Dyslipidemia - an imbalance in the proportions of various cholesterol fractions do not show specific clinical symptoms, but being an agent provocateur of the various pathological conditions in humans.Thus, as an independent disease, dyslipidemia is not considered doctors, but this is a pathological condition provokatornym in relation to the development of chronic diseases such as atherosclerotic vascular lesions.Dyslipidemic disorders inevitably lead to the formation of fat layers on the inner wall of blood vessels, which hinders adequate blood flow and provoke them hemodynamic damage organs and tissues.
Occurrence of dyslipidemia may occur under various conditions, for example, pathological conditions involving the activation process of fat synthesis, as well as the excess of their revenues from food.In addition, the imbalance in the ratio of particles of fat in the body can be triggered by a violation of their digestion and excretion from the body, w
Depending on the pathogenetic mechanisms of dyslipidemic imbalances are several etiopathogenic forms of dyslipidemia.All the hereditary form of dyslipidemia are the primary and divided into monogenic (occurrence of dyslipidemia is caused by transfer of the child of a defective gene from one or both parents suffering from this pathology) and polygenic (dyslipidemia due not only to the transfer of the defective gene, but also the negative impact of the environment).
secondary forms of dyslipidemia is the most difficult to diagnose, because the appearance of it is due to a chronic pathology available to the patient.Underlying diseases that may provoke the development of a particular pathogenic form of dyslipidemia are: hypothyroidism, diabetes and a variety of diffuse diseases of liver parenchyma.
Diagnosis "dyslipidemia alimentary" established on the basis of the facts of excess cholesterol entering the body through food.This embodiment can proceed dyslipidemia transient type in which the increase in the cholesterol takes place a short time due to a single dose, and a large amount of fatty foods, or as a constant dyslipidemia.
disease "dyslipidemia" as a rule, is only installed by prolonged increased rates of cholesterol fractions in blood, despite the fact that this pathology is suffering a significant part of the population worldwide.
Due to the fact that dyslipidemia is the only "laboratory diagnosis" that is, its diagnosis is possible only on the basis of performance of laboratory tests, clinical symptoms in terms of diagnostic criteria does not occupy leading positions.However, even experienced professionals in the visual examination of the patient, long-suffering dyslipidemia, may suspect the disease.One such specific clinical markers are xanthoma, which are small seals on the skin surface, which is favored localized plantar surface of the foot, the skin of the back and joints of the hands and knees.
Excess accumulation of cholesterol in the form of various fractions is accompanied by formation xanthelasma, which are tumors of various sizes on the eyelids, yellow, dense structure, the inner content of which is cholesterol.
inherited form of dyslipidemia characterized by the formation of lipoid arc of the cornea, which is a whitish ring, located on the outer contour of the cornea.
Despite the paucity of clinical diagnosis of dyslipidemia is not difficult, even in an outpatient setting, and includes a set of laboratory studies of various kinds.The most priority laboratory analysis, which is based on data the physician in the diagnosis of "dyslipidemia" is a so-called "lipid profile of the patient."Under lipidogramioy means the determination of the concentration of different fractions of cholesterol and determination of atherogenic factor pointing to an increased risk of atherosclerotic disease in a patient.Due to the fact that the majority of clinical forms of dyslipidaemia hereditary diseases are currently genetic study of patients with defective genes are standard inspection.
types of dyslipidemia
International Classification of dyslipidemia is developed on the basis of data on what fraction of the increased fat in the blood.So, all of dyslipidemia are divided into isolated, where there is increased performance lipoprotein fractions are cholesteric, and combined, under which marks not only the increase in cholesterol and triglyceride levels.
more advanced version of the division is the classification of Fredrickson dyslipidemia, according to which are five types of this disease.
Hereditary primary giperhilomikronemii, dyslipidemia or type 1 is accompanied by extremely increased levels of chylomicrons, which are 90% of triglycerides and only contain 10% cholesterol.A favorable factor is that the current version of dyslipidemia under any circumstances can not become the background for the development of atherosclerotic vascular lesions and heart.When
2a type of dyslipidemia marked increase in performance only low-density lipoproteins, which are the cholesterol fractions with a high level of atherogenic.This option is a polygenic dyslipidemia, ie for the development of combination dyslipidemic imbalances need to inherit the defective gene and the negative impact of environmental factors.
difference of dyslipidemia of type 2b is that the patient has not only increased rates of low-density lipoprotein, and triglycerides.
3 type of dyslipidemia is characterized by the appearance of the patient elevated levels of very low density lipoprotein, which is accompanied by an increased risk of atherosclerotic vascular lesions.
With 4 type of dyslipidemia also noted increased rates of very low density lipoproteins, but the development of this condition is not due to hereditary factors, and endogenous factors.
for 5 types of dyslipidemia is characterized by elevated levels of chylomicrons in the blood, combined with an increase in very low density lipoproteins.
Due to the variety of types of laboratory dyslipidemic disorders in the international classification, there are several forms of this disease, but dyslipidemia ICD 10 has a single code E78.
