Reyes-García R, Rozas-Moreno P, Muñoz-Torres M
Unidad de Metabolismo Óseo, Servicio de Endocrinología, Hospital Universitario San Cecilio, Granada, España.
Rev Clin Esp. 2012 Apr;212(4):188-92. doi: 10.1016/j.rce.2011.06.006. Epub 2011 Jul 27.
A 60-year-old man, who did administrative work, consulted for evaluation of the presence of osteoporosis. He smoked ten cigarettes a day and drank alcohol occasionally. Eight years ago he suffered a Colle's fracture in his right arm after an incidental fall, which resolved without complications. His mother had a hip fracture when she was 78 years old. The patient weighed 89.4 kg and his height was 165 cm (BMI 38 kg/m(2)). The DXA showed a T-score -2.4 at lumbar spine and -1.9 at femoral neck. He had suffered a myocardial infarction one year ago and is presently taking statin, a beta-blocker and enalapril. In summary, this is a male with a background of fracture due to fragility, with lumbar BMD close to those established as diagnostic of osteoporosis and he also has cardiovascular disease. How should this patient be evaluated and treated?
一名60岁从事行政工作的男性前来咨询评估骨质疏松症情况。他每天吸10支烟，偶尔饮酒。8年前，他偶然摔倒后右臂发生科雷氏骨折，骨折愈合且无并发症。他的母亲在78岁时发生过髋部骨折。患者体重89.4千克，身高165厘米（BMI为38千克/米²）。双能X线吸收法（DXA）显示腰椎T值为-2.4，股骨颈T值为-1.9。他一年前曾发生心肌梗死，目前正在服用他汀类药物、β受体阻滞剂和依那普利。总之，这是一名有脆性骨折史的男性，腰椎骨密度接近诊断骨质疏松症的标准，并且他还有心血管疾病。该如何对这名患者进行评估和治疗？
