Lub luag haujlwm ntawm pancreatic enzymes

Qhov txiav ua ntej txiav txim siab tseem ceeb hauv lub cev, nws txoj haujlwm yog los tsim cov enzymes. Nws yog ib qho khoom nruab nrog muaj peev xwm los khi kua txiv. Hauv nws cov qauv muaj ntau yam enzyme ntsiab tsim los ntawm cov txiav: dej, electrolytes, thiab lwm yam. Lawv lub xub ntiag yog qhov tseem ceeb thaum tso cov txheej txheem kev zom.

Cov kua txiv qab zib kab mob nrog rau cov khoom xyaw no kis mus rau hauv txoj hnyuv. Nyob rau hauv duodenum lawv nqa tawm kev sib cais ntawm cov rog, cov khoom xyaw ua kom muaj roj thiab cov protein sib txawv.

Dab tsi yog pancreatic enzymes uas ua:

Lipase - yog tsom cais cov rog uas tsis paub yuav ua li cas nkag ncaj qha rau hauv cov hlab ntshav.
Amylase - ua txoj haujlwm ntawm hloov cov hmoov txhuv nplej siab rau hauv oligosaccharide.
Protease - cais cov protein, tig mus rau hauv peptides.

Tsis tas li ntawd, lwm qhov kev zom cov zaub mov yog tsim los ntawm lub caj pas txiav ntshav, uas tau txum tim rov qab los ntawm lub cev thiab cuam tshuam rau kev hloov pauv ntawm oligosaccharides rau hauv qabzib. Thaum cov piam thaj nkag mus rau hauv cov ntshav, nws yuav dhau los ua cov khoom siv hluav taws xob tseem ceeb. Txawv ntawm cov protein thiab elastin sib txawv los ntawm elastase.

Txhua tus enzymes pancreatic nyob rau hauv cov kua txiv zom. Muab nthuav tawm hauv thaj chaw no, lawv nyob tsis tuaj yeem ua haujlwm, uas tsis tsim cov nqaij ua kom sib cais. Cov enzymes yog qhib los ntawm kev kwv yees kom ntau npaum li cas ntawm cov kua tsib.

Hauv txoj hnyuv me, kev tsim tawm ntawm cov khoom hauv qab no tshwm sim:

ectokinases - yog hloov dua siab tshiab los ntawm trypsinogen, tig mus rau hauv qhov kev nqis tes ua, tab sis nws txoj kev rov qab los ntxiv tsis pom,
trypsinogen - tau pw los ntawm tus txiav hauv daim ntawv pro-enzymatic, hauv txoj haujlwm no cov khoom no muaj nyob rau hauv cov hnyuv me,
trypsin yog cov neeg ua haujlwm loj ntawm lwm yam enzymes ntawm ib hom uas zoo sib xws, cov khoom ua haujlwm nquag yog cov txheej txheem ntawm autocatalysis, vim tias nws twb cuam tshuam rau hauv daim ntawv ntawm lub ntsiab tshuaj.

Kev tsim tawm ntawm cov enzymes tshwm sim sai li sai tau thaum cov khoom noj tau noj, thiab cov khoom noj kis mus rau hauv txoj hnyuv. Cov txheej txheem rau txuas cov enzymes tsis nres tom qab li 12 teev.

Thaum cov ntaub so ntswg thiab cov pias ntawm cov txiav ua mob, lawv tau ua kom zoo dua hauv kev txhim kho ntawm lawv tus kheej cov enzymes, thiab kev txhim kho ntawm kev txiav ua tiav ntawm kev txiav tawm ntawm cov menyuam yaus.

Kev xaiv cov enzymes rau kev kho tus kab mob no feem ntau suav tias yog ib txoj haujlwm nyuaj, vim tias cov enzymes rau cov kab mob ntawm cov txiav ntshav Cov enzymes uas muaj cov kua tsib hauv cov kev ua haujlwm hauv lub pediatric tsuas yog muaj tsawg, vim muaj peev xwm ua kom lub plab zom mov ntau ntxiv thiab choleresis.

Cov hom ntawm Enzymes

Muaj ntau hom kev nqus ntshav ntawm pancreatic zais ntshis tej cov tshuaj yeeb dej caw. Dab tsi ua enzymes ua tus txiav:

Proteases yog cov enzymes uas zom cov protein.
Cov pluas mov yog cov enzymes uas zom cov carbohydrates.
Lipases - faib cov rog.

Trypsin, elastase thiab chymotrypsin suav nrog hauv chav kawm ntawm protease, enzymes proteolytic. Lawv qhov kev ua raws li kev sib cais ntawm cov me me ntawm cov protein mus rau cov khoom siv yooj yim haum - peptides. Tom ntej no, carboxypeptidase koom nrog, nws decomposes peptides rau cov kab ntawm cov amino acids. Ntxiv mus, kev nqus tau tshwm sim hauv cov hnyuv me, ntxiv rau cov nucleic acid, vim nws yuav tsum tau lwj rau nucleotides. Qhov no yog ua tiav nyob hauv tus ntawm nuc thov enzymes.

Amylolitec pancreatic enzymes suav nrog amylase thiab lactase. Amylase cais cov carbohydrates hnyav los yog polysaccharides rau hauv maltose, dextrin, thiab tom qab ntawd rau hauv cov suab thaj zoo ib yam - fructose thiab qabzib, uas tuaj yeem nqus tau ntawm txoj hnyuv. Lactase tau muab faib ua cov piam thaj hauv mis - lactose, uas muaj nyob hauv cov khoom lag luam ntawm cov mis los ua keeb kwm.
Lipolytic enzymes ua haujlwm ua ke. Colipase ua kom cov lipase nyob rau hauv txoj hnyuv, tom qab ntawd nws tawg cov roj me me rau hauv glycerol thiab fatty acids.

Nws yog ib qho tseem ceeb uas cov rog rog tau zom - emulsification nrog cov kua tsib kua qaub, zom kom mus rau hauv cov me me, uas ua rau kev tsim cov dav hlau loj dua ntawm kev sib cuag nrog lub lipase.

Pancreatic Enzyme Qhov Tsis Txaus Cov tsos mob

Rau lub ntuj zom cov zaub mov ntawm cov khoom noj cov khoom noj, qhov yuav tsum tau muaj cov enzymes hauv cov kua txiv kab ntxwv ua kua txig. Ntau cov kab mob tau pom tias muaj feem cuam tshuam nrog cov enzyme compound. Los ntawm cov tshuab ntawm qhov tshwm sim, lawv tau cais raws li cov khoom noj tsis haum.

Kev tsis txaus ntseeg ntawm lub qhov muag tawm sab nraud yog pom thaum txo cov hnyuv ntawm lub plab hnyuv taum txo, nws tuaj yeem txhim kho thaum yug los lossis muaj cov chav kawm ua tau. Kev txhim kho ntawm rooj plaub thawj zaug tau pom vim muaj kev tsim cov noob puas tsuaj, tom ntej no, qhov pib ntawm tus kabmob pib txhim kho vim muaj kev ua haujlwm tsis zoo hauv lub parenchyma ntawm tus txiav.

Cov ntsiab lus uas qhia txog kev ua tsis muaj pancreatic enzyme ntau lawm tsis yog nyob ntawm qhov chaw ntawm lub cev, tab sis cuam tshuam nrog kev cuam tshuam lossis cuam tshuam hauv cov nruab nrog cev.

Muaj ntau cov kabmob uas muaj mob hnyav.
Kev Txom Nyem Ecology.
Tsis muaj kab kawm, vitamins, protein.
Kev qaug Tshuaj Muaj Yees.
Cov kab mob ntawm chav kis.
Pathologies cuam tshuam nrog kev hloov pauv ntawm txoj hnyuv microflora.

Txhua yam ua rau qee zaum ua rau lub plab zom mov tsis zoo muaj cov tsos mob tshwm sim thiab cov tsos mob. Qhov ntsuas ntawm lawv qhov kev xav tsuas yog txiav txim siab los ntawm qhov hnyav ntawm lub hauv paus pathology lossis siv qhov pib ntawm qhov pib.

Tsis qab los noj mov.
Zawv plab
Qhov mob siab nyob hauv qab cov tav ntawm sab laug, qhov mob tshwm sim ob qho tib si tom qab noj mov thiab tsis hais txog kev noj zaub mov.
Los ntshav.
Caug nrog cua.
Ntuav, xeev siab, hauv qhov xwm txheej hnyav - rov ua dua, yam tsis muaj kev cuam tshuam ntawm kev cawm.
Poob ceeb thawj sai sai, qee zaum nrog kev yoj ib ce.
Cov menyuam yaus lub ntsej muag mus rau lub cev.

