OfSapn a ,LercrytLa 37
Transcription
OfSapn a ,LercrytLa 37
OfSapna ,LercrytLa /20/2 37 4. MarcoarcuuB. h. HeilpouuptqaaropHae aucrouns // Tep. apxuB. | 995; 67 (6): 66-70. 5. Aeonrrcea h. B. xaeroquoil SHeprerhKw nph naroAoruu MnoKapaa. IlpuueHeHue L-rcapuuruua: noco6ue a+t epaueil. M.: MEA1PAKTI4M-M, 2009. 52 c. 6. Aa6aaoB H. n., I-l^arouoea T. H., Crcopoueu A. I'1. Koprerccuua ueilponu,t4arpur4: Meroa. peKoMeHAarJhu.Cl-16.,2008. 72 c7. Cepeda lO. 8., Aa6aaoe H. 11.HeilpouhpKy tropHatr auc$yuxunn // Aercxue 6oaeeuu / H. l-1. Itta6a^oa. CI-16.: 11urep, 2002. C. 5 I 8-544. 8. Aeopeurcuil A. 14. CouaroSopunarc paccrpoilcrBa B npaKrhKe repaneBra // pUX. 2002; 19 (10): | 67-t 71 . 9. 3uuaxoe A. lO., Kapnoa A. M. KtunuLrecKa, o uen rca'i$ Se Kru BHo c-ru n c uxofi apu arcorep ann u 6oat Hbrx c couaro$opMHbtMu paccrpoilcraauu [3tercrpounuil pecypcl. Pe>rcuu aocr)/na: www.consiliummedicum.com. 10. flotrcopHroe B. C., CepurcoeaO- h. Couaro$opuuue paccrpoficraa // Medicus Amicus. 2002; 1. ll. Eepesanuea A. lO. I-lcuxocouaruKa u coMaro$opuu ue pactrpoilcraa. M. : t4u$opu. Texuoaoruu, 2 0 0 1 . 1 9 1c . 12. 9epuyct H. fl., Uaruxun A. h. Cundpou fuyurcuuoHaAbHohacreHuu a o6uerepanearuqecxoi npaKTu- tot4 cv|tllCHTlo n nu6o :epaua/ )MOCTb/ b. )onHbrx )KC]4nU lHocT.4l lbrxop)enaparaypvlHl )9pbrrxro KpoTO9HUfl fHKUn|"{ lepBa>/ qacTocnephtit nona (no nu 34 EAbHO)fo/ aH- rce.Tpyauocru auarHocruKh u repanuu//Tpya. nauuenr. 2009: 6-7. 13. Bopo6rcea O. B. f]cnxoBereraruBHbril cuuApoM/ accoLtuupoeauuutZ c rpeaoroil (aonpocu auaruoc-ruKryh repannu) // PMX( 2006; 23 (14): 1696-1699. 14. Bopo6teaa O. 8., Ps6orcout h. B. Crpecc u aHrhc-rpeccoBae'repanue// Aeq. apau. 201| ; 5: 85-89. 15. Eby G. A., Eby K. L. Magnesium for treatmentresistant depression: a review and hypothesis // Med. Hypotheses. 201 0; 74 (4): 649-660. 16. ArcapauxoaaE. C. Oueuxa eSSeK-ruaHocrhnpuMeHeHheMarue 86 y nauueuroB c KAt4Hu.tecKhMh npoeBAeHuzMucrpecca // MeahiJhHa.201 0; 6 (99): 93-98. 17. Kannnuua A. 8., Eeu6eeaa P U. Koprerccuu e aercrcoi HeBpotoruLrecrcoilnpaxrurce // Consilium Medicum. 201 0; 9 (12): 10l-l 05. 18. Ceueurcuu A. A., Astnxona E. A. Apyrc h. B. n ap. [acrpouHTecrhHaubHHenpozBteHhq y Auu c ahcnaasneil coeat4HureAbuoilrxauu, accouttt4poBaHHbre c ct4HApoMoMBererarhBHoil duc$yurcuuu // Aeu. apau. 201 | ; 4 ptexrponnuil pecypcl. Pe>ruuaocryna: www. lvrach.ru. 19. fopuaxoaa H. A. llpuueueuue Kparata B KoMnaexcuoil Tepanuh 6oatuux uweMhqecKoh 6oaesntn cepnua u nefrpounprcytnropuoy'raucrouueil // 3doponae )KeHutuHbt. 