富血小板血浆治疗肌腱病的影响因素与机制  

Influencing factors and mechanisms of platelet-rich plasma in tendinopathy

作　　者：陆加霖 高尧[1] 李涵 张紫钰 王一茗 徐瑞 王中汉 金辉[1] Lu Jialin;Gao Yao;Li Han;Zhang Ziyu;Wang Yiming;Xu Rui;Wang Zhonghan;Jin Hui(Department of Pain,The Second Hospital of Jilin University,Changchun 130041,Jilin Province,China;Bethune Medical Department,Jilin University,Changchun 130021,Jilin Province,China;Department of Endocrinology and Metabolism,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Orthopedics,The Second Hospital of Jilin University,Changchun 130041,Jilin Province,China)

机构地区：[1]吉林大学第二医院疼痛科,吉林省长春市130041 [2]吉林大学白求恩医学部,吉林省长春市130021 [3]上海交通大学医学院附属瑞金医院,内分泌代谢科,上海市200025 [4]吉林大学第二医院骨科,吉林省长春市130041

出　　处：《中国组织工程研究》2023年第12期1944-1953,共10页Chinese Journal of Tissue Engineering Research

基　　金：吉林大学博士研究生交叉学科科研资助计划(419100200861),项目负责人:王中汉。

摘　　要：背景:富血小板血浆因其含有多种细胞因子与其他蛋白成分且易制备、较安全,被作为治疗肌腱病的主要或辅助疗法。目前,对于富血小板血浆肌腱病的最佳治疗方案和疗效存在争议。目的:综述影响富血小板血浆对肌腱病疗效的相关因素以及富血小板血浆治疗的肌腱病机制,给出富血小板血浆联合辅助治疗肌腱病的方案。方法:检索PubMed、Web of Science、中国知网数据库,英文检索词为“PRP,tendinopathy,preparation,mechanism,combination therapy”,中文检索词为“富血小板血浆,肌腱病,制备,机制,联合疗法”,检索各数据库建库至2021年7月发表的相关文献。共检索到相关文献490篇,按照纳入与排除标准,最终纳入135篇文献进行总结。结果与结论:目前,富血小板血浆制备过程无统一标准,制备方法和成分、激活方式以及给药方式和施用次数等治疗方法差异可能影响富血小板血浆的疗效,最佳制备工艺参数尚未确定。评价富血小板血浆对肌腱病疗效的最佳方式是确定特定生长因子在肌腱修复相关分子信号通路中所起的作用,体外和体内基础研究发现,富血小板血浆具有促进组织再生和调节炎症的功能,可增加肌腱的力学强度、弹性模量和机械载荷。此外,肌腱病治疗的影响因素是多重的,应用富血小板血浆联合治疗能在一定意义上克服单一富血小板血浆存在的局限性,对于肌腱病更具现实意义。与组织工程学疗法、临床疗法联用可以在一定程度上提升富血小板血浆对肌腱病的治疗效果,取得更好的预后,进一步拓展富血小板血浆的应用范围。BACKGROUND: Platelet-rich plasma has been widely used as a promising therapeutic agent for tendinopathy, because it contains a variety of cytokines and other protein components. However, there are controversies about the optimal treatment regimen and efficacy of platelet-rich plasma for tendinopathy.OBJECTIVE: To summarize the factors that contributed to the efficacy of platelet-rich plasma and the underlying mechanism of platelet-rich plasma in the improvement of tendinopathy, as well as to prospect the potential of platelet-rich plasma combination therapy in the treatment of tendinopathy. METHODS: Articles published from inception to July 2021 were retrieved on PubMed, Web of Science, and CNKI by the keywords of “PRP, tendinopathy, preparation, mechanism, combination therapy”. A total of 490 articles were picked, and 135 articles were finally selected for this review according to the criteria of inclusion and exclusion. RESULTS AND CONCLUSION: Currently, the preparation process of platelet-rich plasma is multifarious. The therapeutic efficacy of platelet-rich plasma is depended on several factors such as preparation methods, composition, activation methods, way of administration, and number of applications. The best way to evaluate the efficacy of platelet-rich plasma in tendinopathy is to determine the role of specific growth factors in molecular signaling pathways associated with tendon repair. In vitro and in vivo basic researchers have found that platelet-rich plasma has the ability to promote tissue regeneration, modulate inflammation and increase mechanical strength, elastic modulus and mechanical load of tendons. In addition, factors infiuencing tendinopathy treatment are multiple. Platelet-rich plasma combined with other treatment strategy may overcome the limitations of single platelet-rich plasma to a certain extent and has practical significance for treating tendinopathy. Combined with tissue engineering and clinical methods, the therapeutic effect of platelet-rich plasma will be enhanced to a ce

关 键 词：肌腱病 富血小板血浆 制备 机制 联合疗法 综述 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学] S857.166[农业科学—临床兽医学]