唑来膦酸钠预防来曲唑所致绝经后乳腺癌患者骨量丢失的临床观察

Effects of zoledronic acid on bone metabollsm in postmenopausal breat cancer patients

目的:通过观察唑来膦酸钠对来曲唑所致绝经后乳腺癌患者骨量丢失的临床疗效,探讨唑来膦酸钠对乳腺癌患者的骨保护作用。方法:60例绝经后乳腺癌患者均采取手术治疗,且术后常规行6个疗程的化疗,无骨转移病例。对照组:30例化疗后继续服用来曲唑2.5 mg/d;治疗组:30例患者化疗后服用来曲唑2.5 mg/d+静滴唑来膦酸钠4 mg,每3个月为1个疗程,共12个月。在治疗前后分别测定两组患者骨密度(BMD)、血钙(Ca)、血磷(P)、Ⅰ型胶原羧基末端肽(β-Crosslaps)及血清骨钙素(OPG),对两组患者治疗前后各项指标进行分析比较。结果:治疗12个月后,治疗组腰椎和股骨颈的骨密度、血清OPG均较治疗前增加,β-Crosslaps较前降低,差异有统计学意义(P<0.05),两组血钙、血磷与治疗前比较,差异无统计学意义(P>0.05)。结论:唑来膦酸钠对应用来曲唑辅助治疗的乳腺癌患者有很好的骨保护作用。

Objective To investigate the effects of zoledronic acid on bone metabollsm in postmenopausal breat cancer patients. Method 60 patients with postmenopausal breat cancer received conventional chemotherapy for six cycles. They were divided into treatment group and control group randomly. Control group： 30 patients after chemotherapy continued taking Letrozole 2. 5mg/d. Treatment group： In addition to taking Letrozole 2. 5 mg/d,30 cases after chemotherapy used zoledronic 4mg injecdon,every 3 months for a course. The bone mineral density（ BMD）,blood calcium and phosphorus,Crossl procollagen type Ⅰ carboxytermina（ β-Crosslaps）,serum osteoprotegerin. were detected at starting point and after 12 months treatment. Results After 12 months treatment,the lumbar spine and femoral neck BMD,serum osteoprotegerin of two groups increased than before,The treatment group was higher than that of control group. β-Crosslaps were delined in treatment group（ P 〈 0. 05）. There was no significant difference between two groups in blood calcium and phosphorus（ P 〉 0. 05）. Conclusion Zoledronic acid has good bone protection in patients with breat cancer who are treated with letrozole.