Ivumelaniswe ngokuzimela ngumzimba ku-adrenal cortex noma i-hormone eyenziwe i-laboridale eyenziwe ngegciwane, i-glucocorticoid ihlose ukuvimba abalamuli abangavuvukeli.
I-Medicine inqume ukuhlukaniswa kwe-glucocorticoids ngokwendlela yokusebenzisa, umsebenzi, amandla okusebenza, kuye ngomzila wokuphatha.
Ama-glucocorticosteroids asetshenziswa ngokungemthetho ayadingeka ukuvimbela ukugxila kokuvuvukala, okungabekelwe kangako emithini yokwaliwa noma njengomuthi we-immunosuppression.
Ama-steroid wemvelo
Ngaphansi kwethonya lohlelo oluphambili lwezinzwa kanye ne-pituitary gland, isigaxa sehomoni senziwa ku-adrenal cortex, okuhloswe ngaso ukugcina isimo esijwayelekile ngesikhathi sokuxineka, i-metabolism ejwayelekile, kanye nokususa i-foci yokuvuvukala. Izikhathi ezahlukahlukene zosuku zithinta ukwenziwa kwehomoni ethile.
Cortisol
Ama-steroid alandelayo emvelo ahlukaniswa:
- i-cortisol (hydrocortisone) kukhiqizwa phakathi kwengcindezi, okuhlose ukuvusa amandla eguqukayo omzimba wokubekezelela izimo ezicindezelayo. Ukucindezelwa njalo kuholela ekuqothulweni ngokweqile kwe-cortisol, okunomthelela ekuqongeleleni isisindo ngokweqile, ukubekwa kwamafutha emahlombe nasezinkalweni, ukudangala, ukuphazamiseka kokulala, i-pathology yamathambo nomsebenzi wokuzala. I-cortisol yegazi ephansi iholela ekulahlekelweni kwesisindo, yehlise umfutho wegazi, ukuzamazama komhlaba, ukukhathazeka;
- i-cortisone Yenziwe ngendlela efanayo nge-cortisol, kepha ngamanani amancane. Umgomo wayo ukuqinisa izinqubo ze-metabolic, ukukhuthaza ukusebenza kwemisipha. Lokhu kunciphisa ukusebenza kwengqondo, ukuvikela okungokwemvelo komzimba, umsebenzi wegaya wokugaya ukudla.
Ukwanda okujwayelekile okuhlala isikhathi eside noma okwesikhashana kwe-cortisol kungenzeka emzimbeni: ngesikhathi sokuzala kwengane kwabesifazane, ngemuva kokulimala noma ukutheleleka, ukucindezela isikhathi eside, ukuzikhandla komzimba okuqedayo.
Inani eliphakeme le-hormone esegazini libonakala ekuseni, cishe amahora angama-8, lincipha kancane kancane phakathi nosuku, lifinyelela ubuncane balo ngamahora amathathu ekuseni.
Izalwe elabhorethri
Ukwelashwa kwezifo ezithile, ukusiza ezimweni ezicindezelayo, kanye nokulawulwa kwezinqubo ze-metabolic, ama-glucocorticoids asuselwa ngokwenziwe. Umsebenzi wabo ufana nemvelo, asetshenziselwa ukukhiqizwa okunganele kwe-hormone emzimbeni.
Hlunga amalungiselelo we-glucocorticoid ngokusekelwe kunhloso nomphumela wawo emzimbeni. Izinkampani ezenza amakhambi zazimelela i-hormone ekutolikeni okungafani, okuhluka ngokwakhiwa kwama-ejenti asizayo, nasekuqoqweni kwento esemqoka.
