2 курс / Гистология / Гистология_пищеварительной_системы

ɉɢɳɟɜɚɪɢɬɟɥɶɧɚɹ ɫɢɫɬɟɦɚ

Ʉɨɧɫɩɟɤɬ ɫ ɡɚɧɹɬɢɣ ɥɭɱɲɟɝɨ ɩɪɟɩɨɞɚ ɋɟɱɟɧɨɜɫɤɨɝɨ ɭɧɢɜɟɪɫɢɬɟɬɚ ±

Ȼɨɪɨɧɢɯɢɧɨɣ Ɍɚɬɶɹɧɵ ȼɥɚɞɢɦɢɪɨɜɧɵ

ɉɂɓȿȼɈȾ

ɬɢɩɢɱɧɚɹ ɱɚɫɬɶ ɩɢɳɟɜɚɪɢɬɟɥɶɧɨɣ ɬɪɭɛɤɢ ɫɤɥɚɞɤɢ ɨɛɪɚɡɨɜɚɧɵ ɫɥɢɡɢɫɬɨɣ ɢ ɩɨɞɫɥɢɡɢɫɬɨɣ

ɋɅɂɁɂɋɌȺə ɈȻɈɅɈɑɄȺ

ɋɥɨɢ

-ɦɧɨɝɨɫɥɨɣɧɵɣ ɩɥɨɫɤɢɣ ɧɟɨɪɨɝɨɜɟɜɚɸɳɢɣ ɷɩɢɬɟɥɢɣ ɷɤɬɨɞɟɪɦɚɥɶɧɵɣ ɩɨ ɩɪɨɢɫɯɨɠɞɟɧɢɸ

-ɫɨɛɫɬɜɟɧɧɚɹ ɩɥɚɫɬɢɧɤɚ ɫɥɢɡɢɫɬɨɣ ɩɪɨɯɨɞɹɬ ɧɟɪɜɵ ɢ ɫɨɫɭɞɵ .

-ɦɵɲɟɱɧɚɹ ɩɥɚɫɬɢɧɤɚ ɫɥɢɡɢɫɬɨɣ ɝɥɚɞɤɚɹ ɦɵɲɟɱɧɚɹ ɬɤɚɧɶ ɩɭɱɤɢ ± ɜɞɨɥɶ ɨɪɝɚɧɨɜ ± ɜ ɩɢɳɟɜɨɞɟ ɗɬɨ ɩɨɞɫɥɢɡɢɫɬɚɹ ɨɫɧɨɜɚ ȼ ɟɺ ɫɨɫɬɚɜɟ ± ɠɟɥɟɡɵ ɋɨɛɫɬɜɟɧɧɵɟ ɠɟɥɟɡɵ ɩɢɳɟɜɨɞɚ ± ɫɥɨɠɧɵɟ ɪɚɡɜɟɬɜɥɟɧɧɵɟ ɚɥɶɜɟɨɥɹɪɧɵɟ ɠɟɥɟɡɵ ɜɵɪɚɛɚɬɵɜɚɸɬ ɫɥɢɡɶ ± ɨɛɥɟɝɱɟɧɢɟ ɩɪɨɞɜɢɠɟɧɢɹ ɩɢɳɢ .

ɆɕɒȿɑɇȺə ɈȻɈɅɈɑɄȺ

ɫɥɨɹ ɦɟɠɞɭ ɧɢɦɢ ± ɝɚɧɝɥɢɣ ɦɟɠɦɵɲɟɱɧɨɝɨ ɧɟɪɜɧɨɝɨ ɫɩɥɟɬɟɧɢɹ

ɇɚɪɭɠɧɵɣ ɫɥɨɣ ± ɫɨɟɞɢɧɢɬɟɥɶɧɚɹ ɬɤɚɧɶ ± ɚɞɜɟɧɬɢɰɢɹ Ƚɚɧɝɥɢɣ ɥɟɠɢɬ ɜ ɚɞɜɟɧɬɢɰɢɚɥɶɧɨɣ ɨɛɨɥɨɱɤɟ ȿɫɥɢ ɫɨɟɞɢɧɢɬɟɥɶɧɚɹ ɬɤɚɧɶ ɩɨɤɪɵɜɚɟɬɫɹ ɦɟɡɨɬɟɥɢɟɦ ɬɨ ɷɬɨ ɛɭɞɟɬ ɫɟɪɨɡɚ ɉɢɳɟɜɨɞ ɢɦɟɟɬ ɫɟɪɨɡɭ ɦɚɥɟɧɶɤɢɣ ɤɭɫɨɱɟɤ ± ɩɪɨɛɨɞɚɟɬ ɞɢɚɮɪɚɝɦɭ ɢ ɢ ɭɯɨɞɢɬ ɜ ɛɪɸɲɧɭɸ ɩɨɥɨɫɬɶ - ɋȿɊɈɁɇȺə ɈȻɈɅɈɑɄȺ

Ʉɪɨɜɟɧɨɫɧɵɟ ɫɨɫɭɞɵ ɩɪɢɫɭɬɫɬɜɭɸɬ ɜɨ ɜɫɟɯ ɨɛɨɥɨɱɤɚɯ ɫɚɦɵɟ ɤɪɭɩɧɵɟ ± ɜ ɩɨɞɫɥɢɡɢɫɬɨɣ ȼ ɫɥɢɡɢɫɬɨɣ ɨɛɨɥɨɱɤɟ ɫɨɫɭɞɵ ɩɪɢɧɚɞɥɟɠɚɬ ɦɢɤɪɨɰɢɪɤɭɥɹɬɨɪɧɨɦɭ ɪɭɫɥɭ ȿɫɥɢ ɹɡɜɚ ɜ ɫɥɢɡɢɫɬɨɣ ɬɨ ɤɪɨɜɢɬ ɧɟɦɧɨɝɨ ɚ ɟɫɥɢ ɜ ɩɨɞɫɥɢɡɢɫɬɨɣ ɬɨ ɦɨɠɟɬ ɪɚɡɪɭɲɢɬɶ ɤɪɭɩɧɵɟ ɫɨɫɭɞɵ -> ɤɪɨɜɨɬɟɱɟɧɢɟ ɉɪɨɛɨɞɧɚɹ ɹɡɜɚ ± ɬɨɥɶɤɨ ɜ ɩɨɞɫɥɢɡɢɫɬɨɣ

