.

21/2361

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, .
1.
2.
3.
4.
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:
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.
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30/16.9.1993 31/23.9.1993 .

, :

1. ,

,
,
.
(8) (2)
:
2. 1.12.1993.
.
, 5 1993

.
( - - - )
1.1.

1.1.1. (AIDS)
.
HIV.
RNA DNA
.
.

 : ,
( , , ...)
.
.
1

1. .
2. , ,
, ,
.

,

(),
,

.
CD4 HIV
.
-
, .
20-25%
2

, Kaposi,
, ... .

. P24
.
-

, .
67-80%
3

:
, , , , ...


.
-
.

 100%
1.1.2.
.
(common cold)
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Coxsackie, Mycoplasma ...
. .
. 40 C, , -
4 .
.
1

, , , , .

.
-
.
5-10% [1 ]
2

, , , ...
- -.

/ : - , , .
.
-
.
40-50% [1 ]
1.1.3.
.

- .
1.
2.
1


, , ( ).

ASTO 200 . Todd , ,
.
-
.

- ...50-55% [3 ]
- ...20-25% [3 ]
2

() .

.
-
.
.

20-25%
- 25-50%
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3

.
-
-
-

: (PQ, QRS).
. .
-
.
.

-
..68-80% [3 ]
..55-67% [12 ]
-
- ()

- ()

35-50%
(. )
1.1.4.
.
Salmonella typhi ( ). :
- ()
- -
-
-
-
.
1

, , , , , ,
( ).

.
. .
-
3-4
.
.35-55% [2 ]
2

30% : (), (), ,
(), (), ().


.

- : .55-60% [2 ]
- : .80-87% [3 ]
- :
..55-60%
15-20%
- :
..55-67% [2 ]

 35-50%
1.1.5.
.
(C. trachomatis) ( L1-L3)
.

. .
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.
1

, , , .

.
IgM .
-
.
.....25-35% [3 ]
2

, (), () (,
), ().

.
-
.
.

- , .15-20% [3 ]
- ..25-35%
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1.2.

1.2.1.
.
.
( ).
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:
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.
1
- .

.

Ht 28-40%, MCV 55-75 fl
.
Hb : =80-95%, 2=4-8%, F=1-5%.
,
-- (alpha
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.
-
.

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2
- Cooley - .

, , ,
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.

Ht 10%.
, , , ,
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 , 2 F :
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-
.
:
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2)
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- (3)
... 70%
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2 .
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.
...5-55%
1.2.2.
.
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DNA ( 6
-).
.
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.
,

.

S.
-

.

 .0-5%
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HbF
. , ,
.
,
.
.

Ht 20-30%.
5-50%, 10-25%
12-15.000 ...
.
.

- ..50%
-
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1.2.3. (
)
.

Na,
.
.
.
1

:
.
-
.
..15%
2

1.
2.
3.


:
-
-
-
.
. Coombs .

.
. (). . .
-
.

- ...55%
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1.2.4.
.
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,
.
.
1

.
.
.

. -,
, LDH, test
.
C3b .

- .35-50%
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1.2.5. ( , )
.

. VIII IX
.
. ,

II, VII, V, IX, X .
.
1

,
.
.

,
, , .
AIDS .
VIII IX .

.

-
..70-100%
-
..50-67%
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, ,

...> 67%

, ,
.

: , , ,
, .

 :
1. ( Werlhof)
-
-
- IgG

- ...67% [6 ]
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- ...35%
2.
-
-
-
-
-
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- (PTT)
.
.

- ...80-100%
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.55-67%
3.
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.
ADP
.

- ' ..35-50%
- > 67%
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.
.

...20-30%
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Willebrand (vWF) .
,
.

 .
..35-70%
1.2.6.
.

.
:
1.
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Gram

-).
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5. .
.
1

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- , , .
- .
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.
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.
-
.
...80-100%
1.2.7.
.

()
.
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() .
.
1

:
1. .
2. .
3. .
:
1. , , .
2. .
3. .
4. .

:
1. . 2. , , , .
3. , . 4. . 5.
. 6. -. 7. . 8.
.
:
. : 1. . 2. (
). 3. ( ). 4.
.
. : . .

-
.
.....80%
-
.

...80-100%
1.2.8.
.
' .

. 2 .

1 3-5 .
( ,
2 3-6
.

.
1

- .
- (, ).
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- (
).
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:
, , , .
:
1. .
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3. .
4. . -.
5. Philadelphia (
22 5).
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.
.

- ...80%
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2

:
1.
2. .

- .
- .
- .
- 20% ()
, .. (Tdt).

(Tdt ).

( ).
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.

3-4 .
.80-100%
1.2.9.
.
William Damesher. "
".
.
(
) (
Coombs).

IgM IgD. Ia,
C3 Fc .
1%
.
. -
.
.
1

- . .
- .
- (, ).
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 :
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.
2. .
3.
.
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Rai .
.

- 0: ..40%
- : + .50%
- : + - .60%
- : +.70%
- IV: 80%
1.2.10.
.

.
.

.
1

- .
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:
, , ().
:
1.

, . .
2.
(" ").
.
3.
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4.

Philadelphia
.

-
.
.
..80%
1.2.11. Waldenstrom
.
Waldenstrom
IgM .
.
1

- .
- .
- .
- .
- ( ).
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- .
- .
- Raynaud.
- .
- .

.
-
. 3 .
...> 67%
1.2.12.
.

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' (IgG, IgA, IgM, IgD IgE).

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.
1


).
.
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.
.

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,

).
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.
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:
1. .
2. .
3. .
4. .
5. .
(< 2 ).
80%
, ( 7 ).
67%
1.2.13.

1.2.13.1. Hodgkin
.

, ,
,
( ,
).

Hodgkin
Hodgkin .
Hodgkin :
1. .
2. .
3. .
4.
.
1

1), 2), , . 3).

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, . 5) , , . 6) . 7)
().

(), , , .
Reed Sternberg.

, , ,
,
.
: .
: 2
.
.
:
, .

 V: .

- .80% [6 ]
- . ...67% [4 ]
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- .80% [6 ]
- , ...67% > [6 ]
- V. ...80% [1-2 ]
- , .
...
1.2.13.2. Hodgkin
.
Hodgkin

. 2

8 14 ( )
( c
myc).
.
1

Hodgkin :
) .
) .
) .
(
).
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Hodgkin 2 :
1. Hodgkin ,

2. , .
.

-
(. ) .
.
67% [2 ]

- IV
( )
80% [2 ]
1.3.
1.3.1. Nelson
.

Cushing. (10-78%)
Cushing
.
.
1

, , .
.

ACTH .
.


1. ,
(.
Cushing)
> 67% [2 ]
..20-30% [ ]
2. ,
(. Cushing)
[3 ]
...30% [ ]
1.3.2. Cushing
.
ACTH 1 10mm
() 10 mm ().

ACTH

.
.
1

,
, .

, ACTH ( ),
24, .

. .

.

-
67% [2 ]
-
, 6-18 ,
..67% [2 ] 20% [6-18 ]
-

....50%
1.3.3.
.
< 1 cm () > 1 cm ()
(PRL).
.
1

: , .
: libido.

100-200 ng/ml.
(< 1 cm).

 ()
( ).

- ( 90%) 5
67% [2 ]
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()...20% [5 ]
-
.20%
2

1
, .

> 200 ng/ml. .
(>2 cm).

,
.
...30%
.
...67%
1.3.4.
.
(GH) ()
().

.
.
1

, ,
, , .

 , , .
20%.
.

) < 2 cm , ,
>90%
.
...67% [2 ]
) >2 cm 60-70%.
6 2 ,
GH
67% [2 ] 30% [2 ]
) >2 cm
. 10
.
..67% [ 2 ]
...40-50% [10 ]
2

1 , ,
, . , ,
.

1 .
.

)

..55-67% [ 2 ]
)

.100%
1.3.5.
.

 .
:
1) .
2)
( Sheehan).
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,
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.
.
1
( )

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.

, (),
().

.
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2
( )

, .

4 3, TSH.

.
...10%
3
ACTH ( )


,
.

, ACTH.


