中国组织工程研究

中国组织工程研究 ›› 2017, Vol. 21 ›› Issue (20): 3123-3128.doi: 10.3969/j.issn.2095-4344.2017.20.002

• 软骨组织构建 cartilage tissue construction • 上一篇    下一篇

射频联合富血小板血浆修复半月板白区撕裂

周伟峰1，朱  琳2，姜雪峰1，王亚斌1   

  1. 江阴市人民医院，1骨科，2中心实验室，江苏省江阴市  214400
  • 修回日期:2017-02-22 出版日期:2017-07-18 发布日期:2017-07-28
  • 通讯作者: 王亚斌，硕士，副主任医师，江阴市人民医院骨科，江苏省江阴市 214400
  • 作者简介:周伟峰，男，1990年生，安徽省亳州市人，汉族，南通大学医学院骨科学专业在读硕士，主要从事骨关节损伤与修复的研究。 并列第一作者：朱琳，女，1987年生，江苏省如东县人，汉族，2012年南通大学毕业，硕士，助理研究员，主要从事骨关节损伤与修复的研究。
  • 基金资助:

    江苏省卫生科研项目(Z201217)；江苏省科技计划项目(澄政科[2011]85号社-22)

Radiofrequency combined with platelet-rich plasma for repair of white meniscal tears

Zhou Wei-feng1, Zhu Lin2, Jiang Xue-feng1, Wang Ya-bin1   

  1. 1Department of Orthopaedics, 2Central Laboratory, Jiangyin People’s Hospital, Jiangyin 214400, Jiangsu Province, China
  • Revised:2017-02-22 Online:2017-07-18 Published:2017-07-28
  • Contact: Wang Ya-bin, Master, Associate chief physician, Department of Orthopaedics, Jiangyin People’s Hospital, Jiangyin 214400, Jiangsu Province, China
  • About author:Zhou Wei-feng, Studying for master’s degree, Department of Orthopaedics, Jiangyin People’s Hospital, Jiangyin 214400, Jiangsu Province, China; Zhu Lin, Master, Master, Research assistant, Central Laboratory, Jiangyin People’s Hospital, Jiangyin 214400, Jiangsu Province, China. Zhou Wei-feng and Zhu Lin contributed equally to this work.
  • Supported by:

    the Project of Health Scientific Research of Jiangsu Province, No. Z201217; the Science and Technology Project of Jiangsu Province, No. (2011)85-22

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文题释义：
射频(RF)：是Radio Frequency的缩写，表示可以辐射到空间的电磁频率，频率范围从300 kHz-30 GHz之间。射频简称RF射频就是射频电流，它是一种高频交流变化电磁波的简称。每秒变化小于1 000次的交流电称为低频电流，大于10 000次的称为高频电流，而射频就是这样一种高频电流。
半月板撕裂：是体育运动中非常常见的一种运动创伤，往往由于关节活动的不协调，如踢球时踢空、对脚，或跑动中被绊倒等膝关节扭伤时，导致半月板卡在股骨和胫骨间，引起撕裂。如果同时存在其它情况，如长期处于蹲位劳动、原来有过韧带损伤、原来有盘状半月板等，则更容易引起撕裂。老年人由于半月板有退变老化，也很容易引起撕裂。而这些撕裂的引起甚至可以没有明显的外伤。

 

摘要
背景：应用生物学方法有助于半月板白区损伤的修复，物理学方法亦能促进半月板的修复，两者联合使用的效果可能更好。
目的：了解射频联合富血小板血浆对半月板白区撕裂修复的影响。
方法：48只成年新西兰大白兔随机分为：单纯缝合组、射频组、富血小板血浆组、射频联合富血小板血浆组共4组。所有实验动物均建立半月板后角损伤模型。单纯缝合组仅行半月板间断褥式缝合；射频组在半月板缝合后给予射频治疗(20 W，45 ℃)；富血小板血浆组在半月板缝合后关节内注射富血小板血浆凝胶；射频联合富血小板血浆组在半月板缝合后先予射频治疗，再在关节内注射富血小板血浆。术后3，12周时观察半月板大体形态及组织学变化，并检测转化生长因子、血管内皮生长因子、血小板衍生生长因子的表达。
结果与结论：①术后12周标本显示单纯缝合组的半月板裂口仍然未见愈合；射频组和富血小板血浆组半月板创口部分填塞，射频联合富血小板血浆组半月板创口闭合，愈合组织内可见软骨细胞、胶原纤维排列较未愈合组织规则；射频联合富血小板血浆组与单纯缝合组之间愈合率有明显差异(P=0.003)；②在3周时射频组、富血小板血浆组及射频联合富血小板血浆组血管内皮生长因子的表达较单纯缝合组明显增高，12周时明显下降。3周时各实验组，尤其是富血小板血浆组和射频联合富血小板血浆组，血小板衍生生长因子的表达增高。在12周时富血小板血浆组转化生长因子β1仍较高表达；③结果说明，射频联合富血小板血浆促进了半月板白区撕裂的修复，增加细胞增殖、促进细胞有丝分裂及血管形成是其机制之一。 

 

 

关键词: 组织构建, 组织工程, 射频, 富血小板血浆, 半月板, 修复, 撕裂, 白区, 细胞因子

Abstract:

BACKGROUND: Both biological and physical methods contribute to the repair of white meniscal tears, so the combined use will be better.
OBJECTIVE: To study the influence of radiofrequency combined with platelet-rich plasma (PRP) on the repair of white meniscal tears.
METHODS: Forty-eight adult New Zealand white rabbits were randomly divided into four groups, including simple suture, radiofrequency, PRP, and combination groups, and then the model of medial meniscus posterior root tears was established in all experimental animals. The simple suture group underwent interrupted mattress suture; the radiofrequency group was treated with radiofrequency (20 W, 45 ℃) after suture; the PRP group received the intra-articular injection of PRP after suture; the combination group was firstly treated with radiofrequency after suture, and then underwent the intra-articular injection of PRP. The gross and histological changes of the meniscus were observed, and the expression levels of transforming growth factor β1, vascular endothelial growth factor and platelet-derived growth factor were detected at 3 and 12 weeks postoperatively.
RESULTS AND CONCLUSION: At 12 weeks after operation, the simple suture group showed no healing; the radiofrequency and PRP groups healed partially; and the combination group healed completely, and chondrocytes and collagen fibers arranged regularly. There was a significant difference in the healing rate between combination and simple suture groups (P=0.003). At 3 weeks postoperatively, the expression levels of vascular endothelial growth factor in the radiofrequency, PRP and combination groups were obviously higher than that in the simple suture group, which decreased markedly at the 12th week. At 3 weeks postoperatively, the expression level of platelet-derived growth factor was increased in all groups, especially in the PRP and combination groups. The PRP group showed the highest level of transforming growth factor β1 at 12 weeks postoperatively. These results manifest that the combination of radiofrequency and PRP promotes the repair of white meniscal tears by increasing the cell proliferation, cell mitosis and angiogenesis.

 

 

Key words: Menisci, Tibial, Cather, Ablation, Platelet-Rich Plasma, Lacerations, Tissue Engineering

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