Cov ntshav hauv cov ntshav txo qis tshuaj: tshuaj xyuas cov neeg sawv cev

Kev siv tshuaj kho mob rau cov lipid metabolism tsis zoo yog ua rau kev tsis muaj txiaj ntsig ntawm lipid-txo cov zaub mov noj, kev ua kom lub cev ua kom lub cev thiab poob ceeb thawj rau 6 lub hlis. Nyob rau theem ntawm tag nrho cov roj (cholesterol) hauv cov ntshav siab dua 6.5 mmol / l, cov tshuaj yuav raug sau tseg ua ntej lub sijhawm no.

Txhawm rau kho cov lipid metabolism, cov tshuaj los tiv thaiv atherogenic (lipid-txo qis) yog raug kho. Lub hom phiaj ntawm lawv qhov kev siv yog txhawm rau txo cov qib "phem" cov cholesterol (tag nrho cov roj cholesterol, triglycerides, lipoproteins tsawg heev (VLDL) thiab tsis tshua ntom (LDL)), uas ua rau qeeb ntawm kev txhim kho vascular atherosclerosis thiab txo qhov kev pheej hmoo ntawm nws cov kev mob tshwm sim: angina pectoris, mob plawv nres, mob hlab ntsha tawg thiab lwm yam kab mob.

Kev faib tawm

Anion-pauv cov roj hmab thiab tshuaj uas txo cov nqus (nqus) ntawm cov roj cholesterol hauv cov hnyuv.
Nicotinic acid
Probukol.
Fibrates.
Statins (3-hydroxymethyl-glutaryl-coenzyme-A-reductase inhibitors).

Ua raws li cov txheej txheem ntawm kev txiav txim, cov tshuaj yuav txo cov ntshav hauv cov ntshav siab tuaj yeem muab faib ua ntau pawg.

Cov tshuaj uas inhibit lub synthesis ntawm atherogenic lipoproteins ("roj (cholesterol) tsis zoo):

statins
fibrates
nicotinic acid
probucol
benzaflavin.

Txhais tau tias ua rau kom tsis txhob nqus ntawm cov cholesterol los ntawm cov zaub mov hauv cov hnyuv:

sequestrants ntawm cov kua tsib kua qaub,
guarem.

Lipid metabolism correctors uas ua rau nce qib ntawm "cov rog" zoo:

Sequestrants ntawm cov kua tsib kua qaub

Cov kua tsib cov kab mob ua kom sib xyaw (cholestyramine, colestipol) yog cov tshuaj tiv thaiv anion-resins. Ib zaug hauv txoj hnyuv, lawv "ntes" cov kua tsib kua qaub thiab tshem tawm ntawm lub cev. Lub cev pib tsis muaj cov kua tsib kua qaub, uas yog qhov tsim nyog rau kev ua haujlwm. Yog li ntawd, hauv lub siab, txheej txheem ntawm coj los ua ke ntawm lawv los ntawm cov rog yog pib. Cov roj (cholesterol) yog "noj" los ntawm cov ntshav, vim li ntawd, nws cov concentration muaj nws tsawg.

Cholestyramine thiab colestipol muaj ntau hom tshuaj hmoov. Qhov koob tshuaj txhua hnub yuav tsum tau muab faib ua 2 rau 4 koob tshuaj, noj los ntawm kev ua kom cov tshuaj yaj hauv cov kua (dej, kua txiv).

Anion-pauv cov roj hmab tsis nqus rau hauv cov ntshav, ua haujlwm tsuas yog hauv plab hnyuv lumen. Yog li ntawd, lawv muaj kev nyab xeeb thiab tsis muaj teeb meem loj tsis xav tau. Ntau tus kws tshaj lij ntseeg tias nws yog qhov yuav tsum tau pib kho hyperlipidemia nrog cov tshuaj no.

