Kuwerenga pa luso la mankhwala omwe amapezeka mu mtundu wachiwiri wa odwala matenda ashuga Gogina Elena Dmitrievna

Mu odwala a 112 (maso a 222) omwe ali ndi vuto lachiwiri la matenda ashuga omwe amaphatikizika ndi prrolifative diabetesic retinopathy, zomwe zimatulutsa timadzi tambiri m'magawo osiyanasiyana pambuyo poti patretinal laser ya interleukin-4 cytokine, yomwe imalimbikitsa kukula kwa thupi lawo siligwirizana. Zinawonetsedwa kuti kukhazikitsidwa kwa immunocorrection mu postoperative nthawi kumathandizira kusintha zotsatira zogwira ntchito kwa gawo lachiwonetsero pambuyo pakuwunda kwa laser ndikuwonjezera kuchepa kwakukulu pazomwe zili ndi ma interleukin4 mumadzimadzi a lacrimal, motero, kumachepetsa kuyankha kosagwirizana ndikuwotcha ndipo, mwina, kupezeka kwa chotchinga cha magazi.

Mu odwala a 112 (maso a 222), omwe ali ndi vuto la matenda ashuga awiri, ophatikizika ndi prroliferative diabetesic retinopathy, adawerengera zomwe zili mu interleukin4 cytokine, zomwe zimalimbikitsa kukula kwa mayankho osagwirizana, mumadzi amadzimadzi a lacrimal panthawi zosiyanasiyana pambuyo pa lasercoagulation ya lapretinal. Chowonetsedwa ndichakuti kuperekera mphamvu yakuwongolera mthupi la munthu pambuyo pa ntchito kumathandizira zotsatira zabwino za diso pambuyo pa lasercoagulation ndikuyambitsa kukwezedwa kwambiri kwa mulingo wa interleukin4 m'magazi amadzimadzi ndipo, chifukwa chake, kumachepetsa kuyanjana ndi zotsatira zoyipa, ndipo, mwina , kuchuluka kwa zotchinga magazi-ocular.

Zolemba pa ntchito ya sayansi pamutu wakuti "Postoperative immunocorrection with exuls of prrolifative diabetesic retinopathy pambuyo panretinal laser coagulation"

UDC 616.379 - 008.64 - 06: 617.735 - 085.849.19: 617.764.1 - 008.8 - 07: 577.175.859

POSTOPERATIVE IMMUNO KULIMA KWA KULENGA DIABETIC RETINOPATHY DERINATE Pambuyo PANRETINAL LASERCOAGULATION

Vladimir Borisovich Kuzin, Tatyana Pavlovna Sokolova

Department of General and Clinical Pharmacology (Mutu - Prof. VB Kuzin) Nizhny Novgorod State

Mu odwala a 112 (maso a 222) omwe ali ndi vuto lachiwiri la matenda ashuga omwe amaphatikizika ndi prrolifative diabetesic retinopathy, zomwe zimapezeka m'misempha yambiri panthawi zingapo pambuyo potiwotcha laser coagulation wa interleukin-4-cytokine, yomwe imalimbikitsa kukula kwa matupi awo sagwirizana. Zinawonetsedwa kuti kukhazikitsidwa kwa immunocorrection mu postoperative nthawi kumapangitsa magwiridwe antchito a gawo lachiwonetsero pambuyo pakuwunda kwa laser ndikuwonjezera kuchepa kwakukulu pazomwe zili ndi ma interleukin-4 mumadzi a lacrimal, motero, kumachepetsa kuyankha kosagwirizana ndi kutentha komanso, mwina, kupezekanso kwa zotchinga zamagazi.

Mawu ofunikira: matenda ashuga retinopathy, pan-retinal laser coagulation, lacrimal fluid, interleukin-4.

Matenda a diabetesic retinopathy, malinga ndi mabuku, ndi omwe amachititsa kuti khungu lisagwire ntchito zaka 4, 10. Njira yosankhira mankhwalawa kwa odwala omwe ali ndi vuto la matenda ashuga a retinopathy ndi retinal laser 1, 10. Pakadali pano, zomwe zimatchedwa kuti panra zimagwiritsidwa ntchito ngati njira yayikulu -inal laser coagulation, zomwe zimayambitsa kuwonongeka kwakukulu kwa retina ndikusinthana ndi minofu yosakanikirana ndi minofu ina yobwereza (khungu) yomwe imadya mpweya wochepa kwambiri 1, 6, 7, 9, 10. Wie laser mphamvu kuzibweretsa diso anafunika kupeza zotsatira achire, motsogozedwa ndi mosalephera kuwonongeka kwambiri kwa nyumba yake, kuphatikizapo neuroepithelium ndi,zomwe zimatsimikiziridwa ndi maphunziro azachipatala komanso morphological ndi electrophysiological. Pali malipoti a kafukufuku wokhudzana ndi kukhudzika kwachisokonezo cha minyewa ya maso pambuyo pa kusokonekera kwa laser retinal, zomwe zikuwonetsa kupezeka kwa kusintha mu chilengedwe cha autoimmune

pa Otsirizawo akuwonetsa kufunikira kwa kuchiritsa kwa mankhwala a immunomodulating pakuwongolera kutupa ndi zowonongeka ndi njira za autoimmune pambuyo paziwunda za laser.

Kukhazikitsidwa kwa njira zosasinthira zopezeretsera matenda ndi amodzi mwa madera oyambitsidwa ndi mankhwala amakono. Njira yosavuta, yofikira komanso yophunzitsira yomwe imakupatsani mwayi wodziwa za kagayidwe kazakudya ndi katemera wa diso ndi kuwunika kwamadzi amadzimadzi 2, 3, 5. Kuphatikizika kwa magawo am'magazi komanso zamankhwala am'maso ndizotsimikizika poyesera ndipo, zikuwoneka, zimafotokozedwa ndimagwero wamba opaka magazi kudiso. ndi zotupa zachilengedwe. Mpaka pano, palibe chidziwitso m'mabuku omwe amapezeka pakusintha kwa magawo a madzi am'mimba pazomwe zimapangidwira patsekeke laser pambuyo pang'onopang'ono laser ndikuwonekeranso kumbuyo kwa immunocorrection.

Cholinga cha ntchitoyi chinali kuphunzira momwe zinthu zingasinthire zomwe zili ndi ma interleukin-4 (IL-4) m'magazi a shuga a odwala 2 omwe amavuta chifukwa cha prinopathy ya matenda ashuga, onse atatha kusintha kwa laser komanso posteroperative kukonza ndi immunomodulator derinat.

Tidaona odwala 112 (maso 222) azaka za 47 mpaka 74 (zaka zapakati pa zaka 58) omwe ali ndi vuto lachiwiri la matenda ashuga odziwika bwino chifukwa cha matenda ashuga a shuga. Kutalika kwa matenda ashuga kunali pafupifupi 25 zaka. Kuunika kwa Ophthalmologic kunaphatikizapo ma visometry, biomicroscopy

gawo lakunja kwa diso, losalumikizana ndi maso.

Gawo lolondola la matenda ashuga retinopathy anali chizindikiro chachindunji cha kupanikizika kwa laser. Odwala onse adalandira magawo awiri a panretinal laser coagulation pagalon ya lason yokhala ndi mawonekedwe a 532 nm (Zeiss) ndi gawo la masiku 10. Magawo a laser coagulation anali motere: mphamvu - kuchokera pa 100 mpaka 220 mW, m'mimba mwake mwa laser malo - 200 μm, nthawi yowonetsera kukoka kamodzi - 60 ms, kuchuluka kwa coagulates pa gawo limodzi - 1500. Mphamvu panthawi ya laser coagulation idasankhidwa payekhapayekha kuti ipangike coagrate ya 2nd degree ( lolemba L'Esperans). Odwala adagawika m'magulu awiri. Gulu loyamba limaphatikizapo anthu a 56 (maso a 111), omwe sanalandire chithandizo cha postoperative pambuyo laser coagulation. Pambuyo pakukula kwa laser, odwala 56 a gulu lachiwiri (maso a 111) adawonetsedwa kuti amununomodulator ndi derinat wakomweko komwe kumatsalira kwa chipilala cha 1-2 kumatsika katatu pa tsiku kwa mwezi umodzi. Derinat ndi m'gulu la amunomodulators ndipo ndi mchere wa sodium wa native deoxyribonucleic acid (DNA-Na) mu yankho la 0.1% sodium chloride. Mankhwala amateteza chitetezo chamthupi pamaselo a cellular komanso amanyazi, ndi cholimbikitsa champhamvu cha kukonza ma cell, kusinthanso komanso kukhazikika kwa hematopoiesis. Odwala onse adalandira madzimadzi amisodzi katatu - asanafike laser, masiku 10 ndi mwezi umodzi pambuyo gawo loyamba. Misozi ya misozi idatengedwa ndi micropipette wosabala kuchokera kumunsi wozungulira wa ma conjunctival mu epindorfs mu 0,5 ml ndipo amasungidwa ozizira pa -18 ° C kwa miyezi iwiri. An enzyme yolumikizidwa ndi puloteni ya immunosorbent analyzer (Stat Fax) idagwiritsidwa ntchito pophunzira zinthu zachilengedwe zomwe zimapezeka ndi enzyme yolumikizidwa ndi immunosorbent assay kuti mudziwe zomwe zili mu cytokine interleukin-4 (IL-4). Zotsatira zonse zowunikira zidayang'aniridwa pamakompyuta pawokha pogwiritsa ntchito pulogalamu ya Exel application.

Malinga ndi deta yathu, mwa odwala a gulu lachiwiri, zomwe zili mu IL-4 m'madzi akungotuluka pamaso pa laser zisanachitike anali 135 ± 36.07 pg / ml, m'gulu la 1 - 132.12 ± 37.61 pg / ml.Patatha masiku 10 laser yakhala ikuchitika, zomwe IL-4 imapezeka m'madzimo a madzi mu odwala a gulu loyambirira idakwera pafupifupi 356.7 ± 45.01 pg / ml, lachiwiri - mpaka 224.91 ± 5.21 pg / ml , atatha mwezi umodzi kuchepa, motero, kuti 209.53 ± 30.61 ndi 120.43 ± 31.23 pg / ml.

Chifukwa chake, m'magulu onse awiriwa, kupanikizika kwa laser kwam'mimba kunayambitsa kuwonjezeka kwakukulu muzolemba za IL-4 m'madzi osungunuka pambuyo masiku 10 - 2.7 mu gulu la 1 (p 0.05). Mphamvu zakuthamangitsidwa kwa IL-4 mwa odwala a gulu lachiwiri zimawonetsedwa mu mkuyu. 1.

Pamaso pa opaleshoni masiku 10 m'mwezi umodzi

pambuyo pa opaleshoni atachitidwa opaleshoni _ _ ■ popanda postoperative therapy

- motsutsana ndi kagwiritsidwe ntchito ka ntchito ka Derinat

Mkuyu. 1. Mphamvu pazomwe zimakhala za IL-4 m'matumbo amisodzi mwa odwala omwe ali ndi matenda a shuga 2 omwe amaphatikizika ndi prolliferative diabetesic retinopathy nthawi zosiyanasiyana pambuyo laser coagulation.

Interleukin-4 ndiye chinthu chachikulu cha othandizira a kalasi la 2 T, amathandizira kusiyanitsa kwawo, amathandizira kukhazikika kwa zotsutsana, ndipo amakhala ndi vuto la antitumor. Kuwonjezeka kwa chizindikirochi mu postoperative nthawi kumatha kukhala kuwonetsa kuyankha kwamomwe akuwonetsa kuyatsidwa kwa boriti ya laser. Makhalidwe otsika a chizindikirochi motsutsana ndi kagwiritsidwe ntchito ka mankhwala a desten akhoza kufotokozedwa ndi kutanthauzanso mphamvu kwa mankhwalawa komanso kuwonjezeka kwapang'onopang'ono kwa kuvomerezedwa kwa chotchinga magazi muubongo poyerekeza ndi zomwe zili pagulu la odwala omwe sanalandire chithandizo cha postoperative.

Zotsirizirazi zimatsimikizidwanso ndi zotsatira za kafukufuku wamawu owoneka m'magulu onse awiriwa. Odwala a gulu la 1, pafupifupi visual acuity pamaso pa laser coagulation anali 0.54 ± 0.029, ndipo mwezi umodzi pambuyo pakupanga laser, 0.48 ± 0.028, pagulu lachiwiri, motsatana, 0.58 ± 0.023 ndi 0.66 ± 0.024. Chifukwa chake, pagulu la odwala omwe sanalandire kuchepa, kuwala kwa laser retinal kunapangitsa kuchepa kwa ntchito patatha mwezi atachitidwa opaleshoni ndi 11% (p sindikutha kupeza zomwe mukufuna? Yesani ntchito yosankha mabuku.

4. Khyshiktuev B.S., Maksimenya M.V., Kozlov S.A. Kuzindikira kufunika kwa maphunziro amadzimadzi mu diabetesic retinopathy // Klin. labu. kuzindikira - 2006. - Ayi. 3. - P.34 - 36.

