΡΠ°ΠΏΠΈΡΠ° Π½Π° Π±ΡΠ±ΡΠ΅ΠΆΠ½Π° ΡΠ»Π°Π±ΠΎΡΡ, ΡΡΠΏΠΎΡΡΠ²Π°ΡΡΠΈ ΡΠ° ΠΏΡΠΎΠ³ΡΠ΅ΡΠΈΡΠ°ΡΠ° Π½Π° Π±ΠΎΠ»Π΅ΡΡΠ° (EMPA-KIDNEY). ΠΠ΅ΠΊΠΎΡ Π΅ ΠΎΠ΄ΠΎΠ±ΡΠ΅Π½ ΠΎΠ΄ ΠΠΌΠ΅ΡΠΈΠΊΠ°Π½ΡΠΊΠ°ΡΠ° Π°Π³Π΅Π½ΡΠΈΡΠ° Π·Π° Ρ
ΡΠ°Π½Π° ΠΈ Π»Π΅ΠΊΠΎΠ²ΠΈ ΠΊΠ°ΠΊΠΎ Π»Π΅ΠΊ Π·Π° Ρ
ΡΠΎΠ½ΠΈΡΠ½Π° Π±ΡΠ±ΡΠ΅ΠΆΠ½Π° ΡΠ»Π°Π±ΠΎΡΡ. ΠΠΌΠΏΠ°Π³Π»ΠΈΡΠ»ΠΎΠ·ΠΈΠ½ΠΎΡ ΠΈ Π»Π΅ΠΊΠΎΠ²ΠΈΡΠ΅ ΠΎΠ΄ ΠΎΠ²Π°Π° Π³ΡΡΠΏΠ° Π½Π°ΠΏΡΠ°Π²ΠΈΡΠ° Π·Π½Π°ΡΠ°Π΅Π½ ΠΈΡΡΠ΅ΠΊΠΎΡ Π²ΠΎ ΡΡΠ΅ΡΠΌΠ°Π½ΠΎΡ Π½Π° ΡΡΡΠ΅Π²Π° ΡΠ»Π°Π±ΠΎΡΡ, Π±ΡΠ±ΡΠ΅ΠΆΠ½Π° ΡΠ»Π°Π±ΠΎΡΡ ΠΈ Π΄ΠΈΡΠ°Π±Π΅ΡΠ΅Ρ ΠΌΠ΅Π»ΠΈΡΡΡ ΡΠΈΠΏ 2.
ΠΠ»ΡΡΠ½ΠΈ Π·Π±ΠΎΡΠΎΠ²ΠΈ: Π±ΡΠ±ΡΠ΅ΠΆΠ½Π° ΡΠ»Π°Π±ΠΎΡΡ, Π΄ΠΈΡΠ°Π±Π΅ΡΠ΅Ρ ΠΌΠ΅Π»ΠΈΡΡΡ ΡΠΈΠΏ 2, Π΅ΠΌΠΏΠ°Π³Π»ΠΈΡΠ»ΠΎΠ·ΠΈΠ½, ΠΈΠ½Ρ
ΠΈΠ±ΠΈΡΠΎΡΠΈ Π½Π° Π½Π°ΡΡΠΈΡΠΌ-Π³Π»ΠΈΠΊΠΎΠ·Π° ΠΊΠΎ-ΡΡΠ°Π½ΡΠΏΠΎΡΡΠ΅Ρ 2, ΡΡΡΠ΅Π²Π° ΡΠ»Π°Π±ΠΎΡΡ
ΠΠΈΠ»Π΅ΠΌΠ° ΡΠΎ Π΄Π²ΠΎΡΠ½Π° Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·Π°: Π Π°Π·ΠΎΡΠΊΡΠΈΠ²Π°ΡΠ΅ Π½Π° ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ΄ΠΈΡΡΠΈΡ ΠΈ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ²Π΅Π½ Π΅Π½Π΄ΠΎΠΊΠ°ΡΠ΄ΠΈΡ ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½Ρ ΡΠΎ Π·Π°ΠΌΠΎΡ, Π±ΠΎΠ»ΠΊΠ° Π²ΠΎ Π³ΡΠ± ΠΈ ΡΡΠ΅ΡΠΊΠ°
ΠΠ½ΡΠ΅ΠΊΡΠΈΠΈΡΠ΅ Π½Π° ΡΠ±Π΅ΡΠ½ΠΈΠΎΡ ΡΡΠΎΠ»Π± ΠΌΠΎΠΆΠ΅ Π΄Π° ΡΠ΅ ΠΏΡΠ΅Π·Π΅Π½ΡΠΈΡΠ°Π°Ρ ΡΠΎ ΡΠΈΡΠΎΠΊ ΡΠΏΠ΅ΠΊΡΠ°Ρ Π½Π° ΠΊΠ»ΠΈΠ½ΠΈΡΠΊΠΈ ΡΠΈΠΌΠΏΡΠΎΠΌΠΈ. ΠΠ°ΡΡΠ΅ΡΡ ΡΠΈΠΌΠΏΡΠΎΠΌ Π΅ Π±ΠΎΠ»ΠΊΠ° Π²ΠΎ Π³ΡΠ±ΠΎΡ, Π½ΠΎ Π½Π΅Π²ΡΠΎΠ»ΠΎΡΠΊΠΈ Π΄Π΅ΡΠΈΡΠΈΡΠΈ Π½Π΅ ΡΠ΅ ΡΠ΅ΡΠΊΠΎΡΡ.
