I-Steroid Yesikhathi Eside Ukusebenzisa Amathanga Angenamandla, Iholele ekutheni i-Steroid-Induced Osteoporosis
Uma une- inflammatory disease (IBD) , udokotela wakho kungenzeka ukuthi ubeke i-steroids efana ne- prednisone ukuze unciphise ukuvuvukala ngesikhathi se-flare-up. Imiphumela emibi yocingo ye-steroids ivela ekucasulayo ekudambiseni, kodwa iningi lazo lizohamba lapho umthamo uphethwe phansi futhi unqanyuliwe.
Kodwa-ke, ama-steroids angasiza ekuthuthukiseni imiphumela engaba yingozi futhi engapheli, ikakhulukazi uma ethathwa ezinyangeni eziphakeme noma ngezikhathi ezinde.
Enye yalezi zimo i-steroid-induced osteoporosis. Kuyaziwa ukuthi ama-steroids angabangela ekulahlekelweni kwethambo. Kulabo abathatha i-steroids, ukubuza udokotela mayelana nokuqeda i-osteoporosis nokuhlola ngezikhathi ezithile izinto ezibalulekile ezingasiza ekubanjeni noma yikuphi ukulahlekelwa amathambo ekuqaleni.
Kuyini Ukukhubazeka Kwegazi?
I-osteoporosis iyanciphisa amathambo, okubangela ukuba balahlekelwe ubukhulu babo futhi babe ne-brittle futhi bangakwazi ukuhlukumezeka. Ngokuyinhloko kucatshangwa ukuthi yisifo sabesifazane besifazane abahamba phambili, okuyiqiniso kuyizingxenye ezithile, kodwa kungenzeka kubantu noma abesifazane banoma yisiphi isikhathi esengozini. Ezinye zezici eziyingozi zihlanganisa:
- Ubudala (ngaphezu kuka-65)
- Ukuba ngumdabu waseCaucasus noma wase-Asia
- Umlando womndeni we-osteoporosis
- Ukwakha okuncane / okuncane (ngaphansi kuka-154 lbs)
- Ukuhlukana kwangaphambilini
- Ukusetshenziswa kwemithi ethile (kubandakanya i-steroids namahomoni wegciwane)
- Ukuyeka esikhathini sokuqala
- Ukudla okunganele kwe-calcium; ukungenisa i-vitamin enganele
- Ukudla okuphezulu kwamaphrotheni
- Indlela yokuphila yama-sedentary
- Ukubhema
- Ukuphuza utshwala
- Izifo ze-parathyroid
I-Steroid-I-Osteoporosis Eyingozi
Nakuba i-steroids yenza ukwehlisa ukushisa, futhi kunciphisa ukwakheka kwamathambo amasha, ukwandisa ukwehla kwethambo elidala, futhi kunciphise ukumuncwa kwe-calcium ekudleni komzimba. Endabeni ye-IBD, ukuthuthukiswa kwe-osteoporosis kungase kuhlanganiswe inani eliphansi kakade le-calcium elithathwa ngumzimba.
Ukuxilongwa kwesifo se-Steroid-Ukukhulelwa Kwegazi
I-osteoporosis itholakala ukuthi ine-test okuthiwa i-double-energy x-ray absorptiometry (DEXA). I-DEXA izwela kakhulu kune-x-ray evamile futhi ingathola ukulahleka kwethambo ezinyathelweni zayo zakuqala. Akubuhlungu futhi kuthatha imizuzu engaba ngu-10 ukuqedela.
I-American College of Rheumatology ikhuthaza u-DEXA ukuhlolwa ekuqaleni kokuphathwa kwe-steroid kanye ngezikhathi ezithile (mhlawumbe ngonyaka) ngemuva kwalokho ngenkathi ukwelashwa kuqhubeka.
I-osteoporosis ijwayele ukuvame kakhulu kubantu abane-Crohn's disease kunelabo abane-ulcerative colitis, ngakho-ke i-DEXA eyisisekelo yokubamba ukulahlekelwa kwamathambo okuqala kunconywa iziguli ze-Crohn's disease.
I-DEXA inconywa kuphela ezigulini ezine-ulcerative colitis ezibekwe i-steroids njenge-therapy yesikhathi eside.
Ukuvimbela i-Steroid-Induced Osteoporosis
I-taper steroids. Ukuvimbela ukulahlekelwa kwethambo lokuqala, i-steroids kufanele isetshenziswe kuphela esilinganisweni esincane kunazo zonke isikhathi esincane kakhulu. Ukwelashwa kwe-steroid kungasiza kakhulu ezimweni eziningi zokuvuvukala, kodwa izinzuzo kufanele zilinganiswe ngokusemandleni emiphumela emibi njenge-osteoporosis. Ungalungisi imithi yakho ngokwakho ngaphambi kokukhuluma nodokotela wakho.
