"Tsis txhob ua xyem xyav tias ib pawg me me ntawm cov pej xeem uas xav txog thiab mob siab rau lawv lub neej muaj peev xwm hloov lub ntiaj teb. Qhov tseeb, nws yog tib tug xwb nyob ntawd."
Cureus lub hom phiaj yog hloov tus qauv luam tawm kev kho mob uas tau muaj ntev los lawm, uas kev xa cov kev tshawb fawb tuaj yeem kim heev, nyuaj, thiab siv sijhawm ntau.
Platelet-rich plasma/prp, kev tsim cov ntaub so ntswg tshiab, platelet activation, glucose proliferative therapy, platelets, proliferative therapy
Hais txog tsab xov xwm no li: Harrison TE, Bowler J, Reeves K, et al. (Tsib Hlis 17, 2022) Cov nyhuv ntawm cov piam thaj rau cov ntshav platelet thiab ntim: cov txiaj ntsig rau kev kho mob rov qab. Kev kho 14 (5): e25081. doi: 10.7759 / cureus.25081
Cov ntshav uas muaj cov ntshav ntau (PRP) thiab cov kua nplaum hypertonic glucose feem ntau siv rau kev txhaj tshuaj hauv kev kho mob rov qab, qee zaum ua ke. Cov nyhuv ntawm hypertonic glucose rau kev lysis thiab kev ua haujlwm tsis tau tshaj tawm ua ntej. Peb tau sim cov nyhuv ntawm cov ntshav qabzib ntau ntxiv rau cov ntshav platelet thiab erythrocyte, nrog rau cov cell hauv PRP thiab cov ntshav tag nrho (WB). Kev txo qis ib feem ntawm cov ntshav platelet tau tshwm sim nrog txhua qhov sib xyaw glucose sib xyaw nrog PRP lossis cov ntshav tag nrho, sib xws nrog kev lysis ib feem. Tom qab thawj feeb, cov platelets tseem ruaj khov, qhia txog kev hloov pauv sai ntawm cov platelets seem mus rau qhov siab tshaj plaws (> 2000 mOsm) hypertonicity. Tom qab thawj feeb, cov platelets tseem ruaj khov, qhia txog kev hloov pauv sai ntawm cov platelets seem mus rau qhov siab tshaj plaws (> 2000 mOsm) hypertonicity. После первой минуты количество тромбоцитов оставалось стабильным, что указывает на быструю акхомтода тромбоцитов до экстремального (> 2000 мосм) гипертонуса. Tom qab thawj feeb, cov platelets tseem ruaj khov, qhia txog kev hloov pauv sai ntawm cov platelets seem mus rau qhov siab tshaj plaws (> 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(> 2000 mOsm 灶端)2000 mOsm) 高渗状态. После первой минуты количество тромбоцитов оставалось стабильным, что указывает на быструх адаптсциюты тромбоцитов к экстремальному (> 2000 мОсм) гиперосмолярному состоянию. Tom qab thawj feeb, cov platelets tseem ruaj khov, qhia txog kev hloov pauv sai ntawm cov platelets seem mus rau qhov siab tshaj plaws (> 2000 mOsm) hyperosmolar xeev.Qhov muaj cov piam thaj ntau ntawm 25% thiab siab dua ua rau muaj kev nce ntxiv ntawm cov ntshav platelet nruab nrab (MPV), qhia txog theem pib ntawm kev ua haujlwm ntawm cov ntshav platelet. Yuav tsum muaj kev tshawb fawb ntxiv los txiav txim siab seb cov ntshav platelet lysis lossis kev ua haujlwm puas tshwm sim thiab seb kev txhaj tshuaj hypertonic glucose ib leeg lossis ua ke nrog PRP puas tuaj yeem muab cov txiaj ntsig ntxiv rau kev kho mob.
Xyoo 1950, kws phais neeg Asmeskas George Hackett tau tshawb pom tias nws tuaj yeem pab txo qhov mob pob qij txha thiab mob nraub qaum rau ntau tus neeg mob los ntawm kev txhaj tshuaj proliferative rau hauv cov leeg thiab cov leeg. Nws cov kev sim ntawm cov luav tau qhia tias kev kho mob, uas nws hu ua proliferative therapy, ua rau cov leeg loj hlob thiab muaj zog. Cov kev tshawb fawb histological tau lees paub tias collagen tshiab tau tsim tawm thaum lub sijhawm no [1].
Thaum ob peb xyoo caum thawj zaug, ntau txoj kev faib khoom sib txawv tau sim. Los ntawm xyoo 1990, feem ntau cov kws kho mob xav tias cov piam thaj ntau yog txoj hauv kev nyab xeeb tshaj plaws thiab zoo tshaj plaws. Txawm li cas los xij, txoj hauv kev ua haujlwm tseem tsis meej.
Muaj ob peb txoj kev tshawb fawb hauv xyoo pua 20th tom qab Hackett txoj haujlwm. Txawm li cas los xij, xyoo 2000s muaj kev txaus siab dua thiab ntau qhov kev sim tshuaj kho mob zoo tau ua tiav rau kev kho mob qhov mob nraub qaum qis [2], osteoarthritis ntawm lub hauv caug [3], thiab lateral epicondylitis [4].
