CAJ | 학술논문

目的：建立一种简单、安全、高效、持久的阴茎海绵体神经损伤性勃起功能障碍大鼠模型。方法：30只8周龄Sprague-Dawley大鼠，随机不均等分为两组，正常对照组（NC组5只）、海绵体神经损伤组（CN组25只）。无菌手术条件下经腹腔注射3%戊巴比妥钠（40 mg/kg）麻醉成功后，下腹正中切口3 cm暴露前列腺，于前列腺后外侧找到双侧大鼠阴茎海绵体神经行程，并用双极微电极电刺激诱发勃起确认，同时监测ICP/MAP。CN组以无菌手术钳每侧海绵体神经间隔1 cm双重钳夹30 s/次，并于术中再次电刺激证实阴茎海绵体神经损伤。NC组为假手术组，只暴露海绵体神经而不钳夹损伤。在术后12周进行APO试验，电刺激下ICP/MAP评估以及处死后阴茎海绵体组织HE染色切片检查，CN组在手术造模后第1、2、4、8及12周随机选取5只进行电刺激下ICP/MAP评估以及处死后阴茎海绵体组织HE染色切片检查。结果：NC组ICP/MAP术前、术后12周分别为（0.63±0.08）、（0.60±0.09），术前、术后比较差异无统计学意义（P>0.05）。CN组术前，术后第1、2、4、8及12周电刺激时ICP/MAP分别为（0.64±0.09）、（0.20±0.03）、（0.21±0.04）、（0.25±0.05）、（0.23±0.04）、（0.24±0.06），CN组术后ICP/MAP两两比较，差异无统计学意义（P>0.05），CN组术前与术后ICP/MAP比较差异均有统计学意义（P<0.05）。术后12周APO试验NC组和CN组勃起率分别为100％、0。与NC组比较，CN组HE染色切片结果显示海绵体纤维化在术后第4~8周最明显。结论：间隔分段序贯钳夹双侧阴茎海绵体神经是一种方便易行、简单高效、持久稳定的阴茎海绵体神经损伤勃起功能障碍大鼠模型建模方法。
목적：건립일충간단、안전、고효、지구적음경해면체신경손상성발기공능장애대서모형。방법：30지8주령Sprague-Dawley대서，수궤불균등분위량조，정상대조조（NC조5지）、해면체신경손상조（CN조25지）。무균수술조건하경복강주사3%무파비타납（40 mg/kg）마취성공후，하복정중절구3 cm폭로전렬선，우전렬선후외측조도쌍측대서음경해면체신경행정，병용쌍겁미전겁전자격유발발기학인，동시감측ICP/MAP。CN조이무균수술겸매측해면체신경간격1 cm쌍중겸협30 s/차，병우술중재차전자격증실음경해면체신경손상。NC조위가수술조，지폭로해면체신경이불겸협손상。재술후12주진행APO시험，전자격하ICP/MAP평고이급처사후음경해면체조직HE염색절편검사，CN조재수술조모후제1、2、4、8급12주수궤선취5지진행전자격하ICP/MAP평고이급처사후음경해면체조직HE염색절편검사。결과：NC조ICP/MAP술전、술후12주분별위（0.63±0.08）、（0.60±0.09），술전、술후비교차이무통계학의의（P>0.05）。CN조술전，술후제1、2、4、8급12주전자격시ICP/MAP분별위（0.64±0.09）、（0.20±0.03）、（0.21±0.04）、（0.25±0.05）、（0.23±0.04）、（0.24±0.06），CN조술후ICP/MAP량량비교，차이무통계학의의（P>0.05），CN조술전여술후ICP/MAP비교차이균유통계학의의（P<0.05）。술후12주APO시험NC조화CN조발기솔분별위100％、0。여NC조비교，CN조HE염색절편결과현시해면체섬유화재술후제4~8주최명현。결론：간격분단서관겸협쌍측음경해면체신경시일충방편역행、간단고효、지구은정적음경해면체신경손상발기공능장애대서모형건모방법。
Objective:To establish the simple, safe, efficient and stable way for cavernous nerve injury induced erectile dysfunction model in rats.Method:30 Sprague-Dawley rats were unequally randomized into two groups,cavernous nerve injury group(25 cases of CN group)and normal control group(5 cases of NC group). Under sterile operation conditions,all rats were incised at low-middle abdominal wall and exposed prostate and bilateral cavernous nerves,which were confirmed by electrical stimulation. The rats in NC group accounted for sham operation and the bilateral cavernous nerves of rats in CN group were clamped by forceps at distance-interval sequential pattern.In NC group after operation of 12 weeks,APO test was conformed, ICP/MAP(intra-cavernous pressure/mean artery pressure) was monitored under electrical stimulation and then penile tissues were harvested by sacrificed and stained by hematoxylin and eosin (H&E); in CN group,any 5 rats were selected randomly at 1, 2,4,8 and 12 weeks after operation,ICP/MAP(intra-cavernous pressure/mean artery pressure) was monitored under electrical stimulation and then penile tissues were harvested by sacrificed and stained by hematoxylin and eosin (H&E). Result: Before operation and after operation of 12 weeks, the value of ICP/MAP in NC group were respectively (0.63±0.08) and (0.60±0.09),the difference was statistically significant(P<0.05).Before operation the value of ICP/MAP in CN group was (0.64±0.09);after operation of 1 week and 2,4,8,12 weeks,the value of ICP/MAP in CN group were respectively (0.20±0.03), (0.21±0.04),(0.25±0.05),(0.23±0.04) and(0.24±0.06),the differences were no statistically significant of ICP/MAP at any two time after operation(P>0.05),and the differences were statistically significant between before and after operation in the CN group(P<0.05).APO test induced erectile rate in NC group and CN group was respectively 100%and 0. Compared with NC group,fibrosis was more obvious in CN group after operation from 4 to 8 weeks.Conclusion:Distance-interval sequence pattern is a lasting,effective and convenient way in establishment of rat erectile dysfunction model induced by cavernous nerves injury.