5. Bloomgarden, Z.T. Matenda a shuga a retinopathy // Matenda a shuga. - 2008. - Vol. 31, No. 5. - P.1080 - 1083.

6. Hietala K., Forsblom C., Summanen P. et al. Kuchepa kwa proliferative diabetesic retinopathy // Matenda a shuga. - 2008. - Vol. 57, No. 8. - P.2176 - 2180.

7. Imai M, Iijima H. ​​Zotsatira za patretinal photocoagulation pa Photopic ERG m'maso abwinolo a kalulu // Jpn. Y. Ophthalmol. - 1995. - Vol. 39, Ayi. 2. - R. 120 - 123.

8. Umboni wa immunohistochemical wa macrophages mu leser Photocoagulation lesion mu retina / X. Yi, K. Takahashi, N. Ogata, M. Uyama // Jpn. J .. Ophthalmol. - 1998. - Vol 40, No. 2. - P. 192 - 201.

9. Linss W., Loffler J., Dietze U, Deufrains A. Licht und electronenmikroskopische Befunde am pigmentepithel und an der Bruchscher Membran des Kaninchenaugen nach Fotokoagulation // Fol. Ophthalmol. - 1985. - B.10, Na. 5. - S.311 - 317.

10. Takahashi A, Nagaoka T, Sato E, Yoshida A. Zotsatira za patretinal kujambulidwa kwa kufalikira kwa choroidal m'chigawo cha foveal mwa odwala omwe ali ndi matenda ashuga kwambiri retinopathy // Br. J. Ophthalmol. - 2008. - Vol. 92, No. 10 - P.1369 - 1373.

POSTOPERATIVE IMMUNE-CORRECTION OF PREPROLIFERATIVE DIABETIC RETINOPATHY KUGWIRITSA DERINAT Pambuyo PANRETINAL LASERCOAGULATION

V.B. Kuzin, T.P. Sokolova

Mu odwala a 112 (maso a 222), omwe ali ndi matenda a shuga a 2, ophatikizidwa ndi prrolifative diabetesic retinopathy, adaphunzira zomwe zili mu interleukin-4 - cytokine, yomwe imalimbikitsa kukula kwa thupi lawo siligwirizana, mu lacrimal fluid nthawi zosiyanasiyana pambuyo paziwopseza lasercoagulation. Chowonetsedwa ndichakuti kuperekera mphamvu yakuwongolera mthupi pambuyo pa ntchito kumathandizira zotsatira zabwino za diso pambuyo pa lasercoagulation ndikuyambitsa kukwezedwa kwambiri kwa mulingo wa interleukin-4 m'magazi a lacrimal ndipo, chifukwa chake, kumachepetsa kuyanjana ndi zotsatira zoyipa, ndipo , mwina, kupezeka kwa chotchinga cha magazi-ocular.

Mawu ofunikira: matenda a shuga a retinopathy, mapangidwe a lasercoagulation, lacrimal fluid, interleukin-4.

Zotsatira zamtsogolo za matenda a shuga a 2

Type 2 shuga mellitus, yemwe amadziwika kuti ndi mliri wosachiritsika wa XX - koyambirira kwa zaka za XXI, ndi vuto lalikulu lazachipatala komanso chikhalidwe cha anthu. Malinga ndi akatswiri a WHO, "matenda ashuga ndi vuto la mibadwo yonse ndi mayiko." Pakadali pano, 146.8 miliyoni (2.1%) padziko lapansi pano ali ndi matenda a shuga. Malinga ndikuwonetseratu kwa International Institute of Diabetes pofika chaka cha 2010, kuchuluka kwa anthu omwe akudwala matendawa kungafikire anthu opitilira 200 miliyoni (Amos A. Et al., 1997), kapena 3% yaanthu padziko lonse lapansi (Pratt R., Dzau V., 1999). Malinga ndi I.I. Dedova (2008), ku Russia anthu 8 miliyoni, kapena 5% ya anthu onse, ali ndi matenda a shuga, omwe 90% awo ndi matenda a shuga a 2. Imfa ya odwala omwe ali ndi matenda ashuga a 2 ndi okwera kwambiri kuposa anthu ambiri. Mu 60% ya milandu, chomwe chimayambitsa kufa kwa odwala omwe ali ndi matenda a shuga a 2 ndi angiopathy, omwe ndi mtima, mu 10% - matenda amitsempha yamagazi (Russo, Kaski J. S, 2000). Mpaka 80% ya odwala matenda ashuga omwe ali ndi matenda oopsa (AH) (Alderman M.N. et al., 1991). Mu gululi la odwala, chiopsezo cha kufa msanga chimakula kwambiri, ndipo chiyembekezo cha moyo chimachepetsedwa ndi 1/3 (Bonnardeaux A. et al., 1994). Mwa odwala omwe ali ndi matenda ashuga, kuchuluka kwa matenda a mtima ofunikira (CHD) ndi nthawi 2-4, chiopsezo chokhala ndi infarction ya myocardial infarction (MI) ndi nthawi 6-10 komanso kugwidwa ndi matenda akhunyu nthawi yayitali kwambiri pakati pa anthu osakhala ndi matenda ashuga (Gibbons G., 1997).Chifukwa cha chiwopsezo chachikulu chotenga matenda amtima wamnzeru omwe amachititsa kuti munthu azikhala ndi vuto loyambirira komanso kufa msanga, matenda ashuga amtundu wa 2 posachedwa atha kukhala vuto lalikulu laumoyo wa anthu m'maiko onse padziko lapansi (Lean M.E., 1998). Popeza kafukufuku wa O. Minkowski ndi J. Von Mering (1889-1892), omwe adayambitsa matenda ashuga mu agalu pochotsa ziphuphu zawo, zidapezeka kuti insulin yotchedwa insulin zinthu zofunika pakukula kwa matenda ashuga. Pambuyo pake, ntchito zidawonekera zomwe zimalola kumvetsetsa kwatsatanetsatane kwa etiology yamatendawa (Alberti K.G.M.M., Zimmet P.Z., 1998). Matenda a shuga a Type 2 ndi matenda opatsirana, kukula komwe kumakhudza ma genetic (Gale E., 2005) ndi zachilengedwe (Kononenko IV, Smirnova OM, 2005, Kochemasova TV, 2000), komanso kuphatikiza kwawo zimakhudza kagayidwe kazakudwala (Balabolkin MI, 2000). 1. Zinthu zomwe zimapangitsa kuti pakhale kukana kwa insulini: kukhathamiritsa kwamphamvu kwamafuta acid, ma cytokines: leptin, chotupa necrosis factor alpha (TNF-alpha), etc. (Volkova AK et al., 2000). 2. Ma genetic a matenda ashuga a 2. Malinga ndi kafukufuku wosiyanasiyana omwe adachitika m'maiko osiyanasiyana, amadziwika kuti mtundu wachiwiri wa shuga uli ndi mitundu ya mtundu wa mono- ndi polygenic. 3. M'badwo. Kuyambira pa zaka 45, chiwerengero cha odwala matenda a shuga chikuwonjezeka. Ukalamba pawokha umawonjezera mwayi wokhala ndi insulin kukaniza ndi matenda ashuga (Anderson EA, Mark A.L., 1993). 4. Kulemera kochepa kubadwa kumayesanso vuto la matenda ashuga a 2. Ofufuza ena amati kusowa kwa zakudya m'thupi pa nthawi ya pakati kumatha kuyambitsa kusokonezeka kwa fetus mu mwana wosabadwayo, yemwe pamapeto pake amayamba ndi matenda a shuga (Durrencton P.N., 1991). 5.

Kunenepa kwambiri. 85% ya odwala omwe ali ndi matenda amtundu wa 2 ndi onenepa kwambiri kapena onenepa kwambiri, ngakhale kuti thupi lolemera ndilobadwa kapena lotengedwa (Oganov R.G., Nebieridze A.V., 2002). Kutikirira kwa minofu ya adipose kumabweretsa kukula kwa insulin, kukana kwa leptin komanso kuwonjezeka kwa kusintha kwa androgens kukhala estrogens mu maselo a minyewa ya adipose. Osati kupezekapo kokha, komanso mtundu wogawika wamafuta umakhudza chiopsezo chokhala ndi matenda a shuga a 2 (Kannel W.B., McGee D.L., 1979). Udindo wapadera mwa njirazi umaperekedwa kwa mafuta am'mimba (amental and subcutaneous). 6. Mitundu ya mabanja. 25-33% ya odwala onse omwe ali ndi matenda a shuga a 2 ali ndi abale omwe ali ndi matenda ashuga. Mwa anthu omwe ali ndi wachibale woyamba kudwala matendawa, chiopsezo chokhala ndi matenda a shuga 2 ndi 40%. 7. Mitundu. Chiwopsezo cha kukhala ndi matenda a shuga a mtundu wachiwiri ndi chachikulu pakati pa mitundu yolankhula Chisipanya ya anthu ochokera ku America ndi Canada, okhala zilumba za Pacific ndi Indian Oceans, nzika za India ndi Australia, ndi anthu aku Africa. 8. Zochita zolimbitsa thupi. Kafukufuku wokhudzana ndi mafuko angapo akusonyeza kuti kuchuluka kwa matenda ashuga pakati pa anthu okhala ndi moyo wongokhala nthawi zambiri kumakhala kochulukirapo katatu kuposa pakati pa anthu omwe ali ndi thupi lofanana (Gogin E.E., 1997). 9. Chakudya chopatsa thanzi. Zakudya zama calorie okwera kwambiri zomwe zimakhala ndi mafuta ochulukirapo, mafuta ochepa okhala ndi michere komanso zochepa zamafuta osapsa (kuchokera masamba, zipatso, chimanga) zimawonjezera chiopsezo chokhala ndi matenda a shuga, ndiko kuti, kudalira kumatsimikizika ponse pa zonse zopatsa mphamvu zopatsa mphamvu ndi kukhazikika kwa chakudya (Prekina V.I. ., Tyuryakhi-na N.A., 1999). Pakadali pano, maziko a majini a shuga osadalira insulini (NIDDM) sakayikira (Liberman IS, 1997). Komanso, ziyenera kudziwidwa kuti mitundu yodziwika bwino ya majini a NIDDM ndiyofunikira kwambiri kuposa mtundu woyamba wa matenda ashuga.

Kutsimikizira kwa chibadwa cha NIDDM ndikuti mapasa ofanana NIDDM amakula pafupifupi nthawi zonse (95-100%) mwa onse awiri. Nthawi yomweyo, vuto la chibadwa lomwe limatsimikizira kukula kwa NIDDM silikupangika mokwanira (Blagoslonnaya Y.V. et al., 1996). Kuchokera pakuwona lero, zosankha ziwiri zikuganiziridwa. Yoyamba: majini awiri odziimira pawokha amathandizira pathogenesis ya NIDDM, imodzi imayambitsa kubisala kwa insulin, yachiwiri imayambitsa kukula kwa insulin.Tikuwonanso kuthekera kwa chilema chodziwika mu kachitidwe kodziwika ndi shuga mwa ma cell a P-cell kapena zotumphukira, chifukwa chomwe mwina kuchepa kwamayendedwe a glucose kapena kuchepa kwa mayankho a glucose-3. Anthu omwe ali pachiwopsezo chachikulu chokhala ndi matenda a shuga a 2 amaphatikizanso mapasa ofanana kuchokera kwa makolo omwe ali ndi matenda a shuga a 2, abale ake a odwala, mayi yemwe adabereka mwana wamoyo kapena wakufa wolemera kuposa makilogalamu 4.5, ndi mafuko ena omwe ali ndi vuto lalikulu la matenda ashuga (km. Native American Indian Indian Pima). Achibale a digiri yoyamba ya chibwenzi chokhala ndi vuto laubongo komanso kupitilizidwa kwina kwa glucose adalengeza kukana insulini. M'mapasa a monozygotic omwe ali ndi matenda a shuga omwe amadalira insulin (NIDDM), kukana insulini kumanenedwanso kwambiri kuyerekeza ndi mapasa opanda matenda a shuga. Gawo lomwe limapezeka la insulin limadziwonetsa lokha munthawi ya matenda a shuga. Kafukufuku angapo adawonetsa kuti kukana zolimbitsa thupi kwa insulin komwe kumachitika mwa abale omwe ali ndi digiri yoyamba ya kinship kwinaku akukhalitsa kulolera kwa glucose kumakulitsidwa kwambiri ngati ali ndi vuto la metabolism. Zomwezi zimapezeka pofufuza m'mapasa a monozygotic. Maulalo apamwamba kwambiri a pathogenetic a mtundu 2 wa matenda ashuga ndi: insulin kukana (IR), insulin katulutsidwe ndi zotulukapo zimachitikira, matenda a kapamba kapena ma endocrine syndromes (acromegaly, Itsenko-Cushing's syndrome, pheochromocytoma, etc.) (Curtis J., Wilson C, 2005). Kuwerengera kwa zigawo za pathogenesis ya NID ndizosiyana pamankhwala osiyanasiyana komanso kwa odwala omwewo. Sizikudziwika kuti ndi yani mwa zolakwika zomwe zalembedwa ndizomwe zimayambitsa ALI. Chifukwa chake, pakati pa amwenye a Pima, kukana insulin kumayambira NIDI.

