Bisphosphonates (ARVs): inkcazelo, imiyalelo, ncomo. Bisphosphonates kwi unyango kwamathambo

Xa amathambo abantu kuba ethe-ethe kwaye inkumnkum, kwaye oko kwenzeka kwezinye izifo wethambo, umgangatho wobomi liyehla kakhulu. iintanda okufuthi, iintlungu kwamalunga, umqolo kunye nemilenze kuqala kunye mntu kuyo yonke indawo, apho kungenxa yokuba ungakwazi uyeke ngokupheleleyo uziva uvuyo ebomini yaye gxwa lithemba.

Kodwa ulonwabo lwethu unawe ehlabathini namhlanje iziyobisi ezikhethekileyo enokuthi ngempumelelo tiyisa ijwabu ithambo. Oku ngazo kwaye kuya kuxoxwa ngazo kwinqaku lethu. Wabiza la machiza "bisphosphonates" - iziyobisi kwakhona leyo ukunika ithemba unyango kubantu abaninzi kakhulu. Ndikholelwe, a lot onjalo! Siza kukuxelela ngembali ezi mali, ngoko ezilungileyo kunjalo, yintoni na sisiseko iinzuzo zabo zempilo, uya kuvakalisa amagama bisphosphonates zezona ithandwa kakhulu nolusebenzayo.

Eli nqaku liza kuba luncedo kubo bonke abantu. Ngapha koko, ukuba namhlanje yonke into ukuze, ke, ngelishwa, oko akuthethi akuthethi impilo wena nabo ubathandayo, uya kuhlala ngonaphakade. Iminyaka ihamba, kongezwe isifo yabo iya ngakumbi nangakumbi. Ngoko ke akuyi kuba yintoni malunga namayeza mihla ononyawo. Kodwa luya kuba lukwanele kufika! Masishukume kwi ukufunda ngakumbi ngokunzulu umxholo weli nqaku.

Bisphosphonates - iziyobisi ngempilo ithambo

iqela okukhetha amachiza zokwenziwa ukuba uyakwazi ukuvala umsebenzi umzimba ngayo osteoclasts (iiseli zikukufa inyama bone) nokubuyisela amathambo yaziwa ngokuba bisphosphonates.

Kusetyenziswe la machiza njengangoku kwindawo yokuqala ukulungiselela inkathalelo kwezigulane osteoporosis kunye nezinye izifo ezibangela kwamathambo. Lo mhlaba kakhulu ezixabisekileyo bisphosphonates kwakhona into yokuba ukuze zisetyenziswe kuzo izifo oncological luphawulwa ukuyilwa yamathumba kulo ithambo. Kule meko, ichiza, osixelela inqaku lethu, musa ukunika metastases saa nokunciphisa iintlungu kwezi izigulane.

Indlela yokusebenza ye bisphosphonates kwi unyango kwamathambo

Kwisahluko esingaphambili, wafunda ukuba bisphosphonates - iziyobisi ezikhuthaza amathambo enempilo. Eli lixesha lokuba uthethe ngakumbi indlela yesenzo sabo. iiseli zomzimba Wethu abe zakwazi amaxesha ngamaxesha kuhlaziywa salungiswa. Bone inyama - akukho ngaphandle. Ukulinganisa izakhiwo zabo zigcinwe, kwelinye icala, iiseli osteoblast ukuba banoxanduva ukwakha izihlunu entsha, enye - osteoclasts ukuba banoxanduva intshabalalo yayo. BF unawo amandla isantya umsebenzi osteoclasts kunye ezisebenza indlela yabo self-ngokwawo. Kule impahla elincomekayo kwaye zisekelwe unyango bisphosphonate kwamathambo.

Ndimele ndithi ukuba izazinzulu kangaka ngokude hayi baqonda ngokupheleleyo indlela ukuvimbela le kwamathambo usebenzisa bisphosphonates. Yinto eyaziwayo ukuba ezi izinto abakwaziyo ukubophelela amacandelo ithambo hydroxyapatite, apho banakho ukutshintsha ukugoba yayo kwaye ngexesha elinye ukunciphisa igazi uyondelelwano lwee- hydroxyproline kunye phosphatases.

