“Ntimukigere mushidikanya ko itsinda rito ry’abaturage batekereza kandi bitanze bashobora guhindura isi. Mu by’ukuri, ni ryo ryonyine riri aho.”
Intego ya Cureus ni uguhindura uburyo bwo gusohora inyandiko z’ubuvuzi bumaze igihe kirekire, aho gutanga ubushakashatsi bishobora guhenda, bigoye kandi bigatwara igihe.
Plasma/prp ikungahaye kuri plaquette, kuvugurura ingirabuzima fatizo, gukora plaquette, kuvura isukari ikwirakwira, plaquette, kuvura ikwirakwira
Vuga iyi nkuru nka: Harrison TE, Bowler J, Reeves K, n'abandi (17 Gicurasi 2022) Ingaruka za glucose ku mubare wa platelets n'ingano: ingaruka ku miti ivugurura. Cure 14(5): e25081. doi:10.7759/cureus.25081
Plasma ikungahaye kuri plaquette (PRP) n'ibisubizo bya glucose ikabije bikunze gukoreshwa mu gutera plaquette mu buvuzi bwo kuvugurura, rimwe na rimwe hamwe. Ingaruka za glucose ikabije kuri plaquette no gukora ntabwo zagaragajwe mbere. Twagerageje ingaruka z'ubwinshi bwa glucose ku mibare ya plaquette na erythrocyte, ndetse n'ingano y'uturemangingo muri PRP no mu maraso yose (WB). Kugabanuka kw'igice cy'umubare wa plaquette byabayeho mu buryo bwihuse hamwe n'ibivange byose bya glucose bivanze na PRP cyangwa amaraso yose, bihuye na lysis y'igice. Nyuma y'umunota wa mbere, umubare wa platelets wakomeje kumera neza, bigaragaza ko platelets zisigaye zishobora kwihutisha kugera ku rugero rwo hejuru cyane (>2000 mOsm). Nyuma y'umunota wa mbere, umubare wa platelets wakomeje kumera neza, bigaragaza ko platelets zisigaye zishobora kwihutisha kugera ku rugero rwo hejuru cyane (>2000 mOsm). После первой минуты количестро тромбоцитов уванось стабильным, что указывает на быструю аккомодацию остаточных тромбоцитов до экстремемналного (> 2000 мОсм) гипертонуса. Nyuma y'umunota wa mbere, umubare wa platelets wakomeje kugabanuka, bigaragaza ko platelets zisigaye zinjira vuba cyane ku rugero rwo hejuru cyane (>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（> 2000 mOsm ）高渗状态。2000 mOsm ）高渗状态。 После первой минуты количестро тромбоцитов увасос с стабильным, что указывает на быструю адаптацию остаточных тромбоцитов к экстремемнному (> 2000 мОсм) гиперосмоларному состоянию. Nyuma y'umunota wa mbere, umubare wa platelets wakomeje kumera neza, bigaragaza ko platelets zisigaye zahindutse vuba cyane kugeza ku rugero rwo hejuru cyane (>2000 mOsm).Ingano ya glucose iri ku kigero cya 25% no hejuru yayo yatumye ingano y’amaraso mu maraso yiyongera cyane (MPV), bigaragaza ko hari intambwe ya mbere yo gukora ku maraso. Hakenewe ubundi bushakashatsi kugira ngo hamenyekane niba habaho gukora ku maraso cyangwa gukora ku maraso, kandi niba gutera glucose mu maraso gusa cyangwa hamwe na PRP bishobora gutanga inyungu z’inyongera ku buvuzi.
Mu myaka ya 1950, umuganga w’inzobere mu kubaga w’Umunyamerika George Hackett yavumbuye ko yashoboraga kugabanya burundu ububabare bw’ingingo n’umugongo ku barwayi benshi akoresheje uburyo bwo gutera imiti mu mitsi no mu mitsi. Ubushakashatsi bwe ku nkwavu bwagaragaje ko uburyo bwo kuvura, yise uburyo bwo kuvura indwara zo mu mitsi, bwatumye imitsi ikura kandi ikomera. Ubushakashatsi bw’amateka bwemeje ko collagen nshya ikorwa muri iki gikorwa [1].
Mu myaka mike ya mbere, hageragejwe uburyo butandukanye bwo gukwirakwiza. Mu myaka ya 1990, abahanga benshi mu bya siyansi babonaga ko glucose nyinshi ari bwo buryo bwizewe kandi bufite akamaro kurusha ubundi. Ariko, uburyo ikora ntiburasobanuka neza.
Nyuma y’ibikorwa bya Hackett, ubushakashatsi buke bwakozwe mu kinyejana cya 20. Ariko, mu myaka ya 2000 habayeho kongera gushishikazwa kandi hakozwe igerageza ry’ubuvuzi ry’uburyo bwo kuvura indwara ziyongera ku buryo bufatika ku kuvura ububabare bwo hasi bw’umugongo [2], indwara ya osteoarthritis yo mu ivi [3], na epicondylitis yo mu ruhande [4].