Cov kev mob tshwm sim muaj xws li tsam plab, xeev siab thiab cem quav, tsis muaj quav ntaug xoob. Txhawm rau tiv thaiv cov tsos mob li no, nws yog ib qhov tsim nyog yuav tau nce cov kua dej thiab kev noj haus fiber (fiber, bran).
Nrog lub sijhawm ntev ntawm kev siv cov tshuaj no hauv cov koob tshuaj ntau, yuav muaj kev ua txhaum ntawm qhov nqus nyob rau hauv cov hnyuv ntawm folic acid thiab qee cov vitamins, feem ntau yog cov roj nyeem.

Cov tshuaj noj uas txhaws cov plab hnyuv siab ua kom lub cev tsis haum

Los ntawm kev maj mam nqus ntawm qhov nqus ntawm cov cholesterol los ntawm cov khoom noj hauv cov hnyuv, cov tshuaj no txo nws cov concentration hauv cov ntshav.
Qhov zoo tshaj plaws ntawm pab pawg no cov nyiaj yog guar. Nws yog tshuaj ntsuab ntxiv muab tau los ntawm cov noob ntawm noob taum hyacinth. Nws muaj cov dej-soluble polysaccharide, uas ua cov ntawv ua kua jelly thaum sib chwv nrog kua hauv lub plab hnyuv lumen.

Guarem mechanically tshem cov roj molecules tawm los ntawm lub plab hnyuv phab ntsa. Nws ua kom nrawm tshem tawm ntawm cov kua tsib kua qaub, uas ua rau kom muaj kev ntes cov cholesterol ntau ntawm cov ntshav mus rau hauv lub siab rau lawv cov lus sib txuas. Cov tshuaj siv zog txhawb kev qab los noj mov thiab txo cov zaub mov noj, uas ua rau poob phaus thiab lipid hauv cov ntshav.
Guarem yog tsim nyob rau hauv granules, uas yuav tsum tau ntxiv cov kua (dej, kua txiv, mis nyuj). Kev noj tshuaj yuav tsum tau ua ke nrog lwm cov tshuaj tiv thaiv antiatherosclerotic.

Cov kev mob tshwm sim suav nrog kev tsam plab, xeev siab, mob plab hnyuv, thiab qee zaum tso quav. Txawm li cas los xij, lawv nthuav tawm me ntsis, tsis tshua muaj tshwm sim, nrog txuas ntxiv kev kho mob dhau ntawm nws tus kheej.

Nicotinic acid

Nicotinic acid thiab nws cov derivatives (enduracin, niceritrol, acipimox) yog cov vitamin ntawm pawg B. Nws txo qis cov concentration ntawm "cov roj cholesterol" hauv cov ntshav. Nicotinic acid ua rau cov kab mob fibrinolysis, txo kev muaj peev xwm ntawm cov ntshav tsim cov ntshav txhaws. Qhov tshuaj no tau zoo dua li lwm cov lipid-txo cov tshuaj uas ua rau kev nce siab ntawm "cov roj (cholesterol) zoo" hauv cov ntshav.

Kev kho tshuaj Nicotinic acid yog ua tiav rau lub sijhawm ntev, nrog kev hloov zuj zus ntawm cov koob tshuaj. Ua ntej thiab tom qab noj nws, nws tsis pom zoo kom haus dej kub, tshwj xeeb yog kas fes.

Cov tshuaj no tuaj yeem ua rau lub plab, yog li nws tsis yog qhov kho mob rau lub plab thiab mob plab. Hauv ntau cov neeg mob, qhov liab ntawm lub ntsej muag tshwm thaum pib kho. Maj mam, cov nyhuv no ploj. Txhawm rau tiv thaiv nws, nws raug nquahu kom noj 325 mg ntawm tshuaj aspirin 30 feeb ua ntej noj tshuaj. Hauv 20% ntawm cov neeg mob, nws khaus yog sau tseg.

Kev kho nrog nicotinic acid npaj tau yog contraindicated rau peptic rwj thiab duodenal mob, tus kab mob siab ntev, mob plawv ntxhov siab ntxhov plawv, gout.

Enduracin yog tshuaj yeeb dawb nicotinic acid ntev. Nws yog qhov zoo dua tiv thaiv, ua rau yam tsawg kawg ntawm kev phiv. Lawv tuaj yeem raug kho rau ntev.

