Taufon ndi emoxipin nthawi yomweyo wodwala matenda ashuga

Nthawi zambiri, shuga imayendera limodzi ndi zovuta monga retinopathy. Chiritsani matenda amaso awa mothandizidwa ndi chida chachipatala "Emoksipin." Amagwiritsidwa ntchito kwambiri muzochita za ophthalmic, chifukwa cha kuchiritsa kwake, komwe cholinga chake ndikuchepetsa kupitilira kuwonongeka kwa ziwiya zamaso. Anthu omwe ali ndi matenda a shuga amaloledwa kugwiritsa ntchito “Emoksipin” monga momwe akunenera komanso atakambirana ndi katswiri wodziwa bwino ntchito yake.

ZOFUNIKA KUDZIWA! Ngakhale odwala matenda ashuga kwambiri amatha kuchiritsidwa kunyumba, popanda opaleshoni kapena zipatala. Ingowerenga zomwe Marina Vladimirovna akunena. werengani zonena zake.

Zambiri

Kukonzekera kwa mankhwala "Emoxipin" kuli ndi zinthu zingapo zopindulitsa anthu. Zimawonjezera kukana kwa thupi pakuchepa kwa okosijeni, kumalepheretsa zochita za oxidation ndipo, chifukwa chake, kumalepheretsa kuwonongeka kwa zinthu zazing'ono ndi zazikulu. "Emoksipin" amatenga nawo gawo popereka zombo ndi zotanuka, mphamvu komanso kusalala. Chifukwa cha mankhwalawa, kuthamanga kwamadzi amkati kumayenda bwino.

Shuga amachepetsedwa nthawi yomweyo! Matenda a shuga m'kupita kwa nthawi angayambitse matenda ambiri, monga mavuto amawonedwe, khungu ndi tsitsi, zilonda zam'mimba, zilonda zam'mimba komanso matenda otupa! Anthu amaphunzitsa zinzake zowawa kuti azisintha shuga. werengani.

Ili ndi "Emoksipin" watchula katundu wa antithrombotic, yemwe amakhala ndi kuyambiranso kwa magazi. Kuphatikiza apo, kugwiritsidwa ntchito kwake kumachepetsa kufalikira kwa khoma lamitsempha yama chiwona, kumalepheretsa kutaya magazi (magazi kutuluka kwa chotengera kulowa mkatikati mwa thupi) ndi kusokonezeka kwa phokoso.

Kupanga ndi mawonekedwe a kumasulidwa

Kukonzekera kwa mankhwala kwamankhwala kumadziwika ngati njira yothetsera jakisoni ndi madontho omwe amafunikira kukhazikitsa maso. Chofunikira pakupanga mankhwalawa ndi methyl ethyl pyridinol hydrochloride. Pali zina zowonjezera:

• madzi a jakisoni
• sodium sulfite,
• phosphoric acid potaziyamu mchere,
• chakudya chowonjezera E211.

Wogulitsa mankhwala "Emoksipin" amalembera zochizira zotsatirazi matenda:

Madontho amayikidwa ndi kukhathamira kwa intraocular.

• kuwonongeka kwa retina lolo la masomphenya motsutsana ndi chitukuko cha matenda a shuga,
• kuchuluka kwazovuta zamitsempha,
• zovuta za myopia,
• kudziwika ndi mankhwala ndi kutentha kwambiri pa cornea,
• intraocular hemorrhages osiyanasiyana etiologies.

Momwe mungagwiritsire ntchito?

M'mafotokozedwe ake a mankhwalawa akuwonetsa kuti akuyenera kugwiritsidwa ntchito kawiri kapena katatu patsiku, ndikuwonjezera madontho 1-2 m'diso lililonse. Awa ndi mankhwalawa olimbikitsidwa, ndipo adokotala amakhazikitsa zolondola kwambiri payekhapayekha kwa wodwala aliyense potengera zaka zake, kuzindikira ndi zovuta za matendawa. Kutalika kwa njira ya achire kumatha kusintha masiku atatu mpaka mwezi umodzi. Emoxipin iyenera kugwiritsidwa ntchito kwa odwala omwe ali ndi matenda a shuga, kutsatira malamulo ena omwe angathandize kukwaniritsa zotsatira zabwino kuchokera ku chithandizo komanso kuchepetsa chiopsezo cha matenda m'diso. Mndandanda wa zochita uli motere:

1. Sambani m'manja ndi sopo ndi kupukuta.
2. Imani kutsogolo kwagalasi kuti muwone kuyandikira kwa botolo.
3. Ponyani mutu wanu pang'ono, pang'ono pang'ono kukoka m'maso, yang'anani ndikugwetsa yankho. Osakankha khungu kwambiri, monga m'malovu kutulutsa.
4. Sizofunikira kuti muchepetse botolo pafupi kwambiri, chifukwa mutha kuwononga diso kapena kubweretsa kachilomboka kuchokera kwa gawo lina lamaso.
5. Pambuyo pokhazikitsidwa, tsekani maso anu ndikulimba pang'ono ndi chala chanu kuti mupewe yankho kuti lithe.
6. Ngati mukufuna kuyika magalasi oyenera kulumikizana, muyenera kudikirira pafupifupi 1/3 ola limodzi mutaphunzira.

Contraindication

"Emoksipin" imadziwika kuti ndi yotetezeka ku thupi la munthu, chifukwa chake, ilibe malamulo oletsa kudya. Kutsutsana kwathunthu kogwiritsa ntchito mankhwalawa ndi kudziwa tanthauzo la kapangidwe kake. Osagwiritsa ntchito "Emoksipin" komanso munthawi ya bere.

Zochitika Zosiyanasiyana

Mukamagwiritsa ntchito a Emoxipin, nthawi zambiri mukamaphwanya njira zochiritsira zochiritsidwira zimaphwanyidwa, zizindikiro zotsatirazi zingaoneke:

• redness la maso
• mutu
• kuwonongeka kwamawonekedwe
• kuthamanga kwa magazi
• maliseche ndi kulira
• kugona
• Kutupa m'diso,
• kumverera koyaka.

Nthawi zambiri, izi zimachitika mwa odwala omwe ali ndi zovuta za systemic pathologies zomwe zimafuna chithandizo chamankhwala nthawi zonse. Nthawi zambiri, mavuto am'mbali amadzithetsa okha ndipo safuna kulowererapo, koma ngati vutolo silikukhazikika kwa nthawi yayitali, chithandizo chachipatala chimalimbikitsidwa kwa wovutikayo.

Malangizo apadera "Emoksipina" omwe ali ndi matenda ashuga

"Emoksipin", wogwiritsidwa ntchito mu shuga mellitus pochiza matenda amaso, samavomerezeka kuti agwiritsidwe ntchito ndi madontho ena. Odwala omwe amagwiritsa ntchito magalasi ayenera kuwachotsa kale. Botolo mutatsegula liyenera kusungidwa kuzizira. Wopanga madontho "Emoksipin" akutsimikizira kuti madzi ochiritsira amakhalabe ndi zothandiza pazaka ziwiri. Pambuyo panthawiyi, kugwiritsa ntchito mankhwalawa kumapangidwa mosiyanasiyana.

Migwirizano yogulitsa ndikusunga

Mutha kugula "Emoksipin" mu pharmacy, koma mwa mankhwala. Pambuyo pakupeza, ndikofunikira kuyang'ana momwe mankhwala akusungidwira. Madontho amasungidwa pamalo otetezedwa ndi dzuwa, pamalo otentha osapitirira 24 digiri Celsius. Yankho la jakisoni liyenera kusungidwa pamalo amdima osavomerezeka kwa ana aang'ono. Alumali moyo wa madontho ndi zaka 2, yankho lake ndi zaka zitatu.

Kodi angiopathy ndi matenda a shuga amawoneka bwanji ndipo amathandizidwa bwanji?

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

Vuto la matenda ashuga padziko lonse lapansi limafotokozeredwa kuti ndi achipatala komanso chikhalidwe, ndilofala kwambiri. Mwa matenda onse a endocrine, matenda a shuga ndi 70%, ndipo padziko lonse lapansi pali anthu pafupifupi 120-150 miliyoni omwe akhudzidwa ndi matendawa. Koma sikuti matendawa okha omwe amabweretsera anthu mavuto. Mavuto osiyanasiyana ndi owopsa. Ndipo imodzi mwazowopsa kwambiri kwa anthu ndi matenda ashuga a shuga - kuwonongeka kwa mitsempha.

Ndi matenda a shuga, angiopathy imakhala chifukwa cha kuwonongeka msanga kwa ziwalo zofunika za munthu, chifukwa chake imabweretsa kulumala. Choyamba, zombo zimakhudzidwa, kuyambira ndi capillaries. Choopsa kwambiri kwa matenda ashuga ndi kuwonongeka:

• impso
• miyendo yotsika
• retina.

Phazi la matenda ashuga: Zizindikiro

Vuto lalikulu la matenda ashuga ndi matenda ashuga am'munsi. Chofunikira cha matendawa ndi kutayika kwa bandwidth ndi capillaries, zomwe zimayambitsa kuphwanya kwamkati mwa phazi lakumayenda kwa magazi, zomwe zimapangitsa kuti ziwonekere. Angiopathy of the m'munsi malembedwe amatuluka motere: choyamba zala za atrophy, kenako phazi, mwendo wotsika, ndi ntchafu. Zomangamanga zimadulidwa mwanjira ina, pamene gangrene ayamba kukulira.Nthawi yomweyo, pulsation imapitilizabe kulumikizana ndi chiwalo chomwe chakhudzidwa pamitsempha.

Odwala omwe akudwala matenda a shuga amodalira insulin ayenera kuganizira mofatsa mawonetseredwe oyamba a matendawa.

Munthu wodwala matenda ashuga poyambira matenda atha kufotokozedwa:

• dzanzi komanso kuzirala kwamapazi,
• kulanda
• kuphwanya zamkati
• kupweteka kwapafupipafupi m'miyendo
• kuyanika kwambiri pakhungu la miyendo,
• kumverera koyaka
• kukula kwa misomali.

Pa gawo lotsatira, zilonda zam'mimba, kuchepa kwamphamvu kumawonjezeredwa ndi izi. Komanso, ndikosatheka kuchedwetsa chithandizo, ndikofunikira kugwiritsa ntchito njira zadzidzidzi.

Mankhwala amakono amasiyanitsa magawo anayi panthawi yopanga phazi la matenda ashuga.

1. Hyperemia yokhala ndi edema ya phazi.
2. Phazi la matenda ashuga mu gawo lachiwiri limayendetsedwa ndi kusintha kakang'ono m'mafupa, kusintha koyamba kwa phazi.
3. Pa gawo lachitatu, kusinthika kwa phazi kumatchulidwa, kuthekera kwa ma fractures, kuyimitsidwa kwa magawo am'munsi kumawonjezeka.
4. Pamapeto omaliza owopsa, phazi la matenda ashuga limatenga zilonda zam'mimba, zomwe pambuyo pake zimayambitsa gangore.

Chithandizo cha angiopathy a m'munsi malekezero

Chithandizo cha zamankhwala chimabweretsa mpumulo mpaka pamlingo wina, chifukwa chake, ndikofunikira kufunafuna chithandizo cha dokotala wa opaleshoni ya mtima posachedwapa. Tsoka ilo, ngati pakuchedwa kutha, phazi la matenda ashuga limatsogolera kukulitsa gangore, ndipo kubwezeretsanso magazi kumakhala kosatheka.

Kutengera kuchuluka ndi kuwonongeka kwa mitsempha yoyenda chifukwa cha phazi, phokoso lofunikira limasankhidwa.

• Ngati chifukwa cha matenda ammimba amshuga chikulepheretsa mitsempha yayikulu, ndiye kuti ntchito yayikulu ndikubwezeretsa magazi mu mwendo. Pankhaniyi, kuchiritsa kwamatenda a phazi ndikotheka. Kubwezeretsa kutuluka kwa magazi, opaleshoni yam'mitsempha kapena kulowererapo pang'ono.
• Panthawi yogundika ya mtsempha, mbali yabwino imatheka mwa kulowererapo kwa mtima.
• Ngati angiopathy amachititsa kuti mitsempha ikhale yotalika, ntchito yodutsa kumene imachitika. Amakhala ndikupanga magazi oyenda.

Ndi matenda aliwonse ovuta kwambiri, chinthu chachikulu sikuti kuchita mantha, osataya mtima. Ndikofunikira kusankha chithandizo choyenera ndikupitiliza kutero mwadongosolo komanso mwadongosolo.

Chenjezo la phazi la matenda ashuga

Kuti muchepetse kuthana ndi mavutowa, ndikofunikira kuwona endocrinologist ndikuwunika mayeso apachaka pogwiritsa ntchito kusanthula kwa ultrasound. Ngati mukumva kupweteka mukamayenda m'miyendo kapena kumapazi, maonekedwe a zilonda zam'mapazi phazi, necrosis ya pakhungu kapena zala, ndikofunikira kuti mupange kujambula kwa mapangidwe am'mitsempha yam'munsi yaposachedwa posachedwa.

Kodi angiopathy amatanthauza chiyani?

Zosintha m'mitsempha yamagazi oyambitsidwa ndi kusokonezeka kwa kayendedwe ka manjenje amatchedwa retinal angiopathy. Angiopathy ndizotsatira zamatenda am'thupi a ziwalo zam'mimba, komanso ziwiya za retina, zomwe zimapangitsa kuti mukulumikizidwe bwino kwa zakudya komanso kugwira ntchito kwa chiwalo. Izi zimayambitsa retinal dystrophy, zimatsogolera kukukula kwa myopia, masomphenya osalongosoka.

Angiopathy imadziwika ndi kusintha kwa lumen kapena njira yamitsempha yamagazi: amachepetsa, amachepetsa, amakhala ndi magazi, ndi zina zotero, zomwe zimatengera chifukwa chomwe chidayambitsa kusinthaku. Nthawi zambiri matendawa amakula m'maso onse nthawi imodzi.

Mitundu ya angiopathy pa retina:

1. Retinal hypotonic angiopathy ikuwonetsedwa ndi kukula kwakukulu kwamitsempha, kukoka mitsempha. Zotengera zakunja zimawoneka zofooka.
2. Hypertensive angiopathy imachitika chifukwa cha matenda oopsa. Pa gawo loyambirira la matendawa, atathetsa zomwe zimayambitsa (matenda oopsa), fundus imalandira mawonekedwe abwino.
3. Angiopathy yowopsa ikhoza kukhala chifukwa cha kupsinjika kwadzidzidzi kwa chifuwa, kuvulala kwa ubongo, khosi lachiberekero, lomwe limatsatana ndi kukakamira kwa ziwiya komanso kuchuluka kwazovuta zamitsempha.
4. Matenda a shuga a maso amatha kupezeka ndi matenda ashuga osagwirizana. Pali mitundu iwiri:

• microangiopathy - imakhala yopatulira makoma a capillaries, omwe angayambitse kusokonezeka kwa kayendedwe ka magazi, hemorrhage mu zimakhala zapafupi,
• macroangiopathy - imakhala mu kugonjetsedwa kwa ziwiya zazikulu za retina.

Mu matenda a shuga a shuga, makoma a zotengera amakhala otsekeka ndi ma mucopolysaccharides, ndipo makoma a cell amawonda. Zovuta za capillaries ndizochepa, zomwe mtsogolomo zingayambitse kufalikira kwathunthu. Izi zimapangitsa kuti magazi ayambe kudwala, zomwe zimapangitsa kuti minyewa ikhale ndi njala. Muzovuta kwambiri, zotupa zingapo zimatheka, ndipo chifukwa chake, kuchepa kwakukulu kwa masomphenya.

Njira za Chithandizo cha retinal Angiopathy

Retinal angiopathy iyenera kuzindikiridwa ndi katswiri woyenera. Ndi dokotala yekha amene amatha kudziwa matendawa ndikuwapatsa chithandizo chofunikira. Mankhwala ambiri amakhala mankhwala omwe amachititsa kuti magazi aziyenda bwino m'mitsempha ya retina:

Mankhwala othandizira odwala matenda ashuga angiopathy, kuphatikiza pa mankhwala, adotolo amafotokozera zakudya zapadera zomwe sizimaphatikizira zakudya zokhala ndi zakudya zazakudya zomanga thupi. Odwala omwe amapezeka ndi matenda a shuga angiopathy amalimbikitsidwa kuchita zolimbitsa thupi zomwe zimapangitsa kuti minofu idye shuga komanso kusintha kwa mtima.

Njira zochizira zolimbitsa thupi (acupuncture, magnetotherapy, laser irradiation) zimakhala ndi phindu pa mkhalidwe wa odwala.

Chifukwa chake, mankhwalawa a retinal angiopathy, gawo lofunikira ndi la madokotala apadera komanso akatswiri pazinthu zokhudzana. Katswiri wazachipatala angalimbikitse kugwiritsidwa ntchito kwa mtima pokonzekera Taufon, Emoksipin, mavitamini amaso mwanjira ya mapiritsi (Anthocyan Forte, Lutein Complex) kwa wodwala. Amasintha magawo a magazi mwachindunji m'mitsempha yamaso ndikuthandizira kuti mawonedwe a wodwalayo, akhale ndi physiotherapeutic.

Magalasi a Sidorenko adziwonetsa okha kukhala chida chothandiza kwambiri cha thupi chomwe wodwala amatha kugwiritsa ntchito payekha kunyumba kukonza momwe maso ake alili. Kuphatikiza ma pneumomassage, infrasound, phonophoresis ndi chithandizo cha utoto, amakulolani kuti mukwaniritse zotsatira zazitali m'nthawi yochepa. Kugwiritsa ntchito kwambiri, chitetezo chazida chimatsimikiziridwa ndi mayesero azachipatala.

Madonsi amaso omwe ali ndi matenda ashuga: malamulo ogwiritsira ntchito, mndandanda wa mankhwala

Kwa zaka zambiri osalimbana ndi ma DIABETES?

Mutu wa Bungwe: “Mudzadabwitsidwa kuti kumakhala kovuta motani kuchiritsa matenda a shuga tsiku lililonse.

Chimodzi mwazovuta za matenda a shuga ndi kuwonongeka kwa zida zowonekera, zomwe zimachitika pafupipafupi. Ngati mungadziwe matenda akewo panthawiyi, ndiye kuti mutha kuthana ndi ma eye a m'maso, popanda kugwiritsa ntchito njira zopangira opaleshoni. Muyenera kudziwa kuti ndi matenda ashuga, si onse mankhwala omwe angagwiritsidwe ntchito, chifukwa pali zotsutsana zingapo komanso zovuta.

• Zomwe zimachitika ndi matenda amaso mu shuga
• Popewa kuwonongeka kwa mashuga m'matenda a shuga (kanema)
• Momwe mungayikitsire madontho amaso a mtundu 1 ndi mtundu wa 2 shuga: malangizo othandiza
• Mavitamini amaso omwe ali ndi matenda ashuga
• Kukonzekera kwamaso zochizira matenda a shuga
• Diso limatsika pochiza matenda a shuga
• Ophthalmic othandizira zochizira matenda a shuga

Zomwe zimachitika ndi matenda amaso mu shuga

Kuwonongeka kwa dongosolo lonse la magazi kumakhala kofanana ndi matenda ashuga, chifukwa chomwe mathero amitsempha, maselo ndi minyewa yamkati ya mkati zimavutika.Ndi matenda a shuga, matenda a maso otsatirawa nthawi zambiri amapezeka:

1. Cataract, yomwe imadziwika ndi mitambo ya mandala. Mawonekedwe apamwamba, kungopanga opaleshoni ndikofunikira.
2. Glaucoma ali ngati matenda am'mbuyomu, omwe amapezeka kwambiri mu mtundu uliwonse wa matenda ashuga. Poyerekeza ndi maziko ake, zovuta zowopsa zimayamba.
3. Backin retinopathy imadziwika ndi kuwonongeka kwa capillaries mu retina.
4. Proliferative retinopathy imadziwika ndi kuchuluka kwa ziwiya zatsopano mu retina.
5. Ndi maculopathy, macula amawonongeka.

Matenda a zida zowonera motsutsana ndi matenda a shuga amakhala ndi njira yofulumira. Chifukwa chake, ndikofunikira kuti mulumikizane ndi ophthalmologist kuti mupeze oyenerera pazigawo zoyambirira. Zizindikiro zake zikuluzikulu zimaphatikizapo kuchepa kwamawonedwe owoneka, kuuma kapena, mosiyanasiyana, chinyezi chambiri komanso kupweteka.

Momwe mungayikitsire madontho amaso a mtundu 1 ndi mtundu wa 2 shuga: malangizo othandiza

Lamulo lofunikira kwambiri komanso lofunikira kwambiri pakugwiritsa ntchito mayankho amtundu wa 1 ndi matenda amtundu wa 2 ndikusankhidwa ndikuchotsedwa kwa katswiri woyenera malinga ndi zolemba.

Zomwe zimagwiritsidwa ntchito pakugwiritsa ntchito madontho amaso kwa odwala matenda ashuga:

1. Kutsatira mosamala mankhwalawa adotolo adokotala.
2. Kutalika kwa mankhwalawa kumasiyanasiyana kuyambira masabata awiri mpaka atatu, kutengera zam'magazi ndi matenda ake.
3. Ndi glaucoma, madontho amaso nthawi zonse amapatsidwa chithandizo chambiri.
4. Maso akutsikira angathe kuyatsidwa ndi cholinga chowateteza.
5. Ndondomeko ndikofunikira kuchita kokha ndi manja osambitsidwa bwino.
6. Simungagwiritse ntchito dontho limodzi nthawi kwa anthu awiri. Ziyenera kukhala zongogwiritsa ntchito payekha.
7. Samalani kwambiri alumali moyo, tsiku lopanga, contraindication ndi zolakwika zimachitika malangizo.
8. Ngati mukumwa mankhwalawa kamodzi kapena apo, onetsetsani kuti mukupitilira mphindi 15 pakati pa mankhwala.
9. Pambuyo pakukhazikitsa kwa maso, muzimutsuka bwino ndikuthira mankhwala opaka.
10. Ngati mukukhazikika mukumva kukoma kwa yankho - musadabwe, izi ndizoyenera, chifukwa madontho amalowa mosavuta kudzera m'mitsetse wamkamwa kulowa mkamwa ndi m'mimba.

