Chizvarwa ichangobva pamusoro statin zvinodhaka: zvazvakanakira, mitengo, wongororo

Kirasi statin mishonga kunge synthesized senzira yokuderedza uwandu serum remafuta akawandisa uye kuderedza zvemwoyo ngozi. Kwenguva refu vaongorori uye vanachiremba kushanda chete zvinodhaka, "Lovastatin," "Pravastatin" "Simvastatin", "Fluvastatin." Vakanga synthesized "Atorvastatin" uye "Rosuvastatin" - ndiyo azvino chizvarwa statins, kana pane, inonyatsobudirira zvinodhaka ari muchikwata ichi. Chinhu Pari kuitwa kukudziridza matsva, kuti chinotonyanya yakachengeteka uye inoshanda statins, ramakagadzwa zvikuru nevanhu ndowenyika "pitavastatin."

General pharmacological zvechadenga statins

statins All vanowira muchikwata mishonga kuti chokuita lipid muviri mumuviri womunhu. The Anatomical dzokurapwa Chemical kupatsanura System mishonga zvavari akasarudzwa bumbiro S10AA uye chokuita FIs pamusoro HMG-CoA reductase. Zvichivhiringidza basa enzayemu ichi, ivo kukanganisa kwetunhu remafuta akawandisa, serum yekudyidzana achidzikisa uwandu kwayo. statins Izvi zvinobvumira kuti vabudirire zvavakabvumirana kuwanda yakaderera arambe achirema lipids muropa.

Migumisiro izvi kuti tikwanise kuderedza mwero kukura atherosclerotic Dombo. Uyewo zvinodhaka kudzivirira chiitiko chacho. Kunyange kana zviri kuwanikwa munyika inokosha mugumisiro statins; ivo kudzikamisa endothelium pamusoro atherosclerotic Dombo, panyaya iyi, kuderedza mukana wokuti coronary thrombosis, achiita nenzira yakasiyana mashandiro pane antiplatelet mishonga. Uyezve, kushandisa mari idzi zvikabatanidzwa anobvumira zvakatowanda kuderedza mukana wokuti chomwoyo. Nekuti statins vari yakaiswa pamusoro mutengo zviri kwakakodzera.

Zvikurukuru statins kupatsanura

Pane nzira dzakawanda kuti weboka kupinda makirasi zvinodhaka. Vanogona kuonekwa tichitaura zvinhu kwetunhu. Uyewo, sezvo mishonga statins siyana kunoda yavaive mune mishonga yakasiyana musoro kuti ataure kupatsanura inobva inokurudzirwa dosages. Kupatsanura zvizvarwa sokunge ichi:

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

statins All akakamurwa chakagadzirwa synthesized kubva pakugadzira zvinhu, uye zviwanikwa. Ekupedzisira zvinosanganisira "Lovastatin," "Pravastatin" uye "Simvastatin". mishonga chakaita zvokugadzirwa ndivo zororo. "Fluvastatin," "Atorvastatin", "Rosuvastatin" uye "pitavastatin"

Kupatsanura pakati statins mune mishonga zvichienderana kushanda

makirasi All zvinodhaka, kusanganisira ichangobva chizvarwa statins, noungwaru rakakamurwa yakaderera dose (8 MG), srednedoznye (10-40 MG) mukuru (40-80 MG). In zvikuru:

• soro-anogumbura zvinodhaka ( "atorvastatin", "Lovastatin" "Fluvastatin");
• srednedoznye zvinodhaka ( "simvastatin", "pravastatin", "Rosuvastatin");
• yakaderera dose zvinodhaka ( "pitavastatin").

kupatsanura ino inoratidza mukana varwere vavo kuchirapa siyana. Zvikurukuru, mukuru-zvinodhaka zvine zvazvinoita pamatunhu mari, apo zvakanaka akashivirira. Srednedoznye zvinodhaka, asi "rosuvastatin" zvishoma zvakanaka akashivirira panguva pamatunhu mishonga, asi kubatsira.

