老年女性乳腺癌根治术后骨质疏松症的影响因素及预防策略  

Influencing factors and prevention strategies of osteoporosis in elderly women after radical mastectomy

作　　者：李海燕[1] 李梅红 陈芳[3] Li Haiyan;Li Meihong;Chen Fang(Cardiothoracic Surgery Department,Changzhi Medical College Affiliated Heji Hospital,Changzhi 037000,China;Rehabilitation Medicine Department of Changzhi Medical College Affiliated Heji Hospital,Changzhi 037000,China;Breast and Thyroid Surgery Department,Changzhi Medical College Affiliated Heji Hospital,Changzhi 037000,China)

机构地区：[1]长治医学院附属和济医院心胸外科,长治037000 [2]长治医学院附属和济医院康复医学科,长治037000 [3]长治医学院附属和济医院乳腺甲状腺外科,长治037000

出　　处：《中华内分泌外科杂志（中英文）》2024年第5期670-674,共5页Chinese Journal of Endocrine Surgery

基　　金：山西省卫生健康委科研课题(2023137)。

摘　　要：目的调查老年女性乳腺癌根治术后骨质疏松症的发生情况,分析其影响因素,为预防该疾病提供指导。方法收集103例2020年1月至2021年1月长治医学院附属和济医院收治的老年女性乳腺癌根治术后患者的临床资料,根据有无发生骨质疏松症分为骨质疏松症组(58例)及无骨质疏松症组(45例),分析骨质疏松症发生的影响因素,分析内分泌激素与骨代谢的关系,并制定预防策略。结果骨质疏松症组年龄>70岁、绝经年限≥5年、身体质量指数(body mass index,BMI)<25 kg/m^(2)、内分泌治疗及骨质疏松的患者占比较无骨质疏松症组更高(χ^(2)=8.68、18.54、9.72、16.98、36.51,P=0.003、<0.001、0.002、<0.001、<0.001)。骨质疏松症组雌二醇水平较无骨质疏松症组低(t=20.53,P<0.05),促卵泡刺激素较无骨质疏松症组高(t=19.14,P<0.05)。高龄、内分泌治疗、骨密度低、雌二醇水平低是乳腺癌患者根治术后发生骨质疏松症的危险因素(P<0.05)。Pearson相关性分析显示,乳腺癌根治术后发生骨质疏松症患者的骨密度与其雌二醇、睾酮水平呈正相关(r=0.352、0.316,P<0.05),与促卵泡刺激素水平呈负相关(r=-0.334,P<0.05)。结论老年女性乳腺癌患者根治术后发生骨质疏松症受年龄、内分泌治疗、骨密度及雌二醇的影响,且其激素水平与骨密度存在相关性,临床应从监测骨密度、体育锻炼、安全用药、防跌等方向实施防治措施。ObjectiveTo investigate the incidence of osteoporosis in elderly women after radical mastectomy and analyze its influencing factors,so as to provide guidance for the prevention of this disease.MethodsClinical data of 103 elderly women treated in our hospital after radical mastectomy from Jan.2020 to Jan.2021 were collected and separated into osteoporosis group(n=58)and non-osteoporosis group(n=45)according to whether osteoporosis occurred.The factors affecting the occurrence of osteoporosis and the relationship between endocrine hormones and bone metabolism were analyzed,and prevention strategies were formulated.Results(1)The proportion of patients with osteoporosis>70 years old,menopausal years≥5 years,body mass index<25kg/m^(2),endocrine therapy in osteoporosis group was higher than that in non-osteoporosis group(χ^(2)=8.68,18.54,9.72,16.98,36.51,P=0.003,<0.001,0.002,<0.001,<0.001);(2)The level of estradiol in the osteoporosis group was lower than the other group(t value=20.53,P<0.05),and the level of follicle-stimulating hormone was higher(t value=19.14,P<0.05);(3)Old age,endocrine therapy,low bone mineral density and low estradiol level were the risk factors for osteoporosis after radical mastectomy(P<0.05);(4)Pearson correlation analysis showed that bone mineral density in patients with osteoporosis after radical mastectomy was positively correlated with estradiol and testosterone levels(r=0.352,0.316,P<0.05),and negatively correlated with follicle-stimulating hormone levels(r=-0.334,P<0.05).ConclusionsOsteoporosis in elderly women with radical mastectomy is affected by age,endocrine therapy,bone mineral density and estradiol,and there is a correlation between hormone levels and bone mineral density.Clinical prevention and treatment measures should be implemented in the direction of monitoring bone mineral density,physical exercise,safe drug use,and prevention of falling.

关 键 词：乳腺癌 根治术 骨质疏松症 老年女性 

分 类 号：R737.9[医药卫生—肿瘤] R580[医药卫生—临床医学]