ɊɈɌɈȼȺə ɉɈɅɈɋɌɖ

ɈɋɈȻȿɇɇɈɋɌɂ ɋɌɊɈȿɇɂə ɊɈɌɈȼɈɃ ɉɈɅɈɋɌɂ

xɗɩɢɬɟɥɢɣ ± ɦɧɨɝɨɫɥɨɣɧɵɣ ɩɥɨɫɤɢɣ ɱɚɫɬɢɱɧɨ ɨɪɨɝɨɜɟɜɚɸɳɢɣ ɥɢɲɶ ɜ ɧɟɤɨɬɨɪɵɯ ɦɟɫɬɚɯ ɜɟɪɯɧɹɹ ɩɨɜɟɪɯɧɨɫɬɶ ɹɡɵɤɚ ɬɜɟɪɞɨɟ ɧɟɛɨ ɜ ɨɛɥɚɫɬɢ ɞɟɫɧɵ ɤɪɚɫɧɚɹ ɤɚɣɦɚ ɝɭɛ ɷɤɬɨɞɟɪɦɚɥɶɧɨɝɨ ɩɪɨɢɫɯɨɠɞɟɧɢɹ

xɈɪɬɨɤɟɪɚɬɨɡ ± ɞɟɫɤɜɚɦɚɰɢɹ ɫɥɭɳɢɜɚɧɢɟ ɪɨɝɨɜɵɯ ɱɟɲɭɟɤ

xɉɚɪɚɤɟɪɚɬɨɡ ± ɜ ɩɨɜɟɪɯɧɨɫɬɧɨɦ ɫɥɨɟ ɧɟ ɪɨɝɨɜɵɟ ɱɟɲɭɣɤɢ ɚ ɦɟɪɬɜɵɟ ɤɥɟɬɤɢ ɫ ɹɞɪɚɦɢ ɷɬɨ ɧɨɪɦɚ ɞɥɹ ɪɨɬɨɜɨɣ ɩɨɥɨɫɬɢ ɩɚɬɨɥɨɝɢɹ ± ɞɥɹ ɤɨɠɢ

xɉɨɞɫɥɢɡɢɫɬɚɹ ± ɜ ɧɟɤɨɬɨɪɵɯ ɭɱɚɫɬɤɚɯ ɟɫɬɶ ɬɜɟɪɞɨɟ ɧɟɛɨ ɚ ɜ ɧɟɤɨɬɨɪɵɯ ɧɟɬɞɟɫɧɚ

xɋɤɟɥɟɬɧɚɹ ɦɵɲɟɱɧɚɹ ɬɤɚɧɶ ± ɟɸ ɨɛɪɚɡɨɜɚɧɚ ɦɵɲɟɱɧɚɹ ɨɛɨɥɨɱɤɚ

xɇɚɪɭɠɧɚɹ ɨɛɨɥɨɱɤɚ ɤɚɤ ɬɚɤɨɜɚɹ ɨɬɫɭɬɫɬɜɭɟɬ ȿɟ ɫɨɟɞɢɧɢɬɟɥɶɧɚɹ ɬɤɚɧɶ ɜɧɟɞɪɹɟɬɫɹ ɦɟɠɞɭ ɦɵɲɟɱɧɵɦɢ ɩɭɱɤɚɦɢ

xɆɧɨɝɨ ɦɟɥɤɢɯ ɫɥɸɧɧɵɯ ɠɟɥɺɡ ɳɺɤɢ ɝɭɛɵ ɹɡɵɤ ɢ ɬɞ ɋɥɸɧɧɵɟ ɠɟɥɟɡɵ ɨɛɵɱɧɨ ɪɚɫɩɨɥɚɝɚɸɬɫɹ ɦɟɠɞɭ ɩɭɱɤɚɦɢ ɦɵɲɰ ɢɥɢ ɜ ɩɨɞɫɥɢɡɢɫɬɨɣ.

xɏɨɪɨɲɨ ɪɚɡɜɢɬɚɹ ɥɢɦɮɨɢɞɧɚɹ ɬɤɚɧɶ ɥɢɦɮɨɷɩɢɬɟɥɢɚɥɶɧɨɟ ɝɥɨɬɨɱɧɨɟ ɤɨɥɶɰɨ ± ɦɢɧɞɚɥɢɧɵ

ɉɊȿɉȺɊȺɌ ± əɁɕɄ

-ɧɢɬɟɜɢɞɧɵɟ ɫɨɫɨɱɤɢ

-ɫɨɫɨɱɤɢ ± ɜɵɪɨɫɬɵ ɫɥɢɡɢɫɬɨɣ

-ɷɩɢɬɟɥɢɣ ɧɢɬɟɜɢɞɧɵɯ ɫɨɫɨɱɤɨɜ ± ɨɪɨɝɨɜɟɜɚɸɳɢɣ -> ɜ ɧɢɯ ɧɟɬ ɜɤɭɫɨɜɵɯ ɩɨɱɟɤ

-ɫɨɛɫɬɜɟɧɧɚɹ ɩɥɚɫɬɢɧɤɚ ɫɥɢɡɢɫɬɨɣ ɫɪɚɡɭ ɥɟɠɢɬ ɧɚ ɦɵɲɟɱɧɨɣ

-ɧɢɠɧɹɹ ɩɨɜɟɪɯɧɨɫɬɶ ɝɥɚɞɤɚɹ ɫɨɫɨɱɤɨɜ ɧɟɬ ɩɨɤɪɵɬɚ ɧɟɨɪɨɝɨɜɟɜɚɸɳɢɦ ɷɩɢɬɟɥɢɟɦ, ɦɵɲɟɱɧɚɹ ɩɥɚɫɬɢɧɤɚ ɨɬɫɭɬɫɬɜɭɟɬ

