Bisphosphonates (izidakamizwa): incazelo, imiyalelo, ukubuyekezwa. Bisphosphonates ekwelapheni kwamathambo

Lapho amathambo abantu babe usengozini futhi ziyaqothuka, futhi kwenzeka kwezinye izifo wethambo, izinga lempilo is kakhulu ziyancipha. Ngokuvamile abantu baphuka izinqulu njalo, ubuhlungu emalungeni, emgogodleni, izingalo nemilenze kuqala ezihambisana indoda yonke indawo, yingakho ungayeka ngokuphelele uzizwa injabulo ekuphileni futhi eziphonsa ibe ukudangala. +

Kodwa injabulo yethu nawe ezweni lanamuhla yizidakamizwa ekhethekile ngempumelelo ukuqinisa amathambo izicubu. Kuyinto ngazo futhi kuzoxoxwa ngakho esihlokweni sethu. Ngokuthi le mithi "bisphosphonates" - izidakamizwa ukuthi libuyekeza okuyinto anganikeza ngethemba lokuphulukiswa abantu abaningi yenza ngokuphelelwa yithemba. Believe me, okuningi okunjalo! Sizobe bakutshele ngomlando lezi zimali, ngalokho abayikho ngakho okuhle, ngalokho ngesisekelo izinzuzo zabo zezempilo, izokhipha amagama bisphosphonates kukhona ethandwa kakhulu futhi ngempumelelo.

Isihloko kuyoba ewusizo kakhulu kubo bonke. Phela, ngisho noma namuhla konke ukuze-ke, ngeshwa, akusho impilo wena nabathandekayo bakho, liyokuma kuze kube phakade. Iminyaka ihamba, ne ukwengeza isifo sabo beba more and. Ngakho lokho ngemithi yesimanje ngeke engadingekile. Kodwa ngokwanele kufika! Ake badlulele isifundo esijulile ngaphezulu lesi sihloko esisekelwe kuwo.

Bisphosphonates - izidakamizwa ukuze amathambo wezempilo

iqembu okukhetha izidakamizwa zokwenziwa ukuthi unekhono ukuvimba umsebenzi emzimbeni ka osteoclasts (amaseli ezibhubhisa ithambo izicubu) kanye nohlelo lokubuyiselwa kabusha isakhiwo ithambo is njengoba bisphosphonates ezaziwayo.

Isetshenziswa mithi njengamanje endaweni yokuqala ukunakekelwa kweziguli kwamathambo nezinye izifo ezibangela ukudleka kwamathambo. Impahla eyigugu kunazo zonke bisphosphonates kubuye yokuthi zingase elisetshenziswa izifo oncological libhekene kumiswa izimila e bone. Kulezi zimo, umuthi, ositshela athikili yethu, unganikeli metastases asakazeka futhi inciphisa ubuhlungu kulezi iziguli.

Lo mshini wezenzo ka bisphosphonates ekwelapheni kwamathambo

Esahlukweni esandulelayo, ubungezwa ukuthi bisphosphonates - izidakamizwa ekhuthaza amathambo enempilo. Kuyinto isikhathi sokukhuluma okwengeziwe mshini wezenzo zabo. omzimba wethu ube zinekhono elimangalisayo ngezikhathi olusha futhi lalungiswa. Bone izicubu - iyathinteka. Balance izakhiwo zabo baye balondoloza ubunye, ngakolunye uhlangothi, le osteoblast amaseli banesibopho ukwakhiwa yakhe izicubu ezintsha, elinye - osteoclasts ukuthi banesibopho ukubhujiswa kwalo. BF banamandla ukubambezela umsebenzi osteoclasts ngisho ukusebenzisa azibhubhise zabo indlela. Ngalesi impahla emangalisayo futhi isekelwe ukwelashwa bisphosphonate kwamathambo.

Mangisho ukuthi ososayensi kuze kube bengayiqondi ngokugcwele lo mshini Ukuvinjwa zokuphela kwamathambo usebenzisa bisphosphonates. Kuyaziwa ukuthi lezi zinto ziyakwazi ukuthi abophele ithambo izigaba hydroxyapatite, lapho zingashintsha ukugoba yayo futhi ngesikhathi esifanayo ukunciphisa okuhlushwa igazi hydroxyproline futhi phosphatases.

