阿那曲唑和他莫昔芬对绝经后乳腺癌患者血脂影响的对比研究

A comparative study of the effect of anastrozole and the effect of anastrozole amoxifen on lipid profiles in postmenopausal women with estrogen receptor-positive breast cancer

目的:比较阿那曲唑(ANA)和他莫昔芬(TAM)对绝经后激素受体阳性乳腺癌患者术后辅助治疗的血脂影响。方法:随机将64例乳腺癌患者分为治疗组(ANA)和对照组(TAM)。分别采集两组患者服药不同时间段的空腹静脉血,检测血脂指标:总胆固醇(TC)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、甘油三酯(TG)。结果:A组服药后12个月时TC升高明显,但是各时间段比较未见统计学差异(P>0.05)。B组服药前后TG、HDLC变化无统计学差异(P>0.05),服药后6、12个月TC、LDLC有所下降,具有统计学意义(P<0.05)。结论:TAM对绝经后雌激素受体阳性乳腺癌患者血脂的影响优于ANA,故对于长期使用ANA患者应监测血脂变化,并TAM可能是临床上心血管疾病高危人群的乳腺癌患者的更佳选择。

Objective To investigate the effect of anastrozole and the effect of tamoxifen on blood lipid levels in postmenopausal women with estrogen receptor-positive breast cancer. Methods Sixty-four postmenopausal women with estrogen receptor-positive breast cancer were enrolled and randomized to receive anastrozole ling （n = 30） （A） or tamoxifen 20 mg （n = 34） （B） once daily as adjuvant hormonal treatment. Serum lipid parameters including total cholesterol （TC）, triglyceride （TG）, high-density lipoprotein （HDL） cholesterol and low-density lipoprotein （LDL） cholesterol were determined before antiestrogen therapy and at 3, 6, 9 and 12 months after the treatment. Results No significant changes of all lipid parameters were shown at all assessment time points in the anastrozole group（P 〉 0.05）. TC and LDL cholesterol levels were significantly decreased in the tamoxifen group （P 〈 0.05）, TG and HDL cholesterol levels were not affected in the tamoxifen group （P 〉 0.05）. Conclusion Tamoxifen could provide better effect than anastrozole in terms of the lipid profile in postmenopausal women with estrogen receptor-positive breast cancer, It＇s suggested that blood lipid levels should should be used as a regular monitor for long-term application of anastrozole-treated patients, and tamoxifen may be a better treatment choice for patients at high risk of cardiovascular events.