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Ɍ. 17, ʋ 2, 2012 ȼɟɫɬɧɢɤ ɂɜɚɧɨɜɫɤɨɣ ɦɟɞɢɰɢɧɫɤɨɣ ɚɤɚɞɟɦɢɢ 21 ǵǻǮȅdzǻǶdz DZdzǻǼǰ DZǹǮǰǻǼDZǼ ǸǼǺǽǹdzǸǿǮ DZǶǿȀǼǿǼǰǺdzǿȀǶǺǼǿȀǶ ǰ ǽǾǼDZǾǮǺǺdz ȋǸǿȀǾǮǸǼǾǽǼǾǮǹȊǻǼDZǼ ǼǽǹǼDzǼȀǰǼǾdzǻǶȍ Ɇ. Ⱥ. Ʌɢɩɢɧ1*, Ⱥ. ɂ. Ɇɚɥɵɲɤɢɧɚ1, ɞɨɤɬɨɪ ɦɟɞɢɰɢɧɫɤɢɯ ɧɚɭɤ, ɂ. ɇ. Ɏɟɬɢɫɨɜɚ1,2, ɞɨɤɬɨɪ ɦɟɞɢɰɢɧɫɤɢɯ ɧɚɭɤ, ɀ. Ⱥ. Ⱦɸɠɟɜ1,2, ɋ. ɘ. Ɋɚɬɧɢɤɨɜɚ1 ɎȽȻɍ «ɂɜɚɧɨɜɫɤɢɣ ɧɚɭɱɧɨ-ɢɫɫɥɟɞɨɜɚɬɟɥɶɫɤɢɣ ɢɧɫɬɢɬɭɬ ɦɚɬɟɪɢɧɫɬɜɚ ɢ ɞɟɬɫɬɜɚ ɢɦɟɧɢ ȼ. ɇ. Ƚɨɪɨɞɤɨɜɚ» Ɇɢɧɡɞɪɚɜɫɨɰɪɚɡɜɢɬɢɹ Ɋɨɫɫɢɢ, 153045, Ɋɨɫɫɢɹ, ɝ. ɂɜɚɧɨɜɨ, ɭɥ. ɉɨɛɟɞɵ, ɞ. 20. 2 ȽȻɈɍ ȼɉɈ «ɂɜɚɧɨɜɫɤɚɹ ɝɨɫɭɞɚɪɫɬɜɟɧɧɚɹ ɦɟɞɢɰɢɧɫɤɚɹ ɚɤɚɞɟɦɢɹ» Ɇɢɧɡɞɪɚɜɫɨɰɪɚɡɜɢɬɢɹ Ɋɨɫɫɢɢ, 153000, Ɋɨɫɫɢɹ, ɝ. ɂɜɚɧɨɜɨ, ɩɪ. Ɏɪɢɞɪɢɯɚ ɗɧɝɟɥɶɫɚ, ɞ. 8. 1 ɊȿɁɘɆȿ Ɉɛɫɥɟɞɨɜɚɧɨ 126 ɠɟɧɳɢɧ, ɧɚɩɪɚɜɥɟɧɧɵɯ ɧɚ ɩɪɨɯɨɠɞɟɧɢɟ ɩɪɨɰɟɞɭɪɵ ɷɤɫɬɪɚɤɨɪɩɨɪɚɥɶɧɨɝɨ ɨɩɥɨɞɨɬɜɨɪɟɧɢɹ ɩɨ ɩɨɜɨɞɭ ɬɪɭɛɧɨ-ɩɟɪɢɬɨɧɟɚɥɶɧɨɝɨ ɛɟɫɩɥɨɞɢɹ. Ⱥɧɚɥɢɡ ɩɨɥɢɦɨɪɮɢɡɦɚ ɝɟɧɨɜ ɫɢɫɬɟɦɵ HLA II ɤɥɚɫɫɚ ɜɵɹɜɢɥ ɚɫɫɨɰɢɚɰɢɸ ɦɟɠɞɭ ɩɪɢɫɭɬɫɬɜɢɟɦ ɜ ɝɟɧɨɬɢɩɟ ɚɥɥɟɥɢ DQA1*0201 ɢ ɫɧɢɠɟɧɧɵɦ ɮɨɥɥɢɤɭɥɹɪɧɵɦ ɪɟɡɟɪɜɨɦ; ɚɥɥɟɥɟɣ DQB1*0301/4 ɢ ɯɨɪɨɲɟɣ ɪɟɚɤɰɢɟɣ ɹɢɱɧɢɤɨɜ ɧɚ ɢɧɞɭɤɰɢɸ ɫɭɩɟɪɨɜɭɥɹɰɢɢ. Ʉɥɸɱɟɜɵɟ ɫɥɨɜɚ: ɤɨɦɩɥɟɤɫ ɝɢɫɬɨɫɨɜɦɟɫɬɢɦɨɫɬɢ, HLA, ɝɟɧɵ, ɚɥɥɟɥɢ, ɛɟɫɩɥɨɞɢɟ, ɨɜɨɰɢɬ, ɷɤɫɬɪɚɤɨɪɩɨɪɚɥɶɧɨɟ ɨɩɥɨɞɨɬɜɨɪɟɧɢɟ. * Ɉɬɜɟɬɫɬɜɟɧɧɵɣ ɡɚ ɩɟɪɟɩɢɫɤɭ (corresponding author): [email protected] ȼɨɡɪɚɫɬɚɸɳɢɣ ɢɧɬɟɪɟɫ ɤ ɪɚɡɜɢɬɢɸ ɜɫɩɨɦɨɝɚɬɟɥɶɧɵɯ ɪɟɩɪɨɞɭɤɬɢɜɧɵɯ ɬɟɯɧɨɥɨɝɢɣ (ȼɊɌ) ɜɨ ɜɫɟɦ ɦɢɪɟ ɨɛɭɫɥɨɜɥɟɧ ɩɪɢɨɪɢɬɟɬɧɨɫɬɶɸ ɩɪɨɛɥɟɦɵ ɛɟɫɩɥɨɞɢɹ ɜ ɪɟɩɪɨɞɭɤɬɢɜɧɨɣ ɦɟɞɢɰɢɧɟ [1]. ȼɚɠɧɟɣɲɢɦ ɷɬɚɩɨɦ ɩɪɨɜɟɞɟɧɢɹ ɥɸɛɨɣ ɩɪɨɝɪɚɦɦɵ ɜɫɩɨɦɨɝɚɬɟɥɶɧɵɯ ɪɟɩɪɨɞɭɤɬɢɜɧɵɯ ɬɟɯɧɨɥɨɝɢɣ ɹɜɥɹɟɬɫɹ ɢɧɞɭɤɰɢɹ ɨɜɭɥɹɰɢɢ. ɋɩɨɫɨɛɧɨɫɬɶ ɹɢɱɧɢɤɨɜ ɜ ɨɬɜɟɬ ɧɚ ɫɬɢɦɭɥɹɰɢɸ ɝɨɧɚɞɨɬɪɨɩɢɧɚɦɢ ɩɪɨɞɭɰɢɪɨɜɚɬɶ ɚɞɟɤɜɚɬɧɨɟ ɱɢɫɥɨ ɮɨɥɥɢɤɭɥɨɜ ɨɬɧɨɫɢɬɫɹ ɤ ɜɟɞɭɳɢɦ ɩɪɨɝɧɨɫɬɢɱɟɫɤɢɦ ɩɪɢɡɧɚɤɚɦ ɩɪɢ ɨɰɟɧɤɟ ɢɯ ɮɭɧɤɰɢɨɧɚɥɶɧɨɝɨ ɫɨɫɬɨɹɧɢɹ ɢ ɹɜɥɹɟɬɫɹ ɤɪɢɬɟɪɢɟɦ ɭɫɩɟɲɧɨɝɨ ɥɟɱɟɧɢɹ ɛɟɫɩɥɨɞɢɹ. ɗɬɚ ɪɟɚɤɰɢɹ ɫɨ ɫɬɨɪɨɧɵ ɹɢɱɧɢɤɚ ɨɬɪɚɠɚɟɬ ɬɚɤ ɧɚɡɵɜɚɟɦɵɣ «ɨɜɚɪɢɚɥɶɧɵɣ ɪɟɡɟɪɜ», ɤɨɬɨɪɵɣ ɜ ɨɫɧɨɜɧɨɦ ɡɚɜɢɫɢɬ ɨɬ ɢɫɯɨɞɧɨɣ ɜɟɥɢɱɢɧɵ ɩɭɥɚ ɩɪɢɦɨɪɞɢɚɥɶɧɵɯ ɮɨɥɥɢɤɭɥɨɜ. Ɉɞɧɚɤɨ ɩɨɱɬɢ ɭ 15–22% ɩɚɰɢɟɧɬɨɤ ɧɟ ɭɞɚɟɬɫɹ ɞɨɛɢɬɶɫɹ ɫɨɡɪɟɜɚɧɢɹ ɛɨɥɟɟ ɬɪɟɯ ɮɨɥɥɢɤɭɥɨɜ ɞɚɠɟ ɩɪɢ ɢɫɩɨɥɶɡɨɜɚɧɢɢ ɫɚɦɵɯ ɫɨɜɪɟɦɟɧɧɵɯ ɢɧɞɭɤɬɨɪɨɜ ɨɜɭɥɹɰɢɢ. Ɉɫɥɚɛɥɟɧɢɟ ɪɟɚɤɰɢɢ ɹɢɱɧɢɤɨɜ ɧɚ ɢɧɞɭɤɬɨɪɵ ɮɨɥɥɢɤɭɥɨɝɟɧɟɡɚ ɧɚɡɵɜɚɸɬ «ɛɟɞɧɵɦ ɨɬɜɟɬɨɦ» [3, 4, 10, 15]. ɉɪɨɰɟɫɫ ɪɟɩɪɨɞɭɤɰɢɢ ɭ ɱɟɥɨɜɟɤɚ, ɜɤɥɸɱɚɹ ɝɚɦɟɬɨɝɟɧɟɡ, ɤɨɧɬɪɨɥɢɪɭɟɬɫɹ ɨɩɪɟɞɟɥɟɧɧɵɦɢ ɝɟɧɚɦɢ [7, 16]. ȼ ɷɬɨɣ ɫɜɹɡɢ ɛɨɥɶɲɨɣ ɢɧɬɟɪɟɫ ɩɪɟɞɫɬɚɜɥɹɟɬ ɢɡɭɱɟɧɢɟ ɧɚɫɥɟɞɫɬɜɟɧɧɵɯ ɮɚɤɬɨɪɨɜ, ɤɨɧɬɪɨɥɢɪɭɸɳɢɯ ɩɪɨɰɟɫɫ ɫɨɡɪɟɜɚɧɢɹ ɩɨɥɨɜɵɯ ɤɥɟɬɨɤ ɢ ɬɚɤɢɦ ɨɛɪɚɡɨɦ ɩɪɢɱɚɫɬɧɵɯ ɤ ɮɨɪɦɢɪɨɜɚɧɢɸ ɩɨɬɟɧɰɢɚɥɚ ɞɥɹ ɩɨɫɥɟɞɭɸɳɟɝɨ ɷɦɛɪɢɨɧɚɥɶɧɨɝɨ ɪɚɡɜɢɬɢɹ. ɐɟɥɶɸ ɧɚɫɬɨɹɳɟɝɨ ɢɫɫɥɟɞɨɜɚɧɢɹ ɹɜɢɥɨɫɶ ɨɩɪɟɞɟɥɟɧɢɟ ɱɚɫɬɨɬɵ ɚɥɥɟɥɟɣ ɝɟɧɨɜ ɝɥɚɜɧɨɝɨ ɤɨɦɩɥɟɤɫɚ ɝɢɫɬɨɫɨɜɦɟɫɬɢɦɨɫɬɢ HLA II ɤɥɚɫɫɚ (DRB1, DQA1, DQB1) ɭ ɠɟɧɳɢɧ ɫ ɬɪɭɛɧɨ-ɩɟɪɢɬɨɧɟɚɥɶɧɵɦ ɛɟɫɩɥɨɞɢɟɦ, ɩɪɨɯɨɞɢɜɲɢɯ ɩɪɨɰɟɞɭɪɭ ɷɤɫɬɪɚɤɨɪɩɨɪɚɥɶɧɨɝɨ ɨɩɥɨɞɨɬɜɨɪɟɧɢɹ, ɢ ɜɵɹɜɥɟɧɢɟ ɜɨɡɦɨɠɧɨɣ ɚɫɫɨɰɢɚɰɢɢ ɭɤɚɡɚɧɧɵɯ ɝɟɧɟɬɢɱɟɫɤɢɯ ɦɚɪɤɟɪɨɜ ɫ ɤɨɥɢɱɟɫɬɜɨɦ ɨɜɨɰɢɬɨɜ, ɩɨɥɭɱɟɧɧɵɯ ɩɪɢ ɢɧɞɭɤɰɢɢ ɫɭɩɟɪɨɜɭɥɹɰɢɢ. ǺǮȀdzǾǶǮǹ Ƕ ǺdzȀǼDzȉ Ɉɫɧɨɜɧɭɸ ɝɪɭɩɩɭ ɫɨɫɬɚɜɢɥɢ 126 ɩɚɰɢɟɧɬɨɤ, ɩɪɨɯɨɞɢɜɲɢɯ ɩɪɨɰɟɞɭɪɭ ɷɤɫɬɪɚɤɨɪɩɨɪɚɥɶɧɨɝɨ ɨɩɥɨɞɨɬɜɨɪɟɧɢɹ ɜ ɫɜɹɡɢ ɫ ɧɟɩɪɨɯɨɞɢɦɨɫɬɶɸ ɢɥɢ THE SIGNIFICANCE OF THE GENES OF THE MAIN COMPLEX OF HISTOCOMPATIBILITY IN THE