Ngezinye izikhathi kungase BF amalungiselelo yaphathwa ukuphathwa ngisho izifo ezifana herniation noma protrusion lamadiski intervertebral, njengoba ejenti analgesic. Futhi ulwazi elengeziwe: bisphosphonates ukukhumuzeka kwamathambo ziye zasetshenziswa isikhathi eside, kodwa ngenxa yomdlavuza, ziye zasetshenziswa muva. Esebenzisa izifundo kwatholakala ukuthi ngokufaka umzimba, lapho esebenzayo etholakala inqubo neoplastic, bisphosphonates ungayeki isimila amaseli coalesce ne matrix amathambo kanjalo kuthiye kumiswa metastases. Imininingwane engeziwe mayelana nalokhu kuzoxoxwa ngakho isahluko ehlukene.

Umlando omncane

It kuvela ukuthi bisphosphonates zatholwa ososayensi isikhathi eside, ngisho ngekhulu XIX. Ngokokuqala ngqá synthesis we BF wokuqala kwenziwa e-Germany. Kuyamangalisa ukuthi lezi zinto ekuqaleni esasisetshenziselwa kuphela kwimikhakha eminingi yezimboni ezahlukene (ukwenziwa fertilizer, womshini izindwangu, petroleum yokucwenga nokunye okunjalo. D.) Futhi ezingahlobene imithi elalingazange.

Ngezinhloso yezokwelapha - ekwelapheni ithambo - bisphosphonates zaqala ukusetshenziswa kuphela phakathi nekhulu le-Athazeksesi, lapho kutholakala izimpahla zabo emangalisayo ukuthonya izinqubo ezifana calcification futhi decalcification. Bisphosphonates ukukhumuzeka kwamathambo isetshenziswa kusukela emhlabeni wonke bamatasa kakhulu.

Ukwahlukaniswa bisphosphonates

Namuhla, kwemithi bahlakulele lwesithathu biosfosfonatov isizukulwane. Kodwa lokhu akusho ukuthi odokotela zisilahlile ngokuphelele ukusetshenziswa kwezidakamizwa yesizukulwane sokuqala nesesibili, okwakubekelwa yasungulwa kudala kakhulu kunalokho. Lutho neze! Namuhla kukhona izidakamizwa eziningi zisekelwe bisphosphonates. Konke lokhu ezihlukahlukene imithi is zihlukaniswe ngamaqembu amabili: bezazotovye nemithi kanye nitrogen. nethonya lazo amaseli osteoclast has a indlela ehlukile. Ngezansi sizobheka kokubili amaqembu kabanzi.

bisphosphonates nitrogen-oqukethe

Leli qembu kwezidakamizwa kukhona bisphosphonates, equkethe izithako ezisebenzayo ezilandelayo:

• Ibandronatovaya acid. E ketshezi ukuthi kwemiqondo muva nje, ngakho Isidakamizwa esizukulwane sesithathu. Isetshenziselwa kakhulu ngempumelelo ekwelapheni kanye nokuvinjelwa kwamathambo e besifazane abaye langena enkathini enzima nambili kuya kwabadala. Abesilisa kokuthatha lesi izidakamizwa is hhayi Kunconywa. Ibandronatovuyu acid lisetshenzisiwe nangokuqondene ukwanda sokugembula e-calcium egazini (hypercalcemia).
• Zolendronovaya acid. Futhi siphathelene isizukulwane bisphosphonate lwesithathu. Asakwazi ukwenza ngokukhetha enethambo izicubu. Nge lokhu ngempumelelo esetshenziselwa ukwelapha kwamathambo. I abakhethayo isinyathelo zolendronovoy acid isakhiwo ithambo kusekelwe ziyezwana yaso ephezulu ukuze ngehele osseous enikeza okusithiyayo omuhle kakhulu osteoclasts. Enye impahla ebalulekile izidakamizwa - a emelene isimila umphumela. Ngesisekelo etholakalayo acid zolendronovoy ethandwa bisphosphonates "Zometa", "Zolendronat".
• sodium Alendronate - isekhondi izindlela isizukulwane bisphosphonates. It is a non-hormone proofreader ethize umzimba ithambo izicubu obumba isakhiwo efanele ithambo. Lolo thando ungalubonisa ukuze isetshenziswe kwamathambo kwabesifazane nabesilisa.
• sodium Ibandronate ( "Bonviva" "Bondronat" "Boniva" - bisphosphonates amalungiselelo on ngesisekelo yayo) - izidakamizwa kwesizukulwane sesithathu. Kuvimbela umsebenzi osteoclast ngaphandle kokuphazamisa isibalo sazo. It akuphazamisi kumiswa ithambo amaseli, ngaleyo ndlela ngempumelelo ekunciphiseni nokubhujiswa kwabo. Usizo Good kwabesifazane postmenopausal njengendlela agent izifo ithambo waphuka.

