Kev zom plab thiab kev nqus ntawm cov khoom noj khoom haus los ntawm cov zaub mov yog vim cov kua txiv ua kua uas ua los ntawm cov txiav ua rau txoj hnyuv. Txoj kev ua pa zom ua ke muaj cov enzymes uas ua lub luag haujlwm hauv kev zom zaub mov.
Tus txheej txheem ntawm kev tsim khoom, hom thiab cov haujlwm
Qhov txiav ua pa yog ib qho khoom ntawm sib xyaw ua ke, vim nws tsim tsis tau tsuas yog cov enzymes zom, tab sis kuj yog cov tshuaj hormones - insulin, glucagon thiab lipocaine. Cov tshuaj insulin thiab glucagon tswj cov metabolism hauv kev ua kom yuag, thiab cov tshuaj lipocaine ua rau lub cev yog lub luag haujlwm rau cov txheej txheem biochemical hauv lub siab. Cov tshuaj hormones tseem muaj nyob hauv cov kua txiv pancreatic thiab txhawb kev zom plab hauv cov hnyuv me.
Thaum cov zaub mov tsis nco qab lawm nkag mus rau duodenum ntawm tus txiav, ib lub siab xav kis mus rau qhov uas nws teb los ntawm ejecting qhov tsim nyog npaum li cas ntawm pancreatic secretion. Nws muaj cov pancreatic enzymes nyob rau hauv ib daim ntawv tsis xaj - proenzymes.
Tus ciav uas hla cov kua txiv quav yeeb txav mus rau hauv duodenum 12 hu ua Virsungieva duct thiab nyob raws qhov ntev ntawm lub caj pas tag nrho. Nws xaus rau hauv qab nraub qaum nrog sphincter ntawm Oddi. Hauv cov neeg feem ntau, Virsungiev duct txuas mus rau cov kua tsib uas feem ntau, thiab txuas rau hauv duodenum.
Lub zais zis ua paug nrog cov khoom noj khoom haus los ntawm kev tso tawm cov kua tsib, uas sib xyaw rau hauv cov ciav feem nrog kua txiv pancreatic. Tom qab qhov no, ua kom cov enzymes rau kev ua cov rog, cov protein thiab carbohydrates pib. Nyob rau hauv kev cuam tshuam ntawm cov tshuaj enzymatic, cov khoom noj ua ke hnyav ua kom cov piam thaj, cov protein rau cov amino acids, cov rog rau cov rog thiab glycerol.
Pancreatic enzymes ua kev ua haujlwm ntau tshaj plaws ntawm kev zom cov zaub mov. Cov zaub mov ua tiav los ntawm cov enzymes nkag mus rau hauv txoj hnyuv me, qhov chaw muaj as-ham nyob rau hauv cov hnyuv phab ntsa mus rau hauv cov ntshav, xa mus rau cov nruab nrog cev thiab cov nqaij hauv lub cev.
Txij li thaum cov enzymes uas ua los ntawm cov txiav ua hauj lwm qhov chaw zom zaub mov yog qhov muaj zog heev, txhua yam kev cuam tshuam hauv lub cev tau cuam tshuam rau kev nyob zoo ntawm tus neeg. Muaj teeb meem nrog txoj hnyuv (mob plab), muaj dyspeptic tshwm sim - pom lub cev, tsam plab thiab xeev siab. Vim tias tsis muaj cov kab mob pancreatic enzymes, ntau cov khoom tsis zom, thiab mob pancreatitis.
Kev ua tiav
Muaj 3 hom enzymes - amylase, lipase thiab protease. Amylases zom cov hmoov txhuv nplej siab thiab carbohydrates, txoj haujlwm ntawm lipase yog hydrolysis ntawm cov rog, thiab protease yog lub luag haujlwm rau kev tawg ntawm cov protein.
Cov pab pawg protease suav nrog exopeptidases, uas tawg rau sab nraud peptide hauv cov protein thiab peptides, thiab endopeptidases, uas yog lub luag haujlwm rau hydrolysis ntawm cov protein-peptide bonds. Exopeptidases suav nrog carboxypeptidase A thiab B, proteolytic enzymes uas tawg peptide bonds thiab yog ib feem ntawm cov kab mob pancreatic.
