富血小板血浆满足不同类型关节软骨损伤的治疗需求  

Platelet-rich plasma meets the therapeutic needs of different articular cartilage defects

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

机构地区：[1]吉林大学第二医院,1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]吉林大学第二医院骨科,吉林省长春市130041 [4]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

出　　处：《中国组织工程研究》2023年第17期2772-2779,共8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:关节软骨属于透明软骨,自我修复能力差,传统疗法只能使缺损处再生出纤维软骨,无法彻底修复关节软骨缺损,故需一种可以再生出透明软骨的疗法修复缺损。根据关节软骨的缺损深度、部位以及是否伴随炎症可将关节软骨缺损分类,不同类型的关节软骨缺损有不同的致病机制与治疗策略。富血小板血浆作为富含各种生长因子的自体血小板衍生物被广泛应用于关节软骨缺损的治疗,并且已被大量研究证明对多种类型关节软骨缺损均有较好的治疗效果。就目前而言,富血小板血浆疗法有望治愈关节软骨缺损。目的:总结富血小板血浆的制备、储存以及激活方式,分析富血小板血浆所具性质是否满足不同类型关节软骨缺损的治疗需求,综述富血小板血浆对不同类型关节软骨缺损的治疗作用。方法:检索PubMed、Web of Science、中国知网数据库,中文检索词为“富血小板血浆,关节软骨,制备,机制,软骨缺损”,英文检索词为“platelet-rich plasma,articular cartilage,prepraration,mechanism,full-thickness cartilage defect,osteochondral defect,weight-bearing areas defect,hip,knee,ankle,osteoarthritis,rheumatoid arthritis”,检索建库至2021年8月发表的相关文献。共检索到相关文献225篇,按照纳入与排除标准,最终纳入90篇文献进行归纳总结。结果与结论:富血小板血浆的性质可满足多种类型软骨缺损的治疗需求,包括含有多种高浓度生长因子、促进软骨细胞增殖、调节软骨基质分泌、促进干细胞增殖与分化、可形成具有一定强度的支架结构、减轻炎症、润滑粗糙关节面、降低体内免疫反应等。富血小板血浆对全层软骨缺损、骨软骨缺损、负重区软骨缺损、骨性关节炎、类风湿性关节炎均有较好的治疗作用。同时,富血小板血浆对这些关节软骨缺损的治疗作用提示其具有修复生长板缺损的可能性。BACKGROUND:Articular cartilage is a kind of hyaline cartilage that has poor self-repair ability.Traditional treatments can merely regenerate fibrocartilage in the defect area but not completely repair a cartilage defect.Hence,it is necessary to explore an effective therapy for cartilage defects through regenerating hyaline cartilage.Platelet-rich plasma is an autologous platelet-rich extract containing various growth factors that has been widely applied in the treatment of articular cartilage defects currently and has shown beneficial therapeutic effects on various types of articular cartilage defects.At present,platelet-rich plasma therapy is a promising treatment for articular cartilage defects.OBJECTIVE:To summarize the preparation,storage and activation of platelet-rich plasma,analyze the properties of platelet-rich plasma in treating different types of articular cartilage defects,and discuss the therapeutic effects of platelet-rich plasma in treating articular cartilage defects.METHODS:Related articles were searched in PubMed,Web of Science,and CNKI using the keywords of "platelet-rich plasma,articular cartilage,prepraration,mechanism,full-thickness cartilage defect,osteochondral defect,weight-bearing areas defect,hip,knee,ankle,osteoarthritis,rheumatoid arthritis in English and Chinese.The search time was from database inception to August 2021.Initially 225 articles were searched and 90 eligible articles were included in final analysis.RESULTS AND CONCLUSION:Platelet-rich plasma contains high concentrations of growth factors that can play roles in promoting chondrocyte prolife ration,regulating cartilage matrix secretion,inducing stem cell prolife ration and differentiation,forming a strong scaffold structure,reducing inflammation,lubricating rough articular surface and reducing immune response in vivo,which can meet the requirements for treating various types of cartilage defects.Platelet rich plasma has a good therapeutic effect on full-thickness cartilage defects,osteochondral defects,weight-bearing area

关 键 词：富血小板血浆 关节软骨 全层软骨缺损 骨软骨缺损 负重区软骨缺损 骨性关节炎 类风湿性关节炎 

分 类 号：R457.14[医药卫生—治疗学] R318.17[医药卫生—临床医学] R322.72