Вы находитесь на странице: 1из 300

..

-, 2002

.. .: -, 2000.
- 304 .

ISBN 5-8249-0077-9
, .
. , ,
.
, , , .
, -.

ISBN 5-8249-0077-9

.., 2002
^ -, 2002

, 2002

1.




2.
-







3.

11
15
15
22
24
27
29
32
36
39
46
48
49
70
87
102
109
113
119
120
122
123
129
131
133
139
141

4.

147



150


152


156

166


167
.... 176


177
5. --.

179


185
, .... 187

194
6.

203


205
-

214

218

220

224


225


227
-

230


239

243

250
HLA
251


252
.
.. 257

268

276

285

(GnRH)

(FSH)

(LH)

(TSH)

( DEA)

(DEAS)

170

17-

CBG

TeBG

PiF

VEGF

FGF

BMP

CSF

IGF

IGFBP

- -

EGF

TNF

(S1) (b1-
TGF

37 , . 22
().
28 37 .
22 28 .
,
, ,
.
, , 7
, .
. 15 20%
. , .
, , 60 80% .
.
: , , , , .
: , ,
, , ,
.

. 2% . 5 20%.
, .
, , , ();
/ ; -

- , , , . ,
, 10 , 2,4%.
,
, . .

'

*J%'I

'


.
, (
..), ,

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

, , .
, --, .

. , , . .
,
, ,
.
, .., .., .., .., .., .., .., .., ..,
.., .., .., ... : .. , . , .. ,
". , .. , . , . , .. , .. -

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

1.

I
I

-
- (. 1). - : , .
(- , ) (, , ) .
, .
,
: -, -, -. , , - .
, (Yen, 1998).

. 1. - .

13

. 2. -

- (GnRH) 1 ( ) (. 2).
GnRH (Yen, 1982). GnRH.
(), ,
GnRH. GnRH , .
GnRH - ()
() . GnRH .
, . 1 2
4 . .
, , : - (
) - , .
,
. . ,
- , . -

14

7 19 ,
. , (Talmadge ., 1984).
.
f .
. I -, t , , .


, 28 .
, ,

.
--, : , , ,
. , (S.Yen, R.Jaffe, 1998).
,

, , , ,
, , , . 3 :
, .
,
,
. Peters ., 1975; Gougeon,1986; Erickson, 1986
.
.
10 14 . , , , , ; . .


20 , 2 .
300 .

15

. 3. .


500 .

(Halpin .
1986), , .
,
/ (Yen,
1998). ,
.
,

,
, . ,
,
(Peters ., 1975).


(. 3). , 56 . , 8 1620 ,
67 ,
.
(Zona pellucida).
, , ,
.
16

. :
, .
,
, , . , ,
. , , (Adashi E
., 1982; Hsueh ., 1983).

. . (Tilly J., 1992). G-.-
,
: , -, .
. (Hild-Petito . 1991). - ,
.
,

5-, , , .
, .

, . ,
. (Chabab . ., 1986).

, ,

. - .
.
,
, : -.
, -, (Hsueh
., 1983). -, ^ .
-


.-

17

. 4. ,
.
s

. - , , , (. 4).
-
-, 450 sec -- (Magoffin D.A.,
1991), - (IGF-1)
, .
-.
- 45017 ,
. -
. .
, , ,

18


, , ( ).

, .
, .
, .
/
(, , ), .
;
; ,
(Bicsak, 1986). .
- (IGE). IGF-1 , - (), , , .
IGF-1 -, . -, , (tumor
necrosis factor TNF) (EGF), .
*
EGF . IGF-2
, IGF-1, TNF-a,
TNF-p EGF.
/
, -, .
.
,
. ,
, ,
, . , , -,
(. 5).
, 1012 2436
. , , , .
, .
, , .
3- ,
, , . --

I
I
I
I
I
I

19

. 5. : , ,
2() () ;
; .
. , , .
. . 2-
, , (, )
, (Brannian J.D. . 1991)

20

I
k

8- . ,
(Filicori M. ., 1984).
.
, . ,
(Mac Naughton ., 1992). .
911 .
- , (Press M.F. ., 1988).
, .
,
. - . , , , ,
, .
,
. , .
, , .
;
. , .
, ,
.

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

in

. 12 .
. , , 1214. .
4872 .
- . 67
.
1012 . ,
,
.
1012 (25
26 ). , . ,
68 . . . : ,
, .
G. Nikas (2000) . 48
,
. , ,
. (. 6). .
1516 ,
17
, , . 1819 ,
, . 20
, , (, pinopod)
(. 7). -

22

. 6 17-
( , G Nikas, 2000)

. 7 20- ,
( , G. Nikas, 2000).

. 21 , . , . 22 . 24 , . 26
, 28 .

23

68 iWRSne ,
, ,
. ,

.
, .


.
, ( ) .

. 8.
(..Clinic. Gynec. Endocrinology and Infertility).

PgG2 PgH2, 5 ,
.
2 PgD2.
Moncada S. . (1979)
, (Pgl2), : ,
.

24

2 , 12 . , , , ,
, .
, Aj (Gryglewsky R.
.,1979).

. 9. - .

2 . , . ,
(Moncada S. .,
1979). , . F20t . / .
Olson D.M. . (1993) . (
), .
, .
. ,
(810 ). , (Masotti G. .,1979).
F20( .
: , , (Auletta F.,Flint A.,1988).
.
F (Auletta F. . ,1976;
Gore B.C. ., 1973).

25

, .
,
, ,
(Norwitz E .Wilson . 2000).
, ductus arteriosus
, -, , d. arteriosus. ,
40% (Coceani F. , 1980).
.

2.

(recurrent pregnancy loss), .


, I 75% /
, . , .
.
. -, ,
, . , , .

:
1) ;
-*
2) ;
3) (, );
4) ;
5) ;
6) ( , , , - , ).

. , , .

-

- . . ,
, , . , . , 3- , 1,52 , ,
3- .
, , .

29

. .
, .
.
, , , . -,
( , , .)
.
56 , .
,-s
, , , ,
, , . ,
, (Miller, 1968; lamazaki J. .,
1990).

.
.. (2001), , , , .
23,5 , 2,5 .
24,7%.
I , , 5 (Creasy
., 1994). , ,
. (360500 ), , (Creasy ., 1994).
(, ) .

,
(Quellet-Hellstrom ., 1993).
, ,
, , .
, ,
.
,
, (Clarkson ., 1972).

30

100 .
,
(), , (1991 ). , , .

,
, ,
(Parron . ., 1996).
, , :
.
,
6
(Restrepo M. ., 1990).
, , , . . ,
42 I , 8,5%, ,
42 4,5%. , (Klebanoff ., 1991).
*
,
, 22%,
6,3%. , ,
6,3%, 4,3% ( .., 1991).
, , . , , , , ,
29,80,8 25,70,1 .
2024 2529
( 7,1 7,4%).
' "
20 35
, 15,6%. .
.. (1980) (7,5%). ,
: 8,4%, 9,2%. (Bakketing L.S. ., 1980) ,
, , (
, ).
, , . , ,
, . -

31

.
, , , .
, , , ,
(Mcintosh J., 1984). : , .
( ), . , , .
(Harlop S. .,1980).
.. (1987) ,
29%, 1225%,
22% 0,10,4%.
. , (Jacobson J.L.
.,1994).

(Coopper R. ., 1996). , , . ,
, , .
,

(Golard R. .,1993). -
(Hill J. .,1995).

(Klock ., 1997; .., 1993).
,
, , - .



. .
Weathersbee P.S. (1980) 1015%
. Wilcox . (1988)
22%. ,

32

, . . ,
.
Boue J. . (1975)
5065% . French F.
Bierman J. (1972), 1000 , 5 , 28-
227, , . 30,5% ,
49,8% , 16- ,
23,7% - 17,4% . , ,
, .
(Creasy M. ., 1976).
.. .. (1983), 50% , .
- ,
. 95% ,
.
1 200 . ,
. 1 Jacobs P.A. (1972), 24468 . 121 .
1
,

45.

1
31


47.XYY

23

47.XXY

17

47.

10

32

39

82

, . , .
2 6747

33

<
de novo , ,
.
, ,
, .
30% ( A.M., 1975). ,
: , , , , , , , , .
, ,
, de novo, , ..
.
10 , 2,4%
(Trochet-Royer ., 1981).
.., . ()
. (69XXY, 69XYY ..).
, .

. 45X0 98% 2%
(Paton G., 1974). , .

. ( , , ) , .

, , ( ).
210%, .. , 0,2% ( .. ., 1977).
,
, .
Boue . . (1985), 2 7% , .

.

34

(
), ,
.
, ,
.. Gardner R. . (1996), ,
2550%.
Benirschke . (1988),
,
. 819 83 , (23), (27),
(3), (10).
(Boue I. ., 1975). ,
180.
9- .
. ,
.

, , . . .. (1980) , 21,7%,
.. . , . - ,
,
1, 9, 16, S h ,
Y , .

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

35

2- ,
- , ,
, , , ,
, .
-, , :
1. , (+);
2. ;
3. ; ;
..;
-, ,
.
, 44 (88 ) I ( 78 ), 39 : 12 , 13 (15,9%) .
9 1 , (2,10) . ,
.
9 qh 10 (5 5 ); 11 11qn 11 2- ; 12q ; 13s+
2- ; 13 13q ; 14s+ 3- ; 15s+ 2- 2- ; 15+ 1 ; 16qh 1 ;
21 s+ 3- ; 21 ; 22s 2- 2- ; 22 2- .
, , , .
, ,
.
, , .


20 , ,
. ,
, ,
,
.

36

, , ,
, ,
()
.
,
,
.
, 26 28- .

.
. , Noyes .
(1950), , 1,81 . 3 .
, ,
, . , 25% (Scott J. ., 1988).
, , ,
51,4% 26,7% (Davis O.K. .,
1989).
Botella-Lusia J. (1973),
.
,
. , .
, .
, ,
, (Li T.C.
., 1989; Jordan J. ., 1994).
, , ,
, - . , , , , , ,
,
, , .
7080 . , II
, .

37

, ,
- , - , , . ,
, ( ) . , ,
. - ( ) .

, .
. . ,
. , .. II 31,879,5 /.
,
, .
, .

2 (<0,05) 3
(<0,05).
. ,
. , (<0,05).
,
3 . . /
. .
, -

38

.
, .

, : , , , . , , .
. ,
.
.
,
, , (Rodger L ., 1998).
I
.
,
, , .
.
, (Speroff L, Gloss R.H. ., 1994).
, , , ,
10 . ,

. (Karamaridian L ., 1992).
.

, ,
, .
, 4677%
, 6074% 2132% . .
,

39

, , ,
.
, , 30%
. ; ,
; , ; ,
.
, . - ,
,
(Yen S., Saffe, 1998).
( 1):

1. .

, , , - . , , , .
, -
.
, ,
20%,
, , , . , , (Parker L .,1980; FeherT. .,1985).
- , -,
(Winterer J. .,1985). - (CBG ), - -

40

(TeBg) . .
, , , .
21- ( 212) ( 2):

2. 21-.

, ,
17-.
. -; .
, 17-. , .

17<- - .
, , . 17- 500 ng/dl , .
17 200 ng/dl, 500 ng/dl
(0,25 (-) /, ). 17- 1000 ng/dl, 236392%,
.
- 21 -, 6 HLA ( ).
21 21
21 (Speiser P.W. ., 1988).
21- HLA (B14.B35)

(Speiser P.W. ., 1985).
, 21 - , (, ) (New M.
., 1983).

41

11 - ,
11 - , .

, .
,
( ), , , (Azziz R.
., 1991). 11- 8 ,
HLA ( 3).

3. 11 -.


, .
- ,
,
. ,
.
( - ), , ( 4).

4.
-.

Botelle-Zlucia (1973),
.

42

,
.
, ,

.
.

.
, ,
. .
, 17-,
17 , 21-. ( 80,9%, 92%, 75,8% 90%) 17, , 17- .
( 236392%) , , 17-


. 90,5% ,
( 9,40,6), ..
. 76,2% , 23,8% .

() 12,1%
.

, , , .
. 45017-- , -, (Rosenfeld R. ., 1990).
. ,
. ( ,
), ,
, ( ,
). /, .
(Chom G., 1973).

43

. 10.
(Yen Jaffe,1998).

50% ,

.
, - (Givens J. ., 1975).

. 10.
--. , , , ,/,,.
, , , .
. . ,

44

- . .

. -, , (Seibel M., 1984).
. - I ,
( ) 50% . , ,
.
, .
,
. , : 15,20,6; (26,30,8). ,, ( ,
64,7% ).
, , . 78,6% ,
, 10 , 5 10, .
( ).
57,9%.
(< 0,001) (< 0,001).

17- 17 51,3% . , 1/3 .

, . 49,9% (, ), .
46,1% 69,2% .
(18,3 1,0) (26,50,7) 17
17. (96%) , 60,6%
. , , .

45


:
17, 17- .
- ,
, , 14,3%
. 4 , 10 ,
11 14 .
. 50% , ,
.
-
, , , , no-, ,

--- .
( , , , - .),
. ,
.
-
,
. --
,
,
, .

, , . 1981 . . , . 6- (Owerbach D. .,
1981). . - ,

46

, (S. Yen., 1998).


%
:
1) (-22000) ;
2) (-50000)
3) -.
- .
, - ,
. - (), -
(). --, . , ,,.
, , , .
I ,
10 . ,
(Rigg L. ., 1977).
12
.
, ,
. , 510 . II
.
. ,
. , , ,
(Bigazzi M ., 1981).

, .
/ , . , 40% (Glickman S.
., 1982). -. ,
.
, , , .
.
5- (,
) .
(Gustafson . ., 1980). ,
.
,
(Magoffin D. ., 1982).

47

,
- ,
, , , .


, ( ,
) .
- ,
. ,
, , ,
, .
, .
--.
, ().
() , .
.
,
,
,
-- (Gordon G. ., 1969).
- , , , ,
. , 16- -.

, ,
(Gordon G. ., 1969).
.
. , , , .

48

. ,
, .
, ,
,
.
,
,
, .
12,7% , .
, , ,
.
3-
(2,5%) .
.
13 65 ,
21,0%. .
Stagnoro-Green A. (1990), 19,6%
. Roberts J. . (1996),
36,3% .
, . -, .
, .
. Beer . (1998),
CD 56+, CD19+5+ ,
,
, .
, .


. , , (Witkin S.S.
., 1992; . ., 1993), , , , , (Khan G.
., 1998).

49

,
, ,
.
20 , , .
, . 42% - , , . 100% .
,
.
,
, ,
, .
, , , , ( ), ,
. , , , . , .
, , , (Amstey M., 1976).
,
,
.
,
,
,
,
,
( .. ., 1978).
. ,

,
.

, , , , .
. ,
, .
( P.M., .. ., 1982).
.

50

,
, . , I , 2550%.
.
,
30% ( . 35%
,
, .. (.., 1986).
, .
, .
, , . ,
I , .. . , , .

. I ,
. , .. . , .
.

. , , . , .. .
6 (0,25 / ).

. 25% , .
. . .
.
. . , .. . , ,
.
, - . ,
. . 0,25 . .
- , : HBsAg, HBcAg,
HBeAg. , . 10
15% .

51

, , , . - , ,
(0,5 /)
.
- ,
.
, , , . 50%
. ,
20
. .
, .
, 5,0 23 .
. , .
. ,
, , . , , ,
,
, (Raj R. ., 1996).
, , , .
, , , , / .
, 64%
. -

67,7%.

- . ( , .).
? , , (Shelton A., 1994), ,

52

. 11. ( , 1996).
(Shmgu M., 1989). ,
,
, , .
:
1. - (, ,
-).
2. ( , ).
3. .
4. , .
5. .
, ( .. ), (. 11.): 98% ( 16,7%), 74,5% ( 8,3%), -68-71 47,1% ( 25%),
60,8% ( 25%), 56,9%

53

( 25%), 43,1%( 12,5%), 43,1% (


16,7%), 60,8% ( 16,7%).
,
.
, .
,
, . , , .
, .., .

0,42,3% ( 1%)
(G.A.Nankervisetal., 1984; Pass K.F. etal., 1985; StagnoS. etal., 1985; ..
.,1990), .
, ,
.
, , , .
/
. , , ( .. ., 1990).

, .
,

. , , 55 85%. IgM, IgG ,
. , , .
.
, ,
1 , ,
. , .

54

3040% .
1015%, 2030%
. 90% 10%.
0,21% . , 510% ,
9095%. , 99% .
2 (1996 .) ( ).


100000

(1%)
1000
(10%),
100

20

80
(90%),

900

135

,
. I II
, ,
.
400
( .., 1994). IgG 88%, IgM 8%, 9,2% .
60,8%, 57,5% . ,
: , , , - , .

,
, , ,
( lgM- IgG). 73% , 89%.

55

.
( .. .,1992).


.
,
, . , , .
55%
, 10% ( , ). , .
, .
66% , , .
: , ; ; ; ; (.. );
; ; ; .
.. (1997), 61% . ,
, : , , , , , . ,
, ,
-, - -, . ,
,
.
. ,
, ,
.
, , ,
.

. 56

, ,
.
, , , .

. , , (.3).
3

2 10

+
+
15

1 2

.1997) .

. .
11,33,7 ( 3,50,5) 18,83,4 ( 7,11,0) 6,71,2 ( 17,82,6)
. ,
- 28,6%. ,
71,4 % .
- . , , , .
- . , - (, , ).
, Picornaviridae.
(24 ), (6 ).
ECHO (34 ) -72 . .
, .

57

, , - , ,
,
- .
- 50- (KibrichS.,Benirsche ., 1958).
1967 . .. . .
. , ,
. , , . ,
. .. ,
(.., 1996), , .
,
; : , , ,
.


-.
,

.
, II III .
,
II . ,
,
. , , ..(0!! . 1996).
, , (Hill J., 1999).
.
( .., 1993; .. 2000; Lament R., 1994;Cauci M. ., 1995).
(Kira E. ., 1994; .., 2000), 57,1% 51,6%
58

. , , . .
(1994)
. ,
(Ault . .,1996). ,
,
, (.., 1999).
, (Dudley D. . 1996), 1540% .
, , , .
12% . , ,
,
, , (Zangwill ., ., 1990).
, , , , .
- , (
..), ( - , )
,
: (, , ),
( .., 1993; .., 1993).
,
67,7% , 20% . 20 -
. 129 , 61,4% (, ,
. ), 31,8% ( ), 6,8% ( , ,
). 7 , 26 .
, (103105 /) 6 50
. -
.
.
1025x102 / .
-

59

. , I
, , , , ,
. 73,1% 30,8%
.
, I
, ,
86,7% .
31,6% . , , , - ,
,
, -, , 1/3 .
, ,
70% . (73,3%)
.
,
, , , , ..,
- ,
.
,
( 8% 37,8%
, ). ,

. - , , (, )
4 . , ,

.
, , /
, .
, , ,

60

, . ,
32,3% , 10%
.
( ) 56,9%
I 33,3% .
, ,
,
- . ,
,
,
.
, . -, -, NK-,
, . ,
-, NK-, ,
IgM.lgA.IgG ( .., 1990; Lachapelle M ., 1996). ,
, ,
.
, -


, ,
. , ,
, ,
, , , ( ., 1991; .. ., 1993).
, -
, - (Kolodie, 1989).


, .
, -
,
,
, ( .., 1993, Kolodie L, 1989).

61


, ,
.
, 60% ( ) in vitro ,
(Hill J. ., 1995).
, . , ,
CD4+ 1 (Th1) , , .
, . , ,
, , , .
.
,
,
( .., 1996).

I ( - (3-). ;
II - (Baron S. ., 1994).
. 21- 5- (Balkwill F., 1986). . ,
. ,
. , .
, , , .
25'. .

, .
.

62

- .
. , .
-. . - Th1 Th2.
, -, . NK-, - - (Imanishi J., 1994).
, . I
II III ( .., 1977). , .
- . I 56 , III (Aboagye-Mathiesen G. ., 1993).
.
. , (Zdravkovic M.
., 1997).

I (Hager H. .,
1994). , : -, , , , , .
, , , , (Baron S. .1991).
- . , (>4 /)
. . .
. -

63

, . , -, (Tayler J. . 1994).
, -, (3- -.
.
- -
( .. .1996).

: , , .
,
.
:
, .

, - ( .., 1998).
- , : Th1 Th2. Th1 il-2,
TNF-p, -, .
Th2 il-4,il-5,il-10,
. , , Th2 .

. Th1 (- il-2) I
II III . Th1 Th2 . Th2
. , Th2 , , (, ). -
(Yamada H. ., 1994).

- il-2, il-4
il-10 (Christiansen . ., 1996). - . il-2, -, , (Piccini M. ., 1996).

