Ukwenza utshintsho ukuseka indlela yokuphila enempilo - ngokutya, ukuzivocavoca, okanye ezinye iinguqu-kubalulekile ukugcina i-cholesterol yakho kunye namazinga e-triglyceride enempilo. Ngamanye amaxesha, oku kungenakusebenza, kwaye umboneleli wakho wezempilo unokufuna ukukubeka kumayeza.
Uninzi lwamachiza e-cholesterol-downing currently in the market, kwaye ngalinye lala mayeza aphantsi kwe-cholesterol kunye / okanye amanqanaba e-triglyceride ngeendlela ezahlukeneyo.
Ukongezelela, ngalinye leziyobisi zijolise kwimimandla eyahlukeneyo yepropid profile yakho. Ngokomzekelo, ezinye iziyobisi zingasebenza kuphela ekunciphiseni i- LDL ye- cholesterol, ngelixa ezinye iziyobisi zingabhekisela kuzo zonke iinkalo zeprofayili yakho yepilid. Kwimeko nayiphi na imeko, umboneleli wakho wezempilo uya kulusebenzisa ubunzima kunye neengozi zonyango ngalinye, kwaye ukhethe izidakamizwa ezichanekileyo eziphantsi kweepiliti ezifanelekileyo. Le mishanguzo yonyango njengamanje kwimarike:
ZeNkcazo
Iitatimins, ezaziwa nangokuthi i-HMG-CoA iyanciphisa i-inhibitors, yiyona nto imiselweyo imithi yokunciphisa i-cholesterol. Nangona bafumene idumela elibi kwezinye zezinto ezingathandekiyo, kodwa ezingavumelekanga, iziphumo ezibi , zijolise kuzo zonke iinkalo zeprofayili yakho yeepidid.
Statins zi no:
- Nciphise i- LDL phakathi kweepesenti ezingama-18 kunye ne-65 ekhulwini
- Ukwandisa i- HDL ("intle" ye-cholesterol) ukuya kuma-5 ukuya kuma-15 ekhulwini
- Ukunciphisa i- triglycerides ngamaphesenti ama-7 ukuya kuma-30 ekhulwini
Akunjalo kuphela ama-statins asebenzayo ekuqheleni zonke iinkalo zeprofayili yakho ye-cholesterol, ziye zaphawulwa ukukhusela ukufa kunye neengxaki ngenxa yesifo senhliziyo.
Izitatimende nazo zinempahla echasayo yokunciphisa ukunyuka kwe- atherosclerosis engakhokelela kwisifo senhliziyo. Ngale nzuzo eyongezelelweyo yeemimiselo, leziyobisi zichazwe ngokubanzi kwiyeza zokunciphisa i-cholesterol. Ezi zi yobisi zilandelayo zibalwa njengemigangatho:
- Rosuvastatin (Crestor)
- Atorvastatin (Lipitor)
- ISimvastatin (iZocor)
- Lovastatin (Mevacor)
- Pravastatin (Pravachol)
- IFluvastatin (Lescol)
IiReins ze-Acidi zeBile
Ii-resile ze-acid ze-Bile zinciphisa i-cholesterol egazini ngokukhusela i-bile acid ukusuka ekubuyiselweni kwakhona. Ngokuqhelekileyo basebenza kwi-LDL ye-cholesterol, ukunciphisa phakathi kweepesenti eziyi-15 ukuya kuma-30 ekhulwini kunye nokunyuka kwe-HDL ngokunyuka kuma-5 ekhulwini. Ngokuqhelekileyo, i-triglycerides ayichukumiswanga yi-bile acid resins - kwaye inokunyusa amazinga e-triglycerides. Ukongezelela, ezinye iivithamini kunye neziyobisi azikwazi ukuthatyathwa malunga nexesha othabatha i-bile acid resins, kuba ukuxhatshazwa kwabo kunqongophele kwaye kunokubenza bangasebenzi. La mayeza alandelayo achazwa njenge-bile acid resins:
- Cholestyramine (Questran)
- Colestipol (iColestid)
- Colesevelam (Welchol)
Fibric Acids
I-acids ye-fibric, okanye i-fibrates, iyaziwa kakhulu ngenxa yokukwazi ukunciphisa i-triglycerides, enokunciphisa ngama-20 ukuya kuma-50 ekhulwini. Baye banciphise amanqanaba e-LDL phakathi kwama-5 ukuya kuma-20 ekhulwini kwaye banokuphakamisa amazinga e-HDL ngamaphesenti angama-20. Le klasi yeziyobisi iye yaziwa ukuba ivelise i-muscle toxicity, ingakumbi xa idibaniswe namanye amachiza afana nama-statins kunye ne-warfarin (i-Coumadin). Kule meko, umboneleli wakho wezempilo unokuthi alungele umthamo weziyobisi zakho (njengoko kunjalo kwimeko ye-warfarin).
