“Ungaze uthandabuze ukuba iqaqobana labemi abacingayo nabazinikeleyo linokutshintsha ihlabathi.Enyanisweni, yiyo yodwa ekhoyo.”
Umsebenzi kaCureus kukutshintsha imodeli yexesha elide yokupapashwa kwezonyango, apho ukuhanjiswa kophando kunokubiza kakhulu, kuyinkimbinkimbi, kwaye kuthatha ixesha.
I-Platelet-rich plasma / prp, ukuvuselelwa kwezicubu, ukusebenza kweplatelet, unyango lwe-glucose proliferative, iiplatelet, unyango olukhulayo
Chaza eli nqaku njenge: Harrison TE, Bowler J, Reeves K, et al.(NgoMeyi 17, 2022) Umphumo weglucose kwisibalo seplatelet kunye nevolumu: iimpembelelo kwiyeza lokuhlaziya.Unyango 14(5): e25081.doi:10.7759/cureus.25081
I-Platelet-rich plasma (PRP) kunye ne-hypertonic glucose solutions ziqhelekileyo zisetyenziselwa inaliti kwiyeza lokuvuselela, ngamanye amaxesha kunye.Umphumo we-hypertonic glucose kwi-platelet lysis kunye nokusebenza akuzange kuchazwe ngaphambili.Sivavanye umphumo wokunyuka kwe-glucose concentrations kwi-platelet kunye ne-erythrocyte counts, kunye ne-cell volumes kwi-PRP kunye negazi elipheleleyo (WB).Ukuncipha ngokukhawuleza kwenani leplatelet kwenzeka ngayo yonke imixube yeglucose exutywe ne-PRP okanye igazi elipheleleyo, elihambelana ne-lysis engaphelelanga. Emva komzuzu wokuqala, amanani eplatelet ahlala azinzile, ecebisa ukuhlaliswa ngokukhawuleza kweeplatelet ezishiyekileyo ngokugqithisileyo (>2000 mOsm) hypertonicity. Emva komzuzu wokuqala, amanani eplatelet ahlala azinzile, ecebisa ukuhlaliswa ngokukhawuleza kweeplatelet ezishiyekileyo ngokugqithisileyo (>2000 mOsm) hypertonicity. После первой минуты количество тромбоцитов оставалось стабильным, что указывает на быструю аккомодацию остаточных тромбильным ) гипертонуса. Emva komzuzu wokuqala, inani leplatelet lahlala lizinzile, libonisa ukuhlaliswa ngokukhawuleza kweeplatelet ezishiyekileyo ngokugqithisileyo (>2000 mOsm) hypertonicity.第一分钟后，血小板计数保持稳定，表明残余血小板迅速适应极端（>送送送星。2000 mOsm）高渗状态. После первой минуты количество тромбоцитов оставалось стабильным, что указывает на быструю адаптацию остаточных тромбильным гиперосмолярному состоянию. Emva komzuzu wokuqala, inani leplatelet lahlala lizinzile, libonisa ukulungelelaniswa okukhawulezileyo kweeplatelet ezishiyekileyo ukuya kwimeko egqithisileyo (> 2000 mOsm) hyperosmolar state.Ukugxininiswa kwe-glucose ye-25% nangaphezulu kubangele ukunyuka okubalulekileyo kwi-meat platelet volume (MPV), ebonisa inqanaba lokuqala lokusebenza kweplatelet.Uphononongo olongezelelweyo luyafuneka ukufumanisa ukuba i-platelet lysis okanye i-activation yenzeke kwaye ingaba i-hypertonic glucose injection yodwa okanye idibene ne-PRP inokubonelela ngenzuzo eyongezelelweyo yeklinikhi.
Ngama-1950, ugqirha waseMelika uGeorge Hackett wafumanisa ukuba unokukhulula ngokusisigxina iintlungu ezihlangeneyo kunye nomqolo kwizigulane ezininzi ngokufaka isisombululo sokwandisa kwi-tendon kunye nemigqa.Uvavanyo lwakhe kwimivundla lwabonisa ukuba unyango, awalubiza ngokuba lunyango lokwandisa, lwabangela ukuba imisipha ibe mininzi kwaye yomelele.Izifundo ze-Histological ziqinisekisile ukuba i-collagen entsha iveliswa ngeli xesha [1].
Ngexesha leminyaka embalwa yokuqala, izisombululo ezininzi ezahlukeneyo zokuhambisa zazanywa.Ngeminyaka yee-1990, uninzi lwabasebenzi bacinga ukuba i-glucose ephezulu ibe yeyona ndlela ikhuselekileyo nesebenzayo.Nangona kunjalo, indlela yokusebenza ihlala ingacacanga.
Zimbalwa izifundo zeklinikhi ezenziweyo kwinkulungwane yama-20 emva komsebenzi kaHackett.Nangona kunjalo, kwi-2000s kwakukho umdla ohlaziyiweyo kunye nezilingo ezininzi zeklinikhi eziyimpumelelo zonyango olukhulayo lwagqitywa unyango lweentlungu ezisezantsi [2], i-osteoarthritis yamadolo [3], kunye ne-epicondylitis esecaleni [4].
