1943 1, ( ),, ( ),,,, 6 1989 1994 ( ),, 10 80, 3, 33 ( 23 ) 1

, 2

,, ( WHO), 21, 15% 20%, 10%,,,,,,,,,,, 30,,,, 3 1987 80, 33, 4 1990, 1

,,,,,,,, 1987 3,,,,,,,,,,,,,,,, ( : ) 2

,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ;,,,,,,,,,, ;, 1

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

,,,,,,,,,, ;,,,,,, ;,, ;,,,, ;, ;, ;,,,, ;, ;, ;, ;, ;, ;,,,, :,,, ;,,, ;,,,,,,, ;,,,, 1

,,, 6, 1989,, 1991 1989 ( ) ;,,,,,,,,,,,, ; 80,, 30, 230,,,,,,,,,,,,, ( : ) 2

) ( 4 ) 1., ( 5 ) 2., ( 6 ) 3., ( 6 ) 4., ( 7 ) 5., ( 8 ) 6., ( 9 ) 7., (11) (12) ( ) (16) 1., (17) 2., (18) 3., (19) 4., (22) 5., (23) 6., (25) 7., (26) 8., (28) ( ) (30) 1., (31) 2., (31) 1

, (32) 4., (34) 5., (35) 6., (36) 7., (37) 8., (38) 9., (39) 10., (41) 11., (42) 12., (43) 13., (45) 14., (46) 15., (47) 16., (48) 17., (49) ( ) (50) 1., (51) 2., (52) 3., (52) 4., (54) 5., (55) 6., (56) 7., (58) 8., (59) 2

, (60) 10., (61) 11., (62) 12., (64) 13., (67) 14., (69) ( ) (70) 1., (70) 2., (71) 3., (72) 4., (74) ( ) (75) 1., (76) 2., (78) 3., (79) ( ) (80) 1., (81) 2., (81) 3., (82) 4., (83) 5., (84) 6., (85) ( ) (87) 1., (87) 3

, ( 89 ) 3., ( 90 ) 4., ( 92 ) 5., ( 94 ) 6., ( 95 ) 7., ( 97 ) ( ) ( 99 ) 1., (100) 2., (101) 3., (102) 4., (104) 5., (105) 6., (107) (108) 1., (108) 2., (110) (112) 1., (115) 2., (117) ( PCOS) (122) 1., (124) 2., (125) 3., (126) 4., (128) 4

, (130) ( ) (132) ( ) (132) 1., (133) 2., (134) ( ) ( LPD) ( ) (135) 1., (137) 2., (138) 3., (139) 4., (141) 5., (143) ( ) ( LUF ) (145), (145) ( ) (147) 1., (148) 2., (149) 3., (150) (152) 1., (153) 2., (154) 3., (156) (158) 1., (159) 5

, (160) 3., (161) 4., (162) ( ) ( ) (164) ( ) (164), (164) ( ) (166), (166) ( ) ( ) (167), (168) ( ) (171) 1., (171) 2., (172) ( ) (173) ( ) ( ) (173) 1., (174) 2., (176) ( ) ( ) (177), (178) ( ) ( ) (179), (179) (181) 6

(181) (184), (184) ( ) (186) 1., (188) 2., (190) 3., (192) ( ) (194) 1., ( ) (194) 2., ( ) (197) 3., (199) (202),,, (202) (204), (206) (207), (208) (211) 1., (216) 2., (217) 3., (218) 4., (219) 7

, (220) 6., (221) 7., (224) 8., (226) 9., (228) 10., (231) 11., (233) 12., (235) 13., (236) (242) ( ) (242) 1., (244) 2., (245) 3., (246) 4., (246) 5., (247) 6., (248) 7., (250) ( ) (251) 1., (252) 2., (253) 8

) (255) 1., (257) 2., (259) ( ) (261) 1., (263) 2., (264) 3., (265) 4., (266) 5., (267) 6., (268) ( ) (270) 1., (272) 2., (273) 3., (274) 4., (275) 5., (275) 6., (276) 7., (277) ( ) (279) 1., (280) 2., (281) 3., (282) 4., (283) 5., (284) 9

, (284) 7., (285) 8., (287) 9., (288) 10., (291) ( ) (293), (294) (296) ( ) (297) 1., (298) 2., (299) 3., (300) 4., (301) 5., (303) ( ) (305) 1., (306) 2., (308) 3., (310) ( ) (310) 1., (312) 2., (313) 3., (314) 4., (315) 5., (316) 10

, (318) ( ) (319) 1., (320) 2., (321) ( ) (322) 1., (323) 2., (324) 3., (325) 4., (326) 5., (328) ( ) (330) 1., (332) 2., (332) 3., (333) 4., (334) ( ) (336) 1., (337) 2., (338) 3., (339) 4., (341) 5., (342) ( ) (343) 1., (345) 2., (346) 11

, (347) 4., (348) ( ) (350) 1., (352) 2., (353) 3., (354) 4., (355) 5., (356) 6., (357) 7., (358) 8., (359) ( ) (360) 1., (362) 2., (363) 3., (365) ( ) (367) 1., (369) 2., (370) 3., (370) ( ) (372) 1., (373) 2., (374) 3., (375) 4., (376) 12

),, (381) 1. (381) 2. (381),, (383) 1. (383) 2. (383),, (384) 1. (384) 2. (385),, (387) 1. (387) 2. (389) (393) (396) (397) (401) ( ) (401) 13

) ( ) (406) (408) (410) (411) ( ) :, (411) 1. (411) 2. (412) ( ) : (415) 1. (415) 2. (416) 3., (418) 4.,, (420) (425) 14

) (425) ( ) (425) ( ) (425) ( ) (425) (427) ( ) (427) ( ) (427) ( ) (427) ( ) (428) (431) (431) (433) (435) (439) (442) (445) (448) (451) (453) (454) (457) 15

(459) (460) (460) 16

)

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

,,, ;,,,,,,,, ;,,, :,,,,,,,,, :,,,,,,,,,,,,,, 19 : ( ) ( ) ( ) 3

,,,,,, ( ph 4 5 ),,,,, :,,, ;,,,,, 2 3,,,,,,,,,,,, 10%,,,,, 4

,, : :,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 1., 26 1987 6 27 5,,,,,,,,,,, 10g 10g 15g 10g 10g 10g 15g 30g 12g 10g 10g 10g 24g 6g 10g, 1 70, 1988 :, 5,,, :,,, 5

,,,,?,, :,,,,,,,,,,, ;,,,,,, 2., 25 1987 5 15 3,,,,, 3,,,,,,,,, 30g 15g 30g 10g 12g 15g 15g 30g 12g ( )10g 12g 10g 1, 2 1988 4, :,,,,,,,,,, 3., 25 1987 7 17 1985 1986,,,,,, 6

,,,, 30g 15g 10g ( ) 12g 12g 15g 15g 15g 30g 10g 1, 1987 8 2, 5, ; 10,,,, 20g 20g 15g 12g,,,,,, 2, 1988 6, :,, ;,,,,,,,, 4., 26 1988 2 26 5,,,,,,,, 15g 10g 10g 10g 10g 12g 15g 15g 30g 30g 10g 10g 12g 10g 10g 10g 6g 7

, 15, 1988 3 13,,,, 10 1988 7 9, B 1989 1, :,, 5., 27 1989 8 28 2,,,,,, (40 50 1 ),,,,,,, ( 441 ) 30g 15g 15g 30g 30g 30g ( ) 30g 10g 10g 6g ( )30g 10g ( )10g 1, 1, 1989 9 30,,, 8 21 24 :,, 1990 5 27, :,,,, :,,,, 8

,,,,,,,,,,,,,,,, ;,,,,, ;,, ;,,,,?,,, 6., 26 1990 7 16 2 6 25,, :,,,,,,,,,, 30g 30g 15g 15g 10g 10g 10g ( ) 10g 15g 10g 10g 10g 10g 10g 12g 12g 15g 1, 10 1990 7 27,,,, 9

,, 15g 10g 1, 10 1990 8 10 7 29, 13 B, 1.2cm ( 447 ),,, 10g 10g 12g 20g 15g 15g 10g 15g 15g 15g 10g 10g 5g 1, 7 1990 9 14 47, 22, B, 1991 5 4, : ( ),,,,,,,,,,,,,,,,,, 1 B, 1.0cm,,,, 10

, 33 1991 3 8 7,, 3 4, 1989 5,,,,,,, ( 45 50 1 ),,,,,,,, 24g 12g 12g 12g ( )10g 12g 10g 10g 10g ( )10g ( )10g 20g 10g 10g 10g 10g ( )10g 1, 30 1991 4 12,, 4 5, 60 1991 6 10,, 1992 2, :,,,,,,,,,,,,,,, 11

,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 18, 30,,,,,,,,,,,,,,,,,, 12

,,,,,,,,,,,,,,,,,,, ;,, 0.3 0.5,,,, 4 6, 9 10,, 4 5,,,, 2,,,,,,,,,, ;,,, ; 13

,, ;, ;, ;, ;, ;,,,,,,,,,,,,, ; ;,,,,,,,, :,,,, ;,,, :,,,,,,,,, ;,, :,,,,,,,,,,,,, : 14

, ;,,,,, :,,,,,,,,,,,,, :, 13,,,,,,,,,,,,,,,,,,,,,,?,,,,,,,,,,,, 18 20, 15

,,,,,,,,,,, :,,,,, :, ;,,,,!,,,,,,,,,,,,,,,,,,,,,, : 1,,, 5 10, 5 7,,, ( ),, 16

, ; 1, :,, :,, ;, ;, ;, ;,, ;, ;,,,,,,,, ;,, 1., 35 1987 7 23, 7, 23 25, 1,, 7 20,,,, 30g 15g 15g 15g 10g 10g 12g 10g 10g 10g 12g 15g 15g 20g 1987 7 28 8 2, 1, 6, 7 28 30 8 1 1987 8 23,,,,, 1988 4 25, 17

, ;,,,,,,,,,,,,,,,,,,, 2., 26 1988 3 29 3, 20 25,,15 20 1, 5 6,, 3 24,,,,,, 30g 12g 10g 6g 12g ( )12g 10g 6g 6g 6g 6g 3g 10g 15g 10g 1, 20,,, 1988 6 24 5,,, 6,, 14 1989 4, : :,, ;,, ;, 18

,,,,,?,,, ( ) :,,,, ;,, ;,,?,, 3., 37 1992 9 15 1990 7 12,, 2 B, : ; ; 20 25,,, ( 85kg),,, 15g 12g 12g 12g 12g 12g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 5g 1, 90 1992 12 25, 28 29 1,,,,, 10kg,, 1993 2 14, 5kg, 19

: 10g 5g 5g 5g 10g 10g 5g 10g ( )10g 1993 2 14 2 17, 1, 4 1993 2 18 2 24,, 1, 2, 7 1993 2 25 ( 447 ), 1, 7 B, 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 15g 1993 3 4, 1, 2 1993 3 25 10,, 5, :, ( 452 ) 1, 2 3 1993 11 19, :,, B : ; 4, :,,, :,,,,,,,, ;,,, 20

,,,,, 5,, 15kg B,, 2,,, :,, ;, ;, ;,,,, 3 4 3 2 3,, 4 7 9 12,,,, ;,,, 6 2 3, 9 12,,,,, 15 50 2 3, 3 5,,,,,,,,,, ( ),, 2 3 7 8 9 21

, 26 1994 8 8 1990 4,, 1992 2 15 20, 1 3, 10,,, 1994 6 4, 7 4 : E2 30pg/ ml ( 80 200), P 2.6ng/ ml ( > 5), T 27.1ng/ dl( 40 80), PRL17.0ng/ ml ( 0 20), LH 5.5min/ ml ( 4 20), FSH 10.0min/ ml (4 20 ) :, LH/ FSH,, ( )10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g ( )10g 10g 12g 12g 12g 12g 8g 5g 1, 30,, : 6.5ml,, 25,, 75% 25%, 0 2/ HP 61.8mg/ ml ( 15.29 58.15mg/ ml) : ( Zn)14.75 g/ ml( 163.02 45.26 g/ ml) (Mg) 25.4 g/ ml( 189.03 59.22 g/ ml) ( Ca)68.1 g/ ml( 164.19 66.62 g/ ml) ( Cu)0.115 g/ ml( 0.141 0.040 g/ ml) ( Fe)0.488 g/ ml( 0.563 0.240 g/ ml),,, 22

