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目的 评价术前服用非那雄胺对经尿道前列腺切除术 (TURP)术中出血量的影响及其作用机理。 方法 将拟行TURP术的BPH患者随机分为术前 2周服用非那雄胺组 (每天 5mg)及对照组 ,每组 5 0例。记录TURP前列腺切除重量 ,计算术中失血量。免疫组织化学SP法检测前列腺组织微血管密度 (MVD)及血管内皮生长因子 (VEGF)蛋白表达。 结果 服药组和对照组前列腺组织平均手术切除量分别为 (19.36± 7.95 ) g和 (2 0 .32± 8.6 6 )g(P >0 .0 5 )。术中平均出血量分别为(135 .8± 6 2 .9)ml和 (2 4 5 .1± 16 8.9)ml(P <0 .0 5 )。前列腺组织MVD值分别为 2 1.4± 9.7和 33.4± 11.2 (P <0 .0 5 )。VEGF平均阳性细胞数分别为 112 .1± 30 .1和 2 14 .6± 5 3.4 (P <0 .0 5 )。 结论 术前服用非那雄胺可抑制前列腺组织内VEGF蛋白表达 ,进而抑制前列腺组织血管生成 ,从而减少TURP术中出血。
Objective To evaluate the effect of preoperative taking finasteride on the amount of bleeding after transurethral resection of the prostate (TURP) and its mechanism of action. Methods BPH patients undergoing TURP were randomly divided into two groups: finasteride (5mg daily) and control group (n = 50). Record TURP prostate resection weight, calculate intraoperative blood loss. Immunohistochemical SP method was used to detect the microvessel density (MVD) and the expression of vascular endothelial growth factor (VEGF) in prostatic tissue. Results The average amount of resection of the prostate tissue in the two groups was (19.36 ± 7.95) g and (20.32 ± 8.66) g (P> 0.05), respectively. The mean intraoperative blood loss was (135.8 ± 6.22) ml and (24.5 ± 16.98) ml (P <0.05), respectively. Prostate tissue MVD values were 2 1.4 ± 9.7 and 33.4 ± 11.2, respectively (P <0.05). The average number of VEGF-positive cells was 112.1 ± 30.1 and 214.4 ± 5 3.4 (P <0.05), respectively. Conclusion Preoperative finasteride can inhibit the expression of VEGF protein in prostate tissue, and then inhibit the prostatic tissue angiogenesis, thereby reducing the bleeding in TURP.