Lipalo tsa ho fokotsa cholesterol - tseo lithethefatsi li leng betere

Hypercholesterolemia e tšoenya batho ba bangata. Hoa tsebahala hore lefu lena la methapo ea mantlha ke karolo ea bohlokoa kholisong ea myocardial infarction, atherosclerosis, perterheral arteritis le angina pectoris. Maemong a 60%, li-pathologies tsena li qetella ka lefu. Li-statins tse sebetsang hantle hangata li sebelisoa morieng oa kajeno ho theola cholesterol. Tlhahlobo ea lingaka e tiisa matla a liphetoho, tse bonoang litekong tsa mali tsa laboratori.

Tlhahisoleseling mabapi le "cholesterol" e mpe le "e ntle"

Cholesterol ke ea mafura a bonolo (li-sterols), e entsoe ka 2/3 sebeteng, karolo ea boraro e setseng e kena 'meleng ka lijo. Ntho e boletsoeng hammoho le li-phospholipids li etsa metso ea lisele, ke karolo ea lihormone tsa steroid (estrogen, testosterone, progesterone), li-acid acid le vithamine D₃. Cholesterol e kenella hape ho metabolism ea livithamini tse qhibilihang habonolo (A, D, E, K, F). Li-Sterols li sebetsa e le lisebelisoa tsa matla bakeng sa mesifa ea marapo, li hlokahala bakeng sa ho tlama le ho tsamaisa liprotheine.

Keketseho e eketsehileng ea k'holeseterole maling e baka tšusumetso ea lipopae tse nang le mafura (atherosulinotic) tse kentsoeng maboteng a methapo ea mali. Ha nako e ntse e ea, mafura a mafura a thatafala, a nyenyefatsa leseli la methapo ea methapo, likepe tse koahelang. Ka lebaka la thrombosis, stroke le ho hlaseloa ke pelo li ba teng. Ho fokotsa sekhahla sa cholesterol ea 'mele maling, ho sebelisoa mekhoa e fapaneng: matlapa, linoelo, litlolo bakeng sa tšebeliso ea kantle, jj. Kajeno, ho na le palo e kholo ea meriana e fokotsang khoholeho ea cholesterol e felletseng maling.

Hobaneng a tsoha?

Lihlahisoa tsa liphoofolo li na le cholesterol e ngata, haholo e ngata e fumanehang, nama, tranelate, botoro, lijo tsa leoatleng, lehe la lehe. Leha ho le joalo, cholesterol, e kenang 'meleng ka lihlahisoa tsa lijo, ha e ame litaba tsa eona maling. U ka laola khatello ea ntho ena 'meleng u sebelisa lihlahisoa tse nang le mafura a mangata a polyunsaturated. Tsena li kenyelletsa: oli ea tlhapi, lore, oli ea sebete sa cod, oli ea meroho (rapeseed, mohloaare, peanut, soya, hemp, jj.). Tafole e ka tlase e bonts'a lijo tse phahameng tsa cholesterol.

Li-statins ke eng

Statins e sebelisoa ke moriana ho theola cholesterol. Li sebetsa 'meleng oa motho maemong a sele. Sebete sethaleng sa synthesis se ntša mevalonic acid - ona ke ona mokhahlelo oa pele oa ho etsoa ha k'holeseterole. Statin, e sebelisang acid, e thibela ho ntšoa ha mali a mangata ho tsoa lero la mali. Hang ha e le ka likepeng le methapong ea methapo, enzyme ena e sebetsana le lisele tsa tishu e sebetsanang (endothelium). E thusa ho theha sekaka se sireletsang hantle kahare ho methapo ea mali, e sirelletsang khahlanong le sebopeho sa methapo ea mali le ts'ebetso ea ts'oaetso.

Statin ke setlhare seo ngaka e ka u fang sona bakeng sa kalafo le thibelo ea mafu a pelo le methapo (atherosulinosis, stroke, lefu la pelo). Na karolo ea "statin" ea ho fokotsa cholesterol e bohlokoa? Karabo e totobetse: e, ho netefalitsoe. Empa ka nako e ts'oanang, k'holeseterole e kotsi lits'ebetsong tse ling tsa bohlokoa, haholo batho ba baholo. Qeto e tlameha ho etsoa hammoho le ngaka le motheong oa palo e itseng ea bohlahlobisisi le lithuto tsa 'mele.

Mokhoa oa ho theola cholesterol ea mali lapeng ka li-statins

Ho ngotsoe ho hongata ka statin ho theola cholesterol lapeng. E ka fokotsoa ka lithethefatsi, lihlahisoa, litlatsetso tsa ho ja, litlhare tsa batho.Ka nako e ts'oanang, o hloka ho tseba hore risiti ea lihlahisoa ke 20% feela, tse ling kaofela li hlahisoa ke sebete. Se leng betere - lithethefatsi tsa tlholeho kapa lihlahisoa tsa meriana - li tla khethoa ke boitšoaro ba 'mele le ngaka eu shebileng.

Cholesterol e theolang lithethefatsi

Ho na le li-statins tsa tlhaho le tsa maiketsetso: lithethefatsi tsena li ka fokotsa cholesterol. Lethathamo la lithethefatsi tsa anticholesterol le ka tsoela pele. Nahana ka litlamorao tse nyane:

1. Li-statin tsa tlhaho li entsoe ka li-mushroom. Tsena li kenyelletsa: simvastine, simvastatin, pravastatin le lovastatin.
2. Synthetic e fumanoa ka lebaka la motsoako oa metsoako ea lik'hemik'hale. Tsena ke Atorvastatin, Atoris, Fluvastatin, Roxer le Rosuvastatin / Crestor.

Lipalo-palo tsa tlhaho

Ka ho fetola phepo e nepahetseng (haholo mafura), mmele o ka amohela li-statins. Mafura ao re a jang a na le tšebelisano e fapaneng le sebete mme a ka fetoha mefuta e fapaneng ea cholesterol. Mehopolo ea "e mpe" le "e ntle" e kenelletseng hantle bophelong ba lingaka ka mehla:

• Ea pele ke ka tekanyo e tlase ea lipoprotein. E kenya letsoho ho blockage ea methapong.
• Ea bobeli ke ka bongata bo boholo, mosebetsi oa eona ke ho hloekisa methapo. Boemo bo holimo ba bobeli, bo betere, ebile bo fapana.

Mafura a phetseng hantle ke lijo. Li fumanoa lijong tsa limela: lialmonde, linate, tee e tala, litholoana tsa lamunu. Li-Blueberries, lihoete, konofolo li tla thusa ho theola k'holeseterole kapele. Tšebeliso, litlhapi tsa leoatle, lihlapi tsa leoatle, veine e khubelu (e omileng) le lino tse ncha li tla thusa ho theola cholesterol ntle le meriana. Ho bohlokoa hape ho theola lenane la li-yolks tsa mahe, tsoekere le nama ea khomo e mafura. Ngaka e ka u fa mokhoa oa ho ja o tla thusa ho fokotsa metabolism ea lipid.

Lijoa ke eona feela tsela ea ho theola cholesterol lapeng. Melao e meng e tla thusa ho khutlisa li-statins kapele ho theola cholesterol:

• ho latela boima ba 'mele
• bophelo bo mafolofolo
• ho lahla mekhoa e mebe,
• tšebeliso ea tlatsetso ea phepo.

Qetellong li lokela ho phekoloa ka hloko ha li khothaletsoa ke ngaka. Haeba u nka qeto ea ho theola k'holeseterole ka litlhare tsa batho, joale ho hlokahala hore u ele hloko ho se mamellane ha likarolo ka bomong, ho tlosa li-allergen. Ha ho kgothaletswe ho reka mekotla e meholo ea li-capsules hang-hang, hobane allergies e ka hlaha ho lisebelisoa life kapa life tsa phepelo, mme ha se kamehla matsatsing a pele a tsamaiso.

Tlhahisoleseling ka kakaretso

Cholesterol - Ke joala le mafura, motsoako oa organic o fumanoang ka har'a lisele tsa lintho tse phelang.

Hangata ho sebelisoa likhopolo tse peli - k'holeseterolele k'holeseterole. Phapang ke efe pakeng tsa tse peli? Ha e le hantle, lena ke lebitso la ntho e le 'ngoe, ho lingoliloeng tsa bongaka feela ho thoe "k'holeseterole"Ho tloha pheletsong"ol"E bontša kamano ea eona le li-alcohols. Ntho ena e na le boikarabello ba ho fana ka matla. li-membrane tsa sele.

Empa haeba boemo ba cholesterol 'meleng bo phahame, sebopeho sa cholesterol se kena maboteng a likepe, moo, ho petsoha, ho hlahisang tikoloho e ntle bakeng sa ho theha mali. Litlhapi li nyenyefatsa leseli la sekepe.

Ka hona, kamora tlhahlobo ea k'holeseterole, ngaka, haeba ho hlokahala, e etsa qeto ea hore na e lokela ho etsa eng ka cholesterol e phahameng. Haeba qeto ea tlhahlobo ea cholesterol e bontša litheko tsa eona tse phahameng, hangata setsebi se fana ka litlhare tse turang - li-statins, tse etselitsoeng ho thibela mafu a tsamaiso ea pelo le pelo. Ho bohlokoa hore ngaka e hlalose hore kamora ho khethoa, mokuli o lokela ho noa litafole tse joalo kamehla, joalo ka ha ho laetsoe ke litaelo tsa ho li sebelisa.

Empa lithethefatsi tsa anticholesterol li na le litla-morao tse itseng, tseo lingaka li lokelang ho lemosa bakuli ka tsona, li ba hlalosetsa ho noa lipilisi hantle.

Ka hona, motho e mong le e mong ea nang le maemo a phahameng a cholesterol o lokela ho etsa qeto ea hore na o tla sebelisa lithethefatsi tse joalo.

Hajoale ho fanoa ka lihlopha tse peli tse ka sehloohong tsa lithethefatsi tsa cholesterol: li-statinsle fibrate. Ntle le moo, litsebi li khothaletsa hore bakuli ba je Lipoic acid le Omega 3. Tse latelang ke lithethefatsi tse sebelisetsoang ho theola cholesterol. Leha ho le joalo, ts'ebeliso ea bona e eletsoa feela kamora tlhahlobo le ho khethoa ke ngaka.

Boemo ba ho theola cholesterol

Pele o nka lithethefatsi tse joalo, o hloka ho tseba hore na li "statins" ke eng, melemo le likotsi tsa lithethefatsi tse joalo. Lipalo-palo ke lik'hemik'hale tse fokotsang tlhahiso ea mmele Li-enzymee hlokahala bakeng sa ts'ebetso ea motsoako oa cholesterol.

Litaelo tsa lithethefatsi tse joalo li ka bala tse latelang:

• Fokotsa cholesterol ea plasma ka lebaka la thibelo HMG-CoA reductasehammoho le ho fokotsa tšebeliso ea k'holeseterole e ka har'a sebete.
• Fokotsa boemo ba cholesterol bathong ba mahlomoleng homozygous Familia hypercholesterolemia, e sa phekoleheng ka litlhare tse nang le lithethefatsi tse fokotsang lipid.
• Ts'ebetso ea bona ea ts'ebetso e fokotsa palo ea cholesterol e felletseng ka 30-45%, e "kotsi" - ka 40-60%.
• Ha o nka li-statins HDL k'holeseterole le apolipoprotein Atsoha.
• Lithethefatsi li fokotsa monyetla oa mathata a ischemic ka 15%, haholoholo, ho latela sephetho sa litsebi tsa pelo, kotsi angina pectorisle myocardial infarctione fokotseha ka 25%.
• Ha ho na litlamorao tsa mutagenic le carcinogenic.

