Π”ΠΈΠΏΠ»ΠΎΠΌ, курсовая, ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»ΡŒΠ½Π°Ρ Ρ€Π°Π±ΠΎΡ‚Π°
ΠŸΠΎΠΌΠΎΡ‰ΡŒ Π² написании студСнчСских Ρ€Π°Π±ΠΎΡ‚

БистСмныС ΠΈ мСтаболичСскиС эффСкты Π³ΠΎΡ€ΠΌΠΎΠ½Π° роста Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹ΠΌΠΈ Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Π°ΠΌΠΈ низкорослости

Π”ΠΈΡΡΠ΅Ρ€Ρ‚Π°Ρ†ΠΈΡΠŸΠΎΠΌΠΎΡ‰ΡŒ Π² Π½Π°ΠΏΠΈΡΠ°Π½ΠΈΠΈΠ£Π·Π½Π°Ρ‚ΡŒ ΡΡ‚ΠΎΠΈΠΌΠΎΡΡ‚ΡŒΠΌΠΎΠ΅ΠΉ Ρ€Π°Π±ΠΎΡ‚Ρ‹

На Ρ„ΠΎΠ½Π΅ Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π  ΠΈ ΠΈΠ½Ρ‚Снсивного роста костСй Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ происходит Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠ΅ ΠΏΠΎΠ²Ρ‹ΡˆΠ΅Π½ΠΈΠ΅ содСрТания ΠΎΠ±Ρ‰Π΅ΠΉ ΠΈ ΠΊΠΎΡΡ‚Π½ΠΎΠΉ Ρ„Ρ€Π°ΠΊΡ†ΠΈΠΈ Ρ‰Π΅Π»ΠΎΡ‡Π½ΠΎΠΉ фосфатазы, ΠΎΡΡ‚Π΅ΠΎΠΊΠ°Π»ΡŒΡ†ΠΈΠ½Π° Π² ΡΡ‹Π²ΠΎΡ€ΠΎΡ‚ΠΊΠ΅ ΠΊΡ€ΠΎΠ²ΠΈ, Ρ‡Ρ‚ΠΎ ΡΠ²ΠΈΠ΄Π΅Ρ‚Π΅Π»ΡŒΡΡ‚Π²ΡƒΠ΅Ρ‚ ΠΎ ΠΏΠΎΠ²Ρ‹ΡˆΠ΅Π½ΠΈΠΈ активности остСобластов ΠΈ ΠΏΡ€ΠΎΡ†Π΅ΡΡΠΎΠ² остСосинтСза. Π£Π²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΠ΅ ΠΊΠΎΠ½Ρ†Π΅Π½Ρ‚Ρ€Π°Ρ†ΠΈΠΈ Π² ΡΡ‹Π²ΠΎΡ€ΠΎΡ‚ΠΊΠ΅ ΠΊΡ€ΠΎΠ²ΠΈ ΠΌΠ°Ρ€ΠΊΠ΅Ρ€Π° костной Ρ€Π΅Π·ΠΎΡ€Π±Ρ†ΠΈΠΈ (Π‘-ΠΊΠΎΠ½Ρ†Π΅Π²Ρ‹Ρ…… Π§ΠΈΡ‚Π°Ρ‚ΡŒ Π΅Ρ‰Ρ‘ >

Π‘ΠΎΠ΄Π΅Ρ€ΠΆΠ°Π½ΠΈΠ΅

  • Π’Π’Π•Π”Π•ΠΠ˜Π•
  • ГЛАВА I. ΠžΠ±Π·ΠΎΡ€ Π»ΠΈΡ‚Π΅Ρ€Π°Ρ‚ΡƒΡ€Ρ‹: «Π‘истСмныС ΠΈ ΠΌΠ΅Ρ‚аболичСскиС эффСкты Π³ΠΎΡ€ΠΌΠΎΠ½Π° роста Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹ΠΌΠΈ Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Π°ΠΌΠΈ 10 низкорослости — соврСмСнноС состояниС ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌΡ‹»
  • ГЛАВА II. ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹ исслСдования
  • ГЛАВА III. ΠΠ°Ρ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½Ρ‹ΠΉ рСгистр Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… соматотропной ^ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ Π² Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅Ρ€Π°Ρ†ΠΈΠΈ
    • 3. 1. Π‘ΠΎΠ·Π΄Π°Π½ΠΈΠ΅ ΠΠ°Ρ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½ΠΎΠ³ΠΎ рСгистра Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ
    • 3. 2. Π Π°ΡΠΏΡ€ΠΎΡΡ‚Ρ€Π°Π½Π΅Π½Π½ΠΎΡΡ‚ΡŒ соматотропной нСдостаточности Π² Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅Ρ€Π°Ρ†ΠΈΠΈ
    • 4. 2. Π”Π΅Ρ„ΠΈΡ†ΠΈΡ‚ Π“Π  с Π½Π°Π»ΠΈΡ‡ΠΈΠ΅ΠΌ ΠΈΠ»ΠΈ отсутствиСм ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ со ΡΡ‚ΠΎΡ€ΠΎΠ½Ρ‹ Π³ΠΈΠΏΠΎΡ‚Π°Π»Π°ΠΌΠΎ-Π³ΠΈΠΏΠΎΡ„ΠΈΠ·Π°Ρ€Π½ΠΎΠΉ области Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ
    • 7. 2. ΠΠΈΠ·ΠΊΠΎΡ€ΠΎΡΠ»ΠΎΡΡ‚ΡŒ, обусловлСнная Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹ΠΌ ΠΏΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ Π³Π»ΡŽΠΊΠΎΠΊΠΎΡ€Ρ‚ΠΈΠΊΠΎΠΈΠ΄ΠΎΠ² (рСвматичСскиС заболСвания)
  • ГЛАВА IV. ВроТдСнная Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒ Π³ΠΎΡ€ΠΌΠΎΠ½Π° роста Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ
    • 4. 1. Π˜Π·ΠΎΠ»ΠΈΡ€ΠΎΠ²Π°Π½Π½Ρ‹ΠΉ Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ Π“Π  ΠΈ ΠΌΠ½ΠΎΠΆΠ΅ΡΡ‚Π²Π΅Π½Π½Ρ‹ΠΉ Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ Π³ΠΎΡ€ΠΌΠΎΠ½ΠΎΠ² ^ Π°Π΄Π΅Π½ΠΎΠ³ΠΈΠΏΠΎΡ„ΠΈΠ·Π°
  • ГЛАВА V. ΠŸΡ€ΠΈΠΎΠ±Ρ€Π΅Ρ‚Π΅Π½Π½Π°Ρ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒ Π³ΠΎΡ€ΠΌΠΎΠ½Π° роста Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ
    • 5. 1. Клинико-Π³ΠΎΡ€ΠΌΠΎΠ½Π°Π»ΡŒΠ½Π°Ρ характСристика ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² послС ΡƒΠ΄Π°Π»Π΅Π½Π½ΠΎΠΉ ΠΊΡ€Π°Π½ΠΈΠΎΡ„Π°Ρ€ΠΈΠ½Π³ΠΈΠΎΠΌΡ‹
    • 5. 2. ВлияниС Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π  Π½Π° Ρ€ΠΎΡΡ‚ΠΎΠ²Ρ‹Π΅ ΠΏΠ°Ρ€Π°ΠΌΠ΅Ρ‚Ρ€Ρ‹ Ρƒ ^^ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² послС ΡƒΠ΄Π°Π»Π΅Π½Π½ΠΎΠΉ ΠΊΡ€Π°Π½ΠΈΠΎΡ„Π°Ρ€ΠΈΠ½Π³ΠΈΠΎΠΌΡ‹
    • 5. 3. Π”Π΅Ρ„ΠΈΡ†ΠΈΡ‚ Π“Π  ΠΏΡ€ΠΈ Π΄Ρ€ΡƒΠ³ΠΈΡ… случаях ΠΏΡ€ΠΈΠΎΠ±Ρ€Π΅Ρ‚Π΅Π½Π½ΠΎΠΉ нСдостаточности Π“Π 
  • ГЛАВА VI. Π€Π°ΠΊΡ‚ΠΎΡ€Ρ‹, ΠΎΠΏΡ€Π΅Π΄Π΅Π»ΡΡŽΡ‰ΠΈΠ΅ ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ лСчСния Ρ€- ^^ Π“Π  Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ
    • 6. 1. ВлияниС Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹Ρ… Π΄ΠΎΠ· Ρ€-Π“Π  Π½Π° ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ лСчСния Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ
    • 6. 2. ВлияниС ΠΏΡƒΠ±Π΅Ρ€Ρ‚Π°Ρ‚Π° Π½Π° ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ лСчСния Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ
    • 6. 3. ВлияниС возраста Π½Π°Ρ‡Π°Π»Π° Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π  Π½Π° ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ ΠΊΠΎΠ½Π΅Ρ‡Π½ΠΎΠ³ΠΎ роста Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ
  • ГЛАВА VII. ВСрапия Ρ€-Π“Π  Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π΄Ρ€ΡƒΠ³ΠΈΠΌΠΈ Ρ„ΠΎΡ€ΠΌΠ°ΠΌΠΈ 121 низкорослости
    • 7. 1. Π‘ΠΈΠ½Π΄Ρ€ΠΎΠΌ Π¨Π΅Ρ€Π΅ΡˆΠ΅Π²ΡΠΊΠΎΠ³ΠΎ-Π’Π΅Ρ€Π½Π΅Ρ€Π°
  • ГЛАВА VIII. Π˜Π½ΡΡƒΠ»ΠΈΠ½ΠΎΠΏΠΎΠ΄ΠΎΠ±Π½Ρ‹ΠΉ Ρ„Π°ΠΊΡ‚ΠΎΡ€ роста — 1 ΠΈ Π΅Π³ΠΎ ΡΠ²ΡΠ·Ρ‹Π²Π°ΡŽΡ‰ΠΈΠΉ Π±Π΅Π»ΠΎΠΊ — 3 Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹ΠΌΠΈ Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Π°ΠΌΠΈ 130 низкорослости
  • ГЛАВА IX. БостояниС костной Ρ‚ΠΊΠ°Π½ΠΈ Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ
    • 9. 1. ВлияниС Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚Π° Π“Π  ΠΈ Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π  Π½Π° ΠΌΠΈΠ½Π΅Ρ€Π°Π»ΡŒΠ½ΡƒΡŽ массу ΠΈ ΠΌΠΈΠ½Π΅Ρ€Π°Π»ΡŒΠ½ΡƒΡŽ ΠΏΠ»ΠΎΡ‚Π½ΠΎΡΡ‚ΡŒ костной Ρ‚ΠΊΠ°Π½ΠΈ Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ
    • 9. 2. ВлияниС Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π  Π½Π° ΡΠΎΠ΄Π΅Ρ€ΠΆΠ°Π½ΠΈΠ΅ биохимичСских ΠΌΠ°Ρ€ΠΊΠ΅Ρ€ΠΎΠ² костного ΠΌΠ΅Ρ‚Π°Π±ΠΎΠ»ΠΈΠ·ΠΌΠ° ΠΈ Ρ„осфорно-ΠΊΠ°Π»ΡŒΡ†ΠΈΠ΅Π²Ρ‹ΠΉ ΠΎΠ±ΠΌΠ΅Π½ Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с 144 соматотропной Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ
  • ГЛАВА X. БостояниС ΠΆΠΈΡ€ΠΎΠ²ΠΎΠ³ΠΎ ΠΎΠ±ΠΌΠ΅Π½Π° Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹ΠΌΠΈ ^^ Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Π°ΠΌΠΈ низкорослости
    • 10. 1. ИндСкс массы Ρ‚Π΅Π»Π° Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ ΠΈ Π΅Π³ΠΎ Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ° Π½Π° Ρ„ΠΎΠ½Π΅ Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π 
    • 10. 2. Π‘ΠΎΠ΄Π΅Ρ€ΠΆΠ°Π½ΠΈΠ΅ ΠΆΠΈΡ€ΠΎΠ²ΠΎΠΉ ΠΈ Ρ‚ΠΎΡ‰Π΅ΠΉ массы Π² ΠΎΡ€Π³Π°Π½ΠΈΠ·ΠΌΠ΅ Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ ΠΈ Π΅Π³ΠΎ Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ° Π½Π° Ρ„ΠΎΠ½Π΅ 157 Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π 
    • 10. 3. ИсслСдованиС Π»ΠΈΠΏΠΈΠ΄ΠΎΠ² Π² ΡΡ‹Π²ΠΎΡ€ΠΎΡ‚ΠΊΠ΅ ΠΊΡ€ΠΎΠ²ΠΈ Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹ΠΌΠΈ Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Π°ΠΌΠΈ низкорослости ΠΈ ΠΈΡ… Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ° Π½Π° Ρ„ΠΎΠ½Π΅ Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ 163 Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π 
  • ГЛАВА XI. ИсслСдованиС сСрдСчно-сосудистой систСмы Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ
    • 11. 1. ЭлСктрокардиографичСскоС исслСдованиС Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ^^ соматотропной Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ
    • 11. 2. ЭхокардиографичСскоС исслСдованиС Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с Ρ ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ ^^ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ
  • ΠžΠ‘Π‘Π£Π–Π”Π•ΠΠ˜Π• Π Π•Π—Π£Π›Π¬Π’ΠΠ’ΠžΠ’
  • Π’Π«Π’ΠžΠ”Π«

БистСмныС ΠΈ мСтаболичСскиС эффСкты Π³ΠΎΡ€ΠΌΠΎΠ½Π° роста Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹ΠΌΠΈ Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Π°ΠΌΠΈ низкорослости (Ρ€Π΅Ρ„Π΅Ρ€Π°Ρ‚, курсовая, Π΄ΠΈΠΏΠ»ΠΎΠΌ, ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»ΡŒΠ½Π°Ρ)

ΠΠšΠ’Π£ΠΠ›Π¬ΠΠžΠ‘Π’Π¬ Π˜Π‘Π‘Π›Π•Π”ΠžΠ’ΠΠΠ˜Π―.

