"Kada ku yi shakkar cewa ƙaramin rukuni na 'yan ƙasa masu tunani da sadaukarwa za su iya canza duniya. A gaskiya ma, ita kaɗai ce a can."
Manufar Cureus ita ce ta sauya tsarin buga littattafai na likitanci na dogon lokaci, wanda gabatar da bincike zai iya zama mai tsada, rikitarwa, kuma mai ɗaukar lokaci.
Jini/prp mai wadataccen platelet, farfaɗo da nama, kunna platelet, maganin haɓaka glucose, platelets, maganin haɓaka
Ka ambaci wannan labarin kamar haka: Harrison TE, Bowler J, Reeves K, da sauransu (17 ga Mayu, 2022) Tasirin glucose akan adadin platelet da girma: tasirin maganin sake farfaɗowa. Cure 14(5): e25081. doi:10.7759/cureus.25081
Ana amfani da sinadarin plasma mai wadataccen platelet (PRP) da kuma maganin glucose mai yawan jini a matsayin allura a cikin maganin sake farfaɗowa, wani lokacin tare. Ba a bayar da rahoton tasirin glucose mai yawan jini a kan platelet lysis da kunnawa a baya ba. Mun gwada tasirin karuwar yawan glucose a kan platelet da erythrocyte count, da kuma yawan ƙwayoyin halitta a cikin PRP da cikakken jini (WB). An sami raguwar adadin platelet cikin sauri tare da duk gaurayen glucose da aka haɗa da PRP ko cikakken jini, daidai da lysis na ɓangare. Bayan minti na farko, adadin platelets ya kasance daidai, wanda ke nuna cewa raguwar platelets ɗin da suka rage ya yi sauri zuwa matsanancin ƙarfi (>2000 mOsm). Bayan minti na farko, adadin platelets ya kasance daidai, wanda ke nuna cewa raguwar platelets ɗin da suka rage ya yi sauri zuwa matsanancin ƙarfi (>2000 mOsm). После первой минуты количество тромбоцитов онлайн trombotsitov do эkstremalnoho (> 2000 mОsm) гиpertonusa. Bayan minti na farko, adadin platelets ya kasance daidai, wanda ke nuna saurin daidaitawar sauran platelets zuwa matsanancin ƙarfi (> 2000 mOsm).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月> 2000 mOs.2000 mOsm）高渗状态。 После первой минуты количество тромбоцитов оставось trombotsitov k эkstremalnomu (>2000 mОsm) гиperosmolyarnomu sostoyannyyyu. Bayan minti na farko, adadin platelets ya kasance daidai, wanda ke nuna saurin daidaitawar sauran platelets zuwa yanayin hyperosmolar mai tsanani (>2000 mOsm).Yawan glucose na kashi 25% zuwa sama ya haifar da ƙaruwa mai yawa a cikin matsakaicin adadin platelet (MPV), wanda ke nuna matakin farko na kunna platelet. Ana buƙatar ƙarin bincike don tantance ko platelet lysis ko kunnawa ya faru da kuma ko allurar glucose mai ƙarfi kaɗai ko tare da PRP na iya samar da ƙarin fa'ida a asibiti.
A shekarun 1950, likitan fiɗa na Amurka George Hackett ya gano cewa zai iya rage radadin gaɓɓai da baya a cikin marasa lafiya da yawa ta hanyar allurar maganin yaduwa a cikin jijiyoyi da jijiyoyin jini. Gwaje-gwajen da ya yi kan zomaye sun nuna cewa maganin, wanda ya kira maganin yaduwa, ya sa jijiyoyin suka faɗaɗa da ƙarfi. Nazarin histological ya tabbatar da cewa ana samar da sabon collagen a lokacin wannan tsari [1].
A cikin 'yan shekarun farko, an gwada hanyoyin rarrabawa daban-daban. A shekarun 1990, yawancin masu aiki sun ɗauki yawan glucose a matsayin hanya mafi aminci kuma mafi inganci. Duk da haka, hanyar aiki har yanzu ba a fayyace ba.
An gudanar da bincike kaɗan na asibiti a ƙarni na 20 bayan aikin Hackett. Duk da haka, a cikin shekarun 2000 an sake samun sha'awa kuma an kammala gwaje-gwaje da dama na asibiti na maganin yaduwa don magance ciwon baya [2], osteoarthritis na gwiwa [3], da kuma lateral epicondylitis [4].
Sake farfaɗo da kyallen jiki yana buƙatar haɗin ƙwayoyin halitta. Saboda haka, yawan glucose dole ne ya haifar da ƙaura, kwafi, da bambance-bambancen ƙwayoyin halitta. Muna tsammanin cewa platelets na iya aiki a matsayin manzanni kuma yawan glucose na iya sa platelets su saki cytokines da abubuwan da ke haifar da ci gaba, ta haka ne ke haɓaka hanyoyin sake farfaɗowa, musamman ƙaura da ƙwayoyin halitta zuwa wuraren da ke da yawan glucose.