Cov tsos mob zoo ib yam li no tuaj yeem tshwm sim thaum pancreatic enzymes nrog rau kev yug los yog txais los ua kom mob etiology. Tawm tsam keeb kwm ntawm cov kab mob gene, ib qho tsis txaus enzyme tuaj yeem tshwm sim tom qab yug, pom nws tus kheej:

nkees
kua muag poob
nyob tsis tswm xeev
nto qaub ncaug rau tom qab noj mov
nquag raws plab nrog tus me nyuam hauv plab tsis hnov tsw.

Tus neeg mob cov quav yog tsis tas li, nrog cov ntsiab lus ua npuas thiab ib rab ntxeem acidic tsw ntxhiab, uas feem ntau qhia tias muaj kev ua tsis zoo ntawm cov txheej txheem carbohydrate, enzymes.

Ntxiv nrog rau cov kev tshwm sim uas pom ntawm tus kab mob pancreatic, kuj tseem muaj cov tsos mob tshwj xeeb uas yog nyob ntawm kev cuam tshuam hauv kev tsim cov khoom siv enzyme hauv kev tso pa kab mob zais.

Nrog cov tsis muaj lipase, steatorrhea muaj kev loj hlob - cov roj ntau hauv cov zis ua tau nce ntxiv. Cov quav ua daj, xim txiv kab ntxwv hauv xim, nrog roj ua kua, ua kom xwm yeem.
Amylase deficiency yog tshwm sim los ntawm lub siab xav mus tas li, cov quav ntawm cov qauv dej, tus neeg mob poob phaus, vitamin tsis muaj tshwm sim. Thiab tseem muaj qhov tsis muaj peev xwm hloov cov khoom lag luam uas muaj cov khoom siv roj ntau ntau, cov txheej txheem rau kev nqus cov khoom hauv cov hnyuv hloov me me.
Yog tias tsis muaj cov trypsin tso tawm rau hauv kev nthuav tawm, tsis muaj qhov cuam tshuam ntawm cov protein tsis muaj ntshav. Tus neeg mob tau ntsib nrog kev txhim kho ntawm tus mob anemia.

Yog tias muaj cov cim no tshwm sim, nws yuav tsum tau sab laj nrog kws kho mob siab, qhov twg yuav kuaj thiab kho cov tshuaj kho mob.

Kev npaj enzyme

Kev tsim cov mob ua rau tus kab mob pancreatitis, nyob rau hauv kev sib piv ntawm txoj kev mob ceev, thaum lub txheej txheem ua los ntawm cov ntshav muaj qis tsis txaus, txoj kev tseem ceeb ntawm kev kho tus mob pancreatitis yog kev npaj noj muaj enzymes. Thawj hom tshuaj yog kho nrog lub ntsiab nquag ua kom zoo - pancreatin. Cov kua tsib yuav tsum tsis txhob nyob hauv cov tshuaj, ua rau muaj kev nce ntxiv ntawm kev zais ntawm enzymes thiab txhim kho qhov tsis xis nyob.

Rau kev siv cov tshuaj tiv thaiv enzyme nyob rau hauv daim ntawv ntev dua ntawm tus kabmob yog qhia:

Creon yog txoj kev kho mob niaj hnub.
Mezim-forte - muaj lipase, amylase, protease, ntxiv cov tshuaj.
Pancreatin yog lub ntsiab loj enzyme loj, uas yog ib feem ntawm ntau yam tshuaj enzyme - lipase, amylase, trypsin, chymotrypsin.

Kev noj zaub mov kom noj qab haus huv yuav tsum tau siv sijhawm ntev, qee zaum kev ua kom tag lub neej ntawm lub rooj noj mov yog qhov yuav tsum tau ua, nws txhua tus nyob ntawm qhov degree ntawm enzyme qis dua.

Hauv kev mob hnyav ntawm kev txiav mob ntawm tus kab mob pancreatitis, kev txiav txim siab rau tus kheej ntawm lub cev yog nqa tawm, yog li ntawd, nquag ua pancreatic enzymes yog suppressed. Hauv tsev kho mob, infusions ntawm antiferment tus neeg sawv cev yog siv.

Thiab kuj yog tus kws kho mob tuaj yeem sau ntawv los noj cov tshuaj enzyme ntawm kev sib thooj.

Cov tshuaj tsuas yog xaiv los ntawm cov kws kho mob, sau cov nyiaj raws li cov mob hnyav, tshwj xeeb yog kev noj zaub mov zoo rau kab mob pancreatitis thiab tus neeg mob lub hnub nyoog.

Thaum noj ntau cov tshuaj, ua tiav kev faib ua tiav ntawm cov khoom yog xyuas kom meej, uas ua rau muaj qhov nqus zoo dua thiab ua kom cov quav.

Ntawm tsob nroj enzymes los rov qab ua haujlwm pancreatic yog siv:

Txoj kev tshawb no ntawm cov kua txiv pancreatic kua txiv yog qhov tseem ceeb hauv pathology ntawm lub plab zom mov. Tsis muaj ntau lawm yuav tsum tau hloov txoj kev kho mob nrog enzyme npaj.

Dab tsi yog cov enzymes digestive

Siv cov txiav ua txiav, kev zom cov hlab ntsha ua kom muaj pa yog tsim tawm. Lawv koom nrog hauv kev puas tsuaj ntawm cov khoom noj tseem ceeb: cov khoom noj carbohydrates, cov protein thiab cov rog. Pancreatic enzymes yog cov tshuaj uas faib cov khoom sib xyaw ua ke ntawm cov zaub mov kom yooj yim, uas tom qab ntawd nqus mus rau hauv lub hlwb ntawm lub cev. Raws li qhov txiaj ntsig ntawm qhov kev qhia tshwj xeeb ntawm tus ntawm enzymes, lub koom haum thiab kev cai ntawm cov txheej txheem tseem ceeb hauv lub cev tau tshwm sim. Peb pawg tshuaj yeeb yam no muaj qhov txawv:

Lipases yog cov enzymes uas zom cov rog. Lawv tau tsim los ntawm cov txiav, yog ib feem ntawm cov kua txiv ua kua.
Proteases - cov enzymes zom cov protein ntau thiab normalize microflora ntawm cov hnyuv zom.
Amylases - cov tshuaj uas tsim nyog rau kev ua cov carbohydrates.

Pancreatic enzyme muaj nuj nqi

Lub caj pas loj tshaj plaws nyob hauv tib neeg yog tus txiav. Yog tias nws cov haujlwm tsis cuam tshuam, qhov no ua rau muaj kev ua tsis zoo ntawm ntau lub. Lub luag haujlwm ua haujlwm ntawm lub cev no yog txhawm rau txhawm rau tawm sab nraud thiab sab hauv, uas ua kom lub plab zom mov. Yog tias tsis muaj cov enzymes uas ua los ntawm lub caj pas, tib neeg lub plab tsis tuaj yeem zom cov zaub mov, thiab cov zaub mov ua rau lub cev tsis ua haujlwm thiab tsis tuaj yeem nqus cov ntshav.

Pancreatic enzyme tsis txaus

Kev mob plab zom mov cuam tshuam rau kev ua haujlwm ntawm txhua daim ntaub, kabmob thiab cov tshuab. Lub luag haujlwm tseem ceeb hauv kev zom zaub mov yog ua rau pancreatic enzymes, tab sis qee zaum tus cwj pwm ntawm tus kheej nws tus kheej tsis tso cai rau lawv ua haujlwm thiab ua kom sib xyaw nrog cov nyiaj uas yuav tsum tau ua. Lawv lub cev tsis tuaj yeem ua rau muaj kev ua rau tus mob ua xua, uas muaj qhov tshwm sim hauv qab no:

Cawv kev quav cawv
Tsis muaj zaub mov noj
Cov khoom noj tsis xwm yeem, nrog rau pluas noj,
Thawj qhov ntawm ib hom zaub mov,
Kab mob
Lub cev raug mob thiab qhov lawv rau txim,
Cov tshuaj noj noj uas tsis muaj kev saib xyuas los ntawm tus kws kho mob uas tuaj koom, suav nrog enzyme inhibitors.

Kev mob caj dab - Ib qho kev mob ntxiv rau pancreatic lesion, uas pom los ntawm qhov muaj zog ntau dhau los ua haujlwm ntxov dua li qhov xav tau. Feem ntau, cov enzymes yog tsim tom qab noj zaub mov, tab sis nrog pancreatitis lawv ua kom tsaug zog ua ntej noj mov - tom qab ntawd cov khoom noj cov zaub mov raug puas tsuaj, thiab lub cev ua rau nws tus kheej cuam tshuam los ntawm nws tus kheej cov enzymes.

Kev faib tawm cov enzymatic tsis muaj peev xwm

Qhov tsis txaus ntseeg ntawm kev zais cia sab hauv yog qhov feem ntau pathology - hom 2 mob ntshav qab zib mellitus, thaum cov tshuaj insulin tsis raug tsim tawm hauv cov nyiaj uas yuav tsum tau ua. Tus kab mob yog kuaj tau siv cov ntshav kuaj ntshav - nws txoj cai yog 5.5 mmol / l,
Tsis muaj qhov sib cais sab nraud - thaum muaj kev txo qis ntawm cov hlab ntsha enzymes. Cov neeg mob no tau sib txuam nrog kev ua haujlwm, tshwj xeeb tshaj yog cov rog rog - cov enzymes tsis tuaj yeem zom txhua triglycerides.