Рост Ρ€Π΅Π±Π΅Π½ΠΊΠ° являСтся ΠΎΠ΄Π½ΠΈΠΌ ΠΈΠ· ΠΊΡ€ΠΈΡ‚Π΅Ρ€ΠΈΠ΅Π² Π·Π΄ΠΎΡ€ΠΎΠ²ΡŒΡ Ρ€Π°Π·Π²ΠΈΠ²Π°ΡŽΡ‰Π΅Π³ΠΎΡΡ ΠΎΡ€Π³Π°Π½ΠΈΠ·ΠΌΠ°. ΠŸΠΎΡΡ‚ΠΎΠΌΡƒ Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹Π΅ Π΅Π³ΠΎ Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΡ ΠΌΠΎΠ³ΡƒΡ‚ Π²ΠΎΠ·Π½ΠΈΠΊΠ°Ρ‚ΡŒ ΠΏΡ€ΠΈ мноТСствС Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ эндокринного ΠΈ ΡΠΎΠΌΠ°Ρ‚ичСского Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€Π°.

НаиболСС выраТСнная Π·Π°Π΄Π΅Ρ€ΠΆΠΊΠ° роста отмСчаСтся ΠΏΡ€ΠΈ соматотропной нСдостаточности, ΠΊΠ°ΠΊ ΠΈΠ·ΠΎΠ»ΠΈΡ€ΠΎΠ²Π°Π½Π½ΠΎΠΉ, Ρ‚Π°ΠΊ ΠΈ Π² ΡΠΎΡ‡Π΅Ρ‚Π°Π½ΠΈΠΈ с Π²Ρ‹ΠΏΠ°Π΄Π΅Π½ΠΈΠ΅ΠΌ Ρ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΈ Π΄Ρ€ΡƒΠ³ΠΈΡ… Π³ΠΎΡ€ΠΌΠΎΠ½ΠΎΠ² Π³ΠΈΠΏΠΎΡ„ΠΈΠ·Π°. ИсслСдования послСдних Π»Π΅Ρ‚ ΡΠ²ΠΈΠ΄Π΅Ρ‚Π΅Π»ΡŒΡΡ‚Π²ΡƒΡŽΡ‚ ΠΎ Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ гСтСрогСнности клиничСской ΠΊΠ°Ρ€Ρ‚ΠΈΠ½Ρ‹ этого состояния Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡ‚ΠΈ ΠΎΡ‚ ΡΡ‚ΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈ Ρ‚ΠΈΠΏΠ° Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚Π° Π“Π . ΠšΡ€ΠΎΠΌΠ΅ Ρ‚ΠΎΠ³ΠΎ, Π½ΠΈΠ·ΠΊΠΎΡ€ΠΎΡΠ»ΠΎΡΡ‚ΡŒ ΠΌΠΎΠΆΠ΅Ρ‚ Π±Ρ‹Ρ‚ΡŒ проявлСниСм хромосомных Π°Π½ΠΎΠΌΠ°Π»ΠΈΠΉ (синдром Π¨Π΅Ρ€Π΅ΡˆΠ΅Π²ΡΠΊΠΎΠ³ΠΎ-Π’Π΅Ρ€Π½Π΅Ρ€Π°, Π‘ΠΈΠ½Π΄Ρ€ΠΎΠΌ Нунан, Π‘ΠΈΠ»ΡŒΠ²Π΅Ρ€Π°-РассСла ΠΈ Π΄Ρ€.), Π²Π½ΡƒΡ‚Ρ€ΠΈΡƒΡ‚Ρ€ΠΎΠ±Π½ΠΎΠΉ Π·Π°Π΄Π΅Ρ€ΠΆΠΊΠΈ роста, хроничСских соматичСских заболСваниях (рСвматичСскиС Π±ΠΎΠ»Π΅Π·Π½ΠΈ, хроничСская почСчная Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒ ΠΈ Π΄Ρ€.).

ΠžΡ‚ΡΡ‚Π°Π²Π°Π½ΠΈΠ΅ Π² Ρ€ΠΎΡΡ‚Π΅, Π΄Π°ΠΆΠ΅ носящСС Π²Ρ€Π΅ΠΌΠ΅Π½Π½Ρ‹ΠΉ Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€, ΠΌΠΎΠΆΠ΅Ρ‚ нСблагоприятно ΡΠΊΠ°Π·Ρ‹Π²Π°Ρ‚ΡŒΡΡ Π½Π° ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Слях ΠΊΠΎΠ½Π΅Ρ‡Π½ΠΎΠ³ΠΎ роста, ΠΏΡ€ΠΈΠ²ΠΎΠ΄ΠΈΡ‚ΡŒ ΠΊ Π½ΠΈΠ·ΠΊΠΎΡ€ΠΎΡΠ»ΠΎΡΡ‚ΠΈ. Низкий рост становится Π·Π°Ρ‡Π°ΡΡ‚ΡƒΡŽ ΡΠ΅Ρ€ΡŒΠ΅Π·Π½ΠΎΠΉ психологичСской ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌΠΎΠΉ ΠΈ ΠΏΡ€ΠΈΡ‡ΠΈΠ½ΠΎΠΉ ΡΠΎΡ†ΠΈΠ°Π»ΡŒΠ½ΠΎΠΉ Π΄Π΅Π·Π°Π΄Π°ΠΏΡ‚Π°Ρ†ΠΈΠΈ (Burman P. et al. 1995, Erfurth Π•. et al. 1999). Помимо низкорослости, Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒ Π“Π  сопровоТдаСтся Ρ†Π΅Π»Ρ‹ΠΌ рядом мСтаболичСских Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΠΉ: гипСрхолСстСринСмиСй, сниТСниСм ΠΌΡ‹ΡˆΠ΅Ρ‡Π½ΠΎΠΉ массы ΠΈ Ρ‚олСрантности ΠΊ Ρ„изичСским Π½Π°Π³Ρ€ΡƒΠ·ΠΊΠ°ΠΌ, остСопСниСй, Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΠ΅ΠΌ ΡƒΠ³Π»Π΅Π²ΠΎΠ΄Π½ΠΎΠ³ΠΎ ΠΎΠ±ΠΌΠ΅Π½Π°, ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΠΈΠΌΠΌΡƒΠ½Π½ΠΎΠ³ΠΎ статуса (Salomon et al. 1989, Gilbney et al. 1999, Kann et al. 1998). Π­Ρ‚ΠΈ мСтаболичСскиС Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΡ Π²Π΅Π΄ΡƒΡ‚ ΠΊ ΠΏΠΎΠ²Ρ‹ΡˆΠ΅Π½ΠΈΡŽ заболСваСмости, Ρ€Π°Π½Π½Π΅ΠΉ ΠΈΠ½Π²Π°Π»ΠΈΠ΄ΠΈΠ·Π°Ρ†ΠΈΠΈ ΠΈ ΡΠΌΠ΅Ρ€Ρ‚ности взрослых ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ. Однако, измСнСния Π² ΠΎΠ±ΠΌΠ΅Π½Π½Ρ‹Ρ… процСссах вслСдствиС Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚Π° Π“Π  Π½Π°Ρ‡ΠΈΠ½Π°ΡŽΡ‚ Ρ„ΠΎΡ€ΠΌΠΈΡ€ΠΎΠ²Π°Ρ‚ΡŒΡΡ ΡƒΠΆΠ΅ Π² Π΄Π΅Ρ‚ском возрастС (Saggese et al. 1996, Boot et al. 2002). ΠŸΠΎΡΡ‚ΠΎΠΌΡƒ ΠΈΡ… ΠΈΠ·ΡƒΡ‡Π΅Π½ΠΈΠ΅, Π°Π½Π°Π»ΠΈΠ· Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠΈ ΡƒΠΊΠ°Π·Π°Π½Π½Ρ‹Ρ… ΠΏΠ°Ρ€Π°ΠΌΠ΅Ρ‚Ρ€ΠΎΠ² ΠΏΠΎΠ΄ влияниСм Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π  ΠΏΡ€ΠΈΠΎΠ±Ρ€Π΅Ρ‚Π°ΡŽΡ‚ ΠΎΡΠΎΠ±ΡƒΡŽ Π°ΠΊΡ‚ΡƒΠ°Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ.

Π Π°Π·Ρ€Π°Π±ΠΎΡ‚ΠΊΠ° Π³Π΅Π½Π½ΠΎ-ΠΈΠ½ΠΆΠ΅Π½Π΅Ρ€Π½ΠΎΠ³ΠΎ ΠΌΠ΅Ρ‚ΠΎΠ΄Π° получСния Ρ€-Π“Π  ΠΏΡ€ΠΎΠΈΠ·Π²Π΅Π»Π° Π½Π°ΡΡ‚ΠΎΡΡ‰ΡƒΡŽ Ρ€Π΅Π²ΠΎΠ»ΡŽΡ†ΠΈΡŽ Π² Π»Π΅Ρ‡Π΅Π½ΠΈΠΈ Π΄Π΅Ρ‚Π΅ΠΉ с Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹ΠΌΠΈ Ρ„ΠΎΡ€ΠΌΠ°ΠΌΠΈ низкорослости. Появилась Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡ‚ΡŒ постоянной Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρƒ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… соматотропной Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ, которая позволяСт Π½Π΅ Ρ‚ΠΎΠ»ΡŒΠΊΠΎ Π΄ΠΎΡΡ‚ΠΈΡ‡ΡŒ Π½ΠΎΡ€ΠΌΠ°Π»ΡŒΠ½ΠΎΠ³ΠΎ роста, Π½ΠΎ ΠΈ ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»ΠΈΡ€ΠΎΠ²Π°Ρ‚ΡŒ мСтаболичСскиС Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΡ вслСдствиС Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚Π° Π“Π , Ρ‡Ρ‚ΠΎ Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎ сниТаСт ΡΠΌΠ΅Ρ€Ρ‚Π½ΠΎΡΡ‚ΡŒ ΠΈ ΠΈΠ½Π²Π°Π»ΠΈΠ΄ΠΈΠ·Π°Ρ†ΠΈΡŽ этих ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² ΠΎΡ‚ ΡΠ΅Ρ€Π΄Π΅Ρ‡Π½ΠΎ-сосудистых ослоТнСний ΠΈ ΠΊΠΎΡΡ‚Π½Ρ‹Ρ… ΠΏΠ΅Ρ€Π΅Π»ΠΎΠΌΠΎΠ² (Bulow et al. 2000, Colao et al. 2001).

