Matenda okhwima ali ndi zigawo zikuluzikulu ziwiri: osteoid (organic matrix) ndi hydroxyapatite (inorganic substance). Mankhwalawa amakhala ndi mapuloteni a collagen. Hydroxyapatite - zinthu zovuta, zomwe zimaphatikizapo calcium, phosphate (acidic phosphoric acid residue) ndi magulu a hydroxyl (OH). Komanso, ili ndi magnesiamu. Pogwiritsa ntchito fupa mapangidwe, makina a hydroxyapatite amaikidwa mu matrix osteoid. Mbali yakunja ya fupa ili ndi minofu yambiri yamagazi; mawonekedwe a mkati amayimilidwa ndi minofu yowonongeka yowonjezera ndipo ili ndi maselo ambiri odzaza ndi mafupa ofiira a mafupa omwe amaphatikizapo kupanga maselo a magazi.
Kusunga fupa
Palibe fupa kapena mafupa a spongy omwe amalowa. Ngakhale atatha kukwanira, amasunga zinthu zamagetsi ndipo amangosinthidwa. Izi zimagwirizanitsa ndondomeko, yomwe mbali zina za fupa zimasungunuka ndikuziika ndi minofu yatsopano, ndizofunika kuti thupi likhale ndi thanzi labwino. Mapangidwe a mafupa amatetezedwa ndi maselo apadera - osteoblasts. Amapanga osteoid ndikupanga mapangidwe a hydroxyapatite. Pofuna kupuma mafupa, maselo otchedwa osteoclasts ndiwo ali ndi udindo.
Matenda a mafupa
Mfupa umatha kuwonongeka ndi njira zambiri zowonongeka. Zikhoza kusweka (kupasuka), nthawi zambiri zimakhala malo okhala ndi zotupa zapamwamba (makamaka m'mawere, m'mapapo ndi khansa ya prostate), mitsempha ya mfupa ingasokonezedwe. Pali matenda ambiri a mafupa amagazi. Matenda a osteoporosis ndi omwe nthawi yomweyo amatha kuperewera kwa osteoid ndi mineral mafupa. Izi zimachitika ndi ukalamba, koma chifukwa cha kuchepa kwa estrogen kwa amayi omwe amatha kusamba, zimakhala zofulumizitsa. Chifukwa chachikulu cha chitukuko cha matenda a mitsempha ndi kusalingana pakati pa chiwonongeko ndi kupanga mafupa. Zotsatira zake ndizofooketsa mafupa, zomwe zimapangitsa kuti ziphuphu zikhale zochepa (makamaka m'chiuno, mitsempha ndi matupi a m'mimba), zomwe zimachitika chifukwa chovulala pang'ono.
Osteomalacia
Pamene osteomalacia, kusungunuka kwa mafupa kumasokonezeka, chifukwa cha zomwe zimachepetsanso ndipo zimatha kupweteka, zopweteka kwambiri kapena zopweteka. Osteomalacia kawirikawiri imagwirizanitsidwa ndi kusowa kwa vitamini D kapena zovuta za thupi lake, zomwe zimachititsa kuti alibe calcium yopanga mafupa. Amachizidwa ndi kupatsidwa vitamini D ndi kukonzekera kashiamu.
Matenda a Paget
Matendawa amakhudza okalamba. Chifukwa chake sichidziwike, koma zimadziwika kuti mu matendawa, ntchito ya osteoclasts ikuwonjezeka, zomwe zimabweretsa kufulumira kwa fupa resorption. Izi, zimathandizanso kupanga mapangidwe atsopano a mafupa, omwe ali ochepetsetsa komanso ochepa kwambiri kuposa mafupa onse. Kupweteka kwa matenda a Paget ndiko chifukwa cha kutambasulidwa kwa periosteum, nembanemba yomwe imaphimba kunja kwa mafupa, ndipo imakhala yosamalitsa ndi zopweteka zopweteka. Mankhwalawa amagwiritsidwa ntchito kuthetsa ululu, ndipo matenda omwewo amatha kuchiritsidwa ndi bisphosphonates, zomwe zimachepetsa kupumula kwa mafupa.
