Ps22Pdf

, 6, 1. 2, 25 %,,,,,,,,,,,,,,,,,

,,,

42 2 2 2 3 6 7 9 12 13 13 14 15 16 17 17 19 20 21 22 23 24 25 25 26 27

29 30 31 33 35 36 37 38 39 40 43 45 46 47 48 49 B CT 51 52 6 56 56 57 59 60 61 62 13 64 64 65 67

68 69 70 B 71 C 72 A 72 D 73 73 76 77 8 79 79 80 81 84 85 86 87 87 3 90 90 91 91 9 94 94 95 96 96 97 97 98 101 103

33 106 106 107 108 109 110 112 113 114 115 116 117 119 121 122 123 125 126 126 127 127 128 129 131 132 133 133 134 135 136 137

139 140 141 17 142 142 142 143 144 144 145 146 146 147 147 148 148 149 150 152 152 153 33 156 156 157 158 159 160 161 162 163 164 165

165 166 168 169 170 171 172 173 174 174 175 176 177 177 178 178 180 181 181 182 184 185 186 23 188 188 189 189 191 191 192 194 194 195 196 196 198

199 199 200 201 202 202 203 204 204 205 205 207 207 209 211 212 214 223 249

42 ; ) ( ) ) ( ( ; ;,, 7 1990 5 ( ),

( HAV ) ( HBV ) ( HCV ) ( HDV ) ( HEV ) ( HFV ) ( HGV) ;,,,, ;, 7, 7, : ( 1) 3 :,,,,,, ; ;, 5 7

:,,,,, 2 6 :,,,, 1 3 ( 2),,,,,,,, ( 3) 3 3 :,, 1 2 :, :,,, ( > 85. 5 / ) ( 40% 60% ) ( 4) 10,

,,,,,,, 40 %,,,, 7 14 : 10,, 1 /3 :, ( 5), 3,,,,,,, :,,, ( 6),, :, : :,,,

, :,,,, ( ) - ( - ),, ( ),,,,, 1 2,,,,,,,, ( ),,,,,, ;

,,, -, ( ),,,, ( 1),,, ;,,,, ( 2),,,,

,,, ( 3),,,,, ( 4),,,,, ( 5), ( 6),,,,

: 30 160 ( 2% ) HBe - IgM HBsAg HBc 48 ( ) ( 1) 5 10 38. 5 %, 6. 4%

, 1, 6. 9 %, 2 3 10. 3%, 6 15 12% 30, 13. 8%, 30 5. 7% 30 30 6. 7% 5. 6% ( 2) 371, 72 ( 19. 4% ) 1 ( 3) 53 % ( HBVRNA) 4. 6% 5. 8 %, 0. 8%, 57. 7% 6, 43. 7% ( 4) 3 ( 5), ( 6)

,, ( ) ( 7) ( 8) 20% 50 %, 12% 21% ( 9) ( 10) ( 11),,, ( 15% 30% ),

( 1), ( 2),, ( 3), 59%, ( 4), e,, ( 2 3 ),, 21 30

, -, - ( ),,,,, ( 15 40 ), ( HGV) HGV,

,,,, ( ) 15 45, 30 ( ) 6 6, 3 ( ) 7. 8 ( 5 12 ), 30, 2 ( ) ( ) 14 ( ) 40 ( 10 60 ),, ( ), 61

, 3 ( 1) 2 80%,, 1 /3,,,,,,,,, ( SGPT ALT) ( 2) 2 6,, 1 2,,,, 2 5,,,,,

( 3) 2 4, 1 2,,, 1 2 5%,, 7 14 ( ),, : ( 1),,,,,,,,,,, ( 2),,,,,,,, ( 3),

,,,,,,,,,,,,, 33. 96%, : 38. 58%, 17. 31%, 8. 69%, 8. 15%, 7. 61%, 4. 89%,, 15. 7%, ( 1)

,,,,,,,,,,,,,,,,,,,, ( 2) ( ),,,,,,,,,,,,,

,,,,,,,,,,,,,,,,, ( 3),, ),, (, -,,,,,, 6 ;,,

; ;,,,,,,,, 1 2, ( ),,,,,, M ( - HAVIgM) ; M( - HBcIgM) ( HBsAg),, :,

:,,,, :, :,, :,,, : : : 90%,,,,,,,,,,,,,,

,,,,,,,,, :, 120 250 300,,,,, 40 280 ( ),,, ( 0. 5 4. 0 ),

, 17. 1 /,,, > 34. 2 /,,, ( 1) :,, : / 4 6 ; 17. 1 ( 2) ( ALT, GPT ) 1,,, : 5 25 ( 30 ) ( 3),,, ; / ( A / G)

; : 60 80 / ; 35 55 / 20 30 / ; / 1. 5 1 2. 5 1 ( 4) ( TTT) TTT,, 0 6, 7, ;,,,,,,,,,,,,,,, HBsAg,,,

2% 3%,,, 1 /2,,,,,, :,,,, ( HBV), : ( 1) ( HBsAg),, 10 12 /, 4 10-5

, ( 2) HBV HBV, 37 60 ; 60 4 ; 10 121 10, 65 10, 20 20, HBsAg ph 2. 4, 6, HBsAg, 25, 2 ; 6, 1 HBsAg, 25 1, 6 40,, ;, :,, e, 100%,,

,, : e, ; 8 :,,,, ( ) : ( HBsAg) ( - HBs) e ( HBeAg) e ( - HBe) ( - HBc) ( 1) HBsAg,,, 2 6, 2 8, ; ( 2) - HBs

,, ( 3 5 ), 2, 90 %, ;, ; ( 3) e S e e 10, e, e,, e e e ( 4) e e e e e, ( HBVDNA),, ( 5) 3 5,

