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.. Ky e OCOEHHOCT MEHEH EOMETP HK EBOO E OKA O H X XPOHECKO CEP EHO HE OCTATOHOCT, PA BB E C HA OHE EPTOHECKO O E H Pa e xpec cep e e cac (XCH) np nepec e () ec c a c eee eep e ey a ( ) np a ae a. ppeccp ae XCH np cnp aec ey c ee cpac ap a. e eee ee p ee a c apyee e ya cayca. B ac acec y e eepecx napaep e ec e.

epoeca oe () ec e MATEPA METO oo o aopo pca cepeo-cocy- Oceoao 99 ox (68 e 31 ycx ocoe, o apy oe po- a, cpe opac 50,7+8,8 oa), cpaax ooe xpoeco cepeo e- XCH (0-III yoa acc () o accocaooc (XCH). eppo eoo ey- a H-opco accoa cepa oa () p paaec a aa (NYHA)), paec a oe epoeco poecc [3] oe a yeee ocapy oe. opoy pyy coca 15 opopocaecoo ae yp eo. o a- x (10 y 5 e, cpe opac peecoo cceoa, eppo 42,6 +7,9 e).

ec eac aopo, opee- xoapopaecoe cceoae poo poo aoea [4]. Oao paoa oc oo-, yxepo, yco ocoocex e oaao, o popeccpoae XCH o-ooo oepoco peax a aapae p pax aoeax cepa cao e Acuson 128XP10 (o) c cxpoo pecoo c yeee acc , o c pa- pae . pooc ceye epee apye eo eoep [1, 2]. o poecc : oa eeyooo epeopo ee cpyyp y cepa p pa- acoy ccoy (M, Mc, ); oa x aooecx cocox aaec pe- ae ce acoy ccoy (C, Cc, oepoae. ); poo paep o ocoa B acoee pe pae XCH y ox paoo aaa o epxy acoy (L); o ca ocoo c apyee aco- e acoec epeea paep eco y . o a pa aopo, eoo eyoa (P, ); oe ccoacoeca cy e oo copo- ec epeea paep eoo eyoa oae, o peecye ccoeco c- (CP, ). oe acoec oe ey oe po oe XCH oo eyoa (O, ) oe ccoecae ex cyax, oa oaae epao oe (CO, ) paccac o opeoa (pa poca, yap oe, ye oa Aopeepa ccepa a cocae yey oe po, cepe ec) ee e o cee. a. Opeec ceye oee [5]. Bce o peye oee opoo oc- aae: pa poca (B, %), acca aoc a o opoce. oapa (MM, p.), yap oe (O, ), Baoc apye acoecoo a- y oe (MO, /). cooac oe , ecx poe eoe- ae pacee ecpoae oa oca apaepo peoepoa cepa epxoc ea oaae O, CO, MM, MO, acoee pe ec peeo yye- ooaaee cooeceo O, CO, x cceoa. yee aoc x MM, M. ec cepoc (C) opeeapaepo ac cy ocaoo poco, cey opao: C=P/L. Ooceae o cpye oe a e- y oy ce (OTC) eoo eyoa pacc pooa aoea, a peyao po- ca: OTC=(M+C)/P. Pace cooo ee. coecoo oapaoo cpecca (MC / e aoo cceoa oc yee c2) pooc o opye [1]: MC=Ac x CP/ a peoepoa poecce pa- 4 x Cc x (1+Cc/CP), e Ac ccoecoe XCH y ox epoeco oe. apepaoe aee. oo oo pacc 1 2 ## a ceye oaae, cae copa- yeee ooceo o ce ey y eo eoep [6]: o- (p<0,001). ox epoeco oe c I oee oapaoo cpecca ecpoa- XCH ee caoc ee oee oo oeoo ccoecoo oea MC/ pae, o xapaepye pae peoeCO; ooee pa poca oap- poa o y oepeco eppo.

aoo cpecca B/MC. Cyo ee eoep y aacoece coca eoo eyoa x ox ec co ypoe ocacceoac ye ye cepa pac- py a oap, cece oeoo apepaoo acoecoo ooa (TM). Ope- paoo ae. oeca ooo ec: acaa copoc pacpa- oapaoo cpecca ocyecec a ce oo acoecoo ooa epo paeo a- yee o ceo acc oapoe (Ve, /c); acaa copoc a. B aee, o epe apaca ec pacpaoo acoecoo ooa ep- XCH, ecop a popeccpyee apacae o oeo aoe (Va, /c); E/A oo- acc oapa, pocxo yeee ooc ee acax copoce ooo epo cee ooceo o ce, paeo oeo aoe; pe oo- o ocoeo paeo y ox c III XCH.

