{"id":11824,"date":"2009-12-14T20:00:00","date_gmt":"2009-12-14T20:00:00","guid":{"rendered":""},"modified":"2016-03-24T16:44:35","modified_gmt":"2016-03-24T16:44:35","slug":"osteoporoze-atitolinti-negalia-ir-mirti","status":"publish","type":"post","link":"https:\/\/www.pasveik.lt\/lt\/naujausi-medicinos-straipsniai\/osteoporoze-atitolinti-negalia-ir-mirti\/11824\/","title":{"rendered":"Osteoporoz\u0117: atitolinti negali\u0105 ir mirt\u012f"},"content":{"rendered":"<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 20.0pt;\"><\/span><\/b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\"><a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/osteoporoze\/4312\">Osteoporoz\u0117<\/a> \u2212 tai progresuojanti sistemin\u0117 skeleto liga, kuriai b\u016bdingas kaul\u0173 mas\u0117s ma\u017e\u0117jimas, j\u0173 mikrostrukt\u016bros pakitimai, d\u0117l kuri\u0173 kaulai pasidaro trap\u016bs ir lengvai sul\u016b\u017eta. <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/osteoporoze\/4312\">Osteoporoz\u0117<\/a> ir jos komplikacij\u0173 labai da\u017enai pasirei\u0161kia pagyvenusiems \u017emon\u0117ms. \u0160launikaulio, dilbio ar stuburo kompresiniai l\u016b\u017eiai seniems \u017emon\u0117ms da\u017enai sukelia negali\u0105 ir mirt\u012f. Tod\u0117l <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/osteoporoze\/4312\">osteoporoz\u0117<\/a> tampa labai rimta <b>civilizacijos problema.<\/b><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">1 lentel\u0117je pateikiami senatvin\u0117s ir pomenopauzin\u0117s osteoporoz\u0117s (OP) skirtumai. Senatvin\u0117s OP atveju parathormono (PTH) padid\u0117jim\u0105 lemia kalcio ir vit. D apykaitos sutrikimai. D\u0117l to kaulai nuolat ardomi, ta\u010diau labai l\u0117tai atsinaujina. Kaul\u0173 mas\u0117 senatvin\u0117s OP metu ma\u017e\u0117ja ne taip smarkiai ir greitai kaip pomenopauz\u0117s metu, ta\u010diau vienodai palie\u010diama tiek trabekulin\u0117, tiek kortikalin\u0117 kaulo dalis.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\"><img loading=\"lazy\" decoding=\"async\" src=\"\/wp-content\/uploads\/2020\/11\/ost.bmp\" alt=\"Osteoporoz\u0117: atitolinti negali\u0105 ir mirt\u012f\" width=\"639\" height=\"351\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">80 proc. vis\u0173 osteoporoz\u0117s atvej\u0173 prie\u017eastis susijusi su am\u017eiumi. <\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Diagnostika<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Osteoporoz\u0117s po\u017eymiai:<\/span><\/p>\n<ul style=\"margin-top: 0cm;\">\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo3; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Kaul\u0173 mas\u0117s ma\u017e\u0117jimas yra pagrindinis po\u017eymis. Jam progresuojant, kai kaulai jau n\u0117ra tokie tvirti, kad atlaikyt\u0173 kasdienin\u0117s veiklos kr\u016bv\u012f, atsiranda ry\u0161kiausia OP klinikin\u0117 i\u0161rai\u0161ka \u2013 \u012fvyksta kaul\u0173 l\u016b\u017eis.<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo3; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Patys pavojingiausi \u2013 \u0161launikaulio vir\u0161utin\u0117s dalies l\u016b\u017eiai. Osteoporoziniai rie\u0161o ar \u0161launikaulio l\u016b\u017eiai yra skausmingi, sukelia deformacijas ir negali\u0105. \u0160i\u0173 l\u016b\u017ei\u0173 diagnostika nekelia abejoni\u0173.