436 ) 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g ( ) 10g 12g 5g 1, 30 1994 9 28, 53, B : 1995 5 10, :, ;,,,,,,,,,,,,,,,,, :,,,,,,,, ;,,, ;,,,,, 5., 39 1995 4 26 13, 20 24, 12 15,,,, B :,,,, 23

g 15g ( ) 10g 10g 10g 10g 10g 10g 10g 5g 8g 10g 3g 1, 2 1, 1995 9 15,, 8,, 1, 1, 2 ( 447 ) 10g 10g 10g 15g 15g 12g 12g 12g 10g 5g 1, 7 ( 447 ) 10g 10g 15g 15g 12g 12g 10g 10g 5g 1, 1995 10 13,, 1 B : + +,, ( 452 ), 1, 2 1996 6 15, :,,,,,,,, 24

2,,,,,,,,, ;,,,,,,,,,, 6., 28 1998 12 28 3 15 20, 4,,,,, : ( + ), ( + ), ( + ),, ( 447 ) 10g 10g 10g ( ) 10g 10g 10g 15g 10g 10g 10g 10g 10g 3g 1, 7 1999 1 5 4,, ( 447 ), 1, ; 5, 1 2, 1999 10 8, 25

, 70% 80%,,,,,,, ;,,,,,,,,,,,,,,,,,,,,, 95%,,,,, 7., 26 1999 11 19 4 7 70 22 23,,,,,,, 15g 12g 12g 10g 10g 10g 10g 10g 26

5g 10g 10g 10g 10g 10g 10g 10g 1, 2000 1 12, 27 28 1,,,,, :, 4.6cm 3.7cm 2.9cm,,, 0.6cm, 3.0cm 2.3cm 1.9cm, 1.0cm,,, 2.9cm 2.5cm 1.4cm, :,, 2000 1 29 : LH 4.8min/ ml FSH 13.0min/ ml PRL 82.4ng/ ml T 24.7ng/ dl E2121.5pg/ ml P 1.5 ng/ ml 2, 1, ( 447 )5, 1 ( 447 ), 2 1, 2000 2 29, : ( 452 ), 1, 2, 15 2000 6 24, 5, B :,, 2000 10 28, :,,,,,,,, : 27

,,,,,,, ;,,,, ;, ;,,,,,,,,,,,,,,,, :,,,, ;,,,,,,,,,,, 2,,, 10,,,,,,,,, 8., 33 2000 1 14 7,, 22 24 1, 1,,,,,,,,,,,, 28

15g 15g 12g 12g 10g 10g 10g 10g 10g 10g 10g 12g 10g 10g 5g 5g 5g, 1, 15, 1, 2, 7 2000 1 21, 1, 1 : : : : : : : : : : : : 2000 2 22,, 2000 10, :,,,,,,,,,,,,,, 15,,,,,, 29

,,,,,,, :,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ( ) 7, 1,,,,,,,, :, :,,?,,,,,,,, 30

,, ;,,,,,,,,,, 1., 31 1987 5 4 4, 40 60 1, 3 4,,,, 4 20,,,,, 12g 10g 10g 20g 8g 10g 10g 10g 10g 10g 12g 12g 10g 10g 10g 1 ( 3, 11 16 6 ),, 2, 1, 1987 7 28, 5 28,,, B 1988 3 7, :, ;, ;, ;,,,,, 2., 30 1987 8 19 4 40 50 31

, 6 7,,,,,,,,, 8 8 ;,,,,, 15g 15g 30g 12g 12g 12g 12g 12g 12g 12g 10g 12g 30g 3g 1987 8 26 9 1, 1, 2, 1, 1987 9 17,,, 10,, 1987 10 1 6 6, 1987 10 10 13, 1987 10 30, 10 27, 11 9, 15, 1, 2, 1, 1987 12 19 50, 27, B, 1988 8 4, :,,,,, 3., 25 32

6 9 3 18,, 10,, 1, 1 5 1, 6 7,,,,,, 4,,,,, 10g 8g 10g 12g 8g 8g 10g 10g 10g ( )10g 10g 15g 30g 10g 10g 10g 1, 7 1987 6 16,,, 30g, 24 5, 1, 2, 25 27 29 1987 7 13, 16,,,, 3,,, ( 15g 20g 10g 15g 10g 12g 10g 10g 5g)3, 1987 8 14 B :,, :, 1988 3 20, :, :, 5, 33

,,,,,, :,,,,,,,,,,, B,,,,,, 4., 26 1987 5 15 3 2 3 1, 6 7,,, 5 6,,,,, 30g 15g 15g 30g 15g 15g 30g 20g 15g 10g 10g 5 20 23 4, 21 23 1987 7 15 70, B, 1988 2 15, :,, 3,,,,,,,,,,,,,,, 34

, 26 1987 2 25 3 35 40 1, 4 5,,,, 2 12,,,,, 30g 15g 12g 15g 10g 6g 10g 10g 12g 30g 15g 15g 6g,, 1, 3, ( 457 ), 20g 15g 15g 30g 12g 15g 15g 15g 15g 30g 30g 10g 12g ( )10g 15g 12 18, 6 1988 1 25 11,, 1 20,, 6,, 1988 3 25,B 1988 10 27, :,,, ;,,,, 1, 35

, 28 1987 7 3 3, 70 90 1, 2,,,, 6 20,, 80, 1.55m,,,,,, 10g 12g 10g 10g 12g 12g 12g 10g 12g 10g 20g 12g 10g ( )10g 10g 5g 5g 10g, 1,, 1987 10 9 8 23, 64,,,,,, 10kg 15g 12g,,, 1987 11 8, 24,, B : 1988 7 8, : :,,,,,,,, 36

,?,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, :,,,,,,,,,,,,,, 7., 26 1987 8 14,,,, 40 50 1, 3 7,,, 7 16,,,,,, 10g 15g 10g 12g 10g 10g 10g 12g 37

10g 10g 12g 15g 15g 10g 10g 3g 1, 2, 1987 10 25 8 18 9 19,, 3,, 6,, :, 2, 1, 2 1988 7 1, :,,,,,,,,,,,,,,,, ;, ;, 2,,,, 8., 30 1988 12 28 4,, 40 60 1,,,, 11 28 B :,,,,,, 10g 10g 10g 10g 10g ( )10g 10g 10g 10g 10g 10g 10g 15g 15g ( ) 10g 15g 5g 38

, 15 1989 1 12,, B : 1.4cm,, 1, 3 14 16 1989 2 1, B 1989 10 5, :,?,,,,,,,,,,, ;, ;,,,,,,,,,,,,,,,,,,,, 9., 27 1989 2 24 2 19,,, 1988 10 24, 1,, 3 : :,,,, ( ), :, : 0.5mg, 39

, 5, 20 ; 30mg, 1 ; E 100mg, 1, 3, 2 8, :,,, ( 447 ), 1, 2 3,,,,,, :, 1%,,,, 1, 2 3 1989 5 26 3 18 4 26 5 26,,,, 6 6, 1, 3,, 1 10g 10g 10g 8g 10g 10g 10g 10g 10g 12g 12g 10g 12g 10g 5g ( ) 10g,, :, 60%,, 1, 3 5 ( 452 ), 1, 2, 15 1990 3 5, :,,,,, 3 1 40

,,,,, 3,,,,,,,,,,,, 10., 25 1989 12 5, 35 45 1,,, 5, 3 5,, 5,, 12 3,,,,, ( )10g 10g 10g 15g 10g 10g 12g 10g 10g 10g 10g 10g 10g ( )10g 10g 10g 10g 15g 5g 1, 10 1989 12 15,,,, 1, 2, 7, 1 ( 1 ), 2, 1990 1 26 53,, 25, :, 6g, 3, 41

10, :,,,,,,,,,,,,,, 10,,,,,,,,,,,,,,,,,,,,,,,, 11., 29 1990 12 10 7,, 35 60 1, 3 5,,,,,,,,,,,,,, ;, ; 12g 10g 10g 10g 12g 12g 10g 12g 12g 10g 10g 10g 42

15g 3g 6g 10g 8g 10g 1, 5 1990 12 17 3,, :, 1991 1 26 1 10,,, 40, 1991 2 28 B :,,,,,,,,,,,,,,,, 12., 30 1995 7 28 5, 40 50 1,,,,,,, 7 18,,,,, 12g 10g 10g 10g ( )10g 10g 10g ( )10g 10g 12g 10g 43

g 10g 10g 12g 1, 10 2,, 1995 8 21, 34,, 10g 20g 12g 10g 10g 8g,,,,,,,,, 3,,,, 1995 10 26,, 10 16, ( 447 ) 7 ( 447 ) 1, 1 1996 1 19 B, 1996 9 23, :,, 5,,,,,,, ;,,,,,,,,,,,,,,,,,,,, 44

B,3 13., 27 1990 7 30 4, 17,3 5 1,,,,, 5 24 B : 4.8cm 4.8cm 3.9cm,,,,,,,,, ( )10g ( ) 10g ( )10g 15g 10g 12g 15g 10g 12g 10g 10g 10g 12g 10g 12g 5g 1, 40 1990 9 28,, :, 1991 5, :,,,,,,,,,,,,,,,,,, ; 45

; ; ;,,,, :,,,,,, ;,,,,,,, ;,, ;,,,, 14., 26 1990 10 19 19, 40, 4 1, 8 10,,,,,, 10 9,,,,,, 15g 12g 20g 15g 15g 10g 10g 15g 15g 10g 10g 10g 10g 10g 12g 10g 5g 5g 10g 10g 5g 1, 30 1990 11 28,,,,, 5 1, 46

12 18, B :, 2.5cm 2.3cm 1.9cm, 1991 7 28, :,,, ;,,,,, ;,,,,, 15., 25 1997 12 12, 40 50 1,,, 12 3,, 40g 10g 10g 10g 10g 10g 12g 12g 10g 10g 12g 10g 10g 5g 1, 30 1998 1 20 1 5,, ( 447 ) 7,, 15 1998 10, :,,,, :, 47

,,,,,,,,,, 16., 26 1995 9 29 2, 45 60 1, 3 4,,,,, 9 23 :,,,,, 12g 10g 12g 10g 10g 12g 12g 10g 10g 10g 10g 15g 15g 15g 10g 5g 10g 5g 1,,,,,, 1 1995 11 17 10 31,,, B, 1.8cm 7,,, 1995 12 12, B :,, 1.5cm 2.5cm 1.6cm, 48

: 8 8,,,,,, ;,,, ; ;,, 17., 28 1996 9 20 3 20,,,,,,,, 8 26,,,,, 12g 10g 10g 10g 10g 10g 10g 10g 12g 10g 10g 10g 5g 10g 2 1, 2 1996 11 18 10 1 11 3 2,,,,, 7, 1,,,, 1997, : :,,,, 49

,,,,,,,,,,,,,,,,,,,,,,,,, :,,,,,,,, ( ),,,,,, :,,,,,,,,,,,,,,,,,,,,,,,,,,, 14,, 50

,,,,,,,,,,,,,, 1., 27 1987 12 30 3,,, 10,, 1 3,,,, 12 20,,, 30g 15g 20g 30g 12g 15g 12g 10g 10g 10g 10g 10g 12g 12g 10g 12g 3g 1, 6 1988 1 3 1988 1 27, 24, :, 15 :,,, :, ;, 51

,,,,,,, 2., 26 1988 3 11 3,, 3 4, 4 5,, 2 27,4, 3, 1,,,, 30g 12g 12g 15g 30g 12g 6g 6g 30g 15g 15g 1, 6 13 15 1988 4 4, 21, :, 1988 12 5, :, : :,,,,,,,,,,,, B,,,,,, 3., 27 52

8 10 1,,,,,,,,,,,,,,,,,,,,, 15g 10g 12g 10g 10g 9g 8g 10g 30g ( )10g 10g 12g 30g,, 2 8 19 24 6 1988 9 14 9 6,, 9 18 23, 1, 20 22 24 1988 11 20,B 1989 6, :,,,,,,,, :,,,,,,,,,,,,,,,,,,, 53

