Dab tsi yog cov tshuaj glucagon thiab cov tshuaj glucagon

Cov glucagon "tshaib plab" yog qhov paub me ntsis hauv kev sib piv nrog insulin, txawm hais tias ob yam yeeb tshuaj no ua haujlwm nyob rau hauv cov khoom sib txuas thiab ua lub luag haujlwm tseem ceeb hauv peb lub cev. Glucagon yog ib qho ntawm cov tshuaj hormones tseem ceeb ntawm tus txiav, uas, ua ke nrog insulin, yog lub luag haujlwm rau kev tswj ntshav hauv cov ntshav qabzib. Kev npaj tshuaj hormones raws li nws tau nquag siv hauv kev kho mob rau kev rov qab los ntawm mob ntshav qab zib mellitus thiab kev npaj rau kev kuaj mob txoj hnyuv.

Tus qauv thiab synthesis ntawm glucagon

Glucagon hu ua txawv, tab sis feem ntau nws tau txiav txim siab raws li kev xav - cov tshuaj insulin antagonist. Cov kws tshawb fawb H. Kimball thiab J. Murlin tau tshawb pom ib yam khoom tshiab nyob rau hauv lub txiav caj dab hauv xyoo 1923, 2 xyoos tom qab tshawb pom keeb kwm ntawm insulin. Tab sis tom qab ntawd, ob peb tus neeg paub txog lub luag haujlwm tsis cuam tshuam ntawm glucagon hauv lub cev.

Niaj hnub no hauv cov tshuaj, 2 lub luag haujlwm tseem ceeb ntawm "kev tshaib plab hormone" yog siv - hyperglycemic thiab kuaj mob, txawm hais tias qhov tseeb cov tshuaj muaj ntau yam haujlwm tseem ceeb hauv lub cev tam sim ntawd.

Glucagon yog protein ntau, ntau qhov tseeb, peptide hormone hauv nws cov qauv tshuaj. Los ntawm cov qauv, nws yog ib txoj saw polypeptide muaj 29 amino acids. Nws yog tsim los ntawm preproglucagon, ib qho tseem muaj zog tshaj polypeptide uas suav nrog 180 amino acids.

Txawm hais tias qhov tseem ceeb ntawm glucagon hauv lub cev, nws cov qauv amino acid yog qhov yooj yim heev, thiab yog tias peb siv lus science, nws yog "txhawm rau txhawm rau". Yog li, tib neeg, nyuj, npua thiab nas, cov qauv ntawm cov tshuaj no yog qhov zoo ib yam. Yog li no, glucagon npaj feem ntau tau txais los ntawm txoj kev mob siab ntawm tus heev nyuj los yog npua.

Kev khiav dej num thiab cuam tshuam ntawm glucagon hauv lub cev

Kev zais cia ntawm glucagon tshwm sim nyob rau hauv endocrine ib feem ntawm tus txiav hauv qab lub npe hu ua "islets of Langerhans." Thib tsib ntawm cov islets no tshwj xeeb alpha cell uas tsim cov keeb.

3 yam cuam tshuam rau glucagon ntau lawm:

1. Qhov siab ntawm cov piam thaj hauv cov ntshav (kev poob qis hauv cov ntshav qab zib mus rau ib qho tseem ceeb tuaj yeem ua rau qhov nce ntawm ob peb npaug ntawm cov "tshaib plab" hauv ntshav).
2. Kev nce ntxiv ntawm cov amino acids nyob rau hauv cov ntshav, tshwj xeeb yog alanine thiab arginine.
3. Kev siv dag zog lub cev (kev qhia tawm ntawm lub peev xwm ntawm qhov muaj peev xwm ntawm tib neeg muaj peev xwm nce qhov kev ua rau cov tshuaj hormones ntau dua 4-5 zaug).

Ib zaug hauv cov ntshav, "kev tshaib kev nqhis" ua rau cov neeg mob siab, ua kom txoj hlua khi rau lawv thiab txhawb cov kua nplaum tawm hauv cov ntshav, tswj nws kom nyob tus yees. Tsis tas li, qhov tshuaj hormone glucagon ntawm tus txiav ua tiav cov haujlwm hauv lub cev:

• kev ua kom cov lipid tawg thiab cov ntshav cov roj uas txhaws taus
• txhim kho ntshav txaus hauv lub raum
• txhawb nqa kev nthuav dav sai ntawm sodium ntawm lub cev (thiab qhov no pab txoj kev ua haujlwm hauv lub plawv)
• kev koom tes hauv kev tsim dua tshiab ntawm cov qog hlwb
• stimulates tso tawm insulin los ntawm hlwb

Tsis tas li, glucagon yog qhov tseem ceeb uas tsis txaus ntseeg-nyob rau hauv caj npab ntawm adrenaline los muab kev tawm tsam ntawm lub cev "kev sib ntaus lossis ya davhlau". Thaum adrenaline tawm rau hauv cov ntshav, glucagon tsub kom cov piam thaj ntau yuav luag tau txhawm rau txhim kho cov leeg pob txha, thiab ua kom cov leeg muaj pa oxygen ntau dua.

Lub tshuab

Tus txheej txheem ntawm kev ua ntawm glucagon yog vim nws txoj kev khi rau qee yam glucagon receptors uas lub siab ua haujlwm. Qhov no ua rau muaj kev nce G-protein-mediated adenylate cyclase kev ua haujlwm thiab qhov nce hauv cAMP tsim. Qhov tshwm sim yog nce catabolism ntawm glycogen tso rau hauv lub siab (glycogenolysis). qhov chaw tsis tau teev 2198 hnub Glucagon rau hepatocytes pabcuam raws li cov cim qhia sab nraud txog qhov yuav tsum tau tso cov piam thaj rau hauv cov ntshav vim qhov tawg ntawm glycogen (glycogenolysis) lossis kev sib txuas ntawm cov piam thaj los ntawm lwm yam - gluconeogenesis. Cov tshuaj hormones khi rau cov receptor ntawm lub plasma membrane thiab ua kom adenylate cyclase, uas ua rau kev tsim cov cAMP los ntawm ATP, los ntawm G-protein. Hauv qab no yog qhov tsis txaus ntawm kev coj ua hauv lub siab ua rau glycogen phosphorylase thiab kev cuam tshuam ntawm glycogen synthase. Qhov txheej txheem no ua rau muaj kev tso tawm glucose-1-phosphate los ntawm glycogen, uas hloov mus rau cov piam thaj-6-phosphate. Tom qab ntawd, nyob rau hauv qab ntawm qabzib-6-phosphatase, cov piam thaj dawb yog tsim, uas tuaj yeem tawm ntawm cov cell mus rau hauv cov ntshav. Yog li, glucagon nyob rau hauv daim siab, txhawb kev zom zom ntawm glycogen, pab tswj cov piam thaj hauv cov ntshav ntawm ib theem. Glucagon tseem ua rau gluconeogenesis, lipolysis, thiab ketogenesis nyob hauv lub siab.

