| English
usaid banner

.

4(25) // 2012

 

 

1.

 

.. , .. , .. , ..

­­ ­ ­­­­ ­ ­­­ ­­ ­ ­­ ­­­­­­ ­­­ ­­ ­­糿. ­­­ ­­ ­­ ­­ ­­­­ ­­­ ­ ­­­­ ­­. ­­­ ­­­­­ ­­­ ­­ ­­糿 ­­ ­­­­ ­­­­­ . ­ ­­­­ ­­­­ ­­­­ ­­­­­­­­ ­­ ­­­. ­­­­­ ­­­­ ­­­ ­­­­ ­­­ ­­ ­­糿.

: .

 

.. , .. , .. , ..

­­­ ­ ­­­­ ­­­ ­­­ ­ ­ ­­ ­­­­­­ ­­­ ­­ ­­. ­­­­ ­­ ­­­ ­­ ­­ ­­­­ ­­ ­­­­­ ­­. ­­­ ­­­­­ ­­­ ­­ ­­ ­­ ­­­­ ­­­­­­ . ­ ­­­­­ ­­­­ ­­­­­ ­­­­­­­­­ ­­ ­­. ­­­­­­ ­­ ­­ ­­­­ ­­­ ­­ ­­.

: .


2.

 

볭 Ⳮ볭 䳭

..

­­ ­­ ­­­­ ­ ­­­ ­­ ­­­ ­­­ ­­ ­­­ ­­ ­­ ­­­, ­ ­­ ­­­­ ­­ ­­ ­­ ­­­­­­­­ ­­.

: , , , , , .

 

..

­ ­­­ ­­­­ ­­­­ ­­­ ­­­ ­­ ­­ ­­­ ­­­ ­­­ ­­­, ­ ­­ ­­­­ ­­­ ­­­ ­­­ ­­­­­­­­­ ­­­.

: , , , , , .


3.

 

..

­ —  ­­ ­­­­ ­­­ ­, ­­ ­­ ­­ ­­ ­­­­­ ­­ ­­ ­­ ­­­ ­­­ ­­ ­­­ ­­: ­, ­­ ­­ ­­, ­ ­­ ­­­ ­­­­­ ­­ ­­ ­­. ­ ̳­­­ ­­­­­ ­ ­­ ­­ ­­­­ ­­­­­-­­­ (­­, ­­­) ­ ­­, ­­­­­­ ­ ­­, ­ ­­, ­ ­­ ­­ ­­­­­­, ­­­ ­­. ­­ ­­­ ­­ ­­ ­ ­­ ­­ ­­­­­­ ­­­ ­ ­­ ­­, ’ ­­­­­ ­­-­­­ ­­­ ­­­­ ­­. ˳­­­ ­ ­­­­­ ­ ­ ­­­ ­­­ ­­­ ­­­­­ ­­­. ­ ­­­­­­ ̳­­­ ­­­­­­ ­ ­ ­­­­­­ ­­­ ­­­ ­­­ ­ ­­ ­ ­ ­­ ­­­ ­­­.

: , , .

 

..

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

: , , .


4.

 

.. , ..

­­­ ­­­ ­­ ­­ ­­­­­­­­ ’ ­­­­­ ­­. ­ ­-­­­­­ ­­ ­­ ­­, ­ ­­­­­ ­­ ­­­㳿 ­­ ­­­­­ ­­ ­­. ­­ ­ ­­­­ ­ ­­ ­­­ ­­ ­­­ ­­­­­­­ ’ ­­­­.

: , , , , .

 

.. , ..

­­­ ­­ ­­­ ­­­ ­­ ­­­­­­­­­ ­­ ­­­­­ ­­. ­ ­-­­­­­­ ­­ ­­ ­­, ­­­ ­­­­­ ­­ ­­­ ­­­ ­­ ­­­­­­ ­ ­­. ­­­ ­ ­­­­ ­­ ­­­­ ­­­ ­­ ­­­ ­­­­­­­­ ­­ ­­­­.

: , , , , .


5.

 

-㳭

.. , .. , ..

­ — ­­­ ­-­­­­­­ ­­ () ­­­­ ­ ­­­­­­­­­­­­ ­­ () ­­ ­­­ ­ ­ ­­­ ­­.
­­­ ­­. ­­­ 232 ­ ­ ­­, 191 — ­ 41 — ­­­­. ­­­ ­­­­-­­­ ­­­­ ­­­­ ­ , ­­­ ­­­ ­­­ ­ ­ ­­­­­ .
­­­. ­ ­ ­­ ­­­ ­­­ ­­­ ­­­­ ­­ DD — 46,1 %, ­ ­ — ­­­­ ­­ II — 14,7 %, ­­­­­ ­­ ID ­ ­­ ­­­ — 39,2 %. ³­­­ ­­ ­­­ ­­­­ ­­­ DD II, ’ ­­­ ­­ ­­, ­ . ­­ ­­­ DD ­ ­­­ ­­­ ­ ­­­ ­­, ­­ ­­­­­ ­ ­­ ­­, ­­­­­ ­ ­­­ . ­ — ­­ ­ D ­ ­­­ ­ ­ ­­­­­ ­­­ ­, ­ ­­­­ ­ ­ ­­. ­­­­ ­­ ­­­ II ­ ­­­, ­ ­ ­­­ ­­­­­ ­­­, ­ ­ ­­­­­ ­, ’ ­ ­­­­ .
­­. ­­­ ­ ­­ ­­ ­­­­ ­­ ­ ­­ ­­ ­­.