2001; 2 (6): 94-96. l-focrynzna14.05.2012 SACTBA. Soprfl npeCTUE B a 3MO- Suznoo:6yxlrrusoi a a a pouec.B TOM AATHAfl pmHoX rHi ee)B/ )Kelhcrof cnhpa- r$opuy aereil .69 c. ,pnwoapocr,IKA-M, , Aeqeba. un- l a a a a a a a a a a a a a a a a a a a o a a a a a a a a a a a a a t a a a a t a a a a a a a a a o a a a a a a a o a a a a a a ' flpeacraenenu Kprrepvt onpeaeneHhqaharHo3a Hapy' fh" criteria for diagnosis of carbohydrate metabolic uenrfi yrneeoanoroo6uena, a raKxe Meroabrat4arHocrnKn'. . imbalance, also methods oTdiagnosticsare sho*n. aout40rneqeecKofo r HepB- KtttoqeaHecAoBa: Bpaq o6ureX nparrurr, opfaH',/.3aw4'. At4tlt4Hat 3apaBooxpaHeHhr. a a a a a a a a a a a o a a a o a a a a a a a o ceueiuar ue- . Key words: diabetes mellitus, peroral test for glucose . tolerance. a a a a a a a a a a a a a a a a a a a a a a a a a o a a a a a a a a a a Caxapnuil tnader (CA) - rpynna uera6onuf1o aauHurv MexayHapoaaoil tua6errqecro[ qecKhx (o6veHnux) sa6oneeaHzi, xaparrepu3ytona$eaepaurar(lDF),qrcno 3aperhcrphpoBaHHblx rrnxcfl xpoHhqecKoh runeprnnxeuueh, o6ycnoeneH- uheHroBc CA e 2O1Or. aocrhrno285 vnH qeAoBeK/ t{TO COCTaBnteT 7 o/oHaCeneHht nnaHeTbt B BO3paCTe HoZ a6conorH*M AAuorHochrenbHuvaeSuurrou vlHCyAUHa C pa3B4Tvler'a auc$yHrcuhi xhgHeHuo or 20 ao 79 ner K 2030 r. npeanonaraercryBe^hB€DKHbrx opraHoBt4 cucrew. CaxapHsri tna6er se- qeHheqhcna6onuHsrxao 435 MAH.v3 nux BO-95o/o nrercr oAHt4Mus uau6onee pacnpocrpaHeHHbrx npnxolrrcn Ha CA 2 tuna. B ceszu c upeaeuvaiqecKhx aa6oneeaFr xpo H14 uil ennorcpuH Ho i cr creu u, Hoi gHa.{zvocrbloCA no vH}4ltuaruBeIDF ra npra frpeacTaBArer cepbe3Hyo MeahKo-couhzl^bHylo npo- noaaep)KKeMilpoBoi o6utecraenFtocrl4B aera6pe 6nert.ly3a cqer cHVxeHz,AKaqecrBaxiz.3Hvlta rapKe 2006 r. na 61-il ceccvu feHepanuHoitAccau6nen paHHeZlz.HBatuat43alturt4 eucoroi neranbHocrh B OOH 6srnafrBep)<aeHape3onlouhr 61/225 o CA, cB93t4 C pa3BhTileM ]4nporpecchpoBaHheM no3aHl4x B Koropoi nph3Haercrcepbe3HaronacHocrb aaH(xpoHzvecrnx) ocnoxnenuil. Ha SoHe CA e 2-3 HOrOga6oneBaHn'tcBt3aHHoroc Tr)KenbtMh ocnoxpa3a yBenhqhaaercscMeprHocrb,e 2 paza - phcK HeHueMt4 | noaqepKhBaercs Heo6xoal4Mocrbpa3papasBnrte huleMzqecKoil 6onezuu cepaua (146C)n 6orrcn u pa3B|4Tn9 HauhoHanbHbtx nporpaMM ero rH$aprra MzoKapaa,17 paz- narotorrlt4nover, 20 npoSznarcrlxvi t4 neveHhe 15-71.B Hauef crpaHe pa3 - raHrpeHbtHhxHl4xKoHeqHocreZ, 6oneeqeM B c 2OO9 r. ae[creyer 3aroH Pecny6nurcuSenapycu paaa 3 aprephalbHo/ rrneprenshz (Af). CA crorar or 07.O7.2009r. Na 39-3 (O paru$rraun)4 cortaHa nepBoMMecrecpeah npueuHcnenorsr[1-5]. ueHhr o coTpyaHhr{ecTBe focyaapcTB- yqacrHr4KoB Caueiumi lorcfiap / (/)/20/ 2 38 Coapyxecrea HegaeNczvsrxlocya,apcrBs 6ops6e c pocroM :a6oneeaevocrr,lcaxapHsrv Lz a6ero,r.l,. Ktaccufinxaunn caxapHorotua6era. B 1999 r. Kovzrerov gKcneproBBO3 npraHrra 3rhonorhqecKar rnaccz$rrauraq CA v apyrvx HapyueHri rAL4KeMVnt fae Bbtaenrtorcs 4 rcnuauqecxrxrnna CA (ra6n..l) [1]. Ktnnn,recxas KaprHHa.flprz CA 1 tuna o6ur.