Ukubuyekezwa kwezidakamizwa ukwehlisa i-cholesterol yegazi

I-cholesterol ephezulu ithinta kabi impilo. Ukuyinciphisa, amaqembu wezidakamizwa enza ukuthi i-lipid metabolism ihloswe.

Zibekiwe ngokuya ngesimo sesifo kanye nezimpawu zokusebenza komzimba.

Amaqembu nokuhlukaniswa

I-cholesterol ethe xaxa igcinwa emzimbeni futhi ifakwa ezindongeni zemithambo yegazi.

Imvamisa lokhu kuholela ekuguleni kwenhliziyo, isifo senhliziyo nemivimbo. Imithi ehlukahlukene isetshenziselwa ukunciphisa izinga lamafutha e-organic.

Lolu hlu lubandakanya:

1. Izimo zingama-enzyme blockers azibandakanye ekukhiqizeni i-cholesterol.
2. INiacin - yehlisa i-LDL, yehlisa ingozi yokuqhekeka kwegazi.
3. Imithi ekwehlisa ukumunca kancane - imise ukufakwa kwe-cholesterol emathunjini, ukuphuma kwayo kungena egazini.
4. Ama-Fibroic acid izidakamizwa ukwehlisa i-triglycerides yegazi.
5. Izikhathi ezihlukaniswa ngama-bile acid - susa i-bile eyengeziwe emzimbeni.

Ikhambi ngalinye linezimpawu zalo, i-contraindication kanye nemiphumela emibi futhi ichazwe ngokususelwa kumlando wesiguli kanye nemingcele yokuhlaziya.

Izimo, izakhiwo zazo nezici zohlelo lokusebenza

Izinga yimithi eyehlisa i-cholesterol. Isenzo sabo sihloselwe ukuvimbela i-enzyme, ethukuthelisa ukwakhiwa nokukhula kwe-LDL (cholesterol embi).

Izimo zimelelwa yizizukulwane ezi-4, ezokugcina zithathwa njengezisebenza kakhulu. Igama lezokwelapha yi-HMG-CoA reductase inhibitors.

Esibindini, kukhona ukwehla ekuhlelweni kwe-cholesterol, nasegazini, ukwehla kwesilinganiso sayo.

Iqembu lezidakamizwa lijwayeza ikhwalithi yegazi, lithuthukisa isimo semithambo yegazi, livimbe i-thrombosis kanye nama-atherosulinotic plaque. Lapho uthatha ama-statins, kungahle kwehle ngamazinga kashukela. Isenzo esikhulu ukuvimba ukukhiqizwa kwama-enzyme wesibindi.

Ngokusetshenziswa okuhleliwe kwama-statins, kukhona ukwehla kwe-cholesterol ngesilinganiso esingu-40%. Isetshenziselwa ukuvimbela imivimbo kanye nokuhlaselwa yisifo senhliziyo. Isetshenziselwa i-hypercholesterolemia, isifo sokuqina kwemithambo yegazi, izifo zenhliziyo. Izimpawu zinomphumela esibindini.

Lapho welapha ngezidakamizwa, i-biochemistry yegazi iyahlolwa.

Ividiyo evela kuDkt Malysheva mayelana nama-statins:

Phakathi kokubonakaliswa okubi kuyaphawulwa:

• ikhanda, ukuqwasha;
• ukungahambi kahle kwesikhumba;
• kwehla i-libido;
• ukuqina kwemisipha nobuhlungu;
• ukunaka okonakele nokulahlekelwa inkumbulo;
• ukuphazamiseka kwesisu;
• i-thrombocytopenia;
• ukwephulwa kwesibindi;
• myopathy.

Contraindication ukusetshenziselwa:

• ukungasebenzi kwesibindi;
• ukukhulelwa
• ukungasebenzi kwezinso;
• iminyaka efinyelela eminyakeni eyi-18;
• ukuncelisa;
• ukungabekezeleli izingxenye zomuthi.

Izitatimende zimelelwa ngalezi zindlela ezilandelayo: iZokor, Lipostat, Rovakor (isizukulwane sokuqala), Leskol (isizukulwane sesibili), i-Atoris, iTulip, iLipobay (isizukulwane sesithathu), iRosuvastin, iKrestor, Akorta (imithi yesizukulwane esisha).

I-Fibroic acid

Okususelwa ku-asidi ye-fibroic - isigaba sezidakamizwa esenzelwe ukulungisa i-lipid metabolism. Bahlala esigabeni sesibili sokusebenza kahle nokuthandwa ngemuva kwama-statins.

