I¶¶OKPATEIA 2000, 4, 2: 85-89
¶ƒø∆√∆À¶∏ ∂ƒ°∞™π∞
EÎÊÚ·ÛÙÈÎfiÙËÙ· ÙÔ˘ ÁfiÓÔ˘ Ù˘ ÔÏ˘Î˘ÛÙÈ΋˜ ÓfiÛÔ˘ ÙˆÓ
ÓÂÊÚÒÓ - Â›Ó·È ‰È·ÊÔÚÂÙÈ΋ ̤۷ ÛÙËÓ ›‰È· ÔÈÎÔÁ¤ÓÂÈ·;
∆. ∆Û›ÙÛÈÔ˜, ¡. ™ˆÙËÚ·ÎfiÔ˘ÏÔ˜, ª. ªÔ˘Ú·Ù›‰Ô˘, ™. ¶··Ó·ÛÙ·Û›Ô˘, ∫. ª·˘ÚÔÌ·Ù›‰Ë˜
ªÔÓ¿‰· ∆¯ÓËÙÔ‡ ¡ÂÊÚÔ‡ (ª∆¡) °ÂÓÈÎÔ‡ ¡Ô̷گȷÎÔ‡ ¡ÔÛÔÎÔÌ›Ԣ ∫ÔÌÔÙËÓ‹˜
∂›Ó·È ÁÓˆÛÙfi fiÙÈ Ë ÔÏ˘Î˘ÛÙÈ΋ ÓfiÛÔ˜ ÙˆÓ
ÓÂÊÚÒÓ ÎÏËÚÔÓÔÌÂ›Ù·È Ì ÙÔÓ ·˘ÙÔۈ̷ÙÈÎfi ÂÈÎÚ·ÙÔ‡ÓÙ· ¯·Ú·ÎÙ‹Ú· Î·È fiÙÈ Ô ·ıÔÏÔÁÈÎfi˜
ÁfiÓÔ˜, Ô ˘‡ı˘ÓÔ˜ ÁÈ· ·˘Ù‹, ¤¯ÂÈ ÔÈΛÏË ‰ÈÂÈÛ‰˘ÙÈÎfiÙËÙ· Î·È ÂÎÊÚ·ÛÙÈÎfiÙËÙ· ·Ó¿ÌÂÛ· ÛÙȘ ‰È¿ÊÔÚ˜ ÔÈÎÔÁ¤ÓÂȘ. µ¤‚·È· ̤۷ ÛÙËÓ ›‰È· ÔÈÎÔÁ¤ÓÂÈ·, ̤¯ÚÈ ÚfiÛÊ·Ù· Ë ÂÎÊÚ·ÛÙÈÎfiÙËÙ· ÙÔ˘
ÁfiÓÔ˘ ıˆÚÔ‡ÓÙ·Ó ÂÓÈ·›· Î·È Ë ·Ó·ÌÂÓfiÌÂÓË ÂÈ‚¿Ú˘ÓÛË Ù˘ ÓÂÊÚÈ΋˜ ÏÂÈÙÔ˘ÚÁ›·˜ Ì ÙËÓ ÚfiÔ‰Ô ÙÔ˘ ¯ÚfiÓÔ˘ ·ÓÙ›ÛÙÔÈ¯Ë Û fiÏ· Ù· ̤ÏË Ù˘.
ªÂ ·ÊÔÚÌ‹ ÙËÓ ·Ó‡ÚÂÛË Ì¤ÏÔ˘˜ ÔÈÎÔÁ¤ÓÂÈ·˜
Ô˘ ÎÏËÚÔÓfiÌËÛ ÙËÓ ÔÏ˘Î˘ÛÙÈ΋ ÓfiÛÔ ÙˆÓ
ÓÂÊÚÒÓ Î·È ‰ÂÓ Â›¯Â ÙËÓ ·Ó·ÌÂÓfiÌÂÓË ÂͤÏÈÍË
(fiÛÔÓ ·ÊÔÚ¿ ÙÔ ‚·ıÌfi ÂÈ‚¿Ú˘ÓÛ˘ Ù˘ ÓÂÊÚÈ΋˜ ÏÂÈÙÔ˘ÚÁ›·˜), ¤ÁÈÓ ÂÎÙ›ÌËÛË Ù˘ ‡·Ú͢
Î·È ¿ÏÏˆÓ Ù¤ÙÔÈˆÓ ÂÚÈÙÒÛÂˆÓ Ì¤Û· Û ¤Ó·
˘ÏÈÎfi 102 ÔÈÎÔÁÂÓÂÈ·ÎÒÓ ‰¤Ó‰ÚˆÓ Ì ÙË ÓfiÛÔ
·˘Ù‹.
¢È·ÈÛÙÒıËΠfiÙÈ Û ٤ÛÛÂÚȘ ÔÈÎÔÁ¤ÓÂȘ ÌÂ
ÔÏ˘Î˘ÛÙÈ΋ ÓfiÛÔ ÙˆÓ ÓÂÊÚÒÓ, Ô˘ ÂÚÈÏ¿Ì‚·-
Ó·Ó 15 ̤ÏË Ì ÙË ÓfiÛÔ, 4 Á˘Ó·›Î˜ (Ì›· Û οıÂ
ÔÈÎÔÁ¤ÓÂÈ·), ‰ÂÓ Â›¯·Ó ÙËÓ ·Ó·ÌÂÓfiÌÂÓË ÂͤÏÈÍË,
fiÛÔÓ ·ÊÔÚ¿ ÙË ÓÂÊÚÈ΋ ÓfiÛÔ. ∂ȉÈÎfiÙÂÚ· ÂÓÒ
·Ó·Ì¤ÓÔÓÙ·Ó Û‡Ìʈӷ Ì ÙËÓ ËÏÈΛ· ÙÔ˘˜ Î·È ÙËÓ
ÂÚÁ·ÛÙËÚȷ΋ ÂÈÎfiÓ· ÙˆÓ ¿ÏÏˆÓ ÌÂÏÒÓ Ù˘ ÔÈÎÔÁ¤ÓÂÈ·˜ Ì ÙË ÓfiÛÔ, Ó· ¤¯Ô˘Ó ÛËÌ·ÓÙÈ΋ ÂÈ‚¿Ú˘ÓÛË Ù˘ ÓÂÊÚÈ΋˜ ÏÂÈÙÔ˘ÚÁ›·˜ ‹ ·ÎfiÌË Î·È
ÙÂÏÈÎfi ÛÙ¿‰ÈÔ ¯ÚfiÓÈ·˜ ÓÂÊÚÈ΋˜ ·ÓÂ¿ÚÎÂÈ·˜
(á∞), ·˘Ù¤˜ ‰È·ÙËÚÔ‡Û·Ó Ê˘ÛÈÔÏÔÁÈ΋ ÓÂÊÚÈ΋
ÏÂÈÙÔ˘ÚÁ›·, ·Ú¿ ÙÔ fiÙÈ Â›¯·Ó fiÏÔÈ ÙÔ˘˜ ›‰ÈÔ˘˜
ÂÈ‚·Ú˘ÓÙÈÎÔ‡˜ ·Ú¿ÁÔÓÙ˜ (fiˆ˜ ˘¤ÚÙ·ÛË,
ÏÂ˘ÎˆÌ·ÙÔ‡¯Ô˜ ‰›·ÈÙ·, ÂÂÈÛfi‰È· ÔÍ›·˜ ÓÂÊÚÈ΋˜ ·ÓÂ¿ÚÎÂÈ·˜).
