持续小剂量他达拉非早期治疗海绵体神经损伤后勃起功能障碍的实验研究  

Effect of Early Continuous Low-dose Tadalafil on Erectile Dysfunction After Cavernous Nerve Injury in the Rats

作　　者：卞军[1] 刘存东[1] 杨建昆[1] 周其赵[1] 孙祥宙[2] 邓春华[2] 

机构地区：[1]南方医科大学第三附属医院泌尿外科,广州510630 [2]中山大学附属第一医院泌尿外科,广州510080

出　　处：《医药导报》2013年第7期873-877,共5页Herald of Medicine

基　　金：国家自然科学基金青年科学基金资助项目(30901487);广东省自然科学基金资助项目(2008B030301059);广东省医学科研基金资助项目(A2010360)

摘　　要：目的研究早期持续小剂量他达拉非应用对海绵体神经(CN)损伤后勃起功能障碍(ED)的作用。方法通过钳夹损伤CN方法建立神经性ED动物模型后,将大鼠分为治疗组、CN损伤组、假手术组、正常组。治疗组、CN损伤组均予钳夹损伤CN,假手术组仅暴露CN,正常组不作任何处理。治疗组大鼠手术当天即开始给予小剂量他达拉非2 mg.kg-1灌胃治疗,CN损伤组仅建立CN损伤后ED模型,不作任何治疗,假手术组仅对CN进行暴露,不作任何处理和治疗,正常组大鼠不作任何处理。术后4周行阿朴吗啡实验,电刺激盆腔星状神经节(MPG)前、后海绵体内压(ICP)/平均动脉压(MAP)测定,行阴茎海绵体nNOS免疫组化染色。结果阿朴吗啡实验:30 min内,治疗组50%的大鼠出现阴茎勃起,平均勃起(1.13±0.92)次;CN损伤组勃起率和勃起次数均为0;假手术组为100%和(2.03±0.97)次;正常组为100%和(2.36±1.02)次。治疗组阴茎勃起率及勃起次数均高于CN损伤组(P<0.05),仍较假手术组、正常组低(P<0.05)。治疗组电刺激后ICP/MAP明显较CN损伤组高(0.30±0.09 vs 0.12±0.05,P<0.05),仍明显较假手术组、正常组低(P<0.05)。治疗组nNOS阳性神经纤维数目明显较CN损伤组多(54.11±5.02 vs 21.34±3.17,P<0.05),仍明显较假手术组、正常组低(P<0.05)。结论早期持续小剂量他达拉非治疗大鼠CN损伤后ED,有助于勃起功能的恢复。Objective To investigate the effect of early continuous administration of tadalafil on erectile dysfunction after cavernous nerve injury in the rat model. Methods The erectile dysfunction （ED） animal model was established by clamping the rats cavemous nerve（CN）. Rats were divided into four groups： treatment, CN injured, sham operated and normal control. Rats in the treatment group were given with tadalafil daily at a low dose of 2 mg· kg^-1 intragastrically. Rats in sham operated group had the CN exposed without clamping or any treatment. Four weeks after the operation, the apomorphine test was used to assess erectile function by measuring maximum intracavernosal pressure （ICP）/mean arterial pressure （MAP） ratio before and after major pelvic ganglion （MPG） electrical stimulation. The mid-shaft tissue of penes was taken for histological analysis, and immunohistochemical antibody staining was used to detect nNOS and the number of nNOS-positive nerve fibers. Results Penile erection was observed in 50% （6/12） of the rats for an average of （1.13±0.92） times within 30 min in the treatment group, as compared with 0% （0/11 ） of the rats with （0.00±0.00） times in the CN injured group （ P〈0.05 ）, and 100% （10/10） of the rats for （2.03＋0.97） times in the sham group （P〈0.05）, and 100% （10/10） of the rats for （2.36±1.02） times in normal group （P〈0.05）. No significant differences were manifested in ICP/MAP ratio before MPG electrical stimulation in the 4 groups. However, the ICP/MAP ratio of the treatment group was significantly higher than that of the CN injured group （P〈0.05） after MPG electrical stimulation, but lower than that of the sham group （ P〈0.05 ） and normal group （P〈0.05）. The number of nNOS-positive nerve fibers was significantly higher in the treatment group than that in CN injured group （54.11 ±5.02 vs 21.34±3.17, P〈0.05 ）, but significantly lower than that of sham group （76.48±8.24, P〈0.05 ） and norma

关 键 词：他达拉非 海绵体神经 勃起功能障碍 前列腺癌根治术 

分 类 号：R983[医药卫生—药品] R698[医药卫生—药学]