前列腺间质组织成分变化在BPH病程中的意义  

Changes in prostatic stromal composition and benign prostatic hyperplasia

作　　者：沈文[1] 毛向明[2] 吕军[1] 姚华强[1] 邓志雄[1] 赵永斌[1] 刘俊[1] 华伟[1] 汪帮琦[1] 胡卫列[1] 

机构地区：[1]广州军区广州总医院泌尿外科,广东广州510010 [2]南方医科大学南方医院泌尿外科,广东广州510515

出　　处：《中华男科学杂志》2011年第8期703-706,共4页National Journal of Andrology

基　　金：广东省自然科学基金重点项目(8251001002000001)~~

摘　　要：目的:探讨良性前列腺增生(BPH)患者前列腺组织是否存在间质成分改变,以及这种改变在BPH病程中的意义。方法:BPH患者手术或穿刺标本43例,尸检正常前列腺标本5例。所有标本行M asson染色显示前列腺间质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的关系。结果:正常前列腺间质组织中肌纤维和胶原成分比例平均为(3.2±0.2)∶1,而BPH患者前列腺间质组织中肌纤维与胶原成分比例平均为1(∶4.7±3.1),两组前列腺间质组织中成分比较差异有统计学意义(P<0.01)。有膀胱出口梗阻的BPH患者前列腺间质组织中肌纤维和胶原成分比例平均为1∶(5.4±3.7),明显低于无膀胱出口梗阻的BPH患者[1∶(2.5±1.1)](P=0.02)。重度前列腺症状的BPH患者前列腺间质组织中肌纤维和胶原成分比例平均为1∶(9.1±2.9),明显低于中度前列腺症状的BPH患者[1∶(5.3±3.4)]和轻度前列腺症状的BPH患者[1∶(2.8±1.7)](P均<0.01)。药物治疗效果差的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±4.3),明显低于药物治疗效果好的BPH患者[1∶(2.3±1.9)](P<0.01)。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。前列腺间质成分的改变可能在BPH发生发展中起重要作用。Objective： To investigate whether there are different stromal compositions in the prostate tissue of patients with benign prostatic hyperplasia （BPH） and evaluate their significance in the course of the disease. Methods ： Forty-three surgical or bioptie prostatic specimens of BPH and 5 autoptic normal prostatic specimens were stained by the Masson method to display the elements of the muscle fiber and collagen. The relationship of the changes in the prostatic stromal composition was analyzed with the degree of bladder outlet obstruction （ BOO）, IPSS and medication results. Results ： The mean ratio of muscle fiber to collagen in the normal prostate tissue was （3.2 ±0. 2） ： 1, significantly higher than that of the BPH patients （ 1 ： [ 4.7 ± 3. 1 ] ） （P 〈 0.01 ） ; that in the BPH patients with BOO was 1： （5. 4 ± 3.7） markedly lower than in those without BOO （ 1 ： [ 2.5 ± 1.1 ] ） （P = 0.02） ; that in the BPH patients with severe prostatic symptoms was 1 ： （9.1 ± 2.9）, remarkably lower than in those with moderate （ 1 ： [ 5.3 ± 3.4 ] ） and mild prostatic symptoms （1： [ 2.8 ± 1.7 ] ） （P 〈 0.01 ） ; and that in the BPH patients with satisfactory medicinal therapeutic results was 1： （2.3 ＋ 1.9）, significantly higher than in those with poor therapeutic results （ 1 ： [ 7.6± 4.3 ] ） （ P 〈 0.01 ）. Conclusion ： The stromal composition in the prostatic tissue of BPH patients undergoes different degrees of changes. More obvious BPH symptoms and poorer therapeutic results are associated with a bigger proportion of collagens and a smaller proportion of muscle fibers in the prostatic tissue. These changes may play an important role in the development and progression of BPH.

关 键 词：良性前列腺增生 病程 纤维化 

分 类 号：R697.32[医药卫生—泌尿科学]