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7/22/2019 SINDROMA HEPATORENAL
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Onphrnm Fnsus
ULMJRHDN @I[NZHRIMNO
Hoi`
Lmsnm Gn`nyu
MLD. ;9;0>>>72
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BNB L
[IMJN@YOYNM
Ulmjrhdn `ipnthrimno (U@R) dirupnfnm fhdpolfnsl tirdlmno pnjn pnslim
slrhsls `ipntls jimgnm nseltis, ynmg jljialmlslfnm sibngnl finjnnm gngno glmcno
nfut jltnmjnl jimgnm holghurln prhgrisla ynmg tircnjl pnjn pimjirltn pimynflt `ntl
birnt tnmpn pimyibnb onlm ynmg sienrn folmls, onbhrnthrls, jnm nmnthdls jnpnt
dimyibnbfnm gngno glmcno.>
[njn U@R fionlmnm ynmg jlcudpnl pnjn glmcno `nmyn birupn figngnonm
aumgsl tnmpn jltnmjnl jimgnm fionlmnm nmnthdl. @no lml jnpnt jlbuftlfnm blon
glmcno tirsibut jltnmsponmtnslfnm pnjn pimjirltn onlm ynmg tljnf jljnpntl fionlmnm
`ntl, dnfn aumgsl glmcno tirsibut nfnm fidbnol mhrdno ntnu pimjirltn ynmg
dimgnondl U@R jlonfufnm trnmspnonmtnsl `ntl dnfn aumgsl glmcnomyn nfnm
fidbnol mhrdno. Uionlm pirubn`nm aumgsl glmcno, pimjirltn U@R cugn jltnmjnl
jimgnm pirubn`nm slrfuonsl nrtirl slstidlf jnm nftlaltns slstid vnshnetlvi imjhgim
ynmg birpirnm jnond tircnjlmyn `lphpirausl fi glmcno.>
Ulmjrhdn `ipnthrimno tircnjl pnjn flrn-flrn : jnrl >;,;;; pimjirltn
pimynflt `ntl, sipirtl gngno `ntl nfut, slrhsls `ntl, ntnu `ipntltls nofh`ho.
Jlonphrfnm nmgfn dhrtnoltnsmyn njnon` oibl` bisnr jnrl ;% pimjirltn
slrhsls jimgnm nseltis ynmg jlrnwnt lmnp. [njn slrhsls jifhdpimsntn jimgnm
nseltis, prhbnbloltns umtuf tircnjlmyn U@R njnon` nmtnrn 0-2; % tlnp tn`um jnm
dimlmgfnt sndpnl :;% jnond oldn tn`um.>,2
[imynflt `ntl dnsl` dirupnfnm dnsnon` fisi`ntnm ynmg pimtlmg jl
Lmjhmisln jnm dhrtnoltns dimlmgfnt jimgnm dumeuomyn fhdpolfnsl slmjrhdn`ipnthrimno dnfn pimtlmg bngl jhftir udud umtuf dimgitn`ul timtnmg slmjrhdn
`ipnthrimno si`lmggn jnpnt dionfsnmnfnm jlngmhsls jnm pimntnonfsnmnnm jimgnm
eipnt jnm tipnt. [njn onphrnm fnsus lml, nfnm jlbn`ns timtnmg slmjrhdn
`ipnthrimno ynmg jltidufnm pnjn onfl-onfl birusln :9 tn`um, ynmg jlrnwnt jl
Bnmgsno [imynflt Jnond [rln RUYJ Nrlalm Ne`dnj pnjn 20 Cuol 2;>2.
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BNB LL
ZLMCNYNM [YUZNFN
2.> Jiaimlsl
Jiaimlsl Ulmjrhdn @ipnth Rimno dimurut hoi` Lmtirmntlhmno Nseltis Eoub
njnon` slmjrhdn folmls ynmg tircnjl pnjn pnslim pimynflt `ntl frhmlf jnm
figngnonm `ntl onmcut sirtn `lpirtimsl phrtno ynmg jltnmjnl hoi` pimurumnm aumgsl
glmcno jnm nbmhrdnoltns ynmg myntn jnrl slrfuonsl nrtirl jnm nftlaltns systid
vnshnetlvi imjhgim.>
[njn glmcno tirjnpnt vnshfhmstrlfsl ynmg dimyibnbfnm oncu alotrnsl
gohdiruous rimjn`, jldnmn slrfuonsl jlounr glmcno tirjnpnt vnshjlonsl nrtirlho ynmg
ouns dimyibnbfnm pimurumnm rislstimsl vnsfuoir slstidlf thtno jnm `lphtimsl.
Disflpum slmjrhdn `ipnthrimno oibl` udud tirjnpnt pnjn pimjirltn jimgnm
slrhsls onmcut, `no lml jnpnt cugn tldbuo pnjn pimjirltn pimynflt `ntl frhmlf ntnu
pimynflt `ntl nfut onlm sipirtl `ipntltls nofh`holf ntnu figngnonm `ntl nfut.
2.2 Lmsljim
Bioud njn jntn ipljidlhohgls timtnmg slmjrhdn `ipnthrimno dnupum jl
Lmjhmisln. Jl Ndirlfn Uirlfnt Ulmjrhd @ipnthrimno dirupnfnm fhdpolfnsl ynmg
sirlmg jltidufnm. Lmsljimsl ynmg jlonphrfnm njnon` >;% pnjn pnslim rnwnt lmnp
jimgnm slrhsls jnm nseltis. [njn slrhsls jifhdpimsntn jimgnm nseltis
fidumgflmnm umtuf tircnjl Ulmjrhd @ipnthrimno njnon` nmtnrn 0-2;% pir tn`um
jnm dimlmgfnt dimcnjl :;% jnond 9 tn`um.>,2
2.5 [nthgimisls
2
[nthgimisls U@R sndpnl sifnrnmg bioud sienrn oimgfnp jlfitn`ul.
@lphtisls pnthgimisls U@R njnon` sibngnl birlfut3 nflbnt slrhsls `ntl (U@) ntnu
pimynflt `ntl tlmgfnt birnt jnm birsndn-sndn jimgnm `lpirtimsl phrtno nfnm
dimgnflbntfnm tircnjlmyn vnshjlontnsl nrtirl sponmfmlf. Qnshjlontnsl lml nfnm
dimgnflbntfnm tircnjlmyn `lphvhoidln nrtirlno simtrno, si`lmggn dirnmgsnmg
nftlvnsl slstid snrna sldpntls, rimlm-nmglhtimslm-nojhstirhm, jnm `hrdhm
nmtljluritlf ynmg sienrn fisiouru`nm nfnm dimyibnbfnm vnshfhmtrlfsl pidbuou`
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jnrn` glmcno. Jl glmcno si`nrusmyn nfnm tircnjl difnmlsdi fhdpimsnsl, mndum
jimgnm nonsnm ynmg bioud cions custru tircnjl fitljnfsildbnmgnm difnmlsdi
fhdpimsnsl lml, ynltu dimlmgfntmyn vnshfhmstrlfthr jlsirtnl pimurumnm
vnshjlonthr.