Treatment of dyslipidemia
therapeutic measures aimed at eliminating manifestations of dyslipidemia, are very diverse and include not only drug correction, but also compliance with the recommendations of the nutritionist, lifestyle modification.Compliance with the pharmacological profile should not occur as in hereditary forms of dyslipidaemia (to prevent disease progression), and the secondary embodiment.Treatment of secondary dyslipidemia should begin with the elimination of the root causes of its origin, that is, compensation for chronic conditions.
main group of drugs, the effect of which is aimed at reducing total cholesterol and various cholesterol fractions, make statins and bile acid sequestrants.The drugs of choice for the correction of elevated levels of triglycerides and very low density lipoproteins are the fibrates and nicotinic acid.
statin drugs are antibiotics, monokalinami, that target specific inhibition of the enzyme activity that increases the production of cholesterol by the liver fractions.Statins such as lovastatin, atorvastatin, pravastatin may be developed as a microbiological and synthetic methods.Dyslipidemia therapy with statins is accompanied by a decrease in the level of stable long, not only the total cholesterol, but cholesterol and low density, which is important in the prevention of atherosclerotic disease.Priority in the use of statins is also due to the fact that this group of drugs is not only lipid-lowering effect, but also other pleiotropic effects of improved endothelial function, suppression of inflammatory responses in the blood vessels.
cholesterol-lowering effects observed no later than three days from the beginning of statins, however, the maximum therapeutic effect is reached only after 6 weeks of preparation.Perhaps the only negative effect of statins is that after the complete withdrawal of the drug the patient is most often the opposite is the increase in cholesterol, so the drugs in this pharmacological group must be taken continuously.Statins have no significant side reactions, but some patients with prolonged application note the appearance of dyspeptic disorders, due to the development of liver disease drug.
indications for temporary cessation hypocholesterolemic treatment with statins is an acute infection of the body, surgery, trauma, severe metabolic disorders.Absolute contraindication to the use of statin drugs is diffuse or focal disease of liver parenchyma and pregnancy.The initial therapeutic dose is 20 mg of statins, which should be taken once in the evening.The maximum dose of these drugs is not more than 80 mg.Supportive cholesterol-lowering therapy is lifelong, and therefore, it is appropriate 1 time in 3 months to make the control indicators of transaminase levels.
In a situation when statin monotherapy does not bring the desired effect, we recommend that combination therapy with bile acid sequestrants, which is represented by colestipol Cholestyramine at a dose of 4 grams per day orally.This group of drugs exert indirect influence on the synthesis of cholesterol by increasing excretion of bile acids from the body, provoking further formation of bile acids from cholesterol fractions.Absolute contraindication to the use of bile acid sequestrants is a chronic colitis and significant hypertriglyceridemia.
with isolated hypertriglyceridemia, fibrates are the drugs of choice (Ciprofibrate a daily dose of 100 mg).Due to the fact that drugs in this pharmacological group may provoke the development of cholesterol stones in the gallbladder cavity, all patients receiving long fibrates should undergo regular ultrasound examination.Also, when five types of dyslipidemia, combined with pancreatitis, Nicotinic acid is widely used in a daily dosage of 2 g The only limiting factor is not well suited for use in the treatment of nicotinic acid dyslipidemia is its adverse reactions expressed in the form of reddening of the skin of the upper half of the trunk and the head.
addition to classical medical correction when expressed dyslipidemic disorders are widely used hemosorbtion, cascade plasma filtration, which belong to the category of extracorporeal treatment of dyslipidemia.These techniques allow you to change the quality of the blood and can be used for patients of different age groups, as well as pregnant women.
Despite the proven theory of the origin of most forms of hereditary dyslipidemia, genetic engineering has not yet offers effective methods for the treatment of primary dyslipidemia, so these techniques are only at the development stage.
prognosis for recovery of patients suffering from dyslipidemia, depends on the severity of dyslipidemic disorders, the rate of development of atherosclerotic vascular lesions and localization of atherosclerotic plaques.
Diet for dyslipidemia
modification of eating behavior of the patient suffering from dyslipidemia, aimed at eliminating the risk of development and progression of cardiac and vascular pathologies, improvement of the lipid profile, normalization of blood sugar, as well as the prevention of thrombosis.
The main risk for the development of dyslipidemia are persons of high power, so the priority therapeutic measures should be normalization of eating behavior of the patient.Dietary requirements stipulate that a regular diet of a patient suffering from dyslipidemia, should sharply limit the amount of animal fats.Acceptance of meat food may be no more than once a week, and for the enrichment of the body's protein should be in sufficient quantity to consume sea fish.
Main Menu patients with dyslipidemic disorders should be full of vegetable and fruit dishes containing fiber and important nutrients.
There is a controversial opinion that alcohol consumption has a positive effect on the prevention of atherosclerotic vascular disease.In fact, alcoholic drinks contain a colossal concentration of triglycerides, so their use in patients with dyslipidemia is strictly prohibited.
Prevention at dyslipidemia may be primary, when a person performs preventive measures even before the occurrence of metabolic disorders, and secondary, the activities of which are aimed at preventing the development of complications of atherosclerotic heart disease.
Dyslipidemia - a doctor will help ?In the presence or suspected development of dyslipidemia should immediately consult a doctor such as a cardiologist and a gastroenterologist.