,,,,,,,, (CIP) /,. - :,2003.11 ( ) ISBN 7-81060-315-9............ - -.R512.6-44 CIP (2003) 048452 : : ( 818 : 200433 ) : 787 1092 1/ 32 : 11.75 : 263 2003 11 1 2003 11 1 : 1 4 000 ISBN 7-81060-315-9/ R 237 : 19.00
,, 1991, 3,, 60 %, 1. 2, ; 3 000, 200, 30,,,,,,,,,, 1
,,, 2 000,,,,,,,,,,,, 454, 400 ( 2 ),,, 270,, ( ), 288, 150, 2
,, 2003 4 3
1.? ( 1) 2.? ( 2) 3.?? ( 2) 4.? ( 2) 5.? ( 2) 6.? ( 3) 7.? ( 3) 8.? ( 4) 9.? ( 4) 10.? ( 5) 11.? ( 6) 12.? ( 6) 13.? ( 7) 14.? ( 8) 15.? ( 9) 16.? ( 9) 17.? (10) 18.? (11) 1
19.7? (11) 20.? (11) 21.? (13) 22.? (14) 23.? (15) 24.? (16) 25.? (16) 26.? (17) 27.? (17) 28.? (18) 29.?? (19) 30.? (20) 31.?? (21) 32.? (22) 33.? (23) 34.? (23) 35.? (24) 36.? (25) 37.? (26) 38.? (27) 39.?? (27) 40.? (28) 2
41.?? (29) 42.?? (30) 43.? (30) 44.? (31) 45.? (32) 46.? (32) 47.? (33) 48.? (34) 49.? (34) 50.? (35) 51.? (36) 52.? (38) 53.? (40) 54.? (42) 55.? (43) 56.? (43) 57.?? (44) 58.? (45) 59.? (46) 60.? (47) 61. 3
? (48) 62.,? (49) 63.? (50) 64.? (52) 65.? (53) 66.? (54) 67.? (54) 68.?? (55) 69.?? (56) 70.?? (57) 71.? (58) 72.? (59) 73.? (59) 74.? (60) 75.? (60) 76.? (61) 77.? (62) 78.? (64) 79.? (64) 80.? (65) 81.? (65) 82.? (66) 4
83.? (66) 84.??? (67) 85.? (70) 86.? (71) 87.? (73) 88. -?? (74) 89.? (75) 90.? (75) 91.? (76) 92.? (76) 93.? (77) 94.? (77) 95.? (78) 96.? (79) 97.? (79) 98. -? (80) 99.? (80) 100.? (81) 101.? (82) 102.? (82) 103.? (83) 104.? (84) 105.? (86) 106.? 5
? (86) 107.? (87) 108.? (88) 109.? (89) 110.? (90) 111.?? (91) 112.??? (92) 113.? (93) 114.? (94) 115.? (95) 116.? (96) 117.?? (96) 118.?? (98) 119.? (98) 120.? (99) 121.? ( 100) 122.? ( 101) 123.? ( 101) 124.? ( 102) 125.?? ( 102) 126.? ( 103) 127.? ( 103) 128.? ( 104) 129.? ( 105) 130.? ( 105) 6
131.? ( 105) 132.?? ( 106) 133.? ( 107) 134.? ( 108) 135.? ( 108) 136.? ( 109) 137.? ( 109) 138.? ( 110) 139.? ( 111) 140.? ( 111) 141.? ( 112) 142.? ( 112) 143.?? ( 113) 144.? ( 114) 145.? ( 115) 146.? ( 116) 147.? ( 116) 148.?? ( 117) 149.?? ( 118) 7
150.? ( 119) 151.?? ( 120) 152.? ( 121) 153.? ( 122) 154.? ( 122) 155.A/ G? ( 123) 156.? ( 123) 157.? ( 124) 158. -S-? ( 124) 159.? ( 125) 160.? ( 126) 161. G3 CH5 0? ( 126) 162.? ( 127) 163.? ( 127) 164.? ( 128) 165.? ( 128) 166.? ( 129) 167.X? ( 130) 168.? ( 130) 169.? ( 131) 170.? ( 131) 171.? 8? ( 132)
172.? ( 132) 173.,? ( 132) 174.,? ( 133) 175.,? ( 133) 176.,? ( 134) 177. e,? ( 134) 178. e,? ( 135) 179.? ( 135) 180.? ( 137) 181.? ( 139) 182.? ( 140) 183.? ( 140) 184.? ( 142) 185.? ( 145) 186.? ( 147) 187.? ( 147) 188.? ( 148) 189. M? ( 149) 190.? 9
( 150) 191.?? ( 151) 192.? ( 152) 193.,? ( 154) 194.,,? ( 155) 195. M? ( 155) 196., e,? ( 156) 197., e,? ( 156) 198.,,? ( 157) 199.,? ( 157) 200.e e,? ( 158) 201.? ( 158) 202.?? ( 159) 203.?? ( 160) 204. 10
? ( 161) 205.M? ( 162) 206.? ( 162) 207.? ( 163) 208.? ( 163) 209.? ( 164) 210.? ( 165) 211.? ( 167) 212.? ( 168) 213.? ( 168) 214. B?? ( 169) 215. B? ( 170) 216. B? ( 171) 217. C T? CT? ( 171) 218. CT? ( 172) 219. B CT? ( 173) 220.B CT? ( 173) 221.? ( 173) 222.? ( 174) 223.? ( 175) 11
224.? ( 176) 225.? ( 177) 226.? ( 178) 227.? ( 179) 228.? ( 180) 229.? ( 181) 230.? ( 182) 231.? ( 183) 232.? ( 184) 233.? ( 184) 234.? ( 185) 235.? ( 186) 236.,? ( 187) 237.? ( 187) 238.?? ( 188) 239.? ( 189) 240.? ( 189) 241.? ( 191) 242.? ( 191) 243.? ( 193) 244.? ( 194) 245.? ( 195) 12
246.? ( 196) 247.? ( 199) 248.? ( 200) 249.? ( 201) 250.? ( 202) 251.? ( 202) 252.? ( 203) 253.? ( 204) 254.? ( 205) 255.? ( 205) 256.? ( 206) 257.? ( 207) 258.? ( 208) 259.? ( 209) 260.? ( 210) 261.? ( 212) 262.? ( 213) 263.? ( 214) 264.? ( 215) 265.? ( 216) 266.? ( 217) 267.? ( 217) 268.? ( 219) 269.? ( 220) 13
270.? ( 222) 271.? ( 223) 272.? ( 223) 273.? ( 225) 274.? ( 225) 275.? ( 226) 276.? ( 227) 277.? ( 229) 278.? ( 230) 279.? ( 231) 280.? ( 232) 281.? ( 233) 282.? ( 234) 283.? ( 235) 284.? ( 235) 285.? ( 236) 286.? ( 236) 287.? ( 238) 288.? ( 238) 289.? ( 239) 290.?? ( 240) 291.? ( 241) 14
292.? ( 242) 293.? ( 243) 294.? ( 244) 295.? ( 245) 296.,? ( 246) 297.?? ( 247) 298.? ( 249) 299.? ( 249) 300.? ( 250) 301.? ( 250) 302.? ( 251) 303.? ( 253) 304.? ( 253) 305.? ( 257) 306.? ( 259) 307.? ( 261) 308.? ( 262) 309.? ( 263) 310.? ( 264) 311.? ( 265) 312.?? ( 266) 15
313.? ( 268) 314.? ( 268) 315.? ( 269) 316.? ( 270) 317.? ( 270) 318.? ( 272) 319.? ( 273) 320.? ( 274) 321.? ( 274) 322.?? ( 275) 323.?? ( 276) 324.?? ( 277) 325.? ( 279) 326.? ( 279) 327.? ( 280) 328.? ( 281) 329.? ( 282) 330.?? ( 283) 331.? 16? ( 285)
332.? ( 286) 333.? ( 287) 334.?? ( 288) 335.? ( 289) 336.? ( 289) 337.? ( 290) 338.? ( 291) 339.? ( 291) 340.? ( 292) 341.?? ( 293) 342.?? ( 294) 343.? ( 295) 344.? ( 297) 345.? ( 298) 346.? ( 299) 347.? ( 300) 348.? ( 301) 349.? ( 302) 17