Kev tsim cov nqaij tshiab yuav tsum muaj cov hlwb noob (stem cells). Yog li ntawd, cov piam thaj ntau yuav tsum ua rau muaj kev tsiv teb tsaws chaw, kev rov ua dua, thiab kev sib txawv ntawm cov hlwb noob. Peb xav tias cov platelets yuav ua haujlwm ua cov neeg xa xov thiab tias cov piam thaj ntau yuav ua rau cov platelets tso tawm cov cytokines thiab cov yam ntxwv loj hlob, yog li txhawb cov txheej txheem rov ua dua tshiab, tshwj xeeb tshaj yog cov hlwb noob tsiv teb tsaws chaw mus rau thaj chaw uas muaj cov piam thaj ntau.
Kev ua kom cov platelet ua haujlwm ib txwm ua ntej qhov nce ntawm cov calcium hauv cov hlwb [5]. Liu et al. xyoo 2008 tau qhia tias cov ntshav qab zib ntau ntxiv ua rau muaj kev ua haujlwm ntawm cov transient receptor potential canonical type 6 (TRPC6) channels hauv cov plasma membrane, uas ua rau muaj calcium ions nkag mus rau hauv cov platelets [6]. Lwm txoj kev tshawb fawb tau qhia tias kev raug rau thaj tsam microtubule marginal rau calcium ions ua rau so, nthuav dav, thiab deformation ntawm thaj tsam marginal, uas ua rau muaj kev hloov pauv ntawm cov duab los ntawm disc mus rau spherical, ua rau muaj qhov nruab nrab platelet ntim (MPV) [7].
Peb lub tswv yim hauv txoj kev tshawb fawb no yog tias kev raug cov platelets rau cov ntshav qabzib ntau ntau cuam tshuam rau thaj chaw microtubule marginal thiab intracellular ib puag ncig, ua rau muaj kev nce ntxiv hauv MPV.
Txhua tus neeg koom nrog tau kos npe rau daim ntawv tso cai tom qab piav qhia txog cov ntsiab lus ntawm txoj kev tshawb fawb thiab ua ntej tau txais cov qauv. Hauv txoj kev tshawb fawb no, tsuas yog siv cov qauv PRP nrog cov hematocrit ntau dua 2% kom suav cov ntshav liab (erythrocyte) thiab qhov nruab nrab ntawm cov qe ntshav liab (MCV) tuaj yeem suav nrog rau kev sib piv.
Txoj kev tshawb fawb tau ua nyob rau hauv plaub theem, thawj theem yog PRP thiab cov theem seem yog cov ntshav tag nrho (Rooj 1). Raws li tau piav qhia ua ntej [8], txhua lub zog centrifugal (RCF, g-force) tau suav los ntawm qhov nruab nrab (Rmid, hauv cm) ntawm cov ntshav kem hauv lub centrifugal syringe. Peb tau xaiv siv MPV ua lub cim ntawm platelet sensitization thiab platelet suav ua lub cim qhia txog qhov muaj peev xwm platelet lysis, ob qho tib si tuaj yeem ntsuas tau yooj yim ntawm cov qauv hematology analyzers.
Hauv thawj theem, 47 tus neeg ua haujlwm pab dawb tau pub cov qauv ntshav—ib lub raj ntawm ethylenediaminetetraacetic acid (EDTA) thiab ib qho qauv ntshav tag nrho PRP (anticoagulated nrog sodium citrate (NaCl, 3%)) (Rooj 1). Muab lub rocker tso rau hauv lub raj tam sim ntawd. Kev suav ntshav tag nrho (CBC) tau ua tiav rau cov qauv EDTA hauv peb daim, thiab cov qauv NaCl tau soj ntsuam hauv peb daim rau kev soj ntsuam CBC, thiab tom qab ntawd PRP tau npaj los ntawm ntau txoj kev piav qhia saum toj no [8]. Tag nrho cov qauv PRP tau npaj los ntawm centrifugation ntawm 900–1000 g. Sib tov txhua tus qauv PRP ntawm lub vortex mixer rau 5–10 vib nas this, tom qab ntawd faib tsib 0.5 ml aliquots rau hauv cov raj.
Txhawm rau soj ntsuam qhov cuam tshuam ntawm platelet raug rau cov piam thaj ntau ntxiv, cov nyiaj sib npaug (0.5 ml) ntawm 0%, 5%, 12.5%, 25%, thiab 50% qabzib hauv dej tau sib xyaw nrog cov qauv platelet kom tau txais 0%, 2.5% 6.25%, 12.5% ​​thiab 25% ntawm cov piam thaj sib xyaw thiab sib tov cov raj ntawm lub raj ntsuas shaker rau 15 feeb. TAC ntawm txhua qhov sib xyaw tau soj ntsuam hauv triplicate tom qab 15 feeb. Platelet suav (PLT), RBC suav, MCV, thiab MPV tau nruab nrab rau txhua lub raj, thiab nruab nrab platelet suav, RBC suav, MCV, thiab MPV tau suav rau txhua tus qauv PRP.
Tom qab thawj theem ntawm kev sau cov ntaub ntawv tiav lawm, peb pom tias muaj kev nce ntxiv ntawm cov platelets hauv PRP platelets tom qab ntxiv D50W. PRP platelets tsis tas yuav sawv cev rau txhua cov platelets hauv cov ntshav, thiab PRP nruab nrab txawv ntawm WB nruab nrab. Yog li ntawd, peb tau txiav txim siab ua qhov kev sim theem ob ntawm cov nyhuv ntawm kev ntxiv D50W rau tag nrho cov ntshav.