Glucagon tau siv tsis muaj qhov cuam tshuam rau lub glycogen ntawm cov pob txha pob txha, thaj vim tias qhov tsis muaj qhov yuav luag tiav ntawm glucagon receptors hauv lawv. Glucagon ua rau muaj kev nce ntxiv hauv cov insulin secretion los ntawm kev noj qab haus huv ntawm pancreatic cells-cells thiab kev cuam tshuam ntawm insulinase. Qhov no yog, thaj, ib qho ntawm kev tsim kho lub cev ntawm kev tiv thaiv kab mob glucagon hob hyperglycemia.

Glucagon muaj qhov muaj zog inotropic thiab chronotropic rau lub myocardium vim muaj ntau qhov kev tsim ntawm cAMP (uas yog, nws muaj cov nyhuv zoo ib yam li cov haujlwm ntawm β-adrenergic receptor agonists, tab sis tsis muaj kev cuam tshuam β-adrenergic hauv qhov tseeb ntawm cov nyhuv no). Qhov tshwm sim yog qhov nce ntawm cov ntshav siab, ib qho kev nce siab hauv lub zaus thiab lub zog ntawm kev mob plawv.

Hauv qhov siab, glucagon ua rau lub zog antispasmodic zoo, so ntawm cov leeg ntawm cov khoom nruab nrog sab hauv, tshwj xeeb cov hnyuv, tsis yog kho kom haum los ntawm adenylate cyclase.

Glucagon koom nrog hauv kev siv ntawm "kev ntaus lossis khiav" kev cuam tshuam, ua kom muaj qhov muaj zog ntawm lub zog ntxiv (tshwj xeeb, qabzib, cov roj dawb, keto acids) rau cov leeg pob txha thiab nce cov ntshav mus rau cov leeg pob txha los ntawm kev txhim kho lub luag haujlwm ntawm lub plawv. Tsis tas li ntawd, glucagon tsub kom lub zais ntawm catecholamines los ntawm adrenal medulla thiab ua rau kev cuam tshuam ntawm cov ntaub so ntswg ntau dua rau catecholamines, uas tseem nyiam qhov ua kom tiav ntawm "ntaus lossis khiav" cov tshuaj tiv thaiv.

Daim ntawv tso tawm

Ampoules nyob rau hauv cov npe 669, 668, 667, 666.

Lyophilized hmoov rau niam txiv kev txhaj tshuaj hauv vials:

• ib daim ntawv tshuaj, 1 mg ntawm cov tshuaj nquag, ua tiav nrog cov kuab tshuaj rau hauv lub ntim 5 ml,
• rov siv daim ntawv siv tshuaj, 2 mg ntawm cov tshuaj nquag hauv cov khoom siv nrog cov kuab tshuaj rau hauv lub ntim ntawm 5 ml lossis 10 mg ntawm cov tshuaj nquag hauv cov khoom siv nrog cov kuab tshuaj hauv ib qho ntim ntawm 10 ml.

Pharmacodynamics thiab pharmacokinetics

Glucagon yog ib qho khoom siv uas muaj cov kabmob biosynthetic sib npaug ntawm tib neeg Glucagon, ob qho kev xaiv zoo tib yam hauv cov qauv.

Cov Tshuaj Hauv Tshuaj

Glucagon yog yam tshuaj uas sau ua rau lub siab glycogen, uas nyeg tawm hauv daim foos piam thaj rau hauv cov ntshav. Glucagon tsis muaj txiaj ntsig hauv kev tsis txaus glycogen hauv lub siab. Qhov tshwm sim ntawm cov tshuaj Glucagon yog qhov tsis txaus ntseeg hauv cov neeg mob uas tsis tau noj zaub mov ntev ntev, hauv cov neeg mob ntshav qab zib tsawg, adrenal tsis txaus lossis nrog cov ntshav qab zib hypoglycemia.

Tsis tas li ntawd, qhov haujlwm ntawm glucagon yog los txhawb kev zais ntshis. kev ua noj ua hausCov. Ntawm pheochromocytoma nws yuav ua rau muaj kev tso tawm ntau dhau kev ua noj ua haus, uas ua rau kom muaj kev nce siab ceev ceev. Nws inhibits lub suab thiab ua rau lub zog ntawm cov nqaij ntshiv ntawm cov hnyuv zom.

Cov Tshuaj Pharmacokinetics

Nws yog cleaved nrog kev pab ntawm enzymes hauv plab hnyuv siab raum thiab ntshav ntshav. Lub siab thiab lub raum muaj qhov ua tau zoo ntawm kev tshem tawm ntawm lub cev. Qhov kev tshem tawm ib nrab-lub neej ua rau 4-5 feeb. Thaum muab cov tshuaj pleev qhov tseeb, cov nyhuv pib tiav nyob rau hauv ib feeb tom qab kev tswj hwm. Lub sijhawm ua haujlwm ntawm 5-20 feeb.

Tom qab kev tswj hwm intramuscular, qhov pib ntawm kev ua tau yog pom tom qab 7-15 feeb thiab tuaj yeem mus txog 40 feeb. Hauv kev kho cov ntawv hnyav tshuaj qog ntshavxeev ntxim rau cov concentration piam thaj hauv cov ntshav yuav tsum nyob hauv nruab nrab 10 feeb tom qab thov.