, 26 1989 5 15 3,,, 19,, 3 5, 15 16, 1 2,,, 5 6,,,,,,,, ;, ;,, 12g 12g 10g 10g 10g 10g 12g 12g 12g 5g 15g 5g 12g 12g 10g 3g 1, 10 1989 5 25,,, 2, 1, 2 1990, : 3,?,,,,,,,,,,,, :,,,,,,,,,, 54

,,,,,,,,,, ;,,,, 5., 28 1987 8 6 5,,,, 21 22, 3 5,,,,, 10,,,,,,,,,,,,, ( ) 10g 12g 10g 10g 10g 10g 15g 15g 10g 10g 12g ( ) 10g 10g 12g 10g 3g 1, 60 1987 10 20 ( 9 17 10 17 ), 6,,, 10 23 11 3, ( 447 ) 10g 10g 10g 10g 55

g 10g 10g 10g 10g 10g 10g 1, 12 11 1 3, 11 3 ( 447 ) 10g ( )10g 10g 10g 10g 10g 10g 10g 1, 20 1987 11 30,, B, 1988 7, :,,,,,,, 2,,,,, 10 23 11 3,,, 6., 28 1988 11 23, 3, 1987, 56

,,,,,,,,,,,,,,, 12g 12g 15g 10g 10g 10g 10g 10g 12g 12g 12g 10g 6g 6g 5g 1, 7 1988 11 30,,, 10g 12g 12g 12g,,, 1, 1988 12 10 B :, 1.3cm ( ),, 10, :,,,,,, 1989 1 10,, 24, : 1989 9 5, :, ;,,, :,,,,,,, ;,,, 57

,,,,,, ;,,, 7., 29 1989 3 28, 5 20 60 1, 4 5,,,, 3 21,, 10g 10g 10g 10g 10g 10g 15g 10g 10g 10g 20g 10g 15g 12g 10g 5g 10g 10g 1, 30, ( 454 ) : 10g,,, 1 1989 4 25 4 20, 12, 5 1 4 4, 1, 2, 1989 6 10 50, B : 1990 1 30, :, 58

,,,,,,,, 8., 28 1989 4 1 3,,,,,,, 15 20,,,,,,,,, 3 10 : FSH 0.27min/ ml( 1.7 8.5min/ ml),,,,,,,,,, 10g 10g 10g 15g 10g ( )15g 10g 10g 6g 12g 30g 30g 20g 15g 15g 10g 1, 18, 16, 11 40 1990 3 10, : 3, 40,,, ( FSH) FSH?? 59

,,,,,,,,,,,,,, :,,,,, 9., 28 1989 4 21 3, 3 5, 20, 2 3,,,,,, 4,,, 3 24,,,,, 12g 12g 12g 10g 10g 12g 12g 12g 12g 10g 12g 15g 20g 10g 5g 1, 1989 6 5 45,,,, 43 B, : 60

cm 5.3cm 4.0cm, 1.8cm 1.5cm 1.3cm 1990, :,, ;, ;, ;,,,, 10., 27 1990 3 13 2 14,, 60 90, 15,,,,,,,,,,, 12g 12g 12g 12g 10g 10g 10g 10g 10g 10g 12g 10g 10g 15g 10g 20g 8g 5g 5g 1,, 1990 7 7 25 36,, 10g 10g :, 1, 2, 5,,, 61

,,,, 1, 2, 7, 1,,,,, 1991 8 15, :,,,,,,,, :, ;,,,,,,,,,,,, 11., 28 1991 9 25 5 20 60 1,, 4 8,,,,,, 9 19,,,, 30g 12g 10g 10g 10g ( )6g 5g 12g 12g 62

, 30 1991 11 4,, 2 10 8 ( 20 ), 11 4 ( 27 ),,,,,,, 12g 10g 10g 10g 12g 12g 10g 10g 10g 15g 10g 10g 10g 5g 1, 30 2 :,,,,,,,,, :,,,,,,,,,,,, ;, ;,,,,,,,,,,,,, ;,,,,,,,,, 63

, :,,,,,,,,,,, 12., 29 1993 5 10 6,,, 20, 3,, 1, 7,,,,,,, B : 4.0cm 4.2cm 3.6cm,,,, : : LH 22.8min/ ml(4 60) ( ) FSH 10.5min/ ml(4 30) ( ) E2 65pg/ ml (100 300) ( ) P 0.5ng/ ml(0.9 0.5 ) ( ) T 23.8ng/ ml( 40 80) ( ) PRL 7.2ng/ ml( 0 20 ) ( ),,,,,,, ( 448 ), 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 64

10g 10g 10g 10g 10g 3g 10g 3g,, 10g 1, 2, 1, : 2 3, 1993 6 18 5 28,,, 2,, 1, 2, 30, 1993 9 8,, 1994, :,,,,, ( 15 - ) : :,, ( LHRH - a ) : ; HMG HCG ; ;, 65

210mg,,,, 80%,,, 24 : :,, ; :,,,,, ;, ( FSH) (LH) FSH FSH,, E2,, 24,, 24, LH, 66

24, FSH, FSH, 24,, FSH LH :, ( ),, LH, LH/ FSH > 3 ( PRL),, ( PIH), ( TRH) 5 - PRL,, PRL,,, PRL :, PRL ;, ; ; ; ; PRL 13., 29 2000 3 14 14,,20 180 1, 9 15, 5, 2, 2 ( ) 1, 67

:, 1, 2 ;, 1, 2 ;, 4, 2 2000 9 15, 3 ( 3 7 7 8 15 9 15 ), 4,,, B, :,,,, : 15g 12g 12g 12g 10g 15g 30g 1, 20,, 2, 2, 4, 2,,, 10 1 4,, 10 1 3 2000 11 3, 39, ( 452 ), 1, 2,, 2001 6 20, : 2,,,,,, ;, ;,,,,,,,,,,,,,,,,,,, 68

,,,,,,,,,,, 14., 29 2000 5 26 4,,,, 50,,,,,, 23 55 1,,,,,,,,,,, 15g 10g ( ) 10g 10g 5g 10g ( ) 10g 10g 10g 10g 10g 10g 15g 10g 10g 10g 10g 10g 10g 10g 1, 30 2000 6 30 6 26,,,,,, 10 B, 2000 8 26 2, B : 2001 4 1, 69

( ),,,, ;,,, :, ;,,, ;,,,,?,,,,,!,, ( ),, ;, 2,,,,,,,,,,,,, :,,,,,, 1., 32 1987 9 18 7,, 1,, 3, 9 15,,, 12g 12g 20g 12g 70

g 10g 10g 20g 30g 15g 30g 15g 12g 6g 9 24 29, 6 ( 441 ), 5, 2, 5 24, 1987 9 30,,, 1987 10 23 21,, B 1988 6 27, :,,,,,,,,,,,, 3, 2., 27 1987 5 4 3, 1,,, 4 25,,,, 12g 30g 12g 10g 10g 8g 10g 10g 30g 15g 30g 20g 15g 30g 10g 1, 60 71

9 20 6 2,, 7 2, 4, 10 15 20, 6 17 19 20 1988 4 10, :, ( 2 3 ),, 3,,,,,,,,, ;,,, ;, ; ;, ;,,,,, 3., 31 1995 7 14 3, 1,,40 50 1,,, 6 25 : LH 2.5min/ ml, FSH 12.1min/ ml, E2 85.4pg/ ml, PRL 12.4ng/ ml, P 0.5ng/ ml, T 40.5ng/ dl,,,,, ( 447 ) 30g 15g 15g 15g 15g 12g 10g 10g 10g 15g 10g 10g ( )10g 72

, 90 1995 11 17 ( 3 8 16 9 26 10 31 ),,,, 3 4,, 10, 1, 3 1995 11 24 25, B :,,, 1.8cm 1.7cm, : 3 24 25 27 3 ( 452 ), 1, 3, 1995 12 12,,,,,,,,, 1996 8 8, :,,,,,,,,,,, ;,, ; ;,, ;,, ;,,,,,,,, 73

, 35 1997 10 6 10 4,,, 25 26, 30 1, 1,, 10,,,,,,,,,,, 2 ( 14 ) : 5,, B :,,,,, 15g 20g 12g 12g 10g 10g 10g 10g 12g 10g 10g ( ) 10g 10g 12g 15g 12g 10g 6g 1, 45 1997 11 21 2, 10 19 11 14,, 2,,,,,, 60 1998 1 30, 1 14,,,, B, 1.9cm, 0.9cm,, 74

2 2, 1998 10 18, :,,,,, ;,,,,,,,,,,,, ( ),,,,,,,,,,,, :, ( ),,,,,,,, :,, ( ) :, ( ) ( ), :, ( ), :,, 75

( ) :, :,,,,,,?,,,,,,,,,,,,,,,,,,,,,, :,,,,,,,,,,, 1., 29 1988 5 31 3 30 32, 7 10,,,,,,,,, 1,,,,,, 76

15g 30g 6g 12g 6g 10g 10g 15g 12g 10g 10g ( )10g 1,, 2 1, 1988 7 20, 5 6,,, 10g, 1, 30 1988 9 7 20, B :, 1, 1 2 1,, 1989 4 20, :,,,, :,,,,,,,,,,,,,,,,, 50,,,,,,,,,,,, 30,,,,, ( ), ( ), ( ),,,,, 77

,,,,,,,,, 6 15g 2., 30 1991 10 9 5,,, 6 7, 1 2, 1,,,,,,,, 9 12,,,,, 20g 12g 15g 6g 12g 10g 10g 6g 3g 6g 1, 10 30g ( ) 10g 10g 1991 10 18 10 10, 5,, 1991 10 25 2,, 1, 30 1991 11 25, 1992 7 15, : :,, ;, 78

,,,,,, 3., 32 1998 6 19 3,, 7 8,,,,, 5 21,,, 20g 12g 12g 10g 10g 10g 10g 10g ( )10g 10g 10g 12g,, 1, 2 1, 5, 1, 3, 1998 10 9 5 6,,,,,, 2 9 22, 10g 1, 20 1998 11 13 42, B, 1999 6 30, :, ;,,,, 79

,,,,,,, ( ),,,,, ;,,,, :,,,, :,,,,,,,,, ; ;, ;,,,, ;, ;,,, ;,,, ;, 80

, 1., 27 1986 6 2 2,,,,,, 1 2 5 24,,,, 10g 10g 15g 10g 10g 10g 10g 15g 10g 15g 15g 10g 30g 12g 10g 6g 6 10, 1, 6 1986 8 30 8 28, 9 13,, 1, 5 1987 6 6, :,, 3 5, 10 15,,,,,,,,,,,, 2., 26 1988 5 4 4,, 81

,,,,, 4 24,,,, 10g 10g 30g 30g 15g 15g 15g 12g 12g 10g 30g 15g 10g 6g 5 12 17, 1, 6 1989 1 28, : :,,?,,,,,?,,,,,,,,,,,,,, 3., 27 1987 8 10,,,, 40,, 30,,,, ( ),,, 30g 15g 10g 10g 12g 6g ( ) 10g 12g 12g 10g 15g 15g 82

g 6g 20g 8g 1, 60 1, 90,, 1988 3 28, 3 13, 29 31 1988 4 13,, 1, 6 1988 4 20,B 1988 12 30, :,,,,,,,, 4., 26 1988 4 21,,, 5 7,, 3 29,,,,,, 30g 15g 6g 6g 12g 10g 15g 15g 15g 40g 12g 15g 10g 3g, 1, 15 1988 5 6, 4 23, 5 1, 83

5 25,, 20 B 1989 2 7, : :,,,,,, ;, :,,,,,,,,,, 5., 26 1990 2 28 2, 1, 1,,,,,, 2 7,,,,, 12g 12g 12g 10g 10g 5g 10g 12g 10g 10g ( ) 10g 10g 1, 3,, 1, 2, 10,, 1, 15 60, 1990 4 22 3 9 4 84

, ( 447 ), 1 3, ( 447 ) 1990 5 20 B, 1991 1 17, :,,, ;,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 6., 33 1993 8 17 10,,,,,,,, 8 85

,,, 10g 10g 10g 6g ( )10g 15g 3g 6g 6g 10g 12g 12g 6g 5g 12g 20g 1, 30, 2 1 (,, 5 ) 3 15g 100g 8g 40g 15g 10g 10g 1993 12 31 80,,, 11 30 18 1994 9 5, :, :,,,,,,, :, :,,,,,, :,,,,?,, :,,,,,, ; 86

