"Ungaze uthandabuze ukuba iqela elincinci labemi abacingayo nabazinikeleyo linokutshintsha ihlabathi. Enyanisweni, lilo lodwa apho."
Injongo kaCureus kukutshintsha indlela ekudala isetyenziswa yokupapasha ezonyango, apho ukuhanjiswa kophando kunokubiza kakhulu, kube nzima, kwaye kuthathe ixesha elide.
Iplasma/i-prp etyebileyo kwiiplatelet, ukuvuselelwa kwezicubu, ukusebenza kweeplatelet, unyango lokwandisa iglucose, iiplatelet, unyango lokwandisa
Caphula eli nqaku ngolu hlobo: Harrison TE, Bowler J, Reeves K, et al. (Meyi 17, 2022) Impembelelo yeglucose kwinani leeplatelet kunye nomthamo: iziphumo zonyango lokuvuselela. Cure 14(5): e25081. doi:10.7759/cureus.25081
I-plasma etyebileyo kwi-platelet (PRP) kunye nezisombululo ze-glucose ezixineneyo zisetyenziswa kakhulu ekufakweni kwiyeza lokuvuselela, ngamanye amaxesha kunye. Isiphumo se-hypertonic glucose kwi-platelet lysis kunye nokusebenza kwayo asikabikwa ngaphambili. Sivavanye isiphumo sokuphakama kwamanqanaba e-glucose kwi-platelet kunye ne-erythrocyte counts, kunye nomthamo weeseli kwi-PRP kunye negazi elipheleleyo (WB). Ukuncipha okukhawulezileyo kwenxalenye ye-platelet count kwenzeke kuyo yonke imixube ye-glucose exutywe ne-PRP okanye igazi elipheleleyo, ngokuhambelana ne-partial lysis. Emva komzuzu wokuqala, inani leeplatelet lahlala lizinzile, nto leyo ebonisa ukuba iiplatelet ezisele zibekwe ngokukhawuleza kwi-hypertonicity egqithisileyo (>2000 mOsm). Emva komzuzu wokuqala, inani leeplatelet lahlala lizinzile, nto leyo ebonisa ukuba iiplatelet ezisele zibekwe ngokukhawuleza kwi-hypertonicity egqithisileyo (>2000 mOsm). После первой минуты количество тромбоцитов оставалось стабильным, что указывает на быструю аккомодацию остаточных тромбильным мОсм) гипертонуса. Emva komzuzu wokuqala, inani leeplatelet lahlala lizinzile, nto leyo ebonisa ukuba iiplatelet ezisele zibekwe ngokukhawuleza kwi-hypertonicity egqithisileyo (>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（>送送送星。2000 mOsm）高渗状态. После первой минуты количество тромбоцитов оставалось стабильным, что указывает на быструю адаптацию остаточных тромбильным мОсм) гиперосмолярному состоянию. Emva komzuzu wokuqala, inani leeplatelet lahlala lizinzile, nto leyo ebonisa ukulungelelaniswa ngokukhawuleza kweeplatelet ezisele kwisimo se-hyperosmolar esigqithisileyo (>2000 mOsm).Ubuninzi beglucose obuyi-25% nangaphezulu bubangele ukwanda okukhulu kwi-mean platelet volume (MPV), nto leyo ebonisa inqanaba lokuqala lokusebenza kweplatelet. Kufuneka uphando olongezelelweyo ukuze kuchongwe ukuba i-platelet lysis okanye ukusebenza kwayo kuyenzeka na kwaye ingaba i-hypertonic glucose injection yodwa okanye xa idibene ne-PRP inokubonelela ngenzuzo eyongezelelweyo yeklinikhi.
Kwiminyaka yoo-1950, ugqirha wotyando waseMelika uGeorge Hackett wafumanisa ukuba angayithomalalisa ngokusisigxina intlungu yamalungu kunye nomqolo kwizigulana ezininzi ngokufaka isisombululo esikhulayo kwimisipha kunye nemisipha. Uvavanyo lwakhe kwimivundla lubonise ukuba unyango, awalubiza ngokuba yi-proliferative therapy, lwabangela ukuba imisipha ikhule kwaye yomelele. Izifundo ze-histological ziqinisekisile ukuba i-collagen entsha iveliswa ngeli xesha lenkqubo [1].
Kwiminyaka embalwa yokuqala, kwazanywa izisombululo ezininzi ezahlukeneyo zokusasaza. Ngeminyaka yoo-1990, uninzi lwabagqirha babecinga ukuba ubuninzi beglucose yeyona ndlela ikhuselekileyo nesebenzayo. Nangona kunjalo, indlela yokusebenza ayikacaci.
Zimbalwa izifundo zeklinikhi ezenziwayo kwinkulungwane yama-20 emva komsebenzi kaHackett. Nangona kunjalo, ngeminyaka yoo-2000 kwabakho umdla omtsha kwaye kwagqitywa iimvavanyo ezininzi zeklinikhi eziphumeleleyo zonyango olukhulayo lokunyanga iintlungu ezisezantsi zomqolo [2], i-osteoarthritis yedolo [3], kunye ne-lateral epicondylitis [4].