Π¦Π΅Π»ΡΠ° Π½Π° ΠΎΠ²ΠΎΡ ΡΡΡΠ΄ Π΅ Π΄Π° ΡΠ΅ Π°ΠΊΡΠ΅Π½ΡΠΈΡΠ° Π½Π° Π½Π΅ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΈΡΠ΅ ΡΠΈΠΌΠΏΡΠΎΠΌΠΈ Π½Π° Π·Π°ΠΌΠΎΡ, Π³ΡΠ±Π½Π° Π±ΠΎΠ»ΠΊΠ° ΠΈ ΠΏΠΎΠΊΠ°ΡΠ΅Π½Π° ΡΠ΅Π»Π΅ΡΠ½Π° ΡΠ΅ΠΌΠΏΠ΅ΡΠ°ΡΡΡΠ°, ΠΊΠΎΠΈ ΡΠ΅ ΡΡΠ΅ΡΠ°Π²Π°Π°Ρ ΠΊΠ°Ρ ΡΠ°Π·Π»ΠΈΡΠ½ΠΈ Π±ΠΎΠ»Π΅ΡΡΠΈ ΠΈ Π΅ ΠΏΠΎΡΡΠ΅Π±Π½ΠΎ Π΄Π΅ΡΠ°Π»Π½ΠΎ ΠΈΡΠΏΠΈΡΡΠ²Π°ΡΠ΅ ΡΠΎ ΡΠ΅Π» Π½ΠΈΠ²Π½ΠΎ Π΅ΡΠΈΠΎΠ»ΠΎΡΠΊΠΎ ΡΠ°Π·ΡΠ°ΡΠ½ΡΠ²Π°ΡΠ΅.
ΠΡΠ΅Π·Π΅Π½ΡΠΈΡΠ°ΠΌΠ΅ ΡΠ»ΡΡΠ°Ρ Π½Π° 67 Π³ΠΎΠ΄ΠΈΡΠ΅Π½ ΠΏΠ°ΡΠΈΠ΅Π½Ρ ΠΊΠΎΡ Π±Π΅ΡΠ΅ ΠΏΡΠΈΠΌΠ΅Π½ Π½Π° ΠΎΠ΄Π΄Π΅Π»Π΅Π½ΠΈΠ΅ Π·Π° Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ° ΠΏΠΎΡΠ°Π΄ΠΈ Π·Π°ΠΌΠΎΡ, Π΄ΠΎΠ»Π½ΠΎΠ³ΡΠ±Π½Π° Π±ΠΎΠ»ΠΊΠ°, ΠΏΠΎΠΊΠ°ΡΠ΅Π½Π° ΡΠ΅Π»Π΅ΡΠ½Π° ΡΠ΅ΠΌΠΏΠ΅ΡΠ°ΡΡΡΠ° ΠΈ Π½Π΅ΡΡΠ°Π±ΠΈΠ»Π½ΠΎΡΡ Π²ΠΎ ΠΎΠ΄ΠΎΡ. ΠΠ΅Π° ΡΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈ ΡΠ΅ΡΠΈΡΠ° Π½Π° Π΄ΠΈΡΠ°Π³Π½ΠΎΡΡΠΈΡΠΊΠΈ ΠΈΡΠΏΠΈΡΡΠ²Π°ΡΠ° Π·Π° Π΄Π° ΡΠ΅ ΡΡΠ²ΡΠ΄ΠΈ ΡΠΎΡΠ½Π°ΡΠ° ΠΏΡΠΈΡΠΈΠ½Π°. ΠΠ΅ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΈΡΠ΅ ΡΠΈΠΌΠΏΡΠΎΠΌΠΈ Π½Π° ΠΌΠ°Π»Π°ΠΊΡΠ°Π½ΠΎΡΡ, ΡΠ»Π°Π±ΠΎΡΡ, Π΅ΠΊΡΠ΅ΡΠΈΠ²Π½ΠΎΡΠΎ Π½ΠΎΡΠ½ΠΎ ΠΏΠΎΡΠ΅ΡΠ΅ ΠΈ ΡΡΠ΅ΡΠΊΠ° ΡΠ°Π·Π±ΡΠ΄ΠΈΡΠ° ΡΠΎΠΌΠ½Π΅ΠΆ Π·Π° ΠΌΠΎΠΆΠ½ΠΎ ΠΊΠ°ΡΠ΄ΠΈΡΠ°Π»Π½ΠΎ ΠΏΠΎΡΠ΅ΠΊΠ»ΠΎ.
