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降低胆固醇的药物和食物

发布时间:2016-08-22   问大夫  责任编辑:红豆

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现在人们错误的饮食习惯越来越严重,导致人体胆固醇升高。胆固醇高,会引发心肌梗死、冠心病等,对人体的危害是及其大的。那么,如何降低胆固醇含量?除了一些常规药物之外,还需要在生活中注意饮食的合理。下面小编给大家介绍一些降低胆固醇的药物和食物。

降低胆固醇的药物

不同类型的降胆固醇药物以不同的方式影响脂质水平,通常有以下分类:

1、他汀类 用于大多数高血脂(血胆固醇过多)患者的一线治疗。他汀类可阻制人体内制造胆固醇的特异酶的生成。已证明,该类药物能减少首次心脏病发作的风险,以及已知疾病患者的复发性心脏病发作和中风。也被证明该类药物可降低心力衰竭患者死亡风险。他汀类药物对降低低密度脂蛋白效果显著,对降低甘油三酯也有些效果。虽然他汀类也可增加高密度脂蛋白水平,但似乎并不如其它降胆固醇类药的效果那样好。他汀类通常副作用较少,虽然也有些报告指出,它会引起一种罕见的肌肉退化亦称之为横纹肌溶解,也有报告称,他汀类与记忆功能减退有关,但这些属于罕见的副作用。定期作血液检测是有必要的,以便监察这两种血脂质方面的副作用和监察肝功能。

选用他汀类药物的依据是结合多方面的临床考虑,包括总胆固醇水平,低密度脂蛋白水平,高密度脂蛋白水平,既往的心肌梗塞史和冠状动脉病,显著糖尿病的其它风险因素。也有证明,他汀类药物对与胆固醇降低程度无关的动脉也具有良好的作用。这种作用被认为是通过对稳定的动脉粥样硬化斑点抗炎作用的结果。为此,有些研究建议,一种强化的直接的他汀疗法可着手用于那些有冠状动脉病的住院患者。

2、胆酸结合树脂 因为肝脏要除去血中的胆固醇以制造胆汁,胆酸结合树脂可防止肠内胆汁酸的重复循环,为此,迫使肝脏从血液中除去更多的胆固醇以便制造更多的胆汁。胆酸结合树脂通常以粉剂或咀嚼棒服用。可是,许多患者服用该类药时有胃肠不适感。胆酸结合树脂也可与其它物质结合,如脂溶性维生素,心脏病用药地高辛,以及抗凝药华法林。因此建议患者在服用这几种药的同时,不要服用胆酸结合树脂。

3、烟酸 亦称维生素B3,大剂量时,对降低甘油三酯和提高高密度脂蛋白水平很有效果。本品也可降低低密度脂蛋白水平,但不如其它降胆固醇药物的效果。服用本品治疗高胆固醇时要慢慢加至大剂量。本品服用太多可导致一些明显的副作用,包括面红,心悸,恶心,甚至出现个别肝中毒的病例(尤其是服用速释剂型)。即使适当增量服用,大约有 50%患者认为本品也难以耐受。本品可以非处方药购得,但,医生更倾向于开本品的控释剂型处方。因为本品可能具有一些较严重的副作用,患者在没有医生的监护下,不应该自行使用。另外,有许多作为非处方药的“不面红”的烟酸食品补充剂出售,但它对血脂水平没有什么作用。

4、贝特类 该类为苯氧酸的衍生物,苯氧酸可减少甘油三酯的生成和提高现有甘油三酯被从血流中清除的速率。贝特类对大多数患者来说,可显著地降低甘油三酯水平并能适当地提高高密度脂蛋白(好的)水平,但对降低低密度脂蛋白(坏的)水平的作用较小。它们最常被用于甘油三酯水平升高的患者,这些患者通常也会伴有高密度脂蛋白水平较低(多数糖尿病患者有这种类型的脂质状况)同时使用贝特类和他汀类时更应小心监察。

5、依泽替米贝 它是直接控制胆固醇在小肠吸收的新一类药物代表(差别是胆酸结合树脂是在肠内与胆汁酸结合)依泽替米贝通常和他汀类合并使用,使低密度脂蛋白水平的降低增加 25%。它也单独使用。已有证明,它的副作用与安慰剂相似。当与他汀合用时,肝酶的上升甚微。

以上各类药物主要包括:

他汀类:阿伐他汀atorvastatin,氟伐地汀fluvastatin,洛伐它丁lovastatin,帕伐他丁pravastatin,罗苏伐他汀rosuvastatin,辛伐他汀simvastatin

胆酸结合树脂:消胆胺(去酯Ⅰ号树脂,考来烯胺)cholestyramine,降脂宁(降脂2号树脂,考来替泊)colestipol,考来维仑colesevelam

烟酸类:烟酸(尼克酸,,维生素PP

贝特类:氯贝特(氯贝了酯,安妥明,冠心平,怯脂乙酯,氯苯丁酯,降酯乙脂)clofibrate, 非诺贝特fenofibrate,吉非贝齐(吉非罗齐,二甲苯氧庚酸,诺衡,吉非洛齐)gemfibrozil

依泽替米贝:是第一个直接阻制胆固醇吸收的新一类药物。

近年来,一项新的旨在提高高密度脂蛋白水平的药物治疗研究正在继续进行中,这种药物称之为CETP(胆固醇酯转移蛋白)抑制剂,该药能够阻断一种与降低高密度脂蛋白水平有关的特殊蛋白。最近在CETP抑制剂名为torcetrapib的化学药的研究中,将它与他汀药联合使用时,意外地发现联合用药比单独使用他汀增加了患者的死亡和心血管事件。有报道称,辉瑞公司已终止torcetrapib的三期临床试验。

降低胆固醇的食物

“一般而言,改变饮食习惯可以降低1020 %胆固醇 。当然了,很多情况要考虑的,比如你原来饮食习惯太坏等。”心脏病专家并美国心脏病协会“降低胆固醇”的活动发言人Roger Blumenthal博士说。那么,一个低密度脂蛋白高且看到豆腐就想吐得人,应该怎么办吗?

