妇科恶性肿瘤年轻患者化疗后骨密度23例临床分析

A clinical analysis of bone mineral density after chemotherapy in 23 young patients with gynecological malignancies.

目的:探讨妇科肿瘤年轻患者化疗后骨密度变化的特点,为临床预防化疗后骨质疏松提供基础。方法:接受化疗的妇科恶性肿瘤年轻患者共23例,均≤40岁,根据年龄分为≤26岁组和>26岁组。分别测定其腰椎正位、股骨近端以及前臂骨密度值,同时测定其血清激素水平及血镁、钙、磷离子水平。结果:(1)23例患者中骨密度减少发生率为43.5%,其中≤26岁组9例患者中骨密度减少6例(66.7%,6/9),>26岁组14例患者中骨密度减少4例(28.6%,4/14)。≤26岁组腰椎L1～L4 BMD值明显低于>26岁组(P<0.05);(2)单纯化疗组及联合放疗组患者骨密度减少发生率的差异无统计学意义;(3)两组患者LH、FSH水平差异有统计学意义(P<0.05),其余激素以及电解质水平差异均无统计学意义。结论:妇科恶性肿瘤年轻患者化疗期间易发生骨密度减少,甚至有发生骨质疏松的可能。应重视其防治研究,对提高年轻肿瘤患者生活质量有重要意义。

Objective：To invesitgate the charactristics of change of the bone mineral density（BMD） after chemotherapy in young gynecological malignancies for providing a basis for the clinical prevention of osteoporosis after chemotherapy.Methods：23 young patients（≤40 years old） with gynecological malignancies who accepted chemotherapy were divided into 2 groups according to age（≤26 years old and 26 years old）.The BMD was detected on the lumbar spine,proximal femur and forearm respectively,and their serum hormone levels and blood magnesium,calcium and phosphate ions levels were determined at the same time.Results：（1）For all 23 patients,the incidence of BMD reduction was 43.5%.In the group≤26 years old,BMD decreased in 6 cases（66.7%,6/9） and 4 cases in the group 26 years old（28.57%,4/14）.Lumbar spine L1~L4 BMD in the group≤26 years old was significantly lower than that of the group26 years old（P0.05）.（2）The difference of the incidence of BMD reduction was not significant between the patients accepted chemotherapy alone and combined with radiotherapy.（3）The LH and FSH levels were significantly different between the two groups（P0.05）,while the other hormones and electrolyte levels were not significantly different.Conclusion：The young patients with gynecological malignancies prone to have a decrease in BMD during chemotherapy,even have the possibility of osteoporosis.The research in prevention and treatment to improve the quality of life for the patients is very important.