Amalungiselelo ukuthi awanalo nitrogen

Futhi manje sizogxila lokho Uyi bisphosphonates nitrogen-mahhala. Izidakamizwa, imaphi amagama ufunda manje, eyakho isizukulwane sokuqala bisphosphonates:

• "Clodronate." It kuvimbela kokubili osteolysis futhi hypercalcemia ukuthuthukiswa. It yakha uxhumano eziyinkimbinkimbi ne amathambo hydroxyapatite sishintsha ngehele crystal futhi ngenkuthalo uphikisa ukwehlukana calcium ne phosphate molecule. Metastases emathanjeni ebambezela ukuthuthukiswa yabo futhi amabhlogo ukudalwa izinhlangano entsha.
• "Sodium Etidronate". Uthuthukisa sokubuyiselwa zokuphela kwamathambo e abesifazane kwathiwa unesifo "ukukhumuzeka kwamathambo." Ingase futhi ingasetshenziswa isifo Paget sika, hypercalcemia nokunye okunjalo. D.
• "Sodium tiludronate". Mineralizes futhi kuqinise amathambo izicubu, ukuqongelela therein yamangqamuzana kwakwakhe ne-calcium-phosphate, kuvimbela ukubhujiswa ithambo. Tinkondlo iziguli izifo of "deforming osteodystrophy" noma "isifo Paget sika" angaqokwa esikhundleni hormone.

Bisphosphonates - izidakamizwa, uhlu esiye eshicilelwe - ithengiswe kuphela kadokotela, okungukuthi ukuba izinto ezinamandla ... Sebenzisa kubo uma bebona kunesidingo kungaba yingozi empilweni yakho! Khumbula ukuthi BF - akuyona amavithamini engeyona ingozi noma amaphilisi nge-calcium. Le mithi ukukhuthalele angenele izinqubo ezenzeka emzimbeni, futhi uma ngendlela engafanele isicelo kungasiza esikhundleni umonakalo.

imithetho yokwemukelwa

bisphosphonates izidakamizwa ngempela kakhulu amuncwa pheshana emathunjini, kunzima ukumuncwa kwabo. Ngakho-ke, it is kakhulu imfundo sinquma ukuphuza le mithi kuphela esiswini esingenalutho, imizuzu engu-30 ngaphambi kokudla - ngokuvamile kusiza ukumuncwa asebenzayo izidakamizwa izinto. Iziguli zidinga ukwazi ukuthi leli qembu izidakamizwa abangela ukuvuvukala ukuguguleka ezingxenyeni ezahlukene pheshana emathunjini. Ukuze ugweme ukuxakeka ezinjalo, ngemuva kokuthola amaphilisi adingekayo uzame ngamahora ayivumanga ukuhamba, futhi uhlale isikhundla uqotho. Umthamo ukhethwa udokotela ukuba khona.

Ngokuvamile, ukuqashwa kukaNksz bisphosphonates udokotela ekunika isiguli namanje futhi ukungenisa ukuphuza amaphilisi amaningi calcium. Ngakho, reception ngesikhathi esisodwa kokubili ezikhishiwe. Amalungiselelo equkethe calcium, lingathathwa ngemva kokuthatha bisphosphonate kuphela ngemuva kwamahora amabili, hhayi ngaphambi kwalokho. Esinye isincomo ezibalulekile: CF kufanele unganathi itiye, ubisi, juice noma ikhofi, namanzi plain (okuningi).

Ukusetshenziswa bisphosphonates yezifo neoplastic

inkulumo okuningi mayelana nokwelashwa bisphosphonate izifo ezihilela ukukhula izimila bemvelo ezahlukene. Okuvela Ukudlulela e bone izicubu side by side nge ukuxhumana okuhambisanayo phakathi isimila cells nomsebenzi umzimba ithambo izicubu. Ngakwelinye ihlangothi, ukuthuthukiswa othakazelisayo metastases kuhambisana adhesion isimila cells ethanjeni izakhiwo, kanye ehlasela, ayanda futhi neoangiogenesis. Ukuhlola okuhlukahlukene preclinical baye bavumela ososayensi ukwenza ngoba kucatshangwa ukuthi BF zivimbela ngalinye kulawa izigaba pathogenesis.