Lub sijhawm ntawm pancreatic tsis txaus ntseeg tau muab faib ua:

Muaj nuj nqi - ib qho mob ib ntus uas tuaj yeem kho tau
Organic - lub caij nyoog ua rau lub cev hloov pauv, uas nws yuav tsis muaj peev xwm ua kom rov qab sai kom qhov ua haujlwm ntawm qhov hloov.

Cov enzymes ua cov txiav ua dab

Tib neeg lub cev tau teeb tsa txoj hauv kev uas txhua tus enzyme muaj nws txoj haujlwm. Qhov txiav ua haujlwm ntxiv nyob rau hauv ua ke nrog lub zais zis zais.

Thaum cov kua tsib yog nyob rau hauv txoj hnyuv, ua haujlwm ntawm cov enzymes yog qhib kom ua haujlwm. Tom ntej no, duodenum yog ntim nrog kua txiv pancreatic. Cov tshuaj no muaj cov hnoos qeev, dej, bicarbonates thiab lwm yam minerals, uas pab txo cov kua qaub ntawm lub plab.

Lub enzymes tseem ceeb uas ua los ntawm cov txiav yog amylase, lipase thiab protease. Nws kuj tseem muaj lwm yam kev ua dej caw.

Nuc thov yog koom nrog hauv kev txaug ntawm nucleic acids, DNA thiab RNA, uas ua rau lub hauv paus ntawm kev noj zaub mov.
Protease nyob rau hauv daim ntawv ntawm elastase pab rhuav tshem cov zom cov nqaijrog thiab elastin. Trypsins thiab chymotrypsins, zoo li pais plab pepsin, zom cov zaub mov muaj protein ntau. Kuj tseem koom nrog hauv kev zom zaub mov yog carboxypeptidases.
Amylases cov metabolism hauv cov pluas mov tsis haum, zom cov glycogen thiab cov hmoov txhuv nplej siab.
Cov tshuaj Steapsins pab zom cov cov rog rog.
Lipase muaj cov nyhuv ncaj nraim rau triglycerides; cov rog no raug coated nrog cov kua tsib, uas ua rau lub siab ua haujlwm rau lub plab hnyuv lumen.

Cov txheej txheem pab ua kom cov protein ua peptides, tom qab ntawd, nrog kev pab carboxypeptidase, cov khoom sib txuas yooj yim tau hloov mus rau hauv cov amino acid thiab nqus hauv plab hnyuv. Tus naj npawb ntawm cov enzymes tsawg zuj zus nrog lub hnub nyoog, thiab lawv qib yuav txo vim kis kab mob.

Amylases kev koom tes hauv kev rhuav tshem cov nyom carbohydrates lossis polysaccharides rau dextrin thiab maltose. Tom qab ntawd, kev tsim cov suab thaj yooj yim - cov piam thaj thiab fructose, uas tau nqus rau hauv txoj hnyuv. Feem ntau amylase raug pom nyob rau hauv txoj cai txiav, thiab cov enzyme no tseem muaj nyob hauv cov qaub ncaug salivary.

Lipases zom cov roj molecules, sib sau glycerin thiab fatty acids. Ua ntej kev zom mov, cov rog tau tawg ua ke los ntawm cov kua tsib kua qaub. Tsis tas li, cov enzymes no hloov cov vitamins E, D, A, K rau hauv lub zog.

Ntxiv rau kev nqus ntawm cov khoom noj khoom haus, pancreatic enzymes muaj kev cuam tshuam txog cov khoom noj metabolic thiab hloov pauv, tswj ntshav qabzib.

Tsis tas li ntawd, cov khoom nruab nrog sab hauv muaj peev xwm tsim cov tshuaj hormones uas tswj cov kev cai biochemical.

Pancreatic Tsis Raug

Feem ntau, tus mob hlaus dai thaum tus neeg tsis saib xyuas nws kev noj qab haus huv thiab ua rau lub neej muaj kev phom sij. Hauv tshwj xeeb, kab mob kev noj qab haus huv tuaj yeem tsim kho yog tias tus neeg mob noj zaub mov tsis zoo, tsis noj mov raws sij hawm, thiab tsis haus dej haus cawv.

Rau tej yam txawv txawv cov tsos mob thiab hnov qhov mob, koj yuav tsum mus ntsib kws kho mob plab, soj ntsuam tag nrho thiab tshawb pom dab tsi los cuam tshuam hauv lub cev.

Yog tias txoj cai ntawm kev noj zaub mov zoo yog tsis ua raws li, tus kws kho mob feem ntau kuaj xyuas kab mob pancreatitis. Tus kab mob no yuav muaj mob los yog mob ntev.

Cov mob huam sai tuaj ntawm cov kab mob tshwm sim yog tias lub tsev me me tsis ua haujlwm zoo, thiab cov enzymes uas tau ua haujlwm tau ua ntej lub sijhawm.Raws li qhov tshwm sim, txoj kev txiav tawm ntawm lub qog nws pib. Tus neeg hnov mob plab heev, kub ib ce, ntuav, thiab mob plab zom mov. Nws yog ib qho tseem ceeb kom nrhiav kev kho mob kom raws sijhawm kom tsis txhob muaj teeb meem loj.
Tus kab mob pancreatitis pib qeeb qeeb, tus neeg mob yuav tsis nco qab tias muaj tus kabmob no. Hauv lub xeev no, cov ntaub so ntswg ua haujlwm yog scarred, cov khoom nruab nrog sab hauv tsis zais cov enzymes txoj cai. Hauv cov mob no, ntshav qab zib feem ntau muaj qhov tshwm sim vim qhov tsis txaus ntawm cov tshuaj insulin.

Cov tsos mob ntawm ib hom mob ntawm pancreatitis yog nrog los ntawm kev hlwv, pob ntseg, raws plab, mob qhov mob ntawm lub txiav.

Txhawm rau tiv thaiv kev txhim kho ntawm cov kev mob tshwm sim, nws yog ib qho tseem ceeb kom pib kho tus kab mob ua ntej, sai li sai tau thawj cov tsos mob ntawm tus mob pancreatitis.

Pancreatic enzyme assay

Txhawm rau txheeb xyuas cov kab mob pathology, tus kws kho mob tau sau ntawv kuaj ntshav biochemical, kuaj ntshav thiab ntshav ntshav kuj tau kuaj xyuas. Lub hom phiaj tseem ceeb ntawm kev kuaj mob yog txiav txim siab txog qib lipase, elastase thiab amylase. Yuav kuaj ntshav rau cov enzymes ua ntshav.

Cov feem ntau kawm cov ntshav amylase. Yog tias qhov kev tshawb nrhiav enzymatic qhia txog qib amylase ntau dua ntawm 130, feem ntau tus neeg yuav mob pancreatitis. Ntawm qhov ntsuas qhov ntsuas 0-130, teeb meem hauv kev ua haujlwm ntawm kab mob pancreas tau qhia. Yog tias cov kev cai ntau dhau tom qab peb kuaj mob, kev kuaj pom ntawm daim kab mob nqaij hlav ntawm lub cev lossis txoj hnyuv perforation.

Cov ntshav dej yog siv los txiav txim siab seb cov qib lipase. Thaum tus kab mob nqus dej tsis zoo, qhov feem pua ntawm cov enzymes tuaj yeem nce txog 90 feem pua. Yog tias theem tsis ua li qub, thiab amylase nce dhau, tus neeg tej zaum yuav muaj cov kab mob sib txawv.

Siv biochemistry, tus kws kho mob kuaj pom tus kab mob thiab xaiv txoj kev kho mob tsim nyog. Yuav kom tau txais cov ntaub ntawv raug, qhov kev txiav txim siab txog qib ntawm cov enzymes tau nqa tawm ntawm lub plab khoob thaum sawv ntxov.

Yog tias tsim nyog, kev soj ntsuam ntawm cov quav thiab tso zis tawm ntxiv.

Tshuaj kho mob nkeeg

Niaj hnub no, ntawm kev muag khoom yog xaiv ntau yam ntawm txhua hom tshuaj siv los kho tus txiav. Lub txiaj ntsig tseem ceeb ntawm cov tshuaj no yog rov sau daim enzymes uas ploj lawm.

Cov tshuaj muaj tshuaj sib txawv, nyob ntawm qhov muaj pes tsawg leeg, txoj kev tsim khoom thiab cov qauv tso tawm. Cov khoom siv tseem ceeb yog cov nqaij nyuj lossis nqaij npuas ua nqaij hlav.