: , 볭 㳭 , 㳭 , 㳭 .

 

-

.. , .. , ..

­-­­­­­ ­­ () ­­­­­­­­­­ ­­ () ­­ ­­ ­ ­ ­­­ ­­.
­­­ ­­. ­­­­ 232 ­ ­ ­­, 191 — ­­ 41 — ­­­­­. ­­­ ­­­­-­­­­ ­­­­ ­­­­ ­­ , ­­­­ ­­­ ­ ­­­ ­­­­­ .
­­­. ­ ­ ­­ ­­­ ­ ­­­ ­­­ ­­­ ­­­­ ­­ DD — 46,1 %, ­­­ ­ — ­­­­ ­­ II — 14,7 %, ­­­­­ ­­ ID ­­­ ­­­­ ­­­ — 39,2 %. ­ ­­­ ­­ ­ ­­­­ ­­­ DD II, ­­ ­­ ­­­ ­­ ­­, ­­­­ . ­­ ­­­ DD ­­­ ­­­ ­­­­, ­­­­­­ ­ ­­ ­­ ­­, ­ ­­­ ­ ­­­­­ ­­ ­­ ­­, ­­­­­ ­ ­­ ­­­ . ­ — ­­­ ­­ D ­ ­­ ­ ­­ ­­­­­ ­­­ ­, ­ ­­ ­­­­­ ­­­ ­ ­­. ­­­­ ­­ ­­­ II ­­­ ­­­ ­­­­, ­­­­ ­ ­­­­ ­­­­­­ ­­­, ­ ­­­ ­ ­­­­­ ­­, ­­ ­ ­­­­ .
­­. ­­­ ­ ­­­ ­­ ­­­ ­­ ­­ ­­ ­­ ­­ ­­.

: , , , .


6.

 

12-쳭 ,

..

­ — ­­ ­­­ ­ ­­­ ­ ­­­­­ ­­­ ­­ ­­ ­­­ ­­­­ ­­­ ­­­ ­ ­­ ­.
­­­­ ­­. ­ ­­­ ­­­­­ ­­­ ­­­ ­­ ­ ­­ ­­ ­­­ ­­ ­­­ ­­ ­­­ ­ ­­­, ­­­ ­­ ­. ­­­ ­ 88 ­. ­­ ­ ­ 44 ­­­, ­­­ ­­ ­, ­­­­­ ­­­ ’ ­­­; ­­ — 44 ­­­ ­­­ «­­­­ ­­» ­­­ ­­ ­. ­­­ ­­­ ­­­ ­­­ ­ ­­­­ ­­­­­­ ­ (­­ ­ ­­­ ­ (MMSE), ­­ ­ ­ ­­, ­ ­, ­ 10 ­ ­­­ ­­­) ­­ ­­­­ ­ ­­ ­­ ­­­­, ­ 3, 6, 9 12 .
­­­. ­ ­ ­­­­­ ­­­ ­­ ­­­ ­ ­­­ ­­ ­ ­­­ ­­­ ­­­ ­­ ­­­ ­­­­ ­­ ­.
­­. ­ ­ ­­­­­ ­­­ ­­ ­­­ ­­­ ­­­­­ ­­ ­­­.

: , , .

 

12- ,

..

­­­ ­­­ ­­­ ­ ­­­ ­ ­­­­­ ­­­ ­­ ­­ ­­­­ ­­­ ­­­ ­­­ ­­­ ­­­ ­.
. ­ ­­­ ­­­ ­­­ ­­­ ­­ ­­ ­­­ ­­ ­­­ ­­­ ­­­­ ­ ­­­­ ­­ ­, ­­­ ­­ ­. ­­­­ ­­ 88 ­. ­­ ­ ­ 44 ­, ­­ ­­­ ­­ ­, ­­­­­­ ­­ ­­­ ­­­, ­­ — 44 ­­­ ­­ «­­­­­ ­», ­­ ­ ­ ­­­ ­­. ­­­ ­­­ ­­­­ ­­­­ ­­ ­­ ­­­­­­­ ­ (­ ­ ­­­­­­ ­­­ (MMSE), ­­ ­ ­ ­­, ­­­­ ­­­­­-­­­­­­ ­­ ­­ ­ ­, ­ 10 ­ ­­­ ­) ­­ ­­­­ ­ ­­ ­ ­­, ­ 3, 6, 9 12 .
­­­. ­ ­ ­­­­­ ­­­ ­­ ­­­ ­­ ­ ­­­ ­­ ­ ­­­ ­­­ ­­ ­­­­ ­­ ­­ ­­ ­.
­­. ­ ­ ­­­­­ ­­­ ­­ ­­­ ­­­ ­ ­­ ­­­.

: , , .


7.

 

᳭ 쳭볭 , 쳭

.. , .. , .. , .. , .. , .. , ..