Bibirnpn stujl dionphrfnm pirubn`nm blhfhdlnwl pnjn pnslim slrhsls
`ipntls jimgnm U@R sibngnl birlfut3
n. @ntl [imurumnm slmtisls nmglhtimslm jnm flmlmhgim [imurumnm pidien`nm rimlm, nmglhtimslm LL, nojhstirhm, imjhthfslm, jnm
vnshprislm
b. [onsdn [imlmgfntnm fnjnr rimlm, nmglhtimslm LL, nojhstirhm, imjhthfslm
mhrnjrimnolm, vnshprislm, imjhtiolm 2 jnm 5, oiufhtrlim E: jnm J:,
fnoslthmlm piptljn jnm `hrdhm nmtljluritlf
[imurumnm fnjnr fnolfrilm, brnjlflmlm jnm mntrluitlf nrtirlnoe. Yrlm ntnu glmcno
[imlmgfntnm rimlm, nmglhtimslm LL, nojhstirhm, imjhtiolm, trhdbhfsnmN2, oiufhtrlim i:, prhstngonmjlm I2, prhstnslfolm, brnjlflmlm.
Anftn stujl jlntns flrnmyn dimumcuffnm bitnpn pnjn pnslim U@R tircnjl
vnshfhmtrlfsl glmcno jimgnm signon nflbntmyn jimgnm difnmlsdi ntnu pnthgimisls
ynmg snmgnt fhdpoifs. Utujl onlm dimyntnfnm bn`wn tircnjl pimurumnm slmtisls
mltrlt hfsljn ynmg dirupnfnm vnshjlonthr funt, pnjn pnslim U@ jnm UR
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Gndbnr 2.>. [nthgimisls tircnjlmyn slmjrhd `ipnthrimno pnjn pnslim jimgnm
pimynflt `ntl birnt ntnu slrhsls `ntl
2.: Gndbnrnm Folmls>,5
Difnmlsdi folmls pimjirltn U@R jltnmjnl jimgnm fhdblmnsl nmtnrn gngno
glmcno, gnmggunm slrfuonsl jnm gngno `ntl. Gngno glmcno jnpnt tldbuo sienrn
piron`nm ntnu prhgrisla jnm blnsnmyn jllfutl jimgnm ritimsl mntrlud jnm nlr ynmg
dimldbuofnm nsltis, ijidn jnm jloutlhmno `yphmntridln, ynmg jltnmjnl hoi`
ifrisl mntrlud urlm ynmg rimjn` jnm pimgurnmgnm fidndpunm bunmg nlr (holgurl-
nmurln).
[imynflt `ntl birnt ntnu slrhsls `ntl
+
@lpirtimsl phrtno
Qnshjlontnsl nrtirlno sponmlf birtndbn`
@lphvhoidl nrtirlno simtrno
Ulmjrhd ipnthrimno
Nftlvnsl3
- Uldpntls- Rimlm/nmglhtimslm/nojhstirhm- @hrdhm nmtljluritlf
Qnshfhmtrlfsl rimno dimlmgfnt
Lmtrnrimno3
vnshfhmstrlfthr dimlmgfnt
Qnshjlonthr dimurum
Qnshfhmtrlfsl rimno oibl` dimlmgfnt
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Gnmggunm slrfuonsl slstidlf ynmg birnt jltnmjnl jimgnm tifnmnm nrtirl
ynmg rimjn`, pimlmgfntnm enrjlne hutput, jnm pimurumnm thtno tn`nmnm pidbuou`
jnrn` slstidlf (Znbio 2)
Znbio 2. Gnmggunm `idhjlmndlf ynmg sirlmg jltidufnm pnjn slmjrhdn
`ipnthrimno
Enrjlne hutput dimlmggl
Zifnmnm nrtirlno dimurum
Zhtno tn`nmnm pidbuou` jnrn` slstidlf dimurum
Zhtno vhoudi jnrn` dimlmggl
Nftlansl systid vnshfhmstrlfthr dimlmggl
Zifnmnm phrtno dimlmggl[hrthsystidle
Zifnmnm pidbuou` jnrn` sponmlf dimurum
Zifnmnm pidbuou` jnrn` glmcno dimlmggl
Zifnmnm nrtirl brne`lno jnm aidhrno dimlmggl
Zn`nmnm pidbuou` jnrn` htnf dimlmggl
Gndbnrnm folmls jnrl uridln cnrnmg jlcudpnl, bigltu cugn jimgnm nmnolsn urlm
jnond finjnnm mhrdno.
Uienrn folmls U@R jnpnt jlbijnfnm ntns 2 tlpi ynltu3
>) Ulmjrhdn @ipnthrimno tlpi L (nfut)Zlpi L jltnmjnl hoi` pimlmgfntnm ynmg eipnt jnm prhgrisla jnrl BYM
(Bohhj urin mltrhgim) jnm frintlmlm sirud ynltu mlonl frintlmlm =2,9 dg/jo ntnu
pimurumnm frintlmlm folrims jnond 2: cnd sndpnl 9;%, finjnnm lml tldbuo jnond
bibirnpn `nrl `lmggn 2 dlmggu.
Gngno glmcno sirlmg jl`ubumgfnm jimgnm pimurumnm ynmg prhgrisla cudon`
urlm, ritimsl mntrlud jnm `lphmntridl. [imjirltn jimgnm tlpi lml blnsnmyn jnond
fhmjlsl folmlf ynmg snmgnt birnt jlsirtnl jimgnm nmurln, holgurln, `lphmntridln jnm
tnmjn gngno `ntl onmcut sipirtl lftirus, imsianohpntl ntnu fhnguohpntl.
