Marcelli C
Service de rhumatologie, Hôpital Lapeyronie CHU, Montpellier.
Rev Prat. 1995 May 1;45(9):1125-32.
Although primary osteoporosis is much more frequent than other diseases associated with osteopenia, the diagnosis of idiopathic osteoporosis should be made only after the causes of secondary osteoporosis have been excluded. Indeed, therapeutic efficiency in secondary osteoporosis depends mainly on the concomitant treatment of the actual cause of osteopenia. Glucocorticoid-induced osteoporosis is the commonest form of secondary osteoporosis, mainly for doses of prednisone of 0.1 mg/kg/day or greater. Hypogonadism in men and women, idiopathic hypercalciuria and chronic alcoholism in men are other frequent causes of osteopenia. The diagnosis of secondary osteoporosis is based on careful examination as well as biochemical and hormonal investigations. Together with the treatment of the associated disease, correction of other risk factors, calcium supplementation, and a regular program of weight-bearing physical activity may be of benefit to reduce bone loss. As fluoride is able to stimulate bone formation, it is an effective agent in the treatment of glucocorticoid or alcohol-induced osteoporosis.
虽然原发性骨质疏松症比其他与骨质减少相关的疾病更为常见，但只有在排除继发性骨质疏松症的病因之后，才能做出特发性骨质疏松症的诊断。事实上，继发性骨质疏松症的治疗效果主要取决于对骨质减少实际病因的同步治疗。糖皮质激素性骨质疏松症是继发性骨质疏松症最常见的形式，主要发生于泼尼松剂量达到或超过0.1mg/kg/天的情况。男性和女性的性腺功能减退、男性特发性高钙尿症和慢性酒精中毒是骨质减少的其他常见病因。继发性骨质疏松症的诊断基于仔细的检查以及生化和激素检查。除了治疗相关疾病外，纠正其他危险因素、补充钙剂以及定期进行负重体育活动可能有助于减少骨质流失。由于氟化物能够刺激骨形成，它是治疗糖皮质激素或酒精性骨质疏松症的有效药物。