Rau qhov kev ntsuam xyuas thib ob, peb tau xaiv qhov loj me ntawm 30 raws li cov txiaj ntsig los ntawm thawj koob, raws li tau piav qhia hauv ntu Kev Tshuaj Xyuas. Hauv cov koob no, 20 tus neeg ua haujlwm pab dawb tau pub cov qauv ntshav (Rooj 1). Cov ntshav tag nrho (1.8 ml) tau raug rub rau hauv lub koob txhaj tshuaj 3 ml thiab anticoagulated nrog 0.2 ml 40% NaCl. Lub koob txhaj tshuaj ntshav tag nrho tau sib xyaw rau tsib vib nas this nrog lub vortex mixer thiab CBC tau raug soj ntsuam ua peb zaug. Tom qab kev soj ntsuam, cov ntshav anticoagulated tau ntxiv rau 2 ml ntawm 50% glucose hauv lub koob txhaj tshuaj 5 ml (qhov kawg glucose concentration yog kwv yees li 25% (D25) thiab muab tso rau hauv lub raj co rau 30 feeb. Tom qab 30 feeb, D25/CBC hauv WB koob txhaj tshuaj tau raug soj ntsuam ua peb zaug. Platelet suav, RBC suav, MCV, thiab MPV ib lub koob txhaj tshuaj tau raug nruab nrab, thiab nruab nrab PLT, RBC suav, MCV, thiab MPV tau raug suav rau txhua tus qauv ua ntej thiab tom qab ntxiv glucose.
Vim tias cov platelets hauv cov ntshav tag nrho feem ntau raug rau hypertonic glucose thaum lub sijhawm kho mob proliferative glucose vim yog kev txhaj tshuaj tsawg kawg nkaus, thiab nws tsis yog ib txwm muaj los sib xyaw PRP nrog hypertonic glucose ua ntej txhaj tshuaj, peb txiav txim siab los kawm hypertonic glucose ua ke nrog WB hauv Ntu 1. Kauj Ruam Peb thiab plaub. Ntawm txhua theem, 20 tus neeg ua haujlwm pab dawb tau pub 7-8 ml ntawm ACD-A (kua qaub uas muaj trisodium citrate (22.0 g / l), citric acid (8.0 g / l) thiab glucose (24.5 g / l), kua dextrose citrate) rau cov ntshav anticoagulants (Rooj 1). Tsuas yog cov khoom sib xyaw ntawm glucose ntau dua 12.5% ​​tau siv los txiav txim siab qhov feem pua ​​​​​​ntawm qhov cuam tshuam nrog kev nce hauv MPV. Ntawm theem peb, 1 ml ntawm cov ntshav tau muab tso rau hauv lub raj kuaj. Tom qab ntawd, muab cov ntshav sib tov rau ntawm lub tshuab sib tov vortex rau 10 vib nas this los ntawm kev ntxiv 1 ml ntawm 30% glucose, 40% glucose, lossis 50% glucose rau hauv lub raj kom tau qhov concentration ntawm glucose kawg ntawm 15%, 20%, thiab 25%, raws li. Cov qauv ntshav glucose tau raug soj ntsuam rau CBC tam sim ntawd tom qab sib tov thiab rov ua dua txhua ob feeb rau 30 feeb.
Thaum lub sijhawm sib tov thawj zaug, qhov ntxiv ntawm 1:1 hypertonic glucose thiab WB lossis PRP ua rau cov platelets raug cov concentration siab tshaj 25% rau ob peb vib nas this. Hauv kauj ruam thib plaub, los ntsuam xyuas qhov cuam tshuam ntawm hypertonic glucose nrog qhov tsawg kawg nkaus pib qhov siab tshaj plaws thiab sim qhov txwv siab tshaj plaws ntawm cov nyhuv ntawm glucose, peb tsuas yog ntxiv me ntsis ntshav rau D25W lossis D50W. Muab 1 ml ntawm D25W lossis D50W rau hauv ib lub raj thiab ntxiv 0.2 ml ntawm WB thaum vortexing cov qauv rau 10 vib nas this. Hauv cov xwm txheej no, cov ntshav tau raug rau glucose ntawm qhov concentration kwv yees li 20% siab dua qhov concentration kawg, es tsis yog 50% siab dua qhov concentration kawg zoo li hauv Theem 3, ua rau qhov concentration kawg ntawm glucose ntawm 20.8% thiab 41.6%. Cov qauv sib xyaw tau soj ntsuam tib lub sijhawm zoo li hauv kauj ruam 3.
Hauv thawj kauj ruam ntawm txhua qhov kev ntsuas qabzib, 30 cov qauv tau coj mus vim qhov no yog qhov loj me ntawm cov qauv tsim nyog rau kev tshawb fawb sim [9]. Thaum kawg ntawm txhua theem (suav nrog thawj theem), ntsuas qhov txaus ntawm qhov loj me ntawm cov qauv siv cov mis siv los txiav txim siab qhov loj me ntawm cov qauv xav tau los kwv yees qhov nruab nrab ntawm qhov sib txawv ntawm qhov tshwm sim tas mus li hauv ib pawg neeg. Cov mis n = Z2 x SD2 /E2. Hauv kab zauv no, Z yog Z-qhab nia, SD yog qhov sib txawv ntawm tus qauv, thiab E yog qhov yuam kev xav tau [10]. Peb tus alpha yog 0.05, uas sib raug rau tus nqi Z ntawm 1.96, thiab peb xav tias qhov yuam kev ntawm 5 (hauv feem pua). Yog li ntawd peb daws rau n = (1.962 x SD2) / 52. Cov txiaj ntsig tau qhia tias qhov loj me ntawm cov qauv xav tau rau txhua theem yog me dua li tus lej tiag tiag uas tau sau.
