bioximiya pecheni

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powerpoint presentation bioximiya pecheni niyozova nigina 1. metabolizm v pecheni 2. bioximicheskie funktsii pecheni 3. pechyonochnie fermenti i markyori plan: pechenochnaya nedostatochnost pri pechyonochnoy nedostatochnosti uroven bilirubina v sivorotke krovi mojet previshat 10 mg/dl, chto ukazivaet na narushenie funktsii pecheni po obrabotke bilirubina i mojet proyavlyatsya jeltuxoy. pechyonochnaya entsefalopatiya, oslojnenie pechyonochnoy nedostatochnosti, xarakterizuetsya narusheniem funktsii golovnogo mozga, soprovojdaetsya izmeneniem urovnya ammiaka v krovi, chasto vishe 100 mkg/dl. lipidniy obmen lipoproteini ochen nizkoy plotnosti (lponp) sinteziruyutsya pechenyu i transportiruyut triglitseridi iz pecheni v perifericheskie tkani, ix uroven tesno svyazan s riskom serdechno-sosudistix zabolevaniy. pechen sinteziruet okolo 80% xolesterina v organizme, reguliruya ego uroven v krovi i predotvrashaya razvitie ateroskleroza. protsess kontroliruetsya fermentami, takimi kak hmg-coa-reduktaza. metabolizm lekarstvennix preparatov pechen metaboliziruet okolo 90% lekarstvennix preparatov, ispolzuya fermentnie sistemi tsitoxroma p450, chto privodit k izmeneniyu ix farmakokineticheskix svoystv i vivedeniyu iz organizma. perviy proxod metabolizma cherez pechen mojet znachitelno snizit biodostupnost peroralno prinimaemix …

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t privesti k gipoalbuminemii, snijeniyu urovnya faktorov svyortivaniya krovi i razvitiyu astsita iz-za narusheniya onkoticheskogo davleniya. detoksikatsionnaya funktsiya pecheni pechen metaboliziruet okolo 90% tsirkuliruyushix v krovi ksenobiotikov, vklyuchaya lekarstvennie preparati, ispolzuya fermentnie sistemi tsitoxroma p450 i glyukuroniltransferazi. v protsesse biotransformatsii pechen osushestvlyaet reaktsii fazi i (okislenie, vosstanovlenie, gidroliz) i fazi ii (kon'yugatsiya), povishaya rastvorimost toksicheskix veshestv dlya ix vivedeniya s jelchyu ili mochoy. lechenie zabolevaniy pecheni transplantatsiya pecheni yavlyaetsya radikalnim metodom lecheniya pri terminalnoy pechyonochnoy nedostatochnosti, s pyatiletney vijivaemostyu patsientov, dostigayushey 70-80% pri uslovii soblyudeniya pojiznennoy immunosupressivnoy terapii. lechenie xronicheskogo gepatita s chasto vklyuchaet v sebya kursi protivovirusnix preparatov pryamogo deystviya (pvpd) prodoljitelnostyu 8-12 nedel, privodyashie k virusologicheskomu izlecheniyu u bolee chem 95% patsientov. laboratornaya diagnostika zabolevaniy pecheni povishenie urovnya alt i ast bolee chem v 5 raz po sravneniyu s normoy ukazivaet na znachitelnoe povrejdenie gepatotsitov, chasto vstrechayusheesya pri virusnix gepatitax ili toksicheskom porajenii pecheni. opredelenie aktivnosti shelochnoy fosfatazi …

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pbx) svyazan s visokim titrom antimitoxondrialnix antitel (ama-m2) u 90-95% patsientov, chto kriticheski vajno dlya diagnostiki etogo zabolevaniya. autoimmunniy gepatit tipa 1 xarakterizuetsya nalichiem antitel ana i antitel k lipoproteinu visokoy plotnosti (lpvp) u bolee chem 50% bolnix. uglevodniy obmen pechen reguliruet uroven glyukozi v krovi cherez protsessi glikogenoliza i glikogeneza, vklyuchaya klyuchevie fermenti, takie kak geksokinaza i glyukozo-6-fosfataza. pechen uchastvuet v glyukoneogeneze, sinteziruya do 90% glyukozi v post absorbtivnom sostoyanii, ispolzuya laktat, glitserol i aminokisloti v kachestve substratov. jirovaya bolezn pecheni jirovaya bolezn pecheni (jbp) chasto assotsiiruetsya s urovnem triglitseridov v krovi vishe 150 mg/dl i mojet progressirovat do nealkogolnogo steatogepatita (nasg) s vospaleniem i povrejdeniem pecheni. fibroz pecheni, xarakterniy priznak zapushennoy jbp, otsenivaetsya po shkale metavir ot f0 (bez fibroza) do f4 (tsirroz), chto vliyaet na prognoz i vibor terapii. biomarkeri porajeniya pecheni uroven gamma-glutamiltranspeptidazi (ggtp) chasto povishaetsya pri xolestaze – zastoe jelchi v pecheni i jelchnix protokax, …

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it klyuchevim bioximicheskim markerom ostrogo i xronicheskogo virusnogo gepatita, povishayas v desyatki raz pri znachitelnom povrejdenii gepatotsitov. virusnie gepatiti tipa v i s vizivayut xronicheskoe vospalenie pecheni u 5-10% infitsirovannix, chto mojet privesti k tsirrozu i gepatotsellyulyarnoy kartsinome cherez 20-30 let. bioximicheskie funktsii pecheni v protsesse glyukoneogeneza pechen proizvodit okolo 90% glyukozi v postprandialniy period, ispolzuya laktat, glitserin i aminokisloti v kachestve substratov, reguliruya uroven saxara v krovi. pechen sinteziruet bolee 500 razlichnix belkov, vklyuchaya albumini, faktori svyortivaniya krovi (naprimer, faktor vii) i lipoproteini, kriticheski vajnie dlya podderjaniya gomeostaza organizma. alkogolnoe porajenie pecheni alkogolniy gepatit razvivaetsya u 10-35% lits, zloupotreblyayushix alkogolem, xarakterizuetsya vospaleniem pechenochnoy parenximi i povisheniem urovnya alt i ast v sivorotke krovi v 2-3 raza vishe normi. pri xronicheskom alkogolnom porajenii pecheni nablyudaetsya fibroz – obrazovanie izbitochnogo kollagena, chto privodit k tsirrozu pecheni na stadii f3-f4 po klassifikatsii metavir u znachitelnoy chasti patsientov. spasibo za vnimanie @taqdimot_robot image4.jpg …

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powerpoint presentation bioximiya pecheni niyozova nigina 1. metabolizm v pecheni 2. bioximicheskie funktsii pecheni 3. pechyonochnie fermenti i markyori plan: pechenochnaya nedostatochnost pri pechyonochnoy nedostatochnosti uroven bilirubina v sivorotke krovi mojet previshat 10 mg/dl, chto ukazivaet na narushenie funktsii pecheni po obrabotke bilirubina i mojet proyavlyatsya jeltuxoy. pechyonochnaya entsefalopatiya, oslojnenie pechyonochnoy nedostatochnosti, xarakterizuetsya narusheniem funktsii golovnogo mozga, soprovojdaetsya izmeneniem urovnya ammiaka v krovi, chasto vishe 100 mkg/dl. lipidniy obmen lipoproteini ochen nizkoy plotnosti (lponp) sinteziruyutsya pechenyu i transportiruyut triglitseridi iz pecheni v perifericheskie tkani, ix uroven tesno svyazan s riskom serdechno-sosudisti...

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