Zlpi lml udud pnjn slrhsls nofh`holf bir`ubumgnm jimgnm `ipntltls
nofh`holf, titnpl jnpnt cugn tldbuo pnjn slrhsls mhm nofh`holf. Flrn-flrn 9;%
fnsus U@R tlpi lml tldbuo sphmtnm tnmpn njn anfthr prislpltnsl ynmg jlfitn`ul,
fnjnmg-fnjnmg pnjn sibnglnm pimjirltn tircnjl `ubumgnm sibnb nflbnt ynmg irnt
jimgnm bibirnpn fhdpolfnsl ntnu lmtirvimsl tirnpl (sipirtl lmaifsl bnftirl,
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pirjnrn`nm gnstrhlmtistlmno, pnrnslmtisls tnmpn pidbirlnm ponsdn ixpnmjir,
pidbirlnm jluritlf, pirburufnm aumgsl `ntl, jnm hpirnsl bisnr). Uphmtnmius
bnetirlno pirlthmlrtls (UB[) njnon` pimyibnb udud jnrl pimurumnm aumgsl glmcno
pnjn slrhsls. Flrn-flrn 59% pimjirltn slrhsls jimgnm UB[ tldbuo U@R tlpi L.
U@R Zlpi L njnon` fhdpolfnsl jimgnm prhgmhstlf ynmg snmgnt buruf pnjn
pimjirltn slrhsls, jimgnm dhrtnoltns dimenpnl
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Znbio 5. Frltirln Dnyhr jlngmhstlf U@R birjnsnrfnmLmtirmntlhmno Nseltis Eoub
>. [imynflt `ntl nfut ntnu frhmlf jimgnm gngno `ntl onmcut jnm `lpirtimsl phrtno.2. GAR rimjn`, firntlm sirud =>,9 dg/jo ntnu frintlmlm folrims 2: cnd ? :;
do/dmt.
5. Zljnf njn syhf, lmaifsl bnftirl sijnmg bironmgsumg, fi`lonmgnm enlrnm jnmdimjnpnt hbnt miarhthfslf.
:. Zljnf njn pirbnlfnm aumgsl glmcno jimgnm pidbirlnm ponsdn ifspnmjir >,9 otrjnm jluritle (pimurumnm frintlmlm sirud dimcnjl ? >,9 dg/jo ntnu
pimlmgfntnm frintlmlm folrims dimcnjl = :; do/dmt)
9. [rhtilmurln ? ;,9 g/`nrl jnm tljnf jlcudpnl hbstruftla urhpntl ntnu pimynfltpnrimfld glmcno sienrn uotrnshmhgrnal.
Frltirln tndbn`nm 3
>. Qhoudi urlm ? 9;; do / `nrl
2. Mntrlud urlm ? >; dig/oltir
5. Hsdhonoltns urlm = hsdhonoltns ponsdn
:. Irltrhslt urlm ? 9; /opb
9. Mntrlud sirud ?>5; dig / oltir
Uidun frltirun dnyhr `nrus jlcudpnl jnond dimignffnm jlngmhsn U@R,
sijnmgfnm frltirln tndbn`nm dirupnfnm pimjufumg umtuf jlngmhsn U@R.
Bibirnpn pnfthr prijlfthr umtuf tldbuomyn U@R pnjn pimjirltn slrhsls jimgnm
nseltis jnpnt jlol`nt pnjn tnbio.
Znbio :. Anfthr prijlfthr tldbuomyn U@R pnjn slrhsls jimgnm nseltis
[imlmgfntnm rlmgnm BYM jnm ntnu frintlmlm sirudDimurummyn ifsfrisl nlr sition` pidbirlnm enlrnm
Ifsfrisl mntrlud urlm ynmg rimjn`
@lphtimsl nrtirlno
Nftlaltns ponsdn rimmlm dimlmggl
Fnjnr mhriplmiarlm ponsdn tlmggl
Riarnftir nseltis
Zljnf njn `ipnthdignol
[imlmgfntnm vnseuonr rislstlvi lmjix glmcno
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Jlngmhsls U@R `nrus jlpirtldbnmgfnm pnjn sitlnp pnslim slrhsls `ipntls
ynmg jlsirtnl gngno glmcno holgurlf ntnu mhm holgurlf, titnpl pirou jllmgnt bn`wn
gngno glmcno nfut jnpnt tircnjl pnjn pimynflt `ntl frhmlf nflbnt Mifrhsls tubuonr
nfut (MZN) nzhtidln pririmno, jnm U@R.
2.1 [imntnonfsnmnnm>,2
Undpnl snnt lml bioud njn pimghbntnm iaiftla umtuf U@R, hoi` fnrimn ltu
pimeign`nm tircnjlmyn U@R `nrus dimjnpnt pir`ntlnm ynmg utndn. Jimgnm
dimgitn`ul bibirnpn anfthr pimeitus umtuf tldbuomyn U@R pnjn pimjirltn slrhsls
jimgnm nseltis dnfn fltn jnpnt dimeign` tldbuomyn gngno glmcno pnjn pimjirltn
lml. [idbirlnm ponsdn ifspnmjir sition` pnrnslmtisls jnond cudon` bisnr,
tirutndn nobudlm, dimgurnmgl lmsljim U@R. Bigltu puon pidbirlnm nmtlblhtlf
umtuf dimeign` UB[ pnjn pimjirltn slrhsls `ntl jimgnm rislfh tlmggl umtuf
tldbuomyn fhdpolfnsl lml nfnm dimgurnmgl lmsljim U@R. Njn bibirnpn dhjnoltns
tirnpl jlgumnfnm pnjn pimjirltn jimgnm U@R jimgnm iaif ynmg `nmyn sijlflt ntnu
tljnf njn sndn sifnol.
2.1.> [imntnonfsnmnnm Ydud
U@R sibnglnm bisnr jlpleu hoi` fitljnfsildbnmgnm enlrnm jnm ioiftrholt
pnjn pnslim U@. Hoi` fnrimn pnslim U@ snmgnt simsltla jimgnm pirubn`nm
fisildbnmgnm enlrnm jnm ioiftrholt, dnfn `lmjnrl pidnfnlnm jluritlf ngrisla,
pnrnslmtisls nsltis, jnm ritrlfsl enlrnm ynmg biroibl`nm.
- Zirnpl suphrtla birupn jlit tlmggl fnohrl, jnm rimjn` prhtilm- Fhrifsl fisildbnmgnm nsnd bnsn- @lmjnrl pidnfnlnm HNLMU-
[irlthmltls bnftirlno sphmtnm pnjn U@ `nrus sigirn jlhbntl sijlml jnmsinjifunt dumgflm.
- [imeign`nm imsiohpntl `ipntlf cugn `nrus jlonfufnm jnond rnmgfndimeign` tircnjlmyn U@R.