ΠΠ°Π±ΠΎΡΠ°ΡΠΎΡΠΈΡΠΊΠΈΡΠ΅ Π°Π½Π°Π»ΠΈΠ·ΠΈ ΠΏΠΎΠΊΠ°ΠΆΠ°Π° ΠΏΠΎΠΊΠ°ΡΠ΅Π½ΠΈ Π²ΡΠ΅Π΄Π½ΠΎΡΡΠΈ Π½Π° Π‘Π ΠΈ Π¦Π Π, Π° Ρ
Π΅ΠΌΠΎΠΊΡΠ»ΡΡΡΠΈΡΠ΅ Π±Π΅Π° Π½Π΅Π³Π°ΡΠΈΠ²Π½ΠΈ. MR Π½Π° Π-Π‘ ΡΠ±Π΅Ρ ΠΎΡΠΊΡΠΈ Ρ
ΠΈΠΏΠΎΡΠΈΠ³Π½Π°Π»Π½Π°, Π΄Π΅Π»ΡΠΌΠ½ΠΎ Π»ΠΎΠ±ΡΠ»ΠΈΡΠ°Π½Π° ΠΏΡΠΎΠΌΠ΅Π½Π° Π½Π° Π½ΠΈΠ²ΠΎ Π½Π° Π-1 ΠΏΡΠ΅ΡΠ»Π΅Π½ΡΠΊΠΎ ΡΠ΅Π»ΠΎ ΠΈ Ρ
Π΅ΡΠ΅ΡΠΎΡΠΈΠ³Π½Π°Π»Π΅Π½ ΠΏΡΠΈΠΊΠ°Π· Π½Π° ΠΠ Π΄ΠΈΡΠΊ. ΠΡΠΎΠΌΠ΅Π½Π°ΡΠ° Π±ΠΈ ΠΌΠΎΠΆΠ΅Π»Π° Π΄Π° ΠΎΠ΄Π³ΠΎΠ²Π°ΡΠ° Π½Π° ΡΠΎΡΡΠΎΡΠ±Π° Π½Π° ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ΄ΠΈΡΡΠΈΡ. ΠΠΠΠ Π½Π°ΠΎΠ΄ΠΎΡ ΡΠΊΠ°ΠΆΡΠ²Π° Π½Π° Ρ
ΡΠΎΠ½ΠΈΡΠ½Π° Π»Π΅Π·ΠΈΡΠ° Π½Π° ΠΏΡΠΎΠΊΡΠΈΠΌΠ°Π»Π½ΠΈΠΎΡ Π΄Π΅Π» ΠΎΠ΄ ΠΌΠΎΡΠΎΡΠ½ΠΈΠΎΡ Π½Π΅Π²ΡΠΎΠ½. ΠΡ
ΠΎΠΊΠ°ΡΠ΄ΠΈΠΎΠ³ΡΠ°ΡΠΈΡΠ°ΡΠ° ΠΎΡΠΊΡΠΈ Π΄ΠΈΠ»Π°ΡΠΈΡΠ°Π½Π° Π»Π΅Π²Π° ΠΏΡΠ΅Π΄ΠΊΠΎΠΌΠΎΡΠ°, ΡΠΎ Π·Π°Π΄Π΅Π±Π΅Π»Π΅Π½ ΠΌΠΈΡΡΠ°Π»Π΅Π½ Π·Π°Π»ΠΈΡΡΠΎΠΊ ΠΈ ΠΏΡΠΈΡΡΡΠ½Π° Ρ
ΠΈΠΏΠ΅ΡΠ΅Ρ
ΠΎΠ³Π΅Π½Π° ΡΠΎΠΏΡΠ΅ΡΡΠ° ΠΌΠ°ΡΠ° Π²ΠΎ ΠΏΡΠ΅Π΄Π΅Π» Π½Π° Π²ΡΠ²ΠΎΡ Π½Π° ΠΏΡΠ΅Π΄Π΅Π½ ΠΌΠΈΡΡΠ°Π»Π΅Π½ ΠΊΡΡΠΏΠΈΡ. ΠΡΡΠ° ΡΠ°ΠΊΠ²Π° ΡΠΎΡΠΌΠ°ΡΠΈΡΠ° ΡΠ΅ ΠΏΡΠ°ΡΠΈ Π½Π° ΠΈΠ½ΡΡΠ°Π²Π΅Π½ΡΡΠΈΠΊΡΠ»Π°ΡΠ½ΠΈΠΎΡ ΡΠ΅ΠΏΡΡΠΌ, ΡΡΡΠΏΠ΅ΠΊΡΠ½ΠΈ Π·Π° Π΅Π½Π΄ΠΎΠΊΠ°ΡΠ΄ΠΈΡΠ°Π»Π½ΠΈ ΠΌΠ°ΡΠΈ ΠΈ ΡΠ΅ΡΠΊΠ° ΠΌΠΈΡΡΠ°Π»Π½Π° ΠΈΠ½ΡΡΡΠΈΡΠΈΠ΅Π½ΡΠΈΡΠ°.
Π‘ΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ΄ΠΈΡΡΠΈΡΠΎΡ Π΅ ΡΠ΅ΡΡΠ° ΠΏΡΠΈΠ΄ΡΡΠΆΠ½Π° ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΡΠ° Π½Π° ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ²Π½ΠΈΠΎΡ Π΅Π½Π΄ΠΎΠΊΠ°ΡΠ΄ΠΈΡ, Π½Π°ΡΠ²Π΅ΡΠΎΡΠ°ΡΠ½ΠΎ ΠΏΠΎΡΠ°Π΄ΠΈ Ρ
Π΅ΠΌΠ°ΡΠΎΠ³Π΅Π½Π°ΡΠ° Π΄ΠΈΡΠ΅ΠΌΠΈΠ½Π°ΡΠΈΡΠ° Π½Π° ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ²Π½ΠΈΠΎΡ Π°Π³Π΅Π½Ρ. ΠΠ°ΡΠΎΠ°, Π²ΠΎ ΡΠΈΡΠ΅ ΡΠ»ΡΡΠ°ΠΈ Π½Π° ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ΄ΠΈΡΡΠΈΡ , ΠΏΡΠΈΡΡΡΡΠ²ΠΎΡΠΎ Π½Π° ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ²Π΅Π½ Π΅Π½Π΄ΠΎΠΊΠ°ΡΠ΄ΠΈΡΠΈΡ ΡΡΠ΅Π±Π° ΡΠ΅ΠΌΠ΅Π»Π½ΠΎ Π΄Π° ΡΠ΅ ΠΈΡΠΏΠΈΡΠ° ΠΈ Π΄Π° ΡΠ΅ ΠΈΡΠΊΠ»ΡΡΠΈ.