La mayeza alandelayo:
- Gemfibrozil (Lopid)
- Fenofibrate (Tricor)
Ukunyusa ama-inhibitors
I-Ezetimibe okwangoku kuphela isilwanyana kule klasi kwaye ngokukodwa iithagethi ze-LDL ze-cholesterol, ukunciphisa amazinga e-LDL ngama-15 ekhulwini. Ngokuqhelekileyo, i-ezetimibe inxulumene nesimo sokuqinisekisa ukuba ifuthe elinamandla xa kunciphisa amazinga e-LDL. Nangona la mayeza aye aboniswa kwi-LDL ephantsi, ababonwanga ukukhusela ngokuthe ngqo ukuphuhliswa kwesifo senhliziyo xa sisetyenziswe yodwa. I-Ezetimibe (Zetia) yiyodwa imithi evunyiweyo ye-FDA ngaphakathi kweli nqanaba leziyobisi.
I-Omega-3 Fatty Acids
Nangona kukho i-omega-3 e-fatty acids e-counter-counter-counter-counter-oil, i-omega-3 e-fatty acid products iye yafumana ukuvavanya okubanzi ukuvavanya ukusebenza nokukhuseleko.
Ezi mveliso ziqukethe i docosahexaenoic acid (DHA) kunye ne-eicosohexaenoic acid (i-EPA) njengezongezelo ezitholakala kwiivenkile, kodwa ezi zixhobo zihlambulukile kwaye zijoliswe xa zithelekiswa nokuveliswa kwee-counter-counter. I-omega-3 fatty acids yesigqirha isetyenziswe ngokubanzi kubantu ukuba bajolise kumanqanaba aphezulu e-triglyceride, ukunciphisa i-triglycerides ngamaphesenti angama-45. Kukho okwangoku ezintathu i-omega-3 fatty acid [iimveliso ezikhoyo:
- Epanova (i-omega-3 carboxylic acid)
- I-Lovaza (i-omega-3 e-fatty acids ekhululekile)
- I-Vascepa (icosapent)
PCSK9 Inhibitors
Ezi zi yobisi zivimba iprotheni ye-PCSK9 ekusebenzisaneni ne-receptors ye-LDL kwaye ibangele ihlaziywe. Oku kuya kuvumela i-LDL receptors ukuba iqhubeke nokusebenza ngokususa i-LDL emzimbeni-obangela ukunciphisa ama-cholesterol ama-LDL ngamaphesenti angama-50 kwizifundo. Amachiza kule klasi ayongezwa xa iyeza zokunciphisa i-cholesterol (njengama-statins) awanciphisi ngokupheleleyo amanqanaba e-cholesterol ye-LDL. Zivame ukusetyenziswa kunye kunye nokutya okunentliziyo kwaye zithathwa ngama-statins okanye ezinye iziyobisi ezinciphisa i-cholesterol. Abantu abathatha la mayeza bafumana enye yeemeko zonyango ezilandelayo:
- isifo se-atherosclerotic ezibandakanya imithana yegazi kunye / okanye intliziyo
- iimeko zonyango ezizuze njengefa, i-homozygous okanye i-heterozygous family hypercholesterolemia
Kukho uphando olukhoyo oluqhubekayo oluhlolisayo ikhono lamachiza kule klasini ukunciphisa umngcipheko wokufa okanye ukuhlaselwa yintliziyo kwintliziyo yabantu abayithathayo. Iziyobisi kule klasi zibandakanya:
Iidakamizwa zeeNtsana
Ezinye iziyeza zokunciphisa i-lipid zichazwe kubantu abanomgangatho ophezulu we-LDL we-cholesterol. La mayeza asemiselweyo kwiimeko apho umntu enesimo esizuze ilifa elidala amaqondo aphakamileyo kakhulu e-lipid, kwaye amanye amayeza - njengemimiselo-ayinakunceda amanqanaba aphantsi e-LDL.
Ezinye zala mayeza zingabangela iziphumo ezibi kakhulu, ezifana nesifo sesibindi, ngoko zidlalwa phantsi kwenkqubo ekhethekileyo ngabaqeqeshi bezempilo abaqhelana namayeza. La mayeza abuye atshale kwiimarike kwaye asebenze ngeendlela ezizodwa zokunciphisa amanqanaba omlomo:
- Ii-inhibitors ze-Antisense: Imithi kule nkcazo yekliniki eyongezelelweyo ibophezela kwicandelo le-RNA yomthunywa elinekhowudi zokwenza i-B-100, ukunciphisa inani le-B-100 elenziwe kwimizimba. Oku kunciphisa inani le-VLDL neLDL cholesterol emzimbeni. Ezi zi yobisi ziquka iKynamro (mipomersen), ehlisa i-LDL malunga nama-25 ekhulwini.
- I-MTTP inhibitors: Ezi ziyobisi zingaphantsi kwe-LDL cholesterol ngokuthintela iprotheni yokudlulisa i-protein (trigger) ye-triglyceride (MTTP), i-molecule emzimbeni ovimbela i- VLDL kunye ne- chylomicron ukuba zenziwe esibindi. I-Juxtapid (i-lomitapide) yodwa imishanguzo evunyiweyo kule klasi yeziyobisi kwaye iphantsi kwe-LDL malunga nama-50 ekhulwini.
Imithombo:
UDipiro JT, uTalbert RL. I-Pharmacotherapy: Indlela yePathophysiological, 9th 2014.