他莫昔芬和来曲唑对绝经后乳腺癌患者子宫内膜及脂质代谢的近中期影响

Effect of tamoxifen and tamoxifen on the endometrium and lipid metabolism in treatment of postmenopausal women with breast cancer

目的探讨他莫昔芬和来曲唑对绝经后乳腺癌患者子宫内膜及血脂代谢的影响,为临床用药提供参考依据。方法选择64例行内分泌治疗的绝经后乳腺癌患者按照随机数字表法分为观察组和对照组各32例,对照组给予他莫昔芬治疗,观察组给予来曲唑治疗。治疗24个月后比较2组患者的子宫内膜病理检查结果及血脂代谢、子宫内膜厚度变化情况。结果治疗后,观察组TG、TC、HDL-L及LDL-L较治疗前均无明显变化,差异无统计学意义;对照组LDL-L、TC较治疗前显著降低(P<0.05);治疗12、24个月后,观察组子宫内膜厚度均低于对照组(P<0.05);治疗后,观察组单纯增生、内膜息肉发生率分别为5.25%和3.13%,对照组分别为18.75%和9.38%,2组患者单纯增生、内膜息肉发生率比较差异无统计学意义。结论来曲唑可减少绝经后乳腺癌患者子宫内膜厚度及子宫内膜病变的发生,他莫昔芬可改善患者的血脂代谢情况。

Objective To investigate the effect of tamoxifen and tamoxifen on the endometrium and lipid metabolism in treatment of postmenopausal women with breast cancer, to provide reference for clinical medication. Methods 64 cases of endocrine therapy for postmenopausal breast cancer patients were selected as the research object, according to the random number table method, the patients was divided into observation group and control group, each of 32 cases. The control group was treated with tamoxifen, the observation group were treated with letrozol. After 24 months of treatment, the endometrial pathological examination results and blood lipid metabolism were compared between the two groups. Results After treatment, the observation group TG, TC, HDL-L and LDL-L than before treatment were no significant changes, the difference was not statistically significant; In control group TC, LDL-L was significantly lower than before treatment, the difference was statistically significant （P 〈 0. 05 ）;After 12,24 months of treatment, the endometrial thickness in the observation group was lower than that in the control group （ P 〈 0.05 ） ; After treatment, the incidence of simple hyperplasia and endometrial polyps were 5.25% and 3.13% respectively, and the control group were 18.75% and 9.38% respectively. There was no significant difference in the incidence of endometrial polyps between the two groups. Conclusion Letrozole can reduce the occurrence of postmenopausal breast cancer patients with endometrial thickness and endometrial lesions. Tamoxifen can improve blood lipid metabolism.