Ngokwezibalo zezokwelapha, ezigulini ezinezifo zenhliziyo ezi-coronary kanye nesifo sikashukela, iphesenti lokufa kwabantu elivela emiphumeleni yesifo senhliziyo liyefana.
Isifo sikashukela singanciphisa ubungozi bezinkinga ezisongela impilo ze-atherosulinosis - angina pectoris, infarction myocardial, coronary die, ischemic stroke.
Zisetshenziswa noma kukhona imiphumela emibi emibi.
Izinzuzo Zokusebenzisa Izitatimende
Ngaphezu kokuqondisa isenzo se-hypolipidemic, ama-statin anama-pleiotropy - amandla okubangela inqubo ye-biochemical futhi isebenze kwizitho ezahlukahlukene ezihlosiwe.
Ukuhlobana kokusebenzisa ama-statins kuhlobo lwe-mellitus yesifo sikashukela I no II kunqunywa ikakhulu ngumphumela wawo ku-cholesterol ne-triglycerides, kwinqubo yokuvuvukala kanye nomsebenzi we-endothelium (choroid yangaphakathi):
- Sebenzisa ngempumelelo i-cholesterol ye-plasma. Ama-Statins awanawo umthelela oqondile kuwo (ekubhujisweni nasekuqothulweni komzimba), kepha anqanda umsebenzi oyimfihlo wesibindi, ovimbela ukukhiqizwa kwe-enzyme ethintekayo ekwakhiweni kwalokhu. Ukusetshenziswa okuhlala isikhathi eside kwemithamo yokwelapha yama-statins kukuvumela ukuthi wehlise inkomba ye-cholesterol ngo-45-50% kusuka ezingeni lokuqala eliphakeme.
- Yenza ngokwejwayelekile ukusebenza kwengqimba engaphakathi yemithambo yegazi, khuphula amandla e-vasodilation (khuphula amandla okukhanya esitsheni) ukwenza ukuhamba kwegazi futhi kuvikele i-ischemia.
Ama-Statins anconywe kakade esigabeni sokuqala sesi sifo, lapho ukuxilongwa kwethambo le-atherosulinosis kungakenzeki, kepha kunokungasebenzi kahle kwendawo. - Izici zokuthonya kokuvuvukala futhi kwehlise ukusebenza komunye wamamaki wayo - i-CRP (protein-C-protein). Ukuqapheleka kwezifo eziningi ngezifo kusivumela ukuthi sisungule ubudlelwane benkomba ephezulu ye-CRP kanye nengozi yezinkinga ezi-coronary. Izifundo ezigulini eziyi-1200 ezazithatha ama-statins wesizukulwane sesine ziye zakhombisa ukwehla kwe-CRP ngo-15% ngasekupheleni kwenyanga yesine yokwelashwa. Isidingo sama-statins sivele lapho i-mellitus yesifo sikashukela ihlanganiswa nokwenyuka kwamazinga we-plasma amaprotheni e-C asebenza ngaphezulu kwe-1 milligram nge-desilita ngayinye. Ukusetshenziswa kwabo kuboniswa noma ngabe kungekho ukubonakaliswa kwe-ischemic emisipha yenhliziyo.
- Leli khono libaluleke kakhulu kwiziguli ezinesifo sikashukela i-mellitus, zombili izinhlobo ezincike kuma-insulin nezingatheni i-insulin, lapho kuthinteka khona imithambo yegazi kanye nengozi yokuthola ama-pathologies angathi sína: i-angiopathy yesifo sikashukela, ukumamatheka kwe-myocardial, isifo sohlangothi.
Ukusetshenziswa kwesikhathi eside kwama-statins kunganciphisa ubungozi bezinkinga zamathambo ngengxenye yesithathu. - Umphumela we-heestasis ubonakala ngokuncipha kokubonakala kwegazi nokwenza lula ukunyakaza kwalo eceleni kombhede we-vascular, ukuvimbela i-ischemia (ukungondleki kwezicubu). Izimo zivimba ukwakheka kwezigaba zegazi nokunamathela kwazo ezigcotsheni ze-atherosulinotic.
Umphumela kushukela wegazi
Eminye yemiphumela emibi yokwelashwa ngezidakamizwa ze-statin ukwanda okusesilinganisweni kwe-glucose yegazi ngamayunithi angama-1-2 (mmol / l).