, , .
.25-30%
4
( Simmond)
[: Simmond .
, .
(..
..)].

, .

LH, FSH, TSH, ACTH. 4 , 3 , , , .
(test ) GH, ACTH
. TRH test TSH. LH RH FSH LH.


.
...30%
1.3.6.
.
:
1) (
).
2) (
)
3) ( ).
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1


(5-25 L), , (5-25 L).

(<1005), ,
.
. .

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, , , , )
.
...15%
2


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,
.

- ,
(), .
-
.
..>67% [1 ]
-
.100%
1.3.7.
.

.
.
1

 ,
.


.

- ...0%
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1.3.8.
.
.
:
1. ( ).
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3. ().
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.
1


, .

.
.

.
.
.
. .
..80% [1-2 ]
2


38-40 C , , .


(>60 mm). -131.
4 / T3.

. 2 .
( ) .
..67% [2 ]
3 .
)
)
) . :
.10% [ ]
3


.
. .

(131).
. 4, 3, 4, 3.

. .
) -blockers.
) .
(: ).
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4
Riedel

( ) ,
, .

. .

- ...10-20%
- .55%
-
...67%

1.3.9.
.
:
1) ( Graves Basedow): (TSI)

.
2) : ) .
3) : TSH , TSH,
, struma ovarii ...
.
1

100/min, ,
, , .

4 3 ( 3). TSH.

.
6 .
3 .
35-40% [2 ]
2

>100/min.
. . .
.

4 3.
TSH.

.
3 .
3 .
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3


2
.

4 3. TSH.

, .
6-24 .
(131)
.
50% [6-24 ]
1. .
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2. ( )
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3. (
)
..67% [12-24 ]
4. ( , ), ,
, , .
...30-80% [3-24 ]
5.
..80-100%
1.3.10.
.

(
) .
.
1

( ). ,
.


4.
.

TSH.

.
.
.
....0-5%
2
( ).
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.

4, TSH .
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.

.
,
2-3 .
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...10% [ ]
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:
0%
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3

: 2
, , ,
, , , .


4 3, TSH. ,
( ).

, , .
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4

, :
24 C. .

4 3, TSH. .

.
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.
...50-67% [ ]
1.3.11.
.
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) .
.
:
1 = 2 .
1 = 4 .
2 = .
3 = .
.
1

1 2 .

1. 4, 3, TSH

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.

( ).
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2

3 .

4, 3 , TSH ,
().

. ,
,
.
.
....10-20%
1.3.12.
.
) . .
) .
1. .
2. .
3. Hurthle cell (80% -20% )
4.
5.
6.
.
1

: <1 cm
.

: <1 cm. (scanning):

<1 cm. : .

.
.
.>67% [1 ]
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2

1. .
2. .
3. Hurthle cell .
4. .

.

1 .

1. . 5 90%.
. ,
(131) .

- ..20%
- ..50-80%
2. . .
.

- ...20%
- 80%
3. Hurthle cell . .

- ..25%
- 90%
4. . .

( ).
.

) 30%

) ...100%
3

, .
. .

.

, ( )
. ,
.
100%
1.3.13.
.

.

1. :
.
2. .
3. .
4. ( ).
.
1

. , Chvostek Trousseau,
, .

7,5-8,5 mg%, , .

.
.
..0-10%

2

1
: , , , ,
.

<7,2 mg %.

.

- ..100%
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- ..20% [ ]
1.3.14.
.
(85%), (9%), (5%)
(1%) (PTH).
.
1

, .

11 mg%, PTH.

.
..0-10%

2

, , , ( ),
.

11-15 mg%, , , ,
c-AMP, , (
),

 ( Recklinghausen), . scanning
201
TI/99Tc .

)
1. ( <15 mg%)
.
..0-10%
2. >15 mg%
..60-100%
)
1. .
...>67% [2 ]
2.
10 .
.>67% [2 ] 30% [10 ]
3. .
..50% [10 ]
4. .
...100% [ ]
1.3.15.
.
.
.
.
1

, , , ,
, , .

VMA 24.
.
/ . scanning
131-MIBG / .

1. , ,
.
... >67% [3 ]
2. ,
,
.
... >67% [1 ]
3. ,
,
(.. ) (. . ).
... >67% [3 ]
1.3.16.
.
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() 21 11-.
.
1
21-

.

. .

. .
..20%
2
21-

: , , .
: , ,
.


, 17-,
,
.

. .
....20-55%
3

2 , .

2 .

.
....25-60%
4


: .
: , , .

, 17- ,
.
.

.
... >67% [3 ]
.
.35% [ ]
5


4 : , , .

 4 :
.

, , , - ..
....100%
1.3.17.
.
()
.
.

. . . .

. ,
.

.

1)
.
... >67% [3 ]
...20% [ ]
2)
.
..30%
1.3.18. ( Addison)
.
. :

.
.


, , , , .

, , , , ,
ACTH.

, .
... >67% [2 ]
(, , )
(
= ).
... >80% [2 ]

:

- .20-40%
- > 55%
1.3.19. Cushing
.

Cushing. :
1. ACTH ( Cushing).
2. ( Cushing).
3. .
4. .
5. ACTH.
.
1
Cushing

, , ,
, ,
ACTH.

 , ACTH, ,
.

1.
ACTH.
... >67%
..
2. ,

.
... >67% [3 ]
... 30%
3. ,
, .
..60 80%
2
( Cushing) (. 1.3.2)
3



.

, ACTH,
.
.

... >67% [3 ]

..30% [1 ]
- .20% [ ]
1.3.20. (Apudomas)
.

 (
) (
).
.
1

: 90% . .

<50 mg%.
<40 mg%. .

- >67% [3 ]
...30% [ ]
- ,
90-100%
2
: 60%

, , ,
.

. .
.

-
..>67% [3 ]
...40% [ ]
- (
)..90-100%

: 60%

, .

, , , . .
.

- ...>67% [5 ]
...30% [ ]

- ...100%
( Verner-Morrison

, , , ,
.

, , VIP .

- >67% [3 ]
...30% [ ]
- ...100%
3

( Zollinger-Ellison) >60%

, .

>100 pg/ml,
().

- (. )
- 250%
- ...100%
1.3.21. (MEN: Multiple Endocrine
Neoplasia)
.
APUD (Amine Precursor Uptake
Decarboxylation) .
. : 1) H MEN I:
, , . 2) MEN II:
, ,
, MEN I:
.
.

1


.
().
(, Cushing, ,
).
Zollinger-Ellison.

/ . .
.

- (, )
..50%
- ..70-90%

..100%
2


. .
(. ).

. .
.


90-100%
( , . ,
).
( , , ).
1.4.

1.4.1.
.

 .
(, ...),
( ), ,
...
.

.
, , Ca (
) Ca
,
.
.
1


FVC/FVC pred 0,8-0,6

.
..5-10%
2


FVC/FVC pred 0,6-0,5

.
20-40% [1 ]
3


FVC/FVC pred <0,5

.
.50% [2 ]
1.4.2.
.


. , ,

. : , , , ,
, , ,
- ..
.
.
.
, ,
.
.
1

.

: .

/: , .
: . :
.
: .

.
..5-10%
2
.

. .

: , ().

/:
.
:
.
.
: .
: .




.
25-50% [1 ]
3
.

. , . .

: , .

/:
.
: .
.
: ( ).
: .

.
.
...67-80% [2 ]
1.4.3.
.
.
, . (
) ( ).

.
1. ()


.

. .
50 .
.
1

. 1500 .

: , . :
.

/ : .
: FEV1/FVC: 0,70-0,60, FEV1/FEV1pr: 0,70-0,60, FEF25-75/FEF25-75pr: 0,600,50.
: .

.
(.. ).
..5-10%
2

. 300
.

:
,
: .

/ : .
.
: FEV1/FVC: 0,60-0,50, FEV1/FEV1pr: 0,60-0,50, FEF25-75/FEF25-75pr: 0,500,40.
: .

.

.
..20-40% 1 2 .
3

. .
100 8 .

: . . :
.

/ :
.
: FEV1/FVC: <0,40, FEV1/FEV1pr: <0,40, FEF25-75/FEF25-75pr: <0,40.
: , .

