I-Corticosteroid-Yenza i-Osteoporosis iViyo kwaye iyakhathazeka
I-Corticosteroids yinto enye yonyango lwe-steroid. Ngamanye amaxesha igama elithi "steroid" lisetyenzisiswa ngokuthe ngqo kunye ne "corticosteroid".
Ngokutsho kwe-ACR, abangaphezu kwezigidi ezingama-30 baseMerika abanokuchaphazeleka zizifo eziqhelekileyo eziphathwe nge-corticosteroids. I-Steroids efana ne- prednisone , isetyenziswe njengonyango kwizifo ezininzi ezinokukhukhumeza nezizimele , ezifana ne:
- i-asthma
- irheumatoid arthritis
- lupus
- izifo zesibindi
Ziye zisetyenziselwa ukunyanga iimeko ezininzi zokugulisa. Nangona i-steroids ngokubanzi isebenza ngokuphumelelayo ekuphatheni izifo ezinjalo, nazo zizona zizathu eziqhelekileyo zonyango lwe- osteoporosis.
Corticosteroids & Bone Remodeling
I-Corticosteroids ithintela i-calcium kunye nesithambo semetabolism ngeendlela ezininzi.
- i-steroids iyancipha inani le-calcium ebanjwe ngamathumbu
- i-steroids yandisa i-calcium excretion ngeentso
Ezi zinto zibini zidibanisa ukuvelisa ukwehla kwe-concentration ye-calcium ionized. Oku kubangela ukuba izigulane eziziphathekayo zenze ukwanda kwe-hormone ye-parathyroid (PTH), imeko eyaziwa njenge-secondary hyperparathyroidism. Amanqanaba e-PTH aphakanyisiweyo enza ukuba ukunyuka kwethambo kwandiswe, njengoko umzimba uzama ukulungisa amanqanaba e-calcium ejikelezayo ngokukhupha i-calcium emathanjeni egazini.
I-Corticosteroids inokunciphisa amanqanaba e-hormone yesini:
- i-estrogen (kwabasetyhini)
- testosterone (ngamadoda)
Ukuhla kwehla kubangelwa ukulahleka kwethambo.
I-Corticosteroids nayo ibangela ubuthakathaka obuthakathaka, obungakhokelela ekusebenziseni nasekulahlekeni kwethambo olongezelelweyo. Enye impembelelo enkulu ye-corticosteroids kukuba iyakwazi ukuchaphazela amathambo ngokuchithwa ngokuthintela isakhiwo se-bone (osteoblastic).
Iipatheni Zokulahlekelwa Kwamathambo
Kukho ezimbini iintlobo zethambo leethambo: i-cortical ne-trabecular.
- Isithambo se-Cortical senza igobolondo yangaphandle yethambo kunye ne-80% yamathambo
- I-bone ye-Trabecular (i-20% eseleyo) ifumaneka ngaphakathi kwethambo
Ithefu ngalinye emasakeni liqulethe zombini iintlobo zethambo, kodwa ukulingana kwazo kuyahluka. I-Corticosteroids ngokuyinhloko ibangela ukulahleka kwenyama kwimihlaba yamathambo anesityebi esithambo, njengomkhuhlane.
Ixesha kunye nexesha
Ukulahleka kwe-Bone kwenzeka ngokukhawuleza kwiinyanga zokuqala ezi-6 ukuya kwe-12 zonyango kwaye kuxhomekeke kuzo zombini:
- dose
- ixesha
Eminye imingcipheko ye-osteoporosis ingaba nempembelelo eyongeziweyo ekulahlekeni kwethambo, njengale:
- ubudala
- ngesini
- sisifo
Ngokomzekelo, amadoda asebekhulile kwi-steroids anokufumana ukulahlekelwa kwethambo enkulu kunye nomngcipheko wokuphuka kunamadoda angama-middle age. I-ACR iqikelela ukuba ngaphandle kwemilinganiselo yokukhusela, uqikelelo lwama-25% wabantu kwi-corticosteroids yexesha elide baya kuphuka.
I dose ye-corticosteroids yindlela eqinileyo yokwenza ingozi. Nangona kungenakucacisa ukuba kukho umyinge weqondo eliphantsi ngaphantsi kokulahlekelwa kwethambo, iziphumo zentsholongwane zifumene i-steroids engabonakaliyo ukuba ingabi nantoni na ekuthinini kwethambo xa ilawulwa kwiimeko eziqhelekileyo ngaphandle kwenkqubo ye-steroids.
Ulawulo lwe-Osteoporosis
I-osteoporosis eyenziwa yi-Steroid iyakhuselwa kwaye iyaphathwa. Ngokutsho kwe-ACR, abantu abakwi-corticosteroids kufuneka babe nokuhlolwa kweetamineral mass test. Olu vavanyo luya kunika umlinganiselo wesiseko oza kubeka iliso utshintsho olulandelayo kwisithambo samathambo. I-ACR iphinda icebise ukutyiwa kwansuku zonke kwe-1500 mg. i-calcium ne-400-800 ye-vitamin D. I-vitamin D. i-calcium kunye ne-vitamin D inokukunceda ukugcina i-calcium balance and standard levels of hormone levels, kwaye iyakwazi nokugcina ubunzima beethambo kwezinye izigulane kwi-dose e-dose ephantsi.
Osteoporosis Izidakamizwa
I-osteoporosis imithi evunyiweyo yi-FDA ye-corticosteroid-induced osteoporosis iquka:
- Actonel (Risedronate) ukukhusela kunye unyango
- I-Fosamax (i-Alendronate) unyango
Kubasebenzisi be-corticosteroid, zombini iziyobisi zizisa iziphumo ezincedisayo kwintlambo kunye ne-hip bone yamaminereral density kwaye zihambelana nokunciphisa emithanjeni yomgudu. I-Estrogen unyango kunye ne-Miacalcin (iCalcitonin) inokunceda ukugcina ubunzima bomgogodla kwi-postmenopausal bafazi kwi-corticosteroids, kodwa akukho-FDA ivunyelwe ukuba i-osteoporosis i-corticosteroid.
Indlela yokuPhila
- Ukuphelisa ukutshaya nokusela, kubalulekile ekunciphiseni umngcipheko we-steroid-induced osteoporosis.
- Umsebenzi wokuzilolonga kunye nokuzilolonga kunokunceda ukugcina ubunzima beethambo nobuhlungu, ngelixa ukwandisa amandla omzimba kunye nokunciphisa umngcipheko wokuwa.
- I-Slip kunye nokuthintela ukuwa kukubaluleka ngokukhethekileyo kubantu abadala kunye nalabo baye bafumana ubuthakathaka obuthakathaka besifo se-steroid.
Ngaphantsi
Amanyathelo okuthintela i-Osteoporosis kufuneka aqale ekuqaleni, ngokufanelekileyo ekuqaleni kwonyango lwe-corticosteroid. Iingcaphephe zincoma ukusebenzisa i-dose ephantsi kakhulu ye-steroid ixesha elincinci yexesha kwaye kunokwenzeka ukuba, xa kunokwenzeka, inhaled or corticosteroids isetyenziswe.
Umthombo:
I-Glucocorticoid-Yenza i-Osteoporosis, i-NIH ORBD ~ NRC, 12/2000