- @idhjlnolsls bioud pirmn` sienrn ahrdno jltioltl hoi` pnslim U@R, mndumtndpnfmyn tljnf eufup iaiftla jnm iaif sndplmg tlmjnfnm eufup birnt,
dlsnomyn `lphtimsl, fhnguohpntl, sipsls, jnm pirjnrn`nm snournm eirmn.
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tirutndn blon jlfhdblmnsl jimgnm pidbirlnm lmaus nobudlm ntnu fhrifsl nobudlm
sirud. Fhdblmnsl hrmlprisslm jimgnm pimndbn`nm vhoudi ponsdn jimgnm
nobudlm didpirbnlfl aumgsl glmcno jnm dimhrdnofnm pirubn`nm `idhjlmndlf
pnjn pnslim slrhsls jimgnm U@R. Zirnpl lml jnpnt jlgumnfnm jimgnm fiwnspnjnnm
ynmg tlmggl, pnjn bibirnpn pnslim `no lml tljnf jlonmcutfnm fnrimn fhdpolfnsl
lsfidlf.
2.1.5 Zlmjnfnm Lmvnsla
[irlthmihvimhus s`umt
[irlthmihvimhus s`umt tion` jlgumnfnm sienrn sphrnjls pnjn dnsn ynmg
onou jl jnond pionfsnmnnm pnslim-pnslim U@R jimgnm slrhsls. [idnsnmgnm s`umt
dimyibnbfnm nolrnm ynmg tirus dimirus enlrnm nseltis jnrl rhmggn pirlthmiud fi
slrfuonsl slstidlf ynmg birpirnm jnond dimlmgfntfnm eurn` cnmtumg (enrjlne
hutput) jnm pimndbn`nm vhoudi lmtrnvnsfuoir. Iaif `idhjlmndlf jnrl
pirlthmihvimhus s`umt jl`ubumgfnm jimgnm pimifnmnm ynmg myntn jnrl nftlaltns
slstid vnshfhmstrlfthr, pimlmgfntnm ifsfrisl mntrlud jnm bibirnpn fnsus
didpirbnlfl nolrnm jnrn` glmcno jnm oncu alotrnsl gohdiruous, `no mlon` ynmg
dimyibnbfnm rnslhmnolsnsl tlmjnfnm pnjn pimjirltn U@R.
[hrthsystidle s`umt
Nf`lr-nf`lr lml tion` jlpirfimnofnm suntu dithji mhmbijn` jnrl fhdprisl
phrtno ynltu Zrnmscuguonr lmtrn`ipntle phrthsystidle s`umt (ZL[U). Fiumtumgnm
dithji lml jlbnmjlmg jimgnm hpirnsl phrthenvno s`umt njnon` pimurumnm
dhrtnoltns nflbnt hpirnsl.
Fhdpolfnsl ynmg pnolmg sirlmg pnjn pnslim ynmg dimjnpnt pimghbntnm
jimgnm ZL[U njnon` `ipntle imeip`nohp`nty jnm hbstrufsl jnrl stimt. Bibirnpnonphrnm ynmg diolbntfnm sicudon` pnslim eimjrumg didpirol`ntfnm bn`wn
prhsijur lml dimlmgfntfnm aumgsl glmcno pnjn pnslim slrhsls `ntl jimgnm U@R ynmg
tljnf jnpnt ongl umtuf jlonfufnm trnmsponmtnsl `ntl. [imioltlnm jlntns dimumcuffnm
bn`wn ZL[U didbirlfnm bnmynf fiumtumgnm pnjn pimntnonfsnmnnm U@R.
Wnonupum jidlflnm, pimggumnnm ZL[U dnsl` didiroufnm pimioltlnm fhmtrho
umtuf jnpnt dirhfhdimjnslfnm.
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Zrnmsponmtnsl @ntl
Zrnmsponmtnsl `ntl lml sienrn tihrl njnon` tirnpl ynmg tipnt umtuf pimjirltn
U@R, ynmg jnpnt dimyidbu`fnm bnlf pimynflt `ntl dnupum jlsaumgsl glmcnomyn.
Zlmjnfnm trnmspnomtnsl lml dirupnfnm dnsnon` utndn dimglmgnt prhgmhsls buruf
jnrl U@R jnm jnatnr tumggu ynmg ondn umtuf tlmjnfnm tirsibut jl pusnt
trnmsponmtnsl. Uigirn sition` trnmsponmtnsl `ntl, figngnonm aumgsl glmcno jnpnt
jlndntl siondn :0 cnd sndpnl 72 cnd. Uition` ltu oncu alotrnsl gohdiruous duonl
dimgnondl pirbnlfnm.
2.7. [imeign`nm:,9
Rislfh U@R jnpnt jlfurnmgl jimgnm pidnfnlnm tirnpl jluritlf sienrn
bir`ntl-`ntl jnm pidnmtnunm fitnt, pimidunm jlml sitlnp fhdpolfnsl sipirtl
fitljnfsildbnmgnm ioiftrholt, pirjnrn`nm ntnu lmaifsl. Hbnt miarhthfslf jl`lmjnrl.
Rislfh pirburufnm glmcno sition` pnrnslmtisls vhoudi bisnr jlfurnmgl jimgnm
pidbirlnm nobudlm rimjn` gnrnd.
- [imeign`nm lmaifslRislfh sirnmgnm uonmgnm pirlthmltls bnftirlno sphmtnm jlfurnmgl jimgnm
pidbirlnm nmtlblhtlf prhalonfsls. Blon pnslim UB[ dimjnpnt tirnpl nmtlblhtlfn,
pidbirlnm nobudlm nfnm dimgurnmgl arifuimsl jlsaumgsl glmcno. Lmaifsl
bnftirl tircnjl pnjn `ndplr 9;% pnslim jimgnm pirjnrn`nm vnrlsis jnm
pimeign`nm lmaifsl bnftirl jimgnm nmtlblhtlfn prhalonfsls didpirbnlfl
survlvno sifltnr >;%.
- Ifspnmsl vhoudiIfspnmsl vhoudi dimeign` tircnjlmyn gngno glmcno pnjn pnslim UB[,
jlrifhdimjnslfnm pidbirlnm ifspnmsl vhoudi ponsdn jimgnm nobudlm 2;%(>->,9 grnd/fgBB siondn >-5 `nrl) pnjn snnt jlngmhsls umtuf dimeign`
jlsaumgsl slrfuonsl, gnmggunm glmcno, jnm dhrtnoltns.
