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Year of Report or Document: 2003 Language(s): English, Mongolian
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Title: Annual research result book of 2002

ÝÌß ÄÝÌÁ

ÀÍÀÃÀÀÕ ÓÕÀÀÍÛ ÝÐÄÌÈÉÍ Á¯ÒÝÝËÈÉÍ ÒÎÂ×ÎÎÍ - 2002 ÎÍ
Ýìõýòãýæ, õÿíàí òîõèîëäóóëñàí Àíàãààõûí øèíæëýõ óõààíû äîêòîð Á. Áóðìàà

Òàëàðõàë
Ýíýõ¿¿ á¿òýýëèéí òîâ÷îîíûã ýìõýòãýí õýâë¿¿ëýõýä ñàíõ¿¿ãèéí äýìæëýã ¿ç¿¿ëñýí ÄÝÌÁ, ò¿¿íèé Ìîíãîë äàõü ñóóðèí òºëººëºã÷ íî¸í Ðîáåðò Õàãàí, ñóóðèí òºëººëºã÷èéí ãàçðûí õàìò îëîíä òàëàðõàëàà èëýðõèéëüå

Show details for ªÌͪà ¯ÃªÌͪà ¯Ã

Hide details for Á¯ËÝà I. ÍÈÉÃÌÈÉÍ ÝЯ¯Ë ÌÝÍÄÁ¯ËÝà I. ÍÈÉÃÌÈÉÍ ÝЯ¯Ë ÌÝÍÄ
Ä.Ýðæåí, Ö.Íàìñðàé, Ã.Ðýãçìàà, Ñ.Òóíãàëàã, Á.Ãýðýëæàðãàë, Ç.Àðèóíáèëýã
Íèéãìèéí ýð¿¿ë ìýíäèéí õ¿ðýýëýí

¯íäýñëýë Õ¿¿õäèéã õºõººð õîîëëîõ òàëààð ͯÁ-ààñ ºðí¿¿ëæ áàéãàà áîäëîãûã Äýëõèéí óëñ îðíóóä õýðýãæ¿¿ëæ îëîí îðîíä “Õ¿¿õäýä Ýýëòýé Ýìíýëýã”-¿¿ä áèé áîëñíîîð, áàãà íàñíû õ¿¿õäèéí ºâ÷ëºë ýíäýãäýë áóóðàõ, ýäèéí çàñãèéí õóâüä õýìíýëò ãàðãàõàä õóâü íýìðýý îðóóëñààð áàéíà.

Õºõ¿¿ë ýõèéí õºõíèé ñ¿¿íèé ãàðöàä ýõèéí õîîë òýæýýë, ñýòãýë ñàíààíû òàâã¿é áàéäàë, õ¿¿õäýý õºõ¿¿ëýõ àðãà áàðèë, õºõ¿¿ëýõ äàâòàìæ çýðýã îëîí õ¿÷èí ç¿éë íºëººëäºã áàéíà. Õºõíèé ñ¿¿íèé ãàðö õîîë òýæýýëýýñ õàìààðàëòàé ýñýõ íü ìàðãààíòàé øèéäýãäýýã¿é áàéãàà àñóóäëûí íýã þì.

Õàðèí õºõ¿¿ë ýõèéí õîîëëîëòûí áàéäëààñ õºõíèé ñ¿¿íèé ãàðö òîäîðõîé õýìæýýãýýð õàìààðäàã áîëîõûã îëîí îðîíä (Áèðì, Ãâàòåìàë, Èíäîíåç) òîãòîîñîí áàéäàã áºãººä æèðýìñýí áà õºõ¿¿ë ¿åä õîîë òýæýýëýýð àâàõ øèìò áîäèñ, àìèíäýì, ýðäýñ áîäèñûí áîëîí íýìýëò èë÷ëýãèéí õýðýãöýý çýðãèéã òóõàéí îðíû õ¿í àìûí îíöëîãò òîõèðóóëàí øèíæëýõ óõààíû ¿íäýñëýëòýéãýýð áîëîâñðóóëæýý.

Ìàíàé óëñàä Ö.Íàìñðàé (1996), Æ.Æàäàìáà (1991), Á.Ñ¿õáààòàð (1992), çýðýã ýðäýìòýä Ìîíãîë ýõèéí õºõíèé ñ¿¿íèé íàéðëàãûã îëîí òàëààñ íü ñóäàëñàí áàéíà. Õàðèí õºõíèé ñ¿¿íèé ÿëãàðàëòûí õýìæýý, õºõ¿¿ë ýõèéí õîîëëîëòîîñ õàìààðàõ áîëîí òýäãýýðèéí õàðèëöàà óÿëäààíû òàëààð õèéãäñýí ñóäàëãàà øèíæèëãýýíèé àæèë îäîîãîîð õàðààõàí ¿ã¿é áàéíà.
Èéìä äýýðõ àñóóäëûí íýã áîëîõ ýõèéí õºõíèé ñ¿¿íèé ãàðöûã õîîë òýæýýëèéí áàéäàëòàé õîëáîí ñóäëàõ øààðäëàãà ç¿é ¸ñîîð òàâèãäàæ áàéíà.

Ñóäàëãààíû àæëûí çîðèëãî: 1 õ¿ðòýëõ íàñíû õ¿¿õýäòýé õºõ¿¿ë ýõ÷¿¿äèéí ñ¿¿íèé ãàðöûã õîîë òýæýýëèéí áàéäàëòàé íü õîëáîí ñóäàëæ, ¿íýëãýý ºãºõ;
Ñóäàëãààíû àæëûí çîðèëò :
1. 1 õ¿ðòýëõ íàñíû õ¿¿õýäòýé õºõ¿¿ë ýõ÷¿¿äèéí õîîë õ¿íñýýð àâ÷ áàéãàà ¿íäñýí áîëîí øèìò áîäèñ, àìèíäýì, ýðäýñ áîäèñûí õîíîãèéí õýðýãëýýã òîãòîîõ.

2. Õºõ¿¿ë ýõèéí õîíîãèéí ñ¿¿íèé ãàðöûã òîîöîõ

Ñóäàëãààíû õ¿ðýý, àðãà ç¿é. Ñóäàëãààíä Óëààíáààòàð õîò, Óâñ, ªìíºãîâü, Õýíòèé, Äîðíîãîâü àéìãóóäûí 18-39 íàñíû íèéò 156 ýõ, õ¿¿õäèéã õàìðóóëàâ. Ýõ÷¿¿äèéí áîäèò õîîëëîëòûí áàéäëûã àñóóìæ, æèíãèéí àðãààð, õîíîãèéí õîîëíû õèìèéí íàéðëàãa, èë÷ëýãèéã òîîöîîíû àðãààð ñóäëàâ .
Õºõíèé ñ¿¿íèé ãàðöûã 24 öàãèéí õóãàöààíä õ¿¿õýä õºõ¿¿ëýõèéí ºìíº áîëîí õºõ¿¿ëñíèé äàðàà õýìæèõ, ¿ëäýãäýë ñ¿¿ã ñààëãàæ õýìæèõ àðãóóäààð ñóäàëãààã ÿâóóëàâ.

Ñóäàëãààíû àæëûí ãîë ¿ð ä¿í. Ãýðòýý õ¿¿õäýý àñðàí ºñãºæ áàéãàà õºõ¿¿ë ýõ÷¿¿äèéí õîíîãèéí èë÷ çàðöóóëàëò 3200 êêàë áàéõàä õîíîãò 2245,8 êêàë èë÷ëýã á¿õèé õîîë õýðýãëýæ áàéãàà íü çàðöóóëñàí èë÷èéí çºâõºí 70,2-èéã õîîë òýæýýëèéí èë÷ëýãýýð íºõºæ áàéíà.

Ñóäàëãààíä õàìðàãäñàí õºõ¿¿ë ýõ÷¿¿äèéí õîîë òýæýýëèéí èë÷ëýã, ýðäýñ, çàðèì òºðëèéí àìèíäýìèéí õýðýãëýý õàíãàëòã¿é, ÿëàíãóÿà àìèíäýì Â6 0,14 ìã, àìèíäýì Ñ 39 ìã, êàëüöè 302,5 ìã-èéã õîíîãò õîîë õ¿íñýýðýý àâ÷ áàéíà. Ýíý íü ñ¿¿, ñ¿¿í á¿òýýãäýõ¿¿í õ¿íñíèé íîãîîã õàíãàëòã¿é õýðýãëýæ áàéãààòàé õîëáîîòîé áàéæ áîëîõ þì.

Õàðèí àìèíäýìèéí õàíãàëò õºäººä õîòîîñ áàãà, ýðäýñ áîäèñ áóþó êàëüö, ôîñôîð, òºìðèéí õàíãàëò õºäººä õîòîîñ èë¿¿ áàéãàà íü ñ¿¿ ñ¿¿í á¿òýýãäýõ¿¿íèéã õºäººä õîòîîñ àõèó õýðýãëýæ áàéãàà íü õàðàãäàæ áàéíà.
Ñóäàëãààíä õàìðàãäñàí ýõ÷¿¿äèéí õºõíèé ñ¿¿íèé ãàðöûã òîäîðõîéëîõîä, 1 ñàðòõé õ¿¿õýäòýé õºõ¿¿ë ýõèéí õîíîãèéí ñ¿¿íèé ãàðö äóíäæààð 624,5 ìë, 2 ñàðòàéä 727,5 ìë, 3 ñàðòàéä – 861,9, 4 ñàðòàéä –778,6, 5 ñàðòàéä –750,6, 6 ñàðòàéä –724 ìë áàéëàà.

Õºõíèé ñ¿¿íèé ãàðö ýõèéí õîíîãèéí õîîëíû èë÷ëýãýýñ òîäîðõîé õýìæýýãýýð õàìààð÷ áàéíà. Òóõàéëáàë, 1037-2000 êêàë èë÷ëýãòýé õîîëûã õîíîãò õýðýãëýæ áàéãàà ýõèéí ñ¿¿íèé ãàðö 660 ìë áàéõàä, 2500- 3200 êêàë èë÷ëýãòýé õîîë õýðýãëýñýí ýõèéí ñ¿¿íèé ãàðö 872,5 ìë áàéâ.

Ä¿ãíýëò.

1. Õºõ¿¿ë ýõ÷¿¿äèéí õîíîãèéí õîîëíû õýðýãëýýíä ¿íäñýí øèìò áîäèñ áîëîí ýðäýñ, àìèíäýìèéí äóòàãäàë èëýð÷ áàéãàà íü õºõ¿¿ë ýõ÷¿¿äèéí õîîë õ¿íñíèé íýð òºðºë öººí, çîíõèëîí íýã òºðëèéí õîîë õýðýãëýæ áàéãààòàé õîëáîîòîé áàéíà.

2. Õºõíèé ñ¿¿íèé ãàðöûã ýõèéí õîîë òýæýýëèéí áàéäàëòàé õàðüöóóëàõàä (R=0.47) ñòàòèñòèê ìàãàäëàëòàé õàìààðàë àæèãëàãäñàí íü õºõ¿¿ë ýõèéí õîíîãèéí ñ¿¿íèé ãàðö ýõèéí õîîë òýæýýëèéí áàéäàëòàé õîëáîîòîé áîëîõûã õàðóóëæ áàéíà.

3.Ýíý ñóäàëãààíû ä¿íä õºõ¿¿ë ýõ÷¿¿äèéí õîîë õ¿íñíèé èë÷ëýãèéã íýìýãä¿¿ëýí ñàéæðóóëàõ àñóóäàë ºíººãèéí øèéäâýðëýõ àñóóäàë áîëîí òàâèãäàæ áàéíà.
Some results on impact maternal diet on breastmilk volume
G.Regzmaa, S.Tungalag, B.Gereljargal, Z.Ariunbileg
Nutrition Research Centre of the Public Health Institute

We surveyed how to influence diet of lactation mother on breastmilk volume. By our survey, showed consumes of the lactation mother much lower amounts of meat, butter, vegetables, and fruit, which are sources of vitamins and minerals, than the recommended dietery intake. The total dietery calorie of the diely nutrient intake of lactation mothers is 2245.8 kcal.
The diet of lactation mother related to milk volume.

Show details for Á¯ËÝà II. ÝÌÍÝË Ç¯ÉÍ ÀÍÀÃÀÀÕ ÓÕÀÀÍÁ¯ËÝà II. ÝÌÍÝË Ç¯ÉÍ ÀÍÀÃÀÀÕ ÓÕÀÀÍ
Show details for Á¯ËÝà III. ÁÈÎÀÍÀÃÀÀÕ ÓÕÀÀÍÁ¯ËÝà III. ÁÈÎÀÍÀÃÀÀÕ ÓÕÀÀÍ
Show details for Á¯ËÝà IV. ÝÌ Ç¯É, ÓËÀÌÆËÀËÒ ÀÍÀÃÀÀÕ ÓÕÀÀÍÁ¯ËÝà IV. ÝÌ Ç¯É, ÓËÀÌÆËÀËÒ ÀÍÀÃÀÀÕ ÓÕÀÀÍ
Hide details for Á¯ËÝà V. ÄÝÌÁ-ÛÍ ÑÀÍÕ¯¯ÆÈËÒÝÝÐ ÕÈÉÃÄÑÝÍ ÑÓÄÀËÃÀÀÁ¯ËÝà V. ÄÝÌÁ-ÛÍ ÑÀÍÕ¯¯ÆÈËÒÝÝÐ ÕÈÉÃÄÑÝÍ ÑÓÄÀËÃÀÀ
ÓËÀÀÍÁÀÀÒÀÐ ÕÎÒÛÍ ÍÀÑÒÀÍÃÓÓÄÛÍ ÀÌÜÑÃÀËÛÍ ÇÀÌÛÍ ªÂ×˪Ë, Ò¯¯ÍÄ ÍªËªªËÆ ÁÓÉ Õ¯×ÈÍ Ç¯ÉËÈÉÍ ÑÓÄÀËÃÀÀ
Æ.̺íõöýöýã, Ö.Öýðýãìàà, Á.Áóðìàà, Àíàãààõ óõààíû èõ ñóðãóóëü, Ýð¿¿ë ìýíäèéí ÿàì

Çîðèëãî. Óëààíáààòàð õîòûí íàñòàíãóóäûí àìüñãàëûí òîãòîëöîîíû ºâ÷ëºëèéí áàéäàë, á¿òýö, ò¿¿íä íºëººëæ áóé çàðèì õ¿÷èí ç¿éëèéã ñóäëàõ.

Ñóäàëãààã õèéñýí õóãàöàà, ãàçàð. Ñóäàëãààã 2002 îíû 3-ð ñàðààñ 2003 îíû 3 ñàðä Óëààíáààòàð õîòîä õèéæ ã¿éöýòãýñýí.

Ñóäàëãààíû àðãà. Óëààíáààòàð õîòûí íàñòàíãóóäûí ñ¿¿ëèéí 4 æèëèéí àìüñãàëûí òîãòîëöîîíû ºâ÷ëºëèéí áàéäàë, àãààðûí áîõèðäîëòûã ýðãýìæ ñóäàëãààãààð, 2002 îíû ºâ÷ëºëèéí áàéäëûã ñàíàìñàðã¿é ò¿¿âýðëýëòèéí àðãààð ñóäàëñàí. Ñàíàìñàðã¿é ò¿¿âýðëýëòýýð ñîíãîñîí íàñòàíãóóäàä àñóóëãûí àðãà, ìýðãýæëèéí ýì÷èéí ¿çëýã, ñïèðîìåòðèéí øèíæèëãýý õèéñýí.

Ñóäàëãààíû ¿ð ä¿í. Ñóäàëãààãààð Óëààíáààòàð õîòûí íàñòàíãóóäûí äóíä àìüñãàëûí ýðõòýí òîãòîëöîîíû ºâ÷èí 12,6% ýçëýæ áàéíà. Óëààíáààòàð õîòûí íàñòàíãóóäûí àìüñãàëûí òîãòîëöîîíû ºâ÷ëºë íü õîòûí àãààðûí áîõèðäîëòòîé øóóä äóíä çýðãèéí õàìààðàëòàé áàéãàà íü òîãòîîãäñîí. Õîòûí àãààðûí áîõèðäîëò æèëýýñ æèëä ñòàòèñòèê ìàãàäëàë á¿õèé èõñýæ áàéíà (p=0.05). Àãààðûí áîõèðäîëò ºâëèéí ñàðóóäàä çóíû ñàðààñ èë¿¿ èõ áàéãààã òîãòîîñîí (p=0.05).

Óëààíáààòàð õîòûí àìüñãàëûí ýìãýãòýé íàñòàíãóóäûí 91% íü àìüñãàëûí äîîä çàìûí ýìãýã, ò¿¿íèé äîòîð áºãëºðºëò õýëáýðèéí àìüñãàëûí äóòàãäàëä õ¿ðãýäýã ýìãýã äàâàìãàéëæ (88.79%) áàéíà. ¯¿íä àðõàã áðîíõèò, ãóóðñàí õîîëîéí áàãòðàà, ¿ðýâñýëò ºâ÷í¿¿ä çîíõèëæ áàéíà. Óëààíáààòàð õîòûí íàñòàíãóóäàä àìüñãàëûí òîãòîëöîîíû ýìãýã ¿¿ñýõýä òàìõè, äàñàë õºäºë㺺íèé õîìñäîë, àãààð ñàëõèíä ãàð÷ ÷àääàãã¿é áàéäàë áóñàä ºâ÷èí õàâñðàõ çýðýã íü ãîë íºëººëºõ õ¿÷èí ç¿éë áîëæ áàéíà.

Íàñòàíãóóäûí àìüñãàëûí òîãòîëöîîíû ýìãýã íü îëîí ºâ÷òýé õàâñàðàõ íü èõ áàéíà (93.6%). ¯¿íä ç¿ðõ ñóäàñ, Ẻð, øýýñ ÿëãàðóóëàõ çàì, ýëýã, öºñ, õîäîîä ãýäýñíèé ºâ÷èí èë¿¿òýé õàâñàð÷ ÿâàãäàæ áàéíà.

Óëààíáààòàð õîòûí íàñòàíãóóäûí àìüñãàëûí òîãòîëöîîíû ýìãýã¿¿ä íü 6, ò¿¿íýýñ îëîí æèë áîëñîí (72,5%), áàéíãà ñýäýð÷ äàõèäàã (100%), àðõàã øèíæòýé áàéíà.

Àìüñãàëûí òîãòîëöîîíû ýìãýãòýé íàñòàíãóóäûí ãîë çîâèóð øèíæ íü ºâºðìºö áóñ ÿäðàõ, áèå ñóëðàõ (88,5%) ÿâäàë çîíõèëæ ºâºðìºö øèíæ¿¿ä á¿äýã, áàãà èëýðäýã îíöëîãòîé áàéíà.

Íàñòàíãóóäûí ãàäààä àìüñãàëûè ¿éë àæèëëàãààíû ¿ç¿¿ëýëò òàìõè òàòäàã íàñòàí, ýìýãòýé÷¿¿äýä èë¿¿ èõ áóóð÷ áàéíà (p<0.05).

Ä¿ãíýëò:

1. Óëààíáààòàð õîòûí (ÑÁÄ, ÑÕÄ) íàñòàíãóóäûí àìüñãàëûí òîãòîëöîîíû ºâ÷ëºë ñ¿¿ëèéí 4 æèëèéí ýìíýëýãò õýâòýãñäèéí ýðãýìæ ñóäàëãààãààð 1000 õ¿íä 21,6 áàéíà. Àìüñãàëûí òîãòîëöîîíû ºâ÷òýé íàñòàíãóóäûã ýìíýëýãò õýâòýõýä õ¿ðãýæ áóé ãîë ºâ÷èí íü Ãóóðñàí õîîëîéí àðõàã ¿ðýâñýë (áðîíõèò), óóøãèíû ¿ðýâñýë, ãóóðñàí õîîëîéí áàãòðàà ºâ÷èí áàéíà. Íàñòàíãóóäûí ºâ÷ëºëèéí á¿òýö ñóäàëãàà õèéñýí 2 ä¿¿ðýãò ÿëãààòàé áàéíà. ÑÁÄ-ò ãóóðñàí õîîëîéí áàãòðàà ãîëëîæ áàéõàä, ÑÕÄ-ò ãóóðñàí õîîëîéí àðõàã ¿ðýâñýë äàâàìãàéëæ áàéíà (p< 0.001).

2. Óëààíáààòàð õîòûí ñóäàëãààíä õàìðàãäñàí Ñ¿õáààòàð, Ñîíãèíîõàéðõàí ä¿¿ðãèéí àãààðûí áîõèðäîëò æèë á¿ð èõñýæ áàéíà. 2 ä¿¿ðãèéã õàðüöóóëñàí ä¿íãýýñ ¿çýõýä Ñ¿õáààòàð ä¿¿ðýãò Ñîíãèíîõàéðõàí ä¿¿ðãýýñ ñòàòèñòèê ìàãàäëàë á¿õèé èõýññýí áàéíà. Àãààðûí áîõèðäîëò ñàð, óëèðëààñ õàìààðàëòàé ºâëèéí ñàðóóäàä ñòàòèñòèê ìàãàäëàëòàéãààð èõñýæ áàéíà. Óëààíáààòàð õîòûí àãààðûí áîõèðäîëò íü íàñòàíãóóäûí àìüñãàëûí òîãòîëöîîíû ýìãýãòýé øóóä äóíä çýðãèéí õàìààðàëòàé áàéíà.

3. Óëààíáààòàð õîòûí 2 ä¿¿ðýãò íàñòàíãóóäûí àìüñãàëûí òîãòîëöîîíû ºâ÷ëºëèéã õ¿í àìûí äîòîð ñàíàìñàðã¿é ò¿¿âýðëýëòèéí àðãààð òîäîðõîéëæ ¿çýõýä íàñòàíãóóäûí 12.6% àìüñãàëûí ýìãýãòýé áàéíà. Àìüñãàëûí ýìãýãòýé íàñòàíãóóäûí 91 % íü àìüñãàëûí äîîä çàìûí ýìãýã, ò¿¿íèé äîòîð áºãëºðºëò õýëáýðèéí àìüñãàëûí äóòàãäàëä õ¿ðãýõ ýìãýã (88.7 %) äàâàìãàéëæ áàéíà.

4. Óëààíáààòàð õîòûí íàñòàíãóóäàä àìüñãàëûí ýìãýã ¿¿ñýõýä òàìõè, äàñãàë, õºäºë㺺íèé õîìñäîë, àãààð ñàëõèíä ãàðäàãã¿é áóñàä õàâñðàëò ãîë íºëººëºõ õ¿÷èí ç¿éë áîëæ áàéíà. Ñóäàëãààíä õàìðàãäñàí ä¿¿ðã¿¿äýä íºëººëºõ áàéäëûí äàðààëëààð çàðèì ÿëãàà áàéíà. Íàñòàíãóóäàä àìüñãàëûí ýìãýãýýð ºâäºõºä óðüä àæèëëàæ áàéñàí àæëûí íºõöºë òîîñ, ÷èéã èë¿¿ íºëººëñºí áàéíà.

5. Óëààíáààòàð õîòûí íàñòàíãóóäûí àìüñãàëûí òîãòîëöîîíû ýìãýã íü èäýð íàñíûõíààñ ÿëãààòàé, ººð ºâ÷èí õàâñðàõ íü èõ (93.6 %) áàéíà. ¯¿íèé äîòîð ç¿ðõ, Ẻð, øýýñ ÿëãàðóóëàõ çàì, ýëýã, öºñ, õîîë áîëîâñðóóëàõ çàìûí ºâ÷èí èë¿¿òýé õàâñàð÷ áàéíà.

6. Íàñòàíãóóäûí àìüñãàëûí òîãòîëöîîíû ýìãýã íü 6 ò¿¿íýýñ äýýø æèë ºâ÷èëæ áàéãàà (72.5 %), áàéíãà ñýäýð÷ äàõèäàã (100%), àðõàã øèíæòýé áàéíà. Íàñòàíãóóäûí àìüñãàëûí ýìãýãèéí ãîë çîâèóð øèíæ íü ºâºðìºö áóñ ÿäðàõ, áèå ñóëðàõ (88.5%) çîíõèëæ, ºâºðìºö øèíæ á¿äýã, áàãà èëýð÷ áóé îíöëîãòîé áàéíà.

7. Íàñòàíãóóäàä ãàäààä àìüñãàëûí ¿éë àæèëëàãààíû ¿ç¿¿ëýëò áóóð÷ áàéíà. Ýíý íü ýð¿¿ë, òàìõè òàòäàãã¿é íàñòàíä õàðüöàíãóé áàãà, òàìõè òàòäàã íàñòàíä èë¿¿, ÿëàíãóÿà ýìýãòýé÷¿¿äýä òîä èëýð÷ áàéíà (p<0.05).

RESULTS OF THE STUDY OF ²RESPIRATORY SYSTEM MORBIDITY OF ELDERS LIVING IN ULAANBAATAR CITY IN CONNECTION WITH SOME INFLUENCING FACTORS²
Ts.Tseregmaa, Munkhtsetseg, B.Burmaa, National Medical University of Mongolia, Ministry of Health

Goal. To study respiratory system diseases among the elderly in Ulaanbaatar, structure and some influencing factors

Duration and Location

The study was conducted in Ulaanbaatar between March, 2002 and March, 2003.

Methodology

Respiratory diseases among the elderly in Ulaanbaatar for the last 4 years and air contamination had been studied by retrospective methodology. Morbidity for 2002 had also been studied with the use of random sampling methodology. The randomly selected elderly had been undergone professional doctor’s check ups and spyrometer examinations.

Results

The study has revealed that respiratory system diseases are 12.6% among the elderly in Ulaanbaatar. It has been identified that respiratory diseases among the elderly living in Ulaanbaatar have direct mild correlation to air contamination in Ulaanbaatar. Air pollution has been increasing with the statistical significance year by year (p=0.05). Air pollution is more in winter months than in summer months (p=0.05).

91% of the elderly with respiratory disorders, lliving in Ulaanbaatar have lower respiratory disorder, in particular obstructive breathing lack (88.79%) takes most part among respiratory diseases. For inctance, chronic bronchitis, asthma and inflammations. The main factors for respiratory system disorder among the elderly in Ulaanbaatar are smoking, lack of physical activity and no possibility to go outside to breath fresh air and both respiratory diseases and other diseases are go togerther. There are many cases of respiratory diseases and other organs diseases to occur at the same time (93.6%). Mostly, cardiovascular, renal and hepatobiliary diseases as well as digestive diseases can be mentioned as an example.

The elderly has been suffering from respiratory diseases for more than 6 years (72,5%) and the diseases are chronic and regularly recurred (100%). The main complaints of the elderly are fatigue (88.5%). External breathing indicators of the elderly are decreasing among the elderly whoc smoke a cigarette and the female elders (Ð<0.05).

