GEPATOLOGIYANING DOLZARB MUAMMOLARI: COVID-19 INFEKSIYASI FONIDA JIGAR VA BUYRAK SHIKASTLANISHI HAMDA FIBROZ RIVOJLANISHINING KLINIK-PATOGENETIK ASPEKTLARI
Ключевые слова:
gepatologiya, COVID-19, jigar shikastlanishi, buyrak yetishmovchiligi, fibroz, NAFLDАннотация
Gepatologiya zamonaviy klinik tibbiyotning eng dolzarb va tez rivojlanayotgan yo‘nalishlaridan biri bo‘lib, jigar kasalliklarining keng tarqalishi global sog‘liqni saqlash tizimi uchun muhim muammo hisoblanadi. Bugungi kunda virusli gepatitlar (B va C), alkogolsiz yog‘li jigar kasalligi (NAFLD), jigar sirrozi hamda gepatotsellyulyar karsinoma nafaqat tibbiy, balki ijtimoiy-iqtisodiy jihatdan ham katta yukni tashkil etadi. Ushbu kasalliklar ko‘pincha surunkali kechishi, kech tashxis qo‘yilishi va og‘ir asoratlar bilan yakunlanishi bilan ajralib turadi.
So‘nggi yillarda COVID-19 (SARS-CoV-2) infeksiyasi gepatologiyada yangi va murakkab klinik muammolarni yuzaga chiqardi. Dastlab respirator infeksiya sifatida qaralgan ushbu kasallik hozirda ko‘p a’zoli tizimli patologiya sifatida e’tirof etilib, jigar va buyraklarni ham sezilarli darajada zararlashi isbotlangan. Klinik kuzatuvlarga ko‘ra, COVID-19 bilan kasallangan bemorlarda jigar fermentlari (ALT, AST, GGT) oshishi, bilirubin almashinuvining buzilishi, o‘tkir jigar shikastlanishi hamda buyrak funksional ko‘rsatkichlarining pasayishi tez-tezuchraydi.
COVID-19 da organ shikastlanishining asosiy patogenetik mexanizmlari sifatida virusning ACE2 retseptorlari orqali hujayralarga kirishi, kuchli yallig‘lanish javobi (“sitokin bo‘roni”), endotelial disfunktsiya, mikrosirkulyatsiya buzilishi, gipoksiya hamda dori vositalarining gepato- va nefrotoksik ta’siri ko‘rsatiladi. Ushbu jarayonlar natijasida jigar va buyrak to‘qimalarida o‘tkir shikastlanish rivojlanib, keyinchalik fibroz jarayonlari shakllanishi mumkin.
Post-COVID davrida esa surunkali yallig‘lanish, oksidativ stress va regeneratsiya jarayonlarining buzilishi natijasida jigar va buyrak fibrozining rivojlanish xavfi ortadi. Fibroz organlarning funksional zaxirasini kamaytirib, surunkali jigar va buyrak yetishmovchiligi rivojlanishiga olib kelishi mumkin.
Ushbu maqolada gepatologiyaning dolzarb muammolari hamda COVID-19 infeksiyasi fonida jigar va buyrak shikastlanishining zamonaviy patogenez mexanizmlari, klinik-laborator o‘zgarishlari va fibroz rivojlanishining prognostik ahamiyati keng yoritiladi
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