内分泌治疗对老年前列腺癌患者血脂代谢和营养状态的影响  

Effects of endocrine therapy on lipid metabolism and nutritional status in elderly patients with prostate cancer

作　　者：田子健[1] 侯惠民[1] 赖世聪 刘圣杰[1] 龙星博 王淼 王建业[1] 刘明[1] Tian Zijian;Hou Huimin;Lai Shicong;Liu Shengjie;Long Xingbo;Wang Miao;Wang Jianye;Liu Ming(Department of Urology,Beijing Hospital,The Key Laboratory of Geriatrics,Beijing Institute of Geriatrics,National center of Gerontology,National Health Commission,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院泌尿外科,国家老年医学中心,国家卫生健康委北京老年医学研究所,国家卫生健康委北京老年医学重点实验室,中国医学科学院老年医学研究所,100730

出　　处：《中华泌尿外科杂志》2020年第2期126-130,共5页Chinese Journal of Urology

基　　金：国家重点研发计划重点专项课题(2017YFC0840102)。

摘　　要：目的探讨内分泌治疗对老年前列腺癌患者血脂代谢和营养状态的影响。方法回顾性分析2010年1月至2018年12月北京医院收治的接受内分泌治疗且随访数据完整的255例老年(≥65岁)前列腺癌患者的临床资料。中位年龄76(65~92)岁。PSA(58.15±9.62)ng/ml,其中<10 ng/ml者101例,10~20 ng/ml者62例,>20 ng/ml者92例。所有患者均经前列腺穿刺活检病理确诊,Gleason评分≤6分62例,7分103例,≥8分90例。内分泌治疗包括最大限度雄激素阻断(197例)和药物去势治疗(58例),并持续治疗至少1年。以高龄80岁为界进行亚组分析,血脂指标数据完善者123例,其中65~80岁组98例,>80岁组25例。总蛋白和白蛋白数据完善者186例,其中65~80岁组147例,>80岁组39例。治疗前胆固醇(4.08±0.87)mmol/L,65~80岁组(4.14±0.86)mmol/L,>80岁组(3.82±0.88)mmol/L;甘油三酯(1.23±0.56)mmol/L,65~80岁组(1.26±0.56)mmol/L,>80岁组(1.11±0.57)mmol/L;高密度脂蛋白胆固醇(1.09±0.24)mmol/L,65~80岁组(1.10±0.25)mmol/L,>80岁组(1.04±0.21)mmol/L;低密度脂蛋白胆固醇为(2.50±0.78)mmol/L,65~80岁组(2.55±0.77)mmol/L,>80岁组(2.34±0.83)mmol/L。治疗前总蛋白(63.81±5.93)g/L,其中65~80岁组(63.95±5.79)g/L,>80岁组(63.30±6.49)g/L;治疗前白蛋白(39.68±3.50)g/L,其中65~80岁组(39.82±3.60)g/L,>80岁组(39.21±3.12)g/L。分析治疗前后各项指标的差异。结果123例血脂数据分析结果显示,治疗后胆固醇[(4.80±1.82)mmol/L]、甘油三酯[(1.59±1.17)mmol/L]、高密度脂蛋白胆固醇[(1.21±0.25)mmol/L]、低密度脂蛋白胆固醇[(3.07±1.53)mmol/L]与治疗前比较均升高且差异有统计学意义(P<0.01)。在亚组分析中,65~80岁组治疗后胆固醇[(4.92±1.95)mmol/L]、甘油三酯[(1.64±1.25)mmol/L]、高密度脂蛋白胆固醇[(1.20±0.25)mmol/L]、低密度脂蛋白胆固醇[(3.15±1.66)mmol/L]与治疗前比较均升高且差异均有统计学意义(P<0.01);>80岁组治疗后血脂指标较术前均升高,其中治疗后胆固醇(4Objective To analyze effects of androgen deprivation therapy on lipid metabolism and nutritional status in patients with prostate cancer.Methods The clinical data of 255 elderly patients(≥65 years old)with prostate cancer who received endocrine therapy and complete follow-up data from January 2010 to December 2018 were analyzed retrospectively.The median age of the 255 patients was 76 years(65-92).The average PSA of patients was(58.15±9.62)ng/ml,where 101 patients had PSA<10 ng/ml,62 patients had PSA 10-20 ng/ml,and 92 patients had PSA>20 ng/ml.All patients were diagnosed pathologically by prostate biopsy.As for Gleason score,Gleason score≤6,Gleason score=7 and Gleason score≥8 had 62,103 and 90 patients,respectively.Endocrine therapy included maximum androgen blockade(197 cases)and drug castration(58 cases),and continued for at least 1 year.Among them,123 cases had complete blood lipid index data,and the subgroup analysis was based on the age of 80 years old,including 98 cases aged 65 to 80 years old and 25 cases over 80 years old.A total of 186 cases had complete data of total protein and albumin,of which 147 cases were 65 years old and 80 years old and 39 cases were more than 80 years old.Before treatment,cholesterol was(4.08±0.87)mmol/L,including(4.14±0.86)mmol/L in the 65-80 years old group,(3.82±0.88)mmol/L in>80 years old group;triglyceride was(1.23±0.56)mmol/L,65-80 age group was(1.26±0.56)mmol/L and>80 years old group was(1.11±0.57)mmol/L;High density lipoprotein cholesterol was(1.09±0.24)mmol/L,65-80 age group was(1.10±0.25)mmol/L and>80 years group was(1.04±0.21)mmol/L.Low density lipoprotein cholesterol was(2.50±0.78)mmol/L,65~80 age group was(2.55±0.77)mmol/L and(2.34±0.83)mmol/L in>80 years old group.The total protein before endocrine therapy was(63.81±5.93)g/L,including(63.95±5.79)g/L in the 65-80 years old group,(63.30±6.49)g/L in>80 years old group.In terms of pre-treatment albumin(39.68±3.50)g/L,including(39.82±3.60)g/L in the 65-80 years old group and(39.21±3.12)g/L in>8

关 键 词：前列腺癌 内分泌治疗 血脂 营养状态 

分 类 号：R737[医药卫生—肿瘤]