. .
, .
.
...50-70% [2 ]
2. ()

.
, .
.
, ,
(. ).
.
1

:
.
.

: . : ..

/ : .
: FEV1/FVC: 0,70-0,60, FEV1/FEV1pr: 0,70-0,60, FEF25-75/FEF25-75pr:
0,60-0,50.
:

.
..5-10%
2

 .
.
.

: , .

/ : .
: FEV1/FVC: 0,60-0,50, FEV1/FEV1pr: 0,60-0,50, FEF25-75/FEF25-75pr: 0,500,40.
: .

.
.
20-40% [1 ]
3

, .
.

: . .

/ : .
.
: .
FEV1/FVC: <0,40, FEV1/FEV1pr: <0,40, FEF25-75/FEF25-75pr: <0,40.
: ( ).
. : .

.
.
.
...50-70% [2 ]
[ 3
(.
). ,

. ,
].
1.4.4.

.

(20-40 ) , , ,
, , , , , (),
.
: ) , ) )
.
Kveim .
:
1) (SACE).
2) -67.
3) .
4) .

.
.
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.
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.
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.


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/

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.
1
pO2 = 80-60 mm Hg.

, . .
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,
pCO2.

.
.. 50% [1 ]

 .
2
pO2 = 60-45 mm Hg.
1
. .
pO2 60-45 mm Hg pCO2 = 70 mm Hg.
,

.
.

. .
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3
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.
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.


.
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.
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.
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.
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IV:
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120 min.
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.
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, .

.

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.
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75-80%
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.
.
()
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2.

(F P) :
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2.
3.
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7.
8. (Pancoast)
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.

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).

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.

.

.

35% 67% ,
.
.
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(
)

.

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).
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1)
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.
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3)
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8-12%, 14%,
23%
40-75%.

 (
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1 ).

5%, 12%,
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40%
60%.
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25% .

20-40%.

:
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.
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60 /1.
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20 /1 , ,
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.
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.
:

.
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0
1
1
2
3
4
4
5

=
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100200 ( 150-250)
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.
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,
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,
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(2:1, 4:1, 6:1).
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300/1 150/1.
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.
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F,
.
,
.

.
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.

 .

.
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.

,
.. 8%,
3% 3,8%.
.

20-35%
:
.20-35%
:
20-35%

20-35%

20-35%
:
20-35%
:
20-35%
:
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QRS
100 200 1.
(
),
.
.
().

 . ,
shock, , ,
.
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.
.
,
.


.50-80%
5)

.
.
100%
.
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,
.
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. .
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.
.

.
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, .
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, 2 Wenckebach 2:1
.
,

.
: .
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.
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3 ..50-80%

.
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( ),
.
P
P-R.

.
3)
.
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.
.
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.
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.

...50-80%
...35-50%
4)

( Purkinje). ,
40 /1. (
) (
).
QRS ,
, R.


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, ...).
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.
1
P-R.
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.
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2
.30-50%
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. ()
3
. .
30 40 1.

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.
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.
.
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.
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,
.

,
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.
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.
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.
:
.

.

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.
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.
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Holter. .
.
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20-50%
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.
7)
.

( Kent, Mahaim),
His ( James).
.
. WOLFF-PARKINSON-WHITE (W-P-W)
WPW P-R
QRS ().


.

.
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.
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,

 .
.
.

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His, 2)
.
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0%
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His.

(
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.
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.
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50 ,
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4. .
5.
.
.

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. QRS
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.
.

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3)
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,
.
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2) , 3) Holter, 4)
(Tl 201), 5) .


:
..35%
:
...50%
:
.67-80%
IV: .100%


( , ...).

PRINZMETAL

:
1) (
),
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30 .
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.
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.

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:
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2, 3 4 )
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.
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.
:
1)
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(, , , .. ...).
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).

.


..25-50%

.

75-80%.
: 90%.

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:
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2) 30

3) 30
90 .
:
1) 6
2)
3) .

:
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6) .

...80-100%
80%
().50%
()
(Tl)
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Tl201(+)...67-80%
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Tl201(-)..50%
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..67-80%
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IV)..>80%
...50-80%
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, .

(: , ,
).
,
.
.
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.
Holter .
..80%
1.5.3.
1.
: .
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4-6 cm2.
6 mm Hg.

( 2 cm2)5-10%
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( 1 cm2
20 mm Hg)..67-80%
50-80%
80%
, ,
..50-80%
100 mm
Hg..80%
( )
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50-67%
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2.
:

.
: (
).

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.
,
,
.

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.

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.
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: cm2.

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50 mm Hg.5-10%
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100 mm Hg....80%
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) (, , )
.

.20-25%
(, ,
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:

.
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:

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.
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.

.
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80%
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...67-80%

5.
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( 50%
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)..35%

7.
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.
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.
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.

:
,
.


) > 2 cm2.25-35%
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click .

.

.
.
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,
,
( ,
).
.
.

5-10%
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"".

1.5.4.
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. ,

 ,
.
1.

mm2 cm2 ( )
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,
.
1 cm2 ,
()

( ).

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.
3-4
.

.
.
.
.
,
.
50 mm Hg
.

.
:

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Eisenmenger)67-100%
.
)

...50-80%
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,
.
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mm 2-3 cm.


.
( Eisenmenger). 40
1) , 2)
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. QRS .
His.

.
.
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.
,

.

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,
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50%
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(
).
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.

...35-50%
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.

,

.
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.

2 .

.

.

.

.

..67-100%
:
. ...10-20%
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.

.
.
.

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.
.

.
.

.100%

..35-50%

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[
].
3.
,
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). : ,
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, .

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.
.
:

.

50%
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50% .35-67%

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.10-67%

4. ( )


.

. (
Eisenmenger) ,
.

.
,
.

.

.
.

. :
: 1 cm,
/ 2
....35-50%
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2, ,
.67-80%
Eisenmenger..100%
(

) -.0%
5.
(95%)
.
(25%) .

( 1-2 mm)
,
.


, .
:
1) ,

2)

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4)
5)

6)
7)
.
:
, ,
Willis,
.

:
(,
),

35-100%.
(
):
,
(
), ...
10-35%.
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( ),
( ).
.
2 cm2/m2 .


. ( 1 cm2)
70 mm Hg, (
2-4 mm)
100 mm Hg ( 200 mm Hg ).
,
.
.
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) 2 ( ).


.

.
Doppler

.


....10-20%
( 70 mm Hg).35-50%
( 100 mm Hg,
7 mm)..67-100%
(, ,
)...20-35%
7. FALLOT
Fallot 1888 :
1) , 2) , 3)
4) .


.
: , , ,
.
:
2 .
,
(coeur en sabot) .
.
20
.
:
,
, .
90%
.

:

50-100%

. ..5-35%
. ..50-80%

8.
:
1) :
.
,
.

..100%

) ( Rashkind)
) ( Mustard)
) (
Jatene)
50-80%
2) :

.
() .

.
3) :
(
),
.
, Ebstein,
.

,
.

( )..35-67%
-
..67-100%

.35-80%
9. EBSTEIN
:
,
(
) .

 (
) .

.
.
.
.

67-100%

...50-80%
10.
,
,
. ,
().
.
.

..100%
(
,

)
.50-80%
1.5.5.
:

.
: ,
, ,
, , , ,
, , , ,
..
:
,

.
: ,
.

:
:
1)
()
.
2)
(.. )
.
3)
. Doppler
.
4)
.
5)

(
) .
6)

.

, :






...80-100%
1.5.6.
:
, .
:

,
,
,
, , , , , .
: 1) (
, , ). 2)
.
: , , , , .
:
, , , ,
. Osler Janeway.

: , ,
.
: , -,
2/3 .
, 3-4 mm.
: 1) () 2) .

...80% [1 ]
1.5.7.
,
/ .
( Coxsackie , , ,
, , , , ,
.
:
1) , 2) , 3)
, 4) , 5) ()
.
: . , , , , ,
, .
:
1) ( )
2)
3) : ST T, ,

4) .
5) Coxsackie B
6)
7)

8)

80-100%
...67-100%
(. )
1.5.8.
: .

