DuABET 1 TUTTA y AeTen, NOApocTKOB wv MONOAbIX NofAen Ka oman Deenepraom Boum queteme 1-p Parnap Xanac, AOKTOp MeAuuMHEI Koncyntant no Neguatpun Tepsoe pycckoe w3qqaHne Apr-Bu3nec-LlentpNepsoe pycckoe u3zgaHne QUABET 1 THITTA y Aeteh, Tloppoctkos u Monogerx Slrogen Kak crate akcneptom B CBOéM AuabeTe 4i-p ParHap Xanac, AOKTOp MequuuHb! KoxHcynbTant no Neguatpun Apt-Bu3xec-Llentp 2011Cogep»kaHve Mipeducnoeue .. Npeducnoeue npocbeccopa B.A, Mlemepnoaoi..... Tpeducnoaue d-pa Tlumepa Ceugma Npeducnosue Banemutts! OuepemeHko BnaeodapHocms = Beenenve. 2. Kak Hay4MTbCA NaQnTb c pnaGerom... Korga Tel anepasie yaHaeww, aro y Te6a quaGer Over manenoKne geTh PerynapHbie OCMoTpEI .... Kirt waraHbI0, KoTOPYIO BBIGMPAeLLE .... 9 Koxtponnpya cBoi cobcTBeHHBIA anaGer Uenn ynpasnenna quaGerom .. Kax qo6urboa aux yenelt : Cranoesct caowm coScraetine axcnepTom Moxto ni pas “sbixoaHoit” oT quaGeTa? AnerepHaTuBHbie M HETPAAMMOHHBIe MeTOALI neveHna - sonesesn 25 . 22 4. TmaGer: HemHoro ocHos. Dwa6er 1 tna seceeasaniscen2T AnaGer 2 Twa Apyrne Twnei amaGera a Kak “acto sctpevaeros auaGer? ... Moxio ni sapasureca aua6erom? Byner nn qnaGer, ecru ecTe CnviKOM MHOrO CHAAOCTEH? ene svesennnenenaniesDd 5. Kak pa6otaet saw oprariese . 32 Vnoynian 33 OpratiaM He ocosHaer, “To HMeeT ANaGeT ...35, Axamomun eauiezo op2aHusma.. 36 Topxenynouwaa xenesa 37 Ocrposxu laxrepranca .. - 38 Knemowiii mema6onuam, 39 Spoposaa knerka 39 Tonoganne DnaGer w wenoctarox mrcynuia enone 40, 6. BeicoKuit ypoBeHb TMOKO3bI KPOBM... Hegoctaro4to mHoynana? ... 42 Kak newb BbICOKMA YPOBEHb rmH0K03b! KpOBM Keroaunaos (anaSerwvieckan Koma) Heuerkoe spenne u avaGer 7. Perynauun rntoKo3bi KpoBy .. TOYOHE rsnennnnnnneennsenin TRIOKATOH nen ABpEHANIH on KOpTHSON nso Topo pocra .... 8. [unornukemwys .... Yposen rmioKosb! KpoBH M CMMNTOMB! TanorniKeMuAn ..... Crom! ranornnweMan npit BsIcoKon FmWOKOSE KPOBH ...... 58 64 ‘Taxxenan rMunornuKempa ... 61 Cyaoporn . 62 Tlopaxaerca nn ronosHom moar npH TAKeNoH ranornuKemun? .. 62 Beccumntomnas ranornaKemua... 64 eHOMeH OTABYM nnn 66 Crmuikom mano eae! anu crhimwiKoM MHOrO voy? . 68 Houias rvnorninkenins 67 eHomex yTpeHHest apn. 70 Cungpom Comopyn 1 Mo>kHo nv ymepeTb OT runornuKkemun? 72 Tlowemy meHsemca yposent 2moKosbt Kpoeu, npu KomopoMm MoxHO 3aMemum e2unoenuKemuto? .. sue Th 9. Nevenne runornuxemun 7 Npaxruveckie pexomerqaunn: 7 BpeMa TANOMMKEMMR ec 80 Tlomouls enopexy c avaGeTom, KoTopEiit nn0xo ce6s uyacrayer 84 Trioxoza 84 ‘pyxtosa 82 4 ‘Zuabem 1 Tuna y Jemed, Modpocmxos u Monodexx Mode © P. Xanac 2005Cnagocta u ranornuaxemna as Rocne rmnornuemun ee) Yaureca pacnosHasarb CMMNTOMD! TAROLMKEMUA 84 10. Ancynunorepanna. PerynapHbiit mcynnn Koporkoro nelicrena . 