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商业可得的富血小板血浆试剂盒在临床应用中的回顾性分析。

A retrospective analysis of a commercially available platelet-rich plasma kit during clinical use.

机构信息

Orthobond Corporation, Princeton, New Jersey, USA.

Rusk Rehabilitation at NYU Langone Health, New York, New York, USA.

出版信息

PM R. 2021 Dec;13(12):1410-1417. doi: 10.1002/pmrj.12569. Epub 2021 Apr 12.

Abstract

INTRODUCTION

Point-of-care analyses of platelet-rich plasma (PRP) are not routine in the orthopedic regenerative medicine field. Therefore, many physicians rely on the manufacturer's reported content for commercial preparation kits. This contributes to a knowledge gap between injectate content and patient outcome.

OBJECTIVE

To assess whether the EmCyte PurePRP II 60-mL preparation kit returns PRP content that meets the manufacturer's expectations when used during routine clinical care for a heterogenous patient population, and to determine whether a change in PRP yield volume affects injectate content. Protocol A (exclusion of granulocytes and low hematocrit) and Protocol B (inclusion of granulocytes and higher hematocrit) were evaluated.

DESIGN

Retrospective review.

SETTING

Private practice.

PARTICIPANTS

One hundred five patients (118 preparations) treated for orthopedic conditions over an 8-month period via PRP injection. Thirteen patients had two independently made preparations on different treatment days that qualified for analysis.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Complete blood count (absolute counts and calculated fold enrichment from baseline of platelets, white blood cells, red blood cells, granulocytes, lymphocytes, monocytes; and hematocrit levels). Confounding variables included age, gender, and preparation yield volume.

RESULTS

During routine clinical use, the cellular content of both Protocols A and B met or exceeded the manufacturer's expectations of platelet enrichment and granulocyte inclusion or exclusion. Hematocrit values were slightly higher than anticipated from Protocol A preparations. The modification of yield volume from 7 to 4 mL led to a significant difference in platelet enrichment without affecting absolute cell counts (2.88; 95% confidence interval [CI] 1, 4.76; P = .003). Both gender and age moderately affected the level of platelet enrichment from baseline but did not significantly affect absolute platelet counts.

CONCLUSION

In the absence of widespread characterization, confirming the variation in commercial PRP kits during clinical use is crucial.

摘要

简介

在骨科再生医学领域,即时检测血小板富血浆(PRP)的分析并不是常规操作。因此,许多医生依赖于商业制备试剂盒制造商报告的含量。这导致了注射物含量与患者结果之间的知识差距。

目的

评估 EmCyte PurePRP II 60 毫升制备试剂盒在常规临床护理中用于异质患者人群时,是否能提供符合制造商预期的 PRP 含量,以及 PRP 产量体积的变化是否会影响注射物含量。评估了方案 A(排除粒细胞和低红细胞压积)和方案 B(包含粒细胞和较高红细胞压积)。

设计

回顾性研究。

设置

私人诊所。

参与者

105 名患者(118 份制剂)在 8 个月的时间内接受了骨科疾病的 PRP 注射治疗。13 名患者在不同的治疗日接受了两次独立的制备,符合分析条件。

干预

不适用。

主要观察指标

全血细胞计数(绝对计数和从基线开始计算的血小板、白细胞、红细胞、粒细胞、淋巴细胞、单核细胞的倍数富集;以及红细胞压积水平)。混杂变量包括年龄、性别和制备产量体积。

结果

在常规临床使用中,方案 A 和 B 的细胞含量均符合或超过制造商对血小板富集和粒细胞包含或排除的预期。红细胞压积值略高于方案 A 制剂的预期值。从 7 毫升到 4 毫升的产量体积的改变导致了血小板富集的显著差异,而不影响绝对细胞计数(2.88;95%置信区间 [CI] 1,4.76;P=0.003)。性别和年龄适度影响了从基线开始的血小板富集水平,但对绝对血小板计数没有显著影响。

结论

在缺乏广泛特征描述的情况下,确认商业 PRP 试剂盒在临床使用中的变化至关重要。

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