全雄激素阻断治疗对老年前列腺癌患者血清钙磷等代谢指标的影响

Effects of maximal androgen blockade therapy on serum calcium,phosphorus and other metabolic indices in elderly patients with prostate cancer

目的探讨全雄激素阻断(MAE)治疗对老年前列腺癌患者血清钙、磷等代谢指标的影响。方法回顾性分析2010年1月至2018年12月期间就诊于我科并接受MAB治疗的前列腺癌患者的临床病理学资料。所有患者均有前列腺穿刺活检病理。收集患者的年龄、体质指数(BMI)、既往病史、治疗方案及患者内分泌治疗前后血钙、血磷、血红蛋白、空腹血糖、三酰甘油及血胆固醇等。结果患者(75.5±5.8)岁,BMI(24.6±3.2)kg/m^2,MAB治疗后血钙[(2.17±0.31)mmol/L和(2.12±0.44)mmol/L,t=0.82,P=0.42]较治疗前有下降趋势,但差异无统计学意义;治疗后血磷高于治疗前[(1.02±0.26)mmol/L和(1.17±0.34)mmol/L,t=-4.12,P<0.01,钙磷比较治疗前降低[(2.10±0.28)和(1.88±0.60),t=3.56,P<0.01];MAB治疗后患者空腹血糖[(5.34±1.04)mmol/L和(6.50±1.55)mmol/L,Z=-7.82,P<0.01]、三酰甘油[(1.22±0.59)mmol/L和(1.66±1.32)mmol/L,t=-3.38,P<0.01]及胆固醇[(4.16±0.90)mmol/L和(4.70±1.08)mmol/L,t=-4.72,P<0.01]均较前升高,血红蛋白[(130.78±23.98)g/L和(122.11±20.43)g/L,t=3.98,P<0.01]浓度较治疗前降低。结论MAB疗法可引起老年前列腺癌患者钙磷代谢、血红蛋白浓度及血糖、血脂等不同程度的紊乱,建议治疗期间密切随访以上指标,积极预防治疗相关并发症。

Objective To investigate the effect of maximal androgen blockade(MAB)therapy on serum calcium,phosphorus and other metabolic indices in elderly patients with prostate cancer.Methods Clinicopathological data of prostate cancer patients treated with MAB in our department from January 2010 to December 2018 were retrospectively analyzed.All patients underwent prostate biopsy for definitive diagnosis.Detailed data on patient's age,body mass index(BMI),previous medical history,treatment plan and peripheral blood indicators before and after endocrine treatment,such as blood calcium,phosphorus,hemoglobin,fasting blood glucose,triglycerides and cholesterol,were collected.Results Patients had a mean age of(75.5±5.8)years and a mean BMI of(24.6±3.2)kg/m^2.Blood calcium levels exhibited a downward trend after MAB treatment compared pre-treatment[(2.12±0.44)mmol/L vs.(2.17±0.31)mmol/L,t=0.82,P=0.42],but had no significant difference.Serum phosphorus concentrations were higher and the calcium-phosphorus ratio was lower after MAB treatment than before treatment[(1.02±0.26)mmol/L vs.(1.17±0.34)mmol/L,2.10±0.28 vs.1.88±0.60,Z=-4.12 and 3.56,P<0.01].After MAB treatment,blood fasting glucose[(6.50±1.55)mmol/L vs.(5.34±1.04)mmol/L,t=-7.82,P<0.01],triglycerides](1.66±1.32)mmol/L vs.(1.22±0.59)mmol/L,t=-3.38,P<0.01]and cholesterol](4.70±1.08)mmol/L vs.(4.16±0.90)mmol/L,t=-4.72,P<0.01]were elevated,while hemoglobin concentrations[(122.11±20.43)g/L vs.(130.78±23.98)g/L,t=3.98>P<0.01]were decreased compared with pretreatment levels.Conclusions MAB therapy can cause varying degrees of metabolic abnormalities in calcium and phosphorus metabolism,hemoglobin concentrations,blood glucose and lipid levels in elderly prostate cancer patients.The above indicators should be closely monitored during treatment,and treatment-related complications should be proactively prevented.