唑来膦酸钠对绝经后乳腺癌患者骨代谢影响结果分析

目的：通过观察唑来膦酸钠对绝经后乳腺癌患者骨代谢影响，探讨唑来膦酸钠在早期预防乳腺癌患者发生骨代谢障碍及抑制骨转移中的作用。方法：85例绝经后乳腺癌患者均手术治疗，且术后常规行6个疗程的化疗，无骨转移病例。对照组：28例化疗后接受中药治疗；来曲唑组：30例化疗后继续服用来曲唑2．5mg／d；来曲唑＋唑来膦酸钠组：27例患者化疗后除服用来曲唑2．5mg／d外，使用唑来膦酸钠注射液4mg＋生理盐水100ml，静脉滴注15min，每4周为1个疗程。6个月后应用双能x线骨密度仪对三组乳癌患者腰椎、股骨近端骨密度（BMD）进行测定，用SPETCT行全身核素骨显像检查，使用全自动生化仪器测定血清碱性磷酸酶（ALP）、血钙（Ca）、血磷（P）等生化指标，用免疫组化方法测定雌激素（E2），对三组患者治疗前后各项指标分析比较。结果：治疗后来曲唑组与对照组病人的BMD、E2、血清Ca、P指标比较，均明显降低（P〈0．05）、ALP明显上高（P〈0．05）；来曲唑＋唑来膦酸钠组与来曲唑组比较，BMD、血清Ca、P指标明显升高（P〈0．05），ALP降低（P〈0．05）、E2未见明显变化（P〉0．05）；来曲唑＋唑来膦酸钠与对照组比较，ALP、E2指标明显降低（P〈0．05），BMD明显升高（P〈0．05），血清Ca、P未见明显变化（P〉0．05）。与对照组比较唑来膦酸钠组的骨转移发生率明显降低（P〈0．05）。结论：唑来膦酸钠对接受来曲唑治疗引起的骨代谢障碍早期防治疗效明显，且对骨转移发生有明显抑制作用。

Effects of zoledronic acid on bone metabolism in postmenopausal breast cancer patients

Objective： To investigate the influence of zoledronic acid on bone metabolism in postmenopausal breast cancer patients. To explore the effect of zoledronie in early intervention bone metabolism disorders and suppression of bone metastasis. Methods： Total of 85 post surgery patients with postmenopausal breast cancer received conventional chemotherapy for six cycles. Control group： 28 eases received Chinese medicine treatment. Letrozole group： 30 patients after chemotherapy continued taking Letrozole 2.5mg/d. Letrozole ＋ zoledronic sodium group： In addition to taking Letrozole 2.5mg/d ,27 cases after chemotherapy used zoledronic 4mg ＋ Sodium Chloride injection 100 ml, intravenous drip 15min, every 4 weeks for a course. After treatment for 6 months, the three groups of breast cancer patients＇bone mineral density（BMD） from dual -energy X ray examination on lumbar and femur, whole -body bone imaging from SPECT , alkaline phosphatase （ALP） serum calcium （Ca）, phosphorus （P） and E2 were compared. Results： It was significantly lower （P 〈0.05） in BMD, E2, serum Ca and P in Letrozole group compared with control group, however, ALP was significantly high （ P 〈 0.05 ） ; There were significant increase of lumbar, femoral MBD, serum Ca, P were 3bserved in patients of Letrozole ＋ zoledronic acid group compared with letrozole group, additionally ALP was lower （ P 〈 0.05 ） and E2 no significant change （ P 〉 0.05 ） ; We also found ALP , E2 were significantly decreased, BMD was significant higher （ P 〈 0.05 ） and serum Ca, P no significant changes （ P 〉 0.05 ） in patients of Letrozole ＋ zoledronic acid group compared with the control. Compared with control group zoledronic sodium group significantly reduced the incidence of bone metastasis （ P 〈 0.05 ）. Conclusion： Zoledronic acid has great val- ue in early intervention Letrozole treatment -induced bone metabolism disorders and suppression of bone metastasis.