Malinga ndi ziwerengero zamankhwala, mwa odwala omwe ali ndi matenda a mtima komanso odwala matenda ashuga, kuchuluka kwa anthu omwe amafa chifukwa cha matenda amtima ndi omwewo.
Matenda a shuga amatha kuchepetsa chiopsezo cha zovuta za atherosulinosis - angina pectoris, infarction ya myocardial, kufa kwa coronary, ischemic stroke.
Amagwiritsidwa ntchito ngakhale pakhale zovuta zoyipa.
Ubwino Wogwiritsa Ntchito Statins
Kuphatikiza pakuwongolera zochita za hypolipidemic, ma statin amakhala ndi zambiri - kuthekera koyambitsa maselo amomwe amapangira michere komanso kuchita mbali zosiyanasiyana za chandamale.
Kugwirizana kwa kugwiritsa ntchito kwa ma statins mu mtundu wa matenda a shuga a I ndi II kumatsimikiziridwa makamaka ndi zotsatira zawo pa cholesterol ndi triglycerides, pakubala ndi ntchito ya endothelium (choroid yamkati):
- Kugwiritsa ntchito bwino cholesterol ya plasma. Ma Statin sakukhudzidwa mwachindunji (kuwononga ndi kuwononga thupi), koma kuletsa ntchito yachinsinsi ya chiwindi, kuletsa kupanga kwa enzyme yomwe imathandizira pakupanga chinthu ichi. Kugwiritsa ntchito kwakanthawi kwakanthawi kwa mankhwala a ma statins kumakuthandizani kuti muchepetse cholesterol index ndi 45-50% kuchokera pamlingo woyamba.
- Sinthani ntchito yamkati yamitsempha yamagazi, kuonjezera mphamvu ya vasodilation (onjezerani lumen ya chotengera) kuti muthandize kutuluka kwa magazi ndi kuteteza ischemia.
Statin tikulimbikitsidwa kale gawo loyambirira la matendawa, ngati chidziwitso cha atherosulinosis sichingathekebe, koma kusokonekera kwa endothelial. - Zokhudzana ndi zotupa ndikuchepetsa magwiridwe amodzi a zolembera zake - CRP (protein ya C-reactive). Kuwona kwamatenda ambiri amatilola kukhazikitsa ubale wa index yayikulu ya CRP komanso kuopsa kwa zovuta zama coronary. Kafukufuku mu odwala 1200 omwe amatenga ma statins a m'badwo wachinayi amatsimikizira kutsika kwa CRP ndi 15% pofika kumapeto kwa mwezi wachinayi wa chithandizo. Kufunika kwa ma statins kumawonekera pamene matenda a shuga akuphatikizidwa ndi kuwonjezeka kwa kuchuluka kwa mapuloteni a C osagwira ntchito oposa 1 milligram pa desilita imodzi. Kugwiritsa ntchito kwawo kukuwonetsedwa ngakhale pakalibe mawonekedwe a ischemic mu minofu ya mtima.
- Kuthekera uku ndikofunikira makamaka kwa odwala omwe ali ndi matenda a shuga, omwe amadalira insulin komanso osadalira insulin, momwe mitsempha yamagazi imakhudzidwira ndipo chiopsezo chokhala ndi ma pathologies akuluakulu chikuwonjezeka: matenda ashuga angiopathy, kulowetsedwa kwa myocardial, matenda a mtima.
Kugwiritsira ntchito ma statin kwa nthawi yayitali kumatha kuchepetsa chiopsezo cha zovuta za mtima ndi wachitatu. - Zotsatira za heestasis zimawonekera mu kuchepa kwa kukhuthala kwa magazi ndikuwongolera kayendedwe kake m'magazi amitsempha, kupewa ischemia (kuperewera kwa michere). Ma Statins amaletsa mapangidwe amitsempha yamagazi ndikumamatira kwawo ku malo a atherosulinotic.
Zokhudza shuga
Chimodzi mwazotsatira zoyipa za mankhwala omwe amapezeka ndi mankhwala osokoneza bongo a statin ndi kuchuluka kwamphamvu kwa glucose a mayunitsi 1-2 (mmol / l).