350.? ( 303) 351.? ( 304) 352.? ( 305) 353.? ( 306) 354.? ( 307) 355.,? ( 308) 356.? ( 309) 357.? ( 310) 358.? ( 311) 359.? ( 312) 360.,? ( 313) 361.? ( 313) 362.,? ( 314) 363.? ( 315) 364.? ( 316) 365.? ( 317) 366.? ( 318) 367.? ( 319) 368.? ( 320) 369.,? ( 321) 370.?? ( 322) 371.? ( 323) 372.? ( 323) 18
373.? ( 324) 374.? ( 325) 375.? ( 325) 376.? ( 326) 377.? ( 326) 378.? ( 327) 379.? ( 328) 380.? ( 328) 381.? ( 329) 382.? ( 330) 383.? ( 331) 384.? ( 332) 385.? ( 334) 386.? ( 335) 387. ( )? ( 335) 388.? ( 336) 389.? ( 336) 390.? ( 337) 391.? ( 338) 392. 19
? ( 339) 393.? ( 339) 394.? ( 341) 395.? ( 342) 396.? ( 344) 397.? ( 345) 398.? ( 346) 399.? ( 346) 400.? ( 347) 401.? ( 348) 402.?? ( 349) 20
1.?,,,,,,,,,,,,,,,,,,, ;, ;, ( ),, 1
2.?,,, ( ) 3,,,, 1/ 3( 3 ) 7,, ( ), 2,,, 3.?? 26, 15, 6,, 1 300, 1 220 4.?,, 5.?,, : (1 ), (2 ), ( ) (3 ) 2
(4 ) (5 ), 6.?,,,,,,,,, : ; ; ; ; ; ; ; 7.?,,,,,,,,,,, 3
,,,,, 8.?,,,,,,,,,,, 9.?, A E K,,,, 4
?, 800 1 000,,,,,,,,, 10.?,,, 98, 40%,,, 10 ;, 180,, ( ),, 5
11.?,,,,,,,,,, 12.?, A K B12,, (1 ) A : A, 95% A, A, A, ( A ) (2 ) B:, B1 ; B1 ; B1, B6 ( ), ; B2 ( F A) ; ( ) ; A 6
(3 ) C:, C,, (4 ) D:, (5 ) K:, (6 ) P P:,, 13.?,,,,,,,,,, ( ) 35,,,,, 7
, ;,, ;, 14.?,,,,,,,,,,,,,,,,,,, 3,,,, 8
,,,,,,,, ( ),,, 15.? 2, 1 ;,,,,,,, 16.? (1 ) :,,, (2 ) :, 6 8 9
,,,,,,,,,, 17.?,,,,,,,,,,,,,,,,,,,,,,,,,,,, 10
,,,,,,,,,,,, ( ) 18.? 7 ( H AV ) ( HBV ) ( HCV ) ( H DV) ( HEV) ( H FV) ( H GV ) 19.7? 1996 : 80.9 % ( 80.9%, ) ; 57.6 % ; 3.2% ; 1.15% ; 18.1% ; 8%, 20.?,, 11
,,,, 1988, 4, 31, 47 5.08, 5.57, 10.65, ( HBsAg ) 10%, 1.2, 1/ 4, 1 400, 30,, 40 %, 80% 90%,, 80 100,,,, 50% 70%, 20%,,,, 12
,,,, 10% 20%,,, 21.?, 5, 950/ 10,, 1988, 23.1/ 10, 41,,,,, 50 % 80 %, 7 8, 10 484 58%, 6 7,, 90 %, 60% 80% 17 1 764, 167, 13
9.47 %,, 6,, 3 23, 20, 12,, 36% 47%, 36% 41%, 10% 25%, 10 % 20 % 22.?, 71.11%, 71.11%,,,,1988,,,,,,, 5 9 20 29,, 80% 14
, 7 10, ( ),,,, 23.?, - : (1 ) :,,,,,,,, (2 ) :,,,,,,,, (3 ) :,, 15
,,,,, 24.? -,,, 5,, 2 4,,,,,, 30% 60 % 3, 3, ( - H A V),,, 25.?,, G ( IgG ) M ( IgM ) A 16
( IgA) G,,,,,, ( ) 26.?,,, 24 M ( -H A VIgM) ( GP T ), ; 1 M,,,, 27.? ( ), 13 6 8, 4, 1.2 : 17
(1 ) :,,,,,,,,,,,, (2 ) :,,, ( 100 ) 10,,,, (3 ) :, 5% 10%, 22% 50 % e ( HBeAg), 90 %,, 40 % (4 ) :, (5 ) :,, 28.?, 18
: (1 ) :,, ( HBsAg ),, (2 ) :,, 37 60 ; 60 4, 10 121 10, 65 10, - 20 20, 2.4, 6,, 25, 2 ; 6, 1, 25 1, 6 40, 29.??,,, 19
, 15 % ;, 85%, ( HIV, ) :,, 40% ; ; : 85%, 90 %,,,, 30.?, 1963, Blaberg,,, 20,
,,,, 2 6, 2 8,, 20 31.??,,, e ( - HBc), B,,,, ( -HBs ),,, e ( HBeAg ) e ( - HBe) ( HBV-DNA P ),,90%, 21
e,,,,,,, 32.?,,, 90,,,,,,, 6 ;, 60%,, 22
33.?,, 90%, 10 % 25%, 15 17,, 60 % 80 %, 12 % 24%,, ( -H CV ),, 34.?, (1 ):,, 90%, 55% 60 %, 29 13, 12 23
(2):,,,, ( HCV-RNA), 56%, ( 14% ),,,, (3 ) :, (4 ) :,, 35.?,, : (1 ) :,, 30% 40%, 60 %,,,, 12.7 % 24
18.5 %,, (2 ) :,,,,,, (3 ):,,,,, 36.? ( delta, ),,,,,, ;,,, ;,,, 25
,,,, 21 30 37.?, (1 ), -, ;, :,, 20, ;,, (2 ), (3 ),, (4 ) (5 ),, 10% 40% ; 0.18% (6 ) 26
,,, 38.?, -, : (1 ) :, ;, (2 ) :, (3 ) :, 18,, 88.3 %, 78.1% ; 0.8% 14.3%,, 39.?? 27
, 1 4 100%, 1 3 70%, 4 6 40%, 7 9 75%, 10 12 4%, 2, :,,,,,,,, 2 ( - HEV),,, 40.?,,,, ;,,,,, 28
,,,,, 41.??, 15 45, 30 ; 6 6, 3 ; 7.8 (5 12 ), 30, 2 ( ) ;,, 14 ; 40 ( 10 60 ),,, 5 5, 1, 29
42.??,, ( ), ( ),,,,,,,,,, 20 %,,, ( ) 80%, 30%, 5% ; 43.? :,,,, e,,,,, 30
, 90% 95%, 5 % 10%,,,,,,,,,,,,, 44.?,,,,, ( 31
),,,, 45.?,,, 2,,,,,,,,,,,,,,,,, 46.?,, 32
,,,,,,,, 230, 14 % 16 %, 1/ 7 1/ 6 47.?,,, 2 3, 5 7,,,,,,,,, : (1 ),, (2 ),, (3 ),, 33
(4 ),,,,,,,, 48.?, ( HBsAg) ( ),, 49.?,,,,,, 50 %,, ( PCR ), 34
, :,,,,,,,, 1/ 4,,,,, 6% ;,,,,,,,,,, 50.?, ( 50% 80% ) 35
,,,? ( e ), 85.7%, 42.8% ; ( e ), 25%,,,,,,?,, 51.?,,, ( ) 3 (1 ) :,,, :, 36
,,,, ( ),,,, ;,, ( ),,,, (2 ) :,, ( ), ( ) e e ( ),,,, e, ( ) ( C ),, e,, (3 ) : e,,,,, 37
,, ;,,,,, e,, ( ),,,,, ;,, ; 80 % 5 52.?, 90% 3, 10% ; 90%, 10%, : (1 ) :,,, ;,, (2 ) :, 38
,,,, ;,,,, (3 ):,, ( ),, (4 ) :,, (5 ) :,, 20,,, (6 ) :, (7 ) :,, T,, (8 ) :,,,, (9 ) :,,,, (10) :,, 39
,, 53.?,,,?,,, 6 :, 1,,,,,,,,, ( 80 % ), ( )2, ( ), ( ) ( 40 120 /, 17.7 34.0 / ), ( e ),,, (20% ) 40
, 1 000, (,, ), ( 120 /, 35 /,,40% 60% 50 100,,,,,, : 171 /, 40 %, ( ) () 50, ( ),,,, ; ( ),,, ( ),,, (, ), 30 50 ( 16.5% 51.0% ),, ( B C T ),,, 41
,,,,, 54.? (1 ) :, ( 80% )?,,,,,,,,,,,,, (2 ) :,,,,? : 400 /, 2 ; B C T : B 2, CT ( 0.5 1.0 ) (3 ) : ( 42
),,,,,,, 1 ( ), ;,,,,, 55.?,,, - -,,, 56.?,,,, e,,,, 43
, 25 %, 57.?? : (1 ) :,,, (2 ) :, (3 ) :,,,,, ( ),,, ( ),,,,, 44
,,,,,,,, 58.?,,,, ;,,?, (1 ) ( 5 ),, e,, e, (2 ),, e,,, e,,, 45
