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×èòàòåëü Íåäóã.Ðó
ß íå ïðåòåíäóþ íà ïîçíàíèÿ â îáëàñòè ìåäèöèíû. Ïðîñòî, õî÷ó âûëîæèòü íåêîòîðóþ èíôîðìàöèþ èç èíòåðíåòà ïðî ãèàëóðîíîâóþ êèñëîòó. Âîçìîæíî, ãäå-òî èíôîðìàöèÿ âûäðàíà èç ñïåöèôè÷.êîíòåêñòà. Íî èñêàë ÿ èíôîðìàöèþ â îáëàñòè ãîíàðòðîçà. Èòàê:
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0. ÃÊ (òðèàìñèíîëîí, ìåòèëïðåäíèçîëîí, áåòàìåòàçîí)
- Îáû÷íî èñïîëüçóåòñÿ ïðè ãîíàðòðîçå
- Èçáåãàòü ìíîãîêðàòíûõ èíúåêöèé
Íàáëþäàþòñÿ:
- Ñèìïòîìàòè÷åñêèé ýôôåêò
- Óëó÷øåíèå ôóíêöèè ñóñòàâîâ
- Íåîáõîäèìû ïîâòîðíûå èíúåêöèè
- Èñïîëüçóþòñÿ òîëüêî äëÿ ëå÷åíèÿ ãîíàðòðîçà
- Âëèÿíèå íà ïðîãíîç òðåáóåò ïîäòâåðæäåíèÿ
- Âûñîêàÿ ñòîèìîñòü
1. ... Ãîðàçäî íàäåæíåå, à ãëàâíîå, áûñòðåå õîíäðîïðîòåêòîðîâ è ôåðìåíòîâ, äåéñòâóþò ïîÿâèâøèåñÿ íåäàâíî ïðåïàðàòû ãèàëóðîíîâîé êèñëîòû (îñòåíèë è äð.).
2. Ââåäåííûé â áîëüíîå êîëåíî, îñòåíèë äåéñòâóåò êàê åñòåñòâåííàÿ ñìàçêà äëÿ ñóñòàâà. Îí îáðàçóåò íà ïîâåðõíîñòè ïîâðåæäåííîãî õðÿùà çàùèò.ïëåíêó, óëó÷øàþùóþ ñêîëüæåíèå ñóñòàâíûõ ïîâåðõíîñòåé êîëåíà, à òàê æå ïðåäîõðàíÿþùóþ õðÿùåâóþ òêàíü îò äàëüíåé.ðàçðóøåíèÿ. Êðîìå òîãî, ãèàëóðîí.êèñëîòà ïðîíèêàåò â ãëóáü õðÿùà, óëó÷øàÿ åãî óïðóãîñòü è ýëàñòè÷íîñòü. Áëàãîäàðÿ îñòåíèëó "ïîäñîõøèé" è èñòîí÷èâøèéñÿ ïðè àðòðîçå õðÿù âîññòàíàâëèâàåò ñâîè àìîðòèçèðóþùèå ñâîéñòâà. Ïðè ýòîì, ââåäåííûé ïðàâèëüíî â ïîëîñòü ñóñòàâà, îñòåíèë ïðàêòè÷åñêè íå äàåò ïîáî÷íûõ ýôôåêòîâ.
3. Îáû÷íî äëÿ ëå÷åíèÿ ãîíàðòðîçà ïðîâîäÿò 3-5 èíúåêöèé îñòåíèëà â ïîðàæåííûé ñóñòàâ. Èíúåêöèè äåëàþò ñ èíòåðâàëîì 10-15 äíåé. Êóðñ ïðîâîäÿò ðàç â ãîä: ïðè ãîíàðòðîçå I ñòàäèè íà ïðîòÿæåíèè äâóõ ëåò; ïðè àðòðîçå II ñòàäèè - íà ïðîòÿæåíèè 2-3 ëåò; ïðè àðòðîçå III ñòàäèè - 3-4 ãîäà. È õîòÿ ïðåïàðàòû ãèàëóðîíîâîé êèñëîòû ïîêà äîâîëüíî äîðîãî ñòîÿò, ïðèìåíåíèå îñòåíèëà ïîçâîëèëî â áóêâàëüíîì ñìûñëå "ïîñòàâèòü íà íîãè" ìíîãèõ áîëüíûõ èç òåõ, êîãî ðàíüøå, äî ïîÿâëåíèÿ ýòîãî ïðåïàðàòà, îäíîçíà÷íî ïðèøëîñü áû îïåðèðîâàòü.
4. Ìîäèôèöèðóþùèå ñðåäñòâà çàìåäëåííîãî äåéñòâèÿ (ãëþêîçàìèí, õîíäðîèòèí, ãèàëóðîíîâàÿ êèñëîòà), ýôôåêò êîòîðûõ ïðîÿâëÿåòñÿ áîëåå ìåäëåííî ïî ñðàâíåíèþ ñ ñèìïòîìàòè÷åñêèìè ñðåäñòâàìè è äëèòñÿ ïîñëå îêîí÷àíèÿ èõ ïðèìåíåíèÿ. Äàííûå ôàðìàêîëîãè÷åñêèå àãåíòû îáëàäàþò õîíäðîìîäèôèöèðóþùèì äåéñòâèåì, ïðåäóïðåæäàÿ äåãðàäàöèþ ñóñòàâíîãî õðÿùà.
5. Ïåðâè÷íàÿ áèîëîãè÷åñêàÿ ðîëü ÃÊ íåïîñðåäñòâåííî îáóñëîâëåíà åãî ñïîñîáíîñòüþ ñòèìóëèðîâàòü áèîñèíòåç ãëèêîçàìèíîãëèêàíîâ è ãèàëóðîíîâîé êèñëîòû, íåîáõîäèìûõ äëÿ ôîðìèðîâàíèÿ ïðîòåîãëèêàíîâ, íàõîäÿùèõñÿ â ñòðóêòóðíîé ìàòðèöå ñóñòàâà. Õîíäðîèòèí ñóëüôàò îáåñïå÷èâàåò äîïîëíèòåëüíûé ñóáñòðàò äëÿ ôîðìèðîâàíèÿ çäîðîâîé ñóñòàâíîé ìàòðèöû.
6. Ãèàëóðîíîâàÿ êèñëîòà- âàæíàÿ ñîñòàâëÿþùåàÿ ñóñòàâíîé æèäêîñòè ("ñìàçêè ñóñòàâîâ". Ïðè íåõâàòêå èëè íåïîëíîöåííîñòè ñóñòàâíîé æèäêîñòè ïðîèñõîäèò "ïîäñûõàíèå" ñóñòàâíûõ õðÿùåé, èõ "ðàñòðåñêèâàíèå" è èñòîí÷åíèå - ÷òî â êîðîòêèå ñðîêè ïðèâîäèò ê àðòðîçó.
7. Îòìå÷åí ïîëîæèòåëüíûé ýôôåêò íà ñîñòîÿíèå ñóñòàâíîãî õðÿùà ïðè ââåäåíèè âíóòðèñóñòàâíî ïðåïàðàòîâ ãèàëóðîíîâîé êèñëîòû êóðñîì ïî 5–10 èíúåêöèé âíóòðèñóñòàâíî.
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×èòàòåëü Íåäóã.Ðó
des, âàì óæå âñå îòâåòèëè, ÷åãî ïåðåëèâàòü èç ïóñòîãî â ïîðîæíåå. Ïåðå÷èòàéòå âñå âíèìàòåëüíî.
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×èòàòåëü Íåäóã.Ðó
...òðåíòàë ÿâëÿåòñÿ èíãèáèòîðîì ìåòàëëîïðîòåèíàç...
Óâàæàåìûé Èâàí Òèìîôååâè÷,
âñå æå ïåíòîêñèôèëèí ñêîðåå ïîçèöèîíèðóåòñÿ â íàó÷í-ìåä. ëèòåðàòóðå êàê àíòèöèòîêèíîâûé ïðåïàðàò (äåéñòâ. ãëàâíûì îáðàçîì íà ÔÍÎ):
Âîò ôðàãìåíò ñòàòüè èç ïîëíîé âåðñèè è ññûëêè ê íåé:
PTX has the property of inhibiting synthesis of proinflammatory cytokines in general, although existing data suggest it may be most effective in inhibiting synthesis of TNF-alpha (8, 10, 38, 55, 61).
8.Colson A, Willems B, and Thissen JP. Inhibition of TNF- production by pentoxifylline does not prevent endotoxin-induced decrease in serum IGF-I. J Endocrinol 178: 101–109, 2003.
10.D'Hellencourt CL, Diaw L, Cornillet P, and Guenounou M. Differential regulation of TNF, IL-1, IL-6, IL-8, TNF, and IL-10 by pentoxifylline. Int J Immunopharmacol 18: 739–748, 1996
38.Marcinkiewicz J, Grabowska A, Lauterbach R, and Bobek M. Differential effects of pentoxifylline, a non-specific phosphodiesteraseinhibitor, on the production of IL-10, IL-12 p40 and p35 subunits by murine peritoneal macrophages. Immunopharmacology 49: 335–343, 2000.
55.Silva JC, Rocha MF, Lima AA, Brito GA, de Menezes DB, and Rao VS. Effects of pentoxifylline and nabumetone on the serum levels of IL-1 and TNF in rats with adjuvant arthritis. Inflamm Res 49: 14–19, 2000.
61.Voisin L, Breuille D, Ruot B, Ralliere C, Rambourdin F, Dalle M, and Obled C. Cytokine modulation by PX differently affects specific acute phase proteins during sepsis in rats. Am J Physiol Regul Integr Comp Physiol 275: R1412–R1419, 1998.
Ïîëíûé òåêñò ñòàòüè
http://ajpheart.physiology.org/cgi/content/full/286/6/H2264