Osteoporosis-ka Corticosteroid-Hoos-u-dhac ayaa ah labada laga hortago oo la daaweyn karo
Corticosteroids waa nooc ka mid ah daawada steroid ah. Mararka qaar ereyga "steroid" waxaa loo isticmaalaa "corticosteroid".
Sida laga soo xigtay ACR, in ka badan 30 milyan oo Maraykan ah ayaa laga yaabaa in ay saameeyaan cudurro badanaa lagu daweeyo corticosteroids. Steroids sida prednisone , waxaa loo isticmaalaa daaweynta cudurada infakshanka badan iyo cudurada , sida:
- neefta
- rheumatoid arthritis
- lupus
- cudurrada mindhicirka
Waxaa sidoo kale loo isticmaalaa in lagu daaweeyo xaalado xasaasiyad badan. Inkastoo steroids ay guud ahaan waxtar u leeyihiin daaweynta cuduradaas, waxay sidoo kale yihiin kuwa ugu badan ee keena cudurka osteoporosis ee daroogada .
Corticosteroids & Dib u habeynta lafaha
Corticosteroids waxay saameeyaa hababka kala duwan ee loo yaqaan 'metabolism' kalsiyum iyo lafaha.
- steroids waxay hoos u dhigtaa qadarka calcium ee uu ku faafay xiidmaha
- steroids waxay kordhisaa maqaarka calcium iyada oo loo marayo kelyaha
Labadan arrimood waxay isku daraan si ay u soo saaraan hoos u dhac ku yimaada diirinta qamriga. Tani waxay dhalinaysaa qanjidhada 'parathyroid' si loo kordhiyo dheecaanka hoormoonka 'parathyroid hormone' (PTH), oo loo yaqaan 'hyperparatyroidism secondary'. Heerarka PTH ee kordhaya waxay keenaysaa burburka lafaha oo kordha, maaddaama jirka uu isku dayayo in uu saxdo heerarka hoose ee calcium wareega isagoo kilyaha ka soo daadinaya dhiigga.
Corticosteroids waxay sidoo kale hoos u dhigi kartaa heerarka hoormoonka galmada:
- estrogen (haweenka)
- testosterone (ragga)
Hoos-u-dhaca ayaa keenay xiriir la leh lafarka
Corticosteroids waxay sidoo kale keentaa daciifka murqaha, taas oo keeni karta in aan dhaqdhaqaaq lahayn iyo laf kale oo dheeraad ah. Saameyn kale oo weyn ee corticosteroids waa inay saameyn karaan lafo tooska ah iyadoo la xakameynayo qaabeynta lafaha (osteoblastic).
Tilmaamaha Lumin Lafta
Waxaa jira laba nooc oo unugyada lafaha ah: kortikal iyo trabecular.
- Lafaha kortida ayaa ka dhigan xuddunta gudaha ee lafta waxayna ka kooban tahay 80% qalfoofka
- Lafaha Trabecular (20% ka haray) ayaa laga helaa gudaha lafta
Laf kasta oo ka mid ah qalfoofka wuxuu ka kooban yahay noocyada lafaha, laakiin waa kala duwan yihiin. Corticosteroids waxay ugu horreyntii keentaa lafaha lafaha meelahaas oo ka mid ah qalfoofka oo hodan ku ah lafaha trabecular, sida lafdhabarta.
Qaadashada iyo mudada
Lafaha lafdhabarku wuxuu dhacaa ugu dhakhsaha badan 6 ilaa 12 bilood oo daaweyn ah waxayna ku xiran tahay labadaba:
- qiyaas
- muddada
Waxyaabaha kale ee halista ah ee loo yaqaan 'osteoporosis' ayaa laga yaabaa inay saameyn ku yeelato lumo lumiso, sida:
- da'da
- jinsiga
- Cudurka ka hooseeya
Tusaale ahaan, waayeelka waayeelka ah ee steroids waxay la kulmi karaan lafaha lafihiisu ka weyn iyo khatarta jabka ee ka dhexeeya ragga dhexe ee dhexe. ACR ayaa qiyaaseysa in aan la qaadin tallaabooyin ka hortag ah, qiyaastii 25% dadka shakhsiyaadka qaba corticosteroids muddo dheer waxay la kulmi doonaan jab.
