Masamba otani omwe angatenge ndi shuga yachiwiri

Matenda a shuga mellitus (DM) ndi matenda oopsa omwe amakhudza machitidwe ambiri mthupi. Onse odwala matenda ashuga ali pachiwopsezo cha kukhala ndi matenda amtima: matenda a mtima, ubongo, kulowetsedwa kwa myocardial, stroke. Nthawi zambiri amakhala ndi vuto la lipid metabolism, lomwe limawonetsedwa molemera kwambiri, kuchuluka kwambiri kwa cholesterol yoyipa, triglycerides, kutsika kochepa kwa sterol yabwino.

Ma Statin ndi mankhwala amphamvu omwe amachepetsa cholesterol, kupewa mavuto a mtima, atherosulinosis. Komabe, amatha kuwonjezera magazi, omwe ndi osayenera kwambiri kwa odwala matenda ashuga. Tiona ngati kuli koyenera kumwa ma statins a shuga mellitus, omwe mankhwalawa amadziwika kuti ndi otetezeka ndipo kodi chidziwitso chazomwe zingavulaze anthu wathanzi chinachokera kuti?

Kodi odwala matenda ashuga amafunikira ma statins?

Kufunika kwama statins kwa odwala matenda a shuga kwaphunziridwa ndi akatswiri osiyanasiyana. Asayansi a ku Scandinavia omwe adayang'ana ubale wapakati pa matenda ashuga komanso kuopsa kwa matenda amitsempha yamafuta akuti kumwa mankhwala kumayambitsa kuchepa kwakukulu kwaimfa. Chosangalatsa ndichakuti kuchepa kwa mwayi wokhala ndi matenda amtima wodwala matenda ashuga kudadziwika kwambiri kuposa anthu athanzi: 42% motsutsana ndi 32% (1).

Poyesanso kwina (Cholesterol and Reconger Events (CARE)), asayansi adaphunzira zotsatira za pravastatin. Gulu lowongolera la anthu omwe amatenga placebo anali ndi vuto lalikulu lamatenda (25%). Chiwerengerochi chinali chofanana ndi odwala matenda ashuga, osadwala.

Kuyesera kwakukulu pakugwiritsa ntchito ma statins The Heart Protection Study (HPS) kunaphatikizapo odwala 6,000 omwe ali ndi matenda a shuga. Gulu la odwala lidawonetsa kuchepa kwakukulu (22%). Maphunziro ena, omwe adangotsimikiziridwa, adakonzedwa ndi data yomwe olemba akale adachita.

Ndi kukula kwa umboni, madokotala ambiri akhulupirira kwambiri kuti ma statins ndi matenda ashuga amatha kukhalapo komanso kukhala opindulitsa. Funso limodzi lokha lomwe lidatsegulidwa: ndani omwe ayenera kumwa mankhwalawa.

Buku lomwe lasindikizidwa posachedwa kwambiri pakugwiritsiridwa ntchito kwa statin ndi American College of Cardiology, American Heart Association, ili ndi yankho lokwanira. Ndikulimbikitsa kuti madokotala popereka mankhwala a odwala omwe ali ndi matenda osokoneza bongo amayang'ana kwambiri kupezeka kwa ziwopsezo zamatenda amtima, osati kuchuluka kwa cholesterol. Statins ayenera kuperekedwa kwa odwala matenda ashuga onse omwe ali ndi atherosclerosis, komanso odwala omwe ali ndi:

• kuthamanga kwa magazi (BP),
• mulingo wa cholesterol yoyipa (LDL) woposa 100 mg / dl,
• matenda a impso
• albinuria
• kubadwa kwamtsogolo
• zaka zopitilira 40
• osuta.

Koma odwala omwe ali ndi zaka zosakwana 40 popanda zoopsa zina, kuphatikiza pa matenda ashuga, mankhwala sayenera kumwa.

Kusankha mtundu woyenera wa matenda a shuga a 2

Pali mitundu ingapo yama statins. Zina mwazo ndi zachilengedwe (lovastatin, pravastatin, simvastatin), gawo lopanga (atorvastatin, rosuvastatin, pitavastatin). Koma kapangidwe ka zochita zawo ndi kofanana kwambiri: mankhwala amateteza ntchito ya enzyme HMG-CoA reductase, popanda iwo kupangika kwa cholesterol sikutheka.

Kusankhidwa kwa mankhwala oyenera ochizira odwala matenda ashuga ndi munthu payekha. Palibe malingaliro ovomerezeka ambiri pankhaniyi. Algorithm yapamwamba kwambiri yosankhidwa ndi mankhwala aperekedwa ndi akatswiri aku America. Amalangiza popereka mankhwala kuti azitsogozedwa ndi mwayi wokhala ndi matenda amtima. Zimatengera zaka zobisika, kukhalapo kwa zinthu zoopsa, cholesterol (LDL).

Malinga ndi ndalamayi, anthu omwe ali ndi mwayi wochepa wokhala ndi mtima wam'magazi ayenera kulandira mankhwala osafunikira - pravastatin, lovastatin, simvastatin, ndi odwala "oopsa" - amphamvu kwambiri: atorvastatin, rosuvastatin.

Mphamvu ya mankhwalawa imangotengera dzina la yogwira. Mphamvu yayikulu pamphamvu ya statin ili ndi mlingo. Mwachitsanzo, Mlingo wotsika wa atorvastatin amakhala ndi zolimbitsa, zapamwamba - zamphamvu.

Matenda a chiwindi osachiritsika ndi chinthu chinanso chomwe chimagwira pakusankhidwa kwa mankhwalawa. Kupatula apo, ma statins osiyanasiyana amadzaza chiwalochi mosiyanasiyana.

Odwala omwe ali ndi matenda ashuga amatha kutsutsana ndi zinthu zomwe zimagwiritsidwa ntchito piritsi. Njira yothetsera vutoli ndikusintha mtundu wa statin kapena kupereka mtundu wina wa mankhwala ochepetsa lipid.

Zotsatira zoyipa zomwe ndingakumane nazo?

Masiku ano, madokotala alibe umboni wotsimikizika wokhudza mgwirizano pakati pa matenda ashuga komanso kuchuluka kwa zovuta ndi ma statins. Monga odwala omwe ali m'magulu ena, odwala matenda ashuga amatha kukumana ndi zovuta zomwe zimachitika chifukwa cha zomwe mankhwalawo apanga. Madandaulo ambiri:

• kutopa,
• kufooka wamba
• mutu
• rhinitis, pharyngitis,
• minofu, ululu wolumikizika,
• kudzikhuthula (kudzimbidwa, kubala, kutsekula m'mimba).

Nthawi zambiri, anthu amakhala ndi nkhawa:

• kusowa kwa chakudya
• kuwonda
• zosokoneza tulo
• chizungulire
• mavuto amawonedwe
• kutupa kwa chiwindi, kapamba,
• zotupa.

Mndandanda wosiyana uli ndi mikhalidwe yomwe imabweretsa chiopsezo kwambiri kwa anthu, koma ndizosowa kwambiri:

• khalokuz
• Edincke's edema,
• jaundice
• kulephera kwa aimpso.

Ngati mukuwona chimodzi mwazizindikiro zomwe zatchulidwa pamalo anu, dziwitsani opereka chithandizo chaumoyo za izi. Kuchepetsa mulingo, kusintha mankhwalawa, kupereka mankhwala othandizira odwala mthupi amathandizira odwala ambiri kusiya zotsatira zosafunikira kapena kuchepetsa mphamvu yawo pamlingo wovomerezeka.

Kodi ma statins angayambitse matenda ashuga a 2 mwa anthu athanzi?

Nkhani yoti kutenga ma statins angayambitse kukula kwa matenda a shuga a 2 afalikira mofulumira kwambiri. Chomwe chimamaliza chinali kusanthula kwa zomwe zimachitika pakati pa anthu omwe amamwa mankhwalawa: zidakhala zapamwamba kuposa anthu wamba. Anazindikira kuti kudya ma statins kumawonjezera mwayi wa matenda ashuga.

Pambuyo pake zidapezeka kuti zinthu ndizovuta kwambiri kuposa momwe zinkawonekera. Zomwe zimayambitsa chitukuko cha matenda ashuga ndi mtima ndizofanana. Mwachitsanzo, mwana wamwamuna wazaka makumi asanu ndi anayi onenepa kwambiri ali ndi mwayi wofufuza matenda a mtima komanso matenda a shuga. Palibe chodabwitsa, pali ambiri omwe amatha kukhala ndi matenda ashuga pakati pa anthu omwe amatenga ma statins.

Koma matendawa sanathe kuthetsa ubale womwe ulipo pakati pa kumwa mankhwala. Kenako asayansi adaganiza zowerengera zomwe zikuwoneka bwino: zabwino zomwe zingachitike pakumwa mankhwalawo kapena kuvulaza komwe kungachitike. Zinapezeka kuti kuchuluka kwa odwala omwe amaletsedwa ndi mankhwalawa ndiochulukirapo kuposa kuchuluka kwa odwala matenda ashuga. Chifukwa chake, lingaliro lamakono la madotolo ndi ili: ma statins ayenera kuyikidwa, koma ngati pali umboni.