, 5 ( ), ( ) e e + - + - + + + + - + - + + + + ( 1 ) + - - + + ( 2) ( ) + - - +, - + ( ) - + - +, - + - ( ) - + - +, - + - - + - - +, - -,? ( ) ( ) - + - - - - ( 3) + - + - + + + + - - + + + - - - + : ( 1) + + + ; ( 2) ; ( 3) -

, ( ) ( CIEP) ( CF) ( ID) 20 100, 1 ( RPHA) 10 100, 0. 1 ( RIA) ( ELISA), 2 5,,,,,,,,,,,, ;,,

1 2 3 1 5 25Karman > > >, ( ALT ( 30 GPT) ) > > > ( AST, GOT) 8 28Karman ( 30 ) < 25 (, 90% ( ADA) Martinek ) 303 ( LDH) 60. 5 LDH LDH 1, LDH 2 > LDH 1 > HDH 1 LDH 5 LDH 3 > LDH 4 > LDH 5 LDH 5 > 4% ( ) 4. 5 / ( GDH )

GST ( GST) > 13. 6 5. 8 > / > > - 72 120 / ( ) ( LCAT), 2 ( MAO) 12 40 MAO ( PHO) 3. 95 1. 187, / ( ) 3, 0. 5 15. 3 ( ALP) -1 /

- ( - GT, GGT) < 40 / ( - ) ( LAP) < 50 /,, 5 - ( 5 17 183 NT) - 1 /,,,?,,,, 90% 95%

20% 10%,,,, ;,,,,,, 65%,,,,, 20%, 10% 6, 12, e 8 10,

2, : ( 1) ( CPH),,, ( ),,,,,, ;,, ( 2) ( CAH),,,,,,,,,,

,,,,,, e, 70% M,,, :,,, :, 5 :,,,,,,,,,,, : :,,,,,,,

: :,,,,,,,,,,,,,, : :,,,,,,,,,,,,,, : :,,,,,,,,,,,,, :, 5% 10%, 18. 7% 30. 2%,,

,, 80%, HBsAg, 85%, 15 % HBsAg,,,,,,,,,,,,,,, ;, -,,,

,,,,,,,,,,,,,,,,

,,, 2 3, 1 2, ;, 1%, 54%,,,, e,,, B,,,,,,,?,,,, ( HBsAg) e ( HBeAg) ( - HBc ), - HBcIgM, ( ALT),,,,,,

,,,, ( ), HBsAg, HBeAg - HB - cigm, ALT,,, HBsAg HBeAg - HBcIgM HBV - DNA ( ),,,,,,,,,,, ( 7 ),, -,,, 50% 80%, 60%, 25%, ;,,,

( ),,,,, ( 28 1 ),, ( 90% ),, 35% 50 % ;, 30%,,, HBeAg 10% 30% ( ),,, ; HBsAg, 10 %,,,, ( ),, :,,,,,,,,,,

,, : DNA( HBV - DNA - PCR) ( ) B ( AFP ) 40 6, 40 3,,,,,,,,,,, 100, 30, 15, 6,, 60, 3 5, 15,, 2 /3, 4 4,, 0. 3, 0. 1, 48,

,, 1 2, 4 6 30, 15,,, 2,,, 5 5, 1,, 10 12,,,, 15 10, 64, 32, 22, 12, 6, 5,,,, 500, 250, 32, 15,,, 64, 32, 15,, 32, 30, 30, 1 ( ) 3,,

, 1 /4,,, 1, 7 :,,, 3 4, 30, 10, 1, 2, : A.,, ; B. ; C.,, : 4,,,, : 4 6,, 1 ( ) 4 10 ( ) (, ) : ; ;,, 2 3, 5

:, 0. 5 1, 1,,, 0. 5% B 1 2, 1, 2 3, 1, 10,,, :,,,,, ;,,,,,,,,,,,,,,,

,,,,,, ;,,,,,,,,,,,, 4 :,,,, 2 % 18 1. 25 % 3. 4% e, 218

,, 48. 2 %, e 1% 3% 9. 9% 16. 6%,,,, 3, 6, 6 1,,,, 10%,, 10. 76

,,,, 50 % 78%,,, 26 % 55%, 25%,, 0. 87% - HCV,, 2% 20 % 2. 2%, 12. 8%,, 3,,,, 10% 20%,,,,,,, 5% 10%,,

( ), HBsAg 24. 8 %, HBsAg HBsAg ; HBsAg 87. 7 %, 18. 9%, 14. 3% HBsAg, HBsAg HBcAg, HBV - DNA DNA, HBV,,,,, 40% 50%, 25%,, - HCV 12. 5%, HCV - RNA 14. 1%, PCR HCV - RNA, HCV, HBV, HDV HBV, 64% 92%, HDV, HDV

B CT B CT CT, 20 CT,, CT CT,, 90%, < 5 CT,, ( ) ;, CT CT, CT : A. : B. :,,,,, C. : D.