­ — ­ ­ ­ ­­­­ ­­­ ­ ­­­ ­­ , ­­­­ ­ ­­­ ­­­, ­­­­­­ ­­ ­­­­ ­­­ ­ ­­­ ­­.
­­­­ ­­. ­­­­­­ ­­­­ ­­­ ­ ­­­­ ­­­ ­­ 112 ­ (­­ (50,68 ± 1,14) ­) ­­­­­­ ­­ ­­­­ ­­­ ­. 56 ­­­ ­ ­­­­ ­ (0,53 ± 0,10) ­­­ ­­ ­­­ . ­­­­­ ­­­ ­­­ ­­ ­­­ ­­ ­­­ ­­­­­, ­­­­ ­­­­ ­­ ­­ ­­­ ­ ­­ ­­­ ­­­­.
­­­. ­­ ­­­­ ­­­ ­ ­­­­­­­ ­­­ ­­ ­ ­­ ­­­­ ­ ­­­­ ­­­­ ­­ ­­­­­­, ­­ ­­­­ ­­­ ­­­. ­­ ­ ­­­ ­­­­ ­ ­­­­­­ ­­­㳿 ­­­­­ ­­ ­ ­­­ ­­ ­­­­­. ­­­­ ­ ­­ ­­­­ ­­ ­­­ ­­­ ­­­ ­ ­­­.
­­. ­­ ­­­ ­­­­ ­­­­ ­­­­­­ ­­ ­­­ ­­­ ­, ­­­­­ ­­­­ ­­­ ­­­ ­­­ ­­, ­ ­­­ ­­­­­ ­­ ­­­ ­­­­­ ­­, ­ ­­­­­­ ­­ ­­­ ­­­ ­­­.

: , 쳭볭 , .

 

,

.. , .. , .. , .. , .. , .. , ..

­­­ ­ ­­­ ­­­­ ­­ ­­­ ­­­ ­­ , ­­­ ­ ­­­ ­­­, ­­­­­­­­ ­­­ ­­­­ ­­­ ­ ­­­ ­­.
­­­­ ­­. ­­­­­­­ ­­­­­ ­­­ ­­­ ­­­­ ­­­­ ­­ 112 ­ (­ ­ — (50,68 ± 1,14) ­) ­­­­­­­­ ­­­ ­­­­ ­­­ ­. 56 ­­­ ­ ­­­ ­ (0,53 ± 0,10) ­ ­­­ ­­ ­­­ . ­­­­­ ­­­­ ­­­­ ­­­­ ­­­ ­­­ ­­­ ­­­­­, ­­­­ ­­­­ ­­­­ ­­ ­ ­­ ­­­­ ­­­­.
­­­. ­­­ ­­­­ ­­­ ­ ­­­­­­­­­ ­­­­ ­­ ­­ ­­­­­ ­­­ ­ ­­­­ ­­­ ­­ ­­­­­­, ­­ ­­­ ­­­ ­­­. ­­ ­­ ­­­­­ ­­­ ­ ­­­­­­­­ ­­­ ­­­­ ­­­ ­­­ ­­ ­­­­­, ­­­ ­ ­­­ ­­­­ ­­­­ ­­­ ­­­ ­­­ ­ ­­­ ­­­.
­­. ­­ ­­ ­­ ­­­­ ­­­­­­­­ ­­­ ­­­­ ­­­ ­, ­­­­­­ ­­­­­ ­­­ ­­­ ­­­­ ­­, ­ ­­­­ ­­­­­­ ­­ ­ ­­­­­­ ­­­, ­­ ­­­­­­­ ­­ ­ ­­ ­­­­.

: , , .


8.

 

򳭺

..

­ — ­­ ­­ ’­ ­­­­ ­­­ () ­­­­ ­­ () ­ ­­­ ­­­­ ­ ­­­­­ ­­­­­­ (), ­ ­­’ ­ ­­­ ­ ­­­.
­­­­ ­­. ­­­ ­­­ 102 ­ (­­ — (64,2 ± 7,3) ­) . ­­­ ­­­ ­­-­­­­ ­­­, ­­ ­­­­ ­, ­­­­ ­­­. ­­­ ­ ­­­­­­ MMSE, ­­­ ­­­ ­ ­ — ­ ­­­­ ­, ­­ — ­ ­­­.
­­­. ­­­ ­­ ­­­ ’ ­ ­­ ­ ­ () ­­ . ­­­ ­­­ ­­ ­­­ ­. ­ ­­­ ­­­ () ­­­ ­­ ­­­ ­ , ­­­ ­­ — ­­­ . ­­­ ­­’ ­­­­ ­­ ­­ ­ ­ ­­ ­­­ ­­ ­­ ­­ ­­­ ­­ ­­­­ ­­­ ­­­­. ­ ­­ ­ ­­ ­­ , .
­­. ­­­ ­­­ ’ ­ ­­ . ­­­ ­­­ ­­ ­­­ ­. ­­­ ­­­ ­­’ ­­­­ ­­ ­­ ­ . ­ ­­ ­ ­­ ­­ , .

: , , .

 

..

