ΠΡΠ΅Π½ΠΊΠ° ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π²Π»ΠΈΡΠ½ΠΈΡ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ Π½Π° ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΠ΅ΠΉ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ
ΠΠΎ ΠΌΠ½ΠΎΠ³ΠΈΡ ΠΈΠ½Π΄ΡΡΡΡΠΈΠ°Π»ΡΠ½ΠΎ ΡΠ°Π·Π²ΠΈΡΡΡ ΡΡΡΠ°Π½Π°Ρ , Π° ΡΠ°ΠΊΠΆΠ΅ Π² Π ΠΎΡΡΠΈΠΈ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΠΠ ΠΎΡΡΠ°Π΅ΡΡΡ Π½Π΅ΡΠ΄ΠΎΠ²Π»Π΅ΡΠ²ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΡΠΌ. Π Π‘Π¨Π Π»ΠΈΡΡ 27% Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ ΠΊΠΎΠ½ΡΡΠΎΠ»ΠΈΡΡΡΡ Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΡΡ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΡ (National Health and Nutrition Examineation Survey 111,1994), Π° Π² ΡΠ΅Π»ΠΎΠΌ ΡΡΠ΅Π±ΡΠ΅ΠΌΡΠΉ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΡΡΠΎΠ²Π½Ρ ΠΠ ΠΎΡΠΌΠ΅ΡΠ°Π΅ΡΡΡ ΠΌΠ΅Π½Π΅Π΅, ΡΠ΅ΠΌ Ρ 40% Π»ΠΈΡ Ρ Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΠ΅ΠΉ (ΠΠ) Bennet S. Π. ΠΈ ΡΠΎΠ°Π²Ρ. 1] 1994 Π³ΠΎΠ΄. ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΡΡΡΡΠΊΡΡΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ… Π§ΠΈΡΠ°ΡΡ Π΅ΡΡ >
- Π‘ΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅
- ΠΡΠ΄Π΅ΡΠΆΠΊΠ°
- ΠΠΈΡΠ΅ΡΠ°ΡΡΡΠ°
- ΠΡΡΠ³ΠΈΠ΅ ΡΠ°Π±ΠΎΡΡ
- ΠΠΎΠΌΠΎΡΡ Π² Π½Π°ΠΏΠΈΡΠ°Π½ΠΈΠΈ
Π‘ΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅
- ΠΠΠΠΠ. ΠΠ±Π·ΠΎΡ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ
- 1. 1. Π ΠΎΠ»Ρ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ^ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ Π² ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΠ
- 1. 2. ΠΠΎΠΊΠ°Π·Π°Π½Π½ΡΠ΅ ΡΠ°ΠΊΡΡ Π½Π° ΠΊΠΎΡΠΎΡΡΠ΅ ΠΎΠΏΠΈΡΠ°Π΅ΡΡΡ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½Π°Ρ Π°Π½ΡΠΈΠ³ΠΈΠΏΠ΅ΡΡΠ΅Π½Π·ΠΈΠ²Π½Π°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ
- 1. 3. ΠΠ°ΡΠ΅ΡΡΠ²ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΠ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ ΡΠ°Π½Π΅Π½ΠΈΡ
- 1. 4. ΠΠ΅ΡΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΎΡΠ½ΠΎΠ²Ρ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΠ
- 1. 5. ΠΡΠ΅Π½ΠΊΠ° ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΠ Π² ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡΡ
- 1. 6. ΠΠ΅ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΎΠ·Π½ΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΠ Π² ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡΡ
- 1. 7. ΠΠ΅ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΎΠ·Π½ΡΠ΅ ΠΏΠΎΠ΄Ρ ΠΎΠ΄Ρ ΠΊ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΠ ΡΠ°ΡΡΠΌΠΎΡΡΠ΅Π½Π½ΡΠ΅ Π² ΠΌΠ΅ΡΠ°-Π°Π½Π°Π»ΠΈΠ·Π΅
- ΠΠΠΠΠ II.
- ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ
- II. 1. ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠ°Ρ Ρ Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠ° Π±ΠΎΠ»ΡΠ½ΡΡ
- Π. 2. Π‘ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½Π°Ρ ΠΊΠ»Π°ΡΡΠΈΡΠΈΠΊΠ°ΡΠΈΡ ΠΠ
- 11. 3. Π‘ΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π° ^ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½Π½ΠΎΠ³ΠΎ Π² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ
- 11. 4. ΠΠ±ΡΠ΅ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ
- 11. 5. ΠΡΠ΅Π½ΠΊΠ° ΠΊΠ°ΡΠ΅ΡΡΠ²Π° Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΠ
- 11. 6. ΠΡΠ΅Π½ΠΊΠ° ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΠΈ ΠΌΠΎΡΠ΅Π²ΠΎΠΉ ΠΊΠΈΡΠ»ΠΎΡΡ ΠΏΠ»Π°Π·ΠΌΡ
- 11. 7. ΠΡΠ΅Π½ΠΊΠ° ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΆΠΈΠ·Π½ΠΈ
- II. 8. Π‘ΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΎΠ±ΡΠ°Π±ΠΎΡΠΊΠ° ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»Π°
- ΠΠΠΠΠ III.