Kuj tseem muaj tshuaj uas suav nrog kua tsib. Tab sis xws li cov enzyme npaj tau contraindicated hauv mob huam thiab mob txha nqaj qaum, kab mob siab, mob plab thiab ua rau lub duodenum, mob thiab lwm txoj hnyuv pathologies.

Ua ntej noj cov tshuaj, lub cev thiab cov txiav yuav tsum npaj rau kev kho enzyme. Txhawm rau ua qhov no, siv cov tshuaj ua ntej tsis haum tshuaj Papaverin, Tsis-Shpa, Drotaverin, uas daws qhov mob. Tsis tas li ntawd, lawv siv ntau yam tshuaj pleev ua kom loog.
Yog tias kuaj pom tus kab mob hauv menyuam yaus, tus kws kho mob tau sau ntawv rau cov menyuam yaus tshwj xeeb siv tshuaj lossis xaiv qhov tsim nyog noj raws li tus neeg mob lub hnub nyoog. Thaum kho cov menyuam yaus, cov tshuaj tau sib xyaw nrog mis lossis dej haus.
Pancreatic enzymes yog ib feem ntawm cov ntsiav tshuaj xws li Mezim-Forte, Abomin, Creon, Festal, Digestal, Betaine, Enzistal, Panzinorm, Penzital thiab lwm yam.
Niaj hnub no, ntawm kev muag koj tuaj yeem nrhiav cov enzymes ntawm tsob nroj, fungal lossis microbial keeb kwm, tus neeg mob tuaj yeem xaiv cov tshuaj tom qab kev pom zoo nrog tus kws kho mob uas koom nrog. Kev npaj nrog tsob ntoo cog ntoo muaj roj ua kom sib xyaw, yog li lawv tuaj yeem sib xyaw zoo nrog cov zaub mov thiab yuav nqus tau sai dua.

Ntxiv nrog rau kev noj tshuaj, cov chav kawm ntawm kev kho mob suav nrog ua raws li kev noj haus tshwj xeeb. Tus neeg mob raug tso cai tsuas yog noj cov zaub mov muaj roj tsawg dua tsis ntxiv nqaij, nqaij npuas thiab kua zaub. Tsis tas li ntawd, nws raug nquahu kom koj haus tsawg kawg yog ob litres ib hnub ntawm dej alkaline ntxhia dej.

Yog tias ib tus neeg muaj exocrine pancreatic tsis txaus, cov tshuaj Pancreatin yog tshuaj. Nws yog siv rau dysbiosis, mob plab peptic, thaum lub plab zom mov muaj qhov nce ntawm hydrochloric acid thiab pepsin, mob plab los yog mob plab hnyuv, thiab ua tsis tau qog ua ntshav tsis txaus.

Txhawm rau nce cov kev ua haujlwm ntawm cov txiav thiab txhim kho zus tau tej cov enzymes, cov tshuaj yog siv uas muaj pacreatin, hemicellulase, kua tsib kua qaub thiab lwm yam. Vim tias qhov no, cov haujlwm ntawm lub plab thiab lub zais zis ua rau lub ntsej muag txaus siab, thiab kev tsim cov roj ntsha hauv plab hnyuv tau txo. Cov kev kho mob zoo li no tau hais tseg yog tias cov tsos mob tau nrog mob plab, belching, cem quav.

Cov ntaub ntawv hais txog kev ua haujlwm rau pancreatic yog muab hauv video hauv tsab xov xwm no.

Pancreatic digestive enzymes

Vim lub siab tshwj xeeb ntawm kev cuam tshuam ntawm cov enzymes, ib lub koom haum zoo ntawm cov txheej txheem tseem ceeb hauv lub neej hauv lub cev tau nqa tawm. Digestive enzymes nquag heev, lawv zom ntau ntau yam khoom hauv organic, uas ua rau zoo rau kev nqus ntawm cov zaub mov. Ib daim ntawv teev tag nrho cov enzymes tseem ceeb thiab lawv koom nrog hauv kev zom zaub mov tau nthuav tawm hauv lub rooj:

Hydrolysis ntawm triglycerides los ua cov roj ntsha

Kev tawg ntawm polysaccharides (glycogen, hmoov txhuv nplej siab)

Txhawm rau zom protein ntau

Txhawm rau rhuav kev cuam tshuam sab hauv ntawm cov protein

Digests Elastin, Txuas Protein nqaij

Carboxypeptidase A thiab B

Txhawm rau hauv cov khaubncaws sab nraud ntawm cov protein,

Proteolytic

Proteolytic enzymes tseem ceeb rau kev zom zom peptide cov pob zeb hauv cov protein molecules thiab zom cov khoom lag luam molecular. Nrog lub hnub nyoog, tsawg dua thiab tsawg dua ntawm cov enzymes uas ua tau. Tsis tas li ntawd, lwm yam sab nraud thiab kis tau mob tsis zoo rau lawv cov synthesis. Yog li no, cov yeeb tshuaj no qee zaum muaj peev xwm tsis pom. Yog tias cov hnyuv muaj cov protein ntau hauv cov enzyme, cov protein yuav tsis tuaj yeem zom sai.

Lub lipase enzyme synthesized los ntawm tib neeg lub cev catalyzes lub hydrolysis ntawm insoluble esters thiab txhawb txoj kev xaus ntawm cov rog hauv nruab nrab. Ua ke nrog cov kua tsib, cov enzyme no ua rau lub plab zom mov ntawm cov roj ntsha thiab cog cov vitamins E, D, A, K, hloov kho lawv ua lub zog. Tsis tas li ntawd, lipase yog koom tes hauv kev nqus ntawm polyunsaturated acids thiab vitamins. Qhov tseem ceeb tshaj plaws enzyme, vim tias kev ua tiav ntawm lipids yog nqa tawm, yog suav tias yog pancreatic lipase, uas tawg tawm cov rog rog emulsified los ntawm hepatic bile.

Lub sij hawm amylase txhais tau tias tag nrho pawg ntawm cov enzymes. Hauv tag nrho, peb hom khoom sib txawv tau txawv: gamma, alpha, beta. Alpha amylase muaj cov ntsiab lus tshwj xeeb rau lub cev (lub npe yog los ntawm Greek keeb kwm). Nws yog ib yam khoom uas zom cov carbohydrates txoj. Kev xav ntau ntawm cov enzyme no tau pom hauv cov neeg txiav caj dab, me me - hauv cov qaub ncaug salivary.

Kev tshawb xyuas Enzyme

Muaj kev ntsuam xyuas tshwj xeeb los txiav txim siab txog qhov kev ua si ntawm lub cev mob caj dab. Tus neeg sawv cev rau enzyme, lipase, amylase, uas tuaj yeem pom hauv cov ntshav lossis ntshav, tau kawm tsawg dua, lawv tuaj yeem pom hauv cov kua dej pleural. Qhov pom tseeb tshaj enzyme yog kev kuaj mob ntshav ntshiab (amylase). Yog tias amylase ntau dua 130, tom qab ntawd qhov no qhia tau hais tias muaj peev xwm ua mob qog nqaij hlav, qhov taw qhia ntawm 60 txog 130 qhia tau tias muaj teeb meem nrog tus txiav. Tshaj li cov kev cai los ntawm 3 zaug qhia tau hais tias mob hnyav ua rau pancreatitis lossis plab hnyuv perforation.

Rau cov ntshav dej, ib qho kev ntsuas lipase tuaj yeem ua tau, nws yog suav tias yog rhiab thaum nws los txog rau kev puas tsuaj rau pancreatic. Nrog ib qho kab mob, lipase nce txog 90%. Yog tias qhov enzyme no tsis nthuav dav, thiab amylase loj, ces koj yuav tsum xav txog lwm yam kab mob. Raws li cov txiaj ntsig tau los ntawm kev kuaj ntshav biochemical, tus kws kho mob tuaj yeem ua qhov tseeb txog kev xaiv qhov tseeb, xaiv ib txoj kev kho mob. Qhov kuaj ntshav ua rau ntawm lub plab khoob. Nws yog qhov zoo dua los ua kev soj ntsuam thaum sawv ntxov, thaum qhov ntsuas enzyme yog ntau lub hom phiaj. Ntxiv rau kev muab ntshav ntxiv, cov ntawv sim hauv qab no tuaj yeem ua:

Tsom tshuaj ntsuam.
Kev ntsuam xyuas tshwj xeeb uas txhawb lub cev nrog tshuaj thiab cov amino acids. Tom qab lawv, cov enzymes tsim nyog tau txiav txim siab los ntawm cov ntsiab lus ntawm txoj hnyuv.
Mob Lub Hlaus Nws yog sau tsuas yog nyob rau hauv huv si tableware.
Kev txheeb xyuas cov ntshav ntshav.

