绝经前Luminal型乳腺癌患者血清生殖激素水平与内分泌治疗后血管舒缩功能障碍的相关性研究  

Correlation between the level of serum reproductive hormones and dysfunction of vasomotoricity after endocrinotherapy in premenopausal patients with Luminal subtype breast cancer

作　　者：杨慧芬[1] 罗华[1] 杨欧欧[1] 胡祖健[1] 何俊玲[1] 徐海滨[1] 

机构地区：[1]浙江省杭州市中医院,杭州310006

出　　处：《浙江创伤外科》2016年第1期1-4,共4页Zhejiang Journal of Traumatic Surgery

基　　金：浙江省中医药科技计划项目;2014ZB098

摘　　要：目的探讨绝经前Luminal型乳腺癌患者使用他莫昔芬内分泌治疗前后血清生殖激素水平的变化及其与表现为潮热等症状的血管舒缩功能障碍的关系。方法动态检测本院2013年3月至2014年12月收治的139例绝经前Luminal型乳腺癌患者的血清生殖激素水平,分析血清生殖激素水平的动态变化与内分泌治疗前后表现为潮热等症状的血管舒缩功能障碍的关系。结果 139例绝经前Luminal型乳腺癌患者的血清孕酮、促黄体生成素、睾酮、卵泡刺激素和泌乳素检测值明显高于绝经前健康女性(P<0.05),血清雌二醇检测值无明显差异(P>0.05);139例患者接受内分泌治疗后的血清P、E2、LH和PRL检测值明显高于内分泌治疗前(P<0.05),而血清T检测值明显则低于内分泌治疗前(P<0.05),血清FSH检测值内分泌治疗前后无明显差异(P>0.05);139例患者中入院或就诊时32(23.0%)例主诉有潮热症状,其中53.1%(17/32)为下午潮热,34.4%(11/32)为前半夜潮热,12.5%(4/32)为其它时间潮热;绝经前Luminal型乳腺癌患者内分泌治疗后出现潮热症状的百分率明显增高,与入院或就诊时和辅助放化疗后有显著差异(P<0.05),其中下午潮热和前半夜潮热的百分率低于入院就诊时和辅助放化疗后(P<0.05),但辅助放化疗后和内分泌治疗后出现的其它时间潮热的百分率较入院或就诊时明显升高(P<0.01);139例绝经前Luminal型乳腺癌患者内分泌治疗后血清P和T检测值与其它时间潮热症状的出现密切相关(P=0.006,0.0001)。结论绝经前Luminal型乳腺癌患者内分泌治疗后表现为潮热等症状的血管舒缩功能障碍,可能与血清P检测值的升高和血清T检测值的降低有关,血清生殖激素水平的动态变化可作为潮热辨证分型和中医药治疗的重要依据。Objective To explore the relationship between serum reproductive hormone levels and vasomotor dysfunction manifested as hot flashes after endocrinotherapy in premenopausal patients with Luminal subtype breast cancer. Methods Reproductive hormone levels were measured in 139 premenopausal patients with Luminal subtype breast cancer administrated in our hospital from Mar 2013 to Dec 2014 and the relation between the level of serum reproductive hormones and dysfunction of vasomotoricity manifested as hot flashes before and after endocrinotherapy was also analyzed. Results The serum levels of progesterone（P）, luteinizing hormone（LH）, testosterone（T）, follicle-stimulating hormone（FSH） and prolactin（PRL） were marked higher in 139 premenopausal patients with Luminal subtype breast cancer than those in controlled healthy premenopausal woman（P〈0.05） and there was no significant difference between patients and controlled healthy premenopausal woman on the serum levels of estradiol（E2）（P〈0.05）. The serum levels of P, E2, LH and PRL tested in 139 premenopausal patients with Luminal subtype breast cancer were higher and serum level of T was lower significantly after endocrinotherapy than those in same patients before endocrinotherapy（ P〈0.05）.There was no significant difference before and after endocrinotherapy on serum FSH（ P〈0.05）. The main clinical symptom of vasomotor dysfunction manifested as hot flashes in 139 premenopausal patients with Luminal subtype breast cancer were hot flashes in afternoon（53.1%） and hot flashes in first half of midnight（34.4%）, the occurrence of hot flashes presented in other time was only 12.5%. The percentage of hot flashes after endocrinotherapy was markedly increased（P〈0.05 = and meanwhile, the ratio of hot flashes presented in afternoon and first half of midnight were significantly lower than that suffered at administration and before endocrinotherapy（ P〈0.05）. The percentage of hot flashes presented in other time before and a

关 键 词：乳腺癌 生殖激素 血管舒缩功能障碍 潮热 

分 类 号：R737.9[医药卫生—肿瘤]