Yeka ukubhema. Ukubhema ugwayi kuhlotshaniswa nezinto eziningi zokuphila ezifaka ekulahlekelweni kwethambo, njengokudla okuncane nokuntuleka kokuzivocavoca.
Abesifazane ababhema bangase bakhiqize i- estrogen encane futhi bahlangabezane nokuya esikhathini sokuqala kunabesifazane abangabhemi. Ngaphezu kwalokho, ababhemayo bathatha isikhathi eside ukuphulukisa kusukela ekuqhekekeni, futhi ukusetshenziswa kogwayi kubonakala kunciphisa amandla esithambo.
Ukuzivocavoca. Ukuzivocavoca umzimba , njengokuzivocavoca, kuyasiza ekwandiseni i-bone mass. Ukuzivocavoca kukhuthaza ukudalwa kwamathambo nokugcinwa kwe-calcium.
Ukwelapha i-Steroid-Induced Osteoporosis
Izithako. Ngenxa yokuthi i-calcium ingene emathunjini amancane, i-malabsorption ivela ikakhulu kubantu abane-Crohn's disease abanezibilini emathunjini amancane . Abantu abane-ulcerative colitis, abonakala emathunjini amakhulu , bangase babe nokunciphisa kangcono kwe-calcium.
Izithako ze-calcium enani lika-1500 mg ngosuku zingase zinconywe ukuphatha noma ukuvimbela ukulahlekelwa kwethambo ekuqaleni. Udokotela wakho uzodinga ukukukwazisa ngokuthi iyiphi imingcele, uma ikhona, efanelekile kuwe.
Kubalulekile ukwazi ukuthi i-calcium ayisebenzi yedwa - idinga i- vitamin D ukuze ixhumane nomzimba. I-Vitamin D ihlanganiswa lapho isikhumba sibhekene nokukhanya kwelanga, kodwa abantu abaningi abachithi isikhathi esanele ngaphandle kokwenza vithamini D. Ukwanele i-calcium, i-vitamin D ayitholakali kahle abantu abanezikhukhula ezikhuthele emathunjini amancane abangwa yi-Crohn's disease. Ukwengezwa kwansuku zonke nge-400 IU ka vithamini D kungase kunconywe ukulwa nokulahlekelwa kwamathambo okuqala; futhi, khuluma nodokotela wakho mayelana nalokho okululekayo kuwe.
Ama-bisphosphonates: i- Fosamax (i-alendronate), i-Actonel (risedronate), i-Didronel (etidronate), i-Boniva (ibandronate), ne-Reclast (i-zoledronic acid) yi- bisphosphonates esetshenziselwa ukusiza amathambo aphule futhi alondoloze amathambo. Le mithi ingase ikhulise imithwalo yamathambo emgodleni nomlenze.
Ama-bisphosphonates njengamanje isigaba sezidakamizwa ezise-FDA-ezivunyelwe ukwelashwa kwe-osteoporosis kumadoda. Zivame ukunikezwa nge-calcium ne-vitamin D.
I-Forteo (i-Teriparatide). I-Forteo iyi-hormone ephathekayo evunyelwe ukwelapha i-steroid-induced osteoporosis; ingasetshenziswa iminyaka engaba ngu-2. Abantu abaye baphathwa ngemishanguzo, njengomdlavuza, abakhethi abahle kulo muthi. I-Forteo iphathwa njalo ngosuku ngomjovo.
I-Calcitonin (i-Calcimar, i-Cibacalcin, i-Miacalcin). I-Calcitonin kusiza ukulahlekelwa ukulahlekelwa kwethambo futhi kuvimbele ukufiphaza emgodleni kodwa hhayi emlonyeni. Le mithi inikezwa njenge-spray yangasese futhi ingabangela ukucasuka emaqenjini angasese. Akukona okuphumelelayo ekwelapheni i-steroid-induced osteoporosis, ngakho-ke i-calcitonin isetshenziselwa kuphela iziguli ezingenakuzithatha noma ezingavumi ukwelashwa ngama-bisphosphonates.
Imithombo:
Amin S. "Ukuqeda I-Glucocorticoid-Yenza Ukuphefumula Kwegazi." I-American College of Rheumatology 2010.
Rosen HN. "Ukuvimbela nokwelashwa kwe-glucocorticoid-induced osteoporosis." Ngomhla ka-Meyi 2010.