Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT 06033, USA.
J Bone Joint Surg Am. 2012 Feb 15;94(4):308-16. doi: 10.2106/JBJS.K.00430.
Varying concentrations of blood components in platelet-rich plasma preparations may contribute to the variable results seen in recently published clinical studies. The purposes of this investigation were (1) to quantify the level of platelets, growth factors, red blood cells, and white blood cells in so-called one-step (clinically used commercial devices) and two-step separation systems and (2) to determine the influence of three separate blood draws on the resulting components of platelet-rich plasma.
Three different platelet-rich plasma (PRP) separation methods (on blood samples from eight subjects with a mean age [and standard deviation] of 31.6 ± 10.9 years) were used: two single-spin processes (PRPLP and PRPHP) and a double-spin process (PRPDS) were evaluated for concentrations of platelets, red and white blood cells, and growth factors. Additionally, the effect of three repetitive blood draws on platelet-rich plasma components was evaluated.
The content and concentrations of platelets, white blood cells, and growth factors for each method of separation differed significantly. All separation techniques resulted in a significant increase in platelet concentration compared with native blood. Platelet and white blood-cell concentrations of the PRPHP procedure were significantly higher than platelet and white blood-cell concentrations produced by the so-called single-step PRPLP and the so-called two-step PRPDS procedures, although significant differences between PRPLP and PRPDS were not observed. Comparing the results of the three blood draws with regard to the reliability of platelet number and cell counts, wide variations of intra-individual numbers were observed.
Single-step procedures are capable of producing sufficient amounts of platelets for clinical usage. Within the evaluated procedures, platelet numbers and numbers of white blood cells differ significantly. The intra-individual results of platelet-rich plasma separations showed wide variations in platelet and cell numbers as well as levels of growth factors regardless of separation method.
富血小板血浆(platelet-rich plasma,PRP)制备物中血液成分的浓度变化可能导致最近发表的临床研究结果存在差异。本研究的目的是:(1)定量检测一步法(临床常用商业设备)和两步法分离系统中血小板、生长因子、红细胞和白细胞的水平;(2)确定三次独立采血对富血小板血浆(platelet-rich plasma,PRP)组成成分的影响。
使用三种不同的 PRP 分离方法(从 8 名年龄为 31.6±10.9 岁的受试者的血液样本中获得),评估三种 PRP 分离方法(PRPLP、PRPHP 和 PRPDS)的血小板、红细胞和白细胞浓度及生长因子水平:(1)两种单步离心法(PRPLP 和 PRPHP);(2)两步离心法(PRPDS)。此外,还评估了三次重复采血对 PRP 成分的影响。
每种分离方法的血小板、白细胞和生长因子含量和浓度均有显著差异。与原始血液相比,所有分离技术均使血小板浓度显著增加。与所谓的单步 PRPLP 和所谓的两步 PRPDS 相比,PRPHP 方法的血小板和白细胞浓度显著更高,尽管 PRPLP 和 PRPDS 之间未观察到显著差异。比较三次采血的血小板数量和细胞计数的可靠性,个体内数量的变化很大。
单步程序能够产生足够数量的血小板用于临床应用。在所评估的程序中,血小板数量和白细胞数量差异显著。无论分离方法如何,PRP 分离的个体内结果均显示血小板和细胞数量以及生长因子水平存在广泛变化。