O‘tkir ikkilamchi peritonitda ikkilamchi immun a’zolarining (regionar limfa tugunlari va taloqning) morfologik va immunogistokimyoviy xususiyatlari
Qabul qilingan: 2026-03-26
Nashr etilgan: 2026-06-29
Annotatsiya
Maqsad. Sifat jihatidan taqqoslash uchun yoshi mos keluvchi, sepsissiz holatlardan olingan to‘qimalardan foydalanib, o‘lim bilan yakunlangan o‘tkir ikkilamchi peritonitda mezenterial limfa tugunlari va taloqning morfologik hamda immunogistokimyoviy (IGK) xususiyatlarini tavsiflash.
Materiallar va usullar. Respublika patologik anatomiya markazida 2018–2023-yillarda autopsiya materiallariga asoslangan ko‘ndalang kesimli tadqiqot o‘tkazildi. O‘tkir ikkilamchi peritonitdan vafot etgan 131 nafar katta yoshli shaxsning (18–45 yosh) mezenterial limfa tugunlari va talog‘i tekshirildi. Sifat jihatidan taqqoslash uchun yoshi mos keluvchi, sepsissiz 15 ta nazorat holatining (o‘tkir miokard infarkti, tizimli yallig‘lanishsiz) to‘qimalaridan foydalanildi. Namunalar 10% buferlangan formalinda fiksatsiya qilinib, parafinga quyildi va gematoksilin-eozin (H&E) bilan bo‘yaldi. Limfa tugunlarining 33 ta namunasida CD3, CD4, CD20 va CD68, taloqning 32 ta namunasida esa CD8, CD68 va Ki-67 markerlari bo‘yicha DAB yordamida aniqlash bilan IGK tekshiruv o‘tkazildi. Natijalar mutlaq sonlar, 95% ishonch oralig‘i (Uilson usuli) bilan foizlar yoki o‘rtacha qiymat ± standart og‘ish (M ± SD) ko‘rinishida ifodalandi.
Natijalar. 24–72 soat ichida har ikkala a’zoda ikkilamchi limfoid kollaps kuzatildi: germinativ markazlarda hujayralarning kamayishi, marginal zonaning denudatsiyasi, T- va B-limfotsitlarning yallig‘lanish o‘choqlari tomon migratsiyasi, retikulotsitlar va makrofaglar proliferatsiyasi hamda interstitsial shish. Limfa tugunlarida makrofaglarning CD68 bo‘yicha musbat reaksiyasi 27/33 holatda aniqlandi (81,8%; 95% ishonch oralig‘i 65,6–91,4%). CD3/CD4 T-limfotsitlar miqdorining kamligi yoki ularning yo‘qligi 21/33 (63,6%) va 12/33 (36,4%) holatda, CD20 B-limfotsitlar miqdorining kamayishi yoki ularning yo‘qligi esa 32/33 (97,0%) holatda qayd etildi. Taloqda CD8 T-limfotsitlar depletsiyasi 27/32 holatda o‘rtacha musbat deb baholandi (84,4%; 95% ishonch oralig‘i 68,2–93,1%). Ki-67 proliferatsiya indeksi 16,21 ± 1,06% ni tashkil etib, regeneratsiyaning yetarli emasligini ko‘rsatdi.
Xulosa. O‘tkir ikkilamchi peritonit limfa tugunlari va taloqda vaqtga bog‘liq strukturaviy hamda immunofenotipik kollapsni yuzaga keltiradi. Bu jarayon T- va B-limfotsitlar kamayishi va kompensator makrofaglar giperplaziyasi bilan kechadi.
Conclusion. Acute secondary peritonitis produces time-dependent structural and immunophenotypic collapse in lymph nodes and spleen, with T- and B-lymphocyte depletion and compensatory macrophage hyperplasia.
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