Ukuhlaziywa kwezicubu kufuna ukuthatha inxaxheba kweeseli ze-stem.Ke ngoko, ukugxila okuphezulu kweglucose kufuneka ngandlela thile kubangele ukufuduka, ukuphindaphinda, kunye nokwahlulahlula iiseli ze-stem.Sicinga ukuba iiplatelet zingasebenza njengezithunywa kwaye ukuba i-glucose concentrations ephezulu inokubangela ukuba iiplatelet zikhuphe i-cytokines kunye nezinto ezikhulayo, ngaloo ndlela zikhuthaza iinkqubo zokuvuselela, ngakumbi ukufuduka kweeseli ze-stem kwiindawo eziphakamileyo ze-glucose.
Ukusebenza kwePlatelet kuhlala kuqala kuqala ukonyuka kwe-intracellular calcium [5].ULiu et al.kwi-2008 ibonise ukuba amanqanaba aphezulu e-glucose anyusa umsebenzi we-receptor yexeshana enokubakho i-canonical type 6 (TRPC6) iziteshi kwi-plasma membrane, ekhokelela ekungeneni kwe-calcium ions kwiiplatelet [6].Olunye uphononongo lubonise ukuba ukuvezwa kwe-microtubule marginal zone kwi-calcium ions kubangela ukuphumla, ukwanda, kunye nokuguqulwa kwendawo engaselunxwemeni, nto leyo eyenza utshintsho kwimilo ukusuka kwi-disc ukuya kwi-spherical, okukhokelela kumthamo weplatelet (MPV) [7].
I-hypothesis yethu kolu cwaningo kukuba ukuvezwa kweeplatelet kwiindawo eziphezulu ze-glucose kuchaphazela i-microtubule marginal zone kunye ne-intracellular environment, ekhokelela ekunyukeni kwe-MPV.
Bonke abathathi-nxaxheba basayine ifom yemvume enolwazi emva kokuba iinkcukacha zophando zichazwe kwaye ngaphambi kokufumana iisampuli.Kulo cwaningo, kuphela iisampuli ze-PRP ezine-hematocrit enkulu kune-2% zisetyenzisiwe ukwenzela ukuba i-erythrocyte (erythrocyte) count kunye nentsingiselo ye-corpuscular volume ye-red blood cells (MCV) ingabandakanywa ukuthelekisa.
Uphononongo luqhutywe kwizigaba ezine, isigaba sokuqala sasiyi-PRP kwaye izigaba eziseleyo yayiligazi elipheleleyo (iThebhile 1).Njengoko kuchaziwe ngaphambili [8], yonke imikhosi ye-centrifugal (RCF, g-force) ibalwa ukusuka kwindawo ephakathi (Rmid, in cm) yekholomu yegazi kwisirinji ye-centrifugal.Sikhethe ukusebenzisa i-MPV njengesiphawuli se-platelet sensitization kunye ne- platelet count njengesalathisi se-platelet lysis enokwenzeka, zombini zinokulinganiswa ngokulula kuhlalutyo oluqhelekileyo lwe-hematology.
Kwinqanaba lokuqala, amavolontiya e-47 anikezela ngeesampuli zegazi-i-tube enye ye-ethylenediaminetetraacetic acid (EDTA) kunye ne-PRP enye isampuli yegazi (i-anticoagulated ne-sodium citrate (NaCl, 3%)) (Itheyibhile 1).Beka i-rocker kwi-tube ngokukhawuleza.Ubalo lwegazi olupheleleyo (CBC) lwenziwa kwiisampuli ze-EDTA kwi-triplicate, kwaye iisampuli ze-NaCl zahlaziywa ngokuphindwe kathathu kuhlalutyo lwe-CBC, kwaye i-PRP yalungiswa ngeendlela ezahlukeneyo ezichazwe ngasentla [8].Zonke iisampuli ze-PRP zilungiswe nge-centrifugation kwi-900-1000 g.Hlanganisa isampuli nganye ye-PRP kwi-vortex mixer ye-5-10 imizuzwana, uze uhlukanise i-aliquots emihlanu ye-0.5 ml kwiityhubhu.
Ukuvavanya isiphumo sokuvezwa kweplatelet ekugxininiseni okuphezulu kweglucose, izixa ezilinganayo (0.5 ml) ze-0%, 5%, 12.5%, 25%, kunye ne-50% yeglucose emanzini zixutywe kunye neesampuli zeplatelet ukufumana i-0%, 2.5% 6.25%, 12.5% ​​yoxinaniso lwe-glucose kunye ne-5% yomxube we-tube yovavanyo kunye ne-25% ye-tube yoxinaniso kwi-tube ye-5%.I-TAC yomxube ngamnye yahlalutywa ngokuphindwe kathathu emva kwe-15 min.I-Platelet count (PLT), i-RBC count, i-MCV, kunye ne-MPV zilinganiselwe kwi-tube nganye, kwaye i-platelet count count, i-RBC count, i-MCV, kunye ne-MPV zibalwe kuzo zonke iisampuli ze-PRP.
Emva kokuba isigaba sokuqala sokuqokelelwa kwedatha sigqityiwe, siye sabona ukwanda okukhulu kweplatelet volume kwiiplatelet ze-PRP emva kokongezwa kwe-D50W.Iiplatelets ze-PRP azibonakalisi zonke iiplatelet egazini, kwaye i-PRP medium iyahluka kwi-WB medium.Ngoko ke, siye sagqiba ekubeni siqhube ulingo lwesigaba sesibini somphumo wokongezwa kwe-D50W kwigazi elipheleleyo.
