{"id":359,"date":"2021-11-20T11:20:39","date_gmt":"2021-11-20T11:20:39","guid":{"rendered":"https:\/\/haymorit.com\/?p=359"},"modified":"2021-11-30T07:35:10","modified_gmt":"2021-11-30T07:35:10","slug":"qaraciy%c9%99r-piyl%c9%99nm%c9%99si","status":"publish","type":"post","link":"https:\/\/haymorit.com\/qaraciy%c9%99r-piyl%c9%99nm%c9%99si\/","title":{"rendered":"Qaraciy\u0259r Piyl\u0259nm\u0259si N\u0259dir? \u018flam\u0259tl\u0259ri v\u0259 M\u00fcalic\u0259 \u00dcsullar\u0131 Hans\u0131lard\u0131r?"},"content":{"rendered":"\n

Qaraciy\u0259rin \u0259sas struktur elementi hepatositl\u0259r, y\u0259ni qaraciy\u0259r h\u00fcceyr\u0259l\u0259ridir. Qaraciy\u0259rin piyl\u0259nm\u0259sind\u0259 piyl\u0259r hepatositl\u0259rd\u0259 (sitoplazmada) damc\u0131 \u015f\u0259klind\u0259 toplan\u0131r. Mikroskop alt\u0131nda a\u011f yuvarlaq, oval k\u00fcr\u0259cikl\u0259r (makrovezik\u00fcll\u0259r) kimi g\u00f6r\u00fcn\u00fcr. Bu s\u0259b\u0259bd\u0259n, makrovezikulyar piyl\u0259nm\u0259 kimi m\u00fc\u0259yy\u0259n edilir. H\u00fcceyr\u0259l\u0259r \u015fi\u015fir, n\u0259tic\u0259d\u0259 qaraciy\u0259r b\u00f6y\u00fcy\u00fcr. Normal qaraciy\u0259rd\u0259 bu ya\u011f damc\u0131lar\u0131 hepatositl\u0259rin 5%-d\u0259 g\u00f6r\u00fcn\u0259 bil\u0259r. Daha \u00e7ox (5%) qaraciy\u0259r ya\u011flanmas\u0131 v\u0259 ya alkoqolsuz ya\u011fl\u0131 qaraciy\u0259r x\u0259st\u0259liyi (ADYLC) adlan\u0131r. <\/p>\n\n\n\n

Labrotar v\u0259 ya klinik simptomlar qaraciy\u0259r ya\u011flanmas\u0131n\u0131n nisb\u0259ti 30%-d\u0259n b\u00f6y\u00fck olduqda ba\u015f verir. Bunlar m\u00fcayin\u0259 v\u0259 ya ultras\u0259s (US) zaman\u0131 a\u015fkar edil\u0259n qaraciy\u0259r b\u00f6y\u00fcm\u0259sidir. US t\u0259r\u0259find\u0259n g\u00f6st\u0259ril\u0259n qaraciy\u0259r piyl\u0259nm\u0259 v\u0259 qanda ALT v\u0259 GTT kimi qaraciy\u0259r testl\u0259rind\u0259 orta d\u0259r\u0259c\u0259d\u0259 (normaldan 1-2 d\u0259f\u0259 aras\u0131nda) y\u00fcks\u0259lm\u0259l\u0259rdir. Bundan \u0259lav\u0259, bu x\u0259st\u0259l\u0259rd\u0259 \u00e7ox vaxt art\u0131q \u00e7\u0259ki, \u015f\u0259k\u0259rli diabet, hiperlipidemiya v\u0259 hipertoniya kimi bir v\u0259 ya bir ne\u00e7\u0259 yana\u015f\u0131 x\u0259st\u0259likl\u0259r olur. Mikrovezikulyar ya\u011flanmada ya\u011f daha ki\u00e7ik v\u0259 mikroskopda g\u00f6r\u00fcnm\u0259y\u0259n hiss\u0259cikl\u0259r \u015f\u0259klind\u0259dir. Bu v\u0259ziyy\u0259t daha az rast g\u0259linir v\u0259 b\u0259zi x\u00fcsusi hallarda (m\u0259s\u0259l\u0259n, hamil\u0259lik zaman\u0131 qaraciy\u0259rin k\u0259skin piyl\u0259nm\u0259si, valproat v\u0259 antiretrovirus preparatlar\u0131n q\u0259bulu n\u0259tic\u0259sind\u0259 qaraciy\u0259rin z\u0259d\u0259l\u0259nm\u0259si v\u0259 Reye sindromu) m\u00fc\u015fahid\u0259 olunur. <\/p>\n\n\n\n