<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo3; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">OP b\u016bdingi stuburo slanksteli\u0173 l\u016b\u017eiai da\u017enai lieka nepasteb\u0117ti. D\u0117l slanksteli\u0173 l\u016b\u017ei\u0173 visada suma\u017e\u0117ja \u016bgis ir pakinta laikysena. D\u0117l OP l\u016b\u017e\u0119s slankstelis niekada neatgauna normalios anatomin\u0117s strukt\u016bros. Slankstelis susiploja, deformuojasi, da\u017enai b\u016bna pakartotini\u0173 stuburo l\u016b\u017ei\u0173 ir tolesn\u0117 deformacija. Tod\u0117l ilgainiui i\u0161sivysto dideli stuburo i\u0161krypimai bei negalia.<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo3; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Progresuojant ligai vystosi kupra (vaizd\u017eiai vadinama \u201ena\u0161l\u0117s kupra\u201c). Ligai progresavus, d\u0117l suma\u017e\u0117jusios pilvo ertm\u0117s gali atsirasti vir\u0161kinimo sutrikim\u0173, tod\u0117l pacientai priversti valgyti da\u017eniau ir ma\u017eesn\u0117mis porcijomis. Eisena tampa atsargi, einant kojos statomos pla\u010diai.<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo3; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Skausmas \u2013 labai individualus poj\u016btis, kurio negali matyti ir \u012fvertinti kiti \u017emon\u0117s. Sergant OP skausmas atsiranda d\u0117l trij\u0173 prie\u017eas\u010di\u0173:<\/span><\/li>\n<\/ul>\n<ol style=\"margin-top: 0cm;\">\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Ilg\u0173j\u0173 kaul\u0173 arba slanksteli\u0173 l\u016b\u017eio.<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Nusilpusi\u0173 raumen\u0173 nuolatinio pertempimo. L\u016b\u017eus kaului, organizmas nat\u016braliai reaguoja \u012f \u0161\u012f pa\u017eeidim\u0105 \u012ftempdamas raumenis ir saugodamas pa\u017eeist\u0105 viet\u0105 nuo judesi\u0173. Deja, \u0161ie raumenys da\u017enai b\u016bna nusilp\u0119 d\u0117l neveiklos, tod\u0117l greitai pervargsta. \u012etemptuose raumenyse gaminasi pieno r\u016bg\u0161tis, kuri ir sukelia skausmo poj\u016bt\u012f.<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Baim\u0117, nerimas, \u012ftampa, nuovargis ir <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/depresija\/4455\">depresija<\/a> sustiprina skausm\u0105.<\/span><\/li>\n<\/ol>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Kaul\u0173 mineralinio tankio tyrimas (KMT)<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Diagnozei patvirtinti ir gydymui kompensuoti atliekamas KMT matavimas densitometru \u2013 DEXA (dvisraut\u0117s radioabsorbciometrijos tyrimas). Indikacijos \u0161iam tyrimui:<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u2022 moterys po menopauz\u0117s iki 65 m., jeigu yra dar nors vienas, be menopauz\u0117s, kaul\u0173 l\u016b\u017ei\u0173 rizikos veiksnys;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u2022 vyresn\u0117s nei 65 m. am\u017eiaus moterys, neatsi\u017evelgiant \u012f tai, ar yra kit\u0173 rizikos veiksni\u0173;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u2022 moterys, kurioms po 40 m. l\u016b\u017eo kaulai;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u2022 lytini\u0173 hormon\u0173 stoka;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u2022 ankstyva <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/menopauze\/4342\">menopauz\u0117<\/a> (iki 45 met\u0173 am\u017eiaus);<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u2022 u\u017esit\u0119susi antrin\u0117 <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/amenoreja\/55011\">amenor\u0117ja<\/a> (ilgiau kaip 1 metus);<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u2022 pirminis moter\u0173 ir vyr\u0173 hipogonadizmas,<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u2022 ligos arba b\u016bkl\u0117s, lemian\u010dios <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/osteoporoze\/4312\">kaul\u0173 ret\u0117jim\u0105<\/a>,<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u2022 tiriant rentgenu nustatoma osteopenija ir\/ar slanksteli\u0173 deformacija,<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u2022 prie\u0161 skiriant gliukokortikoid\u0173 (&gt;7,5 mg per dien\u0105 ilgiau kaip 3 m\u0117n.) arba kit\u0173 vaist\u0173, skatinan\u010di\u0173 kaul\u0173 ret\u0117jim\u0105, bei j\u0173 vartojantiems asmenims;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u2022 prie\u0161 skiriant gydym\u0105 nuo osteoporoz\u0117s bei vertinant jo efektyvum\u0105. DEXA b\u016bdu nusta\u010dius tiriamojo asmens KMT, gautas dydis lyginamas su standartine norma ir apskai\u010diuojami du \u017eymenys, vadinami T ir Z lygmenimis: \u2013T lygmuo (angl. <i>T-score<\/i>) \u2013 tiriamojo asmens KMT nuokrypis, i\u0161reik\u0161tas standartini\u0173 nuokrypi\u0173 skai\u010diumi, palyginti su maksimaliu jaun\u0173 sveik\u0173 tos pa\u010dios lyties asmen\u0173 kaul\u0173 tankio vidurkiu. \u2013 Z lygmuo (angl. <i>Z-score<\/i>) \u2013 tiriamojo asmens KMT nuokrypis, i\u0161reik\u0161tas standartini\u0173 nuokrypi\u0173 skai\u010diumi, palyginti su to paties am\u017eiaus ir lyties asmen\u0173 KMT vidurkiu. Pasaulin\u0117 sveikatos organizacija (PSO) rekomenduoja OP diagnozuoti naudoti T lygmen\u012f (2 lentel\u0117<b>). <\/b>Pirmiausia OP pa\u017eeid\u017eia stuburo kaulus, tod\u0117l ir DEXA tyrimo metu tikslinga pirmiau \u012fvertinti \u0161i\u0105 srit\u012f. V\u0117liau liga pa\u017eeid\u017eia klubo, \u0161launikaulio ir kitus periferinius kaulus.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Osteodensitometrijos metodo pasirinkimas priklauso nuo tyrimo tikslo. \u0160iuo metu Lietuvoje kaul\u0173 mineral\u0173 tankiui nustatyti ir l\u016b\u017ei\u0173 rizikai \u012fvertinti rekomenduojami naudoti kelet\u0105 metod\u0173, kurie apra\u0161yti 3 lentel\u0117je.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\"><img loading=\"lazy\" decoding=\"async\" src=\"\/wp-content\/uploads\/2020\/11\/ost1.bmp\" alt=\"Osteoporoz\u0117: atitolinti negali\u0105 ir mirt\u012f\" width=\"548\" height=\"350\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Radiografin\u0117 diagnostika<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Radiografija vertinga aptinkant kaul\u0173 l\u016b\u017eius ir kai kuriais atvejais \u2013 atskiriant nuo kit\u0173 lig\u0173. Radiogramas tikslinga atlikti tais atvejais, kai \u012ftariami kaul\u0173 l\u016b\u017eiai arba suma\u017e\u0117ja \u016bgis. Konvencin\u0117s radiografijos metodas nejautrus ir nepatikimas vertinant KMT. Jeigu n\u0117ra slankstelio l\u016b\u017eio, radiografija netaikoma OP diagnozuoti.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Gydymas<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Kadangi OP atsiradimo patogenez\u0117 skiriasi, jos gydymas tur\u0117t\u0173 b\u016bti parenkamas individualiai ir nuolat per\u017ei\u016brimas.