Zidadziwikanso kuti si anthu onse omwe amamwa mankhwala omwe ali pachiwopsezo chofanana cha kudwala. Osauka kwambiri (3):

• azimayi
• anthu opitilira 65
• odwala omwe amamwa mankhwala ochulukirapo a lipid amodzi,
• odwala matenda a impso, chiwindi,
• oledzera.

Izi magulu a odwala ayenera kuwunika kwambiri thanzi lawo.

Kodi mungadziteteze bwanji ku matenda ashuga mwa kutenga ma statins?

Mlingo wambiri wa HMG-CoA reductase inhibitors umathandizira pazotsatira zoyipa. Mutha kuthandizira pochepetsa cholesterol m'njira yosagwiritsa ntchito mankhwala, zomwe zingapangitse adokotala kuchepetsa kuchuluka kwa mankhwalawa (3). Kuti muchite izi, muyenera:

• idyani pomwe
• kusuntha kwambiri: osachepera mphindi 30 / tsiku,
• kusiya kusuta
• chepetsa thupi lako kukhala wathanzi.

Atasintha moyo wake, ataganizira zakudyazo, munthu amachotsa zinthu zomwe zingayambitse matenda a shuga 2, zomwe zikutanthauza kuti akuwonjezera mwayi wokhala ndi moyo wopanda matenda.

Mitundu yama statins ndi mafotokozedwe ake

Pa kapangidwe ka chithandizo chovuta, mayina monga Rosuvastatin, Atorvastatin ndi Simvastatin amagwiritsidwa ntchito nthawi zambiri. Yoyamba ndiyo yotchuka kwambiri komanso yogwiritsidwa ntchito nthawi zambiri - imatsitsa cholesterol yoyipa ndi 38%.

Zotsalira ndizothandizanso pamenepa, zikuwongolera zizindikiro ndi pafupifupi 10-15%. Gawo labwino liyenera kuganiziridwa kuti umboniwo uli ndi kuchuluka kwa mapuloteni a C-reactive (chinthu chomwe chimawonetsa kuperewera kwa zotupa m'matumbo).

"Rosuvastatin" amatanthauza othandizira a pharmacological omwe amatchedwa ma statins.

Kuopsa kotenga matendawa

Sikoyenera kuyika patsogolo mwayi wokhala ndi matenda ashuga chifukwa chogwiritsa ntchito mankhwala a atherosulinosis. Matenda oterewa nthawi zambiri amawonedwa mwa odwala omwe ali pachiwopsezo.

Mwachitsanzo, nthawi zambiri kuoneka ngati nthenda "yokoma" imayang'aniridwa kwa odwala mu ukalamba, komanso mwa azimayi omwe adayamba kusamba. Kuphwanya kulekerera kwa shuga kungayambenso kukulitsa zopatuka.

Chifukwa china ndi chomwe chimatchedwa metabolic syndrome. Wodwala akayamba kunenepa kwambiri, matenda oopsa komanso kuchuluka kwa mafuta m'thupi kwambiri apezeka, ndiye kuti matenda onsewa akuyenera kuyamba.

Hypercholesterolemia ndi chithandizo chake

Zotsatira za kutenga ma statins zimawonedwa pakatha mwezi umodzi.

Mavuto a metabolism yamafuta - awa si mutu wofatsa, apa mapiritsi angapo sangathe kuchita. Zotsatira zokhazikika nthawi zina zimatha kubwera m'zaka zisanu zokha. Pambuyo pochotsa mankhwala, posachedwa kukonzanso kumayamba: mafuta kagayidwe kamasokonezekanso.

Popeza pali zifukwa zingapo (kuphatikizapo ma contraindication), madokotala ena amatha kutumiza ma statin pazochitika zina. Mwachitsanzo, ngati wodwala matenda ashuga ali kale ndi vuto la matenda a lipid metabolism kapena chiopsezo chokhala ndi atherosulinosis komanso mavuto amtsogolo.

Hypercholesterolemia ndi chimodzi mwazovuta za metabolism yamafuta (lipid metabolism), yomwe imayendera limodzi ndi kusanthula kwa labotale ndikuwonjezereka kwa kuchuluka kwa zinthuzi m'magazi mpaka 5.2 mmol / l kapena kuposa. Mu ICD-10 International Statistical Classization of Diseases, matendawa amatchedwa "kukula" kwama cholesterol, osagwirizana ndi matenda ena wamba.

Malinga ndi code yomwe yapatsidwa E78.0, hypercholesterolemia ndi gawo limodzi la zovuta zamthupi komanso zopatsa thanzi, koma si matenda.

Cholesterol - "bwenzi" kapena "mdani"?

Zaka za zana la makumi awiri zinali zodziwika ndi "zoneneza" chimodzi mwa zigawo za cholesterol (otsika kachulukidwe lipoproteins) chifukwa chachikulu cha atherosclerosis - mliri wa anthu, womwe umayambitsa matenda akulu onse amtima komanso mtima wamatenda omwe amafa kwambiri.

Chifukwa chake, makampani opanga zamankhwala ndi mankhwala azakudya adasinthana ndi mutuwu ndikusintha kampeni yopanga ndi kutsatsa kwa mankhwala ndi zinthu zomwe zimachepetsa cholesterol. Mpaka pano, misa hysteria yatha, popeza kutsogola kwa kuwonongeka kwa ma virus khoma la mtima kusanapangidwe kwa malo a atherosulinotic kutsimikiziridwa.

Muvuto la kupewa hypercholesterolemia, chidwi chambiri chimaperekedwa kuti muteteze chitetezo, ndipo gawo la menyu wapadera muzakudya lakhala lachiwiri.

Zizindikiro zochepetsera cholesterol: mankhwala otchuka, mfundo yofunika, mtengo

Pulogalamu yachilengedwe yachilengedweyi ndiyofunikira pakupanga mahomoni azimayi ndi akazi, ndikuonetsetsa kuti madzi amapezeka m'maselo a thupi. Zina zomwe zilipo.

Koma cholesterol yowonjezera imabweretsa matenda oyipa - atherosulinosis. Pankhaniyi, zochitika wamba zamitsempha yamagazi zimasokonekera. Zotsatira zake zimakhala zazikulu kwambiri.

Statins - omenyera mafuta a cholesterol

Zizindikiro zazikulu za ma statins ndi:

• atherosulinosis
• matenda a mtima, chiwopsezo cha matenda amtima,
• ndi matenda ashuga - kupewa kapena kuchepetsa mavuto obwera ndi magazi.

Nthawi zina, zolembedwa za atherosulinotic zimatha kupanga ngakhale mafuta ochepa. Ndipo ngati izi zikapezeka mwa wodwala, ma statin amathanso kutumikiridwa.

Momwe ma statins amakhudzira munthu yemwe wapezeka ndi matenda a shuga a 2

Ambiri sananene kanthu za mavuto omwe amabwera chifukwa chogwiritsa ntchito mankhwalawa. Statin amayambitsa matenda a shuga a 2: Mankhwala amachepetsa mphamvu ya insulin mthupi. Zotsatira - matendawo akupita patsogolo.

Matenda ndi matenda ashuga amakambirana nthawi zonse. Kafukufuku wokhudza momwe awonera odwala adawonetsa kuti kuopsa kosintha mtundu 1 wa matenda ashuga kukhala mtundu wachiwiri wa nthendayi kuchokeraku 10 mpaka 20%. Izi ndizotheka. Koma, malinga ndi mayeso, ma statin amapereka chiopsezo chocheperako kuposa mankhwala atsopano.

Kwa omaliza, kafukufuku adachitika pokhudzana ndi zotsatira za anthu athanzi lathunthu kuti awone momwe angathandizire kulimbana ndi cholesterol. Kuyesaku kunakhudza anthu odzipereka okwana 8750. Gulu la zaka 45-33 zaka. Kafukufuku wa mankhwala atsopano amatsimikizira kukula kwa matenda ashuga mu 47% ya anthu athanzi. Chiwerengerochi chikutsimikizira chiwopsezo chachikulu.

Zizindikiro zotere zimakhazikitsidwa chifukwa chazovuta zamankhwala atsopano m'thupi la munthu. Omwe adatenga nawo gawo pa kafukufukuyu ndikumwa ma statins adawonetsa kuchepa kwa insulin ndi 25% komanso kuwonjezeka kwa chinsinsi chake ndi 12,5% yokha.

Mapeto omwe gulu lofufuzira: zatsopano zokhudzana ndi mankhwalawa zimakhudza chidwi chathu chonse cha insulini komanso katemera wake.

