Ursodeoxycholic acid: cov lus qhia rau kev siv, analogs, xyuas

Tsis ntev los no, rau cov kev kho mob los ntawm ntau yam kab mob siab txhab yog nce siv ursodeoxycholic acid. Cov lus qhia rau kev siv ntawm cov tshuaj compound qhia nws cov hauj lwm zoo nyob rau hauv ntau loj cov kab mob. Yuav ua li cas yog khoom no? Yuav ua li cas yog ursodeoxycholic acid? Nyob rau hauv dab tsi cov khoom nws yog tam sim no?

piav qhia

Ursodeoxycholic acid, siv cov uas yog raws li nyob rau hauv nws cov keeb kwm thiab cov khoom, yog ib tug dawb-daj crystalline hmoov. Nws muaj ib tug ntsim saj. Qhov no tshuaj yog nyob rau hauv ib tug ib txwm ua tau hauj lwm tib neeg kab yog ua nyob rau hauv me me qhov ntau. Nws tej lub ntiajteb txawj nqus yog hais txog 5% ntawm cov luj ntawm tag nrho cov kua tsib acids. Nws yog hydrophilic thiab twb tsis muaj cytotoxicity. Qhov no tshuaj compound yog soluble nyob rau hauv cawv thiab glacial acetic acid, me ntsis soluble nyob rau hauv chloroform thiab yuav luag insoluble nyob rau hauv cov dej. Ursodeoxycholic acid yog tsis muaj nyob rau hauv cov khoom siv. Nws twb pom nyob rau hauv lub tsib lub zais zis ntawm cov xim av dais.

Ursodeoxycholic acid (UDCA) yog ib qho epimer ntawm chenodeoxycholic acid. Chiv nws siv rau cov kev kho mob ntawm gastritis reflux thiab splitting gallstones. Thaum lub sij hawm, nws pib mus rau yuav siv tau, thiab nyob rau hauv ntau lwm yam kab mob. UDKH suav hais tias yog feem ntau muaj kev ruaj ntseg ntawm cov kua tsib acids.

Nyhuv ntawm ursodeoxycholic acid

Rau hnub tim, cov kev siv UDKH yog ib tug txheej txheem kev kho rau ntau yam cholestatic siab tus kab mob nrog ib tug autoimmune tivthaiv. Lub mechanism ntawm qhov kev txiav txim ntawm no neeg uas sawv cev mus rau stabilize lub hlwb ntawm lub cev. Nws molecules yuav incorporated mus ua tus nyias nyias ntawm mob hlwb - hepatocytes. Vim li no lawv yuav muaj peev xwm ua kom lawv paub ntau tshaj resistant kom corrosive yam. Qhov no hepatoprotective neeg sawv cev muaj ib tug choleretic nyhuv. UDKH txo cov roj uas txhaws synthesis nyob rau hauv daim siab thiab tiv thaiv nws cov haum nyob rau hauv cov hnyuv. Qhov no tshuaj txo thiab seb puas tsimnyog tau lithogenicity kua tsib acid cov ntsiab lus nyob rau ntawd. Nws tej cov kev ua ntawm lipase, pancreatic thiab pais plab tso pa tawm. Ursodeoxycholic acid muaj ib tug hypoglycemic nyhuv thiab nkoos cov tsim thiab sib cais ntawm kua tsib, nws thiaj li cholesterol.

Qhov no tshuaj favors feem los sis tag cleavage roj uas txhaws taus lub pob zeb. Uas yog vim li cas nws yog siv ntau feem ntau. Txuas nrog roj, nws yuav tsub kom lub solubility ntawm nws cov muaju, uas ua deleteriously rau gallstones. UDKH muaj immunomodulating kev txiav txim uas yog ua rau kom cov lymphocyte kev ua si, thiaj li muaj cov kev qhia sib txawv ntawm cov antigens nyob rau daim nyias nyias ntawm hepatocytes. Nws muaj feem xyuam rau tus xov tooj ntawm T-lymphocytes, thiaj li muaj cov xov tooj ntawm eosinophils.

