Uma ukudla okwehlisa i-lipid kungasebenzi ngokwanele, kungabekwa imishanguzo yokuqeda ukwephulwa kwe-metabolism yamafutha emzimbeni. Uma izinga le-cholesterol esegazini liphakama ngaphezu kuka-6.5 mmol / l, khona-ke udokotela angancoma ukwelashwa okukhethekile ukuthi kwehliswe ngaphambi kwalesi sikhathi.
Ukuhlukaniswa okuyinhloko kwezidakamizwa
Okokuqala, izidakamizwa ezokwehlisa i-lipid kufanele ziphawulwe. Lokhu kufaka phakathi:
- imicu;
- ama-statin
- i-anion eshintshanisa nezidakamizwa nama-resins anciphisa ukumuncwa kwe-cholesterol emathunjini;
- i-nicotinic acid;
- iprucucol.
Ngokusetshenziselwa indlela yokusebenza, le mishanguzo ingahlukaniswa ngamaqoqo amancane:
- izidakamizwa ezivimbela ukukhiqizwa kwe-cholesterol ephansi kwabantu (ibizwa futhi ngokuthi yimbi): ama-statin, i-fibrate, i-nicotinic acid, i-phenucol, i -husflavin;
- ama-ejenti anganciphisa ukumuncwa kwe-cholesterol: ama-guar, ama-sequestriers ama-bile acid;
- abalungisi be-metabolism yamafutha abakhulisa i-cholesterol ephezulu-density: lipostabil, okubalulekile.
Izikhathi zokuhlukaniswa kwama-bile acid
Imithi i-bile bile acid evame ukubizwa ngayo njenge-anion exchange resins. Lapho nje le mishanguzo ingena emathunjini, ama-acid ayathunjwa bese kuthi kamuva akhishwe emzimbeni.
Lesi sakamuva siphendula le nqubo ngokudidiyela ukwakheka kwama-asidi amasha asezitolo ezikhona ze-cholesterol. I-cholesterol ithathwa egazini, esiza ekunciphiseni.
Umkhakha wemithi unikeza izidakamizwa ze-cholestyramine eziyimpuphu, kanye ne-colestipol, ukwehlisa i-cholesterol yegazi. Zingasetshenziswa kwimithamo ye-2-4, ngokufakwa okuyisibopho kokuphoqelelwa ngamanzi.
Ama-resion anion-exchange awakwazi ukudonswa egazini futhi "asebenze" kuphela ku-lumen yamathumbu. Ngenxa yalokhu, umuthi awukwazi ukuba nomthelela omubi emzimbeni.
Imiphumela emibi ingafaka:
- ukuqhakaza;
- isicanucanu
- ukuqunjelwa.
Uma ama-sequestrants of bile acid esetshenziswe emithamo emikhulu isikhathi eside, khona-ke kulokhu kungenzeka ukuthi kube nokwephulwa kokufakwa kwamanye amavithamini, kanye ne-bile acid.
Izidakamizwa ezikuleli qembu zinciphisa ukuqoqwa okubizwa ngokuthi yi-cholesterol emibi, futhi ukuba khona kwe-triglycerides egazini kuhlala kusezingeni elifanayo.
Ama-suppressants e-Cholesterol Absorption
Ngenxa yokufakwa kancane kancane kwe-cholesterol ekudleni, leli qembu lezidakamizwa linganciphisa ukuqina kwalo. Okusebenzayo kakhulu kuzoba yigiya. Lesi sengezo esinomsoco siphephile ngokuphelele futhi sisuselwa kwimbewu kabhontshisi we-hyacinth. Ukwakheka komkhiqizo kufaka i-polysaccharide, ethi, lapho ihlangana noketshezi iphenduke ijeli.
IGuarem ikwazi ukukhipha ngamamolekyuli i-cholesterol ezindongeni zamathumbu. Ngaphezu kwalokho, isidakamizwa:
- kusheshisa ukukhishwa kwe-bile acid;
- isifiso sokudla;
- kusiza ukwehlisa inani lokudla okudliwayo.
Lo mcindezeli wokumunca usefomeni yama-granules ukuze angezwe esiphuzweni. Ukusetshenziswa kwesidakamizwa kungahlanganiswa kalula nezinye izindlela.