Statin adapangidwa kuti achepetse cholesterol yoyipa

Kwa anthu omwe ali ndi matenda monga mtundu wachiwiri wa matenda ashuga, mabungwe amdziko la America (European, European, home) omwe ali ndi matenda ashuga amalangizidwa kuti azigwiritsa ntchito ma statin popewa matenda ozungulira komanso othandizira mtima.

Mwa njira iyi, maphunziro ambiri adachitidwa ndi endocrinologists pakati pa odwala awo omwe alibe chakudya chochepa cha carbohydrate.

Mankhwala osokoneza bongo amathandizira kutsitsa cholesterol yamagazi. Kafukufuku awonetsa kuti ma statins amakhudza zaka za munthu, ndipo kuchuluka kwa kuchuluka kwake kwachitika zaka 3.

Statin adalembedwa kwa odwala omwe ali ndi vuto la mtima, kuwonetsa zotsatira zabwino: adathandizira kuteteza thupi. Mphamvu yofunikira ya mankhwalawo, komanso kutsitsa cholesterol, inali kuponderezedwa kwa njira zotupa. Izi ndi zomwe zimayambitsa matenda amtima. Zochita za njirazi zikayamba kufooka, chitetezo chamthupi chimakulanso.

Pochita izi, zatsimikiziridwa kuti anthu oposa 70% omwe amagonekedwa kuchipatala omwe ali ndi vuto la mtima ali ndi cholesterol yokhazikika.

Tiyeni tiwone bwino momwe ma statins amathandizira ndi matenda ashuga.

Mankhwala ali ndi izi:

1. letsa mapangidwe a mapangidwe amitsempha yamagazi,
2. onetsetsani kuti chiwindi chikugwira ntchito moyenera, lepetsani cholesterol yambiri,
3. chepetsa mphamvu ya thupi kutenga mafuta mu chakudya.

Ma Statin amasintha thanzi.Atherosulinosis ikapita patsogolo ndipo pamakhala chiwopsezo chachikulu cha vuto la mtima, amathandizira kukonza zomwe zimachitika m'matumbo, zimathandizira kupewa sitiroko. Kuwonjezeka kwa metabolidi ya lipid kumadziwikanso. Muzochita zachipatala, pamakhala zochitika pamene ma statins amaperekedwa kwa anthu omwe akukayikira kuti atha kukhala atherosulinosis, cholesterol yapamwamba kapena chiwopsezo cha kupangika kwa cholesterol plaque.

Dokotala akapereka mankhwala a statins, amakupatsaninso chakudya chapadera, chomwe chimayenera kutsatira. Ndikofunikira kuganizira kuchuluka kwamafuta muzakudya, idyani moyenera, khalani olimba, osayiwala za ntchito zakunja.

Anthu odwala matenda ashuga amayeneranso kuyang'anira kwambiri shuga. Mukutenga ma statins, pali kuwonjezeka pang'ono. Mankhwala amachititsanso kuti glycogemoglobin iwonjezeke (ndi 0,3%). Popewa zoyipa, shuga amayenera kusungidwa bwino mothandizidwa ndi zakudya komanso zolimbitsa thupi.

Statins ndi Type 2 Shuga

Kulemba mankhwala othandizira odwala kwa wodwala sikovuta. Koma apa ndikofunikira kuti onse adotolo komanso wodwalayo amvetsetse zoopsa zilizonse zomwe zingatenge mankhwalawa, adziwe za zabwino komanso zoipa.

1 mwa anthu 200 amakhala nthawi yayitali chifukwa cha ma statin. Ndipo ngakhale pakati pa anthu omwe akudwala matenda a mtima, kuchuluka kwake ndi 1%. 10% ya odzipereka omwe adachita nawo kafukufuku wa statins adakumana ndi zovuta mu mawonekedwe a kupsinjika ndi kupweteka kwa minofu. Koma kuti adziwe kuti izi mankhwalawa ndizosatheka. Koma pali zovuta zina zambiri kuposa zomwe akatswiri ofufuza apeza. Zinawululidwa kuti 20% ya maphunziro amatha kupwetekedwa mtima, kukhumudwa, ndikuiwalika.

Kuyesera kumeneku ndikofunikira kudziwa momwe zingasinthire ma statin ndi aspirin. Zinawululidwa kuti mankhwala oyamba amagwiranso ntchito mthupi. Komabe, aspirin ili ndi maubwino angapo.

1. Chowoneka mosiyana ndi mtengo: 20 mtengo wotsika mtengo.
2. Zotsatira zoyipa zochepa, popanda chiopsezo cha kukumbukira, matenda a shuga ndi kupweteka kwa minofu.
3. Ma Statin, mosiyana, amatha kusintha munthu wathanzi kukhala wodwala matenda ashuga a 2. Chiwopsezo ndi 47%. Ma Statin ndi apamwamba kuposa aspirin pazotsatira zoyipa.

Zotsatira zabwino za ma statins zimawonedwa mwa anthu omwe ali ndi vuto la stroke, matenda a mtima, kapena omwe ali ndi matenda a mtima. Pomaliza, aspirin amagwiritsidwa ntchito bwino kwa anthu odwala matenda ashuga m'lingaliro lililonse: mfundo zamtengo, zotsatirapo zake za kumwa mankhwalawo, ndikuwathandiza.

Cholesterol ndi shuga

Asayansi adziwa kwanthawi yayitali kudalira kwa kuchuluka kwa shuga ndi magazi. Pakati pa matenda a shuga, zomwe zimakhala ndi glucose zimachulukirachulukira, koma zimapangitsa kuchuluka kwa lipid osati mwachindunji, koma osati. Popeza kusintha kwamankhwala kumakhala magazi mwa odwala, impso ndi chiwindi zimavutika nthawi zonse, ndipo izi zimakwiyitsa cholesterol.

Mpaka 80% yazinthu izi zimapangidwa m'thupi la munthu, 20% yotsalayo imachokera muzakudya zomwe zadyedwa. Pali mitundu iwiri ya triglycerides:

• madzi sungunuka ("chabwino"),
• imodzi yomwe siyisungunuke mu zakumwa ("zoyipa").

Cholesterol yoyipa imatha kudziunjikira pamakoma a mtima, ndikupanga zolembera. Zotsatira zake, wodwala yemwe ali ndi matenda a shuga, omwe ali ndi lipid yambiri m'magazi, ali ndi chiopsezo chachikulu chotenga matenda a atherosclerosis, omwe ali ofala kwambiri chifukwa cha matenda ashuga. Kuphatikiza apo, zolembera za cholesterol zimayambitsa kuchepa kwa kama wamitsempha ndikusokonekera kwa magazi. Kusintha kotereku m'magazi kumatha kudzetsa matenda a stroko kapena mtima.

Pazifukwa izi, ndikofunikira kuti odwala matenda ashuga azilamulira mafuta m'thupi, omwe angachepetse chiopsezo chokhala ndi matenda amtima. Pazifukwa izi, odwala matenda a shuga, makamaka akapezeka ndi mtundu wachiwiri, amapatsidwa mankhwala monga gawo la zovuta mankhwala. Kugwiritsa ntchito kumakupatsani mwayi wokhala ndi lipid metabolism, zomwe zimapangitsa kupewa zovuta zina zaumoyo.

Kodi ma statins ndi chiyani ndipo amagwira ntchito bwanji?

Statin ndi gulu la mankhwala omwe ali ndi lipid-yotsika - amachepetsa cholesterol yamagazi. Makina awo akuchita motere: ma statins amatseka zochita za enzyme yotchedwa HMG-CoA. Yotsirizira iyi imayang'anira lipid biosynthesis m'maselo a chiwindi. Enzyme iyi ikatsekedwa, kapangidwe ka cholesterol m'chiwindi chimachepetsedwa kwambiri. Ili ndiye ntchito yayikulu yama statins.

Mevalonic acid imathandizanso pakupanga mankhwala a cholesterol. Ndiwe m'modzi amalumikizano oyamba motere. Statins imaletsa kaphatikizidwe kake, motero, kupanga lipids kumachepetsedwa.

Chifukwa cha kuchepa kwa mulingo wake m'mwazi, makina olumikizira adakonzedwa: ma receptor omwe amapezeka pamwamba pa maselo amakhala omvera kwambiri mafuta m'thupi. Izi zimapangitsa kuti pakhale zochulukirapo kuti ma membrane receptors adze, chifukwa, cholesterol yomwe ilipo m'magazi imatsitsidwanso.

Kuphatikiza apo, mankhwalawa ali ndi zotsatira zina mthupi:

• muchepetse kutupa m'matumbo, omwe amathandiza kuti malo azikhazikika,
• amakulolani kusintha kagayidwe kachakudya mthupi,
• amathandizira kuti magazi aziwonda, zomwe zimapangitsa kuti chiwopsezo chopanga mapangidwe azigawo azisungunuka m'mitsempha yamagazi,
• amathandizira zolembera za atherosulinotic mu khola, mukakhala chiopsezo chochepa kwambiri chodzipatula
• Kuchepetsa kuyamwa kwa mafuta m'matumbo a cholesterol
• imalimbikitsa kupanga nitric oxide, yomwe imalimbikitsa ziwiya kuti zizipuma komanso zimapangitsa kufupika pang'ono.