Litlamorao

Kamora ho nka, ho na le litlamorao tse ngata tse mpe:

• Litlamorao tse tloaelehileng: asthenia, ho hloka boroko, hlooho e bohloko, ho sokela, ho nyekeloabohloko ba ka mpeng lets'ollo, myalgia, botlaela.
• Sistimi ea lijo: lets'ollo, ho hlatsa, lefu la sebete, pancreatitischolestatic jaundice anorexia.
• Tsamaiso ea methapo: ho tsekela, amnesia, hypesthesia, malaise, paresthesia, peripheral neuropathy.
• Liponahatso tsa lintho tse bohloko: lepotlapotla le letlalo la letlalo le boreleli, urticaria, anaphylaxis, erythema e hlasimollang, lefu la Lyell.
• Sistimi ea musculoskeletal: bohloko ba morao myositis, cramps, ramatiki, myopathy.
• Sebopeho sa mali: thrombocytopenia.
• Mekhoa ea metabolic: hypoglycemia, lefu la tsoekereboima ba 'mele botenya, ho hloka matlaedema ea peripheral.
• Pheko e tebileng ka ho fetisisa ea kalafo ea statin ke rhabdomyolysisempa sena se etsahala maemong a sa tloaelehang.

Ke mang ea hlokang ho nka li-statins?

Ho tsebahatsa li-statins, lipapatso tsa lipapatso le litaelo tsa lithethefatsi ho bontša hore li-statins - tsena ke lithethefatsi tse sebetsang ho theola k'holeseterole e eketsang boleng ba bophelo ka kakaretso le ho fokotsa menyetla ea ntlafatso. maqeba, myocardial infarction. Ka hona, ho sebelisa lipilisi tsena letsatsi le leng le le leng ke tsela e bolokehileng ea ho theola cholesterol.

Empa ha e le hantle, ho fihlela kajeno ha ho na tlhaiso-leseling e qaqileng ea hore na kalafo ea bakuli ba nang le meriana e joalo e sireletsehile e bile e ea sebetsa. Ka sebele, bafuputsi ba bang ba re likotsi le litlamorao tse ka bang teng li feta melemo ea li-statins joalo ka prophylactic e sebelisetsoang ho thibela mafu a pelo. Litsebi li ntse li phehisana khang ea hore na li nke li-statins, li lekola botle le mathata. Sebaka sa lingaka hangata se na le phehisano ka taba enaStatins - Pros le Cons».

Empa, leha ho le joalo, ho na le lihlopha tse itseng tsa bakuli bao li-statin li tlamehang ho ba teng.

Ho tla sebelisoa lipalo-palo tsa morao-rao tse latelang:

• bakeng sa thibelo ea bobeli kamora strokekapa lefu la pelo,
• ho ts'ebetso e ntlafatsang likepe tse kholo le pelo,
• ho myocardial infarctionkapa acute coronary syndrome,
• ho lefu la mokokotlo la mokokotlo ka monyetla o eketsehang oa ho otloa ke lefu la stroke kapa lefu la pelo.

Ka mantsoe a mang, lithethefatsi tsa cholesterol li bontšoa ho bakuli ba coronary e le hore ba eketse nako ea bona ea bophelo.Tabeng ena, ho fokotsa litla-morao, ngaka e lokela ho khetha moriana o nepahetseng, ho beha leihlo methapo ea biochemical. Haeba ho na le keketseho ea makhetlo a 3 ea li-transaminase, li-statins li hlakotsoe.

Hoa makatsa hore na ho bohlale ho fana ka litlhare tsa sehlopha sena bakeng sa bakuli ba joalo:

Haeba li-statins li fuoe bakuli ba nang le lefu la tsoekere, ba ka hloka lipilisi tse eketsehileng ho fokotsa tsoekere ho madi, kaha ho bakuli ba joalo li-statins li eketsa tsoekere. Meriana ea ho fokotsa tsoekere ea mali e lokela ho fanoa le ho fetoloa ke ngaka ea bona feela.

Hajoale Russia, litekanyetso tsa kalafo ea methapo ea pelo li kenyelletsa tšebeliso ea li-statins. Empa, leha ho na le taba ea hore ho laeloa bongaka ho fokotsa lefu, sena ha se ntho ea bohlokoa bakeng sa ho beha lithethefatsi ho batho bohle ba nang le lefu la methapo ea methapo kapa khatello ea methapo ea methapo. Ts'ebeliso ea bona ha e lumelloe ke batho bohle ba lilemo tse fetang 45, kapa ke bohle ba nang le cholesterol e phahameng.

Ho bohlokoa ho nahana ka ho tsamaellana ha lithethefatsi tsena le lithethefatsi tse ling.

Haeba ho hlokahala, ngaka e beha litlhare tse ling bakeng sa kalafo ea mafu a pelo hammoho le lithethefatsi tsa anticholesterol: Diroton, Khotso, Propanorm le ba bang

Diroton(karolo e sebetsang - lisinopril) e sebelisetsoa ho phekola khatello ea mali ea methapo.

Khotso(karolo e sebetsang - bisoprolol hemifumarate) e sebelisoang bakeng sa kalafo khatello ea kelello ea methapoho nyekeloa ke pelo angina pectoris.

Li-statins li sebetsa joang

Ho na le mefuta e 'meli ea cholesterol' meleng: e "ntle" kapa e phahameng haholo ea li-lipoprotein (HDL), le "mpe" - low density lipoproteins (LDL), eo maemong a phahameng e bakang li-atherosselotic plaques mme e baka mafu a potoloha.

Ketso ea li-statins e etselitsoe ho thibela tlhahiso ea k'holeseterole, ka mor'a moo boemo ba LDL maling bo fokotseha ka 45-50%, mme bakeng sa litlhoko tsa 'mele, ho se ho sebelisitsoe mafura a tsoang li-plagi tsa atherosselotic le mafura a mangata, a thusang ho fokotsa khatello ea mali le phallo ea mali.

Statins e boetse e fokotsa menyetla ea ho phatloha hoa cholesterol plaque, e fokotsa ts'ebetso ea ho ruruha le ho ntlafatsa ts'ebetso ea endothelium likepeng.

Ba beoa neng

Statins e reretsoe cholesterol e phahameng ea mali (e lekiloeng ho latela tlhahlobo ea mali e nang le biochemical), hammoho le litekanyetso tse phahameng tsa protheine ea C-e bonts'ang ho ba teng ha ts'ebetso ea ho ruruha e amanang le nts'etsopele ea atherosclerosis.

Ts'ebeliso ea li-statins e bonts'oa ho thibela ho otla ha pelo, ho nyekeloa ke pelo, ho otloa le litlamorao tse ling tsa cholesterol e phahameng, e atisang ho bontšoa hammoho le mefuta ena ea mafu:

• Phekolo ea lefu la pelo - lefu la pelo le matla, angina pectoris, atherosulinosis, khatello ea mali, tšekamelo ea ho tšoaroa ke lefutso. Phekolo ea Statin e bontšoa kamora ho hlaseloa ke pelo le ho otloa ke mali ho ntlafatsa phallo ea mali e le ho thibela ho hlaseloa hangata.
• Endocrine - mofuta oa 2 lefu la tsoekere, ho hanyetsa insulin, botenya, hobane ka mafu ana menyetla ea ho holofala ea methapo ea methapo le tsamaiso ea methapo ea methapo ea methapo e eketseha.
• Metabolism - dyslipidemia (hypercholesterolemia, hyperlipidemia, hyperglyceridemia) kapa mathata a metabolism ea lipid a bakoang ke mekhoa e fapaneng ea nts'etsopele le ho eketseha hoa mefuta e meng ea lipids. Phekolo ea li-pathologies tse joalo e lokela ho ba kamehla bakeng sa ho boloka sebopeho sa mali se leka-lekaneng.

Kakaretso ea li-statins tse sebetsang hantle le tse sireletsehileng

Ho na le lihlopha tse 'ne tse kholo tsa lithethefatsi bakeng sa ho fokotsa cholesterol, eo har'a tsona li-statins tsa moloko oa morao-rao, tse nang le thepa ea hydrophobic (e qhibilihang ka metsi), ho fapana le lithethefatsi tsa pejana, li netefalitseng katleho ea tsona le polokeho.

Crestor ke mofuta oa bone oa maiketsetso oa maiketsetso o thehiloeng ho rosuvatsatin, eo kapele e theolang bobe le ho eketsa "cholesterol" e ntle. Krestor e fumaneha ka mokhoa oa litafole ho litekanyetso tsa 5, 10, 20 le 40 mg tsa rosuvastatin. Sebopeho sa moriana o kenyelletsa lactose, calcium phosphate, le magnesium stearate.

Litlamorao tsa kalafo ea li-statins li fihlella libeke tse 3-4 kamora ho kenella ha meriana kamehla, ha kotsi ea infyo ea myocardial le stroke e fokotsoa ke 47-54%.

Matlapa a Krestor ha a sebelisoe bakeng sa mamello ea motho ka mong ho ea ho rosuvastatin, ea ka tlase ho lilemo tse 18, nakong ea kemaro le kanyeso, e nang le methapo e matla ea liphio le sebete.

Livazo ke ea moloko oa morao-rao oa lithethefatsi tsa cholesterol. Ntho e sebetsang Livazo (pitavastatin) e tšoauoa ka bioavailability e phahameng le ketso ea nako e telele mme e beoa ka tekanyetso e nyane (ho tloha ho 1 ho isa ho 4 mg ka letsatsi).

Ha o sebelisa Livazo, ho hlokahala hore ho latela lijo tse nang le mafura a tlase, 'me ho khothalletsoa ho sebelisa matlapa khafetsa ka nako e le' ngoe, haholo-holo mantsiboea, ho nahanela litšobotsi tsa metabolism ea lipid 'meleng.

Hoo e ka bang 4% ea batho ba sebelisang lipalo tsa Livazo ba na le bohloko bo tebileng ba mesifa, bo tsamaeang le bofokoli le ho ruruha, mme ba ka tlase ho 3% ba na le ho hlobaela le hlooho.

Maemong a mang (moo ho nang le litla-morao tsa lithethefatsi ho ea ho mefuta e meng ea lithethefatsi, ka mafu a mokhoa oa ho ipolaea, hammoho le tšebeliso e tloaelehileng ea lino tse tahang), kamora tšebeliso e khutšoane ea Livazo, ho hlokahala hore ho etsoe tlhahlobo ho bonahatsa litlamorao tse mpe tse ka hlahisoang ke litho tsa Sisteme.

Maemong ao Livazo e sebelisetsoang ho thibela lefu la pelo ho lefu la tsoekere, tsoekere ea mali e lokela ho beoa leihlo, hobane maemong a mang ho ka ba le keketseho ea tsoekere ho ea maemong a holimo a hlokang phekolo ea bongaka.

