Keywords
Abstract
Autoimmun tireoidit (AIT) — qalqonsimon bez to'qimasiga qarshi yo'naltirilgan autoantitanalar (anti-TPO va anti-Tg) bilan tavsiflangan surunkali autoimmun kasallik bo'lib, reproduktiv yoshdagi ayollarda eng ko'p uchraydigan endokrin patologiyalardan biridir. Homiladorlik davrida AIT fonida qalqonsimon bezning fiziologik moslashuv qobiliyati cheklanishi natijasida manifest va subklinik gipotireoz rivojlanish xavfi sezilarli oshadi. Patogenetik jihatdan antitireoid antitanalarning trofoblast hujayralariga sitotoksik ta'siri, Th1/Th2 immun muvozanatining buzilishi va platsentar angiogenezning izdan chiqishi homiladorlik asoratlarining asosiy mexanizmlari hisoblanadi. Klinik kuzatuvlar shuni ko'rsatadiki, AIT bilan kasallangan homilador ayollarda spontan abort xavfi 2,3 baravar, muddatidan oldin tug'ruq xavfi 1,5–2,0 baravar, preeklampsiya xavfi 1,7–2,2 baravar yuqori bo'lib, homilaning neyrokognitiv rivojlanishida kechikishlar aniqlanadi. Tashxis trimestr bo'yicha differensiyalangan TSH me'yorlari, erkin T4 darajasi va antitireoid antitanalar titriga asoslanadi. Davolashning asosiy yondashuvi levotiroksin bilan o'rinbosar terapiyasini o'z vaqtida boshlash va TSH darajasini trimestr me'yorlarida ushlab turishdan iborat. Eutireoz holatdagi anti-TPO musbat ayollarda profilaktik levotiroksin qo'llashning samaradorligi bo'yicha ma'lumotlar qarama-qarshi bo'lib, bu masala keyingi istiqbolli tadqiqotlarni talab qiladi.
References
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