Kunna platelet koyaushe yana gaba da ƙaruwa a cikin ƙwayoyin calcium na cikin jiki [5]. Liu et al. a cikin 2008 sun nuna cewa matakan glucose masu yawa suna ƙara ayyukan tashoshin canonical potential canonical type 6 (TRPC6) a cikin membrane na plasma, wanda ke haifar da kwararar ions na calcium zuwa cikin platelets [6]. Wani bincike ya nuna cewa fallasa yankin gefen microtubule zuwa ions na calcium yana haifar da shakatawa, faɗaɗawa, da nakasa yankin gefen, wanda hakan ke haifar da canji a siffar daga diski zuwa zagaye, wanda ke haifar da matsakaicin girman platelet (MPV) [7].
Hasashe namu a cikin wannan binciken shine cewa fallasa platelets ga yawan glucose yana shafar yankin gefen microtubule da muhallin cikin ƙwayoyin halitta, wanda ke haifar da ƙaruwar MPV.
Duk mahalarta sun sanya hannu kan takardar amincewa bayan an yi bayani dalla-dalla game da binciken kuma kafin a karɓi samfuran. A cikin wannan binciken, an yi amfani da samfuran PRP kawai tare da hematocrit sama da 2% don a iya haɗa adadin erythrocyte (erythrocyte) da matsakaicin girman ƙwayoyin jini ja (MCV) don kwatantawa.
An gudanar da binciken a matakai huɗu, matakin farko shine PRP kuma sauran matakai sune jini gaba ɗaya (Tebur 1). Kamar yadda aka bayyana a baya [8], an ƙididdige dukkan ƙarfin centrifugal (RCF, g-force) daga tsakiyar (Rmid, a cm) na ginshiƙin jini a cikin sirinji na centrifugal. Mun zaɓi amfani da MPV a matsayin alamar fahimtar platelets da adadin platelets a matsayin alamar yiwuwar lysis na platelets, waɗanda duka za a iya auna su cikin sauƙi akan daidaitattun masu nazarin hematology.
A mataki na farko, masu sa kai 47 sun bayar da gudummawar samfuran jini—bututu ɗaya na ethylenediaminetetraacetic acid (EDTA) da kuma samfurin jini guda ɗaya na PRP (anticoagulated with sodium citrate (NaCl, 3%)) (Tebur 1). Sanya rocker ɗin a cikin bututun nan da nan. An yi cikakken ƙidayar jini (CBC) akan samfuran EDTA a cikin triplicate, kuma an yi nazarin samfuran NaCl a cikin triplicate don nazarin CBC, sannan an shirya PRP ta hanyoyi daban-daban da aka bayyana a sama [8]. An shirya duk samfuran PRP ta hanyar centrifugation a 900–1000 g. A haɗa kowane samfurin PRP a kan mahaɗin vortex na daƙiƙa 5-10, sannan a raba aliquots biyar na 0.5 ml zuwa bututu.
Domin tantance tasirin fallasa platelet akan yawan glucose da ya karu, an haɗa daidai gwargwado (0.5 ml) na 0%, 5%, 12.5%, 25%, da 50% glucose a cikin ruwa tare da samfuran platelet don samun 0%, 2.5% 6.25%, 12.5% ​​​​da 25% na cakuda glucose sannan a haɗa bututun a kan injin girgiza bututun gwaji na tsawon mintuna 15. An yi nazarin TAC na kowane cakuda sau uku bayan mintuna 15. An auna adadin platelet (PLT), RBC count, MCV, da MPV ga kowane bututu, kuma an ƙididdige matsakaicin adadin platelet, RBC count, MCV, da MPV ga duk samfuran PRP.
Bayan an kammala matakin farko na tattara bayanai, mun lura da ƙaruwa mai yawa a cikin adadin platelets a cikin platelets na PRP bayan ƙara D50W. Platelets na PRP ba lallai bane su wakilci dukkan platelets a cikin jini, kuma matsakaicin PRP ya bambanta da matsakaicin WB. Saboda haka, mun yanke shawarar yin gwaji na mataki na biyu game da tasirin ƙara D50W a cikin jinin gaba ɗaya.