- ΠΡΠ΅Π½ΠΊΠ° ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π°
- III. 1. ΠΠ½Π°Π»ΠΈΠ· ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΠΠ
- 111. 2. ΠΠ½Π°Π»ΠΈΠ· ΠΊΠ°ΡΠ΅ΡΡΠ²Π° Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΠ
- 111. 3. ΠΠ½Π°Π»ΠΈΠ· Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠΈ ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ
- 111. 4. ΠΠ½Π°Π»ΠΈΠ· Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΆΠΈΠ·Π½ΠΈ
- 111. 5. ΠΠ½Π°Π»ΠΈΠ· ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ
- ΠΠΠΠΠ IV.
- ΠΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ
- IV. 1. ΠΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΠΠ IV.2. ΠΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΠ
- IV. 3. ΠΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ Π°Π½Π°Π»ΠΈΠ·Π° ΠΌΠ΅ΡΠΎΠ±ΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ
- IV. 4. ΠΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΠΏΠΎ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠΌ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΆΠΈΠ·Π½ΠΈ ΠΠ³ΡΠ°Π½ΠΈΡΠ΅Π½ΠΈΡ Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ
- ΠΡΠ²ΠΎΠ΄Ρ
ΠΡΠ΅Π½ΠΊΠ° ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π²Π»ΠΈΡΠ½ΠΈΡ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ Π½Π° ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΠ΅ΠΉ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ (ΡΠ΅ΡΠ΅ΡΠ°Ρ, ΠΊΡΡΡΠΎΠ²Π°Ρ, Π΄ΠΈΠΏΠ»ΠΎΠΌ, ΠΊΠΎΠ½ΡΡΠΎΠ»ΡΠ½Π°Ρ)
ΠΠ° ΠΏΠΎΡΠ»Π΅Π΄Π½ΠΈΠ΅ Π΄Π΅ΡΡΡΠΈΠ»Π΅ΡΠΈΡ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ ΡΠ°Π½Π΅Π½ΠΈΡ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π»ΡΡ ΡΠ°Π·ΡΡΠ² ΠΌΠ΅ΠΆΠ΄Ρ Π΄ΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΡΡΠ²Π°ΠΌΠΈ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π°Π½ΡΠΈΠ³ΠΈΠΏΠ΅ΡΡΠ΅Π½Π·ΠΈΠ²Π½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΎΠ·Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ (Π½Π° ΡΠΎΠ½Π΅ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π°Π½ΡΠ°Π³ΠΎΠ½ΠΈΡΡΠ°ΠΌΠΈ ΠΊΠ°Π»ΡΡΠΈΡ ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΌΠΎΠ·Π³ΠΎΠ²ΠΎΠ³ΠΎ ΠΈΠ½ΡΡΠ»ΡΡΠ° Π½Π° 42%, Π²ΡΠ΅Ρ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ «ΠΊΠΎΠ½Π΅ΡΠ½ΡΡ ΡΠΎΡΠ΅ΠΊ» Π½Π° 31%, Systolic Hypertension in Europe, 1997; Π² Π·Π°Π²Π΅ΡΡΠ΅Π½Π½ΠΎΠΌ Π² 1999 Π³ΠΎΠ΄Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ Heart Outcomes Prevention Evaluation (HOPE) Π² ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈΠΠΠ€, ΡΠ°ΠΌΠΈΠΏΡΠΈΠ»ΠΎΠΌ Π²ΡΡΠ²Π»Π΅Π½ΠΎ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΈΡΠΊΠ° ΡΠΌΠ΅ΡΡΠΈ Π½Π° 25%, ΠΈΠ½ΡΠ°ΡΠΊΡΠ° ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π° Π½Π° 20% ΠΈ ΠΈΠ½ΡΡΠ»ΡΡΠ° Π½Π° 32%) ΠΈ ΡΠ΅Π°Π»ΡΠ½ΡΠΌ ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ ΡΠ°Π½Π΅Π½ΠΈΡ.