Kukho konke ukwelashwa, ukuphathwa kwamapharamitha we-carbohydrate kuyimpoqo.
Izinqubo eziholela ekunyukeni kwenkomba kashukela azifundwanga, kepha ucwaningo selukhombisile ukuthi ukusetshenziswa isikhathi eside kwama-statin emithanjeni yokwelapha ngo-6-9% kwandisa ubungozi bokuthola isifo sikashukela esingaxhamli nge-insulin (uhlobo II).
Endabeni yesifo esivele sikhona, ukuguqulelwa kwayo kwifomu elibolile kungenzeka, lapho isilinganiso se-glucose egazini sidinga ukulungiswa okungeziwe kusetshenziswa ukudla okuqinile kwe-carb ephansi kanye nokwenyuka komthamo wemithi enciphisa ushukela.
Kodwa-ke, ngokusho kwabenhliziyo nama-endocrinologists, izinzuzo zokuthatha ama-statins ezinesifo sikashukela sazo zombili izinhlobo zokuqala nezesibili zedlula kakhulu ubungozi obukhona bemiphumela emibi esekude.
Ama-statins angaba yingozi kanjani?
Izidakamizwa ezokwehlisa i-cholesterol, ziveze imiphumela emibi, zidinga ukubhekwa kwezokwelapha futhi azilungele ukuzelapha.
Izidakamizwa ze-Hypolipidemic zaleli qembu zinikeza imiphumela yazo ngokusetshenziswa isikhathi eside, kulokhu, imiphumela emibi yezidakamizwa ingatholakala kuphela ngemuva kwesikhathi esithile.
Imiphumela emibi yezidakamizwa isebenza kuzo zonke izitho nezinhlelo:
- IHepatotoxicity yama-statins ivezwa ekubhujisweni kwamaseli, ukwephulwa kwesakhiwo nomsebenzi wesibindi. Naphezu kwekhono lamaseli wesibindi ukuvela kabusha, umthwalo esihlangwini uthandeka.
Ukuqashwa njalo kwama-transaminases wesibindi i-ALT ne-AST, kanye nengqikithi (eqondile futhi eboshiwe) bilirubin, kuyadingeka ukuhlola umsebenzi wesitho. - Izicubu zemisipha zibuye zithonywe ama-statins, anamandla okuqothula amaseli emisipha (ama-myocyte) ngokukhishwa kwe-lactic acid.
Kuboniswa ukuqina kwemisipha, ukukhumbuza imiphumela yokuzivocavoca okukhulu komzimba. Njengomthetho, ushintsho esakhiweni semisipha yemisipha alunaliseki futhi ngemuva kokuhoxiswa kwezidakamizwa kubuyela kokujwayelekile. Kodwa-ke, ezimweni ezine kwayinkulungwane, i-pathology ithatha ifomu elibucayi futhi isongela ukuthuthukiswa kwe-rhabdomyolysis - ukufa okukhulu kwama-myocyte, ubuthi ngemikhiqizo yokubola kanye nokulimala kwezinso ngokuqina kokuhluleka kokuqina kwe-renal. Isimo somngcele, sidinga ukuvuselelwa kabusha. Ingozi yokuthuthukisa i-myopathies - ubuhlungu bemisipha kanye nama-cramps - inyuka ngokusetshenziswa okuhlanganisiwe kwama-statin nezidakamizwa zehypertension, isifo sikashukela noma i-gout.
Ukuhlolwa kwegazi njalo kuyadingeka kwi-CPK (i-creatine phosphokinase) - inkomba ye-myocyte necrosis - ukuhlola isimo sohlelo lwemisipha. - Ushintsho ngaphansi kwesenzo sama-statins wezinto zamakhemikhali nezomzimba zamanzi we-synovial ngaphakathi kwamalunga kungaholela ezinqubweni ze-pathological kanye nokuthuthukiswa kwe-arthrosis, ikakhulukazi enkulu - i-hip, idolo, ihlombe.
- Ukubonakaliswa kohlelo lokugaya ukudla kungabonakala ngokuphazamiseka kwengqondo, ukudangala, isifiso sokudla, nobuhlungu besisu.
- Uhlelo lwezinzwa oluphakathi nolweqile futhi lungaphendula ekusetshenzisweni kwama-statin ngokubonakaliswa okuhlukahlukene: ukuphazamiseka kokulala, ikhanda, izimo ze-asthenic, ukubalwa kwemizwelo, imizwa yokulimala kanye nomsebenzi wezimoto.