Ngamanye amaxesha BF amalungiselelo linokwenziwa unyango nokuba kwezifo ezifana herniation okanye Buze compact intervertebral, njengee-arhente iintlungu. Yaye ulwazi kancinci: bisphosphonates ngokuba kwamathambo ziye zasetyenziswa ixesha elide, kodwa umhlaza, bezisetyenziselwa kutshanje. Esebenzisa izifundo kwafunyanwa ukuba bangene umzimba, apho esebenzayo ezikhoyo kwinkqubo neoplastic, bisphosphonates musani ukumkhwelela nethumba iiseli coalesce kunye matrix ithambo ngokwenjenjalo zinqanda ukubunjwa metastases. Iinkcukacha ezingaphezulu malunga noku ziya kuxoxwa kwisahluko eyahlukileyo.

A incinane

Kubonakala ukuba bisphosphonates esafunyanwa zizazinzulu ixesha elide, nkqu kwinkulungwane XIX. Ngokuba lixesha lokuqala Yindibanisela BF lokuqala lwaqhutywa eJamani. Kuyamangalisa ukuba ekuqaleni ezi izinto ezisetyenziswa kuphela kumacandelo mveliso ezahlukeneyo (kuba ukuvelisa izichumisi, eyimveliso amalaphu, petroleum yokucokisa ezinjalo. D.) Yaye ezinganxulumananga amayeza akazange.

Ukulungiselela iinjongo zonyango - kuba unyango lwe ithambo - bisphosphonates baqalisa ukuba kusetyenziswa kuphela kwinkulungwane ye-omabini, xa kwafunyaniswa ipropati yabo amangalisayo ukuphembelela iinkqubo ezifana calcification kunye decalcification. Bisphosphonates for kwamathambo kusetyenziswa ukususela ehlabathini lonke bakhuthele.

ngezigaba bisphosphonates

Namhlanje, yezemithi yaqulunqa biosfosfonatov isizukulwana wesithathu. Kodwa ke oku akuthethi ukuba oogqirha ngokuyishiya ngokupheleleyo ukusetyenziswa kweziyobisi zezizukulwana lokuqala nolo lukwizinga lesibini, nto leyo bekho ngaphambili. Makube lee oko! Namhlanje kukho iziyobisi ezininzi ezisekelwe bisphosphonates. Yonke le ezahlukeneyo lwamayeza yahlulwe ngamaqela amabini: bezazotovye amayeza kunye nitrogen. negalelo lazo iiseli osteoclast iyakwazi ukukunyanzela eyahlukileyo. Ngezantsi apha siza kujonga omabini amaqela zolwimi ngokunzulu.

bisphosphonates nitrogen aqulethe

Eli qela neziyobisi ezi bisphosphonates, equlethe izithako ezisebenzayo zilandelayo:

• Ibandronatovaya acid. E ke impahla leyo kuhlelwe kutshanje, kunjalo ichiza besesithathu isizukulwana. Lusetyenziswa kakhulu ngempumelelo unyango kunye nothintelo kwamathambo kwabasetyhini abaye bangena xesha linzima ukuya exesheni. Amadoda ukuthatha eli chiza ayikhuthazwa. Ibandronatovuyu acid lisetyenziswa ukwanda zophendlo lwezifo kwi calcium egazini (hypercalcemia).
• Zolendronovaya acid. Kwakhona inxulumene bisphosphonate besesithathu isizukulwana. Akwazi ukwenza ngokukhetha kwi kwezihlunu ithambo. Xa oku kusetyenziswa ngendlela eyiyo ngenxa unyango kwamathambo. Le ikhetha isenzo zolendronovoy acid kubume ithambo isekelwe noFaro yalo phezulu ukuya emkhusaneni osseous elinika inhibition kakhulu osteoclasts. Enye impahla ebalulekileyo ichiza - nempembelelo anti-ithumba ngokukhawuleza. Ngokusekelwe bisphosphonates ezaziwayo "Zometa" ezikhoyo acid zolendronovoy, "Zolendronat".
• sodium Alendronate - lwesibini isizukulwana esebenzisa bisphosphonates. It is a non-hormone iimpazamo zabaguquleli ethile pathways isicwili ithambo oyinxalenye isakhiwo oluchanekileyo ithambo. Oku kuboniswa ukuze zisetyenziswe kwamathambo zombini abasetyhini kunye namadoda.
• sodium Ibandronate ( "Bonviva" "Bondronat" "Boniva" - bisphosphonates amalungiselelo rhoqo layo) - amachiza besesithathu isizukulwana. Abangaphangeliyo umsebenzi osteoclast ngaphandle kokuchaphazela inani lazo. Akunamsebenzi ichaphazele ukuyilwa iiseli ithambo, ngaloo ndlela icuthe intshabalalo yabo. uncedo okulungileyo abafazi postmenopausal njenge arhente othintelo lwe kwamathambo.