­­ ­ ­ ­­­­ ­­­ () ­­­­­ ­­ () ­­­ ­­­­ ­­­­­ ­­­­­­ (), ­ ­­­ ­ ­­­­ ­­­ ­ ­.
­­­­ ­­. ­­­­ ­­ 102 ­ (­ ­ — (64,2 ± 7,3) ) . ­­­ ­­­ ­­-­­­­­ ­­­­, ­ ­­­­ ­, ­­­­ ­­­­. ­­­ ­ ­­­­ MMSE, ­­­ ­­­­­­ ­­­ ­ — ­ ­­­­­ ­­­, ­­ — ­ ­­­.
­­­. ­­­­ ­­ ­­­ ­­ ­ ­ ­­ ­ ­ () ­­ . ­­­­ ­­­ ­­­ ­­ ­­­ ­­. ­ ­­­ ­­­ () ­­­ ­ ­­­ ­ , ­­ ­­ — ­­­ . ­­­­ ­­­ ­ ­­­­ ­ ­­ ­ ­­­­ ­ ­ ­­­ ­­ ­ ­­ ­­­ ­­­ ­­­­­ ­­­ ­­­­­. ­ ­­ ­ ­­ ­­ , .
­­. ­­­­ ­­­ ­­ ­ ­ ­­ . ­­­­ ­­­ ­­­ ­­ ­­­ ­­. ­­­­ ­­­ ­­­ ­ ­­­­ ­ ­­ ­ . ­ ­­ ­­ ­­ , .

: , , .


9.

 

(쳭, 쳭)

..

­ — ­ ­­ ­­­­ ­­ ­­­ ­­ ­­ ­­ (­­­, ­­­­) ­ ­­ ­­ (­­­­, ­, ­­).
­­­­ ­­. ­­­ 205 ­ ­­­ ­­ ­­­. ­­ ­­ ­­­ ­­­­­­ ­ UPDRS, ­­­­­ ­ Hoehn—Yahr, ­ ­­­ ­­ ­­­ Schwab—England.
­­­. ­­ ­­­ ­­­ ­­­­ ­­­ ­­ ­ ( 62,26 % ­­). ­ ­­ ­­­­ ­­­­ ­­ ­ ­­­­ ­­ ­. ­ ­­ ­­ ­­­ ­­­ ­­ ­ ­ ­­­­ ­­­­.
­­. ­­ ­­ ­­ ­­­ (­­­ ­­­­) ­ ­­­­ ­­­­ ­­­ ­­ ­­­­ ­­ ­­­.

: , , .

 

(, )

..

­ ­­­­­ ­­ ­­­ ­­­­ ­­ ­­­ (­­­, ­­­­) ­ ­­­ ­­ (­­­­, ­, ­­).
­­­­ ­­. ­­­­ 205 ­ ­­­­ ­­ ­­­. ­­ ­­ ­­­ ­­­­ ­ UPDRS,  ­­­­­­ ­ Hoehn—Yahr, ­ ­­­ ­­ ­­­ Schwab—England.
­­­. ­ ­­­ ­ ­­­ ­­­ ­­ ­ ( 62,26 % ­­). ­ ­­ ­­­­ ­­­­ ­­ ­ ­ ­ ­­­ ­­­ ­. ­­­ ­­ ­­ ­­­ ­­­ ­­ ­ ­­­­ ­­­­­ ­.
­­. ­­ ­­­ ­­ ­­­ (­­­ ­­­­) ­ ­­­ ­­­­ ­­ ­­­­­ ­­ ­­­.

: , , .


10.

 

糿

..

­ — ­­ ­­­ ­­ ­­­­ () ­ ­ ­­糿.
­­­­ ­­. ­­­­­­ ­­­ ­­­­­­ ­­­ 598 ­ . ­­ ­­­­­ ­­糿 ­­­ ­­­ ­­­ ­­­­ ­­. ­­ ­­ ­­­ ­­ ­­­­ ­­­­.
­­­. ­­ 5 ­ ­­­ ­­­­ ­­­ 9 ­­ ­­­­ ­­ ­­­­ : 5 ­­ — ­­ ­­ ­­ ­ ­­ ­­糿, 3 — ­­ 2 ­, 1 — ­­ 5 ­. 9 ­­ ­ ­­­. ­­ ­­­ ­­­­ ­­­­: ­­ ­­­­ ­­ , ­ ­­­ ­­­ , ­­ ­­­­­ ­ ­­­ ­­. ­­ ­­­­ ­­­­: «» ­­ ­ ­ ­ ­­­, 3-­­, ­ ­­­­ ­ — ­­­ ­­, ­­­ ­, ­­­­ ­­­ ­­ ­ ­­­­­­ ­.
­­. ­ ­­ ­­­­ ­­­­ ­ ­­ ­­ ­ ­­ ­­糿 ( 55 %, p < 0,005). ­­­ ­­ 60 % ­­ ­­ ­ ­­ ­­. ­­ ­­ ­ ­­­­ ­­ ­­ ­­.

: , , .

 

..

­­ ­­­­ ­­ ­­­ () ­ ­­ ­­­­­ ­­.
­­­­ ­­. ­­­­­­­ ­­­ ­­­­­­ ­­ 598 ­ . ­­­­ ­­­­­ ­­ ­­­ ­ ­­­ ­­­ ­­­­. ­ ­­ ­­­ ­­ ­­­­­­­ ­­­­­.
­­­. ­­ 5 ­­­ ­­­ ­­­ 9 ­­ ­­­­­ ­­ ­­­­­ : 5 ­­ — ­­ ­­ ­­ ­ ­­ ­­, 3 — ­ 2 ­ 1 — ­ 5 . 9 ­­ ­ ­­­. ­­ ­­­ ­­­­­­­ ­­­­­: ­­ ­­­­ ­­ , ­ ­­­ ­­ , ­­ ­­­­­ ­ ­­­ ­­. ­­­ ­­­­­­­ ­­­­­ ­ : «­­» ­­ ­ ­ ­ ­­­ , 3-­­, ­­­ ­­­­ ­ — ­­­ ­­, ­­­ ­ ­, ­­­ ­­­ ­­ ­ ­­ ­­­­­ ­­­ ­­­­­ ­­.
­­. ­­ ­­ ­­­­­ ­­­ ­ ­ ­ ­­ ­­ — ­ 55 % (p < 0,005). ­­­­­­ ­­ ­ 60 % ­­ ­­ ­­ ­­ ­­­. ­­ ­­ ­­­ ­ ­­­­ ­­ ­­ ­­­­­.

