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目的 探讨CEF-T六周期化学药物治疗方案对浸润性乳腺癌患者血脂的影响及相关因素分析.方法 对2014年1月至2018年3月南京鼓楼医院集团宿迁市人民医院甲乳外科收治的211例浸润性乳腺癌患者的临床资料进行回顾性分析,所有患者均采取乳腺癌改良式根治术或保乳根治术,术后均行CEF-T六周期辅助化学药物治疗,治疗方案为环磷酰胺+表柔比星+氟尿嘧啶,序贯治疗为多西他赛.化学药物治疗前及每个周期化学药物治疗前1d测定血脂,并对年龄、体质量指数、绝经情况、肿瘤分期等与血脂水平进行多因素分析.结果 辅助化学药物治疗后57例患者出现甘油三酯升高,最终确诊6例患者为高甘油三酯血症;第3周期甘油三酯水平升高的患者数大幅上升,第3周期与第2周期比较,差异有统计学意义(P<0.05).51例患者出现胆固醇升高,最终确诊5例患者为高胆固醇血症;第4周期与第3周期比较,第4周期总胆固醇水平升高的患者数大幅上升,差异有统计学意义(P<0.05).年龄、体质量指数、绝经情况可能是影响患者在辅助化学药物治疗期间甘油三酯及胆固醇升高的危险因素.结论 CEF-T六周期辅助化学药物治疗方案对体内脂质代谢的影响是肯定的.而患者年龄、体质量指数、绝经情况是影响患者在辅助化学药物治疗期间甘油三酯及胆固醇升高的危险因素.脂质代谢紊乱的乳腺癌患者预后欠佳,易复发转移.早期发现并及时干预治疗乳腺癌患者辅助化学药物治疗过程中出现的血脂代谢异常,可减少乳腺癌复发转移.

Objective To investigate the effect of CEF-T six-cycle chemotherapy on blood lipid and related factors in patients with invasive breast cancer. Methods A retrospective study was performed on 211 cases of patients with invasive breast cancer who were admitted from January 2014 to March 2018. All patients were treated with modified mastectomy or breast-conserving radical mastectomy,and all patients were treated with cef-t six cycles of adjuvant chemotherapy. The treatment regimen was cyclophosphamide+ surfactant + fluorouracil,and the sequential treatment was docetaxel. Blood lipids were measured before and 1 d before each cycle of chemotherapy,and multiple factors were analyzed for age,body mass index, menopause,tumor stage,and blood lipid level. Results After adjuvant chemotherapy,57 patients showed increased triglyceride,and 6 patients were finally diagnosed as hypertriglyceridemia. The number of patients with increased triglyceride level in the third cycle increased significantly,and the difference was statistically significant (P<0. 05). There were 51 patients with elevated cholesterol,and 5 patients were finally diag&nbsp;nosed withhypercholesterolemia. Compared with cycle 3,the number of patients with elevated total cholester-ol level in cycle 4 increased significantly,with statistically significant differences (P<0. 05). Age,body mass index,and menopause may be risk factors for elevated triglycerides and cholesterol during adjuvant chemotherapy. Conclusion The effect of CEF-T six-cycle adjuvant chemotherapy on lipid metabolism in vivo is positive. Age,body mass index,menopause were risk factors for elevated triglycerides and cholesterol during adjuvant chemotherapy. Breast cancer patients with lipid metabolic disorder have poor prognosis and are prone to recurrence and metastasis. The abnormal blood lipid metabolism in the course of adjuvant chemotherapy can reduce the recurrence and metastasis of breast cancer.