Zonke izifo zinokuvama okuthile kokusakazeka. Izifo nokulimala kwesithathu kungokwesithathu, izifo ezinobungozi zisengokwesibili, kanti izifo zesifo senhliziyo zithathwa.
Kubandakanya infarction ebabazekayo myocardial; ischemic kanye ne-hemorrhagic stroke; i-vein thrombosis ejulile yemikhawulo ephansi; isifo sokuqina kwemizwa. Lolu akulona uhlu oluphelele lwezifo, kuphela ezivame kakhulu. Zonke ziba yingozi empilweni yabantu nasempilweni.
Kungakho ukukhiqizwa kwezidakamizwa ekwelapheni izifo zenhliziyo nezemithambo kunevolumu ebanzi kangaka, futhi cishe zonke izinkampani ezenza imithi zin okungenani nomuthi owodwa wale mphumela.
Izimbangela Zokugula Kwenhliziyo
Izifo ze-Coronary zivela ngezizathu ezahlukahlukene. Kunezici ezingeke ziguqulwe - ubulili, ubudala, nefa. Futhi kukhona izingozi ezingashintshwa ukuvimba ukuthuthukiswa kwe-pathology.
Izici zokulungiswa zibandakanya:
- Ukubhema - izinsalela zekotini zinobuthi obukhulu emzimbeni womuntu. Lapho bengena egazini ngenethiwekhi eminyene ye-alveolar, bahlala ku-intima yemikhumbi, bangene odongeni, bahlanganiswe ngaphakathi kolwelwesi lweseli, olwenza ukuba liklebhule kanye nama-microcracks. Amapulatifomu, avala isici, ngenkathi kugqamiswa izici zokuqubuka, athambekele kulokhu kulimala. Ngemuva kwalokho ama-lipids anamathiselwe kule ndawo, ahlangana kancane kancane futhi anciphise i-lumen. Ngakho-ke iqala isifo sokuqina kwemithambo yegazi, iholela ekuthuthukisweni kwesifo senhliziyo futhi, kamuva, ekuhohlisweni kwe-myocardial;
- Ukhuluphele. Amafutha atholakala ngesikhathi sokungondleki kahle asatshalaliswa ngokungalingani, okokuqala egxila ezungeze izitho zomzimba. Ngenxa yalokhu, umsebenzi wabo uyaphazamiseka, inhliziyo nemikhumbi emikhulu iyahlupheka. Kubalulekile futhi ukuqaphela ukuthi ngokukhuluphala, izinga lama-lipoproteins asezingeni eliphakeme liyenyuka futhi nezinga lokuphakama kwezifo lipoprotein liyancipha, okufaka isandla ekubonakalweni kwalesi sifo;
- I-Hypodynamia - kuholela ebuthakathakeni bemisipha obungasekeli ithoni ye-vascular, obangela ukuba i-intima ibe buthaka futhi i-atrophy. Lokhu kuholela ezimpondweni ezindongeni zemithambo yegazi;
- Ukudakwa ngokweqile - kuholela ekudakweni komzimba okujwayelekile, kuthinte imithambo yegazi futhi konakalise i-hepatocytes. Kunomphumela ku-vena cava, isikejana esikhulu se-hepatic. Ubuthi buthelela odongeni lwezicubu zomkhumbi, bunciphise bube buthaka.
Ngaphansi kwethonya lezi zinto eziyingozi kubantu, kanye nengcindezi, ukukhathala okungapheli kanye nezifo ezihambisanayo, i-atherosulinosis iba khona - isixhumanisi sokuqala kwezifo ze-coronary.
Ngalo, ama-plaque akha odongeni lwemithambo yegazi evela ku-cholesterol, lapho inqubo yokukhula ivimba ukugeleza kwegazi.
Izindlela Zokwelapha i-Atherossteosis
Lesi sifo siyinkinga yangempela, njengoba bonke abantu besithathu bekhula ngemuva kweminyaka engama-50. Kungakho zonke izinkampani ezenza amakhambi ezemithi zigxile ekwakheni umuthi obhekiswe kwi-atherossteosis.
