Cov pob txha paub tab muaj ob lub ntsiab lus tseem ceeb: osteoid (organic matrix) thiab hydroxyapatite (cov khoom tsis haum). Cov osteoid muaj feem ntau ntawm cov protein ntau. Hydroxyapatite - ib yam khoom, uas muaj cov calcium, phosphate (acidic phosphoric acid residue) thiab hydroxyl pawg (OH). Tsis tas li ntawd, nws muaj ib co magnesium. Nyob rau hauv tus txheej txheem ntawm cov pob txha tsim, hydroxyapatite muaju raug tso rau hauv osteoid matrix. Qhov txheej sab nraud ntawm cov pob txha muaj cov pob txha cortical tuab; cov qauv sab hauv yog sawv cev los ntawm cov ntaub so ntswg ntau dua thiab muaj ntau lub hlwb uas muaj cov pob txha liab liab - cov ntaub so ntswg mus koom rau hauv cov qe ntshav.
Tswj ib tug pob txha
Tsis yog cortical los yog pob txha spongy yog inert. Txawm tias tom qab kawm tiav ntawm qhov kev loj hlob lawm, lawv khaws metabolic kev ua ub ua hawj thiab yog tas li rov kho dua. Qhov kev sib koom tes no, nyob rau hauv qhov chaw ntawm cov pob txha yaj thiab hloov nrog cov ntaub so ntswg tshiab, tsim nyog los tswj kom pob txha noj qab haus huv. Kev tsim cov pob txha cov pob txha yog tswj los ntawm cov tshwj xeeb hlwb - osteoblasts. Lawv ua ke li cov osteoid thiab muab cov tshuaj ntawm hydroxyapatite. Kev kho pob txha ntawm lub cev nqaij daim tawv, lub npe hu ua osteoclasts yog lub luag haujlwm.
Pob txha kab mob
Tus pob txha yog raug puas tsuaj los ntawm ntau txoj kev ua dab tsi. Nws tuaj yeem tawg puas yog kev kho (tawg), feem ntau yog ib qho chaw ntawm qhov chaw qog nqaij hlav hauv ob sab (tshwj xeeb tshaj yog nyob rau ntawm lub mis, mob ntsws thiab mob qog nqaij hlav cancer), cov pob txha metabolism kuj tuaj yeem cuam tshuam. Muaj ntau yam kab mob ntawm cov kab mob metabolic. Txha oob khab yog ib yam kab mob uas ua rau cov pob txha osteoid thiab cov pob zeb hauv pob zeb ua rau tib neeg mob. Qhov txheej txheem no ua rau muaj kev laus zuj zus, tab sis nrog cov tshuaj tsis ua hauj lwm hauv cov poj niam hauv lub cev tsis nto lawm, nws muaj kev kub ceev. Lub ntsiab yog vim li cas rau kev txhim kho ntawm cov kab mob hauv qab no yog qhov sib npaug ntawm qhov kev puas tsuaj thiab tsim cov pob txha pob txha. Nws cov nyhuv loj yog qhov weakening ntawm pob txha cov nqaij, predisposing rau cov pob txha (tshwj xeeb tshaj yog lub plab, lub dab teg thiab vertebral lub cev), uas feem ntau tshwm sim los ntawm kev raug mob me txawm.
Osteomalacia
Thaum osteomalacia, cov mineralization yog pob txha, vim tias lawv muag thiab tuaj deform, ua rau mob mob lossis ua pob txha. Osteomalacia feem ntau yog txuam nrog ib qho deficiency ntawm vitamin D los yog mob ntawm nws cov metabolism, ua rau tsis muaj calcium uas tsim cov pob txha. Nws yog kho los ntawm lub sij hawm ntawm cov vitamin D thiab calcium npaj.
Paget tus kab mob
Tus kab mob hauv cov pob txha no ua mob rau cov neeg laus. Yog vim li cas yog tsis meej, tab sis nws paub hais tias nyob rau hauv tus kab mob no, kev ua si ntawm osteoclasts nce, uas ua rau ib tug acceleration ntawm pob txha resorption. Qhov no, tig mus, tsim cov pob txha ntau dua tshiab, uas, txawm li cas los, nws yog softer thiab tsawg tuab dua pob txha. Mob hauv Paget tus kab mob yog vim ncab ntawm lub periosteum, ib daim nyias nyias npog lub sab nraud ntawm cov pob txha, nplua nuj ntawm kev kho mob. Tshuaj analgesics yog siv los daws qhov mob, thiab tus kab mob nws tus kheej tau kho nrog bisphosphonates, uas qeeb tus pob txha resorption.