PROGRAM OF EXTRACORPOREAL FERTILIZATION Lipin M. A., Malyshkina A. I., Fetisova I. N., Diuzhev Zh. A., Ratnikova S. Yu. ABSTRACT 126 women who were directed to the procedure of extracorporeal fertilization due to tuboperitoneal sterility were examined. The analysis of polymorphism of genes of HLA system, II class revealed the association between the presence of DQA1* alleles in genotype and decreased follicular reserve; DQB1*0301/4 alleles and positive reaction of ovaries to superovulation induction. Key words: histocompatibility complex, HLA, genes, alleles, sterility, oocyte, extracorporeal fertilization. 22 Ʉɨɦɩɥɟɤɫ ɝɢɫɬɨɫɨɜɦɟɫɬɢɦɨɫɬɢ ɩɪɢ ɷɤɫɬɪɚɤɨɪɩɨɪɚɥɶɧɨɦ ɨɩɥɨɞɨɬɜɨɪɟɧɢɢ ɨɬɫɭɬɫɬɜɢɟɦ ɦɚɬɨɱɧɵɯ ɬɪɭɛ; ɜ ɤɨɧɬɪɨɥɶɧɭɸ ɝɪɭɩɩɭ ɜɨɲɥɢ 57 ɠɟɧɳɢɧ ɫ ɭɤɚɡɚɧɢɟɦ ɜ ɚɧɚɦɧɟɡɟ ɧɚ ɪɨɠɞɟɧɢɟ ɞɜɭɯ ɢ ɛɨɥɟɟ ɡɞɨɪɨɜɵɯ ɞɟɬɟɣ ɛɟɡ ɢɫɩɨɥɶɡɨɜɚɧɢɹ ɜɫɩɨɦɨɝɚɬɟɥɶɧɵɯ ɪɟɩɪɨɞɭɤɬɢɜɧɵɯ ɬɟɯɧɨɥɨɝɢɣ. ɂɧɞɭɤɰɢɸ ɫɭɩɟɪɨɜɭɥɹɰɢɢ, ɭɥɶɬɪɚɡɜɭɤɨɜɨɣ ɦɨɧɢɬɨɪɢɧɝ ɢ ɚɫɩɢɪɚɰɢɸ ɮɨɥɥɢɤɭɥɨɜ ɨɫɭɳɟɫɬɜɥɹɥɢ ɩɨ ɨɛɳɟɩɪɢɧɹɬɵɦ ɩɪɨɬɨɤɨɥɚɦ ɩɪɨɝɪɚɦɦɵ ɷɤɫɬɪɚɤɨɪɩɨɪɚɥɶɧɨɝɨ ɨɩɥɨɞɨɬɜɨɪɟɧɢɹ [9, 12]. ɍ ɜɫɟɯ ɩɚɰɢɟɧɬɨɤ ɨɫɧɨɜɧɨɣ ɝɪɭɩɩɵ ɞɥɹ ɢɫɤɥɸɱɟɧɢɹ ɱɢɫɥɟɧɧɵɯ ɢ ɫɬɪɭɤɬɭɪɧɵɯ ɚɧɨɦɚɥɢɣ ɯɪɨɦɨɫɨɦ ɛɵɥɨ ɩɪɨɜɟɞɟɧɨ ɤɚɪɢɨɬɢɩɢɪɨɜɚɧɢɟ ɫ ɢɫɩɨɥɶɡɨɜɚɧɢɟɦ ɞɢɮɮɟɪɟɧɰɢɚɥɶɧɵɯ ɦɟɬɨɞɨɜ ɨɤɪɚɫɤɢ ɯɪɨɦɨɫɨɦɧɵɯ ɩɪɟɩɚɪɚɬɨɜ. Ɉɛɪɚɡɰɵ ȾɇɄ ɩɨɥɭɱɚɥɢ ɢɡ ɥɢɦɮɨɰɢɬɨɜ ɩɟɪɢɮɟɪɢɱɟɫɤɨɣ ɤɪɨɜɢ, ɩɪɢɦɟɧɹɹ ɧɚɛɨɪ ɪɟɚɝɟɧɬɨɜ ɢ ɩɪɨɬɨɤɨɥ ɞɥɹ ɜɵɞɟɥɟɧɢɹ ȾɇɄ ɢɡ ɪɚɡɥɢɱɧɨɝɨ ɛɢɨɥɨɝɢɱɟɫɤɨɝɨ ɦɚɬɟɪɢɚɥɚ «DIAtom DNA Prep100» («ɂɡɨɝɟɧ», Ɋɨɫɫɢɹ). ɇɚ ɩɨɥɭɱɟɧɧɵɯ ɨɛɪɚɡɰɚɯ ȾɇɄ ɩɪɨɜɨɞɢɥɢ ɚɥɥɟɥɶ-ɫɩɟɰɢɮɢɱɟɫɤɭɸ ɩɨɥɢɦɟɪɚɡɧɭɸ ɰɟɩɧɭɸ ɪɟɚɤɰɢɸ ɬɪɟɯ ɥɨɤɭɫɨɜ HLA II ɤɥɚɫɫɚ: