他莫昔芬和阿那曲唑内分泌治疗对乳腺癌患者骨代谢的影响

Effect of endocrine therapy using tamoxifen or anastrozole on bone metabolism of breast cancer patients

目的探讨他莫昔芬和阿那曲唑内分泌治疗对乳腺癌患者骨代谢的影响。方法选择乳腺癌患者148例,随机分为他莫昔芬组75例和阿那曲唑组73例,术后分别给予他莫昔芬(20 mg/d)、阿那曲唑(1 mg/d)口服。治疗前及治疗12个月后比较两组患者的降钙素、骨钙素、骨碱性磷酸酶水平及腰椎骨密度。结果治疗12个月后,两组患者的降钙素、骨碱性磷酸酶水平均较治疗前升高(均P<0.05),骨钙素、腰椎骨密度水平均较治疗前降低(均P<0.05),阿那曲唑组降钙素、骨碱性磷酸酶、骨钙素均高于他莫昔芬组,而腰椎骨密度水平低于他莫昔芬组(均P<0.05)。结论服用阿那曲唑和他莫昔芬均可导致乳腺癌患者骨代谢异常,但他莫昔芬对骨代谢影响程度小于阿那曲唑。

bjective To explore the effect of endocrine therapy using tamoxifen or anastrozole on the bone metabolism in breast cancer patients. Methods A total of 148 patients with breast cancer were randomly divided into tamoxifen group（ n =75） and anastrozole group（ n =73）.The patients in the tamoxifen group and the anastrozole group were administered oral tamoxifen（20 mg/d） and anastrozole （1 mg/d） respectively.Before treatment and after 12 months of treatment,the levels of calcitonin,osteocalcin and bone alkaline phosphatase ,and the bone density of lumbar vertebrae were compared between the two groups. Results After 12 months of treatment,the calcitonin and bone alkaline phosphatase levels increased,the osteocalcin level and the bone density of lumbar vertebrae decreased in both groups compared to the levels before treatment（all P 〈0.05）,the calcitonin,bone alkaline phosphatase and osteocalcin levels increased,and the bone density of lumbar vertebrae decreased in the anastrozole group compared to the tamoxifen group（all P 〈0.05）. Conclusion Both of anastrozole and tamoxifen can cause the abnormal bone metabolism in the patients with breast cancer,but tamoxifen obtains less effects on bone metabolism compared to anastrozole.