Ma Statin a kutsitsa cholesterol - omwe mankhwalawa amakhala bwino

Hypercholesterolemia imavutitsa anthu ambiri. Amadziwika kuti pathology iyi ndikofunikira kwambiri pakukula kwa myocardial infarction, atherosclerosis, zotumphukira za arteritis ndi angina pectoris. Mu 60% ya milandu, izi ma pathologies zimatha muimfa. Mankhwala othandiza kwambiri nthawi zambiri amagwiritsidwa ntchito ngati mankhwala amakono kuti muchepetse cholesterol. Kuunikiridwa kwa madokotala kumatsimikizira kusintha kwakukulu, komwe kumawonedwa poyeserera magazi.

Zambiri za cholesterol "choyipa" ndi "chabwino"

Cholesterol ndi mafuta ophweka (ma sterols), amapangidwa ndi 2/3 m'chiwindi, chachitatu chotsalacho chimalowa m'thupi ndi chakudya. Mankhwala omwe amaphatikizidwa pamodzi ndi ma phospholipids amapanga ma cell membrane, ndi gawo la mahomoni a steroid (estrogen, testosterone, progesterone), bile acid ndi vitamini D₃. Cholesterol imakhudzanso kagayidwe ka mavitamini osungunuka a mafuta (A, D, E, K, F). Sterols amagwira ntchito ngati mphamvu zamafupa am'mimba, ndizofunikira pakumanga komanso kuyendetsa mapuloteni.

Kuchuluka kwa cholesterol m'magazi kumayambitsa mapangidwe a mafupa amtundu wa mafuta (atherosulinotic) omwe amayikidwa pazitseko zamitsempha yamagazi. Popita nthawi, mafupa amafuta amadzaza, amachepetsa lumen ya mitsempha, ziwiya zamataya. Chifukwa cha thrombosis, stroko komanso mtima zimayamba. Kuchepetsa kuchuluka kwa cholesterol ya m'magazi m'magazi, njira zosiyanasiyana zimagwiritsidwa ntchito: mapiritsi, ma dontho, mafuta ogwiritsira ntchito kunja, ndi zina zambiri. Masiku ano, pali mitundu ikuluikulu yamankhwala omwe amachepetsa kuchuluka kwa mafuta m'thupi.

Chifukwa chiyani akuwuka?

Zida zanyama zimakhala ndi kuchuluka kwa mafuta m'thupi, makamaka ambiri mwa nkhola, nyama, zonona, batala, nsomba zam'madzi, dzira la dzira. Ngakhale izi, cholesterol, yomwe imalowa m'thupi ndi zakudya, sizikhudza zomwe zili m'magazi. Mutha kuwongolera kuyika kwa chinthuchi mthupi pogwiritsa ntchito mafuta omwe amapezeka mumafuta a polyunsaturated mafuta acids. Izi zikuphatikiza: mafuta a nsomba, mafuta anyama, mafuta a chiwindi cha cod, mafuta a masamba (rapeseed, olive, peanut, soya, hemp, etc.). Gome ili pansipa likuwonetsa zakudya za cholesterol zokwanira.

Kodi ma statins ndi chiyani

Statins amagwiritsidwa ntchito ndi mankhwala kutsitsa cholesterol. Amagwira thupi la munthu pamaselo. Chiwindi pa kaphatikizidwe kamapangidwe amamasula mevalonic acid - aka ndi gawo loyamba la mafuta a cholesterol. Statin, wogwira asidi, amalepheretsa kutulutsa kowonjezera m'madzi a m'magazi. Kamodzi m'matumbo ndi m'mitsempha, michere iyi imalumikizana ndi maselo a minyewa yolumikizana (endothelium). Zimathandizira kupanga chotchinga chathanzi pamtunda wamkati wamitsempha yamagazi, chimateteza ku mapangidwe a magazi ndi njira zotupa.

Statin ndi mankhwala omwe dokotala angafotokozere zochizira komanso kupewa kwa mtima ndi mtima matenda (atherosulinosis, stroke, kugunda kwa mtima). Kodi gawo la statin kutsitsa cholesterol ndilofunika? Yankho lake ndiwodziwikiratu: inde, zatsimikiziridwa. Koma nthawi yomweyo, cholesterol imakhala yovulaza ku machitidwe ena ofunikira, makamaka achikulire. Lingaliro liyenera kupangidwa limodzi ndi adokotala komanso pamtundu wina wa kusanthula ndi maphunziro a thupi.

Momwe mungachepetse cholesterol yamagazi kunyumba ndi ma statins

Zambiri zalembedwa za statin kuti muchepetse cholesterol kunyumba. Itha kuchepetsedwa ndi mankhwala, mankhwala, zakudya zowonjezera, mankhwala wowerengeka.Nthawi yomweyo, muyenera kudziwa kuti chiphaso cha zinthu ndi 20% yokha, zotsalazo zimapangidwa ndi chiwindi. Zomwe zili bwino - mankhwala achilengedwe kapena mankhwala othandizira - zimatsimikiziridwa ndi momwe thupi limayendera ndipo adokotala akakuwona.

Cholesterol yotsitsa mankhwala

Pali ma statin achilengedwe komanso opanga: mankhwalawa amatha kuchepetsa cholesterol. Mndandanda wa mankhwala a anticholesterol ukhoza kupitilizidwa. Ganizirani zovuta zochepa izi:

1. Ma statin achilengedwe amapangidwa kuchokera ku bowa. Izi ndi monga: simvastine, simvastatin, pravastatin ndi lovastatin.
2. Zopangira zimapezeka chifukwa cha kapangidwe kazinthu zopanga mankhwala. Awa ndi Atorvastatin, Atoris, Fluvastatin, Roxer ndi Rosuvastatin / Crestor.

Ma statin achilengedwe

Mwa kusintha zakudya (makamaka mafuta), thupi limatha kulandira ma statins. Mafuta omwe timadya amakhala ndikuchita mosiyanasiyana ndi chiwindi, amatha kusintha kukhala mafuta osiyanasiyana a cholesterol. Malingaliro a "oyipa" ndi "abwino" omwe adalowa mu moyo watsiku ndi tsiku a madokotala:

• Yoyamba ili ndi kachulukidwe kochepa ka lipoprotein. Zimathandizira kutsika kwamitsempha.
• Lachiwiri ndi lachuma kwambiri, ntchito yake ndikuyeretsa mitsempha. Kukwera kwachiwiri, kwabwino, komanso mosemphanitsa.

Mafuta athanzi ndizakudya. Amapezeka muzakudya zam'mera: ma amondi, mtedza, tiyi wobiriwira, zipatso zamalanje. Ma Blueberries, kaloti, adyo amathandiza kuti muchepetse mafuta m'thupi mosavuta. Kumwa, nsomba zam'nyanja, zam'madzi, vinyo wofiira (wouma), timadziti tatsopano timathandiza kuchepetsa cholesterol popanda mankhwala. Ndikofunikanso kuchepetsa mndandanda wazakudya za mazira, shuga ndi ng'ombe yamafuta. Dokotalayo atha kukulemberani zakudya zomwe zingathandize kuchepetsa matenda a lipid.

Kudya ndi njira yokhayo yotsitsira cholesterol kunyumba. Malamulo ena athandizira kusintha ma statins kuti achepetse cholesterol:

• kulemera kwa thupi
• moyo wokangalika
• kusiya zizolowezi zoipa,
• Zakudya zowonjezera zakudya.

Omaliza ayenera kuthandizidwa mosamala kwambiri potsatira dokotala. Ngati mungaganizire kuchepetsa cholesterol ndi wowerengeka azitsamba, ndiye kuti muyenera kuyang'anira kusalolera kwa zigawozo, chotsani ziwopsezo zonse. Sitikulimbikitsidwa kuti mutenge mapaketi akuluakulu a makapisozi nthawi yomweyo, chifukwa mankhwalawa amatha kuchitika pazakudya zilizonse, ndipo nthawi zonse m'masiku oyambira.

Zambiri

Cholesterol - Ndiwo mowa wamafuta, womwe umapezeka m'zipangidwe za selo.

Nthawi zambiri amagwiritsa ntchito mfundo ziwiri - cholesterolndi cholesterol. Kodi pali kusiyana kotani pakati pa awiriwa? M'malo mwake, ili ndi dzina la chinthu chomwecho, kokha m'mabuku azachipatala omwe akuti "cholesterol"Kuyambira chimaliziro"ol"Chimawonetsera ubale wake ndi ma alcohols. Katunduyu ndi amene amapereka mphamvu. ma cell membrane.

Koma ngati mulingo wa cholesterol m'thupi ukakwezedwa, ma cholesterol plaque amapezeka m'makoma a zombo, omwe, akusweka, amapanga malo abwino kuti apangidwe kuundana kwa magazi. Mapilala amachepetsa lumen ya chombo.

Chifukwa chake, pambuyo pofufuza za cholesterol, adokotala, ngati pakufunika, asankha chochita ndi cholesterol yayikulu. Ngati kusintha kwa kusanthula kwa cholesterol kumawonetsa kukwera kwake, nthawi zambiri katswiri amafotokozera mankhwala okwera mtengo - ma statins, omwe adapangidwa kuti alepheretse matenda a mtima. Ndikofunika kuti adotolo afotokozere kuti pambuyo pokhazikitsidwa, wodwalayo ayenera kumwa mapiritsi nthawi zonse, monga momwe malangizo angagwiritsidwire ntchito.

Koma mankhwala a anticholesterol ali ndi zovuta zina, zomwe madokotala ayenera kuchenjeza odwala, ndikufotokozera momwe amamwa mapiritsi molondola.

Chifukwa chake, munthu aliyense wokhala ndi cholesterol yokwanira ayenera kusankha ngati angamwe mankhwalawa.

Pakadali pano, magulu awiri akuluakulu a mankhwala a cholesterol amaperekedwa: ma statinsndi mafupa. Kuphatikiza apo, akatswiri amalimbikitsa kuti odwala adye Lipoic acid ndi Omega 3. Otsatirawa ndi mankhwala omwe amagwiritsidwa ntchito kuti muchepetse cholesterol. Komabe, kugwiritsa ntchito kwawo kumakhala koyenera pokhapokha pakufufuza komanso kuikidwa ndi dokotala.

Statins kuti muchepetse cholesterol

Musanagwiritse ntchito mankhwalawa, muyenera kudziwa kuti maulosi ndi chiyani - zomwe ali, mapindu ndi zovulaza za mankhwalawa, etc. Ma Statin ndi mankhwala omwe amachepetsa kupanga kwa thupi micherechofunikira pakuchitika kwa cholesterol synthesis.

