Hormone cholecystokinin function. Zhovchogіnnі preparations - classification, indication, particularities of storing, vіdguki, prices
pathology
Above-minded secretion of gastrin is produced by cells of puffin, which produce gastrin, into the slurry, or in the case of Zollinger-Ellison syndrome, in the case of good or malignant gastrinoma.
Adjustment of gastrin concentration in Zollinger-Ellison syndrome
Hypertrophy of the slime slurry, making it easier to fold,
· Functional hyperplasia of shlunks, head and parietal cells.
Hypersecretion of hydrochloric acid and pepsin, as well as wicklica in ailments of the development of gastritis, swirling ailments shlunk or two-fingered intestines, gastroesophageal reflux.
cholecystokinin (CCK; I will name a few words - pancreozymin) ( walnut - ruha zhovchny mikhur ) is a neuropeptic hormone that is violated by I-cells of the mucous membrane of the duodenal intestine and the proximal form of the small intestine. Cholecystokin manifestations in pancreatic islets, intestinal and cerebral neurons.
Establish from the middle - preproholec_stok_in_in the path of decilkoh posttranslated modifications. Cholecystokinin the whole family of children according to the amount of polypeptides. Similar to gastrin, there is a 5-amino acid domain similar to it. In the mucous membrane of the small intestine, 3 molecular forms of cholecystokinin are revealed, which develop for a number of amino acid surpluses:
Cholecystokinin-8 (fits 60-70%.),
Cholecystokinin-12 i
· Cholecystokinin-ЗЗ.
Low molecular weight forms of cholecystokinin are detected when passing through the liver, at that time as large molecular weight cholecystokinin is consumed from the liver into the systemic bloodstream. The concentration of cholecystokinin in the blood of healthy people is 5-800 ng / l. Cholecystokinin can be consumed in the slaughter, saving with a wide biological activity (uroholecistokinin).
stimulants secretion of cholecystokinin є:
· Take a slurry in the storehouse for chemistry, bicarbonate (amino acid), fat (especially fatty acids and with lancet), components of herbs, acids (but not in carbohydrates);
· CCK-releasing peptide is a parakrinny factor, which is secreted by enterocytes of the mucous shlunkovo-intestinal tract;
· Acetylcholine, which is seen as the end of the parasympathetic nervous system (n. Vagus).
Ingibitor secretion of cholecystokinin є:
· Somatostatin;
· Trypsin (protease to the juice of the lactic acid) hydrolysisє CCK-releasing peptide and such a level of control over the synthesis of CCK.
In the acinar cells of the subshlunkovaya zone, the CCK receptor is the cholecystokin A receptor (CCK A), in the brain and the slunk - the cholecystokin B receptor (CCK B). In the central nervous system, there is a large number of SSK receptors, if the hormone does not penetrate through the hematoencephalic bar.
The CCK receptor is also associated with a hormone gastrin, Yakiy regulate the secretion of hydrochloric acid and the growth of mucus slurry.
People who are stumped by a problem Zayvoi Vagi, Crazy, know the hunger hormone - ghrelin and the hormone - leptin. Correctly reacting to the signals, as one and the other hormone, it is possible to quickly put the figure in order and to feel healthy. However, you do not want to know about the hormones that help you to get thinner. You can all on the right in the fact that the snakes in the harvest do not vrahoyuyut even one speech, that it is violated by the twelve-fingered intestine, but by the hormone cholecystokinin itself. This peptide hormone, which can be abbreviated as CCK in medical colas, plays a role in the equal systems of humans and can generate a hundred infusions for the process of thinning. It's time to get to know him closer.
The role of cholecystokinin in the body
The hormone cholecystokin is present in the equine systems, as well as in the human brain. The main function is to imply the stimulation of the robotic slurry for the active viroblast of herbal enzymes and the stimulation of the fast-feeling activity of the beetle nut for the development of the visual function. Until then, the cholecystokinin stimulates the bloating nerve, which means that it drives the psychotic stress and nerves, and prevents sleep and normal sleep.
Whenever it is triggered, it is possible to break a peptide hormone, but not enough peptide hormone to cause damage in etching robots, as well as negatively impact on the mental state. However, the doslіdzhennya vchenyh saw one important situation. To see, cholecystokinin is not less likely to see the hormone leptin! Behind the words of the precursors, the cholecystokinin itself, peeped in the form of the brain about how to remind the shlunk, and occasionally about those, it’s time to pinch it. The qi function of yakraz and zdіysnyuєt through the bloating nerve.
As a matter of fact, the cholecystokinin itself is violated when fat enters the small intestine. To go out, for a quick otrimannya signal about the population of lyudin just goiters' yazyatsya vzhivat fat uzh!
Cholecystokinin and psycho
To appear, malovidomia is large in the presence of the CCK hormone for more than a dozen rockets to reach the test. The early days of 1989 showed the rock that the promotion of cholecystocinitis was tied to the attacks of unreasonable panic. For reasons of addiction, I recommend that you settle down from the great age of fatty people, and in the pre-urban prospect, you also want to rob people who are more aggressive, anxious and fearful. In such a rank, vcheni came to visnovka, where the fatter people live, the more stressful, the more the wine is going through. At the same hour, I see a strong experience of wickedness to live, rich in fats, and in great quantities. go close colo.
Yakshho namagatisya rozirvati tse kolo, having wicked at the time of fat, fighting against the stress of becoming more important. The male factor for many people is a non-exhaustive transition in the struggle from a busy wagon.
Cholecystokinin provoke and release from deposits
The yak is already zgaduvalosya vische, the CCK hormone is a great antidepressant; Previous Dutch scientists showed that the deficiency of the hormone cholecystokinin should be produced before the appearance of depleted deposits in humans, for example, it is hard to drink alcohol or drugs. Navpaki, normalization of the synthesis of this hormone, stabilization of neurochemical processes in the brain, withdrawal symptoms... It’s not for nothing that it’s a matter of vikoristovutsya in preparations for the treatment of drug addiction.
Yak pіdtrimuvati rіven cholecystokinіnu
Yak can be taken into account, for the body of people it is even more important that the hormone is circulated in the norm. An alternating surplus and shortage of hormone is possible without special efforts to reduce the strength and health of the psyche, mice to sleep, and because of the ease of unique abundance of deposits, including fallow ones. So, I know how to adapt the hormone level in the norm, you can see yourself healthy and systematically thin!
Here it is necessary to think that cholecystokinin go viral when fat enters the body. Ale is in the pink bagatokh upholstery itself is fat їzha є head cause Zayvoy Vagi. Until then, the ominous fats will clog up with nerves and stress stuns. Chi is not superfluous?
