Tsis ntev los no, ursodeoxycholic acid tau nce siv los kho ntau yam kab mob siab. Cov lus qhia rau kev siv cov tshuaj sib xyaw no qhia nws cov txiaj ntsig hauv ntau yam kab mob loj. Cov khoom no yog dab tsi? ursodeoxycholic acid siv rau dab tsi? Nws muaj cov khoom dab tsi?
Kev piav qhia
Ursodeoxycholic acid, siv los ntawm nws cov keeb kwm thiab cov khoom, yog cov hmoov dawb-daj crystalline hmoov. Nws muaj ib tug iab saj. Cov tshuaj no nyob rau hauv ib txwm ua haujlwm tib neeg lub cev yog tsim nyob rau hauv me me. Nws lub ntiajteb txawj nqus yog kwv yees li 5% ntawm tag nrho cov kua tsib acids. Nws yog hydrophilic thiab tsis muaj cytotoxicity. Cov tshuaj no yog soluble hauv cawv thiab acetic glacial acid, me ntsis soluble hauv chloroform thiab xyaum insoluble hauv dej. Ursodeoxycholic acid tsis muaj nyob rau hauv cov khoom. Nws tau pom nyob rau hauv lub gallbladder ntawm tus dais xim av.
YUrsodeoxycholic acid(UDCA) yog ib qho epimer ntawm chenodeoxycholic acid. Thaum pib, nws pib siv rau kev kho mob ntawm reflux gastritis thiab kev sib cais ntawm gallstones. Thaum lub sij hawm, nws pib siv rau ntau yam kab mob. UDCA suav hais tias yog cov kua qaub uas muaj kev nyab xeeb tshaj plaws.
Kev ua ntawm ursodeoxycholic acid
Hnub no, kev siv UDCA yog tus qauv kev saib xyuas rau ntau yam kab mob cholestatic daim siab nrog rau kev tiv thaiv autoimmune. Lub mechanism ntawm kev txiav txim ntawm qhov kev kho no yog kom stabilize lub hlwb ntawm lub cev. Nws cov molecules tuaj yeem nkag mus rau hauv daim nyias nyias ntawm daim siab hlwb - hepatocytes. Ua tsaug rau qhov no, lawv muaj peev xwm ua rau lawv tiv taus ntau yam kev txhoj puab heev. Qhov no hepatoprotective tus neeg sawv cev muaj cov nyhuv choleretic. UDCA txo cov synthesis ntawm cov roj cholesterol hauv lub siab thiab tiv thaiv nws txoj kev nqus hauv cov hnyuv. Cov tshuaj no txo cov lithogenicity ntawm cov kua tsib thiab nce nws cov ntsiab lus acid. Nws txhim kho lipase kev ua haujlwm, pancreatic thiab gastric secretion. Ursodeoxycholic acid kuj muaj cov nyhuv hypoglycemic, txhawb kev tsim thiab sib cais ntawm cov kua tsib, thiab txo qis cov roj cholesterol hauv nws.
Cov tshuaj no nyiam ua ib feem lossis ua tiav ntawm cov pob zeb roj cholesterol. Yog vim li cas nws thiaj li tau siv ntau dua. Los ntawm kev sib xyaw nrog cov roj cholesterol, nws ua rau kom cov kua dej muaj zog ntawm nws cov muaju, uas ua rau cov pob zeb puas tsuaj. UDCA muaj cov nyhuv immunomodulatory, uas muaj nyob rau hauv kev ua kom cov lymphocytes, txo.kev nthuav qhia ntawm ntau yam antigens ntawm hepatocyte membranes. Nws cuam tshuam rau tus lej ntawm T-lymphocytes, txo cov eosinophils.
UDKH txo qhov concentration ntawm cov roj cholesterol hauv cov kua tsib los ntawm nws cov dispersion thiab kev hloov ntawm cov tshuaj no mus rau hauv cov kua siv lead ua theem. Nws cuam tshuam rau enterohepatic ncig ntawm cov kua tsib ntsev. Yog li ntawd, cov reabsorption ntawm endogenous hydrophobic thiab tshuaj lom neeg nyob rau hauv txoj hnyuv txo. Cov tshuaj no muaj qhov ncaj qha hepatoprotective thiab choleretic nyhuv. Ursodeoxycholic acid, uas tshuaj xyuas los ntawm cov kws tshaj lij hauv kev kho mob hepatology qhia nws cov txiaj ntsig, muaj peev xwm txo tau daim siab fibrosis hauv nws cov rog degeneration.