{Ho zMeercqrpKar cLiMnroMaru<a:o6unanoeMoqeucnycKalze (ao 3-5 n s cyrrcz), o6ycnosneHuoe r roKo3yphet; )KDKAa(KaK cneacrBfie noreph xhAKOCTl,lBCneaCTBVe no{|/'Ypvlv, a TaK)<e3a CqeT Thnepmr4KeMhu); cnuxeuhe rlaccbt rena (:a Mecru 2-6 <r) nph coxpaHeHHo,\4B Haqane :a6oneeauhr annerhre (Heso:voxuocru yrt4N43auth moKo3br KAerKaMr4/ norepr rnoKo3bt c vovoi); 6ucrpar yroMnreMocrb 14cHl4)KeHrepa6orocnoco6Hocrr (a cBfr3Ltc le$zurrov o6paaoaaHzs iHeprlnt rnzKoF e H ah 6 e n x a e v u u u a x ) . C A 1 r r a n aq a u e p a 3 B Z B a ercr y Leren v Monoabtxnoa,erZ[2, 4,71. Ta6nuua 1 UHCyAUHOBafl HeaOCTa- CaxapuurrZ tua6et 2 runa fecraunoHuurrZ caxapHbrt tua6er c vHcy/'V1ope3hcreHT- Bo:Hzraer Bo BpeMr 6epeveHHocl,r flpz CA 2 ttna KAVHtAqecKr4e nporBneH he pa3- hEC, uesponorhL{ecKar cr4MnroMarrxa. CaxapHsli Bula:r :_rcn6onee MeaneHHo. H ar6onee xapaKrepH br: l..na6e:r 2 runa qaue pa3BVBaercry nzu crapuLe30. KoxHbte nporBneHhr - xoxlrsrI aya (y xeH_ 40 ne1 oaHaKoMoxer BbtrBnerbcru y z;eteit(vaule turfH B o6naclrvt eynsau), KcaHToMaro3, nvlnoua+ttil npn ut6uro.lHoi vacce reta vll4 oxupenuu) 12-61. Herpo6ro: ((nhfMeHTHat ro^eHb)>), nuote}uvtu, npu tpyrux cneur$zqecKux runax CA (vur oHl,1xoM14KO3bt; qaue Ha3btBaeM ero chMnroMarilqecKhM CA) rnrz_ . co cTopoHbt opraHa 3peHt4fl- KOHbIOHKTh_ HilL{eCKar KapThHa 3aBVCt4TOT fraTOfeHeTr{qecKZX Bl,tTbl/KepaThTbr/HafHoeHVfl BOAOCgHbtx AyKoBl4UB oco6eHHocreil pazentut sa6oneeaHkln.Tar, nor o6nactu BeK/ cHhxeHze ocrporbr 3peHhr 3a cqer HahJ4Ll4L4 n a HKpearv ra/ TpaBM n oaxenyaor{ Ho i xe_ aapyuenuh aKKoMoaauzh, pa3Burne KarapaKrbl ne3bl/ naHKpear3KToMl414Heontalz'v r ap. sa6one_ | UAV peThHonaThv I rnayKoMbt; eaHui1 3 K3o Kp14HHo il u act u n ooKenyaoq Ho i xeneg ul . co cropoHbt nonocrl4 pra - nporpeccilpyto_ BoBneKaercr B naronoruqecxuil npouecc il 3HAo_ uhn Kapt4ec,anbBeontpHaq ril,{operI rtAHrhBVT,naKphHHa9ee qacrb/ B pe3ynbTarepa3BVBaeTCr xpo_ paaoHro3; HZqecKar rhnepFnilKevzs (xaxaa I notzyptlut cHt4_ . co cropoHbl KocrHoZ czcrevsr _ ocreone_ xeHze Maccbt rena ,.1ap.), rpe6yrouar Ha3HaqeHZq au\ecrcuf4 chHApoM nnu SopuupoBaHhe ocreoapcaxapocHh)Kaouei Tepanvh. ha nerapcrBeHHbtx rpona-tut4 (cycrae [IJapxo); cpelcrB cnoco6crey ar p a3Bv1r t+o rh neprn h KeM,u,,z . rroaBep)KeHHocrbpa3nhqHbrMzH$eruzou_ rnoKoKoprz Kol4abrvt HuKortlHoBar Kzcnora (Hapy_ HblM/ BocflanilTenbHbtMu rpu6xoer;r,r.r:a6oneeaHz ulaor ae[crBve hHCyhvHa), o- r Hrep$epoH (coaei rv ($ypyHxyne3, KaHAzaaMVKo3, yporeHilranbHbte crByer o6paeosaHzto aHTZTenK ocrpoBKoBbrMKnerun$e<w,v, ry6epxynes h Ap.); ra,ra),rzpeor4aHbteropMoHbl/ B-aapeno6noKaropbt, . HapyueHt e noreHuzv y Myxet4T H Hapyue_ Tza3ilAoBble awyperhKw| aza3oKct4a(cHrxaor ce_ Hhr MeHcTpyanbHofouhKna y )KeHuilH. Kpeuho hHcynuua). flpn ux Ha3HaqeHhr,t y nauheHY nauzeHroe c CA 2 tuna e BO-90 oh cnyua- ro B r-lenecoo6pasuo KoHrponr.ipo Barb ypo BeHb rntoeB hMelorcr o)KhpeHhe nnu uz6sto.lFtsli eec, Af, Ko3brB KpoBr4(2-4 paza e rot) 12,4, 71. U2 iuar!,4.