DRB1, DQA1, DQB1 ɫ ɢɫɩɨɥɶɡɨɜɚɧɢɟɦ ɧɚɛɨɪɚ ɪɟɚɤɬɢɜɨɜ ɇɉɈ «ȾɇɄ-ɬɟɯɧɨɥɨɝɢɹ» (Ɋɨɫɫɢɹ). ɉɪɨɞɭɤɬɵ ɚɦɩɥɢɮɢɤɚɰɢɢ ɚɧɚɥɢɡɢɪɨɜɚɥɢ ɜ 3%-ɧɨɦ ɚɝɚɪɨɡɧɨɦ ɝɟɥɟ ɫ ɨɤɪɚɫɤɨɣ ɚɦɩɥɢɮɢɤɚɬɨɜ ɛɪɨɦɢɫɬɵɦ ɷɬɢɞɢɟɦ ɢ ɜɢɡɭɚɥɢɡɚɰɢɟɣ ɜ ɩɪɨɯɨɞɹɳɟɦ ɭɥɶɬɪɚɮɢɨɥɟɬɨɜɨɦ ɫɜɟɬɟ. Ⱦɥɹ ɫɪɚɜɧɟɧɢɹ ɪɚɫɩɪɟɞɟɥɟɧɢɹ ɱɚɫɬɨɬ ɚɥɥɟɥɟɣ ɝɟɧɨɜ HLA II ɤɥɚɫɫɚ ɛɵɥ ɩɪɢɦɟɧɟɧ ɤɪɢɬɟɪɢɣ Ȥ2 ɉɢɪɫɨɧɚ ɢ ɬɟɫɬ Ɏɢɲɟɪɚ. Ⱦɥɹ ɜɵɹɜɥɟɧɢɹ ɫɜɹɡɢ ɦɟɠɞɭ ɫɬɟɩɟɧɶɸ ɮɨɥɥɢɤɭɥɹɪɧɨɝɨ ɨɬɜɟɬɚ ɩɪɢ ɢɧɞɭɤɰɢɢ ɫɭɩɟɪɨɜɭɥɹɰɢɢ ɢ ɱɚɫɬɨɬɨɣ ɧɨɫɢɬɟɥɶɫɬɜɚ ɨɩɪɟɞɟɥɟɧɧɨɝɨ ɚɥɥɟɥɹ ɢɫɩɨɥɶɡɨɜɚɥɫɹ ɤɨɪɪɟɥɹɰɢɨɧɧɵɣ ɚɧɚɥɢɡ ɫ ɨɰɟɧɤɨɣ ɧɟɩɚɪɚɦɟɬɪɢɱɟɫɤɨɝɨ ɤɨɷɮɮɢɰɢɟɧɬɚ ɪɚɧɝɨɜɨɣ ɤɨɪɪɟɥɹɰɢɢ IJ Ʉɟɧɞɚɥɥɚ. Ɂɚ ɞɨɫɬɨɜɟɪɧɵɣ ɩɪɢɧɢɦɚɥɢ 95%-ɧɵɣ ɭɪɨɜɟɧɶ ɡɧɚɱɢɦɨɫɬɢ (p < 0,05). ǾdzǵȁǹȊȀǮȀȉ Ƕ ǼǯǿȁǴDzdzǻǶdz ȼɨɡɪɚɫɬ ɩɚɰɢɟɧɬɨɤ ɨɫɧɨɜɧɨɣ ɝɪɭɩɩɵ ɜɚɪɶɢɪɨɜɚɥ ɨɬ 26 ɞɨ 45 ɥɟɬ ɢ ɫɨɫɬɚɜɢɥ ɜ ɫɪɟɞɧɟɦ 33,7 ± 4,8 ɝɨɞɚ, ɠɟɧɳɢɧ ɝɪɭɩɩɵ ɫɪɚɜɧɟɧɢɹ – 41,8 ± 1,5 ɝɨɞɚ. ȼɫɟ ɩɚɰɢɟɧɬɤɢ ɨɫɧɨɜɧɨɣ ɝɪɭɩɩɵ ɢɦɟɥɢ ɧɨɪɦɚɥɶɧɵɣ ɤɚɪɢɨɬɢɩ. ȼ ɫɪɟɞɧɟɦ ɭ ɨɞɧɨɣ ɠɟɧɳɢɧɵ ɨɫɧɨɜɧɨɣ ɝɪɭɩɩɵ ɛɵɥɨ ɩɭɧɤɬɢɪɨɜɚɧɨ 9,8 ± 3,2 ɮɨɥɥɢɤɭɥɚ ɢ ɩɪɢ ɷɬɨɦ ɩɨɥɭɱɟɧɨ 7,6 ± 3,4 ɨɜɨɰɢɬɚ. ȼ ɡɚɜɢɫɢɦɨɫɬɢ ɨɬ ɤɨɥɢɱɟɫɬɜɚ ɨɜɨɰɢɬɨɜ, ɩɨɥɭɱɟɧɧɵɯ ɩɪɢ ɬɪɚɧɫɜɚɝɢɧɚɥɶɧɨɣ ɩɭɧɤɰɢɢ, ɜɫɟ ɩɚɰɢɟɧɬɤɢ ɨɫɧɨɜɧɨɣ ɝɪɭɩɩɵ ɛɵɥɢ ɪɚɡɞɟɥɟɧɵ ɧɚ ɱɟɬɵɪɟ ɩɨɞɝɪɭɩɩɵ. ȼ 1-ɸ ɩɨɞɝɪɭɩɩɭ ɜɨɲɥɢ 29 ɠɟɧɳɢɧ (23,0%), ɭ ɤɨɬɨɪɵɯ ɛɵɥɨ ɩɨɥɭɱɟɧɨ 3 ɢ ɦɟɧɟɟ ɨɜɨɰɢɬɚ, ɬɨ ɟɫɬɶ ɢɦɟɥɨ ɦɟɫɬɨ ɨɫɥɚɛɥɟɧɢɟ ɪɟɚɤɰɢɢ ɹɢɱɧɢɤɨɜ ɧɚ ɢɧɞɭɤɬɨɪɵ ɮɨɥɥɢɤɭɥɨɝɟɧɟɡɚ – ɬɚɤ ɧɚɡɵɜɚɟɦɵɣ «ɛɟɞɧɵɣ ɨɬɜɟɬ». ɍ 46 ɩɚɰɢɟɧɬɨɤ (36,5%) ɤɨɥɢɱɟɫɬɜɨ ɨɜɨɰɢɬɨɜ ɫɨɫɬɚɜɢɥɨ 4–7 (2-ɹ ɩɨɞɝɪɭɩɩɚ). Ɉɬ 8 ɞɨ 11 ɨɜɨɰɢɬɨɜ ɛɵɥɨ ɩɨɥɭɱɟɧɨ ɭ 27 ɠɟɧɳɢɧ (21,3%, 3-ɹ ɩɨɞɝɪɭɩɩɚ). Ⱦɜɚɞɰɚɬɶ ɱɟɬɵɪɟ ɩɚɰɢɟɧɬɤɢ (19,0%) ɫ ɦɚɤɫɢɦɚɥɶɧɵɦ ɮɨɥɥɢɤɭɥɹɪɧɵɦ ɨɬɜɟɬɨɦ (12 ɢ ɛɨɥɟɟ ɨɜɨɰɢɬɨɜ) ɨɛɴɟɞɢɧɟɧɵ ɜ 4-ɸ ɩɨɞɝɪɭɩɩɭ. ɋɪɟɞɧɢɣ ɜɨɡɪɚɫɬ ɠɟɧɳɢɧ ɜɫɟɯ ɱɟɬɵɪɟɯ ɩɨɞɝɪɭɩɩ ɛɵɥ ɫɨɩɨɫɬɚɜɢɦ: 32,6 ± 2,4 ɝɨɞɚ – ɜ 1-ɣ, 36,2 ± 5,8 ɝɨɞɚ – ɜɨ 2-ɣ, 31,4 ± 4,3 ɝɨɞɚ – ɜ 3-ɣ, 30,1 ± 4,0 ɝɨɞɚ – ɜ 4-ɣ. Ⱥɧɚɥɢɡ ɪɚɫɩɪɨɫɬɪɚɧɟɧɧɨɫɬɢ ɚɥɥɟɥɟɣ ɝɟɧɨɜ HLA II ɤɥɚɫɫɚ ɩɨɤɚɡɚɥ, ɱɬɨ ɭ ɠɟɧɳɢɧ ɫ ɬɪɭɛɧɨ-ɩɟɪɢɬɨɧɟɚɥɶɧɵɦ ɛɟɫɩɥɨɞɢɟɦ ɞɨɫɬɨɜɟɪɧɨ ɱɚɳɟ, ɱɟɦ ɭ ɡɞɨɪɨɜɵɯ ɠɟɧɳɢɧ, ɜɫɬɪɟɱɚɟɬɫɹ ɚɥɥɟɥɶ DQB1*10 (4,0 ɢ 0,0% ɫɨɜɨɬɜɟɬɫɬɜɟɧɧɨ, p < 0,05). ȼɦɟɫɬɟ ɫ ɬɟɦ, ɜ ɨɫɧɨɜɧɨɣ ɝɪɭɩɩɟ ɩɨ ɫɪɚɜɧɟɧɢɸ ɫ ɤɨɧɬɪɨɥɶɧɨɣ ɨɬɦɟɱɚɥɚɫɶ ɦɟɧɶɲɚɹ ɪɚɫɩɪɨɫɬɪɚɧɟɧɧɨɫɬɶ ɚɥɥɟɥɟɣ ɝɪɭɩɩɵ DQB1*03 (21,1 ɢ 36,7% ɫɨɨɬɜɟɬɫɬɜɟɧɧɨ, p < 0,05), ɚ ɢɦɟɧɧɨ DQB1*0301/4 (15,1 ɢ 21,9% ɫɨɨɬɜɟɬɫɬɜɟɧɧɨ), DQB1*0302 (1,6 ɢ 9,6% ɫɨɨɬɜɟɬɫɬɜɟɧɧɨ, p < 0,05), DQB1* 0303 (4,4 ɢ 5,3% ɫɨɨɬɜɟɬɫɬɜɟɧɧɨ). ɉɨɥɭɱɟɧɧɵɟ ɞɚɧɧɵɟ ɩɨɡɜɨɥɢɥɢ ɜɵɫɤɚɡɚɬɶ ɩɪɟɞɩɨɥɨɠɟɧɢɟ ɨ ɩɪɨɬɟɤɬɢɜɧɨɦ ɡɧɚɱɟɧɢɢ ɚɥɥɟɥɟɣ ɝɪɭɩɩɵ DQB1*03 ɞɥɹ ɪɟɩɪɨɞɭɤɬɢɜɧɨɝɨ ɩɨɬɟɧɰɢɚɥɚ ɠɟɧɫɤɨɝɨ ɨɪɝɚɧɢɡɦɚ. Ɋɟɡɭɥɶɬɚɬɵ ɚɧɚɥɢɡɚ ɩɨɥɢɦɨɪɮɢɡɦɚ ɝɟɧɨɜ ɝɥɚɜɧɨɝɨ ɤɨɦɩɥɟɤɫɚ ɝɢɫɬɨɫɨɜɦɟɫɬɢɦɨɫɬɢ, ɩɪɨɜɟɞɟɧɧɨɝɨ ɜ ɩɨɞɝɪɭɩɩɚɯ ɠɟɧɳɢɧ ɫ ɪɚɡɥɢɱɧɵɦ ɮɨɥɥɢɤɭɥɹɪɧɵɦ ɨɬɜɟɬɨɦ ɧɚ ɢɧɞɭɤɰɢɸ ɫɭɩɟɪɨɜɭɥɹɰɢɢ, ɩɪɟɞɫɬɚɜɥɟɧɵ ɜ ɬɚɛɥɢɰɟ. ɋɨɝɥɚɫɧɨ ɪɟɡɭɥɶɬɚɬɚɦ ɦɨɥɟɤɭɥɹɪɧɨ-ɝɟɧɟɬɢɱɟɫɤɨɝɨ ɨɛɫɥɟɞɨɜɚɧɢɹ, ɭ ɠɟɧɳɢɧ ɫɨ ɫɧɢɠɟɧɧɵɦ ɢ ɭɦɟɪɟɧɧɵɦ ɮɨɥɥɢɤɭɥɹɪɧɵɦ ɨɬɜɟɬɨɦ (1-ɹ ɢ 2-ɹ ɩɨɞɝɪɭɩɩɵ) ɞɨɫɬɨɜɟɪɧɨ ɱɚɳɟ, ɱɟɦ ɭ ɩɚɰɢɟɧɬɨɤ, ɭ ɤɨɬɨɪɵɯ ɩɨɫɥɟ ɩɪɢɦɟɧɟɧɢɹ ɢɧɞɭɤɬɨɪɨɜ ɮɨɥɥɢɤɭɥɨɝɟɧɟɡɚ ɛɵɥɨ ɩɨɥɭɱɟɧɨ 12 ɢ ɛɨɥɟɟ ɨɜɨɰɢɬɨɜ (4-ɹ ɩɨɞɝɪɭɩɩɚ), ɜ ɝɟɧɨɬɢɩɟ ɩɪɢɫɭɬɫɬɜɭɟɬ ɚɥɥɟɥɶ DQA1*0201. Ʉɨɪɪɟɥɹɰɢɨɧɧɵɣ ɚɧɚɥɢɡ ɫ ɨɰɟɧɤɨɣ ɤɨɷɮɮɢɰɢɟɧɬɚ IJ Ʉɟɧɞɚɥɥɚ ɩɨɤɚɡɚɥ ɧɚɥɢɱɢɟ ɨɛɪɚɬɧɨɣ ɫɬɚɬɢɫɬɢɱɟɫɤɢ ɞɨɫɬɨɜɟɪɧɨɣ ɫɢɥɶɧɨɣ ɫɜɹɡɢ ɦɟɠɞɭ ɱɚɫɬɨɬɨɣ ɜɫɬɪɟɱɚɟɦɨɫɬɢ ɜ ɝɟɧɨɬɢɩɟ ɚɥɥɟɥɢ DQA1*0201 ɢ ɤɨɥɢɱɟɫɬɜɨɦ ɩɨɥɭɱɟɧɧɵɯ ɩɪɢ ɢɧɞɭɤɰɢɢ ɫɭɩɟɪɨɜɭɥɹɰɢɢ ɨɜɨɰɢɬɨɜ (ɤɨɷɮɮɢɰɢɟɧɬ ɤɨɪɪɟɥɹɰɢɢ IJ = -0,95, ɪ < 0,05). ȼɦɟɫɬɟ ɫ ɬɟɦ, ɭ ɡɞɨɪɨɜɵɯ ɠɟɧɳɢɧ ɢ ɠɟɧɳɢɧ ɨɫɧɨɜɧɨɣ ɝɪɭɩɩɵ ɫ ɯɨɪɨɲɢɦ ɨɬɜɟɬɨɦ ɧɚ ɢɧɞɭɤɰɢɸ ɫɭɩɟɪɨɜɭɥɹɰɢɢ (4-ɹ ɩɨɞɝɪɭɩɩɚ) ɞɨɫɬɨɜɟɪɧɨ ɱɚɳɟ, ɱɟɦ ɭ ɩɚɰɢɟɧɬɨɤ 1-ɣ ɢ 2-ɣ ɩɨɞɝɪɭɩɩ, ɜ ɝɟɧɨɬɢɩɟ ɢɦɟɥɚɫɶ ɚɥɥɟɥɶ DQB1*03 (ɪ < 0,05). ȼ ɪɟɡɭɥɶɬɚɬɟ ɩɪɨɜɟɞɟɧɧɨɝɨ ɤɨɪɪɟɥɹɰɢɨɧɧɨɝɨ ɚɧɚɥɢɡɚ ɫ ɨɰɟɧɤɨɣ ɤɨɷɮɮɢɰɢɟɧɬɚ IJ Ʉɟɧɞɚɥɥɚ ɜɵɹɜɥɟɧɚ ɩɪɹɦɚɹ, ɛɥɢɡɤɚɹ ɤ ɞɨɫɬɨɜɟɪɧɨɣ ɤɨɪɪɟɥɹɰɢɨɧɧɚɹ ɫɜɹɡɶ ɦɟɠɞɭ ɪɚɫɩɪɨɫɬɪɚɧɟɧɧɨɫɬɶɸ ɚɥɥɟɥɢ DQB1*03 ɢ ɧɚɥɢɱɢɟɦ ɨɬɜɟɬɚ ɹɢɱɧɢɤɨɜ ɧɚ ɢɧɞɭɤɰɢɸ ɫɭ- Ɍ. 17, ʋ 2, 2012 23 ȼɟɫɬɧɢɤ ɂɜɚɧɨɜɫɤɨɣ ɦɟɞɢɰɢɧɫɤɨɣ ɚɤɚɞɟɦɢɢ Ɍɚɛɥɢɰɚ. Ɋɚɫɩɪɨɫɬɪɚɧɟɧɧɨɫɬɶ ɚɥɥɟɥɟɣ HLA II ɤɥɚɫɫɚ ɜ ɩɨɞɝɪɭɩɩɚɯ ɨɫɧɨɜɧɨɣ ɝɪɭɩɩɵ ɢ ɜ ɤɨɧɬɪɨɥɶɧɨɣ ɝɪɭɩɩɟ Ɋɚɫɩɪɨɫɬɪɚɧɟɧɧɨɫɬɶ, % Ⱥɥɥɟɥɢ ɜ ɨɫɧɨɜɧɨɣ ɝɪɭɩɩɟ ɜ 1-ɣ ɩɨɞɝɪɭɩɩɟ ɜɨ 2-ɣ ɩɨɞɝɪɭɩɩɟ ɜ 3-ɣ ɩɨɞɝɪɭɩɩɟ ɜ 4-ɣ ɩɨɞɝɪɭɩɩɟ ɜ ɤɨɧɬɪɨɥɶɧɨɣ ɝɪɭɩɩɟ 12,1* 18,5** 7,4 2,1 11,0 24,1*** 23,9*** 27,8 33,3 36,7 19,0 12,0** 13,0 29,2 21,9 DQA1*0201 DQB1*03 DQB1*0301/4 ɉɪɢɦɟɱɚɧɢɟ. ɋɬɚɬɢɫɬɢɱɟɫɤɚɹ ɡɧɚɱɢɦɨɫɬɶ ɪɚɡɥɢɱɢɣ ɩɨ ɫɪɚɜɧɟɧɢɸ ɫ 4-ɣ ɩɨɞɝɪɭɩɩɨɣ: * – ɪ < 0,05, ** – ɪ < 0,01; ɩɨ ɫɪɚɜɧɟɧɢɸ ɫ ɤɨɧɬɪɨɥɶɧɨɣ ɝɪɭɩɩɨɣ: *** – ɪ < 0,05. ɩɟɪɨɜɭɥɹɰɢɢ (ɤɨɷɮɮɢɰɢɟɧɬ ɤɨɪɪɟɥɹɰɢɢ IJ = 0,74, ɪ = 0,071). ɍɫɬɚɧɨɜɥɟɧɚ ɞɨɫɬɨɜɟɪɧɨ ɛɨɥɟɟ ɜɵɫɨɤɚɹ ɱɚɫɬɨɬɚ ɜɫɬɪɟɱɚɟɦɨɫɬɢ ɚɥɥɟɥɢ DQB1*0301/4 ɭ ɩɚɰɢɟɧɬɨɤ 4-ɣ ɩɨɞɝɪɭɩɩɵ ɩɨ ɫɪɚɜɧɟɧɢɸ ɫ ɠɟɧɳɢɧɚɦɢ 2-ɣ ɩɨɞɝɪɭɩɩɵ; ɩɨɤɚɡɚɧɨ ɧɚɥɢɱɢɟ ɩɪɹɦɨɣ, ɛɥɢɡɤɨɣ ɤ ɞɨɫɬɨɜɟɪɧɨɣ ɤɨɪɪɟɥɹɰɢɨɧɧɨɣ ɫɜɹɡɢ ɦɟɠɞɭ ɩɪɢɫɭɬɫɬɜɢɟɦ ɜ ɝɟɧɨɬɢɩɟ ɠɟɧɳɢɧɵ ɞɚɧɧɨɣ ɚɥɥɟɥɢ ɢ ɯɨɪɨɲɢɦ ɮɨɥɥɢɤɭɥɹɪɧɵɦ ɨɬɜɟɬɨɦ (ɤɨɷɮɮɢɰɢɟɧɬ ɤɨɪɪɟɥɹɰɢɢ IJ = 0,53, ɪ = 0,197). ǰȉǰǼDzȉ Ɍɚɤɢɦ ɨɛɪɚɡɨɦ, ɦɨɠɧɨ ɩɪɟɞɩɨɥɨɠɢɬɶ, ɱɬɨ ɩɨɥɢɦɨɪɮɧɵɟ ɜɚɪɢɚɧɬɵ ɝɟɧɨɜ ɫɢɫɬɟɦɵ HLA II ɤɥɚɫɫɚ ɩɪɢɱɚɫɬɧɵ ɤ ɮɨɪɦɢɪɨɜɚɧɢɸ ɢ ɫɨɯɪɚɧɟɧɢɸ ɨɜɚɪɢɚɥɶɧɨɝɨ ɪɟɡɟɪɜɚ. Ɋɨɥɶ ɚɧɬɢɝɟɧɨɜ HLA ɜ ɧɚɪɭɲɟɧɢɢ ɪɟɩɪɨɞɭɤɰɢɢ ɱɟɥɨɜɟɤɚ ɨɫɬɚɟɬɫɹ ɫɩɨɪɧɵɦ ɜɨɩɪɨɫɨɦ. ȼ ɧɚɭɱɧɨɣ ɥɢɬɟɪɚɬɭɪɟ ɟɫɬɶ ɞɚɧɧɵɟ ɨ ɧɚɤɨɩɥɟɧɢɢ ɨɩɪɟɞɟɥɟɧɧɵɯ ɩɨɥɢɦɨɪɮɧɵɯ ɜɚɪɢɚɧ- ɬɨɜ ɝɟɧɨɜ ɝɥɚɜɧɨɝɨ ɤɨɦɩɥɟɤɫɚ ɝɢɫɬɨɫɨɜɦɟɫɬɢɦɨɫɬɢ ɭ ɥɢɰ ɫ ɪɚɡɥɢɱɧɵɦɢ ɧɚɪɭɲɟɧɢɹɦɢ ɪɟɩɪɨɞɭɤɬɢɜɧɨɣ ɮɭɧɤɰɢɢ [2, 5–8, 11, 13, 14, 17]. ɉɨɥɭɱɟɧɧɵɟ ɧɚɦɢ ɪɟɡɭɥɶɬɚɬɵ ɫɜɢɞɟɬɟɥɶɫɬɜɭɸɬ ɨ ɜɨɡɦɨɠɧɨɣ ɚɫɫɨɰɢɚɰɢɢ ɦɟɠɞɭ ɜɵɹɜɥɟɧɧɵɦɢ ɨɫɨɛɟɧɧɨɫɬɹɦɢ ɩɨɥɢɦɨɪɮɢɡɦɚ ɝɟɧɨɜ ɫɢɫɬɟɦɵ HLA II ɤɥɚɫɫɚ ɢ ɫɨɫɬɨɹɧɢɟɦ ɮɨɥɥɢɤɭɥɨɝɟɧɟɡɚ. ɍɫɬɚɧɨɜɥɟɧɧɵɟ ɨɫɨɛɟɧɧɨɫɬɢ ɝɟɧɨɬɢɩɚ ɠɟɧɳɢɧ ɫ ɧɨɪɦɚɥɶɧɵɦ ɢ ɫɧɢɠɟɧɧɵɦ ɮɨɥɥɢɤɭɥɹɪɧɵɦ ɪɟɡɟɪɜɨɦ ɦɨɝɭɬ ɢɫɩɨɥɶɡɨɜɚɬɶɫɹ ɤɚɤ ɝɟɧɟɬɢɱɟɫɤɢɟ ɦɚɪɤɟɪɵ ɩɪɟɞɪɚɫɩɨɥɨɠɟɧɧɨɫɬɢ ɤ ɮɨɪɦɢɪɨɜɚɧɢɸ ɩɨɬɟɧɰɢɚɥɚ ɞɥɹ ɩɨɫɥɟɞɭɸɳɟɝɨ ɷɦɛɪɢɨɧɚɥɶɧɨɝɨ ɪɚɡɜɢɬɢɹ. Ɋɚɧɧɟɟ ɝɟɧɟɬɢɱɟɫɤɨɟ ɬɟɫɬɢɪɨɜɚɧɢɟ ɩɚɰɢɟɧɬɨɤ, ɧɭɠɞɚɸɳɢɯɫɹ ɜ ɥɟɱɟɧɢɢ ɛɟɫɩɥɨɞɢɹ ɫ ɩɨɦɨɳɶɸ ɜɫɩɨɦɨɝɚɬɟɥɶɧɵɯ ɪɟɩɪɨɞɭɤɬɢɜɧɵɯ ɬɟɯɧɨɥɨɝɢɣ, ɩɨɡɜɨɥɢɬ ɛɨɥɟɟ ɜɡɜɟɲɟɧɧɨ ɪɟɲɚɬɶ ɜɨɩɪɨɫ ɨ ɜɨɡɦɨɠɧɨɫɬɢ ɢ ɰɟɥɟɫɨɨɛɪɚɡɧɨɫɬɢ ɩɪɢɦɟɧɟɧɢɹ ɞɚɧɧɵɯ ɬɟɯɧɨɥɨɝɢɣ. ǹǶȀdzǾǮȀȁǾǮ 1. Ȼɟɫɩɥɨɞɧɵɣ ɛɪɚɤ. ɋɨɜɪɟɦɟɧɧɵɟ ɩɨɞɯɨɞɵ ɤ ɞɢɚɝɧɨɫɬɢɤɟ ɢ ɥɟɱɟɧɢɸ / ɩɨɞ ɪɟɞ. ȼ. ɂ. Ʉɭɥɚɤɨɜɚ. – Ɇ. : ȽɗɈɌȺɊ-Ɇɟɞɢɚ, 2005. – 616 ɫ. 2. Ƚɚɛɢɛɭɥɥɚɟɜɚ Ɂ. Ƚ. Ʉɥɢɧɢɤɨ-ɝɟɧɟɬɢɱɟɫɤɚɹ ɯɚɪɚɤɬɟɪɢɫɬɢɤɚ ɛɨɥɶɧɵɯ ɫ ɩɪɟɠɞɟɜɪɟɦɟɧɧɨɣ ɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶɸ ɹɢɱɧɢɤɨɜ : ɚɜɬɨɪɟɮ. ɞɢɫ. … ɤɚɧɞ. ɦɟɞ. ɧɚɭɤ. – Ɇ., 2008. – 28 c. 3. Ʌɨɤɲɢɧ ȼ. ɇ., Ʉɚɪɢɛɚɟɜɚ ɒ. Ʉ., ɉɨɥɭɦɢɫɤɨɜ ȼ. ȿ. Ȼɟɞɧɵɣ ɨɬɜɟɬ ɜ ɩɪɨɝɪɚɦɦɟ ɷɤɫɬɪɚɤɨɪɩɨɪɚɥɶɧɨɝɨ ɨɩɥɨɞɨɬɜɨɪɟɧɢɹ // Ɇɚɬɟɪɢɚɥɵ VIII Ɋɨɫɫɢɣɫɤɨɝɨ ɮɨɪɭɦɚ «Ɇɚɬɶ ɢ ɞɢɬɹ». – Ɇ., 2006. – ɋ. 438. 