Li Pei, Zhang Ruijie, Zhou Qiang
Department of Orthopedic Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Department of Respiratory Medicine, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China.
Biomed Res Int. 2017;2017:7919201. doi: 10.1155/2017/7919201. Epub 2017 Jul 2.
Several animal studies have demonstrated the positive effects of platelet-rich plasma (PRP) on disc degeneration retardation. The present meta-analysis was to verify the efficacy of PRP in retarding disc degeneration in animal.
Relevant studies were identified and evaluated according to our inclusion and exclusion criteria. The standardized mean difference (SMD) and related 95% confidence interval (95% CI) were estimated to assess PRP efficiency.
In total, eleven studies were included in this meta-analysis. Significant differences were found in the PRP treatment group, which showed increased disc height (SMD = 2.66, 95% CI: 1.86, 3.47, = 0.000), increased MRI T2 signal intensity (SMD = -3.29, 95% CI: -4.44, -2.13, = 0.000), and decreased histological degeneration grade (SMD = -4.28, 95% CI: -5.26, -3.30, = 0.000). However, no significant increase in collagen II expression was found (SMD = 25389.74, 95% CI: -27585.72, 78365.21, = 0.348). Apart from the subgroup analysis of the disc height based on animal species (pig) and disc degeneration model (chymopapain induction), other subgroup analysis based on animal species (rabbit and rat), study design, disc degeneration model, and follow-up period demonstrated that PRP treatment can significantly restore disc height and increase MRI T2 signal intensity.
PRP treatment is potentially effective in restoring disc height of rodent rabbit and rat, reducing histological degeneration grade, and increasing MRI T2 image signal. PRP injection may be promising therapy for retarding disc degeneration.
多项动物研究已证明富血小板血浆（PRP）对延缓椎间盘退变具有积极作用。本荟萃分析旨在验证PRP在延缓动物椎间盘退变方面的疗效。
根据我们的纳入和排除标准识别并评估相关研究。估计标准化均数差（SMD）及相关的95%置信区间（95%CI）以评估PRP的疗效。
本荟萃分析共纳入11项研究。PRP治疗组存在显著差异，表现为椎间盘高度增加（SMD = 2.66，95%CI：1.86，3.47，P = 0.000）、MRI T2信号强度增加（SMD = -3.29，95%CI：-4.44，-2.13，P = 0.000）以及组织学退变分级降低（SMD = -4.28，95%CI：-5.26，-3.30，P = 0.000）。然而，未发现Ⅱ型胶原蛋白表达有显著增加（SMD = 25389.74，95%CI：-27585.72，78365.21，P = 0.348）。除了基于动物物种（猪）和椎间盘退变模型（木瓜凝乳蛋白酶诱导）的椎间盘高度亚组分析外，基于动物物种（兔和大鼠）、研究设计、椎间盘退变模型及随访期的其他亚组分析表明，PRP治疗可显著恢复椎间盘高度并增加MRI T2信号强度。
PRP治疗在恢复啮齿类动物（兔和大鼠）的椎间盘高度、降低组织学退变分级以及增加MRI T2图像信号方面可能有效。PRP注射可能是延缓椎间盘退变的一种有前景的治疗方法。