Kuvugurura ingirabuzimafatizo bisaba uruhare rw'uturemangingo tw'ingirabuzimafatizo. Kubwibyo, ubwinshi bwa glucose bugomba gutuma uturemangingo tw'ingirabuzimafatizo twimuka, twiyongera, kandi tugatandukanya uturemangingo tw'ingirabuzimafatizo. Dutekereza ko platelets zishobora gukora nk'intumwa kandi ko ubwinshi bwa glucose bushobora gutuma platelets zirekura cytokines n'ibintu bikura, bityo bigatera inzira zo kuvugurura, cyane cyane ukwimuka kw'uturemangingo tw'ingirabuzimafatizo tujya mu duce dufite glucose nyinshi.
Gukoresha platelet buri gihe bibanziriza kwiyongera kwa kalisiyumu mu turemangingo [5]. Liu n'abandi mu 2008 bagaragaje ko urugero rwinshi rwa glucose rwongera imikorere y'imiyoboro ya transient receptor potential canonical type 6 (TRPC6) mu membrane ya plasma, bigatuma iyoni za kalisiyumu zinjira mu turemangingo [6]. Ubundi bushakashatsi bwerekanye ko kwinjizwa kwa microtubule ku buso bwa iyoni za kalisiyumu bitera kuruhuka, kwaguka, no guhinduka kwa buso bwa platelet, ibyo bigatuma habaho impinduka mu ishusho kuva kuri disiki kugera kuri spherical, bigatuma ingano ya platelet ihinduka (MPV) [7].
Igitekerezo cyacu muri ubu bushakashatsi ni uko kwegerana kwa plaquettes ku gipimo kinini cya glucose bigira ingaruka ku gice cy’imbere cy’uturemangingo tw ...
Abitabiriye bose basinye ifishi yo kwemera nyuma y’uko ibisobanuro birambuye by’ubushakashatsi bisobanuwe kandi mbere yo guhabwa ingero. Muri ubu bushakashatsi, ingero za PRP gusa zifite hematocrit irenga 2% ni zo zakoreshejwe kugira ngo umubare wa erithrocyte (erythrocyte) n’ingano y’uturemangingo dutukura tw’amaraso (MCV) bishobore gushyirwamo kugira ngo bigereranywe.
Ubushakashatsi bwakozwe mu byiciro bine, igice cya mbere cyari PRP naho ibindi bice byari amaraso yose (Imbonerahamwe ya 1). Nkuko byasobanuwe mbere [8], imbaraga zose za centrifugal (RCF, g-force) zabazwe uhereye hagati (Rmid, muri cm) y'inkingi y'amaraso iri muri syringe ya centrifugal. Twahisemo gukoresha MPV nk'ikimenyetso cyo kumenya platelets n'umubare wa platelets nk'ikimenyetso cy'uko platelets zishobora kuba zikora, byombi bishobora gupimwa byoroshye hakoreshejwe isesengura rya hematology risanzwe.
Mu cyiciro cya mbere, abakorerabushake 47 batanze ingero z'amaraso—umuyoboro umwe wa aside ethylenediaminetetraacetic (EDTA) n'igice kimwe cy'amaraso yose ya PRP (adafite amaraso menshi hamwe na sodium citrate (NaCl, 3%)) (Imbonerahamwe ya 1). Shyira agakoresho gakomeye mu muyoboro ako kanya. Umubare wuzuye w'amaraso (CBC) wakozwe ku ngero za EDTA mu byiciro bitatu, hanyuma ingero za NaCl zisesengurwa mu byiciro bitatu kugira ngo hakorwe isesengura rya CBC, hanyuma PRP itegurwa hakoreshejwe uburyo butandukanye bwavuzwe haruguru [8]. Ingero zose za PRP zateguwe hakoreshejwe centrifugation kuri g 900–1000. Vanga buri gice cya PRP ku mashini ivanga vortex mu masegonda 5–10, hanyuma ugabanyamo ama-aliquot atanu ya ml 0.5 mu miyoboro.
Kugira ngo hasuzumwe ingaruka zo kwangirika kwa plaquettes ku gipimo cya glucose kiri hejuru, ingano ingana (0.5 ml) ya 0%, 5%, 12.5%, 25%, na 50% bya glucose mu mazi yavanzwe n'ibipimo bya plaquettes kugira ngo haboneke 0%, 2.5% 6.25%, 12.5% ​​​​na 25% by'uruvange rwa glucose hanyuma bavanga imiyoboro ku gikoresho cyo gupima mu gihe cy'iminota 15. TAC ya buri ruvange yasesenguwe inshuro eshatu nyuma y'iminota 15. Umubare wa plaquettes (PLT), umubare wa rBC, MCV, na MPV byapimwe kuri buri muyoboro, kandi impuzandengo y'umubare wa plaquettes, umubare wa rBC, MCV, na MPV yabazwe kuri buri ngero zose za PRP.