Srednedozny statin "Rosuvastatin" inogona kupiwa mukuru chipimo chemushonga (80 MG), kana zvichikodzera, kunyange nokuda zvinoderedza zvakakwana wakakwana zvachose remafuta akawandisa uye yakaderera arambe achirema chakapatsanurwa inowanzotaurwa haamanikidzwi. "Pitavastatin" uye anoita zvinoda kwataizoenda shoma mari, nokuti njodzi nenjodzi kakawanda kuvatumwa kuti boka dzomuzana.

Nhoroondo kukura uye okusuma statins

History of statins ndiyo zvikuru nharo. Pakutanga, budiriro yavo kudziviswa zvikuru kushaya ruzivo remafuta akawandisa muviri uye mukana wokuti kukura atherosclerosis, zvichienderana siyana ropa lipids. Uyezve, kamwe synthesized gopoholesterinemicheskie zvinoreva kutitadzise microflora mutsika ose anoumba, aida kuwana wakachena penicillin. Panovhurwa remafuta akawandisa-richikwidibira matanho anoverengeka zvinhu zvinoberekwa notumwe, uye kwakaita kuti kudzidza statins.

Akava wokutanga statin, compactin, uye kwete chakaunzwa kurapwa tsika nokuda dzakawanda zvinotaurwa pamusoro zvachinokonzera. Zvakange kure tsika Penicillium cetrinium. Zvadaro, kubva tsika Monascus ruber rakanga yoga monacolin K, patented muna February 1979. In June 79th patented uye mevinolin, uyo gare gare vakatanga kutakura zita "Lovastatin". mushonga uyu unoshandiswa pakiriniki, pashure chakanga dzoga kana synthesized nokuda ichangobva chizvarwa statins.

A yakawanda wokushora maonero statins hwakaipa kuvandudza, pashure kwakasarudzwa kuti kuitisa pamwero mukuru miedzo zvekuchipatara. Pari, chikuru uye anobatsira zvikuru kwaiva kudzidza Air Simvastatin Survival Study. Wakafupisa zita rayo «4S». Zvinonzi zvakazara inopikisanawo mukana carcinogenic zvirwere chokuita zvinodhaka kutarisira, uye kuratidza kuti kwavo kushandisa yekudyidzana kunowedzera upenyu anotarisirwa uye anoderedza kuitika chakasimba coronary pathologies.

Abstracts kubatsira statins

Kana kutanga wevasungwa zvachose remafuta akawandisa ane 7.4 mmol / L, statin kurapa uye kuti vabudirire pamwero 5.4 mmol / L yekudyidzana kunoderedza ngozi nokufa zvemwoyo zviitiko 40% pamusoro anotevera 5 years. Vanoverengeka dzimwe netsvakurudzo kuti richikwidibira zvachose remafuta akawandisa pamwero chete 1 mmol / L kuburikidza cheshanu kunoderedza mukana wokuti coronary thrombosis saka chomwoyo kana sitiroko.

Uchifunga statins, zvayakanakira nezvayakaipira izvo anotaura zvakawanda nyanzvi uye varwere, tinogona kunzwisisa zvinotevera: unogona kushandisa mishonga sezvo mangwanani sezvo zera 40 uye vakuru uye kuderedza ngozi chemwoyo - ndaisagona nzira inoshandiswa nguva refu upenyu. Uye sezvo statins mutengo rakanyatsojeka nyore, mishonga iyi nekusimba kunobudirira, inogona kutorwa pasina rusaruro kune yayo bhajeti. Chokwadi, ichangobva chizvarwa statins vari zvikuru anodhura, kunyange chete "Rosuvastatin" Pfungwa, zviri zvikuru zvinodhura kuti murwere. Uye ndicho chipa chimiro kugadzirira "Merten".

Okufananidza Unhu: zvayakanakira nezvayakaipira

Kuzviona statins, uye pamusoro pavo kutaura chaizvo nyore. Yaitaurwa "nokuti" zvakakurumbira zvavo kuchirapa kuita: rutapudzo ropa remafuta akawandisa uye yakaderera arambe achirema zvikamu zviduku, kudzivisa ngozi chakasimba zviitiko uye rubatsiro pakurapwa yavo. Zvisinei, mishonga yakadai statins, munewo contraindications. Kune marwadzo, svitsanisa nharo pamusoro kushanda.