Ukuhlaziywa kwezicubu kufuna inxaxheba yeeseli ezisisiseko. Ke ngoko, ubuninzi beglucose kufuneka ngandlela ithile bubangele ukufuduka, ukuphindaphinda, kunye nokwahluka kweeseli ezisisiseko. Sicinga ukuba iiplatelets zinokusebenza njengabathunywa kwaye ubuninzi beglucose bunokubangela ukuba iiplatelets zikhuphe ii-cytokines kunye nezinto zokukhula, ngaloo ndlela zikhuthaza iinkqubo zokuvuselela, ngakumbi ukufuduka kweeseli ezisisiseko ukuya kwiindawo ezinobuninzi beglucose.
Ukusebenza kweplatelet kusoloko kukhokelela ekwandeni kwe-calcium yangaphakathi kweseli [5]. ULiu et al. ngo-2008 babonise ukuba amanqanaba aphezulu eglucose anyusa umsebenzi weendlela ze-transient receptor potential canonical type 6 (TRPC6) kwi-plasma membrane, nto leyo ekhokelela ekungeneni kwe-calcium ions kwiiplatelets [6]. Olunye uphando lubonise ukuba ukuvezwa kwe-microtubule marginal zone kwi-calcium ions kubangela ukuphumla, ukwanda, kunye nokuguqulwa kwe-marginal zone, nto leyo ebangela utshintsho kwimo ukusuka kwi-disc ukuya kwi-spherical, nto leyo ebangela i-mean platelet volume (MPV) [7].
Ingcamango yethu kolu phononongo kukuba ukuvezwa kweeplatelets kumazinga aphezulu eglucose kuchaphazela indawo engaphantsi kwe-microtubule kunye nendawo engaphakathi kweseli, nto leyo ekhokelela ekwandeni kwe-MPV.
Bonke abathathi-nxaxheba batyikitye ifomu yemvume enolwazi emva kokuba iinkcukacha zophando zichaziwe nangaphambi kokuba bafumane iisampulu. Kolu phononongo, kusetyenziswe iisampulu zePRP kuphela ezine-hematocrit engaphezulu kwe-2% ukuze kusetyenziswe i-erythrocyte (erythrocyte) kunye nomthamo ophakathi weeseli ezibomvu zegazi (MCV) ukuze kuthelekiswe.
Olu phononongo lwenziwe ngamanqanaba amane, isigaba sokuqala yayiyi-PRP kwaye amanye amanqanaba yayiligazi elipheleleyo (Itheyibhile 1). Njengoko kuchaziwe ngaphambili [8], onke amandla e-centrifugal ahambelanayo (i-RCF, i-g-force) abalwe ukusuka kwindawo ephakathi (i-Rmid, ngo-cm) yekholamu yegazi kwisirinji ye-centrifugal. Sikhethe ukusebenzisa i-MPV njengophawu lokuqonda kweplatelet kunye nokubalwa kweplatelet njengophawu lwe-plaquette lysis enokubakho, zombini ezinokuthi zilinganiswe ngokulula kwii-analyzers ze-hematology ezisemgangathweni.
Kwisigaba sokuqala, amavolontiya angama-47 anikele ngeesampulu zegazi—ityhubhu enye ye-ethylenediaminetetraacetic acid (EDTA) kunye nesampuli yegazi elipheleleyo le-PRP enye (engaxutywanga ne-sodium citrate (NaCl, 3%)) (Itheyibhile 1). Beka i-rocker kwityhubhu ngoko nangoko. Ubalo lwegazi olupheleleyo (CBC) lwenziwa kwiisampulu ze-EDTA kwi-triplicate, kwaye iisampulu ze-NaCl zahlalutywa kwi-triplicate ukuze kuhlalutywe i-CBC, kwaye emva koko i-PRP yalungiswa ngeendlela ezahlukeneyo ezichazwe apha ngasentla [8]. Zonke iisampulu ze-PRP zalungiswa nge-centrifugation kwi-900–1000 g. Xuba isampuli nganye ye-PRP kwi-vortex mixer imizuzwana emi-5–10, uze wahlule ii-aliquots ezintlanu ze-0.5 ml kwiityhubhu.
Ukuvavanya impembelelo yokuvezwa kweplatelet kumanqanaba aphezulu eglucose, kuxutywe ubungakanani obulinganayo (0.5 ml) be-0%, 5%, 12.5%, 25%, kunye ne-50% yeglucose emanzini kunye neesampuli zeplatelet ukuze kufunyanwe uxinano lwe-0%, 2.5% 6.25%, 12.5% ​​kunye ne-25% yomxube weglucose kwaye kuxutywe iityhubhu kwi-test tube shaker imizuzu eli-15. I-TAC yomxube ngamnye ihlalutywe kathathu emva kwemizuzu eli-15. Inani leeplatelet (PLT), inani leeRBC, iMCV, kunye ne-MPV zilinganiswe kwityhubhu nganye, kwaye inani eliphakathi leeplatelet, inani leeRBC, iMCV, kunye ne-MPV zibaliwe kuzo zonke iisampuli zePRP.
Emva kokuba isigaba sokuqala sokuqokelelwa kwedatha sigqityiwe, saphawula ukwanda okukhulu komthamo weeplatelet kwiiplatelet zePRP emva kokongezwa kwe-D50W. Iiplatelet zePRP azimelanga zonke iiplatelet egazini, kwaye i-PRP medium yahlukile kwi-WB medium. Ke ngoko, sigqibe ekubeni senze uvavanyo lwesigaba sesibini ngesiphumo sokongeza i-D50W egazini liphela.
