雄激素剥夺治疗对老年前列腺癌患者骨量丢失的影响  

The influence of androgen deprivation therapy on the bone loss in elderly patients with prostate cancer

作　　者：吴燕华[1] 方晓武[1] 余枫[1] 刘伟[1] 胡文学[1] 郝文科[1] 

机构地区：[1]广州广东省人民医院东病区,广东510080

出　　处：《国际泌尿系统杂志》2015年第4期516-519,共4页International Journal of Urology and Nephrology

摘　　要：目的了解雄激素剥夺治疗（andmgen deprivation therapy，ADT）对老年前列腺癌患者骨量丢失的影响。方法选取36例接受ADT（至少半年）的前列腺癌患者为ADT组及22例口服非那雄胺治疗（至少半年）的良性前列腺增生患者为非ADT组。两组患者在治疗前后均完善血钙、血磷、血清白蛋白、糖化血红蛋白（Glib）、碱性磷酸酶（ALP）、血肌酐（Cr）、前列腺特异性抗原（PSA）、睾酮、雌二醇（E2）等基础资料检测，并在治疗后进行骨密度（bone mineral density，BMD）的测定，使用随机提供的T值作为参照标准对骨质疏松进行诊断。结果ADT组治疗后睾酮明显下降，与ADT前及非ADT组差异有统计学意义（P〈0．01）；ADT组BMD较非ADT组低，在全身骨成分、腰椎（L1—4）、前臂骨两组BMD差异有统计学意义（P〈0．05），股骨颈BMD在ADT组较非ADT组低，但差异不明显（P〉0．05）；ADT组骨质疏松发生率为50．0％，非ADT组为22．7％，两组有统计学差异（P〈0．05）。结论ADT可能加快老年前列腺癌患者骨量丢失，使骨质疏松的发生率升高。在对前列腺癌患者采取去势治疗前，建议先完善BMD的测定，对有明显骨量丢失或有高骨质风险的患者，建议采取适当的干预措施，以减缓骨量丢失。Objectives To study the influence of androgen deprivation therapy（ADT） on the bone loss in elderly patients with prostate cancer. Methods 36 patients with prostate cancer who accepted ADT （ no less than half a year） and 22 patients with benign prostatic hyperplasia who took finasteride daily（ no less than half a year） were enrolled separately in study as ADT group and non ADT group. All patients were measured with biochemical examination and the bone mineral density（BMD） by dual energy X - ray absorptiometry before and after the treatment, The diagnosis of osteoporosis was made ADT according to the result of T scores of dual energy X - ray absorptiometry, Results After treatment , the testosterone was lower significantly in ADT group compared with in ADT group be- fore treatment and in non ADT group（ P 〈 0.01 ）. The BMD of the whole body bone composition,lumbar vertebral （ L1 - 4 ） and forearm in ADT group was lower significantly than in non ADT group（ P 〈 0.05 ）. The BMD of femoral neck was a little lower in ADT group compared with in non ADT group, but the difference between the two groups were not significant（ P 〉0.05 ）. The incidence of osteopornsis in ADT and non ADT groups were 50.0% and 22. 7% respectively. There was significant difference between two groups（ P 〈0.05）. Conclusions DT may speed up the bone mass loss and increase the incidence of osteoporosis in elderly patients with prostate cancer. The patients should have the BMD determination before ADT. It is necessary for the patients with obvious bone lossing or having high risk of osteoporosis that take some preventive measures to slow the bone loss.

关 键 词：前列腺肿瘤 雄激素类 骨和骨组织 

分 类 号：R592[医药卫生—老年医学]