: CT,,,, B CT, B B B,, B,,,,,,,, 1.,,?? 2.,,,,,

,,,,, 3. :, ALT ALT, 30 /, 20 /, A / G,, : 3,, 2 1, ( ),,,,,,, 3,,

, ( ),,,,, 4. B : B B,,,,, B,,, > 12, > 8,, > 4,, B,, B, CT MRI: B CT ( MRI), CT,, CT MRI,,, CT MRI CT, CT CT

MRI CT, B, CT :,,,,,,, 5.,,,,,,,,,,,,,, 6.,,,,

6,,,,,,, 80%,,,, 15 % ( ), 5 %,,,,,, 1 100 200, 5,, 5. 6 %,,,,,,, 50%

, :?,, ( 7 ),, ( ),,,,,,,,,,,,,,, ( 28 1 ),,

,,, e 10% 30 % ( ),, 10%, e, ( ), e,,,,,,,,,,,,,,, ( ),,,,,,,,, ;,

,,,, ( ),,,,, ( HBsAg), ( HBcAg) e ( HBeAg), ( HBs) ( HBc) e ( HBe),,,, e e e,, e,, e,,,, e e

e e,, ;,,,,,,,,,,,,,,,,,,,,,,,, ( e e ), ( HBVDNA), ( ),, ;

,, ; ( HBsAg - HBe - HBc ), HBVDNA,,,,, :,,,,,, :, ;,, 10% 20%,, 500 1 000 :,,, :, 10%,,,,

HBsAg,, EB,, :,, ;, :,,,,,,,,,,, :,,, ;,,,,

13,,,,,,, :,,,,, 2 3, 2 3,,,,,,,,,

, :,,,, 2 3 1, : ; ; ;, 1 2,,,,,,,,,,,

e,, 3 10 80 /,,,,,, 300 500, 3, : 300, 2, 24 ; 300, 8 3, 24, e,,,,,,,,,,

,,,, ( 3),,,,,,, (, ACV) : 1, 1 4 ; 30 45, 200, 4 ( Ara - A Ara - AMP) :, :, 0. 16, 14 8, 6

, ( IFN) : a 1 b,, 300 /,,, 12-2 ( IL - 2 ) :,, 5, 8,, 4-2 :, e, ( 1 / ) 1 160,,,,,,,,,,? ( )

( ) B,,,,,,,,,,, ( HBsAg) e ( HBeAg), 24, 2 3 ( HBsAg) e ( HBeAg),, 6 12 1, 1 1 ( 100 / ) 2 3 6 1 20 ( HBsAg) e ( HBeAg), 0 ( 24 ) 1 6 10 10 10

e ( HBeAg), ( HBsAg), ( HBsAg), 0 1 6 10 10 10, : K( PS - K) CM - 101, 25% : 1, 3,, : 1, 3,,,, : 40, 1, 20 10, 3 30, 2, 6 : : B :

T : : : B B 1 B B 1 B 2 B 6 B 12,,, ; B 2, ; B 6,,,,,, B,,,,, B B 6 10, 2 3

C C,, : C ; ;, ;, ;, ; ;,,, 1 2,, A A, A,, A A,,,,,, A,,

A,,, AD D, D, D,,,,, D, D : D 2, D 2, 40 5 000 10 000 D 3, 30 60, D 3 100, D 3 1 200, D 3,,,,

,,,,,,,,,,, ( 1),, ( ALT) ( AST) : 10 20,, 1, : 10 15,, 1, : 30,, 6 9, 3 ( ) : 10 30,, 1, : 10 15,, 1,,,,, ( 2),,

: 10 25,, 1 : 10 20,, 1 : 10 30,, 1 : 10 15,, 1 : 10 50,, 1 : 10 25,, 1 ( 3) ( ) : 1. 5, 1,, : 1,,, 1 : 10 15,, 1 ( 4), ( HBVDNA e HBeAg ) : 10 20,, 1 3,

: 15 30,, 1 : : 10 30,, 1 ( 5),,,,,,,,,,,, ; ( ),, : ( ),,, ;,,

,, 3 ( ) ( ) 3 : ( ), ( HBVDNA) 1 :, ( P /N ),,,, 1 10, 3

, 30, 30,,,,,,

8,, ( ),, 6 -,,,, ; ( D860) ;

,,,,,,,,,,,,,,,,, ( ),,,

,,,,,,, A, :,,,,,,,,,,,,, ( 1),,,,,

,,, e,,,,,,,,,,, 1,,,,,,,, ; ( ),,,,, ( 2),,,,,,,, ;,,,,, ( 3),,,,,,

, ;,,,, ( 4),,,,,,,,, ( 5) :,,, 3,,, 2,, ( 6) 50, 0. 5, 6 40 24,,,,,,,

,,,, e,,, 1 2,, HBV, HBV,,,,,,,,,,,,,,,,,

,,,,,,,,,,,,,, 1 2 C, : ( ALT), 1. 5 4. 5 ; ; ( BIL) ; ( HBVDNA) ;,,, HBVDNA 30% 40%, : ; ; 60 % 80%,,,

,,,,,,, ( HBVDNA), ; 200 /, 10% 4 HBeAg HBVDNA,,,,,, 4,, ;, ;, ;,,,,,,

,,,,,,,,,,,,,,,,,,,,

,, 1 2,,,,,,,

3,,,,,,,,,,,, :,,,,,,,,,, ;,,,

, 20 60 290 2,,,,,, 3,,,, 6 ( HBV), HBV 1. 2, 3 000, 4. 5 HBV, HBV, HBV : HBV

,, HBV, HBV,,, HBs - HBc - HBe, HBsAg HBeAg HBcAg ;,, 10% ( 1) HBsAg HBeAg - HBc ; HBsAg - HBc - HBe, HBV,,, HBV,,,,,,,, HBV,, HBV,, HBV, HBV, HBeAg, - HBe, ( 2) HBVDNA HBVDNA, HBV, 100% HBVDNA, HBVDNA, HBVDNA HBV

, ( 3),,,,, ( 4), HBVDNA,,,,

9,,,, 90 %, 10%,,,,,,,,,,,,,,, ( 10 % ),,,, ( ) ;,,

,, 90%,,,,, ;,,,,, ;,,, :,,, :?,,,,, 20 70,,,,,,,,,, 50% 70%, 30%,

,,,,,,, ;,,,,,,,,,,,,,,,,,,,

,,,,,,,, e e ( HBVDNA) ( DNAP), M,,,,,,, ;,,, ;,,, ;