;, ; ;, ;,, ;,, ;,, ;,,,,,,, ( ) ;,,,,,,,,,, ;,,,,,,,,,, :, ;, ;,, ;, ( ),,,,,, 1., 28 1987 1 20 5 15 87

, 10, 1,,, ; 1 10,,,,,,,,, 25g 30g 12g 12g 12g 12g 12g ( ) 10g 10g 12g 10g 10g 10g 12g 8g 1, 5, 1987 1 29 3,,,,, 12g 15g 12g 10g 30g 10g 30g 5g 12g 6g 1,,, 5 ( ), 1 1987 3 20, 2 12, 4 ; 3 13, 5,, 1, 5, 1, 1987 9 11 1988 2 28, :,,,,,,,, :,, 88

,,,,,,,,,,,,,,,,,,,, 2., 26 1988 4 14 3 :,,, 10, 40 ;,, 10,, ;,, 4 11,,,,,, 15g 15g 15g 10g ( )10g 10g 10g 8g 8g 15g 15g 8g 15g 3g, 1,, 1,, 1988 5 18 18 27, 9, 1, 24 26 28 1988 6 22 37, 25, 1989 2 15 89

,,,,,,, :, 3., 33 1995 1 20 1989 10, 1,,,,,,,, 3 1993,, 0.125mg, 3,,,,,, : LH 8.5 min/ ml ( 4 60 ), FSH 12.5min/ ml ( 4 30 ), E2 65.6pg/ ml (100 300), P 0.5ng/ ml ( 5 ), PRL 4.9ng/ ml (0 20 ), T 43.1 ng/ dl ( 40 80 ) 1994 7, (0.25mg) 3, 3, ( 1/ 3 ),, :,,,,,,, 1994 12 23,,,,,,,,,,,,,, 12g 10g 12g 12g 90

g 15g 10g 10g 10g 10g 10g 10g 10g 10g 10g ( ) 6g 1, 10 1995 1 31 4, 12g, 12g 10g 10g ( )10g 10g,,,, 1, 40 3 1995 3 14 3 4,,,, 6,,,,,,,,, 12g 12g 12g 12g 10g 10g 12g 1, 60, 1995 5 13, 4 24 B :, 5.9cm 4.8cm 4.3cm,,,, 1.0cm, 3.7cm 3.6cm 2.1cm, 2.0cm,,,,,, 1, 30 1995 6 13 50,, 1 24, B :, 2.1cm 1.7cm 1.6cm, :, 6g, 2 ( 452 ), 1, 2, 91

1996 2 7, :,, ;, ;,,,,,,,,,,,,,,,, ;, ;,,,,, 5,,,,,,,,,,, 4,,,,? 4., 27 1989 6 22 2, 3 15,4 5, : 5 20,,,,,,,,,,, 12g 10g ( ) 10g 3g 12g 6g 10g 10g 92

g 10g 6g 10g ( )3g 3g 6g 1, 10, 1, 3 : :,, :,, 1989 7 7,, 5,, 2 1, 5, 1 2 1, 1989 8 7 7 24,,, 7,,, ( )10g 12g 12g 10g 20g 15g 12g 10g, 1, 5 2 1, 3 1989 12 26, B, 1.9cm 7, 1, 2, 1, 2, 1990 2 5 B 2, 1990 9 1, :,,,, 93

,,,,,,,,,,,,,, 5., 27 1992 10 5 1,,,,, 7, 9 9,,,,,,,,,,,, ( )15g 20g 10g 10g 10g ( )15g 10g 12g 10g 6g 10g 12g 6g 3g 1, 6 1992 10 16 3,, 3, 10, 1, 1, 2, 10, 10,, 1992 11 27,, 11 2, 5, 7,, 94

g, 10g 10g 10g, 1993 8 10, :,,,,,,,,,,,,,,,,,, :, ;,,,?, ;,,,,,,, ;,,,,,,,,,,,,,,, 6., 32 1996 4 12 8, 5 ; 3,,,, 95

,,,,,,,,, 3 24, 20,,,,,,,,, 12g 15g 10g 10g 12g 6g 6g 10g 10g 12g 10g ( ) 3g 12g 12g 3g 5g 3g 1,, 2 1 30 : 1996 5 10, 5 4 26, 5,,, 12g 10g 12g 12g,,,, 1997, :,,,,,,,,,,,, ;, ;,, 96

,,, ; ;,, ; ;,,,,,,,,,,,,, ;,,,, 7., 27 1998 3 20, 18,, 1992 11 14, (, ),, 1995,,, 3 9,,,,,,,,, 12g 12g 12g 12g 12g 12g ( )10g ( )10g 12g 12g 24g 6g 12g 10g ( ) 3g 1, 20 1998 4 10 3 27,,,4 8,, 1,, 2 1, 2 97

6 10, 5 8 6 6, 2, 5 7,,, ( ) 10g 1, 7 1999 3, :,, :,,,,, :, :,,,,, :,,,,,,?,,,,,,,,,,,,,,,,,,,,,,,,,,, ;,, ;,,,,,,, 98

;,,,3,,,, ( ), 14 18,, ;, 3,,,,,, :,,,, ;,,, ;,,,,,, ;, ;,,, ;, ;,,,,,,,, ( ),,,,,,,,,,, :,,,,,,, 99

:,, ;,, ;,, ;,, ;,,,, ;,,,,,,,,,,, 1., 25 1986 11 25 3 18, 3, 7 8 1,,,,,,,,,,,,,,, 4,,,, 15g 15g 10g 10g 3g 6g 12g 12g 12g 10g ( ) 10g 10g 8g 8g 15g 15g 10g 15g 10g 1, 30 1987 3 15 1,, 3 1,, 20g 20g, 1, 100

4 27,B, 1988 1, : :,,,,,,,,,,, 2., 27 1987 8 31 3 18,, 40,, 7 10,,,,,, 1987 6 11 7 9, 5,, : E2 26pg/ ml, LH9.0min/ m1, FSH 10min/ m1, T 20ng/ d1, PRL 5.5ng/ m1, P 0.1ng/ m1,,,,,,,,, 12g 12g 12g 10g 15g 15g 10g ( ) 12g 10g 10g 20g 15g ( )5g 20g 6g, 1, 3 5, 6 3 1987 12 10,, 12 13, 6, 101

3 28,,, : 20g 30g 15g 15g 15g 10g 10g 12g 15g 15g 30g 1, 60 1988 6 3 B :, 6.2cm 3.7cm 4.0cm, : 1989 1, :,,,,,,, 3., 27 1989 2 15 2 18, 6 8 1, 2 3 1988 4 10,,, 12 31 1,,,,,,,, 2 3 : FSH 11min/ m1, LH 10min/ ml, E258pg/ ml, PRL 3.6ng/ ml, P 1.7ng/ ml, T 50ng/ dl,,,, 15g 15g 15g 12g 102

)10g 12g 12g 10g 10g ( )10g 10g 30g 15g 12g 10g 10g 5g 1, 90, 3 ( 1 ) 3 4 :,,,,, 1989 5 25, 3 26 5 6, 2,,,,,,,,,, 1 5g, 10g 10g, 3 1989 8 23,, 2, 14,, ( 447 ) 7,,,, 20g 12g 12g 12g 12g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 3g 1, 7 1989 10 27 2, B : 103

5 20, :,,,, 1,,,,,,,,,,,,,,,,,,,,,, ;,, ;,,,, 4., 27 1991 4 27 6, 5 6 1, 7 10,,,,,,,,,,, 2 28 1990 11 1991 1, 8, : 6, 2,,, 15g 15g 15g 12g 10g 10g 10g 10g 10g 5g 5g 10g 1, 90,, 104

9 9, 3, 71 51 44 5,,,,, B, 1.2cm,, 10g 1, 7, 1, 2, 9 12 14 1991 10 9,,,, 24, : ( 452 ), 1, 2, 30 1992 5 27, :,,,,,,,,,,,,,,,,,,,, 5., 33 1996 6 28 5 1991,, ( : ), 3, 1994 1,, 1 2,,,,,,,, 105

,,, : E2 30.6pg/ ml, P 0.5ng/ ml, T 44.8ng/ dl, PRL 14.4ng/ ml, LH 22.8min/ ml, FSH 10min/ ml,,, 20g 15g 15g 12g 12g 12g 12g 12g 12g 10g 10g 3g ( )10g ( )10g ( )10g 10g 1, 1996 8 30 2,,, 7 16,,, 10g 15g 10g 3, 1996 12 27,,,, 10 17 12 17 2,,, B : 4.3cm 3.9cm 3.1cm,, 3.5cm 2.3cm 2.0cm, 3.5cm 2.9cm 2.4cm, 1.1cm : B,,, 10g, 30g 1, 10 3,,, 1 1997 2 28, 2, 106

1997 9 30, :,, 3,,,,, 6., 28 1998 2 9 3 16, 4 6,,,,, 1997 12,,, 1987 11 15 3 ( ),,, ( 447 ) 15g ( )10g 15g 15g 10g 10g 10g 10g 10g 20g 10g 1, 1998 4 3,, B : 4.1cm 3.9cm 2.7cm,,,, 1.5cm 1, 1, 4, 1998 5 17,, 24,,, : ( 452 ), 1, 2 3 107

1 30, : 2 3,,,,,,,,,,, 2,,,,,,,,,,,,,,, 20 40,,, 1., 34 1987 9 7 1978,,,,,,,,, 4 2 4,, 108

,,,,,,,,,,, : T3 T4 17KS 170HCS :,, T : avf V5, 2,,, 15g 15g 10g 10g 15g 30g 15g 20g 10g 25g ( ) 10g 10g 12g 15g 30g 6g 1, 90 : : :, 1, 8 7 1987 10 7,,,,,,,,, 1, 10 1,, B : 3.0cm 2.2cm 1.5cm,,, : 4,,, 1987 12 24, 1988 12 30 1,, 109

4 1,,, 5, 20 10, 1,, 1, 1989 :,,,,,,,,, 2., 30 1997 10 31 2,,,,,,, 20, 3, 2,,,,,,, 90/ 60 mmhg, :, T 7g :,, T3 T4 : LH 1.25min/ ml, FSH 0.77min/ ml, E2 20.87pg/ ml, P 1.15ng/ ml, T 20.8ng/ dl, PRL 20.8ng/ ml,,,, :, 0.5mg, 20 ;, 10mg, 1, 5 ; 7 10, E, 100mg, 2 110

, 15g 15g 12g 12g ( )12g 12g 12g 10g 10g ( )10g 10g 10g 10g 10g 10g ( ) 10g 20g 10g 10g 10g 1, 30 : :, :, :, : : 11, 1 4 1997 12 5,, 11 27,,, 1998 4 26,,,, 40 45, 2,,,,,,,, ( 10g 15g 12g 12g 12g 12g 10g 10g 10g 10g ( ) 10g 20g 10g), 10g, 2, 3 111

E 100mg,, ( 452 ), 1, 3 3 1999 3 8, :,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ( ) 19, Chiari-Frommel ( PIF ),,,, 112

, ;, ;, :,, (, - ),, ( ),, FSH, :,, ;,, ( ),,, ;, (Anorexia nerrosa),,,,,,,,, 113

,, 10,,,,,, ;,,,, ;,,,,,,,,,,,, 17 ;,,,,,, :,,,,,,,,,,,,,,,,,,,, 114

, 18 1978 10 2.5kg,,,,,,,,, 18,,,, 20g 20g 12g 12g 12g 10g 10g 10g 10g 10g 10g 10g 10g ( )10g 10g 10g 10g 10g 5g ( )3g 1, 10 ; 1, 10, 3,,,, 1979 2,,,,,,, 1983 9, 1 2, 20, 1 2,,,,, : PRL 131ng/ ml ( 0 20 ), LH 4min/ ml, FSH 5.4min/ ml, E2 62pg/ ml, P 0.49ng/ ml, T 45ng/ dl PRL, CT :, PR:,,, ( - ) :, 1, 2.5mg,,, PR L26.2ng/ ml, P 2.5ng/ ml, E2 48.6pg/ ml 115

9 2,, 20 1,,,,,,,,,,,,,, 30g 12g 12g 12g 12g 12g 10g 10g 10g 10g 10g 20g 12g 12g 10g 12g 10g 10g 10g 10g 10g 10g 10g 10g 5g 1,, 2 1, 1984 12 16,, 1,, 10 16, 11 16,, 11 12 9 ( 36.9 ) 0.5 1985 8 25, : 18,,,,,,,,,,,,,,, 116

