Rarraba shirye-shiryen insulin

Diungiyar Ciwon Cutar Kankara ta Duniya ta yi hasashen cewa nan da shekarar 2040 adadin masu haƙuri da ke ɗauke da cutar za su kusan mutane miliyan 624. A yanzu haka mutane miliyan 371 ne ke fama da cutar. Yaduwar wannan cuta tana da alaƙa da canji a rayuwar mutane (ƙarancin salon rayuwa, rashin motsa jiki) da kuma addinai (amfani da sinadarai na kanti masu girma a cikin ƙashin dabbobi).

'Yan adam sun daɗe da sanin ciwon sukari, amma wani ci gaba a cikin maganin wannan cuta ya faru ne kusan ƙarni ɗaya da suka wuce, lokacin da cutar ta yi muni.

Tarihin ganowa da kirkirar insulin wucin gadi

A cikin 1921, likitan Kanada Frederick Bunting da mataimakinsa, ɗalibin likita, Charles Best, sun yi ƙoƙarin neman haɗi tsakanin cututtukan fata da kuma ciwon sukari. Don bincike, malami a Jami'ar Toronto, John MacLeod, ya ba su dakin gwaje-gwaje tare da kayan aikin da suke bukata da karnuka 10.

Likitocin sun fara gwajinsu ne ta hanyar cire kwayar cutar a cikin wasu karnuka, a sauran sun bandeji buhunan hancin kafin cirewa. Bayan haka, an sanya sashin atrophied don daskarewa a cikin maganin maganin hauhawar jini. Bayan ya narke, ana sarrafa abun da ke ciki (insulin) ga dabbobi tare da glandar da aka cire da asibitin kwantar da hankali.

Sakamakon wannan, an rage yawan sukarin jini da haɓakawa a cikin yanayin janar da kyautata lafiyar kare. Bayan haka, masu binciken sun yanke shawarar yin ƙoƙarin samun insulin daga cututtukan maraƙi kuma sun gano cewa zaku iya yin ba tare da jujin jujin ba. Wannan hanyar ba ta zama mai sauƙi da ɗaukar lokaci ba.

Yin farauta da Mafi kyawun sun fara gudanar da gwaji a kan mutane da kansu. Sakamakon gwaji na asibiti, dukansu sun ji daɗi da rauni, amma babu wasu matsaloli masu rikitarwa daga maganin.

A cikin 1923, Frederick Butting da John MacLeod sun sami kyautar Nobel don insulin.

Mene ne insulin?

Ana samun shirye-shiryen insulin daga albarkatun ƙasa na dabba ko asalin mutum. A magana ta farko, ana amfani da maganin ƙwayar aladu ko na shanu. Suna haifar da rashin lafiyar koda yaushe, saboda haka suna iya zama haɗari. Gaskiya ne don insulin bovine, abun da ke ciki wanda ya sha bamban da na ɗan adam (amino acid uku maimakon ɗaya).

Akwai nau'i biyu na insulin ɗan adam:

• Semi-roba
• kama da ɗan adam.

An samo insulin na mutum ta amfani da hanyoyin injin. amfani da enzymes na yisti da E. ƙwayoyin ƙwayar cuta coli. Daidai ne sosai a tsarin abubuwan da ke haifar da kwayar halittar da sinadarin hanji ke fitowa. Anan muna Magana ne game da gyaran jini na janar E. coli, wanda yake da ikon samar da insulin ɗabi'ar ɗan adam. Insulin Actrapid shine farkon hormone da aka samu ta hanyar injiniyan kwayoyin.

Tsarin insulin

Daban-daban na insulin a cikin maganin cututtukan siga sun sha bamban da juna ta hanyoyi da yawa:

1. Tsawon lokacin watsawa.
2. Saurin aiwatarwa bayan gudanar da magunguna.
3. Hanyar sakin miyagun ƙwayoyi.

Dangane da tsawon lokacin bayyanar, shirye-shiryen insulin sune:

• ultrashort (ya fi sauri)
• gajere
• matsakaici-tsayi
• tsayi
• a hade

Magungunan Ultrashort (insulin apidra, insulin humalog) an tsara su don rage sukarin jini nan take. An gabatar dasu kafin abinci, sakamakon sakamakon ya nuna kanta a cikin mintina 10-15. Bayan 'yan sa'o'i kaɗan, sakamakon maganin ya zama mafi yawan aiki.

-An gajeren magunguna (insulin na aiki, cikin gaggawa insulin)fara aiki rabin sa'a bayan gudanarwa. Tsawon lokacinsu shine awa 6. Wajibi ne don sarrafa insulin na mintina 15 kafin cin abinci. Wannan ya zama dole saboda lokacin cin abinci mai gina jiki a jiki ya zo daidai da lokacin bayyanar da miyagun ƙwayoyi.