Ngokuhamba izinhlelo eziningana ucwaningo thina esikalini umphumela bisphosphonate "Clodronate" on ukuthuthukisa metastases e thambo abesifazane kutholakala ukuthi unomdlavuza webele. imiphumela emihle eyatholakala: ukulungiswa yasiza ekunciphiseni nokudlondlobala metastases nokukhula ithambo izicubu ezintsha ezigulini. Okwamanje, ucwaningo kule isiqondiso kuyaqhubeka ngenkuthalo. Bisphosphonates lapho ithambo metastases ngempela ukusiza.

izimila ebulalayo zivame ukuhambisana hypercalcemia (calcium ukukhululwa enkothweni). Lapho lesion metastatic ithambo calcium ukulahlekelwa okusheshayo kwenzeka ngenxa kokubhujiswa kwalo ngo-osteoclasts. Ngaphezu kwalokho, hypercalcemia e umdlavuza uyakwazi zenzeka ngenxa ukuchayeka a peptide lwesimila. Ngaphezu kwalokho, kukhona ukusebenza osteoclasts, okuholela hypercalcemia. Le nqubo luyindida futhi yashesha ngokunciphisa umsebenzi kwezinso.

Lezi zinqubo ingabe zenzeka ne komdlavuza ezifana-squamous cell carcinoma, myeloma amaningi, umdlavuza webele, kwezinso umdlavuza cell futhi abanye lymphomas. Hypercalcemia, cuphuluza umdlavuza, izidakamizwa ephumelela kunazo kukhona bisphosphonates ngoba ukumnika emthanjeni. esungulwe kahle lezi zimo, izidakamizwa ezinjalo, bisphosphonates, njengoba "Zolendronovaya acid" futhi "Pamidronate".

Ukuqaphelwa abonisa ukuthi izinsuku kakade ezimbalwa ngemva emizameni yokuthuthukisa abaphathi iziguli ngemithambo yegazi idatha izidakamizwa e emakamu igazi calcium sibuyela kwesejwayelekile, futhi umphumela ihlala isikhathi eside ngempela isikhathi (kusuka amaviki amabili).

Uhlu izifo lapho bisphosphonates asetshenziswa ngempumelelo

• Lokhu kwakubangelwa ukukhumuzeka kwamathambo.
• Myeloma.
• Ukuphulwa ithambo kumiswa.
• Paget sika isifo (osteodystrophy deforming).
• hyperparathyroidism Primary.
• Izimila kanye metastases e ithambo, ikakhulukazi kuhlangene hypercalcemia.

side effects

Ngeshwa, ukuphathwa bisphosphonate asebenzayo akukwazi engalimazi. Ikakhulukazi uma kuziwa ekuphathweni emthanjeni le mithi. Zingadala okungekuhle side effects ezilandelayo:

• Lapho iqondiswa ngemithambo yegazi, - hypocalcemia.
• Ezingapheli zingayilimaza izinso, kubangele ukudakwa.
• Ngezinye izikhathi reception Amine biosfosfonatov kuphakamisa ukuthuthukiswa osteonecrosis emhlathini.
• Nokufaka isandla ekuthuthukiseni izilonda e emphinjeni kanye esiswini.
• Kungabangela ukuqunjelwa noma isifo sohudo, ezimweni ezingajwayelekile - nobunzima ukugwinya.
• umkhuhlane Jikelele, ubuthakathaka, isicanucanu.
• ubuhlungu bemisipha.
• izinkinga Vision.
• Ukuqubuka emzimbeni.

Yebo, zonke lezi izinkathazo kungabangela bisphosphonates. Izidakamizwa, amagama okuyinto ohlangana kulesi sihloko, ungakwazi yini ukhombe ngokwami ngokuzimela hhayi engaqondile kubangele umzimba umonakalo ongalungiseki. Thina ngamabomu ukuphinda izikhathi eziningana embhalweni! Ukwahlulela ukubuyekezwa, zazo zingafundwa ezithangamini ezehlukene, abantu abayizigidi bamatasa ngokwabelana ngolwazi nomunye mayelana BF ahlukahlukene futhi bancome kalula kubo kwabanye. Lena kancane abangenasimilo. Thatha lezi izidakamizwa ezinamandla kuyadingeka kuphela ngokulandela isincomo udokotela ukuya kanye njalo ayewengamele.