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Nefarmakologin\u0117 pagalba<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u0160iuo metu si\u016bloma nema\u017eai nefarmakologini\u0173 bei farmakologini\u0173 priemoni\u0173 \u0161iai problemai spr\u0119sti. Vienas svarbiausi\u0173 \u017eingsni\u0173 \u2013 rizikos veiksni\u0173 modifikavimas. Labai svarbu sen\u0105 \u017emog\u0173 skatinti b\u016bti kiek \u012fmanoma aktyvesn\u012f. Jiems rekomenduojami tausojamieji pratimai, tokie kaip vaik\u0161\u010diojimas, pradedant nuo ma\u017eesni\u0173 atstum\u0173 ir po truput\u012f juos didinant.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Kalcio bei vitamino D papildai<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Kalcis bei vitaminas D (vit. D) b\u016btini kaul\u0173 masei palaikyti visais am\u017eiaus laikotarpiais. Senatvin\u0117s OP atveju, kai kaul\u0173 apykaita sul\u0117t\u0117jusi ir d\u0117l kalcio bei vit. D stokos vyksta kaulo ardymas, pasirinktinas vaistas tur\u0117t\u0173 b\u016bti kalcis (Ca) su vitaminu D, o labai sul\u0117t\u0117jus inkst\u0173 filtracijai, \u2013 ir veikl\u016bs vit. D analogai, kurie kepenyse greitai virsta kalcitrioliu. Prie\u0161 pradedant gydyti kaul\u0173 rezorbcijos slopintojais reikia \u012fvertinti kaul\u0173 apykaitos greit\u012f tiriant biocheminius \u017eymenis, o paskyrus vaist\u0173 \u2013 neu\u017eblokuoti kaulo statybos ir \u201ene\u012f\u0161aldyti\u201c kaulo apykaitos.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Ypatingas d\u0117mesys gydant vyresni\u0173 \u017emoni\u0173 OP skiriamas vitaminui D. Jo stoka lemia ne tik kalcio tr\u016bkum\u0105, hiperparatireoz\u0119, osteomaliacij\u0105, bet ir raumen\u0173 silpnum\u0105, o kartu ir padid\u0117jusi\u0105 kritimo ir l\u016b\u017eio rizik\u0105. Seniems \u017emon\u0117ms reikalingas vit. D kiekis svyruoja nuo 400 iki 800 TV, o esant \u0161io vitamino tr\u016bkumui, \u2013 ir dar didesnis kiekis. Didesn\u0117s vit. D doz\u0117s skiriamos tik iki vitamino stokos kompensavimo, nes perdozavimas yra toksi\u0161kas.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Seniems \u017emon\u0117ms, tiek vyrams, tiek moterims, neigiamam Ca balansui koreguoti paprastai reikia per par\u0105 suvartoti 1500 mg Ca su maistu, papildais ar specialiais vaistais. Moterims ir vyrams, vyresniems nei 65 m. am\u017eiaus, Ca ir vit. D papildymas per metus suma\u017eina l\u016b\u017ei\u0173 rizik\u0105 nuo 13 iki 6 proc. Tai \u012frodo, kad vartoti Ca ir vit. D klini\u0161kai svarbu norint sustabdyti kaul\u0173 mas\u0117s ma\u017e\u0117jim\u0105, ypa\u010d senyvo am\u017eiaus \u017emon\u0117ms. Taigi, diagnozavus senatvin\u0119 OP, pirmiausiai reikia u\u017etikrinti pakankam\u0105 Ca (1000\u20131500 mg) ir vit. D (400\u2013800 TV) paros doz\u0119 ir tik gerai \u012fvertinus situacij\u0105, skiriama stipri\u0173 kaul\u0173 rezorbcijos slopintoj\u0173.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Bisfosfonatai<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Bisfosfonatai \u2013 tai pirmiausia prad\u0117ti OP gydyti vartojami preparatai, pasi\u017eymintys antirezorbciniu veikimu. Bisfosfonatai (BF) nus\u0117da ant mineralizuoto kaulo pavir\u0161iaus. J\u012f ardydami osteoklastai tarytum \u201eprisivalgo\u201c BF. Pastarieji sukelia osteoklast\u0173 apoptoz\u0119, taip ma\u017eindami kaulinio audinio ardym\u0105. BF blogai pasisavinami i\u0161 vir\u0161kinamosios sistemos, tod\u0117l reikalaujama juos vartoti ryte nevalgius, u\u017egerti stikline vandens ir, siekiant i\u0161vengti stempl\u0117s pa\u017eeidimo, pusvaland\u012f negulti. Gausi\u0173 ilgalaiki\u0173 klinikini\u0173 tyrim\u0173 metu gauti duomenys byloja, kad BF efektyviai apsaugo nuo l\u016b\u017ei\u0173 ir saugiai gali b\u016bti vartojami ilg\u0105 laik\u0105.