Ursodez yog tshuaj hepatoprotective. Cov tshuaj muaj choleretic, hypolipidemic, choleretic nyhuv, muaj ib tug hypocholesterolemic thiab me ntsis immunomodulatory nyhuv. Cov tshuaj nquag yog ursodeoxycholic acid. Cov tshuaj tsis muaj daim ntawv "ntsiav tshuaj" ntau npaum li cas. Ursodez yog tsim nyob rau hauv daim ntawv ntawm capsules.
Txoj Haujlwm Mechanism
Cov tshuaj nquag ntawm cov tshuaj muaj peev xwm ua ke rau hauv daim nyias nyias ntawm hepatocytes, stabilizing lawv cov qauv. Vim li ntawd, cov hlwb raug tiv thaiv los ntawm kev puas tsuaj, kev ua haujlwm ntawm cov kua qaub kua qaub.
Cov txiaj ntsig kho mob ntawm cov tshuaj yog li no tshwm sim hauv kev txo qis hauv cov nyhuv cytotoxic. Tawm tsam keeb kwm ntawm cholestasis, Ca2 + dependent alpha protease yog qhib, exocytosis yog stimulated. Txhais tau tias "Ursodez" (cov lus qhia rau kev siv qhia qhov no) txo qis cov ntsiab lus ntawm cov kua tsib kua qaub (deoxycholic, lithocholic, chenodeoxycholic thiab lwm yam) nrog rau lawv cov concentration ntawm cov neeg mob. Cov kab mob siab ntev.
Thaum noj cov tshuaj, muaj qhov txo qis hauv kev tso tawm thiab kev sib txuas ntawm cov roj cholesterol, inhibition ntawm nws txoj kev nqus hauv cov hnyuv. Vim li no, saturation ntawm cov kua tsib nrog cov compound no txo. Cov tshuaj muaj peev xwm sib tw kom txo tau qhov nqus ntawm lipophilic acids nyob rau hauv txoj hnyuv, ua rau lawv cov fractional turnover ntawm lub hauv paus ntawm enterohepatic ncig. Cov tshuaj nkoos lub excretion ntawm toxic acids, ua rau txoj kev.
Lub tshuab ua haujlwm ntawm cov tshuaj kuj yog los ntawm kev tshuaj xyuas ntawm cov kua tsib tsis-polar bile acids. Qhov no ua rau cov micelles tsis muaj tshuaj lom. Tus neeg sawv cev txhim kho lub solubility ntawm cov cholesterol nyob rau hauv lub biliary system, stabilizes zus tau tej cov kua tsib thiab secretion. Cov tshuaj kuj txo nws cov lithogenicity, nce cov concentration ntawm acids, yog li provoking ib qho kev nce nyob rau hauv kev ua ntawm pancreatic thiab gastric secretion.
Thaum noj cov tshuaj ntsiav, ua kom tiav lossis ib nrab ntawm cov pob zeb tawg. Los ntawm kev txo qis saturation ntawm cov kua tsib, lub zog ntawm cov cholesterol los ntawm calculi nce. Immunomodulatory kev ua haujlwm yog tshwm sim los ntawm kev cuam tshuam cov kev cuam tshuam sib xws hauv daim siab. Cov tshuaj pab txo cov kev qhia ntawm ib tug xov tooj ntawm histocompatibility antigens. Cov tshuaj kuj cuam tshuam rau qib T-lymphocytes, txo cov eosinophils.
Pharmacokinetics ntawm cov tshuaj
Kev nqus ntawm cov tshuaj "Ursodez" (cov lus qhia rau kev siv qhia qhov no) nyob rau hauv cov hnyuv me yog ua los ntawm cov txheej txheem ntawm passive diffusion. Absorbed tib lub sijhawmtxog 90% ntawm cov khoom xyaw active. Nyob rau hauv lub ileum, cov khoom yog absorbed los ntawm active thauj. Cov khoom xyaw nquag mus txog nws cov ntsiab lus siab tshaj plaws hauv ib teev. Cov compound muaj feem pua ntawm cov protein khi - txog li 99%. Ursodeoxycholic acid muaj peev xwm hla lub placental barrier.
