Cholesterol woyipa ndi wabwino, mzanga ndi mdani - momwe mungadziwire?

Mukumvetsetsa kwa anthu ambiri, cholesterol ndiyomwe imayambitsa matenda ambiri owopsa, monga atherosulinosis, kugunda kwa mtima ndi sitiroko. Cholesterol imathandizadi pakupanga matendawa, koma sikuti zonse ndizophweka. Izi ndi zowona pang'ono. Kodi cholesterol ndiyothandiza ndipo ndi chiyani?

Lingaliro lalikulu la cholesterol

Poyamba, ndikofunikira kumvetsetsa kuti cholesterol ndi chiyani ndipo bwanji thupi lathu limafunikira mosiyanasiyana.

Cholesterol ndi phula lachilengedwe, mowa wachilengedwe wa polycyclic lipophilic, wopezeka m'mimba mwa zolengedwa zonse zamoyo, kupatula bowa komanso zopanda nyukiliya. Cholesterol imawonetsetsa kukhazikika kwa ma membrane am'm cell mu kutentha kwakukulu. Ndikofunikira popanga vitamini D, kupangidwa ndi ma adrenal gland a mahomoni angapo a steroid, kuphatikizapo cortisol, aldosterone, mahomoni ogonana - estrogens, progesterone, testosterone - bile acids.

Cholesterol kapena cholesterol imapezeka m'mitundu itatu:

- kuchuluka kachulukidwe lipoprotein cholesterol,

- otsika kachulukidwe lipoprotein cholesterol.

Cholesterol chabwino komanso choyipa

Wachulukane kwambiri lipoprotein cholesterol ndi "wabwino" cholesterol. Zimagwira ntchito yofunika kwambiri pakugwira ntchito kwa munthu, chifukwa zimakwaniritsa kusintha kwa mafuta kuchokera ku dipatimenti ina kupita ku lina. Zimasinthanso cholesterol yathunthu kumitsempha ya mtima, minyewa yamtima, mitsempha yaubongo ndi ziwalo zina zotumphukira ku chiwindi, komwe bile imapangidwa kuchokera ku cholesterol, ndikuchotsa cholesterol yochulukirapo ziwalo zina. Ndi za cholesterol iyi yomwe anthu ambiri amaiwala akamayitcha "owopsa." Anthu ambiri amaganiza kuti cholesterol yeniyeni siyenera kukhalamo, ndipo kupezeka kwake kumaimira vuto, koma izi sizowona.

Koma cholesterol yotsika kwambiri ndi cholesterol "yoipa" kwambiri yomwe madokotala amakonda kuiwopa ndikulimbikitsa kugula zida kuti ziwone magazi ake. Koma alinso ndi gawo m'thupi. Cholesterol chamtunduwu ndiye njira yayikulu yogwiritsira ntchito cholesterol ndikuichotsa ku minofu ndi chiwalo kupita china. Ngakhale imagwira ntchito yofunika, imayambitsa chiopsezo china, chifukwa ndi chitukuko cha matenda a mtima, ndiamene amathandizira kupanga mapangidwe pazitseko zamitsempha yamagazi ndikuwoneka matenda osiyanasiyana.

Mu thupi laumunthu, mumakhala kulimbana kosalekeza pakati pa mitundu iwiri ya cholesterol, chifukwa "zoyipa" zimapanga zolembera pakhoma la zotengera, ndipo "zabwino" zimathandizira pakuchotsa kwawo ndikusamutsa ku chiwindi. Koma, ngakhale pangozi zonse, mtundu umodzi sungakhalepo popanda zinazo. Ili ndi nkhondo yosatha mthupi, pomwe zibaki ndi moyo wa munthu. Cholesterol sitha kutchedwa mdani kapena imzake - imatha kukhala imodzi ndi imzake, kutengera zomwe zili m'magazi, chifukwa chake muyenera kupima magazi pafupipafupi kuti wothandizira yemwe adabadwa mwachilengedwe asayambitse matenda okhumudwitsa.