Kwinqanaba lesibini, sikhethe ubungakanani besampulu obungama-30 ngokusekelwe kwiziphumo zoluhlu lokuqala, njengoko kuchaziwe kwicandelo loHlalutyo. Kolu luhlu, amavolontiya angama-20 anikele ngeesampulu zegazi (Itheyibhile 1). Igazi elipheleleyo (1.8 ml) latsalwa kwisirinji ye-3 ml laza lafakwa i-anticoagulation nge-0.2 ml ye-40% ye-NaCl. Isirinji yegazi liphela laxutywa imizuzwana emihlanu ngomxube we-vortex kwaye i-CBC yahlalutywa kathathu. Emva kohlalutyo, igazi elichasene ne-coagulation longezwa kwi-2 ml ye-50% yeglucose kwisirinji ye-5 ml (uxinzelelo lokugqibela lweglucose lwalumalunga ne-25% (D25) kwaye lwafakwa kwityhubhu yokuxukuxa imizuzu engama-30. Emva kwemizuzu engama-30, i-D25/CBC kwiisirinji ze-WB zahlalutywa kathathu. Inani leeplatelet, inani le-RBC, i-MCV, kunye ne-MPV kwisirinji nganye zabalwa ngokwe-avareji, kwaye i-PLT, inani le-RBC, i-MCV, kunye ne-MPV zabalwa kwisampulu nganye ngaphambi nasemva kokongeza i-glucose.
Ngenxa yokuba iiplatelets egazini liphela zihlala zichaphazeleka yi-hypertonic glucose ngexesha lonyango lwe-glucose olukhulayo ngenxa yokufakwa kwe-invasive encinci, kwaye akuqhelekanga ukudibanisa i-PRP ne-hypertonic glucose ngaphambi nje kokufakwa kwe-injection, sigqibe ekubeni sifunde i-hypertonic glucose kunye ne-WB kwiCandelo 1. Inyathelo Lesithathu nelesine. Kwinqanaba ngalinye, amavolontiya angama-20 anikele nge-7-8 ml ye-ACD-A (i-asidi equlathe i-trisodium citrate (22.0 g/l), i-citric acid (8.0 g/l) kunye ne-glucose (24.5 g/l), isisombululo se-dextrose citrate) kwi-anticoagulants yegazi (Itheyibhile 1). Kuphela yimixube ye-glucose engaphezulu kwe-12.5% ​​​​esetyenzisiweyo ukumisela ipesenti yomda enxulumene nokunyuka kwe-MPV. Kwinqanaba lesithathu, i-1 ml yegazi ifakwa kwityhubhu yovavanyo. Emva koko xuba igazi kwi-vortex mixer imizuzwana eli-10 ngokongeza i-1 ml ye-30% yeglucose, i-40% yeglucose, okanye i-50% yeglucose kwityhubhu ukuze ufumane uxinzelelo lokugqibela lweglucose oluyi-15%, 20%, kunye ne-25%, ngokulandelelana. Iisampulu zegazi leglucose zahlalutywa kwi-CBC emva kokuxuba kwaye zaphindwa rhoqo emva kwemizuzu emibini kangangemizuzu engama-30.
Ngexesha lokuxuba kokuqala, ukongezwa kwe-1:1 hypertonic glucose kunye ne-WB okanye i-PRP kuveza iiplatelets kumanqanaba angaphezu kwama-25% imizuzwana embalwa. Kwinyathelo lesine, ukuvavanya isiphumo se-hypertonic glucose kunye namanqanaba okuqala amancinci kunye nokuvavanya umda ophezulu wesiphumo se-glucose, songeze kuphela inani elincinci legazi kwi-D25W okanye i-D50W. Beka i-1 ml ye-D25W okanye i-D50W kwityhubhu kwaye wongeze i-0.2 ml ye-WB ngelixa ukhupha isampuli imizuzwana eli-10. Kule meko, igazi lavezwa kwi-glucose kumanqanaba amalunga nama-20% ngaphezulu koxinzelelo lokugqibela, endaweni yama-50% ngaphezulu koxinzelelo lokugqibela njengakwiSigaba sesi-3, okubangela ukuba amazinga okugqibela e-glucose abe yi-20.8% kunye nama-41.6%. Iisampulu ezixutyiweyo zahlalutywa ngexesha elifanayo njengakwinyathelo lesi-3.
Kwinyathelo lokuqala lothotho ngalunye lokuxutywa kweglucose, kuthathwe iisampulu ezingama-30 njengoko obu yayibubungakanani besampulu obufanelekileyo kwisifundo sovavanyo [9]. Ekupheleni kwesigaba ngasinye (kuquka isigaba sokuqala), vavanya ukwanela kobukhulu besampulu usebenzisa ifomula esetyenzisiweyo ukumisela ubungakanani besampulu obufunekayo ukuqikelela i-mean ye-continuous result variable kwinani elinye labantu. Ifomula n = Z2 x SD2 /E2. Kule equation, u-Z yi-Z-score, u-SD yi-standard deviation, kwaye u-E yimpazamo efunekayo [10]. I-alpha yethu yi-0.05, ehambelana nexabiso lika-Z le-1.96, kwaye silindele impazamo ye-5 (kwipesenti). Ngenxa yoko sisombulula i-n = (1.962 x SD2)/52. Iziphumo zibonise ukuba ubungakanani besampulu obufunekayo kwisigaba ngasinye buncinci kunenani langempela eliqokelelweyo.