Pancreatic enzyme deficiency yog dab tsi

Lub txiav, zoo li lwm yam hauv nrog cev, tuaj yeem swb. Feem ntau cov kabmob yog nws qhov tsis txaus. Nrog rau ib qho enzymatic tsawg tsawg ntawm cov tshuaj uas tsim tawm los ntawm cov txiav, cov tsos mob ntawm tus kab mob ua tiav tsis tiav thiab ua rau lub plab zom mov, uas yuav ua rau lub cev zom tsis txaus siab thiab kev loj hlob ntawm cov kab mob pathological. Cov ua rau kev ua tsis tau tuaj yeem yog:

Khoom noj khoom haus lom.
Enzyme inhibitors.
Vitamin tsis muaj zog.
Kev puas tsuaj rau pancreatic ntaub so ntswg.
Kev noj haus tsis zoo. Noj mov qab ntsev thiab ua zaub mov muaj roj.
Tsawg theem cov protein ntau.
Txo hemoglobin.
Cuam tshuam tsis zoo.

Lub plab zom mov Enzyme Sau

Lub plab zom mov tsis haum, Duodenal mob rwj

Siv 3 zaug 1 ntsiav tshuaj, tsis pub ntau tshaj 2 hlis

Tsis muaj secretory muaj peev xwm ntawm gastrointestinal ib ntsuj av, pancreatitis, gastritis.

Sab hauv 3 ntsiav tshuaj nrog zaub mov noj.

Nrog lub plab zom mov tsis muaj peev xwm ntawm cov hnyuv thiab lub plab.

Cov neeg laus haus 2 ntsiav tshuaj ua ntej noj mov, tsis muaj dej haus. Tus menyuam tuaj yeem raug muab raws li kws kho mob qhia.

Kev tsis haum lossis qhov chaw zais cia tsis muaj ntxig quav txhauv tsis txaus.

Exocrine muaj nuj nqi - kev tsim tawm ntawm pancreatic enzymes

Pancreatic acinar hlwb tsim tawm pancreatic enzymes los zom cov zaub mov hauv cov hnyuv. Tom qab ntawd lawv poob rau hauv canaliculi, nrog kev pab los ntawm cov ntsiab lus uas tau ntuag mus rau hauv cov ciav dej.

Cov kev hloov pauv ib qho ntxiv ntawm cov enzymes rau cov placebo tau qhia teeb meem loj heev nrog kev tswj glycemic. Hauv cov neeg mob uas muaj ntshav qab zib insulin, vim qhov xwm yeem tsis paub meej ntawm kev tswj glycemic, kev kho mob sab nrauv yuav tsum tau ceev faj heev.

Peb kawm txog cov nyhuv ntawm high-lipase pancreatin ntawm kev nthuav tawm ntawm ntau cov rog. Lawv pom tias kev siv cov pancreatin ua rau txo qhov quav loj, qhov txo qis hauv qhov tso tawm los ntawm cov rog los ntawm quav, tsiaj sterols thiab ntu luv-fatty acids uas yog. Txawm li cas los xij, pab pawg neeg tshawb fawb tsis pom muaj qhov hloov pauv tseem ceeb hauv kev nthuav dav cov quav ntawm cov quav beta-sitosterol, kua tsib kua qaub lossis feem ntau ntawm hydroxylated fatty acids.

Pancreatic enzymes yog cov tshuaj catalysts uas, hauv kev hais txog physiological, nyob twj ywm tsis ua haujlwm kom txog thaum lawv nkag mus hauv lumen ntawm txoj hnyuv me. Muaj lawv tau ua kom tiav los ntawm kev pais plab kua txiv thiab lwm yam kua ntshav enzymes. Cov enzymes sib txawv ua rau ntau hom zaub mov.

Pancreatic enzymes sib tov zom cov khoom noj hauv cov khoom sib luag uas yuav zom tau los ntawm lwm qhov los yog nqus tau ncaj qha rau hauv cov ntshav los ntawm txoj hnyuv.

Kev tshem tawm cov roj ntsha thiab cov xov paj luv luv hauv cov quav ua rau pom qhov muaj qhov sib txuam nrog cov quav quav. Lankish tau qhia txog kev tswjfwm tus neeg mob hauv cov kis teebmeem tsis zoo rau lub chaw tswj xyuas pancreatic. Nws pom zoo kom yuav tsum tau txhaj tshuaj ntau dua ntawm cov enzymes los ntawm kev kuaj xyuas tus neeg mob txoj kev siv tshuaj thiab rov tshuaj xyuas qhov mob. Txawm hais tias qhov kev kho no yuav siv sijhawm, cov neeg mob tsis teb rau pancreatin hloov txoj kev kho los tiv thaiv kev tiv thaiv kev mob lig ntawm pancreatic exocrine pancreatitis.

Lub luag hauj lwm ntawm enzyme ntxiv nyob rau hauv kev mob caj dab ntev yog txuam nrog kev ua ntawm txoj cai txiav txim siab ntawm kev tiv thaiv kab mob thiab cholecystokinin. Kev tswj hwm ntawm lub qhov ncauj ntawm pancreatic enzyme npaj los ntawm qhov ncauj rov qab ntawm cholecystokinin, thaj, ua rau txo qis siab hauv qhov kev txiav txim siab ntawm pancreatic ducts thiab txo qhov mob. Nws tau paub tseeb tias kev hloov kho ntawm lub cev ua qab ntawm cov lus tsis zoo cuam tshuam rau endogenous secretion thiab qhov mob ntawm kev mob caj dab ntev. Hauv 18 cov neeg mob uas mob pancreatitis, ua rau quav thiab cov quav ntawm cov quav elastase tau raug ntsuas ib hnub ua ntej thiab ib hnub tom qab hloov txoj kev kho.

trypsin
chymotrypsin
carboxypolypeptidase,
elastase
kallikrein.

Caro carbohydrate pancreatic enzymes raug txwv rau amylase.

Cov tshuaj uas zom cov rog:

Endocrine muaj nuj nqi

Islet cell ntawm lub caj pas (islets ntawm Langerhans) tsim cov tshuaj hormones uas tswj cov metabolism thiab kev zom zaub mov. Lawv tseem cuam tshuam qhov cia ntawm cov khoom noj tshaj.

Hauv cov neeg mob uas muaj mob loj txog pancreatitis, qhov kev pom tshwm tsawg zuj zus nyob rau qhov fecal elastase qib tau pom. Qhov mob tau txo qis tom qab 2 lub lis piam ntawm enzymatic hloov txoj kev kho. Lwm qhov kev thov ntawm kev kho tshuaj enzymatic yog nws txoj kev siv tom qab phais mob pancreatic. Exacerbations tuaj yeem mob siab rau ntau lub lis piam tom qab phais mob. Active duodenal proteases tuaj yeem txhawb kev xa rov qab ntawm exocrine kev ua si, tab sis cov nyhuv no tau xav tau los ntawm kev siv tshuaj ntau.

Nees neeg mob tau randomized rau txhua ntawm peb pawg. Kev ua haujlwm Exocrine tau tshawb pom los ntawm kev siv qhov kuaj quav kev ywj pheej, kev kuaj pom cov hmoov txhuv nplej siab, thiab kev txheeb xyuas cov tsos mob ntawm lub plab. Tom qab 10 hnub ntawm kev kho mob hauv pab pawg A, pancreatin tau txais txiaj ntsig zoo. Tsis pom muaj qhov sib txawv ntawm qib elastase tau pom nyob hauv txhua pawg. Cov txiaj ntsig ntawm txoj kev kawm no qhia tau tias muaj kev vam khom rau qhov txiaj ntsig ntawm kev kho enzyme rau ntawm koob tshuaj enteric pancreatin siv rau hauv cov neeg mob tom qab phais mob pancreatic.

Cov tshuaj hormones tseem ceeb yog insulin thiab glucagon. Cov Insulin nce cov piam thaj ntau los ntawm cov hlwb, li no ua rau cov ntshav qab zib, thiab pab siv cov carbohydrates ntau heev. Glucagon teeb tsa cov piam thaj ntawm qhov xem thiab nce nws qib hauv cov ntshav.

Somatostatin yog lub plab zom zaub mov uas kuj yog tsim los ntawm cov islets nrog rau D cov hlwb hauv cov qog ua kua ntawm lub plab hnyuv plab. Cov tshuaj no txo cov kev zais ntawm pancreatic (exocrine) thiab lub plab acid enzymes, inhibits kev tso tawm ntawm insulin thiab txo qhov nqus ntawm cov hnyuv tawm hauv cov hnyuv. Somatostatin cuam tshuam cov metabolism.

Qhov kev kho no tuaj yeem ua rau kom muaj kev txhim kho sai ntawm cov haujlwm ntawm exocrine muaj tus kab mob sai, tej zaum ua tau los ntawm kev txo cov lus teb ntawm cholecystokinin rau kev txhawb nqa khoom noj. Qhov no yog qhov ntsuas tseem ceeb heev rau kev hloov kho pancreatin. Qhov cuam tshuam ntawm kev kho mob enzyme 4 thiab 8 lub lis piam tom qab kev phais mob vim mob ntsig txog mob txha caj qaum tau raug txheeb xyuas. Cov tshuaj pab Enzymatic txhim kho zoo dua qhov kev nqus ntawm cov rog los ntawm kev noj haus, uas ua rau lub zog nce ntxiv hauv thawj 4 lub lis piam tom qab kho.