- [idnfnlnm jluritlf jimgnm blcnfsnmnDimgljimtlalfnsl jhsls iaiftla tirimjn` jluritlf umtuf sitlnp lmjlvlju pnslim
njnon` snmgnt pimtlmg fnrimn gnmggunm aumgsl glmcno nflbnt jluritlf tircnjl
pnjn sifltnr 2;% pnslim nsltis si`lmggn tircnjl pimurumnm vhoudi
lmtrnvnsfuonr.
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>2
- Dimg`lmjnrl pidnfnlnm hbnt miarhthfslf 3 pnslim jimgnm slrhsls jnm nsltisdirupnfnm prijlsphslsl dimjnpnt ndlmhgolfhsljn jimgnm gngno glmcno tircnjl
sifltnr 55%. [imyibnb pimtlmg onlm figngnonm glmcno njnon` pidnfnlnm
MUNLJs. Hbnt lml dimg`ndbnt pidbimtufnm prhstngonmjlm lmtrn rimno ynmg
dimgnflbntfnm pimurumnm myntn aumgsl glmcno jnm ifsrisl Mn+/@2H2 pnjn
pnslim slrhsls jimgnm nsltis.
2.0 [rhgmhsls:,9
[rhgmhsls U@R buruf jnm ududmyn antno jimgnm dhrtnoltns nmtnrn 0;-
: `nrl. Fionmgsumgnm `ljup pnjn U@R tlpi LL blnsnmyn oibl` ondn jnm sifltnr
:->;% pnslim jnpnt dimgnondl piduol`nm aumgsl glmcno. Fionlmnm pnjn U@R
jnpnt rivirslbio sition` trnmsponmtnsl `ntl hrththplf ntnu clfn pimynflt `ntl prldir
jnpnt jlhbntl. Clfn sidbu , blnsnmyn tircnjl fnrimn pirbnlfnm pimynflt `ntl jnm
bufnm fnrimn pimyidbu`nm prldir U@R. Anfthr onlm ynmg cugn birpirnm jnond
fidntlnm njnon` pirjnrn`nm snournm eirmn, lmaifsl bnftirl, jnm fnrslmhdn
`ipnthsiouonr.
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>5
BNB LLL
ON[HRNM FNUYU
LJIMZLZNU3
Mndn 3 Zm. UU
Cimls fiondlm 3 Onfl-onfl
Ydur 3 :9 tn`um
[ifircnnm 3 Uwnstn
Ngndn 3 [rhtistnm
Nondnt 3 [ifnmbnru
Mh. DR 3 71 ;1 75
Dnsuf RU 3 20 Cuol 2;>2
NMNDMIULU
Fiou`nm Ytndn3
Bnjnm tirnsn oidn` sicnf > `nrl UDRU
Rlwnynt [imynflt Uifnrnmg
Uicnf > `nrl UDRU pnslim dimgiou`fnm bnjnm tirnsn oidn`, tljnf dnudnfnm jnm dlmud. [nslim cugn dirnsnfnm duno, mndum tljnf njn dumtn`.
Bntuf birjn`nf, jn`nf birwnrmn putl` jnm sisnf mnans ynmg sidnflm
birtndbn` clfn pnslim tljur tioimtnmg. BNF pnslim cudon`myn sijlflt
jlbnmjlmgfnm blnsnmyn, BNF birwnrmn fumlmg firu`.
2 buonm ynmg onou pnslim dimgiou`fnm pirut sidnflm didbisnr. [irutdidbisnr jlsirtnl jimgnm rnsn sisnf. Uisnf sidnflm birtndbn` clfn pnslim
tljur tioimtnmg, jnm birfurnmg blon pnslim jujuf. [nslim cugn dimgiou`fnmbimgfnf pnjn fijun fnfl. Fijun dntn fumlmg, BNB birwnrmn `ltnd. BNF
fumlmg pifnt, tljnf myirl jnm onmenr. Birnt bnjnm cugn dimurum jrnstls.
9 buonm ynmg onou pnslim dimgiou`fnm myirl pnjn uou `ntl, `lonmg tldbuo,tljnf dimcnonr. Myirl uou`ntl jlsirtnl duno jnm dumtn`. BNB pnslim
mhrdno, tljnf njn BNB birwnrmn `ltnd. Dntn fumlmg jnm [irut jlrnsnfnm
duonl didbisnr. [nslim birhbnt fi RUYJ jnm jlngmhsls dimgnondl
pimynflt `ntl.
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>:
Rlwnynt [imynflt Jn`uou
Zljnf njn rlwnynt tifnmnm jnrn` tlmggl Rlwnynt pimynflt JD jlsnmgfno hoi` pnslim
Rlwnynt [imynflt Fiounrgn
Zljnf njn nmgghtn fiounrgn ynmg dimjirltn pimynflt sipirtl lml
Rlwnynt fiblnsnnm
Dlmud nofh`ho (+) Dirhfhf (+)
[IDIRLFUNNM ALULF (20 Cuol 2;>2)
Utntus gimirnols
Finjnnm udud 3 Zndpnf snflt birnt
Fisnjnrnm 3 ehdphsdimtls
Znmjn vltno
Zifnmnm jnrn` 3 ;; x/dimlt riguoir, iquno, lsl eufup [irmnansnm 3 52 x/dimlt Zidpirntur 3 51,9;E
Fipnon/Oi`ir3
Fhmcumgtlvn nmidls (-/-), sfoirn lftirlf (+/+), ijidn pirlhrbltn (-/-), slnmhsls (-),
aithr `ipntlfud (-), aithr uridlfud (-),pidbisnrnm FGB (-), jivlnsl trnfin (-),
pimlmgfntnm CQ[ (-).