Chifukwa cha zovuta zake, ma statins amafunsidwa kupewa matenda a sitiroko ndi mtima, amakulolani kuchira msanga mukakumana ndi vuto la mtima. Gulu la mankhwalawa ndilofunikira kwa odwala omwe ali ndi atherosulinosis, popeza ma statins amatha kubwezeretsa endothelium (mkati mwake) yamitsempha yamagazi, makamaka m'mayambiriro a matendawa, pomwe munthu samamvanso zizindikiro za atherosclerosis ndipo sangadziwike, koma mawonekedwe a cholesterol pamakoma a mtima ayamba kale. Gawani odwala omwe ali ndi matenda a shuga komanso matenda ena omwe amadziwika ndi chiopsezo chowonjezeka cha atherosulinotic pathologies.

Kodi kugwiritsa ntchito ma statin kwa nthawi yayitali kumabweretsa chiyani?

Kuphatikiza pakuwongolera zochita za hypolipidemic, ma statin amakhala ndi zambiri - kuthekera kochititsa kuti zochita za biochemical zichitike ndikumagwira ziwalo zingapo.

Kugwirizana kwa kugwiritsa ntchito kwa ma statins mu mtundu wa matenda a shuga a I ndi II kumatsimikiziridwa makamaka ndi kutengera kwawo kolesterol ndi triglycerides, pakubala ndi ntchito ya endothelium (choroid wamkati):

• Kugwiritsa bwino ntchito cholesterol ya plasma. Ma Statin sakukhudzidwa mwachindunji (kuwononga ndi kuwononga thupi), koma kuletsa ntchito yachinsinsi ya chiwindi, kuletsa kupanga kwa enzyme yomwe imathandizira pakupanga chinthu ichi. Kugwiritsa ntchito kwakanthawi kwakanthawi kwa ma mankhwala a statins kumakuthandizani kuti muchepetse cholesterol index ndi 45-50% kuchokera pamlingo woyamba.
• Sinthani ntchito yamkati yamitsempha yamagazi, kuonjezera mphamvu ya vasodilation (onjezerani lumen ya chotengera) kuti muthandize kutuluka kwa magazi ndi kuteteza ischemia.
  Statin tikulimbikitsidwa kale gawo loyambirira la matendawa, ngati chidziwitso cha atherosulinosis sichingatheke, koma pali kusokonekera kwa endothelial.
• Zokhudzana ndi zotupa ndikuchepetsa magwiridwe amodzi a zolembera zake - CRP (protein ya C-reactive). Kuwona kwamatenda ambiri amatilola kukhazikitsa ubale pakati pa index yayikulu ya CRP ndi chiwopsezo cha zovuta zama coronary. Kafukufuku mu odwala 1200 omwe amatenga ma statins a m'badwo wachinayi adatsimikizira kutsika kwa CRP ndi 15% pofika kumapeto kwa mwezi wachinayi wa chithandizo. Kufunika kwa ma statins kumawonekera pamene shuga ikuphatikizidwa ndi kuwonjezeka kwa kuchuluka kwa mapuloteni a C osagwira ntchito oposa 1 milligram pa desilita imodzi. Kugwiritsa ntchito kwawo kukuwonetsedwa ngakhale pakalibe mawonekedwe a ischemic mu minofu ya mtima.
• Kuthekera uku ndikofunikira makamaka kwa odwala omwe ali ndi matenda a shuga, omwe amadalira insulin komanso osadalira insulin, momwe mitsempha yamagazi imakhudzidwira ndipo chiopsezo chokhala ndi ma pathologies akuluakulu chikuwonjezeka: matenda ashuga angiopathy, kulowetsedwa kwa myocardial, stroke.
  Kugwiritsira ntchito ma statin kwa nthawi yayitali kumatha kuchepetsa chiopsezo cha zovuta za mtima ndi wachitatu.
• Zotsatira za heestasis zimawonetsedwa pakuchepa kwamitsempha yamagazi ndikuwongolera kayendedwe kake pambali yamatumbo, kupewa ischemia (kuperewera kwa michere). Ma Statins amaletsa mapangidwe amitsempha yamagazi ndikumamatira kwawo ku malo a atherosulinotic.

Anthu omwe sakudziwa mavuto omwe amakumana ndi vuto la mtima, sayenera kufalitsa vuto kuchokera ku zinthu zomwe kulibe. Pankhaniyi, kuchepa kwa cholesterol (makamaka motsutsana ndi maziko ogwiritsira ntchito nthawi yayitali) kumabweretsa chiopsezo cha matenda amkati.

Mankhwalawa sangathe kugwiritsidwa ntchito ngati njira yothandizira, kuphatikiza, ndikofunikira kuyesa zoopsa zonse zomwe zingakhalepo. Ngati mankhwala a gululi ali ndi vuto pa maselo a tsinde, izi zimapangitsa kuchepa kuthekera kwa kusiyanitsa zimakhala zina zatsopano.

Ma Statin ndi matenda ashuga ndi mutu wawofufuza komanso kukambirana pakati pa asayansi masiku ano. Kumbali imodzi, zowonera zambiri zimachitika, zomwe zimayang'aniridwa pogwiritsa ntchito placebo. Adawonetsa kuthekera kwa ma statins kuti achepetse mwayi wokhala ndi mtima wama mtima.

Contraindication

Mankhwala osavomerezeka pamene wodwala ali ndi zotsutsana:

• tsankho pazinthu zomwe zimapanga Atorvastatin,
• matenda a chiwindi mu gawo yogwira,
• kuchuluka kwa ma enzymes a chiwindi, zomwe zimapangitsa kuti asatuluke.
• kulephera kwa chiwindi.

Ndi chisamaliro

Gwiritsani ntchito mankhwalawa mosamala pamaso pa zomwe zikuwonetsa ndi zomwe zikuchitika:

• ochepa matenda oopsa
• kusalamulika kwa khunyu,
• mbiri ya wodwala matenda a chiwindi,
• sepsis
• endocrine ndi kagayidwe kachakudya matenda,
• kuvulala
• zotupa zamafupa,
• kusowa kwamphamvu kwa electrolyte,
• uchidakwa.

"Rosuvastatin" akulimbikitsidwa mtundu wa matenda ashuga a 2. Mankhwalawa amavomerezedwa ndi American Diabetes Association. Matenda a shuga amayambitsa chiwopsezo cha mavuto amtima mwa odwala chifukwa cha kuchuluka kwa cholesterol m'thupi. Ma Statin adapangidwa kuti achepetse cholesterol m'malo mwa odwala matenda ashuga, potero amachepetsa kwambiri kupsinjika kwa mtima.

Mankhwalawa amaletsedwa momveka bwino m'magulu otsatirawa a anthu:

• ndi matenda a impso ndi chiwindi,
• mpaka zaka 18
• woyembekezera ndi yoyamwitsa.

Milandu yolamula anthu omwe ali ndi zoterezi imawunikiridwa mosamala:

• uchidakwa
• chithokomiro cha chithokomiro,
• kusokoneza bwino kwamagetsi.

Zina mwazotsatira zoyipa:

• lembani matenda a shuga 2 - mwa anthu athanzi,
• kugaya chakudya m'mimba - kudzimbidwa, kutsekula m'mimba, mseru, kupweteka m'mimba,
• kuyiwalika, kudodometsa,
• mitsempha, mutu,
• kusowa tulo
• thupi lawo siligwirizana - kuyabwa, urticaria.

Asayansi aku Japan adachitanso kafukufuku yemwe adawonetsa kuti kugwiritsa ntchito ma statin kwakanthawi yayitali kumatha kubweretsa insulin kukana, zomwe ndizofunikira kwa odwala matenda ashuga. Adanenedwanso za kuthekera kowonjezera shuga m'magazi. Komabe, chiwopsezo chotere ndi 1 mwa 10. Omwe adatsala nawo anali ndi chiopsezo chochepa cha mavuto a mtima.

Ndemanga ya Atorvastatin 20

Valery Konstantinovich, katswiri wamtima.

Mphamvu ya atorvastatin imatengera wopanga. Pali mankhwala ambiri opangidwa mwapadera, koma si onse omwe angathandize wodwalayo. Mankhwala oyamba ndi mankhwala abwino ochepetsa lipid, koma ali ndi mtengo wokwera.

Eugene, wazaka 45, Penza.

Nthawi yoyeserera, chipatalachi idapeza cholesterol yayikulu. Atorvastatin adalamulidwa kuti atenge, zomwe zimayenera kukhazikitsa matendawa. Anamwa mankhwalawo asanagone mpaka ma CD atatha. Atazindikiranso, zinaululika kuti kuchuluka kwa cholesterol sikunasinthe.

