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0% found this document useful (0 votes)
125 views24 pagesDocument
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Петър КазаковCopyright
© © All Rights Reserved
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OM3HOJIOlMA
HA YOBEKA
—_——
Tog pexaxuuata
Ha npod. JI. BATAHOBA u npod. P. PbPYEB
2008
IIbPBO H3JJAHHE 274/ Pusuonceva
®U3HONOPWA HA BhBPEDHMTE 13;
Mynkunn Ha GE6pennre
Exexperopna dyicuns, Ype3 oSpasyuauara 8 Svdpeun-
Te ypnita ce orsesaT Kpalin npoayxTH or odsanara Ha ae
wecTeara 8 opraniawa, Henorpeduit wan Bpeail eeuLecrBa,
aKTO M IBAHWIHATA GOA 4 muMHEpAT ConM. EKexperopua
dbynkuna uMat 4 Gente apo6ore, yepnust apo6 4 KOkara.
BuGpeuitre ca miasimtre exesperopim opratin 8 woveuncax
oprantsym. pes tax ce oraeamr of opranuana Kpalttis mpo-
AYRTHL OF pesrpartaneTo Ha GenrounTe (ypes, aMoHAk), OF
pasrpaxaavero Ha HykieNHOBTTE KHCeMMM (aHKONHa KICE
sia), OF NeMOPAOGHHA (HAMMEHTH, KOLTO HpILawar WoeTe Ha.
ypuxara), or MyexysHna KpeaTin (xpeaTisHni). C ypiuara ce
ekeKpeTMpaT slekaperua H ApyrH Ky:sAH 3a opraHWaMa Bemte~
erga (kcenoGnoTHun).
Komeocraritna ipyakiner BrGpeunre nourepaar 6o-
Ono-coreaus Garanc Ha opranitama, Te exckpeTupar pasansHiit
KoaHYectua vona H HITpHeMH, KagKCeDH, KaNUUIeDH, MartteSe~
en, hocanin, Meant, uMHKOBH Hap. HoHH 6 3aBCHMOCT OT
‘Texntta MpHen 1 OF HY KMNITE Ha OPraHNIMA 8 AATEHHIR MOMEHT
Bedpewre uMar BMKHO yuacTHe B MOATEPAAHETO Ha atKeLI
o-kuiceniuuome pasnogecue Ha opraniasta pes perysupare
cexpeuiita Ha H' 6 GuGpetnire ryGyan 4 exeKpeusira a
HCO, c ypunara. Buépeuare ocbmectaawar Owscompaiina~
ma peryraywr nd apmepuaniomo narscane, MOLISpxaiIKH
navpnesiia 4 Boas Ganane, ac Towa H oGesta Ha TenecuTe
Tewiocts.
Ennoxpnnna chymeuns, Bsdpeusre oGpasysar roman
Gpoi Guonorwuno axtum wewiecrea: pen, epumpono-
enn, npocmaznandwn, Kui, endomeaune,
asomen oKcud, axmucua dopa va cumanun D,
(1,25-duxudpoxcuxareranyupepon). — OBpaayna-
hero Ha BavoAKTHBHH cyOcranuH, HowMaBAL
CaaOROTO CoNpoTHBsIeNte OnpeneaR yuacrieTo
ha GaGpeanre 9 perynanwimra Ha aprepuaanoto
naasrane. BuSpeunre ca ochonnoro sacto 3a 05-
pasybane Ha epusponoerHn sf satoMA UAT naaKHO
yeacrue 8 peryaatnsra 1a oGpaaywanero Ha epurt~
por. Upes oGpasynaneto tia axransara dopsta
a orrasnun D, 4 perysmpane exexpewsra ita C
W HPO. c ypanara yuacruar b noaeparaneno Ha
xameao-*hoctpoptiara Guana g oprauuanta.
Meradoamrrna dymeunst, B GuGpeannve ty-
Gyms enuTemHH KAETKH Ce HRELpULBA eMonoHe-
ovenexa ~ OSpasyuane Wa rmoKo3a OF HeBLIsIeXtt=
AparaH FoTOUNILUM (aMMHOKICeMIHH, rautuepoa)
Tnroxoneorenexara 8 GuGpeumrre stove aa nocraest
Menyna
(evtpowna) |
panutre & raomepyaisre HHCKOMOAEKYAHN GuctozuNHo axnus-
Mu nenmudu ~ rapatxopmon, anruorersan I, AJIX, AKTX,
nucysium, Tipu yepeamave na CaGpeca Hanausiea paarpacaa.
Neto na Tea BeuLeCTHa, Te ce pesopGupar 4 aonanar OTHOR0
‘8 pba, Tpit xponmnatia SuOpeuita HEMOCTAPRAHOCT MOK 3a
ce noxeu ocreonoposa, KAKTO H XHTePTOHE, MopaaH yeens-
Mapaiie Ha NazMenara KOHUerTpaUK Ha Maparxopsowa Hs Ha
anruorensi 1,
PynkuHonalHa anaTOMAA
na ObOpenntTe
Heibpownr © ochonsara ctpyetypaa m yHrumonanna
emma 11a GLpexa. Bos scexn GvGpex ce aaxmpar mpi
Gawsuteano | sueuIOH Nedipoua. Hedpounr e Harpaaed or
GrOpewo meaye (Mazmurneso Teale) M mydyana cucmena,
‘Oxono nei poria ¢ parmono‘xena cuctena OT KaMTIAEpH a3Ha-
Neva karo nepumyOyrma Ramevipna sipenca, BuOpesuoro tea
ue ce cLcTOH OF Karinapa OpuMKi (caoMepy.t), OGxpateTH
or xancyaara na Baywan. Mexay xeara aucra na xancyaara
ce ocbopss TicHO MpoctparleTBO, Of KoeTO saNO4BA TyGy.IHaR
a cuctema. Ha nowppxnoctra ua GLpeka ce Haxupar camo
SuGpewwn TyOyau. BeOpewarre rem ca pasroroxKeHH no we
ava wpa Wa xopresca. B 2ap(CHMOCT oT pastloao>kertteTo
va GnOpeuoro Teale H oT abmKHEIATA Ha SpMKara sta Xe
ae, Hediponitre ce pasaeaRT Ha aBa BHAA: KopmuKcLINY 1 JOR
poxerwanen
pan 15
Feo ra
“enna
|
— |
Ha opraniama ao 20% of oOpazyeaniara 4pes Tos , T see.
Hponee MmioKox. OSpasysanara or GuGpeurrre _Dereemmaane i,
ruoxosa € oF acoGeno sHayeime npit mazynatie. Xow 7 po
B GuGpeanre ce currresupar mpuuyseremyepane teapeee ke \
uw ocatunndu, KOUTO CuO roMaaaT 8 cHeTeM-
uoto kpreooSpauenne. B S.Gpeunnre tyGymt nor | !
Reficrane 1a XHIpOAITTHIN ERBIMM, OCOGeHO B
Seinen Py BIT eB dunrpue et 1.1 Koperiacren (1) soncraeay apes (2) negpon Be po
—
emaveayrapne, Kopruiagiurre respons sntar weet Xenirems
Gpyokit, AOCTHTAMUT AO FpaNMUATA MexAY BUMMNATA 1 BL
spear Meayna, a GkOpeuiwrTe ust Tena ca pasnonoxKerH
ep BEMUINTE ae TperK Ha GxGpewiara Kopa, KOxcramenty
fiapuirre He*pPOHH HMAT KATH GpHMH Ha Xeuae aocrHraut
‘go nariuera, 9 GoGpeuHsTTE Hat TeruA ca pasriostoaKeHit R Halk
surpemmara "act Ha Kopara, HeTiocpencTaetio 10 Menyaara Ha
Guspexa (Dur: 13.1),
BrGpexno Teaue. Budpeuioro renue € warpareno oF Kant
napa Spiesnent (mmoMepy) oSXeanATH OF teaTa TCTA Ha Kan
ayaara va Bayan, Kppota nana 8 GuGpesoro Teaue wpe
adepenrnara apreprora (vas afferens) usta oT wero ped
egeperrwara aprepuona (vas efferens). Macroto wa Maza
Jane ¥ HaNYeKAHe Ha KPLBTA HU MpocrparcrnoTo, sarpanero
ot rancynara Ha Baywai, ce osHatiaea Karo ebL0B NOMOC 1a
SuGpeunoro Feaue. PaskoncHHaTa Ha vas afferens oSpasynar
mowepyna. Mekay moepyniimre kanunspn ca paanosorkerm
MesaETHALTIH KIETAH 1 MeZaNrHaten MarpuKe. TpocrparierBo-
‘ro Mekay azara AMcTa Ha Kancynara Ha Bayman e wankaveno ©
‘reunoer, nlonysexa npn qiumrpupare Ha nazsara KAMLISpE
re. B nocoka nporuponono7kna Ha CbYOBIIA NoMOC ce HAMA
ov90p BbU PUTPELIHKS JICT Ha Kancynara Ha Baysais, Kolfto ©
up ppeska c poxcamantna TyOya (Dur. 13.2).