Ndiye akuyenera kuchita chiyani kuti muchepetse cholesterol?

• kutenga lipid mayeso. Pambuyo pazaka 40, kafukufuku wotereyu amalimbikitsidwa ndi akatswiri kamodzi pachaka,
• ngati mumasuta, musiye. Palibe chomwe chikuchita koma kuvulaza,

samalira zakudya. Idyani zakudya zomwe zimakhala ndi omega-3 unsaturated acids. Amapezeka mu nsomba zam'madzi (nsomba, hering'i, nsomba zam'madzi), nsomba zam'madzi, nsomba zam'madzi) ndi nsomba zina za mumtsinje. Idyani masamba ndi zipatso zambiri. Pewani zakudya zomwe zili ndi mafuta ambiri (tchipisi, masamba otentha a French, chakudya chofulumira),

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Kodi ndi cholesterol iti yabwino komanso yoyipa

Kodi kukweza cholesterol yathunthu ndi yabwino kapena yabwino? Inde, kuphwanya kulikonse kwamafuta kagayidwe kumadzetsa ngozi yayikulu. Ndi chifukwa cha kuchuluka kwa zinthu zachilengedwe zomwe zili m'magazi pomwe asayansi amaganiza kuti matendawo angayambitse matenda amtundu wa mtima ndi zovuta zake zamtima:

• myocardial infaration
• angina pectoris
• chosakhalitsa kuwukira,
• pachimake cerebrovascular ngozi - sitiroko.

Komabe, mosiyana ndi zomwe ambiri amakhulupirira, sikuti cholesterol yonse ndiyoyipa. Kuphatikiza apo, chinthuchi ndichofunikira mthupi ndipo chimagwira ntchito zofunika zingapo:

1. Kulimbitsa ndi kutanuka kwa nembanemba ya cytoplasmic yama cell onse omwe amapanga ziwalo zamkati ndi zakunja.
2. Kutenga nawo mbali pa kayendedwe ka cell wall permeability - amatetezedwa ku zowonongeka zachilengedwe.
3. Kutenga nawo gawo kapangidwe ka mahomoni a steroid ndi ma glandular cell a adrenal glands.
4. Kuonetsetsa kupangidwa kwachilengedwe kwa bile acid, vitamini D wolemba hepatocytes a chiwindi.
5. Kuwonetsetsa kuyanjana kwapakati pa ma neurons aubongo ndi chingwe cha msana: cholesterol ndi gawo la chimbale cha myelin chomwe chimakwirira mitsempha ndi ulusi.

Mpaka 80% ya cholesterol yomwe imapezeka m'thupi la munthu imapangidwa ndi ma cell a chiwindi.

Chifukwa chake, mulingo woyenera wa cholesterol m'magazi (m'magawo 3.3-5.2 mmol / l) ndi wofunikira pakugwira ntchito mogwirizana kwa ziwalo zonse zamkati ndikusunga kukhalapo kwa mkati mwa thupi.

Mavuto azaumoyo amayamba ndi:

1. Kuwonjezeka kwakukulu pamlingo wa cholesterol yathunthu (OX) yoyambitsidwa ndi metabolic metabolologies, machitidwe a zinthu zoyambitsa (mwachitsanzo, kusuta, kumwa mowa mwauchidakwa, chibadwa chamtsogolo. Mavuto Amadyedwe - Kudya kwambiri zomwe zimadzaza ndi mafuta a nyama kungayambitsenso OX.
2. Dyslipidemia - kuphwanya kuchuluka kwa cholesterol yabwino ndi yoyipa.

Ndi cholesterol iti yomwe imatchedwa yabwino ndipo ndi iti yoyipa?

