Magazi a cholesterol amachepetsa: kuwunika kwa othandizira

Mankhwala ochizira matenda a lipid metabolism amadziwika kuti asagwiritse ntchito mankhwala ochepetsa mphamvu ya lipid, ochita masewera olimbitsa thupi komanso kuchepa thupi kwa miyezi 6. Pa mulingo wa cholesterol yokwanira m'magazi omwe ali pamwamba pa 6.5 mmol / l, mankhwalawa amatha kuikidwa kale kuposa nthawi ino.

Kuwongolera metabolidi ya lipid, mankhwala oletsa anti-atherogenic (lipid-lowering) ndi omwe amapatsidwa. Cholinga chakugwiritsa ntchito kwawo ndikuchepetsa kuchuluka kwa cholesterol "yoyipa" (cholesterol yathunthu, triglycerides, lipoproteins yotsika kwambiri) (VDL) komanso kachulukidwe kachulukidwe (LDL), kamene kamachepetsa kukula kwa mitsempha ya mitsempha komanso kuchepetsa chiwopsezo cha matendawa: angina pectoris, kugunda kwamtima matenda.

Gulu

1. Anion-exchange resins ndi mankhwala omwe amachepetsa mayamwidwe (mayamwidwe) a cholesterol m'matumbo.
2. Nicotinic acid
3. Khalid.
4. Fibates.
5. Statins (3-hydroxymethyl-glutaryl-coenzyme-A-reductase inhibitors).

Kutengera ndi makina amachitidwe, mankhwalawa kuti muchepetse cholesterol yamagazi amatha kugawidwa m'magulu angapo.

Mankhwala omwe amalepheretsa kuphatikizika kwa atherogenic lipoproteins ("cholesterol yoyipa"):

• ma statins
• mafupa
• nicotinic acid
• phenucol
• ezinflavin.

Zomwe zimapangitsa kuti muchepetse kuyamwa kwa cholesterol ku chakudya m'matumbo:

• otsatizana a bile acid,
• kuwongolera.

Lipid metabolism okonza omwe amachulukitsa "cholesterol yabwino":

Otsatira a bile acid

Mankhwala omangira a acid (cholestyramine, colestipol) ndi ma resin osinthana ndi anion. Akangokhala m'matumbo, "amagwira" ma asidi a bile ndikuwachotsa m'thupi. Thupi limayamba kusowa ma bile acid, ofunikira kuti magwiridwe antchito azigwira bwino ntchito. Chifukwa chake, mu chiwindi, njira yophatikiza iwo kuchokera ku cholesterol imayamba. Cholesterol "imatengedwa" m'magazi, chifukwa chake, kumangika kwake kumachepa.

Cholestyramine ndi colestipol amapezeka amtundu wa ufa. Mlingo wa tsiku ndi tsiku uyenera kugawidwa mu 2 kapena 4 Mlingo, womwe umamwetsa mankhwala mu madzi (madzi, madzi).

Maini osinthanitsa ndi anion samayikidwa m'magazi, amangogwira m'matumbo a lumen. Chifukwa chake, ali otetezeka kwambiri ndipo alibe zotsatira zoyipa zosafunikira. Akatswiri ambiri amakhulupirira kuti ndikofunikira kuyambitsa chithandizo cha hyperlipidemia ndi mankhwalawa.

Zotsatira zoyipa zimaphatikizira kutulutsa, mseru komanso kudzimbidwa, m'malo ochepera. Kuti mupewe zizindikiro zotere, ndikofunikira kuwonjezera kuchuluka kwa madzimadzi ndi fiber fiber (fiber, chinangwa).
Pogwiritsa ntchito mankhwalawa kwa nthawi yayitali, mwina pali kuphwanya mayankho mu matumbo a folic acid ndi mavitamini ena, makamaka osungunuka.

Mankhwala omwe amapondereza matumbo a cholesterol

Mwakuchepetsa kuyamwa kwa cholesterol ku chakudya m'matumbo, mankhwalawa amachepetsa kuyika kwake m'magazi.
Chothandiza kwambiri pagululi ndalamazi. Ndi mankhwala azitsamba ochokera ku mbewu za nyemba za hyacinth. Muli ndi polysaccharide yosungunuka m'madzi, yomwe imapanga zonunkhira pakakumana ndi madzi m'matumbo a lumen.

Guarem amangochotsa mamolekyulu a cholesterol kukhoma lamatumbo. Imathandizira kuchotsedwa kwa ma asidi a bile, zomwe zimayambitsa kuwonjezeka kwa cholesterol kuchokera m'magazi kupita m'chiwindi chifukwa cha kaphatikizidwe kake. Mankhwala amachepetsa kudya ndipo amachepetsa kuchuluka kwa zakudya zomwe zimadyedwa, zomwe zimapangitsa kuti achepetse thupi komanso milomo ya lipid m'magazi.
Guarem imapangidwa m'migulu yamagalimoto, yomwe imayenera kuwonjezeredwa ndi madzi (madzi, madzi, mkaka). Kumwa mankhwalawa kuyenera kuphatikizidwa ndi mankhwala ena a antiatherosselotic.