BuGpesan tyGyan, Tydiama cucmena na nehpowa e
iMrpaueHa OT: NpoKcHMaIEH TyGys ¢ NareHaTA H Npawa Hac,
Toika WHAXOAAIMA, TRHKA oRaXogAMA N aeGeRa mEsXUANEIA
wact Ha Gpunkara na Xenne, sncranen wsputr TyGya, conps-
pant TyGyaI M KOPTIKWIEH, DBUUIeH Meaynaper!, seypeMen
Meaynapen cuGupareneH TySya. BowsKu Heppoum a0 nava~
oro Ha cBOupatemuure Ty6yars ca HaNBMHO oTHEAETTH exIDL
of apyr. CuOuparenmre tyGyan ca obit 2a 10 ~12 nemhpo-
va, Burpeninirre Mexysiapiit exGupareain TySymi como ce
‘oSeannavar a opuupar namuapHnte cOupareann tyOyat,
KOHTO ce oTRApRT B SLOpentioro nerenue. CuOnpareannTe Ty
Gyan He MpHHARTERKAT aHaTORGIHO KEKE Hedpporta, HO dysk-
UNOHANHO Ca NKTONHTEMMG BARKHA YaCT, THii-KATO B THX Ce
sonoaua Ha Ge6peyume / 275
Menprina oxoaTeMTIOTO (lopsuparte Ha OGema Ht cRCTARa Ha
ypinara, Teiocrra my ena na TyGyaa ce amisKH BuHarH oF
Xoprexca (TaM © pasnonoaeHo GLopesnoro renue), HaacAy
KM Meaynara Mo HINNOWMOTO pao Ha GpHMKara na Xeune,
BPDILA Ce KN KOPTEKCa NO UBIXOAALUOTO paMO Ha GpHNeKaTa
wa Xenae H oTNOBO ce chycka ZO MeAyNaTa no cKOupaten
nurre TyOyam1, Karo cnet Tosa onasa n Gudpenoro sercH4e,
‘Tam ypinara sie nperepnana noneye npoeni( 2 enon oem
cucran. Mocsesorareniure cermenris 4a SLOpenuirre Ty Oya
Hoar panaisna ctpyerypsa is byHkuMonanHa XapartepnerH
ka, Ti ce onpexena or ocoGenocr irre wa TyGynmirre enuTestin
RaeTRH 11 Ha MeAAYKACTBUMNNTE OpbaKH,
TySptmume enumenne kremKu ca parnoaowKenn eopxy
Sa2a.na MeMGpania 1 ca cpEpsaHH NOMERATY cH e Mey Ke
TRAN eptaKH, Enters 8 npoxcunauma TyGya, ocoGeHO 8
HAWAAKATA MY WaAcT, © HATpAAeH OF RUCOKH KACTKHE ¢ TOMA
Spout nnacimkn na ayMenammara erpava H Harnpanns wa Ga-
2AaHTa CTpanA, KOHTO MHOFOKpATHO YwesUSNaBAT KAETLMMATA
nowppxuocr. Yeranosapar ce M MHOACCTRO MHTOXOHApHH,
oonrypanam oxcrATMRNHTe MpouecH R KMeTKATA CrBpIA
Itc MUTeHIHBHHA akTHBEH TpaHcnopr, KoitTo ce HauEpuiea
B Tou cerment Ha Hedpona, Emurrenor e THKHTE 4acrH Ha
Spunixara na Xerine € WIFpAICH OF HUCKH KIETKH © MalTK
Spoit survoxonapmn BracHiKy, B Test MacT Ha Hedpona aK
Tumen Tpaicnopr He ce ycraogsna. B aeGenara maxoaama
wact na Opamkara na Neve KxeresTe HanonoGaBAt no CTpYK-
‘Typa Tear n npoKenscasnsrre TySyan, 110 Spor Ha Bnacscire
€ no-Maumox, Tlox0Gen © crpoexsbT HM Ha emnsvemmurTe KHETKM
B ANCTANHUA HarbHaT TyGyA, CeLp2santna TyGyN H KOpTHKAste
nua chOupatencn Tyéya. B meayrapinte chGuparennn ‘Ty-
Sy.u npeoGnanavar syGoniaHH eristemM KaeTKH, GeaHn Ha
Kaerbunit opranemn, Boaka vac Ha Hed)pona € Karpagena oT
‘eAiyt THN KneTKH paameaBaM Ce OF TEM A CECEANER Coren,
B kpas ta auctasmiire maestris TySyaH 1 B CbOHpaTentre Ty
Gymi ce yeranonsnar ava Tia KAETKI, OcHOSNU (Ham 90% oT
ods Spoil) n wenepRarapin KaemeU, PagderTuM ce HATH
Avw tan B, (Birk Tpaxenopran
npouect B Herppoa). Enirre-
Baymanosa rancyna
e
Thomenynew
ympadbaumpar
wt B xpaitmirre "act Ha Meqy-
napunre eoGuparenus tyGyne ©
passien or Tosi Ha OcrantaaiiTe
NacrH Ha Hedpowa,
Meocoyenemmuiume — apnt=
ku Mexay Ty6ymaere erueremHi
KACTKH C@ PaSOLOKEHH OTDM
ayMenanHera crpana wa Kier
varre. B rrpoxcumannsrre Ty6yat
Tea BpLaKH MponyeKat cHOGOR-
no Boga N pasTROpENM w 1ieH Be
mecrea, Fopaa Tora, enurener
Ha mpoxcismamiiere TyGya © CRO
Gonwo mponycKane noxodHo Ha
‘TOSH B THKHTE Hepha, XOPHONA-
Nila KIAeKEYe 11 ATHENA MeXyP.
Tipu npomvewnsut enumea we
Morar ma ce CRSiABAT KOHLEH
TpaNuONH rpALHeETH Ht FosTes
ceMorHMBn pazauxn, Meacayssie-
“ruanurre apRKHt Mencay TyGyamnt
‘te enutenun Kaersn & seGeraTa
musxomama sacr Ha Spratcara wa
Acbepentua
aptepvona
wacTHult
Eqpepenmia
aprepuona 278 /Pusuonoaus
Exporen
Sasania
tensa Kanwnapen nysaen
ur, 13.5. Duarpayiona wemGpaxa
kpario nto-wankit or Tesi Ha Nope. Toil Karo NOUTH BCH MEH
aasmenn anGymniit npn Hopsanioro pH Ha nnasmara ca 3a-
peaeHH orpiuarenio, nponyckauaocrra ia ¢buTpaunonHara
MemOpana 3a TAX, KOpMalHo, € MBKMOMIENHO HUcKA. Tpit
NaxOM flaTOMOPHIIHH MpoUeeH Ce yapeKNA He CAMO eTpYKTY-
para na Qunrpaunontara MemGpana, Ho H HaManaRaT oTpite
uaTenHTe 3apaait Ha MemOpanata, MopaaH KOeTO ce TIoRBABA
Genres 8 ypnuara,
Waxtopy, onpercasmn raomepyauara cbuxrpanns.
Thomepymnara dunpauns, xakro w dsurrpauusra » apyrnte
xAnWASpM Ha OpraHiGMa sasitcH or oSwara dumrpauionta
Raoul, uponycknsBocrra Ha (pMaTpanHoHMara MeNGpana 1
or ecpextunoTo atrpaunonHo Hasaraie (EOH). Eponycr-
ansoctra Ha diumpaunonuara MemGpana H oGuara duertpa-
UNONHA TOME onpenerar TA, urmpayuonen Koeuyuenm
(K,). Toft © muoroxpansto no-roaam oT Tos » cHeTeMHOTo
xpbeooSpauetine. Yae4asa ce non nelicTsMeto Ha Bascal
Aavaropit K NaMaAsBa HOR AeTICTBHETO Ha BAIOKONCTPHKTOPH.
Ecexripnoto dunrpaunonno wansraxe (EDH) ce onperens
ov xWupoctar#MHoTO HanaTaHe B rtoMepynnATe KanunapH
(XH,,), xiipoctarnauoro Hamirane & Kaneynara na Baynait
(XH,,) 4 ORKOTHMHOTO HaslATaHe B roMepynHHTe KATMAApH
(x,,), (Our. 13.6).
EOH
XH, - (XH, +7,
ce onpenesit ronemitsara na eomepymiara dpiur7pa~
usta, EH rpaGaa ce ce ymuoxi rio K,.
Xsmpoctarnworo Haiarane m TmOMepyaHWTe KarMaspIE
3aBHCH oF mephbysHoHHOTO Hanarane a GuOpeuMTe MoT Cte
nenra Ha cpneane Ha adepenriara n edepentiare aprepnom
Yoesmmava ce py nosHuasaxe Ha nephyaHoHHOTO Hanarae
wine chneane Ha edbepentHara aprepHona 1 HaManaza pit
hasanenise Ha MepbysMoMNOTO HanAraNe WimH coMBAKe a
adepestara aprepiiona. Xuapocrarmunoro nanarave 8 Kan-
cynava Ha Baya Hopmanvo ¢ a0cTa HOCTOAHMO H 3aBHCH OT
uurpeduGpenrioro nansrane. OHKOTIEHOTO HanaraHe 8 r10-
Mepyonaitre KAUNMULIDH (itp,) Ce OMpeMesA OF KOHUCHTpaLETTA
na miasMentire Geren, Npomenn 8 onxoTKMOrO HaATaHne
ACTABAT NH NPOMEKH B KONNEHTpAUNNATA Ha MaaaMeHITe
Gerrbun (sarySa npu MacueHn warapanna, mapyuenna B Gen
‘Teuntata OGMunA), KAKTO H Mp BOAHO OGpeMeHABaHe Ma ne-
MHApaTauiea Ha OpraHia
nr. 13.6, Daxropy, onpexeasue tmomepyawara dumpayan
‘Yenownara 2a uumrpauna ce npomeHst 1 Xosa Ht KONE:
Pymnox xanunip, B dayasioto Ha xartiiapa E®H e oKo.10 10 mm
Hg. EOH = 45 mm Hg - (10 mm Hg +25 mm Hg) = 10 mm
Hg. Boa 4 chanpxauut ce w Hea HicKomonexyanH BeuecTea
ce durmpupar Karo Konestrpanisera Ha cunaaneauTe Genre
ocrenetHo ce yneniapa x crojwocrra Ha %,,, Hapactea. B on
Peneavett MyHKT Ha Karuinapa mpeau Heroniss Kpall, (DH crasa
Paso Ha ya # rtrpaurra cruupa, Tosi myHST Moxe Aa ce
HOMeCTBA KEM NANAcTOTO MAKE KEM KPaa Ha Tmomepy.tHGe KaMTICLAD
HT chorwervio Hasranana wt ce yrenivara. [pi Hanatenue
a GuOpewnms nagsmen NOTOK TOI MyHKT ce HaMeCTRA KRM 1a
wanovo na Kantaapa, dupaunonnara rutouy HaManaza uD &
o-Manka, JOKaTO MpHt yRemMeHKLe Ha GEOpeuTs TLIZaMCH NO
TOK TOI MyHKT ce HMeCTHA KM Kas tia KAMHAApA, duarpAUe
onnara niout ce yaeanvasa 1 P Hapacroa,
Astoperyaauna ua TO, Phowepymsara duurrpauna e
noamloxelia Ha aBToperysiaMNa H ce NOANpAKA HOKMONHTTEAHO
nocrosuia, Aptoperysiaustrta Ha GuOpeuHHA KPEAOTOK H HA
T® war roaamo sHsteHMe 3a OcbulecTHaBaHe Ha XoMeOCTa-
Twemteta GyHKUMA Ha GeOpeumTe, ramoto exexpenuaTa Ha
Bona Ht COM He JABHCH OT BpeMeNHItTe MpoMeRH B aprepHaN-
noro wanarane (ur. 13.7). Mexanuawure ka anroperynauiat
Ha SuOpesiis KppROTOK 1 Ha TD ca Guns. Te sxmoIBaT: 1.
Muozenen wexanuawu. B ocnonara Ha MHOTeHiHA MexaHiEsbM
cron cpoticrsoro Ha raamkiTe MyckyH Ha ceAoRara cTeHA
Aa MowIpxKar nocTosMHO Hanpexenne, pH ysemmasane
ka neppy3HonHoTo Kanarane KpSOHOCHHAT Chil ce cBlBa, &
pit Hamanewne 1a nepdysHONHOTO HanaraHe ce paxumpaBa
2. Zy6yno-cnamepysina o6pamua epbska, TyGyno-romepynsia-
‘ra perymauma c OGparia BpEsKa ce peammsupa ¢ yuacrHeTo.
ne FOTA . TIpa yneniiasane wa T nan Hamanenne wa pea6-
copSumirra a npoxcusannnte otieait ta wedpora, TySysnmat
uouen # comesit Tosap koe macula densa ce ynemana. Yae-
Awsenata KonusHtpauna Ha Na’ a Cl s tyGyanara Tewnoct
ce manpHema or knerkitre Ha macula densa. Tosa ¢ curnan
3a cTHMyapave Ha cexpeuitira Ha pent. OSpasynanurT ar
FHOTeHSHE IT NpHEMKaEa conUaHe MpexiMHo Ha abepewtiara
aprepuona nF nawaniea nopamit nowoKerne Ha xMapocta-
THMMOTO Hanarale 8 OMEpYNEUETE KATHLLEpH.