Endopeptidases yog pepsin, gastricin thiab chymosin, uas yog zais cov plab hnyuv, thiab pancreatic proenzymes trypsin, chymotrypsin thiab elastase. Cov plab zom mov plab nquag zom cov protein molecules, catalyzing hydrochloric acid txog 95%.
Tom ntej no, pancreatic enzymes suav nrog kev ua haujlwm, ntxiv rau kev zom cov protein nyob rau hauv cov hnyuv. Ua ntej, trypsin, chymotrypsin thiab elastase zom cov protein loj loj rau hauv cov me - peptides. Tom qab ntawd, nyob rau hauv kev txiav txim ntawm carboxypeptidase, peptides yog hydrolyzed rau amino acids uas tau nqus los ntawm cov hnyuv phab ntsa.
Cov kua txiv pancreatic muaj 6 hom kev tiv thaiv, uas txawv hauv cov qauv ntawm cov nquag ua haujlwm hauv nruab nrab:
- serine;
- threonine;
- cysteine;
- aspartyl;
- metalloprotease;
- glutamine.
Nws yuav tsum raug sau tseg tias cov proteases yog ib feem ntawm cov tshuaj feem ntau nrog cov enzymes siv los rov ua haujlwm pancreatic thiab tshem tawm cov tsos mob tsis zoo.
Amylase
Amylolytic pancreatic enzymes zom cov khoom noj muaj hmoov nplej yooj yim rau cov suab thaj yooj yim hu ua oligosaccharides. Nws yog tsaug rau amylase tias ib tus yam ntxwv ntawm qab zib tom qab tshwm sim tom qab noj zaub mov txawv - piv txwv li, mov lossis qos yaj ywm. Qhov enzyme no tseem nyob hauv cov qaub ncaug, nyob rau hauv tus neeg ntawm cov txheej txheem ntawm kev zom zaub mov pib.
Hauv cov kab noj hniav hauv qhov ncauj, cov hmoov txhuv nplej siab tau tawg mus rau dextrin, thiab dextrin thiab maltose yog tsim los ntawm kev ua cov polysaccharides los ntawm cov kua txiv. Cov kauj ruam kawg yog qhov cleavage ntawm carbohydrates nyob rau hauv duodenum 12 rau hauv qabzib thiab fructose nyob rau hauv kev txiav txim ntawm Y-amylase.
Amylolytic enzymes suav nrog lactase, uas zom cov lactose (cov piam thaj hauv mis) uas muaj nyob hauv cov khoom noj siv mis.
Enzyme deficiency ntawm amylase tej zaum yuav qhia kev loj hlob ntawm ib tug xov tooj ntawm pathologies: pancreatitis, tus mob qog (tus mob qog), ntshav qab zib mellitus thiab pancreatic hlav.
Cov leeg
Lipolytic enzymes ua lub hauv paus rau lipid hydrolysis thiab zom cov rog uas tau txais hauv lub cev. Lipase yog ua kom nyob rau hauv txoj hnyuv thiab zom cov zaub mov muaj roj rau hauv glycerin thiab ntau dua cov roj acids. Qhov enzyme no tau muab faib ua hydrophilic thiab hydrophobic qhov chaw ua haujlwm tshwj xeeb rau thaj chaw muaj roj-rog. Yog li no, qhov yuav tsum tau ua ua ntej rau kev zom cov zaub mov yog cov tawg ua me me ntawm cov kua tsib - yog li, thaj tsam ntawm kev sib cuag nrog lipase nce.
Kev nce lipase nce nyob hauv kev kuaj ntshav tau pom rau ntau yam kab mob ntawm txoj hnyuv thiab lub raum, cov kab mob metabolic (mob ntshav qab zib mellitus, mob gout, rog), mob peritonitis, thiab mob qog. Qee qhov xwm txheej, lipase Performance index nce ntxiv vim qhov kev kho mob ntev nrog barbiturates, narcotic analgesics, Heparin thiab Indomethacin.