ecoo paccae (BP, c). o poecc xapaepye pae cepCaceca opaoa peyao o- eco eppo oapa copooaea c cooae aea pax po- ec popeccpoae eoeca. Peypa Statistica 5.0 for Windows (StatSoft.Inc, a aaa pacpeee pax o peo1995). Bce ae pecae e M (cpe- epoa pyax ox c pao ee) m (caapoe ooee). paeoc coo XCH ao cppy o poecc (pc. 1). p o eoxoPETAT OCEHE o oepy, o ye pye ox c Peya ee cpyypo-yo- I e o ooo ooo c opao eoaoo coco oapa o epe popecc- epe ae pye e coo XCH poa XCH y ox epoeco oe- ox c opao eoepe cepa o pecae ae 1. eco. Ta opao, eo peoea o pecaex ax, apye- poae cepa peecye opeee o eoep y y ox epo- oee pae XCH.

eco oe aac ee o pa ee eoep cepa oycoa cepeo eocaooc. x a- ye y aeo e XCH pae ccoeo oeaec aeoe yeee acc eco acoeco cy oapa, ooapa o cpae c opo (p<0,001) ope ycyyc o epe pa popeccpoa cepeo eocaooc. Ta, y aeo c 0 XCH oeaec ocoepoe a Taa 1. aa cpyypo-eoepecx yoax oaaee y ox eoe cee opao cocooc epoeco oe acoc o ec XCH oapa (B/MC) o cpae c opo (p<0,01).

(*-p<0,05 o cpae c pey cpoe) Pae popeccpoae XCH copooae c ae cee B/MC. o pocxoo po oaa e XCH 0 XCH I XCH II XCH III (n=15) ooy, o eppopoa oap e (n=30) (n=30) (n=27) (n=12) MM 83,2+5,3 123,8+4,1* 158,6+7,9* 170,4+11,5* 234,4+21,9* oaae ce coca opao e(/2) P () 50,1+1,4 47,2+0,5* 50,2+0,9* 53,5+2,2 62,9+2,6* o a, ooy oepae oao copaCP () 33,2+1,5 29,8+0,5 33,6+0,8* 36,9+2,2 47,5+2,1* eo cocooc (B) a opao O 62,2+7,4 54,4+2,7* 64,2+2,2* 74,5+7,1* 103,9+9,2* (/2) ypoe ycox cooo oapaoo CO 23,2+4,2 18,1+1,2* 25,2+1,5* 32,2+4,8* 54,3+4,7* (/2) cpecca ocyecec a ce poca ca coB (%) 62,7+2,7 66,7+1,2 61,4+1,4* 58,4+2,4 46,7+2,4* paex eeo p x yoao O () 74,1+3,9 68,9+2,6 73,2+2,4 80,9+6,4* 96,8+12,2* OTC 0,39+0,01 0,48+0,01* 0,58+0,02* 0,45+0,02* 0,43+0,02* eooeoc.

C 0,59+0,02 0,58+0,01 0,59+0,02 0,62+0,01* 0,66+0,02* Aa a oaae MC/CO, oMC 115,6+5,8 202,5+10,1* 223,5+9,8* 287,3+23,9* 439,5+26,6* B/MC 0,570+0,024 0,330+0,019* 0,300+0,026* 0,208+0,034* 0,108+0,028* paaeo cee yac aa ooc MC/CO 4,7+0,3 11,2+0,6* 9,6+0,7* 8,9+0,8* 8,1+0,Ve (/c) 0,68+0,02 0,63+0,03* 0,54+0,03* 0,61+0,07* 71,8+0,06* oeca acoco y cepa, oVa (/c) 0,44+0,03 0,52+0,02* 0,59+0,02* 0,58+0,05 0,35+0,07* aa ceyee. aeo c 0, I y oBP (c) 82,5+3,8 96,2+1,9* 111,9+3,2* 100,0+7,7* 77,0+5,3* E/A 1,56+0,12 1,21+0,09* 0,92+0,07* 1,20+0,10* 2,20+0,20* e ac II oeca cepeo ee#$ 1.....