Chowonadi ndi chakuti chinthu chokhala ngati mafuta chomwe chimapangidwa m'maselo a chiwindi kapena kulowa ngati gawo la chakudya chimangopanda madzi. Chifukwa chake, amatengedwa kudzera m'magazi ndi mapuloteni apadera onyamula - ma apolipoprotein. Kuphatikizika kwa mapuloteni komanso mafuta kunatchedwa lipoproprotein (LP). Kutengera ndi kapangidwe ka mankhwala ndi ntchito zomwe zidapangidwa, magawo angapo a mankhwala amasiyanitsidwa. Onsewa amaperekedwa patebulo pansipa.

Mphamvu ya atherogenic ya LNPP (komanso VPLL yocheperako) pamthupi la munthu imatsimikiziridwa. Amadzazidwa ndi cholesterol ndipo panthawi yoyenda kudzera pamimba yolimba amatha "kutaya" gawo la mamolekyulu a lipid. Pamaso pa zinthu zopsetsa mtima (kuwonongeka kwa endothelial chifukwa cha chikonga, mowa, matenda a metabolic, etc.), cholesterol yaulere imakhazikika kukhoma lamkati la mitsempha. Chifukwa chake njira ya pathogenetic ya chitukuko cha atherosulinosis imayambitsidwa. Chifukwa chotenga nawo mbali pa njirayi, LDL nthawi zambiri imadziwika kuti cholesterol yoyipa.

Mankhwala apamwamba kwambiri a lipoprotein ali ndi zotsatirapo zina. Amatsuka ziwiya za cholesterol zosafunikira ndipo zimakhala ndi antiatherogenic katundu. Chifukwa chake, dzina lina la HDL ndi cholesterol yabwino.

Chiwopsezo chotenga atherosulinosis ndi zovuta zake mwa munthu aliyense payekhapayekha zimatengera chiyezo cha cholesterol choyipa komanso chabwino pakuyesa kwa magazi.

Makhalidwe abwinobwino a lipid

Mwambiri, munthu amafunikira magawo onse a lipoprotein. Miyezo yabwinobwino ya cholesterol yabwino ndi yoyipa mwa amayi, abambo ndi ana imaperekedwa patebulo pansipa.

Malinga ndi kuchuluka kwa zigawo zing'onozing'ono za lipid m'thupi ndi kuthekera kwatsoka

Chochititsa chidwi, kudziwa zofunikira za cholesterol yathunthu, lipoprotein yotsika komanso yapamwamba, madokotala amatha kuwerengera kuti ali ndi vuto la atherosulinosis ndi mtima wake pamavuto amunthu aliyense. Mu mbiri ya lipid, mwayi uwu umatchedwa atherogenic coefficient (CA).

CA imatsimikizidwa ndi formula: (OH - LP VP) / LP VP. Amawonetsa chiŵerengero cha cholesterol choyipa ndi chabwino, ndiko kuti, zigawo zake za atherogenic ndi antiatherogenic. Kuthekera koyenera kumaganiziridwa ngati mtengo wake uli mgawo la 2.2-3.5.

CA yocheperako siyofunika kwambiri pakubwera ndipo imatha kuwonetsa chiopsezo chochepa cha kugunda ndi vuto la mtima kapena stroke. Simuyenera kuichulukitsa mwadala. Ngati chizindikirochi chipitilira chizolowezi, zikutanthauza kuti cholesterol yoyipa imapezeka m'thupi, ndipo munthu amafunikira kufufuza mozama komanso kuchiza matenda a atherosulinosis.

Mlingo wa cholesterol womwe umadwala mwa omwe ali ndi matenda a atherosulinosis ndi 4 mmol / L. Ndi chizindikiro ichi, chiopsezo chokhala ndi zovuta za matendawa chimachepetsedwa kwambiri.

Kusintha kwatsoka pakusanthula kwa lipoproteins: chifukwa chake nchiani?

Dyslipidemia - kuphwanya mafuta kagayidwe - ndi imodzi mwazomwe zimachitika kwambiri pakati pa anthu opitilira zaka 40. Chifukwa chake, kupatuka kwazomwe zimachitika pakupenda mafuta a cholesterol ndi magawo ake sizachilendo. Tiyeni tiwone zomwe zingayambitse kapena kuchepa kwa milingo ya lipoprotein m'magazi.