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Da\u017eniausiai nepageidaujami BF poveikiai yra vir\u0161utin\u0117s vir\u0161kinamojo trakto dalies pa\u017eeidimai, tokie kaip <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/dispepsija\/4503\">dispepsija<\/a>, <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/ezofagitas\/4453\">ezofagitas<\/a>, <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/gastritas\/4354\">gastritas<\/a>, gastroduodenin\u0117 perforacija, simfonin\u0117s vir\u0161kinamojo trakto opos ar <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kraujavimas\/43826\">kraujavimas<\/a>. I\u0161sivys\u010dius \u0161ioms komplikacijoms, gydymas laikinai nutraukiamas. Atsargiai BF reik\u0117t\u0173 skirti esant vir\u0161kinamojo trakto vir\u0161utin\u0117s dalies patologijai ar \u017emon\u0117ms, vartojantiems proton\u0173 pompos inhibitori\u0173, H2 receptori\u0173 blokatori\u0173 ar nesteroidini\u0173 vaist\u0173 nuo u\u017edegimo. Tokiems \u017emon\u0117ms nepageidaujam\u0173 poveiki\u0173 tikimyb\u0117 yra didesn\u0117.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Da\u017eniausiai ir ilgiausiai (daugiau nei 10 met\u0173) klinikin\u0117je praktikoje vartojami risedronatas ir alendronatas bei neseniai atsirad\u0119s ibandronatas, vartojamas kart\u0105 per m\u0117nes\u012f. Klinikin\u0117je praktikoje diegiami nauji preparatai \u2013 vaist\u0173 bei papild\u0173 nuo osteoporoz\u0117s deriniai, pvz., <i><a href=\"https:\/\/pasveik.lt\/vaistai-paieska\/?srch=Actonel\">Actonel<\/a> Combi<\/i>. Toki\u0173 derini\u0173 nauda \u012frodyta naujausiais klinikiniais tyrimais ir turi neabejotin\u0173 privalum\u0173.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Pakei\u010diamoji hormon\u0173 terapija (PHT)<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">PHT estrogenais gali b\u016bti taikoma OP profilaktikai ir jai gydyti. Gaus\u016bs tyrimai parod\u0117, kad estrogenai (E), prad\u0117ti vartoti pirmaisiais 10 met\u0173 po menopauz\u0117s, suma\u017eino \u0161launikaulio ir stuburo kaul\u0173 mas\u0117s netekim\u0105. Vis daugiau duomen\u0173 rodo, kad b\u016btent ma\u017eos E doz\u0117s efektyviai ma\u017eina kaul\u0173 rezorbcij\u0105 bei kaul\u0173 mas\u0117s netekim\u0105 senyvo am\u017eiaus moterims. Ma\u017eesn\u0117s E doz\u0117s turi ir ma\u017eiau nepageidaujam\u0173 poveiki\u0173 nei \u012fprastin\u0117 PHT. Nors E turi teigiam\u0105 poveik\u012f tam tikroms sistemoms, ta\u010diau j\u0173 nepageidaujami poveikiai bei tam tikros lokalizacijos v\u0117\u017eio rizikos didinimas apribojo E skyrim\u0105 pomenopauz\u0117s am\u017eiaus moterims. Pakei\u010diamoji E terapija net 30 proc. moter\u0173, kurioms nepa\u0161alinta gimda, per metus sukelia endometriumo hiperplazij\u0105, kartais \u2013 endometriumo v\u0117\u017e\u012f. Vartojant E kartu su gestagenas, abiej\u0173 patologij\u0173 da\u017enis labai suma\u017e\u0117ja. Ta\u010diau PHT, kaip parod\u0117 kai kurie tyrimai, yra susijusi su padid\u0117jusia kr\u016bties v\u0117\u017eio rizika, bei \u012frodyta, kad, nutraukus PHT, kaul\u0173 tankis v\u0117l pradeda ma\u017e\u0117ti.