中国组织工程研究

中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (30): 4875-4881.doi: 10.3969/j.issn.2095-4344.1416

• 生物材料综述 biomaterial review • 上一篇    下一篇

富血小板血浆：在肌腱和韧带损伤修复中的应用

王皓楠，王继宏，温树正
  

  1. 内蒙古医科大学第二附属医院，内蒙古自治区呼和浩特市  010030
  • 收稿日期:2019-05-10 出版日期:2019-10-28 发布日期:2019-10-28
  • 通讯作者: 温树正，主任医师，内蒙古医科大学第二附属医院手足显微外二科，内蒙古自治区呼和浩特市 010030
  • 作者简介:王皓楠，男，1993年生，内蒙古自治区巴彦淖尔市人，汉族，内蒙古医科大学在读硕士，主要从事骨科研究。
  • 基金资助:

    2017年内蒙古自治区卫生计生科研计划项目(201703120)：功能位固定与传统跖屈位固定在急性跟腱损伤修复术后康复中的对照研究，项目负责人：王继宏 

Platelet-rich plasma: its application in the repair of tendon and ligament injuries

Wang Haonan, Wang Jihong, Wen Shuzheng
  

  1. Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010030, Inner Mongolia Autonomous Region, China
  • Received:2019-05-10 Online:2019-10-28 Published:2019-10-28
  • Contact: Wen Shuzheng, Chief physician, Second Department of Hand and Food Microsurgery, Hohhot 010030, Inner Mongolia Autonomous Region, China
  • About author:Wang Haonan, Master candidate, Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010030, Inner Mongolia Autonomous Region, China
  • Supported by:

    2017 Inner Mongolia Autonomous Region Health and Family Planning Research Project, No. 201703120 (to WJH)

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摘要：

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文题释义：
富血小板血浆：是自体全血经过梯度离心、分离得到的血小板浓缩物，血小板含量丰富。当血小板激活时，能释放多种生长因子，它们在促进骨细胞和成骨细胞的增殖、生长、分化和组织的形成过程中起着重要的作用。自1998年Marx等首次用富血小板血浆复合移植骨修复下颌骨缺损以来，富血小板血浆已被逐渐应用于口腔、整形、骨科、耳鼻喉科、神经外科等领域的组织修复中。1993年Hood等首先提出富血小板血浆概念，并发现富血小板血浆含有丰富的血小板，其数目比全血中数目高3倍以上。血小板中含有大量的生长因子，如血小板衍生生长因子、转化生长因子β，类胰岛素生长因子、表皮生长因子、血管内皮生长因子等。
 
 
背景：富血小板血浆是一种含有高浓度血小板的血浆，含有多种生长因子和细胞因子，有助于促使韧带和肌腱再生，促进多发性肌肉骨骼疾病的恢复。
目的：探讨富血小板血浆用于肌腱和韧带损伤修复的最新文献分析。
方法：以“platelet-rich plasma，ligament injury，repair of ligament，tendon injury，repair of tendon，growth factors”为检索词，应用计算机检索PubMed数据库1990至2018年发表的相关文献共64篇；以“富血小板血浆”在中国知网检索相关文献1篇，对富血小板血浆的制备、分类、血小板源生长因子的释放及其促进韧带、肌腱修复的相关文献进行综述。
结果与结论：虽然富血小板血浆对肩袖和髌骨肌腱病变及尺侧支、前交叉韧带等韧带损伤的治疗效果有限且无定论，但是多项基础科学和活体动物实验支持富血小板血浆在肌腱和韧带疾病中的应用。目前富血小板血浆是一种可行的保守治疗措施，其并发症或不良反应风险较低。在选择富血小板血浆注射方式时，病因可能会有一定的影响，例如富白细胞富血小板血浆与贫白细胞富血小板血浆，贫白细胞富血小板血浆对于肱骨外上髁炎等疾病的治疗可能更有益处，因为其可能有助于诱导炎症反应以达到促进恢复的目的。目前富血小板血浆尚未成为治疗的标准方法之一，然而随着对最佳候选方案的进一步研究，在未来其可能发展为较为普遍的疗法。

关键词: 富血小板血浆, 肌腱损伤, 韧带损伤, 生物制品, 生长因子, 细胞因子, 富白细胞富血小板血浆, 贫白细胞富血小板血浆

Abstract:

BACKGROUND: Platelet-rich plasma contains high levels of platelets and a variety of growth factors and cytokines, which help promote ligament and tendon regeneration and the recovery of multiple musculoskeletal disorders.  
OBJECTIVE: To analyze the latest publications regarding application of platelet-rich plasma in the repair of tendon and ligament injuries.
METHODS: A computer-based online search of PubMed database was performed for related literatures published during 1990-2018 with the search terms “platelet-rich plasma, ligament injury, repair of ligament, tendon injury, repair of tendon, growth factors”. A total of 64 literatures were retrieved. CNKI was searched with “platelet-rich plasma” as the search term. One related literature was retrieved. These retrieved literatures were summarized from the perspectives of preparation and classification of platelet-rich plasma, release of platelet-derived growth factor, and promotion of ligament and tendon repair by platelet-rich plasma.
RESULTS AND CONCLUSION: Although platelet-rich plasma has limited and inconclusive therapeutic effects on rotator cuff and iliac tendon lesions, ulnar collaterals and anterior cruciate ligament injury, many basic science and live animal experiments support the application of platelet-rich plasma in tendon and ligament diseases. At present, platelet-rich plasma is a feasible conservative treatment with a lower risk of complications or adverse reactions. The cause of disease may have certain effects on the injection methods of platelet-rich plasma. For example, leukocyte-poor platelet-rich plasma exhibits better therapeutic effects on the external humeral epicondylitis than leukocyte-rich platelet-rich plasma because it likely helps induce an inflammatory response to promote recovery. Platelet-rich plasma has not become one of the standard treatment methods of tendon and ligament injuries. With in-depth research on the optimal candidate, platelet-rich plasma may develop into a more common therapy in the future.

Key words: platelet-rich plasma, tendon injury, ligament injury, biological product, growth factor, cytokine, leukocyte-rich platelet-rich plasma, leukocyte-poor platelet-rich plasma

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