Show up, dumb! The whole speech can be harmoniously drawn down. The head of the list is below the list of recommendations:
1. Give an omega-3 fatty acid
Bagato already knows that not all fat is the same brown. Є easily assimilated fats, which provoke obesity and “hammer” the judges, causing a number of other health problems. As a rule, the price of food is delicious, you can find yourself in meat and ribbons, as well as with a piece of trans fat, which is used to prepare fast food and bagatokh confectionery virobes. At the same hour, essential omega-3 fatty acids, the so-called "brown" fats, are necessary for the organism to develop a potent robotic etching system. On them something and then the accent in its own way grows.
Thus, it is necessary to reduce the level of cholecystokinin in the body and not to provoke stress, then trim the fat from products rich in Omega-3 fatty acids. And tse seafood riba (tuna і halibut, salmon і oseledets), rib fat, Seafood (shrimp and crabs, squid and meat), as well as eggs and hairs, sprouted wheat and hemp seeds, olive and rice olives.
2. It is not possible to call the view from fat
Well, there is a lot of "shkidlivyh" fats, as they make the most of their organisms, then they are enough to make them to the minimum. Moreover, from fast food and products, to take revenge on trans fats, it later grows up, and meat and riba, to take revenge on food fats, should be served in small portions and not often 2 times per week. It is not possible to call it out of these words, because, on the thought of the Harvard people, outside of the easy-to-eat fat, only the thinnest.
3. Adjust your mood
You know, as a result of cholecystokinin on the nervous system, you can regulate the power of your body to help you implant fat. For example, individuals who were sick before the attacks of the panic, or who were sick to the point of anxiety, can be quickly affected by the implantation of fat, for the reason nervous becoming a high standard for the CCK hormone.
4. Don't forget about vegetables and greens
Roslinny products, rich in grub fibers, see their own health and drive appetite. For example, roslinnі kіtiny spinach and cabbage miraculously drive you to feel hunger and allow you to see us for a long time. By including the food in your race, you will be relieved from a great feeling of hunger, which will become one natural companion in the lean. Good health to you and beautiful figuri!
Cholecystokinin (CCK) is a neuropeptic hormone that is circulated by the mucous membrane of the intestine, and the very two-palate intestine and the proximal form of the small intestine. It’s not that kind of vidomy in colas, it’s quiet, so you lose weight, like hormones, warming and leptin, as you are susceptible to hunger and health, but the role in the process of deterioration is not less important. For the very role of cholecystokinin in the behavior of people and their functions to the body, you can learn from the statistics, as for you to create a site. It is also possible to optimize the release of the hormone by means of the same rank.
Cholecystokinin: a role in the process of thinning fat
Viroblennya cholecystokinin in the intestine to stimulate fat. A lot of neurotransmitter peptide can be found in the human brain. Winning for:
Change in the amount of hydrochloric acid;
... stimulation of pidshlunkovoi;
... stimulation of herbal enzymes;
... stimulation of the vision of women;
... stimulation of the speed of the zhovchny mikhur;
... relaxation of sphinkters of the zhovchny ducts;
... stimulation of the bloating nerve.
The marriage of the given speech in the body is obstructed:
Destroyed in the robots of the chewing mikhur;
... destructive flow of zhovchі into the gut;
... damage to the robot and the intestinal tract as a whole.
Krym, this hormone will take care of your part in the calmness, regulation of sleep, suppressed fear and pain, as well as mental stress.
Cholecystokin grani do not diminish the role in the reduction of the sitosti, not leptin.
A handful of fahivtsi were respected, as the SCC took its part in the regulation of the robotics of the intestinal peristalsis. However, by an unprecedented experimental path, the bulo was established, so that the hormone is circulated into the intestine - one of the main informants in the brain about those who are well fed enough and the meal can be completed. Qiu zh funktsіu vikonuyut peptides YY, yaki:
Pour into the bloody nerve;
... vplyuyut on the hypothalamus.
Activation of the synthesis of the given hormone is released as fat and singular amino acids get into the small intestine. Secrets the CCM to connect to the receptors of the bloating nerve and transmit information about the suppression of hunger.
Cholecystokinin and psyche: why can't you eat fats
Revision of the normal level of cholecystokinin in the body is associated with damage for the sake of the name of the causeless panic. They showed the experiment for the participation of volunteers in 1989, to a young person And the most widespread reason for this damage is a genetic defect, as a result of which people become sensitive to the injection of CCM.
It is not recommended to use a fatty skin for the obvious reasons. Experiments carried out on the greenbacks have shown that it is trivial to be overwhelmed in a fatty race to rob older creatures that are more anxious and fearful. It is linked to changes in the transcription factor CREB, which activates genes that regulate the synthesis of dopamine (in response to satisfaction) and corticosterone (included in the number of hormones in stress).
With such a rank, winikє close the colo: what is fatty їzha, tim gostrіshe stress; Chim Gastrish Stress, Tim More Fatty Is Needed for Wikid Dopamine.
Yakshcho try to interrupt the price and quickly adapt to the fat, struggling with the stress of the age more importantly through marriage to the dopamine. Mozhlvo, tse viciously, for one of the reasons, it is difficult to get thinner.
The role of cholecystokinin in the formulation and elimination of deposits
Cholecystokininu attached to the power of antidepressants. The amount of the given hormone is determined by the behavior and mood of the people. Oskіlki cholecystokіnіn zdatnіyuvati overlіvіvі wikidi dopamіnu, wіn take part in the mechanisms of wine, which is one of the storage formations of deposits.
With a decrease in the level of cholecystokinin, lyudin has more schilations to the level of addictive words (alcohol, drugs).
Cholecystokinin normalization of neurochemical processes in the brain and decrease in turnover and triviality of abstinence from thinking and from adjective speech. Tom yogo vikorystyuyut in drug addiction.
Yak optimizuvatie virobleniya cholecystokininu for help
From the same time, mi z'yasuvali, what a normal level of cholecystokinin - it is healthier to see weed, sleep, smothering the form of deposits, normal kharchova behavior and the psyche is healthy. How can you prevent the release of cholecystokinin according to the norms?
Remember: Adequate amount of fat is a lot, garnishing mood and stress. An excess of fat (especially LPVSH) - the strength to addictions, the lack of coping with stress and moodiness.
1. Build Vibers for Cinnamon Omega-3 Fatty Acids, Be careful not to mess with omega-6 (read the report in our article).
2. You can't call without fat: Enough of all a small number of brown fats, so much more than a little bit of brown fats, but I didn’t see much more, however, more often than not, from a fat woman, only to go overboard (before such a visit, Harvard volunteered to participate in the result)
3. Follow the mood: a short-term view of fat in case of acne to people who are sick to the point of anxiety and panic camps, a potential reason for some of the changes in the normal level of cholecystokin in the body.
4. Products that disperse fatty acids that are fatty acids that stimulate the production of SCCs: coconut oil, fatty fats, olive oil.