,,,,,,,,,,,,,,,,,,, 3 2., 32 1996 5 6 9 22, 23,,,, (, 1mg, 20, 10mg, 1, 5 ) 3 1989 1994 1995 3,,,, 45kg, 8 65kg,,,,,,, : PRL 200 ng/ ml, E2 30pg/ ml, LH 2.6min/ ml, FSH 6.7min/ ml, P 4.7ng/ ml, T 24.5ng/ dl, T3 1.2ng/ ml ( 0.7 2.0 ), T4 4.7ng/ dl ( 6 12 ), TSH 6.7min/ ml ( 5.8 1.5 ) : 46xx,, G ( + ) PRL,, CT, 117

CT :,, CT,, :,, :,,, ;,,,,,,, : 30g 15g 15g 12g 12g 12g 12g 12g 10g 10g 10g 10g 10g 10g 10g ( ) 10g 10g 10g 10g 10g 10g 10g 10g 10g 3g 1, 90, 10g, 2, 3, : ( ),, 2.5mg : 1.25mg ( ), 2 1996 12 10, 10kg,,,, :, 118

1, 90,, 3.75mg (1 ), 2 5.0mg (2 ), 1999 9 1, :, 3,,, 0.15% 0.2%, 10 90 30 40, 3 2, 70%,,,, :, :,,,,,,,,,,,,, 119

,, :,,,,,, :,,,,,,,,,,,,,,,, :,,,,,,,,,,,,,,,,,,,,, ;,,,, ;,,,,,,,,, 120

,,,,,,,, 14,,, :,,,, :,,,,,,,,,,,,, ( 1.3 ),, 2,,,,,,,,,,,, :,, :,,,,,,,,,,,,,,,,,,,,,,,,,, 121

,,, ( ),,,,,,,,, ;, :,,,,, ( PCOS) ( PCOS ), PCOS, PCOS, FSH, ; LH, LH FSH LH/ FSH,,,, LH,, 122

LH PCOS,,, LH, LH PCOS, ( HCA) HCA PCOS, 1/ 4 HCA PCOS HCA,, (, ) ( ) ( ) (, ),,,,,,,,,,,,,,, :,,, ( ), ( 123

, 1., 28 1988 4 6,,,, 7,,,,,,,,,,,, ( ) 10g 15g 30g 10g 15g 10g 12g 15g 15g 25g 20g 15g 8g 1, 1988 8 15, 4 15,, 5 15, 4,,, 8 12,,,, 1988 11 23, B 1989 6 8 :,,,, 124

4, 3,,,,,,,,, B,, ; ; ;,,,,,,,,,,,, 2., 27 1988 6 1 3 15, 3 5 1,, 3 7,,,,, 3 4,, ;, ;, 3,,,,, 20g 10g 30g 10g 12g 12g 10g 10g 10g 20g 10g 10g 10g ( )12g 10g 10g 125

10g ( )3g 8g 15g 15g 3g 3, 12 17 6,, 1988 7 27,,,, 10g 30g, 1989 6, : ( ),,,, : :,,,,,,,,, 3., 29 1991 1 25 6 15, 20 90 120,,,, 6 7,,,,,,, 1990 7 12, 8, 3 : LH ( ) 80min/ ml(40 60 ), FSH ( ) 25min/ ml ( 4 30 ), ( ) 110 ng/ ml (40 80) 1990 9 4,,, : : T 126

( E), 2 (10 9 11 4 ),,, 2, 1991 1 8,, B,,, ( < 0.5cm),,,,,, ( 447 ) 30g 30g 20g 15g 15g 15g 15g 12g 12g 12g 12g 12g 12g 10g 10g ( ) 10g 10g 10g 10g 10g 5g 1, E, 100mg, 2 1991 3 31 2, 2 28 3 31 2,,,,,, 10,, 1, 4, 1, 2, 8 4 12 18, 7 4 16 18 4 19 ( 447 ), 1, 15 127

30g 30g 30g 15g 15g 15g 15g 10g 10g 6g 1991 5 11 11,,, 24, B :, 2.1cm 2.1cm 1.8cm, :, 3 6g, 2 3 1992 1 10, :,,,,,,,,,,,,,,,,, LH/ FSH = 3.2, T,,,,,,,,, 2,,,,,,,,, 4., 26 1993 2 10 4 15, 2 1, 1992 1 6 (, ) 6, 1992 6,,,, 20,, 3, 3 128

: PRL 122.2ng/ ml, LH 14.9min/ ml, FSH 3.0min/ ml, E2 42.3pg/ ml, P 2.5ng/ ml, T 28.9ng/ dl CT, :,, 15g 15g 15g 12g 12g 12g 12g 12g 10g 10g 10g 10g 20g 10g 10g 3g 1, 40 30g, 30g,,, 1, 10 15 3 1, :, 6 1993 3 26,,,, 1994 1, : 4, 2,,,,,,,, 3, 29,, 1,, 129

,,,,,,,,,,,, 5., 25 1995 9 29 16,,, 3 8 1,,, 1994, 1995 1 (, ) 3,,,,, : LH 19.3min/ ml, FSH 4.5min/ ml, E2 74.9pg/ ml, P 0.5ng/ ml, PRL 4.8ng/ ml, T 41.0ng/ dl LH/ FSH > 4.29, 3cm 3,,,,,,,, 15g 15g 10g 10g 10g 12g 12g 10g 10g 10g 10g 10g ( )10g 10g 10g 10g 10g 10g 10g 5g 1,, : 3 4, 1, 5 130

11 10 10 28,,,,, 10,,,, B :, 1.2cm, 1, 3 10g, ( ) 10g, 10g, 1, 1995 11 17 1.7cm, 5, 1, 2, 1995 12 15,,,,, 24 B :, 1.5cm 1.4cm 0.7cm, 1996 8 11, :,,,,,, 2 :,,,, ; ;,,, ( B ),,,,,,,,,, 131

) ( ), ( ), 25% 30%,,, 21,,,,, 3 6 1, Kirchhoff ( 5 25 ),, (,, ) HMG LH-RH, : :, 132

,, :,,,,,,,, 1., 32 1987 10 14 5,, 4, 4 5, :,,,,,,,, : 1987 8 29 B, 9 24, :,,,,,,,,,, 20g 15g 15g 15g 12g 10g 12g 10g 30g 8g 6g 3g 12g 25 2, 1, 9, 23,, 4 : :,, 1988 10, 133

,,,,,,,,,,,,, 2., 26 1999 3 26 3 15, 26 40 1, 6 7,,,,,,, : 3,, 3 17,,, 30g 15g 15g 15g 15g 15g 15g 15g 15g 15g 15g 15g 15g 10g 10g 10g 10g 10g 10g 10g 5g 8g 20g 1, 60 10g, 5 B 1999 6 1 ( 4 12 5 17 ), 26 35 4,,, 16, B 2.0cm 3, 1 1999 8 30 45 B : 134

( 452 ) 1 2000 4 20, :,,,,,,,,,,,,,,,,,,,,,,,,,,,? ( ) (LPD) ( ),, 7 8, 1 2,,,,,,, 1, 3% 8% : 135

, FSH,,,,, :,,,,,,,,, 12,,, 0.5,, 3, 12,,,,,,,,,,,,,,,,,,,,,,,,,, ( LPD) 136

, 10mg,,,,,,,,,,,, 1., 26 1988 1 6 2 1979 3,, 22 24 1, 1, 1,,,,, 30g 30g 15g 15g 9g ( )10g 15g 12g 30g 30g 15g 1, ( ), 1988 2 26 2 21, 28,,,, 6,,,, 2,, 3 1988 3 26 3 24,, 137

1988 4 11 13 3,, 1988 5 4 40, B 1988 12 27, :,,, :,,,,,,,,,,,, : 2., 42 1988 6 1 13, 1984, 4 1, 40 50 1, 1 2,,, 5 28, :,,, ( 447 ), 15g 10g 10g 15g 6g 10g 30g 15g 15g 15g 15g 15g 10g 15g 10g 1 ( 3, 1 ), 1988 8 24, 35 1 (7 3, 8 8 ),,,, 138

, 1988 12 30 50,,, B 1989 8 23, :,, 4, 4,,,,,,,,,,,,,,,,,,,, 3., 28 1997 3 14 5, 35 50 1,,,,,,, : ; : : O ( AB ), 1 32 :,,,, 20g 15g 10g 10g 10g 20g 12g 10g 6g 10g 10g ( ) 30g 1, 90 1997 6 20, 35, 139

, 5, 1,, 15,, 1997 8 22, B, 1.5cm 7,, 1998 5, :,,,,,,,,,,,,,,,,,,,,,,,, B,,, :,,,,,,,,,,,,,,,,,,,,,, ( ),,,,, ;,,,, :,,, 140

,, ;,, ( ),,,,,,,, :,,,, ( ),, ; ;,,,,,,,, 4., 29 2000 8 18 3 18, 24 120, 4 5,,,,,, B :, 3.94cm 3.19cm 3.68cm,,,, 0.47cm,, :, :,,,,,,,,, :, 4, 2 ( 1.5g), 2, 2, 3, 2 ( 0.35g) E, 100mg, 1 141

10 5 9 20, 41,,,,, ( 447 ) : 20g 12g 10g 12g 10g 10g 10g 12g 12g 12g 10g 10g 10g 10g 10g 10g 15g 10g 5g 12g 1, 3, 1, 2, 2001 6, :,,,,, 6,, :,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 1,, 142

, :,,,,,,, 5., 26 1997 11 28 18,, 4 6 1 2,,,,,,,,,,,, 9 16, 2,,,,, ( )10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 5g 1, 90,, 1998 3 31,,,,, ( 12 6, 1 31, 3 10 ),,, B : 5.4cm 4.4cm 3.3cm,,,, 1.4cm 143

,,,,,, 30, 24g 12g 12g 12g 12g 10g 10g 10g 10g 3g 20g 3g 10g 5g 1, 30 1998 5 15 5, 18 :, 1999 1, :,,,,,,,, ;, ;, ;,, :,,,,, ;,,,,,,,,,,,,,, 144

) ( LUF) ( LUF ), PRL,, PRL,,, LUF,,,, 34 1990 3 12 4, (25 27 ) 1989 3 9, 6,, 1 3, B 3, 2 10, 1 11, 13 14 2.1 2.2cm, 22 (LUF 24),,,,,, 2 19,,,,,,,,,,,, 5 ( ),,,, 10, 3,, B, : 5g 3g 5g 8g 145

10g 8g 5g 10g ( )8g 1, 5 ( 447 ) : 15g 15g 15g 15g 15g 15g 15g 10g 10g 10g 10g 1, 10 ( ) : 15g 15g 12g 12g 12g 10g 10g 10g 10g 10g 10g 10g 10g 10g 1, 90 1990 6 14 3, 28 29,, 6 1 B 6 25 27, 1990 8 3 50,, 1991 3 20, :,,,,,,,,,,, 146

,,,,,,,,,,,,,,,,,, ( ),,,,,,,, ;,,,,,,,,, ( ),,,,, :, :,,,,,,,,,,,,?, :,,, 147

,, 1, 20 2, 20 3, 20 2, 1., 31 1988 4 11 6 40 60 1, 2 3,,,, 2 15,, 1987 12,, : B, ( 3.6cm 3.5cm 2.2cm),,,,, ( 448 ) 15g 12g 10g 10g 10g 12g 12g 30g ( )10g 12g 10g 10g 15g 15g 12g, 1, 15, ( ) ( 447 ), 3, 1,,, 2, 1, 3,,,,,,, 1988 7 11 3,, B, (4.5cm 4.1cm 3.0cm) 3 148

7, :,,,,,,,,,, ;,,, ;, 2., 28 1987 6 25 2, 3 18, 1,,,, 20,, 6,,,,,,,,,, ( 447 ) 15g 30g 10g 10g 15g 15g 30g 12g 12g 15g 15g 10g 30g 12g 6g 1, 10, ( 8 17 10 14 ), 2, 1, 20,, 1987 11 5 4,,,, 1 2, 149