Thaum lub sijhawm 1, 3 thiab 4 siv ntau dua ib qho glucose concentration, qhov cuam tshuam ntawm cov glucose concentration sib txawv tau soj ntsuam los ntawm kev sib piv qhov kev hloov pauv ntawm lub sijhawm 0 thiab txhua lub sijhawm tom qab (theem 1 ntawm 15 feeb, lub sijhawm 3 ntawm 15 feeb). thiab plaub ntawm 15 vib nas this, tom qab ntawd txhua ob feeb.) Cov nqi hloov pauv rau txhua lub sijhawm tau sib piv siv Mann-Whitney U-test vim tias cov ntaub ntawv tsis ua raws li kev faib tawm ib txwm raws li txiav txim siab los ntawm Shapiro-Wilk normality test. Txij li thaum kev tshuaj xyuas 1-rau-1 ntawm ntau pawg (tsib) tau ua tiav hauv thawj, thib peb thiab thib plaub kauj ruam (tsib tag nrho), kev kho Bonferroni tau ua tiav los kho qhov xav tau alpha tus nqi rau ≤0.01 tab sis tsis yog ≤0.05.
Kev txo qis ntawm cov platelet suav nrog txhua qhov kev sib xyaw ntawm hypertonic dextrose thiab kev nce ntxiv ntawm MPV hauv PRP platelets ntawm >12.5% ​​dextrose concentration: PRP platelet suav tau nce ntawm ib mus rau tsib zaug concentration piv rau cov ntshav tag nrho, sib txawv los ntawm txoj kev (tsis tau piav qhia). Kev txo qis ntawm cov platelet suav nrog txhua qhov kev sib xyaw ntawm hypertonic dextrose thiab kev nce ntxiv ntawm MPV hauv PRP platelets ntawm >12.5% ​​​​​​dextrose concentration: PRP platelet suav tau nce los ntawm ib mus rau tsib zaug concentration piv rau cov ntshav tag nrho, sib txawv los ntawm txoj kev (tsis tau piav qhia). Уменьшение количества тромбоцитов при всех концентрациях гипертонической декстрозы и увеличение MPV концентрации декстрозы > 12,5%: количество тромбоцитов PRP увеличилось в 1-5 раз по сравонению свльцейхо зависимости от метода (не показано). Txo cov platelet suav ntawm txhua qhov hypertonic dextrose concentration thiab nce MPV hauv PRP platelets ntawm >12.5% ​​​​dextrose concentration: PRP platelet suav nce 1-5 zaug piv rau cov ntshav tag nrho, nyob ntawm txoj kev (tsis tau qhia). ).在> 12.5% ​​ntawm kev lag luam kev lag luam, PRP 血小板中MPV增加：与基线全血相比，PRP 血小板计数从浓度的1倍上升到5倍，因方法而异（迪）. Thaum muaj cov piam thaj ntau dua 12.5%, qhov muaj cov piam thaj ntau ua rau cov ntshav tsawg dua, PRP cov ntshav MPV nce ntxiv: piv rau 与基线全血, cov ntshav PRP nce ntxiv ntawm 1 txog 5 npaug ntawm qhov muaj cov piam thaj ntau (tsis tau piav qhia). При концентрациях глюкозы > 12,5% все концентрации гипертонической глюкозы снижали количестовы швитом, тромбоцитах PRP: количество тромбоцитов PRP увеличивалось от 1- до 5-кратных концентраций по сравнисью концентрациями цельной крови, в зависимости от метода (не описано ). Thaum cov ntshav qabzib ntau dua 12.5%, tag nrho cov ntshav qabzib ntau hauv cov ntshav siab txo cov ntshav platelet thiab nce MPV hauv PRP platelets: PRP platelet suav nce 1- txog 5-npaug piv rau cov ntshav tag nrho, nyob ntawm txoj kev (raws li tau piav qhia).Daim Duab 1 qhia tau hais tias tus naj npawb ntawm cov platelets txo qis yuav luag 75% tom qab dilution hauv dej thiab los ntawm 20-30% tom qab 15 feeb ntawm dilution nrog cov concentration sib txawv ntawm glucose piv rau baseline PRP thiab 1: 1 dilution kho rau ntim (1- k1 nrog kev kho ntim). k -1 yug me nyuam).1 yug me nyuam).
Tus naj npawb ntawm cov cell hauv txhua qhov kev dilution yog qhia ua ib feem ntawm tus lej qub ua ntej kev dilution.
MPV txo qis tsawg kawg nkaus thaum lub sijhawm tsim PRP, tsis muaj kev hloov pauv ntxiv hauv cov concentration dilution mus rau 12.5% ​​​​hauv dej lossis glucose (suav nrog 25% PRP glucose sib xyaw) thiab nce ntau dua 20% tom qab dilution hauv 50% glucose kua (Daim duab .2). Qhov sib piv, erythrocytes tsis pom muaj kev hloov pauv tseem ceeb hauv qhov ntim ntawm txhua qhov dilution lwm yam tshaj li H2O.
Qhov nruab nrab ntawm cov cell hauv txhua qhov kev dilution yog qhia ua feem pua ​​ntawm qhov ntim thawj ua ntej dilution.