UDKH thiaj li concentration ntawm cholesterol nyob rau hauv cov kua tsib los ntawm nws cov dispersion thiab cov kev hloov ntawm lub substance nyob rau hauv ib cov kua siv lead ua theem. Nws muaj feem xyuam rau cov enterohepatic ncig ntawm cov kua tsib ntsev. Raws li ib tug tshwm sim ntawm no poob reabsorption nyob rau hauv lub gut ntawm endogenous hydrophobic thiab lom tebchaw. Qhov no tshuaj muaj ib tug ncaj qha hepatoprotective thiab choleretic nyhuv. Ursodeoxycholic acid, uas los ntawm xyuas ntawm cov kws tshwj xeeb nyob rau hauv hepatology qhia nws cov hauj lwm zoo, muaj peev xwm sawv ntawm kev txo siab fibrosis nyob rau hauv nws cov fatty degeneration.

daim ntawv thov

Ursodeoxycholic acid, uas daim ntawv thov yog ua nyob rau hauv lub saib xyuas ntawm tus kws kho mob yog muab nyob rau hauv xws pathological tej yam kev mob:

• muaj cov roj uas txhaws taus lub pob zeb laus nyob rau hauv lub gallbladder los yog hom duct;

• tsis muaj peev xwm los kho endoscopically los yog surgically;

• mob, atypical, thiab mob autoimmune kab mob siab ;

• muaj cov roj uas txhaws taus lub pob zeb tom qab txhua yam thiab extracorporeal lithotripsy;

• tshuaj lom (tshuaj, haus dej cawv), daim siab puas tsuaj;

• sclerosing cholangitis;

• thawj biliary mob npuas paug, uas tsis muaj tej yam tshwm sim ntawm decompensation;

• atresia, biliary ib ntsuj av tau;

• cystic fibrosis;

• mob active kab mob siab;

• cholestasis thaum lub sij hawm parenteral kev noj haus;

• biliary dyskinesia;

• biliary dyspeptic syndrome nrog biliary dyskinesia thiab holetsistopatii;

• mob opistorhoze;

• congenital biliary atresia;

• biliary reflux esophagitis thiab reflux gastritis.

Ursodeoxycholic acid (UDKH) siv rau kev tiv thaiv ntawm lub siab puas ntxias los ntawm cov thawj coj ntawm cytostatics thiab hormonal contraceptives. Nws yog tshuaj rau lwm yam kab mob tshwm sim los ntawm stagnation ntawm bile. UDKH muab rau adjuvant therapy nyob rau hauv daim siab hloov los yog lwm yam khoom hauv nrog cev.

Contraindications

Ursodeoxycholic acid, uas xyuas qhov cov zoo, muaj loj contraindications. Cov muaj xws li:

• inflammatory kab mob ntawm lub tsib lub zais zis, cov hnyuv thiab cov kua tsib ducts nyob rau hauv lub mob theem;

• rentgenopolozhitelnye gallstones uas muaj calcium cov ntsiab lus;

• txhaws ntawm lub biliary ib ntsuj av tau;

• npau taws me ntsis;

• mob npuas paug thaum lub sij hawm decompensation;

• Crohn tus kab mob;

• cov lus hais irregularities nyob rau hauv lub hauj lwm ntawm lub pancreas, daim siab thiab lub raum.

cov kev txwv ntawm kev siv

Ursodeoxycholic acid, cov lus qhia rau kev siv uas kom meej meej qhia hauv lub qhaj ntawv ntawm nruj kev txwv nyob rau hauv nws daim ntawv thov, yog tsis muab cov me nyuam mos mus rau 3 xyoo nyob rau hauv cov tshuaj ntsiav daim ntawv. Rau lawv cov kev siv los kho tus mob ib tug slurry muaj cov tshuaj no substance. Kom txog rau thaum tam sim no, cov kws txawj tsis tau ua kom tsim nyog kev tshawb fawb aimed ntawm kev txiav txim cov nyhuv ntawm no substance cholelitolitic nyob rau hauv lub hnub nyoog ntawm cov me nyuam. Nyob rau tib lub sij hawm, kev tshawb fawb ua nyob rau hauv lub xub ntiag ntawm cov me nyuam nrog biliary atresia thiab tej daim siab mob tsis tau qhia kev xyuas teeb meem.

Npaj muaj ursodeoxycholic acid, muab rau cev xeeb tub cov poj niam tsuas yog thaum lub npaj cov nyhuv ntawm txoj kev kho nrog no neeg sawv cev yog ntau tshaj lub peev xwm uas muaj feem yuav mus rau hauv plab me nyuam. Peb yuav tsum tsis txhob hnov qab hais tias tag nrho scientific los kawm txog cov tshuaj muaj kev ruaj ntseg rau hauv pawg no ntawm cov neeg mob yog tsis muaj leej twg siv. Txij li thaum yog tsis paub seb UDKH penetrates mus rau hauv niam cov kua mis, ceev faj yuav tsum tau nyob rau hauv lub sij hawm ntawm cov tshuaj mus rau tsev laus cov poj niam.

phiv

Ursodeoxycholic acid, cov lus qhia rau kev siv uas qhia tsis tau tsuas yog rau cov kev txwv nyob rau hauv nws daim ntawv thov, tab sis kuj yuav tau sab los, tej zaum yuav ua rau pathological phenomena xws li:

• cem quav, raws plab;

• xeev siab;

• nce transaminases;

• mob nyob rau hauv txoj cai qaum quadrant thiab epigastric cheeb tsam;

• tsis haum daim tawv nqaij tshua (khaus, tawm pob);

• calcining pob zeb.

