"Ungangabazi ukuthi iqembu elincane lezakhamuzi ezicabangayo nezizinikele lingashintsha umhlaba. Eqinisweni, yilona lodwa lapho."
Umsebenzi kaCureus ukushintsha imodeli yokushicilelwa kwezokwelapha eseyikhona isikhathi eside, lapho ukuthunyelwa kocwaningo kungaba kubi kakhulu, kube yinkimbinkimbi, futhi kudle isikhathi.
I-plasma/prp ecebile ngama-platelet, ukuvuselelwa kwezicubu, ukusebenza kwama-platelet, ukwelashwa kokwandisa i-glucose, ama-platelet, ukwelashwa kokwandisa
Caphuna lesi sihloko kanje: Harrison TE, Bowler J, Reeves K, et al. (Meyi 17, 2022) Umphumela we-glucose ekubalweni kwama-platelet kanye nomthamo: imiphumela yemithi yokuvuselela. I-Cure 14(5): e25081. doi:10.7759/cureus.25081
I-plasma ecebile ngama-platelet (PRP) kanye nezixazululo ze-glucose e-hypertonic zivame ukusetshenziswa ekujovweni kwemithi yokuvuselela, ngezinye izikhathi ndawonye. Umphumela we-glucose e-hypertonic eku-lysis ye-platelet kanye nokusebenza kwayo awukaze ubikwe ngaphambilini. Sihlole umphumela wokugcwala kwe-glucose okuphezulu ekubalweni kwama-platelet kanye nama-erythrocyte, kanye nomthamo wamaseli ku-PRP kanye negazi lonke (WB). Ukwehla okusheshayo kwengxenye ye-platelet kwenzeka ngazo zonke izingxube ze-glucose ezixutshwe ne-PRP noma igazi lonke, okuhambisana ne-lysis engaphelele. Ngemva komzuzu wokuqala, ukubalwa kwama-platelet kwahlala kuzinzile, okubonisa ukuthi ama-platelet asele ahlala ngokushesha ku-hypertonicity eyeqile (>2000 mOsm). Ngemva komzuzu wokuqala, ukubalwa kwama-platelet kwahlala kuzinzile, okubonisa ukuthi ama-platelet asele ahlala ngokushesha ku-hypertonicity eyeqile (>2000 mOsm). После первой минуты количество тромбоцитов оставалось стабильным, что указывает на быструю аккомодацию остаточных тромбильным мОсм) гипертонуса. Ngemva komzuzu wokuqala, inani lama-platelet lahlala lizinzile, okubonisa ukuhlaliswa okusheshayo kwama-platelet asele ku-hypertonicity eyeqile (>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).2000 mOsm）高渗状态. После первой минуты количество тромбоцитов оставалось стабильным, что указывает на быструю адаптацию остаточных тромбильным мОсм) гиперосмолярному состоянию. Ngemva komzuzu wokuqala, inani lama-platelet lahlala lizinzile, okubonisa ukuzivumelanisa okusheshayo kwama-platelet asele esimweni se-hyperosmolar esibi kakhulu (>2000 mOsm).Ukuhlushwa kwe-glucose okungu-25% nangaphezulu kuholele ekukhuleni okukhulu kwevolumu ye-platelet ephakathi (i-MPV), okubonisa isigaba sokuqala sokusebenza kwe-platelet. Kudingeka izifundo ezengeziwe ukuze kutholakale ukuthi i-platelet lysis noma ukusebenza kwayo kwenzeka yini nokuthi ngabe ukujova kwe-glucose e-hypertonic kuphela noma kuhlanganiswe ne-PRP kunganikeza izinzuzo ezengeziwe zomtholampilo.
Ngawo-1950, udokotela ohlinzayo waseMelika uGeorge Hackett wathola ukuthi angaqeda unomphela ubuhlungu bamalunga nomhlane ezigulini eziningi ngokufaka isisombululo esikhulayo emithanjeni nasemigqeni. Ukuhlolwa kwakhe onogwaja kubonise ukuthi ukwelashwa, akubiza ngokuthi ukwelashwa okukhulayo, kwabangela ukuba imisipha ikhule futhi iqine. Izifundo ze-Histological ziqinisekisile ukuthi kukhiqizwa i-collagen entsha phakathi nale nqubo [1].
Phakathi neminyaka embalwa yokuqala, kwazanywa izixazululo eziningi ezahlukene zokusabalalisa. Ngawo-1990, iningi labachwepheshe lalibheka amazinga aphezulu e-glucose njengendlela ephephile nephumelelayo kakhulu. Kodwa-ke, indlela yokusebenza ayikacaci.
Zimbalwa izifundo zezokwelapha ezenziwa ngekhulu lama-20 ngemva komsebenzi kaHackett. Kodwa-ke, ngawo-2000 kwaba nesithakazelo esisha futhi kwaqedwa izivivinyo eziningana zezokwelapha eziphumelelayo zokwelapha ubuhlungu obuphansi emhlane [2], i-osteoarthritis yamadolo [3], kanye ne-lateral epicondylitis [4].