Ngexesha le-1, 3 kunye ne-4 kusetyenziswa uxinzelelo lwe-glucose olungaphezulu kwesinye, isiphumo soxinzelelo lwe-glucose olwahlukeneyo sahlalutywa ngokuthelekisa utshintsho lwe-fractional phakathi kwexesha elingu-0 kunye nexesha ngalinye elilandelayo (isigaba soku-1 kwimizuzu eli-15, isigaba sesi-3 kwimizuzu eli-15). kunye nesine kwimizuzwana eli-15, emva koko rhoqo emva kwemizuzu emibini.) Amanqanaba otshintsho kwixesha ngalinye athelekiswa kusetyenziswa uvavanyo lweMann-Whitney U kuba idatha ayizange ilandele usasazo oluqhelekileyo njengoko lumiselwe luvavanyo lweShapiro-Wilk oluqhelekileyo. Ekubeni uhlalutyo lwe-1-to-1 lwamaqela aliqela (amahlanu) lwenziwe kumanyathelo okuqala, elesithathu nelesine (amahlanu xa ewonke), ukulungiswa kweBonferroni kwenziwe ukulungisa ixabiso le-alpha elifunekayo libe yi-≤0.01 kodwa hayi i-≤0.05.
Ukuncipha kwenani leeplatelet ngazo zonke ii-hypertonic dextrose kunye nokwanda kwe-MPV kwiiplatelet ze-PRP kwi->12.5% ​​ye-dextrose concentration: Inani leeplatelet ze-PRP linyuke ukusuka kwi-1 ukuya kwi-5 ye-concentration xa kuthelekiswa ne-baseline blood whole, lahluka ngokwendlela (engaboniswanga). Ukuncipha kwenani leeplatelet ngazo zonke ii-hypertonic dextrose kunye nokwanda kwe-MPV kwiiplatelet ze-PRP kwi->12.5% ​​​​ye-dextrose concentration: Inani leeplatelet ze-PRP linyuke ukusuka kwi-1 ukuya kwi-5 concentration xa kuthelekiswa ne-baseline blood whole, lahluka ngokwendlela (engaboniswanga). Уменьшение количества тромбоцитов при всех концентрациях гипертонической декстрозы kunye neMPV kwi тромбоцитах PRP прицизикент% количество тромбоцитов PRP увеличилось в 1-5 раз по сравнению с исходной цельной кровью, в зависимости от метода (не показано). Ukwehla kwenani leeplatelet kuzo zonke ii-hypertonic dextrose concentrations kunye nokwanda kwe-MPV kwiiplatelet ze-PRP kwi->12.5% ​​​​dextrose concentration: Inani leeplatelet ze-PRP linyuke ngokuphindwe ka-1-5 xa kuthelekiswa negazi elipheleleyo elisezantsi, kuxhomekeke kwindlela (engaboniswanga). ).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 Xa i-glucose concentration ingaphezulu kwe-12.5%, i-glucose concentration ephezulu inciphisa inani legazi, i-PRP blood MPV iyanda: xa ithelekiswa ne-与基线全血, inani legazi le-PRP liyanda ukusuka kwi-1 ukuya kwi-5 ye-concentration (ayichazwanga). При концентрациях глюкозы >12,5% все концентрации гипертонической глюкозы снижали количество тромбоцитов, а MPV повышам Пипертонической тромбоцитов PRP увеличивалось от 1- до 5-кратных концентраций по сравнению с исходными концентрациями цельной крови, в той в той Xa amazinga eglucose engaphezulu kwe-12.5%, onke amazinga eglucose egazini anciphisa amanani eeplatelet kwaye andise i-MPV kwiiplatelet ze-PRP: Inani leeplatelet ze-PRP linyuke ngokuphindwe ka-1 ukuya ku-5 xa kuthelekiswa namanqanaba egazi elipheleleyo, kuxhomekeke kwindlela (njengoko kuchaziwe).Umfanekiso 1 ubonisa ukuba inani leeplatelet lehle phantse ngama-75% emva kokuxutywa emanzini kwaye ngama-20-30% emva kwemizuzu eli-15 yokuxutywa kunye noxinzelelo olwahlukileyo lweglucose xa kuthelekiswa ne-PRP yesiseko kunye nokuxutywa kwe-1:1 okulungisiweyo kwivolumu (1- k1 ngokulungiswa kwevolumu). k -1 yokuzalisa).1 ukuzalisa).
Inani leeseli kwi-dilution nganye lichazwa njengeqhezu lenani lokuqala ngaphambi kwe-dilution.
I-MPV yehle kancinci ngexesha lokuveliswa kwe-PRP, ngaphandle kotshintsho olongezelelweyo kumanqanaba okuxutywa ukuya kwi-12.5% ​​emanzini okanye kwi-glucose (kuquka imixube ye-25% ye-PRP glucose) kwaye yanda ngaphezulu kwe-20% emva kokuxutywa kwisisombululo se-50% ye-glucose (Umzobo .2). ). Ngokwahlukileyo koko, ii-erythrocyte azibonisanga tshintsho lubalulekileyo kumthamo kuyo nayiphi na i-dilution ngaphandle kwe-H2O.
Umthamo oqhelekileyo weeseli kwi-dilution nganye uchazwa njengepesenti yomthamo wokuqala ngaphambi komxube.