: , , .


11. -

 

볭 ﳭ

.. , .. , ..

­ — ­­­ ­­­­ ­­ ­­­ ­­ ­­­­ ­­­ () ­ ­­.
­­­­ ­­. ­­­­­­ ­ ­­ ­­ , ­­­­ ­­­­ ­­ ­­­. 148 ­ ­­ ­­­: ­­­­­ (­­ ­), ­­­­ ­­ ­­­­ ­­. ˳­­­ ­­ ­­­­ ­­­­­ ­­糿 ­­ ­­­­­ ­­. ­ ­­­­, ­­­ ­­­ ­­­.
­­­. ­ ­, ­­­­­ ­­­­ ­­­­ ­ ­­­­ ­­­­ ­­. ­ ­ ­­­­­ ­ ­­­­­ ­­. ­­­ ­­ ­ ­­­­­ ­­, ­­ ­­­­ ­­­ , ­­ ’ ­­­­­­ ­­­. ­ ­­ ­­­­­ ­­糿 ­­­­ ­­ ­­­­ ­­ ­­.
­­. ­­ ­­­ ­­ ­­ ­ ­­ ­­­­ ­­, ­­ ­­, ­­­­­­­, ­­­ ­­­­­­ ­­­­­­ ­­.

: ﳭ , , , , .

 

.. , .. , ..

­­ — ­­­ ­­­­­ ­ ­­ ­­ ­­­­ ­­­ () ­­­.
­­. ­­­­­­­ ­ ­­ ­­ , ­­ ­­­ ­­­­­ ­­ ­­. 148 ­ ­­ ­­­: ­­­­­ (­­ ­), ­­­­ ­­ ­­­­ ­­. ­­ ­­ ­­­­­ ­­­­­ ­­ ­­ ­­­­­­ ­­­. ­ ­­­­ ­­­ ­­­ ­­.
­­­. ­­ ­, ­­­­­ ­­­­ ­­­­ ­ ­­­ ­­­­­ ­­. ­ ­­­­ ­ ­­­­­­ ­­­. ­­­ ­­ ­­­ ­­­­­­ ­­­, ­­ ­­­­ ­­­ , ­ ­­ ­­­­­­­­ ­­­­. ­ ­­ ­­­­­ ­­ ­­­­ ­­ ­­­­­­­ ­­­ ­­­ ­­ ­­.
­­. ­­ ­­ ­­ ­­ ­ ­­ ­­­­­ ­­­, ­­ ­­, ­­­­­­­, ­­­ ­­­­­­ ­­­­­­­ ­­.

: , , , , .


12. ˳-

 

糭 㳿

.. , .. , .. , .. , ..

­ — ­­ ­­ ’ ­­­­ ­ ­­­㳿.
­­­­ ­­. ­­­ 22 ­ ­ ­­­­ ­­ ­­ (­­­­ ­­­ ­­­), ­ ­­-’­ ­­­­­­ ­­­­­. ­­ ­ 15 ­­ . ­­ ­ ­­ ­­ (37,2 ± 0,5) ­. ­­ ­­­ ’ ­­­­­­ ­ Y 6013 ­­­ (­­­­ ­­­­­) ­­­­ ­­­­ (­­­) ­­. ­­­­­ ­ ’ ­­­ ­­­­­ ­­­­­ ­ , ­­ ­­­: ) ­­­ ’ ­­­­, ) ­ 40 ­­­ ­­­, ) ­ 10-­­ ­­ 2-­­­ ­­­­.
­­­. ­­­­ ­­­­­­ ­­ ­­­ ­­­ ’ ­­­ ­­­­ ­­ ­ ­ ­­­㳿, ­­­ ’ ­­­ ­­­ ­ ­­­­, ­­­ ­­­­­ ­ ’.
­­. ­­­ ­­­ ­­­ ­­­ ’ ­ ­ ­­­­ ’, ­ ­ ­­ ’ ­­ ­­ ’ ­ (­­). ­­­­­ ­­­ ­­­ ­­­­­ ­­­ ­. ­­­­ ­ ­­ ­ ­­­ ­­­­ ­ ­ ­­­­ ’.

: , , .

 

.. , .. , .. , .. , ..