64

. 12.

I
( .., 2000).

TNF,

IL-4

IL-10

/L-6

/L--/P

. 13.


,
,
( .., 2000).

>

IL-6

*<0,01

NK- ,

(Hill J. , 1995). , Th1 Xr(YamadaH.
., 1994). , , , , , , , .
( .. 2000) -1 -, ||-1| ,
Th-2 il-4 il-10, - TNFa, , , I
, TNFa, -, il-113, il-6
il-4 il-10 (. 12). I (. 13).
3-6747

65

120

100
80
i E
! 13
i a

60
40

'.

20 -

:.,.

;'_.

I 60 - '
.

V
**

120 !,-*><
- * -, -
[-"*.''.'-' '*"*' '
100 - . . , ': -f:

80 : , .

f
'

.
V-iS

,..,, . . .

,

40 -'' ' "?- .


20

-^,
^41

>-

,^

-20
=37

. 14. IL-6
( .., 2000).

TNFa,
20 (168,214,1 pg/ml 6,90,7 pg/ml )
1,7 , (98,59,3 pg/ml); - , (2,7+0,2 pg/ml), 2
(1,50,1 pg/ml) ,
(0,14 0,02 pg/ml). -1 (3

4 (115,5+3,9 pg/ml 28,3+3,1 pg/ml), il-6 5 (60,7+7,5 pg/ml
12,00,8 pg/ml < 0,001) (. 14).
11-10 (. 15),
26,2+3,1 pg/ml. il-4
, , (12,3+0,56 pg/ml 4,620,77 pg/ml )
, .
, .
, , 18,1% + , 18,0%
+ .
. II

66

!
j

js
i
j
iI

i
1
I
\
i

60
50
40

|
Q.
20
10

=20

. 15. IL-10 ( )
( , 2000)


, (. 16).
, ,
III
.
25
. ( 17).
TNFa , , 9 (82,73,3 pg/ml
9,30,6 pg/ml); - 10 (1,90,03 pg/ml 0,180,02 pg/ml);
il-1p 6 (72,53,6 pg/ml 12,51,2); il- 5,3
(81,4+2,7 pg/ml 15,8
TNFa
pg/ml
1,9 pg/ml) 100
"
(<0,01).
80;

III 601
(, IL-10
IL-6
16

II

( .., 2000).

IL-4

67

. 17.

III


( .., 2000).

) . -,
, , .

il- (. 18 19). il- .
.
. , ,
,
. , , ,
.

, ( , ) , . -,
,
.
,
il- .
, , il-
500,225,1 pg/ml , , 169,711,2 pg/ml.

68

18 IL-6

( ., 2000).

19 IL-6
III ,
( ., 2000)

- (658,425,8 pg/ml)
, (389,234,1 pg/ml);
TNFa 433,827,2 pg/ml
324,125,3 pg/ml (<0,05).
-/||-4 (=0,90) TNFa/il-4 (=0,77) , ,
.
- , , 66,1 % , 13,6%

69

-
, ,
.
2 il-
,
. -,
, .
-,

.

510 TNFa,
-, il-1p, il-6 , il- 250,0 pg/ml

, - .
, - ,
,
, .




,
- . ,
. ,
, .
.
,
, , , .
, - , , ,
.
, (), - ,
. ,
.

70

Rh- -, Kell, Duffy, Pp .


, ,
, HLA.
,
. .
*


.
( ).
,
(Vianna L. ., 1994). .
, ,
. , - .

2000 .
, ,
(Wilson W.2001).

I. .
1. , .
, .
.
2. :
a. 10 ,
.
b. 34 -
, .

71

. 10
, .
II. :
1. IgG / IgM , 2 6 , |32--1- .
2. , 2
, 6 ,
:
a. - :
();
; ; , -.
b.
.
c. .
d. , .. VIII , .
,
, IgA , -|32-l, , , - .
, .
-2--1 , , , .
.
-|32--l IgA IgG .
(Lee R. . 2001).
2742%%.
,
5%.
,
:
1. , in vitro , 2+- , Va -
() ();
2. ,
().

72


. , ,
. , .
, ,
. ()
, , , , .
, McNeil .. . (1990); Galli M. . (1990); Matsuura E. .
(1990) , , , , , (), (32--1 ((32--1).
J.E. Hunt . (1993) , , ,
2--1,
(), (, , , ), . , 2-1
. , - . L.R. Sammaritano
. (1992), , 2--1,
() . , ,
. , .. Gharavi (1992) ,
. ,
, , ,
(, ,
, , - .).

- . ( )
, ( ) , 2--1, .
(-) . 4 .
. ,
(,

73


( V.D. Lockshin, 1992)


IgG**
**

IgG > IgM


lgG2, lgG4

+

+

** , IgG.

IgM > IgG


IgG^lgGg
?

, , , , ) .

A.Beer J.Kwak (1999,2000). 5 , , .


I HLA HLAc . HLA, , .
II ,
.
2742%.
, - . ,
, . , .
III , 22% . - , .
IV . 10% .
.
V , 45%
. .

74

1 -
CD 56 12%. , CD 56+ 18%
. ,
.
, TNFa.
, , ,
/ ( ).
2- V CD19+5+ . 10% .
, : , , . , ,
. CD 19+5+ , , , , .

, . , ,
.
3- CD 19+5+, , . . ,
, . , , , .
,
. , . .
, V . 10
. ,
.
.
. 78 ,
, , . , 8
A. Beer .
,
, -

75

, ,
.
, ,
, .

HLA.
,
, HLA .
70- . ,
. - - .
.
, . , , , , ,
- -. , 78
( - ), , . .
, -,
, .
. , .
.

( .., 1980).
( .., 1982) , ,
( 33,6%
14,9%). : , , , 4 , , ( 33,6% 7,2%).
. ,
, , ,
. , -

76

, ,
, -,
v
( .., 1978).
.. (1979),
. , ,
. ,
.
83,3% .
, , , ( .., 1978).

. -,
. ,
, .
(Rocklin ., 1976; Takakuwa ., 1986).
.
, ,
(Fraser E. ., 1993, Ober C.L ., 1983).
, ,
.
:
1) , ;
2) , ;
3) ;
4) ;
5) (NazR., 1992).
, . , . - ,
;
. ,
,
- () (Suciu-Foca N. -

77

., 1983), .. - -
. , -HLA-DR (Maruhashi . ., 1984) -Fc (Power D. ., 1983).
,
. ,
. 20% , 64% .
( 9
23%) (Mowbray J., 1997).
, , , - , . - NA1.NA2, NB1
NC1 Lalezari . (1960).
NB2,ND1,NE1 Lalezari . (1971), Verheugt F.
. (1978), Claas F. . (1979) .
N , , HLA(ThossbyE., 1969). , , NA 1 NB1.
- ,2% 20% (Rios E. ., 1991, Zevine D ., 1986). , , .

(Rodwell R. ., 1996).
, ,
.
, - ,
.
.. . (1997),
,
20,5% ,
. .

HLA (Human leycocyte antigens). HLA

,
, - . . HLA I, II III , 6- .
, ,
3x106 ( ., 1999).
I HLA HLA-A-B - , - (CD8+) .

78

II HLADP,-DQn DR -(04+). III


, 2.4 Bf
( ), TNF ( ) (Rhodes D. ., 1998). , , !
NK , .
, NK , 19 HLA-E,
-F G. , HLA-G
.
.
. HLA ,
.. . (1998),
.
5
HLA .
( .. ., 1998)

HLA-A

1
2
A3
9
23
24
10
25
26
11
19
29

31
32

28
34
36

, %
N=2130
21,9
54,8
23,5
22,7
2,9
19,8
14,5
5,9
8,0
12,2
26,2
5,2
6,3
5,2
6,9
2,6
8,3
0,2
0,6

HLA-B

5
51
52
7
8
12
44
45
13
14

15
62
63
16
38
39
17
57
58
18
21
49
50
22
27

, %
N=2130
13,6
10,2
3,4
25,7
13,9
23,0
22,2
0,8
12,2
3,3
9,8
8,8
1,0
7,7
4,2
3,5
7,3
7,3
0,0
12,8
3,3
2,0
1,3
4,1
8,3

HLA-C

Cw1
Cw2
Cw3
Cw4
Cw5
Cw6

, %
N=2130
4,2
22,3
21,2
28,2
11,0
20,0

HLADR
HLA DO
DR1
DR2
DR3
DR4
DR5
DR6
DR7
DR8
DR9
DR10

, %
N=2130
21,7
31,9
19,5
21,7
29,9
19,5
22,7
5,9
0,9
0,9

DQ1
DQ2
DQ3

51,8
33,7
42,6

79

HLA-A

, %
N=2130

HLA-B

, %
N=2130

35

17,5

37
60

1,6
14,3
9,2

61
41
47

5,1
4,1
0,2

53

0,6

40

HLA-C

, %
N=2130

. 5
HLADR
HLADQ
, %
N=2130

HLA . , ,
, 95% , HLA
27 , .. 20 .
Beer . (1999), 86,4% HLA DQ4.
HLA DQa201 50% .
HLA B14
(); HLA B18 .
.. . (1998), HLA-:
19, 8, 13, 15, 35, DR5, DR7 19%, 9,5%, 19%,
17,5%, 22,2%, 69,6% 39,1% 6,3%, 3,8%, 10,3%, 16,7%, 29,9% 22,7% . , HLA- 19,8; 13.15 DR5 1,65,1 .
HLA- 1.8; A3,15; A3, 35;10,18; 19, 15 2,69,2 .
HLA ,
HLA . ,
HLA , . 2 HLA
100% ( .. ., 1998).
HLA
. . (Beer . ., 1987;
Christiansen ., 1996; Mowbray J.F., 1987;).
, , ,
(Fraser E. ., 1993; Ober ., 1983 .).

80

6
HLAI II

( .. ., 1998; 98/195)
HLA




, %
, %

100,0

100,0
75,0

48,3

25,0
51,7

31,0

69,0

|,

: , , , , .. , , .
, HLA .
HLA . 32
, I II HLA: 16 , ,
10 HLA 2 ; 16 I 9 2 .
16 7 HLA DQa201.
HLA.
Chiristiansen .. . (1996), . , HLA. ,
/, . / . , HLA ,
HLA .

HLA .




, . , .

81

. (. .. ).
.
7


( %) ( .., 1996)

CD3+

67,11,7

60,3+0,65*

CD4+

44,51,2

44,00,75

CD8+

25,7+2,1

22,6+0,44

CD4+/CD8+

1,730,12

1,720,04

CD16+

15,01,0

19,71,75*

CD 19+

10,61,7

15,91,31*

<0,05.
. CD3+ 20%, 50%
, 30% .
CD4+: 47,5% , 50% . 57,5%
CD8+ , 20% , 22,5% . 30% ( CD4+/CD8+)
2,060,08, 60% 1,560,03 10% . CD16+
15% , 50% 35%. - CD19+ 45%, 42,5% .

. 20.
,

.

, ,
, (. 8)( ).

82

20.
.

8

,

( . ., 1998)

CD3+

53,12,02*

67,52,12

CD4+

36,91,7*

42,81,04

CD8+

19,141,13*

23,6+0,7

2,10,17

1,870,09

CD16+

21,51,3**

14,31,1

CD19+

10,70,7

CD4+/CD8+

12,070,6

*<0,05,
**<0,001.


, .
CD3+. CD4+.CD8+, -

83

^^* ;

21.
,
( . , 1998).

, .
- -
(CD16+) . -
.
, 50%
-, - - (. 21).

.
.
,
,
. ,

84

,
.
, ,
.
CD19+5+ ,
,
: , , (Beer A.E. ., 1996).
CD19+5+ 2 10%. 10% . CD19+5*
, , , .

.
, . , , .
20 ,
. , , , . . -,
, . -, -, , (DirnhoferS. ., 1994).

.
- ,
(Deshmukh U. ., 1994).
. TalwarG. . (1994),
50 / 1224 . 35 /.
,
35 ; ;
, , ,
, (Dirnhofer S. ., 1994). .

85


. Sokol R. . (1980), 3- . ,
, . Braunstein G. ., (1983)
. ,
, .
PalaA. . (1988), . , -
. Tulppala M.
. (1992), . , , ; ,
.
, !

, , . ,
, .
( .., 2001),
. , , , . ,
7,80,2 (76,4%), 24,80,9 (17,9%) 33,80,8 (5,7%). ,

(IgM) 515, 2125 3033 . .
, .
.
CD 56+ 4 , CD19+5+ 2
.
,
- .
, , 34 . , .

86

, ,
, ,
.
, .. ( ),

, .




. , , , , , .


(PACK) ,

. PACK , ..
.
.
:
, , ;
,
, ;
, .
. , , ,

.
:
1. - ;
2. ;
3. ;
4. .

87

-
- .
. ,
.. (1988), :
1) ( );
2) ;
3) ;
4) /
- III;
5) .

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

, , .


.
. . ,
, .
,
,
. , ,
, , , (3-
. ,
( II). ,
, ,
.
,
,
, , ,
.

88

. 22. - .

(. 22). .,,
. ,
. ,,.
2+ , . , -.


. ( 12), .
, ..
.

89


, (). , 3 .
I , . X,
(), V 2+.
.
II .
III .
X
, (. 23).
(III - III).
().
. -

. 23. .

90

X. X
, .

, .
:
I ;
II ;
III ;
IV ;
V ;
VI V ;
VII ;
VIII ;
IX ( );
X ;
XI ;
XII ;
XIII .

.
. .. (1988), :
1. VII
,
.
2. XII, IX,XI, VIII
,
, .
3. X,V,II,I
, .
,
. .
.



.
,
, . -

91

, - , .
,
, , , . 75%
III (AT III). AT III , ..,
XII , 1, IX , VIII , , A III
. A III 100 . A III . A III ,
,
, . A III 30%
,
. A III -.
, S, 2-.
, . .
S, VIII V. , -, - .
, .
, , , VIII V (
, V).


.
- , . , . . ,
, .
,
, .. Xllf . . -

92

24.
(AtamasS ,1997).
, . 2-, - , .
()
- (). , . /
(), .
,
,
, .
Atamas S (1997),
( 24).

.

93


, .
( ), , , AT III ( ..,
1989 .). -
, .

.
- :
, , , .
.
,
,
. .
- .
, ,
. 150 000/ml . 9.
,
. XI XIII.
3-


.
VIII ( )
, . , -
.
XI XIII (- ). .

94

200450 mg/ml

400650 mg/ml

II

75-125%

100125%

75-125%

100150%

VII

75-125%

150250%

VIII

75125%

200-500%

IX

75125%

100-150%

75-125%

150250%

XI

75-125%

50-100%

XII

75-125%

100-200%

XI II

75125%

35-75%

III

85110%

75-100%

80120%

60-80%

65145%

70150%

, III, , S
.
(Biezenski, 1960) .
.
.
Merskey . . (1969),
. Hedner V. . (1970),
. J. Rand . (1991), 16 3640 .

.

( .., 1994).
.
5533% , . .

95

10
( %)
I


110 3 /
41,20,8
63,35,3
5
57,76,7
1 /
40,03,2
57,37,4
, %
36,42,2
53,3+10,4
1x1 05
38,4+3,4
61,32,4
- 1x1 04
40,44,2

46,312,3
48,02,6
2, 10 /
1103/
0,810,1

1,8 ,
. 39% , (. 10).
, . I .
, , , 1x103 1x105
, .
( ) 1x107 .

.
11

/
,
,
(%)
:
r+k, mm
, mm
...


2,100,02
31,20,3
60,3+0,5
92,50,4


2,80,2
288,81,1
55,92,9
99,91,4

20,8+0,2
46,3+0,3
10,10,5

14,41,1
50,72,3
18,32,8

I
|

I : ,
r+k,
(. 11).

96

, I , , ,
. , I
, ..
().
I 2x10 /. , .
II , , (. 12). , 10%
5% , . . : r+k,
, .
12


II ()



2,60,07
<0,05

1.

2,30,01

2.

33,70,3

3.

61,40,4

4.

, %

98,20,3

100,60,6
<0,05

5.

16,60,2

15,10,4
>0,05

6.

Ma, mm

47,7+0,3

50,80,9
<0,05

1-2

30,20,6
<0,05

12
58,1 + 1,2
< 0,05
1-2
12

r+k, mm

1-2

1-2

7.

, ..

14,20,3

18,41,0
<0,05
12

(. 13)
, , .
4-6747

97

N
1.

2.

4.

5.

6.

7.

13
( %)
II ()




40,70,7
110 3
45,52,0
<0,05
1-2
1 6
34,11,0
47,94,9
<0,05
12
29,82,7

38,41,0
<0,05
1-2
1x1 05
38,30,8
43,6+2,9
<0,05
12

48,03,8
45,4+4,8
1x10"
>0,05
12

52,07,5
48,0+5,0
>0,05
1-2

III (. 14,15), . , , .
, .
14

III ()
N

1.

2,6+0,04

2.

31,20,3

3.

59,20,4

4.

, %

100,2+0,2

5.

15,10,2

6.

r+k, mm
Ma, mm

52,70,3

7.

, ..

19,8+0,4

98



2,60,06
>0,05
29,4+0,6
<0,05
58,90,9
>0,05
96,80,6
<0,05
15,4+0,8
>0,05
54,8+0,9
>0,05
20,11,2
>0,05

I
N
1.
2.
4.
5.
6.
7.

15

( %)
III ()


45,42,2
1x1 03
47,00,5
>0,05
5
45,62,7
1
41,60,7
>0,05

40,52,7
28,32,8
<0,05
6
1x1 0
44,50,7
38,22,5
<0,05

41,13,1
36,01,8
4
<0,05
1

45,8+2,5
48,64,3
>0,05

, , , , () .
,
1
2.
9,2
9,7 / ( 0,33,5 /) (112115% 15,316,3 /,
75150% 8 /). () I III (TAT) , .

(),
. 97%, 5378% ( 70140%).
II 75 / 1 ,
AT III, 45,5%,
0,423 /. 0,612,7 /, 4,70,08 /. , III , 0,8 10,7 /,
3,2 0,04 /, 16,6 /. ,
( ), -

4-

99

,
1, , , , 2, .
, , , ,
-.

II 29% , .
:
I 102+6,4% 15,70,09 /; II 112 277% 11,7 / 25,3 /, 136,811,2 % 14,50,11 /.
III :
104 234% ( 126,89,9%) 10,8 16,3 /,
14,50,11 /. , .
2- (2) I , 3,2 6,2 / ( 2,4 /), 3,360,08 /; II
2,9 6,2 /, 3,820,14 /.
^- (^), 2,0 7,9 /.
2- ^- , ,
, , .

.
,

.
, , , , (. 16,17).
,

. , , ,
.
1, 3 5 . 49% , 51 % .

100

N
1.
2.
3.
4.
5.
6.
7.

N
1.
2.
4.
5.
6.
7.

16

( 5- )()

,
=14
, =44
2,80,1
3,00,1
, /
>0,05
,
30,40,7
26,50,9
>0,05
57,11,4
,
58,31,9
> 0,05
, %
100,31,1
96,81,5
>0,05

18,61,2
13,50,7
r+k, mm
>0,05
Ma, mm
55,0+1,0
54,02,2
>0,05
...
19,62,1
24,72,3
>0,05
17
( %)
( 5- )()

,

, =44
=14
1 3
46,13,2
48,81,8
>0,05
1 5
31,31,2
42,24,8
>0,05

64,54,5
19,84,0
<0,01
s
59,12,0
49,54,9
1x1 0 M
>0,05
54,22,7
18,2+3,3

1x10"
<0,01

58,4+2,7
62,7+2,8
>0,05


( .., 2001),
. : , S, -
II, XII, - , , , V
.

, -

101

- -
.
, ,
11% (Molloy . .,1997).
I (Nelen
W. .,1997). .
.
,
, , , , , .
, IXa, Xa, Xla .
50% .
1:600 1:5000 (Bonnar J.1999).
Va Villa. S , . S
1:500. ,
S
. , S , - (Faught W. .,1995;
Lefkowitz J. ., 1996).

V , .
V , . 9% (Ridker ., 1997). V Leiden (Walker M.C.,
Garner P. .. 1997). . , ,
46 60%,
14% 8% (Bonnar J. ., 1998).




, II III .
0,50,6% (Green L.K.,
Harris, 1976). , ,

102

10 15%, (Buttraue
V.C., 1983; Kusuda M., 1982 .).
*" , , , 10,8
14,3% . - ,
- .
, .
1 - .
() , , , 46 . ,
. ,
. , . : , ,
, ,
.
, .
: - , ,
. .
.
(,
), .. .
(. 25), ( , ), , , , . (, ) .
, .
HillJ. (1998) , .
I ; II ; III
; IV ; V ; VI
. ,
I
- , II III .

103

. 25. .


