Izidakamizwa ze-statin, ezisetshenziselwa ukwehlisa i- cholesterol , ziphakathi kwemithi ejwayelekile kakhulu emisiwe ezweni elithuthukile. Nakuba i-statins ivame ukubekezelela kahle, imiphumela emibi kakhulu evame ukuhambisana nemisipha yamathambo, isimo esibizwa ngokuthi "statin myopathy".
Ziyini Izimpawu Ze-Statin Myopathy?
I-statin myopathy ngokuvamile ithatha enye yezinhlobo ezintathu:
- Ubuhlungu be-Myalgia - imisipha - buhlangene no-2% kuya ku-10% wabantu abathatha ama-statins. I-myalgia eyenziwa yi-statin ngokuvamile ibhekwa njengesihlungu, ngokuvamile emahlombe nasezingalweni, noma ezinqulwini nasemathangeni. Kuvame ukuhambisana nobuthakathaka obuthakathaka.
- I-Myositis - isisu sokuvuvukala - kwenzeka kumuntu oyedwa kubantu abangu-200 abathatha ama-statins. I-Myositis ibangela ubuhlungu besisu, kanye nokuphakama kwamazinga e-CK egazini. I-CK iyi-enzyme ye-muscle, futhi ukuba khona kwayo egazini kubonisa ukuthi umonakalo wangempela wemisipha uyenzeka.
- I-Rhabdomyolysis yingozi kakhulu emzimbeni we-muscle - ngokuyinhloko ukuwohloka okukhulu kwezicubu zomzimba - okuholela ekukhululweni okukhulu kwamaprotheni emzimbeni, okungaholela ekulimaleni okukhulu kwezinso nokufa. I-Rhabdomyolysis ebangelwa ama-statins, ngenhlanhla, ayidlangaladi, futhi cishe cishe kwenzeka icala elilodwa kuwo wonke ama-statin million ezibhalwe ngokomthetho.
Uma izinkinga ze-muscle zenzeka, zivame ukuqala phakathi kwamasonto ambalwa kuya ezinyangeni ezimbalwa ngemuva kokuqala ukwelashwa kwe-statin.
I-myalgia ne-myositis ehlobene ne-Statin izoxazululwa phakathi kwamasonto ambalwa uma ukwelashwa kwesimo se-statin kuphelile. I-rhabdomyolysis izophinde ixazulule ngemuva kokuthi isimiso sabekiwe, kodwa umonakalo owenzayo kungenzeka ungenakuguqulwa.
Ngenkathi kunemibono eminingi, akekho owaziyo ukuthi kungani izitembu zingenza izinkinga zemisipha.
I-statin myopathy cishe iphathelene nokushintsha kwendlela imisipha ikhiqiza noma inqubo yokusebenzisa amandla. Kuze kube manje, abacwaningi abakwazi ukukwenza okungaphezu kwalokhu nganoma yiluphi uhlobo lokuzethemba.
Inkolelo ezuze ukuthambekela kuningi emphakathini ukuthi izitembu zingase ziphazamise ukukhiqizwa kwe-CoQ10, i-coenzyme emisipha. I-CoQ10 isisiza imisipha isebenzise amandla abayidingayo ukusebenza. Ezinye izifundo ezincane ziphakanyisile ukuthi ukuthatha izithako ze-CoQ10 kunganciphisa izigameko zezinkinga zemisipha ezihlobene nesimo se-statin, kodwa idatha (kokubili ukuthi izithimbe zinciphisa amazinga we-CoQ10 nokuthi ngabe i-CoQ10 yengezela yini ukusiza) inzima ngempela.
Ucwaningo lwamuva luye lwaphakamisa ukuthi izinkinga ze-muscle nezimiso zivame kakhulu kubantu abanokuntuleka kwe-vitamin D. Abanye baye bathola ukuthi ukuphatha i-vitamin D kulaba bantu kuzosiza ukuxazulula izimpawu zabo zomzimba ezihlobene nesimiso.
Izingozi Zengozi Ngezinkinga Ze-Muscle
Izinkinga ze-muscle ezinezinhlayiya zivame kakhulu kubantu abazithatha i-Lopid (gemfibrozil) , i-steroids, i-cyclosporine, noma i- niacin.
Abantu abanesifo sezinso ezingelapheki, izifo zesibindi, ukunciphisa amazinga e-vitamin D, noma i- hypothyroidism futhi banamathuba amaningi okubhekana nezinkinga zemisipha nezitho zomzimba, njengabantu abanesifo se-muscular disreexist efana ne- amyotrophic lateral sclerosis (ALS) .
Ezinye izitembu zibonakala zivame ukukhiqiza izinkinga zemisipha kunabanye. Ngokuyinhloko, izimo zezinkinga zomzimba zingase ziphakeme nge- dovithatinatin ephezulu (igama lomkhiqizo iZocor) kunezinye izidakamizwa zesimiso.