 :
) (
).
) (
).
,

.

, .
1. : ,
, ,

( , ,
, , ).

.
2. : (, )
.
3. :
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.
.
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, WPW, ,
, Q QS
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.
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) .

. .
.
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Q QS .
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,
.
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( ),
,
,
, .
-

....50 67%
....80 100%

.

.
,
,
.

,
.
.

,
.
:
.
: , , , .

(50%).

) : ,
, 3 - 4
.
( )
. 4
3 .
) .
Q.

)
(), () /
.
) .
.
)
15 mm (
1,5), ,
,
,

20 mm.
) : ,
.
)
.
) :
,
.
: .


.

.
-

.35%
+ ...67 80%
+ .. ...80%
+ ......67 80%
+ ..67 80%

.

, . ,
.

.

.
.
.

 . -
,
.
.
.
.
,
.
( )
.
...80 100%
1.5.9.
.
. ,
.
.
: , , , , ,
, , ,
, (, , , ).
( ).
.
(, , , )
, ST
.

().

6 .....80%
6
(, ,
) . :
-
.
.0%
- .
.
.....80%
- 6 ..67%

6 , . (
).
( )

80 100%
(
, , ,
, ) 35%
.

.
[ (, , , , ) ]
.
, , , ,
.,
, , , ,
..
(
) , , ,
Kussmaul, Friedreich, Ewart, , , .
shock, ,
, .

.


. : 35 100%.


.

.

.
.
. ,
, ,
.
.

 .

5 10 .
.
,
, .

:
-
-
- ( )
- ( ,
, )
..50 80%

.
,

.
: , , , , ,
, , , .
.
(
, , , ).
, , . . 1/3
.
( )
2 .
, QRS
1/3 .
.
,
.
[ , (76%
),
,
, ,
, .

.
,
, (
)
.


, .

.
-

(, ,
, )....67 100%
.50 67%

1.5.10
.
. 80%
.

[
]

(50% ). 75%
, 20% 5%
. .
50 60 . .
: )
) ) )
( , , , ,
, , Raynaud).
1.

, .

.
(30 60%),
.
.

.
(tumor plop).
.

 .
.
.
. .
2.

(
, , ,
).25 100%

.0%

: ,
, , , .
.
3.

...25 100%
.
,
0%

,
.
-

.10 80%
.0%

.
, .


.

.

,
.



( , ...).

. ,
.


.

.
..80 100%

( , ,
)
.100%

1.5.11
( )
(
)
.

.

(, ,
), (,
), ( )
.

(
).
.
,


(, , , , . ).

( )
.
.

1.5.12
, ,

.

, ,
, .

4 .
:
.
:
.
:
(
).
IV: .

, . [

.
, (
) ( ) ].

( , , ,
, , , ,
).

: , ,
, , , ,
.


, , ,
, , , , ,
( ).

: , (
), ,
, ,
, .


: "
" (.. 35 50%) ,


:
-
I:

...0%
- II: , ,
,
, .....35 50%
- III: ,
, ,
...67 80%
- IV: ,
, , , ,
20%, , ,
...>80 (100%)

1.5.13

.
/
.
( )
1) (5%).
2) .



.
3) (1% - ).
4) . .

5) (20 30%)
.

.
6) . 3 7
,
.
7) .

. ,

.
.
3,5% 20%
,
. 10 15%
. 2%
.

:
1)
(. ).
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,
)
.
3)
.
4)
.
5)
"" .
-

....80%


( )
( ). :
)
1 ...35 50%
2 ...50%
3 ...67 80%
4 ...100% (. ).
)
1 .35 50%

2 .50%
3 .67 80%
4 ..100% (. )
[: 1
.
35 50%.
(,
)].

1.5.14 (PTCA)

.
,
( )
.
2 2,5 cm.

. 3 9
. 30 60 sec.
3 4 .
20%. 85 90%.
: 1- 2%.

(98%). 3 5% (8,8%
).
.
20 30% ( 15 30%) 6 .
>50%
.

ST
.

(), ,

:
( Stents),
Laser, ,
.


(, , ),

 , (.
), , ...)
- .80%
- 4
:
) (
>60%) (
)..35 50%
) ( >60%),

..10 20%
)
( 50 60%) /
( 1
)...50%
) ( 35 50%) /
( .
)..67%
) ( <35%)
/ ( .
)80%
) (
), .
( IV) .>80%

1.5.15.
,


.

(IV)
.

(52%) (40%).
85% 75%
5.

.

.
-

.100%

4 80%
( )

1.6.
1.6.1.
.
:
(
).
1.
:
.
2.
:
.
.
1

1.
:
, .
2.
: , , ,
.

1.
2.

, ,
, IgA .
, , HCl,
Helicobacter pylori.

1520%
....0 5%

. ...0 5%
10 15%
......15 20% [3 ]
(bile reflux)...................................................15%
.70 80%

2

:

. .

...60 80%
..100%
.....20 50% [2 ]
....50% [6 ]
.20%

1.6.2.
.
:
. :
- ( , )
- ( )
. ( ).
95% .
,
.
.
1

.

( ).
.

(). , , .

.
..60 80% [3 ]
. 10%

.

,
.


. , .

. .
().
...70 100%
2
: (, , )

.
. .
...100%

1.6.3.
.
. (,
,, , ) (, , ).
Peutz - Jeghers
.
.
1

. : ,
.
. :
1.

2.

3.
( , ). : , , .

.
.
. Peutz Jeghers: ,
. (
) .

. :
. .
5 - HT (5-).

1.
(flush).
2.
( ).
3.
( , ).
4.
.
5.
( ).
6.
.
: .

. : . .

...5%
. : .
. ().
..67 - 80% (
. 6)
. Peutz Jeghers:

.....10%
.

...30 - 50%
...50
70%

1.6.4.
.
,
. ,
.
.
1

 . .

.

.
.

.....20%
2

5 10 ,
.

, .

. .
...55% [3 ] 35
50% .
3
( )
-
, , , , ,
, , .

, , , ,
2-.
,
.

. : , , .
. :
: , .
: .
: , .
: , , , .



.
(<10%) . .
, 10.
70 - 80% 1 , 35
50%
-

.
.>67%

1.6.5. Crohn
.
,
,
.
10 - 40 .
: 1/3 , 1/3 , 1/3 + . 40%
.
.

.
1

.
.
1.
( )
2.

3.

4.
( )
5.
(, )
.
1.

2.
(, )
3.
( , )
4.
( , )
5.
( )
6.
( , )
7.
(, )
8.

: ) , ) , )
, ) .



,
.
-

(. . 6)

....60% [2 ]

....20%

1.6.6 -
.

( )
( ).
, .
.
.
, ,
, .

.

.
1.

2.
3.

4.
5.

. , , .

Zenker.
12/
.

. .
.
: , , .

, : ,
, , .

.

 ,
, .

.
, .
...5
10%
, . . 6.

1.6.7.
.
.
6 .
: , , ( , ,
, ), (, ),
( ), .

A, B, C
. C
MnA-MnB
MnA-MnB .

.
1.


. ,
, , , ,
, , .

, ,
. IgM HAV-total . 3
(HbcAg-HbeAgHbsAg) DNA . , C
( HDV -HCV ).

 .
.

. 3-16
.
, C, .
80% [3 ]
.
2.
)

, , .

,
HbsAg . .

.....10%
)

.

, IgG, IgM -
,
.
.
.

.
.


.........67%
..>80%

1.6.8. ( )
.


:
) ()
) ()
) ()
)

.
1

. ()
.
. ()
. 20%
. 20%



.

, , .

(6 ) .....60 - 80% [4

]
-

. . 6.

.
.

 .
.... ..60 - 80% 4

1.6.9.
.

. :
, ( ), ,
( , ),
(, Wilson, ), ..

.
1


,
. ( ,
, ).

- .
- .
- - .
- BSP
- .
- .

.
.
.

....

..>67%
2
( )

 :
- , ,
- ( )
-
-
-
-
-
- , ,
- ( )

, , , .

1.
( )
2.

3.

. (35%) 5.
.
....80
- 100%

1.6.10.
.
.
, ( ),
.
, ,
( )

.
1


-
-

 :
1.

