2-TUR QANDLI DIABET BILAN OG‘RIGAN BEMORLARDA BUYRAK SURUNKALI KASALLIGINING TURLI KLINIK-LABORATOR FENOTIPLARIDA METABOLIK VA YALLIG‘LANISH MARKERLARINING XUSUSIYATLARI
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2-tip qandli diabet; buyrak surunkali kasalligi; diabetik nefropatiya; BMP-7; sistatin C; albuminuriya; koptokchali filtratsiya tezligi; C-reaktiv oqsil##article.abstract##
Maqsad. 2-tur qandli diabet (2-TQD) bilan og‘rigan bemorlarda hisoblangan koptokchali filtratsiya tezligi (hKFT) va albuminuriya holatiga qarab buyrak surunkali kasalligining (BSK) to‘rtta fenotipining klinik va laborator xususiyatlarini baholash.
Materiallar va usullar. Prospektiv ko‘ndalang tadqiqotga 2-TQD bilan og‘rigan 153 nafar bemor kiritildi va ular to‘rtta guruhga ajratildi: NRF/NA (normal buyrak funksiyasi/normoalbuminuriya, n=35), DRF/NA (pasaygan buyrak funksiyasi/normoalbuminuriya, n=35), NRF/EA (normal buyrak funksiyasi/oshgan albuminuriya, n=35) va DRF/EA (pasaygan buyrak funksiyasi/oshgan albuminuriya, n=30). Nazorat guruhini 18 nafar sog‘lom shaxs tashkil etdi. Demografik, antropometrik, glikemik, lipid, yallig‘lanish va koagulyatsion ko‘rsatkichlar o‘rganildi.
Natijalar. Guruhlar yosh (p<0,001), arterial bosim darajalari, buyrak funksiyasi markerlari, uglevod almashinuvi va yallig‘lanish ko‘rsatkichlari bo‘yicha sezilarli farq qildi. Eng yuqori C-reaktiv oqsil (CRP) darajasi NRF/EA guruhida qayd etildi (24,5±13,1 mg/l). Shu guruhda sistatin C darajasi formal ravishda normal hKFT saqlangan bo‘lishiga qaramay 5,79±2,0 mg/l ga yetdi. Protrombin indeksi albuminuriyali guruhlarda sezilarli darajada yuqori bo‘ldi. BMP-7 darajasi guruhlar o‘rtasida farq qilmagan (p=0,080), biroq u C-peptid bilan ijobiy korrelyatsiyani namoyon etdi (ρ=0,176; p=0,030).
Xulosa. 2-TQD da BSKni ikki o‘q — hKFT va albuminuriya asosida fenotiplash patogenetik mexanizmlarning geterogenligini aniqlash imkonini beradi va bu differensial nefroprotektiv terapiya uchun amaliy ahamiyatga ega. NRF/EA fenotipi subklinik tubulyar disfunksiya fonida yallig‘lanishga moyillik va prokoagulyant holatning ustunligi bilan tavsiflanadi.
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