Ursodeoxycholic asidhi: mirayiridzo kushandiswa, analogs, wongororo

Munguva ichangopfuura, nokuti pakurapa siyana chiropa maronda iri kuwedzera kushandiswa ursodeoxycholic acid. Mirayiridzo kushandiswa kwemakemikari mukomboni zvinoratidza kubudirira kwayo zvirwere zvakawanda zvakakomba. Chii zvinhu ichi? Chii ursodeoxycholic asidhi? In chii zvigadzirwa izvozvo zviripo?

tsananguro

Ursodeoxycholic acid, kushandiswa iyo yakavakirwa ayo mavambo uye zvivako, munhu chena-yellow crystalline upfu. It ane shungu kuravira. fuma iyi ari kazhinji kutoitwa Nhengo dzomunhu anogadzirwa diki zvakawanda. dzakananga giravhiti Its anenge 5% kubudikidza kurema yose bile acids. Hazvina hydrophilic uye asina cytotoxicity. Ichi remubatanidzwa makemikari zviri soluble doro uye glacial acetic acid, zvishoma soluble mu chloroform uye akapotsa insoluble mumvura. Ursodeoxycholic asidhi haina huri zvigadzirwa. Zvakange yakawanikwa nduru dundira pakati zvisvundu nebere.

Ursodeoxycholic asidhi (UDCA) ane epimer kuti chenodeoxycholic acid. Pakutanga zvakanga raishandiswa Mabatirwo reflux gastritis uye kukamurwa matombo omunduru. Nokufamba kwenguva, izvozvo zvakatanga kushandiswa, uye mune dzimwe hosha dzakawanda. UDKH vaiona kupfuura yakachengeteka zviri bile acids.

Mugumisiro ursodeoxycholic asidhi

Pari, kushandiswa UDKH ane mwero kurapa nokuda siyana cholestatic chiropa chirwere ane autoimmune zvinoriumba. The mashandiro chiito kuti mumiririri uyu kudzikamisa mumasero omuviri. mamorekuru Its inogona rapinzwa membranes kuti chiropa masero - hepatocytes. Nokuda kwaizvozvi vanokwanisa kuvaita zvakawanda nemishonga kungatikanganisa zvinhu. Izvi Muiti hepatoprotective ane choleretic nomugumisiro. UDKH kuderedza remafuta akawandisa usage ari chiropa uye chinonditadzisa Absorção de Água yaro ura. mushonga uyu lowers uye anomutsa lithogenicity bile iine acid kugutsikana mairi. It runogonesa nezvebasa lipase, pancreatic uye gastric secretion. Ursodeoxycholic asidhi ane hypoglycemic kushanda uye kunomutsa paumbwe uye kupatsanurwa bile, izvozvo zvinoderedza remafuta akawandisa.

mushonga uyu anoda kukwana kana kwakakwana cleavage kuti remafuta akawandisa namabwe. Ndokusaka rinoshandiswa kakawanda. Unobva pamwe remafuta akawandisa, nayo inowedzera solubility pamusoro crystals ayo, izvo anoita deleteriously pamusoro matombo omunduru. UDKH ane immunomodulating chiito chiri kuwedzera lymphocyte basa, akazoita kutaura zvakasiyana maantigen pamusoro membranes ose hepatocytes. Zvinokanganisawo nhamba T-lymphocytes, zvinoderedza uwandu eosinophils.

