Effects of Platelet-Rich Plasma on Intestinal Anastomotic Healing in Rats: PRP Concentration is a Key Factor
Effects of Platelet-Rich Plasma on Intestinal Anastomotic Healing in Rats: PRP Concentration is a Key Factor
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DOI：
10.1016/j.jss.2010.10.001
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发表时间：
2012-04-01
影响因子：
2.2
通讯作者：
Ohkohchi, Nobuhiro
中科院分区：
文献类型：
--
作者：
Yamaguchi, Ryushiro;Terashima, Hideo;Ohkohchi, Nobuhiro
背景很少有研究检查了富血小板血浆（PRP）对肠吻合口愈合的影响。已进行的少数研究中使用的制备方法和PRP浓度差异显著。因此，PRP对吻合口愈合过程的积极影响尚不清楚。本研究的目的是检查不同浓度的PRP对肠吻合口愈合的影响。从SD大鼠血液中制备三种不同浓度的血浆：高浓度PRP（H-PRP：血小板计数5 x 10（6）/mm（3））、低浓度PRP（L-PRP：2 x 10（6）/mm（3））和贫血小板血浆（PPP）。雄性SD大鼠行近端空肠吻合和中心静脉置管。将大鼠分为4组（每组n = 12）：对照组、PPP组、L-PRP组和H-PRP组。除对照组外，对每条吻合线应用两种类型的PRP和PPP（0.21 mL）。给予全胃肠外营养（TPN）溶液（151 kcal/kg/d）。术后第5天检测原位吻合口爆破压（ABP）和吻合口组织羟脯氨酸（HYP）浓度。对照组、PPP组、L-PRP组和H-PRP组的ABP值分别为171 +/- 20、174 +/- 23、189 +/- 17和148 +/- 25 mmHg。各组的HYP值分别为516 +/- 130、495 +/- 123、629 +/- 120和407 +/- 143 μ g/g干组织。与其他组相比，L-PRP组的ABP和HYP均显著增加，而H-PRP组的这两个变量均显著降低。结果表明，L-PRP对吻合口愈合有促进作用，H-PRP对吻合口愈合有抑制作用，PPP组与对照组比较差异无统计学意义。富血小板血浆浓度对富血小板血浆的功效起着至关重要的作用。PRP在一定浓度范围内对肠吻合口愈合有促进作用，且呈剂量依赖性，但高浓度时会产生不良反应。PRP的基本作用似乎是由血小板本身驱动的。(C)2012 Elsevier Inc. All rights reserved.
Background. Few studies have examined the effects of platelet-rich plasma (PRP) on intestinal anastomotic healing. The applied preparation methods and PRP concentrations used in the few studies that have been carried out varied markedly. Therefore, the positive effects of PRP on the anastomotic healing process remain unclear. The aim of this study is to examine the effects of different concentrations of PRP on intestinal anastomotic healing.Material and Methods. From SD rat blood, three different concentrations of plasma were prepared: high-concentrated PRP (H-PRP: platelet count 5 x 10(6)/mm(3)), low-concentrated PRP (L-PRP: 2 x 10(6)/mm(3)), and platelet-poor plasma (PPP). Male SD rats underwent proximal jejunal anastomosis and central venous catheterization. Rats were divided into four groups (n = 12 for each group): control, PPP, L-PRP, and H-PRP groups. Two types of PRP and PPP (0.21 mL) were applied to each anastomosis line, with the exception of the control group. Total parenteral nutrition (TPN) solutions were administered (151 kcal/kg/d). Five days after surgery, anastomotic bursting pressure (ABP) in situ and hydroxyproline concentration (HYP) in anastomotic tissue were evaluated.Results. The ABP values of control, PPP, L-PRP, and H-PRP groups were 171 +/- 20, 174 +/- 23, 189 +/- 17, and 148 +/- 25 mmHg, respectively. The HYP values of each group were 516 +/- 130, 495 +/- 123, 629 +/- 120, and 407 +/- 143 mu g/g dry tissue. Compared with the other groups, the L-PRP group exhibited a significant increase in both ABP and HYP, while the H-PRP group exhibited a significant decrease in these two variables. As a result, L-PRP was considered to promote anastomotic wound healing, but H-PRP was considered to inhibit it. There was no significant difference between the PPP group and the control group.Conclusions. PRP concentration plays a crucial role in the efficacy of PRP. PRP might exert positive effects on intestinal anastomotic healing in a dose-dependent manner up to a certain level, but adverse effects occur when it is highly concentrated. The essential PRP action appears to be driven by the platelets themselves. (C) 2012 Elsevier Inc. All rights reserved.