VIRUSLI GEPATITLAR VA SISTEMIK INFEKSIYALAR FONIDA GEPATORENAL SINDROMNING ERTA RIVOJLANISHIDA KLINIK VA GENETIK MARKERLARNING PROGNOSTIK AHAMIYATI

Anagul Samadova

Authors

Anagul Samadova Urganch davlat tibbiyot instituti, Ichki kasalliklar, nefrologiya, gemodializ va reabilitologiya kafedrasi assistenti Urganch sh., O‘zbekiston Author

Keywords:

gepatorenal sindrom, virusli gepatit, sistemik infeksiya, sistatin S, glomerulyar filtratsiya

Abstract

Tadqiqot maqsadi — virusli gepatitlar (B va C) va sistemik infeksiyalar fonida gepatorenal sindrom (GRS) erta rivojlanishida klinik-diagnostik va genetik markerlarning prognostik ahamiyatini kompleks baholash. Virusli gepatit tashxisi qo'yilgan 180 nafar bemor tekshirildi: asosiy guruh (GRS rivojlangan, n=92) va nazorat guruhi (n=88). GRS boshlang'ich bosqichlarida sistatin S, mikroalbuminuriya va viral yuklanma darajalaridagi o'zgarishlar bilan glomerulyar filtratsiya tezligi (GFT) o'rtasida ishonchli manfiy korrelyatsiya aniqlandi (r=–0,41; p<0,05). Buyrak ichi gemodinamikasida rezistentlik indeksi (RI) va puls indeksi (PI) ning ishonchli oshishi kuzatildi. TNF (G-308A) va CAT (C-262T) genlarining mutatsiyalangan genotiplari GRS xavfini 2,1–2,4 barobarga oshirishi aniqlandi. SOD2 (Ala16Val) va eNOS (G894T) genlari ham infeksion kontekstda GRS patogenezida muhim rol o'ynashi isbotlandi. Ishlab chiqilgan prognostik-diagnostik algoritm (sezgirlik 86,4%, o'ziga xoslik 81,2%) virusli gepatit fonida GRS xavfi ostidagi bemorlarni erta aniqlashda yuqori samaradorlik ko'rsatdi

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