تشخيص طبي لارتفاع الكولسترول، أعراضه، أسبابه وعوامل خطره وعلاجه والوقاية منه

?????????? (cholesterol) ?? ???? ????? ?? ?? ???? ?? ????? ????? ???? ??????? ????? ????? ????? ???????? ??????? ???????? ?????? ??. ??? ??? ????? ?????????? ?? ???? ??????? ????? ??? ?? ?????? ????? ?????? ???? ????? ??????? ???????.

?????? ??? ????????? ?? ????? ?????? ???? ???? ?? ????????. ?????? ?? ???? ???? ??? ???? ???? ????? ????????? ???? ????? ?????? ????? ???? ????? ?????? ??????? ????? ????? (heart attack). ??? ??? ???? ???? ??? ???? ??? ??? ??? ???? ??? ??????? ????? ???? (??: ???? ?????? - cerebralstroke).

??? ?????? ??? ??????? ?????? ????? ?????????? (??? ?????????? ?? ???? - hypercholesterolemia). ??????? ?????? ??????????? ???????? ??? ?????? ??????? ?????? ??????? ??? ??????? ?????? ?? ????? ????? ?? ????? ????? ?????????? ?? ????.

???????? ?????? ?????? ?????? ?? ??????? ?????????? ?? ?????:

????? ????? ????? ????? ????? ?????? ?? ????? ????? ??? ??? ???? ????? ?? ??????? ????? ?? ????? ?????? ?????? ???? ????? ????? ?????? ????? ???? ???? ????????? ?? ????? ???????? ?????? ???? ???? ???? ????? ????? ????? ???????? ???????. 

??? ????? ?????? ?????? ?????? ?????? ????? ?????? ???? ????? ????? ?? ??????? ?? ??? ????? ???? ?? ???? ????? ???? (??? ??? ????? ??????? ?????? ??????? ??????) ?? ???? ??? ???? ?? ????? ????. ???? ??? ?????? ??????? ?? ?????? ??? ??? ????? ????? ?????? ??????? ??? ????? ????? ?????? ????? ? ?????:

?? ??????? ??????? ?????? ??? ?????????? ?????? ???????? ????? ??????? ????? ????? ????? ?? ????? ???? ?????? ??? ?? ?? ??? 25 ?????? ??????? ??? ??? 35 ?????? ??????.
?? ??????? ??????? ?????? ????? ????? ??? ?????????? ?????? ???????? ????? ??????? ????? ????? ????? ?? ????? ???? ?????? ??? ?? ?? ??? 35 ?????? ??????? ??? ??? 45 ?????? ??????.
????? ?????? ?? ??????? ?? ????? ????? ?? ???? ?????? ??????? ???? ????????? ?????? ???? ?????? ?????? ?????????? ?????????? ?? ?? ??????? ????? ?????? ???? ?? ???????? ???????. ?????? ????? ???????? ???????. 

????? ??????????:
???? ????? ????? ?????????? ?? ?????? ???? ?????????? ?? ???? (hypercholesterolemia). ?? ?????? ?????? ??? ?????????? ???????? ??? ?????? ?????? ???? ??.

????? ?????? ??? ??????????:

????? ?????????? ?? ??????? ??????? ?? ???? ??????? ????????? (proteins) ????? ?? ????. ??? ???????? ??? ?????????? ??????????? ???? ?????? ?????? "???????? ??????" (??: ?????????? ??????? - lipoprotein).

????? ????? ????? ?????? ?? ??????????? ???? ???? ?????????? ??????? ??? ???????? ?????? (lipoprotein):

1. ?????? ???? ????? ??????? (??: ?????????? ????? -  Low density lipoprotein - LDL) – ?? ???? ???? ?????? ?????????? ?? ?????. ?????????? LDL (?????????? ?????) ?????? ??? ????? ???????? ??????? ???? ????? ?????.

2. ?????? ???? ???? ??????? ( Very - low - density lipoprotein - VLDL) – ??? ????? ?? ???????? ?????? ????? ??? ???? ???? ?? ????? ?????????? (triglycerides) ??? ??? ?? ???????? (lipids) ????? ??????????? ?? ????. ?????? ???? ?????????? LDL? ???? ???? ?????????? VLDL ????? ?????? ?????????? ??????? ???? ??? ???? ??? ????? ??????? ???????.

??? ??? ?????? ????? ???? ????? ?????????? ?? ????? ??? ????? ??? ??? ???? ????? ?????? ?? VLDL? ??? ??????? ??? ????? ??? ???? ????? ???? ????? ?????????? VLDL ?? ???? ???? ??? VLDL ??? ??? ?????? ?????????? (triglycerides).

3. ?????? ???? ???? ??????? (??: ?????????? ????? - High - density lipoprotein - HDL) - ?? ???? ???? ????? ?????????? ??????? ?? ?????? ??????? ??? ?????.

