维生素D在来曲唑干预绝经后雌激素受体阳性乳腺癌患者中的作用及临床意义

摘要

Objective To evaluate the effect of vitamin D in estrogen receptor-positive breast cancer patients treated with letrozole.Methods A total of 50patients with estrogen receptor-positive breast cancerwere investigated in this study.The serum vitamin D concentrations were measured by ELISA.All patients were divided into deficient (serum vitamin D below 10 ng/ml,19 cases),insufficient (serum vitamin D 10-30ng/ml,49 cases) and sufficient (serum vitamin D above 30 ng/ml,20 cases) groups.Patients received letrozole for 3 months in this assay.Besides,patients with deficient and insufficient vitamin D were given 50000 IU vitamin D weekly.The serum calcium,phosphorus,alkaline phosphatase and parathyroid hormone were detected before and after treatment.Results Before treatment,the serum calcium and phosphorus in patients of deficient and insufficient groups were significantly lower than sufficient groups,while the serum alkaline phosphatase and parathyroid hormone were significantly higher(P<0.05).After supplementation of vitamin D for 3 month,the serum calcium and phosphorus of patients were higher and the serum alkaline phosphatase and parathyroid hormone of patients were lower than before supplementation(P<0.05).In addition,the quality of life include physical function,social function,mental health and general health,in patients with insufficient vitamin D were no significant difference in sufficient groups.Conclusion After supplementation with vitamin D,the serum vitamin D concentrations in patients with breast cancer treated with letrozole increasd significantly,and the musculoskeletal symptoms decreased.It could improve those quality of life.%目的 探讨维生素D在来曲唑治疗乳腺癌患者中的作用及临床意义.方法 选取我院普外科收治的88例绝经后雌激素受体阳性乳腺癌患者.所有患者均进行血清维生素D水平的检测,并分为维生素D缺乏组(维生素D<10 ng/ml)共19例、维生素D不足组(维生素D为10-30 ng/ml)共49例和维生素D充足组(维生素D>30 ng/ml)共20例.患者入组后继续服用3个月来曲唑,其中维生素D缺乏组和维生素D不足组均给予每周口服5万单位维生素D.检测治疗前后血清中钙、磷、碱性磷酸酶和甲状旁腺激素等生化指标.结果 治疗前,相较于维生素D充足患者,维生素D缺乏和不足的患者钙和磷浓度较低,而甲状旁腺素和碱性磷酸酶较高(P<0.05);补充维生素D后血清钙和磷均得到明显的升高,而甲状旁腺素和碱性磷酸酶则有显著的降低(P<0.05);治疗后维生素不足组和充足组在躯体功能、社会功能、精神状况和总体健康等指标中的得分差别不大.结论 补充维生素D能够有效抑制来曲唑治疗乳腺癌患者引起的维生素D水平减少,降低肌肉骨骼等并发症发生,提升患者生活质量.