Kodwa-ke, indlela yokuqala yokuvikela isetshenziswa ngokuyinhloko. Ukwanda kokusebenza komzimba, okungenani kuze kube yihora ngosuku (okungaba yizinto zokushaja noma ezifudumele, noma ukuhamba ngezinyawo noma ukuhamba emoyeni omusha), kunciphisa ukuthuthukiswa kwe-atherossteosis ngo-40%. Uma ushintsha ukudla futhi ungeza kukho, ngaphezu kwenyama, okusanhlamvu, izithelo nemifino, khona-ke ingozi izokwehla ngomunye u-10%. Ukuyeka ukubhema kuthatha ingxenye yeshumi yengozi.
Uma zonke lezi zinyathelo zingaphumelelanga, imithi ifakwa enkambweni yokwelashwa. Izidakamizwa zesimanje zokwehlisa i-lipid ezinomphumela obonakalisiwe zasungulwa eminyakeni engamashumi amathathu kuphela edlule, ngaphambi kokuba lokhu kwelashwa kwenziwe ngamahomoni ocansi abesimame - ama-estrogens, i-nicotinic acid, abalandeli be-asidi bamafutha. Bakhombise umphumela odumazayo - ukushona kwabantu ezifweni ezi-coronary kukhuphuke kakhulu.
Ngo-1985, inkampani yezokwelapha yaseJalimane i-Pfizer yamela umuthi omusha - i-Atorvastatin. Ngokusekelwe kuyo, ngokungezwa kwamakhompiyutha asizayo, umuthi wokuqala onomphumela ofanayo we-anticholesterolemic, i-Liprimar, wenziwa. Uvimbe ukuphindwa kabusha kwe-enzyme HMG-CoA, waphazamisa inqubo yokuqanjwa kwe-cholesterol esibindini lapho kwenzeka ukwakhiwa kwe-cholesterol preursor - mevalonate.
Esifundweni esenziwe ngokungahleliwe, esiyimpumputhe, umphumela wemitholampilo we-atorvastatin wembuliwe. Ngenxa yalokhu, kutholakale ukwehla kwezinga lama-lipoprotein aphansi ukuya kuma-40%.
Uma iziguli zine-hypertension ye-arterial, i-Atorvastatin ngethamo lama-milligrams angama-5 kuye kwangama-20 iminyaka emithathu ye-monotherapy inciphisa ingozi yokuhlaselwa i-myocardial infarction ngo-35%.
Imiyalo yokusebenzisa umuthi i-Liprimar
I-Liprimar inemiyalo eningiliziwe yokusetshenziswa.
Ngaphambi kokusebenzisa lesi sidakamizwa ukunciphisa inani lama-lipids eplasma yegazi, kufanele uthintane nodokotela wakho njalo.
Zonke izinkomba zokusetshenziswa kwomuthi zikhonjisiwe kwimiyalo yokusebenzisa umuthi:
Izinkomba eziphambili zingokulandelayo:
- ukuba khona kwe-hypertension ye-arterial kwiziguli - ukwanda kwezibalo zokucindezela kusuka ku-160/1100 mm Hg futhi phezulu;
- i-angina pectoris, isigaba sesithathu sokusebenza;
- i-myocardial infarction ekuxolelweni;
- ilula (ikhuphukile i-LDL), ixubekile (ikhuphukile i-LDL ne-VLDL) noma i-Famer (i-ilifa, i-malignant) hypercholesterolemia engaphezu kwe-6 mmol / l, engamiswa ukumiswa kwendlela yokuphila;
- isifo sokuqina kwemizwa.
Ngokuhambisana nokwelashwa ngomuthi, kufanele unamathele ekudleni, ukuzivocavoca futhi unikeze imikhuba emibi.
Thatha ngomlomo ngaphandle kokuphula noma ukuhlafuna ithebhulethi. Phuza amanzi amaningi. Umthamo wokuthoma we-hypercholesterolemia ekuqaleni otholakele ngu-10 mg ngosuku, ngemuva kwenyanga yokuqapha amandla we-therapy, umthamo uguqulwa uye phezulu, uma kunesidingo. Nge-hypercholesterolemia yomndeni, umthamo mkhulu kakhulu, futhi ngu-40-80 mg. Izingane zinconywa kuphela ama-10 mg ngosuku.