Ngamalungiselelo musa i nitrogen

Ngoku siza kuqwalasela ntoni na umntu bisphosphonates nitrogen-free. Iziyobisi,, apho amagama ufunda Ngoku kwisizukulwana lokuqala bisphosphonates:

• "Clodronate." Oku kuthintela zombini osteolysis kunye hypercalcemia nophuhliso. Yenza uqhagamshelwano yekhabhoni ithambo hydroxyapatite etshintsha yikristale emkhusaneni ngenkuthalo silwe ukwahlulwa calcium phosphate iimolekyuli. Metastases emathanjeni ithintela uphuhliso lwabo kunye neebhloko nokudalwa kumaqumrhu ezintsha.
• "Sodium Etidronate". Kukhuthaza ukubuyiselwa kwamathambo kwabasetyhini unesifo "osteoporosis". Kananjalo zingasetyenziswa sisifo Paget kaThixo, hypercalcemia kunye like. D.
• "Sodium tiludronate". Mineralizes kwaye kuqinisa izihlunu ithambo, baba kulo ezinto eziphilayo ezimbaxa calcium phosphate, abangaphangeliyo ukutshatyalaliswa ithambo. Ubekwa ukuba izigulane iSifo of "deforming osteodystrophy" okanye "isifo Paget kaThixo" banokuthi banyulwe endaweni hormone.

Bisphosphonates - iziyobisi, uluhlu esiye kupapashwa - wathengisa kuphela kagqirha, oko kukuthi ukuba izinto esinamandla ... Sebenzisa nabo ngokwengqiqo yabo kunokuba yingozi empilweni yakho! Khumbula ukuba BF - ayikho iivithamini nabungozi umphutha weekhemikhali okanye izongezo nge calcium. La machiza ngenkuthalo ungenelele kwiinkqubo ezenzeka emzimbeni, kwaye ukuba engafanelekanga isicelo kunceda kunokuba yingozi.

imithetho zokwamkelwa

iziyobisi bisphosphonates kakhulu kakhulu lilo iphecana zesisu, kunzima ukufunxeka zabo. Ngoko ke, kubaluleke kakhulu myalelo umisela ukusela la machiza kuphela ungatyanga, malunga nemizuzu engama-30 phambi kokuba isidlo - ngokuqhelekileyo kunceda kukufakwa kwezinto iziyobisi esebenzayo. Izigulane kufuneka bazi ukuba eli qela iziyobisi abangela ukudumba kunye ukhukuliseko kwiindawo ezahlukeneyo iphecana zesisu. Ukuze siphephe iingxaki ezinjalo, emva kokufumana iipilisi kuyimfuneko ukuzama ngethuba leeyure ukuya, yaye uhlale endaweni tye. Idosi ichanekile ekhethwe gqirha khona.

Ngokuqhelekileyo, ukuqeshwa bisphosphonates ugqirha imisela isigulane kwaye nokudla amathamo ezinkulu calcium. Ngoko ke, ukwamkelwa ngaxeshanye bobabini ngaphandle. Amalungiselelo eziqulathe calcium, angathatyathwa emva kokuthatha bisphosphonate kuphela emva kweeyure ezimbini, kungekhona ngaphambili. Enye ingcebiso ebalulekileyo: CF Kufuneka sisele hayi iti, ubisi, isiselo okanye ikofu, namanzi plain (a lot of).

Ukusetyenziswa bisphosphonates yezifo neoplastic

intetho Okunye unyango bisphosphonate kwezifo ebandakanya ukukhula yamathumba yendalo eyahlukileyo. Kukuvela Ukudlulela apha esiqwini ithambo cala ecaleni kunye intsebenziswano lwentsebenziswano phakathi kwiiseli thumba kunye nomsebenzi pathways esiqwini ithambo. Ngenxa yoko, uphuhliso olutshintshayo metastases ihamba adhesion kweeseli ithumba kwizakhiwo ithambo, kwakunye ukuhlasela, ukwanda kunye neoangiogenesis. izifundo ezininzi preclinical ziye ukuba izazinzulu ukwenza kwinkolelo yokuba BF ukunqanda ngasinye kwezi izigaba Pathogenesis.

