Chikamu chakakosha chekudzivirira kushaya atherosclerosis , coronary artery chirwere (CAD) , kurohwa uye chirwere chetachiona chirwere , kuchengetedza cholesterol yako uye triglyceride mazinga kubva pakukwirira. Kunyange zvazvo vamwe vanhu vanogona kuzadzisa chinangwa ichi nekudya uye kuita zvekurovedza muviri, vazhinji havagone. Kana kudya uye kuita zvekurovedza zvisingakukwani iwe, kana kana ngozi yako yehutano hwepfungwa inonyanya kukwirira, mikana ndeyokuti chiremba wako achada iwe kutanga kutora mishonga yemishonga.
- Verenga pamusoro pezvakakosha zvekushutoriol uye triglycerides.
- Verenga pamusoro pekuudza kana uchida kurapwa.
Mumakore ose aya, marudzi akawanda emishonga akave akarayirwa mukurapa cholesterol uye triglycerides. Kunyange zvazvo statins yakave iyo inonyanya kukosha yekodetori-kuderedza madhiragi, mazhinji emishonga yakakura achiri kushandiswa. Uyezve, mhando itsva yemishonga yekurapa ropa lipids inotanga kupinda muchirwere chekushandisa.
Chero chero kurapwa kwakagadzirirwa iwe, unofanira kuziva chimwe chinhu pamusoro pemishonga inenge yauri kutora. Heino tsanangudzo yakawanda yemishonga inorayira mishonga inowanika mukurapa ropa lipids.
The Statins
Statins ndiyo inonyanya kushandiswa kweyeroti yeklesterol, nokuda kwechikonzero chakareruka - mitemo ndiyo yega yekirasi yeikodermori-kuderedza mishonga yakaratidzwa kugadzirisa zviitiko chaiyo kune vanhu vane ngozi yepamusoro yemwoyo, uye kunyanya kune vanhu vakambove vane kuora mwoyo kana kurohwa.
Izvozvo zvinoshandiswa nemishonga inorambidza enzyme inonzi HMG-CoA reductase, iyo inoderedza kukwanisa kwechiropa kuita cholesterol. Saka zvinyorwa zvinokwana uye zvakaderera zvakaderera zvakakwana ropa rega cholesterol uye LDL cholesterol mazinga.
Statins inoderedzawo kuputika kwemavhesi, kuderedza kushungurudzika kwemavhutu, nekuvandudza zvakakwana vascular function.
Statins inowanzochengetedzwa zvakanaka, asi migumisiro yechirwere inoitika. Chinhu chinonyanya kukosha chinokonzerwa nemarwadzo emasumbu kana utera , izvo zvinowanikwa mu5 - 10% yevarwere vanotora mishonga iyi.
Parizvino zvinyorwa zvinowanikwa zvinosanganisira:
- Lipitor (atorvastatin)
- Lescol (fluvastatin)
- Mevacor (lovastatin)
- Livalo (pitavastatin)
- Pravachol (pravastatin)
- Zocor (simvastatin)
- Crestor (rosuvastatin)
PCSK9 Inhibitors
IQCSK9 inhibitors iboka idzva rekutsvaira-kuderedza mishonga. Iviri yekutanga - Repatha (evolocumab) uye Yakakosha (alirocumab) - yakagamuchirwa neRDA kunopera 2015. Zvinodhaka izvi zvinoshanda nekudzivisa PCSK9 enzyme muropa, izvo zvinoita kuti chiropa chibvise zvakawanda zveLDL cholesterol kubva pakuparadzirwa. ICCSK9 inhibitors, iyo inopiwa nejojo, inogona kutengesa LDL cholesterol kumatunhu akadzika kwazvo, uye, nokuda kweizvi, yakagadzira kushingaira kukuru pakati pevanotsvakurudza.
Mazuva ano mishonga iyi inoshandiswa kune varwere vane hypercholesterolemia yemhuri, kana kuti vanewo LDL cholesterol mazinga anoramba akasimudzirwa pasinei nekurapa nemasimoni. Kushandiswa kwavo kunogona kuwedzera pamakore mashomanana anotevera apo tinodzidza kana vanogona kuvandudza zvigaro zvekuchirapa, kuwedzera kwekushandiswa kwecholesterol - uye ingave inobereka migumisiro yakareba kwenguva yakareba.
Nicotinic Acid (Niacin)
Nicotinic acid, chimiro cheniacin , inoderedza LDL cholesterol uye inowedzera HDL cholesterol mazinga. Mukati yapfuura yapfuura, yakarongedzerwa zvakanaka nguva dzose kuwedzera huwandu hweHDL. Asi zvakadaro, chidzidzo chikuru chekuchirapa chakakonzera kusava nechokwadi kwakanyanya pamusoro pemigumisiro ye nicotinic acid. Muchidzidzo ichi, kwete chete kuti nicotinic acid yakakundikana kuvandudza zvido zvekugadzirira asi zvakare inogona kuwedzera njodzi yekurohwa. Nhasi, nicotinic asidi inoshandiswa chete kune varwere vane high LDL cholesterol mazinga vasingagoni kutora mamwe mishonga.