Π•Ρ‰Π΅ совсСм Π½Π΅Π΄Π°Π²Π½ΠΎ свСдСния ΠΎ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ…, с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ* Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ Π² Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅Ρ€Π°Ρ†ΠΈΠΈ носили Ρ€Π°Π·Ρ€ΠΎΠ·Π½Π΅Π½Π½Ρ‹ΠΉ Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€. БущСствСнным шагом Π½Π° ΠΏΡƒΡ‚ΠΈ ΠΎΠΏΡ‚ΠΈΠΌΠΈΠ·Π°Ρ†ΠΈΠΈ ΠΏΠΎΠΌΠΎΡ‰ΠΈ Π±ΠΎΠ»ΡŒΠ½Ρ‹ΠΌ явилось созданиС ΠΠ°Ρ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½ΠΎΠ³ΠΎ рСгистра Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Π³ΠΈΠΏΠΎΡ„ΠΈΠ·Π°Ρ€Π½ΠΎΠΉ ΠΊΠ°Ρ€Π»ΠΈΠΊΠΎΠ²ΠΎΡΡ‚ΡŒΡŽ, ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡŽΡ‰Π΅Π³ΠΎ ΠΏΠΎΠ»ΡƒΡ‡ΠΈΡ‚ΡŒ ΠΎΠ±ΡŠΠ΅ΠΊΡ‚ΠΈΠ²Π½ΡƒΡŽ ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠ°Ρ†ΠΈΡŽ ΠΎ Ρ€Π°ΡΠΏΡ€ΠΎΡΡ‚ранСнности заболСвания, ΠΏΡ€ΠΎΠ²ΠΎΠ΄ΠΈΡ‚ΡŒ систСматичСский ΡƒΡ‡Π΅Ρ‚ Π΄Π΅Ρ‚Π΅ΠΉ с Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π“Π , ΠΎΠΏΡ€Π΅Π΄Π΅Π»ΡΡ‚ΡŒ ΠΏΠΎΡ‚Ρ€Π΅Π±Π½ΠΎΡΡ‚ΡŒ Π² ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚Π΅ (Ρ€-Π“Π ) для осущСствлСния Ρ†Π΅Π½Ρ‚Ρ€Π°Π»ΠΈΠ·ΠΎΠ²Π°Π½Π½Ρ‹Ρ… Π΅Π³ΠΎ Π·Π°ΠΊΡƒΠΏΠΎΠΊ, ΠΏΡ€ΠΎΠ²ΠΎΠ΄ΠΈΡ‚ΡŒ ΠΌΠΎΠ½ΠΈΡ‚ΠΎΡ€ΠΈΠ½Π³ эффСктивности ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡ‚ΠΈ Π΅Π³ΠΎ примСнСния. Помимо этого, созданиС рСгистра сущСствСнно Ρ€Π°ΡΡˆΠΈΡ€ΡΠ΅Ρ‚ возмоТности всСстороннСй Π½Π°ΡƒΡ‡Π½ΠΎΠΉ ΠΎΡ†Π΅Π½ΠΊΠΈ Π΄Π°Π½Π½ΠΎΠ³ΠΎ заболСвания.

Π’ ΠΎΡ‚СчСствСнной ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΠ΅ исслСдования эффСктивности ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡ‚ΠΈ Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠ³ΠΎ примСнСния Ρ€-Π“Π  ΠΏΡ€ΠΈ Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚Π΅ Π“Π  (ΠΊΠ°ΠΊ Π²Ρ€ΠΎΠΆΠ΄Π΅Π½Π½ΠΎΠΌ, Ρ‚Π°ΠΊ ΠΈ ΠΏΡ€ΠΈΠΎΠ±Ρ€Π΅Ρ‚Π΅Π½Π½ΠΎΠΌ) ΠΈ Π΄Ρ€ΡƒΠ³ΠΈΡ… Ρ„ΠΎΡ€ΠΌΠ°Ρ… низкорослости (синдром Π¨Π΅Ρ€Π΅ΡˆΠ΅Π²ΡΠΊΠΎΠ³ΠΎ-Π’Π΅Ρ€Π½Π΅Ρ€Π°, рСвматичСскиС заболСвания) Π΄ΠΎ ΡΠΈΡ… ΠΏΠΎΡ€ Π½Π΅ ΠΏΡ€ΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΎΡΡŒ. ΠžΡΡ‚Π°Π΅Ρ‚ΡΡ Π½Π΅ ΡΡΠ½Ρ‹ΠΌ Π΅Π³ΠΎ влияниС Π½Π° Π»ΠΈΠΏΠΈΠ΄Π½Ρ‹ΠΉ ΠΎΠ±ΠΌΠ΅Π½, ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ костного ΠΌΠ΅Ρ‚Π°Π±ΠΎΠ»ΠΈΠ·ΠΌΠ°, сСрдСчно-ΡΠΎΡΡƒΠ΄ΠΈΡΡ‚ΡƒΡŽ систСму. НС ΠΎΠΏΡ‚ΠΈΠΌΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½Ρ‹ Π΄ΠΎΠ·ΠΈΡ€ΠΎΠ²ΠΊΠΈ ΠΈ ΡΡ…Π΅ΠΌΡ‹ примСнСния, ΠΊΡ€ΠΈΡ‚Π΅Ρ€ΠΈΠΈ эффСктивности лСчСния ΠΈ Π΅Π³ΠΎ бСзопасности ΠΏΡ€ΠΈ Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹Ρ… Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Π°Ρ… низкорослости.

Π’ ΠΏΠΎΡΠ»Π΅Π΄Π½Π΅Π΅ врСмя всС Π±ΠΎΠ»Π΅Π΅ ΠΏΡ€ΠΈΡΡ‚Π°Π»ΡŒΠ½ΠΎΠ΅ Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅ исслСдоватСлСй Π²ΠΎ Π²ΡΠ΅ΠΌ ΠΌΠΈΡ€Π΅ Π½Π°ΠΏΡ€Π°Π²Π»Π΅Π½ΠΎ Π½Π° ΠΈΠ·ΡƒΡ‡Π΅Π½ΠΈΠ΅ возмоТности примСнСния Ρ€-Π“Π  ΠΏΡ€ΠΈ Π΄Ρ€ΡƒΠ³ΠΈΡ… Ρ„ΠΎΡ€ΠΌΠ°Ρ… низкорослости, Π½Π΅ ΡΠ²ΡΠ·Π°Π½Π½Ρ‹Ρ… с ΠΏΠ΅Ρ€Π²ΠΈΡ‡Π½Ρ‹ΠΌ Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π“Π , — хромосомных аномалиях, рСвматичСских болСзнях, хроничСской ΠΏΠΎΡ‡Π΅Ρ‡Π½ΠΎΠΉ нСдостаточности ΠΈ Π΄Ρ€ΡŽ (Rosenfeld et al. 1998, Czernichow et al. 1998). Однако, Π²Π²ΠΈΠ΄Ρƒ нСясности ΠΏΡ€ΠΎΠ³Π½ΠΎΠ·Π° роста, высокой стоимости лСчСния ΠΈ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΠ³ΠΎ риска возникновСния ΡΠ΅Ρ€ΡŒΠ΅Π·Π½Ρ‹Ρ… ослоТнСний, Ρ‚Π°ΠΊΠΈΠ΅ Ρ€Π°Π±ΠΎΡ‚Ρ‹ носят Ρ€Π°Π·Ρ€ΠΎΠ·Π½Π΅Π½Π½Ρ‹ΠΉ ΠΈ ΠΏΠΎΠ΄Ρ‡Π°Ρ ΠΏΡ€ΠΎΡ‚ΠΈΠ²ΠΎΡ€Π΅Ρ‡ΠΈΠ²Ρ‹ΠΉ Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€. ΠŸΠΎΡΡ‚ΠΎΠΌΡƒ Π΄Π°ΠΆΠ΅ ΠΎΡ‚Π΄Π΅Π»ΡŒΠ½Ρ‹Π΅ наблюдСния ΠΈ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π½Π° Π½Π΅Π±ΠΎΠ»ΡŒΡˆΠΈΡ… Π²Ρ‹Π±ΠΎΡ€ΠΊΠ°Ρ… Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… ΠΏΡ€Π΅Π΄ΡΡ‚Π°Π²Π»ΡΡŽΡ‚ ΠΎΠ³Ρ€ΠΎΠΌΠ½Ρ‹ΠΉ Π½Π°ΡƒΡ‡Π½ΠΎ-практичСский интСрСс ΠΈ ΠΌΠΎΠ³ΡƒΡ‚ ΡΠ»ΡƒΠΆΠΈΡ‚ΡŒ основой для Ρ€Π°Π·Ρ€Π°Π±ΠΎΡ‚ΠΊΠΈ Π½ΠΎΠ²Ρ‹Ρ… ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΠΉ ΠΊ ΠΏΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡŽ ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚ΠΎΠ² Ρ€-Π“Π .

НСсмотря Π½Π° Ρ‚ΠΎ, Ρ‡Ρ‚ΠΎ Ρ€ΠΎΠ»ΡŒ Π“Π , ΠΊΠ°ΠΊ ΠΎΠ΄Π½ΠΎΠ³ΠΎ ΠΈΠ· Ρ†Π΅Π½Ρ‚Ρ€Π°Π»ΡŒΠ½Ρ‹Ρ… рСгуляторов костного ΠΌΠ΅Ρ‚Π°Π±ΠΎΠ»ΠΈΠ·ΠΌΠ°, извСстна Π΄Π°Π²Π½ΠΎ, Π½Π°Π΄Π΅ΠΆΠ½Ρ‹Ρ… ΠΊΡ€ΠΈΡ‚Π΅Ρ€ΠΈΠ΅Π² для ΠΎΡ†Π΅Π½ΠΊΠΈ костной плотности Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π“Π  Π΄ΠΎ ΡΠΈΡ… ΠΏΠΎΡ€ Π½Π΅Ρ‚. ИспользованиС стандартных возрастных Π½ΠΎΡ€ΠΌΠ°Ρ‚ΠΈΠ²ΠΎΠ² Π΄Π°Π΅Ρ‚ Π·Π°Ρ‡Π°ΡΡ‚ΡƒΡŽ искаТСнныС Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. Π’ Ρ‚ΠΎ ΠΆΠ΅ врСмя ΠΎΠ±ΡŠΠ΅ΠΊΡ‚ΠΈΠ²Π½Π°Ρ ΠΎΡ†Π΅Π½ΠΊΠ° состояния плотности кости Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌΠ° для ΠΏΡ€Π°Π²ΠΈΠ»ΡŒΠ½ΠΎΠΉ Ρ‚Π°ΠΊΡ‚ΠΈΠΊΠΈ вСдСния Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ (Boot et al. 2002, Saggese et al. 1996).

Π’ Ρ‚ΠΎ Π²Ρ€Π΅ΠΌΡ ΠΊΠ°ΠΊ Ρƒ Π²Π·Ρ€ΠΎΡΠ»Ρ‹Ρ… ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π“Π  исслСдования ΠΆΠΈΡ€ΠΎΠ²ΠΎΠ³ΠΎ ΠΎΠ±ΠΌΠ΅Π½Π° Π΄Π°Π²Π½ΠΎ ΡƒΠΆΠ΅ носят ΡˆΠΈΡ€ΠΎΠΊΠΎΠΌΠ°ΡΡˆΡ‚Π°Π±Π½Ρ‹ΠΉ Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€, Ρ€Π°Π±ΠΎΡ‚, посвящСнных ΠΈΠ·ΡƒΡ‡Π΅Π½ΠΈΡŽ Π»ΠΈΠΏΠΈΠ΄Π½ΠΎΠ³ΠΎ статуса Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ, ΡΡ€Π°Π²Π½ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎ Π½Π΅ΠΌΠ½ΠΎΠ³ΠΎ. БвоСврСмСнная коррСкция Π΅Π³ΠΎ Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΠΉ Π² Π΄Π΅Ρ‚ском возрастС позволяСт сущСствСнно ΡƒΠ»ΡƒΡ‡ΡˆΠΈΡ‚ΡŒ ΠΎΡ‚Π΄Π°Π»Π΅Π½Π½Ρ‹ΠΉ ΠΏΡ€ΠΎΠ³Π½ΠΎΠ· ΠΈ ΠΊΠ°Ρ‡Π΅ΡΡ‚Π²ΠΎ ΠΆΠΈΠ·Π½ΠΈ этих Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ….

