Isizukulwane yakamuva statin izidakamizwa: izinzuzo, amanani, ukubuyekezwa

Class statin zidakamizwa ziye kwemiqondo njengendlela inciphise serum cholesterol kanye ukwehlisa ubungozi zenhliziyo. Kwaphela isikhathi eside abacwaningi nodokotela isebenze kuphela nama-izidakamizwa, "Lovastatin," "Pravastatin" "Simvastatin", "Fluvastatin." Babaziwa kanjalo ngaleso kwemiqondo "Atorvastatin" futhi "Rosuvastatin" - yisizukulwane yakamuva statin, noma kunalokho, imithi eminye esebenza ngempumelelo kakhulu kulesi sigaba. Libuye okwamanje uthomile ukuthuthukisa entsha, ukuthi iphephile nakakhulu futhi ngempumelelo statin, phakathi okuyinto ethandwa kakhulu kungokwalabo "pitavastatin."

izici Jikelele kwemithi ye-statin

Zonke statin awela isigaba izidakamizwa ezithinta lipid umzimba emzimbeni womuntu. Imithi yokwakheka zokwelapha Chemical Ukwahlukanisa System bona enzelwe ikhodi S10AA futhi baxoxela inhibitor ka reductase HMG-CoA. Ezivimbela Umsebenzi yalesi enzyme, bona uphazamise zamagama cholesterol, serum kunciphise senani. statin Lesi senzo ivumela ukuba kuzuzwe lokuhlala Kunconywa ephansi kwabantu lipids egazini.

Le miphumela enze kube nokwenzeka ukuba kakhulu ukunciphisa izinga yentuthuko qwembe atherosclerotic. Futhi imithi ukuvimbela ivela khona. Ngisho uma itholakala umphumela owusizo statin: bona usimamise endothelium koqweqwe atherosclerotic, kule ndaba, kakhulu ukunciphisa amathuba thrombosis yenhliziyo, esebenza nge indlela ehlukile kunaleyo yokwelapha antiplatelet. Ngaphezu kwalokho, ukusetshenziswa ahlangene we lezi zimali ivumela nakakhulu ukunciphisa amathuba ngemuva kokuhlaselwa yisifo senhliziyo. Ngenxa statin efakwe intengo buyafaneleka ngokugcwele.

Ikakhulukazi statin ngezigaba

Kunezinhlobonhlobo zezindlela ezimbalwa kuya division zibe amakilasi izidakamizwa. Bona kungabonwa ngokuya izici zamagama. Futhi, njengoba ekwelapheni statin ahlukahlukene kudinga Kwabiwa ngemithamo ehlukene Kunengqondo ukwethula ngezigaba esekelwe imithamo Kunconywa. Ukwahlukanisa izizukulwane libukeka kanje:

• Mina isizukulwane "Simvastatin", "Pravastatin", "Lovastatin".
• isizukulwane II, "Fluvastatin."
• III isizukulwane "cerivastatin," "Atorvastatin".
• Generation IV "pitavastatin," "Rosuvastatin."

Zonke statin zihlukaniswe yokufakelwa kwemiqondo izinto zokusetshenziswa, futhi zemvelo. Lezi zingozi zihlanganisa ama "Lovastatin," "Pravastatin" futhi "Simvastatin". izidakamizwa Zokwenziwa kukhona ukuphumula. "Fluvastatin," "Atorvastatin", "Rosuvastatin" futhi "pitavastatin"

Ukwahlukanisa statin ngemithamo kuye isicelo

Zonke amakilasi kwezidakamizwa, kuhlanganise isizukulwane yakamuva statin, ngokukhalipha ihlukaniswe umthamo ongaphakeme (8 mg), srednedoznye (10-40 mg) ephezulu (40-80 mg). Ikakhulukazi:

• izidakamizwa okusezingeni eliphezulu ukuvuvukala ( "atorvastatin", "Lovastatin" "Fluvastatin");
• srednedoznye izidakamizwa ( "simvastatin", "pravastatin", "Rosuvastatin");
• ongaphakeme umthamo izidakamizwa ( "pitavastatin").

Lokhu kuhlukaniswa ibonisa ukuthi kungenzeka enquma zebanga zabo zokwelapha. Ikakhulukazi, ephezulu izidakamizwa nomthelela imali ephezulu, nakuba asibekezeleleki kahle. Srednedoznye izidakamizwa, kodwa "rosuvastatin 'ebekezelele ngokubhekakade kancane kahle ebulilini, kodwa kube nomphumela omuhle.

statin Srednedozny "Rosuvastatin" ingasatshenziswa ngezilinganiso okusezingeni eliphezulu (80 mg), uma kudingekile, noma ngenxa ukuncipha ngokwanele ephelele cholesterol inani ephansi kwabantu ingxenyenamba ukuthi ngokuvamile akudingeki. "Pitavastatin" futhi kanjalo kudinga lapho uya khona imali okungenani, ngenxa yalokho izingozi ukusabela ezingezinhle izikhathi eziningi ephansi kunaleyo nozakwabo ekilasini.

