Mathata a sa foleng a lefu la tsoekere: ho tsepamisa maikutlo ho pentoxifylline

Mathata a sa foleng a lefu la tsoekere a baka ho fokotseha ha nako le boleng ba bophelo ba batho ba nang le lefu lena. Matšeliso a lefu la tsoekere a thatafalloa ke ho fihlella le hole le kamehla ho thibela nts'etsopele le kholo ea mathata. Ha ho fanoa ka pathogenesis e tloaelehileng ea mathata a lefu la tsoekere, ho bohlale ho sebelisa lithethefatsi tsa kemiso, tse kenyeletsang phosphodiesterase blocker pentoxifylline, e fanang ka phello e kopaneng ea vasodilation e fokolang ea motlakase, antiplatelet agent le angioprotector. Tlhahlobo ea katleho ea ts'ebeliso ea pentoxifylline maemong a fapaneng a sa foleng a lefu la tsoekere e hlahisoa.

Mathata a sa foleng a lefu la tsoekere: ho tsepamisa maikutlo ho pentoxifylline

Mathata a tebileng a lefu la tsoekere a bakoa ke phokotso ea bolelele le boleng ba bophelo ba batho ba nang le lefu lena. Letšollo la lefu la tsoekere le thata ho le fihlella mme ha le lumelle ho thibela ntshetsopele ea bona le tsoelo-pele ea bona. Ho ela hloko sechaba sa pathogenesis ea mathata a lefu la tsoekere, ts'ebeliso ea litokisetso tsa ts'ebetso eo ho eona ho sa khethoeng blocker ea phosphodiesterase pentoxifylline e kopantseng litlamorao tsa vasodilator tse fokolang tsa pherekano, moemeli oa antiplatelet le angioprotectora. Tlhahlobo ea katleho ea tšebeliso ea pentoxifylline maemong a fapaneng a sa foleng a lefu la tsoekere a hlahisitsoeng.

Sengoloa sa pampiri ea mahlale mabapi le sehlooho "Liphetoho tse sa feleng tsa lefu la tsoekere: ho tsepamisa maikutlo ho pentoxifylline"

LITLHAKISO TSA BOPHELO LE LITLHAKISO LE

Mathata a sa foleng a lefu la tsoekere: ho tsepamisa maikutlo ho pentoxifylline

ngaka ea mahlale a tsa bongaka, moprofesa oa lefapha la pele la mafu a kahare Univesithing ea Bongaka ea Belarus

MokhortT. Belarusian State Medical University, Minsk Mathata a tebileng a lefu la tsoekere:

tsepamisa maikutlo ho pentoxifylline

Kakaretso Mathata a sa foleng a lefu la tsoekere a baka ho fokotseha ha nako le boleng ba bophelo ba batho ba nang le lefu lena. Matšeliso a lefu la tsoekere a thatafalloa ke ho fihlella le hole le kamehla ho thibela nts'etsopele le kholo ea mathata. Ha ho fanoa ka pathogenesis e tloaelehileng ea mathata a lefu la tsoekere, ho khothalletsoa ho sebelisa lithethefatsi tsa kemiso, tse kenyeletsang "phosphodiesterase blocker" - pentoxifylline, e fanang ka phello e kopaneng ea vasodilation e fokolang ea motlakase, antiplatelet agent le angioprotector. Tlhahlobo ea katleho ea ts'ebeliso ea pentoxifylline maemong a fapaneng a sa foleng a lefu la tsoekere e hlahisoa.

Mantsoe a bohlokoa: lefu la tsoekere, mathata a sa foleng, pentoxifylline, lefu la tsoekere, lefu la tsoekere, mosebetsi oa kelello, lefu le sa foleng la joala la mafura, ho nyekeloa ke pelo.

Litaba tsa bongaka. - 2015. - N. 4. - S. 4-9.

Kakaretso Mathata a tebileng a lefu la tsoekere a bakoa ke phokotso ea bolelele le boleng ba bophelo ba batho ba nang le lefu lena. Letšollo la lefu la tsoekere le thata ho le fihlella mme ha le lumelle ho thibela ntshetsopele ea bona le tsoelo-pele ea bona. Ho ela hloko sechaba sa pathogenesis ea mathata a lefu la tsoekere, ts'ebeliso ea litokisetso tsa ts'ebetso eo ho eona ho sa khethoeng blocker ea phosphodiesterase - pentoxifylline e kopanyang litlamorao tsa vasodilator e fokolang ea pherekano, moemeli oa antiplatelet le angioprotectora. Tlhahlobo ea katleho ea tšebeliso ea pentoxifylline maemong a fapaneng a sa foleng a lefu la tsoekere a hlahisitsoeng.

Mantsoe a bohlokoa: lefu la tsoekere, mathata a sa foleng, pentoxifylline, lefu la tsoekere le lefu la tsoekere, ts'ebetso ea kelello, lefu le se nang mafura la joala, ho nyekeloa ke pelo.

Meditsinskie novosti. - 2015. - N4. - P. 4-9.

Mathata a sa foleng, kapa a morao, mathata a lefu la tsoekere mellitus (DM) ke sesosa sa ho fokotseha ha nako le boleng ba bophelo ba batho ba nang le lefu lena. Ka setso, bongata ba mathata a sa foleng a kenyelletsa microangiopathies (retinopathy, nephropathy), neuropathy le macroangiopathies (atherosclerosis ea methapo ea methapo ea kutlo le nts'etsopele ea lefu la methapo ea methapo ea methapo, methapo le methapo e meng ea methapo). Lilemong tsa morao tjena ho buisanoa ka khafetsa haholo ea ho ingolisa lefu la mafura a se nang joala a joala le boteng ba lefu la tsoekere, 'me sena se re lumella ho amahanya lefu lena le mathata a sa foleng a lefu la tsoekere. Ho ata ha khaello ea kelello le 'dementia' ho boetse ho hohela tlhokomelo, e bontšang tlhoko ea ho ntlafatsa mekhoa ea kalafo ea bona.

Liphuputso tse ngata li hlokometse mabaka a tloaelehileng a kotsi bakeng sa nts'etsopele ea mathata (a sa foleng a hyperglycemia, khatello ea methapo ea mali le dyslipidemia) 'me a tseba mekhoa ea thibelo le kalafo ea mathata a sa foleng a lefu la tsoekere. Meta-analysis ea lithuto tse lekola litlamorao tsa matšeliso bakeng sa metabolism ea carbohydrate, ho bontšoa ho tloaelehileng ha khatello ea mali le boemo ba lipid.

fokotsa kotsi ea ho ba le mathata a morao ka nako, empa, ka bomalimabe, eseng thibelo ea bona ka botlalo le pheko. Ka ho hlakileng, sebopeho sa multifactorial sa mathata a lefu la tsoekere se etsa qeto ea tlhoko ea mehato e eketsehileng ea ho susumetsa maemo a tsoelo-pele ea angio- le neuropathies. E se e le lilemo tse ngata e sebelisoa e le moriana oa kalafo le thibelo ea mathata a pelo a lefu la tsoekere.

phosphodiesterase blocker e sa khethang - pentoxifylline (PF), e kopantseng litlamorao tsa vasodilator e fokolang ea sehokelo, moemeli oa antiplatelet le angioprotector. PF e entsoe ka 1965 e le ntho e tsoang ho li-methylxanthine tse 'maloa tse nang le thepa ea vasodilating. Kamora liteko tsa liteko tsa bongaka le tsa kalafo ka 1972, litlhahiso tsa Grigoleit le Werner, lithethefatsi li ile tsa qala ho sebelisoa lingakeng.

Mathata a morao-rao a lefu la tsoekere

Khopolo e akaretsang ea Mathata a lefu la tsoekere (Brownlee M.) Fonseca V.A. Tleliniki ea lefu la tsoekere e fetolelang lintlha tsa patlisiso ka 2006

t Collagen t Fibronectin

Molao oa tlolo ea molao. Tlatsetso ea Maiketsetso ea Maiketsetso e tla tsosa mofere-fere. mefuta e mengata

phallo ea mali

1Я1Н Liphetoho tsa likokoana-hloko le tsa cellular tsa pentoxifylline

Thepa ea mantlha Ketso tse ling tsa 'mele

Phallo ea mali

Pono ea mali le phallo ea mali

Erythrocyte deformation uwezo + +

Ul Ho potoloha plasma fibrinogen + +

Bokhoni ba li-deformation ba leukocytes + +

¿Adhesion le kopane ea leukocytes + + +

Sephiri sa superoxide ke li-neutrophils + +

Im Ho hlohlona ha li-neutrophils FAT + +

Tlhahiso ea TNF-monocytes +

Response Karabelo ea Leukocyte ho TNF-a +

Response Karabelo ea Leukocyte ho IL-2 +

Activity Ketso ea 'molai oa tlhaho

Coagulation ea mali le fibrinolysis

Tissue plasminogen activator + +

Pholiso e pharalletseng le lisele tse sebetsanang

Onse Karabelo ho TNF-fibroblasts +

TLHOKOMELISO: FAT ke ts'ebetso ea ts'ebetso ea liplatelete, + ke litholoana tse ntle, - eketsa, - fokotseha.

tloaela ho ntlafatsa mekhoa ho microvasculature.

Mokhoa oa ts'ebetso oa PF o bonts'oa ka keketseho ea litaba tsa c-AMP le ATP le ho fokotseha ha tekanyo ea khalsiamo ka seleng. Ka lebaka la PF:

- E eketsa polasetiki ea membrane ea sele ea lisele tse khubelu tsa mali le ho fokotsa sekhahla sa ho fokola,

- E fokotsa kopanyo ea lisele tse khubelu tsa mali,

- e na le sesosa se fokolang sa matla.