Malangizo a mankhwalawa amatha kuwerenga zotsatirazi:

• Chepetsani cholesterol ya plasma chifukwa chopinga HMG-CoA reductasekomanso kuchepetsa kapangidwe ka cholesterol m'chiwindi.
• Kuchepetsa kuchuluka kwa cholesterol mwa anthu akuvutika homozygous achibale hypercholesterolemia, yomwe singagwiritsidwe ntchito ndi mankhwala ochepetsa lipid.
• Makina awo amachitidwe amachepetsa cholesterol yonse ndi 30-45%, "yoyipa" - mwa 40-60%.
• Mukamatenga ma statins HDL cholesterol ndi apolipoprotein Aamadzuka.
• Mankhwalawa amachepetsa mwayi wovuta wa ischemic ndi 15%, makamaka, malinga ndi zomwe akatswiri a mtima ananena, chiopsezo angina pectorisndi myocardial infarationamatsika ndi 25%.
• No mutagenic ndi carcinogenic zotsatira.

Zotsatira zoyipa

Mukatenga, zotsatira zoyipa zambiri zitha kudziwika:

• Zotsatira zoyipa: asthenia, kusowa tulo, mutu, kudzimbidwa, nserukupweteka m'mimba kutsegula m'mimba, myalgia, chisangalalo.
• Matumbo oyenda: kutsegula m'mimba, kusanza, hepatitis, kapambacholestatic jaundice kukomoka.
• Machitidwe amanjenje: chizungulire, amnesia, hypesthesia, malaise, paresthesia, zotumphukira neuropathy.
• Mawonetseredwe amatsutsa: zotupa ndi Khungu, urticaria, anaphylaxis, erythema wachikulire, matenda a Lyell.
• Musculoskeletal system: kupweteka kumbuyo myositis, kukokana, nyamakazi, myopathy.
• Kupanga kwa magazi: thrombocytopenia.
• Njira zachikhalidwe: hypoglycemia, matenda ashugakunenepa kunenepa, kusabalazotumphukira edema.
• Vuto lalikulu kwambiri la mankhwala a statin ndi rhabdomyolysiskoma izi zimachitika kawirikawiri.

Ndani ayenera kutenga ma statins?

Kudziwitsa zomwe ma statins, zotsatsa zotsatsa ndi malangizo a mankhwala amawonetsa kuti ma statins - awa ndi mankhwala othandiza kuchepetsa mafuta m'thupi (cholesterol), omwe amakulitsa kwambiri moyo, komanso kuchepetsa mwayi wakutukuka mikwingwirima, myocardial infaration. Chifukwa chake, kugwiritsa ntchito mapiritsiwa tsiku lililonse ndi njira yabwino yotsitsira cholesterol.

Koma zoona zake, mpaka pano palibe chidziwitso chokwanira chidziwitso chokwanira ngati chithandizo cha odwala omwe ali ndi mankhwalawa ndichabwino komanso chothandiza. Inde, ochita kafukufuku ena amati zovuta zomwe zingavulaze komanso zotsatirapo zake zimaposa zabwino za ma statins monga prophylactic yomwe imagwiritsidwa ntchito popewa matenda a mtima. Akatswiri akutsutsanabe kuti atenge ma statin, omwe amayeza zabwino ndi zowawa. Madokotala masiku ano pamakhala nkhani zotsutsana pamutuwu “Ma Statin - Ubwino ndi Chuma».

Koma, komabe, pali magulu ena a odwala omwe ma statins ndi ovomerezeka.

Mawumbidwe aposachedwa kwambiri ayenera kugwiritsidwa ntchito:

• kupewa kwachiwiri pambuyo sitirokokapena vuto la mtima,
• at opaleshoni yomanganso pa ziwiya zazikulu ndi pamtima,
• at myocardial infarationkapena pachimake coronary syndrome,
• at matenda amtsempha wamagazi ndi mwayi wowonjezereka wa stroko kapena vuto la mtima.

Ndiye kuti, mankhwala a cholesterol amawonetsedwa kwa odwala a coronary kuti awonjezere moyo wawo.Pankhaniyi, kuti muchepetse mavuto, dokotala ayenera kusankha mankhwala oyenera, kuwunika magawo a biochemical. Ngati pali kuchuluka kwa ma transaminase okwana 3, ma statins adathetsedwa.

Ndizokayikira ngati ndibwino kupereka mankhwala a gululi kwa odwala otere:

Ngati ma statins amaperekedwa kwa odwala omwe ali ndi matenda a shuga, angafunikire mapiritsi owonjezera kuti muchepetse shuga mkati magazi, popeza odwala ma statins amawonjezera shuga. Mankhwala ochepetsa shuga wamagazi amayenera kutumizidwa ndi kusinthidwa ndi adokotala okha.

Pakalipano, ku Russia, njira zochizira matenda amtima zambiri zimaphatikizanso kugwiritsa ntchito ma statins. Koma, ngakhale kuti kuthandizidwa ndi achipatala kumachepetsa kufa, ichi sichofunikira kuti pakhale mankhwala kwa anthu onse omwe ali ndi matenda amitsempha yamagazi kapena matenda oopsa. Kugwiritsa ntchito kwawo sikuloledwa ndi anthu onse omwe ali ndi zaka zopitilira 45, kapena ndi onse omwe ali ndi cholesterol yayikulu.

Ndikofunikira kuganizira momwe mankhwalawa amaphatikizira ndi mankhwala ena.

Ngati ndi kotheka, dokotalayo amapereka mankhwala ena ochizira matenda a mtima limodzi ndi mankhwala a anticholesterol: Diroton, Concor, Propanorm ndi ena

Diroton(yogwira pophika - lisinopril) imagwiritsidwa ntchito pochotsa matenda oopsa.

Concor(yogwira pophika - bisoprolol hemifumarate) ogwiritsidwa ntchito ngati mankhwala ochepa matenda oopsakulephera kwa mtima angina pectoris.

Momwe ma statins amagwirira ntchito

Pali mitundu iwiri ya cholesterol m'thupi.

Kuchita kwa ma statins cholinga chake ndikulepheretsa kupezeka kwa cholesterol, pambuyo pake mulingo wa LDL m'magazi umatsika ndi 45-50%, ndipo pazosowa za thupi, mafuta ochulukirapo kale omwe amachokera ku malo a atherosranceotic ndi ma depositi amafuta amagwiritsidwa ntchito, omwe amathandizira kuchepa kwa magazi ndi kufalikira.

Statin amachepetsa mwayi wodziwika kwa cholesterol plaque, amachepetsa kutupa ndi kukonza magwiridwe antchito a endothelium m'matumbo.

Mukasankhidwa

Ma Statin amapatsidwa cholesterol yayikulu ya magazi (yoyesedwa pogwiritsa ntchito njira yoyesa ya magazi), komanso kuchuluka kwa mapuloteni othandizira a C, omwe akuwonetsa kukhalapo kwa njira yotupa yomwe imakhudzana ndi chitukuko cha atherosulinosis.

Kugwiritsa ntchito ma statins kumawonetsedwa kuti mupewe kugunda kwa mtima, kugunda kwa mtima, kugunda kwa mtima ndi zotsatira zina za cholesterol yayikulu, yomwe imawonetsedwa nthawi zambiri limodzi ndi mitundu iyi ya matenda:

• Mtima - matenda a mtima, angina pectoris, atherosulinosis, matenda oopsa, chizolowezi cha thrombosis. Chithandizo cha Statin chikuwonetsedwa pambuyo povutitsidwa ndi mtima ndi sitiroko kuti magazi azisinthasintha.
• Endocrine - mtundu 2 shuga, insulini kukana, kunenepa kwambiri, chifukwa ndi matendawa amatha kukhala atherosulinosis ndi matenda amkati a mtima ukuwonjezeka.
• Metabolism - dyslipidemia (hypercholesterolemia, hyperlipidemia, hyperglyceridemia) kapena matenda a lipid metabolism omwe amayamba chifukwa cha mitundu yosiyanasiyana ya chitukuko ndi kuchuluka kwina kwa lipids. Mankhwalawa pathologies oterewa ayenera kukhala osalekeza kuti magazi azisungika bwino.

Zowunikira ma statin ogwira ntchito kwambiri komanso otetezeka

Pali magulu anayi akuluakulu a mankhwala ochepetsa cholesterol, mwa omwe ma statins a m'badwo waposachedwa, omwe ali ndi katundu wa hydrophobic (sungunuka), mosiyana ndi mankhwala akale, atsimikizira kugwira ntchito kwawo ndi chitetezo.

Crestor ndi chiphunzitso cha m'badwo wachinayi wozikidwa pa rosuvatsatin, womwe umatsika msanga moipa ndikuyambitsa cholesterol "yabwino". Krestor akupezeka mawonekedwe a mapiritsi mu 5, 10, 20 ndi 40 mg wa rosuvastatin. Kuphatikizika kwa mankhwalawa kumaphatikizapo lactose, calcium phosphate, magnesium stearate.

The achire zotsatira za statins zimatheka masabata 3-4 pambuyo kudya okhazikika mankhwala, pamene chiopsezo cha myocardial infarction ndi sitiroko amachepetsa ndi 47-54%.

Mapiritsi a Krestor sagwiritsira ntchito tsankho la rosuvastatin, wosakwana zaka 18, panthawi yoyembekezera komanso yoyamwitsa, omwe ali ndi matenda a impso ndi chiwindi.

Livazo ndi m'badwo waposachedwa wa mankhwala a cholesterol. The yogwira mankhwala Livazo (pitavastatin) amadziwika ndi mkulu bioavailability ndi nthawi yayitali zochita ndipo amamulembera kochepa Mlingo (kuyambira 1 mpaka 4 mg patsiku).

Mukamagwiritsa ntchito Livazo, ndikofunikira kutsatira zakudya zamafuta ochepa, ndipo tikulimbikitsidwa kugwiritsa ntchito mapiritsi nthawi imodzi nthawi yomweyo, makamaka madzulo, poganizira mawonekedwe a lipid metabolism m'thupi.

Pafupifupi 4% ya anthu omwe amagwiritsa ntchito miyala ya Livazo amamva kupweteka kwambiri minofu, limodzi ndi kufooka komanso kutupa, ndipo ochepera 3% amakhala ndi vuto la kugona komanso mutu.

Nthawi zina (pamaso pa mankhwala ophatikizika ndi mitundu ina ya mankhwala, ndimatenda a pulogalamu ya excretory, komanso kumwa pafupipafupi zakumwa zoledzeretsa), mutagwiritsa ntchito Livazo kwakanthawi kochepa, ndikofunikira kuyesedwa kuti mupeze zovuta zomwe zingayambitse ziwalo zamagulu omwe adalipo.

Mu milandu yomwe Livazo imagwiritsidwa ntchito kupewa matenda amtima m'matenda a shuga, shuga wamagazi amayenera kuyang'aniridwa, monga nthawi zina pamakhala kuwonjezeka kwa shuga mpaka okwera kwambiri omwe amafunikira chithandizo chamankhwala.

Rosuvastatin-SZ

Rosuvastatin-SZ amagwiritsidwa ntchito ngati matenda oyamba ndi achibale, hypertriglyceridemia, komanso kupewa mavuto a mtima.