Ukwehla okufanayo kodwa okungacacanga kangako kwinani leeplatelet kunye nokunyuka kwe-CVR kwabonwa kwi-BC evezwe kwi-50% yeglucose (ukuze kwenziwe nge-25% yeglucose). Itheyibhile yesi-2 ithelekisa amanani eeseli kunye nomthamo weeseli kwigazi elipheleleyo elixutywe kwi-50% ye-dextrose kunye nedatha yesigaba soku-1 se-PRP exutywe kwi-50% ye-dextrose. Utshintsho kwinani lee-RBC kunye ne-RBC MCV belungacacanga kwaye belungeyonto sigxile kuyo.
I-SD = ukuphambuka okuqhelekileyo, i-MD = umahluko ophakathi phakathi kwamaqela, i-SE = ukuphambuka okuqhelekileyo komahluko ophakathi, i-RBC = ii-erythrocytes, i-PLT = iiplatelets, i-PRP = iplasma etyebileyo kwiiplatelets, i-WB = igazi elipheleleyo
Emva kokongeza i-D50W kwi-WB, ipesenti yokulahleka kweplatelet ehlengahlengisiweyo yi-7.7% (310±73 vs. 286±96) xa kuthelekiswa ne-17.8% ye-PRP dilution kwi-D50W (664±348 vs. 544±277). I-MPV WB inyuke nge-16.8% (ukusuka kwi-10.1 ± 0.5 ukuya kwi-11.8 ± 0.6), ngelixa i-MPV PRP inyuke nge-26% (9.2 ± 0.8 vs. 11.6 ± 0.7). Nangona umahluko ophakathi ekunciphiseni inani leeplatelet kunye nokunyuka kwe-MPV bekukhulu kakhulu nge-PRP, utshintsho ekunciphiseni inani leeplatelet ngaphakathi kwe-WB beluphantse lube lukhulu (310 ± 73 ukuya kuma-286 ± 96 (-7.7%); p = .06) kwaye ukwanda kwe-MPV bekubalulekile (10.1 ± 0.5 ukuya kuma-11.8 ± 0.6 (+16.8) p < .001). Nangona umahluko ophakathi ekunciphiseni inani leeplatelet kunye nokunyuka kwe-MPV bekukhulu kakhulu nge-PRP, utshintsho ekunciphiseni inani leeplatelet ngaphakathi kwe-WB beluphantse lube lukhulu (310 ± 73 ukuya kuma-286 ± 96 (-7.7%); p = .06) kwaye ukwanda kwe-MPV bekubalulekile (10.1 ± 0.5 ukuya kuma-11.8 ± 0.6 (+16.8) p < .001).Nangona umahluko ophakathi ekunciphiseni inani leeplatelet kunye nokunyuka kwe-CVR bekukhulu kakhulu nge-PRP, utshintsho ekunciphiseni inani leeplatelet ngaphakathi kwe-WB beluphantse lwabaluleka (310 ± 73 ukuya kwi-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). ukunyuka kwe-MPV bekubalulekile (ukusuka kwi-10.1 ± 0.5 ukuya kwi-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 ± 10. 11.8 ± 0.6 (+16.8) p <.001)尽管 PRP 在 血小板 计数 和 增加 方面 平均 差异 显着 大 , 但 但 内血小板 话显着 的 （（310 ± 73 至 286 ± 96 (-7.7%) ; p = .06）和MPV 的增加是显着的（10.1 ± 0.5 ± 0.5 ± 0.5 ± 10.8 ± 11.8)+ ± 11.8 p. .001.Utshintsho ekunciphiseni inani leeplatelet ngaphakathi kwe-WB lwaluphantse lwabaluleka (ukusuka kwi-310 ± 73 ukuya kwi-286 ± 96 (-7.7%); p = 0.06), nangona i-PRP yayinomahluko omkhulu kakhulu phakathi kokwehla kwenani leeplatelet kunye nokunyuka kwe-MPV. kwaye ukunyuka kwe-MPV kwakubalulekile.(от 10,1 ± 0,5 до 11,8 ± 0,6 (+16,8) р <0,001). (ukusuka kwi-10.1 ± 0.5 ukuya kwi-11.8 ± 0.6 (+16.8) p < 0.001).
Kwakufuneka uxinzelelo lokugqibela lwe-20% yeglucose ukuze kubonakale utshintsho olukhulu kwi-MPV, kodwa utshintsho kwi-MPV lwalubonakala ngakumbi kuxinzelelo lokugqibela lwe-25%. Ukulahleka kweplatelet kuzinze emva kokwehla kokuqala. Siqaphele ukwehla okukhulu kokuqala kwi-CVR, nangona kunjalo, i-CVR yabuyiselwa ngokukhawuleza kuxinzelelo lokugqibela lwe-25% yeglucose, eyayiphezulu kakhulu kunamanqanaba e-CVR abonwe kuxinzelelo lokugqibela lwe-glucose lwe-20% kunye ne-15% (Umzobo 3 kunye nasekhohlo kwiTheyibhile 3; iibhokisi ezinombala). zibonisa amaxabiso e-p ≤ alpha kunye nokulungiswa kweBonferroni kwe-0.01). Kwakukho nokwehla okukhulu kokuqala kwinani le-PLT, okubonwe kwisigaba sokuqala se-0-15 s, kwaye emva koko kwahlala kuzinzile (ukusuka kwimizuzwana eli-15 ukuya kwimizuzu engama-30; ngasekhohlo kweTheyibhile 4).
