Nws yog ib qho nyuaj rau xav txog tias qee yam 100 xyoo dhau los tsis muaj insulin, thiab cov neeg mob ntshav qab zib tau lees tias yuav tuag sai sai. Cov tshuaj ntshav qab zib rau hom ntshav qab zib hom 2 tsuas tshwm sim li ntawm ib nrab xyoo dhau los, thiab ua ntej ntawd, cov neeg mob no kuj tau tag sim neej, txawm hais tias tsis yog sai.
Niaj hnub no nyob hauv Is Taws Nem muaj ntau cov lus qhia txog cov tshuaj tshiab, txoj kev kho mob, cov cuab yeej siv rau lawv kev tswj hwm thiab kev tswj hwm tus kheej ntawm glycemia uas nkag mus tau rau txhua tus neeg mob ntshav qab zib, tias tsuas yog tus neeg tub nkeeg thiab tus neeg tsis saib xyuas yuav cia nws tus kheej tsis quav ntsej txhua yam, tos kom muaj kev phom sij tuag taus.
Ib qho ntawm cov kev tawm tsam tshiab tshaj plaws ntawm cov tshuaj tiv thaiv kab mob ua kom muaj zog yog incretinomimetics (exenatide, liraglutide, sitagliptin, vildagliptin, saxagliptin)Cov. Cov txiaj ntsig ntshav qab zib yog dab tsi?
Cov txheej txheem ntawm kev txiav txim ntawm incretins
Tus incretins yog tib neeg cov tshuaj hormones. Lawv txoj hnyuv tsim tawm tom qab kev noj zaub mov, insulin secretion tam sim no nce 80%. Ob yam ntawm lawv tau txheeb xyuas hauv lub cev - GLP-1 (glucone-zoo li peptide-1) thiab HIP (insulinotropic polypeptide). Cov receptors ntawm cov tom kawg yog nyob ntawm b-hlwb, thiab hauv GLP-1 lawv tuaj yeem nrhiav hauv cov kabmob sib txawv, yog li cov nyhuv ntawm nws cov haujlwm yog multivariate.
- GLP-1 txhim kho kev tsim cov tshuaj endogenous los ntawm b-hlwb;
- Cov tshuaj hormones inhibits qhov zais cia ntawm glucagon los ntawm b-hlwb;
- Incretin ua kom qeeb plab zom mov;
- Nws txo qhov qab los noj mov thiab tsim kom zoo nkaus;
- Muaj txiaj ntsig zoo ntawm lub hauv nruab nrab lub paj hlwb, lub plawv, cov hlab ntsha.
Glucagon, uas ua nyob rau hauv lub siab ntawm b-hlwb, yog qhov sib luag ntawm insulin. Nws tsub kom cov concentration ntawm cov piam thaj nyob rau hauv cov hlab ntshav los ntawm kev tso tawm nws los ntawm daim siab.
Cov leeg nqaij xav tau cov piam thaj txhawm rau rov ua kom lub zog muaj hluav taws xob, qhov twg tam sim no nyob rau hauv hom ntawv glycogen. Los ntawm inhibiting qhov synthesis ntawm glucagon, cov tshuaj hormones incretins thaiv kev tso tawm ntawm cov piam thaj los ntawm daim siab, cia li nce cov kua dej tawm.
Muaj txiaj ntsig dab tsi ntawm ncua plab zom mov rau cov ntshav qab zib? Lub cev nqus feem ntau ntawm cov piam thaj hauv cov hnyuv. Yog tias nws yuav raug xa tawm nyob rau hauv cov koob tshuaj me me, yuav tsis muaj qhov hnyav rau hauv cov ntshav qab zib. Qhov no yuav pab daws teeb meem ntawm postprandial (tav su) glycemia. Nws yog tsis yooj yim sua kom tsis txhob yoo dhau txoj kev xav nyob rau hauv hom 2 mob ntshav qab zib: GLP-1 ncaj qha cuam tshuam rau qhov chaw ntawm kev tshaib plab hauv lub hypothalamus.
Cov txiaj ntsig ntawm incretins rau lub siab thiab cov hlab ntshav yog tam sim no tau nquag kawm. Hauv chav tshawb xyuas, nws pom tias GLP-1 txhawb kev tsim kho tshiab ntawm pancreatic hlwb thiab tiv thaiv b hlwb los ntawm kev puas tsuaj.Dab tsi tiv thaiv kev siv cov tshuaj hormones ntuj dhau los siv tshuaj? GLP-1 raug rhuav tshem los ntawm DPP-4 (hom 4 dipeptidyl peptidase) hauv 2 feeb, thiab HIP - hauv 6 feeb.
Cov kws tshawb fawb tau los nrog 2 pab pawg ntawm cov tshuaj uas zoo ib yam li cov nce qib:
- Mimicking cov txheej txheem ntawm kev ua ntawm GLP-1;
- Kev cuam tshuam cov kev ua ntawm enzyme DPP-4 thiab ua kom ntev lub neej ntawm cov tshuaj hormones.