Ngomjikelezo wesibini, sakhetha ubungakanani besampula ye-30 ngokusekelwe kwiziphumo ezivela kuthotho lokuqala, njengoko kuchazwe kwicandelo lokuHlalutya.Kolu chungechunge, amavolontiya angama-20 anikezela ngeesampuli zegazi (Itheyibhile 1).Igazi elipheleleyo (1.8 ml) litsalwe kwisirinji ye-3 ml kunye ne-anticoagulated kunye ne-0.2 ml 40% ye-NaCl.Isirinji yegazi iyonke yaxutywa imizuzwana emihlanu kunye ne-vortex mixer kwaye i-CBC yahlalutywa kathathu.Emva kokuhlalutya, igazi eli-anticoagulated longezwa kwi-2 ml ye-50% ye-glucose kwi-syringe ye-5 ml (i-concentration yokugqibela ye-glucose yayimalunga ne-25% (D25) kwaye ifakwe kwi-tube yokugubha imizuzu ye-30. Emva kwemizuzu ye-30, i-D25 / CBC kwiisirinji ze-WB zahlalutywa kwi-triplicate. I-CV, kunye neMPV zibalwe kwisampulu nganye ngaphambi nasemva kokongeza iswekile.
Ngenxa yokuba iiplatelet kwigazi elipheleleyo ngokuqhelekileyo zibonakaliswe kwi-hypertonic glucose ngexesha lonyango lwe-glucose ekhulayo ngenxa ye-injection encinci ye-invasive, kwaye akuqhelekanga ukudibanisa i-PRP kunye ne-hypertonic glucose ngaphambi nje kokujova, sagqiba ekubeni sifunde i-hypertonic glucose ngokudibanisa ne-WB kwiCandelo 1. Inyathelo lesithathu kunye nesine.Kwinqanaba ngalinye, amavolontiya angama-20 anikela nge-7-8 ml ye-ACD-A (i-asidi equkethe i-trisodium citrate (22.0 g / l), i-citric acid (8.0 g / l) kunye ne-glucose (24.5 g / l), isisombululo se-dextrose citrate) kwi-anticoagulants yegazi (Itheyibhile 1).Yimixube kuphela yeglucose engaphezu kwe-12.5% ​​esetyenzisiweyo ukumisela ipesenti yomqobo ehambelana nokunyuka kweMPV.Kwinqanaba lesithathu, i-1 ml yegazi ifakwe kwi-tube yokuvavanya.Emva koko xuba igazi kwi-vortex mixer imizuzwana ye-10 ngokudibanisa i-1 ml ye-30% ye-glucose, i-40% ye-glucose, okanye i-50% ye-glucose kwi-tube ukufumana i-glucose concentration ye-15%, i-20%, kunye ne-25%, ngokulandelanayo.Iisampulu zegazi zeGlucose zihlalutyelwe i-CBC ngoko nangoko emva kokuxuba kwaye ziphindaphindwa rhoqo ngemizuzu emibini imizuzu engama-30.
Ngethuba lokuxuba kokuqala, ukongezwa kwe-1: i-1 ye-hypertonic glucose kunye ne-WB okanye i-PRP ibeka iiplatelet kwi-concentrations ngaphezu kwe-25% imizuzwana emininzi.Kwinqanaba lesine, ukuvavanya umphumo we-glucose ye-hypertonic kunye ne-concentration encinci ye-peak yokuqala kunye nokuvavanya umda ophezulu wesiphumo se-glucose, songeze kuphela inani elincinci legazi kwi-D25W okanye i-D50W.Beka i-1 ml ye-D25W okanye i-D50W kwi-tube kwaye ungeze i-0.2 ml ye-WB ngelixa i-vortexing isampuli imizuzwana ye-10.Kule meko, igazi libonakaliswe kwi-glucose kwi-concentration malunga ne-20% ngaphezu kwe-concentration yokugqibela, kunokuba i-50% ngaphezu kwe-concentration yokugqibela njengeSigaba se-3, okubangelwa i-glucose concentrations ye-20.8% kunye ne-41.6%.Iisampulu ezixutyiweyo zahlalutywa ngexesha elinye njengenyathelo lesi-3.
Kwinqanaba lokuqala loluhlu ngalunye lwe-glucose dilution, iisampulu ezingama-30 zathathwa njengoko le yayiyisayizi efanelekileyo yesampulu yophononongo lokulinga [9].Ekupheleni kwesigaba ngasinye (kubandakanywa nesigaba sokuqala), hlola ukufaneleka kobungakanani besampulu usebenzisa ifomyula esetyenziselwa ukugqiba ubungakanani besampulu efunekayo ukuqikelela intsingiselo yesiphumo esiqhubekayo esiguquguqukayo kuluntu olunye.Ifomula n = Z2 x SD2 /E2.Kule nxaki, u-Z yi-Z-score, i-SD kukutenxa okusemgangathweni, kwaye u-E yimpazamo efunekayo [10].I-alpha yethu ngu-0.05, ehambelana nexabiso le-Z le-1.96, kwaye silindele impazamo ye-5 (ngepesenti).Ngenxa yoko sisombulula i-n = (1.962 x SD2)/52.Iziphumo zibonise ukuba ubungakanani besampulu obufunekayo kwinqanaba ngalinye buncinci kunelo nani eliqokelelweyo.
