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ISBN 5-8249-0077-9

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ISBN 5-8249-0077-9

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- (GnRH) -
1 ( ) (. 2).
GnRH -
(Yen, 1982). GnRH.
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GnRH. GnRH -
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.

. 8.
(..Clinic. Gynec. Endocrinology and Infertility).

PgG2 PgH2, -
5 ,
.
2 PgD2.
Moncada S. . (1979)
, (Pgl2), -
: ,
.
24
 2 , 12 . -
, , , ,
, .
, Aj (Gryglewsky R.
.,1979).

. 9. - .

2 . -
-
, . -
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(Moncada S. .,
1979). , . -
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/-
.
Olson D.M. . (1993) -
. (
), .
, .
. -
,
(810 ). -
, -
(Masotti G. .,1979).
F20( -
.
: -
, -
, -
(Auletta F.,Flint A.,1988).
.
-
F (Auletta F. . ,1976;
Gore B.C. ., 1973).
25
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, -
.
,
, ,
(Norwitz E .Wilson . 2000).
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, ductus arteriosus
, -, , d. arte-
riosus. , -

40% (Coceani F. , 1980).
.
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, . -
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-
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2) ;
3) (, );
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5) ;
6) ( , , -
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29
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56 -
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, (Miller, 1968; lamazaki J. .,
1990).

.
.. (2001), , , -
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.
23,5 , -
2,5 .
24,7%.
I -
, , 5 (Creasy
., 1994). , -
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(360500 ), , -
(Creasy ., 1994).
(, ) -
.

,
(Quellet-Hellstrom ., 1993).
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.
,
, (Clarkson ., 1972).
30
 100 .
,
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(1991 ). , -
, .

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, ,
(Parron . ., 1996).
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.
,
6
(Restrepo M. ., 1990).
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. ,
42 I , -
8,5%, ,
42 4,5%. -
, -
(Klebanoff ., 1991).
* ,
, 22%,
6,3%. , ,
6,3%, 4,3% ( .., 1991).
, , -
. , -
, , , ,
29,80,8 25,70,1 .
2024 2529
( 7,1 7,4%). ' "
20 35
, 15,6%. -
.
.. (1980) -
(7,5%). ,
: 8,4%, -
9,2%. (Bakketing L.S. ., 1980) -
,
, , (
, ).
, , -
-
. -
, ,
, . -
31
 -
.
-
, , , .
, -
, , ,
(Mcintosh J., 1984). -
: , -
.
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), -
. , , -
.
(Harlop S. .,1980).
.. (1987) ,
29%, 1225%,
22% 0,10,4%.
-
. , -
(Jacobson J.L.
.,1994).

(Coopper R. ., 1996). , -
, -
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, , .
,

(Golard R. .,1993). -
(Hill J. .,1995).
-

(Klock ., 1997; .., 1993).
,
, -
, -
- .

-
. .
Weathersbee P.S. (1980) 1015%
. Wilcox . (1988)
22%. ,
32
 , -
. -
-
. ,
.
Boue J. . (1975)
5065% . French F.
Bierman J. (1972), 1000 , 5 , 28-
227, -
, . 30,5% ,
49,8% , 16- ,
23,7% - 17,4% . , -
,
, .
-
(Creasy M. ., 1976).
.. .. (1983), -
50% -
, -
.
- -
,
. 95% -
,
.
-
1 200 -
. ,
. 1 -
Jacobs P.A. (1972), -
24468 . 121 .
1
,


45. 1 47.XYY 23
31 47.XXY 17
+ 47. 10
7 32
39 82

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.
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de novo -
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A.M., 1975). ,
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.
-
10 , 2,4%
(Trochet-Royer ., 1981).
..-
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2%
(Paton G., 1974). -
, .

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( , , ) -
, .

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-
, -
( ).
210%, .. , -
0,2% ( .. ., 1977).
-
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, .
Boue . . (1985), 2 -
7% , .

.
34
 (
), ,
.
, ,
.. Gardner R. . (1996), -
,
2550%.
Benirschke . (1988),
,
. 819 -
83 , -
(23), (27),
(3), (10).
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(Boue I. ., 1975). -
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180.
9- .
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21,7%,
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.

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2. -
;
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, 44 (88 ) -
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39 : 12 , 13 -
(15,9%) .
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.
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11 11qn 11 2- ; 12q ; 13s+
2- ; 13 13q ; 14s+ 3- -
; 15s+ 2- 2- ; 15+ 1 ; 16qh 1 ;
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36
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, 26 28- .

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(1950), , 1,81 -
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-
25% (Scott J. ., 1988).
, -
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51,4% 26,7% (Davis O.K. .,
1989).
Botella-Lusia J. (1973),
.
,
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.
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,
, (Li T.C.
., 1989; Jordan J. ., 1994).
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37
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38
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, . -

.
, -
(Speroff L, Gloss R.H. ., 1994).
, , -
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10 . ,

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(Karamaridian L -
., 1992).
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, .
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. -
.
, -

39
 , -
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.
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, , 30%
. ; ,
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.
, -
. -
- ,
,
(Yen S., Saffe, 1998).
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( 1):

1. .

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, - . -
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.
-
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.
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20%,
, -
, , . -
, , -
(Parker L .,1980; FeherT. .,1985).
- , -,
(Winterer J. .,1985). -
--
(CBG ), - -
40
 (TeBg) . -
.
, -
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, .
21- ( 212) -
( 2):

2. 21-.

, ,
17-.
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, .

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500 ng/dl , .
17 200 ng/dl, 500 ng/dl
(0,25 (-) /, ). 17--
1000 ng/dl, 236392%,
.
- -
21 -, 6 -
HLA ( ).
21 21
21 (Speiser P.W. ., 1988).
21- HLA (B14.B35)

(Speiser P.W. ., 1985).
, 21 --
, -
(, ) (New M.
., 1983).
41
 11 - ,
11 - -
-
, .

, .
,
( ), -
, , (Azziz R.
., 1991). 11- 8 ,
HLA ( 3).

3. 11 -.

, .
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,
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.
-
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4.
-.

Botelle-Zlucia (1973),
.
42
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.
-
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.
.

.
-
, -
,
. -
.
, -
17-,
17 , -
21--
. (-
80,9%, 92%, 75,8% 90%) 17, , 17- .
( 236392%) , , 17-


. 90,5% -
,
( 9,40,6), ..
. 76,2% -
, 23,8% .

() 12,1% -

.

, -
, -
, .
. 45017---
, -, -
(Rosenfeld R. ., 1990).
. ,
. -
( ,
), ,
, ( ,
). /, -
.
(Chom G., 1973).
43
 . 10.
(Yen Jaffe,1998).

50% -
,

.
, -
- (Givens J. ., 1975).

. 10.
--
-. -
, , -
, ,/,,.
, , , -
.
. -
. -
,
44
- . -
-
.

. -
-, , -
(Seibel M., 1984).
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I ,
( ) -
50% . , -
,
.
, .
,
. , -
: 15,20,6; -
(26,30,8). ,, -
( ,
64,7% ).
-
, , . 78,6% -
,
, 10 , 5 10, -
.
-
( ).
-
57,9%.
(< 0,001) (< 0,001).
-

17- 17 51,3% -
. -
-
, 1/3 .

, -
. 49,9% (-
, ), .
46,1% 69,2% -
.
(18,3 1,0) (26,50,7) -
17
17. (96%) , 60,6%
. -
, , .
45

:
17, -
17- .
- ,
, , 14,3% -

. -
-
4 , 10 ,
11 14 . -

. 50% -
, ,
.
-
, -
, , , no-, -
,

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

,
,
, -
.

, -
, . 1981 . -
. , -
. 6- (Owerbach D. .,
1981). -
. -
- ,
46
 , -
(S. Yen., 1998). %
:
1) (-22000) ;
2) (-50000)
3) -.
- .
, - ,
. --
(), -
(). --, -
. , ,,.
, , -
, .
I ,
10 . ,
(Rigg L. ., 1977).
12
.
, ,
. , 510 -
. II
.
. ,
. , , -
, -

(Bigazzi M ., 1981).

, .
/ -
, -
. , 40% -
(Glickman S.
., 1982). -. ,
.
, , , -
.
. -

5- (,
) . -

(Gustafson . ., 1980). ,
.
,
(Magoffin D. ., 1982).
47
 ,
- ,
, , , -
.

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

, .
-
, .
-
-
--.
, -
().
() , -
-
.
.
,
,
,
-- (Gordon G. -
., 1969).
- , -
, , -
,
. , -
16- -.