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Qaraciy\u0259r Piyl\u0259nm\u0259si \u018flam\u0259tl\u0259ri N\u0259l\u0259rdir?<\/h3>\n\n\n\n

Qaraciy\u0259r piyl\u0259nm\u0259sinin kliniki t\u0259zah\u00fcrl\u0259ri yoxdur. Sirroz x\u0259st\u0259liyi olan insanlar sirroz yarana q\u0259d\u0259r normal h\u0259yat s\u00fcr\u00fcrl\u0259r. X\u0259st\u0259lik, ad\u0259t\u0259n tez-tez hipertoniya v\u0259 \u00fcr\u0259yin i\u015femik x\u0259st\u0259liyi il\u0259 m\u00fc\u015fayi\u0259t olunur. <\/p>\n\n\n\n

Qaraciy\u0259r Piyl\u0259nm\u0259si Diaqnozu Nec\u0259 Qoyulur?<\/h3>\n\n\n\n

B\u0259z\u0259n yuxar\u0131da qeyd olunan risk faktorlar\u0131na malik olmayan insanlarda da qaraciy\u0259r piyl\u0259nm\u0259si ola bil\u0259r. Burada genetik faktorlarda rol oynay\u0131r. Spirtli i\u00e7ki q\u0259bul ed\u0259n, lakin onu gizl\u0259d\u0259n x\u0259st\u0259l\u0259r d\u0259 diaqnozda \u00e7\u0259tinlik \u00e7\u0259k\u0259 bil\u0259rl\u0259r. Y\u0259ni, bu x\u0259st\u0259l\u0259r tez-tez h\u0259kim\u0259 m\u00fcraci\u0259t ed\u0259n insanlard\u0131r. Ad\u0259t\u0259n qaraciy\u0259rin piyl\u0259nm\u0259si v\u0259 b\u00f6y\u00fcm\u0259si diaqnozu qarn\u0131n yuxar\u0131 hiss\u0259sinin ultras\u0259s m\u00fcayin\u0259sind\u0259 qoyulur. B\u0259z\u0259n rutin m\u00fcayin\u0259l\u0259r olan ALT, AST v\u0259 GGT kimi qaraciy\u0259r testl\u0259ri y\u00fcks\u0259k olduqda, t\u0259tdiq edil\u0259n x\u0259st\u0259d\u0259 qaraciy\u0259r piyl\u0259nm\u0259si x\u0259st\u0259liyi a\u015fkar edilir. \u018flb\u0259tt\u0259 ki, alkoqol qaraciy\u0259r x\u0259st\u0259liyi, viral hepatit (hepatit B v\u0259 hepatit C), d\u0259rman toksikliyi (m\u0259s\u0259l\u0259n, tamoksifen, amiadaron, lomitapid v\u0259 s.) v\u0259 dig\u0259r x\u0259st\u0259likl\u0259r istisna edilm\u0259lidir. Alkoqolsuz ya\u011fl\u0131 qaraciy\u0259r x\u0259st\u0259liyi olan x\u0259st\u0259l\u0259rd\u0259 x\u0259st\u0259liyin gedi\u015fi il\u0259 ba\u011fl\u0131 \u0259n m\u00fch\u00fcm tap\u0131nt\u0131 fibrozun olmas\u0131, y\u0259ni qaraciy\u0259rd\u0259 iltihabi aktivlikl\u0259 birlikd\u0259 birl\u0259\u015fdirici toxuma y\u0131\u011f\u0131lmas\u0131 v\u0259 fibrozun d\u0259r\u0259c\u0259sidir. O h\u0259m sirrozun gedi\u015fat\u0131n\u0131, h\u0259m d\u0259 hepatosel\u00fcler karsinoman\u0131n (HSC) v\u0259 dig\u0259r a\u011f\u0131rla\u015fmalar\u0131n inki\u015faf\u0131na r\u0259hb\u0259rlik edir. <\/p>\n\n\n\n

