СИНДРОМ ОБСТРУКТИВНОГО АПНОЭ/ГИПОПНОЭ СНА: КРИТЕРИИ СТЕПЕНИ ТЯЖЕСТИ, ПАТОГЕНЕЗ, КЛИНИЧЕСКИЕ ПРОЯВЛЕНИЯ И МЕТОДЫ ДИАГНОСТИКИ
Аннотация
Синдром обструктивного апноэ/гипопноэ сна (СОАГС) является распространённым заболеванием с известным патогенезом, этиологией, факторами риска. До недавнего времени для определения степени СОАГС оценивался индекс апноэ/гипопноэ, но прогностическая ценность определения индекса апноэ/гипопноэ (ИАГ) для оценки тяжести и стратификации риска СОАГС является низкой. Клинически степень тяжести СОАГС не всегда коррелирует с ИАГ, так как необходимо учитывать все осложнения и состояния, которые возникли на фоне СОАГС.
Литература
1. Бузунов Р.В., Легейда И.В., Царёва Е.В. Храп и синдром обструктивного апноэ сна у взрослых и детей: Практическое руководство для врачей. – М., 2013.
2. Вейн А.М., Елигулашвили Т.С., Полуэктов М.Г. Синдром апноэ во сне. – М.: Эйдос Медиа, 2002. – 310 с.
3. Вейн А.М. Бодрствование и сон. – М.: Наука, 1970. – 127 с.
4. Вейн А.М., Хехт К. Сон человека. Физиология и патология. – М.: Медицина, 1989. – 272с
5. Вейн А.М. Медицина сна (лекция) // Кремлевская медицина. Клинический вестник. – 1998. - №5 (дополнительный номер). – С. 70–72.
6. Вейн А.М., Елигулашвили Т.С., Полуэктов М.Г. Синдром апноэ во сне и другие расстройства дыхания, связанные со сном: клиника, диагностика, лечение. – М.: Эйдос Медиа, 2002.
7. Зильбер А.П. Синдромы сонного апноэ. – Петрозаводск: Издательство ПГУ, 1994. – 184 с.
8. Зимин Ю.В., Бузунов Р.В. Сердечно-сосудистые нарушения при синдроме обструктивного сонного апноэ: действительно ли они являются самостоятельным фактором риска смертности больных с этим заболеванием? // Кардиология. – 1997. – Т. 37. N9. – С.85-97.
9. Калинкин А.Л. Кардиоваскулярные осложнения и прогностическое значение обструктивного апноэ сна // Доктор.Ру. – 2014. - № 2. – С. 72-75.
10. Калинкин А.Л. Полисомнографическое исследование // Функциональная диагностика. – 2004. - № 2. – С. 61-65.
11. Калинкин А.Л. Синдром обструктивного апноэ сна – фактор риска артериальной гипертонии // Артериальная гипертензия. – 2003. – Т. 9. № 2. – С. 37-41.
12. Кунельская Н.Л., Тардов М.В., Ивойлов А.Ю. Синдром обструктивных апноэ сна: возрастные аспекты // Медицинский совет. – 2014. - № 3. – С. 67-69.
13. Лопатин А.С., Бузунов Р.В., Смушко А.М. и др. Храп и синдром обструктивного апноэ во сне // Российская ринология. – 1998. - № 4. – С.17–32.
14. Полуэктов М.Г. Синдром обструктивного апноэ во сне. Современные представления и роль // Ожирение и метаболизм. – 2005. - №1. – С. 2.
15. Ротарь O.П., Свиряев Ю.В., Звартау Н.Э. и др. Распространенность синдрома апноэ/гипопноэ во сне среди пациентов с сердечно-сосудистой патологией. // Бюллетень научно-исследовательского института кардиологии им. В.А. Алмазова. – 2004. - № 2 (1). – С. 91-94.
16. Тардов М.В. Храп и синдром обструктивного апноэ во сне // Русский медицинский журнал. – 2011. - № 6. – С. 415.
17. Шнайдер Н.А., Кантимирова Е.А., Алексеева О.В. Современные подходы к диагностики апноэ-гипопноэ сна // Вестник клинической больницы № 51. – 2014. - №5. – С. 37-41.
