Surunkali yurak yetishmovchiligi va chiqarib tashlash fraksiyasi saqlangan bemorlarning fenotipik xususiyatlari surunkali buyrak kasalligi bilan birgalikda
Annotatsiya
Kirish. Chiqarib tashlash fraksiyasi saqlangan yurak yetishmovchiligi (HFpEF) murakkab klinik holat bo‘lib, ko‘pincha surunkali buyrak kasalligi (SBK) bilan bog‘liq. Ushbu ikki kasallikning o‘zaro ta’siri yetarlicha o‘rganilmagan. Tadqiqot HFpEF va SBK birgalikda uchraydigan bemorlarning fenotipik xususiyatlarini, ayniqsa biomarkerlarning o‘zgarishi va klinik natijalarini o‘rganishga qaratilgan.
Materiallar va usullar. Tadqiqotda chiqarib tashlash fraksiyasi ≥50% bo‘lgan HFpEF va SBK 1-3b bosqichlari tashxisi qo‘yilgan 200 nafar bemor ishtirok etdi. Klinik ma’lumotlar to‘plandi va NT-proBNP, sistatin C va mikroalbuminuriya (MAU) biomarkerlari mos ravishda kimilyuminestsent immunotahlil (COBAS e411, Roche HITACHI), ftorimmunotahlil (Finecare III PLUS analizatori) va turbidimetrik test (Mindray BS-380 analizatori) usullari yordamida o‘lchandi. GFR CKD-EPI formulasi bo‘yicha hisoblandi.
Natijalar. CKD 3b bosqichida bo‘lgan bemorlarda 2-toifa qandli diabet (T2D) va bo‘lmachalar fibrillyatsiyasi (AF) yuqori darajada uchradi. CKD 3a bosqichidagi bemorlarda esa qon lipidlarining yomonroq nazorat qilinishi kuzatildi. GFR pasayishi kreatinin, sistatin C va MAU darajalarining oshishi bilan sezilarli bog‘liqlik ko‘rsatdi. CKD 1-2 bosqichlarida kreatinin darajasi normal bo‘lsa ham, sistatin C va MAU darajalari me’yoriy ko‘rsatkichlardan yuqori bo‘ldi.
Xulosa. HFpEF bemorlarida SBK 2-bosqichi ko‘pincha semizlik bilan birga kuzatildi. Bunday bemorlarda GFR qiymatlari nisbatan normal bo‘lishiga qaramay, buyrak biomarkerlari (sistatin C va MAU) sezilarli darajada o‘zgarishga uchradi. Bu esa HFpEF bemorlarida buyrak yetishmovchiligini erta aniqlash va boshqarishning ahamiyatini ta’kidlaydi hamda yurak va buyrakni kompleks ravishda parvarish qilish zarurligini ko‘rsatadi.
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