Kodi ma statins amakhudza bwanji thupi?

Cholesterol ndi mankhwala achilengedwe omwe amaphatikizidwa ndikupanga mahomoni ogonana achikazi ndi amuna, imapereka mulingo wabwinobwino wamadzi m'maselo a thupi.

Komabe, ndikachulukirapo m'thupi, matenda oopsa amatha - atherosulinosis. Izi zimabweretsa kusokonezeka kwa magwiridwe antchito amitsempha yamagazi ndipo nthawi zambiri zimayambitsa zovuta kwambiri, chifukwa cha zomwe munthu amatha kuvutika. Wodwala nthawi zambiri amakhala ndi matenda oopsa chifukwa cha kuchuluka kwa cholesterol plaques.

Statin ndi mankhwala a pharmacological omwe amachepetsa magazi lipids kapena cholesterol komanso ochepa kachulukidwe lipoproteins - mawonekedwe amtundu wa cholesterol. Mankhwala othandizira ndi opangidwa, opangidwa pang'ono, zachilengedwe, kutengera mtundu wawo.

Chochita chodziwika bwino cha lipid-kutsitsa chimagwiritsidwa ntchito ndi atorvastatin ndi rosuvastatin wazinthu zopangidwa. Mankhwalawa ali ndi umboni kwambiri.

1. Choyamba, ma statins amalimbitsa ma enzymes omwe amathandizira kwambiri pakudziletsa kwa cholesterol. Popeza kuchuluka kwa ma lipids amkati pakadali pano kuli mpaka 70 peresenti, njira yochitira mankhwalawo imawerengedwa kuti ndi yofunika kuthetsa vutoli.
2. Komanso, mankhwalawa amathandizira kukulitsa kuchuluka kwa zolandirira mawonekedwe a mayendedwe a cholesterol mu hepatocytes. Zinthu izi zimatha kukoka ma lipoprotein omwe amayendayenda m'magazi ndikuwapatsira ma cell a chiwindi, kumene njira Kuchotsa zinyalala za zinthu zovulaza m'magazi.
3. Kuphatikiza ma statins samalola kuti mafuta azilowetsedwa m'matumbo, zomwe zimachepetsa kuchuluka kwa cholesterol yakunja.

Kuphatikiza pa ntchito zofunikira, ma statins amakhalanso ndi chidwi, ndiye kuti, amatha kuchita zinthu zingapo nthawi imodzi, kukonza zomwe munthu amakhala nazo. Makamaka, wodwala yemwe amamwa mankhwalawa pamwambapa amakumana ndi zotsatirazi:

• Mkhalidwe wamkati wamitsempha wamitsempha umakhala bwino.
• Zochita zotupa zimachepa,
• Kuwaza magazi kumalepheretsedwa
• Spasms ya mitsempha yopereka myocardium ndi magazi imachotsedwa,
• Mu myocardium, kukula kwamitsempha yamagazi yatsopano kumapangidwira,
• Myocardial hypertrophy imachepa.

Ndiye kuti, titha kunena mosapita m'mbali kuti ma statins ali ndi zabwino kwambiri zochizira. Dokotala amasankha mlingo woyenera kwambiri, ngakhale mlingo wocheperako umatha kukhala ndi zotsatira zochizira.

Kuphatikiza kwakukulu ndikochepa kwambiri pazotsatira zochizira ma statins.

Ma Statin ndi mitundu yawo

Masiku ano, madokotala ambiri amakhulupirira kuti kutsitsa cholesterol yamagazi m'magulu 2 a shuga ndi gawo lofunikira kwambiri kuti munthu achire. Chifukwa chake, mankhwalawa, monga a Sartan, amawonetsedwa pamodzi ndi mankhwala monga Metformin. Kuphatikiza ma statins nthawi zambiri amagwiritsidwa ntchito ngakhale ndi cholesterol yokhazikika kuti aletse matenda a atherosulinosis.

Mankhwala a gululi amasiyanitsidwa ndi kapangidwe, Mlingo, zoyipa.Madokotala amatenga chidwi makamaka ndi chomaliza, chifukwa chake, chithandizo chamankhwala chimachitika moyang'aniridwa ndi dokotala. Izi ndi mitundu ingapo ya mankhwala ochepetsa magazi m'thupi.

1. Mankhwala a Lovastatin amapangidwa pogwiritsa ntchito nkhungu zomwe zimayeserera kupesa.
2. Mankhwala ofananawo ndi mankhwala a simvastatin.
3. Pravastatin wa mankhwala amakhalanso ndi mawonekedwe ake komanso momwe amagwirira ntchito.
4. Mankhwala opangidwa mokwanira amaphatikizapo Atorvastatin, Fluvastatin, ndi Rosuvastatin.

Chithandizo chothandiza kwambiri komanso chogwiritsidwa ntchito kwambiri ndi rosuvastatin. Malinga ndi ziwerengero, cholesterol m'magazi a munthu atalandira chithandizo chamankhwala kwa milungu isanu ndi umodzi amachepetsedwa ndi 45-55 peresenti. Pravastatin amadziwika kuti ndi mankhwala osagwiritsidwa ntchito kwenikweni, amatsitsa mafuta a cholesterol ndi 20-35 peresenti yokha.

Mtengo wamankhwala umasiyana mosiyanasiyana, kutengera kampani yomwe akupanga. Ngati mapiritsi 30 a Simvastatin angagulidwe ku pharmacy pafupifupi ma ruble 100, ndiye kuti mtengo wa Rosuvastatin umasiyana kuchokera ku 300 mpaka 700 rubles.

Yoyamba achire zotsatira zimatheka palibe kale kuposa mwezi umodzi wokhazikika mankhwala. Malinga ndi zotsatira za mankhwalawa, kupanga cholesterol ndi chiwindi kumachepa, kuyamwa kwa cholesterol kuchokera kuzinthu zomwe zimatengedwa kulowa m'matumbo kumachepetsedwa, ma cholesterol amapezeka kale m'mitsempha yamagazi amathetsedwa.

Ma Statin akuwonetsedwa kuti agwiritse ntchito mu:

• atherosulinosis,
• matenda a mtima, chiwopsezo cha matenda a mtima,
• shuga mellitus kuti muchepetse kapena kuchepetsa magazi.

Nthawi zina maonekedwe a atherosselotic zolembera amatha kuonedwa ngakhale ndi cholesterol yotsika.

Pankhaniyi, mankhwalawa atha kupatsidwanso mankhwala.

Matenda a shuga ndi matenda amtima

Ndi matenda a shuga, pamakhala chiopsezo chachikulu cha zotsatira zoyipa m'magazi a mtima. Anthu odwala matenda ashuga ali ndi mwayi wopeza matenda amtima kuposa anthu omwe ali ndi shuga. 70 peresenti ya odwalawa chifukwa cha zovuta ndi zakupha.

Malinga ndi oimira bungwe la American Heart Association, anthu omwe ali ndi matenda ashuga komanso omwe apezeka ndi matenda amitsempha yamagazi ali ndi chiwopsezo chofanana cha kufa chifukwa cha ngozi yamtima. Chifukwa chake, matenda ashuga si matenda oopsa kuposa matenda a mtima.

Malinga ndi ziwerengero, matenda amtima wapezeka ndi 80% ya anthu odwala matenda ashuga a 2. Mwa 55 peresenti ya anthu oterewa, amafa chifukwa cha kuphwanya myocardial and 30% chifukwa cha stroke. Cholinga cha izi ndikuti odwala ali ndi zovuta zowonekera.

Zina zomwe zili pachiwopsezo cha odwala matenda ashuga ndi:

1. Mwazi wamagazi ambiri
2. Kukula kwa insulin kukana,
3. Kuchulukitsa kwa insulin m'magazi a anthu,
4. Kukula kwa proteinuria,
5. Kuchulukitsa kusinthasintha kwakuthwa kuzidziwitso za glycemic.

Mwambiri, chiopsezo chokhala ndi mtima wamtima chikuwonjezereka ndi:

• olemedwa ndi chibadwa,
• m'badwo winawake
• zizolowezi zoipa
• kusowa zolimbitsa thupi,
• ndi matenda oopsa
• hypercholesterolemia,
• dyslipidemia,
• matenda ashuga.

Kuwonjezeka kwa kuchuluka kwa cholesterol m'mwazi, kusintha kwa kuchuluka kwa ma atherogenic ndi antiatherogenic lipids ndizinthu zodziyimira zokha zomwe zimawonjezera chiopsezo cha matenda opatsirana ndi mtima. Monga kafukufuku wasayansi wosiyanasiyana, zitatha izi kuzindikirika, izi zimayambira kwambiri.