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Qaraciy\u0259r Piyl\u0259nm\u0259sinin M\u00fcalic\u0259si Nec\u0259dir?<\/h3>\n\n\n\n

Ya\u011fl\u0131 qaraciy\u0259rin m\u00fcalic\u0259sind\u0259 ilk add\u0131m ar\u0131qlamaqd\u0131r. Ara\u015fd\u0131rmalara g\u00f6r\u0259, \u0259g\u0259r x\u0259st\u0259 \u00e7\u0259kisinin 10 faizini itirirs\u0259, qaraciy\u0259r x\u0259st\u0259likl\u0259ri geril\u0259yir v\u0259 bununlada m\u00fcsb\u0259t b\u0259rpa \u00e7\u0259kinin 5 faizi itirildikd\u0259 ba\u015flay\u0131r. Eyni zamanda \u015f\u0259k\u0259r x\u0259st\u0259liyi varsa, x\u0259st\u0259lik nizamlanmal\u0131, \u015f\u0259k\u0259rin s\u0259viyy\u0259si m\u00fc\u0259yy\u0259n h\u0259dd\u0259 saxlan\u0131lmal\u0131 v\u0259 \u015f\u0259k\u0259ri p\u0259hriz plus d\u0259rmanlarla t\u0259nziml\u0259m\u0259k laz\u0131md\u0131r. H\u0259m\u00e7inin, bu x\u0259st\u0259l\u0259rin \u0259ks\u0259riyy\u0259tind\u0259 y\u00fcks\u0259k xolesterol s\u0259viyy\u0259l\u0259rid\u0259 var. Buna g\u00f6r\u0259 d\u0259, xolesterin salan d\u0259rmanlar\u0131n istifad\u0259si qaraciy\u0259r \u00fc\u00e7\u00fcn faydal\u0131 olacaqd\u0131r. Bu x\u0259st\u0259l\u0259rin ar\u0131qlamas\u0131 son d\u0259r\u0259c\u0259 vacibdir. Ar\u0131qlama\u011f\u0131n yolu is\u0259 yaln\u0131z p\u0259hriz v\u0259 idmandan ke\u00e7ir. Bundan \u0259lav\u0259, h\u0259ft\u0259d\u0259 \u00fc\u00e7 v\u0259 ya d\u00f6rd g\u00fcn g\u0259zinti, \u00fczg\u00fc\u00e7\u00fcl\u00fck v\u0259 ya idman zal\u0131nda edil\u0259n f\u0259aliyy\u0259tl\u0259r olmal\u0131d\u0131r. Bel\u0259likl\u0259, x\u0259st\u0259nin qaraciy\u0259ri b\u0259rpa oluna bilir. Amma x\u0259st\u0259lik inki\u015faf ed\u0259rs\u0259, son \u00e7ar\u0259 is\u0259 qaraciy\u0259r transplantasiyas\u0131 ola bilir. <\/p>\n\n\n\n

B\u0259s Qaraciy\u0259r Piyl\u0259nm\u0259sinin Qar\u015f\u0131s\u0131n\u0131 Nec\u0259 Almaq Olar? <\/h3>\n\n\n\n

Sad\u0259; h\u0259r bir k\u0259sin ed\u0259 bil\u0259c\u0259yi t\u0259dbirl\u0259r vasit\u0259si il\u0259 qaraciy\u0259r piyl\u0259nm\u0259si x\u0259st\u0259liyinin qar\u015f\u0131s\u0131n\u0131 ala bil\u0259rsiniz. H\u0259min t\u0259dbirl\u0259ri a\u015fa\u011f\u0131dak\u0131 kimi sadalaya bil\u0259rik:<\/p>\n\n\n\n