Лабораторная Диагностика / учебное пособие по лаб д / гемостаз

ɍȾɄ -07(07) ȻȻɄ ɹ

Ʌ

ȾɈɇȿɐɄɂɃ ɇȺɐɂɈɇȺɅɖɇɕɃ ɆȿȾɂɐɂɇɋɄɂɃ ɍɇɂȼȿɊɋɂɌȿɌ

Ⱥɜɬɨɪɵ

Ʌ ȼ ɇɚɬɪɭɫ ɞ-ɪ ɦɟɞ ɧɚɭɤ ɩɪɨɮ ɡɚɜ ɨɬɞɟɥɟɧɢɟɦ ɥɚɛɨɪɚɬɨɪɧɵɯ ɢɫɫɥɟɞɨɜɚɧɢɣ ɍɧɢɜɟɪɫɢɬɟɬɫɤɨɣ ɤɥɢɧɢɤɢ ȾɨɧɇɆɍ ɪɭɤɨɜɨɞɢɬɟɥɶ ɤɭɪɫɚ ɥɚɛɨɪɚɬɨɪɧɨɣ ɞɢɚɝɧɨɫɬɢɤɢ ɢ ɤɥɢɧɢɱɟɫɤɨɣ ɮɢɡɢɨɥɨɝɢɢ ɉ Ⱥ ɑɟɪɧɨɜɨɥ ɜɪɚɱ-ɥɚɛɨɪɚɧɬ ɨɬɞɟɥɟɧɢɹ ɤɚɪɞɢɨ- ɢ ɪɟɧɬɝɟɧɜɚɫɤɭɥɹɪɧɨɣ ɯɢɪɭɪɝɢɢ ȾɈɄ ɌɆɈ ɤɨɨɪɞɢɧɚɬɨɪ ɩɪɨɟɤɬɚ ©ZZZ FRDJXORPHWHU FRP XDª

ȼ Ⱥ Ʉɨɧɨɩɥɹɧɤɨ ɤɚɧɞ ɦɟɞ ɧɚɭɤ ɞɨɰɟɧɬ ɤɭɪɫɚ ɥɚɛɨɪɚɬɨɪɧɨɣ ɞɢɚɝɧɨɫɬɢɤɢ ɢ ɤɥɢɧɢɱɟɫɤɨɣ ɮɢɡɢɨɥɨɝɢɢ Ɇ Ⱥ ɋɧɟɝɢɪɶ ɤɚɧɞ ɦɟɞ ɧɚɭɤ ɞɨɰɟɧɬ ɤɭɪɫɚ ɥɚɛɨɪɚɬɨɪɧɨɣ ɞɢɚɝɧɨɫɬɢɤɢ ɢ ɤɥɢɧɢɱɟɫɤɨɣ ɮɢɡɢɨɥɨɝɢɢ

ɎȽȻɍ ȽȿɆȺɌɈɅɈȽɂɑȿɋɄɂɃ ɇȺɍɑɇɕɃ ɐȿɇɌɊ ɆɂɇɁȾɊȺȼɋɈɐɊȺɁȼɂɌɂə ɊɈɋɋɂɂ ɆȻɈɈɂ ©ɈȻɓȿɋɌȼɈ ȻɈɅɖɇɕɏ ȽȿɆɈɎɂɅɂȿɃª

ɇɉɈ ©ɊȿɇȺɆª WWW.RENAM.RU

Ⱥɜɬɨɪɵ

Ⱥ Ⱥ Ʉɨɡɥɨɜ ² ɞ-ɪ ɛɢɨɥ. ɧɚɭɤ ɡɚɜ. ɥɚɛɨɪɚɬɨɪɢɟɣ ɤɨɦɩɥɟɤɫɧɨɣ ɩɟɪɟɪɚɛɨɬɤɢ ɤɪɨɜɢ ɎȽȻɍ Ƚɟɦɚɬɨɥɨɝɢɱɟɫɤɢɣ ɧɚɭɱɧɵɣ ɰɟɧɬɪ Ɇɢɧɡɞɪɚɜɫɨɰɪɚɡɜɢɬɢɹ Ɋɨɫɫɢɢ ɞɢɪɟɤɬɨɪ ɇɉɈ ©ɊȿɇȺɆª Ⱥ Ʌ Ɇɟɥɤɭɦɹɧ ² ɤɚɧɞ ɦɟɞ ɧɚɭɤ ɦɟɧɟɞɠɟɪ ɩɨ ɦɟɞɬɟɯɧɨɥɨɝɢɹɦ ɇɉɈ ©ɊȿɇȺɆª

Ɍ Ɇ ɉɪɨɫɬɚɤɨɜɚ ² ɤɚɧɞ. ɛɢɨɥ. ɧɚɭɤ ɜɟɞɭɳɢɣ ɧɚɭɱɧɵɣ ɫɨɬɪɭɞɧɢɤ ɎȽȻɍ Ƚɟɦɚɬɨɥɨɝɢɱɟɫɤɢɣ ɧɚɭɱɧɵɣ ɰɟɧɬɪ Ɇɢɧɡɞɪɚɜɫɨɰɪɚɡɜɢɬɢɹ Ɋɨɫɫɢɢ ɢ ɇɉɈ ©ɊȿɇȺɆª

Ɋɟɰɟɧɡɟɧɬɵ

ɋ Ⱥ ȼɚɫɢɥɶɟɜ ² ɞ-ɪ ɦɟɞ ɧɚɭɤ ɩɪɨɮ. ɧɚɭɱɧɵɣ ɪɭɤɨɜɨɞɢɬɟɥɶ ɥɚɛɨɪɚɬɨɪɢɢ ɤɥɢɧɢɱɟɫɤɨɣ ɤɨɚɝɭɥɨɥɨɝɢɢ ɎȽȻɍ Ƚɟɦɚɬɨɥɨɝɢɱɟɫɤɢɣ ɧɚɭɱɧɵɣ ɰɟɧɬɪ Ɇɢɧɡɞɪɚɜɫɨɰɪɚɡɜɢɬɢɹ Ɋɨɫɫɢɢ ȼ ɂ ɑɟɪɧɢɣ ² ɞ-ɪ ɦɟɞ ɧɚɭɤ ɩɪɨɮ. ɱɥɟɧ-ɤɨɪɪ ɇȺɆɇ ɍɤɪɚɢɧɵ ɡɚɜ. ɤɚɮɟɞɪɨɣ ɚɧɟɫɬɟɡɢɨɥɨɝɢɢ ɎɂɉɈ ɫ ɤɭɪɫɨɦ ɥɚɛɨɪɚɬɨɪɧɨɣ ɞɢɚɝɧɨɫɬɢɤɢ ɢ ɤɥɢɧɢɱɟɫɤɨɣ ɮɢɡɢɨɥɨɝɢɢ

Ʌ Ʌɚɛɨɪɚɬɨɪɧɚɹ ɞɢɚɝɧɨɫɬɢɤɚ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ Ⱥ Ⱥ Ʉɨɡɥɨɜ Ʌ ȼ ɇɚɬɪɭɫ,

ɉ Ⱥ ɑɟɪɧɨɜɨɥ, Ⱥ Ʌ Ɇɟɥɤɭɦɹɧ ɢ ɞɪ Ɇ Ʌɢɬɬɟɪɪɚ 136 ɫ

ISBN 978-5-4235-0044-3

ȼ ɭɱɟɛɧɨɦ ɩɨɫɨɛɢɢ ɩɪɟɞɫɬɚɜɥɟɧɵ ɫɨɜɪɟɦɟɧɧɵɟ ɫɜɟɞɟɧɢɹ ɩɨ ɮɭɧɤɰɢɨɧɢɪɨɜɚɧɢɸ ɫɢɫɬɟɦɵ ɫɜɟɪɬɵɜɚɧɢɹ ɤɪɨɜɢ ɜ ɧɨɪɦɟ ɢ ɩɪɢ ɪɚɡɥɢɱɧɵɯ ɡɚɛɨɥɟɜɚɧɢɹɯ ɩɪɢɜɟɞɟɧɵ ɦɚɬɟɪɢɚɥɵ ɩɨ ɧɚɢɛɨɥɟɟ ɱɚɫɬɨ ɜɫɬɪɟɱɚɸɳɢɦɫɹ ɧɚɪɭɲɟɧɢɹɦ ɝɟɦɨɫɬɚɡɚ Ȼɨɥɶɲɨɟ ɜɧɢɦɚɧɢɟ ɭɞɟɥɟɧɨ ɫɨɜɪɟɦɟɧɧɵɦ ɦɟɬɨɞɚɦ ɥɚɛɨɪɚɬɨɪɧɨɣ ɞɢɚɝɧɨɫɬɢɤɢ ɬɪɨɦɛɨɰɢɬɨɩɟɧɢɢ

ɬɪɨɦɛɨɮɢɥɢɢ ɝɟɦɨɮɢɥɢɢ ɢ ɞɪɭɝɢɦ ɧɚɪɭɲɟɧɢɹɦ ɜ ɫɢɫɬɟɦɟ ɫɜɟɪɬɵɜɚɧɢɹ ɤɪɨɜɢ ɩɪɢɨɛɪɟɬɟɧɧɵɦ ɢ ɧɚɫɥɟɞɫɬɜɟɧɧɵɦ Ⱦɟɬɚɥɶɧɨ ɨɩɢɫɚɧɵ ɨɬɟɱɟɫɬɜɟɧɧɵɟ ɧɚɛɨɪɵ ɞɢɚɝɧɨɫɬɢɱɟɫɤɢɯ ɪɟɚɝɟɧɬɨɜ ɪɟɤɨɦɟɧɞɭɟɦɵɟ ɞɥɹ

ɞɢɚɝɧɨɫɬɢɤɢ ɩɚɬɨɥɨɝɢɢ ɝɟɦɨɫɬɚɡɚ ɉɨɫɨɛɢɟ ɩɪɟɞɧɚɡɧɚɱɟɧɨ ɜɪɚɱɚɦ-ɥɚɛɨɪɚɧɬɚɦ ɤɥɢɧɢɤɨ-ɞɢɚɝɧɨɫɬɢɱɟɫɤɢɯ ɥɚɛɨɪɚɬɨɪɢɣ ɜɪɚɱɚɦ ɨɛɳɟɣ ɩɪɚɤɬɢɤɢ ɫɬɭɞɟɧɬɚɦ ɢ ɨɪɞɢɧɚɬɨɪɚɦ ɦɟɞɢɰɢɧɫɤɢɯ ɜɭɡɨɜ ɋ ɰɟɥɶɸ ɩɪɨɜɟɪɤɢ ɭɪɨɜɧɹ ɡɧɚɧɢɣ ɜ ɭɱɟɛɧɨɟ ɩɨɫɨɛɢɟ ɜɤɥɸɱɟɧɵ ɜɨɩɪɨɫɵ ɢ ɫɢɬɭɚɰɢɨɧɧɵɟ ɡɚɞɚɱɢ

ɍȾɄ -07(07) ȻȻɄ ɹ

ɉɪɢ ɨɮɨɪɦɥɟɧɢɢ ɨɛɥɨɠɤɢ ɢɫɩɨɥɶɡɨɜɚɧɚ ɤɚɪɬɢɧɚ Ⱥɬɪɵɝɚɧɶɟɜɚ ɇɢɤɨɥɚɹ Ⱥɥɟɤɫɟɟɜɢɱɚ ©ȼɢɞ ɧɚ ɪɟɤɭ Ɉɫɬɟɪ ɜ Ɇɨɝɢɥɟɜɫɤɨɣ ɝɭɛɟɪɧɢɢª 1885 ɝ

ISBN 978-5-4235-0044-3

Ʉɨɥɥɟɤɬɢɜ ɚɜɬɨɪɨɜ, 2011ɈɈɈ ©ɂɡɞɚɬɟɥɶɫɬɜɨ ©Ʌɢɬɬɟɪɪɚª ɨɮɨɪɦɥɟɧɢɟ

Ɉɝɥɚɜɥɟɧɢɟ

ɋɩɢɫɨɤ ɫɨɤɪɚɳɟɧɢɣ________________________________________________________ 5

Ɏɢɡɢɨɥɨɝɢɱɟɫɤɢɟ ɨɫɧɨɜɵ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ _______________________________ 7