Ukongezwa kwamanqanaba ahlukeneyo eglucose egazini liphela kubangele ukwehla okukhawulezileyo kwe-MPV kulandele ukubuyiselwa okuxhomekeke kuxinzelelo olungaphezulu kwama-20%. Intsomi ibonisa uxinano lweglucose emva kokuxuba. I-D15, i-D20 kunye ne-D25 zenziwe ngokuxuba kwe-1:1. I-D21 kunye ne-D41 zenziwe ngokuxuba kwe-1:5.
Itheyibhile 4 ibonisa utshintsho kwinani leeplatelet xa lixutywe kwi-hypertonic glucose. Sibone ubudlelwane obuxhomekeke kwidosi phakathi kokuhla kwangoko kwamanani e-PLT kwi-dilution ye-1:1 nakwi-dilution ye-1:5. Xa kuthelekiswa ukuxutywa kwe-1:1 njengeqela elinye kunye nokuxutywa kwe-1:5, iqela le-1:1 lancipha ngokukhawuleza kwinani leeplatelet ngaphantsi kweqela le-1:5 elingu-66±48,000 (23%) xa kuthelekiswa ne-99±69,000 (37%). , p = 0.014) kwiqela le-1:5. Emva kokuhla kokuqala kwindawo yokuqala yokulinganisa, inani leeplatelet njengepesenti yeglucose lizinzile (Umzobo 4).
Xa igazi lilonke longezwa kwi-glucose kumlinganiselo we-1:1, inani leeplatelet lincitshiswa malunga nama-25%. Nangona kunjalo, xa igazi lilonke longezwa kumlinganiselo we-1:5, ukuncipha kwaba kukhulu kakhulu - malunga nama-50%.
I-41% yeglucose inyuse i-MPV ngokukhawuleza nangokumangalisayo kune-25% okanye i-21%. Iziphumo ze-MPV ziboniswe kuMfanekiso 3. Kuzo zonke ezinye iindlela zokunciphisa iswekile, akukho kwehla kokuqala kwe-MPV okubonwe emva kokongezwa kwe-50% yeswekile. Xa kusetyenziswa i-25% yeswekile (uxinzelelo lweswekile yi-20.8% ekunyibilikeni kokugqibela), utshintsho kwi-MPV lwalufana notshintsho kwi-20% yeswekile ekunyibilikeni kwe-1:1 (Umzobo 3). Nangona utshintsho kwi-MPV ekuqaleni lwalukhulu kuxinzelelo oluxutyiweyo lwe-41% kune-25%, umahluko kwi-MPV phakathi kwe-41% kunye ne-25% emva kwemizuzu eli-16 wawungasabalulekile (Itheyibhile 3, ekunene). Kwakhona kuyathakazelisa ukuba i-25% yeswekile inyuse i-MPV ngempumelelo kune-20.8%.
Olu phononongo lwe-in vitro luqinisekisile ngokuyinxenye ingcamango yethu. Ibonise ukuba i-partial platelet lysis inokwenzeka ngokudityaniswa kwe-dextrose, ukulungelelaniswa ngokukhawuleza kwee-platelet kwi-hypertonicity egqithisileyo, kunye nokunyuka okukhulu kwe-MPV ngenxa yoxinzelelo lwe-hypertonic dextrose oluyi-25%. Ibonise ukuba i-partial platelet lysis inokwenzeka ngokudityaniswa kwe-dextrose, ukulungelelaniswa ngokukhawuleza kwee-platelet kwi-hypertonicity egqithisileyo, kunye nokunyuka okukhulu kwe-MPV ngenxa yoxinzelelo lwe-hypertonic dextrose oluyi-25%. Он показал потенциальный частичный лизис тромбоцитов примесью декстрозы, быструю аккомодацию тромбоцитов до экстремального до экстремального повышение MPV в ответ на гипертоническую концентрацию декстрозы > 25%. Ibonise ukuba i-partial platelet lysis enokubakho nge-dextrose, ukulungelelaniswa kwe-platelet ngokukhawuleza ukuya kwi-hypertonicity egqithisileyo, kunye nokwanda okukhulu kwe-MPV ekuphenduleni amanqanaba e-hypertonic dextrose >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，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 血小板 溶解 血小板 快速 适应 极端 高华25% 浓度 高渗 葡萄糖 时 时 mpv 显着。。。。 Inkcazelo ngokuthe gabalala значительное увеличение MPV в ответ на концентрацию гипертонической глюкозы > 25%. Ibonisa i-partial platelet lysis enokwenzeka ngokuxuba i-glucose, ukuziqhelanisa ngokukhawuleza kwe-platelet ne-hypertonicity egqithisileyo, kunye nokwanda okukhulu kwe-MPV ekuphenduleni i-hypertonic glucose >25%.Ukwanda kokuqala bekuphezulu kakhulu kwi-41.6% yeglucose exposure, kodwa ukwanda kwe-MPV kusondele kwi-25% yeglucose exposure malunga nemizuzu engama-20 emva kokuvezwa.
Uxinzelelo lweeplatelets luchaphazeleka yiglucose. Siqaphele ukuba ubungakanani bePLT buyehla kuzo zonke iidilutions zeglucose. Ukwehla okukhulu kwinani leeplatelets kwi-H2O (0%) dilutions yoluhlu lwePRP kunokunxulunyaniswa ne-osmotic lysis. Ngaphandle koko, oku kunokuba yinto ebangelwe kukuhlangana kweeplatelets, kodwa oku kwahlukile ekungatshintshi kwe-MPV kolu dilution. Oku kuthetha ukuba ezinye iiplatelets zinovelwano kakhulu kwi-hypoosmolarity.