Pancreatin ua kom zoo dua ntawm cov protein nqus thiab nitrogen tshuav 4-8 lub lis piam tom qab kho, thaum nqus roj thiab lub zog noj tsawg dua hauv cov pab pawg. Cov khoom noj khoom haus ntawm cov neeg mob tsis muaj lub zog tsis muaj zog thaum lub sijhawm 8 lub lim tiam ntawm kev soj ntsuam, txawm tias 4 tus neeg mob tau txais pancreatin muaj qhov hnyav nce ntawm 3.6 kg. Lwm qhov kev tshawb nrhiav tau txheeb xyuas cov xwm txheej uas cuam tshuam txog kev hloov mus sij hawm ntev hauv cov neeg mob uas muaj mob caj dab hlav. 28 cov chaw kuaj mob tau tshawb xyuas hauv 34 tus neeg mob.

Kev ua ntawm pancreatic enzymes hauv lub plab zom mov

Pancreatic pancreatic enzymes yog cov zais rau hauv duodenum los zom cov zaub mov. Cov tshuaj Insulin thiab glucagon tseem ua lub luag haujlwm hauv kev tswj kev zom zaub mov kom zoo. Ua ke nrog dej, bicarbonates ntawm ions thiab hnoos qeev, tag nrho cov kev zais cia ntawm cov enzymatic tshuaj yog kwv yees li 1 liter ib hnub.

Kev siv cov koob tshuaj ntawm cov pancreatic enzymes tsis cuam tshuam rau qhov hnyav, thaum nce siab dua hauv cov neeg mob no tau txais txiaj ntsig zoo. Lwm txoj kev tshawb nrhiav, txawm li cas los xij, qhia txog qhov sib luag ntawm qhov siab thiab txheem koob tshuaj ntawm pancreatic enzymes hauv cov neeg mob pancreatic epitomy. Randomized, muab ob lub qhov muag dig muag, dig muag ob lub qhov muag, dig muag ob qho, xaiv ntsej muag, ob chav dig muag, muab cov tshuaj tso rau qhov chaw, kev kho mob 14-hnub, siv cov qauv zoo thiab koob tshuaj.

Thaum lub sij hawm ob qho kev kho mob nquag, ob qho kev txhaj tshuaj siab thiab cov qauv tau paub cov txiaj ntsig zoo ib yam. Ntawm qhov tod tes, cov sau phau ntawv sau tseg tias kev siv tshuaj uas muaj cov enzyme ntau nyob hauv ib qho tshuaj ntsiav txo qhov ntau ntawm cov tshuaj ntsiav uas yuav tsum tau thiab yog li ua rau muaj kev pheej hmoo rau kev siv tsis tu ncua los ntawm cov neeg mob thiab lawv lub siab nrog qhov yooj yim ntawm kev kho mob.

Lawv raug zais cia los ntawm acini hauv lub caj pas thiab nkag mus rau hauv lub qhov quav pancreatic. Tom qab ntawd muaj qhov tso cai ntawm cov kev muaj feem ntawm cov kua tsib thiab ua kom lub zog hla ntawm duodenum mus rau hauv cov kab noj hniav ntawm txoj hnyuv me. Ua ke nrog lawv, bicarbonate ions thiab dej raug tso tawm. Cov tebchaw no zais cia los ntawm epithelial hlwb kab uas ua rau lub caj pas thiab pab ua kom lub plab cov kua qaub tom qab ua kom tiav ntawm cov kua dej enzymatic. Txhawm rau kev ua tiav kev zom ntawm cov zaub mov, qhov cuam tshuam ntawm ntau yam tshuaj lom neeg yog qhov tsim nyog.

Krivachi et al Tau ua rau pom tias muaj txiaj ntsig zoo ntawm kev txhaj tshuaj pancreatic enzymatic ntau hauv cov neeg mob tom qab ua tiav ntawm gastrectomy. Lawv tau muaj kev txheeb xyuas cov txiaj ntsig tseem ceeb hauv cov ntshiab albumin thiab cov roj cholesterol, thaum ntshav dej uric acid tsis hloov. Qhov nqus ntawm cov hlau zoo dua, yog li tsis muaj qhov xav tau los hloov cov khoom no. Rau tus neeg mob tau txais kev phiv tshuaj.

Ib txoj kev tshawb nrhiav cov ntsiab lus tau txais txiaj ntsig zoo ntawm pancreatin hauv kev mob qog nqaij hlav tsis txiav phais. Qhov nruab nrab ntawm qhov sib txawv ntawm qhov hloov ntawm lub cev qhov hnyav yog 4, 9%. Cov neeg mob uas tau txais cov hlab ntsha pancreatic tau txais qhov hnyav ntawm 1, 2%, thaum cov neeg mob tau txais cov placebo poob 3, 7%. Kev nqus rog hauv cov neeg mob uas tau txais kev hloov pauv pancreatic nce ntxiv 12%, thiab hauv cov pawg placebo los ntawm 8%. Tsis tas li ntawd, kev siv lub zog txhua hnub tau muaj ntau dua nyob rau hauv pawg txiav (pancreas) dua li cov pawg placebo.

Kev ua ntawm pancreatic amylase

Pancreatic amylase yog qhov tsim nyog rau kev hloov pauv ntawm carbohydrates los ntawm cov zaub mov mus rau cov khoom siv tshuaj lom neeg yooj yooj yim uas muaj los ntawm kev tsis tuaj yeem thiab trisaccharides. Tom qab, cov tshuaj yeeb yam xws li lactases, sucrose, maltases thiab iso-maltases yog tsim nyob rau lawv lub hauv paus.

Thaum lub plab tsis ua haujlwm, kev nce qib hauv theem ntawm cov khoom no hauv kev kuaj ntshav biochemical.

Yog li, kev siv cov tshuaj ntawm pancreatin nrog kev noj zaub mov kom tsim nyog hauv cov neeg mob uas tsis ua haujlwm nrog kev mob qog nqaij hlav nrog pancreatic occlusion tuaj yeem tiv thaiv kev poob phaus, tsawg kawg thaum lub sijhawm ua haujlwm, kom tso cov prosthesis ntawm txoj kev tawm.

Kev siv cov pancreatic enzyme hloov tuaj yeem tiv thaiv kom tsis muaj mob tsis zoo thiab rog rog hauv ntau cov neeg mob nrog exocrine pancreatic tsis txaus. Txawm hais tias qhov no tau nrov tshaj plaws, nws tsis yog tsuas yog siv cov tshuaj no. Tam sim no, kev qhia rau kev siv tau nthuav dav rau ntau yam kab mob ntawm tus neeg mob txiav. Cov kev kawm muaj txiaj ntsig zoo tshaj plaws, pom tau tias, yog kev txhim kho cov khoom tshiab nrog kev ruaj khov nyob hauv cov kua qaub thiab tiv thaiv cov kab mob tiv thaiv.

Kev tswj hwm zais

Lub tso pa tawm ntawm pancreatic enzymes yog tswj hwm los ntawm cov hlab ntsha cov hlab ntsha thiab cov hnyuv. Thaum pib lub plab zom mov, qhov chaw nyob ntawm qhov ntswg ntawm lub plab nkag ntawm lub paj hlwb tau tsa sawv. Qee qhov kev xav no tseem ua rau kev tso tawm ntawm acetylcholine. Qhov tshuaj yeeb tshuaj no, ua ke nrog cholecystokinin (CCK), uas yog lub plab zom mov thiab tsim tawm los teb rau cov khoom noj ntawm cov zaub mov mus rau hauv duodenum, ua rau muaj kev tso tawm ntawm pancreatic enzymes los ntawm acini.

Tus mob pancreatitis tsis yog ib hom mob ntsws ntev uas yuav cuam tshuam rau txoj leeg mob leeg. Tus kab mob no yog tus cwj pwm los ntawm cov leeg pob txha ntawm cov nqaij, nrog nws cov ploj ntawm adenocarcinoma. Mob txha cajqab yog tsis thim rov qab thiab nyob tas mus li, raws li muaj pov thawj pom qhov tseeb tias txawm tias tom qab qhov kab mob tiav lawm, nws txuas ntxiv mus. Nws yog ib qho tseem ceeb tias kev mob pancreatic kawg yuav tshwm sim sib xws - tus mob no tuaj yeem hu ua kev mob ntxiv rau pancreatitis.