Ukuvuselelwa kwezicubu kudinga ukuhlanganyela kwamaseli okuqala. Ngakho-ke, ukugxila okuphezulu kwe-glucose kumele ngandlela thile kubangele ukufuduka, ukuphindaphinda, kanye nokwehlukaniswa kwamaseli okuqala. Sicabanga ukuthi ama-platelet angasebenza njengezithunywa nokuthi ukugxila okuphezulu kwe-glucose kungabangela ama-platelet ukuthi akhiphe ama-cytokine kanye nezinto zokukhula, ngaleyo ndlela kukhuthaze izinqubo zokuvuselela, ikakhulukazi ukufuduka kwamaseli okuqala aye ezindaweni ezinokugxila okuphezulu kwe-glucose.
Ukusebenza kweplatelet kuhlala kuqala ukwanda kwe-calcium yangaphakathi kweseli [5]. ULiu nabanye ngo-2008 babonise ukuthi amazinga aphezulu e-glucose akhulisa umsebenzi weziteshi ze-transient receptor potential canonical type 6 (TRPC6) ku-plasma membrane, okuholela ekungeneni kwama-ion e-calcium kuma-platelet [6]. Olunye ucwaningo lubonise ukuthi ukuvezwa kwendawo engaphansi kwe-microtubule kuma-ion e-calcium kubangela ukuphumula, ukwanda, kanye nokuguqulwa kwendawo engaphansi, okubangela ushintsho esimweni kusuka ku-disc kuya ku-spherical, okuholela ku-mean platelet volume (MPV) [7].
Umbono wethu kulolu cwaningo ukuthi ukuchayeka kwama-platelet ekugxilweni okuphezulu kwe-glucose kuthinta indawo engaphansi kwe-microtubule kanye nendawo engaphakathi kweseli, okuholela ekwandeni kwe-MPV.
Bonke ababambiqhaza basayine ifomu lemvume enolwazi ngemuva kokuba imininingwane yocwaningo isichaziwe nangaphambi kokuthola amasampula. Kulolu cwaningo, kwasetshenziswa amasampula e-PRP kuphela ane-hematocrit engaphezu kuka-2% ukuze kubalwe ama-erythrocyte (ama-erythrocyte) kanye nenani eliphakathi lamaseli abomvu egazi (i-MCV) ukuze kuqhathaniswe.
Ucwaningo lwenziwe ngezigaba ezine, isigaba sokuqala kwakuyi-PRP kanti izigaba ezisele kwakuyigazi eliphelele (Ithebula 1). Njengoba kuchaziwe ngaphambilini [8], wonke amandla e-centrifugal ahlobene (i-RCF, i-g-force) abalwa kusukela endaweni ephakathi (i-Rmid, ngo-cm) yekholomu yegazi kusirinji ye-centrifugal. Sikhethe ukusebenzisa i-MPV njengophawu lokuzwela kwama-platelet kanye nokubalwa kwama-platelet njengesibonakaliso se-plaquette lysis engaba khona, kokubili okungalinganiswa kalula kuma-analyzers ajwayelekile e-hematology.
Esigabeni sokuqala, izisebenzi zokuzithandela ezingu-47 zanikela ngamasampula egazi—ithubhu elilodwa le-ethylenediaminetetraacetic acid (EDTA) kanye nesampula yegazi lonke le-PRP elilodwa (elingajiyi igazi nge-sodium citrate (NaCl, 3%)) (Ithebula 1). Beka i-rocker ethubhu ngokushesha. Ukubalwa kwegazi okuphelele (i-CBC) kwenziwa kumasampula e-EDTA kathathu, futhi amasampula e-NaCl ahlaziywa kathathu ukuze kuhlaziywe i-CBC, bese i-PRP ilungiswa ngezindlela ezahlukene ezichazwe ngenhla [8]. Wonke amasampula e-PRP alungiswa nge-centrifugation ku-900-1000 g. Hlanganisa isampula ngayinye ye-PRP ku-vortex mixer imizuzwana emi-5-10, bese uhlukanisa ama-aliquot amahlanu angu-0.5 ml abe ngamathubhu.
Ukuze kuhlolwe umphumela wokuvezwa kweplatelet ekugxilweni okuphezulu kweglucose, amanani alinganayo (0.5 ml) ka-0%, 5%, 12.5%, 25%, kanye no-50% weglucose emanzini axutshwe namasampula eplatelet ukuze kutholakale amazinga angu-0%, 2.5% 6.25%, 12.5% ​​​​kanye no-25% engxube yeglucose bese kuhlanganiswa amashubhu ku-test tube shaker imizuzu eyi-15. I-TAC yengxube ngayinye yahlaziywa kathathu ngemva kwemizuzu eyi-15. Inani lamaplatelet (PLT), inani lama-RBC, i-MCV, kanye ne-MPV kwalinganiswa ngethubhu ngayinye, kanti inani lamaplatelet elimaphakathi, inani lama-RBC, i-MCV, kanye ne-MPV labalwa kuwo wonke amasampula e-PRP.
Ngemva kokuba isigaba sokuqala sokuqoqwa kwedatha sesiqediwe, sabona ukwanda okukhulu kwevolumu yama-platelet kuma-platelet e-PRP ngemva kokwengezwa kwe-D50W. Ama-platelet e-PRP awameleli ngempela wonke ama-platelet egazini, futhi i-PRP medium ihlukile kune-WB medium. Ngakho-ke, sanquma ukwenza isivivinyo sesigaba sesibili somphumela wokwengeza i-D50W egazini lonke.