Ʉɥɢɧɢɱɟɫɤɚɹ ɢ ɥɚɛɨɪɚɬɨɪɧɚɹ ɞɢɚɝɧɨɫɬɢɤɚ ɧɚɢɛɨɥɟɟ ɱɚɫɬɨ ɜɫɬɪɟɱɚɸɳɢɯɫɹ ɧɚɪɭɲɟɧɢɣ ɝɟɦɨɫɬɚɡɚ _____________________________________________________ 21

ɋɨɜɪɟɦɟɧɧɚɹ ɤɥɚɫɫɢɮɢɤɚɰɢɹ ɩɚɬɨɥɨɝɢɢ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ______________________ 31

Ʌɚɛɨɪɚɬɨɪɧɵɟ ɦɟɬɨɞɵ ɩɪɢɦɟɧɹɟɦɵɟ ɞɥɹ ɞɢɮɮɟɪɟɧɰɢɚɥɶɧɨɣ ɞɢɚɝɧɨɫɬɢɤɢ

ɬɪɨɦɛɨɰɢɬɨɩɟɧɢɣ __________________________________________________________________ 38

Ʉɥɚɫɫɢɮɢɤɚɰɢɹ ɨɫɧɨɜɧɵɯ ɜɢɞɨɜ ɬɪɨɦɛɨɮɢɥɢɣ ɩɨ Ȼɚɪɤɚɝɚɧɭ Ɂ ɋ _______ 41

Ʌɚɛɨɪɚɬɨɪɧɵɟ ɦɟɬɨɞɵ ɞɢɚɝɧɨɫɬɢɤɢ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ ___________________ 52

Ɉɫɨɛɟɧɧɨɫɬɢ ɥɚɛɨɪɚɬɨɪɧɵɯ ɦɟɬɨɞɨɜ ɢɫɫɥɟɞɨɜɚɧɢɹ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ ____ 52

Ɇɟɬɨɞɵ ɢɫɫɥɟɞɨɜɚɧɢɹ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ_______________________________ 56

Ɇɟɬɨɞɵ ɢɫɫɥɟɞɨɜɚɧɢɹ ɬɪɨɦɛɨɰɢɬɚɪɧɨ-ɫɨɫɭɞɢɫɬɨɝɨ ɡɜɟɧɚ ɝɟɦɨɫɬɚɡɚ___________ 57

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɢɫɫɥɟɞɨɜɚɧɢɹ ɚɝɪɟɝɚɰɢɨɧɧɨɣ ɚɤɬɢɜɧɨɫɬɢ ɬɪɨɦɛɨɰɢɬɨɜ Ⱥɝɪɟɧɚɦ ____ 60

Ɋɟɚɝɟɧɬ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɚɤɬɢɜɧɨɫɬɢ ɮɚɤɬɨɪɚ ȼɢɥɥɟɛɪɚɧɞɚ___________________________ 64

Ɉɩɪɟɞɟɥɟɧɢɟ ɚɤɬɢɜɧɨɫɬɢ ɮɚɤɬɨɪɚ ȼɢɥɥɟɛɪɚɧɞɚ ɧɚ ɚɝɪɟɝɨɦɟɬɪɟ ɮɢɪɦɵ Ȼɢɨɥɚ ___________ 66

Ɇɟɬɨɞɵ ɢɫɫɥɟɞɨɜɚɧɢɹ ɩɥɚɡɦɟɧɧɨɝɨ ɡɜɟɧɚ ɝɟɦɨɫɬɚɡɚ __________________________ 68

ɉɪɨɬɪɨɦɛɢɧɨɜɵɣ ɬɟɫɬ ɩɪɨɬɪɨɦɛɢɧɨɜɨɟ ɜɪɟɦɹ ɉȼ ɩɪɨɬɪɨɦɛɢɧɨɜɵɣ ɢɧɞɟɤɫ ɉɂ Ɇɟɠɞɭɧɚɪɨɞɧɨɟ ɧɨɪɦɚɥɢɡɨɜɚɧɧɨɟ ɨɬɧɨɲɟɧɢɟ ɆɇɈ ɩɪɨɬɪɨɦɛɢɧ ɩɨ Ʉɜɢɤɭ_________________ 68

Ɍɪɨɦɛɨɩɥɚɫɬɢɧ ɢɡ ɝɨɥɨɜɧɨɝɨ ɦɨɡɝɚ ɤɪɨɥɢɤɚ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɩɪɨɬɪɨɦɛɢɧɨɜɨɝɨ ɜɪɟɦɟɧɢ

Ɋɟɧɚɦɩɥɚɫɬɢɧ ____________________________________________________________________ 69

Ⱥɤɬɢɜɢɪɨɜɚɧɧɨɟ ɱɚɫɬɢɱɧɨɟ ɬɪɨɦɛɨɩɥɚɫɬɢɧɨɜɨɟ ɜɪɟɦɹ ȺɑɌȼ -_______________________ 74

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɚɤɬɢɜɢɪɨɜɚɧɧɨɝɨ ɱɚɫɬɢɱɧɨɝɨ ɬɪɨɦɛɨɩɥɚɫɬɢɧɨɜɨɝɨ

ɜɪɟɦɟɧɢ ȺɑɌȼ-ɬɟɫɬ _______________________________________________________________ 74

Ɍɪɨɦɛɢɧɨɜɨɟ ɜɪɟɦɹ ____________________________________________________________ 76

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɬɪɨɦɛɢɧɨɜɨɝɨ ɜɪɟɦɟɧɢ Ɍɪɨɦɛɢɧ-ɬɟɫɬ _______________ 76

Ɉɩɪɟɞɟɥɟɧɢɟ ɫɨɞɟɪɠɚɧɢɹ ɮɢɛɪɢɧɨɝɟɧɚ ɜ ɩɥɚɡɦɟ ɱɟɥɨɜɟɤɚ ɩɨ ɦɟɬɨɞɭ ɄɥɚɭɫFɚ ___________ 78

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɫɨɞɟɪɠɚɧɢɹ ɮɢɛɪɢɧɨɝɟɧɚ Ɏɢɛɪɢɧɨɝɟɧ-ɬɟɫɬ __________ 79

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɪɚɫɬɜɨɪɢɦɵɯ ɮɢɛɪɢɧ-ɦɨɧɨɦɟɪɧɵɯ ɤɨɦɩɥɟɤɫɨɜ ɊɎɆɄ

ɜ ɩɥɚɡɦɟ ɤɪɨɜɢ ɱɟɥɨɜɟɤɚ ɨ-ɮɟɧɚɧɬɪɨɥɢɧɨɜɵɦ ɦɟɬɨɞɨɦ ɊɎɆɄ-ɬɟɫɬ _______________________ 80

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɷɤɫɩɪɟɫɫ ɨɩɪɟɞɟɥɟɧɢɹ Ⱦ-ɞɢɦɟɪɨɜ ɜ ɰɟɥɶɧɨɣ ɤɪɨɜɢ ɊɟȾ-Ⱦɢɦɟɪ-ɬɟɫɬ _ 82

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɚɤɬɢɜɧɨɫɬɢ 9,,, ɮɚɤɬɨɪɚ ɫɜɟɪɬɵɜɚɧɢɹ ɤɪɨɜɢ

Ɏɚɤɬɨɪ 9,,,-ɬɟɫɬ _________________________________________________________________ 85

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɚɤɬɢɜɧɨɫɬɢ ,; ɮɚɤɬɨɪɚ ____________________________ 91

ɫɜɟɪɬɵɜɚɧɢɹ ɤɪɨɜɢ Ɏɚɤɬɨɪ ,;-ɬɟɫɬ _____________________________________________ 91

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɪɟɡɢɫɬɟɧɬɧɨɫɬɢ ɮ V ɤ ɩɪɨɬɟɢɧɭ ɋ ɊɟɚɅɟɣɞɟɧ-ɬɟɫɬ ____ 94

Ɏɚɤɬɨɪɵ ɫɜɟɪɬɵɜɚɧɢɹ ,, 9,, ; __________________________________________________ 96

Ɏɚɤɬɨɪɵ ɫɜɟɪɬɵɜɚɧɢɹ ;, ;,, ___________________________________________________ 98

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɚɤɬɢɜɧɨɫɬɢ ɮɢɛɪɢɧ-ɫɬɚɛɢɥɢɡɢɪɭɸɳɟɝɨ ɮɚɤɬɨɪɚ

Ɏɚɤɬɨɪ ;,,,-ɬɟɫɬ _________________________________________________________________ 101

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɮɢɛɪɢɧɨɥɢɬɢɱɟɫɤɨɣ ɚɤɬɢɜɧɨɫɬɢ ɩɥɚɡɦɵ ɤɪɨɜɢ

ɱɟɥɨɜɟɤɚ ;,,ɚ-ɡɚɜɢɫɢɦɵɣ ɮɢɛɪɢɧɨɥɢɡ _______________________________________________ 103

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɚɤɬɢɜɧɨɫɬɢ ɩɥɚɡɦɢɧɨɝɟɧɚ ɨɩɬɢɱɟɫɤɢɦ ɦɟɬɨɞɨɦ

Ɋɟɚɯɪɨɦ-ɩɥɚɡɦɢɧɨɝɟɧ ____________________________________________________________ 105

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɚɤɬɢɜɧɨɫɬɢ 2-ɚɧɬɢɩɥɚɡɦɢɧɚ ɨɩɬɢɱɟɫɤɢɦ ɦɟɬɨɞɨɦ

Ɋɟɚɯɪɨɦ-ɚɧɬɢɩɥɚɡɦɢɧ _____________________________________________________________ 107

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɚɤɬɢɜɧɨɫɬɢ ɚɧɬɢɬɪɨɦɛɢɧɚ ,,, ɨɩɬɢɱɟɫɤɢɦ ɦɟɬɨɞɨɦ

Ɋɟɚɯɪɨɦ-ȺɌ ,,, __________________________________________________________________ 110

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɚɤɬɢɜɧɨɫɬɢ ɚɧɬɢɬɪɨɦɛɢɧɚ ,,, ______________________ 112

ɜ ɩɥɚɡɦɟ ɤɪɨɜɢ ɱɟɥɨɜɟɤɚ ɤɥɨɬɬɢɧɝɨɜɵɦ ɦɟɬɨɞɨɦ Ɋɟɚɤɥɨɬ-ȺɌ ,,,-ɬɟɫɬ ________________ 112

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɚɤɬɢɜɧɨɫɬɢ ɩɪɨɬɟɢɧɚ ɋ ɨɩɬɢɱɟɫɤɢɦ ɦɟɬɨɞɨɦ

Ɋɟɚɯɪɨɦ-ɉɪɨɬɟɢɧ ɋ ______________________________________________________________ 114

3

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɫɤɪɢɧɢɧɝɨɜɨɣ ɨɰɟɧɤɢ ɧɚɪɭɲɟɧɢɣ ɜ ɫɢɫɬɟɦɟ ɩɪɨɬɟɢɧɚ ɋ

ɉɪɨɬɟɢɧ ɋ-ɫɤɪɢɧɢɧɝ ɬɟɫɬ ___________________________________________________________117

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɜɨɥɱɚɧɨɱɧɨɝɨ ɚɧɬɢɤɨɚɝɭɥɹɧɬɚ ȼȺ-ɬɟɫɬ _____________119

ɇɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɚɧɬɢ-ɏɚ ɚɤɬɢɜɧɨɫɬɢ ɝɟɩɚɪɢɧɚ ɨɩɬɢɱɟɫɤɢɦ ɦɟɬɨɞɨɦ

Ɋɟɚɯɪɨɦ-ɝɟɩɚɪɢɧ __________________________________________________________________123