Cholesterol yoyipa

Nthawi zambiri, kuwonjezeka kwa kuchuluka kwa osachulukitsa lipoproteins kumaonedwa mu mbiri ya lipid. Izi zitha kukhala chifukwa cha:

• zovuta zamtundu (mwachitsanzo, dyslipoproteinemia cholowa),
• zolakwika m'zakudya (kuchuluka kwa zopangidwa ndi nyama komanso chakudya chamafuta m'zakudya),
• anachita opaleshoni yam'mimba, zotupa za mitsempha,
• kusuta
• uchidakwa
• kupsinjika kwambiri m'maganizo kapena kupsinjika bwino,
• matenda a chiwindi ndi ndulu (hepatosis, cirrhosis, cholestasis, cholelithiasis, etc.),
• mimba ndi nthawi yobereka.

Hypercholesterolemia pa nthawi yomwe mayi ali ndi pakati imadziwika kuti ndi yofanana ndi momwe zimakhalira: Umu ndi momwe thupi la mayi wamtsogolo limakonzekera kubereka.

Kuwonjezeka kwa kuchuluka kwa cholesterol m'magazi ndi chizindikiro chosavomerezeka cha chitukuko cha atherosulinosis. Kuphwanya magazi kwamatenda kotereku, kumakhudza thanzi la mtima. Wodwala:

• mamvekedwe amitsempha,
• chiopsezo cha thrombosis chikukula,
• kuthekera kotukuka kwa myocardial infarction ndi stroko kumawonjezeka.

Choopsa chachikulu cha dyslipoproteinemia ndi njira yotalikilapo ya asymptomatic. Ngakhale ndi kusintha kosiyanasiyana kwa cholesterol yoyipa ndi yabwino, odwala amatha kumva bwino. Nthawi zina amakhala ndi zodandaula za mutu, chizungulire.

Ngati mukuyesera kuchepetsa milingo yayikulu ya LDL kumayambiriro kwa matendawa, izi zikuthandizani kupewa mavuto akulu. Pofuna kuti matenda azovuta za metabolism adzifika nthawi, akatswiri ochokera ku American Association of Cardiology amalimbikitsa kuwunika kolesterol yathunthu ndi bomba lililonse zaka 5 kuti afike zaka 25.

Kachigawo kakang'ono kolesterol LDL muzochita zamankhwala sapezeka. Mothandizidwa ndi OH yotsika mtengo (osati yotsika), chizindikirochi chikuwonetsa chiopsezo chochepa chotengera atherosulinosis, ndipo simuyenera kuyesa kuukweza pogwiritsa ntchito njira zamtundu uliwonse kapena zamankhwala.

Cholesterol chabwino

Palinso ubale pakati pa mulingo wa HDL ndi kuthekera kotukuka kwa zotupa m'matumbo mwa wodwala, ngakhale kuti zotsutsana ndizowona. Kupatuka kwazomwe zimapangitsa kuti pakhale cholesterol yabwino kupita kumbali yaying'ono yokhala ndi mawonekedwe apamwamba kapena apamwamba a LDL ndiye chizindikiro chachikulu cha dyslipidemia.

Izi ndizosangalatsa! Kutsika kwa HDL kwa 0,13 mmol / L iliyonse kuchokera kuzowonetsa bwino kumatha kuwonjezera chiwopsezo cha matenda a mtima ndi 25%.

Zina mwazomwe zimayambitsa dyslipidemia ndi:

• matenda ashuga
• matenda a chiwindi ndi impso,
• matenda obadwa nawo (mwachitsanzo, kalasi IV hypolipoproteinemia),
• pachimake matenda opatsirana oyambitsidwa ndi mabakiteriya ndi mavairasi.

