阿仑膦酸钠对前列腺癌老年患者药物去势治疗后骨密度和骨标志物的影响
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篇名: 阿仑膦酸钠对前列腺癌老年患者药物去势治疗后骨密度和骨标志物的影响
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摘要: 目的:探讨阿仑膦酸钠对前列腺癌老年患者药物去势治疗后骨密度(BMD)和骨标志物的影响。方法:本研究为前瞻性研究。选取84例拟行药物去势治疗的前列腺癌老年患者,按照随机数字表法分为治疗组(45例)和对照组(39例)。对照组患者给予药物去势治疗+碳酸钙D3片1片,po,qn;治疗组患者在此基础方案开始后1周给予阿仑膦酸钠片70 mg,po,每周1次。两组患者治疗时间均为12个月。观察两组患者25-羟基维生素D(25-OH-D)、睾酮、BMD、骨标志物水平,并记录不良反应发生情况。结果:治疗组脱落3例,对照组脱落1例。治疗前,两组患者上述指标比较,差异均无统计学意义(P>0.05)。治疗后,两组患者的25-OH-D水平略上升,但差异无统计学意义(P>0.05);治疗后,两组患者睾酮水平均较治疗前明显降低,差异有统计学意义(P<0.05)。治疗后12个月,治疗组患者腰椎、股骨颈和全髋部BMD水平明显上升,对照组患者明显下降,两组患者上述指标组间比较,差异均有统计学意义(P<0.05);治疗组患者骨钙羟基N端中分子片段、Ⅰ型前胶原氨基端延长肽和β-胶原特殊序列水平明显下降,对照组患者则明显升高,两组患者上述指标组间比较,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:阿仑膦酸钠可预防前列腺癌老年患者药物去势治疗导致的骨量流失,降低骨转换率。
ABSTRACT: OBJECTIVE: To explore the effects of alendronate sodium on bone mineral density (BMD) and bone marker in prostate cancer elderly patients after medical castration therapy. METHODS: In perspective study, 84 elderly patients undergoing medical castration therapy were selected and divided into treatment group (45 cases) and control group (39 cases) according to random number table. Control group received medical castration therapy+Calcium carbonate D3 tablets, 1 tablet, po,qn; treatment group was additionally given Alendronate sodium tablets 70 mg, po,once a week, 1 week after routine treatment, on the basis of control group. Treatment course of 2 groups lasted for 12 months. The levels of 25-OH-D, testosterone, BMD and bone marker were observed in 2 groups, and the occurrence of ADR was recorded. RESULTS: 3 cases of treatment group and 1 case of control group dropped out of the study. Before treatment, there was no statistical significance in above indexes between 2 groups (P>0.05). After treatment, 25-OH-D levels of 2 groups were increased slightly, but there was no statistical significance (P>0.05); testosterone level of 2 groups were decreased significantly compared to before treatment, with statistical significance (P<0.05). 12 months after treatment, BMD of lumbar vertebra, collum femoris and hip were increased significantly in treatment group, while those were decreased significantly in control group; there was statistical significance in above indexes between 2 groups (P<0.05). The levels of N-terminal midfragment of osteocalcin, procollagen Ⅰ N-terminal propeptide and β-crosslaps were decreased significantly in treatment group, while those were increased significantly in control group; there was statistical significance in above indexes between 2 groups (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS: Alendronate sodium can prevent bone loss and reduce the rate of bone turnover in elderly patients with prostate cancer receiving medical castration therapy.
期刊: 2016年第27卷第35期
作者: 段晓宇,朱虹,黄娟
AUTHORS: DUAN Xiaoyu,ZHU Hong,HUANG Juan
关键字: 阿仑膦酸钠;前列腺癌;老年患者;药物去势;骨密度;骨标志物
KEYWORDS: Alendronate sodium; Prostate cancer; Elderly patients; Medical castration; Bone mineral density; Bone marker
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