Momwe mungayerere molondola:

• tsegulani chipewa, ngati kuli kotheka, tengani piritsi loyera,
• khalani pabwino - mukhale pansi kapena kugona,
• tsitsani mutu wanu ndikuyesa kukoka pang'ono m'maso, kuyang'anitsitsa kumayang'aniridwa kumwamba,
• donthoza kuchuluka kwa madontho pansi pachikope pafupi ndi ngodya yamkati mwa diso,
• osaloleza pipette kuti akhudze mucous nembanemba.
• bweza khungu lako momwe unalili momwe unalili;
• kukonza magawidwe a yankho, pukutirani pang'onopang'ono conjunctival sac,
• chotsani njira yotsalira ndi swab wosabala wa thonje,
• khalani maso anu otsekeka kwa mphindi zochepa.

Mavitamini amaso omwe ali ndi matenda ashuga

Choyamba, ndi matenda ashuga, kuikidwa kwa ma proxes a vitamini pazida zowonekera ndikofunikira. Ayenera kukhala ndi mavitamini B1, B6, B2, E, A, C, antioxidants, mchere ndi zinthu zina zofunikira. Zina mwazinthu zabwino kwambiri zomwe zakonzekera ndi mavitamini ndi izi:

"Doppelherz Yogwira Ntchito" (makamaka kwa odwala matenda ashuga) amadziwika ndi kubwezeretsanso kwa zinthu zosakwanira komanso kuthamanga kwa kagayidwe kazinthu mu zida zowoneka. Ndikofunikira kwambiri kuzigwiritsa ntchito kwanthawi yayitali, popeza momwe anthu odwala matenda ashuga akukhalira bwino.

Ophthalmo-DiabetoVit ndi mndandanda wapamwamba kwambiri wa mankhwala apitawa.

Matendawa a Alphabet Diabetes amapangidwa kuchokera ku mankhwala ena azitsamba a mankhwala. Zimalepheretsa kukula kwa zovuta ndi matenda amaso ambiri.

"Alphabet Opticum" imapangidwanso pazinthu zachilengedwe zachilengedwe.

Kukonzekera kwamaso zochizira matenda a shuga

Ndi ma catarices, ma mandala amaso ndi omwe amafunafuna kuthambo, lomwe limayang'anira chithunzi cha kuwala. Mphaka umayamba msanga, koma m'magawo oyambawo amatha kuchiritsidwa pogwiritsa ntchito madontho apadera amaso.Njira zotchuka kwambiri komanso nthawi zambiri zomwe zimafotokozedwa m'maso amtundu wa matenda amishuga amitundu iliyonse:

1. "Taufon" kapena "Taurine" imasintha komanso kubwezeretsa. Ziwalo zam'mimba zimabwezeretsedwa, zochitika za dystrophic zimachotsedwa, kagayidwe kake kamathandizidwa ndikupangitsa kuti mitsempha ichitike mosavuta. Palibe zotsatira zoyipa zilizonse, koma zotsatira zoyipa zimatha kuchitika. Contraindication - zaka mpaka 18, ziwengo zigawo zikuluzikulu. Amaloledwa kukoka 2-4 pa tsiku 2 akutsikira kwambiri. Kutalika kwa chithandizo ndi masiku 90. Kupuma ndi mwezi.
2. "Catalin" imasintha kagayidwe kachakudya kamene limayendetsa disolo la diso, imalepheretsa kukula kwa matenda amtundu ndi kusintha kwa shuga kukhala sorbitol, komwe mandala awonongedwa. Mukagwiritsidwa ntchito, kumva kutentha kwakanthaŵi ndikumayamwa, misozi yowonjezereka, redness ndi ziwengo zimatha. Mutha kudontha mpaka kasanu patsiku, madontho awiri. Njira ya chithandizo imayikidwa pa munthu aliyense.
3. Quinax ili ndi chinthu chachikulu chogwira - azapentacene, chifukwa cha momwe ma metabolic adapangidwira, kupanikizika kwa intraocular kumapangidwira ndipo kukana kwa lens kumapangitsa kuti oxidation iwonjezeke. Mochenjera amachotsa kuthambalala kwa mandala, osakumana ndi zovuta. Lemberani kuyambira 3 mpaka 5 pa tsiku, 2 akutsikira. Kutalika kumatsimikiziridwa ndi katswiri.

Ndi matenda a shuga ndi amphaka, ndizoletsedwa kuchita opaleshoni, chifukwa chake kugwiritsa ntchito mankhwalawa kumatanthauza njira yokhayo yothandizira.

Diso limatsika pochiza matenda a shuga

Ndi glaucoma, kupanikizika kwa mitsempha kumakwera kwambiri, kumapangitsa khungu lathunthu kapena pang'ono. Madontho omwe amagwiritsidwa ntchito kwambiri ndi awa:

1. "Yopidin", "Alfagan R", "Luxfen", "Brimonidin", "Combigan". Madontho awa amachepetsa kupanga kwa intraocular fluid, kusintha kutuluka, zomwe zimapangitsa kuchepa kwa mapanikizidwe a intraocular. Mankhwala osokoneza bongo ndi alpha adrenergic receptor agonists.
2. "Timolol", "Trusopt", "Betoptic", "Levobunolol", "Xonef", "Betaxolol". "Metipranolol" ili ndi beta blockers.
3. Dorzolamide, Brinzolamide amachokera ku carbonic anhydrase inhibitors.
4. "Pilatu", "Physostigmine." Mankhwala osokoneza bongo ndi anga.
5. "Lumigan", "Travoprost", "Latanoprost" - prostaglandins.

Ophthalmic othandizira zochizira matenda a shuga

Ndi retinopathy, kayendedwe ka maso kamakhudzidwa, chifukwa cha kameneka kamene kamayambitsa matenda a retina. Madontho otsatirawa amagwiritsidwa ntchito:

1. Gulu la mankhwala omwe amapangidwira kuchiza matenda amkati (omwe alembedwa pamwambapa).
2. "Emoksipin" imathandizira kuthamanga kwa magazi ndi kagayidwe kazinthu, imapangitsa kuti magazi azituluka. Zotsatira zoyipa zimaphatikizapo kuyaka ndi kuyabwa. Lemberani kawiri patsiku, madontho awiri patsiku.
3. "Holo-Chest" imalepheretsa kuyuma. Amagwiritsidwa ntchito katatu patsiku.
4. Riboflavin amadziwika kwambiri ndi matenda amtundu wa 2. Muli mavitamini B, amatulutsa kapangidwe ka hemoglobin. Imathandizira kagayidwe. Zimawongolera magwiridwe antchito a zida zowoneka. Kugwetsa sikuloledwa kupitirira 1 dontho 2 pa tsiku. Zotsatira zoyipa - kuchepa kwakanthawi kwakanthawi kwamawonekedwe owoneka ndi chifuwa.
5. Lacemox moisturize ndipo amafewetsa, ali ndi chitetezo pamphamvu ya conjunctiva ndi ziphuphu. Imalimbikitsa kukonzanso kwa zotupa m'mawonekedwe owoneka, kumachepetsa kuchuluka kwa kutupira, kubwezeretsa membrane wa retinal. Contraindication - pakati, ziwengo zigawo zikuluzikulu. Mukatha kugwiritsa ntchito, imayambitsa kuyabwa kwakanthawi ndikuwotcha. Mutha kuyikapo katatu patsiku 2 madontho.

Ndikofunika kwambiri kulabadira zizindikiro zomwe zikuwonetsa kukula kwa matenda amaso munthawi yake. Kumbukirani, kupita ku chipatala koyambirira ndikutsatira malangizo onse omwe dokotala amakupatsani kuti musapewe zoyipa - kuyambira pakuchepetsa kuona.

Mitu ya mankhwalawa

Pankhani ya kulekerera kwamunthu m'magulu a "Emoksipin" kapena pazifukwa zina zomwe zimapangitsa kuti pakhale zovuta kugwiritsa ntchito madontho, madokotala amapereka mankhwala ofanana ndi chinthu chogwira ntchito. Othandizira awa azitsamba akhoza kusintha "Emoksipin":

Bwererani ku tebulo la zamkati

Zoyambitsa ndi Zoopsa

Matenda a shuga a retinopathy amakula mwa odwala ambiri omwe ali ndi matenda ashuga. Matendawa ndi omwe amachititsa kuti ziwonetsero zam'mimba zisawonongeke. Ngati matenda ashuga amapezeka pafupifupi zaka 2, matenda am'madzi amapezeka 15% ya odwala, zaka 15 - 50%, zaka 25 kapena kuposerapo - matendawa amafika 100%.

Kuchuluka kwa matenda ashuga retinopathy kumatengera kulondola kwa mankhwalawa, komanso zovuta zina. Matenda a ziwalo zam'mimba amayamba msanga ngati wodwalayo ali ndi mavuto omwewo:

• dyslipidemia,
• kunenepa
• kagayidwe kachakudya matenda
• aakulu aimpso kulephera
• matenda oopsa.

Zomwe zimapangitsa kuti pakhale matenda ashuga retinopathy amatha kukhala oyembekezera, zizolowezi zoipa (kusuta), kutha msinkhu, kudziwitsidwa zam'tsogolo.

Magawo a shuga a retinopathy

Kutengera ndi kusintha kwa pathological, magawo atatu a matendawo ndi omwe amadziwika:

Ine - retinopathy wosapindulitsa. Zimayendera limodzi ndi kutupa kwa retina m'chigawo cha macula, ma micaneurysms, cholinga cha kutulutsa, kutulutsa magazi m'mitsempha, m'matumba a fundus amawonekera mu retina.

II - preproliferative diabetesic retinopathy. Angapo zotupa m'mimba, thonje ndi zolimba exudates ndi khalidwe. Zomwe zidasinthika bwino pakupangidwe kwamitsempha yamaaso.

III - kuchuluka kwa retinopathy. Neovascularization of the optic nerve disc imachitika. Mgawo la preretinal hemorrhage, mafupa am'mimba am'mimba. Nthawi zambiri khalani retina detachment, yachiwiri glaucoma.

Kuopsa kwa matenda ashuga retinopathy ndikuti kwa nthawi yayitali sikuphatikizidwa ndi mawonetseredwe a pathological. Munthawi yamasinthidwe osawonjezereka chifukwa cha kutupa kwa macula wodwala, kuphatikiza pang'ono chabe zinthu, kuvuta kuchita ntchito kutali ndi maso, mwachitsanzo, powerenga, kumatha kusokoneza.

Mokulira, kukhathamiritsa kwamatumbo kumawonekera, kumayambitsa mawonekedwe, ngati chophimba, malo akuda oyenda, omwe pang'onopang'ono amatha. Ngati pali zotupa zazikulu, pali kuchepa kwakumaso kwa maonedwe okwera mpaka kumaliza khungu.

Zizindikiro

Popeza matenda ashuga a retinopathy samawonekera koyamba m'magawo oyambawo, koma amafunika kukhala ndi matenda osokoneza bongo, odwala omwe ali ndi vutoli ayenera kupimidwa pafupipafupi ndi a ophthalmologist. Chifukwa cha matenda oyamba, maphunziro oterewa ndi omwe amalembedwa:

• Ma Visometry
• biomicroscopy
• ophthalmoscopy pansi pa mydriasis,
• zoyipa
• Mgwirizano wamgwirizano
• zachuma.

Kupimidwa kowonjezereka kumatengera chithunzi cholandiridwa. Kujambula kwa diso komwe kumayikidwa ndi maso kumayikidwa mukamayang'ana mukutulutsa thupi ndi mandala. Kuti mudziwe magwiridwe amomwe mitsempha ya kuwala ndi retina imayendera:

• kutsimikiza kwa CFSM,
• elekitolina,
• electrooculography.

Gonioscopy imagwiritsidwa ntchito pa glaucoma yomwe amaganiziridwa. Kuwona m'maganizo ziwiya za thandizo la retina:

• adamayambiri angiography,
• laser kusanthula tomography.

Anthu omwe ali pachiwopsezo chokhala ndi matenda ashuga retinopathy ayenera kuwunikira nthawi ndi nthawi kuti adziwe mawonekedwe a lipid. Komanso, kuwunikira tsiku ndi tsiku, ECG, echocardiography, ultrasound ya zotengera impso zimatha kulembedwa.

Matenda a shuga a retinopathy

Odwala amapatsidwa chithandizo chovuta kwambiri, chomwe chimatengera gawo la matendawa komanso kupezeka kwa ma concomitant pathologies. Onetsetsani kuti mwatsata chithandizo chachikulu cha matenda - shuga mellitus, mlingo wa insulin umasankhidwa. Chithandizo cha Zizindikiro zimalembedwanso:

• antiplatelet agents
• angioprotectors
• antihypertensive mankhwala.

Ngati matenda ashuga retinopathy limodzi ndi macular edema, intravitreal makonzedwe a mankhwala a steroid amachitika. Pakadali pano, kulowererapo kwa laser yambiri kumachitika. Njira iyi imakuthandizani kuyimitsa kukhudzidwa kwa mitsempha, kupewa kuyamwa, komanso kuthana ndi mitsempha yamagazi.

Kupanga kwa laser kumachitika m'mitundu ingapo:

• chotchinga - chimagwiritsidwa ntchito popanga matenda omwe siwachulukirachulukira matenda ndi macular edema
• mogwirizana - akuwonetsedwa ntchito ngati mukupezeka aneurysm, hemorrhage, exudates.

Ngati matenda ashuga retinopathy limodzi ndi zovuta mu mawonekedwe a retinal zotupa, hemophthalmus ndi zina, vitlimomy akuwonetsa - kuchotsa kwa vitreous thupi, hemorrhage, kugawanika kwa zingwe za zolumikizana minofu.

LLC Firm "FERMENT"

1 ml yankho lili

Mphamvu yogwira: Methylethylpyridinol hydrochloride (emoxypine) - 10 mg,

Omwe amathandizira: anhydrous sodium sulfite - 3.0 mg, sodium benzoate - 2.0 mg, potaziyamu dihydrogen phosphate - 6.2 mg, sodium hydrogen phosphate dodecahydrate - 7.5 mg, methyl cellulose 5.0 mg, madzi a jakisoni - mpaka 1 ml .

Zisonyezero zogwiritsidwa ntchito:

• Chithandizo ndi kupewa kutupa ndi kutentha kwa ziphuphu,
• Chithandizo cha zotupa m'mimba mu chipinda chamaso cha diso,
• mankhwalawa komanso kupewa kutaya magazi mu sclera okalamba
• thrombosis yam'kati mwa mtsempha wa retina ndi nthambi zake,
• Chithandizo cha myopia,
• Kutchinga kwa cornea mutavala magalasi amalonda,
• matenda ashuga retinopathy.

Zotsogola ndi kupewa

Kukula kwa matenda ashuga retinopathy kumatengera magawo omwe matendawa adapezeka, komanso kufunika kwa mankhwalawa. Zotsatira zabwino zimawonetsedwa ndi prophylactic laser coagulation mu gawo la prroliferative. Kuchiza kwambiri matenda ashuga komanso kuwunika pafupipafupi magawo a shuga kumathandizanso kuchedwetsa khungu.

Kupewa matenda ashuga retinopathy kumakhala kukuwunika pafupipafupi matenda a shuga makamaka chifukwa cha chibadwidwe chamtsogolo, chithandizo chokwanira cha matenda oyanjana. Prjosis yovuta kwambiri yophatikiza matenda ndi matenda oopsa ndi atherosulinosis.

Katemera wa Emoxipin

Federal State Unitary Enterprise "Chomera cha Moscow Endocrine"

1 ml yankho lili

Mphamvu yogwira: Methylethylpyridinol hydrochloride (Emoxipine) - 10 mg,

Omwe amathandizira: hydrochloric acid 0, 1 M, madzi a jakisoni

Zisonyezero zogwiritsidwa ntchito:

• Subconjunctival ndi intraocular hemorrhage yamavuto osiyanasiyana,
• Angioretinopathy (kuphatikizapo matenda ashuga retinopathy),
• Kati ndi kotentha korioretinal dystrophy, kuphatikizapo zovuta myopia,
• Thrombosis yam'kati mwa mtsempha wa retina ndi nthambi zake,
• Opaleshoni yamaso, mawonekedwe atachitidwa opaleshoni ya glaucoma yokhala ndi choroid
• Matenda a Dystrophic a cornea,
• Kuvulala, kutupa ndi kutentha kwa ziphuphu,
• Kuteteza khungu

Zamkati mwa wolemba dissertation wa sayansi ya zamankhwala Volkova, Natalya Anatolevna

Matenda a shuga ndi njira yofunikira kwambiri mzere woyamba pakati pamavuto omwe asayansi akukumana nawo ndi azaumoyo pafupifupi m'maiko onse. M'zaka zaposachedwa, pakhala chiwonjezeko chosawerengeka cha kuchuluka kwa odwala matenda ashuga, kuwonjezeka chaka chilichonse ndi 6-10%, motero, chiwerengero chonse cha odwala ku Russia chikufikira 2-4% yaanthu onse (Balabolkin MI, 2000, Dedov I.I. ., 2002). Pamodzi ndi matenda amtima komanso matenda a oncological, matenda a shuga amakhalanso amtundu wa matenda omwe amapangitsa kuti munthu azikhala wolumala komanso kufa kwa odwala (Shestakova MV, 2000, Saltykov BB, 2001).

Ngakhale zovuta za pathogenesis ya zovuta zakumapeto kwa matenda osokoneza bongo, malo ofikira poyambira ndi kupitilira kwawo ndi matenda oopsa a hyperglycemia, chifukwa chake, cholinga chachikulu cha chithandizo cha matenda ashuga ndikukwaniritsa chipukutira cha nthawi yayitali komanso chokhazikika cha metabolism ya carbohydrate. Komabe, chithandizo chovuta cha matendawa sichokwanira popanda kugwiritsa ntchito mankhwalawa omwe amakhudza ziwonetsero zina za pathogenetic pakukula ndi kupititsa patsogolo kwa zovuta za matenda ashuga, zomwe ndizofunikira kwambiri zomwe ndizo dyslipidemia. Kuyesera kukopa chimodzi mwazambiri zomwe zimaphatikizidwa ndi matenda a shuga mellitus, adotolo, mwatsoka, amakokedwa mosavomerezeka, polumikizana ndi kuchuluka kwa zotsatira zoyipa, komanso kuchuluka kwaimfa (Nerup J., 1994, Marse J. B. et al. , 2001).

Chifukwa chake, zokonda zimaperekedwa kwa mankhwala osokoneza bongo omwe ali ndi zotsatira zophatikizika, kusankha komwe sikunali kwakukulu: izi ndizotengera za sulfonylurea (Aschcroft F. M. et al., 2001), biguanides (Jansen M. et al., 1991) ndi thiazolidinedione zotengera (Sato Y. et al al. ., 1999).

Zotsatira zoyipa zingapo komanso zotsutsana kwathunthu zimachepetsa kugwiritsidwa ntchito kwa mankhwalawa machitidwe azachipatala. Kugwiritsa ntchito mankhwala ochokera ku sulfonylurea kumacheperako pokhazikitsidwa ndi kukana kwachiwiri kwa iwo mu 5-10% ya odwala omwe ali ndi mtundu wa 2 shuga mellitus (Aleksandrov A.A., 2001). Kuletsedwa kwa kugwiritsidwa ntchito kwa Biguanides kumatsimikiziridwa ndi kuthekera kotukula kwa lactic acidosis (Witztum J.L., 1992), ndi thiazolidinedione zotumphukira zomwe zimawululidwa ndi hepatotoxicity (Forman L.M., et al., 2000).

Zonsezi zimatsimikiza kufunika kopanga mankhwala atsopano othandizira, otetezeka, popeza kungokulitsa kuchuluka kwa mankhwala opatsirana pakamwa kumakulitsa chindapusa cha shuga poganizira momwe wodwala aliyense alili, kusintha moyo wa odwala, kuchepetsa kulumala, kusunga magwiridwe antchito a odwala matenda ashuga, omwe ali ndi kukula kwakukulu kufunikira kwachuma ndi chuma pamadera.