Popeza matenda ashuga amakhudza mitsempha yamagazi, zikuwoneka zomveka kusankha ma statins ngati njira yothandizira. Komabe, kodi iyi ndi njira yoyenera yochizira matendawa, kodi odwala amatha kusankha Metformin kapena ma statins omwe ayesedwa kwa zaka zambiri?

Statin ndi matenda ashuga: kuyenderana ndi mwayi

Kafukufuku waposachedwa awonetsa kuti ma statins ndi mtundu wa 2 shuga amatha kugwirirana. Mankhwalawa amachepetsa osati kuchepa kokha, komanso kufa chifukwa cha matenda amtima pakati pa anthu odwala matenda ashuga. Metformin, monga ma statins, imakhudzanso thupi - imachepetsa shuga.

Nthawi zambiri, mankhwala otchedwa Atorvastatin amachitidwa kafukufuku wa sayansi. Komanso masiku ano, mankhwala a Rosuvastatin atchuka kwambiri. Mankhwalawa onse ndi ma statin ndipo ali ndi chiyambi chopangidwa. Asayansi apanga mitundu ingapo ya kafukufuku, kuphatikizapo ma CARDS, PLANET ndi TNT CHD - DM.

Kafukufukuyu wa CARDS adachitika ndi kutenga gawo la anthu odwala matenda ashuga a mtundu wachiwiri wa matendawa, momwe ma lipoprotein okhala otsika kwambiri sanali apamwamba kuposa 4.14 mmol / lita. Komanso pakati pa odwala kunali kofunikira kusankha omwe alibe ma pathologies mu gawo la zotumphukira, matenda amitsempha yama cell ndi coronary.

Munthu aliyense amene anachita nawo phunziroli anali ndi choopsa chimodzi.

1. Kuthamanga kwa magazi
2. Matenda a shuga
3. Albuminuria
4. Kusuta fodya.

Wodwala aliyense amatenga atorvastatin pafupifupi 10 mg pa tsiku. Gulu lolamulira lidayenera kutenga placebo.

Malinga ndi kuyesera kumeneku, mwa anthu omwe adatenga ma statins, chiopsezo chokhala ndi matenda am'mimba chatsika ndi 50 peresenti, ndipo mwayi wokhala ndi vuto loyambitsa matenda osakhazikika, angina osaphedwa, kufa kwadzidzidzi kwamwamuna kutsika ndi 35 peresenti. Popeza zotsatira zabwino zidapezeka ndikuwonekeratu zopindulitsa, kafukufukuyo adayimitsidwa zaka ziwiri izi zisanachitike.

Mu kuphunzira kwa PLANET, maluso a nephroprotective omwe Atorvastatin ndi Rosuvastatin ali nawo adayerekezedwa ndikuphunzira. Kuyesera kwa PLANET I koyambirira kunakhudza odwala omwe adapezeka ndi mtundu woyamba komanso wachiwiri wa matenda a shuga. Otenga nawo mbali pazoyeserera za PLANET II anali anthu omwe ali ndi magazi abwinobwino.

Aliyense mwa odwala omwe adaphunzira adadziwika ndi cholesterol yokwezeka komanso zolimbitsa mapuloteni - kukhalapo kwa mapuloteni mumkodzo. Ophunzira onse adagawidwa mosagawika m'magulu awiri. Gulu loyamba limatenga 80 mg ya atorvastatin tsiku lililonse, ndipo lachiwiri limatenga 40 mg wa rosuvastatin. Maphunziro adachitidwa kwa miyezi 12.

• Monga kuyesa kwa asayansi kunawonetsa, mwa odwala omwe ali ndi matenda ashuga omwe adatenga Atorvastatin, kuchuluka kwamapuloteni a mkodzo adachepa ndi 15 peresenti.
• Gulu lomwe limamwa mankhwala achiwiri lidachepa ndi mapuloteni 20%.
• Mwambiri, proteinuria sinatheretu pakutenga Rosuvastatin. Nthawi yomweyo, panali kutsika kwamkodzo pang'onopang'ono, pomwe ma data omwe amagwiritsidwa ntchito ndi Atorvastatin amawoneka kuti sanasinthe.

Kafukufuku wa PLANET yemwe ndidapeza mu 4 peresenti ya anthu omwe amayenera kusankha rosuvastatin, kulephera kwaimpso, komanso kuchuluka kwa serum creatinine. Pakati pa anthu. kutenga atorvastatin, zovuta zimapezeka mwa 1 peresenti ya odwala, pomwe palibe kusintha kwa serum creatinine komwe kunapezeka.

Chifukwa chake, zidapezeka kuti mankhwala omwe adagwiritsidwa ntchito ndi Rosuvastatin, poyerekeza ndi analogue, ilibe chitetezo cha impso. Kuphatikiza mankhwala kumatha kukhala koopsa kwa anthu omwe ali ndi matenda amtundu uliwonse komanso kupezeka kwa proteinuria.

Kafukufuku wachitatu wa TNT CD-DM adawunika zotsatira za atorvastatin pachiwopsezo chokhala ndi ngozi yamtima mu matenda amitsempha yamagazi ndi matenda a shuga. Odwala amayenera kumwa 80 mg ya mankhwalawa patsiku. Gulu loyendetsa linamwa mankhwalawa pa 10 mg patsiku.

Malinga ndi zotsatira za kuyesaku, zinaoneka kuti zovuta mu mtima zimachepa ndi 25 peresenti.

Zitha kukhala zowopsa ma statins

Kuphatikiza apo, asayansi aku Japan adachita kafukufuku wina wasayansi, zomwe zidapangitsa kuti adziwe zambiri. Pankhaniyi, asayansi amayenera kuganiza mozama ngati atenge mankhwalawa mtundu wa matenda ashuga a 2.

Izi ndichifukwa choti mutatenga ma statins, panali milandu ya matenda a shuga, omwe amachititsa kuti ayambe kuphunzira mozama za mankhwala.

Asayansi aku Japan adayesa kuphunzira momwe Atorvastatin kuchuluka kwa 10 mg amakhudzira kuchuluka kwa hemoglobin wa glycated ndi shuga m'magazi. Maziko anali pafupifupi shuga m'miyezi itatu yapitayo.

1. Kuyesaku kunachitika miyezi itatu, odwala 76 omwe anapezeka ndi matenda a shuga a 2 adachitapo kanthu.
2. Phunziroli lidawonetsa kuwonjezeka kowopsa kwa kagayidwe kazakudya.
3. Mu kafukufuku wachiwiri, mankhwalawa adaperekedwa muyezo womwewo kwa anthu omwe ali ndi matenda ashuga komanso dyslipidemia.
4. Pa kuyesa kwa miyezi iwiri, kuchepa kwa kuchuluka kwa ma atrogengenic lipids komanso kuwonjezeka kwa munthawi yomweyo kwa hemoglobin ya glycated.
5. Komanso, odwala adawonetsa kuwonjezeka kwa insulin.

Atapeza izi, asayansi aku America adachita kafukufuku wa meta kwambiri. Cholinga chawo chinali choti adziwe momwe ma statins amakhudzira kagayidwe kazakudya ndikuwonetsetsa kuti chiwopsezo cha matenda ashuga chimatha kuchitika ndi ma statins. Izi zidaphatikizapo maphunziro onse asayansi omwe adachitidwa kale omwe akukhudzana ndi chitukuko cha matenda ashuga a mtundu 2.

Malinga ndi zotsatira za kuyesaku, zinali zotheka kupeza deta yomwe idawulula mwa maphunziro 255 amodzi nkhani ya chitukuko cha matenda a shuga 2 atachira ndi ma statins. Zotsatira zake, asayansi akuganiza kuti mankhwalawa angakhudze kagayidwe kazachilengedwe.

Kuphatikiza apo, kuwerengetsa masamu kunapezeka kuti pakuzindikira matenda aliwonse a shuga pali milandu 9 yoletsa ngozi zamtima.

Chifukwa chake, pakadali pano ndizovuta kudziwa kuti ndizothandiza kapena, momwemonso ma statins ndi owopsa kwa odwala matenda ashuga. Pakadali pano, madokotala amakhulupirira kwambiri kusintha kwakukulu pakuwonekera kwa lipids yamagazi mwa odwala atatha kugwiritsa ntchito mankhwala. Chifukwa chake, ngati atathandizidwa ndi ma statins, ndikofunikira kuyang'anira mosamala zizindikiro za carbohydrate.

Ndikofunikanso kudziwa kuti ndi mankhwala ati omwe ali abwino ndikumwa mankhwala abwino okha. Makamaka, tikulimbikitsidwa kusankha ma statins omwe ali mgulu la hydrophilic, ndiye kuti, amatha kusungunuka m'madzi.

Ena mwa iwo ndi Rosuvastatin ndi Pravastatin. Malinga ndi madotolo, mankhwalawa samakhudza kagayidwe kazachilengedwe. Izi zidzakulitsa chithandiziro chamankhwala ndiku kupewa chiopsezo chotsatira zoyipa.