Kev ntsuas rau siv

• kev kho ntshav qoghauv cov neeg mob kev txom nyem mob ntshav qab zib,
• raws li ib qho cuab yeej ntxiv hauv kev tshawb nrhiav radiological ntawm lub txiav, plab thiab plab hnyuv,
• kev kho mob siab nrog lub hlwb pathology.

Sab sij huam

Cov kev mob tshwm sim ntau tshaj plaws yog ntuav thiab xeev siab, tshwj xeeb tshaj yog thaum siv ib koob ntau dua 1 mg lossis nrog kev tswj hwm ceev ntawm cov tshuaj (txog li 1 feeb). Nyob rau hauv tsawg ករណី, ib tug thib ob ntshav qog.

• kev tiv thaiv tsis haum: kev tiv thaiv tsis haum mus txog anaphylactic poob siab,
• Kev tsim kho plab zom mov: xeev siab, ntuav, mob plab.

Cov lus qhia rau kev siv glucagon (txoj kev thiab qhov ntau npaum li cas)

Nyob rau hauv raws li kev soj ntsuam cov cim, cov tshuaj feem ntau yog siv ntawm qhov ntau ntawm 0.5 lossis 1 units subcutaneously, tso ntshav los yog intramuscularly.

Txhab kom rov npaj glycogen hauv cov kab mob siab thiab tiv thaiv kev txhim kho cov ntshav theem nrab hypoglycemia carbohydrates yuav tsum tau noj tom qab txhaj tshuaj. Yog tias siv cov glucagon tsis muaj txiaj ntsig, kev tswj hwm tau pom zoo piam thaj tso leeg ntshav.

Noj ntau dhau

Nrog rau kev qhia txog ntawm ntau npaum li cas ntawm cov tshuaj, xeev siab lossis ntuav tuaj yeem tshwm sim. Kev kho mob tshwj xeeb hauv cov rooj plaub no, raws li txoj cai, tsis tas yuav los ua. Peb tseem yuav txo cov ntsiab lus tsawg dua. poov tshuajhauv ntshav ntshav Qhov tshwm sim no yuav tsum tau kho thiab saib xyuas yog tias tsim nyog.

Kev sib txuam

Glucagon nkaus antagonistic rau kev ua tshuaj insulin.

Nyob rau keeb kwm ntawm kev kho mob beta blockers kev qhia ntawm cov tshuaj tuaj yeem ua rau kom muaj zog tachycardia thiab ntau siab.

Nrog tib lub sijhawm siv nrog Indomethacin cov tshuaj yuav plam nws qhov peev xwm nce siab piam thajhauv cov ntshav.

Thaum muab sib xyaw nrog Warfarin tuaj yeem txhim kho nws cov nyhuv.

Kev ntsuas rau siv

Kev siv cov tshuaj glucagon tau qhia nyob rau hauv cov xwm txheej zoo li no:

• Kev kho mob ntawm hypoglycemia (mob ntshav qis ntshav qab zib) hauv cov neeg muaj ntshav qab zib
• Rau kev pabcuam tivthaiv rau kev sojntsuam radiological ntawm lub txiav thiab lub plab zom mov
• Kev kho mob poob siab hauv qhov chaw kho mob hlwb.

Cov kev cai ntawm glucagon nyob rau hauv cov ntshav thiab nws cov kev ntshawv siab

Tus nqi ntawm cov piam thaj hauv cov ntshav nws txawv rau cov menyuam yaus thiab cov neeg laus. Hauv cov menyuam hnub nyoog 4-14 xyoos, qib "tshaib plab nqhis dej" tuaj yeem sib txawv ntawm 0-148 pg / ml, rau cov neeg laus khiav ntawm 20-100 pg / ml tau tso cai. Tab sis yog tias qhov ntsuas qog glucagon poob qis los yog nce hauv qis dua tus qauv, qhov no tuaj yeem cuam tshuam ntau yam teeb meem hauv lub cev.

Kev txo qis hauv cov ntshav ntawm glucagon nyob rau hauv cov ntshav feem ntau qhia tias mob cystic fibrosis, mob ntsig txog mob txha nqaj qaum, thiab kuaj tau tom qab txiav mob hlab hlwb (tshem tawm ntawm tus txiav).

Ib qho kev nce ntxiv hauv cov qib hormone yog qhov qhia tau ntawm cov kab hauv qab no:

• ntshav qab zib hom 1
• glucagonoma (qog ntawm thaj tsam ntawm alpha hlwb hauv cov txiav)
• mob leeg txhaj leeg
• mob ntsws
• Cushing's syndrome
• mob raum tsis ua hauj lwm
• Mob ntshav qab zib tsawg
• tej kev ntxhov siab loj heev (kev raug mob, hlawv, haujlwm, thiab lwm yam)

Kev Sib Sau thiab daim ntawv ntawm kev tso tawm

Hauv 1 ampoule No. 666 muaj 49 mg ntawm lactose thiab 1 mg ntawm glucagon ua hom tshuaj hydrochloride. 1 lub raj mis No. 667 - glycerin, phenol (tshuaj tsis huv) thiab cov tshuaj ua kom nquag plias nyob rau hauv tib tus nqi. 1 lub raj mis No. 668 ntawm tib cov tshuaj muaj zog hauv tib tus nqi thiab 140 mg ntawm lactose. 1 lub raj mis No. 669 muaj 10 mg ntawm glucagon hydrochloride, glycerol thiab phenol.

Dawb lyophilisate hauv ampoules rau kev zom nrog dej tsis huv. Rau ib qho kev tswj hwm nkaus xwb - 1 mg ntawm tus neeg sawv cev nquag + 5 ml ntawm cov khoom hnyav. Rov siv daim ntawv tso tawm - 2 mg tshuaj + 5 ml ntawm cov tshuaj lom lossis 10 mg ntawm tshuaj thiab 10 ml ntawm cov tshuaj lom.