- cru Ht49 ,KO- pat H(B tKotBa- :TaIHT- tbtil 30lue _61. (vur 6nKUX npu )Ke)nee3bl laotpo:HVH]49 HbIX AAVl rpyiei\eTrpbl/ ceteHnlo- 2bSagna ,LerclrLa B rpynny recrauhoHHor-o caxapHoro ara6era BXoagTBce HapyueHhr yrneBoanoro o6veHa/ Bo3Hr4KrxheBnepBbreBo BpeMe 6epeveHHocrr. llocne poaopa3 peueH ilr KoHrpo^h pyercr ypoBeHb rnloKo3br B KpoBLtLtepe3 6 Heaenu, 6 n 12 MecrueB/ TaK KaK AaHHbre)KeHUhHbtoTHoctTcr K rpynne phcKa no pa3B'l'rtlro CA 2 runa u apyrvlM npoqBneHhrM Aaera6onh.recKor-o chHApoua [2, 4, 8,9). Anarnocrnxa c.rxapHoro daa6era. AzarHos CA BbrcTaBn9eTcrHa ocHoBaHun KAUHAqeCKhX nporBnenuil (rveorcr He eceraa), aaHHbtxaHavue:a (cerveZHag orq roueH Hocrb/ recrau uouuHil caxapu sri *ta6et Bo BpeMr 6epeueHHocril/ noBbmeHheypoBHr rnoKo3u B KpoBz Ha $oHe crpeccoBbtxcnryauuit vt tp.) u pe3y braroB na6oparopHbtx r4ccneaosaHvlil. MeroAu noArBep)raenus dnarnosa CA : . onpeaeneHze ypoBHe r oKo3bt B KpoBH rrpoM HaTouIaK; . onpeaeneHhe ypoBHq rnloKo3btnpx cnyvaiHoM r4ccneaolaHnv e no6oe BpeMfl cfroK BHe 3aBttct4Mocrv or BpeMeH/ npileMa nrurr (nocrnpaHahanbHoe rccneaosaHue); . npoBeaeHhe flepopanbHoro TecTa ronepaHrHocrh K rntoKo3e(flTTl-); . onpeaeneHHe ypoBHr mhKhpoBaHHoro fe, v t o r n o 6 z H aH b A , c 1 1 , 2 , 4 , 1 r 1 ) . ltnxeuns HarorrlaK n npu crtyuailnou onpeaeAeHnu e tn6oe BpeMn c/ToK. B reveHhe nocneaHux aecgTntert"lZ orMe.{aercr y)KecroqeHHe KphrepileB AharHocturu CA, vro o6ycnoBneHo BbtcoKhM pl4cKoM HaNt\iv* ocAo)KHeHh h npn ycraHoBneHh ta al4arH03a. Hopuattnoe coaepxeHue rlK)Kosbt B KpoBH .reAOBeKa: SAO?OBOTO . yrpoM HarorrraK (orcyrcraue npheMa nilulh He MeHee B vacoa, Ho He 6onee 14 qacoe) - 3r55rS uuortt/tt npz:a6ope KpoBl4h3 nanbua (uenuHaq KanLlnnepHar rpoas) u 410-6rl uuorch npu za6ope KpoBl4r43BeHbt(nnaava eeHogHofir<poera); . nph aa6ope KpoBh s nn6oe BpeMt cyrox (cnyuailHoe onpeaeneHre) - to 7,8 *t*tortt/rt (c 2003 r. to 7,5) (He aaercrr or sa6opa KpoBh r43 nanbua rnr seHsr). flpz yposHe rnoKo3u B KpoBl,tfrpoM HarouaK 6onee 6rl uuo'tt/tt B KanilAnspHoi rpoar unu 6onee 7r0 wUtO'tt/rtB nna3MeeeuosHo[ KpoBh (onpeaeneHze He MeHee 2 paz) npv HaAVv;AhKAhHl4L{ecKoicrunroMarnKV BbrcraBruercr a/arHo3 CA. CornacHo coBpeMeHHbrMAaHHbrM/ 6onuuee avafHocrttqecKoe 3HaqeHhe hMeeT onpeaeneHile ypoBHr r^|oKo3btB KpOBt4 nauheHTa s nto6oe npeun cytox (sae 3alncvlMocru or BpeMeHhnp/eMa nhutul - cnyvainoe onpeaeneure). (onpeaeflpra ypoene rnroKo3bt6onee llrl unont/l neHhe He MeHee 2 paz) vt HaNAL1t4v KlhHt4qecKoil cuunroMarzKl4 BbrcraBnrercrararHo3 CA 12,4, 1l l. (ne Meaee 2 paz) ypoEca,n ueo.tnoxparno BCHb TANKCMHH B TC'TCHUC CYIOK NPCBbIWACT 39 llrl uuo'tr/rt m6o ypou Harouerc npeBbrrilaet 7r0 uuott/n (s ntasue xponu) atu 6rl uuoas/n (s ue,rtnofi xannttnpuoil xposn), anarHos