Ingxenye ebalulekile yokuvimbela i- atherosclerosis , i- coronary artery disease (CAD) , imivimbo kanye ne- peripheral artery disease , ukugcina amazinga akho e-cholesterol kanye ne-triglyceride aphezulu kakhulu. Nakuba abanye abantu bengakwazi ukufeza lo mgomo ngokudla nokuzivocavoca, abaningi abakwazi. Uma ukudla nokuzivocavoca akwanele kuwe, noma uma ingozi yakho yesifo senhliziyo iphakeme kakhulu, kungenzeka ukuthi udokotela wakho uzokufuna ukuthi uqale ukuthatha imithi kadokotela.
- Funda mayelana nezisekelo ze-cholesterol ne-triglycerides.
- Funda mayelana nokuthi ungatshela kanjani ukuthi udinga ukuphathwa.
Kule minyaka, izinhlobo eziningana zezidakamizwa ziye zabekwa ukuba zithathe i-cholesterol ne-triglycerides. Ngenkathi ama-statins abe yiqembu elibaluleke kunazo zonke izidakamizwa ezinciphisa i-cholesterol, imishanguzo eminingi emidala isasetshenziswa. Ngaphezu kwalokho, izinhlobo ezintsha zezidakamizwa zokwelapha igazi lipids ziqala ukungena emtholampilo.
Kungakhathaliseki ukuthi ukwelashwa kunikezelwe ngani, kufanele wazi okuthile mayelana nemithi ethize oyithathayo. Nansi incazelo jikelele yemithi yokwelashwa etholakalayo yokwelapha igazi lipids.
The Statins
Izitatimende ziyisisekelo esiyinhloko sokwelashwa kwe-cholesterol, ngenxa yesizathu esilula - izitembu ziwukuphela kwesigaba semithi ye-cholesterol-ukwehlisa okuye kwaboniswa ukuze kuthuthukiswe imiphumela yangempela kubantu abanezinkinga eziphezulu ze-cardiovascular, ikakhulukazi kubantu asebevele benalo ukuhlasela kwenhliziyo noma isifo sohlangothi.
Izidakamizwa ze-statin zivimbela i-enzyme ebizwa nge-HMG-CoA reductase, okunciphisa ikhono lesibindi lokwenza i-cholesterol. Ngakho-ke ama-statins aphansi kakhulu futhi athembekile amancane ama-cholesterol ne-LDL ama-cholesterol amazinga.
Izitatimende ziyanciphisa ukuvuvukala kwezicathulo, ukunciphisa i-thrombosis ye-vascular, nokuthuthukisa umsebenzi jikelele wezinsiza.
Izitatimende zivame ukubekezelela kahle, kodwa imiphumela emibi yenzeke. Umphumela ophawulekayo kakhulu wukuhlukunyezwa komzimba noma ubuthakathaka , obonakala ku-5-10% weziguli ezithatha lezi zidakamizwa.
Izitembu ezikhona manje zibandakanya:
- I-Lipitor (atorvastatin)
- I-Lescol (i-fluvastatin)
- I-Mevacor (i-lovastatin)
- Livalo (pitavastatin)
- I-Pravachol (i-pravastatin)
- I-Zocor (i-simvastatin)
- I-Crestor (i-rosuvastatin)
I-PCSK9 Inhibitors
I- PCSK9 inhibitors yilasilasi elisha lezidakamizwa ezinciphisa i-cholesterol. Amabili amabili - i-Repatha (evolocumab) ne-Praluent (alirocumab) - avunywe yi-FDA ngasekupheleni kuka-2015. Lezi zidakamizwa zisebenza ngokuvimbela i-PCSK9 enzyme esibindi, okubangela ukuthi isibindi sususe okuningi kwe-LDL cholesterol ekusakazweni. I-PCSK9 inhibitors, enikezwa umjovo, ingadala i-cholestolol ye-LDL emazingeni aphansi kakhulu, futhi ngenxa yalesi sizathu, yenze umdlandla omkhulu phakathi kwabacwaningi.
Namhlanje lezi zidakamizwa zisetshenziselwa iziguli ezine-hypercholesterolemia yomndeni, noma ezinezinhlobo ze-LDL ze-cholesterol ezihlala ziphakanyisiwe kakhulu naphezu kokwelashwa nama-statins. Ukusetshenziswa kwabo kungase kwandiswe eminyakeni eminingana ezayo njengoba sifunda ukuthi bangayithuthukisa imiphumela yomtholampilo, ngaphezu kwamazinga e-cholesterol - nokuthi ngabe akhiqiza imiphumela emibi yesikhathi eside.
I-Nicotinic Acid (i-Niacin)
I-Nicotinic acid, uhlobo lwe-niacin , inciphisa i-cholesterol ye-LDL futhi ikhulise amazinga we-HDL ye-cholesterol. Esikhathini esedlule, kwakunqunywe ngokufanele njalo ukwandisa amazinga e-HDL. Kodwa-ke, isifundo esikhulu somtholampilo siye sabangaza kakhulu ngezinzuzo ze-nicotinic acid. Kulesi sifundo, hhayi kuphela ukuthi i-nicotinic asihluleki ukuthuthukisa imiphumela yomtholampilo kodwa futhi kungenzeka ukuthi yandisa ingozi yokushaya isifo. Namuhla, i-nicotinic acid ngokuvamile isetshenziselwa iziguli ezinezinga eliphezulu le-LDL lama-cholesterol abangakwazi ukuthatha ezinye izidakamizwa.