Kev kho mob ntawm thawj biliary mob npuas paug npaj no tej zaum kuj ua rau kom tus neeg mob muaj decompensation transitory, disappearing tom qab ntsoos ntsoos tau txais cov tshuaj no.

precautionary ntsuas

Yuav kom ntse litholysis cholesterol pob zeb siv UDKH yuav tsum coj mus rau hauv tus account lub nram qab no tej yam kev mob:

• lawv loj yog tsis ntau tshaj li 2 cm;

• lawv tsis muab ntxoov ntxoo nyob rau hauv lub radiograph;

• gallbladder yog ua tau hauj lwm feem ntau;

• ducts muaj patency;

• ib tug npuas uas muaj cov pob zeb tsawg tshaj li ib nrab;

• cov kua tsib ciav tsis muaj pob zeb.

Yuav ua li cas lwm txwv tsis pub rau kev txais neeg kawm yog ursodeoxycholic acid? Cov lus qhia rau qhov no kho mob preparations ntawd hais tias lub sij hawm ntev tej kev kho mob, uas yog ntau tshaj li 1 lub hli, yuav tsum muaj tsis tu ncua (1 txhua txhua 30 hnub) rau kev saib xyuas ntawm hepatic transaminases, phosphatase, bilirubin, gamma-glutamyl transferase ntshav. Ua xws analyses yog tshwj xeeb yog ib qho tseem ceeb nyob rau hauv thawj zaug 3 lub hlis ntawm txoj kev kho nrog UDKH. Cov hauj lwm zoo ntawm kev kho mob yog paub tseeb hais tias los ntawm X-ray txhua txhua rau lub hlis thiab ultrasound bile. Rau kev tiv thaiv ntawm kev rov muaj dua ntawm qaug dab peg ntxiv rau cholelithiasis kev kho mob thiab tom qab ua tiav nyias mus nyias ntawm lub pob zeb. Nws yuav siv ntau lub hlis.

Thaum lub sij hawm kev kho mob UDKH cov poj niam uas nyuam muaj hnub nyoog yog pom zoo kom siv txhim khu kev qha txoj kev tiv thaiv tawm tsam cev xeeb tub. Tej zaum nws yuav tsis yog-hormonal tshuaj los yog contraceptives muaj me me ntawm cov tshuaj no.

Tso daim ntawv thiab ntau npaum

Ursodeoxycholic acid, los ntawm cov uas phau ntawv qhia muab ib tug paub piav qhia txog ntawm nws txais tos circuitry, yog manufactured nyob rau hauv xws tshuaj cov ntaub ntawv:

• Tsiav tshuaj thiab cov ntsiav tshuaj ntawm 150 thiab 250 mg;

• ncua kev kawm ntawv rau cov me nyuam.

Ntau npaum UDCA nruj me ntsis teeb ib lub zuj zus. Nws nyob ntawm tus heev ntawm tus tib neeg mob thiab nws lub cev muaj ceeb thawj. Nyob rau hauv feem ntau, nws yog tshuaj los ntawm 10-20 mg / kg ib hnub twg. Qhov no tshuaj noj ib lub sij hawm, nyob rau hauv lub yav tsaus ntuj. Lub caij ntawm txoj kev kho yog nyob ntawm cov pov thawj. Qhov no tshuaj yog absorbed rau hauv lub me me hnyuv, thiab tom qab 3 teev cov ntshav yog muab sau rau nws siab tshaj plaws concentration. Qhov kev txais tos medicaments muaj ursodeoxycholic acid, ua rau nws cov thawj cov kua tsib acid nyob rau hauv tib neeg lub cev. Qhov no cov ntaub ntawv uas twb raug mus rau ib tug ntau yam ntawm transformations thiab zaum kawg tshwm sim yog tso zis li metabolites nyob rau hauv cov quav thiab zis.

Duration ntawm kev kho yog txiav txim los ntawm lub mus kawm tus kws kho mob. Nws yuav ua tau txawv nyob ntawm seb hom ntawm tus kab mob. Nyob rau hauv ib co loj heev zaum, tus txais tos UDKH tshuaj kav rau xyoo.

Sis nrog lwm yam tshuaj

Nyob rau hauv ib tug sib koom txais tos thiab UDKH "Cyclosporine" unpredictable nce lub haum ntawm lub yav tas. Nyob rau hauv cov ntshav dramatically tsub kom lub concentration ntawm medicinal npaj. Nyob rau hauv tsawg zaum lub txais tos UDKH ib txhij nrog qhov kev npaj "Ciprofloxacin" kawg concentration tsawg.