, ,
(Gordon G. ., 1969).
. -

. -
, , -
, .
48
 . -
,
, .
, -
,
,
.
,
,
, .
12,7% , -
.
, , -
,
.
3-
(2,5%) .
-
.
13 65 ,
21,0%. .
Stagnoro-Green A. (1990), 19,6%
. Roberts J. . (1996),
36,3% -
.
, -
-
. -, -
.
, -
.
. Beer . (1998),
CD 56+, CD19+5+ ,
,
, .
, .

-
. , -
, (Witkin S.S.
., 1992; . ., 1993), , -
, , , (Khan G.
., 1998).
49
 ,
i
, ,
.
20 , -
, .
, -
. 42% -
- , , -
. 100% .
,
.
,
, ,
, .
-
, , , -
, ( -
), ,
. , -
, , -
. , -
.
, , -
, -
(Amstey M., 1976).
,
,
.
,
,
,
,
,
( .. ., 1978).
-
-
. ,

,
.

, , , -
, .
. -
,
, .
( P.M., .. ., 1982).
.
50
 ,
, . -
, I , 2550%.
.
,
30% ( . 35%
,
, .. (.., 1986).
, -
.
, .
-
, , . ,
I , .. . -
, , .

. I -
,
. -
, .. -
. , -
.
.

. -
, , -
. , .. -
.
6 (0,25 / ).

. 25% -
, .
. . -
.
.
. -
. , .. -
. , ,
.
, - . -
,
. . -
0,25 . -
.
- , : HBsAg, HBcAg,
HBeAg. , . 10
15% .
51
 , -
, , -
. -
- , ,
(0,5 /)
.
- ,
.
, , , . 50%
. ,
20
. .
, .
-
, 5,0 23 .
-
. -
, .
-
. ,
-
, -
, . , -
, ,
,
, (Raj R. ., 1996).
-
, , -
, -
.
, -
, , -
, -
/ .
, -
-
64%
. -

67,7%.

- . -
-
( , .).
-
? , , -
(Shelton A., 1994), ,
52
. 11. -
( , 1996).

(Shmgu M., 1989). ,

,
, , .
:
1. - (, ,
-).
2. ( , ).
3. .
4. , .
5. .
, (-
.. ), -
(. 11.): 98% ( 16,7%), -
74,5% ( 8,3%), -68-71 47,1% ( 25%),
60,8% ( 25%), 56,9%
53
( 25%), 43,1%( 12,5%), 43,1% (
16,7%), 60,8% ( 16,7%).
,
.
, .
,
, -
. , , -
.
, -
.., -
.

-
0,42,3% ( 1%)
(G.A.Nankervisetal., 1984; Pass K.F. etal., 1985; StagnoS. etal., 1985; ..
.,1990), -
.
-
, ,
.
, , -
, .
-
/
. -
, -
, -
( .. ., 1990).

, -
.
,

. , , 55 85%. -
IgM, IgG ,
. -
, , .
.
, ,
1 , ,
. , -
.
54 t
 3040% .
1015%, 2030%
. 90% 10%.
-
0,21% . -
, 510% ,
9095%. -
, 99% .
2 -
(1996 .) ( ).
2



100000

(1%) 1000
-
(10%), 100
20
80
(90%),
900

135

-
,
. I II
, ,
.
-
400
( .., 1994). IgG 88%, IgM 8%, -
9,2% .
60,8%, 57,5% . ,
-
: -
, , -
, - , .

,
, , ,
( lgM- -
IgG). -
73% , -
89%.
55
 -
.
( .. .,1992).

.
,
, . -
, -
, .
55%
, 10% -
( , ). , -
-
.
, .
66% , -
, .
: , -
; ; ; ; -
(.. );
; ; ; .
.. (1997), 61% -
. ,
, : -
, , , , -
, . ,
, ,
-, --
-, -
. ,
,
.
-
. ,
-
, -
,
.
, -
, ,
.

. -
56
, ,
.
, -
, , .

. -
, , (.3).
3


2 10
1 2
+
+
15 7

.1997) -
.

-
. -
-
.
11,33,7 ( 3,50,5) 18,83,4 ( 7,11,0) -
6,71,2 ( 17,82,6)
. -
,
- 28,6%. -
,
71,4 % .
- . -
, , -
, -
.
-
- . , -
- (, , ).
, Picornaviridae.
(24 ), (6 ).
ECHO (34 ) -72 . -
-
.
, -
.
57
 , -
, - , ,
,
- .
- 50- (KibrichS.,Benirsche ., 1958).
1967 . .. . -
-
.
-
. , ,
. -
, -
, . -
,
. -
.. ,
(.., 1996), -
, .
,
; -
: , -
, ,
.

-
-.
,

.
, II III .
,
II . ,
,
. , -
, -
..(0!! . 1996).
, -
, -
(Hill J., 1999). -

.
-
( .., 1993; -
.. 2000; Lament R., 1994;Cauci M. ., 1995).
(Kira E. -
., 1994; .., 2000), 57,1% 51,6%
58
 . -
, , . .
(1994)
. ,
(Ault . .,1996). ,
,
, (.., 1999).
, -
(Dudley D. . 1996), -
1540% .
, , , -
.
12% . , ,
,
, , (Zangwill ., ., 1990).
, -
, , -
, .
- -
, (
..), -
( - , )
,
: (-
, , ), -

( .., 1993; .., 1993).
-
,
67,7% -
, 20% -
. 20 -
. 129 , -
61,4% (, ,
. ), 31,8% ( -
), 6,8% ( , ,
). 7 , -
26 .
, (103105 /) -
6 50
. - -

.
.
1025x102 / .
-
-
59
. -
, I
, , , -
, ,
. -
73,1% 30,8%
.
-
, I
, ,
86,7% . -

31,6% . , -
, , - -
,
,
, -, , -
1/3 -
.
, ,
70% -
. -
(73,3%)
.
-
,
, , , , ..,
- ,
-
.
,
( 8% 37,8%
, -
). ,

. -
- , , -
(, )
4 -
. , ,

.
-
, , /
, .
, -
, ,
60
, . ,
32,3% -
, 10%
.
( ) 56,9%
I 33,3% .
, ,
-
,
- . ,
, -

,
.
, -
. -
-, -, NK-,
, -
-
. ,
-, NK-, ,
IgM.lgA.IgG ( .., 1990; Lachapelle M ., 1996). -
,
, ,
.
, -


, ,
. -
, ,
, ,
, , , -
( ., 1991; .. ., 1993).
, -
, -
- (Kolodie, 1989).


, -
.
, -
,
,
, -
( .., 1993, Ko-
lodie L, 1989).
61

, -
,
.
, 60% -
( ) -
in vitro -
,
(Hill J. ., 1995).
-
, . -
, ,
CD4+ 1 (Th1) , , .
-
, . -
, -
,
, , , -
-
.
.
,
,
( .., 1996).

I ( - (3-). -
;
II - -
(Baron S. ., 1994).
. -
21- 5- (Balkwill F., 1986). -
. -
,
. ,
-
. , -
.
, , -
, -
.
25'-
. -
.

, . -

.
62
 - -
.
-
. -
, .
-. -
. - -
Th1 Th2.
, -, . -
-
NK-, -
- - (Imanishi J., 1994).
-
, . I
-
II III ( .., 1977). -
, -
.
- -
. I 56 -
, III (Aboagye-Mathiesen G. ., 1993).
.
-
. -
, (Zdravkovic M.
., 1997).
-

I (Hager H. .,
1994). , -
: -, , , , -
, -
.
, , -
, -
-
, (Baron S. .1991).
- -
. , -
(>4 /) -

. -
. -
.
-
-
. -
63
 , -
. , -, -
(Tayler J. . 1994).
-
, -
-
-, (3- -.
.
- -
-
( .. .1996).
-

: , -
, .
, -

.
:
, -
.

, -
- ( .., 1998).
- -
-
, : Th1 Th2. Th1 il-2,
TNF-p, -, .
Th2 il-4,il-5,il-10,
. -
, , -
Th2 .

. Th1 (- il-2) -
I
II III . Th1 Th2 -
. Th2
. , Th2 -
, , -
(, ). -
(Yamada H. ., 1994).

- il-2, il-4
il-10 (Christiansen . ., 1996). - -
. -
il-2, -, -
, (Piccini M. ., 1996).
64
. 12. TNF,

I
( .., 2000).


IL-4 IL-10

/L-6 /L--/P

. 13.


-
,
- >
,
( .., 2000).