Ezitimibe
I-Ezetimibe inciphisa ukumuncwa kwe-cholesterol emathunjini, okwenza isibindi sithole okuningi kwe-cholesterol edinga ngokukususa egazini legazi.
Ngenxa yalokho, amazinga e-LDL ama-cholesterol ancipha.
Izivivinyo zemitholampilo nge-ezetimibe (ezithengiswa njengeVivinin, kanye ne-simvastatin njengeZetia) ziye zadumazeka kakhulu, futhi izidakamizwa azisebenzisi kaningi emisebenzini yomtholampilo. Isetshenziswa ikakhulukazi kubantu abanezinga eliphezulu le-cholesterol naphezu kwe-statin therapy, noma abangakwazi ukuthatha ama-statins.
Ama-Sequestrants A-Bile.
Amakhemikhali e-bile acid avimbela ukuphindaphinda kabusha kwe-cholesterol equkethe i-bile acids emathunjini. Lokhu kubangela isibindi ukususa i-cholesterol engaphezu kokusakaza. I-bile acid sequestrants yi-Questran (cholestyramine), iCholestid (colestipol), ne-Welchol (colesevelam).
Nakuba lezi zidakamizwa futhi zinciphisa ngempumelelo amazinga e-LDL ama-cholesterol, athambekele ekubangela imiphumela emibi yamathumbu eyanciphisa ukusebenza kwawo. Futhi, njengezinye izidakamizwa ezinciphisa i-cholesterol, izifundo zokwelashwa zihlulekile ukubonisa ukuthi zithuthukisa imiphumela.
Nansi ulwazi oluthe xaxa ku-cholestyramine , i- bileququrantrant ye -bile ejwayelekile kakhulu.
Fibrate.
I- fibrates - i-Antara (gemfibrozil) ne-Lopid (i-fenofibrate) - iyasebenza kakhulu ekunciphiseni amazinga egazini le-triglyceride (ngo-50%). Bakwandisa amazinga e-HDL we-cholesterol futhi banciphise amazinga e-LDL ama-cholesterol ngezinga elithile. I-fibrates isebenza ngokuvimbela ukukhiqizwa kwama-lipoprotein acebile nge-triglyceride esibindi. Kodwa futhi, naphezu komphumela omuhle wegazi lipids, izilingo eziningana ezingahleliwe ziye zahluleka ukukhombisa noma yikuphi ukuthuthukiswa emiphumeleni yomtholampilo ne-fibrates.
Ukusetshenziswa okuyinhloko kwama-fibrate namuhla ukuphatha iziguli ezine- hypertriglyceridemia enamandla . Umphumela ovelele kakhulu we-fibrates wukuthi angabangela ukuxhunywa kwe-muscle, ikakhulu uma isetshenziselwa iziqu.
Izwi elivela
Nakuba izigaba eziningana zezidakamizwa ziye zaboniswa ukuthi zinomthelela omuhle kumazinga e-cholesterol namazinga we-triglyceride, kuphela izitembu eziboniswe ukuthi ziphuthumise kakhulu imiphumela yomtholampilo. Iziqondiso zamanje zokuphatha uketshezi lwe-cholesterol zinciphisa iziphakamiso zabo ezidakamizwa ze-statin - ezinye izidakamizwa azitholakali ngaphandle kwamacala azodwa.
Kodwa-ke, abacwaningi balindele ngokulangazela imiphumela yezilingo zomtholampilo manje ezenziwa nge-PCSK9 inhibitors, iklasi elisha lezidakamizwa elinomphumela wokuncipha we-cholesterol engakaze ibe khona.
> Imithombo:
> Stone NJ, uRobinson JG, uLichtenstein AH, et al. Isiqondiso sika-ACC / AHA sika-2013 ku-Treatment of Blood Cholesterol ekwehliseni ingozi ye-Atherosclerotic Inhliziyo kubantu abadala: Umbiko we-American College Association of Cardiology / American Heart Association Task Force on Guidelines Practice. Ukujikeleza 2014; 129: S1.
> Navarese EP, Kolodziejczak M, Schulze V, et al. Imiphumela ye-Proprotein Convertase Subtilisin / Kexin Uhlobo lwe-Antibodies lwe-9 ku-Adults Nge-Hypercholesterolemia: Ukubuyekezwa Okuhlelekile nokuhlaziywa kwe-Meta. U-Ann Intern Med 2015; 163: 40.
> Abaphenyi be-AIM-HIGH, uBoden WE, Probstfield JL, et al. I-Niacin ezigulini ezinamazinga aphansi e-HDL ama-Cholesterol athola ukwelashwa kwe-Statin ejulile. N Engl J Med 2011; 365: 2255.