Gabatarwa matsakaici na kwayoyi (insulin protafan, insulin humulin, basal insulin, sabon hadewar insulin) bai dogara da lokacin cin abinci ba. Tsawon lokacin wahayi shine 8-12 hoursfara yin aiki sa'o'i biyu bayan allura.

Mafi dadewa (kusan awanni 48) akan jiki ana motsa shi ta wani nau'in shiri na insulin. Yana fara aiki sa'o'i huɗu zuwa takwas bayan aikin (tresiba insulin, flekspen insulin).

Cakuda shirye-shirye sune gauraya abubuwa na daskararru daban-daban na bayyanar juna. Farkon aikinsu yana farawa rabin sa'a bayan allura, kuma jimlar aikin su shine awoyi 14-16.

Abubuwan insulin na zamani

Gabaɗaya, mutum zai iya bambance irin kyawawan halayen analogues kamar haka:

• yin amfani da tsaka tsaki, ba maganin acidic ba,
• sake fasalin fasahar DNA
• sabon salo na sabbin kayan magunguna na zamani na analogues.

An kirkiro kwayoyi masu insulin-ins kamar su sake tsara amino acid don inganta tasirin kwayoyi, yawan shansu da kuma shakatawa. Dole ne su wuce insulin ɗan adam a cikin duk kaddarorin da sigogi:

1. Insulin Humalog (Lyspro). Sakamakon canje-canje a cikin tsarin wannan insulin, ya zama yana saurin shiga cikin jiki daga wuraren allura. Kwatanta insulin na mutum tare da humalogue ya nuna cewa tare da gabatarwar mafi girman maida na karshen ana samun saurin sauri kuma yana sama da maida hankali na mutum. Haka kuma, maganin yana cikin hanzari a cikin kwayar cuta kuma bayan sa'o'i 4 sai aka mayar da hankalin sa zuwa darajar farko. Wani fa'idodin humalogue akan ɗan adam shine 'yancin kai na tsawon lokacin bayyanarwa zuwa kashi.
2. Insulin Novorapid (aspart). Wannan insulin yana da ɗan gajeren lokaci na bayyanar mai aiki, wanda ke sa ya yiwu a sarrafa cikakke na glycemia bayan abinci.
3. Levemir insulin penfill (detemir). Wannan shi ne ɗayan nau'in insulin, wanda ke ɗauke da haɓakar aiki tare da biyan bukatar mai haƙuri da ciwon sukari na mellitus don insulin basal. Wannan kwatanci ne na tsawon lokaci, ba tare da wani babban aiki ba.
4. Apidra ta insulin (Glulisin). Yana aiwatar da tasirin ultrashort, kaddarorin na rayuwa suna daidai da insulin mutum mai sauki. Ya dace da amfani na dogon lokaci.
5. Glulin insulin (lantus). An nuna shi ta hanyar dogon lokaci, rarrabawa mafi rarrabawa cikin jiki. Dangane da tasiri, insalin lantus daidai yake da insulin na mutum.

Shirye-shiryen insulin

Magunguna (allunan insulin ko allura), kazalika da ƙwararrun likitan yakamata su zaɓi ƙwararrun masana. Magungunan kai na kanka na iya cutar da cutar da wahalar da ita.

Misali, yawan insulin na marasa lafiya da ke dauke da ciwon sukari na 2 don sarrafa sukari na jini zai fi yadda masu ciwon sukari nau'in 1 yake. Mafi sau da yawa, ana yin insulin insulin ne yayin da aka yi amfani da gajeren insulin insulin lokuta da yawa a rana.

Mai zuwa jerin magunguna ne wadanda aka fi amfani dasu wajen maganin masu cutar siga.

Kyawawan nau'ikan ciki

Akwai rarrabuwa daban-daban dangane da wanda endocrinologist ya zabi tsarin kulawa da magani. Ta hanyar asali da nau'in, ana bambanta nau'ikan magungunan:

• Insulin din ya hade daga cututtukan dabbobi na wakilan dabbobin. Bambancin da ke tattare da shi daga kwayar halittar jikin mutum shine kasancewar wasu amino acid uku, wanda ya kunshi haɓaka halayen halayen ƙwayar cuta a jikin mutum.
• Allurar kwayar cutar kansa tayi kusa da tsarin sinadarai zuwa jikin mutum. Bambanci shine maye gurbin amino acid daya a cikin sarkar sunadarai.
• Kankana whale ya banbanta da asalin kwayar halittar dan adam sama da wacce aka hada ta da shanu. Ana amfani dashi da wuya.
• Analog na mutum, wanda aka haɗu ta hanyoyi guda biyu: ta amfani da insulin na Escherichia coli (insulin ɗan adam) da kuma maye gurbin “amino acid ɗin“ da bai dace ba ”a cikin ƙwayar halittar porcine (nau'in inginin kwayoyin).

