不同治疗方法对绝经后乳腺癌患者骨密度的影响  

Effects of different adjuvant therapies on bone mineral density in postmenopausal women with breast cancer

作　　者：万颖[1] 邹德环[1] 朱旭生[1] 佘立群[1] 李镜发[1] 

机构地区：[1]广州医学院附属广州市第一人民医院核医学科,510180

出　　处：《中华生物医学工程杂志》2009年第2期112-114,共3页Chinese Journal of Biomedical Engineering

摘　　要：目的探讨不同治疗方法对绝经后乳腺癌患者骨密度（BMD）的影响。方法研究分为健康对照组（50例）、肿瘤组[48例，其中24例再行他莫昔芬（TAM）组治疗]。采用双能X线骨密度仪（DEXA）测定所有研究对象的基线BMD。肿瘤组术后均进行辅助化疗，其中24例（TAM组）化疗后继续使用TAM行内分泌治疗。用DEXA测量腰椎和左髋部位的BMD，比较肿瘤组化疗前、后以及TAM组行内分泌治疗8个月后BMD变化。结果肿瘤组化疗后腰椎部位BMD（0．87±0．15）g/cm^2比化疗前（0．93±0．15）g／cm^2明显降低（P〈0．05）；TAM组行内分泌治疗8个月后腰椎BMD（0．90±0．04）g／cm^2和股骨颈（0．74±0．05）g／cm^2等左髋部位的BMD均有明显增加（P〈0．05）。结论化疗可能导致绝经后乳腺癌患者BMD的下降，而TAM治疗能缓解化疗引起的BMD降低。Objective To investigate the effects of different adjuvant therapies on bone mineral density（BMD） in postmenopausal women with breast cancer. Methods Forty-eight postmenopausal women with breast cancer and 50 healthy postmenopausal women were enrolled in this study. Patients with breast cancer received chemotherapy, and 24 cases of them received tamoxifen therapy after chemotherapy. BMD of all the people was measured by dual-energy X-ray absorptiometry （DEXA） at base line. BMD results of lumbar vertebrae and hip joint of all the patients before and after chemotherapy were compared, and the changes of BMD after 8 months tamoxifen therapy in 24 patients were evaluated. Results BMD after chemotherapy （n=48） significantly decreased at lumbar vertebrae [ （0.87 ± 0.15） g/cm^2 vs （0.93 ± 0.15） g/cm^2, P〈0.05] , BMD of the patients after 8 months tamoxifen therapy increased at lumber vertebrae , femoral neck and others of hip joint [ （0.90±0.04） g/cm^2, （0.74±0.05） g/cm^2, P〈0.05]. Conclusions The adjuvant chemotherapy can reduce BMD of the postmenopausal women with breast cancer. But bone loss can be attenuated by tamoxifen treatment.

关 键 词：乳腺肿瘤 药物疗法 联合 骨密度 他莫昔芬 骨质疏松 

分 类 号：R737.9[医药卫生—肿瘤]