Dyslipidemia ke eng le ho alafa lefu: lisosa, matšoao le matšoao

Dyslipidemia (DL) ke lefu le amanang le lefu la methapo le amanang le lefu la ho fokola ha lipid le lipoprotein, i.e. phetoho ho karolelano ea khatello ea bona maling. Ke e 'ngoe ea lisosa tse ka sehloohong tsa kotsi ea atherosulinosis ea mafu a itšetlehileng ka ona.

Lipids le lipoprotein ke e 'ngoe ea mehloli ea matla a hlokahalang ke' mele oa motho. Ke likhomphutha tse kang mafura. Lipids ke karolo ea lipoprotein.

Lisosa tsa dyslipidemia li ka aroloa ka ha e fetohe (endo native) le e ka fetoha (kantle).

Lintho tsa pele li kenyelletsa lilemo, bong, semelo sa lihormone le boemo ba lefutso.

Sehlopha sa maemo a kotsi a DL se ngata haholo. Mabaka a ka sehloohong a kenyelletsa:

• khaello ea phepo e nepahetseng (ho ja lik'hilojule tse ngata, mafura a mangata, lik'habohaedreite tse bonolo),
• ho tsuba
• ho nona ho feta (visceral obesity),

• lefu la tsoekere
• tlhekefetso ea joala
• khatello e phahameng ea mali
• khatello ea nako e telele
• bophelo ba ho lula fatše
• khatello ea maikutlo ea 'mele,
• ho ruruha ho sa feleng.

Hape, lisosa tsa DL e ka ba mafu a fapaneng, li-syndromes tsa pathological le ho sebelisa meriana e itseng.

Diteng tsa dintho tse mafura tse kang chylomicrons le triglyceride maling di itshetlehile haholo ka mabaka a kantle. Ho fihla ho 80% ea cholesterol e tlase e nang le methapo ea kutlo e entsoe 'meleng, haholo-holo sebeteng,' me ho latela maemo a fokolang ho latela mabaka a ka ntle. Mefuta ea liphatsa tsa lefutso tsa lelapa e thehiloe ka botlalo holima mabaka a lefutso.

Lisosa tsa lefu lena

Dyslipidemia e ka hlaha tlasa maemo a fapaneng, ho etsa mohlala, ka mathata a tsamaeang le ts'ebetso ea mafura a kopantsoeng, le tšebeliso e ngata ea mafura a tsoang lijong.

Ntle le moo, ho se lekane ka tekanyo ea likaroloana tsa mafura a 'mele ho ka bakoa ke lefu la ho arohana le ho ikarola. Sena se ka etsahala le ka ho ja mafura a mangata mmeleng ka lijo.

Ho latela ts'ebetso ea pathogenetic ea nts'etsopele ea dyslipidemic imbalance, ho na le mefuta e 'maloa ea etiopathogenetic dyslipidemia. Ehlile mefuta eohle ea lefu la dyslipidemia ke ea mefuta ea mantlha mme e arotsoe ka monogenic le polygenic.

1. Mefuta ea Monogenic e tšoauoa ka nts'etsopele ea dyslipidemia ka lebaka la ho amohela gene e nang le phoso ke ngoana ho e mong oa batsoali ba nang le lefu lena, kapa ho tsoa ho bobeli ka nako e le ngoe.
2. Nts'etsopele ea polygenic ea dyslipidemia ha e khethoe feela ke lefa la mofuta o senyehileng, empa hape le tšusumetso e mpe ea tikoloho.

Bohlokoa! Ho thata ka ho fetisisa ho khetholla ke mofuta oa bobeli oa dyslipidemia, kaha ho ba teng hoa lefu lena ho hlahisoa ke bokuli bofe kapa bofe bo sa foleng boo mokuli a nang le bona.

Mafu a mantlha a ka bakang sena kapa mofuta oa dyslipidemia ea pathogenetic ke:

• lefu la tsoekere
• hypothyroidism
• mefuta eohle ea ferekanya mafu a sebete.

Tlhahlobo ea dyslipidemia ea tsebetso e thehiloe 'neteng e netefalitsoeng ea tšebeliso ea k'holeseterole e ngata hammoho le lijo. Phapang e tšoanang ea dyslipidemia e ka ba ea nakoana, moo cholesterol e nyolohang ka nako e khuts'oane feela, mme sena se bakoa ke ts'ebeliso e le 'ngoe ea lijo tse mafura tse ngata.

Maemong a mangata, dyslipidemia e fumanoa feela ka keketseho e telele ea likaroloana tsa cholesterol maling. 'Me sena le ha ho na le' nete ea hore karolo e kholo ea batho lefats'eng lohle e na le lefu la kelello.

Matšoao a matšoao

Dyslipidemia e fumaneha feela ka laboratoring. Ka lebaka lena, lefu le ka tšoaetsoa feela ho latela bopaki ba laboratori. Ka lebaka lena, matšoao a kliniki ha a lule sebakeng se etellang pele.

Litsebi tse nang le boiphihlelo, leha ho le joalo, esita le ka tlhahlobo ea pono ea mokuli ea nang le bothata ba dyslipidemia ka nako e telele, a ka belaella lefu lena. Matšoao a joalo a kliniki a kenyelletsa xanthomas - litiiso tse nyane letlalong. Libaka tse ratehang tsa ho ithuisa xanthomas ke,

1. Maoto a maoto,
2. manonyeletso a mangole le matsoho
3. lits'oants'o tsa mokokotlo.

Ho bokella ka bongata k'holeseterole, e hlahisoang ka mokhoa oa likaroloana tse fapaneng, e tsamaisana le ponahalo ea xanthelasm. Tsena ke li-neoplasms tse mosehla tsa boholo bo fapaneng, tse fumanehang lintšing. Li-Xanthelasms li na le sebopeho se teteaneng, 'me se kahare ho sona ke cholesterol.

Ka tlhaho ea lefu la dyslipidemia, lesapo la lipoid le bakoang ke cornea le hlaha. Ona ke mohala o mosoeu o haufi le khubung ea khoele.

Leha ho na le bofutsana ba lipontšo tsa kliniki, ho ka etsahala hore motho a tsebe ho bala lefu la dyslipidemia leha a le ka ntle. Mochine ona o kenyelletsa lipatlisiso libakeng tse fapaneng.

Tlhahlobo e tsebahalang ka ho fetisisa ea laboratori kajeno, ho data eo ngaka e e lebelletseng ha e etsa tlhahlobo ea dyslipidemia, ke boemo ba molomo ba mokuli. Ka polelo ena ho boleloa:

• qeto ea mahloriso a likarolo tse fapaneng tsa cholesterol,
• qeto ea boleng ba atherogenicity.

Ka bobeli ba matšoao ana a bontša kotsi e kholo ea lefu la atherosulinotic ho mokuli. Ka lebaka la hore palo e kholo ea mefuta ea kliniki ea dyslipidemia ke lefutso la lefutso, kajeno tlhahlobo ea liphatsa tsa lefutso ea bakuli ka tlhaloso ea sete ea mefuta e nang le phoso ke tlhahlobo e tloaelehileng. Ntle le moo, o ka sebelisa sesebelisoa sa ho lekanya k'holeseterole le ho nka litekanyo lapeng.

Mefuta ea maloetse

Khethollo ea machaba ea mefuta ea lefu lena e ntlafatsoa motheong oa tlhahisoleseling mabapi le hore na karolo efe ea mafura e eketsoa maling a mokuli. Li-dyslipidemia tsohle li arotsoe ka thoko 'me li kopane.

1. Isolated ke tsona moo matšoao a lipoprotein, e leng likaroloana tsa cholesterol, a eketsoang.
2. Ho kopantsoe - le dyslipidemia ena, ntle le cholesterol, keketseho ea triglycerides e boetse e hlokomeleha.

Khetho e pharaletseng ea phapang ea dyslipidemia ke ho khetholloloa ha Fredrickson, ho latela hore na psychology ena e arotsoe ka mefuta e mehlano:

• Hereditary primary hyperchilomicronemia, mofuta o fapaneng 1 dyslipidemia. Boloetse bona bo tsamaisana le keketseho ea tekanyo ea chylomicrons feela, e nang le 90% ea triglycerides le 10% ea cholesterol. Taba ea hore phapang ena ea dyslipidemia le ka mohla e ke ke ea fetoha eona ntho e ka sehloohong bakeng sa nts'etsopele ea methapo ea pelo le methapo ea mali e ea khothatsa.
• Mofuta oa bobeli oa dyslipidemia o tšoauoa feela ka keketseho ea matšoao a lipoprotein tse tlase tse amanang le likaroloana tsa cholesterol e nang le boemo bo phahameng ba atherogenicity. Mofuta ona oa lefu ke polygenic, hobane ho ba teng ha lefu la dyslipidemic ho hloka motsoako oa lefutso le nang le tšoaetso le lefutso le maemo a mabe a tikoloho. Tšobotsi e ikhethileng ea mofuta oa dyslipidemia ke 'nete ea hore mokuli ha a phahame feela ka tekanyo ea lipoprotein tse tlase, empa le boemo ba triglycerides.
• Mofuta oa boraro oa dyslipidemia o tšoauoa ka ponahalo ho mokuli oa letšoao le phahameng la lipoprotein tse fokolang haholo, sena se tsamaisana le monyetla o phahameng oa makhopho a arteriosranceotic vascular.
• Ka mofuta oa bone, ho na le keketseho ea boemo ba lipoprotein tse tlase haholo. Empa ntlheng ena, maemo ha a tsoe ka lebaka la lefutso, empa e le a mabaka a tlhaho.
• Mofuta oa bohlano oa dyslipidemia ke keketseho ea palo ea li-chylomicron maling, e kopantsoeng le keketseho ea palo ea lipoprotein tse tlaase haholo.

Ka lebaka la mefuta e fapaneng ea laboratori ea mathata a dyslipidemic mokhatlong oa machaba, ho na le mefuta e 'maloa ea pathology ena. Leha ho le joalo, bakeng sa 10 mcb dyslipidemia e na le khoutu e le 'ngoe E78.

Mehato ea kalafo le ea thibelo e reretsoeng ho felisa matšoao a lefu lena e fapane haholo. Ha li amane feela le khalemelo ea lithethefatsi, empa hape li tsamaisana le litaelo tsa setsebi sa phepo, phetohong ea mokhoa oa bophelo.

Ela hloko! Litlhahiso mabapi le ts'ekamelo ea lefu leo ​​e seng lithethefatsi li lokela ho nkuoa ka bobeli ka mefuta ea lefutso (ho thibela tsoelo-pele) le mefuta ea bobeli. Bakeng sa kalafo ea dyslipidemia ea bobeli, ho hlokahala hore o felise sesosa sa pele sa ho hlaha, ke hore, psychology e sa foleng.

