富血小板血浆对肩袖损伤后脂肪浸润干预作用的研究  

Effect of platelet-rich plasma on fat infiltration after rotator cuff injury in rats

作　　者：赵晨[1] 胡劲涛[2] 张琼[3] 贲定严 ZHAO Chen;HU Jintao;ZHANG Qiong;BI Dingyan(Department of Orthopedics,Zhejiang Provincial People's Hospital(People's Hospital of Hangzhou Medical College),Hangzhou 310014,China)

机构地区：[1]浙江省人民医院(杭州医学院附属人民医院)骨科,杭州310014 [2]浙江中医药大学附属杭州市中医院骨伤科 [3]浙江省人民医院(杭州医学院附属人民医院)手术室,杭州310014 [4]湖南中医药大学护理学院

出　　处：《浙江医学》2021年第23期2533-2537,2542,I0007,共7页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目(2019327519、2020373261)。

摘　　要：目的探讨富血小板血浆(PRP)对肩袖损伤模型大鼠肩袖相应肌肉脂肪浸润的干预作用及其机制。方法将30只SD大鼠按随机数字表法分为假手术组、模型组、PRP组,每组10只。假手术组仅予以切开皮肤,暴露肩袖组织后缝合,于冈上肌组织多部位肌肉内注射0.9%氯化钠注射液0.5 ml,每2 d注射1次;模型组和PRP组暴露肩袖组织后予以切断冈上肌肌腱,然后缝合皮肤。模型组于冈上肌组织多部位肌肉内注射0.9%氯化钠注射液0.5 ml,每2 d注射1次;PRP组于冈上肌组织多部位肌肉内注射PRP 0.5 ml,每2 d注射1次。将新鲜获取的健侧及造模侧冈上肌组织进行称重,获得肌肉湿重比。采用油红O染色观察3组大鼠冈上肌组织中脂肪形成情况,随机选取冈上肌组织中腹部5个区域,采用Image J软件计算每个区域内20根肌纤维的横截面积。采用qRT-PCR法检测3组大鼠成脂指标[CCAAT增强子结合蛋白(C/EBPβ)、过氧化物酶体增殖物激活受体(PPARγ)]、磷脂酰肌醇3-激酶(PI3K)、丝氨酸/苏氨酸激酶(Akt)、哺乳动物雷帕霉素靶点(mTOR)mRNA表达水平,采用Western blot法检测3组大鼠C/EBPβ、PPARγ、PI3K、Akt、mTOR蛋白表达水平。结果造模8周后,模型组大鼠冈上肌肌肉湿重比小于假手术组和PRP组(均P<0.01),PRP组大鼠冈上肌肌肉湿重比大于假手术组(P<0.05)。对3组大鼠冈上肌病理切片脂肪浸润情况进行观察,模型组大鼠冈上肌中脂滴形成较假手术组明显增多,且肌肉组织出现萎缩;PRP组冈上肌中脂滴形成数量较模型组明显减少,且肌肉组织萎缩程度也较轻。模型组大鼠肌纤维横截面积小于假手术组和PRP组(均P<0.01),PRP组肌纤维横截面积大于假手术组(P<0.01)。模型组大鼠C/EBPβ、PPARγmRNA及蛋白表达水平均高于假手术组(均P<0.05),而PRP组大鼠C/EBPβ、PPARγmRNA及蛋白表达水平均低于模型组(均P<0.05)。模型组大鼠PI3K、Akt、mTOR mRNA及蛋白表达水平�Objective To explore the effect and mechanism of platelet-rich plasma(PRP)on fat infiltration after rotator cuff injury in rats.Methods Thirty SD rats were randomly divided into model group,PRP group and sham operation group with 10 rats in each group.The rotator cuff injury model was induced by cutting supraspinatus tendon in model group and PRP group,and only sham operation was performed in sham group.Then 0.5 ml PRP was injected into multiple spots of the supraspinatus muscle once every 2 days in PRP group,while 0.5 ml normal saline was injected in model and sham operation groups instead.The freshly obtained supraspinatus muscle tissues of the healthy side and the modeled side were weighed to obtain the wet weight ratio of the muscle.Oil red O staining was used to observe the fat formation in the supraspinatus muscle of the three groups.The cross-sectional area of the muscle fiber was randomly selected from 5 regions of the supraspinatus muscle tissue.Image J software was used to calculate the cross-sectional area of 20 muscle fibers in each area,and the average value was taken.The mRNA and protein expression levels of lipid-forming indicators(C/EBPβ,PPARγ),PI3K,Akt and mTOR in muscle tissue were detected with qRT-PCR and Western blot,respectively.Results After 8 weeks of modeling,the supraspinatus muscle wet weight ratio in the model group was lower than that in the sham operation group(P<0.01),while the ratio in the PRP group was higher than that in the sham operation group(P<0.01).Compared with the sham operation group,the formation of lipid droplets in the supraspinatus muscle of the model group was significantly increased,and the muscle tissue was atrophy.Compared with the model group,the number of lipid droplets formed in the supraspinatus muscle of the PRP group was significant decrease,and the degree of muscle tissue atrophy is also lighter.The muscle fiber cross-sectional area ratio in the model group was smaller than that in the sham operation group(P<0.01),and the ratio in the PRP group was larger

关 键 词：富血小板血浆 肩袖损伤 脂肪浸润 

分 类 号：R686[医药卫生—骨科学]