Ka noiʻi a me ka noiʻi o ka PRP i ka maʻi kuli maʻamau

Ka noiʻi a me ka noiʻi ʻana o ka PRP i nā maʻi maʻamau o ka hui kuli

Platelet-rich plasma (PRP) ʻo ia ka plasma i haku nui ʻia me nā platelets a me nā keʻokeʻo keʻokeʻo i loaʻa ma ka centrifugation o ke koko peripheral autologous.ʻO ka nui o nā kumu ulu a me nā cytokines e mālama ʻia i loko o nā granules α o nā platelets.Ke hoʻāla ʻia nā platelets, hoʻokuʻu kā lākou α granules i kahi helu nui o nā kumu ulu.Ua hōʻike nā haʻawina e hiki i kēia mau mea ulu ulu ke hoʻoikaika i ka hoʻokaʻawale ʻana o ka cell, proliferation, extracellular matrix a me collagen synthesis, no laila e hoʻoikaika ai i ka hana hou ʻana a me ka hoʻoponopono ʻana o ka cartilage articular a me ka ligament.ʻē aʻenā lole.I ka manawa like, hiki iā ia ke hoʻomaikaʻi i ka pane inflammatory o ka wahi lesion a hoʻemi i nā hōʻailona maʻi o nā maʻi.Ma waho aʻe o kēia mau mea ulu ulu, aia ka PRP i ka nui o nā keʻokeʻo keʻokeʻo.Hiki i kēia mau keʻokeʻo keʻokeʻo a me nā platelets ke hoʻokuʻu i nā ʻano peptides antimicrobial e hoʻopaʻa i nā pathogens, ke kāohi a pepehi i nā pathogens, a pāʻani i kahi hana antibacterial.

Ua hoʻohana nui ʻia ʻo PRP ma ke ʻano o nā orthopedic ma muli o kāna kaʻina hana maʻalahi, hoʻohana maʻalahi a me nā kumu kūʻai haʻahaʻa, ʻoi aku hoʻi i ka mālama ʻana i nā maʻi kuli i nā makahiki i hala.E kūkākūkā kēia ʻatikala i ka noiʻi lapaʻau a me ka noiʻi ʻana o ka platelet-rich plasma i ka osteoarthritis o ke kuli (KOA), ʻeha meniscus, cruciate ligament injury, knee synovitis a me nā maʻi kuli maʻamau.

ʻenehana noi PRP

ʻO ka PRP i hoʻopau ʻole ʻia a me ka hoʻokuʻu ʻana o ka PRP i hoʻokuʻu ʻia he wai a hiki ke hoʻopili ʻia, a hiki ke hoʻomalu ʻia ka PRP unactivated e ka hoʻohui ʻana i ka calcium chloride a i ʻole thrombin e hoʻomalu i ka manawa agglutination i hiki ke hoʻokumu ʻia ka gel ma hope o ka hiki ʻana i ka wahi i manaʻo ʻia. e hoʻokō i ke kumu o ka hoʻokuʻu mau ʻana i nā kumu ulu.

PRP lapaau o KOA

ʻO KOA kahi maʻi kuli degenerative i hōʻike ʻia e ka luku holomua ʻana o ka cartilage articular.ʻO ka hapa nui o nā maʻi he mau makahiki waena a ʻelemakule.ʻO nā hōʻike lapaʻau o KOA ka ʻeha o ke kuli, ka pehu, a me ka palena o ka hana.ʻO ka imbalance ma waena o ka synthesis a me ka decomposition o articular cartilage matrix ke kumu o ka hanana o KOA.No laila, ʻo ka hoʻoikaika ʻana i ka hoʻoponopono ʻana i ka cartilage a me ka hoʻoponopono ʻana i ke koena o ka cartilage matrix ke kī o kāna mālama ʻana.

I kēia manawa, kūpono ka hapa nui o nā maʻi KOA no ka mālama conservative.Hoʻohana mau ʻia ka lāʻau lapaʻau conservative ʻo ka hui pū ʻana o ka hyaluronic acid, glucocorticoids a me nā lāʻau lapaʻau ʻē aʻe a me nā lāʻau anti-inflammatory non-steroid.Me ka hoʻonui ʻia ʻana o ka noiʻi ʻana ma ka PRP e nā ʻepekema kūloko a me nā ʻāina ʻē, ua ʻoi aku ka nui o ka mālama ʻana o KOA me PRP i nā makahiki i hala.

