Inxalenye ebalulekileyo yokuthintela i- atherosclerosis , isifo se-coronary disease (CAD) , izibetho kunye nesifo se-artery , kukugcina i-cholesterol yakho kunye ne-triglyceride ephezulu. Nangona abanye abantu banokufeza le njongo ngokutya kunye nokuzilolonga, abaninzi abanako. Ukuba ukutya kunye nokuzivocavoca akwanele kuwe, okanye ukuba umngcipheko wesifo se-cardiovascular is high, amathuba ukuba ugqirha wakho uya kufuna ukuba uqale ukuthatha imithi yonyango.
- Funda malunga neziseko ze-cholesterol kunye ne-triglycerides.
- Funda malunga nendlela yokuxelela ukuba kufuneka uphathwe.
Kule minyaka, iintlobo ezininzi zamachiza ziye zamiselwa ukwelapha i-cholesterol kunye ne-triglycerides. Nangona i-statins sele iyona nto ibaluleke kakhulu yeeklesterol-ezinciphisa iziyobisi, amaninzi amayeza adala asetyenziswayo. Ukongezelela, iintlobo ezitsha zamachiza ekunakekeleni i-lipids yegazi ziqala ukuza kusetyenziswa ukliniki.
Naluphina unyango olwenzelwe wena, kufuneka ukwazi into ethile malunga neziyobisi ezithile ozithathayo. Nantsi inkcazo epheleleyo yonyango lomgulo okhoyo olwenziwe kunyango lwegazi.
Iitatimins
Iitatimins ziyintloko yeliyilithi ye-cholesterol, ngenxa yesizathu esilula kakhulu - izitembu ziphela zeklasi zee-cholesterol-ezinciphisa iziyobisi eziye zaboniswa ukuphucula iziphumo ezibonakalayo kubantu abanomngcipheko we-cardiovascular risk, ngokukodwa kubantu abaye bafumana ukuhlaselwa intliziyo okanye ukubetha.
Izidakamizwa ze-statin zivimbela i-enzyme ebizwa ngokuthi i-HMG-CoA yokunciphisa, eyanciphisa ikhono lobindi lokusebenzisa i-cholesterol. Ngoko iimimiselo zincinci kwaye zithembekileyo zincinci ye-cholesterol yegazi kunye namazinga e-cholesterol ye-LDL.
Izitatimende nazo zinciphisa ukuvuvukala kweengculaza, ukunciphisa intlanzi ye-vascular, kunye nokuphucula umsebenzi jikelele we-vascular.
Izitatimende zivame ukunyamezeleka, kodwa iziphumo zecala zenzeka. Umphumo osisigxina kakhulu kwiintlungu okanye ubuthathaka , obonwa kwi-5 ukuya kwi-10% yezigulane ezithatha izi yobisi.
Iimimiselo ezikhoyo ngoku ziquka:
- Lipitor (atorvastatin)
- Lescol (i-fluvastatin)
- Mevacor (lovastatin)
- Livalo (pitavastatin)
- Pravachol (pravastatin)
- Zocor (simvastatin)
- Crestor (rosuvastatin)
PCSK9 Inhibitors
I- PCSK9 inhibitors yiklasi elitsha lezidakamizwa ezinciphisa i-cholesterol. Eyokuqala ezimbini - i-Repatha (evolocumab) kunye ne-Praluent (alirocumab) - yavunywa yi-FDA ngasekupheleni kuka-2015. La machiza asebenza ngokuvimbela i-PCSK9 enzyme kwisibindi, esibangela isibindi ukususa i-cholesterol engaphezulu kweLDL. I-PCSK9 inhibitors, ezinikezwa ngejojo, ziyakwazi ukuqhuba i-cholestolol ye-LDL kumazinga aphantsi kakhulu, kwaye ngenxa yesi sizathu, ziye zadala intshiseko enkulu phakathi kwabaphandi.
Namhlanje ezi zidakamizwa zisetyenziswe kwizigulane ezine-hypercholesterolemia, okanye zinezinga le-LDL le-cholesterol ehlala liphakamileyo kakhulu nangona kukho unyango kunye nama-statins. Ukusetyenziswa kwabo kunokwandiswa kwiminyaka emininzi ezayo njengoko sifunda ukuba ingaba ziphucule iziphumo zekliniki, ngaphezu kwezinga le-cholesterol - kwaye ingaba zivelisa imiphumo emide yexesha elide.
I-Nicotinic Acid (Niacin)
I-Nicotinic acid, uhlobo lwe-niacin , linciphisa i-cholestolol ye-LDL kwaye yandisa ama-cholesterol ye-HDL. Kwiminyaka edlulileyo, yayimiselwe ngokukhawuleza ukunyusa amazinga e-HDL. Nangona kunjalo, uphando olunzulu lweklinikhi luye lwafakaza kakhulu kwiintlobo ze-nicotinic acid. Kule sifundo, akukona nje ukuba i-nicotinic asiyiyo kuphela ukuphucula iziphumo zekliniki kodwa kwaye ingenokwandisa umngcipheko wesifo. Namhlanje, i-nicotinic acid isetyenziswa kuphela kwizigulane ezinezinga eliphezulu ze-LDL ze-cholesterol ezingenakuthatha ezinye iziyobisi.