18. American Academy of Neurology Therapeutics and Technology Assessment Subcommittee. Assessment: techniqnes associated with the diagnosis and management of sleep disorders // Neurology. – 1992. – Vol. 42. – P. 269-275.
19. American Electroencephalographic Society Ad Hoc Guidelines Committee, Robin L. Gilmore, Chairman. Guidelines // J. Clin. Neurophysiol. – 1994. – Vol. 11. – P. 2-126
20. Djonlagic I., Guo M., Matteis P., et al. Untreated sleep-disordered breathing: links to aging-related decline in sleep-dependent memory consolidation// PLoS One. – 2014. - № 9. – P. e85918.
21. Djonlagic I., Saboisky J., Carusona A. Increased sleep fragmentation leads to impaired off -line consolidation of motor memories in humans // PLoS One. – 2012. - №7. – Р. 34106.
22. Guilleminault C., Demen W.C. Sleep apnoea syndromes – N.Y.: Alan R. Liss Inc. 1978.
23. Heinzer R., Vat S., Marques-Vidal P., et al. Prevalence of sleepdisordered breathing in the general population: the HypnoLaus study// Lancet Respir Med. – 2015. - № 3. – Р. 310–318.
24. Johns M.W. A new method for measuring daytime sleepiness: the Epworth sleepiness scale // Sleep. – 1991. – Vol. 14(6). – Р. 540-545.
25. Lindberg E., Elmasry A., Gislason T., et al. Evolution of sleep apnea syndrome in sleepy snorers: a population-based prospective study// Am J Respir Crit Care Med. – 1999. – Vol. 159. – Р. 6024-6027.
26. Malhotra A., Orr J. E., Owens R.L. On the cutting edge of obstructiv e sleep apnoea: where next? // Rapid Review. – 2015. – Vol. 3. – Р. 397-402.
27. Management of obstructive sleep apnoea/hypopnoea syndrome in adults. A national clinical guideline [article online], 2003. — URL: http://www.sign.ac.uk/uidelines/fulltext/73/index. html. [Cited: 2016.06.01]
28. Marin J.M., Gascon J.M., Carrizo S., Gispert J. Prevalence of sleep apnoea syndrome in the Spanish adult population // Int J Epidemiol. – 1997. – Vol. 26. – Р. 381-386.
29. NICE technology appraisal guidance 139, march 2008. Continuous positive airway pressure for the treatment of obstructive sleep apnoea/hypopnoea syndrome, Diagnosis and treatment of obstructive sleep apnea in adults, Institute for Clinical Systems Improveme. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI), 2008.
30. Peppard P.E., Young T., Barnet J.H., et al. Increased prevalence of sleep-disordered breathing in adults // Am J Epidemio. – 2013. – Vol. 177. – Р. 1006–1014.
31. Punjabi N.M., Newman A, Young T., et al. Sleep disordered breathing and cardiovascular disease: an outcome-based definition of hypopneas // Am J. Respir Crit Care Med. – 2008. – Vol. 177 (10). – Р.1150–1155.
32. Punjabi N.M., Beamer B.A. Alterations in glucose disposal in sleepdisordered breathing // Am J Respir Crit Care Med. – 2009. – Vol. 179. – Р. 235–240.
33. Rahangdale S., Yeh S.Y., Novack V., et al. The infl uence of intermittent hypoxemia on platelet activation in obese patients with obstructive sleep apnoea // J Clin Sleep Med. – 2011. – Vol. 7 (2). – Р. 172–178.
34. Shahar E., Whitney C.W., Redline S., et al. Sleep disordered breathing and cardiovascular disease: cross–sectional results of the Sleep Heart Health Study // Am J Respir Crit Care Med. – 2000. – Vol. 163. – Р. 19-25.
35. Sleep–related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force // Sleep. – 1999. – Vol. 22. – Р. 667-689.
36. Thornton A.T., Singh P., Ruehland W.R., Rochford P.D. AASM criteria for scoring respiratoryevents: interaction between apnea sensor and hypopnea definition // Sleep. – 2012. – Vol. 35 (3). – Р. 425-432.
37. Young T., Palta M., Dempsey J., et al. The occurrence of sleep-disordered breathing among middle-aged adults // N Engl J Med. – 1993. - №3. – Р. 1230–1235.
