Mbali yofunika kwambiri yoteteza matenda a atherosclerosis , matenda a mitsempha ya m'magazi (CAD) , zikwapu ndi mitsempha ya mitsempha ya mitsempha , ndiyo kusunga makilogalamu anu a cholesterol ndi triglyceride kuti asakhale apamwamba kwambiri. Ngakhale anthu ena angathe kukwaniritsa cholinga chimenechi ndi zakudya ndi masewera olimbitsa thupi, ambiri sangathe. Ngati zakudya ndi masewera olimbitsa thupi sizikwanira kwa inu, kapena ngati chiopsezo cha matenda a mtima chikukwera kwambiri, ndiye kuti dokotala wanu akufuna kuti muyambe kumwa mankhwala.
- Werengani za zofunikira za kolesterolo ndi triglycerides.
- Werengani momwe mungadziwire ngati mukufuna kuchiritsidwa.
Kwa zaka zambiri, mankhwala osiyanasiyana adalangizidwa kuti athe kuchiza kolesterol ndi triglycerides. Ngakhale kuti statins yakhala yofunika kwambiri ya mankhwala osokoneza mafuta a kolesterolini, mankhwala ambiri achikulire akugwiritsidwabe ntchito. Kuwonjezera apo, mitundu yatsopano ya mankhwala ochizira magazi lipids akuyamba kubwera kuchipatala.
Kaya mankhwala ali ndi chiani kwa inu, muyenera kudziwa china chake chokhudza mankhwala omwe mukuwatenga. Pano pali kufotokozera kwa mankhwala ochiritsira omwe akupezeka pochiza magazi lipids.
Statins
Statins ndizofunikira kwambiri pa mankhwala a kolesterolini, chifukwa chapafupi - zilembo ndizokhalo la mankhwala osokoneza mafuta a kolesterolomu omwe asonyezedwa kuti apange zotsatira zenizeni kwa anthu omwe ali ndi vuto la mtima, makamaka kwa anthu omwe ali kale ndi matenda a mtima kapena stroke.
Mankhwala a statin amaletsa mavitamini otchedwa HMG-CoA reductase, omwe amachepetsa mphamvu ya chiwindi kuti apange cholesterol. Kotero, statinsyi imakhala yochepa kwambiri komanso yokhazikika m'magazi onse a kolesteroloni ndi LDL cholesterol.
Statins imachepetsanso kutupa kwa thupi, kuchepetsa kupwetekedwa kwa mitsempha, komanso kusintha mthupi lonse.
Ma Statins nthawi zambiri amalekerera, koma zotsatira zake zimachitika. Chochititsa chidwi kwambiri pambali ndi kupweteka kwa minofu kapena kufooka , komwe kumawoneka mu 5 - 10% a odwala omwe amatenga mankhwalawa.
Malamulo omwe alipo alipo ndi awa:
- Lipitor (atorvastatin)
- Lescol (fluvastatin)
- Mevacor (lovastatin)
- Livalo (pitavastatin)
- Pravachol (pravastatin)
- Zocor (simvastatin)
- Crestor (rosuvastatin)
PCSK9 Inhibitors
The PCSK9 inhibitors ndi gulu latsopano la mankhwala osokoneza mafuta m'thupi. Zoyamba ziwiri - Repatha (evolocumab) ndi Zamtengo wapatali (alirocumab) - zinavomerezedwa ndi FDA kumapeto kwa 2015. Mankhwalawa amagwira ntchito poletsa puloteni ya PCSK9 m'chiwindi, zomwe zimayambitsa chiwindi kuchotsa kwambiri LDL cholesterol. The PCSK9 inhibitors, zomwe zimaperekedwa ndi jekeseni, zimatha kuyendetsa cholesterol cha LDL kukhala otsika kwambiri, ndipo chifukwa cha ichi, zachititsa chidwi kwambiri pakati pa ochita kafukufuku.
Masiku ano mankhwalawa amagwiritsidwa ntchito kwa odwala omwe ali ndi matenda a hypercholesterolemia, kapena omwe ali ndi LDL cholesterol. Kugwiritsa ntchito kwawo kungawonjezeke pazaka zingapo zotsatira pamene tikuphunzira ngati angathe kusintha zotsatira zachipatala, kuphatikizapo mafuta a kolesterolini - komanso ngati atulutsa zotsatira za nthawi yaitali.
Nicotinic Acid (Niacin)
Nicotinic acid, mawonekedwe a niacin , amachepetsa cholesterol cha LDL ndipo amachulukitsa mpweya wa cholesterol wa HDL. Zakale zapitazo, adauzidwa mobwerezabwereza kuonjezera miyeso ya HDL. Komabe, kufufuza kwakukulu kachipatala kwatsimikizira kuti phindu la nicotinic acid. Mu phunziro ili, sikuti nicotinic asidiyo inalephera kusintha zotsatira zachipatala komanso izi zikhoza kuwonjezera chiopsezo cha matenda a stroke. Masiku ano, nicotinic acid nthawi zambiri imagwiritsidwa ntchito kwa odwala omwe ali ndi mitsempha yapamwamba ya LDL ya cholesterol omwe sangathe kutenga mankhwala ena.
