• 南方醫(yī)科大學(xué)南方醫(yī)院創(chuàng)傷骨科（廣州，510515）;

目的 富血小板血漿（platelet-rich plasma，PRP）具有促進(jìn)損傷組織修復(fù)作用。通過(guò)觀察PRP 局部注射對(duì)大鼠跟腱斷裂早期愈合的影響，為臨床應(yīng)用提供實(shí)驗(yàn)依據(jù)。 方法 SPF 級(jí)SD 大鼠46 只，雌雄不限，體重190 ～ 240 g。取10 只大鼠心臟動(dòng)脈血制備PRP 及貧血小板血漿（platelet-poor plasma，PPP）；其余36 只隨機(jī)分為3 組（n=12），分別為空白對(duì)照組、PPP 組及PRP 組。大鼠制備雙側(cè)跟腱斷裂模型后，PPP 組和PRP 組跟腱周圍局部對(duì)應(yīng)注射PPP 及PRP，每側(cè)100 μL，每周1 次至處死；空白對(duì)照組不作處理。術(shù)后觀察大鼠一般情況，于1、2、3、4 周取雙側(cè)跟腱，行大體、組織學(xué)及免疫組織化學(xué)染色觀察，測(cè)量新生跟腱Ⅰ型膠原纖維含量；并于4 周行生物力學(xué)測(cè)試。 結(jié)果 大鼠均存活至實(shí)驗(yàn)完成。隨著時(shí)間延長(zhǎng)，各組大鼠跟腱水腫逐漸減退，滑動(dòng)性逐漸改善；術(shù)后3 周內(nèi)各組跟腱粘連逐漸加重，4 周時(shí)減輕，1、4 周時(shí)各組跟腱粘連程度分級(jí)差異均無(wú)統(tǒng)計(jì)學(xué)意義（P  gt; 0.05）。術(shù)后1 周PRP 組炎性細(xì)胞浸潤(rùn)、毛細(xì)血管及膠原纖維增殖較空白對(duì)照組、PPP 組明顯，之后炎性反應(yīng)及毛細(xì)血管生成逐漸減少。各時(shí)間點(diǎn)各組均可見(jiàn)Ⅰ型膠原纖維陽(yáng)性表達(dá)，術(shù)后1、2、3 周PRP 組Ⅰ型膠原纖維陽(yáng)性密度值多于空白對(duì)照組和PPP 組（P  lt; 0.05），4 周時(shí)3 組差異無(wú)統(tǒng)計(jì)學(xué)意義（P  gt; 0.05）。生物力學(xué)測(cè)試：術(shù)后4 周3 組跟腱最大滑動(dòng)距離比較，差異均無(wú)統(tǒng)計(jì)學(xué)意義（P  gt; 0.05）；PRP 組跟腱彈性模量及最大抗拉力明顯高于空白對(duì)照組及PPP 組（P  lt; 0.05）。 結(jié)論 大鼠跟腱斷裂早期于斷端周圍注射PRP 能促進(jìn)跟腱愈合。

引用本文： 熊小龍,伍亮,相大勇,倪國(guó)新,趙培冉,余斌. 富血小板血漿對(duì)大鼠跟腱斷裂早期愈合的影響. 中國(guó)修復(fù)重建外科雜志, 2012, 26(4): 466-471. doi: 復(fù)制

1. and radiographic animal study on the use of autogenous scaffolds and platelet-rich plasma. Int J Oral Maxillofac Surg, 2002, 31(3): 281-286.
2. Assoian RK, Grotendorst GR, Miller DM, et al. Cellular transformation by coordinated action of three peptide growth factors from human platelets. Nature, 1984, 309(5971): 804-806.
3. Fennis JP, Stoelinga PJ, Jansen JA. Mandibular reconstruction: a clinical.
4. Foster TE, Puskas BL, Mandelbaum BR, et al. Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med, 2009, 37(11): 2259-2272.
5. Lyras DN, Kazakos K, Verettas D, et al. The influence of platelet-rich plasma on angiogenesis during the early phase of tendon healing. Foot Ankle Int, 2009, 30(11): 1101-1106.
6. Camargo PM, Lekovic V, Weinlaender M, et al. Platelet-rich plasma and bovine porous bone mineral combined with guided tissue regeneration in the treatment of intrabony defects in humans. J Periodontal Res, 2002, 37(4): 300-306.