Conclusion

Á.Áóðìàà, Ø.Ýíõöýöýã, Í.Ñóâäàà, Ä.Îþóíáèëýã, Á.È÷èíõîðëîî, ×.Íÿìðàã÷àà, Ö.Ò¿âøèíæàðãàë, Ñ.Öýãìèä, Ä.Íÿìõîðëîî, Ä.Ñ¿ðýíæàâ, Íèéãìèéí ýð¿¿ë ìýíäèéí õ¿ðýýëýí

Äýëõèéí àëü ÷ óëñ îðîíä õîòæèëò, õ¿í àìûí òºâëºðºëòèéí óëìààñ õ¿ðýýëýí áóé îð÷èí ÿëàíãóÿà õîò, ñóóðèíû îð÷èí õèìè, ôèçèê, áèîëîãèéí õ¿÷èí ç¿éëýýð áîõèðäîæ, óëìààð õ¿í àìûí ýð¿¿ë ìýíäýä ñºðºã íºëºº ¿ç¿¿ëýõ áîëëîî.

Óëààíáààòàð õîòûí àãààð, óñûã Áàÿíç¿ðõ, Õàí-Óóë, Ñîíãèíîõàéðõàí, Íàëàéõ ä¿¿ðãèéí 12 õîðîîíû õ¿í àìûí ºâ÷ëºëòýé õîëáîí ñóäëàõàä ÄÝÌÁ-èéí çºâëºìæèä çààñàí ÷àíàðûí øààðäëàãûã Óëààíáààòàð õîòûí àãààð äàõü õ¿õýðëýã õèé, àçîòûí äàâõàð èñëèéí æèëèéí äóíäàæ õýìæýýãýýð õàíãàñàí, 1997-2001 îíä í¿¿ðñòºðºã÷èéí äóòóó èñëèéí õýìæýý 0.5-1.0ìã/ì3 ºíäºð áóþó 50-100 äàõèí, òîîñíû õýìæýý 0.131-0.162ìã/ì3 áàéãàà íü ÄÝÌÁ ñòàíäàðòààñ 2-2.7 äàõèí èõ áàéíà.

Ìîíãîë óëñûí àãààðûí ÷àíàðûí ñòàíäàðòàä çààñàí õýìæýýíýýñ ºâëèéí óëèðàëä õ¿õýðëýã õèé, àçîòûí äàâõàð èñëèéí õîíîãèéí äóíäàæ àãóóëàìæ ºíäºð, 2002 îíû óãòóóëñàí ñóäàëãààãààð àãààð äàõü õàð òóãàëãûí àãóóëàìæ 24-45 äàõèí èõ áàéâ.

2002 îíû óãòóóëñàí ñóäàëãààãààð áóëãèéí óñíû ñîðüöûí 28.6%, óñ ò¿ãýýõ áàéðíû óñíû ñîðüöûí 17.9%, òºâëºðñºí óñàí õàíãàìæèéí óñíû ñîðüöûí 5.5%-ä ãýäýñíèé ñàâõàíöàð èëýðñýí íü òóõàéí óíäíû óñ íÿíãèéí áîõèðäîëòîéã õàðóóëæ áàéíà. ÄÝÌÁ-èéí óíäíû óñíû ÷àíàðò òàâèãäàõ çààâðûí øààðäëàãûí õýìæýýíýýñ Õàí-Óóë ä¿¿ðãèéí áóëàã, òºâëºðñºí óñàí õàíãàìæèéí óñ /ÒÓÕ/, Ñ¿õáààòàð ä¿¿ðãèéí óñ ò¿ãýýõ áàéð, ÒÓÕ-ûí óñ, Ñîíãèíîõàéðõàí ä¿¿ðãèéí áóëãèéí óñíû òºìðèéí àãóóëàìæ 1.2-2.1 äàõèí, Ñîíãèíîõàéðõàí ä¿¿ðãèéí áóëãèéí óñíû öàéðûí àãóóëàìæ 1.1 äàõèí, õàð òóãàëãûí àãóóëàìæ á¿õ ä¿¿ðãèéí óíäíû óñàíä 1.3-32.2 äàõèí èõ, áóñàä ä¿¿ðýã, õîðîîíû óíäíû óñíû òºìºð, öàéðûí àãóóëàìæ øààðäëàãûí õýìæýýíä èëýðñýí áàéíà.

ÄÝÌÁ-ûí Àçè Íîìõîí Äàëàéí Ýðãèéí Áàðóóí Á¿ñèéí îðíóóäûí ýð¿¿ë ìýíäèéí áàéäàëòàé õàðüöóóëàõàä ìàíàé óëñûí õ¿í àìûí äóíä àìüñãàëûí áîëîí õîîë áîëîâñðóóëàõ çàìûí ýðõòíèé ºâ÷ëºë èõ áàéíà. 1998-2002 îíä àìüñãàëûí ýðõòíèé ºâ÷ëºë 0-14 íàñíû õ¿¿õýä, ºíäºð íàñòàé õ¿í àìûí äóíä èë¿¿ áàéãàà áà Áàÿíç¿ðõ, Õàí-Óóë, Ñîíãèíîõàéðõàí ä¿¿ðã¿¿äýä Íàëàéõààñ èë¿¿ á¿ðòãýãäñýí áàéíà. Íàñíû àíãèëëààð àâ÷ ¿çýõýä Íàëàéõ ä¿¿ðýãò Ñîíãèíîõàéðõàí, Áàÿíç¿ðõ, Õàí-Óóë ä¿¿ðã¿¿äèéí 0-14 íàñíû õ¿¿õäèéí öî÷ìîã áðîíõèòûí ºâ÷ëºëººñ öººí, àðõàã áðîíõèòûí ºâ÷ëºë èë¿¿, õàðèí óóøãèíû ¿ðýâñëèéí ºâ÷ëºë á¿õ ä¿¿ðýãò 0-14 íàñàíä áóñàä á¿õ íàñíû õ¿í àìòàé õàðüöóóëàõàä èë¿¿, 0-14 íàñíû õ¿¿õäèéí õàâüòàëò õàðøëûí ºâ÷ëºë Íàëàéõ ä¿¿ðýãò õàìãèéí èõ, Áàÿíç¿ðõ ä¿¿ðýãò õàìãèéí áàãà òîõèîëäñîí áàéíà.

Ä¿ãíýëò:

1. Àãààð äàõü õîðòîé áîäèñûí àãóóëàìæ õîòæèëò, ñóóðüøèëò, õ¿í àìûí øèëæèëò õºäºë㺺í, àâòîòýýâðèéí òîî èõýññýíòýé õîëáîîòîéãîîð æèë èðýõ òóñàì íýìýãäýæ áàéíà.

2. Óíäíû óñíû øèì áîõèðäîëòûí àãóóëàìæ ÄÝÌÁ-ûí óíäíû óñíû ÷àíàðò òàâèãäàõ øààðäëàãûí õýìæýýíä, òºâëºðñºí óñàí õàíãàìæèéí, 纺âðèéí óñàí õàíãàìæèéí, èë çàäãàé óñàíä íÿíãèéí áîõèðäîëòîé áàéãàà áà òºìºð, õàð òóãàëãûí áîõèðäëûí ò¿âøèí ºíäºð áàéíà.

3. 1998-2002 îíä Óëààíáààòàð õîòûí õ¿í àìûí àìüñãàë, õîîë áîëîâñðóóëàõ ýðõòýí, õàðøëûí ºâ÷ëºë áóóðñàí õàíäëàãà àæèãëàãäàæ áàéãàà áîëîâ÷ ºðõèéí ýìíýëãèéí á¿ðòãýëèéí ìàòåðèàë õàíãàëòã¿é, õàëäâàðò ºâ÷èí, õàâäðûí ºâ÷ëºë ºññºí ÷ òóõàéí ºâ÷íººð ºðõèéí ýìíýëýãò áàðàã õàíääàãã¿é ó÷èð ¿íýí çºâ ä¿ãíýëò ºãºõ áîëîìæã¿é ãýæ ¿çýæ áàéíà.

4. Óëààíáààòàð õîòûí àãààðûí áîõèðäîë õ¿í àì, ÿëàíãóÿà õ¿¿õäèéí àìüñãàëûí ýðõòíèé íèéò ºâ÷ëºë, ò¿¿íèé äîòîð öî÷ìîã àðõàã, áðîíõèò, óóøãèíû ¿ðýâñýë, õàðøëûí ºâ÷ëºëä íºëººëæ áàéíà. Óíäíû óñíû ýõ ¿¿ñâýðèéí õóâüä áóëãèéí óñ, óñ ò¿ãýýõ áàéðíû óñ íü õ¿í àìûí ýð¿¿ë ìýíäýä ñºðºã íºëºº ¿ç¿¿ëæ áîëîõ ìàãàäëàëòàé íü õàðàãäàæ áàéíà.


ENVIRONMENTAL HEALTH IMPACT ASSESSMENT
B.Burmaa, Sh.Enkhtsetseg, N.Suvdaa, D.Oyunbileg, B.Ichinkhorloo, Ch.Nyamragchaa, Ts.Tuvshinjargal, S.Tsegmid, D.Nyamkhorloo, D.Surenjav, Public Health Institute

Environment especially environment of city is polluting by chemical, physical and biological factors due urbanization in any cities of world. Therefore it is negatively affecting people’s health. By the study of correlation between air, water and morbidity of population of 12 khoroos of Bayanzurkh, Khan-Uul, Songinokhairkhan, Nalaikh districts, annual mean of sulfur dioxide, nitrogen dioxide in air is satisfying with the requirements. Mean of the carbonmonoxide is 0.5-1.0mg/m3 from 1997 to 2001 or 50-100 times higher, mean of TSP is 0.131-0.162mg/m3 or 2-2.7 times higher than ambient air quality standard of WHO. Daily mean of sulfur dioxide and nitrogen dioxide is higher in winter season than ambient air quality standard of Mongolia. By the prospective study of lead in air 2002, it’s 24-45 times higher.

By the prospective study of spring water in 2002, E.Coli is revealed 28.6% in spring water samples, 17.9% in water distribution point samples, 5.5% in central water samples and it shows that there is high bacteriological pollution in drinking water. Iron content of spring and central water supply of Khan-Uul district, water distribution point and central water supply of Sukhbaatar district, spring water of Songinokhairkhan district is 1.2-2.1 times higher, zinc content of spring water of Songinokhairkhan district is 1.1 times higher, lead content of all district is 1.3-32.2 times higher than water quality guideline of WHO. Iron and zinc content of remained water samples of all districts are satisfying the requirements.

Compare to health status of countries of WPRO, WHO, morbidity of respiratory and digestive system of Mongolia is high. Respiratory disease from 1998 to 2002 is high among the children aged 0-14 and elderly and it’s higher registered in Bayanzurkh, Khan-Uul, and Songinokhairkhan district compare to Nalaikh district. By the age classification, acute bronchitis among the children aged 0-14 is less in Nalaikh district than that of other districts while chronic bronchitis is higher. Pneumonia is high in children aged 0-14 in all districts to compare to that of other ages. About allergic dermatitis, morbidity among children aged 0-14 is the highest in Nalaikh district while it’s the lowest in Bayanzurkh district.

Conclusion

1. Air pollution is increasing year to year because of urbanization, settlement, and increasing number of population migration and auto vehicles

2. Organic contimination of drinking water is satisfying water quality guideline of drinking water, WHO and water of central water supply, water distribution point, and open water has a bacteriological contamination. There is high level contamination of iron and lead.

3. Though it is observed there is a tendency of decreasing morbidity of respiratory, digestive and allergic diseases and increasing morbidity of infectious and cancer diseases in Ulaanbaatar city from 1998 to 2002 registration material is not sufficient enough. We see that it is not avaiable to give right conclusion on this area.

Air pollution of Ulaanbaatar city is affecting population health especially general respiratory disease including acute and chronic bronchitis, pneumonia, and allergic disease of children. About sources of drinking water, there is a probability of affecting water of spring, water distribution point to population health.


DESCRIPTION OF RISK FACTORS FOR PATIENTS AND DOCTORS DELAY OF PULMONARY SMEAR POSITIVE TUBERCULOSIS IN MONGOLIA
N.Naranbat, S.Otgontsetseg, National Center of Communicable Diseases

Setting: Darkhan-uul and Khan-uul tuberculosis dispensaries in Mongolia

Objective: To describe patient-related and doctor-related risk factors for delays in the diagnosis and treatment of new smear-positive TB patients. To develop public health interventions to reduce these delays.

Design: A total 209 patients with newly diagnosed smear-positive pulmonary tuberculosis in the selected study settings. The time intervals between the initial onset of symptoms, the first medical consultation, the final diagnosis and the commencement of anti-tuberculosis treatment were determined.

Results: The median patient delay was 30 days, the median doctor delay was 20 days and the median total delay was 71 days. By logistic regression analysis, patients aged 0-24 years (95% CI 0.8-36.4) and 55-64 years (95% CI 2-8), patients with only primary school education (95% CI 2.7-9.2) or no formal education (95% CI 0.8-5.5), and patients who were afraid of receiving a diagnosis of tuberculosis (95% CI 2.8) were associated with longer patient delays.

Family and soum (township level) doctors were associated with longer doctor delays.

Conclusion: To reduce patient delays in seeking treatment for tuberculosis, health education campaigns should be instigated to inform the public about the early symptoms of tuberculosis and the importance of early medical consultations. The quality of medical training for both family and soum (township level) doctors should also be improved in order to increase awareness of tuberculosis and reduce doctor delays.


ÝËÝÃÍÈÉ ÀÍÕÄÀÃ× ªÌªÍÃÈÉÍ ÒÀËÀÀÐÕ Õ¯Í ÀÌÛÍ ÌÝÄËÝà ÄÀÄËÀÃÀ ÕÀÍÄËÀÃÛÍ ÑÓÄÀËÃÀÀ
Í.Íÿìäàâàà, Æ.×èíá¿ðýí, Õàâäàð ñóäëàëûí òºâ

Òàíèëöóóëãà:

Ñ¿¿ëèéí 20 æèëä Ìîíãîë óëñàä õ¿í àìûí äóíäàæ íàñëàëò óðòñàæ õàëäâàðò áóñ ºâ÷íèé ºâ÷ëºë ¿ëýìæ íýìýãäæýý. Ç¿ðõ ñóäñàíû ºâ÷èí, õàâäàð, ãýìòýë çýðýã õàëäâàðò áóñ ºâ÷èí õ¿í àìûí íèéò íàñ áàðàëòûí ¿íäñýí øàëòãààí áîëæ, íàñ áàðæ áàéãàà õ¿íèé 5 õ¿íèé íýã íü õàâäðûí óëìààñ ýíäýæ áàéíà (1). Àëü ÷ õ¿éñýíä õàâäðûí ºâ÷ëºë, íàñ áàðàëòûí á¿òöýä ýëýãíèé àíõäàã÷ ºìºí (ÝÀª) òýðã¿¿ëæ (2), Ìîíãîë óëñ ÝÀª-èéí ºâ÷ëºëèéí áàéäëààð Àôðèêèéí áóóðàé õºãæèëòýé óëñ îðíóóäûí íýãýí àäèë äýëõèéä òýðã¿¿í áàéðàíä îðñîîð áàéíà (3). Ìàíàé óëñàä ÝÀª-èéí ºâ÷ëºë èõ áàéãààãèéí ¿íäñýí øàëòãààí íü ãåïàòèò  âèðóñûí õàëäâàð ºíäºð áàéäàãòàé õîëáîîòîé (3). ÝÀª ¿¿ñýõýä íºëººëºõ õ¿÷èí ç¿éëä àðõè, õàìãààëàëòã¿é áýëãèéí õàðüöàà, õîîë õ¿íñ, ÿëàíãóÿà õºãçºð÷ ìóóäñàí õ¿íñíèé á¿òýýãäýõ¿¿í çýðãèéã õàìðóóëäàã (4). Ãýòýë ÝÀª ¿¿ñýõýä íºëººëäºã õ¿÷èí ç¿éëñ¿¿äèéí õ¿í àìûí äóíäàõ òàðõàëò áîëîí ýäãýýð õ¿÷èí ç¿éëñèéí òàëààðõ ìýäëýã, õàíäëàãûã òîãòîîñîí ñóäàëãààíû àæèë ºíººã õ¿ðòýë õîìñ áàéíà. Èéìä áèä ñóäàëãààíû äàðààõ ¿íäñýí çîðèëòóóäûã äýâø¿¿ëñýí þì. ¯¿íä:

- ÝÀª ¿¿ñýõýä íºëººëºõ õ¿÷èí ç¿éëñèéí õ¿í àìûí äóíäàõ òàðõàëòûí ò¿âøèíã òîãòîîõ;

- ÝÀª-èéí õàëãààò õ¿÷èí ç¿éëñèéí òàëààðõ ìýäëýã, äàäëàãûí ò¿âøèíã òîäîðõîéëîõ;

- ÝÀª-ººñ óðüä÷èëñàí ñýðãèéëýõ, õ¿í àìä ÷èãëýñýí çºâëºìæ áîëîâñðóóëàõàä øààðäàãäàõ çàðèì ñóóðü ¿ç¿¿ëýëò¿¿äèéã áîëîâñðóóëàõ.

1.1.Ñóäàëãààíû àðãà

Ñóäàëãààíä Óëààíáààòàð õîòûí á¿õ ä¿¿ðã¿¿ä, ñàíàìñàðã¿é ò¿¿âýðëýëòèéí àðãààð ñîíãîñîí 10 àéìãèéã (ªâºðõàíãàé, ªìºíãîâü, Çàâõàí, Òºâ, Äîðíîä, Õýíòèé, Äîðíîãîâü, Õºâñãºë, Ãîâü-Àëòàé, Îðõîí àéìàã) õàìðóóëñàí.

Óðüä÷èëàí áîëîâñðóóëæ, áàòàëãààæóóëñàí òóñãàé àñóóìæèéí äàãóó íýã àãøèíû ñóäàëãàà õèéñýí. Àñóóìæ íü 4 õýñãýýñ á¿ðäñýí áàéâ:

- Õ¿í àì ç¿éí ìýäýýëýë: íàñ õ¿éñ, îðøèí ñóóãàà ãàçàð, ãýð á¿ëèéí áàéäàë, áîëîâñðîëûí ò¿âøèí, àæèë ìýðãýæèë áà îðëîãî.

- Õàëãààò õ¿÷èí ç¿éëñèéí òàëààðõ ìýäýýëýë: àðõè óóäàã ýñýõ (äàâòàìæ, àíõ óóæ ýõýëñýí íàñ, ñ¿¿ëèéí 30 õîíîãèéí äîòîð àðõè õýðýãëýñýí áàéäàë), òàìõè òàòäàã ýñýõ, áýëãýâ÷ õýðýãëýäýã ýñýõ áà õîîëíû çóðøèë (õîîëíû äýãëýì, ÷àíàð ã.ì).

- Ãåïàòèòààð ºâ÷èëñºí ýñýõ áà ãåïàòèò Â-èéí ýñðýã âàêöèíæóóëàëò; ÝÀª-èéí õàëãààò õ¿÷èí ç¿éëñèéí òàëààðõ ìýäëýã.

- Ýð¿¿ë ìýíäèéí ìýäýýëëèéí ýõ ¿¿ñâýð.

Ñóäàëãààíä ä¿¿ðýã, àéìãèéí íýãäñýí ýìíýëã¿¿äýä õàíäñàí õ¿ì¿¿ñ (ýëýã, öºñíèé çîâèóð øàíàëãààã¿é áîëîí ýäãýýð ýìíýëã¿¿äèéí ýì÷, àæèëòíóóäààñ ñàíàìñàðã¿é ò¿¿âðèéí àðãààð ñîíãîí õàìðóóëñàí áà àñóóìæèéã óðüä÷èëàí ñóðãàëòàä õàìðàãäñàí ñóâèëàã÷ íàð àâñàí áàéíà. Íèéò 600 àñóóìæ òàðààãäñàíààñ øààðäëàãà õàíãàñàí 330 àñóóìæèä SPSS ïðîãðàìì õàíãàìæèéí òóñëàìæòàé ñòàòèñòèê áîëîâñðóóëàëò õèéâ.

Ñóäàëãààíä õàìðàãäàãñäûí áàðàã òàë õóâü (40.9%) íü õºäºº îðîí íóòãààñ áàéâ. Îðîëöîãñäûí èõýíõ íü ãýðëýñýí, àæèëòàé, äóíä ñóðãóóëü ä¿¿ðãýñýí áàéíà.

Ñóäàëãààíä õàìðàãäàãñäûí èõýíõ íü (57.5%) ñàðä äîð õàÿæ 1 óäàà àðõè àðõè óóäàã, 6.1% íü ñ¿¿ëèéí ñàðä 10 äýýø õîíîã àðõè óóñàí. Íàñíû á¿ëãýýð àíãèëàí ä¿í øèíæèëãýý õèéõýä àðõè óóõ äàâòàìæèéí õóâüä ñòàòèñòèêèéí ¿íýí ìàãàäòàé ÿëãàà áàéõã¿é áàéâ (x2=0.54; ð=0.762); ãýõäýý 40-ººñ äîîø íàñíû õ¿ì¿¿ñ àõèìàã íàñíûõàíòàé õàðüöóóëàõàä èë¿¿ çàëóó íàñàíäàà àðõè àíõ óóæ ýõýëñýí áàéíà ( õ2 =11.51; ð=0.003). Ýìýãòýé÷¿¿äòýé õàðüöóóëàõàä ýðýãòýé÷¿¿ä àðõè óóõ íü ò¿ãýýìýë (õ2 =12.79; ð=0.000) áàéõûí çýðýãöýý 20-èîñ äîîø íàñàíäàà àðõè àíõ óóæ ýõýëñýí íü èë¿¿òýé áàéíà (õ2 =13.216; ð=0.000). Íýã ñîíèðõîëòîé ä¿í ãàðñàí íü áîëîâñðîë äýýøëýõ òóñàì àðõè óóõ íü èë¿¿ áàéâ (õ2 =8.234; ð=0.016); ãýõäýý áîëîâñðîë äîðîé õ¿ì¿¿ñ õàðüöàíã¿é çàëóó (20-èîñ äîîø) íàñàíäà óóæ ýõýëäýã áàéíà (õ2 =95.096; ð=0.000).

Ñóäàëãààíä õàìðàãäñàí õ¿ì¿¿ñèéí áàðàã òàë õóâü íü òàìõè òàòäàã (44.9%). Íàñíû á¿ëã¿¿äèéã õîîðîíä íü õàðüöóóëàõàä òàìõè òàòäàã ýñýõ (õ2=0.167; ð=0.682) áîëîí òàìõè àíõ òàòàæ ýõýëñýí íàñíû (õ2 =2.951; ð=0.229) õóâüä ñòàòèñòèêèéí ¿íýí ìàãàäòàé ÿëãàà àæèãëàãäñàíã¿é. Ò¿¿í÷ëýí òàìõè òàòäàã ýñýõ, òàìõè àíõ òàòàæ ýõýëñýí íàñíû áîëîâñðîëûí ò¿âøèíòýé õàìààðàëã¿é áàéâ (õ2=1.674; ð=0.433 áà =2.09; ð=0.148). Õàðèí ýðýãòýé÷¿¿ä òàìõè òàòàõ íü ýìýãòýé÷¿¿äýýñ èë¿¿ (õ2 =21.707; ð=0.000), ìºí ýðýãòýé÷¿¿äýýñ èë¿¿ ýðò òàìõè òàòàæ ýõýëäýã áàéíà (õ2 =9.702; ð=0.002). Àíõ òàìõè òàòñàí, àðõè óóæ ýõýëñýí äóíäàæ íàñ 20.9 áà 25.6 (õ¿ñíýãò 3). Òàìõè òàòàæ àðõè óóæ ýõýëñýí äóíäàæ íàñ ýìýãòýéä 26.6 áà 24.9 õàðèí ýðýãòýéä 23.9 áà 17 áàéíà.

Ñóäàëãààíä îðîëöîãñäûí òàëààñ äýýø õóâü íü (59.7%) áýëãèéí õàðüöààíä îðîõäîî áýëãýâ÷ õýðýãëýäýã áàéíà. Ãýðýëñýí õ¿ì¿¿ñ áýëãýâ÷ èë¿¿ õýðýãëýæ çàíøñàí (õ2=5.96; ð=0.015)ýíý íü áýëãýâ÷èéã ãýð á¿ë òºëºâëºëòèéí àðãà áîëãîí õýðýãëýäýãòýé õîëáîîòîé áàéæ áîëîõ þì. Õ¿ì¿¿ñèéí áîëîâñðîë áàãà áàéõ òóñàì áýëãýâ÷èéí õýðýãëýý áàãà áàéâ (õ2=4.103; ð=0.043).

Á¿õ õ¿ì¿¿ñ õ¿íñýíäýý áîðö õýðýãëýäýã áàéíà (56.1%-õàÿà, 43.9%-òîãòìîë). Ýíý íü íàñ (õ2=0.046; ð=0.865), õ¿éñ (õ2=0.141; ð=0.707), áîëîâñðîëòîé (õ2=4.432; ð=0.109) õàìààðàëã¿é áàéâ. Îðîëöîãñäûí 19.2% íü õºãöòýé öàãààí èäýý ýð¿¿ë ìýíäýä ñàéí ãýñýí áîë 25.6% íü ìýäýõã¿é ãýñýí áàéíà.

Ñóäàëãààíä îðîëöîãñäûí 35.9% íü âèðóñò ãåïàòèòààð ºâäºæ áàéñàí áà ýíý íü õ¿éñ (õ2=0.534; ð=0.766), ýìíýëýãò àæèëëàäàã ýñýõòýé õàìààðàëã¿é áàéâ (õ2 =1.5; ð=0.221). Ãåïàòèòààð ºâ÷èëæ áàéñàí õ¿ì¿¿ñèéí 26.3% íü 2 áà ò¿¿íýýñ äýýø óäàà óã ºâ÷íººð ºâäºæýý. Íèéò ñóäàëãààíä õàìðàãäàãñäûí 49% íü ãåïàòèò Â-èéí ýñðýã âàêöèí õèéëãýñýí áîë 33.8% íü õèéëãýýã¿é, õàðèí 15.9% íü ìýäýõã¿é ãýæ õàðèóëñàí áàéíà. Íàñíû á¿ëãýýð àâ÷ ¿çýõýä 40-ººñ äîîø íàñíûõàí âàêöèíæóóëàëòàä õàìðàãäñàí íü èë¿¿ (õ2=8.112; ð=0.017), ãåïàòèòààð ºâ÷èëñºí íü áàãà áàéâ (õ2=9.509; ð=0.009). Ýìýãòýé÷¿¿ä ýðýãòýé÷¿¿äèéã áîäâîë äàðõëààæóóëàëòàä èë¿¿òýé õàìðàãäñàí (õ2=6.102; ð=0.047), õàðèí âàêöèíæóóëàëò áîëîâñðîëûí ò¿âøèíãýýñ õàìààðàëã¿é áàéâ ( õ2=4.595; ð=0.331).

