Kupanga kusintha kuti mukhale ndi moyo wathanzi - kudzera mu zakudya, zochita masewera olimbitsa thupi, kapena kusintha kwina - ndikofunika kuti musamakhale ndi thanzi lanu la mafuta m'thupi ndi triglyceride. Nthawi zina, izi sizingagwire ntchito, ndipo wothandizira zaumoyo wanu angafune kukupatsani mankhwala.
Mankhwala ambiri otsika kwa kolesterolini pakalipano ali pa msika, ndipo mankhwalawa amatsitsa cholesterol ndi / kapena triglyceride m'magulu osiyanasiyana.
Kuonjezerapo, mankhwalawa ali ndi mbali zosiyanasiyana za mbiri yanu. Mwachitsanzo, mankhwala ena angakhale othandizira kuchepetsa makilogalamu anu a cholesterol, pamene mankhwala ena amatha kulumikiza mbali zonse za mbiri yanu yamakiti. Mulimonsemo, wothandizira zaumoyo wanu adzayesa ubwino ndi zoopsa za mankhwala alionse, ndipo sankhani mankhwala abwino ochepetsa mankhwala omwe ali oyenera. Mankhwala awa amalembedwa pa msika:
Statins
Statins, yomwe imadziwikanso kuti HMG-CoA reductase inhibitors, ndiyo mankhwala omwe amaletsa kwambiri mafuta m'thupi. Ngakhale adalandira mbiri yoipa chifukwa cha zina zosayenera, koma zosavuta, zotsatira zake , zimayang'ana mbali iliyonse ya mbiri yanu.
Statins akhoza:
- Lambitsani LDL pakati pa 18 peresenti ndi 65 peresenti
- Kuwonjezera HDL (cholesterol "wabwino") mpaka 5 peresenti mpaka 15 peresenti
- Kuchepetsa triglycerides ndi 7 peresenti mpaka 30 peresenti
Malamulowa amathandiza kwambiri kuti muzimvetsetsa kuti muli ndi cholesterol, komanso kuti mumateteza imfa ndi mavuto chifukwa cha matenda a mtima.
Statins imakhalanso ndi anti-yotupa katundu yomwe imathandiza kuchepetsa kukula kwa matenda a atherosclerosis omwe angayambitse matenda a mtima. Ndi mankhwala ena owonjezerawa, mankhwalawa ndi omwe amalembedwa kwambiri ndi mankhwala ochepetsa mafuta m'thupi. Mankhwala awa akutsatidwa monga statins:
- Rosuvastatin (Crestor)
- Atorvastatin (Lipitor)
- Simvastatin (Zocor)
- Lovastatin (Mevacor)
- Pravastatin (Pravachol)
- Fluvastatin (Lescol)
Mitambo ya Acid Yoyaka
Mafuta amchere a asidi amachepetsa mafuta m'thupi mwa kukaniza bile acid kuti asabwezeretsedwe. Amagwira ntchito pa LDL cholesterol, kuchepetsa pakati pa 15 peresenti mpaka 30 peresenti ndi kukula kwa HDL kufika pa 5 peresenti. Kawirikawiri, triglycerides sakhudzidwa ndi bile acid resins - ndipo makamaka imayambitsa magulu a triglycerides. Kuonjezerapo, mavitamini ndi mankhwala osokoneza bongo sangathe kutengedwera nthawi yomwe mumatenga mankhwala a asidi, popeza kuti kuyamwa kwawo kuli kochepa ndipo kungawathandize kukhala opanda mphamvu. Mankhwala otsatirawa amadziwika monga bile acid resins:
- Cholestyramine (Questran)
- Colestipol (Oyang'anira Colestid)
- Colesevelam (Welchol)
Fibric Acids
Fibric acids, kapena fibrates, amadziwika kwambiri chifukwa chotha kuchepetsa triglycerides, yomwe ingathe kuchepetsedwa ndi pakati pa 20 peresenti mpaka 50 peresenti. Amachepetsanso maseĊµera a LDL pakati pa 5 peresenti mpaka 20 peresenti ndipo amatha kukweza ma CDL ndi 20 peresenti. Gulu la mankhwalawa ladziwika kuti limatulutsa minofu, makamaka ngati ili ndi mankhwala ena monga statins ndi warfarin (Coumadin). Pankhaniyi, wothandizira zaumoyo wanu angasinthe mlingo wa mankhwala anu (monga momwe zilili ndi warfarin).