2.
( )
3.

4.

5.

.... 10%
. 6
2


: 1) ,
, , , 2) 3)
.

: .
.

......60 - 80%

1.6.11.
.

() ().
.
, (, ).

.
1

1.

.
2.

3.
4.

1.
1-
2.
(, GT, ,
)
3.
( 50% )
4.
( )
5.
( )
6.

7.

8.

. . . .

.......100%

1.6.12.
.
. 90%

, ,
.

.
1
.

.
-

........0 - 5%
. . 6.

 .
-

........0 - 10%
. . 6.

. . . 6.
2

1. ( , , ,
).

. .
.....60% [1
]
2. .
.

. .
(. . 6)
3. . .
, , ,
.

. .
(. . 6)
4. . . .

. .
(. . 6)
5. ( , , ,
) ( ).



. .
.....60% [1
]
6. . , .

.
7. . , , , .

.
8. .

. .

1.6.13.
.
, ,
, .

,
.
:
1.
.
2.
.
3.

().
4.
(, ).
5.
(, ).
: ) ) .

.
1

 , , , . :
, , , ,
, shock.

. . , .
. . , .
. .
-

: , 70% [3 ]
: . 70 80%

.70% [3 ]

.35 67%

:
- .
- .
- .
- .
- .
- .
- .
- .

1.6.14.
.
:
1.
( ).
2.
( ).
3.
(). .
4.
(
).
5.
.

.
1


. .
. , ,
.

.

. . .

.0 5%
. . .
(. . 6)
2

.
.

.
:
1.
2.
3.
4.
.

.
.
.
NaCl

(. . 6)
-

).....80 100%

1.6.15.
.
90%
, 10% .

 4 (
).

.
1

.
1.
.
2.
, .
3.
, .
4.
.
5.
( ).
6.
.
7.
.
8.
.
9.
( ) .
10.
(Cushimg, ).
:
1.
.
2.
.
3.
(ERCP).

. , 95%.

.80%

1.7
1.7.1. ()
.
: .
.
. .
.

.
1

, , .

1)

.
2)
:

100.000/ml .
3)

.
30% [2
]
2


.

, , , ,
.

1) ,
.
2) .
3) .
4)
.
5) , clearance .
6) .

.
.

......55

67%
-

...67
80%

1.7.2.

.
.
.
.

.


.

2g .
.
.
-

......67%

...80%

1.7.3.
.
(
)
.
.

Gram .

.
.

.

.
, , .

 , , , , .
.

....40% [6
]
55 67%

...>67%

1.7.4.
.
(, Grawitz,
)
.

.

, , , , , ,
.

, , .
, , ,
. .
.

5 45%.
65%.
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.67%
, , ...80
100%

1.7.5.

.
(
) .
:
) : ,
, , (Henoch
Schnlein), , , ..
) :
.
) : , , , .

.

.
1

.
. .

.

:
) , 4g/24h.
) .
:
) :
- -.
) .

..67 - 80%

1.7.6
.
.
, ,

 , , ,
, .

.
1

) .
) (, , , ,
).
) (, , ).

. .

, , clearance
. Clearance <75 ml/min.

.40%
2

) ( , ,
, , ).
) (, , ,
, , , , ,
, , ).
) ( ,
, ).

, , , ,
, , , , D,
.
-

50 ml/min..... 67%
50 ml/min.80%

1.7.7.
.

 .

.

. .

.
1

.

, ,
, , , Ca ,
, ,
, .

: , , .
-

......>80%
...67%
[2 ]

...80%

1.7.8.
.
,

.

.
1

) . Gram
Staphylococcus aureus. ,
, , .
) .
.


.
.
-

..5 10% [1 ]
..20%

1.8.

1.8.1. , ,
.

.
, .

.
1
, (=3x106)
.

..10 - 20%
2

( , , , , ).

..20 - 30%

1.8.2.
. -
.
.

.

.

( ).

..0 - 4%

1.8.3.
. -
.

( 21).

.

, , , ,
(, )
.

( ). Barr.

..0 - 4%

1.8.4. Turner ( )
.


.

, ,
, , , ,
, .

45, . Barr.

.
1

, .

.
-

, .
..15%

, , ...50%
, , ,

petit
mal

..67%

...80%

2


, .
-

.30%
...50%
..60%
...67%
..80%

1.8.5.


.

.

.
1

.

.
.
.

0 - 10%

.
, ,
, (DES)
.

.
1 : 0 (Ca in situ)

.

. .

..10 - 20%
2 :
.

. .

 ..40 - 50% [2 ]

3 : II
,
.

. .
.....67% [2 ]

4 : III-IV
(III).
(IV).

..80%

[2

1.8.6.
.
(
).

.
1

( V):
..

. .

..0 - 5%

1.8.7.

.
.

.
1

, , .

(U/S) .

..0 - 5%
2
40
.

..0 - 5%
3
40
.
...30% [2
]

1.8.8.
.
,
( , ,
),
.

.

.

Test Pap, , .

( )
.

.......0%
0 .......................................................................................................0%

- ....................................20% []
- .............70% [2 ]
- ................20% [2 ]
, I, ( )...70% [2 ]
( )..80% [2 ]
IV ( )..80%

1.8.9.
.
.
. , ,
.

.
1


.

Test Pap, , Mi- Mark, , .

 2
:

.67%
2
-

....67%
.80%

1.8.10.
.
.

.
1 :

, ,
..

. .
......10 - 20% [2 ]

2 :
.

. .
.....30 - 40% [2 ]

3 :
.

 .
...67% [2 ]

4 : IV
.

. .

.....80%

[2

1.8.11. Steln - Leventhal

.
.

.
1

, , , .

-
- ( 17-OHPRG).

..0 - 5%

1.8.12. .
.
, , .

, , , , ,
, .


- .
- (FSH LH SHBG 17-OH-PRG).
- .

.
1

.

. 50 .

. .

...5%
2

.

. 35 ,
.

.....15%

1.8.13. :
.

, .
:
, , , Brenner,
.

 ,
.

.

.
-

,
45 ....0 5%
,
45 ..0 5%

45...0 5%
45
...15%

1.8.14. :
.
6% .
, ,
. , ,
, ,
, , ,
, , , , ,
.

.
1

, , , , ,
, .

, , ,
, ,
, .

 ,
, .
-

I 5 60%.40 50% [2 ]
II 5 40%....67% [2 ]
III 5 7%..80% [2 ]
IV ( )80%

1.9.
1.9.1.
.
.
: 1. 2.
().

.

.
1

1.
: .
2.
: .
, , , ,
, Raynaud,
.

LE cell test .
, , ,
Coombs, -DNA Sm HLA
DR2-DR3.

( ).
.

. .
: .
-

..0 5%

- ...35-50%
- ..>67%

2

,
: , , , , , , .

.

.
-

...>67%
....80 100%

1.9.2.
.
,
, , , .
. .

.
1

Raynaud.
, , .
, , .
.

, , 35%,
Scl-70 , .

 .25
50%
2

.
. .

.

.
.50
- 80%
3

( ), (
), .

.

.
...80
100%

1.9.3. -
.

. .
.

.
1

:

) , .
) .
) (, , ).
)
.


.

.
.
.35
50%
2

(
), , , ,
. .
.
, ,
, . , .

) , ,
.
) .
) ,
.
.70
80%

1.9.4.
.
.
.

1

, , ,
.
, , , ,
.

, , .
.

..50 - 67%
2

1)

: , .
2)

:
.
3)
: ,
, ,
.
4)
:
.
5)
:
, .
6)

,
.

.
(HsAg), 30 50%
.

.80%

1.10.
1.10.1.
.

.
.
.
, ,
, , . = cm 100.

.
1

20 50% .

..0 - 5%
2

50 100% .

..10 - 20%
3

>100%, , .

, .

 >67% [2
]

1.10.2.
.
,
.

,
, (IDDM,
Insulin Dependent Diabetes Mellitus) .

.
1

, , ().

> 140 mg/dl, , ()
().
(HbAlc) > 8mg%.

1.

MODI.

5 - 15%

2.

( ).