5. Don't forget about greens and vegetables: greens and vegetables, a lot of crumbs, have long seen their good health to drive an appetite. Tilakoindi, wow to take revenge in cabbage and spinach, to drive me to hunger and drink more and more.
Support, information, a website has been provided, to help you achieve a healthy and balanced harvesting regime. Do not forget that it’s the most important thing to consume your body in a quiet and lively talk and develop an effective plan for a leaner, more qualified doctor!
Ecology of living. Health: Yak vіdomo, everything is kind in the world. To that, vicorize the power of fat in a reasonable way, due to the urahuvannya of your individual features ...
Today I will discuss one intestinal hormone - cholecystokinin.
Yogo vision stimulates fat and wine and has an even more important role in harnessing, the whole process can be easily inserted into other food.
You are good, the red hormone will also give you a feeling of peace and sleep.
So scho, "druzhish with fats - druzhish with the head."
Zrozumilo, I will tell you about those who, like their hankuvannyam, fit into the yogo rіven.
Cholecystokinin (pancreozymin, CCK) is a neurotransmitter peptide that regulates the reaction of humans in physiological acts. Cholecystokinin manifestations in the brain and equanimity systems of food and people. The CCK-A receptor stimulates the speed of the chewing gum, and the CCK-B receptor plays a role in the regulation of mental stress, fear and pain. Vіn galmuє harchovі motivation, the destruction of its viroblennya can also lead to the wrong robot michur і the destruction of the good gut in two-fingered gut, and in the zagalniy ruin the robot shlunkovo-intestinal tract.
The head informant for the brain about the city
For a long time, we were thinking: what kind of brain can there be in what kind of "food" and "energetic" organism is there? The first information was rejected by the Americans James Gibbs, Robert Young and Gerard Smit - all three were given cholecystokinin (CCK). The whole hormone, like a virobly, two-twelve-fingered intestine, even if it was a vidomy - they knew how to regulate the robot's slurry and fast slurry. Ale viyavilosya, scho, like a hormone in a pure viglyadi to give schuras in front of a horse, the stench is much less significant.
Naturally, a thought was born, which hormones, how to vibrate by the intestinal tract for every hour, inform the brain about the number of people and about those, if it’s time to stop.
If you have seen more and some words that can also be synthesized in the intestines and drive you a little hunger, for example, peptides YY or PYY. Stink from two sides: on the bloody nerve, which is the bottom herbal tract and the brain, and even on the hypothalamus, where the stink is consumed with blood. Ale naygolovnіshe speech - tse, zvychayno, cholecystokinіn. Wine is infused into the food behavior of the people, they are vicious because of the situation and control their appetite.
Cholecystokinin: shlunkovo - zhovchno - intestinal coordinator
Stimulates the appearance of cholecystokinin in fat and amino acids. Cholecystokinin causes the emptying of the slurry and changes in the appearance of hydrochloric acid. Also, I will stimulate pidshlunkovy zalozu i stimulating the vision of herbal enzymes, vidіlennya zhovchі and fast zhovchny mіkhura, relaxes the sphіnkterі zhovchnyh ducts.
Cholecystokinin actively stimulates the vagus, which is very intense. If lively speech from a given reason, I will activate the receptor in the small intestine, the type of clitin, the secretion of the intestinal dilation, the secretion of the hormone cholecystokinin.
Cholecystokinin to bind to receptors on the ends of neurons to pass near the bloating nerve, flashing electrical pulses, which are transmitted to prodovuvaty brain For the day, I will call it “the nucleus of a solitary way” (lat .: Nucleus tractus solitarius), which will reduce the appetite and change the amount of food, which will help you.
Cholecystokinin (CKK) and mental strength.
Yak is not marvelous, ale cholecystokinin is also called "panic hormone". If you are aware of it, like "a causeless panic", so the axis of people with a central problem, the level of cholecystokinin, is meaningfully changing the norm. And the people are hungry to reach the smallest number of the population of the earth - from 2 to 4%, it is important to develop the disease in young people, in women twice as often, but not in choloviks. For the treatment of the central ailment, special drugs-tranquilizers are used to reduce the panic hormone.
In 1984, Jens Rehfeld discovered that the peptide, which was administered to healthy volunteers, did not respond to anxiety or panics (Rehfeld and Van Solinge, 1992). The central receptor of CCK at a great concentration grows in the areas of the central nervous system, taking a part in the form of anxiety. Biological development of a subtype of receptors in fields in the modulation of a number of classical neuromediators (including endogenous opiates and dopamine) and control bagatokh central functions... Transmitting changes in the activity of the cholecystokinergic system (CCK-system), whether there is hypersensitivity of CCK receptors to internal receptors, connected with cystic receptors, and also 1994; Shlik et al., 1997).
Chronic excess fatty іzhі and permanently adjustments cholecystokininu is not safe. For example, after sitting on a fat one, the grizzlies became more anxious, more protective, respected for being more beautiful, and not being able to tell the new territory. It was found that in the brain of such targets there is a high level of transcription factor CREB, which is responsible for the activation of genes that are responsible for the synthesis of dopamine and corticosterone. Dopamine, yak vidomo, pratsyuє in neural lancers, knitted for a lot of satisfaction, and corticosterone is one of the stress hormones.
With such a rank, behind the words of the pre-eminent, it is necessary to start offensive: the organism starts to survive the stress better, and the stress spontaneously is greater than that, the dopamic people are satisfied with the stress. Chim fatter, we get the brain more than dopamine, and we will be stressed out. As soon as Lyudin is quick to swallow, immediately switch to a healthy child, it will be difficult for you: surplus of stress hormone will be, as it is called, squeezed on the head, and rivin is dopamine, as if it is a bit of stress to keep it low. It is possible, for the very fact that there are a lot of people with an overwhelming vagina, it is so important to lose weight.
Cholecystokinin and dopamine, as well as all the nerves.
Besides, cholecystokinin acts as a regulator of behavioral physiological acts. MAK Vladyvosti antidepressants. I am aware of the fear and pathogenesis of schizophrenia. Both lack and excess of cholecystokinin reduce behavioral problems and attitudes.
Rivn cholecystokininu nadaє significantly infused into the mechanism of the "city" and additional help but also stykishe in the form of deposits. High level of cholecystokinin dressings with a greater style to "dopamine pastes". Cholecystokinin is also driven overwhelmingly to dopamine. It is important to synthesize cholecystokinin. Cholecystokinin vikoristovuyutsya in medical diagnostics and in the treatment of zakrem, stasis to stop the withdrawal syndrome in case of drug addiction.