*<0,01
IL-6

NK- -
,
-

(Hill J. , 1995). , Th1 Xr(YamadaH.
., 1994). , , -
, , , -
, , .
( .. 2000) -
-1 -, ||-1| ,
Th-2 il-4 il-10, - -
TNFa, -
, , I
, -
TNFa, -, il-113, il-6
il-4 il-10 (. 12). -
I -
-
(. 13).
65
3-6747
 120
: 120 !,-*>< - * -, -
[-"*.''.'-' '*"*' '
100 100 - . . , ': -f:
- -
80 80 : , . ;'_.

i E

! 13 60 I 60 - ' ,..,, . . .
i a . ,
40 '. V .
40 -'' ' "?- .
**
f V-iS
20 - :.,. 20 :
'


-^,
^41 -
. >- ,^
-20
=37
. 14. IL-6
( .., 2000).

TNFa,
20 -
(168,214,1 pg/ml 6,90,7 pg/ml )
1,7 , -
(98,59,3 pg/ml); - , -
(2,7+0,2 pg/ml), 2
(1,50,1 pg/ml) -
,
(0,14 0,02 pg/ml). -1 (3

4 (115,5+3,9 pg/ml 28,3+3,1 pg/ml), il-6 5 (60,7+7,5 pg/ml
12,00,8 pg/ml < 0,001) (. 14).
-
11-10 (. 15),
26,2+3,1 pg/ml. il-4
, , -
(12,3+0,56 pg/ml 4,620,77 pg/ml )
, .
, -
.
-
, , 18,1% + , 18,0%
+ .
-
. -
II
66
 !
j 60
js
i 50
j
40
iI
|
i Q.

1 20
I
\ 10
i 0

=20

. 15. IL-10 ( )
( , 2000)

, (. 16).
, ,
III
.
25
. -
( 17).
TNFa -
, , 9 (82,73,3 pg/ml
9,30,6 pg/ml); - 10 (1,90,03 pg/ml 0,180,02 pg/ml);
il-1p 6 (72,53,6 pg/ml 12,51,2); il- 5,3
(81,4+2,7 pg/ml 15,8 TNFa
1,9 pg/ml) - pg/ml
(<0,01). 100 "
80;

III - 601
(, -
IL-10 IL-6
-

16

-
II

( .., 2000). IL-4
67
 . 17.

III



( .., 2000).

) -
. -,
, -
, .

il- (. 18 19). il- -
-
.
-
.
-
. , ,
,
. , -
-
, ,
.

, ( , -
) , -
. -,
,
.
,
il- -
.
, , il-
500,225,1 pg/ml -
, , 169,711,2 pg/ml.
68


18 IL-6

( ., 2000).

19 IL-6
III ,
( ., 2000)

- (658,425,8 pg/ml)
-
, (389,234,1 pg/ml);
TNFa 433,827,2 pg/ml
324,125,3 pg/ml (<0,05).
-
-/||-4 (=0,90) TNFa/il-4 (=0,77) -
, -
,
.
- , -
, 66,1 % -
, 13,6%
69
 -
, ,
.
2 -
il-
,
. -,
, .
-,

.

510 TNFa,
-, il-1p, il-6 , il- 250,0 pg/ml

, --
.
, - ,
, -

, .

,
- . -
,
. ,
, -
.
.
,
, -
, , -
.
, - , , -
,
-
.
, -
(), --
,
. ,
.
70
 -
Rh- -, -
Kell, Duffy, Pp . -

, ,
, HLA.
,
. -
-
. *

-
. -

( -
).
,
(Vianna L. ., 1994). .
, ,
. , -
-
- .

2000 .
, ,
(Wilson W.2001).

I. .
1. -
, .
-
, .
-
.
2. :
a. -
10 ,
.
b. -
34 -
, .
71
 . 10
, -
.
II. :
1. IgG / IgM , -
2 -
6 , -
|32--1- .
2. , 2
, 6 , -

:
a. - :
();
; ; -
, -.
b.
.
c. -
.
d. , .. VIII , -
.
,
, IgA , -|32-
-l, , -
, - .
, .
-2--1 , -
, , -
.
.
-|32--
-l IgA IgG .
-
(Lee R. . 2001).
-
2742%%.
,
5%.
,
:
1. , in vitro -
, 2+- -
, Va -
() ();
2. ,
().
72

. -
, ,
. -
, .
, ,
. ()
, , -
, , -
.
, McNeil .. . (1990); Galli M. . (1990); Matsuura E. .
(1990) , , -
, , , -
(), -
(32--1 ((32--1).
J.E. Hunt . (1993) , , -
,
2--1,
(), -
(, , , -
), . , 2-1
-
. -
, -
- . L.R. Sammaritano
. (1992), , 2--1,
() -
. , -
,
. -
, .. Gharavi (1992) ,
. ,
, , -
,
(, ,
, , - .).

- . (-
)
, (-
) , -
2--1, .
-
(-) . 4 -
.
-
. ,
(,
73
 4

( V.D. Lockshin, 1992)


IgG > IgM IgM > IgG
IgG** lgG2, lgG4 IgG^lgGg
** ? ?

+
, ,

+
+
** , IgG.

, , , -
, ) .

-
A.Beer J.Kwak (1999,2000). -
5 , -
, .
I HLA -
HLAc . -
HLA, , -
.
II ,
.
2742%.
-
, - . ,
-
, . -
-
, .
III , -
22% -
. - -
, .
IV . -
10% -
.
.
V , 45%
. .
74
 1 -
CD 56 12%. , CD 56+ 18%
. ,
.
, TNFa.
, -
, ,
/ ( ).
2- V CD19+5+ . -
10% .
, -
: , , -
. , ,
. CD 19+5+ -
, , -
, , -
.

, -
. -
, ,
.
3- CD 19+5+, -
, . -
. ,
, -
. -
, , , .
, -

. , -
. -
.
, V -
. 10
. -
,
.
.
. 78 ,
, -
, -
. -
, 8
A. Beer .
,
, -
75
, ,
.
, -
,
, .

HLA.
,
, HLA .
70- . ,
-
. - - -
-
.
.
, -
. , , , -
, ,
- -. , 78
( - ), -
, . -
.
, -,
, -
.
-
. -
-
, .
-
.

( .., 1980).
( .., 1982) , -
,
( 33,6%
14,9%). : , -
, , -
4 , , -
( 33,6% 7,2%).
-
. ,
-
-
, , ,
. -
, -
76
 , ,
, -,
v
( .., 1978).
.. (1979), -

. -
, -
,
. -
-
,
.
83,3% .
-
, , , -
( .., 1978).

. --
,
. ,
, .
(Rocklin ., 1976; Taka-
kuwa ., 1986).
-
.
, ,
(Fraser E. ., 1993, Ober C.L ., 1983).
, -
,
.
:
1) , -
;
2) , -
;
3) ;
4) ;
5) (NazR., 1992).
, -
. , -
. -
- ,
;
-
. ,
,
- () (Suciu-Foca N. -
77
., 1983), .. - -
. -
, -HLA-DR (Maruhashi . -
., 1984) -Fc (Power D. ., 1983).
,
. ,
-
. 20% -
, 64% .
( 9
23%) (Mowbray J., 1997).
, , , -
- , -
. - NA1.NA2, NB1
NC1 Lalezari . (1960).
NB2,ND1,NE1 Lalezari . (1971), Verheugt F.
. (1978), Claas F. . (1979) .
N , -
, HLA(ThossbyE., 1969). -
, , NA 1 NB1.
- -
,2% 20% (Rios E. ., 1991, Zevine D ., 1986). -
, -
, .

(Rodwell R. ., 1996).
, ,
.
, - ,
.
.. . (1997),
-
,
20,5% ,
. .