Emzuliswaneni wesibili, sikhethe usayizi wesampula ongu-30 ngokusekelwe emiphumeleni yochungechunge lokuqala, njengoba kuchaziwe esigabeni sokuhlaziya. Kulolu chungechunge, izisebenzi zokuzithandela ezingu-20 zanikela ngamasampula egazi (Ithebula 1). Igazi eliphelele (1.8 ml) ladonswa esirinjini engu-3 ml futhi lafakwa i-anticoagulation nge-0.2 ml 40% NaCl. Isirinjini lonke legazi laxutshwa imizuzwana emihlanu nge-vortex mixer kwathi i-CBC yahlaziywa kathathu. Ngemva kokuhlaziywa, igazi elingasebenzi kahle lanezelwa ku-2 ml ye-50% glucose esirinjini engu-5 ml (ukuhlushwa kokugcina kweglucose kwakungacishe kube ngu-25% (D25) kwafakwa eshubhu lokuxubha imizuzu engu-30. Ngemva kwemizuzu engu-30, i-D25/CBC esirinjini ze-WB yahlaziywa kathathu. Inani lamaplatelet, inani lama-RBC, i-MCV, kanye ne-MPV ngesirinji ngayinye kwalinganiswa isilinganiso, futhi isilinganiso se-PLT, inani lama-RBC, i-MCV, kanye ne-MPV sabalwa ngesampula ngayinye ngaphambi nangemva kokufaka i-glucose.
Ngenxa yokuthi ama-platelet egazini lonke avame ukuchayeka ku-glucose e-hypertonic ngesikhathi sokwelashwa kwe-glucose ekhulayo ngenxa yokujova okuncane, futhi akuvamile ukuhlanganisa i-PRP ne-glucose e-hypertonic ngaphambi nje kokujova, sanquma ukutadisha i-glucose e-hypertonic ngokuhlanganiswa ne-WB kuSigaba 1. Isinyathelo Sesithathu nesesine. Esigabeni ngasinye, izisebenzi zokuzithandela ezingu-20 zanikela nge-7-8 ml ye-ACD-A (i-asidi equkethe i-trisodium citrate (22.0 g/l), i-citric acid (8.0 g/l) kanye ne-glucose (24.5 g/l), isixazululo se-dextrose citrate) semithi yokuvimbela ukugaywa kwegazi (Ithebula 1). Kusetshenziswa izingxube ze-glucose ezingaphezu kuka-12.5% ​​kuphela ukunquma iphesenti lomkhawulo elihlotshaniswa nokwanda kwe-MPV. Esigabeni sesithathu, i-1 ml yegazi ifakwa epayipini lokuhlola. Bese uxuba igazi ku-vortex mixer imizuzwana eyi-10 ngokufaka i-1 ml ye-glucose engu-30%, i-glucose engu-40%, noma i-glucose engu-50% epayipini ukuze uthole ukuhlushwa kokugcina kwe-glucose okungu-15%, 20%, kanye no-25%, ngokulandelana. Amasampula egazi le-glucose ahlaziywe nge-CBC ngokushesha ngemva kokuxuba futhi aphindaphindwa njalo ngemizuzu emibili imizuzu engama-30.
Ngesikhathi sokuxuba kokuqala, ukungezwa kwe-glucose ye-hypertonic engu-1:1 kanye ne-WB noma i-PRP kuveza ama-platelet ezingeni elingaphezu kuka-25% imizuzwana embalwa. Esinyathelweni sesine, ukuhlola umphumela we-glucose ye-hypertonic ngezinga eliphansi lokuqala lokuhlushwa kanye nokuhlola umkhawulo ophezulu womphumela we-glucose, sengeze inani elincane legazi ku-D25W noma ku-D50W. Beka i-1 ml ye-D25W noma i-D50W epayipini bese wengeza u-0.2 ml we-WB ngenkathi upheqa isampula imizuzwana eyi-10. Kulezi zimo, igazi lavezwa ku-glucose ezingeni elicishe libe ngu-20% ngaphezu kwezinga lokugcina, kunokuba libe ngu-50% ngaphezu kwezinga lokugcina njengaseSigabeni sesi-3, okwaholela ekuhlushweni kokugcina kwe-glucose okungu-20.8% no-41.6%. Amasampula axubile ahlaziywe ngesikhathi esifanayo njengasesigabeni sesi-3.
Esigabeni sokuqala sochungechunge ngalunye lokuxuba ushukela, kuthathwe amasampula angu-30 njengoba lokhu kwakuwusayizi wesampula ofanele wesifundo sokuhlola [9]. Ekupheleni kwesigaba ngasinye (kufaka phakathi isigaba sokuqala), hlola ukwanela kosayizi wesampula usebenzisa ifomula esetshenziselwa ukunquma usayizi wesampula odingekayo ukulinganisa isilinganiso se-continuous outcome variable kubantu ababodwa. Ifomula n = Z2 x SD2 /E2. Kulesi sibalo, u-Z uyi-Z-score, u-SD uyi-standard deviation, kanye no-E yiphutha elifunwayo [10]. I-alpha yethu ingu-0.05, ehambisana nenani lika-Z elingu-1.96, futhi silindele iphutha elingu-5 (ngamaphesenti). Ngakho-ke sixazulula i-n = (1.962 x SD2)/52. Imiphumela ibonise ukuthi usayizi wesampula odingekayo esigabeni ngasinye wawuncane kunenombolo yangempela eqoqwe.
