富血小板血浆治疗兔跟腱病的实验研究  

Experimental study of platelet-rich plasma in treatment of Achilles tendinopathy in rabbits

作　　者：巩栋 赵茂胜 苏文财 董晨辉 邓银栓 甄平 GONG Dong;ZHAO Maosheng;SU Wencai;DONG Chenhui;DENG Yinshuan;ZHEN Ping(Department of Orthopedics,the 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army,Lanzhou Gansu,730050,P.R.China)

机构地区：[1]联勤保障部队第九四〇医院骨科中心

出　　处：《中国修复重建外科杂志》2019年第7期871-876,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：全军后勤科研计划面上项目(CWH17J007);甘肃省自然科学基金资助项目(18JR3RA409)~~

摘　　要：目的探讨富血小板血浆(platelet-rich plasma,PRP)治疗兔跟腱病的效果,为PRP治疗跟腱病的临床应用提供实验依据。方法取成年新西兰大白兔48只,体质量2.5~3.0 kg,雌雄不限,随机分为模型组(A组)、模型对照组(B组)、模型+治疗对照组(C组)、模型+治疗组(D组),每组12只。A、C、D组注射Ⅰ型胶原酶制备兔跟腱病模型,B组注射等剂量生理盐水。D组取自体耳中心动脉血,采用二次离心法制备PRP,血小板计数提示PRP血小板达全血的3~5倍。模型制备后,C、D组于造模部位分别注射生理盐水、自体PRP,每周1次,每次0.8 mL,连续4周。于PRP注射结束后1周,采用超声弹性定量成像检测技术评价各组跟腱相对硬度,以HRD%(硬度百分比)表示;万能电子拉力试验机测定跟腱最大断裂负荷;ELISA法测定Ⅰ、Ⅲ型胶原蛋白含量;HE染色和Masson染色观察跟腱胶原纤维形态。结果各组动物均存活至实验完成。超声弹性定量成像检测及力学试验示,A组跟腱硬度评价指标HRD%及最大断裂负荷显著小于B组(P<0.05),C组显著小于D组(P<0.05)。ELISA检测示,A组Ⅰ型胶原蛋白含量显著低于B组、C组显著低于D组,A组Ⅲ型胶原蛋白含量显著高于B组、D组显著高于C组,差异均有统计学意义(P<0.05)。HE染色和Masson染色示,A组跟腱胶原纤维呈不规则卷曲,结构严重破坏;B组呈平行有序排列、结构完整;C组呈不规则卷曲,结构紊乱;D组呈轻微卷曲,结构较为完整。结论Ⅰ型胶原酶注射可成功构建兔跟腱病模型,PRP治疗可增加跟腱硬度和最大断裂负荷,上调Ⅰ、Ⅲ型胶原蛋白表达水平,改善跟腱胶原纤维结构和形态,促进兔跟腱病的恢复。Objective To explore the effect of platelet-rich plasma(PRP) in treatment of Achilles tendinopathy in rabbits, and provide experimental evidence for the clinical application of PRP in treatment of Achilles tendinopathy.Methods Forty-eight adult New Zealand white rabbits, weighing 2.5-3.0 kg, male or female, were randomly divided into model group(group A), model control group(group B), model+treatment control group(group C), model+treatment group(group D), with 12 in each group. The rabbits were injected with type Ⅰ collagenase to prepare Achilles tendinopathy models in groups A, C, and D, and with an equal dose of normal saline in group B. The blood from the central artery of rabbit ear was taken to preprare PRP by secondary centrifugation in group D. The results of platelet counts showed that PRP platelets reached 3 to 5 times the whole blood. After the model was prepared, the rabbits in groups C and D were injected with physiological saline and autologous PRP at the molding site respectively, once a week,0.8 mL each time for 4 weeks. At 1 week after PRP injection, the relative hardness(expressed as HRD%) of Achilles tendon was evaluated by ultrasound elastic quantitative imaging detection technique;the maximum breaking load of Achilles tendon was measured by universal electronic tensile testing machine;the contents of collagen type Ⅰ and Ⅲ were determined by ELISA;and the morphology of Achilles tendon collagen fibers was observed by HE and Masson stainings.Results All animals survived during the experiment. The results of ultrasound elastic quantitative imaging and mechanical tests showed that the HRD% and the maximum breaking load were significantly lower in group A than in group B(P<0.05) and in group C than in group D(P<0.05). The results of ELISA showed that the content of collagen typeⅠ was significantly lower in group A than in group B(P<0.05) and in group C than in group D(P<0.05);the content of collagen type Ⅲ was significantly higher in group A than in group B(P<0.05) and in group D than in g

关 键 词：富血小板血浆 跟腱病 兔 

分 类 号：R686.1[医药卫生—骨科学]