HLA (Human leycocyte antigens). HLA

,
, - -
. -
. HLA I, II III , -
6- .
, ,
3x106 ( ., 1999).
I HLA HLA-A-B - -
, - (CD8+) .
78
 II HLADP,-DQn DR -
-(04+). III
, 2.4 Bf
( ), TNF ( ) -
(Rhodes D. ., 1998). , , !
NK , .
, NK , -
19 HLA-E,
-F G. , HLA-G
.
.
-
. HLA ,
.. . (1998),
.
5
HLA .
( .. ., 1998)
HLA-A - HLA-B - HLA-C - HLADR -
, % , % , % HLA DO , %
N=2130 N=2130 N=2130 N=2130
1 21,9 5 13,6 Cw1 4,2 DR1 21,7
2 54,8 51 10,2 Cw2 22,3 DR2 31,9
A3 23,5 52 3,4 Cw3 21,2 DR3 19,5
9 22,7 7 25,7 Cw4 28,2 DR4 21,7
23 2,9 8 13,9 Cw5 11,0 DR5 29,9
24 19,8 12 23,0 Cw6 20,0 DR6 19,5
10 14,5 44 22,2 DR7 22,7
25 5,9 45 0,8 DR8 5,9
26 8,0 13 12,2 DR9 0,9
11 12,2 14 3,3 DR10 0,9
19 26,2 15 9,8
29 5,2 62 8,8 DQ1 51,8
6,3 63 1,0 DQ2 33,7
31 5,2 16 7,7 DQ3 42,6
32 6,9 38 4,2
2,6 39 3,5
28 8,3 17 7,3
34 0,2 57 7,3
36 0,6 58 0,0
18 12,8
21 3,3
49 2,0
50 1,3
22 4,1
27 8,3

79
 . 5
HLA-A - HLA-B - HLA-C - HLADR -
, % , % , % HLADQ , %
N=2130 N=2130 N=2130 N=2130
35 17,5
37 1,6
40 14,3
60 9,2
61 5,1
41 4,1
47 0,2
53 0,6

HLA -
. , ,
, 95% , HLA
27 , .. 20 .
Beer . (1999), 86,4% HLA DQ4.
HLA DQa201 50% .
HLA B14
(); HLA B18 -
.
.. . (1998), -
HLA-:
19, 8, 13, 15, 35, DR5, DR7 19%, 9,5%, 19%,
17,5%, 22,2%, 69,6% 39,1% 6,3%, 3,8%, 10,3%, 16,7%, 29,9% 22,7% -
. -
, HLA- 19,8; 13.15 DR5 -
1,65,1 .
HLA- 1.8; A3,15; A3, 35;10,18; 19, 15 -
2,69,2 .
HLA ,
HLA . ,
HLA , -
. 2 HLA
100% ( .. ., 1998).
HLA
-
. -
-
. (Beer . ., 1987;
Christiansen ., 1996; Mowbray J.F., 1987;).
, , -
,
(Fraser E. ., 1993; Ober -
., 1983 .).
80
 6
HLAI II

( .. ., 1998; 98/195)
HLA

, % , %
4 100,0 0
3 100,0 0
2
|, 75,0 25,0
1 48,3 51,7
0 31,0 69,0

-
: , -
, , , .. -
, , .
, -
HLA .
HLA . 32
, I II HLA: 16 -
, ,
10 HLA 2 ; 16 -
I 9 2 .
16 -
7 HLA DQa201.
HLA.
Chiristiansen .. . (1996), -
. -
-
, HLA. ,
/, . / -
. , -
HLA ,
HLA .

HLA .

, -
. -
, .
81
 . -
-
(. .. ).
-
-
.

7


( %) ( .., 1996)

CD3+ 67,11,7 60,3+0,65*
CD4+ 44,51,2 44,00,75
CD8+ 25,7+2,1 22,6+0,44
CD4+/CD8+ 1,730,12 1,720,04
CD16+ 15,01,0 19,71,75*
CD 19+ 10,61,7 15,91,31*
<0,05.

-
. -
CD3+ 20%, 50%
, 30% .
CD4+: 47,5% , 50% . 57,5%
CD8+ , 20% , 22,5% -
. 30% -
( CD4+/CD8+)
2,060,08, 60% 1,560,03 10% -
. CD16+
15% , 50% -
35%. - CD19+ 45%, -
42,5% .

. 20.
,

.
-

, ,
, (. 8)(-
).
82


20.
.

8

,

( . ., 1998)

CD3+ 53,12,02* 67,52,12
CD4+ 36,91,7* 42,81,04
CD8+ 19,141,13* 23,6+0,7
CD4+/CD8+ 2,10,17 1,870,09
CD16+ 21,51,3** 14,31,1
CD19+ 10,70,7 12,070,6
*<0,05,

I
**<0,001.

-
, .
CD3+. CD4+.CD8+, -

I
83

; ^^* ;

21.
,
( . , 1998).

, .
-
- - -

(CD16+) -
. -
.
, -
50%
-, - --
-
(. 21).

.
-
.
, -

,
. ,
84
 ,
.
, ,
.
-
CD19+5+ ,
,
: , , -
(Beer A.E. ., 1996).
CD19+5+ 2 10%. -
10% . CD19+5*
-
, -
, , -
.

-
.
, -
. , -
, .
20 -
,
. , -
-
, , . -
. -,
, -
. -, -
-, -
, (DirnhoferS. ., 1994).

.
- ,
-
(Deshmukh U. ., 1994).
. TalwarG. . (1994),
50 / 1224 -
. 35 /.
,
35 ; -
;
, -
, ,
, (Dirnhofer S. ., 1994). -
-
.
85

. Sokol R. . (1980), -
3- -
. ,
, . Braunstein G. ., (1983)
-
-
. ,
, -
.
PalaA. . (1988), -
. -
, -
. Tulppala M.
. (1992), -
. , -
, -
; ,
.
, !

, -
, . ,
, . -

( .., 2001),
. -
, , , -
. -
,
7,80,2 (76,4%), 24,80,9 (17,9%) 33,80,8 (5,7%). ,

(IgM) 515, 2125 3033 . -
.
, -
.
.
-
CD 56+ 4 , CD19+5+ 2
.
-
,
- .
, , -
34 . -
, -
.
86
I , ,
, -
,
.
, .. -
( ),

-
, -
-
.

. -
, -
, , , -
, .

-
(PACK) ,

. PACK , ..
.
.
:
, , ;
,
, ;
, -
.
-
. , -
, ,

.
:
1. - ;
2. ;
3. ;
4. .
87
 -

- -
.
. ,
.. (1988), :
1) -
( -
);
2) ;
3) ;
4) /
- III;
5) -
.

, -
,
, ,
, ., , -
, .
, , ,
, -
. -
- .

, , .


.
. -
. ,
, .
,
,
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II ;
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IV ;
V ;
VI V ;
VII ;
VIII ;
IX ( );
X ;
XI ;
XII ;
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. -

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:
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.
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,
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91
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III (AT III). AT III -
, ..,
XII , 1, IX , VIII , , A III
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,
, . A III 30%
,
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.
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( 24).

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XI XIII.
3-


.
VIII ( )
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.
XI -
XIII (- -
). .
94
 9


200450 mg/ml 400650 mg/ml
II 75-125% 100125%
V 75-125% 100150%
VII 75-125% 150250%
VIII 75125% 200-500%
IX 75125% 100-150%
X 75-125% 150250%
XI 75-125% 50-100%
XII 75-125% 100-200%
XI II 75125% 35-75%
III 85110% 75-100%
S 80120% 60-80%
65145% 70150%

, -
III, -
, S
.
(Biezenski, 1960) -
.
.
.
Merskey . . (1969),
. Hedner V. . (1970),
-
. J. Rand . (1991), -
16 -
3640 .

.

-
(-
.., 1994).
.
5533% , -
. -
.

I 95
 10
( %)
I

110 3 / 41,20,8 63,35,3
5
1 / 40,03,2 57,76,7
, % 36,42,2 57,37,4
1x1 05 38,4+3,4 53,3+10,4
- 1x1 04 40,44,2 61,32,4
48,02,6 46,312,3
1103/ 0,810,1 2, 10 /

1,8 ,
. -
39% , (. 10).
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-
. -
I .
, -
-
, -
, 1x103 1x105
, .
-
( ) -
1x107 .