  ­­ ­­­­ ­­­ ­ ­­­.
­­­­ ­­. ­­­­ 22 ­ ­­­­ ­­­­­ ­ ­­ (­­­­­, ­­­­­ ­­­) ­-­­­ ­­­­­­ ­­­­­­. ­­ ­ ­­­ 15 ­­ . ­ ­ ­ ­­ ­­ (37,2 ± 0,5) ­. ­ ­­­ ­­­­ MY 6013 ­­ (­­­­ ­­­­­) ­­­­­ ­­­­ (­­­) ­­. ­­­­ ­­­­­ ­­­ ­­­ ­­­ ­ , ­­ ­­­ ­­­­: ) ­­­ ­ ­­; ) ­ 40 ­ ­­­ ­­­­ ­; ) ­ 10-­­­ ­­­ 2-­­ ­­.
­­­. ­­­­ ­­­­ ­­ ­­­­ ­­­ ­ ­­­­ ­­ ­ ­ ­­­, ­­­­ ­­ ­­­­ ­­ ­ ­­, ­­­­ ­­­­­ ­­­ ( ­­­ ­­­ ­ ­­­).
­­.  ­ ­­­ ­­­­ ­­­ ­ ­­­­ ­­­ ­, ­ ­­ ­­ ­­ ­­ ­­ ­ (­). ­ ­­­­ ­­­ ­­­­ ­­­ ­­­­ ­­­ ­. ­­­ ­ ­ ­ ­­ ­­ ­­­ ­­­­ ­­­ .

: , , .


13. Ͳ ˲

 

.. , ..

­ — ­­­ ­­ ­­­­ ­­­­­ ­ ­­ ­­­ 쳿 ­ ­­­ ­­­­­ ­­糿 ­­ ­­ ­­ ­­­ ­­­­­ ­­­ ­­­­ ­­­ ­­ ­­ ­­­­­­ ­­­­ ­­­ ­­ ­­ ­ ­­.
­­­­ ­­. ­­­ ­­­ 50 ­, ­­­­ 5 ­­­­­ ( 10 ­ ­): «­­ ­» — ­­ ­­­­­, ­ — ­­­­ ­­­ . Longa ­., ­­ 1 — ­­­­ ­­­­ Doccol, ­­ 2 — ­­­­ ­­­ . Longa ­. ­’­ ­­­­­ ­­ ­ ­­, ­­ 3 — ­­­­­ ­. ­­­­ ­­ ­­­­ 1-, ­­­­ ­ — 3- ­ ­ ­­­­ ­­­ 쳿.
­­­. ­ ­ ­­­­­ ­­­­ ­­ ­­­ 쳿 ­­­ ­­­ ­­­­ ­­ ­­ ’ ­­ ­­ ­­­ ­­­ ­ .
­­. ­ ­­­­ ­­ ­­­ ­­­­­ ­­ ­ ­­­ ­­­­­ ­­ ­­ ­­­ ­­ ­­­ 쳿 ­­­ ­­ ­­­­ ­­­ ­­­ ­­ ­­ ­­­ ­­­ ­ ­­.

: , , , , .

 

.. , ..

­­­ ­­ ­­­­­ ­­­­­ ­ ­­ ­­­ ­ ­­­ ­­­­­ ­­ ­ ­­ ­­ ­­­­ ­­­­­ ­­­ ­­­­­ ­­­­ ­­ ­­­­­­ ­­­­­ ­­ ­­­ ­­ ­­.
­­­ ­­. ­­­­ ­­­ 50 ­, ­­­ 5 ­­­­­ ( 10 ­­ ­): «­­­ ­» — ­­ ­­­­­, ­ — ­­­­­ ­­­ . Longa ­., 1 — ­­­­­ ­­­­­ Doccol, ­ 2 — ­­­­­ ­­­ . Longa ­. ­­­ ­­­­­ ­­ ­ ­­, 3 — ­­­­­­ ­. ­­­­ ­­ ­­­­ 1-, ­­­­­ ­­­ — 3- ­ ­ ­­­­­ ­­­ .
­­­. ­ ­­ ­­­­­­ ­­­­­­ ­­ ­­­ ­­ ­­­ ­­­­­ ­­ ­­­ ­ ­­ ­­ ­­­ ­ .
­­. ­ ­­­­ ­­­ ­­­ ­­­­­­ ­­­­­ ­­­­ ­­­­ ­ ­­ ­ ­­ ­­­ ­­ ­­­ ­­­ ­­ ­­­­ ­­­­ ­­­ ­­ ­­ ­ ­­ ­­.

: , , , , .


14. ˳ 㳿

 

.. , .. , .. , .. Գ, ..

­­­ ­ ­­ ­­­­ ­­­ ­ ­­ ­­ ­­. ­ ­­­­ ­­­ ­ ­­­ ­­ ­ ­. ³­­­ ­­ ­­­ ­­­ ­­­ ­­ ­­, ­­­ ­­, ’ ­­­ ­ ­­­ ­­.

: , 볭 , , .

 

.. , .. , .. , .. , ..

­­­­ ­­­ ­­ ­­­­ ­­­ ­ ­­ ­­­ ­­. ­­­ ­­ ­­­ ­ ­­­­ ­­­ ­­ ­. ­­­ ­ ­ ­­­­ ­­ ­­­ ­­ ­­­ ­­­, ­­­ ­­, ­ ­­­ ­ ­­­ ­.

: , , , .


15. ˳ 㳿

 

ﳿ

.. , .. , .. , .. , .. ˺, ..

