阿那曲唑对乳腺癌术后化疗患者血脂、肝功能及安全性的影响

摘要

Objective To investigate effects of Anastrozole on blood lipid, liver function and safety of breast cancer patients undergoing postoperative chemotherapy. Methods A total of 122 breast cancer patients undergoing post-operative chemotherapy during April 2008 and March 2010 were divided into observation group ( n =61 ) and control group (n=61) according to different treatment methods. Control group was treated with routine chemotherapy combined with Tamoxifen, while observation group underwent routine chemotherapy combined with Anastrozole endocrine therapy. Level changes of blood fat and liver function, clinical curative effect and adverse reactions before and year treatment in two groups were compared. Results In 1 year after treatment, levels of triglyceride ( TG) , total cholesterol ( TC) and low density lipoprotein cholesterol ( LDL-C) were decreased, and high density lipoprotein cholesterol ( HDL-C) levels were increased, and the changes continued for 5 year after treatment; especially in the 5th year, in observation group, TG, TC and LDL-C levels were lower, while HDL-C level was higher than those in control group (P<0. 05). In 1st, 2nd, 3rd, 4th and 5th year after treatment, levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin ( TBIL) and glutamyl transpeptidase ( GGT) were decreased in different degrees;especially in the 5 th year after treatment, in observation group, AST, ALT, TBIL and GGT levels were significantly lower than those in control group (P<0. 05). In the 5th year after treatment, total remission and survival rates in observation group were significant-ly higher than those in control group (P<0. 01). There was no significant difference in incidence rates of adverse reac-tion between two groups (P>0. 05). Conclusion Anastrozole adjuvant endocrine therapy in treatment of breast cancer patients undergoing postoperative chemotherapy can significantly improve the blood lipid and liver function with good clin-ical effect and safety.%目的：研究阿那曲唑对乳腺癌术后化疗患者血脂、肝功能和安全性的影响。方法选取2008年4月—2010年3月武汉市第十一医院收治的122例乳腺癌术后化疗患者,按照治疗方法不同分为观察组和对照组,每组61例。对照组采取常规化疗方案加他莫昔芬进行内分泌治疗,观察组采用常规化疗方案加阿那曲唑进行内分泌治疗。比较两组治疗前后血脂、肝功能变化,临床疗效及不良反应情况。结果治疗1年后,甘油三酯( TG)、总胆固醇( TC)、低密度脂蛋白胆固醇( LDL-C)均降低,高密度脂蛋白胆固醇( HDL-C)升高,持续至治疗后第5年,尤其是第5年,观察组TG、TC、LDL-C低于对照组(P<0．05),HDL-C高于对照组(P<0．05)。在治疗后1、2、3、4、5年,天冬氨酸转氨酶( AST)、丙氨酸转氨酶( ALT)、总胆红素( TBIL)及谷氨酰转肽酶( GGT)均呈不同程度的降低,尤其是治疗后第5年,观察组AST、ALT、TBIL及GGT显著低于对照组(P<0．05)。治疗后5年,观察组总缓解率和总存活率明显高于对照组(P<0．01)。两组不良反应发生率差异无统计学意义(P>0．05)。结论乳腺癌术后化疗患者采取阿那曲唑进行内分泌辅助治疗,能明显改善血脂及肝功能指标,临床疗效良好,安全性高,值得推广使用。