Ɂɚɞɚɧɢɹ ɞɥɹ ɩɪɨɜɟɪɤɢ ɭɪɨɜɧɹ ɡɧɚɧɢɣ______________________________________ 126

Ʌɢɬɟɪɚɬɭɪɚ____________________________________________________________ 134

4

ɋɩɢɫɨɤ ɫɨɤɪɚɳɟɧɢɣ

ELISA ± Enzyme-Linked ImmunoSorbent Assay CAP ± College of American Pathologists

CLSI ± Clinical and Laboratory Standards Institute ECCL ± European Coalition for Community Living Ig ± ɢɦɦɭɧɨɝɥɨɛɭɥɢɧɵ

ISO ± Ɇɟɠɞɭɧɚɪɨɞɧɚɹ Ɉɪɝɚɧɢɡɚɰɢɹ ɋɬɚɧɞɚɪɬɢɡɚɰɢɢ GLP ± ɇɚɞɥɟɠɚɳɚɹ Ʌɚɛɨɪɚɬɨɪɧɚɹ ɉɪɚɤɬɢɤɚ

GMP ± ɇɚɞɥɟɠɚɳɚɹ Ɇɟɞɢɰɢɧɫɤɚɹ ɉɪɚɤɬɢɤɚ GP ± ɝɥɢɤɨɩɪɨɬɟɢɧ

GPIIb-IIIa ± ɝɥɢɤɨɩɪɨɬɟɢɧɨɜɵɣ ɤɨɦɩɥɟɤɫ ɧɚ ɦɟɦɛɪɚɧɟ ɬɪɨɦɛɨɰɢɬɨɜ ɫ ɮɭɧɤɰɢɟɣ ɚɞɝɟɡɢɢ ɢ ɚɝɪɟɝɚɰɢɢ

Hct ± ɝɟɦɚɬɨɤɪɢɬ

PAI ± Plasminogen $FWLYDWRU ,QKLELWRU ɢɧɝɢɛɢɬɨɪ ɚɤɬɢɜɚɬɨɪɚ ɩɥɚɡɦɢɧɨɝɟɧɚ PAF ± ɮɚɤɬɨɪ ɚɤɬɢɜɚɰɢɢ ɬɪɨɦɛɨɰɢɬɨɜ

ɊIVɄȺ ± Ɋroteins Induced by Vitamin K Absence or Antagonist (ɫɢɧɨɧɢɦ ± ɉɂȼɄȺ)

ɪ1Ⱥ ± ɩɚɪɚ-ɧɢɬɪɨɚɧɢɥɢɧ PrC ± ɩɪɨɬɟɢɧ ɋ

t-PA ± WLVVXH 3ODVPLQRJHQ $FWLYDWRU ɚɤɬɢɜɚɬɨɪ ɩɥɚɡɦɢɧɨɝɟɧɚ ɬɤɚɧɟɜɨɝɨ ɬɢɩɚ TFPI ± 7LVVXH )DFWRU 3DWKZD\ ,QKLELWRU ɢɧɝɢɛɢɬɨɪ ɩɭɬɢ ɬɤɚɧɟɜɨɝɨ ɮɚɤɬɨɪɚ

u-PA ± urokinase-WLSH 3ODVPLQRJHQ $FWLYDWRU ɭɪɨɤɢɧɚɡɧɵɣ ɚɤɬɢɜɚɬɨɪ ɩɥɚɡɦɢɧɨɝɟɧɚ vWF ± ɮɚɤɬɨɪ ȼɢɥɥɟɛɪɚɧɞɚ

XL-ɉȾɎ ± ɩɪɨɞɭɤɬɵ ɞɟɝɪɚɞɚɰɢɢ ɩɨɩɟɪɟɱɧɨɫɲɢɬɨɝɨ ɮɢɛɪɢɧɚ ȺȼɊ ± ɚɤɬɢɜɢɪɨɜɚɧɧɨɟ ɜɪɟɦɹ ɪɟɤɚɥɶɰɢɮɢɤɚɰɢɢ ȺȾɎ ± ɚɞɟɧɨɡɢɧɞɢɮɨɫɮɚɬ ɚɄɅ ± ɚɧɬɢɬɟɥɚ ɤ ɤɚɪɞɢɨɥɢɩɢɧɭ

ȺɊɋ-ɪɟɡɢɫɬɟɧɬɧɨɫɬɶ ± ɪɟɡɢɫɬɟɧɬɧɨɫɬɶ ɤ ɚɤɬɢɜɢɪɨɜɚɧɧɨɦɭ ɩɪɨɬɟɢɧɭ ɋ AT-III ± ɚɧɬɢɬɪɨɦɛɢɧ III

ȺɌɎ ± ɚɞɟɧɨɡɢɧɬɪɢɮɨɫɮɚɬ ȺɎɋ ± ɚɧɬɢɮɨɫɮɨɥɢɩɢɞɧɵɣ ɫɢɧɞɪɨɦ

ȺɑɌȼ ± ɚɤɬɢɜɢɪɨɜɚɧɧɨɟ ɱɚɫɬɢɱɧɨɟ ɬɪɨɦɛɨɩɥɚɫɬɢɧɨɜɨɟ ɜɪɟɦɹ ȻȽȽɉ ± ɛɨɝɚɬɨɝɨ ɝɢɫɬɢɞɢɧɨɦ ɝɥɢɤɨɩɪɨɬɟɢɧɚ ɩɪɨɞɭɤɰɢɹ ȻɌɉ ± ɛɟɞɧɚɹ ɬɪɨɦɛɨɰɢɬɚɦɢ ɩɥɚɡɦɚ ȼȺ ± ɜɨɥɱɚɧɨɱɧɵɣ ɚɧɬɢɤɨɚɝɭɥɹɧɬ ȼɂɑ ± ɜɢɪɭɫ ɢɦɦɭɧɨɞɟɮɢɰɢɬɚ ɱɟɥɨɜɟɤɚ ȼɄ ± ɜɪɟɦɹ ɤɪɨɜɨɬɟɱɟɧɢɹ ȼɆɄ ± ɜɵɫɨɤɨɦɨɥɟɤɭɥɹɪɧɵɣ ɤɢɧɢɧɨɝɟɧ ȽȽɌ ± ɝɚɦɦɚ-ɝɥɭɬɚɦɢɥɬɪɚɧɫɮɟɪɚɡɚ

ȽɂɌ ± ɝɟɩɚɪɢɧ-ɢɧɞɭɰɢɪɨɜɚɧɧɚɹ ɬɪɨɦɛɨɰɢɬɨɩɟɧɢɹ Ƚɍɋ ± ɝɟɦɨɥɢɬɢɤɨ-ɭɪɟɦɢɱɟɫɤɢɣ ɫɢɧɞɪɨɦ ȾɇɄ ± ɞɟɡɨɤɫɢɪɢɛɨɧɭɤɥɟɢɧɨɜɚɹ ɤɢɫɥɨɬɚ ɀɄɌ ± ɠɟɥɭɞɨɱɧɨ-ɤɢɲɟɱɧɵɣ ɬɪɚɤɬ ɂȻɋ ± ɢɲɟɦɢɱɟɫɤɚɹ ɛɨɥɟɡɧɶ ɫɟɪɞɰɚ

ɂɌɉ ± ɢɞɢɨɩɚɬɢɱɟɫɤɚɹ ɬɪɨɦɛɨɰɢɬɨɩɟɧɢɱɟɫɤɚɹ ɩɭɪɩɭɪɚ ɢɞɢɨɩɚɬɢɱɟɫɤɢɟ ɚɭɬɨɦɦɭɧɧɵɟ ɬɪɨɦɛɨɰɢɬɨɩɟɧɢɢ ɂɎȺ ± ɢɦɦɭɧɨɮɟɪɦɟɧɬɧɵɣ ɚɧɚɥɢɡ

ɄɅɂ ± ɤɥɢɧɢɤɨ-ɥɚɛɨɪɚɬɨɪɧɵɟ ɢɫɫɥɟɞɨɜɚɧɢɹ

5

Ʌȼɋ ± ɥɨɤɚɥɢɡɨɜɚɧɧɨɟ ɜɧɭɬɪɢɫɨɫɭɞɢɫɬɨɟ ɫɜɟɪɬɵɜɚɧɢɟ ɤɪɨɜɢ ɅȾȽ ± ɥɚɤɬɚɬɞɟɝɢɞɪɨɝɟɧɚɡɚ Ʌɉ ± ɥɢɩɨɩɪɨɬɟɢɞ

Ʌɉȼɉ ± ɥɢɩɨɩɪɨɬɟɢɞɵ ɜɵɫɨɤɨɣ ɩɥɨɬɧɨɫɬɢ Ʌɉɇɉ ± ɥɢɩɨɩɪɨɬɟɢɞɵ ɧɢɡɤɨɣ ɩɥɨɬɧɨɫɬɢ ɅɉɈɇɉ ± ɥɢɩɨɩɪɨɬɟɢɞɵ ɨɱɟɧɶ ɧɢɡɤɨɣ ɩɥɨɬɧɨɫɬɢ Ɇȿ ± ɦɟɠɞɭɧɚɪɨɞɧɵɟ ɟɞɢɧɢɰɵ

ɆɁ ɊɎ ± Ɇɢɧɢɫɬɟɪɫɬɜɨ Ɂɞɪɚɜɨɨɯɪɚɧɟɧɢɹ Ɋɨɫɫɢɣɫɤɨɣ Ɏɟɞɟɪɚɰɢɢ Ɇɂɑ ± ɦɟɠɞɭɧɚɪɨɞɧɵɣ ɢɧɞɟɤɫ ɱɭɜɫɬɜɢɬɟɥɶɧɨɫɬɢ ɆɇɈ ± ɦɟɠɞɭɧɚɪɨɞɧɨɟ ɧɨɪɦɚɥɢɡɨɜɚɧɧɨɟ ɨɬɧɨɲɟɧɢɟ ɇɆȽ ± ɧɢɡɤɨɦɨɥɟɤɭɥɹɪɧɵɟ ɝɟɩɚɪɢɧɵ

ɇɉȼɉ ± ɧɟɫɬɟɪɨɢɞɧɵɟ ɩɪɨɬɢɜɨɜɨɫɩɚɥɢɬɟɥɶɧɵɟ ɩɪɟɩɚɪɚɬɵ ɈɌɉ ± ɨɛɨɝɚɳɟɧɧɚɹ ɬɪɨɦɛɨɰɢɬɚɦɢ ɩɥɚɡɦɚ ɉȺɉ ± ɩɥɚɡɦɢɧ-ɚɧɬɢɩɥɚɡɦɢɧɨɜɵɣ ɤɨɦɩɥɟɤɫ ɉȼ ± ɩɪɨɬɪɨɦɛɢɧɨɜɨɟ ɜɪɟɦɹ ɉȽ± ɩɪɨɫɬɚɝɥɚɧɞɢɧɵ

ɉȽG2 ± ɩɪɨɫɬɚɝɥɚɧɞɢɧ G2 ɉȽɇ2 ± ɩɪɨɫɬɚɝɥɚɧɞɢɧ ɇ2

ɉȾɎ ± ɩɪɨɞɭɤɬɵ ɞɟɝɪɚɞɚɰɢɢ ɮɢɛɪɢɧɚ ɮɢɛɪɢɧɨɝɟɧɚ ɉɈ ± ɩɪɨɬɪɨɦɛɢɧɨɜɨɟ ɨɬɧɨɲɟɧɢɟ ɉɗ ± ɩɪɟɚɧɚɥɢɬɢɱɟɫɤɢɣ ɷɬɚɩ

ɊɎɆɄ ± ɪɚɫɬɜɨɪɢɦɵɟ ɮɢɛɪɢɧ-ɦɨɧɨɦɟɪɧɵɟ ɤɨɦɩɥɟɤɫɵ ɋɁɉ ± ɫɜɟɠɟɡɚɦɨɪɨɠɟɧɧɚɹ ɩɥɚɡɦɚ ɋɄȼ ± ɫɢɫɬɟɦɧɚɹ ɤɪɚɫɧɚɹ ɜɨɥɱɚɧɤɚ ɋɈ ± ɫɤɪɢɧɢɧɝɨɜɨɟ ɨɬɧɨɲɟɧɢɟ ɌȺɉ ± ɬɤɚɧɟɜɨɣ ɚɤɬɢɜɚɬɨɪ ɩɥɚɡɦɢɧɨɝɟɧɚ

