Mankhwala otchedwa Statin, omwe amagwiritsidwa ntchito pochepetsa cholesterol , ndi amodzi mwa mankhwala omwe amaperekedwa kudziko lotukuka. Ngakhale kuti ma statins amavomerezedwa bwino, zotsatira zovuta kwambiri zimakhudzana ndi mitsempha ya chigoba, chomwe chimatchedwa "statin myopathy".
Kodi Ndi Zizindikiro Ziti za Static Myopathy?
Static myopathy nthawi zambiri amatenga mitundu itatu:
- Myalgia - ululu wa minofu - umakhala ndi 2% mpaka 10% mwa anthu omwe amatenga zilembo. Mafilimu omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda amawopsya, nthawi zambiri amawoneka ngati opweteka, nthawi zambiri pamapewa ndi manja, kapena m'chiuno ndi m'chuuno. Nthawi zambiri zimakhala ndi zofooka.
- Myositis - kutupa kwa minofu - kumapezeka pafupifupi mmodzi mwa anthu 200 omwe amatenga zilembo. Myositis imayambitsa kupweteka kwa minofu, komanso kukwera kwa ma CK m'magazi. CK ndi enzyme ya minofu, ndipo kupezeka kwake m'magazi kumasonyeza kuti kuwonongeka kwa minofu kukuchitika.
- Rhabdomyolysis ndi kuvulala kwa minofu - makamaka kuwonongeka kwakukulu kwa minofu ya minofu - zomwe zimapangitsa kuti kutuluka kwa mapuloteni a mitsempha kukhale magazi, zomwe zingabweretse mavuto aakulu a impso ndi imfa. Rhabdomyolysis yowonongeka ndi zilembo, mwamwayi, ndizosazolowereka, ndipo pali vuto limodzi lomwe likupezeka pazilembo khumi ndi zinai zalembedwa.
Ngati mavuto a minofu amapezeka, amayamba mkati mwa masabata angapo mpaka miyezi ingapo atayambira mankhwalawa.
Myalgia ndi myositis zokhudzana ndi Statin zidzasintha pakatha masabata angapo ngati mankhwala a statin amaletsedwa. Rhabdomyolysis idzatulutsanso pambuyo poti statinimayi iimitsidwa, koma kuwonongeka kumene kumayambitsa kungakhale kosasinthika.
Ngakhale pali ziphunzitso zingapo, palibe amene akudziwa motsimikiza kuti ma stin akhoza kubweretsa mavuto a minofu.
Statin myopathy mwinamwake ikugwirizana ndi kusintha kwa momwe minofu imabala kapena kuyendetsa mphamvu. Pakalipano, ofufuza satha kuchita zambiri kuposa izi ndi chidaliro chilichonse.
Chiphunzitso chomwe chapeza njira yopambana kwambiri ndi anthu ndikuti statins ikhoza kusokoneza kupanga COQ10, coenzyme mu minofu. CoQ10 imathandiza minofu kugwiritsira ntchito mphamvu yomwe ikufunikira kuti ikhale yogwira ntchito. Kafukufuku wina wanena kuti kutenga CoQ10 zowonjezereka kungachepetse mavuto a misinkhu, koma deta (zonse ngati statins imachepetsa coQ10 ndondomeko komanso ngati CoQ10 supplementation kumathandiza) ndizofooka kwenikweni.
Kafukufuku wam'tsogolo wanena kuti mavuto a minofu ndi statins amapezeka mwa anthu omwe ali ndi vuto la vitamini D. Ena apeza kuti kupereka mavitamini D kwa anthuwa kudzathandiza kuthetsa zizindikiro zawo za mthupi.
Zinthu Zowopsa Kwa Mavuto Osavuta
Mavuto a misampha ndi statins amapezeka mwa anthu omwe amatenga Lopid (gemfibrozil) , steroids, cyclosporine, kapena niacin.
Anthu omwe ali ndi matenda a impso, matenda a chiwindi, kuchepa kwa mavitamini D, kapena hypothyroidism amakhalanso ndi vuto la minofu ndi ma statins, monga anthu omwe ali ndi matenda osokoneza bongo monga amyotrophic lateral sclerosis (ALS) .
Malembo ena amawoneka kuti amachititsa mavuto a minofu kusiyana ndi ena. Makamaka, mavuto a minofu angakhale apamwamba kwambiri ndi simvastatin yapamwamba (dzina la Zocor) kuposa mankhwala ena amtundu wina.
