现代泌尿外科杂志
現代泌尿外科雜誌
현대비뇨외과잡지
JOURNAL OF MODERN UROLOGY
2015年
5期
347-352
,共6页
夏磊磊%王先进%许天源%秦亮%张祥%朱照伟%张小华%钟山%张敏光%沈周俊
夏磊磊%王先進%許天源%秦亮%張祥%硃照偉%張小華%鐘山%張敏光%瀋週俊
하뢰뢰%왕선진%허천원%진량%장상%주조위%장소화%종산%장민광%침주준
糖尿病%勃起功能障碍%雄激素%磷酸二酯酶抑制剂
糖尿病%勃起功能障礙%雄激素%燐痠二酯酶抑製劑
당뇨병%발기공능장애%웅격소%린산이지매억제제
diabetes mellitus%erectile dysfunction%androgen%phosphodiesterase inhibitor
目的：建立糖尿病性勃起功能障碍（DMED）大鼠模型，评价雄激素联合5型磷酸二酯酶抑制剂对DMED的治疗作用。方法通过链脲佐菌素（STZ）腹腔注射的方法建立DMED大鼠模型，造模成功4周后随机分为4组：DM组、DM 补充睾酮组、DM补充西地那非组、DM补充睾酮联合西地那非组，正常大鼠作为对照组。给药6周后通过电刺激海绵体神经诱发勃起的方法测定各组大鼠的勃起功能，ELISA法测定各组大鼠的血清睾酮水平，HE染色和masson染色评价各组阴茎海绵体形态学改变， Western blot和免疫组织化学检测内皮型一氧化氮合酶（eNOS）的表达。结果 DM大鼠较正常大鼠勃起功能显著下降，睾酮水平明显降低，eNOS表达降低，阴茎海绵体间质纤维化程度增加而平滑肌成分减少。睾酮补充治疗和长期西地那非治疗均可改善DM ED大鼠的勃起功能和改善DM ED大鼠阴茎的纤维化程度，睾酮和长期西地那非联合治疗改善效果最明显。结论 DM大鼠的勃起功能明显降低，DM ED发生的部分原因可能与雄激素水平降低有关，雄激素联合长期5型磷酸二酯酶抑制剂可明显改善D M ED大鼠的勃起功能和阴茎纤维化程度。
目的：建立糖尿病性勃起功能障礙（DMED）大鼠模型，評價雄激素聯閤5型燐痠二酯酶抑製劑對DMED的治療作用。方法通過鏈脲佐菌素（STZ）腹腔註射的方法建立DMED大鼠模型，造模成功4週後隨機分為4組：DM組、DM 補充睪酮組、DM補充西地那非組、DM補充睪酮聯閤西地那非組，正常大鼠作為對照組。給藥6週後通過電刺激海綿體神經誘髮勃起的方法測定各組大鼠的勃起功能，ELISA法測定各組大鼠的血清睪酮水平，HE染色和masson染色評價各組陰莖海綿體形態學改變， Western blot和免疫組織化學檢測內皮型一氧化氮閤酶（eNOS）的錶達。結果 DM大鼠較正常大鼠勃起功能顯著下降，睪酮水平明顯降低，eNOS錶達降低，陰莖海綿體間質纖維化程度增加而平滑肌成分減少。睪酮補充治療和長期西地那非治療均可改善DM ED大鼠的勃起功能和改善DM ED大鼠陰莖的纖維化程度，睪酮和長期西地那非聯閤治療改善效果最明顯。結論 DM大鼠的勃起功能明顯降低，DM ED髮生的部分原因可能與雄激素水平降低有關，雄激素聯閤長期5型燐痠二酯酶抑製劑可明顯改善D M ED大鼠的勃起功能和陰莖纖維化程度。
목적：건립당뇨병성발기공능장애（DMED）대서모형，평개웅격소연합5형린산이지매억제제대DMED적치료작용。방법통과련뇨좌균소（STZ）복강주사적방법건립DMED대서모형，조모성공4주후수궤분위4조：DM조、DM 보충고동조、DM보충서지나비조、DM보충고동연합서지나비조，정상대서작위대조조。급약6주후통과전자격해면체신경유발발기적방법측정각조대서적발기공능，ELISA법측정각조대서적혈청고동수평，HE염색화masson염색평개각조음경해면체형태학개변， Western blot화면역조직화학검측내피형일양화담합매（eNOS）적표체。결과 DM대서교정상대서발기공능현저하강，고동수평명현강저，eNOS표체강저，음경해면체간질섬유화정도증가이평활기성분감소。고동보충치료화장기서지나비치료균가개선DM ED대서적발기공능화개선DM ED대서음경적섬유화정도，고동화장기서지나비연합치료개선효과최명현。결론 DM대서적발기공능명현강저，DM ED발생적부분원인가능여웅격소수평강저유관，웅격소연합장기5형린산이지매억제제가명현개선D M ED대서적발기공능화음경섬유화정도。
ABSTRACT:Objective To establish the rat model of diabetes mellitus erectile dysfunction (DMED) and evaluate the ther‐apeutic effect of androgen combined with phosphodiesterase type 5 (PDE5) inhibitor .Methods DMED models were estab‐lished by peritoneal injection of streptozotocin (STZ) .Four weeks later the DMED rats were randomly divided into 4 groups:DM group ,testosterone group ,sildenafil group ,and testosterone plus sildenafil group .Healthy rats served as controls .Six weeks after the initiation of treatments ,the erectile function of each group was evaluated using electrostimulation of the cav‐ernous nerve .The serum testosterone levels were determined with enzyme‐linked immunosorbent assay (ELISA) .The morpho‐logical changes of corpus cavernosum of penis were evaluated with hematoxylin‐eosin staining and masson staining .The endo‐thelial nitric oxide synthase (eNOS) level were determined with Western blot and immunohistochemistry .Results Compared with healthy rats ,the erectile function ,testosterone level and eNOS level of diabetic rats were significantly decreased .The smooth muscle cells of diabetic rats'corpus cavernosum were reduced while extracellular matrix fibrosis was increased .Testos‐terone replacement and chronic sildenafil treatment could ameliorate erectile function and extracellular matrix fibrosis ,and combined treatment with testosterone and sildenafil had the most significant effect .Conclusions The erectile function of DM rats is significantly impaired .The pathogenesis of DMED may be partly attributed to the low androgen level .Combined treatment of testosterone and sildenafil can significantly improve erectile function and extracellular matrix fibrosis of DMED rats .