Ezitimibe
I-Ezetimibe inciphisa ukutywala kwe-cholesterol ukusuka emathunjini, okwenza isibindi sithole enye ye-cholesterol eyidinga ngokuyisusa egazini.
Ngenxa yoko, amanqanaba e-LDL e-cholesterol ancipha.
Uvavanyo lwezonyango nge-ezetimibe (oluthengiswa njengeVivinin, kunye kunye ne-simvastatin njengoZetia) luye ludumala, kwaye isilwanyana asisetyenziswanga rhoqo kwiinkqubo zonyango. It isetyenziswe ikakhulu kubantu abaqhubela phambili ama-cholesterol amanqanaba nangona unyango lwe-statin, okanye abangakwazi ukuthatha i-statins.
Abadlali bee-Acid Sequestrants.
I-Bile acid sequestrants ikhusela ukubuyiswa kwakhona kwe-cholesterol equkethe i-bile acid kwi-intestine. Oku kubangela ukuba isibindi sisuse i-cholesterol engakumbi kwi-circulation. I-bile acid sequestrants yiQuestran (cholestyramine), iCholestid (colestipol), ne-Welchol (colesevelam).
Nangona la machiza ayanciphisa ngempumelelo amazinga e-cholesterol ye-LDL, athambekele ekubangela iziphumo zesisu esiswini sokunciphisa ukusetyenziswa kwazo. Kwakhona, njengamanye amaninzi e-cholesterol-downing, izifundo zeklinikhi ziye zahluleka ukubonisa ukuba ziphucula iziphumo.
Nantsi ulwazi oluthe xaxa malunga ne-cholestyramine , i- asequestrant ye -bic acid esetyenziswa ngokuqhelekileyo.
Fibrates.
I- fibrates - i-Antara (gemfibrozil) kunye ne-Lopid (i-fenofibrate) -yona ingcono kakhulu ekunciphiseni amanqanaba egazi le-triglyceride (ngo-50%). Bakwandisa amazinga e-cholesterol e-HDL kwaye banciphise amazinga e-cholesterol ye-LDL kwinqanaba elithile. I-fibrates isebenza ngokuthintela ukuveliswa kweepoprostin ezicebileyo ze-triglyceride esibindi. Kanti, nangona kunjalo, nangona igalelo labo elihle kwigazi lipids, izilingo ezininzi ezingaphelelanga zihlulekile ukubonisa naluphina uphuculo kwiziphumo zeklinikhi kunye ne-fibrates.
Ukusetyenziswa ngokusemgangathweni kwama-fibrates namhlanje kukunyanga izigulane ezine- hypertriglyceridemia enkulu . Impembelelo ebonakalayo yecandelo le-fibrates kukuba iyakwenza ubuthi obuyingozi, ngakumbi xa isetyenziswe ngama-statins.
ILizwi
Nangona iiklasi eziliqela zezonyango ziboniswe ukuba zinefuthe elihle kwi-cholesterol nakwizinga le-triglyceride, kuphela iimimiselo ziboniswe ukuba ziphucule kakhulu iziphumo zekliniki. Izikhokelo zangoku ekuphatheni umlinganiselo we-cholesterol iziphakamiso zabo kwiimithi ze-statin - ezinye iziyobisi azikhuthazwa ngaphandle kwamacala athile.
Nangona kunjalo, abaphandi balindele ngokulangazela iziphumo zezilingo zekliniki ngoku ziqhutyelwa nge-PCSK9 inhibitors, iklasi elitsha leziyobisi ezinomphumela wokunciphisa i-cholesterol.
> Imithombo:
> Stone NJ, uRobinson JG, uLichtenstein AH, et al. 2013 ACC / AHA isikhokelo kwiNyango yeGazi ye-Cholesterol ekunciphiseni ingozi ye-Atherosclerotic ye-Cardiovascular Risk kuBantu abadala: Ingxelo ye-American College of Cardiology / American Heart Association Task Force on Practice Guidelines. Ukuhamba ngo-2014; 129: S1.
> Navarese EP, Kolodziejczak M, Schulze V, et al. Iimpembelelo zeProprotein Convertase Subtilisin / Kexin Uhlobo lwe-Antibodies e-Adults nge-Hypercholesterolemia: Uhlolo lokuHlola kunye nokuhlaziywa kwe-Meta. Ann Intern Med 2015; 163: 40.
> Abaphandi be-AIM-HIGH, iBoden WE, Probstfield JL, et al. I-Niacin kwizigulane ezineqondo eliphantsi kwe-HDL ye-Cholesterol Levels Ukufumana iStatic Treatment enzulu. N Engl J Med 2011; 365: 2255.