Adamzat ómirindegi teńdesi joq eń qundy syilyq jáne baǵa jetpes zor bailyq – densaýlyq. Dana halqymyz «Densaýlyq – zor bailyq» dep, oǵan jiti nazar aýdaryp otyrýdy únemi shegelei túsýi mine, osydan bolsa kerek. Óitkeni deni saýdyń jany saý bolatyndyǵy aitpasa da túsinikti. Desek te, búgingi tańda aýrýdyń túrleri kóbeiip, adamdardyń odan zardap shegýi shekten tys ulǵaiyp barady. Qazaqstanda 35 myńǵa jýyq naýqas Parkinson diagnozymen ómir súrip jatyr. Jyl saiyn olardyń qatary 2,5 myń adamǵa artyp otyrady eken.
Sonymen Parkinson degen qandai aýrý? Ol qandai jaǵdaida paida bolady? Klinikalyq belgileri, ony emdeýdeýdiń em-domdyq túrleri qandai? Mine, osy siiaqty basqa da ózekti suraqtarǵa jaýapty kópshiliktiń nazaryna usynǵandy jón sanadyq.
Parkinson – júike júiesiniń eń qaýipti ári jumbaq aýrýlarynyń biri. Bul aýrýǵa shaldyqqanda midaǵy neirondar qyzmeti buzylady. Ádette, bul dert 55 pen 65 jas aralyǵyndaǵy adamdarda jáne kóbine erler arasynda jii kezdesedi. Biraq 30-40 jasynda, tipti 20 jasynda Parkinsonǵa shaldyqqan naýqastar da joq emes. Ókinishke orai, qazirgi meditsina bul aýrýdyń neden paida bolatynyn dóp basyp, dál anyqtai almai otyr.
Sondyqtan Parkinson aýrýy qazirgi tańda Altsgeimer aýrýynan keiin álemde eń keń taraǵan neirodegeneratsiialyq aýrý bolyp tabylady. Neirodegeneratsiia degenimiz nerv jasýshalarynyń birtindep óz qyzmetin joǵaltyp, túbinde ólip qalýy. Neirodegeneratsiia adamdy múgedektikke alyp kelýi múmkin. Búgingi kúnde álemde parkinson aýryna shaldyqqyn adamdardyń sany 4 millionǵa jýyq. Parkinson aýrýynyń orta eseppen taralýy 100 myńǵa shaqqanda 150-200, alaida bul kórsetkish jasy 70-80-nen asqan adamdar arasynda 300-ge deiin jetýi ábden múmkin. Parkinson aýrýyna negizinde egde jasqa jetken adamdar beiim bolǵanmenen, sońǵy jyldary bul aýrý 30 ben 60 jas aralyǵyndaǵy jumys isteitin jas adamdar arasynda jiilep ketti. Qazaqstanda PA epidemiologiiasy zerttelmegen. Álemdik statistikany saraptaǵanda bizdiń elimizde mólshermenen otyz bes myńǵa jýyq adam Parkinson aýrýyna shaldyqqan dep sanaýǵa bolady. Ǵalymdardyń boljamy boiynsha bul aýrýmen aldyńǵy on jyldyqta eki millionǵa jýyq adam aýyrady. Osy statistikalyq boljamdy eskere otyryp, egemen Qazaqstanda Parkinson aýrýynyń keń taralýy tek áleýmettik emes, ekonomikalyq yqpaldyń da áserinen týyndaýy múmkin dep oilaýǵa bolady.
Parkinson aýrýynyń sebebi midyń jasaýshalarynda alfa sinýklein degen aqýyzdyń mólsherden tys jinalýy, jinalǵan aqýyzdyń toksin bólýi jáne sol toksinderdiń saldarynan ortalyq mida ornalasqan qara sýbstantsiianyń DOFAMIN degen himiialyq zatty túzetin nerv jasýshalarynyń ólýi bolyp tabylady. Dofamin jetkiliksizdigi Parkinson aýrýynyń negizgi belgilerine alyp keledi. Olar aiaqtaǵy qaitalmaly qimyl-qozǵalys shapshańdyǵy baiaýlaýy men bulshyqettiń, beldiń siresýi, qajýy. Bundai belgini meditsina tilinde bradikineziia dep atalady. Bradikineziia Parkinson aýrýynyń negizgi belgisi. Aýrýdyń qosymsha belgileri qol men aiaqtyń dirildeýi, qaqsap aýrýy, bulshyqetterdiń tyrysyp, qatyp qalýy. PA 90% jaǵdaida sporadikalyq túrde paida bolady, iaǵni aýrýdyń anyq sebebi bolmaidy. On paiyz jaǵdaida aýrý tuqym qýalap júretini de belgili bolyp otyr. Mida alfa sinýklein jinalýyna sporadikalyq jaǵdailarda birqatar risk gender men qorshaǵan orta faktorlarynyń ózara qarym qatynasy alyp keledi.