Ñóäàëãààíä õàìðàãäàãñäûí èõýíõ íü âèðóñò ãåïàòèò òàðõàõ çàìûã çºâ òîäîðõîéëñîí áîëîâ÷ 71.6% íü õàëäâàð áýëãèéí çàìààð òàðõàäàãã¿é ãýæ õàðèóëæýý. Àðõè áà ãåïàòèò íü ÝÀª ¿¿ñýõýä íºëººëäºã ãýæ ñóäàëãààíä õàìðàãäàãñàä ¿çñýí áàéíà (õ¿ñíýãò 4). Âèðóñò ãåïàòèò òàðõàõ çàì, ÝÀª ¿¿ñýõýä íºëººëºõ õ¿÷èí ç¿éëñèéã òîäîðõîéëñîí áàéäàë íü íàñ, õ¿éñ, áîëîâñðîëîîñ õàìààðàëã¿é áàéâ (ð>0.05).

Èõýíõè õ¿ì¿¿ñ ýì÷, òåëåâèç, ñîíèíãîîñ ýð¿¿ë ìýíäèéí ìýäýýëýë àâäàã ãýñýí áàéíà. Íàñ, õ¿éñ, áîëîâñðîëûí ò¿âøèí㺺ñ õàìààðàõã¿éãýýð íèéò îðîëöîãñäûí 89% íü ýð¿¿ë ìýíäèéí òàëààð èë¿¿ èõ ìýäýýëýë àâàõ ñîíèðõîëòîé áàéäàã ãýñýí áàéíà (õ2=0.559; ð=0.454). Áîëîâñðîëûí ò¿âøèí áàãà áàéõ òóñàì ñîíèí, õýâëýëýýñ àâàõ íü áàãà áîëîõ íü õàðàãäëàà (õ2=8.009; ð=0.018).

Õýëýëö¿¿ëýã. Ñóäàëãàà íü õ¿í àìûí äóíä àðõè, òàìõèíû õýðýãëýý ºðãºí òàðõñàí áºãººä ýðýãòýé÷¿¿ä õàðüöàíãóé çàëóó íàñàíäàà äýýðõè õîðò çóðøèëä èë¿¿òýé àâòàæ áàéãààã õàðóóëëàà. Àðõè àíõ óóæ ýõëýõ íàñ 40-ººñ äîîø íàñíû õ¿ì¿¿ñèéí õóâüä õàðüöàíã¿é áàãà (20-èîñ äîîø) áàéíà. Ò¿¿í÷ëýí çàëóó÷óóä áýëãýâ÷èéã èë¿¿òýé õýðýãëýäýã, ãåïàòèò Â-èéí ýñðýã âàêöèíæóóëàëòàä èë¿¿òýé õàìðàãäñàí, ãåïàòèòààð ºâäºõ íü õàðüöàíã¿é áàãà áàéãààã ñóäàëãàà õàðóóëëàà. Áîëîâñðîë äîðîé áàéõ òóñàì ýðò àðõèíä îðæ, áýëãýâ÷ áàðàã õýðýãëýäýãã¿é áàéíà. Õ¿íñýíäýý áîðö õýðýãëýõ íü á¿õ íàñíû õ¿ì¿¿ñò áîëîâñðîë, õ¿éñ ¿ë õàðãàëçàí àäèë áàéíà.

Íèéò ñóäàëãààíä õàìðàãäàãñäûí 1/3 íü âèðóñò ãåïàòèòààð ºâ÷èëñºí áàéõ áºãººä îðîëöîãñäûí èõýíõ íü ãåïàòèò áýëãèéí çàìààð òàðõäàã òàëààð ìýääýãã¿é áàéíà.

Ýð¿¿ë ìýíäèéí ìýäýýëëèéã ýì÷, òåëåâèç, ñîíèíãîîñ èë¿¿òýé àâäàã áàéíà. Ãýõäýý áîëîâñðîëûí ò¿âøèí áàãà áàéõ òóñàì ñîíèí ñîíèí, õýâëýëèéã ìýäýýëëèéí ýõ ¿¿ñâýð áîëãîí àøèãëàõ íü áóóð÷ áàéãàà íü õàðàãäëàà. Íèéò îðîëöîãñîä ýð¿¿ë ìýíäèéí òàëààð èë¿¿ èõ ìýäýýëýë àâàõ õ¿ñýë ìàø èõ áàéäàã íü àæèãëàãäëàà.

Ä¿ãíýëò, çºâëºìæ

Ñóäàëãààíû ¿ð ä¿íä ¿íäýñëýí äàðààõ çºâëºìæ ãàðãàæ áàéíà. ¯¿íä:

ÝÀª-ººñ óðüä÷èëàí ñýðãèéëýõ ìýäýýëýë, ñóðãàëò, ñóðòàë÷èëãàà (ÌÑÑ)-ã ãåïàòèòûí áýëãèéí áîëîí ïàðåíåðàëü çàìààð òàðõàõ àþóëûã òàíèóëàõ, õîðò çóðøëààñ ñýðãèéëýõ, àþóëã¿é áýëãèéí õàðüöààã ñóðòàë÷èëàõ ÷èãëýëýýð õèéæ, ÌÑÑ-íû àæëûã çàëóó÷óóäàä ñîíèðõîëòîé õýëáýðýýð çîõèîí áàéãóóëàõàä àíõààðàõ íü ç¿éòýé. Ýð¿¿ë ìýíäèéí ìýäýýëëèéã ñîíèí, õýâëýëýýñ ººð ñóâãààð õ¿ðãýõ íü èë¿¿ ¿ð ºãººæòýé þì.

Öààøèä ÝÀª-èéí øàëòãààíûã õÿíàëòûí á¿ëýã àøèãëàí, ºâ÷íèé ñòàòóñûã áîäèòîîð òîäîðõîéëîõ àðãà (ëàáîðàòîðèéí áóþó áóñàä áàãàæèéí øèíæèëãýý)äýýð ¿íäýñëýí àíàëèòèê ñóäàëãààíû àðãààð õèéõ øààðäëàãàòàé áàéíà.


STUDY ON PUBLIC KAPB AS IT RELATES TO PRIMARY LIVER CANCER
N.Nyamdawaa, J.Chinburen, Oncology center

Introduction

During the last two decades Mongolia has experienced pronounced demographic and epidemiological transitions with resultant longer life expectancy at birth and preponderance of non-communicable diseases. Currently, cardiovascular diseases, malignant neoplasms and injuries are the three leading causes of population mortality, with cancers being responsible for almost one-fifth of all deaths annually (1). The principal cause of cancer morbidity and mortality is the primary liver cancer (PLC) in both sexes (2). Furthermore, Mongolia has one of the highest PLC incidence rates in the world, ranking together with a number of the least developed African countries (3). One of the causes of such a burden of PLC is high prevalence of HBV infection in our population (3). It is also speculated that such risky behaviors as excessive use of alcohol and unsafe sex practices as well as traditional Mongolian diet rich in dried meet and mouldy dairy products (considered to be a major source of carcinogenic aflotoxin) could serve as significant risk factors for PLC (4). Lack of public awareness and knowledge on the role of certain behavioral risk factors in PLC is believed to compound the problem further. However, no studies have been conducted to explore the extent of the public awareness on behavioral risk factors for PLC. Therefore, a Study on Public KAPB as It Relates to Primary Liver Cancer was conducted with the following main objectives:

- To assess the extent of certain behavioral risk factors for PLC in the population (excessive alcohol consumption, dietary habits, etc.);

- To study the level of public awareness on risk factors for PLC;

- To formulate recommendations for PLC prevention.

Methodology

This is a baseline study to assess the public KAPB with regards to PLC, and to define the knowledge gaps and appropriate strategies for public awareness building. Therefore, a cross-sectional study design has been utilized with the use of self-administered questionnaires, validated during an initial field-testing. The questionnaire consists of four parts:

- Demographic information: age, gender, place of residence, marital status, education, occupation and income.

- Information on certain risk behaviors: alcohol use (frequency, age at initiation, last month report), smoking, condom use and dietary habits (use of dried meet and mouldy dairy products).

- History of hepatitis and vaccination against HBV; knowledge of risk factors for hepatitis and liver cancer.

- Health information channels.

The study was conducted in all districts of the capital city and 10 randomly selected aimags or provinces (Uvurkhangai, Umnugobi, Zavkhan, Tuv, Dornod, Khentii, Dornogobi, Khuvsgul, Gobi-Altai and Orkhon aimags). Specially trained nurses obtained an informed consent from all study subjects, who were randomly chosen from district and aimag hospital visitors and employees. Of a total of 600 questionnaires distributed, 330 completed questionnaires have been returned and analyzed using SPSS.

Results. A third (34.6%) of the study subjects were males and 65.4% - females. Mean age of the respondents was 37 years.

Almost half (40.9%) of the study participants were from rural areas. The study participants were more likely to be married, employed and have at least completed secondary schooling.

The majority of the respondents (57.5%) used alcohol at least once a month with 6.1% of the study subjects drinking on more than 10 days of the last month. There was no significant difference in the frequency of alcohol consumption when stratified by age (c2 = 0.54; p = 0.762); however, those below 40 years of age were significantly more likely to start using alcohol at younger ages compared to their older counterparts (c2 = 11.51; p = 0.003). Men were significantly more likely to drink than women (c2 = 12.79; p = 0.000), and more likely to initiate drinking at the age below 20 (c2 = 13.216; p = 0.000). Another interesting finding was a significant increase in alcohol use with increased educational level (c2 = 8.234; p = 0.016); however, the lower the educational level the more likely the person to initiate drinking at the age below 20 years (c2 = 95.096; p=0.000).

Almost half (44.9%) of the respondents smoked. There were no statistically significant differences in current smoking (c2 = 0.167; p = 0.682) and the age at smoking initiation (c2=2.951; p=0.229) between different age groups. Similarly, no differences observed with regards to education (c2=1.674; p= 0.433 and c2=2.09; p=0.148, respectively). However, men were more likely to smoke compared to women (c2=21.707; p=0.000), and more likely to initiate smoking at the age below 20 years (c2=9.702; p=0.002). Mean ages at smoking and drinking initiation were 20.9 and 25.6 years, respectively (table 3). When segregated by gender, the mean ages at drinking and smoking initiation were 26.6 and 24.9 years for females, and 23.9 and 17 years for males, respectively.

Slightly more than a half (59.7%) of the study participants used condom during sexual intercourse. Younger subjects (£ 39 years) were significantly more likely to use condoms than their older counterparts (c2 = 6.19; p = 0.013). Similarly, married respondents were more likely to use condoms (c2 = 5.96; p = 0.015), which could be related to the use of condoms as a family planning method. Less educated study subjects were less likely to use condoms (c2 = 4.103; p = 0.043).

All study subjects used dried meet in their diet (56.1% - occasionally, 43.9% - regularly) without statistically significant differences in dietary habits in different age groups (c2 = 0.046; p = 0.865), between genders (c2 = 0.141; p = 0.707), or with regards to schooling (c2 = 4.432; p = 0.109 ). Although only 19.2% of the respondents agreed that mouldy dairy products are healthy, one quarter (25.6%) were not sure if they were unhealthy.

More than a third (35.9%) of the study subjects replied that they had viral hepatitis at some point in their lives without statistically significant difference between males and females (c2 = 0.534; p = 0.766), or those in medical or non-medical occupation (c2 = 1.5; p = 0.221). Of those who have had hepatitis, 26.3% were infected with it two or more times. Slightly less than a half (49%) of the study subjects have had a vaccination against hepatitis B, 33.8% - were not immunized and 15.9% - did not know. When stratified by age, the study subjects below 40 years of age were significantly more likely to have been vaccinated against hepatitis B (c2 = 8.112; p = 0.017) and less likely to have had hepatitis (c2 = 9.509; p = 0.009). Females were also more likely to be vaccinated compared to their male counterparts (c2 = 6.102; p = 0.047). However, there was no significant difference in vaccination status by schooling (c2 = 4.595; p = 0.331).

The majority of the respondents correctly identified ways of transmission of hepatitis. However, the overwhelming majority (71.6%) was not aware of the sexual transmission of viral hepatitis (table 4). Study participants have identified alcohol and hepatitis as the causes of liver cancer. When stratified by age, sex and educational background there were no significant differences (p>0.05) in identification of the ways of hepatitis transmission or liver cancer causes.

Physicians, TV and newspapers have been identified as the major sources of health information, and the overwhelming majority (89%) of the study participants expressed their interest and need in getting more information on health-related issues irrespective of age, sex and educational background (c2 = 0.559; p = 0.454). There were no statistically significant differences in information sources between different age groups. However, the lower the educational level, the less likely the person was to identify newspapers as a source of health information (c2 = 8.009; p = 0.018).

Similar analyses were performed on data stratified by occupation (medical vs. non-medical). No significant differences were found regarding alcohol use (c2 = 2.002; p = 0.157), smoking (c2 = 2.385; p = 0.122), condom use (c2 = 1.476; p = 0.224), dried meet consumption (c2 = 0.274; p = 0.601), hepatitis history (c2 = 1.5; p = 0.221), or hepatitis B vaccination status (c2 = 1.51; p = 0.47). Medical staff was significantly more aware of the harm of mouldy dairy products (c2 = 15.601; p = 0.000) and alcohol (c2 = 8.931; p = 0.003), as well as hepatitis transmission through contaminated syringes (c2 = 6.681; p = 0.01) and unprotected sex (c2 = 12.641; p = 0.000).

Discussions:

The study findings revealed relatively high prevalence of alcohol use and smoking in the population with more males being affected at a comparatively early age. Younger generations (below 40 years of age) were more likely to start drinking at the age below 20 years, use condoms and receive vaccination against hepatitis B, and less likely to have had hepatitis. Less educated respondents were more likely to start drinking at early ages and less likely to use condoms. Use of dried meet (suspected to be a major source of carcinogenic aflotoxin) was almost universal regardless of age, sex, education or occupation.

More than a third of the respondents have had hepatitis. However, the overwhelming majority of the study subjects were not aware of sexual transmission of hepatitis irrespective of age, sex and education.

Physicians, TV and newspapers have been identified as the major sources of health information in general. However, less educated respondents were significantly less likely to use newspapers as a source of such information. An almost unanimous interest in getting more health information has been expressed by the study participants.

Conclusions and recommendations

Based on the study findings it is recommended to streamline IEC (information, education and communication) activities on PLC prevention towards increasing the public awareness on sexual and parenteral transmission of hepatitis, and promotion of substance-free living and safe sex practices utilizing strategies that are most appealing to the younger generations. Communication messages are best delivered by the physicians or mass media (although in reaching the less educated, most vulnerable segments of the population information channels other than written media need to be actively sought).

Further analytical studies into the behavioral causes of PLC supported by unbiased objective measurement of the disease status (using laboratory testing or other instrumental assessment) need to be performed.


Hide details for Á¯ËÝà VI. ÎÞÓÒÍÛ ÝÐÄÝÌ ØÈÍÆÈËÃÝÝÍÈÉ "ÌÀÑÒÅÐ-2003" ÕÓÐËÛÍ ÈËÒÃÝ˯¯ÄÁ¯ËÝà VI. ÎÞÓÒÍÛ ÝÐÄÝÌ ØÈÍÆÈËÃÝÝÍÈÉ "ÌÀÑÒÅÐ-2003" ÕÓÐËÛÍ ÈËÒÃÝ˯¯Ä

ÕÝÒ ÀÂÈÀÍ ÄÎÏÏËÅÐÎÃÈÉÍ ÎÍÎØËÎÃÎÎ, ÌÎÍÃÎË Õ¯ÍÈÉ ÒÀÐÕÈÍÛ ÑÓÄÀÑÍÛ ÄÎÏÏËÅÐÎÃÐÀÔÈÉÍ ÕÝÂÈÉÍ ¯Ç¯¯ËÝËÒ
Ä.Òàìèð, “À÷” Àíàãààõ Óõààíû Äýýä Ñóðãóóëü

Òàðõèíû öóñíû ýðãýëòèéí ººð÷ëºëò¿¿ä íü õ¿í àìûí äóíä îëîíòàà òîõèîëäîæ, õ¿í àìûí íàñ áàðàëò, òàõèð äóòóó áîëîõ ãîë øàëòãààíóóäûí íýã áîëæ áàéãàà áºãººä ò¿¿íèé îíîøëîãîî, ýì÷èëãýýíèé ò¿âøèíã äýýøë¿¿ëýõ àñóóäàë ÷óõàë áàéíà. Òàðõèíû ñóäàñíû õýò àâèàí äîïïëåðîãðàôè (ÒÑÕÀÄ)íü òàðõèíû ñóäàñíû ýìãýãèéí áàéäëûã ýíãèéí íºõöºëä îíîøëîæ, ýì÷èëãýýíèé ÿâöûã äàâòàí õÿíàõ áîðëîìæòîé õÿìä òºñºð, èíâàçèâ áóñ, ýð¿¿ë ìýíäýä õîðã¿é àðãà þì.

Ìàíàé îðîíä ÒÑÕÀÄ-èéí îíîøëîãîî 1996 îíîîñ õèéãäýæ áàéãàà áîëîâ÷ ýð¿¿ë Ìîíãîë õ¿íèé ÒÑÕÀÄ-èéí õýâèéí ¿ç¿¿ëýëòã¿é áàéíà.

Ñóäàëãààíû çîðèëãî:

-Áèä ýíýõ¿¿ ñóäàëãààíä ýð¿¿ë Ìîíãîë õ¿íèé òàðõèíû ñóäàñíû äîïïëåðîãðàôèéí õýâèéí ¿ç¿¿ëýëòèéã òîãòîîõ

-Íàñ àõèõ òóñàì äýýä ìýäðýëèéí ñèñòåìèéí ¿éë àæèëëàãààíû ººð÷ëºëòèéí äýñäàðààã ñóäëàõ çîðèëò òàâüñàí.

Ñóäàëãààíû àðãà, ìàòåðèàë: 2000-2002 îíû õóãàöààíä Ï.Í.Øàñòèíû íýðýìæèò êëèíèêèéí òºâ ýìíýëãèéí õýò àâèàí äîïïëåðîãðàôèéí îíîøëîãîîíû êàáèíåòýä ¿ç¿¿ëñýí 16-ààñ äýýø íàñíû íèéò 210 ýð¿¿ë õ¿íèé òàðõèíû ñóäñàí äàõü öóñíû ýðãýëòèéí ¿ç¿¿ëýëò¿¿äèéã õýò àâèà íü äîïïëåðîãðàôèéí DWL Multi-DopP 1500 àïïàðàòààð õýìæñýí ¿ð ä¿íã ñòàòèñòèê áîëîâñðóóëàëòàíä îðóóëæ ä¿ãíýâ.

Íàñíû á¿ëýãëýëèéã 16-20 íàñ, 21-30 íàñ, 31-40 íàñ, 41-50 íàñ, 51-60 íàñ, 61-70 íàñ, 71-ýýñ äýýø ãýñýí íàñààð àíãèëàâ.

ÒÑÕÀÄ-èéí ¿ç¿¿ëýëòèéã àãøèëòûí ¿åèéí õàìãèéí ºíäºð, ñóëðàëòûí ¿åèéí õàìãèéí áàãà áîëîí äóíäàæ õóðäóóä, ëóãøèëòûí áà ýñýðã¿¿öëèéí èíäåêñ¿¿äûã ãàâëûí ãàäíà áà äîòíî 9 òîì ñóäñóóäàä õýìæèæ ä¿ãíýñýí.

Áèäíèé ñóäàëãààíààñ äýýðõ ñóäàñíóóäûí äóíäàæ õóðä áîëîí ýñýðã¿¿öýë íü íàñ àõèõ òóñàì ººð õîîðîíäîî àäèëã¿é ñàëàà ñàëààãààðàà æèãä ººð÷ëºãäºæ áàéãàà íü àæèãëàãäñàí þì. Íàñ àõèõàä ººð÷ëºëºíä ýð÷èìòýé îðäîã áîëîí õîæóó ººð÷ëºëòºíä îðäãîîð íü 2 õóâààñàí.

I ñàëàà: à. carotis communis II ñàëàà: a. vertebralis V3

a. carotis externa a. vertebralis V5

Ñóäàëãààíû ¿ð ä¿í. Áèä ñóäàëãààíäàà 16-ààñ äýýø íàñíû (7 á¿ëýã, á¿ëýã á¿ðò 30 õ¿í) íèéò 210 ýð¿¿ë Ìîíãîë õ¿íèé òàðõèíû ñóäàñíû ¿ç¿¿ëýëò¿¿äèéã õýò àâèàí äîïïëåîãðàôèéí àïïàðàòààð õýìæñýí ëàâëàãàà ¿ç¿¿ëýëòèéã òîãòîîëîî.

Ñóäàëãààíààñ ¿çýõýä äýýðõ ñóäàñíóóäûí äóíäàæ õóðä áîëîí ýñýðã¿¿öýë íü íàñ àõèõ òóñàì ººð õîîðîíäîî àäèëã¿é, ñàëàà ñàëààãààðàà æèãä ººð÷ëºãäºæ áàéãàà íü àæèãëàãäàæ áàéëàà. Ñóäàñíû äóíäàæ õóðäíû ººð÷ëºëò íü ñèñòîëûã áîäâîë äèàñòîëîîñ èë¿¿ èõ õàìààð÷ áóé íü àæèãëàãñàí þì. Ýð¿¿ë Ìîíãîë õ¿íèé òàðõèíû ñóäàñ íü 31-50 íàñíû õîîðîíä õàìãèéí ºíäºð õóðä, õàìãèéí áàãà ýñýðã¿¿öýëòýé áàéäàã íü àæèãëàãäëàà.

Ä¿ãíýëò:

1. Áèäíèé ñóäàëãààãààð Ìîíãîë õ¿íèé òàðõèíû äóíä àðòåðèéí äóíäàæ õóðä íü ãàäààäûí ñóäëàà÷äûíõòàé îéðîëöîî áàéñàí áà ñóäàëãààíààñ ¿çýõýä íàñíû áàéäëààñ õàìààð÷ ñóäàñíû õàíàíû óÿí õàòàí ÷àíà𠺺ð÷ëºãäñºíººñ õàìààð÷ õàðèëöàí àäèëã¿é õýìæýýñ ãàðäàã áàéíà.

2. Áèäíèé ñóäàëãààãààð äýýä ìýäðýëèéí ñèñòåìèéí äóõ, ÷àìàðõàé, çóëàéí äýëáýíã¿¿äýä îðøèõ òºâ¿¿äèéí ¿éë àæèëëàãààíû àëäàãäàë íü íàñ àõèõ òóñàì ýõýëæ èëýðäýã áà õàðèí äàãçíû äýëáýíä îðøèõ òºâ¿¿äèéí ¿éë àæèëëàãààíû ººð÷ëºëò íü ñ¿¿ëä àæèãëàãääàã íü ñóäàñíû äýýðõ ººð÷ëºëò¿¿äòýé õîëáîí ¿çýæ áîëîõ òàëòàé.

3. Äýýðõ ñóäàëãààíû àæèë íü ìîíãîë õ¿íèé òàðõèíû ñóäàñíû ýìãýãèéã ýðò îíîøëîõ áîëîí ýì÷ëýõýä ÷óõàë à÷ õîëáîãäîëòîé þì.


ÌÝÑ ÇÀÑËÛÍ ÀÐÃÀÀÐ ÕÓËÌÀÑÛÃ ÀÐÈËÃÀÕ ÁÎËÎÌÆ

Äàâààäîðæ, Ýíõáîëä, Áàò-Ýðäýíý, Ò¿äýâäîðæ, Ýíõ÷óëóóí, Aíàãààõ Óõààíû Èõ Ñóðãóóëü

Õºëñíèé áóë÷èðõàéíààñ ø¿¿ðäýã ºíãºã¿é øîðâîã àìòòàé øèíãýíèéã áèä õºëñ ãýäýã áà õîíîãò åðäèéí íºõöºëä 400-600 ìë õºëñ ÿëãàðäàã. Õºëñíèé 98-99% óñ, ¿ëäñýí õýñýãò íü ìî÷åâèí, øýýñíèé õ¿÷èë êåðàòèíèí, ñàâàí ìýòèéí áèîëîãèéí íýãäë¿¿ä áîëîí ñòåðîèä äààâðóóä ÿëãàðóóëäàã. Ýêêðèí áóë÷èðõàéíààñ ÿëãàðàõ õºëñíèé ÐÍ=3.8-5.6 àïîêðèí áóë÷èðõàéíààñ ÿëãàðàõ õºëñíèé ÐÍ=6.2-6.9 õºëñíèé õóâèéí æèí=1.001-1.006 áàéäàã áàéíà.

Àïîêðèí áóë÷èðõàéí ø¿¿ðýë ÿëãàðóóëæ áóé ýñèéí îðîéí õýñýã íü ãýìòýæ áàéæ ø¿¿ðëýý ÿëãàðóóëäàã áºãººä óã ø¿¿ðýë íü óóðàã àãóóëñàí áà ø¿ëòëýã îð÷èíòîé ó÷èð áàêòåðè (èõýâ÷ëýí ñòàôèëîêîêê) àìàðõàí ¿ðæäýã. Óã áàêòåðè íü õºëñòýé õàìò óóðøäàã áîäèñ áîëîõ 3 ìåòèë ãåêñàí õ¿÷èë ÿëãàðóóëñíû óëìààñ õóëìàñíû ýâã¿é ¿íýð ¿íýðòäýã íü íýãýíò òîäîðõîé áîëæýý.

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ÑÍ3 ÑÍ2 ÑÍ2 ÑÍ ÑÍ2 Ñ ÎÍ

Õóëìàñòàé ºâ÷òºíèé çîâèóð íü:

1. Öàéâàð, öàãààí ºíãèéí õóâöàñ ºìñºõºä áàéíãà íîéòîí áîëäîã

2. Ýâã¿é ¿íýð áàéíãà ¿íýðòäýã

3. ¯¿íäýý ñýòãýë ñàíààíû õóâüä çîâèóðòàé

4. ¯íýð áîëîí õºëñºº äàðàõ ãýæ ãîî ñàéõíû áàðàà á¿òýýãäýõ¿¿í áàéíãà õýðýãëýæ ýäèéí çàñãèéí õóâüä òºâºãòýé áàéäàëä õ¿ðäýã

Èéì çîâèóðòàé ºâ÷òºí¿¿ä õîâîð ÷ ãýñýí òîõèîëäñîîð áàéãàà íü ýíý òàëààð ñóäàëãà ÿâóóëàõ ¿íäýñ áîëëîî.