Ib qho kev txo qis zoo sib xws tab sis tsis tshua pom tseeb hauv cov ntshav platelet thiab kev nce ntxiv hauv CVR tau pom hauv BC raug rau 50% glucose (los tsim nrog 25% glucose). Rooj 2 piv cov lej cell thiab cov ntim cell hauv cov ntshav tag nrho diluted hauv 50% dextrose nrog theem 1 PRP cov ntaub ntawv diluted hauv 50% dextrose. Kev hloov pauv hauv RBC suav thiab RBC MCV tsis pom tseeb thiab tsis yog qhov tseem ceeb ntawm peb qhov kev saib xyuas.
SD = tus qauv sib txawv, MD = qhov sib txawv nruab nrab ntawm cov pab pawg, SE = tus qauv sib txawv ntawm qhov sib txawv nruab nrab, RBC = erythrocytes, PLT = platelets, PRP = platelet nplua nuj plasma, WB = tag nrho cov ntshav
Tom qab ntxiv D50W rau WB, qhov feem pua ​​ntawm cov platelet poob uas tau kho los ntawm kev dilution yog 7.7% (310 ± 73 vs. 286 ± 96) piv rau 17.8% rau PRP dilution hauv D50W (664 ± 348 vs. 544 ± 277). MPV WB nce 16.8% (los ntawm 10.1 ± 0.5 txog 11.8 ± 0.6), thaum MPV PRP nce 26% (9.2 ± 0.8 vs. 11.6 ± 0.7). Txawm hais tias qhov sib txawv nruab nrab ntawm ob qho kev txo qis ntawm cov ntshav platelet thiab kev nce MPV ntau dua nrog PRP, qhov kev hloov pauv ntawm kev txo qis ntawm cov ntshav platelet hauv WB yuav luag tseem ceeb (310 ± 73 txog 286 ± 96 (-7.7%); p = .06) thiab qhov nce ntawm MPV tseem ceeb (10.1 ± 0.5 txog 11.8 ± 0.6 (+16.8) p < .001). Txawm hais tias qhov sib txawv nruab nrab ntawm ob qho kev txo qis ntawm cov ntshav platelet thiab kev nce MPV ntau dua nrog PRP, qhov kev hloov pauv ntawm kev txo qis ntawm cov ntshav platelet hauv WB yuav luag tseem ceeb (310 ± 73 txog 286 ± 96 (-7.7%); p = .06) thiab qhov nce ntawm MPV tseem ceeb (10.1 ± 0.5 txog 11.8 ± 0.6 (+16.8) p < .001).Txawm hais tias qhov sib txawv nruab nrab ntawm ob qho kev txo qis ntawm cov ntshav platelet thiab CVR ​​nce ntxiv ntau dua nrog PRP, kev hloov pauv ntawm cov ntshav platelet poob qis hauv WB yuav luag tseem ceeb (310 ± 73 txog 286 ± 96 (-7.7%); p = 0.06).увеличение MPV было значительным (los ntawm 10,1 ± 0,5 rau 11,8 ± 0,6 (+16,8) p < 0,001). qhov kev nce ntxiv ntawm MPV yog qhov tseem ceeb (los ntawm 10.1 ± 0.5 txog 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的更多内容11.8 ± 0.6 (+ 16.8) p < .001).尽管 PRP 在 血小板 计数 和 增加 方面的 平均 差异 显着的 大， 但 但内血宏氿几乎是显着的（（310 ± 73至 286 ± 96 (-7.7%)）； p = .06）和MPV的增加是显着的（10.1 ± 1.5） p = 10.5 <.001).Qhov kev hloov pauv ntawm cov ntshav platelet txo qis hauv WB yog qhov tseem ceeb (los ntawm 310 ± 73 txog 286 ± 96 (-7.7%); p = 0.06), txawm hais tias PRP muaj qhov sib txawv loj dua ntawm cov ntshav platelet txo qis thiab MPV nce. thiab qhov nce ntawm MPV yog qhov tseem ceeb.(los ntawm 10,1 ± 0,5 до 11,8 ± 0,6 (+16,8) р < 0,001). (txij li 10.1 ± 0.5 txog 11.8 ± 0.6 (+16.8) p < 0.001).
Yuav tsum muaj qhov concentration kawg ntawm 20% glucose kom pom qhov kev hloov pauv tseem ceeb hauv MPV, tab sis qhov kev hloov pauv hauv MPV tau pom tseeb dua ntawm qhov concentration kawg ntawm 25%. Platelet poob ruaj khov tom qab qhov poob qis thawj zaug. Peb tau pom tias qhov kev txo qis thawj zaug hauv CVR, txawm li cas los xij, CVR tau rov qab los sai sai ntawm 25% qhov concentration glucose kawg, uas siab dua li cov qib CVR ​​pom ntawm qhov concentration glucose kawg ntawm 20% thiab 15% (Daim Duab 3 thiab sab laug ntawm Rooj 3; cov thawv duab ntxoov ntxoo). qhia p-nqis ​​≤ alpha nrog Bonferroni kho ntawm 0.01). Kuj tseem muaj qhov poob qis thawj zaug hauv tus lej ntawm PLT, pom nyob rau theem pib ntawm 0-15 s, thiab tom qab ntawd tseem ruaj khov (los ntawm 15 s txog 30 feeb; sab laug ntawm Rooj 4).