Cov tshuaj zoo txo cov theem ntawm cov roj "zoo" thiab "phem". Cov tshuaj tsis cuam tshuam rau theem ntawm triglycerides.

Cov tshuaj tshem tawm LDL los ntawm cov ntshav, ua rau kev nthuav dav ntawm cov cholesterol nrog cov kua tsib. Nws inhibits lipid peroxidation, nthuav tawm cov nyhuv antiatherosclerotic.

Cov nyhuv ntawm cov tshuaj tshwm sim li ob hlis tom qab pib kev kho mob thiab kav ntev li rau lub hlis tom qab nws txiav. Nws tuaj yeem ua ke nrog lwm txoj hauv kev los txo cov roj (cholesterol).

Hauv qab ntawm qhov tshuaj, ib lub sijhawm ntev ntawm Q-T luv ntawm lub tshuab electrocardiogram thiab kev txhim kho ntawm lub cev tsis ua haujlwm ntawm lub cev loj heev tuaj yeem ua tau. Thaum lub sijhawm nws tswj hwm, nws yog qhov yuav tsum tau rov ua electrocardiogram tsawg kawg ib zaug txhua 3 mus rau 6 lub hlis. Koj tsis tuaj yeem cob probucol ib txhij nrog cordarone. Lwm qhov kev tsis xav tau muaj xws li tsam plab thiab mob plab, xeev siab, thiab qee zaum tso quav.

Probucol yog contraindicated nyob rau hauv ventricular arrhythmias cuam tshuam nrog ncua Q-T luv, nquag ntu ntawm myocardial ischemia, thiab tseem nrog pib theem qis ntawm HDL.

Fibrates zoo txo cov qib triglycerides hauv cov ntshav, kom tsawg dua qhov kev sib txuam ntawm LDL cov roj (cholesterol) thiab VLDL. Lawv raug siv nyob rau hauv cov mob ntawm tseem ceeb hypertriglyceridemia. Cov cuab yeej siv feem ntau yog:

gemfibrozil (lopid, gevilon),
fenofibrate (lipantil 200 M, treicor, ex-lipip),
cyprofibrate (lipanor),
choline fenofibrate (trilipix).

Cov kev mob tshwm sim suav nrog cov leeg mob (mob, ua kom tsis muaj zog), xeev siab thiab mob plab, ua haujlwm rau lub siab ua haujlwm. Fibrates tuaj yeem txhim kho qhov tsim ntawm laij lej (pob zeb) hauv gall zais zis. Muaj qee zaus, nyob rau hauv kev cuam tshuam ntawm cov neeg sawv cev no, kev txwv tsis pub hematopoiesis tshwm sim nrog kev txhim kho ntawm leukopenia, thrombocytopenia, ntshav liab.

Fibrates tsis yog tshuaj rau cov kab mob ntawm daim siab thiab lub zais zis, hematopoiesis.

Statins yog qhov ua tau zoo tshaj plaws ntawm cov tshuaj lipid-txo qis. Lawv thaiv cov enzyme ua lub luag haujlwm rau kev sib sau ntawm cov cholesterol hauv lub siab, thaum nws cov ntsiab lus hauv cov ntshav txo qis. Tib lub sijhawm, cov naj npawb ntawm LDL receptors yog nce, uas ua rau kom nrawm nrawm ntawm "cov roj (cholesterol) phem" los ntawm cov ntshav.
Cov tshuaj yuav luag muaj ntau yog:

simvastatin (vasilip, zokor, aries, simvagheksal, simvakard, simvakol, simvastin, simvastol, simvor, simlo, sincard, holvasim),
lovastatin (cardiostatin, choletar),
pravastatin
atorvastatin (anvistat, atocor, atomax, ator, atorvox, atoris, vazator, lipoford, lypimar, liptonorm, novostat, torvazin, torvakard, tulip),
rosuvastatin (akorta, ntoo khaub lig, mertenil, rosart, rosistark, rosucard, rosulip, roxera, xeb xoob, tevastor),
pitavastatin (livazo),
fluvastatin (leskol).