Amaphilisi wePrednisone
Ama-glucocorticoids angenawo ugesi:
- betamethasone. Inomphumela we-vasoconstrictor, uthinta i-metabolism kanye ne-metabolism ye-BZHU. Kwethulwa njengokumiswa noma isixazululo somjovo. Isetshenziselwa ukuvuvukala, ukunciphisa imizwa yokungezwani komzimba kanye nokulunywa kwesikhumba. Kuqukethwe emithini: Beloderm, Betazone, Betaspan, diprospam, Celederm, Celeston;
- isimilo. Isetshenziselwa ukudambisa ukusabela okubi kakhulu komzimba, izimo zokwethuka, inamandla okulinganisa aphakathi. Ukuhlukaniswa kwe-glucocorticoids yaleli qembu ngokwendlela yesicelo ihlukaniswe: ngomlomo, ngokujova, ngobuzali. Kwethulwa yizidakamizwa: Prednisolum, Medopred, Decortin;
- methylprednisolone. Kusetshenziswa njengento evimbelayo ye-leukocytes kanye nama-macrophage wezicubu. Ukwelashwa kwenziwa ngomlomo nangokuba ngumzali, kusebenza ngenkuthalo nezifo ze-endocrine. Imithi enehomoni: iMedrol, Metipred.
Ukuze kufakwe ama-glucocorticoids ama-fluores ahlanganisiwe afaka:
- dexamethasone. Iyakwazi ukungena ohlelweni lwezinzwa oluphakathi, ihlinzeka ngomphumela we-immunosuppression kanye ne-anti-inflammatory. Kutholakala ngemijovo, emacwecwe, amaconsi eso. Umuthi yi-hormonal, Ngakho-ke, iziguli zithola ukungasebenzi kahle ohlelweni lwe-hormonal, izinqubo ze-metabolic, kanye noshintsho esimweni esingokomzwelo. Kuqukethwe emithini: Dexazone, Dexamed, Mexicoidex;
- triamcinolone. Yenzelwe ukwelashwa kwe-autoimmune thyroiditis, i-psoriatic, gouty kanye ne-rheumatoid arthritis, i-hypercalcemia kuma-neoplasms abuhlungu. Kwethulwa amafomu endawo, omjovo, wokuphefumula, wendawo. Into esemqoka yemithi: i-Kenalog, Berlicort, Polcortolone, Triacort.
Ukusetshenziswa kwe-corticosteroids yokufakelwa
Ukuba nomthelela wasendaweni noma ojwayelekile emzimbeni, izidakamizwa ezine-glucocorticoids zingatholakala ngesimo samathebhulethi, amakha, amaconsi, imijovo. Umsebenzi wabo oyinhloko ukulungiselela ukubonakaliswa kwendawo komzimba, ukuqeda ukugxila kokuvuvukala, kanye nokunikeza umphumela wokuvuselela amandla. Ngokwendlela yokusebenzisa, ama-glucocorticoids ahlukaniswa ngamaqembu ama-2: imiphumela yasendaweni neyenqubo.
I-Betamethasone Ointment
Iqembu 1 - ukubonakaliswa kwendawo:
- kwesicelo sesikhumba (amafutha, i-powder, ukhilimu): Mometasone, Betamethasone, Fluocinolone Acetonide;
- amaconsi ngenxa yamehlo, izindlebe: IBetamethasone;
- inhalation: budesonide, flunisolid, fluticasone propianate;
- umjovo we-intraarticular: I-Betamethasone;
- Isingeniso sezicubu ze-periarticular: Hydrocortisone.
Iqembu 2 - i-glucocorticoids ehlelekile:
- IHydrocortisone (isidakamizwa esisebenzayo (LS) - Cortef);
- I-Prednisone;
- I-Prednisone;
- Methylprednisolone;
- I-Dexamethasone;
- I-Triamcinolone;
- I-Betamethasone.
I-Glucocorticosteroids ivimba ukubopha kwe-immunoglobulin kumaseli wamast, kuvimbele ukubonakaliswa kwe-allergic. Izidakamizwa zeHormonal zisetshenziswa uma kwenzeka kuguliswa i-allergic kakhulu: i-edema ka-Quincke's, ukwethuka kwe-anaphylactic, urticaria. Kwesinye isikhathi isetshenziselwa ukuqedwa kwendawo yokwaliwa
Ngamandla okucindezela ukungatheleleki, ama-glucocorticoids asetshenziswa ngempumelelo kwi-transplantology. Ukwehla kwemisebenzi yokuvikela umzimba kuvimbela ukwenqatshwa kwezicubu eziguquliwe.