Daim ntawv thov
Ursodeoxycholic acid, kev siv uas yog ua raws li kev saib xyuas ntawm tus kws kho mob tuaj koom, raug tshuaj rau cov kab mob hauv qab no:
• muaj cov pob zeb roj cholesterol nyob hauv lub gallbladder lossis cov kav dej;
• impossibility ntawm endoscopic lossis phais kho;
• mob ntev, atypical, mob thiab autoimmune kab mob siab;
• muaj cov pob zeb roj cholesterol tom qab cov neeg kho tshuab thiab extracorporeal lithotripsy;
• tshuaj lom (tshuaj, cawv) daim siab puas;
• sclerosing cholangitis;
• thawj tus kab mob cirrhosis uas tsis muaj cov tsos mob ntawm decompensation;
• biliary atresia;
• cystic fibrosis;
• chronic active hepatitis;
• cholestasis nrog parenteral khoom noj khoom haus;
• dyskinesiakab mob biliary;
• biliary dyspeptic syndrome nrog biliary dyskinesia thiab cholecystopathy;
• chronic opisthorchiasis;
• congenital atresia ntawm bile ducts;
• biliary reflux esophagitis thiab reflux gastritis.
Ursodeoxycholic acid (UDCA) kuj tseem siv los tiv thaiv daim siab puas tsuaj los ntawm cytostatics thiab tshuaj tiv thaiv hormonal. Nws kuj raug sau tseg rau lwm yam kab mob tshwm sim los ntawm stagnation ntawm cov kua tsib. UDCA kuj raug sau tseg rau kev kho mob hauv siab lossis lwm yam kev hloov pauv hauv nruab nrog cev.
YContraindications
Ursodeoxycholic acid, tshuaj xyuas uas feem ntau zoo, muaj contraindications loj. Cov no suav nrog:
• inflammatory kab mob ntawm lub gallbladder, cov hnyuv thiab cov kua tsib nyob rau theem mob;
• X-ray siab calcium gallstones;
• biliary obstruction;
• siab;
• cirrhosis ntawm daim siab thaum lub sij hawm decompensation;
• Crohn's disease;
• hais lus tsis txaus ntseeg hauv kev ua haujlwm ntawm pancreas, siab thiab raum.
Siv txwv
Ursodeoxycholic acid, cov lus qhia rau kev siv uas qhia meej meej tias tsis muaj kev txwv nruj rau nws siv, tsis raug sau rau cov menyuam yaus hnub nyoog qis dua 3 xyoos hauv daim ntawv tshuaj ntsiav. Rau lawv txoj kev kho mob, cov tshuaj tshem tawm uas muaj cov tshuaj no yog siv. Txog tam sim no, tsis muaj cov kev tshawb fawb cuam tshuam tau uatsom rau kev txiav txim siab cov nyhuv cholelitholytic ntawm cov tshuaj no, nyob ntawm lub hnub nyoog ntawm tus menyuam. Nyob rau tib lub sijhawm, cov kev tshawb fawb tau ua rau cov menyuam yaus uas muaj cov kab mob hauv cov hlab ntsha atresia thiab qee cov kab mob siab tsis tau pom muaj teeb meem tshwj xeeb rau menyuam yaus.
Kev npaj uas muaj ursodeoxycholic acid yog muab rau cov poj niam cev xeeb tub nkaus xwb thaum qhov kev xav tau ntawm kev kho mob nrog cov tshuaj no ntau dua qhov muaj feem pheej hmoo rau tus menyuam hauv plab. Nyob rau tib lub sijhawm, ib tus yuav tsum tsis txhob hnov qab tias tsis muaj leej twg tau ua tiav kev tshawb fawb txog kev nyab xeeb ntawm cov tshuaj no rau pawg neeg mob. Txij li nws tsis paub meej tias UDCA nkag mus rau hauv cov kua mis, yuav tsum tau ceev faj thaum sau cov tshuaj no rau cov poj niam lactating.
Side effects
Ursodeoxycholic acid, cov lus qhia rau kev siv uas qhia tsis tsuas yog kev txwv ntawm kev siv, tab sis kuj muaj kev phiv, tuaj yeem ua rau muaj qhov tshwm sim xws li:
• cem quav, raws plab;
• xeev siab;
• nce kev ua haujlwm transaminase;
• mob hauv txoj cai hypochondrium thiab thaj tsam epigastric;
• cov tawv nqaij ua xua (khaus khaus, ua pob khaus);
• calcination ntawm pob zeb.
