【摘要】 目的 探讨他莫昔芬与氟维司群对乳腺癌患者腰椎骨密度的影响。方法 将118例乳腺癌患者按照治疗方式的不同分为A组58例和B组60例，A组患者采取氟维司群治疗，B组患者采取他莫昔芬治疗。比较两组患者的治疗效果、腰椎骨密度、骨代谢指标[骨钙素（OCN）、甲状旁腺激素（PTH）、降钙素（CT）及骨碱性磷酸酶（BAP）]、不良反应发生情况及生活质量[乳腺癌患者生命质量测定量表（FACT-B）]。结果 两组患者疾病控制率及各不良反应发生率比较，差异均无统计学意义（P﹥0.05）。治疗后，B组患者腰椎骨密度高于A组，差异有统计学意义（P﹤0.05）。治疗后，两组患者OCN、CT水平均升高，PTH、BAP水平均降低，B组患者CT水平低于A组，OCN、PTH、BAP水平均高于A组，差异均有统计学意义（P﹤0.05）。治疗后，两组患者FACT-B量表各维度评分均升高，且B组患者FACT-B量表各维度评分均高于A组，差异均有统计学意义（P﹤0.05）。结论 他莫昔芬与氟维司群治疗乳腺癌患者的效果及安全性相当，其中他莫昔芬对乳腺癌患者的骨代谢及腰椎骨密度影响较小，且可提高乳腺癌患者的生活质量，具有临床应用价值。更多还原

【Abstract】 Objective To investigate the influence of tamoxifen and fulvestrant on lumbar bone mineral density in patients with breast cancer(BC). Method A total of 118 BC patients were divided into group A(58 cases) and group B(60 cases) according to different treatment methods. Group A was treated with fulvestrant, and group B was treated with tamoxifen. The treatment effect, lumbar bone mineral density, bone metabolism indexes [osteocalcin(OCN), parathyroid hormone(PTH), calcitonin(CT) and bone alkaline phosphatase(BAP)], adverse reactions and quality of life [function assessment of cancer therapy-breast(FACT-B)] were compared between the two groups. Result There were no statistical differences in disease control rate and incidence of adverse reactions between the two groups(P>0.05). After treatment,the lumbar bone mineral density in group B was higher than that in group A, and the difference was statistically significant(P<0.05). After treatment, the levels of OCN and CT in the two groups increased, and the levels of PTH and BAP decreased, the level of CT in group B was lower than that in group A, and the levels of OCN, PTH and BAP were higher than those in group A, and the differences were statistically significant(P<0.05). After treatment, the scores of all dimensions of the FACT-B scale in the two groups increased, and the scores of all dimensions of the FACT-B scale in the group B were higher than those in the group A, and the differences were statistically significant(P<0.05). Conclusion The efficacy and safety of tamoxifen and fulvestrant in the treatment of BC patients are similar. Tamoxifen has less effect on bone metabolism and lumbar bone mineral density, and can improve the quality of life of BC patients, which has clinical application value.更多还原