38. Young T., Finn L., Peppard P.E., Szklo–Coxe M., et al. Sleep Disordered Breathing and Mortality: Eighteen–Year Follow–up of the Wisconsin Sleep Cohort // Sleep. – 2009.– Vol. 31 (8). – P.1071–1078.
REFERENCES
1. Buzunov R.V., Legeyda I.V., Tsaryova E.V. Snoring and obstructive sleep apnea syndrome in adults and children: A Practical Guide for Physicians. – Moscow, 2013. (in Russian)
2. Vein A.M., Eligulashvili T.S., Polouektov M.G. Sleep apnea syndrome. – Moscow: Eidos Media, 2002. – 310 p. (in Russian)
3. Vein A.M. Wakefulness and sleep. – Moscow: Nauka, 1970. – 127 p. (in Russian)
4. Vein A.M., Hecht K. Son of man. Physiology and pathology. – Moscow: Meditsina, 1989. – 272 p. (in Russian)
5. Vein A.M. Sleep Medicine (lecture) // Kremlevskaya meditsina. Clinichaskij Vestnik. – 1998. - №5 (extra is.). – P. 70-72. (in Russian)
6. Vein A.M., Eligulashvili T.S., Polouektov M.G. Sleep apnea and other breathing disorders associated with sleep: clinical features, diagnosis, treatment. – Moscow: Eidos Media, 2002. (in Russian)
7. Zilber A.P. Sleep apnea syndrome. – Petrozavodsk: PGU Publishing, 1994. – 184 p. (in Russian)
8. Zimin Y.V., Buzunov R.V. Cardiovascular disorders in obstructive sleep apnea syndrome: whether they are an independent risk factor for mortality in patients with this disease? // Kardiologia. – 1997. – Vol. 37. N9. – P. 85-97. (in Russian)
9. Kalinkin A.L. Obstructive Sleep Apnea: Cardiovascular Complications and Prognostic Significance // Doktor.Ru. – 2014. - № 2. – P. 72-75.
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14. Polouektov M.G. Obstructive sleep apnea. Modern concepts and role. // Ozhirenie I Metabolizm. – 2005. - №1. – P. 2-7. (in Russian)
15. Rotar’ O.P., Sviryaev J.V., Zvartau N.E., et al. Prevalence of sleep apnea syndrome / hypopnea during sleep in patients with cardiovascular disease. // Bulleten Nauchno-Issledovatelskogo Instituta Kardiologii imeni V.A. Almazova. – 2004. – Vol. 2 (1). – P. 91-94. (in Russian)
16. Tardov M.V. Snoring and obstructive sleep apnea syndrome // Russkij Meditsinskij Zhurnal. – 2011. - № 6. – P. 415. (in Russian)
17. Schneider N.A., Kantemirova E.A., Alekseeva O.V. Modern approaches to the diagnosis of sleep apnea-hypopnea // Vestnik Klinicheskoj Bolnitsy № 51. – 2014. - №5. – P. 37-41. (in Russian)
18. American Academy of Neurology Therapeutics and Technology Assessment Subcommittee. Assessment: techniqnes associated with the diagnosis and management of sleep disorders // Neurology. – 1992. – Vol. 42. – P. 269-275.
19. American Electroencephalographic Society Ad Hoc Guidelines Committee, Robin L. Gilmore, Chairman. Guidelines/ / J. Clin. Neurophysiol. – 1994. – Vol. 11. – P. 2-126.
20. Djonlagic I., Guo M., Matteis P., et al. Untreated sleep-disordered breathing: links to aging-related decline in sleep-dependent memory consolidation// PLoS One. – 2014. - № 9. – P. e85918.
21. Djonlagic I., Saboisky J., Carusona A. Increased sleep fragmentation leads to impaired off -line consolidation of motor memories in humans // PLoS One. – 2012. - №7. – Р. 34106.
22. Guilleminault C., Demen W.C. Sleep apnoea syndromes – N.Y.: Alan R. Liss Inc. 1978.
23. Heinzer R., Vat S., Marques-Vidal P., et al. Prevalence of sleepdisordered breathing in the general population: the HypnoLaus study// Lancet Respir Med. – 2015. - № 3. – Р. 310–318.
24. Johns M.W. A new method for measuring daytime sleepiness: the Epworth sleepiness scale // Sleep. – 1991. – Vol. 14(6). – Р. 540-545.