Mtsogolo muli mankhwala omwe angakhudze kwambiri ziwonetsero zazikulu za matenda ndikuwapatsanso mwayi wopewa komanso kukonza mavuto a mtima. Popeza gawo lofunikira la kukhazikitsidwa kwa njira zophatikizira zamankhwala okhathamira omwe amapezeka mu pathogenesis ya matenda osokoneza bongo a shuga ndi zovuta zake zam'mimba (Balabolkin M.I. et al., 1999, Korchin V.I., 2000, Bondar I.A. et al., 2001, Fadeeva N.I. . et al., 2001), mankhwala a antioxidant amtundu wamachitidwe akhoza kukhala kalasi lamankhwala labwino pamaphunziro amenewo. Mu diabetesology, zokumana nazo zapezedwa ndikugwiritsa ntchito mankhwalawa ambiri omwe ali ndi ntchito ya antioxidant, kuphatikizapo nicotinamide (Gorelysheva V.A. et al., 1996, Bondar I.A. et al., 2001, Kolb N. et al., 1999, Pozzilli et al., 1999), a-tocopherol (Ceriello A. et al., 1991,

Pozzilli P. et al., 1997, Frei B., 1999, Bursell S.E. et al., 1999, Emmert D. M. et al., 1999), lipoic acid (Balabolkin M.I. et al., 2000). M'zaka zaposachedwa, akatswiri ofufuza ndi akatswiri azachipatala adakulitsa chidwi ndi gulu la madzi omwe amasungunuka ndi madzi, omwe amaphatikizapo zomwe zimachokera ku 3-hydroxypyridine, zomwe zimatha kukhudza pathogenesis zingapo za matenda osokoneza bongo nthawi imodzi. Malinga ndi mabuku (Grechko A.T., et al., 1998, Smirnov L.D., 1998, Nelaeva A.A., 1999, Lukyanova L.D., 1999, 2000, 2002 ,, T. Devyatkina et al., 2000, V. Yasnetsov et al., 1999) ndi zotsatira za maphunziro am'mbuyomu (V. Inchina et al., 1996, 2000, A. V. Zorkina, 1997, 1999, L.N. Sernov ., 1996, 1998, Spasov A.A. et al., 1997, 1999, Nazipova D.A. et al., 1998, Vintin N.A., 1999, Mikhin V.P. et al., 1998, 2002 , Mironov N.V. et al., 2002, Katikova O.V. et al., 2002 ndi ena), ophatikizidwa ndi mndandanda wamankhwala awa amawonetsa hypoglycemic, hypolipidemic, antioxidant, antihypoxic, anticoagulant Nowa, antithrombogenic, antiplatelet, immunomodulatory, Kakhungu oteteza kwenikweni. Chifukwa chake, kusaka mankhwala ochepetsa mphamvu ya kachilomboka pamodzi ndi zotsatira zophatikizika za 3-hydroxypyridine ndizomveka komanso koyenera.

Cholinga chachikulu cha kafukufukuyu chinali kuphunzira za mexidol ndi emoxipin magawo ena a metabolic pansi pa kuphatikiza koyesa kwa hyperglycemia ndi hypercholesterolemia ya kunja kwa nyama zoyesera, komanso m'magazi a odwala omwe ali ndi matenda a shuga 2.

Malinga ndi zolinga momwe ntchito iyi ikuyendera, ntchito zotsatirazi zidathetsedwa:

1. Kuti muwerenge zotsatira za mexidol, emoxipin, dimephosphone ndi a-tocopherol pa glycemia, zina zotupa za lipid ndi mapuloteni a metabolism poyesa matenda a shuga mellitus osakanikirana ndi exo native hypercholesterolemia.

2. Kuphunzira momwe mankhwalawa amaphatikizira njira ya lipid peroxidation ndi dongosolo la antioxidant mu magazi a m'magazi komanso minyewa ya nyama yoyeserera mikhalidwe ya masanjidwe oyenda.

3. Kuphunzira kusintha kwamachitidwe a bioelectric a myocardium kumbuyo kwa kugwiritsa ntchito mankhwala ophunzirira antioxidants pazotsatira zophatikizidwa za kuyesa kwa shuga ndi matenda oopsa.

4. Kuphunzira za mexidol, emoxipin ndi dimephosphon pamlingo wa glycemia, kuchuluka kwa glycation hemoglobin, dziko la lipid peroxidation mu plasma yamagazi ndi maselo ofiira am'magazi a odwala omwe ali ndi mtundu wa 2 shuga.

Sayansi yantchito

Zotsatira za mexidol, emoxipin, dimephosphone ndi a-tocopherol pa boma la chakudya, lipid, mapuloteni, lipid peroxidation ndi ntchito ya antioxidant mu plasma yamagazi ndi minofu ya nyama yoyesera idaphunziridwa chifukwa cha zotsatira zoyeserera za matenda a shuga a mellitus ndi exo native hypercholesterolem. Hypoglycemic ndi antioxidant zotsatira, zomwe zimawonetsedwa poyerekeza ndi dimephosphone ndi a-tocopherol.

Kwa nthawi yoyamba, zidawonetsedwa kuti mexidol, emoxipine ndi dimephosphon, akaphatikizidwa ndi matenda osokoneza bongo ndi hypercholesterolemia, kukonza kusakhazikika kwamagetsi, ndikuthandizira kubwezeretsa ntchito ya bioelectric ya myocardium.

Adawonetsedwa koyamba kuti kuphatikiza magazi a odwala omwe ali ndi matenda ashuga mexidol ndi emoxipin kumachepetsa kuchuluka kwa glycemia ndikuletsa hemoglobin glycation mu vitro. Kukhazikika kwa magazi ndi mankhwala ophunzirira antioxidants amaletsa lipid peroxidation (ozungulira ndi zitsulo), kumakulitsa mkhalidwe wa antioxidant mu plasma yamagazi ndi erythrocyte ya odwala matenda a shuga. Kutheka kwakukulu kunawululidwa pamene Mexicoidol idalowetsedwa muzosakaniza zosakaniza.

Ubwino wothandiza pantchitoyo

Zotsatira za kafukufukuyu zimawonjezera kumvetsetsa kwa pharmacology ya mexidol, emoxipin, dimephosphone ndi - tocopherol. Zothandiza pamtengo ndizomwe zimatha kugwiritsa ntchito ma antioxidants omwe aphunziridwa kuti athe kukonza zovuta zamatumbo, lipid, metabolism ya protein, kusakhazikika kwamagetsi pazotsatira zophatikizidwa za kuyesa kwa shuga ndi matenda oopsa.

Zomwe zapezedwa zitha kugwiritsidwa ntchito popitiliza kuphunzira zotsatira za mankhwala omwe amapezeka ndimankhwala limodzi ndi izi.

Zotsatira zakufufuza mozama zimadziwitsidwa mu ntchito yofufuza ya Department of Pharmacology ya Mordovia State University.

Mfundo Zofunikira Kuteteza

1. Zotsitsa za 3-hydroxypyridine ndizothandiza kwambiri poyerekeza ndi dimephosphone ndi vuto lotsogolera tocopherol la carbohydrate, mapuloteni ndi lipid metabolism pazotsatira zophatikizidwa za kuyesa kwa shuga ndi exo native hypercholesterolemia.

2. Onse omwe amaphunzira antioxidants amaletsa kukula kwa kusakhazikika kwa magetsi, ndikuchepetsa kupezeka kwa gawo la QT.

4. Mexidol mu Mlingo wophunziridwa ndi emoxipin ali ndi kutchulidwa kwakanthawi kotsutsa, kuletsa kutseguka kwa njira ya lipid peroxidation komanso kukhumudwa kwa dongosolo la antioxidant mu plasma yamagazi ndi minyewa ya nyama yoyesera ndi kuphatikiza kwa shuga ndi zina zotulutsira kunja.

5.Mexidol pa mlingo wa 0,025 mg / ml, ali ndi hypoglycemic yokwanira, antioxidant zotsatira, amathandiza njira ya hemoglobin glycation, lipoperoxidation process (spontaneous and Fe-indened) m'magazi am'magazi komanso erythrocyte ya odwala panthawi yolumikizana ndi magazi a odwala omwe ali ndi matenda a shuga.

Zotsatira zakufufuza ndi zomwe zimafotokozedwa mu dissertationzi zidachitika pamsonkhano wa asayansi achichepere a Mordovia State University. N.P. Ogareva (Saransk, 2002), X Russian National Congress "Man and Medicine" (Moscow, 2003), 2nd Congress of Pharmacologists of the Russian Federation (Moscow, 2003), XXXI Ogarev Readings (msonkhano wa sayansi ku N.P. Mordovian State University Ogareva, Saransk, 2003).

Mabuku Pamutu wa dissertation lofalitsidwa limagwira.

Kukula ndi kapangidwe ka ntchito

Nkhaniyi ili ndi mawu oyambira, kuwunika kwa mabuku, mitu itatu, zomwe zidafotokoza zomwe tafufuza, kukambirana pazotsatira, mawu omaliza ndi mndandanda wazomwe zalembedwazi. Ntchitoyi yakhazikitsidwa pamasamba olembedwa, ojambulidwa ndi zojambula ndi matebulo. Mndandanda wamabukuwo uli ndi mayina a ntchito, kuphatikizapo olemba am'nyumba ndi akunja.

Mutu 1. Kupenda zolemba

1.1. Malingaliro amakono pazokhudzana ndi matenda a shuga.

Udindo wa lipid peroxidation mu pathogenesis ya shuga.

Pharmacotherapy a shuga mellitus ndi ntchito yovuta kuchipatala, kuthetsa komwe kuli kofunikira kuganizira zomwe zimachitika pakuchitika kwa matenda. Pakadali pano, mtundu wa matenda am'mimba otchedwa shuga umatengedwa ngati matenda amtundu, pakachitika ndi chitukuko chomwe zotsatira za autoimmune ndizofunikira kwambiri (Balabolkin MI, 2000, Baker J. R., 1997). Pankhaniyi, kuwonongeka kwa ma p - maselo a kapamba amatha kuchitika onse awiri chifukwa chodziwonetsa mwachindunji, komanso chifukwa cha zovuta zam'magazi m'matumbo (Bobyreva L.E., 1998). Makina a autoimmune omwe amapezeka a matenda amtundu wa shuga ali ndi chibadwa chogwirizana ndi majini amtundu wa HLA (Conrad D., et al., 1997). Ma Cytokines amatenga nawo gawo pakukonzekera kuwonongeka kwa chitetezo cha mthupi (Chung Y. N., 1999), zomwe zimasokoneza kuyanjana kwa ma cell komanso zimapangitsa kuti ma molekyulu azinthu zazikuluzikulu za histocompatability pa (maselo atatu). Njira yogwira autoimmune imayendera limodzi ndi kuwonjezeka kwa kusintha kwazinthu zaulere pakapangidwe kazinthu zopangira poizoni. kuwonongeka ndi apoptosis ya ma cell a pancreatic P (Gorelysheva VA, 1999, Azazo OA, 2001, Ametov AS, 2001, Kaneto Hideaki et al., 1995, Dandona P., 1996). nthawi, chibadwa maziko a shuga - mtundu sayambitsa Mwa kukayikira kwawo.Kutengera lero, masankho awiri akuwunika: woyamba - majini awiri odziimira pawokha akhudzidwa ndi matenda a matenda a shuga a mtundu wa 2. Mmodzi amachititsa kuti insulin itulutsidwe, chachiwiri - chimayambitsa chitukuko cha kukana insulini. kapena zotumphukira (Dedov II, et al., 2002).

Chofunikira cha pathogenetic pakupanga mtundu wa 1 shuga ndikuchepa kwa kaphatikizidwe ka insulin, kamene kamakhudza kagayidwe kazakudwala kamene kamayambira mbali ziwiri. Choyamba, kaphatikizidwe wa diacylglycerol amawonjezeka, omwe amasokoneza magwiridwe antchito a Na / K-ATPase, komanso amachititsa kusowa kwa michere ya intracellular, yomwe imachepetsa msana wa fructose-2, -phosphate, imachepetsa glycolysis ndikuwonjezera gluconeogenesis (Ishii N., 1998, Kim SJ et al. ., 1998). Kachiwiri, njira yosinthana ndi polyol imayendetsedwa ndikupanga sorbitol, yomwe imachepetsa ntchito za Na / K - ATPase. Kutembenuka kwaposachedwa kwa sorbitol kukhala fructose, komwe ndi gawo la njira za glycosylation, kumathandizira kusintha kwa parametolic (non-enzymatic), komwe kumayambira pakapangidwe ka glycosylation pamlingo wa michere, glycosaminoglycans wa nembanemba ndi mapuloteni a plasma.

Njira za lipid peroxidation zimalumikizidwa ndi kusintha kwa parametolic, chifukwa pali kulumikizana mwachindunji pakati pa mulingo wa zinthu za autooxidation ndi kuopsa kwa zovuta zamankhwala (Bobyreva L.E., 1996, Verbova N.I. et al., 1997, Chernov Yu.N. et al. , 1999, Hori O. et al., 1998, Brownlee M., 1999, Brownlee M. 2000).

Free radid lipid oxidation ndi gawo limodzi lazinthu zambiri zofunika, monga kusunthidwa kwa elekitoni ndi zinthu za flavin, kukonzanso kwa lipid kuphatikizidwa kwa biomembranes, oxidative phosphorylation mu mitochondria, mitogeneis, nerve implement, kuvomerezedwa, etc. (Lankin V.Z. et al., 2000, Halliwell V., 2000). Zogulitsa za lipid peroxidation (lipid peroxidation) ndizomwe zimatsogolera ma prostaglandins ndi zotumphukira zawo - ma thromboxanes ndi prostacyclin (Kagan V.E., et al., 1992). Machitidwe a peroxidation omwe amapezeka pafupipafupi ndimatumbo amtunduwu amathandizira kuti apange mapangidwe awo a lipid ndikukonzanso ntchito yolingana ndi michere yonse yolumikizana ndi lipid, yomwe imaphatikizapo pafupifupi machitidwe onse a enzyme a thupi (Voskresensky ON, 1986, Dubinina E.E., 1995, Burlakova E.N. ., 1998, Lankin V.Z., et al., 2000, Morugova T.V., 2000, Velichkovsky B.T., 2001).

Malinga ndi olemba angapo, kupangika kwa mpweya waulere kwapakatikati komwe kumayendetsedwa ndi ma cytokines kumathandizira kwambiri mu pathogenesis ya matenda a shuga mellitus. Ma Cytokines monga interleukin-1, chotupa necrosis factor ndi γ-interferon amatha kusokoneza katemera wa insulini ndipo amatha kukhala ndi cytotoxic pa p-cell ya kapamba mu vitro (Smirnova OM, Gorelysheva V.A. 1999).

Kuchulukitsitsa kwa ma free radicals a oxygen kumasungidwa ndi ma macrophages okhazikitsidwa ndi ma cell a P owonongeka (Kroncke K.D., et al., 1991, Burkard V., et al., 1992, Madndrup - Poulsen T., et al., 1993). Maselo a Islet ali ndi chitetezo chofooka cha antioxidant ndipo amakhala pachiwopsezo chachikulu cha ma radicals aulere, ndicho chifukwa chachikulu chomwe amathandizira kuti ayambe kudwala matenda a shuga mellitus (Kogan A.Kh., 1999, Asayama K., et al., 1996). Kupititsa patsogolo kwa njira za lipid peroxidation kwatsimikiziridwa poyesera pamitundu yakale ya matenda a shuga a mellitus omwe ali ndi alloxan ndi streptozotocin.

Zotsatira za matenda ashuga zimatsimikiziridwa ndi tropism ya alloxan kupita ku maselo a P - ndipo amachepetsa kuwonongeka kwawo (Karagezyan K.G., Hovsepyan L.M., Adonts K.G., 1990, Fridovich I, 1992). Tropism ya alloxan imalumikizidwa ndi kuyanjana kwake mwachindunji, mwachilengedwe cha P - maselo okha, makonzedwe a magulu amtundu wa SH omwe ali ndi kuchuluka kwa ionization, opezeka m'chigawo cha glucose receptors. Kufanana kwa magawo a mamolekyulu a glucose ndi alloxan, kupezeka kwa ma atomu a nayitrogeni ndi magulu a carbonyl mu kapangidwe kake, kumatsimikizira kuyanjana kwa alloxan ndi SH - magulu a glucose receptors ndi kulowerera kwake kwaulere mu (3 - maselo a kapamba (Karagezyan K.G., Gevorkyan D.M., 1989 , Litvinchuk M.M., 1994).

Makina a chitukuko cha matenda a shuga a streptozotocin amagwirizanitsidwa ndi kuthekera kwake kuchepetsa kuchuluka kwa NAD, chifukwa cha kuchuluka kwa ntchito ya poly-ATP ribose synthetase (Yamoto N. et al., 1990), activation ya lipid peroxidation, kuchepa kwa ntchito ya antioxidant system ndi superoxide dismutase (Ovcharova N.I., al. 1998). Kukhazikitsidwa kwa lithizone pakuyesayesa kumathandizanso kukulitsa kuchepa kwa insulin kwathunthu, chifukwa cha kupangidwa kwa zinthu zakupha ndi zinc ndi thapeloizone ndikupanga njira zowonongeka mu (3 - maselo a islets of Langerhans (Bayers JW, 1991) activation of LP and maganizo of antioxidant defense are allindlela in the development of all liteko. mitundu ya matenda a shuga a mellitus sikuti amangokhala a 1, komanso a mtundu: mukamadyetsa makoswe akale ndi sucrose owonjezera, kukula kwa nkhawa ya oxidative m'maselo a beta kuwululidwa (Yu I. et al., 1999).

Zadziwika kuti si hyperglycemia yokha, komanso hyperinsulinemia imathandizira njira zowonjezera kupsinjika kwa oxidative mu shuga. (Balabolkin M.I., 2000). Zikutsimikiziridwa kuti hyperglycemia yosatha kudzera pakuwonjezera kuchuluka kwa autooxidation kwa glucose kumachulukitsa mapangidwe a radicals waulere, kuchuluka kwa njira za glycosylation, kumayambitsa mapangidwe ophatikiza mapuloteni ophatikiza ndi okosijeni, ndikuwonjezereka kwa njira ya polyol ya metabolism ya glucose kumathandizira kutsika kwa masitolo a NADPH +.Hyperinsulinemia imayendetsa masheya am'maso am'madzi komanso kupanga ma radicals omasuka chifukwa cha ma catecholamines, ndipo kudzera mu kuchuluka kwachulukidwe wamafuta acids omwe amapezeka ndi catecholamines kumawonjezera mapangidwe a radicals aulere komanso amachepetsa msana wa glutathione (imodzi mwazofunikira kwambiri zosungunulira antioxidants) (Balabolkin MI, Klebano )

Ma radicals aulere, mosasamala kanthu za makina ndi magwero a mapangidwe awo, yambitsani cholembera Nf - kB, imathandizira apoptosis ndikuwonjezera mapangidwe a oxidized low-density lipoproteins (LDL) (Demidova I.A. et al., 2000). The transcript factor Nf - kB imagwira ntchito yofunika - imayang'anira zimachitika zambiri, zomwe zimapangitsa kuti masinthidwe a endombojeni a endothelium khoma la mtima. Factor Nf-kB mkhalapakati wa kutulutsa kwa tumor necrosis factor a-interleukin-1P, komwe kumakhudzanso njira zambiri zomwe sizimangoyambitsa kusintha kwa khoma la mtima, komanso kufooka pobisalira ndi kuchitapo kanthu kwa insulin komanso kuwonongeka kwa mitsempha yodutsa. .V., Et al. 1996).

Chifukwa chake, mu shuga mellitus, kuphatikiza kwa oxidative kumayendera limodzi ndi kupangika kwa ma radicals aulere, omwe, mogwirizana ndi lipids, carbohydrate ndi amino acid, amasintha mapuloteni kuti apange zinthu zoyambira zamakina a oxidation komanso nkhawa za carbonyl intermediates (carbonyl nkhawa). (Chernov, Yu.N., et al., 1998, Podoprigorova V.G., 2001).

1.2. Zomwe zimachitika ndi lipid metabolism mu shuga mellitus, udindo wake mu atherogeneis.

Kwa nthawi yayitali, matenda a shuga ankangowona ngati kuphwanya kagayidwe kazakudya, ndikuwonetsetsa kuti magazi abwinobwino m'magazi amatengedwa ngati cholinga chokhacho cha insulin (Laakso M., et al., 1998). Komabe, tsopano zikuwonekeratu kuti matendawa amaphatikizidwa ndimatenda ovuta a metabolic osati chakudya chokha, komanso lipids ndi mapuloteni, komanso zovuta ziwiri zazikulu za matenda a shuga: kuwonongeka kwa atherosclerotic ku ziwiya zazikulu ndi ketoacidosis ndi chifukwa cha vuto la lipid metabolism (Andrade S. E, et .., 1996).

Odwala omwe ali ndi matenda amtundu wa shuga, kuwongolera bwino mishuga ya glucose, milingo ya lipid ndi kuthamanga kwa magazi kumakhala kwachilendo kwa nthawi yayitali. Komabe, kusayendetsa bwino kwa shuga ndikukula kwa nephropathy kumayendetsedwa ndi dyslipidemia ndi ochepa hypertension. (Doborgginidze JIM., Graziansky N.A., 2001).

Choopsa chofunikira kwambiri cha kudwala kwa odwala omwe ali ndi matenda ashuga ndi dyslipidemia, yomwe imadziwika ndi kusintha kwamphamvu komanso kuchuluka kwa lipoproteins yamagazi (Kozlov S.G. et al., 2000, Laasko M., 1995).

Zizindikiro zodziwika kwambiri komanso zodziwika bwino za dyslipidemia mwa odwala matenda a shuga ndi awa: (Steiner G., 1994, Haffner SM, 1999): 1) kuchuluka kwa triglycerides (TG) komanso otsika kwambiri a lipoproteins (VLDL), omwe ali onyamula kwambiri a TG, 2) kuchuluka kwa cholesterol ya "anti-atherogenic" kachigawo - mkulu osalimba lipoproteins (HDL). Pathogenesis yamakhalidwe awa ndi yovuta ndipo imatha "kuyambitsa" m'njira zingapo, ngakhale imatha kupezeka nthawi zonse chifukwa cha hyperinsulinemia chifukwa cha kukana insulini komanso kunenepa kwambiri, komwe nthawi zambiri kumapezeka mu shuga (Howard V. V., 1995).

Kukana kwa insulin kumayambitsa kuchuluka kwa lipolysis ndi kutulutsidwa kwamafuta ambiri am'mafuta a asidi a adipose, omwe, limodzi ndi kuchuluka kwa shuga wamagazi, kumapereka gawo lina la gawo la kaphatikizidwe ka TG m'chiwindi (komwe kumadutsa m'njira ya glycerophosphate). Malinga ndi izi, kuchuluka kwambiri kwa otsika kwambiri opanga ma lipoproteins (VLDL) olemera mu TG amapangidwa (Yafasov K.M., Dubyanskaya N.V., 2001, Pierce L. R., et al., 1990, Herman W.H. et al., 1999).