Kho thaj chaw

Glucagen muaj hyperglycemic zog, i.e. - Txhim kho cov ntshav qab zib, ua ib cov insulin antagonist. Ib cov tshuaj hluavtaws yog qhov zoo sib xws rau cov tshuaj hormones ntuj hauv tib neeg lub cev. Cov tshuaj no nws tuaj yeem ceev cov glycogen, cov lus sib txuas ntawm cov uas tshwm sim hauv daim siab, tom qab ntawd nws tau tso tawm rau hauv cov ntshav hauv daim ntawv ntawm cov piam thaj. Yog tias nws cov peev txheej hauv lub siab yog ua kom zoo heev, ces cov tshuaj yuav tsis pab.

Cov tshuaj muaj qhov tsis zoo rau cov neeg mob uas tau tshaib plab rau lub sijhawm ntev, haus dej cawv, thiab tseem nyob hauv cov neeg mob kev txom nyem tsis txaus adrenal. Cov tshuaj muaj cov kev ua haujlwm ntawm stimulating catecholamines, kom ntshav siab tuaj yeem tshwm sim. Tsis tas li, tom qab kev tswj hwm, lub suab ntawm cov hnyuv leeg poob qis, peristalsis tsis muaj zog, uas thaum kawg tuaj yeem ua rau hnyuv atony thiab ua rau cem quav.

Tom qab nkag mus rau hauv tib neeg lub cev, cov tshuaj nrog kev pab ntawm enzyme tebchaw tau tawg nyob rau hauv cov ntaub so ntswg, plab hnyuv siab raum thiab ntshav ntshav. Hormonal clearance nyob ntawm daim siab thiab lub raum tsis ncaj. Ib nrab-lub neej ntawm lub cev yog luv heev, txog tsib feeb. Yog tias koj txhaj tshuaj rau qhov mob, nws yuav muaj nws qhov kev kho kom zoo tom qab 60 vib nas this, thiab lub sijhawm ntev ntawm cov nyhuv yuav nyob ntev mus txog 20 feeb sib law. Yog tias glucagon nkag tau rau hauv cov leeg, tom qab ntawd pib ntawm cov nyhuv tshwm sim ntau qeeb, mus txog 10 feeb, tab sis lub sijhawm ntawm cov nyhuv tsawg kawg yog 40 feeb.

Txoj kev ntawm daim ntawv thov

Tus nqi nruab nrab ntawm cov tshuaj hauv Lavxias yog li 800 rubles rau ib pob.

Cov lus qhia hauv qab zib qhia tau tias qhov tshuaj pib yog 0.5 IU lossis 1 IU ntawm cov tshuaj ib zaug. Nws tuaj yeem raug tswj hwm subcutaneously, intramuscularly lossis intravenously. Ib qho kev qhia ntxiv yog tias tom qab kev txhaj tshuaj nws yog qhov zoo dua rau noj cov khoom noj khoom noj uas yog cov khoom noj carbohydrate kom rov ntxiv cov khw glycogen hauv lub siab. Yog tias cov tshuaj tsis pab, nws yog qhov zoo dua rau kev tswj cov piam thaj hauv lub cev.

Thaum cev xeeb tub thiab pub niam mis

Nws yog ua tau, tab sis ua tib zoo saib, muaj kev tswj xyuas tag nrho ntawm cov neeg mob thiab tus menyuam hauv plab lossis menyuam mos.

Cia rau cov neeg mob

• tsis txhob cia kom khov ntawm cov tshuaj, yog li kom tsis txhob lam tau lam ua kom lub koob phem nrog cov kuab tshuaj muaj nyob hauv,
• khw nyob ntawm qhov kub thiab txias txog 25 ° C tsuas yog nyob hauv lub ntim thawj,
• kom tsis txhob ncav lub teeb,
• kev npaj npaj rau kev siv yuav tsum tau siv ncaj qha tam sim tom qab kev npaj. Tsis txhob tawm hauv cov tshuaj npaj rau tom qab siv.
• Txhob nyob ze cov me nyuam
• tsis txhob siv tom qab hnub tas sij hawm qhia ntawm pob.

Cov lus qhia tshwj xeeb

Nws yuav tsum tau nco txog qhov ntawd tshuaj insulin yog ib qho kev tawm tsam ntawm glucagon.

Tsis txhob siv cov tshuaj ntawm cov tshuaj yog tias nws tau coj qhov sib xws ntawm ib qho los yog hmoov tsis tau tag nrho cov yaj.

GlucaGen 1 mg HypoKit.

Glucagon Novo.

Qhov ntau npaum li cas tau muab xam los ntawm lub hnub nyoog lossis qhov hnyav ntawm tus menyuam raws li cov qauv hauv qab no:

• yog hais tias lub cev hnyav dua 25 kg lossis tus menyuam lub hnub nyoog ntev tshaj li 6-8 xyoo, ces cov ncauj lus 1 ml ntawm lub raj mis yog ua tiav,
• yog hais tias lub cev hnyav dua li 25 kg lossis thaum tus menyuam muaj hnub nyoog qis dua 6-8 xyoo, tom qab ntawd ib nrab ntawm cov ncauj lus 1 ml tau muab rau ua.

Thaum cev xeeb tub thiab lactation

Cov poj niam cev tsis tab seeb yuav tsum yog cov tshuaj nkaus xwb thaum tsim nyog siv.

Lub sijhawm pub niam mis cov tshuaj yog siv nrog huab ceev faj.

Cov tshuaj yeeb tshuaj yog siv feem ntau hauv kev xyaum nyob ruaj ruaj thiab yog cov tshuaj ntawm kev xaiv rau mob hnyav hypoglycemic tej yam kev mob,xav tau kev kho mob sai.

Glucagon tus nqi, qhov twg yuav

Yuav Glucagon (1 ml ntawm cov tshuaj thiab 1 ml ntawm cov tshuaj lom) hauv Russia yuav raug nqi 730-970 rubles, hauv Ukraine tus nqi ntawm daim ntawv tso tawm tshuaj no yog kwv yees li 350 hryvnias.

Kev Kawm: Kawm tiav los ntawm Vitebsk State Medical University nrog daim degree hauv Kev Kho Mob. Nyob rau hauv tsev kawm ntawv qib siab, nws tau coj tus thawj coj ntawm Cov Tub Ntxhais Tub Ntxhais Kev Kawm.Kev kawm ntxiv hauv xyoo 2010 - hauv kev tshwj xeeb "Oncology" thiab xyoo 2011 - hauv qhov tshwj xeeb "Mammology, pom cov ntawv ntawm oncology".