Raum osteodystrophy
Nws raug pom hauv cov neeg mob uas muaj mob hlais tsis ntev. Qhov tseem ceeb tshaj plaws nyob rau hauv tus kab mob no yog qhov ua rau cov kab mob vitamin D metabolism hauv lub sijhawm ua rau lub siab thiab lub raum, vitamin D hloov dua siab tshiab rau calcitriol, hormone uas tswj cov calcium absorption. Kev mob raum tsis ua haujlwm, zus tau cov calcitriol ntau lawm. Tus mob yog kho los ntawm kev teem caij ntawm calcitriol los yog cov yeeb tshuaj zoo sib xws. Cov kev kuaj xws li fluoroscopy, isotope scanning thiab kev ntsuam xyuas keeb kwm ntawm cov pob txha cov tawv nqaij yog qhov tseem ceeb ntawm cov kab mob hauv pob txha. Muaj txiaj ntsig txheeb xyuas cov lus qhia txog pob txha kab mob, nrog rau kev txhim kho cov kab mob hauv lub cev, feem ntau yuav tau txais los ntawm kev kuaj ntshav.
Kev kuaj ntshav
Cov kev ntsuam xyuas tseem ceeb tshaj plaws yog ntsuas ntawm cov concentration hauv cov ntshav dej ntawm cov calcium thiab phosphate, thiab txoj haujlwm ntawm alkaline phosphatase, ib qho enzyme uas yog tsim los ntawm osteoblasts. Calcium concentration hauv plasma Feem ntau nws txawv ntawm 2.3 thiab 2.6 mmol / l. Cov qib calcium uas yog tswj los ntawm ob hom tshuaj hormones - capcitriol (ib tug derivative ntawm vitamin D) thiab parathyroid hormone. Nws txo qis osteodystrophy, thiab feem ntau ntawm osteomalacia thiab rickets. Nyob rau hauv osteoporosis thiab Paget tus kab mob, calcium concentration yog khaws cia ntawm ib txwm theem (tab sis nrog Paget tus kab mob, yog hais tias tus neeg mob yog immobilized, nws muaj peev xwm sawv). Ib qho concentration ntawm calcium hauv plasma tau pom nrog thawj hyperparathyroidism (feem ntau yog tshwm sim los ntawm tus kab mob benign parathyroid qog). Parathyroid hormone activates osteoclasts, tiam sis qhov mob tshwm sim ntawm cov kab mob hauv cov kab mob hauv tus kab mob no tsis yog nquag. Ib qib siab ntawm cov ntshav calcium uas tseem muaj nyob hauv cov neeg mob khees xaws. Qee zaum, qhov no yog vim qhov kev puas tsuaj ntawm cov pob txha los ntawm metastases, hauv lwm tus vim yog qhov ua tawm los ntawm tus qog nws tus kheej ntawm cov tshuaj xws li parathyroid hormone (GPT peptides). Qhov concentration ntawm phosphate nyob rau hauv cov ntshav yog feem ntau ntawm 0.8 thiab 1.4 mmol / l. Ua rau lub cev tsis tuaj yeem tshwm sim hauv lub raum tsis ua hauj lwm (thaum lub concentration nyob hauv cov kua tshuaj tua kab mob thiab cov creatinine, cov khoom ntawm cov metabolism, feem ntau tawm ntawm lub cev nrog cov zis, hnoos nce), thiab poob - nrog osteomalacia thiab rickets. Nrog Paget tus kab mob thiab osteoporosis, cov concentration ntawm phosphate hauv plasma feem ntau yog nyob rau hauv lub cev ntau. Plasma alkaline phosphatase activity Cov kev ua kom muaj zog ntawm qhov enzyme no tau pom hauv osteomalacia, Paget's kab mob thiab lub raum osteodystrophy. Nrog txoj kev kho mob zoo, nws txo qis. Tshwj xeeb yog alkaline phosphatase yog ib qho tseem ceeb raws li tus cim kev lag luam ntawm kev kho mob hauv Paget tus kab mob. Lub plasma alkaline phosphatase theem kuj nce siab nyob rau qee yam kab mob ntawm lub siab thiab cov kab mob hauv lub cev, tab sis feem ntau yog qhov no tsis muaj teeb meem nrog kev kuaj mob.
Lwm cov kev kuaj ntshav
Yog tias tsim nyog, qhov ntsuas tau hauv cov ntshav ntawm cov tshuaj vitamin D yuav tsum ntsuas: Ib qib qis qis qhia tias osteomalacia lossis rickets. Tsis muaj cov kev ntsuas tau piav saum toj no tuaj yeem txhuam tau txha, vim qhov tsis txaus siab ntawm tus nqi ntawm kev tsim thiab kev puas tsuaj ntawm cov pob txha nrog no feem ntau maj mam loj hlob kab mob me me. Tus mob no yuav muaj tseeb nrog kev pabcuam tshwjxeeb X-ray. Cov pob txha cov pob txha hauv cov duab hluav taws xob tsis hais meej, nrog rau cov kab mob hauv cov pob txha, cov pob txha pob txha ua rau tsis khov thiab zoo li tsaus nti hauv daim duab. Txhawm rau ntsuas cov pob txha cov pob zeb hauv siab, ib txoj kab x-ray densitometry siv ob-photon siv tau hais tias muaj peev xwm confidently kuaj txha osteoporosis. Cov kws kho mob yuav tsum tau muaj kev xav tau yooj yim los txheeb xyuas cov neeg uas muaj kab mob hauv lub cev los sis cov uas muaj feem yuav ua rau muaj tus kab mob no, thiab saib xyuas kev ua haujlwm zoo.