Ho etsa liphetoho ho theha bophelo bo botle - ka lijo, ho ikoetlisa, kapa liphetoho tse ling - ke habohlokoa ho boloka lihlopha tsa hau tsa k'holeseterole le triglyceride li phela hantle. Ka linako tse ling, sena se ka 'na sa se ke sa sebetsa,' me mofani oa hao oa tlhokomelo ea bophelo a ka 'na a batla ho u beha meriana.
Meriana e mengata ea ho theola li-k'holeseterole e ntse e le 'marakeng,' me e mong le e mong oa meriana e theola k'holeseterole le / kapa metsoako ea triglyceride ka litsela tse fapaneng.
Ho phaella moo, e mong le e mong oa lithethefatsi tsena o lebisa lintlha tse fapaneng tsa boemo ba hau ba lipilisi. Ka mohlala, lithethefatsi tse ling li ka atleha feela ho fokotsa lDLLL ea hau, empa lithethefatsi tse ling li ka lebisa lintlha tsohle tsa boemo ba hau ba lipilisi. Ho sa tsotellehe boemo leha e le bofe, mofani oa hao oa tlhokomelo ea bophelo o tla lekanya melemo le likotsi tsa lithethefatsi ka 'ngoe,' me u khethe lithethefatsi tse molemohali tse fokolang lipilisi tse loketseng. Lithethefatsi tsena tsa meriana li ntse li le 'marakeng:
Litemoso
Statins, e tsejoang hape e le HMG-CoA reductase inhibitors, ke meriana e theolelang ka ho fetisisa e fokolang meriana. Le hoja ba amohetse botumo bo bobe bakeng sa ba bang ba sa rateheng, empa ba sa tloaelehang, litla-morao , ba lebisa tlhokomelo likarolong tsohle tsa boemo ba hau ba lipilisi.
Litemana li ka:
- Fokotsa LDL pakeng tsa 18 lekholong le 65 lekholong
- Eketsa HDL ("molemo" k'holeseterole) ho fihlela ho karolo ea 5 ho ea ho karolo ea 15 lekholong
- Fokotsa triglycerides ka karolo ea 7 ho ea ho karolo ea 30 lekholong
Li-statins ha li sebetse feela ho etsa hore likarolo tsohle tsa boemo ba hau ba k'holeseterole li sebetse, li boetse li tsebahala ho thibela lefu le mathata ka lebaka la lefu la pelo.
Melao e boetse e na le lintho tse khahlanong le ho ruruha tse fokolang tsoelo-pele ea atherosclerosis e ka lebisang ho lefu la pelo. Ka melemo ena e eketsehileng ea li-statin, lithethefatsi tsena ke tsona tse ratoang ka ho fetisisa tsa meriana ea ho qeta k'holeseterole. Lithethefatsi tse latelang li khetholloa e le li-statins:
- Rosuvastatin (Crestor)
- Atorvastatin (Lipitor)
- Simvastatin (Zocor)
- Lovastatin (Mevacor)
- Pravastatin (Pravachol)
- Fluvastatin (Lescol)
Li-Resin tse hlahisoang ka metsi
Li-resin tse nang le li-acid tse ngata li fokotsa k'holeseterole maling ka ho thibela bile acid hore li se ke tsa khutlisetsoa hape. Ka tloaelo ba sebetsa ka LDL k'holeseterole, ba e fokotsa ka karolo ea 15 lekholong ho ea ho karolo ea 30 lekholong le ho eketseha ha HDL ka liphesente tse 5. Ka tloaelo, triglycerides ha e angoe ke li-resin tsa bile-'me e ka hlahisa maemo a triglycerides. Ho phaella moo, li-vithamine tse ling le lithethefatsi li ke ke tsa nkoa ho pota ha u ntse u nka li-resin tsa bile acid, kaha ho noa ha tsona ho lekane 'me ho ka etsa hore li se ke tsa atleha. Meriana e latelang e aroloa e le bile acid acid:
- Cholestyramine (Questran)
- Colestipol (Bo-Colestid)
- Colesevelam (Welchol)
Fibric Acids
Fibric acids, kapa fibrates, e tsebahala haholo ka matla a bona a ho theola triglycerides, e ka theoleloang ke pakeng tsa 20 lekholong le 50 lekholong. Ba boetse ba theola LDL maemong a pakeng tsa 5 lekholong le 20 lekholong mme ba ka hlahisa maemo a HDL ka karolo ea 20 lekholong. Sehlopha sena sa lithethefatsi se tsebahala ho hlahisa chefo ea mesifa, haholo ha e kopantsoe le lithethefatsi tse ling tse kang statins le warfarin (Coumadin). Tabeng ena, mofani oa hao oa tlhokomelo ea bophelo a ka 'na a fetola tekanyo ea lithethefatsi tsa hau (joalo ka tabeng ea warfarin).