∞fi ÙË ÌÂϤÙË ·˘Ù‹ Ê·›ÓÂÙ·È fiÙÈ Ë ÂÎÊÚ·ÛÙÈÎfiÙËÙ· ÙÔ˘ ÁfiÓÔ˘ Ù˘ ÔÏ˘Î˘ÛÙÈ΋˜ ÓfiÛÔ˘
ÙˆÓ ÓÂÊÚÒÓ ‰ÂÓ Â›Ó·È ÂÓÈ·›· ̤۷ ÛÙËÓ ›‰È· ÔÈÎÔÁ¤ÓÂÈ·, ÁÂÁÔÓfi˜ Ô˘ ›Ûˆ˜ ·ÔÙÂÏ› ÂÏ›‰· ÁÈ·
ÔÚÈṲ̂ÓÔ˘˜ ·ÛıÂÓ›˜ Ô˘ ÎÏËÚÔÓfiÌËÛ·Ó ÙÔÓ
·ıÔÏÔÁÈÎfi ÁfiÓÔ.
πÔÎÚ¿ÙÂÈ· 2000, 4 (2): 85-89
∏ ÔÏ˘Î˘ÛÙÈ΋ ÓfiÛÔ˜ ÙˆÓ ÓÂÊÚÒÓ Â›Ó·È ÎÏËÚÔÓÔÌÈ΋ Î·È ÌÂÙ·‚È‚¿˙ÂÙ·È Ì ÙÔÓ ·˘ÙÔۈ̷ÙÈÎfi
ÂÈÎÚ·ÙÔ‡ÓÙ· ¯·Ú·ÎÙ‹Ú· 1. ∏ ÂÎÊÚ·ÛÙÈÎfiÙËÙ· ÙÔ˘
ÁfiÓÔ˘ (ˆÓ) Ù˘ Â›Ó·È ÔÈΛÏË, ˆÛÙfiÛÔ Â›Ó·È ‚È‚ÏÈÔÁÚ·ÊÈο ÁÓˆÛÙfi fiÙÈ ·˘Ù‹ Â›Ó·È ÂÚ›Ô˘ ›‰È· ̤۷
ÛÙËÓ ›‰È· ÔÈÎÔÁ¤ÓÂÈ· 2. ¢ËÏ·‰‹ ·Ó·Ì¤ÓÂÙ·È Ë
ÔÚ›· Ù˘ ÓÂÊÚÈ΋˜ ‚Ï¿‚˘ ÂÓ‰ÔÔÈÎÔÁÂÓÂȷο
Ó· Â›Ó·È ·ÓÙ›ÛÙÔÈ¯Ë Î·È Ë ÓfiÛÔ˜ fiˆ˜ ı· ÂÎÊÚ·ÛÙ› Û ¤Ó· ·fi Ù· ÂËÚ·Ṳ̂ӷ ̤ÏË Ù˘, ¤ÙÛÈ
ÂÚ›Ô˘ ı· ÂÎÊÚ·ÛÙ› Î·È ÛÙ· ¿ÏÏ·. ∞ÊÔÚÌ‹ ÁÈ·
ÙË ÌÂϤÙË ·˘Ù‹ ·ÔÙ¤ÏÂÛÂ Ë ‰È·›ÛÙˆÛË fiÙÈ ÔÚÈṲ̂ÓÔÈ ·ÛıÂÓ›˜ Ì ÔÏ˘Î˘ÛÙÈ΋ ÓfiÛÔ ÙˆÓ ÓÂÊÚÒÓ
Ù‡Ô˘ ÂÓËÏ›ÎˆÓ (¶∫¡∂) ‰ÂÓ ·ÚÔ˘Û›·˙·Ó ·ÓÙ›-
ÛÙÔÈ¯Ë ÂÈ‚¿Ú˘ÓÛË Ù˘ ÓÂÊÚÈ΋˜ ÏÂÈÙÔ˘ÚÁ›·˜ ÌÂ
ÙËÓ ÚfiÔ‰Ô ÙÔ˘ ¯ÚfiÓÔ˘ Û ۯ¤ÛË Ì ٷ ÏÔÈ¿
̤ÏË Ù˘ ÔÈÎÔÁÂÓ›·˜ ÙÔ˘˜.