Ngexesha le-1, i-3 kunye ne-4 isebenzisa i-concentration ye-glucose engaphezulu kweyodwa, umphumo we-glucose concentrations eyahlukeneyo yahlalutywa ngokuthelekisa utshintsho lwe-fractional phakathi kwexesha le-0 kunye nexesha ngalinye elilandelayo (isigaba 1 kwimizuzu ye-15, ixesha le-3 kwimizuzu ye-15).kunye nezine kwimizuzwana ye-15, emva koko yonke imizuzu emibini.) Ukutshintsha amazinga kwixesha ngalinye lifaniswa usebenzisa i-Mann-Whitney U-test ngenxa yokuba idatha ayizange ilandele ukusabalalisa okuqhelekileyo njengoko kunqunywe nguvavanyo oluqhelekileyo lwe-Shapiro-Wilk.Ekubeni uhlalutyo lwe-1 ukuya ku-1 lwamaqela amaninzi (amahlanu) lwenziwa kwinqanaba lokuqala, lesithathu kunye nesine (ezintlanu zizonke), ukulungiswa kweBonferroni kwenziwa ukulungisa ixabiso elifunwayo le-alpha ku-≤0.01 kodwa kungekhona ≤0.05.
Ukunciphisa inani leplatelet kunye nayo yonke imilinganiselo ye-hypertonic dextrose kunye nokunyuka kwe-MPV kwiiplatelet ze-PRP kwi> 12.5% ​​i-dextrose concentration: I-PRP platelet counts yavuka ukusuka kwelinye ukuya kwi-5 amaxesha okugxininiswa xa kuthelekiswa negazi elisisiseko, elihluka ngendlela (engabonakaliswa). Ukunciphisa inani leplatelet kunye nazo zonke izigxina ze-hypertonic dextrose kunye nokunyuka kwe-MPV kwiiplatelet ze-PRP kwi-> 12.5% ​​ye-dextrose yoxinaniso: I-PRP platelet counts inyuke ukusuka kwelinye ukuya kwi-5 yoxinaniso xa kuthelekiswa negazi elisisiseko, elihluka ngendlela (engaboniswanga). Уменьшение количества тромбоцитов при всех концентрациях гипертонической декстрозы kunye neMPV kwi тромбоцитах PRP прицентрациях прицентрациях тромбоцитов PRP увеличилось в 1-5 раз по сравнению с исходной цельной кровью, в зависимости от метода (не показано). Ukunciphisa inani leplatelet kuzo zonke i-hypertonic dextrose concentrations kunye nokunyuka kwe-MPV kwiiplatelet ze-PRP kwi> 12.5% ​​i-dextrose concentration: I-PRP platelet count yanda amaxesha angama-1-5 xa kuthelekiswa negazi elisisiseko, kuxhomekeke kwindlela (engaboniswanga). ).在> 12.5% ​​的葡萄糖浓度下，所有浓度的高渗葡萄糖降低血小板计数，PRP RP 血小板计数从浓度的1 倍上升到5 倍，因方法而异（未描述）. Kwi> 12.5% ​​ye-glucose concentration, i-concentration ephezulu ye-glucose inciphisa inani legazi, i-PRP yegazi le-MPV iyanda: xa kuthelekiswa ne-与基线全血, inani legazi le-PRP linyuka ukusuka kwi-1 ukuya kwi-5 amaxesha e-concentration (engachazwanga). При концентрациях глюкозы >12,5% все концентрации гипертонической глюкозы снижали количество тромбоцитов, а MPV повышали песни : тов PRP увеличивалось от 1- до 5-кратных концентраций по сравнению с исходными концентрациями цельной крови, в зависимопости от . Kwi-glucose concentrations> 12.5%, zonke i-glucose concentrations zinciphisa izibalo zeplatelet kwaye zanda i-MPV kwiiplatelet ze-PRP: I-PRP platelet counts yanda i-1- ukuya kwi-5-fold xa kuthelekiswa nesiseko segazi elipheleleyo, kuxhomekeke kwindlela (njengoko kuchaziwe).Umzobo we-1 ubonisa ukuba inani leeplatelet liyancipha malunga ne-75% emva kokuhlanjululwa emanzini kunye ne-20-30% emva kwemizuzu ye-15 yokuhlanjululwa kunye neentlobo ezahlukeneyo ze-glucose xa kuthelekiswa nesiseko se-PRP kunye ne-1: i-1 dilution elungiselelwe umthamo (1- k1 kunye nokulungiswa kwevolumu).k -1 ukuzala).1 ukuzala).
Inani leeseli kwidilution nganye lichazwa njengeqhezu yenani lokuqala phambi kokuhlanjululwa.
I-MPV iyancipha ngokuncinci ngexesha lokuveliswa kwe-PRP, ngaphandle kolunye utshintsho kwi-dilution concentrations ukuya kwi-12.5% ​​emanzini okanye kwi-glucose (kubandakanywa ne-25% ye-PRP imixube ye-glucose) kwaye yanda ngaphezu kwe-20% emva kokuhlanjululwa kwi-50% isisombululo se-glucose (Fig. .2).).Ngokwahlukileyo, i-erythrocytes ayizange ibonise utshintsho olubalulekileyo kwivolumu kuyo nayiphi na i-dilution ngaphandle kwe-H2O.
Umthamo ophakathi weeseli kwidilution nganye uchazwa njengepesenti yomthamo wokuqala phambi kokuhlanjululwa.