7. Schmitz JP, Hollinger JO. The biology of platelet-rich plasma. J Oral Maxillofac Surg, 2001, 59(9): 1119-1121.
8. 劉驥, 袁霆, 張長(zhǎng)青. 富血小板血漿治療慢性組織損傷的研究進(jìn)展. 中國(guó)修復(fù)重建外科雜志, 2010, 24(6): 754-757.
9. 耿震, 王宸, 周海洋. 富血小板血漿對(duì)肌腱愈合影響的實(shí)驗(yàn)研究. 中國(guó)修復(fù)重建外科雜志, 2011, 25(3): 344-348.
10. Aspenberg P, Virchenko O. Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand, 2004, 75(1): 93-99.
11. Landesberg R, Roy M, Glickman RS. Quantification of growth factor levels using a simplified method of platelet-rich plasma gel preparation. J Oral Maxillofac Surg, 2000, 58(3): 297-300.
12. 湯錦波, 侍德, 石井清一. 各種傷情下屈肌腱的愈合及粘連形成: 肌腱愈合新理論系統(tǒng)的探討. 手外科雜志, 1992, 8(1): 31-35.
13. Möller A, Astron M, Westlin N. Increasing incidence of Achilles tendon rupture. Acta Orthop Scand, 1996, 67(5): 479-481.
14. Bhattacharyya M, Gerber B. Mini-invasive surgical repair of the Achilles tendon—does it reduce post-operative morbidity? Int Orthop, 2009, 33(1): 151-156.
15. 商曉軍, 朱亞平, 韋兆祥. 閉合性跟腱斷裂微創(chuàng)腱皮縫合的遠(yuǎn)期療效觀察. 中國(guó)矯形外科雜志, 2007, 15(18): 1371-1373.
16. Lansdaal JR, Goslings JC, Reichart M, et al. The results of 163 Achilles tendon ruptures treated by a minimally invasive surgical technique and functional aftertreatment. Injury, 2007, 38(7): 839-844.
17. Willits K, Amendola A, Bryant D, et al. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Joint Surg (Am), 2010, 92(17): 2767-2775.
18. Carter CA, Jolly DG, Worden CE Sr, et al. Platelet-rich plasma gel promotes differentiation and regeneration during equine wound healing. Exp Mol Pathol, 2003, 74(3): 244-255.
19. Kajikawa Y, Morihara T, Sakamoto H, et al. Platelet-rich plasma enhances the initial mobilization of circulation-derived cells for tendon healing. J Cell Physiol, 2008, 215(3): 837-845.
20. Kajikawa Y, Morihara T, Watanabe N, et al. GFP chimeric models exhibited a biphasic pattern of mesenchymal cell invasion in tendon healing. J Cell Physiol, 2007, 210(3): 684-691.
21. 盛加根, 曾炳芳, 姜佩珠, 等. 外源性堿性成纖維細(xì)胞生長(zhǎng)因子對(duì)鞘內(nèi)肌腱愈合和粘連的影響. 中國(guó)修復(fù)重建外科雜志, 2007, 21(7): 733-737.
22. 余利鵬, 羅永湘. 跟腱損傷治療進(jìn)展. 中國(guó)修復(fù)重建外科雜志, 2003, 17(4): 343-345.
23. Spindler KP, Murray MM, Detwiler KB, et al. The biomechanical response to doses of TGF-beta 2 in the healing rabbit medial collateral ligament. J Orthop Res, 2003, 21(2): 245-249.
24. Taylor DW, Petrera M, Hendry M, et al. A systematic review of the use of platelet-rich plasma in sports medicine as a new treatment for tendon and ligament injuries. Clin J Sport Med, 2011, 21(4): 344-352.
25. Schepull T, Kvist J, Norrman H, et al. Autologous platelets have no effect on the healing of human achilles tendon ruptures: a randomized single-blind study. Am J Sports Med, 2011, 39(1): 38-47.
  1. 1. and radiographic animal study on the use of autogenous scaffolds and platelet-rich plasma. Int J Oral Maxillofac Surg, 2002, 31(3): 281-286.
  2. 2. Assoian RK, Grotendorst GR, Miller DM, et al. Cellular transformation by coordinated action of three peptide growth factors from human platelets. Nature, 1984, 309(5971): 804-806.
  3. 3. Fennis JP, Stoelinga PJ, Jansen JA. Mandibular reconstruction: a clinical.
  4. 4. Foster TE, Puskas BL, Mandelbaum BR, et al. Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med, 2009, 37(11): 2259-2272.