- e fokotsa viscosity ea mali (ho eketseha ha fibrinolysis le ho fokotsa khatello ea "fibrinogen"),

- E fokotsa pokello ea liplatelete,

- e tlosa phello e senyang ea neutrophils ho endothelium.

Thepa e thathamisitsoeng e bohlokoa ka ho khetheha ho lefu la tsoekere, hobane keketseho ea hemoglobin ea glycated ho hyperglycemia e sa fetoheng e fetola boemo ba lisele tse khubelu tsa mali le ho eketsa ho khomarela ha tsona le ho fokotseha ha le holofala.

Ka lebaka la sebopeho sa eona sa lik'hemik'hale, PF e na le bokhoni ba ho eketsa synthetxane synthesis le ho fokotsa sebopeho sa thromboxane A2 liseleng tsa endothelial, inhibit synthesis of tumor necrotic factor-a (TNF-a) le li-cytokine tse ling, e fetole mahloriso a plasma fibrinogen le tšebetso ea plasminogen activator inhibitor, block phosphodiesterase, e lebisang ho bokelleng ha liplatelete tsa cAMP 17, 32, 35, 39. Liphetho tsena kaofela li thibela ho khabisoa ha liplatelete le lisele tse khubelu tsa mali, tse amang ka matla likarolo tsa rheological tsa Mali Properties.

Litholoana tsa mantlha tsa tlhaho ea PF li fanoa ka har'a tafole. Ho feta lilemo tse mashome a mane tsa boiphihlelo ka ts'ebeliso ea PF (lithutong tsohle mofuta oa pele oa PF - Trental e ne e sebelisoa) e bonts'a katleho ea eona ho li-pathologies tse fapaneng, empa, ka ho shebisisa lefu la tsoekere, re sekaseka menyetla ea ho sebelisa PF bakeng sa mathata a sa foleng a sa foleng.

Boloetse bo sa foleng ba methapo ea methapo ea methapo e tlase (HOSANK) ke sesosa sa nts'etsopele ea ischemic le mefuta e kopaneng ea lefu la tsoekere. Ha ho na pelaelo ea hore mekhoa ea mantlha ea kalafo e thehiloe ho khutliseng phallo ea mali methapong, i.e. Ho kenella ha angiosoviet moo ho nang le stenosis e bohloko. Maano a thibelo le a kalafo a kenyelletsa, ho kenyelletsa litlhahiso tse amoheloang ka kakaretso (matšeliso bakeng sa metabolism ea carbohydrate,

dyslipidemia, normalization ea khatello ea mali), e eketsehileng. Litlhahiso tse ling:

- ho ts'oaroa ke ho tsuba, ho ikoetlisa (ho ba teng ha metsotsoana e 45-60 ho tsamaea ho fihlela bohloko bo hlaha ka ho phomola ka makhetlo a 3 ka beke),

- li-antiplatelet le antithrombotic agents - aspirin kapa thienopyridines (ticlopidine kapa clopidogrel) kapa platelet receptor glycoprotein IIb / IIIa inhibitors (abciximab, eptifibatide, tirofiban).

Ho felisa mats'oao a ho kenella lipakeng tsa claudication, quinolinone derivative, Cilostazol, ka bomalimabe ha e so ngolisoe Rephaboliking ea Belarus e le sethethefatsi sa pele sa khetho. Cilostazol inhibits mofuta oa 3 phosphodiesterase mme e eketsa litaba tse kahare tsa cAMP, e khutlisa lintho tse thibellang liplatelese, palo e fetang ea asipirini, dipyridamole, ticlopidine le PF, e thibelang ho etsoa ha lisele tsa mesifa e boreleli, e na le vasodilator le hypo-lipid. Cilosta-zol ke eona feela setlhare se fokotsitseng ho etsoa ha li-restenoses kamora ho kenngoa ka masenke a tšepe a sa koaheloang (CREST).

Ka lebaka la monyetla oa ho sebelisa cilostazol, setlhare sa boikhethelo ke PF, ts'ebeliso ea eona, ho latela tlhahlobo ea meta ea lithuto tse 23, ho kenyelletsa le ho hlahloba bakuli ba 2816, e eketsang nako e se nang bohloko ea ho tsamaea le nako eohle ea ho tsamaea ka ho chencha claudication (Fontaine phase 2). Lithutong tse kenyellelitsoeng, sebaka se se nang bohloko sa ho tsamaea se nyolohile ho tloha ho 33,8 ho isa ho 73,9%. Ntle le moo, cilostazol e na le monyetla o moholo ho feta PF ho baka litla-morao (hlooho e opang, mathata a mokokotlo, lets'ollo le palpitations). Ha ho fanoa ka tsebo e tlase haholo ea costostazol ha e bapisoa le PF, tlhaiso e lekanyelitsoeng ea tšebeliso ea ts'ebetso le mamello ea lithethefatsi tsena le litšenyehelo tse phahameng tsa kalafo tse nang le cilostazol, PF e lokela ho khethoa mohato oa pele oa kalafo, mme cilostazol e lokela ho beoa maemong a ho hloka botsitso ha PF.

Tlhahiso ea ts'ebeliso ea PF ho HOZANK e kenyelletsa karolo e netefalitsoeng ea ts'oaetso e sa foleng ea "batang", e sa khetholloang feela ke keketseho ea ketsahalo ea ba tšoaeang matšoao, empa hape le ts'ebetso ea ts'ebetso ea sehlahisoa.

endothelium of procoagulant tishu factor, leukocyte adhesion, inhibition of endothelial nitric oxide synthesis, activation of plasminogen-1 activator inhibitor synthesis. Ts'ebetso tsena li kenya letsoho ho vasoconstriction le ho eketsa pono ea mali ka kotsi e eketsehileng ea thrombosis. Hape, PF, joalo ka ha ho boletsoe ka holimo, e khona ho fokotsa liphetoho liseleng tse khubelu tsa mali ka keketseho ea bokhoni ba tsona ba ho khomarela maemong a hyperglycemia 30, 45.

Ka likelellong tsa lingaka, ho na le maikutlo a seng a siiloe ke nako a hore "lefu la bosholu", le hlaha ha mokuli a e-na le neuropathy ebile e le ka lebaka la phello e mpe. Mekhoa e metle ea ts'ebetso ea Pf e hlalositsoe ke ts'usumetso e seng ts'ebetsong ea sekepe, empa ka ho phalla ha mali, e sa lumelleng nts'etsopele ea "lefu la bosholu".

Boithuto bo 'maloa bo sitiloe ho bonts'a molemo oa PF ho kalafo ea lefu la tsoekere la lefu la tsoekere. Leha ho le joalo, ntlafatso ea phallo ea mali e khaolehang methating ea methapo e ile ea bonoa, e tsamaea le ntlafatso ea matšoao a methapo ho bakuli ba nang le mofuta oa 1 le lefu la tsoekere la 2 le sensor diabetesic neuropathy kamora ho sebelisa PF 10, 27. EReggap et al. e bonts'a hore ho ba sieo ha phello ea kalafo ea PF ho neuropathy ho amana le tlhaiso ea nakoana, hobane ho ka nka lilemo tse tharo ho isa ho tse 'ne ho ntlafatsa ntlafatso.

Lefu la tsoekere la maoto le nang le lefu la tlhaho le fapaneng le lona le atisa ho tsamaisana le liso tsa trophic - tsena ke liponahatso tsa mafu a methapo ea methapo (HoAznk le varicose veins) le neuropathy. Nts'etsopele ea ulophers ea trophic e thehiloe ts'ebetsong ea apoptosis, ho ata ha liprotheine, khaello ea lintlha tsa kholo le li-cytokines, li-angiogeneis, joalo-joalo. Kalafo ea li-ulcers tsa trophic e mengata ebile e arohantsoe, ho latela sesosa, e kenyelletsa liketso tse etselitsoeng ho ntlafatsa phepelo ea mali (kalafo ea bothata ba methapo ea pelo), antibacterial kalafo (haeba ho bontšoa), kalafo ea lehae e sebelisa bokhoni ba ho khutlisa ba lithethefatsi. Ka lebaka la ho kopana khafetsa ha methapo ea methapo ea methapo ea methapo le methapo ea varicose le nts'etsopele ea lefu le sa foleng la venous, ts'ebeliso ea PF e fokotsa haholo ts'enyo ea lisele le mangoleng a ithutileng, e ntlafatsa bokhoni ba pholiso ho bakuli ba nang le li-ulcers tsa khale tsa post-thrombotic tsa maoto le matsoho.

boholo ba bakuli. Ka hona, lipatlisisong tse bonoang ka mahlo a mabeli, tse sa reroang, tse lebelletsoeng sebakeng se itseng ho bakuli ba 80 ba nang le setšoantšo sa kalafo ea li-ulcers tsa lits'oants'o, ho kenyelletsoa ha pentoxifylline ho mokhoa o tloaelehileng oa ho roala le ho tlamella li-bandage ho eketsa khafetsa ea pholiso ea liso tsa venous.

Diabetesic retinopathy e tšoauoa ka phetoho ea boholo ba karolo ea kamore e ka tlase, nts'etsopele ea khatello ea methapo ea methapo le ho eketseha ha sekhahla, deformation ea lisele tse khubelu tsa mali le ho sitisoa ha oksijene ea ho tsamaisa moea (hypoxia), pokello ea liplatelete, ho fokotseha hoa palo ea li-pericyte ka nts'etsopele ea aneurysms, edema edinal le hemorrhages. Phekolo ea retinopathy e rarahaneng, e emisang tlhoko ea laser Photocoagulation ea retina, e kenyelletsa ho boloka matšeliso bakeng sa lefu la tsoekere, khatello e tloaelehileng ea mali (lithethefatsi tsa khetho ea pele ke li-angiotensin-converting enzyme), lipid-lowing therapy le li-antiplatelet agents (aspirin, tse sa ekeheng kotsi ea hemorrhages, ticlopidine kapa PF). Haeba ho na le data e hanyetsanang mabapi le katleho ea ho sebelisa li-statins ho retinopathy (thutong ea HPS sehlopheng sa simvastatin, tlhoko ea laser photocoagulation e eketsehile ka mokhoa o sa lekanyetsoang (ka 8%), ho ASCOT-LLA keketseho ea retinal thrombosis e ne e sa ts'epahala (+ 3%), mme atorvastatin e sebelisitsoe thutong ea CARDS e lebisitse ho fokotseheng ha tsoelo-pele ea DR le tlhoko ea laser Photocoagulation 6, 7, 34. Ts'ebetso ea thibelo le tšebeliso ea fenofibrate e netefalitsoe lithutong tsa FIELD le ACCord 14, 42.