Kuyesa kwa shuga m'magazi

Ndi mtundu 2 wa matenda ashuga, pali kuphwanya kwamtundu wa heestatic system. Miyezo yokwezeka ya glucose imayambitsa mapuloteni glycosylation komanso kuchuluka kwa zinthu zomaliza za glycosylation, zomwe ndizochitika zoyambira kwambiri zomwe zimatsogolera zochitika zotsatizana khoma la chombo zomwe zimatsimikizira kusintha kwotsatira kwa morphological ndi kapangidwe kake (Shostak N.A., Anichkov D.A., 2002). Zogulitsa zomaliza za glycosylation (glucose kuwonjezera amine - gulu la NH2 la amino acid lysine la mapuloteni aliwonse) zimamangirira mosagwirizana ndi mapuloteni, ndikusintha mawonekedwe ndi mawonekedwe a mapuloteni ofanana. Mapuloteni okhala ndi moyo wautali (collagen, etc.) ndi omwe amachititsa ntchito zambiri zamkati mwa chipinda chapansi, kuphatikiza kwamitsempha yamagazi, kupindika ntchito, ndi zina zambiri. , immunoglobulins ndipo, motero, zovuta za chitetezo cha mthupi (Klebanova E.M., Balabolkin M.I., Kreminskaya V.M. et al., 2006). Maofesi ngati amenewa amakhala "achilendo" kwa thupi, zomwe zimaphatikizapo maselo olimbitsa thupi (Pickup J.C., Crook M.A., 1998). Mapuloteni okhala ndi zomaliza za glycosylation amalumikizana ndi ma macrophage receptors, omwe poyankha izi amapanga komanso amapanga magulu angapo a ma cytokines (chotupa necrosis factor, IL-1, ndi zina), zomwe zimathandizira kukulitsa maselo komanso kuzungulira kwa khoma lamankhwala (Bak JF, Schmitz O., Niels SS, Pedersen O., 1989). Zomwezo, poyanjana ndi ma receptor of endothelial cell, zimathandizira kuwonjezera mapangidwe a cell BAS mwa iwo monga, mwachitsanzo, endothelium-1, yomwe ndi chinthu champhamvu cha vaso-constrictor chotsogolera ku thrombosis yam'deralo (Juhan-Vague I et al., 1993). Nthawi yomweyo, kapangidwe ka cyclin yosavuta mu maselo a endothelial amachepetsa (Williamson JR, Tilton RG, Chang K., 1998).Pamodzi ndi izi, kapangidwe ka thromboxane kumawonjezeka mchikakamizo cha kudzikundikira kwa zinthu zomaliza za glycosylation m'mapulatelet. Chiwerengero cha prostacyclin ndi thromboxanes chimasinthika pakuwonjezeka kwa chomaliza, chomwe chikuwonjezeranso chifukwa chowonjezera kukoka kwam'mimba, kuwonjezeka kwa thrombosis (Celermager D.S. 1994). Zotsatira zake, omwe amadziwika kuti dissuse intravascular coagulation syndrome (DIC) amakula (Klimont A.L. et al., 2004).

Pharmacotherapy yamavuto omwe ali ndi odwala omwe ali ndi matenda a shuga a 2 komanso kuthekera kogwiritsa ntchito mankhwala a Derinat immunomodulator. Mfundo zamakono zothandizira odwala omwe ali ndi zovuta za shuga zimachokera pamalingaliro okhudza pathogenesis yakukula kwawo (Van Staa et al., 1997). Maulalo otsatirawa a pathogenesis a matendawa amasiyanitsidwa (Shestakova M.V., Chugunova L.A., Shamkhalova M. Sh., 2002, Savelyev BC, Koshkin V.M., Nosenko E.M., Dadova L.V. et al. ., 2003), yomwe imatha kutsogoleredwa ndi njira ya pharmacotherapeutic: 1) mapangidwe a zopangidwa kumapeto kwa glycation, 2) kusokonekera kwamphamvu, 3) kuwonjezeka kwa mapangidwe a free radicals, 4) kuchepa kwa magwiridwe antchito a antioxidant ndi chitetezo. Chithandizo chovuta cha angiopathies chimaphatikizapo, kuwonjezera pa kusintha kwachulukidwe ndikuwongolera kagayidwe kazakudya, magawo osiyanasiyana osiyanasiyana, monga kugwiritsa ntchito mankhwala ochokera kuma gulu osiyanasiyana a pharmacological - painkiller, antispasmodics, mankhwala omwe amasintha michere ya trophic, miccirculation ndi rheological yamagazi, lipid-lowering, antioxidant ndi ena. (Weidmann PR, 1991). Chimodzi mwamafuta olimbikitsa a gulu la immunomodulator omwe agwiritsidwa ntchito kuchipatala cha endocrinology ndi a Derinat, omwe ndi mchere wa sodium ya DNA ndipo ali ndi vuto losakhala losatsimikizika lachilengedwe. Kuyambira 1994, kukonzekera kwa Derinat kwavomerezedwa kuti agwiritsidwe ntchito kwachipatala ndi Komiti ya Pharmacological ya Russian Federation. Mu 1997, Russian Biographical Institute inazindikira kuti mankhwalawa ndi mankhwala abwino kwambiri m'gulu la immunomodulator. Derinat imakwaniritsa zofunikira zofunikira zamankhwala amtunduwu (Gorodkov B.G., 2002). Mankhwalawa amakhala ndi zinthu zofunika kwambiri pa mankhwala: 1. Low toxity (Sharygin AS, 2002). 2. Kuchuluka kwa njira zochizira kuchokera ku 0 mg mg (dontho limodzi la yankho la 0,25%) mpaka 75 mg (jekeseni imodzi ya jekeseni) (Kaplina EN, 2004). 3. Zotsatira zake za mankhwalawa zimatengera momwe wodwalayo aliri komanso matenda ake. Mankhwalawa sathandizira munthu wathanzi, ndipo m'mikhalidwe yokhala ndi matenda amadziwika kuti ndi antitoxic komanso activation (Filonenko SB, Lipatov V.A., 2001). 4. Palibe choletsa kuyanjana ndi mankhwala ena omwe amadziwika (Chernov VN, 2008). 5.

Synergistic, i.e. osagwiritsa ntchito mankhwala ofunikira kwambiri (interleukin-2, maantibayotiki) (Dubynina V.P., 2000). 6. Mankhwalawa amathandizira kuti athe kuthana ndi zovuta zomwe zikubwera chifukwa cha anti-infential shughuli (maantibayotiki - doxorubicin, interferons) (Chernov VN, Sharkovskaya TE, 2007). 7. Derinat siyikuphwanya lingaliro lamkati lazoyankha pazinthu zoyipa zomwe zili palokha. Chifukwa chake, mankhwalawa ali ndi mphamvu yotsutsa-yotupa pakakhala kutupa kochulukirapo, ndipo mosemphanitsa, ngati njira zosafunikira zimachulukitsa kutupa ndikuthandizira kufulumizitsa kumaliza kwa matendawa (Andrievsky A.E., 2004). 8. Mpaka pano, palibe zotsutsana zomwe zimagwiritsidwa ntchito pa Derinat, kupatula kusalolerana kwamtundu wina (Karaulov A.V., 2002). Malinga ndi mabuku, pakuchita kwa kukonzekera kwa Derinat m'thupi, pali njira zingapo zomwe ndizofunikira pakulimbana ndi matenda a shuga.

Njira yodziwira zoyeserera za HCT

Kutsimikiza kwa cholesterol mu seramu yaumunthu kunachitika pogwiritsa ntchito zida zogwiritsira ntchito kuchuluka kwa cholesterol yathunthu (yotsimikizika ndi yopanda tanthauzo) mu seramu yaumunthu kuchokera ku Diacon DDS, Russia-Germany. Seramu yopanda anthu idagwiritsidwa ntchito. Seramu yamagazi idalekanitsidwa ndi ma cell am'magazi pasanathe ola limodzi pambuyo pakupereka magazi. Mfundo za njira. Panthawi ya hydrolysis ya cholesterol esters ndi cholesterol esterase, cholesterol yaulere imapangidwa.Cholesterol yopangidwa chifukwa cha hydrolysis ndipo ilipo mu sampuli imapukusidwa ndi mpweya wa mlengalenga motsogozedwa ndi cholesterol oxidase kuti ipange kuchuluka kofanana ndi hydrogen peroxide. Mothandizidwa ndi peroxidase, hydrogen peroxide imatulutsa ma chromogenic ndikamapangira kachulukidwe kakuda, komwe kukula kwake kumakhala kolingana ndi kuchuluka kwa cholesterol mu sampu ndipo amayeza mojambula patsekeke ya 500 (480-520) nm. Ma seramu wamba kapena plasma cholesterol mozama ndi 4,4 ± 1.1 mmol / L. Kudziwitsa za cholesterol yokhala ndi ma lipoproteins okwera kwambiri komanso otsika kunachitika ndi njira yotsatsira magazi mu seramu pogwiritsa ntchito zida zogwiritsira ntchito kuchuluka kwa cholesterol yapamwamba kwambiri ya lipoproteins (HDL) mu seramu yamunthu. Mfundo za njira. Phosphovungstic acid ndi ma magnesium ion amamanga ma chylomicrons, lipoproteins wotsika kwambiri komanso lipoproteins yotsika mu seramu. Momwe zimapangidwira zimapangidwira ndi centrifugation. Kachulukidwe kakakulu ka lipoprotein kotsalirako kamakhala mu supernatant yowonekera, momwe mawonekedwe a cholesterol a HDL amatsimikiziridwa ndi njira ya enzymatic Photometric pamawonekedwe a 500 (480-520) nm. Maselo omwe anawunikirawa ndi seramu yamagazi yopanda magazi. Seramu yamagazi idalekanitsidwa ndi ma cell am'magazi pasanathe ola limodzi pambuyo pakupereka magazi.

3 ml ya magazi a heparinised adatengedwera mu centrifuge chubu, 1 ml yankho B idawonjezeredwa, yosakanizidwa mosamala, ndipo chubu adayikidwa mu 37C thermostat kwa 20 min (erythrocyte sedimentation). Woyesererayo adachotsedwa mu chubu choyera cha centrifuge, yankho A mpaka 10 ml adawonjezedwa pamenepo, centrifuged kwa 10 min pa 1000 rpm. Wopambanayo anachotsedwa, yankho A mpaka 10 ml linawonjezeredwa kwa mpweya wokhawo, wokhazikitsidwa ndi zomwezo. Wotsogola adatsitsidwa, kuchuluka kwa kuyimitsidwa kwa selo kunasinthidwa kukhala 1 ml yankho A. Phunziro lililonse, ma sampuli awiri anayikidwa: ndi latex - "O" ndipo popanda latex - "K". 50 μl ya kuyimitsidwa kwa khungu, 50 μl ya lalabala, 50 μl yankho C adawonjezeredwa pachitsime cha "O". 50 μl yankho A adapangidwa pachitsime cha "K" m'malo mwa lalabala. Kenako, 50 μl ya osakaniza adatengedwa kuchoka kuzitsime, ndikusamutsira ku magalasi osalongosoka otayika ndikuyikidwa mu 37C thermostat yamphindi 30 m'chipinda chonyowa (mbale ya Petri yokhala ndi pepala lothira). Masileti anayikidwa kuti ayime osakanikirana mpaka pouma kwathunthu. Magalasi amaikidwa mu mowa wa ethyl kwa mphindi 30. Pakujambula mini, magalasi ankawagwiritsa ndi azure-eosin malinga ndi Romanovsky kwa mphindi 3. Galasi idasambitsidwa ndi madzi osungunuka.

Kuyesa Kwabwino Kwa Moyo Kuchokera Fomu Yachidule (SF) -36 Mafunso

Kuyeza kuchuluka kwa magazi, chida cha Mini-Maatse-Doppler-K chinagwiritsidwa ntchito, kupangidwa ndi kupangidwa ndi Minimax LLC (St. Petersburg). Mphamvu ziwiri zopanga zomwe zimagwiritsa ntchito zimagwiritsidwa ntchito pafupipafupi 20 MHz. Dongosolo la gawo la sensa polumikizana mwachindunji ndi mamililita ndi 0,65 mm, ndipo zotumphukira zamagazi zowerengedwa zimawerengedwa kuti ndi "gawo lophatikizira hemodynamic" la gawo ili. Akupanga mosalekeza-mafunde Dopplerography ya microvasculature idachitika m'malo a msomali woloza chala chachitatu cha dzanja. Kugwiritsa ntchito mayeso a ischemic (kuumitsa kwa brachial artery ndikuchotsa pambuyo pake cuff). Miyezo yamitsempha yamagalimoto yotchinga kuyeza kwa kuthamanga kwa magazi imayesedwa ndikuyerekeza: systolic maximum flow flow velocity (Vs, cm / s), maximum diastolic velocity (Vd, cm / s), average Speed ​​for the average flow flow (Vm, cm / s), and also the period magazi kubwezeretsa. M'zaka zaposachedwa, njira zatsopano zatulukira pakuwunika mphamvu ya chithandizo chokhudzana ndi moyo wa wodwala.Ubwino wamoyo umafotokozedwa ngati gawo lofunikira la wodwalayo, malingaliro ake, momwe amagwirira ntchito komanso momwe amagwirira ntchito, kutengera kuzindikira kwake. Kuti tiwone momwe moyo uliri, tidagwiritsa ntchito Mafunso Pafupifupi (SF) -36, omwe akuphatikiza masikelo otsatirawa: 1) PhysikalFunctioning (PF) - kugwira ntchito zolimbitsa thupi, 2) Role-Physikal (RP) - magwiridwe antchito, 3) Bodili Pain ( BP) - pamlingo wowawa, 4) General Mtima (GH) - thanzi lonse, 5) Vitaliti (VT) - mphamvu, 6) Ntchito Zachikhalidwe (SF) - magwiridwe antchito, 7) Machitidwe-Emotional (RE) - mkhalidwe wamalingaliro, 8) Mtima Wam'mutu (MH) - thanzi la maganizo. Malingaliro makumi atatu mphambu anayi afunsowa adagawika m'magawo asanu ndi atatu: magwiridwe antchito, masewera, ululu wamthupi, thanzi lonse, mphamvu zake, zochita zake, momwe munthu akumvera, komanso thanzi lam'mutu. Kuchita kwa mulingo uliwonse kumasiyana kuchokera pa 0 mpaka 100.