..50 - 60%
3.
()
.
(),
.
80
- 100%

2

, , .


Hb 8 mg%,
, .

.
.

..40 - 60%
3

, , , .

.
-

.
HbAlc.
.

.
-

.
-

.
.
-

..60 80%
..80 100%

1.10.3.
.
.
,
.
pH
. .

.
1


. .

: ( )

, .

.
.
-

.....0 5%
.
....5%

2

: , , , ,
, , .

( ),
,
.

.
:
-

1 ...20 25% [15 20 ]
2 .25 40% [15 20 ]
3 50 60% [15 20 ]
.10%

3

, , .
,
(), , (), .



, , , , .
-

.
...35%
..50 67%
180 mmHg55 80%
+ 80 100%

2.
2.1.
.
,
, ,
, , (, ,
, ),
, .
, ,
, .

,
.

.
1

, , ,
,
.

. . .

.

..10 - 15%

2
, ,
( )
, .

. ,

.
..20 35% [1 2
]
3
,
.
.

, ,

.
.50 - 80% [1 3
]

2.2.
.
, ,
.
, , .

.
BCE (,
, Laser) . ,
,
. .

.
1

 () ()

.
.

. (
). .
.

..0 - 5%
2
(, , )

. .

. .

.
...5 - 20% [1 2
]

2.3.
.
, ,
.

(, , , , , ).

,
, .

, ,

,
,
.

.
1
,
, ,

, .

. .
.
, .
..50 - 67% [1 2
]

2

, ,
,

.

.
. .
.
.67 - 80% [1 3
]

2.4. ()
( )
.
.
, . ,

.
,
. ,
,

 ,
,

. , , (
).
, (
) . ,
,
,
. tests (patch
tests) ()

(. . 8).
.
.

.
1

.

. , , .
.
.0 - 5% [1/2 1
]
2
,
, .

. .
. ( )
.
.5 - 15% [1 2
]
3

( ).

. .



.
. .
,
.
...15 - 30% [3 1
]
4


.

( ..
).

.
(
) .
.
. .
.35 - 50% [1 2
]

2.5. -
.
,
, , ,
, .
( ),
,
() .
,
.
, ,
.
.

, .

 .

. , ,

, ,

(. ).

.
1
, ,

. .

, .
.
.
.5 - 15% [1 3
]
2
, ,

.
.

. , ,
. .
...20 - 50% [6 1
]

2.6.
.
.
,
, .
.


, ,
.
( ) .
, .

.
1
,
.
. .

.
. ,
.
.0 - 5% [1/2 1
]
2
,
. , ,
.
.

. .
.
.
...10 - 20% [2 6
]
2 ..

2.7.
.

,
,
. ,
, , ,

, ,
, , ,
.

.
,
.
, ,
, , ,
.
..
,

..
.

.
1
,
.

.
.
... 5% [1
]
2

(,
, ).

. .
.
.
...10 - 20% [2 1
]
3
,
,

. .
.
,
.
.
20 - 35% [6 2
]

2.8.
.

.

. , , ,
, , .
.
, , ,
, .

. ( ,
, ).
,

( ,
, ).
( ).
,
,
, ,
.

.
1
, , , , ,
, .
.



.
.
... 5% [1
]
2
, ,
, , ,
.

. .

.
.
...10 - 20% [3 6
]
3

,
(). , ,
.
, ,
.

.
.
, .
.
...25 - 50% [6 1
]

2.9. ( Hansen)
.
Hansen
. , , ,

. (
12 15 ) . , ,
1950 .

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(110-45)

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00-900
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110-130...=35% =30%
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120 - 135
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4.2.10 ( ,
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---
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&
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Volkmann

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4.4.3. ( Dupuytren)

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4.4.4.
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4.5.3.

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4.5.12.
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4.5.13. (,
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2. (Tompson, Moore
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New York
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67% [1 ]
7.6.1.
1.
2.
3.
4.
5.
6.

( Marchesani)
(
Marfan)
,
, , .

67%
10-35% 50-67%
3,4 550-67%
35-67%
7.6.2.

1.
2.

()

3.
4.
5.
6.
7.
8.
9.
10.

()



,

, .. .

..
,
.
.
1.
2.
3.
4.
5.

(, , ,
..)
(.. , ,
, x- Rays, - ,
, ..), .
- , ( Soemmering,
Elsching).
.

, ,
, ,
, , .
.
7.6.4.
1.
2.
3.
4.

rosett- shaped )



,
..
,
, .
7.6.5
1.
2.
3.
4.
5.
6.

( , , ,
, , ..)

.

.
7.6.6
1.
2.
3.
4. (- Mintacol- DFP..)
5. , ..

.
7.6.7
, ,
, ,
. , , ,
,
.
, , :
1) , 11,00
.

2) .
, .
3) ,
,
.
4)
, ,

.
5)

, ,
.
6)
, .
7) , 10-15,

, ,
,
.
8)
.
,
.
9)
,
,




.
.
20%.
, .. 15%
.
10/10,
40%,
20/10 (10/10+10/10=20/10)

10/10,
10/01. ..
4/10 .. 20%+6%=26%

7.7
7.7.1

,
:
1.
Tyndall
2.

3.

4.
- (cellophane maculopathy)
5.


.
7.7.2

, ,
. ,
,
.
1. ( )
2.
3.
4.
5.
6.

.
7.7.3
1.
2.
3.
4.

( )
- Wagner
Wagner

7.7.4.
1.

.
7.7.5 ( )
10
,
() , ..
.. (macular pucker).
.
, (open sky
vitrectomy) (closed type vitrectomy)
paars plana .
.
,

.
67% [1 ]
( ,
,
).
7.8.

,
, ,
, ,
, .

.
7.8.1.

1.

2.
3.
4.
5.
6.

PosnerSchlossman
, .. ,
, , , ..
()
Fuchs

20%
35% .

1.
2.
3.
4.
5.
6.
7.

Boeck
Heerfordt
- Behcet, Stevens- Johnson Reiter
,

( Vogt- Koyanagi)
8.
9.
10. Harada

,
20 50%
50% .
7.8.2.
1.
2.
3.
4.
5.
6.
7.
8.
9.

()

, , ,
(gyrate)



,
20% 50%
50% .
7.8.3.
1.
2.
3.
4.
5.
6.

, , ,
.

..
.
7.8.4
1.
2.
3.
4.
5.
6.
7.

( , ,
)
( , , ..)

(
,
)
,
,
,

.
7.8.5.
1.

.
.
.
.
.

.
2.
.
. (- )
.
.
.
.


50% .
80%
67% .
50%.
7.8.6.

. .
, .
.
1 /100.000/
. 100 .

.

Callender
. :
)
)
)
)
)
)

95%.

 84%.
,
.
, 75%
, .

.
.
, ,
( 30%).

50% ,
.

, .


. ,
.

. ,
,
. ,
,
.
:
: 1) 2) .

) - ,
(60Co)
, (125).
) ().
/ 106 (106Ru/106Rh)

5 . 4 .
. )
, DNA
.

,
.

 :
1) 50% , 2) ,
, 3)
4 .
7.8.7.

:

.
-

50-67%
67-80%
.
7.9.
7.9.1.


67%
80%

( Iaser)
35-40%[1 ]
40-50[1 ]
( )
67%[1 ]
67% [1 ]
( )
80%[1 ]
>80%

80%
>80%
( )
35-50%[1 ]
67%
( 1 )
67%[1 ]
>80%


).

7.9.2
.


,


.

1o ( )

.

, , .

.
25-30%
2
, 30 40 (
). ,
. .


.
. .
67%
3

, ,
. . (
) 5-10%

.

 >80%

7.9.3.
.
()
.

40-60 .

, .
.
1 ( )


. .

.
10%
2 ( )
, ,
. ,
,
.
.

.
15%-25%
.
3 ( )



,

 .
.

.
.
50%
7.9.4.

35%

()
.

25-30%

20-25%
50-67%

35-50%
67%
7.9.5.
Eales . 30-40 . .
1 : ,

25-53%

50-67%

2 : ,
< 2-4/10

35-50%

.67%

3 :

67-80%

4 :
,

>50%

>80%
.