Phakathi nezikhathi 1, 3 kanye no-4 kusetshenziswa ukuhlushwa kwe-glucose okungaphezu kokukodwa, umphumela wokuhlushwa kwe-glucose okuhlukene wahlaziywa ngokuqhathanisa ushintsho lwengxenye phakathi kwesikhathi 0 nesikhathi ngasinye esilandelayo (isigaba 1 ngemizuzu eyi-15, isikhathi 3 ngemizuzu eyi-15). kanye nesine ngemizuzwana eyi-15, bese kuba njalo ngemizuzu emibili.) Amazinga okushintsha kwesikhathi ngasinye aqhathaniswa kusetshenziswa ukuhlolwa kwe-Mann-Whitney U ngoba idatha ayizange ilandele ukusatshalaliswa okuvamile njengoba kunqunywe ukuhlolwa kokujwayelekile kwe-Shapiro-Wilk. Njengoba ukuhlaziywa kwe-1 kuya ku-1 kwamaqembu amaningana (amahlanu) kwenziwa ezinyathelweni zokuqala, zesithathu nezesine (ezinhlanu sezizonke), ukulungiswa kwe-Bonferroni kwenziwa ukulungisa inani le-alpha elifunwayo libe yi-≤0.01 kodwa hhayi i-≤0.05.
Ukwehla kwenani lama-platelet ngawo wonke amazinga e-dextrose ye-hypertonic kanye nokwanda kwe-MPV kuma-platelet e-PRP ku->12.5% ​​amazinga e-dextrose: Inani lama-platelet e-PRP lenyuke kusukela ekugxilweni okukodwa kuya kokuhlanu uma kuqhathaniswa negazi lonke eliyisisekelo, kuyahlukahluka ngendlela (engaboniswanga). Ukwehla kwenani lama-platelet ngawo wonke amazinga e-hypertonic dextrose kanye nokwanda kwe-MPV kuma-platelet e-PRP ku->12.5% ​​​​ukuhlushwa kwe-dextrose: Inani lama-platelet e-PRP lenyuke kusukela ekuhlushweni okuphindwe kahlanu kuya kokuphindwe kahlanu uma kuqhathaniswa negazi lonke eliyisisekelo, kuyahlukahluka ngendlela (engaboniswanga). Уменьшение количества тромбоцитов при всех концентрациях гипертонической декстрозы kanye ne-MPV увеличение в тромбоцитах PRP прицентрациях гипертонической декстрозы kanye ne-MPV ku-тромбоцитах PRP прицентрациях прицентрацияй количество тромбоцитов PRP увеличилось ku 1-5 раз по сравнению с исходной цельной кровью, в зависимости от метода (не показано). Inani lamaplatelet elinciphile kuzo zonke izilinganiso ze-dextrose ye-hypertonic kanye ne-MPV ekhuphukile kumaplatelet e-PRP ku->12.5% ​​​​inani le-dextrose: Inani lamaplatelet e-PRP likhuphuke izikhathi ezingu-1-5 uma kuqhathaniswa negazi lonke eliyisisekelo, kuye ngendlela (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（未漉。 Uma kugxilwe ku-glucose okungu->12.5% ​​​​, ukugxilwa okuphezulu kwe-glucose kunciphisa inani legazi, i-PRP blood MPV iyanda: uma kuqhathaniswa ne-与基线全血, inani legazi le-PRP liyanda kusukela ku-1 kuya ku-5 izikhathi zokugxilwa (akuchazwanga). При концентрациях глюкозы >12,5% все концентрации гипертонической глюкозы снижали количество тромбоцитов, а MPV повышам Питана тромбоцитов PRP увеличивалось от 1- до 5-кратных концентраций по сравнению с исходными концентрациями цельной крови, втопи за видео Uma amazinga e-glucose angaphezu kuka-12.5%, wonke amazinga e-glucose ane-hypertension anciphise inani lama-platelet kanye ne-MPV eyandayo kuma-platelet e-PRP: Inani lama-platelet e-PRP landa ngokuphindwe ka-1 kuya ku-5 uma kuqhathaniswa namazinga egazi lonke ayisisekelo, kuye ngendlela (njengoba kuchaziwe).Isibalo 1 sibonisa ukuthi inani lama-platelet lehle cishe ngo-75% ngemva kokuxutshwa emanzini kanye nango-20-30% ngemva kwemizuzu eyi-15 yokuxutshwa ngamanani ahlukene e-glucose uma kuqhathaniswa ne-PRP eyisisekelo kanye nokuxutshwa okungu-1:1 okulungisiwe ngevolumu (1- k1 ngokulungiswa kwevolumu). k -1 ukuzalanisa).1 ukuzalanisa).
Inani lamaseli ekuxubeni ngakunye livezwa njengengxenye yenombolo yokuqala ngaphambi kokuxuba.
I-MPV yehle kancane ngesikhathi sokukhiqizwa kwe-PRP, ngaphandle kokushintsha okwengeziwe ekugxilweni kokuxuba kube ngu-12.5% ​​​​emanzini noma ku-glucose (kufaka phakathi izingxube ze-glucose ze-PRP ezingu-25%) futhi yanda ngaphezu kuka-20% ngemva kokuxuba kusisombululo se-glucose esingu-50% (Isithombe .2). ). Ngokuphambene nalokho, ama-erythrocyte awazange abonise ushintsho olukhulu kuvolumu kunoma yikuphi ukuxuba ngaphandle kwe-H2O.