KΠ»ΡΡΠ½ΠΈ Π·Π±ΠΎΡΠΎΠ²ΠΈ : ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ΄ΠΈΡΡΠΈΡ, ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ²Π΅Π½ Π΅Π½Π΄ΠΎΠΊΠ°ΡΠ΄ΠΈ
Π₯ΠΈΠΏΠ΅ΡΡΡΠΎΡΠΈΡΠ½Π° ΠΊΠ°ΡΠ΄ΠΈΠΎΠΌΠΈΠΎΠΏΠ°ΡΠΈΡΠ° ΡΠΎ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΡΠ° ΠΌΠ°ΡΠΈΠ²Π½Π° ΠΏΡΠ»ΠΌΠΎΠ½Π°Π»Π½Π° Π΅ΠΌΠ±ΠΎΠ»ΠΈΡΠ°
ΠΠΎΠ²Π΅Π΄: Π₯ΠΈΠΏΠ΅ΡΡΡΠΎΡΠΈΡΠ½Π°ΡΠ° ΠΊΠ°ΡΠ΄ΠΈΠΎΠΌΠΈΠΎΠΏΠ°ΡΠΈΡΠ° ΠΏΡΠ΅ΡΡΡΠ°Π²ΡΠ²Π° Π·Π°Π΄Π΅Π±Π΅Π»ΡΠ²Π°ΡΠ΅ Π½Π° ΡΡΡΠ΅Π²ΠΈΠΎΡ ΠΌΡΡΠΊΡΠ» (β₯ 15ΠΌΠΌ) ΡΠΈΠΌΠ΅ΡΡΠΈΡΠ½ΠΎ ΠΈΠ»ΠΈ Π°ΡΠΈΠΌΠ΅ΡΡΠΈΡΠ½ΠΎ, ΡΠ΅ΡΡΠΎ Π³Π΅Π½Π΅ΡΡΠΊΠΈ ΠΎΠ΄ΡΠ΅Π΄Π΅Π½ΠΎ. ΠΠ°Π±ΠΎΠ»ΡΠ²Π°ΡΠ΅ΡΠΎ ΠΌΠΎΠΆΠ΅ Π΄Π°
Π±ΠΈΠ΄Π΅ Π°ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΡΡΠΊΠΎ Π΄ΠΎΠ»Π³ΠΈ Π³ΠΎΠ΄ΠΈΠ½ΠΈ ΠΏΡΠ΅Π΄ Π΄Π° ΡΠ΅ ΠΏΠΎΡΠ°Π²Π°Ρ Π·Π½Π°ΡΠΈ Π·Π° ΠΈΡΡ
Π΅ΠΌΠΈΡΠ° ΠΈ Π°ΡΠΈΡΠΌΠΈΠΈ, ΠΊΠΎΠΈ ΠΌΠΎΠΆΠ°Ρ Π΄Π° Π΄ΠΎΠ²Π΅Π΄Π°Ρ Π΄ΠΎ Π½Π°Π³Π»Π° ΡΠΌΡΡ. ΠΠΎΡΡΠΎΠ΅ΡΠ΅ΡΠΎ Π½Π° ΠΏΠΎΠ²Π΅ΡΠ΅ ΠΊΠ°ΡΠ΄ΠΈΠΎΠ²Π°ΡΠΊΡΠ»Π°ΡΠ½ΠΈ ΡΠΈΠ·ΠΈΠΊ ΡΠ°ΠΊΡΠΎΡΠΈ
Π²ΠΎΠ΄ΠΈ Π΄ΠΎ Π·Π³ΠΎΠ»Π΅ΠΌΠ΅Π½ ΠΌΠΎΡΠ±ΠΈΠ΄ΠΈΡΠ΅Ρ ΠΈ ΠΌΠΎΡΡΠ°Π»ΠΈΡΠ΅Ρ. Π¦Π΅Π»ΡΠ° Π½Π° ΠΎΠ²Π°Ρ ΠΏΡΠΈΠΊΠ°Π· Π½Π° ΡΠ»ΡΡΠ°Ρ Π΅ Π΄Π° ΠΏΠΎΠΊΠ°ΠΆΠ΅ΠΌΠ΅ Π΅Π΄Π½Π° Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·Π° Π½Π΅ ΠΈΡΠΊΠ»ΡΡΡΠ²Π° ΠΏΠΎΡΡΠΎΠ΅ΡΠ΅ Π½Π° Π΄ΡΡΠ³ΠΈ Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·ΠΈ.