Thawj hom tau nthuav tawm ntawm kev lag luam hauv teb chaws los ntawm Bayeta (raws li exenatide) thiab Viktoza (raws li liraglutide) - cov duab sib piv ntawm GLP-1, kiag li duplicating nws lub peev xwm, tab sis nrog lub txiaj ntsig ntev. Qhov zoo tuaj yeem muab ntxiv thiab qhov hnyav poob txog 4 kg rau rau lub hlis thiab txo qis glycated hemoglobin los ntawm 1.8%.
Qhov thib ob yog sawv cev hauv peb lub teb chaws los ntawm peb cov tshuaj - Galvus (raws li vildagliptin), Yanuviya (raws li sitagliptin), Ongliza (hauv nws muaj pes tsawg leeg - saxagliptin). Lawv lub luag haujlwm tseem ceeb yog txhawm rau thaiv lub zog DPP-4, uas ua rau lub zog nce zuj zus. Cov kev ua ntawm cov tshuaj hormones nce ntau kawg yog 2 zaug, yog li glycemia tsis hem neeg. Cov tshuaj khuam muaj ob peb qhov tsis xav ua, vim tias cov tshuaj hormones ntau ntxiv hauv qhov ntau ntawm lub cev.
Cov nyhuv ntawm lawv qhov hnyav yog qhov nruab nrab, glycated hemoglobin raug txo qis hauv txoj hauv kev tib yam li thawj pab pawg.
Daim ntawv tso tawm khoom tawm
Saxagliptin yog cov tshuaj kho tshiab ntawm chav kawm ntawm DPP-4 inhibitors. Nws lub npe lag luam yog Onglisa. Lawv tso tawm cov tshuaj hauv 2.5 thiab 5 mg, muag tshuaj ntsiav tshuaj. Txee lub neej ntawm cov tshuaj yog 3 xyoos, chaw cia khoom yog txheej txheem.
Saxagliptin tsis muaj nyob rau hauv tsoomfwv daim ntawv teev cov tshuaj muaj feem tshwj xeeb, txawm hais tias nyob hauv qee thaj chaw nws tau sau tseg raws kev sau npe hauv ib cheeb tsam los ntawm pob nyiaj hauv cheeb tsam. Txhawm rau kho Onglisa ntawm tus nqi ntawm cov khw muag tshuaj online, koj yuav tsum siv 1700 rubles. hauv ib hlis (5 ntsiav tshuaj mg). Rau kev sib piv, qhov kawm ib hlis ib zaug ntawm Januvia (koob tshuaj 100 mg) yuav raug nqi 2,400 rubles, Galvus - 900 rubles.
Kev pom zoo rau kev siv
Saksagliptin cov lus qhia rau kev siv pom zoo kom noj 1p. / Hnub., Lub sijhawm tsis khi rau kev noj zaub mov. Koj tuaj yeem siv cov cuab yeej rau kev kho mob monotherapy lossis hauv daim foos.
Cov tshuaj sib xyaw ua ke saxagliptin thiab metformin tseem tsis tau tsim tawm, zoo li nws cov analogues YanuMet thiab GalvusMeta.
Hais txog cov teeb meem me hauv lub raum, koj tsis tas yuav kho qhov tshuaj ntau ntxiv; hauv qhov mob loj dua, tus nqi yuav txo qis 2 zaug.
Leej twg yog tus tsim tshuaj Saxagliptin
Saxagliptin-based tshuaj (ib qho lus - Onglisa) tuaj yeem tau kho txawm tias nyob rau theem ntawm kev mob ntshav qab zib hom thib 2, thaum hloov kho txoj kev ua neej (noj cov zaub mov qis, ua haujlwm lub cev txaus, kev tswj lub cev hauv lub siab) tsis muab cov ntshav qab zib nyob rau hauv cov hlab ntshav.
Saxagliptin kuj tseem tsim nyog rau kev kho mob nyuaj, kom raws nraim li ntau npaum li cas ntawm cov tshuaj yuav raug siv tib lub sijhawm tom qab kuaj mob yuav yog nyob ntawm kev ua haujlwm ntawm glycated hemoglobin. Nyob rau hauv parallel nrog Ongliza, metformin yog qhov tsim nyog, thiab thaum tsis muaj kev tswj hwm glycemic txaus, sulfonylurea npaj thiab thiazolidinediones yog tshuaj.
Cov Yuav Tsum Muaj
Nrog
Sau tag nrho:
- Lub sijhawm ua cev xeeb tub thiab pub mis;
- Hnub nyoog: ua ntej 18 thiab tom qab 75 xyoo;
- Nrog rau cov kua qab zib-galactose malabsorption;
- Ntshav Qab Zib Hom 1;
- Ntshav qab zib ketoacidosis;
- Nrog galactose intolerance, lactase tsis muaj peev xwm;
- Kev ua haujlwm tsis txaus siab rau cov txheej txheem ntawm cov mis.