4. Ɇɢɥɸɬɢɧɚ Ɇ. Ⱥ., Ʉɚɥɢɧɢɧɚ ȿ. Ⱥ., Ʉɭɡɶɦɢɱɟɜ Ʌ. ɇ. Ɉɰɟɧɤɚ ɨɜɚɪɢɚɥɶɧɨɝɨ ɪɟɡɟɪɜɚ ɭ ɩɚɰɢɟɧɬɨɤ ɫɨ ɫɧɢɠɟɧɧɨɣ ɪɟɚɤɰɢɟɣ ɹɢɱɧɢɤɨɜ ɧɚ ɫɬɢɦɭɥɹɬɨɪɵ ɨɜɭɥɹɰɢɢ ɜ ɩɪɨɝɪɚɦɦɟ ɗɄɈ ɢ ɉɗ // Ɇɚɬɟɪɢɚɥɵ VIII Ɋɨɫɫɢɣɫɤɨɝɨ ɮɨɪɭɦɚ «Ɇɚɬɶ ɢ ɞɢɬɹ». – Ɇ., 2006. – ɋ. 456. 5. ɉɨɥɢɦɨɪɮɢɡɦ ɝɟɧɨɜ HLA II ɤɥɚɫɫɚ ɜ ɫɟɦɶɹɯ ɫ ɧɨɪɦɚɥɶɧɨɣ ɢ ɧɚɪɭɲɟɧɧɨɣ ɪɟɩɪɨɞɭɤɰɢɟɣ / ɂ. ɇ. Ɏɟɬɢɫɨɜɚ [ɢ ɞɪ.] // Ɇɚɬɟɪɢɚɥɵ VIII ɤɨɧɝɪɟɫɫɚ «Ɇɚɬɶ ɢ ɞɢɬɹ». – Ɇ., 2006. – ɋ. 547–548. 6. Ɋɨɥɶ ɚɧɬɢɝɟɧɨɜ II ɤɥɚɫɫɚ ɝɥɚɜɧɨɝɨ ɤɨɦɩɥɟɤɫɚ ɝɢɫɬɨɫɨɜɦɟɫɬɢɦɨɫɬɢ ɜ ɩɪɢɜɵɱɧɨɦ ɧɟɜɵɧɚɲɢɜɚɧɢɢ ɛɟɪɟ- ɦɟɧɧɨɫɬɢ / Ɍ. ɋ. Ȼɟɫɤɨɪɨɜɚɣɧɚɹ [ɢ ɞɪ.] // ɉɪɨɛɥ. ɪɟɩɪɨɞɭɤɰɢɢ. – 2006. – ʋ 2. – ɋ. 46–54. 7. Ɏɟɬɢɫɨɜɚ ɂ. ɇ. ɇɚɫɥɟɞɫɬɜɟɧɧɵɟ ɮɚɤɬɨɪɵ ɩɪɢ ɪɚɡɥɢɱɧɵɯ ɮɨɪɦɚɯ ɧɚɪɭɲɟɧɢɹ ɪɟɩɪɨɞɭɤɬɢɜɧɨɣ ɮɭɧɤɰɢɢ ɫɭɩɪɭɠɟɫɤɨɣ ɩɚɪɵ : ɚɜɬɨɪɟɮ. ɞɢɫ. … ɞ-ɪɚ ɦɟɞ. ɧɚɭɤ. – Ɇ., 2007. – 40 c. 8. Ɏɟɬɢɫɨɜɚ ɂ. ɇ., Ⱦɨɛɪɵɧɢɧɚ Ɇ. Ʌ., Ⱦɸɠɟɜ ɀ. Ⱥ. ɉɨɥɢɦɨɪɮɢɡɦ ɝɟɧɨɜ HLA II ɤɥɚɫɫɚ ɜ ɫɟɦɶɹɯ ɫ ɩɪɢɜɵɱɧɨɣ ɩɨɬɟɪɟɣ ɛɟɪɟɦɟɧɧɨɫɬɢ // Ɇɟɞɢɰɢɧɫɤɚɹ ɢɦɦɭɧɨɥɨɝɢɹ. – 2006. – Ɍ. 8, ʋ 2–3. – ɋ. 323–324. 9. ɗɤɫɬɪɚɤɨɪɩɨɪɚɥɶɧɨɟ ɨɩɥɨɞɨɬɜɨɪɟɧɢɟ ɢ ɟɝɨ ɧɨɜɵɟ ɧɚɩɪɚɜɥɟɧɢɹ ɜ ɥɟɱɟɧɢɢ ɠɟɧɫɤɨɝɨ ɛɟɫɩɥɨɞɢɹ (ɬɟɨɪɟɬɢɱɟɫɤɢɟ ɢ ɩɪɚɤɬɢɱɟɫɤɢɟ ɩɨɞɯɨɞɵ) : ɪɭɤ-ɜɨ ɞɥɹ ɜɪɚɱɟɣ / ɩɨɞ ɪɟɞ. ȼ. ɂ. Ʉɭɥɚɤɨɜɚ, Ȼ. ȼ. Ʌɟɨɧɨɜɚ. – Ɇ., 2001. – 782 ɫ. 10. Anti-Mullerian Hormone (AMH) levels in serum and follicular Àuid as predictors of ovarian response in stimulated (IVF and ICSI) cycles / A. Tolikas [et al.] // Hum. Fertil. (Camb). – 2011. – Vol. 14 (4). – P. 246–253. 11. Bao X., Wang W. 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