前列腺动脉栓塞治疗激素诱导犬前列腺增生的有效性研究

Evaluation of prostate arterial embolization in treatment of hormone-induced prostatic hyperplasia in dogs

目的:探讨前列腺动脉栓塞治疗激素诱导犬前列腺增生的有效性。方法:将16只健康雄犬分别肌内注射丙酸睾酮3个月,诱导犬前列腺增生模型,模型诱导成功后将16只雄犬随机分为研究组(8只)及对照组(8只),使用Embosphere微球栓塞研究组雄犬双侧前列腺供血动脉。采用前列腺核磁共振检查对犬前列腺体积进行测量,随后将16只雄犬处死后取前列腺及周围组织进行组织病理学检查。结果:16只健康雄犬均成功诱导出良性前列腺增生模型,研究组8只雄犬均栓塞成功,无手术相关并发症。前列腺核磁共振检查显示经Embosphere微球栓塞前列腺供血动脉2个月后,研究组雄犬的前列腺体积明显缩小。栓塞前研究组与对照组前列腺体积比较差异无统计学意义[(24.6±3.1)ml vs.(25.0±1.6)ml,P>0.05];栓塞后2个月,两组的前列腺体积比较差异有统计学意义[(9.7±1.7)ml vs.(24.5±2.4)ml,P<0.05)]。与栓塞前比较,研究组平均体积减少60.6%,差异有统计学意义(P<0.05);对照组平均体积减少2.0%,差异无统计学意义(P>0.05)。栓塞后2个月病理学检查显示,研究组雄犬前列腺的供血动脉周围大片腺体组织萎缩,部分呈缺血坏死样改变。对照组可见前列腺腺体及周围间质组织增生。结论:经导管前列腺动脉微球栓塞能有效地引起前列腺组织梗死并能明显减少前列腺的体积,对临床上良性前列腺增生患者的治疗有潜在的临床意义。

Objective：To evaluate the efficacy of transarterial prostate embolization for the treatment in hormone-induced dogs with prostate hyperplasia.Method：Prostate hyperplasia was induced on 16 healthy adult male dogs by injecting testosterone propionate for three months.Then,16 adult male dogs were randomly assigned to treatment group（n=8）and control group（n=8）.Three months after executing the hormone treatment,8 dogs in treatment group underwent prostatic arterial embolization with Embospheres.The volume of prostate was measured by MRI.Finally,all dogs were sacrificed and the prostate was excised for histopathology study.Measurement data were expressed as x-±s.The prostatic volume between before the procedure of prostatic arterial embolization and after the procedure of prostatic arterial embolization were compared by samples paired t test.Result：The successful rate of BPH model establishment and prostatic arterial embolization were 100%.No serious surgery-related complication was observed.After three months of hormone injection,the mean volume of prostate was（24.6±3.1）ml in treatment group and（25.0±1.6）ml in control group before embolization,without statistical difference（P〈0.05）.Two months after being received prostatic arterial embolization,the mean volume of prostate was（9.7±1.7）ml in treatment group and（24.5±2.4）ml in control group with significant statistical difference（P〈0.05）.Compared with pretreatment measurement,the mean volume of prostate decreased by60.6%,at two months after embolization with significant statistical difference（P〈0.05）.But there was no statistical difference between the two time points in control group with a 2.0% mean decrease（P〈0.05）.The result of histopathology revealed that large pieces of prostatic glands arounding blood supply artery atrophy in male dog of treatment group,part of prostatic issue revealed ischemic necrosis change.Prostatic glands and surrounding interstitial tissue hyperplasia can be observed in control group.Conclusion：Transarterial prostatic embolization is an effective method that can induce prostatic infarction and obviously decrease the volume of prostate.The findings has potential clinical significance in the treatment of BPH.