Kev: Ua haujlwm nyob rau hauv cov chaw kho mob dav dav rau 3 xyoos ua tus kws phais neeg (Vitebsk tsev kho mob xwm txheej ceev, Liozno CRH) thiab qee lub sijhawm ib cheeb tsam cov kws kho mob thiab kws kho mob phais. Ua haujlwm raws li tus neeg sawv cev ua liaj ua teb thawm xyoo ntawm Rubicon.

Nthuav 3 qhov kev lees paub meej txog cov ncauj lus "Kev ua kom zoo ntawm kev kho tshuaj raws li hom kev sib xyaw ntawm microflora", 2 qhov haujlwm ua haujlwm yeej khoom plig hauv cov koom pheej sib tw- tshuaj xyuas cov ntaub ntawv tshawb fawb (pawg 1 thiab 3).

Lub luag haujlwm ntawm glucagon hauv tib neeg lub cev

Glucagon yog polypeptide hormone ua los ntawm 29 amino acids. Glucagon alpha yog tsim los ntawm islet hlwb. Cov nram qab no glucagon zog ua tau qhov txawv:

• nce ntshav qabzib ntshav (lub luag haujlwm tseem ceeb ntawm lub cev).

Hauv lub siab, cov piam thaj yog muab khaws cia rau hauv daim ntawv ntawm glycogen. Thaum lub sijhawm yoo mov lossis lub sijhawm ua haujlwm ntev, glucagon ua rau muaj qhov tsis zoo, ua kom lub siab ua rau lub siab ua rau lub siab, thiab ua rau lub neej ntawm glycogen. Cov kua nplaum tawm thiab nkag mus rau hauv cov ntshav, ua kom lub cev ua kom tau lub zog.

Ua tib zoo mloog! Glucagon tsis zom glycogen hauv cov leeg nqaij, txij li thaum tsis muaj ib qho tshwj xeeb txais.

• ua kom lub neoplasm ntawm cov piam thaj hauv lub siab los ntawm cov khoom siv tsis muaj carbohydrate nrog rau lub cev tsis muaj peev xwm,
• inhibits kev siv cov piam thaj,
• txhawb txoj kev rhuav tshem ntawm lub cev rog cov roj ntsha. Yog li no, thaum glucagon tsim tawm, cov ntsiab lus ntawm cov roj ntsha hauv cov ntshav nce siab,
• ua kom muaj lub cev ntawm ketone lub cev (cov tshuaj tshwj xeeb uas, thaum sib cais, muab lub cev nrog lub zog hauv qhov tsis txaus ntawm lwm qhov chaw, i.e. thaum cov piam thaj tsis tuaj),
• txhawb kev ruaj ntseg ntawm insulin nyob rau hauv kev txiav txim kom tiv thaiv ib qho dhau ntawm cov piam thaj hauv cov ntshav,
• tsa cov ntshav siab los ntawm kev nce ntxiv zaus thiab lub zog ntawm kev mob plawv,
• ua kom lub cev muaj sia nyob ntawm cov huab cua phem los ntawm kev muaj peev xwm ntxiv los ntawm cov neeg siv zog hauv cov ntshav (qabzib, fatty acids, ketone lub cev), uas tuaj yeem ntes los ntawm cov kabmob thiab siv rau kev ua haujlwm,

Ntshav siab tseem ua rau lub cev tau txais txiaj ntsig zoo dua nyob rau hauv kev ntxhov siab.

• stimulates zus tau tej cov catecholamines los ntawm adrenal medulla,
• nyob rau hauv superphysiological ntau qhov ua kom cov nqaij ntshiv ntawm cov leeg ntawm cov leeg ua haujlwm (cov nyhuv antispasmodic),
• qhov kev txiav txim ntawm glucagon yog pab los ntawm adrenaline thiab cortisol, uas kuj muaj cov nyhuv hyperglycemic.

Kev cai ntawm glucagon tso pa tawm

Tib neeg lub cev yog qhov ua tau zoo ua tiav, yog li xwm tau tsim cov txheej txheem los tswj cov qib ntawm glucagon nyob rau hauv cov ntshav ntawm theem kom raug. Qhov xav tau rau kev ua kom muaj alpha hlwb thiab qhov zais ntshis ntawm glucagon yog:

• txo cov piam thaj hauv qab zib. Nrog lub cev ua haujlwm ntev dhau los yog tshaib plab, ua rau nws cov ntshav tawm mus tsawg heev. Lub cev muaj kev tshaib plab ntawm lub zog thiab xav tau cov piam thaj. Glucagon yog tsim tawm thiab tso tawm cov piam thaj ntawm cov peev,
• amino acids - arginine, alanine, uas raug tso tawm thaum lub sij hawm tawg ntawm cov protein tau txais nrog zaub mov noj. Qhov ntau dua ntawm cov protein ntau hauv cov zaub mov, cov glucagon ntau yog tsim. Yog li, cov khoom noj yuav tsum muaj qhov tsim nyog ntawm cov protein ua tiav,
• Cov tshuaj insulin ntau ntxiv: kom tsis txhob muaj cov piam thaj hauv qab ntev,
• cov tshuaj hormones tsim los ntawm lub plab zom mov - gastrin, cholecystokinin,
• tshuaj - beta-adrenostimulants.

Nws inhibits qhov zais cia ntawm glucagon:

• kev nce ntxiv hauv qabzib, fatty acids lossis ketone lub cev hauv cov ntshav,
• somatostatin tsim nyob rau hauv cov qeeb ntawm tes ntawm islet apparatus.

Kev ua haujlwm ntawm lub cev yog qhia txog kev pom zoo ntawm kev ua kom muaj zog thiab kev cuam tshuam ntawm cov glucagon ntau lawm, uas tswj kev tshuav nyiaj.

Cov Kev Tsis Txaus Ntseeg thiab Kev Ceev Faj

Nws yog contraindicated rau kev txo qis ntev ntawm cov piam thaj mus rau theem tseem ceeb, kev tiv thaiv tsis txaus lossis tsis muaj txiaj ntsig ntawm adrenal muaj nuj nqi.