Kev kho tau zoo ntawm cov tshuaj yog nyob ntawm qhov concentration ntawm cov khoom xyaw nquag hauv cov kua tsib. Nrog rau kev noj zaub mov tsis tu ncua, cov kua tsib kua qaub no dhau los ua qhov tseem ceeb hauv cov ntshav ntshav. Qhov concentration ntawm ursodeoxycholic acid yog hais txog 48%.
Cov tshuaj yog metabolized los ntawm kev hla lub siab hlwb. Yog li ntawd, glycine thiab taurine conjugates yog tsim. Cov khoom tawg yog zais rau hauv cov kua tsib. Kwv yees li 50-70% ntawm cov tshuaj tau tawm hauv cov quav. Ib qho me me ntawm cov tshuaj raug thauj mus rau txoj hnyuv loj. Nyob ntawd nws tau tawg los ntawm cov kab mob (7-dehydroxylation).
Litocholic acid, uas yog tsim los ntawm cov txheej txheem no, yog ib feem ntawm cov hnyuv loj, tab sis ua rau sulfation hauv daim siab thiab raug tso tawm raws li sulfolithocholyltaurine lossis sulfolithocholylglycine conjugate.
Kev qhia
Cov tshuaj "Ursodez" tau pom zoo ua cov tsos mob kho rau thawj tus kab mob cirrhosis yam tsis muaj cov cim qhia ntawm decompensation. Ib qho kev daws teeb meem rau dissolving nruab nrab thiab me me cov roj cholesterol pob zeb nrog lub gallbladder active yog qhia. Muab tshuaj rau biliaryreflux gastritis.
YContraindications
txhais tau tias "Ursodez" cov lus qhia rau kev siv tsis tso cai rau lub sijhawm teem tseg yog tias tus neeg mob tau xoo hluav taws xob zoo (nrog rau qhov nce ntxiv ntawm Ca2 +) cov pob zeb hauv lub gallstones, intolerance rau cov khoom ntawm cov tshuaj. Contraindications muaj xws li cirrhosis ntawm daim siab nyob rau theem ntawm decompensation, mob loj heev ntawm lub txiav, ob lub raum. Cov tshuaj tsis pom zoo rau cov neeg uas muaj lub zais zis tsis ua haujlwm, nws cov kab mob hnyav ntawm qhov mob, nrog rau cov kab mob ntawm cov hnyuv thiab cov kua tsib. Tsis txhob muab tshuaj rau cov poj niam cev xeeb tub thiab lactating. Kev kho mob yog contraindicated rau cov neeg laus thiab cov me nyuam uas hnyav dua 34 kg.
Side effects
Qee qhov xwm txheej, qhov tshwm sim tsis zoo tshwm sim thaum noj tshuaj "Ursodez". Cov lus qhia rau kev siv ceeb toom ntawm qhov tshwm sim ntawm xeev siab, raws plab, ntuav. Raws li kev kho mob, calcified gallstones tuaj yeem tsim. Kev ua kom muaj zog ntawm daim siab transaminases, mob plab, ua xua tshwm sim (xws li urticaria) kuj yog qhov tshwm sim tsis zoo ntawm kev noj tshuaj "Ursodez".
Kev tshuaj xyuas ntawm cov neeg mob qhia tias muaj kev zam tau zoo ntawm cov tshuaj. Thaum kws kho mob tau sau tseg, cov kev mob tshwm sim tsis zoo li qub. Qee qhov xwm txheej, thaum kho cov kab mob biliary cirrhosis, transient decompensation tau sau tseg. Raws li txoj cai, tom qab tso tseg cov tshuaj, qhov tshwm sim no raug tshem tawm ntawm nws tus kheej.
Ursodez npaj. Nqe. Kev qhia
Txoj kev kho tau noj yav tsaus ntuj. Kev noj tshuaj txhua hnub rau kev tawg ntawm pob zeb yog qhov nruab nrab ntawm 10 mg / kg. Rau cov neeg uas hnyav txog 60 kg, nws sib raug rau 2 tsiav tshuaj ib hnub twg, mus txog 81 kg - 3, mus txog 100 kg - 4, ntau tshaj 100 - 5. Duration ntawm kev nkag - los ntawm rau lub hlis mus rau 12 lub hlis. Tom qab cov pob zeb tau yaj lawm, nws raug nquahu kom coj lawv rau ob peb lub hlis ntxiv txhawm rau tiv thaiv kev tsim cov tshiab.