86 Vxcynni anurenbxoro gevicraun Vivcynne cpentero nericrana BHyTpuBeHHEIA mHoynMH . Avaniorm uncynina ynstpakoporkoro eiicrava 87 Basansipih ncynnt 88 Hostie Gazanbibie MCyAHHe soon 88 Torosuie cmecn HHcymMHOS 89 Bontwas qosa aeiicrayer nonbuie 89 Eavinut! 4 KoHUeHTpauMA MHCyAMHA ......... 89 Deyxkpatbiit pexnm Tepanut ....... 90 ‘TpexkpaTibih pexnm Tepannn 90 Pexwnn mHoroKpaTHbix MHbeKL 91 Viroexunn nepeg enoit (Gonioctei neysin) 92 Korga MHe Hago BBOQMTE wricynan nepen en0oii? .. Wucynniosas nomna ....... Mory a nponycrnTs eay? ...... Mory @ MeHaTS apema eat? ... Vincynui nepea cHom Korga Hano Beaute Hi ‘CHOM? .. wes Kora Hano saoguTe nicynNk arwTensHoro Relicrana? .. Cwewneanite ucynnios 96 97 ‘Sdcpext peno . 7 Hackonbko Towa BBOQMMaR O32 HHCYAMHA? 98 Boacisaxne mHcynmHa 98 ro npowaoiger, ecn pa pba He SaKOHWAT AY? oesns i 99 Uro npousoiiger, enn sa6biTb BBecTH MHCyNMH? 104 ro npowsoliner, ecnn BEECTH HE TOT MHCYNHH? ... TlosansTeca ® NocTeNk Ha BEIXOAHEIX Ecnm Hano SoApCTBOBATE BCI HOME 102 103 104 Tlocmentan pabora 105 Dun poxgernn gis 105 Korna HOMyeTe y APYIEA nen 108 Vincynu 8 wkone 4 eTCKOM cany 106 41. CaMoxoxtponb. Moxnropnposanve. Ckonbko TecTos MHe Hao AenaTe? 107 107 Conepxanne 5 "Xopowine” nu “nnoxne" TecTb\’ AuaGer unu Her? .. Ecte nu sanpeujennnbie aeum? Tnioxosa mown. Moves nopor ... Tnioxoaa Kposn Kak nposogHte TecTe! KpoBH’ Ecnit gate Ha BpeMA Yel-To npoKanbiaaTen> MAMBYA connie Tlokasbleaer nu rrieKoMerp npanneHoe 3HaueHne? 7 DnurenbHoe MonuTopmposanue rmoKO3b! ‘Deru u tecte rmioxo3bt xpos... Uysctayelub nv Tel ce6a nnoxo npn ‘abicoKom YPOBHE rmioKo3t KpOBM? Moxer nu anutensHoe npokanbiaakve nanbyes pMBOgMTe K NoTepe YyBCTEMTeNbHOCTH? Keroubi Peora W KeTOHE... Kerout! Kpoai ...... 12. Koutponb HbA‘ .. Kaxum Qomkex 6biTs yposeHb HbA1C? ... Kax vacto Hago nposepaTe cao HbAtc? .. Moxert nu HbA1c 6biTe “CAMLLKOM XOPOLUMM"? sesso HbA‘c 60 spema nyTewecrana Cromt nu penatb TecTb!? ..... pykrosamu .. 18 13. TexHuka HH BeKUME .. Tipwesixas « nHbeKUMAM Virpexymi poautensi .. Yeensuian Gon npn MLE KWAK Kya MHe ssoqur’ mucynun? OGasaTenbHo AM AesMHcbuyMpoBate Kony? 136 Xpavene wHcynnna .... mee) Wnprupt 138 Virwenunn wnpnuann 138 Wnpmu-pysinn 139 Tlovemy He Bce HHCyNMHe! ect 8 wnpmu-py5Kax? 2 139 Cmeva urn 8 wnpmu-pysKe fees 139 Paanuvibie wnpwu-py4Ki ANA AHEBHOFO M HOYHOFO MHCYFIAHA onsen 140 Bogayx 8 kaprpu@xe wna winpHye 141 Viicyni Ha wre WnpHU-PyYKH ... 