Barkva pons & aproperyzaunata Ha GeGpeumin KPEBOTOK
HT urpaat persin-anrnorersitoeara ccTema 1 Gudpennii-
Te npocrarnanantn, Tp aousoKenne Ha GLOpenuoto
SMONNO Hamarane ce CTHMyAHpa CeKpeunaTa Ha peu. C Pusuonoa Ha Gvdpeuume / 279
* apraperynatopin
rpamue
fi ByGperes KpppoToK
/
So
b
40 12 © 160200
Cpentio aptepranto hanarane (mmrg)
240
bur, 13.7, Asroperyacures Ha GoGpeuni xpEAOTOK ML Ha LIOMEpYs
ya Gumrpauex
pasynarnaT anrdorensin Tl, mpH HeBHCOKH KoMeHTpaUMH,
Ma 1o-Cistes BAIOKOHCTPUKTODEH edest BEDXY eibeperTaara
aprepHona's cpabHenue c adeperruara, samyoro rerHoctra
a alirnoTenauHontiTe peuerropH € rlo-Fonama B epepentiaTa
aprepuona, Taka xapocrarmnoro Hasarane B momepysilH-
‘Te xannaiapn ce sanaapa «TD crasa nocrosnna, [py eMcoKH,
sonenTpaui# Ha aNrHoTeNawe UT Hacrortea nasoKOHCTPHRUOET
kaxro Ha e*beperrriara Taxa HHA acepeHTHtata aprepHona 1
To u GuGpeunurr xpuuorok Hawansnet, Tpocrarsauamunre
Nar saIQaMuMraropHo AciicrEHe “pes TpsKo NoamMaBaHE Ha
mankata MycKyaatypa tia CsnoReTe, kAKTO H pes awraroniH
aupanie ie CLHOCEHBAMIHA edbext HpHUsHER OT CHMMATHKORA
ctimynauia. Taka npoctarananaure samanapat Geopewnt
colon Toye M yRemMaRaT GaSpemmUa KpbHoToS, ocoGeHO
2 GuGpeamara wenyna, Te ca or ocoteno sHaYeHHe MPH KPD-
sosaryGa aK oGwa anecresis, xoraro Caromapenue Ha THX
ce Cxpansza GkGpeuHitE KpEBOTOK. MIpit resH caywan MOKE
Aa ce HaGmoaara oeTpa GxOpewa HeMocTATB4HOCT NOpanst
hexesma na OoOpeKe mpHmnesia OT MpOIbiNAUTeNeH crkArEM
ka GuOpewniire KPBYCHOCHH CAOEE, AKO MPeBapHTEAHO €
TMpHaexeHo AedeHKe © MpoTHmORSaTAmiTeMHN cpercTRA, KO-
HTo NoTHEKAT MpocrarnarzuOBaTA cHITEDA,
Ty$ysxuH Tpancnopran mpouecn
To xoaa na Heppona peaScopSunara u cexpeumtTa ce
wewopurmer npes erpeTenmrre KMeTAH ~ Mpareyemyuapen mom
iutit npes MekaykaersetinTe npoctpanerea — napaye:
nom. Tp Tpavicuenysapinn tpadcropr wewectara pent
HapaT NocuegowaTenHo Mpes due KIETEYHM MeMGpamur — ny-
Metaunra (anincania) 1 Ganomatepasea.
Tyéyanara peadcopSusss 4 cexpermia ce ssypusmaT upes
opr
n inpaiicnapm ce ocuinecTamta cpemty KortieH-
Lapen
antissen H nacKBeH TpAHE
Arm
rus
wUHOHeH TALENT, ¢ paINON Ha EHEPrHA 1 € NpeHoCITEN.
Halt-secto © ceppsan c Na‘/K” anenosuntTpipocdaraza Ha
Gazonarepastara memGpasia sia TyGymmnTe emmrresnsn KoreTREL
Tasit Horna nox cusnaca acumerpH4Ho pasnpeaeaente na
Harpaesnre H SantHeBuTe JlOKH ekCTpas st aHtrpaueNyRapHO
© ToRa MOAREpAA TeXHIETe KOHIIeHTpALHOHHH rpaZeHTst. Hs
exara KoNUeATpalna Ha narpHeniTe How 9 tyGysmHTe KAeT-
Kit Chyslaza BhIMOAHOCT 34 HADAKIANE Ha KaTpHEBH HoH oT
Tydyanara TewHoer x envremiara Knerka. BaeqHa © nocner-
mre p Kulerkara HaBsiaNT H apye GeuLecrBa Upes vmopwno
axrnaen mpanenopm (ore T3awe 2)
Tlacuenusm mpancnopm ce mexpina pes npocta andy-
auA H ynecHena ampyana. Dndysiwra ce ocouecrsasa mpi
HATHHKE Ha OEMOTHUEH, KOHURMTpARHOKEN MoM ExeKTpOXH-
MiMeH rpamycHT of aReTe CTpAHH Ha MeGpaxara Ha TyGyaHE-
Te emuranit xnersH, Boaare ce Tpaxcnoptxpa machen no
oemornuen cpaguent, Tpit andysia Ha Bog moaeKyNA F
BopHM 3a ocMosa, TTo XOMUCHTpauMOHeH rpanucHT, nacHBHO
ce Tpaticoprupa ypesra, zoKaro cexpeunata ria K* aneran-
unre oTmeay Ha He*>powa ce HaBEpulBA NO eeNTPOXHMMYEHL
rpamuert, Yaecienara aupyzie ce BeeEpurwa ¢ memOpan~
HM opeocrem, KONTO Morar aa mIpersacaT eAHO ReIIteCTBO
(ymnnopr), sme nim Monee BemecTBa 8 emia TIocOKa (CHM
opt) WIM NpeHacaHe a MporMBocONOta NOCOKA upes pas~
mania (ascimopt).
Tioweve or 75% or dbiazpupauoro xommuecrse Na’ ce pe-
aScopGnpa Tpancuenysapno pes aKTuBeH TpANCHOpr ¢ par-
xog Ha enepris, Harpyesara peaScopSinia ceataRa ocMoTH
Hm H exeKrpHA rpaanerTH, KONTO ca OF 3naTeEHe 3a pead-
copSuiwrra ka noua # Ha pasTeopenn BeuiecTEa, HasmsaxeTo
na Na" y ryOyasnrre «aera craRa no KOMLCHTpanBoNeH rpa-
AeHT NOpadM HICKATA MY BMTPeKTETHINA KONTEHTpAN,
cBaManeHA OF MBAHSAHETO Ha BATH! OF KAeTKATa 4pEs MEp-
bio aKTHBEA TpaHcHIOpt Ha GazonsrepamHaTa MemOpana,
3aeqHo © AaTpHA Mpe2 AyMeHAmMATA weMGpassa MpeMsmanaT
rmoxova, aMiHoxHcerHun, cymbara, ocdare, Ch, Hw mp,
¢ yaacruero Wa pagnHuHis KOTpaHCHOpTHH 1 axtanoprans Me=
anim, Peadcopoxuara na Hatpail m xa cospsarrre c Hero
pasTROPeHH RettecTRA Ch3mABA OCMOTHYEH rpatent, KOHTO e
ABIOKeUIA cHta 2a peadcopGwusra Ha wom,
Boaara mpemusaea npea TyOyneure enuremam xnerKH
Ape? cneanimem acm Kastan, Naperelsm axpanopwen H
pea cessinenamta Mexmy xqerminre, Clem Karo Bouara
PAITROPLHHITe BeMlecT#a MpexuMaT Mpes Gasonarepantara
MemOpana Te nonaaar w GsGpeuia wiTrepeTmieHy Ms, OTKBAC-
‘ro ce peaScopOupar 8 nepiryGymHHTe KannnapH "pes ocMOsL
Wi Ternenie Ha pasteoputers (BGK no-aony), PeaScopGunara
1b neprryGynunTe KanustmpH ce Gnaronpuarcrsa oF HHCKOTO
XHAPOCTATINING HaNsrane 1 BHCOKCTO KONOUNO-CEMOTIEEHO
nanacane B nepiTyGyaHHTe KarAAIDH OF BUCOKCTO Kanara
He Ha NBTepeTHWLaaTa TeMIOCT, MoponeHo oT NpentsniaBa-
Hero Ha TeNHOCT oT TySymMHA TYNEHL
Bunpexn, ve oxo 180 znrrpa mepanuna ypu ce odpa
sysat 3 24 vaca, Sebpeute Hopmanno oraensr 1.5 swrtpe
xpaiina ypima, Orono 99% or romepysiniin dprurmpar.ce peaG-
copOnpa 1 Nonana OTHOBO B CbavBATA CHETEMA, AOKATO CANO
oxono 1% ce oraena © spaitara ypu,
Thancnopmite npoxect ¢ npoxcumaanume mydsin
Tipokcimannure TyOyaK aan BHCOK KoTIaMTITeT 32 aKTHB
naw nacuena peadcopéuys, OSwuaiind, BMpOKCHMANHETe TY. 280/ Pusuonozun
By.1n ce peaScopSupar 70% or oGema na rromepyrunn Gur
tpar, B npoxcnmannirre ty6yax nponmuaemocrra Ha Mexty-
KIETRMUITE BPbIKH € MHOTO rOsLNMA H daTOMA HE ce CLamBUAT
palin CeMOTHMAM patauxn Mexkay TyGyaHaTa TewHOCT H
nitTeperHuMastoTS Mpoetpaucruo, PeaScopoupar ce enim
neHTHH KOAMHECTBA BORA 1 pasraopeHH B Hes BeUleCTBA, Baro-
ba peadcoSuiara # npoKcuslannite TyOyAIN € us0OcMOMUNa
weTaka 8 Havaitora Ha Opimxara 1a Xevine tyOynnara TeMHOCT
© c OcMOTINING HaMAraHe paBHo Ha TOBA Ha nuaswaTa, [Tpit
HAAWSHETO 8 CHOMEpyAHHA (pMATpAT 1a OCMOTHMHO-aKTHBHH
peulectua, KONTO He MOFSr na ce peadcopOupar (HanpHMep
MaHirron nen neHo3Ho MpUROKeKHe) RoAHATA pea CopSWKA
HaMamasa H ce YoenMuaRA KONHMECTAOTO OreneNA ypHita —
ocuomusia duypesa
B npoxcumannirre tySyan ce peaScop6upar oKo.10 70% or
gurrppauusre Na’, K°, Cl, 50% or cbrrrpupanmre Ca", 20
% or duatpapanite Mg” H NopmanHo Hanno ce peadcop-
Supar duntpsipasiara raoKosza M aMHnoxiceauHN. Odembt Ha
qySyanara TenocT HamasBa sHaMHMO, BamtpeKs, 4 cmos
ATETBT Ha TeMHOCTTa 8 ApoKcHManHETe TyOys He ce Mpo-
Mel, SOHLCHTpaNNRTa Ha paamueHItre pasrvoperM BeuLecTEa
papupa cin. Konsuectsoro xa Na” e TyGynwata reuocr
choo Hamartaza, Ho KoHUeHTpaLHTA Ha Na” at K” He ce npo-
ens, KOHMeHTpaLUENTa Hal ype H KpearHHHH ce yRennHaLa, a
Tait Ha TMONOSA, amtaHoKUcEAMHK, HCO, cHuLKO HaMazBa,
PeaScop6una Ha itor 4 Bona. Oxono 75% or dbeutrpupa-
Horo KomMecTBO Na” ce peaBeopGupar tpancuemynaprto “per
aKMHUEH TPAHCHIOPY ¢ pASXO 11a FOAMO KOANECTRO eNepriMs,
PeadcopSuyinra na nosevero weiectea » poxcremamintTe TYGy
We TACHO JaAHCHIMA M cBRpAAHA c TaIH Ha Na”. Mopar roRa,
Gnoxnpavero ji wamanava oGuleTo KomutecTBO peadcopGupall”
raomepynen Qurpar. C HasasaHeTo Ha HaTpAN w eTHETETHKe
Te RIETKH HABTHIAY CulllO TAKA HH PMOKOIA, AMEMOKHee AIT,
ocbara, cyadarn, naar, wstrpar coupraun ¢ nerpHa © O8-
una npenocirren (custriopt) nan ce cexperupar H* (atrrunopt).
