MIOKARDIT

MIOKARDIT (Myocarditis; az mio… va kardio…), gazak giriftani mushaki dil – miokard. Beshtar dar sinni bachagi, hangomi tarbod, bazan dar asnoi bemorihoi siroyati (difteriya, domana, angina, makhmalak, sepsis, gripp va g.) sar mezanad. M.-i tarbodi aksaran yakjoya bo endokardit zuhur meyobad. M. khususiyati allergi ham doshta metavonad, yane on natijai ba mikrobho va mahsuli tajziyai onho, inchunin ba baze doruho nihoyat hassos budani miokard meboshad (nig. Allergiya). Mushaki dil metavonad az sarkoidoz sil, sifilis, toksoplazmoz niz oseb yobad. M.-i paydoishash nomalum niz mavjud ast, mas., M.-i Abramov-Fidler. Hangomi M.-i virusi va siroyatiyu zahri nishonahoi osebi dil dar davrai zahroludshavii vozeh ba mushohida merasand; alomathoi bolinii M. dar asnoi poliomielit ruzhoi avvali rukh namudani falaj zohir megardand; M.-i siroyatiyu allergi, odatan, badi 2 – 3 haftai ogozi bemorii shadid yo khuruji bemorii muzmini siroyati inkishof meyobad. M.-i zardobi pas az 12 – 48 soati ba organizm firistodani zardob (sivorotka) padid meoyad.
Bisyor vaqt M. biduni yagon alomat jarayon megirad. Bazan onro faqat az rui tagyiroti EKG muayyan mekunand. Hangomi M. bemor az dardi dil, ikhtiloli nizomi kashishi dil, ziqi nafas va bemadori, khastagi shikoyat mekunad. Dar surati kori ziyodi jismoni hamai in alomatho avj megirand. Harorat metavonad mutadil yo andak baland shavad. Ba chunin vazi bemor aksar angina, gaymorit, tonzillit va g. sabab megardad.
M. metavonad ba tavri shadid, shadidmonand va muzmin zohir shavad; baze shaklhoi on goh khuruj yofta, goh az khud mohu solhoi daroz darak namedihad. Odatan, jarayoni M.-hoi siroyati, zahri, zardobi va radiatsioni shadid va shadidmonand meshavad. Jarayoni M.-i siroyatiyu allergi va zahriyu allergi goho ba tavri muzmin surat megirad.
M.-e, ki sababi on gripp, surkhakon, surkhcha va gulafshon ast, bisyor vaqt biduni zuhuroti vozehi bolini (kliniki) padid meoyad. Vale onro metavon az rui kund budani ohangi dil, khususan ikhtiloli guzaronish va ritmi on muqarrar kard. Hangomi M.-e, ki bar asari virusi poliomielit sar zadaast, nuqsi dil bisyor vaqt ba tavri shadid ogoz meyobad.
Dar mavridi ba mushohida rasidani aritmiya, damkutohi va dig. alomathoi nuqsi dil (dar odamone, ki qablan bemorii dil nadoshtand, khususan dar javonon) metavon az M. gumonbar shud. Hangomi gundoshtani malumot ba bemorihoi siroyatii az sar guzaronda, zahroludi, ba organizm firistodani zardob etibori jiddi boyad dod. Baroi tashkhisi M. malumoti perkussiya va auskultatsiyai dil niz kumak merasonad. Bo in hama metavon malumoti tadqiqi rentgenologi va EKG-ro niz hamroh kard. Oid ba mavjudiyati M. dar khun afzudani saviyai L2- va Y-globulinho niz darak medihad. Alomati asosii tashkhisi M. dar khun vujud doshtani podtan (antitela) nisbati miokard ast.
Tashkhisi tafriqii M. nisbat ba miokardiodistrofiya, kardioskleroz, kardiomiopatiya, ishemiya, stenokardiya guzaronda meshavad.
Bemoroni giriftori M.-ro dar bemorkhona muolija mekunand. Doruhoi hozirazamon baroi tabobati shaklhoi gunoguni on nihoyat purtasirand. Hangomi muolijai M. tartibi khurok ahamiyati kalon dorad; khuroki bemor boyad zudhazm, servitamin boshad, az shir, sabzavot, gushti obpaz va mohi tahiya shavad; istemoli nushokiho va namaki osh, alalkhusus hangomi sustii kori dil, kam karda meshavad. Baroi bartaraf shudani alomathoi kori susti dil (varam, ziqi nafas va g.) varzishi shifoi tain mekunand (on tahti nazorati qatii dukhtur meguzarad). Varzishro az obutobi mushakhoi uzvi nafas va guruhhoi miyonai mushakhoi dastu poy sar mekunand. Badi khudro khub his kardani bemor doirai mashqhoi varzishiro vase menamoyand; dar surati sabuk budani M. az ruzhoi avvali bemori ba varzishi shifoi shuru mekunand.
M.-i bemorihoi siroyati, odatan purra shifo meyobad. M.-i tarbodi va siroyatiyu allergi metavonad takror shavad. Ammo nazorati dispanseri va muolijai sarivaqti ba takror yoftani onho roh namedihad. Makhsusan ba peshgirii manbahoi siroyati bemori (tonzillit, gaymorit va g.) diqqati makhsus doda meshavad.
Miokardit dar kudakon. Dar kudakon M. beshtar bar asari virusho (gripp, tabkhol, virusi Koksaki), bazan bakteriyaho (stafilokokkho, streptokokkho) paydo meshavad. On hamchunin metavonad badi moyaguzaroni (gulburi) niz padid oyad.
Alomathoi avvalini bemori dar zaminai siroyati shadidi rohi nafas yo 1 – 2 hafta badi on mushohida meshavand. Kudak khastahol va kamishtiho shuda, araqi bisyor mekunad, rangi pust meparad, u beqaroru noorom ast, mesurfad (surfai khushk, khususan hangomi khobondan), kharob meshavad. Tadrijan labho kabud gashta, hatto hangomi oromi niz damkutohi ba vujud meoyad, nafasgiri khalal meyobad, shush sado medihad. Nishonahoi nakhustini M. dar kudakon dilbehuzurii besabab, qay, dard kardani shikam niz meboshand. Harorati badan, odatan, mutadil ast. Dar baze kudakon mumkin ast behushi, tashannuj, paridani rangi pust joy doshta boshad.
M.-i kudakonro ba tavri kompleksi muolija mekunand (antibiotikho, doruhoi ziddi iltihob, glikozidhoi dil, davohoi peshobron, immunodepressantho va g.). Dar surati ba takhir mondani muolija farjomi bemori bad ast.
N. H. Hamidov.