Kuphatikiza pakuphatikiza kaphatikizidwe ka VLDL, kuphwanya katemera wa zinthu izi ndikofunikanso, chifukwa kuchepa kwa ntchito ya extrahepatic lipoprotein lipase mu shuga, yomwe hydrolyzes TG, chylomyocrons ndi VLDL, zomwe zimapangitsa kuti pakhale mafuta acids omwe amagwiritsidwa ntchito ngati mphamvu yopangira minofu. (Taskinen M.R.1992, Baillie G. M., et al., 1998). Zonsezi zimabweretsa chiwonjezeko cha kuchuluka kwa zigawo za ma lipoprotein ozungulira, za triglyceride, zomwe zimawerengedwa makamaka atherogenic. Kuchuluka kwa HDL cholesterol sekondale kumachepera chifukwa cha kuchuluka kwa kusintha kwa cholesterol esters kuchokera ku HDL kupita ku VLDL ndi ma chylomyocrons posinthana ndi triglycerides motsogozedwa ndi puloteni yomwe imasuntha cholesterol esters (Stein EA, et al., 1998, Kozlov S.G., Lyakishev A .A., 1999, Feher MD, et al., 1995).

Kuwonetsedwa kwina kwa kuphwanya kwa lipid ndi lipoprotein chiwonetsero cha magazi ndikuwonjezeka kwa chiwerengero chaching'ono, chaukali LDL phenotype B, chomwe chachulukitsa atherogenicity (Bakker - Arkema R.G., et al., 1996, Chapman M. J., et al., 1998). Mlingo wa apoprotein B ndikuwonetsa kuchuluka kwa tinthu ta LDL, ndipo zomwe cholesterol zomwe zili mu ma LDL zingakhale zosiyanasiyana. Tinthu tating'onoting'ono tambiri tambiri ta LDL timakhala tambiri kuposa tinthu tating'onoting'ono ta LDL (phenotype A), malinga ndi kusintha kwa oxidative ndi enzymatic glycosylation, yomwe imachedwetsa kuchotsedwa kwa plasma (Chapman M.J., et al., 1998).

Mukamachititsa maphunziro a matenda am'mimba mwa odwala omwe ali ndi matenda a shuga a 2, hypercholesterolemia chifukwa cha kuchuluka kwa cholesterol ya LDL nthawi zambiri imapezeka. Malinga ndi kafukufuku wambiri (Harris M.I., 1991, Baillie G.M., et al., 1998, Laasko M., et al., 1998), kuwonjezeka kwa cholesterol ya plasma kwapezeka mu 54-77% ya odwala.

Chimodzi mwamafukufuku ofunikira kwambiri omwe akuwonetsa mgwirizano pakati pa mulingo wazonse! wa magazi cholesterol ndi kufa kwamtima mwa odwala omwe ali ndi matenda a shuga - Multiple Risk Factor Intervention Trial (MRFIT) (Stamler J., et al., 1999, Kannel W.B., et al., 1999). Zotsatira zake zikuwonetsa kuti kukwera kwambiri kwa cholesterol mwa odwala matenda a shuga, kumakhala pachiwopsezo chachikulu cha kufa ndi mtima. Zinapezeka kuti ndi mulingo wofanana wa cholesterol, kufa kwa odwala omwe ali ndi matenda a mtima kunali kwamikiratu katatu pamaso pa anthu odwala matenda ashuga kuposa momwe kuliri. Izi zikusonyeza kuti matenda ashuga amathandizira kwambiri pangozi yakufa kuchokera ku matenda a mtima kuphatikiza hypercholesterolemia.

Pamodzi ndi kuchuluka, odwala omwe ali ndi matenda ashuga, kusintha kwamphamvu kwa lipoprotein kumasiyanitsidwa, zomwe zingayambitse kuchuluka kwawo kwa atherogenicity (Feingold K.R., et al., 1992, Haffner, et al., 1994). Kusintha kwamapangidwe a lipoproteins, omwe amawaganizira kuti ndi omwe angapangitse kuti chiwopsezo cha atherosulinosis mu matenda ashuga chitha kuchitika chifukwa cha nonenzymatic glycosylation a apolipoproteins (Gurtis L.K., Witztum J.L., 1995). Glycosylation zimatengera mwachindunji kuchuluka kwa shuga m'magazi ndipo zimachitika kuyambira chiyambi cha matenda ashuga. Apolipoproteins, omwe ali m'gulu lamakalasi apamwamba a lipoproteins, amatha kudutsa masinthidwe, omwe amatsogolera kusintha kwa kagayidwe kake, makamaka, kuwonjezeka kwa nthawi ya kufalitsa kwa VLDL (Witztum JL, et al., 1992) ndi LDL (Mamo JKL, et al., 1990) . Komabe, chofunikira kwambiri ndikuchepa kwa kuthekera kwa ma glycosylated LDL kuchotsedwa m'magazi kudzera pama receptors awo. Izi zimabweretsa kuchotsedwa kwa gawo lalikulu la LDL m'njira yopanda receptor: LDL yosinthika imatengedwa mwachangu komanso mosavuta ndi ma macrophages ndikupanga maselo a chithovu, chomwe ndichinthu chofunikira kwambiri mu pathogenesis of atherossteosis (Steinbrecher U.P. et al., 1993). Pali umboni wokuwonjezereka kwa kuphatikiza kwa mapulateleti akadziwika ndi glycosylated LDL (Bowie A, et al., 1993, Wolff S.P., Dean R.T., 1997).

Kusintha kwina koyenera kwa lipoproteins mu shuga kungachitike chifukwa cha peroxidation, yomwe ndi gawo la lipids. Zofalitsa zingapo zimayika zofunikira za chiphunzitso chowonjezera cha lipid peroxidation mu shuga mellitus (Dedov II, et al., 2000, Kiahara M., et al., 1980, Hicks M., et al., 1998).

Kulowerera kwa lipoproteins zosinthika khoma lamitsempha mothandizidwa ndi ma receptor oyenera, komanso ma scavenger receptors, kumabweretsa kusakanikirana kosagwiritsidwa ntchito mosagwirizana ndi mapangidwe a mitsempha, ndikutsatira kupangika kwa chitetezo cha chitetezo cha mthupi cha Ig G, P - lipoproteins ndi othandizira. Dziwani kuti ma macrophages oterewa amakopa kwambiri kuposa ma lipoproteins achilengedwe (Serov V.V., 1998).Kuphatikiza apo, macrophages amathandizira kufotokozera kwa ma interleukin endotheliocytes pamitsempha; amathandizira T-lymphocyte, yomwe imathandizira mawu a E-selein, maellellular ndi ma cell a zomatira zomatira ma cell (ICAM-1, VACM-1), macrophage oyambitsa zinthu, interleukin-8, endothelin - 1, yomwe ikuthandizira kuphwanya kwa zomatira, kuchuluka kwa khoma lamankhwala ndi chifuwa (Saltykov BB, 2001). Kupanga kwa macrophage chotupa necrosis chinthu kumawonjezera, komwe kumakulitsa njira za lipid peroxidation ndikupanga ma oxygenated intermediates, kumalimbikitsa njira yotengera arginine popanga nitric oxide, ndikuletsa macrophage popereka ma antigen kupita ku ma cell a T (Nagornev V.A. et al., 1999). Nthawi yomweyo, secretion ya lipoprotein lipase imakakamizidwa, kusintha kwa lipoprotein kumawonjezera ndi kudzikundikira kwawo kwina mu khoma lamitsempha. Lysophosphatidylcholine (LPH) ndiye chinthu chachikulu chowononga cha LDL. Mothandizidwa ndi iye, kapangidwe ka nitric oxide (N0) amasokonekera, kuchuluka kwa matchulidwe a NOS-3 amachepetsa, ndipo kugwira ntchito kwa endothelial synthetase kumathandizanso kwambiri (Zotova I.V. et al., 2002; Balumweva T.V. et al., 2002) .

Hypercholesterolemia imathandizanso kwambiri kuti atherogenesis, ikuthandizira kukulitsa kusokonekera kwa endothelial chifukwa cha kulepheretsa kwachiwiri kwa endothelial synthetase powonjezera kufotokoza kwa genolin gene - (Kazuhino S. et al., 1997).

Odwala omwe ali ndi matenda a shuga, kuwonjezereka kwa mapangidwe amitsempha yamagazi, kuchepa kwa ntchito ya antiplatelet ya khoma lamitsempha, ndikuwonetsa kuwonekera kwa ma cellplates ogona pamitsempha yamitsempha yamagazi ndi kuwonongeka kwamphamvu. Kuphatikiza apo, mapulogalamu amamasulidwe a platelet kukula, omwe ndi mitogen, ndipo amagwira ntchito yofunika kwambiri pakukula kwa atherosulinosis polimbikitsa kukula kwa maselo a minofu yosuntha ndikusunthika kwawo kuchokera pakatikati kamatumbo kupita ku endothelium, ndipo maselo osalala a minofu ndiye gwero la masanjidwe am'mimba a fibro-muscular plaque (Balabolkin M. I. et al., 2000). Kuphatikiza apo, matenda ashuga a micangiopathy vasa vasorum adatulukira (Saltykov D.D., 2002), nawonso, amayambitsa kusokonezeka kwa magazi, kusintha kwa ma trophic m'mapangidwe amitsempha yayikulu, amachititsa hypoxia, amalimbikitsa kuchuluka kwa mtima, kuphatikizika kwa plasma ndi kuwonongeka kwa makoma amitsempha yamagazi komanso kukulira kwa atherosulinosis.

1.3 Mavuto ndi chiyembekezo cha pharmacotherapy a odwala omwe ali ndi matenda osokoneza bongo.

Pharmacotherapy a shuga mellitus ndi ntchito yovuta kuchipatala, kuthetsa komwe kuli kofunikira kuganizira zomwe zimachitika pakuchitika kwa matenda.

WHO yalengeza za matenda ashuga ngati mliri pakati pa matenda osagwiritsidwa ntchito, monga zaka khumi ndi zinayi kuchuluka kwa odwala omwe ali ndi matenda a shuga (Dedov I.I., 2000). Mavuto a shuga a Microvascular akadali vuto lalikulu la matenda ashuga, kuchuluka kwa angiopathy mwa odwala matenda a shuga ndi 90-97%. Diabetesic retinopathy ndi neuropathy, komanso polycururathy ya visceral ndi zotumphukira, ndizomwe zimayambitsa kulumala komanso kufa kwa odwala (Bobyreva JI. E., et al., 2000).

Atherossteosis odwala omwe ali ndi matenda osokoneza bongo amadziwika ndi chitukuko choyambirira komanso kufalikira, zomwe zimatipatsa mwayi wolankhula za matenda ashuga monga mtundu wachilengedwe wa atherosulinosis (Kovaleva P.V., 2002).

Kukula kwa matenda ashuga kumatsimikiziridwa ndi nthawi yowoneka ya angiopathy ndi zovuta zawo. Kukomoka kwa matenda ashuga ndi komwe kumayambitsa kupha odwala osaposa 1-2%, pomwe mafupipafupi amafa chifukwa cha zovuta zam'mitsempha amafikira 65-80% (Fadeeva NI, 2001).

Matenda a shuga ndi matenda amtima amaphatikizidwa. Mu opitilira 60% odwala matenda ashuga, chiyembekezo cha moyo chimakhala chocheperako chifukwa cha matenda amtima wopitilira patsogolo (Karpov, Yu.A., 2002).

Kukhalapo kwa matenda ashuga kumachulukitsa kuchuluka kwa kufa mwadzidzidzi mwa amuna ndi 50% ndipo mwa akazi ndi 300% (IDE, 2000). Ndikofunikira kuti kudalirika kwa odwala omwe ali ndi matenda osokoneza bongo omwe alibe matenda oopsa a mtsempha wamagazi kumakhala kofanana ndi kwa odwala omwe ali ndi matenda amitsempha yamagazi opanda matenda a shuga.Motsogozedwa ndi izi, bungwe la American Heart Association linaika matenda ashuga ngati matenda amtima wamatumbo (Karpov, Yu.A., 2002).

Zomwe zimayambitsa chiwopsezo chachikulu ndi kupititsa patsogolo kwa matenda a shuga a shuga ndi hyperglycemia, ochepa matenda oopsa ndi dyslipidemia (Shestakova M.V., 2002). Chifukwa chake, kuwonjezeka kwa hemoglobin ya glycated kuchokera 6% mpaka 10% kumabweretsa kuwonjezeka kwa kubadwa kwa myocardial infarction kwa odwala omwe ali ndi matenda a shuga a 2 ndi 2,5 nthawi ya (UKPDS, 2000). Kuwonjezeka kwa seramu okwanira cholesterol kuchokera kwa mmol / L 2,5 kuchulukitsa kumwalira kwa odwala omwe ali ndi matenda a shuga kuchokera ku zovuta zamtima (MRFIT, 2000).

Ngakhale kupita patsogolo kwa odwala matenda ashuga amakono, zotsatirapo za chithandizo cha odwala zimakhalabe zosakhutiritsa. Ngakhale m'zaka zaposachedwa, m'maiko angapo, kufa chifukwa cha matenda amtima kwachepa pafupifupi kawiri (Aronov D.M., 2001), ndiye kuti m'maiko ano kufa kwa matenda amtima sikunasinthe m'gulu la odwala matenda a shuga, koma azimayi. ngakhale kuchuluka (Shestakova M.V., 2000, Gu K. et al., 1999, DCST, UKPDS, 2000).

Mpaka pano, mafunso ambiri amakhalabe osayankhidwa okhudzana ndi kukonza kwa matenda a shuga.

Kukhazikitsidwa kwa zotsatira za hypoglycemic kumachitika kukhala vuto lokhazikika, lomwe likuyankhidwa mothandizidwa ndi zakudya zochepa zopatsa mphamvu, zolimbitsa thupi, mankhwala otsitsa shuga pamlomo (zotumphukira zochokera ku sulfonylurea ndi guanine-greatuanides) ndi insulin. Komabe, palibe njira imodzi yomwe ingapangitsire hyperglycemia yomwe ili ndi mwayi wambiri kuposa ena: ndi kugwiritsa ntchito moyenera, kuchuluka kwa kulowetsedwa kwa odwala omwe ali ndi matenda a shuga mellitus kunatsika kwambiri ndi 16% (UPDAS, 1998). Pakadali pano, mankhwalawa a sulfanilamide ndiye mwala wofunikira pakubwezeretsa shuga. Chidwi cha gulu latsopanoli chikufotokozedwa ndikuti ndi gulu lokhalo lazinthu zomwe zimakhala ndi zolandilira zawo pazomwe zimapanga ma plasma (maselo atatu (Ashcroft FM et al., 1998) .Machitidwe awo amachitidwe amazindikirika kudzera mu blockade ya njira za potaziyamu za ATP. kumabweretsa kukokomeza kwa membrane wa plasma, kutsegulidwa kwa njira zama calcium zomwe zimadalira magetsi komanso kuwonjezeka kwa kuchuluka kwa calcium, komwe, pomumanga bata, kumayambitsa insulin exocytosis (Aschcroft FM, 1996, Kramer W. et al., 19 99) Ngakhale pali mankhwala osiyanasiyana a sulufilamide omwe alipo, kusankha kwa mankhwala ochepetsa hyperglycemia nthawi zambiri kumakhala kochepa kwambiri chifukwa chotheka kuti pakhale zovuta zingapo. Mukamamwa sulufilamides, kuchepa kwenikweni kwa hyperglycemia kumachitika pokhapokha 70-75% ya odwala, komanso vuto la mankhwalawa. Zotsatira zophatikizidwa pafupipafupi komanso zowopsa kwambiri ndi hypoglycemia ndi hypoglycemic coma (Coop LC, 1998, Holman RR, Turner RC, 1999). Mu 35% ya odwala omwe amathandizidwa ndi sulfonamides, yachiwiri ya sulfanilamide kukana kumachitika chaka chilichonse.

Kukondoweza kwakanthawi kwa ma pancreatic P - maselo kumatha kuyambitsa kufooka kwazomwekuchepa komanso kuchepa kwa insulini, komanso kuchulukitsidwa katulutsidwe mwa kukhazikika kwa proinsulin ndi maselo a splitproinsulin, omwe amachulukitsa chiopsezo cha atherogenesis (Alexandrov A. A., 2001, Ohkubo Y. et al., 1995, Turner RC, 1999). Kuphatikiza apo, zotsatira zoyipa za kukonzekera kwa sulfonylurea pa mtima wam'tsogolo mwa odwala omwe ali ndi matenda amtundu wa shuga adawululidwa. Mu gulu la odwala omwe amalandira tolbutamide, kufa kwa myocardial infarction kunali 50%, pomwe anali pagululi ndi placebo 18% (Engler R., 1996). Zotsatira zoyipa za sulfonamides pa maphunzirowa ndikukula kwa matenda amtima wamatumbo kwa odwala omwe ali ndi matenda osokoneza bongo chifukwa cha kuthekera kwawo kutseka njira zothetsera potaziyamu za ATP mu myocardium, minofu yosalala komanso mafupa, ndi ma neurons ena aubongo (Aschcroft F.M., 1999).Amakhulupirira kuti njira za Kahf ndizofunikira kulumikizitsa kayendetsedwe ka kagayidwe kazinthu kazinthu komanso kupukusa kwa membrane wa plasma, komanso kuzindikira zomwe zimachitika mu mahomoni ena ndi zinthu zina zomwe zimagwira ntchito ndikuwongolera kamvekedwe ka minofu.

Nicols C.G., 1991, Aschcrofit F.M., Reiman F., 2000). Kachitidwe ka potaziyamu kumakhala ndi zotsatira zamtima mu myocardial ischemia (Escande D., et al., 1992). Zomwe zimachokera ku sulfonylureas zimawunikira izi, chifukwa chake zimakhala zowopsa pakuphatikizidwa kwa matenda a mtima a ischemic ndi matenda a shuga. Zotsatira za kugwiritsa ntchito mankhwala a sulfa kungathenso kuyanjana kapena kupweteka kwa pakhungu (kuyabwa pakhungu, urticaria, edema ya Quincke, leukopenia, granulocytopenia, thrombocytopenia, hypochromic anemia), zomwe zimapangitsa kuti pakhale kuperewera kwa phokoso (mseru, kupweteka m'gawo la epigastric. Nthawi zina pamakhala kuphwanya chiwindi mu mawonekedwe a jaundice chifukwa cha cholestasis (Gorbenko NI, 1999).

Gulu lachiwiri la othandizira pakamwa la hypoglycemic ndi a greatuanides, omwe amachepetsa hyperglycemia mwa odwala omwe ali ndi matenda osokoneza bongo mwa kusintha kukhudzika kwa chiwindi ndi zotumphukira zake mpaka insulin popanda kukhudza chinsinsi cha mahomoni (Dunn C.D., Peters D.H., 1995, Perriello G., 1995). Biguanides amawonedwa ngati mankhwala osankha oyamba othandizira odwala onenepa omwe ali ndi mtundu kapena / kapena matenda ashuga komanso kupezeka kwa dyslipidemia kumayambiriro ngati monotherapy kapena kuphatikiza mankhwala a sulfonamide (Balabolkin M.I. et al., 2001, Dunn C.D., 1995).

Zotsatira zoyipa za biguanides zikufotokozedwa mu lactic acidosis, khungu lawo siligwirizana, mseru, kusokonezeka pamimba ndi kupukusira m'mimba), kuchuluka kwa matenda ashuga a polyneuropathy (chifukwa cha kuchepa kwa mayamwidwe a vitamini B12 m'matumbo aang'ono) (Chernov, Yu.M. et al. ., 1999).

Mwachikhalidwe omwe amagwiritsidwa ntchito mu shuga mellitus, insulin mankhwala imakhalanso ndi zovuta zingapo zomwe sizinathetsedwe. Kuchiza kwambiri ndi insulin kumachepetsa kwambiri vuto la matenda ashuga, komabe, kupitirira kwa insulin kumabweretsa hyperlipidemia, ndikuchulukitsa chiopsezo cha atherosulinosis kangapo (E. Krasilnikova et al., 1996). Kugwiritsira ntchito insulin kumayendera limodzi ndi kukonza kwa zovuta zomwe sizimangowonjezera thanzi la odwala omwe ali ndi matenda osokoneza bongo, komanso zimayambitsa mikhalidwe yomwe imabweretsa ngozi pamoyo wa wodwalayo. Izi zikuphatikizapo: hypoglycemia, posthypoglycemic hyperglycemia (chochitika cha Somogy), matupi awo osagwirizana, insulin kukana, insulin lipodystrophies, insulin edema, kuwonongeka kwa kuwona (Balabolkin MI, 2000). Kuipa kwa insulin mankhwala kulinso njira yaubwino yoyendetsera, yomwe, kuwonjezera pazovuta za wodwalayo, zimagwirizanitsidwa ndi pharmacokinetics yokonzekera insulin: insulin, yoyendetsedwa mosagwirizana, imalowetsa zotumphukira zamitsempha mwachangu kuposa molunjika m'chiwindi, monga mu thupi la Saudek )

Chifukwa chake, zotsatira zosakwaniritsidwa zogwiritsidwa ntchito ndi othandizira a hypoglycemic othandizira, omwe ali ndi chiwopsezo chachikulu cha zotsatira zoyipa, kuchuluka kwakuchuluka kwa zotupa za mtima ndi zotsatira zoyipa ngakhale munthawi yamankhwala, kulamula kufunika kokhazikitsa njira zatsopano, zowopsa komanso zowoneka bwino za kukonza mankhwala pamatenda a shuga mu shuga mellitus (Campbell RK, 1999).

Kafukufuku waposachedwa adawonetsa (Perova N.V. et al., 2001, Heinemann L. et al., 1997, Hoffman A., 1999) kusamalira kwambiri ziwopsezo, kuwongolera bwino matenda a metabolic mu matenda a shuga komanso kumawongolera kwambiri matendawo moyo mwa odwala.