Meriana e latelang ke fibrates:
- Gemfibrozil (Lopid)
- Fenofibrate (Tricor)
Likokoana-hloko tsa ho ikhethela
Hona joale Ezetimibe ke eona feela lithethefatsi sehlopheng sena 'me ka ho khetheha e finyelletse litefello tsa li-cholesterol tsa LDL, ho theola litefatsi tsa LDL ka karolelano ea liphesente tse 15. Ka tloaelo, ezetimibe e kopantsoe le statin ho tiisa hore ho na le phello e matla ha ho theoleloa LDL maemong. Le hoja meriana ena e bontšitsoe hore e fokotse LDL, ha e e-s'o bontšoe hore e thibela ka ho toba tsoelo-pele ea lefu la pelo ha e sebelisoa e le mong. Ezetimibe (Zetia) ke eona feela meriana e amohelehang ea FDA ka hare ho sehlopha sena sa lithethefatsi.
Omega-3 Fatty Acids
Le hoja ho na le omega-3 fatty acids e holimo-ea-counter, lithethefatsi tsa omega-3 tse mafura a mafura li 'nile tsa hlahlojoa ka ho eketsehileng ho hlahloba katleho ea tsona le polokeho.
Lihlahisoa tsena li na le docosahexaenoic acid (DHA) le eicosohexaenoic acid (EPA) joaloka lisebelisoa tse fumanoang mabenkeleng, empa likaroloana tsena li hloekisitsoe haholoanyane ebe lia ameha ha li bapisoa le ho feta li-supplement. Omega-3 fatty acids e sebelisoang ka ho khetheha e sebelisoa ka ho khetheha ho batho ba nang le litekanyetso tse phahameng tsa triglyceride, ho theola triglycerides ka liphesente tse 45. Hona joale ho na le mefuta e meraro ea ngaka ea oli e omega-3 [lihlahisoa tse fumanehang:
PCSK9 Inhibitors
Lithethefatsi tsena li thibela protheine ea PCSK9 ho tloha ho sebelisana le li-receptor tsa LDL le ho etsa hore li silafatsoe. Sena se tla lumella li-receptors tsa LDL hore li tsoele pele ho sebetsa ka ho tlosa LDL 'meleng - e leng ho fokotsang ho theola LDL li-cholesterol maemong ka liphesente tse 50 ho lithuto. Meriana sehlopheng sena e eketsoa ha meriana ea kajeno ea ho theola k'holeseterole (e kang li-statins) e sa fokolise ka ho feletseng LDL k'holeseterole. Hangata li sebelisoa hammoho le phepo e nepahetseng ea pelo 'me li nkiloe ka li-statins kapa tse ling tsa lithethefatsi tse fokolang. Batho ba noang meriana ena ba na le e 'ngoe ea maemo a latelang a bongaka:
- lefu la atherosclerotic le amang methapo ea mali le / kapa pelo
- boemo ba bongaka bo futsitsoeng, ho ba le methapo ea mali ea homozygous kapa heterozygous
Ho na le liphuputso tsa morao-rao tse hlahlobang bokhoni ba lithethefatsi ka tlelaseng ena ho fokotsa kotsi ea lefu kapa ho ba le lefu la pelo ho batho ba ba nkang. Lithethefatsi sehlopheng sena li kenyelletsa:
Lithethefatsi tsa likhutsana
Mefuta e meng ea ho fokotsa meriana e fuoe batho ba nang le li-cholesterol tse phahameng haholo tsa LDL. Hangata meriana ena e laeloa maemong ao ho 'ona motho a nang le boemo bo futsitsoeng bo etsang hore motho a be le molomo haholo ha a le monyenyane,' me meriana e meng - e kang li-statins-ha e thuse maemo a fokolang a LDL.
Tse ling tsa meriana ena li ka baka litla-morao tse tebileng, tse kang lefu la sebete, kahoo li atisa ho fanoa tlas'a lenaneo le ikhethang ka litsebi tsa bophelo bo botle ba tsebang meriana. Meriana ena e boetse e ncha 'marakeng' me e sebetsa ka litsela tse ikhethang tsa ho fokotsa maemo a lipilisi:
- Li-antisense inhibitors: Meriana ena e tlatsanang le sehlopha sa lithethefatsi RNA e fanang ka lintlha tsa ho etsa B-100, e fokotsa bokahohle ba B-100 bo entsoeng 'meleng. Sena se theola boholo ba cholesterol ea VLDL le LDL 'meleng. Lithethefatsi tsena li kenyeletsa Kynamro (mipomersen), e fokotsang LDL ka hoo e ka bang karolo ea 25 lekholong.
- MTTP inhibitors: Lithethefatsi tsena li theoha tlaase ho LDL k'holeseterole ka ho thibela microsomal triglyceride transfer protein (MTTP), molek'hule 'meleng o thibelang VLDL le li- chylomicrons sebeteng. Juxtapid (lomitapide) ke eona feela meriana e amohelehang ho sehlopha sena sa lithethefatsi le ho theola LDL ka hoo e ka bang liphesente tse 50.
Lisebelisoa:
Dipiro JT, Talbert RL. Pharmacotherapy: Pathophysiological Approach, 9th, 2014.