Kuzo zonke i-1:1 dilutions zeglucose, ubungakanani bePLT behle ngama-20-30%, nokuba yi-D5W (hypotonic kwi-252 mOsm), nto leyo enokubonisa isiphumo esithile se-non-osmotic seglucose, kuba zombini i-PLT kunye ne-MPV azizange zitshintshe ngokunyuka kathathu koxinzelelo lweglucose. ukusuka kwi-D5W ukuya kwi-D25W. Enyanisweni, uxinano lwe-PLT luye lwanda kancinci ngokunyuka kwe-osmolarity.
Ukwehla kwe-PLT phakathi kwe-1:1 kunye ne-1:5 dilutions kuthetha ukuba isiphumo sokunyibilika sixhomekeke kuxinzelelo lwe-glucose yokuqala kunye neyokugqibela. Ukuba bekuxhomekeke kuxinzelelo lokuqala kuphela, umntu unokulindela ukubona umahluko ekunciphiseni kwe-PLT phakathi koxinzelelo lwe-1:1. Kodwa asikwenzi oko. Ukuba isiphumo se-lysis sixhomekeke kuphela kuxinzelelo lwe-glucose lokugqibela, ngoko asilindelanga umahluko omkhulu phakathi koxinzelelo lwe-20% 1:1 kunye noxinzelelo lwe-20.8% 1:5. Kodwa ke sikwenzile oko.
Ukuba ukulahleka kweplatelet kwenzeka ngenxa ye-platelet lysis, kwakheka i-lysate engaphelelanga, emva koko ii-cytokines kunye nezinto ezikhulayo zikhutshwa kwindawo engaphandle kweseli. Izifundo ezininzi zibonise ukuba i-platelet lysate isebenza phantse njenge-PRP njengesisombululo sokwanda [11]. I-PRP ngokwayo ibonakalisiwe njengesisombululo esisebenzayo sonyango lokwanda [12-14].
Iiplatelets ezingasebenziyo zijikeleza ngendlela yediski eqiniswe ngezakhiwo ezininzi zangaphakathi. Ngexesha lokusebenza, zithatha imo engqukuva okanye ye-amoeba, nto leyo ebangela ukwanda komthamo. Ukwanda komthamo kufuna ukwanda kwendawo yomphezulu, nto leyo ebangelwa kukuphuma kwenkqubo yetyhubhu evulekileyo (OCS) kunye nokongezwa kweegranules ze-exocytic kwi-membrane. Kusafuneka kumiselwe ukuba ukunyuka kwe-MPV okubangelwa yi-hypertonic glucose kubandakanya enye okanye zombini ezi ndlela, kodwa ukuba le yokugqibela, ukunyuka kwe-MPV kuya kubonisa ukubola kwegranulation.
Olu phononongo lubonise ukuba ukuchatshazelwa kumazinga aphezulu eglucose kwi-PRP okanye kwiiplatelets zegazi elipheleleyo kubangele ukwanda kwe-MPV kwimizuzu eli-15 kunye noxinzelelo lweglucose oluyi-25% kunye ne-41.6%, ngokulandelanayo.
Ukwanda kwe-MPV yeplatelet kusenokuba kungenxa yokwanda kwe-microtubule tangles ezijikelezileyo ngenxa yokungena kwe-calcium. ULiu et al. I-glucose ibonakalisiwe ukuba ilawula ukungena kwe-calcium nge-platelet TRPC6 channel [6]. Ingcinga yethu kukuba i-glucose ibangela ukuphumla kwe-microtubule tangles, nto leyo ekhokelela ekwandeni kwe-MPV kunye nokuqonda kwe-platelet kunye/okanye ukusebenza kwayo. Nangona kunjalo, xa sijonga iziphumo zethu, oku kuyinxalenye nje yebali. Kwiimvavanyo zethu, akukho xinaniso ngaphantsi kwe-D25W kubangele ukwanda kwe-MPV. Ngenxa yokuba asizange sivavanye ukuvezwa kuxinaniso lwe-glucose phakathi kwe-12.5% ​​kunye ne-25%, iziphumo zethu zesigaba soku-1 zibonisa ukuba kunokubakho umda kolu luhlu lwaxinaniso lwe-glucose olukhokelela ekwandeni kwe-MPV. Uvavanyo olongezelelweyo kwizigaba 3 kunye ne-4 lubonise ukuba i-20-25% ye-glucose ibonakala ingumlinganiselo woku, kodwa akucaci ukuba kutheni.
Sikwabone ukwehla kwe-~9% kwi-MPV emva kokufakwa kwe-centrifuge. Akucaci nokuba oku kuncipha kwe-MPV kungenxa yeeplatelets ezinkulu nezixineneyo ezibambeke kumaleko we-RBC we-centrifuge. Olu qwalaselo lunokuba lubalulekile koogqirha njengoko lunokuthetha ukuba iiplatelets ze-PRP zincinci kwaye azixinene kangako kwiiplatelets ze-WB.