Tapatcesynapawar Tpaxcnops Ha Na’ ce nampuiwa npeamsno
8 AMCTanHara TonOBHAA Ha MpoKcuMantus tyéya. Teil Kato B.
vawaTHaTa 4aCT Ha NpoKcHMaTHHA TyGyN He ce HaBEpUIBA KO-
X Navin
AK enco,
Corpouisn wa eano
ear, 13;
Ootionew ypurscaopins nponcen w npoxcimruinye ryO).
‘ypancnopt na Na’ ¢ Ch, & xpatinara my vac Komuerrpauiia
na Che aucoxa 4 Te ce peaScopGupar npes nmtiuite apr
xu, Towa cradaea rpaauenr sa cacuuna peadcopume xa N
B Mexaykaerbinure Mpoctpancrea, rpaniemsr ¢ mTUTHH
Apiakit ce NowMIARG OCMOAAMHTETA MopaMit peaGeop6wia
ha Na’ w Ch pes mureruure epeski H nacuanoro mpemiiaoa
npes Gazonarepannata MemOpala Ha PuOKOSa aMMHOKHCeD
tn, hocdary, eyaarn, naxrar nH HCO,” nee sropara dasa
‘exitita Tpaltwerty:tapeis tpaxicnopr. Topaan peaScopGunsra
pavrmoperiitte peuwecrBa, TAXHATA KOHUEHTpALA 8 TyGyAHA
TCUMOCT HaMaaaga It ce CRBRABAT YNOBHA 3a peaGcopOUA
noma pea ocaova, TIpl mmcKermero Ha noslara upes ocmo
pea TUrSTHHTTe CLeMHTeHNA Ce YOANMAT CLAMO TAKA H HAKOH
pavTaopenirte peuecraa, Tost npoues ce osHasava karo meen
ne na pasmaopumeas. To Tost Hamm ce peadcopSupat ype
K', Cat, Mg (Our, 13.8).
PeaGcopGunst Ha ayumoKcennis a nemtHan, xnrp
pAWTe aMMHOKHeEAMN ce peacopSupar IsURNO B NpoKE
Matiitre TySyM 4pes BTOpKAHO aKTUBeH ‘tpatcnopr (cH
niopr ¢ Na’) npes symenamata memOpasa, B wes ce Hanup
HAKONKO PAIAMMHHE MpeHOCUTEAH, BCeKA OT KOHITO CBBPS!
rpynia of noxoHiit 0 CrpyKTYpa aMMHORSCENAHH, KONKYp.
pau ce HoMeayly CH 3a oopIBAHe c MpeHHocHTens.
Yact or diatpupauure nentuan ce pasrpaxkaar oT ne)
THMASH, PAINOAOKHN NO AySMeKAAKATA MEMOpaa Ha TyGy,
Mre emMTennHt KAETEH AO OMNFOENTHH H ANUHOKHEETHH
Tlocaeanmre ce peaScopGupar saex0 ¢ buarpHpanitre as
HOKMICEAIHI "pes BTOPHNHO AKTUBEN TpAKCNOpT chaMECTE
¢ Na’, J[unentuan ce peadcopOupar apes paantaua (axti
nopt) ¢ H’, xonro ce cexpetupar. Yaer ot dbsrtpmpanin
neni ce peaGcopSupar upes exaousTosa. Tonaoxenic
Wa engouHrora neaTnan ce Pasrparknat suKtoz0MarHo 8 T!
Gyaunre KAeTKH H NonyYeHHTe AMMHOKHCEAMHH Mpesniy:
par pea Gaonatepaanara memGpana, PeadcopSunsta
AMMHOKHCENHH H METH UMA TpaHcropter saKcuMy!
xoiito necso ce Hacnuya,
PeadcopSuna na cuoKora. Toxozara ce u.atpHpa cet
Goato 1 ce peaScopSupa Hamano 8 npoxcustaatrTe TyGyr
Hopmanuo, @ xpaiiiara ypra Hama riuoKosa m HelinHA KT
PBHC € pagen Ha uyaa. [Ipeusttasanero Ha rmoxosata mpt
aYMeHamHara MesGpana ce ocwilecTaxna pes BTOpKEO al
‘Tues Tpanenopr cbemectHo ¢ Na”, Tokosmar npenocure
© pasnonoxen 20 MemOpanara na sacHHaure Ha nyweratH
‘Ta nomepxnoct Ha tyGyaunTe KnevicH. TIpa MaKesatHo Hi
‘Tosapeane na RoH4KH Mpenocittenst 3a LoKoa, peaGcopAp:
Boro ii KomiMeCTRO € NOCTOREHA ReMEMIMHA, KORTO Ce HApHe
mpancropmen staxcusnat (T,,,). Koraro naasmenara KoHue!
‘rpanua e mo-rosayta or 16 mmol/l, raioKosauaT npeHocuTe
ce nucnma 1B Kpaiiiiara ypiitia ce nonBawa cioKo3a (270KO3)
pus), Hax rasn cruiinocr, hapetena 2uonozen npaz, eKcKpeT)
paHoTO KOMMMECTBO FmOKORA ce YREMUARA NponopimoHATA
ha dbuvepnpanoto KomitectBo (Dur, 13.9),
Proroannat npar, oGave, He © duxcupana KouueHtpe
UMA Ha muoKosaTa 8 naasmaTa. Tow sasucn or HugoTo A
T®. put nomexenue Ha Tb, caxro Tosa nomaxora ce ve
Garoaana np suapactuns HHaUOHaN, apart ce ysemaB
gaujOTO NopagH HaMancune Ha ditrrpnpawoto KoaMMeCTB
rmoxosa, a TyGyawTe ce peaScopSupa watoTo H Koanue
CINO, HeBABHCHMO He MIIMEHOTO HIZO HA FHOKOZATA
yaeanueno. Ocrert Towa xe scuuKn Hedponn Hat eaM
ico ¢piuirpripau # peaSeopSrisen Kanauiirer. Hedpowi oriocuTeavo no-ronaa urTpauns 4 HucKa peadcopOuna
na fNOKO32 8 TYOYAKTe, CKCKPeTHPAT FIOKOIA MPH NO-HHt=
cxa naaieta KOHUENTpallMs Ha rmoKOsaTa, B cpasHenne ¢
vegpomn, © no HUCKA huATpaUHA H BHCOKA peadcopOuHA
a naiowo2a. 3aTOBa rmMONOsMMAT Npar ¢ » rpaHMusrTe Ka 10-
16 mmol/l rmoKxoza KOHUERTpaNHA B TaaMara,
‘Tpancnopmen maxctys,
3a noseuero cyScranigm, KOUTO aKTHBHO ce peaScopSn=
par HAM CekPeTHpaT, CbUeCTEyBA OrpaHHTeHHe B KONHE-
crsoto TpaHcnoprupanu weutecrBa nopag NaanHeTO Ha
orpannyert Spofl mpenocuremt w MemBpasnre Ha ty6yaNH-
re eniTenHnt KaleTKH. 3aroBA MeMGpanes Tpancnopr, Koil-
0 ce OCbILECTSKBa ¢ MpeHOCHTeNH, HMa CBOR MaKCHMATHA
crofivocr Hapevena tpaenioprem maxcumym (T,..). Pead=
CopSun#ra Ha rMOKO3a, AMUHOKHCemHH 1 4p. ce XapaKre-
puSHpa ¢ Tpancropred MaxcuMym, CeKperopuute mponect
cbulo ce Xapaxtepuanpar © Tpaucnopren maxcumyst, Bea-
KO OTAEMMO BEULECTRO HMA CROH TPAHCTOpTEN MaKCHMYM,
Cy6cranumHTe, xoHTO MacHBHO ce peadcop6apar Hamat
TpaHCHOpTeH MaKCHMyM, Toit KATO TaXHaTa peadcopouma
JABUCH OT CREKTPOXHMMIAHA rpagHeHT, MponyeKaMeoctra
ka MemGpantara H OT BpeMeTo, Npes KETO TeHHOCTTa ch-
aupxawa cyGcranuara, octaa u TyGymtre, Harpuesara
peaGcopOuna B npoKcHMannuTe Ty6yan Hama TpaHcnopten
MakCHMYM, 2ANOTO MaKCHMAAqMNT TpaHeMOpreH KAMAL
ter #a HaTpHepo-KamHenaTa Mona Ha GaionaTepanara
MenGpana € MHOFO MO-BHCOK OT aKryanHoTO HBO Ma pe-
aScop6una. KouixoTo no-sucoxa © xonuenrpaunxta Ha Na”
8 npoxenManmrre TyGynit 1 KOMKOTO Mo-MastKa ¢ CkOpOCTTA
fa ABWXCHHE Ha TyGymMara TeMOCT ToTKOBA € T1O-BHCOKA
Harpnerara peaScopGuus, B auctannure vacrn Wa Hedpo-
Ha MarpHcnata peadcopSuns ce Xapakrepysnpa ¢ TPaHc
RopTen MaKcuMy no,oSHo Ha apyrirre cyScranusH, KOH-
To ce ypancrioprupar axrxano (ur. 13.9),
= 300 ‘untpaparo,
ae konaecreo
os
g 2 00
#8 500
se
@5 400
BE 200 ‘pancnopren,
£5 maxcamym PeaBcop6una
5 : 200:
a5
100 200 300 400 s00 600 700 800
KonusHTpauna Ha rniokosa 8 nnasmata
{mg/t0om!)
ur, 13.9. Tpanctinpren maxwwrywesa mmoxysa
usuonoaus Ha GeGpeuume / 287
Tpancnopmnu npoxecu 4 Opusxama ua Xenne
B swexonamara act Ha Gpuwara Ha Xewae we ce i
sppurea akTHoen Tpanenopr. Tyk € eCOKa NponycknMBoctra
3 yoda 1 € HHCKa NportyckavBocrTa 3a Hou. Besxonsmara
wact Ha Gpinxara Ha Xewre crpyKTYpHO H dbyHKUMOHATHO ce
ASHEN MA-TRATKA HacT, KORTO € PAMTOMORKEHA BBE HETPCLLAATA
Menyna 4 aeGema Yact, pasnonOxeHa BBE sBHMIHATA MeaysIa.
Busxonnmara wact aa Opuaixara Wa Xewe © Henpostuaesta
3a noga, Axtiteen TpaxcnopT Ha HonM ce HoBBputRa camo B
aeGenara pusxo.mma act Ha GpaMKara Ha Xenne,
Peabcopéywima na tionu ape evsxodsuyama acm 1a Opus
ama wa Xenae ue e comromenana om peateopbyur na aoda
u moca ch3daca xunoocmonaiumem @ mybvamama meuioem.
TyOynnama mesnocm, Koxmo Hasna 6 Gpuwcama na Xenae ¢
rG0cmomuunc, doxamo do HauaTama Hacm Hct Oucmariaume
useumu myGynu eunacu docmuea xunooeMomuNa meHocM C
ocwomima navieane oxoi0 100 masm/kg HO. 3umosa mos
dacm na nedpoxa ce napuxa “paxpemcdaiy cezmexm".
Tloxo6io Ha peaScopSunsTa a mpoxcuManture Tyyn, 6
‘octiopara Ha Horta Tpantcrtopt a aeGenara Yact Ha Opusexara
va Xewie crow Tpanchopra Ha HaTpHeEH H KaHERH HOH npes
Smonatepaswara mempaiia na tyGyauire KaerKH. Toaaepaa-
Hava or Na‘/K* noma Hiicka BuTpeKMeTDStia KONLEHTpALIE 33.