Yog tias tsis muaj lipase txaus nyob rau hauv lub cev, tom qab ntawd qhov ua rau tuaj yeem txo qis kev ua haujlwm pancreatic, cystic fibrosis (cystic fibrosis), kev txhim kho ntawm malignant neoplasms hauv ib yam khoom hauv lub cev dua li tus txiav ua haujlwm. Qee zaum lipase qib qis yog vim kev noj zaub mov tsis tau lub cev nrog kev noj cov zaub mov rog.
Kev kuaj mob thiab cov tsos mob ntawm txo exocrine muaj nuj nqi
Txhawm rau txiav txim siab seb cov enzymes txiav tus kab mob dab tsi tsis ua kom muaj txiaj ntsig txaus, kev sim hauv chav kuaj tau nqa tawm. Raws li cov txiaj ntsig ntawm kev kuaj ntshav, tso zis thiab quav, kev tshawb nrhiav cov twj paj nruag, thiab tseem coj mus rau hauv tus account cov tsos mob uas twb muaj lawm, kev npaj enzyme tuaj yeem raug tshuaj.
Cov qauv rau cov ntsiab lus ntawm cov enzymes yog li hauv qab no:
- ntshav: amylase - 29-99, lipase - 22-66, trypsin - 19.7 - 30.3 mg / l;
- ntshav ntshav: elastase - 01 - 4 ng / ml;
- zis: amylase (diastase) - max 100 units / l;
- coprogram: elastase - los ntawm 200 mcg / g.
Pancreatic enzymes yog tsim nyob rau hauv cov hlwb acinar ntawm tus txiav, tom qab ntawd los ntawm cov leeg me tshaj plaws lawv nkag mus rau hauv cov leeg loj dua uas ua cov kav loj - Virsungov
Kev tsis txaus ntawm cov pancreatic enzymes ua rau muaj kev ua txhaum loj ntawm cov zom zaub mov thiab lub cev tag nrho. Nyob rau hauv cov ntaub ntawv ntawm ntau dhau lawm tsim cov enzymes, ib qho kev mob hnyav ntawm tus mob ntawm tus txiav ua ke kuaj - pancreatitis. Txo cov synthesis ntawm cov enzymes txhais tau tias kev hloov ntawm tus kabmob mus rau ib daim ntawv uas muaj mob ntev.
Cov laj thawj hauv qab no tuaj yeem ua rau kev hloov pauv thiab puas tsuaj hauv kev txiav thiab hloov chaw ntawm qog nqaij hlav nrog cov nqaij mos:
- Ntau dhau thiab tsim txom cov rog rog, haus dej cawv;
- muaj cov neoplasms - nqaij hlav, qog (ob qho tib si benign thiab malignant), fibrosis;
- pathology ntawm duodenum thiab biliary huam;
- txiav phais.
Nrog rau lub enzyme tsis muaj peev xwm, ib tug xov tooj ntawm cov yam ntxwv tshwm sim:
Yuav kuaj xyuas tus txiav- polyfecal (ntau ntawm cov quav ua quav);
- porridge-zoo li, xoob xoob ntawm cov xim greyish nrog lub ci, ci roj thiab qhov tsis hnov tsw;
- muaj cov khoom noj tsis muaj kev txwv hauv plab;
- zoo nkaus li lub plab puv npo thiab xeev siab, kub siab;
- tsw phem nyob rau hauv lub qhov ncauj;
- tsis qab los noj mov;
- flatulence, raging hauv plab;
- kev poob phaus, mob ntshav tsis txaus, ua kom tsis muaj zog, insomnia thiab mob taub hau;
- mob plab tom qab noj mov;
- intolerance rau cov rog thiab ntsim zaub mov.
Txij li thaum lipase synthesis yog feem ntau txo, qhov quav tsis txaus ntseeg yog ib qho ntawm thawj - nws ua tiav khov lossis ib nrab kua. Nws yog tsim nyog sau cia tias cov tsos mob yuav luag zoo tib yam nrog ob qho dhau ntawm cov enzymes, thiab nrog ib qho tsis txaus. Txawm li cas los xij, yog tias muaj enzymes ntau dhau lawm, lub cev kub yuav nce, thiab qhov mob yauv mob zuj zus, hais tawm.
