Bolalar polinevropatiyalari diagnostikasi algoritmlarini optimallashtirish: genetik va orttirilgan turlarida etiologik tasnif va immunologik baholash
Annotatsiya
Kirish. Bolalarda polineyropatiyalarni o'z vaqtida tashxislash zamonaviy bolalar nevrologiyasining dolzarb muammosi bo'lib, etiologik farqlash va immunologik baholash diagnostik aniqlikni sezilarli darajada oshiradi. Tadqiqotning maqsadi — yallig'lanish va naslli polineyropatiyali bolalarda etiologik omillar hamda immunologik holatni baholash asosida yuqori sezuvchanlikka ega kombinlangan diagnostik algoritm ishlab chiqish edi. Materiallar va usullar. Diagnostik algoritmni optimallashtirish maqsadida kombinlangan ball tizimi ishlab chiqildi: OMS oqsili, IgG, CRP va motor NCV ko’rsatkichlarining z-standartlashtirilgan yig’indisi (z-CSF + z-IgG + z-CRP − z-NCV) asosida yallig‘lanish va naslli polineyropatiyalarni ishonchli farqlash imkonini beruvchi integrativ diagnostik model shakllandi. Statistik tahlil GraphPad Prism 10 dasturida amalga oshirildi. Tarqalish normalligi Shapiro–Wilk testi orqali baholandi. Prospektiv-retrospektiv tadqiqot 2022–2025-yillarda o'tkazildi. 105 nafar bola (1–18 yosh) uch guruhga ajratildi: yallig'lanish polineyropatiyasi (n=45), naslli polineyropatiya (n=30) va nazorat (n=30). Klinik, immunologik (IgG, IgM, IgA, CD3⁺/CD4⁺/CD8⁺, TNF-α, IL-6), ENMG va genetik usullar qo'llanildi. Natijalar va muhokama. Yallig'lanish guruhida CD4⁺/CD8⁺ nisbati (1,20±0,35) pasaygan, IgG (14,58±3,33 g/L), TNF-α va IL-6 sezilarli oshgan (p<0,0001). Naslli guruhda immunologik o'zgarishlar kuzatilmadi. Kombinlangan diagnostik algoritm AUC=0,986 ko'rsatkichi bilan yuqori aniqlikni ta'minladi. Xulosa. Ishlab chiqilgan kombinlangan algoritm yallig'lanish va naslli polineyropatiyalarni ishonchli farqlash imkonini beradi, mintaqaviy klinik amaliyotga joriy etish tavsiya etiladi.
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