IGA NEFROPATIYASI BO'LGAN BOLALARDA BUYRAK ZARARLANISHINING MORFOLOGIK XUSUSIYATLARI
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Kirish: IgA nefropatiya (IgAN) butun dunyoda eng keng tarqalgan birlamchi glomerulonefrit bo'lib, unga tashxis qo'yish uchun buyrak biopsiyasi oltin standart bo'lib qolmoqda va kasallikning og'irligi va prognozi haqida qimmatli ma'lumotlarni beradi.
Maqsad: IgA nefropatiyasi bo'lgan bolalarda buyrak biopsiyasi natijalarini baholash va tashxis qo'yilgan paytdagi morfologik o’zgarishlar va klinik parametrlar o'rtasidagi bog'liqlikni tahlil qilish.
Metodlar: Prospektiv kuzatuv tadqiqotida biopsiya bilan tasdiqlangan IgA nefropatiyasi bo'lgan 27 bola ishtirok etdi. Buyrak biopsiyasi namunalari yorug'lik mikroskopiyasi va immunohistokimyoviy usul yordamida baholandi. Gistologik o’zgarishlar Haas tasnifi va Oksford MEST-C ball tizimiga muvofiq tasniflandi. Biopsiya paytida klinik va laboratoriya parametrlari tahlil qilindi.
Natijalar: Kogortadagi nefritik sindrom holatlarining 45,8% ni IgA nefropatiyasi tashkil etdi. Eng keng tarqalgan klinik ko'rinishlar asimptomatik mikrogematuriya va proteinuriya bilan gematuriya edi. Biopsiyalarning 73 foizida mezangial proliferatsiya, 52 foizida segmentar glomeruloskleroz va 10 foizida tubulointerstitsial shikastlanish kuzatildi. Immunohistokimyoviy tahlilda komplement komponenti C3 bilan birga ustunlik qiladigan mezangial IgA cho'kmasi aniqlandi.
Xulosa: Bolalardagi IgA nefropatiyada buyrak biopsiyasi natijalari mezangial proliferatsiya va immun kompleks depozitlari bilan tavsiflanadi. Oksford MEST-C tasnifi muhim prognostik ma'lumotlarni taqdim etadi va kasallikning rivojlanish xavfi yuqori bo'lgan bolalarni aniqlashga yordam beradi.
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