Zotsatira zoyipa zimaphatikizira kutulutsa, mseru, kupweteka m'matumbo, komanso nthawi zina zotayirira. Komabe, zimawonetsedwa pang'ono, sizichitika kawirikawiri, ndikumapitilira mankhwala zimadalira palokha.

Nicotinic acid

Nicotinic acid ndi zotumphukira zake (enduracin, niceritrol, acipimox) ndi mavitamini a gulu B. Amachepetsa kuchuluka kwa "cholesterol yoyipa" m'magazi. Nicotinic acid imayendetsa dongosolo la fibrinolysis, kuchepetsa mphamvu ya magazi kupanga ziwalo zamagazi. Mankhwalawa ndi othandiza kwambiri kuposa mankhwala ena otsitsa a lipid omwe amachititsa kuti magazi azikhala ndi "magazi abwino kwambiri" m'magazi.

Mankhwala a Nicotinic acid amachitika nthawi yayitali, ndikuwonjezereka kwapang'onopang'ono kwa mlingo. Asanayambe ndi kumwa, sikulimbikitsidwa kumwa zakumwa zotentha, makamaka khofi.

Mankhwalawa amatha kukhumudwitsa m'mimba, ndiye kuti samaperekedwa chifukwa cha zilonda zam'mimbazi. Mwa odwala ambiri, khungu limawoneka kumayambiriro kwa chithandizo. Pang'onopang'ono, izi zimatha. Kuti mupewe, tikulimbikitsidwa kuti muthe kutenga 325 mg ya aspirin kwa mphindi 30 musanamwe mankhwala. 20% ya odwala ali ndi khungu loyenda.

Kuchiza ndi kukonzekera kwa nicotinic acid kumapangidwa chifukwa cha zilonda zam'mimba komanso zilonda zam'mimba, hepatitis yayikulu, kusokonezeka kwa mtima.

Enduracin ndi mankhwala a nicotinic acid omwe amakhala atatenga nthawi yayitali. Imavomerezedwa bwino kwambiri, ndikupangitsa zotsatira zoyipa zochepa. Amatha kuthandizidwa kwakanthawi.

Mankhwalawa amachepetsa mphamvu ya mafuta onse 'abwino' ndi 'oyipa'. Mankhwalawa samakhudza kuchuluka kwa triglycerides.

Mankhwala amachotsa LDL m'magazi, imathandizira kupukusa mafuta a cholesterol ndi bile. Imaletsa lipid peroxidation, ndikuwonetsa antiatherosulinotic kwenikweni.

Zotsatira za mankhwalawa zimawonekera miyezi iwiri itatha kuyamba kwa mankhwalawa ndipo zimatha mpaka miyezi isanu ndi umodzi atatha. Itha kuphatikizidwa ndi njira zina zilizonse kuti muchepetse cholesterol.

Mothandizidwa ndi mankhwalawa, kuchulukitsa kwa nthawi ya Q-T pa electrocardiogram ndikukula kwa kwambiri kwamitsempha yamagetsi kumatha. Mukamayendetsa, ndikofunikira kubwereza electrocardiogram osachepera kamodzi pa miyezi itatu kapena isanu ndi umodzi. Simungathe kupatsa probucol nthawi yomweyo ndi cordarone. Zotsatira zina zosavomerezeka ndi monga kuphuka komanso kupweteka kwam'mimba, nseru, komanso nthawi zina zotayirira.

Probucol imaphatikizidwa mu ma ventricular arrhythmias omwe amagwirizanitsidwa ndi nthawi yayitali ya Q-T, zochitika pafupipafupi za myocardial ischemia, komanso ndi gawo lotsika loyambirira la HDL.

Maso amathandizira bwino kuchepetsa kuchuluka kwa triglycerides m'magazi, mpaka kuchepa kwa ndende ya LDL cholesterol ndi VLDL. Amagwiritsidwa ntchito pa milandu ya hypertriglyceridemia. Zida zomwe amagwiritsidwa ntchito kwambiri ndi:

• gemfibrozil (lopid, gevilon),
• fenofibrate (lipantil 200 M, treicor, ex-lipip),
• cyprofibrate (lipanor),
• choline fenofibrate (trilipix).

Zotsatira zoyipa zimaphatikizapo kuwonongeka kwa minofu (kupweteka, kufooka), mseru ndi kupweteka m'mimba, kuwonongeka kwa chiwindi. Mafayilo amatha kupititsa patsogolo kupangika kwa calculi (miyala) mkati chikhodzodzo. Nthawi zina, mothandizidwa ndi othandizira, kuletsa hematopoiesis kumachitika ndi kukula kwa leukopenia, thrombocytopenia, kuchepa magazi.