ɌȺɌ ± ɤɨɦɩɥɟɤɫ ɬɪɨɦɛɢɧ-ɚɧɬɢɬɪɨɦɛɢɧ Ɍȼ ± ɬɪɨɦɛɢɧɨɜɨɟ ɜɪɟɦɹ

ɌɌɉ ± ɬɪɨɦɛɨɬɢɱɟɫɤɚɹ ɬɪɨɦɛɨɰɢɬɨɩɟɧɢɱɟɫɤɚɹ ɩɭɪɩɭɪɚ ɌɎ ± ɬɤɚɧɟɜɨɣ ɮɚɤɬɨɪ Ɍ;Ⱥ ± ɬɪɨɦɛɨɤɫɚɧ Ⱥ

ɌɗɅȺ ± ɬɪɨɦɛɨɷɦɛɨɥɢɹ ɥɟɝɨɱɧɨɣ ɚɪɬɟɪɢɢ ɮ ± ɮɚɤɬɨɪ ɮ 9,, ± ɮɚɤɬɨɪ ɤɨɚɝɭɥɹɰɢɢ 9,,

ɮ 9,,D ± ɚɤɬɢɜɢɪɨɜɚɧɧɵɣ ɮɚɤɬɨɪ ɤɨɚɝɭɥɹɰɢɢ 9,, ɎɗɄ ± ɫɩɟɤɬɪɨɮɨɬɨɦɟɬɪ ɏɉɇ ± ɯɪɨɧɢɱɟɫɤɚɹ ɩɨɱɟɱɧɚɹ ɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶ

ɐɇɋ ± ɰɟɧɬɪɚɥɶɧɚɹ ɧɟɪɜɧɚɹ ɫɢɫɬɟɦɚ ɑɌȼ ± ɱɚɫɬɢɱɧɨɟ ɬɪɨɦɛɨɩɥɚɫɬɢɧɨɜɨɟ ɜɪɟɦɹ

ɗȾɌȺ ± ɷɬɢɥɟɧɞɢɚɦɢɧɬɟɬɪɚɚɰɟɬɚɬ ɷɬɢɥɟɧɞɢɚɦɢɧɬɟɬɪɚɭɤɫɭɫɧɚɹ ɤɢɫɥɨɬɚ

6

1. Ɏɢɡɢɨɥɨɝɢɱɟɫɤɢɟ ɨɫɧɨɜɵ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ

Ⱥɤɬɭɚɥɶɧɨɫɬɶ ɩɪɨɛɥɟɦɵ ɬɪɨɦɛɨɡɨɜ/ɤɪɨɜɨɬɟɱɟɧɢɣ ɋɬɚɬɢɫɬɢɤɚ Ƚɟɦɨɫɬɚɬɢ ɱɟɫɤɢɣ ɛɚɥɚɧɫ Ɇɟɯɚɧɢɡɦ ɬɪɨɦɛɨɨɛɪɚɡɨɜɚɧɢɹ Ɋɨɥɶ ɷɧɞɨɬɟɥɢɹ ɜ ɫɢɫɬɟɦɟ ɝɟɦɨɫɬɚɡɚ Ɍɪɨɦɛɨɰɢɬɵ Ʉɚɫɤɚɞɧɨ-ɤɨɦɩɥɟɤɫɧɚɹ ɫɢɫɬɟɦɚ ɫɜɟɪɬɵɜɚɧɢɹ ɤɪɨɜɢ ɉɥɚɡɦɟɧɧɵɣ ɢ ɬɪɨɦɛɨɰɢɬɚɪɧɨ-ɫɨɫɭɞɢɫɬɵɣ ɩɭɬɶ ɫɜɟɪɬɵɜɚɧɢɹ ɤɪɨɜɢ Ⱥɧɬɢɤɨɚɝɭɥɹɧɬɧɚɹ ɫɢɫɬɟɦɚ Ɏɢɛɪɢɧɨɥɢɡ

Ƚɟɦɨɫɬɚɡ ± ɷɬɨ ɮɭɧɤɰɢɹ ɨɪɝɚɧɢɡɦɚ ɨɛɟɫɩɟɱɢɜɚɸɳɚɹ ɫ ɨɞɧɨɣ ɫɬɨɪɨɧɵ ɫɨɯɪɚɧɟ ɧɢɟ ɤɪɨɜɢ ɜ ɤɪɨɜɟɧɨɫɧɨɦ ɪɭɫɥɟ ɜ ɠɢɞɤɨɦ ɚɝɪɟɝɚɬɧɨɦ ɫɨɫɬɨɹɧɢɢ ɚ ɫ ɞɪɭɝɨɣ ɫɬɨɪɨɧɵ ± ɨɫɬɚɧɨɜɤɭ ɤɪɨɜɨɬɟɱɟɧɢɹ ɩɪɢ ɩɨɜɪɟɠɞɟɧɢɢ ɤɪɨɜɟɧɨɫɧɵɯ ɫɨɫɭɞɨɜ Ɉɪɝɚɧɵ ɢ ɬɤɚɧɢ ɭɱɚ ɫɬɜɭɸɳɢɟ ɜ ɜɵɩɨɥɧɟɧɢɢ ɷɬɢɯ ɮɭɧɤɰɢɣ ɨɛɪɚɡɭɸɬ ɫɢɫɬɟɦɭ ɝɟɦɨɫɬɚɡɚ ɗɥɟɦɟɧɬɵ ɫɢɫɬɟ ɦɵ ɝɟɦɨɫɬɚɡɚ ɭɱɚɫɬɜɭɸɬ ɬɚɤɠɟ ɜ ɬɚɤɢɯ ɜɚɠɧɵɯ ɩɪɨɰɟɫɫɚɯ ɠɢɡɧɟɞɟɹɬɟɥɶɧɨɫɬɢ ɤɚɤ ɜɨɫ ɩɚɥɟɧɢɟ ɪɟɩɚɪɚɰɢɹ ɬɤɚɧɟɣ ɩɨɞɞɟɪɠɚɧɢɟ ɝɨɦɟɨɫɬɚɡɚ ɢ ɞɪ

ɂɡɦɟɧɟɧɢɹ ɜ ɫɢɫɬɟɦɟ ɝɟɦɨɫɬɚɡɚ ɦɨɝɭɬ ɫɬɚɬɶ ɩɪɢɱɢɧɨɣ ɪɚɡɜɢɬɢɹ ɤɚɤ ɝɟɦɨɪɪɚɝɢɱɟ ɫɤɢɯ ɬɚɤ ɢ ɬɪɨɦɛɨɬɢɱɟɫɤɢɯ ɫɨɫɬɨɹɧɢɣ ɤɨɬɨɪɵɟ ɜɨɡɧɢɤɚɸɬ ɭ ɩɚɰɢɟɧɬɨɜ ɫ ɫɚɦɵɦɢ ɪɚɡ ɧɵɦɢ ɡɚɛɨɥɟɜɚɧɢɹɦɢ Ɉɝɪɨɦɧɨɟ ɡɧɚɱɟɧɢɟ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ ɜ ɩɚɬɨɝɟɧɟɡɟ ɡɚɛɨɥɟɜɚɧɢɣ ɫɨɜɪɟɦɟɧɧɨɝɨ ɱɟɥɨɜɟɤɚ ɞɨɤɚɡɵɜɚɟɬɫɹ ɫɬɚɬɢɫɬɢɤɨɣ ɬɚɤɢɟ ɝɟɦɨɫɬɚɬɢɱɟɫɤɢɟ ɧɚɪɭɲɟɧɢɹ ɤɚɤ ɚɬɟɪɨɬɪɨɦɛɨɡ ɢ ɫɢɧɞɪɨɦ ɞɢɫɫɢɦɢɧɢɪɨɜɚɧɧɨɝɨ ɜɧɭɬɪɢɫɨɫɭɞɢɫɬɨɝɨ ɫɜɟɪɬɵɜɚɧɢɹȾȼɋ ɹɜɥɹɸɬɫɹ ɩɪɢɱɢɧɨɣ ɫɦɟɪɬɢ ɛɨɥɟɟ ɱɟɦ ɜ ɩɨɥɨɜɢɧɟ ɜɫɟɯ ɫɥɭɱɚɟɜ Ʌɚɛɨɪɚɬɨɪɧɚɹ ɞɢɚɝɧɨɫɬɢɤɚ ɫɨɫɬɨɹɧɢɹ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ ± ɜɚɠɧɟɣɲɢɣ ɮɚɤɬɨɪ ɷɮɮɟɤɬɢɜɧɨɫɬɢ ɥɟɱɟ ɧɢɹ ɦɧɨɝɢɯ ɡɚɛɨɥɟɜɚɧɢɣ ɢ ɫɧɢɠɟɧɢɹ ɫɦɟɪɬɧɨɫɬɢ ɧɚɫɟɥɟɧɢɹ ȼ ɫɜɨɸ ɨɱɟɪɟɞɶ ɫɨɜɪɟɦɟɧ ɧɚɹ ɥɚɛɨɪɚɬɨɪɧɚɹ ɞɢɚɝɧɨɫɬɢɤɚ ɨɫɧɨɜɚɧɚ ɧɚ ɩɨɧɢɦɚɧɢɢ ɨɛɳɟɛɢɨɥɨɝɢɱɟɫɤɢɯ ɡɚɤɨɧɨɦɟɪ ɧɨɫɬɟɣ ɮɭɧɤɰɢɨɧɢɪɨɜɚɧɢɹ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ ɢ ɜɵɛɨɪɚ ɚɞɟɤɜɚɬɧɵɯ ɦɟɬɨɞɨɜ ɢɯ ɨɰɟɧɤɢ

ɋɨɫɬɚɜɥɹɸɳɢɟ ɫɢɫɬɟɦɭ ɝɟɦɨɫɬɚɡɚ ɤɨɦɩɨɧɟɧɬɵ ɭɫɥɨɜɧɨ ɦɨɠɧɨ ɪɚɡɞɟɥɢɬɶ ɧɚ ɦɨɪɮɨɥɨɝɢɱɟɫɤɢɟ ɢ ɮɭɧɤɰɢɨɧɚɥɶɧɵɟ

Ɇɨɪɮɨɥɨɝɢɱɟɫɤɢɟ ɤɨɦɩɨɧɟɧɬɵ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ

ɨɫɭɞɢɫɬɚɹ ɫɬɟɧɤɚ ɬɪɨɦɛɨɰɢɬɵ ɢ ɤɥɟɬɨɱɧɵɟ ɷɥɟɦɟɧɬɵ ɤɪɨɜɢ

ɩɥɚɡɦɟɧɧɵɟ ɤɨɦɩɨɧɟɧɬɵ ± ɛɟɥɤɢ ɩɟɩɬɢɞɵ ɢ ɧɟɛɟɥɤɨɜɵɟ ɦɟɞɢɚɬɨɪɵ ɝɟɦɨɫɬɚɡɚ ɰɢɬɨɤɢɧɵ ɝɨɪɦɨɧɵ

ɤɨɫɬɧɵɣ ɦɨɡɝ ɩɟɱɟɧɶ ɫɟɥɟɡɟɧɤɚ ɤɚɤ ɦɟɫɬɨ ɫɢɧɬɟɡɚ ɢ ɯɪɚɧɟɧɢɹ ɬɪɨɦɛɨɰɢɬɨɜ ɢ ɩɥɚɡɦɟɧɧɵɯ ɤɨɦɩɨɧɟɧɬɨɜ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ

Ɏɭɧɤɰɢɨɧɚɥɶɧɵɟ ɤɨɦɩɨɧɟɧɬɵ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ

ɪɨɤɨɚɝɭɥɹɧɬɵ ɢɧɝɢɛɢɬɨɪɵ ɤɨɚɝɭɥɹɰɢɢ ɚɧɬɢɤɨɚɝɭɥɹɧɬɵ

ɩ ɪɨɮɢɛɪɢɧɨɥɢɬɢɤɢ

ɢɧɝɢɛɢɬɨɪɵ ɮɢɛɪɢɧɨɥɢɡɚ

ɋɨɯɪɚɧɟɧɢɟ ɨɛɳɟɣ ɚɤɬɢɜɧɨɫɬɢ ɝɟɦɨɫɬɚɡɚ ɜ ɮɢɡɢɨɥɨɝɢɱɟɫɤɢɯ ɩɪɟɞɟɥɚɯ ɦɨɠɧɨ ɨɩ ɪɟɞɟɥɢɬɶ ɤɚɤ ɩɨɞɞɟɪɠɚɧɢɟ ɝɟɦɨɫɬɚɬɢɱɟɫɤɨɝɨ ɛɚɥɚɧɫɚ ɉɪɢ ɫɦɟɳɟɧɢɢ ɞɚɧɧɨɝɨ ɛɚɥɚɧɫɚ ɡɚ ɪɚɦɤɢ ɮɢɡɢɨɥɨɝɢɱɟɫɤɢɯ ɧɨɪɦ ɜɨɡɧɢɤɚɸɬ ɭɫɥɨɜɢɹ ɞɥɹ ɪɚɡɜɢɬɢɹ ɩɚɬɨɥɨɝɢɱɟɫɤɢɯ ɤɪɨ ɜɨɬɟɱɟɧɢɣ ɢ ɬɪɨɦɛɨɡɨɜ ɉɨɫɤɨɥɶɤɭ ɜ ɨɪɝɚɧɢɡɦɟ ɪɚɡɥɢɱɧɵɟ ɦɟɥɤɢɟ ɩɨɜɪɟɠɞɟɧɢɹ ɜɨɡɧɢ ɤɚɸɬ ɞɨɫɬɚɬɨɱɧɨ ɱɚɫɬɨ ɜ ɫɢɫɬɟɦɟ ɝɟɦɨɫɬɚɡɚ ɩɪɚɤɬɢɱɟɫɤɢ ɩɨɫɬɨɹɧɧɨ ɩɪɨɢɫɯɨɞɹɬ ɥɨ

7

ɤɚɥɶɧɵɟ ɩɪɨɰɟɫɫɵ ɉɪɢ ɧɨɪɦɚɥɶɧɨɦ ɝɟɦɨɫɬɚɬɢɱɟɫɤɨɦ ɛɚɥɚɧɫɟ ɱɭɜɫɬɜɢɬɟɥɶɧɚɹ ɞɥɹ ɨɪ ɝɚɧɢɡɦɚ ɤɪɨɜɨɩɨɬɟɪɹ ɩɪɨɢɫɯɨɞɢɬ ɥɢɲɶ ɩɪɢ ɦɚɫɫɢɜɧɨɦ ɩɨɜɪɟɠɞɟɧɢɢ Ɉɞɧɚɤɨ ɩɪɢ ɧɚ ɪɭɲɟɧɢɢ ɝɟɦɨɫɬɚɬɢɱɟɫɤɨɝɨ ɛɚɥɚɧɫɚ ɞɚɠɟ ɧɟɡɧɚɱɢɬɟɥɶɧɵɟ ɩɨɜɪɟɠɞɟɧɢɹ ɦɨɝɭɬ ɜɵɡɜɚɬɶ ɡɧɚɱɢɦɭɸ ɤɪɨɜɨɩɨɬɟɪɸ ɧɚɩɪɢɦɟɪ ɩɪɢ ɝɟɦɨɮɢɥɢɢ Ʌɢɛɨ ɧɚɨɛɨɪɨɬ ɩɚɬɨɥɨɝɢɱɟɫɤɨɟ ɬɪɨɦɛɨɨɛɪɚɡɨɜɚɧɢɟ ɩɪɢɜɨɞɢɬ ɤ ɧɚɪɭɲɟɧɢɸ ɤɪɨɜɨɨɛɪɚɳɟɧɢɹ ɜ ɠɢɡɧɟɧɧɨ ɜɚɠɧɵɯ ɨɪɝɚ ɧɚɯ ȼɨɡɦɨɠɧɨ ɬɚɤɠɟ ɜɨɡɧɢɤɧɨɜɟɧɢɟ ɫɦɟɲɚɧɧɨɣ ɩɪɨɛɥɟɦɵ ɧɟɤɨɧɬɪɨɥɢɪɭɟɦɨɟ ɬɪɨɦɛɨ ɨɛɪɚɡɨɜɚɧɢɟ ɩɪɢɜɨɞɢɬ ɤ ɩɨɬɪɟɛɥɟɧɢɸ ɩɪɨɤɨɚɝɭɥɹɧɬɨɜ ɢ ɪɚɡɜɢɬɢɸ ɢɲɟɦɢɢ ɢ ɨɞɧɨɜɪɟ ɦɟɧɧɨ ɤ ɩɚɬɨɥɨɝɢɱɟɫɤɢɦ ɤɪɨɜɨɬɟɱɟɧɢɹɦ Ⱦȼɋ-ɫɢɧɞɪɨɦ

Ⱥɤɬɢɜɧɨɫɬɶ ɪɚɡɥɢɱɧɵɯ ɤɨɦɩɨɧɟɧɬɨɜ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ ɦɨɠɟɬ ɢɡɦɟɧɹɬɶɫɹ ɜ ɲɢɪɨ ɤɢɯ ɩɪɟɞɟɥɚɯ ɢɡ-ɡɚ ɝɟɧɟɬɢɱɟɫɤɢɯ ɨɫɨɛɟɧɧɨɫɬɟɣ ɢɥɢ ɷɤɡɨɝɟɧɧɵɯ ɜɨɡɞɟɣɫɬɜɢɣ ɧɚ ɨɪɝɚɧɢɡɦ ɉɪɟɞɫɬɚɜɥɟɧɢɟ ɨ ɧɨɪɦɚɥɶɧɨɦ ɮɭɧɤɰɢɨɧɢɪɨɜɚɧɢɢ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ ɨɱɟɧɶ ɭɫ ɥɨɜɧɨ ɢ ɧɟ ɢɦɟɟɬ ɱɟɬɤɢɯ ɪɚɦɨɤ ɑɚɳɟ ɜɫɟɝɨ ɞɢɚɝɧɨɡ ɩɚɰɢɟɧɬɚ ɫɬɪɨɢɬɫɹ ɧɚ ɚɧɚɥɢɡɟ ɤɥɢ ɧɢɱɟɫɤɢɯ ɢ ɥɚɛɨɪɚɬɨɪɧɵɯ ɞɚɧɧɵɯ Ɇɧɨɝɢɟ ɤɨɦɩɨɧɟɧɬɵ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ ɥɚɛɢɥɶɧɵ ɚ ɧɚ ɪɟɡɭɥɶɬɚɬɵ ɚɧɚɥɢɡɚ ɜɥɢɹɟɬ ɰɟɥɵɣ ɪɹɞ ɮɚɤɬɨɪɨɜ ɉɨɷɬɨɦɭ ɞɥɹ ɪɟɲɟɧɢɹ ɜɨɩɪɨɫɚ ɨ ɩɨ ɫɬɚɧɨɜɤɟ ɞɢɚɝɧɨɡɚ ɜ ɫɨɦɧɢɬɟɥɶɧɵɯ ɫɥɭɱɚɹɯ ɧɟɨɛɯɨɞɢɦɨ ɩɪɨɜɨɞɢɬɶ ɧɟɨɞɧɨɤɪɚɬɧɵɟ ɢɫ ɫɥɟɞɨɜɚɧɢɹ ɫ ɢɫɩɨɥɶɡɨɜɚɧɢɟɦ ɪɚɡɥɢɱɧɵɯ ɦɟɬɨɞɨɜ ɢ ɪɟɚɝɟɧɬɨɜ ɞɥɹ ɨɩɪɟɞɟɥɟɧɢɹ ɨɞɧɨɝɨ

ɢ ɬɨɝɨ ɠɟ ɩɨɤɚɡɚɬɟɥɹ

Ɇɟɯɚɧɢɡɦ ɬɪɨɦɛɨɨɛɪɚɡɨɜɚɧɢɹ

ȼ ɝɨɞɭ Ɋɭɞɨɥɶɮ ȼɢɪɯɨɜ ɨɩɢɫɚɥ ɫɨɱɟɬɚɧɢɟ ɩɚɬɨɥɨɝɢɱɟɫɤɢɯ ɮɚɤɬɨɪɨɜ ɹɜ ɥɹɸɳɢɯɫɹ ɨɫɧɨɜɧɵɦ ɩɭɫɤɨɜɵɦ ɦɟɯɚɧɢɡɦɨɦ ɜɧɭɬɪɢɫɨɫɭɞɢɫɬɨɝɨ ɨɛɪɚɡɨɜɚɧɢɹ ɬɪɨɦɛɨɜ ɢ ɢɡɜɟɫɬɧɵɯ ɤɚɤ ɬɪɢɚɞɚ ȼɢɪɯɨɜɚ Ɉɧɚ ɜɤɥɸɱɚɟɬ ɜ ɫɟɛɹ ɡɚɦɟɞɥɟɧɢɟ ɬɨɤɚ ɤɪɨɜɢ ɫɬɚɡ ɩɨ ɜɪɟɠɞɟɧɢɟ ɷɧɞɨɬɟɥɢɹ ɢ ɢɡɦɟɧɟɧɢɟ ɫɜɨɣɫɬɜ ɤɪɨɜɢ ɫɨɫɬɨɹɧɢɟ ɝɢɩɟɪɤɨɚɝɭɥɹɰɢɢ Ⱦɚɥɶ ɧɟɣɲɟɟ ɪɚɡɜɢɬɢɟ ɭɱɟɧɢɹ ɨ ɬɪɨɦɛɨɡɟ ɩɨɤɚɡɚɥɨ ɱɬɨ ɤɨɦɩɨɧɟɧɬɵ ɬɪɢɚɞɵ ȼɢɪɯɨɜɚ ɨɬ ɧɸɞɶ ɧɟ ɪɚɜɧɨɡɧɚɱɧɵ ɢ ɡɧɚɱɟɧɢɟ ɤɚɠɞɨɝɨ ɢɡ ɩɟɪɟɱɢɫɥɟɧɧɵɯ ɮɚɤɬɨɪɨɜ ɞɨ ɫɢɯ ɩɨɪ ɹɜɥɹ ɟɬɫɹ ɩɪɟɞɦɟɬɨɦ ɞɢɫɤɭɫɫɢɢ

ɉɪɢɱɢɧɚɦɢ ɡɚɦɟɞɥɟɧɢɹ ɤɪɨɜɨɬɨɤɚ ɹɜɥɹɸɬɫɹ ɡɚɫɬɨɣ ɤɪɨɜɢ ɜɫɥɟɞɫɬɜɢɟ ɞɟɤɨɦɩɟɧ ɫɚɰɢɢ ɤɪɨɜɨɨɛɪɚɳɟɧɢɹ ɩɪɟɛɵɜɚɧɢɹ ɧɚ ɞɥɢɬɟɥɶɧɨɦ ɩɨɫɬɟɥɶɧɨɦ ɪɟɠɢɦɟ ɢ ɞɪ

ɋɥɟɞɭɸɳɢɟ ɞɜɚ ɮɚɤɬɨɪɚ ɧɟɪɚɡɪɵɜɧɨ ɫɜɹɡɚɧɵ ɞɪɭɝ ɫ ɞɪɭɝɨɦ ȼ ɮɢɡɢɨɥɨɝɢɱɟɫɤɢɯ ɭɫɥɨɜɢɹɯ ɧɟɩɨɜɪɟɠɞɟɧɧɚɹ ɫɨɫɭɞɢɫɬɚɹ ɫɬɟɧɤɚ ɫɩɨɫɨɛɫɬɜɭɟɬ ɩɨɞɞɟɪɠɚɧɢɸ ɠɢɞɤɨɝɨ ɫɨ ɫɬɨɹɧɢɹ ɤɪɨɜɢ