Rosuvastatin-SZ imapangidwa ngati mapiritsi a 5, 10, 20 ndi 40 milligram. Kugwiritsa ntchito statin pafupipafupi kumatha kuchepetsa cholesterol ndi 40-50% mu masabata a 6-8. Mutha kugwiritsa ntchito mankhwalawa mosasamala nthawi ya tsiku kapena chakudya. Mulingo wokwanira wa rosuvastatin m'magazi umawonedwa patatha maola 5 pambuyo pakukonzekera, pang'onopang'ono kuchepa kwa maola 19.

Kuphatikiza pa chithandizo, tikulimbikitsidwa kugwiritsa ntchito zakudya zochepa m'mafuta a nyama ndi masamba, kuti muchepetse kumwa ndi kusuta.

Contraindation poika Rosuvastatin-SZ ndi myopathy, aimpso ndi kwa chiwindi kulephera, lactose tsankho, pakati ndi mkaka wa m`mawere, kugwiritsa ntchito cyclosporine ndi HIV protease zoletsa. Ma Statin omwe ali ndi mlingo waukulu (40 mg) samapangidwira hypothyroidism, komanso kugwiritsa ntchito munthawi yomweyo mafupa.

Liprimar ndi mankhwala othandiza malinga ndi atorvastatin ndipo amagwiritsidwa ntchito pothana ndi vuto la kuthamanga kwamafuta, angina pectoris ndi chiwopsezo chachikulu chodwala mtima, pofuna kupewa kubwerezanso sitiroko, komanso mtundu wa 2 matenda a shuga kuti muchepetse vuto la matenda amtima. Liprimar, ngati kuli kotheka, imatha kuperekedwa kwa ana opitilira zaka 9.

Milandu yomwe ma statins amagwiritsidwa ntchito nthawi yomweyo ndikugwiritsa ntchito nicotinic acid, cephalosporins, fibrate, maantibayotiki ena (erythromycin, clarithromycin) ndi antimycotic, ndiye kuti pali chiopsezo chotukula chimodzi mwazotsatira za mankhwalawa - kufooka kwa magulu ena a minofu (minofu dystrophy).

Atoris, yomwe imaphatikizapo atorvastatin, imalembedwa kuti atherosulinosis, matenda a shuga, kuthamanga kwa magazi, angina pectoris komanso kuchepetsa ngozi ngati pachitika vuto la mtima mu mbiri ya mabanja.

Atoris amachepetsa kwambiri cholesterol "yoipa" (14-18 patatha masiku atayamba chithandizo) ndipo amakhala ndi anti-sclerotic, chifukwa amathandizira vasodilation, poganizira kukula kwa endothelium yamkati, kuchepetsedwa komanso kupukusa magazi.

Ndi kuchepetsedwa kupanikizika, kumwa mowa mwauchidakwa, kusakhazikika kwa electrolyte ndipo atatha opaleshoni, mankhwalawa amalembedwa pambuyo poyesa zowonjezera. Atoris osavomerezeka kuti agwiritse ntchito panthawi yoyembekezera, mkaka wa m`mawere ndi asanafike zaka 16.

Kaduet ndi mankhwala othandizika ophatikizidwa omwe samangoletsa zinthu za cholesterol mthupi chifukwa cha zomwe zili atorvastatin, komanso amatithandizanso kupanikizika mothandizidwa ndi amplodipine, calcium Channel blocker (imapangitsa kuchuluka kwa calcium m'maselo ndipo imathandizira kuchepetsa systolic ndi diastolic.

Mankhwalawa amapezeka mu mawonekedwe a mapiritsi ndipo amatha kukhala ndi zinthu zogwira mosiyanasiyana. Mlingo wa statin umayikidwa payekhapayekha pofufuza mawonekedwe a lipid mu kusanthula kwa zamankhwala am'thupi, mkhalidwe wamtima, impso ndi chiwindi.

Cadet imagwiritsidwa ntchito pa mitundu yonse ya matenda oopsa kuphatikiza ndi angina pectoris, dyslipidemia, kapena atherosulinosis. Mankhwalawa ndi statin, ndikofunikira kuwunika momwe chiwindi chimayendera (kusanthula kwa "chiwindi" transaminases) ndi mano (kuteteza hyperplasia ndi zilonda zamkati) pakadutsa miyezi 6 iliyonse.

Kuchotsa mwadzidzidzi kwa mankhwala a statin Kaduet ndi koletsedwa, chifukwa izi zingapangitse kukula kwa angina pectoris, makamaka kwa okalamba.

Simvagexal

Simvagexal ndi m'badwo woyamba wa ma statins, koma, ngakhale izi, ndizida zotsika mtengo komanso zothandiza, ndipo zimagwiritsidwa ntchito pa matenda a ischemia, hypercholesterolemia ndi hyperlipidemia, kupewa matenda a mtima ndi matenda a mtima.

Popeza kupangika kwa lipoprotein m'thupi kumachitika usiku, ma statin amatengedwa kamodzi patsiku, chifukwa chakuti kuchuluka kwa mankhwalawa kumachitika pambuyo pa maola 1.5-2 ndikuchepera pambuyo maola 12.

Mankhwala omwe ali ndi mtundu uwu wa statin sayenera kuphatikizidwa ndi ntchito ya cytostatics, antimycotic (ketoconazole), immunosuppressants, anticoagulants (mankhwalawa amapititsa patsogolo kuchiritsa kwa anticoagulants ndikuwonjezera ngozi ya magazi).

Zokor ndi wopanga pazolemba zam'badwo woyamba ndipo amagwiritsidwa ntchito kuthana ndi matenda a mtima, cholesterol yayikulu, kusokonezeka kwakanthawi kozungulira muubongo ndi atherosulinosis.

Zokor imachepetsa cholesterol mwachangu, mosasamala kanthu ndi zomwe zimayambira: zotsatira zoyambirira zimadziwika pambuyo pa masabata awiri, ndipo mphamvu yayikulu yothandizira imatheka pambuyo pa masabata a 5-7, pomwe chithandizo chikuyenera kuphatikizidwa ndi chithandizo chamankhwala.

Inegi imakhala ndi kuphatikiza kuphatikiza simvastatin (10 mpaka 80 mg) ndi ezetimibe (10 mg), yomwe imakwaniritsa kuphatikiza kwamankhwala komanso kumathandiza kuchepetsa cholesterol. Mosiyana ndi njira zina, Inegi imatha kuperekedwa kwa anthu omwe ali ndi matenda a impso, komanso ana ndi achinyamata ochokera zaka 10.

Chofunikira kwambiri pakuchiritsika kwa Inegi ndikofunikira kwa kudya kwapadera kwa hypocholesterol (otsika mafuta).

Leskol ndi statin yopanga yomwe ili ndi fluvastatin ndipo imapezeka m'mapiritsi ndi makapisozi. Zisonyezo zakusankhidwa kwa Leskol kwa akulu ndi chithandizo ndi kupewa matenda a mtima ndi mtima, komanso muubwana (kuyambira zaka 9) - achibale hypercholesterolemia.

Asanayambe komanso munthawi yonse ya mankhwala a Leskol, zakudya za hypocholesterol ziyenera kutsatira. Kuchuluka kwa lipid-kutsitsa kwa Leskol kumachitika pambuyo pa masabata 8-12 a mankhwala osokoneza bongo, omwe amatha kutsagana ndi dyspepsia, kupweteka kwam'mimba, komanso kusokonezeka kwa m'mimba.

Leskol amalembedwa moyenera pazinthu zomwe zikufunika kugwiritsa ntchito ma cytostatics (antitumor othandizira omwe amachepetsa kukula komanso magawikidwe a maselo, kuphatikiza oyipa), omwe amatsutsana ndi mitundu ina ya ma statins.

Mndandanda wa mankhwala a statin

Zomwe mankhwala amakhudzana ndi ma statins, ndi ntchito yawo yochepetsera cholesterol, imapezeka pagome pansipa.

Kodi mungasankhe ma statins?

Ngakhale malingaliro onse okhudzana ndi ma statins a kutsitsa cholesterol, wodwalayo ayenera kusankha kuti atenge mankhwalawa, koma izi ziyenera kuchitidwa mothandizidwa ndi katswiri. Chofunikira, choyambirira, osati kuwunika, koma kusankha kwa dokotala.

Ngati munthu adaganiziratu kutenga ma statins, ndiye kuti kusankhidwa sikuyenera kukhala mtengo wamankhwala, koma, choyamba, kupezeka kwa matenda osachiritsika.

Kudzichitira nokha, ngati cholesterol imakwezedwa, palibe mankhwala omwe angachitike. Chithandizo cha cholesterol chachikulu ndi lipid kagayidwe kachakudya kamafotokozedwa ndi mtima kapena akatswiri. Potere, katswiriyo ayenera kuwunika zotsatirazi:

• zaka
• jenda
• kulemera
• zizolowezi zoipa
• matenda a mtima dongosolo, matenda ena (shuga mellitus, etc.).

Ndikofunika kumwa ma statins mu mlingo womwe adauyambitsa ndi dokotala, pomwe ndikofunikira kumwa kuyesa kwamwazi wamagazi nthawi zambiri malinga ndi katswiri.

Ngati mapiritsi okwera mtengo adalembedwa, mutha kufunsa adotolo kuti athetse mankhwala omwe ndi otsika mtengo. Komabe, tikulimbikitsidwa kugwiritsa ntchito mankhwala oyambirirawa, chifukwa ma genetic omwe amapangidwa mkati mwapamwamba ndi otsika kwambiri kuposa mankhwala oyambira omwe opanga akunja amapereka.

Omwe ali ndi chidwi chofuna kudziwa zambiri za phindu lenileni komanso zovuta za ma statins a cholesterol ayenera kuganizira zinthu zingapo zofunika kuti muchepetse kuvulaza kwa mankhwalawa.

Ngati mankhwalawa adalembera odwala okalamba, ziyenera kudziwika kuti chiwopsezo myopathieskuwirikiza ngati muwatenga limodzi ndi mankhwala a matenda oopsa, gout, matenda ashuga.

Mukudwala matenda a chiwindi, ndikofunikira kuti mutenge rosuvastatin muyezo wotsika, mutha kugwiritsanso ntchito Pravastatin (Pravaxol) Mankhwalawa amapereka chitetezo cha chiwindi, koma mukamagwiritsa ntchito, simuyenera kumwa mowa, komanso kuchitira chithandizo maantibayotiki.

Ndi chiwonetsero chokhazikika cha kupweteka kwa minofu kapena chiwopsezo chowonongeka kwa iwo ,alangizidwanso kuti mugwiritse ntchito Pravastatin, popeza siwodetsa minyewa.

Anthu omwe ali ndi vuto lalikulu la impso sayenera kumwedwa. Fluvastin Leskolkomanso sayenera kuledzera Calcium wa atorvastatin (Lipitor), popeza mankhwalawa ndi oopsa kwa impso.

Ngati wodwala akufuna kutsitsa cholesterol yotsika pang'ono, ndikulimbikitsidwa kugwiritsa ntchito mitundu yosiyanasiyana ya ma statins.