A zagaye na biyu, mun zaɓi girman samfurin 30 bisa ga sakamakon da aka samu daga jerin farko, kamar yadda aka bayyana a cikin sashin Bincike. A cikin wannan jerin, masu sa kai 20 sun ba da gudummawar samfuran jini (Tebur 1). An zana cikakken jini (1.8 ml) a cikin sirinji mai 3 ml kuma an haɗa shi da 0.2 ml 40% NaCl. An haɗa cikakken sirinji na jini na daƙiƙa biyar da mahaɗin vortex kuma an yi nazarin CBC a cikin sau uku. Bayan bincike, an ƙara jinin da aka hana haɗa jini zuwa 2 ml na 50% glucose a cikin sirinji mai 5 ml (ƙarshen yawan glucose shine kusan 25% (D25) kuma an sanya shi a cikin bututun girgiza na minti 30. Bayan mintuna 30, an yi nazarin D25/CBC a cikin sirinji na WB a cikin sau uku. An auna adadin platelet, adadin RBC, MCV, da MPV a kowace sirinji, kuma an ƙididdige matsakaicin adadin PLT, RBC, MCV, da MPV ga kowane samfurin kafin da kuma bayan ƙara glucose.
Saboda platelets a cikin jini gaba ɗaya galibi suna fuskantar hypertonic glucose a lokacin maganin glucose mai yaduwa saboda allurar da ba ta da tasiri sosai, kuma ba abu ne da aka saba haɗa PRP da hypertonic glucose kafin allura ba, mun yanke shawarar yin nazarin hypertonic glucose tare da WB a Sashe na 1. Mataki na Uku da na Huɗu. A kowane mataki, masu sa kai 20 sun ba da gudummawar 7-8 ml na ACD-A (acid mai ɗauke da trisodium citrate (22.0 g/l), citric acid (8.0 g/l) da glucose (24.5 g/l), maganin dextrose citrate) don maganin hana zubar jini (Tebur na 1). An yi amfani da gaurayen glucose sama da 12.5% ​​kawai don tantance kashi na iyaka da ke da alaƙa da ƙaruwar MPV. A mataki na uku, ana sanya 1 ml na jini a cikin bututun gwaji. Sai a haɗa jinin a kan mahaɗin vortex na tsawon daƙiƙa 10 ta hanyar ƙara 1 ml na glucose 30%, 40% glucose, ko 50% glucose a cikin bututun don samun jimlar yawan glucose na 15%, 20%, da 25%, bi da bi. An yi nazarin samfuran jinin glucose don CBC nan da nan bayan an haɗa kuma an maimaita su kowane minti biyu na minti 30.
A lokacin haɗakar farko, ƙara sinadarin glucose mai ƙarfi 1:1 da WB ko PRP yana fallasa ƙwayoyin platelets zuwa yawan da ya wuce 25% na daƙiƙa da yawa. A mataki na huɗu, don tantance tasirin sinadarin glucose mai ƙarfi tare da ƙarancin yawan farko da kuma gwada iyakar tasirin glucose na sama, mun ƙara ƙaramin jini kawai zuwa D25W ko D50W. Sanya 1 ml na D25W ko D50W a cikin bututu kuma mu ƙara 0.2 ml na WB yayin da muke jujjuya samfurin na tsawon daƙiƙa 10. A cikin waɗannan yanayin, jinin ya fallasa ga glucose a yawan da ya kai kusan 20% sama da yawan da ya wuce, maimakon 50% sama da yawan da ya wuce kamar yadda yake a Mataki na 3, wanda ya haifar da yawan glucose na ƙarshe na 20.8% da 41.6%. An yi nazarin samfuran gauraye a lokaci guda kamar yadda yake a mataki na 3.
A matakin farko na kowane jerin narkewar glucose, an ɗauki samfura 30 domin wannan shine girman samfurin da ya dace don binciken gwaji [9]. A ƙarshen kowane mataki (gami da matakin farko), kimanta isasshen girman samfurin ta amfani da dabarar da aka yi amfani da ita don tantance girman samfurin da ake buƙata don kimanta matsakaicin canjin sakamako mai ci gaba a cikin al'umma ɗaya. Tsarin n = Z2 x SD2 /E2. A cikin wannan lissafi, Z shine maki Z, SD shine karkacewar da aka saba, kuma E shine kuskuren da ake so [10]. Alfa ɗinmu shine 0.05, wanda yayi daidai da ƙimar Z na 1.96, kuma muna tsammanin kuskure na 5 (a cikin kashi). Don haka mun warware don n = (1.962 x SD2)/52. Sakamakon ya nuna cewa girman samfurin da ake buƙata don kowane mataki ya fi ƙanƙanta fiye da ainihin adadin da aka tattara.
