KASALLIK FAOLLIGIGA QARAB, TIZIMLI BOSHLANGAN YUVENIL ARTRITLI BOLALARDA IMMUNOLOGIK PROFILNING XUSUSIYATLARI
Abstrakt
Dolzarbligi. Sistem boshlanuvchi yuvenil artriti (SBYA) yuvenil artritning alohida autoimmun yallig’lanish subtipi bo‘lib, tizimli yallig‘lanish va qo‘shimcha bo‘g‘im tashqi belgilari, jumladan isitma, toshma va gepatosplenomegaliya bilan xarakterlanadi. Kasallik yallig’lanish sitokinlari (IL-1β, IL-6, IL-18) ishlab chiqarilishining buzilishi bilan kechadi, bu esa kasallik og‘irligini belgilaydi va asoratlar xavfini oshiradi. An’anaviy yallig‘lanish markerlari, jumladan eritrotsitlarning cho‘kishi tezligi (ECHT) va C-reaktiv oqsil (CRO), ko‘pincha kasallik faoliyatini aniq baholash uchun yetarli darajada bo’lmaydi. Shuning uchun sitokin profillarini o‘rganish va ishonchli immunologik biomarkerlarni aniqlash bolalarda SBYAni o‘z vaqtida diagnostika qilish, kasallik faoliyatini ob’ektiv baholash va individual davolash strategiyasini optimallashtirishda ayniqsa dolzarbdir, bu esa klinik natijalarni yaxshilash va kasallik prognozini aniqlashga yordam beradi. Tadqiqot maqsadi. Sistem boshlanuvchi yuvenil artriti (SBYA) bo‘lgan bemorlarda kasallik faoliyatiga qarab yuvyenil artritning kechish xususiyatlarini o‘rganish. Material va metodlar. Prospektiv kogort tadqiqoti 74 ta bolalardan iborat bo’lib (shulardan 44 tasi SBYA bilan) va 2021–2023 yillarda o‘tkazilgan. Diagnostika Xalqaro revmatologik assotsiatsiyalar ligasi (ILAR, 2001) mezonlariga muvofiq qo’yilgan. Immunologik tadqiqotlar yallig’lanish sitokinlari (IL-1, IL-6, IL-18, TNF-α) RANDOX biochip texnologiyasi yordamida, shuningdek, autoimmun markerlar (S-100, qondagi ferritin) ELISA usuli bilan Multiskan FS qurilmada RIPIATM klinik-laboratoriya bo‘limida amalga oshirilgan. Kasallik aktivligi Juvenile Arthritis Disease Activity Score 27 (JADAS27) shkalasi yordamida baholangan. Statistik tahlil StatPlus v8.0.3 va Microsoft Excel dasturlarida o‘tkazilgan; korrelyatsiyalar Spirmanning rang korrelyatsiya koeffitsienti bilan baholangan, farqlar p<0,05 da statistik jihatdan ahamiyatli hisoblangan. Natija. Olingan ma’lumotlar IL-1 va IL-6 o‘rtasida kuchli musbat korrelyatsiyani (rs = 0,89; p = 0,0000), IL-1 va S-100 o‘rtasida o‘rta darajadagi manfiy korrelyatsiyani (rs = –0,298; p = 0,59) va JADAS27 bilan zaif manfiy korrelyatsiyani (rs = –0,278; p = 0,067) ko‘rsatdi. IL-1 va TNF-α (rs = 0,15; p = 0,34) hamda IL-1 va ferritin (rs = 0,18; p = 0,24) o‘rtasida juda zaif musbat korrelyatsiya kuzatildi. Xulosa. SBYA yallig’lanish sitokinlari (IL-1, IL-6, IL-18) darajasi oshgan maxsus immunologik profil bilan xarakterlanadi, bu esa tizimli klinik belgilar va kasallik og‘irligini rivojlanishiga hissa qo‘shadi. IL-18 va ferritin darajalari o‘rtasidagi sezilarli musbat korrelyatsiya (rs = 0,46; p = 0,0019) ferritinning nafaqat yallig‘lanish ko‘rsatkichi, balki SBYA immunopatogenezida faol yallig’lanish mediator bo‘lishi mumkinligini ko‘rsatadi.
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