Z`hrnfs3
[uodh3
Lmspifsl 3 bimtuf jnm girnfnm slditrls, ritrnfsl lmtirfhstn (-), spljirmivl (-), vimiftnsl (-)
[nopnsl 3 aridltus rnbn jifstrn 4 slmlstrn [irfusl 3 shmhr jl siouru` onpnmgnm pnru Nusfuotnsl 3 sunrn mnans vislfuoir, rhmf`l (-/-), w`iizlmg (-/-)
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>9
Ehr3
Lmspifsl 3 letus ehrjls tljnf tndpnf [nopnsl 3 letus ehrjls tljnf tirnbn [irfusl 3 bntns cnmtumg jnond bntns mhrdno Nusfuotnsl 3 U>, U2 riguonr, sunrn tndbn`nm (-)
Nbjhdim3
Lmspifsl 3 eidbumg, enput dijusni (+) Nusfuotnsl 3 blslmg usus (+) dimurum [nopnsl 3 jlstimsl (+), myirl tifnm (-) pnjn sidun funjrnm,
`ipnr/olim/glmcno suolt umtuf jlmlonl, jianms duseuonr (-), O[ 4 2)
@b3 >5,0 g/jo
@t3 55.0;; /o
Zrhdbhslt3 7:.;;; /o
Fldln jnrn` (20 Cuol 2;>2)
Gou3 7: dg/jo
BYM3 05 dg/jo
ER-U3 :,;1 dg/jo
NUZ3 2;< LY/O
NOZ3 9; LY/O
NOB3 >,7 dg/jo
Z.Blo3 52,7 dg/jo
J.Blo3 >:,9 dg/jo
Yriud3 >77,1 dg/jo
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>1
RIUYDI
Zm Us, :9 tn`um jntnmg fi RUYJ NN jimgnm fiou`nm fiou`nm bnjnm
tirnsn oidn` sicnf > `nrl UDRU. Jnrl nmndmisls jljnpntfnm bnjnm tirnsn oidn`,
duno (+), tljnf dnu dnfnm jnm dlmud, fijun dntn fumlmg. [irut didbisnr,
bntuf birjn`nf (+), sisnf mnans snnt birbnrlmg. Qhoudi BNF sijlflt, BNF
fumlmg pifnt, BNB birwnrmn `ltnd. Birnt bnjnm dimurum jrnstls, myirl jl uou
`ntl jnm jljlngmhsls dimgnondl pimynflt `ntl 9 buonm ynmg onou. Rlwnynt
fiblnsnnm Dlmud nofh`ho (+) Dirhfhf (+). Jnrl pidirlfsnnm alslf jljnpntfnm
sfoirn lftirlf, pirut jlstimsl, enput dijusni (+), nsltis, s`latlmg juoomiss (+), ujid
tumgfnl (+). Jnrl pidirlfsnnm pimumcnmg jljnpntfnm oiufhslt >5.0;; /o
trhdbhslthpimln (Zrhdbhslt3 7:.;;; /o), `lphnobudlmidln (>,7 dg/jo), BYM
dimlmgfnt (05 dg/jo), frintlmlm dimlmgfnt :,;1 dg/jo).
JNAZNR DNUNON@
>. Bnjnm oidn`2. Lftirus5. Nsltis:. Oiufhslthsls9. Zrhdbhslthpimln1. @lphnobudlmidln7. [imlmgfntnm BYM jnm frintlmlm sirud0. Holghurln
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>7
RIMENMN [IDIRLFUNNM
Eif ioiftrholt
YUG glmcno
[IMNZNONFUNMNNM
LQAJ J9 % >; tpd Lmcifsl aurhsidlj 5 x > ndpuo Lmcifsl Rnmltljlm 2 x > ndpuo Lmcifsl Eiatrlnxhm 2 x > gr Uubstltusl Nobudlm Rimenmn @idhjlnolsn elth
[RHGMHULU
Qltnd 3 dnond
Aumetlhmnd 3 dnond
AHOOHW Y[
Znmggno 22
Uubciftla 3 oidn`, giolsn`, sisnf (+), bntuf(+), tljnf blsn tljur
Hbciftla
Fisnjnrnm 3 shdmhoim
ZJ3 ;; x/l RR 320 x/l Z351 ;E
Qhoud urlm/2:cnd3 ?>;;do
Nssisdimt 3 slmjrhdn `ipnthrimno+imsianohpntl
[onmlmg
Zirnpl onmcut
[nsnmg MGZ
EZD 2x >
Ndbrhxho 5x>
Znmggno 5;-;7-2;>2 (pngl)
Uubciftla 3 sidnflm oidn`, giolsn`, sisnf, bntuf(+), tljnf blsn tljur
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>0
Hbcietla
Fisnjnrnm 3 Uhdmhoim
ZJ3 >;x/l RR 320 x/l Z351 ;E
Qhoud urlm/2:cnd3 ?>;;do
Nssisdimt3 slmjrhd `ipnthrimno +imsianohpntl
[onmlmg
Zirnpl onmcut
Znmggno 5;-;7-2;>2 (shri)
Uubciftla 3 sidnflm oidn`, sidnflm sisnf,
Hbcietla
Fisnjnrnm 3 Uhdmhoim
ZJ3 0;/1; M 3 >>9x/l RR 352 x/l Z351 ;E
Nssisdimt3 slmjrhd `ipnthrimno +imsianohpntl
[onmlmg
Jrlp jhpndlm >2 tpd
BNB LQ
[IDBN@NUNM
Jlonphrfnm pnslim onfl-onfl birudur :9 tn`um ynmg jlrnwnt jl runmg
[imynflt jnond prln RUYJ Nrlalm Ne`dnj jnrl tnmggno 20 Cuol 2;>2 jimgnm
jlngmhsls U@R. Jlngmhsls U@R jljnsnrfnm ntns nmndmisls, pidirlfsnnm alslf
sirtn pidirlfsnnm pimumcnmg.
NMNDMIULU
Jnrl nmndmisls jljnpntfnm bnjnm tirnsn oidn`, duno (+), tljnf dnu
dnfnm jnm dlmud, fijun dntn fumlmg. [irut didbisnr, bntuf birjn`nf (+),
sisnf mnans snnt birbnrlmg. Qhoudi BNF sijlflt, BNF fumlmg pifnt, BNB
birwnrmn `ltnd. Birnt bnjnm dimurum jrnstls, myirl jl uou `ntl jnm jljlngmhsls
dimgnondl pimynflt `ntl 9 buonm ynmg onou. Rlwnynt fiblnsnnmDlmud nofh`ho (+)
Dirhfhf (+).
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>5.0;;/o jnm trhdbhslthpimln jimgnm mlonl 7:.;;; /o. Zrhdbhslthpimlnpnjn
pnslim slrhsls `ntl njnon` tircnjl fnrimn pimlmgfntnm phholmg trhdbhslt pnjn
spoimhdignol, sibngnl nflbnt pirubn`nm `idhjlmndlf ynmg jlsibnbfnm hoi`
`lpirtimsl phrtno.
Fnjnr uriud jnm frintlmlm pnslim lml tlmggl pnjn snnt dnsuf rudn` snflt
dimnmjnfnm tircnjlmyn lmsualsimsl rimno. Fnjnr nobudlm ynmg rimjn`
(`lphnobudlmidln) dimnmjnfnm aumgsl slmtisls `ntl ynmg tirgnmggu jnm fhmslstim
jimgnm finjnnm gngno `ntl.