Qhov ntxiv ntawm ntau yam kev sib xyaw ntawm cov piam thaj rau hauv cov ntshav tag nrho ua rau thawj zaug txo qis sai hauv MPV ua raws li kev rov qab los ntawm kev sib xyaw ntau dua 20%. Cov lus dab neeg qhia txog kev sib xyaw ntawm cov piam thaj tom qab dilution. D15, D20 thiab D25 tau ua tiav hauv 1: 1 dilution. D21 thiab D41 tau ua tiav ntawm 1: 5 dilution.
Rooj 4 qhia txog kev hloov pauv ntawm cov platelet suav thaum diluted hauv hypertonic glucose. Peb pom muaj kev sib raug zoo ntawm cov koob tshuaj ntawm qhov poob tam sim ntawd hauv cov lej PLT ntawm 1: 1 dilution thiab ntawm 1: 5 dilution. Piv cov 1: 1 dilutions ua ib pawg nrog 1: 5 dilutions, pawg 1: 1 muaj qhov txo qis tam sim ntawd hauv cov platelet suav tsawg dua li pawg 1: 5 66 ± 48,000 (23%) piv rau 99 ± 69,000 (37%). , p = 0.014) hauv pawg 1: 5. Tom qab poob thawj zaug ntawm qhov ntsuas thawj zaug, cov platelet suav ua feem pua ​​​​​​ntawm glucose ruaj khov (Daim duab 4).
Thaum ntxiv cov ntshav tag nrho rau hauv cov piam thaj hauv qhov sib piv 1:1, cov ntshav platelet yuav txo qis li ntawm 25%. Txawm li cas los xij, thaum ntxiv cov ntshav tag nrho ntawm qhov sib piv 1:5, qhov kev txo qis ntau dua - li ntawm 50%.
41% qabzib ua rau MPV nce sai dua thiab ntau dua li 25% lossis 21%. Cov txiaj ntsig MPV tau pom hauv Daim Duab 3. Ntawm txhua qhov kev txo qis, tsis muaj kev txo qis tam sim ntawd hauv MPV tau pom tom qab ntxiv 50% qabzib. Thaum siv 25% qabzib (glucose concentration 20.8% ntawm qhov kev txo qis kawg), qhov kev hloov pauv hauv MPV zoo ib yam li qhov kev hloov pauv hauv 20% qabzib ntawm 1: 1 dilution (Daim Duab 3). Txawm hais tias kev hloov pauv hauv MPV thaum pib loj dua ntawm 41% sib xyaw concentration dua li ntawm 25%, qhov sib txawv hauv MPV ntawm 41% thiab 25% tom qab 16 feeb tsis tseem ceeb lawm (Rooj 3, sab xis). Nws kuj tseem ceeb tias 25% qabzib ua rau MPV nce zoo dua li 20.8%.
Qhov kev tshawb fawb hauv vitro no ib feem lees paub peb qhov kev xav. Nws tau qhia txog qhov ua tau ntawm kev lysis ib feem ntawm cov platelet los ntawm dextrose admixture, kev hloov pauv sai ntawm cov platelets mus rau hypertonicity heev, thiab kev nce ntxiv ntawm MPV los teb rau > 25% concentration ntawm hypertonic dextrose. Nws tau qhia txog qhov ua tau ntawm kev lysis ib feem ntawm cov platelet los ntawm dextrose admixture, kev hloov pauv sai ntawm cov platelets mus rau hypertonicity heev, thiab kev nce ntxiv ntawm MPV los teb rau > 25% concentration ntawm hypertonic dextrose. Он показал потенциальный частичный лизис тромбоцитов примесью декстрозы, быструю аккомодацию тромьроците гипертонуса и значительное повышение MPV в ответ на гипертоническую концентрацию декстрозы > 25%. Nws tau qhia txog qhov ua tau ntawm kev lysis ib feem ntawm cov platelet nrog dextrose, kev hloov pauv sai ntawm cov platelet mus rau hypertonicity heev, thiab kev nce ntxiv ntawm MPV los teb rau cov hypertonic dextrose theem >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鍔帗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 血小板 溶解 血小板 快速 适应 极縫櫗响应> 25% 浓度 高渗 葡萄糖 时时 mpv 显着。。。。 Он показывает потенциальный частичный лизис тромбоцитов смесями с глюкозой, быструю адаптацию тром боцин гипертонусу и значительное увеличение MPV в ответ на концентрацию гипертонической глюкозы > 25%. Nws qhia tau tias muaj peev xwm lysis ib feem ntawm cov platelet los ntawm cov khoom sib xyaw glucose, platelet hloov kho sai rau hypertonicity heev, thiab nce ntxiv ntawm MPV hauv kev teb rau hypertonic glucose >25%.Qhov nce thawj zaug yog qhov siab tshaj plaws ntawm 41.6% kev raug mob ntshav qab zib, tab sis qhov nce ntawm MPV tau mus txog 25% kev raug mob ntshav qab zib li ntawm 20 feeb tom qab raug mob.
Qhov concentration ntawm cov platelets raug cuam tshuam los ntawm glucose. Peb pom tias qhov ntau ntawm PLT txo qis ntawm txhua qhov kev dilutions ntawm glucose. Kev poob qis ntawm cov platelets hauv H2O (0%) dilutions ntawm PRP series tej zaum yuav cuam tshuam nrog osmotic lysis. Xwb, qhov no yuav yog ib qho khoom cuav los ntawm platelet clumping, tab sis qhov no yog qhov sib txawv rau qhov tsis muaj MPV hloov pauv ntawm qhov kev dilution no. Qhov kev tshawb pom no txhais tau tias qee cov platelets muaj kev nkag siab heev rau hypoosmolarity.