Wonderful for a dream of cholecystokinin. Yak vіdomo, hunger, zokrema hormone hunger ghrelin, waking up and changing sleep. And the axis of cholecystokinin will drive the vision of warming and shorten sleep. On the other hand, cholecystokinin stimulates orexin neurons, but it doesn’t lead to sleep disturbance, but it’s deprived of calories to sleep. Cholecystokinin will podovzhu phase of sleep and reduce sleep.
Yak friendship with cholecystokinin
Yak vidomo, everything is good in the world. In this way, use the power of fat in a sensible way because of your individual characteristics. Remember, on the right it is not only in the fat itself, but rather in its warehouse.Unique omega-6 fats.Fat can be captured for additional antioxidants in vegetables and greens. Adequate amount of fat is a whole lot of mood, stress and efficiency and satisfaction. An excess of fat, especially a high degree of fat (confectionery) - the chain is rotten.
1. Znezhirena їzha to produce to a significant loss of nasichenya.
Representatives of the Harvard School of Community Health put on the butt of powerless experiments, which showed that people who switched to products with low fat content, did not allow themselves to be healthy and didn’t make them healthier for a long time. for a high fat content. Food products are not vicious for us. The stench will quickly get into the intestines, and you see hunger after a ten hour of eating. In addition, your fondness for the fact that "light" yoghurt or sir does not shrink your figurines, you can lead to a permanent change.
2. Stimulants of the secretion of cholecystokinin є entrants into the small intestine from the slunk in the storehouse of chemus, bins, fats, especially from the presence of fatty acids in a lancet, warehousing components zhovchoginnyh herbs(Alkaloids, protopin, sanguinarin, essential oilsі ін.), acids (ale not in carbohydrates).
3. Insure injecting cholecystokin in the mood.
A short post without fat and heavy can often reduce anxiety and strength to panic. It is scientifically established that it is zanadno fatty refined їzha to produce an expanded malignant microflora in the traditional system. Experiments, carried out on laboratory greens, revealed the presence of obtrusive behavior, a persistent impression of anxiety and loss of memory from the number of living fat.
4. Pick the right fats (fatty acids and lantsyug) to stimulate cholecystokinin.
Most stimulate the appearance of cholecystokinin fatty acids and dry lance, 10-18 in carbohydrate fats (fatty acids of the lancet 10-18), that is why the stench stimulates cholecystokinin the most, as well as low appetite. For example, price coconut butter, ghee, vershok butter, cow fat. Fatty acids and lancers (LCFA) can be found in 10 to 18 atoms in carbon, can be saturated, monounsaturated and polyunsaturated.
stearic acid- tse eighteen-carbon fatty acid is saturated, it grows, in the main, in melted fat of yalovich and mutton.
oleic acid- tse eighteen-carbon monounsaturated fatty acid, the main component in olive oil.
Insha monounsaturated fatty acid - ce palm / toleic acid with high antibacterial powers. To be consumed vicly in food fats.
5. More green and vegetables.
Everything is greener (there de є chlorophyll) and vegetables (klitkovina) potential, meaningfully podvzhuyut to cholecystokinin. Until then, show that the thylakoid of the green cell membranes (be it) stimulate the robot's cholecystokin and efficiently drive the appetite. Thylakoid stimulate the secretion of hormones in the cell, cholecystokinin and leptin, and also reduce the level of insulin, not changing the level of glucose. bagata live rhymes greens, such yak cabbage and spinach, to take the so-called tylakoids, like, on the thought of the previous ones from the University of Lund at the Shvetsia, Reduce the perception of hunger and help us to see ourselves as we are. published
© NЄMTSOV L.M., 2014
Pathophysiological and CLINIC-DIAGNOSTIC VALUE OF cholecystokinin for bilious pathology
Nєmtsov L.M.
EE "Vitebsk State of the Order of Friendship of the People of the Medical University", Republic of Bilorus
In the survey, there are presented pre-medical reports on the pathophysiological and clinical-diagnostic significance of cholecystokin in patients with bilious pathology, including those of the author of this statute. Chole-cystokinin (CCK) є the best humoral stimulus for the quickening of the chewing moth and relaxation of the sphinkter Oddi from the visions of the female in the education of the small intestine.
About the level of CCK in blood plasma in case of bilious pathology (bilious dysfunction, cholelitis, chronic cholecystitis) To achieve the super-specific, in the protest part of the patients, the resistance of the ruminant to SSC, so that the stimulated concentration of SSC in the blood plasma changes with the change in the efficiency of the evacuator. Mozhlivі mehanіzmi rezistentnostі zhovchnogo mіhura i sfіnktera Oddі to CCK vklyuchayut znizhennya kіlkostі CCK-retseptorіv defect CCK-A retseptorіv i peredachі signal in poєdnannі of abnormally vіdpovіdyami on okislyuvalny Stresa i zapalnі medіatori, toxic exposure The kontsentrovanih rozchinenih zhovchnih rechovin, leyomіopatіyu zhovchnogo mіhura i sfіnktera Oddі ...
Changes in the concentration of SSC in blood plasma in case of bilious pathology, nonspecific and may be interrupted diagnostic value So, as it is necessary to ensure the possibility of the possible pathology, as a result of the overwhelming or lack of SCC secretion. At klіnіchnih tsіlyah is synthetic analog of CCK-8 Mauger Buti vikoristany for otsіnki skorotlivostі zhovchnogo mіhura pid hour holestsіntіgra-fії s99shTe, yak stimulator at manometrichnomu doslіdzhennі funktsії sfіnktera Oddі and takozh for otrimannya duodenal aspіratu zrazka kontsentrovanoї zhovchі i Yogo analіzu on mіkrokristali (bіlіarny sludge) and biochemical dosage (cholesterol, salts of malt acids, phospholipids). Key words: biliary pathology, diagnostics, cholecystokinin.
This review presents the studies on pathophysiological and clinical-diagnostic value of cholecystokinin (CCK) in biliary pathology, including research data of the author of this article. CCK is the most potent humoral stimulus of the gallbladder contraction and relaxation of the sphincter of Oddi with the release of bile into the lumen of the small intestine.
Information about the blood plasma level of CCK in biliary pathology (biliary dysfunction, cholelithiasis, chronic cholecystitis) is rather controversial, but in a certain part of patients there is the gallbladder resistance to CCK, manifested by the increase of stimulated blood plasma CCK concentration and decreased effectiveness of the evacuation function of the gallbladder.
Possible mechanisms of the gallbladder and sphincter of Oddi resistance to CCK include reducing the number of CCK-receptors, defects of CCK-A receptors and signal transduction in combination with abnormal response to oxidative stress and inflammatory mediators, toxic effect of concentrated dissolved bile substances, leiomyopathy of the gallbladder and sphincter of Oddi.
