老年前列腺癌患者雄性激素阻断治疗期间骨密度降低的影响因素分析  

Analysis of the Influencing Factors of Bone Mineral Density Decrease during Androgen Blockade Therapy in Elderly Patients with Prostate Cancer

作　　者：李志清 胡明 LI Zhi-qing;HU Ming(Yan'an City Hospital of Traditional Chinese Medicine,Yan'an Shaanxi 716000)

机构地区：[1]陕西省延安市中医医院泌尿外科,陕西延安716000 [2]汉中市镇巴县中医院泌尿外科,陕西汉中723600

出　　处：《医学临床研究》2023年第3期385-388,共4页Journal of Clinical Research

摘　　要：【目的】探讨老年前列腺癌患者雄性激素阻断治疗期间骨密度降低的影响因素。【方法】回顾性分析2016年4月至2018年5月陕西省延安市中医医院院收治的105例老年前列腺癌患者的临床资料,所有患者均采用雄性激素阻断联合放疗,统计老年前列腺癌患者雄性激素阻断治疗期间骨密度降低的发生率,根据患者治疗期间骨密度是否降低将其分为骨密度降低组及非骨密度降低组,统计两组患者的临床资料,采用Logistic回归分析老年前列腺癌患者雄性激素阻断治疗期间骨密度降低的影响因素,采用Kaplan-Meier法绘制生存曲线,采用log-rank检验分析骨密度降低组及非骨密度降低组无生化失败曲线的差异。【结果】105例老年前列腺癌患者中雄性激素阻断治疗期间骨密度降低患者22例(骨密度降低组),占比20.95%;剩余83例患者未出现骨密度降低(非骨密度降低组),占比79.05%。骨密度降低组GS评分、体重指数(BMI)、血清前列腺特异性抗原(PSA)、白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)水平高于非骨密度降低组(P<0.05),血清睾酮(T)、骨保护素(OPG)水平低于非骨密度降低组(P<0.05);Logistic多因素分析显示,BMI、PSA、T、OPG均为老年前列腺癌患者雄性激素阻断治疗期间骨密度降低的影响因素(P<0.05)。随访2年,骨密度降低组失访1例,非骨密度降低组失访2例,中位随访时间为12(1~24)个月。骨密度降低组2年无生化失败率为80.95%,非骨密度降低组2年无生化失败率为82.72%,两组无生化失败曲线比较,差异无统计学意义(χ^(2)=0.003,P=0.955)。【结论】BMI、PSA、T、OPG均为老年前列腺癌患者雄性激素治疗期间骨密度降低的影响因素,且治疗期间骨密度降低与老年前列腺癌患者远期生化失败无关。【Objective】To investigate the influencing factors of decreased bone mineral density(BMD)in elderly patients with prostate cancer during androgen blockade therapy.【Methods】The clinical data of 105 elderly prostate cancer patients admitted to our hospital from April 2016 to May 2018 were retrospectively analyzed.All patients were treated with androgen blockade combined with radiotherapy.The incidence of bone mineral density reduction during androgen blockade treatment in elderly prostate cancer patients was statistically analyzed.According to whether the bone mineral density decreased during treatment,the patients were divided into reduced bone mineral density group and non reduced bone mineral density group.The clinical data of the two groups of patients were statistically analyzed.Logistic regression analysis was used to explore the influencing factors of bone mineral density reduction in elderly prostate cancer patients during androgen blockade therapy.Kaplan-Meier method was used to draw survival curves,and log rank test was used to analyze the difference in the biochemical failure curve between the reduced bone mineral density group and the non reduced bone mineral density group.【Results】Among 105 elderly patients with prostate cancer,22 patients(20.95%)had decreased bone density during androgen blockade therapy(BMD reduction group);The remaining 83 patients did not have a decrease in bone density(non reduced bone density group),accounting for 79.05%.The GS score,body mass index(BMI),serum prostate specific antigen(PSA),high tumor necrosis factor-α(TNF-α)and interleukin-1(IL-1)levels in the decreased bone density group were higher than those in the non decreased bone density group(P<0.05),while the serum testosterone(T),osteoprotegerin(OPG)levels were lower than those in the non decreased bone density group(P<0.05);Logistic multivariate analysis showed that BMI,PSA,T,and OPG were all influential factors for bone mineral density reduction in elderly prostate cancer patients during androgen blockad

关 键 词：前列腺肿瘤 雄激素拮抗药 骨密度 老年人 影响因素分析 

分 类 号：R737.25[医药卫生—肿瘤]