.
11

I

/ 2,100,02 2,80,2
, 31,20,3 288,81,1
, 60,3+0,5 55,92,9
(%) 92,50,4 99,91,4
:
r+k, mm 20,8+0,2 14,41,1
, mm 46,3+0,3 50,72,3 I
... 10,10,5 18,32,8 |

I -
: ,
r+k,
(. 11).
96
 , I -
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().
I 2x10 /. -
, -
.
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(. 12). , 10%
5% , . -
. -
: r+k,
, .
12

II ()


1. / 2,30,01 2,60,07
<0,05
1-2
2. , 33,70,3 30,20,6
<0,05
12
3. , 61,40,4 58,1 + 1,2
< 0,05
1-2
4. , % 98,20,3 100,60,6
<0,05
12
5. 16,60,2 15,10,4
r+k, mm >0,05
1-2
6. Ma, mm 47,7+0,3 50,80,9
<0,05
1-2
7. , .. 14,20,3 18,41,0
<0,05
12

(. 13) -

, -
, .
4-6747 97
 13
( %)
II ()
N

1. 110 3 40,70,7 45,52,0
<0,05
1-2
2. 1 6 34,11,0 47,94,9
<0,05
12
4. 38,41,0 29,82,7
<0,05
1-2
5. 1x1 05 38,30,8 43,6+2,9
<0,05
12
6. 45,4+4,8 48,03,8
1x10" >0,05
12
7. 52,07,5 48,0+5,0
>0,05
1-2

III -
(. 14,15), . -
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.
, -
.
- 14

III ()
N

1. / 2,6+0,04 2,60,06
>0,05
2. , 31,20,3 29,4+0,6
<0,05
3. , 59,20,4 58,90,9
>0,05
4. , % 100,2+0,2 96,80,6
<0,05
5. 15,10,2 15,4+0,8
r+k, mm >0,05
6. Ma, mm 52,70,3 54,8+0,9
>0,05
7. , .. 19,8+0,4 20,11,2
>0,05

98
I
N
( %)
III ()

15

1. 1x1 03 47,00,5 45,42,2
>0,05
2. 1
5
41,60,7 45,62,7
>0,05
4. 40,52,7 28,32,8
<0,05
6
5. 1x1 0 44,50,7 38,22,5
<0,05
6. 36,01,8 41,13,1
4
1 <0,05
7. 48,64,3 45,8+2,5
>0,05

, , -
, , -
-
() .
,
1
2.
9,2
9,7 / ( 0,33,5 /) -
-
(112115% 15,316,3 /,
75150% 8 /). -
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III (TAT) , -
.

-
(),
. 97%, -
5378% ( 70140%).
II -
75 / 1 ,
AT III, 45,5%,
0,423 /. -
0,612,7 /, 4,70,08 /. , III -
, 0,8 10,7 /,
3,2 0,04 /, 16,6 /. ,
-
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2, . -

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-.

II 29% , .
:
I -
102+6,4% 15,70,09 /; II -
112 277% -
11,7 / 25,3 /, 136,811,2 % 14,50,11 /.
III :
104 234% ( 126,89,9%) 10,8 16,3 /,
14,50,11 /. , -
.
2--
(2) I , -
3,2 6,2 / ( 2,4 /), 3,360,08 /; II
2,9 6,2 /, 3,820,14 /.
^--
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,

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.
1, 3 5 . 49% -
, 51 % -
.
100
 16

( 5- )()
N ,
=14 , =44
1. , / 2,80,1 3,00,1
>0,05
2. , 26,50,9 30,40,7
>0,05
3. , 58,31,9 57,11,4
> 0,05
4. , % 100,31,1 96,81,5
>0,05
5. 18,61,2 13,50,7
r+k, mm >0,05
6. Ma, mm 54,02,2 55,0+1,0
>0,05
7. ... 19,62,1 24,72,3
>0,05

17
( %)
( 5- )()
N ,
=14 , =44
1. 1 3 48,81,8 46,13,2
>0,05
2. 1 5 31,31,2 42,24,8
>0,05
4. 64,54,5 19,84,0
<0,01
s
5. 1x1 0 M 59,12,0 49,54,9
>0,05
6. 54,22,7 18,2+3,3
1x10" <0,01
7. 62,7+2,8 58,4+2,7
>0,05

-
( .., 2001),
-
. -
: , S, -
II, XII, - , , -
, V
.

, -
101
 - --

.
, ,
11% (Molloy . -
.,1997).
I (Nelen
W. .,1997). -
.
-
.
,
, , , -
, -
, .
, IXa, Xa, Xla .
50% -
.
1:600 1:5000 (Bonnar J.1999).
Va Villa. S -
, . S
1:500. ,
S
. , S -
, - (Faught W. .,1995;
Lefkowitz J. ., 1996).

V , .
V , . -
9% (Ridker ., 1997). -
V Leiden (Walker M.C.,
Garner P. .. 1997). -
. , ,
46 60%,
14% 8% (Bonnar J. ., 1998).

-
, II III .
0,50,6% (Green L.K.,
Harris, 1976). , ,
102
 10 15%, (Buttraue
V.C., 1983; Kusuda M., 1982 .).
*" , , -
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14,3% . -
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- -
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.
1 - .
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, ) .
, .
HillJ. (1998) -
, .
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; IV ; V ; VI
. ,
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103
 ,

. 25. .

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,
.
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,
.

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. -
--
--.
.
( -
, ). -
, -
. 53%
, -
( .., 1981; -
.., 1981).
-
, -
104
 ,
( .. .,-1982;
.. ., 1988).
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,
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.
, -
34 -
2-
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- . -
, ,
.
-
.

II -
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-
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,
. ,
1- -
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105
 ( .. .,
1963).
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.
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, -
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.
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6 -
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6,09
2,63 . , ,
, ,
-
.


(., 1987). , > 2
1 ; < 2 2 . -
6 1 , 2 . -
, 0,5 1 -
, 0,5 2 .
46 -
(. 18).
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.
-
106
 , . -
-
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18


1 2
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6

HgS < 0,5 > 0,5

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

-
, . , -
, 3075%
( .., 1985). .. .. (1988),
15% .

,
. -
. -
I . -

. -
.
, -
.
-
. , ,

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107
 ( .. ., 1981; -
.., 1985; .., 1985).

-
( .., 1985).
-
, , . -
. -
, , ,
. ,
, -
, .

. ,
, , -
.
. ..
(1979), 8085% . -
,
(Pittway
., 1988; Naples J. ., 1981).

(FitzSimmons .,1987), , -
, (Metzger D.A. ., 1986; Vercan-
men E., 2000). , ,
/ ,
.
-, , -

.

, -
,
13,2%
( .. .,1973).

, -
. 18,3%
,

(.., 1983), .
, -
, ,
.
108

-
: ,
, , -
. -
, -
,
.
.
, - -
.
, 0,010,39%
( .., 1970). , I 17%

. -
, ,
, 1624 .
2,2% . 65%
-
, : , -
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. 7,7% . 7,8% -
-
.
80%
-
.
. -
-
. 40% -
.
/-
,
.
I

. , -
, -
,
..
80-
, ( .., 1980; -
.. ., 1980). -
, ,
. , -
.
109
 ,
. ,
, -
.

, -
, .
-
. 0,09 0,81 %,
13 . , -
1980 .,
18,620,4%, , -
,
. , -
. , 15,5%
, .
, , , .
17,2%
. 31,7%
, 50% . 18,3%
-
.
(placenta circumvaelate, placenta marginata) -
.
-
. , -
,
-
(Kong ., 1987). -
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, . 2
, 1 (CSF-1) il-3
, Th1
il-12, TGF-p\ , -
il-10 -. I -
, il-12,
TGF-, -, ,
-
. -
, -
. ,
. ,
-
, (Jaffe ., 1997).

. -
.
110
 -
, , -
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(Lee ., 1997).

.
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.
.. . (1998), -

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,
: 21,61,8 40,62,7 / .
-
,
111
 . -
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. -2 -
,
.
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, (57,98,9 17,72,7 -
). , -
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. (1998), 38,8% ,
7,7%.
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, , 42% -
.
, -
.
, -
(Halmesmaki ., 1989).
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 -
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.
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3- .
3- , 2-,
, 2-, 3-, 4- ..
, 2- ,
.
,
-
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4560% (Boue J., Boue A., 1975, Rodriguez-
Thompson ., 1999). ,
- , 75%
. , -
, 66% , -
(1., 1981).
.
,
. ,
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(Hansen J., 1986). .
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2- , 35 , .
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115
, -
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30 ),
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116
 , , -
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, Hill J. (1996), -

(46) 70 25%.
-
(Doss . ., 1995).
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117
 ,
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.

925 929 179 335 419

896_ 887_ 173. 344. 392.
867_ 845. 167. 333. 365.
838 803 161 322 338
809. 761. 155. 311. 311.
780_ 719. 149. 300. 284.

. 26.
( .. ., 1985).
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118
 . -
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60% -
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-
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.
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.
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-
.
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.
119
 ,
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27, 28), (. 29), - -
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27.
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120
 . 30. - .

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(Keltz . ., 1997).

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100 2 , 0,25
3 , 0,5 4 56 .

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122
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123

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19


/ /

336 420-271 1,6 1,9-1,4

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1148 1330-985 2,2 2,5-1,6

640 885-465 44,0 52,237,2

(2223 )

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,
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422,0 / (115 /), -
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(10 /) . -
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 .32. .

.33. .

(Miles ., 1994). ,

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ma ., 1993).
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3- -
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126
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2
6 3- (8 /). ,
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, .

( .., .., 1986) (. 20).

20

( .., .., 1986)

5 +

6 0,5 4
7 0,5 4
8 0,5 3
9 0,5 2 +
10 0,25 2
11 0,1 25 2

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17 22 7 -
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17
, .
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.