-ɛɨɥɶɲɢɟ ɜɟɧɵ ± ɜ ɩɨɞɫɥɢɡɢɫɬɨɣ ɧɢɠɧɟɣ ɩɨɜɟɪɯɧɨɫɬɢ ɹɡɵɤɚ ɩɪɢɠɚɬɵ ɤ ɦɵɲɰɚɦ

ЁI. Ё

Ɏɭɧɤɰɢɢ ɜɧɭɬɪɢɞɨɥɶɤɨɜɵɯ ɩɪɨɬɨɤɨɜ

xɌɪɚɧɫɩɨɪɬɢɪɭɸɬ ɫɟɤɪɟɬ ɢɡ ɚɰɢɧɭɫɚ ɞɚɥɶɲɟ

xɍɱɚɫɬɜɭɸɬ ɜ ɞɨɪɚɛɨɬɤɟ ɫɥɸɧɵ ɤɨɧɰɟɧɬɪɢɪɭɸɬ ɫɥɸɧɭ ɪɟɝɭɥɢɪɭɸɬ ɩɨɬɧɵɣ ɫɨɫɬɚɜ

xɊɟɝɭɥɢɪɭɸɬ ɤɚɦɛɢɚɥɶɧɭɸ ɡɨɧɭ ɜɨ ɜɧɭɬɪɢɞɨɥɶɤɨɜɵɯ ɩɪɨɬɨɤɚɯ ɪɚɫɩɨɥɚɝɚɟɬɫɹ ɤɚɦɛɢɣ

xɌɚɦ ɷɧɞɨɤɪɢɧɧɵɟ ɤɥɟɬɤɢ ɞɢɮɮɭɡɧɨɣ ɫɢɫɬɟɦɵ ɫɟɤɪɟɬɢɪɭɸɬ ɪɚɡɥɢɱɧɵɟ ɝɨɪɦɨɧɵ

xɌɪɚɧɫɩɨɪɬɢɪɭɸɬ ɢɦɦɭɧɨɝɥɨɛɭɥɢɧɵ ɜ ɫɥɸɧɭ ± ɷɬɚ ɮɭɧɤɰɢɹ ɩɪɢɫɭɳɚ ɫɟɪɨɡɧɵɦ ɤɨɧɰɟɜɵɦ ɨɬɞɟɥɚɦ Ɉɧɢ ɫɟɤɪɟɬɢɪɭɸɬ ɫɩɟɰ ɝɥɢɤɨɩɪɨɬɟɢɧ-ɩɟɪɟɧɨɫɱɢɤ ɢɦɦɭɧɨɝɥɨɛɭɥɢɧɚ ɱɟɪɟɡ ɰɢɬɨɩɥɚɡɦɭ ɤɥɟɬɨɤ ɜ ɫɥɸɧɭ

ȼɫɬɚɜɨɱɧɵɣ ɩɪɨɬɨɤ ± ɧɚɱɚɥɶɧɵɣ ɟɫɥɢ ɫɟɪɨɡɧɵɣ ɤɨɧɰɟɜɨɣ ɨɬɞɟɥ ɬɨ ɜɫɬɚɜɨɱɧɵɣ ɩɭɬɶ ɚ ɟɫɥɢ ɫɦɟɲɚɧɧɵɣ ɢɥɢ ɫɥɢɡɢɫɬɵɣ ɬɨ ɜɫɬɚɜɨɱɧɵɣ ɩɪɟɜɪɚɳɚɟɬɫɹ ɜ ɫɥɢɡɢɫɬɵɟ ɤɥɟɬɤɢ ɨɫɥɢɡɧɹɟɬɫɹ Ʉɥɟɬɤɢ ɤɭɛɢɱɟɫɤɢɟ ɰɢɬɨɩɥɚɡɦɚ ɛɚɡɨɮɢɥɶɧɚ ɦɢɨɷɩɢɬɟɥɢɣ ɩɪɢɫɭɬɫɬɜɭɟɬ ɜɫɬɚɜɨɱɧɵɣ ɩɪɨɬɨɤ ɩɨɦɨɝɚɟɬ ɜɵɞɟɥɟɧɢɸ ɫɟɤɪɟɬɚ

ȼɫɬɚɜɨɱɧɵɣ ɩɪɨɬɨɤ ± ɤɚɦɛɢɚɥɶɧɚɹ ɡɨɧɚ ɢɦɟɟɬɫɹ ɬɚɦ ɤɚɦɛɢɣ ɢ ɞɥɹ ɚɰɢɧɭɫɨɜ ɢ ɞɥɹ ɩɪɨɬɨɤɨɜ ȼɫɬɚɜɨɱɧɵɣ ɩɟɪɟɯɨɞɢɬ ɜ ɫɥɟɞɭɸɳɢɣ ɲɢɪɨɤɢɣ

ɂɫɱɟɪɱɟɧɧɵɣ ɩɪɨɬɨɤ

ɂɫɱɟɪɱɟɧɧɨɫɬɶ ± ɩɨɬɨɦɭ ɱɬɨ ɭ ɤɥɟɬɨɤ ɟɫɬɶ ɛɚɡɚɥɶɧɚɹ ɢɫɱɟɪɱɟɧɧɨɫɬɶ

Ʉɥɟɬɤɚ ɥɟɠɢɬ ɧɚ ɛɚɡɚɥɶɧɨɣ ɦɟɦɛɪɚɧɟ ɢ ɭ ɧɟɟ ɩɥɚɡɦɨɥɟɦɦɚ ɨɛɪɚɡɭɟɬ ɫɤɥɚɞɤɢ ± ɞɥɹ ɭɜɟɥɢɱɟɧɢɹ ɩɥɨɳɚɞɢ

Ɇɟɠɞɭ ɫɤɥɚɞɤɚɦɢ ± ɦɢɬɨɯɨɧɞɪɢɢ ɢ ɥɟɠɚɬ ɜɟɪɬɢɤɚɥɶɧɨ -> ɬɪɚɧɫɩɨɪɬ ɚɤɬɢɜɧɵɣ

ɂɫɱɟɪɱɟɧɧɵɣ ɩɪɨɬɨɤ ɤɨɧɰɟɧɬɪɢɪɭɟɬ ɫɥɸɧɭ ɧɚɤɚɱɢɜɚɸɬ ɫɥɸɧɭ ɤɚɥɢɣ ɛɢɤɚɪɛɨɧɚɬɵ ɡɚɛɢɪɚɸɬ ɢɡ ɫɥɸɧɵ ɧɚɬɪɢɣ ɯɥɨɪ ± ɚɤɬɢɜɧɨ ɢɞɟɬ ɬɪɚɧɫɩɨɪɬ ɱɟɪɟɡ ɚɩɢɤɚɥɶɧɵɣ ɤɨɧɟɰ

