Corticosteroid-Inobatsira Osteoporosis - Zvaunofanira Kuziva

Corticosteroid-Inokonzera Osteoporosis Ndiyo Inodzivirirwa uye Inogadziriswa

Corticosteroids imwe yerudzi rwe steroid mishonga. Dzimwe nguva izwi rokuti "steroid" rinoshandiswa zvakasiyana ne "corticosteroid".

• Ndeapi Kusiyana pakati peAnabolic Steroid & Corticosteroids?

Maererano neAACR, vanopfuura mamiriyoni makumi matatu veAmerica vangave vakagadziriswa nezvirwere zvinowanzobatwa ne corticosteroids. Steroid dzakadai se prednisone , dzinoshandiswa sechirwere chezvirwere zvakawanda zvekuvhiringidzika uye zvirwere zvinotapukira , zvakadai se:

• asthma
• rheumatoid arthritis
• lupus
• chirwere chinoputika chirwere

Iyo inoshandiswawo kurapa mamiriro ezvinhu akawanda. Kunyange zvazvo steroid inowanzobudirira mukurapa zvirwere zvakadaro, ihwowo ndiyo inowanzokonzera mushonga-induced osteoporosis.

• Zvinyorwa zveCorticosteroids (Steroids)

Corticosteroids & Bone Remodeling

Corticosteroids inoshandisa calcium uye bone metabolism nenzira dzakawanda.

• steroid inoderedza chikamu che calcium inobatwa nemukumbo
• steroid inowedzera calcium excretion kuburikidza neitsvo

Izvozvi zviviri zvinosanganiswa kuti zvive nekuderera kwekupararira kweionized calcium concentration. Izvi zvinokonzera zvipembenene zveparathyroid kuwedzera kuvharwa kwehomoni inonzi parathyroid (PTH), chiitiko chinonzi sechipiri hyperparathyroidism. Kureba kwePTH mazinga kunowedzera kuwedzerwa kuputsika kwepfupa, sezvo muviri unoedza kugadzirisa kuderera kwema-calcium mazinga nekubudisa calcium kubva pamapfupa kusvika muropa.

Corticosteroids inogonawo kuderedza mazinga ehomoni dzepabonde:

• estrogen (mumadzimai)
• testosterone (mumarume)

Izvozvo zvinoguma zvishoma zvinosanganiswa nekuwedzera kurasikirwa kwefupa.

Corticosteroids inokonzera musimba utera, izvo zvinogona kutungamirira kusakwanisa uye kuwedzera kurasikirwa kwefupa. Chimwe chinokonzerwa nekorticosteroids ndechokuti vanogona kubata pfupa zvakananga nokuderedza bone (osteoblastic) basa.

Maitiro Ekutadza Kwetema

Kune marudzi maviri emapfupa emapfupa: cortical uye trabecular.

• Cortical bone inoumba ganda rekunze refu uye rine 80% yemasaga
• Trabecular bone (iyo inosara 20%) inowanikwa mukati mefupa

Pfupa rimwe nerimwe riri mumasaga rine mhando dzose dzemapfupa, asi huwandu hwavo hunosiyana. Corticosteroids inonyanya kukonzera kurasikirwa kwemafu munzvimbo idzodzo dzemafupa akafuma mumatanda, sezvakaita musana.

Dose uye nguva

Kurasikirwa kwepfupa kunowanzoitika nokukurumidza mumwedzi yekutanga kusvika ku12 yekurapa uye kunobva pane zvose:

• dose
• nguva

Zvimwe zvinokonzera njodzi yeasteoporosis zvinogona kuva nehuwandu hwekuwedzerwa kwemafupa, zvakadai se:

• age
• hukama
• chirwere chepfungwa

Semuenzaniso, varume vakwegura vane steroid vanogona kutora kurasikirwa kukuru kwemapfupa uye mungozi yekuputsika kupfuura varume vakuru vemazana. ACR inofungidzira kuti pasina zviyero zvekudzivirira, inofungidzirwa kuti 25% yevanhu venguva refu ye-corticosteroids ichawana kuparara.

Chirwere che corticosteroids isimboti yakasimba yekuparara kwengozi. Kunyange zvazvo zvisinganzwisisi kana kune chidziro chemuviri wepasi-pasi pasi apo kurasikirwa kwemapfupa hakuiti, zvidzidzo zvitsvakurudzo zvakawana steroid inhaled kuti irege kuita zvishoma pamusana pemafupa apo inoshandiswa mumitambo yakakwana uye kunze kwe systemic steroids.

Osteoporosis Management

Steroid-induced osteoporosis zvose zvinodzivirirwa uye zvinorapwa. Maererano neAACR, vanhu vari mu corticosteroids vanofanira kuva nemapfupa emaminerari ejection test yakaitwa. Ichi chiyero chichapa chiyero chekutanga chekutsvaga shanduko dzinotevera mune bone. ACR inokurudzira kudya kwezuva rimwe nerimwe 1500 mg. calcium uye 400-800 IU yevhitamine D. Calcium uye vitamini D zvinogona kubatsira kuchengetedza calcium balance uye nemahara hormone yepathyroid, uye inogona kuchengetedza bone mashoma mune vamwe varwere paine chirwere chinonzi steroid therapy.

Osteoporosis Zvinodhaka

Mishonga yeOsteoporosis inogamuchirwa neCDA ye corticosteroid-induced osteoporosis inosanganisira:

• Actonel (Risedronate) yekudzivirira uye kurapa
• Fosamax (Alendronate) pakurapa

Muvashandi ve corticosteroid, zvose zvinodhaka zvinounza migumisiro inobatsira pamusana wechipfuva uye hip bone mineral mass uye inobatanidzwa nekuderera kwepasina fractures. Estrogen therapy uye Miacalcin (Calcitonin) inogona kubatsira kuchengetedza musana wepinene mumuviri wevakadzi ve postmenopausal pane corticosteroids, asi hapana FDA inobvumirwa kuti corticosteroid-induced osteoporosis.

Lifestyle Modifications

• Kurega kusvuta uye doro, zvinokosha mukuderedza dambudziko re steroid-induced osteoporosis.
• Basa rekuita muviri uye kurovedza muviri kunogona kubatsira kuchengetedza mapfupa nemasimba, paunowedzera simba remasumbu uye kuderedza dambudziko rekuwa.
• Slip nekudzivirira kunowanikwa kune zvakakosha kune vanhu vakwegura uye kune avo vakawana steroid-inokonzera musimba simba.

The Bottom Line

Maitiro ekudzivirira maEsteoporosis anofanira kutanga pakutanga, zvakakodzera pakutanga kweraticticeroid therapy. Nyanzvi dzinokurudzira kushandisa soroid yakaderera pane imwe nguva shoma uye inogona kuitika, inhaled kana kuti inoricic corticosteroids inofanira kushandiswa.

_Kunobva:

_{Glucocorticoid-Induced Osteoporosis, NIH ORBD ~ NRC, 12/2000}