Kukwera kwakukulu kwa chizindikiro, kuli bwino pamlingo waukulu. Mafunso amafunsidwa kuti adzazidwe ndi odwala kumayambiriro kwa maphunziro ndi masiku 21 atatha chithandizo. Poyerekeza zotsatirazi, kuwunika kwaumoyo kunachitika mwa odwala 20 opanda matenda a shuga omwewo. Zotsatira za phunziroli zidakonzedwa ndikugwiritsa ntchito pulogalamu yoyeserera "Ms Excel XP" pa kompyuta ya IBM-Pentium Ш-500. Kwa ma sampuli angapo, tanthauzo la masamu ndi tanthauzo loti masentimita linali kuwerengeka. Zambiri mu dissertation zimawonetsedwa mu mawonekedwe a M + m. Kusanthula kwa zotsatira zamaphunziro a pharmacological kunachitika ndi njira zowerengera, kudalirika kwa zotsatira kunayesedwa pogwiritsa ntchito njira "% -square" ndi mayeso a Student t (Belenky M.L., 1963, Sernov L.N., Gatsura V.V., 2000) . Kusiyana kunatengedwa ngati kodalirika pamlingo wopezeka wa 0,05. Zida zonse za digito zimapangidwa mwanjira ya matebulo ndi ma graph pogwiritsa ntchito phukusi la Microsoft Graph mu Microsoft Office software product. Matenda a shuga amakhalapo amadziwika ndi kulumala koyambirira komanso kufa kwamphamvu, zomwe zimawavuta kwambiri pantchito zamtundu. Izi ndi zomwe zidakhala maziko a kulinganiza madongosolo olamulira matenda ashuga, kukhazikitsa komwe pambuyo pake kunapeza thandizo kuchokera ku World Health Organisation, International Diabetes Federation, ndi European Diabetes Association. Kafukufuku wamasayansi a asayansi ochokera kumaiko ambiri padziko lapansi akuyembekeza kuti afotokozere momwe matendawo amafanirana ndi matendawa, zovuta zake komanso kukula kwa mankhwala opatsirana pathogenetic, kugwiritsa ntchito komwe kungathandizire kupewa komanso kukonza zovuta zomwe zayamba kale (Melnichenko G.A., 2008). Mavuto osokoneza bongo a matenda a shuga a mellitus (DM) ndi omwe amayambitsa kulumala ndi kufa msanga.

Udindo waukulu poyambitsa zovuta zomwe zimakhudzidwa ndi zovuta za matenda a shuga ndi za hyperglycemia, kuchuluka kwa glucose autoxidation, kupangika kwakukulu kwa zinthu za kumapeto kwa glycosylation, kutsegula kwa lipid peroxidation komanso kuwonjezeka kwa mitundu yama radicals (Mayorov A.Yu., Surkova E.V., 2008). M'zaka zaposachedwa, kafukufuku wachitika kuti apange mankhwala okhala ndi hypoglycemic, hypolipidemic ndi antioxidant ndi zinthu zina zomwe zimakhudza kupewa komanso kukhazikika kwa zovuta za matenda ashuga. Mwa ndalama zomwe zasonyezedwa, malo ena amatengedwa ndi kukonzekera komwe kumapezeka pamaziko a DNA. Mankhwalawa amaphatikizapo Derinat. Kafukufuku ambiri asayansi komanso zoyesera adawonetsa kuti Derinat imathandizira kaphatikizidwe ka insulini ndikulimbikitsa kukonzanso maselo atatu a pancreatic cell (V. Balashov et al., 2003) Kuphatikiza apo, ili ndi mphamvu yogwiritsira ntchito immunostimulating (A. Zhabko. ., 2003) powonjezera kupanga ma antibodies athunthu ndi ma interferon, zomwe zimalimbikitsa kubadwa kwa mitundu ya oxygen yomwe imagwira ntchito ndi ma neutrophils ndi kusintha matenda a immunoglobulins, T ndi lymphocyte. Derinat amakhala ndi metabolid ya lipid, kutsitsa kuchuluka kwa cholesterol yonse, triglycerides, LDL cholesterol ndi kukulitsa kuchuluka kwa cholesterol ya HDL mu seramu yamagazi (Mordanov R., 1999).Kuphatikiza apo, mankhwalawa ali ndi mphamvu yogwira ntchito yamatenda am'mimba, matumbo am'mimba komanso chitetezo cha mthupi, sichikhala ndi mutagenic, embryotoxic, teratogenic, allergenic katundu ndipo sichikhudza ntchito yobereka.

Zamkatikati mwa omwe adagwirizana ndi a Gogina, a Elena Dmitrievna

MUTU I. kuwunika kwa zolemba.

1.1 Matenda a shuga ngati vuto lamakono lazachipatala komanso chikhalidwe.

1.2 Zinthu zomwe zimayambitsa matenda ashuga a 2 mtundu.

1.3 Kutengera kwa majini a shuga osadalira insulini.

1.4 Autoimmune maziko a osachiritsika omwe amadalira shuga.

1.5 Angiopathy ndi imodzi mwazovuta zazikulu za matenda ashuga.

MUTU II. ZOTHANDIZA NDIPO NJIRA ZOFUNA.

2.1 Makhalidwe azachipatala a odwala omwe amaphatikizidwa ndi phunziroli. Makina ophunzirira.

2.2 Njira zakufufuza kwamankhwala.

2.3 Njira zakufufuza zasayansi.

2.3.1 Kutsimikiza kwa shuga wamagazi.

2.3.2 Kutsimikiza kwa glycosylated hemoglobin (HBA1).

2.3.3 Njira zodziwira mbiri ya lipid.

2.3.4 Njira yotsimikizirira ma immunoglobulins A (IgA), M (IgM), G (IgG).

2.3.5 Njira zodziwira mayeso a HCT.

2.3.6 Njira yotsimikizirira mapuloteni a C-reactive (hsCPB).

2.3.7 Kutsimikiza kwa kuchuluka kwa leukocyte.

2.4 Njira za akupanga zowunikira ma microcirculation.

2,5 Kuyesa kwa moyo malinga ndi Fomu Yachidule (SF) -36.

2.6 Kusanthula kwa zotsatira za zotsatira.

MUTU Wachitatu. KULIMBITSA KWA "DERINATE" PAKUPHUNZITSIRA KWA CARBOHYDRATE NDI LIPID METABOLISM MU ZOLEMBA NDI 2 TYPE DIABETES.

3.1. Kuphunzira kwa kagayidwe kazakudya ka odwala omwe ali ndi mtundu wa 2 matenda osokoneza bongo motsutsana ndi kumbuyo kwa kukonza kwa Derinat.

3.2 Zotsatira za Derinat pa metabolidi ya lipid mwa odwala omwe ali ndi matenda a shuga a 2.

MUTU IV. KUTHENGA KWA ZINSINSI ZOGWIRITSA NTCHITO ZINA ZOPANDA CHIYEMBEKEZO POPANDA CHIWEREZO KWA A DM

MUTU V. ULTRASONIC KUSINTHA KWA MICROCIRCULATION MWA MTIMA NDI TYPE 2 DIABETES PAKATI CHOLINGA CHA CHOLINGA CHA CHOLEMA CHINSINSI.

MUTU VI. KULIMA KWA ZINSINSI ZOGWIRITSIRA CHINSINSI CHA MOYO WABODZA MU ZOLEMBA NDI TYPE 2 DM.

Kukhazikitsidwa kwa dissertation (gawo la nthano) pa mutu "Kuphunzira za luso la mankhwala omwe amapezeka mwa odwala omwe ali ndi matenda a shuga a 2"

Kugwirizana kwa mutu. Pakadali pano, matenda a shuga amayamba kukhala ngati "mliri" ndikuyimira vuto lalikulu lazachipatala ndi mayiko onse otukuka ndi mayiko achitatu (Dedov I.I., 2008). Malinga ndi WHO, M'mayiko onse padziko lapansi chiwerengero cha odwala matenda a shuga chimaposa 175 miliyoni. Malinga ndikuyerekeza kwa akatswiri pakufalikira kwa matendawa, pofika chaka cha 2010 chiwerengero cha odwala choterechi chidzafika miliyoni 23,000, pomwe 80-90% idzakhala odwala omwe ali ndi matenda a shuga 2 mellitus (DM) (International Diabetes Federation, 2007).

Mwa anthu okalamba, kuchuluka kwa odwala matenda ashuga a 2 kukuchulukirachulukira. Kuchuluka kwa matenda ashuga ku Russia ndi 5% (Dedov I.I., 2008). Kufunikira kwa kuphunzira kwa matenda ashuga amtundu wa 2 ndikuti matenda amatsogolera ku kulumala koyambirira, komanso kufa kwambiri chifukwa cha zovuta zingapo (nephropathy, neuropathy, retinopathy, etc.). Malinga ndi malingaliro amakono, maphunziro azachipatala komanso momwe munthu angadutsire matenda a shuga mellitus zimatengera kuchuluka kwa kuchuluka kwa zovuta zam'matumbo (micro- and macroangiopathy) mwa odwala (Balabolkin M.I., Klebanova E.M., 2007). Mu 20-30% ya odwala omwe ali ndi matenda a shuga a 2, zotumphukira zamitsempha zamaiyo zimapezekanso panthawi yomwe amapezeka ndi matenda. Oposa 90% ya odwala matenda amtundu wa 2 amakhala ndi metabolic syndrome (MS) panthawi yomwe matendawa amayamba (Klebanova EM, Balabolkin MI, 2006). Zonsezi zimatanthauzira kufunikira kwa matenda a shuga komanso chikhalidwe cha anthu odwala matenda opatsirana chifukwa mitundu ya matenda ashuga yachiwiri imawirikiza kawiri zaka 15 mpaka 20 (Dedov I.I., 2006).

Kufufuza komwe kumayambitsa matenda ashuga a 2 komanso matenda obweretsa matenda a shuga 2 kumabweretsa chidziwitso chatsopano cha njira za matenda ashuga komanso zomwe zimayambitsa zovuta zina zamatenda. Chifukwa chake, kuwunika kwa njira zamagetsi zamagetsi zamagetsi zomwe zimagwirizana ndi odwala omwe ali ndi matenda a shuga a 2 akuwonetsa mawonekedwe a kulumikizana kwa chitetezo cha mthupi ndi endocrine machitidwe popanga njira ya pathological process (Metelitsa, V.I., 2005).Kuphatikizika kwa ntchito kumachitika pophunzira udindo wamagulu olimbana ndi chitetezo chathupi pakupanga insulin kukaniza odwala omwe ali ndi matenda a shuga a 2 komanso kunenepa kwambiri. Chifukwa cha kuphunzira kwa ntchito ya endocrine ya adipose minofu, zidadziwika paziwopsezo zosiyanasiyana za chotupa necrosis factor gene (TNF-a), zomwe zimatha kuyambitsa kutupa, kulepheretsa zochita za insulin, komanso zimathandizira pakukumana kwa ma atherosselotic ndi thrombotic vascular (Dedov I.I. et al., 2004. Cheknev S.B., 1999, De Fronzo RA, 1992., Mercurio F., Manning AM, 1999). The pathological zotsatira za TNF-a zimatsimikiziridwa osati kokha ndi kuyambitsa njira yopanda oxidative yaulere yamafuta acid metabolism (FFA) komanso sanali enzymatic oxidation a glucose. Izi zimathandizanso kufotokozera kwa inhibitor wa activr wa fibrinogen-1, amachepetsa kufotokoza kwa adiponectin, amathandizira mapuloteni kinase C (Almazov V.A. et al., 1999, Butrova S.A., 2001, Shubina A.T. et al., 2001). Chifukwa cha kutupa, kupanga kwa kupumula kwa endothelial, nitric oxide (NO), kuchepa, ntchito yotsitsimutsa ya minofu yosalala imatsitsidwa, kupindika kwamitsempha yama cell kukana (OPSS) kukukulira, kuchuluka ndi kusunthika kwa maselo a minofu yosalala akuwonjezeka - mphamvu ya kukonzanso kwam'mimba, kudziphatika komanso kusunthika kwa monocytes kumayambitsa. - atherogenic ndi pro-yotupa mphamvu, kutsegula kwa kuphatikiza kwa mapulateleti ndi kusakanikirana kumatha kuchitika - zotsatira zowonjezera (Gracheva O.A., Smirnova O.I., 2003, Hotamisligil G., Shargill N., Spiegelman B. , 1993, Ruan H. et al., 2002).