Ivolumu emaphakathi yamaseli ekuxubeni ngakunye ivezwa njengephesenti levolumu yokuqala ngaphambi kokuxuba.
Ukwehla okufanayo kodwa okungacacile kakhulu kwenani lama-platelet kanye nokwanda kwe-CVR kwabonwa e-BC evezwe ku-50% we-glucose (ukwakheka nge-25% ye-glucose). Ithebula 2 liqhathanisa izinombolo zamaseli kanye nomthamo wamaseli egazini lonke elixutshwe ku-50% we-dextrose nedatha yesigaba 1 se-PRP exutshwe ku-50% we-dextrose. Izinguquko ekubalweni kwama-RBC kanye ne-RBC MCV zazingabonakali futhi kwakungeyona into esigxile kuyo.
I-SD = ukuphambuka okujwayelekile, i-MD = umehluko ophakathi phakathi kwamaqembu, i-SE = ukuphambuka okujwayelekile komehluko ophakathi, i-RBC = ama-erythrocyte, i-PLT = ama-platelet, i-PRP = i-plasma ecebile ngama-platelet, i-WB = igazi eliphelele
Ngemva kokwengeza i-D50W ku-WB, ukulahleka kwe-platelet okulungisiwe nge-dilution kwaba ngu-7.7% (310±73 vs. 286±96) uma kuqhathaniswa no-17.8% we-PRP dilution ku-D50W (664±348 vs. 544±277). I-MPV WB ikhuphuke ngo-16.8% (kusukela ku-10.1 ± 0.5 kuya ku-11.8 ± 0.6), kuyilapho i-MPV PRP ikhuphuke ngo-26% (9.2 ± 0.8 vs. 11.6 ± 0.7). Nakuba umehluko ophakathi kokubili ekunciphiseni inani lama-platelet kanye nokwanda kwe-MPV kwakukhulu kakhulu nge-PRP, izinguquko ekunciphiseni inani lama-platelet ngaphakathi kwe-WB zazicishe zibaluleke kakhulu (310 ± 73 kuya ku-286 ± 96 (-7.7%); p = .06) kanye nokwanda kwe-MPV kwakubalulekile (10.1 ± 0.5 kuya ku-11.8 ± 0.6 (+16.8) p < .001). Nakuba umehluko ophakathi kokubili ekunciphiseni inani lama-platelet kanye nokwanda kwe-MPV kwakukhulu kakhulu nge-PRP, izinguquko ekunciphiseni inani lama-platelet ngaphakathi kwe-WB zazicishe zibaluleke kakhulu (310 ± 73 kuya ku-286 ± 96 (-7.7%); p = .06) kanye nokwanda kwe-MPV kwakubalulekile (10.1 ± 0.5 kuya ku-11.8 ± 0.6 (+16.8) p < .001).Nakuba umehluko ophakathi kokubili ekunciphiseni inani lama-platelet kanye nokwanda kwe-CVR kwakukhulu kakhulu nge-PRP, izinguquko ekwehleni kwenani lama-platelet ngaphakathi kwe-WB zazicishe zibaluleke kakhulu (310 ± 73 kuya ku-286 ± 96 (-7.7%); p = 0.06).увеличение MPV было значительным (kusukela 10,1 ± 0,5 до 11,8 ± 0,6 (+16,8) p < 0,001). ukwanda kwe-MPV kwakubalulekile (kusukela ku-10.1 ± 0.5 kuya ku-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 的增劝 ± 10. kufika ku-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 大 , 但 但 内血小板 设显着 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 ± 10.8 ± 11.8) ± 11.8 p. .001).Ushintsho ekunciphiseni inani lama-platelet ngaphakathi kwe-WB lwalucishe lube lukhulu (kusukela ku-310 ± 73 kuya ku-286 ± 96 (-7.7%); p = 0.06), yize i-PRP yayinomehluko omkhulu kakhulu wesilinganiso ekwehleni kwenani lama-platelet kanye nokwanda kwe-MPV. kanti ukwanda kwe-MPV kwakubalulekile.(kusukela ku-10,1 ± 0,5 kuya ku-11,8 ± 0,6 (+16,8) р <0,001). (kusukela ku-10.1 ± 0.5 kuya ku-11.8 ± 0.6 (+16.8) p < 0.001).
Kwakudingeka ukuhlushwa kokugcina kwe-glucose engu-20% ukuze kubonakale ushintsho olukhulu ku-MPV, kodwa ushintsho ku-MPV lwalubonakala kakhulu ekuhlushweni kokugcina okungu-25%. Ukulahleka kwamaplatelet kuzinzile ngemva kokwehla kokuqala. Siphawule ukwehla okukhulu kokuqala ku-CVR, nokho, i-CVR yabuyiselwa ngokushesha ekuhlushweni kokugcina kwe-glucose okungu-25%, okwakuphakeme kakhulu kunamazinga e-CVR abonwe ekuhlushweni kokugcina kwe-glucose okungu-20% no-15% (Isithombe 3 kanye nakwesobunxele seThebula 3; amabhokisi anemithunzi). kukhombisa amanani e-p ≤ alpha ngokulungiswa kwe-Bonferroni okungu-0.01). Kwakukhona nokwehla okukhulu kokuqala kwenani le-PLT, okubonwe esigabeni sokuqala samasekhondi angu-0-15, kwabe sekuhlala kuzinzile (kusukela kumasekhondi angu-15 kuya kumaminithi angu-30; kwesobunxele sethebula 4).
