Qeyb muhiim ah oo ka hortageysa atherosclerosis , cudurka halbowlaha wadnaha (CAD) , stroke iyo cudurada halbowlaha , waa inaad ilaaliso heerarkaaga kolestaroolka iyo triglyceride in aad aad u sareeyso. Inkastoo dadka qaarkood ay ku guuleysan karaan hadafkani oo leh cunto iyo jimicsi, dad badan ma awoodaan. Haddii cuntada iyo jimicsigu kugu filan yahiin, ama haddii aad halis u tahay cudurrada wadnaha iyo xididada , waxaa suurtogal ah in dhakhtarkaagu uu rabo inaad bilowdo qaadashada daawada rijeetada.
- Akhri waxyaabaha aasaasiga ah ee kolesteroolka iyo triglycerides.
- Akhri sida loo sheego haddii aad u baahan tahay in lagugu daaweeyo.
Sannado badan, dhowr nooc oo daawooyin ah ayaa loo soo qoray si loo daaweeyo kolestaroolka iyo triglycerides. Inkasta oo statins ay noqdaan darajada ugu muhiimsan ee daroogada hoos loo dhigo, haddana qaar badan oo ka mid ah daawooyinka waaweyn ayaa weli la isticmaalayaa. Intaa waxaa dheer, noocyo cusub oo daawooyin ah oo lagu daaweynayo lipids-ka dhiigga ayaa bilaabay inuu yimaado isticmaalka kiliinikada.
Daaweyn kasta oo laguu qoray, waa inaad ogaataa wax ku saabsan daawooyinka gaarka ah ee aad qaadato. Halkan waxaa ku qoran sharaxaad guud ee daawooyinka laguu qoray ee la heli karo si loo daaweeyo lipids dhiig.
Statins
Statins waa daaweyn loogu talagalay daaweynta kolestaroolka, sababtoo ah arrin aad u fudud - statins waa heerka kaliya ee daroogooyinka hoos u dhiga oo lagu soo bandhigay si loo wanaajiyo natiijooyinka dhabta ah ee dadka qaba hurgumada wadnaha, oo gaar ahaan dadka horay u lahaa wadno xanuun ama istaroog.
Daawooyinka durbadiiba waxay xayiraan enzymo oo loo yaqaan 'HMG-CoA reductase, taas oo yaraynaysa awoodda beerka ee loo sameeyo kolestaroolka. Sidaa darted, muxaadaradu si weyn oo kalsooni lehna hoos ugu dhaco wadarta guud ee kolestaroolka dhiigga iyo heerarka "kolesterol" LDL.
Statins ayaa sidoo kale hoos u dhigta caabuqa xididdada, waxay hoos u dhigtaa xinjirta xididada dhiigga, waxayna sii wanaajisaa hawlaha guud ee dareeraha.
Statins inta badan waa loo dulqaadan yahay, laakiin waxyeellooyinka ayaa imanaya. Waxyeellada ugu weyn ee la ogaan karo waa muruq xanuun ama daciifnimo , taas oo lagu arko 5 - 10% bukaannada qaata daawooyinkan.
Waqtiga hadda la heli karo waxaa ka mid ah:
- Lipitor (atorvastatin)
- Lescol (fluvastatin)
- Mevacor (lovastatin)
- Livalo (pitavastatin)
- Pravachol (pravastatin)
- Zocor (simvastatin)
- Crestor (rosuvastatin)
Ka hortagga PCSK9
Kaararka PCSK9 waa fasal cusub oo ah daroogooyinka hoos u dhigaya kolesteroolka. Labada hore - Repatha (evolocumab) iyo Praluent (alirocumab) - waxay ansixiyeen FDA dhamaadkii sannadka 2015. Daawooyinkan waxay ku shaqeynayaan in la joojiyo PCSK9 enzyme ee beerka, taas oo keena beerka in ay ka saarto kolesteroolka LDL ee dheecaanka badan. Kaararka PCSK9, oo la siiyo cirbadeynta, waxay u qaadi kartaa heerka LDL kolesteroolka heerar aad u hooseeya, sidaas awgeed, waxay abuureen xiiso badan oo ka dhexeeya cilmi-baarayaasha.
Maanta daawooyinkaan waxaa loo isticmaalaa bukaanka qaba foosha 'hypercholesterolemia', ama sidoo kale leh heerarka "kolesterol" LDL oo aad u sarreeya inkastoo la daaweynayo statins. Isticmaalkooda ayaa si fiican u faafi kara sanadaha soo socda sida aan ku ogaan karno in ay hagaajin karaan natiijooyinka kiliinikada, marka lagu daro heerarka kolesteroolka - iyo haddii ay keenaan saameyno muddo dheer ah.
Nikotinic Acid (Niacin)
Nitrotinic acid, qaab nikoti ah , wuxuu yaraynayaa kolestaroolka LDL wuxuuna kordhiyaa heerarka HDL ee kolestaroolka. Dhowrkii la soo dhaafay, waxaa loo soo qoray si cadaalad ah si loo kordhiyo heerarka HDL. Si kastaba ha ahaatee, daraasad weyn oo kiliinikada ah ayaa shaki badan ka qaaday faa'iidooyinka nicotinic acid. Daraasaddan, ma aha oo kaliya nicotinic acid ma guulaysan in la hagaajiyo natiijooyinka baaritaanka laakiin sidoo kale waxay kordhin kartaa khatarta istaroogga. Maanta, nicotinic acid guud ahaan guud ahaan waxaa loo isticmaalaa bukaanka qaba heerarka sare ee heerka kolestaroolka LDL ee aan qaadan karin daawooyinka kale.
