双磷酸盐类药物联合骨化三醇对乳腺癌内分泌治疗引起的骨质疏松症患者骨密度的影响

Effect of bisphosphonates combined with calcitriol on bone mineral density of patients with osteoporosis due to endocrine therapy for breast cancer

  • 摘要:
      目的  分析双磷酸盐类药物联合骨化三醇在乳腺癌内分泌治疗引起的骨质疏松症患者中的应用效果。
      方法  选取因乳腺癌内分泌治疗引发骨质疏松症的患者159例,分为A组、B组、C组,每组53例。A组采用骨化三醇治疗,B组采用骨化三醇联合双磷酸盐类药物阿仑膦酸钠治疗,C组采用骨化三醇联合双磷酸盐类药物伊班膦酸钠治疗。比较3组骨代谢指标、免疫细胞因子、关节痛、骨密度、临床疗效及不良反应。
      结果  与A组、B组比较,C组抗酒石酸酸性磷酸酶(TRACP)、Ⅰ型原胶原分子N-端前肽(PINP)、骨碱性磷酸酶(BALP)、骨钙素(BGP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、关节疼痛评分降低,白细胞介素-10(IL-10)、肿瘤坏死因子-β1(TGF-β1)、骨密度升高,差异有统计学意义(P < 0.05)。与A组、B组比较,C组总有效率较高,差异有统计学意义(P < 0.05)。
      结论  双磷酸盐类药物联合骨化三醇可增强乳腺癌内分泌治疗引起的骨质疏松症患者的免疫功能,改善骨代谢异常,提高骨密度,其中以双磷酸盐类药物伊班膦酸钠效果最佳。

     

    Abstract:
      Objective  To analyze the effect of bisphosphonates combined with calcitriol in the treatment of patients with osteoporosis due to endocrine therapy for breast cancer.
      Methods  A total of 159 patients with osteoporosis due to endocrine therapy for breast cancer were selected and divided into groups A, B and C, with 53 cases in each group. Group A was treated with calcitriol, group B was treated with calcitriol combined with alendronate sodium (bisphosphonates), and group C was treated with calcitriol combined with ibandronate sodium (bisphosphonates). Bone metabolism indexes, immune cytokines, joint pain, bone mineral density, clinical efficacy and adverse reactions were compared among the three groups.
      Results  Compared with group A and group B, the tartrate resistant acid phosphatase (TRACP), procollagen of type I N-terminal propeptide (PINP), bone alkaline phosphatase (BALP), bone gla protein (BGP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) and the joint pain score decreased significantly in group C, while the levels of interleukin-10 (IL-10) bone mineral density and TNF-β1 (TGF-β1) decreased significantly in group C (P < 0.05). Compared with group A and B, the total effective rate of group C was significantly higher (P < 0.05).
      Conclusion  Application of bisphosphonates combined with calcitriol can enhance the immune function of patients with osteoporosis due to endocrine therapy for breast cancer, improve the abnormal bone metabolism, and increase the bone mineral density. Among lots of bisphosphonates drugs, the effect of ibandronate sodium is the best.

     

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