CA se BbrgbrBaercouueuufr. I1epoparcnuil recr ronepaHrHocrt4K rnoKo3e ffpoBo^hTcr anr yfoqHeH|./'flHa\utl]4r h xapaKTepa Hapyureuri yrneBoaHor-o o6vesa - CA, uapyuleurr ronepaHrHocrh K rnroKoee(HTf) v Hapyuelufl rtvlKeMtz'n HarouaK (HfT). TonepaurHocrbK rntoKo3e Mo)KerBpeMeHHo cHh)Karbcsnph nol{eqHoi ueaocraroqHocrt4| uuppo3eneqeHH/ ran$aprre MhoKapaa/ cencilce h ap. Iloxasauan K npoBeaeHnrc nepopitAbHoro recra ToAepaHTHocrH K rAtuKOSe: . ypoBeHbrnoKo3btB KpoBl4yTpoM HaTOUaK B npeaenaxor 5,5 to 6,1 vr'lonu/n(uensHaqKanhlArpHar xpoet), utru . ypoBeHbrnoKo3btB KpoBt4yrpoM HaTouaK B npeaenaxot 6,1 no 7,0 uvonu/n (nnaeua BeHo3Hoi rpoeu), ufunu . ypoBeHb rntoKo3btB KpoBt4 npu cnyuaitHoMonpeaeteHvlvle no6oe BpeMr cfroK ot 7,8 to 11,1 vvons/n (a nnaaver<poera); . Hatt4que $arropoe phcKa CA npr,r orcyrcrBuv nph3HaKoBsa6oneeauhr(eospacr crapue 35 ne1 hs6Hro,lnaqMaccareta vAVoxu penre, Al , V1EC,ducnunuaeMzfltnoaarpa u tp); . HapyueHheMeHcTpyanbHoro uLlKAay xeHuwlHt4cHhxeHhenonosoi noreHuht4y uyxuua 12, 4, 7, 111. I7porusonoKasaHue ats npoBeaeHnfl IITTF: . ypoBeHbr-noKo3bt B KpoBhrrpoM HaToluaK 6onee 6,'l vr'aons/n(uensHaqKanilAlepHanrcposs) nr,r6o6onee 7,O uuonsfn (nnasva eeHoEHoilrcpoeN) 'l ufunu6onee 1,1 vvons/n npucnyuailHoMonpeaeAeHuve n06oe BpeMrcyroK; . HeoTno)KHbtecocTogH4flt TpaBMbt/ OCTpbte aa6oneeaHrr, gKcrpeHHbrexhpypruqecKhe BMeuJaTenbcTBa; . KpaTKoBperveuHurz npzeM neKapcTBeHHbtx cpeacrB/ noBbruaouhx ypoBeHb r^loKo3brB KpOBh (rnororoprr KorAu / TLIa3ilao Bbte tuy pe:'uru, 6eraaapeHo6noraropbt/ l,ipeohaHbte ropMoHbt u npj [2, 4,7,111. Metoa,uxa npoBeaeHnflnTTf Tecr npoeoarrcr Ha $oHe o6uquoro aBVrarenbHoroh nilueBoro pexhMa. O6cneayer.,rurrZ e reqenre 3 anei ao npoBeAeHutrecra HeAoDKeHMeHtrb nuweeoil poKhM (rconrvecrsoyrneBoaoBB noBceaHeBHoM pauhoHe AoDKHo6urru ne MeHee150 r) u $uzuuecryto aKrr4BHocrb.HaraHyHenpoBeaeHhrrecra nauheHTy Henb3rnorpe6nrru nhuy no3ar-ree 20 vacoe (He MeHee 12 ,aacoeronoaa/ aonycruMo nrru eoay). HaqanonpoBeaeHhrllTTf - B-1'1.{acoeyrpa. f1epea nepBbrMra6opov KpoBr4o6cneayeuovy Heo6xoaHMocnoroxHo nochaeTbB TeqeHhe30 ,raznyr. Kpoas za6upaetct HarouaK h qepe3 2 ,aaca.no- 40 Ce-uartuui )oxnop / (/)/20/ 2 cne nepBoro :a6opa KpoBh B reqeHhe 5 vraHyr o6_ cneayeMbuzeepocnui BbtnhBaer 25 r rntorosur (nr B3pocnbrx/peKoMeHAauuuBO3), pacreopeHuoi a 250-300 Mn Boabt (aenz _ 1,75 r Ha I r<r Maccbl rena/ Ho He 6onee 25 r). flosropHsri :a6op KpoBl,l ocyuecrBlqercr r{epe3 2 qaca. B nepzoa rpoBe_ aeHuq llTTf nauzeHr He aon)KeHKyphrb, aKrhBHo aBurarbcr. [1prz oueure pe3ynbraroB cneayer yqh_ TbrBarb npheM neKapcrBeHHbrxcpeacrs, cnoco6_ Hbtx oKa3btBaTb BnhrHhe Ha cocTorH,4e yrneBoaHo_ r o o 6 v e H a[ 2 , 4 , 6 , 1 0 ] . ZHrepnperauileaaHHbtxflTTl c 75 r rnoKosu npelcraBneHae ta6n. 2. Ta6nuua2 Kpnrepnu tnarHocruKu ctxapHoro