Ukwengezwa kwamazinga ahlukahlukene e-glucose egazini lonke kuholele ekwehleni okusheshayo kokuqala kwe-MPV kulandelwe ukubuyiselwa kwe-concentration okungaphezu kuka-20%. Inganekwane ikhombisa amazinga e-glucose ngemva kokuxuba. I-D15, i-D20 kanye ne-D25 kwenziwa ngokuxuba okungu-1:1. I-D21 kanye ne-D41 kwenziwa ngokuxuba okungu-1:5.
Ithebula 4 libonisa ushintsho ekubalweni kwama-platelet uma kuncishiswa ku-glucose e-hypertonic. Sibone ubudlelwano obuncike kumthamo phakathi kokwehla okusheshayo kwezinombolo ze-PLT ekuncishisweni okungu-1:1 kanye nasekuncishisweni okungu-1:5. Uma kuqhathaniswa ukuncishiswa okungu-1:1 njengeqembu elilodwa nokuncishiswa okungu-1:5, iqembu elingu-1:1 laba nokwehla okusheshayo ekubalweni kwama-platelet okungaphansi kweqembu elingu-1:5 elingu-66±48,000 (23%) uma kuqhathaniswa no-99±69,000 (37%). , p = 0.014) eqenjini elingu-1:5. Ngemva kokwehla kokuqala endaweni yokuqala yokulinganisa, inani lama-platelet njengephesenti le-glucose lazinza (Isithombe 4).
Uma igazi lonke lifakwa ku-glucose ngesilinganiso esingu-1:1, inani lama-platelet lincishiswa cishe ngo-25%. Kodwa-ke, lapho igazi lonke lifakwa ngesilinganiso esingu-1:5, ukwehla kwaba kukhulu kakhulu - cishe ngo-50%.
I-glucose engu-41% inyuse i-MPV ngokushesha nangokumangalisayo kuno-25% noma u-21%. Imiphumela ye-MPV iboniswe kuMfanekiso 3. Kuzo zonke ezinye izinciphiso, akukho ukwehla kokuqala kwe-MPV okubonwe ngemuva kokwengezwa kwe-glucose engu-50%. Lapho kusetshenziswa i-glucose engu-25% (ukuhlushwa kwe-glucose okungu-20.8% ekuhlushweni kokugcina), ushintsho ku-MPV lwalufana noshintsho ku-glucose engu-20% ekuhlushweni okungu-1:1 (Isithombe 3). Nakuba izinguquko ku-MPV ekuqaleni zazinkulu ekuhlushweni okuxubile okungu-41% kuno-25%, umehluko ku-MPV phakathi kuka-41% no-25% ngemva kwemizuzu engu-16 wawungasabalulekile (Ithebula 3, kwesokudla). Kuyathakazelisa futhi ukuthi i-glucose engu-25% inyuse i-MPV ngempumelelo kuno-20.8%.
Lolu cwaningo olwenziwe ngaphandle kokusebenzisa i-vitro luqinisekisile ngokwengxenye umbono wethu. Kubonise ukukhishwa kwama-platelet okungaba khona ngokuhlanganiswa kwe-dextrose, ukufakwa okusheshayo kwama-platelet ku-hypertonicity eqile, kanye nokwenyuka okukhulu kwe-MPV ngenxa yokugxila okungaphezulu kuka-25% kwe-hypertonic dextrose. Kubonise ukukhishwa kwama-platelet okungaba khona ngokuhlanganiswa kwe-dextrose, ukufakwa okusheshayo kwama-platelet ku-hypertonicity eqile, kanye nokwenyuka okukhulu kwe-MPV ngenxa yokugxila okungaphezulu kuka-25% kwe-hypertonic dextrose. Он показал потенциальный частичный лизис тромбоцитов примесью декстрозы, быструю аккомодацию тромбоцитов до экстремальестрозы повышение MPV в ответ на гипертоническую концентрацию декстрозы > 25%. Kubonise ukukhishwa kwama-platelet okungaba khona nge-dextrose, ukuhambisana okusheshayo kwama-platelet ne-hypertonicity eqile, kanye nokwenyuka okukhulu kwe-MPV ekuphenduleni amazinga 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 极端25% 浓度 高渗 葡萄糖 时 时 mpv 显着。。。. Он показывает потенциальный частичный лизис тромбоцитов смесями с глюкозой, быструю адаптацию тромбоцитов к экстремальпитом значительное увеличение MPV в ответ на концентрацию гипертонической глюкозы > 25%. Ibonisa ukuhlanzwa kwe-platelet okungaba khona ngokuhlanganiswa kwe-glucose, ukuzivumelanisa okusheshayo kwe-platelet ne-hypertonicity enkulu, kanye nokwanda okukhulu kwe-MPV ekuphenduleni kwe-glucose ephezulu >25%.Ukwanda kokuqala kwakuphezulu kakhulu ku-41.6% yokuchayeka ku-glucose, kodwa ukwanda kwe-MPV kwasondela ku-25% yokuchayeka ku-glucose cishe imizuzu engama-20 ngemva kokuchayeka.