Parkinson aýrýyn álemde dárilik jáne hirýrgiialyq ádistermen emdeý qolǵa alynǵan. Dárilik emniń negizi midaǵy dofamin jetkiliksizdigin qaita qalpyna keltiretin «Levodopa» dárileri taǵaiyndalady. Qazaqstanda bul aýrýǵa qarsy tirkelgen «Levodopa» dárileri nakom, levokarbisan jáne madopar deitin túrleri bar. «Levodopa» dárilik preparaty Parkinson aýrýy emindegi altyn standart bolyp sanalady. Qazirgi tańda levodopaǵa qaraǵanda jumsaq dáriler shyqty. Olardyń ishinde Qazaqstanda tirkelgenderi «Mirapeks», «Azilekt». Alaida, kóptegen Parkinson aýrýyna qarsy jańa dáriler bizdiń elimizde joq.
Parkinson aýrýyn hirýrgiialyq jolmen emdeýdiń eń utymdy ádisi – midyń tereń stimýliatsiiasy dep atalady (Deep brain stimulation). Bul ádis Qazaqstanda 2013 jyldan bergi ýaqytta Shashkin Shyńǵys Saqauly degen neirohirýrgtiń qolymen qoldanylyp kele jatqany belgili. Osy kúnge dáiin ol 200-den astam Parkinson aýrýymen aýyratyn adamǵa midyń tereń stimýliatsiiasyn jasap úlgerdi. Alaida, bul operatsiia parkinson aýrýynyń negizgi sebepterin túbegeili joia almaidy, biraq aýrýdyń asqyný belgilerin óte jaqsy basady. Operatsiia jasalǵan adamdar kóp dári ishpeidi. Kúndelikti túrlishe jattyǵýlar jasaý men ózin-ózi qatań qadaǵalaýdyń arqasynda uzaq ómir súredi. Bul operatsiiany Qazaqstan azamattary úshin tegin kvota alýdyń kezegine der kezinde turý arqyly jasaýǵa bolady.
Qazirgi tańda álemde parkinson aýrýynyń belgilerin basatyn dáriler ǵana bar. Biraq aýrýdyń údeýin baiaýlatatyn jáne sebebin joiatyn dáriler men ádister áli oilap tabylmaǵan. Sol sebepti ǵalymdar izdenis ústinde. Alaida kóptegen eksperimenttik ádister álemniń túpkir túpkirinde qoldanylyp jatyr. Olardyń ishinde miǵa dofamin túzetin baǵanaly jasýshalardy implantatsiia jasaý, genetikalyq ádistermen aýrý shaqyratyn genderdiń qyzmetin qalpyna keltirý jáne taǵy basqa zamanaýi ádister kiredi. Osy ádisterdi qoldaný áli de keń qoldanysqa engizilmegenine qaramastan, bolashaqta osy ádister óziniń utymdy paidalylyǵy men qaýipsizdigin dáleldep, keń dárejede qoldanylyp, Parkinson aýrýyn tolyq emdeýge alyp keledi degen úmit ǵalymdarda bar.