Pochiza komanso kupewa matenda ashuga ndibwino kugwiritsa ntchito njira zotsimikiziridwa. Kuti muchepetse cholesterol yamagazi, ndikofunikira kusintha zakudya, ndikupanga mtundu wa 2 shuga mellitus, tikulimbikitsidwa kumwa mankhwala Metformin 850, omwe akhala akulimbikitsidwa kwambiri, kapena sartan.

Statins akufotokozedwa mu kanema munkhaniyi.

Matenda ndi matenda ashuga

Matenda a shuga ndi matenda achilengedwe, omwe amadziwika ndi kuchuluka kwa ma concomitant pathologies. Zotsatira zoyipa kwambiri ndizo matenda a mtima ndi mtima, omwe amawoneka motsutsana ndi kuwonongeka kwa mitsempha. Komabe, ndi chisamaliro choyenera, mawonekedwe ndi kutalika kwa nthawi zimatha kusintha. Chimodzi mwazomwe zimapangitsa kagayidwe kachakudya mu thupi ndi ma statins. Amakhudza metabolism yamafuta, yomwe ndiyofunikira kwambiri mtundu wa 2 matenda.

Ntchito yayikulu ya mankhwalawa, yomwe amathandizira odwala matenda ashuga, ndikuletsa kukula kwa zovuta kuchokera ku mtima: kuvulala, kugunda kwa mtima komanso atherosclerosis.

Malingaliro a mabungwe apadziko lonse lapansi, aku Europe ndi ku nyumba zamankhwala pamankhwala omwe amapezeka kwa odwala omwe ali ndi matenda osokoneza bongo amagwira ntchito kwa odwala ambiri omwe ali ndi vutoli:

1. Statins ndikusankha koyamba ngati wodwala yemwe ali ndi matenda a shuga ali ndi LDL cholesterol wamkulu kuposa 2 mmol / L.
2. Kwa odwala matenda ashuga omwe apezeka ndi matenda a mtima, kugwiritsa ntchito mankhwalawa ndizovomerezeka mosasamala kuchuluka koyamba kwa lipids m'magazi.
3. Chithandizo chofananacho kwa odwala omwe ali ndi mtundu wachiwiri wa shuga omwe sazindikira kuti ali ndi ischemia amayenera kufotokozedwa ngati cholesterol yathunthu itapitilira malire a 3.5 mmol / L.
4. Mu milandu yomwe chithandizo cha mankhwala okhala ndi ma statins pazovomerezeka kwambiri sichinayambitse kuchuluka kwa triglycerides kukhala yokhazikika (osachepera 2 mmol / l), mankhwalawa amathandizidwa ndi nicotinic acid, fibrate kapena ezetimibe.

Amakhulupilira kuti masiku ano ma statins ndi gulu lokhalo la mankhwala lomwe cholinga chake ndi kutalikitsa moyo wa munthu wodwala matenda a shuga, osati pochiza matendawa.

Ndi ma statins ati abwino kwambiri a matenda ashuga?

Pazovuta za odwala otere, madokotala nthawi zambiri amagwiritsa ntchito Rosuvastatin, Atorvastatin ndi Simvastatin. Ngati mumayerekezera awa atatu odziwika, ndiye kuti mbadwo waposachedwa, Rosuvastatin, amakhala mtsogoleri wopanda vuto lililonse. Amachepetsa kwambiri cholesterol "yoyipa" - mwa 38%, ndipo malinga ndi ena, chiwerengerochi chimafika pa 55%. Nthawi yomweyo, kuchuluka kwa madzi osungunuka a lipids kumawonjezeka ndi 10%, zomwe zimakhudza kagayidwe kokwanira ka mafuta m'thupi.

Simvastatin ndi Atorvastatin ali m'mbuyo pang'ono potengera izi. Oyamba amachepetsa kuchuluka kwa triglycerides ndi 10-15% ("yoyipa" cholesterol imatsika ndi 22), ndipo yachiwiri ndi 10-20% (kuchuluka kwa mafuta osakwanira amatsika ndi mfundo 27). Zizindikiro zofananazi zidadziwika ku Lovastatin, yomwe nthawi zambiri imafotokozedwa ndi madokotala aku Russia.

Mbali yabwino ya Rosuvastatin ndikuti muumboni wake pali kuchuluka kwa mapuloteni a C-reactive - chinthu chomwe chimadziwika ndi kutupa kwakatundu m'matumbo. Chifukwa chake, rosuvastatin amatha kusamalira zolembera zomwe zilipo m'khola.

Mankhwala, mankhwalawa amatha kupezeka m'mazina azamalonda awa:

Mankhwala achiwiri odziwika komanso othandiza - Atorvastatin - akhoza kupezeka pansi pa mayina awa:

Kuti mumvetsetse mphamvu ndi ma statins, mungathe kuwaganizira monga momwe mibadwo yamankhwala ilili:

Musaganize kuti zolengedwa zachilengedwe ndizabwino kuposa zopangidwa. Malinga ndi malipoti ena, akale anali ndi zotsatira zoyipa kuposa ma statin, omwe ali ndi "chemistry" yokhayo.

Ndikofunikira kudziwa kuti ma statins onse ndi omwe mumalandira mankhwala, chifukwa chake simungasankhe nokha mankhwala.Ena mwa iwo atha kukhala ndi zotsutsana zosiyanasiyana, chifukwa chake musafunse dokotala kuti akupatseni mankhwala abwino mu malingaliro anu. Munthawi zonsezi, mankhwalawa amasankhidwa payekhapayekha, poganizira mawonekedwe a thupi la wodwalayo.

Ndi mankhwala ati omwe angathandize ndi matenda a shuga a 2?

Matenda amtunduwu ali ndi chiopsezo chachikulu chotenga matenda a mtima - 80% motsutsana ndi 40% ya matenda amtundu 1. Pazifukwa izi, mankhwala a statin ndi gawo limodzi la chithandizo chofunikira cha odwala. Amalola kupewa koyambira komanso kwachiwiri kupewa matenda a mtima komanso kuwonjezera kuchuluka kwa moyo wa odwala. Kugwiritsa ntchito ma statins ndikofunikira kwa odwala awa ngakhale atakhala kuti sanapezeke ndi matenda a mtima, kapena cholesterol imakhala yovomerezeka.

M'maphunziro angapo, zidadziwika kuti kwa odwala ambiri omwe ali ndi matenda amtundu wa 2, kuchuluka kwa ma protein tsiku lililonse, komwe kumakhala kothandiza pa matenda a shuga 1, sikunapweteke. Chifukwa chake, mankhwalawa a mtundu wachiwiri wa shuga, mitundu yayikulu yovomerezeka ya mankhwala imagwiritsidwa ntchito masiku ano:

• kwa atorvastatin ndi pravastatin, tsiku lililonse sayenera kupitirira 80 mg,
• kwa rosuvastatin ndi pravastatin - osaposa 40 mg.

Kafukufuku wambiri wamabungwe asayansi yazachipatala 4S, DECODE, CARE, HPS, akhazikitsa ubale pakati pa kugwiritsa ntchito ma statins kwa odwala omwe ali ndi matenda amtundu wa 2 komanso kuchepetsa zovuta komanso kufa kwa matenda a mtima chifukwa cha kupitirira kwa matenda a mtima. Chifukwa chake, Pravastatin adawonetsa zabwino - kufa kumatsika ndi 25%. Pambuyo pa kudya kwa Simvastatin kwa nthawi yayitali, asayansi adalandira zotsatira zofanana - 25% yomweyo.

Kafukufuku wokhudzana ndi kugwiritsidwa ntchito kwa Atorvastatin adawonetsa zotsatirazi: kufa kwatsika ndi 27%, pomwe chiwopsezo chodwala chatsika ka 2. Kafukufuku wofanana wa Rosuvastatin sanatulutsidwebe, chifukwa mankhwalawa adawoneka posachedwa pamsika wazamankhwala. Komabe, asayansi apakhomo amachitcha kuti abwino kwambiri pankhani yochepetsa cholesterol, popeza zikuwonetsa kuti magwiridwe antchito ake amafika 55% kale.

Ndizofunikira kudziwa kuti pankhaniyi ndizosatheka kudziwa kuti ndi maulosi ati omwe ali bwino kwa odwala omwe ali ndi mtundu uwu wa matendawa, chifukwa chithandizo chimasankhidwa payekhapayekha, ndikuganizira zambiri za thupi ndi kapangidwe kazinthu zamagazi.

Type 2 shuga mellitus ndizovuta kuchiza, ndipo kugwiritsa ntchito ma statins sikungapereke zotsatira zowoneka mpaka miyezi iwiri. Chithandizo chokhazikika komanso chokhazikika chomwe gulu ili limakupatsani chimakhala chotsatira.