ΠΠ°ΡΠ΅ΡΠΈΡΠ°Π»ΠΈ ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ: ΠΠ°Ρ ΠΌΠ°ΠΆ Π½Π° 67 Π³ΠΎΠ΄ΠΈΡΠ½Π° Π²ΠΎΠ·ΡΠ°ΡΡ, ΡΠΎ ΡΠΈΠΌΠΏΡΠΎΠΌΠΈ Π½Π° Π³ΡΡΠ΅ΡΠ΅ ΠΈ Π·Π°ΠΌΠΎΡ (NYHA 3) βΠ²ΠΎ ΠΏΠΎΡΠ»Π΅Π΄Π½ΠΎ Π²ΡΠ΅ΠΌΠ΅β, ΠΏΡΠ΅Π»Π΅ΠΆΠ°Π½ ΠΈΠ½ΡΠ°ΡΠΊΡ Π½Π° ΠΌΠΈΠΎΠΊΠ°ΡΠ΄ΠΎΡ ΠΈ ΠΏΠ»Π°ΡΠΈΡΠ°Π½ ΡΡΠ΅Π½Ρ Π½Π°
ΡΠΈΡΠΊΡΠΌΡΠ»Π΅ΠΊΡΠ½Π°ΡΠ° Π°ΡΡΠ΅ΡΠΈΡΠ° Π±Π΅ΡΠ΅ Π½Π°ΠΏΡΠ°Π²Π΅Π½a ΡΡΠ°Π½ΡΡΠΎΡΠ°ΠΊΠ°Π»Π½Π° Π΅Ρ
ΠΎΠΊΠ°ΡΠ΄ΠΈΠΎΠ³ΡΠ°ΡΠΈΡΠ°. ΠΠ°ΡΠ΄ΠΈΠΎΠ²Π°ΡΠΊΡΠ»Π°ΡΠ½ΠΈ ΡΠΈΠ·ΠΈΠΊ ΡΠ°ΠΊΡΠΎΡΠΈ: Π°ΡΡΠ΅ΡΠΈΡΠΊΠ° Ρ
ΠΈΠΏΠ΅ΡΡΠ΅Π½Π·ΠΈΡΠ°, Π΄ΠΈΡΠ°Π±Π΅ΡΠ΅Ρ ΠΌΠ΅Π»ΠΈΡΡΡ ΡΠΈΠΏ 2, Π±Π΅Π½ΠΈΠ³Π½Π° Ρ
ΠΈΠΏΠ΅ΡΠΏΠ»Π°Π·ΠΈΡΠ° Π½Π° ΠΏΡΠΎΡΡΠ°ΡΠ°, Ρ
ΡΠΎΠ½ΠΈΡΠ½Π° Π±ΡΠ±ΡΠ΅ΠΆΠ½Π° ΠΈΠ½ΡΡΡΠΈΡΠΈΠ΅Π½ΡΠΈΡΠ°. Π’ΡΠ°Π½ΡΡΠΎΡΠ°ΠΊΠ°Π»Π½Π°ΡΠ° Π΅Ρ
ΠΎΠΊΠ°ΡΠ΄ΠΈΠΎΠ³ΡΠ°ΡΠΈΡΠ° ΠΏΠΎΠΊΠ°ΠΆΠ° ΠΈΠ·ΡΠ°Π·Π΅Π½Π° Ρ
ΠΈΠΏΠ΅ΡΡΡΠΎΡΠΈΡΠ° ΡΠΎ ΠΎΠΏΡΡΡΡΠΊΡΠΈΡΠ° Π²ΠΎ ΠΌΠΈΠ΄ Π΄Π΅Π»ΠΎΠ²ΠΈ ΠΈ Π°ΠΏΠΈΠΊΠ°Π»Π½Π° Π΄ΠΈΡΠΊΠΈΠ½Π΅Π·ΠΈΡΠ°. ΠΠ°ΠΏΡΠ°Π²Π΅Π½ΠΈ ΡΠ΅ Π»Π°Π±Π°ΡΠ°ΡΠΎΡΠΈΡΠΊΠΈ Π°Π½Π°Π»ΠΈΠ·ΠΈ ΠΈ ΠΌΠ°Π³Π½Π΅ΡΠ½Π° ΡΠ΅Π·ΠΎΠ½Π°Π½ΡΠ° Π½Π° ΡΡΡΠ΅.
Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ: ΠΠ°Π³Π½Π΅ΡΠ½Π°ΡΠ° ΡΠ΅Π·ΠΎΠ½Π°Π½ΡΠ° Π½Π° ΡΡΡΠ΅ ΠΊΠ°ΠΊΠΎ ΡΠ»ΡΡΠ°Π΅Π½ Π½Π°ΠΎΠ΄ ΠΏΠΎΠΊΠ°ΠΆΠ° ΠΌΠ°ΡΠΈΠ²Π½Π° ΠΏΡΠ»ΠΌΠΎΠ½Π°Π»Π½Π° Π΅ΠΌΠ±ΠΎΠ»ΠΈΡΠ° Π²ΠΎ Π³Π»Π°Π²Π½ΠΈΡΠ΅ ΠΏΡΠ»ΠΌΠΎΠ½Π°Π»Π½ΠΈ Π°ΡΡΠ΅ΡΠΈΠΈ ΠΈ ΡΡΠΎΠΌΠ± Π²ΠΎ Π°ΠΏΠ΅ΠΊΡ Π½Π° Π»Π΅Π²Π°ΡΠ° ΠΊΠΎΠΌΠΎΡΠ°, Π΅ΠΊΡΡΠ΅Π½ΡΡΠΈΡΠ½Π° ΠΈΠ·ΡΠ°Π·Π΅Π½Π° Ρ
ΠΈΠΏΠ΅ΡΡΡΠΎΡΠΈΡΠ° (ΡΠ΅ΠΏΡΡΠΌ 23ΠΌΠΌ) ΠΈ Π½Π΅Π²ΠΈΡΠ°Π±ΠΈΠ»Π΅Π½ ΠΌΠΈΠΎΠΊΠ°ΡΠ΄ Π²ΠΎ 41%. ΠΠ°ΡΠΈΠ΅Π½ΡΠΎΡ Π±Π΅ΡΠ΅ Ρ
ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·ΠΈΡΠ°Π½, ΠΎΡΠ΄ΠΈΠ½ΠΈΡΠ°Π½Π° Π±Π΅ΡΠ΅ ΠΏΠ΅ΡΠΎΡΠ°Π»Π½Π° Π°Π½ΡΠΈΠΊΠΎΠ°Π³ΡΠ»Π°Π½ΡΠ½Π° ΡΠ΅ΡΠ°ΠΏΠΈΡΠ° ΡΠΎ Π°ΠΏΠΈΠΊΡΠ°Π±Π°Π½ ΡΠΏΠΎΡΠ΅Π΄ ΠΏΡΠΎΡΠΎΠΊΠΎΠ». ΠΠΎΡΠ»Π΅ ΠΎΡΠΏΡΡΡ ΠΎΠ΄ Π±ΠΎΠ»Π½ΠΈΡΠ° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΡ Π΅ ΡΠΎ ΠΏΠΎΠ΄ΠΎΠ±ΡΠ΅Π½Π° ΠΊΠ»ΠΈΠ½ΠΈΡΠΊΠ° ΡΠΎΡΡΠΎΡΠ±Π° (NYHA 1).
ΠΠ°ΠΊΠ»ΡΡΠΎΠΊ: ΠΠΎΡΡΠ΅Π±Π½ΠΈ ΡΠ΅ ΡΠ΅ΠΌΠ΅Π»Π½ΠΈ ΠΈΡΠΏΠΈΡΡΠ²Π°ΡΠ° ΠΊΠ°Ρ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ. ΠΠ΅ΡΠΎΡΠ°Π»Π½Π°ΡΠ° Π°Π½ΡΠΈΠΊΠΎΠ°Π³ΡΠ»Π°Π½ΡΠ½Π° ΡΠ΅ΡΠ°ΠΏΠΈΡΠ° ΡΠΎ ΠΊΡΠ°Π±Π°Π½ΠΈ ΡΠ΅ ΠΏΠΎΠΊΠ°ΠΆΠ° ΠΊΠ°ΠΊΠΎ Π΅ΡΠΈΠΊΠ°ΡΠ½Π° ΡΠ΅ΡΠ°ΠΏΠΈΡΠ° ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ ΠΏΡΠ»ΠΌΠΎΠ½Π°Π»Π½Π° Π΅ΠΌΠ±ΠΎΠ»ΠΈΡΠ° ΠΈ ΡΡΠΎΠΌΠ± Π²ΠΎ Π»Π΅Π²Π°ΡΠ° ΠΊΠΎΠΌΠΎΡΠ°
ΠΠ΅ΠΏΡΠ΅ΠΏΠΎΠ·Π½Π°Π΅Π½ Π±Π°ΠΊΡΠ΅ΡΠΈΡΠΊΠΈ Π΅Π½Π΄ΠΎΠΊΠ°ΡΠ΄ΠΈΡΠΈΡ - ΠΏΡΠΈΡΠΈΠ½Π° Π·Π° ΡΠ΅ΡΠ΅Π±ΡΠ°Π»Π½Π° Ρ Π΅ΠΌΠΎΡΠ°Π³ΠΈΡΠ°
ΠΠΎΠ²Π΅Π΄: ΠΠ½ΡΠ΅ΠΊΡΠΈΠ²Π½ΠΈΠΎΡ Π΅Π½Π΄ΠΎΠΊΠ°ΡΠ΄ΠΈΡΠΈΡ Π΅ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΡΠ° ΡΠΎ Π²ΠΈΡΠΎΠΊ ΠΌΠΎΡΠ±ΠΈΠ΄ΠΈΡΠ΅Ρ ΠΈ ΠΌΠΎΡΡΠ°Π»ΠΈΡΠ΅Ρ, ΠΏΠΎΠ²ΡΠ·Π°Π½Π° ΡΠΎ ΡΠ΅ΡΠΈΠΎΠ·Π½ΠΈ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ.
Π¦Π΅Π»ΡΠ° Π½Π° ΠΎΠ²ΠΎΡ ΠΏΡΠΈΠΊΠ°Π· Π½Π° ΡΠ»ΡΡΠ°Ρ Π΅ Π΄Π° ΡΠ° ΠΏΠΎΠΊΠ°ΠΆΠ΅ΠΌΠ΅ Π²Π°ΠΆΠ½ΠΎΡΡΠ° ΠΎΠ΄ Π½Π°Π²ΡΠ΅ΠΌΠ΅Π½Π°ΡΠ° Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·Π° Π½Π° Π±Π°ΠΊΡΠ΅ΡΠΈΡΠΊΠΈΠΎΡ Π΅Π½Π΄ΠΎΠΊΠ°ΡΠ΄ΠΈΡΠΈΡ, ΠΊΠ°ΠΊΠΎ ΠΈ Π΅Π΄Π½Π° ΠΎΠ΄ ΠΊΠΎΠ½ΡΡΠ°ΠΈΠ½Π΄ΠΈΠΊΠ°ΡΠΈΠΈΡΠ΅ Π½Π° Π°Π½ΡΠΈΠΊΠΎΠ°Π³ΡΠ»Π°Π½ΡΠ½Π°ΡΠ° ΡΠ΅ΡΠ°ΠΏΠΈΡΠ°.