Umthamo omkhulu ngosuku lomuntu omdala ngu-80 mg. Ngesikhathi sokwelashwa, kuyadingeka ukuthi kulawulwe ama-enzyme wesibindi, uma edlula ngaphezulu kwezikhathi ezi-3, i-Liprimar ikhanseliwe.
Kunemiphumela emibi eminingana evela ekusebenziseni umuthi, okusemqoka yile elandelayo:
- I-Neuropathy, ukuphazamiseka kokulala, ikhanda, i-paresthesias.
- Ubuhlungu bemisipha, ukusonta, i-myositis.
- Ukwehla kwesifiso sokudla, isicanucanu, ukhuphuka kwegesi, isifo sohudo, ukuvuvukala kwamanyikwe.
- Ukuvuvukala kwesibindi, i-jaundice, ukuqina kwe-bile.
- Ukungezwani komzimba, i-urticaria.
I-Liprimar ine-contraindication ezimbalwa, eyinhloko ukungabekezeleli i-lactose noma into esebenzayo ye-atorvastatin. Sebenzisa ngokuqapha ezigulini ezinezifo zesibindi nezinso, izingane ezingaphansi kweminyaka engu-14 ubudala, nabesifazane abakhubazekile.
Ngesikhathi sokukhulelwa, umuthi awunconywa.
Umehluko phakathi kwezangempela nezokususwayo
I-Liprimar akuyona ukuphela kwesidakamizwa esiqhamuka kuma-statin amaningi, yize, ngokungangabazeki, ngokwezifundo zomtholampilo, ingenye ehamba phambili. Phakathi kuka-1985 no-2005, ngenkathi ukuvikela obunikazi bekusebenza, wayehlala yedwa. Kodwa-ke ifomula yakhe yaqala ukutholakala emphakathini, kwavela ukuvela kwezimpawu zokufanekisa, okubizwa ngokuthi ama-generics. Zonke zinefomula ejwayelekile ne-Atorvastatin, futhi, ngokwezifiso, kufanele zibe nomphumela ofanayo wokwelapha.
Kodwa-ke, ngenxa yokwethembeka kwemithetho yamazwe amaningi emkhakheni wokuhlolwa kwezokwelapha, okuwukuphela kwento ehlangene nabasekuqaleni ukwakheka. Ngokusho kwemibhalo evunyelwe ngokujwayelekile, ukuze udale igama elisha lokuhweba, udinga kuphela ukuthumela idokhumenti yokulingana kwamakhemikhali ekhomishini. Kepha inkinga ukuthi indlela yokuthola le nto kungenzeka yenziwe lula, futhi lokhu kuzoholela ekuguqukeni kwezakhiwo. Lokhu kusho ukuthi umphumela wokwelapha uzokwehla, noma ube omncane.
Okwamanje, ama-generator weLiprimar anamagama angaphezu kuka-30 okuhweba, wonke ane-atorvastatin njengento esebenzayo. Okuthandwa kakhulu kuzo yi-Atorvastatin (eyenziwe ngesiRussia) ne-Atoris (umkhiqizi - iSlovenia). Bobabili bathengisa kahle emakhemisi, kepha kunomehluko phakathi kwabo.
Umehluko wokuqala ungabonakala e-ekhemisi - lokhu inani lentengo elilinganayo le-10 mg:
- I-Liprimar - izingcezu eziyi-100 - ama-ruble ayi-1800;
- I-Atoris - izingcezu ezingama-90 - ama-ruble ayi-615;
- I-Atorvastatin - izingcezu ezingama-90 - ama-ruble angama-380.