  5. 5. Lyras DN, Kazakos K, Verettas D, et al. The influence of platelet-rich plasma on angiogenesis during the early phase of tendon healing. Foot Ankle Int, 2009, 30(11): 1101-1106.
  6. 6. Camargo PM, Lekovic V, Weinlaender M, et al. Platelet-rich plasma and bovine porous bone mineral combined with guided tissue regeneration in the treatment of intrabony defects in humans. J Periodontal Res, 2002, 37(4): 300-306.
  7. 7. Schmitz JP, Hollinger JO. The biology of platelet-rich plasma. J Oral Maxillofac Surg, 2001, 59(9): 1119-1121.
  8. 8. 劉驥, 袁霆, 張長(zhǎng)青. 富血小板血漿治療慢性組織損傷的研究進(jìn)展. 中國(guó)修復(fù)重建外科雜志, 2010, 24(6): 754-757.
  9. 9. 耿震, 王宸, 周海洋. 富血小板血漿對(duì)肌腱愈合影響的實(shí)驗(yàn)研究. 中國(guó)修復(fù)重建外科雜志, 2011, 25(3): 344-348.
  10. 10. Aspenberg P, Virchenko O. Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand, 2004, 75(1): 93-99.
  11. 11. Landesberg R, Roy M, Glickman RS. Quantification of growth factor levels using a simplified method of platelet-rich plasma gel preparation. J Oral Maxillofac Surg, 2000, 58(3): 297-300.
  12. 12. 湯錦波, 侍德, 石井清一. 各種傷情下屈肌腱的愈合及粘連形成: 肌腱愈合新理論系統(tǒng)的探討. 手外科雜志, 1992, 8(1): 31-35.
  13. 13. Möller A, Astron M, Westlin N. Increasing incidence of Achilles tendon rupture. Acta Orthop Scand, 1996, 67(5): 479-481.
  14. 14. Bhattacharyya M, Gerber B. Mini-invasive surgical repair of the Achilles tendon—does it reduce post-operative morbidity? Int Orthop, 2009, 33(1): 151-156.
  15. 15. 商曉軍, 朱亞平, 韋兆祥. 閉合性跟腱斷裂微創(chuàng)腱皮縫合的遠(yuǎn)期療效觀察. 中國(guó)矯形外科雜志, 2007, 15(18): 1371-1373.
  16. 16. Lansdaal JR, Goslings JC, Reichart M, et al. The results of 163 Achilles tendon ruptures treated by a minimally invasive surgical technique and functional aftertreatment. Injury, 2007, 38(7): 839-844.
  17. 17. Willits K, Amendola A, Bryant D, et al. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Joint Surg (Am), 2010, 92(17): 2767-2775.
  18. 18. Carter CA, Jolly DG, Worden CE Sr, et al. Platelet-rich plasma gel promotes differentiation and regeneration during equine wound healing. Exp Mol Pathol, 2003, 74(3): 244-255.
  19. 19. Kajikawa Y, Morihara T, Sakamoto H, et al. Platelet-rich plasma enhances the initial mobilization of circulation-derived cells for tendon healing. J Cell Physiol, 2008, 215(3): 837-845.
  20. 20. Kajikawa Y, Morihara T, Watanabe N, et al. GFP chimeric models exhibited a biphasic pattern of mesenchymal cell invasion in tendon healing. J Cell Physiol, 2007, 210(3): 684-691.
  21. 21. 盛加根, 曾炳芳, 姜佩珠, 等. 外源性堿性成纖維細(xì)胞生長(zhǎng)因子對(duì)鞘內(nèi)肌腱愈合和粘連的影響. 中國(guó)修復(fù)重建外科雜志, 2007, 21(7): 733-737.
  22. 22. 余利鵬, 羅永湘. 跟腱損傷治療進(jìn)展. 中國(guó)修復(fù)重建外科雜志, 2003, 17(4): 343-345.
  23. 23. Spindler KP, Murray MM, Detwiler KB, et al. The biomechanical response to doses of TGF-beta 2 in the healing rabbit medial collateral ligament. J Orthop Res, 2003, 21(2): 245-249.
  24. 24. Taylor DW, Petrera M, Hendry M, et al. A systematic review of the use of platelet-rich plasma in sports medicine as a new treatment for tendon and ligament injuries. Clin J Sport Med, 2011, 21(4): 344-352.
  25. 25. Schepull T, Kvist J, Norrman H, et al. Autologous platelets have no effect on the healing of human achilles tendon ruptures: a randomized single-blind study. Am J Sports Med, 2011, 39(1): 38-47.