A lokacin 1, 3 da 4 ta amfani da fiye da yawan glucose ɗaya, an yi nazarin tasirin yawan glucose daban-daban ta hanyar kwatanta canjin sassa tsakanin lokaci 0 da kowane lokaci na gaba (lokaci na 1 a minti 15, lokaci na 3 a minti 15). da kuma huɗu a daƙiƙa 15, sannan a kowane minti biyu.) An kwatanta yawan canje-canje na kowane lokaci ta amfani da gwajin Mann-Whitney U saboda bayanan ba su bi rarrabawar al'ada ba kamar yadda gwajin daidaito na Shapiro-Wilk ya ƙaddara. Tunda an yi nazarin ƙungiyoyi da yawa (biyar) sau ɗaya a matakai na farko, na uku da na huɗu (jimilla biyar), an yi gyaran Bonferroni don daidaita ƙimar alpha da ake so zuwa ≤0.01 amma ba ≤0.05 ba.
Rage yawan platelets tare da duk yawan dextrose na hypertonic da ƙaruwar MPV a cikin platelets na PRP a >12.5% ​​yawan dextrose: Yawan platelets na PRP ya tashi daga yawan 1 zuwa sau biyar idan aka kwatanta da jinin gaba ɗaya, ya bambanta ta hanyar da aka saba amfani da ita (ba a nuna ba). Rage yawan platelets tare da duk yawan dextrose na hypertonic da ƙaruwar MPV a cikin platelets na PRP a >12.5% ​​​​yawan dextrose: Yawan platelets na PRP ya tashi daga maida hankali sau ɗaya zuwa sau biyar idan aka kwatanta da jinin gaba ɗaya, ya bambanta ta hanyar hanyar (ba a nuna ba). Уменьшение Уменьшение количества тромбоцитов концентрации декстрозы > 12,5%: количество тромбоцитов PRP увеличилось в 1-5 раз по сравнению сравнению зависимости от метода ( ba tare da izini ba). Rage yawan platelets a duk yawan dextrose na hypertonic da kuma karuwar MPV a cikin platelets na PRP a >12.5% ​​​​yawan dextrose: Yawan platelets na PRP ya karu sau 1-5 idan aka kwatanta da jinin gaba daya, ya danganta da hanyar da aka bi (ba a nuna ba). ).在> Kashi 12.5%增加：与基线全血相比， PRP 血小板计数从浓度的1 上升到5 倍，因方法而异 A yawan glucose da aka samu daga kashi 12.5%, yawan glucose da aka samu yana rage yawan jini, kuma MPV na PRP yana karuwa a jini: idan aka kwatanta da yawan glucose da aka samu daga jini, yawan PRP yana karuwa daga sau 1 zuwa 5 na yawan glucose (ba a bayyana ba). При концентрациях глюкозы > 12.5% ​​все концентрации в тромбоцитах PRP: количество тромбоцитов PRP увеличивалось от 1- до 5-кратных концентраций по сравненищ концентрациями цельной крови, в зависимости от метода (не описано ). A yawan glucose da ya wuce kashi 12.5%, duk yawan glucose da ke cikin jini ya rage yawan platelets da kuma karuwar MPV a cikin platelets na PRP: yawan platelets na PRP ya karu sau 1 zuwa 5 idan aka kwatanta da yawan jinin da ke cikin jini gaba daya, ya danganta da hanyar da aka bayyana (kamar yadda aka bayyana).Siffa ta 1 ta nuna cewa adadin platelets ya ragu da kusan kashi 75% bayan narkewar ruwa a cikin ruwa da kuma kashi 20-30% bayan mintuna 15 na narkewar glucose daban-daban idan aka kwatanta da PRP na asali da kuma narkewar 1:1 da aka daidaita don girma (1- k1 tare da gyaran girma). kiwo k-1).1 kiwo).1 kiwo).
Adadin ƙwayoyin halitta a cikin kowace narkewa ana bayyana shi a matsayin ƙaramin adadin lambar asali kafin narkewar.
MPV ya ragu kaɗan yayin samar da PRP, ba tare da ƙarin canji a yawan narkewar abinci zuwa 12.5% ​​​​a cikin ruwa ko glucose (gami da 25% gaurayen glucose na PRP) ba kuma ya ƙaru da fiye da 20% bayan narke a cikin maganin glucose na 50% (Hoto na .2). Sabanin haka, ƙwayoyin erythrocytes ba su nuna wani babban canji a cikin girma a kowace narkewa banda H2O ba.
Matsakaicin girman ƙwayoyin halitta a cikin kowace narkewa ana bayyana shi a matsayin kashi na girman asali kafin narkewar.