.
,
.
, , ,
,
.



,
. ---.
.
( , ). , . 53%
, ( .., 1981; .., 1981).
, -

104

,
( .. .,-1982;
.. ., 1988).
,
, ,
. ,
( , ),
,
.
, 34 2-
. , .

, .
.
, , .
, .

:
- , , .

,
. II
- . , ,
.
.

-
II - () 40%, III .
,
. ,
1- , , , 2- -

105

( .. .,
1963).
. , , ,
, , , ..
,
.
.
- -. - , -
. -
, -. , , .
. ,
, 50% ( 15%),
, .
.
-, . 6 .
, 1820 .
6,09
2,63 . , ,
, ,
.


(., 1987). , > 2
1 ; < 2 2 . 6 1 , 2 . , 0,5 1 , 0,5 2 .
46 (. 18).
, , , ,
.
-

106

, . . , .
18



1
2
>2

< 2


HgS

< 0,5

> 0,5

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


, . , , 3075%
( .., 1985). .. .. (1988),
15% .

,
. . I .
. .
, .
. , ,

, -

107

( .. ., 1981; .., 1985; .., 1985).



( .., 1985).
, , . . , , ,
. ,
, , .

. ,
, , .
. ..
(1979), 8085% . ,
(Pittway
., 1988; Naples J. ., 1981).

(FitzSimmons .,1987), , , (Metzger D.A. ., 1986; Vercanmen E., 2000). , ,
/ ,
.
-, ,
.


, ,
13,2%
( .. .,1973).

, . 18,3%
,

(.., 1983), .
, , ,
.

108


: ,
, , . , ,
.
.
, - .
, 0,010,39%
( .., 1970). , I 17%

. , ,
, 1624 .
2,2% . 65%
, : , , , ,
. 7,7% . 7,8% .
80%
.
. . 40% .
/ ,
.
I

. , , ,
..
80-
, ( .., 1980; .. ., 1980). , ,
. , .

109

,
. ,
, .

, , .
. 0,09 0,81 %,
13 . , 1980 .,
18,620,4%, , ,
. , . , 15,5%
, .
, , , .
17,2%
. 31,7%
, 50% . 18,3%
.
(placenta circumvaelate, placenta marginata) .
. , ,
(Kong ., 1987). , ,
, . 2
, 1 (CSF-1) il-3
, Th1
il-12, TGF-p\ , il-10 -. I , il-12,
TGF-, -, ,
. , . ,
. ,
, (Jaffe ., 1997).

. .

110

, , . , (Lee ., 1997).



.
- , , , , .

, .
, ,
,
: , , , .

, , , ,
, .

, , . , ,
, ( ).


, , . ,
,
: , , .
.. . (1998),
,
. , 2- (),
,
: 21,61,8 40,62,7 / .
,

111

. -2 ( 2- 16 /
. -2 ,
.
(), , (57,98,9 17,72,7 ). , ,
.
. , A.M.
. (1998), 38,8% ,
7,7%.
, , , , 42% .
, .
, (Halmesmaki ., 1989).

/, .
. , 3- .
3- , 2-,
, 2-, 3-, 4- ..
, 2- ,
.
,
/. , 4560% (Boue J., Boue A., 1975, RodriguezThompson ., 1999). ,
- , 75%
. , , 66% , (1., 1981).
.
,
. ,
, ,
(Hansen J., 1986). .
-, de novo,
,
: , ,
, .. -,
, ,
.
,
2- , 35 , .
-
. .
. , , , . (,
) . , , . - .
, ,
, , . , ,
, . , -

115

, . .
, , , . , .
,
.
. ,
, , (,
, ), , ,
, . , , , - .
. , , . , .
(, , ), ,
.
.
. , , , , , . ,
. (
30 ),
, .
. ,
( 1516 ). , , , . ,
.
, , . ,
, .

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

116

, , , ,
.
.

. , . ,
, , .
, Hill J. (1996),
(46) 70 25%.
(Doss . ., 1995).
I ,
. . , . -
, , .
, ,
.
- II , , .
, , ,
.
,
.
,
. ,

. , , ,
12 . , , - , , .
, . . ,
. , .

117

,
. , - , , ,
.
, ,
, , , ,
. , .
, ,
, . , (, , ).
,
- ,
.
. , , , , , , ().
, ,
(. 26). ,
. ( , , , )
. , , , .. .

925
896_
867_
838
809.
780_

929
887_
845.
803
761.
719.

179
173.
167.
161
155.
149.

335
344.
333.
322
311.
300.

419
392.
365.
338
311.
284.

. 26.
( .. ., 1985).
();
(); (); ();
().

118

. , , - , . .
,
, , , , .
, . , ,
.
. ,
- . . , ,
, , , , ov.Noboti .
, , . ,
. ,
,
.
, .
, , .


, ,
,
60% , 40% . , , .
, , .
, , , ,
.
, 2 . I .
II .

119

,
. (.
27, 28), (. 29), - (. 30), .
1822 ,
, , .
II
, . II

.
- , II ,
27.
( ).

. 28.
( ).

120

. 29. .

. 30. - .

.
- ( .. ., 1983).
,
,
, . - , .
, ,
: .
, , , . -
, .
.
(Keltz . ., 1997).

, .

100 2 , 0,25
3 , 0,5 4 56 .

: , , 12 .

121


.
. () (. 31).

,
, , . -

. 31.
.
1 ; 2 I - II ; 3 II
- ; 4 .

122

( , ) . ,
. 0,5
. II . . , II 4 6 (. 31-2).
, , . 1822 .
,
, II (. 31 -3).
II , , ,
, . .
,
II .
II .
II (. 31 -4), ,
.
II , -- , .
. , ( ,
, ) .


, .

, 78 I 2123
(4- ).

123


,
( ..), 19.

19


/
/

(78 )

(2223 )

336

420-271

1,6

1,9-1,4

1148

1330-985

2,2

2,5-1,6

640

885-465

44,0

52,237,2

. 367 / (100 /). ,


. 422,0 / (115 /), ,
.
2122- . (. 32).

15,9 / (0,5 /).
33. 47,7 /
(1,5 /) .
,
, .
II 15,9 / (0,5 /)
, 31,8 /
(10 /) . 31,8 /
.
(LIT. ., 1989). , -

124

.32. .

.33. .


(Miles ., 1994). ,

(Azuma ., 1993).
.
.

125

.34. .


, , 17-, .
, , , ,
,
, . . 34.
,
, .
, ,
. , , .

- () 17- (17).
. ,
17 . . 17
3- - .
17

126

. , (, ), ,
17
. , , I , .. 57
, .
.
0,5 6 3- . 3-
, 23 17.
2
6 3- (8 /). ,
. 17 2 ( 50% )
, .

( .., .., 1986) (. 20).


5
6
7
8
9
10
11

20

( .., .., 1986)


+

0,5 4

0,5 4

0,5 3
+
0,5 2
0,25 2

0,1 25 2

17 22 7 . ,
17 . 17
, .
, , , 17, .

(- 40 ) . -

127

21


( .. ., 1986)

1
II
/

/
/
/
/
/
170 /
/

6,9

6,0-7,9
3,6

3,3-4,1
270

243-299
258

228-292
2,0

1,82,2
1,7

1,5-1,9
348

321-377
2,7

2,2-3,3
32

2935

6,9

5,8-8,1
2,7

2,3-3,0
287

257-320
543

502-588
27

23-32
1,7

1,6-1,8
344

315-375
6,4

4,6-8,8
24

2028

17 100%, 190%
160%.
17
46%, 72% 54%. ,
. ,

. ,
. .
, ,
( .., .., 1986).

21.


, , - .
. , ,
.

.
. 34
.
. , .
, , , , .
:
( ), (, ), .
. ,
120 , . , () .
, .. .
(), ( II IV ). 45. .

. : , , , , , .

: ,
.
, .
60, 10 . .
, , .
5 - 6747

1 29

/
, .
, .
.
, , de novo (Ferrier ., 1980).
, . ,
, ( , , ), , .
.
.
, , . , . , , ,
. ,
, , - ..,
, . , , , ,
.
,
I .
, . 35 .
- HLA .
, 56
1000 . , .
, , ,
.

130

HLA.
HLA
( IHLA-A-B-C) - (II DR,DQav-, DP).



. ,
.
, , , ,
, .
- , : II , , .
,
.
23 . - . .

- 56 ,
, ,
,
.
. , . ,
; -
.
, , , - .
.
( ).
5'

131

. 12 . 105 (/).
.
10 .
2500 1000 .
. () ,
,
. , , , . , . IgG ,

. , , , . , ..
, .
:
1. , () .. . (1992).
, ,
.
, . 4+,
.
2. -, -
. . , .
3. (-) .
. -
, , , , .

132

4. , IgG. IgM , , , . IgM .


: ; ;
;
; ;
; ; ().
,
. ,
3
6 ,
.
,
. ,
,
.
.
1. .
, .
22

(. )

109/
, %

CD3+

70,33,5

1,30,07

-/

CD4+

42,4+1,0

0,90,05

-/

CD8+

28,22,8

0,50,02

(NK)

CD4+/CD8+

1,7+0,1

CD 16+

10,61,7

0,20,02

133

. 22



, %

CD 19+
CD56+
CD56-CD16+
CD56+CD16CD56+CD16+
CD5+CD19CD5-CD19+
CD5+CD19+

5,50,3
3,90,7
8,81,5
2,2+0,4
1,70,3
58,33,5
2,20,2
2,5+0,2

1 09/

0,220,01

2. .
5 : IgM (). .
IgG , IgM, .
IgA , , ,
. .
IgE 1/10000 ,
30 , IgE 100 .
IgD -, .
(A,M,G) . IgM .
IgA , .
, .
IgG, , , ,
, /
, IgG
.
IgM IgG ,
. IgM IgG . , , IgM .
,
, , , . . -

134

. IgM, .
, ,
, I .
.
3.
.
, , .,
-, - - (Th-1 ) -. ,
. ,
( J., 1999).

,
. , , -
(),
(, , , , , , , ); -
() (), ().
23
/
( )

4,40,28
4,20,03

73,68,95
243,5
22,53,1
24,53,2
64-256
16-64


,
.
.

135

4. (Elisa) ,
, in vitro .
30 . ,
, :
( 17);
;
,
;
;
;
.
, , , , .
: ;
; ; ;
. ,
, ,
, .. .

, , , , ( .., 1997; .., 1996;
.., 1997).
,
. ,
. , : il-1, il-6,il-8,TNFa,
(Jones . ., 1997).
- il-2, il-4, il-7, il-9, il-13,il-15,
TNFoc. . - : 1 Th2,
. , 2
, , (Contstant S. ., 1997; Marzi M ., 1996).

. , ,
.

136

il-4, il-10.
,
, , , (Krzysiek ., 1996).
, . , ,
, .
5. .
, , .

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

.
.

, .

(). 2742%(NazR., 1992;
Shehate H. . 2001).
. . ,

(, , , , , ) .
, :
, II III , ,
, ,
, , , .

137

, , , , Elisa.
, : - , - , -, -. ,
22% 50% (Incerpi M.H.
., 1998; Malinowski . ., 1995; Ogasawara M. ., 1996).
,
, .
, . . (Eroglu G. ., 1994, Geva E. ., 1997),
, , , . ,
, ,
,
, .
.
CD 19+5+. ,
: , , , , (Beer A., Kwak J., 1999,2000; Kim .
., 1998).
CD19+5+ : , ,
, .
CD19+5+
, , , .
, , ,
.

( .., .., 1995) (..,2001).
, , .
, , , , ,
, , ..
,
. , -

138

, .
, ,
- .


. ,
. , (, , ).
, ,
.
, (. 35,). : ; k
( 20 ): , ; (
)
:

.
k
;
.

(
)

. 35.
( )
.
139

. 36. ( 1-103).

, : ()
110"3, 0,04 / (. 36).

- . .
() , .

();
() ;
(+ 3 );
(
) ( / ) 100.
,
,
. ( , ,

140

, ,
) ,
. ,
.
: ; III, S, .


.
( ..) .
II ,
.
, (. 37). (. 38),
2- -. - -

. 37. . ( ).

141

. 38.
( )
1 -, 2 .

. 39.
1 ,
2 .

, , ,
.
, (. 39).
24

( .., 1992).
24

()

1 II
=25

=42
=36
(=17)

( = 33)
( = 11)
6,41,0 5,9+0,09 6,0+0,09 5,70,09 5,50,06 4,70,07 7,80,09

>0,05
>0,05
<0,001 <0,001
>0,05
>0,05
- 4,00,10 3,90,1
3,80,1
3,9+0,1
3,80,17 6,5+0,15
3,90,1

>0,05
>0,05
>0,05
>0,05
>0,05
<0,05
<0,001

5,00,17 5,7+0,13 5,0+0,11 5,20,12 4,90,12 4,40,15 7,0+0,15

<0,05
>0,05
>0,05
>0,001
>0,05
<0,05
2,0+0,06 1,40,05 1,30,06 1,5+0,06 1,50,06 1,2+0,06 2,60,06
<0,001 <0,001 <0,001 <0,001
>0,01
<0,001

3,50,07 2,80,04 2,7+0,06 3,00,07 2,4+0,12 2,3+0,1

3,00,1

<0,001 <0,001 <0,001 <0,001


<0,001
>0,05

142

. 40.
, 1 , 2 , 3 .
, I
.

:

2540%.
15
26,6% 3134%.
.
, , 50 100%:
(. 40) ( .. .,
1999), . - , 0,5 , (. 41 ,).
Brooke I. . (1981), 1,9
- .
.. . (1990) ,
, 0,30,7 .
, ( .. .1992), (. 42).

143

. 41 .
, 0,5 .
1,5 - .

. 42.
( . , , 1992).

144

, Women's Healts Center (Beer A., 1996).

145

,
I
,
. , , , , .

: , .. .

4.

, : ,
, ;
, ,
, ,
. ,
, 9395%
. ,
, , 6267% .
(Hill J., 1999; ., 1993),
, 30%, ,
70% ,
.
, / -
,
. , ,
, . ,
, , ,
,
.
, . 2, 3, 5 ..
, ,
? 10 ,
500 20 ?
, , , 100% .
,
.

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

149



.
, ,
, . , ,
-
. .
HLA . ( ,
- .). .
. II ,
I - .
. , 17(3 (2 ) ()
10 . () , ,
, . 1 28 . - , ,
, 10 , .
.
- .
, ( , 20- ),
. ,
.
(ethinylestradiol) ( 50 ) 5 50 . 15 18
1 10 (sol.progesterone oleosoe 0,5% 2,0), 18 26 10 . 10 2 100 2 .
, .
, .
( 1 23 )
, , . ,

150

, , .
,
, , ;

.
.
, ,
, , .
23
. , 400 .

. 2 .
-,
, .
II ,
-.
II ,
.

: - 17|3-, , .
( ), .
, ,
. - ,
.
, .
.
50 5 , 1 5 .
- ,
, .
.

151

, , , .
.
,
, .
(2).
- 3- . (
) 1415 510 . .
1 2 . .
, ( )
II .
. , ,
, 5- 15 .
2 .
.. (1995)
0,1 / 57 30 10 . , .

( O.K., 1993; .., 1982).



1.
:
;
, , ;
;
;
HLA ;
;
;
, , ,
;
17 (
II ), -, 17
;
- .

152

. 17, 17- - 8090%


, .
, ,
(-).
, 17 , .
0,125
0,5 17 170 - .

, ( ).
.
23 50 5 9
.

-35 - .
, , 1- .
, 55%
.
2,4 .

, , , 0,5 ( 1/2 1/4 ).



: ,
, , . , ;

;
, , , ,
, , ;
, , /
3; 17 ;
;
, . , 2/3 --

153

,
;
;
HLA;
.
.
,
-
. 0,5 4 3- 6
. 3
15003000 ME.
5- (), 8-
11 - . ,
.
II
. , , . shlag . . (1996), , , . Hunter M. . (2000)
, .
10 2 , 100 2 16 10 , 23 . , 0,5 17 . ,
.
, . ( )
50 5 9 . , ,
100 2 .
II . :
1315
18 , 10 ;

1214 ;
15 /.
, . , ,
. - , .

.
(, , ) 750010000 ME -

154

18 . 36
48 ( .. . 2001).
3-

23 , .
, .
64,7% .
5, 4 . (Hunter M., Sterrrett J., 2000), 3040%, . (1998), 20% .
, .
, .
, ,
.

-35,
(desogestrel, gestodine, norgestimote);
() 100
I 10 ,
.



, , :
;
;
17;
17 51,3% ;
, ;
46,1% , 69,2% ;
17 ,
(-26,507);
, 17, 170 .

, , -

155

. , , .
II (diabetus
mellitus).
, , , , , , (, , ).
. -35,
.
, , 0,5 ,
. 10 14
2,5 2 . , 3- , .
. , ,
.

, ,
, . ,
54,3% . 6,7 .



.
: , , ; /
. :
;
;
;
, , , , ;

156

(IgG) (1).
:
: - ; IgG.lgM.lgA ;
: , (, -
(), - () ;
.
, , ,
. - , , , ,
.
, .
, .
, 38,7% , 20,9%, 22,1 % 18,2%.
85%, 10% 5%.
,

- 36,6% , 15,2%, 20,9%.
-
77,1% , : , , ,
(, ), , .
I , 67,7%
. 61,4% (,
, .), 31,8% (
, ), 6,8% (
,, ).
10,8% ,
26 .
, (103 105 /)
10,2% ,

1025x102 / .

157

45,9%
19,6% ,
43,1%, 5,7% .
, .
, -, ( ) .
.
1- , , 1 79 .
, ,
100 2
, () 0,25 3 , 0,5 4
. 1 79 . , .
0,15 3 7 ; () 0,5
2 ; 0,5 4 9 .
() 0,5 3
9 , .
(. 25).
25

100

60

45
90

10

10

24
48

50
100

:
, , , .;
, ;
,
, .

158

. , , (), .
, , , , . ,
.
, ,
.
, ( 5 3 4045 , 1
) , 92% . ,
, 73% .

, , , . (, , ) 12% .

. 12
6 37 .
0,25 4 , 37 .
,
,
. ,
.
().
, : , , .

, , , . (, ) , .
:
, , ;
, , , > 4,5;
>103 /,
: , , .
,
. -

159

, , ( ),
: () 2% , 7 .
, , 10 .
0,5
7 , .
( 100 250 ) 1 10 .
, .
(200; 100 ) 2 14; ( 200 , 100 ,
100 , 3 ) 1 10 ;
( ) 1 23 10 .
() 100 1 6 ,
500 1 13 . ,
, 150
(, , .).
, (+) , , .
,
; - 1 10 ; ; , .
,
,

. Glabrata
10 .

600 2 6 (Tuomala .,
1999). .
,
,
.
, - ,
. - 2,0 5 , 2,0 1 5 5 .
-
, . ,
, .
1,0 / 2 10 .

160

2- - -
< . , , ,
, , .
, , , . ,
, - , . 1 34 , 2- .
I . . .
.
( (3) , , . , .
2 1, 3, 6, 8 10 . .
, , .
, . , .
-, .
-.
, , ,
. . 1 (0,25) 1,2,4,6,8,11,14 .
612 . 0,25 1 5 3- . .
.
, (3 . . ,
, .
, . 3
250500 1624 . 48 . .
, , . .
612 1 510 . -

-6747

161

1 0,25 0,5%
. .
836.
. , , .
23
23 , .
, ,
,
. ( 3 10 )
. , , . ( 10 4-
)
. . IgA , IgE , ,
.
2 .
1,0 0,005%
1 2 , 1015 .
, ( ). II III 1,0 510 : - ,
- ,
,
/ , .
, , .
.
1 (100 ), 23 510
. ,
.
, , 1,5% . ;
, , , .
, , .

162

,
: . , .
5,0 2 , 5 - . , .
. , , . - .
23
- 23 . _ : - _.- . .
.
, , , ,
- :' 85% . , , < , ,
:.1 , .

- : -2 1
- 10 .
, : -.
. -
.
2-
. :
< :
;
;
- : , , , ,
;
.
.
, .
: -01,
:. 0,65 1 .
: , -/ .
w . 1 7 .
: .

163

. 43.

(.., 1996).

,

( . . ., 1978;
.. ., 1982).

,
(. 43).

- . 10 (, ). , , ,

, .
, ,
,
, ,
, .
3- ,
.
.
3- , 3- .
,
.
- ,
( /, ).
.
1:1.2.
13 , , , .
600900 . 3 .
, 164

. , , < . ,
" (-JHCCOB P.., 1969, .., 1988).
: ( .., 1993).
,
- , -
(). , () II .
, ()
-
.
,
. " . .
, . ,
, .