Na* chulasa KOHUEHTpAUHIOMeH rpAIMeNT Ja MaBmsAHeTO My
ot Ty6yniiara Tewnocr. Iipes aymenamnara memGpava 2aenH0 ¢
XUN HATPHER HARMHIAT ChINO EAHH KANHES 1 ABA XAOpHt fiona,
crupaann ¢ o6u MpenociTen, Tos Tpaxcropr € STOPHAHO ax
‘Thmmen, 2amoTO JaBHe oT HaTpHesara peaScopOwia Ha Gasoma~
‘Tepantara MemOpana, Baoknpaxeto Ha mpeHochtens Ha nyMe-
HaTiaTa MemGpana ¢ JuryPeTHUK BOAH KO CHINO yoeMMMABAKE
Ha BoanaTa W eaexrpomsrHa exeKpelwea ¢ ypHeara,
Oxono nonosuHata ot peaGcopGupanite font BhB Bb3-
xonauara yact 1@ Gpimkara wa Xenae npemmnapar mapa
ueaynapxo nopami rosa, 4e AyMeHanHaTa TeUHOCT ¢ es1EK-
TponOINTHEHA CTpIMO AMTPEKIEFRAMOTO MpocTpAHcTAS
(nr. 13.10).
Boa woaxodmyaina sacm na Spuaxama na Xenae ce pe-
abcopinpam oxoio 20% om duampupanume nampuesu,
anweau u xnopnu tion. B nexodnyama vacm ce peascop-
6upa oda.
or) | HaTeecraym
i =
Par, 33,10, Tpancnopras npoucor's seSenura weaxoamua er sa
ipsa na Xeweg : 262/@usuonoeua
Tpaucnopmnu npouecu 6 ducmainamea vacm na nedpona
Jicrannara uact na Kedbpona € cucTaReHa oF aNCTANHH 13-
BeETit TySyiH, CoLasaU TyGYRH, KOPTHKGUTHN, BHiNuIHOMeNyDap-
si W BETPeUIKO MexysapHn ceOMpaTenHE TyGymN, B ancranara
wacr Ha Hedpona ce peaGcopSupsr MHoro no-ManKi KOUECTEA
Com sr Bow, Ho HeaaRHCHMO OT ToEa TpaHicHIOpTHHTe NpoUecH 3
‘Tosi YaCT Ha HedpoHa ONpeNenAT TonsMa CTeneH KAKBO KON
ecTBo HlonH Ht Boa me ce ekcKpeTHpar ¢ Kpaitnara ypunta, Ha-
_mpuceama u sodnama peadcopbyis ne Burcu copes Napaterne,
2a1yomo nponyexctusocmma ia aoa MooKe cuIno dace Mpoels.
PeaticopGupat ce oxono 9% or ipunzpypanitre HarpHeatt flown
oKon0 20% oF duurrpupanara vona. Tpancnopmuune npoyec 6
smerou acm na wedhponc ca nodnonceru Ka XoPWoHaaEN KoMMpaR
~angocrepon, AHTI, AJIX, naparxopmon. Ha Team xepmon pe-
ALHpaT OCHOBINITE KIETKHS, KONTO CA BK/UOMEHIE B peryaauutAra
a noma 1 coneenta Sanane, Hirrepkanapurre kacrsit peaécop-
Gupat KH cexperupar H*s tTyGymara Tesocr. Te ca nkmiouentt
MlaBHo 6 peryraMIATA Ha GURVTHO-KUCEMMAOTO pagtoRecite,
B ducmanume my6y2u napauenyaaprwim mpancnopm e ekino
ozpameen nopadu moca, ve Mrommume EpRsKU ca Henpomnyar
enn Compecmayea ocwomumna pasmexa mecdy myByaama u
unmepemugucermames mewuocn,
‘Tpancnoprum nponecn s aucranuwre manera Tym,
B ancranuite tyGy1t ce peaScopOnpar Harpies 1 xAopHnt
oun # ce cexpetpat cankean fiom, B wavaniara uM 4acT
paspexnaHeto Ha TySyawata veNHOcT NpoxBvKaBA, 2aUI0TO
envtrerst npomemKava sa € HeNpoRMttaes 32 Bona. HarpHeen-
Te H xnopinite HoH npeniitanar npes nyMertantara weMGpa-
Ha upes cHMMOpTeH MexaunsbM, KoiiTO ce GaOKpa oT THASHTA-
4M Anypetmmn. Harpwenate foun npemmvasar mpes Gaxosma-
Tepatara memOpana Yper Na'/K” noma. B xpaiivtara act Ha
aucrasmuve TyGyan peaScopOunsra aa Na” ce 1ampprina mpes
Towne Kanani, KOTO HsOHparenHo ce GrOKUpat oT aNypeTit=
ka anuinopin (aMmTopAia-syscreureamu HaTpitenit KaMaaut). B
peayntar na Tasn Karpnena peaScopSunt TySyanara TewnocT
CTaBa enexTponeraruuHa CHpAMO KIIETDYNATA, KOCTO CL3RABA
yeaonwa 2a cexpeutet a K°, [pu ayudosa cexpeyuama na K”
Ramaiyied, doKaMO npUu arkanosa ce yeenrasa, Tipt BACOK
pes Ha kati ¢ xpatiara, cexpeunzra wa K* @ Horo rona-
Ma M KommuectaoTo exckpernpann K* Haasuuaea quurpupa-
Horo xommuectso. B ocHonmure KerkH ce peadcopGupar Na”
ie novia Wee cexperupar K", B interepxanapitire KnerKH ce cK
petupar Han ce peaScopGupar HCO,” kaxto # K*. Toao6ut0
Ha erirenmutre KsIcTEH B NpoKcUMasmrte TyOym1 H* 4 HCO,”
ce noaysanar ot H,CO,, o6parynara ¢ y4actHeTo Ha gETpe-
Kreraana KapSoaxiapasa, Taka Ye 3a BCeKM ceKperitpait H
ce peadcopSnpa eanr HCO,”. Cexpenusra 4a He crperiara
Wc peaSeopSumara Ha K* upes H7/K'-AT@aaa, pasnonowena
Ha jyMenamata MemOpania,
‘Tpaxcnopran mpouect 8 cLGupareaure ryéynu. B
Koprukamitata vacr Ha CLONparesmere TOV Wa OCHOBAH
Mo RERTepKanapHH KNETKH Lc CMTE TpaHeMOpTI Code
HOCTH, KaxTO B wvicTanHTe HsoiTTH TydyaK. B Meaynaprara
wacr Ha chOnparenHiTe TyGynu Hamasiava Spor Ha OCHOSH-
Te KIETKH H ce yoenHMaRa TOM Ha UATepKAnapHNRTe, [Zteni-
Hume apbzxu ca enponuyaesn w napayeryrapnicim mon ue
ce wanaraea. Mponyerauwoctra 2a Bora € MOTO HHCKa, HO oe
yeemmana api nanusie ta AUX, B mani tom na uespona
\punama ce kouenmpupa, xnyomo Cemecnsyea suauumer
a ocMomunna pazauKa seondy myByanama w wi
aetnamea meuoom.
ponent
moe | Terencrays
Aveovat
Due: 13,11. Tpaucnoprin npouzce a ocuonnuTe KnerKst Ka kope
mitre cuGupatemsn Ty6y.um
u—
bur; 13.12. Tpancnoptsst npouecn w enystapure exGuparennu ty6)
B cpduparentmrre ty6y:m ce peaScopSupar axono 2%
¢piorrpupadioro xomiuecrso Na’, Harpuesara peaScopOuns
HawEpuuka OT OCHOBHHTE KAETKH pes aMMAOPAA-HY BCTBIET.
vute KanaTtera Ha AYMeHATHATA MeMOpana M-spe2 axTae
Tpatictiopt ita GasonaTepannara menGpasia (dur. 13.11).
yneywima ua co6upamenaume mydyna @ pezynapa
xopuonaino, Peryanpa ce ot andocmepoua, Koitro ce ore
ot kopara Ha HalGLGpexa, oT yponnaaruia, exnotenuMsT,
NNO, GuSpesitre npocrarsasumiey 1 xHENHEL
Cexpeyuima na K* ce ussepuisa om ocHosnume Kiem
kanto npu aan ova ce yeemmaca, a npw ayudosa nanaise
Honiaanero ua K* of OchoBHTTe KeTKH Ce HSELpUIBA 110 XO.
a KOMMLENTPAUMOMHHA FpaMMENT sa KAMA M Ce TpensTcT
or enexrpoxumuuni rpamienr, ZleMtcranero Ha rocae:t
e no-cnaGo Ha myMeHanuaTa MemGpaia 8 cpasnesiie
arepaanara MeMOpaita 1 aatosa K’ aagauer # ty iti RLS Nemes
usvonoaua Ha SvSpeuume / 283
qeamoct, 2 HE Ce BPBULAT OBpaTHo B KpbETa. AKTHBHOCTTA Ha
Na‘/K” nowna Ha Gasonatepannara wemOpasta e onpeaensta
ja crenenra na cexpeunara wa K*, Andocmeponont cmusyzau-
pa cexpeyuima va K
PeaScopSira Ha Bona ZaRHICH OT NporycKmimocrra Ha y-
evcaThata MeMOpata a ocHopiitre wicrsH. PeaScopGunsrra Ha
soma € peryeuspatia OT axmuduypemusiru xopMON H € OKONO 15%
or gvirpapanoto KonuvecTao, C:ysennvananeTo Ha nomata pe
aGcop6uns ce yoesiaBa 1 peaScopSuntrra wa ypes.
‘TySysmurre enurresman KaetKH 8 coOHparemuTe TyGynit ca
Sorat na KapSoaMxnapana w y4acTnar B GuOpeunara peryna-
Ua Ha ATKAAHO-KHCEMMHHOTO papHopecne (eupK Tapa 15).
Coxpeuma Ha BelmecTBa
B OLOpeunHTe TyGyu
B GaGpewmre TyEyam ce cexperupar opranisin xHcem
HM, OpraHMuHH ocHoBH, H*, Kt (Our. 13.13), Opranaunsre
RICONHHE Ca ¢ eHMOTEHEH HHL eoreNeH MposXor. Kom
ITOpBHTe CHANAT MAKONHA KHCEAKHA, YpaTH, OKCANATH, MACTHIE
AUCEDMEM, COM Ha ACTEMEMITE RACEMIC, MPOCTarnaK He 1
ap. Kum eToprre cantar MilorkecTao nexapermenn cpemeraa
xaTo TICHHUHIMH, cymbouaMva, acnupyit, anypersius, a
hilo Taka H MpORYKTH OT MeTASONHTHa TpaxcopMani Ha
lekaPCTACHH H TOKCHYHM ReI\ecTHA, KOHTO ce Nomysanat ype
cunpapane ¢ rmoKypoHona xncemma wax eynpar. Cexperupa
ce Chilo HE NapaaMMHOXHHMTYpOwATa KHCEAAHA, KONTO CE BBBEK
Aa BHORHO H “ITO KNUPBHe Ce HaNONIRA 3a ONPENENsHE Ha
SOpesnna niasmex noroK. Oprannunnte ocHOBH, KOTO ce
CekPeTHpAT ChUIO Ca OT EHOTeHEH HH eKIOFEHEH MpOUSXOR.