Nyuma y’uko icyiciro cya mbere cyo gukusanya amakuru kirangiye, twabonye ubwiyongere bugaragara bw’ingano ya platelets muri platelets za PRP nyuma yo kongeramo D50W. Platelets za PRP si ngombwa ko zigaragaza platelets zose mu maraso, kandi PRP itandukanye n’iy’imashini ya WB. Kubwibyo, twahisemo gukora igerageza ry’icyiciro cya kabiri ku ngaruka zo kongera D50W mu maraso yose.
Ku cyiciro cya kabiri, twahisemo ingano y'icyitegererezo ya 30 hashingiwe ku byavuye mu cyiciro cya mbere, nk'uko byasobanuwe mu gice cy'isesengura. Muri uru rutonde, abakorerabushake 20 batanze ingero z'amaraso (Imbonerahamwe ya 1). Amaraso yose (1.8 ml) yashyizwe mu cyuma cya mililitiro 3 maze ashyirwamo 0.2 ml ya NaCl 40%. Cyuma cyose cy'amaraso cyavanzwe mu masegonda atanu hakoreshejwe icyuma gifunga imirasire y'amaraso maze CBC irasesengurwa mu masegonda atatu. Nyuma yo gusesengura, amaraso adafite amaraso menshi yongewe muri mililitiro 2 za glucose ya 50% muri cyuma cya mililitiro 5 (igipimo cya nyuma cya glucose cyari hafi 25% (D25) maze gishyirwa mu muyoboro wo gushyushya mu gihe cy'iminota 30. Nyuma y'iminota 30, D25/CBC muri cyuma cya WB yasesenguwe mu masegonda atatu. Umubare wa platelet, umubare wa RBC, MCV, na MPV kuri cyuma byapimwe, kandi impuzandengo ya PLT, umubare wa RBC, MCV, na MPV yabazwe kuri buri cyitegererezo mbere na nyuma yo kongeramo glucose.
Kubera ko plaquettes mu maraso yose zikunze guhura n’isukari ikabije mu gihe cyo kuvura isukari nyinshi bitewe no guterwa inshinge nke, kandi ntibikunze kugaragara ko PRP na isukari ikabije mbere gato yo guterwa inshinge, twahisemo kwiga isukari ikabije hamwe na WB mu Gice cya 1. Intambwe ya Gatatu n'iya Kane. Muri buri cyiciro, abakorerabushake 20 batanze mililitiro 7-8 za ACD-A (aside irimo trisodium citrate (22.0 g/l), aside citric (8.0 g/l) na glucose (24.5 g/l), umuti wa dextrose citrate) ku miti igabanya amaraso (Imbonerahamwe ya 1). Uruvange rwa glucose rurenze 12.5% ​​ni rwo rwakoreshejwe kugira ngo hamenyekane ijanisha ry’umubare ujyanye no kwiyongera kwa MPV. Ku cyiciro cya gatatu, mililitiro 1 y'amaraso ishyirwa mu muyoboro w'igerageza. Hanyuma uvange amaraso ku cyuma gitanga umwuka mu gihe cy'amasegonda 10 wongeramo mililitiro 1 ya glucose 30%, glucose 40%, cyangwa glucose 50% mu muyoboro kugira ngo ubone igipimo cya nyuma cya glucose kingana na 15%, 20%, na 25%, uko bikurikirana. Ingero z'amaraso ya glucose zasuzumwe kuri CBC ako kanya nyuma yo kuvanga kandi zigasubirwamo buri minota ibiri mu gihe cy'iminota 30.
Mu gihe cyo kuvanga bwa mbere, kongeramo glucose ya hypertonic ya 1:1 na WB cyangwa PRP bituma plaquettes zigera ku rugero ruri hejuru ya 25% mu masegonda menshi. Mu ntambwe ya kane, kugira ngo dusuzume ingaruka za glucose ya hypertonic hamwe n'urugero ruto rw'ibanze rw'ingaruka za glucose, twongeyeho amaraso make gusa kuri D25W cyangwa D50W. Shyira ml 1 ya D25W cyangwa D50W mu muyoboro hanyuma wongereho 0.2 ml ya WB mu gihe ukoresha icyitegererezo mu masegonda 10. Muri ibi bihe, amaraso yahuye na glucose ku rugero ruri hejuru ya 20% rw'urugero rwa nyuma, aho kuba hejuru ya 50% y'urugero rwa nyuma nk'uko byari bimeze mu cyiciro cya 3, bigatuma glucose ya nyuma igera kuri 20.8% na 41.6%. Ingero zivanze zasesenguwe mu gihe kimwe n'intambwe ya 3.
Mu ntambwe ya mbere ya buri cyiciro cyo gupima isukari, hafashwe ingero 30 kuko ari yo yari ingana ikwiye mu bushakashatsi bw’igerageza [9]. Mu mpera za buri cyiciro (harimo n’icyiciro cya mbere), suzuma ingano y’icyitegererezo ihagije ukoresheje formula yakoreshejwe mu kumenya ingano y’icyitegererezo ikenewe kugira ngo hamenyekane impuzandengo y’impinduka zihoraho mu mubare umwe w’abantu. Formula n = Z2 x SD2 /E2. Muri iki gipimo, Z ni amanota ya Z, SD ni ukunyuranaho bisanzwe, na E ni ikosa ryifuzwa [10]. Alpha yacu ni 0.05, ihuye n’agaciro ka Z ka 1.96, kandi twiteze ikosa rya 5 (mu ijana). Bityo dukemura kuri n = (1.962 x SD2) / 52. Ibisubizo byagaragaje ko ingano y’icyitegererezo ikenewe kuri buri cyiciro yari nto ugereranyije n’umubare nyawo wakusanyijwe.