ΠΠΎ ΠΌΠ½ΠΎΠ³ΠΈΡ ΠΈΠ½Π΄ΡΡΡΡΠΈΠ°Π»ΡΠ½ΠΎ ΡΠ°Π·Π²ΠΈΡΡΡ ΡΡΡΠ°Π½Π°Ρ , Π° ΡΠ°ΠΊΠΆΠ΅ Π² Π ΠΎΡΡΠΈΠΈ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΠΠ ΠΎΡΡΠ°Π΅ΡΡΡ Π½Π΅ΡΠ΄ΠΎΠ²Π»Π΅ΡΠ²ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΡΠΌ. Π Π‘Π¨Π Π»ΠΈΡΡ 27% Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ ΠΊΠΎΠ½ΡΡΠΎΠ»ΠΈΡΡΡΡ Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΡΡ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΡ (National Health and Nutrition Examineation Survey 111,1994), Π° Π² ΡΠ΅Π»ΠΎΠΌ ΡΡΠ΅Π±ΡΠ΅ΠΌΡΠΉ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΡΡΠΎΠ²Π½Ρ ΠΠ ΠΎΡΠΌΠ΅ΡΠ°Π΅ΡΡΡ ΠΌΠ΅Π½Π΅Π΅, ΡΠ΅ΠΌ Ρ 40% Π»ΠΈΡ Ρ Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΠ΅ΠΉ (ΠΠ) Bennet S. Π. ΠΈ ΡΠΎΠ°Π²Ρ. 1] 1994 Π³ΠΎΠ΄.
Π’Π°ΠΊΠΈΠΌ ΠΎΠ±ΡΠ°Π·ΠΎΠΌ, ΠΎΡΠ΅Π²ΠΈΠ΄Π½Π° Π½Π΅ΠΎΠ±Ρ ΠΎΠ΄ΠΈΠΌΠΎΡΡΡ ΠΊΠ°ΠΊΠΈΡ -ΡΠΎ Π½ΠΎΠ²ΡΡ ΠΏΠΎΠ΄Ρ ΠΎΠ΄ΠΎΠ², ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡΡΠΈΡ ΡΠΌΠ΅Π½ΡΡΠΈΡΡ ΡΠ°Π·ΡΡΠ² ΠΌΠ΅ΠΆΠ΄Ρ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡΡ ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΎΠ·Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΡ.
ΠΠ΄Π½ΠΈΠΌ ΠΈΠ· ΡΠ°ΠΊΠΈΡ ΠΏΠΎΠ΄Ρ ΠΎΠ΄ΠΎΠ², ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΡΡΡΠΊΡΡΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ΅ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ [2].
ΠΠΎΠΊΠ°Π·Π°Π½ΠΎ Π² ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡΡ , ΡΡΠΎ ΡΠ°ΠΊΠΎΠΉ ΠΏΠΎΠ΄Ρ ΠΎΠ΄ ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ ΡΠ»ΡΡΡΠ°Π΅Ρ ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ Ρ ΡΠ°Π·Π»ΠΈΡΠ½ΡΠΌΠΈ Π½Π΅ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΎΠ½Π½ΡΠΌΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡΠΌΠΈ (ΡΠ°Ρ Π°ΡΠ½ΡΠΉ Π΄ΠΈΠ°Π±Π΅Ρ, Π±ΡΠΎΠ½Ρ ΠΈΠ°Π»ΡΠ½Π°Ρ Π°ΡΡΠΌΠ°, Π₯Π‘Π)[3,4,2]. Π ΡΠΎ ΠΆΠ΅ Π²ΡΠ΅ΠΌΡ Π²Π»ΠΈΡΠ½ΠΈΠ΅ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ Π½Π° ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΡΡ (ΠΠ), Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ ΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ, ΠΈΠ·ΡΡΠ΅Π½ΠΎ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎ.
ΠΠΎΡΡΠΎΠΌΡ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΠ΅ΡΡΡ Π°ΠΊΡΡΠ°Π»ΡΠ½ΡΠΌ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎΡΠ²ΡΡΠ΅Π½Π½ΠΎΠ³ΠΎ ΠΎΡΠ΅Π½ΠΊΠ΅ Π²Π»ΠΈΡΠ½ΠΈΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ Π½Π° ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΠ.
ΠΠΎΠ²ΠΈΠ·Π½Π° ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ.
ΠΠΏΠ΅ΡΠ²ΡΠ΅ Π² ΡΠ°ΠΌΠΊΠ°Ρ ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΎΡΠ΅Π½ΠΊΠ° Π²Π»ΠΈΡΠ½ΠΈΡ Π½Π° ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΡΡ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ.
Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ.
Π ΡΠ°ΠΌΠΊΠ°Ρ ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΎΡΠ΅Π½ΠΈΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΡΡΡΡΠΊΡΡΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ Π½Π° ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΡΡ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ.
ΠΠ°Π΄Π°ΡΠΈ.
1. Π Π°Π·ΡΠ°Π±ΠΎΡΠ°ΡΡ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΡ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΠ΅ΠΉ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΠΈ ΠΎΡΠ΅Π½Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ, Π½Π°Π±Π»ΡΠ΄Π°ΡΡΠΈΡ ΡΡ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ ΡΠ°Π½Π΅Π½ΠΈΡ.
