AMYOBIAZ

AMYOBIAZ (Amoebiasis), dizenteriyai amyobavi, yak nav bemorii paraziti. Hangomi on rudaho zakhmnok meshavand, goho dumbal (abstsess)-i jigar, mayna ba vujud meoyad, shush va uzvhoi digar oseb meyoband.
Angezai A. (Entamoeda histolytica) ba oilai Entamoebidae, sinfi Sarcodinae (qalbakipoyho), tipi Protozoa mansub ast. Hayoti angezanda az du davra iborat meboshad: nashvi (trofozoid) va oromi (sista). Davrai nashvi az 4 kheli amyobaho iborat ast: boftai, nashvii kalon, javfi va peshsistai. Darozii amyobai boftai 20 – 25 mkm buda, khele serharakat va siroyatovar ast. On hangomi A.-i shadid dar uzvhoi osebyofta va najosati bemor yoft meshavad. Darozii amyobai nashvii kalon az 30 – 40 to 60 – 80 mkm ast. Qobili fagositozi eritrositho (eritrofag) meboshad. Hangomi A.-i ruda dar najosati mariz duchor meoyad. Amyobai javfi (daroziash 15 – 20 mkm) nisbatan kam harakat mekunad. Dar javfi rudai gafs mavjud ast. Dar akhloti odamone, ki A.-i shadidi rudaro az sar guzarondaand, mushohida meshavad. Amyobai peshsistai (daroziash 12 – 20 mkm) kamharakat ast. Dar najosati odamone, ki az A.-i shadidi ruda ofiyat yoftaand, hamchunin dar najosati ashkhosi homili sista badi istemoli davohoi darunron ba mushohida merasad.
Davrai oromii amyobai isholi khunin dar shakli sistaho jarayon megirad. Sistaho mudavvar buda, qutrashon to 9 – 14 mkm ast. Onho dar akhloti odamone, ki A.-i shadidi rudaro pasi sar kardaand, bemoroni mubtaloi A.-i muzmini takrorshavanda (dar davrai behbudii muvaqqati) va homiloni sista mushohida megardand. Sistaho ba tasiri omilhoi muhit tob meorand. Dar akhloti tar, hamchunin ob to 1 moh qobili hayot buda, dar khoki namu joi soya to 8 ruz zinda memonand. Az tasiri garmi va khushkidan zud mahv meshavand.
Manbai siroyati A. shakhsi bemor yo homili amyobaho meboshad. Sistai amyobaho ba vositai akhlot khorij meshavad. Dar 1 g akhlot to 6 mln sista mavjud ast. Odam hangomi istemoli ob va khurokvorii oludai sistaho, hamchunin az dasti iflos siroyat meyobad. A. dar mamoliki iqlimashon garm pahn shudaast. Bemorii mavsimi (tobistonu tiramoh) meboshad. Hususan mohhoi avgust beshtar khuruj meyobad. Ba A. beshtar odamoni miyonsol giriftor meshavand.
Siroyat dar natijai ba rohi uzvhoi hozima aftodani sistai amyoba ba vuqu mepayvandad. Pardai sista dar qismi poyoni rudai borik yo qismi boloi rudai gafs gudokhta shuda, khudi sista dar surokhi qismi ba tana nazdiki rudai gafs zindagi va afzoish menamoyad. Dar chunin mavridho bazan shakhs mariz nashudanash ham mumkin ast (onro amyobahomilii solim menomand). Dar mavridhoi digar, amyobai javfi ba pardai zerluobii ruda vorid shuda, ba amyobai boftaii bemoriovar tabdil meyobad. Sababi ba boftaho daromadan va gudokhta shudani amyobaho moddahoi makhsus – sitolizinho va fermenthoi proteolizi doshtani onho ast. Amyoba dar boftahoi devorai ruda afzoish meyobad va ba paydoishi dumbal (abstsess)-hoi khurd musoidat mekunad. Dumbalho tadrijan chuqur rafta, luobpardaro zakhmnok mesozand. Ba afzoishu osebi amyobaho mikroflorai ruda tasiri kalon merasonad. Dar in bobat tarzi gizogiri va vazi salomatii shakhs niz beahamiyat nest. Bo mururi vaqt adadi zakhmho meafzoyad. Asosan kurruda va rudai bolorav oseb meyobad. Amyoba tavassuti khun mumkin ast ba jigar va uzvhoi digar guzarad. CHunin vazro A.-i gayrirudavi menomand, hol on ki vay orizai khudi A. ast. Ogozi marizi hamesha ba illati rudaho vobastagi dorad. Hini surokh kardani zakhmho peritoniti mahdud ba nazar merasad. Dar mavridi shifo yoftani zakhmho boftaho khadsha basta, mumkin ast ruda tang shavad.
