ISHEMIK INSULTNING O'TKIR FAZASIDAGI BEMORLARDA MELATONINNI QO'LLASH VA UYQU SIFATI O'RTASIDAGI BOG'LIQLIK
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ishemik insult, uyqu buzilishi, melatonin, davolash strategiyasi##article.abstract##
Insult butun dunyo bo'ylab nogironlik va o'limning asosiy sabablaridan biri hisoblanadi. Aholining hayot davomiyligi oshishi tufayli insult bilan kasallanish sezilarli darajada oshib bormoqda, bu esa bemorlar uchun og'ir oqibatlarga olib keladi. Qarilik, gipertoniya, giperlipidemiya, diabet va bo’lmacha fibrilatsiya kabi an'anaviy xavf omillariga qo'shimcha ravishda, uyqu buzilishi insult uchun mustaqil xavf omili sifatida tobora ko'proq o'z tasdiqini topmoqda.
Tadqiqot maqsadi: bemorlarda ishemik insultning o'tkir fazasida melatoninni qo'llash va uyqu sifati o'rtasidagi bog'liqlikni baholash.
Tadqiqot materiali va usullar: Ushbu tadqiqotda randomizatsiyalangan boshqaruv dizaynidan foydalanilgan. Tadqiqotda Toshkent Tibbiyot Akademiyasining ko’p tarmoqli klinikasi Intensiv davolash bo'limidagi bemorlar ishtirok etishdi. Ishtirokchilar o'tkir ishemik insultga chalingan 32 bemordan iborat. Talablarga javob bergan subyektlar oddiy tasodifiy tanlab olish usuli yordamida 2 asosiy guruhga bo'lingan. Birinchi guruh 30 kun davomida kuniga ikki marta melatonin qabul qilgan 16 ta subyektdan, ikkinchi guruh esa 30 kun davomida kuniga ikki marta platsebo qabul qilgan 16 ta subyektdan iborat. Kuzatuv davomida jiddiy nojo'ya ta'sirlar qayd etilmagan.
Natijalar: Uyqu sifati qabulning birinchi kunida va tadqiqotning 30-kunida subyektlar nevrologiya klinikasiga qayta tekshiruv uchun kelganlarida Pitsburg uyqu sifati indeksi (PSQI) so'rovnomasi yordamida o'lchandi. PSQI bo'yicha umumiy ball ≤ 5 yaxshi uyqu sifatini ko'rsatsa, umumiy ball > 5 bo'lishi esa yomon uyqu sifatini ko'rsatadi. Subyektlar asosan erkaklardan (56,3%) iborat bo'lib, o'rtacha yoshi 59,6 ± 10,8 ni tashkil qiladi. Birinchi kundagi o'tkazilgan so'rovnoma ikkala guruhda ham yomon uyqu sifatini ko'rsatib, umumiy PSQI 7,9 ± 2,0 ballni tashkil qildi. Tadqiqot oxirida kuniga ikki marta melatonin olgan guruh global PSQI ko'rsatkichining 1-kuni o'rtacha 7,8 ± 1,7 dan 30 kuni o'rtacha 5,1 ± 2,4 gacha yaxshilanganini ko'rsatdi. Platsebo guruhida bunday sezilarli yaxshilanish kuzatilmadi, protokoldan oldingi va keyingi o'rtacha ko'rsatkichlar o'xshash edi (1-kuni 8,0 ± 2,4 va 30-kuni 6,9 ± 3,1).
Xulosa. O'tkir ishemik insultga chalingan bemorlarda melatonin qo'llash va uyqu sifati o'rtasida bog'liqlik mavjudligi aniqlandi.
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