ɋɨɫɭɞɢɫɬɚɹ ɫɬɟɧɤɚ ɢɦɟɟɬ ɚɤɬɢɜɧɭɸ ɩɨɜɟɪɯɧɨɫɬɶ ɫ ɜɧɭɬɪɟɧɧɟɣ ɫɬɨɪɨɧɵ ɜɵ ɫɬɥɚɧɧɭɸ ɷɧɞɨɬɟɥɢɚɥɶɧɵɦɢ ɤɥɟɬɤɚɦɢ ɷɧɞɨɬɟɥɢɨɰɢɬɚɦɢ ɗɧɞɨɬɟɥɢɨɰɢɬɵ ɫɢɧɬɟɡɢɪɭ ɸɬ ɫɨɞɟɪɠɚɬ ɧɚ ɫɜɨɟɣ ɩɨɜɟɪɯɧɨɫɬɢ ɢ ɜɵɞɟɥɹɸɬ ɜ ɤɪɨɜɶ ɢ ɫɭɛɷɧɞɨɬɟɥɢɚɥɶɧɨɟ ɩɪɨɫɬɪɚɧ ɫɬɜɨ ɰɟɥɵɣ ɫɩɟɤɬɪ ɛɢɨɥɨɝɢɱɟɫɤɢ ɚɤɬɢɜɧɵɯ ɜɟɳɟɫɬɜ ɭɱɚɫɬɜɭɸɳɢɯ ɜ ɝɟɦɨɫɬɚɡɟ ± ɚɧɬɢ ɤɨɚɝɭɥɹɧɬɵ ɢ ɩɪɨɤɨɚɝɭɥɹɧɬɵ Ⱥɧɬɢɤɨɚɝɭɥɹɧɬɵ ± ɝɟɩɚɪɚɧɫɭɥɶɮɚɬ ɬɪɨɦɛɨɦɨɞɭɥɢɧ ɚɞɟ ɧɨɡɢɧɞɢɮɨɫɮɚɬɚɡɚ ȺȾɎ-ɚɡɚ ɩɪɨɫɬɚɰɢɤɥɢɧ ɩɪɨɫɬɚɝɥɚɧɞɢɧɵ ɨɤɫɢɞ ɚɡɨɬɚ ɬɤɚɧɟɜɨɣ ɢ ɭɪɨɤɢɧɚɡɧɵɣ ɚɤɬɢɜɚɬɨɪ ɩɥɚɡɦɢɧɨɝɟɧɚ ɢɧɝɢɛɢɬɨɪ ɬɤɚɧɟɜɨɝɨ ɮɚɤɬɨɪɚ 7)3, ± Tissue )DFWRU 3DWKZD\ ,QKLELWRU ɩɪɨɬɟɢɧ 6 ɚɧɧɟɤɫɢɧ ,, ɢ 9 ɷɧɞɨɬɟɥɢɣ-ɩɪɨɞɭɰɢɪɭɟɦɵɣ ɮɚɤɬɨɪ ɪɟɥɚɤɫɚɰɢɢ ɉɪɨɤɨɚɝɭɥɹɧɬɵ ± ɬɤɚɧɟɜɨɣ ɮɚɤɬɨɪ ɢɧɝɢɛɢɬɨɪ ɚɤɬɢɜɚɬɨɪɚ ɩɥɚɡɦɢɧɨɝɟɧɚ ɮɚɤɬɨɪ ȼɢɥɥɟɛɪɚɧɞɚ ɪɟɰɟɩɬɨɪɵ ɞɥɹ ɮɚɤɬɨɪɨɜ ,;ɚ ɢ ;D ɩɪɨɬɟɢɧɚ ɋ ɢ ɞɪ

Ɉɫɨɛɟɧɧɨ ɫɥɟɞɭɟɬ ɨɬɦɟɬɢɬɶ ɪɨɥɶ ɝɟɩɚɪɚɧɫɭɥɶɮɚɬɚ ɜ ɨɛɟɫɩɟɱɟɧɢɢ ɚɧɬɢɤɨɚɝɭ ɥɹɧɬɧɨɝɨ ɩɨɬɟɧɰɢɚɥɚ ɷɧɞɨɬɟɥɢɹ ɤɨɦɩɥɟɤɫ ɝɟɩɚɪɚɧɫɭɥɶɮɚɬ-ɚɧɬɢɬɪɨɦɛɢɧ ,,, ɹɜɥɹɟɬɫɹ ɫɚɦɵɦ ɚɤɬɢɜɧɵɦ ɢɧɝɢɛɢɬɨɪɨɦ ɫɜɟɪɬɵɜɚɧɢɹ ɤɪɨɜɢ

ɗɧɞɨɬɟɥɢɣ ɭɱɚɫɬɜɭɟɬ ɜ ɮɢɛɪɢɧɨɥɢɡɟ ɡɚ ɫɱɺɬ ɫɢɧɬɟɡɚ ɢ ɜɵɞɟɥɟɧɢɹ ɜ ɤɪɨɜɨɬɨɤ ɬɤɚɧɟɜɨɝɨ ɚɤɬɢɜɚɬɨɪɚ ɩɥɚɡɦɢɧɨɝɟɧɚ ɤɨɬɨɪɵɣ ɚɤɬɢɜɢɪɭɟɬ ɩɥɚɡɦɢɧɨɜɭɸ ɫɢɫɬɟɦɭ

ɉɨ ɦɟɪɟ ɭɞɚɥɟɧɢɹ ɨɬ ɦɟɫɬɚ ɩɨɜɪɟɠɞɟɧɢɹ ɷɧɞɨɬɟɥɢɹ ɫɧɢɠɚɟɬɫɹ ɩɪɨɤɨɚɝɭɥɹɧɬɧɵɣ ɫɬɢɦɭɥ ɢ ɜɨɡɪɚɫɬɚɟɬ ɚɧɬɢɤɨɚɝɭɥɹɧɬɧɵɣ - ɜ ɡɨɧɟ ɧɟɩɨɜɪɟɠɞɟɧɧɨɝɨ ɷɧɞɨɬɟɥɢɹ ɨɧ ɨɝɪɚɧɢ ɱɢɜɚɟɬ ɪɨɫɬ ɫɝɭɫɬɤɚ

8

ɋɩɨɫɨɛɧɨɫɬɶ ɧɟɩɨɜɪɟɠɞɟɧɧɨɝɨ ɷɧɞɨɬɟɥɢɹ ɤɨɧɬɪɨɥɢɪɨɜɚɬɶ ɚɤɬɢɜɧɨɫɬɶ ɬɪɨɦɛɨɰɢ ɬɨɜ ɫɜɹɡɚɧɚ ɫ ɨɬɪɢɰɚɬɟɥɶɧɵɦ ɡɚɪɹɞɨɦ ɷɧɞɨɬɟɥɢɚɥɶɧɵɯ ɤɥɟɬɨɤ ɢ ɫ ɩɨɫɬɨɹɧɧɵɦ ɫɢɧɬɟɡɨɦ ɢɧɝɢɛɢɬɨɪɚ ɚɝɪɟɝɚɰɢɢ ɬɪɨɦɛɨɰɢɬɨɜ ɩɪɨɫɬɚɰɢɤɥɢɧɚ ȺȾɎ-ɚɡɵ ɢ ɨɤɫɢɞɚ ɚɡɨɬɚ ɤɨɬɨɪɵɟ ɩɪɟɩɹɬɫɬɜɭɸɬ ɚɤɬɢɜɚɰɢɢ ɚɞɝɟɡɢɢ ɢ ɚɝɪɟɝɚɰɢɢ ɬɪɨɦɛɨɰɢɬɨɜ

ɉɪɢ ɩɨɜɪɟɠɞɟɧɢɢ ɢɥɢ ɜɨɫɩɚɥɟɧɢɢ ɫɨɫɭɞɢɫɬɚɹ ɫɬɟɧɤɚ ɩɪɢɧɢɦɚɟɬ ɭɱɚɫɬɢɟ ɜ ɨɛɪɚ ɡɨɜɚɧɢɢ ɬɪɨɦɛɚ ɗɬɨ ɫɜɹɡɚɧɨ ɫ ɬɟɦ ɱɬɨ ɨɛɧɚɠɚɸɬɫɹ ɫɭɛɷɧɞɨɬɟɥɢɚɥɶɧɵɟ ɫɬɪɭɤɬɭɪɵ ɤɨ ɬɨɪɵɟ ɨɛɥɚɞɚɸɬ ɦɨɳɧɵɦ ɬɪɨɦɛɨɝɟɧɧɵɦ ɩɨɬɟɧɰɢɚɥɨɦ ɚ ɭ ɫɚɦɨɝɨ ɷɧɞɨɬɟɥɢɹ ɜ ɡɨɧɟ ɩɨ ɜɪɟɠɞɟɧɢɹ ɩɪɢ ɚɤɬɢɜɚɰɢɢ ɩɨɹɜɥɹɸɬɫɹ ɩɪɨɤɨɚɝɭɥɹɧɬɧɵɟ ɢ ɩɪɨɬɢɜɨɜɨɫɩɚɥɢɬɟɥɶɧɵɟ ɫɜɨɣɫɬɜɚ

ɉɨɦɢɦɨ ɩɪɹɦɨɝɨ ɜɥɢɹɧɢɹ ɚɤɬɢɜɢɪɨɜɚɧɧɵɯ ɷɧɞɨɬɟɥɢɚɥɶɧɵɯ ɤɥɟɬɨɤ ɧɚ ɝɟɦɨɫɬɚɡ ɫɭɳɟɫɬɜɭɟɬ ɢ ɨɛɪɚɬɧɨɟ ɜɥɢɹɧɢɟ ɛɟɥɤɨɜ ɝɟɦɨɫɬɚɡɚ ɧɚ ɷɧɞɨɬɟɥɢɚɥɶɧɵɟ ɤɥɟɬɤɢ ɉɪɢ ɩɨ ɜɪɟɠɞɟɧɢɢ ɫɨɫɭɞɢɫɬɨɣ ɫɬɟɧɤɢ ɨɛɧɚɠɚɟɬɫɹ ɫɭɛɷɧɞɨɬɟɥɢɣ ɤɨɬɨɪɵɣ ɹɜɥɹɟɬɫɹ ɦɨɳɧɵɦ ɫɬɢɦɭɥɨɦ ɚɝɪɟɝɚɰɢɢ ɬɪɨɦɛɨɰɢɬɨɜ ɢ ɚɤɬɢɜɚɰɢɢ ɤɚɫɤɚɞɧɨɣ ɫɢɫɬɟɦɵ ɫɜɟɪɬɵɜɚɧɢɹ ɤɪɨɜɢ ȼ ɫɨɫɬɚɜ ɫɭɛɷɧɞɨɬɟɥɢɚɥɶɧɨɣ ɛɚɡɚɥɶɧɨɣ ɦɟɦɛɪɚɧɵ ɜɯɨɞɹɬ ɪɚɡɥɢɱɧɵɟ ɬɢɩɵ ɤɨɥɥɚɝɟɧɚ ɮɢɛɪɨɧɟɤɬɢɧ ɜɢɬɪɨɧɟɤɬɢɧ ɥɚɦɢɧɢɧ ɩɪɨɬɟɨɝɥɢɤɚɧɵ ɝɥɢɤɨɡɚɦɢɧɨɝɥɢɤɚɧɵ ɬɪɨɦɛɨɫ ɩɨɧɞɢɧ ɮɚɤɬɨɪ ȼɢɥɥɟɛɪɚɧɞɚ ɮɢɛɪɢɧ ɉɪɨɤɨɚɝɭɥɹɧɬɧɵɟ ɫɜɨɣɫɬɜɚ ɤɥɟɬɨɤ ɫɭɛɷɧɞɨɬɟɥɢɹ ɨɛɭɫɥɨɜɥɟɧɵ ɧɚɥɢɱɢɟɦ ɧɚ ɢɯ ɩɨɜɟɪɯɧɨɫɬɢ ɬɤɚɧɟɜɨɝɨ ɮɚɤɬɨɪɚ