:
/ 56 89 1314 :
100 1 / 0,01 3 ;
1,0 / 1 ;
0,13 ;
0,25 3 ;
1 (0,1) 3 .
// 15 22 :
0,2 3 ;
() 0,005 3 ;
0,001 3 ;
0,25 3 ;
0,5 3 ;
1 (0,1) 3 .
, , , ,
- . .
. , -

165

() , .
, , .
, : , , IgM , ,
+, , .


. , ,
( ), ( ).

,
.
Lasha . (1950).
, - .
.
-
.. - (1979).
:
,
,
,
,
.

.
, ,
23-
.
. .
-
.

166



*
() : , , ,
, ,
(). ,
. , :
;
- , , , , ;
;
;
.
: , , ,,, . ,
, , . , , ,
. ,
.
, ,
(
), .
, ( 5 3 ) ( -, );
. (, .).
. ~ (. 44).
,
/ ,
.
-

167

. 44.
( .., 1998).

: 2,
, ; 610
2/ .
, , . I
, , ,
.
6 10 ,
. , . ,
, - , ( - ) , .

: , , , . ()
. 25 75 . N , .
, .

168

,
,
,
.
. , ,
, .
,
2 . , ,
, . ,
, , . , , , ,
, .
.
- - ,

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

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

169

.
34 .
/. . .
() 1,52,5 . ,
(Daheman., 1993; DouketisJ. ., 1996). ,
23%.
Monreal . (1994),
15% 10 000 36 . , , ,
.
3% ( ),
, .. , ,
IgG , - (Warkentin .. ., 1995).
, > 100x109/ < 50% 515 .
, 4 (PF4). + PF4, ( .., ..1999).
III , , . ,
.
, , 2% (Ginsberg J.S.,Kowalchuk G. ., 1989). , 28 ,
, 612 .
. ,
, 1% ,
, ,
, , ..
1 . , () , - VIII .
,
.
, (). . ( Sanofi, ) ( Pharmacia

170

and Upjohn). , (98%, 30%


), , 1 . (Cosele H. ., 1999) , ,
, , .
, , , . 2 , 12 .
:
, , , -
; ;
4 -
, -, - (Sanson .
., 1999).
, , , , -, .

. , (
, .. ). 612 . ,
, ,
,
. -.
. , , .
1983 . (Lubbe W. .),
1985. (Branch D. .). 40/
7080 /
20 6080%. Pattison Lubbe (1991),
87% . , , .
, , , . ,
30
, . ,
510 ( .., 2000).

, , -

171

.
: , , .
IgG , // ,
, .. , , . , .
, ,

, .
, , 3 .
, ,
, - .
1914
: .
(), , , , . ,
, .
.
- . , , (),
, , , - , .
200 , . , , ,
. , ?
, () , , , .
,
, -

172

. ,
Rh , , , .
, . A.M., .. (1993)
. . ., . ..
(1999) .
, HELLP-, .

-
. ,
-. , , , . ,
-. , . - 30 .
- - , , ,
-. -,
,

, -.
,
, , .
: , .
:
( ,
, );
( , , , );
( , , , , , );

173


;
.
:
;
;
;
-.
, , .
.
, , (, , ).
, , , LDL-, , , .
, ,
, .
R-70, R-80, Juan , -500, -500/300 , , , , -01,
.


() - .
:
1. ;
2. . 1:1,2
1:2.
II III 100
10% .
3. (400500 ) -500/300.
4. ,

35005000 /.
5. -;

174

6. .
23 ,
500900 1 ( ). 3 .
.
,
. ,
. , ,
, ,
,
. . 510 . . , (),
, , , .
.


1. - ;
2. ( 100 /);
3. ( 55 /);
4. ;
5. ;
6. , .
, .

,
1. , .
, .
2. . , .
3. . ,
.

175

4. (, ), . - .

. ." , ,
,
, ,
, , "
( ...1999). , , .
, , ,
, . II
5 1 , ,
.
2 .
,
.



, ,
; .
, . , - .
.
, ,
/ . (, ) II ,
.
, , . , 5 10 .
15 .
I : , ,
, .

176 '




: . _ ,
" . Simon . . (1991) 3,2% ~ . Stampe Sorensen S. (1988), : 1,2% ,
^ 3,2% 15,3% .
, - , .
^ / , .
" .
.
~ , , i/ . II - ( ),
.
,
,
.
-
~ .
~
" 23 , 23
" .

" (Strassman E.O., 1961). ~= , ,
.'. 3 ,
-~ -, .
3 ,
. 67 ,
;/ . ,
9 .
, ~.1 , . , Ludmire J. . (1990),
-

177

52% 53% 58% 65% .




. -
(), , , .
- . , (, ,
.). -
, ,
, , ( .., .., 1999).
-
.
,
, . 84%
( .., 2000).
I
- ,
, II .
- , - , .

.
. , , , , .

, - .
, , :
1. ;
2. ;
3. 2- ;
4. IgM .;
5. ;
6. ;
7. ;
8. ;
9. .

178

5.

--.

.
, corona radiata. corona
radiata zona pellucida,
, . Zona pellucida , .
. .
, , .
. .
I , . II ,
(23). II ,
, . .
74 - , , ,
. ,
, 2+, , , . , , . ,
, .
, , , , . ,
.
,
, , . , ,
. ,
, , < , .
, .
. - < . - ,
. - -

181

in vitro.
, , .
, . ( )
2- .
,
.
, . . , /
, , (Levran ., 1998). ,
-, ,
(Casan . . . 2000).
- (mRNA), . ,
, ,
. (Casan
. . . 2000), - ,
,
.
, , mRNA , (Raga F.
., 1999). ,
,
.
. -
, . . , ,
, .. ,
.
,
. , ,
. , (PIF) ( . ., 1999),
(VEGF), mRNA VEGF, (Krussel ., 2000).

182

,

, 67
, .
, (Nikas G., 2000).
. , .
,
, 1 episialin,

(DeSouzam M. ., 1999). , .
: 1 , 2
(Kierazenbaum A., 2001). , , . 23 .
(Kierazenbaum A., 2001),
/, , , . , ,
, . . ,
. -, . . ,
(Shiokowa S. ., 2000), ,
-- RhoA
, .

, (trophinin, bustin, tastin).
, ~ ^ . - .
' , _. " .
. : -- , IGFBP.
. , -

183

, . Paria . (2001).
-
(HB-EGF), , , (FGF), (BMP) . .
-,
, (). - II
.

. , -. ,
, -, , . (Loke
Y. . 2000) , , NK- -.
HLA I II , HLA-G. CD8
, . NK- CD3-CD8+CD56+
Th 1, TNFcc,
CD8-CB56+ . ,
()
TNFoc, GM-CSF. , 2, .. , , , (il-4, il-10, il-13 .). Th 1 Th2
.
, .
, Th1 , .
, (fetuin) (spermine). TNF. HLA-G
NK- (Cooke I., 2000).
NK-
GM-CSF, CSF-1, , TGF0, , .
. . , -

184

TJ6, CD56+16+,
( ).

(), . . 1012
.


.
. , , 1, .
:
. .. (1999), .
, , .
, ,
.
, .
, . .
1213
. 3 ,
:> .
" , - aje . ( , ),
~, .
:
" . , 1
_ . < , -.-. . , " , - , 5 .

185

56
, ,
.
. . - - .
.
, - .
710 1416 .
, I
, , .
. ,
. .
, ,
, . ,
; ; ..
.
.
III IV
.
, , . .
.
, - . 16 .
, .
5- , - .
67- , , .

186

III
, ,
.
8- . , .
9- , 3740 .
.

,

,
(. 26).

,

-

-
-
-

-





- 1
(IGF-1)
(EGF)
(PGF)
(FGF)

(TGFP)

-1 (il-1)
-6 (il-6)
1
(CSF1)

26




1 (IGFBP-1)
1
1
(CSF-1)

187

. 26

(), (), (XT), (). , - (-


(GnRH), - (CRH), -
(TRH) ) . ,
(Shi Q. ., 1993).
, . . - , - .
. , -, 6 , - 19 , - 6 19
(Jameson J., 1993). - ,
24 ,
2 (Ren S. ., 1992).
, ,
-, , . 8
, . : 7
, ,
, . : , , . ,
, .
, -, . , , .
810
100000IU/I, 16 1000020000IU/I,
34 . 34 , .

188

( )
, . , , 32 .
1 (Spellocy
W.N., 1973).
Kaplan S. (1974), , ,
. . .
.
, . ,
, IGF-I. 12% ,
, .
, II
36 . ,
IGFI (Frankenne F. ., 1988). .
,
, , . ,
, , .

-- (CRH). CRH . CRH CRH- , .
, , ,
CRH. , CRH . , CRH
. CRH ,
CRH , , CRH ( ) (Grammatopoulos D. ., 1994). , CRH ,

.

.
, .

189

-1 , 1
(CSF-1) . (Li Y. ., 1992). -6, (TNF), -1. -6, TNF
, - (IGF-I IGF-II)
(Pekonen F. ., 1990). .
- (IGFBP-1P). IGF-1
, , . IGFBP-1 IGF-1
. , IGF-1 no6paTHOclGFBP-1 (Osborn ., 1992).
(EGF) .
, , : , , , .
.. , 2 F^.
. GnRH, : , .

, -,
(Petraglia F. ., 1989).
SP, ^
,- (), .. 1971 .
.


.
(Wagner J. ., 1994)

,
, -
. 30,
.
.
--
. ,

. (2),
, -

190

, .
, V
, ; (PG12nPGE2),
. , , .
(-- ) .
. , 14 (Lemire R., 1974). 100 ,
- 19
21 . : , , ; , ,

(KaplanS. ., 1976).
- , . . - () .
I II (Kaplan S. ., 1976). 1022
(, ),
.
-- , , ,
.
. 10
. .

.
:
, -, .
. ,
(Silman R. ., 1976).
,
(2029
), (Kaplan S. .,

191

1976). . ,
.
. , , 85% ,
(
). () .
(Murphy . ., 1975). . , , - .

; ; II > . , -,
. , Liggins G. (1976), , , ,
-2, . . , , 7
(Neville A.M., 1969).
. , ,'
, . 6 . , . ,
.
, 78 , , . /
. -, '
.
8 .
1012
. ,
4 . -

192

, ,
- -. , 20 . ,
. III . 4 4
. 30 , .
(Osgthanondh R.
., 1978). ,
56 . , 30 , 2-
. 4 4
.

, , . ,
, , . .
.
.
, 67 . 8- , , .
, ,
,
. , , , - (CD4 CD8)(Haynes .F., Heinly .S., 1995).
12
(HorstE. ., 1990).
(), , . 95% 34
. 5% , , , CD4 CDS 14 (Asma G. ., 1983).
7-6747

193

- . ,
, , ,
, , , .
20 (Bonati A.
., 1992).
--4 , CD4 CD8, -- CD3. 16
10% ,
. - TNF.
,
, il-3,il-4, il-5, il-10, - , a il-1, il-6, TNF, -, -, il-2
(English ..
., 1988).


.
,
, .
1) - :
() 6 , 4050%. 20
24 ;
40%;
3040%.
, III .
2)
:
;
. , ,
. , .
100 / 30% ;
. 915x109 /,
() ;

140400x109 /;

194

. VIII ,
(. 27);
.
3) :
20%, 02 ;
40%, 20%;
;
2 2832 ..
( );
: .
4) :
: 1,01,5 ,
, ( );
:
5080% I II III (
);
; .
>
27

I II
III

31,235,5%
31,9-36,5%
915x109 /
140400x109 /

200%

:
V
VII
VIII
IX
X
XI
XIII


200%
300%

200%

195

5) .
. ( ),
, , (V, VII, X, XI, XII.
XIII), ( III, S). . ( , , -) .
6) .
, 85% .
, 6 16
, . 70%
- , .
7)
. ,
, - . . (,
), , , .
, , , , . , .
.
, :
1 ,
2 ,
,
.
-, -, . .

.
, .
.
8)
. 50
,
.

196

, .
*
- , , --.
, , .
-- , , ,
:
1) ;
*
2) ;
3) ,
( ).
16-;
4) , ; , ,
, ; , ; 16-, .

, . ( 5).
. 4-, . 5 , - (TulchinsKy D. .,
1973).
, , 17-
. - . . 7
. 10
. II
(. 45). 57
, .. ,
. 10
. 250 .
.
, , - , ,
. ,
.

197

5.

(Mitchell ., 1987).
-.

1020 , . 3 , .
: (), . ,
II. 1200 ,
. .
, (Rotchildl., 1983). ;
, ;

198

10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42

. 45.

, ;
.
, ,
- .
(Siiteri P. ., 1977).

, . .
. 57
, .
.
450 . , ,
, 17|3- ( 6).
- . ,
17- (

199

6. .

. (Gurpide, 1982),
, . , , .
, . ,
, .

200

. , 16-
1 --. .
16- (Madden
., 1978). .
, . , ,
, (Fradsen V., 1961).
. , 810 (Spector W., 1956).
, 85% , ,
15% ,
. . 100 200 /dl ,
35 /dl (Casey ., 1998).
,
(MacDonald P. .,
1978, Liggius G., 1969), . , . ,

, . , ,
, ,

. ,
. , .
( ),
.
- (IGF-I IGF-II)
, IGF-II,
(Mesino S. ., 1993).
.
, .
. -, - (Mesino S. ., 1993).
(Fujieda . ., 1982), "
- .
, , :
, .
4

201

6
^

10

12

14

16 18 20 22 24 26 28

30 32

34

36

38

4C

. 46.

(. 46).
1. 610 .
2 30 /
.
2. 68
6 40 /, , .
3. 9 , , 3135 , .
Jf(

100 , .
:
1) ;
2) , . , HOB(ResnikR., 1974);
3) , , ;
4) ;
5) ;
6) - .

202

6,

1. 12 . 37,237,4. 37 . ,
, , .
2.
,
, , ,
. 12
() 10%, 1316 39%. 39
5%.
,
, .
3.
I .
3- .
25005000 5 80 000 79 , 1213
10 00020 000 3435 ,
, .
,
, , ,
.
, (. 47). 56 ,
1012 , , .
,
.
, . , ,
. I .
4.
, . (. 47)
,
. 5

205

. 47. I
.

, .
,
.
5. I .
I , 11111
.

- - , ,
, (Bradshaw . ., 1986).
.
6.
17 .
17, . , - 3-
.
17 . 20,0 42,0 / (612 /). 17 . 10% 17.

206

17 . 17 170 -S .

; II III .
7. . I 9
. II
( I ) , , - .
1718 .
, - . , 35
,
. (
HLA 14, 3518 ) 17- .
17
. 170
.
8. , , , .
3-
.
, , ,
. 4 .
5- , 67 . , , .
.

.
. . ,
. (. 48, 49). , , .
,
. , .

207

. 48.
, ,
( ) ( ..,1992).
( ) ( ..,1992).

. 49. . .
(1), ,
, (2), .


(. 50).
,
, .

(. 51, 52). - ,
.

208

50 56
/ , 2 , 3 - ( ) (., 1992).
51 I


7 , 1
, , 2 89 ,
,
( ),
8 , 1
; 2 89 ,
, 3
45 ,
( ) ( , 1992)

209

. 52. 14 .
- .
1 , 2

(.., 1992).


.
, ,
, , ,
, , .
: ; . , , .
9.
- - , . 2024 24 .
, . ()
() : - , () :

() , .
10.
, 34 12 (
). ( ) , ..:
= 155x10-4 (Etcp) + 87x107 (Ehm/ - (6410-4) - (Ehma) + 0,33/(maxhma/cp) + 0,95,

; Ehma ; maxhma/cp .
1,0
; 1,0 2,0 ; 2,0

210

3,0 ; 3,0 , .
11.
, , .
- . , 15 /2.
.
. 1520 .
, ,
, . .. :
_

, ; ( ); I
; ; ;
t .
, ..
. (1977). .
. , .
,
. .
. . . 7,5..
, 7,5 ..
.
,
, ,
,
, , .
12. : , ,
, .
13. .
.

211

510% ( ..,
1995; Higgins 1997). 4,4% 32,7% ( .., 1987; .., 1994).
, , ,
, ,
, .. ,
, .
() ,
, .
,
390 ( ), ,
. (.. , ).
24 15- 30- . ,

, ,
, .
.
24- ,
.
:
1. , ,
( .., . ).
2. ( ..).
3. , (%).
4. , (%).
25%.
5. ( )
,
( % ).
10% 1,1.
,
, , . ( ) ,
.

212

COM , i iupui
1 .
,
, .
, , .
- .
.
:
, ,
.
. (45%) ,
.
. ,
,
.

,
,
.
4. , , , .
5. , .
6. ,
, , . ,
, .. , , .

213

-



, ,
.
: , , ,
, (missed abortion), .
, I 75%
, , , .

-^

1.

: ,
. . , ,
. ,
.
:
1.
. . , .
2.
. ,
- .
, , , .
.
3. . .
50% . , .
4. . , ,
(),
. - .
, , , , .
:

214

) 37
( );
) , ;
) .
: , , . ( , ) ,
(, , ,
.), , -. -, .

2.

, . , . , . - ,
. .
, , - .
, .
, :
, ;
- ;
;
/;
/.

, .
, -,
, . ,
( ) , , . ,
,
, ,
.

215

( , ),
. , 5,0 200,0 12 , 2,0 23 .
45 .
() 2,0 23 , 250 3 .
. , -, .

3 3 40
. . (-, ).

3.
,
. ,
.
.
) , ,
. . . , . ,
.
, , . , -. , /
. /
(30 1000 ) 200
( ).
,
, . , - . ,
. - .
) , , . , . , , .

216

1416 , ,
. ,
, , - .

4.
( , missed abortion)
() . , , .
, , , .
.
(4
) .
,
-, .
1214 ( -).
: ..,
F2a,
,. .
(, )
, , . () .
( ),
( )
( ) .
.
.
, .
.
.

217

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



. ,
. , ,
.
, (24 )
50%
,
,
. ,
, , . .
I
, . ,
, :
1. ;
2. , : , .
-

218

.. . (1976)
.. .. (1978),
(.., 1991) - . - , , ,
, , . ,
. ,
, , .

, , ,
.
.
-. (Spatling L, 1988). , 60%.
, , , . ( 6)
. , , .
- ,
. -
4 . 2 2 ; 1 , 1 2
. 2 . , . - 56 ,
. - .
- 2- 200
:
<*>*

219

, ,
85% ;
, 65% ;
, .
, -
. - ,
. - , , ,
, ,
.
3. : - 0,04 3 , 0,02 34 . - 2,0 23
, 2,0 .
4.
, , .
.



.
I , II III , , .

.
, , . , ,
, ,
.

5000 2 . (Fanchin R. . 2001),
, , , .

. -

220

. 56
, II . ,
, 6
10 2 , 100 1 23
per os .
16 , .
, .
,
HLA.

^
^
^
^
$^

()
Beer . . (19701979) . 1978 .
Beer . , 1979 .
(Transplantation Immunology
Congress). Beer . 1978. , , . ..
,
, .
. ..

. I . 14 , , .
, 23 78 , .
, , , .
. .
46 ,
, . , , ( ).
1 2 , , ,
. 14 12 - -
.
.. .. , , .. ( , ), .. ,

221

^
^
^

222

,
.. , , . 1982 .
,
1983 . .. .
, , Chicago Medical School .
. (Mowbray J. ., 1985).
, . , ,
. , Beer . .
, . 1995 .
(ASRM)
. , ,
,
, , ,
- , , ( , - ..), , .. . 1984 . ( ..)
, .
, , ,
, , , ,
Ober ., . .
, , ,
, . 26% , .. ,
, , .
Clarke D. (1999), ,
Ober, , . (Hill J. nAndercenD., 1986, Katzl. ., 1992) ,
,
50 ( ,
, ); ( ); , , (,
, ,
(Tayler . ., 1981));
( ).
,
. , , , ( 20 ), ,
I , ,
, HLA (
1 ).

45 , 4 ( ).
I . , , I II , .
. ,
, -, .
( ),
,
. 364 14.IX.2001 . . , :
RW, , HBsAg, HCV, (, ,
ACT), .
:
1. 50100 .
8,010,0 1,0
. 37
1,52 . 2 ( , ) 510 5 10001500 /.
5,0 10 . , 510 10001500 /. 1
.
510
10001500 /. , . ( + )
. , 8595% , , .
2. . 50100 , 3 3%
Na2 12 18% .
37 60 .
, 510 , 10001500 / 510 . ,
, .
40 ( 8090 ).
.
8
10 . :
, , . 5
7 . , ,
HLA. , HLA,
, . 4
. , .
, , , , -.

