富血小板血漿對大鼠跟腱斷裂早期愈合的影響_《中國修復重建外科雜志》

作者：

熊小龍 , 伍亮 , 相大勇 , 倪國新 , 趙培冉 , 余斌

南方醫科大學南方醫院創傷骨科（廣州，510515）;

關鍵詞：

富血小板血漿跟腱斷裂跟腱愈合 Ⅰ型膠原大鼠

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目的富血小板血漿（platelet-rich plasma，PRP）具有促進損傷組織修復作用。通過觀察PRP 局部注射對大鼠跟腱斷裂早期愈合的影響，為臨床應用提供實驗依據。方法 SPF 級SD 大鼠46 只，雌雄不限，體重190 ～ 240 g。取10 只大鼠心臟動脈血制備PRP 及貧血小板血漿（platelet-poor plasma，PPP）；其余36 只隨機分為3 組（n=12），分別為空白對照組、PPP 組及PRP 組。大鼠制備雙側跟腱斷裂模型后，PPP 組和PRP 組跟腱周圍局部對應注射PPP 及PRP，每側100 μL，每周1 次至處死；空白對照組不作處理。術后觀察大鼠一般情況，于1、2、3、4 周取雙側跟腱，行大體、組織學及免疫組織化學染色觀察，測量新生跟腱Ⅰ型膠原纖維含量；并于4 周行生物力學測試。結果大鼠均存活至實驗完成。隨著時間延長，各組大鼠跟腱水腫逐漸減退，滑動性逐漸改善；術后3 周內各組跟腱粘連逐漸加重，4 周時減輕，1、4 周時各組跟腱粘連程度分級差異均無統計學意義（P gt; 0.05）。術后1 周PRP 組炎性細胞浸潤、毛細血管及膠原纖維增殖較空白對照組、PPP 組明顯，之后炎性反應及毛細血管生成逐漸減少。各時間點各組均可見Ⅰ型膠原纖維陽性表達，術后1、2、3 周PRP 組Ⅰ型膠原纖維陽性密度值多于空白對照組和PPP 組（P lt; 0.05），4 周時3 組差異無統計學意義（P gt; 0.05）。生物力學測試：術后4 周3 組跟腱最大滑動距離比較，差異均無統計學意義（P gt; 0.05）；PRP 組跟腱彈性模量及最大抗拉力明顯高于空白對照組及PPP 組（P lt; 0.05）。結論大鼠跟腱斷裂早期于斷端周圍注射PRP 能促進跟腱愈合。

引用本文： 熊小龍,伍亮,相大勇,倪國新,趙培冉,余斌. 富血小板血漿對大鼠跟腱斷裂早期愈合的影響. 中國修復重建外科雜志, 2012, 26(4): 466-471. doi: 復制

