摘要目的 探讨不同治疗方法 对绝经后乳腺癌患者骨密度(BMD)的影响.方法 研究分为健康对照组(50例)、肿瘤组[48例,其中24例再行他莫昔芬(TAM)组治疗].采用双能X线骨密度仪(DEXA)测定所有研究对象的基线BMD.肿瘤组术后均进行辅助化疗,其中24例(TAM组)化疗后继续使用TAM行内分泌治疗.用DEXA测量腰椎和左髋部位的BMD,比较肿瘤组化疗前、后以及TAM组行内分泌治疗8个月后BMD变化.结果 肿瘤组化疗后腰椎部位BMD(0.87±0.15)g/cm2比化疗前(0.93±0.15)g/cm2明显降低(P<0.05);TAM组行内分泌治疗8个月后腰椎BMD(0.90±0.04)g/cm2和股骨颈(0.74±0.05)g/cm2等左髋部位的BMD均有明显增加(P<0.05).结论 化疗可能导致绝经后乳腺癌患者BMD的下降,而TAM治疗能缓解化疗引起的BMD降低.

abstractsObjective To investigate the effects of different adjuvant therapies on bone mineral density(BMD) in postmenopausal women with breast cancer. Methods Forty-eight postmenopausal women with breast cancer and 50 healthy postmenopausal women were enrolled in this study. Patients with breast cancer received chemotherapy, and 24 cases of them received tamoxifen therapy after chemotherapy. BMD of all the people was measured by dual-energy X-ray absorptiometry (DEXA) at base line. BMD results of lumbar vertebrae and hip joint of all the patients before and after chemotherapy were compared, and the changes of BMD after 8 months tamoxifen therapy in 24 patients were evaluated. Results BMD after chemotherapy (n=48) significantly decreased at lumbar vertebrae [ (0.87±0.15) g/cm2 vs (0.93±0.15) g/cm2, P<0.05 ] , BMD of the patients after 8 months tamoxifen therapy increased at lumber vertebrae , femoral neck and others of hip joint [ (0.90±0.04) g/cm2, (0.74±0.05) g/cm2, P<0.05 ]. Conclusions The adjuvant chemotherapy can reduce BMD of the postmenopansal women with breast cancer. But bone loss can be attenuated by tamoxifen treatment.