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目的探讨不同雄激素去除治疗对老年前列腺癌、前列腺增生患者血清骨代谢的影响。方法检测前列腺癌行药物去势(A组,20例)或手术去势(B组,20例)和前列腺增生(C组,40例)用非那雄胺治疗的老年患者治疗前及治疗1年后血清睾酮(T)、骨钙素(OC)、总Ⅰ型前胶原氨基端肽(tPINP)、Ⅰ型胶原羧基端肽(β-CTx)、甲状旁腺激素(PTH)、钙(Ca)、磷(P)水平。同期体检正常的老年男性40例为对照(D组)。结果治疗前,四组骨代谢相关指标差异均无统计学意义(P>0.05)。治疗1年后,A、B组的tPINP和β-CTx均高于D组(P<0.05),但C组与D组相仿(P>0.05);A、B组的T均低于D组(P<0.01)。结论检测血清tPINP和β-CTx可以帮助临床评估雄激素去除治疗的老年前列腺癌患者骨代谢的变化。非那雄胺对于老年前列腺增生患者血清骨代谢指标水平无明显影响。
Objective To investigate the effect of different androgen removal therapy on serum bone metabolism in elderly patients with prostate cancer and benign prostatic hyperplasia. Methods Pre-treatment and treatment 1 of senile patients treated with finasteride with prostatic cancer (group A, 20 cases) or surgical castration (group B, 20 cases) and benign prostatic hyperplasia (group C, 40 cases) Serum testosterone (T), osteocalcin (OC), total type Ⅰ procollagen (tPINP), type Ⅰ collagen beta-CTx, PTH, ), Phosphorus (P) levels. In the same period, 40 normal elderly men were taken as control group (group D). Results Before treatment, there was no significant difference in the indexes of bone metabolism between the four groups (P> 0.05). After treatment for 1 year, tPINP and β-CTx in group A and group B were significantly higher than those in group D (P <0.05), but C and D were similar (P> 0.05) (P <0.01). Conclusions The detection of serum tPINP and β-CTx can help to evaluate the clinical changes of bone metabolism in androgen-depleted elderly prostate cancer patients. Finasteride for elderly patients with benign prostatic hyperplasia serum bone metabolism indicators had no significant effect.