Changes of the blood plasma CCK concentration in biliary pathology are nonspecific and their diagnostic value is limited, since it is necessary to consider the possibility of other pathology resulting from excessive or inadequate secretion of CCK. For clinical purposes synthetic analogue CCK-8 can be used to assess the gallbladder contractility during cholescintigraphy with 99mTc, and as a stimulator in manometric study of the sphincter of Oddi function, as well as for obtaining duodenal aspirate of a concentrated bile sample and its microcrystals analysis (biliary sludge) and biochemical study (cholesterol, bile salts, phospholipids).
Key words: biliary pathology, diagnosis, cholecystokinin. eleven
cholecystokinin
Cholecystokinin (CCK, the old name is pancreozymin) is a group of similar peptides, which have a specific hormonal activity in the herbal nervous systems(CNS).
E.K. Ivy (A.C. Ivy) і E. Oldberg (E. Oldberg) in 1928 vyavili in dogs in the extract of mucous membrane small intestine Regulatory peptide Tsei peptide, wandering from the power, the preachers called "cholecysto-kinin" (in Greek. Choly - zhovch, kystis - mikhur і kieo - ruhati). A.A. Harper (A.A. Harper) і H.C. Raper (H.S. Raper) in 1943 saw a peptide from the mucous membrane of the small intestine, which stimulates pancreatic secretion and called it "pancreozymin" for quality. In 1964, from the mucous membrane of the small intestine, there was a high purification of the peptide, which accumulated from 33 amino acid surpluses and the activity of SSC and pancreozymin.
Prescription, assignment of SSC, become relevant and in this hour due to the widespread and medical and social significance of pancreatobiliary pathology, and on the basis of evidence about the role of SSC in the regulation of intestinal motility , I will participate in the control of pain and behavior as a neurotransmitter in the control of pain and behavior, in the intake of drugs in the SCC with the help of diagnostics and scientific diagnostics.
Khimichna Budova
CCK is a family of hormones, which value for a number of amino acids, for example CCK-58, CCK-33 and CCK-8
Recognize the SSC and its biologically active fragments as a chemical synthesis or see from the mucous membrane of the small intestine of the creature. Molecular forms ranging in size from 4 to 83 amino acids boules identified in tissues and blood with a re-absorbable molecular form CCK-58,
older CCK-8 and CCK-33. In the intestinal mucosa, there are 3 molecular forms of SSC, which are developed for a few amino acid surpluses (SSC-8, SSC-12 and SSC-ZZ). They have 60-70% of the attack on SSK-8.
All forms of CCK are produced by one and the same gene of post-translational modifications of the prehormone CCK - precholecistokinin, which is stored from 95 amino acid surpluses. All molecular forms of CCK may be active as dilyanka, rosted between the first eight amino acids from carboxylic acids and from a sulfate group to a large excess of tyrosine. Even better for the structure of SSC and gastrin, more than one of the gastrointestinal hormones, which may be one and five amino acids in carboxylic ends. The main biological activity is stored in CCK-8 (8 amino acids), ale peptides 33, 38 and 59 amino acids are also biologically active. All CCK peptides have an excess of tyrosine in the 7th position as a sulfate, which is necessary for biological activity. Desulfurization to produce the biologic activity of the peptide until it is lost. Three-point decapeptide and octapeptide fragments, rendered synthetically, may be approximately 10-15 and 5-7 times more biological activity, less SSK.
Rozpodil SSK in the body and concentration in the blood
In the intestinal tract, CCK is produced by endocrine I-cells of the mucous membrane of the small intestine, the head, in the twelve-fingered intestine - 11-30 clitin-producing CCC per mm2. Rozpodil CCK in the organs of the herbal system: the most - in the twelvefold empty intestines- up to 26.5 pmol / g; lower - in the ileal intestine and antral cavity of the slunk - 2.5-3.0 pmol / g; and in the lower part - in the slurry zone, stravochannel, fundal viddili slunk, in the intestine - close to 0.6 pmol / g.
CCK concentration behind the CCK-26-33 peptide in blood plasma healthy people on the heart in the presence of the vicious method to become 1.13 ± 0.10 pmol / l (IPA) to 8.0 ± 6.3 pmol / l (PIA). converting
Lada with the form of SSK in blood plasma є SSK 26-33.
It was established that there are no significant indications of the concentration of SSK in the blood plasma, as well as there are no significant indications of the concentration of SSK in women in the development period. menstrual cycle... Ogarenie people are tied to the advancement of the basal and stimulated intake of fatty and fatty concentrations of CCK in the blood plasma. From the blood of the SSC can be consumed through the nirki in the cut, saving with a whole biological activity (uroholecistokі-nin).
CCK is produced in the neurons of the enteric nervous system, in the enteroendocrine cells STC-1. CCK is also synthesized in neurons of the central and peripheral nervous systems, playing the role of a neurotransmitter and modulator.
Recipe before CCK
CCK and gastrin are competitively linked to CCK receptors. Primed on їх links, CCK-receptors are classified into three main groups. CCK-A-receptor (alimentary type, CCK-1-receptor) appears in the smooth tissues of the gastrointestinal tract and the intestinal tract, acinar cells of the intestinal tract, D-cells of the slurry, nerve cells Shlunkovo-intestinal tract, bezposredno in the bloating nerve, as well as in the other parts of the central nervous system. The disparity of cich receptors to CCK is significantly lower (in 500-1000 times), lower disparity to gastrin.
CCK-B-receptor (brain type, cerebral type, CCK-2-receptor) may spore up to CCK 10 times more, less spore rate to gastrin. The stench is in a re-absorbed form in the brain and the intestinal tract, and is also presented in the smooth tissues of the gallbladder. The third type of receptor is the gastrin receptor and is found in the parietal and smooth cells of the slunk. Yogo healthiness with CCK is not so tight, not with gastrin. The CCK-B receptor and gastrin receptor are often named spially as the CCK-B receptor for gastrin through genetic homology.
Linking with CCK-A receptors vimag, a surplus of tyrosine heptapeptide amid buv sulfatovanikh, todi yak
CCK-B-receptor You will not be killed by sulfate-baths CCK and non-sulfated peptides, so CCK peptides and gastrin.
Secretion and physiological efficiency of SSK in the biological system
The main stimulants of the production of CCK I-cells in the upper third of the small intestine are the blood and fat, and the hormone gastrin-rilizing peptide is also the hormone gastrin-releasing peptide. One of the endogenous factors that stimulate the secretion of CCK is the trip-syn-sensitive CCK-releasing peptide, which is vivilnya in the cicatricial zone, the vidomium, which is also the monitor peptide (Monitor peptide, MP). The chain peptide interacts without a middle with I-cells, signaling the CCK vision for the growth of internal calcium.