Pakadali pano, palibe umboni wotsimikiza kuti ndikofunikira kutenga kuphatikiza kwa "statins plus nicotinic acid." Mukamamwa nicotinic acid mwa anthu omwe ali ndi matenda ashuga, shuga m'magazi amatha kuchepa, matenda am'mimba, magazi ochokera m'matumbo amachitikanso, mwayi umawonjezeka. rhabdomyolysis ndi myopathy.

Maphunziro azokhudza zotsatira za ma statins m'thupi

Akatswiri a mtima ankakonda kupereka ma statins a anthu omwe akudwala matenda amtsempha wamagazi, ochepa matenda oopsa, komanso kukhala ndi chiopsezo chochepa cha matenda a mtima.

Pakadali pano, malingaliro amtundu uwu wa mankhwala asintha kwa akatswiri ena. Ngakhale ku Russia palibe kafukufuku wokhazikika wodziyimira wazomwe zimachitika chifukwa cha ma statins m'thupi.

Pakadali pano, asayansi aku Canada akuti mutagwiritsa ntchito ma statins, chiwopsezochi amphaka mwa odwala kuchuluka ndi 57%, ndipo zimadandaula kuti munthu akuvutika matenda ashuga, - ndi 82%. Zowopsa zotere zimatsimikiziridwa ndikuwunika kwa ziwerengero.

Akatswiri adasanthula zotsatira za maphunziro khumi ndi anayi azachipatala omwe adachitidwa kuti adziwe momwe ma statins amathandizira. Mapeto awo anali awa: mukamamwa mankhwala amtunduwu, kuopsa kwa stroko ndi mtima kumachepa, koma chifukwa chotsatira zoyipa zake, sizomwe zimaperekedwa kwa anthu omwe sanadwale mikwingwirima kapena matenda amtima. Malinga ndi ofufuza, anthu omwe amamwa mankhwalawa nthawi zambiri amakhala ndi zotsatirazi:

Koma chonsecho, pamakhala malingaliro osiyanasiyana pazomwe mankhwalawa ali ovulaza kapena otetezeka.

• Asayansi aku Germany adatsimikizira kuti ndi cholesterol yotsika, mwayi wokhala nawo khansa, matenda a chiwindi ndi matenda oopsa angapo, komanso kufa koyambirira ndi kudzipha, potero kutsimikizira kuti cholesterol yotsika mtengo ndiyowopsa kuposa okwera.
• Ofufuza ochokera ku USA akuti kugunda kwa mtima ndi mikwingwirima osati chifukwa cha cholesterol yayikulu, koma chifukwa cha kuchepa kwa magnesium m'thupi.
• Statin imatha kupondereza ntchito yofunika ya cholesterol, yomwe imabwezeretsa zovuta m'mizimba ya thupi. Kuti minofu ikule m'thupi, ndi ntchito yake yonse, maselo ochepera mphamvu, ndiye kuti, "cholesterol" yoyipa, amafunikira. Ngati vuto lakumanapo, lingawonekere myalgia, minofu dystrophy.
• Mukamamwa mankhwalawa, kupanga cholesterol kumachepetsa, motsatana, ndikupanga kupitilira, omwe samangopeza cholesterol yokha, komanso zinthu zina zingapo. Amagwira ntchito zofunika mthupi, kotero kuchepa kwawo kungayambitse matenda.
• Gulu la mankhwalawa limawonjezera mwayi wokhala ndi vuto matenda ashuga, ndipo matendawa amabweretsa kuchuluka kwa cholesterol. Olemba osiyanasiyana akuti ngati mutenga ma statins kwa nthawi yayitali, chiopsezo cha matenda ashuga chimachokera ku 10 mpaka 70%. Mothandizidwa ndi mankhwalawa m'chipinda, kuchuluka kwa mapuloteni a GLUT4, omwe amachititsa kuchuluka kwa shuga m'magazi, kumatsika. Ofufuza ku Britain awonetsa kuti kumwa mankhwalawa kumawonjezera chiopsezo cha matenda ashuga mwa azimayi pambuyo pakupita kusamba ndi 70%.
• Zotsatira zoyipa zimayamba pang'onopang'ono, motero, wodwalayo sangazindikire izi, zomwe zimakhala zowopsa ndikugwiritsira ntchito nthawi yayitali.
• Mukamagwiritsa ntchito ma statins, zimakhudza chiwindi. Iwo omwe ali onenepa kwambiri kapena amene amakhala pansi, samakhalapo bwino. Koma popita nthawi, njira zovuta mthupi zimasokonekera, zomwe zimatha kuyipa m'malingaliro am'maganizo, makamaka kwa anthu okalamba.

Munthu wochepera zaka 50 amakhala ndi cholesterol yokwanira, izi zimawonetsa kuti pali zovuta zambiri mthupi zomwe zimafunikira kulandira. M'mayiko ena, mapulogalamu akuwonetsedwa pamlingo wapadziko lonse omwe amalimbikitsa kutsitsa mafuta m'thupi mwa kulimbikitsa moyo wokangalika, kusintha mfundo za kadyedwe, kusiya kugwiritsa ntchito mankhwala osokoneza bongo a nikotini, komanso kugwiritsa ntchito mankhwala osokoneza bongo.

Zotsatira zake, m'maiko ambiri njira iyi "imagwira ntchito": kufa kwa matenda amtima kwachepa kwambiri. Komabe, akukhulupirira kuti kusiya kusuta, kuchita masewera olimbitsa thupi ndikusintha menyu ndi njira yabwino yotalikira moyo kuposa kugwiritsa ntchito mankhwala omwe ali ndi zotsutsana.

Zizindikiro za odwala okalamba

Pakati pa mfundo zomwe zimapangitsa kuti anthu okalamba azigwiritsa ntchito ma statin pokhapokha ataganizira mozama mavutowo ndi mapindu ake, titha kukumbukira kafukufukuyu, yemwe anthu oposa 3,000 wazaka zopitilira 60 omwe amamwa mankhwala a statin. Pafupifupi 30% adawona kuwonetsedwa kwa kupweteka kwa minofu, komanso kuchepa kwa mphamvu, kutopa kwambiri, kufooka.

Kupweteka kwa minofu kumakhala kovuta kwambiri kwa iwo omwe angoyamba kumene kumwa mankhwalawa. Zotsatira zake, izi zimachepetsa kukula kwa zochitika zolimbitsa thupi - zimakhala zovuta kuti anthu aphunzitse ndikuyenda, zomwe pamapeto pake zimayambitsa chiopsezo chowonjezereka cha kugwidwa ndi matenda a mtima. Kuphatikiza apo, mwa munthu yemwe ali ndi kuyenda pang'ono, thupi limayamba kukula pang'onopang'ono, zomwe zimakhalanso chiwopsezo cha matenda a mtima.

Fibates: ndi chiyani?

Kukonzekera mafupaamagwiritsanso ntchito kutsitsa cholesterol. Mankhwalawa ndi ena. fibroic acid. Amamangirira bile acid, potero amachepetsa kupanga mafuta m'thupi ndi chiwindi.

Fenofibates kuchepetsa mankhwalawa lipids, zomwe zimayambitsa cholesterol yotsika. Malinga ndi kafukufuku wazachipatala, kugwiritsa ntchito fenofibrate kutsitsa cholesterol ndi 25%, triglycerides ndi 40-50%, komanso kumakulitsa gawo lotchedwa cholesterol "labwino" mwa 10-30%.

Malangizo ogwiritsira ntchito fenofibrate, ciprofibrate amawonetsa kuti ndi cholesterol yambiri, mankhwalawa amachepetsa kuchuluka kwa zowonjezera, komanso cholesterol yotsika komanso triglycerides mwa odwala omwe ali ndi hypercholesterolemia.

Mndandanda wamafenofibrate:

• Taykolor,
• Lipantil
• Exlip 200,
• WaprofibrateLipanor
• Gemfibrozil.

Koma, musanagule ndi kumwa mankhwalawa, ziyenera kukumbukiridwa kuti kugwiritsa ntchito kwawo kumabweretsa chiwonetsero cha zovuta zina. Monga lamulo, zovuta zingapo zam'mimba zimawonetsedwa nthawi zambiri: chisangalalo, dyspepsia, kutsegula m'mimba, kusanza.

Zotsatira zotsatirazi zimadziwika mutatenga fenofibrate:

• Matumbo oyenda: kapamba, hepatitis, kusanza, kupweteka kwam'mimba, nseru, kutsegula m'mimba, kuwonekera, maonekedwe a gallstones.
• Dongosolo laumiseche: minofu kufooka, rhabdomyolysis, kupatula myalgia, myositis, cramping.
• Machitidwe amanjenje: mutu, kukomoka.
• Mtima ndi mitsempha yamagazi: pulmonary embolism, venous thromboembolism.
• Mawonetseredwe amatsutsa: kuyabwa pakhungu ndi zotupa, khungu urticaria.

Kuphatikiza kwa ma statins okhala ndi ma fibrate kumachitika kuti muchepetse Mlingo ndipo, mwakutero, mawonekedwe owoneka a statins.

Mankhwala omwe amachepetsa matumbo a cholesterol

Mankhwala Ezetimibe(Ezetrol) Kodi ndi lipid yatsopano yochepetsera lipid yomwe imachepetsa kuyamwa kwa cholesterol m'matumbo. Kuphatikiza apo, Ezetimibe (Ezetrol) samayambitsa kukula kwa matenda am'mimba. Muyenera kumwa 10 mg ya mankhwala patsiku. Koma ndikofunikira kulingalira kuti thupi limapanga 80% ya cholesterol, ndipo ndi 20% yokha yomwe imalowa ndi chakudya.

Mankhwala ena onse

Dokotala wanu angakulimbikitseni kutenga zowonjezera pazakudya (BAA).

Komabe, zithandizo zachilengedwe monga Omega 3, Tykveol, mafuta opindika, lipoic acid kuchepetsa cholesterol pang'ono.

Tiyenera kukumbukira kuti zakudya zowonjezera pakudya si mankhwala, chifukwa chake, mankhwalawa amachepetsedwa ndi mankhwala a statin poteteza kupewa matenda a mtima.

Mndandanda wazakudya zowonjezera zomwe zimagwiritsidwa ntchito pazinthu izi ndipo zimakhala ndi zinthu zachilengedwe:

Mapiritsi okhala mafuta a nsomba (Omega 3, Oceanol, Omacor) akulimbikitsidwa kuti agwiritsidwe ntchito ndi anthu omwe akufuna kutsitsa cholesterol. Mafuta a nsomba amateteza thupi ku kukula kwa matenda amitsempha yamagazi ndi mtima, komanso kukhumudwa komanso nyamakazi. Koma muyenera kumwa mafuta a nsomba mosamala kwambiri, chifukwa kuumwa kumawonjezera chiopsezo aakulu kapamba.