Rosuvastatin-SZ

Rosuvastatin-SZ e sebelisoa bakeng sa hypercholesterolemia ea mantlha le ea lelapa, hypertriglyceridemia, hammoho le thibelo ea mathata a mafu a pelo.

Rosuvastatin-SZ e hlahisoa ka mofuta oa matlapa a 5, 10, 20 le 40 milligrams. Tšebeliso ea kamehla ea statin e ka fokotsa cholesterol ka 40-50% ho libeke tse 6 tsa kalafo. U ka sebelisa lithethefatsi ho sa tsotelehe nako ea letsatsi kapa ea lijo. Tekanyo e phahameng ea rosuvastatin maling e bonoa lihora tse 5 kamora ts'ebetso, butle-butle e fokotseha ho feta lihora tse 19.

Ho kopantsoe le kalafo ho khothaletsoa ho sebelisa lijo tse fokolang mafura a liphoofolo le a meroho ho felisa tšebeliso ea joala le ho tsuba.

Litlamorao mabapi le ho khethoa ha Rosuvastatin-SZ ke myopathy, ho lemala le ho senyeha ha sebete, ho se mamellane ha lactose, ho ima le ho nyekeloa, ts'ebeliso ea cyclosporine le thibelo ea liprotheine tsa HIV. Lipalo tse nang le tekanyetso e phahameng (40 mg) ha li fuoe hypothyroidism, hammoho le tšebeliso ea nako e tšoanang ea li-fibrate.

Liprimar ke sethethefatsi se sebetsang se thehiloeng ho atorvastatin mme se sebelisoa maemong a khaello ea mafura a mangata, angina pectoris le kotsi e kholo ea tlhaselo ea pelo, bakeng sa thibelo ea ho ts'oaroa hape, le mofuta oa lefu la tsoekere la 2 ho fokotsa kotsi ea ho ba le mafu a pelo. Liprimar, haeba ho hlokahala, e ka fuoa bana ba ka tlase ho lilemo tse 9.

Maemong moo li-statins li sebelisoang ka nako e ts'oanang le ts'ebeliso ea nicotinic acid, cephalosporins, fibrate, lithibela-mafu tse ling (erythromycin ,cacithromycin) le antimycotic, joale ho na le kotsi e kholo ea ho nts'etsapele litlamorao tse ling tsa lithethefatsi - bofokoli ba lihlopha tse itseng tsa mesifa (mesifa dystrophy).

Atoris, e kenyeletsang atorvastatin, e laeloa lefu la atherosulinosis, lefu la tsoekere, khatello e phahameng ea mali, angina pectoris le ho fokotsa kotsi haeba ho e-na le ts'ebetso e mpe ea tsamaiso ea pelo le nalane historing ea lelapa.

Atoris e fokotsa sekhahla sa cholesterol "e mpe" (matsatsi a 14-18 kamora ho qala kalafo) mme e na le phello e khahlanong le sclerotic, kaha e phahamisa vasodilation, e sebetsa ka lintlha tsa kholo ea endothelium e ka hare, li hlapolla ebile li etsa hore mali a tloaelehe.

Ka khatello e fokotsehileng, tšebeliso e mpe ea joala, ho se leka-lekane ha electrolyte le kamora ho buuoa, moriana o khethoa kamora liteko tse ling. Atoris ha e khothalletsoe ho sebelisoa nakong ea bokhachane, ho lactation le pele ho lilemo tse 16.

Kaduet ke sethethefatsi se sebetsang se nang le sebopeho se kopaneng se sa fokotseng feela se ka har'a k'holeseterole ea 'mele ka lebaka la litaba tsa atorvastatin, empa se boetse se thatafatsa khatello ka thuso ea amplodipine, calcium Channel blocker (e ntlafatsa boemo ba calcium liseleng mme e thusa ho fokotsa khatello ea systolic le diastolic).

Setlhare se fumaneha ka mokhoa oa matlapa 'me se ka ba le lintho tse sebetsang ka tekanyo e fapaneng. Litekanyetso tsa "statin" li fanoa ka bonngoe kamora ho hlahloba boemo ba lipid tlhahlobisong ea biochemical ea mali, boemo ba pelo, liphio le sebete.

Caduet e sebelisoa bakeng sa mefuta eohle ea khatello ea mali e kopaneng le angina pectoris, dyslipidemia, kapa atherosranceosis. Nakong ea kalafo e nang le "statin", ho hlokahala hore ho hlahlojoe boemo ba sebete (tlhahlobo ea "sebete" transaminases) le meno (ho thibela hyperplasia le ho sisa ha menoane) ka mor'a likhoeli tse 'ne.

Ho felisoa ka mokhoa o sa tloaelehang oa kalafo ea "statin" Kaduet ho thibetsoe, kaha sena se ka lebisa nts'etsopele ea angina pectoris, haholoholo ho batho ba baholo.

Simvagexal

Simvagexal ke ea moloko oa pele oa li-statins, empa, leha e le sena, ke sesebelisoa se theko e tlaase ebile se sebetsang, 'me se sebelisoa bakeng sa ischemia e sa foleng, hypercholesterolemia le hyperlipidemia, bakeng sa thibelo ea methapo ea kutlo le lefu la pelo.

Kaha ho thehoa ha lipoprotein 'meleng ho etsahala bosiu, li-statin li nkuoa hanngoe ka letsatsi mantsiboea, ha ho latela hore na khatello e phahameng ea lithethefatsi e fihlella kamora lihora tse 1.5-2 mme ea fokotseha kamora lihora tse 12.

Phekolo ea mofuta ona oa statin ha ea lokela ho kopanngoa le tšebeliso ea cytostatics, antimycotic (ketoconazole), immunosuppressants, anticoagulants (lithethefatsi li matlafatsa phello ea kalafo ea li-anticoagulants le ho eketsa kotsi ea ho tsoa mali).

Zokor ke setlolo sa halofo ea maiketsetso sa moloko oa pele mme se sebelisetsoa ho loants'a lefu la pelo, cholesterol e phahameng, mathata a potoloha ka nakoana bokong le atherosclerosis.

Zokor e fokotsa cholesterol kapele, ho sa tsotelehe matšoao a pele: liphetho tsa pele lia bonahala kamora libeke tse peli, mme phello e phahameng ea kalafo e fumanoa kamora libeke tse 5-7, ha kalafo e lokela ho kopantsoe le phepo ea kalafo.

Inegi e na le sebopeho se kopaneng ho kenyelletsa simvastatin (10 ho isa ho 80 mg) le ezetimibe (10 mg), e tlatselletsang phello ea pharmacological mme e fana ka phokotso e sebetsang ea cholesterol. Ho fapana le mekhoa e meng, Inegi e ka fuoa batho ba nang le lefu la liphio le sa foleng, hammoho le bana le bacha ba lilemo tse 10.

Boemo ba bohlokoa bakeng sa kalafo ea Inegi ke lijo tse khethehileng tsa hypocholesterol (mafura a fokolang).

Leskol ke mofuta oa maiketsetso o nang le fluvastatin mme o fumaneha ka mokhoa oa matlapa le likhabapo. Matšoao a ho khethoa ha Leskol bakeng sa batho ba baholo ke kalafo le thibelo ea mafu a pelo le methapo ea methapo, le bongoaneng (ho tloha lilemong tse 9) - hypercholesterolemia ea lelapa.

Pele o qala le ho pholletsa le nako eohle ea kalafo o sebelisa Leskol, phepo ea hypocholesterol e lokela ho lateloa. Phello e phahameng ea ho fokotsa lipid ea Leskol e etsahala kamora libeke tse 8-12 tsa kalafo ea lithethefatsi, e ka tsamaeang le dyspepsia, bohloko ba ka mpeng, le mathata a ho ja.

Leskol e laetsoe ka nepo maemong ao ho hlokahalang ho sebelisa li-cytostatics (li-antitumor agents tse fokotsang kholo le ho arohana ha lisele, ho kenyelletsa le tse mpe), tse hanyetsanoang le mefuta e meng ea li-statins.

Lethathamo la lithethefatsi tsa statin

Ke lithethefatsi life tse amanang le li-statins, le tšebetso ea bona ea ho theola cholesterol, li ka fumanoa tafoleng e ka tlase.

U ka khetha li-statins?

Leha ho na le litlhahlobo tsohle mabapi le li-statins bakeng sa ho fokotsa cholesterol, mokuli o lokela ho etsa qeto ea hore na o nka meriana e joalo, empa sena se lokela ho etsoa feela ka tataiso ea setsebi. Bohlokoa, pele ho tsohle, eseng litlhahlobo, empa ho khethoa ha ngaka.

Haeba motho a ntse a entse qeto ea ho nka li-statins, khetho ha ea lokela ho ba theko ea moriana, empa, pele ho tsohle, boteng ba mafu a sa foleng.

Boitšoaro, haeba cholesterol e phahame, ha ho lithethefatsi tse ka etsoang. Phekolo e nang le mathata a cholesterol e phahameng le lipid metabolism e laetsoe ke ngaka ea methapo ea pelo kapa setsebi sa bongaka. Maemong ana, setsebi se lokela ho lekola likotsi tse latelang:

• lilemo
• bong
• boima
• boteng ba mekhoa e mebe,
• mafu a tsamaiso ea pelo le mafu a mang, mafu a mang (lefu la tsoekere, joalo-joalo).

Ho bohlokoa ho nka li-statins ka tekanyetso e boletsoeng ke ngaka ea hau, le ha ho le bohlokoa ho e nka tlhahlobo ea mali ea biochemical khafetsa joalo ka ha ho laetsoe ke setsebi.

Haeba ho fanoa ka lipilisi tse theko e boima haholo, u ka kopa ngaka hore e nkele lithethefatsi tse theko e tlaase. Leha ho le joalo, ho khothalletsoa ho sebelisa lithethefatsi tsa pele, hobane li-genetic tse hlahisoang ka tlung li boleng bo tlase haholo ho feta lithethefatsi tsa pele le li-jeniki tseo moetsi oa kantle a fanang ka tsona.

Ba nang le thahasello ea ho nka tlhahisoleseling ka melemo ea 'nete le likotsi tsa li-cholesterol li lokela ho nahana ka lintlha tse' maloa tsa bohlokoa ho fokotsa kotsi ea lithethefatsi tsena.

Haeba moriana o laetsoe bakuli ba tsofetseng, ho lokela ho hlokomeloa hore kotsi myopathiesmakhetlo a mabeli haeba u li nka hammoho le meriana ea khatello ea mali, gout, lefu la tsoekere.

Ho mafu a sebete a sa foleng, ho bohlokoa hore o nke rosuvastatin ka tekanyetso e tlase, o ka sebelisa Pravastatin (Pravaxol) Lithethefatsi tsena li fana ka tšireletso ea sebete, empa ha u li sebelisa, ha ua lokela ho noa joala ka ho felletseng, hape u sebelise kalafo lithibela-mafu.

Ka ponahalo e sa khaotseng ea bohloko ba mesifa kapa kotsi ea ho senyeha, ho boetse ho molemo hore u sebelise Pravastatin, kaha ha e na chefo ho mesifa.