UDKH akazoita wevasungwa kuti remafuta akawandisa mu bile aro vakapararira uye kuchinja zviri pfuma mune mvura sekristaro danho. Zvinokanganisawo enterohepatic riparadzirwe bile munyu. Somugumisiro ichi ungaderedza reabsorption ari dumbu pamusoro endogenous hydrophobic uye chepfu yeimwe. mushonga uyu ane zvakananga hepatoprotective uye choleretic kushanda. Ursodeoxycholic acid, umo akaongororazve kuti vanachiremba vari hepatology vanoratidza simba raro, anokwanisa kuderedza chiropa fibrosis racho mafuta degeneration.

kunyoresa

Ursodeoxycholic acid, iyo kushanda rinoitwa pasi kutarisira kupinda chiremba iri basa panguva pathological ezvinhu akadai:

• kuvapo remafuta akawandisa mabwe vemunyika vari gallbladder kana vanhuwo mutsinga dzinofamba nemukaka;

• kutadza kubata endoscopically kana surgically;

• chirwere, atypical, uye rikwanise autoimmune chiropa ;

• kuvapo remafuta akawandisa mabwe pashure zvemaziso uye extracorporeal lithotripsy;

• chepfu (zvinodhaka, doro), kukuvara chiropa;

• chinonzi sclerosing cholangitis;

• chikuru biliary cirrhosis, pasina zviratidzo decompensation;

• Surgery, biliary turakiti;

• cystic fibrosis;

• chisingaperi achishingaira chiropa;

• cholestasis panguva parenteral kudya;

• biliary dyskinesia;

• biliary dyspeptic chirwere pamwe biliary dyskinesia uye holetsistopatii;

• chisingaperi opistorhoze;

• vachiberekwa biliary Surgery;

• biliary reflux esophagitis uye reflux gastritis.

Ursodeoxycholic asidhi (UDKH) rakashandiswa kudzivirira kukuvara chiropa kunokonzerwa kwokubatsira cytostatics uye hormone pamuviri. Zvinonzi nachiremba zvimwe zvirwere zvinokonzerwa kurega kunotanga kuti bile. UDKH basa nokuti adjuvant kurapa mu chiropa transplantation kana zvimwe nenyere.

Contraindications

Ursodeoxycholic acid, iyo akaongororazve kworutivi akanaka, ane zvakakomba contraindications. Idzi dzinosanganisira:

• anogumbura zvirwere nduru dundira, ura bile ducts iri rikwanise chokutambudzika;

• rentgenopolozhitelnye matombo omunduru dzakakwirira karusiyamu kugutsikana;

• mhingaidzo of biliary turakiti;

• hypersensitivity;

• cirrhosis panguva decompensation;

• chirwere Crohn raMwari;

• kwakaziviswa hadzina kufambiswa zvakanaka zviri kushanda rwatata, chiropa uye itsvo.

zvisingakwaniswi mashandisiro

Ursodeoxycholic acid, mirayiridzo kushandiswa izvo zvinoratidza zvakajeka kusavapo kwokuoma zvausingakwanisi fomu yayo, haina basa vacheche kusvika 3 makore Kamudzira fomu. Nokuti avo kushandisa kurapa munhu slurry dzine mushonga uyu fuma. Kusvikira zvino, nyanzvi vasina aiitisa zvidzidzo zvakakodzera zvainanga Pakusarudza mugumisiro iri pfuma cholelitolitic zvichienderana nemakore mwana. Panguva iyoyowo, zvidzidzo ichiitwa pamberi vana biliary Surgery uye zvimwe zvirwere chiropa mukasazivisa chaiwo matambudziko chiremba.

Kugadzirira ine ursodeoxycholic acid, vakapiwa vakadzi vane pamuviri chete kana inozoshandisirwa mugumisiro yokurapa pamwe mumiririri uyu mukuru kupfuura zvingakanganisa mwana asati aberekwa. Hatifaniri kukanganwa kuti zvizere kudzidza esayenzi kwemakemikari vakachengeteka nokuti chikamu ichi wevarwere ari munhu apedza. Sezvo Hazvizivikanwi kana UDKH chinopinda kupinda mukaka, tinofanira kungwarira mu kugadzwa zvinodhaka roukoti vakadzi.

nemishonga

Ursodeoxycholic acid, mirayiridzo kushandiswa izvo zvinoratidza kwete chete kuitwa fomu kwayo, asi vo zvingakonzerwa nemishonga, kungaita kuti pathological mananara akadai:

• kupatira, manyoka;

• svoto;

• vakawedzera transaminases;

• marwadzo zvakarurama yepamusoro quadrant uye epigastric nharaunda;

• sema ganda siyana (kuvaviwa, mapundu);

• calcining mabwe.