(3 ),,,,, (4 ),, M ( - HBcIgM), (5 ),,,, M, (6 ),,, e,, 6,, 100%,,, e,, 59.?,, ( GP T) ( GOT ),,, 46
,,,,,, : ( ) ( ),,,, ;,, ( ) ;,,, ;,, ;,,, ;,, ;, ( ) ;, ;,,,, 60.? (1 ) : ;, ; ; B, ; 47
, ; ; G( -HBcIgG) ( M, ) (2 ) :, ;, ; (3 ) :,, ;,,,,, ;,,, ;,,,,,,, ;,, 61.? ( HBsAg, ), 48
, ;, ( ),,,, :, ;,,, 62.,?,,,,,,,,,, 5 ( ), e 3,, 49
,, 5 e,,,,,,,,, ;,,,,,,,,,, 63.?, : (1 ) :,,, (2 ) :, 50
(3 ) :,,,,, ( ),, (4 ) :, 95% C : e, e ;,, ; e,, ; e, ;,, (5 ) (ccdna ) : ccdn A,,,,,, : ( ),,, 51
,,, - 500 1 000, 1,, 100 ; 1 2,,,,, ;, 64.? 1, 10%,, 80%, 20%? : (1 ) :,, e,, 100%,, 15 %, (26% ), ( 3% ), (2 ) : 52
,,,, 2/ 3, (3 ) :,,, :,90% 95% ; 20% ; 2% 6 % (4 ) :,,, (5 ) :, (6 ) :,, (7 ) :, 65.?,, 53
,,, 66.?,,,,,,,,,,,,,,,,,,,,,, 67.?, (1 ) :, e, 54
100%,,, (2 ) : e,, (3 ) :,,,,,,,, 68.??, :,,,, 55
,,, -,,,, ( ),,,,,,,, 69.??,,, 37 1 1 000 96, 100 5, 60 10, 20 %, 100 CID ( ), 1/ 100 ( HCV- RNA),,,,,, 56
,,, ( -HCV ), 30% 75%,, 55% 44% 53% 30%, 70.??,,,, 35 37,, ( 22 ),,,,,,,,, ( HDV- RNA ), 57
: (1 )( H DVAg ), (2 ) e, (3 ),,,, 71.?,,,,,,,,, 58
72.?, -,,,,, 27 28,,,, 100 5 5% 3% 73.? : (1 ) :,, 75% 16 35, 1986 1988, 14 15 39 40, 0.9% 6.3% 2.9%, (2 ) :,, 80%, 57% 48%, (3 ) :,, 59
7.7% 1.2%,, 900 2 300, (4 ) :,, 18, 74.?,, 6,,,,, 6 8,, 10% 20%,,, 20.96% ;, 8.64 % ;, 1.5%?,,,,,,, 75.?,,,, : 60
(1 ) 20%,,,,, (2 ),,, (3 ),, (4 ),, (5 ),, (6 ),,,, (7 ),,, (DIC) 76.? ( ),,23% 42%,,,,,,,, 61
,,,,,,,, e,,, 77.?, : (1 ) :, ( CMV) EB ;,,,, EB (2 ) : (3 ) :,,,,, EB,, 62
,, 13% 63
78.?, : ;, ; ; ;,, ;,, 79.?,,,,,, ;,, 5 : ; ; ; 64
; 80.?,,,,,,,,, 81.?, :,,, ( ),,,,,,,,,, 65
,,,,,, 82.?, ( ), 4 : (1 ) :,, (2 ):, (3 ) :,, (4 ) :,,,,,,, 83.?,,, 66
, (1 ) :,,,,,, (2 ) :, (3 ) :,, (4 ) :, 84.???,,,, ;, ;,,,,,,, 67
,,,,,, 20 / ( 1.2 / ), 33.3 / 16.7 33.3 /,,,,, ( ),,,,, ( ) ( ),,,,, 5 : (1 ) :, 85.5 /, ( ), (2 ) : 68
,,, (3 ) :,, 170 510 /,,, (4 ) :,,,,,,, (5 ) : 1, ABO Rh, G-( G-6-PD),, 3 : ( ) ; ( ) ; ( ), : (1 ) :,, 69
,, (2 ) : ( ),,,, ; (3 ) :, ( ) 85.?, 3 : (1 ) : 2,, 1/ 3,,,,, : : ; : ; : ; : ; :, 4% 5% 70
(2 ) : 2 6,,,, 1 2,,,,,,,, (3 ) : 2 4, 1 2,, 1 2 5 %,,,,,,,,,,, 86.?,,,,, (1 ) :, 71
,, (2 ) :, G ( IgG) M ( IgM), (3 ) :,,,,, (4 ): Gianotll, G,,,, (5 ) :,, ; ; 72
,, (6 ) :,,,, (7 ) :,,,20 90 3 : ; ; (8 ) :, ;, ( ), 87.?, (1 ) :, 73
,, ( ALP ) - ( -GT),, B,,,, (2 ) : 1) :,,,,,, 2) : 2,, B 3) :,,, 34.2 68.4 /,,,,,,, 88. -??,,,, - 74
, 89.?,,,,,,,,, 9 11 3,, ;, 90.?, 2 3 1,,,,,,,, 5,,,,,,, ;,,, ;, 75
, 91.?,,,,,,,, B E,, ;, 92.?, 38,,, 3 5 ;, ;, 37.5 38,,,,,,,,,, 2, 76
93.?,,,,,,?,,,,,,,,,,, 94.?, ( ),,,, 60 82 / 60 /, 4 : (1 ) : 77
,,, ( ) (2 ) :, (3 ) : (4 ) :,,,,,,,,,,, 95.?,,,,,,,, 78
,,,,,,,,,,,, 96.?,,,,,,,,,,,, 97.?,,,,,,,,,, 79
,,,,,,,, B, 98. -? - - 20 90,,, - 99.?, ;,,,, ; ; ;, 1 2, 1 ;,,, ;,,,,,, ;, ;,,, 80
,,,,, 100.?,, 9 11, 4 7,,,,,,,, 2 3,,,,,,,,,,,,,,,,,,,,, 81
101.? (1 ) :,,,,,,,, (2 ) :,,, ;,, (3 ) :, ( ),,, 102.? : (1 ) :,,10% 15% ; 50%,,, 82
(2 ) :, 40, (3 ) : (4 ) :,,, (5 ) :,,,,,,,,, 103.? -, 4,,,, 2 6, 1 5 83
,,,,, ( ), 1/ 38 1/ 14,,,,, 104.? (1 ) :,,,,,, (2 ) :,,, B,,,,,, ;, 84
,, (3 ) :,,,,,,,,,,, ;, ; B ;, (4 ) :,,, S-T, T, P- R Q-T,,,, (5 ) :,,, 1 ( ),, 85%,,, 85
105.?, 45 180, 3, 50%,,, ( HBV-DNA ) (DN AP ),, ;,, ; 106.??,,,,, ( ),,,,,,,,, 5% 10%, M, ; ; 86
; ;,, M,,,, : : ; : ; : 107.? 5 % 10 %, 18.7% 30.2%,, : (1 ), 65%,,,,, (2 ),,,,, (3 ), :,, 87
(4 ) :, 45, 12, e 8 10, 108.?, 3 4 : (1 ) :,,,, (2 ) :,, (3 ) :, (4 ) :,,,,,,, 88
109.? : : :,,, :,, :, :,, :, ; : B, :, : :,,,, :, :,, :,, :,, : : 89
, :, :, :,,, :,,, :,, 400, 110.? (1) :,, ( 80% )?,,,,,,,,,,,,, (2 ) :,,,, 90
? : 400 /, 2 ; B CT : B 2, CT (3 ) : ( ),,,,,,, 16.7 / ; ( ),,,,,,, 111.??,,,,,,, 91
, ;, (,, ; ),,,,,,, ( ), -, ( A NA ) ( SMA ),,,,, 112.???,,,, 92
, :,,, ; ;, ;,,, ;, : ;,, 50 000,, ; 113.? 2 26, 8 ; 5 12, 4 2, 1 4,, : (1 ) ( ) :,,, (2 ) :, 1 1.5 2.5,, 93
;,, 400 /,, 3 6,, 114.?,, (1 ) : 3 1) :,,, ( ), 6, ( HDV Ag), M ( -H DVIgM ), G ( -H DVIgG ),, ( > 5 % ) 2) :,,,,,,,,, 94
3) :,, ( H DV-RN A),, ( - HDVIg ),,, (2 ) :,,, 5 115.? 2 10, 6,,,,, ( -HEV ),,, 1/ 3 87%, 6.4 1 ;,,,, 1, 3 6,, 95
1% 2%, 12%, 10,,,, 10% 20%, 40 %, ( 7 9 ),, 116.? Leary ( 1996 ) ( H GV-RN A) 8.7 %, 7.9% 25% 30 %,,,, 1,, 117.??, 96
,,,, EB,,,,,,,,,,,, 70% 14 180,,,,,,,, 50 %,, 97
118.??,,, ( 2 6 ) 3%,, ( 3 6 ),,,,,,,,,, ( A KP ) 1,,,,,,, 119.?,,,,,,,, 98
, : (1 ) :,,,,,,,, ( ),,,, (2 ) :,,,,,,,, (3 ) :,,,,,, 120.?,,,, 1 99
1 (, ), ( ) 1.018 1.018 25 / 25 / 5 10 5 1 10 5 121.?, : ; 5 [ ( HBsAg ) ( - HBs) e ( HBeAg ) e ( - HBe) ( - HBc) ] ; B,, (1 ) (2 ),,,,,,, 100
(3 ), 122.?,?,,,,,,,,,,,,,,,,, 123.?,, 1 4,,,,,,,,, 101
124.?,,,,, 1,,,,,, : (1 ) : (2 ) : ( HEPLL ) (3 ) : 125.??,, -,,,,,,,,,, 102