Batho ba nang le mathata a liphio a sa foleng ha baa lokela ho nkoa. Fluvastin Leskolhape ha ea lokela ho tahoa Calcium ea Atorvastatin (Lipitor), joalo ka ha lithethefatsi tsena li le chefo ho liphio.

Haeba mokuli a batla ho fokotsa cholesterol e tlase haholo, ho kgothaletswa ho sebelisa mefuta e fapaneng ea li-statins.

Hajoale, ha ho na bopaki bo nepahetseng ba hore ho bohlokoa ho nka motsoako oa "statins plus nicotinic acid." Ha o nka nicotinic acid ho batho ba nang le lefu la tsoekere, tsoekere ea mali e ka fokotseha, litlhaselo tsa gout, le mali a tsoang ka mpeng le tsona lia khonahala, monyetla oa eketseha rhabdomyolysis le myopathy.

Boithuto mabapi le litlamorao tsa li-statins 'meleng

Litsebi tsa kelello li ne li tloaetse ho fana ka li-statins bakeng sa batho ba nang le bothata ba lefu la mokokotlo la mokokotlo, khatello ea kelello ea methapo, le ho ba le likotsi tse tlase tsa methapo ea pelo.

Hajoale, maikutlo a mofuta ona oa lithethefatsi a fetohile ho litsebi tse ling. Le ha ho le joalo naheng ea Russia ho fihlela joale ha ho na lithuto tse ikemetseng tse ikemiselitseng tse mabapi le litlamorao tsa li-statins 'meleng tse seng li entsoe.

Ho sa le joalo, bo-rasaense ba Canada ba bolela hore kamora ho sebelisa li-statins, kotsi mats'oenyeho ho bakuli ba eketsehile ka 57%, mme ha motho a utloa bohloko lefu la tsoekere, - ka 82%. Lintlha tse tšosang joalo li netefalitsoe ke tlhahlobo ea lipalo.

Litsebi li ile tsa hlahlobisisa sephetho sa lithuto tsa bongaka tse leshome le metso e mene tse ileng tsa etsoa ho ithuta phello ea li-statins 'meleng. Qeto ea bona e bile tse latelang: ha ho nooa mofuta ona oa bongaka, monyetla oa ho ba le stroke le pelo o oa fokotseha, empa ha o fuoa litlamorao tse mpe, ha o fuoe batho bao ba sa kang ba tšoaroa ke mats'oafo kapa maloetse a pelo. Ho latela bafuputsi, batho ba noang litlhare tse joalo khafetsa ba na le litlamorao tse latelang:

Empa ka kakaretso, ho na le maikutlo a fapaneng mabapi le hore na lithethefatsi tsena li kotsi kapa li sireletsehile haholo.

• Bo-rasaense ba tsoang Jeremane ba paka hore ka cholesterol e tlase, monyetla oa ho hola mofets'e, mafu a sebete le maloetse a mangata a tebileng, hammoho le lefu la pejana le ho ipolaea, ka hona ho tiisa hore k'holeseterole e tlase e kotsi haholo ho feta e phahameng.
• Bafuputsi ba tsoang USA ba bolela joalo lefu la pelo le maqeba eseng ka lebaka la k'holeseterole e phahameng, empa ka lebaka la maemo a tlase a magnesium 'meleng.
• Statins e ka hatella tšebetso ea bohlokoa ea cholesterol, e khutlisetsang litšitiso liseleng tsa 'mele. E le hore boima ba 'mele bo mele' meleng, le ts'ebetsong e tloaelehileng ka kakaretso, lisele tse mafura tse fokolang haholo, e leng "cholesterol e mpe" li hlokahala. Haeba khaello e bonoa, e ka hlaha myalgia, mesifa dystrophy.
• Ha o sebelisa lithethefatsi tse joalo, tlhahiso ea k'holeseterole e ea hatelloa, ka ho latellana le tlhahiso bohareng, e seng mohloli oa cholesterol feela, empa le lintho tse ling tse 'maloa. Li etsa mesebetsi ea bohlokoa 'meleng, ka hona, khaello ea tsona e ka baka kholo ea mafu.
• Sehlopha sena sa lithethefatsi se eketsa monyetla oa ho hola lefu la tsoekere, mme lefu lena le lebisa ho eketseho ea cholesterol. Mehloli e fapaneng e bolela hore haeba u nka li-statin nako e telele, menyetla ea lefu la tsoekere e tsoa ho 10 ho isa ho 70%. Tlas'a tšusumetso ea lithethefatsi tsena ka seleng, khatello ea protheine ea GLUT4, e ikarabellang bakeng sa boemo ba tsoekere maling e ea fokotseha. Bafuputsi ba Borithane ba bonts'itse hore ho nka meriana e joalo ho eketsa kotsi ea lefu la tsoekere ho basali kamora ho khaotsa ho ilela khoeli ka 70%.
• Litla-morao tse mpe li hlaha butle butle, ka ho fapana, mokuli a ka se lemohe hanghang, e leng kotsi ka tšebeliso ea nako e telele.
• Ha u sebelisa li-statins, phello ea sebete e hlokomeleha. Bao ba nkoang ba le batenya kapa ba phela bophelo ba ho lula fatše, hlokomela ka nako e itseng ntlafatso maemong a likepe. Empa ha nako e ntse e tsamaea, lits'ebetso tse rarahaneng 'meleng lia senyeha, tse ka lebisang ho senyeha ha lits'ebetso tsa kelello, haholoholo bathong ba botsofaling.

Ha motho a le ka tlase ho lilemo tse 50 a e-na le cholesterol e phahameng, sena se bontša hore ho ba le mathata a tebileng 'meleng a hlokang ho phekoloa. Linaheng tse ling, mananeo a ntse a hlahisoa boemong ba naha bo khothalletsang ho theola cholesterol ka ho khothaletsa bophelo bo mafolofolo, ho fetola melaoana ea lijo, ho khaotsa ho lemalla tahi ea nicotine le ho sebelisa li-statins.

Ka lebaka leo, linaheng tse ngata mokhoa ona o “sebelitse”: lefu la mafu a pelo le theohile haholo. Leha ho le joalo, ho lumeloa hore ho tlohela ho tsuba, ho ikoetlisa le ho chencha menu ke tsela e ntle ea ho lelefatsa bophelo ho feta ts'ebeliso ea lithethefatsi tse nang le litlamorao.

Lipalo tsa bakuli ba tsofetseng

Har'a likhang tse emelang 'nete ea hore batho ba baholo ba lokela ho nka li-statin feela ka mor'a ho hlahloba ka hloko likotsi le melemo, re ka hopola phuputso eo, e bileng teng batho ba fetang likete tse 3 ba fetang lilemo tse 60 ba noang lithethefatsi tsa statin. Hoo e ka bang 30% e hlokometse ponahatso ea bohloko ba mesifa, hammoho le ho fokotseha ha matla, mokhathala o phahameng, bofokoli.

Bohloko ba mesifa bo boima haholo ho ba sa tsoa qala ho sebelisa meriana e joalo. Ka lebaka leo, boemo bona bo fokotsa botebo ba ts'ebetso ea 'mele - ho ba thata ho batho ho ikoetlisa le ho tsamaea, e leng qetellong e lebisang kotsing e kholo ea ho ba le stroke le ho otloa ke pelo. Ntle le moo, ho motho ea nang le ho sisinyeha ho fokolang, boima ba 'mele bo qala ho eketseha butle-butle, eo hape e leng kotsi ea lefu la pelo.

Fibates: ke eng?

Litokisetso fibratee boetse e sebelisoa ho theola cholesterol. Meriana ena e tsoa ho tse ling. fibroic acid. Li tlama le bile acid, ka tsela eo, li fokotsa tlhahiso e sebetsang ea k'holeseterole ke sebete.

Fenofibrate fokotsa boemo ba meriana lipidsebe eona e lebisa ho cholesterol e tlase. Ho latela lithuto tsa tliliniki, ts'ebeliso ea fenofibrate lowers cholesterol ka 25%, triglycerides ka 40-50%, mme e boetse e eketsa boemo ba seo ho thoeng ke cholesterol e "ntle" ka 10-30%.

Litaelo tsa tšebeliso ea fenofibrate, ciprofibrate li bonts'a hore ka cholesterol e phahameng, meriana ena e fokotsa bongata ba li-deposits tse eketsehileng, hammoho le cholesterol e tlase le triglycerides ho bakuli ba nang le hypercholesterolemia.

Lenane la fenofibrate:

• Taykolor,
• Lipantil
• Hlahisa 200,
• KoprofibrateLipanor
• Gemfibrozil.

Empa, pele o reka le ho sebelisa meriana e joalo, ho lokela ho hopoloa hore tšebeliso ea bona e lebisa pontsong ea litla-morao tse itseng. Ha e le molao, mathata a mangata a amanang le tšilo a lijo a bonahala hangata: botlaela, dyspepsia, lets'ollo, ho hlatsa.

Litlamorao tse latelang li bonoa kamora ho nka fenofibrate:

• Sistimi ea lijo: pancreatitis, lefu la hepatitis, ho hlatsa, bohloko ba ka mpeng, ho nyekeloa ke pelo, lets'ollo, ho hlahella, ponahalo ea mabala.
• Sistimi ea musculoskeletal: bofokoli ba mesifa, rhabdomyolysis, hleka myalgia, myositis, cramping.
• Tsamaiso ea methapo: hlooho e opang, khatello ea kelello.
• Pelo le methapo ea mali: pulmonary embolism, venous thromboembolism.
• Liponahatso tsa lintho tse bohloko: ho hlohlona ha letlalo le lekhopho, ho hloloa hoa mahlo, urticaria.

Ho kopantsoe ha li-statins tse nang le li-fibrate ho etsoa ho fokotsa tekanyo, ka hona, lipontšo tse mpe tsa li-statins.

Motsoako o nyenyefatsang cholesterol ea mala

Bongaka Ezetimibe(Ezetrol) Na ke setlhare se secha se fokotsang lipid se fokotsa ho kenngoa ha k'holeseterole ka mpeng. Ntle le moo, Ezetimibe (Ezetrol) ha e qholotsa nts'etsopele ea letšollo. U hloka ho nka 10 mg ea meriana ka letsatsi. Empa ho bohlokoa ho ela hloko hore 'mele o hlahisa 80% ea cholesterol,' me ke karolo ea 20% feela e kenang le lijo.

Meriana eohle e meng

Ngaka ea hau e ka khothaletsa ho nka li-supplement tsa lijo (BAA).

Leha ho le joalo, litlhare tsa tlhaho tse kang Omega 3, Tykveol, oli e tlotsitsoeng, lipoic acid fokotsa cholesterol hanyane.

Re lokela ho hopola hore litlatsetso tsa phepo ha se lithethefatsi, ka hona, lithethefatsi tse joalo li fokola ho lithethefatsi tsa "statin" mabapi le thibelo ea mafu a pelo.

Lethathamo la li-supplements tsa lijo tse sebelisetsoang morero ona mme li na le likarolo tsa tlhaho:

Matlapa a nang le oli ea tlhapi (Omega 3, Leoatle, Omacor) e khothalletsoa hore e sebelisoe ke batho ba batlang ho theola cholesterol. Oli ea tlhapi e sireletsa 'mele ho hola mafu a methapo ea mali le pelo, hammoho le khatello ea maikutlo le ramatiki. Empa ho hlokahala hore u noe oli ea litlhapi ka hloko haholo, kaha ho e nka ho eketsa kotsi pancreatitis e sa foleng.

