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International scientific-online conference
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MAHALLIY VA UMUMIY ANESTEZYA TA’SIRIDA YURAKDA
YUZAGA KELADIGAN MORFOLOGIK O'ZGARISHLAR
Turniyozov Azamat Asqarovich
Buxoro davlat tibbiyot instituti
https://doi.org/10.5281/zenodo.13336062
Tajriba hayvonlarida miokarddagi morfologik o‘zgarishlarni to‘g‘ri va aniq
tasvirlash patogenezini, tuzilishi va funksiyasidagi o‘zgarishlar o‘rtasidagi
bog‘liqlik mexanizmini tushunish uchun katta ahamiyatga ega. Yurak ko'krak
bo'shlig'ida joylashgan bo'lib, deyarli butunlay o'pka bilan o'ralgan va faqat old-
pastki sohada erkindir. Yurak urishi va ritmi vegetativ va endokrin tizimlar,
gemodinamik omillar [15] tomonidan tartibga solinadi. Yurakni qon bilan
ta'minlash chap va o'ng koronar arteriyalar tomonidan amalga oshiriladi; ularda
ko'plab tosiqlar yo'q. Chap koronar arteriya chap bo’lmacha va o'pka arteriyasi
orasidagi nay ichida intramiokard yo'lidan o'tadi. Kalamushlarda yurakning
haqiqiy sirkumfleks arteriyasi yo'q [3].
Yurak fibroblastlari, kardiomiotsitlar, endotelial hujayralar va qon tomir
silliq mushak hujayralari yurakning asosiy hujayrali komponentlari hisoblanadi.
Sichqonlarning miokardidagi kardiomiotsitlar mahkam o'ralgan parallel
to'plamlar shaklida yoki turli yo'nalishdagi to'plamlarda joylashgan. Atriyal
kardiomiotsitlar maydoni kichikroq va erkinroq joylashgan. Sichqonlarning
miokardlari asosan ikki yadroli kardiomiotsitlar bilan ifodalanadi [11]. Yoshga
bog'liq bo'lgan kalamush yuragidagi strukturaviy o'zgarishlar kardiomiotsitlar
sonining kamayishi, chap qorincha gipertrofiyasining rivojlanishi va qorincha
kameralarining diametrining o'zgarishi bilan tavsiflanadi. Sichqonlarda chap
qorincha gipertrofiyasi interstitsial fibrozdan kelib chiqadi [20].
Yurak gipertrofiyasi. Yurakning massasi va hajmining oshishi amiloid
cho'kishi, biriktiruvchi to'qimalarning ko'payishi, shish, hujayra elementlari
tomonidan infiltratsiya, miotsitlar hajmining oshishi (hajmi, uzunligi va qalinligi,
maydoni) bilan bog'liq bo'lishi mumkin. Kardiomiheliya mahalliy yoki diffuz
bo'lishi mumkin; Kattalashgan kardiomiotsitlarning sitoplazmasi katta
giperxrom yadrolari bilan gipereozinofil bo'lib, ko'pincha miyokarddagi fibroz
bilan birlashadi [5]. Kardiomiotsitlarning distrofiyasi, apoptozi va nekrozi.
1. Gialin tomchi distrofiyasi - kardiomiotsitlar sitoplazmasida gialinga
o'xshash oqsil tomchilari paydo bo'lib, bir-biri bilan qo'shilib, hujayra tanasini
to'ldiradi, hujayraning ultrastruktura elementlari esa yo'q qilinadi. Inson
miokardida kam uchraydi [11].
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2. Gidropik distrofiya - kardiomiotsitlar sitoplazmasida vakuolalar paydo bo'lishi
bilan tavsiflanadi. Gialin tomchilari distrofiyasi va gidropik distrofiya ko'pincha
sitoplazmaning denaturatsiyasi va koagulyatsiyasi yoki hidratsiyasi va
to'qnashuvining ustunligiga qarab sitoplazmatik oqsil almashinuvi buzilishining
ketma-ket bosqichlarini ifodalaydi [11]. Katexolaminlarning haddan tashqari
dozasi bilan o'tkazilgan tajribalarda kalamushlarning miokardida gialin tomchisi
distrofiyasi tashxisi qo'yilgan [13]. Doksorubitsinni kiritish bilan
kalamushlarning miokardida gidropik distrofiya qayd etilgan [10].
Kardiomiotsitlarning apoptozi yadrodagi o'zgarishlar bilan namoyon bo'ladi -
xromatin chegarasi (yadroning periferiyasi bo'ylab xromatinning yarim sharlar
yoki bo'laklar shaklida kondensatsiyasi), xromatin kondensatsiyasi (yadro
piknozi
bilan
namoyon
bo'ladi),
yadrolarning
notekis
konturlari
mikronukleuslarga parchalanish bilan lobli ko'rinish); sitoplazmadagi
o'zgarishlar - bo'yashning o'zgarishi (erta bosqichda bazofiliya va apoptotik
jismlar bosqichida eozinofiliya), vakuolizatsiya (silliq endoplazmatik
retikulumning kengayishi tufayli rivojlanadi), kontur va parchalanishning
o'zgarishi (hujayrada chuqurliklar va o'simtalar paydo bo'ladi. sirt, undan keyin
hujayra parchalanadi) [5]. Efedrin va kofeinni birgalikda qo'llash bilan
kalamushlarning miokardida apoptoz va kardiyomiyositlarning nekrozi
aniqlandi [16].
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