ɆɂɇȾȺɅɂɇȺ

Ɍɚɤɨɣ ɨɪɝɚɧ ɜ ɤɨɬɨɪɨɦ ɥɢɦɮɨɰɢɬɵ ɡɚɫɟɥɹɸɬ ɫɥɢɡɢɫɬɭɸ ɨɛɨɥɨɱɤɭ ɢ ɨɛɪɚɡɭɸɬ ɬɚɦ ɥɢɦɮɨɢɞɧɭɸ ɬɤɚɧɶ Ʌɢɦɮɨɢɞɧɚɹ ɬɤɚɧɶ ± ɫɬɪɨɦɚ ɢ ɪɚɡɜɢɜɚɸɳɢɟɫɹ ɥɢɦɮɨɰɢɬɵ ȼ ɞɚɧɧɨɦ ɫɥɭɱɚɟ ɫɬɪɨɦɚ ± ɷɬɨ ɜɫɹ ɫɥɢɡɢɫɬɚɹ

əɡɵɱɧɚɹ ɦɢɧɞɚɥɢɧɚ ɭ ɧɟɺ ɤɪɢɩɬɚ ɜɨɤɪɭɝ ɧɟɺ ɜɫɟ ɡɚɫɟɥɹɟɬɫɹ ɥɢɦɮɨɰɢɬɚɦɢ ɗɩɢɬɟɥɢɣ ɫɬɚɧɨɜɢɬɫɹ ɢɧɮɢɥɶɬɪɢɪɨɜɚɧɧɵɦ ɫɨɟɞɢɧɢɬɟɥɶɧɵɟ ɬɤɚɧɢ ɨɛɪɚɡɭɸɬɫɹ ɮɨɥɥɢɤɭɥɨɣ ɦɟɠɞɭ ɮɨɥɥɢɤɭɥɚɦɢ ɬɨɠɟ ɜɫɺ ɢɧɮɢɥɶɬɪɨɜɚɧɨ ɢ ɷɩɢɬɟɥɢɣ ɢ ɫɨɟɞɢɧɢɬɟɥɶɧɚɹ ɬɤɚɧɶ ɜɨɤɪɭɝ ɨɛɪɚɡɭɟɬɫɹ ɤɚɩɫɭɥɤɚ ɦɢɧɞɚɥɢɧɵ ± ɢɧɤɚɩɫɭɥɢɪɨɜɚɧɧɵɟ ɨɛɪɚɡɨɜɚɧɢɹ

Ɏɨɥɥɢɤɭɥɵ ± ȼ-ɡɚɜɢɫɢɦɚɹ ɡɨɧɚ ɜɨɤɪɭɝ ɮɨɥɥɢɤɭɥ ± Ɍ-ɡɨɧɚ

ɗɦɚɥɟɜɵɣ ɨɪɝɚɧ

ɂɡ ɷɩɢɬɟɥɢɹ ɪɨɬɨɜɨɣ ɩɨɥɨɫɬɢ ɨɛɪɚɡɭɟɬɫɹ ɫɬɪɭɤɬɭɪɵ ɧɚɩɨɞɨɛɢɟ ɲɚɩɨɱɤɢ ɭ ɧɢɯ ɟɫɬɶ ɧɚɪɭɠɧɵɣ ɷɩɢɬɟɥɢɣ ɦɚɥɵɣ ɷɩɢɬɟɥɢɣ ɩɨ ɦɚɥɨɣ ɤɪɢɜɢɡɧɟ - ɩɭɥɶɩɚ ɜɧɭɬɪɢ ɗɦɚɥɟɜɵɣ ɨɪɝɚɧ ɫɬɢɦɭɥɢɪɭɟɬ ɦɟɡɟɧɯɢɦɭ ɨɧɚ ɪɚɫɬɟɬ ɜɧɭɬɪɶ ɫɨɫɨɱɤɚɦɢ ɢ ɨɤɪɭɠɚɟɬ ɜɫɟ ɷɬɢ ɨɛɪɚɡɨɜɚɧɢɹ ɤɚɩɫɭɥɨɣ ± ©ɦɟɲɨɱɟɤª Ɍɨɥɶɤɨ ɷɦɚɥɟɜɵɣ ɨɪɝɚɧ ɛɭɞɟɬ ɭɱɚɫɬɜɨɜɚɬɶ ɜ ɨɛɪɚɡɨɜɚɧɢɢ ɷɦɚɥɢ ɜɫɟ ɨɫɬɚɥɶɧɨɟ ɨɛɪɚɡɭɟɬɫɹ ɢɡ ɦɟɡɟɧɯɢɦɵ ɢɡ ɫɨɫɨɱɤɨɜ ɮɨɪɦɢɪɭɟɬɫɹ ɩɭɥɶɩɚ ɢ ɞɟɧɬɢɧ ɢɡ ɦɟɲɨɱɤɚ ± ɰɟɦɟɧɬ ɢ ɩɟɪɢɨɞɨɧɬɚɥɶɧɚɹ ɫɜɹɡɤɚ.

Ɍɪɢ ɷɬɚɩɚ ɪɚɡɜɢɬɢɹ ɡɭɛɨɜ

-ɩɟɪɢɨɞ ɡɚɤɥɚɞɤɢ ɢ ɨɛɪɚɡɨɜɚɧɢɹ ɡɭɛɧɵɯ ɡɚɱɚɬɤɨɜ -ɩɟɪɢɨɞ ɞɢɮɮɟɪɟɧɰɢɪɨɜɤɢ ɡɭɛɧɵɯ ɡɚɱɚɬɤɨɜ -ɝɢɫɬɨɝɟɧɟɡ ɡɭɛɧɵɯ ɬɤɚɧɟɣ

ɇɚɪɭɠɧɵɟ ɤɥɟɬɤɢ ɩɭɥɶɩɵ ɭɱɚɫɬɜɭɸɬ ɜ ɨɛɪɚɡɨɜɚɧɢɢ ɤɭɬɢɤɭɥɵ ɷɦɚɥɢ ɤɨɬɨɪɚɹ ɛɵɫɬɪɨ ɫɬɢɪɚɟɬɫɹ

