Jiang Yuan-Hong, Jhang Jia-Fong, Lin Teng-Yi, Ho Han-Chen, Hsu Yung-Hsiang, Kuo Hann-Chorng
Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan.
Department Laboratory Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Front Pharmacol. 2022 Mar 22;13:853776. doi: 10.3389/fphar.2022.853776. eCollection 2022.
Intravesical platelet-rich plasma (PRP) injections have been demonstrated effective in relieving symptoms among patients with interstitial cystitis/bladder pain syndrome (IC/BPS). This study compared the clinical efficacy among different injection number, adding solution, and concentrations of PRP. A total of 63 patients with IC/BPS were enrolled and randomly allocated to four subgroups who received single high-dose PRP (from 100 ml whole blood) plus 10 ml of normal saline or plasma injected over 20 or 40 sites. Patients were followed up at 1, 3, and 6 months for changes in the IC symptom index (ICSI) and problem index (ICPI), visual analog scale (VAS), global response assessment (GRA), and urodynamic parameters. Furthermore, we compared the clinical outcome with our previous study in a group of 55 IC/BPS patients who underwent four monthly low-dose PRP (from 50 ml whole blood) injections. The result of this study showed significant improvements in IC symptoms (ICSI 11.9 ± 4.4 . 10.2 ± 4.9, = 0.009; ICPI 12.3 ± 3.4 . 10.6 ± 4.7, = 0.003); VAS (5.46 ± 2.96 . 3.83 ± 3.1, 0.000), and maximum flow rate (10.4 ± 4.9 . 17.1 ± 11.5 ml/s, = 0.000) at 3 months after single high-dose PRP injection. However, no significant differences in therapeutic results were observed among subgroups, regardless of the added component or injecting site. The improvements of ICSI, ICPI, and GRA at 6 months were lower in comparison with the results of four low-dose PRP injections. All patients were free of dysuria, urinary retention, or urinary tract infection after PRP treatment. Intravesical PRP injection is effective for IC/BPS. The addition of normal saline or plasma and injection site had no influence on therapeutic efficacy. However, the symptom improvement and GRA after a single high-dose PRP injection was lower than that after four low-dose PRP injections 6 months after the first treatment. Limitation of the study is lack of sham control group.
膀胱内注射富血小板血浆（PRP）已被证明可有效缓解间质性膀胱炎/膀胱疼痛综合征（IC/BPS）患者的症状。本研究比较了不同注射次数、添加溶液和PRP浓度的临床疗效。共纳入63例IC/BPS患者，随机分为四个亚组，分别接受单次高剂量PRP（取自100ml全血）加10ml生理盐水或血浆，在20个或40个部位进行注射。在1、3和6个月时对患者进行随访，观察IC症状指数（ICSI）、问题指数（ICPI）、视觉模拟量表（VAS）、整体反应评估（GRA）和尿动力学参数的变化。此外，我们将本研究的临床结果与之前一组55例接受每月4次低剂量PRP（取自50ml全血）注射的IC/BPS患者的研究结果进行了比较。本研究结果显示，单次高剂量PRP注射后3个月，IC症状（ICSI：11.9±4.4对10.2±4.9，P = 0.009；ICPI：12.3±3.4对10.6±4.7，P = 0.003）、VAS（5.46±2.96对3.83±3.1，P = 0.000）和最大尿流率（10.4±4.9对17.1±11.5ml/s，P = 0.000）均有显著改善。然而，无论添加成分或注射部位如何，各亚组之间的治疗效果均未观察到显著差异。与4次低剂量PRP注射的结果相比，6个月时ICSI、ICPI和GRA的改善程度较低。PRP治疗后所有患者均无排尿困难、尿潴留或尿路感染。膀胱内注射PRP对IC/BPS有效。添加生理盐水或血浆以及注射部位对治疗效果无影响。然而单次高剂量PRP注射后的症状改善和GRA低于首次治疗后6个月4次低剂量PRP注射后的情况。本研究的局限性在于缺乏假手术对照组。
Zotero 插件