Kana kurapa pamwe statins mukana myopathy. Zvichida yairevererwa chinovhiringidza pamusoro kwetunhu remafuta akawandisa, iyo inodiwa netsandanyama. The kakawanda izvi yakaderera zvikuru, kunyange zvazvo yakawedzera coadministration nevamwe hypolipidemic nevamiririri. Panewo ngozi kenza yechiropa zvokurwara, kunyange mukana zvirwere zvakadaro, sezvinoratidzwa zvichangobva kudzidzwa, zvikuru pasi. Nenguva nekusimba uye kuti kenza yakanga kushatiriswa zvimwewo. Nokudaro, muna kugadzirirwa "statins" contraindications vanofanira rambidza co-kwokubatsira zvinodhaka izvi nevamwe vamiririri kuti pave vasanyanye wevasungwa masero mafuta.

Mari azvino chizvarwa statins

On azvino chizvarwa statins siyana mitengo, kunyange zvavo migumisiro munokosha kubhadharira. Mumwe mubvunzo ndiyo chete kuti migumisiro yezviito zvavo zvinogona kuitwa nokushandiswa isingadhuri analogues dzekirasi ambotaurwa zvizvarwa. Kunyanya, inonyanya statin Generation IV "Rosuvastatin" mutengo ndiwo anenge sezvinotevera:

• rubles 600 pamahwandefa 40 MG;
• 400-450 pahwendefa 20 MG;
• 300-350 10 Mahwendefa MG;
• 200 rubles 5 MG.

The pasuru rine Mahwendefa 30, zvakakwana kuti mwedzi mumwe kurapwa, ukuwo pamwedzi kurapwa "pitavastatin" mitengo vari ndezvomuzana sezvinotevera:

• 1 MG mahwendefa mari anenge 700-750 rubles;
• Piritsi 2 MG - vanenge 1000 rubles;
• piritsi 4 MG - vanenge 1500 rubles.

Kusarudza pakati "Pitavastinom" uye "rosuvastatin" hunobva nzira ina: mutengo chinhu, mwero rutapudzo yakaderera arambe achirema lipoprotein, mukuru arambe achirema lipoprotein kuwedzera kuzara, kuchengeteka. Nokumhanya richikwidibira remafuta akawandisa uye kuwedzera HDL, uyewo yakanakisisa mutengo anotarira "Rosuvastatin", apo hunonzi yakachengeteka zvikuru ndiyo "pitavastatin."

Kakapetwa kaviri zvinodhura achimuenzanisa "rosuvastatin". Kunyange zvakadaro, pane mukana uchishandisa zvimwe, statins isingadhuri. Zvikuru zvemari zvinobetsera kare kwave "Simvastatin". Zvino chikatsiviwa "Atorvastatin", iro nguva dzose ne "rosuvastatin" (kukosha kwayo kuchaita hazvo kuwa). Uye kana statins ichangobva chizvarwa mitengo vari unaffordable nokuda varwere, zvinokosha kufunga mukana kurapa "atorvastatin" kana "Simvastatin". Zviya, zvidzidzo vakawanda zvinoitiswa "atorvastatin".

Yaitaurwa tsitsi statins vakwegura

Kare, vanachiremba vachizengurira taurira statins varwere vakuru makore 75. Mhaka zvinhu zvinotevera:

• mabiko, nezvimwe makirasi zvinodhaka akawanda;
• yakawiriranwa vasingafariri kundiwedzera mumwe kirasi mishonga;
• Kushaya kana pasi komplaentnost kunorapwa;
• kusada varwere kuti vazvitengere statins uye kuzvishandisa nokuda kutadza kunzwisisa zvazvinokonzera.

A nhamba yezvidzidzo kunze ne "Simvastatin" "Pravastatin" uye "atorvastatin" akaratidza zvinokosha kuderera munyama pavarwere vakuru makore 75. Uyezve, zviri kuderera munyama yakanga yakatokura kupfuura varwere vari zera mumapoka 55-65 uye 65-75 makore. Nokuti zvinodhaka vekirasi ichi (statins) mashoko kubva nyanzvi zvakajeka anosimbisa chokwadi.

mishonga izvi anogona kutorwa papera muupenyu pasinei pakanga aimbova chakasimba zvemwoyo zvirwere. Uye Varwere vari chaizvo dzinokosha yekuzvidzivirira rufu rwake kubva myocardial infarction kana yokukuvadzana, unofanira kunzwisisa kuti kana zvinodhaka unoshanda uye yakachengeteka, tinenge tichishandira zviripo kutora. Kunyanya kuti kurapwa pamwe statins zvava nyore, uye icharamba sezvo vakadaro.