ɉɨɞɫɥɢɡɢɫɬɚɹ

-ɫɨɫɭɞɵ -ɝɚɧɝɥɢɣ ɩɨɞɫɥɢɡɢɫɬɨɝɨ -ɝɨ ɫɩɥɟɬɟɧɢɹ

-ɥɢɦɮɨɢɞɧɵɣ ɭɡɟɥɨɤ ɜɟɪɯɭɲɤɚ ɩɨɩɚɞɚɟɬ ɜ ɫɥɢɡɢɫɬɭɸ ɨɬɬɭɞɚ ɚɧɬɢɝɟɧɵ ɚ ɨɫɧɨɜɚɧɢɟ ɫɩɭɫɤɚɟɬɫɹ ɜ ɩɨɞɫɥɢɡɢɫɬɭɸ

Ɇɵɲɟɱɧɚɹ

ɫɥɨɹ ɦɟɠɞɭ ɧɢɦɢ ɝɚɧɝɥɢɣ ɦɟɠɦɵɲɟɱɧɨɝɨ ɫɩɥɟɬɟɧɢɹ

ɋɟɪɨɡɚ

ȼɧɭɬɪɟɧɧɢɣ ɥɢɫɬɨɤ ɛɪɸɲɢɧɵ ɹɞɪɚ ɦɟɡɨɬɟɥɢɹ Ʉɥɟɬɨɱɧɵɣ ɫɨɫɬɚɜ ɷɩɢɬɟɥɢɹ ɜɨɪɫɢɧɵ - ɢ ɤɪɢɩɬ -5):

1)Ƚɥɚɜɧɵɟ ɤɥɟɬɤɢ ± ɤɚɟɦɱɚɬɵɟ ɷɧɬɟɪɨɰɢɬɵ

2)Ȼɨɤɚɥɨɜɢɞɧɵɟ ɤɥɟɬɤɢ

3)ɗɧɞɨɤɪɢɧɧɵɟ ɷɧɞɨɤɪɢɧɨɰɢɬɵ

4)ɉɪɨɦɟɠɭɬɨɱɧɵɟ ɤɚɦɛɢɣ

5)Ʉɥɟɬɤɢ ɉɚɧɟɬɚ ɫ ɚɰɢɞɨɮɢɥɶɧɨɣ ɡɟɪɧɢɫɬɨɫɬɶɸ ± ɢɫɤɥɸɱɟɧɨ ɜ ɞɨɧɵɲɤɟ ɤɪɢɩɬ

ȼ ɝɪɚɧɭɥɚɯ ɷɬɢɯ ɤɥɟɬɨɤ ± ɛɚɤɬɟɪɢɰɢɞɧɵɟ ɜɟɳɟɫɬɜɚ ɢ ɞɢɩɟɩɬɢɞɚɡɚ ± ɮɟɪɦɟɧɬ ɪɚɫɳɟɩɥɟɧɢɹ ɛɟɥɤɨɜ Ɏɭɧɤɰɢɢ ɤɥɟɬɨɤ ɉɚɧɟɬɚ ± ɪɟɝɭɥɢɪɭɸɬ ɢɧɬɟɫɬɟɧɚɥɶɧɭɸ ɮɥɨɪɭ ɢ ɭɱɚɫɬɜɭɸɬ ɪɚɫɳɟɩɥɟɧɢɢ ɛɟɥɤɨɜ

ɋɢɫɬɟɦɚ ɜɨɪɫɢɧɤɚ-ɤɪɢɩɬɚ

Ʉɪɢɩɬɵ ɨɛɫɥɭɠɢɜɚɸɬ ɜɨɪɫɢɧɤɢ ɨɧɢ ɭɱɚɫɬɜɭɸɬ ɜ ɜɨɫɫɬɚɧɨɜɥɟɧɢɢ ɷɩɢɬɟɥɢɹ ɩɨɷɬɨɦɭ ɫɨɫɬɚɜɥɹɟɬ ɫ ɧɢɦɢ ɟɞɢɧɨɟ ɰɟɥɨɟ ± ɫɢɫɬɟɦɭ

ɀɟɥɟɡɵ ɜ ɩɨɞɫɥɢɡɢɫɬɨɣ ɨɫɧɨɜɟ ɟɫɬɶ ɜ ɩɢɳɟɜɨɞɟ ɢ - ɩɟɪɫɬɧɨɣ ɤɢɲɤɟ

Ʉɪɢɩɬɚ ± ɇȿ ɀȿɅȿɁȺ ɉɨɬɨɦɭ ɱɬɨ ɧɟɬ ɫɟɤɪɟɬɚ ȼ -ɩɟɪɫɬɧɨɣ ɤɢɲɤɟ ɟɫɬɶ ɠɟɥɟɡɵ Ȼɪɭɧɧɟɪɚ -> ɫɟɤɪɟɬɢɪɭɸɬ ɫɥɢɡɢɫɬɵɣ ɫɟɤɪɟɬ ɨɫɧɨɜɧɚɹ ɮɭɧɤɰɢɹ ± ɡɚɳɟɥɚɱɢɜɚɬɶ ɤɢɫɥɵɣ ɯɢɦɭɫ

