目的 收集绝经后乳腺癌患者服用阿那曲唑后的相关临床指标，构建预测模型以评判继发骨质疏松的预测价值， 并验证其应用性。方法 连续性纳入2013 年 5 月至2014 年 4 月期间武汉市中心医院收治的使用阿那曲唑行内分泌治疗的 绝经后乳腺癌患者为研究队列，搜集相关临床资料，对其进行为期 36 个月的随访以确认预后转归。依据随访结果预判继发 OP 风险的影响性指标，并分析继发OP 时间窗以验证该预测模型的应用性。结果 最终搜集252 例符合本次临床试验要求 的乳腺癌患者，其中12 例患者失访、75 例患者继发OP、165 例患者于随访期内骨密度正常或相对正常。Cox 回归分析显 示，阿那曲唑治疗绝经后乳腺癌患者继发OP 的独立影响因素包括绝经时间、服用阿那曲唑时间、服用双磷酸盐时间、碱 性磷酸酶含量组成，其中绝经时间及服用阿那曲唑时间为危险性因素，服用双磷酸盐时间及 ALP 含量为保护性因素；服用 阿那曲唑时间≥3.017 年、服用双磷酸盐时间＜1.878 年的患者，继发OP 的时间窗更短，其临界值具有显著评判效能。结 论 绝经时间、服用阿那曲唑时间、服用双磷酸盐时间、ALP 含量是阿那曲唑治疗绝经后乳腺癌患者继发 OP 的独立影响因 素，且服用阿那曲唑时间≥ 3.017 年、服用双磷酸盐时间＜ 1.878 年为衡量本病患者继发 OP 的时间节点。

Objective To collect postmenopausal breast cancer patients taking anastrozole after the relevant clinical indicators, The predictive model was established to evaluate the predictive value of secondary osteoporosis (OP), and then verify its applicability. Methods Continuity included in the period from May 2013 to April 2014 in Wuhan City Center Hospital treated with anastrozole endocrine therapy for postmenopausal breast cancer patients for the study of the cohort, the clinical data were collected and followed for a follow-up of 36 months to confirm prognosis. According to the follow-up results predictive secondary risk of OP risk indicators, and analyze the secondary OP time window to verify the applicability of the prediction model. Results The final collection of 252 cases of breast cancer patients in line with the clinical trial requirements, of which 12 patients were lost, 75 patients secondary to OP, 165 patients in the follow-up period of bone mineral density normal or relatively normal. Cox regression analysis showed that the independent influencing factors of adjuvant OP in patients with postmenopausal breast cancer were determined by the time of menopause, the time of taking anastrozole, the time of bisphosphonates, the contents of alkaline phosphates (ALP) Among them, menopause time and taking anastrozole time as a risk factor, taking bisphosphonates time and ALP content as protective factors; taking anastrozole time≥3.07 years, taking bisphosphonates time <1. 878 years of patients, secondary OP time window shorter, the critical value of a significant evaluation of efficacy. Conclusion Menopause time, taking anastrozole time, taking bisphosphonates time, ALP content is anastrozole in the treatment of postmenopausal breast cancer secondary OP independent factors, and taking anastrozole time≥3.07 years, taking bisphosphonates time <1.788 years to measure the disease secondary to the patient's time nod