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Kalcitoninas<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Tai peptidinis hormonas, vienas i\u0161 kaulinio audinio rezorbcijos inhibitori\u0173. Kadangi vir\u0161kinamajame trakte \u0161is polipeptidas suskaidomas, tod\u0117l skiriamas injekcijomis ar pur\u0161kiamas \u012f nos\u012f. Pur\u0161kiamas \u012f nos\u012f analogas geriau toleruojamas bei turi ma\u017eiau nepageidaujam\u0173 poveiki\u0173 nei injekuojamoji forma. \u012erodyta, jog jis padidina stuburo KMT ir suma\u017eina slanksteli\u0173 l\u016b\u017ei\u0173 kiek\u012f. Kalcitoninas n\u0117ra toks efektyvus nuo l\u016b\u017ei\u0173 kaip BF ar PHT. Tod\u0117l pastarasis preparatas vartojamas ribotai.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Selektyv\u016bs estrogen\u0173 receptori\u0173 moduliatoriai<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Selektyv\u016bs estrogen\u0173 receptori\u0173 moduliatoriai (SERM) pasi\u017eymi estrogeniniu poveikiu tik tam tikriems organams, pvz., kaulams, ir yra alternatyva PHT. Raloksifeno skirti rekomenduojama OP profilaktikai ir jai gydyti tuoj po menopauz\u0117s, kai yra padid\u0117jusi tik stuburo slanksteli\u0173 l\u016b\u017ei\u0173 tikimyb\u0117.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Raloksifenas vartojamas kart\u0105 per dien\u0105, neatsi\u017evelgiant \u012f paros laik\u0105 ir valg\u012f. Jo vartojant suma\u017e\u0117ja rizika sirgti estrogen\u0173 receptori\u0173 teigiamu kr\u016bties v\u0117\u017eiu ir ma\u017e\u0117ja kardiovaskulini\u0173 \u012fvyki\u0173.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Parathormonas<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Prieskydini\u0173 liauk\u0173 hormonas nuo seno klinicistams \u017einomas kaip stiprus kaulo ardytojas. Pasirodo, \u0161io hormono 1\u201334 aminor\u016bg\u0161\u010di\u0173 dalis, tiesiogiai veikdama osteoblastus, labai didina vis\u0173 kaul\u0173 KMT ir ma\u017eina stuburo slanksteli\u0173 ir kit\u0173 kaul\u0173 l\u016b\u017ei\u0173 skai\u010di\u0173. Vaistas pasirod\u0117 ypa\u010d efektyvus dauginiais l\u016b\u017eiais komplikuotai OP gydyti, kai gydymas BF buvo neveiksmingas. Teriparatido skiriama po oda kart\u0105 per dien\u0105. Leistina gydymo trukm\u0117 JAV \u2013 24 m\u0117nesiai, Europoje \u2013 18 m\u0117nesi\u0173. Trukm\u0117 apribota, kai klinikini\u0173 tyrim\u0173 su pel\u0117mis metu buvo pasteb\u0117ti keli dideli\u0173 teriparatido dozi\u0173 sukeltos kaul\u0173 sarkomos atvejai. \u0160iandien tai kol kas pats veiksmingiausias medikamentas labai progresavusiai, dauginiais l\u016b\u017eiais komplikuotai OP gydyti.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Stroncio ranelatas<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u0160is vaistas priskiriamas medikament\u0173 grupei, veikian\u010diai tiek osteoblastus, \u2013 skatina j\u0173 dauginim\u0105si ir subrendim\u0105, tiek ir osteoklastus \u2013 slopina j\u0173 dauginim\u0105si ir aktyvum\u0105. Taip kaulas ma\u017eiau ardomas, formuojamas naujas, kokybi\u0161kas kaulas. \u0160is medikamentas palankiai veikia tiek trabekulin\u012f, tiek kortikalin\u012f kaulo sluoksn\u012f. Klinikini\u0173 tyrim\u0173 metu patvirtinta, kad stroncio ranelato vartojimas suma\u017eina tiek stuburo slanksteli\u0173, tiek periferini\u0173 kaul\u0173 l\u016b\u017ei\u0173 skai\u010di\u0173. Vaisto vartojimo forma: 2 g miltuk\u0173 i\u0161tirpinama vandenyje ir geriama kiekvien\u0105 dien\u0105.