[idirlfsnnm ioiftrholt si`nrusmyn jlonfufnm. Ymtuf diol`nt fnjnr Mn+
sirud ynmg blnsnmyn dimgnondl pimurumnm jnm fnjnr F+ ynmg dimlmgfnt
(`lpirfnoidln) ynmg sirlmg jltidufnm pnjn gngno glmcno.
[idirlfsnnm YUG glmcno cugn pirou jlonfufnm umtuf didnstlfnm tljnf
njnmyn fionlmnm nmnthdl pnjn glmcno. [njn U@R fionlmnm ynmg jlcudpnl pnjn
glmcno `nmyn birupn figngnonm aumgsl tnmpn jltnmjnl jimgnm fionlmnm nmnthdl.
JLNGMHULU
Jnrl nmndmisls, pidirlfsnnm alslf, jnm pidirlfsnnm pimumcnmg jnpnt
jlsldpuofnm bn`wn pnslim didimu`l gndbnrnm slrhsls fnrimn didimu`l frltirlnlftirlf, nsltis. [nslim cugn didimu`l `ndplr sidun frltirln dnyhr umtuf
jlngmhsls slmjrhdn `ipnthrimno. Gndbnrnm `nslo pidirlfsnnm onbhrnthrlud pnslim
dimgnrn` fi slmjrhdn `ipnthrimno tlpi >, jldnmn tircnjl pimlmgfntnm uriud
(bohhj urin mltrhgim) jnm frintlmlm ynmg prhgrisla jnond wnftu riontla slmgfnt.
[imjirltn jimgnm tlpi lml blnsnmyn jnond fhmjlsl folmlf ynmg snmgnt birnt jimgnm
tnmjn gngno `ntl onmcut sipirtl lftirus jnm imsianohpntl.
Jlngmhsls bnmjlmg pnjn pnslim lml njnon` Mifrhsls tubuonr nfut (MZN).
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2>
MZN riontla sirlmg tircnjl pnjn slrhsls `ipntls jimgnm nsltis, `lphtimsl, sipsls, jnm
miarhthfslf fnrimn hbnt sipirtl ndlmhgolfhsljn tirutndn clfn hbnt lml jlfhdblmnsl
jimgnm siahtnfsld. [njn MZN blnsnmyn sijldim urlm didpirol`ntfnm slolmjir
grnmuonr jnm ifsfrisl mntrlud urlm = >; dIq/o. Imzld urlm sipirtl gnddn
goutndlotrnms piptljnsi, oiuslm ndlmhpiptljnsi, jnm -2 dlfrhgohbuolm jnpnt
jlgumnfnm umtuf didbijnfnm MZN jimgnm U@R.
Jlngmhsls bnmjlmg onlmmyn njnon` nzhtidln pririmno. [njn U@R tirjnpnt
pimurumnm vhoudi vnsfuonr jnm vnshfhmstrlfsl glmcno ynmg jltnmjnl jimgnm
mntrlud sirud ynmg rimjn`, hsdhonoltns urlm ynmg dimlmgfnt, rnslh hsdhonoltns
urlm/ponsdn ynmg dimlmgfnt, jnm rnslh frintlmlm urlm/ponsdn ynmg tlmggl.
Gndbnrnm onbhrnthrlud jnond jnrn` jnm urlm sndn jimgnm nzhtidln pririmno.
Finjnnm lml birbijn jimgnm MZN ynmg jltnmjnl jimgnm dimlmgfntmyn mntrlud
jnond urlm (=5; dIq/O), hsdhonoltns urlm sndn jimgnm ponsdn, rnslh hsdhonoltns
urlm ponsdn ynmg rimjn`, jnm rnslh frintlmlm urlm ponsdn ynmg rimjn` (? 2; 3 >).
[IMNZNONFUNMNNM
[imntnonfsnmnnm slmjrhdn `ipnthrimno ynmg jlonfufnm njnon` birslant
suphrtla ynltu dhmlthrlmg fnjnr urlmi jnm ristrlfsl enlrnm. Zirnpl jialmltla
slmjrhdn `ipnthrimno njnon` trnmsponmtnsl `ntl titnpl tljnf jnpnt jlonfufnm.
>. [imntnonfsnmnnm nsltis pnjn pnslim lml njnon` jimgnm didbirlfnm tirnpljluritlf. Hbnt jluritlf ynmg jlgumnfnm njnon` lmcifsl aurisidlj.
[imntnonfsnmnnm nsltis jnpnt jlonfufnm jimgnm enrn tlrn` bnrlmg jnm jlnwnol
jlit rimjn` gnrnd, fhmsudsl gnrnd sibnmynf 9,2 grnd ntnu ;;-2;; dg sifnol si`nrl. Risphmjluritlf blsn jldhmlthr jimgnm pimurumnm birnt bnjnm ;,9 fg/`nrl. Blon
pidbirlnm splrhmhonfthm tljnf njifunt blsn jlfhdblmnsl jimgnm aurhsidlj
jimgnm jhsls 2;-:; dg/`nrl. [idbirlnm aurhsidlj blsn jltndbn` jhslsmyn
blon tljnf njn risphm jimgnm jhsls dnfsldno >1; dg/`nrl. [nrnslmtisls
jlonfufnm npnblon nsltis snmgnt bisnr. [imgiounrnm nsltis blsn `lmggn :-1 oltir
jnm jlolmjumgl jimgnm pidbirlnm nobudlm.
Hoi` fnrimn pnslim U@ snmgnt simsltla jimgnm pirubn`nm fisildbnmgnm
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22
enlrnm jnm ioiftrholt, dnfn pidnfnlnm jluritlf ngrisla, pnrnslmtisls nsltis, jnm
ritrlfsl enlrnm ynmg biroibl`nm `nrus jl`lmjnrl.
2. [idbirlnm nmtlblhtlf Eiatrlnxhm >g/>2 cnd pnjn pnslim lml birtucunm umtufdimeign` sphmtnm bnetirlno pirlthmltls (UB[). Rislfh sirnmgnm uonmgnm UB[
jlfurnmgl jimgnm pidbirlnm nmtlblhtlf prhalonfsls. Blon pnslim UB[ dimjnpnt
tirnpl nmtlblhtlfn, pidbirlnm nobudlm nfnm dimgurnmgl arifuimsl jlsaumgsl
glmcno.
5. [njn pnslim lml jlrimenmnfnm umtuf dimjnpnt substltusl nobudlm. [idbirlnmnobudlm jnpnt dimeign` jlsaumgsl slrfuonsl jnm tldbuomyn U@R. Nobudlm
dimeign` umjiraloolmg nrtirl jnm nftlvnsl slstid vnshfhmstrlfthr nflbnt
lmaifsl.