142 VicnonbsoBaHibie WIMbI A LIMPMLBE none 142 14. Yetpoiictaa ana BBeAeHHA wHCyNMHa .... ees 143 Asromartaueckie MHbeKTOpEI oe 143 Besbironbibte MHbeKropbt one 148, Aua6em 1 Tuna y Heme, Modpocmkoe u Monodex Shode © P Xanac 20056 Conepxanne Mncycpnon.. Korga Hago nepectasnaTe KaTeTep? Kakoli nHcyriMl MOxHO BBOgiTe Yepes KaTeTep? .. Mepraoe npoctpaxcreo 145 145 Wnebexuus noxpachenuie sees 146 . 149 149 15. NogGop n03 uHcynuHa Havano wxcynmmotepanu ... Kak wHcyninl cHKaeT YOBEHb rm10KO3b! KPOBN? .... 152 Bpemennbie waMeHennn Ao3 MHcynuva ...... 153 Hemboro 0 coctase Apopykros 8 Ts0ei niMWYe .. eee 154 ViameHenue cocraa niu BAUAET Ha TMHOKO3Y KOOBH .... ‘uawseckme ynpaxkHeHMA WAM OTQbIX? ro fenars, Kora ypoBeH TMHOKO3bI KPOBM BBICOKMIA Donrospementibie uameneHnn ‘fos vHCynMa ..... seen 158 Beenie npasanbHsix 3anVncei enn 160 Kakoi nopaqok nyawe npn wameHeHini 203? (Pexuna mHoroKpaTHbix HAeKUMi) .. 160 Hwakas miokosa KpoBh ... 160 Vixcyniii nepen yXHHOM 160 Vnicynuh nepeg cHOM .. 161 Kane cneayioujve aeiicTena? .. 164 Yposett rnioko3bi KPOBM HOUBIO .... 168 Hosnas ranornnkemus 168 VincyninH nepen sastpaKom 167 Vncyniit Ha o6en 0 yKnH 168 Kaninkynst nih BbIxoaHOR? 168 YnpaxveHwa nnn o7Abix? 169 Ny6eprar ... 169 Vicnonbsopanne ananoros uNcynuna ynbtpakoporKoro aeiicrana (HosoPanwa w Xywener). 155 156 2 156 71 NoaGop possi * seers 173 Buicoxaa rnioxoaa kpon eens 173, Tunornikemus 7 176 Moto nn ect Te Ke MPOAYKTEL, HOM PAHBIUE? ne nnen 176 ‘Onanyecke ynpaKHeHns .. 177 Toropsie cMecn HHCyAMHOS .... 178 Tepexog Ha HoaoPanva uni Xymanor .......179 Npamenenne annren Horo ananora Slantyca..... 180 Non6op n03 nicynmna 8 thasy pemnccun. 181 182 183 183 Tunornukemns Huakne sHeNeHia rmH0KO3UI KPOBH Tunornukemms nepen en0i .. ‘Sxcnepwment! .. 16. MncynmHosbie nome ... Havano nevexns nomnoia.. Basanbiaa CKopoct ors Bpementbie nsameHeHna GasanbHoi cKopocte ... 190 Boniocusie goabi nepeg enol 191 Cmela mecta BBeneH .... 193 Bonee vactoe nomauinee MoHUTopMpoBaHne ... 198 leno nicysmva npn neveninn nowno ..... 197 KeToayngos (qnaGeTwueckas Koma) Orcoegmvenie nomnes .. Kak npuste eanHy Wn Ay Curian Tpesorm nownet Cunrian “Het nogaun'’ . Mpotexanine uucynnna . Bosayx 8 Tpy6ke .... Qyv Gonesnn u Temneparypa ... Aoaei npu samexe nomne .... Tocnurannsauvia 8 GonbHiuy .. @uawueckue ynpaXHEHMA ........ Vicnonbsoealive nomni TonbKo HO4BIO Aansetos nv nowna noMexon? : Bpisbisaer nv nomna ysennuenne seca? BoamoxHocTe nogonbwe nopansteca 8 nocTens .. Tloackaskn 8 nytewecrene . eves Vicnonssopavne non y ManbIWed «210 Bepementocts .. nett Avanor nHeynava yneTpaKopoTKoro AeACTEUR ® nowne 2M Kakoe neverue abiGnpaiot npocbeccnonansi- soso 21S MequKn? 