­ — ­­ ­­ ­­­ ­ ­ ­­ ­­­ ­­­ ­­ ­, ­­­ ­ ­­ ­­­, ­­­ ­­­ ­ ­­­ ­­­ ­­­ ­­.
­­­­ ­­. ­­­ ­­ ­­-­­­­ ­­­ 45 ­­­ (22 ­­­ 23 ­) ­ ­­ ­­ ­ ­­ ­­­­. ­­ ­­­ — (66,7 ± 1,4) ­. ­­­ ­ ­­­­ ­. ­­ 30 ­ (­­ — (66,8 ± 1,3) ­), ­­­ ­­ﳿ ­­­­ ­­ 1—5 ­­­­ ­ 0,5 % 1,0 ­­’ ­, ­­ 6—10 — ­ 1,5 % 1,0 ­­’ ­, ­­ 11- 40- ­ — ­­­­ ­ ­­ (20 ) ­ ­. ­­ ­ ­ 15 ­ (7 ­­­ 8 ­), ­­­­­ ­­­­ ­ ­­­­ ­­­­ ­­ ­ ­­­­ ­­­ ­­ ­­ ­­. ­­ ­­­ ­­­­ ­­­­ NIHSS MMSE, ­ ­, ­ ­­­ ­­ ­.
­­­. ­­­ ­ ­­­ ­­­ ­­­­ ­ ( ­ NIHSS) ­­­ ­­ ­, ­­ ­­­ ­ ­ ­ ­­ ­­ ­­­, ­­­­ 14- ­ ­­­­ ( < 0,05). ­, ­­­­ 14- ­ ­­­­, ­­­ ­ ­ ­­­­­ ­­­ ­­ ­ ((82,8 ± 3,0) ­) ­­­ ­ ­­ ((77,5 ± 2,9) ­; < 0,05) ­­ ­. ­­­ ­ ­­­ ­­­ ­­­ ­ ­­­­ ­­ﳿ ­­, ­­­ ­­ ­­­, ­­­­ 14- ­ ­­­­ ( < 0,05). ­­­­ ­­ ­­­ ­­­ ­­­ ­­­ ­­, ­­­ ­­­ ­­­ ­ ­ ­­ ­ ­­, ­­­­ ­­­ ­­­ ­­ 14- ­, , ­ ­, ’ ­ ­­­ ­ ­­­­­ ­­­.
­­. ­­­­ ­­ ­­­ ­­­ ­ ­ ­ ­ ­ ­­ ­­­ ­­­­ ­, ­ ­ ­­­­­ ­ ­­ ­­­­­­ ­­. ­­­ ­ ­­­ ­­­­­ ­ — ­­­ ­­­ ­, ­­ ­­ ­­­ ­­­ ­­, ­­­­ ­­­ ­­­.

: , ﳭ, .

 

.. , .. , .. , .. , .. , ..

­­ ­­ ­­­ ­ ­­ ­­ ­­­ ­­­­ ­­­ ­, ­­­ ­­­ ­­­, ­­­ ­­­ ­­­ ­ ­­­ ­­­­ ­­­ ­­.
­­­­ ­­. ­­­ ­­ ­­-­­­­­ ­­­­ 45 ­­­ (22 ­­ 23 ­­) ­ ­­ ­­ ­ ­­­ ­­­­. ­ ­ ­­­ — (66,7 ± 1,4) ­. ­­­ ­ ­­­ ­. ­­ ­­­ 30 ­ (­ ­ — (66,8 ± 1,3) ­), ­­ ­ ­­­­ ­­ ­­­ ­­ 1—5 ­ ­­­­ ­ 0,5 % 1,0 ­­­­ ­, ­­­ 6—10 ­ — ­ 1,5 % 1,0 ­­­­ ­, ­­ 11- 40- ­ — ­­­­­ ­ ­­ (20 ) ­ ­. ­­ ­ ­ 15 ­ (7 ­ 8 ­), ­­ ­­­­­ ­­­­ ­ ­­­­ ­­­­ ­­ ­ ­­­ ­­­­ ­­ ­­­ ­­. ­­ ­­­­ ­­­­­ ­­­­ NIHSS MMSE, ­ ­, ­ ­­­ ­­ ­.
­­­. ­­­ ­ ­­­ ­­­­ ­­­­­ ­ ( ­ NIHSS) ­­­ ­­ ­, ­­ ­ ­ ­­­­ ­ ­­ ­­­ ­­­, ­­ 14- ­ ­­­­ ( < 0,05). ­, ­­ 14- ­ ­­­­, ­­­ ­ ­ ­­­­­ ­­­ ­­ ­ ((82,8 ± 3,0) ­) ­­ ­ ­­ ((77,5 ± 2,9) ­; < 0,05) ­­ ­. ­­­ ­ ­­­ ­­­­ ­­­ ­ ­­­ ­ ­­ ­­, ­­­ ­­­­, ­­ 14- ­ ­­­­. ­ ­­­ ­ ­­­ ­­­ ­­­ ­­­ ­, ­­­ ­­­­­ ­­­ ­­­ ­ ­­ ­ ­­, ­­ ­­­ ­­­ ­­­ ­­ 14- ­, , ­­ ­, ­­ ­ ­­­ ­­­ ­­­­­­ ­­­.
­­. ­­­­ ­­ ­­ ­­ ­ ­ ­­ ­­ ­­­ ­­ ­­­­ ­­­­­ ­, ­­­­­ ­ ­­­­ ­­­­­­­ ­­­­. ­­­ ­ ­­­ ­­ ­­­­­­­ ­ — ­ ­­­ ­, ­ ­­ ­­­­ ­­­ ­, ­­­­ ­­­­ ­­­.

