目的 观察分别采用他莫昔芬与阿那曲唑乳腺癌内分泌治疗对于骨代谢水平的影响。方法 择取放疗后接受内分泌治疗的乳腺癌患者150例,随机分为ANA组(阿那曲唑治疗)和TAM组(他莫昔芬治疗)各75例,均治疗12个月。于治疗前后采血检测两组患者血清降钙素(CT)、骨钙素(BGP)、骨碱性磷酸酶(NBAP)水平,使用X线骨密度测量仪检测L₂～L₄骨密度。结果 两组患者治疗后的CT、NBAP均高于治疗前,而BGP、L₂～L₄骨密度均低于治疗前(均P<0.01或P<0.05)。治疗后ANA组CT、BGP、NBAP水平均高于TAM组,L₂～L₄骨密度低于TAM组(均P<0.01)。结论 他莫昔芬与阿那曲唑乳腺癌内分泌治疗对于骨代谢水平均有明显影响,阿那曲唑影响更为明显。

Objective To observe the effects of tamoxifen and anatrazole endocrine therapies for breast cancer on bone metabolism.Methods A total of 150 patients with breast cancer who received endocrine therapy after radiotherapy were divided into anatrazole (ANA) group (n=75) and tamoxifen (TAM) group (n=75).All patients were treated for 12 months.The serum levels of calcitonin (CT), osteocalcin (BGP), and bone alkaline phosphatase (NBAP) were measured before and after treatment.The bone mineral density of L₂-L₄ was measured by X-ray absorptiometry.Results After treatment, the CT and NBAP of the two groups were higher than those before treatment, while the BGP and L₂-L₄ bone mineral density were lower (all P<0.01 or P<0.05).After treatment, the levels of CT, BGP, and NBAP in the ANA group were higher than those in the TAM group, while the L₂-L₄ bone mineral density was lower (P<0.01).Conclusion Both the endocrine therapies using TAM and ANA have significant effects on the levels of bone metabolism, especially ANA.