An lura da irin wannan raguwar adadin platelets da ƙaruwar CVR a cikin BC wanda aka fallasa ga 50% glucose (don ƙirƙirar da 25% glucose). Tebur na 2 yana kwatanta lambobin tantanin halitta da yawan tantanin halitta a cikin cikakken jini wanda aka narkar a cikin 50% dextrose tare da bayanan PRP na mataki na 1 da aka narkar a cikin 50% dextrose. Canje-canje a cikin adadin RBC da RBC MCV ba a bayyane suke ba kuma ba su ne abin da muka fi mayar da hankali a kai ba.
SD = karkacewar daidaito, MD = matsakaicin bambanci tsakanin ƙungiyoyi, SE = karkacewar daidaito na matsakaicin bambanci, RBC = erythrocytes, PLT = platelets, PRP = plasma mai wadataccen platelets, WB = jini gaba ɗaya
Bayan ƙara D50W zuwa WB, kashi na asarar platelet da aka daidaita da dilution shine 7.7% (310±73 vs. 286±96) idan aka kwatanta da 17.8% na dilution na PRP a cikin D50W (664±348 vs. 544±277). MPV WB ya ƙaru da 16.8% (daga 10.1 ± 0.5 zuwa 11.8 ± 0.6), yayin da MPV PRP ya ƙaru da 26% (9.2 ± 0.8 vs. 11.6 ± 0.7). Duk da cewa matsakaicin bambance-bambancen da ke tsakanin rage yawan platelets da karuwar MPV sun fi yawa tare da PRP, canje-canje a rage yawan platelets a cikin WB sun kusan zama masu mahimmanci (310 ± 73 zuwa 286 ± 96 (-7.7%); p = .06) kuma karuwar MPV ta kasance mai mahimmanci (10.1 ± 0.5 zuwa 11.8 ± 0.6 (+16.8) p < .001). Duk da cewa matsakaicin bambance-bambancen da ke tsakanin rage yawan platelets da karuwar MPV sun fi yawa tare da PRP, canje-canje a rage yawan platelets a cikin WB sun kusan zama masu mahimmanci (310 ± 73 zuwa 286 ± 96 (-7.7%); p = .06) kuma karuwar MPV ta kasance mai mahimmanci (10.1 ± 0.5 zuwa 11.8 ± 0.6 (+16.8) p < .001).Duk da cewa matsakaicin bambance-bambancen da ke tsakanin rage yawan platelets da karuwar CVR sun fi girma sosai tare da PRP, canje-canje a raguwar adadin platelets a cikin WB sun kusan zama mahimmanci (310 ± 73 zuwa 286 ± 96 (-7.7%); p = 0.06).увеличение MPV было значительным (от 10,1 ± 0,5 da 11,8 ± 0,6 (+16,8) p <0,001). karuwar MPV ta kasance mai mahimmanci (daga 10.1 ± 0.5 zuwa 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内血小板计数减少的变化几乎是显着的（310 ± 73 至286 ± 96 (-7.7%)；p = .06）和MPV的增加是显着的（10.1 ± 0.5 到11.8 ± 0.6 (+16.8) p <.001）。尽管 PRP 在 血小板 计数 和 和 增加 方面 的 平均 差异 显着 大几乎 是 显着 的 （（（310 ± 73 至 286 ± 96 (-7.7%) 0.6 (+16.8) p <.001).Sauyin da aka samu a rage yawan platelets a cikin WB ya kusan zama mai mahimmanci (daga 310 ± 73 zuwa 286 ± 96 (-7.7%); p = 0.06), kodayake PRP yana da manyan bambance-bambancen matsakaici a raguwar adadin platelets da ƙaruwar MPV. kuma ƙaruwar MPV ya kasance mai mahimmanci.(от 10,1 ± 0,5 da 11,8 ± 0,6 (+16,8) р <0,001). (daga 10.1 ± 0.5 zuwa 11.8 ± 0.6 (+16.8) p < 0.001).
An buƙaci yawan glucose na ƙarshe na 20% don ganin babban canji a cikin MPV, amma canjin MPV ya fi bayyana a matakin ƙarshe na 25%. Asarar platelet ta daidaita bayan raguwar farko. Mun lura da raguwar farko a cikin CVR, duk da haka, an dawo da CVR cikin sauri a matakin ƙarshe na glucose na 25%, wanda ya fi girma fiye da matakan CVR da aka gani a matakin ƙarshe na glucose na 20% da 15% (Hoto na 3 da hagu na Tebur na 3; akwatunan inuwa). suna nuna ƙimar p ≤ alpha tare da gyaran Bonferroni na 0.01). Akwai kuma raguwar farko a cikin adadin PLT, wanda aka lura a matakin farko na 0-15 s, sannan ya kasance mai karko (daga 15 s zuwa 30 min; hagu na tebur na 4).