tnafuera^u dpyrux ***p, recra rotepaHrHocrH K rArcKo3e(BOg, lggg) Bpeva uccAeLOBaHUfl KouueHr rn Ko3bl/ MMona/n (ur / an) uenbHar K nna3Ma Haroutar 9epe: 2 ,lacanocneflTTf < 6 , 1( < 1 1 0 ) < g,g (< 160) Haroulax 9epe: 2 .racanocne flTTf Haroutar Llepe: 2 qaca nocne flTTf 9eper 2 qaca nocne flTTf flpnueuauue. Anr nepecvera gHa.leuzi rnloKo3blB KpoBh: vvonsA x 18,O2 = MI/AA; urfdn x 0,055.1 = uuont/n. Pe:ynsraru nTTt Koraa ypoBeHb rntoKo3br B KpoBh yrpoM HarouaK MeHee 6rl uuortt/n (uens_ Hae KanzttepHar rpoeu) znh MeHee 7rO uuont/,t (nna:va eeHognoi rcpoez) u qep* 2 qaca nocne npoBeaeHxr flTTl- c 25 r rno<osbt paBeH unu 6o_ nee 7r8 uuortt/,t, Ho MeHee llrl uuorts,/a, pacue_ KaK HapyueHhe ro\epaHrHocrT K rlnKo"r?,u.3T" 3e (HTt-). l-lprz ypoene rntoKo3br B KpoBtz yrpoM Ha_ rouaK/ paBHoM unu 6onee 516 uuontf Ho Me_ Hee 6rf uuottt/a (uensHas ounrnn"p"rr <poss) nz6o paeHoM t4ut46onee 6rl uuottt/rt, Ho MeHee 7r0 uuortt/rt (nna:va eeHogFto, rpoera), t4 qepes 2 ,raca nocne npoBeaeHhq l-lTTlc 25 r rnoKogur MeHee 7r8 uuortt/,t BbtcTaB^rerc fl a,.ar{o3 HapyueHue TAHKSMHU HarorrraK (HlH). B Hacroquee BpeM, HapyueHhe ronepaHrHo_ cTu K rnloKo3e n HapyueH4e fuhKeMr4tl HaTOUaK pacueHuBatoTcr KaK unpeAaza6err. flaurestsl c HTf u HIT voryr vMerb HopMornr4KeMho B reqe_ Hne AHe14HopManbHath unu 6nuzxult K HeMy HbA, c [4, 12]. Vlcxots 1,13 3roro aaHHbte cocroflHvte qacro He AharHocrupyloTc, A flBuurorcg KKa-rerop'/€n pu_ cKa> Anr pa3Bhrt4z KAZHhqecKoit ctatuu CA,2 tuna h cepAeLfHo-cocyal,tcrbtx:a6oneeaunil. Taxuu na_ uheHTaM peKoMeHAyeTCgt4cK/\(jt.l{Tb 143pauhoHa pa$uuupoeaHHbte yrneBoabt (sce npoayr<rbt nhra_ Ht4st colepxauze caxap), npvHaMarb nuwy 5_6 pa3 B cyrKt4 (3 ocHoeHsrxnpueMa,2_3 neper<yca)c MeHbuJhMKan^opaKeM B BeqepHee BpeMr/ a TaoKe yBexuqhrb $zsrzvecxyro aKrLrBHocrb_ 30_60 uu_ Hyr exeaHeeHoi xoas6br c nocneayorulzM paclxh_ peHheM ABhrarenbHoil axtueuocrz noa KoHTponeM qacrorbt cepaeqHbtx coKpaueHh h u ypoeua aprep,4_ ANbHOTO AABACHVfl. mfioparopntre Meroabr.Drnxnpoean- ....^!!:!" Hbte oetKn. OnpeaeneureypoeuerZrnhKhpoBaHHo_ ro revorno6uua vt Ha [o3Bonrer perpo_ $pyrcro3aMu cfreKThBHO OUeHhrbKoMneHcauhro CA e nepvoa or 2 seaenuao 3 vecquee. Vpoeen, Hb4c eBnrerc, hHTefpanbHbtM noKa: roo6veua ;:';nil;;:':T::"lH?:il:_ "'"""" AeneHo n poaonx hren bHocrbto xt43Ht4ep zrpo flpoueuruoe HbA,c .o.ru"-", :oaepxaHr.re urzra). 4_6 % 0/2 AHO(o3bl wary ^ep) b/A ocne onee tHfl. oro I O$apn a "LercryrLl.l 4/ y flpaKrhqecKu 3aopoBbtx nhu. v naureHroec CA hp^r, nraenoHe$pw u tp.). pa:nzqaror moKo3yypoBeHbHbA-,cnoBbluaercr[2, 4, 7, 1O]. pL4|4aNAMeHTapHbre/ ueHTpanbHbrcvAV HeBporeH_ B aacroguee BpeMq aoKagaHo, rtro ypoBeHb uore (npz qepeflHbtx rpaBMax/ onyxonrx Mo3ra, HhArc Mo)rle;rHcnoubsoBarbcnB KaqecrBeaHarHo- MeHh Hrl,rrax/ ToKCr4 Ko3ax/ cyaoporax, aHue$anrrax cru.tecKoro Kpurepufl CA. ypoeens HbArc B npe_ u t. n.), ropMoHanbHbretnpt Koropbtx t{Meer Mecro AeAitx517-614 %ocnu,terertbcrByeT o Hailurrnn HTF rLlnep- v\h rl/.noceKpeuzg HeKOTOpbtXropMoHoB Nnn HlH, n e. npeaa,Ha6era,a panuufr utn 6onee (aapeHanz u r ApoKCt4H rntoKoKoprt, Kol4abt,A KTf ), I I 615 %onoarBep)KAaerauarHo3CA tl21. n p r : a 6 o n e B a H u hn e q e H hh n o q e K [ 2 , 4 , 1 O ] . 