Ho latela lipalo-palo tsa bongaka, ho bakuli ba nang le lefu la pelo le ba nang le lefu la tsoekere, liperesente tsa batho ba shoang ho tsoa liphellong tsa lefu la pelo le tsona li joalo.
Li-static tsa lefu la tsoekere li ka fokotsa kotsi ea mathata a behang bophelo kotsing ea atherosclerosis - angina pectoris, myocardial infarction, lefu la coronary, ischemic stroke.
Li sebelisoa le ha ho na le litlamorao tse mpe.
Melemo ea ho Sebelisa Statins
Ntle le ts'ebetso ea "hypolipidemic" e sebetsang ka kotloloho, bokhoni ba ho tsitsisa mekhoa ea biochemical le ho sebetsa ka litho tse fapaneng tsa sepheo.
Kameho ea ts'ebeliso ea li-statins ka mofuta oa lefu la tsoekere la II le II e ikemiselitsoe haholo ke phello ea bona ho cholesterol le triglycerides, ts'ebetsong ea ho ruruha le ts'ebetso ea endothelium (choroid ea ka hare):
- Fokotsa cholesterol e sebetsang hantle. Statins ha e na phello e tobileng ho eona (tšenyeho le ho felisoa hoa 'mele), empa e thibela tšebetso ea sephiri sa sebete, ho thibela tlhahiso ea enzyme e kenyelletsoeng ho bopeng ntho ena. Ts'ebeliso ea nako e telele ea litekanyetso tsa kalafo ea li-statins e u lumella ho theola index ea cholesterol ka 45-50% ho tloha boemong ba pele bo phahameng.
- Fokotsa tšebetso ea karolo e kahare ea methapo ea mali, eketsa bokhoni ba vasodilation (eketsa leseli la sejana) ho tsamaisa phallo ea mali le ho thibela ischemia.
Statins e kgothaletswa e se e ntse e le karolong ea pele ea lefu lena, ha ts'ebetso ea ho tsebahatsa lefu la atherosclerosis e e-so khonehe, empa ho na le ho se sebetse hantle hoa endothelial. - Lisosa tsa tšusumetso le ho fokotsa ts'ebetso ea e ngoe ea matšoao a eona - CRP (protein ea C-reactive). Ho shebella ha mafu a seoa a mangata ho re lumella ho theha kamano ea index e phahameng ea CRP le kotsi ea mathata a coronary. Boithuto ho bakuli ba 1200 ba nkang li-statins tsa moloko oa bone ka nepo bo supile ho fokotseha ha CRP ka 15% ho elella bofelong ba khoeli ea bone ea kalafo. Tlhokahalo ea li-statins e hlahella ha lefu la tsoekere le kopana hammoho le keketseho ea liprotheine tsa C tsa protheine tse fetang milligram ka desilitara e le 'ngoe. Ts'ebeliso ea bona e bonts'a leha ho se na lipontšo tsa ischemic ka har'a mesifa ea pelo.
- Bokhoni bona bo bohlokoa haholo ho bakuli ba nang le lefu la tsoekere le lefu la tsoekere, mefuta e meng e itšetlehileng ka insulin le eo e seng ea insulin, moo methapo ea mali e amehang le kotsi ea ho ba le li-pathologies tse kholo e eketseha: angiopathy ea lefu la tsoekere, infraction ea myocardial, stroke.
Ho sebelisoa ha li-statin nako e telele ho ka fokotsa kotsi ea mathata a vascular ka karolo ea boraro. - Tšusumetso ho heestasis e bonahala ka ho fokotseha ha pono ea mali le ho tsamaisa ho tsamaea ha eona haufi le bethe ea methapo, thibelo ea ischemia (khaello ea phepo e nepahetseng ea tishu). Statins e thibela ho thehoa ha methapo ea mali le ho khomarela ha tsona lithutong tsa atherosrance.
Kameho ho Tsoekere ea Mali
E 'ngoe ea litlamorao tsa kalafo ka lithethefatsi tsa statin ke keketseho e leka-lekaneng ea tsoekere ea mali ka li-unit tsa 1-2 (mmol / l).