Mabatirwo chikuru biliary cirrhosis gadziriro iyi dzimwe nguva anoita kuti murwere ane decompensation Inopera, kunyangarika pashure caffeine kugamuchira chinodhaka ichi.

matanho okudzivirira

To zvinobudirira litholysis remafuta akawandisa mabwe uchishandisa UDKH vanofanira kufunga zvinotevera ezvinhu:

• Kukura kwavo hakusi anopfuura 2 cm;

• havaiti kupa mumvuri pamusoro radiograph;

• gallbladder uri kushanda zvakanaka;

• ducts kuramba patency;

• ane dhudhumira akazara mabwe kutapudza pahafu;

• vanhuwo bile mutsinga dzinofamba nemukaka harina matombo.

Ndezvipi zvimwe kurambidzwa kubvuma iri ursodeoxycholic asidhi? Mirayiridzo iyi kugadzirira vezvokurapa kunoratidza kuti kurapa-yakareba, riri kupfuura 1 mwedzi, anofanira kuva kugara (1 ose mazuva 30) kuti kuitisa richiona nezvezvabuda hepatic transaminases, phosphatase, bilirubin, wegamma-glutamyl transferase ropa. Kuitisa Analyses akadaro kunonyanya kukosha kutanga 3 months yokurapa pamwe UDKH. Kubudirira kurapwa kunosimbiswa X-ray mwedzi mitanhatu ose uye Ultrasound bile. Nokuti kudzivirira dzokororo ine pfari kuramba cholelithiasis kurapwa uye pashure zvizere pokufa namabwe. Zvinogona kutora mwedzi yakawanda.

Panguva kurapwa UDKH vakadzi zera rokubereka inokurudzirwa kushandisa yakavimbika nzira kudzivirira pamuviri. Zvingava non-hormone zvinodhaka kana nhumbu ine uwandu inonzi estrogen duku.

Release chimiro uye chipimo chemushonga

Ursodeoxycholic acid, naro murayiridzo Chinyorwa anopa rondedzero yakatodzama ayo kugamuchirwa hushande, iri kugadzirwa zvakadai chipimo chemushonga siyana:

• Capsules uye mahwendefa 150 uye 250 MG;

• kuturika vana.

Chipimo chemushonga UDCA zvachose kuisa nomumwe. It kunobva kwokuomerwa evanhu uye muviri wake uremu. Kazhinji, wapuwa 10-20 MG / makirogiramu pazuva. dose ichi chinobviswa pane imwe nguva, ari manheru. Ya yokurapa kunobva uchapupu. mushonga uyu wefodya mukati ura diki, uye pashure maawa 3 plasma rinozivikanwa ayo soro yevasungwa. Constant kugamuchira medicaments ane ursodeoxycholic acid, zvinoita chikuru bile asidhi ari mumuviri womunhu. Izvi zvinhu zvakaiswa pasi dzakasiyana-siyana transformations uye yokupedzisira mugumisiro uri goho sezvo metabolites mu mutsvina yadzo weti uye.

Duration kuti ARV pakutsvaga kupinda chiremba. Zvinogona kuva zvakasiyana zvichienderana Chirwere. Mune zvimwe Muzviitiko zvakaipisisa, mabiko UDKH zvinodhaka kunotora kwemakore.

Kudyidzana nevamwe zvinodhaka

In Joint kugamuchira uye UDKH "Cyclosporine" kunowedzera nezvimwewo zviri Absorção de Água okupedzisira. In plasma zvinoshamisa kunowedzera wevasungwa kugadzirira somushonga. mabiko UDKH panguva imwe chete pakugadzirira Mune zvisingawanzoitiki Muzviitiko "Ciprofloxacin" wokupedzisira yevasungwa kunoderedza.