Çîðèëãî: Ìîíãîë õ¿íä òîõèîëäîæ áóé õóëìàñûã ìýñ çàñëûí àðãààð ýì÷ëýõ çîðèëãî òàâüñàí.

Çîðèëò:

1. Äýýðõ áóë÷èðõàéã ìýñ çàñëûí àðãààð ýì÷ëýõ àðãà÷èëëûã ººðèéí îðíû íºõöºëä òîõèðóóëàí áîëîâñðóóëàõ áîëîí íýâòð¿¿ëýõ

2. Õàãàëãààíû äàðààõ ¿ð ä¿íã òîîöîõ

3. Àïîêðèíû áóë÷èðõàéí ººð÷ëºëòèéã ýäèéí øèíæèëãýýãýýð áàòëàõ

Ñóäàëãààã áèä óäèðäñàí áàãøèéí õàìò ÓÊÒÝ-èéí ìýñ çàñëûí òàñàãò äýýðõ çîâèóð á¿õèé ºâ÷òºí¿¿äèéí ººðñäèéíõ íü õ¿ñýëòýýð àïîêðèí áóë÷èðõàé àâàõóóëàõ ìýñ çàñëûã 2 ýðýãòýé 8 ýìýãòýé áóþó íèéò 10 ºâ÷òºíä õèéëýý. Ýäãýýð ºâ÷òºí¿¿ä ºìíº íü ýìèéí áîëîí áóñàä òºðëèéí ýì÷èëãýý õèéñýí áîëîâ÷ ¿ð ä¿í ºãººã¿é áàéñàí.

Òåõíèê àðãà÷ëàë: Ñóãàíû áîëîí ãàðûí ¿éë àæèëëàãààã àëäàãäóóëàõã¿éãýýð ñóãàíû ¿ñòýé õýñãèéí àðüñûã ººëæ àâààä ¿ëäñýí áóë÷èðõàéã ò¿¿æ àâàí, àðüñûã ÷ºëººëæ õºíèéä óðñãóóð áàéðëóóëàí øàðõûã ¿å÷ëýí î¸õ çàð÷ìààð ìýñ çàñëûã ã¿éöýòãýñýí.

Ãèñòîëîãèéí øèíæèëãýý: Àïîêðèíû áóë÷èðõàéí òîî îëøèð÷ ãèïåðòðîôè áîëñîí ä¿ãíýëò ãàðëàà.

¯ð ä¿í: Äýýðõ 10 ºâ÷òºí ìýñ çàñëûí ýì÷èëãýý õèéëãýñíèé äàðàà 10-12 õîíîîä ýìíýëãýýñ ãàðñàí.

8 ºâ÷òºí: 2 ñóãàíû øàðõ ýäãýð÷ ¿íýðã¿é áîëñîí áà õºëñ ãàðñàí ÷ õóâöàñ íîðãîõã¿é áîëñîí.

1 ºâ÷òºí: 1 ñóãà ¿íýðã¿é õºëðºõã¿é íºãºº ñóãàíû ¿íýð áóóðñàí.

Ýíý íü íèëýýí èõ õºëºðñíèé äàðàà óñàíä îðîõã¿é õýä õîíîõîä ¿íýðòýíý.

1 ºâ÷òºí: 2 ñóãà áàãà õýìæýýãýýð õºëðºõ áà ¿íýð áóóðñàí.

1. Á¿ðýí ýäãýðñýí

2. Íýã ñóãà íü ýäãýðñýí

íºãºº ñóãàíû ¿íýð áóóðñàí

3. Õî¸ð ñóãàíû ¿íýð áàãàññàí

Õî¸ð ñóãàíû øàðõ ýäãýð÷ îãò ¿íýðã¿é áîëñîí áà õºëºðñºí ÷ ñóãà õýñãýýðýý õóâöàñ íîðãîõã¿é áîëñîí 8 òîõèîëäîëûã áèä á¿ðýí ýäãýðñýí ãýæ ¿çëýý. ÿéöýä ýäãýðýýã¿é õî¸ð òîõèîëäëûí õóâüä ìýñ çàñëûí òåõíèêòýé õîëáîîòîéãîîð çàðèì íýã àïðîêðèíû áóë÷èðõàé ¿ëäñýí áà ñóãà õýò èõ ¿ñòýé, àðüñûã ººëæ àâàõ õýìæýý áàãà áàéñàí, õóëìàñòàé îëîí æèë áîëñîí çýðýã øàëòãààíòàé õîëáîæ ¿çëýý.

Ä¿ãíýëò:

1. Ñóãà èõ õºëºðäºã áîëîí õóëìàñ ¿íýðòäýã ºâ÷òºíã ìýñ çàñëààð ýì÷ëýõ áîëîìæ áàéíà. Ñóãàíû ¿ñòýé õýñãèéí òàëáàé áóë÷èðõàéí áàéðëàõ ã¿íýýñ ìýñ çàñëûí ¿ð ä¿í õàìààð÷ áàéíà.

2. Ñóäàëãààíä õàìðàãäñàí ºâ÷òºíèé 80% íü 100%-èéí ýäãýðýëòòýé áàéíà.


ÂÅÍÈÉÍ ÑÓÄÑÛà ØÈËƯ¯ËÆ ÑÓÓËÃÀÕÀÄ ÃÀÐÀÕ ªªÐ×˪ËÒÈÉà ÑÓÄÀËÑÀÍ ÍÜ

Ä.Òàìèð, Ë.Ýíõáàÿð, Ö.Ãàíáèëýã, Ã.Áàòòºìºð, Á.Ðýíöýíõàíä, Ö.Ãàðìàà, “À÷” Àíàãààõ Óõààíû Äýýä Ñóðãóóëü

Ñóäàëãààíû ¿íäýñëýë: Òóðøèëòûí ìýñ çàñëûí øèíæëýõ óõààí áîë ýðäýì øèíæèëãýýíèé àæëûí õàìãèéí ÷óõàë õýñýã áºãººä îíîëûí øèíæëýõ óõààíû àõèí äýâøèõ áºãººä, îéëãîí ìýäðýõ ÷óõàë øàëãóóð áèëýý. Îð÷èí ¿åèéí ìýñ çàñëûí øèíæëýõ óõààíä ýðõòýí øèëæ¿¿ëýí ñóóëãàõ, õèéìýë ýä ýðõòíýýð îðëóóëàí õýðýãëýõ àñóóäàë íèëýýä ºíäºðò òàâèãäàæ áàéãàà áºãººä ýäãýýð ýä ýðõòýí, õèéìýë ýä¿¿äèéí áèå ìàõ áîäèä äàñàí çîõèöîõ, ººðèéí áîëãîõ íü îëîí õ¿÷èí ç¿éëýýñ øàëòãààëäàã áàéíà.

Ñóäàëãààíû çîðèëãî: Òóðøèëòûí àìüòíû àðòåðèéí ñóäñûã âåíèéí ñóäñààð îðëóóëàí ñóóëãàõàä ò¿¿íä ãàðàõ ººð÷ëºëòèéã ñóäëàõ

Ñóäàëãààíû çîðèëò:

1.Òóðøèëòûí àìüòíû àðüñàí äîîðõ ºíãºö âåíèéí ñóäàñûã òîäîðõîé àðãà÷ëàëûí äàãóó àâ÷ øèëæ¿¿ëýí ñóóëãàõàä áýëòãýõ

2. Øèëæ¿¿ëýí ñóóëãàõ âåíèéí ñóäñààð àðòåðèéí ñóäñûã îðóóëàõ

3. Øèëæ¿¿ëýí ñóóëãàñàí âåíèéí ñóäñûã òîäîðõîé õóãàöààíû äàðàà àâ÷ ò¿¿íä ãàðàõ ººð÷ëºëò¿¿äèéã ýä ýñèéí ò¿âøèíä ñóäëàõ

Ñóäàëãààíû àðãà÷ëàë: Áèä öýâýð áóñ ¿¿ëäðèéí 13 íîõîéä ìýñ çàñàë õèéñýí áîëîâ÷ 5 íîõîéä òîäîðõîé õ¿íäðýë¿¿ä òîõèîëäñîí òóë öààøäûí ñóäàëãààãààð áóñàä 8 íîõîéä ÿâóóëñàí. Òóðøèëòûã Õ-RAY êëóáûí õàãàëãààíû ºðººíä õèéñýí áîëíî.

Áèä òóðøèëòûã 3 áàãèéí á¿ðýëäýõ¿¿íòýéãýýð õèéñýí áà âåíèéí ñóäñûã øèëæ¿¿ëýí ñóóëãàõ ìýñ çàñàë íü 4 ¿íäñýí õýñãýýñ òîãòîíî.

1-ðò Õàãàëãàààíä íîõîéãîî áýëäýýä óðüäàë ýìæ¿¿ëýëò õèéí, ñóäàñíû áîëîí ýôèðèéí ìàñêèéí óíòóóëãà õèéõ (áàã-1)

2-ðò Õàãàëãààíû òàëáàéã çîõèõ ¸ñîîð àðèóòãàí íîõîéí äîîä ìº÷íèé àðüñàí äîîðõ ºíãºö âåíèéí ñóäñûã îð÷íû ýäýýñ ñàëãàí àâàõ (áàã-2)

3-ðò Øèëæ¿¿ëýí ñóóëãàõ âåíèéí ñóäñàà òîäîðõîé àðãà÷ëàëûí (Sol.Heparini 3% 5ml, 0.9% NaCl 400ml, öóñ 10ml-óóñìàë) äàãóó óãààõ (áàã-3)

4-ðò Íýã òàëûí ã¿ðýýíèé åðºíõèé àðòåðèéí ñóäñûã ÿëãàí (çóðàã 2) ò¿¿íèé öóñíû óðñãàëûã õààí, âåíèéí ñóäñûã øèëæ¿¿ëýí ñóóëãàõ (çóðàã 3)(2- áàã)

Õàãàëãààíûõàà ÿâöàä òàðõèíû ýäèéí õ¿÷èëòºðºã÷èéí õýðýãöýýã áàãàñãàõ çîðèëãîîð õºðãºëòèéí áóþó ãèïîòåðìèéã àøèãëàñàí áîëíî.

12-16 õîíîãèéí äàðàà äàâòàí õàãàëãàà õèéæ øèëæ¿¿ëýí ñóóëãàñàí âåíèéí ñóäñàà ýðã¿¿ëýí àâ÷ ýä ýñèéí øèíæèëãýý õèéí (çóðàã,4) ãàðñàí ¿ð ä¿íã ä¿ãíýëýý.

Ñóäàëãààíû ¿ð ä¿í:

1.Òîäîðõîé àðãà÷ëàëûí äàãóó áýëòãýñýí óóñìàëààð øèëæ¿¿ëæ ñóóëãàõ âåíèéí ñóäñûã óãààæ áýëòãýí, àðòåðèéí ñóäñàíä øèëæ¿¿ëæ ñóóëãàñíààñ õîéø 12 õîíîãèéí äàðààãààð òóõàéí ñóäñàíä ýä ýñèéí øèíæèëãýý õèéæ ¿çýõýä:

Èíòèì áîëîí áóë÷èíëàã äàâõàðãà íü ñàéí õºãæñºí, êîëëàãåí á¿òýö íü ÿëãàãäñàí áà óÿí øèðõýãèéí õºãæèë ñàéí áàéñàí. Âåíèéí ñóäñíû õýëáýð çºâ, äîòîð áîëîí áóë÷èíëàã äàâõàðãà õîîðîíäîî òîäîðõîé çààãã¿é. Ñóäñíû ãàäíà äàâõàðãà á¿òýí õàäãàëàãäñàí, ãàäóóðàà õîáîã÷ ýä íü äàâõàðãàòàé.

2. Óóñìàëààð óãààãààã¿é á¿ëýã ýä ýñèéí øèíæèëãýýíä: èíòèì áîëîí áóë÷èíëàã äàâõàðãûí çààã äýýð ãèàëèíû òàëáàé áèé áîëæ, øèëæ¿¿ëýí ñóóëãàñàí ñóäñàíû ãàäíà òàëààð çóçààí õîëáîã÷ ýäýí äàâõàðãà áàéíà.

Ä¿ãíýëò

Òîäîðõîé àðãà÷ëàëûí äàãóó áýëòãýñýí óóñìàëààð øèëæ¿¿ëýí ñóóëãàõ âåíèéí ñóäñûã óðüä÷èëàí óãààæ áýëòãýõ íü ¿ð ä¿íòýé áîëîõ íü õàðàãäàæ áàéíà.


ÕÎÄÎÎÄ ÃÝÄÝÑ ÒÀÉÐÀÕ ÕÀÃÀËÃÀÀÍÄ ÌÝÑ ÇÀÑËÛÍ ÓÒÀÑÍÛ ÑÎÍÃÎËÒ ÕÈÉÕ ÍÜ

Ñ.Áèëýãñàéõàí, À.Äàâààäîðæ, Ñ.Äàøöîãò, Á.Äýìáýðýëíÿìáóó, Á.Óóãàíáàÿð, Á.Èñàãóëü, Àíàãààõ Óõààíû Èõ Ñóðãóóëü, Çàëóó ìýñ çàñàë÷ êëóá

Ñýäýâò àæëûí ¿íäýñëýë. ªíººäºð äýëõèéí óëñ îðîí monocril, Dexon, Vicril, PDS, Maxon, Ethibomd, Ethilon ãýýä îëîí òºðëèéí óòàñ õýðýãëýæ áàéãàà áèëýý ãýâ÷ ýäãýýð óòñûã ÿìàð õàãàëãààíä õýðýãëýâýë àëü íü èë¿¿ èõ òîõèðîìæòîé ãýäýã òàë äýýð òýð á¿ðèéí íàðèéí ñàéí ìýääýãã¿é àëü òààðàëäñàí óòñààð õàãàëãàà îðîõ íü ýëáýã òîõèîëääîã. Õîäîîä ãýäýñ òàéðàõ õàãàëãààíû ¿åä õýðýãëýõ ÿìàð óòàñ õýðýãëýâýë èë¿¿ çîõèìæòîé ýñýõ òàëààð òóðøèëò ñóäàëãààã õèéæ áèå îðãàíèçìûí õàðèó óðâàëûí ¿ð ä¿íã ñóäàëëàà.

Ñóäàëãààíû çîðèëãî: Áèä ýíý óäààä õîäîîä ãýäýñíèé õàãàëãààíä àëü íü çîõèìæòîé áîëîõûã ººðèéí îðíû íºõöºëä õýðýãëýãðýæ áóé çîðèóëàëòûí óòñààð õàãàëãàà õèéæ óëìààð ýäýä ¿ç¿¿ëýõ íºëºº, ýäèéí ýäãýðýëòèéí áàéäëûã ººðñäèéí õèéñýí òóðøèëòààð ñóäëàí öààøèä õîäîîä ãýäýñíèé õàãàëãààíä õýðýãëýâýë çîõèõ õàìãèéí áàãà óðâàëæ ÷àíàðòàé óòàñûã îëæ ìýñ çàñàëä õýðýãëýõ çîðèëãî òàâüñàí þì.

Ñóäàëãààíû àæëûí çîðèëò:


Ñóäàëãààíû àæëûí øèíýëýã òàë:

-Ìàíàé îðíû íºõöºëä ýíý òºðëèéí ñóäàëãààã óðüä ºìíº áàãà õèéæ áàéñàí

-Ìàíàé óëñàä ìýñ çàñëûí çîðèóëàëòàé óòàñ ¿éëäâýðýëäã¿é òóë îðîñ, ãåðìàí,àìåðèê çýðýã îëîí óëñûí ÿíç á¿ðèéí êîìïàíèàñ õóäàëäàí àâäàã. Òóõàéí êîìïàíè ººðèéí õèéñýí óòñûã õàìãèéí ñàéí ìýòýýð ñóðòàë÷èëäàã ýäãýýðèéí ÷óõàì àëü íü ¿íýõýýð ñàéí òàëààð êëèíèêèéí òóðøèëò ñóäàëãàà ÿâóóëàí ¿ð ä¿íã ýì÷ íàðûí äóíä õýëýëö¿¿ëæ áàéãàà íü ýíý òºðëèéí õàãàëãàà õèéëãýæ áàéãàà õ¿ì¿¿ñèéí ìýñ çàñëûí äàðààõ øàðõíû ýäãýðýëò, ãàðàõ õ¿íäðýë, øàíàëãàà çîâèóð çýðýãýýñ óðüä÷èëàí ñýðãèéëæ ýì÷èëãýýíèé ¿ð ä¿íã ñàéæðóóëàõ òàëòàé íü


Çóðàã 1. Õàãàëãàà õèéæ áàéãàà ¿å

Ñóäàëãààíû òåõíèê áà àðãà÷ëàë:

Áèä õî¸ð æèëèéí òóðø ýíýõ¿¿ ñóäàëãààíûõàà àæëûí çîðèëãî, çîðèëòîî õýðýãæ¿¿ëýõèéí òóëä òóðøèëòûí 8-í ãàõàéä õîäîîä òàéð÷ Áèëüðîò 2-ð çàëãàëòûã

- Åðäèéí äààâóó óòàñ


Õðîìæóóëñàí êåòêóòýýð î¸æ ýäèéí ººð÷ëºëòèéã ñóäàëëàà. Õàãàëãààã (Çàëóó ìýñ çàñàë÷) êëóáûí õàãàëãààíû ºðººíä õèéñýí áîëíî. Õàãàëãààíä ãàõàéãàà áýëäýí óðüäàë ìýäýýã¿éæ¿¿ëýëò õèéí ñóäñàíû áîëîí ýôèðèéí ìàñêèéí áîëîí óíòóóëãûí äîð íîéðñóóëñàí. Õàãàëãààíû òàëáàéã çîõèõ ¸ñîîð àðèóòãàí õýâëèéí ãîëûí ç¿ñëýãýýð àéìõàé ìºãººðñíººñ äîîø 10ñì îð÷èí õýâëèéã ¿å÷ëýí íýýæ öóñ òîãòîîæ òóñãààðëàâ. Õýâëèéí õºíäèéã øàëãààä õîäîîäíû íóãàëóóðûã îëæ, õîäîîäíû èõ áàãà ìàõèàã ÷ºëººëºí, õîäîîäíû äîîä 2/3-ûã òàéð÷ õîäîîäíû áàãà ìàõèà òàëûã áèò¿¿ëýí î¸æ èõ ìàõèà òàëä 2.5ñì îð÷èì íàðèéí ãýäýñ çàëãàõ í¿õ ¿ëäýýâ. Íàðèéí ãýäýñíèé ãîãöîî àâ÷ õîäîîäíû èõ ìàõèà òàëä òºãñãºë õàæóóãààð íü ãýäýñ õîäîîäûã Áèëüðîò II àðãààð çàëãàæ î¸â. Õîäîîä ãýäýñíèé çàëãààñíààñ 15ñì çàéä íàðèéí ãýäýñíèé ãîãöîî õîîðîíä Áðàóí õîëáîëòûã õèéâ. Õýâëèéí õºíäèéã óãààæ ¿å÷ëýí õààâ.

Çóðàã 2. Áèëüðîò II çàëãàëò õèéæ áàéãàà íü

Áèä õàãàëãàà õèéñýí ãàõàéãàà ÿìàð óòñààð î¸ñîí ãýäýñíýýñ íü õàìààðóóëæ 4 á¿ëýãò õóâààí àâ÷ ¿çýí øèíæèëãýý ñóäàëãààãàà ÿâóóëñàí.

1-ð á¿ëýã: Ýíý á¿ëãèéí õàãàëãààíä åðäèéí äààâóóí óòàñ ñîíãîí àâ÷ õýðýãëýñýí

2-ð á¿ëýã: Ýíý á¿ëãèéí õàãàëãààíä Dexon 2.0 ã ñîíãîí àâ÷ íýðýãëýñýí

3-ð á¿ëýã: Ýíý á¿ëãèéí õàãàëãààíä PDS 3.0-ã õýðýãëýñýí

4-ð á¿ëýã: Ýíý á¿ëãèéí õàãàëãààíä Õðîìæóóëñàí êåòêóò àâ÷ õýðýãëýñýí. Õàãàëãàà õèéãäñýíýýñ õîéø 15 õîíîãèéí äàðàà äàâòàí õàãàëãàà îðæ Ìàêðî ò¿âøèíä ýäãýðýëò õýðõýí ÿâàãäñàíûã ñóäëàõ. ̺í ò¿¿íýýñ ãàäíà ýä ýñèéí øèíæèëãýýíèé ìàòåðèàë àâ÷ ýìãýã ãèñòîëîãò ýäèéí øèíæèëãýý õèéëãýñýí.

Çóðàã 3. Ýäèéí øèíæèëãýýíä àâñàí ìàòåðèàë

Ñóäàëãààíû ¿ð ä¿í:

1-ð á¿ëýãò õàìðàãäàí åðäèéí äààâóóí óòñààð õàãàëãàà õèéëãýñýí ñóäàëãààíû á¿ëãèéí Ìàêðî ò¿âøèíãèéí ¿ð ä¿í:

θäëóóäûã øàëãàõàä äýýðõè ãýäýñíèé ¸çîîðûí î¸äîë õàâàíòàé, î¸äëûí îð÷èì öóñ õàðâàëòóóä ¿¿ññýí áàéâ. ¯ðýâñýë òóõàéí îð÷èì èõýýð ÿâàãäàæ íààëäàö ¿¿ñýí ýäèéí øèíæèëãýý àâàõàä íèëýýä òºâºãòýé, î¸äîë äýýðýýñ ýäèéí øèíæèëãýý àâñàíû äàðàà î¸õîä õàâàí èõòýé òóë ñýòýð÷ î¸õîä ìàø òºâºãòýé áàéëàà.

Ýäèéí øèíæèëãýýíèé ¿ð ä¿í:

Äàâòàí õàãàëãààíû ìàòåðèàëûã ýìãýã ãèñòîëîãò ýäèéí øèíæèëãýý õèéëãýõýýð èëãýýñýí áºãººä øèíæèëãýýã ìàãèñòð áàãø Á.Òóóë õèéâ. Õàãàëãààíû ìàòåðèàëûã 10%-èéí Ôîðìàëèíû óóñìàëä áýõæ¿¿ëæ ãèñòîëîãè äàìæëàãààð äàìæóóëàí ãèìàòîêñèëèí ýîçèí, Âàí ãèçîíû áóäãààð áóäàæ ãýðëèéí ìèêðîñêîïîîð õàðñàí.

Äààâóóí óòñààð î¸ñîí õýñýãò:

¯æèë èõòýé íèòðîôèëü ýñèéí íýâò÷èëò, öóñ õàðâàëòàé, öóñ õàðâàëò áîëîí ¿ðýâñëèéí ýñ¿¿ä ýð¿¿ë ýä ð¿¿ íýâ÷ñýí, îð÷íû ñàëò á¿ðõýâ÷èéí áóë÷èðõàéíóóä áîäèñûí ñîëèëöîîíû õóâèðàëòòàé.

Ä¿ãíýëò:

¯æèë, ¿ðýâñýë, öóñ õàðâàëò òîä èëýðñýí îð÷íû ýð¿¿ë ýäýä õóâèðàëòòàé.


Çóðàã 4. Äààâóó óòñààð î¸ñîí ýä


2-ð á¿ëýãò õàìðàãäàí Dexon 2.0 óòñààð õàãàëãàà õèéëãýñýí á¿ëãèéí Ìàêðî ò¿âøèíãèéí ¿ð ä¿í:

θäëóóäûã øàëãàõàä äýýðõ ãýäýñíèé ¸çîîðûí î¸äîë õàâàí áàãàòàé, î¸äëûí îð÷èì öóñ õàðâàëòã¿é áàéâ. θäëîîñ ýäèéí øèíæèëãýý àâ÷ äàõèí î¸äîë òàâèõàä ÿìàð íýãýí õ¿íäðýë ãàðñàíã¿é.

Ýäèéí øèíæèëãýýíèé ¿ð ä¿í:

Dexon óòñààð î¸ñîí õýñýãò öóñíû öàãààí ýñýýñ òîãòñîí ¿ðýâñýë èõ èëýðñýí, ¿ðýâñëèéí ýñ¿¿ä îð÷íû ýä ð¿¿ ÿëàíãóÿà áóë÷èíãèéí äàâõàð ðóó íýâ÷ñýí ¿ðýâñëèéí îð÷èìä ãàíö íýã ôèáðîáëàñò, ôèáðîöèò õîëáîõ ýäèéí ýñ¿¿ä àæèãëàãäñàí.

Ä¿ãíýëò:

¯ðýâñëèéí óðâàë òîä èëýðñýí


Çóðàã 5. Dexon óòñààð î¸ñîí ýäèéí øèíæèëãýý


3-ð á¿ëýãò õàìðàãäàí PDS 3.0 óòñààð õàãàëãàà õèéëãýñýí á¿ëãèéí Ìàêðî ò¿âøèíãèéí ¿ð ä¿í:

θäïóóäûã øàëãàõàä äýýðõè ãýäýñíèé ¸çîîðûí î¸äîë õàâàí áàãàòàé, î¸äëûí îð÷èì öóñ õàðâàëòã¿é áàðàã ýäãýðñýí ãýõýýð áàéëàà. θäëîîñ ýäèéí øèíæèëãýý àâ÷ äàõèí î¸äîë òàâèõàä ÿìàð íýãýí õ¿íäðýë ãàðñàíã¿é.

Ýäèéí øèíæèëãýýíèé ¿ð ä¿í:

PDS óòñààð î¸ñîí õýñýãò áàãà çýðãèéí ¿ðýâñëèéí íýâ÷äýñòýé íèòðîôèëü ýñ èõýýð öóãëàðñàí, ýñ¿¿ä òààðóó áàéðëàñàí òýäãýýðèéí äóíä õîëáîõ ýäèéí çàëóó ýñ¿¿ä ãàíö íýã èëýðñýí.

Ä¿ãíýëò:

¯ðýâñëèéí óðâàë áàãàòàé, ñîðèâæèæ ýäãýðýëò ýõýëñýí.