Mechanism o ka hana:

1. Hoʻonui i ka hoʻonui ʻana o nā chondrocytes:

Ma ke anaʻana i ka hopena o ka PRP i ka ola o nā chondrocytes rabbit, Wu J et al.ua ʻike ʻia ua hoʻonui ʻo PRP i ka hoʻonui ʻana o nā chondrocytes, a ua manaʻo ʻo PRP hiki ke pale i nā chondrocytes IL-1β-activated ma ke kāohi ʻana i ka transduction hōʻailona Wnt / β-catenin.

2. Ka hoʻopaʻa ʻana i ka hopena inflammatory chondrocyte a me ka degeneration:

Ke ho'ālaʻia, hoʻokuʻu ka PRP i ka nui o nā mea anti-inflammatory, e like me IL-1RA, TNF-Rⅰ, ⅱ, a me nā mea'ē aʻe. Hiki i ka Il-1ra ke kāohi i ka hoʻouluʻana o IL-1 ma ke kāohiʻana i ka IL-1 receptor, a me TNF-Rⅰ a me ⅱ hiki ke ālai i ke ala hōʻailona pili i ka TNF-α.

Haʻawina maikaʻi:

ʻO nā hōʻike nui he hōʻoluʻolu o ka ʻeha a me ka hoʻomaikaʻi ʻana i ka hana o ke kuli.

Lin KY et al.ua hoʻohālikelike ʻia i loko o ke kino o ka LP-PRP me ka hyaluronic acid a me ka paʻakai maʻamau, a ʻike ʻia ʻoi aku ka maikaʻi o ka hopena curative o nā hui mua ʻelua ma mua o ka hui saline maʻamau i ka wā pōkole, i hōʻoia i ka hopena lapaʻau o LP-PRP a me ka hyaluronic acid, a me ka nānā ʻana i ka wā lōʻihi (ma hope o 1 makahiki) i hōʻike i ka maikaʻi o ka hopena o LP-PRP.Ua hoʻohui kekahi mau haʻawina i ka PRP me ka hyaluronic acid, a ua ʻike ʻo ka hui pū ʻana o ka PRP a me ka hyaluronic acid ʻaʻole hiki ke hoʻomaha wale i ka ʻeha a hoʻomaikaʻi i ka hana, akā e hōʻoia pū i ka hoʻōla hou ʻana o ka cartilage articular e X-ray.

Eia naʻe, ʻo Filardo G et al.Ua manaʻoʻiʻo ua maikaʻi ka hui PRP a me ka hui sodium hyaluronate i ka hoʻomaikaʻi ʻana i ka hana o ke kuli a me nā hōʻailona ma o ke aʻo ʻana i hoʻopaʻa ʻia, akā ʻaʻohe ʻokoʻa nui i loaʻa.Ua ʻike ʻia ke ʻano o ka hoʻokele PRP i kekahi hopena i ka hopena therapeutic o KOA.ʻO Du W et al.mālama iā KOA me ka PRP intravarticular injection a extraarticular injection, a nānā i nā helu VAS a me Lysholm ma mua o ka lāʻau a me 1 a me 6 mau mahina ma hope o ka lāʻau.Ua ʻike lākou he hiki ke hoʻomaikaʻi i nā helu VAS a me Lysholm ʻelua i ka wā pōkole, akā ʻoi aku ka maikaʻi o ka hopena o ka hui injection intra-articular ma mua o ka hui injection extraarticular ma hope o 6 mau mahina.ʻO Taniguchi Y et al.mahele i ka haʻawina e pili ana i ka mālama ʻana i ke koʻikoʻi a hiki i ke koʻikoʻi KOA i intraluminal injection i hui pū ʻia me intraluminal injection o PRP pūʻulu, intraluminal injection o PRP pūʻulu a me intraluminal injection o HA pūʻulu.Ua hōʻike ʻia ka haʻawina ʻoi aku ka maikaʻi o ka hui ʻana o intraluminal injection o PRP a me intraluminal injection o PRP ma mua o ka intraluminal injection o PRP a i ʻole HA no ka liʻiliʻi o 18 mau mahina i ka hoʻomaikaʻi ʻana i nā helu VAS a me WOMAC.

（Paʻi hou ʻia nā mea o kēia ʻatikala, ʻaʻole mākou e hāʻawi i ka hōʻoiaʻiʻo a i ʻole ka hōʻoia ʻana no ka pololei, hilinaʻi a i ʻole ka piha o nā mea i loko o kēia ʻatikala, a ʻaʻole kuleana no nā manaʻo o kēia ʻatikala, e ʻoluʻolu e hoʻomaopopo.)