Ursodeoxycholic acid (analogues)

Ursodeoxycholic acid (tsiav tshuaj, ntsiav tshuaj) manufactured nyob rau hauv ntau lub npe. Tej cov tshuaj mas siv txawv cam nkag mus rau hauv lawv cov muaj pes tsawg leeg. Yog li, cov lag luam yuav tau raws li cov tshuaj nrog ursodeoxycholic acid:

• Tsiav tshuaj "Ursosan" kws kho rau txoj kev kho diffuse daim siab mob, cholelithiasis, nrog biliary reflux gastritis thiab reflux esophagitis, thawj mob npuas paug, tshuaj thiab tshuaj lom lub siab puas, cholecystectomy, haus dej cawv kab mob, sclerosing cholangitis, biliary atresia, nonalcoholic steatohepatitis. Ursodeoxycholic acid ( "Ursosan") yog siv rau kev tiv thaiv ntawm lub siab txhab.

• Ntsiav tshuaj "Ukrliv" uas nyob rau hauv hepatic puas, mob kab mob siab, cholelithiasis.

• Tsiav tshuaj "Ursofalk" nominated rau ntau yam kab mob ntawm lub gallbladder thiab siab, nrog cholestasis, ib tug txo ntawm ib co siab muaj nuj nqi, kom roj ntau ntau. Cov no muaj xws thawj biliary mob npuas paug thiab sclerosing cholangitis, reflux gastritis thiab reflux esophagitis, kab mob siab sib txawv ntawm cov etiology, cholesterol pob zeb, cystic fibrosis, ntau yam txhab ntawm lub siab, kua tsib stasis. Tej kev npaj no yog siv raws li ib tug prophylactic tiv thaiv daim siab kev raug mob thaum tau txais lub hwj chim tshuaj.

• Ntsiav tshuaj "Ursodeks" uas nyob rau ntawm lub biliary mob npuas paug tsis muaj decompensation cov tsos mob thiab reflux gastritis. Lawv yuav siv los yaj me me roj uas txhaws taus lub pob zeb nyob rau hauv lub qub hauj lwm ntawm lub tsib lub zais zis.

• Tsiav tshuaj "Ursodez" siv mus ua txhaum down cholesterol pob zeb, cov kev kho mob ntawm reflux gastritis, rau qhov symptomatic txoj kev kho rau thawj mob npuas paug ntawm lub siab uas tsis muaj tej yam tshwm sim ntawm decompensation.

• Tsiav tshuaj "Ursolizin" nominated rau dissolving roj uas txhaws taus lub pob zeb, thiab symptomatic kev kho mob ntawm biliary mob npuas paug, gallbladder cholesterosis thiab reflux gastritis. Lub tshuaj no yog siv nyob rau hauv lub complex txoj kev kho rau cov neeg mob uas mob tus kab mob siab thiab mob npuas paug.

• Tsiav tshuaj "Choludexan" siv rau cov kev kho mob ntawm uncomplicated cholelithiasis, mob active kab mob siab, dej thiab tshuaj lom siab txhab, nonalcoholic steatohepatitis, thawj biliary mob npuas paug, thawj sclerosing cholangitis, cystic fibrosis, biliary dyskinesia, reflux gastritis thiab reflux esophagitis.

• Tsiav tshuaj "Urdoksa" uas cov kws kho nyob rau hauv thawj biliary mob npuas paug, uas tsis muaj tej yam tshwm sim ntawm decompensation, reflux gastritis. Cov tshuaj yog zoo yaj lub me me thiab medium cholesterol pob zeb, thaum tswj lub cev muaj nuj nqi ntawm lub tsib lub zais zis.

• Tsiav tshuaj "Cursor C", muab nyob rau ntawm lub uncomplicated cholelithiasis, thawj mob npuas paug, mob thiab kab mob siab, sclerosing cholangitis, atresia intrahepatic huam, reflux gastritis thiab reflux esophagitis, cholestasis, thaum lub sij hawm parenteral kev noj haus, biliary dyskinesia, daim siab tus kab mob, nrog rau cystic fibrosis lossis muaj muaj roj gepatoze, dyspeptic syndromes. Cov kev npaj no yog siv rau kev tiv thaiv ntawm lub siab puas nyob rau hauv lub siv ntawm hormonal contraceptives thiab cytostatics, pob zeb tsim nyob rau hauv rog.

Ursodeoxycholic acid, analogs ntawm no cov ntaub ntawv uas yog npaum li cas tsuas tshuaj los ntawm ib tug kws kho mob.