Isicelo seKlinikhi kunye noPhando lwe-PRP kwi-Common Knee Disease

Ukusetyenziswa kweklinikhi kunye nophando lwe-PRP kwizifo eziqhelekileyo zamadolo

I-Platelet-rich plasma (PRP) i-plasma ehlanganiswe ngokukodwa iiplatelet kunye neeseli ezimhlophe zegazi ezifunyenwe nge-centrifugation ye-autologous peripheral blood.Inani elikhulu lezinto zokukhula kunye ne-cytokines zigcinwe kwi-α granules yeeplatelet.Xa iiplatelet zisebenza, i-α granules yazo ikhupha inani elikhulu lezinto zokukhula.Uphononongo lubonise ukuba le miba yokukhula kweeseli inokukhuthaza ukuhlukana kweeseli, ukwanda, i-matrix ye-extracellular kunye ne-collagen synthesis, ngaloo ndlela ikhuthaza ukuvuselelwa nokulungiswa kwe-articular cartilage kunye ne-ligamentenyeizicubu.Ngexesha elifanayo, kunokuphucula impendulo yokuvuvukala kwendawo ye-lesion kunye nokunciphisa iimpawu zekliniki zezigulane.Ukongeza kule miba yokukhula kweeseli, i-PRP ikwaqulethe inani elikhulu leeseli ezimhlophe zegazi.Ezi iiseli zegazi ezimhlophe kunye neeplatelet zinokukhulula iintlobo ze-peptides ezichasene ne-antimicrobial ukuze zibophe kwii-pathogens, zinqande kwaye zibulale iintsholongwane, kwaye zidlale indima ye-antibacterial.

I-PRP isetyenziswe ngokubanzi kwintsimi ye-orthopedics ngenxa yenkqubo yayo yokuvelisa elula, ukusetyenziswa kakuhle kunye neendleko eziphantsi, ngakumbi kunyango lwezifo zamadolo kwiminyaka yamuva.Eli nqaku liza kuxubusha isicelo sekliniki kunye nophando lwe-plasma ecebileyo yeplatelet kwi-knee osteoarthritis (KOA), ukulimala kwe-meniscus, ukulimala kwe-cruciate ligament, i-knee synovitis kunye nezinye izifo eziqhelekileyo zamadolo.

Iteknoloji yesicelo se-PRP

I-PRP engasebenziyo kunye nokukhutshwa kwe-PRP esebenzayo i-liquid kwaye inokuthi ifakwe, kwaye i-PRP engasebenziyo ingalawulwa ngokufaka ngokufanelekileyo i-calcium chloride okanye i-thrombin ukulawula ixesha le-agglutination ukwenzela ukuba i-gel ingenziwa emva kokufikelela kwindawo ekujoliswe kuyo, ukwenzela ukuba ukufikelela kwinjongo yokukhululwa okuzinzileyo kwemiba yokukhula.

Unyango lwe-PRP lwe-KOA

I-KOA sisifo sedolo esibuhlungu esibonakaliswa ngokutshabalalisa okuqhubekayo kwe-articular cartilage.Uninzi lwezigulana ziphakathi nabadala.Ukubonakaliswa kweklinikhi ye-KOA ziintlungu zamadolo, ukuvuvukala, kunye nokunciphisa umsebenzi.Ukungalingani phakathi kwe-synthesis kunye nokubola kwe-articular cartilage matrix sisiseko sokwenzeka kwe-KOA.Ngoko ke, ukukhuthaza ukulungiswa kwe-cartilage kunye nokulawula ibhalansi ye-cartilage matrix ngundoqo kunyango lwayo.

Okwangoku, uninzi lwezigulane ze-KOA zikulungele unyango olulondolozayo.Inaliti edibeneyo yamadolo ye-hyaluronic acid, i-glucocorticoids kunye nezinye iziyobisi kunye namachiza omlomo angenayo i-steroid anti-inflammatory asetyenziswa ngokuqhelekileyo unyango olulondolozayo.Ngokunzulu kophando kwi-PRP ngabaphengululi basekhaya nabangaphandle, unyango lwe-KOA kunye ne-PRP luye lwaba lukhulu ngakumbi kwiminyaka yamuva.