25. Lindberg E., Elmasry A., Gislason T., et al. Evolution of sleep apnea syndrome in sleepy snorers: a population-based prospective study// Am J Respir Crit Care Med. – 1999. – Vol. 159. – Р. 6024-6027.
26. Malhotra A., Orr J. E., Owens R.L. On the cutting edge of obstructiv e sleep apnoea: where next? // Rapid Review. – 2015. – Vol. 3. – Р. 397-402.
27. Management of obstructive sleep apnoea/hypopnoea syndrome in adults. A national clinical guideline [article online], 2003. — URL: http://www.sign.ac.uk/uidelines/fulltext/73/index. html. [Cited: 2016.06.01]
28. Marin J.M., Gascon J.M., Carrizo S., Gispert J. Prevalence of sleep apnoea syndrome in the Spanish adult population // Int J Epidemiol. – 1997. – Vol. 26. – Р. 381-386.
29. NICE technology appraisal guidance 139, march 2008. Continuous positive airway pressure for the treatment of obstructive sleep apnoea/hypopnoea syndrome, Diagnosis and treatment of obstructive sleep apnea in adults, Institute for Clinical Systems Improveme. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI), 2008.
30. Peppard P.E., Young T., Barnet J.H., et al. Increased prevalence of sleep-disordered breathing in adults // Am J Epidemio. – 2013. – Vol. 177. – Р. 1006–1014.
31. Punjabi N.M., Newman A, Young T., et al. Sleep disordered breathing and cardiovascular disease: an outcome-based definition of hypopneas // Am J. Respir Crit Care Med. – 2008. – Vol. 177 (10). – Р. 1150–1155.
32. Punjabi N.M., Beamer B.A. Alterations in glucose disposal in sleepdisordered breathing // Am J Respir Crit Care Med. – 2009. – Vol. 179. – Р. 235–240.
33. Rahangdale S., Yeh S.Y., Novack V., et al. The infl uence of intermittent hypoxemia on platelet activation in obese patients with obstructive sleep apnoea // J Clin Sleep Med. – 2011. – Vol. 7 (2). – Р. 172–178.
34. Shahar E., Whitney C.W., Redline S., et al. Sleep disordered breathing and cardiovascular disease: cross–sectional results of the Sleep Heart Health Study // Am J Respir Crit Care Med. – 2000. – Vol. 163. – Р. 19-25.
35. Sleep–related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force // Sleep. – 1999. – Vol. 22. – Р. 667-689.
36. Thornton A.T., Singh P., Ruehland W.R., Rochford P.D. AASM criteria for scoring respiratoryevents: interaction between apnea sensor and hypopnea definition // Sleep. – 2012. – Vol. 35 (3). – Р. 425-432.
37. Young T., Palta M., Dempsey J., et al. The occurrence of sleep-disordered breathing among middle-aged adults // N Engl J Med. – 1993. - №3. – Р. 1230–1235.
38. Young T., Finn L., Peppard P.E., Szklo–Coxe M., et al. Sleep Disordered Breathing and Mortality: Eighteen–Year Follow–up of the Wisconsin Sleep Cohort // Sleep. – 2009.– Vol. 31 (8). – P.1071–1078.
2. Вейн А.М., Елигулашвили Т.С., Полуэктов М.Г. Синдром апноэ во сне. – М.: Эйдос Медиа, 2002. – 310 с.
3. Вейн А.М. Бодрствование и сон. – М.: Наука, 1970. – 127 с.
4. Вейн А.М., Хехт К. Сон человека. Физиология и патология. – М.: Медицина, 1989. – 272с
5. Вейн А.М. Медицина сна (лекция) // Кремлевская медицина. Клинический вестник. – 1998. - №5 (дополнительный номер). – С. 70–72.
6. Вейн А.М., Елигулашвили Т.С., Полуэктов М.Г. Синдром апноэ во сне и другие расстройства дыхания, связанные со сном: клиника, диагностика, лечение. – М.: Эйдос Медиа, 2002.
7. Зильбер А.П. Синдромы сонного апноэ. – Петрозаводск: Издательство ПГУ, 1994. – 184 с.