,, 126.?,,,,,,,,,,,,,,, : ; ; ; ; 127.? : (1 ) (2 ), (3 ), (4 ),, 103
(5 ), (6 ), 128.? (1) : ; 1 3 (2) : ( ) ; (3 ) : 1 5 50 % ; 16 20 66.7%, M,, M,,,, G, 104
,, ( ), 129.? : (1 ) (2 ) (3 ),, (4 ) 130.? 4 : (1 ), (2 ), (3 ) (4 ) 131.?,,,,,,, 105
, ( ),,,, 10%, 132.??,,, ; ; ; ;,,,,, 5 B,,,, :,,,, 106
,,,,, ;,,, 133.?,,,,,, ; ; ;, ;,, ;,,, ( ) ;, ;,,,,,,, 107
134.?,,,,,, 3 : (1 ),, (2 ),, (3 ) 135.? : (1 ), > 171 / (2 ),, (3 ) (4 ), -, < 1 /,,, / ( / ) (5 ), : (1 ), ;, 108
, ; (2 ) (3 ) (4 ) 136.?,,,,,,, C K,,,,,,,,,,,,,,,, 137.?,, 109
,,,,,, ( ),,,,,, :,,, 138.?,,,,,,,,,,,,,,,,,,, 110
139.?,,,,,,, ;, ;,,,,, 140.? : (1 ),,,,,,,,,,,,, (2 ),,,, 111
,,, 141.?,, :, : (1 ),, 97. 1% (2 ) 1,,, 1,,, (3 ),,, 142.?,,,,,,,,,, ;, 112
,,,,,,,, ;,,,,,,,, 143.??,,, (1 ) :,,,,, ( 3 ) (2 ) :,,, 113
;,,, ;, ( ), (3 ),, : ; ; ( ) ; 144.?,,,,, : (1 ) ( IDDM ) :,,,,,, C,,,, (2 ) ( NIDDM) :,, 1 11,, C,, :,, 114
;, ;,,,,,,,,,,,,, 145.?,,,, ; e,, ;,,,,,,,, 115
,,, 146.? ( ), 1/ 3,, 80%, ;,,, ;,,,,, ( ) ;, ; 3/ 4, 2/ 3,1/ 2 ; 15, 5 0.5 ; 147.?,,,,,,,,,,,,, 116
, ( ),,,, 148.??,, ( ),,,,,,,,,, ( ),,,,,,, 117
149.??, 4, (1 ) : ; :,, ; :, (2 ) : ; :, 17.1 /, ; :, (3 ) :,, ; :, ; :, (4 ) :,, ; :, ; :, 118
150.? (1 ) :,,,,, (, ),, : : 4 6 : 20 / ( 1.2 / ) (2 ) :,,, :5 25 (3 ) :,,, ( ) -, -,, ; 119
, - ; ( /, A/ G) : 60 80 / ; 35 55 / ; 20 30 / ; / 1.5 2.5 1 (4 ):,,,,, ;, : 1) ZT T :, 4 12, ;, ; 2) T T T :, 0 0.5 5 10, 11 30, 151.?? ( AFP ),, 16 20,, 1 5,,, 120
,,,,,, ( < 400 / ),,,,,,,, ;,,,, 50% 3 152.? (1 ) :, 50 300 /,,, (2 ) : 30%,,, (3 ) :,, 300 400 /, 400 500 /, (4 ) :, 500 /, 121
(5) : (3 6 ) ( ),,,,,, ;, B 153.?,,,, 2 ;,, 3 6,, 154.?,, ( ), ( ), 10% 25%,,, 3, 3 122
: ; :, ; :, 155.A / G? A/ G ( ) ( ), 1.5 2.5 A/ G 1, A/ G A/ G,, A/ G ;,, A/ G,, 156.? ( AL P AKP ),,,, 3 13, 1.5 4.0,,,,,,,,,, ;, 123
157.? ( ChE),,,, ;,,,, 4.3 13 /, (1 ) :,,, (2 ) : ; (3 ) :, ;, (4 ),, (5 ),,, 158. -S-? -S- ( GS T ),, 124
,, GS T, GST,,, GS T GST 10 60 / GST,, GS T,,, ; ; GST, GST, 159.?,,70%, 30%, : 2.9 6.0 / ; 2.34 3.38 /, 60% 80% :,,,,, ;,,,, 125
,, /, 160.?, ( PT), 11 15 ( ),,,, ;, ;,, K, ; K,,,,,, 161. C3 C H50?,, C3 :, 50% ( CH5 0 ) ;, C3 : CH5 0 : ( 80 160 ) 10 3 126
/, C3 : 0.75 1.5 /, CH5 0,, C H50 ;, CH50 C3 ;,, CH5 0 C3, C H50, ;, CH50,, 162.?,,,,,,, ;, (1.5 3.0) 10 9 /, ;, 50 10 9 /, 163.? 127
,, (980 50 ) / ( P- - P ),,,, ;,,, 164.? ( MAO),,, MAO 12 14 MAO, MAO ; MAO ; MA O 165.? ( FN), FN, ( ), F N,, FN, FN FN 128
, : F N = ( 228.35 2.066 ), / FN 1/ 2, 166.? ( Ig ), 5, IgG IgM IgA IgD IgE : IgG :6 16 / ; IgA : 0.2 5.0 / ; IgM : 0.6 2.0 / ; IgD: 1 4 / ; IgE : 0.1 0.9 /,,, B, :, IgG IgM ;, IgA, B-Y ;, IgG IgM ;, IgM ; IgM,, IgM ; IgM 10, ;, IgM ;, IgM,, IgM,,, IgA IgG IgM 129
IgM/ IgA > 1.0, > 2.5,, < 1.0, ; IgG/ IgA,, X? 167. X( L P-X), L P-X,, L P-X 3 : L P-X1 LP-X2 LP-X3,,, LP-X2 LP-X1 168.?,,, ( ), -,,,,,,,,, 130
, 169.?,,,, ( 1 ),, 1, 170.?, ( DANE),,,,,,, ; e e e,, e e 5,, 131
171.??, e,,,,,,, 172.?,,,, 3, ( 3 ) ( ),,, 173.,? : 132
(1 ),,,, 2 3, (2 ) ( ),,,,,,, 174.,? 1 5,, 6, 1,,,,, 175.,?,,,, 133
, ;,, 176.,?,,,,,,, : M( -HBcIgM ) G ( - HBcIgG) A ( -H Bc IgA), M, G, M,, ; G ;, 177. e,? e 134
, 4,,,, ; ( e e ) 2, 50% 1,, ( ),,, e, ( ), 178. e,? e e e 20 90 65 % e,, e e,, 179.?,, 135
, ( ), : (1 ) :,,,, (2 ) :,,,, ;,, (3 ) : e,, ; e,, (4 ):,,,, 136
, (5 ) :,, (6 ) :,,, (7 ) :,,,,,,, 180.?,,,,,,,,,, : (1 ) :, 4 : 1 : 137
, ; 2 :,,, ; 3 :,,, ; 4 :,,,,, ;, (2 ) : ( H A) ( LN) 4,,,, ;,,,, ;,,,,, (3 ) B : B,,,,,, ; 138
,? 181.,,,? (1), : :,,,, ( B ) :,, ( ), 35 /, 35 /, 60%,,,, :,,,,, (2 ), : :,, 35 /, 1.0,, 35 /,, 60% :, 139
,,, - ;,,, 182.?,, 3 : : ( ) 35 /, 40 /,, ( ), 1 3,,,, : 26 34 /, 40 80 /, 4 6,,, 200 340 /,, : 25 /, 340 /, 80 /, 6,,,,, 183.? 1.2, 140
,, ;,?,, (1 )( ) :, 1,,,, ( ),, ; B ;,, ; 0 2 (2 )( ) :,, 2 000, ( ), ( 40 120 /, 17.1 34 / ) ( e ) 1 2 (3 )( ) :, ( ), ( 120 400 /, 35 141
85.5 / ), 3 (4 )( ) : (,, ), ( 400 /, 85.5 /, ( ) 32 /, 4 (5 ) :,,, ( ) ( 171 /, 40% ) 4 ( ), ;, 184.?,,, M,,, (1 ) ( ) 1) : 142
e e 5,, 2), :, :, ; e, ;,, 3), ( ) : ; e ( ) ; e ( ) ; M ;,, ;, e, (2 ) : 1) :, ( GS T, 40 / ) ( GOT, 40 / ), - ( -GT, 50 / ) ( ALP, 143
110 / ) ; ( TBIL) 17.1 / ( SBA) ; ( ) / ( A/ G) ( 1.5 ) ; - ( -EP ) ( 19% ) ; ( P TA) ( 80 % ) 2) : 40 120 /, 17.1 34.2 /, 35 /, / 1.3 1.5, - 20%, 70 % 71 %,,,, 3) : 120 400 /, 34.2 85.5 /, 33 34 /, / 1.0 1.2, - 22 % 25 %, 61% 70% 4) : 400 /, 85.5 /, 32 /, / 0.9, - 26 %, 40% 60% 5) : 171 /, 40% 6) : - 30 %, /, ( MAO ) 40 /, ( P ) 10 /, ( H A ) 120 / 144
185.?,, (1 ) : e, e,,,,, (2 ) : e,,,,,,,, C, :,, ;,, (3 ) : 145
, (4 ) :, : M G M,,, G,, (5 ) :,,,, (6 ): e,,,,,,,,,, 6,,, 146
186.?,,,,,, ( ), 5 ( ),,,,,,,, ( ) ( ) ( e ),,, 187.?, 147
