阿那曲唑和他莫昔芬对绝经后乳腺癌患者血脂影响的对比研究

摘要

Objective To investigate the effect of anastrozole and the effect of tamoxifen on blood lipid levels in postmenopausal women with estrogen receptor-positive breast cancer. Methods Sixty-four postmenopausal women with estrogen receptor-positive breast cancer were enrolled and randomized to receive anastrozole lmg (n = 30) (A) or tamoxifen 20 mg (n = 34) (B) once daily as adjuvant hormonal treatment. Serum lipid parameters including total cholesterol (TC), triglyceride(TG), high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol were determined before antiestrogen therapy and at 3, 6, 9 and 12 months after the treatment. Results No significant changes of all lipid parameters were shown at all assessment time points in the anastrozole group (P > 0.05). TC and LDL cholesterol levels were significantly decreased in the tamoxifen group (P < 0.05) , TG and HDL cholesterol levels were not affected in the tamoxifen group (P > 0.05). Conclusion Tamoxifen could provide better effect than anastrozole in terms of the lipid profile in postmenopausal women with estrogen receptor-positive breast cancer. It's suggested that blood lipid levels should should be used as a regular monitor for long-term application of anastrozole-treated patients, and tamoxifen may be a better treatment choice for patients at high risk of cardiovascular events.%目的:比较阿那曲唑(ANA)和他莫昔芬(TAM)对绝经后激素受体阳性乳腺癌患者术后辅助治疗的血脂影响.方法:随机将64例乳腺癌患者分为治疗组(ANA)和对照组(TAM).分别采集两组患者服药不同时间段的空腹静脉血,检测血脂指标:总胆固醇(TC)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、甘油三酯(TrG).结果:A组服药后12个月时TC升高明显,但是各时间段比较未见统计学差异(P＞0.05).B组服药前后TG、HDLC变化无统计学差异(P＞0.05),服药后6、12个月TC、LDLC有所下降,具有统计学意义(P＜0.05).结论:TAM对绝经后雌激素受体阳性乳腺癌患者血脂的影响优于ANA,故对于长期使用ANA患者应监测血脂变化,并TAM可能是临床上心血管疾病高危人群的乳腺癌患者的更佳选择.