Kupitilira muyeso wabwino wa cholesterol yabwino muzochitika zamankhwala, m'malo mwake, kumawerengedwa ngati chinthu chotsutsa-atherogenic: chiopsezo chokhala ndi vuto la mtima kapena matenda a mtima mwa anthu otere amachepa kwambiri. Komabe, izi ndizowona pokhapokha ngati kusintha kwawunikiridwa "kukwiya" ndi moyo wathanzi komanso chikhalidwe cha anthu. Chowonadi ndi chakuti kuchuluka kwakukulu kwa HDL kumawonedwanso m'matenda ena obadwa nawo. Kenako mwina singakwaniritse ntchito zake zachilengedwe komanso kukhala yopanda ntchito kwa thupi.

Zomwe zimapangitsa kuti chiwopsezo cha cholesterol chiwonjezeke:

• masinthidwe obadwa nawo (kuchepa kwa SBTR, mabanja a hyperalphalipoproteinemia),
• aakulu viral / poizoni hepatitis,
• uchidakwa ndi zoledzera zina.

Popeza tazindikira zomwe zimayambitsa matenda a lipid metabolism, tiyeni tiyesetse momwe tingakulitsire cholesterol yabwino ndikuchepetsa yoyipayo. Njira zothandiza popewa komanso kuchiza matenda a atherosulinosis, kuphatikizapo kukonza moyo ndi zakudya, komanso kugwiritsa ntchito mankhwala osokoneza bongo, zimafotokozedwa m'chigawo pansipa.

Moyo wathanzi

Upangiri woyang'anira momwe mumakhalira ndi chinthu choyambirira chomwe odwala atherosulinosis amamva akawona dokotala. Choyamba, ndikulimbikitsidwa kupatula zonse zomwe zingayambitse chiwopsezo cha matendawa:

Kudya pafupipafupi kwa nikotini ndi mowa wa ethyl m'thupi kumapangitsa kuti microdamage ipangidwe bwino. Mamolekyu a cholesterol yoyipa "amamatira" mosavuta, motero zimayambitsa kupangika kwa mapangidwe a atherosranceotic plaque. Munthu akayamba kusuta (kapena kumwa mowa), amapezeka mwayi wokumana ndi matenda amtima.

Hypodynamia (kusowa kochita zinthu zolimbitsa thupi) komanso kulemera kotsatizanaku nthawi zambiri kumayambitsa kusokonezeka kwa metabolic mthupi, kuphatikizapo dyslipidemia.

Kubwezeretsa moyenera cholesterol yabwino m'thupi, tikulimbikitsidwa:

1. Siyani kusuta kapena kuchepetsa kuchuluka kwa ndudu zosuta fodya tsiku lililonse.
2. Osamaledzera.
3. Sunthani zina. Muzichita nawo masewera olumikizidwa ndi omwe amakuthandizani pazaumoyo. Ikhoza kukhala kusambira, kuyenda, yoga kapena maphunziro okwera pamahatchi. Chachikulu ndikuti mumakonda makalasi, koma osachulukitsa dongosolo lanu la mtima. Kuphatikiza apo, yesetsani kuyenda kwambiri ndipo pang'onopang'ono muwonjezere kuchuluka kwa zolimbitsa thupi.
4. Pezani chiyanjano. Nthawi yomweyo, sikofunikira kuti muchepetse kunenepa kwambiri (ngakhale kungakhale koopsa thanzi), koma pang'onopang'ono. Sinthani zinthu zoyipa (maswiti, tchipisi, chakudya mwachangu, koloko) ndi zothandiza - zipatso, ndiwo zamasamba, mbewu monga chimanga.

Zakudya za Hypocholesterol

Zakudya ndi gawo lina lofunikira pakukonzanso kwa dyslipidemia. Ngakhale kuti njira yotsimikizika ya kudya kwa cholesterol mu chakudya ndi 300 mg / tsiku, ambiri amapitilira chizindikiro ichi tsiku lililonse.