Cennorene mpovaxox ca aupenannH, KOMANU, AueTTAXC-
av, XiICTaMMH, a c exoreneH ca nekapeTBeHH cpeNCTRA KATO
arpormus, Mop, xi. Cexperupar ce chuto H HAKOH Bar-
pista karo Diodrast, :
Hes lcseec
‘ur. 13.13. PeadcopSue it cexperms Ha memecTsa B Hepona
Excxpemonra Ha wewécrRara, KOHTO caeu Karo ce GiM:TTpH-
par slonmeauurenHo ce cexpeTupat € BuicoKe, Cexperopuurre
apouecit ce Xapaxrepiaspar ¢ Tparcnopren maxchatys. Ce-
KPCUITA Hwa HiRBO Ha HacHuaHe, KakTO m peaScopouiurra Ha
TmoKo3a 4 aNMMoKHcemHH (Bink 110-rope)
Yipes rySyanara cexpeunia kpnnra ce owncTna or enLToreH-
Rif BEULECTBA KATO MINKOWE KHCEMMNA, ATBUNA KHCeMNHH,
NH, v oF Moro exsorennut seutecrea, Hopasuy nocronuioro
MM oueTRaHe OF opraHiaMa, MHOrO ACKapCTBa ce ApHeMaT
TPH MoH METHpHt METH AHeBHO Mpes papi Hitrepsaan oT Bpe-
Me, 34 2a ce MORAEpAKA MOCTOMIA HHAasMEHA KORUEHTPALAA.
Tydyanara cexpeuns a H’ urpae saxkwa poaa m nonrEpxcane-
‘TO Ha astkano-sHceAMMHOTO pasHoBecie Ha Oprantsma
Peadcop6nusa n cekpenna
Ha HAKOH BemecTBa
Tavoxosa, Hopmaano, uanoro duurrpupano Komvectso
rmoxora ce peadcop6upa 8 npoxcumantime Ty Sym, CnoKo-
3ara npeniiasa npes aywenannara MemGpaua a TyGymanTe
enMTensit KNeTKH 3aeaho ¢ Marpaa (Na"/rmoKoza cinsnopr),
a npes Gazonarepamuara wemOpaxia upea TmoxoxeH yunNOpT.
Tirstumre ceeainenna ca nenporycKamen 3a CuoKo3a MT
He ce spbuia oOparHo 8 ayMena Ha Ty6yaa. TpancnopransT
MAKCMMYN Ha FmOKOZaTA © 375 mgimin # € oKONO 3 METH
Ha oSimaiinoTo QirpHpano KomMmectBo rmoxoxa, Kora-
TO TAAIMEHOTO HiRO Ha TmoOKozaTa HaaxEEpIN 16 mmol/l,
npoxcimammre tyOyaH He ycnapar xa peaScopSipar usnoTo
xommMeCTBO (puATPHpata FTOKOI W 4aCT OT Hest ce rlosBABA
B kpaiixara ypnna. [lo-nararsuinoTo yBeausasane Wa nas
MeHOTO HHBO BOM AO NpOrpeCHEHO yRenHMaoaHe Ha eKcKpe-
unava Ha rmoxoza ¢ ypunata. HepeaScopSupariara rnoxosa,
ocranasa n TyGyaHATa TeMHOCT, 2aMEpHKA BORA, KOTO He ce
peadcopOnpa u Tova yaeniana oGema Ha Kpailwera ypmea
(ocmomua duypesa).
Tera, Haxon nitckomonexysnn stenrinit npenusnasar
pes Momepyanue QMATsp H NonaMAT B TSpsHara ypu.
Fopaau tona, 4e neiinnsT oGem © TeEpae roxaM, HTTpH-
PpaHOTO KOMHYECTRO NENT He Moxe ma ce.npeHeGperne,
Gurrpypamre nentaat npemunasar HenponeHeHN pes
ayMenaaHara MemOpava pes eamounrosa, KoaTO cTaprupa
cue cEMpasane na nemruaHTe che crieuEKpise penenTo-
pit ta MemGpanara, Crenestra Ha enaousrroza ce yaenmana
NPOVOpUHOHANHO Ha KOMIMECTBOTO Ha TemTumrTe B rose
pynina diurrpar ao gocturane Ha T,,.. Towra wanoro Kom
wecrao durpupams ertman ce peadcoSupar B npoKeia:t
worre TyGyant 1 TaKa MpeneOperxnmo MAIKO OF TAX ce OTAEAT
© Kpaiinara ypimia, Mexanvanrer a entounrosa, oBa4e Gepso
ce Hacnula 1 3aToRa APH MopMUZanANe Ha MponycKsIBOCTTA
Ha cnoMepynnara MemMOpana, ce nloaBapa Gerbx B xpaiirara
ypunara (axSysnmypua). ¥ nao neu Mopani rewerHso
oGycrorcia sHnca Ha TpaHeHOprHa ciicreMa 3a WioTIM, ToT
ce Wsmbusa ¢ Kpaituara ypmata (5ccomaypter).
‘Ypes. Okono noacenmara or iurepupanara ypes ce pe-
aécopSmpa 8 mpoKcumanunre ty6yaM pes mapantenynapedt
‘Tpanicnopr, Mrvrnirre ceemmmenita # Gpwwara Ha Xewste 4
ca nponycKausn 2a ypea, Ho KMeTKUTE 8 TRHKIETE paNtena Fa
Spunxata usar npenocHTenH 24 ypeR, KOETO Mo3BaNAEA ce 34 / Pusuonoeun
KonuerTpayia Ty6ynna rewoctinnasma
ur: 13.15. Mpomewn w kouewrpawsrra ta wixose geukectea 8 pass
rane orazaw Ha nedpoma
kpemiara ii 8 tySynuara‘reunoct. Mureperuauymer Ha Meny-
AGTa HM@ SHAYHMO HO-BHCOKA KoHLIeHT PALA Ha ypeR 8 epan~
Henne c ypiitiara, oar Hawavsa 9 Gpustnata Ha Xenie, Konit-
uecrnoTo Ita cekpeTupanara ypes e NpuGaauTEMHO pasHo Ha
komuectworo ypea peadcop6Hpana B nporcuMamurre Ty
at. Uneraminve sence TYSysH H Mas@UIOTO Ha KOPTHKAAHTE
cvSupareann Ty6yan ca HenponycKanpy 3a ypea, Thii-Karo
noseue or 80% or inrpuparara woma neve e peaScoponpana,
kouuedTpaunata Ha ypexta B TYMeHAMMATA TeMHOCT ¢ HAKOA-
_ AGcOpGUNA ROART 2o roEMH MpOMeNM # HarpueRATA ekeKpE:
ko MTBTH no-BHCoKa OT Fas Ha tUIaaMaTa 1 10-BACOKA OT TaBHE
8 uiTeperHunyma Ha Mezynara, B Memynapunre ceGuparenun,
ryGyan ce peaScop6upa oxosio nonoumara of nOCTUPHaRaTa
(HO TAX ype H Taka OKO NOROBMMATa OF ypexTa ce eKcKpETHE
pa c kpaiiara ypima. Bue acwuxn 4actH Ha Hedpora ypesta
ce peadcop6upa nacunuo (dur. 13.14).
Bona, PeaGcopSunata Ha soua € MacHBeH MpoUec, Ko!To
ce onpeaens of passutkuTe B ocMOTHMHOTO HanaraHe OF :Be-
Te cTpAHH Ha KneTRuHaTa MemGpana H OT Heiisata MponycK-
aunoct, Bonara ce peaScopSupa upes npocta, Neto antbyaus
‘apes aksanopauin & MeMOpanitre Ha TyOyautiTTe KeTKA HL Mp3
TRBTHHTE CHEAMHEUHA MeAAy sneTKHTe. Basonarepannera
MenGpana Ha TyGyMuNTe eTHITeAHH KACTKH € BMCOKO HpO-
nyckanisa 3a nora, NopadH KOeTO OcMOAAMTETA R KNeTKUTE ©
eAHAKDS © TOK B OKONHHA HATepeTHUAYM, TponyeKsHB0cT-
Ta Ha aYMenannara MemOpawa 1 Ha MaNTHHTe cheaAAeRi €
poamirsiia 9 oTaenHitTe tySyauK cerMeHTH. B npoxcrmannuire
TGYAK HB HUBxOHAMLOTO pamo Ha OpuuKaTa Ha Xewte Tee
AMOTO BHCOKA, JOKATO BRE BEAXONRUNOTO paMo Ha OpuMeaTa
na Xete e nitcxa H He ce momen, Taopite HiicKa e Ht 8 Aue
‘TanHutTe HBHITHE Ht 8 CLOMpaTesTe TYGy-1H, Ho MoxKe anate
Mo a ce Mpomexs npHt Haueane Ha AJIX. B npoxcumamurre
‘tyGymi nponyeksmnoctra ¢ maxcumama. Tyx peadcopSunara
€ moocMOTHYHA H OCMOTHUHOTO Manarane Ha TyOyamara Te
HocT € pauno Ha Tosa Ha maawara, HusxommUOTO pamo Ha
Spanxara wa Xewre © nponycwmso 3a wona, Tr ce peaScop-
Supa Jo wapannasadte Ha OCMOTIMIHOTO HallaraHe Ha tyGyAae
Ta TewHocT c TORA Ha MiTepCTHNHYsa, KATO TO HapacTua NpH
Hapniane Ha Opimxara ta Nevae B abaGounsa, Busxoaao-
‘TO pamo wa Gpyaikata Ha Xenie € HeNpoMycKAMBe 2a BORA.
Tyk peaScopSunsta Ha iioHM He e Mocnemmana ot peadcap6-
una Ha Bona, TYGyntiava TeNnOcT ce paspexcia He ¢ O-MHCK
cmoTHIHo Hatsrane oT Tosa Ha nuiaswata FponyckmuMmocTTa
3a BORA HA KACTKHTE Ha AMCTAAMUTE 1 ChGMpaTeAHHTe TyOy-
it e MHOTO HHCKA, HO MOKe Gupao ma ce npoMeHA B 2anncH-
Moct of Kometrpawisra a AJTX B runaswata, Tpit axtcoxa
KOHUCHTpAUHA NPONYCKTHBCCTTa € MAKCHMALIHA, MPH HitCKa
koutteHTpatuia mportycxaHaoerra e canada, pes npostana Ha
Mponycictipoctra 3a poa a TOM oTAen Ha Hedpouta ce pery-
AuNpa OcMOTH4HOTO HaaraHe 1 KOAMMECTBOTO OTAeTeHa yp
na, Tlopanit ocoGeHocriite na peadcopGuuuira Ha zona 1 Ha
peaScopOunara wa pastmopenirre seukectea, TAKHATA KOHUEH
‘Tpaunia w rySysmara TeHocT ce npoMena B pawueuiiTe yacTHt
a Hedpona (ur, 13.15).