Ka lilemo tse ngata, PF e sebelisitsoe kalafo ea lefu la tsoekere la lefu la tsoekere. Ho feto-fetoha ha mohato ona ho ipapisitse le ho ntlafatsa phallo ea mali le ho fokotsa khatello ea methapo ho baithaopi ba phetseng hantle, ho bakuli ba nang le retin vein thrombosis le ho lahleheloa ke pono ka tšohanyetso, le ho lefu la tsoekere la retinopathy 8, 13, 33.

E. Ferrari o bontšitse ntlafatso maemong a rheological a mali le keketseho e kholo ea phallo ea mali ho "capina" ea "retina" ho bakuli ba fumanang PF ha e bapisoa le bakuli ba sehlopha sa placebo, le bokhoni ba PF ba ho thibela ts'ebetso ea methapo ea methapo methapong ea methapo ea kutlo. lefu la tsoekere. Lintlha tse phatlalalitsoeng tsa ho fokotsa kholo ea retinopathy ho bana ba nang le lefu la tsoekere la mofuta oa 1. Ts'ebetso ea Meta leha ho le joalo

Liphetho tsa tlhahlobo ea meta mabapi le katleho ea pentoxifylline ho lefu la tsoekere: litlamorao ho proteinuria

Matla a pentoxifylline ho proteinuria a lefu la tsoekere la tsoekere: tlhahlobo ea meta /

McCormick B. B., Sydor A., Akbari A., Fergusson D., Doucette S., Knoll G. // Am. J. Liphihlelo Dis. - 2008. - Moq. 52 (3). - P. 454 - 463.

Lethathamo la lithuto tsa Cochrane la lithuto tse 97 le bonts'a tlhoko ea thuto e sa reroang le moralo o lekaneng ho netefatsa katleho ea retinopathy ho lefu la tsoekere.

Lefu la tsoekere. Tlhahiso ea tšebeliso ea PF ho lefu la tsoekere:

- phello ho li-chemokines le limolek'hule tsa khokahano,

- litlamorao ho lisele tse potoloha, matšoao a ho ruruha - li-neutrophils, monocytes, lymphocyte,

- phello ea liponahatso tsa ts'oaetso ea "serame" - thibelo ea li-cytokine tse butsoeng,

- inhibition ea cumulation ea matrix a kantle ho naha.

Tšusumetso e ntle ea PF maemong a hemorheological a mali nakong ea nts'etsopele ea lefu la tsoekere e bonahetse ka ho fokotseha ho teba ha "proteinuria" ea 1 le mofuta oa 2 lefu la tsoekere, ho sa tsotelehe taolo ea metabolic le boemo ba ts'ebetso ea liphio 10, 12, 37, 38. Phello ena e boetse e bonoa ho bakuli ba nang le lefu la tsoekere le khatello ea methapo ea mali. ea amohetseng PF joalo ka monotherapy kapa ho kopantsoe le angiotensin-converting enzyme 23, 37. Ho bohlokoa ho hlokomela hore nakong ea tlhahlobo ea meta mabapi le phello ea PF ho proteinuria, phello ea eona ea hypoproteinuric tiisitsoe.

Ho ile ha bontšoa hore PF ha e fokotse feela ho fokotseha ha tlhahiso ea protheine ea moroto, empa hape le ho fokotseha hoa boemo ba TNF-a maling a mali, boemo boo sehlopheng sa nephropathy bo ileng ba eketseha haholo. PF e khona ho thibela lits'oants'o tsa "acetyl-p-glucosaminidase (letšoao la lesapo la mokokotlo oa mokokotlo) mokokotlong, e fana ka tlhahiso ea melemo

Tšusumetso e hlakileng eseng feela ponahalong ea maqeba a bonyatsi, empa hape le ts'enyehelong ea liphio tsa tubulo-interstitial ho bakuli ba nang le lefu la tsoekere la 2- 23.

Ho ile ha thehoa hore TNF-a le li-cytokine tse ling tse amanang le lefu la tsoekere li bapala karolo ea bohlokoa ho nts'etsopeleng ea lefu la tsoekere le 19, 20, 26. TNF-a ke prochrate e sebetsanang le methapo e mengata e hlahisoang haholo ke macrophages, haholo lithaelese tsa adipose, le ho ba le litlamorao tsa auto-and paracrine, ho ba mokena-lipakeng oa khanyetso ea insulin le letšoao la ts'oaetso e se nang 'mele ea ho itšireletsa mafung, eo karolo ea hae ea pathogenesis ea lefu la tsoekere e sa nyatseheng, PF e thibelitsoeng, e netefatsang ts'ebetso ea eona ea kalafo.

Setsing se le seng, tse lebelletsoeng, li sa hlophisoe, li laoloa ke PREDIAN ka har'a sehlopha sa bakuli ba 169 ba nang le lefu la tsoekere la 2 le lefu la tsoekere (CKD st. 3-4), ho bonahetse hore tlatsetso ea PF ho angiotensin-converting enzyme e thusa ho boloka litlamorao tse ntle tse fumanoeng (phokotso ea proteinuria, serum creatinine, poloko GFR, maemo a fokotsehileng a cytokine ea cytokine TNF-a, interleukin-6 le 10).

Ka hona, le ha PF e sa kenyelletsoa litlhahisong tsa hajoale bakeng sa kalafo ea lefu la tsoekere, liphuputso tsa morao-rao li re lumella ho e nka e le sethethefatsi se tšepisang ho kenyelletsoa kalafong e rarahaneng ea pathology ena.

Ho senyeha hoa kelello. Leha e le taba ea hore ho fokotseha hoa kelello hoa bakuli ba nang le lefu la tsoekere ho se ho tsebahala ho tloha ka 1922, ha W.R. Miles le H.F Root ba tlaleha mabapi le kamano ea lefu lena la lefu la tsoekere, 'me' nete ena e tiisitsoe ho ba bangata

lithuto, lenaneng la "standard" la mathata a sa foleng a lefu la tsoekere, pathology ena ha e kenyelelitsoe. Leha ho le joalo, ho senyeha hoa kelello ho lefu la tsoekere ho na le mofuta oa 'mele (karolo ea methapo, ho kenyelletsa le menyetla e meholo ea ho ba le stroke le ho senyeha ha kelello ka morao, ho emisoa, ho fokotseha ha glycemic ka ts'ebetso ea protheine glycation le neuroglucopenia, joalo-joalo) mme e tlalehiloe ho batho ba nang le lefu la tsoekere ho fihlela 25%. Kotsi ea 'dementia' ho lefu la tsoekere e atile makhetlo a 1.6 ho feta palo e akaretsang ea batho, menyetla ea ho ba le dementia ea methapo e ka bang makhetlo a 2.0-2.6, menyetla ea lefu la Alzheimer e phahame makhetlo a 1.5 ho sa tsotelehe hore na lefu la tsoekere le qalile neng.

Ts'ebeliso ea PF e baka keketseho e kholo ea phallo ea mali a likhoerekhoere ka botlalo, phallo ea mali a tikolohong sebakeng sa ischemia ea mokokotlo 'me ha e lebise ho tsietsing ea bosholu ba Intracerebral. Phuputso e entsoeng lilemong tsa mashome a morao tjena e senotse likarolo tse ncha tsa lithethefatsi tse atisang ho eketsa monyetla oa ts'ebeliso ea eona ea bongaka ka mefuta e fapaneng ea ischemia e sa foleng ea kelello, eo ka tloaelo ho ikoetlisa hangata ho kopantsoeng le polelo "discirculatory encephalopathy" (DE) ntle le bopaki ba ho fokotseha hoa kelello. Ho bontšoa hore ho khethoa ha PF ho nyoloha ka karolelano ea 20% ho potoloha ha likatse ho bakuli ba nang le mafu a sa foleng a amanang le "cerebrovascular".

Kahoo, tlhahlobo ea liteko tse 10 tsa tleleniki ea bongaka tse sa sebetseng ho lekola katleho ea PF, ho fokotseha hoa tekanyo ea ho haella ha kelello ho fumanoeng, hammoho le ho fokotseha ho hoholo hoa menyetla ea ho senyeha hoa tšebeliso ea boko ba ischemic.

Tlhahlobo e hlophisitsoeng e ipapisitseng le liphetho tsa tlhahlobo ea lihlahisoa tse 20, tse ka bapisoang, tse sa ratoang, tse laoloang habonolo le tse sa bonahaleng hantle ho lekola katleho ea lithethefatsi kalafo ea bakuli ba nang le 'dementia ea methapo.' Kameho e ntle ea PF (1200 mg / day) e ile ea thehoa ho bakuli ba nang le 'dementia ea methapo,' e khetholloang ka ntlafatso ea mesebetsi ea kelello. Ho feta moo, botebo le bohlokoa ba liphapang li eketsehile ka ts'ebeliso ea lits'ebetso tse thata ho tsebahatsa lefu la khatello ea methapo.