????? ????? ????? ??? ?????? ??? (???: ?????? ??????? ????? ?????? ?????? ??? ??????? ???? ?????????) ???? ?? ??? ???? ?????????? ????? - LDL ?? ??? ??? ??? ????  ?????????? ????? - HDL ?? ??? ????.

?????? ????? ???? ???? ??? ??????? ?? ?????? ?? ???? ????? ?????? ?? ????? ????? ?????????? ?? ???. ??? ???? ??????? ??????? ???????? ???? ?? ???? ????? ????? ?? ?????? ????? ????? ?? ?????????? LDL ?????? ??????? ?? ???? ?? ?? ???? ????? ???? ????? ????? ?? ??????????.

??? ??? ????? ??? ???? ??????? ???????? ???????? ???????? ??? ??????? ?? ??????? ?????? ?? ?????????? ?? ?????? ?? ???? ??? ??????? ???? ????:

??????? - ????? ??????? ???? ????? ??????? ??????? ????? ???? ?????? ?????? ?????? ????? ?? ??????. ????????? ??? ???? ?? ?????? ?? ???? ??????? ??? ??? ??????? ?????????? ????? HDL.

????? ?????? – ??? ??? ???? ???? ??? (body mass index - BMI) ???? ?? 30? ???????? ?? ????? ???? ??? ?????? ????? ??????????.

??? ??????? - ??????? ?????? ???????????? ??? ?????? ??????? ??????? ?????? ?????? ?????????? ???? ????? ?????????? ???????? ?? ????. ??? ?? ????? ????? ????? (???? ?????? ?? ?????????) ??????? ???????? (trans) (???????? ?? ??????? ??????? ??? ????? ????????) ?? ???? ??? ?????? ????? ?????????? ?? ????.

??? ?????? ????? ???? - ?????? ?????? ????? ????? ?? ??? ????? ?????????? ????? HDL ???? ????? ?????????? ????? LDL. ??? ?????? ?????? ?????? ???? ?? ????? ?????? ????? ??????????.

??? ???? ??????? - ??? ???? ??????? ??? ????? ???????? ???? ????????? ????? ???? ?? ?????? ?? ???? ????? ????? ???????? ??????? ?? ??????.

??? ??????: ????????? ???????? ?? ????? ?? ???? ???? ??? ?????? ??? ?????????? LDL - ?????????? ????? ???? ??? ?????????? HDL - ?????????? ?????. ??? ?? ????? ???????? ?? ????? ?? ???? ?? ???? ?????? ??????? ????????.

???? ?? ??????? – ??? ??? ??? ???????? ?? ??? ??????? ?? ???? ?? ??? ???? ??? ????? ??????? ?? ?????? ??? ????????? ???????? ?? ?????????? ???? ?????? ??????? ???? ???? ??? ?? ??? ?????? ?????.

??????? ??????????:

????????? ???????? ?? ?????????? ???? ?? ???? ??? ??????? ???? ?????? ??????? (atherosclerosis)? ??? ????? ???? ?? ???????? ??????? ???? ??? ????? ????????. ??? ????????? ??????? ??????? ?? ???? ???? ???? ??????? ?? ????????.

??? ???? ???????? ??????? ?? ???? ???? ???? ??? ????? (???????? ??????? - coronary arteries)? ?????? ?? ???? ????? ?? ????? (angina) ?????? ???? ???? ?????? ???????.

???? ?? ????? ?? ????? ???????? ???????? ?? ????? ????????? ??? ?????? ?? ???? ???? ????? ?? ???? ?????? ??? ?? ???? ???? ????? ?? ?? ????? ?????? ???? ?????? ???.

???? ????? ????? ????? ???? ??? ??????? ????? ?????. ??? ???? ????? ?????? ????? ????? ??? ??????? ????? ????.

????? ??????????:
??? ???? ???? ???? ????? ?????????? ?? ???? (??? ???????? ?? ????)? ??????? ????? ???????? (lipids panel) (??: ????? ?????? ???? - Lipid profile) ???? ????:

??????? ???????? ??????????
 ????? ?????????? LDL - ?????????? ?????
????? ?????????? HDL - ?????????? ?????
????? ????? ?????????? -  ??? ????? ???????? ??????? ?? ????.

???? ??????????:

????? ??????? ?? ??? ?????? (??? ?????? ????? ???? ???? ????) ????????? ??? ????? ???? ???????? - ??? ???????? ???????? ?????????? ???? ???? ?????????? ??????? ?? ????.

 ????? ??? ??? ???? ????????? ?????? ?? ??? ????? ??? ??? ?? ???? ????? ?????????? ???????? ????? ??????? ???????? LDL - ?????????? ?????? ??????? ??? ?????? ?? ????? ????? ??????? ???????.

