青年男性-多椎体压缩性骨折-身高变矮-腰痛  

Young man-multiple vertebral compressive fractures-shorter stature-back pain

作　　者：刘家怡 林小云 刘继东 胡静 姜艳 王鸥 邢小平 夏维波 李梅 LIU Jia-yi;LIN Xiao-yun;LIU Ji-dong;HU Jing;JIANG Yan;WANG Ou;Xing Xiao-pin;XIA Wei-bo;LI Mei(Department of Endocrinology,Key Laboratory of Endocrinology of National Health Commission,Peking Union Medical College Hospital,Chinese academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;Department of Endocrinology,Qilu Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250012,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 [2]山东大学齐鲁医学院、齐鲁医院内分泌科,济南250012

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2022年第5期517-522,共6页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：国家重点研发计划(2018YFA0800801,2021YFC2501704);国家自然科学基金面上项目(81873668,82070908);北京市自然科学基金(7202153);中国医学科学院医学与健康科技创新工程项目(2021-I2M-C&T-B-007,2021-I2M-1-051)。

摘　　要：男性骨质疏松症常常被忽视,其诊断和治疗面临挑战。本文报道1例34岁青年男性,轻微外力下发生多椎体压缩性骨折,身高明显变矮,行骨科手术治疗,术后予唑来膦酸、维生素D和钙剂治疗6个月,仍明显腰背痛。经过细致病史采集和体格检查,完善实验室检查、X线平片、骨密度、骨扫描等检查,发现患者存在重度骨质疏松,且具有幼年反复骨折史、蓝巩膜,经基因检测,最终确诊为成骨不全症。本例疑难病例分析表明,对于成年多发骨折患者,要重视病史挖掘和鉴别诊断,不要忽略对成骨不全症等遗传性骨病的诊断和治疗。Osteoporosis is usually neglected in man,and the diagnosis and treatment are of challenge.We report a young man with multiple vertebral compression fractures under low trauma and significantly shorter stature.After orthopedic surgery and receiving treatment of zoledronic acid,vitamin D,and calcium for 6 months,he still suffered from back pain.With careful medical history collection and physical examination,laboratory tests,X-ray films,bone mineral density measurements,bone scan,and other examinations,the patient was found to have severe osteoporosis.However,he has fractures history in childhood and blue sclera.The diagnosis of osteogenesis imperfecta is confirmed by genetic identification.The analysis of this intractable case indicates that for adults with multiple fractures,collecting medical history and differential diagnosis should be completed in detail,and hereditary bone diseases,such as osteogenesis imperfecta,should not be forgotten.

关 键 词：多椎体压缩性骨折 继发性骨质疏松症 成骨不全症 

分 类 号：R681[医药卫生—骨科学]