普适泰改善中重度老年良性前列腺增生患者前列腺组织学炎症的研究

Efficiency of prostate in improving the histological inflammation of prostates in elderly moderate and severe benign prostatic hyperplasia

目的研究普适泰改善前列腺组织学炎症影响良性前列腺增生（BPH）进展的高危险因素，减轻下尿路症状（LUTS）。方法连续性入组106例中重度BPH患者，采用随机和协商相结合方式分为对照组50例和实验组56例。对照组进行经尿道前列腺电切术（TURP）或经尿道前列腺激光切除术；实验组每日i21服普适泰148mg，3个月后进行手术。组织标本进行HE染色和免疫组织化学染色，由同1位病理医生进行诊断和判读炎症情况。结果对照组50例和实验组53例患者完成研究，组织学炎症程度和环氧合酶（COX-2）与前列腺体积、临床症状评分（IPSS）和血清前列腺特异性抗原（PSA）呈正相关。核因子（NF-kB）和诱导型一氧化氮合酶（iNOS）与血清PSA水平呈正相关。肿瘤坏死因子α（TNF-α）和前列腺体积等指标不相关。实验组前列腺组织学炎症程度评分在中度和重度的比例分别为37．7％（20／53）和7．6％（4／53）；对照组则分别为52．0％（26／50）和26．0％（13／50）。结论前列腺组织学炎症是BPH／LuTs发生的可能机制，COX-2、NF—KB和iNOS是重要的炎症因子。针对性改善炎症可以成为治疗BPH／LUTS的有效途径。

Objective To study the efficiency of prostat in improving the histological inflammation of prostates and lower urinary tract symptoms （LUTS） in elderly males with moderate and severe benign prostatic hyperplasia （BPH）. Methods A total of 106 patients with moderate to severe BPH/LUTS were consecutively selected into this trial and randomly divided into the control group （n= 50） and the experimental group （n= 56）. Transurethral resection of the prostate （TURP） or transurethral laser prostatectomy was carried out in the control cases, and was done after taking 148 mg prostat daily for 3 months in the experimental cases. All the specimens were stained with both HE and immunochemistry method, and the level of histological inflammation was diagnosed by the same experienced pathologist. Results Fifty cases in the control group and 53 cases in the experimental group finished the trial. The levels of histological inflammation and cyclooxygenase （COX）-2 were positively correlated with the volumes of prostate, the international prostate symptom score （IPSS） and serum prostate specific antigen （PSA） level, while NF-B and inducible nitric oxide synthase （iNOS） had positive correlations with the serum PSA. There was no correlation of TNF-α with the volumes of prostate, IPSS and serum PSA level. The proportions of subjects with moderate and severe histological inflammation were 37.7% （20/53） and 7.6% （4/53） respectively in the experimental group, and 52.0% （26/50） and 26.0% （13/50） respectively in control groups. Conclusions Histological inflammation of prostates may he one of the mechanisms of BPH/LUTS.COX 2, NF-kB and iNOS are the imporlant inflammation faclors. Reducing the histological inflammation could be an effective pathway to cure BPH/LUTS.