Monga gawo la metabolic syndrome, odwala matenda a shuga amakhala ndi dyslipidemia, matenda oopsa kwambiri komanso kunenepa kwambiri, zomwe zimayambitsa ngozi ya mtima ndi matenda omwe amafunikira kuwongoleredwa.

Kufalikira kwambiri padziko lonse lapansi pakati pa njira zochiritsira matenda osokoneza bongo ndi matenda a shuga ndi ma statins kapena zoletsa za 3-hydroxy-3-methylglutaryl-coenzyme A-reductase. Mankhwalawa amaletsa kapangidwe ka enzyme yomwe imathandizira kupangika kwa cholesterol mu chiwindi (Shestakova M.V., 1999).Kuchita bwino kwa zamankhwala kwama statins kwatsimikiziridwa motsimikizirika m'maphunziro akulu akulu ochulukirapo (Mellies M.J., 1993). Mmodzi mwa maphunzirowa, a 4s, anali odzipereka pakuphunzira kupulumuka kwa odwala omwe ali ndi matenda amitsempha yamagazi m'mitsempha ya Zocor. Phunziroli lidatenga zaka zambiri, lidakhudza odwala 4444 omwe ali ndi hypercholesterolemia ndi matenda a mtima, omwe adadwala matenda a shuga mellitus (Pyorala K. et al., 1997). Patatha milungu ingapo ya chithandizo ndi Zocor pa 20 mg / tsiku kwa odwala omwe ali ndi matenda ashuga, kuchepa kwa cholesterol yamagazi ndi 28%, cholesterol ya HDL ndi 37%, TG ndi 18% ndi kuwonjezeka kwa cholesterol ya HDL ndi 8% kulembedwa. Pa nthawi iyi, zotsatira zake zidakhala zaka zambiri zamankhwala.

Komabe, kugwiritsa ntchito ma statins kwa nthawi yayitali kumalepheretsa zochitika za antioxidant enzymes Qi0 m'chiwindi, zomwe zimawonjezera chiopsezo cha njira zowonjezeka za LPO (V. Lankin, 2000). Kuphatikiza apo, pakati pa odwala omwe adatenga nawo mbali pamaphunziro, panalibe aliyense wokhala ndi triglycerides, chifukwa chake zotsatira zake sizingafanane ndi kuchuluka kwa odwala omwe ali ndi matenda amitsempha yamagazi.

Pankhaniyi, ma fibrate, omwe amathandizira kwambiri pamlingo wa triglycerides, amatha kukhala mankhwala osankha. Mphamvu ya fibrate pamitsempha yamagazi imayendetsedwa ndi kuchepa kwa kachulukidwe ka LDL, ndipo, chifukwa chake, kuchepa kwa ndende ya atherogenic yaying'ono LDL (Kozlov S.G. et al., 1999). Zikuwonetsedwa kuti kugwiritsa ntchito hemofibrozil kwa nthawi yayitali, kuchuluka kwa odwala matenda ashuga ochokera m'matumbo a mtima kumatsika ndi 22%. Komabe, kugwiritsidwa ntchito kofalikira kwa mankhwalawa kwa gulu lino kumangokhala ndi zotsutsana zambiri komanso zoyipa, kuphatikiza cholelithiasis, kuchuluka kwa cholesterol, kuchuluka kwa zochitika za transaminase, nseru, myalgia, mafupa a hypoplasia, leukopenia, thrombocytopenia, kukula kwa matenda amitsempha.

Nicotinic acid imakhala ndi zofanana ndi ma fiber mu lipid mbiri magawo. Pali umboni wokhudzana ndi chitetezo chamtundu wa kuphatikiza kwa nicotinic acid ndi simvastatin mwa odwala omwe ali ndi cholesterol yotsika ya HDL ndi zotsatira zopindulitsa za kuphatikiza kumeneku pa coronary atherossteosis (Gustafsson I. et al., 2000). Komabe, kugwiritsidwa ntchito kwakanthawi sikungavomerezedwe chifukwa chakuwongolera kuwongolera kwa glycemic, kukulitsa insulin kukana ndikupangitsa kuyambitsa kwakukulu kwa dongosolo la kinin (Mikhaylyuk IB, 1998, Perova N.V. et al., 2001, Heinemann L. et al. 1997, Hoffman A., 1999).

Kuyang'anira kuthamanga kwa magazi ndi ntchito ina yofunika pochiza odwala matenda ashuga. Kukula kwa matenda oopsa omwe ali ndi matenda oopsa pakati pa odwala omwe ali ndi matenda a shuga 2 amafika 70% (Karpov Yu.A., 2001).

Mwachindunji antianginal mankhwala a shuga opatsirana a shuga amayimiridwa ndi: (3 - blockers, Ca antagonists and nitrate.Mu maphunziro a Coteborg ndi MIAMI, chithandizo chokhala ndi P - blockers mu shuga mellitus chidayambitsa kutsika kwa kufa kwa miyezi itatu ndi 49-59%. matenda a shuga ndikuti kusokonezeka kwa metabolic chifukwa cha ischemia kumakhala kowopsa kwambiri chifukwa cha kusinthasintha kwambiri kwa makutidwe amthupi a mafuta mu myocardium, yomwe ndi chimodzi mwazizindikiro za metabolic syndrome, kumabweretsa kukakamiza kwa glycol a, lactate kudzikundikira ndi ionic kusalingana (American Diabetes Association, 1993) .U kafukufuku wa TRIMPOL-1 adawonetsa kuti kuwonjezeranso kwa trimetazidine (preductal), mankhwala omwe ali ndi kagayidwe kazinthu kogwiritsa ntchito monotherapy kokhala ndi antianginal mankhwala, kumathandizira chithandizo chamankhwala ndikuthandizira kulolerana kwambiri komanso Zizindikiro za matendawa mu 50% ya odwala omwe ali ndi matenda osokoneza bongo.Powonjezera nthawi yoyesedwa ndi zochitika zolimbitsa thupi ndikusintha moyo, trimedazidine amachepetsa zomwe zili ndi Wil Wilbb randa (chikhomo cha kuwonongeka kwa endothelial) m'madzi a m'magazi.

M'zaka zaposachedwa, chidwi chachikulu chakhala chikuyendetsedwa pakupanga gulu latsopanoli la mankhwala opatsirana pogwiritsa ntchito mankhwala osokoneza bongo - thiazolidinedione derivatives (troglitazone, rosiglitazone) (Saltiel A.R. et al., 1996). Mankhwala omwe ali mgululi amamangirira - subtype ya activated peroxisomal proliferator receptor (PPARy), zomwe zimapangitsa kuti pakhale kusintha kwamphamvu kwa insulini komanso kuchepa kwa kukana kwa mahomoni (Lebovitz N.E.et al., 2000). Kafukufuku wofufuza ndi zamankhwala awonetsa kuti thiazolidinediones imathandizira kugwiritsidwa ntchito kwa glucose pogwiritsa ntchito zotumphukira pakukulitsa ntchito ya glycogen synthetase komanso kuletsa gluconeogeneis m'chiwindi, zomwe zimapangitsa kuchepa kwa plulin ya insulin. Kuphatikiza apo, pochiza ndi thiazolidinediones, kuchepa kwa ndende ya triglyceride ndi kuthamanga kwa magazi, komanso kukonzanso kwa njira ya atherosulinotic (Sjostrom L. et al., 1998). Komabe, kufalikira kofalikira kwa mankhwalawa kwa gululi kumachepa ndi chiwopsezo chachikulu cha kuwonongeka kwa chiwindi ndi chitukuko cha chiwonetsero cha chiwindi ndi hepatocellular chiwindi necrosis mwa odwala omwe ali ndi matenda osokoneza bongo (Yasuki I., 2000, Riskin F. et al., 2000), komanso kuthekera kuchepetsa kuchuluka kwa maselo ofiira am'magazi ndi hemoglobin chifukwa kupsinjika kwa ubongo (Lebovitz N.E. et al., 2000).

Mu pharmacotherapy a shuga mellitus, kuti muchepetse kusokonezeka kwa metabolic, kugwiritsa ntchito mankhwala omwe amachepetsa njira za glycosylation ndizoyenera. Glycosylation inhibitor yeniyeni ndi aminoguanidine (pimagedin), kapangidwe ka zinthu zomwe zimachitika ndi zinthu za Amadori ndikupanga mankhwala osagwira mu cell molekyulu (Edelstein D. et al, 1992, Zimmerman G.A. et al., 1995).

Kuletsa kwa non-enzymatic glycosylation ya mapuloteni ndi oxidation a otsika osachulukitsa lipoproteins ndikotheka pogwiritsa ntchito potaziyamu yatsopano blocker AL 0671 (Yamauchi Takeshi et al., 1996, Engerman RL ndi Kern TS, 1996, Yasanari Kenichi et al., 1998, Sjostrom L. et al., 1998).

Pofuna kubwezeretsa ma microcirculation ndikuchepetsa mawonekedwe owonjezereka omwe amapanga magawidwe ophatikizika a intravascular coagulation syndrome, omwe amadziwika kuti ali ndi madigiri osiyanasiyana pafupifupi odwala onse omwe ali ndi matenda osokoneza bongo a mellitus, ma prostaglandins inhibitors (acetylsalicylic acid, etc.) ndi thromboxane synthesis inhibitor --ibustrin amagwiritsidwa ntchito (Shestakova M.V. , 2000), heparin ochepa, kulemera kwamphamvu kwambiri, fraxiparin (Savenkov M.P. et al., 1999).

Zoyembekeza zazikulu pakali pano pokonza angiopathy mu matenda a shuga zimayikidwa pa kugwiritsa ntchito ACE zoletsa. Kukonzekera kwa gululi kumakhudza mayendedwe a mtima wamatenda omwe ali ndi matenda osokoneza bongo, kukonzanso molondola kwamatenda amkati, kumalepheretsa kukula ndi kudwala kwa matenda a shuga, ndikuchepetsa kupitilira kwa retinopathy koyambirira (Rayaz A.S., 2000). Kutenga ramipril mwa odwala matenda ashuga kumachepetsa chiopsezo cha kulowetsedwa ndi 22%, ngozi ya mtima ndi 33%, komanso chiopsezo cha kufa ndi matenda amtima ndi 37% (Chugunova JI.A. et al., 1999, Fuhlendorff J. et al, 2000 , Viraly ML, 2000).

Chifukwa chake, popenda zomwe taziwonetsa pamwambapa, titha kunena kuti chiwopsezo cha mavuto obwera chifukwa cha matenda ashuga ndi chachikulu chifukwa cha zovuta za pathogenesis yamatenda, kupezeka kwa ziwalo zingapo za metabolism, kuphatikizira ziwalo zochotsa komanso kuphatikiza kwa biotransfform ya mankhwala munjira ya pathological. Kuyesera kukopa chilichonse cholumikizirana cha pathogenesis, adotolo, mwatsoka, amakokedwa mosavomerezeka. Pachifukwa ichi, titha kunena kuti pochiza odwala omwe ali ndi matenda a shuga, ndikofunikira kupititsa patsogolo njira yowunikira momwe zinthu zimayendera mu kagayidwe kazinthu, kuwunika mayendedwe a peroxide komanso njira yotsatsira antioxidant, yomwe ingalore kusankha komwe kumayesedwa ndikuwongolera chithandizo ndipo kungathandize kukwaniritsa cholinga chachikulu chothandizira - Kutalika ndi moyo wa odwala.

1.4. Cholinga chogwiritsira ntchito antioxidants pochiza matenda ashuga.

Mu diabetesology, zokumana nazo zapezeka ndikugwiritsa ntchito antioxidants ambiri. Kwenikweni, kuikidwa kwa antioxidant mankhwala a shuga kungakhale ndi zolinga ziwiri: kuletsa (kuchepetsa) kukula kwa matendawa, kupewa (kutsitsa) kukula kwa zovuta zake.

Zoyesa zamankhwala za nicotinamide mwa odwala omwe ali ndi mtundu wautali inewo zakhala zikuchitika kuyambira m'ma 80s.Zinawonetsedwa kuti kugwiritsa ntchito milingo yayikulu ya mankhwalawa (kakhumi mopitilira muyeso) kumalepheretsa kuchepa kwa ntchito ya P - maselo, monga momwe kungawonedwere ndi gawo la basal ndikuyambitsa C-peptide (Gorelysheva V.A. et al., 1996, Kolb N. et al., 1999, Pozzilli et al., 1999). Malinga ndi olemba angapo (Bondar I.A. et al., 2001, Hoorens A. et al., 1999, Kolb N. et al., 1999, Nerup J., 2000), nicotinamide therapy imabweretsa chiwonjezeko chachikulu cha kufalikira kwamankhwala matenda omwe amafunikira kuchepa kwa insulini ya exo native (Visalli N., et al., 1999, Greenbaum C.J., 1996) a - Tocopherol ndi free radical scavenger komanso antioxidant yayikulu yamapangidwe am'mimba: imodzi mwa mamolekyulu ake imateteza mamolekyulu 10,000 osapanga mafuta ma acid. Mphamvu yoteteza ya - tocopherol (15 mg / kg patsiku) pantchito ya maselo a P ili pafupi ndi nicotinamide (25 mg / kg patsiku) (Pozzilli P. et al., 1997). Mu kuyesa kwa vitro ndi zinyama, zidapezeka kuti - tocopherol imachepetsa kusokonekera kwa endothelial chifukwa cha hyperglycemia, imalepheretsa kuchulukitsa kwa mamolekyulu osungunuka komanso kusintha mapangidwe a kupumula kwa endothelial factor (nitric oxide - NO) (Frei B., 1999, Cowa D. et al., 1997, Bursell SE et al., 1999, Emmert DM et al., 1999).

Kafukufuku wa CHAOS adapeza kuti mavitamini E othandizira pa mlingo kapena ME / tsiku amatsogolera kuchepa (ndi 66%) pakuchitika kwa infarction yopanda magazi mwa odwala omwe ali ndi vuto la atherosclerosis ya angiographic, koma samatsatiridwa ndi kuchepa kwa kufa kwathunthu chifukwa cha matenda amtima (Stephens NG et .., 1996).

Ntchito yofananira ya kuzungulira kwa mavitamini E ndi C imatheka pokhapokha ndi kuchuluka kwa asidi m'thupi. (Balabolkin M.I. et al., 2000). Komanso, zikuwonetsedwa kuti mogwirizana ndi insulin ndi cholandilira chake pakufalikira kwa zinthu zoyipa za insulin, kupezeka kwa lipoic acid ndikofunikira. Lipoic acid amaperekedwa ngati cofactor mu ma enzyme ambiri ophatikizika, ndi "yoyera" padziko lonse yama radicals mahhala, komanso imathandizanso kubwezeretsa antioxidants ena mthupi. Ili ndi mphamvu yoteteza ndipo imalepheretsa kuwonongeka kwa DNA ndi ma free radicals: imalepheretsa kutsegulidwa kwa cholembera chinthu Nf-kB choyambitsa kupsinjika kwa oxidative, ndi chelator wachitsulo - Co, Cu, Cd, Ni, Zn, As, Fe, Mg ndipo amachita ngati complexon (Bababolkin M. Ndipo et al.,

2000, Perova N.V. et al., 2001, Okovitiy S.M. et al., 2002, Halliwell, W., 2000).

Zambiri zidapezeka pothandizidwa ndi selenium popewa nephropathy m'makola okhala ndi matenda amtundu wa 2 wofotokozedwa ndi streptozotocin. Hypoglycemic zotsatira za selenium zidatchulidwa kwambiri ngati zimagwiritsidwa ntchito limodzi ndi vitamini E. Selenium yachepetsedwa kapena kupangidwira kuchuluka kwa arachidonic acid mu impso za makoswe omwe ali ndi matenda ashuga, ndikuchepetsa pafupipafupi komanso kutha kwa kusintha kwa morphological (Christelec D. et al., 1999).

Zelinsky B.A. et al. Mu 1994 adawonetsa kuti kuphatikiza kwa unitiol mu zovuta zochizira odwala omwe amapezeka munthawi yomweyo a oksijeni ndipo tocopherol yatchulapo zabwino pa phospholipid metabolism ya seramu yamagazi ndi maselo ofiira amwazi, imathandizira kukhazikika kwa membrane wa cell ndikuwonjezera ntchito yake. Ndipo kuyambitsa kuyamikika kuphatikiza ndi ma antiplatelet othandizira odwala omwe ali ndi vuto la mtima wamatenda a shuga, malinga ndi zotsatira za II. Dedova (1998) et al., Kuthandizira pakukhazikika kwa njirayi mopitilira theka la zoyeserera zotsutsana za odwala. Phenolic antioxidants ionol ndi probucol adawonetsa kuthekera kosintha kusintha kwamankhwala komwe kumawoneka mu shuga ya alloxan (Bobyreva L.E., 1997, Tikhase A.K. et al., 1999).

M'zaka zaposachedwa, ofufuza ndi asing'anga awonjezera chidwi ndi gulu la madzi omwe amasungunuka ndi madzi, omwe amaphatikizapo zomwe zimachokera ku 3-hydroxypyridine, yomwe imatha kuchita zolumikizana zingapo za pathogeneis ya matenda osokoneza bongo. Maphunziro ochepa, kuphatikiza maphunziro ndi A.A. Nelaeva ndi E.A. Kashuba adawonetsa kuti kugwiritsa ntchito emoxipin kwa odwala omwe ali ndi matenda osokoneza bongo omwe ali ndi angiopathy ali ndi antioxidant, membrane-stabilizing, pamene amachepetsa pafupipafupi zovuta zama mtima kwa odwala.Izi zikuwonetsa kuti zotumphukira za 3-hydroxypyridine zitha kukhala ndi zochita za antidiabetes. Komabe, njirazi zidawerengedwa kale kwambiri mpaka pano. Tidatipangira kuti mankhwalawa ali ndi kusintha kwazomwe zimayambitsa matenda a shuga mellitus ndi zovuta zake, kutengera deta yomwe ikupezeka pazotsatira zamankhwala pamitundu ya matenda ena am'thupi.

1. Zotsatira za zotumphukira za 3-hydroxypyridine pa lipid peroxidation ndi mkhalidwe wam'mimba.

Mexicoidol (3-hydroxy-6-methyl-2-ethyl pyridine succine) ndi choletsa champhamvu cha njira za LPO, sichigwiritsa ntchito mphamvu zama radicals, imayendetsa superoxide dismutase, imasintha magawo a polar lipid (phosphatidylserine ndi phosphatidylinositis). , amachepetsa mamasukidwe akayimidwe, kumawonjezera madzi ake (Lukyanova L.D., 1999, 2000). Chifukwa cha kusintha kwa magwiridwe antchito a michere, mexidol imabweretsa kusintha kosakanikirana kwa ma macromolecule a mapuloteni, ma synapses, omwe ndi chifukwa chosinthira mphamvu ya mexidol pa zochitika za michere yam'mimba yolumikizana ndi michere ya ion ndi ma receptor, kukulitsa ntchito yawo ya ligand-binding, komanso zochitika za ma neurotransmitters. D. et al., 1993, A. K. Sariev et al., 2001). Kukhalapo kwa mexidol ndikusintha kwazomwe zimachitika mu mawonekedwe a ma synapses ndi njira zimawonetsa kuthekera kwa kusintha kwa mankhwalawa pa insulin cell receptors komanso kuthekera kwa mphamvu ya insulin.

2. Antihypoxic zotsatira zotumphukira za 3-hydroxypyridine.

Udindo wapadziko lonse wa hypoxia mu pathogenesis ya ndondomeko iliyonse imadziwika.

Vutoli limapezekanso mu tizilombo toyambitsa matenda ashuga mellitus. Emoxipin ali ndi zochita za antioxidant komanso zolimbitsa antihypoxic (Lukyanova L.D. et al., 1993), Mexicoidol ndi antihypoxant wamphamvu (Lukyanchuk V.D. et al., 1998, Lukyanova L.D. et al., 1999). Mphamvu yodzitetezera ya Mexicoidol imawonekera pamlingo wa thupi m'njira zosiyanasiyana za hypoxia. Komanso, imatha kuchepetsa kuwonongeka kwa ATP mu minofu pansi pa vuto la kuperewera kwa okosijeni, komanso kuchepetsa matenda amtundu wa oxidative phosphorylation, i.e. Ili ndi mphamvu yolimbikitsa (Devyatkina T.O. et al., 2000, Lukyanova L.D., 2002). Mphamvu yoteteza antihypoxic ya emoxipin ya ischemia imagwirizanitsidwa osati ndi mankhwala a antioxidant okha, koma ndi activation ya transamination reaction, yomwe imawonetsetsa kugwiranso ntchito kwakanthawi kothamanga kwa tricarboxylic acid mzunguko (Okovity S.V. et al., 2001). Mphamvu yotchulidwa ya antihypoxic ya Mexicoidol, yochokera pakukhathamiritsa kwa mphamvu yama cell, imatilola kuti tiziwona ngati adaptogen yothamanga pamavuto, kuwonetsedwa pazinthu zoopsa (Grechko A.T. et al., 1998, Smirnov L.D., 1998, Yasnetsov V.V. et al. ., 1999).