8. Зимин Ю.В., Бузунов Р.В. Сердечно-сосудистые нарушения при синдроме обструктивного сонного апноэ: действительно ли они являются самостоятельным фактором риска смертности больных с этим заболеванием? // Кардиология. – 1997. – Т. 37. N9. – С.85-97.
9. Калинкин А.Л. Кардиоваскулярные осложнения и прогностическое значение обструктивного апноэ сна // Доктор.Ру. – 2014. - № 2. – С. 72-75.
10. Калинкин А.Л. Полисомнографическое исследование // Функциональная диагностика. – 2004. - № 2. – С. 61-65.
11. Калинкин А.Л. Синдром обструктивного апноэ сна – фактор риска артериальной гипертонии // Артериальная гипертензия. – 2003. – Т. 9. № 2. – С. 37-41.
12. Кунельская Н.Л., Тардов М.В., Ивойлов А.Ю. Синдром обструктивных апноэ сна: возрастные аспекты // Медицинский совет. – 2014. - № 3. – С. 67-69.
13. Лопатин А.С., Бузунов Р.В., Смушко А.М. и др. Храп и синдром обструктивного апноэ во сне // Российская ринология. – 1998. - № 4. – С.17–32.
14. Полуэктов М.Г. Синдром обструктивного апноэ во сне. Современные представления и роль // Ожирение и метаболизм. – 2005. - №1. – С. 2.
15. Ротарь O.П., Свиряев Ю.В., Звартау Н.Э. и др. Распространенность синдрома апноэ/гипопноэ во сне среди пациентов с сердечно-сосудистой патологией. // Бюллетень научно-исследовательского института кардиологии им. В.А. Алмазова. – 2004. - № 2 (1). – С. 91-94.
16. Тардов М.В. Храп и синдром обструктивного апноэ во сне // Русский медицинский журнал. – 2011. - № 6. – С. 415.
17. Шнайдер Н.А., Кантимирова Е.А., Алексеева О.В. Современные подходы к диагностики апноэ-гипопноэ сна // Вестник клинической больницы № 51. – 2014. - №5. – С. 37-41.
18. American Academy of Neurology Therapeutics and Technology Assessment Subcommittee. Assessment: techniqnes associated with the diagnosis and management of sleep disorders // Neurology. – 1992. – Vol. 42. – P. 269-275.
19. American Electroencephalographic Society Ad Hoc Guidelines Committee, Robin L. Gilmore, Chairman. Guidelines // J. Clin. Neurophysiol. – 1994. – Vol. 11. – P. 2-126
20. Djonlagic I., Guo M., Matteis P., et al. Untreated sleep-disordered breathing: links to aging-related decline in sleep-dependent memory consolidation// PLoS One. – 2014. - № 9. – P. e85918.
21. Djonlagic I., Saboisky J., Carusona A. Increased sleep fragmentation leads to impaired off -line consolidation of motor memories in humans // PLoS One. – 2012. - №7. – Р. 34106.
22. Guilleminault C., Demen W.C. Sleep apnoea syndromes – N.Y.: Alan R. Liss Inc. 1978.
23. Heinzer R., Vat S., Marques-Vidal P., et al. Prevalence of sleepdisordered breathing in the general population: the HypnoLaus study// Lancet Respir Med. – 2015. - № 3. – Р. 310–318.
24. Johns M.W. A new method for measuring daytime sleepiness: the Epworth sleepiness scale // Sleep. – 1991. – Vol. 14(6). – Р. 540-545.
25. Lindberg E., Elmasry A., Gislason T., et al. Evolution of sleep apnea syndrome in sleepy snorers: a population-based prospective study// Am J Respir Crit Care Med. – 1999. – Vol. 159. – Р. 6024-6027.
26. Malhotra A., Orr J. E., Owens R.L. On the cutting edge of obstructiv e sleep apnoea: where next? // Rapid Review. – 2015. – Vol. 3. – Р. 397-402.
27. Management of obstructive sleep apnoea/hypopnoea syndrome in adults. A national clinical guideline [article online], 2003. — URL: http://www.sign.ac.uk/uidelines/fulltext/73/index. html. [Cited: 2016.06.01]
28. Marin J.M., Gascon J.M., Carrizo S., Gispert J. Prevalence of sleep apnoea syndrome in the Spanish adult population // Int J Epidemiol. – 1997. – Vol. 26. – Р. 381-386.