Ho sebelisoa oli ea peo ea mokopu bakeng sa ba mahlomoleng cholecystitis, atherosulinosis methapo ea kelello hepatitis. Sesebelisoa se fana ka phello ea choleretic, anti-inflammatory, antioxidant, hepatoprotective.

Lipoic acid

Sesebelisoa sena ke sa khale antioxidantE sebelisoa bakeng sa thibelo le kalafo ea coronary atherosulinosis. Kameho e ntle ea lithethefatsi ho metabolism ea carbohydrate e bonoa. Ha e nkoa, trophism ea li-neuron ea ntlafala, 'me maemo a glycogen ho eketseha ha sebete.

Li-vithamine kenya letsoho ho tsebisoang cholesterol, kholo hemoglobin etc. mmele o hloka vithamine b12 le B6, folic acid, Nicotinic acid. Ho bohlokoa haholo hore ana ke livithamini tsa tlhaho, ke hore, ho bohlokoa ho ja lijo tse nang le livithamini tsena.

BAA ke sehokelo sa leoto la fir, se na le beta-sitosterol, polyprenols. E lokela ho nkoa ha khatello ea mali, atherosulinosis, li-triglycerides tse phahameng le cholesterol.

Mekhoa e meng

Li -ququitors tsa bile acid(Baetsi ba mabilijj.) ke meriana e sebelisoang kalafo e rarahaneng e le karolo e thusang ho theola cholesterol. Ba thibela tlhaho ea eona ho plasma.

Koprofibrate Lipanor - e thibela motsoako oa k'holeseterole ka har'a sebete, e theola boemo ba eona maling, e fokotsa boemo ba lipoprotein tsa atherogenic.

Kahoo, lenane la meriana ea cholesterol hajoale le pharalletse haholo. Empa haeba mokuli a tloaetse ho theola cholesterol ea mali ka lithethefatsi, o lokela ho hopola hore lithethefatsi tse tsoang k'holeseterole e tlase li baka litlamorao tse ngata. Ehlile, ha a fana ka litlhare bakeng sa k'holeseterole e phahameng, ngaka e nahana ka sena, hape e tsebisa mokuli ka li-contraindication tsa ho theola k'holeseterole.

Empa leha ho le joalo, meriana ea ho theola cholesterol ea mali e lokela ho nkuoa, e kopanya kalafo e joalo le jahammoho bophelo bo mafolofolo. Ho khothalletsoa ho sebelisa lithethefatsi tse theolelang k'holeseterole ea mali, moloko oa morao-rao, kaha moetsi oa bona o ntlafatsa lithethefatsi.

O ka fokotsa cholesterol ea mali ka lipilisi maemong a itseng. Empa matlapa a theolang cholesterol a lokela ho sebelisoa feela maemong ao ho nang le kotsi e kholo ea ponahatso ea lefu la pelo. Ho na le lihlopha tsa bakuli ba hlokang ho nka lipilisi tsa cholesterol maling. Maemong a mang, pele u qala ho sebelisa lipilisi ho theola cholesterol e tlase, o lokela ho bona ngaka e lekang melemo le likotsi tsa kalafo e joalo.

Bakeng sa ho phela bophelo bo felletseng, ntle le ho nka lipilisi, o hloka ho ja ka nepo, ho bapala lipapali. Haeba cholesterol e phahame haholo, ho molemo hore o fetole mokhoa oa bophelo hanghang, o tla kenya letsoho ho tloaelehileng le ntle le kalafo e eketsehileng. U ka ithuta ho sebelisa litlhare tsa setso, tse kenyelletsang mahe a linotsi le likarolo tse ling tse phetseng hantle tse u lumellang ho "hloekisa" mmele. Setsebi se tla bolela hore na ka makhetlo a makae ka letsatsi ho sebelisa chelete e joalo.

Boemo: ke eng mme ke hobaneng e amoheloa?

Maemo - Ena ke sehlopha sa lithethefatsi tse fokotsang lipid tse sebelisoang ho phekola hypercholesterolemia, i.e., maemo a phahameng a cholesterol (XC, Chol) ka mokhoa o tsitsitseng maling, a ke keng a utloahala bakeng sa khalemelo e seng ea lithethefatsi.

Ketso ea li-statins e thehiloe ho thibelo ea enzyme, e ikarabellang bakeng sa tlhahiso ea k'holeseterole ke sebete (mohloli oa hoo e ka bang 80% ea ntho).

Mokhoa oa ketso Li-statins li na le tšebelisano ea tsona e sa tobang le sebete: li thibela secretion ea enzyme HMG-KoA reductase, e ts'oarang karabelo ea ba pelehi ba khemikhale ea ka hare ea k'holeseterole.

Sena se thusa ho fokotsa palo ea li-lipoproteins tse tlase (LDL, LDL) - "car" e mpe "ho li-tiske, mme, ka lehlakoreng le leng, - e eketsa khatello ea methapo e kholo ea lipoproteins (HDL), bajari ba" XC "e ntle ho khutlela ho sebete, bakeng sa ts'ebetso le ho lahla ka morao ho moo .

Ka mantsoe a mang, ho tsamaisoa ha cholesterol e tobileng le e khutlisetsang morao, ha boemo ba kakaretso bo fokotseha.

Ntle le ketso e ka sehloohong, li-statins li na le litlamorao tse ling tse ntle: li fokotsa ho ruruha ha endothelial, li boloka botsitso ba li-plaque tsa atherosselotic, hape li tsosa motsoako oa nitric oxide, e hlokahalang bakeng sa likepe tse phomotsang.

Ba behiloe maemong afe a k'holeseterole?

Statin e nkuoa ka cholesterol e phahameng - ho tloha ho 6,5 mmol / litha. Empa leha ho na le lipontšo tse joalo, nakong ea likhoeli tse 3-6 ho loketse ho leka ho li fokotsa ka ho lahla litheko, lijo tse matla tsa hypocholesterol le lipapali. Ke feela kamora mehato ena moo potso ea ho khethoa ha li-statins ho nahanoang.

Sebopeho sa li-amana maboteng a methapo ea mali ka lebaka la cholesterol e phahameng maling.

Maemong a mang, lingaka li beha li-statin e le karolo ea kalafo e felletseng esita le ka litheko tse tlase - ho tloha ho 5.8 mmol / litha, haeba bakuli ba na le nalane ea maemo a mpefatsang:

Ho nka esita le "ho nka lintho ka bonolo" ho ka ba le litlamorao tse mpe, ka hona, ho thibetsoe ka thata ho fana ka taelo ea hau. Ka hona, ke ngaka feela e etsang qeto ea hore na ke nako ea k'holeseterole e kae ea ho qala ho noa.

Kotsi e ka bang teng le litlamorao

Ka taelo e nepahetseng, litlamorao tsa li-statins ha li fumanehe hangata (ho fihla ho 3% ea linyeoe) mme haholo ho bakuli ba sebelisang lithethefatsi bakeng sa lilemo tse fetang 3-5, kapa ho ba fetang tekanyetso e khothalletsoang. Ka boits'ebetso, ho na le monyetla o moholo oa ho etsa phoso eseng feela ka litekanyetso, empa le ka khetho ea moriana, o eketsang monyetla oa litlamorao ho 10-14%.

Litlamorao tse mpe tsa ho sebelisa lithethefatsi tse ngata tse feteletseng li na le matšoao a botahoa:

• tlolo ea setuloana sa (sokollo, lets'ollo), ho thunya, ho nyekeloa, ho hlatsa, takatso e fokolang ea lijo,
• jaundice, pancreatitis e hlobaetsang le bohloko ba mpa ba mpa bo sa fumaneheng.
• Mofufutso o eketsehileng le ho ruruha, ho senyeha ha tšebetso ea renal,
• bokhubelu, ho ruruha le ho hlohlona ha 'mele, lekhopho la letlalo ka mokhoa oa urticaria,
• ho tsekela, ho tšoaroa ke hlooho, bofokoli, ho tepella, pono e lerootho.

Tumellanong le ho fokotseha ha lipoprotein, li-statins li fokotsa tlhahiso ea li-coenzymes tsa Q10, tse fanang ka matla hoo e batlang e le lisele tsohle tsa 'mele. Ka hona, ka lebaka la khaello ea eona, mathata a tebileng a ka hlaha hape:

ho eketseha ha sekhahla sa pelo le ho se sebetse hantle, ho tlola ka sekhahla khatello ea mali,

Ho ithuta ka likotsi tsa litlamorao ho nka lipalo tsa meloko ea morao tjena.

Litla-morao tse tlase (ho fihla ho 1% ea linyeoe) litla-morao li senyeha ho utloeng le ho teba ha maikutlo a ho latsoa, ​​keketseho ea kutloisiso ea letlalo ho chatsi, khatello ea maikutlo, ts'ebetso ea ts'ebetso ea boko le ts'abo ea lithapo tsa methapo ea tlhaho e sa foleng.

Ho diabetics, ho nka li-"statin" ho ka baka tsoekere ea mali - ho fihlela ho 2.0 mmol / litha, tse kopanyeletsang taolo ea metabolism ea carbohydrate.

Contraindication

Leha taba ea hore li-statin (haholo-holo moloko o mocha) li na le litla-morao tse fokolang, li ntse li na le li-contraindra:

• mafu a matla a liphio, sebete le tšoelesa ea qoqotho.
• hypersensitivity (allergy) ho likarolo tsa sebopeho,
• lefu la semmuso
• nako ea bokhachane le pelehi, lilemo tsa bana ho fihlela lilemo tse 18.

Ntle le moo, ka lebaka la kotsi e kholo ea bophelo bo botle, ho nka li-statin ha ho kgothaletsoe maemong a latelang:

• ho etsa thobalano ntle le ts'ebeliso ea lithibela-pelehi tse tšepahalang (haholo basali ba banyane lilemong tsa ho ba le bana),
• ho ba teng ha tlhekefetso e kholo tsamaisong ea endocrine, ho senyeha ha li-hormone le tšebeliso ea lithethefatsi tsa lihormone,
• phekolo e kopaneng le li-fibrate, niacin, lithibela-mafu tsa macrolide, cytostatics le li-anttifungal agents.

Tsena tse khahlanong le litlolo ha li felle, leha ho le joalo, maemong a joalo, lingaka li beha li-statins maemong a tšohanyetso feela le ho shebella li amohela ka tlhokomelo e khethehileng.

Tekanyo ea joala

Ts'ebeliso e tšoanang ea li-statin tse nang le joala (ho kenyeletsa le joala bo fokolang) e thibetsoe ka mokhoa o thata: motsoako o joalo o na le phello e mpe liseleng tsa sebete, o baka ts'abo e chefo.

Sebakeng se setle ka ho fetisisa, tšebeliso ea ethanol e tla lebisa ho ho eketseha ho matla ha 'mele, mme maemong a mabe ka ho fetisisa, ka lebaka la ts'enyo e kholo ea hepatocytes, lithane tsa tsona tse amehang li tla nkeloa sebaka, necrosis kapa cirrhosis ea sebete e tla qala ho hola.

