Okuqukethwe
Imiphumela yokuhlaziywa kwe-biochemical, ekhombisa izinga le-cholesterol egazini, ivumela uchwepheshe ukuba anikeze imithi efanele. Ama-statins avame ukutuswa ukuvimbela izinkinga zenhliziyo kuleli cala.
Ngokuvamile, udokotela ohambelayo, echaza izimali ezinjalo, ngokushesha uxwayisa isiguli ukuthi kufanele sithathwe ngaphandle kwekhefu elide. Ngaphezu kwalokho, njengezinye izidakamizwa, ama-statin anemiphumela emibi ehlukahlukene emzimbeni. Isiguli kufanele sicacise leli phuzu ngesikhathi sokuqokwa nodokotela waso. Phela, umsebenzi oyinhloko nge-cholesterol ephezulu ukunciphisa izinga layo. Umphumela utholakala ngosizo lokwelashwa kwezidakamizwa. Nokho, ingabe kufanele kuqalwe imithi kuzo zonke izimo? Ingabe umphumela oyifunayo uzotholakala ngosizo lwabo?
Kusho okuyingxenye yeqembu lama-fibrate noma ama-statins ehlisa i-cholesterol. Ungathuthukisa umphumela wabo ngokuthatha kanyekanye i-lipoic acid ne-Omega-3 fatty acids. Lesi sihloko sinikezwe izidakamizwa ze-pharmacological ezinciphisa i-cholesterol, izici zokusetshenziswa kwazo nemiphumela emibi.
Ukwehlisa i-Cholesterol nge-Statins
Iqembu le-pharmacological lama-statins lihlanganisa izidakamizwa ezinhloso yazo enkulu ukunciphisa ukukhululwa kwama-enzyme athile abandakanyeka ekuhlanganiseni kwe-cholesterol.
Encazelweni yale mithi namaphilisi, izici ezilandelayo zinikezwa:
Basebenza njenge-inhibitor ngokumelene ne-HMG-CoA reductase, ngaleyo ndlela behlisa i-cholesterol, behlisa ukukhiqizwa kwayo;
Basebenza ngisho nalapho kukhona izidakamizwa ezingapheli ezihambisana nazo. Isibonelo, i-homozygous yomndeni hypercholesterolemia ngeke ithinte ukusebenza kwama-statins;
Yiba nomphumela omuhle emisipha yenhliziyo, unciphise amathuba okuhlaselwa yinhliziyo kanye ne-angina pectoris;
Ngemuva kokuthatha izidakamizwa, i-HDL-cholesterol ne-apolipoproteinA ukwanda kwegazi;
Ngokungafani nezinye izidakamizwa eziningi, ama-statins awawona ama-mutagenic noma ama-carcinogenic.
Akuzona njalo izidakamizwa eziwusizo emzimbeni. I-Statins ingadala imiphumela emibi elandelayo:
Ukuqwasha, ikhanda, isicanucanu, isifo sohudo, myalgia;
I-amnesia, i-malaise, i-hypesthesia, i-neuropathy, i-paresthesia;
Ukungakhululeki emisipha emuva, imilenze, myopathy, ukudlikizela;
Ukuhlanza, i-anorexia, i-cholestatic jaundice;
Ukusabela okweqile, okubonakaliswa ukuqubuka kwesikhumba nokuluma, i-urticaria, i-anaphylaxis, i-erythema exudative;
Ukwehla kushukela wegazi, okufaka isandla ekwakhiweni kwesifo sikashukela kanye ne-hypoglycemia;
Ukukhuluphala ngokweqile;
ukukhula kokungabi namandla.
Lapho ama-statins abalulekile?
Izincazelo zama-statins amaningi ziqukethe imininingwane ekhombisa izakhiwo ezizuzisayo zezidakamizwa. Ukunciphisa ingozi yesifo senhliziyo, ukulinganisa amazinga e-cholesterol, ukuvimbela ukushaya kwenhliziyo - yonke le miphumela inikezwa ngendlela yaleli qembu le-pharmacological, ngokusho kwezinkampani zokukhangisa. Nokho, ingabe kunjalo ngempela? Phela, izindleko zezidakamizwa ezinjalo ziphezulu, ngakho-ke ulwazi mayelana nezinzuzo zama-statins kuwumzamo wokuheha abathengi? Ingabe ziyilungele ngempela impilo?