Ukunciphisa okufanayo kodwa okuncinci kwi-platelet count kunye nokunyuka kwe-CVR kwabonwa kwi-BC evezwe kwi-50% ye-glucose (ukwenza i-25% ye-glucose).Itheyibhile 2 ithelekisa iinombolo zeeseli kunye nomthamo weeseli kwigazi elipheleleyo elihlanjululwe kwi-50% ye-dextrose kunye nesigaba se-1 sedatha ye-PRP ehlanjululwe kwi-50% ye-dextrose.Utshintsho kwi-RBC count kunye ne-RBC MCV bezingabonakali kwaye ibingeyiyo eyona nto sigxile kuyo.
SD = ukuphambuka okusemgangathweni, MD = umahluko phakathi kwamaqela, SE = ukuphambuka okusemgangathweni kwentsingiselo, i-RBC = i-erythrocytes, i-PLT = iiplatelet, i-PRP = i-platelet ecebileyo ye-plasma, i-WB = igazi elipheleleyo
Emva kokongeza i-D50W kwi-WB, ipesenti ye-dilution-adjusted platelet loss was 7.7% (310±73 vs. 286±96) xa kuthelekiswa ne-17.8% ye-PRP dilution kwi-D50W (664±348 vs. 544±277).I-MPV WB inyuke nge-16.8% (ukusuka ku-10.1 ± 0.5 ukuya kwi-11.8 ± 0.6), ngelixa i-MPV PRP inyuke nge-26% (9.2 ± 0.8 vs. 11.6 ± 0. 7). Nangona umahluko ophakathi kokubini kokuncitshiswa kweplatelet count kunye nokunyuka kwe-MPV kwakubaluleke kakhulu nge-PRP, utshintsho ekunciphiseni ukubalwa kweplatelet ngaphakathi kwe-WB phantse kubaluleke kakhulu (310 ± 73 ukuya ku-286 ± 96 (-7.7%); p = .06) kunye nokunyuka kwe-MPV kwakubalulekile (10.1 ± 0.5 ukuya ku-10.8 p.6) ± 10.8 ± 10.8. Nangona umahluko ophakathi kokubini kokuncitshiswa kweplatelet count kunye nokunyuka kwe-MPV kwakubaluleke kakhulu nge-PRP, utshintsho ekunciphiseni ukubalwa kweplatelet ngaphakathi kwe-WB phantse kubaluleke kakhulu (310 ± 73 ukuya ku-286 ± 96 (-7.7%); p = .06) kunye nokunyuka kwe-MPV kwakubalulekile (10.1 ± 0.5 ukuya ku-10.8 p.6) ± 10.8 ± 10.8.Nangona umahluko wentsingiselo kuzo zombini ukuncipha kokubala kweplatelet kunye nokunyuka kwe-CVR kwakukhulu kakhulu nge-PRP, utshintsho kwinani leplatelet liyancipha ngaphakathi kwe-WB laliphantse libaluleke kakhulu (310 ± 73 ukuya ku-286 ± 96 (-7.7%); p = 0.06).увеличение MPV было значительным (от 10,1 ± 0,5 до 11,8 ± 0,6 (+16,8) p <0,001). ukwanda kweMPV kwakubalulekile (ukusuka kwi-10.1 ± 0.5 ukuya kwi-11.8 ± 0.6 (+16.8) p <0.001).尽管PRP 在血小板计数减少和MPV 增加方面的平均差异显着更大，但WB 内血小板计均发的（310 ± 73 至286 ± 96 (-7.7%);p = .06）和MPV 的增加是显着的（10.1 ± 0.5 ± 0.6 ± 0.6 (+16.8) p <.尽管 PRP 在血小板 计数 和 增加 方面的 平均 差异 显着 大 , 但 但 内血小板 话着 的 （（310 ± 73 至 286 ± 96 (-7.7%) ; p = .06）和MPV 的增加是显着的（10.1 ± 0.5 ku-11.8 <+10.8 (+10.8).Utshintsho ekuncitshisweni kwenani leplatelet kwi-WB luphantse lubaluleke kakhulu (ukusuka kwi-310 ± 73 ukuya kwi-286 ± 96 (-7.7%); p = 0.06), nangona i-PRP yayinomohluko omkhulu kakhulu wokunciphisa inani leplatelet kunye nokunyuka kwe-MPV.kwaye ukunyuka kweMPV kwakubalulekile.(от 10,1 ± 0,5 до 11,8 ± 0,6 (+16,8) р <0,001). (ukusuka kwi-10.1 ± 0.5 ukuya kwi-11.8 ± 0.6 (+16.8) p <0.001).
I-concentration yokugqibela ye-20% ye-glucose yayifuneka ukuze ibone utshintsho olubalulekileyo kwi-MPV, kodwa utshintsho kwi-MPV lwalubonakala ngakumbi kwi-concentration yokugqibela ye-25%.Ilahleko yePlatelet izinzile emva kokuhla kokuqala.Siqaphele ukuhla okubukhali kokuqala kwi-CVR, nangona kunjalo, i-CVR yabuyiselwa ngokukhawuleza kwi-25% yokugqibela ye-glucose concentration, eyayiphezulu kakhulu kunamanqanaba e-CVR aqatshelwe kwi-glucose concentrations yokugqibela ye-20% kunye ne-15% (umzobo 3 kunye nekhohlo kwiThebhile 3; iibhokisi ezinomthunzi).bonisa amaxabiso e-p≤ alpha ngolungiso lwe-Bonferroni lwe-0.01).Kwakhona kwakukho ukuhla okubukhali kokuqala kwinani le-PLT, elibonwe kwisigaba sokuqala se-0-15 s, kwaye emva koko yahlala izinzile (ukusuka kwi-15 ukuya kwi-30 min; ekhohlo kwitheyibhile 4).