Bisphosphonates - izibuyekezo kodokotela kanye neziguli

Uthi bewazi nje ukuthi minyaka yonke, ngo-October 20, kuwo wonke amazwe of the Day World of ekulweni kwamathambo? Lesi sifo eminyakeni yamuva, ekuzuzeni iqophelo ngempela. Nakuba ezinye izazi zikholelwa ukuthi ukuphuthuma inkinga kwamathambo kulinganiselwe ihaba, ngoba isifo ngokwako akusona ebulalayo. Noma kunjalo, iphesenti abantu abadala abenza izinto afe ngemva ukwa hip, okuyinto ngokuvamile kwenzeka lapho yanda kwamathambo likhulu kakhulu. Ngakho-ke, isibalo esikhulu sabantu has amathemba ethize bisphosphonates. Izibuyekezo ekubulaleni iziguli ezigulela wathola lezi izidakamizwa ngenxa yethemba zokululama, benamandla ukubonga odokotela kwemithi yesimanje, okuyinto wakwazi babanikele isizo ngesikhathi esifanele.

Dr. med. , Onguprofesa nenhloko Centre Scientific-Clinical kwamathambo Svetlana Rodionova ukholelwa ukuthi isimo nge kwamathambo okukhulu okungaholela eRussia. Udokotela owaziwa uthi ezinsukwini zethu, lapho amandla iningi labantu unephutha (yokuntuleka kwe-calcium), uthole ukusatshalaliswa kwenqwaba yemilayezo enjalo imikhuba emibi enjengokubhema, ukusetshenziswa kwezidakamizwa notshwala, futhi umsebenzi ngokomzimba sisondela ngokushesha zero, intsha eningi, ikakhulukazi abesifazane awusona iminyaka ukhulile kwamathambo. Ngakho isidingo izidakamizwa kahle ukusiza ukwelapha lesi sifo eliphezulu kakhulu.

Njengoba for aphoyintimenti bisphosphonates njalo udokotela, uprofesa umbono ukuthi akukhona njalo nyama. Bisphosphonates - ezinikeza izidakamizwa, kodwa isiguli phambi enquma kadokotela ethile, udokotela kufanele qiniseka acabangele izici ezifana umzimba ithambo ne-calcium homeostasis. Lapho nobudedengu engalawuliwe yokwelapha bisphosphonate kungadala eziyingozi: fibrillation atrial, osteonecrosis emhlathini, waphuka subtrochanteric ka kunawo wonke.

Kususelwa umbono nohloniphekile, bisphosphonates akuzona panacea jikelele, ukusetshenziswa kwabo kufanele wasondela ngokuqapha. Phakathi naleso sikhathi, uhlelo "Impilo" okuvezwa kuyithelevishini, lapho Elena Malysheva emomotheka amnandi engenza izithameli ukuthi akukho lula kunaleyo ukulashelwa kwamathambo, i-bisphosphonate oyisizukulwane sesithathu. Musa uthole kakhulu othembela infomercial. Abanye abantu abathola BF is ngokuphelele contraindicated. Ngokwesibonelo, iziguli izifo ezinzima kwezinso.

Manje ukubuyekeza sendlela usebenze bisphosphonates lapho ithambo metastases. umbono Medical licacile: mithi sebeyakwazi ayeke ekukhuleni thambo amaseli abulalayo, okuyinto Yiqiniso, kusiza iziguli unqobe omunye izifo ezinzima kakhulu, okuyinto kuphela ukhona emhlabeni.

isiphetho

Manje uyazi ukuthi iyini - bisphosphonates. Yokusetshenziswa wabo ebekwe lapha, kanye uhlu izidakamizwa esiwuphiwe hhayi njengendlela isincomo futhi isiqondiso kuphela - sicela unake zakho ezikhethekile kule! Uma izinkinga ezingathi sína akudingeki self-medicate ngempilo, okungcono - ngokushesha ukubona udokotela, ngakho wathatha ukuba amalungiselelo wezokwelapha. Sifisela wena yonke impilo eyizingqabavu futhi injabulo!