ВСдущая Ρ€ΠΎΠ»ΡŒ сСрдСчно-сосудистых Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ ΠΊΠ°ΠΊ ΠΎΠ΄Π½ΠΎΠΉ ΠΈΠ· Π³Π»Π°Π²Π½Ρ‹Ρ… ΠΏΡ€ΠΈΡ‡ΠΈΠ½ смСртности Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… с Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π“Π  Π΄ΠΈΠΊΡ‚ΡƒΠ΅Ρ‚ Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌΠΎΡΡ‚ΡŒ всСстороннСго изучСния состояния сСрдСчно-сосудистой систСмы Π½Π° Π²ΡΠ΅Ρ… возрастных этапах ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ ΠΈ, Π² Ρ‡Π°ΡΡ‚ности, Π΄Π΅Ρ‚Π΅ΠΉ.

Π’Π°ΠΊΠΈΠΌ ΠΎΠ±Ρ€Π°Π·ΠΎΠΌ, пСрспСктивными направлСниями Π² ΠΈΠ·ΡƒΡ‡Π΅Π½ΠΈΠΈ соматотропной нСдостаточности Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ ΡΠ²Π»ΡΡŽΡ‚ΡΡ исслСдования Π±Π΅Π»ΠΊΠΎΠ²ΠΎΠ³ΠΎ, ΠΆΠΈΡ€ΠΎΠ²ΠΎΠ³ΠΎ, ΡƒΠ³Π»Π΅Π²ΠΎΠ΄Π½ΠΎΠ³ΠΎ ΠΎΠ±ΠΌΠ΅Π½Π°, состояния костной Ρ‚ΠΊΠ°Π½ΠΈ ΠΈ ΡΠ΅Ρ€Π΄Π΅Ρ‡Π½ΠΎ-сосудистой систСмы, Π° Ρ‚Π°ΠΊΠΆΠ΅ влияниС Π½Π° Π½ΠΈΡ… Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π . Π’Ρ€Π΅Π±ΡƒΡŽΡ‚ΡΡ дальнСйшиС проспСктивныС исслСдования для ΠΎΡ†Π΅Π½ΠΊΠΈ лСчСния, ΠΏΡ€ΠΎΠ²ΠΎΠ΄ΠΈΠΌΠΎΠ³ΠΎ Π² Π΄Π΅Ρ‚ском возрастС, Π½Π° ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ смСртности ΠΈ ΠΈΠ½Π²Π°Π»ΠΈΠ΄Π½ΠΎΡΡ‚ΠΈ взрослых ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π“Π . Π”Ρ€ΡƒΠ³ΠΈΠΌ Π²Π°ΠΆΠ½Ρ‹ΠΌ Π½Π°ΠΏΡ€Π°Π²Π»Π΅Π½ΠΈΠ΅ΠΌ Π½Π°ΡƒΡ‡Π½ΠΎΠ³ΠΎ поиска являСтся ΠΈΠ·ΡƒΡ‡Π΅Π½ΠΈΠ΅ ΠΌΠ΅Ρ…Π°Π½ΠΈΠ·ΠΌΠΎΠ² Π·Π°Π΄Π΅Ρ€ΠΆΠΊΠΈ роста ΠΏΡ€ΠΈ Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹Ρ… патологичСских состояниях, Π½Π΅ ΡΠ²ΡΠ·Π°Π½Π½Ρ‹Ρ… с Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ соматотропной Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΈ Π³ΠΈΠΏΠΎΡ„ΠΈΠ·Π°, ΠΈ ΠΎΡ†Π΅Π½ΠΊΠ° возмоТности примСнСния Ρ€-Π“Π  для Π΅Π΅ ΠΊΠΎΡ€Ρ€Π΅ΠΊΡ†ΠΈΠΈ.

Π¦Π•Π›Π¬ Π˜Π‘Π‘Π›Π•Π”ΠžΠ’ΠΠΠ˜Π―.

Π˜Π·ΡƒΡ‡ΠΈΡ‚ΡŒ Ρ€ΠΎΡΡ‚ΡΡ‚ΠΈΠΌΡƒΠ»ΠΈΡ€ΡƒΡŽΡ‰ΡƒΡŽ ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡ‚ΡŒ примСнСния Ρ€-Π“Π  ΠΈ Π΅Π³ΠΎ систСмныС ΠΈ ΠΌΠ΅Ρ‚аболичСскиС эффСкты ΠΏΡ€ΠΈ Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹Ρ… Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Π°Ρ… низкорослости.

Π—ΠΠ”ΠΠ§Π˜ Π˜Π‘Π‘Π›Π•Π”ΠžΠ’ΠΠΠ˜Π―.

1. ΠŸΡ€ΠΎΠ²Π΅ΡΡ‚ΠΈ эпидСмиологичСскоС исслСдованиС распространСнности соматотропной нСдостаточности Π² Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅Ρ€Π°Ρ†ΠΈΠΈ Π½Π° ΠΎΡΠ½ΠΎΠ²Π΅ ΠΠ°Ρ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½ΠΎΠ³ΠΎ рСгистра Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… с Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π“Π .

2. ΠŸΡ€ΠΎΠ²Π΅ΡΡ‚ΠΈ комплСксноС ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-антропомСтричСскоС ΠΈ Π³ΠΎΡ€ΠΌΠΎΠ½Π°Π»ΡŒΠ½ΠΎΠ΅ исслСдованиС ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹ΠΌΠΈ Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Π°ΠΌΠΈ соматотропной нСдостаточности: органичСским ΠΈ ΠΈΠ΄ΠΈΠΎΠΏΠ°Ρ‚ичСским Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π“Π , ΠΈΠ·ΠΎΠ»ΠΈΡ€ΠΎΠ²Π°Π½Π½Ρ‹ΠΌ ΠΈ ΠΌΠ½ΠΎΠΆΠ΅ΡΡ‚Π²Π΅Π½Π½Ρ‹ΠΌ Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π³ΠΎΡ€ΠΌΠΎΠ½ΠΎΠ² Π°Π΄Π΅Π½ΠΎΠ³ΠΈΠΏΠΎΡ„ΠΈΠ·Π° Π΄ΠΎ ΠΈ Π½Π° Ρ„ΠΎΠ½Π΅ лСчСния Ρ€-Π“Π , ΠΎΠΏΡ€Π΅Π΄Π΅Π»ΠΈΡ‚ΡŒ Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€ становлСния ΠΏΡƒΠ±Π΅Ρ€Ρ‚Π°Ρ‚Π° ΠΈ Π΄ΠΎΡΡ‚иТСния ΠΊΠΎΠ½Π΅Ρ‡Π½ΠΎΠ³ΠΎ роста Ρƒ ΡΡ‚ΠΈΡ… Π΄Π΅Ρ‚Π΅ΠΉ.

3. Π˜ΡΡΠ»Π΅Π΄ΠΎΠ²Π°Ρ‚ΡŒ ΡΠ΅ΠΊΡ€Π΅Ρ†ΠΈΡŽ Π³ΠΎΡ€ΠΌΠΎΠ½Π° роста ΠΈ Ρ€ΠΎΡΡ‚ΠΎΠ²Ρ‹Ρ… Ρ„Π°ΠΊΡ‚ΠΎΡ€ΠΎΠ², антропомСтричСскиС ΠΈ Π³ΠΎΡ€ΠΌΠΎΠ½Π°Π»ΡŒΠ½Ρ‹Π΅ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ ΠΈ ΠΎΡ†Π΅Π½ΠΈΡ‚ΡŒ ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡ‚ΡŒ примСнСния Ρ€-Π“Π  ΠΏΡ€ΠΈ синдромС Π¨Π΅Ρ€Π΅ΡˆΠ΅Π²ΡΠΊΠΎΠ³ΠΎ-Π’Π΅Ρ€Π½Π΅Ρ€Π°.

4. ΠžΡ†Π΅Π½ΠΈΡ‚ΡŒ возмоТности примСнСния Ρ€-Π“Π  для ΠΊΠΎΡ€Ρ€Π΅ΠΊΡ†ΠΈΠΈ низкорослости, обусловлСнной Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Π³Π»ΡŽΠΊΠΎΠΊΠΎΡ€Ρ‚ΠΈΠΊΠΎΡΡ‚Π΅Ρ€ΠΎΠΈΠ΄Π½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠ΅ΠΉ.

5. Π˜ΡΡΠ»Π΅Π΄ΠΎΠ²Π°Ρ‚ΡŒ содСрТаниС инсулиноподобного Ρ„Π°ΠΊΡ‚ΠΎΡ€Π° роста -1 (ИЀР-1) ΠΈ ΡΠ²ΡΠ·Ρ‹Π²Π°ΡŽΡ‰Π΅Π³ΠΎ Π±Π΅Π»ΠΊΠ°-3 (Π˜Π€Π Π‘Π‘-3) Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹ΠΌΠΈ Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Π°ΠΌΠΈ низкорослости ΠΈ ΠΈΡ… Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΡƒ Π½Π° Ρ„ΠΎΠ½Π΅ лСчСния Ρ€-Π“Π  Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ.

6. ΠžΡ†Π΅Π½ΠΈΡ‚ΡŒ Π΄ΠΈΠ°Π³Π½ΠΎΡΡ‚ΠΈΡ‡Π΅ΡΠΊΡƒΡŽ Π·Π½Π°Ρ‡ΠΈΠΌΠΎΡΡ‚ΡŒ Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹Ρ… способов измСрСния ΠΌΠΈΠ½Π΅Ρ€Π°Π»ΡŒΠ½ΠΎΠΉ плотности кости Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ. Π˜Π·ΡƒΡ‡ΠΈΡ‚ΡŒ влияниС Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π  Π½Π° ΠΌΠΈΠ½Π΅Ρ€Π°Π»ΡŒΠ½ΡƒΡŽ массу ΠΈ ΠΏΠ»ΠΎΡ‚Π½ΠΎΡΡ‚ΡŒ костной Ρ‚ΠΊΠ°Π½ΠΈ Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π“Π .

7. Π˜ΡΡΠ»Π΅Π΄ΠΎΠ²Π°Ρ‚ΡŒ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ ΠΆΠΈΡ€ΠΎΠ²ΠΎΠ³ΠΎ ΠΎΠ±ΠΌΠ΅Π½Π° Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ ΠΏΡ€ΠΈ Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹Ρ… Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Π°Ρ… низкорослости, ΠΎΡ†Π΅Π½ΠΈΡ‚ΡŒ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ массы Ρ‚Π΅Π»Π°, особСнности Π»ΠΈΠΏΠΈΠ΄Π½ΠΎΠ³ΠΎ профиля Π΄ΠΎ ΠΈ Π½Π° Ρ„ΠΎΠ½Π΅ лСчСния Ρ€-Π“Π .

8. Π˜ΡΡΠ»Π΅Π΄ΠΎΠ²Π°Ρ‚ΡŒ особСнности ΠΌΠΎΡ€Ρ„ΠΎ-Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½ΠΎΠ³ΠΎ состояния сСрдСчно-сосудистой систСмы Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π“Π  Π΄ΠΎ ΠΈ Π½Π° Ρ„ΠΎΠ½Π΅ лСчСния Ρ€-Π“Π .

НАУЧНАЯ ΠΠžΠ’Π˜Π—ΠΠ Π˜Π‘Π‘Π›Π•Π”ΠžΠ’ΠΠΠ˜Π―.

Π’ΠΏΠ΅Ρ€Π²Ρ‹Π΅ Π² Π ΠΎΡΡΠΈΠΈ создан ΠΠ°Ρ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½Ρ‹ΠΉ рСгистр Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ, ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-эпидСмиологичСскоС исслСдованиС распространСнности Π³ΠΈΠΏΠΎΡ„ΠΈΠ·Π°Ρ€Π½ΠΎΠ³ΠΎ Π½Π°Π½ΠΈΠ·ΠΌΠ° Π² Ρ€ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ популяции.

На Π±ΠΎΠ»ΡŒΡˆΠΎΠΌ клиничСском ΠΌΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Π΅ Π²ΠΏΠ΅Ρ€Π²Ρ‹Π΅ Π±Ρ‹Π»Π° ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΎΡ†Π΅Π½ΠΊΠ° эффСктивности ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡ‚ΠΈ Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠ³ΠΎ лСчСния Ρ€-Π“Π  ΠΈ Π²Ρ‹ΡΠ²Π»Π΅Π½Ρ‹ особСнности ростового эффСкта Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π  Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹ΠΌΠΈ Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Π°ΠΌΠΈ низкорослости.