ɗɧɞɨɤɪɢɧɨɰɢɬɵ

ɗɬɢ ɤɥɟɬɤɢ ɩɪɢɧɚɞɥɟɠɚɬ ɤ ɞɢɮɮɭɡɧɨɣ ɷɧɞɨɤɪɢɧɧɨɣ ɫɢɫɬɟɦɟ ɱɚɫɬɶ ɷɬɢɯ ɤɥɟɬɨɤ ɪɚɡɜɢɜɚɟɬɫɹ ɢɡ ɧɟɪɜɧɨɝɨ ɝɪɟɛɧɹ ɍɱɟɧɵɣ ɉɢɪɫ ɨɛɴɟɞɢɧɢɥ ɢɯ ɜ ©APUDª ɫɢɫɬɟɦɭɨɛɪɚɡɭɸɬ ɛɟɥɤɨɜɵɟ ɝɨɪɦɨɧɵ Ɇɨɪɮɨɥɨɝɢɱɟɫɤɢ ɤɥɟɬɤɢ ɯɚɪɚɤɬɟɪɢɡɭɸɬɫɹ ɧɚɥɢɱɢɟɦ ɛɚɡɚɥɶɧɨɣ ɡɟɪɧɢɫɬɨɫɬɢ ɜ ɛɚɡɚɥɶɧɨɦ ɩɨɥɸɫɟ ± ɝɪɚɧɭɥɵ ɫɟɤɪɟɬɚ Ʉɥɟɬɤɢ ɜɵɹɜɥɹɸɬɫɹ ɧɢɬɪɚɬɨɦ ɫɟɪɟɛɪɚ ɫɨɥɹɦɢ ɯɪɨɦɚ ± ɯɪɨɦɨɮɢɥɶɧɵɟ ɤɥɟɬɤɢ Ʉɥɟɬɨɤ ɷɬɢɯ ɦɧɨɝɨɜ ɨɛɨɡɧɚɱɚɸɬɫɹ ɛɭɤɜɚɦɢ ɇɚɩɪɢɦɟɪ ɤɥɟɬɤɚ S ± ɨɛɪɚɡɭɟɬ ɫɨɦɚɬɨɫɬɚɬɢɧ Ʉɥɟɬɤɚ G ± ɝɚɫɬɪɢɧ ɢ ɬɞ

Ɏɭɧɤɰɢɢ ɷɧɞɨɤɪɢɧɨɰɢɬɨɜ

Ʌɨɤɚɥɶɧɚɹ ɪɟɝɭɥɹɰɢɹ ɩɪɨɰɟɫɫɚ ɜɵɞɟɥɢɥɢ ɢ ɬɭɬ ɠɟ ɞɟɣɫɬɜɭɸɬ ɚ ɦɨɝɭɬ ɩɨɩɚɞɚɬɶ ɜ ɤɪɨɜɶ ɢ ɞɟɣɫɬɜɨɜɚɬɶ ɧɚ ɩɟɱɟɧɶ ɠɟɥɭɞɨɤ ɠɟɥɱɧɵɣ ɩɭɡɵɪɶ ɨɛɴɟɞɢɧɹɹ ɨɪɝɚɧɵ ɜ ɤɨɦɩɥɟɤɫɵ ɤɨɬɨɪɵɟ ɪɚɛɨɬɚɸɬ ɧɚɞ ɟɞɢɧɨɣ ɮɭɧɤɰɢɨɧɚɥɶɧɨɣ ɡɚɞɚɱɟɤ Ɇɨɝɭɬ ɞɚɬɶ ɧɚɱɚɥɨ ɨɩɭɯɨɥɢ

Ɏɭɧɤɰɢɢ ɤɚɺɦɱɚɬɵɯ ɤɥɟɬɨɤ ɷɧɬɟɪɨɰɢɬɵ

1)ɉɪɢɫɬɟɧɨɱɧɨɟ ɩɢɳɟɜɚɪɟɧɢɟ ɮɟɪɦɟɧɬɵ ɫɟɤɪɟɬɢɪɭɸɬɫɹ ɫɚɦɨɣ ɤɥɟɬɤɨɣ ɧɚ ɩɨɜɟɪɯɧɨɫɬɶ ɦɢɤɪɨɜɨɪɫɢɧɨɤ

2)ȼɫɚɫɵɜɚɧɢɟ

3)Ɉɛɪɚɡɨɜɚɧɢɟ ɯɢɥɨɦɢɤɪɨɧɨɜ ɧɟɣɬɪɚɥɶɧɵɣ ɠɢɪ ɜ ɛɟɥɤɨɜɨɣ ɨɛɨɥɨɱɤɟ Ɉɧɢ ɜɫɚɫɵɜɚɸɬɫɹ ɜ ɥɢɦɮɭ ɬɨ ɟɫɬɶ ɥɢɦɮɚ ɫɨɞɟɪɠɢɬ ɤɚɩɟɥɶɤɢ ɠɢɪɚ ɨɤɪɭɠɟɧɧɵɟ ɛɟɥɨɱɧɨɣ ɨɛɨɥɨɱɤɨɣ -! ɝɭɫɬɚɹ ɥɢɦɮɚ -! ɝɥɚɞɤɢɟ ɦɵɲɰɵ ɫɨɤɪɚɳɚɹɫɶ ɩɨɦɨɝɚɸɬ ɟɟ ɞɜɢɝɚɬɶ

4)Ɍɪɚɧɫɩɨɪɬ Ig ɜ ɩɨɥɨɫɬɶ ɬɨɥɫɬɨɣ ɤɢɲɤɢ

Ɇ-ɤɥɟɬɤɚ ± ɷɩɢɬɟɥɢɚɥɶɧɚɹ ɤɥɟɬɤɚ ɪɚɫɩɨɥɚɝɚɟɬɫɹ ɩɨɜɟɪɯ ɥɢɦɮɨɢɞɧɵɯ ɭɡɟɥɤɨɜ ɚɧɬɢɝɟɧ ɩɪɟɡɟɧɬɢɪɭɸɳɚɹ ɤɥɟɬɤɚ

ɉɥɚɡɦɨɰɢɬɵ ± ɫɟɤɪɟɬɢɪɭɸɬ IgA.

ɗɧɬɟɪɨɰɢɬɵ ɬɪɚɧɫɩɨɪɬɢɪɭɸɬ ɷɬɢ ɢɦɦɭɧɨɝɥɨɛɭɥɢɧɵ ɜ ɩɪɨɫɜɟɬ ɤɢɲɟɱɧɢɤɚ.