Mafuta a dzungu amaperekedwa kwa iwo akuvutika cholecystitis, atherosulinosis mitsempha yamaubongo chiwindi. Chidacho chimapereka choleretic, anti-kutupa, antioxidant, hepatoprotective.

Lipoic acid

Chida ichi ndi cha m'mbuyomu antioxidantAmagwiritsidwa ntchito popewa komanso kuchiza matenda a coronary atherosulinosis. Zotsatira zabwino za mankhwala pa kagayidwe kazakudya zimadziwika. Ikatengedwa, trophism of neurons imasintha, ndipo milingo ya glycogen mu chiwindi imachulukirachulukira.

Mavitamini zimathandizira kuti matenda a cholesterol azikulika, kuchuluka hemoglobin etc. Thupi limafunikira vitamini b12 ndi B6, folic acid, Nicotinic acid. Ndikofunika kwambiri kuti awa ndi mavitamini achilengedwe, ndiye kuti, ndikofunikira kudya zakudya zomwe zimakhala ndi mavitamini awa.

BAA ndi gawo la phazi lamafir, ili ndi beta-sitosterol, polyprenols. Iyenera kutengedwa pamene matenda oopsa, atherosulinosis, triglycerides yayikulu ndi cholesterol.

Njira zina

Otsatira a bile acid(Opanga ma Wheeletc.) ndi mankhwala omwe amagwiritsidwa ntchito mu chithandizo chovuta monga chothandizira pakuchepetsa cholesterol. Amalepheretsa kaphatikizidwe kake kam'madzi.

Waprofibrate Lipanor - amalepheretsa kaphatikizidwe wa cholesterol m'chiwindi, amachepetsa mulingo wake m'magazi, kuchepetsa kuchuluka kwa lipotroteins ya atherogenic.

Chifukwa chake, mndandanda wamankhwala a cholesterol pakadali pano ndiwokulira. Koma ngati wodwala amachepetsa cholesterol yamagazi ndimankhwala, ayenera kukumbukira kuti mankhwala omwe amachepetsa cholesterol amayambitsa zovuta zingapo. Zachidziwikire, popereka mankhwala a cholesterol okwanira, adokotala amawaganizira izi, ndikuwadziwitsanso wodwalayo za contraindication yotsitsa cholesterol.

Komabe, mankhwala ochepetsa cholesterol yamagazi amayenera kumwa, kuphatikiza chithandizo choterocho ndi chakudyakomanso moyo wokangalika. Ndikofunika kumwa mankhwala omwe amachepetsa cholesterol yamagazi, m'badwo waposachedwa, popeza wopanga wawo amawongoletsa mankhwala.

Mutha kuchepetsa cholesterol yamagazi ndi mapiritsi mpaka ena. Koma mapiritsi ochepetsa cholesterol ayenera kugwiritsidwa ntchito pokhapokha ngati pali chiwopsezo chachikulu cha matenda a mtima. Pali magulu a odwala omwe amafunika kumwa mapiritsi a cholesterol m'magazi. Nthawi zina, musanayambe kumwa mapiritsi kuti muchepetse cholesterol, muyenera kufunsa dokotala yemwe amayeza zabwino komanso zovuta za chithandizo chotere.

Kuti mukhale ndi moyo wokwanira, kuwonjezera pa kumwa mapiritsi, muyenera kudya moyenera, kusewera masewera. Ngati cholesterol ndiyambiri, ndibwino kuti musinthe moyo nthawi yomweyo, zomwe zimathandizira kuti zizolowereka popanda chithandizo chowonjezera. Mutha kuphunziranso kumwa mankhwala azitsamba, omwe amaphatikizapo uchi ndi zinthu zina zabwino kwambiri zomwe zimakupatsani "kuyeretsa" thupi. Kangati komanso kangati patsiku kuti mugwiritse ntchito ndalama zotere, katswiri adzakuuzani.

Ma Statistics: ndi chiyani ndipo chifukwa chiyani amavomerezedwa?

Madera - Ili ndi gulu la mankhwala ochepetsa lipid omwe amagwiritsidwa ntchito pochiza hypercholesterolemia, i.e., okwera kwambiri m'magazi a cholesterol (XC, Chol) m'magazi, omwe sangathe kuwongolera popanda mankhwala.

Kuchita kwa ma statins kumakhazikitsidwa ndikuletsa kwa enzyme, yomwe imayang'anira kupanga cholesterol ndi chiwindi (gwero la pafupifupi 80% ya chinthucho).

Njira yamachitidwe ma statins amakhala mosalumikizana ndi chiwindi: amatchinga kubisalira kwa enzyme HMG-KoA reductase, yomwe imapangitsa zomwe zimachitika poyambira mafuta amkati mwa cholesterol.

Izi zimathandizira kuchepetsa kuchuluka kwa otsika osalimba a lipoproteins (LDL, LDL) - onyamula "oyipa" XC ku minofu ndipo, matembenuzidwe, - amalimbikitsa kuchuluka kwa kupsinjika kwapamwamba kwa lipoproteins (HDL), onyamula "abwino" XC abwerere ku chiwindi, pokonzekera komanso kutaya pambuyo pake .

Ndiko kuti, kayendedwe ka cholesterol mwachindunji ndikusintha, pomwe lonse limatsika.

Kuphatikiza pa zochita zazikulu, ma statins ali ndi zotsatirapo zina zabwino: amachepetsa kutupa kwa endothelial, amasunga kukhazikika kwa zolembera za atherosulinotic ndikuthandizira kaphatikizidwe ka nitric oxide, komwe ndikofunikira pakupuma ziwiya.

Kodi amamulembera pamlingo uti wa cholesterol?

Statin amatengedwa ndi cholesterol yambiri - kuchokera 6,5 ​​mmol / lita. Koma ngakhale ndizizindikiro zotere, pakatha miyezi 3-6 ndikofunikira kuyesetsa kuti muchepetse iwo ndikuchotsa zizolowezi, masewera olimbitsa thupi a hypocholesterol. Pambuyo pokhapokha pokhapokha pokhapokha pakhala funso lokasankhidwa ndi ma statins omwe amawaganizira.

Kapangidwe ka madongosolo pamakoma amitsempha yamagazi chifukwa chokwanira cholesterol m'magazi.

Nthawi zina, madokotala amakupangira mankhwala opatsirana ngati gawo la mankhwala osokoneza bongo ngakhale otsika kwambiri - kuchokera pa 5.8 mmol / lita, ngati odwala ali ndi mbiri yoyipa:

Kutenga ma "statin" mwanjira yocheperako kungakhale ndi zotsatirapo zoipa, chifukwa chake ndizoletsedwa kupereka nokha. Chifukwa chake, adokotala yekha ndi amene angaganize kuti ndi nthawi yanji ya cholesterol nthawi yakumwa.

Zotheka kuvulaza komanso mavuto

Ndi mankhwala oyenera, zotsatira zoyipa za ma statins ndizosowa (mpaka 3% ya milandu) ndipo makamaka mwa odwala omwe amagwiritsa ntchito mankhwala osaposa zaka 3-5, kapena mwa iwo omwe amapitilira mlingo woyenera. Ndi kudziwongolera nokha, pali mwayi waukulu wolakwitsa osati ndi mlingo, komanso ndi kusankha kwa mankhwalawa, komwe kumawonjezera mwayi wazotsatira mpaka 10-14%.

Zotsatira zoyipa za mankhwala osokoneza bongo okhala ndi ma statins amakhala ndi zizindikiro za kuledzera:

• kuphwanya chopondapo (kudzimbidwa, kutsekula m'mimba), kutulutsa, mseru, kusanza, kusowa kudya,
• jaundice, pancreatitis pachimake ndi ululu wam'mimba womwe sunatchulidwe,
• kutuluka thukuta ndi kukodza, kusokonezeka kwa impso,
• redness, kutupa ndi kuyabwa kwa thupi, zotupa pakhungu la urticaria,
• chizungulire, kupweteka mutu, kufooka, kutopa, kuona.

Kufanana ndi kuchepa kwa lipoproteins, ma statins amachepetsa kupanga ma Qenz coenzymes, omwe amapereka mphamvu pafupifupi minofu yonse ya thupi. Chifukwa chake, ndi kuchepa kwake, mavuto akulu amathanso kuoneka:

kuchuluka kwa kugunda kwa mtima ndi kusagwira bwino ntchito, kudumphira mu magazi,

Kuwerenga za zomwe zimachitika chifukwa chobwera chifukwa cha kupezeka kwa mibadwo yaposachedwa.

Zovuta zodziwika bwino (mpaka 1% ya milandu) zoyipa zimawonongeka pakumva ndi kuwonongeka kwa zomverera, kuwonjezeka kwa khungu ku dzuwa, kukhumudwa, kuwonongeka kwa ubongo ndi kuwonongeka kwa minyewa yam'mimba yosakhala yotupa.

Mu odwala matenda ashuga, kumwa ma statins kumatha kuwonjezera kuchuluka kwa shuga m'magazi - mpaka 2.0 mmol / lita, zomwe zimapangitsa kuti kagayidwe kazachilengedwe kagayidwe.

Contraindication

Ngakhale ma statin (makamaka m'badwo watsopano) ali ndi zovuta zochepa, amakhalabe ndi zotsutsana:

• Matenda oopsa a impso, chiwindi ndi chithokomiro.
• Hypersensitivity (ziwengo) ku zigawo za kapangidwe,
• cholowa cham'mimba
• nthawi ya pakati ndi kuyamwa, ana ochepera zaka 18.

Kuphatikiza apo, chifukwa chakuwopsa kwambiri paumoyo, kumwa ma statin sikulimbikitsidwa pazinthu zotsatirazi:

• zogonana osagwiritsa ntchito njira zodalirika zakulera (makamaka azimayi achichepere azaka zakubala),
• kukhalapo kwa zovuta zazikulu mu endocrine system, kusokonezeka kwa mahomoni ndi kugwiritsa ntchito mankhwala a mahomoni.
• kuphatikiza mankhwala ndi ma fibrate, niacin, ma macrolide olimbana ndi ma cell, cytostatics ndi antifungal agents.

Izi zophwanya malamulo sizotsimikizika, komabe, muzochitika zotere, madokotala amapereka ma statin pokhapokha mwadzidzidzi ndikuwonetsetsa momwe amalandirira mosamala.

Kuyenderana ndi mowa

Kugwiritsa ntchito pamodzi kwa ma statins ndi mowa (kuphatikizapo mowa wochepa) sikuletsedwa: kuphatikiza kotereku kumawononga maselo a chiwindi, kumapangitsa kuwonongeka kwa poizoni.

Mwanjira yabwino kwambiri, kugwiritsa ntchito ethanol kumapangitsa kuti thupi lizikumana ndi vuto lalikulu, ndipo vuto lalikulu kwambiri, chifukwa cha kuwonongeka kwakukulu kwa hepatocytes, minofu yawo yolumikizidwa imaloledwa, necrosis kapena cirrhosis ya chiwindi iyamba kukulira.