Naphezu kwemiphumela yocwaningo efakazela ukungabikho kwemiphumela eyingozi yezidakamizwa emzimbeni womuntu, bambalwa ochwepheshe abangancoma ngokuzethemba ama-statins ukuze bamukelwe. Lokhu kuyiqiniso ikakhulukazi ezigulini ezindala. Ngakolunye uhlangothi, ucwaningo luye lwafakazela ukuthi ukwelashwa ngezidakamizwa ngama-statins kuyasiza ekwehliseni i-cholesterol. Ziphinde zivikele ezifweni eziningi ezimbi. Kepha ochwepheshe abaningi banombono ohlukile, bakholelwa ukuthi umphumela omuhle wama-statins uhlotshaniswa nengozi enkulu. Amathuba okuba nemiphumela emibi kakhulu, okuyingozi kakhulu ezigulini esezikhulile.
Ngasikhathi sinye, izidakamizwa zaleli qembu ziyimpoqo ezibekwe ezimweni ezilandelayo:
Kunini lapho ukuvimbela kwesibili kunikezwa ezigulini ezinesifo senhliziyo noma sohlangothi;
Ngesifo se-ischemic esisongela ukuthuthukisa izinkinga ezihlukahlukene;
Nge-coronary syndrome noma isifo senhliziyo;
Ukuhlinzwa kwe-coronary artery bypass kuhlanganisa nokuthatha ama-statins.
Ukusetshenziswa kwama-statins phambi kwesifo sikashukela i-mellitus, kanye nabesifazane abangakafiki iminyaka yokuya esikhathini, akunconywa. Asikho isidingo sokuphuza izidakamizwa uma kungenzeka ukuthola enye imithi ukugwema imiphumela emibi.
Amakhemisi aseRussia anikezela ukusebenzisa ama-statins alandelayo ngomsebenzi ohlukile:
I-Rosuvastatin: I-Acorta, i-Crestor, i-Mertenil, i-Rosuvastatin, i-Rosucard, i-Rosulip, i-Roxera, i-Tevastor
I-Lovastatin: I-Cardiostatin, Choletar, Cardiostatin
I-Atorvastatin: I-Atomax, i-Atorvastatin Canon, i-Atoris, i-Liprimar, i-Torvacard, i-Tulip, i-Liptonorm
I-Fluvastatin: Leskol Forte
I-Simvastatin: Vasilip, Zokor, Ovencor, Simvagexal, Simvard, Simvastatin, Simvastol, Simvor, Simgal, Simlo, Sinkard
Izidakamizwa zitholakala ngezindlela ezihlukahlukene, izindleko zazo nazo ziyahlukahluka.
Ungakhetha kanjani ama-statins?
Isiguli kufanele sizinqumele ukuthi siyawathatha yini ama-statin. Kulesi simo, kufanele uqale uthintane nochwepheshe abaqeqeshiwe, okuthi uma kunesidingo, banikeze umuthi othize. Akunconywa ukuthatha noma yisiphi isenzo ngaphandle kosizo lukadokotela. Uma ukuhlolwa kwegazi kwe-biochemical kubonisa ukuba khona kwanoma yikuphi ukungahambi kahle, udinga ukuvakashela udokotela kanye ne-endocrinologist. Ngempela, lapho ekhetha ama-statins, udokotela ugxile ebulilini, ubudala ngisho nesisindo sesiguli, ucabangela ukuthi unemikhuba emibi kanye nezifo ezingapheli.
Ngesikhathi sokwelashwa, kuyadingeka ukunamathela kumthamo osungulwe nguchwepheshe, uthatha izivivinyo njalo. Uma umuthi ongenisiwe onconywe udokotela ungatholakali ngenxa yezindleko eziphakeme, okuvamile kuma-statins amaningi, ungathola njalo i-analogue yasekhaya ethengekayo. Nakuba lokhu kungase kuthinte ukusebenza kwethuluzi.
Kubalulekile ukukhumbula ukuthi kuphephile ukuthatha imithamo ephansi ye-rosuvastatin ku-pathologies yesibindi engapheli, engathathelwa indawo yi-pravastatin. Awukwazi ukuhlanganisa izidakamizwa notshwala noma ama-antibiotic. Inzuzo enkulu ye-pravastatin futhi ubuthi bayo obuphansi, yingakho ikhonjiswa ezigulini ezinobuhlungu bemisipha. Amathuba okuhlanganisa ama-statins ne-nicotinic acid nawo ahlala eyinkinga. Kunombono wokuthi lokhu kungabangela ukwanda kwezifo ezingapheli.
Kungani ama-statins eyingozi?
E-Russia, izidakamizwa zabekwa ngenkuthalo ngemuva kodokotela baseMelika. Isifo se-Ischemic, i-arterial hypertension - zonke lezi zifo zelashwa ngama-statins. Kulokhu, imithamo emikhulu isetshenzisiwe. Nokho, e-United States, ngokushesha kwenziwa ucwaningo olwafakazela ukuxhumana phakathi kokuthuthukiswa kwezifo eziningi kanye nokusetshenziswa kwama-statins. Ngo-2013, i-British Medical Journal yashicilela ulwazi mayelana nemiphumela yabo emibi empilweni yeziguli. Kodwa kwakungekho izifundo ezizimele eRussia, futhi ochwepheshe bayaqhubeka nokusebenzisa izidakamizwa zaleli qembu ngenkuthalo.
