Izidakamizwa ze-Statin, ezisetyenziselwa ukunciphisa i- cholesterol , ziphakathi kweempawu eziqhelekileyo eziqhelekileyo kwilizwe eliphuhlisiweyo. Nangona i-statins ixhomekeke kakuhle, imiphumo emibi kakhulu echaphazelekayo ihambelana nemisipha yamathambo, imeko ebizwa ngokuba yi "statin myopathy".
Ziziphi iimpawu zeStatin Myopathy?
I-statin myopathy ibamba enye yeendlela ezintathu:
- Inhlungu ye-Myalgia - imisipha - ifumana u-2% ukuya kwi-10% wabantu abathatha ama-statins. I-myalgia eyenziwe nge-statin ibhekene nobunzima obuqhelekileyo, ngokuqhelekileyo kumagxa kunye neengalo, okanye izikhwepha kunye namathanga. Ngokuqhelekileyo kuhamba kunye nobuthathaka obuthathaka.
- I-Myositis - ukuvuvukala kwemisipha - ivela kumntu omnye kwi-200 abantu abathabatha ama-statins. I-Myositis ibangela ubuhlungu besisu, kunye nokuphakama kwamanqanaba e-CK egazini. I-CK i-enzyme ye-muscular, kwaye ubukho bayo egazini bubonisa ukuba umonakalo wangempela wemisipha uyenzeka.
- I-Rhabdomyolysis inobungozi obukhulu be-muscle-ngokuyininzi ukuphazamiseka okukhulu kwezicubu ze-muscle-kubangele ukukhululwa okukhulu kweprotheyini ye-muscle kwigazi, okungavelisa umonakalo omkhulu wezintso nokufa. I-Rhabdomyolysis ebangelwa yimimiselo, ngenhlanhla, ayinqabile kakhulu, kunye necala elithile elivela kuyo yonke imimiselo yeemimiselo ezi-10 ezibhalwe ngokomthetho.
Ukuba iingxaki zesisu zivela, zivame ukuqala ngeveki ezimbalwa ukuya kwiinyanga ezimbalwa emva kokuqala unyango lwe-statin.
I-myalgia ne-myositis enxulumene ne-Statin iza kulungiswa kwisithuba seveki ezimbalwa ukuba unyango lwe-statin luyeke. I-Rhabdomyolysis iya kugqitywa emva kokuba i-statin igqitywe, kodwa umonakalo obangelwayo unokungenakwenzeka.
Nangona kukho iingcamango ezininzi, akukho mntu uyazi ngokuqinisekileyo ukuba kutheni i-statins ingavelisa iingxaki ze-muscle.
I-Statin myopathy mhlawumbi ifana neenguqu kwiindlela iimisipha ezivelisa okanye ukwenza ngayo amandla. Kuze kube ngoku, abaphandi abazange bakwazi ukuthatha okungaphezulu kunoko nangayiphi na inqanaba lokuzithemba.
Ingcamango eye yafumana ukulandelelana kakhulu kuluntu kukuba i-statins ingaphazamisa umveliso we-CoQ10, i-coenzyme kwimisipha. I-CoQ10 inceda izihlunu zisebenzisa amandla afuna ukuzenza. Ezinye izifundo ezincinci zicebise ukuba ukuthatha izongezo zeCoQ10 kunokunciphisa iziganeko zeengxaki ze-muscle ezinxulumene ne-statin, kodwa idatha (zombini ukuba i-statins inganciphisa amanqanaba e-CoQ10 kwaye nokuba i-CoQ10 yokuncedisa ukuncedisa) inzima kakhulu.
Uphando olutshanje luye lwaphakamisa ukuba iingxaki ze-muscle kunye neemimiselo zihlala zihlala rhoqo kubantu abane- vitamin D. Abanye baye bafumanisa ukuba ukulawula i-vitamin D kula bantu kuya kunceda ukuxazulula iimpawu zabo zomzimba.
Iingxaki zobungozi Kwiingxaki zeMiscle
Iingxaki ze-muscle ezinemimiselo ziqhelekile kubantu abathatha i-Lopid (gemfibrozil) , i-steroids, i-cyclosporine, okanye i-niacin.
Abantu abanesifo esingasigxina sesifo, isibindi sesibindi, ukunciphisa amayeza e-vitamin D, okanye i- hypothyroidism banokuthi bafumane iingxaki zemisipha kunye nama-statins, njengabantu abanobuhlungu besifo se-muscular ezifana ne- amyotrophic lateral sclerosis (ALS) .
Ezinye iimimiselo zibonakala zinokwenzeka ukuba zivelise iingxaki zesisu kunezinye. Ngokukodwa, iziganeko zeengxaki ze-muscle zinokuphakanyiswa nge- dovvatinatin ye -dose ephezulu (igama lomthi uZocor) kunezinye izidakamizwa ze-statin.
