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XXI 25 28 2011 , . ...

-- [ 14 ] --

. 56 . 39, 17 16 70 . , , (18 ), , . , . III . . . 0,1 0,2% . 1 60 100 . , , , 0,006 . , . 6 7 . ( ).

516. : ..1, ..2, ..2, .. : Ǡ,ꠖ1, ,ꠖ : () .

XI : 372 , . 275, 19 79 . 2 . 1- , 10% - - 25-30 . 2 10% , . 2- 2 10% . 4 5% . . () .

.

: . () . 1- , 2- . . 2- 1- .

: .

517. : ..1, ..1, ..1, ..2, .. : ӠΠ -Ի1;

-,ࠖ2;

Ǡ -Ġ軠3.

: - () , - .

: 4000 . 4 1000 . I- . II- . III- . IV- .

: I- 333 () (33,3%), .. () 100 (10,0%)). II- 128 (12,8%);

III- 21 (2,1%) IV- . II- III- .

: .

XI 518. , A/H1N1/CA/2009, : ..1, ..2, ..2, ..2, ..2, .. : ӠȠ蠖1, 2.

, A/H1N1/ : CA/2009 () .

: 44 , 2009 . . : , () () , , , . (21 ) (23 ). , 12 () ().

: 1-9 , 1-16 , 6 21 6 27 . 76,2% 26,1% (=6,01, 95% 1,35-28,5;

0,01). (90%), (80%), (60%), (50%), (80%), (70%), (60%) (50%). 37 100% , 87% , 38 28,6% 21,5% . (47,2% 17,4%, 0,001), (95,2% 87,0%), (52,4% 30,4%, 0,001), (14,3% 0,0%) (28,6% 13,0%;

=2,68, 95% 2,12-3,40;

0,001). (61,1% 31,6%, 0,001), (44,4% 21,1%, 0,001), (44,4% 31,6%, 0,001), (33,3% 10,5%, 0,001).

519. : ..1, ..2, ..2, ..2.

: ӠΠ....ࠖ1. Ǡ3.蠖2.

: .

: 14.10.2010 . 410 , 45 30,9%, 45 69,1%, 97 (23,8%) 313 (76,2%). 31,2% (128 ).

: 170 .

(41,9%) . 200 . (48,9%) (, , ), (, %) (FEV, %). 79 . (19,6%) .

: , ( , , ) () (FEV1) .

520. (1996 2010 .) : ..1, ..1, ..2 : 򠖠1, : 1996-2010 .

: - .

XI : 1996 74,3 100 000, 2000 80,3;

2005 68,1;

2010 . 57,8 100 000. . 1996 . 10, 100 000, 2000 . 26,2;

2005 . 28,7;

2010 25,9 100 000. (2010 . 22,9 100 000), . (1996 . 26,4;

2000 . 39,3;

2005 . 28,4;

2010 . 25,2 100 000), , . , : 1996 . 11,7;

2000 . 9,6;

2005 . 7,4;

2010 . 4,0 100 000 . , .

, . , .

521. : ..1,2, .. : ...-1, ȠΠ͠ () . 732 : 462 20 60 . 50,5% .

, 302 (52,5% 20,6% ). 23,5%, 15,5% . 1,7 , , 3, 4 . . () 4,4% ( 3,9 , ). () 17,8% .

, . 46,8% 10,1% . , . , . - XI 522. , , : ..

: , . , : , () .

: 137 , 2 . 1 56 , 1 . 117 : , , (=0,7778) 45% (25/56) 1 34% (40/117) . (1 ), 1 (21% (12/56) 8% (9/117), , =0,0156). 1 , , , , , . 2 .

: , , 21% , .

523. - : ..,..

: , . , (). .

, . , , , . . , , - , , . , , , , . , , , . , .

524. : ..,..,.., ..,..

: ӠΠ ,. : () ( XI -2) .

: ( ͻ .), , , 5 5-7 ( ). - , , , . , . , , .

: 150*18 - 35*25, - -6. - , .

: - .

525. : ..,..

: , () : .

: , .

: 484 . -286 (59,1%), 198 (40,9%). : 20 56 (11,6 %), 21 30 78 . (16,1 %), 31- -118 (24,4%), 41-50 -113 . (23,3%), 51 60 -62 (12.8%) 60 -57 (11,8 %). , , : , , 10,9% (53 .)- 56,6%;

, , 16,0% (77 .), 63,6%;

14,8% (72 .): 52,8% 47,2% ;

40,2 % (194 ), 65%;

18,1% (88 .): 55,7% 44,3% . . - , 79,6 95,5% , .

