Nws yog qhov tsim nyog rau kev txhaj tshuaj intrathecal thiab lwm txoj hauv kev kho mob (xws li kev siv tshuaj tua kab mob, kev kho mob ntxiv lossis cov ntaub qhwv) Ziconotide yog ib qho muaj zog, xaiv thiab thim rov qab N-hom voltage-rhiab calcium channel blocker, uas yog siv tau rau qhov mob refractory, thiab tsis tsim. tshuaj tiv thaiv tom qab kev tswj hwm mus ntev, thiab nws tsis ua rau lub cev thiab lub hlwb dependence, thiab tsis ua rau lub neej ua pa nyuaj siab vim yog overdose.Kev pom zoo txhua hnub koob tshuaj tsawg dua, nrog kev kho kom zoo, kev nyab xeeb siab, tsis tshua muaj kev phiv, tsis muaj tshuaj tiv thaiv thiab kev quav tshuaj.Cov khoom no muaj lub khw muag khoom loj loj li cov tshuaj tua kab mob.
Raws li kev txheeb cais tsis tiav, qhov tshwm sim ntawm qhov mob hauv ntiaj teb yog kwv yees li 35% ~ 45% tam sim no, thiab qhov tshwm sim ntawm qhov mob ntawm cov neeg laus yog qhov siab, txog 75% ~ 90%.Ib qho kev tshawb fawb Asmeskas qhia tau hais tias qhov tshwm sim ntawm migraine tau nce los ntawm 23.6 lab hauv 1989 mus rau 28 lab hauv 2001. Hauv kev tshawb nrhiav qhov mob ntev hauv rau lub nroog hauv Suav teb, pom tias qhov tshwm sim ntawm qhov mob ntev rau cov neeg laus yog 40%, thiab tus nqi kho mob yog 35%;Qhov tshwm sim ntawm qhov mob ntev hauv cov neeg laus yog 65% ~ 80%, thiab tus nqi mus ntsib kws kho mob yog 85%.Nyob rau hauv xyoo tas los no, cov nqi kho mob rau kev kho mob tau nce ib xyoos ib zaug.
Txij xyoo 2013 txog Lub Xya Hli 2015, Lub Chaw Tshawb Fawb Kev Mob hauv Tebchaws Meskas thiab ntau lub tsev kho mob tau ua qhov kev tshawb fawb ntev, ntau qhov chaw thiab kev soj ntsuam ntawm kev txhaj tshuaj ziconotide hauv 93 tus neeg laus cov poj niam dawb uas muaj mob hnyav.Qhov mob digital qhab nia ntsuas thiab tag nrho cov qhab nia ntawm cov neeg mob uas muaj kev txhaj tshuaj intrathecal ntawm ziconotide thiab tsis txhaj tshuaj ziconotide tau muab piv rau ntawm lawv, 51 cov neeg mob siv intrathecal txhaj ntawm ziconotide, thaum 42 tus neeg mob tsis ua.Cov qhab nia ntawm qhov mob hauv paus yog 7.4 thiab 7.9, feem.Qhov pom zoo koob tshuaj ntawm intrathecal txhaj ntawm ziconotide yog 0.5-2.4 mcg / hnub, uas tau hloov kho raws li tus neeg mob qhov mob thiab cov kev mob tshwm sim.Qhov nruab nrab thawj koob tshuaj yog 1.6 mcg / hnub, 3.0 mcg / hnub ntawm 6 lub hlis thiab 2.5 ntawm 9 lub hlis.Thaum 12 lub hlis, nws yog 1.9 mcg / hnub, thiab tom qab 6 lub hlis, qhov txo qis yog 29.4%, qhov sib piv nce tus nqi yog 6.4%, thiab kev txhim kho ntawm tag nrho cov qhab nia yog 69.2% thiab 35.7% feem.Tom qab 12 lub hlis, qhov txo qis yog 34.4% thiab 3.4% raws li, thiab kev txhim kho ntawm tag nrho cov qhab nia yog 85.7% thiab 71.4% feem.Qhov tshwm sim siab tshaj plaws yog xeev siab (19.6% thiab 7.1%), hnov qab (9.8% thiab 11.9%) thiab kiv taub hau (13.7% thiab 7.1%).Cov txiaj ntsig ntawm txoj kev tshawb no ib zaug tau lees paub qhov ua tau zoo thiab kev nyab xeeb ntawm ziconotide pom zoo ua thawj kab intrathecal txhaj.
Txoj kev tshawb fawb ua ntej ntawm ziconotide tuaj yeem taug qab rov qab mus rau xyoo 1980s, thaum muaj peev xwm kho tau cov tawv nqaij thiab cov protein zoo li peptides hauv conus venom tau tshawb pom thawj zaug.Cov conotoxins no yog me me peptides nplua nuj nyob rau hauv disulfide bonds, feem ntau 10-40 residues nyob rau hauv ntev, mus rau lub hom phiaj ntau yam ion channels, GPCR thiab transporter proteins zoo thiab xaiv.Ziconotide yog 25-peptide muab tau los ntawm Conus magus, uas muaj peb daim ntawv cog lus disulfide, thiab nws luv luv β-fold yog spatially teem rau hauv cov qauv peb-dimensional, uas tso cai rau nws xaiv inhibit CaV2.2 raws.
