[摘 要] 目的：探究地塞米松联合阿比特龙对去势抵抗性前列腺癌（CRPC）患者尿流动力学、外周血循环肿瘤细胞雄激素受 体剪切变异体7（AR-V7）、人同源盒基因B13（HoxB13）水平及生存预后的影响。方法：回顾性选取本院收治的114例CRPC患者 病历资料，根据治疗方案分为对照组（予以0.5 mg地塞米松治疗，n = 51）和观察组（予以0.5 mg地塞米松联合1 000 mg阿比特龙 治疗，n = 63）。比较两组疗效、尿动力学、外周血循环肿瘤细胞AR-V7、HoxB13水平以及生存预后。结果：观察组63例，对照组 51例。治疗8周后，观察组疾病控制率与客观缓解率（分别为42.86%与96.83%）均显著高于对照组（分别为23.53%与86.27%） （P < 0.05）。观察组的最大尿流率[（14.58 ± 1.02）mL/s vs （11.18 ± 1.16）mL/s）]、平均尿流率[（12.92 ± 1.21）mL/s vs （9.83 ± 0.59） mL/s）]均显著高于对照组，而剩余尿量[（24.12 ± 1.96）mL vs （28.03 ± 1.68）mL）]显著低于对照组（均P < 0.05）。观察组与对照组 的AR-V7 mRNA表达水平相近[（1.78 ± 0.32） vs （1.68 ± 0.46）]，差异无统计学意义（P > 0.05）；但观察组的HoxB13 mRNA表达水 平显著低于对照组[（1.21 ± 0.27） vs （1.57 ± 0.37），P < 0.05]。观察组的中位无进展生存期[6.22个月（95%CI：5.63~6.63）]显著长 于对照组[3.66个月（95%CI：3.01~3.74）]（P < 0.05）；观察组的 3 年总生存率为12.70%，显著高于对照组的0.00%（P < 0.05）。 结论：地塞米松联合阿比特龙治疗CRPC患者具有显著疗效，能明显改善患者尿流动力，下调外周血循环肿瘤细胞中HoxB13的 表达，未显著影响AR-V7的表达，还能延长患者PFS，提高3年总生存率。

[Abstract] Objective: To investigate the effects of dexamethasone combined with abiraterone on the urodynamic parameters, levels of androgen receptor splice variant 7 (AR-V7) and human homeobox B13 (HoxB13) in peripheral blood circulating tumor cells, and survival prognosis of patients with castration-resistant prostate cancer (CRPC). Methods: Medical records of 114 CRPC patients admitted to our hospital were retrospectively selected. According to the treatment regimen, they were divided into the control group (treated with 0.5 mg dexamethasone, n = 51) and the observation group (treated with 0.5 mg dexamethasone combined with 1 000 mg abiraterone, n = 63). The efficacy, urodynamic parameters, levels of AR-V7 and HoxB13 in peripheral blood circulating tumor cells, and survival prognosis of the two groups were compared. Results: There were 63 patients in the observation group and 51 in the control group. After 8 weeks of treatment, both the disease control rate (42.86% vs 23.53%) and the objective response rate (96.83% vs 86.27%) were significantly higher in the observation group than in the control group (P < 0.05). The maximum urinary flow rate ([14.58 ± 1.02] mL/s vs [11.18 ± 1.16] mL/s) and the average urinary flow rate ([12.92 ± 1.21] mL/s vs ([9.83 ± 0.59] mL/s) were significantly higher in the observation group, while the residual urine volume ([24.12 ± 1.96] mL vs [28.03 ± 1.68] mL) was significantly lower than in the control group (all P < 0.05). The expression levels of AR-V7 mRNA were similar between the observation group (1.78 ± 0.32) and the control group (1.68 ± 0.46), with no statistically significant difference (P > 0.05). However, the expression level of HoxB13 mRNA in the observation group (1.21 ± 0.27) was significantly lower than that in the control group (1.57 ± 0.37) (P < 0.05). The median progression-free survival was significantly longer in the observation group (6.22 months [95% CI: 5.63~ 6.63]) than in the control group (3.66 months [95% CI: 3.01~3.74]) (P < 0.05). The 3-year overall survival rate was 12.70% in the observation group, significantly higher than 0.00% in the control group (P < 0.05). Conclusion: The combination of dexamethasone and abiraterone demonstrates significant efficacy in treating CRPC patients. It can markedly improve urodynamic parameters, downregulate HoxB13 expression in peripheral blood circulating tumor cells without significantly affecting AR-V7 expression, prolong progression-free survival, and increase the 3-year overall survival rate.