辅助化疗、内分泌治疗对绝经后乳腺癌患者骨密度的影响

Influence of adjuvant chemotherapy and endocrine therapy on bone density in postmenopausal patients with breast cancer

目的研究辅助化疗、内分泌治疗对绝经后乳腺癌患者骨密度及骨丢失的影响。方法收集2013年6月至2015年10月在本院诊断为绝经后乳腺癌患者共50例，分别在患者外科术后、接受常规化疗前及常规化疗完全结束后，内分泌AI治疗1年后，采用双能x线骨密度测量仪测量腰椎L2。L4及右股骨颈的骨密度。比较常规化疗前与常规化疗后，常规化疗后与AI治疗1年后腰椎及股骨颈的骨密度是否存在差异。结果常规化疗后患者腰椎及股骨颈的骨密度较常规化疗前显著降低，其差异具有统计学意义；AI治疗1年后腰椎和股骨颈的骨密度较常规化疗后的骨密度显著降低，其差异具有统计学意义。结论辅助化疗及内分泌治疗可不同程度的影响绝经后乳腺癌患者的骨代谢、降低骨密度，早期采用干预措施对预防骨丢失及骨质疏松是非常必要的。

Objective To study the influence of adjuvant chemotherapy and endocrine therapy on the bone density in postmenopausal patients with breast cancer. Methods 50 postmenopausal patients diagnosed with breast cancer at our hospital from June, 2013 to October, 2015 were collected. Their bone density of lumbar 2-4 and right femoral neck was measured by dual-energy X-ray absorptiometry after surgery, before conventional chemotherapy, after conventional chemotherapy, and after 1 year of endocrine AI therapy. Paired t test was used to compare the difference in bone density of lumbar and femoral neck between before and after conventional chemotherapy and between after conventional chemotherapy and after 1 year of endocrine AI therapy. Results The bone density of lumbar and femoral neck was significantly lower after than before conventional chemotherapy, with a statistical difference, and was significantly lower after 1 year of endocrine AI therapy than after conventional chemotherapy, with a statistical difference. Conclusions Adjuvant chemotherapy and endocrine therapy for postmenopausal patients with breast cancer can affect their bone metabolism and decrease their bone density. It is necessary to take early cautions to prevent bone loss and osteoporosis.