JIGARNING NOALKOGOLLI YOG‘ KASALLIGIDA KLINIK VA LABORATOR- INSTRUMENTAL TADQIQOTLARNING IMKONIYATLARI
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jigarning noalkogolli yog‘ kasalligi, klinik tekshiruv, laborator ko‘rsatkichlar, ultratovush diagnostikasi, semizlik, steatoz, elastografiya##article.abstract##
Kirish: So‘nggi yillarda jigarning noalkogolli yog‘ kasalligi (JNYK) dunyo miqyosida dolzarb tibbiy muammoga aylandi. Zamonaviy turmush tarzi, nosog‘lom ovqatlanish, jismoniy faollikning kamligi, semizlik, metabolik sindrom va 2-tur diabet JNYKning keskin ortishiga sabab bo‘lmoqda. Klinik amaliyotda mazkur kasallikni erta va aniq tashxislash uchun klinik, laborator va instrumental usullardan foydalanish zarur. Tadqiqotning maqsadi — JNYK bosqichlarini aniqlashda klinik-laborator va instrumental metodlarning imkoniyatlarini baholash.
Usullar: Tadqiqot Samarqand davlat tibbiyot universitetining 1-sonli ko‘p tarmoqli klinikasida o‘tkazilib, unda JNYKning turli bosqichlaridagi 120 nafar bemor ishtirok etdi (55 erkak, 65 ayol, yoshi 19 dan 77 gacha). 25 nafar sog‘lom shaxs nazorat guruhi sifatida kiritildi. Tekshiruvlar shikoyatlarni yig‘ish, umumiy ko‘rik, laborator tekshiruvlar (ALT, AST, bilirubin, glyukoza, xolesterin) va jigarning kulrang shkalali ultratovush tekshiruvi (o‘lchami, exogenligi, ovoz o‘tkazuvchanligi, qon tomir tuzilishi)ni o‘z ichiga oldi.
Natijalar: Bemorlarning 42,5%da I daraja, 30%da II daraja, 19,1%da III darajali semizlik aniqlandi. Shikoyatlar orasida holsizlik (50,8%), o‘ng qovurg‘a ostida og‘irlik (45%), ishtaha kamayishi (38,3%) va ko‘ngil aynishi (30,8%) yetakchi o‘rinda turdi. Laborator natijalarda ALT, bilirubin va xolesterinning yuqoriligi ayniqsa og‘ir bosqichlarda kuzatildi. UTTda jigar kattalashishi (20,8%), ovoz o‘tkazuvchanligi pasayishi (70%), jigar va portal venalarning yomon ko‘rinishi (20%), xoletsistit (21,6%) va surunkali pankreatit (8,3%) qayd etildi. UTT asosida 55 bemorda I daraja, 41 bemorda II, 24 bemorda esa III darajali gepatoz aniqlandi. UTT diagnostikasi orqali yog‘li gepatozni aniqlash ko‘rsatkichi 75%ni tashkil etdi.
Muhokama: Natijalar shuni ko‘rsatadiki, klinik, laborator va instrumental usullarni kompleks qo‘llash JNYKni aniqlash va bosqichlashda samarali hisoblanadi. ALT va xolesterin oshishi kasallikning erta laborator belgisi sifatida xizmat qiladi. Kulrang shkalali UTT informativ bo‘lsa-da, og‘ir bosqichlarda sezuvchanligi past bo‘lganligi sababli elastografiya kabi ilg‘or texnologiyalarni qo‘llash zarur. Diagnostik algoritmlarni ishlab chiqish JNYKni erta aniqlash va samarali davolash strategiyalarini yaratishga xizmat qiladi.
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