Kev kho tus kab mob biliary cirrhosis nrog cov tshuaj no qee zaum ua rau tus neeg mob tau txais kev hloov pauv hloov pauv uas ploj mus thaum cov tshuaj nres.
Kev Tiv Thaiv
Rau kev ua tiav litholysisCov pob zeb roj cholesterol siv UDCA, cov xwm txheej hauv qab no yuav tsum raug txiav txim siab:
• lawv qhov loj tsis tshaj 2 cm;
• lawv tsis muab duab ntxoov ntxoo rau hauv xov tooj cua;
• gallbladder ua haujlwm ib txwm;
• ducts tseem qhib;
• tsawg dua ib nrab ntawm pob zeb;
• Cov duct uas muaj kab mob tsis muaj pob zeb.
Dab tsi ntxiv txwv tsis pub ursodeoxycholic acid muaj? Cov lus qhia rau cov tshuaj no qhia tau hais tias nrog kev kho mob ntev tshaj li 1 lub hlis, nws yog ib qho tsim nyog yuav tsum tsis tu ncua (1 zaug hauv 30 hnub) saib xyuas hepatic transaminases, phosphatase, bilirubin, ntshav gamma-glutamyltransferase. Ua qhov kev ntsuam xyuas no yog qhov tseem ceeb tshwj xeeb hauv thawj 3 lub hlis ntawm kev kho mob siv UDCA. Kev ua tau zoo ntawm kev kho mob tau lees paub txhua rau lub hlis los ntawm x-ray thiab kuaj ultrasound ntawm cov kua tsib ducts. Txhawm rau tiv thaiv kev tawm tsam ntawm tus mob cholelithiasis, kev kho mob txuas ntxiv tom qab ua tiav cov pob zeb tawg. Nws tuaj yeem nyob tau ntau lub hlis.
Cov poj niam uas muaj hnub nyoog muaj menyuam raug qhia kom siv cov kev tiv thaiv kev tiv thaiv zoo thaum kho nrog UDCA. Cov no tuaj yeem yog cov tshuaj uas tsis yog tshuaj hormonal lossis tshuaj tiv thaiv kab mob me me ntawm estrogens.
Kev tso tawm thiab ntau npaum li cas
Ursodeoxycholic acid, cov lus qhia rau kev siv uas muab cov lus piav qhia ntxaws txog cov txheej txheem rau nws cov kev tswj hwm, muaj nyob rau hauv cov ntawv hauv qab no:
• 150 thiab 250 mg capsules thiab ntsiav tshuaj;
• ncua kev rau menyuam yaus.
YUrsodeoxycholic acid ntau npaumteem nruj nruj rau tus kheej. Nws nyob ntawm qhov hnyav ntawm tus neeg mob thiab nws lub cev hnyav. Feem ntau, nws raug sau tseg ntawm 10-20 mg / kg ib hnub. Qhov koob tshuaj no yog noj ib zaug, thaum yav tsaus ntuj. Lub sijhawm ntawm kev kho yog nyob ntawm qhov qhia. Cov tshuaj no yog absorbed nyob rau hauv cov hnyuv me, thiab tom qab 3 teev nws cov concentration siab tshaj plaws nyob rau hauv cov ntshav plasma. Kev noj cov tshuaj tas li uas muaj ursodeoxycholic acid ua rau nws cov kua tsib tseem ceeb hauv tib neeg lub cev. Cov tshuaj no tau dhau los ntawm ntau qhov kev hloov pauv thiab thaum kawg tau tawm los ua cov metabolites hauv cov quav thiab zis.
Lub sijhawm kho yog txiav txim los ntawm tus kws kho mob tuaj koom. Nws yuav txawv nyob ntawm seb hom kab mob. Hauv qee kis tshwj xeeb, UDCA cov tshuaj siv tau ntev xyoo.
Kev sib tham nrog lwm yam tshuaj
Thaum noj UDKH thiab "Cyclosporin" ua ke, qhov nqus ntawm cov tom kawg nce ntxiv unpredictably. Nyob rau tib lub sijhawm, qhov concentration ntawm cov tshuaj no hauv cov ntshav plasma nce ntxiv. Muaj tsawg zaus, noj UDCA ib txhij nrog cov tshuaj "Ciprofloxacin" cov concentration ntawm tom kawg txo qis.
