肺癌合并尘肺患者行放疗及其BMD、BGP含量测定的临床观察  

The clinical observation of the conformal radiotherapy for patients with lung cancer and pneumoconiosis and the determination of BMD,BGP

作　　者：郭海[1] 解春生[1] 王媛媛[1] 陈奇[1] 方砚华[1] 刘立华[1] 孙晓伟[1] 

机构地区：[1]北京房山区第一医院,北京102400

出　　处：《中国骨质疏松杂志》2013年第2期164-165,134,共3页Chinese Journal of Osteoporosis

摘　　要：目的观察肺癌合并尘肺患者的血清骨钙素(BGP)和骨密度(BMD)放疗前后含量的变化与继发性骨质疏松发生发展的关系,以改进临床工作,提高患者的生活质量。方法对肺癌合并尘肺患者30例及30例健康对照组均采用放射免疫法检测血清BGP,用双能X线吸收检测BMD,用SMAC技术检测血清ALP、Ca、P等,肺癌患者采用美国瓦里安1800加速器体外照射1 f/d,2 Gy/f,剂量55～65 Gy。结果肺癌合并尘肺患者放疗前BMD、BGP较对照组明显降低,两者比较有显著性差异,P<0.01。ALP增高,P<0.05。血Ca、P没有明显差异。结论肺癌合并尘肺患者BMD和BGP改变的临床意义:肺癌放疗前BMD、BGP降低,ALP增高,缓解期可逆转与肺癌合并尘肺病情基本一致,尤其是中晚期肺癌患者胃肠功能紊乱,放疗前影响钙代谢,而钙代谢异常加重了病情,因此肺癌合并尘肺患者定期检测BMD、BGP和ALP,在放疗的同时注意肺癌患者伴骨质疏松存在的风险,以便能够得到早治疗早预防的目的,对他们以后的生活至关重要。Objective To observe the changes of serum osteocalcin （BGP） and bone mineral density （BMD） in patients with lung cancer and pneumoconiosis before and after radiotherapy, and to investigate the relationship between the changes and the development of secondary osteoporosis, in order to improve clinical practice and the life quality of the patients. Methods Thirty patients with lung cancer and pneumoconiosis and 30 healthy controls were selected. Serum BGP of all the subjects was detected using radioimmunoassay. BMD was detected using dual energy X-ray absorptiometry. Serum ALP, Ca, and P was detected using SMAC. Patients with lung cancer received the external irradiation （If/d, 2Gy/f, total dose 55 -65Gy） using Varian 1800 accelerator. Results BMD and BGP of the patients with lung cancer and pneumoconiosis before the radiotherapy was significantly lower than those in control group, and the difference was significant （ P 〈 0.01 ）. Serum ALP was increased （ P 〈 0.05 ）. Serum Ca and P had no significant difference with that in control group. Conclusion The clinical significance of the change of BMD and BGP in patients with lung cancer and pneumoconiosis： the decrease of BMD and BGP and the increase of ALP before the radiotherapy are reversed in the alleviating period, which is in accordance with the situation of pneumoconiosis and lung cancer. Especially in patients with advanced lung cancer, who have gastrointestinal disorders, the abnormal calcium metabolism aggravates the disease. So BMD, BGP, and ALP in patients with lung cancer and pneumoconiosis should be detected regularly. The risk of osteoporosis related to radiotherapy in patients with lung cancer should be noticed, in order to prevent and treat osteoporosis at an early stage, which is essential for their future life.

关 键 词：肺癌合并尘肺 骨钙素 骨密度 骨质疏松 

分 类 号：R45[医药卫生—治疗学]