【作者】 沈文； 吕军； 姚华强； 邓志雄； 赵永斌； 刘俊； 华伟； 汪帮琦； 胡卫列；

【Author】 SHEN Wen,LV Jun,YAO Hua-qiang,DENG Zhi-xiong,ZHAO Yong-bin,LIU Jun,HUA Wei,WANG Bang-qi,HU Wei-lie. Department of Urology,Guangzhou general hosipital of Guangzhou command,Guangzhou 510010,China

【机构】 广州军区广州总医院泌尿外科；

【摘要】 目的:探讨观察前列腺增生(benign prostatic heyperplasia,BPH)患者前列腺组织是否存在间质成分改变并探讨这种改变在BPH病程中的意义。方法:BPH患者手术或穿刺标本43例,另年轻尸体正常前列腺标本5例。所有标本行Masson染色显示前列腺组织肌纤维和胶原成分。以肌纤维成分与胶原成分比值量化前列腺间质组织成分变化程度。评估前列腺间质成分变化程度与膀胱出口梗阻程度、IPSS评分及药物治疗效果之间关系。结果:正常前列腺组织中肌纤维和胶原成分比例平均为3.2: 1,而BPH患者前列腺组织中肌纤维比胶原成分比例平均为1:4.7,两组前列腺组织中成分差异有统计学意义(P<0.001)。有膀胱出口梗阻BPH患者前列腺组织中肌纤维和胶原成分比例平均为1:5.4,明显低于无膀胱出口梗阻BPH患者前列腺组织中肌纤维和胶原成分平均比例1:2.5(P=0.02)。重度前列腺症状BPH患者前列腺组织中肌纤维和胶原成分平均比例1:9.1明显低于中度前列腺症状BPH患者平均比例1:5.3低于轻度前列腺症状BPH患者1:2.8(P均<0.001)。药物治疗效果差BPH患者前列腺组织中肌纤维和胶原成分比例平均为1:7.6明显低于药物治疗好BPH患者的1:2.3(P<0.001)。结论:BPH患者存在不同程度的间质成分改变。BPH临床症状越明显,药物治疗效果越差,前列腺间质组织中肌纤维成分越低,胶原纤维成分越多。前列腺间质改变在BPH发生发展中起到重要作用。更多还原

【Abstract】 Objective:To observe whether there are different stromal compositions of prostatic tissue in patients with benign prostatic hyperplasia(BPH)and to evaluate its significant.Methods:43 surgical or bioptic prostatic specimens of patients with benign prostatic hyperplasia and 5 normal prostatic specimens were stained by Masson method to show the element of muscle fiber and collagen.The relationship between degree of bladder outlet obstruction,IPSS,therapeutic effect of medicine and the rate of muscle fiber/collagen were approached by statistical method,respectively.Results:The mean rate of muscle fiber/collagen in healthy people was 3.2:1,it is significently higher than the mean rate of muscle fiber/collagen in BPH patients 1:4.7(P<0.001).The mean rate of muscle fiber/collagen in BPH patients with bladder outlet obstruction was marked lower than BPH patients without bladder outlet obstruction(rate=1:6.4 and 1:2.5,respectively,P=0.02).The mean rate of muscle fiber/collagen in BPH patients with severe prostatic symptom was signiflcently lower than patients with medium prostatic symptom was significantly lower than patients with slight prostatic symptom(rate=1:9.1,1:5.3,1:2.8,respectively,P all<0.001) The mean rate of muscle fiber/collagen in BPH patients with satisfactory theraprutic effect of medicine was 1:2.3,which was significently lower than BPH patients with little theraprutic effect of medicine(rate=1:2.3,P<0.001).Conclulsions:There are different degrees of stromal compositions in prostatic tissue of BPH.The worse symptom and therapeutic effect of medicine in patients with BPH may suggest more collagen and less muscle fiber in prostatic tissue.Changes in prostatic stromal may play a important role in development of BPH.更多还原