Kev ua txhaum ntawm exocrine muaj nuj nqi ntawm tus txiav yuav tsum tau kev kho mob uas yuav tsum tau ua, vim nws tuaj yeem ua rau txoj kev txhim kho ntawm cov kabmob uas muaj kabmob xws li pancreatic necrosis, pais plab rwj, kab mob siab thiab kab mob ntsws.
Cov tshuaj uas muaj enzyme
Cov tshuaj Enzymes rau cov txiav ntshav yog raws li cov txiaj ntsig ntawm kev tshuaj ntsuam thiab raws li cov tsos mob uas twb muaj lawm. Cov tshuaj thiab qhov ntau npaum li cas yog nyob ntawm lub hnub nyoog thiab qhov hnyav ntawm tus neeg mob, nrog rau daim ntawv ntawm tus kabmob. Hauv kev hloov tshuaj enzyme, tshuaj siv tau uas suav kev lipase, amylase thiab trypsin. Qhov no yog, ua ntej txhua yam, Pancreatin thiab nws cov lus dag - Creon, Mezim Forte, Pangrol, Panzitrat, thiab lwm yam.
Feem ntau, cov kws kho mob pom zoo kom noj Creon, vim tias nws zoo dua nqus thiab muaj qhov zoo. Creon tsis muaj nyob rau hauv cov ntsiav tshuaj, tab sis nyob rau hauv tsiav tshuaj nrog kev tiv thaiv ob npaug. Txhua lub tshuaj ntsiav muaj ntau lub mini-microspheres, uas tsis vau thaum muaj kev txhoj puab heev ntawm hydrochloric acid ntawm lub plab thiab ncav cuag lawv qhov chaw nyob - hauv cov hnyuv. Tsis tas li ntawd, cov muaj pes tsawg leeg ntawm Creon suav nrog dimethicone, uas txo cov roj tsim.
Tus nab npawb ntawm cov tshuaj muaj sib xyaw ua ke, ntxiv nrog bile Cheebtsam. Lawv raug sau tseg rau kho qhov ua rau lub siab thiab lub zais zis. Cov tshuaj sib xyaw suav nrog Festal, Digestal, Kotazim Forte, Enzistal.
Lub unienzyme raws li tsob nroj enzyme papain txhawb kev ua tiav ntawm kev zom cov protein, cov rog thiab carbohydrates, muaj kev nqus, laxative thiab suppressing roj tsim cov nyhuv.
Hauv kev mob taub hau kom meej meej, enzyme inhibitors uas txwv qhov kev ua haujlwm ntawm kab mob plab - Somatostatin, Contrical, Ingitrile, Glucagon, Gordox, thiab lwm yam yog thawj zaug tau siv.
Thaum muaj teeb meem hauv cov khoom noj khoom haus lossis nrog cov tsos mob me ntawm pancreatitis, siv cov nroj tsuag enzymes tuaj yeem siv - piv txwv, Oraza, Pepfiz, Unienzyme, Wobenzym, Solizim, Abomin.
Kev noj haus tau txais txiaj ntsig
Yuav kom tau txais cov txiaj ntsig zoo tshaj plaws los ntawm kev kho mob nrog cov tshuaj enzyme, koj xav tau kev noj zaub mov kom zoo. Nws yog ua raws cov qauv ntsiab ntawm kev noj haus naj npawb 5, kev ua kom nrawm nrawm dua:
- fractionality - tus naj npawb ntawm cov zaub mov ib hnub tsis yog tsawg dua 5;
- qhov hnyav ntawm ib qho ua haujlwm yuav tsum tsis pub ntau tshaj 200 g .;
- tag nrho cov tais diav yog ci, hauv qhov cub lossis cub;
- zaub mov kub - txog 35-40 °;
- rog, kib, cawv yog txwv tsis pub.
Nqaij cov nqaij thiab ntses ntawm cov roj ntsha uas muaj roj tsawg, nqaij qaib qe, buckwheat, oatmeal, txiv apples, txiv tsawb thiab tsev cheese tau pom zoo rau siv.
Txhawm rau kom rov qab ua haujlwm pancreatic los ntawm kev npaj enzyme, kev tshuaj xyuas yog tsim nyog. Raws li cov txiaj ntsig tau rau txhua tus neeg mob, kev kho tus kheej thiab kev noj tshuaj yuav tau xaiv.