Mu gihe cya 1, 3 na 4 hakoreshejwe ingano ya glucose irenze imwe, ingaruka z'ingano ya glucose itandukanye zasesenguwe hagaragazwa impinduka hagati y'igihe cya 0 na buri gihe gikurikiraho (icyiciro cya 1 ku minota 15, igihe cya 3 ku minota 15). na kane ku masegonda 15, hanyuma buri minota ibiri.) Igipimo cy'impinduka kuri buri gihe cyagereranyijwe hakoreshejwe ikizamini cya Mann-Whitney U kuko amakuru atakurikije ikwirakwizwa risanzwe nk'uko byagenwe n'ikizamini cya Shapiro-Wilk. Kubera ko isesengura rya 1 kuri 1 ry'amatsinda menshi (atanu) ryakozwe mu ntambwe ya mbere, iya gatatu n'iya kane (eshanu muri rusange), hakozwe ikosora rya Bonferroni kugira ngo hakosorwe agaciro ka alpha kifuzwaga kagere kuri ≤0.01 ariko ntabwo kageze kuri ≤0.05.
Kugabanuka kw'umubare wa platelets hamwe n'ubwinshi bwose bwa dextrose ikabije hamwe n'ubwiyongere bwa MPV mu platelets za PRP ku gipimo cya dextrose kiri hejuru ya 12.5%: Umubare wa platelets za PRP wazamutse kuva ku gipimo kimwe kugeza kuri eshanu ugereranije n'ubwinshi bw'amaraso yose, bitandukanye bitewe n'uburyo (butagaragajwe). Kugabanuka kw'umubare wa platelets hamwe n'ubwinshi bwose bwa dextrose ikabije hamwe n'ubwiyongere bwa MPV mu platelets za PRP ku gipimo cya dextrose kiri hejuru ya 12.5%: Umubare wa platelets za PRP wazamutse kuva ku gipimo kimwe kugeza kuri eshanu ugereranije n'ubwinshi bw'amaraso yose, bitandukanye bitewe n'uburyo (butagaragajwe). Уменьшение количества тромбоцитов при всех гранх гипертонической декстрозы и увеличение MPV в тромб Мтахах PRP при кровуве, вависимости от метода (не показано). Kugabanuka kw'umubare wa platelets ku gipimo cyose cya dextrose ikabije kandi MPV yiyongera mu platelets za PRP ku gipimo cya dextrose kiri hejuru ya 12.5%: Umubare wa platelets za PRP wiyongereye inshuro 1-5 ugereranije n'amaraso yose y'ibanze, bitewe n'uburyo (bitagaragajwe). ).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 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（未描述）。 Ku gipimo cya glucose kiri hejuru ya 12.5%, igipimo kinini cya glucose kigabanya umubare w'amaraso, PRP mu maraso MPV iriyongera: ugereranije na 与基线全血, igipimo cy'amaraso ya PRP kiriyongera kuva ku nshuro 1 kugeza kuri 5 z'igipimo (nticyasobanuwe). При за грек глюкозы> 12,5% все исходными тарих барми цельной крови, в зависимости от метода (не описано). Ku gipimo cya glucose kiri hejuru ya 12.5%, igipimo cyose cya glucose iterwa n'umuvuduko ukabije w'amaraso cyagabanije umubare wa platelets kandi MPV yiyongera mu platelets za PRP: Umubare wa platelets za PRP wiyongereye inshuro 1 kugeza kuri 5 ugereranije n'igipimo cy'amaraso yose, bitewe n'uburyo (nk'uko byasobanuwe).Ishusho ya 1 igaragaza ko umubare wa plaquettes wagabanutseho hafi 75% nyuma yo gushonga mu mazi no kuri 20-30% nyuma y'iminota 15 yo gushonga hamwe n'ibipimo bitandukanye bya glucose ugereranije na PRP y'ibanze n'igipimo cya 1:1 cyahinduwe hakurikijwe ingano (1- k1 hamwe no gukosora ingano). k - 1 yo kororoka).1 yo kororoka).
Umubare w'uturemangingo muri buri gushonga ugaragazwa nk'igice cy'umubare w'umwimerere mbere yo gushonga.
MPV yagabanutseho gato mu gihe cyo gukora PRP, nta kindi gihinduka mu gushonga kugera kuri 12.5% ​​mu mazi cyangwa glucose (harimo 25% by'imvange ya glucose ya PRP) kandi yiyongereyeho ibirenze 20% nyuma yo gushonga mu gisubizo cya glucose cya 50% (Ishusho ya .2). ). Ibinyuranye n'ibyo, erythrocytes nta mpinduka nini yagaragaje mu bunini mu gushonga ukundi uretse H2O.