∞™£∂¡∂π™ – ª∂£√¢√π
™ÙË ÌÂϤÙË ·˘Ù‹ ¤ÁÈÓ ηٷÁÚ·Ê‹ ÙˆÓ ÌÂÏÒÓ
102 ÔÈÎÔÁÂÓÂÈ·ÎÒÓ ‰¤Ó‰ÚˆÓ Ì ¶∫¡∂, ÙfiÛÔ ·˘ÙÒÓ
Ì ÙË ÓfiÛÔ, fiÛÔ Î·È ·˘ÙÒÓ Ô˘ ‰ÂÓ ¤ÊÂÚ·Ó ÙÔÓ
·ıÔÏÔÁÈÎfi ÁfiÓÔ Î·È ÂÎÙÈÌ‹ıËÎÂ Ë ÓÂÊÚÈ΋ ÙÔ˘˜
ÏÂÈÙÔ˘ÚÁ›·. ™ÙË Û˘Ó¤¯ÂÈ· ÂÓÙÔ›ÛÙËÎ·Ó 4 ÔÈÎÔÁ¤ÓÂȘ ÛÙȘ Ôԛ˜ ‰È·ÈÛÙÒıËΠfiÙÈ Û ¤Ó· ÙÔ˘Ï¿¯ÈÛÙÔÓ Ì¤ÏÔ˜ ÙÔ˘˜ Ë ÂÈ‚¿Ú˘ÓÛË Ù˘ ÓÂÊÚÈ΋˜
ÏÂÈÙÔ˘ÚÁ›·˜ ‹Ù·Ó ËÈfiÙÂÚË ¤Ó·ÓÙÈ ÙˆÓ ¿ÏψÓ
∞Ó·ÎÔÈÓÒıËΠÛÙËÓ 60Ë ∂ÈÛÙËÌÔÓÈ΋ ™˘Ó‰ڛ·ÛË Ù˘ ∂ÏÏËÓÈ΋˜ ¡ÂÊÚÔÏÔÁÈ΋˜ ∂Ù·ÈÚ›·˜,
£ÂÛÛ·ÏÔÓ›ÎË, ¡Ô¤Ì‚ÚÈÔ˜ 2000
86
T. T™π∆™π√™
ÌÂÏÒÓ. ™Ù· ̤ÏË ÙˆÓ 4 ·˘ÙÒÓ ÔÈÎÔÁÂÓÂÈÒÓ Ô˘
¤ÊÂÚ·Ó ÙÔÓ ·ıÔÏÔÁÈÎfi ÁfiÓÔ (n=15) ηٷÁÚ¿ÊËΠÙÔ Ê‡ÏÔ, Ë ËÏÈΛ·, ÔÈ ·ÛıÂÓ›˜ Ô˘ ¤Î·Ó·Ó
¤Ó·ÚÍË ˘ÔηٿÛÙ·Û˘ Ù˘ ÓÂÊÚÈ΋˜ ÏÂÈÙÔ˘ÚÁ›·˜
Ì Â͈ÓÂÊÚÈ΋ οı·ÚÛË Î·È Ë ¯ÚÔÓÈ΋ ÛÙÈÁÌ‹ Ù˘
¤Ó·Ú͢, fiˆ˜ Î·È Ù· Â›‰· Ù˘ ÎÚ·ÙÈÓ›Ó˘
ÙÔ˘ ÔÚÔ‡ Û fiÛÔ˘˜ ‰ÂÓ ‹Ù·Ó Û ÚfiÁÚ·ÌÌ· Â͈ÓÂÊÚÈ΋˜ οı·ÚÛ˘. ∫·Ù·ÁÚ¿ÊËΠ·ÎfiÌË ÛÙÔ˘˜
·ÛıÂÓ›˜ ·˘ÙÔ‡˜ Ë ·ÚÔ˘Û›· ˘¤ÚÙ·Û˘, fiˆ˜
Î·È Ë Ù‹ÚËÛË ‹ ÌË ÙÔ˘ ‰È·ÈÙÔÏÔÁ›Ô˘ fiÛÔÓ ·ÊÔÚ¿
ÙËÓ ÚÔÛÏ·Ì‚·ÓfiÌÂÓË ÔÛfiÙËÙ· Ï¢ÎÒÌ·ÙÔ˜,
fiˆ˜ Â›Û˘ Î·È Ù· ÂÂÈÛfi‰È· ÔÍ›·˜ ÓÂÊÚÈ΋˜
·ÓÂ¿ÚÎÂÈ·˜ (√¡∞) Ô˘ ›¯·Ó ̤¯ÚÈ ÙË ÌÂϤÙË.
∏ ‰È¿ÁÓˆÛË Ù˘ ÓfiÛÔ˘ Ù¤ıËΠ·fi ÙËÓ ·ÚÔ˘Û›· ıÂÙÈÎÔ‡ ÔÈÎÔÁÂÓÂÈ·ÎÔ‡ ÈÛÙÔÚÈÎÔ‡ ÛÙËÓ ÔÈÎÔÁ¤ÓÂÈ· Î·È ÙËÓ ‡·ÚÍË Î‡ÛÙÂˆÓ ÛÙÔ˘˜ ÓÂÊÚÔ‡˜
ηٿ ÙÔÓ ˘ÂÚ˯ÔÙÔÌÔÁÚ·ÊÈÎfi ¤ÏÂÁ¯Ô (ÁÓˆÛÙ¿
ÎÚÈÙ‹ÚÈ·) 3,4. ∏ ÂÎÙ›ÌËÛË Ù˘ ÓÂÊÚÈ΋˜ ÏÂÈÙÔ˘ÚÁ›·˜ ¤ÁÈÓ Ì ‚¿ÛË Ù· Â›‰· Ù˘ ÎÚ·ÙÈÓ›Ó˘
ÙÔ˘ ÔÚÔ‡ (Ê.Ù. ÂÚÁ·ÛÙËÚ›Ô˘ ¤ˆ˜ 1.6 mg/dl). £ÂˆÚ‹ıËΠfiÙÈ Ô/Ë ·ÛıÂÓ‹˜ ÙËÚÔ‡Û ÙȘ ‰È·ÈÙËÙÈΤ˜
Ô‰ËÁ›Â˜ fiÛÔÓ ·ÊÔÚ¿ ÙËÓ ÚÔÛÏ·Ì‚·ÓfiÌÂÓË ÔÛfiÙËÙ· Ï¢ÎÒÌ·ÙÔ˜ fiÙ·Ó ·Ú·ÎÔÏÔ˘ıÔ‡ÓÙ·Ó ·fi ÙÔ
ÓÂÊÚÔÏÔÁÈÎfi Â͈ÙÂÚÈÎfi È·ÙÚÂ›Ô Î·È ‰‹ÏˆÓ fiÙÈ
ÙȘ ·ÎÔÏÔ˘ıÔ‡ÛÂ Î·È ·Ú¿ÏÏËÏ· ·˘Ùfi ÙÂÎÌËÚÈÒÓÔÓÙ·Ó ·fi ÙËÓ ÂÎÙ›ÌËÛË ÙˆÓ ÂÈ¤‰ˆÓ ÙÔ˘ ·˙ÒÙÔ˘ Ù˘ Ô˘Ú›·˜ ÙˆÓ Ô‡ÚˆÓ 24ÒÚÔ˘ Û ‰‡Ô ÌÂÙÚ‹ÛÂȘ ÁÈ· οı ÂÚ›ÙˆÛË. ÀÂÚÙ·ÛÈÎfi˜ ıˆÚÔ‡ÓÙ·Ó Ô ·ÛıÂÓ‹˜ Ô˘ ›¯Â Û˘ÛÙÔÏÈ΋ ·ÚÙËÚȷ΋
›ÂÛË >150 mmHg ‹ ‰È·ÛÙÔÏÈ΋ ·ÚÙËÚȷ΋ ›ÂÛË
>90 mmHg ‹ fiÙ·Ó Â›¯Â ÔÔÈ·‰‹ÔÙ Â›‰·
·ÚÙËÚȷ΋˜ ›ÂÛ˘ ÂÓÒ ‚Ú›ÛÎÔÓÙ·Ó ˘fi ·ÓÙÈ˘ÂÚÙ·ÛÈ΋ ·ÁˆÁ‹.
