【摘要】 目的:探讨温度敏感的水凝胶与富血小板血浆(platelet-rich plasma,PRP)对大鼠前交叉韧带(anterior cruciate ligament,ACL)部分损伤的愈合是否有促进作用。方法:按照既往文献报道的方法制备PRP,将其与温度敏感的水凝胶——单甲氧基聚乙二醇-聚乳酸乙醇酸嵌段共聚物(m PEG-PLGA)在特定条件下混合,制备成复合体。共采用110只12周龄雄性Sprague-Dawley大鼠右侧膝关节,其中10只作为完整对照组(n=10,ACL无损伤),其余100只随机分为2组:损伤对照组(n=60,ACL部分损伤后用生理盐水处理损伤部位)、实验组(n=40,ACL部分损伤后将m PEG-PLGA-PRP复合体注射于损伤部位)。共观察三个时间点:手术后即刻、术后2周和术后6周。观察并比较组间与组内的组织学与生物力学变化。结果:组织学结果表明,实验组术后6周组织学观察可见ACL损伤已出现部分愈合,炎性细胞减少,出现新生纤维组织,但走行与正常ACL组织仍有差异,可见新生血管形成。韧带成熟度评分,实验组显著高于损伤对照组(20.6±4.9 vs 4.7±1.0,P<0.01)。生物力学实验结果表明,术后6周拉断强度实验组显著高于对照组(52.7±11.2 vs 30.3±8.8,P<0.05)。结论:在大鼠模型下采用m PEG-PLGA-PRP复合体治疗ACL部分损伤,术后6周在组织学与生物力学方面与对照组相比均有显著改善,但是尚未恢复到损伤前的水平。更多还原

【Abstract】 Objective To explore the effect of the temperature-sensitive hydrogel and platelet-richplasma(PRP)complex on the healing of anterior cruciate ligament(ACL)partial tear in a rat model.Method PRP was processed according to an established method and then mixed with poly(ethylene gly-col)monomethyl ether and poly(lactic-co-glycolic acid)(m PEG-PLGA). A total of 110 right knees ofSprague-Dawley male rats(12-week old)were included and randomly divided into a healthy controlgroup(n=10),a lesion control group(n=60)and a study group(n=40). The saline and m PEG-PLGA-PRP complex was applied at the lesion site respectively. Samples were harvested 0,2 weeks and 6 weeks post-operatively and the histological and biomechanical changes were observed and comparedamong the 3 groups. Results Histologically,at 6 weeks after surgery,the torn ACL of the study grouphad been partially healed,with decreased number of inflammatory cells and new fibrous tissues and micro-vessels appearing. The ligament maturity index revealed a significantly higher score in the studygroup than the lesion control group(20.6 ± 4.9 vs. 4.7 ± 1.0,P<0.01). Biomechanically,at 6 weeks af-ter surgery,the tensile strength of the study group was significantly higher than the control groups(52.7± 11.2 vs. 30.3 ± 8.8,P<0.05). Conclusion At six weeks after surgery,the m PEG-PLGA-PRP com-plex can enhance the healing of ACL partial tear,although the ligament was not recovered to the nor-mal state.更多还原