Ukwenza izinguquko ekusunguleni impilo enempilo - ngokusebenzisa ukudla, ukuzivocavoca, noma ezinye izinguquko - kubalulekile ekugcineni amazinga akho e-cholesterol ne-triglyceride aphilile. Ngezinye izikhathi, lokhu kungase kungasebenzi, futhi umhlinzeki wakho wezempilo angathanda ukukubeka emithini yemithi.
Imithi eminingi yokunciphisa i-cholesterol okwamanje iyimakethe, futhi ngayinye yale mithi iyanciphisa ama-cholesterol kanye / noma amazinga e-triglyceride ngezindlela ezahlukene.
Ukwengeza, ngayinye yalezi zidakamizwa ihlose izici ezihlukile kuphrofayela yakho ye-lipid. Ngokwesibonelo, ezinye izidakamizwa zingasebenza kuphela ekunciphiseni amazinga akho e- LDL ama- cholesterol, kanti ezinye izidakamizwa zingabhekisela kuzo zonke izici zephrofayela yakho ye-lipid. Kunoma yikuphi, umhlinzeki wakho wezokunakekelwa kwezempilo uzobe esilinganisa izinzuzo nezingozi zomuthi ngamunye, bese ukhetha izidakamizwa ezihle kakhulu ezithwala i-lipid ezifanelekile kuwe. Le mithi yokwelashwa ikhona emakethe:
Izitatimende
I-Statins, eyaziwa nangokuthi i-HMG-CoA i-reductase inhibitors, yiyona imithi evame kakhulu yokunciphisa i-cholesterol. Nakuba bathole idumela elibi kwezinye zezinto ezingathandeki, kodwa ezingavamile, nemiphumela emibi , zikhomba zonke izici zephrofayela yakho ye-lipid.
Izitatimende zinga:
- Nciphisa i- LDL phakathi kwamaphesenti angu-18 namaphesenti angu-65
- Ukwandisa i- HDL ("okuhle" kwe-cholesterol) kuze kufike kumaphesenti angu-5 kuya kuma-15 amaphesenti
- Nciphisa i- triglycerides ngamaphesenti angu-7 kuya kuma-30%
Akukhona nje ukuthi ama-statins asebenza kahle ekuqaliseni zonke izici zephrofayli yakho ye-cholesterol, nazo ziye zaqaphela ukuvimbela ukufa nezinkinga ngenxa yesifo senhliziyo.
Izitatimende nazo zinezakhiwo eziphikisayo ezisiza ukunciphisa ukuqhubeka kwe- atherosclerosis engabangela izifo zenhliziyo. Njengoba lezi zinzuzo ezengeziwe ze-statins, lezi zidakamizwa zibekwa kakhulu kunazo zonke imithi yokwehla kwe-cholesterol. Lezi zidakamizwa ezilandelayo zihlukaniswa njengezimiso:
- I-Rosuvastatin (i-Crestor)
- I-Atorvastatin (i-Lipitor)
- I-Simvastatin (Zocor)
- I-Lovastatin (i-Mevacor)
- I-Pravastatin (Pravachol)
- I-Fluvastatin (Lescol)
Ama-Resin Bile we-Bile
Ama-resin acid e-bile anciphisa i-cholesterol egazini ngokuvimbela i-bile acids ekubuyiselweni kabusha. Zivame ukusebenza ku-LDL cholesterol, ukunciphisa ngamaphesenti angu-15 kuya kuma-30 futhi i-HDL ekhulayo kancane ngamaphesenti angama-5. Ngokujwayelekile, i-triglycerides ayithinteki yi-bile acid resins - futhi ingase ikhulise amazinga e-triglycerides. Ukwengeza, amanye amavithamini nezidakamizwa azikwazi ukuthathwa nxazonke lapho uthatha izinhlayiya ze-bile acid, ngoba ukumunwa kwazo kunciphise futhi kungenza zingasebenzi. Imithi elandelayo ihlukaniswa njenge-bile acid resins:
- I-Cholestyramine (i-Questran)
- I-Colestipol (i-Colestid)
- I-Colesevelam (Welchol)
I-Fibric Acids
Ama-acidi e-fibric, noma ama-fibrate, ahlonishwa kakhulu ngenxa yokukwazi ukunciphisa i-triglycerides, enganciphisa phakathi kwamaphesenti angu-20 kuya kuma-50%. Futhi banciphisa amazinga e-LDL phakathi kwamaphesenti angu-5 kuya kuma-20 futhi angakhuphula amazinga e-HDL ngamaphesenti angama-20. Leli klasi lezidakamizwa liyaziwa ukuthi likhiqize isifo sofuba, ikakhulukazi uma kuhlangene nezinye izidakamizwa ezifana nezitembu kanye ne-warfarin (i-Coumadin). Kulesi simo, umhlinzeki wakho wezokunakekelwa kwempilo angase alungise umthamo wesidakamizwa sakho (njengasekuqaleni kwe-warfarin).