223



,
. ,
, . , ( ) . .
, 17
, , 1/
4 , . 13, 24 28 .
, . 34 7
.
17 17,
, 16 ( ). ,
, .
, , , . ,
- , 2/3
, .
I .
, ,
. , . ,
.
, ,
, . 1718
ccFP, , 2, 170.
17 17 . 17 . , ,
, ." . ,

224

, ,
, . ( ,
) , .
I (911 ) -

^%\V\W^MW^

, ,
. .



, , , 36 % . , -, 17,
2 .
,
. ,
, 0,5
. ,
, .
.
17.
, 2\ "! ,5. ,
. 16 , .

16 , 3536 . ( , 34,2% ),
3536 .
.
- - ,
, , 30,8%. , , ,
.

, - .
,
,
8 - 6747

225

76,8% , 77,8% 92% .


4 ( 36,4% 9,3%)
11 ( 63,6% 5,7%). .
(Hunter M. . 2000; ..,
1996; .., 1998 .), - . , .
, , ,
.
, ..
.. (1990), , ,
. ,
, , ,
. (67,7%) , 8 .

, ,
74,5% .
15,7% .

.
-,
, : 3- (31,4%) .
(35,7%) (48%) 34
, (11,9%).
- ,
, - . 1,54 ,
. , ,

( 25 ),

226

, ,
. 45
,
, - , . .
, ,
( 35 )
, ,
.
,
, :
(25%), (36,6%), (33,3%),
(45,4%), (27,3%), (18,5%),
(43,7%).



.
, ,
, , , .
,
2 ; . , , , .
, , . I
. , 25,0 3. ,
2,5 2 23. -
78 . , , . .
, / .

8-

227

-
,
, ,
.
, 1 3
5,0 200,0 5 .

-. , , , , , ,
.
, , I
, , ,
, .
, ,
, , .
I , , , , , 1314 ,
. I , . , .
II , .
II , - . , .
,
. .
, . 2 ( )
. , .
(il-
) (TNFcc, il-1),
.
il- (. 53). ,
il- ,
.
III (. 54).

228

. 53. IL-6

( .., 2000).

. 54. IL-6



( .., 2000).

. 55. IL-6


- III
( .., 2000).

il- .
il- , (=0,92) (. 55).
, , , .
, - ( , , , , )

229

.
, .
35 .
, . 1,0 / 510 .
2- . 25,0 3 2,5 23 .
2 10 . II - - .
, 5,0 200,0 2,0 200,0 ( , )
5 . , . II , , .
III
, ,
, , , - - , .
, , . 25,0 3, .
-
.

-

. , , . . . (1996),
:
, 3 ,
20
.
^,.
28
, 3,7 -

230

, 4,5 ( ).
1314
3,63,7 .
1720 2,9.
, 2 ,
.

, 0,5 .

10- 36- 2,58 4,02 .

1,160,04 , 1,530,03.
.
,
. ,
.
. :
1)
;
2) ;
3) .
.
,
, , , .

. ,
, .
,
.
, , :
MacDonalda, , -
.
Czendi, . ^ ^

231

:
( 11111 );
, , : , , , .
:
, ( - , , , ,
);
, ;
, ;
,
(-, );
IIIIV . ,
, .

. Czendi .
13
27 .
. , 20 ,
,
1317 .
1317 ,
.
.
.
, , ,
.

- .
:
1. MacDonald
(1957) (. 56). .

232

:
( 11111 );
, , : , , , .
:
, ( - , , , ,
);
, ;
, ;
,
(-, );
IIIIV . ,
, .

. Czendi .
13
27 .
. , 20 ,
,
1317 .
1317 ,
.
.
.
, , ,
.

- .
:
1. MacDonald
(1957) (. 56). .

232

. 56. .

. ,
. , , . 5.
2. MacDonald
.. . (1973).
. .
.
3. .. (1969). ,
. , .
, . .
5.
. .
.
4. - .. .. (1981) (. 57). .
. -

233

.-

Y V

. 57. -
.. ..

, 0,5
, , .
,
.
. , 0,5 .
,
. . 23
.
5.
( .. ..
(1995)). , . 3- 9- ( 2 )
0,5 .
34 ( ).

. , . .
, , .
.
5. .

234

. 58.
.. ., 1988.
6. - ( ,
.. ., 1988) ( 1438734).
( )
.
MacDonald,
. (. 58)
: 1,5 ,
.
, ,
.
, .
.
,
,
.
1. Czendi . (1961).
.
0,5 .
0,5 .

. 23 .
Czendi . , .

235

2. Baden W. . (1960):
11,5 .
-
. . .

. , , - ,
.
23 : , - 0.04 3 , -.
- (, , ) 2,5 ( 1/2)
1,25 (1/4 ) 4 1012 .
(3-.
II
25 4 , 100 1 56 . , .
23 , 3% , 1:5000, (56 ), , .
. .
,
. , .
2,0 57 .
500 000 4 . 57 .
2 . 3738 . .
Czendi 23 .
3% , (1:5000), , , ,
45 , . 9 . 9- .
.
- , .

236


.
- . , , . , , .
10 . 2530 .
, ,
. . 23 : ,
, , .

2,0 57 . III , . : , , .
. , . -
. -, , .
- , - . 25,0 3 .
IgA . ,
2,5 2 2 .
(, , ).
. 1,0 1 10 .
, 3% ,
1:5000, . , , , 56
, , , . (3- , , 0.5 400
,
5 4 , 5 . -

237

10 12 , 0,04
34 .
(3- , . .
11,5
.
: 2 . 3738 .
, ,
. , -, ,
, ; -,
;
, .
MacDonald , ,
. -
, .
.
, , , .

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

23 .
,
, ,
.
.

(, ).
,
, , , , ,

238


.
, ,
, .



I , , 2 . 2- 1 (5 ) . ,
/ . I N
25 3 .
5 000 3 0,3 1 0,2 (2,500 ME) 2 .

400,0 10 000 23 . , .

.
- , .
, , , . ,
.
, , .. ( ), 13%
11 % 6 1,5 .
, 510 .

, . (, ) , , 10 800 1200 10
, 259, 2 ?
, , , ,

239

, . ,
Shehota H. . (2001),
18%, 31%
43%, 7%. .. .. (2002), , I , 7,6%, 7,6% 19,2%,
II 17,3%, 7,6%,
27,6%, 19,2%. , 98,8% , 26 .
Ginsberg J. . (1989),
. ,
33,6%, 6,4% 762 ; 6 , 26,5% 230 .
.
. , . 3- ,
25 (1,25) 3 ,
. , .
24 .
.
,
.
, . . , Spinnato J. . (1995), Clark A.L. . (1999),
,
1 /1 2- 36 , . 12 , ,
,
. ,
, :
,
, 7000 14000 , ;

240

- ,
;
,
, ;

(Clarke D.A., DayaS., 1998; Thornton . .,
1993; Hill J., 1999).
, . -
.
, , . IgGJgM IgA.
IgA - .
, , , , ,
. ,
-.

.

. (). , ,
. , , , , , .
. 70% , ,
.
34 .

- .

, , (Jacobson S.L, etal.,
1990; ., 1990). 1620 34 . 9-6747

241

.
,
, , . ,
, . ( ,
) , , . 8 .
, - , , .
I . , , , ,
, .

5 250,0 ( 5
), 2,0 200,0
, 5 . - , ,
.

- , ,
.
.

9596,7%
, .
, .
,
, .
, 5,1 () ()
1:1,5. ,
. 242

- . ^ , .
.
, ,
90% : 91 %, Scott J. . (1987),
Brauch D. . (1991), 57% 33% , 10% . .

.. (2000) , 90,8% .
, , ,
. (46%) (24%) , , .
, - (CD3+), - (CD4+), - (CD19+), ,
(CD11 +), , - ,
- .
, , -
.
.



, , , .
.
20 29

,,
243

. 1-
, , . :
+ k = 10,0 0,2 , = 48,4 0,3 , = 27,0 0,2 .. 2- 80%
, , , :
+ k = 15,5 0,3 , = 51,0 0,8 , = 11,6 1,5 .. 3-
. , , :
+ k = 7,2 0,1, = 60,0 0,5, = 48,7 0,43 .. 67-
. ,
, , 1214- ,
.
,
5
10 . 35 .
10 20 1012
(, ) 100 .
,
,
.
, , -, .


(Asherman R.A., 1997).
A. .
. :
;
;
HELLP- (, , )
B. ;
. ;
. .
, Asherman R.A. 1992 .,
(Ingram S.
., 1987),
244

.
. ,
. ,
()
.

( R.A. Asherman, 1992)

:
(45%)
-
(63%)
(55%)
(63%)

(63%)

(100%)

- (54%)
:

70%
, ;
29,711,9 (90%
45 )
( ) ,
( ),
( ), ,

, ,

(, ), ,
ST,
, ,
,
, , ,
, ,

,
,
, IgG ,
(1011)
,

245

. .
^
^
^
^
^
^
^
^
^
^
^
i5
^
^
^
^
^
fc
^
^
|
^
^
^
^

ffc
^
^

3., 22 , 28 . . . . . .
. : 1 -
18 . 16 , . , . , .
2223 .
20 . 24 , ,
, 150/110 ..
, , 34 , (
). , , , . 1998 .
, , , . ,
.
. 20 , , . : , . 130/90, ,
.
10 , . 28 2526 , .
:
1 , RW, HbsAg, HCV
2. : -114 /; -30 /; L-15,3; -5; -13; -69;
-11; -1; 243 000 /
3. r+k = 15+7122

^
^
,
^
^
^
|
|

^
%
|

^
|
|
^
^

= 52
= 15,..

4.
\
\gG
.+
.+

+
+
+ +

+ +
5. : 1. 307 /; 22 /; 237 /; 477 /; - 151 /; 18,2 /;
1,1 /; 66/; 8,7/;
25 /.
6. : 0,1 /; L-0-1 ; -;
.
7. : 8750; 58750;
.
8. .
9. .

246

^
^
^
^
^
^
^
%
s
^
^
^
^

^
^
^
^
^
^
^
^
%
^
^
^
|
|
^
^
^
^
^
^
%
^
^
%

10. HBsAg ; ;
HCV ; HAV .
11. : , 2627 , 2526
. (+). , 3,7 . , . .
12. (); - .
13. : , . ,
. . ,
. . , . , .
14. :
-
.
20x11x27 . , -, 2-
^- , , . ,
v. Portal . 15x6x14 , . . , : 12x5,5x5 ; 12,8x5,6x5.8 . , .
: , - ,
.
: 28 . . , . . . .
\\-\\\ . \ . .
. .
HELLP-, - .

HELLP-

HELLP-

3.

^
^

+
+
+
+

+
+/+

^
^
^
^
^
^

,
,
:
, ,
,

+
+
+

fc

+
+

+
+

247


, -

XV4
^

^
248

( R.A.Asherman, 1992)


+
+
+
(,
, )

+
+/+

+
+/+
()

+/+
+
:

_
+
_


+
+

+

()
+


+
?
+

+
+/+/

+/: 816 . 15 000 , 200,0 / . 400,0 /


3. 1,0 4 / 5 . : 400,0 /
3, - / 6; 250,0
/ 6; 400 / 3; 50 , 20 ; , .
2 . , .
.
, , , .
2
. ,
, 872 , 32 .
1 - 1 , 5- 6 . 800,0 .
. , 2 2-
. 3 ,
.
:
: , - , 10% , ;
120 / ;
1,0 3 /, 100,0 2 /
;
0,3 2 /;
.

. 59. 3. ( ).
, 60 . ,
,
39,0, 180 / /. 1,0x2 /, , 5000
3 /. , 5 .
20
. : 50 2
, 20 . . (. 59), , ,
(. 60). .
.

249

. 60. 3. ( ).

, 5 8
100.
. 1,5 -
, . .

, , ,
, .
, .
, , ,
.


,
.
, 2024, 3334 , 2,55 . .

250

I -. ( ) ,
. , , , . : , ,
.
,
.
, .
? ,
,
(Alexander H. ., 1998).
, d. basalis. ,
,
, ,
, (
..,1999). ( ..,2001) -
. , 1015
, 2 , , .
, , , . ,

.
, . 34 ,
10 23 .


HLA
HLA
. 80-
. , HLA, DQcc . -

251

-
() , (Beer A.E. ., 1981; Beer A.E. .,
1991; MowbrayJ. ., 1985).
.. . (1997), HLA-
5069% 3444% . HLA-B 3038% 1828% ;
HLADR 4271 % 2030% . , . ..
, 2 . , .
Beer A.E. . (1991) HLA
6 2 2
,
4 10 . , .
.
HLA .
, .

Beer A.E. ,
4 . , 34 4 HLA.
, .
, ,
(Reindollar R.,2000 Hill J., 1996). .
, .
, , - ,
.



.
. , - , -

252


. ,
. ,
, . , , ,
. .
.
, ,
. , , ,
.
, , .
70- , , ,
. .

. (.., . . .,
1979).
-1
. 810 11,5 .
. .
. , , . ,
.
, , -
, -

253

. , 5 7 . .
. ,
.
.
.
-
, . . . (1974),
-3, -4.
5 ; 1015 . .

- , .
.
-
, - .
50500 , 10 4.
-01 . . 30 , 1 3 .
,
.
1516 , , .
, , .
.
, .
, , ,
. . , . . , 36 (36III,
--), 5TR (5, -) 2F (2XII, -).
:
1) , , ;

254

2) ;
3) ;
4)
;
5) -
;
6) : , ;
7) ,
.

, , , .

,
.

, , ,
, .
, ,
.


, ,
, . ,
- , , .
, . ,
:
, , ,
. .
.
1:1 (1- ) 36 ( ); II
(2- ) 36 ; III (3- ) 36 5TR ; IV (5- ) 36 5TR ; V
(7- ) 36 5TR ; VI (9- ) 36 5TR . .
2: \ (1- ) 2F ; II (2- ) 2F ;
III (3- ) 2F 5TR ; IV (5- ) 2F 5TR
; V (7- ) 2F 5TR ; VI (9- ) 2F

255

5TR .
, , , . . .

36 5TR 2F 5TR.
34 . 3
, 23 12 .
, 46
. 711 . 1015 .
, , , . 2 .
.
, , 1015 .
.
, , .
10 40
. 36 , 5TR 2F .
. 1 3 ,
.
.. (1987), () -147 . -147,
1520 5 .
. . (1998), () 4 2.
815 . 45
. - , .
O.K. (1993) .
,
, . ()

256

. , , 0,1 , 1,5 3 1
45 . 1,5 120. , 1014 .
810
, .
2 :
1
: V31 -34; V28,29,30; Rp4,6,10; E25; J7; TR5; R6,3.
2 . 1
F2,3; VC6; Gi 10,11 ,
, - (55),
(34), (25), (37), (100), (101). 1014 68
36 .
,
,
-, .


.


() ,
, ,
. .
,
.
, , 47,677,3%% .
, ,
,
, , , , .

257

- , - . - ,
.
,

. , , .
, , ,
, , . , 48% ( .., 1994).
611 ,
, , , , .
:
.
, , , .
, , .
.. (1991) ,
, , , :
, -
- .
-, .
-, .
( 16 ),
, - , . -

258

- , , , , .
. ( , ,
, ). , , , .
.
,
.
() ,
.
. , .
()
. , .
. . , .. , 60%.

II III .
. .
, - / . ( .., 1985) , .
, . ,
(Lampe L, Gaal J., 1978):
,
,
;
, .

259

,
.
.
, .

, ,

. ,
, , , , .
:

.
.
(, ,
, ).
(, ,
, , ,
, ).
, , ,
,
, .
, ( , ).
-
1619 .
- -.

80%. .
- . . , I. Vladimiroff (1987), 70%
45 . , .
.

260

(, , , , (
,-), ( ,-).
, , , .
.
-, , ,
.
I
.
13
.
I 50%
.
(), , ,
.
, 4050% 1720 .
, . ,
,
.
- ()
- .
58 37 .

( 5
10 ) I II III . I
( ) , , .
- () ,
.
30 /,
.
II III , ( 200 /) ( 95%).

261


(, , (ACT), (), (),
(), - (-),
(), - (-), , ).
, , .
, .
.
( , , , -).
- (),
.
,
, .. ,
.
, , , - ,
, , -
, .
.

.
:
,
, , .
,
- . , , - - , ,
--.
- , , , , . . , ,
- . .
0.5 500

262

1030 , 2,5 1,25 4


.
- ,
, :
- , , , , , , .
,
.
, - (, , ) - . 15 -.
-, , .
- , , .
(), , . ,
35 400 . 510 .
: ,
.
, , .

, , , , , ,
.
1 2 .
-
(, ,).
, -
- , .
, , , , .
. .
- -
. 57
,
. 100 , 5%- . .

263

, ( ), 30 ..
( , ), 1 0,06% .
. 2,4% 10.0 500 5%- 1020%- .
.
. , , , ,
.
15 3 , 2,0 15% . 14 .
- . , , . .
0,025 3 1 .
(100200 ) , - . , .

510% 400500
5% 35 100 .
, ( ),
.
5
35 .
,
.
.

.
, . 5 5%-
250 57 .
. (, 400 ). .


.

264

: - , , ,
, . 2 250 1 5
1 . , ,
.
,
,

.
I : (), -, , , - . , II
, , , - (, ),
, , (, ). , ,
. , - , , . ,
,
,
.

,
(, - , ,
, , , )
- .
.
, , , .
1012 23-
.

.

265

( ..,2000):
.
(0,9% NaCI). , , , 100 400 . 500/300.

CR-412 Jouan () 2500 20 20 . ,
, . 150 . 12 , , .
400900 . 8002700 .
() (HES 5%
10%, Infukol HES 6% 10%), , 1:2. 60 /. .
100 .
5000 .
3- 24 .

() , , Moore:
- , ;
( 55 70 /). ,
/: Ht=Hb 3, Ht /; /.
:
= (100%-).
,
,
.
, ( .., .., 1990). H.C.S.Wallenburg (1990).
,
- .
, - -

266

,
.
-
. -

20 . - - , .

, - , , .

.

, , 3 . .
: 3 , 2,6 , .
. , .
,
, - . ,
, . ,

, .
, 10%
() , ,
, .

267



,
.
. , .
6070%
6575% , 813 , .
33 ,
.
- ,
, . , , ,
, , . , .
, 28 37 ;
1000 . 22 500 .

,
: 2227 ;
2833 ; 3437 .
, 2227 (
500 1000 ) - ,
. , , .
.
.
. .
2833 (
10001800 ) , .
30%.
. ,

268 "

23 .
.
3437 (
19002500 ) , ,
50%.
. ,
,

.
34
37 (55,3%), 2227 10 (5,7%).
-
1000
, , -: ,
, ; : ,
, , , , . ,
. , ( ).
.
, .
, ,
,
, 5 . 2538% .


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

269

. - , , . - 0,04 (1 .)
34 . , , -, , .
().
-
. , - , . ,
-, .
-, , 86%.

( .., 1989).
200 1 - 50 4
( 100 2 ), 23 50 8 , 46 50
12 , 78 50 .
1000 . 59 . - , .
23 ,
.
34 . ,
, 72%.

.
.
, ,
, -.
, , -. - ,
, - .
().
2% 200 1 57 . ,
, , . , -
, 67%.

270

. -01 .
30
.
- , .
, , , .
812 ( 4
2 23 2 4
, 2 3 , 2 2 ).
,
, , 23 .
,
,
.
: ( ), III .,
, , , , , .
- -
.

.
2833 .

. . , ,
. , , , . 34 .
,
, . , .
: 10 , , , , .., (

271

10 ) ( ,
).
I . 4 ,
5 10 . , 0,8 /, 3,5 /.
(6,250,312 ),
(2,160,15 )
(6,320,27 3,290,27 , ). , I
8,1 0,4
, 9,40,4 , II 0,360,02 0,570,04
, .
, , , ,
. , (8,540,38 10,21 0,47 , ),
. ,
- , ,
.
-
, , 1
, , - ,
, 23 ; - 1
, , , .
- -
. - f
. .
,
. , ,
. .
,
. ,
- , .
.
, ,

272

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

, , .
: , 0,81 / 2,53 / , 5
10 , 5 , 2100 2430 .

1020 , , 1 .

,
.
(0,5 250300 0,9% ).
10 0,8 / (10 1 ).
. ,
1,2 3,0 /, .. 40
, ,
10 .
34 10 . 23 , ,
.
.
89 , .. 3040 .
1,0 5 300 .
. 40 1 (1,23 /)
160170 1 , ,
10 - 6747

273

.
. .
,
, ,
, , , .
, ,
.
', ,
. , .
2,5 F 2 2,5 500,0
0,9%. 58
. 1020 45
34 10 . , , , , .
12 , .
,
. , ,
.
II
.
, 5 , 12 20 .
, -
. 3437 .

, .
, (
).

274

.
34 . ,
, (, ) -
.

,
.

(),
3851% .
. , ,
.

. , , .
:
, , , ,
4 .
12 , .
, . : - ,
- , -
( ).

il- , 25 . .