∞¶√∆∂§∂™ª∞∆∞
∞fi Ù· 102 ÔÈÎÔÁÂÓÂȷο ‰¤Ó‰Ú·, Û ٤ÛÛÂÚȘ
ÔÈÎÔÁ¤ÓÂȘ Ô˘ ÂÚÈÏ¿Ì‚·Ó·Ó 9 ¿Ó‰Ú˜ (∞) ηÈ
6 Á˘Ó·›Î˜ (°) Ô˘ ¤·Û¯·Ó ·fi ¶∫¡∂, ‰È·ÈÛÙÒıËΠ‰È·ÊÔÚÂÙÈ΋ (ÌË ÂÓÈ·›·) ÂÎÊÚ·ÛÙÈÎfiÙËÙ· ÙÔ˘ ÁfiÓÔ˘ Ù˘ ÙÂÏÂ˘Ù·›·˜. ∂ȉÈÎfiÙÂÚ· ÛÂ
οı ̛· ÙȘ ·fi ÔÈÎÔÁ¤ÓÂȘ ·˘Ù¤˜ 1-4 ¤Ó· ̤ÏÔ˜
Ù˘ ‰ÂÓ ·ÎÔÏÔ‡ıËÛ ÙËÓ ÔÚ›· ÙˆÓ ¿ÏÏˆÓ fiÛÔÓ
·ÊÔÚ¿ ÛÙÔ ‚·ıÌfi ÂÈ‚¿Ú˘ÓÛ˘ Ù˘ ÓÂÊÚÈ΋˜ ÏÂÈÙÔ˘ÚÁ›·˜ (¶›Ó·Î·˜ 1). ŒÙÛÈ Û οı ÔÈÎÔÁ¤ÓÂÈ·
Ì›· Á˘Ó·›Î· ·Ó¿ÌÂÛ· ÛÙ· ·‰¤ÏÊÈ· Ô˘ ÎÏËÚÔÓfiÌËÛ·Ó ÙË ÓfiÛÔ Â›¯Â Ê˘ÛÈÔÏÔÁÈ΋ ÓÂÊÚÈ΋ ÏÂÈÙÔ˘ÚÁ›·, ·Ú¿ ÙÔ fiÙÈ ·Ó·Ì¤ÓÔÓÙ·Ó Ó· ¤¯ÂÈ ÛËÌ·ÓÙÈ΋ ¤ÎÙˆÛ‹ Ù˘ ‹ Ó· ¤¯ÂÈ Î·Ù·Ï‹ÍÂÈ Û ÙÂÏÈÎfi
ÛÙ¿‰ÈÔ Ã¡∞, fiˆ˜ ‰ËÏ·‰‹ Û˘Ó¤‚Ë Ì ٷ ˘fiÏÔÈ· ̤ÏË Ù˘ ÔÈÎÔÁ¤ÓÂÈ¿˜ Ù˘ Ô˘ Â›Û˘ ÎÏËÚÔÓfiÌËÛ·Ó ÙË ÓfiÛÔ.
¶›Ó·Î·˜ 1. √ÈÎÔÁ¤ÓÂȘ (1-4), ʇÏÔ (∞ ‹ °),
ÓÂÊÚÈ΋ ÏÂÈÙÔ˘ÚÁ›· Î·È Ë ·ÓÙ›ÛÙÔÈ¯Ë ËÏÈΛ· ÙˆÓ ·ÛıÂÓÒÓ
(HD=·ÈÌÔοı·ÚÛË, ™º¶∫=Û˘Ó¯‹˜ ÊÔÚËÙ‹ ÂÚÈÙÔÓ·˚΋ οı·ÚÛË)
(̤۷ Û ·Ú¤ÓıÂÛË Ù· Â›‰·
Ù˘ ÎÚ·ÙÈÓ›Ó˘ ÙÔ˘ ÔÚÔ‡ ηٿ ÙËÓ
¤Ó·ÚÍË Ù˘ ÌÂϤÙ˘ ·˘Ù‹˜)
AÛıÂÓ‹˜/ʇÏÔ
(·Ó¿ ÔÈÎÔÁ¤ÓÂÈ·)
1A
1°
1°
2°
2∞
2°
2°
3∞
3∞
3°
3A
4A
4∞
4∞
4°
¡ÂÊÚÈ΋ ÏÂÈÙÔ˘ÚÁ›· ∏ÏÈΛ·
(Cr mg/dl)
Û‹ÌÂÚ·
(4.4 mg/dl)
(1.0 mg/dl)
HD ·fi 46 ÂÙÒÓ
(1.2 mg/dl)
™º¶∫ ·fi 54 ÂÙÒÓ
HD ·fi 50 ÂÙÒÓ
HD ·fi 58 ÂÙÒÓ
(4.5 mg/dl)
HD ·fi 35 ÂÙÒÓ
(0.8 mg/dl)
(2.8 mg/dl)
HD ·fi 52 ÂÙÒÓ
HD ·fi 42 ÂÙÒÓ
HD ·fi 45 ÂÙÒÓ
(0.9 mg/dl)
46 ı¿Ó·ÙÔ˜
52
54
50
59
69
65
42 ı¿Ó·ÙÔ˜
44
47
37
60
54
52
48
¶›Ó·Î·˜ 2. ∞ÛıÂÓ›˜ ·fi ÙȘ ÔÈÎÔÁ¤ÓÂȘ ÌÂ
˘¤ÚÙ·ÛË, ÂÂÈÛfi‰È· √¡∞ Î·È fiÛÔÈ
Ù‹ÚËÛ·Ó ˘ÔÏÂ˘ÎˆÌ·ÙÔ‡¯Ô ‰›·ÈÙ·
√ÈÎÔÁ¤ÓÂÈ· À¤ÚÙ·ÛË §Â˘ÎˆÌ·ÙÔ‡¯Ô˜
‰›·ÈÙ·
1
2
3
4
0/3
4/4
4/4
2 (˘fi HD)/4
π¢π∞ 4/4
π¢π∞ 4/4
π¢π∞ 4/4
1 ŸÃπ/3 ¡∞π
∂ÂÈÛfi‰È·
√¡∞
1/3
1/4
0/4
0/4
∏ ·ÚÔ˘Û›· ˘¤ÚÙ·Û˘ Ô˘ ı· ÌÔÚÔ‡Û ӷ
ıˆÚËı› ÂÈ‚·Ú˘ÓÙÈÎfi˜ ·Ú¿ÁÔÓÙ·˜ Û οı ̛·
·fi ÙȘ ÙÚÂȘ ÚÒÙ˜ ÔÈÎÔÁ¤ÓÂȘ ‰ÂÓ ‰È¤ÊÂÚÂ
ÌÂٷ͇ ÙˆÓ ÌÂÏÒÓ ÙÔ˘˜ (0/3, 4/4, 4/4 ·ÓÙ›ÛÙÔȯ·),
fiˆ˜ Â›Û˘ ›‰È· ‹Ù·Ó Î·È Ë Ù‹ÚËÛË ‰È·ÈÙÔÏfiÁÈÔ˘, fiÛÔÓ ·ÊÔÚ¿ ÛÙ· Ï¢ÎÒÌ·Ù· (x2-test, p=NS).