Imithi elandelayo i-fibrates:
- I-Gemfibrozil (i-Lopid)
- Fenofibrate (Tricor)
Ukuthwala ama-inhibitors
I-Ezetimibe okwamanje iyisidakamizwa kuphela kuleli klasi futhi ngokuyinhloko ihlose amazinga we-LDL cholesterol, ukwehlisa amazinga e-LDL ngokwesilinganiso samaphesenti angu-15. Ngokujwayelekile, i-ezetimibe ihlanganiswe nesimiso ukuqinisekisa ukuthi kunomthelela onamandla lapho kunciphisa amazinga e-LDL. Nakuba le mithi iboniswe ku-LDL ephansi, ayizange iboniswe ukuthi ivimbele ngokuqondile ukuthuthukiswa kwesifo senhliziyo uma isetshenziswe yodwa. I-Ezetimibe (Zetia) yiyona kuphela imithi evunyelwe i-FDA ngaphakathi kwalesi sigaba samachiza.
Ama-Omega-3 Amafutha Acat
Nakuba kune-omega-3 fatty acid etholakalayo, i-omega-3 fatty acid imikhiqizo iye yahlolwa kabanzi ukuze ihlolwe ukusebenza kwayo nokuphepha.
Le mikhiqizo iqukethe i-docosahexaenoic acid (i-DHA) ne-eicosohexaenoic acid (i-EPA) njengezengezo ezitholakala ezitolo, kodwa lezi zingxenye zihlanzwa futhi zigxilwe ngokuqhathaniswa nezithako ezingaphezu kwe-counter. Amakhemikhali e-omega-3 acty prescription asetshenziselwa abantu ukuba bahlose amazinga aphakeme kakhulu e-triglyceride, ehlisa i-triglycerides ngamaphesenti angama-45. Kukhona okwamanje izinhlobo ezintathu ze-omega-3 fatty [imikhiqizo etholakalayo:
- I-Epanova (i-omega-3 carboxylic acid)
- Lovaza (ama-omega-3 mahhala ama-acids)
- I-Vascepa (i-icosapent)
I-PCSK9 Inhibitors
Lezi zidakamizwa zivimbela amaprotheni we-PCSK9 ekusebenzisaneni nama-receptors e-LDL futhi kubangele ukuthi bahlaziywe. Lokhu kuzovumela abamukeli be-LDL ukuthi baqhubeke nokusebenza ngokususa i-LDL emzimbeni - okuholela ekunciphiseni amazinga e-LDL ama-cholesterol ngamaphesenti angaba ngu-50 kwizifundo. Imithi kuleli klasi yengezwa uma imithi yamanje yokunciphisa i-cholesterol (njengama-statins) inganciphisi ngokuphelele amazinga e-LDL we-cholesterol. Zivame ukusetshenziselwa kanye nokudla okunempilo-enempilo futhi kuthathwa iziqu noma ezinye izidakamizwa ezinciphisa i-cholesterol. Abantu abathatha le mithi banezimo ezilandelayo zezokwelapha:
- isifo se-atherosclerotic esihilela imithwalo yegazi kanye / noma inhliziyo
- izimo zezokwelapha ezizuzwe njengefa, hypercholesterolemia yomndeni ongenayo i- homozygous noma heterozygous
Kunezifundo zamanje eziqhubekayo zokuhlola ikhono lezidakamizwa kuleli klasini ukunciphisa ingozi yokufa noma ukuhlaselwa yinhliziyo kubantu abazithathayo. Izidakamizwa kuleli klasi zifaka:
- I-Repatha (evolocumab)
- Okuphambili (i-alirocumab).
Izidakamizwa zezintandane
Ezinye imithi yokunciphisa i-lipid imiswe kuphela kubantu abanezinga eliphezulu kakhulu le-LDL cholesterol. Lezi imithi ngokuvamile zibekiwe ezimweni lapho umuntu enesimo esizuze njengefa esibangela amazinga aphakeme kakhulu e-lipid esemncane, kanti neminye imithi - njengama-statins-awasizi amazinga aphansi e-LDL.
Eminye yale mithi ingabangela imiphumela emibi kakhulu, njengezifo zesibindi, ngakho-ke zivame ukunikezelwa ngaphansi kohlelo olukhethekile ngabachwepheshe bezempilo abajwayele imithi. Le mithi iphinde isetshenziswe emakethe futhi isebenze ngezindlela ezihlukile zokunciphisa amazinga e-lipid:
- Ama-inhibitors we-Antisense: Imithi kule klasi yezidakamizwa ibophezela esigabeni se-RNA isithunywa esenza amakhodi wokwenza i-B-100, ukunciphisa inani le-B-100 elenziwe emzimbeni. Lokhu kunciphisa inani le-VLDL ne-LDL cholesterol emzimbeni. Lezi zidakamizwa zifaka i- Kynamro (mipomersen), ehlisa i-LDL ngama-25 amaphesenti.
- I-MTTP inhibitors: Lezi zidakamizwa ziphansi kwe-LDL cholesterol ngokuvimbela amaprotheni wokudlulisa i-microsomal triglyceride (MTTP), i-molecule emzimbeni evimbela i- VLDL nama- chylomicron ukuba zenziwe esibindi. I-Juxtapid (i-lomitapide) yiyona kuphela imithi evunyiwe kuleli klasi yezidakamizwa futhi ihlisa i-LDL ngamaphesenti angu-50.
Imithombo:
UDipiro JT, u-Talbert RL. I-Pharmacotherapy: Indlela Yokuthola Pathophysiological, 9th 2014.