Ɋɨɥɶ ɬɤɚɧɟɜɨɝɨ ɮɚɤɬɨɪɚ ɌɎ ɜ ɩɪɨɰɟɫɫɟ ɫɜɟɪɬɵɜɚɧɢɹ ɨɱɟɧɶ ɜɟɥɢɤɚ Ɉɧ ɨɛɥɚ ɞɚɟɬ ɨɱɟɧɶ ɛɨɥɶɲɨɣ ɬɪɨɦɛɨɝɟɧɧɨɣ ɚɤɬɢɜɧɨɫɬɶɸ - ɩɪɢ ɫɜɹɡɵɜɚɧɢɢ ɮɚɤɬɨɪɚ 9,,D ɫ ɌɎ ɮɨɪɦɢɪɭɟɬɫɹ ɚɤɬɢɜɧɵɣ ɤɨɦɩɥɟɤɫ ɤɨɬɨɪɵɣ ɜ ɩɪɢɫɭɬɫɬɜɢɢ ɢɨɧɨɜ ɤɚɥɶɰɢɹ ɚɤɬɢɜɢɪɭɟɬ ɮɚɤɬɨɪ ; ɉɨ ɫɨɜɪɟɦɟɧɧɵɦ ɩɪɟɞɫɬɚɜɥɟɧɢɹɦ ɷɬɨɬ ɩɪɨɰɟɫɫ ɹɜɥɹɟɬɫɹ ɨɫɧɨɜɧɵɦ ɮɢɡɢɨɥɨ ɝɢɱɟɫɤɢɦ ɩɭɬɟɦ ɡɚɩɭɫɤɚ ɩɪɨɰɟɫɫɚ ɫɜɟɪɬɵɜɚɧɢɹ ɂɡɧɚɱɚɥɶɧɨ ɌɎ ɤɥɚɫɫɢɮɢɰɢɪɨɜɚɥɢ ɤɚɤ ɨɞɢɧ ɢɡ ɩɥɚɡɦɟɧɧɵɯ ɮɚɤɬɨɪɨɜ ɫɜɟɪɬɵɜɚɧɢɹ ɬɤɚɧɟɜɨɣ ɬɪɨɦɛɨɩɥɚɫɬɢɧ ɮ ,,, ɂɫɫɥɟɞɨ ɜɚɧɢɹ ɩɨɤɚɡɚɥɢ ɱɬɨ ɌɎ ɮɢɤɫɢɪɨɜɚɧ ɧɚ ɤɥɟɬɨɱɧɨɣ ɦɟɦɛɪɚɧɟ ɢ ɜ ɮɢɡɢɨɥɨɝɢɱɟɫɤɢɯ ɭɫɥɨ ɜɢɹɯ ɧɟ ɩɨɫɬɭɩɚɟɬ ɜ ɤɪɨɜɨɬɨɤ ɩɨɷɬɨɦɭ ɨɧ ɛɵɥ ɢɫɤɥɸɱɟɧ ɢɡ ɤɥɚɫɫɢɮɢɤɚɰɢɢ ɩɥɚɡɦɟɧɧɵɯ ɮɚɤɬɨɪɨɜ ɫɜɟɪɬɵɜɚɧɢɹ

ɉɪɢ ɨɛɧɚɠɟɧɢɢ ɫɭɛɷɧɞɨɬɟɥɢɹ ɜ ɩɪɨɫɜɟɬ ɫɨɫɭɞɚ ©ɜɵɜɚɥɢɜɚɸɬɫɹª ɚɤɬɢɜɧɵɟ ɫɬɪɭɤɬɭɪɵ ɢ ɜ ɩɟɪɜɭɸ ɨɱɟɪɟɞɶ ɤɨɥɥɚɝɟɧɵ ȼ ɝɟɦɨɫɬɚɡɟ ɤɨɥɥɚɝɟɧɵ ɜɵɩɨɥɧɹɸɬ ɧɟ ɫɤɨɥɶɤɨ ɜɚɠɧɵɯ ɮɭɧɤɰɢɣ

-ɨɧɢ ɨɛɪɚɡɭɸɬ ɷɥɚɫɬɢɱɧɵɣ ©ɤɚɪɤɚɫª ɫɨɫɭɞɚ ɢ ɜɨ ɦɧɨɝɨɦ ɨɩɪɟɞɟɥɹɸɬ ɟɝɨ ɩɪɨɱ ɧɨɫɬɶ ɭɫɬɨɣɱɢɜɨɫɬɶ ɤ ɧɚɝɪɭɡɤɚɦ ɢ ɪɟɨɥɨɝɢɱɟɫɤɢɟ ɯɚɪɚɤɬɟɪɢɫɬɢɤɢ

-ɨɛɥɚɞɚɸɬ ɜɵɫɨɤɨɣ ɩɪɨɤɨɚɝɭɥɹɧɬɧɨɣ ɚɤɬɢɜɧɨɫɬɶɸ ɚɤɬɢɜɢɪɭɹ ɬɪɨɦɛɨɰɢɬɵ ɗɬɨɬ ɦɟɯɚɧɢɡɦ ɫɜɹɡɚɧ ɫ ɜɡɚɢɦɨɞɟɣɫɬɜɢɟɦ ɤɨɥɥɚɝɟɧɨɜ ɫ ɮ. ȼɢɥɥɟɛɪɚɧɞɚ ɢ ɫ ɬɪɨɦɛɨɰɢɬɚɪɧɵ ɦɢ ɪɟɰɟɩɬɨɪɚɦɢ ɬɟɦ ɫɚɦɵɦ ɨɛɟɫɩɟɱɢɜɚɹ ɚɞɝɟɡɢɸ ɢ ɞɟɝɪɚɧɭɥɹɰɢɸ ɬɪɨɦɛɨɰɢɬɨɜ

Ɏɭɧɤɰɢɢ ɬɪɨɦɛɨɰɢɬɨɜ

Ɉɫɧɨɜɧɵɦɢ ɮɭɧɤɰɢɹɦɢ ɬɪɨɦɛɨɰɢɬɨɜ ɹɜɥɹɸɬɫɹ

1.ɮɨɪɦɢɪɨɜɚɧɢɟ ɩɟɪɜɢɱɧɨɣ ɬɪɨɦɛɨɰɢɬɚɪɧɨɣ ɩɪɨɛɤɢ ɜ ɡɨɧɟ ɩɨɜɪɟɠɞɟɧɢɹ ɫɨɫɭ ɞɚ ɡɚ ɫɱɟɬ ɚɞɝɟɡɢɢ ɢ ɩɨɫɥɟɞɭɸɳɟɣ ɚɝɪɟɝɚɰɢɢ

2.ɚɤɬɢɜɚɰɢɹ ɝɟɦɨɫɬɚɡɚ ɡɚ ɫɱɟɬ ɩɪɟɞɨɫɬɚɜɥɟɧɢɹ ɮɨɫɮɨɥɢɩɢɞɧɨɣ ɩɨɜɟɪɯɧɨɫɬɢɮɚɤɬɨɪ ɬɪɨɦɛɨɰɢɬɨɜ ɢɥɢ ɬɪɨɦɛɨɰɢɬɚɪɧɵɣ ɬɪɨɦɛɨɩɥɚɫɬɢɧ ɧɟɨɛɯɨɞɢɦɨɣ ɞɥɹ ɜɡɚɢɦɨɞɟɣɫɬɜɢɹ ɛɨɥɶɲɢɧɫɬɜɚ ɩɥɚɡɦɟɧɧɵɯ ɛɟɥɤɨɜ ɝɟɦɨɫɬɚɡɚ ɢ ɡɚ ɫɱɟɬ ɜɵɛɪɨɫɚ ɩɪɨɤɨɚɝɭɥɹɧɬɨɜ ɢɡ ɩɭɥɚ ɯɪɚɧɟɧɢɹ ɬɪɨɦɛɨɰɢɬɨɜ

3.ɪɟɬɪɚɤɰɢɹ ɫɝɭɫɬɤɚ ɤɪɨɜɢ

4.ɫɬɢɦɭɥɹɰɢɹ ɫɩɚɡɦɚ ɫɨɫɭɞɚ ɜɨɫɫɬɚɧɨɜɥɟɧɢɹ ɬɤɚɧɟɣ ɢ ɪɟɝɭɥɢɪɨɜɚɧɢɹ ɦɟɫɬɧɨɝɨ ɜɨɫɩɚɥɟɧɢɹ ɡɚ ɫɱɟɬ ɜɵɛɪɨɫɚ ɫɨɨɬɜɟɬɫɬɜɭɸɳɢɯ ɦɟɞɢɚɬɨɪɨɜ ɢɡ ɩɭɥɚ ɯɪɚɧɟɧɢɹ ɬɪɨɦɛɨɰɢɬɨɜ

9

ɋɨɜɪɟɦɟɧɧɚɹ ɬɟɨɪɢɹ ɫɜɟɪɬɵɜɚɧɢɹ ɤɪɨɜɢ

Ʉɚɤ ɭɠɟ ɛɵɥɨ ɫɤɚɡɚɧɨ ɫɢɫɬɟɦɚ ɝɟɦɨɫɬɚɡɚ ɜɵɩɨɥɧɹɟɬ ɜ ɨɪɝɚɧɢɡɦɟ ɠɢɡɧɟɧɧɨ ɜɚɠ ɧɭɸ ɮɭɧɤɰɢɸ ɩɨɞɞɟɪɠɚɧɢɹ ɤɪɨɜɢ ɜ ɠɢɞɤɨɦ ɫɨɫɬɨɹɧɢɢ ɜɧɭɬɪɢ ɤɪɨɜɟɧɨɫɧɵɯ ɫɨɫɭɞɨɜ ɢ ɜɦɟɫɬɟ ɫ ɬɟɦ ɩɪɟɞɭɩɪɟɠɞɚɟɬ ɢ ɤɭɩɢɪɭɟɬ ɤɪɨɜɨɬɟɱɟɧɢɟ ɢɡ ɩɨɜɪɟɠɞɟɧɧɨɝɨ ɫɨɫɭɞɚ ɜɨɫ ɫɬɚɧɚɜɥɢɜɚɹ ɰɟɥɨɫɬɧɨɫɬɶ ɫɨɫɭɞɢɫɬɨɣ ɫɬɟɧɤɢ

Ɉɞɧɨɣ ɢɡ ɨɫɧɨɜɧɵɯ ɨɫɨɛɟɧɧɨɫɬɟɣ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ ɹɜɥɹɟɬɫɹ ɧɟɨɛɯɨɞɢɦɨɫɬɶ ɧɚɥɢɱɢɹ ɧɚɪɹɞɭ ɫ ɮɚɤɬɨɪɚɦɢ ɫɜɟɪɬɵɜɚɧɢɹ ɤɪɨɜɢ ɦɟɦɛɪɚɧɧɵɯ ɮɨɫɮɨɥɢɩɢɞɧɵɯ ɩɨ

ɜɟɪɯɧɨɫɬɟɣ ɢ ɢɨɧɨɜ ɦɟɬɚɥɥɨɜ ɛɢɜɚɥɟɧɬɧɵɟ ɢɨɧɵ ɤɚɥɶɰɢɹ ɰɢɧɤɚ ɢ ɦɚɝɧɢɹ Ⱦɪɭɝɨɣ ɜɚɠɧɨɣ ɨɫɨɛɟɧɧɨɫɬɶɸ ɫɢɫɬɟɦɵ ɝɟɦɨɫɬɚɡɚ ɹɜɥɹɟɬɫɹ ɜɵɫɨɤɚɹ ɛɵɫɬɪɨɬɚ ɨɬ

ɜɟɬɚ ɢ ɫɨɨɬɜɟɬɫɬɜɟɧɧɨ ɫɤɨɪɨɫɬɶ ɪɟɚɤɰɢɢ Ʉɪɨɦɟ ɬɨɝɨ ɲɢɪɨɤɨ ɪɚɫɩɪɨɫɬɪɚɧɟɧɧɵɣ ɦɟ ɯɚɧɢɡɦ ɩɨɥɨɠɢɬɟɥɶɧɨɣ ɨɛɪɚɬɧɨɣ ɫɜɹɡɢ ɫɩɨɫɨɛɫɬɜɭɟɬ ɭɫɤɨɪɟɧɢɸ ɪɟɚɤɰɢɣ ɧɚɱɚɥɶɧɵɯ ɷɬɚɩɨɜ ɫɜɟɪɬɵɜɚɧɢɹ Ɍɚɤ ɚɤɬɢɜɚɰɢɹ ɨɞɧɨɣ ɦɨɥɟɤɭɥɵ ɩɪɟɞɲɟɫɬɜɭɸɳɟɝɨ ɭɪɨɜɧɹ ɜ ɫɢɫ ɬɟɦɟ ɫɜɟɪɬɵɜɚɧɢɹ ɩɪɢɜɨɞɢɬ ɤ ɚɤɬɢɜɚɰɢɢ ɨɬ ɧɟɫɤɨɥɶɤɢɯ ɞɟɫɹɬɤɨɜ ɞɨ ɧɟɫɤɨɥɶɤɢɯ ɬɵɫɹɱ ɩɨɫɥɟɞɭɸɳɢɯ ɦɨɥɟɤɭɥ

