Keywords
Abstract
Podagra — monosodium urat (MSU) kristallarining bo'g'imlar va yumshoq to'qimalarda cho'kishi natijasida yuzaga keladigan surunkali metabolik va yallig'lanish xarakteridagi artropatiyadir, uning asosida surunkali giperurikemiya yotadi. Ushbu sharh maqolasi giperurikemiya va podagraning patogenetik mexanizmlari, tasnifi va zamonaviy davolash tamoyillari bo'yicha so'nggi ma'lumotlarni, jumladan Amerika Revmatologiya Kolleji (ACR, 2020) va Yevropa Revmatologik Ligasi (EULAR) tavsiyalarini umumlashtiradi. Giperurikemiya purin metabolizmining kuchayishi va/yoki buyrak orqali urat ekskretsiyasining kamayishi natijasida rivojlanadi, bunda hollarning aksariyat qismida (taxminan 90%) buyrak orqali urat chiqarilishining pasayishi asosiy rol o'ynaydi. Sarum urat darajasi eruvchanlik chegarasidan (taxminan 6.8 mg/dL) oshganda MSU kristallari bo'g'im bo'shlig'ida cho'kadi, bu esa NLRP3 inflammasomasining faollashuvi, interleykin-1β (IL-1β) ishlab chiqarilishi va keskin neytrofil infiltratsiyasi orqali o'tkir yallig'lanish reaksiyasini (podagra xuruji) keltirib chiqaradi. Davolash ikki asosiy yo'nalishga bo'linadi: o'tkir xurujni bartaraf etish (NSAID, kolxitsin, glyukokortikoidlar) va surunkali urat pasaytiruvchi terapiya (UPT) orqali qayta xurujlar va tofus rivojlanishining oldini olish, bunda maqsad sarum urat darajasini 6 mg/dL dan (og'ir kasallikda 5 mg/dL dan) past darajada barqaror ushlab turishdir. Giperurikemiya va podagraning patogenetik mexanizmlarini chuqur tushunish, shuningdek qo'shma kasalliklarni (semizlik, arterial gipertenziya, buyrak yetishmovchiligi) hisobga olgan holda individuallashtirilgan davolash strategiyasi, jumladan O'zbekiston sog'liqni saqlash tizimi sharoitida ham, bemorlar hayot sifatini yaxshilash va asoratlarning oldini olish uchun muhim ahamiyatga ega.
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