3 22 5,,,,,, 14, 1988 7 13 1, 1,,,, 5,, 1 5 1988 12 30, B, 5.2cm 4.2cm 4.1cm,, 2.0cm 1.9cm 1.6cm, 2.1cm 2.0cm 1.9cm 1989 5 5 3, B 1989 12 30, :,,,,,,,,,,, 3., 27 1991 9 10 3 15, 17, 50 60 1, 1 2,,, 8 22 B ( 3.7cm 3.4cm 2.1cm), : 150

,,,,,, 100g 100g 50g 50g 50g 100g 200g 50g 50g 100g 100g 100g 50g 100g 100g 100g 100g 100g 100g 200g 100g 100g 50g 50g 50g,, 10g, 2, 3,, 1991 12 18,, 3, ( 30 40 1 ),,,,,,,,, 1992 3 24 50 1992 11 25, :,,,, :,,,, 151

,,,, 30% 40% ;,, 20% 36%, 20,,,, Douglas,,,,,,,,,,,,,,,,,,,,,,, ;, :,, 152

,, 1., 25 1988 6 3 2 25 27, 5 6,,, 5 21, 5 31 :, 2.5cm 2.5cm 1.5cm,,,, B :,,,,, 6cm 5cm 3cm, 1.5cm 1cm 1cm ; 5cm 4cm 3cm,,, :,, 15g 15g 15g ( ) 10g 10g 10g 10g 10g 15g 10g 15g 30g 15g 30g 6g 15g 15g 10g 3, 10 6 1988 9 9 3,,, ( 447 ), 10g 10g 15g 20g 15g 10g 15g 15g 153

g 10g 15g 30g 10g 6g 1988 12 10 3,,, 2, 3 5, 1989 5 20 2, B 1990 1, :,,,,,,,,,,,,,, 2., 31 1990 11 24 17, 1 2, 23 33 2,,,,,,,,, ( 2 ),,,,, :,,,,,,,,, 11 18,, 154

,,, 20g 15g 15g 15g 15g 12g 10g 10g 10g ( )10g ( )10g 10g ( )10g 10g 10g 10g 10g 10g 5g 5g 3g ( ) 3g, 1, 1990 12 3,, 1990 12 8, B, 1.8cm, 1,, 5,, 1, 2,,, 1990 12 28,, 18 : 1991 8 20, :,,,,,, ( :,,, ),,,,,,,,,,,,, 155

,,,,,,, 3., 34 1995 9 15 1991 ( 2 ) 11 12, 40,,,, 1995 5 22, : 360, :,, ; : LH 17.3min/ ml, FSH 16.2min/ ml, E2 89.3pg/ ml, T 37.2ng/ dl, P 0.5ng/ ml, PRL 14.7ng/ ml LH/ FSH E2 T 4,,,, 24 27,,,,, 8 27,,,, 10g 10g 10g 10g 10g 10g ( ) 8g 8g 8g 8g 5g 5g 2g 5g 8g, 1, 2, 1, 2, 1, 2, 156

1995 12 29,,,,,, 9 12 1996 7 16,,,, 10g 5g 5g 10g 5g, 5 2 3 7 8 9,, 1996 9 13 9 1 B, 1.8cm, 13 15 1 3 1996 10 11, 1997 6 10, :,,,, : 360,,,,, B,, 80%,,, :, ( ), 5, 4, 3,,, ;,,,,,, 157

4,,,, 5,,,,,, 30,,,,,,,,,,,,,,,,,,,,,, ;,,, ;,,,,, 30% 40%,, 158

,,,,,,, ;,,,,,,, 1., 28 1988 2 24 3,,,,,,,, 1 28,,,,,,,, : 15g 15g 15g 10g 10g 15g 15g 30g 15g 30g 15g 10g 12g 10g 1, : 30g 10g 10g 15g 3g 15g 15g 15g 10g,,, 1,, 1 1988 3 25 3 18,, 159

4 27 4 18 B,,,, 3,, 1988 7 20 1989 2 25, :,,,,,,,,,,, 2., 28 1988 3 15 6 17, 30, 6,,,, 1986,, 1987 11 18,,, 3 4,, ( 447 ) 15g 10g 10g 15g 15g 30g 12g 15g 15g 15g 15g 3g 15g 30g 15g 15g 6g 15g 1,, ( ), ( 454 ),,, 1 1988 4 8 4 3,, 160

1988 5 30,,,, B, 1989 1, : 17,,,,,,,,,,,, 3., 30 1996 10 18 7, 5, 30 35 1, 3 5,,, 10,,,,,,,,, 10 1,,, 12g 10g 10g ( ) 10g 10g ( )10g 10g 10g 10g 10g 10g 10g 10g 15g 15g 1, 60 ( 453 ), 1 10 15 1 2,, 3 1997 1 31 30 31,, 1, 7, 161

5, 7,, 2, 1 ;, 1, 1 3 1997 3 21 B 1997 11 13, : :,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 4., 29 1999 6 22 5 1997 B :,, ;, : 5 12,, :, 32 40, 2 3,,, 6 13, 162

, ( 447 ) ( 454 ),, : 15g ( )10g ( )10g 10g 10g 10g 10g 10g 10g 10g 6g 1,, 30, 15,, 3 1999 8 9 7 21 : ;,, 24, :,,,, 9, B 1999 10 27 4 12 B, 6.6cm 5.3cm 2.4cm,, 0.3cm, 4.2cm 3.0cm 2.8cm, 2.2cm,,, 1.2cm B 1.0cm 3, 1 2000 9 24, : 40%,,, 163

,,,,,,,,,,,, ; 2,,,, 2, 1,,,, ( ) ( ),,,,, ( ), 32 1986 11 27 7,, 11 5,,, 1985 10 15, 1986 8 23,, 164

, 15g 15g 15g 15g 30g 15g 30g 20g 10g 6g ( ) 10g 1, 1986 12 18,,, 1987 3 31,, 30g 15g 10g 10g 10g 6g, 1, 6 1987 4 13 4 9 B, 4.5cm 4.4cm 3.3cm, 2.1cm 1.7cm 16cm, 1.1cm; 4.5cm 4.4cm 4.0cm, 2.2cm 2.1cm 1.9cm, 1.6cm 0.3, 1 1987 5 3,,, 1988 1, :,,, : ; ;, ;,, 165

), 32 1982 7 2 1978 5 10,,,,,, 1978 5 16, 30 90 1, 4 5,,,,,, 20g 12g 10g 9g 10g 12g 10g 10g 20g 20g 15g 15g 30g 6g 1, 1983 7 12 1,,, 1985 1 9, 40, 2, 15g 15g 20g 15g 10g ( )6g 3g 6g 3g 10g 10g 10g 10g 30g 10g 10g 10g 1, 1985 1 18 2,, 3, : 166

,,,,,, 30g 10g 30g,,, 10g, 2, 3 1988 1 26 3 B, 15g 10g 10g 10g 8g 3g 6g 30g 10g 12g ( ) 10g 1, 30,,, 30 1988 8 3, : :, :,,,,,?,,,,,,, ( ) ( ),,,,, ;,, 167

,,, 29 2000 7 15 3, 2, 40, 2 3 :, 29 31, 5 7,,,, ( : ( - ), : ( - ), ( - ), ( - ),, ), 7 14 : LH 5.3min/ ml ( 24 60), FSH 8.7min/ ml( 10 30), PRL 25.2ng/ ml( 0 20), T 39.1ng/ d ( < 80 ), E2 106.9pg/ ml ( 100 350), P 0.2ng/ ml( 0.9 0.5),,,,,,, ( )10g 30g 15g 15g 12g 12g 12g 15g 12g 15g ( ) 10g ( )10g 15g 15g 15g 12g 10g 10g 5g 1, 168

8 15,, 7 30 B :,, 0.8cm, 2.0cm, 15g 15g 10g 10g 1, 3 2000 10 9 40,, 2,,,, 2 3, 1 2,, B :,, 1.1cm 1.13cm 0.9cm,, : 25, 0.45 0.5,,,,,,,, ( 452 ), 2, 2 3, 2000 10 26 1,, B :, 3.87cm 3.08cm 2.90cm,,, 1, 2001 4 12, :, 2001 5 29, : :,,,,,,,,, :,, ;,, 169

,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 2 40,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 170

, ( ) 1., 32 1989 2 27 9 26 28, 4,,,,, 2 9 1988 5 : ; 2,, B : 4.3cm 5.3cm 3.6cm,, 2.2cm 1.7cm 2.0cm, 2.5cm 1.4cm 2.3cm :,,, ( 1 ),, 12g 15g 15g 15g 10g 10g ( ) 10g 10g 15g 15g 15g 10g 15g 15g 3g 3, 9 14 6, ( 2 ), 1, 10g 15g 10g 10g 10g 10g 10g 10g 10g ( )10g 10g 3g 171

3 12 3 6, ( 1 2 ), :,,,,, 1, 1, 10 2,, 1989 3 16 B, 2.0cm, 1.2cm, 5 1990 2, :,,,,, 2., 32 1988 4 8 5 21 30,,,, 3 26 4 7 : 1.5cm, 4.0cm,,,, 16cm,,,, 30g 20g 15g 12g 12g 12g 10g 10g 10g 10g 10g 5g 1, 30 1988 5 20 4 21, :, 172

1, 15,, 1, 3, 5 1988 6 23 1,,, : B,, 2.2cm 2.4cm 1.3cm,, 6g, 3, 7 1989 2 28, :,,,,,,,,,,, ( ) ( ) ( ), 30 50, 40 50, 20,, ; 3,,, 30% 40%,, 173

,,,, : ( ) (,, ),, ; 2,, ; 2.5,, ; 35, 1., 29 1988 3 16 3 20 23, 7 10, 1986 11 8 12 3, 4,, 1987 9 2 10 19 174

8, 5, 2, 1 1987 11 B, 12 17 4.5mg/ 24h( 5 15mg/ 24h), 17 6.5mg/ 24h ( 7 15mg/ 24h ), 1987 12 1988 2, 3,, 10mg, 5,, 2 14,,,, 30g 15g 15g 15g 15g 24g 15g 15g 15g 15g 30g 3g 15g ( )10g 6g, 1, 6 1988 4 1 3 25, 6,,, 4 8 13, 6, 4 11 13 3, 1988 5 16 4 26, 4,,,, 12, 1988 9 16 50 : 1989 5 14, : :, ; :,,,,,,,, 175

, ; ;, ;,,,,, :,,,,,,,,,!,,,,,,,, 2., 28 1995 11 3 3 24 26, 5 6,, 10 28 B, :,,,, ( 447 ) 15g 15g 15g 15g 15g 15g 15g ( ) 10g 10g 10g 10g 10g 10g 10g 10g 10g 1 15g; 10g 3, 1996 3 22 27 29, 4 5,, B,,, 15g 15g 15g 15g 15g 15g 15g 12g 176

10g 10g 10g 10g 15g 10g 5g 1, 90 1996 6 21 15, B, 1.9cm, 0.8cm, 7, ( 452 ), 3, 1, 30, 1, 3 1997 3 12, :,, ;,, ;,,, ; 3,,,,,,,,,, ( ) ( ),,,,, 10% 20%, 85% 97%, 95%,,,,,,, 177

,,,,,,, 29 1987 11 27 2 1985 4,, 30 47 1, 1 3, 11 20,,,, 30g 15g 15g 15g 10g 10g 10g 15g 20g 20g 10g 20g 10g 6g, 1, 3, 13, 6 1988 4 11 3, 1, ; 2, 3 1988 6 13 40,, 18 1989 2 10, :,,,,, 178

,,,,, 2,,,,,, ; ;,,, ;,,,,,,,,, ( ) ( ),,,,,, < 4cm,, 2,,,,,, 4 6cm, 2,, 29 1995 1 13 1992 11 45 1993 8 2,, 1994 8,,,, 33 40 60 96,,,, 96,, 179

, ( )12g ( ) 12g ( )12g 12g 12g 12g 12g 12g 12g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 5g 1, 10g, 1995 4 30 3, 3,, 37 39 31,,2 7, 3 4, 10g 10g,, 10g, 2, 3, B 1995 10 13, 3, 3 9 3 ( 37 37.1 ) 21,, B :, 1.76cm 2.08cm 1.56cm :,, 2, 1, 3 1996 6 12, :, 2,,, 1994,,, 8 3 9 B,,,, 180

