CAJ | 학술논문

目的：了解雄激素剥夺治疗（ androgen deprivation therapy ，ADT）对老年前列腺癌患者骨量丢失的影响。方法选取36例接受ADT（至少半年）的前列腺癌患者为ADT组及22例口服非那雄胺治疗（至少半年）的良性前列腺增生患者为非ADT组。两组患者在治疗前后均完善血钙、血磷、血清白蛋白、糖化血红蛋白（GHb）、碱性磷酸酶（ALP）、血肌酐（Cr）、前列腺特异性抗原（PSA）、睾酮、雌二醇（E2）等基础资料检测，并在治疗后进行骨密度（ bone mineral density，BMD）的测定，使用随机提供的T值作为参照标准对骨质疏松进行诊断。结果 ADT组治疗后睾酮明显下降，与 ADT前及非 ADT组差异有统计学意义（ P ＜0．01）；ADT组BMD较非ADT组低，在全身骨成分、腰椎（L1－4）、前臂骨两组 BMD差异有统计学意义（ P ＜0．05），股骨颈BMD在ADT组较非ADT组低，但差异不明显（ P ＞0．05）；ADT组骨质疏松发生率为50．0％，非ADT组为22．7％，两组有统计学差异（ P ＜0．05）。结论 ADT可能加快老年前列腺癌患者骨量丢失，使骨质疏松的发生率升高。在对前列腺癌患者采取去势治疗前，建议先完善BMD的测定，对有明显骨量丢失或有高骨质风险的患者，建议采取适当的干预措施，以减缓骨量丢失。
목적：료해웅격소박탈치료（ androgen deprivation therapy ，ADT）대노년전렬선암환자골량주실적영향。방법선취36례접수ADT（지소반년）적전렬선암환자위ADT조급22례구복비나웅알치료（지소반년）적량성전렬선증생환자위비ADT조。량조환자재치료전후균완선혈개、혈린、혈청백단백、당화혈홍단백（GHb）、감성린산매（ALP）、혈기항（Cr）、전렬선특이성항원（PSA）、고동、자이순（E2）등기출자료검측，병재치료후진행골밀도（ bone mineral density，BMD）적측정，사용수궤제공적T치작위삼조표준대골질소송진행진단。결과 ADT조치료후고동명현하강，여 ADT전급비 ADT조차이유통계학의의（ P ＜0．01）；ADT조BMD교비ADT조저，재전신골성분、요추（L1－4）、전비골량조 BMD차이유통계학의의（ P ＜0．05），고골경BMD재ADT조교비ADT조저，단차이불명현（ P ＞0．05）；ADT조골질소송발생솔위50．0％，비ADT조위22．7％，량조유통계학차이（ P ＜0．05）。결론 ADT가능가쾌노년전렬선암환자골량주실，사골질소송적발생솔승고。재대전렬선암환자채취거세치료전，건의선완선BMD적측정，대유명현골량주실혹유고골질풍험적환자，건의채취괄당적간예조시，이감완골량주실。
Objectives To study the influence of androgen deprivation therapy(ADT)on the bone loss in elderly patients with prostate cancer.Methods 36 patients with prostate cancer who accepted ADT ( no less than half a year) and 22 patients with benign prostatic hyperplasia who took finasteride daily ( no less than half a year) were enrolled separately in study as ADT group and non ADT group.All patients were measured with biochemical ex-amination and the bone mineral density(BMD)by dual energy X-ray absorptiometry before and after the treatment. The diagnosis of osteoporosis was made ADT according to the result of T scores of dual energy X-ray absorptiometry. Results After treatment ,the testosterone was lower significantly in ADT group compared with in ADT group be-fore treatment and in non ADT group( P <0.01).The BMD of the whole body bone composition、lumbar vertebral (L1~4)and forearm in ADT group was lower significantly than in non ADT group( P <0.05).The BMD of femoral neck was a little lower in ADT group compared with in non ADT group, but the difference between the two groups were not significant( P >0.05).The incidence of osteoporosis in ADT and non ADT groups were 50.0% and 22. 7% respectively.There was significant difference between two groups( P <0.05).Conclusions DT may speed up the bone mass loss and increase the incidence of osteoporosis in elderly patients with prostate cancer.The patients should have the BMD determination before ADT.It is necessary for the patients with obvious bone lossing or having high risk of osteoporosis that take some preventive measures to slow the bone loss.