唑来膦酸预防东北地区非转移性前列腺癌GnRH激动剂治疗后所致骨质流失的临床研究

Clinical study of zoledronic acid in preventing bone loss induced by GnRH agonist in non-metastatic prostate cancer in Northeast China

目的研究唑来膦酸对性腺激素释放激素(GnRH)激动剂所致性腺功能减低男性前列腺癌患者骨质流失的疗效。方法选取2015年6月~2019年6月期间哈尔滨医科大学附属第二医院泌尿外科住院的80例患有非转移性前列腺癌并接受了GnRH激动剂治疗的男性患者,随机分为唑来膦酸组(仅在第1天静脉注射4 mg)和安慰剂组。使用双能X线吸收测定法检测腰椎和髋骨密度;在治疗后3、6、9、12个月监测血骨碱性磷酸酶、P1NP浓度。结果唑来膦酸组腰椎、髋关节骨密度变化率下降程度明显低于安慰剂组(P<0.001);在9和12个月时血骨碱性磷酸酶、P1NP唑来膦酸组活性明显低于安慰剂组中(P<0.05)。结论唑来膦酸可能是预防性腺激素释放激素(GnRH)激动剂致性腺功能减退前列腺癌患者骨质流失的一种方便有效的方法。

Objective To study the efficacy of zoledronic acid on preventing bone loss in patients with prostate cancer caused by gonadal hormone releasing hormone(GnRH) agonist-induced hypogonadism. Methods Eighty male patients with non-metastatic prostate cancer who underwent GnRH agonist treatment in the Department of Urology, the Second Affiliated Hospital of Harbin Medical University from June 2015 to June 2019 were randomly divided into zoledronic acid group(4 mg intravenously only on day 1) and placebo group. Lumbar spine and hip bone density were measured by dual energy X-ray absorptiometry;bone alkaline phosphatase and P1 NP concentrations were monitored at 3, 6, 9 and 12 months after treatment. Results The rate of change of bone mineral density in lumbar spine and hip was significantly lower in the zoledronic acid group than in the placebo group(P<0.001). At 9 and 12 months, the bone alkaline phosphatase and the activity of P1 NP was significantly lower in the zoledronic acid group than in the placebo group(P<0.05). Conclusion Zoledronic acid may be a convenient and effective method for preventing bone loss in patients with hypogonadal hypogonadism caused by a preventive hormone releasing hormone(GnRH) agonist.