自体富血小板血浆凝胶促进慢性难愈合创面愈合的相关机制

The mechanism of autologous platelet-rich plasma gel promoting the healing of chronic refractory wounds

目的探讨自体富血小板血浆(PRP)凝胶在促进慢性难愈合创面愈合中的作用及其机制。方法慢性难愈合创面30例,自体PRP凝胶治疗组18例,对照组12例,临床动态观察创面愈合情况,HE染色镜下观察肉芽组织生长情况;免疫组织化学检测创面组织中CD31表达的新生微血管变化情况。结果临床观察应用PRP凝胶组创面有明显的愈合,对照组无明显改变。PRP凝胶组创面肉芽组织致密,纤维母细胞增生明显,排列规则、含有丰富的胶原纤维和微血管断面,对照组肉芽组织结构疏松,纤维母细胞增生不明显,胶原纤维和微血管较少。PRP凝胶组的第7天和第14天CD31表达的微血管结构数量分别为33.10±4.58、30.25±3.79,明显高于同一时间点的对照组(16.47±3.89、17.24±3.75,P<0.05)。结论自体PRP凝胶明显促进慢性难愈合创面的愈合,与促进创面局部微血管生成相关。

Objective To explore the role and mechanism of autologous platelet-rich plasma(PRP)gel in promoting the healing process of chronic refractory wounds.Methods 30 cases of chronic refractory wounds,18 cases of autologous platelet-rich plasma gel treatment group,and 12 cases of control were used for clinical observation of wound healing.HE staining was used to observe the growth of granulation tissue,immunohistochemistry was used to detect CD31 expression.Results PRP gel promoted the healing of wounds,with dense granulation tissue and the obvious fibroblast proliferation and regular arrangement and rich collagen fibers and microvessels compared to the control group.The number of CD31 positive microvascular structures was significantly higher in PRP group(33.10±4.58 and 30.25±3.79)than in the control group(16.47±3.89、17.24±3.75,P<0.05).Conclusion Autologous PRP gel significantly promotes the healing of chronic refractory wounds,which is related to the promotion of local microangiogenesis of wound.