Ukongezwa koxinzelelo olwahlukeneyo lweglucose kwigazi elipheleleyo kubangele ukuhla okukhawulezileyo kweMPV okulandelwa kukuchacha okuxhomekeke kugxininiso olungaphezulu kwama-20%.I-legend ibonisa ukuxinwa kweglucose emva kokuhlanjululwa.I-D15, i-D20 kunye ne-D25 zenziwe nge-1: 1 dilution.I-D21 kunye ne-D41 zenziwe nge-1:5 dilution.
Itheyibhile 4 ibonisa utshintsho kwinani leplatelet xa lihlanjululwe kwi-hypertonic glucose.Siqaphele ubudlelwane obuxhomekeke kwidosi phakathi kokuhla kwangoko kwamanani e-PLT kwi-1: i-1 dilution kunye ne-1: i-5 dilution.Ukuthelekisa i-1: 1 dilution njengeqela elinye kunye ne-1: 5 dilution, iqela le-1: 1 liye lehla ngokukhawuleza kwi-platelet count engaphantsi kwe-1: iqela le-5 66±48,000 (23%) xa lithelekiswa ne-99±69,000 (37%)., p = 0.014) kwiqela le-1:5.Emva kokuhla kokuqala kwinqanaba lokuqala lokulinganisa, i-platelet count njengepesenti ye-glucose ezinzile (umzobo 4).
Xa igazi elipheleleyo longezwa kwi-glucose kwi-1: 1 ratio, i-platelet count iyancipha malunga ne-25%.Nangona kunjalo, xa igazi elipheleleyo longezwa kwisilinganiselo se-1: 5, ukunciphisa kwakukhulu kakhulu - malunga ne-50%.
I-41% ye-glucose inyuse i-MPV ngokukhawuleza kwaye ngokumangalisayo ngaphezu kwe-25% okanye i-21%.Iziphumo zeMPV ziboniswe kuMfanekiso 3. Kuzo zonke ezinye iidilutions, akukho kuncipha kwangoko kweMPV kubonwe emva kokongezwa kwe-50% yeglucose.Xa usebenzisa i-25% ye-glucose (i-glucose concentration ye-20.8% kwi-dilution yokugqibela), utshintsho kwi-MPV lufaniswa noshintsho kwi-20% ye-glucose kwi-1: 1 dilution (Umfanekiso 3).Nangona utshintsho kwiMPV ekuqaleni belukhulu kwi-41% yoxinaniso oluxubeneyo kune-25%, umahluko kwi-MPV phakathi kwe-41% kunye ne-25% emva kwemizuzu ye-16 yayingasenamsebenzi (iThebhile 3, ekunene).Kukwanika umdla ukuba i-25% yeglucose inyuse iMPV ngempumelelo kune-20.8%.
Olu phononongo lwe-in vitro luqinisekise ngokuyinxenye ingqikelelo yethu. Ibonise i-platelet lysis enokuthi ibe khona nge-dextrose admixture, indawo yokuhlala ngokukhawuleza kwiiplatelet ukuya kwi-hypertonicity egqithisileyo, kunye nokunyuka okukhulu kwe-MPV ekuphenduleni> i-25% yoxinzelelo lwe-hypertonic dextrose. Ibonise i-platelet lysis enokuthi ibe khona nge-dextrose admixture, indawo yokuhlala ngokukhawuleza kwiiplatelet ukuya kwi-hypertonicity egqithisileyo, kunye nokunyuka okukhulu kwe-MPV ekuphenduleni> i-25% yoxinzelelo lwe-hypertonic dextrose. Примесью декстрозы, быструю аккомодацию тромбоцитов до экстремального ние MPV в ответ на гипертоническую концентрацию декстрозы > 25%. Ibonise i-platelet lysis enokuthi ibe khona kunye ne-dextrose, indawo yokuhlala yeplatelet ngokukhawuleza ukuya kwi-hypertonicity egqithisileyo, kunye nokunyuka okukhulu kwe-MPV ekuphenduleni amanqanaba e-hypertonic dextrose> 25%.它显示出通过葡萄糖混合物潜在的部分血小板溶解，血小板快速适应极端高渗，2渗葡萄糖时MPV 显着上升.它 显示 出 通过 葡萄糖 潜在的 部分 血小板 溶解 血小板 快速 适应 极端 极站度 高渗 葡萄糖 时 时 mpv 显着。。。。 Он показывает потенциальный частичный лизис тромбоцитов смесями с глюкозой, быструю адаптацию тромбоцитов к экстремальзеном личение MPV в ответ на концентрацию гипертонической глюкозы > 25%. Ibonisa i-platelet lysis enokuthi ibe khona ngokuxutywa kwe-glucose, ukulungelelaniswa kweplatelet ngokukhawuleza kwi-hypertonicity egqithisileyo, kunye nokunyuka okukhulu kwe-MPV ekuphenduleni i-hypertonic glucose> 25%.Ukonyuka kokuqala kwakuphezulu kwi-41.6% ye-glucose exposure, kodwa ukunyuka kwe-MPV kusondela kwi-25% ye-glucose exposure malunga nemizuzu engama-20 emva kokuba sesichengeni.