Lethathamo le ka sehloohong la meriana e reretsoeng ho theola cholesterol le mefuta eohle ea likaroloana tsa eona ke balateli ba li-acid acid le li-statins, matlapa a cholesterol. Ho lokisa litekanyetso tse phahameng haholo tsa lipoprotein tse fokolang haholo le triglycerides, fibrate le nicotinic acid li sebelisoa.

Lithethefatsi tseo e leng karolo ea sehlopha sa statin ke lithibela-mafu tsa monocaline, tseo litlamorao tsa tsona li feteletsang ho thibelo e itseng ea ts'ebetso ea enzyme, e eketsang tlhahiso ea likaroloana tsa cholesterol ke sebete.

Lithethefatsi Atorvastatin, Lovastatin, Pravastatin, tseo e leng karolo ea sehlopha sa statin, li ntlafalitsoe kajeno ka mekhoa ea maiketsetso le ea maiketsetso. Phekolo ea dyslipidemia e nang le statins e tsamaisana le ho fokotseha ha nako e telele hoa cholesterol eseng feela ka kakaretso empa hape le cholesterol e tlase haholo. Sena se bapala karolo e kholo ho thibelo ea arterosmithosis.

Monyetla ts'ebelisong ea li-statins e boetse e bakoa ke taba ea hore kalafo e joalo ha e na phello e fokotsang lipid feela, empa e boetse e na le litlamorao tsa mofuta oa ntlafatso ea ts'ebetso ea ho hatella lits'ebetso tsa ho ruruha likepeng.

Haeba monotherapy e nang le li-statins ha e hlahise litholoana tse ntle, kalafo e rarahaneng e laetsoe ho sebelisoa li-acids tsa bile, ka mohlala, Colestipol kapa Cholestyramine ka litekanyetso tsa 4 g. ka letsatsi ka molomo.

Sehlopha sena sa lithethefatsi se na le phello e tobileng ho motsoako oa cholesterol. Sena se etsahala ka ho eketseha ha li-acid acid tse tsoang 'meleng le sebopeho sa tsona ho tsoa likaroloana tsa cholesterol.

Hypertriglyceridemia ea bohlokoa le colitis e sa foleng ke li-contraindication tse felletseng bakeng sa ts'ebeliso ea li-sequestrants tsa bile. Ho hypertriglyceridemia e arotsoeng, ho sebelisoa li-fibrate, ka mohlala, ciprofibrate - 100 mg / ka letsatsi.

Ka lebaka la hore sehlopha sena sa lithethefatsi se ka baka majoe a cholesterol ka hara gallbladder cavity, bakuli bohle ba neng ba ntse ba nka li-fibrate ka nako e telele ba lokela ho feta ka har'a ultrasound khafetsa.

Ntle le moo, haeba mofuta oa 5 dyslipidemia o tsamaisana le pancreatitis, ho bohlokoa ho sebelisa nicotinic acid - 2 g / letsatsi.

Empa ntho ena e na le litlamorao tse sa lumelleng tšebeliso e atileng ea nicotinic acid ntoeng khahlanong le dyslipidemia. Boitšoaro bo bontšoa joalo ka bofubelu ba letlalo 'meleng le hloohong tse holimo.

Litlhahiso mabapi le lijo

Ho kenyelletsa liphetoho tsa phepo ea mokuli ea nang le mofuta oa dyslipidemia e reretsoe ho:

• Ho felisoa ha kotsi ea ho ba teng le tsoelo-pele ea methapo ea pelo le pelo,
• normalization ea boemo ba tsoekere ea mali,
• ntlafatso ea lipid,
• thrombophlebitis prophylaxis.

Sehlopha se ka sehloohong sa kotsi bakeng sa dyslipidemia se kenyelletsa batho ba nang le phepo e matlafatsang, ka hona, kalafo ea mantlha ea pele ke boemo bo tloaelehileng ba ho ja ha mokuli. Litataiso tsa phepo ea lijo li bolela hore mokhoa oa ho ja oa letsatsi le letsatsi oa mokuli ea nang le dyslipidemia o lokela ho fokotsa ho ja mafura a liphoofolo.

Lihlahisoa tsa nama li lumelloa ho kenyelletsoa lijong hang feela ka beke, 'me molemong oa ho matlafatsa' mele ka protheine, lihlapi tsa metsing li lokela ho jeoa ka bongata bo amohelehang. Lisebelisoa tsa bakuli ba nang le mathata a dyslipidemic li lokela ho ba lijana tsa litholoana le meroho tse nang le limatlafatsi tse ngata le fiber.

Tlhahisoleseling ka kakaretso mabapi le lefu lena

Haeba boemo ba lipid bo phahame haholo, joale pathology e bitsoa hyperlipidemia. Nts'etsopele ea lefu lena e angoa ke mokhoa oa bophelo, lijo, ho sebelisa lithethefatsi tse ling, ho hloka mesebetsi le mekhoa e mebe.

Dyslipidemia e bontša tlolo ea tekano ea likarolo tsa mafura. Lithako tsena tse tlase tsa boima ba limolek'hule li entsoe ka har'a sebete 'me li tsamaisoa ka mor'a lipaliso tsa methapo ea methapo le liphatsa tsa litho tsa' mele ka lipoprotein - mechini e rarahaneng ea lipid protein. Mefuta e meraro e ka khetholloa moo ho nang le maemo a tlase haholo, a phahameng kapa a tlase haholo.

LDL le VLDL ke meaho e meholo e nang le bokhoni bo hlalositsoeng ba ho kenya ts'ebetsong ea cholesterol. Li baka mafu a bethe ea pelo le pelo, mme cholesterol ena e "mpe". LDL e qholotsa sebopeho sa li-plaque ho endothelium, e fokotsang lumen ea vascular.

HDL ke molek'hule e qhibilihang metsing mme e thusa ho tlosa cholesterol, e thibela ho hlaha ha eona ka har'a likepe. Sebeteng, li ka fetoloa li-acid acid, tsa siea 'mele ka mpeng.

Boleng ba atherogenic (coeffanele) ke karolelano ea kakaretso ea LDL le VLDL ho likarolo tse phahameng tsa letsoalo. Hypercholesterolemia ke palo e feteletseng ea lintho tse joalo maling a motho.

Khahlano le semelo sa mathata ana, hammoho le dyslipidemia, atherosclerosis e ka hlaha, e bakang tishu hypoxia. Ho tseba boemo bona, ho lekane ho sekaseka sampole ea mali le ho lekola metabolism ea lipid.

Mabapi le ho se leka-lekane ba re ha:

• Cholesterol (kakaretso) e feta 6.3 mmol / L.
• KA e feta 3.
• TG e fetang 2,5 mmol / L.
• LDL e feta 3 mmol / L.
• HDL e ka tlase ho 1 mmol / L ho banna mme e ka tlase ho 1,2 mmol / L bakeng sa basali.

Lintlha tsa Pathology

Lisosa tsa lefu la lefu le ka aroloa ka lihlopha tse 'maloa:

• Boitšisinyo. Dyslipidemia ea mantlha e fetisoa ho tsoa ho batsoali ba nang le ntho e sa tloaelehang ho DNA ea bona e ikarabellang bakeng sa khemik'hale ea cholesterol.
• Lintho tse bakang dyslipidemia ea bobeli li fumanoa:
  1. Ka hypothyroidism, ha ts'ebetso ea tšoelesa ea qoqotho e fokotsehile.
  2. Ho bakuli ba nang le lefu la tsoekere mellitus, ha ts'ebetso ea tsoekere e senyehile.
  3. Haeba ho na le lefu la sebete setulong sa litšitiso, ha ts'ebetso ea bile e ferekanngoa.
  4. Ka tšebeliso ea meriana e itseng.

• Liphoso tsa phepo e nepahetseng. Ho na le mefuta e 'meli e khetholloang nako le nako. Ea pele e tšoauoa ka ponahalo ea hypercholesterolemia hang kapa ka letsatsi kamora ts'ebeliso e kholo ea lijo tse mafura. Psychology e lulang e hlaha e bonoa ho batho ba jang lijo khafetsa ka bongata ba mafura a liphoofolo.

Sehlopha sa likotsi

Re lokela ho hopola hore lintlha tse bakang kholo ea atherosclerosis li ameha ho bopeng dyslipidemia. Li ka aroloa hore e be tse fetoletsoeng le tse ke keng tsa qojoa. Ho na le sehlopha sa batho ba kotsing ea ho tšoaroa ke lefu lena.

• Lijo tse sa sebetseng hantle, tseo ho tsona lijo tse nang le mafura a mangata.
• Mokhoa oa bophelo bo iketlileng.
• Ho ba teng ha khatello ea maikutlo.
• Mekhoa e mebe: joala, ho tsuba.
• Ho Nona Haholo
• Khatello ea mali e phahameng.
• Phello ea lefu la tsoekere.

Lintlha tsena li ka khalemeloa haeba mokuli a lakatsa.

Mabaka a sa boleloang a ke ke a fetoloa. Ke tšobotsi ea banna ba baholo ho feta lilemo tse 45.Batho ba nang le nalane ea lelapa ba bileng le maemo a ho qaleha ha lefu la sethoathoa, dyslipidemia, lefu la pelo, stroke, lefu le tšohanyetso le tsona li hlasetsoe ke mafu.

Matšoao a bokuli

Matšoao a kantle a ka bonahala e le:

• Xanthomas. Tsena ke maqhubu a tiileng ho ama, a nang le likaroloana tsa cholesterol. Li fumaneha ka holim'a li-tendon. Boholo ba tsona li ka fumanoa matsohong, hangata li hlaha liatleng le metsong, morao kapa libakeng tse ling tsa letlalo.
• Xanthelasma Li bonahala ka ho bokellana ha cholesterol tlasa mealo ea eyelone. Ka ponahalo e tšoana le maqhutsu a 'mala o bosehla bo bosehla kapa' mala o tloaelehileng oa letlalo.
• Lipoid arc ea cornea. Ka ponahalo, ke moqomo o behiloeng pheletsong ea cornea ea leihlo. E tšoeu kapa e putsoa. Haeba ho hlaha mathata ho bakuli ba seng ba le lilemo tse 50, joale sena se fana ka maikutlo a hore sesosa sa lefu lena ke lefu le futsitsoeng.

Boloetse bona bo na le pherekano ea hore e se ke ea bonahala nako e telele, ha ts'enyo e kholo e se e entsoe 'meleng. Mothating oa pele oa thuto ea lefu la kelello, bothata bo ka bonoa ha ho fetisoa tlhahlobo ea lipid.

