Clinical application uye kutsvagisa kwePRP mune zvakajairika zvirwere zvemabvi akabatanidzwa
Platelet-rich plasma (PRP) iplasma inoumbwa zvakanyanya nemaplatelet uye masero machena eropa anowanikwa ne centrifugation ye autologous peripheral blood.Nhamba huru yekukura kwezvinhu uye cytokines zvakachengetwa mu α granules yemaplatelet.Kana maplatelet akamiswa, iwo α granules anoburitsa huwandu hukuru hwekukura zvinhu.Zvidzidzo zvakaratidza kuti izvi kukura kwesero zvinhu zvinogona kukurudzira kusiyanisa kwesero, kupararira, extracellular matrix uye collagen synthesis, nekudaro kukurudzira kuvandudzwa uye kugadziriswa kwearticular cartilage uye ligament uye.zvimwetishu.Panguva imwecheteyo, inogonawo kuvandudza mhinduro yekuputika kwenzvimbo yekukuvadza uye kuderedza zviratidzo zvechipatara zvevarwere.Mukuwedzera kune izvi masero ekukura kwezvinhu, PRP inewo nhamba huru yemasero machena eropa.Aya masero machena eropa uye maplatelet anogona kuburitsa akasiyana siyana eantimicrobial peptides kuti asunge kune hutachiona, inhibit uye kuuraya hutachiona, uye kutamba basa reantibacterial.
PRP yakashandiswa zvakanyanya mumunda we orthopedics nekuda kwekuita kwayo kuri nyore kugadzira, kushandiswa kuri nyore uye kudhura kwakaderera, kunyanya mukurapa kwezvirwere zvemabvi mumakore achangopfuura.Ichi chinyorwa chichakurukura nezvekushandiswa kwekliniki uye tsvakurudzo yeplatelet-rich plasma mumabvi osteoarthritis (KOA), meniscus kukuvara, cruciate ligament kukuvara, mabvi synovitis uye zvimwe zvakajairika mabvi zvirwere.
PRP application tekinoroji
Iyo PRP isina kushandiswa uye yakagadziriswa PRP kusunungurwa imvura uye inogona kubayiwa, uye iyo isina kushandiswa PRP inogona kudzorwa nekuwedzera kuwedzera calcium chloride kana thrombin kudzora nguva yeagglutination kuitira kuti gel rigone kuumbwa mushure mekusvika panzvimbo yakatarwa, kuitira kuti zadzisa chinangwa chekusimudzira kusunungurwa kwezvinhu zvinokura.
PRP kurapwa kweKOA
KOA chirwere chemabvi chinopera chinoratidzwa nekuparara kunofambira mberi kwearticular cartilage.Vazhinji vevarwere vane zera repakati uye vakwegura.Makiriniki ekuratidzira kweKOA kurwadziwa kwemabvi, kuzvimba, uye kudzora basa.Iko kusaenzana pakati pekubatanidza uye kuparara kwearticular cartilage matrix ndiyo hwaro hwekuitika kweKOA.Nokudaro, kukurudzira kugadziriswa kwecartilage uye kugadzirisa kuenzana kwecartilage matrix ndiyo kiyi yekurapa kwayo.
Parizvino, varwere vazhinji veKOA vanokodzera kurapwa kwekuchengetedza.Ibvi rejojo jekiseni re hyaluronic acid, glucocorticoids nemimwe mishonga uye oral non-steroid anti-inflammatory drugs inowanzoshandiswa kurapa kwekuchengetedza.Nekudzika kwekutsvagisa paPRP nevadzidzi vekumba nevekunze, kurapwa kweKOA nePRP kwave kuwedzera uye kwakawedzera mumakore achangopfuura.
Mechanism yekuita:
1. Kurudzira kuwanda kwemachondrocytes:
Nekuyera mhedzisiro yePRP pakubudirira kwetsuro chondrocytes, Wu J et al.akawana kuti PRP yakawedzera kuwedzera kwechondrocytes, uye yakafungidzira kuti PRP inogona kudzivirira IL-1β-activated chondrocytes nekudzivisa Wnt / β-catenin transduction transduction.
2. Kudzivisa chondrocyte inflammatory reaction uye degeneration:
Kana yakagadziriswa, PRP inobudisa nhamba yakawanda yezvinopesana nekuputika, zvakadai seIL-1RA, TNF-Rⅰ, ⅱ, nezvimwewo. Il-1ra inogona kudzivisa IL-1 kushandiswa nekuvhara IL-1 receptor, uye TNF-Rⅰ uye ⅱ inogona kuvharira TNF-α yakabatana yekusaina nzira.
Efficacy study:
Kuratidzwa kukuru ndiko kusunungurwa kwemarwadzo uye kuvandudzwa kwebasa remabvi.
Lin KY nevamwe.akaenzanisa intra-articular jekiseni reLP-PRP ine hyaluronic acid uye yakajairika saline, uye akawana kuti kurapa kwemapoka maviri ekutanga kwaive nani pane iyo yakajairika saline boka munguva pfupi, iyo yakasimbisa kliniki mhedzisiro yeLP-PRP. uye hyaluronic acid, uye kutarisa kwenguva refu (mushure megore re1) kwakaratidza kuti mhedzisiro yeLP-PRP yaive nani.Zvimwe zvidzidzo zvakabatanidza PRP ne hyaluronic acid, uye zvakaona kuti kusanganiswa kwePRP uye hyaluronic acid hakugoni kubvisa marwadzo nekuvandudza basa, asiwo kusimbisa kuvandudzwa kwe articular cartilage ne X-ray.
Zvisinei, Filardo G et al.aidavira kuti boka rePRP neboka resodium hyaluronate raive rakabudirira mukuvandudza kushanda kwemabvi uye zviratidzo kuburikidza nekudzidza kwakarongwa, asi hapana kusiyana kukuru kwakawanikwa.Yakawanikwa kuti nzira yePRP administration yakanga ine imwe mhedzisiro pakurapa kweKOA.Du W et al.akabata KOA nePRP intravarticular injection uye extraarticular injection, uye akacherechedza VAS neLysholm scores vasati vatora mishonga uye 1 uye 6 mwedzi mushure memishonga.Vakaona kuti nzira mbiri dzejekiseni dzinogona kuvandudza zvibodzwa zveVAS neLysholm munguva pfupi, asi mhedzisiro yeboka rejekiseni re-intra-articular raive nani pane boka rejekiseni rekuwedzera mushure memwedzi mitanhatu.Taniguchi Y et al.akakamura chidzidzo pakurapa kwepakati kusvika kune yakanyanya KOA mujekiseni remukati memudumbu rakasanganiswa nejekiseni remukati meboka rePRP, jekiseni remukati meboka rePRP uye jekiseni remukati reHA boka.Chidzidzo chacho chakaratidza kuti kusanganiswa kweinjection intraluminal yePRP uye intraluminal jekiseni yePRP yakanga iri nani kudarika intraluminal jekiseni yePRP kana HA kweinenge mwedzi 18 mukuvandudza VAS uye WOMAC scores.
(Zviri muchinyorwa ichi zvakadhindwa patsva, uye isu hatipe chero vimbiso yechokwadi, kuvimbika kana kuzara kwezviri muchinyorwa chino, uye hatina mhosva yemafungiro echinyorwa ichi, ndapota nzwisisa.)
Nguva yekutumira: Nov-04-2022