Lovastatin thiab simvastatin yog tsim los ntawm cov hu ua fungi. Cov no yog cov "prodrugs" uas nyob rau hauv lub siab tig mus ua cov roj metabolites. Pravastatin yog ib qho kev sib txuas ntawm cov fungal metabolites, tab sis tsis yog metabolized hauv daim siab, tab sis twb yog ib qho tshuaj muaj zog. Fluvastatin thiab atorvastatin muaj cov tshuaj ua kom muaj zog.

Statins tau sau tseg ib hnub ib hnub nyob rau yav tsaus ntuj, txij li lub ncov ntawm cov roj khov tsim hauv lub cev tshwm sim thaum tsaus ntuj. Maj mam, lawv cov koob tshuaj yuav nce ntxiv. Cov nyhuv tshwm sim twb tau nyob rau thawj hnub ntawm kev tswj hwm, nce mus txog qhov siab kawg hauv ib hlis.

Statins muaj kev nyab xeeb txaus. Txawm li cas los xij, thaum siv cov koob tshuaj loj, tshwj xeeb tshaj yog ua ke nrog cov fibrates, ua kom lub siab ua haujlwm yog ua tau. Qee tus neeg mob ntsib cov leeg mob thiab mob leeg tsis muaj zog. Qee zaum muaj mob plab, xeev siab, cem quav, tsis qab los noj mov. Qee qhov, insomnia thiab mob taub hau yuav ntxim.

Statins tsis cuam tshuam rau purine thiab carbohydrate metabolism. Lawv tuaj yeem tsim kho rau mob gout, mob ntshav qab zib, rog.

Statins yog ib feem ntawm cov qauv rau kev kho mob ntawm atherosclerosis. Lawv raug kho raws li kev kho mob monotherapy lossis hauv kev sib xyaw nrog lwm cov tshuaj tiv thaiv antiatherosclerotic. Muaj cov npaj txhij-ua ke ntawm lovastatin thiab nicotinic acid, simvastatin thiab ezetimibe (ingi), pravastatin thiab fenofibrate, rosuvastatin thiab ezetimibe.
Kev sib xyaw ua ke ntawm statins thiab acetylsalicylic acid, zoo li atorvastatin thiab amlodipine (duplexor, caduet) muaj. Kev siv ntawm kev npaj ua ke nrog cov neeg mob nce ntxiv cov neeg mob ua raws li kev kho mob (ua raws), muaj txiaj ntsig kev lag luam, thiab ua rau muaj kev phiv ntau dua.

Lwm yam tshuaj lipid-txo qis

Benzaflavin belongs rau cov pab pawg vitamin B2. Nws txhim kho cov metabolism hauv lub siab, ua rau txo qis ntshav hauv cov piam thaj, triglycerides, roj tag nrho. Cov tshuaj yog zoo zam, tshuaj hauv cov kev kawm ntev.

Qhov tseem ceeb muaj cov phospholipids, B vitamins, nicotinamide, cov roj ntsha tsis txaus, sodium pantothenate. Cov tshuaj txhim kho cov kev tawg thiab tshem tawm cov "roj" "roj", ua kom muaj txiaj ntsig zoo muaj txiaj ntsig "roj" cholesterol.

Lipostable yog nyob rau hauv qhov muaj pes tsawg leeg thiab nqis tes ua rau Qhov Tseem Ceeb.

Omega-3 triglycerides (omacor) tau raug tshaj tawm rau kev kho mob hypertriglyceridemia (tsuas yog zam ntawm hom 1 hyperchilomicronemia), zoo li ntxiv rau kev tiv thaiv cov kab mob myocardial infarction.

Ezetimibe (ezetrol) ncua kev nqus ntawm cov cholesterol nyob rau hauv txoj hnyuv, txo nws kev nqus hauv lub siab. Nws txo cov ntsiab lus ntawm cov "cholesterol" hauv cov ntshav. Cov tshuaj yog qhov ua tau zoo tshaj plaws nrog rau kev ua yeeb yam.

Yees duab ntawm cov ncauj lus "Cholesterol thiab statins: nws puas tsim nyog noj tshuaj?"