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OaHarco KeroHyprr Moxer Bcrpeqarbcr/ noMhMo CL' n npvt LpYfrlx naTonorhLtecKrlx cocToflHzflXi TOAOAaHVI,r' | azeTe c BbtcoKt4Mcoaep)KaH,leM Xr4pa/ anKoronb_ HoM Keroauhao3e u vtuSe<uuoHHsrx :a6on eB a+'z,ux, nporeKaouzx c BbtcoKoZrevneparypoil 12,1Ol. Ta6nuta 3 Kpnrepnu d,uaruoctu xu n apywen nil yne sotnoro o6uen a Xapa<rep Hapyluenrzi pvL4na naoHa 4Ta- 5-6 a)c CaxapHuri tua6et KXE MVl- ut4AeM tprlHapyueuHar JAH. TOnepaHTHOCTb tHo- K Fn0KO3e 'po\OT )TC' ,HO- tpeta)' 3% Hapyr.ueHrze rtt4KeMr4n HATOUAK Ce-udunrt )oxnap | (/)/2012 42 HuuynopeaxrnsnHil uHCyAnH n C-nemnt. Ats AharHocrl,{ Kr,rCA (o uen KV tAHCy AuHnpoayurapyouei $yHruran) Mo)<er 6urr rcnonb3oBaHo onpeaeneHhe 14 MMy Ho pe a Kr h BHo ro nHcyAnHa (V1PV1)u C-nenr u a.a. flo rx ypoBHro MoxHo cyahrb o coxpaHHocrt uHcy 14 Hoce Kperop Hoi cn oco6Hocry B-xneror noa)KenyaouHorZ )Kene3bt. ZccneaoeaHue l4PA no3Boneer oueHhTb ceKpeuh|o 3HAoreHHofo vlHCyAnHaTOnbKOy nauheHToB/ He nonyqalouhx npeflapaTbt l4HcynhHa. 9aue ecero LrccneaoBaHre C-nenrraa (roHueaoi nenrhA/ orueflnrouvnca or npoilHcy HHa B npouecce cLlHTe3anHcy^.nHa B 3KBl4MOnrpHbtXl4HcynhHy Konuqecraax) npoeoanr anr anSSepeHuraasHoi AharHocrhKn CA 1 v 2 tunoe: npra CA 1 rrna ero KoHueHTpauvfl HV3Kafl (uoxer orcfrcrBoBarb nph AnrrenbHoM TeqeHhh :a6oneeaHhr), CA 2 r:l.na aonroe BpeMn coxpaHrTbcr B npeae^ax HopMa^bHblx sHaqeHhi t4N4 aaxe 6ulrs nossrrueHHoi, r{To cBhaerenbcrByer o rtanephHcyhuHeMnn[2,7, 101. Tarcru o6pasom, aLtarHo3 CA u tpyrux Hapyweuuit yrneBoaHoro o6veHa ycraHaBnhBaercs Ha ocHoBaHnu KoMnneKcaKnzHruecKnx rz na6oparopHbrxaaHHbtx (cri,r.ra6n. 3). 4. Sudoxpunonorufl: Hau. pyKoBoacreo / noa pea. h. h. Aedoaa, f. A. Me rnu,reurco.M-: f)OTAP-Meana, 2008. 1072 c. 5. 3a6apoacrcan3. B. Caxapuuil tua6er 2 runa: oco6euuocru $apuarcorepanuh y Auu noxuuoro Bo3pacta // ARSMEDICA. 2010; 2 (22): 77-90. 6. Mailopoa A. lO., Cypxoea E. B. Caxapuuil tua6er 2 rnna: pyKoBoacrBoatz apauert o6ueil nparcrurcu/ nod ped. npo$. h. h. Aetoea. M., 2008. 76 c. 7. Caxapuuil tua6er. Knuuuxa, auarHocruKa, no3AHue octor<HeHhs/ caxapocHnKaniltag h uera6oAuLrecKaerepant4tr: yue6.-uerod. noco6ue / B. h. EopoAuHa [u ap.]; noa pea. npofi. B. h. \opotnuort. M.: MEA]PAKTI.IKA-M, 2009. 60 c. 8. Xoaoaoea E. A., 3a6apoBcKae3. B. AuaruocruKa recrauuoHHoro caxapuoro dua6era // ARSMEDICA. 2010;6 (26):3442. 