Mathata ao a thehiloe ho metabolic syndrome, ka kakaretso, ke phapang e tebileng lipakeng tsa metabolism ea mafura le normalization ea khatello ea mali. Lipontšo tsa tšobotsi e kanna ea ba phetoho ea palo ea lipids tlhahlobong ea mali, khatello ea mali, hyperglycemia, liphoso tsa hemostasis.

Pehelo ea mafu

Ho ipapisitsoe le boholo ba lipids, mefuta ena ea pathology e khetholloa:

• Isolated hypercholesterolemia ha ho nyoloha k'holeseterole, e leng karolo ea lipoprotein.
• Hyperlipidemia e tsoakiloeng, ha tlhahlobo e senola keketseho ea cholesterol le triglycerides.

Dyslipidemia ka mochini oa ketsahalo e ka ba ntho ea mantlha (hona ho kenyelletsa lefu la tsoalo) kapa la bobeli, le hlahileng tlasa ts'usumetso ea lintho tse bohloko.

Ntle le moo, ho na le karohano ho latela Fredrickson, moo mefuta ea mafu a amanang le mofuta oa lipid e phahamisitsoeng. Maemong a mangata, lefu lena le ka lebisa ho atherosclerosis. Mefuta e latelang e khethollotsoe:

• Herederal hyperchilomicronemia. E fapana ka hore ke li-chylomicrons feela tse phahamisitsoeng tlhahlobong ea mali. Ena ke eona feela subspecies eo ho eona menyetla ea ho ba le atherosclerosis e fokolang.
• Maikutlo a 2a - ona ke lefutso kapa lefutso le futsitsoeng ka tlasa ts'usumetso ea lintho tse mpe tse kantle. Ka nako e ts'oanang, matšoao a LDL a eketseha.
• Mofuta oa 2b, sena se kenyelletsa hyperlipidemia e kopaneng, ha lipoprotein tsa tekanyo e tlase haholo le tse tlase haholo, hammoho le triglycerides.
• Mofuta oa boraro ke lefutso la lefu la dysbeta lipoproteinemia, ha LDL e phahame.
• Mofuta oa 4 o bitsoa endo native hyperlipidemia, athe boemo ba lipoprotein tse fokolang haholo bo eketseha.
• Mefuta ea ho qetela e mehlano e kenyelletsa lefu la semelo sa lefutso, moo li-chylomicrons le lipoprotein tse fokolang haholo li eketsoang.

Ts'oaetso

Maemong a mangata, dyslipidemia e ka fumanoa ka ho etsa tlhahlobo e ikhethang ea liteko. Tlhahlobo ea ho qetela e etsoa ka mor'a:

• Tlhahlobo ea pele e nang le pokello ea litletlebo le anamnesis e ntse e tsoela pele. Ngaka e leka ho tseba matšoao a lefu lena ho mokuli, hape le tlhaiso-leseling e mabapi le lefutso le lefutso.
• Boteng ba xanthelasm, xanthoma, le lipoid arch ea cornea li senoloa.
• Fana ka mali le moroto bakeng sa tlhahlobo.
• Ho nkuoa profil ea lipid. E thusa ho tseba ho lekana ha atherogenicity.
• Li-immunoglobulin tsa Class M le G li fumanoa maling.

Phekolo ea mafu

Ho fetofatsa metabolism ea mafura, lingaka li ka fana ka litlhare tse khethehileng, lijo tsa ho ja, mokhoa o mafolofolo le mekhoa ea meriana ea setso.

Mokhoa oa kalafo oa kalafo o nka:

• Statins ke lithethefatsi tse thusang ho fokotsa cholesterol biosynthesis liseleng tsa sebete. Lithethefatsi tsena li na le phello e khahlanong le ho ruruha. Tse atileng haholo ke atorvastatin, lovastatin, fluvastatin.
• Fibrate e laetsoe li-triglycerides tse phahameng. Phekolo e etsa hore ho be le keketseho ea HDL, e thibelang ponahalo ea atherosulinosis. E sebetsang ka ho fetisisa ke ho kopanngoa ha li-statins le li-fibrate, leha ho le joalo, litlamorao tse mpe tse mpe tse kang myopathy li ka hlaha. Ho tsoa sehlopheng sena, ho sebelisoa clofibrate, fenofibrate.
• Acid ea Nicotinic ka sebopeho sa Niacin, Enduracin. Lithethefatsi tsena li na le thepa e fokotsang lipid.
• Li-acids tsa polyunsaturated tse mafura, omega-3. Li ka fumanoa ka oli ea lihlapi. Phekolo ena e thusa ho fokotsa cholesterol ea mali, lipids, LDL le VLDL. Lithethefatsi tse joalo li anti-atherogenic, li ka ntlafatsa rheology ea mali le ho thibela sebopeho sa maro a mali.
• Li-inhibitors tsa chlesterol tse thusang ho emisa ho kenella ka mpeng e nyane. Setlhare se tsebahalang haholo ke Ezetimibe.
• Resins bakeng sa khokahano ea li-acid acid: Colestipol, Cholestyramine. Lithethefatsi tsena lia hlokahala e le monotherapy bakeng sa hyperlipidemia kapa e le karolo ea kalafo e rarahaneng e nang le lithethefatsi tse ling tsa hypocholesterolemic.

Mekhoa ea lapeng

Litlhare tsa Folk li thusa ho fokotsa cholesterol le ho ntlafatsa boemo ba methapo ea mali. Li ka sebelisoa e le thuso e eketsehileng.

Mekhoa e tloaelehileng ka ho fetisisa ke:

• Kamohelo ea lero la litapole. E lokela ho nooa letsatsi le leng le le leng ka mpeng e se nang letho. Ho etsa sena, litapole tse tala li peeled, li hlatsoa le ho pikitisoa, tse ka hare li pepesoa. Se nooang se nooang se sa tsoa khuoa.
• Motsoako oa linoko, mahe a linotsi, oli ea meroho. Hoa hlokahala ho noa moriana o joalo nako e telele, bonyane likhoeli tse 2-3.
• Tee ea Melissa. E khutsisa le ho tsitsisa hantle, e ntlafatsa methapo ea mali ea bokong le ea pelo.
• Literei tse nang le meutloa. Bakeng sa sena, semela se sa tsoa khuoa se kenngoa ka bateng e chesang. Ha ba se ba qetetse halofo ea hora, ba tlisa mocheso o hlokahalang, 'me maoto a qoelisoa metsing ana. Sena se thusa ho emisa atherosclerosis lipheletsong tse tlase.

Melao-motheo ea Nutla ea Maloetse

Lijo tse nang le phepo ena li hlokahala ho theola cholesterol. Ho ja lijo tse nang le phepo e ntle ho thusa ho fokotsa boima ba 'mele haholo le ho ntlafatsa tsoekere ea mali.

Ha dyslipidemic syndrome e bonoa, mokuli o lokela ho hana bongata bo bongata ba mafura a liphoofolo a jang.

Lere, tranelate e bolila, li-yolks tsa mahe, botoro, nama e mafura, soseji, soseji, offal, shrimp, squid, caviar, chisi e nang le mafura a fetang 40% e lokela ho kenyelletsoa lijong.

Ho netefatsa hore phepo e lula e felletse, o ka nkela mafura a liphoofolo sebaka ka mafura a meroho. Ho tla ba molemo ho bakuli ho nka poone, soneblomo, cottonseed, linseed, oli ea soya.

Ntle le moo, ho bohlokoa ho hlahisa lijo tse ling tsa tlhaho ea limela, e leng:

• Litholoana, monokotsoai, meroho, linaoa. Lintho tsena kaofela li na le fiber ea lijo, e hlokang bonyane 30 g ka letsatsi.
• Oli ea khale le ea soya, e nang le stanols. Palo ea bona ea letsatsi le letsatsi e lokela ho ba 3 g.
• Li-plums tse ncha, liapolekose, liperekisi, li-currants tse ntšo, lihoete, lihoete. Lihlahisoa tsena li na le li-pectin tse ngata. Motšehare o hloka ho ja tse ka bang 15 g ea lijo tse joalo.

Litlhahiso tse kholo tsa phepo ea dyslipidemia ke ho latela melao e 'maloa:

• Kamehla ja litholoana, meroho le monokotsoai.
• Ts'ebeliso ea mafura a polyunsaturated, mono - 'me e tletse e lokela ho hlaha ka karolelano ea 1: 1: 1.
• Tekanyetso ea lihlahisoa tse phahameng tsa lebese.
• Fokotsa tšebeliso ea lehe ho isa ho a 3 ka matsatsi a 7.

Tšebeliso e mpe ea tahi e kopanetsoe, leha ho le joalo, veine e khubelu e omisitsoeng, e nkuoeng ka bongata pele ho lijo, e na le thuso ho bakuli.

Mathata a thuto ea methapo

Liphetho tsohle tse mpe tsa lefu lena li ka aroloa ka ho hlaka le ho sa foleng. Ea pele e kenyelletsa infroction, myocardial infarction. Pathology e tsoela pele ka potlako 'me hangata e bolaea.

Mathata a sa foleng a kenyelletsa ho putlama mali, arrhythmia, khatello ea maikutlo, aortic valve stenosis, ho se sebetse hantle ka mpeng, angina pectoris, trophic ulcers, intermittent claudication syndrome.

Kaha ho na le tšenyo ea methapo ea methapo e bonoa ka lebaka la ho bokellana ha litheolelo tsa atherosulinotic, atherosulinosis e khetholloa:

• Aorta E baka khatello ea mali ea methapo, maemong a mang e ka baka likotsi tsa pelo, ho haella ha aortic, stenosis.
• Lisebelisoa tsa pelo. E ka lebisa ho kenella ka har'a myocardial infarction, ho hloleha ha morethetho oa pelo, lefu la pelo, kapa ho akheha ha pelo.
• Likepe tsa likerese. Ka nako e ts'oanang, ts'ebetso ea setho e mpefala. Ho phatloha ha vascular ho ka hlaha, ho baka ischemia le stroke.
• Methapo ea kutlo. E iponahatsa e le khatello ea mali.
• Methapo ea kahare. Hangata ho lebisa ho infarction ea ka mpeng.
• Lisebelisoa tsa libaka tse tlase. E ka baka ho hlaka kapa ho hlaka ka nakoana.