Umbuzo uphakama, kungani intengo ihluke kangaka futhi ingathathelwa indawo kanjani i-Atorvastatin U-Liprimar wenze ucwaningo oluphelele lwezemitholampilo, wathola igunya lobunikazi, futhi kwathatha izinsiza kusebenza eziningi ukukhiqiza nokukhangisa. Ngakho-ke, inkampani ibeka inani eliphakeme kangako njengokukhokhwa kwekhwalithi ethembekile, ehlolwe phakathi kweminyaka eyishumi yokuhlolwa.
I-Atoris, ekhiqizwe eSlovenia, yathola isifundo seminyaka emithathu esiyimpumputhe, lapho kwafakazelwa khona ukuthi yehlisa ama-lipoprotein aphansi ngamaphesenti ama-5% kunaphansi koqobo, kodwa umphumela wayo wokwelapha awungabazi futhi ungasetshenziswa ngempela njenge-analogue yeLiprimar.
I-Domestic Atorvastatin ayidlulanga kuzo zonke izigaba zokuhlolwa kwempilo, futhi kwafana nokuqinisekiswa kwamakhemikhali kuphela, ngakho kushibhile kakhulu. Kodwa-ke, umphumela wawo emzimbeni awaziwa ngokuqinisekile, usebenza ngokukhetha, okungukuthi, ungasiza umuntu oyedwa futhi alimaze omunye. Kuthengwa ngabantu abangakwazi ukuthenga umuthi ongenisiwe.
Umphumela wezidakamizwa ungahlolwa ngemuva kokuphathwa. Kodwa-ke, ukuze uzuze umphumela, i-Liprimar idinga ukuthathwa amasonto amabili kuphela, i-Atoris emithathu, ne-Atorvastatin izifundo zezinyanga ezimbili. Lokhu kungadala ukulimala kwesibindi.
Ukuvimbela lokhu kungenzeki, kunconywa ukuthatha i-hepatoprotectors kadokotela ngokufana.
Ungawahlanganisa kanjani ama-statins?
Ngaphezu kokutholakala kwe-atorvastatin, kunezinye izinto ezisebenzayo emakethe yezokwelapha esetshenziselwa i-atherossteosis. Lokhu kuthathwe kwe-losartan, i-angiotensin 2 inhibitor, ngokwesibonelo, isidakamizwa i-Lozap. Isenzo saso esikhulu asihloselwe ukulwa ne-cholesterol ye-LDL, kepha ekwehliseni ingcindezi, ngakho-ke kuvame ukusetshenziswa kanye nemibhede ekwelashweni okuhlanganisiwe. Kodwa-ke, iLozap inomphumela kuma-hepatocytes, ngakho-ke abantu abanezimpawu zokuhluleka kwesibindi kufanele babonane nodokotela ngaphambi kokuqala ukwelashwa. Imiphumela emihle nokho ehlanganiswe nama-statins ikhonjiswa ngabakhi besiteshi se-calcium, ngokwesibonelo, i-Amlodipine.
Endabeni yokusabela okwenziwa yi-Liprimar, kuyadingeka ukusebenzisa ama-analog kanye nokubambela i-atorvastatin. Lezi yi-rosuvastatin ne-simvastatin. Bona, njengamanye ama-statins, womabili athinta izinga le-enzyme ye-HMG-CoA reductase futhi ane-pharmacodynamics efanayo.
Kodwa-ke, ekucwaningeni kutholakale ukuthi iRosuvastatin ine-nephrotooticity, okungukuthi, ingathinta i-renal parenchyma, isongela ukuthuthukiswa kokuhluleka kwe-renal.
I-Simvastatin yehlisa izinga lamazinga aphansi we-lipoproteins ngo-9% ngaphansi kweLiprimar, okubonisa ukusebenza kwayo okuphansi. Lokhu kusho ukuthi uLiprimar ubelokhu futhi ehola phambili emakethe yokuthengisa eqenjini lama-statins, okuqinisekiswa hhayi ngemiphumela yocwaningo kuphela kanye nolwazi oluningi lweminyaka yokulisebenzisa odokotela ekwelapheni i-atherossteosis, kodwa nangempendulo enhle evela ezigulini.
I-Atorvastatin ichazwe kuvidiyo kule ndatshana.