Ngenxa yalesi sizathu, ngoJuni 2011, i-Food and Drug Administration yancoma ukuthi inani le-simvastatin lilinganiselwe ku-40 mg ngosuku. Kulesi sifo, izimo zezinkinga zomzimba nge-simvastatin azibonakali ziphakeme kakhulu.
Ingozi yezinkinga zemisipha ibonakala ingaphansi kakhulu nge-Lescol (i-fluvastatin), i-Pravachol (pravastatin) futhi mhlawumbe iCrestor (rosuvastatin). Uma imiphumela emibi ehlobene nemisipha ivela nezinye izakhi, ukushintshela komunye walezidakamizwa kungase kuxazululwe inkinga.
I-Statin myopathy ingcono nakakhulu kubantu abahlanganyela ekuzivocavoca ngamandla, ikakhulukazi uma benza kanjalo ngaphandle kokuyakha kancane kancane.
I-Static-Related Related Muscle Izinkinga Zithathwa Kanjani?
Ngokuvamile, uma kunenkinga yemisipha ehlobene nesimo se-statin, odokotela bayomisa isidakamizwa se-statin, okungenani kuze kube yinkinga yemisipha ixazulula. Ukuhlolwa kufanele kwenziwe ngenxa yokuntuleka kwe-vitamin D kanye ne-hypothyroidism, kanye nanoma yikuphi ukusebenzisana kwezidakamizwa okungase kwandise izinkinga zemisipha ehambisana nesimo se-statin. Noma yikuphi kwalezi zici eziyingozi ezikhonjelwe kufanele zibhekiswe ngazo.
Uma izimpawu ezihlobene nemisipha zihlanganisa kuphela ubuhlungu futhi mhlawumbe ukuphakama okuncane kumazinga egazi le-CK, futhi uma ukuqhubeka kwe-statin therapy kubonakala kubalulekile, kunezindlela ezimbalwa ezingavumela ukubuyiselwa okuphumelelayo kwesimiso.
Okokuqala, ukushintshela kwisimiso esingeke sikwazi ukudala izinkinga zomzimba (njenge-pravastatin noma i-fluvastatin) ngokuvamile kuvumela umuntu ngezinkinga zangasese zangaphambilini ukuthi athathe isithunzi ngokuphumelelayo. Futhi, ukubeka izidakamizwa zesimiso nsuku zonke, esikhundleni sosuku ngalunye, kuye kwaba usizo kwabanye abantu ababengenakubekezelela ukwelashwa kwesimanje nsuku zonke. Okokugcina, nakuba ochwepheshe abaningi bengakholelwa ukuthi ukwesekwa kwe-CoQ10 kuyasiza ekuhlinzekeni ukuvuselelwa kwe-statin therapy, kunemibiko ehlakazekile ukuthi lokhu kungaba usizo.
Izwi elivela
Ngenkathi imiphumela emibi ye-muscle iyinkinga ejwayelekile kakhulu ebonwe nezitembu, lemiphumela emibi ingavamile kakhulu kubantu abangenazo izinkinga ezengeziwe. Ngaphezu kwalokho, futhi uma kwenzeka, izinkinga zemisipha zivame ukuguqulwa njalo. Izinkinga zemisipha ezisongela ukuphila ezisuka ezihlotsheni ziyinto engavamile kakhulu.
Noma kunjalo, uma uthatha isidakamizwa se-statin kufanele uqaphele ukuthi kungenzeka ukuthi uthuthukise ubuhlungu obunzima noma ububuthakathaka, futhi uma lezi zimpawu zenzeka kufanele uzihambise nodokotela wakho.
> Imithombo:
> Gupta A, Thompson PD. Ubudlelwano be-Vitamin D Ukuntuleka kwe-Statin Myopathy. I-aestrosclerosis 2011; 215: 23.
> Rosenson RS, Baker SK, Jacobson TA, et al. Ukuhlolwa nguStatistics Muscle Safety Task Force: Update 2014. J Clin Lipidol 2014; 8: S58. T
> Stroes ES, Thompson PD, uCorsini A, et al. Izimpawu ze-Muscle ezihambisana nesitembu: Impact kwi-Statin Therapy-I-European Atherosclerosis Society Isitatimende Senhlangano Yokubambisana Yokuhlola, i-Aetiology and Management. I-Eur Heart J 2015; 36: 1012.
> Thompson PD, Clarkson PM, Rosenson RS, iNational Lipid Association iStatin Safety Task Force I-Panic Safety Expert Panel. Ukuhlolwa kwezokuphepha kwe-statin yi-Muscle Experts. Am J Cardiol 2006; 97: 69C.