Kwisifundo sangaphambili, sibonise ukuba ukulungiswa kwe-PRP ngeendlela ezenziwe ngesandla akubizi kakhulu [8]. Ukuba i-glucose yenza ukuba iiplatelets okanye i-PRP zibe buthathaka kwizicubu, nto leyo eyenza ukuba zibe sengozini yokuqalisa ukusebenza, okanye ukuba i-PRP iveliswa ngeempawu ze-lysate ezingaphelelanga, oku kunokuphucula ukuvuselelwa kwakhona kwaye kunciphise isidingo sonyango. Ke ngoko, indibaniselwano ye-PRP kunye ne-glucose egxininisiweyo kakhulu inokuba nexabiso eliphantsi kune-PRP okanye i-glucose yodwa.
Uphononongo lwethu luneentsilelo ezininzi. Okokuqala, sisebenzisa i-PRP efunyenwe kwiindlela ezahlukeneyo. Oku kunokukhokelela kwiziphumo ezingqubanayo. Okwesibini, asikwazanga ukwenza uhlalutyo lwe-biochemical lwazo naziphi na iisampuli zethu ukuze siqinisekise ngokuchanekileyo ukuba ukwenziwa kwe-platelet kwenzeke na. Singathanda ukulinganisa i-P-selectin, i-platelet factor 4, ii-monocytic platelet aggregates, okanye ezinye iimpawu zokwenziwa kwe-platelet ukuze siqonde ngcono inqanaba okanye ubukho be-alpha granule degranulation, kodwa oku kungaphaya kolu phononongo. Okwesithathu, asikwazanga ukuqinisekisa nge-electron microscopy okanye ezinye iindlela ukuba ukwanda kwe-MPV kwii-platelet ezivezwe yi-glucose kwakubangelwa yimpembelelo kwi-microtubule tangles.
Imixube ye-WB okanye i-PRP ene-25% yeglucose yonyuse i-MPV, nto leyo ebonisa ukuqala kokusebenza kweplatelet, nangona olu phononongo lungakhange lubonise ukuqhubela phambili kokuhlanganiswa okanye ukubola kwegranulation. Umxube weglucose we-hypertonic ubangele ukulahleka kweplatelet, mhlawumbi okumela isiphumo se-lytic. Ukusebenza okuncinci okanye i-lysis yeeplatelet kunokubangela ukuvuselelwa kwezicubu emva kokufakwa kweplatelet. Akucaci ukuba zeziphi iziphumo zonyango ezi tshintsho ezinokukhokelela kuzo. Izifundo ezongezelelweyo zibonise ukulinganiswa okuchanekileyo kokusebenza okanye i-lysis kwaye zivavanye iziphumo ezahlukeneyo zonyango zemixube yeglucose ye-hypertonic ene-WB okanye i-PRP.
Unyango lokwandisa iswekile yegazi lunyango olulula nolungabizi kakhulu olukhula ngokukhawuleza noluxhasa uphando lwezonyango. Olu phononongo lubonisa indlela yokusebenza komzimba, ukuba iqinisekisiwe, enokusinceda siqonde inxalenye yendlela yokuvuselela yonyango lokwandisa iswekile yegazi.
I-Biomedical kunye ne-Health Informatics kwiYunivesithi yaseMissouri, kwiSikolo sezonyango saseKansas City, eKansas City, eMelika
Abantu Abachaphazelekayo: Bonke abathathi-nxaxheba kolu phononongo banike imvume okanye abavumanga. I-International Society for Cellular Medicine ikhuphe imvume ye-ICMS-2017-003. Le protocol ilandelayo ivunyiwe ukuba isetyenziswe ngakumbi yiBhodi yoHlolo lweZiko le-International Society for Cellular Medicine: Isihloko: Ukubalwa kwemveliso yeziyobisi ze-plasma ezityebileyo ngeeplatelet ngokusekelwe kwinani leeplatelet ze-CBC ezisisiseko. Abantu Abachaphazelekayo kwiZilwanyana: Bonke ababhali baqinisekisile ukuba akukho zilwanyana okanye izicubu ezibandakanyekileyo kolu phononongo. Iingxabano zoMdla: Ngokuhambelana neFomu yokuTyhilwa kwe-ICMJE Uniform, bonke ababhali bavakalisa oku kulandelayo: Ulwazi lwentlawulo/lwenkonzo: Bonke ababhali bavakalisa ukuba abazange bafumane inkxaso-mali kuyo nayiphi na intlangano ngomsebenzi ongenisiweyo. Ubudlelwane bezeMali: Bonke ababhali bavakalisa ukuba okwangoku okanye kwiminyaka emithathu edlulileyo abanabo ubudlelwane bezemali nayo nayiphi na intlangano enokuba nomdla kumsebenzi ongenisiweyo. Ezinye iiNtlangano: Bonke ababhali bavakalisa ukuba akukho budlelwane okanye imisebenzi enokuchaphazela umsebenzi ongenisiweyo.
UHarrison TE, uBowler J, uReeves K et al. (Meyi 17, 2022) Impembelelo yeglucose kwinani leeplatelet kunye nomthamo: iziphumo zonyango lokuvuselela. I-Cure 14(5): e25081. doi:10.7759/cureus.25081
© Ilungelo lokushicilela ngo-2022 uHarrison nabanye. Eli linqaku elivulelekileyo elisasazwa phantsi kwemigaqo yeLayisensi yeCreative Commons Attribution CC-BY 4.0. Ukusetyenziswa, ukusasazwa, kunye nokuveliswa kwakhona okungenamkhawulo kuyo nayiphi na indlela kuvumelekile, ukuba nje umbhali wokuqala kunye nomthombo banikwe imbeko.