E-Canada, kwatholakala ukuthi iziguli esezikhulile ezizithathayo zivame ukuba nokuwohloka ngokushesha kombono kanye nokuthuthukiswa kolwelwesi lwamehlo. Ingozi iyanda kakhulu lapho kukhona isifo sikashukela.
Amanye amaqiniso afaka ukungabaza ngezinzuzo zama-statins:
Izidakamizwa zingathinta i-cholesterol ukuze ibe ngaphansi kokujwayelekile, okuyingozi kakhulu kunokweqisa kwayo. Kungabangela izimila eziyingozi, isifo sesibindi, i-anemia, unhlangothi, ukuzibulala kanye nokucindezeleka.
Ama-statins aphazamisa umsebenzi wokubuyisela we-cholesterol. Ngenxa ye-cholesterol, umonakalo uyaqedwa emzimbeni. Lokhu kungenxa yokuthi ingenye yezingxenye ezibaluleke kakhulu ekubunjweni kwezicubu ezibomvu. Futhi, i-cholesterol embi ibalulekile ekuthuthukisweni kwesisindo somzimba kanye nomzimba wonke. Ukuntuleka kwayo kubangela ubuhlungu bemisipha kanye ne-dystrophy.
Ukushoda kwe-Magnesium, hhayi i-cholesterol eyeqile, kuholela ekushayweni nesifo senhliziyo. Lo mbono ubeka ukungabaza ngesidingo sokusebenzisa ama-statins.
Kanye nokuncipha kwamazinga e-cholesterol, ukwakheka kwezinye izinto eziningi ezibalulekile emzimbeni nakho kuyancishiswa. Lokhu kusebenza kunhlanganisela efana ne-melovanate. Ibandakanyeka emisebenzini eminingi yezinto eziphilayo, kuhlanganise nokwakheka kwe-cholesterol.
Isenzo sama-statins sivusa isifo sikashukela, esithinta kabi ukukhiqizwa kwe-cholesterol futhi sibe nomthelela ekwakhiweni kwezinye izifo. Lesi sizathu, ngokusho kwabacwaningi baseJalimane, kubangela i-angina pectoris ne-arrhythmia, unhlangothi. Lokhu kwenzeka ngenxa yokuncipha kokugcwala kweprotheyini ebhekele amazinga kashukela egazini. Ngokwemiphumela yocwaningo, abesifazane abaseminyakeni yokunqamuka kokuya esikhathini basengozini.
Kunezinkinga ebuchosheni ngenxa yokuphuza izidakamizwa. Okokuqala, ama-statins athinta i-cholesterol metabolism, ethinta ukusebenza kwesibindi. Ngesikhathi esifanayo, izidakamizwa zinomthelela omuhle emithanjeni yegazi. Nokho, noma iliphi ithonya lamakhemikhali liyingozi emzimbeni. Ngenxa yalokho, izinguquko ezingenakuhlehliswa zenzeka ezinqubweni zomzimba, kuhlanganise nokusebenza kwengqondo kungase kuphazamiseke.
Imiphumela emibi yama-statins ivame ukutholwa sekwephuze kakhulu.
Abanye ososayensi, bebheka i-cholesterol ephezulu njengokuqinisekisa ubukhona bezifo ezimbi kakhulu, bagqamisa ukucindezeleka nokunye ukuvuvukala njengezimbangela ze-pathologies yenhliziyo. Sekuyisikhathi eside amazwe amaningana ekhuthaza indlela yokuphila enempilo ukuze avimbele izinkinga emsebenzini wenhliziyo. Ngenxa yalokhu, inani leziguli ezinama-pathologies anjalo lehlile, okufakazele ukuthi i-cholesterol ingashintshwa ngokuyeka imikhuba emibi nokukhetha ezemidlalo nokudla okufanele. Ngakho-ke, indlela yokuphila enempilo ikuvumela ukuba ugweme ukuphuza imithi ehlukahlukene enenani elikhulu lemiphumela emibi, futhi ugweme ukuthuthukiswa kwama-pathologies ayingozi.
