Respirator distress-sindromidan nobud bo‘lgan chaqaloqlarda adrenal-timik tizim a’zolarining patomorfologik va morfometrik o‘zgarishlari
Qabul qilingan: 2026-03-26
Nashr etilgan: 2026-06-29
Annotatsiya
Maqsad. RDS sababli vafot etgan chala tug‘ilgan chaqaloqlarda buyrak usti bezi va timus morfologiyasini tavsiflash hamda ularning o‘zaro integral bog‘liqligini baholash.
Materiallar va usullar. Farg‘ona viloyati Patologik anatomiya byurosida 2020–2024-yillar davomida patologoanatomik tekshiruvdan o‘tkazilgan, gestatsiya muddati 26–32 hafta bo‘lgan 185 nafar chaqaloqning buyrak usti bezi va timus to‘qimalari retrospektiv tavsifiy tarzda tahlil qilindi (umumiy tanlanma N=185, shundan RDSning klinik-morfologik tashxisi tasdiqlangan guruh n=155: 0–7 kunlik n=95, 8–28 kunlik n=60; RDSsiz nazorat guruhi n=30). To‘qimalar gematoksilin-eozin bilan bo‘yaldi; miqdoriy ko‘rsatkichlar M±m ko‘rinishida ifodalandi, guruhlar orasidagi farqlar Styudent t-mezoni yordamida baholandi (p<0,05).
Natijalar. Buyrak usti bezining koptokchali zonasi barcha holatlarda primordial holatda qoldi, tutamli zona spongiotsitlarida lipid kiritmalari kam yoki umuman aniqlanmadi, po‘stloq va miya qavatlarida venoz to‘laqonlilik hamda diapedez qon quyilishlari barcha holatlarda kuzatildi. Buyrak usti bezining o‘rtacha massasi 0–7 kunlik o‘tkir bosqichda 2,08±0,3 g, 8–28 kunlik davrda 3,05±0,04 g bo‘lib, nazorat ko‘rsatkichidan (4,01±0,05 g) sezilarli darajada past bo‘ldi. Timus massasi mos ravishda 4,05±0,06 g va 8,02±0,09 g bo‘lib, yosh me’yoridan past, biroq buyrak usti bezi yetishmovchiligi darajasiga nisbatan kompensator kattalashuv belgilari bilan kechdi (limfotsitlar apoptozi 0–7 kunlikda 54,8±0,05%, 8–28 kunlikda 32,4±0,01%; nazoratda ≈5%). Apgar bahosi past (0–3 ball, 1-daqiqada) bo‘lgan holatlarda mintaqaviy o‘lim ko‘rsatkichi 70–80% ga yetdi; ushbu ko‘rsatkich mintaqaviy klinik hisobotlarga asoslangan bo‘lib, mazkur tadqiqot doirasida alohida hisoblangan natija emas.
Xulosa. Buyrak usti bezining strukturaviy yetilmaganligi timusning kompensator involyutiv-giperplastik o‘zgarishlari bilan birga kechib, neonatal RDSda o‘lim bilan bog‘liq muhim morfologik omillardan biri bo‘lishi mumkin; bu bog‘liqlikni yakuniy tasdiqlash uchun nazorat guruhli statistik tadqiqotlar zarur.
Kalit so‘zlar
Adabiyotlar ro'yxati
-
Berger D.S., Garg B., Penfield C.A., Caughey A.B. Respiratory distress syndrome is associated with increased morbidity and mortality in late preterm births. American Journal of Obstetrics & Gynecology MFM. 2024;6(6):101374.
-
Bhat V., Saini S.S., Sachdeva N., Walia R., Sundaram V., Dutta S. Adrenocortical dysfunctions in neonatal septic shock. Indian Journal of Pediatrics. 2022;89(7):714–716.
-
Gosavi A., Amin Z., Carter S.W.D., Choolani M.A., Fee E.L., Milad M.A., Jobe A.H., Kemp M.W. Antenatal corticosteroids in Singapore: a clinical and scientific assessment. Singapore Medical Journal. 2024;65(9):479–487.
-
Gutierrez C.E., De Beritto T. Relative adrenal insufficiency in the preterm infant. NeoReviews. 2022;23(5):e328–e334.
-
Holmstrom L.E., Jnah A.J. Relative adrenal insufficiency: crisis averted? Neonatal Network. 2021;40(6):369–376.
-
Xatamov R.I., Xolmatov I.X. Yangi tug‘ilgan chaqaloqlarda rivojlangan RDS sindromida buyrak usti bezlari va timusning integral bog‘liqligining patomorfologik jihatlari. InLibrary.uz ilmiy-tadqiqot elektron resurs markazi. 2025. https://doi.org/10.71337/inlibrary.uz.science-research.96106.
-
Khatamov R.I., Kholmatov I.Kh. Pathomorphology of the Integral Connection of the Adrenal Glands and Thymus in RDS Syndrome in Newborn Infants. InLibrary.uz ilmiy-tadqiqot elektron resurs markazi. 2025. https://doi.org/10.71337/inlibrary.uz.science-research.96806.
-
Ma Y.J., Sun Y., Zhang C.H. Adverse perinatal outcomes associated with respiratory distress syndrome in preterm infants: a retrospective analysis. Italian Journal of Pediatrics. 2025;51(1):235.
-
Parker R., Colley E., Vieira M., Konradsen J.R., van Meel E.R., Jauniaux E. et al. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database of Systematic Reviews. 2020;(12).
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