Ma statin ena amakupatsani mwayi wokhala ndi matenda ashuga.

Ma statins ena omwe amagwiritsidwa ntchito kuti muchepetse cholesterol angakulitse chiopsezo chanu chokhala ndi matenda a shuga a 2. Pakafukufuku pa mutuwu, zidadziwika kuti chiopsezo cha matenda osokoneza bongo chimachulukirachulukira mukamamwa mankhwala monga atorvastatin (trademark Lipitor), rosuvastatin (Crestor) ndi simvastatin (Zocor). Zotsatira za kafukufukuyu zidafalitsidwa mu magazini ya BMJ.

Poganizira za anthu 500,000 a Ontario, Canada, ofufuzawo adazindikira kuti mwayi wokhala ndi matenda ashuga odwala omwe akugwiritsa ntchito ma statins ndi wotsika. Komabe, anthu omwe amamwa atorvastatin anali ndi chiwopsezo chachikulu cha 22% chotenga matenda ashuga, rosuvastatin 18% okwera, komanso simvastatin 10% kuposa omwe amamwa pravastol, mankhwala omwe Malinga ndi madotolo, zopindulitsa kwambiri kwa anthu omwe ali ndi matenda ashuga.

Ofufuzawo amakhulupirira kuti popereka mankhwalawa, madokotala ayenera kuganizira zoopsa zonse komanso mapindu ake. Izi sizitanthauza kuti odwala ayenera kusiyiratu kumwa mankhwala a statins, kupatula apo, kafukufuku wamakhalidwewo sanapereke umboni wamphamvu wa ubale wapakati pakati pa kumwa mankhwalawa komanso kupitirira kwa matendawa.

"Kafukufukuyu, yemwe cholinga chake ndi kudziwa mgwirizano pakati pa kugwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito matenda opatsirana pogwiritsa ntchito mankhwala osokoneza bongo ndi chiopsezo chotenga matenda ashuga, pali zovuta zingapo zomwe zimapangitsa kuti zikhale zovuta kufotokoza mwachidule," atero Dr. Dara Cohen, pulofesa wa zamankhwala ku Mount Sinai Medical Center (New York). "Kafukufukuyu sanatchulidwe za kulemera, mtundu, komanso mbiri ya mabanja, zomwe ndi zinthu zofunika kwambiri kuchititsa matenda ashuga."

Mwamalemba ake, madokotala aku Finland adalemba kuti chidziwitso chowopsa sichiyenera kulimbikitsa anthu kuti asiye kugwiritsa ntchito ma statin. "Pakalipano, phindu lokhala ndi ma statins likuwonetsa bwino lomwe mwayi wokhala ndi matenda ashuga," akutero ofufuza aku Turku University (Finland). "Zatsimikiziridwa kuti ma statins amachepetsa mavuto a mtima, chifukwa chake mankhwalawa amathandizira kwambiri pakuchiza."

Komabe, kafukufuku wazindikira kuti ma statins ena amatengedwa bwino ndi odwala matenda ashuga kuposa Lipitor, Crestor, ndi Zocor. "Kugwiritsa ntchito pravastatin makamaka ndi fluvastatin kuli koyenera," kafukufukuyu adatero pofalitsa nkhani, kuwonjezera kuti pravastatin itha kukhala yothandiza kwa odwala omwe ali pachiwopsezo chachikulu chotenga matenda a shuga. Kugwiritsa ntchito fluvastatin (Lescol) kumalumikizidwa ndikuchepetsa kwa 5% pachiwopsezo chotenga matendawa, komanso kudya kwa lovastatin (Mevacor) ndi 1%. Kafukufuku wam'mbuyomu wasonyeza kuti kugwiritsa ntchito rosuvastatin (Crestor) kumalumikizidwa ndi chiwonjezeko cha 27%, pomwe kudya pravastatin kumalumikizidwa ndi chiopsezo chotsika cha 30% cha matenda a shuga.

Mwa anthu omwe ali ndi matenda a shuga a 2, kuchuluka kwa shuga m'magazi kumakwezedwa chifukwa matupi awo satha kuyamwa bwino insulin. Malinga ndi ofufuzawo, ndizotheka kuti ma statins ena amalepheretsa insulin katulutsidwe ndikuletsa kutulutsidwa kwake, komwe mbali yake kumafotokozera zomwe zapezazo.

Kodi ma statins amaposa ziwopsezo zomwe zimakhudzidwa?