Popeza kudalirana kwa matenda okhudzana ndi matenda a immunological and metabolic omwe amachitika mwa odwala omwe ali ndi matenda a shuga a 2 komanso zovuta zina zokhudzana ndi matendawa, vuto la kugwiritsidwa ntchito mosamala mu chithandizo chovuta cha odwala omwe ali ndi matenda osokoneza bongo limakhala lofunikira kwambiri.

Cholinga: kufufuza zamankhwala ogwira ntchito ku Derinat immunomodulator mu zovuta za odwala omwe ali ndi mtundu wachiwiri wa matenda osokoneza bongo omwe amaphatikizana ndi angiopathy a malekezero apansi.

Zolinga za phunziroli. Malinga ndi cholinga mukamachita ntchito zotsatirazi:

1. Kuti muphunzire zotsatira za Derinat pa kagayidwe kazakudya kwa odwala omwe ali ndi vuto lachiwiri la shuga ndi zovuta za angiopathy zam'munsi.

2. Kuchita kafukufuku wa kusintha kwa milomo ya magazi ya lipid ya odwala omwe ali ndi matenda amtundu wa 2 komanso kulandira mankhwala "Derinat" monga gawo la zovuta.

3. Kuphunzira zotsatira za kukonzekera kwa Derinat pazizindikiro zina zokhudzana ndi chitetezo chamthupi komanso ma cell omwe ali ndi odwala 2 a shuga.

4. Kuyang'ana momwe zovuta za mtundu wa matenda ashuga a mtundu 2 zimaphatikizira, kuphatikizapo kukonzekera kwa Derinat, pamalo a kama.

5. Kuti tisanthule za kuchuluka kwa zisonyezo za moyo kwa odwala omwe ali ndi matenda a shuga 2 omwe amavuta ndi angiopathy am'munsi, chithandizo chovuta chomwe chimaphatikizapo Derinat.

Zosavuta pazasayansi. Kafukufuku adachitika pokhudzana ndi kukonzekera kwa Derinat mu zovuta za odwala omwe ali ndi matenda a shuga a 2, ophatikizika ndi angiopathy a malekezero, pama carbohydrate metabolism. Zadziwika kuti kugwiritsidwa ntchito kwa Derinat kumayendetsedwa ndi kuthamangitsa kwa mawu kuti alipire njira ya pathological, yomwe imawonetsedwa kuchepa kwa postprandial glycemia ndi glycated hemoglobin.

Mukamawerengera momwe zinthu zina zingakhalire ndi odwala omwe ali ndi matenda a shuga a 2, zidapezeka kuti kukonzekera kwa Derinat ndikosintha kwina komwe kumayambitsa zovuta zoyambira - macrophage, chitetezo chokwanira. Nthawi yomweyo, Derinat imawonjezera kuyankha kwamphamvu kwa thupi - malinga ndi mapuloteni a C-rease, koma ochepera kwambiri kuposa kugwiritsa ntchito mankhwalawa. f

Zinapezeka kuti cholinga cha kukonzekera kwa Derinata ndicholondola komanso pathogenetically pamankhwala ovuta a odwala omwe ali ndi matenda amtundu wa 2, chifukwa zimapangitsa kutsika kwa kuchuluka kwa kupitirira kwa atherosulinosis: kuchepa kwakukulu kwa cholesterol (cholesterol) ndi lipensitone yotsika kwambiri (LDL).

Zinawonetsedwa kuti mwa odwala omwe amathandizidwa ndi zovuta zovuta, kuphatikiza Derinat, pali kusintha pazitsogozo za Dopplerographic, zomwe zikuwonetsa kusintha kwa microcirculation.Odwala omwe ali ndi matenda a shuga a mtundu wa 2 omwe adalandira Derinat, nthawi ya kubwezeretsa magazi pambuyo poyesedwa ndi ischemic inali 4.0 ± 0.67 min. Kwa odwala omwe sanalandire mankhwala a immunocorrection, chizindikiro ichi chinali 3.0 ± 1.2 mphindi. Komabe, kuchira pang'onopang'ono kwa nthawi yobwezeretsanso magazi kunathandizira kukulira kwakukulu kwa zomwe zaphunziridwa ndi dopplerographic ndi kusunga kwawo kwakanthawi.

Kufufuza kwazomwe zikuwonetsa mtundu wa moyo wa odwala omwe ali ndi njira zosiyanasiyana zamankhwala kunawonetsa kuti kuphatikizidwa kwa Derinat mu chithandizo choyambirira cha matenda a shuga a 2 kumapangitsa kuti thupi lizigwira ntchito, kumachepetsa ululu komanso kumakulitsa thanzi lam'mutu.

Makonzedwe otetezedwa. 1. "Derinat" mu chipatala chovuta kwambiri cha matenda a shuga 2 amathandizira kukulitsa chiwongola dzanja cha matenda a shuga, omwe amatsogozedwa ndi kuchepa kwa shuga ndi glycosylated hemoglobin m'magazi, komanso kuchepa kwa cholesterol kwathunthu, lipoproteins yotsika, posakhala kuti pakuwoneka zotsatira za triglycerides ndi milingo yapamwamba.

2. Kugwiritsa ntchito kukonzekera kwa Derinat mu chithandizo chovuta cha odwala omwe ali ndi matenda a 2 matenda a shuga kumayendera limodzi ndi kusungunuka kwa chitetezo cha mthupi, zomwe zimanenedwa mu malamulo a chitetezo chamthupi komanso ma cell, komanso kusintha kwa zotumphukira zam'mimba.

3. Kuphatikiza mankhwala a matenda ashuga a mtundu 2 ndikugwiritsidwa ntchito ndi Derinat immunomodulator kumabweretsa kuwongolera kwakuthupi ndi thanzi laumunthu, cholinga komanso chidziwitso chogwirizana, chitukuko chomwe chimaphatikizapo zotumphukira za angiopathy, zomwe zimayambira ndi matenda awa.

Kugwirizana kwenikweni. Kutengera ndi maphunzirowa, chithandizo chokwanira cha odwala omwe ali ndi mtundu wachiwiri wa matenda osokoneza bongo omwe amaphatikizidwa ndi angiopathy am'munsi, kuphatikiza muyezo wa hypoglycemic pogwiritsa ntchito immunomodulator yachilengedwe, ndi othandizira.

Zotsatira zomwe zimapezeka pa kugwiritsa ntchito Derinat komanso momwe zimasokonezera kagayidwe kachakudya ndi kuthekera kwa kusowa kwa chitetezo cha mthupi zimatilola kuvomereza mu zovuta za mtundu wa matenda a shuga 2.

Mphamvu ya kukonzekera kwa Derinat pazomwe zikuwonetsa ma microcirculation kumakhala ndi zotsatira zabwino pa angiopathy mwa odwala omwe ali ndi mtundu wa 2 matenda a shuga, kuchepetsa kuchepa kwawo, komwe kumawongolera moyo wa odwala ndikuchedwa kutha kwa nthawi yolumala. Kuphatikiza mankhwala ndi Derinat kumathandizira kuthandizira komanso kuchiritsa odwala omwe ali ndi matendawa.

Kuyesa zotsatira za ntchito. Zotsatira za ntchitoyi zidanenedwa ku III Congress of Russian Pharmacologists "Pharmacology - Practical Health Care" (St. Petersburg, 2007), msonkhano wodziwitsa za anthu odwala matenda a "matenda a Morpho komanso zothandiza anthu pazachipatala" (Tver, 2007), ndi msonkhano wapadziko lonse "Allergology and Clinical Immunology - Interdisciplinary mavuto ”(Moscow, 2008), XV Russian National Congress" Man and Medicine "(Moscow, 2008), msonkhano wapachaka wa sayansi ku Mordovian State University" Ogarevsky Readings "(Saransk, 2008).

Kukwaniritsidwa kwa zotsatira za kafukufuku. Zotsatira za kafukufukuyu adazipeza mu ntchito yachipatala ya a dipatimenti ya a Health Health Institution "District Clinical Hospital", Tver, ndipo amagwiritsidwa ntchito popanga maphunziro ndi kafukufuku ku dipatimenti ya Pharmacology ndi maphunziro a zamankhwala a chipatala ndipo a Unduna wa Zaumoyo ndi Zaumoyo a SEI HPE "Mordovian State University dzina lake N.P. "Ogareva."

Mabuku Pamutu wa dissertation, mabuku 8 omwe adasindikizidwa adasindikizidwa, kuphatikiza 2 m'mabuku omwe amavomerezedwa ndi a Highest Attestation Commission of the Ministry of Education and Science of the Russian Federation.

Kapangidwe ndi kukula kwa dissertation.Mituyi imakhala ndi mawu oyambira, kuwunikira mabuku, zida ndi kafukufuku, zotsatira za kafukufuku wathu, kukambirana pazotsatira, zomaliza ndi mndandanda wa mabuku, wokhala ndi zinthu 167, kuphatikizapo 60 akunja. Ntchitoyi yakhazikitsidwa pamasamba 145 a mitundu, ali ndi zithunzi 24 ndi matebulo 13.

Kukhazikitsa kwa dissertation pamutu "Pharmacology, Clinical Pharmacology", Gogina, Elena Dmitrievna, abstract

Kugwirizana kwa mutu. Pakadali pano, matenda a shuga amayamba kukhala ngati "mliri" ndikuyimira vuto lalikulu lazachipatala ndi mayiko onse otukuka ndi mayiko achitatu (Dedov I.I., 2008). Malinga ndi WHO, M'mayiko onse padziko lapansi chiwerengero cha odwala matenda a shuga chimaposa 175 miliyoni. Malinga ndikuyerekeza kwa akatswiri pakufalikira kwa matendawa, pofika chaka cha 2010 chiwerengero cha odwala choterechi chidzafika miliyoni 23,000, pomwe 80-90% idzakhala odwala omwe ali ndi matenda a shuga 2 mellitus (DM) (International Diabetes Federation, 2007).

Mwa anthu okalamba, kuchuluka kwa odwala matenda ashuga a 2 kukuchulukirachulukira. Kuchuluka kwa matenda ashuga ku Russia ndi 5% (Dedov I.I., 2008). Kufunikira kwa kuphunzira kwa matenda ashuga amtundu wa 2 ndikuti matenda amatsogolera ku kulumala koyambirira, komanso kufa kwambiri chifukwa cha zovuta zingapo (nephropathy, neuropathy, retinopathy, etc.). Malinga ndi malingaliro amakono, maphunziro azachipatala komanso momwe munthu angadutsire matenda a shuga mellitus zimatengera kuchuluka kwa kuchuluka kwa zovuta zam'matumbo (micro- and macroangiopathy) mwa odwala (Balabolkin M.I., Klebanova E.M., 2007). Mu 20-30% ya odwala omwe ali ndi matenda a shuga a 2, zotumphukira zamitsempha zamaiyo zimapezekanso panthawi yomwe amapezeka ndi matenda. Oposa 90% ya odwala matenda amtundu wa 2 amakhala ndi metabolic syndrome (MS) panthawi yomwe matendawa amayamba (Klebanova EM, Balabolkin MI, 2006). Zonsezi zimatanthauzira kufunikira kwa matenda a shuga komanso chikhalidwe cha anthu odwala matenda opatsirana chifukwa mitundu ya matenda ashuga yachiwiri imawirikiza kawiri zaka 15 mpaka 20 (Dedov I.I., 2006).