ΠžΡ†Π΅Π½Π΅Π½Ρ‹ Ρ„Π°ΠΊΡ‚ΠΎΡ€Ρ‹, ΠΎΠΊΠ°Π·Ρ‹Π²Π°ΡŽΡ‰ΠΈΠ΅ влияниС Π½Π° ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡ‚ΡŒ лСчСния Ρ€-Π“Π  ΠΏΡ€ΠΈ соматотропной нСдостаточности. Показан дозозависимый эффСкт Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π  Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π“Π  ΠΈ ΠΈΠ·Π±Ρ‹Ρ‚ΠΎΡ‡Π½ΠΎΠΉ массой Ρ‚Π΅Π»Π°.

Π”Π°Π½Π° характСристика становлСния ΠΏΡƒΠ±Π΅Ρ€Ρ‚Π°Ρ‚Π° ΠΈ Π΄ΠΎΡΡ‚иТСния ΠΊΠΎΠ½Π΅Ρ‡Π½ΠΎΠ³ΠΎ роста ΠΏΡ€ΠΈ соматотропной нСдостаточности. Показано, Ρ‡Ρ‚ΠΎ Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½Π°Ρ Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½Π°Ρ тСрапия Ρ€-Π“Π  Π² ΠΏΡ€Π΅ΠΏΡƒΠ±Π΅Ρ€Ρ‚Π°Ρ‚Π½ΠΎΠΌ возрастС позволяСт Π΄ΠΎΡΡ‚ΠΈΡ‡ΡŒ ΡΠΎΡ†ΠΈΠ°Π»ΡŒΠ½ΠΎ ΠΏΡ€ΠΈΠ΅ΠΌΠ»Π΅ΠΌΠΎΠ³ΠΎ роста. Π’ΠΏΠ΅Ρ€Π²Ρ‹Π΅ Π² ΠΎΡ‚СчСствСнной ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΠ΅ продСмонстрирована Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡ‚ΡŒ эффСктивного использования Ρ€-Π“Π  ΠΏΡ€ΠΈ Π»Π΅Ρ‡Π΅Π½ΠΈΠΈ низкорослости Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΈΠ½Π΄Ρ€ΠΎΠΌΠΎΠΌ Π¨Π΅Ρ€Π΅ΡˆΠ΅Π²ΡΠΊΠΎΠ³ΠΎ-Π’Π΅Ρ€Π½Π΅Ρ€Π°.

Π’ΠΏΠ΅Ρ€Π²Ρ‹Π΅ Π΄ΠΎΠΊΠ°Π·Π°Π½Π° ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡ‚ΡŒ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π  Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с Ρ€Π΅Π²ΠΌΠ°Ρ‚ичСскими заболСваниями. Π’ΠΏΠ΅Ρ€Π²Ρ‹Π΅ Π² ΠΎΡ‚СчСствСнной клиничСской ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΠ΅ ΠΈΠ·ΡƒΡ‡Π΅Π½ΠΎ влияниС Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚Π° Π“Π  Π½Π° ΡΠΎΡΡ‚ояниС костной Ρ‚ΠΊΠ°Π½ΠΈ Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ ΠΈ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ Π°Π½Π°Π»ΠΈΠ· Π΅Π΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ Π½Π° Ρ„ΠΎΠ½Π΅ Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π .

Π”ΠΎΠΊΠ°Π·Π°Π½Π° диагностичСская Π·Π½Π°Ρ‡ΠΈΠΌΠΎΡΡ‚ΡŒ объСмной ΠΌΠΈΠ½Π΅Ρ€Π°Π»ΡŒΠ½ΠΎΠΉ плотности кости ΠΈ Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌΠΎΡΡ‚ΡŒ опрСдСлСния ΠΏΡ€ΠΎΠ΅ΠΊΡ†ΠΈΠΎΠ½Π½ΠΎΠΉ ΠΌΠΈΠ½Π΅Ρ€Π°Π»ΡŒΠ½ΠΎΠΉ плотности кости с ΡƒΡ‡Π΅Ρ‚ΠΎΠΌ костного возраста, ΠΊΠ°ΠΊ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΠΎΠ±ΡŠΠ΅ΠΊΡ‚ΠΈΠ²Π½Ρ‹Ρ… ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»Π΅ΠΉ для ΠΎΡ†Π΅Π½ΠΊΠΈ состояния костной Ρ‚ΠΊΠ°Π½ΠΈ Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ. ΠŸΡ€ΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½Ρ‹ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ массы Ρ‚Π΅Π»Π° ΠΈ ΠΆΠΈΡ€ΠΎΠ²ΠΎΠ³ΠΎ ΠΎΠ±ΠΌΠ΅Π½Π° Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹ΠΌΠΈ Ρ„ΠΎΡ€ΠΌΠ°ΠΌΠΈ низкорослости. Показана Π³Π΅Ρ‚Π΅Ρ€ΠΎΠ³Π΅Π½Π½ΠΎΡΡ‚ΡŒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π“Π  ΠΏΠΎ Π˜ΠœΠ’ ΠΈ Π»ΠΈΠΏΠΈΠ΄Π½ΠΎΠΌΡƒ ΠΏΡ€ΠΎΡ„ΠΈΠ»ΡŽ Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡ‚ΠΈ ΠΎΡ‚ Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Π° низкорослости, Π° Ρ‚Π°ΠΊΠΆΠ΅ Π΄ΠΎΠΊΠ°Π·Π°Π½ΠΎ благоприятноС влияниС Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π  Π½Π° ΡΡ‚ΠΈ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ.

Π’ΠΏΠ΅Ρ€Π²Ρ‹Π΅ ΠΏΡ€ΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½Ρ‹ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ структуры ΠΈ Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΈ сСрдца Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ Π΄ΠΎ ΠΈ Π½Π° Ρ„ΠΎΠ½Π΅ лСчСния Ρ€-Π“Π . Показано, Ρ‡Ρ‚ΠΎ Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ Ρ€Π°Π·ΠΌΠ΅Ρ€Ρ‹ сСрдца сниТСны ΠΎΡ‚Π½ΠΎΡΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎ хронологичСского возраста, Π° Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½Π°Ρ тСрапия Ρ€-Π“Π  ΠΏΡ€ΠΈΠ²ΠΎΠ΄ΠΈΡ‚ ΠΊ ΡƒΠ²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΡŽ всСх морфомСтричСских ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»Π΅ΠΉ Π² ΡΠΎΠΎΡ‚вСтствии с ΡƒΠ²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΠ΅ΠΌ антропомСтричСских ΠΏΠ°Ρ€Π°ΠΌΠ΅Ρ‚Ρ€ΠΎΠ².

ΠŸΠ ΠΠšΠ’Π˜Π§Π•Π‘ΠšΠΠ― Π—ΠΠΠ§Π˜ΠœΠžΠ‘Π’Π¬ Π˜Π‘Π‘Π›Π•Π”ΠžΠ’ΠΠΠ˜Π―.

На ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ Π΄Π°Π½Π½Ρ‹Ρ… РСгистра, ΠΏΠΎΠ»ΡƒΡ‡Π΅Π½Ρ‹ достовСрныС свСдСния ΠΎ Ρ€Π°ΡΠΏΡ€ΠΎΡΡ‚ранСнности соматотропной нСдостаточности Π² Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅Ρ€Π°Ρ†ΠΈΠΈ, Π° Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-эпидСмиологичСского Π°Π½Π°Π»ΠΈΠ·Π° ΠΌΠΎΠ³ΡƒΡ‚ Π±Ρ‹Ρ‚ΡŒ ΠΈΡΠΏΠΎΠ»ΡŒΠ·ΠΎΠ²Π°Π½Ρ‹ Π² ΡΡ„Π΅Ρ€Π΅ здравоохранСния ΠΈ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡ‚ обоснованно ΠΏΠ»Π°Π½ΠΈΡ€ΠΎΠ²Π°Ρ‚ΡŒ расходы Π½Π° ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΈ ΡƒΡ‚ΠΎΡ‡Π½ΠΈΡ‚ΡŒ ΠΈΡΡ‚ΠΈΠ½Π½ΡƒΡŽ ΠΏΠΎΡ‚Ρ€Π΅Π±Π½ΠΎΡΡ‚ΡŒ Π² Π»Π΅Ρ‡Π΅Π½ΠΈΠΈ Ρ€-Π“Π . Π Π°Π±ΠΎΡ‚Π° с Π Π΅Π³ΠΈΡΡ‚Ρ€ΠΎΠΌ спСциалистов Π½Π° ΠΌΠ΅ΡΡ‚Π°Ρ… способствуСт ΡƒΠ½ΠΈΡ„ΠΈΠΊΠ°Ρ†ΠΈΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠ² диагностики соматотропной нСдостаточности, Ρ‡Ρ‚ΠΎ ΠΏΠΎΠ²Ρ‹ΡˆΠ°Π΅Ρ‚ качСство мСдицинской ΠΏΠΎΠΌΠΎΡ‰ΠΈ.

Π”ΠΎΠΊΠ°Π·Π°Π½ ΠΏΠΎΠ»ΠΎΠΆΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹ΠΉ рост-ΡΡ‚ΠΈΠΌΡƒΠ»ΠΈΡ€ΡƒΡŽΡ‰ΠΈΠΉ эффСкт Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π  ΠΏΡ€ΠΈ отсутствии ΡΠ΅Ρ€ΡŒΠ΅Π·Π½Ρ‹Ρ… ΠΏΠΎΠ±ΠΎΡ‡Π½Ρ‹Ρ… явлСиий ΠΊΠ°ΠΊ ΠΏΡ€ΠΈ соматотропной нСдостаточности, Ρ‚Π°ΠΊ ΠΈ ΠΏΡ€ΠΈ Π΄Ρ€ΡƒΠ³ΠΈΡ… Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Π°Ρ… низкорослости, Π½Π΅ ΡΠ²ΡΠ·Π°Π½Π½Ρ‹Ρ… с Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π“Π . Для своСврСмСнного выявлСния ΠΏΠΎΡ‚Π΅Ρ€ΠΈ костной массы ΠΈ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΠΉ дальнСйшСй Π΅Π΅ ΠΊΠΎΡ€Ρ€Π΅ΠΊΡ†ΠΈΠΈ Π΄ΠΎΠΏΠΎΠ»Π½Π΅Π½ Π°Π»Π³ΠΎΡ€ΠΈΡ‚ΠΌ обслСдования ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ ΠΈ ΠΎΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½Π° Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌΠΎΡΡ‚ΡŒ провСдСния остСодСнситомСтрии Ρƒ ΡΡ‚ΠΈΡ… Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ…. Π”ΠΎΠΊΠ°Π·Π°Π½Π° Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌΠΎΡΡ‚ΡŒ ΠΎΡ†Π΅Π½ΠΊΠΈ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»Π΅ΠΉ остСодСиситомСтрии Π½Π΅ Ρ‚ΠΎΠ»ΡŒΠΊΠΎ ΠΏΠΎ Π²ΠΎΠ·Ρ€Π°ΡΡ‚Π½Ρ‹ΠΌ Π½ΠΎΡ€ΠΌΠ°Ρ‚ΠΈΠ²Π°ΠΌ, Π½ΠΎ ΠΈ Ρ ΡƒΡ‡Π΅Ρ‚ΠΎΠΌ костного возраста ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ².

Π”ΠΎΠΊΠ°Π·Π°Π½Π° Π·Π½Π°Ρ‡ΠΈΠΌΠΎΡΡ‚ΡŒ ИМВ, трансформированного Π² ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ Π‘ΠžΠ‘, ΠΊΠ°ΠΊ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΠΎΠ±ΡŠΠ΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΠ³ΠΎ критСрия стСпСни оТирСния, ΡƒΡ‡ΠΈΡ‚Ρ‹Π²Π°ΡŽΡ‰Π΅Π³ΠΎ Π½Π΅ Ρ‚ΠΎΠ»ΡŒΠΊΠΎ рост ΠΈ Π²Π΅Ρ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ…, Π½ΠΎ ΠΈ ΠΈΡ… возраст.