,,,,, 1.5 3, 3,,,,, 35 2000 9 1 13, 1990 7, 2000 6 14 :,,,, ( > 8 ),,,,, : EM? 7 8, 30ml,,, : 7 19 3 : AsAb: IgG( + ), IgM( + ), IgA( - ) ; EMAb: IgG( - ), IgM( + ) ; AOCAb ( - ) ( ), 32 37, 3 5,,,,,, 10,,, 181

, 15g 10g 15g 12g 12g 12g ( )10g ( )3g 10g 10g 10g ( )10g 12g 10g 10g 10g 5g 2, 3cm 40 2 3,, 2 ( ),,, ( ), 1, 2000 9 19 B ( TVS) ( 16 ) :, 5.3cm 5.1cm 4.9cm,, 0.6cm, 1.0cm,, 0.2cm, 2.6cm 1.7cm, 2.8cm 2.2cm, 1.6cm : ; (?), 0.2 0.25,,, 1, 3 2000 10 10 2 31,,,,, :,,,,, 1, 2 3,, 182

454 ), 2, : 3 4, 1, 5 2000 11 14, 15 10 29 31,,,,,,, 1 2001 2 5 4, 11 14 12 18 1 20 1 2, B :,,, 2.2cm, 1.0cm,,, :, 2001 7 10, :,,,,,,,, ( ),,,, 10,,,, : AsAb: IgG( + ), IgM( + ), EMAb:IgM( + ) 2,,,,,,,,,,,,, B (TVS), 183

,,, 10 5, 13,,,,,,, 1.5 3,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 30 1994 12 16 2,,,,, 2,,,,,, 184

11 26,,,,,,,,,, 3 30g 10g 10g 10g 10g ( )10g 10g 10g 10g ( )10g 10g 10g 3g 3g 1, 30 1, 60 30 1995 4 12,,, 2 3 25,, 28 33,,,, 6g 2g 3g 6g ( )6g 6g 3g 10g 10g 6g, 5, 1,, 1995 6 27, 20, 5 21 : 1996 2 26, :,,,,,,,,,,,,,,, 185

,,,,,,,,,,,,,,,,,,,, ( ) ( ), ( WHO) 8% 10%, 30%,,,, ( ) ( ELISA), 4,,,, ( ) (AsAb) (Anti-sperm Antibody),,,, ( ) 186

EMAb) (Anti-Endometrium Antibody),,,,,,,,, ( AoA) (Anti-ovary Antibody) ( FSH ),,,,,,, ( HCGAb ) ( Anti-Human Chorionic Conadotropin Antibody) (AHCG ) (HCG),, HCG HCG,, HCG,,, : (AsAb), 2 3 ( EMAb), E 1 3 (AoA) ( HCGAb) 187

,,,,,,,,, ( ) 1., 26 1997 11 28 2 14, 20 37, 2 3,,,,,,, 1,, 11 24, :, :,,,,,,,3,,, 3, 15g 12g 10g ( ) 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 15g 3g ( ) 5g 1, ( ), 5mg, 3 ; E, 100mg, 2 ;, 25mg, 3, 1, 188

2 27,,,,, 9,,,, 10g 15g E, 1998 5 8 14 B 1.0cm,, 3,,, 1999 2 5, :,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 189

, 33 2000 5 9 6 ( 1993 10, 1994 4, 1994 11, 1997 5, 1997 11, 1998 10 ), 45 100 1, 5 6,,,,, 5 6,, : ( IgM) : ( + ), ( + ) : A, B : IgG A ( - ), ABO ( - ), ( - ),, 12g 10g 10g 12g 12g 10g 10g 6g 10g 6g 3g 6g 1,, :, 1g, 3 ; C, 100mg, 3 ; E, 100mg, 1, 25mg, 3,, 5mg, 3, 3 ;, 2, 3 ;, 1, 4 10, 10 10 2000 8 11,, 7 29, B ( TVS) :, 190

cm 5.2cm 2.9cm,,, 0.7cm, 2.6cm 1.1cm, 1.3cm 1.1cm, 2.3cm 1.5cm, 1.3cm 1.2cm 8 11 16, 6 8 13 15, 2, 8 17, ( 452 ), 1, 3, 2000 9 26 59,, B :, 3.2cm 3.5cm 1.9cm,, 2, 1, 2 3 2001, :,, ;,,,,,,,,,,,,,,,,,,, 3,,,,,,,,,, 191

,,,, :,,,,,,, ;,,,,,,,, 3., 38 1988 7 15 13 17, 24 28, 3 4,,,, 1986 7 3,, ; 11 24,,,,,,,,,,,,,,,,, 15g 20g 20g 15g 15g 10g 12g 10g 10g 6g 10g 10g 10g 15g 30g 10g 30g 20g 6g 192

, 1, 6 : 15g 30g 30g 30g 30g 20g 30g 15g 1 2 1988 9 14,,, : 30g 15g 10g 15g 10g 15g 15g 15g 15g 10g 15g 10g 10g 10g 15g 15g, 15g, 1988 12 25, 1990 3 26, :,,,,,,,,,,,,,,,,,,, 193

) 1., ( ) 28 1989 6 20 1984, 12 3,,,,, 2,,, 2, 35,,,, 10, 27 31, 2 5,,,,, 1, 1, A, B,,,,,,,, 12g 12g 10g 10g ( )10g 10g 10g 10g 12g ( )12g 12g 12g 12g 12g 10g 5g, 1, 5 11, 1, 7, 194

1, 2, E 100mg,,,,,, : 5 7 / HP, 1, 6 700 / ml, 4 m/, 0 50% ( Zn) 5.6mg/ dl, / 0.73, ( 436 ) 15g 12g 10g 10g 10g 15g 15g ( ) 10g 10g 10g 10g 10g 30g 30g 6g 1, 30, 1 1989 8 9,,, 15% 30,, 18mg/ dl,,, 10g, 10g, 1, 1989 9 24, 28, 2,,, 195

1, 5,, 1989 12 29 3, B :,, 2.3cm,, 7.5cm :, 1990 7 1, :,,,,,, :,,,,, ( ),,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 196

,,,,,,,,,,, ( ),,,,,,,,,,,,,,,,, 2., ( ) 26 1989 8 8 1987 12 13 34,,, 40,,,,,,,,,,,,,,,,, 30g ( )10g 10g 3g 3g 3g 5g 5g 6g 1, 30, 197

g, 1,, :,,,,,, ( 406 ) 24g 12g 10g 10g 10g 10g 10g 10g 12g 12g 15g 15g 15g 15g 1, 30, 1 1989 9 28 40, 20,,, 10 1989 10 5 B :, 2.4cm 1.7cm 3.3cm, 1989 12 28 18 + 5 (4 + ) B :, 4.3cm :,, 1990 5 23, :,,,, 198

,,,,,,,,,,,,,, :,,,,,,?,,,,,,,,,,,,,,,,,,, :,,,,,,, 30, 30,,,,,,,,, 3., 33 199

8 18 8,,,, 23 28, 5 7,,,,, 8 1,,,, 45xx, t (14; 15) ( Rob ),, : ( 1 5 ) ( 11 16 ) : 30g 10g 10g 10g 500ml, 30,, 2,, 50g,,,, ( 6 10 ), 1, 2 ( ), 1, 2 20g 3g 3g 1g 1g 1g, 3,, 0, 50%,,,,,, ( 436 ) 15g 15g 15g 15g 12g 12g 10g 10g 10g 10g ( ) 10g 10g 10g 10g 5g 200

, 90, 1 1994 11 18 26 28, 4 5,,,,,,, 12, ( 447 ),,,, 15g 15g 15g 15g 15g 15g 15g 15g 15g 15g 5g 1, 15 16, ( 448 ), 1, 10,,,,,, 10g 10g 10g 15g 15g 15g 15g 5g 20g 2g 2g 2g,,,,, :,,, 10g, 3, 1995 1 25 12 23 24 2 30, ( 452 ),, 1995 9 18, : Langdon Down 1866 21 201

Down ), 21 1% 2% 21 : Down, G1,, 3.5% Down, Down, 45, 46, G,,,, 21q21q, 100%,,,,,,,,,,,,,,,,,,, 31 1992 3 9 7, 1991 9, 15 20, 1,,,,, 202

,,,, 5,,,,,,, 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 10g 5g 1, 30 1992 5 27,,, : 3 29 4 26 5 26, 28, 1,, B 1992 12 5, : 6, 5,,,,,, ;,,,,, ;,,,,,,,, ;,,,,,,,,,,,,,, ;, ;,, ; 203

, ;,,,,,,, 1 000ml 2 000ml, 0.5% 10.0% 25%, 10, : 3 000ml,, ( 1),, 20 24, 2%,,,,,,,,,,,, ( 2),, 98%,,,,,,, 204

; ;,,, ;, :,,, X ( -FP ), B, > 9cm,,,, X : ( 1),,, 500ml,,, ( 2) :,,,,,,,,,,,,, ;,, ;,,, ; 205

;, ;,,,,,,, 31 2000 10 25 5,,,,,,,,,,,,,,,,,,,,,, 15g 15g 15g 15g 15g 15g 6g 10g 10g 10g 10g 10g 12g 12g 5g 5g 20g 1, 2000 11 16,,,,,, : 32 110/ 70mmHg 85kg ( ) 37cm ( 10cm) 110cm ( 3cm) LoA, 140 / ( - ) B : :, 8.9cm, LoA,, 14cm,, 5cm, :, 206

B,,, 2000 12 4,,,, 4, 2 ;, 1, 2, 15 2001 1 9 B :,,, 2001 1 12, :,,,,,, ( ), :,,,,,,,,,, ;,,,, 300ml, 207

88.24%, :,,,,,,,,,,,,,, :,,,,,,,, 5, 28 2001 6 21 24 + 2 ( 2001 1 2 ), B : : 6.2cm,,, ( ),, 4.3cm :, 208

( ) :, 1.0 1.2 2.0 2.5 cm,,, 2 1,,, ( 460 ) 30g 15g 10g 12g 12g 12g 12g 12g 12g 12g 10g 10g 10g 10g 10g 6g 10g 10g 1 450ml, 150ml, 3,, 3g 3g 1g 3g, 2001 6 28,, 1.0 1.5 B : 3.5 3.6 ; cm : :,,, 2001 7 19 28 + 3 B :.., 7.3cm, 5.2cm,, :, ; 1.8 4.0 3.5 3.7 :, cm; : :, ; 209

: 10 2, :,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, :,,,,,,, 210

,,,, :,,,,,,,,,, :,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ( ), ; ( ) ; ( ) ;, ;, ;,,,, 28 1 000g, 12, 12 28, 211

,,, :,, 50% 60%, ( X ), ( ),,, :, ( DDT ) ( ) : A. : ;,,,, B. : ( ) ( ),, C. :, D. :, :, 212

8,, -HCG GPC,, :,,,, ( ) : 28, ( ),,,,,,, ;, :,, ( ),, :,,,,,,,,, :,,, 213

, :, :,,,,,, : 3 3,,,,,,,,,,,,,,,,,,,,,,, 20mg,,, E, ( ),, 214

2,,,, B -HCG,,,,,,,,,,,,,,,,,,,,, 10 20mg, 10,,,,,,, 14 16,,,,,, :,,,,,,,,, 215

, ( ),,, 1., 39 1987 10 16 12,, 1984,, 2,, 1986 7 16, 24 37 1, 1,,,, 5,,,, 12g 12g 10g 15g 30g 15g 15g 15g 15g 30g 15g 15g 12g 10g 2, 12 4, 1988 3 16 5,, 10,, ( 3 ) ( 447 ) 30g 20g 15g ( ) 10g 15g 30g ( ) 10g 1988 6 22 2, B,, 216

, 10 16 B,, 1989 1 31, :, ;,,,,?,,,,,,,,,,,,,, 2., 30 1988 7 23 7, 3, 50,30 50 1,,,,,,,, 15g 30g 10g 15g 15g 10g 10g 10g 15g 15g ( ) 10g, 3, 1,, 1988 8 27 50, B :, 1988 9 5,,, 1989 4 15, 217

:,,,,,,,,,,, 3., 25 1987 9 4 1985 5 1985 11 1986 10, 3,,,,, 46xx, G ; 46xy, G : : B Rh + B ; O Rh + O : IgG B, ABO,,,,, 3 15g 20g 15g 15g 15g 15g 20g 10g 10g 10g 10g 30g 20g 15g 6g 3 1987 12 7 3,,, 3,12 19 24 6 218

