АРТЫҚ САЛМАҒЫ БАР ЕРЛЕРДЕГІ ЖАСҚА БАЙЛАНЫСТЫ ГИПОГОНАДИЗМДІ ТҮЗЕТУДІҢ МЕДИКАМЕНТОЗДЫ ЕМЕС ӘДІСТЕРІ. ӘДЕБИЕТТЕРДІ ШОЛУ.
Кіріспе: Гипогонадизмнің дамуында тестостеронның төмендеуі маңызды рөл атқарады, заңдылық бойынша олар орта және егде жастағы ер адамдарда дамиды. Қазіргі уақытта бұндай науқастардың саны 43% жетті. Ер адамдардың қартаюы жөніндегі мәселеге арналған Массачусентс (ММАS –Massachusetts Male Aging Study) зерттеуі барлығы 1491 ерадамның ішінен 40 пен 70 жас аралығындағы ер адамдардың қанындағы тестостерон деңгейін анықтады. 30-35 жасаралығынан бастап жалпы тестостеронның деңгейі 0,8%, ал бос тестостерон деңгейі жылына 2% төмендейтіні анықталды. Жасына, бағасына байланысты алынған жүйелі ақпараттарға жүгіне отырып, АҚШ-ташамамен 2,4 млн ер адамныңішінде 40-69 жасаралығындағы ер адамдар андрогендердің жеткіліксіздігі мен зардап шегеді. Осы ауру жайлы аланған мәліметтерге сүйене отырып, біз АҚШ-та 40-69 жасаралығындағы ер адамдарда жылына шамамен 481 000 жаңа жағдай андрогендердің жетіспеушілігі бойынша кездесетінін анықтадық. Бұл мәлімет басқада елдермен континенттердің ер адамдарында күмәнсіз кездестіруге болады. Мақсаты: Қазақстанда, жақын шетелдермен әлемде артық салмағыбар, жасы ұлғайған еркектердегі гипогонадизмді медикаментозды емес әдіспен анализдеп, коррекциялау. Іздеу стратегиясы: осы кілт сөздер бойынша (жасқа байланысты гипогонадизм, артық салмақ, гипогонадизмді коррекциялау әдісі) PubMed, CochraneLibrary, ResearchGate, Webofscience, GoogleScholar, Paragraphmedicine, ScienceDirect және e-library электронды жүйелерінде әдебиетті іздеу жүргізілді. 74 орынды жұмыстың ішінде мәселені айқындай тын сипаттамалар шолу мақсатында қабылданған. Нәтижелері: Жас ұлғаюына байланысты тестостеронның төмендеуін медикаментозды емес емдеу негізін де жүйелі тәсілжатыр. Дұрыс тамақтану балансын сақтау және стресстік жағдайларды азайту көрінісінде адекватты физикалық жүктеме ең перспективті болып табылады. Осы негізгі әдіске қосымша ретінде курорттық терапия және жалпы бальнеотерапия, жыныс мүшелерінің қосымша ауруларын: варикоцеле, гидроцеле, созылмалы простатиттің асқынуын коррекциялау болып табылады. Айқын артық салмақ кезінде бариатрикалық хирургия ең танымал. Қорытынды: жас ұлғаюына байланысты гипогонадизмді медикаментозды емес коррекциялауға арналған әдіс-тәсілдер ішінде бұл категорияда ғы науқастарды қадағалау дабіріккен енгізілетін стандарты әдісі жоқ. Андроген дефициті кезінде қолданылатын барлық әдістероң нәтиже бергенімен, жоғарыэ ффект беретініндәлелдемейді. Сол себепті олар ықарай жас категориясына байланысты заманауи талаптарға сайқұрылымдық және бейімділікті қажететеді.
Мерхат Н. Аккалиев1, https://orcid.org/0000-0003-3122-7411 Нурлан Е. Аукенов2, Меруерт Р. Масабаева1, https://orcid.org/0000-0001-8240-361Х Бахытбек А. Апсаликов1, https://orcid.org/0000-0001-6983-9224 Нариман М. Садыков3, Муратхан Т. Кудербаев1, https://orcid.org/0000-0002-7431-6273 1 КеАҚ «Семей медицина университеті» Семей к., Қазақстан Республикасы; 2 ҚР ДМ Ғылым мен адамиресурстар департаментінің ғылым мен жаңа технологиялар басқармасы, Нұр-Сұлтан қ., Қазақстан Республикасы; 3 Павлодар филиалы КеАҚ, «Семей медицина университеті», Павлодар қ., Қазақстан Республикасы.
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