Обоснована Ρ†Π΅Π»Π΅ΡΠΎΠΎΠ±Ρ€Π°Π·Π½ΠΎΡΡ‚ΡŒ динамичСского контроля ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»Π΅ΠΉ Π»ΠΈΠΏΠΈΠ΄Π½ΠΎΠ³ΠΎ профиля Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π“Π  для опрСдСлСния стСпСни риска развития Ρƒ Π½ΠΈΡ… Ρ€Π°Π½Π½ΠΈΡ… сСрдСчно-сосудистых ослоТнСний. Π”Π°Π½Ρ‹ практичСскиС Ρ€Π΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°Ρ†ΠΈΠΈ для назначСния Ρ€-Π“Π  ΠΏΡ€ΠΈ рСвматичСских заболСваниях. ΠŸΡ€ΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡ‚Ρ€ΠΈΡ€ΠΎΠ²Π°Π½Π° ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π  Ρƒ Π΄Π΅Π²ΠΎΡ‡Π΅ΠΊ с ΡΠΈΠ½Π΄Ρ€ΠΎΠΌΠΎΠΌ Π¨Π΅Ρ€Π΅ΡˆΠ΅Π²ΡΠΊΠΎΠ³ΠΎ-Π’Π΅Ρ€Π½Π΅Ρ€Π°.

ΠΠŸΠ ΠžΠ‘ΠΠ¦Π˜Π― Π ΠΠ‘ΠžΠ’Π«.

ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Ρ‹ диссСртации обсуТдСны ΠΈ ΠΎΠ΄ΠΎΠ±Ρ€Π΅Π½Ρ‹ Π£Ρ‡Π΅Π½Ρ‹ΠΌ Π‘ΠΎΠ²Π΅Ρ‚ΠΎΠΌ Π“Π£ ЭНЦ РАМН (2004) — Π½Π° Π’сСроссийских ΡΡŠΠ΅Π·Π΄Π°Ρ… эндокринологов (2000, 2001, 2002, 2003), Π½Π° ΡΡŠΠ΅Π·Π΄Π°Ρ… московских эндокринологов (1999, 2000), Π½Π° ΠΊΠΎΠ½Ρ„СрСнциях эндокринологов ΠΈ ΠΏΠ΅Π΄ΠΈΠ°Ρ‚Ρ€ΠΎΠ²-эндокринологов (Π£Ρ„Π°, ЧСлябинск, Π‘Π°Π½ΠΊΡ‚-ΠŸΠ΅Ρ‚Π΅Ρ€Π±ΡƒΡ€Π³, Вомск, Π‘Π°Ρ€Π°Ρ‚ΠΎΠ², Π‘Π°ΠΌΠ°Ρ€Π°), Π½Π° Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π½Π°ΡƒΡ‡Π½ΠΎ-практичСской ΠΊΠΎΠ½Ρ„Π΅Ρ€Π΅Π½Ρ†ΠΈΠΈ «Π—аболСвания Π³ΠΈΠΏΠΎΡ‚Π°Π»Π°ΠΌΠΎ-Π³ΠΈΠΏΠΎΡ„ΠΈΠ·Π°Ρ€ΠΏΠΎΠΉ систСмы» (Москва, 2001), IX ΠΊΠΎΠ½Π³Ρ€Π΅ΡΡΠ΅ ΠΏΠ΅Π΄ΠΈΠ°Ρ‚Ρ€ΠΎΠ² России (Москва, 2004), III ВсСросийской Π½Π°ΡƒΡ‡Π½ΠΎ-практичСской ΠΊΠΎΠ½Ρ„Π΅Ρ€Π΅Π½Ρ†ΠΈΠΈ «ΠΠΊΡ‚ΡƒΠ°Π»ΡŒΠ½Ρ‹Π΅ ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌΡ‹ нСйроэндокринологии» (Москва, 2003), IV Π’сСроссийском конгрСссС эндокринологов (Π‘Π°Π½ΠΊΡ‚-ΠŸΠ΅Ρ‚Π΅Ρ€Π±ΡƒΡ€Π³, 2001), XI ΡΡŠΠ΅Π·Π΄Π΅ ΠΏΠ΅Π΄ΠΈΠ°Ρ‚Ρ€ΠΎΠ² России (Москва, 2004). ΠŸΠΎΡΡ‚Π΅Ρ€Π½Ρ‹Π΅ Π΄ΠΎΠΊΠ»Π°Π΄Ρ‹ прСдставлСны Π½Π° ΠΌΠ΅ΠΆΠ΄ΡƒΠ½Π°Ρ€ΠΎΠ΄Π½Ρ‹Ρ… конгрСссах ΠΈ Π΅ΠΆΠ΅Π³ΠΎΠ΄Π½Ρ‹Ρ… ΡΡŠΠ΅Π·Π΄Π°Ρ… ЕвропСйского ΠžΠ±Ρ‰Π΅ΡΡ‚Π²Π° ΠΏΠ΅Π΄ΠΈΠ°Ρ‚Ρ€ΠΎΠ²-эндокринологов (ESPE): Π² ΠœΠΎΠ½Ρ€Π΅Π°Π»Π΅ (Канада, 2001), Π² Π›ΡŽΠ±Π»ΡΠ½Π΅ (БловСния, 2003), Π² Π‘Π°Π·Π΅Π»Π΅ (ШвСйцария, 2004), ΠœΠ΅ΠΆΠ΄ΡƒΠ½Π°Ρ€ΠΎΠ΄Π½Ρ‹Ρ… симпозиумах «Π“ΠΎΡ€ΠΌΠΎΠ½ роста ΠΈ Ρ„Π°ΠΊΡ‚ΠΎΡ€Ρ‹ роста Π² ΡΠ½Π΄ΠΎΠΊΡ€ΠΈΠ½ΠΎΠ»ΠΎΠ³ΠΈΠΈ» (ΠœΠ°Π»ΡŒΡ‚Π°, 2001, Π–Π΅Π½Π΅Π²Π°, 2004, Афины, 2005).

ΠŸΠ£Π‘Π›Π˜ΠšΠΠ¦Π˜Π˜.

По ΠΌΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Π°ΠΌ диссСртации ΠΎΠΏΡƒΠ±Π»ΠΈΠΊΠΎΠ²Π°Π½ΠΎ 33 Π½Π°ΡƒΡ‡Π½Ρ‹Π΅ Ρ€Π°Π±ΠΎΡ‚Ρ‹, ΠΈΠ· Π½ΠΈΡ… 18 — Π² ΠΎΡ‚СчСствСнной ΠΈ 15 — Π² Π·Π°Ρ€ΡƒΠ±Π΅ΠΆΠ½ΠΎΠΉ ΠΏΠ΅Ρ‡Π°Ρ‚ΠΈ.

БВРУКВУРА И ΠžΠ‘ΠͺΠ•Πœ Π”Π˜Π‘Π‘Π•Π Π’ΠΠ¦Π˜Π˜

.

ДиссСртация состоит ΠΈΠ· Π²Π²Π΅Π΄Π΅Π½ΠΈΡ, ΠΎΠ±Π·ΠΎΡ€Π° Π»ΠΈΡ‚Π΅Ρ€Π°Ρ‚ΡƒΡ€Ρ‹, описания ΠΌΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»ΠΎΠ² ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠ², 9 Π³Π»Π°Π² Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΎΠ² собствСнных исслСдований, обсуТдСния ΠΏΠΎΠ»ΡƒΡ‡Π΅Π½Π½Ρ‹Ρ… Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΎΠ², Π° Ρ‚Π°ΠΊΠΆΠ΅ Π²Ρ‹Π²ΠΎΠ΄ΠΎΠ², практичСских Ρ€Π΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°Ρ†ΠΈΠΉ, ΠΈ ΡΠΏΠΈΡΠΊΠ° использованной Π»ΠΈΡ‚Π΅Ρ€Π°Ρ‚ΡƒΡ€Ρ‹ (678 источников). ДиссСртация ΠΈΠ·Π»ΠΎΠΆΠ΅Π½Π° Π½Π° 283 страницах машинописного тСкста, ΠΈΠΌΠ΅Π΅Ρ‚ 49 рисунков ΠΈ 51 Ρ‚Π°Π±Π»ΠΈΡ†Ρƒ.

Π²Ρ‹Π²ΠΎΠ΄Ρ‹.

1. Π Π°ΡΠΏΡ€ΠΎΡΡ‚Ρ€Π°Π½Π΅Π½Π½ΠΎΡΡ‚ΡŒ соматотропной нСдостаточности Π² Π Π€ составляСт 7,5 Π½Π° 100 ООО Π΄Π΅Ρ‚ΡΠΊΠΎΠ³ΠΎ насСлСния. Боматотропная Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒ Ρ‡Π°Ρ‰Π΅ встрСчаСтся Ρƒ ΠΌΠ°Π»ΡŒΡ‡ΠΈΠΊΠΎΠ² -9,7 Π½Π° 100 ООО, Ρ‡Π΅ΠΌ Ρƒ Π΄Π΅Π²ΠΎΡ‡Π΅ΠΊ — 5,1 Π½Π° 100 000.

2. ΠŸΡ€ΠΈ Π²Ρ€ΠΎΠΆΠ΄Π΅Π½Π½ΠΎΠΉ соматотропной нСдостаточности Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ Π½Π° Ρ„ΠΎΠ½Π΅ лСчСния Ρ€-Π“Π  ΠΏΠΎΠ»ΡƒΡ‡Π΅Π½Π° Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»ΡŒΠ½Π°Ρ ΠΏΡ€ΠΈΠ±Π°Π²ΠΊΠ° Π² Ρ€ΠΎΡΡ‚Π΅: Π·Π° ΠΏΠ΅Ρ€Π²Ρ‹ΠΉ Π³ΠΎΠ΄ — 10,4±2,3 ΡΠΌ, Π·Π° 2 Π³ΠΎΠ΄ -8,21±1,55 ΡΠΌ, Π·Π° 3 Π³ΠΎΠ΄ — 6,96±-1,89 ΡΠΌ (срСдняя ΠΏΡ€ΠΈΠ±Π°Π²ΠΊΠ° Π·Π° 3 Π³ΠΎΠ΄Π° лСчСния составила 25,57±6,9 см). Π’ Π΄Π°Π»ΡŒΠ½Π΅ΠΉΡˆΠ΅ΠΌ СТСгодная ΠΏΡ€ΠΈΠ±Π°Π²ΠΊΠ° Π² Ρ€ΠΎΡΡ‚Π΅ ΡƒΠΌΠ΅Π½ΡŒΡˆΠ°Π΅Ρ‚ΡΡ, ΠΎΡΡ‚Π°Π²Π°ΡΡΡŒ Π²Ρ‹ΡˆΠ΅ срСднСпопуляционной для Π΄Π°Π½Π½ΠΎΠ³ΠΎ возраста.

3. АдСкватная тСрапия Ρ€-Π“Π  Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ позволяСт Π΄ΠΎΡΡ‚ΠΈΡ‡ΡŒ Π½ΠΎΡ€ΠΌΠ°Π»ΡŒΠ½ΠΎΠ³ΠΎ срСднС-популяционного роста. Π Π΅ΡˆΠ°ΡŽΡ‰ΠΈΠΌΠΈ Ρ„Π°ΠΊΡ‚ΠΎΡ€Π°ΠΌΠΈ ростового ΠΏΡ€ΠΎΠ³Π½ΠΎΠ·Π° ΡΠ²Π»ΡΡŽΡ‚ΡΡ возраст, статус ΠΏΠΎΠ»ΠΎΠ²ΠΎΠΉ зрСлости Ρ€Π΅Π±Π΅Π½ΠΊΠ°, ΡΡ‚Π΅ΠΏΠ΅Π½ΡŒ низкорослости Π² Π½Π°Ρ‡Π°Π»Π΅ лСчСния, Π°Π΄Π΅ΠΊΠ²Π°Ρ‚Π½ΠΎΡΡ‚ΡŒ ΠΈΡΠΏΠΎΠ»ΡŒΠ·ΡƒΠ΅ΠΌΠΎΠΉ Π΄ΠΎΠ·Ρ‹ Ρ€-Π“Π .

4. ΠŸΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Ρ€-Π“Π  Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΠΏΡ€ΠΈΠΎΠ±Ρ€Π΅Ρ‚Π΅Π½Π½Ρ‹ΠΌ Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π“Π  (послС удалСния ΠΊΡ€Π°Π½ΠΈΠΎΡ„Π°Ρ€ΠΈΠ½Π³ΠΈΠΎΠΌΡ‹) позволяСт Π΄ΠΎΠ±ΠΈΡ‚ΡŒΡΡ ΠΏΠΎΠ²Ρ‹ΡˆΠ΅Π½ΠΈΡ Ρ‚Π΅ΠΌΠΏΠΎΠ² роста ΠΈ Π½ΠΎΡ€ΠΌΠ°Π»ΠΈΠ·Π°Ρ†ΠΈΠΈ Π»ΠΈΠΏΠΈΠ΄Π½ΠΎΠ³ΠΎ ΠΎΠ±ΠΌΠ΅Π½Π°, Ρ‡Ρ‚ΠΎ Π²Π΅Π΄Π΅Ρ‚ ΠΊ ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΡŽ ΠΈΡ… Π²Π΅ΡΠΎ-ростовых ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»Π΅ΠΉ ΠΏΡ€ΠΈ отсутствии развития Π·Π½Π°Ρ‡ΠΈΠΌΡ‹Ρ… ΠΏΠΎΠ±ΠΎΡ‡Π½Ρ‹Ρ… эффСктов ΠΈ ΠΏΠΎΠ²Ρ‹ΡˆΠ΅Π½ΠΈΡ частоты Ρ€Π΅Ρ†ΠΈΠ΄ΠΈΠ²ΠΎΠ² ΠΎΠΏΡƒΡ…ΠΎΠ»ΠΈ.

5. ΠŸΡ€ΠΈ синдромС Π¨Π΅Ρ€Π΅ΡˆΠ΅Π²ΡΠΊΠΎΠ³ΠΎ-Π’Π΅Ρ€Π½Π΅Ρ€Π° Π½ΠΈΠ·ΠΊΠΎΡ€ΠΎΡΠ»ΠΎΡΡ‚ΡŒ Π½Π΅ ΠΎΠ±ΡƒΡΠ»ΠΎΠ²Π»Π΅Π½Π° сниТСниСм сСкрСции Π“Π , ΠΎΠ΄Π½Π°ΠΊΠΎ тСрапия Ρ€-Π“Π  позволяСт ΡƒΠ²Π΅Π»ΠΈΡ‡ΠΈΡ‚ΡŒ ΡΠΊΠΎΡ€ΠΎΡΡ‚ΡŒ роста. Π‘Ρ‚Π΅ΠΏΠ΅Π½ΡŒ ΠΏΠΎΠ²Ρ‹ΡˆΠ΅Π½ΠΈΡ скорости роста ΠΏΡ€ΠΈ синдромС Π¨Π΅Ρ€Π΅ΡˆΠ΅Π²ΡΠΊΠΎΠ³ΠΎ-Π’Π΅Ρ€Π½Π΅Ρ€Π° зависит ΠΎΡ‚ Π²ΠΎΠ·Ρ€Π°ΡΡ‚Π° Π½Π°Ρ‡Π°Π»Π° Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ ΠΈ Π°Π΄Π΅ΠΊΠ²Π°Ρ‚ности Π΄ΠΎΠ·Ρ‹.

6. Π‘Ρ‚Π΅ΠΏΠ΅Π½ΡŒ сниТСния ΠΌΠΈΠ½Π΅Ρ€Π°Π»ΡŒΠ½ΠΎΠΉ плотности костной Ρ‚ΠΊΠ°Π½ΠΈ Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎ Π²Π°Ρ€ΡŒΠΈΡ€ΡƒΠ΅Ρ‚ Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡ‚ΠΈ ΠΎΡ‚ ΠΌΠ΅Ρ‚ΠΎΠ΄Π° Π΅Π³ΠΎ расчСта: ΠΌΠΈΠ½Π΅Ρ€Π°Π»ΡŒΠ½Π°Ρ ΠΏΠ»ΠΎΡ‚Π½ΠΎΡΡ‚ΡŒ костной Ρ‚ΠΊΠ°Π½ΠΈ, рассчитанная ΠΏΠΎ Ρ…ронологичСскому возрасту Π±Ρ‹Π»Π° Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎ сниТСна (остСопороз выявлСн Ρƒ 56%, остСопСния — Ρƒ 33%). ΠŸΡ€ΠΈ пСрСсчСтС Π½Π° ΠΊΠΎΡΡ‚Π½Ρ‹ΠΉ возраст остСопороз диагностирован Ρƒ 36%, остСопСния — Ρƒ 47% Π΄Π΅Ρ‚Π΅ΠΉ. ΠŸΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ объСмной ΠΌΠΈΠ½Π΅Ρ€Π°Π»ΡŒΠ½ΠΎΠΉ плотности кости с ΡƒΡ‡Π΅Ρ‚ΠΎΠΌ Π΅Π΅ Ρ€Π΅Π°Π»ΡŒΠ½ΠΎΠ³ΠΎ Ρ€Π°Π·ΠΌΠ΅Ρ€Π° Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎ ΠΏΡ€Π΅Π²Ρ‹ΡˆΠ°ΡŽΡ‚ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ ΠΏΡ€ΠΎΠ΅ΠΊΡ†ΠΈΠΎΠ½Π½ΠΎΠΉ ΠΌΠΈΠ½Π΅Ρ€Π°Π»ΡŒΠ½ΠΎΠΉ плотности ΠΊΠ°ΠΊ ΠΏΠΎ Ρ…ронологичСскому, Ρ‚Π°ΠΊ ΠΈ ΠΏΠΎ ΠΊΠΎΡΡ‚Π½ΠΎΠΌΡƒ возрасту: остСопСния выявлСна Ρƒ 67% Π΄Π΅Ρ‚Π΅ΠΉ, остСопороза Π½Π΅ Π±Ρ‹Π»ΠΎ.

7. На Ρ„ΠΎΠ½Π΅ Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π  ΠΈ ΠΈΠ½Ρ‚Снсивного роста костСй Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ происходит Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠ΅ ΠΏΠΎΠ²Ρ‹ΡˆΠ΅Π½ΠΈΠ΅ содСрТания ΠΎΠ±Ρ‰Π΅ΠΉ ΠΈ ΠΊΠΎΡΡ‚Π½ΠΎΠΉ Ρ„Ρ€Π°ΠΊΡ†ΠΈΠΈ Ρ‰Π΅Π»ΠΎΡ‡Π½ΠΎΠΉ фосфатазы, ΠΎΡΡ‚Π΅ΠΎΠΊΠ°Π»ΡŒΡ†ΠΈΠ½Π° Π² ΡΡ‹Π²ΠΎΡ€ΠΎΡ‚ΠΊΠ΅ ΠΊΡ€ΠΎΠ²ΠΈ, Ρ‡Ρ‚ΠΎ ΡΠ²ΠΈΠ΄Π΅Ρ‚Π΅Π»ΡŒΡΡ‚Π²ΡƒΠ΅Ρ‚ ΠΎ ΠΏΠΎΠ²Ρ‹ΡˆΠ΅Π½ΠΈΠΈ активности остСобластов ΠΈ ΠΏΡ€ΠΎΡ†Π΅ΡΡΠΎΠ² остСосинтСза. Π£Π²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΠ΅ ΠΊΠΎΠ½Ρ†Π΅Π½Ρ‚Ρ€Π°Ρ†ΠΈΠΈ Π² ΡΡ‹Π²ΠΎΡ€ΠΎΡ‚ΠΊΠ΅ ΠΊΡ€ΠΎΠ²ΠΈ ΠΌΠ°Ρ€ΠΊΠ΅Ρ€Π° костной Ρ€Π΅Π·ΠΎΡ€Π±Ρ†ΠΈΠΈ (Π‘-ΠΊΠΎΠ½Ρ†Π΅Π²Ρ‹Ρ… Ρ‚Π΅Π»ΠΎΠΏΠ΅ΠΏΡ‚ΠΈΠ΄ΠΎΠ²) Π½Π° Ρ„ΠΎΠ½Π΅ Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Π“Π  ΡƒΠΊΠ°Π·Ρ‹Π²Π°Π΅Ρ‚ Π½Π° Π°ΠΊΡ‚ΠΈΠ²Π°Ρ†ΠΈΡŽ процСссов Ρ€Π΅Π·ΠΎΡ€Π±Ρ†ΠΈΠΈ. Π­Ρ‚ΠΎ ΡΠ²ΠΈΠ΄Π΅Ρ‚Π΅Π»ΡŒΡΡ‚Π²ΡƒΠ΅Ρ‚ ΠΎ ΡΠΎΠΏΡ€ΡΠΆΠ΅Π½Π½ΠΎΡΡ‚ΠΈ процСссов костного рСмодСлирования Π½Π° Ρ„ΠΎΠ½Π΅ лСчСния Ρ€-Π“Π  Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ. ΠšΠΎΡΡ‚Π½Π°Ρ фракция Ρ‰Π΅Π»ΠΎΡ‡Π½ΠΎΠΉ фосфатазы являСтся прогностичСским ΠΌΠ°Ρ€ΠΊΠ΅Ρ€ΠΎΠΌ ростового эффСкта, Ρ‚Π°ΠΊ ΠΊΠ°ΠΊ имССтся прямая коррСляционная Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡ‚ΡŒ ΠΌΠ΅ΠΆΠ΄Ρƒ этим ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»Π΅ΠΌ ΠΈ ΡƒΡΠΊΠΎΡ€Π΅Π½ΠΈΠ΅ΠΌ роста.

8. Π§Π΅Ρ€Π΅Π· Π΄Π²Π° Π³ΠΎΠ΄Π° Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π  Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ Π½Π° Ρ„ΠΎΠ½Π΅ постоянного роста ΠΌΠΈΠ½Π΅Ρ€Π°Π»ΡŒΠ½Π°Ρ ΠΏΠ»ΠΎΡ‚Π½ΠΎΡΡ‚ΡŒ костСй ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡ‡Π½ΠΈΠΊΠ° достовСрно увСличиваСтся (Π½Π° 7%) ΠΏΠΎ ΠΎΡ‚Π½ΠΎΡˆΠ΅Π½ΠΈΡŽ ΠΊ ΠΈΡΡ…ΠΎΠ΄Π½ΠΎΠΉ, хотя ΠΈ Π½Π΅ Π΄ΠΎΡΡ‚ΠΈΠ³Π°Π΅Ρ‚ Π½ΠΎΡ€ΠΌΠ°Π»ΡŒΠ½Ρ‹Ρ… Π·Π½Π°Ρ‡Π΅Π½ΠΈΠΉ. ΠŸΡ€ΠΈ этом ΠΈΠΌΠ΅Π΅Ρ‚ мСсто сниТСниС ΠΌΠΈΠ½Π΅Ρ€Π°Π»ΡŒΠ½ΠΎΠΉ плотности кости Π² ΠΏΠ΅Ρ€Π²Ρ‹Π΅ 6 мСсяцСв лСчСния.

9. Π›Π΅Ρ‡Π΅Π½ΠΈΠ΅ Ρ€-Π“Π  Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ Π² ΠΏΠ΅Ρ€Π²Ρ‹Π΅ 6 мСсяцСв Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π  ΠΏΡ€ΠΈΠ²ΠΎΠ΄ΠΈΠ»ΠΎ ΠΊ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡŽ индСкса массы Ρ‚Π΅Π»Π° Π²ΠΎ Π²ΡΠ΅Ρ… Π³Ρ€ΡƒΠΏΠΏΠ°Ρ…, нСзависимо ΠΎΡ‚ ΠΈΡΡ…ΠΎΠ΄Π½ΠΎΠ³ΠΎ вСса Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ…. НаиболСС Π·Π½Π°Ρ‡ΠΈΠΌΠΎΠ΅ Π΅Π³ΠΎ сниТСниС ΠΎΡ‚ΠΌΠ΅Ρ‡Π°Π»ΠΎΡΡŒ Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΠΎΠΆΠΈΡ€Π΅Π½ΠΈΠ΅ΠΌ. Π’ Π΄Π°Π»ΡŒΠ½Π΅ΠΉΡˆΠ΅ΠΌ Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΠΎΠΆΠΈΡ€Π΅Π½ΠΈΠ΅ΠΌ сохранялся достигнутый ΡƒΡ€ΠΎΠ²Π΅Π½ΡŒ массы Ρ‚Π΅Π»Π°, Ρ‚ΠΎΠ³Π΄Π° ΠΊΠ°ΠΊ Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π½ΠΎΡ€ΠΌΠ°Π»ΡŒΠ½Ρ‹ΠΌ ΠΈ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½Ρ‹ΠΌ вСсом индСкс массы Ρ‚Π΅Π»Π° постСпСнно нарастал.