Umlando ukuthuthukiswa kanye nokwethulwa statin

Umlando statin kuyinto impikiswano enkulu. Ekuqaleni, ukuthuthukiswa yabo kakhulu thiya ngaphambilini ngenxa yokuswela ulwazi cholesterol umzimba futhi amathuba asathuthuka atherosclerosis, kuncike amazinga wegazi lipids. Ngaphezu kwalokho, gopoholesterinemicheskie kanye kwemiqondo kusho ekuvimbeleni microflora emasikweni ka isikhunta, okuhloswe ukuthola penicillin akuzange kusize okumsulwa. Ukuvulwa yesenzo ane-ukwehlisa eziningi izinto ezivezwa isikhutha, nezilwanyana ekwenzele ekutadisheni statin.

Waba statin lokuqala, compactin, hhayi busuka umkhuba emtholampilo ngenxa yabantu eminingi engqubuzanayo yezindlela imiphumela yayo. Kwakuthinta behlukene isiko Penicillium cetrinium. Khona-ke, kusukela isiko Monascus ruber kwaba monacolin angawodwa K, lobunikazi ngo-February 1979. Ngo-June 79th nelungelo lobunikazi kanye mevinolin, kamuva awuthwala igama "Lovastatin". Lesi sidakamizwa isetshenziswa emtholampilo, ngemva kokuba ezingase noma kuhlelwe umqondo ngu isizukulwane yakamuva statin.

Kuningi sokumelana ukubukwa statin engasenamahloni ukuthuthukiswa, ngemva kwalokho kwanqunywa ukuba ukuqhuba emikhulu zokwelapha. Kuze kube manje, enkulu kunazo zonke futhi ewusizo kakhulu kwaba ukutadisha zaseScandinavia Simvastatin Ukusinda Isifundo. Efinqiwe igama layo «4S». It is ngokugcwele ukulahlwa kungenzeka izifo umdlavuza ezihlobene izidakamizwa ukuphatha, futhi afakazele ukuthi ukusebenzisa kwawo i kakhulu kwandisa ubude bempilo kanye kunciphisa tigameko acute pathologies yenhliziyo.

Izifushaniso ukuze kuzuze statin

Lapho emakamu kokuqala cholesterol ingqikithi 7.4 mmol / l, ukwelashwa statin futhi bafinyelele ezingeni 5.4 mmol / L kakhulu kunciphisa ingozi ebulalayo izenzakalo senhliziyo ngo-40% eminyakeni 5 ezayo. Miningi eminye ucwaningo luye lwabonisa ukuthi ukwehlisa inani cholesterol kuphela 1 mmol / L ngumuntu yesihlanu kunciphisa amathuba thrombosis yenhliziyo futhi ngalesosizathu isifo senhliziyo noma unhlangothi.

Uma ucabangela statin, izinzuzo nezingozi ukhuluma zazo eziningi ochwepheshe kanye neziguli, sizwisise la maqiniso alandelayo: ungakwazi linqume izidakamizwa kudala njengoba engu-40 ubudala noma ngaphezulu, futhi ukunciphisa izingozi yesifo senhliziyo - iqhinga okunengqondo ngelula ukuphila. Futhi njengoba ama-statin intengo ngempela kufinyeleleke, le mithi zikufakazela ngempumelelo, ingase ikhishwe ngaphandle kokubandlulula isabelomali lalo. Yiqiniso, isizukulwane yakamuva statin ibiza kakhulu, nakuba "Rosuvastatin" efanayo Ngomqondo onabile, kuba impela ezibizayo ukuze isiguli. Futhi kuba engabizi kakhulu ifomu ukulungiselela "Merten".

izici Comparative: Izinzuzo nezingozi nebubi

Ukuhlola ama-statin, futhi ngokumelene nabo bakhulume kakhulu ukumane. Izimpikiswano "ngoba" kukhona isici wezenzo zazo zokwelapha: nokwehlisa egazi cholesterol kanye ongaphakeme-ukuminyana amafraktjhini, ekuvimbeleni ingozi izenzakalo oyingozi futhi usizo nokwelashwa kwazo. Nokho, izidakamizwa ezifana statin, kukhona Izimo. Kunemiphumela emibi, thobeka izizathu eziphikisa isicelo.