我们不需要重申,要多吃水果和蔬菜。每个人都应该多食用这些食物。每天吃一份沙拉,少吃一些干酪,熟咸肉丁。理想沙拉配料包括绿色食品,豆类,向日葵种子和橄榄油或芥油调料。午餐和晚餐的时候,你应该多吃些素菜。吃零食的时候,选择吃水果。早上多吃一些谷物类食品。就是这么那么简单了。

即使你吃绿色食品,但是你可以做得更多。这里是五个最好的降胆固醇的食品。

1、大豆

研究显示,每天摄取大豆蛋白约25克,可降低胆固醇。如果你不喜欢丹贝或豆腐,你可以选择些什么来吃呢?“现在市场上,有很多的大豆含量高的产品。”一位注册营养师并兼美国饮食协会发言人Jeannie Moloo说。超级市场里,你可以买些大豆 ,豆制坚果,豆制冰淇淋和麦片,饼干及大豆蛋白做的署条。

2、豆科植物:

你甚至可能不知道什么是豆类作物。 “很多人认为豆类作物就是蔬菜。”Moloo说。豆类是任何种类的豆和小扁豆。每周推荐吃三个半天杯份豆类作物。你不需要煮,使用罐装豆类或吃点蛋糕就可以了。要想培养这种饮食习惯,你可以尝试民族食谱。举例来说,印度木豆是一种美味的扁豆菜。每周,多吃一份大米,豆类或豆腐或吃一份肉类食物。撒上一些鹰嘴豆, cannellini或菜豆在你的沙拉或者你也可以多吃些菠菜三明治。这豆类的确是很神奇。

3、大自然的海绵 燕麦:

“燕麦高含水溶性纤维” Moloo说。“想一想看,你就知道可溶性纤维就像海绵一样,它实际上可以吸收胆固醇,并将这些胆固醇排出你的体外。”每天3克燕麦纤维能降低胆固醇及低密度脂蛋白胆固醇。也就是说,你每天应该吃一个半杯煮熟的燕麦。它有没有必要是快煮或者是慢熟的呢? “即使快煮或即时燕麦粥,可以提供一个大量可溶性纤维的。” 所以,如果我们撒上一些燕麦麸在甜甜圈上呢,会怎么样呢? “这么说吧,如果你想吃零食,一包即食燕麦片,总比糖果要好很多。”亚麻也是很好的,你也可以选择亚麻。它不仅有可溶性纤维,而且它高含奥米加-3脂肪酸和木脂素-这些元素对降低胆固醇也很有很效的。每天撒上23大汤匙亚麻种子到谷类食品,酸奶或沙拉上。

4、坚果:

为什么每个人都被吃坚果与放弃呢? "单脂肪,可以降低低密度脂蛋白,并提高高密度脂蛋白胆固醇。“美国心脏协会的 Blumenthal说。单脂肪一般在坚果和种子里(南瓜,向日葵等),鳄梨和各种油类,如蔬菜,橄榄油,红花,向日葵和油菜籽。这并不意味着你可以毫无顾忌的吃这些食物。请记得,富含脂肪的食物也高含热量,所以限制好所吃的份量:用一茶匙的油涂在沙拉上,一次不能吃超过一盎司的坚果。”营养师Moloo 建议到

5、“功能性食品”:

在饮食界,有一种被成为“功能性食品”的产品。这种食物是为了使人更健康或更加愉快而设计的,它可以预防疾病。举例来说, benecol ”和“Take Control 这两种食品,可以代替人造奶油或黄油。他们利用植物甾体和stanols (一种和可溶性纤维功能相似的物质) 。植物甾醇和stanols也加入到酸奶,橙汁,沙拉酱中。短短几年,在超级市场的货架上,多了许多设计师制定了降低胆固醇的食品。

每种这类食品有益于你的健康。“最终,你想要的是一个均衡健康的饮食。”Blumenthal说。别忘了,即使你已经把这些食物放在你日常饮食计划中,但这并不表示你可以不限制的吃其他食物。正如Blumenthal指出的那样,“你还必须尽量减少吃那些碳水化合物,甜食,红烧肉类和油炸食品。”

胆固醇高不能吃什么

胆固醇高不能吃什么呢?胆固醇高的人在饮食上需要注意很多方面,此外,由于引起胆固醇的原因很多,患者要根据自己的情况调整生活和作息。

1、不能吃煎炸、油炸的食物,以防引起脑血栓。

2、要注意饮食控制,以防引起动脉硬化。

3、鱼类比肉类更适合胆固醇高的人食用,但泥鳅、鲫鱼、生鱼、鱿鱼、龙虾、墨鱼等只能吃少量,不适合多吃。值得注意的是,胆固醇的人不能盲目补充鱼肝油,容易加重病情。

4、胆固醇高的人每天摄入的胆固醇应该控制在200mg以下,蛋黄、动物内脏等胆固醇含量较高的食物,日常生活中最好少吃或不吃。

5、饮食中要用植物油取代动物油,这是因为动物油含有过量的饱和脂肪酸,容易导致患者动脉粥样硬化,值得注意的是,椰子油是不适合患者食用的,因为椰子油中富含胆固醇。

降低胆固醇,你应该多吃这些食物。它们也可以帮助你降低血压,改善心血管健康。何不马上去尝试一下呢?

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