17. No6ounbie scpepextb! MHcynmHoTepanun Bons i Beirexawe wicyninna Bnoxmposanve wr .. CvHAKM Mocne MHbeKUMi >Knposbie ynnoTHEHMA Tloxpacteviwe nocne u4Sexyinn Axrwrena k MHCYNMHY Muxnoarpocbuay .. Wxcynviostil orex 18. NotpeGHocTe B MHCyNHHe... Ckonbko wkcynia Hao ‘TeoeMy OpraHuamy? .. My6eprar pocr basa pemuccni ("MeqoBbIl| MECAL”) QuaGem 1 Tuna y Lemet, Modpocmxos u Monoduix Moded © P. Xanac 2005Ckonbko uHcynula npoayumpyer nogpkenyfounan xeNesa? .... UyacTauTenbHocTe W pesHcTeHTHOCTe K Heyy... VigeanbHtsie Aoabi nHCyrAk 220 221 oo 224 19. Nutanne. . 226 Beacbiaakue yrneBogos . 228 Ocao6oxnenne xenyaKa .... 230 Conepxwntoe caxapa 8 Hawel nile 231 YorpeGnavive nuKocrH € eno 233, 233 234 235 Dvermecne xupet . Tnujesas knetuaTka Trukemuyeckuit wHpeKc Monoxo 237 Osouyn 237 Kaptocbenb 237 XG rns 238 Maxapoxiie uagenna . 239 Maco u psa... 239 Tuya... 240 Cont 240 240 240 240 Tpasti npaHOCTH .. ‘©pykrat u sropbt Bpema enbi Tlepexycs! (nononiurrenbibie npweme! niu) Moxto na uameHse pacnopafok en Fonopitii nn Cbitbiit? ... oe Nuranne rpygHbix nere 242 Mopever yrnesonos 243 Pasnwsubie MeTonbl OYeHKH yrneBono. ..... 244 Wkona ....... COT 247 Cneywansbie “quaGermueckve" npopyKTb? ..... “Beictpan ena” 8 3aKycouHBix 241 242 242 248 248 Ena s o6yaiowynx narepax 248 BererapnanoTeo m seretapnanckne quer! 248 Pastbie kynbypbi 249 Ha npasaHnkax uw BevepnnKax 250 20, Caxapozamenntenu - 251 Bes caxapa? 251 Vcxyccreennuie caxaposamenurenn 251 Harypanbibie caxaposamenutenn .......... 253 Dvermveckne Hanurai u “nerkne” npoaykTb 254 21. Koncbetet, cnagoctu MW MOpoxeHoe ... . 255 Ckonbko wHcynAHa Hao BEOAKTS AononHHTeNbHO? 256 Mopoxetioe ... 258 Wokonaa 259 Conepxanne 7 Koucersi +259 Koxcberei no BbIXogHbIM Zenaa nepepeie or koncber Kaprodensibie Yun... >Keparenbuas pena .. 22. KorTpont weca Yposnetsopenne unu “uyscTeo cbitoctu"? . 264 CHmxkenne Beca ..... ce 265 HemHoro nuwHeHbKoro ... Beicoknii HbA1c MW CHiaKeHMe BECA .. 23. Hapywienwa nuweBoro nopeeups .. 270 Moxer ni rntoxo3a KpOBH NOBbICHTECA BO BpeMA 24. @u3nueckne ynpaxkHeHnsa .. ynpaxHeHni'? .. Tanornikemma nocne ynpaxneniit . Ypoxu cbuskybrype ..... Tlarepa u nbixuble nporynin CopesHosaliia Ha BbICOKOM ypoBHe Kak coxpaHit xopowy1o chopmy np qua6ere ...... Mapacborickne Harpyski! AvaGonuueckne creponats ... Nonsontce nnasann 25. Crpecc .. Crpecc 8 nosceaHesHoit 3H... 26. Nuxopaaka 4 AHH GonesHH Towinora 4 psota ; TactposuTeput Tlevexne pax Xupypraveckoe neveHne .. Nlexapcrea, KoTopbie BnMAKKT Ha rioxosy KpoBn , Sy6bi... Banyan 27. Kypenne .. TlaccusHoe kypeHne Kak 6pocnte kyput> HioxatenbHbiid Ta6ak .. 