Bangare

Rarraba mai zuwa na nau'in insulin ya danganta ne da yawan abubuwan haɗin. Idan magani ya ƙunshi cire tsintsiyar ƙwayar cuta ta nau'in dabba guda, alal misali, alade kawai ko sa ne kawai, yana nufin wakilai masu hana ƙwayoyin cuta. Tare da haɗewar abubuwa iri ɗaya na iri iri, ana kiran insulin a hade.

Matsayi na tsarkakewa

Ya danganta da bukatar tsarkakewar wani sinadari mai aiki da sinadaran, wadannan aji akwai:

• Kayan aiki na yau da kullun shine sanya magunguna su zama ruwa tare da ethanol na acidic, sannan aiwatar da tacewa, salted out da crystallized sau da yawa. Hanyar tsabtatawa ba cikakke ba ne, tunda yawancin adadin ƙazamai ya rage a cikin abubuwan da ke cikin kayan.
• Magungunan Monopik - a farkon farkon tsarkakewa ta amfani da hanyar gargajiya, sannan tacewa ta amfani da gel na musamman. Matsayi na ƙazanta ba ƙasa da hanyar farko.
• Samfurin monocomponent - ana amfani da tsabtatawa mai zurfi ta hanyar murkushewar kwayar cuta da musayar ion musaya, wanda shine mafi kyawun zaɓi don jikin mutum.

Sauri da tsawon lokaci

Ana daidaita magungunan na huhu don saurin haɓaka tasirin sakamako da tsawon lokacin aiki:

• ultrashort
• gajere
• matsakaici na tsawon lokaci
• tsawo (tsawa)
• hade (hade).

Hanyar aikinsu zai iya bambanta, wanda kwararrun yayi la'akari yayin zabar magani don magani.

Ultrashort

Tsara don saukar da sukari na jini nan da nan. Ana sarrafa waɗannan nau'ikan insulin kai tsaye kafin abinci, saboda sakamakon amfani ya bayyana a cikin minti 10 na farko. Mafi tasiri tasirin maganin yana tasowa, bayan awa daya da rabi.

Analog na insulin na ɗan adam da kuma wakilcin ƙungiyar aikin ultrashort. Ya banbanta da ginin da ake amfani dashi a tsari irin na amino acid. Tsawon lokacin aikin zai iya kaiwa awanni 4.

Ana amfani dashi don nau'in 1 na ciwon sukari, rashin haƙuri ga magungunan wasu kungiyoyi, juriya na insulin a cikin nau'in ciwon sukari na 2, idan magungunan baka basu da tasiri.

Ultrashort magani dangane da insulin aspart. Akwai shi azaman bayani mara launi a cikin sirinji na alkalami. Kowane yana riƙe da 3 ml na samfurin daidai yake da 300 PIECES na insulin. Misali ne na kwayar halittar mutum ta hanyar amfani da E. coli. Bincike ya nuna yiwuwar yin wasiyya ga mata yayin haihuwar yaro.

Wani sanannen wakilin kungiyar. Amfani da shi don kula da manya da yara bayan shekaru 6. Anyi amfani dashi tare da taka tsantsan wajen lura da masu juna biyu da tsofaffi. Zaɓin jigilar hanyar sashi aka zaɓi akayi daban-daban. Anyi allurar ciki ko ta amfani da tsarin aikin famfo na musamman.

Short shirye-shirye

Wakilan wannan rukunin suna sanadin cewa aikin su yana farawa ne a cikin mintuna 20-30 kuma zai kai tsawon awanni 6. Short insulins na buƙatar sarrafawa mintina 15 kafin a saka abinci a ciki. Bayan 'yan sa'o'i bayan allura, yana da kyau a yi ɗan “abun ciye-ciye”.

A wasu halaye na asibiti, ƙwararrun masana sun haɗu da amfani da gajeren shirye-shirye tare da insulins masu aiki na dogon lokaci. Yi kimanta yanayin mai haƙuri, shafin gudanarwar hormone, sigogi da alamu na glucose.