9. Cxpunuur h MoHuropuHr recrarJhoHHoro caxapHoro dua6e'ra/ 3. S. 3a6apoecrcaz[u tp.] // CoapeMeHHHeMeroabr auarHocrr4Kh/ AeqeHng u npofiunarcrurcu sa6oteeanuil: c6. uucrpyrcr.-Meroa. dorcrt.(oQuuust.). S-il eHn. Muucx: PHM|, 2005. T. 5: Hefipo,rorhq. Suaoxpnuoaornz MeauLIt4HCKafl.KAnnnqecrcaq atteprotorur. Ypoaorua. Iletuarpun. Axywepcreo u rh HeKouon4e. Oro p u no,,tapuHrouoru r. Crouaroaorns u qeApcrHo-AuueBafl xr4pyprhn. Ofuratruoaornq. C. 68-77. 10. 3a6aposcrcan 3. B. Kpnrepuh auarHocrt4Kh caxapHoro tua6era: yue6.-ueroa. noco6ue. Muucx: MfMh, 1999. 12 c. ll. Atropuru cneuuaAh3npoeauuoil MeahLthHcrcoil nouowu 6oatuuu caxapHbrM,a,na6erou/ noa pu,. lrl. h. Aetoea, M. B. Aetraxosoil (usa. 4, ton., 4-h eatn.).M.,2009. 103 c. 12. Standards of medical care in diabetes - 201 0 (ADA) // DiabetesCare.2010; 33(1): t1-66. AI4TEPAryPA 1. WHO Consultation: definition, diagnosis and classification of diabetes mellitus and its complications: Report of a WHO Consultation. Part l: Diagnosis and classification of diabetes mellitus. Geneva: WHO/NCD/ NCS/99.2, WHO,|999, 2. Auos k|. h., Aecraxoea M. B- Caxapnuil tua6er: pyxoaotcrBo aAfl epaueil. M.: Ynueepcyu lla6rtuwuu,20O3.455 c. 3. 3a6apoacrcan3. 8., Aene^rrceanq A. ti. Caxapuuil aua6er 2 runa KaK KoMnoHeHr uera6ortu,lecKoro cunapoua // Meauuuua. 2008; 4: 22-25. flocrynzna 1O.O5.2O12 - t " " t " . . a a a a a a a a a a a t a a o a a a a a a a a a a a a a a a a a a a o a a a a a a a a a o a a a a a a a flpeacraeneHil repMxHo^orun, rtraccuSmaurr, Sarcro- ' The terminology,classification,risk factorsand diagnostic pbl phcKa,Kpt4Tepvua|i.arHo3a pa3lhqHblxQopla rrnepreH3rB- ' criteria of different-forms of hypertensional condition ?uring ' HblxcocroeHht nph oepeMeHHocrt4t a raKxe raKThKaBeaeHhr pregnancy are presented,also here the pregnant management . ts snown. 6onuuurx. K,tto,resne c^oBa: apTept4it^bHaJt frnepre"rrr, 6"p.rer- " " t " " t ' a t a a Key words:arterial hypertension, pregnancy. I HOCTb. . a a a a a a a a a a a a . a a a a a a a a a a a a a a funepreHazeHulfi crHapoM sBntercq Har6onee qacrot npo6AeMor y 6eper'aeuHux (no pa3nhqHuM aaHHblM/or 4 ao 29 "/" ecex 6epeveHHocrel). AprepranbHaJtrhnepreH3hq (Af) euruna Ha nepBoeMecro B Mhpe cpeAh npAeAH neftIAbHblx hcxoAoB y 6epeMeHHblx. OcnoxneHrq Af cofiaBnetor 2O_3O % cnyqaeB B crpytcrype MarephHcroi cueprHocrh. AprepraauHat rhnepreH3ht o3Haqaer yxyaueHhe a a a a a a a o t a a a a a a a o a a a a nporHo3a KaK anr Marepl4t TaK v ar\s pe6eHKa: a t )KeHuhHu - yBenuqeHhe qacrorbt npoKAeBpeMeHHbrx poaoB/ orcnoixz HopManbHo pacnonoxeHuoi nnaueHTbt/ uepe6poeacKylqpHbrx ocno>KHeHri, nonhopraHHoi HeAocraToLtHocTl4,paaerzlar ABCcHHApoMa;ans nnoaa - noBbtureH/e phcKa pa3Burt4e BHyr-phffpo6HorZ saaepxKt4 pa3lt4rtfl v1 BHyrpl4yrpo6HoI ru6enu, a B noc1eay|gtueM - yBe^hqeHile