Shibata Yasuhiro, Ono Yoshihiro, Kashiwagi Bunzo, Suzuki Kazuhiro, Fukabori Yoshitatsu, Honma Seijiro, Yamanaka Hidetoshi
Department of Urology, Gunma University School of Medicine, Maebashi, Gunma, Japan.
Urology. 2003 Nov;62(5):942-6. doi: 10.1016/s0090-4295(03)00566-1.
To clarify the basic aspects of the regulation of the prostatic blood supply by antiandrogens, their effect on the prostatic blood supply was studied for both androgen content and morphology of true capillaries in the rat ventral prostate. The effectiveness of antiandrogens on the control of hemorrhagic status in prostatic diseases has been previously reported.
Androgen concentrations in the prostate were quantified after administration of chlormadinone acetate (CMA), finasteride, or flutamide. The prostatic blood supplies were measured after administration of CMA, finasteride, flutamide, or bicalutamide. The alpha-blockers, terazosin and tamsulosin, were included in the study as negative controls. The histologic changes in the capillaries of the ventral prostate were observed, and the luminal area was measured.
The prostate dihydrotestosterone concentrations were decreased by the administration of all antiandrogens. Treatment with CMA, finasteride, flutamide, or bicalutamide reduced the prostatic blood supply by 50% to 65%. The parallel reduction in luminal areas of the true capillaries was observed in rats treated with CMA. Treatment with alpha-blockers did not affect the prostate androgen content, prostatic blood supply, or capillary luminal area.
The reduction of the prostatic blood supply was suggested to be the result of a decrease in dihydrotestosterone content and the reduction in the luminal area of capillaries. The early reductive effect of antiandrogens on the prostatic blood supply suggests an alternative use for antiandrogens independent of their typical use for prostate volume regression. The results support the basic aspects of the advantage of preoperative treatment with CMA, flutamide, and bicalutamide, similar to finasteride, in reducing perioperative hemorrhage.
为阐明抗雄激素药物对前列腺血液供应调节的基本方面,研究了其对大鼠腹侧前列腺雄激素含量及真毛细血管形态的影响,此前已有关于抗雄激素药物控制前列腺疾病出血状态有效性的报道。
在给予醋酸氯地孕酮(CMA)、非那雄胺或氟他胺后,对前列腺中的雄激素浓度进行定量。在给予CMA、非那雄胺、氟他胺或比卡鲁胺后,测量前列腺的血液供应。研究纳入α受体阻滞剂特拉唑嗪和坦索罗辛作为阴性对照。观察腹侧前列腺毛细血管的组织学变化,并测量管腔面积。
所有抗雄激素药物给药后,前列腺二氢睾酮浓度均降低。CMA、非那雄胺、氟他胺或比卡鲁胺治疗使前列腺血液供应减少了50%至65%。在用CMA治疗的大鼠中,观察到真毛细血管管腔面积平行减小。用α受体阻滞剂治疗不影响前列腺雄激素含量、前列腺血液供应或毛细血管管腔面积。
前列腺血液供应减少被认为是二氢睾酮含量降低和毛细血管管腔面积减小的结果。抗雄激素药物对前列腺血液供应的早期减少作用表明,抗雄激素药物除了用于使前列腺体积缩小的典型用途外,还有其他用途。结果支持了术前使用CMA、氟他胺和比卡鲁胺(类似于非那雄胺)在减少围手术期出血方面的优势的基本观点。