ΠΠ°ΡΠ΅ΡΠΈΡΠ°Π»ΠΈ ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ: ΠΠ°ΠΆ Π½Π° 63 Π³ΠΎΠ΄ΠΈΡΠ½Π° Π²ΠΎΠ·ΡΠ°ΡΡ, Π±Π΅Π· ΠΊΠ°ΡΠ΄ΠΈΠΎΠ²Π°ΡΠΊΡΠ»Π°ΡΠ½ΠΈ ΠΊΠΎΠΌΠΎΡΠ±ΠΈΠ΄ΠΈΡΠ΅ΡΠΈ, Π΄Π΅Π·ΠΎΡΠΈΠ΅Π½ΡΠΈΡΠ°Π½ ΠΈ ΠΊΠΎΠ½ΡΡΠ·Π΅Π½, ΡΠΎ ΠΏΠΎΠ΄Π°ΡΠΎΠΊ Π·Π° Π΄Π΅Π½ΡΠ°Π»Π½Π° ΠΈΠ½ΡΠ΅ΡΠ²Π΅Π½ΡΠΈΡΠ° ΠΏΡΠ΅Π΄ Π΄Π²Π° ΠΌΠ΅ΡΠ΅ΡΠΈ ΠΏΠΎΡΠ»Π΅ ΠΊΠΎΡΠ° Π΄ΠΎΠΆΠΈΠ²Π΅Π°Π» ΠΌΠΎΠ·ΠΎΡΠ΅Π½ ΡΠ΄Π°Ρ, Π΄ΠΎΠ°ΡΠ° Π½Π° ΠΊΠ°ΡΠ΄ΠΈΠΎΠ»ΠΎΡΠΊΠΈ ΠΏΡΠ΅Π³Π»Π΅Π΄. ΠΠ°ΡΠΈΠ΅Π½ΡΠΎΡ Π·Π΅ΠΌΠ°Π» Π°ΡΠ΅Π½ΠΎΠΊΡΠΌΠ°ΡΠΎΠ» ΠΏΠΎ ΡΠ΅ΠΌΠ° ΠΏΠΎΡΠ°Π΄ΠΈ ΠΏΡΠ΅ΡΠΏΠΎΡΡΠ°Π²ΠΊΠ° Π΄Π΅ΠΊΠ° ΠΈΠΌΠ°Π» Π°ΡΡΠΈΡΠ°Π»Π½Π° ΡΠΈΠ±ΡΠΈΠ»Π°ΡΠΈΡΠ° ΠΊΠ°ΠΊΠΎ ΠΏΡΠΈΡΠΈΠ½Π° Π·Π° ΠΌΠΎΠ·ΠΎΡΠ½ΠΈΠΎΡ ΡΠ΄Π°Ρ. ΠΠ°ΠΏΡΠ°Π²Π΅Π½ΠΈ ΡΠ΅ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠΈΡΠΊΠΈ Π°Π½Π°Π»ΠΈΠ·ΠΈ, Ρ
Π΅ΠΌΠΎΠΊΡΠ»ΡΡΡΠ°, Π΅Ρ
ΠΎΠΊΠ°ΡΠ΄ΠΈΠΎΠ³ΡΠ°ΡΠΈΡΠ°, ΠΌΠ°Π³Π½Π΅ΡΠ½Π° ΡΠ΅Π·ΠΎΠ½Π°Π½ΡΠ° Π½Π° ΡΡΡΠ΅ ΠΈ ΠΠ‘ΠΠ’ Π½Π° ΠΌΠΎΠ·ΠΎΠΊ.
Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ: Π’ΡΠ°Π½ΡΡΠΎΡΠ°ΠΊΠ°Π»Π½Π°ΡΠ° Π΅Ρ
ΠΎΠΊΠ°ΡΠ΄ΠΈΠΎΠ³ΡΠ°ΡΠΈΡΠ° ΠΏΠΎΠΊΠ°ΠΆΠ° ΡΠ΅ΡΠΊΠ° ΠΌΠΈΡΡΠ°Π»Π½Π° ΡΡΠ΅Π½ΠΎΠ·Π° ΡΠΎ ΡΠΌΠ΅ΡΠ΅Π½Π° ΠΌΠΈΡΡΠ°Π»Π½Π° ΡΠ΅Π³ΡΡΠ³ΠΈΡΠ°ΡΠΈΡΠ°, ΡΡΡΠΏΠ΅ΠΊΡΠ½Π° Π²Π΅Π³Π΅ΡΠ°ΡΠΈΡΠ° Π½Π° ΠΏΡΠ΅Π΄Π½ΠΈΠΎΡ ΠΌΠΈΡΡΠ°Π»Π΅Π½ ΠΊΡΡΠΏΠΈΡ. 256-ΠΠ‘ΠΠ’ Π½Π° ΠΌΠΎΠ·ΠΎΠΊ ΠΏΠΎΠΊΠ°ΠΆΠ° ΡΡΠ±Π°ΠΊΡΡΠ½ΠΈ ΠΏΠΎΡΡΠΈΡΡ
Π΅ΠΌΠΈΡΠΊΠΈ Π»Π΅Π·ΠΈΠΈ ΠΈ ΡΠ΅ΡΠ΅Π±ΡΠ°Π»Π½Π° Ρ
Π΅ΠΌΠΎΡΠ°Π³ΠΈΡΠ°. ΠΠ°Π±ΠΎΡΠ°ΡΠΎΡΠΈΡΠΊΠΈΡΠ΅ Π°Π½Π°Π»ΠΈΠ·ΠΈ Π±Π΅Π° Π²ΠΎ ΠΏΡΠΈΠ»ΠΎΠ³ Π½Π° Π·Π³ΠΎΠ»Π΅ΠΌΠ΅Π½ΠΈ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ²Π½ΠΈ ΠΌΠ°ΡΠΊΠ΅ΡΠΈ (Π¦Π Π-71,8 mg/l). Π₯Π΅ΠΌΠΎΠΊΡΠ»ΡΡΡΠ°ΡΠ° Π±Π΅ΡΠ΅ ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π½Π° Π½Π° Streptococcus viridans. ΠΠ°Π³Π½Π΅ΡΠ½Π°ΡΠ° ΡΠ΅Π·ΠΎΠ½Π°Π½ΡΠ° Π½Π° ΡΡΡΠ΅ ΠΏΠΎΡΠ²ΡΠ΄ΠΈ ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠ°Π½Π° ΠΌΠΈΡΡΠ°Π»Π½Π° Π±ΠΎΠ»Π΅ΡΡ, ΠΈΡΠΊΠ»ΡΡΠΈ ΠΏΡΠΈΡΡΡΡΠ²ΠΎ Π½Π° ΡΡΠΎΠΌΠ±ΠΈ. ΠΠΎΡΠ»Π΅ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΡΠΊΠ° ΡΠ΅ΡΠ°ΠΏΠΈΡΠ° Π·Π° Π±Π°ΠΊΡΠ΅ΡΠΈΡΠΊΠΈ Π΅Π½Π΄ΠΎΠΊΠ°ΡΠ΄ΠΈΡΠΈΡ ΠΈ ΡΠ°Π½ΠΈΡΠ°Π½ΠΎ ΠΌΠΎΠ·ΠΎΡΠ½ΠΎ ΠΊΡΠ²Π°ΡΠ΅ΡΠ΅, ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΡ Π±Π΅ΡΠ΅ Π½Π°ΠΏΡΠ°Π²Π΅Π½Π° Π·Π°ΠΌΠ΅Π½Π° Π½Π° ΠΌΠΈΡΡΠ°Π»Π½Π°ΡΠ° Π²Π°Π»Π²ΡΠ»Π° ΡΠΎ Π±ΠΈΠΎΠ»ΠΎΡΠΊΠ° ΠΏΡΠΎΡΠ΅Π·Π°. ΠΠΎΡΡΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΈΠΎΡ ΡΠ΅ΠΊ ΠΏΠΎΠΌΠΈΠ½Π° Π±Π΅Π· ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ. ΠΠ°ΡΠΈΠ΅Π½ΡΠΎΡ Π΅ Π°ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΡΡΠΊΠΈ 2 Π³ΠΎΠ΄ΠΈΠ½ΠΈ ΠΏΠΎΡΠ»Π΅ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΡΠ°.
ΠΠ°ΠΊΠ»ΡΡΠΎΠΊ: ΠΠ°ΠΊΡΠ΅ΡΠΈΡΠΊΠΈΠΎΡ Π΅Π½Π΄ΠΎΠΊΠ°ΡΠ΄ΠΈΡΠΈΡ Π΅ Π΅Π΄Π½Π° ΠΎΠ΄ ΠΏΡΠΈΡΠΈΠ½ΠΈΡΠ΅ Π·Π° ΠΌΠΎΠ·ΠΎΡΠ΅Π½ ΡΠ΄Π°Ρ. Π’Π΅ΠΌΠ΅Π»Π½Π° Π°Π½Π°ΠΌΠ½Π΅Π·Π° ΠΈ ΡΠΎΠΎΠ΄Π²Π΅ΡΠ½Π° Π΄ΠΈΡΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° ΡΠ΅ Π½Π΅ΠΎΠΏΡ
ΠΎΠ΄Π½ΠΈ Π·Π° Π½Π°Π²ΡΠ΅ΠΌΠ΅Π½Π° Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·Π° ΠΈ ΠΏΡΠ΅Π²Π΅Π½ΡΠΈΡΠ° Π½Π° ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ ΠΎΠ΄ Π±Π°ΠΊΡΠ΅ΡΠΈΡΠΊΠΈ Π΅Π½Π΄ΠΎΠΊΠ°ΡΠ΄ΠΈΡΠΈΡ.
ΠΠ»ΡΡΠ½ΠΈ Π·Π±ΠΎΡΠΎΠ²ΠΈ: ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ²Π΅Π½ Π΅Π½Π΄ΠΎΠΊΠ°ΡΠ΄ΠΈΡΠΈΡ, ΡΠ΅ΡΠ΅Π±ΡΠ°Π»Π½Π° Ρ
Π΅ΠΌΠΎΡΠ°Π³ΠΈΡΠ°, Streptococcus viridans, ΠΌΠΈΡΡΠ°Π»Π½Π° ΡΡΠ΅Π½ΠΎΠ·
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