(- 40 ) . -
-
127
 21


( .. ., 1986)

1 II
/ 6,9 6,9
6,0-7,9 5,8-8,1
/ 3,6 2,7
3,3-4,1 2,3-3,0
/ 270 287
243-299 257-320
/ 258 543
228-292 502-588
/ 2,0 27
1,82,2 23-32
/ 1,7 1,7
1,5-1,9 1,6-1,8
/ 348 344
321-377 315-375
170 / 2,7 6,4
2,2-3,3 4,6-8,8
/ 32 24
2935 2028

-
17 100%, 190%
160%.
17
46%, 72% 54%. ,
-
. -
,

. -
,
. -
.
-
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( .., .., 1986).
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21.


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130
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.

132
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22

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, % 109/
CD3+ 70,33,5 1,30,07
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(NK) CD 16+ 10,61,7 0,20,02
133
 . 22


, % 1 09/

- CD 19+ 5,50,3 0,220,01

CD56+ 3,90,7
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CD5+CD19+ 2,5+0,2

2. .
5 : IgM -
-
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.
IgG , IgM, -
.
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30 , IgE 100 .
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134
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135
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-
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( .., 1997; .., 1996;
.., 1997).
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(Jones . ., 1997).
- il-2, il-4, il-7, il-9, il-13,il-15,
TNFoc. -
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, , -
(Contstant S. ., 1997; Marzi M ., 1996).

. , -
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136
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Shehate H. . 2001).
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137
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50% (Incerpi M.H.
., 1998; Malinowski . ., 1995; Ogasawara M. ., 1996).
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. (Eroglu G. ., 1994, Geva E. ., 1997),
, , , -
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: , , -
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., 1998).
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( .., .., 1995) -
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138
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139
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140
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141
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24

( .., 1992).

24

-
()
- - 1 II =25
=42 =36
(=17) -
( = 33)
( = 11)
6,41,0 5,9+0,09 6,0+0,09 5,70,09 5,50,06 4,70,07 7,80,09
>0,05 >0,05 >0,05 <0,001 <0,001 >0,05
- 4,00,10 3,90,1 3,90,1 3,80,1 3,9+0,1 3,80,17 6,5+0,15
>0,05 >0,05 >0,05 >0,05 >0,05 <0,05 <0,001

5,00,17 5,7+0,13 5,0+0,11 5,20,12 4,90,12 4,40,15 7,0+0,15
<0,05 >0,05 >0,05 >0,05 <0,05 >0,001
2,0+0,06 1,40,05 1,30,06 1,5+0,06 1,50,06 1,2+0,06 2,60,06
- <0,001 <0,001 <0,001 <0,001 >0,01 <0,001

3,50,07 2,80,04 2,7+0,06 3,00,07 2,4+0,12 2,3+0,1 3,00,1
<0,001 <0,001 <0,001 <0,001 >0,05 <0,001

142
 . 40.
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.
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:

2540%.
15
26,6% 3134%. -

.
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(. 40) ( .. .,
1999), . -
- , -
0,5 , -
(. 41 ,).
Brooke I. . (1981), 1,9
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.
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143
 . 41 .
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1,5 - .

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( . , , 1992).
144
 -
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145
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(Hill J., 1999; ., 1993),
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149


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150
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151
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2 .
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30 10 . -
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( O.K., 1993; .., 1982).

1.
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152
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3; 17 ;
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153
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15003000 ME.
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Hunter M. . (2000)
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10 2 , 100 2 -
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1214 ;
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(, , ) 750010000 ME -
154
 18 . 36
48 ( .. . 2001).
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I 10 ,
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17 51,3% ;
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17 ,
(-26,507);
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155
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156
 (IgG) -
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157
 -
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158
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159
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160
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162
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163
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(.., 1996).

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164
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165
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166

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168
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169
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170
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87% . -
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171
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172
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A.M., .. (1993)
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173

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174
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176 '


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177
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178
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181
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(Levran ., 1998). ,
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(Casan . . . 2000).
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. . . 2000), -
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.
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., 1999). ,
,
. -

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.
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. -
, ,
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(PIF) ( . ., 1999),
(VEGF), mRNA VEGF, -
-
(Krussel ., 2000).
182
 ,

, 67
-
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.
, -
(Nikas G., 2000).
. , -
.
-
,
, 1 episialin,

(DeSouzam M. ., 1999). -
, .
: 1 -
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(Kierazenbaum A., 2001). , -
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23 .
(Kierazenbaum A., 2001),
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(Shiokowa S. ., 2000), ,
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183
 , . Paria . (2001).
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(BMP) . -
.
-,
, -
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.
-

. -
, -
-. ,
, -, -
, . (Loke
Y. . 2000) , -
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HLA-G. -
CD8
, -
. NK- CD3-CD8+CD56+
Th 1, TNFcc,
CD8-CB56+ . ,
()
TNFoc, GM-CSF. -
, 2, .. -
, , , -
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.
-
, .
, Th1 -
, .
, -
(fetuin) (spermine). -
TNF. HLA-G
NK- -
(Cooke I., 2000).
NK-
GM-CSF, CSF-1, , TGF0, -
, .
-
. -
. , -
184
 TJ6, CD56+16+,
( ).

(), -
. -
. -
1012
.

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185
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710 1416 .
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186
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, 3740 .
.

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(. 26).
26

, ,

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1 (IGFBP-1)
- 1
1
(CSF-1)



- 1
(IGF-1)
(EGF)
(PGF)
(FGF)

(TGFP)



-1 (il-1)
-6 (il-6)
1
(CSF1)
187
 . 26

-
(), (), -
(XT), (). -
, - (-
(GnRH), - (CRH), -
(TRH) ) . ,
-
(Shi Q. ., 1993).
-
, . -
. - -
, - .
. , -, -
6 , - 19 -
, - 6 19
(Jameson J., 1993). - ,
24 ,
2 (Ren S. ., 1992).
, ,
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, . -
: 7
, ,
, -
. : , -
, . ,
-
, -
.
, -, -
. , , -
.
810
100000IU/I, 16 1000020000IU/I,
34 . 34 -
, .
188
 ( -
)
, . -
, -
, 32 .
1 (Spellocy
W.N., 1973).
Kaplan S. (1974), -
, ,
. . -
.
.
, -
. ,
, -
IGF-I. 12% ,
, .
-
, II
36 . ,
IGFI (Frankenne F. ., 1988). -
.
,
, -
, -
. ,
, , -
.

-- (CRH). CRH -
. CRH CRH- -
, .
, , ,
CRH. , CRH -
. , CRH
. CRH ,
CRH , -
, CRH ( -
) (Grammatopoulos D. ., 1994). , -
CRH ,

.

.
, -
.

189
 -1 , 1
(CSF-1) . -
(Li Y. ., 1992). -
-6, (TNF), -1. -6, TNF
, - (IGF-I IGF-II)
(Pekonen F. ., 1990). -
-
.
--
(IGFBP-1P). IGF-1
, , -
. IGFBP-1 IGF-1
. , -
IGF-1 no6paTHOclGFBP-1 (Osborn ., 1992).
(EGF) -
.
, , : , -
, , .
.. -
, 2 F^.
-
. GnRH, : -
, .

, -,
(Petraglia F. ., 1989).
SP, ^
,- (), -
.. 1971 .
.


.
(Wagner J. ., 1994)

,
, -
. 30,
.
.
--
. -
,

. (2),
, -

190
 , -
.
, V
, -
; (PG12nPGE2),
. -
, -
, .
(-- ) -
.
. -
, -
14 (Lemire R., 1974). 100 -
,
- 19
21 . -
: , -
, ; , ,

(KaplanS. ., 1976).
- , -
. -
. --
() .
I II -
(Kaplan S. -
., 1976). 1022
(, -
),
.
-- , , -
,
.
. 10
. .

.
:
, -, .
. -
,
(Silman R. ., 1976).
,
(2029
), (Kaplan S. .,

191
1976). . ,
-
.
. -
, -
, 85% ,
(
). -
() . -

(Murphy . ., 1975). -
. -
, -
, - .

; -
; II > -
. -
, -,
. , Liggins G. (1976), -
, -
, ,
-2, . -
. -
, , 7
(Neville A.M., 1969).
. , ,'
, . 6 -
. , -
. -
,
-
.
, -
78 , -
, . /
. --
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-
.
8 -
.
1012
. ,
4 . -

192
 , ,
- -. -
, 20 -
. ,
-
. -
III . -
4 4
. 30 -
, .
(Osgthanondh R.
., 1978). ,
56 . -
, 30 , 2-
. 4 4
.

