Totalité de la thèse de E. Sarlandie de la Robertie - CMGE

!
"!
!"#$%&'#(%)*#%&&%)%()+,&#%)-!&#%)
*,&#')$#)
.,-!/(%)0%)+%0%-#"%)*#%&&%)%()+,&#%)-!&#%)
ANNEE$2012$
$
$
$
(1%'%))
02-(2&,()%")+%0%-#"%)
'*%-#,/#(%)+%0%-#"%)3%"%&,/%)
N°2012PA06G063$
$
$
$
$
*4567)78)9:;4<7)=7)>;)=?@>7@4)=7)>A?B5B7)
C?D7887);5<@E)F)
&7G4H678B;B5?8)=76)CH=79586)
<H8H4;>56B76)
$
$
Par$%C7>587)',&/,"0#%)=7)/,)&2I%&(#%$
Née$le$15$avril$1982$à$Perpignan$
Présentée$et$soutenue$publiquement$le$C;4=5)J)=H97CK47)LMNL$
$
$
$
$
$
$
O@4D)
$
DIRECTEUR$DE$THESE$:$Madame$le$Professeur$Anne‐Marie$Magnier$
PRESIDENT$DE$THESE$:$Monsieur$le$Professeur$Emmanuel$Grimprel$
$$$$$$$$ASSESSEUR$:$Monsieur$le$Professeur$Jean$Lafortune$
$ASSESSEUR$:$Madame$le$Docteur$Esther$Soyeux$

!
#!
$
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
“Guérir$parfois,$soulager$souvent,$écouter$toujours.”$
Louis$Pasteur$
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!

!
$!
)
&7C74957C78B6))
!
!"#$%&'()*"+(",*$-(&&()*".//0%)(+"1*'/2*(+3"2*4&'5(%6"5)"7)*89"
%&'(!)*!+,-.*(!/01&22*'3!4*!536(-4*3!7*!8'39!*.!8*!:&'(!*2!3*)*37-*;!%&(!7&)56.*27*(!
('3!/*!('8*.!67/,-3*3&2.!2&.3*!.3,:,-/;!
!
!"#050/("+(",*$-(&&()*"!%%(:#0*'("#0;%'(*9"
<*37-!40,:&-3!,77*5.6!40=.3*!),!4-3*7.3-7*!4*!.1>(*;!%&(!7&)56.*27*(?!:&.3*!4-(5&2-@-/-.6!
*.!:&.3*!*A-B*27*!)0&2.!5*3)-(!406:&/'*3!4,2(!)&2!.3,:,-/!*.!40,553*243*!C!71*371*3!/*!
<-*'A;!D2!@*/!,553*2.-((,B*!4*!:-*!E!
!
!"#$%&'()*"+(",*$-(&&()*"<(0%"=0-$*6)%(9"
F*!:&'(! 3*)*37-*!5&'3! /0-2.63=.!G'*! :&'(!,:*H! 5&3.6!C! )&2!.3,:,-/;! F*!('-(! 1&2&36*!4*!
:&.3*!536(*27*!4,2(!)&2!8'39!4*!.1>(*;!
!
!"#050/("+(">$?6()*".&6@(*"A$8()B9"
<*37-! 4*! )0,:&-3! +,-.! /01&22*'3! 4*! 5,3.-7-5*3! C! )&2! 8'39! 4*! .1>(*;! F*! :&'(! 3*)*37-*!
(567-,/*)*2.!4*!)0,:&-3!B'-46*!*.!67/,-36*!/&3(!4*!/,!7&2(.3'7.-&2!4*!7*!('8*.;!
!
!)B" #45(?'%&" *(+(?6()*&" 5(" +C46)5(9! D2! -))*2(*! )*37-! 5&'3! /*! .*)5(! G'*! :&'(!
)0,:*H!,77&346;!I0*(.!5,3!7*..*!3*/*7.'3*!)'/.-5/*!G'*!/06.'4*!*(.!40,'.,2.!5/'(!+-,@/*!E!
"
!)B" #45(?'%&" ;4%4*0+'&6(&3" 20*6'?'20%6&" 5(&" D-$?)&" ;*$)2E9" <*37-! 5&'3! :&.3*!
4-(5&2-@-/-.6;!J,2(!:&'(?!3-*2!20,'3,-.!6.6!5&((-@/*!E"
!
!)B" #45(?'%&:.%&(';%0%6&" 5)" >.F#1" 5(" A6" !%6$'%(" G'-! (0-2:*(.-((*2.! @*,'7&'5!
,'53>(!4*(!6.'4-,2.(;!<*37-!4*!2&'(!+&3)*3!C!/,!3*71*371*!73-.-G'*!40-2+&3),.-&2(;"
!
!)B" ,*$-(&&()*&" 5(" /45(?'%(" 6$)+$)&0'%&" G'-! )0&2.! .3,2()-(! '2! *2(*-B2*)*2.!
+&24,)*2.,/?!*.!,'!/-.!4'!5,.-*2.?!G',24!8*!+,-(,-(!)*(!53*)-*3(!5,(!*2!.,2.!G'*!(&-B2,2.;"
!
!