Phekolo eo eseng ea lithethefatsi

Ha ho bohlale ho phekola dyslipidemia ka meriana ntle le ts'ebeliso ea mekhoa eo e seng ea meriana. Ntle le moo, ka ho fetola mokhoa oa ho ja, ho sebetsa le ho phomola, hammoho le ho ikoetlisa, o ka fumana phello e ntle haholo ea kalafo. Ho etsa sena, o tlameha ho:

• fokotsa bongata ba mafura a liphoofolo lijong tsa letsatsi le letsatsi, 'me ka linako tse ling u a tlohele ka botlalo,
• etsa hore boima ba 'mele bo fetohe
• eketsa ho ikoetlisa ho tsamaisana le matla le bokhoni ba mokuli,
• fetohela ho ja ka tsela e leka-lekaneng, e matlafalitsoeng le e tsoakiloeng,
• fokotsa kapa ho tlohela ka botlalo ts'ebeliso ea joala, e eketsang palo ea li-triglycerides maling a mokuli, e thusa ho tiisa marako a methapo ea mali le ho potlakisa nts'etsopele ea atherosclerosis.
• ho tsuba ho bapala karolo ea bohlokoa ho holiseng lefu lena.

Pheko ea lijo

Joalokaha ho boletsoe ka holimo, phepo ea dyslipidemia ke e 'ngoe ea lintlha tsa mantlha tsa kalafo e sebetsang. Lijo ha se taba ea nakoana, empa mokhoa oa bophelo le phepo eo thibelo ea atherosclerosis e thehiloeng ho eona. Lijo tsa lefu lena li etselitsoe mokuli ebile li na le melaoana e mengata:

• fokotsa ts'ebeliso ea mefuta e mafura ea nama, tlhapi, lore, shrimp, botoro, mefuta e mafura ea lihlahisoa tsa lebese, chisi ea indasteri, lisose le lisoseji,
• ntlafatsa lijo tsa hau ka mafura, tlhaho ea meroho, meroho, litholoana, mefuta e fokolang ea likhoho le litlhapi,
• Lihlahisoa tsa lebese la skim le tsona li bontšoa mofuteng ona oa lefu,
• , ka likarolo tse nyane nako le nako.

Phekolo ea extracorporeal

Phekolo e joalo e sebelisetsoa ho fetola thepa le sebopeho sa mali kantle ho mmele oa motho. Sysleipic dyslipidemia ke sesupo sa ts'ebeliso ea mokhoa ona. Ka nnete, dyslipidemia ea atherogen ke ntho e tlatsetsang kholisong ea mathata a mofuta oa maloetse a pelo le pelo.

Ho ka ba le mathata le litlamorao

Boloetse bona boa phekoleha, empa mohato ona o nka nako e telele 'me o hloka khalemelo le matla ho tsoa ho mokuli. Empa boiteko bona bo bohlokoa ho thibela mathata a bophelo bo thata le a kotsi ka tsela ea:

• atherosmithosis,
• lefu la pelo
• lefu la pelo
• stroke
• pherekano ea morethetho oa pelo,
• khatello ea kelello ea methapo le,
• atherosclerosis,
• atherosclerosis ea likarolo tse tlase.

Ho latela mochine oa ntlafatso, mathata ohle a ka aroloa ka lihlopha tse peli:

• bohale
• sa foleng.

Mathata a hlobaetsang ke ho ba teng ha stenosis (compression) ea sekepe le ho rusolla ha thrombus sebakeng sa eona se hoketsoeng. Ka mantsoe a mang, lesela le koahelang mali ka botlalo kapa ka mokhoa o itseng le koala leseli la sejana ebe embolism e ba teng. Hangata, lefu la kelello le na le phello e bolaeang. Mathata a nako e telele ke ho tsitsipana ha leseli ka sekhahla le ho etsoa ha sehokelo sa mali ho sona, e isang ho ischemia e sa feleng ea sebaka se fanoeng ka sekepe sena. Phihlello ea dyslipidemia e ipapisitse le:

• botebo le mofuta oa lefu,
• lehae la tsepamisa maikutlo ho atherosulinosis,
• sekhahla sa nts'etsopele ea ts'ebetso ea methapo,
• tlhahlobo ea nako le kalafo.

Thibelo

Lefu lena, joalo ka ba bang bohle, ho bonolo ho le thibela ho feta kamora nako e telele le ho le thata ho le phekola. Ka hona, dyslipidemia e ka ba ea mefuta e fapaneng:

1. Thibelo ea mantlha - methati e ikemiselitseng ho thibela ho qala ha lefu lena. Bakeng sa morero ona, ho khothalletsoa:
2. Thibelo ea bobeli - mehato e reretsoeng ho thibela nts'etsopele ea mathata le kholo ea lefu lena. Mofuta ona oa prophylaxis o sebelisoa bakeng sa dyslipidemia e seng e fumanehile. Bakeng sa morero ona, o ka kenya kopo:
   • normalization ea boima ba 'mele
   • tsela e mafolofolo ea bophelo
   • ho qoba khatello ea maikutlo
   • ho arolelana nako ea mabaka bakeng sa mosebetsi le boikhathollo,
   • tlhahlobo ea khafetsa ea bongaka ka liteko tsa mali le tsa moroto hammoho le litekanyo tsa khatello ea mali,
   • kalafo ya ho ja
   • drug prophylaxis,
   • litlamorao tse seng tsa lithethefatsi sesosa sa lefu lena.

Ha matšoao a pele a tšohanyetso a hlaha, batla thuso e loketseng ea bongaka.

Thibelo, tšoaetso le kalafo, e etsoang ka nako e loketseng, e ka lelefatsa le ho boloka bophelo ba mokuli le boleng ba eona. Feela boemo ba mantlha ba polelo e joalo ea boitlhopho ke ho ba le taeo le maikutlo a hlokolosi bophelong ba motho.

Dyslipidemia ke eona ntho e ka sehloohong ebile, mohlomong, e leng sesosa sa kotsi bakeng sa nts'etsopele ea lefu la pelo le lefu la pelo (ASC), le hlahang pele mabaka a mang a kotsi a qala ho itlhahisa. Bopaki ba Epidemiological bo boetse bo fana ka maikutlo a hore hypercholesterolemia le mohlomong coronary atherosulinosis le tsona ke lintho tse ka bakang kotsi ea ho tšoaroa ke lefu la ischemic. Ho ea ka datha, ho tloha ka 2009 ho isa ho 2012, Maamerika a maholo a fetang limilione tse 100 a le lilemo li ≥20 a na le cholesterol e felletseng (cholesterol) ≥200 mg / dl mme batho ba ka bang limilione tse 31 ba na le maemo a 40240 mg / dl.

Ho na le bopaki bo eketsehileng ba hore kotsi e joalo bakeng sa mafu a methapo ea methapo, ischemic stroke, hammoho le ACSB, joalo ka ho tsitsisa ha insulin, keketseho ea botebo ba eona e lebisang keketseho ea boemo ba triglycerides (TG), lipenshene tsa lipoproteins tse phahameng (LDL) le ho fokotseha hoa khatello ea methapo ea methapo e phahameng ea methapo ea methapo (HDD). ) ka plasma ea mali.

Mabapi le sena, ka la 23 Mmesa, 2017, koranta ea Endocrine Exercise e phatlalalitse litlhahiso tsa bongaka bakeng sa lingaka tse ntlafalitsoeng ke Boto ea Batsamaisi ba Mokhatlo oa Amerika oa Clinical Endocrinologists (AACE) Boto ea Tsamaiso le Boto ea Batsamaisi ea Koleche ea Amerika ea Endocrinology (Amerika College of Endocrinology (ACE) Board of Trasti), e lumellanang le protocol ea AACE e phatlalalitsoeng pejana bakeng sa phepelo e lekanang ea litataiso tsa tloaelo ea tleleniki.

Ho ea ka bangoli, lebaka le leng la ntlafatso ea tataiso ena e ne e le likhothaletso tse hanyetsanang tsa American Cardiology Association / American College of Cardiology ka 2013, e ileng ea tlosa sepheo sa ho theola litekanyetso tsa LDL mme ho fapana le moo ea khothaletsa ho fapana ha matla a kalafo ea statin.

Ebile, tataiso ena ke molaetsa o hlophisitsoeng o hlophiselitsoeng ho thusa litsebi tsa tlhokomelo ea bophelo ho etsa liqeto tsa bongaka bakeng sa linyeoe tse ikhethang tsa bongaka, empa, joalo ka bangoli ba sengoloa, ha se sebaka sa kahlolo bakeng sa kahlolo e ikemetseng ea bongaka mme ha ea lokela ho nkuoa e le tataiso.

Bahlahisi ba hlakisa hore boholo ba litaba tsa likhothaletso tsena li thehiloe litlhahlobisong tsa lingoliloeng, le maemong a belaetsang bangoli ba sebelisitse kahlolo ea malebela.Litataiso tsena ke tokomane e sebetsang e bonts'ang boemo ba sebaka sena ka nako ea phatlalatso, empa kaha ho lebelletsoe liphetoho tse potlakileng sebakeng sena, tlhahlobo ea nako le nako e ke keng ea qojoa. Litsebi tsa bophelo bo botle li khothaletsoa ho sebelisa tlhaiso-leseling ena hammoho le tlhahlobo e ntlafalitsoeng ea bongaka eseng sebaka, mme litlhahiso tse ka hlahisoang li kanna tsa se ke tsa amoheleha maemong ohle. Qeto efe kapa efe ea litsebi ea ho sebelisa tataiso ena e lokela ho etsoa ho latela bokhoni ba lehae le maemo a motho ka mong.

Kakaretso ea tokomane ena e na le likhothaletso tse 87, tseo tse 45 (51.7%) li leng tsa sehlopha A, 18 (20.7%) - B, 15 (17.2%) - C le 9 (10.3%) - ho sehlopha sa D. Likeletso tsena tse qaqileng, tse nang le bopaki li lumella liqeto tsa kliniki hore li etsoe ka tlhokomelo li-nuances tse mabapi le likarolo tse ngata tsa tlhokomelo ea bongaka maemong a nnete. Ntlafatso ena e na le mehloli ea 695, eo 203 (29.2%) e nang le bopaki ba boleng bo holimo, 137 (19.7%) e nang le bopaki ba boleng bo itekanetseng, 119 (17.1%) ba fokolang le 236 (34.0%) a) linyeoe ha ho na bopaki ba tliliniki.