2. ΠΠ·ΡΡΠΈΡΡ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΠΊΡΠΈΡΠ΅ΡΠΈΠΈ ΠΎΡΠ΅Π½ΠΊΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΠ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΠΈ ΠΎΡΠ΅Π½Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ ΠΏΠΎ ΠΊΡΠΈΡΠ΅ΡΠΈΡΠΌ ΠΊΠΎΠ½ΡΡΠΎΠ»ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΡΠΎΠ²Π½Ρ ΠΠ, ΡΠ°ΠΊΡΠΎΡΠ°ΠΌ ΡΠΈΡΠΊΠ° ΠΈ ΠΏΠΎ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠΌ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΆΠΈΠ·Π½ΠΈ (ΠΠ).
Π‘ ΠΏΠΎΠΌΠΎΡΡΡ Π²ΡΡΠ΅ΡΠΊΠ°Π·Π°Π½Π½ΡΡ ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² Π² ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΌ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΠΏΡΠΎΠ²Π΅ΡΡΠΈ ΠΎΡΠ΅Π½ΠΊΡ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΠ΅ΠΉ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΠΈ ΠΎΡΠ΅Π½Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ.
ΠΡΠΎΠ²Π΅ΡΡΠΈ ΠΎΡΠ΅Π½ΠΊΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΡΡΡΠΊΡΡΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² ΠΎΡΠ΅Π½ΠΊΠΈ Ρ ΠΎΠ±ΡΡΠ°Π²ΡΠΈΡ ΡΡ ΠΈ Π½Π΅ ΠΎΠ±ΡΡΠ°Π²ΡΠΈΡ ΡΡ Π±ΠΎΠ»ΡΠ½ΡΡ .
ΠΠ° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΡ Π΄Π°Π½Π½ΡΡ , ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°ΡΡ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ ΠΏΠΎ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΠ΅ΠΉ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎΡΠΎΡΡΠ΄ΠΈΡΡΡΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ.
ΠΡΠ²ΠΎΠ΄Ρ.
1. Π ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ΅ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ ΠΈ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ 62% ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠ ΠΈ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ Π΄ΠΎΡΡΠΈΠ³Π»ΠΈ ΡΠ΅Π»Π΅Π²ΠΎΠ³ΠΎ ΡΡΠΎΠ²Π½Ρ ΠΠ.
2. ΠΠ° ΡΠΎΠ½Π΅ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΠ»ΡΡΡΠ°Π΅ΡΡΡ ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎ ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΎΠ·Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΠ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ: ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°Π΅ΡΡΡ Π΄ΠΎΠ»Ρ Π±ΠΎΠ»ΡΠ½ΡΡ , ΠΏΠΎΠ»ΡΡΠ°ΡΡΠΈΡ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ Π°Π½ΡΠΈΠ³ΠΈΠΏΠ΅ΡΡΠ΅Π½Π·ΠΈΠ²Π½ΡΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΡ (ΠΠΠΠ€, Π΄ΠΈΡΡΠ΅ΡΠΈΠΊΠΈ ΠΈ Π±Π΅ΡΠ°-Π°Π΄ΡΠ΅Π½ΠΎΠ±Π»ΠΎΠΊΠ°ΡΠΎΡΡ).
3. ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΡΡΡΡΠΊΡΡΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΠ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ ΡΠ°Π½Π΅Π½ΠΈΡ ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π΅ΡΡΡ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΠΌΠΈ Π²ΡΠ°ΡΠ΅Π±Π½ΡΡ ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΎΠ·Π½ΡΡ ΠΈ Π½Π΅ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΎΠ·Π½ΡΡ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ.
4. Π£ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΏΡΠΎΡΠ΅Π΄ΡΠΈΡ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ ΠΎΡΠΌΠ΅ΡΠ°Π΅ΡΡΡ ΡΠ΅Π½Π΄Π΅Π½ΡΠΈΡ ΠΊ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ.
5. ΠΠ±ΡΡΠ΅Π½ΠΈΠ΅ Π±ΠΎΠ»ΡΠ½ΡΡ ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π΅ΡΡΡ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΡΠΌ ΡΠ»ΡΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΆΠΈΠ·Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΏΠΎ ΡΠΊΠ°Π»Π°ΠΌ Π²ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊΠ° SF-36.
ΠΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ.
ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΡΡΡΡΠΊΡΡΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΠ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ ΡΠ΅Π»Π΅ΡΠΎΠΎΠ±ΡΠ°Π·Π½ΠΎ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°ΡΡ Π² Π°ΠΌΠ±ΡΠ»Π°ΡΠΎΡΠ½ΡΡ ΠΈ ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ½ΡΡ ΡΡΠ»ΠΎΠ²ΠΈΡΡ ΡΡΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠΉ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ ΡΠ°Π½Π΅Π½ΠΈΡ Π΄Π»Ρ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° Π»Π΅ΡΠ΅Π½ΠΈΡ, Π²ΠΊΠ»ΡΡΠ°Ρ ΠΊΠ°ΠΊ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΡΡΠΎΠ²Π½Ρ ΠΠ, ΡΠ°ΠΊ ΠΈ Π΄ΡΡΠ³ΠΈΡ ΠΌΠΎΠ΄ΠΈΡΠΈΡΠΈΡΡΠ΅ΠΌΡΡ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ° ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ.