Hauv txhua qhov kev sib xyaw ua ke ntawm cov piam thaj hauv cov ntshav 1:1, qhov ntau ntawm PLT txo qis los ntawm 20-30%, txawm tias los ntawm D5W (hypotonic ntawm 252 mOsm), uas tej zaum yuav qhia txog qhov cuam tshuam tshwj xeeb tsis yog osmotic ntawm cov piam thaj, vim tias ob qho tib si PLT thiab MPV tseem tsis hloov pauv ntawm qhov nce peb zaug hauv qhov concentration. glucose. los ntawm D5W txog D25W. Qhov tseeb, PLT concentrations feem ntau nce me ntsis nrog kev nce osmolarity.
Qhov txo qis hauv PLT ntawm 1: 1 thiab 1: 5 dilutions txhais tau tias qhov cuam tshuam ntawm kev yaj nyob ntawm qhov pib thiab qhov kawg glucose concentration. Yog tias nws tsuas yog nyob ntawm qhov pib concentration, ces ib tug yuav xav pom qhov sib txawv hauv PLT txo qis ntawm 1: 1 concentration. Tab sis peb tsis ua. Yog tias qhov cuam tshuam lysis tsuas yog nyob ntawm qhov kawg glucose concentration, ces peb tsis xav tias yuav muaj qhov sib txawv ntau ntawm 20% 1: 1 dilution thiab 20.8% 1: 5 dilution. Thiab tseem peb tau ua nws.
Yog tias cov platelet poob vim yog platelet lysis, ib feem lysate raug tsim, tom qab ntawd cytokines thiab cov yam ntxwv loj hlob raug tso tawm mus rau hauv ib puag ncig extracellular. Ntau txoj kev tshawb fawb tau qhia tias platelet lysate yuav luag zoo li PRP ua cov tshuaj proliferation [11]. PRP nws tus kheej tau pom tias yog cov tshuaj zoo rau kev kho mob ntawm kev proliferation [12-14].
Cov platelets uas tsis ua haujlwm ncig ua ib daim disk uas muaj ntau lub qauv sab hauv. Thaum lub sijhawm ua haujlwm, lawv yuav zoo li lub voj voog lossis amoeba, ua rau muaj qhov ntim ntau ntxiv. Qhov nce ntawm qhov ntim yuav tsum tau nce qhov chaw ntawm qhov chaw, uas yog qhov tshwm sim ntawm kev tawm ntawm lub qhov qhib tubule system (OCS) thiab ntxiv cov exocytic granules rau ntawm daim nyias nyias. Nws tseem yuav tsum tau txiav txim siab seb qhov nce ntawm MPV uas tshwm sim los ntawm hypertonic glucose cuam tshuam nrog ib lossis ob qho ntawm cov txheej txheem no, tab sis yog tias qhov kawg, ces qhov nce ntawm MPV yuav qhia txog degranulation.
Txoj kev tshawb fawb no qhia tau hais tias kev raug rau cov piam thaj ntau ntawm PRP lossis cov ntshav platelets tag nrho ua rau muaj kev nce ntxiv hauv MPV hauv 15 feeb nrog cov piam thaj ntawm 25% thiab 41.6%, raws li.
Qhov nce hauv platelet MPV tej zaum yuav yog vim dilatation ntawm cov microtubule tangles nyob ib puag ncig los teb rau calcium influx. Liu et al. Glucose tau pom tias yog tus neeg nruab nrab calcium influx los ntawm platelet TRPC6 channel [6]. Peb qhov kev xav yog tias glucose ua rau so ntawm microtubule tangles, ua rau muaj kev nce hauv MPV thiab platelet sensitization thiab / lossis kev ua haujlwm. Txawm li cas los xij, txiav txim los ntawm peb cov txiaj ntsig, qhov no tsuas yog ib feem ntawm zaj dab neeg. Hauv peb qhov kev sim, tsis muaj qhov concentration hauv qab D25W ua rau muaj kev nce hauv MPV. Muab hais tias peb tsis tau sim kev raug rau cov glucose concentration ntawm 12.5% ​​thiab 25%, peb cov txiaj ntsig theem 1 qhia tias tej zaum yuav muaj qhov txwv hauv qhov ntau ntawm cov glucose concentration uas ua rau muaj kev nce hauv MPV. Kev sim ntxiv hauv theem 3 thiab 4 qhia tau tias 20-25% glucose zoo li yog qhov txwv rau qhov no, tab sis nws tseem tsis meej vim li cas.
Peb kuj tau pom tias muaj ~ 9% txo qis hauv MPV tom qab centrifugation. Nws tsis meej tias qhov kev txo qis hauv MPV no yog vim cov platelets loj dua thiab ntom dua raug kaw hauv RBC txheej ntawm centrifuge. Qhov kev soj ntsuam no yuav tseem ceeb rau cov kws kho mob vim nws yuav qhia tau tias PRP platelets yog cov platelets me dua thiab tsawg dua ntawm WB platelets.
Hauv kev tshawb fawb yav dhau los, peb tau qhia tias kev npaj PRP los ntawm kev siv tes yog pheej yig [8]. Yog tias cov piam thaj ua rau cov ntaub so ntswg lossis PRP rhiab heev, ua rau lawv yooj yim dua rau kev ua haujlwm, lossis yog tias PRP tsim nrog cov khoom lysate ib nrab, qhov no yuav ua rau kev rov tsim dua tshiab thiab txo qhov xav tau kev kho mob. Yog li ntawd, kev sib xyaw ua ke ntawm PRP thiab cov piam thaj uas muaj zog heev yuav raug nqi ntau dua li PRP lossis qabzib ib leeg.
