Creatinine Clearance

In mushonga ano, mashoko okuti "Clearance", iro rinomiririra quantitative chakarurama nokukurumidza napakusuka zvimwe zvinwiwa zvoutachiona. Tichishandisa chakarurama izvi yekudyidzana kudzamisisa kunzwisisa kwedu pharmacokinetics uye pharmacodynamics izvi uye zvimwe zvinhu.

Saka, Somuenzaniso, creatinine Clearance akatsunga kushandisa chirwere miedzo Reberga-Toreeva. Zvinokosha kucherechedza kuti pane iyi zvinoita kuona filtration mwero sezvo endogenously synthesized fuma uye akapa kubva kunze (mishonga uye nedzimwe nzira). Estimation rinoitwa nevanhu pakuverenga kunyatsoita mupise (glomeruli) of plasma kusunungurwa mwero kubva imwe fuma. Nhoroondo iri rakaitirwa munhu akadarika nguva (kunyanya - zuva).

Achitaura creatinine, vanofanira kuteerera chokwadi kuti vachibvisa kubva muviri kunyanya nokuda filtration basa neitsvo. Kubva musi uyu, zvakadai somunhu creatinine Clearance zvazvingava kwaizova rinokosha mune kunyatsoongorora renal glomerular filtration inoshanda. Zvinofanira kucherechedzwa kuti nhamba iyi inozivikanwa kwete chete dzichipfekeka vanokwanisa pakati Sefa ezvinhu, asiwo vamwe nokuvhiringidzirwa nhengo dzakavandika dzevanhu uye hurongwa. Modified pasi, creatinine Clearance uye angava anoratidza kukwana ropa kuyerera kusvika netsvo (atherosclerosis, uye unopinza chakasimba uye kukura - thromboembolism).

Mwero kwokuderera renal basa kunoitika pashure pemakore makumi mana. Kuderedza glomerular filtration yevanhu 1% pagore. Pashure pemakore makumi matanhatu, padanho yebasa ipfupi zvishoma nokukurumidza (kuchinja aya anonyanya chokuita yakwegura iri muviri). Zvisinei, zvinofanira kucherechedzwa kuti chero kuratidzwa ndokuchinja yakadaro haina kuchengetwa nokuti vakwegura iri tava kuderera zvose metabolic urongwa pasi, kusanganisira kwetunhu endogenous creatinine.

Paunogadzirira mharidzo Rehberg zvakafanira haabatanidzi kushandisa zvimwe zvinodhaka kuti anogona kukanganisa nzira kudzidzwa (zvinodhaka "Cortisol" "Furosemide", "Corticotropin", "Methylprednisolone," "Thyroxine" uye vamwe).

Kuisa nzwisa weti zvakabudiswa rinoitwa, uyewo ropa bvunzo paavhareji nenhanho yeplasma creatinine.

Pakati zvairatidza chidzidzo chinangwa: kwemakemikari anobudiswa zvokurwara, tinyatsonzwisisa renal dzichipfekeka basa, uyewo tinyatsonzwisisa matambudziko kurovedza muviri.

Zvichienderana padanho zvinoderedza Clearance kutsanangura izvi kana zvimwe kutyorwa.

• 30 Rine mamiririta / Maminitsi / m2 uye 1,7 - kuderera renal basa zvine mwero;
• 30-15 Rine mamiririta / Maminitsi / m2 1,7 - kuvapo renal kukundikana (kana ndanyarara hangu subcompensated dhigirii);
• <15. / Maminitsi / m2 1,7 - renal kukundikana decompensation danho.

Zvakakosha kunzwisisa kuti dzichipfekeka vanokwanisa pakati filtration hurongwa kunotema renal Clearance pakati creatinine, mwero iri panguva mharidzo Reberga anoratidza kuipa neitsvo.

Zvisinei, vamwe zvirwere haanamati kuchinja ari chinoratidza (semuenzaniso, chirwere pyelonephritis).

creatinine pamwero muropa kunoenderana basa rayo endogenous kwetunhu uye pamusoro wayo mwero Urinary excretion. Zvakakosha kunzwisisa kuti nhamba iyi kunobva kwete basa rokuchenesa ezvinhu, asiwo nokukurumidza uye bhuku reabsorption ose zvinhu pakugadzirwa chinonyanya weti.

Saka, pari Reberga mharidzo (kuziva creatinine Clearance) zvakakwana kuwana kushandiswa kwakapararira chirwere mushonga. A rakananga ukama pakati Clearance uye itsvo kushanda rinopa yakakwirira chirwere kukosha pakuvhiya.