Lapho ukwelashwa nge-statin ingozi myopathy. Cishe ayengumlamuleli waso okusithiyayo we zamagama cholesterol, okuyinto edingekayo imisipha. Imvamisa lo mphumela liphansi kakhulu, yize ke kukhuphuke ngo coadministration namanye amanxusa hypolipidemic. Kukhona ingozi yomdlavuza isibindi zokugula, nakuba amathuba leso sifo, njengoba kwaboniswa yindlela ucwaningo lwamuva, eliphansi kakhulu. Ngesikhathi esifanayo neshaya yokuthi umdlavuza ecasulwa ngezinye izinto ezisemaceleni. Ngakho, ngo-unamasu "statin" Izimo kufanele iyakwenqabela co-ukuphatha le mithi namanye amanxusa ekhuthaza ukwehla lokuhlushwa amaseli fat.

Izindleko isizukulwane yakamuva statin

On isizukulwane yakamuva statin ngamanani ahlukene, nakuba imiphumela yabo nibaluleke ekhokhela. Omunye umbuzo kuphela ukuthi imiphumela yezenzo zabo bungatholakala nokusetshenziswa eshibhile analogue ekilasini zezizukulwane zangaphambili. Ikakhulu, i-ezivamile statin Generation IV "Rosuvastatin" Intengo cishe ngendlela elandelayo:

• ruble 600 amaphilisi 40 mg;
• 400-450 kwithebhulethi 20 mg;
• 300-350 amaphilisi 10 mg;
• ruble 200 5 mg.

Iphakheji liqukethe amaphilisi 30, ngokwanele inyanga eyodwa yokwelashwa, kuyilapho nyangazonke ukwelashwa "pitavastatin" amanani cishe ngendlela elandelayo:

• amaphilisi 1 mg abiza ruble mayelana 700-750;
• I-Tablet 2 mg - ruble mayelana 1000;
• ithebhulethi 4 mg - ruble 1500.

Kumelwe ukhethe phakathi "Pitavastinom" futhi "rosuvastatin" kusekelwe amane zindlela: Intengo isici, izinga lokwehliswa ephansi kwabantu Esilula, Isidlulisilwazi Esilula ukwanda ukugcwala, ukuvikeleka. Ijubane ukwehlisa cholesterol nokukhuphula HDL, kanye intengo engcono ubukeka "Rosuvastatin", kuyilapho kwakuthiwa ivikeleke kakhulu iyona "pitavastatin."

Okokugcina kabili njengoba ezibizayo uma iqhathaniswa 'rosuvastatin ". Noma kunjalo, kukhona kungenzeka usebenzisa ezinye, ama-statin eshibhile. Kakhulu kwezomnotho kunenzuzo kwaba ngaphambilini "Simvastatin". Manje salandelwa "Atorvastatin", okuyinto njalo indawo "rosuvastatin" (value yayo ngeke ngempela iwe). Futhi uma statin zakamuva amanani isizukulwane ngabe bayehluleka ngekwetimali for the iziguli, kubalulekile ukuba sicabangele ukuthi kungenzeka kokuphatha "atorvastatin" noma "Simvastatin". By the way, izifundo kakhulu efundelwa "atorvastatin".

Izimpikiswano esivuna statin abadala

Ngaphambili, odokotela bayanqikaza linqume statin iziguli abaneminyaka engama-75. Imbangela lezi zinto ezilandelayo:

• reception, eziningana kwamanye amakilasi izidakamizwa;
• ukwenqena mutual kokwengeza enye uhlobo lwemithi;
• yokuntuleka noma ukwelashwa ongaphakeme komplaentnost;
• ukwenqena iziguli ukuba bazithengele statin nokuyisebenzisa ngenxa ukungasiqondi imiphumela yabo.

A inani lezifundo eyenziwa nge "Simvastatin" "Pravastatin" futhi "atorvastatin" wabonisa ukwehla okukhulu futhi ngokwempilo yangenyama ezigulini abaneminyaka engama-75. Ngaphezu kwalokho, ukwehla ngokwempilo yangenyama lalilide ngisho kunalokho of iziguli amaqembu wobudala 55-65 futhi eminyakeni 65-75. Ngoba izidakamizwa alesi sigaba (ama-statin) amazwana kusukela ochwepheshe kuqinisekisa ngokucacile iqiniso.