Harpnii, Harpuat ce dumrpupa caoSoxHo 8 rnomepyaite
Te U ce peaScopSupa 8 GLdpesnste TySymmt, OKar0 70% or
busrcpupasina narpuii ce peaScopGupat » npowcumanite ry-
Syms, 20% w Opmuxara na Xewte w 9% B ancramuUNTe YaCrH
Ha nedpoxa. Mexay 0.5%-1% or cbwsmpupanna Rarpull ce
otaena HopmaitHo ¢ xpafinata yputa, 3a peaGcopSumara Ha
HaTPHA Ce HopasxouBa roMAMO KosueeCTBO eXteprun, Oxo
80% of GeOpeunara KiCHOpOAMA KOMCYMALUIA € CaDpsaHa ¢
Harpwenata peaScop6uns. C Hest e canprata peaScopGunara
xa roam Gpoil vewecrua Hedpowa, Harpiesura peaScopé-
UNA € nox dursHomOTHNKiA KOKTPON Ma HepaHi, NoPMOHATHHL
W Tapaxpiniins daxropn, KOTO CcHrypAKA HarpHerara xox
ocrasa 6 opranmema. Clopaau towa, 4e ce diuttpnpat roaemit
KOAMMeCTua HATpHi, AOPH H MaTKH MpOMeNE s KaTpHEBATA pe
Ha, Boe ScHYKH CerMeHTH Ha Hedbpous siarpiaT npenniana
Gasonatepauinara memOpana Npea axTHBeH TpancHOpT (r7aBKO @usuonoeus Ha Suspeyumne / 285
apes Na"/K" nowma WB mastka erenter Na’/HCO,” ersimiopr) 1
jarosa HaTpHesaTa KOHUeHTpauMa 8 TyyaKara KIeTKa € TIO
HUCKa B CPABHeHMe ¢ TySy:mara TeaHOCT. Taka eBTpeKHETEH-
HoTO NPOCTPAHCTRO Ce sapeKAA TPHUATEMHO No oTHOIEHRE
na Ty6ynHara TeaHOcT H HarpHesstTe fonn npemmtapaT na-
cHmHo B KASTKATA MO XOMA Ha eNeKTPONUMEAHA rpagHenn.
Tipe: aymenanmara menGpava saemHo ¢ Harpua spe cxxmopr
npemMpanar THOKOIA, AMMEOKHCENHEN, Ghocharn, cympara,
a upes atrimopt H*, Harpuar npesiniasa 4 caxocroxtenno
pes HarpHesn kata. Hait-ronaara wact or HaTpHa mpenst-
vasa syMeHamHara MemsSpana pes Na°/H? anrrniopr.
Xaop. PeaScopOunara na xop B GwOpewsurre TySyaH &
SaBiicHMa oT HarpHewara peaGcopOuna 1 2arona peaScopous
.rra Ma *OIOpMuCTe House KeTO MpOLeTT OF (pHEFTPHPAHOTO KOH
NecTao 9 OTAeAMITE cerMeNT# Ha Hembpona e cxoaHa ¢ Ta
2a Harpies fionss, Xaoparre ion npemtHasar esoG0sHo
pes WUIBTHIETE CREMIHEHHS 8 MpoKcuManMiTe TyByaK. Flpe-
MuvianaHeTo Ha xnOpHHrTe flown npez ayMenantara MeMGpanta
eaarpyaveno nopans dasa, se ubtpexierbemoTo sIpocTpan-
Two € sapenedo OTpHuaTesHO 4 Te TpxGuA 2a ce BHAT Cpe
my eneKTpoxHMetuHHa rpanyient. Xnopuute HoH MpeMHHa-
nat npea nyMenarttara MeMGpatia ¢ nowomra Ha npenocHTer
‘apes cussopr ¢ Harpisa, [Ipw nlocruraxe Ha BucoKa suTpeKsIe~
“TaN KOMMeHTpALLA Ha XAIOPHH OHNE Te ce MpHUBHKBAT Npes
GasomaTepammara wenOpatia, Vamusaseto wa Cl or Ty6ysnre
xaeTKH pes Gasonatepaniara MemGpada ce HsBBpuIEA 11 O
xOMl Ha EEKEPOXIUM4HHA FpaaneHt Mlopaun exlextponerare
aueta Ha noTpeKncTB4HOTO MpocTpaHCTEO.
Kaamii. Kaauat ce dbintpapa cooGoaio # Han 60'
nero ce ‘peaScopOmpar BnpoKcumanniTe TySyAN TaBHo
pez napauenyaapes tpaxcnopt. B xeGenoto Bb3xonatno
pamo Ha Spymxara xa Xenne peaScopSunsra npomtnKana
‘pea Na‘-K*-2C cuwnopr 4 maka act 4pes napaueny-
Japex Tpancnopr. OGwaiNo AO aNCTANHUTE HSBMTH Ty
dy goctura oKoxo 10% or umrpupanns Kamali. B ct
Guparenuurre tyGynH peaScopSuna na Kami ce HapEpumDa
oT HETepKasapHre KneTKH THN A (K’/H* anTsmopr). UIpit
Hcka Ha KanMiit AMeTA ce OTMEAAT c ypHHaTa OKOMO 5% oT
uxrpupanna xannii. Ocronture xaeven 8 coGuparemi-
Te Tydyiin, oGave cexperupar Kastui. Toit npemmmasa upes
akTiugex Tparcropr npes Gasonarepannara MeMGpana Hi Ta~
cHRto npe3 syMeHanHata MemGpaa. TIpu eucoKa Ha KamHit
AMeTa ce CTHMYsIHpa Mpoueca Ha CexpeuHs 1 GecTo NopaaH
Toba, He ce CeKpeTUpa MOBEYe KaHit OTKOKOTO ce peAd-
copOupa, excxpeTHpanoro KoMMMecTRO KATMit © ypuHaTa
€ mo-romaMo of huxrpupanoto. Excxpenwsra ua Kamit ¢
ypiwara ce perymipa OcHOBHO pes MpoMaua B cexpeunaTa
ka Kauii 3 cbOuparenKure Ty6ymn. Koraro cexpeumara ¢
BHCOKA ce OTAENAT roneMIs KOMMUCCTBA KasM!, NOKATO, KO-
Faro ceKpeunaTa € MHCKA ce OTMEMA MATKO KATHI ¢ yputa-
ta. Cexpeunsra na K* 3apHoH MOF ankanHo-KicemManoto
pannosecue B oprauuama (ova no-rope)
ocarH. Oxono 85% or (purrpapanmte (bocdarn ce pe-
aGeopOupar # npoxcHMaTHnTe TYGyrIH, KOHTO ca emEMeTHEHO
10 wsacTo 3a TaxHaTa peadcopdtuta B Hepporta. Peadcopoust-
va na (bociparn ce HmEpurea ypes CHNMIOpT ¢ HarpHA H MIpH
‘Texaba TPAHCHOpreN MaKCHMYM, KOHTO € masIKO HO-RHCEK OF
oBituaiinoro xommeerso ¢bumrpnpann bocdars, 3eroRa npHt
yuemnmanase Ha TAEIMaHErO HirBO HA ociparirre (yneHHEH
TMpitest ume yreansieno ocuoSoacanane na ibocdarr or KocTI
Te) ce yneainana ciao ocharnara excpeuta © ypunara
ea
‘Kasumi. Tlo-ronaara sacr or ¢bsurrpapanna Kasil ce
peaScopOupa 2 npoxeumannirre ty6yz (oK00 60%) 4 prt
kara na Xenne (oKono 25%). Kanu ce peaScopOupa 1» auc
Tamire HaBisTH HB CDOMpatensitre tyOvan. C xpaiitara ypina
ce ormenar 1-2% or bwurrpupantia xanutii. PeaScopéunara wa
Kami 8 ApoxcHMamurre Ty6yH HB AeGeROTO BEAXOAAIO
paMmo ta Gpamnara Ha Xevine e acnaa n mapauenyaapHa, 10-
karo B AMICTANHITTe OTEK Ha Hecpporia ¢ aKTsNBHA H TpaAHcUe-
ayoapua, B wleTkHTe Ha ACTANHTTe HamieTiC H cLOMparemut
tyGyan KanunaT Hasansa Mpe? AyMeHaTHara MeMOpana nacuB-
Mo MIpes KamieRi KAMAE H MAEA OT TEAM KNCTEH aKTITRHO
pea Gasonarepanniara MessGpatia pes Na‘/Ca** anrunop. B
AUCT@THIFTe SacTH Ha Heippowa ce ocbULecTeRBa xopmonamtara
peryraunn Ha Kasmmesara exexpeuns ¢ yprmsnra,
Marneaii. B npoxcmmanuirre TySyan ce peaScopSupar
oxon0 25% or dpiarrpupaiiis Marvesuil, OcHowHoro acto 2a
peaScopuiia Ha Marneanii © Opinxara aa Neww1e, eset ce
peadcopSupar oxoro 65% ot dpunrrpupaniia. Camo oxon0 5%
ov QHmtpHpanna Marneausit ce peaScopOupar » anerauiiTe
uapirris 1 cbOMparesnn TyGy.tn. C xpaitniara ypwsa wopmasiHo
ce exexpetupar 10 a0 15% or cbuntpupania MardesHil
HCO, a HY. PeadcopSumsra wa xnaporenxapGonar-
HM HoH © Mponec, KOMTO € cBLpzaH csc CeKpenmaTa Wa H*.
Boaopoar xarvown ce cexperupat mo manera mumKna Ha
nepona. PeaScopOunsra wa HCO, 1 cexpeuuara xa He ce
uauepunma rio oGuL Mexannsna B ues HedpoH (Pur, 13.16).
Or noaa u CO, nom neffetane Ha xapSoamxunpasara ce
o6paryna HCO, KosTo ancoummpa xa HCO,,, xoitro npe-
sunana npes Gasonarepamara MemOpana it Ha H*, woiiro ce
cexpemipa akruaxo B TyGyaRHA ayMeN. 34 aceKM ceKpeTi
pax H” npe2 yMewammara memSpana, ce peaScopsupa exun
HCO, npe2 Gascaarepanniara memGpana. Cexpeusrra Ha
Hi ce oceuectpsea pez pasuieasm aymenanii menGpaxent
tpancnoptepy. B mpoxcumannure tyGym1 onepapa Na‘/H*
ANTHTLOpT, AOKATO B IntrepKasapHNTE KaeTKHE THN A Ha ROH
pareanirre-tyGyan H’ ce cexpeTitpa pes mmpoiteno axtitena
Ht AT@-asa wan pea H-K"-AT@-asa, Xunporenxapso-
Ravmirte fiom npemsuanar pes GasonarepaniaTa nemSpaua
«pea CIYHCO,’ autimopt nan Na‘/HCO, cumnopr karo 8
Agata cny'4aa MIPHMBIDKBAHeTO € NAcHBHO, NO xoAa Ha eNeK- an 8
EER RS RRRERR EEG
286 / Pusuonoeua
dywen, Jyatex,
26} as
nara TeunoeT HownsauneTa Hae
ceannure ce yseaunasa, peaScopt
—\ uuaTa HA Wawacapa H ekcxpette,
@ \ gq | ssccosncunsa. pu noszscenssan
<—— LE | xa ty6ynnara teanocr excxpeui
_) |, sana, aoxato npi ankaantsupaner
| 4 nasartaga. Bugno e, 4e sanaHe
| eto wa pH wa tyGyanara TewHoc
| sDPxy Honnsauera wc Tosa Bxpx
peadcopéunata Ha oprannatin
KueeattH H.1H OCHOBLL € MUOTO re
A B qamo. Upes npomava na pH wa ty
peabcop6unt i _
Synuara TeaHocr, exckpeunaTa ®
GB xehomnpsns (] fp tomarpana xucenma | oprannauiere KHceMMKK 4 ocHOR
Mowe Ja Obe HacoUBaHa B AEN
[E settomanpana i] J somsuparca ocuosa
xa mlocoxa. [pa orpaszuns, pe
Duy 13.17, Heftonta arpyana w Gbdpeumere TyGyH
ANKATHSHpAne HAH NoAKHCesABAR
Ma ypunara ce noctara yBeane
A— nut tntcxo pH wa TyGyanara Tenocr ce peaScopSupar xuceamut; B -npx wicow pH ua tyGya- HME HA EKCKpeuMsTa Ha nonaaHan
Hata Tewlocr ce peaGcopSupar ocuosst
apoxuMunnns cpaanent Ha HCO,. Comecroyea a0Gep o-
Mepyno-TySyneH Gananc mp peadcopounsta na HCO, [Ips
yeennuasane komyectsoro Ha hurrpHpan HCO,’, texMara
peaScopOuns a npoxchManuure TyGymit ce yeeauaga, KoeTO
gaciiaga cexpeunara Ha H 4 cTumysitpa MarpHeeara peaS-
copSuns nopani acrieupane Ha Na"/H’ axrnnopr
Exkckpenna
Ha ek30renHH BemlecTBA
BrOpeunara exckpeuma Ha Sy cil 3a opraHy3Ma XHMMGHH
semtectsa (KoeHOOHOTHIIN), KbM KONTO cTamaT neKaperneHH
Speactea 4 Senn 3a OpraHusna Beulecrua ce OcbUIECTER-
Ba 4pes uorrpaunia wus ypes GarTpauna u aomsAUTeAKa
CeKPeLMA R TOKCHMaNHEtTE THEM, B KOTO Te He ce pead=
copSupar. Cexpeunata ce ocbultecroapa «pes arcriinen Tpane~
HOP, SoiTO HMa TPaHCHOpTeH MaKCHMYM pit KONKypHpane
3a cappanane ¢ eat H cbINM APeHOCHTENM.