Funso ili silikudzutsidwa koyamba. Kuti tiyankhe funsoli, ofufuzawo adasanthula zotsatira zawo pogwiritsa ntchito ma statins popewa komanso kupewa kwachiwiri kwa zochitika zamtima. Zotsatira zake zikuwonetsa kuti mwa okalamba omwe akutenga nawo mbali, chiopsezo chimakhalabe chokwera, mosaganizira kuchuluka kwa atorvastatin ndi simvastatin.

Ofufuzawo anena kuti madokotala ayenera kusamala popereka ma statins. Amati: "Zokonda ziyenera kuperekedwa kwa pravastatin kapena, kwambiri, fluvastatin." Malinga ndi iwo, pravastatin imatha kukhala ndi phindu kwa odwala omwe ali pachiwopsezo chachikulu cha matenda a shuga.

Pothirirapo ndemanga pankhaniyi, asayansi aku University of Turku (Finland) adalemba kuti phindu lonse la ma statins limaposa chithunzi cha odwala omwe ali ndi matenda ashuga. Amayang'ana kwambiri kuti ma statins adawonetsedwa kuti ndi othandiza kwambiri poletsa zochitika zam'mtima, chifukwa chake ndi gawo lofunika kwambiri pakuchiritsa.

Kumbukirani kuti kafukufuku waposachedwa ndi asayansi aku Harvard adawonetsa kuti phindu logwiritsa ntchito ma statins limaposa chiwopsezo mwa odwala ena.

Zinali za odwala onenepa kwambiri omwe ali pachiwopsezo chachikulu cha CVD ndi matenda a shuga nthawi imodzi.

Ubale pakati pa matenda ashuga ndi mtima

Kuwonongeka kwa mtima ndi vuto la shuga. Ndi matenda, ma protein okhala ndi protein amapezeka pamakoma awo, ndikuchepetsa lumen ndi kusokoneza magazi. Izi zimakhudza kwambiri mkhalidwe wa ziwalo zonse ndi machitidwe.

Anthu odwala matenda ashuga ali ndi chiopsezo chowopsa cha matenda a mtima ndi stroko. Zomwe zimachitika ndi matenda amitsempha yamagazi. Odwala nthawi zambiri amakhala ndi vuto la kusokonezeka kwa mitsempha komanso maliseche a mtima chifukwa cha kuwonongeka mumitsempha ya mtima.

Mu odwala matenda ashuga, matenda a mtima ndi mitsempha yamagazi amapezeka mwachangu kwambiri kuposa anthu wamba ndipo amatha kuwonekera ali ndi zaka 30.

Ubwino wama statins mu shuga

Matenda a shuga ali ndi izi:

• muchepetse kutupa kwamphamvu, komwe kumapangitsa kuti malo azikhala odekha
• kusintha kagayidwe kachakudya mthupi,
• thandizirani kuonda kwa magazi,
• Pewani kupatukana kwa zolembedwa za atherosselotic, zomwe zimapewa thrombosis,
• muchepetse kuyamwa kwa mafuta m'matumbo,
• imathandizira kupanga nitric oxide, yomwe imathandizira kuti mitsempha ya magazi ikhale yopuma komanso kuti iwonjezeke pang'ono.

Mothandizidwa ndi mankhwalawa, kuthekera kwa matenda owopsa a mtima, omwe ali ndi vuto la matenda ashuga, kumachepa.

Kuopsa kotenga matenda a shuga

Statin amaganiziridwa kuti amathandizira kagayidwe kazakudwala. Palibe lingaliro limodzi pamakina amomwe angapangire chitukuko cha matenda ashuga.

Pali milandu yokhudza kuchepa kwa insulin mothandizidwa ndi ma statins, kusintha kwa glucose pamene agwiritsidwa ntchito pamimba yopanda kanthu.

Kwa ambiri, mankhwala a statin amaphatikizidwa ndi chiwopsezo cha matenda ashuga ndi 9%. Koma chiwopsezo chotheratu ndichotsika kwambiri, chifukwa pakupita maphunziro adapezeka kuti kuchuluka kwa matendawa ndi mlandu umodzi mwa anthu chikwi omwe amathandizidwa ndi ma statins.

Ndi ma statins omwe ndi abwino kwambiri kwa matenda ashuga

Pochizira odwala matenda ashuga, madokotala nthawi zambiri amagwiritsa ntchito Rosuvastatin ndi Atorvastatin. Amathandizira kuchepetsa cholesterol yoyipa mpaka yovomerezeka. Potere, lipids yosungunuka yamadzi imakwera ndi 10%.

Poyerekeza ndi mankhwala a m'badwo woyamba, ma statin amakono amadziwika ndi kugwiritsidwa ntchito kwakukulu m'magazi ndipo amakhala otetezeka.

