小骨盆静脉曲张时前列腺的状态研究（实验研究）

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绪论：慢性盆腔疼痛综合征/慢性非细菌性前列腺炎是泌尿外科最常见的疾病之一。尽管该病的发病频率很高，但其发病机制仍然知之甚少。众所周知，慢性炎症的形态学表现是 硬化，在其发展中前列腺静脉过剩是非常重要的。

目的：在慢性实验中评估小骨盆慢性静脉充血对前列腺的影响。

材料与方法：一个小骨盆持续慢性静脉充血的原始模型已经建立。试验选用雄性成熟 兔34只，体重2.6–3.2 kg。动物均分为三组。第一组（n=5）进行正常解剖。第二组（n=15）采 用骶中静脉结扎联合肌注黄体酮建立盆腔静脉充血模型。第三组（n=15）行假手术并给予孕酮治疗。1个月，3个月和6个月后对盆腔静脉进行双工扫描，在手动压迫后评估其直径和 回流。将动物从实验中取出后，对前列腺组织进行组织学检查和形态测定。在前列腺样 本中，羟脯氨酸的浓度作为结缔组织发育的标志进行了研究。

结果：第二组动物盆腔器官的静脉充血对前列腺结构有负面影响。组织学检查显示前列腺组织浸润，间质水肿，实验开始时静脉急剧扩张；在将来，结缔组织的增殖，腺泡的压缩和前列腺分泌活动的减少被注意到。形态测量的结果显示基质成分的面积增加，在很大程度上是由于结缔组织体积的增加。第二组动物前列腺组织中羟脯氨酸浓度有升高的趋势，在实验第6个月达到最大值。第三组动物的前列腺结构未见明显改变。

结论。慢性静脉充血的形态学表现为前列腺间质浸润和硬化。

作者简介

Anton Tsukanov

Omsk State Medical University

编辑信件的主要联系方式.
Email: autt@mail.ru
ORCID iD: 0000-0002-3497-5856
SPIN 代码: 9310-1220
Scopus 作者 ID: 57194497218
http://omsk-osma.ru/vracham-i-provizoram/centr-povysheniya-kvalifikacii-i-professional-noy-perepodgotovki-specialistov/kafedry-i-kursy-dpo/hirurgicheskih-bolezney-i-urologii-dpo/sotrudniki-kafedry

Dr. Sci. (Med.), Professor, Head of the Department of Surgical Diseases and Urology of Additional Professional Education

俄罗斯联邦, 12, Lenina Street,Omsk, 644099

Nickolay Rudchenko

Omsk State Medical University

Email: nrudrus@gmail.com
ORCID iD: 0000-0002-0121-3425

Postgraduate Student

俄罗斯联邦, 12, Lenina Street,Omsk, 644099

Alexandr Kuzovkin

Clinical Medical and Sanitary Hospital №9

Email: autt@mail.ru

Head of the pathological department

俄罗斯联邦, Omsk

Daniyar Ahmetov

Omsk State Medical University

Email: dsahmetov@gmail.com

Postgraduate Student

俄罗斯联邦, 12, Lenina Street,Omsk, 644099

Stepan Alyabushev

City Clinical Emergency Hospital No. 2

Email: alyabushev1992@mail.ru

Urologist

俄罗斯联邦, Omsk

参考

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1. JATS XML
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2. 图.1.第一组动物前列腺的显微制备：a—正常前列腺的显微图，呈扇形，小叶间隔薄，分泌量大；b—孤立结缔组织的图像，在ImageJ程序中处理；c—在ImageJ程序界面中计算结缔组织的面积 Fig. 1. Micropreparation of the prostate gland of an animal of the 1st group: a – microphotograph of a normal prostate gland, scalloped contour, thin interlobular septa, a large amount of secretion; b – the image is isolated of connective tissue, processed in the ImageJ program; c – calculation of the area of connective tissue in the interface of the ImageJ program

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3. 图.2.实验开始后1个月，第二组动物前列腺微制片：a—腺状轮廓光滑，分泌活性降低（白色箭头），前列腺内静脉扩张（红色箭头），苏木精伊红染色，×100；b—明显的小叶间纤维化（黑色箭头），局灶周围纤维化，小静脉壁增 厚（白色箭头），马洛里染色，×100 Fig. 2. Micropreparation of the prostate gland of an animal of the 2nd group 1 month after the beginning of the experiment: a – smoothed glandular contour, decreased secretory activity (white arrow), dilated intraprostatic veins (red arrow), hematoxylin-eosin stai­ning, ×100; b – severe interlobular fibrosis (black arrow), perifocal fibrosis and thickened venule wall (white arrow), Mallory staining, ×100

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4. 图.3.微制备动物的前列腺的第二组实验开始后3个月：a,b—脱屑上皮腺泡腔的（黄色箭头），明显的小叶间和病灶周边纤维化（红色箭头），扩张小静脉（蓝色箭头），大幅降低的高度上皮（黑色箭头）。马洛里染色，×100；c—前列腺改变的显微照片，外形光滑，小叶间隔厚，无分泌物；d—孤立结缔组织图像，在ImageJ程序中处理；e—在ImageJ程序界面中计算结缔组织的面积 Fig. 3. Micropreparation of the prostate gland of an animal of the 2nd group 3 month after the beginning of the experiment: a, b – desquamated epithelium in the lumen of the acini (yellow arrow), pronounced interlobular and perifocal fibrosis (red arrow), dilated venules (blue arrow), a sharp decrease in the height of the epithelium (black arrow). Mallory staining, ×100; c – microphotograph of the altered prostate gland, smoothed contour, thick interlobular septa, no secretion; d – the image is isolated of connective tissue, processed in the ImageJ program; e – calculation of the area of connective tissue in the interface of the ImageJ program

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5. 图.4.实验开始6个月后，对第二组动物的前列腺进行显微制备：a—增厚的纤维层挤压腺体结构（白色箭头），分离的腺泡，上皮高度降低（黄色箭头）。Mallory染色，×40；b—前列腺腺泡纤维化（白色箭头），腺泡管腔内无分泌物的上皮轮廓清晰平滑（黑色箭头）。Mallory染色，×100；c—前列腺改变并有明显腺泡内纤维化的显微照片； d—孤立结缔组织图像，在ImageJ程序中处理；e—在ImageJ程序界面中计算结缔组织的面积 Fig. 4. Micropreparation of the prostate gland of an animal of the 2nd group 6 month after the beginning of the experiment: a – thickened fibrous layers squeeze the glandular structures (white arrow), individual groups of acini with reduced epithelial height (yellow arrow). Mallory staining, ×40; b – fibrotic changes in the acini of the prostate (white arrow), a sharply smoothed contour of the epithelium with no secretion in the lumen of the acini (black arrow). Mallory staining, ×100; c – microphotograph of the altered prostate gland with pronounced intraacinar fibrosis; d – the image is isolated of connective tissue, processed in the ImageJ program; e – calculation of the area of connective tissue in the interface of the ImageJ program

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