二氯化镭223对去势抵抗性前列腺癌伴骨转移患者血细胞计数骨痛程度和血PSA f-PSA和OPG的影响

doi:10.3969/j.issn.1006-6233.2025.01.030

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摘要 目的: 探究二氯化镭223对去势抵抗性前列腺癌(CRPC)伴骨转移患者血细胞计数、骨痛程度和血前列腺特异性抗原(PSA)、游离PSA(f-PSA)和骨保护素(OPG)的影响。方法: 研究西安交通大学第一附属医院2020年2月至2023年12月收治的122例CRPC伴骨转移患者,采用随机数字法将上述患者分为观察组(n=61,采用二氯化镭223+常规治疗)和对照组(n=61,采用常规治疗),6个月后,比较两组患者血细胞计数、骨痛程度、血清因子、疗效、不良反应。结果: 治疗后,两组红细胞、NK细胞、CD4⁺、血小板计数均有下降,治疗前后差值具有统计学意义(P<0.05);治疗后,两组VAS、PSA、f-PSA、OPG均有下降,治疗前后差值具有统计学意义(P<0.05)。观察组总有效率高于对照组(P<0.05);观察组胃肠道不适、肌肉酸痛或乏力、体温异常、周围性水肿单项不良反应发生率及合计发生率(6.56%、13.11%、9.84%、11.48%、40.98%)与对照组(8.20%、9.84%、11.48%、3.28%、32.79%)比较时,差异均无统计学意义(P>0.05)。结论: 对于CRPC伴骨转移患者而言,二氯化镭223有利于改善其血细胞计数及OPG水平,减轻骨痛严重程度,降低PSA和f-PSA水平,增强疗效,且安全性较高,具有推广价值。

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关键词 ：二氯化镭223, 前列腺癌, 骨转移, 前列腺特异性抗原

Abstract：Objective: To investigate the influence of radium-223 dichloride on blood cell count, bone pain degree, and serum prostate-specific antigen (PSA), free PSA (f-PSA), and osteoprotegerin (OPG) in patients with castration-resistant prostate cancer (CRPC) complicated by bone metastasis. Methods: A total of 122 patients with CRPC and bone metastasis at the First Affiliated Hospital of Xi'an Jiaotong University were studied from February 2020 to December 2023. They were randomly divided into an observation group (n=61, radium-223 dichloride + conventional treatment) and a control group (n=61, conventional treatment). After 6 months, blood cell count, bone pain degree, serum factors, efficacy, and adverse reactions were compared between the groups. Results: The counts of red blood cells, NK cells, CD4⁺ cells, and platelets decreased in both groups after treatment, with statistically significant differences before and after treatment (P<0.05). After treatment, the VAS, PSA, f-PSA, and OPG levels were reduced in both groups, with statistically significant differences between pre- and post-treatment levels (P<0.05). The total effective rate was higher in the observation group than in the control group (P<0.05). The incidence rates of adverse reactions such as gastrointestinal discomfort, muscle soreness or fatigue, abnormal body temperature, and peripheral edema, as well as the total incidence rate (6.56%, 13.11%, 9.84%, 11.48%, 40.98% in the observation group), were not statistically different from those in the control group (8.20%, 9.84%, 11.48%, 3.28%, 32.79%) (P>0.05). Conclusion: For CRPC patients with bone metastasis, radium-223 dichloride is beneficial for improving blood cell count and OPG levels, alleviating bone pain severity, reducing PSA and f-PSA levels, and enhancing treatment efficacy. It also demonstrates high safety and has value for promotion.

Key words： Radium-223 dichloride Prostate cancer Bone metastasis Prostate-specific antigen

基金资助:陕西省共性技术研发平台资助项目,(编号:2023GXJS-01)

通讯作者: 杨爱民

引用本文:

白洁, 崔雅婷, 杨雨静, 吴跃, 梁红梅, 杨爱民. 二氯化镭223对去势抵抗性前列腺癌伴骨转移患者血细胞计数骨痛程度和血PSA f-PSA和OPG的影响[J]. 河北医学, 2025, 31(1): 165-170.
BAI Jie, CUI Yating, YANG Yujing, et al. Influence of Radium-223 Dichloride on Blood Cell Count Bone Pain Degree and Serum PSA f-PSA and OPG in Patients with Castration-Resistant Prostate Cancer Complicated with Bone Metastasis. HeBei Med, 2025, 31(1): 165-170.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.01.030 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I1/165

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