™ÙËÓ Ù¤Ù·ÚÙË ÔÈÎÔÁ¤ÓÂÈ· ÔÈ ‰‡Ô ·fi ÙÔ˘˜ Ù¤ÛÛÂÚȘ ·ÛıÂÓ›˜ ›¯·Ó ˘¤ÚÙ·ÛË (Î·È ÔÈ ‰‡Ô ‹Ù·Ó
˘fi ·ÈÌÔοı·ÚÛË) Î·È Ô ¤Ó·˜ ‰ÂÓ ·ÎÔÏÔ‡ıËÛÂ
οÔÈÔ ‰È·ÈÙÔÏfiÁÈÔ fiÛÔÓ ·ÊÔÚ¿ ÙËÓ ÚÔÛÏ·Ì‚·ÓfiÌÂÓË ÔÛfiÙËÙ· Ï¢ÎÒÌ·ÙÔ˜ (‚Ú›ÛÎÔÓÙ·Ó ÛÂ
ÙÂÏÈÎfi ÛÙ¿‰ÈÔ Ã¡∞ fiÙ·Ó Ù¤ıËÎÂ Ë ‰È¿ÁÓˆÛË Ù˘
¶∫¡∂ Î·È ·ÔÙ¤ÏÂÛ ÙËÓ ·ÊÔÚÌ‹ Ó· ÂÚ¢ÓËıÔ‡Ó
Î·È Ù· ·‰¤ÏÊÈ· ÙÔ˘). ™ÙËÓ ÚÒÙË Î·È ÙË ‰Â‡ÙÂÚË
I¶¶OKPATEIA 2000, 4, 2
ÔÈÎÔÁ¤ÓÂÈ· ‰È·ÈÛÙÒıËΠ·ÓÙ›ÛÙÔȯ· ¤Ó· ÂÂÈÛfi‰ÈÔ √¡∞ Û ¤Ó· ·ÛıÂÓ‹ οı ÌÈ·˜, ÂÓÒ ÔÈ ˘fiÏÔÈÔÈ ‰ÂÓ Â›¯·Ó ηӤӷ ÂÂÈÛfi‰ÈÔ (¶›Ó·Î·˜ 2),
‰È·ÊÔÚ¤˜ Ô˘ ‰ÂÓ ‹Ù·Ó ÛÙ·ÙÈÛÙÈο ÛËÌ·ÓÙÈΤ˜
(x2, p=NS). ™ÙȘ ‰‡Ô ÔÈÎÔÁ¤ÓÂȘ Ô ·ıÔÏÔÁÈÎfi˜
ÁfiÓÔ˜ ÎÏËÚÔÓÔÌ‹ıËΠ·fi ÙÔÓ ·Ù¤Ú· Î·È ÛÙȘ
¿ÏϘ ‰‡Ô ·fi ÙË ÌËÙ¤Ú·.
™À∑∏∆∏™∏
µÈ‚ÏÈÔÁÚ·ÊÈο ıˆÚÂ›Ù·È fiÙÈ ÂÚÈÛÛfiÙÂÚÔÈ
¿Ó‰Ú˜ ·fi fiÙÈ Á˘Ó·›Î˜ ÂÓÙ¿ÛÛÔÓÙ·È Û ÚfiÁÚ·ÌÌ· Â͈ÓÂÊÚÈ΋˜ οı·ÚÛ˘ 5 Î·È Ì¿ÏÈÛÙ·
Êı¿ÓÔ˘Ó Û ÙÂÏÈÎfi ÛÙ¿‰ÈÔ Ã¡∞ ÓˆÚ›ÙÂÚ· ·fi
fiÙÈ ÔÈ Á˘Ó·›Î˜ 6-10, ÁÂÁÔÓfi˜ Ô˘ ‰È·ÈÛÙÒÛ·ÌÂ
ÎÈ ÂÌ›˜, fiÔ˘ ·Ó¿ÌÂÛ· Û 46 ·ÛıÂÓ›˜ Ì ÙÂÏÈÎfi
ÛÙ¿‰ÈÔ Ã¡∞ (27∞, 19°), ÔÈ ¿Ó‰Ú˜ η٤ÏËÍ·Ó ÛÂ
·˘Ùfi ÛÙ·ÙÈÛÙÈο ÛËÌ·ÓÙÈο ÓˆÚ›ÙÂÚ· ¤Ó·ÓÙÈ ÙˆÓ
Á˘Ó·ÈÎÒÓ (46,6±7,1 Vs 51,6±8,7, p<0,04) 11.