, , . -
,
, , -
. -
.
-
.
.
, -
67 . 8- -
-
, , .
, ,
,
. , -
, -
, - -
(CD4 CD8)(Haynes .F., Heinly .S., 1995).
12
(HorstE. ., 1990).
-
(), -
, . -
95% 34
. 5% , -
, , -
CD4 CDS 14 (Asma G. ., 1983).

7-6747 193
 - . -
,
, , ,
, , , -
.
20 (Bonati A.
., 1992).
--4 , CD4 CD8, --
- CD3. 16
10% ,
. -
- TNF.
,
, il-3,il-4, il-5, il-10, - -
, a il-1, il-6, TNF, -, -, il-2
(English ..
., 1988).

.
,
, -
.
1) - :
() 6 -
, 4050%. 20
24 ;
40%;
3040%. -

, III -
.
2)
:
;
. -
, ,
. , .
100 / 30% ;
. -
915x109 /,
() ;

140400x109 /;
194
 -
. VIII , -

(. 27);
.
3) :
20%, 02 ;
40%, -
20%;
;
2 2832 ..
( );
: -
.
4) :
: 1,01,5 ,
, ( -
);
:
5080% I II III (
);
; -
. >

27

:

I II 31,235,5%
III 31,9-36,5%
915x109 /
140400x109 /
:
200%

:
V
VII 200%
VIII 300%
IX
X 200%
XI
XIII

195
 5) .
-
. -
( ),
, , (V, VII, X, XI, XII.
XIII), ( III, S). -
. -
( , , --
) .
6) .
, 85% .
, 6 16
, . 70%
- , .
7)
. ,
-
, - . -
. -
(,
), , , -
.
, , , , -
. -
, .
.
, -
:
1 , -

2 ,
,
.
--
, -, -
. .

.
, -
. -

.
8)
. 50
-
,
.
196
 -
, -
. *
-
- , , -
--.
-
, -
, .
-- , , -
,
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2) ;
3) ,
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).
16-;
4) , -
; , ,
, ; -
, -
; 16-, .

, . -
( 5).
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(TulchinsKy D. .,
1973).
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. --
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. 7
. 10
. -
II
(. 45). 57
, .. ,
. 10
. -
250 .
.
, -
, - , ,
. ,
.
197
 5.

(Mitchell ., 1987).
-.

1020 , . -
3 , -
.
: -
(), . ,
-
II. 1200 ,
. -
.
, -
(Rotchildl., 1983). -
;
, ;

198
 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42

. 45.

, ;
.
, ,
- . -

(Siiteri P. ., 1977).

, -
. .
. -
57
, . -

.
450 . -
, ,
, -
17|3- ( 6).
- -
. ,
17- (

199
 6. .

. (Gurpide, 1982),
, . , -
, .
-
, . ,
, .
200
 . -
, 16-
1 --. -
.
16- (Madden
., 1978). -
.
, -
. , ,
, (Fradsen V., 1961).
. -
, -
810 (Spector W., 1956).
, 85% , ,
15% ,
. . -
100 200 /dl ,
35 /dl (Casey ., 1998).
,
(MacDonald P. .,
1978, Liggius G., 1969), -
. -
, -
. ,

, . , -
,
, ,

. ,
. , -
.
-
( ),
.
- (IGF-I IGF-II)
, IGF-II,
(Mesino S. ., 1993).
.
, . -

. -, -
- (Mesino S. ., 1993).
(Fujieda . ., 1982), -
"
- .
, , -
:
, .

I
4
201
 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 4C
^

. 46.

-
(. 46).
1. 610 .
2 30 /
.
2. 68
6 40 /, , -
.
3. 9 , -
, 3135 , .
Jf(

100 , .
:
1) ;
2) , -
. , -
-
HOB(ResnikR., 1974);
3) , , -
;
4) ;
5) ;
6) - .
202
 6,

1. 12 -
. -
37,237,4. 37 -
. ,
, -
, .
2.
,
, , -
,
. 12
-
() 10%, 1316 39%. 39
5%.
,
, -
.
3.
I .
3- .
25005000 5 80 000 79 , 1213
10 00020 000 3435 ,
, .
,
, , ,
.
, -
(. 47). 56 ,
1012 -
, -
, -
.
,
.
, . -
, ,
. I -
.
4.
, -
. (. 47)
,
. 5
205
 . 47. I
.

, .
,
.
5. I -
.
I , 11111
.

--
- , ,
-
, (Bradshaw . ., 1986).
.
6.
-
17 .
17, -
. , -
- 3-
.
17 . -
20,0 42,0 / (612 /). -
17 -
. 10% 17.
206
 17 . -
17 170 -S -
.

; II III -
.
7. -
. I 9
-
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( I ) -
, -
, - .
1718 .
, - -
. , 35
,
. -
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HLA 14, 3518 ) -
17- .
17
. 170
.
8. , -
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3-
.
, , ,
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.
5- , 67 . -
-
, , .
.

.
. . -
,
. -
(. 48, 49). -
, -
, .
,
. -
, -
.
207
 . 48.
, ,
( ) ( ..,1992).
( -
) ( ..,1992).

. 49. . .
(1), ,
, (2), .

(. 50).
-
,
, .

(. 51, 52). - ,
.
208
 50 56
/ , 2 , 3 -
- ( ) (-
., 1992).

51 I


7 , 1
, -
, 2 89 ,
,
( ),
8 , 1
-
; 2 89 -
,
, 3
45 ,
( ) (-
, 1992)

209
 . 52. 14 .
- .
1 , 2

(.., 1992).

-
.
, ,
, -
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-
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.
: -
; -
. , -
, .
9.
- --
, . -
2024 24 -
.
, -
. -
()
() : --
, () :
-
=

() , -
.
10.
, 34 12 (
). ( -
) , ..:

= 155x10-4 (Etcp) + 87x107 (Ehm/ - (6410-4) - (Ehma) + 0,33/(maxhma/cp) + 0,95,

; Ehma -
; maxhma/cp -
.
1,0
; 1,0 2,0 ; 2,0
210
3,0 ; 3,0 -
, .
11.
, -
, -
.
- -
. -
, 15 /2.
.
. -
1520 .
, ,
, . -
.. -
:
_ X

, -
; ( ); I
; ; ;
t .
, ..
. (1977). .
. , -
.
,
. -
-
.
. -
. -
. 7,5..
, 7,5 ..
.
,
, ,
,
, , -
.
12. -
: , ,
, -
.
13. .
.
211
 510% ( ..,
1995; Higgins 1997). 4,4% 32,7% -
( .., 1987; .., 1994).
, , ,
, ,
, .. ,
, .
() ,
, -
.
,
390 ( ), ,
. -
(.. -
, ).
24 15- 30--
. ,

, ,
, .
.
24- -
,
-
.
-
:
1. , ,
( .., . ).
2. -
( ..).
3. -
, (%).
4. -
, (%).
25%.
5. ( -
)
,
( % ). -

10% 1,1.
,
, , -
. (-
) -
, .
212
 COM , i iupui
1 .
,
, -
.
, , -
.
--
.
-
. -

:
-
, ,
.
. (45%) -
,
.
. ,
-
, -

.

,
,
.
4. , -
, -
, -
.
5. -
-
, -
.
6. ,
-
, -
, . -
,
, .. -
, , -
.
213
 -



, ,
.
: , , ,
, (missed abortion), -
.
, I 75%
, -
, -
, .

-^ 1.

: -
,
. -
. , ,
. ,
.
:
1.
. -
. -
, .
2.
. ,
- .
, , , .
.
3. . .
50% . -
, .
4. . -
, ,
(),
. - . -

, , -
, , .
-
-
:
214
 ) 37
( -
);
) , ;
) .
: , -
, . (-
, ) ,
(-
, , ,
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-, .

2.

, . -
, . -
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,
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.
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;
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.
215
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12 , 2,0 23 .
45 .
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23 , 250 3 -
.
. -
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3 3 40
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, ).

3.

,
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,
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. /
(30 1000 ) 200
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,
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216
 1416 -
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- .

4.
( , missed abortion)

(-
) . -
, -
, .
, , -
, -
.
.
(4
) .
,
-, -
.
1214 (-
-).
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,. -
-
.
(, -
)
, , . -
() -
.
( ),
( )
( ) . -

.
-
.
, .
.
.
217
. , -
, .
,
.
, , -
,
. .
-
. -
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-
,
, .
-
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-
.