Moloko oa pele

Boemo ba moloko oa 1 (1) ke li-lipid tse theolang lipalo tse thehiloeng ho lintho tsa tlhaho kapa tse hahiloeng ka maiketsetso - lovastatin (lovastatin), pravastatin (pravastatin) le simvastatin (simvastatin).

Katleho ea ketso ea li-statins tsa pele ho profil ea lipid e totobetse: li fana ka phokotseho ea "cholesterol" e mpe "ka 27-27%) mme e thibela tlhahiso ea tlhaho e tsoetseng pele. Ho feta moo, ba na le bioavailability e tlase, ka mantsoe a mang, ba kenella ka mokhoa o tsitsitseng mme ha ba na phello e ngata ho kenngoeng ha k'holeseterole e "ntle".

Monyetla o ka sehloohong oa lithethefatsi ke theko ea tsona, hammoho le motheo oa bopaki ba nako e telele: haholo-holo, ho latela HPS, tlhahlobo ea simvastatin bakeng sa bakuli ba likete tse 20,5 e bontšitse hore tšebeliso ea eona ea nako e telele e ntlafatsa boemo ba vascular le ho thibela atherossteosis.

Litsietsi tse mpe le likotsi tse ka bang teng tsa li-statins tsa pele li bakoa ke kotsi e kholo ea rhabdomyolysis. Ka lebaka la sena, litekanyetso tse kholo (tse fetang 40 mg) tsa lithethefatsi li fuoe hangata haholo, haeba mekhoa e meng ea kalafo e sa khonehe.

Taeo ea ts'ebeliso e kenyelletsa ho nka matlapa a 1 ka letsatsi, ho qala ka 10-20 mg, nakong ea lijo tsa mantsiboea kapa bosiu.

Litokisetso tsa sehlopha sa "statin" sa moloko oa 1 se thehiloeng ho lovastatin:

Litokisetso tsa sehlopha sa "statin" sa moloko oa 1 se thehiloeng ho pravastatin:

Litokisetso tsa sehlopha sa li-statins tsa moloko oa 1 se thehiloeng ho simvastatin:

Moloko oa bobeli

Lipalo tsa moloko oa II (2) ke lithethefatsi tse entsoeng ka botlalo (joalo ka meloko eohle e tlang) e nang le fluvastatin (fluvastatin) ka mokhoa oa letsoai la sodium.

Ts'ebetso ea fluvastatin khahlano le cholesterol e maemong a eona a tsosang molemong oa tlhahiso ea lipoprotein tse phahameng haholo, ka lebaka leo litaba tsa lipoprotein tse tlase (24-31%) le li-triglycerides li buselitsoeng, hammoho le boemo bo tloaelehileng ba k'holeseterole ea mali e thathamisitsoe.

Monyetla o ka sehloohong oa lithethefatsi ke hore li na le bioavailability e ngata, e fokotsang monyetla oa litlamorao. Ka hona, li ka fuoa esita le ho batho kamora ho fetisoa ha litho, kalafo ka cytostatics le bana ba lilemo tse 10 ka lefu la hypocholesterolemia.

Likotsi le likotsi tse ka bang teng tsa litlhare tse thethefatsang lipid ke phofo ea tsona e fokolang, hobane ka hona, ho fumana sephetho se hlahisitsoeng, motho o lokela ho nka tekanyetso e eketsehileng ea ntho e sebetsang, e eketsang mojaro oa lithethefatsi 'meleng.

Taeo ea ts'ebeliso e boetse e tiisa tlhokeho ea ho sebelisa litekanyetso tse phahameng - u se u ntse u hloka ho nooa matlapa a 40-80 mg hang ka letsatsi, haholo-holo mantsiboea.

Litokisetso tsa sehlopha sa li-statins tsa moloko oa II se thehiloeng ho fluvastatin:

Moloko oa boraro

Li-statins tsa Atorvastatin III (3) tsa lingaka ke lithethefatsi tsa pele tse theolelang lipid - li leka-lekana ho latela tekanyo ea theko / boleng le bokahohleng, ke ho bontša sephetho se tsitsitseng sa kalafo ho bakuli ba lihlopha tse fapaneng tsa lilemo batho ba baholo.

Ts'ebetso e sebetsang Ntho ena bakeng sa maemo a cholesterol e netefalitsoe ke liteko tse ngata tsa kliniki, ho kenyelletsa CURVES, GRACE le TNT, tse bonts'itseng phokotseho e phahameng ea boemo ba lipoprotein tse otlolohileng (ka 39–47%). Ntle le moo, atorvastatin e sebetsana le ho thehoa ha cholesterol ho tsoa li-depositi tsa mafura tse teng.

Monyetla o ka sehloohong oa lithethefatsiNtle le ts'ebetso ea bona e hlakileng, ke hore ka litekanyetso tse tlase (10 mg), atorvastatin ha e sebelisane le lithethefatsi tse ling tse nkiloeng ke bakuli ba nang le mofuta oa bobeli oa hypercholesterolemia.

Lits'ebetso le likotsi tse ka bang teng ho tsoa Atorvastatin ka mokhoa o tsitsitseng li itšetlehile ka tekanyo ea tsona le hore na ke nako e telele hakae. Ka kalafo e matla ea nako e telele, litla-morao tsa mosebetsi oa sebete li atisa ho hlokomeloa, leha ho le joalo, li tšoana le lipalo tse ling tsa lipophilic (I, II le III).

Litaelo tsa tšebeliso li bonts'a phapang e fapaneng ea tekanyetso ea pele ea moriana - ho tloha ho 10 ho isa ho 80 mg 1 ka letsatsi, e nkuoa ho sa tsotelehe lijo ka nako efe kapa efe ea letsatsi.

Lithethefatsi tse ntle ka ho fetisisa tsa sehlopha sa III sa statin se thehiloeng ho atorvastatin:

Moloko oa bone (o mocha)

Moloko oa Statins IV (4), i.e. rosuvastatin (rosuvastatin) le pitavastatin (pitavastatin) ke lithethefatsi tsa morao-rao tse fokotsang lipid, li nkuoa e le lipalo tse sebetsang hantle le tse sireletsehileng bakeng sa cholesterol.

Ts'ebetso e sebetsang li-statin tsa mehleng ena li feta meloko eohle e fetileng ea lithethefatsi sehlopheng sena. Teko e bapisoang ea Rosuvastatin LUNAR e bontšitse ho fokotseha ho matla hoa matšoao a "cholesterol" e mpe "(ka 47-51%) le keketseho ea likaroloana tsa eona tsa antiatherosranceotic. Ntle le moo, e hloka litekanyetso tse tlase haholo ho feta, mohlala, Atorvastatin.

Monyetla o ka sehloohong oa lithethefatsi - palo e nyane haholo ea li-contraindication, hammoho le kotsi e tlase ea litlamorao. Ho fapana le li-statins tse ling, ha li ame metabolism ea carbohydrate, ka hona li lumelloa ho nkoa esita le ho tsamaellana le kalafo e akaretsang ea lefu la tsoekere.

Litsietsi le likotsi tse ka hlahang ho li-statins tsa ho qetela ke ketsahalo e sa atiseng ho etsahala, empa ka linako tse ling ts'ebeliso ea bona ea nako e telele e sitisa boemo ba liphio ho bakuli bao moroto oa bona o nang le protheine kapa methapo ea mali. Ntlheng ena, li ka ba tsa lefeela kapa tsa ba kotsi ho bakuli ba nang le lefu la tsoekere.

Litaelo tsa tšebeliso li na le tlhaiso-leseling mabapi le tlhoko ea litekanyetso tsa mmele butle-butle ho ea lithethefatsi, ka hona ho khothalletsoa ho qala ho e nka le litekanyetso tse fokolang - rosuvastatin 5-10 mg kapa pitavastatin 1 mg 1 nako hoseng kapa ka shoalane.

Lithethefatsi tse ntle ka ho fetisisa tsa sehlopha sa IV sa li-statins tse thehiloeng ho rosuvastatin:

Lithethefatsi tse ntle ka ho fetisisa tsa sehlopha sa IV sa statin se thehiloeng ho pitavastatin:

Mabitso a teng a lithethefatsi: lenane le felletseng

'Marakeng oa merianali-generics (li-analogues) tse entsoeng ka ntho e le 'ngoe e sebetsang tlasa lebitso le fapaneng (INN).

Lethathamo la li-Statins tsohle tse ngolisitsoeng ka molao Russia:

• lovastatin(I) - Cardiostatin, Mevacor, Holetar, Lovastatin, Rovacor, Medostatin, Lovacor, Lovasterol,
• pravastatin (I) - Lipostat, Pravastatin,
• simvastatin (I) - Simvalimite, Zokor, Vabadin, Simvastol, Avestatin, Simgal, Actalipid, Simvastatin-Ferein, Simplakor, Atherostat, Vasilip, Zorstat, Levomir, Ovenkor, Simvageksal, Allesta, Simvakol, Simvastatin, Simvor Zimak, Simvakov, Simvorv , Simvatin,
• fluvastatin (II) - Leskol, Leskol forte,
• atorvastasti (III) - Tulip, Liptonorm, Torvakard, Atoris, Liprimar, Atorvastatin, Atorvastatin Canon, Atomax,
• pitavastatin (IV) - Pitavastatin, Lizao,
• rosuvastatin (IV) - Roxera, Crestor, Po-statin, Mertenil, Rosulip, Lipoprime, Tevastor, Rosuvastatin-C3, Rosistark, Rosart, Suvardio, Rosuvastatin, Akorta, Reddistatin, Rosucard, Cardiolip, Rosuvastatin Canon, Rosuvastuastatin, calcium .

Ntle le lebitso la khoebo, lihlahisoa tsa jenereithara li fapana ho tloha ho patent ea pele ho theknoloji ea tlhahiso, theko le sebopeho sa likarolo tse thusang. Ho seng joalo, li tšoana hantle, kahoo motho o na le tokelo ea ho ikhethela hore na analog e molemo ho feta efe ebe e nkela ea pele. Empa ke feela kamora ho buisana le ngaka ea hau.

Li lokela ho nkuoa nako e kae?

Ka mofuta oa kalafo o khethiloeng ka nepo, li-statin tse ngata li fana ka phello ea pele ea lipid ka mor'a libeke tse peli kamora ho qala ha tsona, ntle le ts'ebeliso ke rosuvastatin feela: e na le phello e boletsoeng kamora matsatsi a 7-9 ho tloha qalong ea kalafo. Sephetho se phahameng ka ho fetisisa se hlaha kamora likhoeli tse 1-1.5 tsa ho nka li-statins leha e le life mme li bolokoa nakong eohle ea lithuto.

Hangata, ho tloaeleha ha metabolism ea mafura ke ts'ebetso e telele haholo, ka hona, li-statins li beoa nako ea likhoeli tse 'maloa ho isa lilemo tse' maloa. Ka mofuta oa lefutso la hypercholesterolemia, hammoho le mathata a tebileng a lipid, ho nka litafole hoa hlokahala bakeng sa bophelo.