?? ?????? ?????? ??????? ?? ??????? ??? ??? ????? ?? ??????? ????? ?????????? ????? ??? ??? ?????? ?? ?????: ????? ???????? ???????? ????? ???? ???? ????? ?????? ???????? ???????? ????????.

?? ??? ??????? ??????? ????????? ????? ?????????? :

??????? (Statins): ?? ?????? ?????? ????? ????? ????? ?????????? ? ???? ????? ?????????? ?? ????? ?? ???? ????? ?????? ??????? ?????? ?????????? ?? ?????.
????? ???? ??????? ????????? (Bile - acid - binding resins): ?????? ????? ?????????? ?????? ??????? ????????? (????? ???????)? ???????? ?????? ????? ?? ?????.
 ????? ????? ??????? ?????????? (Cholesterol absorption inhibitors): ??????? ??????? ???? ?????????? ??????? ?? ?????? ?????? ??? ?????? ???????.
 ????? ??? ????? ????? ??????? ?????????? ??????????.
??? ???? ??????? ????? ?????????? ?? ???? ??????? ??? ???? ???? ?????????? ?????? ??:

???????? (fibrates): ??????? ??????? (Lofibra)? ???????????????? (TriCorfenofibrate)? ????? (Lopid)? ????????? (gemfibrozil) ???? ?? ??????? ????? ?????????? ?? ???? ????? ????? ???????? ???????? ?????? ???? ??????? (VLDL) ??? ???? ????? ????? ?????? ?? ????? ?????????? ?? ????. ???????? ?? ????????  VLDL ????? ??? ????? ?????? ?? ????? ??????????.
?????? (niacin): ??????? (Niaspan) ???? ??????? ????? ?????????? ?? ???? ????? ???? ????? ??? ????? ???????? LDL ????????? VLDL.
??? ??? ?????? ????????: ??? ???? ????? ?????? ????????? ???????? ??? ?????????? ?????? ?? ????? ?? ??????? ????? ???? ???? ????? ??? ???? ?? ???????? ????? ???? ?????? (Simcor) ?? ??????? (Advicor).
?????? ??? ??????? ???? ??? ??????? ?????? ????? ??? ???????? ????? ?? ??? ????. ????????? ???????? ??????? ??: ????? ?? ???????? ????? ?? ?????? ?????? ????? ?? ?????.

??? ???? ????? ????? ??????? ??? ??????????? ?????? ?? ????? ????? ??????? ????????? ????? ?????? ????? ???? ??????? ??? ??????? ??? ????.

??????? ?? ??????????:

??????? ?? ??? ?????? ????? ?????? ???? ?? ??????? ?????????? ?? ????. ?? ??? ??? ??? ?????????? ?? ????? ????: ?????? ?? ????? ??????? ????? ???? ??? ?????? ?????? ??????. ???? ??? ????? - ???? ?? ???????.

???? ?????? ?????? ???? ????
????? ?? ???????
???? ?? ???????????? ???????
 ????? ????? ????: ?????? ???? ??????? ????? ????? ??? ????? ?????????? ????. ??? ???????? ???? ??????? ?? ??????? ?????? ???????? ???????? ??????  ???? ?????? ?????? ?????? ?????????? ??? ?????? ??? ???????? ???? ?????? ????????? ?? ??? ??????? ??????????
 ???? ?????? ?? ??????? ??????
 ????? ?? ????? ????? ????? ??? ???? ?????? (trance)
 ??? ???? ?????? ????? ???????????. ?????: ?? ?? ???? ?????? ?? 300 ???????? ?? ?????????? ?????? ?? ??? ?? 200 ???????? ?? ?????? ??? ??? ????? ?? ??? ????
???? ????? ????? ?? ????? ??????. ???? ???? ????? ?????? ?? ????? ?????? ????? ?? ?????? ??? ??? ????.
???? ??? ??????? ????? ?????? ?? ?????? ????????
???? ???  ??????? ????? ?????. ????? ????? ?? ????? ???? ??? ????? ?????? ?????? ??????? ????? ??? ??????? ?????? ?? ???????? ???? ????? ????? ?? ???????? ??????? ???????????? ?????? ??????? ???????.

???????? ???????:

?????? ?? ?? ??? ???????? ???????? ???? ???? ???????? ?? ??? ??????? ?????????? ?? ????? ??? ?? ??? ???????? ????? ?????.

??? ???? ?????? ??? ?????? ??? ????? ??????? ??????? ???? ????? ?????????? ????:

??????? (?????? ????)
??????
???? ?????????? (Beta - sitosterol)
 ??? ????????? ?????? (Blond psyllium)
?????
 ????? ???????

* ????? ??? ???: ??? ?????? ??????? ???? ????? ?? ?????? ?????? ??????.

* ?? ????? ?????? ??????? ??? ????? ??????? ?????????.