Munthawi yonse ya mankhwalawa, kuwongolera magawo a chakudya ndi kovomerezeka.
Njira zomwe zimapangitsa kuti chiwonetsero cha shuga chiwonjezeke sizinaphunzire, koma kafukufuku wasonyeza kuti kugwiritsa ntchito ma statins kwa nthawi yayitali ndi 6-9% kumawonjezera mwayi wokhala ndi matenda osokoneza bongo omwe amadalira insulin (mtundu II).
Pankhani ya matenda omwe alipo, kusintha kwake kukhala mawonekedwe obisika kumatha, momwe kuchuluka kwa glucose m'magazi kumafunikira kusintha kosinthika pogwiritsa ntchito chakudya chokhazikika cha carb komanso kuwonjezeka kwa kuchuluka kwa mankhwala ochepetsa shuga.
Komabe, malinga ndi akatswiri a mtima ndi ma endocrinologists, maubwino omwe amatenga matenda a shuga a mitundu yoyamba ndi yachiwiri amapitilira muyeso wowopsa wazotsatira zoyipa.
Kodi ma statins angakhale oopsa motani?
Mankhwala ochepetsa mphamvu ya cholesterol, adanenanso zoyipa, amafunika kuyang'aniridwa kuchipatala ndipo sanayenere kudzipangira mankhwala.
Mankhwala a Hypolipidemic a gululi amapatsa zotsatira zawo pogwiritsa ntchito nthawi yayitali, potengera izi, zotsatira zoyipa za mankhwala zimatha kupezeka pokhapokha patapita nthawi.
Zotsatira zoyipa za mankhwala zimagwira ntchito ku ziwalo zonse ndi machitidwe:
- Hepatotoxicity ya statins ikuwonetsedwa pakuwonongeka kwa maselo, kuphwanya kapangidwe ndi ntchito ya chiwindi. Ngakhale mphamvu za maselo a chiwindi zimatha kusintha, katundu pa chiwalocho ndiwosatheka.
Kuwunikira pafupipafupi kwa chiwindi transaminases ALT ndi AST, komanso okwana (mwachindunji ndi omangika) bilirubin, amafunika kuyesa ntchito ya chiwalo. - Minofu minofu imapangidwanso ndi ma statins, omwe amatha kuwononga maselo a minofu (myocyte) ndikamasulidwa kwa lactic acid.
Amawonetsedwa ndi kuwawa kwa minofu, kukumbukira zomwe zimachitika chifukwa chakuchita zolimbitsa thupi kwambiri. Monga lamulo, kusintha kwamapangidwe amkati mwa minyewa sikakhazikika ndipo kusiya mankhwala kumatha kubwereranso kwina. Komabe, pazochitika zinayi mwa chikwi, matenda am'mimba amatenga mawonekedwe owopsa ndikuwopseza kukula kwa rhabdomyolysis - kufa kwakukulu kwa myocyte, poyizoni wazinthu zowonongeka ndi kuwonongeka kwa impso ndi kuwonjezeka kwa kupweteka kwambiri kwaimpso. Dera lamalire, likufuna kukonzanso. Chiwopsezo cha kukulitsa myopathies - kupweteka kwa minofu ndi kukokana - kumawonjezera ndi kuphatikiza kwa mankhwala a statins ndi mankhwala osokoneza bongo, matenda a shuga kapena gout.
Kuwunikira magazi pafupipafupi ndikofunikira kwa CPK (creatine phosphokinase) - chizindikiro cha myocyte necrosis - kuwunika mkhalidwe wamisempha. - Kusintha komwe kumachitika chifukwa cha ma statins a mphamvu ya mankhwala ndi zinthu zina zamalumikizidwe mkati mwa mafupa kumatha kuyambitsa njira zamatenda ndikukula kwa nyamakazi ndi arthrosis, makamaka zazikulu - m'chiuno, bondo, phewa.
- Kuwonetsedwa kwa dongosolo logaya chakudya kungathe kudziwika ndi vuto la kusowa kwa magazi, kusakhazikika kwa chilakolako chofuna kudya, kupweteka kwam'mimba.