Mankhwala otsatirawa ndi fibrates:
- Gemfibrozil (Lopid)
- Fenofibrate (Tricor)
Zosakaniza zozizwitsa
Ezetimibe panopa ndi mankhwala okhawo m'kalasiyi ndipo makamaka akuwongolera mbali za LDL cholesterol, kuchepetsa ma LDL ndi pafupifupi 15 peresenti. Kawirikawiri, ezetimibe ikuphatikizidwa ndi statin kuti zitsimikizire zotsatira zowonjezera pochepetsa ma LDL. Ngakhale mankhwalawa atsimikiziridwa kuti amachepetsa LDL, iwo sanawonetsere kuti amalepheretsa mwachindunji kukula kwa mtima wamaganizo pamene agwiritsidwa ntchito payekha. Ezetimibe (Zetia) ndi mankhwala okhawo a FDA omwe amavomerezedwa m'kalasi la mankhwalawa.
Omega-3 Fatty Acids
Ngakhale kuti pali omega-3 fatty acids owonjezera, omega-3 fatty acid mankhwala agwiritsidwa ntchito poyesera kuti aone momwe angakhalire ndi chitetezo.
Zakudyazi zili ndi docosahexaenoic acid (DHA) ndi eicosohexaenoic acid (EPA) monga zakudya zowonjezera zomwe zimapezeka m'masitolo, koma zigawozi zimakhala zoyeretsedwa kwambiri poyerekeza ndi zowonjezerapo. Mankhwala omega-3 fatty acids amagwiritsidwa ntchito makamaka pa anthu omwe amawunikira kwambiri m'magulu a triglyceride, kuchepetsa triglycerides ndi 45 peresenti. Panopa pali mankhwala atatu omega-3 fatty [mankhwala omwe alipo:
PCSK9 Inhibitors
Mankhwala awa amaletsa mapuloteni a PCSK9 kuti asagwirizane ndi amalandila a LDL ndi kuwatsogolera. Izi zidzalola operekera LDL kuti apitirize kugwira ntchito pochotsa LDL ku thupi - zomwe zimapangitsa kuchepetsa mphamvu ya LDL cholesterol ndi pafupifupi 50 peresenti mu maphunziro. Mankhwala m'kalasiyi akuwonjezeka pamene mankhwala opatsirana pakondolomu (monga statins) sakudzichepetsa kwambiri LDL cholesterol. Amagwiritsidwa ntchito nthawi zambiri pamodzi ndi zakudya zopatsa thanzi ndipo amatengedwa ndi statins kapena mankhwala ena otsika kwa kolesterolini. Anthu omwe amamwa mankhwalawa ali ndi chimodzi mwazifukwa izi:
- matenda a atherosclerotic okhudza mitsempha ya magazi ndi / kapena mtima
- matenda obadwa nawo, achilendo kapena a heterozygous family hypercholesterolemia
Pali maphunziro omwe akuchitika panopa omwe akufufuza momwe lusoli likugwiritsira ntchito mankhwalawa kuti athetse chiopsezo cha imfa kapena kukhala ndi vuto la mtima mwa anthu omwe akuwatenga. Mankhwala osokoneza bongo m'kalasi ili ndi awa:
- Repatha (evolocumab)
- Zamtengo wapatali (alirocumab).
Mankhwala Osamalira Ana Amasiye
Mankhwala ena ochepetsa kumwa mankhwala amangolembedwera kwa anthu omwe ali ndi mitsempha yapamwamba ya LDL ya cholesterol. Mankhwalawa amalembedwa ngati munthu ali ndi chibadwa chomwe chimayambitsa chifuwa chachikulu msinkhu, ndipo mankhwala ena - monga statins - samathandiza kuchepetsa LDL.
Zina mwa mankhwalawa zingayambitse mavuto aakulu, monga matenda a chiwindi, motero amaperekedwa pansi pa pulogalamu yapadera ndi akatswiri azaumoyo omwe amadziwa mankhwala. Mankhwalawa amakhalanso atsopano pamsika ndipo amagwiritsa ntchito njira zodzichepetsera m'magulu:
- Antisense inhibitors: Mankhwala omwe ali m'gulu la mankhwalawa amamanga gawo la mthenga wa RNA omwe amalemba kuti apange B-100, kuchepetsa kuchuluka kwa apo B-100 yopangidwa m'thupi. Izi zimachepetsa kuchuluka kwa VLDL ndi LDL cholesterol mu thupi. Mankhwalawa ndi Kynamro (mipomersen), omwe amachepetsa LDL pafupifupi 25 peresenti.
- MTTP inhibitors: Mankhwalawa amachepetsa m'matumbo a LDL cholesterol mwa kulepheretsa mapuloteni othandizira (MTTP), omwe amachititsa kuti VLDL ndi ma chylomicrons zisapangidwe m'chiwindi. Juxtapid (limitapide) ndi mankhwala okha omwe amavomerezedwa m'kalasi iyi ya mankhwala osokoneza bongo ndipo amachepetsa LDL ndi pafupifupi 50 peresenti.
Zotsatira:
Dipiro JT, Talbert RL. Pharmacotherapy: Njira ya Pathophysiological, 9th, 2014.