Mabaka a kotsi a nts'etsopele ea ASHB, bangoli ba bontšitse maemo a latelang. Tse ka sehloohong ke: keketseho ea lilemo, boemo bo phahameng ba k'holeseterole ea serum le LDL, keketseho ea cholesterol e sa amaneng le HDL (cholesterol eo eseng HDL), ho fokotseha ha HDL, ho ba teng ha lefu la tsoekere, lefu la methapo ea methapo, lefu le sa foleng la ausi, ho tsuba, nalane ea lelapa e boima. Mabapi le ASB. Ho ile ha hlokomeloa lintlha tse ka bang kotsi: botenya, nalane e boima ea lelapa ea hyperlipidemia, keketseho ea LDL, ho itima lijo ka potlako le ka mor'a ho ja hypertriglyceridemia, polycystic ovary syndrome, dyslipidemic (lipid) triad (motsoako oa hypertriglyceridemia, LDL-C e phahameng le cholesterol e tlase). Bangoli ba boetse ba thathamisitse maemo a kotsi eo e seng a setso, joalo ka keketseho ea boemo ba lipoprotein (a), keketseho ea tšebetso ea mabaka a makhopho a mali, likhakanyo tsa matšoao a tšoaetso, maemo a homocysteine, uric acid le TG.

Bacha bohle ba nang le lefu la tsoekere ba lokela ho hlahlojoa bakeng sa profil ea lipid ka nako ea tlhahlobo ea mafu. Haeba LDL e ka har'a sekhahla se amohelehang sa kotsi (3.0 mmol / L,

Ho khetholla tlolo ea molao ho thusa tlhahlobo ea liphatsa tsa lefutso, lipatlisiso tsa immunological, liteko tsa mali le urine. Sehlopha se ka tlase se ipapisitse le mochini oa nts'etsopele:

• ea mantlha (eseng ka lebaka la bokuli)
• monogenic - mofuta o futsitsoeng,
• homozygous ke mofuta o sa tloaelehang o hlahang ka lebaka la ho amohela mefuta e mebe ho batsoali,
• heterozygous - mofuta o qapiloeng kamora semelo sa phoso ea e mong oa batsoali a fetiselitsoeng ho ngoana,
• polygenic foromo - lefutso, mabaka a kantle,
• Mofuta oa phepo e ntle o hlaha ka lebaka la khaello ea phepo e nepahetseng,
• dyslipoproteinemia - mofuta o hlahang o susumetsoa ke lintlha tsa atherogenic,
• dyslipidemia ea bobeli ke litholoana tsa mafu.

Ntle le moo, ho na le karohano ho latela boemo ba lipids, boo mefuta ea dyslipidemia e shebahalang ka tsela ena:

1. Isolated hypercholesterolemia ke keketseho ea cholesterol, e tlang ka karolo ea li-protein tsa protheine.
2. Hyperlipidemia e kopaneng - keketseho ea palo ea TG (li-esters tse nang le mafura acid) le cholesterol.

Fredrickson karohano ea dyslipidemia

Rasaense ea tummeng o arotse naha ena ka lipids. Se latelang ke karohano ea dyslipidemia ho latela Fredrickson:

1. Hyperlipoproteinemia ea lefutso ke lefutso la lefutso, leo ho lona palo ea chylomicrons e ntseng e eketseha. Mofuta ona ha o bake atherosulinosis (ICD khoutu E78.3).
2. Hyperlipoproteinemia ea Type II e arotsoe hape ka lihlopha tse peli. Mofuta oa IIa hyperlipidemia ke eng? Ona ke mofuta oa mofuta oo ho ata haVV e tsebahalang. Sena se hlalositsoe ke tšusumetso ea tikoloho le kantle ea lefutso. Type IIb ke foromo e kopaneng eo ho eona LDL, TG, le VLDL li eketsoang.
3. Hyperlipoproteinemia ea Type III, ho ea ka Fredrickson, ke lefu la dysbeta-lipoproteinemia le keketseho ea LDL le TG.
4. Hyperlipoproteinemia ea Type e bakoa ke keketseho ea mali ea VLDL. Lebitso le leng bakeng sa foromo ke hypoosipemia ea mehleng.
5. Mofuta oa ho qetela ho latela Fredrickson ke lefutso la lefutso. Ka mofuta oa V hyperlipoproteinemia, li-chylomicrons le keketseho ea VLDL maling.

Boholo ba bakuli ba bonang ts'oaetso ena kareteng ea bona ha ba utloisise dyslipidemia - hore na ke eng le hore na e ba le mabaka afe. Ho ka ba le lintlha tse 'maloa. Lisosa tse ka sehloohong tsa dyslipidemia ke:

• Khaello ea li-receptor ea LDL
• lefu le thibelang sebete,
• khatello ea kelello ea methapo
• lefu la tsoekere
• liphatsa tsa lefutso (hyperlipoproteinemia, polygenic hypercholesterolemia),
• botenya ka mpeng,
• lipoprotein lipase
• hypothyroidism
• kalafo ea nako e telele ea lithibela-mafu,
• bophelo ba ho lula fatše
• mekhoa e mebe.

Dyslipidemia - Matšoao

Tlhahlobo ea nalane ea bongaka, tlhahlobo ea 'mele ea mokuli, le liteko tsa mali (tlhahlobo ea immunological, lipid profil, index ea atherogenic, tlhahlobo ea mali ea biochemical) li thusa ho tseba pherekano ena le ho etsa tlhahlobo ea mali. Matšoao a dyslipidemia a ka hlaha ka tsela e latelang.

Dyslipidemia ke tlolo ea metabolism ea lipid, e kenyang phetoho phetohong ea lipids maling (ho fokotseha kapa ho eketseha) mme e bua ka mabaka a kotsi bakeng sa nts'etsopele ea ts'ebetso ea methapo e mengata ea 'mele' meleng.

Cholesterol ke motsoako o hlophisitsoeng oo, har'a lintho tse ling, e leng karolo ea litho tsa litho tsa sele. Ntho ena ha e qhibilihe ka metsing, empa e qhibilihisoa ka mafura le lintho tse qolotsoeng. Hoo e ka bang 80% ea cholesterol e hlahisoa ke 'mele ka boeona (sebete, mala, litšoelesa tsa adrenal, liphio, le litšoelesa tsa thobalano li nka karolo ho hlahiseng), karolo e setseng ea 20% e kena' meleng ka lijo. Microflora ea kahare e kenella ka mafolofolo ho metabolism ea cholesterol.

Mesebetsi ea chlesterol e kenyelletsa ho netefatsa botsitso ba membrane ea sele ka mocheso o fapaneng, o nka karolo sebopeho sa vithamine D, lihormone tsa adrenal (ho kenyelletsa estrogen, progesterone, testosterone, cortisol, aldosterone), hammoho le asiti ea bile.

Ha ho se na kalafo, atherosclerosis ea likepe e hlaha khahlano le semelo sa dyslipidemia.

Mefuta ea lipids ea 'mele ho ea ka' mele, hammoho le likarolo tsa sebopeho sa lisele, ke lipoprotein, tseo e leng lipina tsa mofuta oa lipids (lipo-) le liprotheine (liprotheine). Lipoprotein li arotsoe ka mahala (lipoprotein ea plasma ea mali, e qhibilihang ka metsing) le sebopeho (lipoprotein tsa membrane ea lisele, myelin sheath ea methapo ea methapo, e sa keneng ka metsing).

Li-lipoprotein tsa mahala tse ithutoang haholo ke plasma lipoprotein, tse khethollotsoeng ho latela letsoalo la tsona (tse holimo tsa litaba tsa lipid, le ho theola letsoalo):

• li-lipoprotein tse tlaase haholo,
• lipenshene tsa letsoele tse tlaase,
• high density lipoprotein,
• chylomicrons.

Cholesterol e tsamaisoa liseleng tse tsoang mothapong ka li-chylomicrons, lipoprotein tse tlaase haholo le tse tlase, 'me li-lipoprotein tse phahameng li fetisetsoa ho sebete. Nakong ea ho senyeha ha lipoloptiki tsa lipoprotein tse tlase haholo, tse etsahalang tlasa ts'ebetso ea lipoprotein lipase enzyme, lipomprotein tsa methapo e bohareng li thehoa. Ka tloaelo, lipoprotein tsa methapo e bohareng li tšoauoa ke bophelo bo bokhutšoaane maling, leha ho le joalo, li ka ipokellela ka mathata a itseng a metabolism ea lipid.

Dyslipidemia e bua ka mabaka a mantlha a kotsi bakeng sa nts'etsopele ea atherosulinosis, eo, 'me e ikarabellang bakeng sa li-pathologies tse ngata tsa tsamaiso ea methapo ea pelo tse etsahalang botsofaling. Mathata a atherogenic a lipid metabolism a kenyeletsa:

• keketseho ea li-triglycerides le lipoprotein tse tlase,
• ho fokotseha ha lipoprotein tse phahameng haholo.

Mabaka a nts'etsopele ea dyslipidemia e ka ba a ho fetoha hape (liphetoho tse le 'ngoe kapa tse ngata tse bakang khatello ea maikutlo kapa bofokoli tokollong ea li-triglycerides le lipoprotein tse fokolang kapa hypoproduction kapa tlhahiso e feteletseng ea lipoprotein tse phahameng haholo), kapa tse fumanoeng. Hangata, dyslipidemia e bakoa ke ho kopana ha lintlha tse 'maloa.

Phekolo ea lithethefatsi ea dyslipidemia ho bana e etsoa feela ka mor'a lilemo tse 10.

Mafu a mantlha a tlatsetsang ho ntlafatseng ha ts'ebetso ea methapo ena ea methapo a kenyelletsa mafu a sebete, ho hloleha ho sa sebetseng hantle ha methapo, hypothyroidism. Dyslipidemia hangata e hlaha ho bakuli ba nang le lefu la tsoekere. Lebaka ke tšekamelo ea bakuli ba joalo ho atherogeneis hammoho le bongata ba li-triglycerides tse nyane le lipoprotein tse fokolang maling le ho fokotseha ka nako e tšoanang maemong a lipoprotein tse phahameng haholo. Bakuli ba nang le lefu la tsoekere la mofuta oa 2 ba kotsing e kholo ea dyslipidemia, haholoholo ka ho kopana le taolo e tlase ea lefu la tsoekere le botenya bo boholo.

Lintlha tse ling tsa kotsi li kenyeletsa:

• boteng ba dyslipidemia nalaneng ea lelapa, i.e., bokapele ba lefa,
• khaello ea phepo e nepahetseng (haholo ho ja ho feta tekano, tšebeliso e matla ea lijo tse mafura),
• ho se ikoetlise
• ho nona ho feta (haholo botenya ba mofuta oa mpa),
• mekhoa e mebe
• khatello ea kelello le maikutlo,
• ho sebelisa meriana e meng (li-diuretic drug, immunosuppressants, jj),
• lilemo tse fetang lilemo tse 45.