Ngenxa yesi sizathu, ngoJuni 2011, uLolawulo lwezoKutya kunye noTywala likhuthaze ukuba i-dovastatin i-simvastatin ibe ngumyinge wama-40 mg ngosuku. Kule dosi, iziganeko zeengxaki ze-muscle ne-simvastatin azibonakali ziphezulu.
Ingozi yemingcipheko yemisipha ibonakala ingaphantsi kakhulu kunye ne-Lescol (i-fluvastatin), iPravachol (pravastatin) kunye mhlawumbi neCrestor (rosuvastatin). Ukuba iziphumo zecala ezinxulumene nemisipha zenzeka kunye nezinye iimimiselo, ukutshintshwa kwenye yezi ziyobisi kunokusombulula ingxaki.
I-statin myopathy ininzi ngakumbi kubantu ababandakanyeka ngokuzilolonga, ngakumbi xa benza njalo ngaphandle kokuyakhela kancane kancane.
Iingxaki ze-Statin-Related Related Muscle Zithathwa Njani?
Ngokuqhelekileyo, ukuba ingxaki ye-muscle ehlobene nesimo sommangalo iyaxoliswa, oogqirha baya kumisa isigxina se-statin, ubuncinane de kube yinkinga yesisombululo. Uvavanyo lufanele lwenziwe ngokusweleka kwe-vitamin D kunye ne-hypothyroidism, kunye naluphi na ukusebenzisana kwezidakamizwa ezinokunyusa iingxaki ze-muscle ezinxulumene nezimo. Naliphi na le mingcipheko echongiweyo kufuneka iqwalaselwe.
Ukuba iimpawu ezinxulumene nemisipha ziquka kuphela intlungu kwaye mhlawumbi ukuphakama kwamancinci kumanqanaba egazi le-CK, kwaye ukuba ukuqhubeka kweyeza kwe-statin kubonakala kubalulekile, kukho iindlela ezimbalwa ezinokuvumela ukuqaliswa ngokuphumelelayo kwesimiselo.
Okokuqala, ukutshintshela kwisimo esithile esingenakwenzeka ukuba kubangele iingxaki ze-muscle (njenge-pravastatin okanye i-fluvastatin) ngokuqhelekileyo vumela umntu ukuba abe nemiba yangaphambili ye-muscle ukuba athathe imimiselo ngempumelelo. Kwakhona, ukucacisa izidakamizwa zesigxina imihla ngemihla, endaweni yosuku ngalunye, kuye kwaba luncedo kwabanye abantu abangenako ukunyamezela unyango lwemihla ngemihla. Ekugqibeleni, ngelixa uninzi lweengcali azikholelwa ukuba ukongezwa kwe-CoQ10 kunceda ekuncedeni ukuphinda kuqaliswe unyango lwe-statin, kukho iingxelo ezazisasazeka ukuba oku kunokuba luncedo.
ILizwi
Nangona iziphumo ezinobungozi be-muscle yiyona ngxaki eqhelekileyo ibonwe ngama-statins, ezi ziphumo zibi kakhulu kubantu abangenayo ingozi engakumbi. Ukongezelela, kwaye xa zivela, iingxaki zomzimba zihlala zihlaziywa rhoqo. Iingxaki ezisisongela ubomi ezivela kwiimimiselo ziqabile kakhulu.
Sekunjalo, ukuba uthatha isicatshulwa se-statin kufuneka uqaphele ukuba unokuphuhliswa kwentlungu okanye ubuthathaka, kwaye ukuba ezi zibonakaliso kufuneka uzizise ugqirha wakho.
> Imithombo:
> Gupta A, Thompson PD. Ulwalamano lwe-Vitamin D ukusilela kwi-Statin Myopathy. Atherosclerosis 2011; 215: 23.
> Rosenson RS, Baker SK, Jacobson TA, et al. Uvavanyo lweStatistics Muscle Safety Task Force: Uhlaziyo lwe-2014. J Clinic Lipidol 2014; 8: S58. T
> Stroes ES, Thompson PD, uCorsini A, et al. I-Statin-ehambelana nemizimba yamathambo: Impembelelo kwi-Statin Therapy-I-European Atherosclerosis Society I-Consel Statement Statement kwi-Assessment, Aetiology kunye noLawulo. I-Eur Heart J 2015; 36: 1012.
> Thompson PD, Clarkson PM, Rosenson RS, Umbutho weSizwe wePilid iState Safety Task Panel I-Expert Safety Panel. UkuVavanywa koKhuseleko lweStatin ngamaSuncle Experts. Ngaba uJ Cardiol 2006; 97: 69C.