Legrand E, Le Levier F, Chappard D, Audran M
Service de rhumatologie, CHU, Angers.
Rev Prat. 1994 Jun 15;44(12):1563-8.
Careful examination as well as biochemical and hormonal investigations should be performed in men suffering from vertebral crush fractures, in order to detect a destructive skeletal process (multiple myeloma, bone metastatic lesions, lympho and myeloproliferative disorders), a mineralization defect (osteomalacia) or a secondary osteoporosis: primary hyperparathyroidism, hypogonadism, hyperthyroidism, renal hypercalciuria, alcoholism and tobacco smoking. The diagnosis of idiopathic osteoporosis should be made only after these causes have been excluded; the pathogenesis of the disease is unclear but risk factors have been identified: family history of osteoporosis, low dietary calcium intake, delayed puberty, ethanol use, tobacco smoking, inactive lifestyle and lean body build. Correction of risk factors, calcium supplementation, regular program of weight bearing physical activity, in some instances correction of testosterone deficiency may be of benefit to reduce bone loss. Severe osteopenia or osteoporosis may require sodium fluoride therapy.
对于患有椎体压缩性骨折的男性，应进行仔细检查以及生化和激素检查，以检测是否存在破坏性骨骼疾病（多发性骨髓瘤、骨转移瘤、淋巴和骨髓增殖性疾病）、矿化缺陷（骨软化症）或继发性骨质疏松症：原发性甲状旁腺功能亢进、性腺功能减退、甲状腺功能亢进、肾性高钙尿症、酗酒和吸烟。只有在排除这些病因后，才能诊断为特发性骨质疏松症；该病的发病机制尚不清楚，但已确定了风险因素：骨质疏松症家族史、饮食中钙摄入量低、青春期延迟、饮酒、吸烟、久坐不动的生活方式和消瘦体型。纠正风险因素、补充钙、定期进行负重体育锻炼，在某些情况下纠正睾酮缺乏可能有助于减少骨质流失。严重的骨质减少或骨质疏松症可能需要氟化钠治疗。
