万古霉素对细菌性前列腺炎及良性前列腺增生合并细菌性前列腺炎大鼠的前列腺透过性及其治疗效果研究

目的:了解万古霉素对大鼠急性细菌性前列腺炎(BP)以及良性前列腺增生(BPH)合并BP的前列腺透过性与治疗效果。方法:采用每天由尾静脉注射1次万古霉素(100 mg/kg体重)共5 d的方法,分别对正常前列腺(NP,n=42)、BP(n=73)以及BPH合并BP(n=43)的SD雄性大鼠给药。注射后10 m in~24 h分离动物血清和前列腺,分别以琼脂扩散法及最低抑菌浓度(M IC)法检测血清抗生素活性,同时对前列腺进行病原菌的分离培养与计数;治疗结束后1~5周,分离BP治疗组动物的前列腺,进行病理学检查。结果:正常大鼠的前列腺组织内始终不能检出任何病原菌,未注射万古霉素的BP组大鼠前列腺组织至感染后的28 d仍可检出不同数量的病原菌。各BP治疗组动物的前列腺组织内病原菌的数量随给药时间延长而逐渐明显减少,在给药第5 d后91.7%的动物的前列腺组织已不能检出病原菌。各组大鼠给药后10~150 m in期间,其血清及前列腺组织内均可检出明显的抗生素活性,前列腺组织的M IC为0.05~0.005 g/m l,分别低于、等于或高于同期的血清抗生素活性。在给药6 h和24 h后,各组大鼠的血清与前列腺组织内已不能检出抗生素活性。组织病理学检查可见BP组大鼠的前列腺组织表现出明显的渗出、白细胞浸润,BPH组大鼠的前列腺具有明显的腺组织增生。随给药时间延长以及前列腺病原菌数量的减少或消失,BP组大鼠前列腺的组织炎性病理学改变可明显缓解。结论:静脉注射的万古霉素能够进入大鼠急性细菌性炎症前列腺以及BPH合并细菌性炎症前列腺的组织内,并且达到等于或高于血清抗生素浓度的水平,从而能够有效地杀灭前列腺组织内的敏感细菌,以促进前列腺组织的炎症反应缓解及其损伤组织的修复。

Penetrability and Therapeutic Effect of Vancomycin to the Prostates of Rats with Bacterial Prostatitis (BP) or BPH-BP

OBJECTIVE: To explore the penetrability and therapeutic effect of vancomycin to the prostates of rats with bacterial prostatitis (BP) or benign prostate hyperplasia (BPH)-BP. METHODS: The experimental rats with BP or BPH-BP were injected with vancomycin through the tail vein. The prostate tissues and sera were isolated respectively from the rats at 10 min to approximately 24 h after treatment and the antibiotic activities of the samples were detected by serial dilution test and agar diffusion test. The rats with BP or BPH-BP were treated with vancomycin by intravenous injection daily for 5 days. The prostates were collected the second day after injection and bacteria were isolated and determined. One to five weeks after treatment, the prostates of the animals were isolated and pathologic tests were done. RESULTS: No bacteria could be isolated from the prostates of the normal rats, but positive isolation was achieved from the prostates of the infected animals 28th day after infection. In the first 4 days after treatment, a decrease of bacteria could be detected in the prostate samples of the rats treated with BP or BPH-BP. After 5th day, no bacteria could be detected from 91.7% prostates of the treated groups. Obvious antibiotic activity in both sera and prostates could be detected 10 to approximately 150 min after the antibiotic injection. Antibiotic activity of the prostate tissues could be lower or higher than or equal to that of the sera in the same period. Pathologic tests detected obvious exudation and leukocyte invasion in the prostate tissues of the BP rats and gland proliferation in the BPH rats. Vancomycin treatment and the consequent reduction of bacteria obviously alleviated the inflammatory pathological changes in the prostates of the BP rats. CONCLUSION: Vancomycin given intravenously has more penetrability to the prostates of either BP or BPH-BP rats. The antibiotic concentration in the prostate tissues may be equal to or higher than that of the sera, so that the susceptive bacteria in the prostates will be killed and the alleviation of the inflammation and repair of the tissues accelerated effectively.