Cov kev tshawb fawb qhia tias cov cawv yuav tsum muaj rau kev txhim kho tus kab mob sib txawv nyob ntawm tus yam ntxwv ntawm cov neeg tau kawm. Nws tau tawm tswv yim tias qhov no tuaj yeem yog vim caj ces lossis ib puag ncig, xws li khoom noj tsis zoo lossis haus luam yeeb. Nws tau muab tawm tias kev noj haus nplua nuj protein thiab rog hauv cov neeg uas haus dej haus cawv ua rau muaj txiaj ntsig ntawm kev mob caj dab mob ntev, thiab haus luam yeeb yog qhov tseem ceeb sib txuam ua ke.

Lwm qhov kev zom tshuaj hu ua secretin ua rau muaj kev tso tawm ntau ntawm bicarbonate ions thiab dej. Cov tshuab no tswj lawv txoj kev thauj mus rau hauv lumen ntawm txoj hnyuv. Kev zais cia yog zais nyob rau hauv teb rau pais plab acid nkag mus rau duodenum.

Yuav ua li cas yog pancreatic enzyme deficiency manifested?

Nrog rau qhov tsis muaj teeb meem ntawm digestive enzymes thaum pib theem, cov tsos mob hauv qab no tshwm sim:

Cov hauv qab no ua rau kev mob caj dab ua ke nrog: rov ua dua kab mob pancreatic los yog mob nrawm, ua piv txwv, vim mob gallstone lossis kev haus cawv ntau dhau. Nws tau pom tias 20% ntawm tus mob pancreatitis tuaj yeem yog idiopathic keeb kwm, uas ib daim ntawv huab cua sov ntawm tus kab mob tuaj yeem suav nrog, nyob rau hauv uas etiological yam tseem tsis tau paub. Tus yam tsis tshua pom muaj ua rau mob txhaws ntswg nrog kev hloov pauv nrog kev rhuav ntawm kev tso dej ntawm cov txiav mus rau hauv duodenum.

hnyav hauv lub plab tom qab noj mov,
tsam plab
cov roj ntau dua tiam,
kev nraub qaum tom qab noj mov,
xeev siab, ntuav,
tsis qab los
raws plab thiab nquag cem quav.

Ntev enzymatic tsis muaj peev xwm ua rau lub siab nqaj ntawm cov nruab nrog cev. Deficiency ntawm pancreatic enzymes manifests nws tus kheej hauv daim ntawv ntawm:

Lwm yam uas cuam tshuam qhov pib ntawm tus kab mob no yog: hloov caj ces, xws li mob caj dab mob txha nqaj qaum, hloov kho lub cev tsis muaj zog, autoimmune pancreatitis ntev, thiab metabolic factor, xws li hyperthyroidism. Cov tsos mob ntawm tus mob pancreatitis.

Malabsorption syndrome yog ib qho ntawm cov tsos mob tseem ceeb ntawm tus mob leeg hlwb. Cov yeeb yam tseem ceeb ntawm cov duab hauv chaw kuaj mob ntawm tus neeg mob yog li nram qab no. Cov tsos mob feem ntau ntawm tus kab mob yog mob plab, tshwj xeeb yog hais tias nws rov ua dua thiab kav ntev li ob peb teev mus rau ntau hnub. Kev mob taub hau feem ntau mob hnyav uas feem ntau ua rau nws ua rau tus neeg mob tsis tuaj yeem ua haujlwm. Qhov mob feem ntau tshwm sim hauv zos nyob rau hauv lub plab mog sab sauv thiab tuaj yeem sab hauv plab lossis sab xis. Lwm qhov tsos mob ntawm tus kab mob yog lub caij nyoog qaug zog, uas yog lub txiaj ntsig ntawm kev noj zaub mov noj vim kev ntxhov siab ntawm cov zaub mov tom qab noj mov, uas qhov tseeb txwv tsis pub tus neeg mob noj zaub mov. Lwm cov tsos mob thaum ntxov ntawm tus mob pancreatitis yog sib daj sib deev. Qhov no tshwm sim thaum lossis tom qab raug mob hnyav thiab yog tshwm sim ntawm kev ntuav ntawm tus txiav, nias ntawm cov kua tsib cov leeg. Qhov no tej zaum yuav yog vim cov kua tsib cov leeg txha caj qaum thiab nws txoj kev nqaim tas mus li. Yog li no, qhov no yuav txhais tau tias yog kab mob txaus ntshai. Feem ntau daj ntseg yog ib ntus. Hauv cov kab mob pancreatitis, qhov tso tawm ntawm cov enzymes tsawg dua, uas tuaj yeem ua rau lub plab tsis zoo thiab nqus tau. Qhov xwm txheej no hauv kev mob ntsig txog mob txhawm rau pom yog ua los ntawm kev rog rog, uas tuaj yeem nrog kev muaj ntau lub cev ntawm cov nitrogen hauv cov quav. Nws yog ib qho tseem ceeb uas cuam tshuam ntawm kev rog ntawm cov quav ua rau raws plab yog feem ntau tsis txaus ntawm cov vitamins-rog. Qee lub sij hawm thaum kawg ntawm tus mob hlaus vwm, muaj kev tiv thaiv txaus endocrine yuav tshwm sim, uas tuaj yeem pab txhawb kev qabzib ua lub siab. Tus mob no yog qhov tseem ceeb vim yog tus neeg mob cov zaub mov noj, uas yuav tsum tau hloov pauv kom haum.

Qhov laj thawj tseem ceeb rau qhov no yog kev noj zaub mov ntau hauv cov rog lossis dej cawv.
Hom kev mob no feem ntau kav txij ob peb teev mus rau ntau hnub.

Ntxiv rau cov tsos mob no, xeev siab, ntuav, tsis nco qab kev, tsam plab, thiab cem quav yuav tshwm sim.

metabolic ntshawv siab
nce phaus ntxiv lossis poob phaus,
daim tawv nqaij qhuav,
fragility ntawm tes,
plaub hau poob
anemia
nquag kiv taub hau.

Nws yog ib qho tsim nyog yuav tsum kuaj xyuas tus mob no raws sijhawm thiab ntsuas kev kho kom zoo thiab kho tus mob.

Tsis muaj cov ntaub ntawv ntsig txog pom.

Pancreatitis, lossis ua mob rau hauv daim tawv nqaij, yog tus kab mob ntawm lub cev uas cov kws kho mob thiab cov neeg mob ntsib. Nyob rau hauv parallel, kab mob thib peb feem ntau tsim vim muaj ntau qhov tsis txaus ntawm cov enzymes digestive. Sim los cuam tshuam nrog qhov tshwm sim, tus kws kho mob tuaj yeem sau ntawv kho mob enzymatic npaj rau kev kho kom rov zoo li qub ntawm sab hauv ntawm cov enzymes uas ploj lawm. Tom qab siv cov tshuaj, kev zom zaub mov rov qab los rau qhov qub, txiav tawm ua haujlwm rov qab rau hauv kev ua haujlwm, tus neeg mob tus mob zoo dua.

Xav txog dab tsi cov enzymes nyob rau hauv nqe lus nug, yuav ua li cas siv tshuaj rau kom rov zoo dua.

Cov enzymes yog cov kev ua haujlwm lom biologically uas tsim los ntawm cov caj pas thiab xa mus rau cov plab hnyuv siab raum thiab cov ntaub so ntswg ntawm lub cev ua cov haujlwm loj. Piv txwv li, tus txiav ua kab mob insulin, glucagon thiab lipocaine - cov tshuaj hormones tsim nyog rau kev zom zaub mov. Lipocaine tsis yog tshuaj hormones hauv qhov muaj pes tsawg leeg, tab sis ua cov haujlwm zoo sib xws - nws ua kom muaj kev cuam tshuam ntawm cov tshuaj lom neeg hauv lub siab.

Cov Enzymes yog ib feem ntawm cov kua txiv qab ntsev, muaj peev xwm txhawb kev zom cov hnyuv hauv plab hnyuv plab. Yog tias cov yeeb yaj kiab nruab nrab hla cov ducts, cov enzymes yuav tsum ua kom lawv thiaj li koom nrog hauv kev ua kom tshem tawm cov txheej txheem.

Raws li txoj cai, lub xaib ntawm kev ua ntawm cov enzymes yog duodenum. Yog tias, vim qhov tsis paub, qhov tshuaj tiv thaiv yog pib ua ntej, tsis xis nyob tshwm sim. Piv txwv li, thaum kev sib cuam tshuam ntawm cov enzymes nrog cov hnyuv tshwm sim ib txhij nrog kev tso tawm cov kua tsib.

Cov enzymes dab tsi ua kev zom nyob ntawm?

Ntawm feem ntau ntawm cov enzymes uas ua los ntawm kev txiav ntshav, enzymes koom nrog kev zom zaub mov yog qhov tseem ceeb rau tus neeg mob, uas nws lub cev tsis txaus ua lub luag haujlwm tsis zoo hauv lub plab zom mov. Peb tab tom tham txog lipase, amylase thiab protease. Cov enzymes no yog tsim los zom cov zaub mov: carbohydrates, protein thiab rog; lawv txawv ntawm lawv txoj haujlwm.