Ma statin opanga sangakhale oyambitsa zovuta kuposa zachilengedwe, chifukwa chake nthawi zambiri amauzidwa odwala matenda ashuga. Simungasankhe nokha mankhwalawo, chifukwa onse amagulitsidwa ndi mankhwala. Ena a iwo ali ndi contraindication, kotero ndi katswiri yekha yemwe angasankhe yoyenera kuganizira zomwe zimachitika mthupi la wodwalayo.

Ndi ma statins omwe angathandize ndi matenda ashuga a 2

Zizindikiro zokhala ndi matenda amtundu wachiwiri ndizofunikira kwambiri, chifukwa momwe izi zimapangitsa kuti matenda a coronary akhale apamwamba kwambiri. Chifukwa chake, mankhwala a statin amaphatikizidwa ndi zovuta zochizira matendawa. Amapereka prophlaxis yoyamba komanso yachiwiri ya ischemia ndikukulitsa chiyembekezo cha moyo wa wodwalayo.

Odwala amatchulidwa mankhwala makamaka ngakhale atakhala kuti alibe matenda a mtima kapena cholesterol siyaposa yovomerezeka.

Kafukufuku wambiri wawonetsa kuti kwa odwala omwe ali ndi mtundu wachiwiri wa shuga, Mlingo, monga kwa odwala omwe ali ndi mtundu woyamba, samapereka zotsatira. Chifukwa chake, mlingo woyenera wovomerezeka umagwiritsidwa ntchito pochiza. Mukalandira chithandizo ndi Atorvastatin patsiku, 80 mg imaloledwa, ndipo Rosuvastatin - osapitirira 40 mg.

Statin a mtundu 2 matenda a shuga amathandizira kuchepetsa zovuta ndi kufa kwa matenda a mtima mkati mwa kufalikira kwa matenda azachilengedwe.

Asayansi pakuchita kafukufuku atsimikiza kuti chiopsezo cha imfa chimachepetsedwa ndi 25%. Njira yabwino yotsitsira cholesterol imadziwika kuti ndi rosuvastatin. Ichi ndi mankhwala atsopano, koma mawonekedwe ake ogwira ntchito afikira kale 55%.

Dziwani kuti ndizosatheka kunena ndendende omwe ma statin ndi othandiza kwambiri, chifukwa mankhwalawa amaperekedwa payekhapayekha, poganizira mawonekedwe a thupi komanso kapangidwe kazinthu zamagazi.

Popeza matenda a shuga a mtundu wachiwiri ndi ovuta kuchiza, zotsatira zooneka kuchokera kutenga ma statins zimawonekera pakapita miyezi iwiri. Ndi chithandizo chokhazikika komanso chachitali chamtunduwu ndi gulu la mankhwalawa chomwe chitha kukwaniritsidwa.

Momwe mungatenge ma statins a shuga

Njira ya chithandizo ndi ma statins imatha kukhala zaka zingapo. Pa chithandizo, zotsatirazi ziyenera kuonedwa:

1. Ndikofunika kugwiritsa ntchito mapiritsi madzulo okha, chifukwa nthawi imeneyi pamakhala kuphatikiza kwa cholesterol m'chiwindi.
2. Simungathe kutafuna mapiritsi, amizidwa lonse.
3. Imwani madzi oyera okha. Simungagwiritse ntchito msuzi wa mphesa kapena chipatsocho, chifukwa izi zimakhudza luso la mankhwalawo.

Mankhwalawa amaletsedwa kumwa mowa, chifukwa izi zimapangitsa kuti chiwindi chiwonongeke.

Pomaliza

Kaya ma statins amatha kuwonjezera shuga wamagazi kapena ayi, kutsutsana kumakhalabe. Kafukufuku wambiri akuwonetsa kuti kugwiritsa ntchito mankhwalawa kumapangitsa kuti matendawo awoneke mwa wodwala m'modzi chikwi. Makamaka ndalama zotere ndizofunikira kwa anthu odwala matenda ashuga a 2, chifukwa ndizovuta kwambiri kuchiza. Kugwiritsa ntchito ma statins pamenepa kungathandize kupewa kufalikira kwa matenda a mtima komanso kuchepetsa kufa kwa 25%. Zotsatira zabwino zimatheka pokhapokha ngati mumagwiritsa ntchito mankhwala pafupipafupi kapena kwa nthawi yayitali. Amamwa mapiritsi usiku, kutsukidwa ndi madzi, nthawi zambiri milingo yayikulu imayikidwa kuti ikwaniritse, koma pamakhala chiwopsezo cha kusinthaku.