Ntxiv nrog rau cov ntawv sau contraindications, thaum kos duab kev kho mob tus txheej txheem, tus kws kho mob yuav siv mus rau hauv kev cuam tshuam ntawm saxagliptin nrog lwm cov tshuaj uas tus mob ntshav qab zib siv rau cov kab mob concomitant. Nws yog ib qho tseem ceeb uas yuav tau qhia rau tus kws paub txog endocrinologist txog txhua yam teem sijhawm ntxiv kom raws sijhawm.
Phiv thiab haus tshaj
Saxagliptin yog qhov muaj kev tiv thaiv hypoglycemic zoo, vim nws tsis ua rau cov ntshav puas siab ntsws, tab sis, zoo li lwm yam tshuaj tua kab mob, nws tuaj yeem muaj qhov cuam tshuam tsis zoo. Yog tias cov tsos mob no lossis lwm qhov tsis xis nyob tshwm sim, koj yuav tsum sab laj nrog kws kho mob: nws yuav hloov qhov tshuaj lossis xaiv qhov hloov pauv.
Ntawm cov kev ua phem tshaj plaws:
- Kab mob sib kis;
- Kev hlais tawm cov txheej txheem ntawm cov tshuab tua kabmob (genitourinary system);
- Dyspeptic cuam tshuam;
- Mob taub hau;
- Kev mob pob txha
- Lub plab zom mov
Cov kev qhia tsis hais txog cov tsos mob ntawm kev haus ntau dhau, txij li kev tshawb fawb soj ntsuam hauv kev muab tshuaj kho rau cov neeg tuaj yeem noj qab haus huv ntawm kev txhaj tshuaj ntau tshaj qhov kev ntsuas nrog 80 lub sijhawm pom tias tsis muaj kev qaug dab peg.
Dab tsi tuaj yeem hloov tau saxagliptin
Nrog kev ua siab ntev tsis zoo lossis tsis pom kev, tus kws kho mob yuav xaiv cov tshuaj analogues rau saxagliptin. Tsis muaj lwm txoj hauv kev rau Onglise nrog tib lub ntsiab lus nquag, tab sis raws li cov txheej txheem ntawm kev nqis tes ua, kev ua nruj ua tsiv ntawm DPP-4 enzyme yuav raug thaiv:
- Januvia yog thawj cov tshuaj ntawm chav kawm no, uas tau siv thawj zaug hauv Asmeskas, tom qab ntawd nyob hauv Europe. Ib nrab ib teev tom qab noj mov, cov tshuaj yuav thaiv qhov enzyme rau ib hnub. Koj tuaj yeem yuav cov ntsiav tshuaj ntawm 25.50 thiab 100 mg. Cov qauv koob tshuaj yog 100 mg / hnub. Qhov tshwm sim tau nthuav tawm nyob hauv ib hlis. Rau qhov yooj yim ntawm kev kho mob nyuaj, cov tshuaj tau tsim tawm ua ke nrog metformin - YanuMet.
- Galvus yog cov tshuaj Swiss zoo, tsim nyog rau kev kho mob nyuaj, suav nrog nrog tshuaj insulin. Cov tshuaj sib xyaw ua ke GalvusMet kuj tseem tso tawm, nws muaj pes tsawg leeg yog ntxiv nrog metformin. Ua ntej, cov tshuaj tau noj ntawm 50 mg / hnub. Yog tias tsim nyog, tus nqi yuav tsum tau ua ob npaug, faib nws ua 2 zaug.
Qhov kev ua tau zoo thiab kev nyab xeeb ntawm txhua cov tshuaj hauv cov pab pawg no zoo ib yam, qhov kev xaiv ntawm cov tshuaj tshwj xeeb yuav yog nyob ntawm kev muaj peev xwm ntawm tus neeg mob thiab kev paub dhau los ntawm tus kws endocrinologist nrog rau cov tshuaj. Rau saxagliptin, tus nqi yog qhov zoo dua thaum piv nrog analogues.
Saxagliptin raws li onlagis, kev tsim kho tshiab ntawm European kws muag tshuaj hauv cov kws kho mob ntshav qab zib, tsis tsuas yog hypoglycemic, tab sis kuj tseem muaj kev cuam tshuam ntxiv: nws txo qis kev qab los noj thiab qhov hnyav, tiv thaiv cov txiav, pab tswj ntshav siab, thiab muaj peev xwm cardioprotective.
Koj tuaj yeem kawm paub ntau ntxiv txog incretins thiab qhov muaj peev xwm ntawm cov tshuaj tiv thaiv kab mob raws li lawv los ntawm lub vev xaib ntawm endocrinologist Dilyara Lebedeva hauv daim yeeb yaj kiab no.