Ƙara yawan glucose daban-daban a cikin jini gaba ɗaya ya haifar da raguwar MPV da sauri, sannan kuma murmurewa ya dogara da yawan glucose fiye da 20%. Labarin ya nuna yawan glucose bayan an narkar da shi. An yi D15, D20 da D25 a cikin narkar da 1:1. An yi D21 da D41 a narkar da 1:5.
Tebur na 4 yana nuna canjin adadin platelet lokacin da aka narkar da shi a cikin glucose mai yawan gaske. Mun lura da alaƙar da ta dogara da kashi tsakanin raguwar lambobin PLT nan take a cikin dilution na 1:1 da kuma dilution na 1:5. Idan aka kwatanta dilution na 1:1 a matsayin rukuni ɗaya tare da dilution na 1:5, ƙungiyar 1:1 ta sami raguwar nan take a cikin adadin platelet ƙasa da ƙungiyar 1:5 66±48,000 (23%) idan aka kwatanta da 99±69,000 (37%). , p = 0.014) a cikin ƙungiyar 1:5. Bayan digo na farko a wurin aunawa na farko, adadin platelet a matsayin kashi na glucose ya daidaita (Hoto na 4).
Idan aka ƙara jini gaba ɗaya zuwa glucose a cikin rabo 1: 1, adadin platelets yana raguwa da kusan kashi 25%. Duk da haka, lokacin da aka ƙara jini gaba ɗaya a rabo 1: 5, raguwar ta fi girma - kusan kashi 50%.
Sakamakon MPV na kashi 41% ya ƙara MPV da sauri kuma ya fi 25% ko 21%. An nuna sakamakon MPV a Hoto na 3. A duk sauran naɗe-naɗen, ba a lura da raguwar farko a MPV ba bayan ƙara 50% na glucose. Lokacin amfani da 25% na glucose (yawan glucose 20.8% a naɗe na ƙarshe), canjin MPV ya yi daidai da canjin 20% na glucose a naɗe-naɗen 1:1 (Hoto na 3). Duk da cewa canje-canje a cikin MPV sun fi girma da farko a naɗe-naɗen 41% fiye da 25%, bambancin MPV tsakanin 41% da 25% bayan mintuna 16 bai ƙara zama mai mahimmanci ba (Tebur na 3, dama). Hakanan abin sha'awa ne cewa 25% na glucose ya ƙara MPV yadda ya kamata fiye da 20.8%.
Wannan binciken in vitro ya tabbatar da wani ɓangare na hasashenmu. Ya nuna yiwuwar rage yawan platelets ta hanyar haɗa dextrose, saurin daidaita platelets zuwa matsanancin hypertonic, da kuma ƙaruwa mai yawa a cikin MPV sakamakon fiye da kashi 25% na yawan dextrose na hypertonic. Ya nuna yiwuwar rage yawan platelets ta hanyar haɗa dextrose, saurin daidaita platelets zuwa matsanancin hypertonic, da kuma ƙaruwa mai yawa a cikin MPV sakamakon fiye da kashi 25% na yawan dextrose na hypertonic. Он показал потенциальный частичный лизис тромбоцитов. Ekstremalnoho гиpertonusa и значительный повышение MPV Ya nuna yiwuwar rage yawan platelets tare da dextrose, saurin daidaitawa da platelets zuwa matsanancin hypertonic, da kuma ƙaruwa mai yawa a cikin MPV sakamakon matakan dextrose na hypertonic sama da kashi 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应极端高帗>2浓度的高渗葡萄糖时MPV 显着上升。它 显示 出 通过 葡萄糖 潜在 的 部分 一小板 溶解响应> 25% 浓度 高渗 葡萄糖 时 时 mpv 显着。。 Он показывает потенциальный частичный. Ekstremalnomu гиpertonusu и значительные увеличение MPV Yana nuna yiwuwar rage yawan platelets ta hanyar haɗakar glucose, saurin daidaitawa da platelets zuwa matsanancin hypertonic, da kuma ƙaruwa mai yawa a cikin MPV sakamakon hypertonic glucose >25%.Karin farko ya kai kashi 41.6% na fallasa glucose, amma karuwar MPV ta kusa kusan kashi 25% na fallasa glucose kimanin mintuna 20 bayan fallasa.
Yawan platelets yana shafar glucose. Mun lura cewa adadin PLT ya ragu a duk wani narkewar glucose. Faɗuwa mai ƙarfi a cikin adadin platelets a cikin H2O (0%) narkewar jerin PRP na iya dangantawa da osmotic lysis. A madadin haka, wannan na iya zama wani abu da ke faruwa sakamakon tarin platelets, amma wannan ya bambanta da rashin canjin MPV a wannan narkewar. Wannan binciken yana nufin cewa wasu platelets suna da matukar damuwa ga hypoosmolarity.