Kufufuza komwe kumayambitsa matenda ashuga a 2 komanso matenda obweretsa matenda a shuga 2 kumabweretsa chidziwitso chatsopano cha njira za matenda ashuga komanso zomwe zimayambitsa zovuta zina zamatenda. Chifukwa chake, kuwunika kwa njira zamagetsi zamagetsi zamagetsi zomwe zimagwirizana ndi odwala omwe ali ndi matenda a shuga a 2 akuwonetsa mawonekedwe a kulumikizana kwa chitetezo cha mthupi ndi endocrine machitidwe popanga njira ya pathological process (Metelitsa, V.I., 2005). Kuphatikizika kwa ntchito kumachitika pophunzira udindo wamagulu olimbana ndi chitetezo chathupi pakupanga insulin kukaniza odwala omwe ali ndi matenda a shuga a 2 komanso kunenepa kwambiri. Chifukwa cha kuphunzira kwa ntchito ya endocrine ya adipose minofu, zidadziwika paziwopsezo zosiyanasiyana za chotupa necrosis factor gene (TNF-a), zomwe zimatha kuyambitsa kutupa, kulepheretsa zochita za insulin, komanso zimathandizira pakukumana kwa ma atherosselotic ndi thrombotic vascular (Dedov I.I. et al., 2004. Cheknev S.B., 1999, De Fronzo RA, 1992., Mercurio F., Manning AM, 1999). The pathological zotsatira za TNF-a zimatsimikiziridwa osati kokha ndi kuyambitsa njira yopanda oxidative yaulere yamafuta acid metabolism (FFA) komanso sanali enzymatic oxidation a glucose. Izi zimathandizanso kufotokozera kwa inhibitor wa activr wa fibrinogen-1, amachepetsa kufotokoza kwa adiponectin, amathandizira mapuloteni kinase C (Almazov V.A. et al., 1999, Butrova S.A., 2001, Shubina A.T. et al., 2001). Chifukwa cha kutupa, kupanga kwa kupumula kwa endothelial, nitric oxide (NO), kuchepa, ntchito yotsitsimutsa ya minofu yosalala imatsitsidwa, kupindika kwamitsempha yama cell kukana (OPSS) kukukulira, kuchuluka ndi kusunthika kwa maselo a minofu yosalala akuwonjezeka - mphamvu ya kukonzanso kwam'mimba, kudziphatika komanso kusunthika kwa monocytes kumayambitsa. - atherogenic ndi pro-yotupa mphamvu, kutsegula kwa kuphatikiza kwa mapulateleti ndi kusakanikirana kumatha kuchitika - zotsatira zowonjezera (Gracheva O.A., Smirnova O.I., 2003, Hotamisligil G., Shargill N., Spiegelman B. , 1993, Ruan H. et al., 2002).

Popeza kudalirana kwa matenda okhudzana ndi matenda a immunological and metabolic omwe amachitika mwa odwala omwe ali ndi matenda a shuga a 2 komanso zovuta zina zokhudzana ndi matendawa, vuto la kugwiritsidwa ntchito mosamala mu chithandizo chovuta cha odwala omwe ali ndi matenda osokoneza bongo limakhala lofunikira kwambiri.

Cholinga: kufufuza zamankhwala ogwira ntchito ku Derinat immunomodulator mu zovuta za odwala omwe ali ndi mtundu wachiwiri wa matenda osokoneza bongo omwe amaphatikizana ndi angiopathy a malekezero apansi.

Zolinga za phunziroli. Malinga ndi cholinga mukamachita ntchito zotsatirazi:

1. Kuti muphunzire zotsatira za Derinat pa kagayidwe kazakudya kwa odwala omwe ali ndi vuto lachiwiri la shuga ndi zovuta za angiopathy zam'munsi.

2. Kuchita kafukufuku wa kusintha kwa milomo ya magazi ya lipid ya odwala omwe ali ndi matenda amtundu wa 2 komanso kulandira mankhwala "Derinat" monga gawo la zovuta.

3. Kuphunzira zotsatira za kukonzekera kwa Derinat pazizindikiro zina zokhudzana ndi chitetezo chamthupi komanso ma cell omwe ali ndi odwala 2 a shuga.

4. Kuyang'ana momwe zovuta za mtundu wa matenda ashuga a mtundu 2 zimaphatikizira, kuphatikizapo kukonzekera kwa Derinat, pamalo a kama.

5. Kuti tisanthule za kuchuluka kwa zisonyezo za moyo kwa odwala omwe ali ndi matenda a shuga 2 omwe amavuta ndi angiopathy am'munsi, chithandizo chovuta chomwe chimaphatikizapo Derinat.

Zosavuta pazasayansi. Kafukufuku adachitika pokhudzana ndi kukonzekera kwa Derinat mu zovuta za odwala omwe ali ndi matenda a shuga a 2, ophatikizika ndi angiopathy a malekezero, pama carbohydrate metabolism. Zadziwika kuti kugwiritsidwa ntchito kwa Derinat kumayendetsedwa ndi kuthamangitsa kwa mawu kuti alipire njira ya pathological, yomwe imawonetsedwa kuchepa kwa postprandial glycemia ndi glycated hemoglobin.

Mukamawerengera momwe zinthu zina zingakhalire ndi odwala omwe ali ndi matenda a shuga a 2, zidapezeka kuti kukonzekera kwa Derinat ndikosintha kwina komwe kumayambitsa zovuta zoyambira - macrophage, chitetezo chokwanira. Nthawi yomweyo, Derinat imawonjezera kuyankha kwamphamvu kwa thupi - malinga ndi mapuloteni a C-rease, koma ochepera kwambiri kuposa kugwiritsa ntchito mankhwalawa. f

Zinapezeka kuti cholinga cha kukonzekera kwa Derinata ndicholondola komanso pathogenetically pamankhwala ovuta a odwala omwe ali ndi matenda amtundu wa 2, chifukwa zimapangitsa kutsika kwa kuchuluka kwa kupitirira kwa atherosulinosis: kuchepa kwakukulu kwa cholesterol (cholesterol) ndi lipensitone yotsika kwambiri (LDL).

Zinawonetsedwa kuti mwa odwala omwe amathandizidwa ndi zovuta zovuta, kuphatikiza Derinat, pali kusintha pazitsogozo za Dopplerographic, zomwe zikuwonetsa kusintha kwa microcirculation. Odwala omwe ali ndi matenda a shuga a mtundu wa 2 omwe adalandira Derinat, nthawi ya kubwezeretsa magazi pambuyo poyesedwa ndi ischemic inali 4.0 ± 0.67 min. Kwa odwala omwe sanalandire mankhwala a immunocorrection, chizindikiro ichi chinali 3.0 ± 1.2 mphindi. Komabe, kuchira pang'onopang'ono kwa nthawi yobwezeretsanso magazi kunathandizira kukulira kwakukulu kwa zomwe zaphunziridwa ndi dopplerographic ndi kusunga kwawo kwakanthawi.

Kufufuza kwazomwe zikuwonetsa mtundu wa moyo wa odwala omwe ali ndi njira zosiyanasiyana zamankhwala kunawonetsa kuti kuphatikizidwa kwa Derinat mu chithandizo choyambirira cha matenda a shuga a 2 kumapangitsa kuti thupi lizigwira ntchito, kumachepetsa ululu komanso kumakulitsa thanzi lam'mutu.

Makonzedwe otetezedwa. 1. "Derinat" mu chipatala chovuta kwambiri cha matenda a shuga 2 amathandizira kukulitsa chiwongola dzanja cha matenda a shuga, omwe amatsogozedwa ndi kuchepa kwa shuga ndi glycosylated hemoglobin m'magazi, komanso kuchepa kwa cholesterol kwathunthu, lipoproteins yotsika, posakhala kuti pakuwoneka zotsatira za triglycerides ndi milingo yapamwamba.

2.Kugwiritsa ntchito kukonzekera kwa Derinat mu chithandizo chovuta cha odwala omwe ali ndi matenda a 2 matenda a shuga kumayendera limodzi ndi kusinthasintha kwa chitetezo cha mthupi, chomwe chikufotokozedwa muzochitika zonse zamiseche komanso ma cell, komanso kusintha kwa zotumphukira zam'mimba.

3. Kuphatikiza mankhwala a matenda ashuga a mtundu 2 ndikugwiritsidwa ntchito ndi Derinat immunomodulator kumabweretsa kuwongolera kwakuthupi ndi thanzi laumunthu, cholinga komanso chidziwitso chogwirizana, chitukuko chomwe chimaphatikizapo zotumphukira za angiopathy, zomwe zimayambira ndi matenda awa.

Kugwirizana kwenikweni. Kutengera ndi maphunzirowa, chithandizo chokwanira cha odwala omwe ali ndi mtundu wachiwiri wa matenda osokoneza bongo omwe amaphatikizidwa ndi angiopathy am'munsi, kuphatikiza muyezo wa hypoglycemic pogwiritsa ntchito immunomodulator yachilengedwe, ndi othandizira.

Zotsatira zomwe zimapezeka pa kugwiritsa ntchito Derinat komanso momwe zimasokonezera kagayidwe kachakudya ndi kuthekera kwa kusowa kwa chitetezo cha mthupi zimatilola kuvomereza mu zovuta za mtundu wa matenda a shuga 2.

Mphamvu ya kukonzekera kwa Derinat pazomwe zikuwonetsa ma microcirculation kumakhala ndi zotsatira zabwino pa angiopathy mwa odwala omwe ali ndi mtundu wa 2 matenda a shuga, kuchepetsa kuchepa kwawo, komwe kumawongolera moyo wa odwala ndikuchedwa kutha kwa nthawi yolumala. Kuphatikiza mankhwala ndi Derinat kumathandizira kuthandizira komanso kuchiritsa odwala omwe ali ndi matendawa.

Kuyesa zotsatira za ntchito. Zotsatira za ntchitoyi zidanenedwa ku III Congress of Russian Pharmacologists "Pharmacology - Practical Health Care" (St. Petersburg, 2007), msonkhano wodziwitsa za anthu odwala matenda a "matenda a Morpho komanso zothandiza anthu pazachipatala" (Tver, 2007), ndi msonkhano wapadziko lonse "Allergology and Clinical Immunology - Interdisciplinary mavuto ”(Moscow, 2008), XV Russian National Congress" Man and Medicine "(Moscow, 2008), msonkhano wapachaka wa sayansi ku Mordovian State University" Ogarevsky Readings "(Saransk, 2008).

Kukwaniritsidwa kwa zotsatira za kafukufuku. Zotsatira za kafukufukuyu adazipeza mu ntchito yachipatala ya a dipatimenti ya a Health Health Institution "District Clinical Hospital", Tver, ndipo amagwiritsidwa ntchito popanga maphunziro ndi kafukufuku ku dipatimenti ya Pharmacology ndi maphunziro a zamankhwala a chipatala ndipo a Unduna wa Zaumoyo ndi Zaumoyo a SEI HPE "Mordovian State University dzina lake N.P. "Ogareva."

Mabuku Pamutu wa dissertation, mabuku 8 omwe adasindikizidwa adasindikizidwa, kuphatikiza 2 m'mabuku omwe amavomerezedwa ndi a Highest Attestation Commission of the Ministry of Education and Science of the Russian Federation.

Kapangidwe ndi kukula kwa dissertation. Mituyi imakhala ndi mawu oyambira, kuwunikira mabuku, zida ndi kafukufuku, zotsatira za kafukufuku wathu, kukambirana pazotsatira, zomaliza ndi mndandanda wa mabuku, wokhala ndi zinthu 167, kuphatikizapo 60 akunja. Ntchitoyi yakhazikitsidwa pamasamba 145 a mitundu, ali ndi zithunzi 24 ndi matebulo 13.

Kutulutsa mafomu ndi kapangidwe kake

Mankhwalawa amapangidwira intramuscular, subcutaneous, kugwiritsa ntchito mankhwala akunja ndi mankhwala am'kamwa, amapezeka mu mawonekedwe amadzimadzi omwe ali ndi gawo lalikulu la 0.25 ndi 1.5%.

Madzimadzi a subcutaneous ndi mu mnofu jakisoni amapangidwa mu opaque galasi ziwiya 5 ndi 10 ml.

Pofuna kuthana ndi mphuno ya mphuno, mankhwalawa amagulitsidwa m'chiwiya chagalasi ndi chopopera kapena chopopera cha 10 ml.

Njira yamachitidwe

The pharmacological zotsatira zimachokera ku immunomodulating katundu wa mankhwala. Mankhwalawa amagwira ntchito pamankhwala omwe amapezeka m'madzi a m'thupi la munthu, amalimbikitsa ntchito yawo ndikuyambitsa ntchito zoteteza.Kuphatikiza apo, mankhwalawa amathandizira kupititsa patsogolo machiritso a bala ndi kukana minofu ya necrotic pamalo opatsirana chifukwa chobwezeretsanso katundu.

Mukamachita radiotherapy mwa odwala khansa, kuchepa kwa vuto pama cell a ionizing radiation kunadziwika, komwe kumathandizira kuchita mobwerezabwereza maphunziro a chithandizo ndikuwonjezera mphamvu yake.

Mankhwalawa matenda a mtima, thunthu limawonjezeredwa ku mtundu wovuta, kukonza myocardial ntchito, kukulira chipiriro.

Mankhwala amathandizira kufulumira ndikuwongolera kuchira kwa mucous membrane wam'mimba ndi duodenum wokhala ndi zilonda zam'mimba.

Pharmacokinetics

Gawo logwira ntchito limatengeka mosavuta ndi ma cell a cell ndikugawa mwachangu mwa iwo chifukwa cha plasma ndi zigawo zopangidwa ndi magazi, limalowetsedwa mu ma microstructures ndikuchita nawo ma cell othandizira.

Mankhwalawa amachotsedwa pang'ono ndi ndowe, ndipo kwakukulu, ndi mkodzo.

Kutsika kwamagazi kumawonedwa pambuyo pa maola asanu. Ndi makonzedwe a tsiku ndi tsiku, mankhwalawa amatha kudziunjikira minofu: makamaka m'mafupa, ndulu, zamitsempha, zochepa m'mimba, chiwindi, ubongo.

