Podagrani erta tashxislashda zamonaviy usullar va individual davolash yondashuvlarining samaradorligi
Ключевые слова:
Podagra, kompyuter tomografiya, rentgenografiya, ultratovush tekshiruviАннотация
Tadqiqot metodologiyasi sifatida global epidemiologik ma‘lumotlar (Global Burden of Disease 2021), klinik kuzatuvlar, laborator va instrumental tekshiruvlar (sinovial suyuqlik mikroskopiyasi, rentgenografiya, ultratovush tekshiruvi va dual energiyali kompyuter tomografiya) natijalari tizimli tahlil qilindi. Diagnostik mezonlar sifatida mononatriy urat kristallarini aniqlash, klinik simptomatika hamda yallig'lanish markerlari baholandi. Natijalar shuni ko'rsatdiki, podagraning asosiy patogenetik omili bo'g'imlarda urat kristallarining cho'kishi bo'lib, bu o'tkir yallig'lanish reaksiyasini chaqiradi. Zamonaviy tasviriy diagnostika usullari, xususan ultratovush va dual energiyali KT, kasallikni erta bosqichda aniqlashda yuqori sezgirlikka ega ekanligi aniqlandi. Davolashda ―treat-to-target‖ strategiyasi ustun bo‗lib, serum siydik kislotasi darajasini ≤360 μmol/L (tofusli holatlarda ≤300 μmol/L) ga tushirish klinik xurujlar sonini kamaytiradi. Farmakologik davolash (allopurinol, NSAIDlar, kolxisin, glyukokortikoidlar) bilan bir qatorda dietoterapiya va qo‗shimcha vositalar (vitamin C, antioksidantlar) kompleks yondashuvda ijobiy natija beradi. Xulosa qilib aytganda, podagrani samarali boshqarish integratsiyalashgan yondashuv — aniq diagnostika, maqsadli farmakoterapiya va turmush tarzini modifikatsiya qilish asosida amalga oshirilishi zarur. Bu yondashuv kasallikning kechishini nazorat qilish va asoratlarni kamaytirishda muhim ahamiyat kasb etadi.
Библиографические ссылки
1. Becker MA, Jolly M. Clinical gout and pathogenesis of hyperuricemia. Clin Cornerstone. 2006;8(Suppl 1):S5–S17. intake,
2. Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Purine-rich foods, dairy and protein and risk of gout. N Engl J Med. 2004;350:1093–1103. https://doi.org/10.1056/NEJMoa035700
3. Choi HK, Curhan G. Vitamin C intake and risk of gout in men. JAMA. 2009;301(20):2123 2129. https://doi.org/10.1001/jama.2009.672
4. Dalbeth N, Merriman TR, Stamp LK. Gout. Lancet. 2016;388(10055):2039–2052. https://doi.org/10.1016/S0140-6736(16)00346-9
5. FitzGerald JD, Dalbeth N, Mikuls T, et al. 2020 American College of Rheumatology guideline for the management of gout. Arthritis Care Res (Hoboken). 2020;72(6):744–760. https://doi.org/10.1002/acr.24180
6. Khanna D, Fitzgerald JD, Khanna PP, et al. 2012 American College of Rheumatology guidelines for management of gout. Arthritis Care Res. 2012;64(10):1431–1446. https://doi.org/10.1002/acr.21773
7. Richette P, Doherty M, Pascual E, et al. 2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2017;76(1):29–42. https://doi.org/10.1136/annrheumdis-2016-209707
8. Schumacher HR. Crystal-induced arthritis: gout and pseudogout. Am J Med. 1996;100(5A):46S–52S. https://doi.org/10.1016/S0002-9343(97)89402-1
9. Stamp LK, Chapman PT. Gout and its comorbidities: implications for therapy. Lancet. 2013;382(9896):1559–1570. https://doi.org/10.1016/S0140-6736(13)60233-1
10. Terkeltaub R. Clinical practice. Gout. N Engl J Med. 2003;349:1647–1655. https://doi.org/10.1056/NEJMcp030733