12 23 25 1988 1 8,, :, ( 447 ) 1, 30g 10g 15g 15g 10g 30g 30g 15g 12g 15g 6g 10g 10g 10g 1988 3 10 3 9,, 6g, 6,, 1, 4 5 1988 9 10, : :,,,,,,,, 4., 33 1987 7 23 3, 5, 4 2, 38, B,,,,,,, 30g 20g 30g ( ) 12g 15g 25g 15g 15g 30g 20g 30g 10g 6g 6g 10g 1, 60 219

3 28, :,,,, 5., 24 1988 7 22 1, 2, 3, B,,, 24 31, 2 3, 7 7,,,, 15g 10g 10g 15g 20g 30g 15g 15g 15g 15g 15g 15g 10g 15g 30g 10g 10g 6g 1, 30 1, 1988 10 5,,, :, O B : IgG B 1 64( 1 32), ABO : : 446mg/ 100ml, 66mg/ 100ml, 197mg/ 100ml, ABO,,, E, 100mg, 1 C, 100mg,1 2, 1988 12 22 220

2 22,, 500ml C 200mg, 7 5,, IgC B 1 4, 1989 6 22,, 1, 15, 1989 8 20, :, O, A B AB, Rh ABO,,,,,,,, IgG B 1 64,, 6., 35 1989 1 15 6, 3 40 50,, E, 3 4,,,, 3, 23 24, 6 7,,,,,,,,,,,,,, 221

g 10g 10g 10g 6g 3g 2g 10g 10g 5g 10g ( ) 6g 10g 10g 1,,, 1, 20 30 20g 20g 15g 15g 15g 10g, 1,, 1989 4 15, 27 28 1, 3 4,, 4 10, ( 447 ),, 15g 12g 12g 12g 12g 10g 10g 10g 10g 10g 10g 10g 5g 10g 1, 12 4 22 24 26, 4 27, ( 447 ), 15g 15g 15g 15g 12g 12g 12g 12g 10g 10g 3g ( )10g ( ) 10g 222

, 1989 6 20,, B :, 4.5cm 4.6cm 5.5cm,, 10g 6g 1, 2 3 1 ( 1 2 3 ), 10 1989 9 10 B : 1990 1 11, :,,,,,, :,,,,,,,,,,,,,,, :,,, :,,,,,,,,, 223

,, ( ),,, (, ),,,,,,,,,,,, 3,, B,,, 5,,,, 7., 42 1991 11 18 1976, 1980 12 1983 11 1987 10 1989 11, 4 40 50,, 2 3 20 24 1,,,,,,,, 11 16,,,,, 15g 12g 12g 12g ( )12g 12g 12g 12g 10g ( )10g ( )10g 15g 10g 1, 1992 1 15, 12 7 1 3, 21 27 11 224

3 : a. ; b. ; a b 1992 2 5,, 20 : ( 452 ),,, 12g 12g 12g 12g 10g 10g 10g 10g 12g 10g 10g 6g 1, 20 2 1, 5,, 1992 4 5, 1992 10 12, :,,,,,,,,,,,, ;,, ; ;,,,,,, ;,,,,,,,, 1, 2,, 225

),,,, ( ),,,,,,,,,,,,,,,,,,,,,,, 8., 38 1997 11 5 15, 11, 7, 3, 1 3 6 24 27 1, 4 5,,,,,,,,,,,, 2,, 1, 2 2, 1, 2, 0.3g, 3, 10 ( 448 ), 1,, ( 447 ), 6 3 1998 2 17, 226

, B : 1.5cm, 1, 3 2, 4, 2 1998 3 12, 20 : ( 452 ), 1, 3 5,, 1, 7 1998 11 10, : :,,,,,,,,,,,, ( ), :,, ( ), :,, ( ), :,, 3,, ( ), :,, ( ), :,,, 227

), :,,, 3,,,,,, ;,, ;,,,,, ( ), :,,,,,, ;,,,, ;,,, 9., 29 1993 3 19 ( ) 6, 3 (1990 7,1992 2, 1992 8 ) 2 : :, 46xx, G : A, O, Rh ( + ), : IgG A 1 32 : MB - 1 :1 256,, 60 70 1, 6 7,,,,,, 30g 15g 15g ( ) 10g 228

10g 10g 10g 6g 10g 6g 6g 6g 10g 10g 1, :, 1g, 3 E, 100mg, 1 C, 100mg, 3 : 5.0ml, :, < 30, ph: 7.4 : 8600 / ml, 1/ 2 80%, 21% 40%, ( SVT ) 9.39 m/ s, 20mm : 57%, 18%, 5%, 17%, 3% 3 5 / HP : Zn 18mg/ dl, Mg 3.81mg/ dl, Ca 20.79mg/ dl, Cu 0.81mg/ dl :, 46xy, G C ( < 25% ),,,,,,,,,, 1, 2, 2, 2 1993 6 4 MB 1 : ( - ), A, ( - ),, 12 1,,, 1993 9 4 50,, B : ( 452 ), 1, 2 229

: 4 1, :, :,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ; ;,, ; ;,,,,,,,,,,,, ( ),,,,,, ( ) ( ) 230

), 1/ 3 ( 3 ),,, ; : ; :,, ( ) (, ),,, ( ), 10., 33 1989 12 1 1988 5 10, 1989 3, 3 40,, 30 50,, 50 60 1, 4 5,,,,,,,,,,,, 231

30g 15g 15g 12g 12g 12g 10g ( ) 10g 12g 12g 12g 15g 12g 10g 1, 60 ( 436 ) ( ) 2, 2 1990 2 23,, 8 10 2 20, 30g 30g ( ) 10g 10g 10g 10g 10g 10g ( )10g 6g 1, 30 1990 3 30 3 22,, 15 4 15, ( 452 ), 1, 2 1990 4 27 6, 3, B 1990 6 1,,, 1991, : :,,,,,,, 232

,,,,,,,,,,,,,,,,,,,,,,,,, :,, 2,,,,,,,,,,,,,,,, ;,,, 11., 34 1990 9 18 5, 7.5 8 3 1990 1,,,, 8 31 : O, AB,,, 233

g 15g 15g 15g 10g ( )10g 30g 15g 10g 10g 10g 15g 10g 10g 10g 10g 1, 60 1990 11 20, 10,, 1990 12 31, 12 1991 1 13 18,, 1, 3,, 1991 2 19 50,, B :, 3.9cm 3.2cm 1.5cm, : 36.9 37 28 ( 452 ) 1, 2 3 30 2 1991 5 31 5, B, : 5.4cm, : RoA, 4.5cm, : 0 : 2.7cm, 2.9cm, 0.6cm :, 1991 10 4, : :,,,,,,,,,,,,,, 234

,,,,, ;,,,, 3,,, 12., 32 1993 2 8 1990 5 1991 3 1992 3, 3 3,,,,,,,,, ( ) 2 8 12, 1, 5, ( ), 1 : 15g 10g 10g 10g 10g 12g 10g 10g 10g 10g ( ) 6g : 15g 15g 15g 10g 10g 10g 10g 10g ( )6g 6g ( )10g 1993 5 3,,, 4 21, 5 4 9, 6, 5 10,, 10g, 1 1993 5 31 40,,, 235

B, :,, 10g 10g 3g, 1,, ( 452 ), 1, 1 2, 15 1993 8 31 4,, 1994 1 25, : : ( ),,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 30,,,,,,,,,, 13., 28 1997 11 14 1996 8 1997 4 5 10 236

, 3, 50,, 27 31 1, 3 4,,,,, 11 7,,,,, ( 447 ) 12g 12g 10g 10g 12g 12g 12g ( ) 10g 10g 10g 12g 5g 1, 1998 3 20,,,, 10 B ( 14 ) :, 4.5cm 3.9cm 3.5cm, 0.6cm,, 1.0cm :,,,, 1, 30 1998 4 19 4 7, 12 B : 4.5cm 4.0cm 3.9cm,, 1.0cm, 2.0cm, 1998 5 12,, : ( 452 ), 1, 3, 30, 1, 2, 1998 8 25, B : 1999 1 14, 237

50,,,,,,, ;,,,,,,, 4,,,,, 2,,,,,,,,,, 238

,,,,,,,,,

,,,,,, 15%, 50%,,,, :,,,,, :,,,,,,,?,,,,,,,,,,,,,,?,, ;, ; ;,,,,,,,,,,, 241

,,,, ;, ;,,, ;, ;, ;,,,,,,,,,,,,,,,,,, ( ),,, 3 :, ;,, ; 242

( ) ( ) ( ) ( ) (, 5% 40% ) :,,, 3,,,,,,,,,,,,,, 90% 95%,,,,, : ;, ;, ; ;,,, 243

) ( ),,,,,,,,, ; ;,,,,,,,,,,,,,,,,,,,,,,,,,, 1., 24 1987 4 27,, 4 5,,,,, ;,, ;,,,,,, 1 2, 1988 3, 244

, ;, ;,,,,,,,,,,,,,,,,,,, ;,,,,,,,,,,,, 2., 24 1987 7 11 4, 3,,,,,,,,,, 10g 10g 15g 15g 30g 10g 10g 10g 12g 5g 10g 10g 10g 12g 1,, 1988 6, :,,,,,,,,,,,,,,, 245

,,, 3., 41 1987 7 15 12,, 4,,,,,,,,,,,, 30g 30g 12g 12g 10g 10g 12g 8g ( )10g 12g 15g 15g 15g 10g 10g 6g 1 60,,, 1 8, :,,,,,,,,,,,,,,,,,,,,,,, 4., 28 1987 7 10 3,,,,, 246

,,, 1%,,,,, 15g 15g 30g 12g 10g 15g 10g 10g 10g ( )12g 30g 10g 12g 10g 1 2,,, 1988 6 10, :,,,,,,,, :,,,,, 5., 39 1987 4 29,, 1,,,,,,,, 12g 15g 10g 10g 247

g 10g 10g ( ) 12g 15g ( )10g 10g 10g 5g 1 1, 1, 3,, :,,,,,,,,,,,, :,,,, 6., 27 1994 4 8 2, 1,,,,,,,,,, 30g 30g 30g 20g 20g 30g 15g 15g 15g 10g 10g 10g 10g 10g 10g 5g 5g 1,, 1, 30 60 1994 5 18,, 248

, 10g 10g, 30g 10g 1, 30,, 1994 7 8,,, 1995 3 :,,,,,,,, :,,,,,,,,, :,,,,,,,,,,,,,, ;,,,,,,,,,,,,,,,,,,,,,,,, 249

,,,,, ; ; ; ;,,,,,,,,,, 7., 34 1997 5 2 6,,,, 1,,,,,,,,, 3,,,,,,,,,,,,,,, 15g 15g 10g 10g 10g 10g 10g ( ) 10g 10g 10g 10g 10g 10g 10g 10g 5g 5g 10g 1,, 1 : 250

( ) ( ) ( ) : 3 5, 1, 3, 3,,,, ( ) 1997 7 30 1998 3, :,,,,,,, ;, ;, ;,,,,?,,,,,,,,,,,,,,,, ;,, ;,, ;,,,,, ;, ;,,,,,,,,, ( ),,,, ;, 251

,,, :,,,,,, ;,,,,,, ;,,,,,,,,,,,, ;,,, ;,,,, 1., 26 1987 12 27 1985,,,,,,,,,,,, 4 5,,,,,, 15g 15g 10g 10g 12g 15g 15g 15g 10g 15g 10g 20g 252

10g 1, 30g, 15g,, 1 2, 1, 3, 1,, 3, 1 2,, ( 436 ) 20g 20g 30g 15g 10g 20g 20g 15g 15g 15g 15g 30g 15g 6g 1, 1,,, 1, 1988 12, :,,,,,,,,,,,,,,,,,,,,, 2., 25 1988 2 5,, 253

,,,,,, ( ),,,,,,,,,,,,, 12g 20g ( ) 10g ( )3g ( ) 3g ( )10g 10g 10g 10g 10g 10g 6g 3g 1,,,, 1,,, 15 20 2,,, 6g, 1, 2 1989, :,,,,,,,,,,, ;,,,,,,,,, 254