28. Ankoronb... ‘Ankorons 4 neveHb Touemy onacho 6biTb niaHbiM Np ANaBeTe? .. ‘OckosHbie npasuna .. Uro menare, ecru abi CNMUIKOM MHOrO BbINANH? ‘Aua6em 1 Tuna y fee, Mlodpocmxos u Monodsix Sioded © P. Xanac 20058 Conepxanne Moxo nv ebinvsats 20Ma? ...... 302 29. 3anpeweHHbie npenapatet........ 303 30. Bepemenvocte v CBA3aHHbIe C Hen Bonpocpi. 305 07 307 Mlogrotoska k GepemeHHocTs ... HaGniogerne 3a matepaiun ...... Kak 6yget pasenearecn pebexor 308 Byger sm y peSenka qua6er? .. 309 Becnnoaue .. Kak MeHneToA noTpeGHoCTe @ UHCYMINHe BO Bpema MeHcTpyanbHoro wena? CexcyansHocts : Korrpayeraess.. 3aGbinu npnnaTs TaGnerny? Asapiiiian KOHTpAUeNuyA ..... 31. Couvanbble Bonpoctl.. WHOM os .seeeee Alerckisi can u yxon 3a peGeHKoM ... Tloco6ne no yxony 28 peGekom 317 YesIHOBNEHHE ose se BAT BulGop paSorel unm npodeccun 317 Boenwaa cnyx6a 318 Bogurentckwe npasa 318 Boxpenne u quaber ... fo B19 Crpaxostie nonucei riosnd 2d Ygoctosepenne quaera ...... 322 Cembu noagepxice 322 MexayraponHeii Donn MoonenosaHnit HOsennnstoro DuaGera ... = 322 Auaermeckne Accoumaun... 323 Poccwiickan [maberaveckan Denepayua ... 323 Pocewiicxas [JnaGermveckan Accounauua .. 324 Benopyccran Accounayna “Bleroxni Anaber" 324 Yapanncan AuaGeriveckan Senepaunn ...324 Gma6etnueckar Accounaua Pecny6nuKn Kagaxctan ......... .. 325 DuaBermeckan Accounayua Keipreiscrana 325 Mexayrapoanan AIMabeTmveckan Senepauna (IDF) . 325 Mexaytapoanoe O6ulecreo no AimaGery y Aerei u Moapoctios (ISPAD) .. 325 Cent-Brucentcxaa flexnapayna .. 328 Auadermeckne nareps 1 oGy¥arouyne KaHMKyrIE i 326 Kora Monogan mintiocre espocneer? 327 ‘unancuposae auaGeruecknx cpencts 327 328 32. Maer u MnTeprer... 33. Nogcka3Kn B Qopory.. Baxumauun ..... - SaGonenn sarpanuyen? NpoGnemei c anapeen Tepener vepes ¥acoBble NOAA ...cn rome 383 34. Conyrereynouine: 3aGonesaHun. 336 Uenvarue .... i Boneakn uyTosuaHon meneasi Bonestin xox Wacbexyan Fpu6xopbie uncbeKyyit 35. Nosqune ocnoxHeHnAn AmaGeta Uro ebisbisaeT ocnoxHeHMA? .. Kpyniibie kposeHocHtie cocyabt Menne KpopeHocHtie cocyat! ... Tnasnere ocnomnenua (pemunonamus). 342 Hapywenne speHms npn HecTa6unbHoii rnioxose kposn 5 Ounn KonTaKtHbie niaiabi Ocnoxnenus nowex (Herpponamun). OcnoxHenus HepsHoil cucmemet (netponamus). 36. CHwkeHMe pucka OCnOxKHeEHMA.. 350 Uccneaosanne ns Ocno .... . Crokronbmckoe nccnenoBaHie ... DCCT nccnegosanne ...... Bepnuckoe rnasHoe vccnenosaHie Ucenegosanna ns SIMHKOnWHT Kaxoro HbA tc MoxHo qoGuTbca B YeHTpe? 354 37. VccnegosaHun HOBIE Ppa3zpa6orKn Hoewie cnoco6e1 nevenus duaGem: Vunnantupyembie uicyniHoebie nowt... 355 Tniokomerpel 356 Cenicop rmokoati . 