Lithethefatsi tse fokotsang tlhaho

• sterols tsa semela (phytosterols) - sea-buckthorn le oli ea raese, kokoana ea koro, soneblomo le peo e ntšo ea sesame, peo ea poppy, linaoa le avocado,
• li-polyphenols tsa antioxidants - chokeberry, honeysuckle, rosa e hlaha, kharenate, litholoana tse omisitsoeng, li-Persimmons, li-currants tse ntšo, tamati le eiee e khubelu,

Meroho le litholoana tse tlatsetsang ho thateng ha cholesterol.

Lisebelisoa tse tlatsetsoang linthong tsena tse sebetsang li sebetsa ka potlako - bakeng sa likhoeli tse 2,5 - 3, boemo ba cholesterol bo fokotsehile ka 15-23%. Sephetho sa lihlahisoa ka mofuta o lokela ho lebelloa nako e telele - likhoeli tse ka bang 4-7

Tlhahlobo mabapi le katleho ea lithethefatsi

Bopaki ba bakuli ba nkang "statins" ho theola cholesterol e tlase bo etsa hore ho khonehe ho ngola setšoantšo se felletseng le ho lekanya "melemo" le "tsohle":

Maikutlo a joalo a bontša hore batho ba bangata ba belaela haholo ka li-statin mme ba ela hloko lintlha tse ntle le tse mpe ts'ebelisong ea bona. Ho bohlokoa ho ela hloko mohopolo, o tsejoang ke liteboho tse ngata ho lenaneo la thelevishene "Ntho ea bohlokoa ka ho fetisisa", e ngotsoe ke Dr. Myasnikov, ea bolelang hore li-statins li laetsoe feela bakeng sa ts'okelo e kholo ea bophelo bo botle: atherosclerosis e seng e ntse e tsoetse pele kapa motsoako oa lintlha tse 3 kapa ho feta tsa ts'ebetso (mekhoa e mebe, e eketsehileng boima, jj.).Lithethefatsi sehlopheng sena li na le moroalo o moholo 'meleng ebile ha li laeloe ho kheloha ho tloaelehileng.

Ke hokae ho reka li-statins ho theola cholesterol ea mali?

O ka reka li-statin tsa mantlha le li-generator tsa tsona tse ntle hantle ho tloha lapeng, o reka ho tsoa ho k'hemiste e tšepahalang ea inthanete:

• https://apteka.ru - li-ruble tsa Krestor 10 mg No. 28 - 1255 li-ruble, Simvastatin 20 mg No. 30 - 226 li-ruble, Leskol forte 80 mg No. 28 - 2537 li-ruble, Liprimar 40 mg No. 30 - 1065 ruble,
• https://wer.ru - Krestor 10 mg No. 28 - 1618 li-ruble, Simvastatin 20 mg No. 30 - 221 li-ruble, Leskol forte 80 mg No. 28 - 2714 ruble, Liprimar 40 mg No. 30 - 1115 rubles.

Motse-moholo, lithethefatsi tsena li ka rekoa ka shopong efe kapa efe e haufi:

• Puisano, st. Perovskaya 55/56 ho tloha ka 07:00 ho isa 22:00 tere. +7 (495) 108-17-39,
• Bophelo bo Motle, st. Khetla ea 2-4 / 44, leq. 1. Ho tloha ka 08:00 ho fihlela ka 23:00 tel. +7 (495) 797-63-36.

St. Petersburg

St. Petersburg, e le molao, hape ha ho na mathata ka ho reka li-statins:

• MatšaAve. E khethehileng 25/18 ho tloha ka 07:00 ho isa ho 23:00 tere. +7 (812) 603-00-00,
• Rigla, st. Pea 41a, pom. 9h ho tloha ka 08:00 ho isa 22:00 bosiu. +7 (800) 777-03-03.

Qetellong, ho bohlokoa ho ela hloko hape hore li-statin ha se mokhoa oa thibelo ea mantlha ea atherosclerosis, empa meriana e tebileng e ka tlisang melemo le likotsi ka bobeli. Leha ho le joalo, leha ho na le tšabo ea bakuli, ba nang le methapo e matla ea pelo, morero oa bona o na le mabaka, hobane maemong ana ba hlile ba pholosa bophelo.

Li-statins tsa cholesterol: ha ho laetsoe, litlamorao

HMG-CoA reductase inhibitors, ka mantsoe a mang, li-statins, ke sehlopha se ka sehloohong sa lithethefatsi tse fuoeng k'holeseterole e phahameng, e se nang li-analogues. Haeba palo ea cholesterol e kotsi ea LDL e feta haholo phetoho e tloaelehileng le phepo e sa thusang ho lokisa boemo, mokuli o fuoa kalafo ea "statin" ea nako e telele.

Molao-motheo oa ketso ea bona ke ho hatella ketso ea enzyme e ikarabellang bakeng sa tlhahiso ea k'holeseterole ka har'a sebete, le ho liehisa tsoelo-pele ea atherossteosis. Ho ja lipilisi khafetsa ho thusa ho lelefatsa bophelo ba batho ba nang le lefu la ho ferekana ho sa feleng, mathata a ho potoloha, kapa mafu a amanang le pelo le methapo.

Ke mang le mang ea hlokang ho nka li-statins

Li-statins tsa cholesterol li laeloa batho ba nang le kotsi e kholo ea ho otloa ke pelo le ho otloa, ha cholesterol e phahameng e tsitsitse, ha e theohe, 'me ke 300-330 mg / dl kapa 8-11 mmol / l, hammoho le maemong ao bonyane boemo bo le bong bo phethahalang:

• lefu la pelo, setorouku kapa tlhaselo ea ischemic,
• coronary artery by gassting grafting,
• atherosclerotic lesion of coronary artery
• phahamisa liprotheine tse nang le "c" tse sebetsang hantle le calcium.

Phekolo ka lipilisi tsa cholesterol ha e fuoe batho ba phetseng hantle ka keketseho e nyane ho litekanyetso tsa LDL, hobane phello e mpe 'meleng e tla ba matla ho feta melemo. Ha ho kgothaletswe ho qala kalafo ka li-statins maemong a latelang:

• keketseho e nyane hape e sa tsitsang ea cholesterol,
• ho haella ha atherosulinosis,
• ha ho na lefu la pelo kapa stroke
• ha ho na calcium e hlahisoang ka har'a methapo kapa ha e na letho,
• protheine e sebetsang hantle e ka tlase ho 1 mg / dl.

Re lokela ho hopola hore kalafo e nang le li-statins e ka tsoela pele bophelo bohle. Ha li se li hlakotsoe, boemo ba cholesterol bo tla khutlela maemong a eona a fetileng.

Ts'ebeliso ea li-statins e lokela ho etsoa feela ho khothaletso ea ngaka hobane ho na le li-contraindication le litlamorao tse ngata. Ha u fana ka matlapa a ho beha lintlha, ho nahanoa lintlha tse latelang:

• lilemo le bong ba mokuli
• mafu a fetileng kapa a teng a tsamaiso ea pelo le hematopoietic, ho kenyeletsoa lefu la tsoekere.

Bakuli ba tsofetseng ba lokela ho nka li-statin ka hloko e kholo haeba ba sebelisa meriana e meng e etselitsoeng ho phekola khatello ea mali, lefu la sethoathoa kapa lefu la tsoekere. Bakeng sa sehlopha sena sa bakuli, liteko tsa mali le taolo ea sebete li etsoa makhetlo a 2 khafetsa.

Lefu la tsoekere le lipalo

Statins li na le minus e 'ngoe ea bohlokoa - li eketsa tsoekere ea mali ka 1-2 mmol / L. Sena se eketsa kotsi ea lefu la tsoekere la mofuta oa II ka 10%. Le ho bakuli ba seng ba na le lefu la tsoekere, ho nka li-lawins ho sitisa ho laola le ho eketsa monyetla oa ho tsoela pele ka potlako.

Empa, ho lokela ho utloisisoa hore melemo ea ho nka li-statins e ka ba kholo haholo ho feta litla-morao tse mpe tseo ba nang le tsona 'meleng. Mekhoa ea litlhare e fokotsa kotsi ea ho tšoaroa ke pelo le stroke, e lelefatsa nako ea bophelo, e bohlokoa haholo ho feta keketseho e leka-lekaneng ea tsoekere ea mali.

Ka lefu la tsoekere, ho bohlokoa haholo hore kalafo e felletse. Ho nka litafole ho lokela ho kopantsoe le lijo tse nang le khabone e fokolang, ho eketsa mesebetsi ea 'mele le litekanyetso tsa insulin.

Ts'oaretso ea li-statins

Sehlopha sa li-statins se kenyelletsa palo e kholo ea lithethefatsi. Ka moriana, li arotsoe ho latela likhakanyo tse peli: ka meloko (nako ea ho lokolloa 'marakeng oa litlama) le tšimoloho.

• Moloko oa ka: Simvastatin, Pravastatin, Lovastatin. Boemo ba lipoprotein tse phahameng haholo bo eketseha ka bongata bo fokolang. Tšusumetso e ntle ho boemo ba methapo ea mali, ho ntlafatsa sebopeho sa mali, ho ba le thepa ea antioxidant. Li na le litlamorao tse fokolang tsa lithethefatsi tsohle. Matlapa a ngoletsoe bakuli ba nang le hypercholesterolemia ea mantlha, ba nang le kotsi e kholo ea ho nts'etsapele coronary atherosclerosis.
• Moloko oa II: fluvastatin. Ka katleho e fokotsa tlhahiso ea k'holeseterole liseleng tse amehang ho kenyeng ea eona, e ntlafatsa ho phahamisa le ho ntšoa ha LDL. Ho lithethefatsi tsohle tse fokotsang k'holeseterole, e na le tšusumetso e ngata 'meleng. Abela litlolo tsa metabolism ea lipid ho thibela mathata: coronary atherosclerosis, coronary artery lefu, ho otla ha pelo le stroke ka mor'a ho buuoa.
• Moloko oa III: Atorvastatin. Matlapa a sebetsang a ngoletsoeng bakuli ba nang le mefuta e rarahaneng ea hypercholesterolemia, e nang le lefu le tsoakaneng la lefu lena. E etselitsoe batho ba nang le mafu a pelo, le kotsi e kholo ea ho ba le lefu la methapo ea methapo.
• Moloko oa IV: Rosuvastatin, Pitavastatin. Lithethefatsi tsa sejoale-joale tse sebetsang hantle ka ho fetisisa tse nang le litlamorao tse ngata. Fokotsa LDL 'me u eketse HDL, hloekisa methapo ea mali, u thibele ho itšetleha ka marako a methapo ea cholesterol. E sebelisoa bakeng sa kalafo le thibelo ea atherosulinosis le litlamorao tsa eona. Ho fapana le lithethefatsi tsa meloko e fetileng, Rosuvastatin ha e loane lipoprotein feela tse mpe, empa hape e imolla ho ruruha ha methapo, eo ho ea ka bo-ramahlale, e boetse e le sesosa sa atherosclerosis. Pitavastatin ke sethethefatsi se loketseng bakuli ba nang le lefu la tsoekere. Ena ke tharollo feela sehlopheng sa li-statins tse sa amang metabolism ea glucose, ka hona, ha e eketse boemo ba eona.