ɌɈɅɋɌȺə ɄɂɒɄȺ

-Ɍɨɥɶɤɨ ɤɪɢɩɬɵ ɜɨɪɫɢɧ ɧɟɬ ɪɨɜɧɚɹ ɩɨɜɟɪɯɧɨɫɬɶ -ɏɨɪɨɲɨ ɪɚɡɜɢɬɚ ɥɢɦɮɨɢɞɧɚɹ ɬɤɚɧɶ ɬ ɤ ɦɧɨɝɨ ɛɚɤɬɟɪɢɣ ɜ ɬɨɥɫɬɨɣ ɤɢɲɤɟ

-ɗɩɢɬɟɥɢɣ ɬɚɤɨɣ ɠɟ ɤɚɤ ɢ ɜ ɬɨɧɤɨɣ ɤɢɲɤɟ ɨɞɧɨɫɥɨɣɧɵɣ ɩɪɢɡɦɚɬɢɱɟɫɤɢɣ ɤɚɺɦɱɚɬɵɣ ɧɨ ɜ ɷɩɢɬɟɥɢɢ ɩɪɟɨɛɥɚɞɚɸɬ ɛɨɤɚɥɨɜɢɞɧɵɟ ɤɥɟɬɤɢ ɧɟɬ ɤɥɟɬɨɤ ɉɚɧɟɬɚ ɚ ɜɫɟ ɨɫɬɚɥɶɧɵɟ ɟɫɬɶ

Т

Ɏɭɧɤɰɢɢ ɤɚɟɦɱɚɬɵɯ ɤɥɟɬɨɤ ɜ ɬɨɥɫɬɨɣ ɤɢɲɤɟ

1)ȼɫɚɫɵɜɚɧɢɟ ɜɨɞɵ ɬɚɤ ɤɚɤ ɧɭɠɧɨ ɢɡ ɯɢɦɭɫɚ ɫɞɟɥɚɬɶ ɤɚɥ

2)ȼɫɚɫɵɜɚɧɢɟ ɝɥɸɤɨɡɵ ɢɡ ɤɥɟɬɱɚɬɤɢ ɬɚɦ ɛɚɤɬɟɪɢɢ

ɉȿɑȿɇɖ

ɉɚɪɟɧɯɢɦɚ ± ɷɩɢɬɟɥɢɣ ɠɟɥɟɡɢɫɬɵɣ ɷɧɬɨɞɟɪɦɚɥɶɧɵɣ ɚ ɫɬɪɨɦɚ ± ɷɬɨ ɫɨɟɞɢɧɢɬɟɥɶɧɚɹ ɬɤɚɧɶ.

Ⱦɨɥɶɤɢ ɩɟɱɟɧɢ ɩɚɪɟɧɯɢɦɚ ɨɪɝɚɧɢɡɨɜɚɧɚ ɜ ɞɨɥɶɤɢ.

ɤɥɚɫɫɢɱɟɫɤɚɹ

со

Ɉɬɬɨɤ ɤɪɨɜɢ ɨɬ ɩɟɪɢɮɟɪɢɢ ɤ ɰɟɧɬɪɭ ɜ ɰɟɧɬɪ ɜɟɧɭ ɂɡ ɰɟɧɬɪɚɥɶɧɨɣ ɜɟɧɵ ɤɪɨɜɶ ɩɨɩɚɞɚɟɬ ɜ ɩɨɞɞɨɥɶɤɨɜɭɸ ->

ɜ ɜɟɧɭ hepatica -> ɜ ɧɢɠɧɸɸ ɩɨɥɭɸ ɜɟɧɭ

Ⱦɜɭɯɫɬɨɪɨɧɧɹɹ ɩɨɥɹɪɢɡɚɰɢɹ ɝɟɩɚɬɨɰɢɬɚ:

ȼɚɫɤɭɥɹɪɧɵɣ ɩɨɥɸɫ ± ɦɨɳɧɵɣ ɨɛɦɟɧ ɦɟɠɞɭ ɤɪɨɜɶɸ ɢ ɝɟɩɚɬɨɰɢɬɨɦ

Ȼɢɥɢɚɪɧɵɣ ɩɨɥɸɫ ± ɮɭɧɤɰɢɹ ± ɫɟɤɪɟɰɢɹ ɠɟɥɱɢ

Ɍɢɩ ɤɚɩɢɥɥɹɪɚ ± ɫɢɧɭɫɨɢɞɧɵɣ ɩɨɪɢɫɬɵɣ

ɉɥɨɬɧɵɟ ɤɨɧɬɚɤɬɵ ɡɚɤɪɵɜɚɸɬ ɠɟɥɱɧɵɟ ɤɚɩɢɥɥɹɪɵ ɦɟɠɤɥɟɬɨɱɧɵɟ ɳɟɥɢ ȿɫɥɢ ɨɧɢ ɡɚɤɪɵɬɵ ɠɟɥɱɶ ɧɟ ɩɨɩɚɞɟɬ ɜ ɤɪɨɜɶ

ɉɥɨɬɧɵɟ ɤɨɧɬɚɤɬɵ ɱɭɜɫɬɜɢɬɟɥɶɧɵ ɤ ɩɨɜɵɲɟɧɢɸ ɞɚɜɥɟɧɢɹ ɜ ɫɢɫɬɟɦɟ ȿɫɥɢ ɞɚɜɥɟɧɢɟ ɩɨɜɵɲɚɟɬɫɹ ɬɨ ɤɨɧɬɚɤɬɵ ɪɚɫɯɨɞɹɬɫɹ -> ɠɟɥɱɶ ɩɨɩɚɞɚɟɬ ɜ ɤɪɨɜɶ ©ɦɟɯɚɧɢɱɟɫɤɚɹ ɠɟɥɬɭɯɚª

ɉɪɨɫɬɪɚɧɫɬɜɨ Ⱦɢɫɫɟ ɜɨɤɪɭɝɫɢɧɭɫɨɢɞɧɨɟ ɩɪɨɫɬɪɚɧɫɬɜɨ ± ɜ ɧɟɦ ɧɚɯɨɞɢɬɫɹ ɚɦɨɪɮɧɵɣ ɤɨɦɩɨɧɟɧɬ ± ɪɟɬɢɤɭɥɹɪɧɵɟ ɜɨɥɨɤɧɚ - ɷɬɨ ɩɪɨɫɬɪɚɧɫɬɜɨ ± ɬɟɪɪɢɬɨɪɢɹ ɞɥɹ ɨɛɦɟɧɚ ɩɨ ɧɟɦɭ ɩɟɪɟɞɜɢɝɚɸɬɫɹ ɜɟɳɟɫɬɜɚ ɑɟɦ ɛɨɥɶɲɟ ɜɨɥɨɤɨɧ ɬɟɦ ɯɭɠɟ ɬɪɚɧɫɩɨɪɬ 2- ɷɬɨ ɡɚɦɟɧɚ ɥɢɦɮɚɬɢɱɟɫɤɢɦ ɤɚɩɢɥɥɹɪɚɦ - ɜ ɷɦɛɪɢɨɧɚɥɶɧɵɣ ɩɟɪɢɨɞ ɬɚɦ ɩɪɨɢɫɯɨɞɢɬ ɤɪɨɜɟɬɜɨɪɟɧɢɟ ɨɧɨ ɦɨɠɟɬ ɜɨɡɨɛɧɨɜɢɬɶɫɹ ɩɪɢ ɚɧɟɦɢɢ ɬɹɠɟɥɨɣ ɯɪɨɧɢɱɟɫɤɨɣ