Shahararrun wakilai:

• Actrapid NM wani magani ne wanda aka kirkira shi wanda aka sarrafa shi a ciki da ciki. Hakanan zai yiwu, amma kamar yadda kwararren likita ya umarce shi. Magani ne takardar sayan magani.
• "Harkokin Humulin na yau da kullun" - an wajabta shi don ciwon sukari mai dogaro da insulin, wani sabon cutar da aka gano da kuma lokacin daukar ciki tare da nau'in insulin-mai cuta na cutar. Subcutaneous, ciki da jijiyoyin ciki yana yiwuwa. Akwai shi a cikin gwal da kwalabe.
• Humodar R magani ne na yau da kullun wanda za'a iya haɗe shi da insulins-matsakaici. Babu ƙuntatawa don amfani yayin daukar ciki da lactation.
• "Monodar" - an wajabta shi don cututtukan nau'in 1 da 2, juriya ga Allunan, a lokacin haila. Abincin alade na naman alade.
• "Biosulin R" nau'in samfurin da aka kera shi cikin kwalabe da katako. An haɗe shi da "Biosulin N" - insulin na matsakaicin tsawon lokacin aiki.

Matsakaiciyar Tsawan Tsafe

Wannan ya haɗa da kwayoyi waɗanda tsawon lokacin aikinsu ya kasance a cikin kewayon daga 8 zuwa 12 hours. Kwana ɗaya ko biyu ya isa. Suna fara yin awowi 2 bayan allura.

• ilimin halittar injinanci yana nufin - “Biosulin N”, “Insuran NPH”, “Protafan NM”, “Humulin NPH”,
• Shirya-Sintin roba - "Humodar B", "Biogulin N",
• insulins alade - "Protafan MS", "Monodar B",
• dakatarwar zinc - "Monotard MS".

"Dogon" kwayoyi

Farawa na aiwatar da kudade yana tasowa bayan sa'o'i 4-8 kuma yana iya zuwa kwanaki 1.5-2. Babban aiki yana bayyana tsakanin 8 zuwa 16 hours daga lokacin allura.

A miyagun ƙwayoyi nasa ne mai girma-insulins. Abubuwan da ke aiki a cikin abun da ke ciki shine insulin glargine. Tare da taka tsantsan an wajabta shi a lokacin daukar ciki. Amfani da shi wajen lura da ciwon sukari a cikin yara 'yan kasa da shekaru 6 ba da shawarar ba. Ana sarrafa shi sosai subcutaneously sau ɗaya a rana a lokaci guda.

Ana amfani da "Insulin Lantus", wanda ke da tasirin aiki na tsawon lokaci, azaman magani guda kuma a hade tare da sauran magunguna waɗanda ke nufin rage sukarin jini. Akwai shi a cikin almalin sirinji da katukan katako don tsarin famfo. Ana sake shi ne kawai ta takardar sayan magani.

Daidaitan wakilan biphasic

Waɗannan kwayoyi suna kama da dakatarwa, waɗanda suka haɗa da insulin “gajere” da insulin na tsawon lokaci a wasu gwargwado. Amfani da irin waɗannan kuɗaɗen yana ba ku damar iyakance adadin adadin alluran da suka wajaba cikin rabi. An bayyana manyan wakilan kungiyar a cikin tebur.

Yanayin ajiya

Dole ne a adana kwayoyi a cikin firiji ko firiji na musamman. Ba za a iya ajiye kwalban buɗewa ba a cikin wannan halin fiye da kwanaki 30, tun da samfurin ya rasa kaddarorinsa.

Idan akwai bukatar sufuri kuma ba zai yiwu a yi jigilar ƙwayar a cikin firiji ba, kuna buƙatar samun jaka ta musamman tare da refrigerant (gel ko kankara).

Amfani da insulin

Dukkanin ilimin insulin ya dogara ne da yawancin hanyoyin magani:

• Hanyar gargajiya ita ce a hada gajeriyar magani da dadewa a cikin rabo daga 30/70 ko 40/60, bi da bi. Ana amfani dasu a cikin kula da tsofaffi, marasa lafiya marasa ƙwarewa da marasa lafiya da ke fama da tabin hankali, tunda babu buƙatar kulawa da glucose na yau da kullun. Ana yin magunguna sau 1-2 a rana.
• Hanyar da aka tsananta - ana rarraba kashi ɗaya na yau da kullun tsakanin magunguna gajere da aiki mai tsayi. Na farko an gabatar da shi bayan abinci, kuma na biyu - a safe da dare.

Likita yana son nau'in insulin da ake so, idan yayi la'akari da abubuwan da aka nuna:

• halaye
• amsawar jiki
• yawan gabatarwar ake bukata
• yawan ma'aunin sukari
• shekaru
• alamomin glucose.

Don haka, a yau akwai nau'ikan magunguna da yawa don maganin ciwon sukari. Tsarin ingantaccen magani da aka zaɓa daidai da kuma bin shawarar kwararru zai taimaka wajan kula da matakan glucose tsakanin tsarin da aka yarda da kuma tabbatar da cikakken aiki.