: , 6 , , . 50 . , , , . .

526. : ..,..,..

: Ӡλ .

: (), ( () 100 ) . 1-, 3-, 7-, 14-, 21- 30- . 10 , 24 .

: 1- . 3- 10 , 1-2 7- , . 14- 6 , . 3 , , , . 1 . 3 , 30- . 30- 8 , .

2 , 3 .

: .

XI 527. : ..1,2, ..1, ..3, .. : 211, 򠖠2, Ѡ3, , : () () ().

: 40 60 . (). CD3+-, CD4+-, CD8+,- CD20+, IgA, IgM, IgG (). 20 30 () 10 . 20 30 ( ).

: , Ig , CD3+, CD4+-, CD8+, IgA. - , . , : , .

528. : ..1, 2,..1..1, : 21-1, 2.

() : ().

: : , , . () () (). () ().

() (, , , , ).

: , , . . - , , - . .

: , .

529. : ..1,2, ..2, ..1, ..1, .. : 211, 򠖠2, Ѡ3, ., () : ().

, : , . () ().

, in vitro , .

: , , , . , in vitro , , . , .

. : , , .

XI 530. 2011 .

: ..,..

: ӠΠӠ...a - .

: 2011 .

: 24 5,5 15 . 18 , 14 .

: 2011 .

, , (58,3%), (, - ). , , (8,3%). , , (44%), . , H1N1 swine, B. .

(72%) (77,8%) . - ( , , , ). B (16,6% 5.1% ).

531. /, H1N : ..,..,..

: ӠȠ : 12 22 , / H1N1. 3, 6 12 . , (, , DLCO), , 6 (6-MWT), , . .

: , DLCO 80% (50.920.9%) ( 6-MWT 453.7 36.6 ). (FVC 57,710,6% vs 101,910,2%, p=0,01;

TLC 72,07,1 vs 106,57,6, p=0,01;

DLCO 29,53,9 vs 64,95,8%, p=0,01, ). 1- DLCO: 3 62,15,8% vs 85,73,2%, p=0,01;

67,85,2% vs 89,02,2%, p=0,01, 12 67,97,4% vs 92,21,5%, p=0,01, ).

: , , , . 12 . .

532. : ..1, ..2, ..2, ..2.

: ӠΠӠ蠖1, Ӡ ࠹1 ......2. . .

.

: 80 6 12 . 72, 8. 15 92 35 29 , 35 60 42, 60 9. , . 32 (40%) . . ( . 2257161, 2005).

3 . 42 (52,5%) , , 12 (15%) , XI , 26 (32,5%) , .

: 42 2 (4,8%), 12 (25%), . 80 (6,2%). - .

: , , , 6,2% .

*** .

: ..,..,.., ..,..,..

: Ǡ, , . , , , .

, , , ;

/ .

2006 . 2011 . 132 : : 132 25 (18.9%) . / 8 (6.1%), (, , ) 9 (6,8%). , () () 90 : 35 (26.5%), + 14 (10.6%), 41 (31.1%).

42 : 14 ;

11 ;

( ) 5 ;

9 , ;

(, , .) 8 . 24, 18;

18 75 . . 3 , ( 4-6) . : 18 48 ( ;

).

XI . , , : 2-3 ;

;

;

;

.

.

, , : ..,..,..,..,.., ..

: Ǡ, .

, 2006 2011 .

132 . 25 (18,9%) . 8 (6,1%) . 9 (6,8%) , , . 35 (26,5%) . 14 (10,6%) 2-3 . 41 (31,1%) 2-3 .

14 (10,6%) 11 (8,3%). . . . .

. 3 4 6 . . 1,5-2 , . 2 : 48 . 18 48 .

2-3 ( ) , . 86%.

. . , . , .

