CAJ | 학술논문

目的探讨富血小板血浆(PRP)联合主动运动对大鼠髌股关节全层软骨缺损修复的效果.方法 SPF级SD大鼠30只,15只用来提取富血小板血浆(PRP),另外15只随机分成5组(n=6):A组:空白对照组,B组:造模+自由活动组,C组:造模+主动运动组,D组:造模+ PRP+自由活动组,E组:造模+ PRP+主动运动组.10周后进行大体、组织学、免疫组化观察,检测血清中金属蛋白酶组织抑制因子-1 (TIMP-1)、基质金属蛋白酶-3(MMP-3)含量,计算TIMP-1与MMP-3OD值比值,并进行比较.结果大体观察、HE染色、免疫组化染色显示:A组,软骨表面光滑,软骨细胞数量多,排列有序,Ⅱ型胶原含量丰富;B组软骨缺损仍较大,表面不平整,成纤维细胞数量最少,Ⅱ型胶原含量最少;C、D、E3组分别进行主动运动或(和)PRP干预后软骨缺损基本修复,表面比较平整,成纤维细胞数量相对较多,Ⅱ型胶原含量相对较多;后3组缺损部位修复的软骨组织基本为纤维软骨组织,很少有透明软骨.各组TIMP-1/MMP-3OD值的比值分别为0.401±0.056、0.247±0.028、0.583±0.054、0.435±0.054、0.387±0.125,差异有统计学意义(F=8.585,P=0.003).其中B组低于A、C、D、E组,C组高于D、E组,差异均有统计学意义(P＜0.05).结论软骨缺损后,早期进行中等强度主动运动或(和)关节腔内注射PRP,对软骨修复有一定的促进作用,尚不能证实主动运动和PRP之间的协同促进作用.
목적 탐토부혈소판혈장(PRP)연합주동운동대대서빈고관절전층연골결손수복적효과.방법 SPF급SD대서30지,15지용래제취부혈소판혈장(PRP),령외15지수궤분성5조(n=6):A조:공백대조조,B조:조모+자유활동조,C조:조모+주동운동조,D조:조모+ PRP+자유활동조,E조:조모+ PRP+주동운동조.10주후진행대체、조직학、면역조화관찰,검측혈청중금속단백매조직억제인자-1 (TIMP-1)、기질금속단백매-3(MMP-3)함량,계산TIMP-1여MMP-3OD치비치,병진행비교.결과 대체관찰、HE염색、면역조화염색현시:A조,연골표면광활,연골세포수량다,배렬유서,Ⅱ형효원함량봉부;B조연골결손잉교대,표면불평정,성섬유세포수량최소,Ⅱ형효원함량최소;C、D、E3조분별진행주동운동혹(화)PRP간예후연골결손기본수복,표면비교평정,성섬유세포수량상대교다,Ⅱ형효원함량상대교다;후3조결손부위수복적연골조직기본위섬유연골조직,흔소유투명연골.각조TIMP-1/MMP-3OD치적비치분별위0.401±0.056、0.247±0.028、0.583±0.054、0.435±0.054、0.387±0.125,차이유통계학의의(F=8.585,P=0.003).기중B조저우A、C、D、E조,C조고우D、E조,차이균유통계학의의(P＜0.05).결론 연골결손후,조기진행중등강도주동운동혹(화)관절강내주사PRP,대연골수복유일정적촉진작용,상불능증실주동운동화PRP지간적협동촉진작용.
Objective To investigate the effect of platelet-rich plasma(PRP) plus active-motion on the repair of full-thickness cartilage defects at the patellofemoral joint in rats.Methods Thirty SD rats were used for this study.Of them,15 were used for preparation of platelet-rich plasma,and the other 15 were randomized into 5 equal groups (n =6).Group A was subjected to no intervention after sham operation; after modeling of full-thickness cartilage defects at the patellofemoral joint,group B was subjected to free motion,group C to active motion,group D to PRP injection plus free motion,and group E to PRP injection plus active motion.The animals were sacrificed 10 weeks postoperation for gross observation and HE staining to assess the defects,ELISA to assess the serum contents of TIMP-1 and MMP-3,and immunohistochemical staining to detect type Ⅱ collagen.The ratio of TIMP-1 to MMP-3 was calculated and compared between groups.Results Gross observation,HE staining and immunohistochemical staining revealed smooth articular surface and plentiful well-arranged chondrocytes and type Ⅱ collagen in group A,the largest defects with a rough surface and the least type Ⅱ collagen in group B,and defects generally repaired with a relatively smooth surface and more content of type Ⅱ collagen in groups C,D and E.The regenerated tissue was fibrous cartilage rather than hyaline cartilage.The OD value of TIMP-1/MMP-3 was 0.401 ±0.056 in group A,0.247 ±0.028 in group B,0.583 ±0.054 in group C,0.435 ±0.054 in group D,and 0.387 ±0.125 in group E,showing significant differences between groups (F =8.585,P =0.003).Group B had a significantly lower value than Groups A,C,D and E (P ＜ 0.05).Group C was significantly higher than groups D and E (P ＜ 0.05).Conclusions After articular cartilage defection,early active-motion or (and) PRP injection into the articular cavity may promote repair of cartilage,but the synergistic effect of the two has not been fully confirmed.