Iziphumo ezine ezichaphazelekayo zestatins (kunye nendlela yokulwa nazo)

Ulwazi lweziyobisi

Kungabonakala ngathi i-cholesterol ephezulu ayisiyonto enkulu-emva kwayo yonke loo nto, ngaphezulu kwe-102 yezigidi zaseMelika ngaphezulu kweminyaka ye-20 inenqanaba le-cholesterol liphela kuluhlu oluqhelekileyo (200 mg / dL), ngokwe Amaziko oLawulo lweZifo noThintelo (I-CDC). Okubi nangakumbi, malunga nezigidi ezingama-35 zalabo bantu badala banamazinga angama-240 mg / dL okanye ngaphezulu, okubeka kwindawo eyingozi yokuphuhlisa isifo sentliziyo. Kungenxa yokuba iqhelekile, oko akuthethi ukuba ungayihoya ukuba eyakho inyathelo elingaphezulu kwamanqanaba asempilweni. Kubaluleke kakhulu ukuba uqonde kwaye ulawule i-cholesterol yakho-mhlawumbi ngokusebenzisa unyango njengama-statins.

Yintoni icholesterol?

Ikholesterol yinto enetyhefu evela esibindini (umzimba uyenza ngokwendalo) nakwindlela otya ngayo (ifumaneka kwimithombo yokutya kwezilwanyana, njengenyama, amaqanda, kunye nobisi olunamafutha apheleleyo). I-cholesterol ijikeleza egazini kwaye iyimfuneko kwimisebenzi emininzi yomzimba, kubandakanya ukuveliswa kwehomoni, ivithamin D, kunye neembrane zeseli. Nangona kunjalo, i-cholesterol engaphezulu kwegazi-oko kukuthi i-low-density lipoprotein okanye i-LDL cholesterol-inokubambelela kwiindonga zemithambo kwaye ijike ibe lilitye.

Iplaque kwimithambo yethu inokuthintela ukuhamba kwegazi kwaye ikhuthaze ukwakheka kwehlwili, ekhokelela ekonakaleni kwentliziyo (umzekelo, isifo sentliziyo) kunye nokonakala kwengqondo (ukubetha), utshilo uJoshua Yamamoto, MD, ugqirha wentliziyo, umseki-mbumba weFoxhall Medicine eWashington , DC, kunye nombhali we Unokuthintela iStrowuku . Ngapha koko, ukukhula kwamacwecwe ayisosifo [esibizwa ngokuba yi-hypercholesterolemia] -yindalo yendalo, isiphumo sexesha nobudala ekujikelezeni kwethu.

Yintoni ii-statins?

I-Statins, iklasi yamachiza athoba i-cholesterol, sele ingumgangatho wegolide kunyango lwe-hypercholesterolemia, uyachaza UGqirha Jennifer Haythe, MD , ugqirha wezilwanyana e-NewYork-Presbyterian / Columbia University Irving Medical Centre. Ngapha koko, ngaphezulu kwe-11.6 yezigidi zabantu abadala baseMelika ngoku bathatha iziyobisi ze-statin zesifo sentliziyo (ASCVD), ngokwezibalo ezivela kutshanje Uphando lweSizwe lwezeMpilo kunye novavanyo lweSondlo .

Iimpawu eziqhelekileyo ziquka:

• ICrestor (irosuvastatin)
• Iilipitor (atorvastatin)
• UZocor (simvastatin)
• IPravachol (ipravastatin)
• Altoprev okanye iMevacor (lovastatin)
• I-Lescol (i-fluvastatin)
• ILivalo (pitavastatin)

Zisebenza njani ii-statins?

I-Statins isebenza ngokungavali kuphela i-enzyme evelisa i-cholesterol, kodwa ikwanceda umzimba ukubuyisela i-cholesterol esele ikho, uGqirha Haythe ucacisa. Ugqirha Yamamoto wongeza ukuba ii-statins kufuneka zithathelwe ingqalelo njengamayeza okhusela imithambo kuba ezi meds zinako ukukhusela imithambo, ukuthintela ukukhula kwamatye, kwaye-okona kubaluleke kakhulu-kuthintela ukuhlaselwa yintliziyo, ukubetha, ukonakala kwengqondo kunye nokufa ngaphambi kwexesha.

Iziphumo ebezingalindelekanga

Kwaye ngelixa ziqhelekile kwaye zivunyiwe nguLawulo lokutya kunye noLawulo lweeDrug (FDA), iimpendulo zinokwenzeka ngamanye amaxesha ekusebenziseni izitemins. (Uhlalutyo lukaDisemba 2018 olukhutshwe yi Umbutho wentliziyo yaseMelika ithe iziphumo ebezingalindelekanga zinqabile — kwaye izibonelelo zingaphaya komngcipheko.) Nazi iziphumo ebezingalindelekanga ezinokubakho.

1. Iintlungu kunye neentlungu

Bobabini ogqirha esithethe nabo bayavuma ukuba iintlungu kunye neentlungu zemisipha (ekwabizwa ngokuba yi-myalgia) sisikhalazo sokuqala kwizigulana, naphina phakathi kwe-4% kunye ne-10% yabantu abachaphazelekayo. Kubalulekile ukuba uqaphele ukuba i-1 kwi-20 yethu ithambekele ekuphuhliseni ngokulula iintlungu zemisipha, uGqirha Yamamoto wongeza.