3. Mphamvu ya zotengera 3-hydroxypyridine pa lipid zikuchokera magazi seramu ndi njira ya IHD.

Monga tawonera kafukufuku woyesa ndi zamankhwala, a Mexicoidol adawonetsa kutulutsa kotsitsa kwa lipid ngati poyesera mtundu wamavuto amiseche (Inchina V.I. et al., 1996, 2000, Zorkina A.V., 1997, 1999.), pa mtundu wa dyslipidemia mu Akalulu (Keleinikov S.B., et al., 2000). Kuphatikizika kwapadera kwa hypolipidemic ndi antihypoxic kanthu kuwulula mphamvu ya mexidol mu matenda a mtima a ischemic ndi infarction ya myocardial. Emoxipin adawonetsa kukhudzika mtima kwa kuphatikizika kwa mtima mwa zoyeserera monga poyesera (Svetlikova I.V., 1994, Pashina I.V., 1995, Gatsura V.V. et al., 1996, Svetlikova I.V., Sernov L.N., 1996), komanso kuchipatala. Zabwino muzochitika za emoxipin ndi mexidol ndizosakhalapo, mosiyana ndi beta-blockers ndi calcium block blockers, a cardiodepressant action. Emoxipin adachepetsa kuchuluka kwa zigawo za arrhythmias, kuchuluka kwa kulephera kwa mtima, ndikuchepetsa mapangidwe a necrosis mwa odwala omwe ali ndi infarction yokhala ndi myocardial infarction (Lazebnik LB et al., 1994, Repin AN et al, 1994).Fomu ya pakamwa ya mexidol mexicor pa mlingo wa 0,3 g patsiku idachepetsa LPO, cholesterol yathunthu, cholesterol ya LDL, apo-B ndikuwonjezera cholesterol ya HDL mwa odwala matenda a coronary artery matenda (Mikhin V.P., 1998, 2002, Sernov L.N. et al. , 1998, Guranova N.I., 1998), idawongolera magwiridwe antchito am'mimba ndikuchepetsa kuchepa kwa magazi kwa magazi kumanzere kwamitsempha yamagazi (pichugin V.V., Sernov L.N., 1998, Mikhin V.P. et al., 2002). Mlingo wa mg / tsiku kwa masabata adakulitsa zochitika za ambulera AOS odwala a Mironov N.V. et al., 2002, Eremin P.A. et al., 2002, Katikova O.V. et al., 2002).

4. Anticoagulant, antiplatelet ndi antithrombogenic zotsatira za 3-hydroxypyridine zotumphukira.

Pakukhazikitsa njira zoteteza zomwe zimachokera ku 3-hydroxypyridine zotumphuka, mphamvu zawo za antithrombogenic ndizofunikira. Mexidol ndi zina zotumphukira za 3-hydroxypyridine zoletsa kuphatikizika kwa maselo, kuteteza maselo ofiira a hemolysis, kupewa oxidative kusintha kwa minofu ya thromboplastin, kuonjezera kuthekera kwa antithrombogenic kwa khoma lamankhwala poyesa atherosulinosis (Popov S.B., 1992, Spasov A.A. et al., 1997, 1999, Spasov A.A. et al., 1997, 1999, Spasov A.A. et al., 1997, 1999, Spasov A.A. et al. Nazipova D.A. et al., 1999, Vintin N.A., 1999, Bruttseva N.A., 2000, Gavrilova L.V., 2001).

Kuphatikiza kwa zinthu monga hypolipidemic, antithrombogenic, antiaggregant, antihypoxic kungakhale maziko oyesera pazoyeserera zomwe zingatheke popanga mankhwala a shuga. Mphamvu ya zotsatirazi, kuphatikizapo nootropic, imayankhanso ntchito yapamwamba kwambiri ya 3-hydroxypyridine derivatives (Mironov M.V. et al., 2001).

5. Mphamvu yotsutsa-yotupa komanso ya immunomodulatory ya 3-hydroxypyridine yotengera zinthu zingapo: kusinthika kwa mgwirizano wamgwirizano pakati pa macrophages ndi ma lymphocyte (Dorovskikh V.A. et al., 1999), kuwonjezeka kwa phosphoinositides komwe kumakhala ndi anti-yotupa mu maselo a cell (Bazanov B.vaz). et al., 1997, Demidova M.A., Popov D.A., 1999), kusinthidwa kwa ntchito ya cytochemical and phagocytic of granulocytes (Dubovskaya T.N., 1997).

Poganizira gawo la chitetezo cha chitetezo cha m'thupi, kuphatikiza kupangika kwa ma cellantibodies a cell pancreatic a shuga mellitus, mphamvu ya immunomodulatory ya 3-hydroxypyridine yotulutsa ikhoza kukhazikitsidwa pokonza insulin.

6. P kukhazikitsa antitoxic zotsatira za Mexidol, gawo lofunikira limaseweredwa ndi hepatoprotein effect.

Hepatoprotective katundu wa mexidol adapezeka mu mitundu yosiyanasiyana ya kuwonongeka kwa chiwindi .Atakhudzidwa ndi tetrachloromethane, mexidol adachepetsa gawo la chiwindi necrosis mu akalulu (Keleinikova T.T., 1997) Ndi mowa, mexidol adachepetsa kuwonongeka kwa hepatocytes ndikuwonjezera zomwe zidapangidwa ndi ma nucleic acid mwa iwo (Voron T.A et al., 1997). Mothandizidwa ndi hepatotropic carcinogen dinitrosamine, mankhwalawo adaletsa kusintha kwa khungu ndi P-450, potero amakhala ndi mphamvu yoteteza (Dumaev K.M. et al., 1995).

7. Nephroprotective zotsatira za zotumphukira 3-hydroxypyridine.

Munthawi ya zovuta za impobilization, Montidol adachepetsa kuchuluka kwa impso za kalulu, adachepetsa kuwonongeka kwa magazi, chotupa mu ziwiya za impso, adakulitsa kusefukira kwa chimpweya komanso chinsinsi cha impso.

Shirshikova O.V., 1997). Mankhwala anali ndi nephroprotective mu kuvulala kwa mankhwalawa (Korolkova E.E., 2000). Mu ntchito za Yu.I. Mashkov (2001), zotsatira zapamwamba zaexidol zinaululidwa mu zakumwa zoopsa za aminoglycoside ndi poyizoni wakupha ndi tetrachloride ya carbon. Wolemba adawonetsa kutetezedwa kwa mankhwalawa m'magazi a alloxan mu makoswe, pomwe Mexicoidol, mosiyana ndi dimephosphone ndi alpha-tocopherol, adakonza kuwonjezeka kwa msana wa triglycerides mu impso.

Chifukwa chake, popereka chidule cha zotsatira za 3-hydroxypyridine, chifukwa cha kuchuluka kwa zotsatira zake zamankhwala, kuthekera kuwongolera pafupifupi mbali zonse zazikulu zamatenda a shuga mellitus ndi activation ya LPO, membrane-chitetezo, Cardio-chitetezo, hepato-, nephro-, angioprotective zotsatira, ndi kukonza kwa hypercoagulemia , titha kuganiza kuti kugwiritsa ntchito mankhwala osokoneza bongo kukhala kotheka. Ndipo pogwiritsira ntchito njira yotchulidwa ya hypolipidemic ya mankhwala a gululi, kuteteza kwake kungakhale ndi kuphatikiza kwa matenda osokoneza bongo komanso chodabwitsa hypercholesterolemia.

Chithandizo chotsimikizika chokonza matenda a metabolic mu shuga ndi dimephosphon. Mu ntchito za Khafizyanova R.Kh et al., (1993, 1994) kunawonetsedwa kuti dimephosphon amalimbikitsa kuyambiranso kwa ATP nthawi ya ischemia, imathandizira ntchito ya antioxidant enzymes. Mankhwala amawonjezera • ntchito ya yofunika enzyme glycolysis ya pentose phosphate shunt ndi tricarboxylic acid circ (Anichkova L.I. et al., 1992), yachilendo, ei CBS mu acidosis, yomwe imayamba chifukwa cha kuchuluka kwa aimpso komanso m'mapapo a acid-base state, kuchuluka kwa magazi mkati ndi minofu kagayidwe. Lipophilicity imalola dimephosphon kulowa mkatikati mwa cell ya cell ndikupanga mawonekedwe a chosakanizira (Kinyabulatov A.I., 1996, Malyshev V.G., 1996). Zambiri zoyeselera zapezeka pa antistress zochita za mankhwalawa nthawi yayitali yolimbana ndi nkhawa (Zorkina A.V., 1994, 1997, Kudashkin S.S., 1996). Pakukhazikitsa njira yoteteza ya dimephosphone mothandizidwa ndi matenda osokoneza bongo a shuga ndi hypercholesterolemia, mphamvu yake yotsutsana, kuwonjezeka kwa ntchito ya glutathione peroxidase mu mtima, ubongo, ndi chiwindi ndizofunikira (Geraskina MA, 1997). Kafukufuku woyeserera akuwonetsa kuchuluka kwa mtima wa mankhwalawo. Dimephosphon ndi kuphatikiza kwake ndi dilzem ndi yaprilin amawonetsa anti-ischemic zotsatira zowonjezera zolimbitsa thupi komanso kuchepetsa myocardial misa (N. Tyuryakhina, 2000). Mitundu yosiyanasiyana ya mankhwala omwe amadza chifukwa cha mankhwalawa imapereka chifukwa cholosera mphamvu ya mankhwalawa mu shuga.

Chifukwa chake, kupenda kosindikizidwa kukuwonetsa kuthekera kwa zotsatira zabwino za mankhwala omwe ali ndi antioxidant zochita pamayendedwe a shuga komanso kuphatikiza ndi exer native hypercholesterolemia.

Mutu 2. Zipangizo ndi njira zakufufuzira

Malinga ndi zolinga ndi zolinga, mphamvu ya mexidol mu Mlingo ndi mg / kg, emoxipin muyezo wa 12.5 mg / kg, dimephosphone mu mlingo wa mg / kg ndi - tocopherol muyezo wa mg / kg pazizindikiro zina za carbohydrate, lipid, protein. kagayidwe, mkhalidwe wa lipid peroxidation dongosolo ndi antioxidant chitetezo m'magazi am'magazi komanso ziwalo zamkati za nyama zoyesera mothandizidwa ndi kuyesa kwa matenda a shuga mellitus ndi exo native hypercholesterolemia.

Kafukufuku woyeserera adachitika pamiyambo yoyera yomwe sinali mzere wa azimayi onse awiri olemera 20 g. Nyama zinagawika m'magulu:

I. Nyama yolimba, yomwe poyeserera yonseyi inkasungidwa pakudya kwa vivarium-10.

II. Nyama zomwe zimabayidwa ndi kuyimitsidwa kwamafuta kwa cholesterol pakapita masiku mg mg pa kilogalamu yanyama, zomwe kale zimasungunuka mu 0,5 ml ya mafuta a masamba. Pofuna kuwonjezera kupsinjika kwa peroxide, vitamini D adawonjezeredwa kwa emulsion pa mlingo wa ED pa kg iliyonse ya misa - 8.

III. Nyama zolandila pa os 0,5 ml ya mafuta a masamba - 8.

IV. Nyama zomwe zimayesa hyperglycemia - 12. Kuti apange mtundu wa njira yoyesera matenda osokoneza bongo, nyama nthawi imodzi, zimagwiritsidwa ntchito mosiyanasiyana muyezo wa mg / kg. Kuti apange shuga yokhazikika komanso yokhazikika, makoswe amasungidwa pakudya wamba kwa masiku.

V.Gulu lolamulira linali ndi nyama zomwe zimayesa matenda a shuga mellitus osakanikirana ndi exo native hypercholesterolemia - 10.

VI. Nyama zomwe zimayesa shuga mellitus pansi pazinthu za exer native hypercholesterolemia, nthawi yomweyo katundu wa cholesterol, amalandira tsiku ndi tsiku subcutaneous mexidol pa mlingo wa mg wa pa kilogalamu ya thupi la nyama - 8.

VII. Nyama zoyeserera hyperglycemia pansi pa exo native hypercholesterolemia, yemwe amalandila tsiku ndi tsiku subcutaneous mexidol pa mg wa kg pa kilogalamu ya thupi - 8.

Viii. Nyama zokhala ndi shuga woyesera kuphatikiza ndi hypercholesterolemia, zimalandira tsiku lililonse emoxypine mosadukiza pamiyeso ya 12,5 mg wa pa kilogalamu ya thupi la nyama - 8 patsiku.

IX. Nyama zomwe zimaphatikizidwa ndi mayesero a shuga a mellitus ndi hypercholesterolemia, omwe adalowetsedwa ndi dimephosphon tsiku lililonse pa mlingo wa mg wa pa kilogalamu - 8.

X. Nyama yokhala ndi kuphatikiza kwa shuga ndi njira yoyesera yoyeserera, yomwe masiku angapo, imalandira - tocopherol tsiku lililonse mg - kg - 8.

Imfa pakati pa makoswe omwe ali ndi matenda osokoneza bongo a alloxan anali 25%. Mu gulu loyendetsa, imfa inali 30%. M'magulu otsalawo, kufa kwanyama sikunachitike. Nyama zamagulu II-IV zinaphedwa tsiku la 15, magulu a V-X patsiku la 29 ndi kudzikongoletsa pansi pa mankhwala oletsa kupanikizika okhala ndi chakudya cham'mbuyo kwa maola 16. Asanagwe pansi pa antenhesia opepuka, nyama zonse zinajambula ECG pa njira yamagetsi yamagetsi imodzi pogwiritsa ntchito singano ma electrodes mumizere itatu (I, II, III), milozo itatu yosatulutsa (aVR, aVL, aVF) ndi kutsogolera kumodzi kwa chifuwa (V4).

Pamapeto pa kuyeseraku, nyama zonse zomwe zili mu seramu yamagazi zimayesedwa kuti zimapangitse chakudya, lipid (cholesterol yathunthu, triglycerides, P - lipoproteins, kuchuluka kwa lipoprotein cholesterol) ndi protein metabolism (mapuloteni onse, albumin), transaminase shughuli (ALT, ACT).

Kukula kwa lipid peroxidation kunaweruzidwa ndi zomwe zili mu plasma za nyama zoyesera zomaliza za lipoperoxidation - malondialdehyde (Konyukhova S.G., 1989). Mkhalidwe wa antioxidant udaweruzidwa ndi zomwe zimachitika mu plasma yamagazi a enzyme catalase (Korolyuk MA, 1988). Mkhalidwe wa lipid peroxidation ndi antioxidant chitetezo mu zimakhala zazinyama zimawunikidwa ndi zomwe malondialdehyde ndi zochitika za catalase mu homogenates a myocardium, chiwindi, ndi impso.

Zochitika myocardial bioelectric zidayesedwa ndi kutalika kwa nthawi ya PQ, kukula kwa kusiyana kwa nthawi ya QT, komanso kusintha kwa nthawi ya QT, yokonzanso kuchuluka kwa mtima.

2.1. Zinthu zophunzirira

Zinthu zofufuzirazi zinali magazi ndi minofu (myocardium, chiwindi, impso) zama mbewa yoyera. Magazi amatengedwa pambuyo pochita kusamba, amasungidwa kwa ola limodzi kutentha kwa chipinda ndikugwiritsira ntchito plasma.

Kuti mupeze madzi a m'magazi, magazi anali mkati mwa mphindi 30 pa TsRL-1 centrifuge.

Kupeza minofu homogenates.

Pomaliza kuyesera, nyamazo zinali kuperekedwa nsembe, m'mimba mwake munatsegulidwa ndipo chiwindi ndi impso zimachotsedwa, ndiye kuti chifuwacho chatsegulidwa ndipo mtima wake udachotsedwa. Impso zinkamasulidwa m'mbale. Tizidutswa tating'onoting'ono timadulidwa ndi lumo, timatsukidwa kwathunthu ndimagazi ndi 0.9% sodium chloride solution, yowuma ndi pepala la fayilo ndikuyika ayezi. Zitsanzo za minyewa yokonzekera phunziroli zimayikidwa mudongo. Pogwiritsa ntchito pestle yopukutira, homogenization yokwanira idapangidwa mu chosungunulira chomwe chimasankhidwa kuyesa (0,9% sodium chloride solution) mu chiyerekezo cha 1: 9

2.2. Njira zofufuzira

Mu seramu yamagazi, magawo a lipid metabolism adawerengedwa: cholesterol yathunthu, triglycerides, kuchuluka kwa choleopolotein cholesterol pogwiritsa ntchito Olvex reagent kits pogwiritsa ntchito FP-901 biochemistry analyzer (Finland).Kudzipereka kwa ndende ya (3 - lipoproteins kunachitika ndi enzymatic colorimetric njira pa KFK-3 magetsi photocalorimeter.

Ntchito za ma Alym ndi ma AcT enzymes zimatsimikiziridwa pa masterite ya Hospitex Screen kuphatikiza theka-automatic analyzer (Switzerland) yokhala ndi ma diagnostic azachipatala a Hospitex.

Mapuloteni onse adawunika ndi zotsatira za biuret, zidutswa za mapuloteni zimatsimikiziridwa ndi electrophoresis ya kampani yaku Swiss "Hospitex" yokhala ndi kompyuta.

Tanthauzo la MDA (Konyukhova S.G., 1989).

Kuti mudziwe plasma MDA, makulitsidwe obisika omwe ali ndi 0,5 ml ya zinthu zoyeserera, 0,5 ml ya madzi osungunuka ndi 0,6 ml ya TBA mu glacial acetic acid imawiritsa kwa mphindi, ndipo pambuyo pozizira, onjezani 5 ml ya KOH ndi ml ya isopropyl mowa. Centrifuged pa 6000 rpm. mkati mwa min Mu centrifugate, timazindikira kuyamwa kwa ndi nm motsutsana ndi kayendedwe kamene kali ndi madzi m'malo mwa zida zoyeserera. Kusiyana kwa kupyola kwa kuwala kumakhala ngati zomwe zili mu MDA. Posankha zomwe zili mu MDA mu minofu homogenates, mapuloteni ovuta a lipid adakhazikitsidwa ndi trichloroacetic acid.

Zochita za Catalase zimatsimikiziridwa mu plasma ndi minofu homogenates ya nyama yoyesera.

Kutsimikiza kwa ntchito za catalase (Korolyuk MA, 1988).

Njira yodziwira ntchito ya catalase imakhazikitsidwa pakuwongolera kusintha kwa kachulukidwe ka kuwala chifukwa cha kulumikizana kwa hydrogen peroxide (WH2 02) ndi mchere wa molybdenum.

Posankha zochita za catalase, 0,13 ml ya H202 (pepala lopanda kanthu lomwe lili ndi madzi osungunuka) linawonjezeredwa ndi 0,5 ml ya madzi achilengedwe. Pambuyo mphindi, anachita anasiya ndi 4 ml ya ammonium molybdate. Kukula kopanga utoto kunayezedwa pa SF - pamlingo woyeserera wa nm motsutsana ndikuwongolera kwa H2 ndikuwonjezeranso kwa ml ya H2O - gawo lomaliza la dilution.

2.3. Chizindikiro cha gulu lazachipatala

Mu chipatalachi, chitetezo cha mankhwala omwe amaphunziridwa chinaphunziridwa mwa odwala omwe ali ndi matenda a shuga.

Odwala omwe ali ndi vuto lachiwiri la matenda ashuga adayesedwa pamaziko a dipatimenti yachipatala ya City Clinical 4 ya Saransk. Odwala anali pa nthawi yodwala matenda a shuga ndipo analandila chithandizo chokwanira, kuphatikiza mankhwala a hypoglycemic, mankhwala a metabolic, mankhwala omwe amasintha microcirculation, antihypertensive mankhwala. Odwala onse anali okhazikika ndi jenda, zaka, kuuma komanso kutalika kwa matendawa, kupezeka kwa matenda amtunduwu. Mwa odwala omwe amayesedwa 41% ya amuna achimuna, 59% achikazi, 4,5% pagulu kuyambira zaka, 45.45% azaka zapakati, 31.82% azaka zapakati pa 18 zaka, 18.18% wamkulu kuposa zaka. 22.73%) odwala omwe ali ndi matenda a shuga mpaka zaka, 36.36%) a odwala omwe ali ndi zaka kuyambira zaka mpaka zaka, 31-81%) amadwala matenda a shuga kuyambira zaka mpaka zaka ndi 9.09%) pazaka zambiri. 45.45%) pagulu lofufuziroli anali ndi matenda oopsa a shuga, 54,55% mwa iwo anali ndi matenda oopsa a shuga. Mwa odwala onse omwe adawunikidwa, matenda oyanjana ndi mawonekedwe a IHD, matenda oopsa, ndi ena otere adawululidwa.

Gawo la kafukufukuyu linali magazi athunthu a odwala. Magazi oti ayang'anitsidwe adatengedwa kuchokera kumitsempha ya ulnar pamimba yopanda kanthu.

Mu ntchitoyi, momwe mankhwala a lipid peroxidation amathandizira (ozungulira komanso othandizira), mkhalidwe wa antioxidant mu plasma yamagazi ndi erythrocyte, kuchuluka kwa glycemia, ntchito ya hemoglobin glycation panthawi yomwe akupanga malo okhala ndi magazi athunthu a odwala omwe ali ndi matenda a shuga.

Mwa izi, kafukufuku wonse adagawika m'magulu awiri: mndandanda wa 1 ndiwowongolera komanso wophatikizira machubu omwe anakhazikitsidwa popanda mankhwala, mndandanda wa 2 unapangidwa ndi mexidol pamlingo wa 0.005 mg pa ml ya magazi, mndandanda wa 3 unapangidwa ndi mexidol pa mlingo wa 0,025 mg / ml ya magazi, mndandanda wa 4 unapangidwa ndi emoxipin pa mlingo wa 0,0125 mg / ml wa magazi, mndandanda wa 5 unapangidwa ndi dimephosphone pamlingo wa 0,050 mg / ml wa magazi.

Gulu loyerekeza linali ndi anthu amibadwo yathanzi (ndi izi).

Kuwunika kukula kwa lipid peroxidation kunachitika ndi kuchuluka kwa madzi am'magazi komanso erythrocyte odwala omwe ali ndi matenda osokoneza bongo a lipoperoxidation yachiwiri ya lipoperoxidation mankhwala a malondialdehyde panthawi yomweyo komanso momwe amapangira lipid peroxidation malinga ndi njira ya S. Konyukhova et al. (1989). Kuti mupeze ntchito ya Fe-induction lipid peroxidation, ml ya yankho la 0,05 M wa iron sulfate idagwiritsidwa ntchito.