27%, .
, -
.
4872 , .
.

^**^*

10*

275


, . , 34 ,
.
.

: , - , , ., , ,
. , .


1961 .
2500 . ,

.
:
1) , ( );
2) , , ,
, ;
3) , , , , . . , .
, , : 2500 , 45 , , , ( ), ,
, ,
, ,
, ().
(, 1976)
(. 28). 2 .
, .

276

(, 1976)

28
30
32
33
34
36
35

28

1000

28

37

38

10001200

1200
1500

15001800

1800
1900

1900
2100

21002400

24002700

27003000

3000

34

35

37

40

41

42

44

45

49

50

25

26

28

29

30

31

32

32

35

36

21

24

26

26

27

27

28

32

34

35

27

34

34

42

42

42

49

50

50

60

s~\

V.

!

0
0

V-4

^~\
f
)



1
1

/ MOL

hle 1
0

^
f
}

1 2

23


>
1
0

.^.
S^^^l
.x^

3

3

^^

s~-\
f
i

s~\
^*/

HI 1
2

- ,
.
. , 1500
0 3 50%,
3000 57% . 5 . , .
, , . , .

. , , -, . ,
, ,
.
, . 2 , 2
, . ,
,
.
.
.
, .
, . . . ,
, . , . .
.
i
- - 1
. - '
, ,
. - .
, , .

278

29

( )

1- 2- 3- 4- 5- 6- 7-


0
1
2
.
0 .
1
, , .
. . , .
2
, , . , . , , .


, :
1)
;
2) ;
3) ;
4) ;
5) (, ).
0 2 . . , (. 29).
. ,
.

. , , , .
. -

279

, . 1500 5 , .
,
.
.
.
. , .
,
, , .
. ,
, . , , , ,
.
. , 2 .
,
. ,
.
,
, , .
,
, .
, ,
,
.
. . , .
, 0,3'
. ,
.
.
, , , , 3235'.
.
,
. -

280

,
2040% , .
, . ,
. , ,
, , , .
, .
10001500 . , .
22
24 .
.
- 34-35
; .

, , , ,
. ,
, . .
,
. , .
, . .
, , ,
.
.
, ( , ). ,
.
( , ,
). .
. ,
.
, (. 3. ,1986),

281

- . 2832 (67%).
3336 30%.

(
.., 1989). , 2832 ,
3336 . , I , . ,
3,1 2 2832 5,7 2 3336 .
,

-, ,
(, , -), . , 32 .

, , . - .
,
33 . 32 - .
, -
, ,
, -
,
.

, ,
, . , ,
, , 5 . , 32 .
,
-

282

. , , .
-
: , . , , .
, , - .
. , .
, , .
. -
, .
- 5'-
.
, , , , , . . ,
. ,
, - 5'- . ,
- . -
, , .
,

.
, , - ,
. -
, .
,
.
>'

283

. - .
( , , , ,
,
, .). , , .
,
,
.


1.

2.
3.

4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.

17.

A.M., .. . ., 1993,
1-2, 27-34.
..
( ) . ..., ., 1999.
. ., 3. . . , 610 , 1994, 494.
.. , , 1995.
.., ..
. ., 1983. 1,3841.
.. - . ...,
., 1989.
.. , 1970.
.. ., ,
1988.
.. ., , 1979.
.., .. ., , 1976, 168.
. - . ..., ., 1987.
P.M., .., .. , 1982, 9, 5153.
.., ..
. ., 1999, 2,3741.
.. . . ..., , 1985.
.., .., .. ., , 1973.
.., ..

. . , , , 1920 , 1994.
.., .., ..
, 1998,1,52.

285

18.

.. , , . ..., ., 2000.
19.
..
. ..., ., 1998.
20. .. , ,
. . ..., , 1983.
21. . ., .. .:
, , 1988, 4445.
22. .., .. ., , 1981.
23. .., .. .
, 1990,7, 1823.
24.
.. . ...,
., 1994.
25.
.. . ..., ., 1982.
26. .. , . . ..., ., 1996.
27.
.., .. . ., 2002,
1, 2427.
28. .., .. . - , 1978, 12, 106107.
29.
.. ., , 1979.
30. .. - . ., 1978, 4, 811.
31. .. . ..., ., 1994.
32. .., .. .
- . , 1992, 70.
33. .., .., .. , , 1999,7,3,189190.
34. .., ..
, 1990, 8, 8992.
35. .. . ..., .. 1993.
36. ..
', . ..., ., 1993.
37. .. - ., , 1994.
38.
- .., .. - . ., 1979,2,29-31.
39.
.. ., , 1996.
40. .., .., .. , 1996, 41, 4, 172.

286

43.
44.
45.
46.

47.
48.
49.
50.
51.
52.

53.
54.
55.
56.
57.

58.
59.
60.
61.

.., .., ., ..

. ., 1982, 12, 48.
.., .. .
-., 1979.
.., .., ..
. ., 1963, 4, 35.
..
. ..., ., 1980.
.. . ..., ., 1994.
..
. . ...,
., 1989.
.. .
..., ., 2001.
.. , 1997, 1, 5961.
..
. ..., .. 2000.
.., .. . , ,
1978, 11,7980.
.., .., .. , 1982, 4, 5254.
.., .. . , ( ) , 1977, 5, 138145.
A.M. (
) . . ..., ., 1975.
.. . ..., ., 1996.
.. - . ., 1996, 4, 57.
.., .., .. .
, ., 1992.
.., .. . -
.: , , 1973, 244246.
..
. ..., ., 1969.
.., .. -
-
. ., 1981, 9, 40.
.. .
. ., 1974, 9,4548.
.., .. ., Rqsso, 2Q01,

287

62.
63.
64.
65.

66.
67.
68.
69.
70.
71.
72.
73.
74.
75.

76.

77.
78.
79.
80.

81.

82.

288

.. .
., Russo, 2001.
..
.
. ..., ., 2000.
.., .., .. ., , , 2001.
.. , . ..., ., 1993.
..
- . ..., ., 1981.
.. ( , ,
) ...., ., 1997.
.. . . ..., ., 2000.
.. -- ., ,
1999.
.. .: , , 1981, 163168.
.. . ..., ., 1990.
.. , ( , , ) . . ..., ., 1998.
.., .. .
, 1987, 6, 1418.
.. - . .
., 1969, 5, 8591.
.., .. .
.: , , ., 1986.
.., ..
- , , 1985.
..
, 1996, 58,6,37.
O.K. . ..., .,1993.
.. (, , ) . ..., , 1997.
., .. Immunol. Aspects
of reproductive health., M., 1995, 119127.
.., .., .. -2- . 20 , , 1998.
.. -
. . ..., ., 1990.

83.

.. , --.
. ..., .. 1979.
84. .. . . ...., ., 1985.
85.
.., .. .:
, ,
., 1986.
86.
..
. ..., .. 1990.
87. .., ., .. . ., 1967, 2, 3237.
88.
.. . . ..., ., 2000.
89. . , ., 1991.
90. .., .. . ., 1985, 12, 6669.
91. .., .., .. . ., , 1991, 276.
92. .., .., .. . ., 1981, 11, 24.
93. .., ..

( ) , , 1974, 1.
94. .., .. , ., 1993.
95. .., .. . HLA-
(
) 98/195, .,1998.
96. .., .. . HLA -
, ., 1997.
97. .. ., , 1985.
98. .., .., .. . . ., 1/98, 52.
99.
.. ,
. . ..., ., 1991.
100. ..
. . ..., .,
2001.
101. .., .., ..
.: , ., , 1990.
102. .., .. .: ,
, ., 1992.
-***>

289

103. .. ...., ., 2000.


104. .. .. ., 1976.
105. ..
. ., 1981, 2, 55.
106. ..
. ..., ., 1989.
107. .. . ..., ., 1982.
108. .., .., .. - . .,1985, 10, 56.
109. .. .
. ..., 1996.
110. .. . . ., 1990, 7, 7375.
111. .. - , , 1980.
112. .. . ..., ., 1999.
113. .. ., 1987.
114. ..
. . . ..., , 1997.
115. .. - ,
. .
..., ., 1988.
116. ..
, 1997, 5, 714.
117. Aboague-Mathissen, Toth F. et al. Production of interferons in human placental
trofoblast subpopulations and possible roles in pregnancy Clin. Diagn. Lab. Immunol.,
1994,1,6,650.
118. Adashi E., Hsueh A. Ectrogens augment the stimulation of ovarian aromatase activity
by FSH in cultured rat granulasa cells J. Biol. Chem., 257:6077,1982.
119. Alexander H., Zimmermann G. et al. Secretion of HCG by peripheral mononuclear
cells during pregnancy Am. J. of Rep. Immunol., 1998, 40, 4, 280.
120. Amstey M.S. Viral infection in pregnancy: some general principles Clin. Obstet.
Gynecol., 1976, Mar. 19(1), 5560.
121. Aoki R., Fukuda M. Recent molecular approaches to elucidate the mechamism of
embryo implantation: trophinin, bystin, tastin, as molecules involved in initial
attachment of blasto cysts to the uterus in human Semin. Reprod. Med., 18(3),
2000, 265-271.
122. Atamas S.P. Alternative splice variants of cytokines: making a list Life Sciences,
1997,61, 12, 11051112.
123. Asherman R.A. The catastrophic antiphospholipid syndrom J. Rematology, 1992,
19,508512.
,. ,
....
, .,

290

124. Asma G.E., Van-den Bergh R., Vossen J.M. Use of monoclonal antibodies in a study
of the development of lymphocytes in the human fetus Clin. Exp.lmmunol., 1983,
53, 429-436.
125. Auletta F.J. et al. Estrogen -induced luteolysis in the rhesus monkey: reversal with
indomethacin Prostaglandins, 1976, 11:745.
126. Auletta F.J., Flint A.P.F. Mechanisms controlling corpus luteum function in sheeps,
cows, primates and women especially in relation to the time of luteolysis Eudocrin.
Rev., 1988,9,88.
127. Ault K.A., Taulik O.W. et al. Tumor necrosis factor-alpha response to infection with
chlamydia trachomatis in human fallopian tube organ culture Am. J. Obstet.
Gynec.,1996,175, 1242-1245.
128. Azziz R., Boots L. et al. 11-hydrolase deficiency in hyperandrogenism Fert.
Steril.,1991,55,733-741.
129. Azuma K., Calderon I. et al. Is the luteo-placental shift a myth? Analysis of low
progesterone levels in successful ART pregnaonciees J.CIin.Endocrinol.
Metab., 1993,77, 195198.
130. Asherson R.A. Antiphospholipid syndrome variants Proceeding of the XIX, ILAR
Congress of Rheumatology, Edit. Feng P.M..Singapore, 1997, 445451.
131. Baden W., Baden F. Cervical incompetance: current therapy Amer. J. Obstet.
Gynecol., 1960, 79, 4, 545-549.
132. Bakketing L.S., Hoffman H.J. Pregnancy order and reproductive loss British Med.
J., 1980, 3,716.
133. Balkwill F.P. Interferons: from molecular biology to man Part I genetics and molecular
biology of the interferon system Microbiol. Sci., 1986, Jul. 3(7), 212.
134. Barnea E.R., Simon J. et al. Progress in characterization of preimplantation factor in
embryo cultures and in vivo Am. J. Reprod. Immunol., 42 (2), 1999, 995.
135. Baran S., Dianzani F. The interferons: a biological system with therapeutic potential in
viral infections Antiviral Res., 1994, Jul. 24(23), 97.
136. Baran S., Tyring S. etal. The interferons mechanism of action and clinical applications
JAMA, 1991,266, 1375.
137. Battram V.C. Milleran anomalies and their management Fertil. Steril., 1983,
40,2,159.
138. Baserga R., Porcu P.,Sell C. Oncogenes, growth factors and control of the cell cycle
Cancer Surv., 1993, 16, 201213.
139. Beer A.E., Billingham R.E., Yon S. Lymphocyte immune therapy in experimental
animals J. Exp. Med.,1972,135,808816.
140. Beer A.E., Kwak J. Reproductive medicine program Finch University of Health Science
Chicago Medical School, 1999, 132.
141. Beer A. E., Kwak J. Reproductive medicine program Finch University of Health Science
Chicago Medical School, 2000, 96.
142. Beer A.E., Kwak J. Peripheral blood lymphocytes in women with recurrent pregnancy
losses Clin. Immunal., 1996, 15, 3039.
143. BicsakT.A. .Tucker E.M. et al. Hormanal regulation of granulosa cell inhibin biosynthesis Endocrinology, 1986, 119, 2711.
144. Biezenski J. Antifibrinolytic activity in normal pregnancyJ. Clin. Pathol., 1960,13,220
223.
145. Bigazzi M.,Nardi E. Prolactin and relaxin: antagonism on the spontaneous motility of
the uterus J. Clin. Endocrin. Metab., 1981, 53, 665.
146. Benirschke . .: , ., , 1998, 354421. ' .
*

291

147. Bonati A., Zanelli P. et al. T-cell receptor B-chain gene rearrangement and expression
during human thymic ontogenesis Blood, 1992, 79,14791483.
148. Bonnar J. Can more be done in obstetric and gynecologic practice to reduce morbidity
and mortality associated with venous thromboembolism ? Am.J.Obstet. Gynecol.,
1999, 180,4,784-791.
149. Bonnar J., Morris L, Greene R. Inherited thrombophilia: the obstetric perspective
Semin. Hematal., 1998, Suppl 1, 24, 4953.
150. Botella-Zlusia J. Edocrinology of women Philadelphia: Saunders, 1973.
151. Boue J., Boue A., Lasar P. The epidemiology of human spontaneous abortions with
chromosomal anomalies In: Aqing gametes Basel, 1975, 330348.
152. Boue J., Boue A., Lasar P. Retrospective and prospective epidemiologic studies of
1500 Karyotyped spontaneous abortions Teratology, 1975,11, 1126.
153. Boue A., Boue J., Grapp A. Cytogenetics of pregnancy was tage advances in human
genetics New. York, Plenum Press, 1985, 3031.
154. Bradshaw K., Carr B. Placental sulfatase deficiency: maternal and fetal expression of
steroid. Sulfatase deficiency and X-linked ichthyosis Obstet. Gynecol. Survey., 1986,
41,401.
155. Branch D.W., Scott J. et al. Obstetrics complications associated with the lupus
anticoagylant N. Engl. J. Med., 1985, 313, 1322.
156. Branch D.W. Scott J. Clinical implications of antiphospholipid antibodies: the Utah
experience in Phospholipid -Binding Antibodies CRC Press Boca Raton, Fl., 1991,
335.
157. Brannian J., Stouffer R.L. Progesterone production by monkey luteal cell subpopulation
at different stages of menstrual cycle: changes in agonist responsiveness Biol.
Reprod., 1991,44, 141.
158. Braunstein G.P., Bloch S.K. et al. Characterization of anti-human chorionic
gonadotropin serum antibody appearing after ovulation induction J. of Clin. Endocr.
and Metab., 1983, 57, 6, 11641172.
159. Brook J., Feingold M. et al. Ultrasonography in the diagnosis of cervical incompetence
in pregnancy a new diagnostic approach Brit. J. Obstet. Gynecol., 1981, 88, 6,
640643.
160. Bulun S. Aromatase deficiebg and estrogen resis-tance: from molecular genetics to
clinic Sem. Reprod. Med., 2000, 18(1).
161. Casele H., Laifer S. et al. Pharmacokinetics of the low-molecular weigh heparin
enoxaparin sodium during pregnancy Am. J. Obstet. Gynecol., 1999, 121, 5.
162. Casan E.M., Raga F., Bonilla-Musoles F., Polan M. Human oviductal GhRH: Possible
implications in fertilization, early embryonic development and implantation J. Clin.
Endocrin. and Metab., 2000, 85,4, 13771382.
T63. Casey L., MacDonald P. Endocrine changes of pregnancy Williams textbook of
Endocinology 9th ed, W.B. Sauders Company, 1998.
164. Cauci M.N.,Coulman C.B. et al. Predictive factors in recurrent spontaneous aborters a
multicenter study Am. J. Reprod. Immunol., 1995, 33, 167170.
165. Cauci S. et al. Specific immune response against gardnerella vaginalis hemolysin in
patieuts with bacterial vaginosis Am. J. Obstet. Gynecol., 1996, 175, 16011605.
166. CDC (Centers Disease Contr.) Preventing lead reasoning in young children
Statement dy the centers for disease control/ Atlanta, GA, October, 1991.
167. Chabab A., Hedon B.,Arnal F. et al. Follicular steroids in regulation to oocyte
development and human ovarian stimulation protocols Hum. Reprod., 1986, 1,449.
168. Chom G. The prepubertal and pubertal growth of the adrenal (adrenarehe) Beitr.
Pathol., 1973, 150,352.
292

169. Christiansen .., Mathiesen . et al. Idiopatic recurrent spontaneous abortion:


evidence of a familial predisposition ActaObst. Gynec., 1990, 69, 597.
170. Christiansen . . A fresh look at the causes and treatments of recurrent miscarriage,
especially its immunological aspects Hum. Reprod. Update, 1996, 2, 4, 271.
171. Clark D. Critically examining the immunologic causes of recurrent miscarriage
Medscape women's Health, 1999, 4 (3).
172. Clark D.A., Daya S. Is there hope for Ivlg? Amer. J. Reprod. Immunol., 1998, 39,
65-68.
173. Clark A.L, Branch D.W. et al. Pregnancy complicated by the antiphospholipid
syndrome: outcomes with intravenous immunoglobulin therapy Obstet. Gynecol.,
1999,93,437-41.
174. Clarkson T.W. The pharmacology of mercury compounds Ann. Rev. Pharmacol.,
1972, 12,348.
175. Class F. et al NE 1: a new neutrophil specific antigen Tissue Antigens, 1979, 13,
129-134.
176. Coceani F., Olley P., LockJ. Prostaglandins, ductusarteriosis, pulmonary circulation:
current concepts and clinical potential Eur. J. Clin. Pharmacol., 1980; 18, 75.
177. Constant S.L., Bottomly K. Induction of Th-1 and Th-2 CD4+ cell responses: the
alternative approaches Ann. Rev. Immunol., 1997, 15, 297322.
178. Cooke I.D., Lim K. An overview of uterine receptivity XV1 FIGO World Congress of
Obstet. Gynec., 2000.
179. Cooper R., Goldenberg R., et al The preterm prediction study: Maternal stress is
associated with spontaneous preterm birth at less than thirty-five weeks gestation, Amer.
J. Obst. Gynec., 1996, 175, 1286-1296.
180. Coulam C.B., Stephenson M., et al. Immunotherapy for recurrent pregnancy loss:
Analysis of results from clinical trials, Amer. J. Reprod. Immunol., 1996, 35, 352359.
181. Creasy M.R., Crolla J., Alberman E. A cytogenetic study of human spontaneous
abortions using banding techniques Hum. Genet., 1976, 31, 177.
182. Creasy R.K., Resnick R. Maternal-Fetal Medicine: Principles and Practice. 3rd ed.
Philadelphia, WB Saunders, 1994/
183. Daheman T.C. Osteoporotic fractures and the recurrence of thromboembolism during
pregnancy and the puerperium in 184 women undergoing thromboprophylaxis with
heparin Am. J. Obstet. Gynecol., 1999, 168, 12651270.
184. Davis O.K., Berkley A.S. et al. The incidence of luteal phase defect in normal, fertile
women, determined by serial endometrial biopsy Fertil. Steril., 1989, 51, 582.
185. Deshmukh U.S., Talwar G.P., Gupta S.K. Antibody response against three epitopic
domains of human chorionic gonadotropin in women and rodents immunized with bhgc-based immunoconraceptive vaccine J. Clin. Immunol., 1994,14, 3, 162168.
186. De Souza M.M. et al. MUC 1/episialin: a critical barrier in the female reproductive
tract J. Reprod. Immunol., 1999, 45(2), 127158.
187. Diznhofer S., Wick G., Berger P. The suitability of human chorionic gonadotropin (hgc)
based birth -central Immunol. Today, 1994, 15, 10, 469474.
188. Doss B.J., Green M.F., Hill J.A. et al. Massive chronic intervillositis associated with
recurrent abortions Hum. Pathol., 1995, 14,431434.
189. Douketis J., Ginsferg J. et al. The effects on long-term heparin therapy during
pregnancy on bone density Throm. Haemost., 1996, 75, 254257.
190. DudlyD., CollmerD. etal. Inflammatory cytokinemRNA in human gestational tissues:
implication for term and preterm labor J. Soc. Gynecol. Invest., 1996, 3, 328335.
191. English B.K.,Burchett S.K. etal. Production of lymphotoxin and tumor necrosis factor
by human neonatal mononuclear cells Pediatr. Res., 1988, 24, 717.
hr

293

192.
193.