Boithuto bo fapaneng bo netefalitse monyetla oa ho sebelisa PF ha ho hlokahala ho susumetsa bofokoli ba kelello: ho fokotseha ho tsoelang pele ha temohisiso

ho senyeha, ho hopola ho ntlafalitsoeng, tlhokomelo, haholoholo ho batho ba baholo ba 25, 29.

Tlhahiso-leseling mabapi le bokhoni ba PF ea ho fokotsa sekhahla sa ho senyeha hoa kelello ho bohlokoa ho tsoa ponong ea ts'ebeliso ea ts'ebeliso ea lithethefatsi bakeng sa thibelo ea bobeli ea likarolo tsa lefu la mokokotlo la sethoathoa. Ho entsoe lipatlisiso mabapi le monyetla oa ho thibela litlhaselo tse ipheta-phetang tsa ischemic.

Bokhoni bo netefalitsoeng ba li-PF ba ho thibela lisele tsa mononuclear lisele, li-neutrophils le T-lymphocyte, li thibela ho hlophisoa ha li-cytokine tsa pro-inflammatory li ka fana ka litlamorao tse ling tsa ts'ireletso nts'etsopele ea ischemia ea "cerebral ischemia" le "ceptitive". Ka bomalimabe, ho ne ho sa khonehe ho fumana lithuto ka bothata bona bo entsoeng ho batho ba nang le lefu la tsoekere, empa mekhoa ea tlhaho ea tlhaiso-leseling e bonts'a hore ts'ebeliso ea PF e tla ba le phello e ntle matleng a kelello a bakuli bana.

Lefu le se nang mafura la sebete sa 'mele (NAFLD). Ho pakoa hore ho bakuli ba nang le BMI e fetang 10-40% le ho hanyetsa insulin, kotsi ea NAFLD e eketseha. Ho ruruha ha methapo ea mafu ho 95-100% ea linyeoe ho kopantsoe le nts'etsopele ea hepatosis le ho 20-47% ea steatohepatitis. Mofuta oa 2 oa lefu la tsoekere o amahanngoa le NAFLD maemong a 75%. Kopano ea lefu la tsoekere le NAFLD e na le litlamorao tse mpe tseleng ea mafu ana. Ka NAFLD le lefu la tsoekere, khafetsa maqhubu a methapo ea methapo ea methapo ea kutlo, e leng se ka lebisang ho eketseheng ha kotsi ea pelo le ho u lumella ho totobatsa boteng ba NAFLD e le sesosa sa kotsi ea lefu la pelo le mofuta oa lefu la tsoekere la 2, ho sa tsotelehe taolo ea glycemic, profil ea lithethefatsi 40, 43. Kamano e boetse e ikemiselitse NAFLD le kotsi e eketsehileng ea mathata a lefu la tsoekere. Ka lehlakoreng le leng, boteng ba lefu la tsoekere bo tsamaisana le ts'ebetso ea ts'ebetso ea ho ruruha, ho qala tsoelopele ea NAFLD ho steatohepatitis (NaSg).

Ho pakoa hore kamora ho bokellana ha mafura ho li-hepatocytes le lisele tsa stellate ka lebaka la ho eketseha ha mafura a mahala a sebete ka har'a sebete, steatosis ea sebete e thehoa, likarolo tsa oxidation li hlahisoa mme ts'ebetso e kholo ea liphetoho tse hlahisang khatello ea oxidative e hlahisoa, e lebisang ho senyeha ha lisele tsa sebete le ho thehoa ha steatohepatitis e se nang joala ea 41. 43. Kamano ea NAFLD le botenya ba visceral, li baka nts'etsopele ea IR le tse ling

mathata a metabolic a hlahisoang ke tlhahiso ea palo e kholo ea li-substrates tse sebetsang tsa biologically ke li-visceral adipose tiske (pro-inflammatory cytokines - tumor necrosis factor-a (TNF-a), interleukin-6, jj., adipocytokines - adipe-nectin, ghrelin, jj. ), e khethollang nts'etsopele ea metabolic syndrome le likarolo tsa eona, e khethang mekhoa ea ho thibela le ea kalafo.

Hammoho le likhothaletso tsa ho theola boima ba 'mele, ho ikoetlisa ka' mele, ho fihlela le ho boloka Normoglycemia, ho sebelisa lipid tse fokotsang kalafo, le livithamini, katleho ea PF e netefalitsoe. Sena se bakoa ke netefatso ea karolo ea li-cytokine tsa pro-inflammatory, ho kenyeletsoa TNF-a, ho pathogenesis ea NAFLD. Ho bakuli ba nang le NASH, overexpression ea TNF-a mRNA e fumanoe eseng feela litekeng tsa adipose, empa hape le hepatocytes, e bonahatsoang ke lipalo tse phahameng tsa plasma tsa TNF-a, tse lebisang ho nts'etsopele ea maloetse a mangata a amanang le NAFLD 41, 46. Lintlha tse kaholimo li supa boikitlaetso ba ho kenyeletsa moleng oa kalafo oa litokisetso tsa NASH tsa TNF-inhibitors. PF le angiotensin receptor blockers (losartan) li ka sebelisoa bakeng sa morero ona.

Boithuto ba boithuto le tliliniki bo bonts'itse bokhoni ba PF ba ho thibela tlhahiso ea TNF-ka tlhahlobo ea liphatsa tsa lefutso. Haufinyane tjena, ho ile ha phatlalatsoa tlhahlobo ea meta ea lithuto tse hlano (bakuli ba 147) e ileng ea lekola katleho ea pentoxifylline bakeng sa NAFLD, e bontšang ho fokotseha hoa ts'ebetso ea enzyme, interleukin-6, ntlafatso ea setšoantšo sa nalane - ho fokotseha ha tekanyo ea ts'ebetso ea steatohepatitis, ntlafatso ponts'o ea ho ruruha ha lobular, ntlafatso ea tšenyo ea nako ea steatosis, balloon sebopeho le ho teba ha fibrosis. Motsoako o khothalelitsoeng oa PF o sebelisitsoeng lithutong tse kaholimo e ne e le 1200-1600 mg ka letsatsi bakeng sa likhoeli tse 6-12.

Liphetoho tse senotsoeng tse ntle li lumella ho kenyelletsa ho kenyeletsoa ha PF kalafong ea NAFLD. Liphetho li thehile motheo oa hore ka selemo sa 2012 Mokhatlo oa Lefatše oa Gastroenterological o kenyelelitse pentoxifylline ho lithethefatsi tse khothaletsoang bakeng sa kalafo ea NAFLD.

Ho nyekeloa ke pelo. Har'a lisosa tsa mantlha tsa kholo ea lefu la pelo le sa foleng, lefu la tsoekere le maemong a mantlha hammoho le a sa foleng

Lefu le hanyetsang la pulmonary, khatello ea methapo ea mali le lefu la pelo. Kotsi ea hore motho a ka bolaoa ke lefu la pelo le methapo e ka ba makhetlo a 2.8 - 13.3 ho feta ho batho ba se nang lefu la tsoekere - ena ke axiom. Mabaka ke ho potlakisa ha atherosulinosis, ts'ebetso ea ho ruruha, le ts'enyo e tobileng ea lefu la tsoekere, eo hangata e bitsoang "lefu la tsoekere la" lefu la tsoekere "le ka tsamaeang le ho mpefala ha systolic mme hangata, ts'ebetso ea diastolic ea ventricle e ka lehlakoreng le letšehali.

Liphetho tsa mantlha tsa PF li ka ba le thuso ho ho nyekeloa ke pelo, ho nts'etsopele ea moo batšehetsi ba ts'oaetso ba lebelletsoeng ho nka karolo, ho isa tekanyong e kholo ka lebaka la litlamorao tsa lithethefatsi tlhahisong ea TNF-a le li-cytokine tse ling. Mefuta e fokotsehileng ea li-cytokine le lipontšo tsa ho hloleha ha pelo li tlalehiloe lithutong tse fapaneng tsa liteko le tsa bongaka. Tlhahlobo ea meta ea lithuto tse ts'eletseng ho tlhahlobo e lekantsoeng ea phello ea PF (1200 mg ka letsatsi bakeng sa likhoeli tse 6) lipontšong tsa ho se atlehe ha pelo ho kenyelletsa data ho bakuli ba 221 ba nang le karolo ea karolo e itseng ea methapo. Leka ts'ebeletso ea khetho ea lingoliloeng.

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All-Russian Educational Internet Session

Tlhahisoleseling le lisebelisoa tse hlahisitsoeng sebakeng sena sa marang-rang ke tsa saense, li-index, tsa tlhaiso-leseling ka tlhaho, li etselitsoe feela litsebi tsa tlhokomelo ea bophelo bo botle, ha li reretsoe ho khothaletsa lihlahisoa 'marakeng' me li ke ke tsa sebelisoa e le likeletso kapa litlhahiso ho mokuli bakeng sa tšebeliso ea meriana le mekhoa ea kalafo. ntle le ho buisana le ngaka ea hau.

Meriana, tlhaiso-leseling ka eona e fumanehang sebakeng sena sa marang-rang, e na le li-contraindication, pele u e sebelisa, u lokela ho bala litaelo le ho etela setsebi.

Maikutlo a Tsamaiso a kanna a se tsamaisane le maikutlo a bangoli le baphethahatsi. Tsamaiso ha e fane ka tiiso mabapi le sebaka seo le se ka har'a sona, ho kenyeletsoa, ntle le meeli, mabapi le boleng ba mahlale, boleng, ho nepahala, botlalo, ts'episo ea tlhahisoleseling ea mahlale e fanoeng ke babuelli kapa ho latela litaba tse mabapi le litekanyetso tsa machaba tsa boikoetliso bo botle ba kliniki le / kapa meriana e thehiloeng ka bopaki. Sebaka sa marang-rang ha se na boikarabello bakeng sa litlhahiso kapa maikutlo afe kapa afe a ka ba teng, leha e le hore ts'ebeliso ea thepa ea sebaka sena e ka sebelisoa maemong a itseng a kliniki. Tlhahisoleseling eohle ea mahlale e fanoa ka sebopeho sa eona sa pele, ntle le tiiso ea phetheho kapa nako ea nako. Tsamaiso e etsa boiteko bohle ho fa basebelisi leseli le nepahetseng le le tšepahalang, empa ka nako e ts'oanang ha le qhele monyetla oa liphoso.