A cikin dukkan narkewar glucose 1: 1, adadin PLT ya ragu da kashi 20-30%, har ma da D5W (hypotonic a 252 mOsm), wanda zai iya nuna takamaiman tasirin glucose wanda ba shi da osmotic, tunda duka PLT da MPV ba su canza ba a ƙaruwar yawan glucose sau uku daga D5W zuwa D25W. A zahiri, yawan PLT ya ɗan ƙaru kaɗan tare da ƙaruwar osmolarity.
Ragewar PLT tsakanin 1:1 da 1:5 na nufin cewa tasirin narkewar ya dogara ne akan yawan glucose na farko da na ƙarshe. Idan ya dogara ne kawai akan yawan glucose na farko, to mutum zai yi tsammanin ganin bambanci a rage PLT tsakanin yawan glucose na 1:1. Amma ba mu yi ba. Idan tasirin lysis ya dogara ne kawai akan yawan glucose na ƙarshe, to ba ma tsammanin bambanci mai yawa tsakanin yawan glucose na 20% 1:1 da kuma yawan glucose na 20.8% 1:5. Duk da haka mun yi hakan.
Idan asarar platelet ta faru saboda lysis na platelet, ana samar da wani ɓangare na lysate, bayan haka ana sakin cytokines da abubuwan da ke haifar da girma zuwa cikin yanayin da ke cikin ƙwayoyin halitta. Nazari da dama sun nuna cewa lysate na platelet kusan yana da tasiri kamar PRP kamar maganin yaduwa [11]. An nuna cewa PRP kanta mafita ce mai tasiri don magance yaduwa [12-14].
Platelets marasa aiki suna zagayawa a cikin siffar faifai da aka ƙarfafa tare da wasu tsare-tsare na ciki. A lokacin kunnawa, suna ɗaukar siffar mai siffar ƙwallo ko amoeba, wanda ke haifar da ƙaruwar girma. Ƙarar girma yana buƙatar ƙaruwa a yankin saman, wanda shine sakamakon fitar da tsarin tubule na buɗe (OCS) da kuma ƙara ƙwayoyin exocytic zuwa membrane. Har yanzu ba a tantance ko ƙaruwar MPV da glucose mai hawan jini ya haifar ya ƙunshi ɗaya ko duka waɗannan hanyoyin ba, amma idan na ƙarshe, to ƙaruwar MPV zai nuna raguwar girma.
Wannan binciken ya nuna cewa yawan sinadarin glucose da ke cikin jini a cikin PRP ko kuma dukkan platelets ya haifar da karuwar MPV cikin mintuna 15 tare da yawan sinadarin glucose da ke cikin jini da kashi 25% da kuma kashi 41.6% bi da bi.
Ƙara yawan ƙwayoyin halittar jini (platelet MPV) na iya faruwa ne sakamakon faɗaɗa ƙwayoyin halittar jini da ke kewaye da su sakamakon kwararar ƙwayoyin halittar jini (calcium). An nuna cewa Liu da abokan aikinsa (Liucose) suna shiga cikin sinadarin calcium ta hanyar hanyar TRPC6 [6]. Hasashenmu shi ne cewa glucose yana haifar da sassauta taruwar ƙwayoyin halittar jini (microtubule), wanda ke haifar da ƙaruwar MPV da kuma fahimtar ƙwayoyin halittar jini (platelet) da/ko kunnawa. Duk da haka, idan aka yi la'akari da sakamakonmu, wannan wani ɓangare ne kawai na labarin. A cikin gwaje-gwajenmu, babu wani taro da ya kai D25W da ya haifar da ƙaruwar MPV. Ganin cewa ba mu gwada fallasar ƙwayoyin halittar jini tsakanin 12.5% ​​da 25% ba, sakamakonmu na mataki na 1 ya nuna cewa akwai yiwuwar samun ƙofa a cikin wannan kewayon yawan ƙwayoyin halittar jini wanda ke haifar da ƙaruwar MPV. Ƙarin gwaji a matakai na 3 da 4 ya nuna cewa kashi 20-25% na glucose ya bayyana a matsayin ƙofa ga wannan, amma har yanzu ba a fayyace dalilin ba.
Mun kuma lura da raguwar kashi 9% a cikin MPV bayan centrifugation. Ba a fayyace ko wannan raguwar MPV ta faru ne saboda manyan platelets da suka makale a cikin RBC Layer na centrifuge ba. Wannan lura na iya zama da mahimmanci ga likitoci domin yana iya nuna cewa platelets na PRP ƙanana ne kuma ba su da yawa.