Ukuhlushwa kwama-platelet kuthinteka yi-glucose. Siqaphele ukuthi inani le-PLT lehla kuzo zonke izingxube ze-glucose. Ukwehla okukhulu kwenani lama-platelet ekuhlungeni kwe-H2O (0%) kochungechunge lwe-PRP kungahlotshaniswa ne-osmotic lysis. Ngaphandle kwalokho, lokhu kungaba yinto ebangelwa ukuhlangana kwama-platelet, kodwa lokhu kuphambene nokuntuleka koshintsho lwe-MPV kulokhu kuhlanganiswa. Lokhu okutholakele kusho ukuthi amanye ama-platelet azwela kakhulu ku-hypoosmolarity.
Kuzo zonke izingxube ze-glucose ezingu-1:1, inani le-PLT lehle ngo-20-30%, ngisho nange-D5W (hypotonic ku-252 mOsm), okungase kubonise umphumela othize we-glucose ongeyona i-osmotic, njengoba kokubili i-PLT ne-MPV zahlala zingashintshi ekukhuleni okuphindwe kathathu kokuhlushwa kwe-glucose. kusuka ku-D5W kuya ku-D25W. Eqinisweni, ukuhlushwa kwe-PLT kwavame ukwanda kancane ngokukhula kwe-osmolarity.
Ukwehla kwe-PLT phakathi kokunciphisa okungu-1:1 no-1:5 kusho ukuthi umphumela wokuncibilika uncike ekugxilweni kwe-glucose kokuqala nokokugcina. Uma kuncike ekugxilweni kokuqala kuphela, khona-ke umuntu angalindela ukubona umehluko ekunciphiseni kwe-PLT phakathi kokugxila okungu-1:1. Kodwa asikwenzi lokho. Uma umphumela we-lysis uncike ekugxilweni kwe-glucose kokugcina kuphela, khona-ke asilindele umehluko omkhulu phakathi kokunciphisa okungu-20% 1:1 kanye nokunciphisa okungu-20.8% 1:5. Kodwa-ke sikwenzile lokho.
Uma ukulahleka kweplatelet kwenzeka ngenxa ye-platelet lysis, kwakheka i-lysate engaphelele, ngemva kwalokho ama-cytokine kanye nezinto zokukhula zikhishwa ziye endaweni engaphandle kweseli. Izifundo eziningana zibonise ukuthi i-platelet lysate icishe ifane ne-PRP njengesixazululo sokwanda [11]. I-PRP ngokwayo iboniswe njengesixazululo esisebenzayo sokwelapha ukwanda [12-14].
Ama-platelet angasebenzi ajikeleza ngesimo sediski eqiniswe ngezakhiwo eziningana zangaphakathi. Ngesikhathi sokusebenza, aba nesimo esiyindilinga noma se-amoeba, okuholela ekwandeni kwevolumu. Ukwanda kwevolumu kudinga ukwanda kwendawo engaphezulu, okuwumphumela wokukhishwa kwesistimu evulekile ye-tubule (OCS) kanye nokwengezwa kwama-granules e-exocytic ku-membrane. Kusazonqunywa ukuthi ukwanda kwe-MPV okubangelwa yi-hypertonic glucose kuhilela yini enye noma zombili lezi zindlela, kodwa uma lokhu kokugcina, khona-ke ukwanda kwe-MPV kuzobonisa ukubola kwe-granulation.
Lolu cwaningo lubonise ukuthi ukuchayeka ekugxilweni okuphezulu kwe-glucose ku-PRP noma kuma-platelet egazi aphelele kuholele ekwandeni kwe-MPV zingakapheli imizuzu eyi-15 kanye nokugxilwa kwe-glucose okungu-25% no-41.6%, ngokulandelana.
Ukwanda kwe-MPV yeplatelet kungase kubangelwe ukwandiswa kwe-microtubule tangles ezizungezile ngenxa yokungena kwe-calcium. ULiu nabanye. I-glucose iboniswe ukuthi ilawula ukungena kwe-calcium ngesiteshi se-platelet TRPC6 [6]. Inkolelo-mbono yethu ukuthi i-glucose ibangela ukukhululeka kwe-microtubule tangles, okuholela ekwandeni kwe-MPV kanye nokuzwela kwe-platelet kanye/noma ukusebenza kwayo. Kodwa-ke, uma sibheka imiphumela yethu, lokhu kuyingxenye nje yendaba. Ezivivinyweni zethu, akukho ukuhlushwa okungaphansi kwe-D25W okuholele ekwandeni kwe-MPV. Njengoba singakahloli ukuvezwa kokuhlushwa kwe-glucose phakathi kuka-12.5% ​​no-25%, imiphumela yethu yesigaba 1 iphakamisa ukuthi kungaba nomkhawulo kulolu hlu lokuhlushwa kwe-glucose okuholela ekwandeni kwe-MPV. Ukuhlolwa okuqhubekayo ezigabeni 3 no-4 kubonise ukuthi i-glucose engu-20-25% ibonakala iyimingcele yalokhu, kodwa akucaci ukuthi kungani.
