富血小板血浆治疗椎间盘源性腰痛的研究进展  

Research progress of platelet-rich plasma in treatment of discogenic low back pain

作　　者：黄华桂 王金佐 刘鑫 张警 孙天泽 李忠海[1] HUANG Huagui;WANG Jinzuo;LIU Xin;ZHANG Jing;SUN Tianze;LI Zhonghai(Department of Orthopedics,the First Affiliated Hospital of Dalian Medical University,Dalian Liaoning,116011,P.R.China)

机构地区：[1]大连医科大学附属第一医院骨科,辽宁大连116011

出　　处：《中国修复重建外科杂志》2023年第3期377-382,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：辽宁省自然科学基金面上项目(2022-MS-322);大连市科技创新基金应用基础项目(2022JJ12SN045)。

摘　　要：目的总结富血小板血浆(platelet-rich plasma,PRP)用于治疗椎间盘源性腰痛(discogenic low back pain,DLBP)的研究进展。方法广泛查阅关于PRP治疗DLBP的相关文献,从PRP的分类、治疗机制、体内外实验及临床研究进展等方面进行总结。结果根据PRP成分、制备方法及理化性质的差异,目前较常用的PRP分类系统大致有五类。PRP通过促进髓核细胞再生、增加细胞外基质合成、调节退变椎间盘内部微环境等方式,参与延缓或逆转椎间盘退变和控制疼痛的过程。尽管多项体内外研究证实PRP可促进椎间盘再生和修复,且能大幅缓解DLBP患者的疼痛甚至改善其行动能力,但在少数研究中仍得出了相反结论,同时PRP的临床应用也存在一定局限性。结论目前研究证实了PRP治疗DLBP及椎间盘退变的有效性与安全性,同时还证实PRP具有取材及制备便利、免疫排斥反应小、再生和修复能力强以及能弥补传统治疗方式不足等优势;但仍需开展相关研究进一步优化PRP制备方法,统一系统分类准则,明确其远期疗效。Objective To summarize the research progress of platelet-rich plasma(PRP)for the treatment of discogenic low back pain(DLBP).Methods The literature on the treatment of DLBP with PRP was extensively reviewed,and the classification,treatment mechanism,in vitro and in vivo experiments and clinical trial progress of PRP were summarized.Results According to the PRP composition,preparation methods,and physicochemical properties,there are five commonly used PRP classification systems at present.PRP is involved in delaying or reversing the progress of disc degeneration and pain control by promoting the regeneration of nucleus pulposus cells,increasing the synthesis of extracellular matrix,and regulating the internal microenvironment of degenerative intervertebral disc.Although several in vitro and in vivo studies have confirmed that PRP can promote disc regeneration and repair,significantly relieve pain,and even improve the mobility of DLBP patients.But the contrary conclusion has been reached in a few studies,and there are limitations to the application of PRP.Conclusion Current studies have confirmed the effectiveness and safety of PRP in the treatment of DLBP and intervertebral disc degeneration,as well as the advantages of PRP in terms of ease of extraction and preparation,low immunological rejection,high regenerative and repair capacity,and the ability to compensate for the shortcomings of traditional treatment modalities.However,relevant studies are still needed to further optimize PRP preparation methods,unify systematic classification guidelines,and clarify its long-term effectiveness.

关 键 词：富血小板血浆 椎间盘源性腰痛 椎间盘退变 生长因子 

分 类 号：R681.55[医药卫生—骨科学]