Kulchavenya E V, Shvetsova O P, Breusov A A
Novosibirsk Tuberculosis Research Institute of Minzdrav of Russia, Novosibirsk, Russia.
Novosibirsk State Medical University of Minzdrav of Russia, Novosibirsk, Russia.
Urologiia. 2018 Oct(4):64-71.
Chronic inflammation of the prostate leads to the formation of excess fibrous connective tissue, which hinders patients recovery and aggravates the symptoms.
This study aimed to confirm the correlation between inflammation and prostatic fibrosis and the abnormalities of urodynamic and microcirculation in the prostate gland in humans, and the possibility of increasing the effectiveness of treatment of patients with chronic nonbacterial prostatitis using antisclerotic therapy.
The study was carried out in two stages. At the first stage, pathomorphological findings, uroflowmetry data and degree of microcirculation disturbance were studied in 18 patients with chronic prostatitis who underwent prostate biopsy. At the second stage, an open prospective randomized comparative study was conducted. Two groups of patients with chronic nonbacterial prostatitis with signs of inflammation were formed. A control group (n=29) received standard treatment, rectal 0.5 methyluracil suppositories three times per week, 20 suppositories per course. In addition to the standard treatment, the patients of the study group (n=31) were administered Longidaza 3000 IU rectal suppositories also three times a week, 20 suppositories per course.
Prostatic fibrosis worsens microcirculation by one and half times and statistically significantly negatively affects urodynamic. Using Longidaza resulted in neutralizing the negative consequences of the formation of excess fibrous connective tissue. Overall, an excellent and good effect was achieved in 21 (67.7%) and 9 (29.1%) patients of the study group, respectively; only in one case (3.2%) there was no effect. In the control group, an excellent and good effect was achieved in 14 (48.3%) and 11 (37.9%) patients, respectively; in 4 patients (13.8%) the treatment was considered of low effectiveness.
Prevention of the fibrous connective tissue formation and regression of the fibrosis are pathogenetically valid. Anti-sclerotic enzyme therapy with Longidaza in the form of rectal suppositories results in a significant improvement in the symptoms of prostatitis, an increase in the maximum urinary flow rate and an improvement in the microcirculation of the prostate.
前列腺的慢性炎症会导致过多纤维结缔组织形成，这会阻碍患者康复并加重症状。
本研究旨在证实人体前列腺炎症与纤维化之间的相关性以及尿动力学和微循环异常情况，以及使用抗硬化疗法提高慢性非细菌性前列腺炎患者治疗效果的可能性。
研究分两个阶段进行。第一阶段，对18例接受前列腺活检的慢性前列腺炎患者的病理形态学结果、尿流率数据和微循环障碍程度进行研究。第二阶段，开展一项开放性前瞻性随机对照研究。将两组有炎症迹象的慢性非细菌性前列腺炎患者分组。对照组（n = 29）接受标准治疗，每周直肠给药0.5甲基尿嘧啶栓剂三次，每个疗程20枚栓剂。研究组（n = 31）患者除接受标准治疗外，还每周直肠给药龙津酶3000 IU栓剂三次，每个疗程20枚栓剂。
前列腺纤维化使微循环恶化1.5倍，并且在统计学上对尿动力学有显著负面影响。使用龙津酶可消除过多纤维结缔组织形成带来的负面后果。总体而言，研究组分别有21例（67.7%）和9例（29.1%）患者取得了优效和良好效果；仅1例（3.2%）无效。对照组分别有14例（48.3%）和11例（37.9%）患者取得了优效和良好效果；4例（13.8%）患者的治疗被认为效果欠佳。
预防纤维结缔组织形成和使纤维化消退在发病机制上是有效的。以直肠栓剂形式使用龙津酶进行抗硬化酶疗法可显著改善前列腺炎症状，提高最大尿流率并改善前列腺微循环。