Çóðàã 6. PDS óòàñààð î¸ñîí ýäèéí øèíæèëãýý

3-ð á¿ëýãò õàìðàãäàí Õðîìæóóëñàí êåòêóò óòñààð õàãàëãàà õèéëãýñýí á¿ëãèéí Ìàêðî ò¿âøèíãèéí ¿ð ä¿í:

θäëóóäûã øàëãàõàä äýýðõè ãýäýñíèé ¸çîîðûí î¸äîë õàâàíòàé, î¸äëûí îð÷èì öóñ õàðâàëò, ¿ðýâñýëòýé áàéâ. ¯ðýâñýë îð÷èì áàãà çýðýã íààëäàö ¿¿ñýæ õàâàãíàí ýäèéí øèíæèëãýý àâàõàä áàãà çýðãèéí áýðõøýýëòýé, äàõèí î¸õ ÿâöàä ñýòýð÷ áàéâ.

Ýäèéí øèíæèëãýýíèé ¿ð ä¿í:

Õðîìæóóëñàí êåòêóòýýð î¸ñîí õýñýãò: ¿õæëèéí ººð÷ëºëòººñ ãàäíà ¿ðýâñëèéí íýâ÷äýñ èõòýé, ¿ðýâñëèéí öóñíû öàãààí ýñýýñ ãàäíà, îëîí òîîíû ãàäíû áèåòèéí ýñðýã àâðàãà ýñ¿¿ä öóãëàðñàí, ýäãýýð ýñ¿¿ä íü õýìæýýãýýðýý òîì îëîí Ẻìòýé, Ẻãíºð÷ áàéðëàñàí áàéíà. ̺í õîëáîõ ýäèéí çàëóó ýñ¿¿ä øèðõýã¿¿ä àæèãëàãäàíà.

Ä¿ãíýëò:

Ãàäíû áèåòèéí ýñðýã ¿¿ñýõ àâàðãà ýñèéí óðâàë òîä èëýðñýí, õîëáîõ ýäèéí óðãàëò ºðíºæ áóé äààâóó óòñààð î¸ñîí õýñýãò:

¯õæèë èõòýé, íåéòðîôèëü ýñèéí íýâ÷èëò, öóñ õàðâàëòòàé, öóñ õàðâàëò áîëîí ¿ðýâñëèéí ýñ¿¿ä ýð¿¿ë ýä ð¿¿ íýâ÷ñýí, îð÷íû ñàëñò á¿ðõýâ÷èéí áóë÷èðõàéíóóä áîäèñûí ñîëèëöîîíû õóâèðàëòàé.


Çóðàã 7. Õðîìæóóëñàí êåòêóòààð î¸ñîí ýäèéí øèíæèëãýý


Ýíý á¿õíýýñ ¿çýõýä PDS óòñààð î¸ñîí õýñýãò ¿ðýâñëèéí õàðèó óðâàë áàãà, 15 õîíîãèéí äàðàà óòàñ õàéëààã¿é, î¸äëûí òîãòîö ñàéí áàéæýý. Dexon óòñààð î¸õîä ¿ðýâñëèéí óðâàë èëýðñýí ÷ ýäèéí ýäãýðýëò äàâõàð ÿâàãñàí óòàñ õàéëààã¿é, î¸äëûí òîãòîö ñàéí áàéñàí. Õðîìæóóëñàí êåòêóòýýð î¸ñíû äàðàà óòàñ õàéëæ ýõýëñýí, ãàäíû áèåòèéí ýñðýã ýñ èõýýð ¿¿ññýí, ¿ðýâñýë èõòýé áàéæýý.

Ä¿ãíýëò:

1. Äààâóó óòñààð î¸ñíû äàðàà îð÷íû ýäýä ¿õæèë ¿¿ññýí íü õàãàëãààíû äàðààõ î¸äîë çàäðàõ õ¿íäðýëèéí ãîë øàëòãààí áàéæ áîëíî ãýæ ¿çëýý

2. Õîäîîä äýýðõè ãýäýñíèé õàãàëãààíä PDS óòàñ õàìãèéí òîõèðîìæòîé. Dexon óòàñ òîãòîö ñàéòàé, êåòêóò áîëîí äààâóó óòàñíààñ ¿ðýâñýë èõýýð ¿¿ñ÷ õî¸ðäîã÷ õàëäâàð àâñàí òîõèîëäîëä î¸äîë çàäðàõ àþóëä õ¿ð÷ áîëîõ íü äýýðõè òóðøèëòààñ òîäîðõîé áàéíà

3. Èéìýýñ õàãàëãààíû ¿åä PDS, Dexon çýðýã çîðèóëàëòûí óòàñ õýðýãëýõ íü õàãàëãààíû äàðààõ î¸äîë çàäðàõ, î¸äëûí õýñýã ¿ðýâñýõ, çàëãààñ ñîðâèæèæ íàðèéñàõ õ¿íäðýëýýñ ñýðãèéëýõ íýãýí áîëîìæ áóéã äýýðõ áîëîìæ õàðóóëæ áàéíà.


LARELL ELECTROPHORES-ÈÉÍ ÀÐÃÀÀÐ HBsAg-ÈÉ ÕÝÌÆÝÝà ÒÎÄÎÐÕÎÉËÎÕ ÎÐ×ÈÍ ¯ÅÈÉÍ ÀÐÃÀ

Á. Õèøèãòºð, Æ.Îþóíáèëýã, Íèéãìèéí ýð¿¿ë Ìýíäèéí Õ¿ðýýëýí, Ìîíãîë Óëñûí Èõ Ñóðãóóëü

Ãåïàòèò íü ìàíàé îðîíä òºäèéã¿é äýëõèé íèéòýä ºðãºí òàðõñàí âèðóñèéí õàëäâàðò ºâ÷èí þì. Ãåïàòèò  âèðóñ íü õ¿íèé ýëýãíèé ýñýä ¿ðæèí îëøèð÷ óëìààð ýä ýñèéã ººð÷ëºëòºíä îðóóëàí õýâèéí ¿éë àæèëëàãààã àëäàãäóóëæ öî÷ìîã áîëîí àðõàã ãåïàòèò ýëýãíèé õàòóóðàë áà ýëýãíèé àíõäàã÷ ºìºíã ¿¿ñãýäýã. ̺í äýëõèéí íèéò õ¿í àìûí 2 òýðáóì ãàðóé íü ãåïàòèò  âèðóñèéí õàëäâàð àâñíû 350 ñàÿ íü òýýã÷ áîëäîã.

Ìàíàé õ¿í àìûí 77.7% íü ãåïàòèò  âèðóñûí õàëäâàð àâñàí áºãººä òýäãýýðèéí 3-21.6% íü âèðóñ òýýã÷ áîëñíûã îëîí óäààãèéí ñóäàëãàà õàðóóëæ áàéíà. Èéìýýñ ãåïàòèò  âèðóñèéã îíîøëîõ íü ýìíýë ç¿é, òàðõâàð ñóäëàëûí ÷óõàë à÷ õîëáîãäîëòîé þì. Ãåïàòèò  âèðóñèéí õàëäâàðûã ÃÂÂ-èéí õàëäâàðòàé ºâ÷òºíèé èéëäñýí äýõ ºâºðìºö àíòèòåë-àíòèãåíýýð èëð¿¿ëäýã. Èõýíõ ïðàêòèê áîëîí ëàáîðàòîðèä ÃÂÂ-èéã èëð¿¿ëýõ íàéäâàðòàé îíîøëîãîî íü ñåðîëîãèéí ìàðêåðóóäèéã õýðýãëýõ ÿâäàë þì (HBsAg, HbeAg, anti-HBc, anti-HbclgM, anti-Hbe, HbeAg, anti-HBe). Ìàíàé òîõèîëäîëä HBsAg èéã Laurell electrophorese-èéí àðãûã õýðýãëýæ îíîøèëñîí þì.

Laurell electrophorese-èéí àðãûí à÷ õîáîãäîë:

-Èéëäñýí äýõ HBsAg-èé òîî õýìæýýã (ìã/ìë) ìàø íàðèéí òîäîðõîéëäîã.

Õàðèí îäîî õýðýãëýæ áàéãàà Òàñàëäàëò Èììóíîýëåêòðîôîðåçèéí àðãà íü çºâõºí òèòðèéã ë òîãòîîäîã.

-Õÿìä òºñºð, öàã õóãàöàà áàãà øààðääàã, ìàãàäëàë ºíäºðòýé

-Òóíàäàñæèëòûí çóðâàñ øèíæëýãäýõ¿¿íýýñ õîë ¿¿ñýõ ó÷èð ºâºðìºö áóñ òóíäàñæèëòûã àìàðõàí ÿëãàõ áîëîìæòîé.

Àæëûí çîðèëãî: Öóñíû äîíîð ñîíãîëò, âèðóñò ãåïàòèòûí ÿëãàí îíîøëîëò, áýëäìýëä ÷àíàðûí õÿíàëò õèéõ, âàêöèíû äîíîðûã ñîíãîõ çýðýãò Òàñàëäàëò Èììóíîýëåêðîôîðåçèôèéí àðãûã õýðýãëýæ áàéãàà ìàíàé îðíû íºõöºëä ò¿¿íèé ìýäðýã ÷àíàðûã ñàéæðóóëàõ àñóóäàë çàéëøã¿é ãàð÷ èðæ áàéãàà þì. Ýíý øààðäëàãûí ¿íäñýí äýýð Laurell electrophorese-èéí àðãûã òóðøèæ ¿çýõ çîðèëãî òàâüëàà.

Ìàòåðèàë, àðãà ç¿é: Ýíý àðãà èéëäýñ þìóó ïëàçìàä àãóóëàãäàõ 0.2-50ìã/ìë õýìæýýòýé HBsAg-èéã èëð¿¿ëýõýä àøãèëäàã. Õýðýâ ¿¿íýýñ ºíäºð êîíöåíòðàöèòàé áàéâàë øèíãýëýõ øààðäëàãàòàé.

Óðâàëæóóä: ñòàíäàðò low àãàðîçå (Biorad Order No. 162-0100)

-Laurell butter-ò: tris-17.7g, CaCe2- -0.15g, Dietylbarbital-9.0 bidest H2 O, NaN3 –260mg, PH=8.6

Áàãàæ òîíîã, òºõººðºìæ: 5õ7.5ñì õýìæýýòýé øèëýí òàâèóð, 7.5õ10 ñì õàðüöààòàé filter öààñ, àãàðîçûí ãåëýý ç¿ñýæ àâàõàä øààðäàãäàõ õóòãà, 25ìã-èéí pipett, thermostat (water bath), 20ml, 10ml, pipettes, àãàðîçîî áóöàëãàõ øèëýí êîëáî, 10ìë-èéí õóðóóí øèë, ãåëü í¿õëýã÷ áà òàõèð ç¿¿, õàð ºíãèéí äýëãýö, ELECTROPHORESE èéí àïïàðàò.

Àðãà ç¿é:


0ìì 1ìì 2ìì 3ìì 4ìì 5ìì 6ìì 7ìì 8ìì 9ìì 10ìì11ìì 12ìì 13ìì 14ìì 15ìì 16ìì 17ìì 18ìì 19ìì 20ìì

Ä¿ãíýëò:

1.Ýíý àðãûã òóðøèæ ¿çñýíèé ¿íäñýí äýýð Ìîíãîëä íýâòð¿¿ëýõ áîëîìæòîé ãýæ ¿çëýý. Ó÷èð íü ÍÝÌÕ-èéí õ¿ðýýëýíãèéí âèðóñîëîãèéí òºâ ëàáîðàòîðè íü: Öóñíû äîíîðóóäûí öóñàíä øèíæèëãýý õèéæ HBsAg èëýðñýí äîíîðûí 1(-2) òèòðòýé èéëäýñíýýñ  âèðóñûí ýñðýã âàêöèí ãàðãàäàã áºãººä HBsAg-ã îíîøëîõäîî ºíººã õ¿ðòýë ÒÈÝÔ õýðýãëýäýã íü ó÷èð äóòàãäàëòàé áàéíà. ªºðººð õýëáýë Laurell electrophorese-èéí àðãààð èéëäñýíä àãóóëàãäàæ áàéãàà HBsAg-èé õýìæýýã òèòðýýð áèø èë¿¿ íàðèéí òîãòîîõ áîëîìæòîéãîîñ ãàäíà õÿìä òºñºð àðãà þì.

2.Ǻâõºí HBsAg ÷ áèø áóñàä ñåðîëîãèéí ìàðêåðóóäûã ýíý àðãààð èëð¿¿ëýõ áîëîìæòîé îíîøëîãîîíû ÷óõàë àðãà þì. Èíãýñíýýð èéëäýñò áîëîí õàëäâàðò ãåïàòèòèéã ÿëãàí îíîøëîõ, ýì÷èëãýýíèé òåõíèêèéã áîëîâñðóóëàõ ñýðãèéëýõ àðãà õýìæýýã çîõèîí áàéãóóëàõ, ýëãýíä ýä ýñèéí ººð÷ëºëò ãàð÷ àðõàãøñàí, îð÷èí òîéðîíäîî õàëäâàð èõ áàéãààã õàðóóëàõ ¿ç¿¿ëýëò áîëîõîîñ ãàäíà öóñíû äîíîðûã ñîíãîí àâàõ, âàêöèíä àãóóëàãäàõ Ag-èé õýìæýýã òîãòîîõ ó÷èð ÷óõàë à÷ õîëáîãäîëòîé þì.

3.Èéìä Laurell electrophorese-èéí àðãûã ïðàêòèêò íýâòð¿¿ëæ çºâõºí ÝËÝ òºäèéã¿é õîäîîä, óóøèã, óëààí õîîëîé, óìàéí õ¿ç¿¿ çýðýã áóñàä áàéðëàëûí õàâäðóóäûí ¿åä àøèãëàõ áîëîìæèéã òóðøèæ ¿çýõ øààðäëàãàòàé ãýæ ¿çýæ áàéíà. Ýíý àðãà íü íèéòýä õ¿ðòýýìæòýé, òîõèðñîí, ñîíãîìîë, ìàãàäëàë ºíäºðòýé õÿìä òºñºð àðãà þì.


ÕÎÐÒÎÉ ÕÀÂÄÀÐÒÀÉ Õ¯Ì¯¯ÑÈÉÍ ÒÀÌÕÈ ÒÀÒÀËÒÛÍ ÁÀÉÄËÛÍ ÒÀÍÄÀËÒ ÑÓÄÀËÃÀÀ

Î.Îäáààòàð, Àíàãààõ Óõààíû Èõ Ñóðãóóëü

Ñóäàëãààíû ¿íäýñëýë: ÄÝÌÁ-ûí ìýäýýëñíýýð çºâõºí òàìõèíààñ ¿¿äýëòýé ºâ÷íèé óëìààñ 1 æèëä 4 ñàÿ õ¿í íàñ áàðæ áàéíà. Ýíý òîî 2030 îí ãýõýä 10ñàÿä õ¿ðýõ áà ýäãýýðèéí 70% áóþó 7 ñàÿ íü Ìîíãîë ìýò õºãæèæ áàéãàà îðíóóäàä íîîãäîæ áàéíà ãýæ òîîöîîëæýý.

Òàìõèíä 4000 òºðëèéí õîðò áîäèñ áàéäàã áà ¿¿íèé äîòîð Íèêîòèíû áà õîðò õàâäàð ¿¿ñãýäýã 43 òºðëèéí òóõàéëáàë: ìàøèí óòàà, àêóìóëÿòîðûí øèíãýí, øàë öýâýðëýã÷, 2-íàòèëàìèí, 4-àìèíîáèôåíèë, áåíçàòðàöèí, áåíçîë, áåíçîïðèí, ôîðìàëüäåãèä, ìîíîêñèäêàðáîí ãýõ ìýò áè÷èë õýñýã áàéäàã áàéíà. Òàòàæ áóé òàìõèíû 20% íü ýçíèéõýý, 80% íü îð÷íû àãààðò äýãäýæ ýðãýí òîéðíû õ¿í àìûã õîðäóóëäàã àæýý. ̺í òàìõè òàòäàãã¿é õ¿ì¿¿ñ òàìõèíû óòààòàé ºðººíä íýã öàãèéí òóðø áàéõàä 15 øèðõýã òàìõè òàòñàíòàé òýíöýõ¿éö õýìæýýíèé õîðò õàâäàð ¿¿ñãýã÷ áîäèñóóäààð àìüñãàëæ áàéãàà íü èðýõ 20 æèëèéí äîòîð óóøãèíû áîëîí òºâºíõèéí õîðò õàâäðààð íàñ áàðàõ õ¿ì¿¿ñèéí òîîã 5 äàõèí ºñãºõ ñóóðèéã òàâüæ ºã÷ áàéãàà àæýý. Îäîî ìàíàé õ¿í àìûí íàñ áàðàëòûí øàëòãààíû äîòîð òàìõèíààñ èõýýõýí õàìààðàëòàé íü øèíæëýõ óõààíû ¿íäýñòýé íîòëîãäñîí Ç¿ðõ ñóäàñíû ºâ÷èí (31.3%), Õîðò õàâäàð (19.9%), àìüñãàëûí ýðõòýí òîãòîëöîîíû ºâ÷èí (12.8%) íü ýõíèé 1,2,3-ð áàéðàíä îðæ ñ¿¿ëèéí 10 æèëä ç¿ðõ ñóäàñíû ýìãýãýýð íàñ áàðæ áàéãàà 6 õ¿í òóòàìûí íýã íü õàâäàðûí óëìààñ ýíäýõ áîëëîî.

Õàðèí ñóäëàà÷äûí ¿çýæ áàéãààãààð òàìõèäàëòààñ òàòãàëçàõ íü õîðò õàâäàðûí ºâ÷ëºëèéã 25-30% áóóðóóëíà ãýæ òîãòîîñíîîñ ¿çâýë õîðò õàâäðààð æèëä 3000 ãàðóé õ¿í øèíýýð ºâ÷èëäºã ìàíàé óëñàä æèë á¿ð 750-900 õ¿íèéã õîðò õàâäðààð ºâ÷ëºõººñ ñýðãèéëýõ áîëîìæ îëäîõ þì ãýñýí òîîöîî ãàðñàí áàéíà.

Òàìõèíä îðñîí øàëòãààíààñ ¿çâýë ñàâààã¿é ñîíèó÷ çàíãààð ýðýãòýé÷¿¿ä íü á¿õ ¿ç¿¿ëýëòèéí 55%-èéã ýçýëæ áàéõàä ýìýãòýé÷¿¿ä íü 12%-èéã ýçýëæ áàéãàà íü ¿ç¿¿ëýëò¿¿äèéí õàìãèéí èõ õóâü þì.

Òàìõè òàòàæ ¿çñýí íàñíààñ ¿çâýë ýðýãòýé÷¿¿ä íü 16-20 íàñàíä 27% áàéõàä ýìýãòýé÷¿¿ä íü 20-îîñ äýýø íàñàíäàà 21-èàð õàìãèéí èõ òàìõèíä îðæýý. Òàìõè õýð óäààí òàòñàí õóãàöààã æèëýýð ñóäëàæ ¿çâýë ýðýãòýé÷¿¿ä íü 16-20 æèëä íü 17% áàéõàä ýìýãòýé÷¿¿ä íü 1-5 æèë òàìõè òàòñàí íü 20%-èàð èõ áàéíà. ªäºðò òàòäàã òàìõèíû òîîíîîñ õàðâàë ýðýãòýé÷¿¿äèéí 22% íü 10-15 øèðõýãèéã òàòäàã áàéõàä ýìýãòýé÷¿¿äèéí 19% íü ºäºðò 1-5 øèðõýãèéã òàòäàã àæýý.

Òàìõèíààñ ãàðàõ îðîëäëîãîîñ ¿çýõýä ýðýãòýé ýìýãòýé íèéëýýä òàìõèíààñ ãàðàõûã îãò îðîëäîîã¿é áàéíà. Õîðòîé áà õîðã¿é õàâäàðòàé õ¿ì¿¿ñèéã õàðüöóóëàí ¿çýõýä 10-15 íàñàíäàà àíõ òàìõèíä îðæ ºäºðò 16-ààñ èõ øèðõýãýýð, îëîí æèëýýð (16-äýýø) òàìõè òàòæýý.

Ñóäàëãààíû ä¿ãíýëò:

Ñóäàëãààíä õàìðàãäñàí õ¿ì¿¿ñèéí ñàâààã¿é ñîíèó÷ çàíãààñàà áîëæ (67%) àíõ òàìõèíä îðæýý. Ýìýãòýé÷¿¿äèéí èõýíõ íü 1-5 æèë, ýðýãòýé÷¿¿äèéí èõýíõ íü 16 äýýø æèë òàìõè òàòñàí áàéíà.

̺í ýðýãòýé÷¿¿äèéí èõýíõ íü ºäºðò 10-15 øèðõýã ýìýãòýé÷¿¿äèéí èõýíõ íü ºäºðò 1-5 øèðõýã òàìõè òàòàæ áàéíà. Ñóäàëãààíààñ õàðàõàä íèéò òàìõè òàòäàã õ¿ì¿¿ñ 5-20 æèëèéí äàðàà ãýõýä ÿìàð íýãýí õîðòîé áîëîí õîðã¿é õàâäàðààð ºâääºã áîëîõ íü àæèãëàãäëàà.


ÒÀÐÂÀÃÀÍ ÒÀÕÀË ªÂ×ÍÈÉ ÁÓË×ÈÐÕÀÉÍ ÕÝËÁÝÐÈÉÍ ¯ÅÈÉÍ ÕªË ÕÎÐÈÎÍÛ ÝÄÈÉÍ ÇÀÑÃÈÉÍ ÇÀÐÄÀËÄ Ä¯Í ØÈÍÆÈËÃÝÝ ÕÈÉÑÝÍ ÍÜ


Ñóäàëãààíû ¿íäýñëýë: Òàðâàãàí òàõëûí áàéãàëèéí ãîëîìòûí ¿íäñýí àãóóëàã÷èéí íýã òàðâàãàí õ¿í àìûí çàðèì õýñãèéí õ¿íñíèé õýðýãöýýã õàíãààä çîãñîõã¿é àðèëæàà îðëîãûí ýõ ¿¿ñâýð áîëæ áàéãàà ýíý öàã ¿åä 1990-ä îíîîñ ýõëýí òàðâàãàí òàõëûí ºâ÷ëºë óðüä ºìíºõ 10 æèëòýé õàðüöóóëàõàä íýìýãäýõ õàíäëàãàòàé áàéíà. Òóõàéëáàë: Ãîëîìòûí òîî 67.7%, ºâ÷ëºã÷èéí òîî 73.4%-èàð, íàñ áàðàëò 2.7 äàõèí ºññºí áàéíà (Ç.Àäüÿàñ¿ðýí, 1999). Ìàíàé îðîí çàõ çýýëèéí îðîî áóñãàà ºíºº ¿åä òºñâèéí çºâ çîõèñòîé çàðöóóëàëò íýí òýðã¿¿íèé ÷óõàë àñóóäàë áîëæ áàéíà.

2001 îíä ìàíàé îðîíä òàðâàãàí òàõëûí òàëààð ÄÝÌÁ ñóäàëãàà õèéñíèé ¿íäñýí äýýð ãàðãàñàí.

Ǻâëºìæ 3.2-ò Òàðâàãàí òàõëûí áóë÷èðõàéí õýëáýðýýð ºâ÷èëñºí ºâ÷òí¿¿ä, õàâüòëóóäûã òóñãààðëàõ àñóóäëûã çîãñîîõ òàëààð äóðüäñàí áàéíà.

Ǻâëºìæ 3-3-ò Õýðýâ áîëîìæòîé áîë ºâ÷í¿¿ä, õàâüòëóóäûã ãýðò íü òóñãààðëàõ (Ǻâëºñºí ÄÝÌÁ-ûí çºâëºõ Äýâèä Ò.Äåííèñ, Êàòåðàí Ôåëäìàí, Êåííåò Ë.Ãåéëö, Å.Ä.Òèõòìèðîâ, 2001)

Öýâýð áóë÷èðõàéí õýëáýðèéí ¿åä õàëäâàð õàâüòëààð òàðõäàã. Èéìä ãàäíà õºë õîðèî òîãòîîõã¿éãýýð çºâõºí õàâüòëûã òóñãààðëàí óðüä÷èëàí ñýðãèéëýõ ýì÷èëãýý õèéõ íü ýäèéí çàñàã áîëîí áóñàä ñºðºã íºëººã áàãàñãàõ áîëîìæòîé þì.

Ñóäàëãààíû çîðèëãî: Öýâýð áóë÷èðõàéí õýëáýðèéí ãàäíà õºë õîðèîíû ¿åä çàðöóóëñàí íèéò çàðäàë íü çàéëøã¿é çàðöóóëàãäàõ çàðäàë áîëæ áàéãàà ýñýõèéã òîäðóóëàõ

Ñóäàëãààíû çîðèëò:


Ñóäàëãààíû àðãà÷ëàë: 1997-2001 îíä ãàðñàí òàðâàãàí òàõëûí õ¿íèé ºâ÷ëºëèéí òàéëàí, ºâ÷íèé ò¿¿õ çàäëàí øèíæèëãýýíèé ïðîòîêîë çýðýãò ýðãýìæ ñóäàëãàà õèéâ. Ñóäàëãààíû ìàòåðèàëûã Áàéãàëèéí ãîëîìò õàëäâàðò ºâ÷íèéã ýñýðã¿¿öýí ñóäëàõ òºâèéí àðõèâààñ íèéò 29 ãîëîìòûí 39 òîõèîëäëûí ºâ÷ëºëèéí òàéëàí, ºâ÷íèé ò¿¿õ áîëîí çàðöóóëàãäñàí çàðäëûí á¿ðòãýëèéã àøèãëàâ. Òóõàéí ãîëîìòîíä çàðöóóëàãäñàí íèéò çàðäëûã íü ø¿¿æ òýäãýýðýýñ öýâýð áóë÷èðõàéí õýëáýðò çàðöóóëñàí íèéò çàðäëûã òîîöëîî. Ñóäàëãààíä äýýðõ ìàòåðèàëóóäûã Windows îð÷íû Word, Excel, SPSS 9.0 ïðîãðàììóóäûã àøèãëàí ñòàòèñòèê ä¿í øèíæèëãýý õèéæ õîîðîíäûí õàðèëöàí õàìààðëûã áîäîæ ãàðãàëàà.

Ñóäàëãààíû ä¿í:

1997-2001 îíû ÖÁÕ-èéí 16 òîõèîëäîë áàéíà. Íèéò 29 ãîëîìòûí 39 òîõèîëäîë 132628428.3 ¥ çàðöóóëàãäñàí áà öýâýð áóë÷èðõàéí õýëáýðèéí ¿åä 81753705.5¥ áóþó 61.6% çàðöóóëñàí áàéíà.