Qiyaasta corticosteroids waa saadaal xoog leh ee halista jab. Inkastoo aysan caddayn in ay jirto qadar yar oo ka hooseeya qiyaasta lafaha lafteedu aysan dhicin, baaritaanada dhawaan la helay ayaa laga heley steroids in la yareeyo saameyn aan laf dhabarta lahayn lafaha marka la isticmaalo qiyaasaha caadiga ah iyo marka laga reebo steroids nidaamka.
Maaraynta Osteoporosis
Cudurka osteoporosis-ka ee lafdhabarta ayaa labadaba la ilaalin karaa lana daweyn karo. Marka loo eego ACR, dadka ku jira corticosteroids waa inay sameeyaan tijaabada caanaha macdanta ah. Baaritaankani wuxuu bixin doonaa cabbir asal ah oo laga yaabo inuu kormeero isbeddelada dambe ee lafaha. ACR waxay sidoo kale ku talineysaa maalin kasta qaadashada 1500 mg. kalsiyum iyo 400-800 IU ee fitamiin D. Calcium iyo fitamiin D waxay gacan ka geysan kartaa ilaalinta miisaanka calcium iyo heerarka hormoonka caadiga ah ee hormoonada, iyo xitaa xitaa ilaalin karaan lafaha bukaannada qaar ka mid ah daaweynta yar ee daaweynta steroid ah.
Mukhaadaraadka Cudurka Osteoporosis
Dawooyinka osteoporosis ee ay ansixisay FDA-da ee loo yaqaan 'corticosteroid osteoporosis' waxaa ka mid ah:
- Actonel (Risonronate) ee ka hortagga iyo daaweynta
- Fosamax (Alendronate) ee daaweynta
Isticmaalayaasha corticosteroid, labadaba daawooyinka ayaa bixiya waxtarka faa'iidada leh ee lafdhabarta maskaxda laf dhabarta iyo laf dhabarta waxayna la xiriirtaa hoos u dhaca jabanka lafdhabarta. Cudurka Estrogen iyo Miacalcin (Calcitonin) ayaa laga yaabaa inay ka caawiso ilaalinta lafaha laf dhabarta dumarka postmenopausal ee corticosteroids, laakiin sidoo kale maaha FDA in la siiyo corticosteroid osteoporosis.
Wax-ka-beddelidda hab-nololeedka
- In la tirtiro sigaarka iyo aalkolada, waxay muhiim u tahay yaraynta halista ah osteoporosis-ka laf-dhabarka.
- Dhaqdhaqaaqa jirka iyo jimicsiga ayaa gacan ka geysan kara ilaalinta lafaha iyo muruqa, iyada oo kor u qaadeysa xoojinta muruqa iyo yaraynta khatarta dhacdooyinka.
- Ka-hortagga iyo ka-hortagga ka-hortagga ayaa muhiim u ah shakhsiyaadka waayeelka iyo kuwa ku dhacay tabar-darro muruqa ah.
Khadadka hoose
Tallaabooyinka ka-hortagga lafa-beelka waa inay billaabaan bilawga, si siman marka laga bilaabo bilawga daaweynta corticosteroid. Khubaradu waxay kugula talinayaan isticmaalka qiyaasta ugu hooseeya ee steroid muddada ugu gaaban ee suurtagalka ah, iyo, marka la suubin karo, la nadiifiyay ama corticosteroids la isticmaalay.
Xigasho:
Cudurka Ousoporosis Glucocorticoid, NIH ORBD ~ NRC, 12/2000