Ursodeoxycholic asidhi (analogues)

Ursodeoxycholic asidhi (capsules, mapiritsi) kugadzirwa pasi mazita akasiyana. nevasori kwakadaro dzinosiyana Excipients vachipinda sezvamunoita yavo. Saka, nepamusika unogona kusangana zvinodhaka izvi pamwe ursodeoxycholic asidhi:

• Capsules "Ursosan" nachiremba kurapa diffuse chiropa chirwere, cholelithiasis, pamwe biliary reflux gastritis uye reflux esophagitis, chikuru cirrhosis, zvinodhaka uye chepfu kukuvara chiropa, cholecystectomy, doro chirwere, chinonzi sclerosing cholangitis, Biliary Surgery, nonalcoholic steatohepatitis. Ursodeoxycholic asidhi ( "Ursosan") rinoshandiswa kuti kudzivirira chiropa maronda.

• Mahwendefa "Ukrliv" uyo kutora hepatic vanotaura, chisingaperi chiropa, cholelithiasis.

• Capsules "Ursofalk" nominated kuti siyana zvirwere gallbladder uye chiropa, achiperekedzwa cholestasis, vasanyanye zvimwe chiropa basa, mafuta omumuviri akawandisa mumatunhu. Izvi zvinosanganisira zvepuraimari biliary cirrhosis uye chinonzi sclerosing cholangitis, reflux gastritis uye reflux esophagitis, hepatitis akasiyana etiology, remafuta akawandisa mabwe, cystic fibrosis, maronda akawanda pamusoro pechiropa, bile stasis. gadziriro iri kushandiswa senzira prophylactic pamusoro chiropa kukuvara kana kugamuchira zvinodhaka simba.

• Mahwendefa "Ursodeks" vanotora panguva biliary cirrhosis pasina decompensation zviratidzo uye reflux gastritis. Ivo anoshandiswa kuiparadza duku remafuta akawandisa matombo ari chakaipa nokushanda kwenhengo nduru dundira.

• Capsules "Ursodez" rinoshandiswa kuputsa remafuta akawandisa mabwe, kurapa reflux gastritis, nokuti symptomatic kurapa nokuda chikuru cirrhosis chiropa asina zviratidzo decompensation.

• Capsules "Ursolizin" nominated kuti Kuparadzwa remafuta akawandisa mabwe, uye symptomatic vabatwe biliary cirrhosis, gallbladder cholesterosis uye reflux gastritis. The mushonga rinoshandiswa kunzwisisa kurapa varwere vane chirwere kuzvimba chiropa uye cirrhosis.

• Capsules "Choludexan" raishandiswa pakurapa nyore cholelithiasis, chisingaperi vanoshingaira hepatitis chidhakwa uye chepfu chiropa maronda, nonalcoholic steatohepatitis, chikuru biliary cirrhosis, chinonzi sclerosing cholangitis, cystic fibrosis, biliary dyskinesia, reflux gastritis uye reflux esophagitis.

• Capsules "Urdoksa" kuti vari nezvaro chikuru biliary cirrhosis, pasina zviratidzo decompensation, reflux gastritis. The mushonga akapora urwa vaduku uye svikiro remafuta akawandisa mabwe, apo tiine dzose kushanda nduru dundira.

• Capsules "Cursor C", basa panguva nyore cholelithiasis, chikuru cirrhosis, chenjera uye chisingaperi chiropa, chinonzi sclerosing cholangitis, Surgery intrahepatic turakiti, reflux gastritis uye reflux esophagitis, cholestasis, panguva parenteral zvokudya, biliary dyskinesia, chiropa chirwere, pamwe cystic fibrosis, mafuta gepatoze, dyspeptic syndromes. Kugadzirira rinoshandiswa kuti kudzivirira kukuvara chiropa kushandisa hormone nhumbu uye cytostatics, ibwe inotungamirwa mu kufutisa.

Ursodeoxycholic acid, analogs izvi zvinhu vanobviswa chete ushandiswe nachiremba.