损伤神经周围注射自体PRP对周围神经损伤的修复效果观察  

The effect of autologous PRP injection around injured nerve on the repair of injured peripheral nerve

作　　者：王辉[1] 韩新生 焦勇强 吕亚军[1] 高宏阳[1] Wang Hui;Han Xinsheng;Jiao Yongqiang(Department of Orthopedics,the First Hospital of Hebei Medical University,Shijiazhuang050031;不详)

机构地区：[1]河北医科大学第一医院骨科,石家庄050031 [2]河北省定兴县医院神经内科 [3]河北工程大学附属医院骨外科

出　　处：《卒中与神经疾病》2020年第2期200-204,共5页Stroke and Nervous Diseases

基　　金：河北省医学科学研究重点课题计划(编号为20170510)。

摘　　要：目的探讨损伤神经周围注射自体富血小板血浆(platelet-rich plasma,PRP)对周围神经损伤的修复效果。方法选取2017年1月-2018年7月于本院接受治疗的周围神经损伤患者130例,随机分为手术组、PRP联合组各65例,手术组患者进行显微外科手术,PRP联合组患者在手术基础上注射自体PRP进行治疗;用酶联免疫吸附实验法检测血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平,用Western blot法检测胰岛素样生长因子1(IGF-1)、血管内皮生长因子(VEGF)表达水平,并对2组患者神经传导速度、下肢运动功能、基本功能优良率以及肌电图疗效进行检测。结果治疗1、3、6、12个月后PRP联合组患者CRP、TNF-α水平均低于手术组,IGF-1、VEGF表达水平均高于手术组(P<0.05);治疗1、3、6、12个月后PRP联合组患者感觉、运动神经传导速度、下肢运动功能评分、基本功能恢复优良率、肌电图愈显率均高于手术组(P<0.05)。结论在手术治疗的基础上注射自体PRP对周围神经损伤患者进行治疗,能够减轻患者炎性损伤程度,上调IGF-1、VEGF的表达水平,加快神经传导速度,促进患者下肢运动功能恢复。Objective To explore the effect of autologous platelet-rich plasma(PRP)injection around injured nerve on the repair of injured peripheral nerve.Methods 130 patients with peripheral nerve injury of lower extremity who were treated in our hospital from January 2017 to July 2018 were randomly divided into operation group and combined PRP group,65 cases in each group.The operation group underwent microsurgery,and the combined PRP group received autologous PRP injection on the basis of operation.The levels of serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and insulin-like growth factor-1(IGF-1)and vascular endothelial growth factor(VEGF)were detected by enzyme-linked immunosorbent assay(ELISA)and Western blot.The nerve conduction velocity,lower limb motor function,excellent and good rate of basic function of the two groups were measured.The curative effect of muscle electrogram was tested and compared.Results At 1,3,6 and 12th month after treatment,the levels of CRP andTNF-αin combined PRP group were lower than those in operation group,and the expression levels of IGF-1 and VEGF in combined PRP group were higher than those in operation group(P<0.05).At 1,3,6 and 12th month after treatment,the sensory,motor nerve conduction velocity,motor function score of lower limbs in combined PRP group were obviously higher than those in operation group(P<0.05).The excellent and good rate of functional recovery and the marked rate of EMG were higher than those of the operation group(P<0.05).Conclusion Injecting PRP into peripheral nerveinjury patients on the basis of surgical treatment could alleviate the degree of inflammation injury,up-regulate the expression levelsof IGF-1 and VEGF,accelerate nerve conduction speed,and promote the recovery of lower limb motor function.

关 键 词：周围神经损伤 自体富血小板血浆 神经传导速度 

分 类 号：R745[医药卫生—神经病学与精神病学]