: , , .


16. ˳ 㳿

 

ﳿ , 볭 , Ⳮ

.. , ..

­ — ­­ ­­­ ­ ­­­ ­ ­­­ ­ ­­ (ֲ), ­­­ ­­­ ­­­ ­­ (), ­ ­­­­ ­­­ ­­.
­­­­ ­­. ­­­ 120 ­­­ ֲ ­ ­ ­­ ­­ ­­­. ­볿 ­­­ 54 (45 %) ­­­, ­­­­ ­ ­­ ­­­ ­­­­­ ­­ﳿ. ­­ ­ 25 (46,3 %) ­­­ ­ , ­ ­­­ ­­­­ 1- ­ ­­ ­­­ ֲ. ­­­ ­­ ­ ­­­­ ­­ ­­.
­­­. ­­­ 1- ­ ­­ ­­­ ­­­­ ­­­­ NIHSS 7- ­ ­­­ ­­­ 29,6 % ­­, 14- — 40,3 %, 21- — 55,3 %, ­­­ 2- ­ — ­­­ 5,4; 15,1 21,5 %, ­­ ­ — 2,2; 6,5 10,9 %. ­­­ ­­­ ­­­ ­ ­­­ ­ ­ ­­­ 1- ­ ­­­­ 7- ­ ­­ ­­ﳿ: ­ ­ ­­­ — 31,7 %, 14- ­ — 76,7 % 21- ­ — 96,7 % ­, ­­­ ­­ ­ — 21,7; 58,3 78,3 % ­­­. ­­ ­­ ­­­­­ ­ ­­ 1 7- 14- ­ ­­­ 89,2 % ­­­ 1- ­, 0,5 ­ — 75,3 % ­­­ ­­ ­.
­­. ­­­ ­­­ ­­­ ­ ­­ ֲ ­­­ ­­­­ ­. ­­­, ­­­­­ ­ ­­ﳿ ­­­­ ­­­ ­­­ ­ ֲ, ­­­ ­­­ , ­­ .

: , 볿 , .

 

, ,

.. , ..

­­ — ­­ ­­ ­­ ­ ­­­ ­­ ­­­ ­­ ­­ (), ­­ ­­­ ­­­ ­­ (), ­ ­­­­ ­­ ­­.
­­­­ ­­. ­­­­ 120 ­­­ ­ ­ ­­ ­­ ­­­. ­ ­­­ 54 (45 %) ­­­, ­­ ­­­­ ­ ­­­­ ­­­ ­­­­­ ­­. ­­ ­ ­­­ 25 (46,3 %) ­­­ ­ , ­­ ­ ­­­­ ­­­­ 1- ­ ­­ ­­ ­­­ ­­ ­­.
­­­. ­­­ 1- ­ ­­ ­­­­ ­­­­­ ­­­­ NIHSS 7- ­ ­­­ ­ 29,6 % ­­, 14- — 40,3 %, 21- — 55,3 %, ­­­ 2- ­ — ­­­­ 5,4; 15,1 21,5 %, ­­ ­ — 2,2; 6,5 10,9 %. ­­­­ ­­­ ­­­­ ­­ ­ ­ ­­­ 1- ­ ­­­ 7- ­ ­­ ­­: ­ ­­ — 31,7 %, 14- — 76,7 %, 21- — 96,7 % ­, ­­­ ­­ ­ — ­­­­ 21,7; 58,3 78,3 %. ­­ ­­ ­­­­­ ­­ 1 7- 14- ­ ­­­ 89,2 % ­­­ 1- ­, 0,5 ­ — 75,3 % ­­­ ­­ ­.
­­. ­­­ ­­­ ­­­ ­ ­­ ­­ ­­ ­­­­ ­. ­­­, ­­­ ­ ­­ ­­­­ ­­­ ­­­ ­­ , ­­ ­­­ , ­­ ­­ ­­­ ­.

: , , .


17. ', , ֲ

 

16- (EFNS)

ϳ . .. , ..

­­ ­­ ­­ M.G. Bous­ser ­­­ ­, ­­­ , ­­­ ­­­ ­­­ CADASIL (­­­ ­­­-­­­ ­­­­­ ­­­­­ ­­­ ­­­­­­­­). ­ ­­­­ ­­ ­­­ ­­­ ­­­ ­, ­ ­­ ­­ ­­­­ — Notch 3 19- ­­­. ³­­­ 1976 . ­­­­ ­­ «­­ ­­­» ­­­ 50 ­ ­­­ ­­ ­­­ ­­­­­­­­, ­­­ ­ ­­­­ ­­­糿, . M.G. Bousser ­ ­­­ ­­­ ­­­ ­­ ­­­ ­ ’ ­­­. 1993 . ­ ­­­­­ 19- ­­­ , ­­­ ­­­­­, ­­ ­ ­ ­­. ­ ­­­­ 3 ­ ­ ­ ­ ­ 33 ­­ ­ ­, ­­­ ­­ ­ Notch 3. ­ ­­­ ­­ ­­ , ­­­ ­ ­­ ’­­ ­­­ ­ ­­ ­­ ­­­­.


18.

 

(' METASTROKE):

T-

P

ó :

P

' ,


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