356 C-nentua .. .. 356 Banyanauns ... 357 Cannyunosas xucnor: 357 Ymo ebisbieaem Guabem?. 357 AyTonmmynlioe saGonesann 358 Hacnencrsennocte 359 ‘axropst opyxkaiowjeli cpenst.. 359 Koposte monoko .. 361 Kanwar. 362 KMIT (AGE) 362 Bronuposanue uumynoso npoyece 363 VumyHorepann....... sevens 363 Qua6em 1 Tuna y emeii, Modpocmnos u Monodtix Mhoded © P Xanac 2005Conepxanne 9 Ceetoneverne: Awasoxcuag ..... Huworananng, Tpancnnanmayua ToaxenynosHolt xenesei TpaxcnnakTayna ocTpoBkoB THHO-MHKEHEPHBIC KNETKM .. Apyeue cnoco6si eeedenus uncynuna.. 366 HasanpHuii cnpen . TaGnerin..... VHeynitt 8 CYNOSHTOPHAX once. VTanaUMOHHBII MHCYTIAH nocconnneee 367 Xwminveckoe waMeHeHne MOneKyMbt MHCYRIAHA ..... 38. Newxonorua. 368 Hawano ana6era.. 368 AnaSermecnue win cemeriibie npasnna?. 370 Kak crate apysbsmn co caowm auabetom.. 371 DwaGer BninseT Ha BCIO CEMBIO wwe 373 PogctaeHii« wna apyr Koro-nu60 ana6eTom, .. 373 Pasrogop c apysbann 374 Kak namennte ca0h o6paa xu3HH 375 AuaGem wa pasneix cmaduax paseumus 376 Mnapesup! (0-1% ropa) . 376 Aer vinaqwero sospacta (1%-3 roga)...... 377 Dern AowKonbHoro Bospacta (3-6 ner)..... 378 Dem mnaqwero uxoneHoro sospacra ...... 379 Derm cpeanero sospacra. 380 Ny6eprar 381 Snopossie cn6cei. ae OOM Passeneniile cembn 385 Yuactve oTua... a 385 TlaGuneHei anaser .. es 386 Kavectso ans” .. 387 39. Urnoco6un.... .. 388 40. V3eecTHbIe miogu c AnaGeTom .. 390 Kapsx Waxrangse: Y MOE KV3HM ECTb LEN... Visa WeGnbikin: A BbDKMN, NOTOMY YTO ABMANCA.... 393 .. 390 Tappu Ma66ar. 395 Topa Mopan 396 Crue Paaprois. 396 Hutton BKoHCOH .. . 397 Snunoe. 399 Vinniocrpauini 1 Apyrne UCTOMHMKI nee. 399 Croeape... si AOR Slumepamypa. sone 414 MipedmemHitt yRasaments .n.- 425 QuaGem 1 Tuna y Aemed, Modpocmxos u Monodeix Modes © P. Xanac 2005Mpeaucnosue Unero aereli w noxpoerkos ¢ MaGeToM | THA BO aceM Mupe mlocroaHHo yrenumnaeres. Kaxeres, “470 TY TeHEHUNIO BEISBIBAIOT KaKHe-TO (baKTOpE! Oxpyxaiomeit cpemsi, mockomBKy reneTHYecKHe HGMeHEHHA He NpoHcxOLsT y suoNeli TAK GuIeTpO. Tero 2Ke MONONBIX BSPOCIIEKX, ¥ KOTOPEIX pasBH- paerea anaGer 1 Tana, HaoGopor, ocTaeTes craGH- TbHBIM WOH MaKe CHINKAeTeR B HeKOTOpEIX paiionax. 9ro mpeanonaraer To, #70 onpenenentas TPYNMNa HHAHBHAYYMOB HMeET CKIOHHOCTS K pas- BuTHiO aHaGera | Tuma, Ho haKTOpst OKpyxaioutelt peal, KOTOPEIE BEISHIRAIOT FO, MPOsBAMOTCR Ha Gone panxix oranax »xusHH, Fonopa B ueOM, B CTpAHaX € BKICOKHM YPOBHEM >HSHIC TAKE HMe- TCH H BEICOKHil MporteHT jleTeit c AHaGeTOM 1 TH- na, B Ounuumn, me celiac on scrpevaerca waule Bcero, oxuaeTeA, TO y 0,6% Bcex nereli Moker paaBHTéea