Lokolla liforomo le sebopeho

Setlhare se entsoe ka mokhoa oa matlapa, dragees le tharollo e etselitsoeng infravenous infusions (li-droppers), liente le tsamaiso ea methapo.

Ho sa tsotelehe mofuta oa tokollo, sethethefatsi se na le motsoako o ka sehloohong o sebetsang - the pentoxifylline (ka Selatine - Pentoxyphyllinum).

Maemong ana, litekanyetso tsa karolo e sebetsang li ka fapana.

Matlapa a koahetsoeng ka enteric a na le 100 mg ea pentoxifylline.

Moriana ke oa sehlopha sa vasodilators (vasodilators).

Tharollo e sebelisitsoeng ka ente e na le 20 mg ea motsoako o sebetsang ka 1 ml. Setlhare se rekisoa ka ampoules ea 1, 2, 5 ml.

Li-dragees (li-retard) ke li-capsules tse nang le membrane ea filimi ea pinki. Letlapeng le le leng 1 ho na le 400 mg ea ntho e sebetsang.

Mokhoa oa ketso

Moriana ke oa sehlopha sa vasodilators (vasodilators).

Phello ea pharmacological ea lithethefatsi e etselitsoe ho khetholla phallo ea mali le ho ntlafatsa thepa ea mali.

Moriana ona o na le litlamorao tse latelang 'meleng oa mokuli:

e fokotsa mali, 'me e fokotsa menyetla ea mali,
e hlapolla methapo ea mali (ka tekano), e tlosa mathata ka ho sisinyeha ha mali,
e ntlafatsa satane ea oksijene, e thibela nts'etsopele ea hypoxia (ka lebaka la keketseho ea lijana tsa pulmonary le pelo),
eketsa molumo oa phokotso, mesifa ea ho hema,
phello e molemo tšebetsong ea tšebetso ea methapo ea kutlo,
E thusa ho tlosa makhopho le bohloko mesifa ea namane e amanang le mathata a ho potoloha ka maoto le matsoho.

Setlhare se fokotsa bongata ba mali, se fokotsa menyetla ea mali.

Ho thusang

Setlhare se sebelisoa kalafong ea li-pathologies tse latelang:

Tlolo ea phepelo ea mali a arohanang matsohong le maotong (lefu la Raynaud),
Tšenyo ea lisele e bakoang ke ho holofala ha mali methapong le methapong (li-ulcers tsa letlalo la trophic, lefu la posthlebotic, gangrene),
ho senyeha ha pono le ho utloa ho amanang le ho potoloha ha mali,
ischemia
Boloetse ba Buerger (thromboangiitis obliterans),
ho hloka matla ho bakoang ke phepelo e fokolang ea mali ho litho tsa ho tsoala,
cerebral atherosulinosis,
khatello ea kelello ea methapo
angiopathy ho bakuli ba nang le lefu la tsoekere,
lefu la pelo
vegetovascular dystonia,
encephalopathy ea etiologies tse fapaneng.

Setlhare sena se sebelisoa kalafo ea lefu la Raynaud.
Moriana ona o sebetsa bakeng sa lefu la sethoathoa.
Pentoxifylline e sebelisoa bakeng sa ho hloka matla ho bakoang ke phepelo e sa lekaneng ea mali ho litho tsa botona.
Sesebelisoa se sebelisetsoa ho phekola khatello ea mali.
Pentoxifylline e sebelisoa kalafo ea angiopathy ho bakuli ba nang le lefu la tsoekere.
Pentoxifylline e laetsoe vesttovascular dystonia.

Sesebelisoa se boetse se sebelisoa kalafo ea osteochondrosis e le vasodilator e thusang.

Contraindication

Lethathamo la li-contraindication mabapi le ts'ebeliso ea meriana e kenyeletsa:

lefu la porphyrin
infarction ea bohlokoahali
heminal hemorrhage,
ho tsoa mali haholo.

Tharollo ha e sebelisoe ha atherosulinosis ea methapo ea kelello le pelo le hypotension e matla.

Ts'ebeliso ea Pentoxifylline ha e khetholloe ho bakuli ba nang le hypersensitivity ho karolo e sebetsang ea lithethefatsi, li-excipients li kenyellelitsoe sebopeho sa eona, kapa meriana e meng e tsoang sehlopheng sa xanthine.

Ka atherosclerosis ea methapo ea kelello le pelo, ha ba sebelise lithethefatsi ka mokhoa oa tharollo.

U ka e nka joang

Setlhare, se fumanehang ka mokhoa oa dragees le matlapa, se etselitsoe ho tsamaisoa ka molomo. Sebelisa moriana ka mor'a lijo. U ke ke ua hlafuna. Li lokela ho hlatsuoa ka metsi a manyane.

Ngaka e beha tekanyetso e nepahetseng ea lithethefatsi ka bonngoe ho mokuli ka mong, ho nahanela litšobotsi tsa 'mele oa hae le tlhaiso-leseling ho tsoa setšoantšong sa bongaka ba lefu lena. Regimen e tloaelehileng ea litekanyetso li 600 mg ka letsatsi (200 mg makhetlo a 3 ka letsatsi). Kamora libeke tse 1-2, ha matšoao a lefu lena a fokola, tekanyetso ea letsatsi e fokotseha ho 300 mg (100 mg makhetlo a 3 ka letsatsi). Se ke oa nka ho feta tekanyo e khothalletsoang ea lithethefatsi ka letsatsi (1200 mg).

Nako ea kalafo e nang le pentoxifylline matlapeng ke libeke tse 4 ho isa ho tse.

Tharollo e ka fanoa ka methapo, kahare le kahare. Litekanyetso li beoa ka bomong, ho nahanela botebo ba mathata a methapo ea methapo. Litaelo tsa tšebeliso ea lithethefatsi li re u hloka ho sebelisa tharollo ka tsela e latelang.

Ka mokhoa oa li-droppers - 0,1 g ea moriana o kopantsoeng le 250-500 ml ea saline kapa tharollo ea glucose ea 5%. Hoa hlokahala ho hlahisa moriana butle-butle, nakong ea lihora tse 1.5-3.
Liente (intravenous) - mothating oa pele oa kalafo, ho fanoa ka 0,1 g ea lithethefatsi (e kenelletsoe ka 20-50 ml ea sodium chloride), ebe lethal dose le eketseha ho 0,2-0.3 g (e kopantsoe le 30-50 ml ea solvent). Ho hlokahala ho kenya meriana butle-butle (0,1 g nakong ea metsotso e 10).
Intramuscularly, sethethefatsi se tsamaisoa ka tekanyetso ea 200-300 mg makhetlo a 2-3 ka letsatsi.

Regimen e tloaelehileng ea litekanyetso li 600 mg ka letsatsi (200 mg makhetlo a 3 ka letsatsi).

Ts'ebeliso ea tharollo e ka kopantsoe le tsamaiso ea molomo ea mofuta oa litlhare.

Le lefu la tsoekere

Litokisetso tsa Pentoxifylline li khothaletsoa ka molao hore li sebelisoe kalafong ea liso tsa trophic, gangrene, angiopathy le ho kheloha tsamaisong ea pono ho bakuli ba lefu la tsoekere. Leha ho le joalo, o ka nka moriana feela joalokaha o laetsoe ke ngaka, ea behang litekanyetso ka bonngoe mme o na le bonnete ba hore o e fetola haeba mokuli a sebelisa lithethefatsi tsa hypoglycemic. Ho ikoetlisa ka pentoxifylline maemong ana ha ho amoheloe, hobane mofuta oa phekolo e khethiloeng ka nepo o ka lebisa ho hola hoa maikutlo a sa lokelang (ho kenyeletsoa le hypoglycemic coma).

Pentoxifylline ka ho haha 'mele

Ts'ebeliso ea Pentoxifylline e ka ba molemo eseng feela kalafong ea li-pathologies tsa potoloho, empa hape le lipapaling, hobane lithethefatsi li khona ho eketsa katleho ea koetliso, li eketsa mamello, li potlakisa katleho ea sephetho se lakatsehang ka lebaka la litlamorao tse ntle 'meleng.

Pentoxifylline e khona ho eketsa katleho ea koetliso, eketsa mamello, e potlakisa katleho ea sephetho se lakatsehang.

Baatlelete le lihahi tsa 'mele ba eletsoa ho sebelisa pheko ena ka tsela e latelang.

Hoa hlokahala ho qala ka litekanyetso tse nyane - 200 mg makhetlo a 2 ka letsatsi. Noa lipilisi kamora lijo.
Ha ho na le litlamorao le ho mamella lithethefatsi hantle, u ka eketsa litekanyetso tsa letsatsi le letsatsi ho isa ho 1200 mg (400 mg makhetlo a 3 ka letsatsi).
Ho fihlela sephetho se setle ka ho fetisisa, ho khothalletsoa ho nka moriana metsotso e 30 pele o ikoetlisa le lihora tse 'maloa ka mor'a hore o phethe.
Nako ea ts'ebeliso ea lithethefatsi ke libeke tse 3-4. Kamora thupelo, o hloka ho phomola bakeng sa likhoeli tse 2-3.