Amylase tau tsim los txhawm rau rhuav tshem carbohydrates. Kev ua kom lwj yog nqa nrog "pab" ntawm lwm cov enzymes uas ua los ntawm txoj hnyuv.

Protease (cov tshuaj tiv thaiv kab mob). Muaj ntau ntau yam ntawm cov enzymes:

Qhov thib ob xav tau rau kev rhuav tshem ntawm cov protein nyob rau hauv rooj plaub thaum muaj cov txheej txheem loj molecular. Lub enzyme kawg tau koom nrog peptides, uas nws cov qauv tsim qauv pom cov cuab yeej yooj yim, ua rau cov amino acids tsis siv sijhawm ntau.

Cov hais txog hom enzymes yog suav tias yog qhov phom sij heev, tshwj xeeb tshaj yog thaum ua haujlwm. Los ntawm cov txiav, los ntawm cov tshuaj nruab nrab yog nruab nrab, nquag thaum kov raug trypsin, uas tuaj yeem ua kom nws tus kheej. Lub sijhawm, nrog rau cov kev ua si trypsin nrog cov proteolytic enzymes, pib mob, cov kws kho mob feem ntau yuav tsum tau txiav qhov kev txiav txim ntawm cov enzymes. Yuav kom ua tiav qhov no, nws yog ib qho tsim nyog los tiv thaiv qhov tsis siv neeg lub tshuab los ntawm kev pib: ib qho ntawm cov khoom nquag yog tsuas yog tawm ntawm lub xovtooj ntawm phab ntsa ntawm trypsin lwg me me.

Nucleases, uas suav nrog RNA thiab DNA, yog lub luag haujlwm rau kev hloov cov ntaub ntawv ntawm caj ces.

Xav tau Lipase los txhawm rau cov rog hauv cov tshuaj yooj yim. Raws li xaiv cov enzymes, lipase ua haujlwm hauv kev sib txuas nrog lwm tus uas tau tsim hauv qhov chaw ntawm lub plab zom mov.

Lub enzyme phospholipase paub. Los ntawm lub npe nws yog qhov tseeb: ib yam tshuaj lom neeg yog ncaj qha cuam tshuam rau kev tawg ntawm phosphorus, phospholipids thiab collagenose, uas zoo rau cov qauv ntawm cov ntaub so ntswg sib txuas. Thaum lub nqus tsev ntawm thaj chaw muaj kev cuam tshuam, cov ntaub so ntswg no raug kev txom nyem, ntawm lwm tus, cov roj ntsha pab tau txais tos.

Cov ua rau Enzyme Tsis Muaj

Cov kws kho mob txheeb xyuas ntau qhov laj thawj rau qhov tsis muaj enzymes:

pancreatic ntuj ntaub so ntswg raug hloov los ntawm kev sib txuas,
pancreatic ducts atrophy
pancreatic ducts swell, thiab lub plab zom mov tsim nyog rau kev zom tsis tau mus txog nws qhov chaw,
pancreatic cov ntaub so ntswg tau sib cais vim muaj cov txheej txheem ua mob, rhuav tshem cov khoom nruab nrog.

Nws yog qhov tseeb rau noj cov tshuaj uas tuaj yeem rov qab cov enzymes nrog mob pancreatitis hauv lawv tus kheej txoj cai.

Cov hnyuv me

Ua rau lub qog ua kua qaub ua pa rau alpha-amylase (ptyalin) nyob rau hauv lub qhov ncauj kab noj, uas tawg ntau cov hmoov txhuv nplej siab mus ua cov thooj me thiab ua kom cov kua qab zib (dextrins, maltose, maltriosis).

Lub plab

Cov enzymes zais cia los ntawm lub plab yog hu ua pais plab enzymesCov. Los ntawm cov khoom siv roj ntsha, yuav luag txhua qhov enzymes yog cov protein.

Pepsin yog qhov tseem ceeb ntawm kev mob plab. Hydrolytically cleaves peptide bonds cov denatured proteins rau peptides. Nws ua nyob rau hauv lub npe hu ua "cov hlwb tseem ceeb" nyob rau hauv kev ua tsis muaj zog hauv daim ntawv ntawm pepsinogen los tiv thaiv tus kheej kev zom ntawm lub plab hnyuv. Hauv plab kab noj hniav hauv qhov chaw tiv thaiv acid (pH = 1.5-2.5), pepsinogen hloov pauv mus ua pepsin nquag. Hauv qhov no, pepsin inhibitor yog cleaved. Tus txheej txheem yog autocatalytic nrog kev koom tes ntawm Hcl (H + ions), uas kuj tau ua hauv cov plab hnyuv, tab sis nyob rau hauv qhov chaw hu ua "parietal cells". Qhov hnyav molecular ntawm pepsinogen yog li ntawm 42,000, thiab pepsin yog kwv yees li 35,000. Nws ua raws los ntawm qhov no tias qhov tshuaj tiv thaiv ntawm hloov pepsinogen rau pepsin yog los ntawm kev tshem ntawm 15-20% ntawm cov qauv qub. Kev ua kom muaj tshwm sim vim kev tshem ntawm N-qhov xaus ntawm pepsinogen, uas txhua qhov loj amino acids muaj. Ntawm cov khoom lag luam kom tsis txhob muaj, muaj pepsin inhibitor nrog cov molecular hnyav ntawm 3242 thiab tsib qhov tawg me me, nyob rau hauv tag nrho sib raug rau ib phaus molecular ntawm txog 4000. Kev ua haujlwm ntawm hydrochloric acid kuj yog denaturation ntawm cov protein zaub mov thiab qhov nruab nrab ntawm pathogenic microflora los ntawm cov zaub mov. Txhawm rau tiv thaiv lub phab ntsa ntawm lub plab los ntawm qhov muaj cov kua qaub zoo, "mucosal cells" ntawm cov mucosa ua cov hnoos qeev - glycoprotein - thiab bicarbonate ions.
Nkaws sib xyaw nkaws nkaws hauv cov nkaws thiab collagen, cov qog nqaij tseem ceeb ntawm cov nqaij.

Cov hnyuv me

Cov tsos mob ntawm enzyme deficiency

Pom txog qhov tsis muaj enzyme tshwj xeeb hauv lub cev tsis yog qhov yooj yim. Tawm tsam keeb kwm ntawm tus neeg mob txoj kev mob, nws nyuaj rau ntes cov tsos mob ntawm tus neeg. Yog tias koj ua tib zoo saib, nws yuav pom:

tas mus li tsam plab,
xav xeev siab thaum noj tej zaub mov,
raws plab, tsis tu ncua lossis cuam tshuam,
tsis muaj qab los noj mov, los sis, hloov pauv, kev yaum yaum,
tsis xis nyob hauv plab yam tsis muaj qhov pom tseeb hauv zos,
tas li, piav tsis tau qaug zog.

Tus mob Pancreatic tas li ua rau lub plab zom mov, cov tsos mob tsuas yog qhia enzymatic tsis muaj peev xwm. Txawm li cas los xij, cov kws kho mob tsis tas yuav sau tshuaj enzyme rau kev txiav pancreatitis.

Kev taw qhia rau kev teem caij ntawm enzyme npaj

Qhov txheeb ze thiab qhov tsis muaj qhov enzymes hauv lub cev tau paub. Kev tshem tawm - mob heev ntxiv dua li txheeb ze, tab sis cov tshuaj los kho kom rov qab muaj enzyme tseem tshuav tshuaj.

Qhov tshwj tsis yog kis yog thaum qhov enzyme sib npaug hauv lub cev yog qhov qub. Qhov txiaj ntsig zoo sib xws yog tiav nyob rau theem ntawm kev zam txim. Ua ntej pib hnub so ntsiag to, kev noj cov tshuaj no yog vim tus kws kho mob xav tau kwv yees tias kev tsis muaj enzymes hauv lub cev.

Muaj ob peb yam yuav tsum tau ua, yam tsis muaj kev kho kom ua tiav. Cov mob no zoo li no:

koj yuav tsum tau noj zaub mov ntau, feem me me - piv txwv li, faib pluas su rau 5-6 noj thaum nruab hnub,
nws zoo dua yog tsis txhob haus cov carbohydrates yooj yim, muaj ntau cov rog, zaub mov kib,
koj yuav tsis haus cawv uas txwv tsis pub cov paib tsim tawm,
tsis txhob hnov qab ua kis las ua si, vim kev qoj ib ce ua haujlwm ntawm cov tshuaj yeeb dej caw sai dua,
yog tias koj tsis noj hmo yav tsaus ntuj, qhov no yuav ua rau cov hnyuv tuaj yeem ua cov txheej txheem thiab zom cov zaub mov noj thaum nruab hnub.

Tus kws kho mob uas sau tshuaj rau cov neeg mob enzyme yuav qhia txog cov xwm txheej teev.