Ngokucindezela umsebenzi we-phospholipase, umphumela wokulwa nokuvuvukala wama-corticosteroids uyatholakala. Ukwehla kokukhipha uketshezi ngenxa yokuncipha kwenethiwekhi ye-capillary kuholela ekunciphiseni kwezibonakaliso ze-edematous. Ukubuyiselwa emuva kwenzeka ngenxa yokwanda kwe-microcirculation ku-lesion.Kungakhathalesi ukwahlukaniswa, ama-glucocorticoids emvelo nawokwakheka anekhemisi efanayo, umphumela wawo wokwelapha uwukuthi:
- ukumiselela (ngokuntuleka kwama-hormone);
- pathogenetic (anti-inflammatory, anti-shock, immunosuppressive, anti-allergic effect);
- ukucindezela (ukucindezelwa kokukhiqizwa kwe-corticoliberin, ebhekele ukuvezwa kokukhathazeka) umsebenzi.
Imiphumela emibi
Izidakamizwa zemvelaphi yama-hormone zinomphumela omuhle ekwelashweni futhi zinemiphumela emibi.
Kubalulekile ukwenza inkambo yokwelashwa ngaphansi kokubhekwa ngudokotela okuqinile, ngaphandle kokuzelapha.
Okungafuneki ukubonakaliswa okufana nokwanda ushukela egazini, ukuba khona ushukela emchameni. Isifo sikashukela seSteroid esibangelwa ukubamba iqhaza kwama-hormone kumetabolism yama-carbohydrate siyingozi ikakhulu.
Ukubamba iqhaza okungenangqondo kwama-steroid kuma-protein metabolism kuholela ekuqhekekeni kwezicubu zemisipha. Ukukhiqizwa kwe-collagen okwehlisiwe kubangela ukuguga kwesikhumba, kunciphisa i-turgor yayo. Ukucindezela kokuhlanganiswa kwamaprotheni kuthinta ukwakheka kwezicubu ezintsha, okubalulekile lapho upholisa amanxeba nokusika.
Umphumela we-glucocorticoids kuma-metabolism wamafutha uholela ekusatshalaliswa kwe-asymmetric kwezicubu ze-adipose emzimbeni. Iziguli zinokukhanya okuncane kwamaseli wamafutha angaphansi emilenzeni, kodwa ungqimba olukhulisiwe entanyeni, ebusweni, esifubeni.
Ukusetshenziswa kwesikhashana kwama-steroid akubandakanyi i-pathology yesistimu yenhliziyo.
Ukusetshenziswa kukaHaphazard isikhathi eside kwezidakamizwa zemvelaphi ye-hormonal kunomthelela ekubonakaleni komfutho wegazi ophakeme, ukuphazamiseka kwenhliziyo.
Imiphumela emibi ingafaka ukuqwasha, ukwazi ukungasebenzi kahle, ukubanjwa kwesithuthwane ezigulini, ulcer esiswini, ukukhula kancane kwezingane, i-osteoporosis. Ukubonakaliswa kwasendaweni akuvamisile ukubona i-candidiasis ye-nasopharynx, hoarseness, ukukhwehlela, ukopha okungenzeka kolwelwesi lwama-mucous.
Amavidiyo ahlobene
Izinkulumo ngokubaluleka kwama-glucocorticosteroids kwezokwelapha:
Ukuhlukaniswa okuningiliziwe kwe-glucocorticoids kunikeza isithombe esiphelele sokusetshenziswa kwezidakamizwa eziqukethe ama-steroid. Ama-hormone atholakala ngokuthile athwala isenzo esiqondile ekulweni nokugxila kokutheleleka noma i-microflora ye-pathogenic. Imithamo emincane yento iba nomthelela enkambisweni enhle yesifo ngaphandle kwezinkinga ezivela kwezinye izinhlelo zomzimba.
