Nonsteroidal Anti-anogumbura zvinodhaka - a mushonga kana kunonoka muurayi?

Most inowanzoshandiswa kurapwa tsika protivovspalitelnye nonsteroidal zvinodhaka, kana NSAIDs. Ivo anogadzwa anogumbura pezvakaitwa siyana etiology kuti kutsvaga kunobva kuzvimba, kurwadziwa, fivha, yekuzvidzivirira thrombosis (zvatinosiita asipurini zvose). Maererano nenhamba kubva WHO, mishonga iyi unopisa vanhu vanenge mamiriyoni 30 zuva nezuva, pamwe chete chete muzvitatu wavo - yachiremba mushonga. Zvaitoshamisa nhamba, kunyanya rheumatic zvirwere. It Vakawana kuti Anti-anogumbura zvinodhaka kuti vagari asunungurwa anenge 80% kubva rheumatologists.

Asi kana zvinodhaka izvi mururame akakurumbira? Clinical kubudirira hakusi mubvunzo, asi ane zvimwe zvatisingagoni, nekuti kunyange mishonga duku nehurumende pfupi anogona kupa divi migumisiro muna 25% wevarwere, uye muna 5% nyaya upenyu pangozi. Kunyanya, nezvezvitadzo vakwegura, uye chaizvoizvo vanoumba 60% vose NSAID vanoshandisa.

Kana kare 70 vawana musimboti chiito zvinodhaka izvi (chinovhiringidza pamusoro cyclooxygenase basa, chikuru enzayemu rinobatanidzwa muviri pamusoro prostaglandins), zvakava pachena kuti kudivi kwepasi wakasungwa kuva kukura abnormalities muropa kuyerera renal, nemudumbu. Pashure pezvose, prostaglandins (PGs) zvinoita basa rinokosha pano. Munguva 90s, zvitsva zvinhu nezvebasa GHGs mukufamba anokosha pezvakaitwa ari mumuviri womunhu. Saizvozvowo, Anti-anogumbura zvinodhaka vozdestvuyut yose-siyana muupenyu siyana, kunyanya nokuda kweropa uye vascular matauriro, mapfupa muviri, embryogenesis, ikure tsinga masero, zvinyama kugadzira uye nevamwe vakawanda.

Panguva iyoyo zvakanga zvaratidzwa kuti pane isoforms maviri cyclooxygenase: Cox-1 uye Cox-2. Uyezve, wokutanga basa dzose kushanda nhengo panguva cellular vanochiva uye chinovhiringidza wechipiri chete kunoratidza kuchirapa mugumisiro. Saka, kubudisa zvinodhaka Anti-anogumbura anogona kuita zvokusarudza musi Cox-2, zvinokwanisika kurerutsa panowanikwa nemishonga uye zvikuru yakachengeteka kurapwa.

Rimwe nevamiririri izvi anyatsosarudza iri ibuprofen. Maererano zvidzidzo zvinenge zvose, pangozi panowanikwa gastrointestinal pathologies panguva kugamuchirwa waro usingashandi zvichienzaniswa Somuenzaniso, piroxicam.

Tichishandisa ichangobva kuwanikwa rumwe mugumisiro chinokonzera vasiri steroidal Anti-anogumbura zvinodhaka. Ivo kuderedza vascular matauriro, riri kunyanya ngozi vanhu chirwere chemwoyo. In varwere kugamuchira NSAIDs rinooneka, sezvinoita mutemo, wakawedzera BP, uyewo vakawanda vakwegura varayire zvinodhaka izvi nokuda rheumatic marwadzo, kazhinji vanotova nhoroondo neBP.

Uyezve, NSAIDs kuderedza kubudirira diuretic chiito vazhinji antihypertensive mishonga. Kunyanya, avhareji kuchirapa mishonga kubva indomethacin, naproxen uye piroxicam chakunodzikisira mishonga ine furosemide uye hydrochlorothiazide, prazosin zvakadai zvinodhaka kana captopril. Zvisinei, sezvo zvakazivikanwa kuti chiito zvokusarudza zvinodhaka pane zvakasiyana isoforms kuti Cox, sezvataurwa pamusoro apa, regai yekudyidzana kukanganisa kumwoyo. Saka, pane chinoramba munda mukuru webasa kuti pakusikwa zvinodhaka zvikuru zvokusarudza shoma kukanganisa BP, uye vazhinji akakodzera vakwegura. Uye mishonga izvi vakatanga kuoneka. Somuenzaniso, Cox-2 selectivity nhaka inokosha meloxicam, celecoxib.

Zvinosuruvarisa Luda vakura kwete chete kazhinji pachavo taurira nonsteroidal Anti-anogumbura zvinodhaka kuti chikosoro Somuenzaniso, pasina kunzwisisa zvose pezvingazoitika. NSAIDs vari chaizvo kutsiva chimwe chinhu, asi kuti vaongorore kubudirira mushonga vose zvichibvira njodzi chiremba anogona vanokwanisa chete.