10. На Ρ„ΠΎΠ½Π΅ лСчСния Ρ€-Π“Π  Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ ΡΠΎΠΎΡ‚Π½ΠΎΡˆΠ΅Π½ΠΈΠ΅ ΠΆΠΈΡ€ΠΎΠ²ΠΎΠΉ ΠΈ Ρ‚ΠΎΡ‰Π΅ΠΉ массы сущСствСнно мСняСтся Π² ΠΏΠΎΠ»ΡŒΠ·Ρƒ послСднСй. ΠΠ±ΡΠΎΠ»ΡŽΡ‚Π½ΠΎΠ΅ содСрТаниС ΠΆΠΈΡ€ΠΎΠ²ΠΎΠΉ Ρ‚ΠΊΠ°Π½ΠΈ Ρ€Π΅Π·ΠΊΠΎ ΡƒΠΌΠ΅Π½ΡŒΡˆΠ°Π΅Ρ‚ΡΡ Π² ΠΏΠ΅Ρ€Π²Ρ‹Π΅ 6 мСсяцСв, Π° Π² ΠΏΠΎΡΠ»Π΅Π΄ΡƒΡŽΡ‰ΠΈΠ΅ 18 мСсяцСв Π½Π΅ ΠΏΡ€Π΅Ρ‚Π΅Ρ€ΠΏΠ΅Π²Π°Π΅Ρ‚ Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ. ΠΠ±ΡΠΎΠ»ΡŽΡ‚Π½ΠΎΠ΅ содСрТаниС Ρ‚ΠΎΡ‰Π΅ΠΉ массы достовСрно нарастаСт Π½Π° ΠΏΡ€ΠΎΡ‚яТСнии всСго срока 2-Π»Π΅Ρ‚Π½Π΅ΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π .

11. Π£ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ гипСрхолСстСринСмия выявлСна Ρƒ 58%: ΠΏΠΎΠ³Ρ€Π°Π½ΠΈΡ‡Π½ΠΎ-высокий ΡƒΡ€ΠΎΠ²Π΅Π½ΡŒ ΠΎΠ±Ρ‰Π΅Π³ΠΎ холСстСрина (5,2−6,2 ммоль/Π») Ρƒ 26% Π΄Π΅Ρ‚Π΅ΠΉ ΠΈ Π²Ρ‹ΡΠΎΠΊΠΈΠΉ (> 6,2 ммоль/Π») — Ρƒ 32% Π΄Π΅Ρ‚Π΅ΠΉ. Π‘ΠΎΠ»Π΅Π΅ Π·Π½Π°Ρ‡ΠΈΠΌΠΎΠ΅ ΠΏΠΎΠ²Ρ‹ΡˆΠ΅Π½ΠΈΠ΅ ΠΎΠ±Ρ‰Π΅Π³ΠΎ холСстСрина ΠΈ Π›1Π¨11 ΠΎΡ‚ΠΌΠ΅Ρ‡Π°Π»ΠΎΡΡŒ Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΠΌΠ½ΠΎΠΆΠ΅ΡΡ‚Π²Π΅Π½Π½Ρ‹ΠΌ Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π³ΠΎΡ€ΠΌΠΎΠ½ΠΎΠ² Π°Π΄Π΅Π½ΠΎΠ³ΠΈΠΏΠΎΡ„ΠΈΠ·Π°. ΠŸΡ€ΠΈ соматотропной нСдостаточности содСрТаниС холСстСрина ΠΈ Π›ΠŸΠΠŸ Π±Ρ‹Π»ΠΎ Π²Ρ‹ΡˆΠ΅, Ρ‡Π΅ΠΌ ΠΏΡ€ΠΈ идиопатичСской низкорослости ΠΈ ΡΠΈΠ½Π΄Ρ€ΠΎΠΌΠ΅.

Π¨Π΅Ρ€Π΅ΡˆΠ΅Π²ΡΠΊΠΎΠ³ΠΎ-Π’Π΅Ρ€Π½Π΅Ρ€Π°. Π—Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½Π°Ρ тСрапия Ρ€-Π“Π  Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ ΠΏΡ€ΠΈΠ²ΠΎΠ΄ΠΈΡ‚ ΠΊ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡŽ ΡƒΡ€ΠΎΠ²Π½Π΅ΠΉ холСстСрина, Π›ΠŸΠΠŸ ΠΈ, Ρ‚Π°ΠΊΠΈΠΌ ΠΎΠ±Ρ€Π°Π·ΠΎΠΌ, ΠΎΠΊΠ°Π·Ρ‹Π²Π°Π΅Ρ‚ Π°Π½Ρ‚ΠΈΠ°Ρ‚Π΅Ρ€ΠΎΠ³Π΅Π½Π½Ρ‹ΠΉ эффСкт.

12. Π£ Π΄Π΅Ρ‚Π΅ΠΉ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ Ρ€Π°Π·ΠΌΠ΅Ρ€Ρ‹ сСрдца ΠΎΡ‚Π½ΠΎΡΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎ хронологичСского возраста Ρ€Π΅Π±Π΅Π½ΠΊΠ° Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎ сниТСны. Π”Π»ΠΈΡ‚Π΅Π»ΡŒΠ½Π°Ρ Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½Π°Ρ тСрапия Ρ€-Π“Π  ΠΏΡ€ΠΈΠ²ΠΎΠ΄ΠΈΡ‚ ΠΊ ΡƒΠ²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΡŽ всСх Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½Ρ‹Ρ… ΠΈ ΠΌΠΎΡ€Ρ„омСтричСских ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»Π΅ΠΉ сСрдца Π² ΡΠΎΠΎΡ‚вСтствии с ΡƒΠ²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΠ΅ΠΌ роста, Ρ‡Ρ‚ΠΎ ΡΠ²ΠΈΠ΄Π΅Ρ‚Π΅Π»ΡŒΡΡ‚Π²ΡƒΠ΅Ρ‚ ΠΎΠ± Π°Π½Π°Π±ΠΎΠ»ΠΈΡ‡Π΅ΡΠΊΠΎΠΌ эффСктС Π“Π  Π½Π° ΠΌΠΈΠΎΠΊΠ°Ρ€Π΄.

ΠŸΠ ΠΠšΠ’Π˜Π§Π•Π‘ΠšΠ˜Π• Π Π•ΠšΠžΠœΠ•ΠΠ”ΠΠ¦Π˜Π˜.

1. Π£ Π΄Π΅Ρ‚Π΅ΠΉ с ΠΏΠΎΠ΄Ρ‚Π²Π΅Ρ€ΠΆΠ΄Π΅Π½Π½ΠΎΠΉ соматотропной Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ цСлСсообразно ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ ΠΌΠ°Π³Π½ΠΈΡ‚Π½ΠΎ-рСзонансной Ρ‚ΠΎΠΌΠΎΠ³Ρ€Π°Ρ„ΠΈΠΈ. ΠŸΡ€ΠΈ выявлСнии структурных Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΠΉ Π³ΠΈΠΏΠΎΡ‚Π°Π»Π°ΠΌΠΎ-Π³ΠΈΠΏΠΎΡ„ΠΈΠ·Π°Ρ€Π½ΠΎΠΉ области Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌΠΎ исслСдованиС Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΈ всСх Ρ‚Ρ€ΠΎΠΏΠ½Ρ‹Ρ… Π³ΠΎΡ€ΠΌΠΎΠ½ΠΎΠ² Π³ΠΈΠΏΠΎΡ„ΠΈΠ·Π° для ΠΈΡΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΡ ΠΈΡ… Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚Π° ΠΈ Π½Π°Π·Π½Π°Ρ‡Π΅Π½ΠΈΡ Π±ΠΎΠ»ΡŒΠ½Ρ‹ΠΌ Π°Π΄Π΅ΠΊΠ²Π°Ρ‚Π½ΠΎΠΉ Π·Π°ΠΌΠ΅ΡΡ‚ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ.

2. ВсСм ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°ΠΌ с ΠΏΡ€ΠΈΠΎΠ±Ρ€Π΅Ρ‚Π΅Π½Π½Ρ‹ΠΌ Π΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚ΠΎΠΌ Π“Π  послС удалСния ΠΊΡ€Π°Π½ΠΈΠΎΡ„Π°Ρ€ΠΈΠ½Π³ΠΈΠΎΠΌΡ‹, Π²Π½Π΅ зависимости ΠΎΡ‚ Ρ€ΠΎΡΡ‚ΠΎΠ²Ρ‹Ρ… ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»Π΅ΠΉ, Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌΠΎ Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅ Ρ€-Π“Π  Π² Π΄ΠΎΠ·Π΅ 0,03 ΠΌΠ³/ΠΊΠ³/сут для прСдотвращСния дальнСйшСго отставания Π² Ρ€ΠΎΡΡ‚Π΅ ΠΈ ΠΊΠΎΡ€Ρ€Π΅ΠΊΡ†ΠΈΠΈ мСтаболичСских Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΠΉ.

3. ΠΠΈΠ·ΠΊΠΎΡ€ΠΎΡΠ»ΠΎΡΡ‚ΡŒ, обусловлСнная Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹ΠΌ ΠΏΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ Π³Π»ΡŽΠΊΠΎΠΊΠΎΡ€Ρ‚ΠΈΠΊΠΎΡΡ‚Π΅Ρ€ΠΎΠΈΠ΄ΠΎΠ² ΠΏΡ€ΠΈ соматичСских заболСваниях, ΠΌΠΎΠΆΠ΅Ρ‚ Π±Ρ‹Ρ‚ΡŒ скомпСнсирована Π½Π°Π·Π½Π°Ρ‡Π΅Π½ΠΈΠ΅ΠΌ Ρ€-Π“Π .

4. ВсСм ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΊΠ°ΠΌ с ΡΠΈΠ½Π΄Ρ€ΠΎΠΌΠΎΠΌ Π¨Π΅Ρ€Π΅ΡˆΠ΅Π²ΡΠΊΠΎΠ³ΠΎ-Π’Π΅Ρ€Π½Π΅Ρ€Π° ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΎ Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅ Ρ€-Π“Π  Π² Π΄ΠΎΠ·Π΅ 0,05 ΠΌΠ³/ΠΊΠ³/сут ΠΏΡ€ΠΈ сниТСнии Π—Π‘Π‘ роста Π΄ΠΎ -2 ΠΈ ΠΌΠ΅Π½Π΅Π΅, рассчитанного ΠΏΠΎ Π½ΠΎΡ€ΠΌΠ°ΠΌ для Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… с ΡΠΈΠ½Π΄Ρ€ΠΎΠΌΠΎΠΌ Π¨Π΅Ρ€Π΅ΡˆΠ΅Π²ΡΠΊΠΎΠ³ΠΎ-Π’Π΅Ρ€Π½Π΅Ρ€Π°.

5. ВсСм Π±ΠΎΠ»ΡŒΠ½Ρ‹ΠΌ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ рСкомСндуСтся исслСдованиС ΠΌΠΈΠ½Π΅Ρ€Π°Π»ΡŒΠ½ΠΎΠΉ плотности костной Ρ‚ΠΊΠ°Π½ΠΈ с ΡƒΡ‡Π΅Ρ‚ΠΎΠΌ костного возраста ΠΌΠ΅Ρ‚ΠΎΠ΄Π°ΠΌΠΈ двухэнСргСтичСской рСнгСновской абсорбциомСтрии с Ρ†Π΅Π»ΡŒΡŽ выявлСния Ρ€Π°Π½Π½ΠΈΡ… проявлСний остСопСничСского синдрома.

6. Для обСспСчСния достиТСния ΠΏΠΈΠΊΠ° костной массы ΠΈ ΠΏΡ€ΠΎΡ„ΠΈΠ»Π°ΠΊΡ‚ΠΈΠΊΠΈ остСопороза ΠΈ ΠΊΠΎΡΡ‚Π½Ρ‹Ρ… ΠΏΠ΅Ρ€Π΅Π»ΠΎΠΌΠΎΠ² всСм ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°ΠΌ с ΡΠΎΠΌΠ°Ρ‚ΠΎΡ‚Ρ€ΠΎΠΏΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΎ ΠΏΡ€ΠΎΠ΄ΠΎΠ»ΠΆΠ΅Π½ΠΈΠ΅ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ€-Π“Π  Π΄Π°ΠΆΠ΅ послС закрытия Π·ΠΎΠ½ роста.

ΠŸΠΎΠΊΠ°Π·Π°Ρ‚ΡŒ вСсь тСкст

Бписок Π»ΠΈΡ‚Π΅Ρ€Π°Ρ‚ΡƒΡ€Ρ‹

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