øÛÙfiÛÔ ÔÚÈṲ̂ÓÔÈ Û˘ÁÁÚ·Ê›˜ ‰ÂÓ ‚ڋηÓ
Ù¤ÙÔȘ ‰È·ÊÔÚ¤˜ ·Ó¿ÌÂÛ· ÛÙ· ‰‡Ô ʇϷ 12 ηÈ
η٤ÏËÍ·Ó ÛÙÔ Û˘Ì¤Ú·ÛÌ· fiÙÈ ÔÈ ‰È·ÊÔÚ¤˜ ·˘Ù¤˜
¤¯Ô˘Ó ÙË ÛËÌ·Û›· ÙÔ˘˜ Û ÚÒÈÌ· ÛÙ¿‰È· á∞
(ÎÚ·ÙÈÓ›ÓË ÔÚÔ‡ <3,0 mg/dl) Î·È fiÙÈ Û ·˘Ù‹
ÙË ‰È·ÊÔÚÂÙÈ΋ ÂÎÊÚ·ÛÙÈÎfiÙËÙ·, ÛËÌ·ÓÙÈÎfi ÚfiÏÔ
·›˙Ô˘Ó Ù· ˘„ËÏfiÙÂÚ· Â›‰· ·ÚÙËÚȷ΋˜ ›ÂÛ˘ Ô˘ ¤¯Ô˘Ó ÔÈ ¿Ó‰Ú˜ (p<0,03) ‹ Ë Û˘¯ÓfiÙÂÚË ·ÚÔ˘Û›· ˘¤ÚÙ·Û˘ Û ·˘ÙÔ‡˜, fiˆ˜ ˘ÔÛÙ‹ÚÈÍ·Ó ·Ï·ÈfiÙÂÚ· ¿ÏÏÔÈ Û˘ÁÁÚ·Ê›˜ 13. ∞ÓÙ›ÛÙÔȯ· ¿ÏÏÔÈ Û˘ÁÁÚ·Ê›˜ ˘¤ıÂÛ·Ó fiÙÈ ÔÈ ÔÚÌfiÓ˜ ÙÔ˘ ʇÏÔ˘ (ÔÈÛÙÚÔÁfiÓ· Î·È ·Ó‰ÚÔÁfiÓ·) ηÈ
Ë Û¯¤ÛË ÙˆÓ ‰‡Ô ·˘ÙÒÓ ·›˙Ô˘Ó ÎÚÈÙÈÎfi ÚfiÏÔ
ÛÙË Ú‡ıÌÈÛË Ù˘ ÛÂÈÚ·Ì·ÙÈ΋˜ ‰È‹ıËÛ˘ ηÈ
ÛÙËÓ ÂͤÏÈÍË Ù˘ ÓÂÊÚÈ΋˜ ‚Ï¿‚˘ 14.
Œ¯ÂÈ ·Ó·ÎÔÈÓˆı› fiÙÈ Ë ‰È·ÊÔÚÂÙÈ΋ ÂÎÊÚ·ÛÙÈÎfiÙËÙ· ÛÙËÓ ¶∫¡∂ Û¯ÂÙ›˙ÂÙ·È Ì ÙÔ ·Ó Ë ÁÂÓÂÙÈο ÌÂÙ·‰È‰fiÌÂÓË ÓfiÛÔ˜ ÎÏËÚÔÓÔÌ‹ıËΠ·fi
ÙÔÓ ·Ù¤Ú· ‹ ÙËÓ ÌËÙ¤Ú·. ŒÙÛÈ Ô Bear Î·È ÔÈ
Û˘ÓÂÚÁ¿Ù˜ ÙÔ˘ ‰È·›ÛÙˆÛ·Ó fiÙÈ fiÙ·Ó Ô ·ıÔÏÔÁÈÎfi˜ ÁfiÓÔ˜ ÎÏËÚÔÓÔÌÔ‡ÓÙ·Ó ·fi ÙË ÌËÙ¤Ú·
ÙÔ ÙÂÏÈÎfi ÛÙ¿‰ÈÔ Ù˘ á∞ Â¤Ú¯ÔÓÙ·Ó ÛËÌ·ÓÙÈο
ÓˆÚ›ÙÂÚ· ¤Ó·ÓÙÈ ·˘ÙÒÓ ÛÙÔ˘˜ ÔÔ›Ô˘˜ ÎÏËÚÔÓÔÌÔ‡ÓÙ·Ó ·fi ÙÔÓ ·Ù¤Ú· 15, οÙÈ Ô˘ ÂȂ‚·ÈÒıËÎÂ Î·È ·fi ¿ÏÏÔ˘˜ Û˘ÁÁÚ·Ê›˜ 9,16-18, ÁÂÁÔÓfi˜
‚¤‚·È· Ô˘ ‰ÂÓ ‰È·ÈÛÙÒıËΠÛÙÔ ‰ÈÎfi Ì·˜ ˘ÏÈÎfi,
·ÊÔ‡ ·fi ÙȘ Ù¤ÛÛÂÚȘ ÔÈÎÔÁ¤ÓÂȘ Ô˘ ·Ó·Ê¤ÚÔÓÙ·È, ÛÙȘ ‰‡Ô Ô ÁfiÓÔ˜ ÎÏËÚÔÓÔÌ‹ıËΠ·fi ÙË
ÌËÙ¤Ú· Î·È ÛÙȘ ¿ÏϘ ‰‡Ô ·fi ÙÔÓ ·Ù¤Ú·.
∞˘Ùfi Ô˘ ÂÌ›˜ ‰È·ÈÛÙÒÛ·Ì ÛÙȘ Ù¤ÛÛÂÚȘ
ÔÈÎÔÁ¤ÓÂȘ Ô˘ ·Ó·Ê¤ÚıËÎ·Ó ·Ú·¿Óˆ ‰ÂÓ ‹Ù·Ó
·Ï¿ Ë Î·Ï‡ÙÂÚË ÔÚ›· Ù˘ ¶∫¡∂, fiÛÔÓ ·ÊÔÚ¿
87
ÙË ÓÂÊÚÈ΋ ÏÂÈÙÔ˘ÚÁ›· Û ÔÚÈṲ̂Ó˜ Á˘Ó·›Î˜,
·ÏÏ¿ Ë ‰È·Ù‹ÚËÛ‹ Ù˘ ÛÂ Ê˘ÛÈÔÏÔÁÈο Â›‰·,
¤Ó·ÓÙÈ ÙˆÓ ¿ÏÏˆÓ ÌÂÏÒÓ Ô˘ ÙȘ ÂÚÈÛÛfiÙÂÚ˜
ÊÔÚ¤˜ Ì ·ÓÙ›ÛÙÔÈ¯Ë ËÏÈΛ· ›¯·Ó ‹‰Ë Êı¿ÛÂÈ ÛÂ
ÙÂÏÈÎfi ÛÙ¿‰ÈÔ Ã¡∞ (¶›Ó·Î·˜ 1). ªÂ Ù· ‰Â‰Ô̤ӷ
·˘Ù¿ Û˘ÌʈÓÔ‡Ó Î·È Ô Milutinovic Î·È ÔÈ Û˘ÓÂÚÁ¿Ù˜ ÙÔ˘ Ô˘ ‰È·›ÛÙˆÛ·Ó ÂÓ‰ÔÔÈÎÔÁÂÓÂȷο ÌË
ÔÌÔÈÔÁÂÓ‹ ÚfiÔ‰Ô Ù˘ ÓÂÊÚÈ΋˜ ‚Ï¿‚˘ ÛÙÔ 38%
ÙˆÓ ·ÛıÂÓÒÓ Ô˘ ¤ÊÂÚ·Ó ÙÔÓ ·ıÔÏÔÁÈÎfi ÁfiÓÔ,
fiÙ·Ó Ë Û‡ÁÎÚÈÛË Á›ÓÔÓÙ·Ó Ì ‚¿ÛË ÙËÓ ÎÚ·ÙÈÓ›ÓË ÙÔ˘ ÔÚÔ‡ 19, ÁÂÁÔÓfi˜ Ô˘ ÂȂ‚·ÈÒıËΠηÈ
·fi ¿ÏÏÔ˘˜ Û˘ÁÁÚ·Ê›˜ 18.