Manyowa odwala matenda otupa thupi
Amakhala odwala omwe ali ndi vuto lolephera kupuma. Chinthu chofunika kwambiri pa matendawa ndi kuwonongeka kwa vitamini D shuga. M'kati mwa zomwe zimachitika m'chiwindi ndi impso, vitamini D imasandulika ku calcitriol, hormone yomwe imayendetsa kuyamwa kwa calcium. Ndi kulephera kwina kwa nkhumba, kupanga calcitriol kwafupika. Matendawa amachitidwa ndi kuikidwa kwa calcitriol kapena mankhwala ofanana. Njira monga fluoroscopy, isotope kusanthula ndi histological kufufuza mafupa minofu zitsanzo ndizofunikira mbali ya matenda a mafupa matenda. Mauthenga ofunika kwambiri okhudza matenda a mafupa, kupatulapo matenda otupa mafupa, amatha kupezanso magazi.
Mayeso a magazi
Mayesero ofunikira kwambiri ndizoyeso za m'madzi a plasma a calcium ndi phosphate, komanso ntchito ya alkaline phosphatase, mavitamini omwe amapangidwa ndi osteoblasts. Mavuto a calcium m'magazi Ambiri amasiyana pakati pa 2.3 ndi 2.6 mmol / l. Mlingo wa kashiamu umayendetsedwa ndi mahomoni awiri - capcitriol (chochokera kwa vitamini D) ndi hormone ya parathyroid. Amachepa ndi nthenda yotchedwa renal osteodystrophy, komanso nthawi zambiri za osteomalacia ndi rickets. Mu matenda a kutupa kwa matenda ndi matenda a Paget, mchere wa calcium umasungidwa pamtundu wabwino (ngakhale kuti uli ndi matenda a Paget, ngati wodwalayo sangathe kuwuka). Kalisium yochulukirapo m'magazi amadziwika ndi hyperparathyroidism (yomwe imayambitsa chifuwa choipa cha gland parathyroid). Hemoniyoni ya parathyroid imayambitsa mafinya, koma maonekedwe a matenda a mafupa m'matendawa sakhala ochuluka. Pamwamba pa kashiamu wa m'magazi amakhalanso wamba pa odwala khansa. Nthawi zina, izi zimachokera ku chiwonongeko cha mafupa a metastases, mwa ena chifukwa cha kaphatikizidwe ndi chotupachocho cha zinthu zofanana ndi hormone ya parathyroid (GPT peptides). Phosphate ya m'magazi amadziwika kwambiri pakati pa 0,8 ndi 1.4 mmol / l. Kuwonjezereka kwakukulu kumawoneka mu kulephera kwa mphuno (pamene chiwerengero cha plasma cha urea ndi creatinine, zomwe zimagwiritsidwa ntchito mumthupi, nthawi zambiri zimachotsedwa mthupi ndi mkodzo, zikuwonjezeka kwambiri), ndipo zimachepa - ndi osteomalacia ndi rickets. Ndi matenda a Paget ndi osteoporosis, phosphate ya m'magazi ambiri nthawi zambiri imakhala yosiyana. Ntchito yowonjezera ya phosma phosphatase Ntchito yowonjezereka ya puloteni imeneyi imapezeka mu osteomalacia, matenda a Paget ndi matenda otupa thupi. Ndi mankhwala othandiza, imachepa. Makamaka phalapasase amathandiza kukhala chizindikiro chothandiza kwambiri kuchipatala cha Paget. Madzi a plasma amchere a phosphatase amachulukanso ku matenda ena a chiwindi ndi bile, koma kawirikawiri panopa palibe vuto ndi matenda.
Mayeso ena a magazi
Ngati ndi kotheka, m'magazi a vitamini D akhoza kuyeza. Mbali yapansi imasonyeza osteomalacia kapena rickets. Palibe mayesero omwe atchulidwa pamwambapa angathe kuzindikira kuti matendawa amatha chifukwa chakuti kusayenerera pakati pa mapangidwe ndi kuwonongeka kwa fupa ndi matendawa ndi ochepa kwambiri. Matendawa angatsimikizidwe ndi kuthandizidwa ndi njira yapadera ya X-ray. Thupi lodziwika bwino la radiographs likufotokozedwa momveka bwino, ndi matenda otupa mafupa, minofu ya mafupa imakhala yochepa kwambiri ndipo imawoneka mdima. Pofuna kupima mitsempha ya minofu ya mafupa, njira yogwiritsira ntchito photon X-ray densitometry imatha kugwiritsidwa ntchito molimba mtima. Madokotala akufunikira mwachangu njira zosavuta kuti adziwe anthu omwe ali ndi matenda otupa matendawa kapena omwe ali ndi chiopsezo chowonjezereka chokhalitsa matendawa, komanso kuyang'anira momwe chithandizo chikuyendera.