Surunkali koronar sindromni tashxislash va davolashda stress-exokardiografiyaning zamonaviy o‘rni: fiziologiyadan klinik taktikagacha
Qabul qilingan: 2026-07-15
Nashr etilgan: 2026-06-29
Annotatsiya
Surunkali koronar sindrom (SKS) butun dunyoda, ayniqsa Markaziy Osiyo mamlakatlari va O‘zbekiston Respublikasida o‘lim hamda nogironlikning yetakchi sabablaridan biri bo‘lib qolmoqda. Ushbu sharhda SKS bilan og‘rigan bemorlarni tashxislash, xavf darajasini stratifikatsiya qilish va davolash taktikasini belgilashda stress-exokardiografiyaning o‘rniga zamonaviy nuqtayi nazar taqdim etilgan. SKS tushunchasining evolyutsiyasi, ishemiyaning asosiy patofiziologik mexanizmlari (epikardial stenozlar, mikrovaskulyar disfunksiya, vazospazm), shuningdek, ANOCA/INOCA holatlari ko‘rib chiqilgan. Stress-exokardiografiyaning diagnostik va prognostik ahamiyati boshqa usullar (EKG stress-testi, SPECT, PET, stress-MRT) bilan qiyosiy tahlil qilingan. Yarim yotgan holatda veloergometrda jismoniy yuklama bilan o‘tkaziladigan stress-exokardiografiyaga, yuklamaning eng yuqori darajasida vizualizatsiya qilishning afzalliklariga va zamonaviy miqdoriy texnologiyalarga (strain, koronar qon oqimi zaxirasi) alohida e’tibor qaratilgan. Muhim tadqiqotlar (COURAGE, FAME, ISCHEMIA) va ESC 2024 tavsiyalarining tahlili stress-exokardiografiya invaziv koronar angiografiyani o‘tkazish zaruratini aniqlashda samarali «gatekeeper» ekanini hamda endovaskulyar revaskulyarizatsiya bo‘yicha qarorlar qabul qilishda muhim o‘rin tutishini ko‘rsatdi. Usulning iqtisodiy samaradorligi, xavfsizligi va operator malakasiga bog‘liqligi muhokama qilingan. Xulosa. Stress-exokardiografiya «xarajat–samaradorlik» nisbati maqbul bo‘lgan, qulay, xavfsiz va yuqori samarali funksional diagnostika usulidir. O‘zbekiston Respublikasi va Markaziy Osiyo sharoitida stress-exokardiografiyani, ayniqsa yarim yotgan holatda veloergometrda o‘tkaziladigan usulni keng joriy etish diagnostika algoritmlarini sezilarli darajada optimallashtirishi va surunkali koronar sindrom bilan og‘rigan bemorlarni davolash natijalarini yaxshilashi mumkin.
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Mualliflik huquqi (c) 2026 Х.Г. Фозилов, Ф.М. Бекметова, Б.Б. Рузиев, Ш.А. Оринбаев (Автор)

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