爱普列特减少经尿道前列腺汽化电切术中出血的作用研究

Preoperative epristeride on decreasing operative bleeding during transurethral vaporization of prostate

目的:探讨术前服用非竞争性5α-还原酶抑制剂爱普列特减少经尿道前列腺汽化电切术(transurethraluaporization of the prostate,TUVP)术中出血的作用。方法:将拟行TUVP的前列腺增生症(benign prostatic hyper-plasia,BPH)患者84例随机分为爱普列特治疗组和空白对照组,每组42例,计算术中出血量;免疫组织化学SP法检测前列腺组织内皮型一氧化氮合酶(eNOS)及VEGF蛋白的表达。结果:治疗组eNOS的蛋白表达较对照组减少31.5%,治疗组VEGF的表达阳性率明显低于对照组的表达阳性率(P<0.05)。爱普列特治疗组术中失血量(4.2±1.5)ml/g,空白对照组(7.1±2.3)ml/g,差异有显著性意义(P<0.05)。结论:术前服用爱普列特可抑制前列腺组织内VEGF蛋白和eNOS蛋白表达,抑制前列腺组织血管生成,减少TUVP术中出血。

Objective ： Study the effect of preoperative epristeride on decreasing operative bleeding during transurethral vaporization of the prostate （TUVP）. Methods ： 42 patients pretreaded with epristeride before TUVP and 42 patients without such a preoperative management, calculated the operative bleeding volume, eNOS and VEGF expression were measured by ISH SP method in prostatic tissue. Results ： The expression of eNOS in epristeride group decreased 31.5 % compared with control group, and the positive expression rate of VEGF in treated group is lower than that in control group obviously （ P 〈 0.05 ）. In epristeride group and control group the operative bleeding are（4.2 ± 1.5）ml/g and（7.1 ± 2.3）ml/g（ P 〈 0.05）. Conclusion ： The VEGF and eNOS expression and angiogenesis in the prostate tissue are suppressed,blood loss during operation（TUVP） decreased by preoperative use of epristeride.