(1 ) :,, : :,,,, ; : (2 ) : ( ), ( ) 188.? (1 ) : (2 ) : (3 ) : B CT,,,,,, (4 ) : ( ),, /, (5 ), 148
,, : (, ), ; ( ),,,,,,, 189. M? M, ( ),, 3 8,,,, M,,, M 149
190.? (1 ) :,,,,, ;,,, 6, 8,, 6, 6, ( ), 12 (2 ) : D ; ; ( PAS ) ; P AS ( BSP ) (3 ) : 1,,, ;,,, 10 150
191.??,,,, : (1 ) : : 4 6 ; 20 / (2 ) : 5 25 /,,, ( ),, / 1 1.5,, / ;, / (3) ( P T) ( PA) :,,, 20%, 151
K, K 24,, 60%, 11 15, 80% (4 ) ( ) / :,,, 25 /,, /,, / : 60 80 / ; 35 55 / ; 20 30 / ; / 1.5 2.5 1 (5 ) : (54% 61% ) 1 - (4 % 6% ) 2 - ( 7% 9 % ) - ( 10 % 13 % ) - ( 17% 22% ),, 1-2 - -, -, / 192.?,, 3 : ; e e ; 152
(1 ) ( HBsAg) :, 1 2 ; 1 6, 20 ;,,,, (2 ) ( -HBs ) :,, 90 %,, (3 ) ( HBcAg ) :,, (4 ) ( -HBc) :, 3 5, : M G M ; G,,, 153
(5 ) e ( HBeAg) : C, e,,, (6 ) e ( - HBe) : e, e,,, 15% e : e,,, C e e,, e, ;, e 193.,?,, 154
194.,,?,,,, 195. M?, M, M, M,, M,,, M ;,,, 155
196., e,?,,,,,,, e e,, 197., e,?, e, e ;, e, e, e e, e,,, e, e 156
198.,,?,, ;, : (1 ),,,, (2 ) ( ),,,, 199.,?, : (1 ) :,, 50%, (2 ) :,, (3 ), 157
,, 200.e e,? e e, : (1 ), e e e, e, (2 ),,, 201.? [ ( HBsAg ) ( - HBs) e ( HBeAg) e ( -HBe) ( - HBc) ] 2 2 HBsA g - HBs H BeAg - HBe - HBc 1 - - - - - H BV 2 - - - - + HBV, 3 - - - + + HBV 158
( ) HBsA g - HBs H BeAg - HBe - HBc 4 - + - - -, HBV 5 - + - + +, HBV 6 - + - - +, HBV 7 + - - - + HBV, HBs Ag 8 + - - + +, HBV, 9 + - + - +, H BV,, 10 + - - - - H BV, HBsAg 11 + - + - - H BV 12 - - + + + 13 + - + + + 14 + - - + - 15 - - - + - 16 - + - + - HBV : HBV 202.,? :,, e :, G 159
, 1,,,, 203.??, 65 %, ; 25 % ;5 % 10 %, 2 12, 6 6,, : (1 ) :, (2 ) :,,,, (3 ) :,,, 160
(4 ) :,,,, (5 ) :,, e, e,, 204.?,,,, (1 ),, (2 ), (3 ),,,, 161
205. M? M G, 1 2, M, M 4, M, 4 18 M G 6, ; M M G, G M 206.?,,,,,,,, ;, 10%, 162
207.? M G, 10%, M,,, 208.?,,, (1 ) :,,,,,,,, (2 ):,,, 163
M G,, M, 2 4, M, M G, M, G M,,, (3 ) :,,,,,, 209.?, M (1 ) :, 164
,, (2 ) M :, 2 20 ;, M, M, M, (3 ):,,,,, (4 ) :, (5 ),, 210.? : (1 ) :, ;, ; (2 ) :,,, 165
( ),,,, ( ) (3 ) : 1) ( -HEV) :,,, 2) M( -H EVIgM ) : M, 95% M,, 3) ( HEV Ag ) :, :, ( 2 ),,, 4) : G,,, 166
, M,,,,,,,, 211.?, (1 ) :, (2 ) (3 ) : (4 ) : ( R T-nPCR ), E2 E2, C NS3 NS5,, (40% 60% ), 4 (3 ) (4 ) ; (1 ) (2 ) 167
212.?,,,, (1 ) :,, 1.018, ;,, 1.018, (2 ) : ( ), < 25 / ;, > 25 / (3 ) : 100 / 3, ; 500 / 3,, (4 ) :,,, (5 ) :, 213.? ( Hb) ( RBC ) ( WBC) 168
: : 120 160 /, 110 150 / ; : ( 4.0 5.5 ) 10 1 2 /, (3.5 5.0) 10 12 / ; : ( 4.0 10.0 ) 10 9 / ; : 0.01 0.05, 0.5 0.7, 0.005 0.05, 0.01, 0.2 0.4, 0.03 0.08 ; : (100 300) 10 9 /,, ; ;, ;,, 214. B?? 20 000,,,,,,,,,,,,, 169
,, B, B, B,,,, B,,, 2, 80%,,,,, X CT ( MRI),,,,, ;,,,,,,, B,, B, B 215. B? B, 170
, : 11 13 ; 6 8 ; 3 5 ; 0 3 : 7 10 2.5 3.5 ; < 0.6 : : < 8.5, < 3.5 : < 0.3, ; < 0.6 : 1.0 1.3 : 1.6 2.4 ; 1.0 1.6 ; < 0.3 216. B?,, ;, ;, 217. CT? CT? CT X, 20 70, X CT, X CT 171
,, CT, C T CT B,, B,,,, C T C T 218. CT? CT X, CT : :, ( ), CT 40 70 H u;,, CT 60 90 Hu : ( ) 5 10, 11 17 ( 15.1 ) : CT, 6 C T 0 20 H u, 7 10, 2.5 3.5, 1 : CT 49 H u,, > 10, > 6, > 15 172
219. B CT?,,,,,, ( + ) B CT, ( CT ),, 220.B CT?, B CT : (1 ) :,, 60 %, ( GP T ), - (2 ) ( P TA ) : 60%,, P TA (3 ) ( A KP ) ( T-CH ) X( L P-X) (4 ) : (5 ) B CT, 221.? (1 ) : 2.2 2.7 / 173
,, (2 ) : 0.8 1.2 /, (3 ) : 13.6 28.3 /, 10.7 31.0 /,,, (4 ) : 14 20 /, / 0.8 1.0 / 1.0, / 0.1 0.5 (5 ) : (10.9 9.2 ) /,,,, (6 ) :,,, (7 ) :, 222.?,,,,,,,,,, 174
,,,, : (1 ), (2 ),,, (3 ), (4 ), (5 ),, : (1 ) :,,, (2 ): (3 ) : 223.?,,,, (1 ) : ; 175
, ; (2 ) : (3 ) :,,, 0.5 2,, (4 ) :, ( TT T ) ( > 17.1 / ), (5 ) :, ( ),, ;,,,, 224.? : (1 ) : ( 3 ),,,, 1,,,, 176
(2 ) :, ( ALP ) - ;, (3 ) B :, (4 ) : 2% 8%, 24% (5 ) : (6 ) :,, 225.? (1) :,,,,,, (2 ) : 7, 5 H A V HBV H CV H DV HEV : ; :, 1 177
; :,, 6 ; :,, ( ) ; :, M, ( H DV- RNA), ( ) (3 ) :,,, 1), ( CP H ) ( CLH ) ( CA H ), ; /, ( PN) ; 2) ( ), ;, ( BN) ;, 3) ( ), ;, ;, 226.? : (1 ), 1 4 ( ) 178
(2 ) (3 ) 0.06 (4 ) (5 ) (6 ) (7 ), 227.?,,,,,,, ( ),,,,,,,, : 179
,,,, ( 75 % ),,,,,,, :,, 90 % 95% 34 50 /,, 1 228.? ( ) 3 (1 ) :,,,,, :, e, ;, ; 180
,,,, (2 ) :,,,,,, (3 ) :, : ;,, ; : ; ; 6.0,, 229.?, ( NIDDM),, : (1 ) :, 7.8 /, 2 11.2 / (2 ) :, ; 2 9 / ; ;, ;, 0. 5 1 11.0 181
/,,2 11.0 /, 8.0 /, 2 + +,, C 230.? ( ), : :, ( 28.4 /, 60 / ), 1.5 ;, 1.5, 4, ( ),,,,,, ( ),,,,,,, 182
, :, 1.5,, -, ( ),,, 231.?,, (1 ), (2 ), 200 (3 ),,,, (4 ),,,,, ( P T) 40%,,,, ;, 500 ; ; ;, 183
;,, 232.?,,,,,,,, 233.? ( ),,, ; 3 ;1 3 2 ; 3 5 1 ; 5, 9.4%, 5 54.4%,, 184
,,, 234.? 20,,,, ;,,,,,,,,,,,, ( ),,,, 185
,,,,,,,, 235.?,,,, (1 ),,, (2 ),,, (3 ),,,, ;,,,,,,,,,, B CT,, 186
,, 236.,?, 20 /, 34.2 /,,,,,,,,,,,,, 237.? ( T T T ) 0 6,, T T T, 187
, TT T T TT, TT T :, T T T ;, T T T,, TT T, ( ), -, 1 -, T TT, TT T 238.,?,,,,,,,,,,,,,, 188