Ãàäíà õºë õîðèî òàâèõã¿é áà õîðèîíû õóãàöàà áîãèíîñãîõ íü íèéò çàðäëûí àæèëëàãñäûí öàëèí 35%, øàòàõóóíû çàðäëûí 19%, õîîë õ¿íñíèé çàðäëûí 15% çýðã¿¿ä õýìíýãäýõ þì. Àæèëëàãñäûí öàëèí 74.6%, øàòàõóóíû çàðäàë 46.3%, õîîë õ¿íñíèé çàðäàë 38.2%, õîëáîîíû çàðäàë 50% õýìíýãäýíý ãýñýí òîîöîî ãàðëàà.

- 64% ººðèéí áîëãîîìæã¿éãýýñ áîëæ õàëäâàð àâñàí áàéíà.

- Áóë÷èðõàéí õýëáýð 82% áàéãàà áà ýíäýýñ öýâýð áóë÷èðõàéí õýëáýð 50% áàéãàà áà ýíý õýëáýð äàâàìãàéëæ áàéãààã õàðóóëæ áàéíà

- Áóë÷èðõàéí õýëáýð 82% áàéãàà áà ýíäýýñ 50% õî¸ðäîã÷îîð óóøãè, ¿æèë õýëáýðò øèëæñýí áà íàñ áàðàëò 43.58% áàéãàà íü ýìíýëýãò õîæóó õàíäñàí (46%), îãò õàíäààã¿é 18% áàéíà. Ýíý íü àðä ò¿ìýíä ýíý òàëààðõ ìýäýýëýë äýýøë¿¿ëýõ íü ÷óõëûã õàðóóëæ áàéíà.

- Ýð¿¿ë ìýíäèéí áàéãóóëëàãûí ýì÷ ýìíýëãèéí àæèë÷äûí Òàðâàãàí òàõëûí òàëààðõ ìýäëýã áîëîí îéëãîëò ñóë áàéíà.

Õ¿¿õäèéí ºâ÷ëºë (37%) èõ áàéãàà øàëòãààí íü õ¿¿õäèéí äàðõëàë ñóë,áîëãîîìæã¿éãýýñ ¿õñýí òàðâàãíû ñýã, çýìýýð îðîëäîõ, óðõèààð òàðâàãà óðõèäàõ áà ýíä íü ìóó òàðâàãà àâëàãääàã (Ẻñ), ãàðàà ýñãýõ òîõèîëäîë èõ ãýõ ìýò îëîí øàëòãààíòàé. Àæèëã¿é õ¿ì¿¿ñ èõ ºðòºæ áàéãàà íü àìæèðãààíû ò¿âøèí áîëîí ìºí㺠îëîõ ººð áîëîìæ õîìñîîñ ¿¿äýëòýé õîëáîîòîéã áàòàëæ ºã÷ áàéíà. Íàñ àõèõ òóñàì ºâ÷ëºëèéí òîî áóóð÷ áàéíà.

1997-2001 îíä ãàðñàí òàðâàãàí òàõàë íü Óëààíáààòàð õîò (1998), Òºâ, Õýíòèé, Õºâñãºë, Áàÿíõîíãîð, ªâºðõàíãàé, Àðõàíãàé, Ãîâü-Àëòàé, Çàâõàí, Õîâä, Áàÿí-ªëãèé çýðýã 11 àéìãèéí 21 ñóìàíä ãàðñàí áàéíà.

Ãîëîìò ãàðñàí àéìãèéí ãàçàð ç¿éí áàéðøèëààñ ¿çâýë ìàíàé ýõ îðíé òºâèéí áîëîí áàðóóí õýñãýýð áàéãàëèéí èäýâõæèëòýé ãîëîìò áàéãàà íü õàðàãäàæ áàéíà.

Òîõèîëäëóóäûã òýãøèòãýëèéí àðãààð òîîöîõîä ¿ë ÿëèã èõñýõ õàíäëàãàòàé áàéíà. Ýäãýýð àéìàã ñóìóóäûã áóñàä íóòãóóäààñàà èë¿¿ èõ àíõààð÷ óðüä÷èëñàí àðãà õýìæýýãýý ÷àíàðæóóëæ, äàðõëààæóóëòàíä á¿ðýí õàìðàãäóóëàõ ¿ð á¿òýýëòýé àðãà ñýäýõ íü ç¿éòýé þì.

Ä¿ãíýëò:

1997-2001 îíû ÖÁÕ-èéí 16 òîõèîëäîë áàéíà. Íèéò 29 ãîëîìòûí 39 òîõèîëäîëä 132628428.3¥çàðöóóëàãäñàí áà öýâýð áóë÷èðõàéí õýëáýðèéí ¿åä 81753705.5¥ áóþó 61.6% çàðöóóëñàí áàéíà. Õîðèî òîãòîîã¿é áîë 16 òîõèîëäëûí 3759262.4¥ õýìíýãäýõ áàéñàí áà 5 æèëèéí õóãàöààíä 77994443.1¥ õýìíýæ áîëîõ áàéñàí áàéíà (íýã òîõèîëäîëä 234953.5¥ õýìíýõ).

Ñàíàë çºâëºìæ:

- Ýì÷ ýìíýëãèéí àæèë÷èä áîëîí àðä èðãýäýä çîðèóëñàí ñóðòàë÷èëãààíû ìàòåðèàë òàðààæ òàíèëöóóëàõ

- Òóõàéí ãîëîìòûí èäýâõæèëòòýé ãàçðóóäàä íýã ýì÷èä íîîãäîõ õ¿íèé òîîã öººëºõ ìºí äóóäëàãûí ìàøèí òýðãýýð õàíãàõ

- ¯ðã¿é çàðäëûã ºâ÷ëºë ãàðàõàä áóñ óðüä÷èëàí ñýðãèéëýõ àæèë çîõèîõîä çàðöóóëàõ

- ÄÝÌÁ çºâëºìæèéí äàãóó öýâýð áóë÷èðõàí õýëáýðèéí ¿åä öààøèä õ¿íäðýë ãàðãàõã¿é áàéõ íºõöºëèéã á¿ðä¿¿ëæ ãàäíà õºë õîðèî òîãòîîõã¿é áà õºë õîðèîíû õóãàöààã áîãèíîñãîíî. Ýíý æóðàìûã ýì÷ íàðò òàíèëöóóëñàí ñóðãàëòûã çîõèîí áàéãóóëàõ

- Äîíîð îðíóóäûí àíõààðëûã ýíý ÷èãëýëä õàíäóóëàõ èíãýñíýýðýý îëîí òàëààð à÷ õîëáîãäëîî ºãºõ þì.


ÒÓÓË ÃÎËÛÍ ÁÎÕÈÐÄËÛÍ ÕÎÐÄÓÓËÀÕ ÁÎËÎÍ ÌÓÒÀÃÅÍ ¯ÉË×ÈËÃÝÝà ÑÓÄËÀÕ ÁÈÎËÎÃÈÉÍ ÇÀÃÂÀÐ

Ö.Ò¿âøèíæàðãàë, Ìîíãîë Óëñûí Èõ Ñóðãóóëü

Õ¿ðýýëýí áóé õèìè, ôèçèê, áèîëîãèéí áîõèðäîë òóõàéëáàë: òåõíèêèéí ãàðàëòàé áîõèðäóóëàã÷èä õèìèéí áîäèñ, ò¿¿íèé òóíäàñ, ¿ëäýãäýë íü õºðñ, àãààð, óñ, õîîë õ¿íñýýð äàìæèí õ¿íèé ýð¿¿ë ìýíäýä íºëººëºõ öààøëààä àìüä áèå ìàõáîäûí óäàìøèëûí ìàòåðèàëä ìóòàöè ¿¿ñýõ áîëçîøã¿é áàéäàë íýìýãäñýýð áàéãàà íü Ìîíãîë óëñàä, òºäèéã¿é äýëõèé íèéòýä òóëãàìäñàí àñóóäàë áîëæ áàéíà. 1979 îíä Å. Áàíçàð, 1993 îíä Ë. Íàðàíòóÿà áóñàä ‘’Òóóë ãîëûí óñíû öýâðèéí çýðãèéí ò¿âøèí, ýð¿¿ë àõóéí ¿íýëãýý’’ã.ì ñóäàëãààíû àæëóóäûã ÿâóóëñàí áàéíà. Õîðäóóëàõ áîëîí ìóòàãåí ¿éë÷èëãýý ¿ç¿¿ëäýã òåõíèêèéí ãàðàëòàé áîõèðäóóëàã÷èä íü ãàäðàãûí óñíû øèíæ ÷àíàðò õýðõýí íºëººëæ áàéãààã ñóäàëñàí ñóäàëãààíû àæèë óðüä ºìíº ìàíàé îðîíä õèéãäýæ áàéãààã¿é áàéíà. Õ¿ðýýëýí áóé îð÷èíã áîõèðäóóëàã÷ òåõíèêèéí ãàðàëòàé áîõèðäóóëàã÷èéí õîðäóóëàõ áîëîí óäàìøèëä ¿ç¿¿ëýõ íºëººëëèéã ãîëûí óñíû áîõèðäëûí ¿åä áèîëîãèéí çàãâàð îáúåêò (áèîëîãèéí ìîíèòîðèíã) áîëîõ õºðºíãºíöðèéí îìîã äýýð òóðøèõ íü ÷óõàë à÷ õîëáîãäîëòîé ãýæ ¿çýæ áàéíà. Ñóäàëãààíä õºðºíãºíöðèéã àøèãëàõäàà ýíãèéí çîõèîí áàéãóóëàëòòàé, ýóêàðèîò îðãàíèçì, ýìãýã òºð¿¿ëýõ øèíæ áàéõã¿é, ïðàêòèêò ºðãºí àøèãëàãääàã, õÿìä òºñºð, îëîõîä õÿëáàð ã.ì øèíæ¿¿äèéã íü ¿íäýñëýâ. Óñûã áîõèðäóóëàã÷ õèìèéí áîäèñûí õîðäóóëàõ ¿éë÷èëãýý áîëîí ìóòàãåí ¿éë÷èëãýýã õºðºíãºíöðèéí îìîãò ¿ç¿¿ëýõ íºëººë뺺ð ¿íýëýõ íü õÿìä òºñºð, ìýäðýã áîëîõîä îðøèíî.

Ñóäàëãààíû çîðèëãî: Òóóë ãîëûí óñíû áîõèðäîëûí ¿åä õîðäóóëàõ áîëîí ìóòàãåí ¿éë÷èëãýýã áèîëîãèéí çàãâàð îáúåêò áîëîõ õºðºíãºíöðèéí îìîã äýýð ñóäàëæ, ¿íýëýõ çîðèëãîîð ýíýõ¿¿ àæëûã õèéæ ã¿éöýòãýâ.

Çîðèëò:


Ñóäàëãààíû àæëûí øèíýëýã òàë: Òóóë ãîëûí áîõèðäëûí õîðäóóëàõ áîëîí ìóòàãåí áèîëîãèéí çàãâàð îáúåêò äýýð ¿íýëñýíýýð öààøäûí ñóäàëãààíû àæëûí ñóóðü ñóäàëãàà áîëíî. ßëàíãóÿà õèìèéí áîäèñûí áîõèðäîëòîé õýìýýí òààìàãëàæ áóé õýñãèéí áîõèðäëûí ¿åä íü òîêñèêîãåíåòèêèéí ñóäàëãààã õèéæ áàéõ íü õîðäóóëàõ áîëîí ìóòàãåí ¿éë÷èëãýýòýé áîäèñûã ýðò èëð¿¿ëýõ áîëîëöîî îëãîõ þì.

Ñóäàëãààíû àðãà ç¿é: Õîðäóóëàõ ¿éë÷èëãýýã ¿õñýí êîëîíèé òîîãîîð, õàðèí ìóòàãåí ¿éë÷èëãýýã öèòîïëàçì áà àóêñîòðîô ìóòàíòèéí õóâèàð èëýðõèéëíý (9). Áèîëîãèéí îáúåêò áîëãîæ ñóäàëãààíä õýâèéí ¿ðæëèéí òîãòîëöîîòîé, íºõöºëò ïðîòîòðîô ýóêàðèîò îðãàíèçì áîëîõ “Saccharomyces cerevisiae T-25” õºðºíãºíöðèéí îìãèéã ñîíãîæ àâëàà (7). Òóóë ãîëûí äàãóó òîäîðõîé òîãòîîñîí 9 öýã¿¿äýýñ àâñàí óñíû äýýæ áîëîí öýâýðëýõ áàéãóóëàìæ, àðüñ øèðèéí ¿éëäâýðýýñ àâñàí äýýæ¿¿äèéã ìåìáðàí ø¿¿ëò¿¿ðýýð ø¿¿íý. 10-6 øèíãýð¿¿ëýëòòýé ºñãºâºðèéí ñóñïåíçýýñ:

- ýõíèé õýñýãò òóñ á¿ð 0.2ìë ñóñïåíç+ñîðüö òóñ á¿ðýýñ 0.1 ìë

- äàðààãèéí õýñýãò 0.2ìë ñóñïåíç+ôåíîë (0.25-1 ìë)

- ñ¿¿ëèéí õýñýãò 0.2ìë ñóñïåíç+ÄÌÑÎ (0.25-1ìë) õèÿæ õîëèìîã áýëòãýíý.

Áýëòãýñýí õîëèìîãèéã 12-24 öàãèéí äàðàà õàòóó òýæýýëò áîëîí ìèíèìàëü îð÷èíä òàðüæ, 72 öàã òåðìîñòàòàíä ºñãºâºðëºíº.

Ñóäàëãààíû ¿ð ä¿í: Òóóä ãîëûí óñíû áîõèðäîëûã õ¿÷èëòºðºã÷èéí ãîðèìûí ¿ç¿¿ëýëòýýð (ÁÕÕ, ÕÕÕ, óóññàí õ¿÷èëòºðºã÷, èñýëäýõ ÷àíàð) Òóóë ãîëûí óðñãàëûí äàãóó òîäîðõîé òîãòîîñîí öýã¿¿äýýñ òóõàéëáàë: Òýðýëæèéí ã¿¿ðíýýñ ýõëýýä Àëòàíáóëàã õ¿ðòýë ñóäàëãààíû 9 öýã¿¿äýýñ àâñàí äýýæèíä òîäîðõîéëñîí øèíæèëãýýã Ìîíãîë Óëñûí Áàéãàëü Îð÷íû ñàéä, Ýð¿¿ë Ìýíäèéí ñàéäûí 1997 îíû 143 /À-352 òîîò òóøààëààð áàòàëñàí “Ãàäàðãûí óñíû öýâðèéí çýðãèéí àíãèëëûí íîðì” (4)-òýé õàðüöóóëàí ¿íýëãýý ºãºõºä Òýðýëæèéí óñ ìàø öýâýð àíãèëàëä, Çàéñàí, Áàÿíç¿ðõèéí ã¿¿ð, Øóâóóí Ôàáðèêèéí îð÷èìä áàãà áîõèðäîëòîé àíãèëàëä, ßàðìàãèéí ã¿¿ðíèé îéðîëöîî, Ñîíñãîëîíãèéí ã¿¿ð, Àëòàíáóëàãèéí öýãò áîõèðäîëòòîé àíãèëàëä, Ñîíãèíû ã¿¿ð, Íàëàéõûí áîõèð óñ íèéëñýí öýãò èõ áîõèðäîëòòîé ãýñýí àíãèëàëä áàãòàæ áàéíà. Ñòàíäàðò òîêñèêàíò áîëîí ìóòàãåí áîäèñûã 0.25-1ìë õ¿ðòýëõ õýìæýýãýýð àâ÷ ñóäàëëàà. Õàðüöóóëæ áóé òîêñèêàíò áîäèñûí 1ìë õýìæýý íü õºðºíãºíöðèéí ºñãºâðèéã 100% ¿õ¿¿ëñýí íü õîðäóóëàõ ¿éë÷ëýë íü èëýð÷ áàéãààã õàðóóëæ áàéíà. Òîêñèêàíò ìóòàãåíû õýìæýý èõýñýõýä òýäãýýðèéí õîðäóóëàõ áîëîí ìóòàãåí ¿éë÷èëãýý íü íýìýãäýæ áàéëàà. ÄÌÑÎ-ûí 1ìë õýìæýý íü õºðºíãºíöðèéí ýñýä ìóòàãåí ¿éë÷èëãýý ¿ç¿¿ëæ áàéãàà íü ò¿¿íèé ìîëåêóëûí á¿òýö áîëîí ýñèéí ìåìáðàíû óóðãóóä, 纺âºðëºã÷ ôåðìåíòòýé õàðèëöàí ¿éë÷èëñýíòýé õîëáîîòîé. Òýæýýëèéí îð÷èíä 0.5ìë ôåíîëûã õèéõýä óðãàñàí êîëîíèé òîîã Òóóë ãîëûí óðñãàëûí äàãóó òîäîðõîé öýã¿¿äýýñ àâñàí äýýæèéã ñóäàëñàí ä¿íòýé õàðüöóóëàõàä õàìãèéí èõ áîõèðäîëòîé öýãýýñ àâñàí äýýæèíä óðãàñàí êîëîíèé òîî íü áàãà, öýâýð óñòàé öýãýýñ àâñàí äýýæèíä óðãàñàí êîëîíèé òîî íü èõ áàéâ. Òóóë ãîëûí óñíû óðñãàëûí äàãóó òîäîðõîé òîãòîîñîí æýã¿¿äýýñ àâñàí óñíû äýýæòýé õîëüñîí õºðºíãºíöðèéí õîëèìîãò àóêîñòðîô ìóòàíòûí òîî èëðýýã¿é. Õàðèí òýæýýëèéí îð÷èíä ÄÌÑÎ-ûã 0.25 ìë õýìæýýòýé õèéõýä àóêîñòðîô ìóòàíò 1.58%-èàð èëýðñýí, 1ìë-èéã õèéõýä 15.8%-èàð ìóòàíò èëýðëýý. ¯¿íýýñ ¿çýõýä Òóóë ãîëûí óñíû óðñãàëûí äàãóó òîäîðõîé òîãòîîñîí öýã¿¿äýýñ àâñàí äýýæ òóñ á¿ðò ìóòàöè ¿¿ñãýõ õèìèéí õ¿÷èí ç¿éë èëðýýã¿é áîëíî.

Ä¿ãíýëò: Òóóë ãîëûí óñíû áîõèðäîëòûã õ¿÷èëòºðºã÷èéí ãîðèìûí ¿ç¿¿ëýëòýýð ¿íýëýõýä öýã òóñ á¿ðò õàðèëöàí àäèëã¿é, õîòîîñ äýýø Òýðýëæ îð÷ìûí Òóóë ãîëûí óñ íü ìàø öýâýð àíãèëàëä, Òîëãîéòûí öýâýðëýõ áàéãóóëàìæèéí áîõèð óñ íèéëæ áàéãàà Ñîíãèíû ã¿¿ð, Íàëàéõ îð÷ìûí Òóóë ãîëûí óñ íü èõ áîõèðäîëòòîé ãýñýí àíãèëàëä áàãòàæ áàéíà. Òýðýëæ, Áàÿíç¿ðõèéí ã¿¿ð, Çàéñàí, ßàðìàãèéí îéðîëöîî Òóóë ãîëûí óñàíä óðãàñàí êîëîíèé òîî íü èõ, õîðäóóëàõ øèíæ ÷àíàð èëðýýã¿é, óñ íü öýâýð, Ñîíñãîëîí, Ñîíãèíû ã¿¿ð, Øóâóóí Ôàáðèê, Àëòàíáóëàãèéí îéðîëöîî Òóóë ãîëûí óñàíä óðãàñàí êîëîíèé òîî íü áàãà, õîðäóóëàõ øèíæ ÷àíàð òîäîðõîé õýìæýýãýýð èëýð÷ óñ íü áîõèðäîëòòîé ãýñýí àíãèëàëä áàãòàæ áàéíà. Ìºí “Ñóòàé” àðüñ øèðíèé ¿éëäâýð, Õºòºë, Íàëàéõûí áîõèð óñàíä óðãàñàí êîëîíèé òîî áàãà áàéëàà. Òóóë ãîëûí óñíû óðñãàëûí äàãóó òîäîðõîé òîãòîîñîí öýã¿¿äýýñ àâñàí óñíû äýýæèíä ìóòàöè ¿¿ñãýõ õèìèéí õ¿÷èí ç¿éë èëðýýã¿é.

1 ìóòàöè ¿¿ñãýõ õèìèéí õ¿÷èí ç¿éë

2ìóòàöè ¿¿ññýí õºðºíãºíöðèéí îìîã


ÁªªÐÍÈÉ ÄÝÝÄ ÁÓË×ÈÐÕÀÉÍ ÕÎËÒÎÑËÎà ÄÀÂÕÀÐÃÛà ÒÓÐØÈËÒÛÍ ÀÌÜÒÀÍÄ ØÈËƯ¯ËÝÍ ÑÓÓËÃÀÆ ÒÎÃÒÎÖÛà ÑÓÄÀËÑÀÍ ÍÜ

Ä. Òàìèð, Ë. Ýíõáàÿð, Ö. Ãàíáèëýã, “À×” Àíàãààõ Óõààíû Äýýä Ñóðãóóëü

Ñóäàëãààíû ¿íäýñëýë: Èöåíêî-Êóøèíãèéí ºâ÷íèé ¿åä àíõíû ìýñ çàñëûí ýì÷èëãýýã 1932 îíä Ì.Â. Walters, G.S. Wilder, A.C. Kepler íàð õèéæýý. Òóõàéí ¿åä ñóäëàà÷èä Ẻðíèé äýýä áóë÷èðõàéã õýñýã÷èëýí òàéð÷ àâàõ ìýñ çàñëûã õèéäýã áàéñàí áîë êëèíèêèéí ïðàêòèêò êîðòèêîñòåðîéäûí áýëäìýë àíõ íýâòýðñýíòýé õîëáîîòîéãîîð Ẻðíèé äýýä áóë÷èðõàéí õî¸ð òàëûã á¿ðýí àâàõ (òîòàëüíàÿ àäðåíàëýêòîìèÿ) ìýñ çàñëûã õèéæ ýõýëæýý. ¯¿íòýé õîëáîîòîéãîîð Ẻðíèé äýýä áóë÷èðõàéã á¿ðýí àâñàí òîõèîëäîëä õîëòîñëîã äàâõàðãûã áèåèéí àëü íýã õýñýãò øèëæ¿¿ëýí ñóóëãàõ (àóòîòðàíñïëàíòàöè) øààðäëàãà òàâèãäàæ óëìààð ñóäàëãàà øèíæèëãýýíèé àæèë õèéãäýí êëèíèêèéí ïðàêòèêò íýâòýð÷ ýõýëñýí áàéíà.

Ìàíàé îðîíä àíõ Êëèíèêèéí Òºâ ýìíýëýãò Õ.Àþóø íàð Èöåíêî-Êóøèíãòàé ºâ÷òºíä Ẻðíèé äýýä áóë÷èðõàéí õîëòîñëîã äàâõàðãûã øèëæ¿¿ëýí ñóóëãàõ ìýñ çàñëûã õèéæýý. Áººðíèé äýýä áóë÷èðõàéí õîëòîñëîã äàâõàðãûã áèåèéí àëü íýã õýñýãò øèëæ¿¿ëýí ñóóëãàâàë òîãòîö íü èë¿¿ ¿ð ä¿íòýé áàéõ òàëààð ñóäàëãàà øèíæèëãýý ÿâóóëæ, ñóäëàà÷èä ººõºí ýäýä òîãòîö ñàéí áàéãààã òîãòîîñîí áîëîâ÷ ÷óõàì àðüñàí äîîðõ, Ẻð îð÷ìûí ººõºí ýäýä áîëîí ñýìæèíä àëèíä íü ñóóëãàâàðûã øèëæ¿¿ëýí ñóóëãàõàä èë¿¿ ¿ð ä¿íòýé áîëîõ íü ºíººã õ¿ðòýë ìàðãààíòàé õýâýýð áàéíà.

Ñóäàëãààíû çîðèëãî: Áººðíèé äýýä áóë÷èðõàéí õîëòîñëîã äàâõàðãûã òóðøèëòûí àìüòàíä øèëæ¿¿ëýí ñóóëãàæ òîòîöûã ñóäëàõ. Äýýðõ çîðèëãîäîî õ¿ðýõèéí òóëä äàðààõ çîðèëòóóäûã äýâø¿¿ëýý. ¯¿íä:

- Áººðíèé äýýä áóë÷èðõàéí õîëòîñëîã äàâõàðãûã áèåèéí àëü õýñãèéí ººõºí ýäýä øèëæ¿¿ëýí ñóóëãàõ

- Áóë÷èðõàéã øèëæ¿¿ëýí ñóóëãàñíû äàðàà òîäîðõîé õóãàöààíû äàðàà ñóóëãàöàíä ñóäàñæèëò õýðõýí ¿¿ñýæ íºõºí òºëæèæ áàéãààã òîãòîîõ

- Øèëæ¿¿ëýí ñóóëãàñàí ñóóëãàöûí íºõºí òºëæèëòºíä àñêîðáèíû õ÷ëèéí ¿ç¿¿ëýõ íºëººã òîãòîîõ

- Øèëæ¿¿ëýí ñóóëãàñàí áóë÷èðõàé ººðèéí äîòîîä ø¿¿ðëèéí ¿éë àæèëëàãààã õýðõýí ã¿éöýòãýæ áàéãàà ýñýõ

Ñóäàëãààíû àðãà, ìàòåðèàë: Äýä ñóäàëãààãàà “À×” ÀÓÄýÑ-èéí äýðãýäýõ çàëóó ìýñ çàñàë÷äûí X-RAY êëóáò öýâýð ¿¿ëäðèéí 12 íîõîé äýýðõ ñóäàëãààã òóðøèí ÿâóóëëàà.

Áèä òóðøèëòàà B.A. YOUNG--èéí àðãààð íóðóóíû äàãóó( ïàðàâåðòåáðàëüíûé) ç¿ñëýãýýð õýâëèéí õºíäèéí àðûí çàéãààð íýýæ Ẻðíèé äýýä áóë÷èðõàéã îð÷íû ýäýýñ ÿëãàí á¿ðýí àâñàí. Òóõàéí áóë÷èðõàéí õîëòîñëîã äàâõàðãûã ÿëãàí àâ÷ ýðã¿¿ëýí àðüñàí äîîðõ ººõºí ýäýä 8, Ẻð îð÷ìûí ººõºí ýäýä 2, ñýìæèíä 2 íîõîéíä òóñ òóñ øèëæ¿¿ëýí ñóóëãàñàí.