Umuthi wokuqala kuleli qembu wawungu-clofibrate. Namuhla, amazwe amaningi awasebenzisi ngoba enobuthi obuphakeme nemiphumela emibi. Emva kwalokho kwaqala ukusetshenziswa uBezafibrate, uCyprofibrate noFenofibrate.

Indawo yokugcina ihamba phambili. Bayakwazi nokulawula ushukela wegazi, amazinga e-uric acid aphansi. Lokhu kuyiqiniso ikakhulukazi kwiziguli ezinesifo sikashukela kanye ne-gout ngasikhathi sinye.

Umphumela oyinhloko we-asidi ukuthi bashintsha iphethini ye-lipid metabolism. Isithako esisebenzayo sehlisa i-LDL, sandisa i-HDL, futhi sijwayeza ukusebenza kwe-lipid metabolism.

Iqinisa izindonga zemithambo yegazi, ikhuphula ukuqina, ivimbela ukwakheka kwezigcawu. Ivimbela ukugeleza kwegazi. Ngaphansi kwethonya le-fibrate, ukwakheka kwama-triglycerides kuyancipha, ukuhlukana nokuvinjwa kokukhula kwe-LDL kuyasheshiswa. Ukuphuza umuthi kunciphisa izingozi zesifo senhliziyo. Iqembu lezidakamizwa linomphumela omuhle esizweni sohlelo lwezinhliziyo.

Izinkomba ezisetshenziswayo yilezi:

• i-dyslipidemia yesifo sikashukela;
• cholesterol ephezulu (inhlanganisela yokwelapha);
• umthamo omkhulu we-triglycerides;
• ukungalingani kwe-lipid;
• gout
• ukukhuluphala
• isifo se-metabolic.

Ukuqapha kufanele kuthathwe ekuhlanganiseni i-fibrate neminye imithi. Lokhu kungandisa imiphumela emibi ezinso nasezibindini.

Phakathi kwemiphumela emibi iyabonakala:

• ukuphazamiseka kwesisu;
• umsebenzi wezinso ongonakalisiwe;
• ikhanda
• ukungahambi kahle komzimba;
• ukwanda kwama-indices e-hepatic;
• ukwephulwa kwesibindi;
• ukuphazamiseka kwemizwa.

I-contraindication eyinhloko yokusetshenziswa kwama-fibrate:

• ukungasebenzi kwesibindi;
• ukukhulelwa nokuqunjelwa;
• ukwehluleka kwezinso;
• utshwala;
• ukuqina kwesibindi;
• i-cholecystitis ebaliwe;
• iminyaka efinyelela eminyakeni eyi-18;
• cholelithiasis.

Imithi ngokuqapha ngokweqile kufanele isetshenziswe abantu asebekhulile.

Izikhathi zokuhlukaniswa kwama-bile acid

Ngeabahleli bama-bile acid - iqembu lemithi elihlobene nezidakamizwa ezisehlisa i-lipid. Yizidakamizwa ezisizayo ukwehlisa i-cholesterol ephezulu yegazi.

Umphumela oyinhloko ukubopha ama-bile acid nge-excretion elandelayo, ukucindezela ukukhiqizwa kwe-cholesterol. Umuthi osebenzayo ubopha ama-asidi futhi uwahlukanise.

Ukubuyiselwa kwe-bile kuvinjelwe. Ukuhlanganiswa kwe-HDL kuhlinzekiwe, futhi i-LDL ikhishwa egazini. Ngaphezu kwalokho, i-glycosylated hemoglobin ne-glucose iyancipha ezigulini ezinesifo sikashukela.

Imithi ayifakwa ekujikelezweni kwe-systemic, ikhishwa ngamathumbu. Kulokhu, ukuthuthukiswa kwemiphumela emibi kuncishiswa kube okungenani. Isimo esibi esivame kakhulu sibonwa emgudwini wesisu - ukugaya, ukuthamba, ukuqunjelwa nokuqhakaza, ushintsho ekunambithekeni.

Ekugxilweni okuphezulu, ama-sequestrants anganciphisa ukumuncwa kwe-B6 namavithamini ancibilikayo anamafutha D, A, K, E. Kunezingozi zokuphuma kwegazi ngesikhathi sokwelashwa ngezidakamizwa ezivela kulwelwesi lwama-mucous ezilimele, njengoba ukwehla kwegazi kuncipha.

