Wahi a nā helu loea, i nā mea maʻi me ka maʻi naʻau coronary a me ka maʻi ʻana i ka maʻi diabetes, ka like o ka nui o ke koena o ka maʻi mai nā hopena o ka maʻi cardiovascular.
Hiki i nā statins diabetes ke hōʻemi i ka hopena o nā pilikia hoʻoweliweli o ka atherosclerosis - angina pectoris, myocardial infarction, coronary death, ischemic stroke.
Hoʻohana ʻia lākou e kū i mua i nā hopena hopena koʻikoʻi.
Ka pōmaikaʻi o ka hoʻohana ʻana i nā Kumuhana
Hoʻopili i kahi hana hypolipidemic pololei, loaʻa i nā statins ka pleiotropy - hiki ke hoʻokauwī i nā hana biochemical a hana i kēlā me kēia ʻaoʻao.
ʻO ka pilina o ka hoʻohana ʻana o statins i ka mellitus type I a me II ua hoʻoholo ʻia ma o kā lākou hopena i ka cholesterol a me ka triglycerides, ma ke kaʻina hana a me ka hana o ka endothelium (choroid kūmole):
- Hoʻomaʻamaʻa maikaʻi i ka plasma cholesterol. ʻAʻole i loaʻa i nā statins ka hopena pololei e pili ana iā ia (ka luku a me ke kinai ʻana mai ke kino), akā ke kāohi nei lākou i ka hana huna i ka ʻūhā, pale i ka hana ʻana o ka huina e pili ana i ka hana o kēia ʻano. ʻO ka hoʻohana mau ʻana i ka lōʻihi o nā papa o nā therapeutic e hiki ai iā ʻoe ke hoʻohaʻahaʻa i ka index kolesterol ma ka 45-50% mai ka pae kiʻekiʻe.
- Hoʻoponopono i ka hana o ke kime o nā kīʻaha koko, e hoʻonui i ka hiki i ka vasodilation (hoʻonui i ka lumen o ka moku) e hoʻomaʻamaʻa i ke kahe koko a pale aku i ischemia.
A kuhikuhi ʻia nā statins i ke hoʻomaka mua o ka maʻi, inā ʻaʻole hiki ke hoʻopiʻi ʻia nā mea pono o ke atherosclerosis, akā aia ka hopena endothelial. - Hoʻomoe i nā mea hoʻonāwaliwali a hōʻemi i ka hana o kekahi o kāna mau māka - CRP (C-reactive protein). ʻO nā nānā nānā epidemiological nui e ʻae iā mākou e hoʻokūkū i ka pilina o kahi huaʻāina o kahi CRP kiʻekiʻe a me ka hopena o nā hoʻopiʻi coronary. ʻO nā haʻawina ma 1200 nā mea maʻi e lawe ana i nā statins o ka hanauna ʻehā me kaʻoiaʻiʻo i hōʻoia i ka hōʻemi o ka CRP e 15% ma ka hopena o ka hā o ka malama o ka mālama ʻana. Hōʻike ka pono o nā statins i ka wā e hui pū ai nā mellitus diabii me ka hoʻonui o nā kaila plasma o nā protein C-reactive i ʻoi aku ma mua o ka 1 milligram i kēlā me kēia deciliter. Hōʻike ʻia ko lākou hoʻohana ʻana ma ka haʻalele ʻana o nā mea hōʻike ischemic i ka ʻōpū o ka naʻau.
- Ua kūpono kēia pono no nā poʻe maʻi me ka diabetes mellitus, nā ʻano ʻelua a me nā ʻano i hilinaʻi ʻole ʻia ma ka insulin, kahi e pili ai nā kīʻaha koko a me ka hopena o ke kūkulu ʻana i nā ala nui.
ʻO ka hoʻohana wā lōʻihi i nā statins hiki ke hōʻemi i ka hopena o nā pilikia vascular e kahi hapakolu. - Hōʻike ʻia ka hopena i ka hemostasis i ka hoʻokaʻawale ʻana i ke kahe koko a me ka hoʻomaʻamaʻa ʻana o kāna neʻe ma ka wahi o ka vascular moe, ka pale ʻana o ischemia (pōʻino o nā kino). Hōʻalo nā statins i ke kanu ʻana o nā māno koko a me kā lākou hoʻopili ʻana i nā pāla atherosclerotic.
Ka hopena ma ke kō kō kōkō
ʻO kekahi o nā hopena o ka hopena o ka hopena me ka lāʻau lapaʻau statin he hoʻonui hōʻemi i ka hoʻoliʻi o ke koko e nā 1-2 keneki (mmol / l).
Ma kahi o ka mālamaʻana, ka mana o ke kāʻei o nā kalowa he nui.
