芳香化酶抑制剂对绝经后乳腺癌患者骨折的影响  

The effect of aromatase inhibitors on bone fractures in postmenopausal patients with breast cancer

作　　者：徐露[1] 王珏[1] 薛旦旦[1] 何畏[1] 

机构地区：[1]南京医科大学第一附属医院乳腺外科,南京210029

出　　处：《中国骨质疏松杂志》2012年第3期269-272,280,共5页Chinese Journal of Osteoporosis

摘　　要：目的探讨芳香化酶抑制剂(aromatase inhibitors,AI)对绝经后乳腺癌患者骨折发生的影响。方法选择接受AI治疗的绝经后乳腺癌患者70例为治疗组,未接受任何内分泌治疗的绝经后乳腺癌患者89例为对照组。收集骨折相关资料,并以5年用药期为界,比较两组患者骨折发生率及风险。同时,在治疗组患者中,分析相关临床风险因素对骨折发生的影响。结果治疗组和对照组患者总骨折发生率分别为12.86%(9/70)和1.12%(1/89),5年用药期间的骨折发生率分别为10.00%(7/70)和1.12%(1/89),5年用药期过后,治疗组8例患者中有2例发生骨折,而对照组19例患者无一例发生骨折。治疗组患者的骨折发生率均高于对照组(P=0.003,0.018,0.026)。治疗组患者总骨折发生风险和5年用药期间的骨折发生风险高于对照组(P=0.008,0.026)。治疗组患者中,个人骨折史和骨折家族史是增加骨折发生的临床风险因素。结论接受AI治疗的绝经后乳腺癌患者的骨折发生率和骨折发生风险明显增加。因此,绝经后乳腺癌患者在使用AI防治乳腺癌时,要全面评估骨折发生的风险,必要时应采取有效的临床干预措施。Objective To explore the effect of aromatase inhibitors（AI） on bone fractures in postmenopausal patients with breast cancer.Methods Seventy postmenopausal patients with breast cancer accepting AI therapy were selected as treatment group and 89 postmenopausal patients with breast cancer without any endocrine therapy were observed as control group.Bone fracture information was collected.The incidence and risk of fracture in the two groups were compared in a 5-year interval.At the same time,the effects of some clinical risk factors on the fracture were also analyzed in the treatment group.Results The overall incidence of bone fractures in the treatment and control group were 12.86%（9/70） and 1.12%（1/89）,respectively.During the 5 years,the incidence of the fracture in the treatment group and control group were 10.00%（7/70） and 1.12%（1/89）,respectively.After the 5 years,2 patients in the treatment group got fracture.However,none was found in the control group.The incidence of the fracture in the treatment group was higher than that in the control group（P=0.003,0.018,0.026）.The overall fracture risk and 5-year treatment period fracture risk in treatment group were higher than that in control group（P=0.008,0.026）.The previous bone fracture history and family history of bone fracture were two clinical risk factors for bone fractures in the treatment group.Conclusion The incidence and risk of bone fractures increase in the postmenopausal patients with breast cancer treated with AI.Therefore,a comprehensive assessment of fracture risk is needed for the postmenopausal patients with breast cancer and AI treatment,and the effective clinical intervention should be provided when necessary.

关 键 词：骨折 芳香化酶抑制剂 绝经后乳腺癌 

分 类 号：R45[医药卫生—治疗学]