™ÙÔ ˘ÏÈÎfi Ì·˜ ‰È·ÈÛÙÒıËÎ·Ó ‰È·ÊÔÚ¤˜ ÛÙËÓ
ÂÎÊÚ·ÛÙÈÎfiÙËÙ· Ô˘ ‰Â ı· ÌÔÚÔ‡Û·Ó Ó· ‰ÈηÈÔÏÔÁËıÔ‡Ó ·fi ÙËÓ ·ÚÔ˘Û›· ‹ ÌË ·Ú·ÁfiÓÙˆÓ
Ô˘ ÂÈ‚·Ú‡ÓÔ˘Ó ÙË ÓÂÊÚÈ΋ ÏÂÈÙÔ˘ÚÁ›·, fiˆ˜
Ë ·ÚÙËÚȷ΋ ˘¤ÚÙ·ÛË, Ë ‰›·ÈÙ· ˆ˜ ÚÔ˜ ÙÔ Ï‡Έ̷ Î·È Ù· ÂÂÈÛfi‰È· ÔÍ›·˜ ÓÂÊÚÈ΋˜ ·ÓÂ¿ÚÎÂÈ·˜, ·ÊÔ‡ ÔÈ ·Ú¿ÁÔÓÙ˜ ·˘ÙÔ› ‰Â ‰È¤ÊÂÚ·Ó ÌÂٷ͇ ÙˆÓ ÌÂÏÒÓ ÙˆÓ ÔÈÎÔÁÂÓÂÈÒÓ. ÿÛˆ˜ ÙË
‰È·ÊÔÚÂÙÈ΋ ÔÚ›· Ù˘ ÓfiÛÔ˘ ̤۷ ÛÙËÓ ›‰È·
ÔÈÎÔÁ¤ÓÂÈ· ı· ÌÔÚÔ‡Û ӷ ÂÍËÁ‹ÛÂÈ Ë ÎÏÈÓÈ΋
Ê·ÈÓÔÙ˘È΋ ÂÙÂÚÔÁ¤ÓÂÈ· ·fi ·ÛıÂÓ‹ Û ·ÛıÂÓ‹,
·ÏÏ¿ Î·È ÛÙÔÓ Î¿ı ¤Ó· ÓÂÊÚfi ¯ˆÚÈÛÙ¿. ŒÙÛÈ ‰È·ÈÛÙÒıËΠfiÙÈ ÔÈ ÓÂÊÚÒÓ˜ Ô˘ ÂÍÂÏ›ÛÛÔÓÙ·È ÛÂ
·ÛÙÂȘ Â›Ó·È ·˘ÙÔ› Ô˘ ÂÎÙfi˜ ·fi ÙÔÓ ·ıÔÏÔÁÈÎfi ÁfiÓÔ Ô˘ ʤÚÔ˘Ó, ¤¯Ô˘Ó ˘ÔÛÙ› Î·È Ì›·
‰Â‡ÙÂÚË ÌÂÙ¿ÏÏ·ÍË ÛÙÔ ·ÏÏËÏfiÌÔÚÊÔ ÁÔÓ›‰ÈÔ
Ô˘ Â›Ó·È ˘‡ı˘ÓÔ ÁÈ· ÙËÓ ¤ÎÊÚ·ÛË Ù˘ ¶∫¡∂
Î·È ÙÔ ÔÔ›Ô ÎÏËÚÔÓÔÌ‹ıËΠ·fi ÙÔÓ Ê˘ÛÈÔÏÔÁÈÎfi ÁÔÓ¤· 20. ¢ËÏ·‰‹ ÌÂÙ¿ ÙË Û‡ÏÏË„Ë ÙÔ˘
ÂÌ‚Ú‡Ô˘ Î·È Î·Ù¿ ÙË ‰È¿ÚÎÂÈ· Ù˘ ˙ˆ‹˜, Û˘Ì‚·›ÓÔ˘Ó ÛˆÌ·ÙÈΤ˜ ÌÂÙ·ÏÏ¿ÍÂȘ ÛÙÔ ‰Â‡ÙÂÚÔ
·ÏÏËÏfiÌÔÚÊÔ ÁÔÓ›‰ÈÔ, Ì ·ÔÙ¤ÏÂÛÌ· ÙÂÏÈο Ó·
Ê·›ÓÂÙ·È fiÙÈ ‰ÂÓ ·ÚΛ Ó· ÎÏËÚÔÓÔÌËı› ÌfiÓÔ
¤Ó·˜ ·ıÔÏÔÁÈÎfi˜ ÁfiÓÔ˜, fiˆ˜ Ï.¯. ÛÙËÓ ÚÔΛÌÂÓË ÂÚ›ÙˆÛË ‰ÂÓ ·Ó·Ù‡ÛÛÔÓÙ·È ÔÈ ÓÂÊÚÈΤ˜ ·ÛÙÂȘ, ·Ó ‰ÂÓ ÌÂÙ·ÏÏ·¯ı› Î·È ÙÔ ·ÓÙ›ÛÙÔÈ¯Ô ·ÏÏËÏfiÌÔÚÊÔ ÁÔÓ›‰ÈÔ. ∞˘Ùfi ÛËÌ·›ÓÂÈ fiÙÈ
ÙÂÏÈο Ë ¶∫¡∂ ‰ÂÓ ÌÂÙ·‚È‚¿˙ÂÙ·È Ì ÙÔÓ ·˘ÙÔۈ̷ÙÈÎfi ÂÈÎÚ·ÙÔ‡ÓÙ· ¯·Ú·ÎÙ‹Ú·, ·ÏÏ¿ ÏÂÈÙÔ˘ÚÁ› Û·Ó ·˘ÙÔۈ̷ÙÈο ˘ÔÙÂÏ‹˜ ÓfiÛÔ˜ 21.