Ceev faj - kev xeeb tub thiab lactation.

Hla kev sib txuam yeeb tshuaj

Glucagon yog lub tshuaj tua kab mob insulin. Beta-blockers, thaum noj ua ke, ua rau lub plawv dhia ceev ceev. Indomethacin tsub kom lub siab ntawm ib yam khoom hauv cov ntshav; cov nyhuv ntawm warfarin nce nrog kev kho mob ib txhij.

Glucagen 1 mg HypoKit

Novo Nordisk, Denmark

Tus nqi nruab nrab nyob rau hauv Russia - 725 rubles rau ib pob.

Glucagen HypoKit muaj 1 mg ntawm cov khoom hauv lub raj mis. Nws yog ib qho ua tiav analogue.

Pros:

Cons:

• Tsis pheej yig
• Muaj cov kev mob tshwm sim.

Humulin Regulator

Eli Lilly East, Switzerland

Tus nqi nruab nrab nyob rau hauv Russia - 810 rubles rau ib pob.

Humulin Regulator - ultra-luv luv insulin, ua tiav glucagen antagonist. Nws yog qhov tsim nyog rau cov tshuaj hormones tsis txaus, nrog lub xeev ntawm hyperglycemia.

Glucagon thiab Metabolism

Qhov kev txiav ua tiav rau ob peb txoj haujlwm. Exocrine muaj hauv kev tsim cov kua txiv zom, uas yog tawm los ntawm cov hlab mus rau hauv duodenum 12. Kev ua haujlwm ntawm endocrine yog qhov ntau lawm thiab tso tawm ncaj qha rau cov roj ntsha ntawm polypeptides thiab cov tshuaj hormones: insulin, glucagon, somatostatin, ghrelin thiab lwm tus. Cov tshuaj ua ke ntawm cov tshuaj no nyob hauv cov islet of Langerhans, cov haujlwm tau muab faib ua ob peb hom hlwb. Glucagon yog tsim los ntawm a-cov hlwb; lawv muaj kwv yees li 20% ntawm tag nrho cov naj npawb ntawm cov hlwb hauv pancreatic islets.

Glucagon hais txog polypeptide cov tshuaj hormones, nws cuam tshuam rau txhua hom metabolism. Lub luag haujlwm tseem ceeb ntawm glucagon yog dab tawm tsam:

Hauv cov neeg muaj kev noj qab haus huv, cov ntshav qabzib hloov me ntsis, tom qab noj mov nws yuav rov qab zoo li qub. Kev cai ntawm glycemia yog cov txheej txheem nyuaj, uas suav nrog lub hlwb, lub plab hnyuv, cov leeg, qog pituitary, lub qog thiab tus txiav, ob lub raum, nplooj siab thiab lwm yam plab hnyuv siab raum. Raws li qhov tshwm sim ntawm lawv cov kev ua haujlwm ua ke, cov qib zoo ntawm cov piam thaj rau cov metabolism yog tswj hwm.

Lub cev ua kom sib haum

Yog tias cov piam thaj hauv ntshav poob vim yog ua haujlwm hauv lub cev lossis tsis muaj zaub mov noj, glucagon synthesis nce siab. Yuav muaj dab tsi tshwm sim thaum ua qhov no:

1. Glycogen khw muag khoom noj uas tiv thaiv lub siab yog qhib kom ua haujlwm. Glycogen lov, raug pov rau hauv cov ntshav hauv daim ntawv ntawm cov piam thaj, glycemia normalizes. Cov nyhuv ntawm glucagon tsis siv rau glycogen tso rau hauv cov leeg nqaij.
2. Lub siab pib ua haujlwm ntxiv cov piam thaj los ntawm pyruvate thiab lwm yam khoom uas tsis yog carbohydrate.
3. Qhov kev noj ntawm cov piam thaj hauv kev tsim hluav taws xob tau qeeb qeeb.
4. Lub zog xav tau ntawm lub cev pib ua tiav los ntawm cov ntaub so ntswg rog, qhov kev xav ntawm fatty acids hauv cov ntshav nce. Tib lub sijhawm, ketone lub cev, cov khoom lag luam ntawm kev tawg ntawm cov rog, pib nkag mus rau hauv cov hlab ntshav.
5. Tam sim ntawd tom qab qhov kev tso tawm ntawm glucagon, insulin ntau lawm nce. Ua tsaug rau lawv cov counteraction, hyperglycemia yog tiv thaiv.
6. Cov tshuaj glucagon muab kev ua haujlwm ntawm lub siab, nce ntxiv ntawm lub zog thiab ntau zaus ntawm nws txoj kev mob plab. Vim tias qhov nce hauv siab, cov khoom noj khoom haus ntawm tag nrho cov ntaub so ntswg ntawm lub cev tau zoo tuaj.
7. Kev tso tawm ntawm catecholamines nce, qhov kev xav ntau dhau los. Tus tib neeg yuav hnov ​​qhov ntshai, khaus. Cov tsos mob zoo li no tshwm sim ua rau koj mob siab rau koj tus mob thiab tshem tawm cov ntshav qab zib.
8. Hauv cov siab, cov tshuaj hormones ua ib qho antispasmodic: relaxes plab hnyuv leeg.

Glucagon yog tsim nyob rau hauv teb rau poob rau hauv glycemia, muaj zog insulin ntau lawm. Glucagon synthesis yog tsa los ntawm lub zog ua haujlwm ntawm lub hlwb, yog li nws cov khoom lag luam nce nrog kev siv sympathomimetics thiab adrenostimulants.

Cov ntshav qab zib ntau ntau, ib qho dhau heev ntawm cov ketone lub cev thiab cov roj ntsha hauv cov hlab ntsha, thiab ib qib siab somatostatin cuam tshuam nrog glucagon ntau lawm.