Malo okhala ndi lipid a peroxidation mu plasma ndi erythrocyte omwe ndinatsimikiza ndikuwerengetsa masamu malinga ndi kakhazikidwe: Fe-MDA - MDA / MDA (Kuzmenko D.I., Laptev B.I., 1999).

Mkhalidwe wa antioxidant dongosolo adaweruzidwa ndi zomwe zimachitika mu seramu yamagazi ndi erythrocyte odwala omwe ali ndi puloteni yayikulu yomwe imalepheretsa hydrogen peroxide, catalase (Korolyuk MA, 1988).

Mwazi wamagazi unatsimikiziridwa ndi njira ya glucose oxidase yogwiritsira ntchito muyezo wa Photoglucose reagent kit (Moscow).

Kukula kwa hemoglobin glycation kunaweruzidwa ndi mulingo wa glycogemoglobin pamayeso apakati. Zolemba zake zidatsimikizika pogwiritsa ntchito kampani ya Bio-LA-Test "Pliva-L lla", (Czech Republic) pa wasantimu wa biochemical. Mfundo za njirayi ndikuti mawonekedwe osasunthika a glycohemoglobin ali ndi 1-deoxy- (TM - valyl) fructose, yemwe amachoka ndi phosphoric acid kuti apange mtundu wa zovuta ndi adsorption pazokwanira ku nm. Palibe mtundu wa glycogemoglobin kapena fetog hemin womwe sungasokoneze kutsimikiza mtima.

Kusakaniza kwa makulitsidwe kunasinthidwa kuti zidziwike pazomwe zimaphunziridwa pamphindi zoyambirira komanso pambuyo pa tsiku la makulidwe a kutentha kwa firiji. Kudzipereka kwa shuga m'magazi a seramu kunachitikanso ola limodzi pambuyo poyambira makulitsidwe.

Zotsatira zonse zomwe zapezedwa zidakonzedwa pamakompyuta pawokha pogwiritsa ntchito pulogalamu ya Excel. Kufunika kwa kusiyana kunayesedwa ndi zotsatsa za Student.

Mexicoidol (3 - hydroxy - - methyl - - ethylpyridine -) - anti-soluble antioxidant - mawonekedwe analogue ophatikizana ndi gulu la Vitamini B6. Malinga ndi kapangidwe kazomwe zimapangidwira, mexidol ndi mchere wa succinic acid.

Zotsatira za pharmacological za Mexicoidol N

Ianenanso antioxidant ndi zoteteza khungu lanu, zimalepheretsa lipid peroxidation, mogwirizana ndi lipid peroxides. Phenolic ndi hydroxyl radicals a peptides ndi mapuloteni (Smirnov J1. D., 1995, 1998, 1999, Lukyanova L. D. et al., 1999).

Montidol imawonjezera ntchito ya ma antioxidant enzyme omwe amachititsa kupanga ndi kumwa kwa lipid peroxides, komanso mitundu yogwira ya oxygen. Imakhazikitsanso michere ya michere, imakhala ndi malangizo a lipid. Kuchulukitsa kulumikizana kwa zigawo za polar lipid - phosphatidyl serine ndi phosphatidyl inosine, kutsitsa kuchuluka kwa cholesterol / phospholipids, potero kumachepetsa kuyang'ana kwa lipid wosanjikiza (Smirnov L.D., 1995, Inchina V.I. et al., 1996, 2000, K. Dumayev, M.M. . et al., 2002)

Gulu la mexidol (3 - hydroxypyridine) limalumikizana ndi zinthu zachilengedwe, limalowa mkati mwake, zomwe zimapangitsa kukonzanso ndikupanga zovuta kwa mitundu ya okosijeni yolowera zotsalira zamafuta acid - magawo a lipid peroxidation reaction. Mexidol imatchulidwanso cyclic nucleotide phosphodiesterase inhibitors, imawonjezera zomwe zili za cAMP, kutsika kwa mapulateleti am'munsi, komanso zimakhudza kagayidwe ka mphamvu.

Mexicoidol imatha kukhala ngatioteteza pokhapokha pakuchita zinthu zowonongeka zosiyanasiyana ndikuwonetsa ntchito yowonjezera ngati nembanemba, wailesi, chithunzi, hepatoprotector.

Zimaphatikiza zomwe zimapangitsa kuti pakhale ma tranquilizer ndipo mankhwala a nootropic ali ndi antihypoxic ndipo samaphwanya hemodynamics.

Zotsatira zamatsenga a dimephosphone

1,1 - Dimethyl - - oxobutylphosphonic acid dimethyl ether

Zotsatira zam'magazi a dimephosphone ndizosiyanasiyana.Mankhwala amachititsa hypothermic zotsatira, antidote zotsatira za poizoni ndi cholineterase zoletsa, antacid zotsatira, linalake ndipo tikuwonetsa ntchito za ma enzymes angapo, zimapangitsa kupangika kwa mahomoni ena, kuwonetsa ntchito ya neurotropic (Garaev RS, 1969, Gataulin I.A., 1980, Latfullin IA. , 1985, Anichkova L.I. et al., 1991, Khafizyanova R.Kh., 1994).

Mawonekedwe osiyanasiyana a pharmacotherapeutic zotsatira za dimephosphone apezedwa ndikufufuzidwa - anti-yotupa, machiritso a bala, kusakhazikika, antihistamine ndi anti-serotonin (Svyatkina O.B., 1987, Blatun L.A. et al., 1991, Ziganshina L.E. et al., 1992).

M'maphunziro angapo, njira zomwe zimapangitsa kuti dimephosphon azigwira ntchito yophatikiza ma cellels aopereka amoyo wathanzi, omwe amawonedwa ngati chitsanzo cha momwe masinthidwe ama cellular anaphunzirira. Zinapezeka kuti mankhwalawo amalepheretsa kuphatikizana kwa mapulateleti opangidwa ndi ADP ndi adrenaline.

Kuwongolera kwamakina a pharmacological a dimephosphone, komwe kumayang'ana madera omwe mankhwalawa amagwiritsidwa ntchito ngati mankhwalawo, akuphatikizira kukangana kwake pakugwira ntchito kwa intracellular Ca2 + ngati mthenga wachiwiri. Mapeto a zochita za dimephosphon adzawonetsedwa ndi kuponderezedwa kwa ntchito zama cell mothandizidwa ndi olimbana ndi zakuthupi - kutchulidwa kwa anti-H1 receptor zotsatira ndi zotsatira zoyipa pamlingo wa H2 receptor activation. Kusinthasintha kwa mankhwala kumalumikizidwa ndi mawonekedwe a mgwirizano wapakati pa machitidwe a intracellular apakati.

Zotsatira zamatenda a vitamini E

Udindo wofunikira pakukhazikika kwadongosolo losasintha la maselo ali ndi vitamini E, yemwe ali ndi katundu wa antioxidant.

CH3 sn2- (CH2-CH2-CH-CH2) 2- (CH2) 2-CH sn.

Mawu akuti "vitamini E" amatanthauza zachilengedwe zomwe zimapanga mafuta osakanikirana (ma tocopherols). Omwe amagwira ntchito kwambiri ndi alpha-tocopherol. Alpha tocopherol amalowetsedwa mu dongosolo la lymphatic ndikumayendetsa molumikizana ndi ma chylomicrons. Mu plasma, alpha-tocopherol imapezeka m'magulu onse a lipoprotein, koma kuchuluka kwake kwakukulu kumalumikizidwa ndi apo-B-lipoprotein. M'maselo, zomwe zimakhala ndizopezeka mu mitochondria ndi endoplasmic reticulum. Ntchito yayikulu ya alpha-tocopherol ndikukhazikitsa mawonekedwe komanso magwiridwe antchito a michere. Alpha-tocopherol acetate ndi mafuta ofunikira kwambiri osungunuka a phenolic mtundu, imagwira ntchito ngati cholembera pa lipid peroxidation, imapereka mapangidwe osagwira, osagwirizana ndi mayendedwe a lipid peroxidation, radicals (Erin A.N. et al., 1998).

Ma radical awa ndi okhazikika, chifukwa ma elekitiromu osalumikizidwa a atomu ya oksijeni mu mawonekedwe a C-6 amatha kusunthidwa mu mawonekedwe a mphete yofukizira, potero amawonjezera kukhazikika kwawo.

Kuli kudziwika kuti alpha-tocopherol imakhazikitsa gawo la lipid la menbranes yachilengedwe mwa maselo osachepera, kuteteza motsutsana ndi: a) lipid peroxidation, b) zowonongeka za singlet oxygen, c) kuwonongeka kwa phospholipid chifukwa cha phospholipase A2, d) kukhazikika thupi (microviscosity) ya lipid bilayer. Kuphatikiza pa ntchito ya "quenchers" yama radicals osasunthika komanso ma cell a cell cell, vitamini E imayendetsa michere ya enzymatic antioxidant, ndikuwonjezera ntchito ya glutathione peroxidase (Vasilieva O.V. et al., 2000).

Mutu 3. Zotsatira za mexidol, emoxipin, dimephosphone ndi α-tocopherol pazizindikiro zina zama metabolic komanso zothandiza za makoswe oyera omwe ali ndi zotsatirapo za alloxan ndi exo native hypercholesterolemia.

3.1. Zotsatira za mexidol, emoxipin, dimephosphone ndi - tocopherol pa carbohydrate metabolism mu makoswe oyera omwe amayesa matenda a shuga mellitus motsutsana ndi maziko a hypercholesterolemia.

Kuwerenga momwe zotsatira za kuyesa matenda ashuga zam'mimba zimayendera matenda a hypercholesterolemia pamatenda a carbohydrate metabolism, kusintha kwakuthwa mu magawo omwe aphunziridwa a magazi owonongera a nyama zoyeserera adawonetsedwa.

Kukhazikitsidwa kwa makoswe a alloxan muyezo wa mg / kg kunathandizira kuwonjezeka kwakukulu kwa magazi seramu glucose (kuyambira 5.42 ± 0.10 mmol / L mpaka 9.85 ± 0.43 mmol / L, P 0.05 6.25 ± 0, 20 P 0.05 Pi 0.05 P2> 0.05 P2 0.05

Mu% ya 135.20 87.50 87.50 124.79 192.71 121.21 110.43 114.09 119.51 114.42 mosavuta

% Of control 100.0 62.71 57.09 58.99 61.82 59.19

HDL cholesterol, 2.24 ± 1.80 + 2.48 ± 0.15 0.79 ± 0.04 0.59 ± 0.06 1.60 ± 0.05 1.85 ± 0.04 1.63 ± 0.03 1.46 ± 0.05 1.48 ± 0.07 mmol / L 0.08 0.05 P> 0.05 P 0.05 10.50 ± 0.67 P 0.05 Pi 0.05 Pi 0.05 8.67 ± 0.67 P 0.05 0.47 ± 0.02 P> 0.05 1.47 ± 0.02 P 0.05 0.65 ± 0.03 P emoxipine 12.5 mg / kg> mexidol mg / kg> a- tocopherol mg / kg> dimephosphon mg / kg. Mlingo wa - cholesterol motsutsana ndi kukhazikitsidwa kwa Mexicoidol pamwala wa mg / kg ukuwonjezeka kuchokera ku 0.59 ± 0.06 mmol / L mpaka 1.85 ± 0.04 mmol / L, i.e. nthawi zopitilira muyeso wowongolera. Mu emoxipin ndi mexidol mg / kg, njira yofananirana yamankhwala idawululidwanso pamayesedwe: kuchuluka kwa cholesterol ya HDL m'magulu awa kunakwera kufika ku 1.63 ± 0.03 mmol / L ndi 1.6 ± 0.05 mmol / L ndipo kudutsa ulamuliro mwa 178 , 63% ndi 173.50%, motsatana.

Kukhazikitsidwa kwa - tocopherol ndi dimephosphone kunathandizira kukulira kwakukulu pamlingo wapamwamba kwambiri wa lipoprotein cholesterol ku 1.48 ± 0.07 ndi 1.46 ± 0.05 mmol / L.

Chifukwa chake, kufupikitsa mphamvu yazomwe zimaphunziridwa za metabolid ya lipid, titha kunena kuti zotsatira za kuchuluka kwa nyama pamiyeso yoyeserera zimathandizira kukulira kwa zovuta zotchedwa lipid metabolism, zomwe zimayendetsedwa ndi kuwonjezeka kwakukulu pamlingo wa (3-lipoproteins and triglycerides, ndi 80.0% ndi 193.60%, zomwe zimaposa Zizindikiro zowoneka motsutsana ndi maziko a kuchepa kwa cholesterol ya HDL ndi 64.69% yazotsatira. Kusintha uku kunadziwika monga dyslipidemia ya matenda ashuga. Kuphatikiza kwa shuga ndi cholesterol katundu ndizofunikira komanso zofunikira. Zidakulitsa chisokonezo chomwe chidayamba, ndikuwonjezera kuchuluka kwa gawo la atherogenic la lipoproteins ndi triglycerides, lomwe limapitilira zizindikiritso za matenda a shuga a alloxan zoposa chinthu.

3.3. Kupanga kwamapuloteni kwathunthu mapuloteni ndi albumin mu makoswe oyera ndi kuphatikizika kwa alloxan ndi cholesterol katundu.

Matenda a shuga ndi matenda amtundu wa endocrine omwe amayenda limodzi ndi kuphwanya mitundu yonse ya kagayidwe, kuphatikizapo mapuloteni. Izi zimawonetsedwa makamaka pakuchepa kwa kaphatikizidwe ka mapuloteni komanso kugwiritsa ntchito kwakukulu ngati mphamvu yamagetsi. Kuphwanya kapangidwe kake ndi kuwonongeka kwakumapuloteni ndizodziwikiratu chifukwa chakuyambitsa kwa michere ya proteinolytic yomwe imathandizira kuwonongeka kwake (Lapteva NN, 1989), komanso chifukwa cha kutseguka kwa lipid peroxidation, komwe kumayambitsa kuwonongeka kwa ziwalo za hepatocytes zomwe zimayambitsa kapangidwe kake (Matyushkin B.N. , Loginov A.S., 1996). Kulepheretsa kwa kaphatikizidwe ka mapuloteni kuchokera ku amino acids ndikofunikira kuti mapangidwe a chakudya azikhala kwa iwo. Chifukwa chake, mavuto a metabolic mu shuga mellitus amadziwika ndi kuchepa kwa kaphatikizidwe ka mapuloteni komanso kuthamanga kwa mapuloteni othandizira, zomwe zimapangitsa kuti asakhale ndi nayitrogeni bwino.

Poyerekeza ndi kukhazikitsidwa kwa alloxan, mawonekedwe a metabolic a metabolic komanso opuwala opanga chiwindi pantchito yofufuzira adadziwonetsa okha pakusintha kwakukulu mu magazi a seramu a nyama zoyesera mapuloteni onse ndi albumin. Patsiku la 14 pambuyo pa kukhazikitsidwa kwa alloxan, kuchepa kwakukulu pazomwe zili ndi mapuloteni onse ndi albumin zidadziwika (Table 3.3.1). Chifukwa chake, kuchuluka kwa mapuloteni onse kunachepa kwambiri kuchokera pamlingo wazinyama 61.85 ± 1.85 g / l mpaka 42.46 ± 0.96 g / l, P 0.05 95.11 46.33 ± 0.67 P> 0 05 95.30

Masamba 60,58 ± 0.88 97.94 47.33 ± 1.33 97.36 mafuta P> 0.05 P> 0.05

Alloxan 42.46 ± 0.96 59.54 36.83 ± 1.17 75.76 mg / kg P 0.05). Kukhazikitsidwa kwa a-tocopherol kwathandizira kuwonjezeka kwakukulu kwa kuchuluka kwa mapuloteni onse kukhala 57.17 ± 1.83 g / l, omwe anali 23,81% kuposa mphamvu zowongolera 46.17 ± 1.17 g / l ndipo sanangofika 7.59% mulingo woyenera. Potengera zomwe zimachitika pazakudya zonse za protein, mexidol pa mlingo wa mg / kg ndi - tocopherol anali ofanana. M'magawo awa, kuwonjezeka kwa kuchuluka kwa mapuloteni onse ndi 22.38% ndi 23,81%, motsatana. Dimephosphon anali wocheperako poyerekeza ndi mankhwala ena omwe anaphunziridwa molingana ndi kuopsa kwa kuwongolera, koma kuchuluka kwa mapuloteni onse kunalinso kodalirika ndipo kunali 19.13% yolamulira.

Malinga ndi momwe mankhwalawo amagwirira ntchito pokonza zomwe zili mu albumin, mankhwalawo akhoza kuphunzitsidwa motere: Mexicoidol mg / kg> Mexicoidol mg / kg> Emoxipine 12.5 mg / kg.

Poyerekeza ndi kukhazikitsidwa kwa mexidol pamwala wa mg / kg, mulingo wa albumin unakulirakulira kuchokera pamitengo ya 32.96 ± 1.55 g / l mpaka 46,52 ± 0.87 g / l, kupitilira ndi 41.11%, koma sunafike nyama zolimba ndi 4.33%.

Mankhwala kukonza kukonza mapuloteni kagayidwe mu makoswe oyera chifukwa cha kuphatikizika kwa alloxan ndi hypercholesterolemia M ± m

Series Total protein, g / l In% to lead In% to control Albumin, g / l In% to B% to control

Njira 61.85 ± 1.85 48.62 ± 1.72

Alloxan + cholesterol 46.17 ± 1.17 P 0.05 91.35 122.38 46.52 ± 0.87 P> 0.05 Pi 0.05 Pi 0.05 Pi 0.05 P2 0.05 P2 0 05 P, 0.05 92.41 123.81 30.40 ± 1.47 P 0.05 P2 0.05 P> 0.05

Alloxan 1.61 ± 0.05 + 97.55 1.45 ± 0.08 + 79.75

135 mg / kg P emoxipin. A-tocopherol ndi dimephosphone adawonetsa kufananiza kwamankhwala: mulingo wa ALT mndandanda uno anali 1.10 ± 0.11 mmol / L ndi 1.10 ± 0.06 mmol / L, omwe anali 37,54% ndi 37.37% kuwongolera moyenerera. Chiwerengero chakuchepa kwa ntchito za ACT m'maguluwa, kuwerengedwanso ndikuwunika, anali 26.94% ndi 22.70%, motsatana.

Mgulu la nyama zomwe zimalandila emoxipin, kuchepa kwa mulingo wa ALT ndi 57.17%, AcT ndi 20.84% ​​kulembedwa poyerekeza ndi kayendedwe, i.e. ochepa pharmacological kwenikweni.

Zotsatira za mexidol, dimephosphone, emoxipin ndi - tocopherol pa zochitika za transaminases mu magazi seramu yoyera makoswe atayatsidwa alloxan ndi hypercholesterolemia M ± m

AlT mndandanda, mmol / L Mu% kuti mutsitse%% kuwongolera AcT, mmol / L Mu% kuti B% ithe

Zovuta 0.82 ± 0.06 0.81 ± 0.06

Alloxan + cholesterol 2.93 + P 0.05 Pi 0.05 132.20 36.96 1.10 ± 0.07 P 0.05 135.94 71.71

Alloxan + cholesterol + mexidol 25 mg / kg 0.97 ± 0.06 P> 0.05 Pi 0.05 149.1 79.16

Alloxan + cholesterol + dimephos-phon mg / kg 1,09 ± 0,06 Р 0,05 133,50 37,37 1,18 ± 0,04 Р 0,05 145,66 77,30

Alloxan + cholesterol + a-tocopherol mg / kg 1.10 ± 0.11 P 0.05 134.80 37.54 1.12 ± 0.08 P 0.05 138.42 73.06

Chidziwitso: P - tanthauzo la kusiyana komwe kuwerengedwa poyerekeza ndi mulingo woyenera, Pi - mpaka kuwongolera (alloxan + cholesterol), P2 - ku data ya alloxan + cholesterol + mexidol gulu mg / kg

Chithunzi 3.4.1 Zotsatira za ma antioxidant ena pantchito ya transaminase mu seramu yoyera yama mbewa yoyera chifukwa cha kuphatikizika kwa alloxan ndi exo native hypercholesterolemia (%%)

1 - nyama zolimba, - gawo lolamulira (matenda ashuga mellitus + hypercholesterolemia), - alloxan shuga + hypercholesterolemia + mexidol mg / kg, - alloxan shuga + hypercholesterolemia + mexidol mg / kg, - alloxan shuga + hypercholesterolemia, / emgipin 12 kg - alloxan shuga + hypercholesterolemia + dimephosphone mg / kg, - alloxan shuga + hypercholesterolemia + a-tocopherol mg / kg, * - tanthauzo la kusiyana limawerengeredwa pokhudzana ndi data yolamulira

Chifukwa chake, zikutsatira kuchokera pamwambapa kuti kuyendetsa alloxan kuyesa nyama ndikuyendetsa kwa cholesterol kumayambitsa kukula kwa cytolytic syndrome, monga zikuwonekeranso ndi kuwonjezeka kwakukulu kwa ntchito ya alanine ndi proteic transaminases m'magulu awa. Kuphatikiza kwa zinthu izi kumachulukitsa citrlysis. Mexicoidol imakonzedwa bwino ndi zovuta zomwe zimachitika, zimathandizira kubwezeretsa ntchito ya ALT kuzikhalidwe zoyandikira kwambiri. Komabe, ntchito ya ACT imakhala yokwezeka m'mitsempha yamagazi ngakhale nthawi yamankhwala, yomwe imawonetsa kusintha kwina kosasintha m'thupi la nyama zoyeserera.

5.5. Zotsatira za mexidol, emoxipin, dimephosphone ndi - tocopherol pa electrophysiological zochita za myocardium poyesa matenda a shuga mellitus pansi pazikhalidwe za exer native hypercholesterolemia.

