伊班膦酸钠联合阿法骨化醇对乳腺癌术后内分泌疗法导致骨质疏松患者临床疗效研究

摘要

目的 探讨对乳腺癌术后内分泌疗法引起骨质疏松患者采用伊班膦酸钠联合阿法骨化醇治疗的临床效果.方法 选取乳腺癌术后内分泌疗法导致的骨质疏松患者90例,随机分为对照组和研究组,每组45例.对照组患者在常规治疗的基础上给予阿法骨化醇胶囊口服,每次0.5μg,1天2次,1年内连续口服;研究组患者在对照组的基础上加用伊班膦酸钠注射液静脉滴注,首次剂量为2 mg,此后均给予3 mg,每3个月滴注1次,用药1年.对两组患者的临床疗效、骨密度以及不良反应发生情况进行统计和比较.结果 对照组疗效评价总有效率为73.33%(33/45),研究组为91.11%(41/45),两组之间总有效率比较,差异具有统计学意义(P＜0.05);②治疗后,两组患者腰椎、股骨颈、Ward三角区的骨密度均明显改善,与同组治疗前相比,差异具有统计学意义(P＜0.05),且研究组患者骨密度改善情况明显优于对照组,两组之间差异具有统计学意义(P＜0.05);③在治疗过程中,对照组患者发生不良反应7例,发生率为15.6%(7/45);研究组患者发生不良反应12例,发生率为26.7%(12/45),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 对乳腺癌手术结合内分泌疗法引起骨质疏松患者联合给予伊班膦酸钠和阿法骨化醇进行治疗,不仅显著增强临床疗效,对患者临床症状的改善、骨密度的提高也有明显的帮助,而且无明显增加的不良反应发生,安全性高,值得临床上进一步研究应用.%Objective To discuss the efficacy of ibandronate sodium combined with Alfacalcidol on osteoporosis in patients with endocrine therapy after breast cancer surgery.Methods Ninety osteoporotic patients with endocrine therapy after breast cancer surgery were randomly divided into control group and study group, with 45 cases in each group.Patients in the control group received oral Alfacalcidol 0.5 μg per time, 2 times per day, on the basis of conventional treatment for 1 years.Patients in the study group received intravenous ibandronate sodium, 2 mg at the first dose, 3 mg every 3 months thereafter, on the basis of the control group, for 1 year.The efficacy, bone mineral density (BMD), and adverse reaction were recorded and compared.Results 1) The total effective rate of was 73.33%(33/45) in the control group, and 91.11%(41/45) in the study group.The difference between the two groups was statistically significant ( P＜0.05).(2) After treatment, BMD of the lumbar, femoral neck and Ward’s triangle areas in both groups improved significantly, compared with those before treatment, and the difference was statistically significant (P＜0.05).The improvement of BMD in the study group was better than that in the control group, and the difference was statistically significant (P＜0.05).(3) During the treatment, there were 7 cases of adverse reaction in the control group, and the incidence rate was 15.6%(7/45).There were 12 cases of adverse reaction in the study group, and the incidence rate was 26.7%(12/45).The difference between the two groups was not statistically significant ( P ＜0.05 ).Conclusion Ibandronate sodium combined with Alfacalcidol enhances clinical efficacy for the treatment of the osteoporotic patients with endocrine therapy after breast cancer surgery.It also relieves the the clinical symptoms and improves BMD, with no obvious adverse reaction.It is worthy of further clinical application.