Kev siv cov glucagon

Hauv cov theem pib, hypoglycemia yog yooj yim tiv thaiv los ntawm kev tswj hwm ntawm qhov ncauj sai ntawm cov carbohydrates: zib ntab, qab zib, qab zib, kua txiv. Yog tias lub sijhawm no ploj thiab tus neeg mob lub siab, nws muaj ob txoj hauv kev nce glycemia: los ntawm kev tswj cov piam thaj lossis glucagon. Rau cov piam thaj, kev tswj hwm cov dej num yog qhov yuav tsum tau, yog li ntawd, nws tsis haum raws li cov neeg sawv cev yooj yim-txav ceev. Tab sis glucagon tuaj yeem hno intramuscularly, thiab nrog hom kev coj ua no, nws pib ua tom qab 5-15 feeb.

Tus qauv ntawm glucagon hauv txhua hom tsiaj muaj npe yuav luag zoo tib yam; hauv tib neeg, yam tshuaj hormones ntawm tsiaj tuaj yeem siv tau zoo. Txhawm rau kom tsis txhob mob ntshav qab zib, tshuaj uas tau los ntawm nyuj los yog npua npua yog siv feem ntau. Cov qauv ntawm glucagon tau paub zoo, yog li ntawd, kev ua haujlwm ntawm kev tsim cov kabmob no tau tsim los siv cov qauv hauv kev ua haujlwm engineering.

Tam sim no, tsuas yog ib cov tshuaj glucagon tau sau npe nyob rau hauv Lavxias lub npe tshuaj - GlucaGen HypoKit, tsim los ntawm lub tuam txhab Danish NovoNordisk. Cov tshuaj nquag hauv nws yog glucagon hydrochloride, tsim los ntawm kev sim, siv kev hloov pauv ntawm tus kab mob Escherichia coli. Cov tshuaj nquag muaj nyob hauv daim ntawv ua hmoov, ntim hauv lub khob fwj.

Cov khoom siv suav nrog lub raj mis nrog 1 mg ntawm glucagon hmoov, koob txhaj tshuaj nrog cov kuab tshuaj, xaum xaum xaum kom yooj yim nqa cov tshuaj nrog koj, cov lus qhia. Tus nqi ntawm lub teeb yog los ntawm 635 txog 750 rubles.

Teem Caij Nyoog

Lub teb tseem ceeb ntawm daim ntawv thov ntawm cov tshuaj yog kev daws teeb meem ntawm ntshav qab zib nyob rau hauv rooj plaub uas tswj hwm qhov ncauj ntawm cov suab thaj tsis yooj yim sua vim tsis nco qab lossis tus cwj pwm tsis tsim nyog. Qhov ua rau hypoglycemia yuav yog kev noj tshuaj insulin ntau dhau, qee yam tshuaj tiv thaiv kab mob ntshav siab, kev tshaib plab, muaj kev ntxhov siab ntev ntev.

Hauv cov tsev kho mob, glucagon siv yog ib qho kev kho mob kub ntxhov rau kev ua paug nrog cov tshuaj plawv plawv. Nws kuj tseem siv tau hauv kev kuaj mob ntawm lub plab zom mov qoj ib ce uas yog txhais tau tias ua kom cov leeg nqaij so.

Tus kws kho mob ntawm Kev Tshawb Fawb Kev Kho Mob, Lub Taub Hau ntawm lub koom haum ntawm Diabetology - Tatyana Yakovleva

Kuv tau kawm mob ntshav qab zib tau ntau xyoo. Nws yog txaus ntshai thaum muaj coob tus neeg tuag, thiab haj yam ua rau neeg xiam vim ntshav qab zib.

Kuv maj nrawm los qhia txoj xov zoo - Endocrinological qhov chaw tshawb fawb ntawm Lavxias Academy ntawm Medical Science tau tswj hwm los tsim cov tshuaj uas kho cov mob ntshav qab zib mellitus kom zoo. Thaum lub sijhawm, cov hauj lwm zoo ntawm cov tshuaj no tau nce mus txog 98%.

Lwm qhov xov xwm zoo: Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv tau txais kev nyab xeeb qhov kev saws me nyuam ntawm cov haujlwm tshwj xeeb uas them rau cov nqi tshuaj ntau. Hauv Lavxias, neeg mob ntshav qab zib kom txog thaum lub Tsib Hlis 18 (suav nrog) tuaj yeem tau txais nws - Tsuas yog 147 rubles!

Lub luag haujlwm tseem ceeb ntawm glucagon yog sib sau cov khw muag khoom glycogen. Cov tshuaj hormones pib ua haujlwm glycogenolysis txheej txheem, vim li ntawd glycogen tau tawg nyob rau hauv nplooj siab rau phosphorylated kua nplaum. Lub sijhawm pib ntawm cov tshuaj hormone yog nyob ntawm tus txheej txheem kev tswj hwm. Nrog cov ntshav qab zib kom ntshav qab zib pib loj tom qab 1 feeb, cov nyhuv kav ntev txog 20 feeb. Ib txoj kev ua tus thawj coj loj yog qhov zoo dua yog tias koj tsis yog kws kho mob. Glycemia pib nce ntxiv tom qab 5 feeb. 10 feeb tom qab txhaj tshuaj, tus neeg mob feem ntau rov qab nco qab. Lub sijhawm tag nrho ntawm qhov kev txiav txim ncav 40 feeb. Nrog txoj kev tswj hwm subcutaneous, qhov nqus ntawm glucagon mus rau hauv cov ntshav yog qhov qeeb tshaj - los ntawm ib nrab ib teev.

Cov tshuaj yuav tsis ua hauj lwm zoo rau cov neeg mob uas muaj cov khoom siv muaj txiaj ntsig glycogen. Qhov ua rau cov mob glycogen tuaj yeem yog cov ntshav qab zib nrog cov ntshav qog ntau dhau, kev noj zaub mov carbohydrate tsis pub, tshaib plab, haus dej cawv, qaug cawv, rov qab ua dua coj ntawm glucagon. Glycogen yuav tsis txaus nrog kev siv ntau dhau ntawm cov tshuaj uas txo cov suab thaj.

Taw qhia cov kev cai

Glucagon xav tau npaj rau kev tswj hwm. Txheej Txheem

1. Peb hle lub hau ntawm lub raj mis, thiab lub hau ntawm cov koob txhaj tshuaj.
2. Ntxig tus ntxig rau hauv cov roj hmab nres, tso txhua cov kua los ntawm cov roj ntsha hauv lub vial.
3. Yog tias tsis rub tawm rab koob, tshiav lub vial rau ib pliag kom yaj cov hmoov ntawd.
4. Peb sau cov tshuaj tiav tas mus rau hauv cov phwj.
5. Tsa cov koob txhaj tshuaj nrog rab koob nce, tso cua los ntawm nias lub piston.