A wani bincike da aka yi a baya, mun nuna cewa shirye-shiryen PRP ta hanyar amfani da hannu ba shi da tsada [8]. Idan glucose yana sa platelets nama ko PRP su yi tasiri ga kunnawa, ko kuma idan an samar da PRP tare da wasu abubuwan lysate, wannan na iya haɓaka farfadowa da rage buƙatar magani. Saboda haka, haɗin PRP da glucose mai yawan gaske na iya zama mafi inganci fiye da PRP ko glucose kawai.
Bincikenmu yana da kurakurai da dama. Na farko, muna amfani da PRP da aka samu daga hanyoyi daban-daban. Wannan na iya haifar da sakamako masu karo da juna. Na biyu, ba mu iya yin nazarin sinadarai na kowanne daga cikin samfuranmu don tantance ko kunna platelet ya faru daidai ba. Muna so mu auna P-selectin, platelet factor 4, monocytic platelet aggregates, ko wasu alamomin kunna platelet don fahimtar matakin ko kasancewar lalacewar alpha granule, amma wannan ya wuce iyakokin wannan binciken. Na uku, ba mu iya tabbatarwa ta hanyar na'urar microscopy ko wasu hanyoyi cewa karuwar MPV a cikin platelets da glucose ya bayyana ya faru ne saboda tasirin da ke kan tangles na microtubule.
Cakudawar WB ko PRP tare da kashi 25% na glucose ya ƙara MPV, wanda ke nuna farkon kunna platelet, kodayake wannan binciken bai nuna ci gaban tarin ko raguwar granulation ba. Cakudawar glucose mai yawan gaske ta haifar da asarar platelet, wataƙila tana wakiltar tasirin lytic. Kunnawa ko lysis na platelets na iya haifar da sake farfaɗo da nama bayan allurar platelet. Ba a fayyace irin sakamakon asibiti da waɗannan canje-canjen za su iya haifarwa ba. Ƙarin bincike sun nuna ma'aunin kunnawa ko lysis mafi daidaito kuma sun kimanta tasirin asibiti daban-daban na gaurayen glucose masu yawan gaske tare da WB ko PRP.
Maganin yawan sukari magani ne mai sauƙi kuma mai araha wanda ke faɗaɗa cikin sauri kuma yana tallafawa binciken asibiti. Wannan binciken ya nuna wata hanyar ilimin halittar jiki wadda, idan aka tabbatar, za ta iya taimaka mana mu fahimci wani ɓangare na hanyar sake farfaɗowa ta hanyar rage yawan sukari.
Biomedical and Health Informationtics a Jami'ar Missouri, Kansas City School of Medicine, Kansas City, Amurka
Mutanen da ke cikin wannan binciken: Duk waɗanda suka halarci wannan binciken sun bayar ko ba su ba da izini ba. Ƙungiyar Duniya don Magungunan Kwayoyin Halitta ta bayar da amincewar ICMS-2017-003. An amince da wannan yarjejeniya don ci gaba da amfani da ita ta Hukumar Bita ta Ƙungiyar Duniya don Magungunan Kwayoyin Halitta: Take: Lissafin yawan magungunan plasma masu wadataccen platelet bisa ga ƙididdigar platelet na CBC na asali. Mutanen da ke cikin Dabbobi: Duk marubutan sun tabbatar da cewa babu dabbobi ko kyallen takarda da ke cikin wannan binciken. Rikice-rikicen Sha'awa: Dangane da Tsarin Bayyanawa na ICMJE Uniform Disclosure, duk marubutan sun bayyana waɗannan: Bayanin biyan kuɗi/sabis: Duk marubutan sun bayyana cewa ba su sami tallafin kuɗi daga kowace ƙungiya don aikin da aka gabatar ba. Hulɗar Kuɗi: Duk marubutan sun bayyana cewa a halin yanzu ko a cikin shekaru uku da suka gabata ba su da alaƙar kuɗi da kowace ƙungiya da za ta iya sha'awar aikin da aka gabatar. Sauran Hulɗa: Duk marubutan sun bayyana cewa babu wasu alaƙa ko ayyuka da za su iya shafar aikin da aka gabatar.
Harrison TE, Bowler J, Reeves K da sauransu. (17 ga Mayu, 2022) Tasirin glucose akan adadin platelets da girma: tasirin maganin sake farfaɗowa. Maganin 14(5): e25081. doi:10.7759/cureus.25081
© Haƙƙin mallaka 2022 Harrison da sauransu. Wannan wani labari ne da aka rarraba a ƙarƙashin sharuɗɗan Lasisin Haƙƙin mallaka na Creative Commons CC-BY 4.0. An yarda da amfani, rarrabawa, da kuma sake bugawa ba tare da iyaka ba a kowace hanya, muddin an ba da lada ga marubucin asali da kuma tushensa.