Maer B nospacTe 10 15 ner. Orpostuste you.tHi9 aksiasinaioes B HecmenORAHHs, ‘roGsi HaiitH nipuunuy zuaGera u crioco6 ero H3- aresenns. Ho moa Han Hao cjlesaTs HSH c 1Ha- Gero WIA HAMIMX geTeH HM MosOMBIX mOReti nanGostee ynpassenoit, C Tex nop, Kak HanHcaT nepayio pexakiuo 9Tofl KHHTH B 1998, npoHsouLtH Gombe usMeHeHHa B MHCyaHHOTepaMH, Bum coaaHisi HOBBIE AHALOTH Kak YABTpAKOPOTKOTO, TAK 4M auMTensHoro JelicTBHs. ITO OTKPKIO HOBBIE TOPH3OHTEI JU1a CO31aHHA H “MOueHpOBaHHs” HH- AMBHAYaNLHO! MECyAMMOTepANHH, KoTOPA OA XoNMITa OBI K OSpasy *KHSHH KarKOTO MemIOBEKA, Mesepnstearoume coperss 110 HerIOnBs0BaHHHO 9THX HOBKIX allasoron Terlepb BKMOGeHB B KHMTy. HH CYAMHOBEI MOMMEI UIHpe MpHMeHAOTeA y MOTO- JbIX mogeli, nooTOMy rasa Ha aTy TeMy Gpina sHauuTebHo OGHoBeHa. [aga 10 HCCTeOBAHIAM HW HoBBIM: paspaGorKaM oTpaxkaeT nce nocaenMHe AAHHBIe, BKMOYAA OOHALEAHBAIOMIMe pesyasrarel Tpanenmanraunn Gera-kseToK. JloGasten pasren no ANaGeTHeCKHM opraHimaNHaM, TaOKe BEI naijlete Hopsie TeMl, HanpHMep, KaK GesomacHo BONMT aBTOMOGHT c¢ ANabeTOM H GaroBBie PexoMesaunH mo nloxexety yrienonos. Beero oGbem Matepnaios stoi KKMTH yrennannes wa 27% co Bpemenu nepBofi pexaKus. Mena sceraa nopaxaer va orpomiax MoTHBALHA nembix cemeli, ¢ KoTopoit OM BKMONaIOTER B Mpo- uece oGysenus. Yacto posuresn socTHraior nopa- 3HTeTBHOTO YPOBHA 3HAHHii B CTpeMuTeHHH cenaTs 2XXHGHB cBOeTO peCeHKA ¢ AHAGETOM KAK MOKHO aysmie. 3a Napy Heme OHM Ye cTIOCOGHEI caMO- CTOsTeNbHO H XOpoulO cnpaBnaTses ¢ MOBCeAHeR- HBIMH CHTYAUMAMH, CBRSAHHBIME ¢ mHaGeTOM. A Tae-To Yepes Tox, MepexHE Ace COGKITH OOBIUHOH CemeltHoll KHSHH, BKIOYAR HM POAEHHR, KaHH- KYA, 3AHATHA COPTOM, a TAIKKE HHEKLHH, rac- ‘TpODHTepHTHL HM MoTOGHEI Zea, YoTOKHEKONINE 2KSHB, OHH GepyT Opasiet MpaBsIcHHA B CBOH PYKH H caMM CTaHopaTes oKcMepTaMHt B cBoeM AHaGeTe, Vimenno y TaKHx cemeit « Haysuiea OGpamarses ¢ AMaGeTOM H Hava RepHO MOHHMATh BBIpaxeHHe mpoeccopa J>xouH Jhonsnrecona: “He ovens Recenlo UMeTs jiNabeT, HO Halo yMeTb nionyyaTh YAOBOECTBHE OT IKHSHH sake € NHAGETOM” SA Hane1ocs, HTO 9TO HOBOE yconepuleHCTBOBAHHOe naaHHe sHasHTeNbHO OGNerHHT HSH C mMaGETOM aaa aeteli, MompocTkoB HM MonOgKIX suOKel, Mue xoTes10cs Ost ysHaTh Bae MHEHHE H BrlevaTACHHE © conepKAHHH 9TOH KHMTH, WTOOK BMecTe MBI MOM yaySINITS eee HaGera. Parviap Xavac, aoKtop MeauuyHe!, MD, PhD, Koxicynstat no Neguatpun Oraenenne neanatpun Bonsxnya Yagessnna (Uddevalla Hospital) S-451 80 Yanessnna (Uddevalla) Wseuna Fax +46-522-93149 E-mail: ragnar.hanas@vgregion.se 10Npeaucnosue npodeccopa B.A. Netepkoson expenue paxyiocn, to oty KHMTy, HanueaRHyio YMOM