摘要
目的 观察醋酸阿比特龙联合泼尼松对转移性去势抵抗性前列腺癌(mCRPC)患者尿流动力学指标及预后营养指数(PNI)、中性粒细胞/淋巴细胞比(NLR)水平的影响.方法 前瞻性选取2020年1月至2022年12月达州市中西医结合医院收治的84例mCRPC患者为对象,按照随机数字表法将其分为观察组与对照组,每组各42例.对照组给予泼尼松治疗,观察组给予醋酸阿比特龙联合泼尼松治疗.比较两组临床疗效,检测并比较两组治疗4周后的尿流动力学指标[最大尿流率(MFR)、剩余尿量(RVP)]、前列腺特异性抗原(PSA)、睾酮、嗜铬粒蛋白A(CgA)、PNI值、NLR值的水平,并比较两组的不良反应发生情况.结果 观察组的总有效率为85.71％,高于对照组(66.67％),差异有统计学意义(P＜0.05).治疗 4 周后,观察组 MFR 为(13.98±1.56)mL/s,高于对照组[(12.28±1.44)mL/s],RVP 为(21.11±2.23)mL,低于对照组[(25.23±2.17)mL],差异均有统计学意义(P＜0.05).治疗4周后,观察组总前列腺特异性抗原(tPSA)、游离前列腺特异性抗原(fPSA)、睾酮、CgA水平分别为(18.54±10.74)、(7.78±2.05)、(0.63± 0.10)、(96.85±15.65)ng/mL,均低于对照组[(32.56±12.02)、(13.23±4.11)、(0.81±0.12)、(105.63±21.14)ng/mL],差异均有统计学意义(P＜0.05).治疗4周后,观察组PNI值为56.58±10.11,高于对照组(51.29±9.74),NLR值为2.09±0.19,低于对照组(2.43±0.21),差异均有统计学意义(P＜0.05).两组不良反应发生率比较,差异无统计学意义(P＞0.05).结论 醋酸阿比特龙联合泼尼松可调节mCRPC患者PSA、睾酮及PNI、NLR的水平,改善尿流动力学,提高疗效.
Abstract
Objective To observe the effects of abiraterone acetate combined with prednisone on urodynamic index,prognostic nutrition index(PNI)and neutrophil/lymphocyte ratio(NLR)in patients with metastatic castration-resistant prostate cancer(mCRPC).Methods A total of 84 mCRPC patients admitted to Dazhou Integrated Traditional Chinese and Western Medicine Hospital from January 2020 to December 2022 were prospectively selected as the study subjects.They were divided into the observation group and the control group using a random number table method,with 42 patients in each group.The control group was treated with prednisone,and the observation group was treated with abiraterone ace-tate combined with prednisone.The efficacy of the two groups were analyzed,and the levels of urodynamic indicators[maximum flow rate(MFR),residual urine volume(RVP)],prostate specific antigen(PSA),testosterone,chromaffin A(CgA),PNI value,and NLR value after 4 weeks of treatment were detected and compared between two groups,and the adverse reactions of the two groups were compared.Results The total effective rate of the observation group was 85.71％,which was higher than that of the control group(66.67％),the difference was statisti-cally significant(P＜0.05).After 4 weeks of treatment,the MFR of the observation group was(13.98±1.56)mL/s,which was higher than that of the control group[(12.28±1.44)mL/s],and the RVP was(21.11±2.23)mL,which was lower than that of the control group[(25.23 ±2.17)mL],and the differences were statistically significant(P＜0.05).The levels of tatal prostate specific antigen(tPSA),free prostate specific antigen(fPSA),testosterone,and CgA in the observation group were(18.54±10.74),(7.78±2.05),(0.63±0.10),and(96.85 ±15.65)ng/mL,respectively,which were lower than those in the control group[(32.56±12.02),(13.23±4.11),(0.81±0.12),and(105.63±21.14)ng/mL],and the differences were statistically significant(P＜0.05).After 4 weeks of treatment,the PNI value of the ob-servation group was 56.58±10.11,which was higher than that of the control group(51.29±9.74),and the NLR value was 2.09±0.19,which was lower than that of the control group(2.43±0.21),and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Abiraterone acetate combined with prednisone can regulate the levels of PSA,testosterone,PNI and NLR in mCRPC patients,improve urodynamic index and improve therapeutic effect.
维普
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