双膦酸盐治疗骨转移癌骨痛及对血清钙磷的影响  

The effect of zoledronic and pamidronate acid in treating bone pain in bone metastases of malignant tumor and its impact on serum calcium and phosphorus

作　　者：王妹兴[1] 戴月娣[1] 陶莉[1] 李安琪[1] 江联萍[1] 肖谜[1] 杨梅[1] 

机构地区：[1]复旦大学附属肿瘤医院闵行分院,上海200240

出　　处：《中国癌症杂志》2010年第11期842-846,共5页China Oncology

摘　　要：背景与目的：恶性肿瘤骨转移发生率有上升趋势,双膦酸盐已广泛应用于治疗骨转移癌.本研究旨在评价唑来膦酸与帕米膦酸治疗骨转移癌骨痛及对血清钙磷的影响.方法：对病理及影像确诊的100例骨转移癌患者分别使用唑来膦酸或帕米膦酸进行治疗,评价患者治疗1、2个月后疼痛缓解情况及血清钙、磷变化.结果：双瞵酸盐治疗1、2个月后,疼痛较前无明显变化（P＞0.05）,双膦酸盐治疗后中度疼痛似有下降趋势（x2=3.48,P=0.062）.骨转移癌患者血钙和血磷间存在直线正相关关系.双膦酸盐治疗1个月后,低钙血症的发生率为54%,治疗2个月后的发生率（56%）较治疗前（36%）显著增加（x2=6.55,P=0.011;x2=8.05,P=0.005）.治疗1个月后,血钙、血磷较治疗前显著降低（t=4.39,P=0.000;t=2.50,P=0.014）;治疗2个月后,血钙、血磷较治疗前仍低（t=4.32,P=0.000;t=2.49,P=0.010）.唑来膦酸和帕米膦酸相比,对骨痛缓解及血钙、血磷、碱性磷酸酶的影响差异无统计学意义（P＞0.05）.结论：唑来膦酸与帕米膦酸能缓解骨转移癌患者骨痛,引起低钙血症,打破原有钙磷相关关系.唑来膦酸与帕米膦酸比较对骨痛缓解及血钙、血磷及碱性磷酸酶的影响差异无统计学意义.Background and purpose： Bisphosphonates were widely used due to the rapidly increasing rate of bone metastases of malignant tumors. The aim of this study was to evaluate zoledronic and pamidronate acid therapy used for bone metastases of malignant tumors, and its effect on bone pain, serum calcium and phosphorus level. Methods： One hundred bone metastases cancer patients were diagnosed using pathological and imaging methods. After zoledronic or pamidronate acid intravenous infusion 1 and 2 months, ostealgia degree, serum calcium and phosphorus were observed respectively. Results： Ostealgia degree did not change after diphosphonate treatment at either 1 or 2 months （P〉0.005）. There was a linear correlation between serum calcium and phosphorus levels in bone metastases cancer patients before therapy and dismissed after therapy. The incidences of hypocalcium after 1 month （54%） and 2 months （56%） of diphosphonate treatment were more than those before the initial treatment （36%） （2,2=6.55, P=0.011; χ2=8.05, P=0.005）. Serum calcium and phosphorus decreased after 1 month （t=-4.39, P=0.000; t=-2.50, P=0.014） and 2 months of treatment （t=4.32, P=0.000; t=2.49, P=0.010）. There were no differences between the zoledronic and pamidronate acid groups in terms of ostealgia and serum calcium and phosphorus levels. Conclusion.. Zoledronic and pamidronate acid can relieve bone pain in bone metastases cancer patients and can also induce hypocalcium, break the relationship between calcium and phosphorus. There were no differences between zoledronic and pamidronate acid in treating bone pain and inducing hypocalcium and hypophosphorus.

关 键 词：唑来膦酸 帕米膦酸 骨痛 钙 磷 

分 类 号：R730.53[医药卫生—肿瘤]