Olunye uhlengahlengiso kwindlela yakho yokuphila lunokunceda ukunciphisa umngcipheko we-myopathy kunye nokonakala kwemisipha, kubandakanya ukunciphisa amandla omzimba (kuba amandla okusebenza angabeka uxinzelelo kwimisipha esele ikho) kunye nokuthatha i-coenzyme Q10 yokutya.

Ugqirha Yamamoto uthi ngenxa yokuba i-CoQ10 yenziwe kwimisipha, unyango lwe-statin lunokuyiphelisa kwinkqubo, ibangele ukukhathazeka kwemisipha. Imifuno ihlala ithambekele kwiintlungu kunye neentlungu ezinxulunyaniswa nokusetyenziswa kwe-statin kuba i-CoQ10 ifunyanwa ngokwendalo kwinyama ebomvu, utshilo. Kodwa gcinani engqondweni ukuba i-vegan ayenzi ngandlela zonke ukuba isikhusele kwiziphumo zexesha, kwaye esona sizathu siphambili sokufa kwezilwanyana sisasisifo sentliziyo.

2. Iswekile eninzi yegazi

IiStatins zinokunyusa amanqanaba eswekile yegazi kubantu abane-metabolic syndrome, isifo seswekile ngaphambi kwexesha okanye amanqanaba eswekile esegazini, utshilo uGqirha Haythe. Uphononongo luka-2017 olupapashwe kwiphephancwadi I-BMJ evulekileyo yoPhando ngeSwekile kunye noKhathalelo uqaphele ukuba ii-statins zinxulunyaniswa namazinga aphezulu eswekile kwizigulana ezazisemngciphekweni omkhulu wokukhulisa uhlobo lweswekile yesi-2.

3. I-enzyme zesibindi eziphakanyisiweyo

Abanye abaguli ngamanye amaxesha baya kuva ukudumba kwesibindi ekuthatheni ii-statins, ngokwe Ikliniki yaseMayo . Ukanti amanani mancinci-inqaku elipapashwe kuhlelo lowe-2013 lweli phephancwadi I-Gastroenterology kunye neHepatology Uvavanyo lweklinikhi lubonisa ukuba ii-statins zidityaniswe nokuphakama kwe-serum alanine aminotransferase (ALT, i-enzyme efumaneka ikakhulu esibindini nasezintso) kwi-avareji yeepesenti ze-3 yezigulana.

Iimpawu zomonakalo wesibindi zibandakanya ukudinwa okugqithisileyo, ukuphelelwa ngumdla wokutya, iintlungu kumzimba ongaphezulu, umchamo omnyama ngombala, kunye / okanye utyheli kolusu okanye lamehlo. Ukuba ukonyuka kwe-enzyme yesibindi kuncinci, abaguli banokuqhubeka nokuthatha ii-statins, kodwa ukuba ukusebenza kwesibindi kuya kuba nefuthe elibi, kuya kuchazwa med eyahlukileyo.

4. Ukuphulukana nenkumbulo nokudideka

Isikolo seHarvard Medical yalatha kuphando olwenziwe ngo-2015 Unyango lwaNgaphakathi lweJAMA evavanye unxibelelwano olunokwenzeka phakathi kwamayeza anciphisa i-cholesterol kunye nokulahleka kwememori. Emva kokuphonononga iirekhodi zonyango ezimalunga nezigidi ezili-11 zezigulana, abaphandi bafumanisa ukuba abantu abadala abathathe ii-statins (kunye noluphi na uhlobo lwechiza le-cholesterol) babephantse amaxesha amane okuxela ukuphazamiseka kwengqondo xa kuthelekiswa nabo babengathathi iklasi enye yeemali. Nangona kunjalo, uHarvard wongeza ukuba umbutho akunakulindeleka ukuba unikwe umahluko osisiseko kwindlela i-statin kunye ne-non-statin cholesterol iziyobisi ezisebenza ngayo.

Ngaphaya koko, kwiphepha lowama-2016 Unonophelo lweSwekile , Ababhali bokufunda abavela kwa-Israyeli bahlalutya iziphumo ezivela kwizilingo ezifanayo zokujonga kunye nezilindelekileyo. Iziphumo zabo: Iimeko ezichaziweyo zokulahleka kwememori zazinqabile, kwaye abaphandi bagqiba kwelokuba ubudlelwane obusisiseko abukagqitywa.

Ezinye iziphumo ebezingalindelekanga ezichaziweyo zibandakanya:

• Intloko ebuhlungu
• Kunzima ukulala
• Isicaphucaphu
• Ukuba nesiyezi
• Ukuqhawula
• Urhudo
• Ukuhlaziywa kweRhabdomyolysis
• Irhashalala

Imiba yomngcipheko wokunganyamezelani kwe-statin, ngokwe Ikliniki yaseMayo , zibandakanya:

• Ngaba ngabasetyhini
• Ngaphezulu kweminyaka yobudala engama-80
• Yiba nomzimba omncinci
• Ngaba ukusilela kwezintso okanye isifo sesibindi
• Unayo i-hypothyroidism okanye i-neuromuscular disorder
• Thatha amayeza athile ukunyanga i-cholesterol okanye usulelo
• Sebenzisa kakhulu utywala
• Sebenzisa izixa ezikhulu zeediliya, kubandakanya ijusi yeziqhamo

Ugqirha Haythe uthi ezinye iziphumo ebezingalindelekanga zinokulawulwa ngoncedo lonyango, onokuthi acebise ukutshintshela kumgaqo owahlukileyo okanye ukunciphisa idosi yeyeza. Thetha nogqirha wakho ukuba ufumana naziphi na iziphumo ezibi.