Keywords
Abstract
Gipoksiya — organizm to‘qimalariga kislorod yetkazib berilishi yoki undan foydalanish jarayonining buzilishi natijasida yuzaga keladigan patofiziologik holat bo‘lib, u ko‘plab kasalliklar va shoshilinch klinik vaziyatlarning umumiy patogenetik bo‘g‘ini hisoblanadi. Kislorod tanqisligi yurak-qon tomir, nafas olish, markaziy asab tizimi, buyrak va jigar faoliyatining izdan chiqishi bilan kechib, metabolik disbalans, hujayra energetik yetishmovchiligi va ko‘p a’zoli yetishmovchilik rivojlanishiga olib kelishi mumkin. Gipoksiya nafaqat o‘tkir shoshilinch holatlarda (shok, asfiksiya, o‘pka emboliyasi, og‘ir pnevmoniya), balki surunkali patologiyalarda ham (yurak yetishmovchiligi, surunkali obstruktiv o‘pka kasalligi, anemiya, diabetik mikroangiopatiya) klinik ahamiyat kasb etadi. Mazkur maqolada gipoksiyaning rivojlanish mexanizmlari patofiziologik nuqtai nazardan keng yoritilib, uning asosiy turlari: gipoksik (respirator), gemik, sirkulyator, to‘qima (gistotoksik), substrat va aralash gipoksiya shakllari ilmiy asosda tahlil qilinadi. Kislorod transporti zanjirining bosqichlari — ventilyatsiya, alveolyar diffuziya, perfuziya, gemoglobin bilan bog‘lanish, mikrosirkulyatsiya va mitoxondrial oksidlovchi fosforillanish — gipoksiya patogenezining asosiy “kritik nuqtalari” sifatida ko‘rib chiqiladi. Shuningdek, gipoksiya sharoitida hujayra metabolizmining anaerob yo‘lga o‘tishi, laktatatsidoz, ion pompalarining izdan chiqishi, hujayra shishi, oksidlovchi stress, erkin radikallar ortishi, kaltsiy homeostazining buzilishi hamda apoptoz va nekroz jarayonlarining faollashuvi asosiy patogenetik mexanizmlar sifatida bayon etiladi. Maqolada gipoksiyaga moslashuv reaksiyalari ham alohida tahlil qilinib, simpatoadrenal tizim faollashuvi, giperventilyatsiya, yurak chiqarish hajmining ortishi, eritropoezning kuchayishi, gemoglobin affinitetining o‘zgarishi, HIF-1α (hypoxia-inducible factor) orqali gen ekspressiyasi va angiogenez jarayonlari kabi kompensator mexanizmlarning fiziologik hamda patologik chegaralari yoritiladi. Yakunda gipoksiyaning oqibatlari sifatida ko‘p a’zoli yetishmovchilik, miya ishemiyasi, miokard disfunktsiyasi, buyrak tubulyar nekrozi, ichak barer funksiyasining buzilishi, yallig‘lanish mediatorlari ortishi va reoksigenatsiya shikastlanishi (reperfuziya sindromi) masalalari ilmiy asosda umumlashtiriladi.
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