194.
195.
196.

197.
198.
199.

200.
201.

202.

203.
204.
205.
206.
207.
208.
209.
210.
211.
212.
213.

294

Erickson G.F. An analysis of follicle development and ovum maturation Seminars


Reprod. Endocrinol., 1986, 4, 233.
Eroglu G.E., Scopeliltis E. Antinuclear and antiphospholipid antibodies in healthy
women with recurrent spontaneous abortion Amer. J. Reprod. Immunol., 1994, 31,
1-6.
Fanchin R., Frydman R., et al. Human Chorionic gonadotropin: Does it affect human
Endometrial morphology in vivo? Sem Reproductive med., 2001, 19(1), 3135.
Faught W., Garner P., et al. Changes in protein and protein S levels in normal
pregnancy Amer. J. Obstet. Gynec., 1995, 72, 14750.
FeherT., Szalay K.S., etal. Effect of ACTH and prolactin on dehydroepiandrosterone,
its sulfat ester and cortisol production by normal and tumorouse human adrenocortical
cells J. Steroid. Biochem., 1985,23, 153157.
Ferrier K. Cytogenetics of aborters and abortuses Amer. J. Obstet. Gynec., 1978,
131, 1,33-38
Fielding J.K. MR imaging of mullerian anomalies: Impact on therapy Amer. J.
Roentghenol., 1996, 167, 1491-1495.
FillicoriM., Butler J.P., CrowleyW.F. Neuroendocrine regulation of the corpus luteum
in the human: evidence for pulsative progesterone secretion J. Clin. Invest., 1984,73,
1638.
Fitzsimmons J., Stahl R., et al Spontaneous abortion and endometriosis Fertil. Steril.,
1987,47,696-698.
Flynn L, Byrne ., Carton J., Kelehon P., etal. Menstrual cycle dependent fluctuations
in NK and T-lymphocyte subsets from nonpregnant human endometrium Am. J. Reprod
Immunol., 2000, 43 (4), 209217.
Fradsen V.A., Stakeman G. The site of production of oestrogenic hormones in human
pregnancy: hormon excretion in pregnancy with anencephalic fetus Acta Endocrinol.,
1961,38,389-391.
Frankenne F., Closset J., etal. The physiology of growth hormones (GHs) in pregnant
women and partial characterization of the placental GH variant J. Clin. Endocrin. Metab.
-1988,66,1171.
Fraser E.J., Grimes D.A., et al. Immunization as therapy for recurrent spontaneous
abortion: A review and metaanalysis Obst. Gynec., 1993, 82, 854859.
French F., Bierman J. Probability of fetal mortality Public Health Rep., 1972,77, 835.
Fujiede K., Faiman C., et al. The control of steroidogenesis by human fetal adrenal
cells in tissue culture: IV. The effects of various hormonal peptides. J. Clin. Endocrin.
Metab., 1982, 54, 89.
Gabbe Obstetrics. Normal and Problem pregnancies. 3rd ed. Churchill Livingstone,
1996.
Galli M., Comfurius P., etal. Anticardiolipin antibodies directed not to cardiolipin, but
to a plasma protein cofactor Lancet, 1990, 2, 335, 15441547.
Gardner R., Sutherland G. Chromosome abnormalities and genetic counseling, 2nd
Edition New York Oxford University Press, 1996.
GevaE., Amit A. etalAutoimmunity and reproduction Fertil. Steril., 1997, 67,599
611.
GharaviA.E. Origin of aPL: induction of aPL by viral peptides Lupus, 1998,7suppl.
2, 552-554.
Ginsberg U.S., Kawalchuk G., et al. Heparin therapy during pregnancy: risk to fetus
and mother Arch. Intern. Med. 1989, 149, 22332236.
Givens J., Wilroy R., et al Features of Turner's syndrome in women with polycystic
ovarii Obstet. Gynec., 1975, 110, 959.

214. GlickmanS., RosenfieldR.,etal Multipleandrogenicabnormalities, including elevated


free testosterone, in hypoprolactinemic women J. Clin. Endocrin. Metab., 1982, 55,
251.
215. Golard R., Jozak S., et al Elevated levels of umbilical cord anticorticotropin releasing
hormone in growth retarded fetuses J.CIin. Endocrin. Metab., 1993,77,11741179.
216. Golbus M.J. Chromosome aberrations and mmalian reproduction In Mastroianni
L, Biggers J., Sadler W. editors Fertilization and embryonic development in vitro, NewYork, 1981, Plenum Press
217. Gordon G.G., Southren A., etal. Effect of hyperthyroidism and hypothyroidism on the
metabolism of testosterone and androstendion in man J. Clin. Endocrin. Metab., 1969,
29, 164.
218. Gore B.C. etal. Estrogen-induced human luteolysis J. Clin. Endocrin. Metab., 1973,
36,615.
219. Gougeon A. Dynamics of follicular growth in the human: a model from preliminary
results Hum. Reprod., 1986, 1,81.
220. Grammatopoulos D., Milton N., Hillhouse E. The human myometrial CRH receptor: G
protein and second messengers Mol. Cell. Endocrin., 1994, 99, 245250.
221. Grammatopoulos D.,Thompson S., et al The human myometrium expresses multiple
isoforms of the corticotropin-releasing hormone receptor J. Clin. Endocrin. Metab.,
1995,80,2388-2393.
222. Green L.K., Harris R. Uterine anomalies: Frequency of diagnosis and obstetric
complications Obstet. Gunec., 1976, 47, 1500.
223. Gryglewski R.Y., Korbut R., et al. Lungs as a generator of prostacyclin hypothesis
on physiological significance Arch. Pharmacol., 1979, 45, 304.
224. Gurpide E., Marks C., de Ziegler P., Berk P.O., et al. Asymmetric release of estrone
and estradiol derived from labeled precursors in perfused human placentas Am. J.
Obstet. Gynecol., 1982, 144(5), 551555.
225. Gustafson A.B., Banasiak R., et al. Correlation of hyperprolactinemia with altered
plasma insulin and glucagon J. Clin. Endocrinol. Metab., 1980, 51, 242.
226. Hager H., Aboagye-Mathieseng, Peterson P.M. Human trophoblast interferone
enhance major histocompatibility complex class 1 antigen expression on human term
trophoblast cells in culture Placenta, 1994, 15, 7, 709
227. Halmesmaki E., Valimark M., et al. Maternal and paternal alcohol consumption and
miscarriage Br. J. Obst. Gynaecol., 1989, 96, 188191.
228. HalpinD.M.G., JonesA., FinkG., CharltonH.M. Postnatal ovarian follicle development
in hypogonadal and normal mice and associated changes in the hepothalamic-pituitary
axis J. Reprod. Fertil., 1986, 77, 287.
229. Hansen J.P. Older maternal age and pregnancy outcome: A review of the literature
Obst. Gynec. Surv., 1986, 41, 726-742.
230. Hara N., Fujii et al Altered expression of human leukocyte antigen G (HLA-G) on
extravillous trophoblast in preeclampsia: immunohistological demonstration with anti
HLA-G specific antibody CAMS.2 and anticytokeratin Amer. J. Reprod. Immunol.,
1996,36,6,349-358.
231. Harlop S., Shiono P.H. Alcohol, smoking and incidence of spontaneous abortions in
the first and second trimester Lancet, 1980, 2, 173178.
232. Haynes B.F., Heinly C.S. Early human T-cell development: Analysis of the human
thymus at the time of initial entry of haematopoietic stem cells into the fetal thymic
microenvironment J. Exp. Med., 1995, 181, 1445.
233. Hedner V., Astedt B. Fibrinolytic split products in serum and urine in pregnancy
Acta Obstet. Gynecol. Scand., 1970, 49, 363366.
295

234. Hershlag A., Peterson C. Endocrine disorders Novak's Gynecology, 12th Ed., Williams
andWilkins, 1996.
235. Higgins J.R., Walshe J.J., etal Can 24-hour ambulatory blood pressure measurement
predict the development of hypertension in primigravidae? Br. J. Obst. Genaec., 1997,
104,356.
236. Hild-Petito S.,West N., Brenner R., Stouffer R. Localization of androgen receptor in
the follicle and corpus luteum of the primate ovary during the menstrual cycle. Biol.
Reprod., 1991,44,561.
237. Hill J.A. Recurrent pregnancy loss in. Kistner's Gynecology womens Health. 7th ed.
Mosby, 1999.
238. Hill J.A., Polgar K. T-helper 1 -type immunity to trophoblast in women with recurrent
spontaneous abortion JAMA, 1995, 28, 24, 1933.
239. Hill J., Andersen D. Blood transfusions for recurrent abortion. Is the treatment worse
than the disease? Fertil. Steril., 1986, 46, 152153.
240. Horst E., Meijer C.J., et al The ontogeny of human lymphocyte recirculation high
endothelial cell antigen (HECA-452) and CD 44 homing receptor expression in the
development of the immune system Eur. J. Immunolog., 1990, 20, 14831489.
241. Howlette S., Holmes N., et al Evaluation of trophoblast HLA-G antigen with a specific
monoclonal antibody Tissue Antigens, 1997, 50, 135.
242. Hsueh A., Jones E., Adashi C., Wang L, et al Intraovarian mechanisms in the hormonal
control of granulosa cell differentiation in rats J. Reprod. Fertil., 1998, 69, 325
243. Hunt J.E. Krilis S. Antiphospholipid antibodies beta2-glicoprotein 1 and thrombosis
Lupus, 1993, 2, 5, 285287.
244. Hunter M., Sterrett J. Polycystic ovary Syndrome: It's not just infertility Am. Family
Physician, 2000, 52, 5.
245. Imanishi J. Interferon-alfa, beta, gamma Gan. To. Kagaku Ryone, 1994, 21,16,2853.
246. Incerpi M.N., BankE., etal. Significance of antinuclear antibody testing in unexplained
second and third trimester fetal deaths J. Matern. Fetal. Med., 1998, 7, 2, 61.
247. Ingram S.B., Goodnight S., Bennet R. An unusual syndrome of devasting noninflammatory vasculopathhy associated with anticardiolipin antibodies: report of two
cases Arth. Rheum., 1987,30, 1167-1171.
248. Jacobs P.A. Chromosome mutations: frequency at birth in human Humangenetik,
1972, 16,37.
249. Jacobson J.L., Jacobson S.W., Sokol R. Effects of alcohol use, smoking and illicit
drug use on fetal growth in black infants J. Pediat., 1994, 8, 105118.
250. Jacobson S.L., Imhof R., et al The value of Doppler assessment of the utero-placental
circulation in predicting preeclampsia or intrauterine growth retardation Amer. J.
Obstet. Gynec., 1990, 162,110114
251. Jaffe R., Jauniaux E., Hustin J. Maternal circulation in the first trimester human
placenta myth or reality? Amer. J. Obstet. Gynec., 1997, 176,695705
252. Jameson J.L., Hollenberg A.N. Regulation of chorionic gonadotropin gene expression
Endocrin. Rev., 1993, 14,203
253. Jones C.A., Finlay-Jones J., etal Type 1 and type 2 cytokines in human late-gestation
decidual tissue Biol. Reprod., 1997; v. 57, N 2, p. 303
254. Jordan J., Craig K., et al Luteal phase defect: the sensitivity and spesificity of diagnostic
methods in common clinical use Fertil. Steril., 1994, 62, 54.
255. Kaplan S.L., Grumbach M. The ontogenesis of human foetal hormone II Luteinizing
hormone (LH) and follicule stimulating hormone (FSH), Acta Endocrinol 1976,81,808.
256. Kaplan S.L. The Endocrine milien of pregnancy, puerperium and childhood. Report of the
third Ross Comference on Obstet. Research In Jaffe R.B.(ed) Columbus, 1974,77.
296

257. Karamardian L.M., Grimes D.A. Luteal phase deficiency effect of treatmente on
pregnancy rate Am. J. Obstet. Gynecol., 1992, 167, 1391.
258. Katz I., Fisch B. et al. Cutaneous graft-versus-host live reactions after paternal
lymphocyte immunization for prevention of recurrent abortion Fert. Steril. 1992, 57,
927-929.
259. Kelts M.D., Olive D.L. et al. Sonohysterography for screening in recurrent pregnancy
loss. Fertil. Steril., 1997, 67,670-674.
260. Khan G., Heggen D. Recurrent miscarriage-an updated Appraisal The Female
paftient Aug., 1998.
261. Kibrich S-, Benirsche K. Severe generalized disease occurring in the newborn period
and due to infection with coxsckie virus group B. Evidens of intrauterine infection with
this agent Pediatrics, 1958, 22, 57875.
262. Kierszenbaum A.L Decidualization and implantation: embryo-uterine bioinformatics
at work - Med. Reprod. Devel., 2001, 59 (2), 159-167.
263. Kim C.H., ChaeH.D. etal. Influence of anti-thyraid antibodies in euthyroid women on
in vitro fertilization-embryotransfer outcome. Am. J. Reprod. Immunol., 1998, 40, 1,
2-8.
264. Kimber S. Molecular in interaction at the maternal-embryonic interface during the
early phase of implantation Semin. Reprod. Med.,2000, 18(3), 237253.
265. Kira E.F. et al. Bacterial vaginosis and genital chlamydiosis. Diagnosis and treatment J.
Obstet. Gynecol., 1994, 4, Supl2, 557.
266. Klebanoff M. A., Shiono P. H. et al. Spantaneous and induced abortion among resident
physicians JAMA, 1991, 265, 2821.
267. Klock S.C., Chang G. et al. Psychological distress among women with recurrent
spontaneouse abortion Psychosomat., 1997, 38, 503507.
268. Kolodie L Disseminated intravascular coagulation. Etiology, physiopathology,
diagnosis, principles for treatment Rev.Prat., 1989,1139 (26), 2375.
269. Kong T.Y., Liddell., Robertson W.B. Defective haemochorial placentation as a cause
of miscarriage: A preliminary, study Br. J. Obstet. Gynecol., 1987, 94, 649655.
270. Krussel J., Behr B. et al. Expression of vascular endothelial growth factor mRNA in
human preimplantation embzyos derived from tripronuclear zygotes Fertil. Steril.,
2000,74(6), 12201226.
271. Krzysiek J., Turowski G. Immunology of early pregnancy. Immunologically competent
cells in the endometrium and decidua Ginekol. Pol., 1996, 67, 9, 467.
272. Kusuda M. Infertility and metroplasty Acta Obstet. Gynecol. Scand., 1982,61, 5,407.
273. Kutteh W. et al. A clinical trial for the treatment of antiphospholipid antibody-associated
recurrent pregnancy loss with lower dose heparin and aspirin Medical. Com. Fames
pregnancy, journal automation, 962302009001 html.
274. Lachapelle M.H., Miron P. etal. Endometrial T,B, and NKcells in patients with recurrent
spontaneous abortions. Altered profile and pregnancy outcome J. Immunol., 1996,
156, 10,40274034.
275. Lalezari P. et al. NB1, a new neutrophil specific antigen involved in the pathogenesis
of neonatal neutropenia J. Clin. Invest,1971, 50, 1108.
276. Lalezari P., Nussbaum M. etal. Neonatal neutropenia due to maternal isoimmunization
Blood, 1960, 15,236-243.
277. Lampe L., Gaal J., Lampe L. et al. Our experience with programed deliveries Orv.
Hetil., 1975, 116(3), 128-132.
278. Lamont R.E. Is it possible to predict and prevent preterm labour by eradicating
abnormal genital tract colonization in early pregnancy J. Obstet. Gynecol., 1994, 14,
2, 50-52.
297

279. Lash A.F., Lash S.R. Habitual abortion the incompetent internal os of the cervix
Amer. J.Obstet. Gynecol. 1950, 59, 1, 6876.
280. LefkowitzJ.., Clarke S., Barbour L. Comparison of protein Sfunctional and antigenic
assays in normal pregnancy Am. J. Jbstet. Gynecol., 1996, 175, 657660.
281. Lee R., Branch D., Silver R. Immunoglobulin A anti-beta2-glycoprotein antibodies in
women who experience unexplained recurrent spontaneous abortion and fetal death
Am. J. Obstet. Gynecol. 2001, 185, 3.
282. Lemire R.J. Embriology of the central nervous system In Davis JA.Dobbiny (eds),
Philadelphia, 1974,547.
283. LevineD., Madyastha P. etal. Neonatal isoimmuneneutropenia Pediatr. Res., 1982,
16, 296A.
284. Levine D., Madyastha P. Isoimmune neonatal neutropenia Am. J. Perinatal, 1986,
3,231-233.
285. Levran D., MashiachS. J.A. etal. Zygote intrafallopian transfer may improve pregnancy rate in patients with repeated failure of implantation Fertil. Steril.,1998, 69,
2630.
286. Li Y., Matsuzaki N. et al. Trophoblast derived tumor necrosis factor induces release
of human chorionic gonadotropin usung interleikin-6 (il-6) and il-6 receptor dependent
system in normal human trophoblasts J. Clin. Endocrin. Metab., 1992, 74, 184.
287. Li T.C., Dockery P. et al. Haw precise is histologic dating of endometrium using the
standard dating criteria Fertil.Steril., 1989, 51, 759.
288. Liggins G.C. Premature delivery of fetal lambs infused with glucocorticoids
J.Endocrinol., 1969, 45, 515523.
289. Liggins G.C. Adrenocorticol-related maturational events in the fetus Am. J. Obstet.
Gynecol., 1976, 126,931.
290. LokeY.W., King A. Immunological aspects of human implantation J. Reprod. Fertil.
Supplement, 2000, 55, 8390.
291. LubbeW.F., ButlerW.S. etal. Fetal survival after prednisolone suppression of maternal
lupus anticoagulant Lancet.,1983, 1, 13611363.
292. Lubbe W.F., Butler W.S. et al. Lupus anticoagulante in pregnancy Br.J.Obstet.
Gynecol. 1984, 91, 357363.
293. Ludmire J., Samuels P. etal. Pregnancy outcome of patients with uncorrected uterine
anomalies managed in a high-risk obstetric setting Obstet. Gynecol., 1990, 75, 906.
294. Madden J.D., Gant N.F. etal. Study of the kinetics of conversion of maternal plasma
dehydroisoandrosterone sulfate to 16a-hydroxydehydroisoandrosterone sulfate,
estradiol and estriol Am. J. Obstet. Gynecol., 1978, 132, 392.
295. MacDonald P.C., Porter J.C. et al. Initiation of parturition in human female Semin.
Perinatal., 1978, 2, 273-286.
296. Mac Naughton J., Banah M., Me Cloud P. et al. Age related changes in follicle
stimulating hormone, luteinizing hormone, oestradiol and immunoreactive inhibin in
women of reproductive age Clin. Endocrin., 1992, 36, 339.
297. Magoffin D.A., Erickson G.F. Prolactin inhibition of luteinizing hormone-stimulated
androgen synthesis in ovarian interstitial cells cultured in defined medium: Mechanism
of action Endocrmol., 1982, 111, 2001.
298. Magoffin D.A. Regulation of differentiated functionis in ovarian theca cells Seminar
Reprod. Endocrin., 1991, 9, 321.
299. Malinowski A., Szpakowski M. et al. Occurrence of antinuclear antibodies in women
with endometriosis and unexplained infertility Gynecol.Pol., 1995, 66, 7, 420424.
300. Maruhashi ., Takakuwa K. et al. Characterization and detection of blocking antibodies
in early pregnant sera Am. J. Reprod.Immunol.Microbiol., 1984, 5, 99.