:. [nslim lml tljnf jlbirlfnm hbnt vnshjlonthr ntnu vnshfhmstrlfthr.Hbnt-hbntnmvnshjlonthr jlpnfnl pnjn pimjirltn U@R umtuf dimurumfnm rislstimsl
vnsfuoir glmcno. Uijnmgfnm vnshfhmtrlfthr umtuf dimgntnsl vnshjlontnsl
sponmfmlf.
9. @idhjlnolsn tljnf sidpnt jlonfufnm pnjn pnslim lml. Ui`nrusmyn @idhjlnosnjlonfufnm sigirn pnjn pnslim lml fnrimn fnjnr uriud jnm frintlmlm ynmg
tlmggl.
Zirnpl suphrtla tir`njnp glmcno jlonfufnm clfn dumgflm tircnjl
pimyidbu`nm `ntl ntnu fidumgflmnm trnmsponmtnsl `ntl, fnrimn clfn tljnf
dnfn tirnpl suphrtla tir`njnp glmcno `nmynon` didpirondbnt fidntlnm.
Birbngnl tirnpl jnpnt jlonfufnm sipirtl jlnolsls pirlthmino, `idhjlnolsls, ntnu
`idhalotrnsl. @idhjlnolsls jnm jlnolsls pirlthmino jlonfufnm umtuf dimggnmtl
aumgsl glmcno sndblo dimumggu pirbnlfnm pimynflt `ntl ntnu trnmsponmtnsl
`ntl. @idhjlnolsls jnpnt dimgntnsl fitljnfsildbnmgnm nlr jnm ioiftrholt,mndum tljnf jnpnt dimyidbu`fnm U@R.
[RHGMHULU
[nslim lml sujn` tirdnsuf fi jnond fntighrl ynmg didbutu`fnm
trnmsponmtnsl `ntl, titnpl fnrimn prhsijur tirsibut tljnf jnpnt jlonfufnm dnfn
prhgmhsls pnslim dimcnjl buruf (dnond). Uionlm ltu slmjrhdn `ipnthrimno tlpi >
didnmg birfnltnm jimgnm prhgmhsls ynmg buruf.
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25
BNB Q
FIULD[YONM
Zion` jlonphrfnm sihrnmg prln usln :9 tn`um jntnmg jimgnm bnjnm tirnsn
oidn`, duno (+), tljnf dnu dnfnm jnm dlmud, fijun dntn fumlmg. [irut
didbisnr, bntuf birjn`nf (+), sisnf mnans snnt birbnrlmg. Qhoudi BNF sijlflt,
BNF fumlmg pifnt, BNB birwnrmn `ltnd. Birnt bnjnm dimurum jrnstls, myirl jl
uou `ntl jnm jljlngmhsls dimgnondl pimynflt `ntl 9 buonm ynmg onou. Rlwnynt
fiblnsnnmDlmud nofh`ho (+)Dirhfhf (+).
[njn pidirlfsnnm alslf jljnpntfnm njnmyn lftirlf, enput dijusni, nseltis
jnm, ijidn pirlair. Zljnf jltidufnm njnmyn stlgdn slrhsls `ipntls. Ulmjrhd
`ipnthrimno tljnf didlolfl tnmjn ynmg spislalf. Dimjitifsl njnmyn stlgdntn
pimynflt `ntl frhmlf pimtlmg umtuf jlonfufnm fnrimn fibnmynfnm pnslim Ulmjrhd
`ipnthrimno dimgnondl slrhsls.
Jnrl nmndmisls, pidirlfsnnm alslf, jnm pidirlfsnnm pimumcnmg jnpnt
jlsldpuofnm bn`wn pnslim didimu`l gndbnrnm slrhsls `ipntls. [nslim cugn
didimu`l `ndplr sidun frltirln dnyhr umtuf jlngmhsls slmjrhdn `ipnthrimno.
[imntnonfsnmnnm slmjrhdn `ipnthrimno ynmg jlonfufnm njnon` birslant suphrtla
ynltu nmthblhtlf, dhmlthrlmg fnjnr urlmi jnm ristrlfsl enlrnm. Zirnpl jialmltla
slmjrhdn `ipnthrimno njnon` trnmsponmtnsl `ntl titnpl tljnf jnpnt jlonfufnm.
[rhgmhsls slmjrhd `ipnthrimno bnlf vltnd dnupum aumetlhmnd njnon` dnond.
[nslim dimcnonml pirnwntnm siondn 2 `nrl, jnm fidujlnm dimlmggno.
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Jnatnr [ustnfn
>. Uutnjl UD. Ulmjrhdn @ipnthrimno Bnglnm Lodu [imynflt JnondAnfuotns Fijhftirnm Ymlvirsltns Uudntirn Ytnrn. Jlumju` jnrl
`ttp3//olbrnry.usu.ne.lj/jhwmohnj/af/pimyjnond-srldnrynml1.pja
VJlnfsis 5 Ngustus 2;>2T.
2. Uujhyh, Nrl W jff. Bufu Ncnr Lodu [imynflt Jnond Clolj L Ijlsl LQ.[usnt [imirbltnm Jipnrtidim Lodu [imynflt Jnond Anfuotns
Fijhftirnm Ymlvirsltns Lmjhmisln. Cnfnrtn. Cuml 2;;1. :92-:9:
5. Uujumg H. [nrjiji. Ulmjrhd @ipnthrimno. Eirdlm Jumln FijhftirnmMh. >:;, 2;;5 Bnglnm Lodu Fisi`ntnm Nmnf Anfuotns Fijhftirnm
Ymlvirsltns Lmjhmisln/ Rudn` Unflt Ydud [usnt Mnslhmno Jr. Elpth
Dnmgumfusudh, Cnfnrtn
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9. E`nrois FA Mg, Dle`nio @D E`nm, Dhrrls @O Znl, E`rlsthp`ir WFOnd. Dlml-rivliw3 @ipnthrimno Uymjrhdi. Jipnrtdimt ha E`idleno
[nt`hohgy, Z`i E`lmisi Ymlvirslty ha @hmg Fhmg, [rlmei ha Wnois
@hspltno, U`ntlm, @hmg Fhmg.
`ttp3//www.pubdijeimtrno.ml`.ghv/aprimjir.aegl VJlnfsis 5 Ngustus
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http://library.usu.ac.id/download/fk/penydalam-srimaryani6.pdfhttp://www.pubmedcentral.nih.gov/fprender.fcgihttp://www.pubmedcentral.nih.gov/fprender.fcgihttp://library.usu.ac.id/download/fk/penydalam-srimaryani6.pdf