Ukuxinwa kweeplatelet kuchaphazeleka yi-glucose.Siqaphele ukuba isixa se-PLT sehlile kuzo zonke ii-dilutions zeglucose.Ukuhla okubukhali kwinani leeplatelet kwi-H2O (0%) i-dilutions yochungechunge lwe-PRP inokudibaniswa ne-osmotic lysis.Kungenjalo, le inokuba yi-artifact ebangelwa kukudityaniswa kweeplatelet, kodwa oku kuchasene nokungabikho kotshintsho lweMPV kolu dilution.Oku kufunyanisiweyo kuthetha ukuba ezinye iiplatelet zinovelwano kakhulu kwi-hypoosmolarity.
Kuzo zonke i-1: i-1 i-dilutions ye-glucose, inani le-PLT lehla nge-20-30%, nangona i-D5W (hypotonic kwi-252 mOsm), enokuthi ibonise umphumo othile we-non-osmotic we-glucose, ekubeni zombini i-PLT kunye ne-MPV yahlala ingatshintshi ekunyuseni okuphindwe kathathu.iswekile.ukusuka kwi-D5W ukuya kwi-D25W.Ngapha koko, ukugxilwa kwe-PLT kuthande ukonyuka kancinci ngokunyuka kwe-osmolarity.
Ukuncipha kwe-PLT phakathi kwe-1: 1 kunye ne-1: i-5 dilutions kuthetha ukuba umphumo wokutshatyalaliswa kuxhomekeke kwi-concentration yokuqala kunye neyokugqibela ye-glucose.Ukuba kwakuxhomekeke kuphela kwingqwalasela yokuqala, ngoko umntu unokulindela ukubona umehluko ekunciphiseni kwe-PLT phakathi kwe-1: i-1.Kodwa asikho.Ukuba umphumo we-lysis uxhomekeke kuphela kwi-concentration yokugqibela ye-glucose, ngoko asilindelanga ukubahluko omkhulu phakathi kwe-20% 1: 1 dilution kunye ne-20.8% 1: 5 dilution.Kwaye senzile.
Ukuba ukulahleka kweplatelet kwenzeka ngenxa ye-platelet lysis, i-lysate inxalenye yenziwe, emva koko i-cytokines kunye nezinto zokukhula zikhutshwa kwindawo engaphandle.Izifundo ezininzi zibonise ukuba i-platelet lysate iphantse isebenze njenge-PRP njengesisombululo sokwandisa [11].I-PRP ngokwayo ibonakaliswe njengesisombululo esisebenzayo sonyango lokunyuka [12-14].
Iiplatelet ezingasebenziyo zijikeleza ngendlela yediski eqiniswe ngezakhiwo ezininzi zangaphakathi.Ngethuba lokusebenzisa, bathatha i-spherical okanye i-amoeba shape, ekhokelela ekunyuseni kwevolumu.Ukunyuka komthamo kudinga ukwanda kwendawo, okusisiphumo sokukhutshwa kwenkqubo ye-tubule evulekileyo (OCS) kunye nokongezwa kwe-granules exocytic kwi-membrane.Kuhlala kuqikelelwa ukuba ukunyuka kwe-MPV okubangelwa yi-hypertonic glucose kubandakanya enye okanye zombini ezi ndlela, kodwa ukuba okokugqibela, ukunyuka kwe-MPV kuya kubonisa ukuchithwa.
Olu pho nonongo lubonise ukuba ukuvezwa kwe-glucose ephezulu kwi-PRP okanye iiplatelet zegazi elipheleleyo kubangele ukwanda kwe-MPV ngaphakathi kwemizuzu ye-15 kunye ne-glucose concentration ye-25% kunye ne-41.6%, ngokulandelanayo.
Ukonyuka kwe-MPV yeplatelet kunokuba ngenxa yokwandiswa kwe-microtubule tangles ejikelezayo ekuphenduleni ukungena kwe-calcium.ULiu et al.I-glucose ibonakaliswe ukuba idibanise ukungena kwe-calcium nge-platelet TRPC6 channel [6].I-hypothesis yethu kukuba i-glucose ibangela ukuphumla kwe-microtubule tangles, ekhokelela ekwandeni kwe-MPV kunye ne-platelet sensitization kunye / okanye i-activation.Nangona kunjalo, ukugweba ngeziphumo zethu, oku yinxalenye yebali kuphela.Kwiimvavanyo zethu, akukho xinzelelo olungaphantsi kwe-D25W lubangele ukwanda kwe-MPV.Ngenxa yokuba asikhange sivavanye ukuvezwa kokugxilwa kweglucose phakathi kwe-12.5% ​​kunye ne-25%, iziphumo zethu zesigaba soku-1 zibonisa ukuba kunokubakho umqobo kolu luhlu lokugxilwa kweglucose ekhokelela ekonyukeni kweMPV.Uvavanyo olongezelelweyo kwizigaba ze-3 kunye ne-4 lubonise ukuba i-20-25% i-glucose ibonakala ingumqobo wale nto, kodwa ihlala ingacacanga ukuba kutheni.