,,,,,,,,, ;,???,,,,,,,,,, ( ),,,,

:,,? ( 1), ( ),,,, ),, ( ( HBV - DNA) ( 2),,,,, :,,,,, ;,,,, ;,,,

, C,,,,,,,,, S,,,,,,,,,,,,,,,, :,,, ;,,,,,, ;,

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

,,,,,,,,,,,,,,,,,,,,,,,, ( ),,,,,,,,,,

,,,,,,,,,,

33,,,,,,,, 15 24 HBsAg, HBV,, ( ) :,,,,,,,

,,,?,,,, 1,, 12 13 14 15, 16,,

17 18,, 19 1 /2 2, ( ) M e e,,, e, 3 e,, 6 1 e,,, ;

,, e,,?? :,,,,,,,,,,,,, 1, 2,

:,,,,,,, : 1 1 3,?,,,,,,,, 1 300,,,,,,, ( 1),

,,,,,,, ( 2),,,,,, ( 3), : : :, :,, : 34 /, :, :,

400 /, 4,,,,,, B :,,,,,, B, CT :,,,,, 3 4,,,,,,, 200,,,, 1,,

,,, ;, ; 40%, ;, 500,,,,,,,,,,,,, 40%

,,,,,,,,,,,,,,,,,,,,, 1,,,,,,,

,,,,,,, :,,,, :,,,,, ;,,,,,,, ;, ;,,,,

,,,,,,,,,,,, : 2%,,,,, ( HBsAg),,,,,,,, 1,

,,, M e 1 ; 2 3 4, 2 3 4, e e, e e e e,,,,, ;,,, 0 1 6, 6, : :,,, 4 10, -,,,,

: HBsAg HBV - DNA,, 15. 0% 38%, HBsAg,,,, :, - HCV HCV - RNA,,,, 2 11,, 6,, - HCV HCV - RNA, 1 HCV - RNA,,, :,, HBsAg,

,, : HEV, HEV, HBsAg, HBsAg,,,, HBsAg, HBsAg HBsAg,, : HBsAg,,,, HBsAg HBeAg 3 ; HBsAg, HBeAg,, 6 1,, ;,,

2, ;, 7 8,, 1 5 10 ; 10,,,,, HBsAg,, HBsAg,,,,, HBsAg HBsAg HBeAg,,, HBsAg,,,,,

, HBsAg,,, HBsAg,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 10%

15 %,,, 1 2, 1 2, 1 2,,,,,,,, :,,,,,,,,,,,,, ; 1,,,,,,,,,

10450 10868, 65%, 20%, 15% 100 ( ),, 6, 16. 7 %, 200 5,, e ( HBV), 3 :, 75 150,, HBsAg 50% 90%, 90%, ;, : ( HBIg) ( 1) HBIg,,

,, 200,, 100 ; 0. 075 0. 2 ( 2) 1986,,,, 3, 4,,, e,, HBsAg, : 48 HBIg( ), 2 4 0 1 6 5 ( 30 ) 70% 90 %

,,,,,,,,,,,,, ;, 3, 20,,,,,,,, 24,,,,,,

,,, HBsAs, -,,, HBV 2?, HBV - DNA, HBV, HBV, HBV,, HBsAg,,,,,,,,

,,,,, 1, 2 1 2, 3,, B X CT,,,,,,,,,,,,,

,,,,, 25% 40%,,,,,,,,,,,,,,,,,,,,, ; ;,, ;,,,,,,,,,,,,

,,,,,,,,,,,,,,,,, 1 500,,,,,,,,,,,,,,,,,,,, 25 20,

0. 3% 1. 5% 60 20 40 % 50%,,, 60 85 40 50 %,, 90 30 51. 8% 40% 67%,,,,,,,,,,,,,

,,,,, : ( 1),,,,,,,,,,,,,,, ( 2), :,,,,,,,

,,, 30,, 15 30 ( ) 30 30,, 4% 12, 2,, 2,, l 200 1, 2,, : 300 (, 98 % 99% ) 150 (, 29% ) ;, 18%,

,, ( 1), 1,, 121, 2, ( 2), 10,,,, 3% 1 ; 2%, 20 121, 20,, 2

0. 5 %,, 0. 4 / 3 ; 100 / 3, 12 24,,,,,,,,,,,,,,,,,,

,,,,,,,,,,,,,, X, ;,, : 3%, 25 10-5, 15,, : 0. 2% 0. 5% 15%, 10 30,,

: 2% ; 10 % : 1% 25 15,,,, 2, ; 0. 1% 0. 5% 2 10-4 1 2,,,,,,,,,,,,

,,,,,,,, ; ( ),,,,, : 100 1 15 20,, 1, 15 20 ( )

:, :,,, : 20 30 1 2 10% 20% ; 1 /5 1 /4, 2,, 3% l 3% : 3,, 100,,, 3% 1 ( ) 333 84,, ; 40 60 ; ; ;, 40 100 200 1 1 10

, 1 ( ),,, 1, : 0. 3% 0. 5 % 0. 75 1 / 30, 0. 2 % 2 : 1989,,,,,,, 21,,,, 84 2 30, 6, 84 ( 1 % )