Ho pholletsa le kalafo, taolo ea li-parameter tsa carbohydrate e tlameha.
Ts'ebetso e hlahisang keketseho ea index ea tsoekere ha e e-so ithutoe, empa liphuputso li bonts'itse hore tšebeliso ea nako e telele ea li-statins ka litekanyetso tsa kalafo ka 6-9% e eketsa kotsi ea ho ba le lefu la tsoekere le sa ts'epeng insulin (mofuta oa II).
Tabeng ea bokuli bo seng bo le teng, phetoho ea eona e ea sebopeho se ka khonehang, moo boemo ba tsoekere maling bo hloka phetoho e eketsehileng ka ho sebelisa lijo tse matla tsa carb tse tlase le keketseho ea litekanyetso tsa lithethefatsi tse theolelang tsoekere.
Leha ho le joalo, ho latela litsebi tsa pelo le li-endocrinologists, melemo ea ho nka li-statins bakeng sa lefu la tsoekere la mefuta ea pele le ea bobeli e feta haholo likotsi tsa litlamorao tse hole.
Li-statins li ka ba kotsi joang?
Lithethefatsi tse fokotsang Cholesterol, li boletse litla-morao, li hloka tlhokomelo ea bongaka 'me ha li tšoanelehe bakeng sa kalafo.
Lithethefatsi tsa Hypolipidemic tsa sehlopha sena li fana ka litlamorao tsa tsona ka tšebeliso e telele ea nako e telele, ntlheng ena, litlamorao tsa lithethefatsi li ka fumanoa feela kamora nako e itseng.
Litlamorao tse mpe tsa lithethefatsi li sebetsa ho litho tsohle le litsong tsohle:
- Hepatotoxicity ea li-statins e bontšoa ka ho timetsoa ha lisele, tlolo ea sebopeho le tšebetso ea sebete. Leha matla a lisele tsa sebete a khona ho nchafala, moroalo oa setho se ka khonehang.
Ho beha leihlo khafetsa ka li-transaminase tsa sebete ALT le AST, hammoho le kakaretso (e tobileng le e tlamang) bilirubin, hoa hlokahala ho lekola ts'ebetso ea setho. - Lithane tsa mesifa li boetse li susumetsoa ke li-statins, tse nang le bokhoni ba ho senya lisele tsa mesifa (myocyte) ka ho lokolloa ha lactic acid.
E bontšoa ke ho opeloa ke mesifa, ho hopola litlamorao tsa ho ikoetlisa ho matla ha 'mele. Ha e le molao, liphetoho lits'ebetsong tsa mesifa ea mesifa ha li ts'oarehe mme kamora ho tlohela lithethefatsi ho khutlela ho tloaelehileng. Leha ho le joalo, maemong a mane ho tsoa ho sekete, ts'ebetso ea methapo ea methapo e nka sebopeho se tebileng mme e sokela nts'etsopele ea rhabdomyolysis - lefu le leholo la li-myocyte, chefo ke lihlahisoa tse bola le ho senyeha ha liphio ka bongata bo boholo ba ho hloleha ha renal. Boemo ba moeli, bo hloka ntlafatso. Kotsi ea ho ba le myopathies - bohloko ba mesifa le mahlaba - e eketseha ka tšebeliso e kopaneng ea li-statins le lithethefatsi bakeng sa khatello ea mali, lefu la tsoekere kapa gout.
Ho hlahlojoa mali khafetsa hoa hlokahala bakeng sa CPK (creatine phosphokinase) - sesupo sa myocyte necrosis - ho lekola boemo ba tsamaiso ea mesifa. - Phetoho tlasa ketso ea li-statins tsa methapo ea lik'hemik'hale le ea 'mele ea mokelikeli o ka hare ho manonyeletso o ka lebisa lits'ebetsong tsa pathological le nts'etsopele ea ramatiki le arthrosis, haholoholo e kholo - hip, knee, mahetla.
- Liponahatso tsa tsamaiso ea tšilo ea lijo li ka tšoauoa ka mathata a ho hlohlona, ho hloka botsitso, bohloko ba ka mpeng.
