TUG‘MA YURAK NUQSONLARI FONIDA O‘PKA GIPERTENZIYASI RIVOJLANISHIDA GIPOKSIYA VA O‘PKA QON OQIMINING ORTISHI AHAMIYATI
Kalit so‘zlar:
tug‘ma yurak nuqsonlariAbstrak
Dolzarbligi. Tug‘ma yurak nuqsonlari bolalarda o‘pka gipertenziyasi va o‘pka tomir kasalligi rivojlanishining muhim sabablaridan biridir. Ayniqsa, tizimli-o‘pka shuntlari mavjud bo‘lgan holatlarda o‘pka qon oqimining ortishi, ayrim murakkab va sianotik nuqsonlarda esa surunkali gipoksemiya o‘pka tomir tizimiga uzoq muddatli patologik ta’sir ko‘rsatadi. Yuqori oqim va bosim yuklamasi endotelial funksiyaning buzilishiga, gipoksiya esa vazokonstriksiya, oksidativ stress va proliferativ jarayonlarning faollashishiga yordam beradi. Ushbu mexanizmlarning davomiyligi o‘pka tomirlarining strukturaviy remodelingi va o‘pka tomir qarshiligining ortishi bilan yakunlanishi mumkin.
Maqsad. Tug‘ma yurak nuqsonlari bo‘lgan bolalarda o‘pka gipertenziyasi rivojlanishida gipoksiya va o‘pka qon oqimining ortishining patogenetik ahamiyatini, shuningdek ularning endotelial disfunksiya va o‘pka tomir remodelingi bilan bog‘liqligini 2020–2025-yillardagi zamonaviy ilmiy manbalar asosida tahlil qilish.
Material va usullar. Narrativ adabiyotlar sharhi bajarildi. PubMed/MEDLINE bazasida va xalqaro professional jamiyatlar materiallarida 2020–2025-yillarda chop etilgan pediatrik o‘pka gipertenziyasi, tug‘ma yurak nuqsonlari, o‘pka qon oqimining ortishi, gipoksiya, endotelial disfunksiya va o‘pka tomir remodelingi bo‘yicha ilmiy maqolalar, klinik tavsiyalar hamda ekspert konsensuslari tahlil qilindi.
Natijalar. Tug‘ma yurak nuqsonlarida o‘pka gipertenziyasi faqat o‘pka arteriyasidagi bosim oshishi bilan cheklanmaydi. Chapdan-o‘ngga shuntlarda o‘pka qon oqimining ortishi tomir endoteliyiga doimiy mexanik va gemodinamik yuklama beradi. Surunkali gipoksiya esa gipoksik vazokonstriksiya, oksidativ stress, endotelial-mesenximal transformatsiya va hujayra proliferatsiyasini faollashtirishi mumkin. Jarayon uzoq davom etganda medial gipertrofiya, intimal proliferatsiya va fibroz rivojlanib, o‘pka tomir qarshiligi ortadi. Zamonaviy pediatrik tadqiqotlarda gipoksiya bilan bog‘liq molekulyar remodeling mexanizmlari ham tasdiqlanmoqda.
Xulosa. Tug‘ma yurak nuqsonlari bilan bog‘liq o‘pka gipertenziyasida o‘pka qon oqimining ortishi va gipoksiya bir-birini kuchaytiruvchi patofiziologik omillar sifatida qaralishi kerak. Ularning erta aniqlanishi, o‘pka gemodinamikasining kompleks baholanishi va tug‘ma yurak nuqsonini optimal muddatda korreksiya qilish qaytmas o‘pka tomir kasalligi rivojlanishining oldini olishda muhim ahamiyatga ega.
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