Ekuhambeni kweenkqubo zophando eziliqela kuvavanywa impembelelo bisphosphonate "Clodronate" kuphuhliso metastases e kwamathambo abafazi kwafunyaniswa ukuba unomhlaza webele. iziphumo ezigqwesileyo zifunyenwe: ukulungiswa wanceda ukunciphisa izehlo metastases kunye nokukhula esiqwini bone entsha kwizigulane. Ngokwangoku, uphando kweli cala lusaqhubeka ngamandla. Bisphosphonates xa metastases ithambo ngokwenene ukwazi ukuba sincede.

yamathumba abulalayo soloko ilandelwa lutshintsho lwemithetho (release calcium ukusuka ithambo) hypercalcemia. Xa sisilonda esidumbileyoesingaphakathi kuwenza ngecalcium bone ilahleko rapid kwenzeka ngenxa intshabalalo zawo osteoclasts. Ukongeza, hypercalcemia kwi umhlaza ekwaziyo zenzeka ngenxa ukwenekwa peptide ithumba. Ngaphezu koko, kukho ukusebenza osteoclasts, ekhokelela hypercalcemia. Le nkqubo inzima kwaye kwandiswa ngokunciphisa umsebenzi kwezintso.

Ezi nkqubo zenzeka ezinezigulo ezifana cell carcinoma carcinomas, ezigula ezininzi, umhlaza webele, umhlaza iseli kwezintso kunye ezithile lymphomas. Hypercalcemia, wamqumbisa yi ngumhlaza, amachiza kakhulu ophumelelayo bisphosphonates ukuze ukumnika efakwa. esekwe kakuhle ezi meko, iziyobisi ezinjalo, bisphosphonates, njengoko "Zolendronovaya acid 'yaye' Pamidronate".

Kokuma zibonisa ukuba kwiintsuku esele ezimbalwa emva kokuqaliswa kolawulo kwizigulana butofelwe iziyobisi data kwi calcium igazi xi yi nganye, kwaye isiphumo ithatha ixesha kakhulu elide (ukusuka kwiiveki ukuya ezimbini).

Uluhlu kwezifo apho bisphosphonates zisetyenziswa ngempumelelo

• Kwamathambo.
• Ezigula.
• Ukutyeshelwa ukubunjwa ithambo.
• Paget kaThixo izifo (osteodystrophy deforming).
• hyperparathyroidism Primary.
• Nangezilonda, metastases kwi ithambo, ingakumbi kuhlanganiswe hypercalcemia.

imiphumela emibi

Ngelishwa, le unyango bisphosphonate esebenzayo ngeke ibe kwezinye. Ingakumbi xa kufikwa ulawulo efakwa kula machiza. Baya kungabangela iimpembelelo ilandelayo icala:

• Xa ufakwe yegazi, - hypocalcemia.
• Ngaba ichaphazele nezintso, kubangele ukunxila.
• Ngamanye amaxesha reception ngomdla biosfosfonatov kuphakamisa uphuhliso osteonecrosis kwemihlathi.
• Ukwenza igalelo kuphuhliso izilonda apha kuvuleke iminxunya kwaye esiswini.
• Kungabangela ukuqhina okanye ukurhuda, kwiimeko ezinqabileyo - ubunzima ligwinya.
• oluthile jikelele, ubuthathaka, isicaphucaphu.
• ubuhlungu kwezihlunu.
• iingxaki Umbono.
• Irhashalala phezu komzimba.

Ewe, zonke ezi ngeengxaki kunokubangela bisphosphonates. Iziyobisi, amagama apho kudibana kweli nqaku, awukwazi kumisela ngokwam ngokuzimeleyo ukuze hayi bengazi ukuba umzimba umonakalo noqhekeko. We ngabom ukuphinda izihlandlo eziliqela kwisicatshulwa! Xa nokubuyekezwa, leyo ezinokufundwa kwiiforam ezahlukeneyo, abantu ngokukhutheleyo ngokwabelana ngolwazi omnye nomnye malunga BF ezahlukeneyo lula bacebisa ukuba kwabanye. Oku Kuthi nezimiso. Thatha la machiza esinamandla kuyimfuneko kuphela ngengcebiso kagqirha ukuya kwaye usoloko phantsi kweliso lakhe.