I-cells release CCK into the bloodstream, if the chyme with a high amount of frequent digestion of fats and white fatty acids, especially high-lance fatty acids, storage components of the antioxidant rosins (alkaline) The SSC from the blood quickly goes to the central nervous system, the corkscrew, the stove, and the creeper. SSC sponujes gallbladder to fast and visible zhovchy in the small intestine, and the lactic acidosis - to visible enzymes. Enzymes of the slurry zolozi and zhovch through the ducts are seen in the intestine two to twenty digits, so that the molecules themselves are overdriven and soaked, which stimulate the secretion of CCK. With such a rank, if soaking up will be completed, the secretion of CCK will be attached.
SSK viklikє zupinku emptying the shlunka for the help of the speed of the pyloric sphincter, and also lowering the tone of the cardiac sphincter. Then there is a change in the role of a neurotransmitter in the central nervous system, and it is a reaction to the presence of the system. SSC signals about the improvement of bile formation and about the appearance of herbal enzymes. In addition, SSC stimulates intestinal motility and sprouting of the lactic acidosis.
Acceptance of їzhі wiklikє spilling of the gallbladder by 75% of the cob volume (and more)
cholecystokinin
yang SSK for the participation of nerve mechanisms (central and muscle gastroduodenal reflexes), which is realized through cholinergic nerves. In healthy people, there is a normal correlation between the concentration of SSC in the blood plasma and in the bulk of the gallbladder. It was revealed that there is a lineage of fallowness between the stimulated by the growth of SSC and the rapidity of the vision of the muscular woman.
Non-adrenergic non-cholinergic nerves wick the relaxation of the sphincter Oddi (CO), see the vasoactive intestinal peptide (VIP) and nitrogen oxide, which is responsible for post-ganglionic neurotransmission. According to the data, SSK wicks relaxation of CO through the mechanism of dressing with nitrogen oxide, increased internal concentration of cAMP and cGMP.
Mensh virazhenim, nіzh in SSK, Cholek-genetic dієu volodyut gastrin, secretin, glucagon, motilin, bombesin, histamin, estrogen; at the same hour, neurotensin, ВІП, enkephalini, somatostatin, angiotensin, distal intestinal hormone peptide YY (PYY) galvate fast ZhP.
The nervous systems of the CCK have the role of a neurotransmitter or a modulator. Innervation of the bilious tract will prevent the vagal eferent nerves, which are seen by acetylcholine; nice fibers that see norepinephrine; and sensitive (sensory) nerves. SSK is injected onto the vegetative neurons in the ZhP and CO. In the ZhP SSK are presynaptic on cholinergic neurons. The CCK-A receptor has been shown to be of the middle type in the bloating nerve, as it is in the gallbladder. Vvazhayut, that postprandial CCK-induction of the speed of the gastrointestinal tract is wicked through the CCK-A-receptor on the blistering nerve by the way of stimulation of the vision of acetylcholine and in the ventricular at an average stimulation of the meazy speed.
At the same hour, 11 types of peptidergic nerve fibers were detected in the gallbladder and CO, including CCK / gastrin - as well as somato-statin-, PP (pancreatic polypeptide), PYY- (peptide YY), NPY- (neuropeptide Y ), VIP- (ВІП), GIP- (shlunkovy ingibitorny peptide), neurotensin-, substance P, serotonin and galanin- immunoreactivity of nerve fibers. SSK is also active without pre-mediated non-holinergic non-adrenergic
nya inhibitory pathways (NANC, nonadrenergic non-cholinergic inhibitory pathways) in CO, reducing both thin and phase peristaltic speed.
In such a rank, the onset of the physiological effects of SSK in the biliary systems є CNS-mediated - the speed of the life cycle for the additional SSK-induction of acetylcholine, and relaxation of the SS, which is mediated by the CCC-reduction.
Clinical meaning of changes in CVC in blood plasma of patients with bilious pathology
C. Ruixin and the authors (2004) established that the level of CCK-8 in the blood plasma of patients with cholelithiasis was significant in the control group (42.91 ± 2.88 pmol / l vs 31.50 ± 1.62 pmol / l, p<0,05). После холецистэктомии уровни ССК снизились до 34,21±2,56 пмоль/л (p<0,05).
According to the data, in patients with grub ailments (housing and communal services) with normal evacuation health, there was a decrease in the stimulated secretion of the CCK, at the same time, there was an increase in the sensitivity of the blood smooth muscle stimulation. In patients with cholecystolithiasis due to a decrease in the evacuation health of the gallbladder, with normal stimulated secretion of the CCK, the motility of the gallbladder was reduced, so to indicate a decrease in the sensitivity of the smooth-running apparatus.
Changes in the concentration of SSK-8 (decrease) and VIP (pidyom) in syrovatz blood can be important causes of CO dysfunction and play a role in the form of concrements of gallbladder. Prior to this, the possibility of a paradoxical reaction of the sphinkter's apparatus to the infusion of physiological doses of CCK in the eyes of the spasm of CO, abnormally fast duct, was evident. SSC wiklikє fast-flowing gallbladder, at the same hour of the eye the concentration in the blood plasma of the gallbladder is spilled.
For the determination of the functional distributions of ZhP and CO, there can be a significant change in the stimulated secretion of the CCK and
VISNIK VSMU, 2014 rock, VOL. 13, No. 4
sensitiveness to the CCK of the nerve-meat apparatus of the zhovchidilnoy system.
Behind the author's vigorous data, I will look around, from the hour of the cholekinetic test with sorbitol until the moment of the maximum speed of the LP (in the middle after 30 minutes the intake is taken in the middle of 20.0 g of sorbitol, dispensed in 100 ml of water), it is statistically significant (p<0,001) повышение концентрации CCK в плазме крови как у обследованных пациентов с заболеваниями билиарной системы (ЖКБ, хронический некалькулезный холецистит, дисфункция ЖП), так и в контрольной группе. Показатели как базальной (утром натощак), так и стимулированной концентрации ССК в плазме крови не имели статистически значимых различий с контрольной группой и в подгруппах пациентов, сформированных как по диагнозу билиарной патологии, так и по характеру опорожнения ЖП. У пациентов с гипокинетической дискинезией ЖП обнаружено повышение стимулированной концентрации CCK в плазме крови в сочетании с повышением порога ответа ЖП к приросту концентрации CCK, по сравнению с контрольной группой (p<0,01) и пациентами с сохраненной моторно-эвакуаторной функцией ЖП (p=0,005).
The sensitivity of the neuromuscular apparatus of the gastrointestinal tract and of the sphincter apparatus of the gastrointestinal tract before SSK is associated with the variability of the clinical manifestation of bilious pathology (housing and communal services, chronic noncalculous cholecystitis, dysfunction of the gallbladder). For patients with a seven-second variant of the clinical manifestation of bilious pathology, in the case of a low-symptom variant, characteristic (p<0,05) более высокая частота гипокинезии ЖП в сочетании с повышением стимулированной концентрации ССК в плазме крови и повышением порога ответа ЖП к повышению концентрации CCK в плазме крови . Следовательно, у пациентов с симптомным вариантом клинической манифестации, как и у пациентов с гипокинетической дискинезией, возникает резистентность нейро-мышечного аппарата ЖП к повышению концентрации CCK в плазме крови .
