Zhu Yaqiong, Jin Zhuang, Wang Jing, Chen Siming, Hu Yongqiang, Ren Ling, Wang Yu, Song Qing, Tian Xiaoqi, Xie Fang, Peng Jiang, Peng Nan, Luo Yukun, Wang Yuexiang
Departments of Ultrasound, the first Medical Center of Chinese PLA General Hospital, Beijing, China.
Medical College of Nankai University, Tianjin, China.
NPJ Regen Med. 2020 Nov 20;5(1):21. doi: 10.1038/s41536-020-00101-3.
Ultrasound-guided platelet-rich plasma (PRP) injection is able to make up for the limitations of applying a single growth factor. The goal of this study was to investigate the effects of serial ultrasound-guided PRP injections of the appropriate concentration on the treatment of sciatic nerve crush injury, and explore the value of multimodality ultrasound techniques in evaluating the prognosis of crushed peripheral nerve. In vitro, optimal concentration of PRP (from 150%, 250%, 450%, and 650%) was screened due for its maximal effect on proliferation and neurotrophic function of Schwann cells (SCs). In vivo, ninety rabbits were equally and randomly divided into normal control, model, PRP-2.5×, PRP-4.5×, and PRP-6.5× groups. The neurological function and electrophysiological recovery evaluation, and the comparison of the multimodality ultrasound evaluation with the histological results of sciatic nerve crush injury were performed to investigate the regenerative effects of PRP at different concentrations on the sciatic nerve crush injury. Our results showed that the PRP with a 4.5-fold concentration of whole blood platelets could significantly stimulate the proliferation and secretion of SCs and nerve repair. The changes in stiffness and blood perfusion were positively correlated with the collagen area percentage and VEGF expression in the injured nerve, respectively. Thus, serial ultrasound-guided PRP injections at an appropriate concentration accelerates the recovery of axonal function. Multimodality ultrasound techniques provide a clinical reference for prognosis by allowing the stiffness and microcirculation perfusion of crush-injured peripheral nerves to be quantitatively evaluated.
超声引导下富血小板血浆（PRP）注射能够弥补单一生长因子应用的局限性。本研究的目的是探讨连续超声引导下注射适当浓度的PRP对坐骨神经挤压伤治疗的效果，并探索多模态超声技术在评估挤压伤周围神经预后方面的价值。在体外，筛选出PRP的最佳浓度（150%、250%、450%和650%），因其对雪旺细胞（SCs）的增殖和神经营养功能具有最大作用。在体内，将90只兔子平均随机分为正常对照组、模型组、PRP - 2.5倍组、PRP - 4.5倍组和PRP - 6.5倍组。通过进行神经功能和电生理恢复评估，以及将多模态超声评估结果与坐骨神经挤压伤的组织学结果进行比较，来研究不同浓度的PRP对坐骨神经挤压伤的再生作用。我们的结果表明，全血血小板浓度为4.5倍的PRP能够显著刺激SCs的增殖和分泌以及神经修复。硬度和血流灌注的变化分别与损伤神经中的胶原面积百分比和VEGF表达呈正相关。因此，连续超声引导下注射适当浓度的PRP可加速轴突功能的恢复。多模态超声技术通过对挤压伤周围神经的硬度和微循环灌注进行定量评估，为预后提供了临床参考。