Lezi imithi lingathathwa kamuva ekuphileni kungakhathaliseki lapho ababengaziphathi acute iziyaluyalu zenhliziyo. Futhi ezigulini ngempela izimpikiswano ezibalulekile ukunciphisa ingozi yokufa kwakhe kusukela isilethikusebenza noma ukufa uhlangothi, kudingeka uqonde ukuthi uma umuthi ngempumelelo futhi iphephile, kumnandi impela ukuthatha. Ikakhulukazi ukuthi ukwelashwa nge-statin isibe kufinyeleleke kakhulu, futhi uzoqhubeka njengoba enjalo.

Izici nokubuyekezwa isizukulwane yakamuva statin

Iziguli amazwana ekuhloleni izinga a statin ethile ejwayelekile akuzona eyabonisa, ngoba abazange wazizwa izinguquko eziphawulekayo kusukela bokusebenzisa imithi le. Ukuthuthukisa iphrofayela igazi lipid akuveli isimo sempilo kanye asinazo izimpawu zangaphandle. Sivuma iphrofayela lipid kuphela. Ngoba uma silinganisa statin ngokuhlakanipha waqondisa izazi isibuyekezo. Futhi mayelana amalungiselelo lapho isithako esebenzayo kuyinto pitavastatin, ochwepheshe zendawo Awukwazi ukuphendula.

Ngo umkhuba emtholampilo ku CIS "pitavastatin" ngoba zibiza futhi ngenxa khona "rosuvastatin" futhi imithi ejwayelekile yayo asisebenzi. Ngo amalungiselelo "rosuvastatin", okuyinto kushiwo ngenhla, isinyathelo esisheshayo: iphrofayela lipid kwesejwayelekile izinyanga 1-2. I "atorvastatin" isikhathi nezikhathi nengxenye ngaphezulu. Futhi ejwayelekile "rosuvastatin" ephephile, njengoba lezi zinhlobo ezimbili kuthiwa akheka yi cytochrome. Okwamanje, lolu lwazi ethathwa amazwana wezazi, idlala indima ebalulekile ekukhethweni kuka statin ezimweni ezithile zokwelapha.

Iziphetho jikelele izizukulwane yakamuva statin

Izidakamizwa "pitavastatin" futhi "Rosuvastatin" kukhona eziphambili kakhulu phakathi abameleli besigaba statin, okuyiwona neqembu elikhulu kakhulu ubufakazi eziqoqiwe. nemiphumela yayo ngokuvamile ezifana nalezo we "atorvastatin", kodwa kunomehluko. "Pitavastatin" futhi "Rosuvastatin" ukuvumela ukufinyelela emazingeni target cholesterol, futhi ongaphakeme ukuminyana Esilula ngezilinganiso aphansi ukwedlula "atorvastatin".

Ngaphezu ukuphakama ngaphezu statin isizukulwane yakamuva kubalulekile futhi isici. Okungukuthi, ekwelapheni "pitavastatin" futhi "rosuvastatin" waphawula ukuzinza okusheshayo wegazi lipids nokuqeda homocysteinemia. Lokhu kubalulekile njengoba kwaba njalo endabeni ka-acute isifo senhliziyo, futhi in iziguli isifo senhliziyo, senziwa isifo sokuqina kwemithambo yegazi yenhliziyo. Ukuphepha ukusetshenziswa statin ephakeme kunaleyo kardioform acetylsalicylic acid. Noma kunjalo, khona Izimo unqabela ukusetshenziswa kwabo ezithile nesineke labantu (bheka. Izimo General).

izibonelo ekwakhiweni

Imithi equkethe "Rosuvastatin" iyatholakala ngaphansi amagama alandelayo ukuhweba: "AKORT", "Rozistark", "Rozukard", "Rozart", "Merten", "Rozulip", "Roxer", "Rustor", "Tevastor". Konke lokhu mithi ejwayelekile "Crestor" elaba rosuvastatin kuqala. Izidakamizwa, lapho izidakamizwa esebenzayo pitavastatin, bhalisiwe njengoba «Livalo». imithi ejwayelekile bakhona «Pitavas» futhi «Pivasta». abazi zenzeka CIS, nakuba ebhaliswe Pharmacopoeia.

isifinyezo

Ngokuhambisana ekilasini izidakamizwa imiphumela kanye nokuhlaziywa ukusebenza ukusetshenziswa kwabo, ukusetshenziswa statin siyavunyelwa ngoba eliletha ukuthula qwembe atherosclerotic futhi kuvimbele uhlobo yayo. Asetshenziswa ukunciphisa umfutho isifo sokuqina kwemithambo yegazi, ezithinta iphrofayli lipid wegazi serum. Ngenxa yalokho, lesi sigaba izidakamizwa kuyadingeka ngempela e nezenhliziyo. Kanti nezinga zakamuva isizukulwane statin kakade indlela ephumelelayo nokuvinjelwa ebulalayo thrombosis yenhliziyo.