手术去势对前列腺癌患者血脂代谢的影响

目的：探讨前列腺癌患者去势手术后雄激素水平降低及对血脂代谢的影响。方法：对诊断明确的36例进展期前列腺癌患者行双侧睾丸切除术，分别于术前、术后1、3、6个月及1年测定血清睾酮（T）、游离睾酮（FT）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A1（APO-A1）、载脂蛋白B（APO-B）。结果：去势术后1个月，T、FT较术前明显降低（0．45±0．05ng／mlVS4．88±0．21ng／ml，P〈0．01；2．09±0．56pmol／I。VS35．25±4．20pmol／I，，P〈0．01），以后持续下降，术后6个月降至最低。TG于术后1个月开始较术前显著升高（1．88±0．28mmol／L，VS1．38±0．20mmol／L，P〈0．01）。FC、LDL-C于术后3个月开始较术前明显升高（5．29±0．7lmmol／L VS3．6l±0．59mmol／L，P〈0．01；3．13±0．44mmol／L VS1．72±0．26mmol／L，P〈0．01），以后呈继续上升趋势。HDL-C于术后3个月开始较术前明显降低（1．47±0．28rnmol／L VS1．86±0．24mmol／L，P〈0．01）。APO-A1、APO—B在手术前后无明显变化。结论：前列腺癌患者去势手术后，随着雄激素水平的降低，出现血脂代谢异常，TG、TC、LDL-C升高，HDL-C降低，可能使相关心血管疾病的发生率增加。

Effect of Surgical Castration on Lipid Metabolism in Patients with Prostate Cancer

Objective:To analyze the effect of surgical castration on testosterone level and lipid metabolism in patients with prostate cancer.Methods:A total of 36 patients diagnosed with advanced prostate cancer had undergone the bilateral orchiectomy.The serum levels of testosterone(T),free testosterone(FT),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apoprotein -A1(APO-A1) and apoprotein-B(APO-B) were determined just prior to,and 1,3,6 months and 1 year after castration respectively.Results:T and FT decreased significantly 1 month after castration(0.45±0.05 ng/ml vs 4.88±0.21 ng/ml,P<0.01;2.09±0.56 pmol/L vs 35.25±4.20 pmol/L,P<0.01),reaching and maintaining the lowest level about 6 months after the surgery.TG increased significantly 1 month after castration(1.88±0.28 mmol/L vs 1.38±0.20 mmol/L,P<0.01).TC and LDL-C increased significantly 3 months after castration(5. 29±0.71 mmol/L vs 3.61±0.59 mmol/L,P<0.01;3.13±0.44 mmol/L vs 1.72±0.26 mmol/L,P<0.01), and continued to increase thereafter.HDL-C decreased significantly 3 months after castration(1.47±0.28 mmol/ L vs 1.86±0.24 mmol/L,P<0.01).APO-A1 and APO-B were not changed.Conclusions:After surgical castration, the androgen levels decrease,and the lipid metabolism becomes abnormal,thus may increase the incidence of cardiovascular disease.