Ezitimibe
Ezetimibe inoderedza kunwa kwecholesterol kubva mumatumbu, zvichiita kuti chiropa chiwane zvakawanda zveku cholesterol inoda kuburikidza nekuchibvisa kubva muropa.
Somugumisiro, LDL cholesterol mazinga akaderedzwa.
Mishonga yemakemikari ne ezetimibe (inotengeswa seVytorin, uye pamwe chete nesimvastatin saZetia) yakanyanyisa kuodza mwoyo, uye mishonga haisati yashandiswa kakawanda mumagariro ekurapa. Iyo inoshandiswa kunyanya kune vanhu vakaramba vachikwikwidzana neholesterol yepamusoro pasinei nehutachiona hwetsika, kana kuti ndiani asingakwanisi kutora mitemo.
Bile Acid Sequestrants.
Bile acid sequestrants inodzivirira kubvisazve chealterol-containing bile acids kubva mumutsipa. Izvi zvinokonzera kuti chiropa chibvise kleurholoni yakawanda kubva pakuparadzirwa. I-bile acid sequestrants ndiyo Questran (cholestyramine), Cholestid (colestipol), uye Welchol (colesevelam).
Kunyange zvazvo madhiragi aya uye achibudirira kugadzirisa LDL cholesterol mazinga, anowanzokonzera kugadzikana kwemigumisiro inogadzirisa kukosha kwavo. Uyewo, kufanana nedzimwe dzakawanda dzehutachiona-kuderedza zvinodhaka, zvidzidzo zvekliniki zvakakundikana kuratidza kuti dzinovandudza migumisiro.
Heano humwe humwe ruzivo rwecholestyramine , iyo inowanzoshandiswa bile acid sequestrant.
Fibrate.
I- fibrates - Antara (gemfibrozil) uye Lopid (fenofibrate) - inobudirira kwazvo mukuderedza urwere hwe triglyceride (kusvika 50%). Vanowedzera HDL cholesterol uye vanoderedza LDL cholesterol mazinga kusvika pamwero. I-fibrates inoshanda nekudzivisa kugadzirwa kwe triglyceride-rich lipoprotein muropa. Kamwezve, zvisinei, pasinei nemigumisiro yavo inofadza panyaya yeropa, miedzo yakawanda yemaitiro yakakundikana kuratidzira chero upi noupi huri nani mukugadziriswa kwekliniki ne fibrates.
Kushandiswa kukuru kwe fibrates nhasi ndiko kurapa varwere vane chirwere chakasimba che hypertriglyceridemia . Nzvimbo dzakakosha pamagetsi e fibrates ndezvekuti dzinogona kukonzera muscle inxicity, kunyanya kana inoshandiswa nemashizha.
Shoko Rinobva
Kunyange zvazvo makirasi akawanda emishonga akave akaratidzwa kuti ane simba rakanaka pane cholesterol uye triglyceride levels, chete iyo mitemo yakaratidzwa kuti inonyatsovandudza zvibereko zvechipatara. Nhasi mazano ekurapa cholesterol migumisiro yavo mazano kumutemo wemishonga - mamwe mishonga haafaniri kukurudzirwa kunze kwezviitiko zvakasiyana.
Zvisinei, vatsvakurudzi vanomirira nomwoyo wose zvinoguma zvekuongororwa kwekliniki ikozvino kuitiswa neCPSK9 inhibitors, boka idzva rezvinodhaka izvo zvine chisina kumboitika cholesterol-kuderedza simba.
> Sources:
> Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC / AHA murayiridzo pamusoro peArapa yeRopa Cholesterol kunoderedza Atherosclerotic Cardiovascular Risk muVanhu Vakuru: Nhoroondo yeAmerican College of Cardiology / American Heart Association Task Force pamusoro Pemitemo Yezvokuita. Circulation 2014; 129: S1.
> Navarese EP, Kolodziejczak M, Schulze V, et al. Migumisiro yeProprotein Convertase Subtilisin / Kexin Rudzi rwe 9 Anodeti muVanhu Vakura NeHypercholesterolemia: Ongororo Yakarongeka uye Meta-analysis. Ann Intern Med 2015; 163: 40.
> AIM-HIGH Vatsvakurudzi, Boden WE, Probstfield JL, et al. Niacin muVarwere Vanotapukira HDL Cholesterol Levels Kuwana Statin Intrasive Therapy. N Engl J Med 2011; 365: 2255.