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目的:探讨前列腺癌患者去势手术后雄激素水平降低及对血脂代谢的影响。方法:对诊断明确的36例进展期前列腺癌患者行双侧睾丸切除术,分别于术前、术后1、3、6个月及1年测定血清睾酮(T)、游离睾酮(FT)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(APO-A1)、载脂蛋白B(APO-B)。结果:去势术后1个月,T、FT较术前明显降低(0.45±0.05 ng/ml vs 4.88±0.21 ng/ml,P<0.01;2.09±0.56 pmol/L vs 35.25±4.20 pmol/L,P<0.01),以后持续下降,术后6个月降至最低。TG于术后1个月开始较术前显著升高(1.88±0.28 mmol/L vs 1.38±0.20 mmol/L,P<0.01)。TC、LDL-C于术后3个月开始较术前明显升高(5.29±0.71 mmol/L vs 3.61±0.59 mmol/L,P<0.01;3.13±0.44mmol/L vs 1.72±0.26 mmol/L,P<0.01),以后呈继续上升趋势。HDL-C于术后3个月开始较术前明显降低(1.47±0.28 mmol/L vs 1.86±0.24 mmol/L,P<0.01)。APO-A1、APO-B在手术前后无明显变化。结论:前列腺癌患者去势手术后,随着雄激素水平的降低,出现血脂代谢异常,TG、TC、LDL-C升高,HDL-C降低,可能使相关心血管疾病的发生率增加。
OBJECTIVE: To investigate the effect of androgen deprivation and lipid metabolism in patients with prostate cancer after castration surgery. Methods: Twenty-six patients with advanced prostate cancer were enrolled in this study. Bilateral orchidectomy was performed. The levels of serum testosterone (T), free testosterone (FT) TG, TC, HDL-C, LDL-C, APO-A1, apolipoprotein B APO-B). Results: At 1 month after castration, T and FT were significantly lower than those before operation (0.45 ± 0.05 ng / ml vs 4.88 ± 0.21 ng / ml, P <0.01; 2.09 ± 0.56 pmol / L vs 35.25 ± 4.20 pmol / L , P <0.01), then continued to decline after 6 months to a minimum. TG was significantly higher than preoperative one month after surgery (1.88 ± 0.28 mmol / L vs 1.38 ± 0.20 mmol / L, P <0.01). TC and LDL-C were significantly increased at 3 months after operation (5.29 ± 0.71 mmol / L vs 3.61 ± 0.59 mmol / L, P <0.01; 3.13 ± 0.44 mmol / L vs 1.72 ± 0.26 mmol / L , P <0.01), then continued to rise. HDL-C decreased significantly from 3 months after operation (1.47 ± 0.28 mmol / L vs 1.86 ± 0.24 mmol / L, P <0.01). APO-A1, APO-B before and after surgery no significant change. Conclusion: After the castration of prostate cancer patients, with the decrease of androgen levels, abnormal blood lipid metabolism, TG, TC, LDL-C increased, HDL-C decreased, may increase the incidence of cardiovascular disease.