Malingaliro oyambira

“Tidayesa mayeso pagulu la anthu omwe ali pachiwopsezo chachikulu chokhala ndi matenda a shuga a mtundu wachiwiri. Malinga ndi zomwe takumana nazo, ma statin amawonjezera mwayi wokhala ndi matenda a shuga ndi 30%, "atero Dr. Jill Crandall, mkulu wofufuza, pulofesa wa zamankhwala komanso mkulu wa dipatimenti yoyesa za matenda aza matenda a shuga ku Albert Einstein College of Medicine, New York.

Koma, akuwonjezera, izi sizitanthauza kuti muyenera kukana kutenga ma statins. "Ubwino wa mankhwalawa popewa matenda amtima ndiwambiri ndipo ndiwotsimikizika kotero kuti malingaliro athu sayenera kusiya kumwa, koma kuti iwo omwe amamwa mankhwalawa amayenera kupimidwa pafupipafupi kuti adziwe matenda a shuga ".

Katswiri wina wa matenda a shuga, Dr. Daniel Donovan, pulofesa wa zamankhwala komanso wamkulu wa Clinical Research Center ku Aikan School of Medicine ku Mount Sinai Institute of Diabetes, Obesity and Metabolism ku New York, adagwirizana ndi izi.

"Tifunikabe kupereka mankhwala okhala ndi" mafuta "oyipa kwambiri. Kugwiritsa ntchito kwawo kumachepetsa mwayi wokhala ndi mtima ndi 40%, ndipo matendawa angachitike popanda iwo, "atero Dr. Donovan.

Zambiri

Kafukufuku watsopanoyu ndiwowunikira deta kuchokera ku kuyesanso kwinanso komwe odwala oposa 3200 ochokera m'malo 27 a matenda ashuga aku US akutenga nawo mbali.

Cholinga cha kuyesaku ndikuti tiletse kukula kwa matenda ashuga amtundu wa 2 mwa anthu omwe ali ndi chiyembekezo chodwala. Onse omwe amagwira nawo ntchito modzifunira ndi onenepa kapena onenepa kwambiri. Onse ali ndi zizindikiro za kagayidwe kachakudya ka shuga, koma osati pamlingo woti apezeka kale ndi matenda a shuga 2.

Adapemphedwa kutenga nawo gawo pazaka 10 zomwe amayeza shuga m'magazi kawiri pachaka ndikuwunika kuchuluka kwa ma statin. Kumayambiriro kwa pulogalamuyi, pafupifupi 4% ya omwe adatenga nawo gawo adatenga ma statins, pafupi kutsiriza kwake kumaliza 30%.

Asayansi oonera nawonso amayesa kupanga insulin ndi kukana insulin, atero Dr. Crandall. Insulin ndi timadzi timene timathandizira kuti thupi lisungirenso shuga kuzakudya mpaka maselo ngati mafuta.

Kwa iwo omwe amatenga ma statins, kupanga insulini kunachepa. Ndipo ndi kuchepa kwa mulingo wake m'magazi, shuga omwe amawonjezereka. Phunziroli, komabe, silinawonetse mphamvu ya ma statins pa kukana insulini.

Madokotala amayesetsa

Dr. Donovan akutsimikizira kuti zomwe zalandirazi ndizofunikira kwambiri. "Koma sindikuganiza kuti tiyenera kusiya ma statin. Ndiwotheka kuti matenda amtima amatsogolera matenda a shuga, motero ndikofunikira kuyesa kuchepetsa zoopsa zomwe zilipo kale, "akuwonjezera.

"Ngakhale sanatenge nawo phunziroli, anthu omwe ali ndi matenda a shuga 2 ayenera kusamala kwambiri ndi kuchuluka kwa shuga ngati atenga ma statins," akutero Dr. Crandall. "Palibe zambiri pofika pano, koma pamakhala nkhani zina zonena kuti shuga akukwera ndi mitengo."

Dotolo adatinso kuti omwe sangakhale pachiwopsezo cha matenda a shuga sangakhudzidwe ndi ma statins. Ziwopsezo izi zimaphatikizapo kunenepa kwambiri, kukalamba, kuthamanga kwa magazi, komanso matenda obwera chifukwa cha matenda ashuga mbanja. Tsoka ilo, adotolo akuti, anthu ambiri atatha kudwala matenda ashuga, omwe sakudziwa, ndipo zotsatira za phunzirolo ziyenera kuwapangitsa kuganiza.