Indlela yokwenza:

1. Ukukhuthaza ukwanda kwe-chondrocytes:

Ngokulinganisa umphumo we-PRP ekusebenzeni kwee-chondrocytes zomvundla, Wu J et al.yafumanisa ukuba i-PRP iphucule ukwanda kwe-chondrocytes, kwaye icinge ukuba i-PRP inokukhusela i-IL-1β-activated chondrocytes ngokuvimbela i-Wnt / β-catenin transduction signal.

2. Ukuvinjelwa kwe-chondrocyte reaction inflammatory and degeneration:

Xa ivuliwe, i-PRP ikhupha inani elikhulu lezinto ezichasayo, ezifana ne-IL-1RA, TNF-Rⅰ, ⅱ, njl njl. ingavala i-TNF-α enxulumene nendlela yomqondiso.

Uphononongo olusebenzayo:

Ukubonakaliswa okuphambili kukukhululeka kwentlungu kunye nokuphuculwa komsebenzi wamadolo.

ULin KY et al.kuthelekisa inaliti ye-intra-articular ye-LP-PRP kunye ne-hyaluronic acid kunye ne-saline eqhelekileyo, kwaye yafumanisa ukuba isiphumo sokunyanga samaqela amabini okuqala sasingcono kuneqela eliqhelekileyo le-saline kwixesha elifutshane, eliqinisekisa umphumo wekliniki we-LP-PRP. kunye ne-hyaluronic acid, kunye nokuqwalaselwa kwexesha elide (emva kwe-1 ngonyaka) kubonise ukuba umphumo we-LP-PRP wawungcono.Ezinye izifundo ziye zadibanisa i-PRP kunye ne-hyaluronic acid, kwaye yafumanisa ukuba ukudibanisa kwe-PRP kunye ne-hyaluronic acid ayinakukwazi ukukhulula intlungu kunye nokuphucula umsebenzi, kodwa iphinde iqinisekise ukuvuselelwa kwe-articular cartilage nge-X-ray.

Nangona kunjalo, uFilardo G et al.bakholelwa ukuba iqela le-PRP kunye neqela le-sodium hyaluronate liphumelele ekuphuculeni umsebenzi wamadolo kunye neempawu ngokusebenzisa isifundo esilawulwa ngokungahleliwe, kodwa akukho ntlukwano ebalulekileyo efunyenweyo.Kwafunyaniswa ukuba indlela yolawulo lwe-PRP inefuthe elithile kwimpembelelo yonyango ye-KOA.Du W et al.iphathwe i-KOA nge-PRP ye-intravarticular injection kunye ne-extraarticular injection, kwaye yaqaphela amanqaku e-VAS kunye ne-Lysholm ngaphambi kokuba amayeza kunye ne-1 kunye neenyanga ze-6 emva kweyeza.Baye bafumanisa ukuba zombini iindlela zokutofa zinokuphucula amanqaku e-VAS kunye neLysholm kwixesha elifutshane, kodwa umphumo weqela le-intra-articular injection yayingcono kuneqela le-extraarticular injection emva kweenyanga ze-6.Taniguchi Y et al.Ukwahlula isifundo kunyango lwe-KOA ephakathi ukuya kwi-intraluminal edibeneyo kunye nenaliti ye-intraluminal yeqela le-PRP, inaliti ye-intraluminal yeqela le-PRP kunye nenaliti ye-intraluminal yeqela le-HA.Uphononongo lubonise ukuba ukudibanisa kwe-injection ye-intraluminal ye-PRP kunye ne-injection ye-intraluminal ye-PRP yayingcono kune-injection ye-intraluminal ye-PRP okanye i-HA ubuncinane kwiinyanga ze-18 ekuphuculeni amanqaku e-VAS kunye ne-WOMAC.

(Imixholo yeli nqaku ishicilelwe, kwaye asiboneleli nasiphi na isiqinisekiso esicacileyo okanye esichaziweyo sokuchaneka, ukuthembeka okanye ukugqibelela kokuqulathwe kweli nqaku, kwaye abanaxanduva ngezimvo zeli nqaku, nceda uqonde.)