TURLI JOYLASHUVDAGI O‘TKIR MIOKARD INFARKTI VA BO‘LMACHALAR FIBRILLYATSIYASI BILAN KASALLANGAN BEMORLARDA KORONAR QON TOMIR TIZIMI HOLATINI BAHOLASH
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o‘tkir miokard infarkti, bo‘lmachalar fibrillyatsiyasi, koronarografiya, teri orqali koronar intervensiya, koronar qon tomir tizimi##article.abstract##
Kirish. O‘tkir miokard infarkti (O‘MI) butun dunyo bo‘ylab o‘limning asosiy sabablaridan biri hisoblanadi. Bo‘lmachalar fibrillyatsiyasi (BF) bilan birga kechganda esa kasallik kechishi og‘irlashib, tromboembolik asoratlar xavfi sezilarli darajada ortadi. BF va koronar o‘zan shikastlanishi o‘rtasidagi o‘zaro bog‘liqlik zamonaviy kardiologiyaning dolzarb muammolaridan biri bo‘lib qolmoqda, chunki BF koronar qon aylanishining yomonlashuviga ham sabab, ham oqibat bo‘lishi mumkin.
Materiallar va usullar. Tadqiqot Respublika ixtisoslashtirilgan kardiologiya ilmiy-amaliy tibbiyot markazida o‘tkazildi. Unda turli joylashuvdagi O‘MI bilan og‘rigan 236 nafar bemor ishtirok etdi, ularning 98 nafarida BF mavjud edi. Pastki O‘MI uchun o‘ng koronar arteriya (O‘KA) va o‘rovchi arteriya (UA) ning jalb etilishi xosdir. BFning doimiy shakli bilan og‘rigan bemorlarda paroksizmal shaklga nisbatan koronar arteriyalarning ko‘p o‘choqli shikastlanishi yaqqol namoyon bo‘ladi.
Natijalar. Angiografik ma’lumotlar tahlili quyidagilarni ko‘rsatdi:
- Oldingi O‘MI va BF bilan og‘rigan bemorlarda oldingi qorinchalararo arteriya (OQA) va uning diagonal tarmoqlarining shikastlanishi ko‘proq uchraydi. - Pastki O‘MI uchun o‘ng koronar arteriya (O‘KA) va aylanma arteriyaning zararlanishi xos. - BFning doimiy shakli bilan og‘rigan bemorlarda paroksizmal shaklga nisbatan koronar arteriyalarning ko‘p o‘choqli shikastlanishi yaqqolroq namoyon bo‘ladi. - O‘MI va BF bilan og‘rigan bemorlarda surunkali okklyuziyalar va trombotik asoratlarning yuqori chastotasi aniqlandi. Bu esa revaskulyarizatsiyaning erta va faol taktikasini talab qiladi.
Xulosa. O‘MI va BF bilan og‘rigan bemorlarda koronar o‘zanning ko‘p o‘choqli zararlanishi yuqori darajada kuzatiladi. Bu esa bunday bemorlarni davolashda individual yondashuvni talab etadi. Koronar arteriyalar holatini angiografik baholash davolashning maqbul taktikasini tanlash va asoratlarning oldini olish uchun muhim vosita hisoblanadi. O‘z vaqtida amalga oshirilgan revaskulyarizatsiya va tegishli antikoagulyant terapiya qo‘shma patologiyali bemorlar prognozini yaxshilashda hal qiluvchi ahamiyatga ega.
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