Phekolo ea ka mpeng

Moriana o ka baka ho ruruha ha sebete, ho tsamaisana le bothata ba ho phatloha ha masapo a bile, ho mpefatsa ha lefu le sa foleng la gallbladder, ho mpefala ha mokokotlo oa mala, ho fokotseha takatso ea lijo, le maikutlo a ho omella bokong ba molomo. Maemong a sa tloaelehang, ho tsoa mali ka har'a mala ho bonoa.

Sesebelisoa se ka baka ho ruruha ha sebete, se tsamaisana le bothata ba ho hlaha ha masapo a bile.

Tsamaiso ea methapo e bohareng

Ho ka ba le maikutlo a ferekanyang, hlooho ea hlooho, ho tsekela 'mele le boroko bo fokolang.

Mokuli ea noang moriana o lula a koata ebe o tšoenyeha haholo.

Ha u sebelisa meriana ena, ho na le mathata a ho etsa lintho ka letlalo (ho hlohlona, urticaria) le ho thothomela ha anaphylactic.

Boitšoaro bo bong

Ho ka ba le ho fifala ha boemo ba moriri, lipekere, ho ruruha, bofubelu ba letlalo (“likhohla” tsa mali sefahlehong le sefubeng).

Ha o sebelisa moriana, ho ka ba le mathata a ho kula letlalo le mokokotlo.

Ho senya pono ea pono le nts'etsopele ea scotomas ea leihlo ha e qheleloe ka thoko.

Litaelo tse khethehileng

Pathoxifylline kalafo e etsoa ka tlhokomelo e kholo ho batho ba nang le bothata ba peptic ulcer le duodenum, methapo ea methapo le sebete, ho hloleha ha pelo, ba tloaetse khatello ea mali e tlase. Bakeng sa mekhahlelo ena ea bakuli, ho hlokahala hore u fetole litekanyetso tsa tekanyetso le taolo e matla ea lingaka nakong eohle ea kalafo.

Tekanyo ea joala

Lingaka li khothaletsa ka matla hore bakuli ba noang moriana o thehiloeng ho Pentoxifylline ba qhele ho sebelisa joala pele ho fela kalafo.

Ho khothalletsoa ho se kenyelletse tšebeliso ea joala pele pheletso ea kalafo e nang le Pentoxifylline.

Tai ea Ethyl e khona ho tlama limolek'hule tsa ntho ena ea lithethefatsi, e li khelosa kapa e ntlafatsa ts'ebetso ea likarolo tse sebetsang, tse ka lebisang ho fokotseha ha katleho ea lithethefatsi kapa tsa baka mathata.

Tšusumetso ho bokhoni ba taolo ea methapo

Setlhare ha se ame ka kotloloho matla a ho laola mekgwa e rarahaneng, ho kenyelletsoa le makoloi, leha ho le joalo, haeba litla-morao tse ling (ho tsekela, ho tsitsinyeha ha boroko, joalo-joalo) li ka hlaha, tlhokomelo ea mokuli e ka senyeha. Sena se ka fokotsa boleng ba ho khanna le likoloi tse ling.

Se laetsoeng bana

Ho sebetsa hantle le polokeho ea lithethefatsi bongoaneng ha li e-so ithutoe, ka hona, baetsi ba Pentoxifylline ha ba khothale ho fana ka taelo ena ho bakuli ba ka tlase ho lilemo tse 18.

Pentoxifylline ha e khothalletsoe ho fana ka setlhare sena ho bakuli ba ka tlase ho lilemo tse 18.

Leha ho le joalo, ts'ebetsong, haeba ho hlokahala ka ho hlaka, lingaka li ka fa ngaka sehlahisoa sena ho ngoana ea lilemo tse fetang 12. Hangata sena se bakoa ke mathata a ho potoloha ha mali le ho se sebetse hantle hoa kalafo e 'ngoe.

Bongata

Ka tšebeliso ea nako e telele ea litekanyetso tsa moriana, ho ka hlaha matšoao a latelang a lithethefatsi tse ngata:

ho nyekeloa ke pelo, ho hlatsa "libaka tsa kofi" (ho supa nts'etsopele ea mali a tsoang ka mpeng),
ho tsekela
bofokoli
cramps.

Maemong a tebileng a ho sebelisa lithethefatsi tse ngata, ho akheha, khatello ea maikutlo a ho hema, anaphylaxis lia bonoa.

Maemong a matla haholo, ho akheha, khatello ea maikutlo a ho hema, anaphylaxis lia bonoa.

Ho sebelisana le lithethefatsi tse ling

Moriba o ka ntlafatsa litlamorao tsa litlhare tse latelang:

anticoagulants
thrombolytics
khatello ea mali e fokotsang lithethefatsi
lithibela-mafu
lithethefatsi tse nang le insulin
litokisetso tse thehiloeng ho valproic acid.

Tšebeliso e tšoanang ea Pentoxifylline le lithethefatsi tse nang le cimetidine li eketsa kotsi ea litla-morao. Litokisetso tse thehiloeng ketorolac le Mexico ha li tsamaisane le Pentoxifylline, hobane ha ba sebelisana le moriana, ba eketsa monyetla oa ho tsoa mali ka hare.

O ka reka sehlahisoa feela haeba o na le lengolo le loketseng la ngaka le laetsoeng ke ngaka ea hau.

Ha ho khothalletsoe ho kopanya ts'ebeliso ea lithethefatsi le ts'ebeliso ea li-xanthine tse ling, kaha sena se ka baka thabo e feteletseng ea letsoalo.

Phekolo ea li-pathologies tse bakoang ke mathata a potoloha, ho sebelisoa li-analogues tse latelang tsa Pentoxifylline:

Cavinton
Trental
Pentoxifylline-NAS,
Piracetam
Pentilin
Mexicoidol
Fluxital,
Latren
nicotinic acid.

Ho tseba hore na ke lithethefatsi life tse sebelisoang hantle bakeng sa bokuli bo itseng ba potoloho ea mali, o lokela ho bona ngaka ea hau.

LITLHAKISO TSA SESOTHO. Ke hloka ho hlapolla methapo ea mali le lithethefatsi. Pentoxifylline

Tlhahlobo ea Pentoxifylline

Lingaka le bakuli ba bangata ba arabela hantle ts'ebelisong ea Pentoxifylline.

E. G. Polyakov, neurosurgeon, Krasnoyarsk

Lithethefatsi li na le phello e ntle likhatellong tse fapaneng tsa potoloho ea lipakeng le ea potoloho. Sesebelisoa ke sa boleng bo holimo le sa theko e tlase, ka hona se fumaneha bakeng sa mefuta eohle ea bakuli. Likotsi tsa lithethefatsi li kenyelletsa phello e fokolang ho angiopathies.

Lily ea lilemo li 31, Astrakhan

Ke ne ke lula ke tšoeroe ke litlhaselo tsa vesttovascular dystonia, e ileng ea nkama haholo. Hona joale ke ntse ke phekoloa ka Pentoxifylline. Ka tlhaselo e latelang, ke qala ho nka pheko ena khafetsa (nakong ea matsatsi a 10). Ho imoloha ho etsahala matsatsing a pele a kalafo, 'me ka mor'a matsatsi a 10 matšoao ohle a fela ka botlalo. Ho lebisoa tlhokomelo e khethehileng ho theko ea sethethefatsi: e tlase haholo hoo qalong e bileng e tšosang. Empa boleng ba Pentoxifylline ea Russia ha bo bobe ho feta ba mahlale a linaha tse ling, a jang habeli kapa makhetlo a 3 a theko e phahameng haholo.

Igor ea lilemo li 29, Volgograd

Ho ntlafatsa bongata ba mali maling a liphio, li-vasodilator li tlameha ho nkuoa. Curantil o ne a laetsoe pejana, empa hlooho ea hae e ile ea utloa bohloko haholo, ka hona ke ile ka tlameha ho fetolela Trental. Tsena ke lipilisi tse ntle, empa li theko e boima haholo, ka hona ke nkile qeto ea ho li khutlisa ka Pentoxifylline e entsoeng ke Russia. Ha kea ka ka hlokomela phapang efe kapa efe (ntle le theko). Ba boetse ba nka bohato, ha ba bake lintho tse bohloko, ba etsa mosebetsi oa bona hantle.

Sebopeho le mofuta oa tokollo

Matlapa a 100 le 400 mg, a kopantsoe le koae e pinki. Sephutheloana sena se na le likotoana tse 20 le 60.

Matlapa a 100 le 400 mg. Sephutheloana sena se na le likotoana tse 20 le 60.

Matlapa a entsoe a 400 le tse 600 mg tse lokiselitsoeng tse lokollang le mohala o arolang - sephutheloana se na le likotoana tse 50.

Ampoule ka tharollo ea entetso. Ho 1 ml ea tharollo e na le:

pentoxifylline - 20 mg,
sodium chloride - 90 mg,
metsi - ho fihlela 1 ml.

E fumaneha ka ampoules ea 5 ml. Pakete e na le li-ampoules tse 5.

Na ho kotsi ho nka pentoxifylline nakong ea kemolo?

Hoa tsebahala hore moriana o mong le o mong o lumelloa ho nooa nakong ea

ha feela a fetisitse taolo e ikhethang ea polokeho ho 'm'a le lesea. Pentoxifylline ha ea ka ea fetisa taolo e joalo, ka hona, litaelo tsohle li bontša hore e emisitsoe ho ima.

Na ho na le matšoao a ho laela pentoxifylline nakong ea kemolo?

Joalo ka ha u tseba, libekeng tsa pele tsa moimana, lithethefatsi tsohle li tlatsitsoe. Meriana e neng e sa etsa liteko tsa polokeho e lokela ho sebelisoa feela kamora libeke tse mashome a mabeli tsa moimana, ka tlasa taolo ea ngaka e moimana.