239.?,,,,,,, ;,,,,, :,,,, 10 10 9 /, 0. 80;, ( ), 50% X, :, ;,,,, X, 240.?, 189
,,, : (1 ) :, ;, (2 ) :,,,, (3 ) :, 3 7,, ;, 20 49,, (4 ) : 15 50,,, ; 60 160,, (5 ) : :, ( ), 1 3,, : ;, 1 8, ;, M (6 ) :, 190
241.?, :,, ; ( ) ( ),,,,,, : e M ( - HBeIgM ) G( -HBcIgG), ;,, 242.?,,, : (1 ) 10, 191
;,, 3 4 (2 ) ;, (3 ), (4 ), 1, 192
243.?, : (1 ),,,, (2 ),, 20% 30%,,, (3 ),,,,,,,,, 193
,,, ;, ( ),, 244.?, ;,, (1 ) :,,,,,!,, ( ),,,,,,,,,,, (2 ) :,,,, 194
, (3 ) :,,, (4 ) :,,, (5 ) : 7 8,,,,, 245.?,,,,,,,,, 4 : (1 ) : B C E K, (2 ) : ( ),,, (3 ), : 195
( ) ( ) (4 ), : (654-2), ( ) 3 6, ;,,,,,,,,,, 3, 246.?,,,,,,, (1 ),,, ( ), 196
,, : 1) :,,, ( ),,, 2) :,,,,,, 3) :,,,,,,,,,,, (2 ),,,, ;,,,,,,,, : 1) :,,, 197
2) :,,,, ( ) 3) :,,,,,,,,,,, 4) :,,,, ( ),,, 5) :,,,,,,, (3 ),,,,,,,, 198
: 1) :,,,,,,,,,,,, : 30, 9, 6, 12, 30, 9, 30, ( ) 15 2) :,,,,,,, : : 30, 9, 15, 12, 30, 9, 6, : 60 120, ( ) 30, 6 10 247.? : (1 ), :, : 15, 9, 25 (2 ), :, : 9, 12, 15, 3, 3 :, 10 ;, 9 ;, 9 15 ;, 6 199
;, 9 ;, 9 (3 ), :,, : 9, 3, 15, ;, ;, (4 ), :, : 12, 10, 30, 3, 6, (5 ), :,,, : 9, 15, ;, ;, ;, ;, 248.? (1 ) :,,,, (2 ) :,,,, 200
,,,,, (3 ) :,,,,, 6 1,,,, 3 1, 4 249.?, : (1 ) : (2 ) B : (3 ) T : (4 ) : (5 ) : 201
(6 ) : 250.? : ( ),, 251.? ( ATP) A ( CoA ) (691 ) ( ) ( ), ( TAD) 1, 6- ( FDP ), ( ) ( ), 202
,,,,,,, 252.? (1 ) : (2 ) : ( ) ( ) ( ) (3 ) : ( ) ( ) (4 ) : (5 ) : (6 ) : ( ) (7 ) : 203
(8 ) : ( ) ( ) ( ) (9 ) :,,, 253.?,,,, : (1 ), (2 ),, ( ),, (3 ) (4 ),, (5 ),, (6 ),,,,, 204
254.? : (1 ) :, 1, ;,, (2 ) :,,,, (3 ),,,,,, 255.?,,,,, (1 ) :,,,, 205
(2 ) :,,, (3 ) :,, (4 ):, ; 256.?,,,,,,, ;,,,,,,,, C B ;, ( ),, (1 ) : (2 ) : 3 5,, : ; ; ; ; 206
(3 ) :,, 1 500 2 000, 5% 10% 250 500, 0.6 0.8, C 3, 1 ( ATP ) 40, A 100, 4 6, 20 40 5% 10 % ( 5% ) 250 500, K 20,, 10 20, 1 ; 20 30, 3, 4, ;, 0.015 0.03, A 2.5, 3,,,,,,, 257.?,,,,,,,,,, 1 2 207
( ),,, ; 6912 ( ) :,,,,,,,,,, 258.? 3 : (1 ) :,,,, :, ;, ;, ;, (2 ) :,, ; ; (3 ) : 208
1) : 2) : : ; : ( ATP) A, ( A A T P ),, C B12, 3) : 4) : 5) : 259.?,,,,,,,,,,,, ; 209
, ( ) 3,,,, (3 6 ), 1 2,,,,,,,, ( ), 3 3 ( ) ( ) 260.?,, 210
: (1 ),, (2 ) e 3 ; 2 ; e 2 ; 1 4,,,,,,,,,,, : (1 ) e,,,,, e,,,, 16 (2 ) e, ;, : 211
,,,,,,,,,,,,,,,,,,,,,,,, 261.?,,,,, : (1 ),,,, (2 ),,,,, 212
;,, 262.? (1 ) :,,,,,,, (2 ) :,,,,,,,,,, (3 ) :,,,,, ;, (4 ) :,,,,,,, 3 6 1, ;,,,, 213
, (5 ) :,,,,,,,,, 263.?,, (1 ) :,, e, e, e e (2 ) :,,,,,,,,,,, 214
,, (3 ) :, :,, ;,, ;,,, ( ), 264.?,,,,,,,,,,,, :,?, 215
,,, 265.? (1 ) :,,,,,,,,,,,,,, (2 ) :,,, ( ), (3 ) :,,, (4 ) :,,, 216
(5 ) :,, 3 6 1 ( ),,? 266.,,,,,, ;,, ( ),,,, ( ASC),,,, ;,,,,, 267.? (1 ) :,,, 17.1 51.3 /,,, 217
,,, 12, 10,, 2, 1,,, (2 ) :,,,,,,,, 1 2 1,, : 12, 10,, 1, 3 (3 ):,,,,,,,,, ( 4 / ) ( 0.8 / ) ( 1.2 / ),, 0.5 1, 3,, ;,,, 218
; 30, 15, 10, 500, 268.?,,, (1 ),,,, (2 ), 200,,, (3 ),,,,, (4 ),,, ( ),,, (5 ), ( ), ( ),,, 219
(6 ), 500,,, (7 ),,, ;,, (8 ),,, (9 ),,,,, (,, ) ( ),, (10),,,,, 269.? (1 ),,,,, (2 ),, 5 220
,, ( e ),, ;,, ( 16 ),, (3),,, ( 34 / ),,,,,,,, (4 ),,,,,,,,, -, (5 ),,,,,,, 221
( ), (6 ),,,, ( ),,,, 40 %, 40 /, ( ), ( ),,,, ( ),,, 270.? ( ),,,,,,,,, ;, 222
, 271.?,, ( ) ( ) B, ( ) ; ; B ; B,, 3 8 1, 1 1 272.?, 3, e,,,, 223
e,,,, ( ), e, ;,,, e,,,,,, e, ( ), e,,,, (cccdn A),,,,,,, 224
273.?, :, ;,, ( ) ;, :, ; ;,,,,,,,,,,,,,,, 274.?,,,,, 225
: (1 ) :, ( ) ( ),,, (2 ) :,, 1,,,,, 2 1 ;,, (3 ),,,, ( e ),,,,, 275.? 226
,, SB - (DTP-HB) 1995 160 2 4 6, 1,,, 98 %, 4, -,,,,,,, 276.?,,, ( ),,, 68% 227
,,,, 5, 3,6 1, 50 60 ( ), 80, 3, 10,, 3, 200 /, 2 4, 3 ( 2 ), 50, 14 15 1.0, 16 20, 60, 228
277.?,,, ( NIDDM), 2,,, C,,, : (1 ) : ;,, ;, 4 1,, + +, ; (2 ) : ( IDDM ) 2,,, 2,,, ;,,, 2,,, 229
, : ; ;,,? 278.,,, 11.2 /,,,?, : [ ( ) = ( ) - 105 ], ( 1.04 1.25 ) 10 5, ( 1.25 1.46 ) 10 5 ; ; (1.46 1.6 ) 10 5 ; 1.6 10 5, 5 %, 0.5 1.0,,, 1,, 1.5 2, 1, 15% 20% 30% 40 % 230
50 % 55 %,,,,,,,,, ;,,,,,, ( ),,,, 10 %,, 279.? ( ), 27%,, 231
(1 ), ( ),,, 20 60, 10 20, (2 ) 2 3, ( ) ( ) (3 ) 10 60, 6 1 (4 ) 10% C 1 10 10% 500, 1 2,, 280.? ( ) 8% 13%,,,,,, 232
; ( ),, 2 1,,,,, ;, 281.?, 4, : (1 ) :,,,, (2 ) :,,, (3 ) :,,,,,, 233
(4 ):,,,, ;,, ;,,,, 282.?,,,,,,,,,,,,, 100, 1,, 10 % 500 A, C 2 234
, 8 12, 1 2, 283.?, :,,,,, 90% 98%, : :, :, :,,,, 284.? ;, ;, ; ( ) ; A B C D K,,, 235
,,, 285.?,,,,,,, 7 50 %,, 286.? :,,,, (1 ) :,,,,,,,,,,,,,, 236
(2 ) :,,,,,, 0.5 1, 20%,,,,, (3 ) : 1) :,,,5 10 /, 3,,,, 2) : C 3) : ( ), 4) : C B2 B6 B12,,,,, C,,,,, 237
, 287.?,, 288.?, : (1 ) :,,, 80 %, ( ), 100 /, 3, ; 30 ;, (2 ) :,,,, 40 60 /,,,,,, (3 ) :,, 238
,,, ( ) IgG,, 20 30 /,,, (4 ) :,,,,, 40 60 / ;,,,, 289.?,,,,, (1 ) :,,,,,, (2 ) : 239
( ), (3 ) :, 290.?? : (1 ) :, ;, (2 ) :, (3 ) :, (4 ) :,,,,,,,,,,,,,, 240