, 2, 0. 5% 84,,,,, 3 5, ( ) ( ),,,,, 0. 075 0. 2, 24 ; 1 2, 2 1 6,,,, ; 1 ; 1,

, ( 2) 5 /, 0 1 6 0 24 1, 1 ; 1 1 1 2, 6 1 6 3 3 10 5 5,,,,, 5,,

17, HBsAg, ( HBsAg),,,,,,, 0. 2% 84 20, 30,, :,,

, ;,,,,,,,,,,,,,,,, 12, 0 1 6 ; ( ),,,

,, :,,, 30,,, 15, 0. 2 % 84 20, 84,,,,,,

3 1984, 1,, 2,,,,, 1, 2,,,,,,,,,,,,,,,,,,

,,, 8, 1,,,,,,,,,,,,

,,,,,,,,,,,,, 2,,,,,,,,,,,,,,,, ;

,,,,,,,,,,, 10, 10,,,,,,,,,,

,, 1 2, 1 2 1, 1 2,,,, 2,,,,,,,,,, 10% 15%,,,,,,,,,, ( ), 1, 2 ; 40

,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

,,,,,,,,,,,,,,,,, 30% HBV,,, HBV,, HBsAg 57. 1% 88. 6%, ( HBV),,,,

,, 3 500,,, 25%, 5 000 6 000,,, 24, 1 6, 80 % 90%,,,,,,,,,

, ALT,,,, ( ),, ALT,,,,,,,,,,

33,,,,,, :,,,,, 30,,,,,,,,,,,,,,

,,,,,,,,,, 4 8,,,,,,,,,,,,,,,,,,,,,

,,, C C,,, C C, A,,, A,,,,,,,,,,,,,,, :,,,

:,,, :,,,,,?,,,,,,, 97. 5 130,, 2 3 ;,,,,

, 70, 90 100 : 16% 25% 20%, 100, 25% 20 3 1,, 8,,,,,,,,,,, 1 2 7,,,

400,,,?,,,,,,,, 600, 5% 10 % ( ),,,,,,, ( SOD) : SOD, :,

C E : C E E, : :, 2 :, 4, 6,, 20 70 Fischer,,

( ), ( ),,, A :,, B 1 ( ) : B 2 ( ) :, B 6 :, C( ) :,, D : K :, K( K 1 K 2 )

,,,, ( ) ( ) ( ) ( ) ( ) ( MJ) 50 3. 8 0. 5 38. 5 173 ( 0. 73 ) 50 5. 0 0. 9 37. 3 177 ( 0. 74 ) 70 10. 0 8. 0 112 ( 0. 47 ) 100 0. 6 0. 2 1. 6 11 ( 0. 05 ) 100 0. 4 0. 5 13. 0 58 ( 0. 24 ) 150 100 100 11. 4 21. 3 0. 6 1. 3 4. 5 0. 1 115. 9 1. 4 1. 9 521 ( 2. 18 ) 131 ( 1. 31 ) 11 ( 0. 05 ) 50 0. 3 0. 1 0. 8 5 ( 0. 02) 100 1. 2 0. 6 19. 5 88 ( 0. 37 ) 50 4. 8 1. 8 36. 4 181 ( 0. 76 ) 100 9. 9 1. 8 74. 6 355 ( 1. 48 ) 50 8. 6 15. 5 173 ( 0. 73 ) 25 5. 4 2. 0 1. 7 46 ( 0. 19 ) 150 3. 3 0. 4 2. 8 28 ( 0. 12 ) 20 20. 0 180 ( 0. 75 ) 87 58 345 2250( 9. 45)

,,,,,, 2 3,,,,,, 50,, 10 15 61 % ( 70 ),,,,,, 6 9

9 200, 10 12 10 900, 97 800, 12 % 14%, ( ) 1 /3, 25 % 30%, 60 %, 77 90, 100 3. 2, 6, 1 ( 200 ) 1 2,,,,,,, : 50%,,, 1. 5 2,,, 2,,

25%,,,, 50 60,,, 500,,,,, 5 6,,,,,,,,, 5,,, 150 200, 1 500 2 000

,, C, B 2 K,,,,,,,,,, 15 3,, ;,,, 5 021 6 694, 75 %,,,, 150 200,,,, 20%

,, :,,,,,,,, :,,, 25, 14 61 %, 1 000,,, :,, :,,,,, :,,,,,

, :,,,,, E,,,,,,,, ;,,,,,,

:,,,,,, : B 6,,, C :,, 1, 3 - -,, T,, :, :,,, :,,,,,,

, :,,,,, :, E,,,, 0. 5 0. 6 0. 8,,,,,,,, 1993 LPS 273 : ( EPA),, ( ),

95 %,,, Aston Tisdale :, ( EPA),, 80% EPA,,,,,,,,,,,,,,,, ;, ;,,

B,,,,,,,,, C,,, 6 7 C, C,,,,, C A B 1 B 2,, :

