胰岛素控制血糖对糖尿病大鼠阴茎勃起功能障碍的防治

Protective effects of insulin on erectile function in rats with streptozotocin-induced diabetes

目的：观察利用胰岛素严格控制血糖对糖尿病性勃起功能障碍（DMED）防治效果。方法年龄8周的健康Sprague-Dawley（SD）大鼠，STZ腹腔注射诱导糖尿病，监测血糖两个月诱导DMED模型，分正常对照组（NC），糖尿病安慰剂治疗组（DM），糖尿病胰岛素治疗组（DM-Inshulin）胰岛素每次2~6个单位，一天2次腹腔注射，连续治疗4周，早晚监测血糖。治疗结束后检测阴茎海绵体神经刺激下阴茎海绵体内压与平均动脉血压（ICP/MAP）评估勃起功能。留取阴茎组织进行组织学检测。结果 DM-Insulin组大鼠血糖和糖化血红蛋白得到有效控制，虽然勃起功能（以ICP/MAP检测）比较DM 组有所改善，但是比较NC组显著降低。DM-Insulin组大鼠阴茎海绵体内皮细胞标记物vWF、平滑肌等组织学病理变化及组织细胞凋亡指数比较DM组显著改善，但仍未恢复至NC组水平。结论糖尿病大鼠利用胰岛素严格控制血糖水平，可部分改善阴茎勃起功能和阴茎海绵体病理变化，但是不能完全修复勃起功能障碍的病理变化，这可能与糖尿病糖基化终末产物及其受体（AGE-RAGE）相关代谢记忆有关，有待于进一步深入研究。

Objective To investigate the therapeutic effects of insulin on eretile dysfunction in a rat model with streptozotocin-induced diabetes. Methods The diabetic erectile dysfunction （DMED） rat model was made by injecting the male 8-week-old Sprague-Dawley rats intraperitoneally with vehicle or freshly prepared 60 mg/kg streptozocin, and blood glucose level was measured in the later experiments. Then the rats were divided into three groups： the normal control group （N）, the diabetes group （DM） and the diabetes plus insulin therapy group （DM＋Insulin）. 8 weeks after STZ injection, the DM＋Insulin group were treated with 2~6 units of neutral protamine Hagedorn twice a day for 4 weeks through subcutaneous injection. After the final treatment, all rats were tested for erectile function by measuring the intracavernous pressure and mean arterial pressure （ICP/MAP）, and the penile was harvested for histology study. Results Although the glycemic level was tightly controlled by insulin in the therapy group, ICP/MAP level was partially restored compared to that of the normal control group, so with the endothelial and smooth muscle contents and apoptosis index. Conclusion Insulin could partially restore the erectile functions and pathology changes in the streptozotocin-induced diabetes rat model. Further studies are needed to investigate the underlying mechanisms in the processes of diabetic erectile dysfunction.