, 90% ; ; 37%,, 71.4% ; 25 %, 291.?,, ( 3 ) ( ),,,,,, : (1 ) :,,, (2 ) :,, (3 ) : B C K, (10% 15% ) 500 1 000, C, (4 ), 241
,,,? 292., ( ),, : (1 ),,,, (2 ),,,,, (3 ) :,,, ;, ;,,, ;, (4 ) (5 ) :,,,, ;,,,,,, 242
(6 ) 293.?, 3, (1 ) :,,, ;,,,,,,,, (2 ) : 1) : - ( IF N- ), 300, 3,, 500, 2, 3 6, 50%,, 1,,,,,, 243
2) :, 3) : ( 259 ) (3 ) :,, ( 269 ) 294.?, 60% 80 %, 10% 25%,, ( 5 ),,,,,,, 50% 70 % 80 %,,, 6 ( 57% ) ( 28% ),,, 10% 20% 1,,,,, 244
, 61.2 %, 3 28.4 % 75 %,, 2.5,, 20,,,,,,, 295.?,,,,,,,,, - ( PF A) : (1 ) - : 900, 3, 75% 300, 3, 12,, 245
66%,,,,,,, -, 2 3,, (2 ) :,,,,,,,,,, 296.,?,,,,, 246
,,,,, :, ;,,,,,, ( ), ( ),, 297.??,,, (1 ) :,, ; ( 256 257 258 ) (2 ) :, 247
,,,, ( 269 ),,,,,, ( 6 9 ),, 1% 2%, 12 %, 10% 10% 20%, 40 %,, 248
298.?,, 299.? (1 ),,, (2 ),,,, (3 ), (4 ),,,, 249
(5 ),, 300.? (1 ) :,,,,,, (2 ) :,, (3 ) :,,, 301.?,,,,, 250
, ( ),,,,,,,,,,,,,,,,,,,,,,,,, 302.?,, -,, : (1) : 251
,,,,,,,,,,,,,,,,,,,,,,,,, (2 ) :,,,,,,,,,,, 252
;, (3 ) : ( ),,,,,,,,,,,,,,, 303.?,,,,,,,, 304.? 4 13 253
4 / 5 / 254
6 / 7 / 255
8 / 9 / 10 / 256
11 / 12 / 13 / 305.?, 257
, : (1 ), :,, :,, ; ;, ; (2 ), :,,, :,,,, ; ; (3 ) :,, :,,,,, 258
; ; (4 ) :, :,,, ; ; 306.? (1 ) :,, ;,,,, ; ; (2 ) :,, 259
; (3) :, ; ; (4 ) :, ; ; ; (5 ) :,,,,,,,, ; ; 260
307.?,,,,,,,,,,,, 3 ;,,,,,,,,,, 261
6,,,,, 308.?,,, : (1 ),, (2 ), 1 : 1, 2, 3, ;1, 6 15 45, 2, M (3 ),, 5, 1, 45 160, 1,,,,,,, 262
309.? (1 ) : 1) : 98.066 121 126 10 15, ;, 20, 2) : 100 1, ; 15 20, ( ),, 3) :,, 6 4) : ( ), (2 ) : 1) 3% 2%, 1 ; 1 % 20 % 2 2), 0.2% 0.5% ( ) ; 0.75 1 / 263
30 3) 0.2% 2, 4) 100 / 12 24 ( ) 333 84,, 310.?,, : (1 ) :,,, (2 ) : ( ), 3, 6, IgM ( -H A V IgM -H EVIgM ) (3 ) : 1), 2),, 264
, 3),,, 4),, 5),,, 6), (4 ), : 16%, 0.05 1, 7 ; 311.? (1 ) : 1 2 2, ( 200 250 ) 10-6, 0.2% (2 ) : 20, ( 121 2 ) ; 0.5% 3% 2% 2 % 3% 1, 10 (3 ) : 20 (4 ) : 30 ; 121 20 ; 2 ; 0.5%, ; ( 0.4 / ) ( 100 / ) 265
, 12 24 ; 2% 2 (5 ) : 15 30, 20, 160 1 (6 ):0.5 % 3 % 2% (7 ) : 1 2 10% 20%, 2 (8 ) :2 % 3 % 1 (9 ) : 0.5 1 /,, 312.?? 20 90,, 98 2 ; 0.5%,1 ;,,, 266
( ),,,, X,,,, : (1 ) : 3% 250 10 6, 15,, (2 ) : 0.2% 0.5 % 15%, 10 30,, (3 ) : 2%,, 10 % (4 ) : 1% 25 15, ( 200 10-6 ),, 2,, 0.1% 0.5% 200 10-6 1 2 267
313.?, 4 10-5,,,,, e,,,, 314.?, (1 ), :,,,,, 85%,,, (2 ) : 1) : 268
,,,,,,, 2), :,,,, 3) : 4) : 5) :, 180 6) :,, 7) :, ; 8) :,,,, 315.?, 269
,,,, ; ;,, ( ),,, 316.? (1 ), (2 ), (3 ),, (4 ),,,,, 317.?,,,, 270
,,,,, : (1 ) :,,, ( PCR ),,, (2 ), (3 ) (4 ) (5 ),,, 5, 1 5, (6 ) ( 3 ) 80% 90% 3 271
318.?, : (1 ),,, (2 ),,,, ;,,, (3 ),,,,,, ( ),,, (4 ),,,, (5 ): ; ; ; ;,, ;, ; 272
,,,, (6 ) :, ( ) ;, ;, 319.?,,,,, : (1 ) :,,,,,,,,,,,,, (2 ) :,, (3 ) :,, 273
(4 ) :,,,,, 320.?,,, ( ),,,,,,,, 321.?, 3 6, ; (, ), 274
, 1.2,,, : (1 ),,, 3, (2 ), :,, ;, (3 ), (4 ), ;,,,, 322.?? : ; 275
2 0.05 0.1 /, 3,, 3 G ( 15% ),, 323.??,,,,, 3, 98 % 24 1 6 10 30 30 20, 82%, 90 %,, 3, ;5, 2/ 3 10 / 276
, e,, 3 : 24, 8 ; 2 3 1 3 0 1 3, 24,,, ;,,1 2 324.??,,, e ;, : (1 ), e (2 ) (3 ) ( ) 277
,,,,,,, 24 ;,,,,,,,,,, ; 2 3 3 : :, 1, : 2 1, : 3 4,,, 2, 278
325.? 80 %,, 4 8,,80%,,,,,,,,, 326.? 0 1 6 ( 0 1 6 1 ),,,,,,,,, 5,, 1,,, 0 1 6 279
327.?,, 95 %, 96.6%, 96.2 % 5%,,?, : (1 ) :,,, (2 ) :, ( 10 ), 1, 3 4 ; 3, 2, 1, 1 2 ;, 0.1, 1, 3 (3 ) :, ( PCR ),,,, 280
,,,,, PCR,, e e ( ),,,,, e,,, e,, (4 ),,,,,,,,, 328.?,,, 281
( ) ( ),, 75%, 72%, 93.6%,,,,,,,, 329.? : (1 ) e, 24 1 6 30, 0 1 6, 1 2 ( H BIg), 6 2 1, 2 3 5 20 (2 ) e, 0 1 6, 30 20 10 ; 282
30 10 10, 3 5, 100% (3 ) 0 6 6, 5 5 5, 100% (4 ),,, ( - HBs),, 3, 10 (5 ),, 72 3 72 2 6, 30,,, 0 1 6, 5, 330.??,,,,,,, 5 10 20,,, 283
90%, e, ( 30 / ), 0 1 6, 15 e, 84.82% ; 30 20 10, 56.42% ; 1 2 30, 95 %,, 100%,,, 6 7, 80 % 90 % 18 3 ; 3, 3,, 10 /,,,,,,,, 4 5,, 284
331.??, 3 1 3 4 : (1 ) : 3, (2 ) : 10 / 5% (3 ) : 10 100 / (4 ) : 100 /, 3 10 /, 10 /, 1, : ; ;, ; 285
,,,, 332.?, 5% ( - HBs < 10 / ), : (1 ) (2 )( 0.1 3 ) ( 30 ), 1, 3 4 ; 3, 2, 1, 1 2 ;, 0.1, 1, 3 ; 20 2,, 30 (3 ) ( PCR),,, PCR,, e e 286
( ),,, e,,,,, 333.?,,,,,,,,,,,, 287
334.?? : (1 ),,, (2 ) (3 ),, 10 / (4 ),,, (5 ),, 1,,,,, 3 1 3,,,, 3,,,, 1,,, 288
335.? 3, ( - HBs ), 10 / ( ), 3, 40 % 3 4, 10 /, 3 4,,,,, 3, 1 000 /, 7 10 ; 10 100 /, 3 5, 3,, 10 /, 336.?,, 289
,, 50%,, 35,,,, 337.?,, 3 e,, : (1 ), 48 1 1 200, 0 1 5 3 20 (2 ), 0 1 6 30 20 10 290
,, 90 %, 338.?,,,,,,,,,,, ;,,,,,, 339.?,, 80%,, ( e ),, 7 8 9 1 ( 200 ), 291
, 4 8,,,,,,? 340.,,,,,,,,, ( e ),,,,,,,, : (1 ), e,, 0 1 6, 1 2 ( 10 / ) 292
(2 ) e, 7 8 9, 1 ( 200 ), 2 ( 1 1, 200 ) 3 ( 10, 2 3 5 1 ) ; 1 3 ( 15, 1 6 1 ) 90%,,,,, 341.??,?,,,,,, 6, 293
,,,,, 342.??,,, -,,,,, ;,,? :,,,,, 294
