血小板源性生长因子在富血小板血浆治疗高原地区脊柱结核病中的作用机制研究  

The mechanism study of platelet derived growth factor in the platelet-rich plasma treating spinal tuberculosis in high altitude area

作　　者：李钊伟[1] 李泽清[1] 唐保明[1] 李春亮[2] 赵磊[3] 杨爱荣[4] LI Zhao-wei LI Ze-qing TANG Bao-ming LI Chun-liang ZHAO Lei YANG Ai-rong(Trauma department of orthopedics, Qinghai university affiliated hospital Qinghai university affiliated hospital Department of orthopedics, Qinghai Provincial People＇s Hospital Department of preventive medicine,Qinghai University School of Medicine)

机构地区：[1]青海大学附属医院创伤骨科 [2]青海省人民医院骨科 [3]青海大学医学院预防医学系 [4]青海大学附属医院

出　　处：《中国高原医学与生物学杂志》2017年第1期44-49,共6页Journal of Chinese High Altitude Medicine & Biology

基　　金：青海省科技厅自然科学基金项目(2014-ZJ-761)

摘　　要：目的观察富血小板血浆对高原地区脊柱结核病治疗的影响,了解血小板源性生长因子在富血小板血浆治疗高原地区脊柱结核病的作用机制。方法收集本院自2013年3月~2016年3期间青海本地脊柱结核患者,根据患者术中是否经PRP治疗分为PRP组和非PRP组,术后给予相同治疗,并于术后连续4周每周复查各组患者CRP、ESR值;12只家兔随机分为两组(实验组和对照组),每组6只,无菌操作去除各组家兔椎体侧方1 cm×1 cm骨组织,用咬骨钳将其咬碎备用,实验组骨组织与预先制备好的PRP混合,并植入对应家兔骨缺损处;对照组骨组织与等体积的生理盐水混合,并植入对应家兔骨缺损处,术后分笼常规饲养。8周后无菌获取各组适量骨缺损处组织,置于液氮速冻再移至-80℃冰箱暂存,采用Western Blot技术检测各组骨缺损处组织PDGF、AP-1以及IL-6蛋白的表达水平。结果 PRP组(n=61)和非PRP组(n=57)治疗脊柱结核病均达到治愈,但PRP组术后复发感染、血肿以及窦道均比非PRP组少;术前PRP和非PRP组ESR、CRP值差异无统计学意义(P>0.05),但PRP组和非PRP组术后2、3、4周ESR和CRP值变化差异均有统计学意义(P<0.05),且均随术后时间延长而降低。12只家兔,造模前后无感染和死亡,均进入结果分析,无托失值;家兔PRP组和对照组骨缺损处组织PDGF、AP-1以及IL-6蛋白的表达水平变化差异有统计学意义(P<0.05),且PRP组三种蛋白表达水平均明显升高。结论血小板源性生长因子可能通过PDGF、AP-1以及IL-6蛋白改变发挥减少脊柱结核患者术后并发症的作用,提高富血小板血浆治疗高原地区脊柱结核病术后伤口愈合效果。Objective By observing the influence of platelet-rich plasma on the treatment of spinal tuberculosis in high altitude area,we sought to test the molecular mechanism of platelet-derived growth factor in the platelet- rich plasma in the treatment of spinal tuberculosis.Methods During 2013/03-2016/03,we enrolled spinal tubercu- losis patients in Qinghai University affiliated hospital who were all from Qinghai area.The patients who were under the PRP therapy entered into the PRP group and the rest entered into non-PRP group. Then give them the same treatment postoperatively.Finally, CRP and ESR of each patient in two groups were tested for four weeks.12 rabbits were randomly divided into 2 groups（ the experimental group and the control group） ,six rabbits in each group.Each rabbit were taken sterile operation to remove vertebral side 1 cm× 1 cm bone tissue, rongeur were used to bite it.The bone tissue of PRP group was mixed with PRP which was prepared, implanted it into bone defect of corresponding rabbit; the bone tissue of the control group mixed with same volume of normal saline, implanted it into bone defect of corresponding rabbit;divided in cage raising for 8 weeks.A moderate amount of bone tissue was obtained from the bone lesions, which was firstly placed in liquid nitrogen and then moved to -80 ℃ refrigerator. Western Blot were used to test PDGF,AP-1 and IL- 6 protein level in each group of bone defect tissue.Results All patients of spinal tuberculosis were cured in the PRP group （n = 61 ）and the non-PRP group （n = 57）, but the case of infection, hema- toma, postoperative recurrence and antrum in PRP group were less than that of the PRP group.There was no signifi- cant difference of ESR and CRP value between the PRP group and the non-PRP group preoperatively（P〉0.05）. The difference of ESR and CRP values had statistical significance（P〈0.05 ）between the PRP group and the non- PRP group after using PRP therapy for 2weeks, 3weeks, 4 weeks, and the changing speed of ESR and CRP values i

关 键 词：高原脊柱结核 血小板源性生长因子 富血小板血浆 

分 类 号：R363.1[医药卫生—病理学]