Momwe mankhwalawa amakhudzira thupi

Algorithm yayikulu ya kukopa kwawo ndi hypolipidemic - iwo amachepetsa cholesterol. Kuphatikiza apo, njira yotupa yosalekeza m'matumba imachepetsedwa, zomwe zimathandiza kuti zolembazi zisasunthike. Chodziwika ndi kuthekera kukonza ma aligorivimu a metabolic.

Tisaiwale za kulimbikitsa kupatulira magazi (izi zimachepetsa chiopsezo cha kupangika kwa mitsempha mu mtima), kukonza malo osinthika mosakhazikika, momwe mungathe kupatukana. Ubwino wa ma statins ngati mankhwala uyenera kuwonedwa ngati kuchepa kwa mayamwidwe am'matumbo a cholesterol kuchokera ku chakudya chomwe chimagwiritsidwa ntchito ndikupanga kukhazikitsidwa kwa nitric oxide. Zonsezi zimapangitsa kuti sitimazi zizipuma mosavuta komanso zimakhudza kukukula kwawo pang'ono.

Ndi ma statins omwe mungasankhe odwala matenda ashuga

Pochizira matenda omwe aperekedwa, mulingo wovomerezeka wa dzina la mankhwalawa umagwiritsidwa ntchito: kwa Atorvastatin ndi Pravastatin, chiyezo sichiyenera kupitirira 80 mg, komanso kwa Rosuvastatin - pafupifupi 40 mg.

Kafukufuku wambiri wakhazikitsa ubale pakati pa kugwiritsa ntchito mankhwalawa mtundu wa matenda ashuga a 2 komanso kuchepa kwa kuchuluka kwa zovuta komanso kufa kwa matenda a mtima. Pravastatin amawonetsa zotsatira zabwino - kupulumuka kumawonjezeka ndi 25%. Zilinso chimodzimodzi ndi mayina ena, mwachitsanzo, Atorvastatin.

Dziwani kuti kudziwa mitundu yokhala ndi shuga komanso mtundu wachibiri wophatikizidwa bwino ndizosatheka.

Izi zili choncho chifukwa chithandizo chimatsimikiziridwa payekhapayekha, poganizira zolimbitsa thupi ndi zida zamagazi zamagazi.

Mitundu ya odwala matenda ashuga osakhudzana ndi insulin ndiyovuta kuithetsa, chifukwa kugwiritsa ntchito mankhwalawa sikungawonetse zotsatira zowoneka kwa miyezi iwiri kapena kupitilira. Kuchiza pafupipafupi komanso kwanthawi yayitali ndi gulu lowonetsa mayina a mankhwalawa kudzapereka zotsatira zokhazikika.

Kodi mankhwalawo amatha bwanji kukhala oopsa?

Pambuyo pogwiritsira ntchito ma statin, milandu yokhudzana ndi kuwonongeka kwa matenda oyambitsidwa idadziwika. Izi zinapangitsa asayansi kufufuza mozama zamankhwala. Ndikofunikira kuti:

• ndizovuta kuyankhula za ma statins othandiza kapena owopsa kwa odwala omwe ali ndi matenda a endocrine,
• madokotala ali ndi chidaliro kuti kusintha kwakukulu kwa lipid atatha kugwiritsa ntchito mankhwala,
• kutengera kugwiritsa ntchito zinthu izi, tikulimbikitsidwa kuwunikira mosamala Zizindikiro za carbohydrate,
• ndikofunikira kufunsa katswiri pasadakhale ndikugwiritsa ntchito mitundu yabwino yokha yotsimikizika,
• Ndikulimbikitsidwa kugwiritsa ntchito ma statins omwe amaphatikizidwa ndi gulu la hydrophilic - ndiye kuti, omwe amatha kusungunuka m'madzi.

Mndandanda womwe waperekedwa uli ndi Rosuvastatin ndi Pravastatin, omwe ali ndi mphamvu yochepa pakuwonjezera mafuta. Izi zimapangitsa kuonjezera kuchuluka kwa magwiridwe antchito, komanso kupewa kupewa zotsatira zoyipa.

Matenda a shuga omwe amauzidwa ndi DIABETOLOGIST ndi odziwa Aleksey Grigorievich Korotkevich! ". werengani zambiri >>>

Mankhwalawa komanso kupewa matenda amtundu wa endocrine, ndi bwino kusintha njira zotsimikiziridwa. Kuti muchepetse cholesterol yamagazi ndi kusintha shuga m'magazi, ndikofunikira kusintha zakudya, kuonetsetsa zolimbitsa thupi. Ndi chitukuko cha matendawa, amalimbikitsa kukhazikitsidwa kwa mankhwalawa Metformin 850, yomwe yatsimikizira bwino. Angiotensin receptor blockers kapena sartan amathanso kugwiritsidwa ntchito.

Zomwe akatswiri ati

Kafukufuku adatenga zaka ziwiri kapena zisanu. Anthu omwe adatenga nawo mbali adagawika m'magulu osiyanasiyana: Placebo ndi Rosuvastatin. Mu gulu lachiwiri, 27% ya milandu yodwala matendawa 2 idalembedwa kuposa yoyamba. Ngakhale panali anthu oterewa, uthenga wabwino udalengezedwa. Chiwopsezo cha matenda a mtima chatsika ndi 54%, ndi milandu ya stroke - ndi 48%. Kuchuluka kwathunthu: kufa kwazonse zomwe zimayambitsa odwala kumatsika ndi 20%.

Chiwopsezo chokhala ndi mtundu wachiwiri wa matenda ashuga mukamamwa Rosuvastatin ndi 27%. M'moyo, awa ndi anthu 255 omwe adayamwa kuti amwe mankhwalawa, ndipo m'modzi yekha mwa iwo ndi amene adayamba kudwala matenda ashuga a 2 kwazaka 5. Koma zitha kupewa kufa kwa 5 chifukwa cha matenda apamtima omwe akupita patsogolo. Kumwa mankhwala oterewa kumawoneka kuti ndi kotheka, ndipo chiopsezo cha zovuta za shuga kapena zovuta sizofunikira kwenikweni pankhaniyi.

Palinso mankhwala ena a statin. Poyerekeza ndi mankhwala am'mbuyomu, Atorvastatin ali ndi chiwopsezo chofanana chotenga matenda a shuga ndipo amagwiranso ntchito mofananamo, koma amawononga ndalama zochepa. Pali ma statins omwe ndi ocheperako pang'ono kuposa akale - Lovastatin ndi Simvastatin. Katundu wa mankhwala: palibe chiopsezo chachikulu cha matenda ashuga, koma machitidwe awo samachepetsa kwambiri cholesterol m'matumba. Kunja, mankhwala a Pravastatin ndiwotchuka, omwe samakhudza kusowa kwa kagayidwe kazachilengedwe.

Momwe mungasankhire ma statins a shuga?

M'malo ogulitsa mankhwalawa assortment yayikulu ya mankhwala otere. Pakati pa otsika mtengo kwambiri komanso otetezeka - Lovastatin, Simvastatin, Pravastatin. Koma rosuvastatin, atorvastatin, fluvastatin amakhalabe atsogoleri omveka bwino ogulitsa odwala matenda ashuga, ngakhale panali ndondomeko yamitengo. Akufunikira chifukwa cha luso lawo labwino lakuchiritsa.

Kudzichitira nokha mankhwala kungawononge thanzi. Kupatula apo, gululi la mankhwalawa ndilabwino kwambiri, mutha kugula ndikugwiritsa ntchito ma statins pokhapokha ngati dokotala wakupatsani. Inde, kumwa kumayambitsa matenda ashuga mwa munthu wathanzi, koma ndi othandiza kwa odwala omwe ali ndi vuto la mtima. Pambuyo poti atayezetsa kwambiri pomwe dokotala wapadera amamulembera ma statins.

Mitundu ina ya anthu imatengeka kwambiri ndi matenda ashuga atatha kudya mankhwalawa. Awa ndi akazi okalamba, amuna okalamba omwe ali ndi vuto la metabolic. Madokotala amalimbikitsa kuti azitsatira zakudya, azikhala wathanzi komanso azisamalira shuga.

Atherosulinosis ndi matenda ashuga amakambirana nthawi zonse. Malinga ndi zotsatira za kafukufuku, zinatsimikiziridwa kuti matenda ashuga amakhumudwitsa mawonekedwe a atherosclerosis.

Atherosulinosis ndi matenda ashuga amakambirana nthawi zonse. Malinga ndi zotsatira za kafukufuku, zinatsimikiziridwa kuti matenda ashuga amakhumudwitsa mawonekedwe a atherosclerosis.

Ma Statin a chiwindi, kapena, kayendetsedwe kake kamaletsa kuperewera kwa chiwindi. Nthawi yomweyo, amachepetsa chiopsezo chamitsempha yamagazi.

Ndi ma statins ati omwe ali otetezeka komanso othandiza kwambiri? Asayansi azindikira mankhwalawa: Simvastatin, Rosuvastatin ndi Atorvastatin.