【摘要】 目的 比较恩扎卢胺与阿比特龙分别联合雄激素剥夺治疗（ADT）在转移性去势抵抗性前列腺癌（mCRPC）患者中的疗效。方法 选取2023年6月—2024年12月贺州市人民医院收治的mCRPC患者50例，采用随机数字表法分为观察组和对照组，每组25例。观察组给予恩扎卢胺联合ADT治疗，对照组给予阿比特龙联合ADT治疗，2组均治疗6个月。比较2组近期疗效，治疗前后血清指标[前列腺特异性抗原（PSA）、睾酮（T）、神经元特异性烯醇化酶（NSE）]、尿流动力学指标[最大尿流率(Q_max)、剩余尿量（PVR）]及不良反应。结果 观察组与对照组疾病控制率比较差异无统计学意义（92.00%vs. 72.00%,χ²=2.168,P=0.141）。治疗6个月后，2组PSA、T、NSE水平低于治疗前，且观察组低于对照组（P<0.01）;2组Q_max高于治疗前，PVR低于治疗前，且观察组高/低于对照组（P<0.01）。观察组与对照组不良反应总发生率比较差异无统计学意义（24.00%vs. 32.00%,χ²=0.397,P=0.529）。结论 恩扎卢胺联合ADT治疗mCRPC展现出更好的临床效果和安全性优势，能有效调控血清标志物水平，改善排尿功能，并未增加不良反应。更多还原

【Abstract】 Objective To compare the efficacy of enzalutamide and abiraterone respectively combined with androgen deprivation therapy（ADT） for metastatic castration-resistant prostate cancer（mCRPC）. Methods Fifty patients with mCRPC who were admitted to the People′s Hospital of Hezhou from June 2023 to December 2024 were selected and divided into the observation group and the control group by the random number table method, with 25 cases in each group. The observation group was treated with enzalutamide combined with ADT, while the control group was treated with abiraterone combined with ADT. Both groups were treated for 6 months. The clinical efficacy, the serum indicators（PSA, T, NSE）, urodynamic indicators(Q_max, PVR) before and after treatment, and adverse reactions were compared between two groups. Results There was no statistically significant difference in the disease control rate between the observation group and the control group（92.00% vs. 72.00%, χ²=2.168, P=0.141）. After 6 months of treatment, the levels of PSA, T and NSE in both groups were lower than those before treatment, and those in the observation group were lower than those in the control group（P<0.01）. The Q_max were higher than those before treatment, the PVR were lower than those before treatment in two groups, and the observation group were higher/lower than the control group（P<0.01）. There was no statistically significant difference in the total incidence of adverse reactions between the observation group and the control group（24.00% vs. 32.00%, χ²=0.397, P=0.529）. Conclusion Enzalutamide combined with ADT in the treatment of mCRPC shows better clinical efficacy and safety advantages. It can effectively regulate the levels of serum markers, improve urination function, and does not increase adverse reactions.更多还原