oc ocyecec oe cee a ce oepo oe, coaco oopo papoca copaex eeo yee e XCH p ca ocoo oo c acc p ooceo yee oo- acoeco cye . Oao a c (oepeca eppo). aeee pecaec, o a opoc ec copopeccpoae XCH, cee opao- pee eoooec, ee aoooecc oao acoco y cepa (B/ , ocoy opaa pa poca ee MC B) copooaec aae ooc e oaae ocyce apye copaoc cee MC/CO (cepeca - oapa. eo cee aeaoc pa eppo). Heoxoo ae oe, o - poca eec eoepeco oe aa ooc y ax ox ec, o- caeo p ao eo eoep apye o cooo apepaoo ae, oo- o oo opeee paeoc yoae aopo oe apy a - x apye.

oap a ce eoaec eoo o- oppeo aa aoc ec ee cepo op yee oap- XCH y ox epoeco oe cpyaoo cpecca. ypo-yoax oaaee pecaee acoeco y , - e ae 2. pecaex ax ee a ocoe aaa cepa TM, y o- o, o ec eoeca cepeo eex xapaepoac cey: o- oc oe cee ac o eoepecx c 0 XCH ocoeo c I o xapa- x oaaee (OTC, O p.) B/MC, epo cee cex copocx oaaee a e o coco oao copaoc (B).

E (Ve), opaax epo paeo aoe Oeea ae oee paea c cpae c opo. B o e pe y x o- acoecx apye p epoeco ox oeaoc yeee copoc oppoa- e c eoepec apaepa, e c co a A (Va), o ceecye o yee- coe acoco y eoo eyoa (B, aa pecep aoee . popec- O).

cpyee apyee peaca cece ye- Heoxoo oe, o y ox e acc eppopoaoo oapa ea opeeea ocoeoc aoc aeee oppoa pacpaoo - cpyyp acoecoo aoe (E/A) acoecoo paea ae copooaoc eoepecx apaepo, apep oocyeee pee ooecoo paccae (BP) o 96,2+1,9 c y ox c 0 XCH B 9,111,9+3,2 c c I (p<0,05). 22,19,Ocae e ee a opaee ae pacex oaaee. Bea E/A y ox c XCH 0 I a oco35,8 72,epo e ooceo op, o xapaepoao apye ceD C pa TM y ax ox a eppoec. o epe popeccpoa XCH peoepoa pocxoa aooepa aa ee cpyyp acoecoo aoe copoy peoaa paeo aoe. o xapaepoaoc yeee ooe E/A opaa eoe p ; o e p ecoe peoe poa e;

oppoae ceoopaoo ( II), a ae pecpoo c e p eca ep po ; o e p eca ep po .

( III) o apye aco (a. 1).

Pcyo 1. Pacpeeee ox epoeco oe (XCH 0 A, I B, II C, III D) Ta opao, oyee a acoc o eoep ( poeax) e, a ep , poopea 1 2 #% 1,Taa 2. acoc ec XCH o eoepecx 2, yoax oaaee y ox above oaa e B B/MC E/A OTC MC O CO E/A (NYHA) r=-0,43 r=-0,53 r=0,60 r=-0,54 r=0,63 r=0,58 r=0,p <0,05 <0,001 <0,001 <0,001 <0,001 <0,001 <0,Taa 3. acoc cpyyp aco o eoepecx yoax oaaee y ox oaa e B/MC B O MC OTC O CO B/MC E/A r=-0,40 r=-0,29 r=0,22 r=0,52 r=-0,42 r=0,40 r=0,p <0,01 =0,07 =0,08 <0,001 <0,01 <0,01 <0,OTC Pcyo 2. Baoc eoep (OTC), acoeco eo o ce (OTC). p aae coy (E/A) copaoc (B/MC) y ox oyoc ax o ce pe yoa acca oeaec opaea oppe- aoe. coa, opaa acoa c, o opaae oy ay oeca y eooa e opao apye acoeco y o epe po- eoep eoo eyoa.

peccpoa XCH. Ho y aeo, ex apye eoep e oepeco - BBO eppo oepecoo peoepoa 1. Hapye eoep y eoo ( ocoo I , aco, II), a eyoa peecy pa XCH y oc ooea (r=0,41; p<0,01). Oao x epoeco oe.

o e poope, o aoc y- 2. Pae XCH p epoeco oeoax eoepecx apaepo oc cao e oo c apye acoecee xapaep. a a ee pa o- o y , o c eyo cee op o o, o eo ee eoep o opaoc oapa.

oo opee y cepa. Ec 3. Oeea oee paea acoc opac pcyy 2, o oe ye, o e ec XCH o cpyypo-eoepecx ooo yeee, o yeee ooce- aaee, e o coco acoco y .

o o ce e opax a- 4. oe eee eoep cepa ee e po apye acoecoo a coo apyee yoaoo cayca .

_ Cco cooao epayp:

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