XI ..430,433, BayerstorferR.437 204,441,442,514,202, BayerstorferR. .. ..395 HaasV. ..121, HaasV.437 ..103, HohlsM. .. HohlsM.437 ..43 ..7, KuhtinO.437 ..185,186, KuhtinO.21 187,178,179,180,182, ..340,341, MaM.A. ..341 .. NiehuesT.21 ..298 .. WexP.437 ..425, ..449 ..473 .. ..487,488,527 ..351,353 ..130 ..5,221, ..37 .. ..88 .. ..402, .325, 403,404,405 ..41 ..381,382 ..158 ..407 .. ..467 .. ..126,169,469,531 ..202, ..276 204 ..154,443,448 ..136, ..96 ..242 -..425,432 ..351,353 ..337,340,341 .. ..487 .. XI ..358, ..66, ..149,277,493 ..351, ..29 ..75 ..123,124, 152,431,201, ..276 .. .. .. .. .. . ..91, ..313 .͠44, .. 109,110,230,518, .. .. ..523 .. .. ..289,290 ..49, .. ..126,184 .. .. ..232,233, ..29, ..72,123, ..240 ..413 .. ..140 ..247,248,249, .. ..180 .. ..165,166, ..292 ..118, .à292 ..349 .. .. .6, .. . 470, .. 321,322,323,144 ..375 ..63,310 ..389 ..300 .. ..61,281 .. ..183 .. ..464,465,463 .. ..463,465,464 .. ..485 ..368. ..145 ..393, ..102 394,392,65, ..101 ..392, 253,490,393, ..69 ..107 ..105, .. ..284 ..217, .. ..155 . 470 ..129,161,162,477 .. .. ..,16, ..348, ..350, 354,355,360,361 ..359, ..350, ..95 354,355,360,361 .. ..361 ..53 ..,16,269 .. ..87,306 ..76, ..311 78,79,77,80, ..249,227 .. ..510 ..415 .. .. ..355 ..418 .. .. .. ..349 .. .. .. .. ..183 ..276 ..29 ..45, .. ..14, ..121 .. ..27,64,67, ..219 ..141, ..28, .. ..359 ..121, ..147 .. ..13, .͠103,104,158 ..241,304, ..128 445,295,301, ..1,29 ..305,445,295, .. ..253,392, 393,394,65,490 .. ..149,277,493 ..412, ..346 ..184 ..149,277,493. .. ..176,177 ..255 ..332 ..203 ..516 .. ..6,155 .. ..519 .. ..411 ..494, ..89 ..457, XI ..424 .. ..6,155 ..375, ..2 .. ..46 ..2,129 ..103,104 .. ..235 ..430, ..13,20 ..91 ..67 .. ..435,436,429,434 .. ..213,214,215 .. ..139 .. ..472 ..165,166, ..319 ..497, ..235 ..204,441,442 ..533,534 .. ..385 ..52,60,273,236, ..2 .. ..59 ..289,290, ..247,249 . 109 ..317 .. ..317 ..47, ..3 ..23 ..367 ..365, ..415 ..107, 231,232, .. ..198, ..13, .. ..75 .. .. ..346385, .. .. .. ..135,137 ..107, ..319 ..213,214, .. ..57 .. .. ..311 ..4,157, .. ..91,93 ..444,446, ..159 .. ..500 .. ..501 .. ..503, ..458, ..175,438, .222 ..350 ..260 ..418,430, ..441,442,204 ..427, ..261 ..351,353 ..289 .. ..372 ..344 ..97 .Ϡ174,492 ..134 ..132 ..402,403 ..44 ..136,138 .. ..253 .. ..490 ..240,327, ..283,284 .. .. .