. -
,
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,
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.
, (24 )
50%
,
,
. ,
, -
, . -
-
.
I
, -
. ,
, :
1. ;
2. , : , .
-
-
218
 .. . (1976)
.. .. (1978),
(.., 1991) --
. -
- -
, , ,
, , -
. -
-
,
-
. , -

, -
, .

-
, -
, , -

. -
-

.
-
-. -
(Spatling L, 1988). -
, 60%.
, -
, , . -
( 6)
. -
, , -
.
- -
,
. -
4 . 2 -
2 ; 1 , 1 2
. 2 -
. -
, . -
- 56 ,
. - -
.
- 2- 200
: <*>*
219
 , ,
85% ;
, 65% -
;
, -
.
, - -

. - -
,
. - -
, , ,
-
, ,
.
3. : - 0,04 3 , -
0,02 34 . -
- 2,0 23
, 2,0 .
4.
, , -
.
.

.
I , -
II III -
, , -
.

.
, -
, . , ,
, ,
.

5000 2 -
. (Fanchin R. . 2001),
, , -
, -
.

. -
220
. 56
, -
II . -
,
, 6
10 2 , 100 1 23
per os .
16 , .
-
, -
.
,
-
HLA.

^ ()
^ Beer . . (19701979) . 1978 .
^ Beer -
^ . , -
$^ 1979 .
(Transplantation Immunology
Congress). Beer . 1978. -
, -
, . ..
,
, .
. ..

. -
I -
. 14 , -
, .
, 23 78 -
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, , -
, .
-
. .
46 ,
, -
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, -
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1 2 -
, , ,
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-
- -
.
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239
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Ginsberg J. . (1989),
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240
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(Clarke D.A., DayaS., 1998; Thornton . .,
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1990; ., 1990). 1620 -
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9-6747 241
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242
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-
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B. ;
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, Asherman R.A. 1992 .,
(Ingram S.
., 1987),
244
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( R.A. Asherman, 1992)

70%
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45 )
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(100%) , IgG ,
(1011)
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245
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1 , RW, HbsAg, HCV
ffc 2. : -114 /; -30 /; L-15,3; -5; -13; -69;
^ -11; -1; 243 000 /
^ 3. r+k = 15+7122
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= 15,..
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237 /; 477 /; - 151 /; 18,2 /;
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% 25 /.
| 6. : 0,1 /; L-0-1 ; -;
.
^ 7. : 8750; 58750;
|
| .
^ 8. .
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*
246
^ 10. HBsAg ; ;
^ HCV ; HAV .
^ 11. : , -
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247

, -
( R.A.Asherman, 1992)

+ + +
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: 816 . 15 000 , -
200,0 / . 400,0 /
3. 1,0 4 / 5 . : 400,0 /
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248
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249
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250
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10 23 .

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HLA
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. -
251
 -
() , (Beer A.E. ., 1981; Beer A.E. .,
1991; MowbrayJ. ., 1985).
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5069% 3444% . -
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HLADR 4271 % 2030% . -
, -
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, 2 . -
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, .
Beer A.E. . (1991) HLA
6 2 2
,
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.
HLA .
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4 . , -
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253
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255
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1. A.M., .. -
. ., 1993,
1-2, 27-34.
2. ..
( -
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3. . ., 3. . -
. -
, 610 , 1994, 494.
4. .. -
, , 1995.
5. .., ..
. ., 1983. 1,3841.
6. .. - -
. ...,
., 1989.
7. .. , 1970.
8. .. ., ,
1988.
9. .. ., , 1979.
10. .., .. -
., , 1976, 168.
11. . --
. ..., ., 1987.
12. P.M., .., .. -
, 1982, 9, 5153.
13. .., ..
. -
., 1999, 2,3741.
14. .. -
. . ..., , 1985.
15. .., .., .. ., -
, 1973.
16. .., ..

. . -
, -
, , 1920 , 1994.
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, 1998,1,52.

285
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, . ..., ., 2000.
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. ..., ., 1998.
20. .. , ,
. . ..., , 1983.
21. . ., .. -
.:
, , 1988, 4445.
22. .., .. ., , 1981.
23. .., .. . -

, 1990,7, 1823.
24. .. -
. ...,
., 1994.
25. .. -
. ..., ., 1982.
26. .. , -
. . ..., ., 1996.
27. .., .. -
. ., 2002,
1, 2427.
28. .., .. . - -
, 1978, 12, 106107.
29. .. ., , 1979.
30. .. - -
. ., 1978, 4, 811.
31. .. -
. ..., ., 1994.
32. .., .. .
- . -
, 1992, 70.
33. .., .., .. -
, , 1999,7,3,189190.
34. .., ..
, 1990, 8, 8992.
35. .. . ..., .. 1993.
36. ..
-
', . ..., ., 1993.
37. .. - ., -
, 1994.
38. - .., .. -
- . -
., 1979,2,29-31.
39. .. ., , 1996.
40. .., .., .. -
-
, 1996, 41, 4, 172.
286
 .., .., ., ..

. ., 1982, 12, 48.
.., .. .
-., 1979.
43. .., .., ..
. ., 1963, 4, 35.
44. ..
. ..., ., 1980.
45. .. -
. ..., ., 1994.
46. ..
. . ...,
., 1989.
47. .. -
.
..., ., 2001.
48. .. -
, 1997, 1, 5961.
49. ..
. ..., .. 2000.
50. .., .. -
. , ,
1978, 11,7980.
51. .., .., .. -
, 1982, 4, 5254.
52. .., .. . -
, ( ) -
, 1977, 5, 138145.
53. A.M. (
) . . ..., ., 1975.
54. .. -
. ..., ., 1996.
55. .. - -
. ., 1996, 4, 57.
56. .., .., .. . -

, ., 1992.
57. .., .. . -
.: -
, , 1973, 244246.
58. ..
. ..., ., 1969.
59. .., .. -
-
. ., 1981, 9, 40.
60. .. .
. ., 1974, 9,4548.
61. .., .. -
., Rqsso, 2Q01,

287
62. .. .
., Russo, 2001.
63. ..
.
. ..., ., 2000.
64. .., .., .. -
., , , 2001.
65. .. , -
-
. ..., ., 1993.
66. ..
- . ..., ., 1981.
67. .. ( , ,
) ...., ., 1997.
68. .. -
. . ..., ., 2000.
69. .. -- ., ,
1999.
70. .. -
.: , , 1981, 163168.
71. .. -
. ..., ., 1990.
72. .. , -
( , , ) . . ..., ., 1998.
73. .., .. .
, 1987, 6, 1418.
74. .. - -
. .
., 1969, 5, 8591.
75. .., .. .
-
.: , -
, ., 1986.
76. .., ..
- -
, , 1985.
77. ..
, 1996, 58,6,37.
78. O.K. -
. ..., .,1993.
79. .. (, -
, ) . ..., , 1997.
80. ., .. -
Immunol. Aspects
of reproductive health., M., 1995, 119127.
81. .., .., .. -2--
. 20 -
, , 1998.
82. .. -
. . ..., ., 1990.

288
83. .. , -
--.
. ..., .. 1979.
84. .. -
. . ...., ., 1985.
85. .., .. -
.:
, ,
., 1986.
86. ..
. ..., .. 1990.
87. .., ., .. -
. ., 1967, 2, 3237.
88. .. -
. . ..., ., 2000.
89. . , ., 1991.
90. .., .. -
. ., 1985, 12, 6669.
91. .., .., .. . -
., , 1991, 276.
92. .., .., .. -
. ., 1981, 11, 24.
93. .., ..

( ) , -
, 1974, 1.
94. .., .. -
, ., 1993.
95. .., .. . HLA-
(
) 98/195, .,1998.
96. .., .. . HLA - -

, ., 1997.
97. .. ., , 1985.
98. .., .., .. -
-
. . ., 1/98, 52.
99. .. ,
. . ..., ., 1991.
100. ..
. . ..., .,
2001.
101. .., .., ..
.: -
, ., , 1990.
102. .., .. -
-
.: ,
, ., 1992. -***>

289
103. .. -
.-
..., ., 2000.
104. .. -
.. ., 1976.
105. ..
. ., 1981, 2, 55.
106. ..
. ..., ., 1989.
107. .. -
. ..., ., 1982.
108. .., .., .. --
-
. .,1985, 10, 56.
109. .. -
.
. ..., 1996.
110. .. . -
. ., 1990, 7, 7375.
111. .. - -
, -
, 1980.
112. .. -
. ..., ., 1999.
113. .. ., 1987.
114. ..
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115. .. - ,
. .
..., ., 1988.
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