M'badwo woyamba

Ma Statin a m'badwo wa 1 (1) ndi othandizira kutsitsa zamadzimadzi potengera zinthu zachilengedwe kapena zosakanikirana - lovastatin (lovastatin), pravastatin (pravastatin) ndi simvastatin (simvastatin).

Kuchita kwa zoyambirira za ma statins pa lipid mbiri ndizodziwikiratu: zimapereka kuchepa kwa cholesterol "yoyipa" (pofika 27- 34%) ndikuletsa kuphatikizira kwina kwamkati. Kuphatikiza apo, ali ndi bioavailability otsika, ndiye kuti, amawamwa mopanda chidwi ndipo samakhudza kwambiri kuchuluka kwa cholesterol yabwino.

Ubwino waukulu wa mankhwalawa ndi mtengo wawo, komanso umboni wautali wa umboni: makamaka, malinga ndi HPS, kuyesa kwa simvastatin kwa odwala okwana 20,5,000 kunawonetsa kuti kugwiritsidwa ntchito kwakutali kumapangitsa mkhalidwe wamsempha komanso kumalepheretsa atherossteosis.

Zoyipa ndi kuvulaza komwe kungakhalepo chifukwa cha ma statins oyambirira ndi chifukwa cha chiopsezo cha rhabdomyolysis. Chifukwa cha izi, mlingo waukulu wa mankhwala (oposa 40 mg) wa mankhwala amadziwika kwambiri, ngati njira zina zochiritsira sizingatheke.

Malangizo ogwiritsira ntchito amaphatikizapo kumwa mapiritsi 1 kamodzi patsiku, kuyambira 10-20 mg, nthawi yamadzulo kapena usiku.

Kukonzekera kwa gulu la statin la m'badwo woyamba 1 kutengera lovastatin:

Kukonzekera kwa gulu la statin la m'badwo woyamba 1 kutengera pravastatin:

Kukonzekera kwa gulu la ma statins a m'badwo wa 1 kutengera simvastatin:

M'badwo wachiwiri

Statins a m'badwo wachiwiri (2) ndi mankhwala opangidwa kwathunthu (monga mibadwo yonse yotsatira) yomwe ili ndi fluvastatin (fluvastatin) mwanjira yamchere wa sodium.

Kugwiritsa ntchito kwa fluvastatin motsutsana ndi cholesterol kumayambira pakulimbikitsa mphamvu yopanga lipoproteins yapamwamba, chifukwa zomwe zili za lowopeneti lipoproteins (24-31%) ndi triglycerides zimalipiridwanso, komanso momwe mulingo woyenera wa cholesterol imakhala yofanana.

Ubwino wawukulu wa mankhwalawa ndikuti ali ndi bioavailability, omwe amachepetsa mwayi wazotsatira zoyipa. Chifukwa chake, amatha kuperekedwa ngakhale kwa anthu atatha kupatsidwa ziwalo, chithandizo cha cytostatics, ndi ana azaka 10 zokhala ndi cholowa cha hypocholesterolemia.

Zoyipa ndi vuto lomwe lingakhalepo ngati mankhwala opatsirana ndi lipid ndi kuchepa mphamvu kwawo, chifukwa chake, kuti apeze zotsatira zotchulidwa, munthu ayenera kutenga milingo yambiri yogwira ntchito, yomwe imawonjezera kuchuluka kwa mankhwala m'thupi.

Malangizo ogwiritsidwira ntchito amatsimikiziranso kufunika kwa mlingo waukulu - kale muyenera kumwa mapiritsi a 40-80 mg kamodzi patsiku, makamaka madzulo.

Kukonzekera kwa gulu la ma statins a m'badwo wa II kutengera fluvastatin:

M'badwo wachitatu

Ma stator a m'badwo wa Atorvastatin III (3) madokotala ndiwo mankhwala oyamba ochepetsa lipid - ali oyenera kwambiri poyerekeza ndi mtengo / kuchuluka kwake ndi chilengedwe, i.e., akuwonetsa chikhazikitso chamankhwala odwala omwe ali amisinkhu yosiyanasiyana, kuphatikiza okalamba.

Kuchita bwino Vutoli la kuchuluka kwa cholesterol limatsimikiziridwa ndi mayeso angapo azachipatala, kuphatikizapo CURVES, GRACE ndi TNT, omwe adawonetsa kuchepetsedwa kwakukulu pamlingo wa lipoproteins lotayirira (mwa 39-47%). Kuphatikiza apo, atorvastatin imathandizira kupangidwa kwa cholesterol kuchokera kumafuta omwe alipo.

Ubwino wawukulu wa mankhwala, kuphatikiza pakuchita kwawo kwodziwikiratu, ndikuti pa mlingo wochepa (10 mg), atorvastatin kwenikweni samalumikizana ndi mankhwala ena omwe amatengedwa ndi odwala omwe ali ndi mawonekedwe ena a hypercholesterolemia.

Zoyipa ndi zovuta zomwe zingachitike ku Atorvastatin zimatengera mlingo wake komanso nthawi yonse ya maphunzirowo. Ndi chithandizo cha nthawi yayitali, zotsatira zoyipa za ntchito ya chiwindi zimadziwika, komabe, monga zina za lipophilic statins (I, II ndi III mibadwo).

Malangizo ogwiritsira ntchito amawonetsa kusiyanasiyana kwa koyamba kwa mankhwalawa - kuyambira 10 mpaka 80 mg 1 nthawi patsiku, amatengedwa mosasamala za kudya nthawi iliyonse yamasiku.

Mankhwala abwino kwambiri a gulu la III genin statin kutengera atorvastatin:

M'badwo wachinayi (watsopano)

Statins IV (4) m'badwo, i.e. rosuvastatin (rosuvastatin) ndi pitavastatin (pitavastatin) ndi mankhwala aposachedwa kwambiri a lipid, amadziwika kuti ndi othandiza kwambiri komanso otetezeka a cholesterol.

Kuchita bwino ma statin amakono amaposa mibadwo yonse yambuyomu yomwe ili mgululi. Kuyesa koyerekeza kwa Rosuvastatin LUNAR kunawonetsa kuchepa kwakukulu kwa zomwe zikuwonetsa cholesterol "yoyipa" (mwa 47-51%) ndikuwonjezereka kwa magawo ake a antiatherosranceotic. Kuphatikiza apo, pamafunika mlingo wotsika kwambiri kuposa, mwachitsanzo, Atorvastatin.

Ubwino wawukulu wa mankhwala - ochepa ochulukitsa, komanso chiwopsezo chochepa cha zotsatira zoyipa. Mosiyana ndi ma statin ena, samakhudza kagayidwe kazakudya, chifukwa chake amaloledwa kutengedwa ngakhale limodzi ndi chithandizo cha matenda ashuga.

Zoyipa ndi kuvulaza komwe kungachitike chifukwa cha ma statins omaliza nthawi zambiri kumachitika, koma nthawi zina kugwiritsidwa ntchito kwawo kwa nthawi yayitali kumalepheretsa impso ku odwala omwe mkodzo wawo uli ndi mapuloteni kapena magazi. Mwakutero, amatha kukhala opanda ntchito kapena oopsa kwa odwala omwe ali ndi dialysis.

Malangizo ogwiritsira ntchito ali ndi chidziwitso pakufunika kwa kusintha pang'onopang'ono kwa thupi ndi mankhwalawa, motero tikulimbikitsidwa kuti ayambe kumwa ndi mankhwala ochepa - rosuvastatin 5-10 mg kapena pitavastatin 1 mg 1 nthawi ya m'mawa kapena madzulo.

Mankhwala abwino kwambiri a IV m'badwo wa statins gulu lochokera ku rosuvastatin:

Mankhwala abwino kwambiri a IV m'badwo wa statin gulu lotengera pitavastatin:

Mayina omwe alipo: mankhwala athunthu

Pa msika wogulitsa mankhwala sikuti mankhwala oyamba a gulu la statin okha omwe amagulitsidwa, komanso kukopera mankhwala, otchedwama generics (analogues) omwe amapangidwa kuchokera ku chinthu chomwecho yogwira pansi pa dzina lina (INN).

Mndandanda wa onse omwe adalembetsedwa ku Russia:

• lovastatin(I) - Cardiostatin, Mevacor, Holetar, Lovastatin, Rovacor, Medostatin, Lovacor, Lovasterol,
• pravastatin (I) - Lipostat, Pravastatin,
• simvastatin (I) - Simvalimite, Zokor, Vabadin, Simvastol, Avestatin, Simgal, Actalipid, Simvastatin-Ferein, Simplakor, Atherostat, Vasilip, Zorstat, Levomir, Ovenkor, Simvageksal, Allesta, Simvakol, Simvastatin, Simvor Zimak, Simvakov , Simvatin,
• fukudzi (II) - Leskol, Leskol forte,
• atorvastasti (III) - Tulip, Liptonorm, Torvakard, Atoris, Liprimar, Atorvastatin, Atorvastatin Canon, Atomax,
• pitavastatin (IV) - Pitavastatin, Lizao,
• rosuvastatin (IV) - Roxera, Crestor, Po-statin, Mertenil, Rosulip, Lipoprime, Tevastor, Rosuvastatin-C3, Rosistark, Rosart, Suvardio, Rosuvastatin, Akorta, Reddistatin, Rosucard, Cardiolip, Rosuvastatin Canon, Rosuvastuastatin, calcium .

Kuphatikiza pa dzina lamalonda, zida zamagetsi zimasiyana ndi zoyambirira za umisiri waumisiri wopanga, mtengo ndi kapangidwe kazinthu zothandizira. Kupanda kutero, ndizofanana ndendende, kotero munthu ali ndi ufulu wosankha payekha kuti analog ndiyabwino ndikusintha choyambayo. Koma pokhapokha mutakambirana ndi dokotala.

Kodi azitengedwa nthawi yayitali bwanji?

Ndi regimen yosankhidwa bwino ya mankhwala, ma statin ambiri amapereka mphamvu yoyamba ya lipid mkati mwa masabata awiri atayamba kudya, kusiyiratu kungokhala rosuvastatin: imakhala ndi tanthauzo pambuyo pa masiku 79 kuyambira chiyambi cha mankhwala. Zotsatira zabwino kwambiri zimayamba pambuyo pa miyezi 1-1.5 mutatenga ma statin aliwonse ndipo amayesedwa nthawi yonseyi.

Nthawi zambiri, kuchuluka kwa mafuta kagayidwe m'thupi ndi njira yayitali kwambiri, motero ma statins amaperekedwa kwa miyezi ingapo kufikira zaka zingapo. Ndi mawonekedwe amtundu wa hypercholesterolemia, komanso makamaka ndi vuto lalikulu la lipid, kumwa mapiritsi ndikofunikira moyo.

