芳香化酶抑制剂治疗乳腺癌患者的骨密度研究 _药学论文.docVIP

芳香化酶抑制剂治疗乳腺癌患者的骨密度研究 _药学论文 芳香化酶抑制剂治疗乳腺癌患者的骨密度研究 _药学论文 【摘要】 目的 探讨芳香酶抑制剂治疗对绝经后乳腺癌患者骨密度水平的影响。方法 采用法国CHALLENGER公司双能X 线骨密度仪，测定35例应用芳香酶抑制剂治疗和33例同年龄段应用安慰剂治疗的乳腺癌患者腰椎(L2～4)及左髋部骨密度值。结果 (1) 芳香酶抑制剂治疗组腰椎骨密度（BMD）较对照组明显降低,差异具有极显著性(0.01);而左侧整体髋BMD也较对照组降低，两组差异有显著性（0.05）。(2) 两组患者骨量减少的发生率均占绝大多数,其次为骨质疏松的发生率。芳香酶抑制剂治疗组患者骨量减少和骨质疏松的发生率均高于对照组,但差异无显著性（Pgt;0.05）。结论 绝经后乳腺癌患者不同程度地存在骨量减少和骨质疏松，芳香酶抑制剂治疗可使乳腺癌患者BMD 明显下降，对接受芳香酶抑制剂治疗乳腺癌患者, 定期BMD监测和预防性的骨质疏松治疗是必要的。 【关键词】 乳腺癌;内分泌治疗;芳香酶抑制剂；骨质疏松; 骨密度 Study of bone mineral density in women with breast cancer undergoing aromatase inhibitors treatment 【Abstract】 Objective To evaluate the effects of aromatase inhibitors(AIs) on bone mineral density in women with breast cancer. Methods Using dual-energy X-ray absorptiometry, bone mineral density in lumbar spine and left fhip were measured in 35 women with breast cancer receiving adjuvant treatment with AIs and 33 age-matched women with breast cancer receiving placebo treatment.　Results (1) In comparison to the reference group, the women with AIs treatment had significantly lower lumber spine BMD value (0.01) and left total hip BMD value (0.05). (2) The majority of women allocated in two groups suffered from osteopenia or osteoporosis. Although the morbidity of osteopenia and osteoporosis in AIs group was higher than that in the reference group, there were no significant differences between two groups (Pgt;0.05).　Conclusion Pre-existing osteopenia and osteoporosis are common in post menopausal women with breast cancer. The use of aromatase inhibitors in treatment of breast cancer could significantly decrease bone mineral density, and monitoring the BMD with the use of anti-osteoporotic therapies is necessary for women with breast cancer receiving aromatase inhibitors treatment. 【Key words】 breast cancer; endocrine treatment; aromatase inhibitors; osteoporosis; bone mineral density 乳腺癌是女性常见的恶性肿瘤之一，在全世界范围内，乳腺癌的发病率和死亡率均呈上升趋势，且发病越来越年轻化，严重危害妇女健康［1］。乳腺癌的治疗以手术切除为主，辅助治疗有放疗、化疗、内分泌疗法和免疫疗法等，近年来，乳腺癌内分泌治疗受到了越来越多的重视。有关乳腺癌内分泌治