29. NICE technology appraisal guidance 139, march 2008. Continuous positive airway pressure for the treatment of obstructive sleep apnoea/hypopnoea syndrome, Diagnosis and treatment of obstructive sleep apnea in adults, Institute for Clinical Systems Improveme. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI), 2008.
30. Peppard P.E., Young T., Barnet J.H., et al. Increased prevalence of sleep-disordered breathing in adults // Am J Epidemio. – 2013. – Vol. 177. – Р. 1006–1014.
31. Punjabi N.M., Newman A, Young T., et al. Sleep disordered breathing and cardiovascular disease: an outcome-based definition of hypopneas // Am J. Respir Crit Care Med. – 2008. – Vol. 177 (10). – Р.1150–1155.
32. Punjabi N.M., Beamer B.A. Alterations in glucose disposal in sleepdisordered breathing // Am J Respir Crit Care Med. – 2009. – Vol. 179. – Р. 235–240.
33. Rahangdale S., Yeh S.Y., Novack V., et al. The infl uence of intermittent hypoxemia on platelet activation in obese patients with obstructive sleep apnoea // J Clin Sleep Med. – 2011. – Vol. 7 (2). – Р. 172–178.
34. Shahar E., Whitney C.W., Redline S., et al. Sleep disordered breathing and cardiovascular disease: cross–sectional results of the Sleep Heart Health Study // Am J Respir Crit Care Med. – 2000. – Vol. 163. – Р. 19-25.
35. Sleep–related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force // Sleep. – 1999. – Vol. 22. – Р. 667-689.
36. Thornton A.T., Singh P., Ruehland W.R., Rochford P.D. AASM criteria for scoring respiratoryevents: interaction between apnea sensor and hypopnea definition // Sleep. – 2012. – Vol. 35 (3). – Р. 425-432.
37. Young T., Palta M., Dempsey J., et al. The occurrence of sleep-disordered breathing among middle-aged adults // N Engl J Med. – 1993. - №3. – Р. 1230–1235.
38. Young T., Finn L., Peppard P.E., Szklo–Coxe M., et al. Sleep Disordered Breathing and Mortality: Eighteen–Year Follow–up of the Wisconsin Sleep Cohort // Sleep. – 2009.– Vol. 31 (8). – P.1071–1078.
REFERENCES
1. Buzunov R.V., Legeyda I.V., Tsaryova E.V. Snoring and obstructive sleep apnea syndrome in adults and children: A Practical Guide for Physicians. – Moscow, 2013. (in Russian)
2. Vein A.M., Eligulashvili T.S., Polouektov M.G. Sleep apnea syndrome. – Moscow: Eidos Media, 2002. – 310 p. (in Russian)
3. Vein A.M. Wakefulness and sleep. – Moscow: Nauka, 1970. – 127 p. (in Russian)
4. Vein A.M., Hecht K. Son of man. Physiology and pathology. – Moscow: Meditsina, 1989. – 272 p. (in Russian)
5. Vein A.M. Sleep Medicine (lecture) // Kremlevskaya meditsina. Clinichaskij Vestnik. – 1998. - №5 (extra is.). – P. 70-72. (in Russian)
6. Vein A.M., Eligulashvili T.S., Polouektov M.G. Sleep apnea and other breathing disorders associated with sleep: clinical features, diagnosis, treatment. – Moscow: Eidos Media, 2002. (in Russian)
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Опубликована
2018-04-17
Как цитировать
АЛЕКСЕЕВА, Ольга Владимировна et al.
СИНДРОМ ОБСТРУКТИВНОГО АПНОЭ/ГИПОПНОЭ СНА: КРИТЕРИИ СТЕПЕНИ ТЯЖЕСТИ, ПАТОГЕНЕЗ, КЛИНИЧЕСКИЕ ПРОЯВЛЕНИЯ И МЕТОДЫ ДИАГНОСТИКИ.
Сибирский медицинский журнал (Иркутск) 16+, [S.l.], v. 140, n. 1, p. 91-97, апр. 2018.
ISSN 1815-7572. Доступно на: <http://smj.ismu.baikal.ru/index.php/osn/article/view/230>. Дата доступа: 24 фев. 2025
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