Mankhwala ochepetsa lipid achilengedwe

• mitengo yothira (phytosterols) - sea buckthorn ndi mafuta a mpunga, nyongolosi ya tirigu, mpendadzuwa ndi nthangala zakuda za sesame, mbewu za poppy, nyemba ndi avocado,
• antioxidants polyphenols - chokeberry, honeysuckle, duwa lamtchire, makangaza, zipatso zouma, ma supimmons, ma currants akuda, tomato ndi anyezi ofiira,

Masamba ndi zipatso zomwe zimathandizira kuti cholesterol ikhale yachilendo.

Zakudya zozizira pazogwira izi zimagwira ntchito mwachangu - kwa miyezi ya 2,5 - 3, kuchuluka kwa cholesterol kumachepetsedwa ndi 15-23%. Zotsatira kuchokera pazogulitsa zamkati zimayenera kudikirira nthawi yayitali - miyezi 4-7.

Ndemanga pakugwiritsa ntchito bwino mankhwala

Umboni wa odwala omwe amatenga ma statins kuti achepetse cholesterol imapangitsa kuti pakhale chithunzi chonse ndikuyeza "zabwino" ndi "zolakwika" zonse:

Malingaliro oterewa akuwonetsa kuti anthu ambiri amakayikira kwambiri ma statin ndipo amawona zabwino komanso zoyipa pakugwiritsa ntchito. Ndikofunikira kulingalira za malingaliro, omwe amadziwika chifukwa chambiri pawailesi yakanema "Pa chinthu chofunikira kwambiri", cholemba Dr. Myasnikov, yemwe akuti ma statins adangokhazikitsidwa pokhapokha poopseza thanzi: kale atherosclerosis yomwe ikupita kale kapena kuphatikiza zinthu zitatu kapena zingapo zowopsa (zizolowezi zowonjezera, zowonjezera kulemera, etc.).Mankhwala osokoneza bongo omwe ali mgululi ali ndi katundu wambiri mthupi ndipo samayikidwa pakulakwitsa pang'ono.

Kodi kugula statins kuti muchepetse cholesterol?

Mutha kugula ma statin apoyamba ndi zida zawo zapamwamba kunyumba, ndikuyitanitsa ku pharmacy yodalirika yapaintaneti:

• https://apteka.ru - Krestor 10 mg No. 28 - 1255 rubles, Simvastatin 20 mg No. 30 - 226 rubles, Leskol forte 80 mg No. 28 - 2537 rubles, Liprimar 40 mg No. 30 - 1065 rubles,
• https://wer.ru - Krestor 10 mg No. 28 - 1618 rubles, Simvastatin 20 mg No. 30 - 221 rubles, Leskol forte 80 mg No. 28 - 2714 rubles, Liprimar 40 mg No. 30 - 1115 rubles.

Muli likulu, mankhwalawa atha kugulika ku pharmacy iliyonse yapafupi:

• Kukambirana, st. Perovskaya 55/56 kuyambira 07:00 mpaka 22:00, tel. +7 (495) 108-17-39,
• Thanzi Lama City, st. Chuma 2-4 / 44, p. 1. Kuyambira 08:00 mpaka 23:00, tel. +7 (495) 797-63-36.

Ku St. Petersburg

Ku St. Petersburg, monga lamulo, mulibe zovuta pakugula ma statins:

• MadziAve. Mwapadera 25/18 kuyambira 07:00 mpaka 23:00, t. +7 (812) 603-00-00,
• Rigla, st. Pea 41a, pom. 9h kuyambira 08:00 mpaka 22:00, tel. +7 (800) 777-03-03.

Pomaliza, ndikofunikira kuyang'ananso kuti ma statins sindiye njira yothandizira kupewa atherosclerosis, koma mankhwala akulu omwe angapangitse onse kuti apindule komanso kuvulaza. Komabe, ngakhale ali ndi mantha a odwala, omwe ali ndi vuto lalikulu la mtima, cholinga chawo chimakhala cholondola, chifukwa m'mikhalidwe imeneyi amapulumutsadi miyoyo.

Mafuta a cholesterol: akapatsidwa mankhwala, mavuto

HMG-CoA reductase inhibitors, mwanjira ina, ma statins, ndiye gulu lalikulu la mankhwala omwe amaperekedwa kwa cholesterol yayikulu, yomwe ilibe ma analogues. Ngati kuchuluka kwa cholesterol ya LDL yamavuto yoposa muyeso ndikuwongolera kwa zakudya sizithandiza kukonza vutoli, wodwalayo amapatsidwa mankhwala okhala ndi nthawi yayitali.

Mfundo ya zomwe akuchita ndi kupondereza zochita za enzyme yomwe imayang'anira chiwindi, ndikuchepetsa kupitilira kwa atherosulinosis. Kudya mapiritsi pafupipafupi kumathandizira kuti akhale ndi moyo wautali kwa anthu omwe akudwala matenda opatsirana a mtima, omwe ali ndi vuto la kufalikira kwa magazi.

Liti ndipo ndani akuyenera kutenga ma statins

Ma cholesterol statins amaperekedwa kwa anthu omwe ali ndi chiopsezo chachikulu cha kugunda kwa mtima komanso kugunda kwa mtima, pomwe cholesterol yayikulu imakhazikika, osatsika, ndipo ndi 300-330 mg / dl kapena 8-11 mmol / l, komanso ngati milandu itakwaniritsidwa kamodzi:

• matenda a mtima, stroko, kapena ischemic,
• chotupa cham'madzi chodutsa,
• atherosulinotic zotupa zam'mitsempha yamagazi,
• kukweza c-yogwira mapuloteni ndi calcium calcium m'mitsempha.

Chithandizo cha mapiritsi a cholesterol sichikuperekedwa kwa anthu athanzi omwe amawonjezera pang'ono m'magawo a LDL, chifukwa zotsatira zoyipa za thupi zimakhala zamphamvu kuposa maubwino. Sitikulimbikitsidwanso kuti ndiyambe kulandira mankhwalawa chifukwa:

• kuwonjezeka pang'ono ndi kosakhazikika kwa cholesterol,
• kusowa kwa atherosulinosis,
• palibe matenda amtima kapena stroko
• mulibe calcium m'mitsempha kapena ndi ochepa,
• mapuloteni a c-yogwira ndi ochepera 1 mg / dl.

Tiyenera kukumbukira kuti chithandizo ndi ma statins chikhoza kupitilira moyo wonse. Akachotsedwa, cholesterol level imabwelera m'migawo yake yapitayi.

Kugwiritsa ntchito ma statins kuyenera kuchitika pongotsatira kwa dokotala chifukwa cha zotsutsana zambiri ndi zoyipa. Mukamapereka mankhwala, zotsatirazi ndi izi:

• zaka komanso jenda odwala
• matenda am'mbuyomu kapena omwe alipo a mtima ndi hematopoietic dongosolo, kuphatikizapo matenda a shuga.

Odwala okalamba ayenera kumwa mankhwala a statins mosamala kwambiri ngati akugwiritsa ntchito mankhwala ena opangira matenda oopsa, gout, kapena matenda ashuga. Mwa gulu ili la odwala, kuyesa magazi ndikuwunika kwa chiwindi kumachitika kawiri kawiri.

Matenda a shuga ndi ma statin

Ma Statin ali ndi minus ina yofunika - amawonjezera shuga m'magazi ndi 1-2 mmol / L. Izi zimawonjezera chiwopsezo cha matenda a shuga II amtundu 10%. Ndipo mwa odwala omwe ali ndi matenda ashuga kale, amatenga ziwonetsero zama cellins ndikuwonjezera chiopsezo cha kupititsa kwake msanga.

Koma, ziyenera kumvetsedwa kuti zabwino zomwe zimatenga ma statins zitha kukhala zazikulupo kuposa zovuta zomwe zimakhala ndi thupi. Mankhwala amathandizira kuchepetsa chiopsezo cha matenda a mtima ndi mikwingwirima, kukulitsa nthawi yokhala ndi moyo, yomwe ndiyofunika kwambiri kuposa kuchuluka kwochepa kwa shuga m'magazi.

Ndi matenda a shuga, ndikofunikira kuti mankhwalawa akhale okwanira. Kutenga mapiritsi kuyenera kuphatikizidwa ndi chakudya chamafuta ochepa, kuchuluka kwa zochita zolimbitsa thupi ndi Mlingo wa insulin.

Gulu la ma statins

Gulu la ma statins limaphatikizapo kuchuluka kwa mankhwala. Mankhwala, amagawidwa malinga ndi magawo awiri: mbadwo (nthawi yotulutsidwa pamsika wamankhwala) ndi chiyambi.

• Mbadwo: Simvastatin, Pravastatin, Lovastatin. Mulingo wa lipoproteins wapamwamba kwambiri umachulukidwa ndizochepa kwambiri. Zothandiza pa boma la mitsempha yamagazi, kusintha magazi, kukhala ndi antioxidant katundu. Amakhala ndi mphamvu yofooka ya mankhwala onse. Mapiritsi amalembedwa kwa odwala omwe ali ndi vuto lalikulu la hypercholesterolemia, omwe ali pachiwopsezo chotenga matenda a coronary atherosulinosis.
• M'badwo wachiwiri: fluvastatin. Mothandizidwa amachepetsa kupanga cholesterol m'maselo omwe akukhudzidwa ndi kapangidwe kake, kumathandizira kutenga ndi kutulutsa kwa LDL. Mwa mankhwala onse omwe amachepetsa cholesterol, imakhala yothandiza kwambiri pakulimbitsa thupi. Gawani zakusemphana kwa lipid kagayidwe kachakudya popewa zovuta: matenda a m'matumbo, matenda am'mitsempha, matenda a mtima komanso sitiroko pambuyo pakuchita opaleshoni.
• M'badwo wachitatu: Atorvastatin. Mapiritsi ogwira ntchito, omwe amalembedwa kwa odwala omwe ali ndi mitundu yovuta ya hypercholesterolemia, omwe ali ndi matenda osakanikirana, matenda obadwa nawo. Amawonetsedwa kwa anthu omwe akudwala matenda amtima, omwe ali ndi chiopsezo chotenga matenda amitsempha yamagazi.
• Mbadwo wa IV: Rosuvastatin, Pitavastatin. Mankhwala abwino amakono omwe ali ndi zotsatira zabwino komanso zochepa zoyipa. Chepetsani LDL ndikuwonjezera HDL, yeretsani mitsempha ya magazi, pewani kudzipereka pamakoma amitsempha yama cholesterol. Ntchito mankhwalawa komanso kupewa atherosulinosis ndi zotsatira zake. Mosiyana ndi mankhwala amibadwo yam'mbuyomu, Rosuvastatin samangolimbana ndi lipoprotein zovulaza, komanso amathandizanso kutukusira kwa mtima, komwe, malinga ndi asayansi, komanso chifukwa cha atherosclerosis. Pitavastatin ndi mankhwala abwino kwa odwala matenda ashuga. Ili ndiye njira yokhayo pagulu la ma statins omwe samakhudzana ndi kagayidwe ka glucose ndipo, motero, silikukweza mulingo wake.