Zakudya za odwala atherosulinosis ayenera kusaganizira:

• nyama yamafuta (makamaka zinthu zovuta pamavuto a mapangidwe a atherosulinosis amaonedwa kuti ndi nkhumba ndi mafuta a ng'ombe - Refractory komanso ovuta kugaya),
• ubongo, impso, chiwindi, lilime ndi zina zotuluka,
• mafuta mkaka ndi mkaka - batala, zonona, tchizi zolimba,
• khofi, tiyi wamphamvu ndi mphamvu zina.

Ndikofunikira kuti maziko a chakudyacho anali masamba atsopano ndi zipatso, CHIKWANGWANI, chimbudzi cholimbikitsa, chimanga. Mapulogalamu abwino kwambiri okhala ndi mapuloteni amatha kukhala nsomba (munyanja mumapezeka zambiri zamafuta odega-3 - cholesterol yabwino), nkhuku zamafuta ochepa (bere la nkhuku, nkhuku), kalulu, mwanawankhosa.

Zakumwa zoledzeretsa zimakambirana ndi wodwala aliyense payekhapayekha. Ndichabwino kwambiri kumwa mpaka malita 2-2,5 amadzi patsiku. Komabe, ndi matenda oopsa kwambiri, matenda a impso kapena matumbo, chizindikiro ichi chimatha kusintha.

Kodi pharmacology ingathandize bwanji?

Chithandizo cha mankhwala a atherosulinosis nthawi zambiri chimafotokozedwa ngati ziwonetsero zingapo (kukonza moyo ndi zakudya) sizinabweretse zotsatira zomwe zingafunike pakadutsa miyezi 3-4. Mankhwala osankhidwa bwino amatha kuchepetsa kwambiri LDL yoyipa.

Njira za chisankho choyamba ndi:

1. Statins (Simvastatin, Lovastatin, Atorvastatin). Makina awo ochitapo kanthu amatengera kuponderezana kwa puloteni yofunika ya kapangidwe ka cholesterol ndi maselo a chiwindi. Kuchepa kwa kupanga kwa LDL kumachepetsa chiopsezo cha mapangidwe a atherosulinotic plaque.
2. Fibates (kukonzekera kochokera mu fibroic acid). Ntchito zawo zimayenderana ndi kugwiritsidwa ntchito kochulukira kwa cholesterol ndi triglycerides ndi hepatocytes. Gulu la mankhwalawa nthawi zambiri limalembedwa kwa odwala omwe ali ndi kunenepa kwambiri, komanso ndi kuwonjezeka kwakutali kwa triglycerides (LDL imachulukitsidwa, monga lamulo, pang'ono).
3. Bile acid omanga othandizira (cholestyramine, cholestide) nthawi zambiri amaloledwa kuti asalole ma statin kapena kulephera kutsatira zakudya. Zimapangitsa kutulutsa kwachilengedwe kwa cholesterol yoyipa kudzera m'mimba, potero kumachepetsa chiopsezo cha mapangidwe a atherosclerotic zolembera.
4. Omega 3.6. Zakudya zamagetsi zochokera pamafuta othandiza a polyunsaturated mafuta zimatha kukula kwambiri mu mulingo wa HDL m'magazi. Zimatsimikiziridwa kuti kugwiritsa ntchito kwawo pafupipafupi (maphunziro mwezi uliwonse 2-3 pachaka) kumapangitsa kuti pakhale zotsatira zabwino za antiatherogenic ndikuchepetsa chiopsezo chokhala ndi matenda am'mimba / matenda a mtima.

Chifukwa chake, ntchito yayikulu yoletsa komanso kuchiza matenda a atherosulinosis ndikubwezeretsa pakati pa cholesterol yabwino ndi yoyipa. Matenda a normalization wa kagayidwe sikungakhudze thupi, komanso amachepetsa kwambiri kuwonongeka kwa mapangidwe a atherosselotic zolembera ndi zovuta zina.

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