Kev mob plab hnyuv siab raum yog kho ntawm koob tshuaj 250 mg / hnub. Lub sijhawm kawm - los ntawm 10-14 hnub. mus txog ib nrab xyoo. Qee zaum, lub sijhawm ntawm kev kho mob yog nce mus rau ob xyoos. Raws li kev kho mob cov tsos mob, cov tshuaj tau sau tseg ntawm 10-15 mg / hnub. Nrog rau qhov hnyav txog li 34 kg, ib daim ntawv tshem tawm ntawm cov khoom raug pom zoo. Tus nqi ntawm cov tshuaj nyob rau hauv daim ntawv ntawm cov tshuaj ntsiav yog los ntawm ib puas rubles.
Puas Ursodez muaj analogues?
Kev npaj uas muaj tib yam khoom siv tau tsim ntau heev. Ntawm lawv, nws yog ib qho tsim nyog hais txog cov ntsiab lus xws li Ursodox, Ursoliv. Ib qho ntawm feem nrov yog cov tshuaj "Ursosan". Cov lus qhia rau kev siv cov tshuaj no yog me ntsis dav. Tshwj xeeb, nws tau muab tshuaj rau cystic fibrosis ntawm daim siab, mob sclerosing cholangitis.
Ntau tus neeg mob txaus siab rau qhov zoo dua: Ursodez lossis Ursosan. Nws yuav tsum tau hais tias tus kws kho mob xaiv ib los yog lwm txoj kev kho nyob rau hauv raws li qhov xwm, chav kawm ntawm lub pathology thiab lub siab ntev ntawm cov tshuaj los ntawm tus neeg mob. Nyob rau hauv cov kab mob ntawm daim siab, gallbladder, nws tus kheej noj tshuaj yog heev pom zoo. Ua ntej noj ib yamtshuaj yuav tsum tau kuaj thiab sab laj nrog kws kho mob.
Kev soj ntsuam cov txiaj ntsig ntawm kev kho mob yuav tsum tau ua txhua 6 lub hlis. Hauv qhov no, kev kuaj ultrasound thiab x-ray tsis tu ncua raug sau tseg thaum thawj xyoo ntawm kev kho mob. Yog hais tias nyob rau hauv thawj rau lub hlis lub dissolution ntawm lub pob zeb tsis tshwm sim, ces feem ntau nws yog tsis pom zoo kom mus kawm ntawv vim inefficiency.
xov xwm ntxiv
Txhawm rau kom ua tiav kev ua tiav ntawm cov calculi, nws yog ib qho tsim nyog kom cov pob zeb tsuas yog cov roj cholesterol, thiab lawv qhov loj tsis pub tshaj 15 lossis 20 millimeters. Nyob rau tib lub sijhawm, lub gallbladder yuav tsum tsis pub ntau tshaj ib nrab, thiab cov ducts yuav tsum khaws lawv cov haujlwm tag nrho.
Nyob rau hauv cov ntaub ntawv ntawm kev kho mob mus sij hawm ntev tshaj ib hlis, yuav tsum tau ua ib qho kev soj ntsuam biochemical los ntsuam xyuas cov kev ua ntawm transaminases hauv daim siab. Tsis tas li ntawd, qhov concentration ntawm bilirubin thiab lwm yam tshuaj yuav tsum tau saib xyuas. Thaum tswj hwm tus nqi siab, tsis txhob noj Ursodez. Kev tshuaj xyuas ntawm ntau tus kws tshaj lij, txawm li cas los xij, muaj txiaj ntsig zoo txog kev ua haujlwm ntawm cov tshuaj.
Zoo kawg
Yog tias tsis muaj qhov tshwm sim, lwm yam tshuaj yuav raug sau lossis cov kev kho mob yuav raug kho tag nrho. Ua ntej siv cov tshuaj, koj yuav tsum nyeem cov lus piav qhia.
