Keywords
Abstract
Bolalarda immunoglobulin A bilan bog‘liq vaskulit mayda qon tomirlarining yallig‘lanishi bilan kechadigan tizimli kasallikdir. Teri purpurasi uning eng tanish belgisi bo‘lsa-da, bo‘g‘imlar, me’da-ichak tizimi va buyraklar zararlanishi uzoq muddatli kuzatuv zaruratini belgilaydi. Klinik ko‘rinishning o‘zgaruvchanligi tufayli dastlabki ko‘rikda kasallik faolligini to‘liq baholash har doim ham oson emas. Siydik tekshiruvi, qon bosimi va umumiy klinik holatni qayta baholash muhim o‘rin tutadi [1], [2]. Maqola kasallikning ko‘p tizimli belgilari va immun javobga oid ma’lumotlarning klinik qo‘llanilishini tahlil qiladi. Chop etilgan kuzatuv materiallarida ikki davrga mansub jami 721 ta kasallik tarixi retrospektiv tahlil qilingan va 3–18 yoshdagi 223 nafar bola prospektiv kuzatilgan. Tahlil yo‘nalishlari teri, bo‘g‘im va qorin belgilaridan tashqari, gemostaz ko‘rsatkichlari, immunoglobulinlar hamda interleykinlar bilan bog‘liq bo‘lgan. Immunoglobulin A va Th17 bilan bog‘liq yallig‘lanish yo‘llari kasallik patogenezini tushunishda qiziqish uyg‘otadi [3], [4]. Biroq bitta biomarkerning ko‘tarilishi og‘ir buyrak zararlanishini yoki qaytalanishni mustaqil ravishda aniq bashorat qiladi degan xulosa qilish mumkin emas. Amaliy kuzatuvda asosiy e’tibor siydikdagi qon va oqsil, buyrak faoliyati, arterial bosim hamda qorin bilan bog‘liq xavf belgilariga qaratiladi. Gemostaz va immunologik markerlar esa klinik vaziyatga qarab qo‘shimcha baholanishi mumkin. Maqolada birlamchi ko‘rik, takroriy tekshiruv, xavf belgisini ajratish va tegishli mutaxassisga yo‘naltirish ketma-ketligi bayon etiladi. Ish yangi klinik natija yoki mustaqil prognostik formula taklif qilmaydi. Uning maqsadi mavjud dalillarni ehtiyotkor talqin qilish orqali bolalarda ushbu vaskulitni izchil kuzatishning amaliy tamoyillarini aniqlashtirishdir. Kuzatuv muddatlari kasallikning boshlang‘ich og‘irligi va keyingi klinik dinamikaga qarab moslashtirilishi kerak. Toshma yo‘qolgandan keyin ham siydikdagi o‘zgarishlar paydo bo‘lishi ehtimoli saqlanishi mumkin. Shu sababli ota-onaga qayta murojaat qilish belgilarini tushuntirish, laborator tekshiruv sanalarini aniq belgilash va natijalarni oldingi o‘lchovlar bilan taqqoslash juda muhim. Yondashuvning qiymati murakkab testlar sonida emas, xavfli belgini o‘tkazib yubormaslik imkoniyatidadir.
References
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