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同种异体和自体富血小板血浆(PRP)治疗雄激素性脱发的疗效比较。

Comparison of the Efficacy of Homologous and Autologous Platelet-Rich Plasma (PRP) for Treating Androgenic Alopecia.

作者信息

Ince Bilsev, Yildirim Mehmet Emin Cem, Dadaci Mehmet, Avunduk Mustafa Cihat, Savaci Nedim

机构信息

Department of Plastic, Reconstructive and Aesthetic Surgery, Meram Faculty of Medicine, Necmettin Erbakan University, 42080, Meram, Konya, Turkey.

Department of Pathology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.

出版信息

Aesthetic Plast Surg. 2018 Feb;42(1):297-303. doi: 10.1007/s00266-017-1004-y. Epub 2017 Nov 3.

Abstract

BACKGROUND

Androgenetic alopecia (AGA), the most common cause of hair loss in both sexes, accounts for 95% of all cases of hair loss. Although the literature has suggested that both nonactivated (n-PRP) and activated autologous (a-PRP) PRP can be used to treat AGA, we did not find any study investigating the use of homologous PRP (h-PRP) for this purpose. Also, to the best of our knowledge, there are no studies comparing the efficacy of h-PRP, a-PRP, or n-PRP on AGA therapy.

OBJECTIVES

The aim of this study was to compare the increase in hair density, average number of platelets, complications, preparation, and duration of application in the treatment of AGA using a-PRP, n-PRP, and h-PRP.

METHODS

Between 2014 and 2015, we studied male patients who had experienced increased hair loss in the last year. Patients were divided into three groups: Group 1 received n-PRP, Group 2 received active PRP, and Group 3 received h-PRP. For Group 1, PRP was prepared by a single centrifugation prepared from the patient's own blood. For Group 2, the PRP was prepared from the patient's own blood, but a second centrifugation was applied for platelet activation with calcium chloride. For Group 3, the PRP was prepared from pooled platelets with the same blood group as the patient from the blood center. PRP was injected at 1, 2, and 6 months. The hair density (n/cm) of each patient before and after injection was calculated. Each patient was assigned a fixed evaluation point at the time of application to calculate hair density.

RESULTS

At 2, 6, and 12 months after the first treatment, the increase in hair density was calculated as 11.2, 26.1, and 32.4%, respectively, in Group 1; 8.1, 12.5, and 20.8%, respectively, in Group 2; and 16.09, 36.41, and 41.76%, respectively, in Group 3. The increase in hair density was statistically significantly greater in Group 1 than in Group 2 and more so in Group 3 than in both groups among all controls (p < 0.05).

CONCLUSION

The efficacy of both PRPs was determined in AGA treatment in our study. However, it was determined statistically that the increase in hair density with h-PRP was greater than with autologous PRP groups. We believe that h-PRP therapy can be used in patients with AGA presenting with hair loss.

LEVEL OF EVIDENCE II

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

摘要

背景

雄激素性脱发(AGA)是男女脱发最常见的原因,占所有脱发病例的95%。尽管文献表明非激活的(n-PRP)和激活的自体富血小板血浆(a-PRP)均可用于治疗AGA,但我们未发现任何关于使用同源富血小板血浆(h-PRP)治疗AGA的研究。此外,据我们所知,尚无研究比较h-PRP、a-PRP或n-PRP治疗AGA的疗效。

目的

本研究旨在比较使用a-PRP、n-PRP和h-PRP治疗AGA时,毛发密度增加情况、平均血小板数量、并发症、制备方法及应用持续时间。

方法

2014年至2015年期间,我们研究了过去一年脱发增多的男性患者。患者分为三组:第1组接受n-PRP,第2组接受激活的富血小板血浆,第3组接受h-PRP。对于第1组,富血小板血浆通过从患者自身血液进行单次离心制备。对于第2组,富血小板血浆由患者自身血液制备,但进行第二次离心并用氯化钙激活血小板。对于第3组,富血小板血浆由血库中与患者血型相同的混合血小板制备。分别在第1、2和6个月注射富血小板血浆。计算每位患者注射前后的毛发密度(根/cm)。每位患者在注射时被指定一个固定评估点以计算毛发密度。

结果

首次治疗后2、6和12个月,第1组毛发密度增加分别计算为11.2%、26.1%和32.4%;第2组分别为8.1%、12.5%和20.8%;第3组分别为16.09%、36.41%和41.76%。在所有对照中,第1组毛发密度增加在统计学上显著高于第2组,第3组高于两组(p<0.05)。

结论

在我们的研究中确定了两种富血小板血浆在AGA治疗中的疗效。然而,统计学确定h-PRP导致的毛发密度增加大于自体富血小板血浆组。我们认为h-PRP疗法可用于AGA脱发患者。

证据水平II:本刊要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述,请参阅目录或在线作者指南www.springer.com/00266

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