Chifukwa chaichi, mu June 2011, Food and Drug Administration analimbikitsa kuti mlingo wa simvastatin ukhale 40 mg patsiku. Pa mlingo uwu, chiwerengero cha mavuto a minofu ndi simvastatin sichikuwoneka kukhala chapamwamba kwambiri.
Kuopsa kwa misampha ya minofu sikuwoneka kuti ndifupi ndi Lescol (fluvastatin), Pravachol (pravastatin) komanso mwinamwake Crestor (rosuvastatin). Ngati zowawa zokhudzana ndi minofu zimapezeka ndi ma statins ena, kusintha kwa mankhwalawa kumatha kuthetsa vutoli.
Static myopathy ndizovuta kwambiri kwa anthu omwe amachita masewera olimbitsa thupi, makamaka akamachita zimenezi popanda kumangoyamba pang'ono.
Kodi Matenda Okhudzana ndi Mitsempha Yotani Amayambitsidwa?
Kawirikawiri, ngati vuto la mitsempha losemphana ndi maonekedwe aumunthu likudandaula, madokotala amasiya mankhwala a statin, mpaka vuto la minofu limatsimikiza. Kafukufuku ayenera kuchitidwa chifukwa cha kuchepa kwa vitamini D ndi hypothyroidism, komanso kulimbikitsana kulikonse komwe kungawonjezere mavuto a mthupi. Zina mwazifukwa zomwe zingayambitse vutoli ziyenera kuchitidwa.
Ngati zizindikiro zokhudzana ndi minofu zimangokhala zopweteka komanso mwinamwake kufupika kwazigawo za m'magazi a CK, ndipo ngati kupitirizabe mankhwala a statin kumawoneka kofunikira, pali njira zingapo zomwe zingalolere kupitanso patsogolo kwa statin.
Choyamba, kusinthika ku statin yomwe sizingatheke kuchititsa mavuto a minofu (monga pravastatin kapena fluvastatin) nthawi zambiri imalola munthu amene ali ndi vuto la minofu yam'mbuyo kuti atenge statin bwinobwino. Komanso, kutchula mankhwala osokoneza bongo tsiku lililonse, mmalo mwa tsiku lirilonse, kwathandiza anthu ena omwe sangathe kulekerera chithandizo cha tsiku ndi tsiku. Potsirizira pake, ngakhale akatswiri ambiri samakhulupirira kuti CoQ10 supplementation ndi yothandiza poyambitsa kuyambiranso kwa mankhwala a statin, pali mauthenga osokonezeka kuti izi zingakhale zothandiza.
Mawu Ochokera
Ngakhale zovuta za minofu ndizovuta kwambiri zomwe zimawonedwa ndi zilembo zamtunduwu, zotsatira zake zimakhala zochepa kwambiri kwa anthu omwe alibe zifukwa zina zoonjezera. Komanso, ndipo zikachitika, mavuto a minofu nthawi zambiri amatha kusintha. Matenda a mitsempha yochokera ku statins ndi osowa kwambiri.
Komabe, ngati mukugwiritsa ntchito mankhwala osokoneza bongo, muyenera kudziŵa kuti mungathe kukhala ndi ululu kapena kufooka kwa minofu, ndipo ngati zizindikirozi zikuchitika muyenera kuzibweretsa kwa dokotala wanu.
> Zotsatira:
> Gupta A, Thompson PD. Kugwirizana kwa Vitamini D Kulephera kwa Statin Myopathy. Atherosclerosis 2011; 215: 23.
> Rosenson RS, Baker SK, Jacobson TA, et al. Kuyesedwa ndi Static Muscle Safety Task Force: 2014. J Clinic Lipidol 2014; 8: S58. T
> Stroes ES, Thompson PD, Corsini A, et al. Zizindikiro za Mitsempha Yogwirizana ndi Statin: Impact pa Statin Therapy-European Atherosclerosis Society Chigwirizano Chokhazikitsa Phunziro, Aetiology ndi Management. Mtima; 36: 1012.
> PD PD, Clarkson PM, Rosenson RS, Gulu la National Lipid Association Statin Chitetezo Gulu Gulu Masewera Safety Expert Panel. Kuunika kwa Kutetezeka kwa Statin ndi Ofufuza Osokonezeka. Am J Cardiol 2006; 97: 69C.