25 20, 0.3% 1.5 % 60, 20 40 % 50 %,,, 85 40 50% ; 90 30 51.8 %, 40%, 2/ 3,,,,,,, 343.??,,,,,,,,,,,,,,,,,,, 295
,,,,,,,,,,,,,, :,,,,, 3,,,,, 296
344.?,,, (1 ) :,,, B1 ( ) ; ; C ( ) ; A ( ) (2 ) : ; ; ;, ; ;,, (3 ) : 297
, ; ; ;,,, (4 ) :,,,,,, A B,,,, 345.? : (1 ),,, :,,,,,,,,,,,,,, (2 ),, 298
, C,,,,,,,,,,,,,,,,,,,, ;,,,, (3 ), :,,,, 346.?, ( ),, 1984,, 40, 299
,,,,,,,,,, 7 531 10 460,, 347.?,,,,,,,,, 300
;,, ; D,,,,,,,,, 348.?, 70 ;, 90 100 : (1 ) 16% 25 % : 20%, 25 % (2 ) :, 8,,,,,,, (3 ), :,, 301
,,,, 1 1 2, 1 7,, (4 ) : ( ) 400,,,,,, :,, (5 ),, 1, 349.?,, 60% 75% 302
,,, ( ),, 350.?, ;,,, ;, p H 7.4,, ;,,,,,,,, A D, C,, 303
,,,, 351.?, ph 7.35,,, p H ph 7,,,, ;,,,,,,,,,,,, 2/ 5,,, ;,,, 304
,,, 10.3,,,,,,,, 352.? 7,,,,,,,, 2,,,,,,,,,,,,,,,,,,,,,, 305
353.?,,,,,, :,,,,,,,, ;,, ; : 30% 40%,, 70 % 80 %,,,,,, -,,,,,, :,, :, 3.6 15.1 ; 306
,, 5 040,,, 354.?,,,,,,,,,,, : (1 ) : 2 000,,,,,,, (2 ) :,,,,, (3 ) :,,, 307
,,,,,, (4 ), :,,,,, ;, (5 ), :,,,,,,, 1, 1,1, 1, (6 ) :,,,, 355.,?, 3, B1 60% 65% ; B1 45% ; 13%,, 308
,,,, C,, B 1/ 4 B 50%,, B,, 75% 25% B1 B2 30 % 40 %,, B1, 500 600,,, :,,,,,,, 356.? C B2 100 C 540, 86.3%,,, 24, 0.6, ; 200, 90,, ; 50,, 309
, ; 100 472, ; ; ( ),,,,,,,, ;,, ;,,, ;,,, 1 2, ; ;,, ; 1, 1.5,,,,,, ;,, 9, 120,,,, 357.? :,,,, 310
,,,,,,, :,,,,,,,,,,,,,,,,, ;, ;, ;,,,,,,, 358.?,, : 2,,,,,, 311
,,,,,,,, 359.? 8 368, 16.7,,,,,,,,,,,,,,,,,,,,,,, 312
360.,?, 1983 19, 1984 1987 :, 1988 3 29,,,,,, 4,, : 4 361.?, (1 ) :, ;,,, 30 60, 10 12,, 313
(2 ) :,, ;,, 90 ( 30 ), 250,,,, 2, (3 ):, ;, ; 2 3, 30 30,,,,,, (4 ) :,, ;,,,,,,, 200, 200,,, 362.,?,,,,,,,,, B1 314
B2,, 7%,,,,,,,,, 363.?,500 600 850,,,,,,,,,,, 1993 273, ( E PA),, ( ), 95%,,,,, 315
EPA,,,,,,,,, 364.?,,,,,, D3, 500, 1 000 1 500, 2.85 6.48 /, 4 6, 3, 12.95 / 4.66 /, :,, 2, 316
,,,, :, 365.? 0.5 1 1.5 6, B, B,,, 65.3%, 84.9%,, 92% 96%,,,,,,, 317
C, C, 6 7 C ( 100 C 9, 6 ) 366.?, 1866 1956,, 1963,,,,,, 1973 A( 1) 20 90,,,,,, ;, ;,,,,,,, 318
367.?,,,,,,,,, 418.4 836.8, 1, 15 20 0.5 1, 1,,,,, 1 6,,,,,, ;,,, 319
368.?,,,,,,,,,,,,,,,,,,, ;,,,,,,,,,,,,,, 6, 1 6,, ;,, 320
,, ;,,,,,,, ;,,, 369.,?,,,,,,, ; ;,, ;,,,, ;,,,75% 7,,,, 321
,,,? 370.?,,, 25 20 0.3 % 1.5% 60 20 40 % 50%,, : 60 85 40 50 %,, 90 30 51.8%, 40% ; 67%,,,,, 322
,,,,,,,,, 371.?,,,,,,,,,,,,,,,, 10, 10,,, 372.? 20 :,, (1 ) 1 323
(2 ) 1 (3 ) 1 2 (4 ) 1 2 (5 ) 1 (6 ) 4 :,, ;,, ;,,, : 1 1.5,,,3, 1,, 373.? : (1 ), 8 368 10 460 324
, (2 ) ( ), 17% 22% 61% (3 ), (4 ),, 10 (5 ), 4 5 (6 ) 374.?,,,,,,,,,,,,, 50 60 375.?,,,,, 325
97.5 130,, 2 3 ;,,, 376.? 20 70,, ( ), ( ),,, 377.? A, B, B2, B6 326
, C,,, K( K1 K2 ), K,,, 378.?,,,,,,,,, A,, 60%,,, 327
379.?,90%,, ;,,,,,, : ;, ;,,,,,, 380.?,, 328
,,,,,,,,,, 381.?,,,,,,,,, : (1 ) :,,,,,, 2 3 (2 ) :,,,, 329
,, 50, 10 15, (3 ) : 61 % ( 70 ),, (4 ) : 4 5,,, 3, ; ;,, ;,,,,, 382.? (1 ) :,,, ;,,,, 330
, 80%, D3,, (2 ) :,,,,,,,, 7 10 7 10 (3 ) :, 4,,,,,,,,,,,, 383.?,,, 331
,,,, (1 ) :, 1,,, (2 ) :,, (3 ) :,, (4 ), :,,, ;,,,,,,,,,,,,,,, 384.?, 332
, : (1 ) : 50 %,,,, 1.5 2,,,, 2,, (2 ) : 25 %,,, 60,,, 500 (3 ) :,,,,,, 5 6,,,, 333
(4 ) :,,,,, 5, 150 200, (5 ) :, 1 500 2 000 385.?,,,, 15 90, 60 3,,,,,,, 3.5 5,,,,,,,,, 1, 1, 334
,,,,,,,,,, 386.?,, C,?,,,,,,,,,,,, 387. ( )?, 65 % ; 20% ; 15%,,,, 55, 80 95,, 335
, 388.?,,,,, ( ),, ( ) : (1 ),, (2 ), (3 ),,, (4 ),, 389.?,, 336
,, 5 : (1 ),,,,, (2 ),,,, (3 ), 15 %, 20% 25 %, 60% 65%, B C (4 ),, (5 ) 300, 40 60,, 390.?,,,,,,, 3 4,, 337
, 1/ 5 2/ 5 2/ 5,, ; 1/ 3 1/ 3 1/ 3 ; 2/ 7 2/ 7 2/ 7 1/ 7 ( 1 ),,,, 391.?,,,, : (1 ) :,,,,,,,,,,,,,,, (2 ) : ( ),,,, (3 ) :,, 338
392.?,, : (1 ) : (2 ) :, (3 ) : 1,,,,, (4 ) :,, (5 ) :,, ;, 393.? 5 339
,,, : (1 ):,,,,,,,,,,,, 8 368 (2 ) :,,, 15% 18%, ( ) (3 ) :,,,,,,,,,,,, (4 ) :,,,, ; 340
;,, 20% 25%,,,,, (5 ): B1 B2 C,,,,,, (6 ) :,,,, ;, ; ;, 394.?,,, C,,,,,, 341
,,, 395.?,,, (1 ) : 30, 30, 30, 500,, 200, 3 5 2 000, 3 4,, (2 ) : 200, 20, 1 000, 600, 15 150, 3 4 (3 ) : 30, 2 (4 ) : 50, 500, 1,, 1,, 3, : (1 ) :,, : 1) : 15, 3 4,, 342
2) : 100 150, 100, 30, 3, 1, 3) : 9, 30, 10,, 1, 2, 10 15 (2 ) :,,, : 1) : 250, 200, 50, 100,,, 2, 20 30 2) : 30, 10, 2, 3) :, 100, 9, 3,,,, (3 ) : : 1) : 15,, 1, 7 10 2) : 30, 20, 100,, 343
2,, 3) : 500, 1 ( 500 ), 15,, 2 3, 1,,,, : 3, 60,,, ; : 6,, 10, 1, ; : 25 50, 5,,, 15 20, 396.? (1 ),,, (2 ), 5 ;, 3 (3 ), 1.5 1,,, (4 ),,, 344
, 397.?,,,,, 1 120, 6,, 2 3,,,,,,,,,,, 345
,,,, ;, 398.?,,, 1,, 3 10 15,,,,,,, C C,, 300 8 368 10 042 399.?, 346
,,,,,,,, A B C,,,, 100 9.4, 100 0.4 0.6,, 400.?,,,,,,, 347
,,,, : (1 ),, (2 ),,,,, (3 ), 300 350, 5 7,, 2/ 3,,,,,,, 50 (4 ),, 401.?,,,,,,,,,, ;, ;, 348
,,,,,,,,,,,,,, 402.??, :,,,,,, : (1 ), 1.5 2, 30% ( ) 349
,, (2 ) 12 552, 167 188 (3 ), 60 75,,,, 50, (4 ) B C, C B (5 ),,,,,, 350