Ezitimibe
Ezetimibe amachepetsa kuyamwa kwa kolesterolini m'matumbo, kuchititsa chiwindi kukhala ndi cholesterol chofunika kwambiri pochotsa m'magazi.
Zotsatira zake, kuchepetsa kuchepa kwa kolera kwa mafuta a LDL.
Zovuta zachipatala ndi ezetimibe (ogulitsidwa ngati Vytorin, kuphatikizapo simvastatin monga Zetia) zakhala zikukhumudwitsa, ndipo mankhwalawa sagwiritsidwa ntchito nthawi zambiri m'maganizo. Amagwiritsiridwa ntchito makamaka mwa anthu omwe akupitirizabe kukhala ndi mitsempha yapamwamba ya cholesterol mosasamala kanthu za mankhwala opatsirana, kapena omwe satha kutenga statins.
Zomwe zimapezeka m'magazi a sequestrants.
Mafuta omwe amachititsa kuti mankhwalawa asamangidwe amalepheretsa kubwezeretsanso kwa mafuta m'thupi. Izi zimayambitsa chiwindi kuchotsa mafuta ambiri m'thupi. Anthu omwe amakhala ndi acid acid ndi Questran (cholestyramine), Cholestid (colestipol), ndi Welchol (colesevelam).
Ngakhale mankhwalawa amachepetsanso mphamvu za mitsempha ya LDL, zimayambitsa vuto la m'mimba zomwe zimachepetsa ntchito yawo. Ndiponso, monga mankhwala ena ambiri otsika kwa kolesterolini, maphunziro a zachipatala alephera kusonyeza kuti amakweza zotsatira.
Nazi zambiri zokhudza cholestyramine , yomwe imagwiritsidwa ntchito kwambiri ndi acid acid sequestrant.
Ziphuphu.
The fibrates - Antara (gemfibrozil) ndi Lopid (fenofibrate) - amathandiza kwambiri kuchepetsa magazi a triglyceride (ndi 50%). Amawonjezeranso mavitamini a HDL komanso amachepetsa mpweya wa cholesterol. The fibrates amagwira ntchito poletsa kutulutsa lipoprotein wolemera m'chiwindi. Koma kachiwiri, ngakhale kuti iwo amawoneka bwino pa lipida zamagazi, mayesero angapo osasintha amalephera kusonyeza kusintha kulikonse ndi zotsatira za matenda.
Kugwiritsiridwa ntchito kwa fibrates lerolino ndi kuchiza odwala okhala ndi hypertriglyceridemia . Chowopsa kwambiri pambali ya fibrates ndi chakuti akhoza kuchititsa minofu poizoni, makamaka ngati imagwiritsidwa ntchito ndi statins.
Mawu Ochokera
Ngakhale magulu angapo a mankhwala asonyezedwa kuti ali ndi zotsatira zabwino pa cholesterol ndi triglyceride levels, okhawo ma statins awonetsedwa kuti amasintha kwambiri zotsatira zachipatala. Zotsatira zamakono zokhudzana ndi kuchiza kolesterolini zimachepetsa malingaliro awo ku mankhwala a statin - mankhwala ena samakondweretsedwa kupatula pa milandu yoyenera.
Komabe, ochita kafukufuku amadikirira mwachidwi zotsatira za mayesero a zachipatala omwe akuchitidwa ndi PCSK9 inhibitors, kalasi yatsopano ya mankhwala omwe ali ndi mphamvu yotsika kwambiri ya cholesterol.
> Zotsatira:
> Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC / AHA chitsogozo pa Chithandizo cha Magazi a Cholesterol Pochepetsa Matenda a Atherosclerotic Kuopsa kwa Okalamba: Lipoti la American College of Cardiology / American Heart Association Ntchito Yogwira Ntchito Zothandiza. Circulation 2014; 129: S1.
> Kuphunzira EP, Kolodziejczak M, Schulze V, et al. Zotsatira za Proprotein Convertase Subtilisin / Kexin Mtundu wa 9 Matenda Achikulire Mwa Anthu Achikulire Omwe Ali ndi Hypercholesterolemia: Kusanthula Mwadongosolo ndi Kusanthula Meta. Ann Intern Med 2015; 163: 40.
> Ofufuza AIM-HIGH, Boden WE, Probstfield JL, et al. Kuchiza kwa Odwala Amene Ali ndi Mavuto Ochepa a HDL Mitsempha ya Cholesterol Imalandira Static Therapy. N Engl J Med 2011; 365: 2255.