- Ts'ebetso ea methapo e bohareng le e poteletseng e ka arabela ts'ebeliso ea li-statins ka lipontšo tse fapaneng: ho ts'oenyeha ha boroko, hlooho e bohloko, maemo a asthenic, matla a maikutlo, ho sithabela ha maikutlo le ts'ebetso ea makoloi.
Ho ea ka phuputso ea bongaka, khafetsa ea e 'ngoe ea litlamorao tse ka hlahang tsamaisong ea methapo ha e fetang 2%. - Ts'ebetso ea "coronary" e le 'ngoe le halofo ea linyeoe tsa kalafo ea "statin" e ka arabela ka ho fokotseha ha khatello ea mali ka lebaka la ho eketseha ha methapo ea methapo, ho utloa ho otla ha pelo, arrhythmia le migraine ka lebaka la phetoho ea molumo oa methapo ea mali ea boko.
Boemo bo tloaeleha ha 'mele o tloaela' musong o mocha oa phepelo ea mali ea lisele. Ka nako e 'ngoe ho hlokahala phetoho ea litekanyetso.
Lipalo le lefu la tsoekere: ho ikamahanya le maemo
Endocrinologists ke ba nang le maikutlo a hore li-statins ke tsona feela sehlopha sa lithethefatsi tse fokotsang lipid tseo ketso ea tsona e reretsoeng ho ntlafatsa bophelo ba bakuli ba nang le lefu la tsoekere le sa ts'epeng insulin (mofuta II).
Ba nang le lefu la mofuta ona oa lefu lena ba na le kotsi e habeli ea ho senyeha ha ischemic myocardial ha e le bakuli ba nang le lefu la tsoekere le lahleloang ke lefu la tsoekere.
Ka hona, ho hlahisoa ha li-statins morerong oa phekolo ea lefu la tsoekere la mofuta oa II ho bontšoa le maemong ao cholesterol e leng boemong bo amohelehang mme ho fumanoe lefu la methapo ea methapo.
Ke li-statins life tse molemo ho li khetha?
Ts'ebetso ea boithatelo ba lithethefatsi tse fokotsang lipid tsa sehlopha sena ha e khonehe: li-statins li ajoa ka litlhare tsa meriana feela ka taelo ea ngaka.
Ngaka e eang teng e fana ka litlhare ka mokhoa o ikhethileng, li nahanela litšobotsi tsa mokuli le litšobotsi tsa moriana.
- Moloko oa pele - Li-statins tsa tlhaho (simvastatin, lovastatin), cholesterol e tlase ka 25-38%. Litla-morao tse fokolang, empa le katleho e tlase ho hatella triglycerides.
- Moloko oa bobeli - synthetic (fluvastatin), e nang le ketso e telele, e fokotsa cholesterol ke karolo ea boraro.
- Moloko oa boraro - maiketsetso (atorvastatin), e batlang e emisa index ea cholesterol, e thibela tlhahiso ea eona ho tsoa lithong tsa adipose. E khothalletsa ho eketseha ha boemo ba hydrophilic lipids.
- Moloko oa bone - maiketsetso (rosuvastatin) - tekanyo ea ts'ebetso e phahameng le polokeho, e fokotsa cholesterol ho fihlela ho 55% mme e thibela tlhahiso ea lipoprotein tse tlase. Ka lebaka la hydrophilicity, e na le phello e bobebe ho sebete 'me ha e bake lefu la myocyte. Sephetho se fihla botebong bo boholo bekeng ea bobeli ea ts'ebeliso mme e bolokoa boemong bona, ho latela ts'ebeliso e tsoelang pele.
Lithethefatsi tsa khetho ntlheng ena ke li-form tsa hydrophilic (tse qhibilihang ka metsi): pravastatin, rosuvastatin. Ba khona ho fana ka liphetho tse phahameng ka likotsi tse tlase tsa litla-morao.
Tlas'a tšusumetso ea data e ncha e fumanoeng nakong ea liteko tsa tleliniki, maikutlo a ts'ebeliso ea meriana a fetoha. Hajoale, li-statins li khona ho fokotsa likotsi tsa lefu la mathata a methapo le methapo, ka hona, li sebelisoa haholo kalafong ea lefu la tsoekere.