Ngesikhathi sokulashwa kwe-FFA, i-cholesterol eyingozi ikhishwa ku-45%, isimo se-lipid tata sithuthukisa ngama-20%. Ukusetshenziswa isikhathi eside kukhulisa izinga le-cholesterol enenzuzo. Umphumela we-Hypocholesterolemic utholakala ngokwesilinganiso ngemuva kwenyanga yokuphatha. Ekuqhubekeni kwezifundo, umphumela omuhle we-FFA ezifweni zenhliziyo nokuthinteka kwabo wanqunywa.

Amagama ezidakamizwa: Colestipol, Cholestyramine.

Izinkomba ezisetshenziswayo:

• ukuhlaselwa yinhliziyo;
• Isifo senhliziyo se-Ischemic;
• dyslipidemia;
• isifo sokuqina kwemizwa;
• hypercholesterolemia;
• izinkinga ze-coronary.

Ngokuqapha, amaphilisi athathelwa ukumuncwa kwamathumbu, i-cholelithiasis.

Contraindication FFA ifaka:

• i-phenylketonuria;
• ukusabela kwe-hypersensitivity;
• i-hypertriglyceridemia;
• ukuvinjezelwa kwesiqu se-biliary;
• isilonda sesisu;
• ukuphazamiseka kwegazi;
• ukuqunjelwa okungapheli;
• Ukuvinjwa kwe-billiard;
• hyperlipoproteinemia yezinhlobo III no IV.

Izidakamizwa zithinta ukumuncwa kwamathumbu. Ukudla kahle ihora noma amahora ama-4 ngemuva kokudla. Okokuqala kunqunywe kumithamo emincane, khona-ke umthamo uyandiswa kancane kancane. Isikimu esinjalo sinciphisa ukuthuthukiswa kwemiphumela emibi.

Ama-Sequestrant ama-FAs athinta ukufakwa kwezidakamizwa eziningi. Lokhu kufaka phakathi ama-penicillin antibiotics, ama-diuretics, ama-block adrenergic. Ehlelweni lokwelashwa isikhathi eside, kunikezwa i-biochemistry yokuqapha izinkomba.

Kusho ukuthi kuvimbela ukumunwa kwe-cholesterol emathunjini

Imithi evimbela ukufakwa kwe-cholesterol emathunjini inciphisa ukumunca ukunciphisa ukuncipha kwayo egazini.

Iqembu elethwe yizidakamizwa lifaka i-Lipobon, Ezetrol, Tribusponin, iGuarem. Abangenwa egazini, bahlanganiswe kahle nezinye izidakamizwa, ngokungafani neFFA abayikhulisi imfihlo yokuqothuka kwe-bile acids.

Ngenxa yalokho, ngemuva kwezinsuku eziyi-14 zokuphuza le mishanguzo, ukumuncwa kwe-cholesterol kwehliswa ngo-50%. Ukusetshenziswa kanyekanye kokudla akukuphazamisi ukusebenza kwezidakamizwa kweqembu elethwe. Esezinhlelweni zokuthatha izinga le-cholesterol lehliselwe kuma-20%.

Izinkomba ezisetshenziswayo:

• i-homozygous yomndeni hypercholesterolemia;
• i-hypercholesterolemia eyinhloko;
• ukungasebenzi kahle kwe-statin monotherapy;
• homozygous sitosterolemia.

Kusetshenziswa ngokuhlangana nokwelashwa kokudla, lapho ungekho umphumela, ahlanganiswe nama-statins. Imvamisa abalungisa i-lipid basebenzisa i-Essentiale, Lipostabil.

Phakathi kokuphikisana kokusetshenziswa:

• ukwehluleka kwesibindi;
• ukungabekezeleli noma ukuntuleka kwe-lactose;
• ukusabela kwe-hypersensitivity;
• iminyaka ingaphansi kweminyaka eyi-18;
• ukusetshenziswa kanyekanye ngemicu.

Phakathi kwemiphumela emibi ebaliwe:

• ukuqhakaza;
• ukuthopha;
• ukuphazamiseka kwesitulo (ukuqunjelwa kanye nohudo);
• ukungasebenzi kahle kwesibindi;
• ukukhathala
• ikhanda.

I-Nicotinic acid

I-Nicotinic acid iyi-vithamini encibilikiswa ngamanzi edingekayo ekusebenzeni okujwayelekile komzimba. Umphumela wokwelapha: kwehlisa i-cholesterol nezingxenyana ze-lipid, vasodilation.

Kuvimbela ukuthuthukiswa kwezifo zenhliziyo, kunomthelela wokudambisa nokuthoba.

