比卡鲁胺联合戈舍瑞林不同给药方式治疗晚期前列腺癌的效果比较及[摘要]目的分析比卡鲁胺联合戈舍瑞林不同给药方式治疗晚期前列腺癌患者的效果及对患者血清前列腺特异性抗原（PSA）、血管内皮生长因子（VEGF）和miRNA-34a（miR-34a）的影响。方法选取2015年2月～2016年12月大连医科大学附属第一医院接诊的80例晚期前列腺癌患者作为研究对象，按照随机数字表法分为研究组和对照组，每组各40例。研究组患者口服比卡鲁胺并皮下注射戈舍瑞林，当PSA<0.2ng/mL时停止服用这两种药物，而当PSA>4ng/mL时则继续服用这两种药物，而对照组患者给予持续性给药。检测并记录治疗前后两组患者血清PSA、VEGF、miR-34a以及排尿梗阻情况，以及比较两组治疗效果、不良反应发生率、平均治疗费用。结果治疗后3、6、9个月以及12个月两组患者血清PSA、VEGF、miR-34a及排尿梗阻?l生率均较治疗前降低，差异有统计学意义（P<0.05），而两组比较，差异无统计学意义（P>0.05）。治疗后，研究组的总缓解率明显高于对照组，差异有统计学意义（P<0.05）；研究组患者的治疗费用明显低于对照组，差异有统计学意义（P<0.05）；两组患者均有不同程度的不良反应出现，但二者比较，差异无统计学意义（P>0.05）。结论比卡鲁胺联合戈舍瑞林间歇以及持续给药方式均可以改善晚期前列腺癌患者血清PSA、VEGF和miR-34a，而间歇型给药方式效果更加明显，效果良好。[关键词]比卡鲁胺；戈舍瑞林；前列腺癌；血清前列腺特异性抗原；血清VEGF[]R737.25[文献标识码]A[]1673-7210（2018）02（c）-0053-04ComparisonoftheeffectsofdifferentwaysofgivingBicalutamidecombinedwithGoserelininthetreatmentofadvancedprostatecancerandinfluenceontheexpressionofserumPSA，VEGFandmiR-34aLIXiunanQIN激eZHANGJunpengMAChuanyuWANGXingliWUDongjunCHENXiaochiDepartmentofUrology，theFirstAffiliatedHospitalofDalianMedicalUniversity，LiaoningProvince，Dalian116600，China[Abstract]ObjectiveToanalyzetheeffectsofdifferentwaysofgivingBicalutamidecombinedwithGoserelininthetreatmentofadvancedprostatecancerandinfluenceontheexpressionofserumprostate-specificantigen（PSA），vascularendothelialgrowthfactor（VEGF）andmiRNA-34a（miR-34a）.MethodsFromFebruary2015toDecember2016，80patientswithadvancedprostatecancerintheFirstAffiliatedHospitalofDalianMedicalUniversitywereselectedasresearchobjects，anddividedintostudygroupandcontrolgroupbyrandomnumbertable，with40casesineachgroup.ThestudygroupwastreatedwithoralBicarbonideandsubcutaneousinjectionofGoserelin，whenPSA<0.2ng/mL，stoptakingthesetwodrugs，andwhenPSA>4ng/mL，continuetotakethesetwodrugs.Thecontrolgroupwasgivencontinuousmedication.TheserumPSA，VEGF，mir-34aandtheincidenceofurinarytractobstructionweredetectedandrecordedbeforeandaftertreatment，andthetreatmenteffect，theincictenceofadverseeffects，theaveragetreatmentcostbetweentwogroupswerecompared.ResultsTheserumPSA，VEGF，mir-34aandurinaryobstructionofpatientsinthetwogroupsaftertreatmentfor3，6，9monthsand12monthswerealllowerthanthosebeforetreatment，thedifferenceswerestatisticallysignificant（P<0.05），andthetwogroupswerecompared，thedifferenceswerenotstatisticallysignificant（P>0.05）.Aftertreatment，theoverallresponserateinthestudygroupwashigherthancontrolgroup，thedifferencewasstatisticallysignificant（P<0.05），theaveragetreatmentcostinthestudygroupwaslowerthancontrolgroup，thedifferencewasstatisticallysignificant（P<0.05），bothgroupshaddifferentlevelsofadversereactions，buttheywerecompared，thedifferencewasnotstatisticallysignificant（P>0.05）.ConclusionBicalutamidecombinedwithGoserelinintermittentandcontinuousadministrationallcanimprovetheserumPSA，VEGFandmiR-34ainpati...