Empa ho ka ba le maemo a fetal moo ho hlokahalang ho nka lithethefatsi tsena. Li sebelisetsoa ho ntlafatsa phepelo ea placenta ka mali le oksijene.

Litlhare li na le litlamorao life nakong ea kemolo?

Pentoxifylline e ama microcirculation ho tishu, e holisa methapo e menyenyane ea mali, e fokotsa ponahalo ea mali le ho ntlafatsa phallo ea eona methapong ea mali. Mali a qala ho potoloha haholo, ka hona a ntlafatsa phepelo ea oksijene ho placenta. Lintho tsena li bohlokoa haholo molemong oa kholo ea masea.

Ha ho pelaelo hore lingaka li sekaseka melemo le likotsi tsohle tsa ho beha moriana nakong ea kemolo. Hangata thepa ea eona e nang le melemo e phahame ho feta kotsi ea litlamorao tse mpe.

Litlhahlobo tsa basali ba baimana ba nkang Pentoxifylline hangata li ntle.

Ho ea ka litaelo, Pentoxifylline ha e khethoe nakong ea kemolo / ho beleha.

Kaha ha ho na boiphihlelo ka tšebeliso ea lithethefatsi har'a basali baimana, le polokeho ea litlamorao tsa lithethefatsi ho nts'etsopele ea lesea ha e so bonoe, matlapa a Pentoxifylline ha a ngolloa basali ba lebelletseng ngoana.

Ho na le lintlha tse mabapi le bokhoni ba ho fepa sethethefatsi ka lebese la matsoele, ka hona, haeba ho hlokahala hore motho a phekoloe, mosali o lokela ho etsa qeto ea ho qeta ho beleha hore a se ke a pepesetsa ngoana kotsi e sa lokelang.

Ho sebelisana le lithethefatsi

E ntlafatsa phello ea lithethefatsi tsa antihypertensive le tse antidiabetic (lethalinyana le lokela ho fokotsoa). Ha e kopantsoe le kutloelo-bohloko, li-ganglioblockers, li-vasodilator, ho fokotsa khatello ea mali ho ka etsahala, ka ketolorac, meloxicam - keketseho ea nako ea prothrombin le kotsi ea ho tsoa mali, ka heparin, lithethefatsi tsa fibrinolytic le anticoagulants e sa tobang - phello ea anticoagulant.

Cimetidine e eketsa haholo khatello ea maikutlo

Pentoxifylline

maling le monyetla o eketsehileng oa litla-morao.

Pentoxifylline, e le molao, e ntlafatsa phello ea lithethefatsi tse fokotsang khatello ea mali, hammoho le lithethefatsi tse reretsoeng kalafo

Ts'ebeliso e kopaneng ea Pentoxifylline le lithethefatsi / lintho tse ling li ka lebisa nts'etsopele ea litlamorao tse latelang:

Cimetidine: e eketsa bongata ba pentoxifylline plasma ea mali, ka lebaka leo, menyetla ea ho fetoha hampe,
Valproic acid, heparin, theophylline, lithethefatsi tsa fibrinolytic, li-antihypertensive le hypoglycemic agents (insulin, li-agents tsa hypoglycemic), lithethefatsi tse amang tsamaiso ea mali ea mali (li-anticoagulants, thrombolytics), lithethefatsi tse thibelang likokoana-hloko (ho kenyeletsa le cephalosporins, li eketsa):
Li-xanthine tse ling: Ho tsofala ho feteletseng hoa hlaha.

Tlhahlobo

Cerebrovascular pathology, haholo-holo lefu la masapo a mokokotlo, maemo a ka mor'a lefu la ho nyekeloa, lefu la tsoekere le lefu la pelo le "angiopathies" ea lefu la tsoekere, ho senyeha ha potoloho ea mali (lefu la Raynaud, endarteritis, joalo-joalo).

Ts'ebetso e utloisang bohloko ea ts'ebetso ea methapo.

Abela kahare kahare le kahare. Ka hare, nka, ho qala ka 0,2 g (matlapa a mabeli) makhetlo a 3 ka letsatsi ka mor'a lijo, ntle le ho hlafuna. Kamora ho qala ha phello ea kalafo (hangata kamora libeke tse 1-2), lethaliti le fokotsetsoa ho 0,1 g (pilisi e le 1) makhetlo a 3 ka letsatsi. Nako ea kalafo ke libeke tse 2-3. le tse ling.

Haeba ho hlokahala (likhathatso tse mpe tsa potoloho ea mali kapa methapo ea methapo / mali) e tsamaisoa kahare kapa kahare. 0,1 g (1 ampoule) e tsamaisoa ka matla ho 250-500 ml ea tharollo ea isotonic sodium chloride kapa ka tharollo ea glucose ea 5% bakeng sa metsotso e 90-180.

Tekanyetso ea letsatsi le letsatsi e ka eketsoa le ho feta ho 0,0-0.3 g, ka makgetlo a pele, 0,1 g ea moriana e fanoa ka 20-50 ml ea tharollo ea isotonic sodium chloride, mme ka matsatsi a latelang, 0,2-0,3 g e ngoe le e ngoe. 30-50 ml ea solvent). Kenya ka tekanyo ea 0,1 g (5 ml ea tharollo ea 2% ea moriana) bakeng sa metsotso e 10

Mokhoa oa ho fokotsa litekanyetso le tsela ea tsamaiso: litafole, liente, li-slipper

Moriana o nooa ka molomo le ka botsoali, ho latela botebo ba lefu lena.

Ha ho nooa ka molomo, ho sebelisoa litafole tse nang le litekanyetso tsa 100 mg. Ba qala ho nka boholo ba lipilisi tsa 200 mg - makhetlo a 2 ka makhetlo a mararo ka letsatsi ka mor'a lijo. Ebe, ha phello ea kalafo e fumaneha, tekanyetso ea fokotseha, 'me letlapa le ntse le tsoela pele ho nooa makhetlo a mararo ka letsatsi. Nako ea kalafo e nang le ho hlophisoa ha letlapa e nka khoeli.

Ho mafu a hlobaetsang le a matla a litho tsa ka hare, pentoxifylline e laetsoe ka ampoules. Ho na le mekhoa e 'meli ea tsamaiso ea lithethefatsi: intraarterial le intravenous.

Moemeli o tsamaisoa ka tsela ea mofuta oa lerotholi. Ampoule e le 'ngoe e sebelisoa ka 250 ml ea sodium chloride solution, kapa tharollo ea glucose. Tekanyetso ena e fanoa ka nako e fetang hora le halofo ho isa ho tse peli, butle butle.

Tekanyetso ea letsatsi le letsatsi e ka eketsoa ka mamello e ntle ho 0,2-0.3 g (ho latela lipontšo).

Kahare, ba qala ho fana ka moriana oa 0,1 g ea lithethefatsi ka 50 ml ea tharollo ea sodium chloride, ebe 0,0-0.3 g e ngoe le e ngoe.

Tharollo e kenngoa butle butle ka nako ea metsotso e 10. Thupelo ena e sebelisa infusions tse 10.

Le maloetse a vascular

Pentoxifylline (Trental) e sebelisoa ka katleho kalafo ea dyscirculatory e sa foleng

Lefu la Cerebrovascular ke lona le lebisang ho lefu ho batho, haholoholo maqheku. Khafetsa ha ho na mathata a tebileng a ho potoloha ha lisele, empa le a mofuta o sa foleng.

Naheng ea Russia, likotsi tse sa foleng tsa "cerebrovascular" li khetholloa e le DE - discirculatory encephalopathies. Lefu lena le bontšoa ka tlolo e tsoelang pele ea mesebetsi ea boko, e hlahisoang ke ho se sebetse hantle ha mali.

Matšoao a mantlha a lefu lena ke matšoao a methapo, a maikutlo le a kelello, ha ho na le ho fokotseha ha mohopolo, ho fokotseha hoa ts'ebetso ea kelello, ho tšoenyeha ha boroko le mathata a mang.

Ho phekola lefu lena, lingaka li beha Pentoxifylline, kapa analogues ea eona. Lithethefatsi tsena li ntlafatsa microcirculation, li fokotsa ho kopana ha liplatelese, hape li eketsa phallo ea mali.

Ho ea ka bo-rasaense, ts'ebeliso ea Pentoxifylline bakeng sa libeke tse tharo ho isa ho tse 'nè e ntlafatsa phallo ea mali a tsoang ka likhase ka 17%. Leha ho le joalo, tšebeliso ea lithethefatsi ha e bake lefu la bosholu ba Intracerebral.

Pentoxifylline e sebelisoa haholo ho phekola mafu a vascular. Tsena li kenyelletsa ho hlonama nako le nako ho bakuli ba nang le tšenyo ea likepe tse liphahameng tse tlase. Sesebelisoa se sebetsang sa kalafo ea kalafo ea trophic ulcers ea tlase lipheletsong.

Ha ho phekoloa ulcers ea trophic

Lefu lena le baka mahlomola a maholo ho bakuli -

fola butle, eba le tloaelo ea ho khutlela morao.

Ts'ebeliso ea Pentoxifylline e na le mabaka a ho phekola ulcers ea trophic. Setlhare, se ntlafatsa phallo ea mali sebakeng se amehang, se khothaletsa pholiso e potlakileng ea bofokoli ba letlalo khahlano le mokokotlo oa mekhoa e meng.

Le mafu a sebete

Pentoxifylline e fokotsa menyetla ea mathata

Lilemong tsa morao tjena, libaka tse ncha li fumanoe ts'ebelisong ea Pentoxifylline. Hajoale, ho hlahisitsoe phello e ntle ea kalafo ka setlhare sena bakeng sa lefu le kang hepatitis e matla ea joala.