Π‘ΠΏΠΈΡΠΎΠΊ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ
- Bennett SA, Magnus P. Trends in cardiovascular risk factors in Astralia. Results fron the National Heart Foundations Risk Factor Prevalence Stady, 1980−1989 Med J Australia 1994- 161: 519−527
- Jaarsma Π’., Halfens R., Huijer Abu-Saad H., Dracup K., Gor-gels Π’., van Ree J., Stappers J. Effects of education and support on self-care and resource utilization in patients with heart failure. Eur. Heart J. 1999- 20: 673−682
- Arnold P, Stepka-Trasey C, Zheng D, Sterrett J, Babb E, Her-mayer Π von hove S, Carson D, Price W- Sayers S- Lindemann R Diabetes patient education. JS Π‘ Med Assoc 1998- Nov- 94(11):478−84
- Sudre P, Jasqument S, Uldry C, Perneger TV, Objectives, methods and content of patient education programmes for adults with asthma: systematic riview of stadies published between 1979 and 1998. Thorax 1999 Aug-54(8):681−7
- Clark N.M., Gong M. Management of chronic disease by practitioners and patients: are we teaching the wrong things? BMJ 2000−320:572−575.
- Ellis J, Mulligan, Rowe J, Sackett DL. Inpatient general medicine is evidence-based. A-team, Nuffield Department of Clinical Medicine. Lancet 1995−345:407−410.
- Mac Mahon S, Rodgers A. The effects of antihypertensive treatment on vascular disease: Reappraisal of the evidence in 1994. J Vase Med Biol 1993- 4: 265−271
- Veterans Administration Cooperative Study Group on Antihypertensive Agents. Effects of treatment on morbidity in hypertension. Results in patients with diastolic blood pressures averaging. 115 through 129 mmHg. JAMA 1967- 212: 1028−1034
- Veterans Administration Cooperative Study Group on Antihypertensive Agents. Effects of treatment on morbidity in hypertension. Results in patients with diastolic blood pressures averaging. 90 through 129 mmHg. JAMA 1970- 213: 1143−1152
- Medical Research Council Working Party. MRC trial on treatment of hypertension: principle results. BMJ 1985:291:97−104
- Dahlof Π, Lindeholm LH, Hansson L. Morbidity and mortality in the Swedish trial in old patients with hypertension (STOP-Hypertension). Lancet 1991- 338: 1281−1284
- SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. JAMA 1991- 265: 3255−3264
- The Heart Outcome Prevention Evaluation Study Investigators. Effects of an angiotensin-converting enzyme inhibitor, ramipril, on death from cardiovascular causes, myocardial infarction and stroke in high risk patients. N Engl J Med 2000- 342: 145−153
- Hollenberg NK, Sever PS. The past, present and future of hypertension management: a potential role for ATi-receptor antagonists. J Renin-Angiotensin-Aldosteron System 2000- 1(1): 5−10
- Hansson L, Lindholm LH, Niskanen L, Lanke J, Hedner T, Niklason A, Luomanmaki K, Dahlof B, de Faire U, Morlin C, Karlberg BE, Wester PO, Bjorck J-E, for the Captopril Prevention Project (CAPPP) study group.
- National Health and Nutrition Examination Survey III (NHANES III). National Center for Health Statistics, Centers for Disease Control and Prevention, 1994
- Health Survey for England '96. Volume 1. London: The Stationery Office, 1998.
- Isles CG, Walker LM, Beevers GD. Mortality in patients of the Glasgow Blood Pressure Clinic. J Hypertens 1986- 4: 141−156
- Frohlich ED. The necessity for recognition and treatment of patients with «mild» hypertension. Am J Coll Cardiol 1999- 34(5): 13 691 377
- JCAHO. (1998). Comprehensive accreditation manual for hospitals: The official handbook. Oakbrook Terrace, IL: Joint Commission on Accreditation of Health Care Organizations.
- Todd WE, Nash D: Disease Management: A Systems Approach to Improving Patient Outcomes. American Hospital Publishing Inc., Chicago, 1996.
- Campbell G.R. The enigma of hypertension management. Pharmacare Economics 1996, 11:16−23.