Qhov kev txhaj tshuaj tuaj yeem ua tau hauv txhua qhov muaj cov leeg mob, tab sis zoo dua nyob hauv lub pob tw lossis ncej puab. Raws li cov lus qhia rau kev siv, cov neeg laus tau muab tag nrho txoj kev daws teeb meem, cov menyuam kawm preschool thiab cov menyuam yaus uas hnyav dua 25 kg - ib nrab koob ntawm cov tshuaj hormones. Sai li cov ntshav qab zib rov qab nco qab, nws yuav tsum tau muab cov piam thaj rau dej haus: tshuaj tov tshuaj, dej qab zib lossis kua txiv. Yog tias tsis muaj kev hloov hauv tus neeg mob lub sijhawm 10 feeb lossis tshaj feeb, nws xav tau kev kho mob sai.

Kev tiv thaiv kev nyab xeeb

Thaum tswj hwm kev noj qab haus huv glucagon, cov hauv qab no yuav tsum raug xam tias:

1. Nrog hyperglycemia, glucagon tuaj yeem ua rau tus neeg mob tus mob hnyav dua. Cov tsos mob ntawm tus mob hyper- thiab lub qog ntshav qab zib muaj qhov zoo sib xws, yog li nws yuav tsum paub ntsuas qab zib ua ntej tswj hwm lub cev.
2. Tus neeg mob yuav muaj kev fab tshuaj rau cov tshuaj, kev pheej hmoo ntawm anaphylactic ceeb yog ntsuas qis heev.
3. Qhov tshuaj hormones no tuaj yeem muab rau thaum cev xeeb tub thiab HB yam tsis muaj kev pheej hmoo rau tus menyuam.
4. Glucagon tsis tuaj yeem siv rau pheochromocytoma, vim tias qhov no yog fraught nrog qhov nce siab hauv lub siab.
5. Cov lus qhia ntawm cov tshuaj yuav ua tsis tau nrog lub sijhawm ntev ntawm kev siv tshuaj indomethacin. Tsawg tsawg zaus, cov ntshav qog ntshav qab zib tseem exacerbated.
6. Cov tshuaj hormone txhim kho qhov kev txiav txim ntawm anticoagulants.

Tom qab cov tswj hwm ntawm glucagon, lub plawv dhia yuav nce siab, lub zog yuav nce ntxiv, tachycardia ib ntus yuav tshwm sim, thiab xeev siab yuav tshwm sim. Thaum noj cov beta-blockers, cov tsos mob no feem ntau qhia tau meej meej.

Nco ntsoov kawm! Koj puas xav tias kev tswj hwm kev noj qab haus huv ntawm cov tshuaj thiab cov kua dej yog ib txoj kev los tswj cov piam thaj kom tswj? Tsis muaj tseeb! Koj tuaj yeem soj ntsuam qhov no koj tus kheej los ntawm kev pib siv nws. nyeem ntxiv >>

Pharmacological kev txiav txim siab ntawm glucagon

Cov nyhuv ntawm cov tshuaj hluavtaws glucagon zoo ib yam li cov nyhuv physiological ntawm endogenous hormone:

• Kev zom cov glycogen hauv lub siab rau cov piam thaj, uas tom qab ntawd nkag mus rau hauv cov hlab ntshav. Thaum cov tshuaj tau txhaj rau hauv txoj hlab ntshav, qhov kev txiav txim siab pom tau tom qab 5 - 25 feeb, nrog intramuscular - tom qab 15 - 26 feeb, nrog subcutaneous - tom qab 30 - 45 feeb, yog li ntawd, rau qhov tshwm sim ntawm cov nyhuv, nws yog qhov yuav tsum tau tos lub sijhawm,
• So cov leeg du (cov nyhuv antispasmodic). Nrog kev tswj hwm kom zoo tom qab 45-60 vib nas this, nrog rau kev tswj hwm intramuscular tom qab 8-10 feeb,
• Tsub kom ntau zaus ntawm kev cuam tshuam ntawm lub plawv dhia.

Cov lus qhia rau kev siv hais tias cov nyhuv tsis loj hlob mus txog qhov theem tom qab lub sijhawm yoo mov, haus dej haus cawv. Tus nqi ntawm glycogen nyob rau hauv daim siab yog txo kom glucagon tsis muaj peev xwm ua tau ib qho kev ntxim siab.

Nrog kev siv lub sijhawm ntev ntawm glucagon, plab hnyuv lub cev yog inhibited thiab cem quav kev loj hlob.

Cov kev siv tsis txuam rau kev siv glucagon

• hyperglycemia: thaum ua glucagon, cov ntshav qab zib ntawm lub cev nce ntxiv,
• hypersensitivity rau nqaij nyug thiab nqaij npuas protein nyob rau hauv cov zaub mov,
• insulinoma (lub qog ntawm lub islet apparatus ntawm lub txiav), vim tias qhov no tuaj yeem ua rau cov tshuaj tiv thaiv tsis tuaj yeem - hypoglycemia),
• pheochromocytoma (mob qog ntawm adrenal medulla uas ua rau adrenaline ntau. Vim nws yog synergist ntawm glucagon, qhov no tuaj yeem ua rau hyperglycemia,
• mob ntshav qab zib mellitus (kev pheej hmoo ntawm hyperglycemia)

• Cov tshuaj glucagon tsis dhau los ntawm qhov chaw tiv thaiv kab mob, yog li nws tuaj yeem siv rau hauv cov poj niam cev xeeb tub. Txawm li cas los xij, nws tsis paub tseeb tias seb cov tshuaj mus rau leej niam cov kua mis, yog li ntawd, hauv qhov xwm txheej no, cov tshuaj yuav tsum tau siv nrog ceev faj,
• Txhim kho cov txiaj ntsig ntawm kev tsis ncaj ntawm anticoagulants.