,,,, : A P - 450,,,,,,,, 100 150, 60 ( 30 ),,, 1, 100 150, 10 10 4 6 ;,,, 100, 50,,, 3 5, 15, 3,,,, ( ),

,, ; 1,,,, 1 000 1 500,,,,,,,,,,,,,,,

,, E 50,,,,,,,,,,

, :, ( ) ( ),,,,,,,,,,,, C 1 600 2 250, 30 50, 5 C

40, 30 P E C C,, 93%, C 50% C,, 80 %, C,, C, 20%, 4,,, 10 50%,,,,,,,, 50 100,,,, 1 /3,,, B

,,,,,,, TEB,,,,, TEB,,,,,,,,,

,,,, 85%,,,,,,,,,,,,,, ;,,,

,,,, 418 836, 1, 20 1 1,,,,, 1 6,,,,,,,,,,,,,,,,,,,,,

,,,,,,,,,,, 2,,,,,,,,,,,,,, ;,,,

( ),,,, ;, :,, :, C,, C, 80 100 C ( DNA) ( RNA),,,, :,, 1,

,,,,, 6, 18,, 10% 20%,, 1%, 7% ;,,,,,, 1. 5,,, ( 1 1), D 400,,,, 60 ( ),

, 20, 700 900,, 20,,,,,,,,,,,, ( 1) 75, 3 4-4 000 24

, : A., B., C.,, ( 2),,,,,,, ( 3),, B,,,,,,

23 :,,,, 55 % 65%, 70% 80%,, 90 100,,,,,,,,,,?, 12%,

,,,,,,,, 16 736 20 920, 70 150, 150 200, 450 500, 1 /2 1 /3,,,,,,,,,,,,,

3, B 1 60% 65%, B 1 45%, 13%,,,,, C,, B 1 /4 B 50 %,, B 75% 25%, B 1 B 2 30% 40%,, B 1 500 600,,,,,,,,,,,,,

,,,,,,,, 0. 000 1, ( ),,,, ph 6. 0,, ph 6. 5 8. 5,,,,

,,,,,,,,,,,,,,,,,,,,,, : A., B.,,,, C. D., 2001,

10,,, 1999, :,,,,,,,,, 2 400, D,,,,,,,,,,,,,,,

,, ;,,,,, :,,,,,,,,,, ; ;,,

; ;,,,, 75 % 7,,,,,,,,, 2?,,,,,,,,,,,,,

, 40,,,, 70,, ( 1982 50%, 10 14 15% ),,,,,,,,,,,

,, ; D 3, 500, 1 000 1 500,,, 3, 500 /100 180 /100 ;, :,, 1,,,,,,,, 2,,,

: :,,,,, :,, :,,,,,,,,,, :,,,, :,,,,,,,,,,

,,,,,,,,,,,, 50,,,,, : :

, 90% ( ),, ;,,,,,,,,,,, ;,,,,,,,,,, ;, 2,,,

,,,,,, ;, ( ), 100,,,,,,,,,,,,,,,,,,,,,,,,

,,,,,,,,,,,,, :,, ;,,,, :,,, :,,,

:,, :, :,,,,,,,,,,,,,,,,

?,,, 3, ; ;,,, ;,,,,,,,, C,?,,,

,,,,,,,,,,,,,,,,,, : ( 1) ; ; ; ;, ;, ;, ; ;

; ; ( 2) ; ; ; ;, ; ; ; ; ; ; ; ;, ; ; ; ; ; ; ;,,

,,,,,,,,,,,, ( : ) ( 50), ( 50, 5 ), ( 25), ( 87 2 ) ( 150), ( 100, 15), ( 50), ( 125) ( 100, 50 ), ( 125 ), ( 50, 5), ( 125) ( 20 ), ( 5 ) ( 200, 10), ( 50)

1 2 1 ( ) 1 ( )

: 9 782 ; 95. 7, 50. 5, 375, A 6 246, B 1 1. 49, B 2 2. 96, 33. 3, C 107, E 20. 95, 2 299, 3 843. 1, 691, 304, 40. 1, 5. 15, 15. 5, 2. 61, 1 372, 76 : ( ) 400 425, 200 250, 325 350, 400 450, 20 25, 5 10 ( 1 5 ) 7, : 7 113 ; 59. 5, 47. 2, 260, 800, 10, A 1 600, 2, B 1 B 2 1, 10, C 50

( 4 ) ( : ) ( 25 ), ( 50 ), ( 25), 1 ( 49) ( 50, 75), ( 75 ), ( 75), ( 150 ), ( 12. 5), ( 1. 5) ( 60, 45, 45), ( 30, 5 ), ( 75), ( 12. 5 ) ( 1. 5) ( AD 200, 10), ( 50 ), : 275, 250, 150, 300 350, 25, 5, 150 200,, ( 4 ) ( )

,,

: 9 728 ; 102, 58. 7, 347, B 1 1. 8, B 2 1. 14, C 126, E 33. 28, 943, 639 ( : ) ( 250, 10 ), ( 50 ), ( 50), ( 40), ( 1), ( 30) ( 200, 30), ( 10, 150), ( 50, 25), ( 125), ( 150 ), ( 15), ( 2) ( 85, 49, 10, 50 ), ( 50, 75), ( 2, 40 ), ( 125), ( 15), ( 2) : 375, 400 450, 250, 500, 150, 30, 5, 5 858 6 276, 20, 30, 280, 1 2, 3, 15, 30, 300 320

, 1 2, 3, 15, ( 6 ) ( : ) 10 % 300 ( 30, 30, 6, 0. 5) 300 ( 250, 30, 50) ( ) 300 ( 50, 20, 6, 0. 5) 300 ( 100, 20, 200) 300 ( 250, 25, 50) 10 % 300 ( 30, 30, 6, 0. 5) : 6 125 ; 18. 4, 27. 4, 287, 0. 6, 4. 4 : : 100, 100, 3 :,,,,,,, 20,,

1. [ ] 100 [ ] 200, [ ], [ ] [ ] 7. 6, 1, 76 B [ ], [ ] 25, 100, 15 [ ],,,, [ ],,, [ ] [ ] 12, 1, 100 A B C [ ],,,,

2. [ ] 1, ( ) 100, 10, 2 [ ],,,,,, 1, 1 [ ],, [ ] [ ] 100 17, 4, 50, 204, 1 [ ] [ ] 20, 100 [ ],,,,,,, [ ],,, [ ] [ ] 100 21, 5, 11, 270, 25 [ ], [ ] 100, 150 [ ],

,, 1, 10 [ ], [ ] [ ] 100 15, 1, 190, 300, 50 [ ],,, [ ] 100, 100 [ ],,,,,, 2 [ ], [ ] [ ] 100 16, 28, 5. 5, 103, 1. 25 [ ] ( ) 30 [ ], [ ], [ ] [ ] 6, 2, 30, 40 [ ] ( ),