Ingano mpuzandengo y'uturemangingo muri buri gushonga igaragazwa nk'ijanisha ry'ingano y'umwimerere mbere yo gushonga.
Kugabanuka gukomeye kw'umubare wa platelet n'ubwiyongere bwa CVR byagaragaye muri BC byagaragaye kuri 50% bya glucose (kugira ngo bibe byakozwe na 25% bya glucose). Imbonerahamwe ya 2 igereranya imibare y'uturemangingo n'ingano y'uturemangingo mu maraso yose yakuwe muri 50% bya dextrose hamwe n'amakuru ya PRP yo mu cyiciro cya mbere yakuwe muri 50% bya dextrose. Impinduka mu mubare wa RBC na RBC MCV ntizagaragaye kandi ntabwo byari byo twibandaho cyane.
SD = gutandukana gusanzwe, MD = itandukaniro ry'ikigereranyo hagati y'amatsinda, SE = gutandukana gusanzwe kw'ikigereranyo, RBC = erythrocytes, PLT = platelets, PRP = plasma ikungahaye kuri platelets, WB = amaraso yose
Nyuma yo kongeramo D50W kuri WB, igipimo cyo gutakaza platelet mu buryo bwa dilution-adjusted plaquettes cyari 7.7% (310±73 vs. 286±96) ugereranije na 17.8% bya PRP dilution muri D50W (664±348 vs. 544±277). MPV WB yiyongereyeho 16.8% (kuva kuri 10.1 ± 0.5 kugeza kuri 11.8 ± 0.6), mu gihe MPV PRP yiyongereyeho 26% (9.2 ± 0.8 vs. 11.6 ± 0.7). Nubwo itandukaniro ry’impuzandengo mu kugabanuka kw’umubare wa platelet n’ubwiyongere bwa MPV ryari rinini cyane kuri PRP, impinduka mu kugabanuka kw’umubare wa platelet muri WB zari hafi kugaragara (310 ± 73 kugeza 286 ± 96 (-7.7%); p = .06) kandi ukwiyongera kwa MPV kwari gukomeye (10.1 ± 0.5 kugeza 11.8 ± 0.6 (+16.8) p < .001). Nubwo itandukaniro ry’impuzandengo mu kugabanuka kw’umubare wa platelet n’ubwiyongere bwa MPV ryari rinini cyane kuri PRP, impinduka mu kugabanuka kw’umubare wa platelet muri WB zari hafi kugaragara (310 ± 73 kugeza 286 ± 96 (-7.7%); p = .06) kandi ukwiyongera kwa MPV kwari gukomeye (10.1 ± 0.5 kugeza 11.8 ± 0.6 (+16.8) p < .001).Nubwo itandukaniro ry’impuzandengo mu kugabanuka kw’umubare wa platelet n’ubwiyongere bwa CVR ryari rinini cyane kuri PRP, impinduka mu kugabanuka kw’umubare wa platelet muri WB zari hafi kugaragara (310 ± 73 kugeza 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). Ubwiyongere bwa MPV bwari bugaragara cyane (kuva kuri 10.1 ± 0.5 kugeza kuri 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 差异 显着 大 （（（ 的 几乎 是 （（（ （（（ 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 (Impinduka mu kugabanuka kw'umubare wa platelet muri WB yari hafi kugaragara (kuva kuri 310 ± 73 kugeza kuri 286 ± 96 (-7.7%); p = 0.06), nubwo PRP yari ifite itandukaniro rinini cyane mu kugabanuka kw'umubare wa platelet n'ubwiyongere bwa MPV. Kandi ukwiyongera kwa MPV kwari gukomeye.(от 10,1 ± 0,5 до 11,8 ± 0,6 (+16,8) р <0,001). (kuva kuri 10.1 ± 0.5 kugeza kuri 11.8 ± 0.6 (+16.8) p < 0.001).
Byari ngombwa ko habaho impinduka ikomeye muri MPV, ariko impinduka muri MPV yagaragaye cyane ku rugero rwa nyuma rwa 25%. Gutakaza plaquettes byarahagaze nyuma yo kugabanuka kwa mbere. Twabonye igabanuka rikomeye rya CVR, ariko, CVR yasubijwe vuba ku rugero rwa nyuma rwa 25% rwa glucose, rwari ruri hejuru cyane ugereranyije n'urugero rwa CVR rwabonetse ku rugero rwa nyuma rwa glucose rwa 20% na 15% (Ishusho ya 3 n'ibumoso bw'Imbonerahamwe ya 3; udusanduku dufite ibara ry'igicucu). bigaragaza agaciro ka p ≤ alpha hamwe n'ikosora rya Bonferroni rya 0.01). Habayeho kandi igabanuka rikomeye ry'umubare wa PLT, ryagaragaye mu cyiciro cya mbere cya 0-15 s, hanyuma rikomeza kuba rihamye (kuva ku minota 15 kugeza ku minota 30; ibumoso bw'imbonerahamwe ya 4).
