Daroogada magnyl anti-bararka - talogelin ama dilaaga la'ahay?

Inta badan loo isticmaalo si dhab ah protivovspalitelnye daroogada magnyl clinical, ama NSAIDs. Iyagu waxaa weeye in geedi socodka bararka ee etiology kala duwan ee ay joogaan isha barar, xanuun joojiye, qandho, loo yareeyo khatarta thrombosis-ka (sida caadiga ah ee aspirin oo dhan). Sida laga soo xigtay tirakoob ka WHO, daawooyinka, kuwaas oo gubtay, oo ku saabsan 30 milyan oo qof maalin kasta, mid saddexaad mid kaliya oo ka mid ah - dhaqtar kuu qorin. Xitaa tiro ka badan oo cajiib ah, gaar ahaan cudurada rheumatic. Waxa la ogaaday in daawooyinka anti-bararka , waayo, si wadajir ah soo saaray oo ku saabsan 80% of rheumatologists.

Laakiin in daawooyinkan yihiin sir la'aada sida loo jecel yahay? waxtarka caafimaad ee ma aha in su'aasha, laakiin waxa uu leeyahay la dhaafi karin qaar ka mid ah, maxaa yeelay, xataa yar ka qaataan maamulka muddo gaaban ku siin kartaa waxyeellooyin in 25% ka mid ah bukaanka, iyo 5% ka mid ah xaaladaha jira naf-gooyada ah. Gaar ahaan, waxa ay ku saabsan tahay dadka waayeelka ah, iyo dhab ahaantii waxay ka samaysan 60% dhammaan dadka isticmaala NSAID.

Marka dib ee 70 ayaa helay mabda'a of tallaabo oo ka mid ah daroogada (Iscelin of hawlaha cyclooxygenase, enzyme ugu weyn ee ku lug-shiid ee prostaglandins), waxaa u cadaatay in saamayn dhinaca ku xidhan tahay in ay horumarka aan caadi ahayn ee socodka dhiigga kelyaha, iyo mareenka caloosha iyo mindhicirka. Ka dib oo dhan, prostaglandins (PGs) halkan ka ciyaaraan door muhiim ah. In 90s ee, xaqiiqooyinka cusub oo ku saabsan doorka GHGs in koorsada oo ka mid ah hababka ugu muhiimsan ee jirka aadanaha. Iyadoo la raacayo, daawooyinka anti-bararka vozdestvuyut kala duwan oo dhan reactions nolosha, gaar ahaan xinjirowga dhiigga iyo midab vascular, dheef lafta, embryogenesis, koritaanka unugyada habdhiska, dayactir nudaha iyo kuwo kale oo badan.

Isla mar ahaantaana waxaa loo waxyooday in ay jiraan laba isoforms of cyclooxygenase: Cox-1 iyo Cox-2. Waxaa intaa dheer, ka masuul ugu horeysay ee ay hawlaha caadiga ah ee xubnaha ee heer gacanta, iyo is-celin labaad kaliya muujinaysaa saamaynta ku daweynta. Sidaas darteed, soo saara daawooyinka anti-bararka in matali karta eegista on Cox-2, waa suurtogal in la yareeyo dhicitaanka waxyeellooyinka iyo daaweynta ugu ammaan ah.

Mid ka mid ah wakiilada ee doorashada waxaa ibuprofen. Sida laga soo xigtay ku dhowaad dhammaan waxbarashada, halista ah ee dhacdo of heley caloosha iyo mindhicirka ee ay soo dhaweynta waxaa ugu yar marka la barbar dhigo, tusaale ahaan, piroxicam.

Xad dhawaan helay kale saamayn dhinaca keena daawooyinka ka hortaga bararka non-steroidal. Waxay si weyn u yareeyo midab vascular, kaas oo si gaar ah halis u ah dadka qaba cudurka wadnaha. In bukaanlayda qaadato NSAIDs dhacdaa, sida caadiga ah, kordhay cadaadiska dhiigga, iyo sidoo kale inta badan ee dadka waayeelka ah kuwaas oo qori kuwaas daawooyinka xanuunka rheumatic, caadi ahaan hore u leedahay taariikh hypertension.

Intaa waxaa dheer, NSAIDs yareeyo waxtarka tallaabo lagu durayo of badan oo daawooyinka antihypertensive. Gaar ahaan, celceliska qaadasho ku daweyn of indomethacin, naproxen iyo piroxicam burin daawo ay ku jirto furosemide iyo hydrochlorothiazide, prazosin sida daroogada ama captopril. Si kastaba ha ahaatee, sida ay ogaaday in ficilka la xushay ee daroogada ku isoforms kala duwan ee Cox, sida kor ku xusan, ma si weyn u saameeya nidaamka wadnaha. Sidaas darteed, waxaa weli beer weyn oo ah hawlaha la abuuro of daroogada aadka u xushay sida saamaynta ugu yar ee dhiig-karka, iyo ugu haboon dadka waayeelka ah. Iyo daawooyinka, kuwaas oo bilaabay in ay ka muuqan. Tusaale ahaan, Cox-2 selectivity hantidaan meloxicam weyn, celecoxib.

Nasiib darro, ma aha oo kaliya ka weyn Luda inta badan isku qoro daawooyinka anti-bararka magnyl for hergebka, tusaale ahaan, iyada oo aan waxgarasho oo dhan ka dhalan kara. NSAIDs waa runtii adag tahay in la bedelo wax, laakiin si ay u qiimeeyaan wax ku oolnimada daroogada ah ee dhammaan khataraha suuragal ah keliya dhakhtar awoodo u qalma.