Uma igxilwe, i-nicotinic acid iguqulwa ibe yi-nicotinamide esebenzayo. Ubamba iqhaza ezinqubweni ze-metabolic zamavithamini, izinqubo zokwenziwa, ukuphefumula kwezicubu.

Into le ithuthukisa i-microcirculation, i-lipoproteins ijwayelekile, ihlise i-LDL ne-triglycerides, futhi inyusa i-HDL. It is metabolized in the isibindi, okukhishwa izinso. Inani lokuphakama kwento lifinyelelwa emva kwemizuzu engama-45.

Uhlu lwezidakamizwa: i-Enduracin, i-Niceritrol, i-Acipimox. Ukulungiswa kwe-Nicotinic acid kushibhile futhi kungabizi kwabaningi.

Izinkomba ezisetshenziswayo:

• isigaba sokuqala se-hyperlipidemia;
• ingozi ye-cerebrovascular;
• ukuntuleka kwevithamini PP;
• ukucindezela isikhathi eside
• isifo sokuqina kwemizwa;
• ngesikhathi sokuvuselelwa ngemuva kokuhlaselwa yinhliziyo nemivimbo;
• i-microagniopathy;
• isifo sokuqina kwemithambo yegazi
• izilonda kulwelwesi lwama-mucous kanye nesikhumba;
• angina pectoris;
• i-nerve yezinzwa zobuso;
• imisebe yemithambo yemilenze;
• isifo sikashukela se-polyneuropathy;
• i-enterocolitis, i-colitis, i-gastritis.

Contraindication ukusetshenziselwa:

• hypersensitivity kwento;
• isilonda se-peptic sesisu (ukukhuphula amandla);
• iminyaka engaphansi kweminyaka emi-2.

Ngokuqapha, umuthi uthathwa ngabantu abanokwehluleka kwesibindi, i-glaucoma, i-gout.

Imiphumela emibi ngesikhathi sokuphatha:

• ukungena kwesibindi okunamafutha kuyabonakala lapho uthatha umuthi ngemithamo ephezulu;
• hypotension;
• ukuvela kwesikhumba se-allergic;
• secretion ekhuphukile yejusi yesisu;
• ukwehla kokubekezelela ushukela;
• ukucasulwa kwe-mucosa esiswini;
• ukwephulwa kwesibindi;
• i-hyperemia yesikhumba;
• ubungozi bokuthuthukisa i-myopathy uma ihlanganiswa nama-statins.

Izindlela ezingezekile

Ngaphezu kokulungiswa kwezidakamizwa, kunezinye izindlela ezisebenzayo futhi ezinhle kakhulu zokunciphisa i-cholesterol. Lokhu kufaka phakathi indlela yokuphila efanele nokudla okunempilo. Zisetshenziselwa ukwanda okuncane kwe-cholesterol - kufinyelela ku-18% wesilinganiso esijwayelekile.

Izindlela ezifanayo zokuvimbela zifaka:

• ukungafakwa kokudla okuyingozi ekudleni;
• ukusebenza komzimba, ukucindezela, ukuvivinya umzimba;
• ukuthatha ukudla okwehlisa i-cholesterol.

Ukunciphisa i-LDL, kuhlanganiswa ukudla okune-fiber-rich kanye namavithamini amaningi ekudleni. Khipha ngaphandle kwamafutha, ukudla okuthosiwe nokunamafutha, ukudla okusemathinini, izitsha ezinokuqukethwe okuphezulu kwe-cholesterol embi. I-Fibre itholakala ngobuningi besinkwa sokusanhlamvu okugcwele, okusanhlamvu, okusanhlamvu, imifino nezithelo

Kufanelekile ukudla ukudla okwehlisa i-cholesterol emvelo ngokwemvelo. Lawa ngama-avocados, ummbila, uwoyela womnqumo nelanga. Ama-acid anamafutha asemafutheni ezinhlanzi afakwa ngokujwayelekile yi-lipid metabolism. Ukusetshenziswa okuhleliwe kwale mikhiqizo kunganciphisa i-LDL nge-10%. Ukusetshenziswa kwama-vithamini e-lipoic acid nama-B nakho kunomthelela omuhle kuzinkomba.

Izinto zevidiyo ekudleni ukwehlisa i-cholesterol:

Izidakamizwa ezokwehlisa i-cholesterol zinezici eziningi. Zinqunyelwe ku-tata ne-monotherapy, zibonisa izakhiwo ezinhle lapho zisetshenziswa kahle. Inhloso yesidakamizwa ngasinye kufanele ibe nesizathu.