7.9.6.
.
1.
, - ,
().
2.
(circinate maculopathy).
3.
- .
4.
.
5.
(stellate maculopathy)
.
6.

.
7.
.
8.

Berlin, .
9.
Cellophane maculopathy,
.
10.
.

.
.
1.


. .
.

 .
2.
-
. Stargardt ().
. Behr ().
. Best () .
. ,
.
. .
.

.
3.

. Sjogren.
.
(butterfly shaped pigment dystrophy).
. flavimaculatus.
. Doyne.
. - Sorsby.

.
.

, .
1.

Tay-Sachs.
2.
-
Batten- Mayou Tay-Sachs
3.

Niemann- Pick.

.
7.10.
:
)
)

)
)
)
)
)
7.10.1.
1.
2.
3.
4.
5.
6.
7.
8.
9.

Morning glory
Bergmeister

Drusen

.
.
Morning glory ( )
,
,

. ,
.
Fuchs diversion

. Bergmeister
,



( ).
7.10.2.

. ,
.

,
. .
,
, .

(evulsio nervi optici),
.


, , ,


,
.


.
7.10.3.

.

.
1.

.
2.
.
3.

, .
(
, Devic, ),
(, , , ),
(, , ,
, , )
( , , ,
, ).

,
.
,

 .
, afferent papillary defect.

. .
,
.
.
.

50-80% ,
.
15-20%.

.
7.10.4.
1.

,

. , , ,
. :
( ), ,
, .
2. Leber Leber

.

. 20-30
10-20 30-40. .


.
, .
,
,
. Leber
, .

. ,
. .
25-30% .

 .
35-50%
.
7.10.5.
1.

2.
3.
4.
5.
6.

, :
) ,
.
) Von Hippel-Lindau, Bourneville,
Recklinghausen.
) , , , ,
.
, .
.
.
.
.

.
,
.
3
, , .
30 . ,

.

. ()

.

.

.
7.10.6.

 .
.
: ) , )
)
. 55 ,
.
.

,
.
. 2-3
. ,
. -
.

.
7.10.7.

,
.
:
1. .
(1, 2, 6, 12, ).
2. .
.
3. ( , , ,
, , , , ,
)


. (cecocentral) .
.

.

.
.

7.11.
.

(trabeculum) .
,
,
.


( ) ,
.
(
),
.

.

( )
.
( )

( ) .

.
.
1 ( )
.
.
. .
...5%
.
2

. .
.
.
( ) ,

 .
.
...10-50%
.
3
.

.
.
.
.
. .
.
.50-80%
.
4
(C/D=1). .
.
( ).
.
.>80%
( )
7.12.

.
(confrontation
test) ()
(, ).
,
.
, , 90,
50, 50 60.
,

.
: 1)
, 2) 3) .
7.12.1.

 .
, , ,
.

- : 10
.. ( ),
, , ,
, .

- 30: .5%
- 30: 20%
- 10: ..10%
- 10:
...80%
7.12.3.

.
, ,
.
) (
).
, , .
30%
) (
).
(
).
35%
) (
).
( ,
)
67%
) :

). Meyer
( )
10%

(

).
.
25%

) (
).
.
.
10%
.
.
45%
:

- .67%
- ..80%
- ...50%
- ..80%

, . .
7.13.
7.13.1.

( )
( )
( ).
.
, ,
.

6 ,
.

.

 ,
.


..
.
7.13.2.
.
.
( )
( ).

, , .
.
, ,

. ( )

, .

.
5% 20%

.
.


.
1
( 5/10
). .
.
..5-20%
, .
2
5/10 2-3/10 .
.
..20-35%
.
.. .

3
1-2/10.
.
. (, )
.
..50-67%
.
..
4
.
. .
Fuchs .
.
-
.
.
....80 %
.. .
( 1/20
) .
7.13.3.

,

.
,
.
, ,
( Sturm) .
..
,
.
7.13.4.

.
1,5 ,
, 1,5
.
.

7.14.
.

,
.
,
4-7%.
.

,
. :
1.
2.
3. (
)
4.
5.

( )
.
1.
2. , ,
3.
4. amaurosis fugax
5.

, , ,
.

.
.



.
,
( )

, ,
.
7.15.
.
3
() .
(8%) (0,4%).
, ,
.

.
(),
,
Hart,
Rayleigh ( )
, .

, ,
.
.

( )
( ). .

- ..35%
, , ,
.
- ....10%
-

, , , ,
,
7.16.

7.16.1.

.
,

,
.
,
,

, .
:
:
: (concomitan)
.

. ,
(). ,

. ,



,
.
1.
2.
3.
4.
5.
6.

.
, .
.
.
,
(torticollis)
(false
projection).



Langaster-Hess screen test.

, ,
, .
..50% [1 ]
..35% ( )
.

,
,
, .

. :
1.
( )
2.

3.
,

4.
,
, ( )
5.
(, )
6.
,


,

. ,
. ,
,
.
. ,
,

.
...25%
,
.
.

 .
, ,

. , .
:
1. (superior oblique sheath syndrome
Browhs syndrome).
2. Duane (Duanes retraction syndrome)
-
.

Duane
.

,
.
,
Brown
,
.

.
7.16.2.
.
:
1. :
.
2. :
.

)
)
)

) -
) -
()
67%
) -
...35-50%

)

)
...67%
7.16.3.
.
,
, ( )
.

.

- ..50-60%{ 1 }
- 25-50%{ 1 }
7.16.4.

,
.
.

.

.50-67%{1 }

( )
7.17.

.

,

()

 .
.
Snellen

( )
.
(6 ).
Monoyer
10
10 1. 10/10
6/6 20/20 Snellen, 1/10 6/60 20/200
Snellen. 1/10 1/20, 1/30, 1/40
.

Snellen

6/6
20/20
6/9
20/30
6/12
20/40
6/18
20/60
6/24
20/80
6/60
20/200

10/10
7/10
5/10
3/10
2,5/10
1/10

100,0
91,4
83,6
69,9
58,5
20,0

0,0
8,6
16,4
30,1
41,5
80,0

.
,
, ,

.


.

.. .
(, , )

. ,
,
, ,

. ..

 4 0 7 0
4 7
. ,
,
(!).
.
,

,
.

.
) : ,
,
.
.
.
.
) :
.
+7,00
0,50 . .


.
,
.

. ,

( )
.
,
.


,

. ,

( ,
(!).

 ( , ,
) ,
.
, , , .
. (1954),
,

. .
.
, ,
1/20 .

1/20.
( )
.

10-5/10
4/10
3/10
2/10
1-2/10
1/10
1/20
1/20
0
10-5/10
0
5
10
10
15
20
25
25
25
4/10
5
10
15
15
20
20
30
30
35
3/10
10
15
20
30
35
35
40
45
45
2/10
10
15
30
30
35
40
45
50
55
1-2/10
15
20
35
35
45
50
55
60
60
1/10
20
20
35
40
50
60
70
85
85
1/20
25
30
40
45
55
70
85
90
95

1/20
25
30
45
50
60
85
90
95
100
0
25
35
45
55
60
85
95
100
100
: .

8.
8.1.
.
Pb.
.
1



Pb <40 mg/100ml, -ALA 0,6 mg/100ml

 ,
.
.
20%
2

, .

Pb 40-80 mg/100ml, -ALA 0,2 mg/100ml.
( b)

,
(3 ) .
20-50% [3 ]
3

, , .

Pb 80-120 mg/100ml, -ALA 2-4 mg/100ml.

.
EDTA .
50-67% [1-2 ]
4

, , , , , , ,
, .

Pb 120 mg/100ml, -ALA > 4 mg/100ml.

.
.
67% [2-3 ]
8.2.
.

.
.

1

, .
, .

Hg .


.
......... 35% [3 ]
2

, , , , ,
, . ,
. , . ,
. .

Hg . .

. BAL EDTA.
50% [1-3 ]
8.3.
.

, , ,
,
.
.
1

, , , .

. <10mg/L.

.
. 20%
2

, ,


. >10mg/L

,
20-50% {1 }
3
60%.

2_ 200-499 mg/L.

50-67% {2 }
4
, , .