298

301. Marz C.M., Vigano A. et al. Characterization of type 1 and type-2 cytokine production
profile in physiologic and pathologic human pregnancy Clin. Exp.lmmunol., 1996,106,
1,127.
302. Masotti G., Poggesi L, Galanti G. et al. Differential inhibition of prostacyclin production
and platerlet aggregation by aspirin Lancet., 1979, 2, 1213.
303. Matsuura E., Igarachi Y. et al. Anticardiolipin cofactor(s) and diferential diagnosis of
autoimmune disease Lancet, 1990, 336,8708, 177178.
304. McDonald I.A. Suture of the cervix for inevitable miscarriage J. Obstet. Gynecol.
Br.Empire., 1957, 64, 346-350.
305. Mcjntosh J.D. Smoking and pregnancy: attributable risks and public health implications Can. J. Public. Health, 1984, 75, 141148.
306. McNeil H.P., Simpson R.J. et al. Anti-phospholipid antibodies are directed against a
complex antigen that includes a lipid binding inhibitor of coagulation, b-2-glycoprotein
I P.N.A.S., 1990,87,4120.
307. Merskey C., Kleiner G. etal. Fibrin degradation products Br.Med. J., 1969,4,234
235.
308. Mesino S.,Mellon S., Jaffe R. Mitogenic action, regulation and localization of insulin
like growth factors in human fetal adrenal gland J. Clin.Endocrin. Metab., 1993,76,968.
309. Metzger D.A., Olive D.L. etal. Association of endometriosis and spontaneous abortion:
effect of control graup selection Fertil. Steril., 1986, 45, 1822.
310. Miller R.W. Effects of ionizing radiation from the atomic bomb on Japanese children
Pediatrics, 1968,41,257.
311. Miles R.A., Paulson R.J.- Pharmackinetics and endometrial tissue levels of progesterone
after administration by intramuscular and vaginal routes: a comparative study
Fortal.Steril.,1994, 62, 485-490.
312. Mitchell ., Challis J. et al. Progesteron synthesis by human amnion, chorion and
decidua at termAm.J.Obstet.Gynecol.,1987,157,349.
313. Molloy A.M., Daly S. et al. Thermolabile variant of 5,10-methylentetra-hydrofolate
reductase associated with low red cell folates: implications for folate intake recommendationLancet, 1997,72, 147150.
314. Moncade S., Vane J.R. Arachidonic acid metabolites and the interactions between
platelets and blood vessels walls New.Engl.J.Med., 1979, 300, 1142.
315. Monreal M., Lafoz E. et al. Comparison of subcutaneous unfractionated heparin with
a low molecular weight heparin (Fragmin) in patients with venous thromboembolism and
contraindications to coumarin Thromb. Haemost, 1994,71, 711.
316. Mowbray J., Liddel H. et al. Controlled trial of treatment of recurrent spontaneous
abortion by immunization with paternal cells Lancet., 1985, 1, 941943.
317. Mowbray J.F. A controlled trial of immunotherapy with paternal cells in recurrent
spontaneous abortion. Inmmunoregulation and fetal survival, Gill and Wegman T.G.
Eds Oxford Univ. Press. New-York, 1987, 300.
318. Murphy B.E., Patrick J. et al. Cortisol in amniotic fluid during human gestation J.
Clin. Endocrin. Metab., 1975, 41, 626.
319. Nankervis G.A., Kumar M.L., Cold E. et al. Prospective study of maternal
cytomegalovirus intection and its effect on the fetus Am. J. Obstet. Gynecol., 1984,
15, 149 (4), 435-440.
320. Naples J.D., Sadigh H. Spontaneous abortion rate in patients with endometriosis
Obstet.Gynecol., 1981, 57, 509512.
321. Naz R.K. Immunology of reproduction CRS Press Boce Raton, 1992.
322. Nelen W.L, Steegers E. et al. Genetic risk factor for unexplained recurrent early
pregnancy loss Lancet, 1997, 350, 861.
,v-

299

323.
324.
325.
326.
327.
328.
329.
330.

331.
332.
333.
334.

335.
336.
337.

338.
339.

340.
341.
342.
343.
344.

300

Neville A.M. The adrenal medulla. In Symington, (ed) Functional pathology of the
human adrenal gland E. and S. Livingstone L.T.D. London, 1969, 219.
New M., Lorenzen A. et al. Genotyping steroid 21 -hydroxylase deficiency: hormonal
reference data J. Clin. Endocrin. Metab., 1983, 57, 320.
Nikas G. Endometrial receptivity: changes in cell-surface morphology
Sem.Reproductive Med., 2000, 18(3), 229235.
Norwitz E., Wilson T. Secretory component. A potential regulator of endometrial-decidual
proctaglandin production in early human pregnancyAm. J. Obstet. Gynecol., 2000,183,1.
Noyes R.W., Hertig A.T.R., Rock J. Dating the endometrial biopsy Fertil. Steril.,
1950.-1,3.
Ober C.L., Martin A.O. et al. Shared HLA antigens and reproductive performance
among Hutterites Am.J.Hum.Genet., 1983,35,994.
Ogasawara M., Aoki K. et al. Prevalence of autoantibodies in patients with recurrent
miscarriage Am.J.Reprod.lmmunol., 1999,41, 1,8690.
Osathanondh R., Chopra J. etal. Thyraid function at birth in infants maternal thyroxine,
triiodthyronine, reverse triiodthyronine and thyrothropin levels J. Clin. Endocrin.
Metab., 1978,47, 1236.
Olson D.M., Zakart T. Intrauterine tissue prostaglandin synthesis : regulatory
mechanisms Seminars Reprod. Endocrin., 1993, 11, 234.
Osborn B.H., Fowekes J. et al. Nutritional regulation of insulin-like growth factorbinding protein gene expression in the ovine fetus and pregnant ewe Endocrinology,
1992,131, 1743.
Owerbach D., Rutter W. et al. The prolactin gene is located on chromosome 6 in
humans Science, 1981, 212, 815.
Pala A., Goghi Z., Spampinato G. Immunochemical and biological characteristics of a
human antoantibody to human chorionic gonadotropin and luteinizing hormone J.
Clin.Endocrin and Metab., 1988,67,6, 13171321.
Parker L.N.,OdellW.D. Central adrenal androgen secretion Endocr.Rew., 1980,1,
392-410.
Parron ., Hernandez A. et al. Clinical and biochemical changes in green house
sprayers chronically exposed to pesticides Hum. Exp. Toxicol., 1996, 15, 957963.
Pattison N.S., Lubbe W.F. Treatment of antiphosphilid antibody mediated fetal loss:
the case for corticosteroid therapy in phospholipid binding antibodies Harrie et al.
ads. CRC Press, Boca Faton, FL.,1991.
Paton G.R. et al. Comparison of cell cycle time in normal and trisomic cells Human
genetic, 1974, 23, 173.
PeKonen F., Farrell E. et al. lusulin-like growth factor binding proteins in maternal
serum throughout gestation and in the puerperium: effects of a pregnancy associated
serum protease activity J. Clin. Endocrinol. Metab., 1990, 71, 806.
Peters H., Byskov A.G., Himelstein-Graw R. et al. Follicular growth: the basic event in
the mouse and human ovari J. Repro. Fertil.,1975, 45, 559.
Petraglia F., Vaugham J. et al. Inhibin and activin modulate the release of gonadotropinreleasing hormone, human chorionic gonadotropin and progesterone from cultured
placenta! cells Proc. Nate. Acad. Sci. USA., 1989, 86, 5114.
Piceini M.P., Romagnani S. Regulation of fetal allograft survival by a hormonecontrolled Th1 and Th2 type cytokines Immunol. Res., 1996, 15,2, 141.
Pittway D.E. etal. Spontaneous abortions in women with endometriosis Fertil. Steril.,
1988,50,56,711.
. ., ., ,
, 1999.
^

345. PowerD.A., CattoG. etal. Thefertusasanallograft: evidence for protective antibodies


to HLA-linked paternal antigens Lancet, 1983, 2, 701.
346. Press M.F., Greene G.L. Localization of progesterone receptor with monoclonal
antibodies to the human progestin receptor Endocrinology, 1988, 122, 1165.
347. Quellet-Hellstrome R., Stewart W. Miscarriages among female physicol therapists
who report using radio- and microwave-frequency electromagnetic radiation Am.J.
Epidemiol., 1993, 138, 775-786.
348. Raeetal. Kistners Gynecology Women's Health 1999, 7th, Mosby.
349. Raga F., Cason E., Kruessel J. et al. The role of gonadotropin-releasing hormone in
murine preimplantation embryonic development Endocrinology, 1999,140,3705
3712.
350. Raj R., Clifford K., Regan L The modern preventive treatment of recurrent miscarriage
Brit. J. Obstet. Gynecol., 1996, 103, 2, 106-110.
351. Rand J. et al. Reduction of annexin-V (placental anticoagulant protein-1) on placental
villi, of women with antiphospholipid antibodies and recurrent spontaneous abortion
Am. J. Obstet. Gynecol., 1994, 171, 15661572.
352. ReindollarR. Contemporary issues for spontaneous abortion Obst. Gynecol. Clinic,
2000, 27, 3.
353. Ren S.G., Braunstein G.D. Human chorionic gonadotropin Seminar Reprod.
Endocrinol., 1992, 10, 95.
354. Resnik R., Killam F. et al. The sfimulation of uterine blood flow by various estrogens
Endocrinology, 1974, 94, 1192.
355. Restrepo M., Munoz N. et al. Prevalence of adverse reproductive outcomes in a
population occupationally exposed to pesticides in Colombia Scand J. Work Environ.
Health., 1990, 16, 232238.
356. Rhodes D., Trowsdale J. Genetics and molecular genetics of the MHC Combridge
CB2, 1 Q.P.U.K., 1998.
357. Ridker P.M., Miletich J.P. et al. Ethnic distribution of factor V leiden in 4047men and
women: implications for venous thromboembolism screening JAMA, 1997, 277.1305
1307.
358. Rigg L.,Yen S.- The pattern of increase in circulating prolactin levels during human
gestation Am. J. Obstet. Gynecol., 1977, 129, 454.
359. Rios E., Heresi G., Arevalo M. Familial alloimmune neutropenia of NA2 specificity
Am. J. Pediatr. Hematol. Oncol., 1991, 13, 296299.
360. Roberts J., Jenkins C. et al. Recurrent miscarriage is associated with increased numbers
of CD5/20 positive lymphocytes and an icreased incidence of thyroid antibodies Eur. J.
Endocrinol.,1996, 134(1), 8486.
361. RocklinR.E., Kitzmiller J. etal. Maternal fetal relation. Absence of an immunologic
blocking factor from the serum of women with chronic abortion N. Engl. J. Med., 1976,
295,1209.
362. Rodger L., Bick M.H. et al. Recurrent miscarriage: causes, evaluation and treatment
Medscape Women's Health, 1998, 3(3).
363. Rodwell R., Gray P. et al. Granulocyte colony stimulating factor treatment for alloimmun
neonatal neutropenia Arch. Dis. Chied, 1996,75, 5758.
364. Rodwell R., Shin R. et al. Intavenous gamma-globulin in treatment of isoimmune
neonatal neutropeina J. Pediatr., 1995, 127, 508509.
365. RosenfeldR.L, Barnes R. etal. DysregulationofcytochromeP450-17aasacauseof
polycystic ovarian syndrom Fertil. Steril., 1990, 53, 785791.
366. Rothchild J. Role of progesterone in initiating and maintaining pregnancy. In
Progesterone and Progestins Raven Press, New-York, 1983, 219229.

301

367. SammaritanoLR. Antiphospholipid antibodies and fetal loss Clin. Lab. Med., 1992,
12, 1,41-59.
368. Sanson B.J., Lensing A.M. et al. Safety of low-molecular weight heparin in
pregnancy: a systemic review Thromb. Haemost., 1999, 81,668672.
369. Scott J.R., Rote N., Branch D. Immunologic aspects of recurrent abortion and fetal
death Odstet. Gynec., 1987, 70, 645.
370. ScottR.T., SynderR.R. etal. The effect of interobserver variation in dating endometrial
history on the diagnosis of luteal phase defects Fertil. Steril., 1988, 50, 888.
371. Seibel M.M. Toward uderstanding the pathophysiology and treatment of polycystic
ovary desease Semin.-Reprod. Endocrin., 1984, 2, 297.
372. Shehata H., Nelson-Piercy C., Khamashta M. Management of pregnancy in
antiphospholipid syndrom Rheumatic Disease Clinics of North America, 2001, 27, 3.
373. SheltonA.J., HarherJ.M. etal. Association between familial autoimmune disease and
recurrent spontaneous abortions Am. J. Reprod. Immunol., 1994, 32, 8287.
374. Shi Q.J. et al. Novel role of human chorinic gonadotropine in differentiation of human
cytotrophoblastas Endocrinology, 1993, 132, 1387.
375. Shingu M. Laboratory diagnosis of viral myocarditis IphCirl. J., 1989,53, 1,8793.
376. Shiokawa S., Sakai K. et al. Function of the small guanosine triphospate binding
protein RhoA in the process of implantation Jorn. Clinical Endocrin and Metabolism,
2000,85, 12,4742.
377. Shirodkar V.N. Habitual abortion in the second trimester In. Contributions to
Obstetrics and Gynecology Shirodkar V. N. (ed), Edinburgh, Livingstone.
378. Siiter P.K., Febres F. et al. Progesterone and maintenance of pregnancy: Is
progesterone nature's immunosuppressant Am. NYAcad. Sci., 1977, 286, 384.
379. Silman R.E., ChardT. etal. Human pituitary peptidesand parturition Nature, 1976,
260,716.
380. Simon C., Marinex L. et al. Mullerian defects in women with normal reproductive
outcome Fertil. Steril., 1991,56, 1192.
381. Spatling L., Spatling C. Magnesium supplementation in pregnancy. A double-blind
study Br. J. Obstet. Gynecol., 1988,95, 120125.
382. SpectorW.C. Hand book of biological data. Philadephia W.B. Saunders, 1956,353.
383. Speiser P.W., Dupont B. et al. High frequency of non classical steroid 21 -hydroxylase
deficiency Am.J. Hum. Genet., 1985, 37, 650.
384. Speiser P.W., New M., White P.C. Molecular genetic analysis of non classic steroid
21-hydroxylase deficiency associated with HLA-B 14, DRI N.Engl.J. Med., 1988, 319,
19-23.
385. Spellacy W.N. Human placenta! lactogen in high-risk pregnancy Clin. Obstet.
Gynecol., 1973, 16, 298312.
386. Speroff L., Glass R.H. et al. Clinical gynecologic endocrinology and infertility 5 ed
Baltimore Williams a.Wilkins, 1994.
387. Spinnato J.A., Clark A.L. et al. Intravenous immunoglobulin therapy for the
antiphospholipid syndrome in pregnancy Am.J.Obstet.Gynecol., 1995, 172, 690
694.
388. Sokol R.Z., Mellure R.D. et al. Gonadotropin therapy failure secondary to human
gonadotropin induced antibodies J. of Clin. Endocr. And Metab.,1980, 52,5, 929
933.
389. Stagno S. et al. Herpes virus infections of pregnancy Part I, Cytomegalovirus and
Epstein-Barr virus infections N. Engl.Med., 1985, 14,313(20), 12701274.
390. Stampe-Sorensen S. Estimated prevalence of mullerian anomalies Acta Obstet.
Gynecol. Scand., 1988, 67, 441.
.n,
302

391.
392.
393.
394.
395.
396.
397.
398.
399.

400.

401.
402.
403.
404.

405.
406.
407.
408.
409.
410.

411.
412.
413.

Strassmann E.G. Operations for double uterus and endometrial atresia


Clin.Obstet.Gynecol., 1961, 4, 240242.
Suciu-Foca N., Reed E. et al. Antiidiotypic antibodies to anti-HLA receptors induced
by pregnancy Proc. Natl. Acad. Sci. USA, 1983, 80,830.
Stagnara-Green A. et al. Detection of at risk pregnancy by meens of highly sensitive
assays for thyroid autoantibodies JAMA, 1990, 264, 14221425.
Szendi B. Operative treatment of unsufficiency of the cervical os in pregnancy
Wien.Klin.Wsch.,1961, Bd 73, 618-620.
Taemadge K., Vamvakopoulas N., Fiddes J. Evolution of the genes for the betasubunits of human gonodotropin and luteinizing hormone Nature, 1984, 307, 37.
Takakuwa K., Kanazawa K. et al. Production of blocking antibodies by vaccination
with husband's lympocytes in unexplained recurrent aborters; the role in succesful
pregnancy Am.J.Reprod. Immunol. Microbiol., 1986, 10, 1.
Talwar G.P., Singh 0., Pal R. et al. A vaccine that prevents pregnancy in women
J.Biochem (Tokyo), 1994, 115(3), 596-601.
Tayler C., Faulk M.P. Preventing recurrent abortion with leukocyte transfusions
Lancet, 1981, 40, 372375.
Tayler J., Tom P. et al. Regulation of herpes simplex virus thymione kinase in cells
treated with a synergistic antiviral combination of alfa interferone and acyclovir
Antimicrob Agents Chemother, 1994, 38, 853. ~
Trochet-RoyerC., Sele B. etal. Avortementsspontaneset anomalies chromosomiques
parentales etude cytogenetique de 248 couples Rew.Franc Gynecol., 1981, 76, 3,
195-199.
Thornton C.A., Bellow M. Safety of intravenous immunoglobulin Arch. Nenrol., 1993,
50, 135-136.
Thorsby E. HLA antigens on human granulocytes studies with cytotoxic iso-antisera
obtained by skin grafting Br.J.Haematol, 1969, 6, 119127.
Tilly J., LaPolt P., Hsueh A. Hormonal regulation of FSH receptor messenger ribonucleic
acid levels in cultured rat granulosa cells Endocrinology, 1992, 130, 1296.
Tulchinsky D., Hobel C.J. Plasma human and chorionic gonadotropin, estrogen,
estradiol, estriol, progesterone and 17a -hydroxyprogesterone in human pregnancy
Am.J.Obstet.Gynecol., 1973, 117, 884.
Tulppala M. et al. Absence of autoantibodies to human chorionic gonadotropin in
women with history of habitual abortion Fert, andSteril., 1992, 58, 8, 946949.
Tuomala R., Chen K. Gynecologic infection part I and II Kistners Gynecology.
Women's Health 7* ed., 1999, Mosby, InC.
Vaux D.L. Toward an understanding of the molecular mechanisms of physiological
cell death Proc. Nate. Acad. Sci. USA., 1993, 90, 786789.
Vercammen E., Hooghe T. Endometriosis and recurrent pregnancy loss Sem.
Reproduc. Med., 2000, 18(4), 363368.
VerheugtF. etal. ND1, a new neutrophil granulocyte antigen Vox.Sang., 1978, 35,
13-17.
ViannaL, KhamashtaM., Ordi-Ros J. etal. Comparison of the primary and secondary
antiphospholipid syndrom: A European Multicenter Study of 114 patients
Am.J.Med.,1994, 96, 3-9.
Wagner J.M. etal. Placenta, 1994, 15,625681.
Walker W.H. etal. The human placental lactagen genes: structura, function, evolution
and transcriptional regulation Endocrin.Rew.,1991, 12, 316.
Walker M.C., Garner P.R. etal. Changes in activator protein resistence during normal
pregnancy Am. J. Obstet. Gynecol., 1997,177,162169.

303

414. Warkentin .., Levine M.N. et al. Heparin-induced thrombocytonemia in patients


treated with low-molecular-wight heparin or unfractionated heparin N. Engl. J. Med.,
1995,332, 13301335.
415. Weathersbee P.S. Early reproductive loss and the factors that may infeuence its
occurrence J. Reprod. Med., 1980, 25, 6, 315318.
416. WilcoxA.J.,WeinbergC.R.etal. Incidence of early pregnancy loss N. Engl. J. Med.,
1988,319, 189.
417. Wilson W.A. Antiphospholipid syndrome Rheumatic Disease Clinics of North
America, 2001, 27, 3.
418. Winterer J., Gwirtsman H.E. et al. Adrenocorticotropin stimulated adrenal androgen
secretion at low weight with normalization after long-term weight recovery J. Clin.
Endocr. Metab.,1985, 61, 693-697.
419. Witkin S.S., Ledger W. Antibodies to chlamidia trachomatis in sera of women with
recurrent spontaneous abortions Am.J. Obstet. Gynecol., 1992, 167, 135.
420. Wladimiroff J.W., Van Bel F. Fetal and neonatal cerebral blood flow Semin. Perinatal.,
1987, Oct., 11(4), 335346.
421. Yamada H., Polgar K., Hill J. Cell-mediated immunity to trophoblast antigens in women
with recurrent spontaneous abortion Am.J.Obstet.Gynecol., 1994, May 170 (1),
1339.
422. Yamazaki J.N., Schull W.H. Perinatal loss and neurological abnormalities among
children of the atomic bomb: Nagasaki and Hiroshima revisited 19491989 JAMA,
1990,264,605.
423. Yen S., Jaffe R. Reproductive Endocrinology Second edition, 1998.
424. Yen S. Neuroendocrine regulation of gonodotropin and prolactin secretion in women:
disorders in reproduction Current Endocrinology, New-York, 1982, 137176.
425. Zangwill K.M., Schuchart A. et al. Report from a multistate active surveillance system
US Department of Health, Centers for Disease Control, MMWWR 41/NoSS-6, Atlanta
Georgia, 2533.
426. Zangwill K.M., Schuchat A., Wenger J.D. Group streptococcal disease in the United
State 1990: report from a multistate active surveillance system Mortal WKIY Rep.
CDC SurveillSumm.,1992, 20, 41(6), 2532.
427. Zdravkovic M., Knudsen H.J., Liu X. High interferon alfa levels in placenta, maternal
and cord blood suggest a protective effect against intrauterine herpes virus infection
J. Med. Viral., 1997,51,3,210.

3.09.2002 . 70x100/16. 19 ..
. 5000 . 6747

121099, , , 6