[ ] 30, 100 [ ],,,, 1 [ ],, [ ] [ ] 100 21, 5, 1. 4, 11, 270, 25, 8. 7, B 1 0. 4, B 2 2. 11, C 18 [ ] 150, l [ ],, 1, [ ],, [ ] [ ] 100 18, 1 50, 154, 3 [ ],, [ ] 1, 200 [ ],,,, [ ],,, [ ]

[ ] 100 23, 2, 22, 190, 4. 7 A C E [ ] 100 23, 2,, 200, 2, ( ) [ ] 100, 100 [ ] 2 3,,, 1 2, [ ],, [ ] [ ] 100 16, 29, 5. 5, 103, 1. 25 [ ] ( ) 30, 150 [ ],, ( ) [ ], [ ] [ ] 100 18, 1 50, 154, 3 [ ],

3. ( ) [ ] 30, 100 [ ] ( ) [ ],,, [ ] [ ] 100 7, 1. 4, 39, 127, 11. 4 [ ], [ ] 50, 2 [ ],,,, [ ], [ ] [ ] 100 12, 10, 48, 176, 2 [ ] 1 ( 250 ), 500, 50, 30 [ ], 500,,,, [ ],

[ ] [ ] 100 16, 7, 11, 145, 4. 1 [ ] 30, 2 [ ],, [ ],, [ ] [ ] 100 12, 10, 48, 176, 2 [ ] 4. [ ] 250, 100 [ ],, 1, 20 [ ],, [ ] [ ] 100, 100 2. 3, 3, 22, 31, 0. 4 [ ], [ ] 120, 150, [ ],,

[ ], [ ] [ ] 100 2, 2 [ ], [ ] 250, 100, [ ],, 2 [ ], [ ] [ ] 100 7. 5, 76, 3, 99, 0. 4 [ ],, [ ] 30 60, 3 5, 6, 30, 50 100, [ ],,, 2 3 [ ], [ ] 5. ( ) [ ] 500

[ ] ( ), [ ], [ ] [ ] 20 [ ],, [ ], [ ] [ ] 10 [ ],, [ ], [ ] [ ] 6, 500 [ ],, 1, [ ], [ ] ( ) [ ] 120 [ ], [ ], [ ] [ ] 100 1. 2, 13

, 4, 44, 0. 5 [ ] 1. [ ] 25, 100, 15 [ ],,,, [ ],,, [ ] [ ] 12, 1, 100 A B C [ ],,, 2. [ ] 60 ( 120 ), 6, 2 [ ],, 1, [ ],,

[ ] [ ] 100 12, 10, 48, 176, 2 [ ] 100, 40, 15, [ ],,,, [ ], [ ] [ ] 100 23, 2, 22, 190, 4. 7 [ ],,, [ ] 150, 30, [ ],,,,,,, [ ],, [ ] [ ] 100 20, 4. 3, 31, 184, 0. 9 [ ],, ( )

[ ] 100, 150, [ ],, 2 3,, [ ], [ ] [ ] 100 21, 5, 1. 4, 11, 270, 25, B 1 0. 4, B 2 2. 11, C 18 [ ] [ ] 250, 20 [ ],, 20 [ ],, [ ] [ ] 100 18. 6, 7. 4, 24, 160, 1. 1 [ ] 1, 1, 1, 2 [ ],

[ ], [ ] [ ] 100 19. 2, 2. 8, 7, 135, 4. 4 [ ] 100, 100 [ ],, [ ], [ ] [ ] 100 16, 28, 5. 5, 103, 1. 25 [ ] 250, 100 [ ],, [ ],, [ ] [ ] 100 20, 10, 5, 179, 2. 1 [ ] [ ] 1, 10, 10, 10, 10 [ ],,,, 1 [ ],

[ ] [ ] 100 15. 5, 4. 8, 12, 215, 6. 1 [ ], [ ] 15, 100 [ ], 1 [ ],, [ ] [ ] 100 23, 2, 22, 190, 4. 7 [ ] [ ] 125, 50, 10 [ ] [ ], [ ] [ ] 100 16. 8, 4. 6, 52, 107, 2. 9 [ ],, [ ] 5, 5, 1

[ ],,, 1 ( 100 150 ), [ ], [ ] [ ] 100 22, 2, 17, 210, 2. 3 [ ] [ ] 9, 6, 250 [ ] 3 [ ],, [ ] [ ] 100 16. 5, 7. 5, 11, 145, 4. 1 [ ] [ ] 20, 8, 2 [ ] 3,,,, 1 [ ],, [ ] [ ] 100 12, 10, 48, 176, 2 [ ] ( ) [ ] 100, 600,

15 [ ],,, 3 [ ], [ ] [ ] 100 13, 1, 54, 203, 2. 5 [ ] [ ] 2, 15, 15, 15 [ ],,,,, [ ], [ ] [ ] 11, 10 [ ] 1, 30 [ ],,, [ ], [ ] [ ] 100 23, 2, 22, 190, 4. 7

[ ], 100,, [ ] 20, 10, 2 [ ],,,, 1 [ ], [ ] [ ] 100 12, 10, 48, 176, 2 [ ], ( ) [ ] 1 ( 500 ), 30, 30, 15, 15 [ ], 4,, 2 [ ] [ ] [ ] 100 17. 3, 4, 15, 94, 2. 5 [ ] 100,, [ ] 15 30, 8, 2 [ ] 3,,, 1 [ ],,,

[ ] [ ] 12, 10, 48, 176, 2 [ ] [ ] [ ], ( 100 ),,, 6, 3, [ ], [ ] [ ] 100 18, 1, 50, 154, 3 [ ],, 1, [ ] 30, 100, 8 [ ],,, 10 15 [ ],, [ ] [ ] 16, 29, 5, 60, 105, 103 [ ] 15, 100 [ ],,,, 1, 10 15