.103, ..477 ..39, ..181,279,477,315, ..89 316,517,7,15,70,129,161,162 .. ..324 .. ..46 .. ..245 .. ..284,419 ..5,221. ..5,221, ..151 ..460,461, ..240,473 ..57 ..240, ..264 473,493,6,93, .. ..10, ..125,428 ..10 ..100, ..116, ..148 .. .. ..317 .. .. ..443, ..474 .. .. ..533, ..193, ..360,361 .. ..443, ..343,345 ..189,190, .. . ..347 ..494,495 ..55, ..52,60 ..122 ..32,33,34, ..324 35,36,207,208,455, ..336, XI .. .. ..203 .. ..226 .. ..409 ..144 ..455,456 .. ..524 ..66,488 ..268,270 ..460,461, ..123 ..320 ..404,405 .. ..324 .. ..519 .. ..503,504 ..497, ..60 .. ..499 ..213,214, ..270 ..402, ..352 403,404, ..132 .. ..406,407,408 .. ..220,475,476,479 .. ..16,269 ..449 ͠..175,440 ..299 ..93 ..368,369, ..531 .. ..189,190,191 ..358 ..48,49 ..112, ..326 .. ..129 .. ..343,345,379,380 ..396, 397,398,389, ..144 ..240,473,487,528 .. ..229 .. ..311 ..136,138 ..334,496 ..229 ..225,308,318 ..123, 124,152,431,426, ..225,308, ..149,277, ..193, 194,195,222,511 ..113,115, 117,259,260,261,262, .. ..268, ..298 . .. .. ..65, .. ..334, ..198 ..50, ..175,438,440 ..213,214, ..347 .. ..219 .. ..107 ..444,446, ..265 .. ..481 ..219 ..52,60 ..164 .. ..178,179, ..135, 180,182,184,185,186,187 136,137,138,228 ..483 .. ..179 .. ..162 .. ..194, .. 195,470,471,511 ..459 ..486 ..167 ..144 ..135, ..244 136,137,138, ..414 .. ..503 .. ..387 .. ..451 .. ..434 ..153,429,427, ..530 ..202,514 ..124 .. ..63,310 ..164, ..492 .. ..274 . ..8 .  ..325 ..193, .222 ..63, ..161 .. ..116 .. ..237 ..38, ..202,514 .. ..274 .. ..327 ..167,168,293, ..136,138 ..258, 266,267,508, ..134 ..144 .. .. .. ..261 ..439 ..1,45,72 ..205,206, XI ..121,423 ..399,400, .. .. ..48 .. ..326 䠖203,204, ..170,174,200,492 ..338 ..512 .. ..235 -..124 ..144 ..354 ..241 ..324, 300,291,288,278, ..308 ..144, .. ..435, ..258,266, ..271, .. ..196 ..94,130 .ߠ1,159 ..284 .. ..144, ..332 415,321,322, .. .. ..132 ..304 ..430,433 ..277 ..450, ..38,39,40,48, .. ..107,231, . .69 .. ..194 .. ..48, ..385 ..251,252, .. .. .. .. .. ..391484 .. ..148 ..460,461, ..365,366,367, .. 368,369,370,371,372, .. ..365,366,367, .. ..197, .. .. .. .. .Ƞ176,177, ..424 127,227,247,248,249, ..160 .. ..203 ..101 .. .. ..122 .. ..275 ..362,363, ..367 ..135,137, ..254 ..13, ..171,395 .. ..200 ..412,417 ..200 ..244 ..87,306 .. ..56,512,513 ..427 ..328 .. .Р376 ..283,284 ..22 ..165,166, ..198,332 .. ..513 .. ..12 .Ġ ..192 ..131,149 ..242 .. ..192 ..27,64,67, ..383 .. ..93 .. .͠ .,369 ..508, ..46 .. ..16, ..428 ..264 ..163 .. ..474 .. ..396,397 ..298, ..26 .. ..295 ..198 ..178,184 .. ..125 .. ..82,413 ..312 ..2 .. ..350 ..255 ..451 ..425, ͸..38,39,40 ..351, ..42, ..411 54,217,218,522 ..276 ..120 .. ..20 ..44, ..188 .. .. ..172 .. ..48,49 .. XI .. ..25,26 .. ..317 ..165 ..147 ..332 ..343,345 .. ..421,422 .. ..364 ..312 ..273 .. ..158 ..65, 253,392,394, ..189,190, .. .. ..287 ..32,33, 34,35,36,207,208 .. ..480 ..75,77,78, ..135, ..76,77, 136,137,138,228 78,79,80,81,500, ..449 .. ..348,409 .. ..134,146 .. .