ʻAʻole i aʻo ʻia nā hana i loaʻa ai ka piʻi ʻana o ka hilo gula, akā ua hōʻike nā noiʻi i ka lōʻihi o ka hoʻohana ʻana o nā statins i nā pehu therapeutic e 6-9% hoʻonui i ka pilikia o ka hoʻomohala ʻana i ka diabetes-type-type-type (type II).
Ma ka mea e loaʻa ai ka maʻi i hala, hiki i ka neʻe ʻana i kahi palapala decompensated, ma kahi o ka hōʻemi o ka glucose i ke koko e koi hou i ka hoʻoponopono hou ʻana me ka hoʻohana ʻana i ka ʻai haʻahaʻa-aila keʻokeʻo a me ka hoʻonui ʻana i ka hoʻōho o nā lāʻau lapaʻau hoʻokaʻa gula.
Eia nō naʻe, e like me nā cardiologists a me nā endocrinologists, ʻo nā pono o ka lawe ʻana i nā statins no ka maʻi o nā ʻano mua a me ka lua hoʻi he nui ma mua o ka hopena e hiki ai i nā hopena hōʻea.
Pehea e kūleʻa ai nā statins?
ʻO nā lāʻau lapaʻau hoʻoliʻi hōʻola, ua hoʻolaha ʻia nā hopena ʻaoʻao, koi i ka mālama ʻana i ka lāʻau lapaʻau a ʻaʻole kūpono kēlā no ka lāʻau lapaʻau ponoʻī.
Hāʻawi i nā lāʻau Hypolipidemic o kēia pūʻulu i kā lākou hopena me ka hoʻohana mau ʻana i ka wā lōʻihi, ma kēia hana, hiki ke ʻike ʻia nā hopena o nā lāʻau lapaʻau ma hope o kekahi manawa.
Hoʻopilikia ka hopena maikaʻi o nā lāʻau i nā kino āpau a me nā ʻōnaehana:
- Ua hōʻike ʻia ka Hepatotoxicity o nā statins i ka luku ʻia o nā hua liʻiliʻi, ke kīpē ʻana o ka hoʻonohonoho a me ka hana o nā ate. ʻOiai ke hiki i nā pūpū o nā ate ke hoʻoponopono hou, ua palpable ka waiho ʻana ma luna o ke kino.
Pono ka nānā ʻana o ka transaminases ate i ka ALT a me AST, a me ka uku (pololei a paʻa) bilirubin, pono e loiloi i ka hana o ke kino. - Hoʻomaʻi ʻia ka ʻōpū māhili ma nā statins, nā mea i hiki ke hoʻopau i nā pūpū pili (myocytes) me ka hoʻokuʻu i ka waika lactic
Hōʻike ʻia e ka ʻehaʻeha o ke kino, hoʻomanaʻo ʻia i ka hopena o ka hana kino kino.ʻO ke ʻano he kānāwai, ka hoʻomau ʻole o ka hoʻololi ʻana i ke ʻano o nā pona o ka ʻiʻo a ma hope o ka hoʻi ʻana i nā lāʻau lapaʻau ke ʻano maʻamau. Eia nō naʻe, i loko o ʻehā mau kūlana i hoʻokahi tausani, ke kālai nei kahi ʻano koʻikoʻi a hoʻoweliweli i ka hoʻomohala ʻana o ka rhabdomyolysis - make nui o ka myocytes, nā mea make e nā huahana decay a me nā pōʻino i ka wā o ka hōʻemi o ka maikaʻi ʻole o ka maikaʻi ʻole. ʻO ke kūlana o ka palena, e pono ai ka resuscitation. ʻO ka pilikia o ka hoʻomohala ʻana i ka myopathies - ʻehaʻeha me ka hōʻeha o ka naʻau a me ka hōʻiliʻili ʻana - me ka hoʻohui pū ʻana me ka hoʻohana ʻana i nā statins a me nā lākaʻi no ke hypertension, diabetes mellitus a i ʻole gout.
Pono ka nānā ʻana i ke koko maʻamau no CPK (creatine phosphokinase) - kahi hōʻike o ka myocyte necrosis - e nānā i ka kūlana o ka ʻōnaehana muscular. - ʻO ka hoʻololi ma lalo o ka hana o nā statins o ka ʻoi a me nā kino o ke kaila synovial i loko o nā kuʻuna e hiki ke alakaʻi i nā kaʻina pathological a me ka hoʻomohala ʻana o ka lāʻau a me ka arthrosis, ka nui o nā mea nui - ka ʻili, ke kuli, nā poʻohiwi.
- Hōʻike ʻia nā kūmole o ke kaomi kikowaena e nā maʻi dyspeptic, ka instability o ka makemake, ka ʻeha o ka ʻōpū.