[ ], [ ] [ ] 100 16, 28, 5. 5, 103, 1. 25 [ ] ( ) 10, 10, 100 [ ] 4,,,, 1, 20 [ ], [ ] [ ] 100 21, 5, 1. 4, 11, 270, 25 [ ] [ ] 30, 7 8, 100 [ ] 3,, 1 [ ],, [ ] [ ] 16, 29, 5, 60, 105, 103 [ ] 250, 30

[ ] 1 2,,,,,, 1, 20 [ ],, [ ] [ ] 100 11, 4, 93, 19. 7 [ ],, 3. [ ] ( 30 ), 5 [ ], [ ],,, [ ] [ ] 50, 10 [ ], [ ], [ ] [ ] ( ) 3 5, 30 [ ], 2, 1, [ ], [ ]

[ ] 9, 6, 5, 1, 1. 5 [ ] 5, [ ] [ ] [ ] 10, 10, [ ] 20,,, 1 000,,,, 3 4, [ ] [ ] [ ] 100, 12, [ ],,,,, [ ] [ ] [ ] 100 21, 5, 11, 270, 75 [ ] 1, 3, 3, 6, 2, [ ],,

2 3 [ ], [ ] [ ] 90, 9, 68, 840, 90 [ ] 30, 200, [ ],,,,, [ ], [ ] [ ] 36, 8, 12, 292, 4. 6 [ ] 10, 250 [ ] 3, [ ], [ ] [ ] 32, 3, 135, 510, 6. 2 [ ] 6, 30 [ ] 3, [ ],, [ ]

[ ] 6, 10 ( ), [ ],,,, [ ], [ ] [ ] 2, 0. 1, 14, 74, 20 [ ] 150, 150 [ ],, [ ], [ ] [ ] 500, 5, 5, 50, [ ],,,, 3,,, 2 [ ],, [ ] [ ] 100 17, 4, 50, 204, 1 [ ]

[ ] 80, 250, [ ],,,, 5,,, 1 [ ],,, [ ] [ ] 100 21, 5, 11, 270, 25 [ ] [ ] 9, 12, 500 [ ], [ ],, [ ] [ ] 100 17. 3, 4, 15, 94, 2. 5 [ ], [ ] 1, 200 250 [ ],,,, [ ], [ ] [ ] 100 13, 1. 1

, 54, 203, 2. 5 [ ] 1 ( ), 150, 50 ( ) [ ] 3, [ ], [ ] [ ] 100 16. 5, 7. 5, 11, 145, 4. 1 [ ] 90, 250 [ ] 30,, 10,, [ ], [ ] [ ] 100 6. 2, 2. 5, 2. 4, 116, 90, 1. 5 [ ] 30, 30 [ ],,,, 1 [ ], [ ] [ ] 14, 2,

50, 210 4. [ ] 100, 100 [ ],, [ ] [ ] [ ] 100 7, 2, 76, 10, 200, 1. 5 [ ] 3, 100, 2, [ ],,,,,, 1, 20 [ ],, [ ] [ ] 100 7, 2, 76, 10, 200, 1. 5, [ ] ( ) 15, 15, 15, 50 [ ],, 1, 20

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( ) [ ],, [ ] [ ] 100 7, 2, 76, 10, 200, 1. 5 [ ] 20, 100, [ ],,, [ ], [ ] [ ] 100 7, 2, 76, 10, 200, 1. 5 [ ] 20, 100, [ ],,,, 2, 15 [ ], [ ] [ ] 100 7, 2, 76, 10, 200, 1. 5 [ ] 2, 15, 15,

100, [ ], 1, 20 [ ], [ ] [ ] 23, 8, 77, 23, 237, 3. 2 [ ] 30, 100 [ ],, 1, 20 [ ],, [ ] [ ] 15, 2. 5, 76, 130, 204, 2. 5 [ ] 50, 15, 100 [ ],,, 1, 15 20 [ ], [ ] [ ] 16, 9, 80, 10, 200, 1. 5

[ ] 20, 20, 5, 100, [ ] ( ),,, 2, 1 [ ], [ ] [ ] 100 7, 2, 76, 10, 200, 1. 5 [ ] 50, 100, [ ], 15 1, 20 [ ], [ ] [ ] 100 7, 2, 76, 10, 200, 1. 5 [ ] 10, 10, 10, 100, [ ] 3, ( ),, 1 [ ],

[ ] [ ] 100 7, 2, 76, 10, 200, 1. 5 [ ] 10, 100 [ ],, 1 2, 10 [ ], [ ] [ ] 100 7, 2, 76, 10, 200, 1. 5 [ ] 60, 5, 6, 30, 100, [ ] 4, ( ), 2 [ ], [ ] [ ] 100 7, 2, 76, 10, 200, 1. 5 5. [ ] ( ) 15 [ ],

[ ], [ ] [ ] 10, 30 [ ],,, 5, 3, 1 [ ] [ ] [ ] 3, 3 [ ],, 1 1, [ ] [ ] [ ] 120, 120 [ ],,, 30,, [ ],,, [ ] [ ] 20 [ ], 1, 30 [ ], [ ] ( ) [ ] 100,

[ ],, 30,, 3,, 1,, 1 1, 30 [ ],, [ ] ( ) [ ] 250, 500, 250, 1 000, 60 [ ] 3 2,, 30,, 3, 1,, [ ], [ ] [ ] 10, 10, [ ], [ ],, [ ] [ ] 50, [ ],, [ ] [ ] [ ] 50,

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