!
K!
!"/0"-0/'++(9"
F*!:&'(!3*)*37-*! 4*!)0,:&-3!*27&'3,B6*!.&'.!,'!/&2B! 4*!7*!4-++-7-/*!,553*2.-((,B*!G'*!
(&2.!/*(!6.'4*(!)64-7,/*(;!!
D2!B3,24!)*37-!C!),!3*/*7.3-7*!,..-.36*!G'-!(*!3*7&22,L.3,!EEEE!
"
!"/(&"0/'&9"
<*37-!4*!)0,:&-3!,77&)5,B26*!.&'.!,'!/&2B!4*!7*(!,226*(!E!
!
!"/(&"?$:'%6(*%(&"(6"0/'(&"5("2*$/$9"
M&'3!.&'.!7*!G'*!2&'(!,:&2(!5,3.,B6!40*++&3.(!*.!4*!71,//*2B*(!5&'3!4*:*2-3!)64*7-2!E!
!
#(*?'"G"
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!

!
N!
O226*!'2-:*3(-.,-3*!#P"PQ#P""!
)
*4?P7667@46)=76)@85Q7465BH6)R)*4;B595786)
:?6G5B;>5746)
"!
OIOR!
I13-(.&51*!
I1-3'3B-*!.1&3,7-G'*!
MSTSU!JOVMUTRSURU!
#!
OWDT!
X*23-!
%-3&/&B-*!
MSTSU!JOVMUTRSURU!
$!
OVO<YZSTIX!
J&2-,!
[*'3&/&B-*!
TU[Y[!
K!
!""#"!#$%&'()*+,-).&
F*,2\]3,2^&-(!
M(971-,.3-*!,4'/.*!
MSTSU!JOVMUTRSURU!
N!
O<ORU[IY!
W63,34!
R664'7,.-&2!+&27.-&22*//*!
RYTXJIXSV_!
`!
O<YDRO!
a,1-3!
<64*7-2*!-2.*32*!
MSTSU!JOVMUTRSURU!
b!
O<JUVU<!
J*3B*!
W626.-G'*!
TRYDJJUOD!
c!
O[_RU!
T1-*339!
X65,.&!W,(.3&!U2.63&/&B-*!
MSTSU!JOVMUTRSURU!
d!
O[_RUUVVS!
],@3-H-&!
U24&73-2&/&B-*!
MSTSU!JOVMUTRSURU!
"P!
O[TYS[U!
F*,2\<,3-*!
W9267&/&B-*!&@(.6.3-G'*!
TU[Y[!
""!
OROITS[WS!
J*/-)!
_*3),.&/&B-*!
TU[Y[!
"#!
ORVUT!
W'-//,')*!
e,7.63-&/&B-*!
TU[Y[!
"$!
ORRS%U!
V-&2*/!
R,4-&/&B-*!
JOS[T!O[TYS[U!
"K!
OJTOW[UOD!
M,(7,/!
U5-46)-&/&B-*QJ,2.6!M'@/-G'*!
MSTSU!JOVMUTRSURU!
"N!
ODIYDTDRSUR!
M-*33*!
S))'2&/&B-*!
JOS[T!O[TYS[U!
"`!
OD_Rf!
W*&3B*(!
I1-3'3B-*!:-(763,/*!-2+,2.-/*!
TRYDJJUOD!
"b!
ODRU[WY!
O2436!
e-&519(-G'*Q)64;!['7/6,-3*!
MSTSU!JOVMUTRSURU!
"c!
ODTRO[!
e3-B-..*!
S))'2&/&B-*Q@-&!7*//'/,-3*!
MSTSU!JOVMUTRSURU!
"d!
eOVVO_DR!
M-*33*!
I1-3'3B-*!B6263,/*!
JOS[T!O[TYS[U!
#P!
eORRYD!
e*2&L.!
D3&/&B-*!
MSTSU!JOVMUTRSURU!
#"!
eOJ_U%O[T!
O32,'4!
['.3-.-&2!
MSTSU!JOVMUTRSURU!
##!
eOD_!
V,'3*2.!
UA5/&3,.-&2(!+&27.-&22*//*(!
TU[Y[!
#$!
eODVOI!
<-71*/!
O2,.&)-*Q[*'3&/&B-*!
MSTSU!JOVMUTRSURU!
#K!
eOD<UVYD!
O/,-2!
[6513&/&B-*!
MSTSU!JOVMUTRSURU!
#N!
eOaYT!
<,37!
R,4-&/&B-*!
TU[Y[!
#`!
eUODWURSU!
V,'3*2.!
W,(.3&*2.63&/&B-*Q['.3-.-&2!
JOS[T!O[TYS[U!
#b!
eUODJJSUR!
<,37!
O2*(.16(-&/&B-*QR6,2-),.-&2!
JOS[T!O[TYS[U!
#c!
eUV<S[!
F&g/!
<64*7-2*!-2.*32*QW63-,.3-*!
I1,3/*(!]YSh!
#d!
/%0&1!234&'()*+,-).&
O/@*3.!I/,'4*!
I1-3'3B-*!:,(7'/,-3*!
MSTSU!JOVMUTRSURU!
$P!
eU[S]VO!
F*,2\V&'-(!
W9267&/&B-*!&@(.6.3-G'*!
TRYDJJUOD!
$"!
/%0'2!0&'()*+,-).&
O/@*3.!
[6513&/&B-*!
TRYDJJUOD!
!