Ɋɚɡɪɚɛɨɬɚɧɧɚɹ ɜ ɫɟɪɟɞɢɧɟ ;; ɜɟɤɚ ɬɟɨɪɢɹ ɝɟɦɨɫɬɚɡɚ ɛɚɡɢɪɨɜɚɥɚɫɶ ɧɚ ɢɫɫɥɟɞɨɜɚ ɧɢɹɯ ɜɵɩɨɥɧɟɧɧɵɯ LQ YLWUR ɢ ɧɟ ɭɱɢɬɵɜɚɥɚ ɪɟɚɥɶɧɵɟ ɭɫɥɨɜɢɹ ɜ ɫɢɫɬɟɦɟ ɤɪɨɜɨɨɛɪɚɳɟ ɧɢɹ ȼ ɩɨɫɥɟɞɧɟɟ ɞɟɫɹɬɢɥɟɬɢɟ ɛɵɥɚ ɪɚɡɪɚɛɨɬɚɧɚ ɤɚɫɤɚɞɧɨ-ɦɚɬɪɢɱɧɚɹ ɬɟɨɪɢɹ ɫɜɟɪɬɵɜɚ ɧɢɹ ɤɪɨɜɢ ɜ ɤɨɬɨɪɨɣ ɭɱɬɟɧɵ ɧɟ ɬɨɥɶɤɨ ɪɟɚɤɰɢɢ ɜɡɚɢɦɨɞɟɣɫɬɜɢɹ ɛɟɥɤɨɜ ɩɥɚɡɦɵ ɢ ɬɪɨɦ ɛɨɰɢɬɨɜ ɧɨ ɢ ɜɥɢɹɧɢɟ ɤɨɦɩɨɧɟɧɬɨɜ ɫɨɫɭɞɢɫɬɨɣ ɫɬɟɧɤɢ ɢ ɞɪɭɝɢɯ ɤɥɟɬɨɤ ɤɪɨɜɢ

ȼ ɞɚɧɧɨɣ ɪɚɛɨɬɟ ɨɩɢɫɚɧɵ ɥɢɲɶ ɜɚɠɧɟɣɲɢɟ ɦɨɦɟɧɬɵ ɫɥɨɠɧɟɣɲɟɝɨ ɤɨɦɩɥɟɤɫɚ ɪɟɚɤɰɢɣ ɝɟɦɨɫɬɚɡɚ ɞɥɹ ɩɪɚɜɢɥɶɧɨɣ ɤɥɢɧɢɱɟɫɤɨɣ ɢɧɬɟɪɩɪɟɬɚɰɢɢ ɥɚɛɨɪɚɬɨɪɧɵɯ ɬɟɫɬɨɜ

Ɍɪɨɦɛɨɰɢɬɚɪɧɨ-ɫɨɫɭɞɢɫɬɵɣ ɝɟɦɨɫɬɚɡ

ȼ ɩɟɪɜɵɣ ɦɨɦɟɧɬ ɩɨɫɥɟ ɩɨɜɪɟɠɞɟɧɢɹ ɫɨɫɭɞɚ ɪɚɡɜɢɜɚɟɬɫɹ ɜɚɡɨɤɨɧɫɬɪɢɤɰɢɹɫɩɚɡɦ ɫɨɫɭɞɨɜ ± ɜ ɦɟɥɤɢɯ ɫɨɫɭɞɚɯ ɢɦɟɸɳɢɯ ɦɵɲɟɱɧɵɣ ɫɥɨɣ ɗɬɨɬ ɫɩɚɡɦ ɨɛɭɫɥɨɜɥɟɧ ɫɨɤɪɚɳɟɧɢɟɦ ɝɥɚɞɤɨɦɵɲɟɱɧɵɯ ɤɥɟɬɨɤ ɨɧ ɜɨɡɧɢɤɚɟɬ ɪɟɮɥɟɤɬɨɪɧɨ ɩɨɞ ɞɟɣɫɬɜɢɟɦ ɷɧɞɨ ɬɟɥɢɧɚ ɩɟɩɬɢɞɧɨɝɨɝ ɝɨɪɦɨɧɚ ɢɡ ɝɪɭɩɩɵ ɰɢɬɨɤɢɧɨɜ ɢ ɩɪɨɞɥɟɜɚɟɬɫɹ ɫɟɪɨɬɨɧɢɧɨɦ ɬɪɨɦɛɨɤɫɚɧɨɦ Ⱥ ɢ ɞɪɭɝɢɦɢ ɜɚɡɨɤɨɧɫɬɪɢɤɬɨɪɚɦɢ ɤɨɬɨɪɵɟ ɩɨɹɜɥɹɸɬɫɹ ɢɡ ɷɧɞɨɬɟɥɢ ɚɥɶɧɵɯ ɤɥɟɬɨɤ ɢ ɬɪɨɦɛɨɰɢɬɨɜ ȼ ɩɟɪɜɵɟ ɦɢɧɭɬɵ ɷɬɨ ɩɪɟɤɪɚɳɚɟɬ ɤɪɨɜɨɬɟɱɟɧɢɟ ɢɡ ɤɚ ɩɢɥɥɹɪɨɜ ɦɟɥɤɢɯ ɜɟɧ ɢ ɚɪɬɟɪɢɨɥ ɢɥɢ ɩɨ ɤɪɚɣɧɟɣ ɦɟɪɟ ɡɧɚɱɢɬɟɥɶɧɨ ɫɧɢɠɚɟɬ ɤɪɨɜɨɩɨ ɬɟɪɸ ɋɩɚɡɦ ɫɨɫɭɞɚ ɫɨɡɞɚɟɬ ɭɫɥɨɜɢɹ ɞɥɹ ɛɨɥɟɟ ɷɮɮɟɤɬɢɜɧɨɝɨ ɬɪɨɦɛɨɰɢɬɚɪɧɨɝɨ ɝɟɦɨɫɬɚɡɚ

Ɏɨɪɦɢɪɨɜɚɧɢɟ ɩɟɪɜɢɱɧɨɣ ɬɪɨɦɛɨɰɢɬɚɪɧɨɣ ɩɪɨɛɤɢ ɜ ɡɨɧɟ ɩɨɜɪɟɠɞɟɧɢɹ ɫɨɫɭɞɨɜ ɜɨɡɧɢɤɚɟɬ ɜɫɥɟɞɫɬɜɢɟ ɩɪɨɰɟɫɫɚ ɤɨɬɨɪɵɣ ɦɨɠɧɨ ɭɫɥɨɜɧɨ ɪɚɡɞɟɥɢɬɶ ɧɚ ɫɬɚɞɢɢ

1.Ⱥɞɝɟɡɢɹ ɬɪɨɦɛɨɰɢɬɨɜ ɤ ɫɭɛɷɧɞɨɬɟɥɢɚɥɶɧɵɦ ɫɬɪɭɤɬɭɪɚɦ

2.Ⱥɤɬɢɜɚɰɢɹ ɷɬɢɯ ɬɪɨɦɛɨɰɢɬɨɜ ɫ ɜɵɛɪɨɫɨɦ ɦɟɞɢɚɬɨɪɨɜ ɢɡ ɢɯ ɩɭɥɚ ɯɪɚɧɟɧɢɹ

3.Ⱥɝɪɟɝɚɰɢɹ ɬɪɨɦɛɨɰɢɬɨɜ

Ⱥɞɝɟɡɢɹ ɬɪɨɦɛɨɰɢɬɨɜ ȼ ɩɪɨɰɟɫɫɟ ɚɞɝɟɡɢɢ ɜɚɠɧɭɸ ɪɨɥɶ ɢɝɪɚɸɬ ɦɟɯɚɧɢɡɦɚ Ɉɞɢɧ ɢɡ ɧɢɯ - ɧɟɩɨɫɪɟɞɫɬɜɟɧɧɚɹ ɚɞɝɟɡɢɹ ɬɪɨɦɛɨɰɢɬɨɜ ɱɟɪɟɡ ɬɪɨɦɛɨɰɢɬɚɪɧɵɟ ɪɟɰɟɩɬɨ ɪɵ ɤ ɤɨɥɥɚɝɟɧɭ ɫɭɛɷɧɞɨɬɟɥɢɹ Ɉɞɧɚɤɨ ɷɬɨɣ ɚɞɝɟɡɢɢ ɧɟɞɨɫɬɚɬɨɱɧɨ ɞɥɹ ɭɞɟɪɠɚɧɢɹ ɬɪɨɦ ɛɨɰɢɬɨɜ ɜ ɦɟɫɬɚɯ ɜɨɡɞɟɣɫɬɜɢɹ ɜɵɫɨɤɢɯ ɫɤɨɪɨɫɬɟɣ ɤɪɨɜɨɬɨɤɚ ± ɚɪɬɟɪɢɹɯ ɢ ɚɪɬɟɪɢɨɥɚɯ Ⱦɪɭɝɨɣ ɦɟɯɚɧɢɡɦ ɷɮɮɟɤɬɢɜɧɨ ɭɞɟɪɠɢɜɚɸɳɢɣ ɬɪɨɦɛɨɰɢɬɵ ɩɪɢ ɜɵɫɨɤɨɣ ɫɤɨɪɨɫɬɢ ɤɪɨ ɜɨɬɨɤɚ ɨɫɭɳɟɫɬɜɥɹɟɬɫɹ ɩɪɢ ɩɨɦɨɳɢ ɦɨɥɟɤɭɥ ɚɞɝɟɡɢɢ - ɮɚɤɬɨɪɚ ȼɢɥɥɟɛɪɚɧɞɚ ɮɢɛɪɨ ɧɟɤɬɢɧɚ ɜɢɬɪɨɧɟɤɬɢɧɚ ɥɚɦɢɧɢɧɚ ɬɪɨɦɛɨɫɩɨɧɞɢɧɚ ɢ ɞɪ

ɉɚɪɚɥɥɟɥɶɧɨ ɩɪɨɰɟɫɫɭ ɚɞɝɟɡɢɢ ɩɪɨɢɫɯɨɞɢɬ ɚɤɬɢɜɚɰɢɹ ɬɪɨɦɛɨɰɢɬɨɜ. Ⱥɤɬɢɜɚɰɢɹ ɬɪɨɦɛɨɰɢɬɨɜ ɦɨɠɟɬ ɛɵɬɶ ɨɛɪɚɬɢɦɨɣ ɩɪɢ ɤɪɚɬɤɨɜɪɟɦɟɧɧɨɦ ɜɨɡ

ɞɟɣɫɬɜɢɢ ɫɥɚɛɨɝɨ ɫɬɢɦɭɥɚ ɢ ɧɟɨɛɪɚɬɢɦɨɣ ɩɪɢ ɞɥɢɬɟɥɶɧɨɣ ɢɥɢ ɫɢɥɶɧɨɣ ɚɤɬɢɜɚɰɢɢ Ʉ ɫɥɚɛɵɦ ɫɬɢɦɭɥɹɬɨɪɚɦ ɬɪɨɦɛɨɰɢɬɨɜ ɨɬɧɨɫɹɬɫɹ ɦɚɥɵɟ ɞɨɡɵ ȺȾɎ ɚɞɪɟɧɚɥɢɧ

ɜɚɡɨɩɪɟɫɫɢɧ ɫɟɪɨɬɨɧɢɧ ɋɢɥɶɧɵɟ ɫɬɢɦɭɥɹɬɨɪɵ ɬɪɨɦɛɨɰɢɬɨɜ ± ɤɨɥɥɚɝɟɧ ɬɪɨɦɛɢɧ ɛɨɥɶɲɢɟ ɞɨɡɵ ȺȾɎ

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