Kongeramo ingano zitandukanye za glucose mu maraso yose byatumye MPV igabanuka vuba, hagakurikiraho gukira kw'ingano ishingiye ku gipimo kirenga 20%. Inkuru igaragaza ingano ya glucose nyuma yo gushonga. D15, D20 na D25 byakozwe mu gushonga kwa 1:1. D21 na D41 byakozwe mu gushonga kwa 1:5.
Imbonerahamwe ya 4 igaragaza impinduka mu mubare wa platelets iyo isukari ya hypertonic yagabanutse. Twabonye isano ishingiye ku gipimo hagati y’igabanuka ry’umubare wa PLT ako kanya ku gutandukana kwa 1:1 no ku gutandukana kwa 1:5. Tugereranije gutandukana kwa 1:1 nk'itsinda rimwe n'ugutandukana kwa 1:5, itsinda rya 1:1 ryagize igabanuka ry’umubare wa platelets munsi y’itsinda rya 1:5 66±48.000 (23%) ugereranyije na 99±69.000 (37%). , p = 0.014) mu itsinda rya 1:5. Nyuma yo kugabanuka kw’ibanze ku gice cya mbere cyo gupima, umubare wa platelets nk'ijanisha rya glucose warahagaze (Ishusho ya 4).
Iyo amaraso yose yongewe muri glucose ku gipimo cya 1: 1, umubare wa plaquettes ugabanukaho hafi 25%. Ariko, iyo amaraso yose yongewe ku gipimo cya 1: 5, igabanuka ryari rinini cyane - hafi 50%.
41% bya glucose byiyongereyeho MPV vuba kandi bikabije kurusha 25% cyangwa 21%. Ibisubizo bya MPV bigaragara ku Ishusho ya 3. Mu zindi ngero zose, nta kugabanuka kwa mbere kwa MPV kwagaragaye nyuma yo kongeramo 50% bya glucose. Mu gihe cyo gukoresha 25% bya glucose (igipimo cya glucose 20.8% mu gihe cyo gushonga bwa nyuma), impinduka muri MPV yagereranywa n'impinduka muri 20% bya glucose mu gihe cyo gushonga bwa 1:1 (Ishusho ya 3). Nubwo impinduka muri MPV zari nini mbere ku gipimo cya 41% kivanze kurusha 25%, itandukaniro muri MPV hagati ya 41% na 25% nyuma y'iminota 16 ntiryari rikiri rinini (Imbonerahamwe ya 3, iburyo). Birashishikaje kandi ko 25% bya glucose byiyongereyeho MPV neza kurusha 20.8%.
Ubu bushakashatsi bwakorewe muri vitro bwemeje igice cy’igitekerezo cyacu. Byagaragaje ko hashobora kubaho lysis y’ibice bya platelet binyuze mu kuvanga dextrose, uburyo platelet zinjira vuba mu mubiri zikagera ku gipimo cya hypertonicity ikabije, ndetse n’izamuka rikomeye rya MPV bitewe n’ubwinshi bwa dextrose irenga 25%. Byagaragaje ko hashobora kubaho lysis y’ibice bya platelet binyuze mu kuvanga dextrose, uburyo platelet zinjira vuba mu mubiri zikagera ku gipimo cya hypertonicity ikabije, ndetse n’izamuka rikomeye rya MPV bitewe n’ubwinshi bwa dextrose irenga 25%. Он показал данный частичный лизис тромбоцитов примесу декстрозы, бстрстую аккомодацию тромбоцитов до экстремального гипертонуса и значительное повшенение MPV в ответ на гиоффическую Byagaragaje ko hashobora kubaho ko plaquette ikora neza hamwe na dextrose, ko platelet ishobora kwihutisha ihinduka ry’umuvuduko ukabije w’amaraso, ndetse no kwiyongera gukomeye kwa MPV bitewe n’urugero rwa dextrose ikora neza >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，以及响应> 25% 浓度的高渗葡萄糖时 MPV 显着上升。25% 出 时 时 v v v 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 Он показывает କାନный частичный лизис тромбоцитов смесями с глюкозой, бструю адаптацию тромбоцитов к экстремальному гипертонусу и значительное увеличение MPV в ответ на Igaragaza ko glucose ishobora gukwirakwira mu bice bimwe by'amaraso binyuze mu ruvange rwa glucose, ihinduka ryihuse rya platelets ku buryo bukabije bwo kugabanuka kw'amaraso, ndetse n'ubwiyongere bugaragara bwa MPV mu gusubiza glucose ikabije >25%.Izamuka rya mbere ryari rinini cyane kuri 41.6% by’isukari, ariko ukwiyongera kwa MPV kwageze kuri 25% by’isukari nyuma y’iminota 20 nyuma yo kuyikoresha.
Igipimo cya platelets kigirwaho ingaruka na glucose. Twabonye ko ingano ya PLT yagabanutse iyo glucose yagabanutse. Kugabanuka gukabije kw'umubare wa platelets mu gabanuka rya H2O (0%) rya PRP series bishobora kuba bifitanye isano na osmotic lysis. Ubundi buryo, ibi bishobora kuba ari ikintu giterwa no gushwanyagurika kwa platelets, ariko ibi bitandukanye no kutagira impinduka za MPV muri uku gushwanyagurika. Ibi bivuze ko platelets zimwe na zimwe zigira ingaruka cyane kuri hypoosmolarity.