.134,146 .. ..172,303 ..173 ..229 .. ..453 .. ..307 .. ..320 ..229 ..320 .. .͠224 . ..449 .. ..80 ..287 ..231, ..506 232,233,505,454 ..194, ..502 470,471, ..424 ..305, ..480 .. ..298,299,164 .. ..328 .. ..185 ..18,43 ..412,417 ..18,43,172 ..412,417 ..245 ..489,529 .. ..158 ..73,74, ..158 ..135,137, ..516 ..77 ..52, ..210, .. ..1,129,161,478 .. ..296,297,387 ..7,15, ..43 ..88, ..3 ..226 ..238 .. ..256 .. ..275 ..91 ..143 .. ..431 ..213,214, ..124,152, .. ..279 ..288, ..171 .. .. .. .. ..109,110,230, ..525 .. ..178, .. 179,182,185, ..130 .. ..93 ..18,43 ..1,455, ..55, .. ..427 ..240, .. ..220,475,476, ..295, ..246, ..147 .. .. ..124, .. .. .. .. 75,78,79,80, ..125 ..533, .. ..76, .. .. .. .. ..313 .. .. ..73 ..122 ..199,284, ..460,461, .. ..83 ..112, ..203 .. ..48, ..238, .. ..533,534 ..265 XI ..167, 168,293,356 ..213,214, ..491 .. ..530 .. ..125 ..205,206, ..150 ..311,313 ..359 ..325 . 358,359 .,376, ..411 ..213,214, ..280 .. ..359 .. ..289 .. ..74 .. ..,9 ..259,260,262, ..295 .. .,250 .ʠ376, 377,378, .. ..301 .. .. ..449 .. .. .., ..52,60 .. ..111,211,212, ..306 ..97,412,417, 193,194,195,470,471,511,222, Π.. ..38,39,40 ..337,340 ..174 .. ..166,170 ..503, ..342 .. ..213,214,215 .. ..364 ..434, ..260 ..436 ..333,416 ..289, ..259 ..341 ..92 ..424 ..344 ..120 ..421,422 ..48,49,39, ..242 .. ..12 .. ..533,534 ..44 ..449 ..340 ..354,361 ..124 .. .. .. .. ..289,290, .. ..41,325,524 ..141, ..41,524 .. ..22,24,329 ..84,85, .. .. 22,24,329,330 .. ..500, ..69 ..61, ..412,417 .. ..526 .. ..150,188,264 .Ԡ112,243, ..150,264 .. ..203 ..282335, ..134 385,346,386, ..450,452 .ʠ ..276 .. ..8 .. ..251 ..121, ..384 ..234, ..518 .. .. ..192 .. ..91 ..533, ..131, .. 141,142,159,96,98, .. .. .. ..251252, .. 529,523,223240,473,487, 488,489,493,527,528,529, .. ..251, 252,489,527,529,66 .429,153, 346,347,427,434, .. ..429, ..458 ..149,277,493 ..,.154,448, .. ..304 .. ..121, ͠.. ..140 .. ..113,114, .. ..352,379,380, .. ..23 .. .. .. .. ..164 ..480 .. XI ..412, .. ..287,290 .. ..253, .. 392,393,394,490 ..457, ..287, ..245 289,290, ..238,239, .. .Ġ309 ..282,335, .. .. .. .. ..289, .. .. .. ..240, .. ..279 .. ., ..444,446, ..167,168, ..203, ..153,122,164, .. 176,177,225,247,248,249, ..427 .. ..87, ..129477,517 .. ..109,110, ..44,126,169, 259,260,261,262, 110,113,115,469,195,449, ..455, ..283, .. 284,410,419, ..83 .. ..349 ..17,18, ..23,119, ..176, .Ƞ .. .. ..14, .. ..275 .. .. ..279 .. ..1, ..48 ..336, ..91 ..315,316,450, ..226, ..93 246,265,294,457, ..312 .. ..358 .. .Ѡ .. ..365, ..311, .. ..226,294 .. ..375 ..91 ..336, ..69 337,338,339,340 .. ..306 ..172, ..87 ..199,283, ..344,347 ..213,214, ..332 ..44 ..347 ..57 ..243 XI 1. : ................................................................................................. 2. II : ..,..,.....................................................

3. : ..,..,..,.., ..,................................................................. 4. , : .

.................................................................................................. 5. 24- () : ..1,..2,..1.......................... 6. : ..1,.2.,..2.,.. 2,..3......................................................................................... 7. - : ..1,..2,..1.............................. 8. 1 : ..,..,..,.........

XI 9. X : ..,................................................................. 10. : ..1,..,..2......................................... 11. : ................................................................................................... 12. , : ..1,..1,..1,..1, ..2............................................................................................ 13. : ..1,..1,..1, ..2......................................................................................... 14. : ..,................................................................. 15. - : ..1,..2,..1.............................. 16. , 2 , : ..,..,..,..,..... 17. : ................................................................................................. 18. .

: ..,..,..,.., ..,.................................................................. 19. : ..,................................................................. 20. : ..,.., .., .., ..,..,............................................... 21. : HaasV.,KuhtinO.,NiehuesT.,BayerstorferR.,HohlsM................................ 22. : ..,..,............................... 23. : ..,..,..,...................... 24. : ..,.......................................................... 25. Ļ : .................................................................................................

26. : ..,................................................................... 27. - : ..,..,................................................... 28. : ..1,..2.......................................................

29. : ..,.., .., ..1, ..2..................................................................................... XI 30. : ............................................................................................. 31. / / .

: .....................................................................................................

32. ( ) : ..1,..2............................................................

33. ( ), 2.

: ..1,..2............................................................

34. ( ), 1.

: ..1,..2............................................................

35. . : ..1,..2............................................................

36. . : ..1,..2............................................................

37. : .., .........................................................................

38. B- PAX-5 : ..,..,͸..,.................................. 39. STAT6 : ..,..,͸..,..,.., ................................................................................................

40. IL-4, IL- : ..,..,͸..,..,........... 41. : ..,...................................... 42. : .................................................................................................. 43. : ..,..,C..,.., ..,......................................................................... 44. .

: ..,..,..,..,.., ..,................................................................. 45. - : ..1,..2................................................................... 46. : ..1,..1,..1, ..2..

47. : ........................................................................................... 48. , -5, BCL-2 BAX -3 ().



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