1.	and radiographic animal study on the use of autogenous scaffolds and platelet-rich plasma. Int J Oral Maxillofac Surg, 2002, 31(3): 281-286.
2.	Assoian RK, Grotendorst GR, Miller DM, et al. Cellular transformation by coordinated action of three peptide growth factors from human platelets. Nature, 1984, 309(5971): 804-806.
3.	Fennis JP, Stoelinga PJ, Jansen JA. Mandibular reconstruction: a clinical.
4.	Foster TE, Puskas BL, Mandelbaum BR, et al. Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med, 2009, 37(11): 2259-2272.
5.	Lyras DN, Kazakos K, Verettas D, et al. The influence of platelet-rich plasma on angiogenesis during the early phase of tendon healing. Foot Ankle Int, 2009, 30(11): 1101-1106.
6.	Camargo PM, Lekovic V, Weinlaender M, et al. Platelet-rich plasma and bovine porous bone mineral combined with guided tissue regeneration in the treatment of intrabony defects in humans. J Periodontal Res, 2002, 37(4): 300-306.
7.	Schmitz JP, Hollinger JO. The biology of platelet-rich plasma. J Oral Maxillofac Surg, 2001, 59(9): 1119-1121.
8.	劉驥, 袁霆, 張長青. 富血小板血漿治療慢性組織損傷的研究進展. 中國修復重建外科雜志, 2010, 24(6): 754-757.
9.	耿震, 王宸, 周海洋. 富血小板血漿對肌腱愈合影響的實驗研究. 中國修復重建外科雜志, 2011, 25(3): 344-348.
10.	Aspenberg P, Virchenko O. Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand, 2004, 75(1): 93-99.
11.	Landesberg R, Roy M, Glickman RS. Quantification of growth factor levels using a simplified method of platelet-rich plasma gel preparation. J Oral Maxillofac Surg, 2000, 58(3): 297-300.
12.	湯錦波, 侍德, 石井清一. 各種傷情下屈肌腱的愈合及粘連形成: 肌腱愈合新理論系統的探討. 手外科雜志, 1992, 8(1): 31-35.
13.	Möller A, Astron M, Westlin N. Increasing incidence of Achilles tendon rupture. Acta Orthop Scand, 1996, 67(5): 479-481.
14.	Bhattacharyya M, Gerber B. Mini-invasive surgical repair of the Achilles tendon—does it reduce post-operative morbidity? Int Orthop, 2009, 33(1): 151-156.
15.	商曉軍, 朱亞平, 韋兆祥. 閉合性跟腱斷裂微創腱皮縫合的遠期療效觀察. 中國矯形外科雜志, 2007, 15(18): 1371-1373.
16.	Lansdaal JR, Goslings JC, Reichart M, et al. The results of 163 Achilles tendon ruptures treated by a minimally invasive surgical technique and functional aftertreatment. Injury, 2007, 38(7): 839-844.
17.	Willits K, Amendola A, Bryant D, et al. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Joint Surg (Am), 2010, 92(17): 2767-2775.
18.	Carter CA, Jolly DG, Worden CE Sr, et al. Platelet-rich plasma gel promotes differentiation and regeneration during equine wound healing. Exp Mol Pathol, 2003, 74(3): 244-255.
19.	Kajikawa Y, Morihara T, Sakamoto H, et al. Platelet-rich plasma enhances the initial mobilization of circulation-derived cells for tendon healing. J Cell Physiol, 2008, 215(3): 837-845.
20.	Kajikawa Y, Morihara T, Watanabe N, et al. GFP chimeric models exhibited a biphasic pattern of mesenchymal cell invasion in tendon healing. J Cell Physiol, 2007, 210(3): 684-691.
21.	盛加根, 曾炳芳, 姜佩珠, 等. 外源性堿性成纖維細胞生長因子對鞘內肌腱愈合和粘連的影響. 中國修復重建外科雜志, 2007, 21(7): 733-737.
22.	余利鵬, 羅永湘. 跟腱損傷治療進展. 中國修復重建外科雜志, 2003, 17(4): 343-345.
23.	Spindler KP, Murray MM, Detwiler KB, et al. The biomechanical response to doses of TGF-beta 2 in the healing rabbit medial collateral ligament. J Orthop Res, 2003, 21(2): 245-249.
24.	Taylor DW, Petrera M, Hendry M, et al. A systematic review of the use of platelet-rich plasma in sports medicine as a new treatment for tendon and ligament injuries. Clin J Sport Med, 2011, 21(4): 344-352.
25.	Schepull T, Kvist J, Norrman H, et al. Autologous platelets have no effect on the healing of human achilles tendon ruptures: a randomized single-blind study. Am J Sports Med, 2011, 39(1): 38-47.