Ngesikhathi sokusebenzisa, imiphumela emibi nayo iyenzeka, ngokwesibonelo, ukuncipha kwesitulo, izinhlungu emathunjini, isicanucanu nokuqhakaza. Lezi zimpawu zincane futhi kuyaqabukela zenzeka. Ngisho noma kungekho ukwelashwa, zidlula ngokushesha, ngenkathi kunokuncipha okuhleliwe kwe-cholesterol yegazi.
I-Nicotinic Acid
I-Nicotinic acid nakho konke okususelwa kulo, isibonelo:
- i-acipimox
- niceritrol
- i-enduracin
empeleni, amavithamini a-B. Le mishanguzo inciphisa i-cholesterol ephansi futhi ibuye isebenze uhlelo lwe-fibrinolysis, olusiza ekunciphiseni amathuba okuba ne-thrombosis. Izindlela zingcono kunezinye izidakamizwa ezokwehlisa i-lipid ezikhulisa okuqukethwe kwe-cholesterol enhle egazini lesiguli.
Ukwelapha nge-nicotinic acid kuthatha isikhathi eside ngokwenyuka okuphoqelekile komthamo. Ngemuva kokuthatha amalungiselelo, ngaphambi kwalokho kufanele ungaphuzi iziphuzo ezishisayo, ikakhulukazi ikhofi yemvelo.
INiacin ingacasulisa izindonga zesisu, okungafaki ukusetshenziswa kwayo ezimweni zezilonda kanye ne-gastritis. Inani elikhulu leziguli, ubomvu bobuso bungabonakala ekuqaleni kokulashwa, noma kunjalo, lesi sibonakaliso siyanyamalala ngokuhamba kwesikhathi. Ukuvimbela ubomvu, udinga ukuphuza ama-255 mg we-aspirin isigamu sehora ngaphambi kokusebenzisa umuthi.
I-contraindication eyinhloko kwi-nicotinic acid ifaka:
- i-hepatitis engamahlalakhona;
- gout
- ukuphazamiseka kwesigqi senhliziyo.
Kukhona umuthi ongadala inani elincane lemiphumela emibi futhi uqhubeke isikhathi eside - lena yi-enduracin.
I-probucol
I-probucol ayithinti i-triglycerides, kodwa futhi ilungisa ibhalansi ye-cholesterol enhle nokubi egazini. Amathebhulethi avimbela ukubonwa kwamafutha futhi abonise umphumela obizwa ngokuthi yi-anti-atherosulinotic, othinta ukwehla kwe-cholesterol yegazi.
Umphumela wokwelashwa nge-Probucol ungatholakala ngemuva kwezinyanga ezi-2 futhi ungahlala ufike ezinyangeni ezi-6 ngemuva kokuqedwa kokusetshenziswa kwawo. Ithuluzi lingahlanganiswa ngokuphelele nezinye izidakamizwa ezisehlisa i-cholesterol.
Ngesikhathi sokwelashwa, kungandiswa isikhathi sokushaya kwenhliziyo nokuthuthukiswa kwethambo yethambo inhliziyo kungaphawulwa. Ukuvimbela lesi simo, kuyadingeka ukuthi ungene ngaphansi kwe-electrocardiogram okungenani isikhathi esingu-1 ezinyangeni ezi-6.
I-probucol ayikwazi ukubekwa ngasikhathi sinye ne-cordarone.
Imiphumela emibi emzimbeni ifaka phakathi ubuhlungu besisu, isicanucanu kanye nohudo.
Umuthi akufanele uphathwe nalokhu:
- i-ventricular arrhythmias;
- iziqephu ezivame kakhulu ze-myocardial ischemia;
- amazinga aphansi we-HDL.
Izicucu
Ama-figrate angabhekana ngokufanele nezinga lama-triglycerides, kanye nokuhlushwa kwe-LDL ne-VLDL. Zingasetshenziswa nge-hypertriglyceridemia ebalulekile. Okudume kakhulu kungabizwa ngokuthi amaphilisi anjalo:
- gemfibrozil (lopid, gevilon);
- fenofibrate (Tipantil 200 M, Tricor, Exlip);
- i-cyprofibrate (lipanor);
- choline fenofibrate (trilipix).