Peb txoj kev tshawb fawb muaj ntau qhov tsis zoo. Ua ntej, peb siv PRP tau los ntawm ntau txoj kev sib txawv. Qhov no tuaj yeem ua rau muaj kev sib txawv. Qhov thib ob, peb tsis tuaj yeem ua qhov kev tshuaj xyuas biochemical ntawm peb cov qauv kom paub tseeb dua seb puas muaj platelet activation. Peb xav ntsuas P-selectin, platelet factor 4, monocytic platelet aggregates, lossis lwm yam cim ntawm platelet activation kom nkag siab zoo dua txog qib lossis muaj alpha granule degranulation, tab sis qhov no dhau ntawm qhov kev tshawb fawb no. Qhov thib peb, peb tsis tuaj yeem lees paub los ntawm electron microscopy lossis lwm txoj hauv kev uas qhov nce hauv MPV hauv cov platelets uas muaj glucose yog vim muaj qhov cuam tshuam rau microtubule tangles.
Cov sib xyaw ntawm WB lossis PRP nrog 25% qabzib ua rau MPV nce ntxiv, qhia txog qhov pib ntawm kev ua haujlwm ntawm cov ntshav platelet, txawm hais tias kev tshawb fawb no tsis tau qhia txog kev nce qib ntawm kev sib sau ua ke lossis degranulation. Cov sib xyaw hypertonic glucose ua rau cov ntshav platelet poob, tej zaum sawv cev rau qhov cuam tshuam lytic. Ib feem ntawm kev ua haujlwm lossis lysis ntawm cov ntshav platelets tuaj yeem ua rau cov ntaub so ntswg rov qab tom qab txhaj tshuaj platelet. Nws tsis meej meej tias cov kev hloov pauv no yuav ua rau muaj cov txiaj ntsig zoo li cas. Cov kev tshawb fawb ntxiv tau ua pov thawj ntau dua qhov kev ntsuas ntawm kev ua haujlwm lossis lysis thiab tau soj ntsuam cov teebmeem sib txawv ntawm kev kho mob ntawm cov sib xyaw hypertonic glucose nrog WB lossis PRP.
Kev kho mob glucose proliferative yog ib txoj kev kho mob yooj yim thiab pheej yig uas tab tom nthuav dav sai thiab txhawb nqa kev tshawb fawb hauv tsev kho mob. Kev tshawb fawb no qhia txog lub cev txoj kev kho mob uas, yog tias lees paub, tuaj yeem pab peb nkag siab ib feem ntawm txoj kev kho mob proliferative.
Biomedical thiab Health Informatics ntawm University of Missouri, Kansas City School of Medicine, Kansas City, Tebchaws Meskas
Cov Neeg Kawm Txog Tib Neeg: Txhua tus neeg koom nrog hauv txoj kev tshawb fawb no tau muab lossis tsis tau muab kev pom zoo. Lub Koom Haum Thoob Ntiaj Teb rau Kev Kho Mob Cellular tau muab kev pom zoo ICMS-2017-003. Cov txheej txheem hauv qab no tau raug pom zoo rau kev siv ntxiv los ntawm Pawg Neeg Saib Xyuas Kev Tshawb Fawb ntawm Lub Koom Haum Thoob Ntiaj Teb rau Kev Kho Mob Cellular: Lub Npe: Kev suav cov tshuaj plasma uas muaj platelet ntau raws li cov lej platelet CBC. Cov Neeg Kawm Txog Tsiaj: Txhua tus kws sau ntawv tau lees paub tias tsis muaj tsiaj lossis cov nqaij koom nrog hauv txoj kev tshawb fawb no. Kev Tsis Sib Haum Xeeb: Raws li Daim Ntawv Qhia Txog Kev Sib Tw ICMJE, txhua tus kws sau ntawv tshaj tawm cov hauv qab no: Cov ntaub ntawv them nyiaj/kev pabcuam: Txhua tus kws sau ntawv tshaj tawm tias lawv tsis tau txais kev txhawb nqa nyiaj txiag los ntawm ib lub koom haum rau cov haujlwm xa tuaj. Kev Sib Raug Zoo Nyiaj Txiag: Txhua tus kws sau ntawv tshaj tawm tias lawv tsis muaj kev sib raug zoo nyiaj txiag nrog ib lub koom haum uas yuav xav tau cov haujlwm xa tuaj. Lwm Yam Kev Sib Raug Zoo: Txhua tus kws sau ntawv tshaj tawm tias tsis muaj lwm yam kev sib raug zoo lossis kev ua ub no uas yuav cuam tshuam rau cov haujlwm xa tuaj.
Harrison TE, Bowler J, Reeves K et al. (Tsib Hlis 17, 2022) Cov nyhuv ntawm cov piam thaj rau cov ntshav platelet thiab ntim: cov txiaj ntsig rau kev kho mob rov qab. Kev kho 14 (5): e25081. doi: 10.7759 / cureus.25081
© Copyright 2022 Harrison et al. Qhov no yog ib tsab xov xwm qhib rau kev nkag mus rau hauv raws li cov nqe lus ntawm Creative Commons Attribution License CC-BY 4.0. Kev siv, kev faib tawm, thiab kev tsim dua tshiab tsis txwv hauv txhua qhov chaw raug tso cai, muab tus sau thawj thiab qhov chaw tau txais credit.