Bisphosphonates - nokubuyekezwa koogqirha kunye nezigulane

Ngaba uyazi ukuba nyaka ngamnye, ngo-Oktobha 20, kuwo onke amazwe uSuku lweHlabathi yokulwa kwamathambo? Esi sifo kwiminyaka yakutshanje, ukufumana ngokwenene olinganise bhubhane. Nangona ezinye iingcali zikholelwa ukuba ukungxamiseka ingxaki kwamathambo ngandlel akabaxwa, esi sifo kuba ayikho ngokwayo obulalayo. Kunjalo, ipesenti yabantu abadala abathi bafe emva kokuba ukwaphulwa womlenze, nto leyo edla ngokwenzeka xa kwandiswa ilahleko ithambo mkhulu kakhulu. Ngoko ke, kukho inani elikhulu labantu amathemba ethile kwi bisphosphonates. Izimvo ezigulane abafumana la machiza ngenxa yethemba kwakhona, kuxhotyiswa ngumbulelo koogqirha kunye Pharmacology mihla, leyo wakwazi ukuba banike uncedo ngexesha elifanelekileyo.

Dr med. , Unjingalwazi nentloko yalo iZiko Scientific-Clinical kwamathambo uSvetlana Rodionova ikholelwa ukuba imeko kwamathambo kakhulu ngokwaneleyo eRashiya. Ugqirha ezaziwayo-kakuhle uthi ukuba imihla yethu, xa amandla uninzi lwabantu sinesiphene (ukunqongophala calcium), ukufumana kusasazwa nemikhwa emibi ezifana ezifana nokutshaya, ukusetyenziswa kweziyobisi kunye notywala, kunye nomsebenzi komzimba kuyeza zero ngokukhawuleza, abantu abaninzi abaselula, ikakhulu abafazi bagwetyelwe kwiminyaka abaqolileyo ngaphezu kwamathambo. Ngoko ke imfuno yamachiza omuhle ukunceda ukunyanga esi sifo iphezulu kakhulu.

Ke bisphosphonates zokuqeshwa ugqirha rhoqo likaThixo, uprofesa unoluvo ukuba akusoloko ugwetyelwe. Bisphosphonates - yokusebenza-kuphuculwe iziyobisi, kodwa isigulana phambi kokuba echaza ummiselo othile, ugqirha kufuneka uqinisekise ukuthatha ingqalelo imiba efana yokucolwa iigusha kunye calcium homeostasis. Xa uthomalaliso bisphosphonate ngokungakhathali kunye olungalawulwayo kunokubangela iingxaki ezinkulu: fibrillation atrial, osteonecrosis kwemihlathi, Ukophuka subtrochanteric ye yifemur.

Ngokusekelwe uluvo kagqirha ohloniphekileyo, bisphosphonates aba ilikhubalo jikelele, ukusetyenziswa kwazo kufuneka aphathwe ngokuqaphela. Ngelo xesha, inkqubo "Impilo" lisasazwa kumabonakude, apho Elena Malysheva ngoncumo esimnandi ndiqiniseke abaphulaphuli ukuba akukho nto kulula ngaphezu ukunyangelwa kwamathambo, a bisphosphonate wesithathu-ngezizukulwana. Musa ukuba kakhulu ukuthemba infomercial. Abanye abantu abafumana BF nakanjani contraindicated. Umzekelo, izigulane zizifo kakhulu sezintso.

Ke kaloku, ukuba uhlaziyo indlela yokuqhuba bisphosphonates xa metastases ithambo. uluvo Medical icacile: la machiza bayakwazi ngokwenene ukuyeka wokukhula bone indlela iiseli yingozi, leyo, Kakade ke, inceda izigulane boyise enye izigulo ezininzi eziqatha, efumaneka ehlabathini.

isiphelo

Ngoku uyazi ukuba yintoni na - bisphosphonates. Imiyalelo yokusebenzisa yabo echazwe apha, kwakunye noluhlu unikezwa kuthi hayi nje ingcebiso kwaye ukhokelo kuphela - nceda qwalasela yakho zibalulekileyo kulo! Ukuba iingxaki ezinkulu akukho mfuneko yokuba self-medicate yimpilo, eyona - ngokukhawuleza bonana nogqirha, ngoko Ndikuthabathele ukuba amalungiselelo zonyango. Sininqwenelela nonke impilo robust nolonwabo!