REPRODUKTIV ORGANLAR SARATONI BILAN OG'RIGAN BEMORLARDA PREKAХEKSIYA RIVOJLANISHINI SEKINLASHTIRISHDA MULTIMODAL TERAPIYANING SAMARADORLIGI
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prekaheksiya, reproduktiv organlar saratoni, multimodal terapiya, yallig'lanish markerlar, tana massasini barqarorlash, hayot sifati##article.abstract##
Maqsad: Tuxumdon, endometriy va bachadon bo'yni saratoni bilan kasallangan IV bosqich bemorlarda prekaheksiya holatida kombinatsiyalangan davolash sxemasining yallig'lanish markerlariga va metabolik parametrlarga ta'sirini baholash. Material va metodlar: 2023-2024 yillarda 55 nafar ayol bemor uchun prospektiv kohort tadqiqoti o'tkazildi. Fearon mezonlariga muvofiq prekaheksiya tasdiqlanib, ECOG 1-2 darajasida bo'lgan bemorlar qabul qilindi. Terapiya sxemasiga tselekoksib (kuniga 400 mg), megestrol asetat (kuniga 320-480 mg), omega-3 yog' kislotalari (kuniga 2 g EPA), metformin (kuniga 1500-2000 mg) va nutritiv qo'llab-quvvatlash kirdi. Bemorlar 24 hafta davomida kuzatildi. Birlamchi yakuniy nuqtalar: S-reaktiv oqsil (SRO) darajasidagi o'zgarish, tana massasining barqarorlashuvi, FAACT shkalasi bo'yicha ishtahaning yaxshilanishi. Ikkilamchi parametrlar: interleukin-6, TNF-α, albumin, EORTC QLQ-C30 shkalasi, kaheksiyaning progressivlashuviga qadar o'tgan vaqt. Natijalar: 4-haftada SRO mediana qiymati 18,5 mg/l dan 14,2 mg/l gacha pasaydi (23,2% kamayish; p<0,001). 12 hafta davomida tana massasining barqarorlashuvi 22 bemorada (40,0%) kuzatildi. Ishtahaning yaxshilanishi 26 bemorada (47,3%) qayd etildi. Interleukin-6 24 haftada 34,9% ga kamayib (p<0,001), TNF-α esa 21,8% ga pasaydi (p<0,001). Albumin darajasi 32,1 g/l dan 35,1 g/l gacha ko'tarildi (p<0,001). EORTC QLQ-C30 bo'yicha umumiy salomatlik 42,3 balldan 53,8 ballga oshdi (p<0,001). Kaheksiyaning progressivlashuvi 18 bemorada (32,7%) davom etdi. 3-4 darajali noxush hodisalar 12,7% bemorlarda qayd etildi, asosan oshqozon-ichak buzilishlari. Xulosa: Multimodal terapiya prekaheksiyaning progressivlashuvini sekinlashtiradi, tizimli yallig'lanish markerlarini kamaytiradi va hayot sifatini yaxshilaydi. Biroq tana massasining ortishi cheklangan (20%) va kaheksiya progressivlashuvi uchinchi qismida davom etadi. Ushbu sxema qabul qilinadigan xavfsizlik profiliga ega bo'lsa-da, yanada samarali strategiyalar ishlab chiqish zarur.
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