VIRUSLI GEPATITLAR VA SISTEMIK INFEKSIYALAR FONIDA GEPATORENAL SINDROMNING ERTA RIVOJLANISHIDA KLINIK VA GENETIK MARKERLARNING PROGNOSTIK AHAMIYATI
Kalit so‘zlar:
gepatorenal sindrom, virusli gepatit, sistemik infeksiya, sistatin S, glomerulyar filtratsiyaAbstrak
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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