Haeba ho na le mafu a sebete a sa foleng, ho kgothaletswa ho sebelisa meriana ea sejoale-joale ka litekanyetso tse tlase haholo. Li-statins tsa morao-rao tse sirelletsang lisele li sireletsa lisele tsa sebete 'me li senya' mele hampe. Empa ba thibetsoe ka thata ho kopanya le joala le mofuta ofe kapa ofe oa lithibela-mafu.

Ka tlhaho, li-statin tsohle li arotsoe ka:

• Tlhaho: Lovastatin. Meriana, motsoako o ka sehloohong oa eona ke moetlo o arohaneng le fungus ea penicillin.
• Semi-synthetic: Simvastatin, Pravastatin. Li hlahisitsoe ka mokhoa o itseng oa mevalonic acid.
• Synthetic: fluvastatin, rosuvastatin, atorvastatin, pitavastatin. Litafole tse fokotsang k'holeseterole e nang le thepa e ncha.

Ha ho na tlhoko ea ho nahana hore lipilisi tsa cholesterol ea tlhaho li sireletsehile ka lebaka la sebopeho sa tsona. Maikutlo ana a fosahetse. Le tsona li na le litla-morao tse ngata, joalo ka bo-mphato ba tsona ba maiketsetso.Ho feta moo, litsebi li re lithethefatsi tse sireletsehileng ka ho phethahetseng tse sa hlahiseng litlamorao tse mpe ha li eo.

Lihlahisoa tsa "li-" "statin" ("statins") "

Ke meriana efe e amanang le statins le hore na e sebetsa hantle hakae bakeng sa ho theola cholesterol e ka fumanoa tafoleng.

Li-Fibrate - Mehloli ea Fibroic Acid

Fibrate ke moriana oa bobeli o sebetsang ho thusa ho sebetsana le k'holeseterole e phahameng. Hangata li sebelisoa hammoho le li-statins. Maemong a mang, li fanoa e le chelete e ikemetseng.

Mokhoa oa ts'ebetso ea litafole ke ho ntlafatsa ts'ebetso ea lipoproteinplase, e arolang likaroloana tsa letsoalo le tlase haholo. Nakong ea kalafo, metabolism ea lipid e potlakisitsoe, boemo ba k'holeseterole e nang le molemo bo eketseha, metabolism ea carbohydrate ka har'a sebete e beha maemong a tloaelehileng, mme kotsi ea ho etsoa ha methapo ea methapo le methapo ea methapo ea methapo e fokotseha.

Figrate cholesterol lithethefatsi li mamelloa hantle ke bakuli. Litla-morao tse mpe li hlaha maemong a sa tloaelehang (hoo e ka bang 7-10%).

Lipheko tse sebetsang hantle ke tsena:

• Clofibrate. E na le ts'ebetso ea hypolipidemic e boletsoeng, e ntlafatsa ts'ebetso ea metabolic ka har'a sebete, e fokotsa pono ea mali le thrombosis. Ha e fuoe thibelo ea lefutso kapa lefu lena le fuoeng hypercholesterolemia.
• Gemfibrozil. Clofibrate e nkiloeng ka chefo e fokolang le litla-morao. E phatlalalitse thepa e fokotsang lipid. E fokotsa LDL, VLDL le triglycerides, e eketsa HDL, e potlakisa ho felisoa ha mafura a mahala ho sebete.
• Bezafibrat. Lowers cholesterol le tsoekere, e fokotsa kotsi ea thrombosis. E phatlalalitse thepa ea antiatherosmithotic.
• Fenofibrate. Motsoako oa sejoale-joale o sebetsang ka ho fetisisa oa cholesterol o tsoang sehlopheng sa li-fibrate. E nkoa e le tharollo ea bokahohleng ntoeng khahlanong le metabolism ea lemid ea methapo le mokokotlo o eketsehileng oa insulin. Ntle le thepa ea ho fokotsa lipid, e na le litlamorao tse khahlanong le ho ruruha, antioxidant le tonic.

Fibrate e thibetsoe ka thata bakeng sa batho ba nang le cholelithiasis, lefu la nyooko, sebete le ho se sebetse ha meno. Ka tlhokomelo e kholo, e fuoa bacha le batho ba baholo.

Li -ququitors tsa bile acid

Sehlopha sa lithethefatsi tse fokotsang lipid tse hatellang tlhahiso ea cholesterol. Li sebelisoa e le litlatsetso tsa kalafo e rarahaneng.

Li-acid tsa bile li thehoa nakong ea phetoho ea metabolic pakeng tsa cholesterol le mafura.Bo-ralichelete ba tlama li-acid tsena ka mpeng e nyane ebe ba li tlosa 'meleng ka tlhaho. Ka lebaka leo, ho ja ha bona ka har'a sebete ho fokotsehile haholo. Setho se qala ho kopanya li- acid tsena, se sebelisa LDL e ngata, e fokotsang bongata ba sona maling.

Li -ququuction tse kopanyang li-acid acid li arotsoe ka lihlopha ka lihlopha tse tharo:

• Colestyramine (cholestyramine). Ha e kena ka mpeng e nyane, e theha mefuta ea li-acid acid e sa ananeleng. E potlakisa bohloeki ba bona mme e fokotsa ho kenngoa ha k'holeseterole ka marako a mala.
• Colestipol. Molek'hule e phahameng ea boima ba limolek'hule. E fokotsa ho monya k'holeseterole e tsoang kantle. Ha e sebetse ho feta colestyramine, ka hona, hangata e laoloa kalafo e rarahaneng bakeng sa bakuli ba nang le hypercholesterolemia ea mantlha.
• Baetsi ba mabili. Matlapa a tsoang molokong o mocha oa k'holeseterole. Li sebetsa hantle ho feta moo, ha li bake maikutlo a mabe. Tsamaea hantle le lithethefatsi tse ling. E ka nooa nakong ea kemaro.

Ntle le ho fokotsa khatello ea cholesterol e kotsi, lithethefatsi li fokotsa kotsi ea ho ba le lefu la pelo, mathata a pelo, ho nyekeloa ke pelo. Ha li kenelle tsamaisong ea kemiso, ka hona, li baka litla-morao tse fokolang. Maemong a mangata, ana ke mathata a ho hlobaela: lefu la ho phatloha, takatso e sa laoleheng, setuloana se khopisang.

Lintho tse tsoang ho Nikotinic acid

Niacin (Niacin, Vitamin PP, B₃) - sethethefatsi se amehang ho metabolism ea lipid, synthetic encyme, liphetoho tsa redox.

Ka k'holeseterole e phahameng, Niacin e laetsoe hammoho le lithethefatsi tse ling ho ntlafatsa thepa ea mali, ho eketsa leseli la methapo le ho tsamaisa potoloho ea mali. Niacin e boetse e thibela ho ruruha, ho hlapolla le ho matlafatsa methapo ea mali, e nang le phello e rarahaneng 'meleng.

Pheko e etsoa tlasa taolo e tiileng ea ngaka. Ho arabela ka tsela e fapaneng ho ka etsahala - allergy, maikutlo a mocheso o feteletseng, ho se sebetse hantle ha lisebelisoa tsa tšilo ea lijo, keketseho ea tsoekere (e kotsi ho bakuli ba nang le lefu la tsoekere).

Li-inhibitors tsa chokosterol

Meriana ea mokhahlelong ona ha e eketse tlhahiso ea li-acid acid mme ha e thibele tlhahiso ea k'holeseterole ke sebete. Ketso ea bona e etselitsoe ho fokotsa phallo ea asiti ho tloha ka mpeng e nyane e kena ka har'a sebete. Ka lebaka la sena, lipolokelo tsa ntho li fokotsehile, 'me ho tsoa ha tsona maling ho ntlafatsoa.

Lithethefatsi tse sebetsang hantle sehlopheng sena:

• Ezetimibe (analogues: Ezetrol, Lipobon). E fana ka sehlopha se secha. Fokotsa ho kenngoa ha cholesterol ka mpeng e nyane. Se ke oa fokotsa kotsi ea ho tšoaroa ke lefu la pelo le ho otloa ke lefu la pelo, le se ke la ama nako eohle ea bophelo ba mokuli. E sebetsa haholo ha e kopantsoe le li-statins. Litlamorao li ka etsahala - allergies, lets'ollo, ho senyeha hoa mali a mali.
• Guarem (guar gum). E na le phello ea hypocholesterolemic le hypoglycemic. E fokotsa ho kenngoa ha cholesterol ka mpeng e nyane, ha e ntse e ntlafatsa lits'ebetso tsa metabolic ka har'a sebete. Ka phekolo e rarahaneng, e fokotsa boemo ba LDL le triglycerides ka 10-15%.

Lithethefatsi tsa ho fokotsa cholesterol ea mali li fuoe mofuta oa mantlha le lefutso la hypercholesterolemia, le nang le lipid metabolism ha ho na le lefu la tsoekere.

Lithethefatsi tse ntlafatsang ho phahama ha lebota la vascular

Li sebelisoa ho ntlafatsa boleng le katleho ea kalafo e ka sehloohong le thibelo ea mathata a atherosulinosis. Phekolo e thusang e kenyelletsa lithethefatsi tse ntlafatsang thepa ea mali, boemo ba marako a methapo ea mali, phepelo ea mali a likhoerekhoere:

• Vinpocetine. E khaola mesifa ea mesifa ea methapo ea mali, e ntlafatsa phallo ea mali a khoheli, e lokisa methapo ea methapo le khatello ea mali. E na le phello e molemo tsamaisong ea methapo e bohareng.
• Dihydroquercytin. Lipilisi tsa ho ntlafatsa ts'ebetso ea pelo le boemo ba methapo. Normalize lipid metabolism, fokotsa tsoekere, fokotsa butle-butle tsoelo-pele ea atherosclerosis.
• Acetylsalicylic acid. Abela ho hlapolla mali le ho fokotsa kotsi ea likhahla tsa mali.
• Tlatsetso ea k'holeseterole. Monyetla oa ho li nka ka keketseho e tsitsitseng ea LDL o na le lipelaelo haholo. Ho fapana le lithethefatsi ho theola cholesterol ea mali, lisebelisoa tsa tlatsetso li hlahlojoa feela bakeng sa polokeho. Hajoale ha ho na bopaki ba matla a bona a ho phekola. Empa li ka sebelisoa ka ho kheloha hanyenyane LDL ho latela tloaelo, hammoho le kalafo ea phepo le phetoho ea bophelo.

Matlapa ohle a lokela ho nkuoa feela joalokaha a laetsoe ke ngaka ea hau. Ntle le ho sebelisa meriana, batho ba nang le cholesterol e ngata ba tlameha ho fetola mokhoa oa bona oa bophelo le lijo. Ke maemong ana feela kalafo e ka bang e sebetsang haholo le e sebetsang.

Lingoliloeng

1. George T. Krucik, MD, MBA. Mekhoa e meng ea Statins bakeng sa ho theola Cholesterol, 2016
2. Susan J. Bliss, RPh, MBA. Lithethefatsi tse fokotsang Cholesterol, 2016
3. Omudhome Ogbru, PharmD. Mekhoa ea Tlokotsi ea Cholesterol, 2017
4. A. A. Smirnov. Tlhahlobo e bapisang bokhoni ba kliniki ba li-statins tsa mehleng ena

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