Ngokusho kocwaningo lomtholampilo, imvamisa yemiphumela ngayinye evela ohlelweni lwezinzwa ingaphezu kwe-2%. - Isistimu ye-coronary kumaphesenti elilodwa nohhafu wamacala ukwelashwa kwe-statin ingaphendula ngokuncipha kwengcindezi yegazi ngenxa yokwanda kwemithambo ye-peripheral, umuzwa wokushaya kwenhliziyo, i-arrhythmia, ne-migraine ngenxa yokushintsha kwephimbo lemithambo yegazi yobuchopho.
Isimo sijwayelekile njengoba umzimba ujwayela umbuso omusha wokuhlinzekwa kwegazi lezicubu. Kwesinye isikhathi ukuncishiswa komthamo kuyadingeka.
Izimo nesifo sikashukela: ukuhambisana kanye nenzuzo
Ama-endocrinologists anombono wokuthi ama-statins ukuphela kweqembu lezidakamizwa elehlisa i-lipid isenzo salo sihlose ukuthuthukisa ikhwalithi yempilo yeziguli ezingena-insulin-based (uhlobo II) isifo sikashukela esingaxinekile.
Labo abahlushwa yile ndlela yalesi sifo banengozi ephindwe kabili yokulimala kwe-ischemic myocardial njengoba iziguli ezinesifo sikashukela esibangwa i-insulin (uhlobo I).
Ngakho-ke, ukwethulwa kwama-statins ohlelweni lokwelashwa kwesifo sikashukela sohlobo II kuboniswa ezimweni lapho i-cholesterol isezingeni elamukelekayo kanye nokuxilongwa kwesifo se-coronary artery isifo kungasungulwa.
Yimaphi ama-statin angcono ukukhetha?
Ukuzilawula kwezidakamizwa ezokwehlisa i-lipid zaleli qembu akunakwenzeka: ama-static asatshalaliswa emakhemisi kuphela ngomuthi obhaliwe.
Udokotela ohambelayo unquma umuthi ngamunye, ecabanga ngezimpawu zesiguli kanye nezimpawu zomuthi:
- Isizukulwane sokuqala - Ama-statins wemvelo (i-simvastatin, i-lovastatin), i-cholesterol ephansi ngo-25 38%. Imbalwa imiphumela emibi, kodwa futhi nokusebenza okuphansi kokucindezela ama-triglycerides.
- Isizukulwane sesibili - zokwenziwa (i-fluvastatin), ngesenzo esithatha isikhathi eside, yehlisa i-cholesterol yesithathu.
- Isizukulwane sesithathu - zokwenziwa (i-atorvastatin), cishe ukucaphuna inkomba ye-cholesterol, kuvimbela ukwakheka kwayo kusuka kwizicubu ze-adipose. Ikhuthaza ukwanda kwezinga le-hydrophilic lipids.
- Isizukulwane sesine - zokwenziwa (i-rosuvastatin) - ukulinganisela kokusebenza okuphezulu nokuphepha, kwehlisa i-cholesterol kuze kufike ku-55% futhi kuvimbela ukwakheka kwama-lipoprotein aphansi. Ngenxa ye-hydrophilicity, inomphumela obuthakathaka kakhudlwana esibindini futhi akubangeli ukufa kwama-myocyte. Umphumela ufinyelela kubukhali obukhulu evikini lesibili lokusetshenziswa futhi ugcinwe kuleli zinga, ngokuya ngokusetshenziswa okuqhubekayo.
Izidakamizwa zokukhetha kuleli cala ngama-hydrophilic (amanzi ancibilikayo) ama-statins: pravastatin, rosuvastatin. Bayakwazi ukunikeza imiphumela ephezulu ngobungozi obuphansi bemiphumela emibi.
Ngaphansi kwethonya ledatha entsha etholwe phakathi kokuvivinywa kwemitholampilo, isimo sengqondo ngokusetshenziswa kwemithi siyashintsha. Njengamanje, ama-statins ayakwazi ukunciphisa ubungozi bokushona kwezifo zemithambo yegazi kanye nama-coronary, ngenxa yalokho, asetshenziswa kabanzi ekwelapheni isifo sikashukela.