Ngati pali matenda osachiritsika a chiwindi, tikulimbikitsidwa kuti mugwiritse ntchito mankhwala amakono pazomwe zimakhala zochepa. Ma statins a m'badwo waposachedwa amateteza maselo a chiwindi ndipo samavulaza thupi. Koma amaletsedwa kuphatikiza mowa ndi mtundu uliwonse wa antibacteria.

Mwa chiyambi, ma statin onse amagawidwa kukhala:

• Zachilengedwe: Lovastatin. Mankhwala, chinthu chachikulu chomwe chimapanga ndi chikhalidwe chomwe chimachokera ku penicillin bowa.
• Zopanga: Simvastatin, Pravastatin. Amasinthidwa pang'ono ndi mevalonic acid.
• Zopangira: fluvastatin, rosuvastatin, atorvastatin, pitavastatin. Mapiritsi otsitsa cholesterol okhala ndi katundu watsopano.

Palibe chifukwa choganiza kuti mapiritsi a cholesterol achilengedwe ndi otetezeka chifukwa cha kapangidwe kake. Malingaliro awa ndi olakwika. Amakhalanso ndi zovuta zingapo, ngati anzawo.Komanso, akatswiri akuti mankhwala otetezedwa kwathunthu omwe sayambitsa kuyipa kulibe.

Mitundu ya ma statins, mtengo wamba pama pharmacies

Mankhwala omwe amagwirizana ndi ma statins ndi othandiza motani pochepetsa cholesterol imatha kupezeka pagome.

Fibates - Zotsatira za Fibroic Acid

Fibates ndiye mankhwala achiwiri othandiza kwambiri kuthana ndi cholesterol yayikulu. Nthawi zambiri amagwiritsidwa ntchito limodzi ndi ma statins. Nthawi zina, amaperekedwa ngati ndalama zodziimira pawokha.

Njira yogwiritsira ntchito mapiritsi ndi kupititsa patsogolo ntchito za lipoproteinplase, yomwe imaphwanya tinthu tating'onoting'ono komanso kotsika kwambiri. Mankhwala, lipid metabolism imathandizira, kuchuluka kwa cholesterol yopindulitsa kumachuluka, kagayidwe kazakudya mu chiwindi imagwiranso ntchito, ndipo chiopsezo cha mapangidwe a atherosulinotic ndi pathologies amtima amachepa.

Mankhwala olimbitsa mtima a cholesterol amaloledwa bwino ndi odwala. Zotsatira zoyipa zimachitika kawirikawiri (pafupifupi 7-10%).

Malangizo othandiza kwambiri ndi awa:

• Clofibrate. Ili ndi ntchito yotchulidwa ya hypolipidemic, imapangitsa kagayidwe kachakudya ka chiwindi, imachepetsa kukhuthala kwa magazi ndi thrombosis. Sichikuperekedwa pofuna kupewa cholowa kapena cholowa chamwazi.
• Gemfibrozil. Clofibrate zotumphukira ndi zochepa poizoni ndi zoyipa. Adanenanso kuti katundu wa lipid-kutsitsa. Imachepetsa LDL, VLDL ndi triglycerides, imachulukitsa HDL, imathandizira kuchotsetsa kwamafuta am'mafuta a chiwindi.
• Bezafibrat. Amachepetsa cholesterol ndi glucose, amachepetsa chiopsezo cha thrombosis. Adanenanso antiatherosranceotic katundu.
• Fenofibrate. Mankhwala amakono komanso othandiza kwambiri a cholesterol kuchokera pagulu la ma fibrate. Amawaganizira kuti ndi njira yodziwika pothana ndi vuto la lipid metabolism komanso kuchuluka kwa insulin. Kuphatikiza pa kuchepa kwa lipid, kumakhala ndi zotsutsana ndi kutupa, antioxidant ndi zotsatira za tonic.

Mafayilo amaletsedwa mwamphamvu kwa anthu omwe ali ndi cholelithiasis, chikhodzodzo, chiwindi ndi vuto la impso. Ndi chisamaliro chachikulu, amaperekedwa kwa achinyamata ndi okalamba.

Otsatira a bile acid

Gulu la mankhwala ochepetsa lipid omwe amaletsa kupanga mafuta a cholesterol. Amagwiritsidwa ntchito ngati othandizira zovuta mankhwala.

Ma acid akhungu amapangidwa nthawi ya metabolic yomwe imachitika pakati pa cholesterol ndi mafuta.Omwe amachokera m'matumbo am'mimbamo amatulutsa am'mimba ndipo amawachotsa m'thupi mwachilengedwe. Zotsatira zake, kudya kwawo m'chiwindi kumachepetsedwa kwambiri. Chiwalochi chimayamba kuphatikiza zidulo izi, ndikugwiritsa ntchito LDL yambiri, yomwe imachepetsa kuchuluka kwake m'magazi.

Okhazikika omwe amamanga ma asidi a bile amagawidwa m'magulu atatu:

• Colestyramine (cholestyramine). Mukalowa m'matumbo ang'onoang'ono, amapanga ma protein a asidi osagwira. Imathandizira kuchotserera kwawo ndikuchepetsa kuyamwa kwa cholesterol ndi makoma am'mimba.
• Colestipol. Mkulu kwambiri kulemera kopolymer. Amachepetsa kuyamwa kwa exsteridi cholesterol. Osagwiritsa ntchito kuposa colestyramine, motero, nthawi zambiri amadziwikanso mu zovuta kwa odwala omwe ali ndi hypercholesterolemia yoyamba.
• Opanga ma Wheel. Mapiritsi a m'badwo watsopano wa cholesterol. Zimagwira kwambiri, sizimayambitsa mavuto. Zimayenda bwino ndi mankhwala ena. Itha kutengedwa nthawi yapakati.

Kuphatikiza pakuchepetsa kuchuluka kwa cholesterol yoyipa, mankhwalawa amachepetsa chiopsezo chokhala ndi matenda a mtima, matenda a mtima, kugunda kwa mtima. Samatengedwa mu kayendedwe kazinthu, motero, amayambitsa zovuta zochepa. Nthawi zambiri, awa ndimavuto oyeserera: kusokonezeka, kusowa chakudya, kukhumudwa.

Acototic acid

Niacin (Niacin, Vitamini PP, B₃- - mankhwala okhudzana ndi lipid kagayidwe, michere kaphatikizidwe, redox zimachitikira.

Ndi cholesterol yayikulu, Niacin imayikidwa limodzi ndi mankhwala ena kuti magazi azitha, kukulitsa zotupa za m'mimba ndikulimbitsa magazi. Niacin imathandizanso kutulutsa, kutulutsa ndi kulimbitsa mitsempha yamagazi, imakhala ndi zovuta ku thupi.

Mankhwalawa amachitika moyang'aniridwa ndi dokotala. Kusintha kosiyanasiyana ndikotheka - ziwopsezo, kumva kutentha kwambiri, kugwiritsidwa ntchito kwa zida zam'mimba, kuchuluka kwa shuga (kowopsa kwa odwala matenda a shuga).

Cholesterol mayamwidwe zoletsa

Mankhwala amtunduwu samachulukitsa kuchuluka kwa ma asidi a bile ndipo samalepheretsa kupangika kwa cholesterol ndi chiwindi. Kuchita kwawo kuli ndi cholinga chofuna kuchepetsa kuchuluka kwa ma asidi kuchokera m'matumbo ang'onoang'ono kupita m'chiwindi. Chifukwa cha izi, ndalama zomwe zimasungidwa zimachepetsedwa, ndipo kuchoka kwa magazi kumalimbikitsidwa.

Mankhwala othandiza kwambiri m'gululi:

• Ezetimibe (analogues: Ezetrol, Lipobon). Akutenga kalasi yatsopano. Kuchepetsa mayamwidwe a cholesterol m'matumbo ang'ono. Osachepetsa chiopsezo cha matenda a mtima ndi sitiroko, musakhudze kuchuluka kwa moyo wa wodwalayo. Zothandiza kwambiri pamene zimaphatikizidwa ndi ma statins. Zotsatira zoyipa ndizotheka - chifuwa, kutsegula m'mimba, kuwonongeka kwa magazi.
• Guarem (garu gamu). Ili ndi hypocholesterolemic ndi hypoglycemic. Amachepetsa mayamwidwe a cholesterol m'matumbo ang'onoang'ono, pomwe amalimbikitsa njira zama metabolic mu chiwindi. Ndi zovuta mankhwala, amachepetsa mulingo wa LDL ndi triglycerides ndi 10-15%.

Mankhwala ochepetsa cholesterol yamagazi amapatsidwa njira yoyambira komanso cholowa cha hypercholesterolemia, omwe ali ndi vuto la lipid metabolism pamaso pa matenda a shuga.

Mankhwala osokoneza bongo omwe amasintha kutanuka kwa khoma la mtima

Amagwiritsidwa ntchito kuti apititse patsogolo chithandizo komanso chofunikira kwambiri pochiza komanso kupewa zovuta za atherosulinosis. Chithandizo chothandizira chimaphatikizapo mankhwala omwe amasintha magazi, mkhalidwe wamakoma amitsempha yamagazi, magazi a magazi:

• Vinpocetine. Amachotsa kuphipha kwamitsempha yamagazi, kusintha magazi, Imakhala ndi phindu pamkatikati yamanjenje.
• Dihydroquercytin. Mapiritsi kusintha mtima ntchito ndi mtima. Sinthani kagayidwe ka lipid, muchepetse shuga, muchepetse kupita patsogolo kwa atherosulinosis.
• Acetylsalicylic acid. Perekani kuti muchepetse magazi komanso muchepetse ziwopsezo zamagazi.
• Zowonjezera pa cholesterol. Kuthekera kowatenga ndi kuwonjezeka kokhazikika kwa LDL ndikokayikira kwambiri. Mosiyana ndi mankhwala ochepetsa cholesterol yamagazi, zowonjezera zakudya zimangoyesedwa kuti zikhale zotetezeka. Palibe umboni uliwonse wothandiza pochiritsa. Koma zimatha kugwiritsidwa ntchito ndikupatuka pang'ono kwa LDL kuchokera pazizolowezi, limodzi ndi chithandizo chamankhwala komanso kusintha kwa moyo.

Mapiritsi onse ayenera kumwedwa kokha malinga ndi dokotala. Kuphatikiza pa kumwa mankhwala, anthu omwe ali ndi cholesterol yambiri ayenera kusintha moyo wawo ndi zakudya. Pokhapokha ngati mankhwalawa atha kukhala othandiza komanso othandiza kwambiri.

Zolemba

1. George T. Krucik, MD, MBA. Zina mwa Statins Zotsitsa Cholesterol, 2016
2. Susan J. Bliss, RPh, MBA. Mankhwala Ochepetsa a Cholesterol, 2016
3. Omudhome Ogbru, PharmD. Mitundu Yotsitsa ya Cholesterol, 2017
4. A. A. Smirnov. Kuyerekeza kusanthula kwamphamvu kwa ma statin amakono

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