Choyambitsa chachikulu cha kupunduka kwakukulu ndi kufa kwa odwala omwe ali ndi matenda ashuga ndi matenda amtima (kulowerera m'mitsempha, vuto la mtima, sitiroko, zotumphukazo za angiopathies) (Shestakova MV, 2002). Udindo waukulu pakukula kwa mtima wamavuto a shuga mellitus ndi wa oxidative nkhawa ndi sanali enzymatic autooxidative glycosylation (Balabolkin M.I. et al., 1999). Njira izi zimawononga osati ma mtsempha wamagazi okha, komanso myocardium, popeza ma radicals aulere, mapuloteni ophatikiza ndi okosijeni amakhala ndi mphamvu yowonongeka pamitsempha yama mtima ndi ma cell a mtima dongosolo la conduction, amathandizira apoptosis, omwe amathandizira kusokoneza ntchito ya bioelectric ya myocardium (Karpov Yu. 2002). Chifukwa chake, kuphunzira za kuthekera kwakukonza magwiridwe antchito mothandizidwa ndi antioxidants ndichosangalatsa.Mu ntchitoyi, tidafufuza za mexidol, emoxipin, dimephosphone pazinthu zina zamagetsi zamagetsi myocardium molumikizana ndi zotsatira zoyesa za matenda a shuga a mellitus ndi hypercholesterolemia.

Monga zotsatira za maphunziro athu (Gawo 3.5.1) zikuwonetsa, kuyambitsidwa kwa mafuta a cholesterol mu nyama zoyesera kunathandizira kukulira kwakukulu kwa kuthamanga kwa mtima (HR) kuchokera pa 397.06 ± 15.46 mpaka 513.0 ± 37.77 pamphindi, yomwe ili 29.20 % yapitilira mulingo woyenera. Mu gulu la alloxan, palibe kusintha kwakukulu pamlingo wamtima komwe kunachitika. Kuphatikiza kwa mayesero a shuga a mellitus ndi exo native hypercholesterolemia kunawonetsa chizolowezi chowonjezera kugunda kwa mtima mpaka 418.40 ± 16.10 pamphindi, zotsatira izi sizinali zosadalirika. Poyerekeza zotsatira zomwe zapezeka m'magulu okonza ndi zisonyezo zowongolera, tinapeza kuti: modalirika kukonza mtima, kubwezeretsanso ku mfundo zosavuta, mexidol muyezo wa mg / kg (kutsika kwa kugunda kwa mtima kuchokera 418.40 ± 16.10 pamphindi kuwongolera mpaka 387.80 ± 14.84 pamphindi), emoxipin pa mlingo wa 12,5 mg / kg (mpaka 376.95 ± 23.32 pa mphindi) ndi - tocopherol (mpaka 391.5 ± 27.7 pamphindi).

Pogwira ntchitoyi, tidatsimikiziranso kutalika kwa nthawi ya PQ kuti tiwone mayendedwe a atrioventricular conduction. Zinawonetsedwa kuti kukhazikitsidwa kwa matenda a shuga m'magulu oyesera kunathandizira kukulira kwa nthawi yayitali ya PQ kuchokera 50.0 ± 2.86 ms mpaka 61.25 ± 2.19 ms, P 0.05 0.51 ± 0.03 P> 0, 05

Alloxan mg / kg 381.36 ± 22.30 P> 0.05 61.25 ± 2.19 P 0.05

Alloxan + cholesterol 418.40 ± 16.10 P> 0.05 63.30 ± 3.18 P 0.05 P, 0.05 Pi> 0.05 P2> 0.05 8.57 ± 0.45 P> 0.05 P, 0.05 0,50 ± 0,02 P> 0.05 P, 0.05

Alloxan + cholesterol + mexidol 25mg / kg 427.78 ± 18.20 P 0.05 51.67 ± 2.78 P 0.05 P, 0.05 Pi 0.05 P,> 0.05 P2> 0.05 8.33 ± 0.56 P> 0.05 P, 0.05 0.52 ± 0.04 P> 0.05 Pi 0.05

Alloxan + cholesterol + dimephosphon mg / kg 405.97 ± 22.60 P> 0.05 P,> 0.05 P2 0.05 Pi> 0.05 P2> 0.05 8.75 ± 0.43 P> 0 .05 Pi 0.05 0.60 ± 0.05 P> 0.05 Pi 0.05

Alloxan + cholesterol + a - tocopherol ZOMg / kg 391.56 ± 27.70 P> 0.05 Pi 0.05 P2 0.05 0.67 ± 0.05 P> 0.05 Pi 0.05

Chidziwitso: P - kufunika kwa kusiyana komwe kuwerengedwa mokhudzana ndi mulingo woyenera, Pi - kuwongolera deta,

P2 - ku data ya mndandanda alloxan + cholesterol + mexidol mg / kg

Mphamvu ya mexidol, emoxipin, dimephosphone ndi - tocopherol pa kusakhazikika kwamagetsi kwa myocardium yophatikizika ndi matenda a shuga a shuga ndi hypercholesterolemia (%%)

1 - intact, - alloxan + cholesterol, - alloxan + cholesterol + mexidol mg / kg, - alloxan + cholesterol + mexidol mg / kg, - alloxan + cholesterol + emoxipine 12,5 mg / kg, - alloxan + cholesterol + dimefosfon mg / kg kg, 7- alloxan + cholesterol + a- tocopherol mg / kg, * - tanthauzo la kusiyana limawerengeredwa mogwirizana ndi gawo lolamulirako

Zotsatira za antioxidants omwe adaphunzira pakapita nthawi ya PQ komanso kuphatikiza kwa kuyesayesa kwa shuga ndi zina zaposachedwa hypercholesterolemia (%%)

1 - intact, - control (alloxan + cholesterol), - alloxan + cholesterol + mexidol mg / kg, -alloxane + cholesterol + mexidol mg / kg, - alloxan + cholesterol + emoxipine 12,5 mg / kg, - alloxan + cholesterol + dimephosphon mg / kg, - alloxan + cholesterol + a-tocopherol mg / kg, * - tanthauzo la kusiyana limawerengeredwa mogwirizana ndi gawo lolamulira

Chifukwa chake, zotsatira za kafukufuku wathu zikuwonetsa kuti njira yodziyendera imathandizira kuti pakhale chisokonezo chapazinthu zamagetsi zamagetsi: kusokonekera kwa mawonekedwe a AV, monga momwe kukuwonjezera nthawi yayitali ya PQ (mwa 26.60%), kusakhazikika kwamagetsi, komwe maziko ake ndi kuwonjezeka kwa kupezeka kwa gawo la QT pofika 238 , 52%. Montidol mu mg wa mg / kg imathandizira kwambiri kutsitsa kwa magetsi kwamphamvu mu atria (kufupikitsa nthawi ya PQ ndi 18.37% yoyendetsa). Onse omwe amaphunzira antioxidants amalepheretsa kukhazikika kwa kusakhazikika kwa magetsi ndi kuphatikiza kwa kuyesayesa kwa shuga ndi hypercholesterolemia, kuchepetsa kufalikira kwa nthawi ya QT ndi oposa 60%.

Mutu 4. Zotsatira za mexidol, emoxipin, dimephosphone ndi atocopherol pa lipoperoxidation njira ndi ntchito ya antioxidant dongosolo mu madzi am'magazi komanso minyewa ya makoswe oyera atayatsidwa alloxan motsutsana ndi maziko a cholesterol katundu.

4.1 Mphamvu ya omwe amaphunzira antioxidants pamapangidwe a lipid peroxidation ndi ntchito ya antioxidant michere m'magazi am'magazi oyera ndi kuphatikiza kwa matenda a shuga a alloxan ndi hypercholesterolemia.

Ofufuza ambiri amati njira yopangira poizoni ya alloxan pakuwonongeka kwake pakupanga ma free radicals (Baranov V.G., 1993, Yurina M.A., Adeykina O.A., 2000, Gard A., Grandy S., 1990). Monga momwe kafukufuku wathu wasonyezera, kuyang'anira alloxan kuyesa nyama kumalimbikitsa kwambiri kuyambitsa lipid peroxidation m'madzi a m'magazi. Tidawerengera kuwuma kwa lipid peroxidation ndi zomwe zili m'magazi a chomaliza cha LPO - malondialdehyde. Patsiku la 14 pambuyo pa kuperekedwa kwa alloxan, kuwonjezeka kwa zomwe zili mu MDA m'magazi a nyama zoyesera kunalembedwa kuchokera 5.8 ± 0.3 mmol / L mpaka 10,27 ± 0.3 mmol / L, P 0.05 + 22.0 23, 48 ± 1,02 p 0.05 -5.43 34.52 ± 0.81 p> 0.05 - 1.26

Alloxan mg / kg 10.27 ± 0.33 p 0.05 - 23.43 - 74.23 34.38 ± 1.29 P> 0.05 P, 0.05 -1.70 + 184.6

Alloxan + cholesterol + mexidol 25 mg / kg 4.13 ± 0.24 P 0.005 P, dimephosphon> a - tocopherol.

4.2. Zotsatira za mexidol, emoxipin, dimephosphone ndi - tocopherol pa lipid peroxidation komanso chitetezo cha antioxidant mu myocardium yophatikizika ndi matenda a shuga a alloxan ndi exo native hypercholesterolemia

Mtima ndi matenda a shuga ndizomwe zimayambitsa kulemala komanso kufa. Atherosulinosis odwala omwe ali ndi matenda osokoneza bongo amadziwika ndi kukula koyambirira ndikufalikira, zomwe zimatipatsa mwayi kuti tikambirane za matenda ashuga monga mtundu wachilengedwe wa atherosulinosis (Kozlov S.G., Lyakishev A.A., 1999, Haffner SM et al., 1990, Stamler J., et .., 1993). Amadziwika kuti gawo lalikulu pakupanga mitsempha ya mtima wamatenda a shuga ndiosakhala enzymatic autooxidative glycosylation ndi oxidative nkhawa (Lankin V.Z. et al., 2000, Halliwell V., 1999).

Chifukwa chake, pantchito iyi, tidasanthula mkhalidwe wa lipid peroxidation ndi chitetezo cha antioxidant mu myocardium ya nyama zoyesera ndi alloxan shuga mellitus mumikhalidwe ya hypercholesterolemia.

Monga zotsatira za maphunziro athu zikuwonetsa, kukhazikitsidwa kwa alloxan kunathandizira kuwonjezeka kwakukulu kwa TBA, chinthu chogwira ntchito, malondialdehyde mu myocardium ya makoswe oyera, omwe akuwonetsa kuyambitsa kwakukulu kwa njira za lipoperoxidation. Zotsatirazi kuyambira pa tebulo 4.2.1, MDA idakwera kwambiri kuchokera ku 5.78 ± 0.19 mmol / L mu nyama zolimba mpaka 18,84 ± 0.69 mmol / L mu nyama zatsatanetsatane, zomwe zidakwana 325.95% yazotsatira ndi nthawi zopitilira muyeso wa mulingo woyenera. Kuwonetsedwa kwa nyama zoyesera ku cholesterol katundu kumapangitsanso kuwonjezeka kwakukulu kwa kuchuluka kwa MDA mu myocardial homogenates mpaka 17.72 ± 0.58 mmol / L, yomwe idakulitsa kwambiri gawo la 206.77%.

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Mapeto a dissertation pamutu wakuti "Pharmacology, pharmacology", Volkova, Natalya Anatolevna

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Kufotokozera ndi katundu

Emoxipin Ndiwanthu wokhala ndi ufa wamchere wokhala ndi mawonekedwe amakristalo komanso amatha kusungunuka kwambiri m'madzi. Dzina lapadziko lonse lapansi lomwe limagwira ndi methylethylpyridinol.

Mankhwala ali ndi mphamvu ya antioxidant ndi antihypoxant, komanso vasoconstrictor ndi antiplatelet wothandizira. Mphamvu za antioxidant za Emoxipin zimapatsa kulowererapo kwa ma radicals aulere, kuthetseratu kwa oxidative reaction, chifukwa chake, amalepheretsa kuwonongeka kwa ma molekyulu achilengedwe - DNA, mapuloteni, michere, ma cell membrane, ndi zina zambiri.

Katundu wa antihypoxant amalola Emoxipin kuti ateteze kufewetsedwa kwa oksijeni mkati ndi ziwalo zamkati popereka mpweya wambiri ndikuwonjezera kulowa kwake kudzera khoma la mtima komanso nembanemba yama cell.

Katundu wa vasoprotective wa Emoxipin akuwonetsedwa kuti akupereka mphamvu, kusalala ndi zotanuka kukhoma la chotengera. Pa nthawi yomweyo ndi kuwonjezeka kwa mphamvu ya khoma la mtima, kupezeka kwake kumachepa.

Mawonekedwe osalala a ziwiya zimathandizira kuchepetsa "kumamatira" pazinthu zam'magazi, komanso kuteteza kukhazikika kwawo pamakoma a mitsempha ndi mitsempha, yomwe imawonetsetsa kuti katundu wa antiplatelet a Emoxipin. Chifukwa cha izi, madzi amwazi amathandizidwanso, ndiye kuti mamasukidwe ake amachepa.

Kuphatikiza pa kuchepetsa "gluing" yama cell am'magazi, Emoxipin imathandizira njira zotulutsira magazi m'magazi, imachepetsa kutsekeka kwa mitsempha yamagazi ndikuletsa ma hemorrhages, komanso imathandizira kuyambiranso kwamasamba mofulumira. Mu matenda a mtima, Emoxipin amakhala ndi vuto lotulutsa mtima, amalimbikitsa kufalikira kwa msana komanso kupenda bwino kwa chotupa pakachitika vuto la mtima, kumalimbitsa mphamvu yokhudzana ndi contractions ndikufotokozeranso zomwe zikukhudza, kupewa kusokonezeka kwa mtima. Mwambiri, Emoxipin imachulukitsa kukana kwa minofu ya thupi pakusowa kwa oxygen komanso magazi.

Ntchito ya Emoxipin

Njira zachipatala zogwiritsa ntchito kuwala kochokera pansi kwambiri komanso pafupipafupi zimafuna kutetezedwa ndi maso pazotsatira zoyipa izi. Muzochitika izi, Emoxipin amagwiritsidwa ntchito kuteteza maso ku radiation ya ultraviolet ndi ma laser, kuphatikizapo kutentha kwa dzuwa.

Odwala omwe apeza choroid ndikuchita njira ina, monga glaucoma, amafunikira Mlingo wa Emoxipin kuti usawonongeke m'mitsempha ndi mitsempha ya gawo la masomphenyawo.

Kuphatikiza pa machitidwe a ophthalmic, mankhwalawa amagwiritsidwa ntchito mu mtima, chifukwa amakhala ndi chitetezo, kuphatikizapo pamitsempha yama mtima. Cardioprotective katundu wa Emoxipin amagwiritsidwa ntchito pochiza kuphwanya kwa myocardial infarction, komanso kupewa "reperfusion syndrome." Kutenga Emoxipin kumathandizira kwambiri kupatsa thanzi komanso kagayidwe ka minofu ya mtima pambuyo pa vuto la mtima. Angina osakhazikika amayendetsedwa bwino ndi ntchito ya Emoxipin, ndipo zizindikiro zowawa komanso zowopsa pamtima zimayamba kutchulidwa komanso kukhala zosowa.

Muzochita zamitsempha, Emoxipin amagwiritsidwa ntchito pochiza matenda obisika aubongo osiyanasiyana. Komanso, mankhwalawa amagwiranso ntchito molingana ndi kuchepa kwamphamvu kwa magazi ndi kukha magazi m'mitsempha ya ubongo. Pambuyo pa kuchitapo kanthu pochita opaleshoni yochotsa hematomas yomwe ili m'malo ophatikizika ndi ozungulira, mankhwala a Emoksipin amakulolani kusintha kayendedwe ka magazi, komanso kupewa kutaya magazi pafupipafupi.

Masiku ano, Emoxipin amagwiritsidwa ntchito pofuna kuthana ndi vuto lililonse lomwe magwiridwe antchito a peroxidation, i.e. oxidative nkhawa. Kupsinjika kwa Oxidative kumawonedwa pamatenda osiyanasiyana, mwachitsanzo, ndi kulowetsedwa kwa myocardial, stroke, glaucoma, matenda a virus, ndi zina zambiri.

Mitsempha yamkati ndi ma jekeseni opangira mankhwalawa a mtima ndi minyewa

2. Pakupita masiku 10-30, yankho la 3% la Emoxipin limayendetsedwa kudzera mu mnofu, 3-5 ml ya jakisoni. Kukhazikitsidwa kwa mankhwalawa kumachitika katatu patsiku.

Nthawi ya chithandizo ndi Emoxipin mwachindunji zimatengera zovuta zamatendidwe, kuthamanga kwachiritsidwe komanso kuphatikizidwa kwa magwiridwe antchito amthupi.

Emoxipin jakisoni wa Chithandizo cha Matenda a Diso

Ophthalmologists amagwiritsa ntchito yankho la 1% la Emoxipin, ndipo majekeseni amachitidwa pafupi ndi eyeball (retrobulbar ndi parabulbar), komanso pansi pa conjunctiva (subconjunctival). Jekeseni wa Emoksipin parabulbarly ikuchitika kamodzi patsiku kapena tsiku lililonse, ndipo jekeseni ndi 1% yankho mu 0,5-1 ml. Pansi pa conjunctiva, yankho la 1% la jakisoni limaperekedwanso tsiku lililonse, kapena tsiku lililonse, 0,2-0,5 ml. Subconjunctival ndi parabulbar makonzedwe a Emoxipin amachitika mu maphunziro a masiku 10-30. M'chaka chimodzi cha kalendala, mutha kubwereza mankhwalawa katatu.

Ndi kuwonongeka kwakukuru kwa diso, njira ya retrobulbar yoyang'anira 1% yankho la Emoxipin ya jekeseni imagwiritsidwa ntchito. Njira ya mankhwalawa imakhala ndi limodzi kwa masiku ano a Emoxipin 1,5 mu 0,5-1 ml kwa masiku 10-15.

Kuti muteteze diso pa nthawi ya laser coagulation, phula kapena kuyendetsa makina a piritsi la 1% ya Emoxipin mu 0.5-1 ml ikuchitika kawiri - maola 24 ndi ola limodzi musanayambe opareshoni. Pambuyo pakuchita opaleshoni kwa masiku 2-10, mankhwalawa amaperekedwa chimodzimodzi, 0,5 ml ya yankho la 1% kamodzi patsiku, tsiku lililonse.

Malangizo apadera ogwiritsira ntchito Emoxipin

Ngati munthu akudwala matenda oopsa, ndiye kuti ntchito ya Emoksipin iyenera kuchitika pang'onopang'ono poonetsetsa magazi. Muyeneranso kuyang'anitsitsa kuchuluka kwa magazi.

Ngati Emoxipine mu mawonekedwe a madontho amaso ayenera kugwiritsidwa ntchito molumikizana ndi mankhwala am'deralo, ndiye kuti athandizireni kumapeto kwa mphindi zosachepera 10-15 mutatha kugwiritsa ntchito njira yothandizira.

Emoxipin sayenera kusakanikirana ndi mankhwala ena, makamaka kuyambitsa kwa mankhwala olumikizana ndi syringe yomweyo sikuloledwa.

Zotsatira zoyipa za Emoxipin

Madontho amaso amatha kupweteketsa, kuwotcha, kutsina m'maso pakatha kutsata. Izi zomasulira nthawi zambiri zimatha palokha.

Jakisoni wa intraocular (retrobulbar, parabulbar, subconjunctival) wa Emoxipin atha kukhala limodzi ndi zotsatirazi zoyipa:

• kupweteka pamalo a jekeseni
• kuyabwa
• kuyaka
• redness
• kufoola kwa minyewa yazungulira mbali yamaso.

Mothandizidwa ndi mtsempha wa magazi a Emoxipin pa matenda a mtima ndi matenda amitsempha yamagazi angayambitse zotsatirazi:

• kusachedwa kwakanthawi,
• kugona
• kuchuluka pang'ono kwa mavuto
• zotupa zakderalo (zotupa pakhungu, zotupa, ndi zina).

Emoxipin wa jakisoni ndi madontho amaso - ndemanga

Emoxipin ndi mankhwala othandiza kwambiri, koma ali ndi vuto losasangalatsa lam'deralo, lomwe limapangitsa zinthu zosasangalatsa mukamagwiritsa ntchito mankhwalawa m'maso. Anthu omwe akudwala matenda amaso akulu, ndikutenga madontho ndi jakisoni wa Emoxipin, poganizira zomwe zikuwonetsa komanso kumvetsetsa kwofunikira kwa chithandizo, amapeza zotsatira zabwino. Potere, malingaliro abwino a mankhwalawa amapangidwa nthawi zonse, motero, kuwunika koyenera. Ngati a Emoxipin amagwiritsidwa ntchito pochiza zovuta zazing'ono, ndipo munthu sanakonzekere kukumana ndi zovuta zina, izi zimapangitsa kubwereza mankhwalawa, chifukwa munthawi imeneyi chithandizo chamankhwala chimakhala chochepa ndipo chimagwirizanitsidwa ndi zovuta.

Emoxipin wa jakisoni anathandizira kuthetsa zotsatila za kugunda kwa mtima ndi stroko mwa odwala ambiri omwe amatha kuchepetsa kwambiri mawonetseredwe amisempha yamitsempha m'nthawi yochepa. Gulu la odwala ili ndi chidziwitso chokwanira chogwiritsira ntchito mankhwalawa, motero, kuwunika koyenera. Komanso, anthu omwe adagwiritsa ntchito ndi cholinga chofuna kutulutsa magazi ndi kuthamanga kwa hematomas mwachangu amayankha bwino za mankhwalawa. Ndemanga zoyipa zomwe zimagwiritsidwa ntchito pakugwirira ntchito a Emoxipine nthawi zambiri zimasiyidwa ndi anthu omwe amagwiritsa ntchito mankhwalawo pawokha kuti azitha kuchitira magazi omwe amawatcha "magazi okhathamira."