YUrsodeoxycholic acid (analogues)
Ursodeoxycholic acid (capsules, ntsiav tshuaj) muaj nyob rau hauv ntau lub npe. Cov nyiaj zoo li no txawv ntawm ib leeg los ntawm cov khoom pabcuam uas ua rau lawv muaj pes tsawg leeg. Yog li, ntawm kev muag khoom koj tuaj yeem pom cov tshuaj hauv qab no nrog ursodeoxycholic acid:
• Ursosan capsules tshuaj rauKev kho mob ntawm daim siab diffuse, cholelithiasis, biliary reflux gastritis thiab reflux esophagitis, thawj cirrhosis, tshuaj thiab tshuaj lom lub siab puas, cholecystectomy, kab mob cawv, sclerosing cholangitis, biliary atresia, tsis-alcoholic steatohepatitis. Ursodeoxycholic acid (Ursosan) kuj tseem siv los tiv thaiv daim siab puas.
• ntsiav tshuaj "Ukrliv", uas tau noj rau daim siab tsis ua haujlwm, kab mob siab ntev, cholelithiasis.
• Capsules "Ursofalk", sau rau ntau yam kab mob ntawm lub gallbladder thiab siab, nrog rau cholestasis, txo qis hauv qee lub siab ua haujlwm, thiab nce qib roj cholesterol. Cov no muaj xws li: thawj cirrhosis thiab sclerosing cholangitis, reflux gastritis thiab reflux esophagitis, kab mob siab ntawm ntau yam etiologies, cholesterol pob zeb, cystic fibrosis, ntau yam kab mob siab, kua tsib stasis. Cov tshuaj no yog siv los ua prophylactic tiv thaiv daim siab puas thaum noj cov tshuaj muaj zog.
• ntsiav tshuaj "Ursodex", uas tau noj nrog biliary cirrhosis yam tsis muaj cov tsos mob ntawm decompensation thiab reflux gastritis. Lawv tau siv los ua kom cov pob zeb cholesterol me me thaum lub sijhawm ua haujlwm ntawm lub zais zis.
• Ursodez capsules siv rau kev faib cov pob zeb roj cholesterol, kev kho mob reflux gastritis, rau cov tsos mob ntawm thawj daim siab cirrhosis yam tsis muaj cov tsos mob ntawm decompensation.
• Capsules "Ursolisin", sau rau kev tshem tawm cov pob zeb roj cholesterol thiab kho cov tsos mob ntawm biliary cirrhosis, cholesterosis ntawm lub gallbladder thiab reflux gastritis. Cov tshuaj no yog siv nyob rau hauv txoj kev kho mob rau kev kho mob ntawm cov neeg mob uas muaj kab mob siab ntev thiab daim siab cirrhosis.
• Choludexan capsules siv los kho tus mob cholelithiasis tsis yooj yim, mob siab ua haujlwm siab, haus dej cawv thiab ua rau lub siab puas tsuaj, tsis haus dej cawv steatohepatitis, thawj cirrhosis ntawm biliary cirrhosis, thawj sclerosing cholangitis, cystic fibrosis, biliary dyskinesia, reflux gastritis.
• Capsules "Urdoksa", uas tau sau tseg rau thawj tus kab mob siab biliary cirrhosis yam tsis muaj cov tsos mob ntawm decompensation, reflux gastritis. Cov tshuaj dissolves me me thiab nruab nrab cov roj cholesterol pob zeb zoo thaum tswj lub gallbladder muaj nuj nqi.
• Ursor C capsules tau sau tseg rau qhov tsis yooj yim cholelithiasis, thawj cirrhosis ntawm lub siab, mob siab thiab mob siab ntev, sclerosing cholangitis, intrahepatic atresia, reflux gastritis thiab reflux esophagitis, cholestasis, parenteral khoom noj khoom haus, biliary dysentery, nrog cystic fibrosis, fatty hepatosis, dyspeptic syndrome. Cov tshuaj kuj tseem siv los tiv thaiv lub siab puas tsuaj thaum siv cov tshuaj tiv thaiv kab mob hormonal thiab cytostatics, tsim cov pob zeb hauv kev rog.
Ursodeoxycholic acid, analogues ntawm cov tshuaj no tsuas yog siv raws li tus kws kho mob uas tuaj koom.