Mu gushonga kwa glucose kwa 1:1, ingano ya PLT yagabanutseho 20-30%, ndetse no kuri D5W (hypotonic kuri 252 mOsm), ibi bishobora kugaragaza ingaruka zidasanzwe za glucose idahinduka, kubera ko PLT na MPV byombi byagumye bihinduka ku kwiyongera gutatu kwa glucose kuva kuri D5W kugeza kuri D25W. Mu by'ukuri, ingano ya PLT yakundaga kwiyongera gato uko osmolarity yiyongera.
Kugabanuka kwa PLT hagati ya 1:1 na 1:5 bivuze ko ingaruka zo gusenyuka biterwa n'ubwinshi bwa glucose bwa mbere n'ubwa nyuma. Iyo biba bishingiye gusa ku bwinshi bwa glucose bwa mbere, umuntu yakwitega kubona itandukaniro mu kugabanuka kwa PLT hagati ya 1:1. Ariko ntabwo ari ko bimeze. Niba ingaruka za lysis zishingiye gusa ku bwinshi bwa glucose bwa nyuma, ntabwo twiteze itandukaniro rinini hagati ya 20% 1:1 yo gushonga no gushonga kwa 20.8% 1:5. Nyamara twarabikoze.
Iyo platelet itakaye bitewe na platelet lysis, igice cya lysate kibaho, hanyuma cytokines n'ibintu bikura bigasohorwa mu kirere cyo hanze y'umubiri. Ubushakashatsi bwinshi bwagaragaje ko platelet lysate ifite akamaro kangana na PRP nk'igisubizo cyo gukwirakwiza [11]. PRP ubwayo byagaragaye ko ari igisubizo cyiza mu kuvura gukwirakwiza [12-14].
Uduce duto tw’amaraso tudakora tuzenguruka mu buryo bwa disiki ikomejwe n’imiterere myinshi y’imbere. Mu gihe cyo gukora, bigira ishusho y’uruziga cyangwa amoeba, bigatuma ingano yiyongera. Ubwiyongere bw’ingano busaba kwiyongera k’ubuso, ari na byo biva mu gusohoka kwa sisitemu y’uturemangingo tw’amaraso (OCS) no kongeramo utunyangingo tw’amaraso mu ruhu. Haracyakenewe kumenya niba ukwiyongera kwa MPV guterwa na glucose ikabije bifitanye isano n’imwe muri izi nzira cyangwa zombi, ariko niba ari uko byavuzwe, kwiyongera kwa MPV byaba bigaragaza ko granulation igabanuka.
Ubu bushakashatsi bwagaragaje ko guhura n’isukari nyinshi kuri PRP cyangwa plaquettes z’amaraso yose byatumye MPV yiyongera mu minota 15, aho isukari ya 25% na 41.6%, uko bikurikirana.
Ukwiyongera kwa MPV mu mitsi ishobora guterwa no kwaguka kwa mikorotubule zikikije bitewe n’ubwiyongere bwa kalisiyumu. Liu n'abandi. Glucose byagaragaye ko itera kwiyongera kwa kalisiyumu binyuze mu muyoboro wa TRPC6 [6]. Igitekerezo cyacu ni uko isukari ituma imitsi ya mikorotubule iruhuka, bigatuma MPV na platelet birushaho kwiyongera ndetse/cyangwa bigakora. Ariko, dukurikije ibyavuye mu bushakashatsi bwacu, iki ni igice cy'inkuru gusa. Mu bizamini byacu, nta gipimo kiri munsi ya D25W cyatumye MPV yiyongera. Bitewe nuko tutarapima ubwiyongere bwa glucose hagati ya 12.5% ​​na 25%, ibisubizo byacu bya phase 1 bigaragaza ko hashobora kuba hari igipimo muri uru rwego rw'igipimo cya glucose gituma MPV yiyongera. Ibindi bizamini mu cyiciro cya 3 n'icya 4 byagaragaje ko glucose 20-25% isa nkaho ari yo gipimo, ariko ntibirasobanuka impamvu.
Twabonye kandi igabanuka rya ~9% rya MPV nyuma yo gupima. Ntibiramenyekana neza niba iri gabanuka rya MPV riterwa n'udupira tunini kandi twinshi twafatiwe mu rubavu rwa RBC rwa centrifuge. Iki gitekerezo gishobora kuba ingenzi ku baganga kuko gishobora gusobanura ko udupira twa PRP ari uduce duto kandi tudakomeye twa platelets za WB.
Mu bushakashatsi bwakozwe mbere, twerekanye ko gutegura PRP hakoreshejwe uburyo bwakoreshejwe intoki bihendutse [8]. Niba glucose ituma platelets cyangwa PRP zumva neza, bigatuma zishobora gukoreshwa, cyangwa niba PRP ikozwe mu buryo bwa lysate, ibi bishobora kongera kwiyubaka no kugabanya gukenera ubuvuzi. Kubwibyo, guhuza PRP na glucose irimo imbaraga nyinshi bishobora kuba bihendutse kurusha PRP cyangwa glucose yonyine.