Esinye isici esibi ngokuthatha ama-statins
Ngokocwaningo oluthile lwabantu abangu-3070 abaneminyaka engu-60 nangaphezulu, ukusetshenziswa kwe-statin kubangela ubuhlungu bemisipha ku-30% yabantu, okunciphisa umsebenzi wabo womzimba. Ngenxa yokwanda kobuhlungu emisipha, iziguli zenqaba ukudlala imidlalo, ukuhamba kancane. Zonke lezi zici ziholela ekuzuzeni isisindo futhi zandise ingozi yesifo senhliziyo.
Ama-Fibrates Asiza Ukwehlisa I-Cholesterol
I-fibric acid derivatives eyaziwa ngokuthi ama-fibrate ivame ukusetshenziswa njengenye indlela yama-statins. Basebenza ngqo esibindini, behlisa ukuphuma kwayo kwe-cholesterol. Ama-fibrates nawo athinta inani le-lipids, anciphisa ukwakheka kwamadiphozithi angaphandle kwemithambo. Ngemuva kokuthatha le mithi, izinga lakho kokubili i-cholesterol enhle nembi lijwayelekile.
Kanye nemiphumela emihle, ama-fibrate nawo anomphumela omubi, obonakaliswa ngendlela:
I-Hepatitis, i-pancreatitis, isifo sohudo, isicanucanu, ukuhlanza, ubuhlungu besimiso sokugaya ukudla;
I-thromboembolism ye-venous, i-pulmonary embolism;
Ubuthakathaka bemisipha kanye nama-spasms, ukusabalalisa i-myalgia;
ikhanda, ukungasebenzi kahle kocansi;
Ukuzwela ukukhanya nokungezwani komzimba.
Imvamisa, kusetshenziswa ukwelashwa okuyinkimbinkimbi, okubandakanya inhlanganisela yama-fibrate nama-statins. Ngakho, kungenzeka ukunciphisa umthamo wokugcina.
Ama-fibrates amelwe izizukulwane ezintathu:
I-Clofibrate - i-fibrate ephelelwe yisikhathi yesizukulwane sokuqala, manje ayisasetshenziswa, ngoba ifakazelwe ukuthi inomthelela ekubukeni kwe-oncology;
I-Gemfibrozil, i-bezafibrate - isakhiwo sifana kakhulu ne-clorifibrate, kodwa sinobuthi obuncane. Ibuye ibhekwe njengengasebenzi, manje ayisasetshenziswa kakhulu;
I-Fenofibrate, i-Ciprofibrate - ingeyesizukulwane sesi-3 samafibrate, manje isithandwa kakhulu. Ngaphezu kokunciphisa i-cholesterol, kunciphisa izinga le-uric acid, futhi kunciphisa amathuba okuba nezinkinga zesifo sikashukela. Ithengiswa ngaphansi kwamagama okuhweba i-Traykor (France), i-Lipantil 200 M (France), i-Fenofibrate Canon (Russia), i-Exlip (eTurkey).
Ukunciphisa ukumuncwa kwe-cholesterol emathunjini
Iningi lezidingo zansuku zonke ze-cholesterol zihlangatshezwa ngumzimba, enye igcwaliswa ngokudla.
Ukulungiswa kwamazinga e-cholesterol ngamalungiselelo emvelo
Odokotela abaningi batusa esikhundleni sama-statins nama-fibrate ukwehlisa amazinga e-cholesterol ngezindlela ezilandelayo:
Omega-3 okunamafutha acid. Atholakala ngobuningi bawo emafutheni enhlanzi nakuwoyela we-flaxseed, futhi asebenza njenge-prophylactic ngokumelene nesifo sohlangothi, ukuphazamiseka kwemizwa, kanye nesifo samathambo. Ngasikhathi sinye, umthamo wamafutha ezinhlanzi akufanele wephulwe, ngoba ukweqisa kwawo kungadala i-pancreatitis.
Ithanga. Leli khambi lemvelo amafutha embewu yethanga. Isetshenziselwa ukuvimbela i-atherosclerosis yemikhumbi yobuchopho, i-hepatitis, i-cholecystitis, inemiphumela elwa nokuvuvukala, i-hepatoprotective, choleretic kanye ne-antioxidant.
I-Lipoic acid. Ivimbela i-atherosclerosis ye-coronary, umphumela ezingeni le-glycogen esibindini. Ngosizo lwe-lipoic acid, i-neuronal trophism ingathuthukiswa.
Ukwelashwa ngamavithamini. Umthombo omuhle kakhulu wezinto ezidingekayo emzimbeni kuzoba yimikhiqizo yemvelo ecebile ku-nicotinic ne-folic acid, amavithamini B3, B6, B12.
Izithako zokudla Kulokhu, kufanelekile ukusebenzisa i-SitoPren - i-fir foot extract. Iqukethe i-beta-sitosterol, ukwakheka kuqukethe nama-polyprenols, awusizo ku-atherosclerosis, isifo sikashukela.