H CepAlleM, MOAHO MpOMHTaTs Ha PyCcKOM mauike. PaGoras oxon0 40 ner ¢ jeTbMH, GosIbABINIt caxapHbiM 7HaGeTOM, H MPOKUB KH3HE BMECTe C GonsHKIM caxapiiiM jHaGeTOM ¢ 1OHOCTH MY>KEM, 5 MOrY KOHCTATHPORATS, NTO 9TO O¥eHE TlomesHas kuura, Beem pouirenaa 1 eTaM ¢ ZHaGeTOM, KTO Ye YMeeT THTATb, CORETYIO BHHMATCIBHO ce Mpoyecte Bcio, a 3areM MHOrO pas K Heli BO3- Bpaularbes 32 COBETOM M10 THOGOMY BOTIpOCY Baueit 2kNBHH ¢ aHAGeTOM. Yaepsio Bac, 4TO BEI HalineTe B heii orner Ha moGoii mirepecytommit Bac Bonpoc. Kura amcaa Bpayom, KoTopstii wa passtsix TOBOPIT ¢ MOSIONBIMH MOAB ¢ stHAGETOM. 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BO BpeMs STHX OCMOTPOB MBI CMOKEM CKazaTS, KaKOH y TeGa sun KoHTpomb sHaGera 3a npensayume 2-3 meca- a ¢ MOMOMIHIO HaMepeHHIA NOKasATENA B KPOBH, HasBaHHOrO TIMKUpOBAKHBIH remorsioGun HbAle (ea. erp. 124). Baxno, 7061 ¢ camoro Havana Guu NOHHMAHIHe, 4TO HEBOSMOXHO OGuTECH OT- AIMUHOTO YpORHS TOKOSBI KPOBH Ka NeHb. Ha howe metou0n sievenns, XOCTyMHBX B HacTOsUIee BPeMA, MONTH y KaXKTOTO NeTOBeKa ¢ qHaGeTOM eXeIHeBHO OMIBAIOT BEICOKHE 3HAYCHHA FIIOKOSBI KpOBH, Mi 3TO He fOmKHO TeGx caMKOM GecnoKonTs, Baxkiee, 4106s THOl cpenHHit ypo- et PHOKOSKI KPOBH GbLT MpHEMeMsIM, Bombure maopMaunn Ha 9Ty TeMy TH HaiiteUNs jane B oroii knnre, Crapume noxpoctku acto mpeanounrator mpHxo- AUITS Ha OCMOTPSI CAMIE HUIH B KOMTIAKHH € JIpyTOM ua naprnepom. Ecam y ac cepseausie otHoute- Hug, O¥eHb BaxHO, TOM TBO apyr/nonpyra MpHxosHAN € TOGO B AUAGeTHYeCKHit KeHTp. Tet MOxkellb MOTOBOPHTS © AMETONOFOM BO BpEMA oSuteli BerpesH ¢ AMaGeTHYeCKOH KOMaHOM HH oOparutsca 3 coneToM HenocpesCTREHHO K HeMy. (Onun pas B rom y Te6a oOsraH0 Gyner Gonee TuLa- Tenbubili OCMOTP, BKAOYAIOUMT NomHOe KIM uimyeckoe oGcxezoBaHHe. B exeroaustit ocMorp MOFYT Obie BKIIONEHS HeCKONbKO AOMOAHHTEN- HbIx aHasH30B (B OCHOBHOM’aHanH36t xpoBHt) (cM. emp. 336). TeGe HeoGxonuMo sHarb, YTO Te HMeHEHUA, KO- TOpsIe MIPOHCXONAT B TBOEM OpraHHaMe BO BpeMs Mo_poctkoporo Bospacra, GyayT BNMATS Ha AHaber, Bo ppema nyGeprara TBoeMy oprannsmy 10- tpeGyerea Hawnoro Gonpine MHcymuHa (eM. etp. 218), Baxto 3HaTs, Kak NOBBIMATS 103y. ?KUTb KM3HbIO, KOTOpyroO BbiGupaelib ImaGer - 9t0 xponnueckas Goness, Koropaa Gy- Aer WAMSTE Ha TeGK KAKMDIT EHS BCIO OKHSHB. Tlocrapaiica noapyxxnreca ¢ auaGetom (no Kpaii- Auabem 1 Tuna y Lemeu, Modpocmxos u Monodsix Shode © P Xanac 2005Kak Hayunteca nanuTb c AMaGeTom 21 Mei nposeprem Teoh Bec H oct 80 BpeMma KaxKqoro Bn suTa, “TOG yGenvTecs, TO Tel npononmacuie pach Tak 2xe xopoU, Kak M 20 ANaGETa. 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