BOLALARDA O‘TKIR BRONXIOLITDA SITOKIN STATUSI XARAKTERISTIKASI
Abstrakt
Bu original maqolada o‘tkir bronxiolit bilan og‘rigan erta yoshdagi bolalarda sitokin profilini o‘rganish uchun o‘tkazilgan kliniko – laborator tekshiruv natijalari keltirilgan. Interleykin tarkibini o‘zgarishini kasallikni og‘ir kechishini bashorat qiluvchi markerlar sifatida qo‘llash tavsiya etiladi.
Tadqiqot maqsadi: bolalarda o‘tkir bronxiolitda sitokin statusini xususiyatlarini o‘rganish.
Tadqiqot materiali va usullari. RShTTYoIMSF shoshilinch pediatriya va bolalar reanimatsiyasi bo‘limida 2022-2023 yillar oralig‘ida o‘tkir bronxiolit bilan davolangan 1 -12 oylikkacha bo‘lgan 36 nafar bola tekshirildi. Barcha bolalarda turli og‘irlik darajasidagi bronxoobstruksiya kuzatildi. Bronxiolit kechishini og‘irlik darajasini oqibatini baholash uchun, klinik va auskultativ belgilarga asoslangan ESBA ballik shkalasidan foydalanildi (J.M. Ramos Fernandez et all, 2013).
Barcha bemorlarga laborator – instrumental tekshirishlar o‘tkazildi: umumiy qon tahlili, kislorod saturatsiyasini aniqlash (SpO2), ko‘krak qafasi a’zolarini rentgenografiyasi. IL-6, IL-8, TNF ά miqdorini aniqlash uchun qattiq fazali immunoferment tahlili usulidan foydalanildi. Virus (RSV, adenovirus, rinovirus, paragripp) antigenini aniqlash uchun «Reverta» va «Amplisens-200» (Rossiya) to‘plamlaridan foydalanib ma’lum belgilangan vaqt ichida polimeraz zanjir reaksiyasi bajarildi. Infeksiya qo‘zg‘atuvchisini (Chlamidia pneumonia, Mycoplasma pneumonia) aniqlash uchun standart «XEMA» (Rossiya) tijorat reaktivlari yordamida immunoferment tahlil (IFA) o‘tkazildi.
Natijalar. Ilk marotaba mintaqamizda klinik ko‘rsatkichlardan iborat bo‘lgan, o‘tkir bronxiolitni og‘irlik darajasi Shkalasi (ESBA) qo‘llanildi, uning yordamida instrumental tekshirish usullari qo‘llaniguncha birlamchi shifokor ko‘rigidayoq bemorning umumiy ahvoli baholandi.
Interleykinlarni eng yuqori patologik miqdori RSV bilan Chlamidia pneumonia birga kelganda kuzatildi (n=3) (IL-8 - 39,66±0,66 pg/ml, IL-6 – 47,33±1,20 ng/ml, TNFα 69,0±9,6 ng/ml), bunda interleykinlar miqdori RSV bilan monoinfitsirlanishda (n=19) ham yuqori miqdorlarda qoldi, oldingi gururhlardan ishonchli darajada farq qilmadi (IL-8 - 39,021±0,92 ng/ml, IL-6 – 43,68±1,75 ng/ml, TNFα 60,7±3,68 ng/ml).
Xulosa. Interleykinlar ekspressiyasi va o‘tkir bronxiolitni og‘irlik darajasi o‘rtasida o‘zaro bog‘liqlik aniqlandi, bu kasallikni og‘irlik darajasiga qarab IL-6, IL-8 va TNFα konsentratsiyasini oshishi bilan xarakterlanadi. Interleykinlar tarkibidagi o‘zgarishlarni kasallik kechishini og‘irlik darajasini bashorat qiluvchi markerlar sifatida qo‘llash tavsiya etiladi. Mikst infeksiyali bemorlarda (RSV bilan Chlamidia pneumonia) va RSV bilan monoinfitsirlanishda interleykin profili ko‘rsatkichlarini ancha yuqori bo‘lishi aniqlandi. Interleykinlar tarkibini o‘zgarishini kasallik kechishini og‘irligini baholash markeri sifatida qo‘llash tavsiya etiladi.
Kalit so'zlar:
Mualliflar haqida
Adabiyotlar ro'yxati
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