Ñóóëãàâàðûí òîãòîöûã ñóäëàõ çîðèëãîîð ýõíèé ìýñ çàñëààñ õîéø 12-16 õîíîãèéí äàðàà äàâòàí ìýñ çàñàë õèéæ ñóóëãàâàðûã îð÷íû ººõºí ýäýäòýé õàìò àâ÷ ýä ýñèéí øèíæèëãýý õèéæ ñóäàñæñàí áàéäëûã òîãòîîñîí. Áèä òóðøèëòûí àìüòíàà 2 á¿ëýã áîëãîí àâ÷, íýãýíä íü àñêîðáèíû õ¿÷èë òàðüæ, íºãºº á¿ëýãò íü õýðýãëýýã¿é áîëíî.

Áèä òóðøèëò ñóäàëãààíû àæëàà áàòàëãààæóóëàõûí òóëä òóðøèëòûí àìüòíàà òóðøèäòàíä îðîõûí ºìíº, íýã òàëûí Ẻðíèé äýýä áóë÷èðõàé àâàõ ìýñ çàñàë (àäðåíàëýêòîìè) õèéãýñíèé äàðàà , òîäîðõîé õóãàöààíû äàðàà ¿ëäñýí áóë÷èðõàéãàà àâñíû äàðàà òóñ òóñ öóñàí äàõü êîðòèçîëûí øèíæèëãýý õèéæ ä¿ãíýñýí. Ñóóëãàâàðûã àëü áîëîõ õóðäàí õóãàöààíä, õîëòîñëîã áîëîí òàðõèëàã õýñãèéã íü ÿëãàí, çºâõºí õîëòîñëîã õýñãèéã øèëæ¿¿ëýí ñóóëãàëàà.

Ñóäàëãààíû ¿ð ä¿í: Áèä ñóäàëãààíû ÿâöàä äàðààõ ç¿éëñèéã àæèãëàñàí áîëíî. Áººðíèé äýýä áóë÷èðõàéí õîëòîñëîã äàâõàðãûã øèëæ¿¿ëýí ñóóëãàõ íü õýä õýäýí ¿å øàòòàé áºãººä áîãèíî õóãàöààíä øèëæ¿¿ëýí ñóóëãàæ, ñóóëãàâàðàà ¿õæèõýýñ ñýðãèéëýõýä îíöãîé àíõààðàõ íü ÷óõàë áàéíà. ¯¿íä:

- Áººðíèé äýýä áóë÷èðõàéí õîëòîñëîã äàâõàðãàä áàéðëàõ áóë÷èðõàéëàã ýñ¿¿ä íü õ¿÷èëòºðºã÷èéí äóòàãäàëä õàìãèéí èõ ìýäðýã, ýìçýã ó÷èð íýí òýðã¿¿íä ãýìòäýã áàéíà.

- Áººðíèé äýýä áóë÷èðõàéã õºðãºõ íü ò¿¿íèé ã¿í äàâõàðãà äàõü áè÷èë ñóäñûã àã÷èëä (âàçîñïàçì) õ¿ðãýäýã áàéíà.

Ìýñ çàñëûí äàðàà àñêîðáèíû õ¿÷èë õýðýãëýñýí òîõèîëäîëä ñóóëãàâàð ñàéí òîãòîæ, àìüäðàõ ÷àäâàðòàé áàéãàà íü ãèñòîëîãèéí øèíæèëãýýãýýð òîãòîîãäëîî.

Ä¿ãíýëò

¯Ð ÕªÂЪËÈÉÍ ÕªÃÆËÈÉÍ ¯Å ØÀÒ Ò¯¯ÍÈÉ ÄÎÐÍÛÍ ÁÎËÎÍ ªÐÍÈÉÍ ÀÍÀÃÀÀÕ ÓÕÀÀÍÛ ÕÀÐÜÖÓÓËÑÀÍ ÑÓÄÀËÃÀÀ

×.Áàòíàéðàìäàë, Àíàãààõ Óõààíû Èõ Ñóðãóóëü

Ñóäàëãààíû àæëûí ¿íäýñëýë: ÕÕ çóóíû 50-èàä îíîîñ ýõëýí äîðíî äàõèíû àíàãààõ óõààí ñóäëàë õýìýýõ øèíæëýõ óõààí øèíý ÷èãëýë áèé áîëæ 2000-3000 æèëèéí ò¿¿õòýé ýðòíèé Ýíýòõýãèéí Àþóðâåäèéí, Ò¿âä, Ìîíãîë, Õÿòàäûí óëàìæëàëò àíàãààõ óõààíû îíîë, îíîøëîãîî, ýì÷èëãýý, çàñàë ýìò áîäèñûí ñóäàëãààã îð÷èí áèîëîãè, àíàãààõ óõààí ãåíåòèê, äàðõëàë ñóäëàëûí ò¿âøèíä ñóäëàæ îëîí ñîíèðõîëòîé ç¿é òîãòîîëûã èëð¿¿ëýýä áàéíà.

Àíàãààõ óõààíä õ¿íèé áèå ìàõáîäûí ýðõòýí ñèñòåì, ýä, ýñèéí ¿éë àæèëëàãààíû íóóöûã òàéëàõàä áèåèéí á¿òýö ç¿éí øèíæëýõ óõààí ÷óõàë ¿¿ðýã ã¿éöýòãýäýã. Îð÷èí ¿åä õ¿íèé ¿ð õºâðºëèéã ìîëåêóë, ãåíåòèêèéí ò¿âøèíä ñóäàëãàà øèíæèëãýýíèé àæèë õèéãäýæ áàéíà.

Ñóäàëãààíû àæëûí çîðèëãî.

Áèä Äîðíî äàõèíû àíàãààõ óõààí ñóäëàëûí õàìãèéí ÷óõàë õýñýã áîëîõ ¿ð õºâðºëèéí õºãæëèéí ¿å øàòûã îð÷èí ¿åèéí àíàãààõ óõààíû ¿ð õºâðºëèéã òàéëáàðëàæ áóé îíîëóóäòàé õàðüöóóëàí ñóäëàõ çîðèëãî òàâüæ ñóäàëãààíû àæèë õèéñýí áîëíî.

Ñóäàëãààíû àæëûí çîðèëò.

Äýýðõ ñóäàëãààíû àæëûí õ¿ðýýíä ¿ð õºâðºëèéí õºãæëèéí õàðüöóóëàí ñóäàëãààãààð äàðààõ àñóóäëûã øèéäâýðëýõèéã çîðüñîí þì.¯¿íä :

1. Äîðíî äàõèíû àíàãààõ óõààíû ¿ð õºâðºëèéí õºãæèëòèéã õèé , øàð, áàäãàí, àðãà áèëýã, òàâàí ìàõ áîäûí îíîëûí ¿¿äíýýñ ýõ çîõèîë, ñóðâàëæ áè÷èã äýýð òóëãóóðëàí õàðüöóóëñàí ñóäàëãàà õèéõ

2. Îð÷èí ¿åèéí àíàãààõ óõààíû ¿ð õºâðºëèéí õºãæèëòèéí Carnegie-23 ¿å øàòòàé õàðüöóóëñàí ñóäàëãàà ÿâóóëàõ

3. Áèåèéí 36 ìàõáîä áóþó ýðõòýí ñèñòåìèéí á¿ðýëäýí òîãòîõ ¿åèéí õàðüöóóëñàí ñóäàëãàà

4. Òàâàí öóë, çóðãààí ñàâ ýðõòýíèé óÿëäàà õîëáîî ò¿¿íèé ñóäàñ øèíæëýëèéí à÷ õîëáîãäëûã ñóäëàõ

5. Äîðíî äàõèíû àíàãààõ óõààíû ¿ð õºâðºëèéí õºãæèëòèéí ãåí õðîìñîìûí òóõàé îéëãîëò

6. ¯ð õºâðºëèéí õºãæèëòèéí ¿å øàòàíä îþóí ñàíàà á¿ðýëäýí òîãòîõ ¿å øàò, õ¿íèé áèå îðãàíèçìä áàéäàã áèîýíåðãèéí òºâ¿¿äèéí òóõàé îéëãîëòûã òîäðóóëàõ

Ñóäàëãààíû àæëûí ìàòåðèàë, àðãà ç¿é:

- ýõ çîõèîë ñóðâàëæèò áè÷ã¿¿äèéí õàðüöóóëñàí ñóäàëãàà

- õ¿íèé õºâðºëèéí ¿å øàòûã Carnegie- 23 ãàðãàñàí àíãèëàëòàé õàðüöóóëàõ

- ¿ð õºâðºëèéí ãåí, õðîìñîìûí õºãæëèéí ¿å øàòûã õèéíèé ¿éë àæèëëàãààòàé õàðüöóóëàõ

- áèåèéí 36 ìàõáîäûí õºãæèëòèéã ¿íäñýí 3 ñóäàñ, ýíäî, ýêòî, ìåçîäåðì, îðãàíîãåíåçûí õºãæèëèéí ¿å øàòòàé õàðüöóóëàí ñóäëàõ

Ñóäàëãààíû àæëûí ¿ð ä¿í: Äîðíî äàõèíû àíàãààõ óõààíû áîëîí ºðíèéí àíàãààõ óõààíû ¿ð õºâðºëèéí õàðüöóóëñàí ñóäàëãàà ÿâóóëàõàä íèëýýä õýä õýäýí áýðõøýýë òóëãàð÷ áàéñàí áîëîâ÷ áèä õ¿íèé áèåèéí á¿òýö ç¿éã ºðíèéí äîðíûí ãýñýí õî¸ð ººð îíîëîîð òàéëáàðëàæ áàéñàí ÷ òýð îíîëóóäûã ìåõàíèêààð òóëãàõ îðîëäëîã îãò õèéãýýã¿é áºãººä ñóäàëãààíû àæëûí ¿ð ä¿íãýýðýý çàðèì ñîíèðõîëòîé ¿ð ä¿íä õ¿ðñýíèéã òà á¿õýíä òîëèëóóëæ áàéíà

Ñóäàëãààíû àæëûí l øàò: Ýíý ¿å øàòíû ñóäàëãààíä õºâðºë õýðõýí ¿¿ñäýã âý? ãýñýí àñóóëòàíä õàðèóëò ºãºõºä ÷èãëýãäýæ áàéëàà. Îð÷èí ¿åèéí àíàãààõ óõààíä õºâðºëèéí ¿¿ñýëòèéã ýð ýìèéí ýñ íèéëæ ¿ð òîãòîíî ãýæ òàéëáàðëàäàã. Ãýòýë äîðíû àíàãààõ óõààíä ýð, ýì áýëãèéí ýñýýñ ãàäíà òàâàí ìàõáîä, ñ¿íñ äºðºâ íèéëæ áàéæ ñàÿ ¿ð òîãòîíî ãýæ ¿çäýã íü ñîíèðõîë òàòàæ áàéãàà þì. ªºðººð ýð, ýì áýëãèéí ýñ íü çºâõºí õ¿íèé áèå ìàõáîäûã ¿¿ñýãäýã õ¿íèé ñýòãýõ¿é îþóí óõààí íü ñ¿íñýýð äàìæèæ îðäîã, ¿éë àæèëëàãààã íü òàâàí ìàõáîä ÿâóóëäàã ãýñýí ñîíèðõîëòîé ä¿ãíýëòýíä õ¿ðñýí þì.

Ñóäàëãààíû àæëûí ll ¿å øàò: 19-ð çóóíû ñ¿¿ë÷ýýñ ýõëýí õ¿íèé ¿ð õºâðºëèéã ñóäàëæ ýõýëñýí õýäèé ÷ Âàøèíãòîíû Carnegie èíñòèòóòûí ¿ð õºâðºëèéí òýíõìèéã ¿íäýñëýí áàéãóóëàã÷ Ð. Ìàll (1914) õ¿íèé ¿ð õºâðºëèéí õºãæèëèéã àíõ óäàà øàò÷èëæ ñóäàëñàí áàéäàã. Ñ¿¿ëèéí ¿åä Âàøèíãòîíû Carnegie-èéí èíñòèòóòýýñ ýõèéí õýâëèéä á¿ðýëäýí òîãòîõ ýõíèé 57 õîíîãèéã ¿ð õºâðºëèéí õºãæèëèéí ¿å øàò õýìýýí òîìú¸îëæ õºãæëèéí 23 ¿å øàò äàõü á¿òýöèéí õýâèéí ¿ç¿¿ëýëòèéã ãàðãàæ ñòàíäàðò áîëãîí òîãòîîñîí ýä¿ãýý äýëõèéí ¿ð õºâðºë ñóäàëàà÷èä ìºðäëºã áîëãîí õýðýãëýæ áàéãààòàé õàðüöóóëñàí þì. Äîðíî äàõèíû àíàãààõ óõààíä õºâðºëèéí ¿å øàòûã 7 õîíîãîîð àâ÷ ¿çñýí íü õàðüöóóëàõàä íèëýýä áýðõøýýëòýé áàéñàí ÷ áèä çàðèì îíöëîã ¿ð ä¿íã ãàðãàæ àâñàí þì.

Ñóäàëãààíû àæëûí lll ¿å øàòàíä: Õ¿íèé áèå ìàõáîä àìüäðàëûí á¿õ ¿éë àæèëëàãààã ¿ð àøèãòàé áèåë¿¿ëýõèéí òóëä ýìõ öýãö äýñ äàðààòàé ¿éë÷èëäýã ýëåìåíò¿¿äèéí íýãäýë þì.ªðíèéí àíàãààõ óõààíä ýíý ¿¿ðãèéã èæèë õýëáýð áàéãóóëàìæòàé ýñ¿¿ä ã¿éöýòãýõ áºãººä ÿíç á¿ðèéí ýä íýãäýæ ýðõòýí, îëîí ýðõòýí òîäîðõîé ¿éë àæèëëàãàà ã¿éöýòãýõèéí òóëä íýãäýæ òîãòîëöîîã ¿¿ñãýíý. Äîðíûí àíàãààõ.óõààíä 5 ìàõáîä ò¿¿íèé õóðààíãóé õèé, øàð, áàäãàíà, ¿íäñýí 3 ñóäàñ ýä ýðõòýí, òîãòîëöîîã ¿¿ñãýæ áèé áîëãîíî.

Ñóäàëãààíû àæëûí lY ¿å øàòàíä: Õÿòàäûí õàð çóðõàéí òàâàí ìàõáîäûí îíîëîîð òàâàí öóë çóðãààí ñàâ ýðõòýíèéã õîîðîíä áàðèëäóóëæ ºâ÷èí ýìãýãèéí ýìãýã æàìûã òàéëáàðëàõ, ñóäàñ áàðüæ îíîøëîõîä õýðýãëýíý. Æèøýý íü ç¿ðõ-íàðèéí ãýäýñ, óóøèã-îëãîé ãýõ ìýò. Ýäãýýðèéí îð÷èí ¿åèéí ¿ð õºâðºë ñóäëàëûí ¿¿äíýýñ õàðüöóóëàí ñóäëàæ äàðààõ ä¿ãíýëòýíä õ¿ðëýý.

- òàâàí öóë, çóðãààí ñàâ ýðõòýí íü ¿ð õºâðºëèéí íýã ãàðàë ¿¿ñýëòýé

- öóñàí õàíãàìæ ìýäðýëæ¿¿ëýëòèéã íýã ãàçðààñ àâäàã

- áîäèñûí ñîëèëöîî ÿâóóëàõ ¿éë àæèëëàãààíä èæèë ¿¿ðýãòýé îðîëöäîã.

- òóõàéí öóë ýðõòýíä ÿâàãäàæ áàéãàà áîäèñûí ñîëèëöîîíû ¿ð ä¿íä ÿëãàðñàí ñàâ ýðõòýí íü õóðààäàã. Æèøýý íü: ýëýãíýýñ ÿëãàðàõ öºñèéã öºñíèé õ¿¿äèé, Ẻðíººñ ÿëãàðàõ øýýñèéã äàâñàã õóðààõ ãýõ ìýò.

Ñóäàëãààíû àæëûí V ¿å øàò: Äîðíî äàõèíû àíàãààõ óõààíûã áèåèéí á¿òýö ç¿éí ¿¿äíýýñ îãò àâ÷ ¿çäýãã¿é ìýòýýð îéëãîëò îäîî õ¿ðòýë õýâýýð áàéíà. ªºðººð õýëáýë õèéñâýðëýñýí ñýòãýëãýý, áÿñàëãàëûí ¿ð ä¿í ìýò îéëãîäîã. Òýãâýë óëàìæëàëò àíàãààõ óõààíä ãåíèéã ñîíãîìîëîîð ºäººã÷ õ¿÷èí ç¿éë áàéæ ãåí çîõèöóóëàõ óóðãèéí ¿¿ðãèéã 47 õèéãýýð ãàðãàæ èðñýí íü ÄÍÕ, ÐÍÕ õðîìñîìûí òóõàé îéëãîëòòîé áàéñíûã õàðóóëæ áàéíà.

Ñóäàëãààíû àæëûí Vl ¿å øàò: Äîðíî äàõèíû àíàãààõ óõààíä õºâðºëèéí ¿¿ñýõýä íàìøè-ñ¿íñ ÷óõàë ¿¿ðýãòýéã îíöëîí äóðüäñàí áàéäàã òºäèéã¿é ¿íäñýí ãóðâàí ñóäàñ (óì, ðîì, æàíìà) õîîðîíäîî íýãäýæ çàíãèëàà ¿¿ñýõ áºãººä ¿¿íèéã ÷àêðà áóþó õ¿ðä (ýíåðãèéí òºâ) ãýæ íýðëýäýã. Ìºí ¿¿íèéã àìèí ãàçàð ÷ ãýæ íýðëýäýã.

Ä¿ãíýëò

Äîðíî äàõèíû àíàãààõ óõààíû õºâðºëèéí òóõàé îéëãîëòûã îð÷èí ¿åèéí õºâðºë ñóäëàëûí øèíæëýõ óõààíû àðãààð õàðüöóóëàí ñóäàëñíààð ýä, ýñ, ýðõòýí òîãòîëöîî, ãåí õðîìñîìûí ò¿âøèíãèéí îëîí ñîíèðõîëòîé ç¿é òîãòîë èëð¿¿ëýýä áàéíà.


¯ÕÐÈÉÍ ÖÈÑÒÈÖÅÐÊÎÇÛà ÎÍÎØËÎÕ ÝÑÐÝà ҪЪÃ×, ÝÅÐÝà ÈÉËÄÝÑ ÁÝËÒÃÝÍ, ÈÄÝÂÕÈÉà ÒÎÄÎÐÕÎÉËÑÎÍ ÍÜ

Ò.Ýðäýíýñàéõàí, պ人 Àæ Àõóéí Èõ Ñóðãóóëü

¯¿ñãýã÷ íü õ¿íýýñ ¿õýðò, ¿õðýýñ õ¿íä õàëäâàðëàäàã ýíýõ¿¿ çîîíîç ºâ÷èí íü ìàíàé îðíû õ¿íñíèé ¿éëäâýðëýëèéí ýäèéí çàñàãò íýëýýä õîõèðîë ó÷ðóóëæ áàéíà. ¯õðèéí öèñòèöåðêîçûã çºâõºí ìàëûã íÿäëàñíû äàðàà ë îíîøëîäîã ó÷ðààñ öèñòèöåðêîçîä íýðâýãäñýí ìàëûí ìàõ øóóä çààçëàãäàí õàÿãääàã, óã ºâ÷íèéã îíîøëîõ èéëäýñ ñóäëàëûí àðãà õàðààõàí áîëîâñðîãäîîã¿é áàéãàà çýðãýýñ áèä öóñ íààëäóóëàõ øóóä áóñ óðâàë (ÖÍØÁÓ)-ûí ºâºðìºö ýñðýã òºðºã÷, ýåðýã èéëäñèéã áýëòãýæ èäýâõèéã òîäîðõîéëîí ìàëûã àìüä ¿åä íü îíîøëîõ áýëäìýëèéí çàãâàð áèé áîëãîõ çîðèëãî òàâüæ àæèëëàëàà. Ìàõíû ¿éëäâýðëýëä öèñòèöåðêîç èëð¿¿ëýõ ¿çëýãèéã òîëãîé äàðààëàí õèéäýã áîëîâ÷ ýíýõ¿¿ ¿¿ñãýã÷ýýð õ¿ì¿¿ñ õàëäâàðëàñààð áàéãàà íü îð÷èí ¿åèéí øèíýëýã àðãûã áîëîâñðóóëàõ ÷óõàë øààðäëàãàòàé áàéãààã õàðóóëæ áàéíà.

Àðãà ç¿é, õýðýãëýãäýõ¿¿í

Taenia saginata ç¿éë õîðõîéã ýì÷èéí çààâðààð òóóëãàõ çàìààð õ¿íýýñ ÿëãàæ àâààä, áýëýã áîëîâñîðñîí ¿å¿¿äèéã ñàéòàð öýâýðëýýä 0.15 Ì àðèóí ôîñôàòûí áóôåð (pH 7.2)-ýýð 3 óäàà óãààâ.T.saginata-èéí ¿åèéã ãîìîãåíèçàòîð (MOULINETTE, Èñïàíè óëñ)-ààð æèæèãëýí íýãýí æèãä áîëãîîä 1:5 õàðüöààãààð 0.15 Ì-èéí ôîñôàòûí áóôåð (pH 7.2) íýìæ öèéä¿¿ëýýä, 22êÃö-èéí äàâòàìæòàé õýò àâèà (UH-50.Òàéëàíä)-ãààð 10 ìèíóò ¿éë÷ë¿¿ëýâ Óã öèéäìýãèéã 12000 ýðã/ìèí-ä 30 ìèíóò õóðèëäóóðäààä (HITACHI CR 21E,ßïîí óëñ)äýýä øèíãýíèéã íü àâ÷ áèåèéí ýñðýãòºðºã÷ áýëòãýõ àíõäàã÷ ìàòåðèàë áîëãîâ. Óã àíõäàã÷ ìàòåðèàëûã äèýòèëàìèíîýòèë (ÄÝÀÝ)-öåëëþëîçûí (SIGMA) öàðöìàãò ãåëüõðîìàòîãðàôèéí àðãààð ø¿¿æ, ãàðñàí ýäþàòûí óóðãèéã ñïåêòðîôîòîìåòð (JASCO, ßïîí)-èéí 280 íì äîëãèîíû óðòàä õýìæèæ, õàìãèéí èõ óóðàã àãóóëñàí ýëþàòûã T.saginata-èéí áèåèéí ýñðýã òºðºã÷ áîëãîí àøèãëàâ.

T.saginata-èéí áèåèéí ýñðýãòºðºã÷èéí ìîëåêóë æèíã Laemmli (1970)-ãèéí áîëîâñðóóëñàí äîäåöèë ñóëüôàò íàòðè-ïîëèàêðèëàìèä ãåëü ýëåêòðîôîðåç (SDS-PAGE)-èéí àðãààð òîäîðõîéëîâ. Öàðöìàãûã íèòðîöåëëþëîçûí öààñàíä Towbin(1979) íàðûí àðãààð (Immunoblot áóþó Western blot ãýæ íýðëýäýã) áóóëãààä óã öààñûã ¿õðèéí èéëäýñíèé àëüáóìèíû 3õóâèéí óóñìàë, 1:100 øèíãýëñýí Tsaginata-èéí ýñðýã òóóëàéíû ýåðýã èéëäýñ, ýð¿¿ë òóóëàéíû èéëäýñ, òóóëàéíû IgG-èéí ýñðýã ïåðîêñèäàçòàé õîëáîñîí êîíúþãàò çýðãýýð ¿éë÷èë¿¿ëýýä äèàìèíîáåíçèäèí (ÄÀÁ)-ýýð áóäàæ, æèøèã óóðàãòàé ä¿éæ ýñðýãòºðºã÷èéí ìîëåêóë æèí áîëîí ºâºðìºö ÷àíàðûã òîãòîîâ.

T.saginata-èéí áèåèéí ýñðýã òºðºã÷èéã H.Fey íàð (1976)-ûí àðãààð òóóëàéä òàðüæ, õýò äàðõàëàà ¿¿ñãýõ çàìààð ýåðýã èéëäñèéã áýëòãýâ.

ÖÍØÁÓ-ä õýðýãëýõ óëààí öîãöñûã K.Wainbach (1958)-ûí àðãààð ôîðìàëèíæóóëàâ.

Ôîðìàëèíæóóëñàí óëààí ýñèéí ãàäàðãóóä J.Jandle (1957)íàðûí àðãûã õýðýãëýí T.saginata-èéí áèåèéí ýñðýã òºðºã÷èéã ñóóëãàæ, óëààí öîãöñûí îíîøëóóð (ÓÖÎ)-ûã áýëòãýâ.

ÓÖÎ áîëîí T. saginata-èéí ýåðýã èéëäñèéã íèéòýä õýðýãëýääýã àðãûí äàãóó øàòàð÷ëàí òàíèëöàæ ÖÍØÁÓ-ûã òàâèâ.

¯ð ä¿í: T.saginata-èéí áèåèéí ýñðýãòºðºã÷ 1.28 ìã/ìë, 0.235 ìã/ìë, 0.253ìã/ìë, 0.184 ìã/ìë óóðàã á¿õèé 4 çàäðàã àãóóëæ áàéíà.

T.saginata-èéí áèåèéí ýñðýã òºðºã÷èä 6.5-220 êÄà æèíòýé óóðãèéí 11 òîëáî èëýð÷ áàéãàà áºãººä 91 áà 110 êÄà æèíòýé óóðãóóä ºâºðìºö áóñ, áóñàä óóðãóóä ºâºðìºö áàéãàà íü ýíýõ¿¿ ýñðýãòºðºã÷ººð öèñòèöåðêîç ºâ÷íèéã îíîøëîõîä á¿ðýí áîëîìæòîéã õàðóóëæ áàéíà.

ÖÍØÁÓ-ààð T.saginata-èéí áèåèéí ýñðýãòºðºã÷ 1:640, ýåðýã èéëäýñ 1:160, øèíãýëýëòýíä èäýâõèòýé áàéâ.


Preparation of somatic antigens from Taenia saginata and hyperimmune serum to them
T.Erdenesaikhan1, D. Temuulen2, G. Battsetseg3, State University of Agriculture1, National Medical University of Mongolia2, Institute of Veterinary Medicine3

The Taenia saginata somatic antigen and hyperimmune antiserum to them were active indilution 1:640 and 1:160 by an indirect haemagglutination test.