The data of the cluster analysis are statistically significant associations (p<0,05) ответа ЖП на увеличение концентрации ССК со следуюшими клинико-
laboratory characteristics of patients with bilious pathology (housing and communal services, chronic noncalculous cholecystitis, dysfunction of the gastrointestinal tract) - clinically symptomatic (pain syndrome); efficiency of spraying of gallbladder; tovshchinoyu stinki ZhP; the functional activity of the suprasegmental and segmental ravines of vegetative regulation.
Possible mechanisms of GB resistance to SSK were analyzed by Portincasa P., Di Ciaula A., van Berge-Henegouwen G.P. (2004). Epithelium and smooth muscles of the gallbladder are fed into the concentration of gum rhythams, including cholesterol and potentially toxic hydrophobic salts of gum acids, which are good to be poured into the gum. The impairment of speed of smooth muscles and / or relaxation of the gallbladder in cholesterol stones can be associated with gallbladder leiomyopathy. There may be a shortage of CCK-A receptor defects and signal transmission in response to abnormal responses to oxidative stress and ignition mediators. Abnormal speed of smooth muscles, impaired motility of the gallbladder and increased stagnation are key factors in the pathogenesis of cholesterol gum stones.
One of the mechanisms of the SSK-resistance of GB is the reduction of the number of SSK receptors. Based on the results of the immunogistological and infrastructural awareness of patients with cholecystectomy of female mice, a correlation was established for the number of SSK receptors in the patient's stomach with the speedy function of patients in the housing and communal services sector. The change in the number of receptors in the SSC can be an early stage in the pathogenesis of stones in the gallbladder, and there is a decrease in gallbladder motility in patients.
Established a decrease in the mediator function of prostaglandin F2 in the implementation of SSK on GB with hypokinetic dysfunction of GB. There are also indications of the sensitization of lymphocytes to the SSK, which can lead to the accumulation of antibodies to the same peptide and leads to the formation of cholecystocyte deficiency.
At the level of CCK secretion and characteristics of bilious dysfunction in the inflow of pathology of the organs of the pancreatoduodenal zone and the stun of the slunk - the speed of evacuation
cholecystokinin
instead, the acidity of the shlunk juice, the upper form of the small intestine and the gallbladder itself. An important role in the development of gallbladder and gallstones dysfunction is to trace the endogenous deficiencies in the education of the SSC, and to be spared in case of malignant duodenal infections, celiac disease, in some cases with duodenitis. Disruption of the release of releasing factors in cases of malnutrition and proximal small intestine can be one of the mechanisms in the development of motor dysfunction of the bilious tract.
Infused with an increase in progesterone on the sensitivity of the gallbladder to the SSK and the function of the SB, it is possible to explain the meaning of the females of the middle of the patients with the functional deterioration of the biological system.
Also, in view of the interconnection between the CCK secretion and the motor-evacuation function of the fatty tissue and the fatty tissue in patients with bilious pathology, they have an irreconcilable character and the singing world is superb. We can increase the mechanisms of gallbladder dysfunction to recognize the resistance of gallbladder and CO to SSC for an absolute decrease in the number of SSC receptors, as well as a decrease in sensitivity to SSC of neuromuscular deficiency in life and CO, as well as accumulation of autoantitils up to SSK.
The value of CVC in the diagnosis of bilious pathology
The level of CCK-8 in the blood plasma of patients with cholelithiasis can be an additional marker for clinical diagnostics. For cholecystectomy, CVC significantly decreases (vs before surgery, p<0,05) .
concentration CCK<0,5 нг/мл косвенно свидетельствует о наличии гипертонуса СО, а при сочетании этого показателя с характерными клиническими проявлениями, изменениями биохимических показателей крови во время приступа, отсутствии органической патологии по данным ультразвукового исследования (УЗИ) и фиброэзофагогастродуоденоскопии
(FEGDS) to indicate the manifestation of dysfunction of the functional nature.
When assessing the concentration of SSC in the blood, it is necessary to reduce the possibility of a minor pathology, which is caused by an overwhelming or lack of SSC secretion. Deficiency of CCK in the descriptions in human organisms as a part of polyglandular autoimmune syndrome of type I, which manifests itself clinically as malabsorption syndrome in case of exocrine deficiency of the depressions. Low level of SSC descriptions in celiac disease, in patients with atrophic mucous membrane of the intestine and in the form of bulimia nervosa. In the last pre-sluggish children, with a ruptured grubby behavior, including anorexia nervosa, and in patients in the blood, an increase in SSK was found.
Increases in SSK boules have appeared in children with chronic pancreatitis, imovirno, in the case of a decrease in the secretion of enzymes in the flesh zone and altered regulation of the vocal ring. The concentration of SSC in the blood plasma is adjusted in patients with intestinal and intestinal infections and in patients with the syndrome of intestinal motility.
Vikoristannya drugs in SSK in the diagnosis of bilious pathology
Is synthetic analog of CCK-8 (sіnkalіd, sincalide), by fіzіologіchnіy dії vіdpovіdny natural octapeptide CCK-8 vikoristovuєtsya in klіnіchnih tsіlyah for otsіnki skorotlivostі gallbladder pid hour rent-genkontrastnoy cholecystography, ultrasonic doslіdzhennya abo holestsіntіgrafіі (gepatobіlіarnogo skanuvannya) s99mTc and takozh at otrimannі duodenal aspirate of a concentrated gum for microscopy on microcrystals and biochemical analysis for cholesterol, salts of human acids, phospholipids.
For the diagnosis of pain syndrome from bilious pathology, it was carried out in obscure drops of provocative test with CC ^ and also with vicious morphine in the face of prognosis (or lack of such a low
VISNIK VSMU, 2014 rock, VOL. 13, No. 4
and specificity. For viklyuchennya zahvoryuvan scho viklikayut podіbnі to bіlіarnoї disfunktsієyu klіnіchnі symptoms neobhіdno vikonannya skrinіngovih doslіdzhen: Holding pechіnkovih testіv, vimіryuvannya rіvnya fermentіv pіdshlunkovoї zalozi, holding ultrasonografії cherevnoї porozhnini, endoskopіchnoї retrogradnoї holangіopankreatografіya, holestsіntіgra-fії s99mTc, endoskopії shlunkovo-kishkovogo tract.
When an ultrasound aboradiopaque diagnostics of a gallbladder and a gallbladder is carried out, it is tied, first for everything, from the background of the standard diagnostics of cholecyte diagnostics.
