A health program to prevent a patient who received a gastrectomy from bone metabolism disorder

本研究的目的是了解胃切除术后骨代谢障碍的影响，以及饮食生活和体力活动对骨密度的影响，为预防骨质疏松症的生活方式教育提供基本信息。研究对象为39名在A、B两所医学院被诊断为胃癌并接受过胃切除术的80岁及以下男性患者。所有受试者均表示知情同意。骨代谢参数ALP3、BAP、DPD、NTX、代偿性钙的测定通过骨细胞密度测定、超声密度仪检测骨代谢受损程度。体力活动用步数测量，饮食生活用问卷调查。两所医学院的骨代谢受损指标SOS值在胃切除术后3周均有下降。虽然SOS值恢复了一次，但它似乎减少了…六个月后又有更多的E。术后恢复至术前水平。在A医学院，成骨标记物ALP3和BAP在术后3周显著下降，3个月后升高。骨吸收标志物DPD水平显著升高。B医学院患者术后3周ALP3、BAP水平明显下降，3个月后升高。胃切除后3周，DPD水平显著升高，3个月后显著下降。胃切除术后NTX水平呈随时升高趋势，术后1年较术前显著升高。在这两所大学中，体力活动和饮食生活对骨密度的影响没有得到承认。虽然胃切除术后3周出现骨代谢障碍，但骨吸收后的骨形成过程受个体差异的影响。较少

The aim of this study is to examine effects of bone metabolism impairment after a gastrectomy, and the effects of dietary life and physical activity on bone density, in order to obtain basic information for education regarding lifestyle which prevent osteoporosis.The study subjects were 39 male patients aged 80 years old or less who had been diagnosed as having gastric cancer in A and B medical colleges and had received a gastrectomy. All subjects gave their informed consent. The level of the bone metabolism impairment was examined by bone cell density measurement, by ultrasound densitometer and measurement of bone metabolism parameters, i.e. ALP_3, BAP, DPD, NTx, compensation Ca. Physical activity was measured by the number of steps, and dietary life was investigated using a questionnaire.In both medical colleges, the SOS value, which is an index to the bone metabolism impairment, decreased three weeks after the gastrectomy. Although the SOS value recovered once, it appears to decreas … More e after sixth months again. Afterwards, it recovered to the preoperative level. In A medical college, the levels of ALP_3 and BAP, which are the osteogenesis markers, significantly decreased 3 weeks after gastrectomy and increased three months later. DPD level, which is a bone resorption marker, increased significantly. In B medical college, the levels of ALP_3 and BAP significantly decreased three weeks after gastrectomy, and increased three months later. However, DPD level significantly increased three weeks after gastrectomy, and significantly decreased after three months. NTx levels showed a tendency to increase at anytime after gastrectomy and significantly increased one year later compared with preoperative level. In both universities, the effect of physical activity and dietary life on the bone density was not recognized. Though the bone metabolism impairment appeared 3 weeks after the gastrectomy, the bone formation process after bone resorption was affected by individual differences. Less