Keywords
Abstract
Yurak yetishmovchiligi yurak-qon tomir tizimining keng tarqalgan va klinik jihatdan murakkab sindromlaridan biri bo‘lib, yurakning organizm metabolik ehtiyojlarini qondiradigan darajada qon haydash yoki to‘qimalarning normal perfuziyasini ta’minlash qobiliyati buzilishi bilan tavsiflanadi. Kasallikning rivojlanishida arterial gipertenziya, yurak ishemik kasalligi, miokard infarkti, kardiomiopatiyalar, yurak klapanlari patologiyasi, aritmiyalar, qandli diabet va buyrak kasalliklari muhim o‘rin tutadi. Zamonaviy klinik amaliyotda yurak yetishmovchiligini faqat simptomlar asosida aniqlash yetarli emas; uning etiologiyasi, chap qorincha ejeksiya fraksiyasi, gemodinamik holat, buyrak funksiyasi, elektrolitlar muvozanati va hamroh kasalliklar kompleks baholanishi zarur. Mazkur maqolada yurak yetishmovchiligining zamonaviy diagnostik mezonlari, klinik-funksional tasnifi, instrumental va laborator tekshiruvlarning ahamiyati, shuningdek farmakoterapiyaning asosiy yo‘nalishlari tahlil qilindi. Ayniqsa, ejeksiya fraksiyasi pasaygan yurak yetishmovchiligida angiotenzin retseptorlari va neprilizin ingibitori, beta-adrenoblokatorlar, mineralokortikoid retseptor antagonistlari hamda natriy-glyukoza kotransportyor-2 ingibitorlaridan tashkil topgan kompleks terapiyaning o‘rni yoritildi. Ejeksiya fraksiyasi biroz pasaygan va saqlangan yurak yetishmovchiligida SGLT2 ingibitorlarining klinik samaradorligi hamda ularning qandli diabet mavjud yoki mavjud emasligidan qat’i nazar qo‘llanish imkoniyatlari ko‘rib chiqildi. Diuretiklar esa, asosan, suyuqlik to‘planishi va dimlanish belgilarini nazorat qilishga qaratilgan simptomatik vosita sifatida baholandi. Tahlil natijalari yurak yetishmovchiligini davolashda monoterapiyadan ko‘ra patofiziologik mexanizmlarning turli bo‘g‘inlariga bir vaqtning o‘zida ta’sir qiluvchi kompleks yondashuv muhimligini ko‘rsatadi. Farmakoterapiya samaradorligi klinik simptomlar, gospitalizatsiyalar soni, jismoniy faollik, hayot sifati, buyrak funksiyasi va uzoq muddatli yurak-qon tomir prognozi orqali baholanishi lozim. Erta tashxis, individual davolash strategiyasi, preparatlarni o‘z vaqtida titrlash va muntazam monitoring yurak yetishmovchiligi bilan bog‘liq asoratlarni kamaytirishning muhim shartlaridir.
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