Qazaqstan men Ortalyq Aziiada Parkinson aýrýymen júieli túrde ainalysatyn Parkinson ortalyǵy qazirgi tańda ázirge tek Almaty qalasynda ǵana bar. Bul ortalyq «Standardneuro ortalyǵy» dep atalady. Ol Parkinson aýrýynyń Qazaqstan aimaǵy boiynsha meditsinanyń joǵary sanatyndaǵy bilikti dáriger, izdenimpaz ǵalym, bastamashyl mamandar – Qaiyrjanov Raýan Baǵdanuly men Parkinson aýrýyn neirohirýrgiialyq jolmen emdeitin Shashkin Shyńǵys Saqaulynyń tikelei uiymdastyrýymen qurylǵan. Búgingi tańda bul ortalyqta birqatar Parkinson aýrýyna qatysty maman-nevrolog dárigerleri, parkinson reabilitologtary, psihologtar, sóileý men jutyný joldaryn emdeý mamandary, midy magnitti stimýliatsiia jasaý mamandary, neirohirýrgtar jumys isteidi. Ortalyq 2018 jyldyń naýryz aiynda ashylyp búgingi kúnge deiin 500-den astam Parkinson aýrýyna shaldyqqan syrqattardy qarap, olarǵa dál diagnoz qoiyp, dispanserli esepke alǵan. Birneshe ai boiy ortalyq Parkinson aýrýynyń kompleksti reabilitatsiiasyn jasaýdy túbegeili qolǵa alǵan. Kompleksti reabilitatsiiaǵa reabilitologtyń qaraýyna qosa onyń jeke reabilitatsiialyq programmasynyń qurastyrylýy, odan keiingi jekeshe túrde instrýktormen jattyǵý zalynda, júzý basseininde jalǵastyrý, psihologpen ainalysý, daýysty jaqsartý jattyǵýlary, sonymen qatar óziniń tiimdi paidalylyǵyn klinikalyq zertteýlermen dáleldengen toptasymen jasalatyn tango bii, Roni Gardiner mýzyqalyq ádisi, skandinaviialyq taiaqpen júrý arqyly bútkil dene qurylysyn serpiltý, shynyqtyrý, kino-ioga ádisteri kiredi. Standardneuro ortalyǵynan reabilitatsiiadan ótken adamdar onyń paidasyn kórip jatyr. Standardneuro Ortalyǵy Parkinson aýrýyn emdeýdiń tolyqqandy tsiklyn qamtýdy jedel túrde qolǵa alǵan. Iaǵni aýrýdyń diagnozyn der kezinde dál anyqtaý, dispanserli esepke alý, parkinson aýrýynyń aýyrlyǵyn anyqtaityn halyqaralyq shkalany jasaqtaý, aýrýdy tiimdi dárilik jolmen emdeý, reabilitatsiia jasaý, midy magnitti stimýlatsiialaý, aýrýdy hirýrgiialyq jolmen emdeý taǵy sol siiaqty emdeý tásilderi atalmysh tsikldiń quramyna kiredi. Standardneuro Ortalyǵynda aýrý adamdar men olardyń týystary úshin «Parkinson aýrýy mektebi» uiymdastyrylyp otyr. Bul óz kezeginde tegin túrde Parkinson aýrýy jaily tolyq aqparat berý, onyń utymdy em-domy jáne dietasy, ómir jasyn uzartýǵa qatysty túrlishe jattyǵýlardyń utqyrlyǵyn arttyrý jóninde utymdy aqparat alyp otyrý úshin jasalǵan eń utymdy taptyrmas múmkindik bolyp tabylady. Óitkeni qazaq elinde Parkinson aýrýymen aýyratyn adamdar qaida, kimge bararyn bilmei, aýrýdyń der kezinde diagnozyn anyqtai almai jáne der kezinde utymdy em-domǵa qolyn jetkize almai, óz úiinde shekten tys zardap shegip jatqan syrqattardyń sany qanshama. Oǵan qosa keibir dárigerdiń bilimsizdigi, biliksizdigi, jaýapsyzdyǵy taǵy bar. Olai bolsa, Parkinson aýrýyna dýshar bolǵan adamdardyń qamy úshin qurylǵan asa qajetti «Klinikalyq Standardneuro Ortalyǵyna» árdaiymda sáttilik tileimiz.
«Klinikalyq Standardneuro Ortalyǵynyń» meken-jaiy: Almaty qalasy, «Qalqaman» yqsham aýdany, Báiken Áshimov kóshesi, 2, №1 qalalyq aýrýhananyń ǵimaratynda ornalasqan. Uialy tel.: 8 701 550 50 26.
Moldaǵali MATQAN
Álem halyqtary Jazýshylary Odaǵynyń múshesi,
Halyqaralyq Mustafa Kemal Atatúrik atyndaǵy Altyn medaldiń iegeri,
qoǵam qairatkeri, pýblitsist-jazýshy, akademik.