Mefuta ea Dyslipidemia

Dyslipidemia e arotsoe ka congenital le e fumanoeng, hammoho le e arotsoe ebile e kopantsoe. Hysher dyslipidemia ke monogenic, homozygous le heterozygous. Ho fumaneha e ka ba ea mantlha, ea bobeli kapa ea boemeli.

Dyslipidemia ha e le hantle ke letšoao la laboratori le ka khetholloang feela ka liphetho tsa tlhahlobo ea mali ea biochemical.

Ho ea ka karohano ea dyslipidemia (hyperlipidemia) ho ea ka Fredrickson, e amoheloang ke Mokhatlo oa Lefatše oa Bophelo e le semenclature ea machabeng ea mathata a metabolism ea lipid, ts'ebetso ea methapo ea methapo ea methapo e arotsoe ka mefuta e mehlano:

• mofuta 1 dyslipidemia (hereditary hyperchilomicronemia, hyperlipoproteinemia) - e tšoauoa ka keketseho ea boemo ba li-chylomicrons, e se karolo ea lisosa tse kholo tsa kholo ea kholo ea methapo ea methapo ea methapo, ho hlaha hangata ho bongata ka kakaretso ke 0,1%,
• mofuta 2 dyslipidemia (polygenic hypercholesterolemia, hereditary hypercholesterolemia) - keketseho ea boemo ba lipoprotein tse tlase, khafetsa ea liketsahalo ke 0,4%,
• mofuta oa 2b dyslipidemia (hyperlipidemia) - keketseho ea lipoprotein le li-triglycerides tse tlase haholo, tse fumanoeng hoo e ka bang 10%,
• mofuta oa 3 dyslipidemia (lefu la dysbeta-lipoproteinemia) - keketseho ea lipoprotein tsa methapo e bohareng, menyetla e phahameng ea ho theha liso tsa methapo ea methapo ea methapo ea mali, mokokotlo oa liketsahalo ke 0,02%,
• mofuta 4 dyslipidemia (endo native hyperlipemia) - keketseho ea boemo ba lipoprotein tse fokolang haholo, tse fumanoang ho 1%,
• mofuta 5 dyslipidemia (lefutso la lefutso) - keketseho ea boemo ba chylomicrons le lipoprotein tsa letsoalo le tlase haholo.

Matšoao a Dyslipidemia

Kaha DL ke lefu la laboratori, liponahatso tsa lona li amana le lefu la methapo ea methapo ea litho le lisele tse ba li fang:

• ischemia
• lefu la pelo
• atherossteosis obliterans ea methapo ea methapo e tlase, joalo-joalo.

Lefu la pelo - Lefu le tšoaetsanoang ka ho fetisisa le letona le amanang le lefu lena. Batho ba bangata ba bolaoa ke eona ho feta mefuta eohle ea mofets'e. Hangata, lefu lena le iponahatsa ka sebopeho angina pectoris kapa myocardial infarction.

Angina pectoris e ne e bitsoa "angina pectoris", e tšoaeang hantle matšoao a lefu lena - e tobetsa kapa e hatella maikutlo ka mora sternum ka bophahamo ba khatello ea maikutlo kapa ea maikutlo, e nkile metsotso e 'maloa le ho emisa kamora ho sitisoa ha mojaro kapa ho nka nitroglycerin.

Myocardial infarction e amanang le ho phatloha hoa lets'oao la atherosulinotic methapong ea pelo le ho thehoa ha sekoahelo sa mali sethaleng. Sena se lebisa ho koalo e potlakileng ea methapo, ischemia e mpe, tšenyo le necrosis ea myocardium.

Boko bo ka ba le bothata ba ischemia e sa foleng le e mpe, e bonahatsoang ke ho tsekela, ho felloa ke kelello, ho felloa ke puo le ho sebetsa ha koloi. Sena ha se letho ntle le ho otloa ke lefu la sethoathoa kapa boemo ba pele ho stroke - tlhaselo ea nakoana ea ischemic. Ka khaello ea methapo ea kutlo e lipelong tse tlase, ho fokotseha ha phepelo ea mali maotong hoa etsahala. Hoa bohlokoa ho hlokomela hore nako e telele atherosclerosis e lula e le setsiala, lipontšo tsa kliniki li qala ka ho fokotseha ha methapo ea methapo ka 60-75%.

Dyslipidemia ea mofuta oa lelapa e ka hlaha le stigmata, joalo ka letlalo xanthomas le eyelid xanthelasms.

Keketseho e kholo ea khatello ea mali triglycerides (e fetang 8 mmol / l) e ka lebisa ho pancreatitis e mpe, e tsamaeang le bohloko bo boholo mpeng, ho nyekeloa ke pelo, ho hlatsa, ho nyekeloa ke pelo le bofokoli bo akaretsang.

Pathogenesis ea dyslipidemia

Li-lipids tse ka sehloohong tsa plasma ke:

• cholesterol (cholesterol) - se tlang pele ho li-acid acid, lihormone tsa thobalano le vithamine D,
• phospholipids (PL) - likarolo tsa mantlha tsa sebopeho sa lisele tsohle le bokantle ba likarolo tsa lipoprotein,
• triglycerides (TG) - lipids tse thehiloeng ho mafura acid le glycerol, tse kenngoeng ka lijo, ebe li fetisetsoa li-depots tsa mafura kapa li kenngoa lipoprotein.

Mafura a mafura (LC) plasma ea mali - mohloli oa matla le karolo ea sebopeho sa TG le PL. Li na le metsi a mangata ebile li sa koaheloa. LCD e tsamaisitsoeng ke karolo ea mafura a liphoofolo. Ha e sebetseLCD etsa mafura a meroho 'me a arotsoe ka mafura a mangata- le a polyunsaturated. Li-Monounsaturated FAs li fumaneha ka bongata ho oli ea mohloaare, le li-FAF tsa polyunsaturated ho oli ea lihlapi le oli e meng ea meroho. Ho lumeloa hore mafura ana kaofela aa hlokahala bakeng sa batho, tekanyo ea bona e leka-lekaneng e lokela ho ba karolo ea 30% ea khalori ea lijo tsa letsatsi le letsatsi ebe e ajoa likarolong tse ka bang tharo tse lekanang lipakeng tsa li- FA, polyunsaturated le saturated FAs.

Motsoako o kopaneng oa mafura le liprotheine o bitsoa lipoprotein kapa lipoprotein.

Mokhoa oa ho thibela lefu lena

Thibelo ea dyslipidemia ke:

• Fokotsa boima ba 'mele.
• Boloka bophelo bo mafolofolo.
• Phallo ea maemo a sithabetsang.
• Ho fana ka liteko tsa thibelo.
• Phepo e nepahetseng.
• Ho fihlella matšeliso bakeng sa li-pathologies tse sa foleng tse kang lefu la tsoekere. Li hloka ho phekoloa ka nako, ho qoba mathata.

Ntho e kotsi ka ho fetisisa eo mokuli a ka kopanang le eona ke nts'etsopele ea atherosulinosis, ho nyekeloa ke pelo, ho otloa ke pelo, ho hloleha ha pelo.

Phekolo e kenyelletsa haholo khalemelo ea metabolism ea mafura, li-statins, fibrate, nicotinic acid, li-inhibitors tsa cholesterol, li-resin tsa bile acid tse tlamang, li-acid tse nang le mafura a polyunsaturated.

Likaroloana tsa lipid le dyslipidemia

Motho o ithuta ka dyslipidemia ka ho fumana sephetho sa tlhahlobo ea mali. Maemong a mangata, mokuli ha a belaele le hore na ke eng, kaha boemo ba methapo ea methapo ha bo iponahatse ka tsela efe kapa efe.

Mmele oa motho o hloka mafura le lintho tse kang mafura bakeng sa tšebetso e tloaelehileng. E 'ngoe ea tsona ke cholesterol. Karolo e ka sehloohong ea komporo ena e thehoa ka har'a sebete 'me ke karolo ea bohlano feela e tlang ka lijo.Lisele tsohle li hloka k'holeseterole. O nka karolo ho etseng li-membrane, empa a ke ke a kena liseleng ka phallo ea mali, kaha e sa qepha ka plasma. Bakeng sa ho isa cholesterol liseleng, ho hlokahala liproteine ​​tse tsamaisang. Ha li kopana le lipid, li theha mefuta ea lipoprotein ea mefuta e latelang:

• VLDL (letsoalo le tlase haholo),
• LDL (letsoalo le tlase),
• LPPP (letsoele le bohareng),
• HDL (letsoalo le phahameng).

Ha e theola letsoalo la lipoprotein, e ba bonolo le ho feta, e lokolle cholesterol. VLDL le LDL li isa lipid ho tsoa ka sebete ho liseleng, 'me ha likhahla tsena li le ngata, menyetla ea "ho lahleheloa ke" cholesterol "e tseleng." Eena o lula marakong a methapo ea mali, a fokotsa phallo ea mali mme a etsa lesaka la atherosselotic.

HDL e tsitsitse haholoanyane. Li fana ka phetoho e fapaneng ea k'holeseterole ho sebete, moo bile e thehiloeng ho eona. Lipid tsohle tse feteletseng ka tloaelo li lokela ho pepesetsoa, ​​empa hangata ha ho etsahale joalo. Ha lipoprotein tse fokolang tsa mali li eketseha maling le mokokotlo oa marotholi a HDL, ena ke e 'ngoe ea matšoao a dyslipidemia.

Lingaka li sebetsa ka sesupo se kengoang ke katleho ea maiketsetso. Ena ke karolelano ea cholesterol e felletseng ho litaba tsa HDL, e fokotsoe ke e le 'ngoe. Haeba boleng ba index ea atherogenic bo feta ba 3, joale ba bua ka dyslipidemia.

Ntle le moo, boemo bona ba "pathological" bo tsamaisana le khatello e kholo ea plasma ea triglycerides le chylomicrons. Tse fetileng ke li-esters tsa glycerol le mafura acid. Ka ho petsoha, ba fa lisele matla - ona ke o mong oa mesebetsi ea bona ea bohlokoa ka ho fetisisa. Keketseho ea khoholeho ea "triglycerides" (TG) plasma ea mali ke sesupo se seng sa dyslipidemia. Joalo ka cholesterol, metsoako ena e tsamaea ho pholletsa le 'mele ka tsela e rarahaneng ka liprotheine. Empa TG ea mahala e na le kotsi e ngata ea atherosclerosis.

Leha ho le joalo, likhahla tse eketsehileng tsa mofuta o mong oa lipalang - chylomicrons - le tsona li bonoa ka mefuta e meng ea dyslipidemia.