Zizindikiro zogwiritsidwa ntchito

Kugwiritsa ntchito kwa Derinat ndikofunikira pankhani izi:

1. Chithandizo cha mavuto a fuluwenza ndi pachimake tizilombo matenda, amene akuwoneka mu mawonekedwe a bronchitis, chibayo, mphumu.
2. Kukhalapo kwa matenda opumira kwambiri.
3. Kufooka kwa thupi ndi tizilombo tating'onoting'ono.
4. Ngati ndi kotheka, sinthani zizindikiro za matenda: chifuwa, mphumu, dermatitis.
5. Mukamazindikira zilonda zam'mimba za duodenum ndi m'mimba.
6. Imathandizira kuchiritsa mabala, kuwotcha, pamaso pa minofu ya necrotic, matenda.
7. Mu gynecology ndi urology mankhwalawa polycystic, chlamydia, mycoplasmosis, herpes, endometriosis, prostatitis, ureaplasmosis.
8. Pochita opaleshoni pokonzekera opaleshoni komanso nthawi yokonzanso.
9. Mankhwalawa matenda a mtima.
10. Ndi stomatitis.
11. Kuti muchepetse zovuta zomwe zimayambitsa zilonda zam'mimba.
12. Mankhwalawa yotupa m'maso zotupa.
13. Chifukwa cha kuwonekera kwa radiation.
14. Mu zovuta kuchira pambuyo pambuyo poizoniyu kapena mankhwala mankhwala odwala khansa.

Kutenga?

Intramuscularly, mankhwalawa amaperekedwa pang'onopang'ono kuposa mphindi 1.5-2 mu Mlingo 5 ml (1 ml wofanana ndi 15 mg wa mankhwalawa).

Mlingo wa akulu:

Mlingo wa ana:

Chiwerengero chovomerezeka cha jakisoni wa ana ku maphunziro 1 ndi 5.

Chiwerengero chovomerezeka cha jakisoni wa ana 1 kiyi ndi 5.

Kodi ndizotheka kumwa mankhwalawa chifukwa cha matenda ashuga?

Kulandila ndikotheka pofufuza mosamala kuchuluka kwa shuga m'magazi.

Pazakumwa njira yogwiritsa ntchito nebulizer pakukumana ndi zotupa, sinusitis, adenoids ndipo mukazizira, yankho la 0.25% limagwiritsidwa ntchito, mlingo waukulu wa mankhwala patsiku ndi 2 ml wothandizidwa ndi 2 ml ya Sodium chloride.

Pochiza matenda opatsirana a bronchitis, kupuma, tikulimbikitsidwa kugwiritsa ntchito yankho la 1.5%.

Kutalika kwa ndondomeko ya 1 sikuyenera kupitirira mphindi 5.

Ndi matenda ashuga

Mukamagwiritsa ntchito mankhwalawa, anthu omwe ali ndi matenda ashuga ayenera kuyang'anitsitsa kuchuluka kwa shuga m'magazi, chifukwa mankhwalawa amatha kukhala ndi vuto la hypoglycemic, i.e. shuga wotsika.

Chida chake sichimayambitsa mayankho chifukwa choti munthu alibe mtima pazinthu zake, m'malo mwake, amachotsa zizindikiro za chifuwa.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Kutenga Derinat pakubala kwa mwana kumaloledwa pokhapokha kukaonana ndi dokotala ngati zotsatira zoyenera kwa wodwalayo zitha kukhala pachiwopsezo cha mwana wosabadwayo. Pakudyetsa mwana mkaka wa m'mawere, kugwiritsa ntchito mankhwalawa kumaloledwanso mosamalitsa ngati adokotala adamuwuza.

Kuchita ndi mankhwala ena

Ndi makonzedwe omwewo a Derinat ndi maantibayotiki, kuwonjezeka kwa mphamvu yomalizayi kumawonedwa. Mankhwalawa matenda opatsirana ndi zilonda zam'mimba, mankhwalawo, limodzi ndi mankhwala ofunikira, amatha kuchepetsa njira ya mankhwalawa, kuchepetsa kuchuluka kwa mankhwalawa, ndikuwonjezera nthawi yakukhululuka.

Pochita opaleshoni, kuyang'anira Derinat kumathandizira kuchepetsa kuledzera, kupewa matenda kuti asalowe bala, kuyambitsa chitetezo cha mthupi, komanso kukhazikika pakupanga magazi.

Mankhwalawa sagwirizana ndi mafuta amakono omwe amakonzedwa ndi mafuta.

Zambiri bwanji?

Mtengo wa mankhwalawa umakhudzana mwachindunji ndi cholinga chake:

Migwirizano ndi malo osungirako Derinat

Mankhwalawa amakhalabe oyenera kugwiritsidwa ntchito zaka 5 kuyambira tsiku lopangidwa. Iyenera kusungidwa m'malo amdima ndipo ana sangathe kuwapeza, pamawonekedwe a +4. + 18 ° C.

Ndemanga za Derinat

Vladimir, wazaka 39, Arkhangelsk.

Ndinkazunzidwa ndi mphuno pafupipafupi, makamaka nthawi yamalimwe ndi yophukira chaka, kuikidwa kwa Derinat, kuchulukana kumathamanga, ndipo kubwereranso kumacheperachepera. Sindinayese chilichonse chabwinoko.

Victoria, wazaka 25, Zainsk.

Dokotala wa ana adapereka mankhwalawa kwa mwana wazaka 2, adamulamula kuti atengere inhalations ndikugwetsa mphuno yake. M'chaka chatha, nthawi zambiri amapezeka ndi bronchitis yolepheretsa, yothandizidwa ndi manyumwa, sizinathandize. Chida ichi chinapirira mwachangu.

Momwe mungagwiritsire ntchito viburnum ndi matenda a shuga a 2?

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Kodi viburnum yothandiza ndi shuga yachiwiri ndi iti? Ena odwala matenda ashuga amapatsa mbewu iyi pafupifupi chilichonse chomwe chitha kuchiritsa matenda a shuga. Inde, kuchiritsa kwathunthu ndi nthano ya anthu osinthika, koma kugwiritsa ntchito zipatso za viburnum, kupangika kwa khungwa ndi masamba kumathandiza mu thupi la wodwalayo. Koma kodi machiritso a mbewuyi ndi otani ndipo amatha kuthandizidwa nthawi zonse?

Mphamvu ya viburnum thupi la odwala matenda ashuga

Viburnum yokhala ndi matenda a shuga a 2 amathandizira kulimbitsa thupi la wodwalayo, kupereka mavitamini komanso kupewa kuteteza zovuta za matenda ashuga. Chimachitika ndi chiani mthupi ndi matenda ashuga? Zachidziwikire, poyambirira, kupanga insulini kumasokonezeka ndipo kuchuluka kwa shuga m'magazi kumakwera. Koma kuphwanya shuga kagayidwe ndi gawo limodzi chabe la matendawo. Ndi chitukuko cha matendawa, kuthekera kotenga mavitamini ndi ma michere ndi njira zina za metabolic kumasautsika, nthawi zambiri monga zovuta, zotupa zam'matumbo ndi mtima, chiwindi, ndi impso zimayamba.

Viburnum yokhala ndi matenda a shuga a 2 amathandizira kuchepetsa mwayi wokhala ndi zovuta za matenda ashuga.

Chomera chimakhala ndi zotsatirapo zakepi:

1. Anti-kutupa komanso kuchiritsa mabala. Ubwino uwu ndi wofunikira kwambiri kwa odwala matenda ashuga, chifukwa ndi matendawa, mphamvu ya thupi yokana kukweza matenda opatsirana ndi ma virus imachepa, ndipo mabala ochiritsa olakwika komanso njira zina zotupa mthupi nthawi zambiri amatenga kachilombo.
2. Kubwezeretsa.Viburnum mwanjira iliyonse imalimbitsa machitidwe ndi ziwalo zonse, imawonjezera mamvekedwe a khoma la mtima ndipo imalimbitsa minofu yamtima, komanso imathandizira kugwira ntchito kwa chiwindi ndi kapamba.
3. Zambiri Kuchepetsa kumathandiza wodwalayo kupumula, kusintha usiku kugona. Kuphatikiza apo, matenda a shuga amawoneka ngati "matenda opsinjika" komanso zovuta zomwe zimapangitsa kupsinjika kwa insulin ndi ntchito ya enzymeyi kwatsimikiziridwa kale.
4. Antispasmodic. Spasms ya zombo zazing'ono, makamaka kumadera otsika, ndizodziwika ndi matendawa. Kukhalitsa kwa nthawi yayitali ndi vuto la magazi osokoneza bongo kumabweretsa kukula kwa minofu hypoxia komanso kuvutikira pafupipafupi kwa odwala matenda ashuga monga gangrene.
5. Kuyeretsa magazi. Cholesterol owonjezera, zinthu zowola ndi zinthu zina zowopsa zimachotsedwa m'magazi, ndipo zomwe zimakhala ndi shuga zimakhazikika.

Momwe mungagwiritsire ntchito

Mutha kudya zipatso, mowa monga tiyi, masamba kapena kupanga khungwa:

• Tiyi wa Viburnum. Zipatso zouma kapena zatsopano zimatsanuliridwa mu ketulo. Kuchuluka kwake kumachitika mosaganizira, kuti mulawe, mutha kuwonjezera masamba a viburnum, achire zotsatira zake zimakhala zapamwamba kwambiri. Thirani madzi otentha ndikuphimba ketulo ndi pepala lotenthetsera, kuyembekezera kuzirala kwathunthu. Mutha kumwa tiyi ya viburnum popanda zoletsa, zimathandizira kukula kwa shuga, kusintha kugona ndikuchepetsa kusangalala kwamanjenje.

• Madzi. Amawaza zipatso zatsopano zomwe zimaphatikizidwa chisanu (kuwawa kumapitilira zipatso mpaka chisanu). Madzi amakhudzanso thupi ndi tiyi, chizolowezi chatsiku lililonse siziyenera kupitilira 200 ml. Kumwa madzi amalimbikitsidwa masana, kugawa madzi mu 2 kapena 3 waukulu.
• Uchi ndi mabulosi osakaniza. Njira yabwino yothandizira odwala matenda ashuga omwe amakhala ochepa matenda oopsa monga zovuta zachiwiri. Sakanizani zigawo zonse mu 1: 1 ndipo mudye supuni 2 kapena katatu patsiku.
• Bark. Kulowetsedwa kuchokera ku makungwa nthawi zambiri kumalimbikitsidwa poyambira matendawa kuti matenda azikhala ndi shuga, koma kumathandizanso thupi la iwo omwe ali ndi matenda a shuga kwa nthawi yayitali. Supuni yokhala ndi phokoso la khungwa lakutsanulira imathiridwa ndi kapu yamadzi otentha ndikuwiphika kwa theka la ora mumadzi osamba. Pambuyo pake, chidebe chokhala ndi msuzi chimakulungidwa mu nsalu yotentha ndikusiyidwa kuti kuzizire. Kumwa kumalimbikitsidwa katatu patsiku kwa kotala chikho.

Mukapanda kudya viburnum

Matenda a 2 a shuga nthawi zonse amakhala ndi zovuta, ndipo ena mwa iwo, viburnum imatha kukulitsa matendawa.

Zomera sizingadye ndi izi:

• thrombophlebitis. Kuphwanya patency ya zombo zazing'ono kumabweretsa thrombosis. Pakadutsa matenda a matenda ashuga, magazi amawoneka m'mitsempha yayikulu kapena mitsempha ya varicose imatha. Kudya viburnum kumawonjezera mamasukidwe amwazi, kuyambitsa mapangidwe atsopano wamagazi,
• mimba. Mphamvu yotsitsimutsa ya viburnum imatha kukhala ndi vuto lililonse mutagona machitidwe ndi ziwalo za mwana wosabadwayo,
• gout. Matendawa amadziwika ndi kuchuluka kwa mchere wa uric acid m'malumikizidwe, ndipo michere ina yomwe imapanga chomeracho imatha kukulitsa mchere ndikupangitsa kuti gouty iwonongeke.
• hyperthyroidism. Ayodini amene amapezeka mu zipatso za viburnum amakhudza kugwira ntchito kwa chithokomiro, ndipo matendawa ntchito zake zimatupa. Mlingo wowonjezera wa ayodini ungapangitse kukulira kwa hypothyroidism.

Zotsutsana zina ndizotheka, zambiri zimagwirizanitsidwa ndi kuphwanya mchere wa mchere.

Chithandizo cha Mankhwala

Matenda a shuga ndi matenda osachiritsika masiku ano. Anthu ambiri amakhala naye. Koma ngati mungatsatire malangizo a dokotala, musaiwale za mayeso oletsa kupewa matenda, kutsatira kadyedwe ndi masewera olimbitsa thupi, ndiye kuti wodwala wodwala matenda ashuga adzaza. Njira zambiri zosachiritsika zochizira matendawa zimadziwika.Chithandizo chodziwika bwino cha matenda ashuga ndi kugwiritsa ntchito, modabwitsa, koloko yophika. Njira imeneyi yakhala ikuchitidwa kwa nthawi yayitali. Nkhondo yoyamba yapadziko lonse, wodwala yemwe ali ndi matenda ashuga atagwa, adamupatsa yankho la msuzi wowotchera kudzera mu mtsempha.