∏ ‰Â‡ÙÂÚË ·˘Ù‹ ÌÂÙ¿ÏÏ·ÍË Â›Ó·È Ù˘¯·›·, Û˘Ì‚·›ÓÂÈ ÛÔÚ·‰Èο Î·È ·Ô‰›‰ÂÙ·È Û ÂÚÈ‚·ÏÏÔÓÙÔÏÔÁÈΤ˜ ‹ ¿ÏϘ ·Èٛ˜ 22. ªÂ Ù· ‰Â‰Ô̤ӷ
·˘Ù¿ Û˘ÌʈÓÔ‡Ó Î·È ¿ÏÏÔÈ Û˘ÁÁÚ·Ê›˜ Ô˘ ˘ÔÛÙ‹ÚÈÍ·Ó fiÙÈ Ë ¶∫¡∂ ·ÔÙÂÏ› ÁÂÓÂÙÈ΋ ÓfiÛÔ
Ô˘ ¯·Ú·ÎÙËÚ›˙ÂÙ·È ·fi ·ÛÙ·ı¤˜ ÎÏËÚÔÓÔÌÔ‡ÌÂÓÔ DNA 17.
™˘ÌÂÚ·›ÓÂÙ·È fiÙÈ Ë ÂÎÊÚ·ÛÙÈÎfiÙËÙ· ÙÔ˘ ÁfiÓÔ˘
Ù˘ ¶∫¡∂ fiÛÔÓ ·ÊÔÚ¿ ÛÙË ÓÂÊÚÈ΋ ‚Ï¿‚Ë ‰ÂÓ
88
T. T™π∆™π√™
Â›Ó·È ÂÓÈ·›· ̤۷ ÛÙËÓ ›‰È· ÔÈÎÔÁ¤ÓÂÈ· Î·È Èı·Ó¿
Ó· Â›Ó·È ËÈfiÙÂÚË ÛÙȘ Á˘Ó·›Î˜. ŒÙÛÈ ˘¿Ú¯ÂÈ Ë
Èı·ÓfiÙËÙ· ÔÚÈṲ̂ÓÔÈ ·ÛıÂÓ›˜ Ô˘ ÎÏËÚÔÓfiÌËÛ·Ó ÙË ÓfiÛÔ, Ó· ÌËÓ ÙËÓ ÂÎÊÚ¿ÛÔ˘Ó ÛÙÔ ‚·ıÌfi
Ô˘ ı· ‰ËÌÈÔ˘ÚÁ‹ÛÂÈ ÛËÌ·ÓÙÈÎfi Úfi‚ÏËÌ· ÛÙË
ÓÂÊÚÈ΋ ÙÔ˘˜ ÏÂÈÙÔ˘ÚÁ›·.
4.
5.
6.
ABSTRACT
Tsitsios T, Sotirakopoulos N, Mouratidou M,
Papanastasiou S, Mavromatidis K. The gene
expression of autosomal dominant polycystic
kidney disease (ADPKD). Is there any
difference within families? Hippokratia 2000,
4 (2): 85-89
Polycystic kidney disease is caused by
mutation in more than two genes and is
characterized by an autosomal dominant
transmission. It is known that the age at which
the onset of end stage renal disease appears is
more homogeneous within families than between
families. We studied 102 genetic trees with
ADPKD, and we found that in four families, 15
patients suffered from the disease, four women
(one from each family) had a different renal
expression of their abnormal gene. Especially
one woman in each of the above four families
continued to have normal renal function while
the other members of the same family had end
stage renal disease or severe renal failure. It is
emphasized that there were no any differences
between the members of the same family,
regarding the existence of hypertension or their
protein diet e.t.c., that in turn could influence
their renal function. So we concluded that
patients with ADPKD from the same family could
have different renal expression of their abnormal
gene.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
µπµ§π√°ƒ∞ºπ∞
19.
1. ª·˘ÚÔÌ·Ù›‰Ë˜ ∫, ™fiÌÔÏÔ˜ ∫. ∏ ÔÏ˘Î˘ÛÙÈ΋ ÓfiÛÔ˜ ÙˆÓ
ÓÂÊÚÒÓ. ∂ΉfiÙ˜: ª·˘ÚÔÌ·Ù›‰Ë˜ ∫, ™fiÌÔÏÔ˜ ∫, £ÂÛÛ·ÏÔÓ›ÎË 1991
2. Zeier M, Geberth S, Stier E, Ritz E. Evolution of renal failure
in autosomal dominant polycystic kidney disease (ADPKD)
is more homogenous within families. Int Congress in
Nephrology, Jerusalem 1993, p. 610
3. Raviine D, Gibson RN, Walter RC, Sheffield IJ, Kincid-Smith
P, Danks DM. Evaluation of ultrasonographic diagnosis criteria
20.
21.
for autosomal dominant polycystic kidney disease. Lancet
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ª·˘ÚÔÌ·Ù›‰Ë˜ ∫. ∂ÎÊÚ·ÛÙÈÎfiÙËÙ· Î·È ‰ÈÂÈÛ‰˘ÙÈÎfiÙËÙ· ÙÔ˘
ÁfiÓÔ˘ Ù˘ ¶∫¡∂ Î·È Ë Û˘ÌÂÚÈÊÔÚ¿ ÙˆÓ ∂ÏÏ‹ÓˆÓ Èı·ÓÒÓ
ÊÔÚ¤ˆÓ ÙÔ˘ ·ıÔÏÔÁÈÎÔ‡ ÁfiÓÔ˘. ™ÙÔ ∑ËÚÔÁÈ¿ÓÓ˘ ¶¡, ∞ÁÚ·ÊÈÒÙ˘ ∞ı., (∂Ή). ∫ÏËÚÔÓÔÌÈΤ˜ ·ı‹ÛÂȘ ÙˆÓ ÓÂÊÚÒÓ,
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