富血小板浓缩物:基础科学与当前临床应用
Platelet rich concentrate: basic science and current clinical applications.
作者信息
Mehta Samir, Watson J Tracy
机构信息
Department of Orthopaedic Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania 19104,
出版信息
J Orthop Trauma. 2008 Jul;22(6):432-8. doi: 10.1097/BOT.0b013e31817e793f.
Improvements in resuscitation, dissemination of ATLS protocols, and growth of regional and local trauma centers has increased the survivability after severe traumatic injuries. Furthermore, advances in medical management have increased life expectancy and also patients with orthopaedic injuries. While mechanical stabilization has been a hallmark of orthopaedic fracture care, orthobiologics are playing an increasing role in the management of these patients with complex injuries. Platelet-rich concentrate is an autologous concentration of platelets and growth factors, including transforming growth factor-beta (TGF-beta), vascular endothelial growth factor (VEGF), and platelet-derived growth factor (PDGF). The enhancement of bone and soft tissue healing by the placement of supraphysiologic concentration of autologous platelets at the site of tissue injury or surgery is supported by basic science and clinical studies. Due to the increased concentration and release of these factors, platelet-rich plasma can potentially enhance the recruitment and proliferation of tenocytes, stem cells, and endothelial cells. A better understanding of platelet function and appropriate clinical use is essential in achieving the desired outcomes of platelet-rich concentrate in orthopaedic clinical applications.
复苏技术的改进、高级创伤生命支持(ATLS)协议的推广以及区域和地方创伤中心的发展,提高了严重创伤后的生存率。此外,医疗管理的进步延长了患者的预期寿命,也使骨科损伤患者受益。虽然机械固定一直是骨科骨折治疗的标志,但骨科生物制剂在这些复杂损伤患者的治疗中发挥着越来越重要的作用。富血小板浓缩液是血小板和生长因子的自体浓缩物,包括转化生长因子-β(TGF-β)、血管内皮生长因子(VEGF)和血小板衍生生长因子(PDGF)。基础科学和临床研究支持在组织损伤或手术部位放置超生理浓度的自体血小板可促进骨和软组织愈合。由于这些因子的浓度增加和释放,富血小板血浆可能会促进肌腱细胞、干细胞和内皮细胞的募集和增殖。更好地理解血小板功能并合理临床应用,对于在骨科临床应用中实现富血小板浓缩液的预期效果至关重要。