ȼ ɩɟɱɟɧɨɱɧɨɣ ɛɚɥɤɟ-ɩɥɚɫɬɢɧɤɟ ɧɚɯɨɞɢɬɫɹ ɥɢɩɨɰɢɬ ɤɥɟɬɤɚ ɂɬɨ ɜ ɰɢɬɨɩɥɚɡɦɟ ɦɧɨɝɨ ɥɢɩɢɞɧɵɯ ɬɤɚɧɟɣ

Ɍɪɟɭɝɨɥɶɧɚɹ ɤɥɟɬɤɚ ȼɟɪɯɭɲɤɚ ɧɢɤɨɝɞɚ ɧɟ ɤɨɧɬɚɤɬɢɪɭɟɬ ɫ ɠɟɥɱɶɸ ɚ ɨɫɧɨɜɚɧɢɟ ɲɢɪɨɤɨɟ ɫɦɨɬɪɢɬ ɜ ɩɪɨɫɬɪɚɧɫɬɜɨ Ⱦɢɫɫɟ

Ɏɭɧɤɰɢɢ ɥɢɩɨɰɢɬɚ:

1)ɇɚɤɨɩɥɟɧɢɟ ɠɢɪɨɪɚɫɬɜɨɪɢɦɵɯ ɜɢɬɚɦɢɧɨɜ A/D/K.

2)ɋɟɤɪɟɰɢɹ ɜɨɥɨɤɨɧ ɢ ɚɦɨɪɮɧɨɝɨ ɤɨɦɩɨɧɟɧɬɚ ɱɟɪɟɡ ɲɢɪɨɤɨɟ ɨɫɧɨɜɚɧɢɟ ɜɵɞɟɥɹɸɬɫɹ ɜɟɳɟɫɬɜɚ ɜ ɩɪɨɫɬɪɚɧɫɬɜɨ Ⱦɢɫɫɟ

ȿɟ ɨɫɧɨɜɧɚɹ ɡɚɞɚɱɚ ± ɧɚɤɚɩɥɢɜɚɬɶ ɥɢɩɢɞɵ Ʉɥɟɬɤɚ ɢɝɪɚɟɬ ɤɥɸɱɟɜɭɸ ɪɨɥɶ ɩɪɢ ɪɚɡɜɢɬɢɢ ɰɢɪɪɨɡɚ ɜ ɫɥɭɱɚɟ ɚɥɤɨɝɨɥɶɧɨɣ ɢ ɧɚɪɤɨɬɢɱɟɫɤɨɣ ɡɚɜɢɫɢɦɨɫɬɢ ɜɫɟ ɷɬɨ ɛɶɟɬ ɩɨ ɥɢɩɨɰɢɬɭ ɱɬɨ ɨɧ ɫɜɨɢ ɥɢɩɢɞɧɵɟ ɤɚɩɥɢ ɜɵɛɪɚɫɵɜɚɟɬ ɢ ɩɪɟɨɛɪɚɡɭɟɬɫɹ ɜ ɧɚɫɬɨɹɳɢɣ ɮɢɛɪɨɛɥɚɫɬ ± ɦɢɨɮɢɛɪɨɛɥɚɫɬ ɬ ɟ ɫɩɨɫɨɛɧɵɣ ɫɨɤɪɚɳɚɬɶɫɹ -> ɫɟɤɪɟɬɢɪɭɟɬ ɜɨɥɨɤɧɚ -> ɜɨɥɨɤɧɚ ɜ ɩɪɨɫɬɪɚɧɫɬɜɨ Ⱦɢɫɫɟ -> ɧɚɪɭɲɚɟɬɫɹ ɮɭɧɤɰɢɹ ɝɟɩɚɬɨɰɢɬɚ ɫɩɨɫɨɛɟɧ ɫɨɤɪɚɳɚɬɶɫɹ ɢ ɭɦɟɧɶɲɚɬɶ ɩɪɨɫɬɪɚɧɫɬɜɨ ɫɢɧɭɫɨɢɞɚ -> ɩɨɜɵɲɚɟɬɫɹ ɞɚɜɥɟɧɢɟ

ɉɈȾɀȿɅɍȾɈɑɇȺə ɀȿɅȿɁȺ

ɋɥɨɠɧɚɹ ɪɚɡɜɟɬɜɥɟɧɧɚɹ ɚɥɶɜɟɨɥɹɪɧɚɹ ɠɟɥɟɡɚ ɨɛɪɚɡɭɸɳɚɹ ɛɟɥɤɨɜɵɣ ɫɟɤɪɟɬ ɗɬɢ ɛɟɥɤɢ

± ɩɢɳɟɜɵɟ ɮɟɪɦɟɧɬɵ

Ʉɨɧɰɟɜɵɟ ɨɬɞɟɥɵ ɚɰɢɧɭɫɵ

"

Lɋɬɪɨɦɚ ɞɟɥɢɬ ɠɟɥɟɡɭ ɧɚ ɞɨɥɶɤɢ Ʉɥɟɬɤɢ ɜɵɫɨɤɢɟ ɩɪɨɫɜɟɬ

ɩɪɚɤɬɢɱɟɫɤɢ ɧɟ ɜɢɞɟɧ Ⱥɩɢɤɚɥɶɧɚɹ ɱɚɫɬɶ ɰɢɬɨɩɥɚɡɦɵ ɨɤɫɢɮɢɥɶɧɚ ɨɫɬɚɥɶɧɚɹ ± ɛɚɡɨɮɢɥɶɧɚ ȼ ɛɚɡɨɮɢɥɶɧɨɣ

ɱɚɫɬɢ ɝɪɚɧ ɗɉɋ ɜ ɚɩɢɤɚɥɶɧɨɣ ɱɚɫɬɢ ± ɝɪɚɧɭɥɵ ɫɟɤɪɟɬɚ

.