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u0160iuo metu bisfosfonatai \u2013 tai pirmiausia pasirenkami vaistai osteoporozei gydyti.<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Vyr\u0173 osteoporoz\u0117s gydymo ypatumai<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Labai ma\u017eai yra duomen\u0173 apie s\u0117kming\u0105 vyr\u0173 OP gydym\u0105 bei profilaktik\u0105. Adekvatus Ca bei vit. D kiekis bei fizinis aktyvumas yra senyvo am\u017eiaus vyr\u0173 OP gydymo bei profilaktikos programos dalis. Ca balansui palaikyti vyras turi suvartoti apie 900 mg kalcio per dien\u0105. Kaulo rezorbcij\u0105 slopinan\u010di\u0173 vaist\u0173 efektyvumas OP sergantiems vyrams n\u0117ra pakankamai i\u0161tirtas. Antrin\u0117s osteoporoz\u0117s gydymas remiasi ligos, suk\u0117lusios kaul\u0173 mas\u0117s ma\u017e\u0117jim\u0105, gydymu.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><i><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 9.0pt;\">\u00a0<\/span><\/i><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><i><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 9.0pt;\">Pareng\u0117 gyd. R\u016bta Nutautien\u0117<\/span><\/i><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><i><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 9.0pt;\">Kauno medicinos universitetas<\/span><\/i><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify;\"><i><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 8.0pt;\">(Literat\u016bros s\u0105ra\u0161as \u2013 redakcijoje)<\/span><\/i><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">\u017durnalas \u201cGydymo menas\u201d<\/span><\/p>\n<p>\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">Osteoporoz\u0117 \u2212 tai progresuojanti sistemin\u0117 skeleto liga, kuriai b\u016bdingas kaul\u0173 mas\u0117s ma\u017e\u0117jimas, j\u0173 mikrostrukt\u016bros pakitimai, d\u0117l kuri\u0173 kaulai pasidaro trap\u016bs ir lengvai sul\u016b\u017eta. Osteoporoz\u0117 ir jos komplikacij\u0173 labai da\u017enai pasirei\u0161kia pagyvenusiems \u017emon\u0117ms. \u0160launikaulio, dilbio ar stuburo kompresiniai l\u016b\u017eiai seniems \u017emon\u0117ms da\u017enai sukelia negali\u0105 ir mirt\u012f. Tod\u0117l osteoporoz\u0117 tampa labai rimta <b>civilizacijos problema.<\/b><\/span><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[27313],"tags":[689,7643,548,1347,791,8049,259,24,24771,60,6175,138],"site":[],"post_item_type":[27345],"class_list":["post-11824","post","type-post","status-publish","format-standard","hentry","category-gydymo-naujienos","tag-diagnostika","tag-hormonas","tag-kalcis","tag-kaulas","tag-mases","tag-osteoporoze","tag-preparatai","tag-profilaktikai","tag-score","tag-terapija","tag-tikimybe","tag-vaistai"],"acf":{"post_sites":false},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/11824","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/comments?post=11824"}],"version-history":[{"count":0,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/11824\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/media?parent=11824"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/categories?post=11824"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/tags?post=11824"},{"taxonomy":"site","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/site?post=11824"},{"taxonomy":"post_item_type","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/post_item_type?post=11824"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}