芳香化酶抑制剂在绝经后女性乳腺增生治疗中的价值  

Value of aromatase inhibitors in treatment of postmenopausal women with breast hyperplasia

作　　者：黄自明[1] 王蓉[1] 余春姣 魏刚[1] 田亦文 姜冉[1] 薛明兴[1] 

机构地区：[1]湖北省妇幼保健院甲乳外科,湖北武汉430070

出　　处：《中国妇幼保健》2016年第15期3085-3087,共3页Maternal and Child Health Care of China

基　　金：湖北省自然科技基金面上项目(2014CFB472)

摘　　要：目的探讨芳香化酶抑制剂在绝经后女性乳腺增生治疗中的临床效果及价值。方法选取2012年1月-2013年1月在该院就诊并确诊为绝经后合并乳腺增生的患者360例,随机分为3组,分别服用来曲唑(A组)、他莫昔芬(B组)和安慰剂(C组),均服药12个月。服药后每3个月复查,记录增生临床症状变化,并行乳腺彩超检查,了解乳腺导管和纹理的变化,每年复查乳腺X线摄影,了解乳腺密度变化,同时观察各治疗组治疗期间不良反应发生情况。结果服药前后,检测患者雌二醇(E2)、黄体生成素(LH)以及各项血液指标水平有明显差异,治疗组临床症状明显缓解;且超声检查提示乳腺导管和纹理较治疗前差异极其明显,差异有统计学意义(P<0.05),服药后1年复查乳腺X线,乳腺密度Wolfe评分及总百分率相比分析明显下降(P<0.05)。不同治疗组不良反应发生率比较,差异无统计学意义(P>0.05)。结论芳香化酶抑制剂应用于绝经后女性乳腺增生其效果显著,且安全性与常规疗法无明显差异,具有良好的临床应用及推广价值。Objective To explore the clinical effect and value of aromatase inhibitors in treatment of postmenopausal women with breast hyperplasia. Methods A total of 360 postmenopausal women diagnsoed as breast hyperplasia definitely in the hospital from January 2012 to January 2013 were selected and randomly divided into three groups： group A （letrozole）, group B （tamoxifen）, and group C （comfort a- gent）, all the women were treated for 12 months. The women were reexamined every three months after treatment, the changes of clinical symptoms were recorded, breast color uhrasonography was conducted to understand the changes of mammary ducts and texture, breast X-ray examination was carried out every year to understand the change of breast density, the incidence rates of adverse reactions during treatment in the three groups were observed. Results After medication, the levels of estradiol, luteinizing hormone （LH） and other hematologic parameters changed significantly, the clinical symptoms were relieved significantly; ultrasound examination showed that mammary ducts and texture changed significantly compared before treatment （P〈0. 05） . After one year of treatment, breast X-ray examination showed that breast den- sity Wolfe score and the total percentage decreased significantly （ P〈0. 05 ） . There was no statistically significant difference in the incidence rates of adverse reactions among different groups （P〉0. 05） . Conclusion Aromatase inhibitors used for postmenopausal women with breast hyperplasia have significant effect, compared with routine therapy, there is no significant difference in the safety, aromatase inhibitors have good clinical application and popularization value.

关 键 词：绝经后乳腺增生 芳香化酶抑制剂 临床疗效 化学预防 

分 类 号：R737.9[医药卫生—肿瘤]