500-999% mg/L.

.
.67% { 2 }
8.4.
.

, .
.
1

,
().

.

, .
2

, , , , , .

 - ,
(). .

. .
BAL EDTA.
.50-80% {1-3 }
8.5

.

.
.
1

EDTA.
. 20% {6 }
2

, , , .

.
8.6.
.

, ,
, .
.
1

, , , ,
.

. .

 .20-50% {1-2 }
2

, , , ,
.

.
.50-80% {1-3 }
8.7.
.

(AsH3, As).
.
1

, , , .

, .

.
...0-20%
2

, , , , , ,
, .

,

.
...20-67% {1-2 }
3
, . .
;

, ,
.
...67% {2-3 }

8.8. ,
.

.
.
1

, , , .

.
....0-50% {1 }
2

, ,
.

.
....67% {2 }
8.9.
.

. clearence
, .
.
.
1

,
, . , , ,
.

.
......35% {6 }

2

, ,
.

.
.....35-50% {1-2 }
3

.

, .
.....67-80% {2-3 }
8.10.
.

, .
(, ).
(, ,
, ), ,
.
.
1


.
.....
2
,
.


.
......20-50%
3
. ,
.

. .

 ......67-80%
8.11.

.

.
.
.
.
1
. , , ,
.

. .
.....
2
. , , , , ,
, , .

.
.....
3
, .
.

.
......50-67%
8.12.

.

, , , ,
(
). , ,
, , , , .
.

1
, , .

.
.
......5-20%
2
, , .

.
( )35-67%
8.13.

.
(CO)
.
.
CO .
CO
.
.
1
, , .


CO.
.
2
, , , , .
..
3
.

, .
..
4
( ),
.


.
......50-67%
8.14.

.
, , ,
, , ( ), .
. .
( , ,
).
.
1
, , , ,
.


.
...10-50% { 6 -1 }
2
. .

.
.....50-67% { 1-2 }
3
, .
...80%
8.15.

(, ,
)

.


, .
.
,
.
,
. .

 DNA .
.

.
.
1

.
...0-35%
, .
2
, .
....67-80%
8.16.

(, )

.
,
, ,
. (V, VI,
VIII, IX XII) V .
, .
.
.
1
, , .
..
2
.
.....35-50% {1 }

8.17.
.
: )
. )
. ) .


.
, , .
.
.
.
.


.
, .
.
.
.
1
, , , .
...... 35%
2
. .
......35-50%
3
, , .
......67-80%
8.18.
.
,
.
.
, , , .
.

.
.
1
, , (
).
..

2
.
......50-80%
8.19.
.
, , ,
, , , , , , ,
, , .

. 18 .
.
, , ,
(, , , ).
, , .
.
1
, , , , .
..
2
, , .
...35-50% {1-2 }
3
, .
...50-67%
8.20.
.
.
.
.
.
1
. , .
..

2
(, )
...50-80%
8.21. -- -

.
.
(
).
- - , ,
, . ,
, , . ,
, .
. ,
Heinz.
.
1
, , , , .
..
2
, , .
...50-67% {6 -1 }
8.22.
.
.
.
,
. ,
.
2,4- .
,
. , , ,
.
. ,
.
,
.

.
1
, , , .
..
2
. ( ).
...35-50% {1 }
8.23.
.
. .
, , .
) , ) ) .
.
1
.
.

.
.
....50-67% {6 -1 }
2


, .
...50-80% {1 }
8.24. -
.
Leptospira interrogans.
. , ,
, . .
, , , ,
. .
.
1

, , .

, , .

.
2
, , , .

, .
...50-67% {6 1 }
8.25.
.
. .
, .
.
.
.
1
.
,
.


.
..
8.26.
.
Ankylostoma duodenale Necator
americanis. .
8.27.
.
,
.
: )
)

 10 )
5.500 .

.

.
,
.
.
1
.
..
2
, , , , .
.

.
..50% {6 -1 }
3

...67-80%
8.28.
.

.
,
.
, ,
.
. :
, ,
.
.
1
.
..

2
.
.
...35-50% {6 -1 }
8.29.
.


. 2506000/min. , , .

, Raynaud
(white finger), ,
Dupuytren, ,
, .
.
1
Raynaud.
.
...35-50% {1 }

2
.
( ) .
...67-80%
8.30. -
.

. ,

, .
.
40 DB
1000, 2000 3000 z.
4000 z,
,
.

.. .

8.31.
.
,
.
.
.
,
.

,
,
, .

..
.
8.32. ,
.


.
,
. ,
.
, , ,
, , , .

..
.
8.33.
.
..
, ..
,
, .
.
.
.

1
.
...35-50% {1 }
2
.
...67% {1 }
8.34.
.
,
.. , .

.. (.
).
8.35.
.

8
10 m2 .
,

,
.

.

.

. ,
, ,
,
.
ILO
.
/ I L O
1)

1,5 mm

q
r

t
u

1,5-3 mm
3-10 mm

2) ( ).
12

0
0/-,0/0,0/1

1
1/0,1/1,1/2

2
2/1,2/2,2/3

3
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.
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52%
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46%
44%
38%
36%
35%
28%
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55%
53%
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--

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.
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52%
52%
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. .65% 52%


. .






1

10%
15%
5%
3%
3%
2%
15%
10%
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7%
12%
4%
2%
2%
2%
12%
7%
6%

5%
5%

4%
4%

. .

23%
29%
34%
33%
39%

19%
23%
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27%
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. .

21%
25%
28%
31%
35%

17%
21%
23%
25%
29%

21%
23%
26%
31%
33%

17%
19%
21%
25%
27%

. .

20%
23%
25%
30%
33%

17%
19%
21%
25%
27%

10%
14%
17%
16%
20%
23%
21%
25%

8%
12%
14%
12%
16%
18%
17%
21%

10%
12%
15%
16%
18%
21%
21%
23%

8%
10%
12%
12%
14%
16%
17%
19%

9%
12%
14%
15%
18%
20%
20%
23%

8%
10%
12%
12%
14%
16%
17%
19%

8%
10%

6%
8%

13%
12%
14%
17%
15%
17%

10%
10%
12%
14%
12%
14%

7%
10%
12%
11%
14%
16%
14%
17%

6%
8%
10%
10%
12%
14%
12%
14%

7%
10%
12%
9%
12%
14%
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6%
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10%
8%
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12%
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.
,
. .
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,
,
,
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,
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,
,
,

27%
31%
34%
33%
37%
40%
38%
42%
45%
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41%
44%
43%
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22%
26%
28%
26%
30%
32%
31%
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37%
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52%

43%

,
,
,
,
,
,

,
,
,
,
,
,
,
,
,

,
,
,

25%
27%
30%
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31%

20%
22%
24%
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34%
32%
34%
37%
35%
37%
40%
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41%

28%
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30
28%
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32%
32%
34%

44%
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36%
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24%
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20%
22%
24%
24%
26%
28%
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30%
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32%
32%
34%
36%
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36%

,
24%
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,
29%

20%
22%

,
,
,
,
,
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,
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,

24%

,
,
,
,
,
,
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,
,

,
,
,

26%

22%

29%

24%

31%
29%
32%
34%
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26%
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28%
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32%
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41%
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26%
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35%

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38%
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43%
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45%

30%
31%
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48%
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38%
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26%
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30%

,
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37%
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31%
33%
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14%
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26%
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11%
13%
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29%
27%
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32%
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31%
34%
32%
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23%
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26%
28%
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28%

13%
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20%
18%
21%
23%
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22%
24%
21%
24%

17%
15%
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26%
24%
27%
29%
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27%
29%
26%
29%
31%
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21%
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23%
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26%
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32%

26%

13%
16%
18%
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20%
23%
25%
19%
22%
24%
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26%
28%
26%
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31%
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31%

11%
13%
15%
15%
17%
19%
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21%
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25%
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26%

,
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33%

28%

31%

26%

34%

28%

11%
14%
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9%
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22%
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26%

19%
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31%
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25%
27%

36%
35%

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37%

31%

40%

33%

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56%
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56%

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54%

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58%

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60%

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17%
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22%
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28%

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36%

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39%

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31%

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