托瑞米芬联合他莫昔芬治疗晚期乳腺癌的效果观察及对肝功能和血脂的影响

Curative effect of Toremifene and tamoxifen in the treatment of advanced breast cancer and its effects on liver function and serum lipid

目的探讨托瑞米芬联合他莫昔芬治疗晚期乳腺癌的效果观察及对肝功能和血脂的影响。方法选取2013年6月至2016年6月本院收治的72例晚期乳腺癌患者为研究对象,随机分为观察组和对照组各36例。对照组患者采用他莫昔芬治疗,观察组患者采用托瑞米芬联合他莫昔芬治疗。比较两组患者的临床疗效、治疗前后肝功能水平和血脂水平及治疗后的不良反应发生情况。结果观察组患者化疗总有效率75.0%,显著高于对照组患者总有效率52.8%,差异有统计学意义(Z=-2.216,P=0.027)。治疗后,两组患者ALT、AST及γ-GT水平比较,差异无统计学意义(P>0.05),但观察组患者ALP水平,显著低于对照组患者,差异有统计学意义(P<0.05);观察组患者TC、TG水平显著低于对照组患者,而HDL水平显著高于对照组患者,差异有统计学意义(P<0.05)。两组患者的恶心呕吐、白细胞减少、粒细胞减少及血小板减少发生率比较,差异均无统计学意义(P>0.05)。结论托瑞米芬联合他莫昔芬治疗晚期乳腺癌的疗效确切,可在一定程度上降低血脂水平,不明显增强肝功能损伤及不良反应。

Objective To investigate the clinical efficacy of toremifene and tamoxifen in the treatment of advanced breast cancer and the effects on liver function and serum lipid. Methods From June 2013 to June 2016, 72 patients with advanced breast cancer treated in our hospital were selected. All patients were randomly divided into observation group （n= 36） and control group （n= 36）. The control group was treated with tamoxifen, while the observation group was treated with toremifene and tamoxifen. The clinical curative effect, the level of liver function and blood lipid before and after treatment, and the incidence of toxic and side effects after treatment were compared.Results The effective rate of chemotherapy in the observation group （72.2%） was significantly higher than that in the control group （52.8%） （Z =-2.216,P= 0.027）. After treatment, ALT, AST and γ-GT of two groups had no statistically significant difference （P〉 0. 05）, but ALP level of the observation group was significantly lower than the control group （P〈 0.05）. After treatment, TG and TC level of the observation group was significantly lower than the control group （P〈0. 05）, while the HDL was higher than the control group （P〈0. 05）. Nausea and vomiting, white blood cells, granulocyte decrease and thrombocytopenia incidence rate of two groups had no significant difference （P〉0.05）. Conclusions Effects of toremifene and tamoxifen in the treatment of advanced breast cancer is explicit, can reduce the blood lipid on a certain extent, and the damage of liver function and side effects showed no enhancement, but it also need to carry on the further clinical research.