维生素D缺乏性骨软化症一例  

Osteomalacia induced by vitamin D deficiency: a case report

作　　者：马池发 李响 李伟 平凡 张化冰 夏维波 邢小平 许岭翎 李玉秀 MA Chi-fa;LI Xiang;LI Wei;PING Fan;ZHANG Hua-bing;XIA Wei-bo;XING Xiao-ping;XU Ling-ling;LI Yu-xiu(Department of Endocrinology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Key Laboratory of Endocrinology of National Health Commission of the People s Republic of China,Beijing 100730,China)

机构地区：[1]中国医学科学院/北京协和医学院/北京协和医院内分泌科/国家卫生健康委员会内分泌重点实验室,北京100730

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2020年第4期357-361,共5页Chinese Journal Of Osteoporosis And Bone Mineral Research

摘　　要：成人维生素D缺乏导致骨软化症相对少见,易被误诊、误治。本文报道1例中年男性,以骨痛、乏力、活动受限就诊,生化提示血钙、血磷降低,尿钙偏低,碱性磷酸酶升高、维生素D缺乏,骨骼X线提示肋骨假骨折及椎体轻度双凹变。追问病史,本例患者长期保持不良的生活方式,导致维生素D的摄入与合成显著不足。予钙剂及维生素D补充,嘱规律作息、改善生活方式,患者症状明显好转出院。本文在复习相关文献的基础上探讨成人骨软化症的病因、鉴别诊断及治疗,以期为临床诊治提供参考。Osteomalacia induced by vitamin D deficiency was less common among adults,which was easy to be misdiagnosed and mistreated.Here we reported a middle-aged man presented with skeletal pain,weakness,and physical limitation.The biochemical parameters were manifested as hypocalcemia,hypophosphatemia,decreased urinary calcium,elevated alkaline phosphatase,and vitamin D deficiency.Bone X-ray revealed pseudofractures at the ribs and mild biconcave deformity of vertebra.Long-term unhealthy lifestyle associated with inadequate dietary intake of vitamin D and inadequate vitamin D synthesis was revealed by further inquiries about medical history.By vitamin D and calcium supplementation and improvement of lifestyle,the symptoms improved obviously and the patient was discharged from hospital.We explore the etiology,differential diagnosis,and treatment of osteomalacia in adults based on review of the relevant literatures,in order to provide reference for clinical diagnosis and treatment.

关 键 词：骨软化症 维生素D缺乏 生活方式 

分 类 号：R681[医药卫生—骨科学]