Imiphumela emibi yokuphuza ibangelwa wubuhlungu emisipha, isicanucanu kanye nobuhlungu emgodini wesisu. Amafiga angakhuphula ukuvela kwamatshe wezinso kanye nesinye. Akuvamile, ukuvimbela kwe-hematopoiesis kungabhekwa.
Le mishanguzo ayinakubekelwa izifo zezinso, isifo se-gall kanye nezinkinga zegazi.
Izimo
Izimo ngamaphilisi okwehlisa cholesterol ephumelela kakhulu. Bayakwazi ukuvimba i-enzyme ekhethekile ephendula ekukhiqizweni kwento efana namafutha esibindini, kuyilapho kunciphisa ukuqina kwayo egazini. Ngasikhathi sinye, inani lama-receptors e-LDL liyanda, okunikeza umfutho ekukhishweni okusheshayo kwe-cholesterol ephansi.
Njengomthetho, izidakamizwa ezilandelayo zinqunyelwe:
- i-simvastatin (vasilip, chakor, aries, simvageksal, simvakard, simvakor, simvastatin, simvastol, simvor, simlo, sincard, holvasim);
- i-lovastatin (i-cardiostatin, i-choletar);
- pravastatin;
- i-atorvastatin (anvistat, atocor, atomax, ator, atorvox, atoris, vazator, lipoford, lypimar, liptonorm, novostat, torvazin, torvakard, tulip);
- i-rosuvastatin (akorta, isiphambano, i-mertenyl, i-rosart, i-rosistark, i-rosucard, i-rosulip, i-roxer, i-rustor, i-tevastor);
- i-pitavastatin (livazo);
- i-fluvastatin (leskol).
I-Simvastatin, kanye ne-lovastatin, zenziwe ngesikhunta. Izidakamizwa ezifanayo zamathebulethi e-cholesterol ephezulu ziphenduka kuma-metabolites asebenzayo. I-Pravastatin ingukutholwa okuyisikhunta ngokwayo okwinto ebonakalayo.
Amanani anganconywa kanye njalo ebusuku. Le ndlela yokwelashwa ichazwa iqiniso lokuthi inani eliphakeme kakhulu lokwakheka kwe-cholesterol yegazi kwenzeka ebusuku. Ngokuhamba kwesikhathi, umthamo wama-statins ungakhushulwa, futhi ukusebenza kwawo kuzotholakala ngemuva kwezinsuku ezimbalwa zokuqala zokuphatha, kufinyelele esiphezulu kungakapheli inyanga.
Ama-Statins aphephile ngokwanele kubantu, kepha kubaluleke kakhulu ukuthi ungasebenzisi imithamo emikhulu, ikakhulukazi ngama-fibrate, egcwele izinkinga zesibindi.
Ezinye iziguli zingaba nobuthakathaka bemisipha nobuhlungu emzimbeni. Kwezinye izimo, ubuhlungu besisu, ukuqunjelwa, isicanucanu, kanye nokuphelelwa ngokuphelele kokudla, ukuqwasha nokuqaqanjelwa kwekhanda kuyaphawulwa.
Le mishanguzo yokunciphisa i-cholesterol ayikwazi ukuthinta i-carbohydrate ne-purine metabolism, evumela ukuthi isetshenziselwe ama-degree ahlukahlukene okukhuluphala, i-gout nesifo sikashukela. Qaphela ukuthi uma i-cholesterol ephezulu ibonwa ngesikhathi sokukhulelwa, kubalulekile ukubonana nodokotela ngomuthi.
Uma sicabangela ama-regical regimens ekwelapha, ama-statins angaxhunyaniswa ekwelapheni i-atherossteosis njenge-monotherapy noma kanye nezinye izidakamizwa.
I-Pharmacology inikeza ukuhlanganiswa okwenziwe ngomumo okusekwe ku:
- i-lovastatin ne-nicotinic acid;
- ezetimibe ne-simvastatin;
- pravastatin ne-fenofibrate;
- rosuvastatin kanye ezetimibe.
Ukuhlukahluka kwama-statins ne-acetylsalicylic acid, i-atorvastatin ne-amlodipine kungakhishwa.
Ukusetshenziswa kwezidakamizwa ezenziwe ngomumo akuyona inzuzo engaphezulu kuphela ngokulondolozwa kwemali, kepha futhi kudala inani eliphansi lemiphumela emibi.