Ubushakashatsi bwacu bufite inenge nyinshi. Ubwa mbere, dukoresha PRP twakuye mu buryo butandukanye. Ibi bishobora gutera ibisubizo bivuguruzanya. Icya kabiri, ntitwashoboye gukora isesengura rya biochemical ry'ingero zacu zose kugira ngo tumenye neza niba platelet yarakoreshejwe. Twifuza gupima P-selectin, platelet factor 4, monocytic platelet aggregates, cyangwa ibindi bimenyetso byerekana platelet akoreshejwe kugira ngo dusobanukirwe neza ingano cyangwa kubaho kwa alpha granule degranulation, ariko ibi biri kure y'ubu bushakashatsi. Icya gatatu, ntitwashoboye kwemeza dukoresheje electron microscopy cyangwa ubundi buryo ko ubwiyongere bwa MPV muri platelet zigaragaramo glucose bwatewe n'ingaruka kuri microtubule tangles.
Uruvange rwa WB cyangwa PRP hamwe na 25% bya glucose byiyongereyeho MPV, bigaragaza ko platelet yatangiye gukora, nubwo ubu bushakashatsi butagaragaje ko platelet itangiye guterana cyangwa igabanuka ry’uturemangingo. Uruvange rwa glucose ya hypertonic rwatumye platelet itakaza, bishobora kuba bigaragaza ingaruka za lytic. Gukora igice cyangwa lysis ya platelet bishobora gutuma ingirabuzima fatizo zisubira kumera neza nyuma yo guterwa platelet. Ntibiramenyekana neza ingaruka izi mpinduka zishobora gutera. Ubushakashatsi bwiyongereye bwagaragaje ibipimo nyabyo by’imikorere cyangwa lysis kandi bwasuzumye ingaruka zitandukanye z’ubuvuzi z’imvange ya glucose ya hypertonic hamwe na WB cyangwa PRP.
Uburyo bwo kuvura indwara yo mu bwoko bwa glucose butera imbere ni uburyo bworoshye kandi buhendutse bwo kuvura indwara yo mu bwoko bwa glucose, burimo kwaguka vuba kandi bushyigikira ubushakashatsi ku buvuzi. Ubu bushakashatsi bugaragaza uburyo umubiri ukoresha, nibwemezwa, bushobora kudufasha gusobanukirwa igice cy’uburyo bwo kuvura indwara yo mu bwoko bwa glucose butera imbere.
Inyigisho ku buzima n'ubuvuzi muri Kaminuza ya Missouri, Ishuri ry'Ubuvuzi rya Kansas City, Kansas City, muri Amerika
Abantu: Abitabiriye ubu bushakashatsi bose batanze uburenganzira cyangwa ntibabutange. Umuryango Mpuzamahanga w’Ubuvuzi bw’Amagufwa watanze icyemezo cya ICMS-2017-003. Amasezerano akurikira yemejwe kugira ngo akoreshwe n’Inama Ishinzwe Isuzuma ry’Ikigo Mpuzamahanga cy’Ubuvuzi bw’Amagufwa: Umutwe: Kubara umusaruro w’imiti ikungahaye kuri plazma hashingiwe ku mubare w’ibanze wa plazma za CBC. Abantu bakorewe ku matungo: Abanditsi bose bemeje ko nta nyamaswa cyangwa ingingo zagize uruhare muri ubu bushakashatsi. Amakimbirane y’inyungu: Dukurikije Ifishi yo Gutangaza ICMJE Uniform, abanditsi bose batangaza ibi bikurikira: Amakuru y’ubwishyu/serivisi: Abanditsi bose batangaza ko batabonye inkunga y’amafaranga iturutse ku muryango uwo ari wo wose ku murimo watanzwe. Imibanire y’Imari: Abanditsi bose batangaza ko ubu cyangwa mu myaka itatu ishize badafite umubano w’imari n’umuryango uwo ari wo wose ushobora kuba ushishikajwe n’umurimo watanzwe. Indi Mibanire: Abanditsi bose batangaza ko nta wundi mubano cyangwa ibikorwa bishobora kugira ingaruka ku murimo watanzwe.
Harrison TE, Bowler J, Reeves K n'abandi (17 Gicurasi 2022) Ingaruka za glucose ku mubare wa platelets n'ingano: ingaruka ku miti ivugurura. Cure 14(5): e25081. doi:10.7759/cureus.25081
© Uburenganzira 2022 Harrison n'abandi. Iyi ni inyandiko ifunguye ikwirakwizwa hakurikijwe amabwiriza ya Creative Commons Attribution License CC-BY 4.0. Ikoreshwa, ikwirakwizwa, no gukorerwa inyandiko mu buryo butagira umupaka mu buryo ubwo aribwo bwose byemewe, mu gihe umwanditsi w'umwimerere n'isoko byemejwe.