骨组织及软组织修复作用中富血小板血浆的制作及其原理

Fabrication and principle of platelet-rich plasma in the the repair of bone and soft tissues

目的:富血小板血浆(platelet-richplasma,PRP)含有多种高浓度生长因子,可促进骨愈合及软组织修复。探讨通过离心法制作富血小板血浆的原理,为临床利用PRP修复组织缺损提供实验依据。方法:从肘前静脉取血5mL,选用4种不同离心次数、离心力和离心时间的PRP制作方法,制作的PRP均为0.7mL,对比研究各种PRP和全血中的血小板计数和活化率。结果:全血标本的平均血小板计数是214.41×109L-1。在不同方法制作的PRP中,血小板计数均明显高于全血,分别是629.95×109L-1(Anitua法),1093.00×109L-1(Petrungaro法),1323.80×109L-1(Landesbergo法)和1347.05×109L-1(Aghaloo法),是全血血小板计数的2.92,5.10,6.17和6.28倍。PRP中血小板计数与全血血小板计数呈正相关,相关系数分别为rAnitua=0.79,rPetrungaro=0.83,rLandesberg=0.93和rAghaloo=0.89。活性检测,CD62P的表达在全血中是0.85%,Anitua法4.87%,Petrungaro法9.79%,Landesberg法6.05%,Aghaloo法9.12%。PRP的CD62P表达率与全血的CD62P表达率以及各PRP之间均呈显著性差异。结论:二次离心法制作的PRP其血小板浓度和血小板回收率显著高于一次离心法。在这4种方法中,以Landesberg法制作的PRP中血小板浓度高、活化率小。

AIM:The platelet-rich plasma(PRP) contains various high-concentration growth factor,and it can promote the bone healing and repair of soft tissues.The aim of this paper is to investigate the principle of making PRP with centrifuging in order to provide an experimental basis for repairing the tissue defect with PRP in clinical application. METHODS:From the antecubital veins,5 mL blood was drawn.Four methods with different centrifugal times,force and time were selected to make PRP,all the PRP were 0.7 mL.The count and activation rate of platelet in all kinds of PRP and the whole blood were measured in comparison. RESULTS:The mean platelet count in whole blood was 214.41×109 L-1,significantly lower than that in all the PRP productions made by different ways.Platelet counts in PRP were 629.95×109 L-1 (Anitua method), 1 093.00×109 L-1 (Petrungaro method), 1 323.80×109 L-1(Landesbergo method), 1 347.05×109 L-1(Aghaloo method),respectively,which were 2.92,5.10,6.17 and 6.28 times of the platelet count.The platelet count in PRP and the platelet count in whole blood were in positive correlation,and the correlation coefficients were rAnitua=0.79,rPetrungaro=0.83,rLandesberg =0.93 and rAghaloo=0.89,respectively.The expression of CD62P in whole blood was 0.85%,and 4.87%(Anitua),9.79%(Petrungaro),6.05%(Landesberg) and 9.12 %(aghaloo) by activation detect.There were significant differences in the expressional rate of CD62P between whole blood and PRP,and among PRPs as well. CONCLUSION:Concentration and recovery rate of platelet in PRP after twice centrifugation are higher than that after once centrifugation.Landesberg method of making PRP is a better one in comparison with other methods,which can produce higher concentration of platelet and lower rate of activation.