- Bernard DB, Townsend RR, Sylvestri MF. Health and disease management: what is it and where is it going?: what is the role of health and disease management in hypertension? Am J Hypertens 1998- 11(8 Part 2): 103S-108S
- Dahlof B, Devereux RB, Julius S. Characteristics of 9194 patients with left ventricular hypertrophy: the LIFE study. Losartan Intervention For Endpoint reduction in hypertension. Hypertension 1998- 32: 989−997
- Hansson L., Lithell H, Skoog. Study on COgnition and Prognosis in the Elderly (SCOPE). Blood pressure 1999- 8: 177−183
- Mann J, Julius S. The Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial of cardiovascular events in hypertension. Rational and design. Blood pressure 1998- 7:176−183
- Ferran Mercade M, Casabella Abril B, Parcet Solsona J, Fernandez Ferre LI Health educations in arterial hypertension/ Aten Pri-maria 1990: Mar- 7(3) 194, 196−8
- German C, Heierle C, Zunzunegui MV, Contreras E, Blanco P, Ruis E, Salas A. The control of arterial hypertension in primary care the evaluation of a program of self-care. Aten Primaria 1994 Jan- 13(1) 3−7.
- Marquez Contreras E, Casado Martinez JJ, Jelotti Gomes B, Gascon Vivo J, Martin de Pablos JL Anten Primaria 1998 Mar 15- 21 (4): 199−204.
- Sousa AL, Jardim PC, Monego ET, Raimundo MS, Lopes KE, Coelho J, Santos R, Condim MR. Multidisciplinary expirience in the approach to the hypertensive patient. Arq Bras Cardiol 1992 Jul- 59(1): 315.
- Consoli SM, Ben Said M, ean J, Menard J, Plouin PF, Chatel-lier. Benefits of a computer-assisted education program for hypertensive patients compared with standard education tools. Patient Educ Couns 1995 Sep- 26(1−3): 343−7.
- Vacheron A., The «health booklet for hypertensive patients». Rev Prat 1990: Jun- 21 40(18Suppl) 57−9.
- Silaste M, Dietary and other non-pharmacological treatments in patients with drug-treated hypertension and control intern med 2000 mar 247- (3):318−24.
- Ramsay LE. Weight reduction in a blood pressure clinic. 1978- 2: 244−5.Ρ
- Reisin E. Effect of weight loss without salt restriction on the reduction of blood pressure in over weight hypertensive patients. 1978- 298: 1−6
- Haynes RB Failure of weight reduction to reduse mildly elevated pressure a randomized trial 1984
- Mac Mahon Mahon Comparison of weight reduction with metoprolol in treatment of hypertension in young over weight patient
- Oberman A Pharmacologic and nutritional treatment of mild hypertension changes in cardiovascular risk status 1990
- Colanowski J. Effect of dexfenfluramine treatment on body weight blood ressure and noradrenergic activity in obese hypertensive patients. 1992- 42: 599−605.
- Fagerberg B. Weight reduction versus antihypertensive drug therapy in obese men with high blood pressure: effects upon plasma insulin. 1992- 10: 1053−61.
- Whelton PK. Sodium reduction and eight loss in the treatment of hypertension in older patients 1998- 79: 839−46.
- Morgan T, Adam W, Gillies A, et al. Hypertension treated by salt restriction. Lancet 1978- 227−230.
- Costa F., Effect of a low-salt diet and of acute salt loading on blood pressure and intralymfocytic sodium cocentration in young subjects with borderline hypertension Clin Sci 1981- 61:21S- 23S.
- Silman A, Locke C, Mitchel P, Humpherson P Evaluation of the effectivenes of a low sodium diet in the treatment of mild to moderate hypertension. Lancet 1983- i: 1179−1184.
- ErwetemanT, Nagelkerke N, Lubsen J, Koster M, Dunning A. B- Blocade diuretics and salt restriction for the management of mild hypertension a randomised double blind trial. Br Med J 1984- 289:406−409.
- Logan A. Sodium manipuletion in the management of hypertension. The view against its general use. Can JRhysiol 1986- 64: 793 802.
- Langford H Effect of drug and diet treatment of mild hypertension on diastolic blood pressure Hypertension 1991- 17: 210 217.
- Herbert P.R., Trials of hypertension Prevention (TOHP) Collaborative Research group Ann Epidemiol 1995- 5: 130−139.
- Reisin E, Abel R, Modan M. et el Effect of weaigth loss without salt restriction on the reduction of blood pressure in overvweight hypertensive patients. N Engl J Med 1978- 298: 1−6.
- Croft P, Brigg D, Smith S. et el How useful is weight reduction in the management of hypertension. J R Coll Gen Pract 1986- 36: 445−448
- Langford H., Effect of drug and diet treatment of mild hypertension on diastolic blood pressure Hypertension 1991- 17: 210 217.
- Jalcanen L The effect of a weight reduction program on cardiovascular risk factors among overweight hypertensives in primary care. Scand J Social Med 1991- 19:66−71
- Hypertension prevention Trial research Group. The Hyper-tensin Prevention Trial three-year effects of dietary changes on blood pressure. Archs Intern Med 1990- 150: 153−162.