As soon as there is a problem with patients with a typical disease of the bilious type, according to the description of the criteria of the Roman III consensus, then the viconati CCK-stimulated cholescyte-type of generalized malignancy, Cholesntigraphy of s99mTc on the basis of internal infusions of SSC with the most accurate method for assessing the stage of sponging of the gallbladder. The destruction of the spirits of the sphincter can be tied to a decrease in the speedy health of the sphincter or the increased support, for example, by the tone of the sphinkter's mihura and / or the sphinkter Odd. Pisle of infusion CCK is unavailable in case of cholecystitis. ZhP is used to treat cholecystitis; Patients, in some of the days of the type, are of the biliary type (in case of pain in the epigastrium and / or the right upper quadrant of the abdomen is 30 hvili;
SSK-stimulated cholescyntigra-phia allows the development of the faction of the wikid of the ZhP (GBEF). According to the data of the authors, the normal fraction of the wikidum (GBEF) should be set at least 35-40% - up to 90% maximum for 60-hiline infusion CCK at a dose of 0.02 ng / kg. yaksho paciєnti
I can diagnose a type of pain with a biliary type with a low fraction of the gallbladder (GBEF<40%), то диагноз функционального расстройства ЖП следует считать вероятным.
Hypothetically positive results of CCK-stimulated cholesteric graphy can be found in cases of incapacitation, in cases of decreased fertility - in case of diabetes, celiac disease, obesity, calcification of the liver, and some progression of the disease opia, benzodiazepini, atropin, octreotide and theophilin.
Treatment of biliary pain before an hour of SSK-stimulated cholescyntigraphy with a fraction of the wikidum of the stomach is less than 40% to prevent the diagnosis of BM dysfunction and CO to reach the imovirnym. The evidence of pain syndrome of intermittent internal infusion of the SCC requires the need for a pressure gauge and retrograde cholangiopan-creatography.
SSK-stimulated cholescyntigra-phia allows for a high degree of pre-cholecystectomy in patients with a painful biliary type. Patients are candidates for cholecystectomy, as the stinks are satisfying to the clinical criteria for the functional distribution of ZhP, as well as an alternative explanation of the symptoms in the bullet of the disease and as the faction of the wikis in the IVF (GBEF<40%) (уровень рекомендаций - 2В). Кроме того, некоторые пациенты с нормальным опорожнением ЖП и болью билиарного типа могут также извлечь пользу из операции. При этом необходимо отличать боль билиарного типа от ощущений при спазме гладкой мускулатуры ЖП, которые могут возникать при слишком быстрой инфузии ССК и прекращаются при замедлении либо остановке инфузии .
Renovation of clinical symptoms, but insist on SSK-provocation, overturning the value of reduced fraction of the wikidum (GBEF) for the diagnosis of chronic cholecystitis and the priming of the indication before cholecytectomy. Cholecystectomy is seen as a possible variant of treatment in patients with a typical disease of a bilious type and a normal fractional wikis of the ZhP
cholecystokinin
Because of this, the empirical methods of treating their illnesses (for example, therapy is important to the acid secretion) are not effective, and it is not effective in case of SSK infusion.
Lindholm E.B. і Spіvavtory (2013) showed in their preliminaries, that in case of hypercritical gastrointestinal tract (GBEF> 80%) in patients with type of biliary pain per hour CCK-stimulated cholecystitis-graphy
SSC stagnates in the quality of the stimulator with manometric dosage of CO, as it becomes the "gold standard" for diagnostics of CO dysfunction. In healthy patients, a lot of the introduction of the SSK is a decrease in the frequency and amplitude of the phase manometric pressure, as well as the basal grip of the CO. Insha reaction to the test for SSK є familiar with SO dysfunction. However, it is paradoxical to increase the grip of the sphinkter on the introduction of the SSC, for any analogs of the winery are far from all types, and at the same time lowering the informativeness of the given method.
The value of SSK for the development of methods of treatment
SSK is a very smart and hard-hitting cholekinetic day - an ear of fast fat in 1-2 minutes, maximum - 5-15 minutes, triviality of days - 2 years. However, SSK drugs were not known to be stagnant in clinical practice in cases of disease / disability, which are especially associated with pharmacological activity, since it is necessary to try internal infusion due to an The rate of efficiency is greater than that of a widespread infusion.
On the basis of the evolutionary mechanisms of the SSC in the capacity of the forced SSC-antagonist of the proponents of loxiglumide (loxiglumide), the efficiency of the latter in the case of an attack by a bilious type of bulwark has been demonstrated.
A description of the pharmacological power of the bagatoch ligand CCK-A receptors has been developed, the protein clinical potential
cial more than vn_styu vivcheniyu. Peptide analogs of CCK (JMV180, OPE, Ac-CCK-7 and іnshі), as well as agony of CCK-A-receptors, as well as non-peptide agonies of CCK-receptors, tiozol-1.5 ... It is important to develop large selective partial agonists and allosteric modulators of these receptors, which may play an important role in the sublimation of CVC-resistance of gastrointestinal tract and CO in cases of biliary pathology.
visnovok
SSC is the most tense humoral stimulus for speeding up the stomach and relaxation of the CO with the vision of the small intestine. Evidence of the level of CVS in the blood in case of bilious pathology to achieve a super-accurate, protein in a significant part of the patients is less resistant to GBS, which is manifested by an increase in stimulation of the stimulatory concentration of the CVS in the blood plasma. We increase the mechanisms of dysfunction of the gastrointestinal tract and CO, tolerate the resistance to CSC for an absolute decrease in the number of CSC receptors and / for the decrease in the sensitivity of the neuromuscular apparatus of the fat and CO, as well as the endogenous deficiency.
Is synthetic analog of CCK-8 Mauger Buti vikoristany for otsіnki skorotlivostі gallbladder pid hour holestsіntіgrafіі s99tTs, yak stimulator at manometrichnomu doslіdzhennі funktsії CO and takozh for otrimannya duodenal aspіratu zrazka kontsentrovanoї zhovchі i Yogo analіzu on mіkrokristali (bіlіarny sludge) i bіohіmіchnogo doslіdzhennya (cholesterol, solі gum acids, phospholipid).
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Nadіysla 08/27/2014. Accepted until 07.10.2014 r
Nєmtsov L.M. - Doctor of Medical Sciences, Associate Professor, Professor of the Department of Propedeutics of Internal Ailments of the EE "Vitebsk State Order of Friendship of the People of the Medical University".
Addresses for correspondence: Republic of Bilorus, 210027, m Vitebsk, Chernyakhovsky avenue, 20, bldg. 4,
apartment 51. Email: [Email protected]- Numtsov Leonid Mikhailovich. twenty