Siphinde sabona ukwehla okungu-9% kwe-MPV ngemva kokufakwa kwe-centrifuge. Akucaci ukuthi lokhu kwehla kwe-MPV kungenxa yama-platelet amakhulu namakhulu abanjwe ungqimba lwe-RBC lwe-centrifuge. Lokhu kuqaphela kungabaluleka kodokotela njengoba kungase kusho ukuthi ama-platelet e-PRP ayingxenyana encane futhi engaxinene kakhulu yama-platelet e-WB.
Esifundweni sangaphambilini, sibonise ukuthi ukulungiselela i-PRP ngezindlela ezenziwe ngesandla akubizi [8]. Uma i-glucose ithinta ama-platelet ezicubu noma i-PRP, okwenza kube lula ukuthi asebenze, noma uma i-PRP ikhiqizwa ngezakhiwo ze-lysate ezingaphelele, lokhu kungathuthukisa ukuvuselelwa futhi kunciphise isidingo sokwelashwa. Ngakho-ke, ukuhlanganiswa kwe-PRP kanye ne-glucose egxile kakhulu kungaba ngcono kakhulu kune-PRP noma i-glucose yodwa.
Ucwaningo lwethu lunezinkinga eziningana. Okokuqala, sisebenzisa i-PRP etholwe ngezindlela eziningana ezahlukene. Lokhu kungaholela emiphumeleni engqubuzanayo. Okwesibili, asikwazanga ukwenza ukuhlaziywa kwamakhemikhali kwanoma yimaphi amasampula ethu ukuze sinqume ngokunembile ukuthi ngabe ukwenziwa kwe-platelet kwenzeke yini. Singathanda ukukala i-P-selectin, i-platelet factor 4, ama-monocytic platelet aggregates, noma ezinye izimpawu zokwenziwa kwe-platelet ukuze siqonde kangcono izinga noma ukuba khona kwe-alpha granule degranulation, kodwa lokhu kungaphezu kobubanzi balolu cwaningo. Okwesithathu, asikwazanga ukuqinisekisa nge-electron microscopy noma ezinye izindlela ukuthi ukwanda kwe-MPV kuma-platelet avuleke nge-glucose kwakubangelwa umphumela kuma-microtubule tangles.
Izingxube ze-WB noma i-PRP ene-glucose engu-25% zinyuse i-MPV, okubonisa ukuqala kokusebenza kwe-platelet, yize lolu cwaningo lungazange lubonise ukuqhubeka kokuhlangana noma ukubola kwe-granulation. Ingxube ye-glucose ye-hypertonic iholele ekulahlekelweni kwe-platelet, okungenzeka ukuthi imele umphumela we-lytic. Ukusebenza okuyingxenye noma i-lysis yama-platelet kungabangela ukuvuselelwa kwezicubu ngemva kokujova kwe-platelet. Akucaci ukuthi yimiphi imiphumela yezokwelapha lezi zinguquko ezingaholela kuyo. Izifundo ezengeziwe zibonise izilinganiso ezinembile kakhulu zokusebenza noma i-lysis futhi zihlole imiphumela ehlukene yezokwelapha yezingxube ze-hypertonic glucose ne-WB noma i-PRP.
Ukwelashwa kokwandisa i-glucose kuyindlela elula futhi engabizi yokwelapha okuvuselelayo ekhula ngokushesha futhi esekela ucwaningo lwezokwelapha. Lolu cwaningo lusikisela indlela yokusebenza komzimba, uma iqinisekiswa, engasisiza siqonde ingxenye yendlela yokuvuselela yokwelapha okwandisa i-glucose.
I-Biomedical and Health Informatics e-University of Missouri, eKansas City School of Medicine, eKansas City, e-USA
Izihloko Zabantu: Bonke abahlanganyeli kulolu cwaningo banikeze imvume noma abanikezanga. I-International Society for Cellular Medicine ikhiphe imvume ye-ICMS-2017-003. Le protocol elandelayo ivunyelwe ukusetshenziswa yiBhodi Lokubuyekezwa Kwezikhungo le-International Society for Cellular Medicine: Isihloko: Ukubalwa kwesivuno semithi ye-plasma ecebile ngama-platelet ngokusekelwe ekubalweni kwama-platelet e-CBC okuyisisekelo. Izihloko Zezilwane: Bonke ababhali baqinisekisile ukuthi azikho izilwane noma izicubu ezihilelekile kulolu cwaningo. Ukungqubuzana Kwezintshisekelo: Ngokuhambisana neFomu Lokudalula Elifanayo le-ICMJE, bonke ababhali bamemezela okulandelayo: Ulwazi lokukhokha/lwensizakalo: Bonke ababhali bamemezela ukuthi abazange bathole ukwesekwa kwezezimali kunoma iyiphi inhlangano ngomsebenzi othunyelwe. Ubudlelwano Bezezimali: Bonke ababhali bamemezela ukuthi okwamanje noma phakathi neminyaka emithathu edlule abanabo ubudlelwano bezezimali nanoma iyiphi inhlangano engaba nentshisekelo emsebenzini othunyelwe. Obunye Ubudlelwano: Bonke ababhali bamemezela ukuthi azikho ezinye ubudlelwano noma imisebenzi engathinta umsebenzi othunyelwe.
UHarrison TE, uBowler J, uReeves K et al. (Meyi 17, 2022) Umphumela we-glucose ekubalweni kwama-platelet kanye nomthamo: imiphumela yemithi yokuvuselela. I-Cure 14(5): e25081. doi:10.7759/cureus.25081
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