^(32)P-GTMS治疗前列腺增生的动物研究及初步临床应用探讨

The animal investigation on the treatment of prostate proliferation by^(32)P-GTMS and its preliminary study of clinical application

采用3 2 P -GTMS治疗前列腺增生 ,能抑制前列腺间质细胞增生 ,改善排尿障碍症状。 (1)取 7条雄性健康草犬 ,以 2 5mg/kg丙睾每周 3次肌肉注射 ,持续 30d ,制成前列腺增生模型。 5条草犬模型在超声引导下注入 9.2 5— 74MBq/mL不等的3 2 P -GTMS ,分别于 30、6 0、90d活检 ,了解前列腺破坏、缩小数据。 2条草犬模型不予3 2 P -GTMS治疗 ,维持肌肉注射丙酸睾酮 ,直至治疗草犬疗效观察结束后作前列腺增生后缩小率比较。 (2 )根据草犬模型提供资料对 34例前列腺增生患者也行在超声引导下穿刺 ,注入3 2 P -GTMS 111± 18.5MBq ,分别于 30、6 0、90d测定前列腺容积 ,尿流率 ,残余尿及I -PSS评分结果 ,部分患者作活检病理。表明 7条草犬经注射丙酸睾酮后 30d ,前列腺平均增大 2倍以上。经3 2 P -GTMS治疗的 5条前列腺增生模型草犬的前列腺均出现前列腺细胞变性 ,炎性细胞浸润。当3 2 P -GTMS用量大于 13.88MBq/mL时呈显效结果 ,90d平均缩小率 >4 3.4 %,而对照组平均缩小率 <13%。 34例前列腺增生患者治疗 90d后前列腺缩小 17%,最大尿流率增加 4 1%,残余尿减少 74 %,I -PSS评分下降 31%,(P <0 .0 1)。病理切片结果显示 :增生前列腺细胞变性 ,萎缩。实验结果提示 ,采用B超引导下穿刺 ,在增生的前列腺内注入3 2

The radiation from 32P-GTMS was used to suppress the proliferation of prostate mesenchymal cell and improve the symptom of dysuria. (1) 25mg/kg of testosterone propionate were intramuscularly injected into 5 male healthy dogs three times a week for 30 days to establish the prostate proliferation model. Under the guidance of ultrasonography 9.25-74mBq/mL of 32P-GTMS were injected and 30, 60, 90 days post injection biopsy were examined to get the data of prostate destruction and its shrinking. Another 2 dogs were not treated with 32P-GTMS, but injected with testosterone propionate to serve as controls. Then we compare the rate of proliferatioe of prostate proliferation. (2) According to the data from dogs, 111±18.5mBq of 32P-GTMS were injected to 34 prostate proliferation patients under the guidance of ultrasonography and the prostate volume, urine flow, remnant urine and I-PSS scores were recorded at 30, 60 and 90 days post injection. In dogs, 30 days after the injection of testosterone propionate, the prostate were enlarged more than 2 times. After treatment with 32P-GTMS, 5 dogs all showed cytometaplasia and mesenchymal cell infiltration. After 90 days the average shrinking rate was larger than 43.4%, the average shrinking rate of compare group was loss than 13%. The average shrinking rate of 34 cases of prostate proliferation patients are 17% and the urine flow increased by 41%, remnant urine were decreased by 74% and I-PSS score decreased by 31%,(P<0.01). Pathological sections showed degeneration and atrophy of the prostate measenchymal cell. The method is an easy and non- painful way that can shrink the prostate and make the emiction freely.