- ʻO ka kikowaena kikowaena a peripheral hiki ke pane hou i ka hoʻohana ʻana o nā statins e nā ʻano hōʻike like ʻole: ka hiamoe o ka moe, ke poʻo, ka hopena o ka asthenic, ka hana ʻana i ka naʻau, ka maʻi ʻoluʻolu a me ka hana ʻoihana.
Wahi a kahi haʻawina loea, ʻo ka pinepine o kēlā me kēia hopena mai ka hoʻopili o ke aʻe, ʻaʻole ʻoi aku ma mua o 2%. - Ma ka hapa a me ka hapa 100 o nā hihia, pane mai ka punawai coronary i ka therapy statin me ka hoʻohaʻahaʻa ʻana i ke kahe koko no ka hoʻonui ʻana o nā kīʻaha koko peripheral, kahi maʻi o ka puʻuwai, arrhythmia, a me ka migraine ma muli o kahi loli o ke kahe o nā kīʻaha koko o ka lolo.
Hoʻohālikelike ke ʻano i ka hoʻohana ʻana o ke kino i ke aupuni hou o ka hāʻawi koko koko. I kekahi manawa makemake ʻia kahi hoʻemi dosis.
ʻO nā statins a me ka maʻi diabetes: kūlike a me nā pono
ʻO ka Endocrinologists ka manaʻo o nā statins ka hui wale nō o nā lipid-hoʻemi haʻahaʻa i hana ʻia e ka hoʻomaikaʻi ʻana i ka ola o ke ola no nā maʻi me ka maʻi ole-insulin (type II) mellitus.
ʻO ka poʻe e loaʻa ana i kēia ʻano maʻi o ka maʻi pālua ʻelua me ke kiʻekiʻe nui o ka pōʻino myocardial ischemic e like me nā mea maʻi me ka maʻi diabetes mellitus (type I).
No laila, ua hōʻike ʻia ka hoʻomaka ʻana o nā statins i ka papa hana no ka maʻi type II no ka mea i hiki ke kūpaʻa ka kolamu a me ka ʻike ʻana mai i ka maʻi ʻalani coronary.
ʻO wai nā statins e maikaʻi ke koho?
ʻAʻole hiki ke mālama kūʻokoʻa o nā lāʻau i ka lipid-haʻahaʻa o kēia hui: hāʻawi ʻia nā statins i nā lāʻau lapaʻau ma o ka lāʻau lapaʻau wale nō.
Kuhi aku ke kauka komo i ka lāʻau lapaʻau pū kekahi, me ka nānā ʻana i nā hiʻohiʻona o ka mea maʻi a me nā ʻano o ka lāʻau lapaʻau:
- ʻĀpana mua - Nā statins kūlohelohe (simvastatin, lovastatin), hoʻohaʻahaʻa i ka cholesterol ma o 25-38%. Heʻuʻuku kekahi hopena hopena, akā ʻo ka haʻahaʻa haʻahaʻa ma ka hoʻopaʻa ʻana i nā triglycerides.
- ʻO ka lua o nā hanauna - synthetic (fluvastatin), me ka hana lōʻihi, hoʻemi ʻia ka cholesterol ma kahi hapakolu.
- ʻO ka hanaunaʻolu - synthetic (atorvastatin), aneane haʻalele i ka index cholesterol, pale i kona synthesis mai ka pili o adipose. Hoʻololi ka hoʻonui ʻana i ka pae o nā lipids hydrophilic.
- ʻO ka hanauna ʻehā - synthetic (rosuvastatin) - kahi kaulike o ke kiʻekiʻe kiʻekiʻe a me ka palekana, e hōʻemi ana i ka kolesterol a hiki i ka 55% a pale i ka synthes o nā lipoproteins haʻahaʻa haʻahaʻa. Ma muli o ka hydrophilicity, ua loaʻa i ka hopena maikaʻi loa o ka ate a ʻaʻole i ka hopena i ka make o myocytes. Loaʻa ka hopena i ka paʻakikī koʻikoʻi ma ka hebedoma mua o ka hoʻohana a mālama ʻia ma kēia pae, e kau ʻia i ka hoʻohana mau ʻana.
ʻO nā lāʻau lapaʻau i koho i kēia hihia he hydrophilic (hoʻokahe wai-wai) stins form: pravastatin, rosuvastatin. Hiki iā lākou ke hāʻawi i nā hopena kiʻekiʻe loa me nā haʻahaʻa o nā hopena o ka hopena.
Ma lalo o ka hopena o ka ʻikepili hou i loaʻa i ka wā e ho'āʻo ai i nā lāʻau lapaʻau, e loli nei ka ʻano o ka hoʻohana ʻana i nā lāʻau lapaʻau. I kēia manawa, hiki i nā statins ke hōʻemi i nā pōʻino o ke kino o nā hoʻopiʻi vascular a me ka coronary, no laila ke hoʻohana nui ʻia i ka mālama ʻana i ka maʻi maʻi.