Keketseho ea khoholeho ea "cholesterol" e kotsi (LDL le VLDL) e beha kotsi ea atherosulinosis. Leha ho le joalo, lefu lena ha le iponahatse ka tsela leha e le efe kapa ho fana ka matšoao a hlakisitsoeng ho fihlela ho phatloha ho felletseng ha sekepe leha e le sefe se seholo le ho senyeha ha ts'oaro ea tischemic (necrosis, lefu la pelo, stroke).

Leha ho le joalo, dyslipidemia e ka bonoa maemong a mang. Matšoao a eona a hlakileng ke li-cholesterol tse hlahelletseng: xanthomas le xanthellasma, polelo ea lipoid arc ea cornea.

Hangata Xanthomas e theha ka holim'a lisele. Tsena ke maqhubu a teteaneng, 'me libaka tseo a li ratang haholo ke libaka tsa maoto, matsoho, matsoho, hangata morao.

Ho bonolo ho bona Xanthellasma sefahlehong. Tsena ke liforomo tse mosehla tse tlatsitsoeng ke cholesterol. Li fumaneha lintšing tsa sefahleho 'me ke liphofu tsa bohloeki. Ha ho na lebaka la ho li phekola ho fihlela tekanyo ea lipids maling e tloaelehile.

Ho bakuli bao lilemo tsa bona li fetang lilemo tse 50, ka linako tse ling u ka bona lephid la leoatle le potileng cornea. E na le 'mala o moputsoa kapa o mosoeu. A lipoid arc hase letho haese k'holeseterole e feteletseng.

Mabaka le liforomo

Mabaka a tlolo ea profid ea lipid a mangata, 'me ho latela bona ho na le karohano e joalo ea dyslipidemia:

Foromo ea mantlha ke thuto e ikemetseng ea pathology. Ha e amane le lefu lefe kapa lefe kapa mabaka a mang. Dyslipidemia ea mantlha e khethoa ke liphetoho tse bang teng kahare ho mofuta o le mong kapa ho feta tse ikarabellang bakeng sa ho theha cholesterol:

• sebopeho se heterozygous (ke motsoali a le mong feela ea fetisang mofuta o holofetseng),
• sebopeho se homozygous (batsoali ka bobeli ba fetisetsa ho mofuta oa tlhaho ea lefutso).

Hyssygous lelapa la dyslipidemia le hlaha makhetlo a 2 ka tlase ho heterozygous: ka karolelano, motho a le mong ho ba milione. Empa boemo bona bo thata le ho feta.

Leha ho le joalo, khafetsa bofokoli bo teng liphatseng tsa lefutso bo na le lintlha tse ngata tsa tikoloho tse bakang pherekano ea metabolic. Tabeng ena, ba bua ka dyslipidemia ea polygenic. Ona ke ona mofuta o atileng haholo oa boemo ba bophelo. Haeba feela liphetoho tsa liphatsa tsa lefutso li hlahisitse mathata a metabolism ea lipid, dyslipidemia e nkoa e le monogenic.

Ho fapana le ea mantlha, foromo ea bobeli e hlaha khahlano le semelo sa lefu:

• lefu la tsoekere
• hypothyroidism
• lefu la sebete
• khaello ea estrogen (basali),
• gout
• botenya
• gallstones.

Dyslipidemia ea mahareng le eona e ka tsosa lithethefatsi tse ling:

• li-hormonal (lithibela-pelehi),
• lithethefatsi tsa khatello.

Mofuta oa bobeli oa dyslipidemia oa amoheleha nakong ea kemolo. Kamora ho hlaha, metabolism ea mafura e khutlela ho tloaelehileng.

Ho ke ke ha khoneha ho hlola ka botlalo mofuta oa mantlha oa pathology, hobane lisebelisoa tse nang le phoso tsa liphatsa tsa lefutso li ke ke tsa fetoloa ke meriana ea sejoale-joale. Motho a ka felisa dyslipidemia ea bobeli feela ka ho laola lefu lena le tlase. Empa foromo ea alimentary ke eona e bonolo ho e phekola. Mathata ao a bakoa ke ho ja cholesterol e ngata mmeleng ka lijo. Haeba o fetola mokhoa oa ho ja, profid ea lipid e tloaelehile, 'me kalafo ea lithethefatsi ha e hlokehe.

Sehlopha sa Fredrickson

Ts'ebetsong ea bongaka, mefuta ea dyslipidemia e khetholloa, ho latela hore na likarolo tsa lipid tse maling li atoloha ho eng. Ho latela molao-motheo ona, ho hlophisoa ka sehlopha ho ea ka Frederickson. Tumellanong le eona ho na le lihlopha tse kholo tsa 5.

Mofuta oa 1 dyslipidemia ke lefa. Li amahanngoa le ho bokellana ho feteletseng ha li-chylomicron maling, empa ha li nkuoe e le atherogenic.

Dyslipidemia 2a, ho fapana le ea pele, e kotsi le ho feta. Tabeng ena, LDL e fumaneha ka bongata ho lero la mali. Haeba, ka ntle, litaba tsa VLDLP le / kapa triglycerides li eketseha, ho thoe mofuta oa 2b o joalo.

Kotsi e kholo le ho feta ea atherosulinosis e nang le dyslipidemia 3. Maemong ana, khatello ea VLDL e eketseha. Likaroloana tse ts'oanang li ipokella ka mofuta oa 4 oa dyslipidemia, empa ho fapana le ea 3, ha se lefutso, empa e halefisoa ke lisosa tsa ka hare. Mofuta oa bohlano oa ho hloka taolo o ikemiseditse ka liphatsa tsa lefutso mme o iponahatsa e le pokello e feteletseng ea VLDL, triglycerides le chylomicrons.

Dyslipidemia mofuta 2a le tsohle tse latelang li lebisa ho atherosclerosis. Maemo ana a ke ke a hlokomolohuoa!

Ntshetsopele ea dyslipidemia ea atherogenic

Atherogenic dyslipidemia e tlalehiloe haeba ho lekantsoe lipakeng tsa LDL le HDL, ke hore, mahlaseli a "cholesterol" e mpe a eketseha mme "botle" bo fokotseha. Haholoanyane, sena se bontšoa ke keketseho ea index ea atherogenic ho likarolo tse 3 kapa ho feta.

Lintlha tse ling tsa kotsi ke likarolo tsa bophelo:

• ho hloka boikoetliso
• ho sebelisa joala khafetsa
• ho tsuba
• khatello ea maikutlo
• lerato la lijo tse potlakileng.

Lintlha tsena kaofela li ka baka liphetoho tse amanang le lefutso kapa tsa mpefatsa tsela eo e seng e le teng. Khahlano le nalane ea lintlha tsena, ho thehoa mofuta oa limela tsa astheno. E iponahatsa ka mathata a tsamaiso ea methapo ea kutlo, e ka amang setho se seng le se seng.

Khafetsa mathata a asthenovegetative a fetoha le khatello ea mali, lefu la tsoekere, atherosclerosis. Maemong a joalo ho thata haholo ho utloisisa hore na sesosa e ne e le eng.

Dyslipidemia ho bana

Mathata a metabolite ea lipid a tlalehiloe eseng ho batho ba baholo feela. Li ama bana le bacha. Hangata ba na le dyslipidemia ea mantlha, ke hore, lefa. Maemong a 42%, ho fumanoa mofuta oa 2b. Ka nako e ts'oanang, ha a le lilemo li hlano, ngoana o ba le li-xanthomas, matšoao a ho lematsa ha pelo le mathata a amanang le limela.

Dyslipidemia ea bobeli baneng hangata e bonoa ho li-pathologies tsa seteraeke sa ka mpeng. Mafu a amanang le lefu la duodenum le mala, sebete le manyeme a ka senya botsitso ba lipids 'meleng oa bana. Ho fokotseha ha sebopeho sa li-acid acid ka tlhaho ho tsamaisana le keketseho ea mahloriso a LDL.

Ntle le moo, dyslipidemia e lula e bonoa ho botenya, lefu la tsoekere. Ho na le mefuta e amanang le carbohydrate. Phepo e nepahetseng e nang le phepo e kholo ea lijo tse potlakileng, liswiti, li-muffin, mafura le lijo tse halikiloeng lijong tsa bana, haholo-holo haeba ngoana a sa kenelle lipapaling, o rata ho lula ka pel'a TV kapa ho qeta nako e ngata khomphuteng, ke tsela e tobileng ea ho ba motenya.

Haeba dyslipidemia e fumanoa ho motho e moholo kapa ho ngoana, kalafo ha e na ho ba meriana. Mekhoa ea phekolo e khethoa ke ho se tsotelle ha ts'ebetso, ho ba teng le boemo ba liphetoho tsa atherosselotic, pathologies tse amanang. Mekhoa ea ho theola k'holeseterole e "mpe" maling e ka ba ka tsela e latelang:

• phetoho ea bophelo
• ja
• kalafo ea lithethefatsi
• kalafo ea extracorporeal.

Mokhoa o sa sebeliseng lithethefatsi

Liphetoho tse nyane profil ea lipid, joalo ka molao, ha li hloke phekolo ea lithethefatsi. Ho sebetsana le tsona ho thusa ho ja le ho fetola mekhoa ea bophelo. Ka k'holeseterole e phahameng, u tla tlameha ho tlohela lihlahisoa tsena:

• lijo tse potlakileng
• soseji, pastes, lihlahisoa tse felileng,
• nama e mafura
• mafura a mangata le lihlahisoa tsa lebese,
• lik'habohaedreite tse potlakileng (polokelo ea lebenkele),
• joala

Lijo tsohle tse nang le mafura a liphoofolo ha lia lumelloa, empa oli ea meroho le lijo tsa leoatleng lia lumelloa, ntle le shrimp. Lijo tsa leoatleng li na le mafura a mangata a omega a ka fokotsang boemo ba cholesterol e mpe. Mafura a meroho a fumanoang ka linate le peo ea folaxe a na le thepa e tšoanang. Lihlahisoa tsena li ka jeoa ntle le tšabo - ha li phahamise cholesterol.

Ntle le moo, ka dyslipidemia, ho bohlokoa ho kenyelletsa meroho e ncha kapa e phehiloeng, e phehiloeng, e phehiloeng phepong. Ka mokhoa o loketseng e tlama cholesterol ea fiber e fumanehang ka har'a lekala. Mohloli o motle oa liprotheine ke litlhapi le nama e halikoang:

Leha ho le joalo, ha ua lokela ho ipehela molemong oa ho ja feela. Ho bohlokoa ho nahanisisa ka mokhoa oa bophelo, ho tlohela nicotine (ho tsuba), joala le lijo tse bobebe. Haeba o nonne haholo, o hloka ho sebetsana le ona. Ka lefu la tlhaho le la dyslipidemia, ho hlokahala mojaro o lekaneng, ho bohlokoa ho ikoetlisa khafetsa, empa eseng ho imolla mmele. Lenaneo la liphatsa tsa lefutso le senyehileng le ka ts'oaroa ke ho se latele puso ea mosebetsi le phomolo, ho eketsa khatello ea maikutlo, khatello ea maikutlo khafetsa. Ho bohlokoa ho ela hloko sena ka ho khetheha.