1. and radiographic animal study on the use of autogenous scaffolds and platelet-rich plasma. Int J Oral Maxillofac Surg, 2002, 31(3): 281-286.
2. Assoian RK, Grotendorst GR, Miller DM, et al. Cellular transformation by coordinated action of three peptide growth factors from human platelets. Nature, 1984, 309(5971): 804-806.
3. Fennis JP, Stoelinga PJ, Jansen JA. Mandibular reconstruction: a clinical.
4. Foster TE, Puskas BL, Mandelbaum BR, et al. Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med, 2009, 37(11): 2259-2272.
5. Lyras DN, Kazakos K, Verettas D, et al. The influence of platelet-rich plasma on angiogenesis during the early phase of tendon healing. Foot Ankle Int, 2009, 30(11): 1101-1106.
6. Camargo PM, Lekovic V, Weinlaender M, et al. Platelet-rich plasma and bovine porous bone mineral combined with guided tissue regeneration in the treatment of intrabony defects in humans. J Periodontal Res, 2002, 37(4): 300-306.
7. Schmitz JP, Hollinger JO. The biology of platelet-rich plasma. J Oral Maxillofac Surg, 2001, 59(9): 1119-1121.
8. 劉驥, 袁霆, 張長青. 富血小板血漿治療慢性組織損傷的研究進展. 中國修復重建外科雜志, 2010, 24(6): 754-757.
9. 耿震, 王宸, 周海洋. 富血小板血漿對肌腱愈合影響的實驗研究. 中國修復重建外科雜志, 2011, 25(3): 344-348.
10. Aspenberg P, Virchenko O. Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand, 2004, 75(1): 93-99.
11. Landesberg R, Roy M, Glickman RS. Quantification of growth factor levels using a simplified method of platelet-rich plasma gel preparation. J Oral Maxillofac Surg, 2000, 58(3): 297-300.
12. 湯錦波, 侍德, 石井清一. 各種傷情下屈肌腱的愈合及粘連形成: 肌腱愈合新理論系統的探討. 手外科雜志, 1992, 8(1): 31-35.
13. Möller A, Astron M, Westlin N. Increasing incidence of Achilles tendon rupture. Acta Orthop Scand, 1996, 67(5): 479-481.
14. Bhattacharyya M, Gerber B. Mini-invasive surgical repair of the Achilles tendon—does it reduce post-operative morbidity? Int Orthop, 2009, 33(1): 151-156.
15. 商曉軍, 朱亞平, 韋兆祥. 閉合性跟腱斷裂微創腱皮縫合的遠期療效觀察. 中國矯形外科雜志, 2007, 15(18): 1371-1373.
16. Lansdaal JR, Goslings JC, Reichart M, et al. The results of 163 Achilles tendon ruptures treated by a minimally invasive surgical technique and functional aftertreatment. Injury, 2007, 38(7): 839-844.
17. Willits K, Amendola A, Bryant D, et al. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Joint Surg (Am), 2010, 92(17): 2767-2775.
18. Carter CA, Jolly DG, Worden CE Sr, et al. Platelet-rich plasma gel promotes differentiation and regeneration during equine wound healing. Exp Mol Pathol, 2003, 74(3): 244-255.
19. Kajikawa Y, Morihara T, Sakamoto H, et al. Platelet-rich plasma enhances the initial mobilization of circulation-derived cells for tendon healing. J Cell Physiol, 2008, 215(3): 837-845.
20. Kajikawa Y, Morihara T, Watanabe N, et al. GFP chimeric models exhibited a biphasic pattern of mesenchymal cell invasion in tendon healing. J Cell Physiol, 2007, 210(3): 684-691.
21. 盛加根, 曾炳芳, 姜佩珠, 等. 外源性堿性成纖維細胞生長因子對鞘內肌腱愈合和粘連的影響. 中國修復重建外科雜志, 2007, 21(7): 733-737.
22. 余利鵬, 羅永湘. 跟腱損傷治療進展. 中國修復重建外科雜志, 2003, 17(4): 343-345.
23. Spindler KP, Murray MM, Detwiler KB, et al. The biomechanical response to doses of TGF-beta 2 in the healing rabbit medial collateral ligament. J Orthop Res, 2003, 21(2): 245-249.
24. Taylor DW, Petrera M, Hendry M, et al. A systematic review of the use of platelet-rich plasma in sports medicine as a new treatment for tendon and ligament injuries. Clin J Sport Med, 2011, 21(4): 344-352.
25. Schepull T, Kvist J, Norrman H, et al. Autologous platelets have no effect on the healing of human achilles tendon ruptures: a randomized single-blind study. Am J Sports Med, 2011, 39(1): 38-47.

《中國修復重建外科雜志》

富血小板血漿對大鼠跟腱斷裂早期愈合的影響

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《中國修復重建外科雜志》

富血小板血漿對大鼠跟腱斷裂早期愈合的影響

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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