- Wing RR, Jeffery RW. Effect of modest weight loss on changes in cardiovascular risk factors are there differences between men and women or between weight loss and maintanance. Int J Obesity 1995- 19: 67−73.
- Trials of hypertension Prevention Collaborative Research Group. The effect of nonfarmacologic interventions on blood pressure ofpersons with high normal levels Results of the trials of Hypertension Prevention. JAMA 1992- 267: 1213−1220.
- Fortmann S, Haskell W, Wood P. et al Effects of weight loss on clinic and ambulatory blood pressure in normotensive men. Am J Cardiol 1988- 62: 89−93.
- Patel C, Marmot M. Can general practicioners use training in relaxation and management of stress to reduse mild hypertension. Br Med J1988- 296:21−24.
- Van Montfranse G A Karemaker JM Wiling W Dunning A J Relaxeation therapy and continuous ambulatory blood pressure in mild hypertension an controlled study 1990 300 1368−1372
- Patel C, Marmot M. Can general practicioners use training in relaxation and management of stress to reduse mild hypertension. Br Med J1988- 296:21−24.
- Bennet P, Carroll D. Stress management approaches to the prevention of coronary heart diseaseio. Br J Clin Psych 1990- 29: 1−12.
- Johnston DW, Gold A. Kentish et al Effect of stress management on blood pressure in primary hypertension. Br Med J 1993- 306: 963−966.
- Johnston DW, Gold A, Kentish et al Effect of stress management on blood pressure in primary hypertension. Br Med J 1993- 306: 963−966.
- Canino E, Cardona R, Monsalve P. et al A behaveroural treatment program as therapy in the control of primary hypertension. Acta Cientifica Venesolana 1994- 45: 23−30.
- Hagberg G. Effect of exersise training in 60−69 year-old persons with essential hypertension .1989- 64: 348−353.
- Hellenius M. Diel and exesises are eqully effective in redusing risk for cardiovascular disease 1993- 103: 81−91.
- Mac Keen PC. A 13-year follow up of a coronary heart disease risk factor screening and exercise program for 40to50 year old men: exercise habit maintenance and physiologic status.
- King A. Group-vs home- based exercise training in healthy older men and women 1991- 266: 1535−1542.
- Stensel D. Brisk walking and serum lipoprotein variables in formerly sedentary men aged 42−59 years. 1993- 85: 701−708.
- Juneau M. Effectivenes of self monitored home-based moderate intensity exersise training in middle-aged men and women. Am j Cardiol 1987- 60: 66−70.
- Anderssen SA. Diet and Exersise stady a one year randomized intervention trial. Nutr Metab Cardiovasc Dis 1995- 5:189−200.
- Capuccio F. Does potassium suplementation and blood pressure? A meta analysis of published trials. 1991- 9: 465−473.
- ΠΠΎΠ±Π°Π»Π°Π²Π° Π.Π. ΠΠ΅ΠΆΠ΄ΡΠ½Π°ΡΠΎΠ΄Π½ΡΠ΅ ΡΡΠ°Π½Π΄Π°ΡΡΡ Π»Π΅ΡΠ΅Π½ΠΈΡ Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΠΈ: ΡΠΎΠ³Π»Π°ΡΠΎΠ²Π°Π½Π½ΡΠ΅ ΠΈ Π½Π΅ΡΠΎΠ³Π»Π°ΡΠΎΠ²Π°Π½Π½ΡΠ΅ ΠΏΠΎΠ·ΠΈΡΠΈΠΈ. Π’ΡΡΠ΄Ρ ΠΏΠ΅ΡΠ²ΠΎΠ³ΠΎ ΠΌΠ΅ΠΆΠ΄ΡΠ½Π°ΡΠΎΠ΄Π½ΠΎΠ³ΠΎ ΡΠΎΡΡΠΌΠ° ΠΠ°Ρ. 1999: 208 209.
- Π¨ΠΈΠ»Π»Π΅Ρ Π., ΠΡΠΈΠΏΠΎΠ² Π. Π. ΠΠΈΠ°ΡΡΠΎΠ»ΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΡΠ½ΠΊΡΠΈΡ Π»Π΅Π²ΠΎΠ³ΠΎ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠ°. ΠΠ°ΡΡΠ° ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π° Π»Π΅Π²ΠΎΠ³ΠΎ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠ°. ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΡ ΠΎΠΊΠ°ΡΠ΄ΠΈΠΎΠ³ΡΠ°ΡΠΈΡ 1993:66−73
- ΠΠΈΠ»ΡΡΠ΅Π²ΡΠΊΠΈΠΉ Π‘. Π . ΠΡΠ»ΠΎΠ² Π.Π. ΠΈ ΡΠΎΠ°Π²Ρ. Π‘ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½Π°Ρ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ»ΠΎΠ³ΠΈΡ ΠΎΡΠ΅Π½ΠΊΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΆΠΈΠ·Π½ΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ Ρ Ρ ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΡΡ.