Òóðøèëòûí àìüòàíä ýëýãíèé öî÷ìîã, àðõàã ¿ðýâñëèéí ýìãýã çàãâàð ¿¿ñãýí ýëýãíèé ýñèéí íºõºí òºëæèëòºíä íºëººëºõ óëàìæëàëò àíàãààõ óõààíû çàðèì ýìèéí ôàðìàêîëîãè ¿éëäýë

Ð.Îðãèëìàà, Óëàìæëàëò Àíàãààõ Óõààíû Äýýä Ñóðãóóëü

Ñóäàëãààíû àæëûí ¿íäýñëýë. Âèðóñèéí ãåòàòèò äýëõèé äàõèíä íýí ÿëàíãóÿà Àçè, Àôðèêèéí îðíóóäàä ò¿¿íèé äîòîð Ìîíãîë îðîíä ºðãºí òàðõñàí íóòàãøìàë (Ï.Íÿìäàâàà, 1986 îí) áºãººä õ¿í àìûí ýð¿¿ë ìýíä õèéãýýä óëñ îðíû ýäèéí çàñàãò èõýýõýí õîõèðîë ó÷ðóóëæ áàéíà.

Âèðóñèéí ãåïàòèò íü ýëýãíèé àíõäàã÷ ºìºí (ÝÀª) ¿¿ñãýõ ãîë øàëòãààí áîëæ áàéíà. Ãåïàòèòèéí  âèðóñèéí HBõ ýñðýã áèå íü õàâäàð äàðàíãóéëàã÷ ð53 ãåíèéí õýâèéí ¿éë àæèëëàãààã àëäàãäóóëæ óëìààð 20-30 æèëèéí äàðàà ÝÀª ¿¿ñãýæ áàéãàà íü òîãòîîãäæýý.

Äýëõèéí ýëýã ñóäëàëûí õîëáîîíîîñ (Òàéâàí, 2002) ýëýã ñóäëàëûí ÷èãëýëýýð ñóäàëãàà øèíæèëãýýíèé àæèë õèéæ áàéãàà ñóäëàà÷èä ýëýãíèé ºâ÷íèéã á¿ðýí îíîøëîõûí òóëä ãèñòîìîðôîëîãèéí áîëîí ãèñòîõèìèéí øèíæèëãýý çàéëøã¿é õèéõèéã çºâëºæ áàéíà.

Ñóäàëãààíû àæëûí çîðèëãî. Ýëýãíèé ºâ÷íèé òàëààð äýëõèé äàõèíä øèíýýð ãàð÷ áóé îíîë, ýì÷èëãýýíèé àðãûí òàëààð õýâëýëèéí òîéì ìàòåðèàëòàé òàíèëöàæ, òóðøèëòûí àìüòàíä ýëýãíèé ºâ÷íèé ýìãýã çàãâàð ¿¿ñãýí, ýëýãíèé ºâ÷íèé ¿åä õýðýãëýæ áàéãàà óëàìæëàëò àíàãààõ óõààíû çàðèì æîðûí ôàðìàêîëîãèéí ¿éëäëèéã øèíæëýõ óõààíû ¿íäýñëýëòýé òîäðóóëàõ çîðèëòûí õ¿ðýýíä äîîðõ çîðèëòóóäûã äýâø¿¿ëýí ñóäàëãàà øèíæèëãýýíèé àæèë õèéæ ã¿éöýòãýëýý.

Ñóäàëãààíû àæëûí çîðèëò

- Òóðøèëòûí àìüòàíä *Ýëýãíèé öî÷ìîã áîëîí àðõàã ¿ðýâñëèéí ýìãýã çàãâàð ¿¿ñãýõ* àðãà÷ëàëä ñóðàëöàõ

- Òóðøèëòûí àìüòàíä *Ýëýãíèé èðìýãýýñ õýâèéí áóñ òàéðàõ ìýñ àæèëáàð* -ûí àðãà÷ëàëä ñóðàëöàõ

- Ýëýãíèé ºâ÷íèé ýìãýã çàãâàðûí àðãà÷ëàë äýýð ¿íäýñëýí ýëýã õàìãààëàõ ¿éëäýëòýé ýìèéí æîðûí çàðèì ôàðìàêîëîãè ¿éëäëèéã òîäîðõîéëîõ

Ñóäàëãààíû àæëûí ìàòåðèàë, àðãà ç¿é:

- Ýëýãíèé öî÷ìîã, àðõàã ¿ðýâñëèéí ýìãýã çàãâàð ¿¿ñãýõäýý òóðøèëòûí öàãààí õàðõàíä 50%-èéí CCL4 -ººð 0.4 ìë/100 ãð òóíãààð 4. 21.28 ºäºð äàðààëàí àðüñàí äîð òàðèõ àðãààð ¿¿ñãýâ.

- Ñîðèë òóðøèëòûí àæèëä ñîíãîæ àâñàí òóðøèëòûí àìüòíûã 4 á¿ëýãò õóâààñàí áºãººä:

I á¿ëýã-ýð¿¿ë

II á¿ëýã- õÿíàëòûí

III á¿ëýã-îð÷èí ¿åèéí ýì÷èëãýýíèé

IY á¿ëýã-óëàìæëàëò àíàãààõ óõààíû ýì÷èëãýýíèé

- Áèä 180-200ãð æèíòýé Âèñòàð ¿¿ëäðèéí íèéò 15 òóðøèëòûí öàãààí õàðõàíä *Ýëýãíèé èðìýãýýñ õýâèéí áóñ òàéðàõ * ìýñ àæèëáàðûã Â.Ñ.Øàïêèíû àðãààð Õàâäàð Ñóäëàëûí ýìíýëãèéí ëàáîðàòîðèéí ºðººíä õèéëýý. Åðºíõèé ìýäýý àëäóóëàëòàí äîð õàðõíû ñ¿¿ëíýýñ íü áàðüæ íóðóóãààð íü áàéðëóóëæ òàëáàéã çîõèõ ¸ñîîð íü àðèóòãàæ õýâëèéí ãîëûí äýýä øóãàìààð 2.5ñì îð÷èì ç¿ñëýã õèéæ õýâëèéã ¿å÷ëýí íýýãýýä ýëýãíèé ç¿¿í äýëáýíä Vicril ¹2-èéí óòñààð Ï õýëáýðèéí î¸äîë òàâüæ ýëýãíèé èðìýãýýñ 1* 1.5ñì õýìæýýòýé òàéðëàà. Öóñ òîãòîîëòûã øàëãààä õýâëèéã ¿å÷ëýí õààâ.

- Òóðøèëòûí öàãààí õàðõàíä ìýñ àæèëáàð õèéõäýý êåòàìèíû 2 ìë óóñìàëûã 2-3 ìã /êã-ààð òîîöîæ áóë÷èíä òàðüæ óíòóóëàâ.

- Õàðõàíä ýì óóëãàõäàà õàðõíû ñ¿¿ëýí äýýðýýñ áàðüæ íóðóóãààð íü áàéðëóóëñíû äàðàà ç¿¿í ãàðûã íóðóóã íü äàãóóëàí ÿâóóëæ ýðõèé äîëîîâîð õóðóóãààð áýõëýýä õ¿ç¿¿íýýñ íü ÷èìõýæ áàðèíà. Äàðàà íü òóñãàé áýëòãýñýí ãóóðñûã òàðèóðò áýõëýýä RÞR-1(Ðåí÷èíþíèíðàíèë) ýìèéã 0.01 ãð-ûã ñîðóóëæ àìààð íü óóëãàâ.

- ÓÀÓ-íû ýìòýéãýý õàðüöóóëàõ çîðèëãîîð *Îðîòàò êàëè *-èéã ñîíãîæ àâñàí áºãººä 0.01ãð –ààð ºäºðò 1 óäàà 42 õîíîãèéí òóðø óóëãàâ.

- Ãèñòîìîðôîëîãèéí øèíæèëãýýã Ã.À.Ìåðêóëîâèéí àðãààð óñã¿éæ¿¿ëýõ, òîñã¿éæ¿¿ëýõ äàìæëàãóóäààð äàìæóóëàí ìèêðîòîìîîð 5 ìê-íû çóçààíòàéãààð ç¿ñëýã õèéæ åðäèéí ãåìàòîêñèëèí ýîêèí áîëîí õîëáîã÷ ýä èëð¿¿ëýõ Âàí Ãèçîíû áóäãóóäààð áóäàæ ãýðëèéí áè÷èë õàðóóðààð 100 äàõèí ºñãºæ õàðëàà.

- Õàâäðûí ìàðêåðèéí øèíæèëãýýã õèéõäýý çàõûí öóñíààñ 4-5 ìë öóñ àâààä Fj 2003 / 50PC êîìïüþòåð ãàììà òîðûã ä¿¿ðãýýä J125 èçîòîïèéí òóñëàìæòàéãààð õàâäðûí ìàðêåð áîëîõ AFP-èéã òîäîðõîéëëîî.

- Ñòàòèñòèê áîëîâñðóóëàëòûã SPSS ïðîãðàììààð êîìüþòåðýýð áîäîæ ãàðãàâ.

Ñóäàëãààíû àæëûí ¿ð ä¿í

- Òóðøèëòûí àìüòíûã CCL4-ººð ýëýãíèé öî÷ìîã, àðõàã ¿ðýâñëèéí ýìãýã çàãâàð ¿¿ñãýñíýýñ õîéø 4. 21. 28 äàõü õîíîãóóäàä *Ýëýãíèé èðìýãýýñ õýâèéí áóñ òàéðàõ* ìýñ àæèëáàð õèéæ ãèñòîìîðôîëîãèéí øèíæèëãýý õèéæ ¿çýõýä 4 äýõ õîíîãò öî÷ìîã ¿ðýâñýë, 21 äýõ õîíîãò àðõàã ¿ðýâñýë, 28 äàõü õîíîãò ÝÀª ¿¿ññýí áàéëàà.

- Òóðøèëòûí 18, 35, 42 äàõü õîíîãò ðåëàïàðîòîìè õèéí ýëýãíèé ýäýýñ äýýæ àâ÷ ãèñòîìîðôîëîãèéí øèíæèëãýý õèéæ ¿çýõýä õÿíàëòûí á¿ëãèéí àìüòäàä òàðõìàë ººõºí õóâèðàë ¿¿ññýí áàéõàä RÞR-1 óóñàí á¿ëãèéí àìüòäûí ýëýãíèé ýñèéí ººõºí õóâèðëûí õýìæýý ýðñ áàãàñàæ ýëýãíèé ýä ýñ ñýðãýñýí áàéíà.

Ñóäàëãààíû àæëûí ä¿ãíýëò

ĺðâºí õëîðò í¿¿ðñòºðºã÷ íü ýëýãíèé õèìèéí ãàðàëòàé öî÷ìîã, àðõàã ¿ðýâñëèéã ¿¿ñãýõ òîõèðîìæòîé çàãâàð áºãººä óäààí õóãàöààãààð õýðýãëýõýä ýëýãíèé àíõäàã÷ ºìºíã ¿¿ñãýõ íºëººã ¿ç¿¿ëæ áàéíà.

Öààøèä ýëýãíèé ºâ÷íèéã á¿ðýí ã¿éöýä ¿íýí çºâ îíîøëîõûí òóëä ãèñòîìîðôîëîãèéí øèíæèëãýýã çàéëøã¿é õèéõ õýðýãòýé áºãººä òóðøëàãûí àìüòàíä ýëýãíèé ýñèéí íºõºí òºëæèëòèéã ñóäëàõàä *Ýëýãíèé èðìýãýýñ õýâèéí áóñ òàéðàõ* ìýñ àæèëáàð íü õàìãèéí òîõèðîìæòîé þì.

ÓÀÓ-ä õýðýãëýäýã RÞR-1 æîð íü ýëýãíèé ýñèéí çàäðàëûã áóóðóóëäàã, ýëýãíèé ýñèéí íºõºí òºëæèëòèéã ñàéæðóóëàõ ¿éëäýë ¿ç¿¿ëäýã áîëîâ÷ ýëýãíèé õàâäðûí ìàðêåð àëüôàôåòîïðîòåéíû õºäëºë ç¿éä íºëºº ¿ç¿¿ëýõã¿é áàéíà.


ÝËÝÃÍÈÉ ÁÎÐÛÍ ¯ÅÄ ÕÝÐÝÃËÝÃÄÄÝà ÝÌÒ ÁÎÄÈÑÛÍ ÇÀÐÈÌ Ó×ÈÐ ØÀËÒÃÀÀÍ


Ø.̺íãºíãýðýë

Àíàãààõ Óõààíû Èõ Ñóðãóóëü

“Ýëýãíèé áîðûí ¿åä ãîë õýðýãëýãääýã ýìò áîäèñûí çàðèì ó÷èð øàëòãààí” ñýäâýýð òàâüæ áóé èëòãýëèéí ýõíèé õýñýãò ýëýãíèé áîð ºâ÷íèéã ÿàãààä ñóäëàõ áîëñîí øàëòãààí áà àíàãààõ 34 æîðîíä áàéãàà ýìò áîäèñûí àãóóëãûã òîäîðõîéëæ, öààøèä ýíý ìýò áîäèñóóäûí õèìèéí íàéðëàãà, ó÷èð øàëòãààíûã òîãòîîõ çîðèëãîòîé àæèëëàâ.

Áîð ºâ÷íèé ãîëîìòûí àäèë áóñûã ¿íäýñëýæ ººðèéí îðîí áóþó áóñäûí îðîí ãýæ 2 ç¿éëä õóâààäàã. ªºðèéí îðîí ãýäýã íü óóë ºâ÷íèé ¿¿ñãýñýí øàëòãààíòàé õîëáîãäîõ ¿¿ñãýñýí îðíûã çààäàã áºãººä õîäîîä (Áàäãàíûí îðîí), ýëýã (Öóñíû îðîí), ãýäýñ (Øàðûí îðîí), îëãîé (Õèéí îðîí) 4 îðíî. Õàðèí áîð ºâ÷íèé íºõöëèéã îð÷èí ¿åèéí àíàãààõ óõààíòàéòàé õàðüöóóëáàë:

Ýíäýýñ ¿çýõýä õàëóóí íºõöºëä ¿¿ññýí áîð ºâ÷èí íü öóñíû áîõèðäëîîñ õàðèí õ¿éòýí íºõöºë äýõ íü áèå ìàõáîäûí ¿éë àæèëëàãààíû äóòàãäëààñ òóñ òóñ ¿¿ññýí ãýæ ¿çýæ áîëíî.

¯¿íèéã “ Öóñíû ãýìòýë ¿ã¿é áîð ºâ÷èí ãýæ áàéäàãã¿éòàé àäèëààð ýëýãíèé ãýìòýë ¿ã¿é áîð áàéäàãã¿é” ãýæ òýìäýãëýñýí áàéíà. Èéìä áîð ºâ÷íèéã àíàãààõ æîðûí ñóäàëãààãàà ýëýãíèé áîðûã àíàãààõ ýìò áîäèñóóäàä ÿâóóëëàà.

Ñóäàëãààíû ä¿í:

Íèéò ñóäàëãààíä õàìðàãäñàí 107 áîðûí ºâ÷íèé æîðîîñ ºâ÷íèéã çàñàõ áóþó àíàãààõ ýðäìèéã íü ¿íäýñëýí ýëýãíèé áîð ºâ÷èíä õýðýãëýõ 34 æîðä àíàëèç õèéëýý. ¯¿íä õàìãèéí èõ õýðýãëýãäýõ ýìò áîäèñóóäûã ò¿¿âýðëýí àáâàë:

1. Áàðàãøóí 22/35 (62.86%) 7.Æ¿ð ¿ð 15.35(42.86%)

Ðóäà 22/35 (62.86%) Óäâàë 15.35 (42.86%)

2. Áàøàãà 21/35 (60%) 8. Áðèÿíãó 14.35 (40%)

3. à ¿ðã¿ì 20/35(57.14%) ¯ñ¿ 14.35 (40%)

4. Ãèâàí 19.35(54.29%) 9. Äýãä 13.35 (37.14%)

5. ÀÐ ¿ð 18.35 (51.43%) Æóãàí 13.35 (37.14%)

Áèáëèí 18.35 (51.43%) 10. Æîíø 12.35(34.29%)

Ìàí¿ 18.35 (51.43%) Ñýðæìÿäàã 12.35 (34.29%) áàéíà.

6. Ñ¿ãìýë 17.35 (48.57%)

Äýýðõ 17 ýìò áîäèñûã äîîð áè÷èãäñýí ýëýãíèé áîðûí ºâ÷èíèé æîðóóäûí íàéðëàãàíä áàéãàà íèéò 148 ýìò áîäèñóóäààñ àãóóëãààð íü áàéð ýçë¿¿ëæ ýõíèé 10-ã ÿëãàí æàãñààæ áè÷ñýí áîëíî.

Ä¿ãíýëò:

1. Áîðûí ºâ÷íèé ¿¿ñýõ õàëóóí íºõöºë íü öóñíû áîõèðäëîîñ, õàðèí õ¿éòýí íºõöºë íü áèå ìàõáîäûí ¿éë àæèëëàãààíû äóòàãäëààñ áîëæ èäýâõæèí ºðíºäºãòýé õîëáîîòîéã ¿íäýñëýí ýëýãíèé áîð ºâ÷íèéã àíàãààõ ýìèéí æîðóóäûã ñóäëàõ áîëñîí.

2. Ñóäàëãààíä áîðûí ºâ÷íèéã àíàãààõ íèéò 107 ýìèéí æîð îðñíîîñ 34 ýìèéí æîð íü ýëýãíèé áîðûã àíàãààõ æîðä õàìðàãäëàà.

3. Ýëýãíèé áîð ºâ÷íèéã àíàãààõ 34 ýìèéí æîðîîñ 148 ýìò áîäèñ áàéñàí áºãººä ¿¿íýýñ õàìãèéí èõ õóâèàð àãóóëàãäàõ áîäèñóóäûã øàò äàðààëóóëàí ãàðãàñàí áîëíî.

4. Äýýðõ áîäèñóóäûí 50 %-ààñ äýýø àãóóëàãäàæ áàéãàà äàðààõ 8 ýìò áîäèñ áîëîõ áàðàãøóí, ðóäà, áàøàãà, ã¿ðã¿ì, ãèâàí, àð ¿ð, áèáëèí, ìàíó çýðãèéã öààøäûí ñóäàëãààíûõàà îáúåêò áîëãîí àâëàà.


ÎÍÄÀÒÐÛÍ ÌÀÕ ÁªªÐÍÈÉ ¯ÐÝÂÑÝËÄ ÕÝÐÕÝÍ ÍªËªªËªÕÈÉà ÑÓÄÀËÑÀÍ ÍÜ

Ë.Ýðäýíýõ¿¿ü Àíàãààõ Óõààíû Èõ Ñóðãóóëü

Ñóäàëãààíû ¿íäýñëýë: Áººðíèé ºâ÷òýé õ¿íèéã îíäàòð áóþó çààðò õàðõíû ìàõààð ýì÷èëäýã àðäûí óëàìæëàëò àðãûã øèíæëýõ óõààíû ¿íäýñëýëòýéãýýð òàéëáàðëàñàí ñóäàëãàà øèíæèëãýý îäîîã õ¿ðòýë õèéãäýýã¿é áàéíà.

Ñóäàëãààíû øèíýëýã òàë, à÷ õîëáîãäîë

Îíäàòðûí ìàõûã Ẻðíèé ¿ðýâñýëä õýðõýí íºëººëºõèéã øèíæëýõ óõààíû ¿íäýñëýëòýéãýýð òîãòîîõ ýì÷èëãýýíèé çîðèëãîîð, àí àãíóóðûí àæ àõóéã áèé áîëãîõ, íèéãýì ýäèéí çàñàã, ýð¿¿ë ìýíäèéí ñàëáàðò àøèãëàõ ¿íäñèéã áèé áîëãîí öààøèä ã¿íçãèéð¿¿ëýí ñóäàëæ øèíý òºðëèéí ýìèéí áîäèñ ãàðãàí àâàõàä ñóäàëãààíû àæëûí à÷ õîëáîãäîë îðøèíî.

Ñóäàëãààíû çîðèëãî

Îíäàòð áóþó çààðò õàðõíû ìàõ íü Ẻðíèé ¿ðýâñýëä íºëººëäºã ýñýõèéã òóðøèëòûí àðãààð òîäîðõîéëîõ çîðèëãî òàâüñàí.

Ñóäàëãààíû çîðèëò:

1. Îíäàòðûí ìàõíû ýðäýñ áîäèñûí íàéðëàãûã àòîì øèíãýýëòèéí ñïåêòðîôîòîìåòðèéí àðãààð òîäîðõîéëîõ

2. Îíäàòðûí ìàõíû óóðãèéí àìèí õ¿÷ëèéí íàéðëàãà, õýìæýýã òîãòîîæ ¿õýð, õîíèíû ìàõòàé õàðüöóóëàõ

3. Ẻðíèé ¿ðýâñëèéã ýì÷ëýõ ÿâöûã òóðøèëòûí àìüòäûí öóñíû äýëãýðýíã¿é øèíæèëãýýãýýð òîäîðõîéëîõ

4. Áººðíèé ¿ðýâñýëò ººð÷ëºëòºä îíäàòðûí ìàõûã õýðýãëýõýä õýðõýí íºëººëñíèéã ýä ñóäëàëûí àðãààð òîäîðõîéëîõ

Ñóäàëãààíû ìàòåðèàë, àðãà ç¿é. Ñóäàëãààíû îáúåêò: ÀÓÈÑ-èéí Ýðäýì Ñóäëàëûí Òýíõèì, Ýìãýã Ñóäëàë Ø¿¿õ Ýìíýëãèéí Òýíõèì, Øèíæëýõ Óõààíû Àêàäåìè õèìè, õèìè-òåõíîëîãèéí, ôèçèê òåõíîëîãèéí õ¿ðýýëýí Óëñûí êëèíèêèéí Òºâ Ëàáîðàòîðóóäàä íàñ áèå ã¿éöñýí 16 õóëãàíàä òóðøèëòûã ÿâóóëñàí.

Ñóäàëãààíû àðãà ç¿é: Îíäàòðûí ìàõíû áîäèñûí íàéðëàãûã ÀÀÑ-áàãàæèéí òóñëàìæòàéãààð, ìàõíû óóðãèéí àìèí õ¿÷ëèéí á¿ðäëèéã öààñàí õðîìîòîãðàôèéí àðãààð òîäîðõîéëîõ, Ẻðíèé ¿ðýâñëèéã çîõèîìëîîð ¿¿ñãýí îíäàòðûí ìàõàà øºë õýëáýðýýð óóëãàæ ýì÷ëýõ, òóðøèëòûí õóëãàíóóäàä öóñíû øèíæèëãýý áîëîí ýìãýã-ãèñòîëîãèéí øèíæèëãýýãýýð ¿ð ä¿íã òîîöîõ àðãûã áîëîâñðóóëëàà.

Ñóäàëãààíû ¿ð ä¿í

Àòîì øèíãýýëòèéí ñïåêòðîôîòîìåòðèéí Ïåðêåí-Åëìåð 500 àïïàðàòààð ýðäýñ áîäèñûí íàéðëàãûã òîäîðõîéëîõîä äèéëýíõ õóâèéã 58.57% Zn-25.02%, Ñu-1.12% çýðýã ýëåìåíò¿¿ä ýçýëæ áàéíà.

Óóðãèéí õðîìàòîãðàôèéí öààñàí Watman-1 ñèñòåì, óóñãàã÷ Íîðìàë áóòàíîë: öóóíû õ¿÷èë: Óñ (4:1:5) àøèãëàí òîäîðõîéëîõîä àñïàðãèí, ãëþòàìèíû õ¿÷èë çîíõèëñîí íèéò 14 àìèí õ¿÷èë èëðýýä áàéíà.

Öóñíû äýëãýðýíã¿é øèíæèëãýýãýýð ýð¿¿ë õóëãàíóóäûí íåéòðîôèëèéí ýçëýõ õóâü äóíäàæ íü 14% áàéñàí áîë ºâ÷ë¿¿ëñýí õóëãàíóóäûí íåéòðîôèëèéí äóíäàæ íü 47% áîëæ íýìýãäýí õàðèí ýì÷èëãýýíèé ¿ð ä¿íä 29% áîëæ áóóðñàí áàéíà.

Ýä ñóäëàëûí øèíæèëãýýãýýð Ẻðíèé ýäèéí öóñ áàãàäàëò, çàâñðûí ýäèéí òàðõìàë ¿ðýâñýë, óóðãèéí äèñòðîôè áîëñîí Ẻð íü ýì÷èëãýýíèé ¿ð ä¿íä íºõºí òºëæëèéí ¿å øàòàíä îðñîí Ẻðíèé ýäèéí á¿òýöòýé áîëñîí.

Ä¿ãíýëò

1. Îíäàòðûí ìàõíû íàéðëàãûã àòîì øèíãýýëòèéí ñïåêòðîôîòîìåòðèéí àðãààð òîäîðõîéëîõîä Fe äèéëýíõ õóâèéã ýçýëæ áàéíà.

2. Îíäàòðûí ìàõíû óóðãèéí àìèí õ¿÷ëèéí á¿ðäëèéã öààñàí õðîìîòîãðàôèéí àðãààð òîäîðõîéëîõîä ò¿¿íèé íàéðëàãàíä áóé Ëèçèí, Ãèñòèäèí, Ìåòèîíèí, Ôåíèëàëàíèí çýðýã ¿ë îðëîãäîõ àìèí õ¿÷ëèéí àãóóëàìæ õîíèíû ìàõ 31.41%, ¿õðèéí ìàõ 31.15%-òàé õàðüöóóëàõàä çààðò õàðõíû ìàõàíä 64.76% áóþó 2 äàõèí èõ áàéãàà íü ýíýõ¿¿ ìàõ íü áèå ìàõáîäûí áîäèñûí ñîëèëöîî ÿëàíãóÿà àìèí õ¿÷ëèéí ñîëèëöîîíä ÷óõàë ¿¿ðýãòýé áîëîõûã õàðóóëæ áàéíà.

3. Öóñíû øèíæèëãýýíèé ¿ç¿¿ëýëòýýñ ¿çýõýä ¿ðýâñëèéí ýñ ëåéêîöèòèéí òîî öººð÷ (ýð¿¿ë-14%, ºâ÷òýé 47%, ýì÷èëñýí 29%) õýâèéí ¿çø¿¿ëýëò ºã÷ áàéãàà íü ýì÷èëãýýíèé ¿ð ä¿í ñàéòàé áîëîõûã õàðóóëæ áàéíà.

4. Ýä ñóäëàëûí øèíæèëãýýíèé ¿ð ä¿íãýýñ ¿çâýë ºâ÷òýé õóëãàíûã îíäàòðûí ìàõààð ýì÷èëñýí íü 0.9%-èéí NaCl-ûí óóñìàëààð õîîëëîæ áàéñàí õóëãàíààñ õàðüöàíãóé ýð¿¿ë Ẻðíèé ãèñòîëîãè á¿òýöòýé áîëñîí íü Ẻðíèé ¿ðýâñýëò ºâ÷íèé ¿åä õàðüöàíãóé ¿ð ä¿íòýéã õàðóóëæ áàéíà.




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