芳香化酶抑制剂对绝经后乳腺癌患者的骨密度影响

The effect of aromatase inhibitors on bone mineral density of postmenopausal women with breast cancer

目的评估芳香化酶抑制剂(aromatase inhibitors,AIs)对绝经后乳腺癌患者骨密度(bonemineral density,BMD)的影响。方法利用双能X线骨密度仪对203例绝经后乳腺癌妇女进行腰椎正位(L1-L4)、左侧股骨颈以及左侧全髋的BMD测定,其中103例患者接受了AIs治疗,对照组为100例同年龄段未接受AIs治疗的乳腺癌患者。结果接受AIs治疗患者的腰椎、左股骨颈和左侧全髋三个部位的BMD均显著低于对照组(P<0.05)。病例组中有67例(65.0%)被诊断为骨量减少,24例(23.3%)被诊断为骨质疏松;对照组中有60例(60.0%)被诊断为骨量减少,19例(19.0%)被诊断为骨质疏松。病例组患者中骨质疏松加骨量减少的总发生率高于对照组,两组间有统计学差异(P<0.05)。结论绝经后乳腺癌患者存在不同程度的骨量减少和骨质疏松,芳香化酶抑制剂对乳腺癌患者的骨密度具有负面影响,对接受芳香化酶抑制剂治疗的绝经后乳腺癌患者,应当定期监测其骨密度和采取适当的预防性骨质疏松治疗,以减少骨质疏松和骨折的风险。

Objective To evaluate the effect of aromatase inhibitors （AIs） on bone mineral density （BMD） of postmenopausal women with breast cancer （BC）. Methods BMD of the lumbar, left femoral neck, and the total hip of 203 Chinese postmenopausal women with BC were assessed using dual energy Xray absorptiometry. Among those, 103 patients were treated with AIs, and 100 agematched patients did not receive AIs as controls. Results BMD of the lumbar, left femoral neck, and the total hip of patients treated with AIs was significantly lower than those in control group （ P 〈 0. 05 ）. In case group, 67 women （65.0%） were diagnosed with osteopenia and 24 women （23.3%） with osteoporosis. While in control group, 60 women （60.0%） were with osteopenia and 19 women （19.0%） with osteoporosis. The total prevalence of osteopenia and osteoporosis in AIs group was higher than that in control group, and the difference was statistically significant （P 〈0. 05）. Conclusion Postmenopausal women with BC may have osteopenia and osteoporosis with different degree. AIs negatively affect BMD of postmenopausal women with BC. BMD should be measured periodically and proper therapy should be given to prevent osteoporosis in order to reduce the risk of osteoporosis and bone fracture of patients with treatment of AIs.