- Mitsempha yapakati komanso yapafupipafupi imatha kuyankhanso kugwiritsa ntchito ma statins pogwiritsa ntchito mawonekedwe osiyanasiyana: kusokonezeka kwa tulo, kupweteka mutu, asthenic zochitika, kutengeka mtima, kusokonekera kwamphamvu ndi ntchito zamagalimoto.
Malinga ndi kafukufuku wazachipatala, pafupipafupi mphamvu iliyonse yazomwe zimachitika kuchokera ku dongosolo lamanjenje siziposa 2%. - Mu gawo limodzi ndi theka la milandu, dongosolo la coronary limayankha mankhwala a statin ndi kuchepa kwa kuthamanga kwa magazi chifukwa cha kuchuluka kwa mitsempha ya magazi, kudziwa kugunda kwa mtima, kuchepa kwa mtima, ndi migraine chifukwa cha kusintha kwa kamvekedwe ka mitsempha ya magazi muubongo.
Vutoli limafanana ndi thupi litayamba kuzolowera magazi. Nthawi zina kuchepetsedwa kwa mankhwalawa kumafunikira.
Statin ndi matenda ashuga: kuyenderana ndi mwayi
Endocrinologists ali ndi lingaliro loti ma statins ndi gulu lokhalo la mankhwala omwe amachepetsa lipid omwe zochita zawo zimafuna kusintha moyo wa odwala omwe samadalira insulini (mtundu II) matenda a shuga.
Omwe akudwala matendawa amatenga chiopsezo kuwonongeka kawiri kawiri chifukwa cha odwala omwe ali ndi matenda a shuga.
Chifukwa chake, kuyambitsidwa kwa ma statins mu ndondomeko ya chithandizo cha matenda amtundu wa II akuwonetseredwa ngakhale mu milandu yomwe cholesterol ili pamlingo wovomerezeka komanso kupezeka kwa matenda a m'mitsempha a m'mitsempha samakhazikitsidwa.
Ndi ma statins omwe ali bwino kusankha?
Kudziyendetsa nokha kwa lipid-kuchepetsa mankhwala a gululi sikungatheke: ma statins amawagawa m'mafakitori pokhapokha ngati akupatseni mankhwala.
Dokotala yemwe amakupatsani mankhwala amakupatsirani mankhwalawo payekha, poganizira zomwe wodwalayo ali ndi mikhalidwe yake:
- M'badwo woyamba - Ma statins achilengedwe (simvastatin, lovastatin), cholesterol yotsika ndi 25 38%. Zotsatira zoyipa zochepa, komanso kugwiranso ntchito kothinikizira kwa triglycerides.
- M'badwo wachiwiri - kupanga (fluvastatin), ndikakhala ndikugwira ntchito nthawi yayitali, kumachepetsa cholesterol ndi wachitatu.
- M'badwo wachitatu - kapangidwe (atorvastatin), pafupifupi halle cholesterol index, akuletsa kaphatikizidwe kazake kuchokera ku minofu ya adipose. Chimalimbikitsa kuchuluka kwa hydrophilic lipids.
- M'badwo wachinayi - kupanga (rosuvastatin) - kuyendetsa bwino kwambiri komanso chitetezo, kumachepetsa cholesterol mpaka 55% ndikulepheretsa kaphatikizidwe ka lipoproteins otsika. Chifukwa cha hydrophilicity, imakhala yovuta kwambiri pachiwindi ndipo siyomwe imayambitsa kufa kwa myocyte. Zotsatira zake zimafika pakuwopseza kwambiri sabata yachiwiri yogwiritsira ntchito ndipo imasungidwa pamlingo uwu, malinga ndikugwiritsa ntchito mosalekeza.
Mankhwala osankha pamenepa ndi ma hydrophilic (madzi sungunuka) ma statins: pravastatin, rosuvastatin. Amatha kupereka zotsatira zapamwamba kwambiri ndi zoopsa zochepa zoyipa.
Mothandizidwa ndi chidziwitso chatsopano chomwe chimapezeka pazoyeserera zamankhwala, momwe amagwiritsidwira ntchito mankhwala akusintha. Pakadali pano, ma statins amatha kuchepetsa zoopsa zomwe zimadza chifukwa cha mitsempha ndi ma coronary, chifukwa chake amagwiritsidwa ntchito kwambiri pochiza matenda ashuga.