Litlhahlobo mabapi le ts'ebeliso ea Pentoxifylline li ntle haholo. Setlhare sena se sebetsa hantle bakeng sa ho ruruha ha methapo ea litho le litsamaiso tse ngata. Ka tloaelo motho ea tšoeroeng ke lefu la vascular o qobelloa ho nka meriana habeli ka selemo - ke feela moo o ka laolang boemo ba hau le tsela ea lefu lena.

Ho fanoa ka litlhahlobo tse ngata mabapi le ts'ebeliso ea Pentoxifylline ho banna ba nang le bothata ba ho emisa ka morao ho sa feleng le lefu lena le sa tloaelehang. Pentoxifylline ke lithethefatsi tsa bona 1, ha lefu lena le ntse le tsoela pele.

Matlapa le tharollo li tsoa ho eng? Moriana o laetsoe mafu a amanang le phepelo ea mali, "trophism" ea lefu la sethoathoa, lefu le felisang tšoaetso ea mokokotlo, lefu la morao-rao, lesapo la mokokotlo, lesapo la mokokotlo, lefu la methapo ea methapo, le dyscirculatory encephalopathy.

Hape matšoao a ts'ebeliso ea Pentoxifylline ke: myocardial infarction, coronary pelo, lefu la bronchial asthma, ho ferekana ho hoholo hoa phallo ea mali ho retina, choroid, otossteosis, ho hloka matla hoa tšimoloho ea methapo.

Tharollo ea Pentoxifylline, litaelo tsa tšebeliso

Moriana ho ampoules o fanoa ka methapo le kaharera maemong a supine a mokuli.

Ka lefu la methapo ea methapo ea kutlo, litekanyetso li fokotsoa ho karolo ea 50-70 lekholong ea tekanyetso e tloaelehileng.

Ho tsamaisoa ka mokhoa o potileng butle, ho baloa ho latela morero: 50 mg bakeng sa 10 mg e ngoe ea sodium chloride 0,9%, e kenngoeng metsotso e 10, ebe e fetoleloa e le lerotholi: 100 mg e kentsoe ka 250-500 ml ea sodium chloride 0,9% kapa tharollo ea dextrose 5 %

Kahare: 100 mg e kenngoa ka 20-50 ml ea sodium chloride.

Intramuscularly e fanoe ka botebo makhetlo a mararo ka letsatsi, 100-200 mg.

Matlapa a Pentoxifylline, litaelo tsa tšebeliso

Ntle le tsamaiso ea batsoali, hoa lumelleha ho tšela moriana kahare ka mor'a ho ja habeli ka letsatsi, ho 800-1200 mg. Tekanyetso ea pele ea letsatsi le letsatsi ka mokhoa oa pilisi ke 600 mg, butle-butle palo ea lithethefatsi e fokotseha ho 300 mg ka letsatsi. Mefuta e telele ea lithethefatsi e nooa habeli ka letsatsi.

Pentoxifylline angioprotector e bontšoa hore e sebelisoe kalafo e rarahaneng ea maloetse a methapo ea pelo.

Moriana o laetsoe kalafo ea lijana tsa pherekano, ka ho se lekane ha venous.

Pentoxifylline, e kenelletseng maling, sebakeng seo e sebetsang likepeng tse amehang, e tlosa li-depherits tsa atherosselotic, e matlafatsa lerako la venous.

Matšoao a fanoang ke moriana:

tlolo ea potoloho ea potoloha (endarteritis, angiopathy),
atherosselotic or discirculatory angiopathies,
kotsi ea pelo
post-ischemic, boemo ba post-stroke.

Tharollo ea infusion, tharollo bakeng sa tsamaiso ea methapo le methapo

Tsamaiso ea Intraarterial: tekanyo - 10 mg ka motsotso, tekanyetso ea pele - 100 mg ea lithethefatsi (ka 0.9% sodium chloride tharollo e nang le molumo oa 20-50 ml), nakong e tlang, lethal dose le eketseha ho 200-300 mg (ka tharollo ea sodium chloride ea sodium. moqolo 30-50 ml).

Pentoxifylline e tsamaisoa ka methapo e tsamaeang butle butle ka nako ea metsotso e 90-180:

Tharollo ea infusion: lethal dose - 50-100 mg, haeba ho hlokahala - 200 mg (boholo ka letsatsi - 300 mg). Nakong ea kenyelletso, mokuli o lokela ho ba maemong a phahameng,
Tharollo bakeng sa taolo ea methapo le methapo: litekanyetso - 100 mg ea moriana ka tharollo ea 0,9% ea sodium chloride kapa 5% glucose (dextrose) tharollo ka bongata ba 250-500 ml. Ka atherosclerosis e matla ea lijana tsa mokokotlo, ho kenngoa ha moriana ka mokokotlong oa carotid ho thibetsoe.

Bakuli ba nang le bothata ba ho phekola ba renal e sa foleng (tumello ea creatinine e ka tlase ho 30 ml ka motsotso) ba hloka phokotso ea lethal dose ea 30-50%.

Bakeng sa kalafo ea maloetse a sa foleng kapa a lefu la tsoekere, ho kenngoa ka mokhoa o mongata ho fanoa ka letsatsi le leng le le leng kapa letsatsi le leng le le leng.

Matlapa a Pentoxifylline a nooa ka molomo ntle le ho hlafuna kapa ho a hlakola (a felletse), a hlatsuoa ka metsi, haholo-holo ka mor'a lijo.

Ha e le molao, matlapa a koahetsoeng ka enteric ea Pentoxifylline a khethoa ho 2 likhomphutha. Makhetlo a 3 ka letsatsi. Tekanyetso e tloaelehileng ea letsatsi le letsatsi ke 600 mg, e phahameng ke 1200 mg. Hangata, kamora libeke tse 1-2, tekanyo e le 'ngoe e fokotseha ho letlapa le le leng, ha bongata ba Pentoxifylline bo lula bo sa fetohe.

Ngaka e lekola hore na nako ea phekolo e tla nka nako e kae ka boeona, e le molao, ke likhoeli tse 1-3.

A ho hloleha ho phekoloa ha leqhubu (tumello ea tumello ea tlholeho e ka tlase ho 10 ml ka motsotso), ho hlokahala hore ho fokotsoe litekanyetso tsa makhetlo a 2.

Pentoxifylline ka mefuta e meng ea litekanyetso li behoa khafetsa taolong makhetlo a mabeli ka letsatsi, nako ea phekolo e tsoa ho libeke tse 2-3 kapa ho feta.

Angioneuropathy (paresthesia, lefu la Raynaud),
Mathata a potoloha ka potoloho, a bakoang ke ts'ebetso ea ho ruruha, lefu la tsoekere, atherosclerosis,
Likotsi tsa Ischemic tsa cerebrovascular (e hlobaetsang le e sa foleng),
Ho emisa endarteritis,
Ho hloleha ho potoloha ha mali le ho kula haholo ho sa feleng ka har'a retina kapa choroid,
Mathata a amanang le lefu la sethoathoa a amanang le mathata a amanang le bothata ba venous kapa arterial microcirculation (serame, trophic ulcers, gangrene, post-thrombophlebitis syndrome),
Ho utloa ho senyeha ka methapo ea pelo
Encephalopathy ea atherosulinotic le discirculatory etiology.

Nako ea karolelano ea kalafo le tekanyetso ea letsatsi le letsatsi e khethoa ke ngaka ho mokuli ka mong ka boeona, ho latela tlhahlobo ea bongaka, ho teba ha matšoao a kliniki le litšobotsi tsa 'mele.

Letlapa le nooa hang ka mor'a lijo, hang-hang le metse, le se ke la silakanya le hlafuna, le noe metsi a mangata kapa mokelikeli o mong.

Ho latela litaelo, batho ba kaholimo ho lilemo tse 18 ba fuoa 200 mg ea moriana ka makhetlo a mararo ka letsatsi. Matlapa a 400 mg a behiloe ka tekanyetso e le 'ngoe eseng makhetlo a fetang a mabeli ka letsatsi. Nako ea kalafo ho latela litaelo ke libeke tse 3, haeba ho hlokahala, ngaka e lelefatsa kapa ea khutsufatsa nako ea kalafo.

Theko ea Pentoxifylline

Theko ea lithethefatsi le li-analogues tsa eona li itšetlehile ka moetsi, ho litekanyetso le mofuta oa tokollo. Ka karolelano, theko ea lithethefatsi tsa lapeng Pentoxifylline e tsoa ho li-ruble tse 33 ho isa ho tse 72.

Theko ea Trental e tloha ho li-ruble tse 157 ho isa ho tse 319, Agapurin e bitsa li-ruble tse 90 ho isa ho tse 137.

Theko ea Pentoxifylline matlapeng a 0,1 g e tsoa ho li-ruble tse 85 ho isa ho tse 130 ka sephutheloana sa likotoana tse 60.

Theko ea li-ampoules tsa Pentoxifylline 2% ea 5 ml ke li-ruble tse 40 ka likotoana tse 10.

Theko e lekanyelitsoeng ea Pentoxifylline ke: matlapa a khutlang (400 mg ka 'ngoe, likhomphutha tse 20) - ho tloha li-ruble tse 273, matlapa a kopaneng (100 mg, 60 likhomphutha) - ho tloha li-ruble tse 62, tharollo ea ente (20 mg / ml) , 10 ampoules ea 5 ml ka 'ngoe) - ho tloha ho li-ruble tse 35., Tsepamisa maikutlo bakeng sa ho hlophisoa ha tharollo bakeng sa tsamaiso ea methapo le methapo ea methapo (20 mg / ml, 10 ampoules ea 5 ml) - ho tloha ho li-ruble tse 36.

Litšenyehelo tse tloaelehileng tsa matlapa a Pentoxifylline ho lithemisi tsa Moscow ke li-ruble tse 450-600, ho latela tekanyetso le palo ea litafole tse sekoahelong.