3a Muoro oF KxceHOGHOTHUHTE, KOHTO ca cyuTYpHpaLHt Hd
au CeRpeTHpai 8 npoxcunansuTe TyOyan, Kpafiuara ek-
MA IABUCH OT CTeMeHTa Ha peadcop6uns, Na KOATO ca
NOnAOKCHH A ANCTARMHTe TySyaH. OGenwT Ha TySynHaTA
Teuoct, KOATO AOCTUra HO EHCTANHMTE HaCTH Ha HeMpo~
va © CHINO MAMasIeH H KOHMEHTpautaTa Ha pasTaopeniiTe
Mes aewecrna e yaeanvena, Tora chaaasa xonseuTpaLie
ONeH rpanuerr 3a peaScopSuse ¥per AudysuA Mo RocoKA
sa uareperaunysa. TIpes Ty6ymuute enirenun KaeTKIE
Apemubasar camo HeROHNSUpaHHTe woneKyaH, Zarosa B
aueramure TySyan ce peaScop6upa upes andysua act oF
puTpHpanire H ceKperHpani4 exsorentus eutecTDa, KOTO
ca B Helioniiaitpana bopma (medonna Oubysua). Ta ce onpe-
neaa oT pH va epenata u or pK wa pemeeraoro (30 pK ax.
ypaunesinero na Henderson-Hasselbaich x rapa 15), pH ha
ryyanara vewHoer napiipa Mexkay 4.5 u 8.2, Cpu xucena
mute'Kic
estioct oprat
HH Ca B HeftoHHaMpana hopma
# Morar aa ce peaScopSupar, Hpi ankanmanpane ua tyGya-
8 opramicma TOKCHMHH Reulecre:
Hanpusep, mpi orpasane ¢ Mor
Gu Haw Xi NOMKHCENIBARET
Ha Ypunara upes apHAoxeule Ha aMoeR xAOpHA yeaE
Mapa ekcKPeUHATA HIM, 2OKATO MIpHt OTPABAHE Che CbHOTBOF
Horo epenerao (benoGapGuran aaKanusapanero na ypHnar
yeunga Heroworo exexpetupane (Dur 13.17).
Konyentpupane
H pa3peajane
Ha ypHuHara
Kontentpypasiero i pasperaasero wa ypunata ocurypa
Ba HOLLPXANE Ha BOKUO-COsleWaAra XoMEOCTAIA TPH SHAUN
TeAKM KosteGaiiHé Ha OpHeNa Ha com HM Bona. KonuestTpupe
HeTO H pazpexaaneTo Ha ypHHara ce weBpunBa B MeRyTaTA
GxOpera ¢ yyacruero Ha MiNXONAMATA H BRAXOAAMaTA eC
Ha Gpunkara wa Xetiae, cbOuparemuure TyGysus, GeSpenna
wurreperuunye, vasa recta,
Tipu paspexcianie Ha ypmiiara Makcumanxust it oem oct
ra 24 suerpa sa 24 vaca, a miutumanuuat ocmasaniter e 50-10
mosm/kg F,0, 3a na ce oTies AiMOOCMOTHYHA YpHHa, BORNE
Ta peaScopourta B ANCTATHHTE InAMTH H CBOMparenaH Ty6YT
rpaGna na Giue cHoMo orpammena sum Kambito noTHCHETe
‘roll karo TyGyanara TewiocT, MocTormaLa B TeSH OUAENH H
wepona ot spsxoIAWiOTO pao Ha Opunnara Ha Xenae HHAT
€ xunoocmotuatta. Badpewite y donex Kouuentpapar ypHtKar
0 1200 mosnvkg H,O, ne. ofono verapH muTH Fal TnaaMe
1 ocMonamtrer, XumepoomorHuna yputa ce oGpazyna TP:
orpauntiena peaScopSuna Ha comm 3acinena peaBcopouna A
outa. Boaara ce peacopSutpa nacuntio no soa Ha ocworite
rpawient, 3arowa npexrocTasKa Za KOHLEHTPApAHe Ha YpHHE
7a € Chaqapane Ha OCMOTHYEH rpaaHenT, KOFITO 7a OCBULECTB
peaScopOusara 1a vosa, B O.Gpenva mereperiunyM eDitlect
byea Kopmuxornanurapen oemomuien zpaduenm, Oestouterh
TeTer Ka MrepeTHMamHaTa TeHHOCT pacre
aynara # aoctura 10 1200 mosmvkg H,O. Caea noctisrane
para that
BHGOKa KOUMHTPAUHA Ha pasTBOPEIM ReMeCtwa B MeqysIAT: wee
©) ypunava (Dar 13.19),
Pusuonozua Ha SeGpeuume /287
ce NOATSpxa pe Gatante Meway nocrommaneto HW ovtema-
nero Ha 3028 M OCMOTHNHO aKTHRNH nemecTea, Faire cpax-
op, YHACTHAMI B CBOAPAHETO Ha BHCOKA KOMUIEHTPALHA Ha
ceMOTHUHO-AKTHBHM RemIecTBa 8 Menynara Ha GyOpexa ca: 1.
Axnssex! Tpanenopr Ha Na’, # korpanenopt a K*, Clu apy-
nition 2 aeGenOTO BESxXOAAMIO paMO Ha SpHMKara Ha Xewute
Ceutecrayea ¥ nacuaea peaScopéuna Ha Na’ a Clg TsHKoro
maxoaalio paMo Ha GpuMKara. 2. Airunest tparenopr Ha fiotit
5 coOuparemutre Ty6yomt. 3. Yaecuenia andy:n0a Ha roreMit KO-
imuecraa Yped BLB EETPeMMMITTE NeaysIApHEE COUpaTesM Ty-
iyan. 4, Fncby3v1a Ha oTHOCHTTe-MO Marko o;la B MenyaapanTe
-ry6ymi (MHOFO 11O-MaaKO OT peaGcopGupaniitre ocmoTiMMo-aK-
‘HOHE BeWeCTBA), Thii KaTO OcHoRHaTa WacT OT BoaaTa ce pead-
copéipa a npenxonuiire Yaeri Ka Hedpona (nr 13.18).
Kopmuxo-nanurapnwim oemomunen epaduenm ce cnsda-
aa 0m RPOMUGOMOKOS MHODKCUMENEH MeXaIUZsM, ONEpUpaty
6 Gpuucama ua Xenne u ce noddyprca om npomusomoxos
oGucnnur @ Medynapnume xpeaonocn cvdoce w perupxyme-
panemo na ypexma.
XapaxrepHoro yerpoiicrao wa Opum«ara Ha
Xewne st onpesenenmre or Hero hynxnnonannH
OcobeHOCTH ca 8 CCHORATA Ha cHMARANETO Ha
KOpTHNO-naNKnapHHA OcMOTHYeH rpaanern Y
woxeka 0x00 20% or nedppornste ca 1oKcTame-
aynapHa ¢ mbatra OpunKa Ha Xesne w vasa recta,
XOHTO HaBAWBAT ;RBAGOXO & MeaysIaTa NpeAN Aa ce
pepHat xbM Kopata, Camo Gozafiimmnte 4 sTH-
irre itwar Gpraxa Ha Xevne 4 worn 1a KOR-
uextpupar ypunara, KKMBoTHNCKH aiLOLe © 110-
sara SpyiwKa Ha Xewre koUUeHTpApAT TO-cHAKO
OF npoxcuMannnre TyGyaK 8 suaxXomsMATA
‘act Ha SpmmKara wa Xewae Hasnusa W00cMo-
‘tauna yprtia oxon0 (300 mosmvkg HQ). Axo cn
NpencranHy, Ye cnen WTBMBANe Ha GpHMKaTa
veanara ee TOBA cTMpAa NOTOKa, ocmonamHTe-
Tor 8 anata GpHnka we Geae 300 mosnvkg H,O
120 Nac
‘100 Af 300
NaCl H:0 Ypen
1200
‘bur 13.18. Koprinxo-amsmapen ocoruen rpaamert (300-1200
mosm/kg H,O)
(®ur. 15.20). B neGenoto sysxommne pao Ha
Spmckara na Xevine ce peaScopoupar Na’, Kt,
9 npeacram
2 MpaTHMOTONOD MinaaTtere-ze MeXaKEIM 288 /Pusuonozua
Ci i apynns Hom, Ho He ce peaScopSupa ona, nopaut KO-
e0 OcMonaniterst Ha tyGyanata TewocT MaMactApa, a TOR
va metepotHunyMa ce ysenmasa, Tlopann aucoxara npo-
AYCKMMOCT 32 HORA Ha ENHTEAFUITE KAETKU Ha HUBKOAAMLOTO
pawo Ha Gpuokara Ha Xewste, BOMHM MoneKyAN npeMAHaBat
bM XIMMepocMOapHia HATEPCTHLAYM 1 ocMoaamItTeTST Ha
ryOyatiara TeIHOCT B HIESXOARULOTO paMo HapacToa H ce H-
pamiiea c To3it ha wirreperiamyMa. Measay TyGynnara Te
MOCT B ChOTRETCTRALIH TONKH HA aIReTe pameHa Ha GpinMkara
va Xewne ce yotaxonana ooMor4na pasmxa or 200 mosm/
kg H,O. Crofinocrra a noctosnia pasanxa or 200 mosn/
kg H.O ce onpezena of ornomenneto weauly axTuBnocrTa Ha
Na‘/K* nowna n crenenra na napauerynapnara 2udy3na Ha
fionit Kost TyGysuaTa TeMHOcT oT uHTepcrHuHyMa, Or ettep-
Talika meatia Touka TOsH MPOLEC € HSOHOMHYEH, JaULOTO ce
caerkna AO CRANABAHE Ha CoMOTHNES rpanneHT caMo OT 200
mosm/kg 4,0.
* Xunepocmorimaoetra Ha OvOpeuin Meaynapen uTep=
eTiunyst ce caaaasa (