非那雄胺对前列腺增生组织微血管密度的影响

目的评价术前服用非那雄胺对前列腺经尿道前列腺电切除术（transurethral resection of prostate,TURP）术中出血的影响,以及对前列腺组织中微血管密度（microvascular density,MVD）的影响。方法 160例良性前列腺增生症（benign prostatic hyperplasia,BPH）患者,术前服用非那雄胺5mg/d,2周的45例患者为A组;4周的52例患者为B组。术前未服用非那雄胺的63例患者为对照组,记录TURP前列腺切除重量,计算术中失血量,免疫组织化学方法检测前列腺组织微血管密度（MVD）。结果 A组中,前列腺体积在40～80mL者,与同体积对照组相比,术中出血量,平均切除1 g前列腺组织失血量,前列腺微血管密度小于对照组,差别有显著性意义（P〈0.05）。而前列腺体积〉80mL者,差别无显著性意义（P〉0.05）;B组中,与对照组相比,差别有显著性意义（P〈0.05）。结论前列腺体积在40～80mL者,术前应用非那雄胺2周即可减少TURP术中出血,减少腺体内微血管的密度,应用4周,疗效更加明显。前列腺体积〉80mL者,术前应用非那雄胺4周方可减少TURP术中出血,减少腺体内微血管的密度。

Effect of Finasteride on microvascular density in BPH patients with large-volume prostate

【Objective】 To evaluate preoperative finasteride on decreasing operative bleeding during TURP,and to study its mechanism.【Methods】 Totally 160 patients with benign prostatic hyperplasia（BPH） were scheduled for TURP;before surgery,45 of them were received 5mg of finasteride daily for two week（A group）,52 of them were received 5mg of finasteride daily for four weeks（B group）,the other 63 patients were not received finasteride（control group）.A comparative study of clinical data was made among the four groups.【Results】 The operation was successfully completed in 160 cases.For patients with prostate size among 40～80mL,Intraoperative blood loss,blood loss of 1 gram prostate tissue for resection,the expression of microvascular density of groups A and groups B were significantly less than the control group（P0.05）;for patients with prostate size greater than 80mL,there were no statistical significant difference in the above clinical indexes between the groups A and control group（P0.05）,whereas there were statistically significant difference between the groups B and control group（P0.05）.【Conclusion】 For patients with prostate size among 40～80mL,the use of finasteride before TURP for 2 weeks can reduce perioperative bleeding;for patients with prostate size greater than 80mL,only the use of finasteride before TURP for 4 weeks can reduce perioperative bleeding.