Sikwaqaphele ukuhla kwe-MPV nge-9% emva kokufakwa kwe-centrifugation.Akukacaci ukuba oku kuhla kweMPV kungenxa yeeplatelet ezinkulu kunye ezixineneyo ezivaleleke kumaleko weRBC wecentrifuge.Olu qwalaselo lunokubaluleka kwiiklinikhi njengoko kunokuthetha ukuba iiplatelet ze-PRP zincinci kwaye zingaphantsi kwe-subset ye-WB platelets.
Kuphononongo lwangaphambili, sibonise ukuba ukulungiswa kwe-PRP ngeendlela zezandla akubizi [8].Ukuba i-glucose ivuselela iiplatelets zezicubu okanye i-PRP, ibenze bachaphazeleke ngakumbi ekusebenzeni, okanye ukuba i-PRP iveliswa ngeepropati ze-lysate, oku kunokuphucula ukuvuselelwa kunye nokunciphisa imfuno yonyango.Ngoko ke, ukudibanisa kwe-PRP kunye ne-glucose egxininiswe kakhulu kunokuba yindleko-esebenzayo kune-PRP okanye i-glucose yodwa.
Isifundo sethu sineentsilelo ezininzi.Okokuqala, sisebenzisa i-PRP efunyenwe kwiindlela ezininzi ezahlukeneyo.Oku kunokukhokelela kwiziphumo eziphikisanayo.Okwesibini, asikwazanga ukwenza uhlalutyo lwe-biochemical yayo nayiphi na iisampulu zethu ukufumanisa ngokuchanekileyo ukuba i-platelet activation yenzekile.Singathanda ukulinganisa i-P-selectin, i-platelet factor 4, i-monocytic platelet aggregates, okanye ezinye iziphawuli ze-activation yeplatelet ukuze uqonde ngcono iqondo okanye ubukho be-alpha granule degranulation, kodwa oku kungaphaya kobubanzi bolu phononongo.Okwesithathu, asikwazanga ukuqinisekisa nge-electron microscopy okanye ezinye iindlela zokunyuka kwe-MPV kwi-glucose-exposed platelets ngenxa yempembelelo kwi-microtubule tangles.
Imixube ye-WB okanye i-PRP kunye ne-25% ye-glucose yokwandisa i-MPV, ebonisa ukuqala kokusebenza kweplatelet, nangona olu cwaningo aluzange lubonise ukuqhubela phambili kwe-aggregation okanye i-degranulation.Umxube we-glucose we-hypertonic ubangele ukulahleka kweplatelet, mhlawumbi ukumela umphumo we-lytic.Ukusebenza ngokuyinxenye okanye i-lysis yeplatelet inokubangela ukuvuselelwa kwezicubu emva kokutofa kweplatelet.Akucaci ukuba zeziphi iziphumo zeklinikhi ezinokuthi zikhokelele kuzo.Uphononongo olongezelelweyo lubonise imilinganiselo echanekileyo ngakumbi yokusebenza okanye i-lysis kwaye ivavanye iziphumo ezahlukeneyo zekliniki zemixube ye-hypertonic glucose kunye ne-WB okanye i-PRP.
Unyango lokwandisa iGlucose lunyango olulula nolungabizi kakhulu lokuhlaziya olukhula ngokukhawuleza kwaye luxhasa uphando lwezonyango.Olu pho nonongo lucebisa indlela ye-physiological ethi, ukuba iqinisekisiwe, inokusinceda siqonde inxalenye yendlela yokuvuselela unyango olukhulayo.
I-Biomedical kunye ne-Health Informatics kwiYunivesithi yaseMissouri, kwiSikolo saseKansas City of Medicine, kwisiXeko saseKansas, eMelika.
Izifundo zoluntu: Bonke abathathi-nxaxheba kolu phononongo banike okanye abazange bavume.I-International Society for Cellular Medicine ikhuphe imvume ye-ICMS-2017-003.Le protocol ilandelayo ivunyiwe ukuba isetyenziswe ngakumbi yiBhodi yokuHlola yeZiko loMbutho waMazwe ngaMazwe we-Cellular Medicine: Isihloko: Ukubalwa kwe-platelet-rich plasma drug led based on baseline CBC platelet count.Izifundo zezilwanyana: Bonke ababhali baqinisekisile ukuba akukho zilwanyana okanye izicubu ezibandakanyekayo kolu cwaningo.Ukungqubuzana koMdla: Ngokuhambelana neFom ye-ICMJE yokuDala i-Uniform, bonke ababhali bavakalisa oku kulandelayo: Ulwazi lwentlawulo / inkonzo: Bonke ababhali bavakalisa ukuba abazange bafumane inkxaso yezemali kuyo nayiphi na inhlangano yomsebenzi ongenisiweyo.Ubudlelwane bezeMali: Bonke ababhali bavakalisa ukuba okwangoku okanye kwiminyaka emithathu edlulileyo banobudlelwane bezemali kunye nawo nawuphi na umbutho onokuba nomdla kumsebenzi ongenisiweyo.Olunye uBudlelwane: Bonke ababhali bavakalisa ukuba akukho budlelwane obunye okanye imisebenzi enokuchaphazela umsebenzi ongenisiweyo.
Harrison TE, Bowler J, Reeves K et al.(NgoMeyi 17, 2022) Umphumo weglucose kwisibalo seplatelet kunye nevolumu: iimpembelelo kwiyeza lokuhlaziya.Unyango 14(5): e25081.doi:10.7759/cureus.25081
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