Davrai nihonii A. az 1 hafta to 3 moh (beshtar 3 – 6 hafta) meboshad. A. chunin khelho dorad: 1) A.-i rudai (shadid, muzmin, pinhoni); 2) A.-i gayrirudai (gepatiti amyobai, dumbali jigar, dumbali uzvhoi digar, A.-i pust); 3) A.-i mushtarak (yakjoya bo gelmintozho, dizenteriyai bakteriyavi rukh menamoyad).
A. odatan ba tavri shadid ogoz meyobad. Mariz sustu behol shuda, sar va goho shikam ba dard medaroyad. Minbad ishol paydo meshavad, akhlot bo khunu luob omekhta ast. Mavzei kurruda va rudai bolorav hangomi dast rasondan dard mekunad.
Pas az davrai shadidi davrai ofiyati bardavom sar meshavad, ki bemor khudro solim mepindorad. Vale dertar marizi boz khuruj mekunad va jarayoni on muzmin megardad. Dar surati tabobat nakardan, A.-i muzmin to 10 sol davom menamoyad. Vay ba du tarzi sariri (kliniki) – takrorshavanda va muttasil padid meoyad.
A.-i takrorshavanda goh khuruj karda, goho khomush meshavad. Dar mavridi khuruj vazi bemoron qarib, ki betagyir va harorati badan mutadil ast, poyoni qaburgai tarafi rost dard mekunad (binobar in onro bazan sahvan appenditsit menomand), ishol rukh menamoyad.
Hangomi A.-i muzmini muttasil marizi biduni davri sabukshavi jarayon megirad. Vale, bo vujudi in, padidahoi bemori goho tezutund (dardi shikam, ishol, qabziyat, najosati khunolud, bazan tafsu tab kardani bemor) va goho kame sust meshavand.
Ba orizahoi A. peritoniti umumi yo juzi, tang shudani ruda, amyoboma, khunshorii ruda, kuchidani luobpardai rudai rost mansuband. Dar natijai tang gashtani ruda va amyoboma mumkin ast surokhi ruda basta shavad. Amyoboma tashkilai omosshakl buda, dar devorai ruda padid meoyad va hini takror yoftani siroyat fasod hosil mekunad. Ba orizahoi khorijirudai dumbali jigar, mayna, osebi pust mansuband. Dumbali jigar nisbatan beshtar duchor meoyad. Ba tavri shadid jarayon giriftani dumbal boisi tab, tablarza, sustivu beholi va dardi zeri qaburgai rost meshavad. Dumbali amyobavi mumkin ast ba uzvhoi nazdik guzashta, ba paydoishi dumbali zeridiafragmavi, peritonit, plevriti fasoddor va perikardit musoidat binmoyad. Dumbali jigar goho ba rui pust mebaroyad va dar chunin holatho dar mavzei nosur osebi amyobavii pust ba vuqu mepayvandad. Dumbalhoro hangomi tahqiqi rentgenologi oshkor kardan mumkin ast.
A. dar bemorkhona muolija karda meshavad.
Ad.: Hashimov Dj.M., Kishechniy amyobiaz v Tadjikistane, D., 1970; Qamardinov H.Q (va dig.), Bemorihoi siroyati, D., 2000; Hamon mual., Infeksionnie i parazitarnie bolezni, D., 2009
H.Q. Qamardinov,
E.R. Rahmonov.