Fibates sinafotokozedwe matenda a chiwindi ndi ndulu, hematopoiesis.

Statin ndi mankhwala othandiza kuchepetsa matenda a lipid. Amatseka enzyme yomwe imayambitsa kupezeka kwa cholesterol m'chiwindi, pomwe zomwe zili m'magazi zimachepa. Nthawi yomweyo, chiwerengero cha ma LDL receptors chikuchulukirachulukira, zomwe zimatsogolera kuti kuthamangitsidwe kwa "cholesterol yoyipa" kuthamangidwe.
Mankhwala omwe amadziwika kwambiri ndi awa:

• simvastatin (vasilip, chakor, aries, simvageksal, simvakard, simvakol, simvastin, simvastol, simvor, simlo, sincard, holvasim),
• lovastatin (cardiostatin, choletar),
• pravastatin
• atorvastatin (anvistat, atocor, atomax, ator ,x, atoris, vazator, lipoford, lypimar, liptonorm, novostat, torvazin, torvakard, tulip),
• rosuvastatin (akorta, mtanda, mertenil, rosartark, rosucard, rosulip, roxera, rustor, tevastor),
• pitavastatin (livazo),
• fluvastatin (leskol).

Lovastatin ndi simvastatin amapangidwa kuchokera ku bowa. Izi ndi "mankhwala opatsirana" omwe mu chiwindi amasintha kukhala metabolites yogwira. Pravastatin amachokera ku fungal metabolites, koma osapangidwira m'chiwindi, koma ali kale ndi ntchito. Fluvastatin ndi atorvastatin ndi mankhwala opangidwa mokwanira.

Statin amalembedwa kamodzi patsiku madzulo, popeza kuchuluka kwa mafuta m'thupi kumachitika usiku. Pang'onopang'ono, Mlingo wawo umatha kuchuluka. Zotsatira zimachitika kale m'masiku oyamba kukonzekera, zimafika pazofika pamwezi.

Ma boma ndi otetezeka. Komabe, mukamagwiritsa ntchito milingo yayikulu, makamaka kuphatikiza ndi fibrate, chiwindi chovuta kugwira ntchito ndizotheka. Odwala ena amamva kupweteka kwa minofu ndi kufooka kwa minofu. Nthawi zina pamakhala kupweteka kwam'mimba, mseru, kudzimbidwa, kusowa kwa chakudya. Nthawi zina, kusowa tulo komanso kupweteka kumutu kumachitika.

Ma Statin samakhudza metaboline wa purine ndi carbohydrate. Amatha kupatsidwa mankhwala otupa, matenda ashuga, kunenepa kwambiri.

Statin ndi gawo limodzi mwa mfundo zochizira atherosulinosis. Amawonetsedwa ngati monotherapy kapena kuphatikiza ndi ena anti antiososoticotic. Pali zosakaniza zopangidwa kale za lovastatin ndi nicotinic acid, simvastatin ndi ezetimibe (ingi), pravastatin ndi fenofibrate, rosuvastatin ndi ezetimibe.
Kuphatikiza kwa ma statins ndi acetylsalicylic acid, komanso atorvastatin ndi amlodipine (duplexor, caduet) kulipo. Kugwiritsira ntchito kosakanikirana kopangidwa kumapangidwira kumawonjezera kutsatira kwa wodwala chithandizo (kutsata), kumakhala kopindulitsa pachuma, komanso kumabweretsa zotsatira zoyipa zochepa.

Mankhwala ena otsitsa lipid

Benzaflavin ndi wa gulu la vitamini B2. Imasintha kagayidwe mu chiwindi, imayambitsa kutsika kwamagazi a shuga, triglycerides, cholesterol yonse. Mankhwalawa amalekeredwa bwino, osankhidwa mu maphunziro atali.

Chofunikira chimakhala ndi phospholipids, mavitamini a B, nicotinamide, mafuta osakwaniritsidwa acids, sodium pantothenate. Mankhwalawa amathandizira kusweka ndi kuthetsedwa kwa cholesterol "yoyipa", yothandizira maubwino a cholesterol "abwino".

Lipostable ili pafupi kwambiri pakupanga komanso kuchitapo Kofunika.

Omega-3 triglycerides (omacor) amapatsidwa mankhwala ochizira hypertriglyceridemia (kupatula mtundu 1 hyperchilomicronemia), komanso kupewa kubwereza kwapawiri kwa myocardial infarction.

Ezetimibe (ezetrol) imachedwetsa kuyamwa kwa cholesterol m'matumbo, kuchepetsa kuchepa kwake kwa chiwindi. Amachepetsa cholesterol "choyipa" m'magazi. Mankhwalawa ndi othandizira kwambiri kuphatikiza ndi ma statins.

Kanema pamutu "Cholesterol ndi ma statins: kodi ndi bwino kumwa mankhwalawo?"