Mekhoa ea Phekolo ea Moetlo

Ha mokhoa o sa amaneng le lithethefatsi o sa lekana - mokuli o ekelitse cholesterol e mpe "haholo", atherosulinosis e hlaha, ho na le matšoao a bonahalang a hypercholesterolemia - o ka se e etse ntle le meriana. Bakeng sa morero ona, lithethefatsi tsa lihlopha tse latelang hangata li fanoa:

• li-statins
• fibrate
• li-sequestrants tsa li-acid acid,
• cholesterol absorption inhibitors,
• omega-3 PUFAs (mafura a polyunsaturated fatty acids),
• nicotinic acid.

Tse laoloang ka ho fetisisa ke li-statins le li-sequestrants tsa bile acid. Lintho tsa pele tse ntlafatsang ho hlohlona ha lipid, li thibela ho hlophisoa ha tsona ka har'a sebete, 'me ka holimo, li ntlafatsa boemo ba methapo e kahare ea methapo ea mali mme li fana ka phello e khahlanong le ho ruruha. Tse sebetsang ka ho fetisisa ke atorvastatin, rosuvastatin, simvastatin, lovastatin.

Haeba lithethefatsi tsa sehlopha sa pele li sa bake ho fokotseha ha "cholesterol" e mpe, ho eketsoa li-acid tse ling. Phekolo e joalo e sebetsa haholo, empa e fana ka litlamorao tse mpe. Li-sequence tsa bile acid ha li ame ka ho toba metabolism ea mafura le tlhahiso ea k'holeseterole. Li bile li-acid tse ka har'a lumen ea mala le ho li tlosa haholo. Sebete ha se arabela sena se qala ho kopanya bile e ncha ka mafolofolo, e jang k'holeseterole. Kahoo boemo ba lipid bona bo fokotseha. Li-sequestrant tse joalo tsa li-acids li sebelisoa:

Haeba boemo ba triglycerides maling bo phahame, ho fanoa ka li-fibrate. Lithethefatsi tsena li eketsa maemo a HDL, a nang le phello ea antiatherogenic. Sehlopha se kenyelletsa clofibrate, cyclofibrate, fenofibrate.

Ka mokhoa o atlehileng theola "cholesterol" e mpe "le li-PUFA tsa omega-3, hammoho le nicotinic acid (niacin) le livithamini tse ling tsa B. Oli ea tlhapi e na le li-acid tse ngata tsa omega. U ka li fumana ka bongata ka ho ja lihlapi tsa metsing.

Lithethefatsi tse ling tsa khetho bakeng sa dyslipidemia ke li-inhibitors tsa cholesterol. Li na le katleho e fokolang, hobane ha li ame tlhahiso ea cholesterol ke 'mele, empa li tlama feela le ho tlosa mafura lijong. Setho feela se lumelletsoeng sa sehlopha ke Ezithimibe.

Leha ho le joalo, ha se lithethefatsi tsohle tsa lihlopha tse boletsoeng ka holimo tse thusang, mme bakuli ba bang (bana, basali baimana) ba ferekantsoe ka ho felletseng. Ebe kalafo ea extracorporeal e hlokahala ho loantsha dyslipidemia. E phethe ka mekhoa e latelang:

• Mali a UFO
• hemosorption
• lisahlehler
• plasmapheresis
• kopanaloke.

Litsela tsena kaofela ke thepa ea letsoho. Li bolela "ts'ebetso" ea mali kantle ho mmele oa mokuli, e etselitsoeng ho sefa, ho senya kapa ho tlama le ho tlosa cholesterol le likaroloana tse ling tsa lipid.

Ho sa natse hore na dyslipidemia e hlaha ka mofuta ofe, ho bohlokoa ho hopola ka thibelo. E tla thusa ho thibela kapa ho lieha le ho fokotsa mohato oa boemo bona ba methapo. Ho bohlokoa ho rala lijo hantle, ho qoba mekhoa e mebe le khatello ea maikutlo, u se ke oa lebala ka thuto ea 'mele.

Ho ja hampe le ho se ikoetlise 'meleng

Tsena ke likarolo tse peli tsa chelete ea tšepe e le 'ngoe.

Ntlha ea Alimentary: bakuli ha ba na nako ea ho ja ka botlalo le ka nepo, ho pheha. Ho sebelisoa lijo tse ka makotikoting, lijo tse potlakileng, lijo tse fumanehang habonolo le lihlahisoa tse ling tse belaetsang tsa "ho pheha" ha indasteri, tse ka se keng tsa bitsoa lijo ka molao.

Kahoo ho ja mafura a mangata 'meleng. Ho feta moo, boleng ba phepo e nyane haholo le palo e kholo ea lipids. Ka hona maikutlo a sa feleng a tlala, tlhoko ea ho pheta lijo.

Lesakana lea koala. Palo e hlahisoang ke mafura e etsa tlhahiso ea matla. Empa ha ho na moo re ka e behang teng, haholo-holo ka ho lula re lutse.

Kahoo phallo ea mali e pharalletseng maling, ebe polokelo e ka bongata.

Ho senya metabolism ea mafura a 'mele

Ntlha ea bobeli ea bohlokoa. E bonahatsoa ke ho se sebetse hantle ha liprotheine tsa lipalangoang tse tsamaisang lipids 'meleng le mathata a ho boloka (deposition).

Lintho tsena tse jereng thepa li bobebe haholo, li hlatsuoa habonolo le ho senyeha, li siea cholesterol morao.

Le ha ho tsamaisoa hantle ha lik'hemik'hale, khahlano le semelo sa ho kenella ka bongata, ho na le mathata ka boemo ba sehlopha sohle sa dintho.

Hangata hona ke ts'ebetso ea lefutso, empa e ka ba teng. Hangata, mathata a joalo a ea ho motho ea nang le lefu la tsoekere, ho se leka-lekane ha li-hormone.

Mehato ena ka bobeli e bapala karolo ea mantlha e le motheo.

Ka mor'a moo, mohato o tsamaea ka sebopeho se le seng.

Lintho tse nang le mafura a mangata li potoloha maling. Lipids li lula marakong a methapo ea methapo. Lokisa 'me u thehe likarolo tse fapaneng. Seo ho thoeng ke li-plaque. Ha se k'holeseterole kamehla. Hona le mefuta e meng e mengata ea motsoako oa mafura.

Ho feta moo, phallo e tloaelehileng ea mali ea ferekana, litho li na le bothata ba ho haella ha oksijene le limatlafatsi. Kahoo mathata a mosebetsi oa bokong, pelo le keketseho ea khatello ea mali.

Likotsi tsa maemo a kotsi, ho kenyelletsa ho otloa ke pelo le ho otloa, li ntse li eketseha haholo.

Tsebo ea mochine oa hlokahala ho utloisisa ts'ebetso ea nts'etsopele. Ntle le sena, ha ho na kalafo ea boleng bo phahameng.

Mefuta ea Dyslepidemia

Re ka khetholla mefuta ea dyslipidemia, e ipapisitse le mekhoa e meraro. Ke ntho ea bohlokoa ho qala ka hore ts'ebetso ea ts'oaetso ea lefu lena e fetoha lebaka.

• Foromo ea mathomo. E fetoha litholoana tsa lefutso le boima. Hape, le haeba ho na le baena ba nang le bothata bo joalo, ka thibelo e nepahetseng, hoa khoneha ho qoba ho pheta-pheta boemo bo seng botle.
• Foromo ea bobeli.e hola joalo ka motho a e fumaneng, khahlano le semelo sa maemo a tloaelehileng, eseng a phahametseng a mang. Mohlala, ka lebaka la lefu la tsoekere, hypothyroidism (mathata le tšoelesa ea qoqotho). Thibelo e beha ntlha kahara taba, leha ho le thata ho utloisisa hore na hobaneng e bile lebaka le ka sehloohong. Mofuta oohle oa tlolo ea molao o bapala karolo.

Morero oa bohlophisi ba bobeli ke hore na nako ke mofuta oa mofuta oa lefu lena le bophelo:

• Pono e khuts'oane kapa e khuts'oane. E tsamaisana le mathata ka nakoana. Kamora ho felisoa ha mafura a mangata, ntho e ngoe le e ngoe e felisoa ka boeona. Ntle le tlhokomelo ea bongaka.
• Mofuta oa kamehla Ho rarahana haholo. Hangata e amana le thupelo ea methapo ea methapo. E hloka kalafo, tšebeliso e matla ea meriana.

Qetellong

Dyslipidemia ke lefu la metabolic. Ka ho khetheha, mefuta e fapaneng ea metabolism ea mafura e utloa bohloko.

Boholo ba liphapang tsena li lebisa ho atherosulinosis, 'me ka eona bo sa sebetse hantle ho li-pathologies tsa pelo, methapo ea mali, bokong le litho tse ling.

Linyeoe tse ts'oeroeng li sokela bokooa bo haufi kapa lefu. Ka hona, o se ke oa hlokomoloha likeletso tsa ka mehla tsa thibelo.

Bonyane hanngoe ka likhoeli tse 6 u hloka ho etela setsebi sa bongaka, ho etsa tlhahlobo ea mali ka kakaretso le biochemistry.

• European Society of Cardiology (EOK) le European Society of Atherosclerosis (EOA) sehlopha se sebetsang mabapi le tlhahlobo le kalafo ea dyslipidemia. Litlhahiso tsa kliniki.
• M.V. Ezhov (Moscow), I.V. Sergienko (Moscow), D.M. Aronov (Moscow), G.G. Arabidze
  (Moscow), N.M. Akhmedzhanov (Moscow), S.S. Bazhan (Novosibirsk). Ho hlahloba le ho lokisa mathata a metabolism ea lipid e le ho thibela le ho phekola lefu la atherosclerosis. Khothaletso ea VI ea ntlafatso ea VI.
• LITLHAKISO TSA BOPHELO BA EUROPEAN OF CARDIOLOGISTS LE EUROPEAN SOCIETY YA ATHEROSCLEROSIS Bakeng sa TLHOLO EA DYSLIPIDEMIA. Rational Pharmacotherapy ho Cardiology 2012, ts'ebeliso ea No.