Ezitimibe
Ezetimibe wuxuu yareeyaa xaddiga kolestaroolka mindhicirka, taasoo keenta in beerku u helo dheecaan badan oo ka mid ah kolesteroolka uu u baahan yahay isaga oo ka saaraya dhiigga.
Natiijo ahaan, heerarka "kolesterol" LDL waa la dhimayaa.
Baaritaanada caafimaadka ee ezetimibe (iibiya sida Vytorin, iyo isku-darka simvastatin sida Zetia) ayaa si niyad jab leh, daroogada looma isticmaalo inta badan daaweynta kiliinikada. Waxaa badanaa loo isticmaalaa dadka qaba heerarka kolestaroolka sare ee dheeraadka ah inkastoo daaweynta daweynta statin, ama aan awoodin inay qaadaan astaanta.
Dhejiyeyaasha Acid Bile.
Qalabka lafdhabarta ah ayaa ka hortagaya dib-u-soo-saarka jirka ee kolestaroolka ku jirta xaydhka ka sameysan xiidmaha. Tani waxay keenaysaa beerka inuu ka saaro kolestarool ka badan wareegga. Xajinta Astaamaha Astaamaha waa Questran (cholestyramine), Cholestid (kolestipol), iyo Welchol (colesevelam).
Inkasta oo daroogooyinkaasi ay si wax ku ool ah u yareeyaan heerarka LDL ee kolestaroolka, waxay u muuqdaan inay sababaan saameynaha mindhicirka ee xaddidaya faa'iidadooda. Sidoo kale, sida daroogada kale ee daroogada hoos loo dhigo, daraasaadka kiliinikada ayaa ku fashilmay inay muujiyaan in ay hagaajiyaan natiijooyinka.
Halkan waxaa ku qoran macluumaad dheeraad ah oo ku saabsan cholestyramine , xajmiga ugu badan ee loo isticmaalo xiidka.
Fibrates.
Qeybaha dabiiciga ah - Antara (gemfibrozil) iyo Lopid (fenofibrate) - ayaa ah kuwa ugu waxtarka badan ee hoos u dhigaya heerka dhiigga ee triglyceride (ilaa 50%). Waxay sidoo kale kordhiyaan heerarka baruurta ee HDL waxayna yareynayaan heerarka LDL ee kolesteroolka illaa xad. Fayrasku waxay ka shaqeeyaan iyadoo la xakameynayo wax soo saarka lipoproteins-ka ee triglyceride-ka ee beerka. Mar labaad, si kastaba ha ahaatee, inkastoo ay saameyn ku yeesheen dufanka dhiigga, dhowr tijaabo oo kala duwan ayaa ku fashilmay inay muujiyaan wixii horumar ah ee ka soo baxa natiijooyinka kiliinikada ee fibrates.
Isticmaalka ugu weyn ee fibrates maanta waa in lagu daaweeyo bukaanka qaba hypertriglyceridemia daran . Saameynta ugu badan ee daawada fibrates waxay tahay inay sababi karto sunta sunta, gaar ahaan marka loo isticmaalo statins.
Ereyga
Inkasta oo dhowr daroogo oo daroogo ah lagu muujiyay inay saameyn wanaagsan ku yeesheen heerarka kolesteroolka iyo triglyceride, kaliya waxaa loo muujiyay in ay si weyn u hagaajinayaan natiijooyinka caafimaad. Tilmaamaha hadda jira ee lagu daaweynayo kolestaroolku waxay xadidaan talooyinkooda dawooyinka dawooyinka - daroogooyinka kale laguma talinayo marka laga reebo kiisaska shakhsi ahaaneed.
Si kastaba ha ahaatee, cilmi-baarayaashu waxay rajeynayaan in ay sugaan natiijooyinka tijaabooyinka bukaan-socodka ee hadda la sameeyo PCSK9 xannibaadayaasha, daroogo cusub oo daroogo ah oo leh saameyn aan badnayn oo kolesteroolka ah.
> Ilo:
> Stone NJ, Robinson JG, Lichtenstein AH, iyo al. 2013 ACC / AHA tilmaameedka Daaweynta Dhiigxinjirta Dhiigga si loo yareeyo Khatarta Wadnaha ee Atherosclerotic ee Dadka Qaangaarka ah: Warbixin ka timid Kulliyoolajiyada Mareykanka ee Daaweynta Daaweynta Daaweynta Wadnaha / American Heart Association. Wareegga 2014; 129: S1.
> Nawaaxiga EP, Kolodziejczak M, Schulze V, et al. Saameynta Transrotein Convertase Subtilisin / Kexin Nooca 9 Dhibaatooyinka Lagu Daawanayo Dadka Qaan-Gaarka ah Hypercholesterolemia: Dib-u-eegis nidaamsan iyo falanqayn metadal. Ann Intern Intern Med 2015; 163: 40.
> AIM-HIGH Investigators, Boden WE, Probstfield JL, et al. Niacin ee Bukaanada leh Heerka HDL-da Hoose Heerka Qaadashada Daaweynta Isticmaalka Dabiiciga ah. N Engl J Med 2011; 365: 2255.