Features wongororo pamusoro ichangobva chizvarwa statins

Varwere Mashoko kuongorora unhu imwe Generic statins hazvisi INDICATIVE, nekuti havana vainzwa kuchinja kubva pakutora zvinodhaka. Kuvandudza ropa lipid Profile asimo pamusoro mamiriro utano uye hakuna kwokunze zviratidzo. It anoziva chete lipid profile. Nokuti kana vanoongorora statin nokuchenjera wakatungamirirawo ongororo nyanzvi. Uye pamusoro gadziriro umo zvinoshingaira chirungiso ndiye pitavastatin, nyanzvi vemo havagoni kudavira.

In kurapwa tsika iri Kishi "pitavastatin" nemhaka kudhura uye nokuda kuvapo "rosuvastatin" uye generics ayo haushandi. In gadziriro "rosuvastatin", ayo pamusoro apa, chiito: lipid Profile normalized 1-2 mwedzi. The "atorvastatin" ndiyo nguva nehafu nguva yakawanda. Uyewo Generic "rosuvastatin" njodzi, sezvo mhando mbiri rinoita kuti cytochrome. Panguva iyoyo, mashoko aya inotorwa zvakataurwa nenyanzvi, anobatsira inokosha basa pakusarudzwa statin mu zvakananga zvekuchipatara ezvinhu.

Mukuru mhedziso azvino Zvizvarwa statins

Zvinodhaka "pitavastatin" uye "Rosuvastatin" ndiwo zvemberi pakati vamiririri statin mukirasi, izvo guru muviri uchapupu inounganidzwa. Zvazvinokonzera Kazhinji zvakafanana vaya "atorvastatin", asi pane misiyano. "Pitavastatin" uye "Rosuvastatin" kubvumira kusvika chipfuro remafuta akawandisa yomuropa, uye pasi arambe achirema lipoprotein akaderera chipimo chemushonga kupfuura "atorvastatin".

Kuwedzera pamusoro apa ukuru statins ichangobva chizvarwa kunokosha uye chimwe chinhu. Kureva, pakurapa "pitavastatin" uye "rosuvastatin" vakachengeta kutsanya normalization rimwe lipids ropa uye kubviswa homocysteinemia. Izvi zvinokosha sezvo kuna chakasimba coronary chirwere, uye vari varwere chisingaperi coronary chirwere, kukonzerwa coronary atherosclerosis. Wakachengeteka kushandiswa statins kupfuura kardioform acetylsalicylic acid. Kunyange zvakadaro, kuvapo contraindications unorambidza kushandisa kwavo zvimwe murwere hwevanhu (ona. General contraindications).

Pfungwa mienzaniso

Medicines ane "Rosuvastatin" rinowanikwa pasi zvinotevera kutengeswa mazita: "AKORT", "Rozistark", "Rozukard", "Rozart", "Merten", "Rozulip", "Roxer", "Rustor", "Tevastor". All zvinodhaka izvi Generic "Crestor" izvo akava rosuvastatin wokutanga. Chinodhaka, sezvamakaropafadzwa kushingaira fuma iri pitavastatin, vakanyorwa sezvo «Livalo». generics ayo «Pitavas» uye «Pivasta». havaiti kuitika munyika Kishi, kunyange vakanyorwa muna Pharmacopoeia.

pfupiso

Maererano boka zvinodhaka zvinokonzerwa uye kuongorora kubudirira kwavo kushandiswa, kushandiswa statins kuumbwa kuti pakudzikamisa atherosclerotic Dombo uye kudzivirira kugozha kwayo. Vanewo kushandiswa kuderedza atherosclerosis, kukanganisa lipid Profile ropa serum. Somugumisiro, kirasi iyi zvinodhaka Zvechokwadi zvinokosha cardiology. Uye kunaka azvino chizvarwa statins uchitova vanobudirira achishandisa kudzivirira dzinouraya coronary thrombosis.