Zokhudza kuphika kwa koloko thupi

Sodium bicarbonate ndiyosavulaza kwambiri, ndipo nthawi zina, imakhala yothandiza kwa anthu. Keke yophika imakhazikika moyenera acid-base. Mwa munthu wathanzi, mkhalidwe wa PH ndi 7.35-7.45. Ngati mukupatuka pamenepa, muyenera kufunsa katswiri kuti muwone zomwe zimayambitsa matendawa.

Soda yophika mkate imadziwika chifukwa chake:

• antimicrobial
• anti-allergic
• anti-yotupa katundu.

Amagwiritsidwa ntchito kwambiri pochiza matenda a rhinitis ndi bronchitis. Kuphika keke kuchitira stomatitis ndi zilonda. Ndi chithandizo chake, kupsa pang'ono komanso kulumidwa ndi tizilombo timakonzedwa, zimathandizanso bwino ndi kutupa ndi kutupa pakhungu. Soda yophika imagwiritsidwa ntchito kwambiri pakuyeretsa mano.

Mu cosmetology, sodium bicarbonate imagwiritsidwa ntchito popanga zodzikongoletsera zowoneka bwino. Njira yothetsera koloko imatsuka miyala ndikuphimba bwino tsitsi, ndikupangitsa kuti ikhale yoperera.

Ndi zabwino zonse komanso kugwiritsa ntchito koloko ya soda, sitiyenera kuyiwala kuti siichiritso cha matenda onse. Ndi kuchepa kwa acidity yam'mimba, kugwiritsa ntchito njira yophika koloko kumakhala koletsedwa, chifukwa kufalikira kwamatenda ndikotheka. Ndi kuchuluka kwa acidity, zotsatirapo zamankhwala zimatheka.

Shuga wa shuga

Ofufuza ku University of California anena kuti shuga imayamba chifukwa cha kuchuluka kwa chiwindi acidity. Thupi laumunthu limasungidwa nthawi zonse, limafunikira kuyeretsedwa kosalekeza kuzakumwa. Kuchuluka kwa acidity kumachepetsa ntchito yoteteza chiwindi. Izi zimakhudza kapamba, yemwe amachepetsa pang'onopang'ono kupanga insulin, yomwe imayambitsa matenda a shuga a II.

Pankhaniyi, asayansi akufuna kuti achepetse kwambiri hepatic acidity ndi soda yosavuta. Izi, mwa malingaliro awo, zidzachepetsa chiopsezo cha kupangidwa kwa matendawa komanso zina zamatenda. Ngati mungaganizire izi, ndiye kuti kugwiritsa ntchito sodium bicarbonate solution kungaganizidwe kuti ndi njira imodzi yochizira matendawa. Ndi matenda a shuga a mtundu II, koloko yophika imachepetsa uchere wamatumbo ndikuwatsuka, chiwindi chikasiya kugwira ntchito zake mwamphamvu.

Njira yophika ndi soda imathandizira kuchepa kwa shuga m'magazi. Koma wodwalayo ayenera kukumbukira kuti izi zimakhudza kapamba.

Masiku ano, mankhwala amakono amapereka njira zambiri zosankhira odwala omwe ali ndi matenda ashuga, njira zatsopano zamankhwala zapangidwa ndikuyambitsidwa, koma ngati wodwalayo akufuna kugwiritsa ntchito mankhwala ndi adjuvants, ayenera kuyang'anira chidwi chophika mkate chifukwa cha kupezeka kwake.

Mankhwala azisamba malinga ndi Neumyvakin

Ivan Pavlovich Neumyvakin, wasayansi wodziwika kwambiri padziko lonse lapansi, amadziwika kuti ndi katswiri wazithandizo zomwe sizoyambira pachikhalidwe. Amasamalira mwapadera njira zomwe chilengedwe chimapatsa munthu.

Chithandizo cha onse padziko lapansi cha matenda angapo, malinga ndi Neumyvakin, ndi mankhwala wamba ophika, ndipo pulofesayo amupatsa malo apadera pakumupatsa matenda ashuga a mtundu II. Buku lake "Soda - Myth or Reality" ndilodziwika kwambiri pakati pa owerenga.

Malinga ndi wasayansiyo, vuto lalikulu lomwe anthu ali nalo limalumikizidwa ndi kusintha kwa acid-base state, momwe mulingo woyenera kukhala wokhazikika.

Pa sikelo kuyambira 0 mpaka 14, chizindikiro ichi chikuyenera kukhala chofanana ndi 7. Chizindikiro pansipa 0 ndi malo acidic, pamwambapa 7 - zamchere. Chizindikiro chomwe chimapitilira mitundu ya 7.35-7.45, chimanenanso za kukhalapo kwa matenda omwe amafunika kuti azindikire mwachangu, chithandizo ndichofunika kuyang'aniridwa ndi katswiri.

Musanayambe chithandizo cha matenda a shuga monga njira ya Dr. Neumyvakin, muyenera kukayezetsa kuchipatala kuti muwone ngati pali zovuta zina komanso kupezeka kwa matenda. Izi zimatha kubweretsa zovuta. Izi zikuphatikiza:

• khansa yachitatu
• kuchuluka kapena kuchepa acidity,
• matenda am'mimba
• chifuwa
• lembani matenda ashuga.

Kugwiritsa ntchito koloko pophika sikulimbikitsidwa kuti pakusefukira kwam'mimba mwatsatanetsatane, komwe kumakwiyitsa m'mimba.

Mankhwala othandizira odwala a shuga II amtundu wa 2 malinga ndi Neumyvakin ayenera kuyambitsidwa ndi mlingo yaying'ono, kuyang'anira dongosolo lomwe lakonzedwa. Katatu patsiku, muyenera kumwa koloko yosungunuka m'madzi ofunda kapena mkaka.

Yankho limakonzedwa pamlingo wa ¼ supuni ya supuni ya koloko pa kapu imodzi yamadzimadzi limodzi. Kugwiritsa ntchito yankho la koloko malinga ndi njira ya Neumyvakin kukuwonetsa kuwonjezeka kwa mlingo kuchokera 1 / 4h. l mpaka 1 tsp - kawiri patatha maola awiri mutadya. Malinga ndi chiwembuchi, yankho liyenera kutengedwa kwa masiku atatu, ndiye kuti kupumula kwa masiku atatu ndikofunikira, kenako pitilizani kumwa mlingo. Njira yothetsedwayo imadyedwa mphindi 15 musanadye chakudya.

Kukonzekera yankho, ndikofunikira kusakaniza kapu ya hot ya madzi otentha ndi soda, kenako ndikuthira ndi madzi otentha. The zikuchokera ayenera kutentha. Mankhwala a boda amayamba m'mawa pamimba yopanda kanthu.

Momwe chithandizo chomwe Dr. Neumyvakin adagwiritsira ntchito sichinali chothandiza, muyenera kukumbukira nthawi zonse kuti dokotala amayenera kumwa mankhwalawa. Nthawi zambiri zotsatira za mankhwala omwe mumadzipeza nokha ndim zotsatira zoyipa kwambiri. Njira iliyonse yomwe wodwala angasankhe (ndi mankhwala, sopo kapena zitsamba), chinthu chachikulu sikuti kuvulaza thupi lanu.

Mildronate: momwe mungapewere zovuta za matenda a shuga a 2

Matenda a shuga amawononga mitsempha yamagazi ndipo amayambitsa matenda a mtima. Mavutowa ndi malo oyamba pakati pa matenda omwe amabweretsa imfa. Chifukwa chake, madotolo amayang'anira kwambiri kupewa izi zovuta za matenda a shuga.

Masiku ano, mankhwala omwe amatchedwa "Mildronate" ayamba kutchuka, omwe amathandiza kulimbana bwino ndi matenda amitsempha yamagazi komanso mtima. Zakhala zikupangidwa kuyambira 1984 ndipo zotsatira zake ndikugwiritsa ntchito kwambiri kuposa momwe madokotala amawanenera.

Tiyeni tiwone mwatsatanetsatane momwe mankhwalawa amathandizira popewa zovuta za matenda ashuga.

Mildronate ndi matenda ashuga

Mankhwalawa ali ndi (3- (2,2,2-trimethylhydrazinium) propionate dihydrate), meldonium ndi MET-88. Mankhwala odana ndi ischemic anapangidwa ndi Latvia Institute of Organic Synthesis. Kuchuluka kwa mtima kwa Mildronate kumachitika chifukwa cha kuletsa kwa γ-butyrobetaine hydroxylase komanso kuchepa kwa oxidation a beta acids.

Zotsatira za Mildronate mu shuga adawerengera makoswe. Zotsatira za kuyeseraku zikuwonetsa kuti mu nyama zomwe zili ndi matendawa, zomwe zimapatsidwa Mildronate zoposa masabata anayi, kuchuluka kwa shuga kunachepa ndipo kukulira kwa zovuta zambiri kunayima.

Muzipatala, mankhwalawa adagwiritsidwa ntchito pochiza odwala matenda a shuga a mtundu wachiwiri. Kuyesaku kunatsimikizira kuti kugwiritsidwa ntchito kwa mankhwalawa kusinthasintha shuga m'magazi ndikutchingira kukula kwa discirculatory encephalopathy, diabetesic retinopathy, autonomic neuropathy ndi matenda ena. Izi zimatsimikizira kufunikira kwa kugwiritsa ntchito mankhwalawa m'matenda a shuga pofuna kupewa zovuta zamatendawa, odwala komanso achinyamata.

Komanso, mankhwalawa ndiwothandiza matenda a coronary. Imathandizira njira zamthupi zopangira thupi, kupatsa munthu mphamvu zowonjezereka, komanso zimathandizira kukhazika minofu yamtima ndi okosijeni, ndikumapereka ku myocardium.

Mankhwalawa amathandizira kuti thupi lonse likhale labwino, kupirira zolimbitsa thupi. Mankhwalawa amathandizira ubongo, zomwe zimapangitsa kuti magwiridwe antchito ambiri azikhala bwino. Anthu odwala matenda a shuga nthawi zambiri amakhala otopa ndipo amatopa msanga.Mildronate matendawa athandizira kuthana ndi izi ndikupereka mphamvu. Mukamagwiritsa ntchito mankhwalawa, mphamvu zimabwezeretseka kangapo mwachangu.

Mphamvu ya vasodilating ya mankhwalawa imathandiza kukonza magazi mu ziwalo zonse. Mildronate amathandiza thupi kuchira msanga pambuyo pa vuto la mtima. Zimalepheretsa mapangidwe a necrosis, kotero munthu amachira mwachangu. Pakulephera kwa mtima kwambiri, mankhwalawa amathandizira mgwirizano wamisempha yamtima, amapangitsa kuti azikhala wolimba mtima ndi nkhawa, chifukwa chake ziwopsezo za angina zimachepetsedwa kwambiri.

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Mankhwalawa amabwezeretsa magazi molondola.

Kugwiritsa ntchito Mildronate kumachiritsa uchidakwa wambiri, kuthandiza kuthana ndi zovuta zamagulu amanjenje, zomwe nthawi zambiri zimayamba ndi kumwa mowa kwambiri.

Mankhwala amapangidwa monga mapiritsi ndi mapiritsi. Pali mitundu yosiyanasiyana: 250 ndi 500 mg. M'mapaketi oyenera, nthawi zambiri mapiritsi 40-60.

Adadziwonetsa bwino mu chithandizo chovuta cha matenda osiyanasiyana, kuphatikizapo matenda ashuga kwa achinyamata ndi achikulire.

1. Chithandizo cha myocardial infarction.
2. Kuchulukitsa thupi mwamphamvu kwambiri.
3. Ndi ntchito yochulukitsa.
4. Chithandizo cha mikwingwirima, angina pectoris ndi kulephera mtima.
5. Chithandizo cha kufalikira kwa matenda amtundu wa 2 matenda a shuga, matenda amchiberekero, khosi lachiberekero, matenda oopsa komanso matenda ena.
6. Cardiomyopathy yomwe imayamba chifukwa cha kusokonekera kwa mahomoni ndi kusintha kwa thupi kwa akazi achikulire.
7. Kutopa kwambiri.
8. Chithandizo cha zotengera zam'mimba mu mtundu 2 shuga.
9. Kuletsa matenda mu mankhwalawa uchidakwa.

Momwe mungatenge Mildronate

Mankhwalawa amayenera kumwedwa m'mawa, chifukwa amasangalatsa mitsempha ndipo amatha kuyambitsa matenda okalamba, ngati mumamwa mukatha kudya.

1. Kuchulukitsa kwachulukira.
2. Intracranial neoplasms.
3. Kuphwanya kwa venous kufalikira mu ubongo.
4. Ziwengo magawo a mankhwala.

• zotupa pakhungu
• nseru
• Edincke's edema,
• tachycardia
• kuchuluka kwa okalamba.

Zotsatira za mankhwalawa kwa amayi apakati ndi ana sizinayesedwe. Mtundu wachiwiri wa matenda ashuga, Mildronate amalembedwa m'maphunziro kuti akhale ndi mtima wathanzi komanso mitsempha yamagazi, kuti abwezeretse ntchito bwino. Mankhwalawa amatha kuledzera kokha ndi chilolezo cha adokotala. Simungathe kupereka mankhwalawa nokha.