- Green CP, Porter Π‘Π, Bresnahan DR, Spertus JA. Development and evaluation of the Kansas City Cardiomyopaty Questionnaire: a new health status measure for heart failure. J Am Coll Cardiol 2000- 35(5): 1245−55
- Edelman D, Williams GR, Rothman M, Samsa GP. A comparison of three health status measures in primary care outpatients. J Gen Intern Med 1999- 14(12): 759−62
- Perneger TV, Leplege A, Guillain H, Ecosse E, Etter JF COOP Charts in French: translation and prelminary data on instrument properties. Quil Life Res 1998- 7(8): 683−92
- Scharg A, Selai C, Jahanshahi M, Quinn NP. The EQ-5D-a generic quility of life in patients with Park-insons disease. J Neurol Neu-rosurg Psychiatry 2000 Jul- 69(l):67−73
- Leplege A, Ecosse E, Verdier A, Perneger TV. The French SF-36 Health Survey translation validation and norming J Clin Epidemiol 1998- 51 (11): 1013−23
- Quittan M, Sturm B, Wiesinger GF, Pacher R, Fialka-Moser V Quality of life in patients with chronic heart failure: a randomised controlled trial of changes indused by a regular exercise program. Scand J Rehabil Med 1999- 31 (4): 223−8.
- Apolone G, Mosconi P. The italian SF-36 Health Survey: translation validation and norming. J Clin Epidemiol 1998- 51(11) 102 536
- Alonso J, Regigor E, Barrio G, Prieto L, Rodriguez Π‘ de la Fuente L. Population reference values of the Spanish version of the Health Questionnaire SF-36. Med Clin (Bare) 1998- 111(11): 410−6
- Bjorner JB, Thunedborg K, Kristenser TS, Modvig J, Bech P. The Danish SF-36 Health Survey translation and preliminary validity studies. J Clin Epidemiol 1998 51(11): 991−9
- Fucuhara S, Ware JE Jr, Kosinski M, Wada S, Gandec B. Psychometric and clinical tests of validity of the Japanese SF-36 Health Survey .J Clin Epidemiol 1998- 51(11): 1045−53.
- Lam CL Gandec Π Ren XS Chan MS Tests of scaling assumptions and construct validity of the Chinese (HK) version of the SF-36 Health Survey J Clin Epidemiol 1998- 51(11): 1139−47
- ΠΠΈΠΎΡΡΠ°Ρ. ΠΡΠΎΠ³ΡΠ°ΠΌΠΌΠ° Π΄Π»Ρ IBM PISI ΡΠΎΠ²ΠΌΠ΅ΡΡΠ½ΡΡ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠΎΠ². ΠΠ·Π΄Π°ΡΠ΅Π»ΡΡΠΊΠΈΠΉ Π΄ΠΎΠΌ «ΠΡΠ°ΠΊΡΠΈΠΊΠ°», 1999
- Kannel WB, Gordon Π’ and Schwartz MJ Systolic versus diastolic blood pressure and risk of coronary heart disease: the Framingham Study. Am J Cardiol 1971,27:335−345
- Rogers MA, Small D, Buchan DA, et al. Home monitoring service improves mean arterial pressure in patients with essential hypertension A randomized controlled trial. Ann Intern Med 2001 Jun 5- 134: 1024−32
- Kaplan NM. Multiple risk factors for coronary heart disease in patients with hypertension. J hypertens 1995 Aug 13 (Suppl.2):Sl-S5
- Gleason J.A., Bourdet KL, Koehn K, Holay SY, Schaefer EJ. Cardiovascular risk reduction and dietary compliance with a home-delivered diet and lifestyle modification program. Related Articles, Links J Am Diet Assoc 2002 Oct- 102(10): 1445−51
- ΠΠΈΠ»ΡΡΠ΅Π²ΡΠΊΠΈΠΉ C.P., ΠΡΠ»ΠΎΠ² B.A., Π₯Π°ΠΌΠ°Π³Π°Π½ΠΎΠ²Π° Jl.K. ΠΠ»ΠΈΡΠ½ΠΈΠ΅ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ Ρ Π₯Π‘Π Π½Π° ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎ ΠΈΡ ΠΆΠΈΠ·Π½ΠΈ ΠΈ ΠΏΠΎΡΡΡΠ΅Π±Π½ΠΎΡΡΡ Π² ΡΠ°Π½Π½ΠΈΡ ΠΏΠΎΠ²ΡΠΎΡΠ½ΡΡ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΡΡ . ΠΠΊΡΡΠ°Π»ΡΠ½ΡΠ΅ Π²ΠΎΠΏΡΠΎΡΡ ΡΡΠ°Π½ΡΠΏΠΎΡΡΠ½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½Ρ. 2001,6,412−416