切换至 "中华医学电子期刊资源库"

中华妇幼临床医学杂志(电子版) ›› 2022, Vol. 18 ›› Issue (03) : 255 -261. doi: 10.3877/cma.j.issn.1673-5250.2022.03.002

专题论坛

富血小板血浆在妇科疾病治疗中应用及其研究现状
徐瑞涓1, 林渝2, 谭世桥1,()   
  1. 1四川大学华西第二医院妇产科、生殖内分泌和生殖调控研究室、出生缺陷与相关妇儿疾病教育部重点实验室,成都 610041
    2四川大学华西第二医院手术室,成都 610041
  • 收稿日期:2021-09-30 修回日期:2022-04-30 出版日期:2022-06-01
  • 通信作者: 谭世桥

Application and research status of platelet-rich plasma in gynecological diseases

Ruijuan Xu1, Yu Lin2, Shiqiao Tan1,()   

  1. 1Department of Obstetrics and Gynecology, Laboratory of Reproductive Endocrine and Reproductive Regulation, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
    2Department of Operating Room, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2021-09-30 Revised:2022-04-30 Published:2022-06-01
  • Corresponding author: Shiqiao Tan
  • Supported by:
    Key Research Project of Science and Technology Department of Sichuan Province(2020YFS0074)
引用本文:

徐瑞涓, 林渝, 谭世桥. 富血小板血浆在妇科疾病治疗中应用及其研究现状[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(03): 255-261.

Ruijuan Xu, Yu Lin, Shiqiao Tan. Application and research status of platelet-rich plasma in gynecological diseases[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2022, 18(03): 255-261.

富血小板血浆(PRP)是人自体全血经离心后获得的血小板浓缩物,含有大量生长因子及蛋白质。PRP因其有助于组织再生、伤口愈合、瘢痕修复等作用,在骨科、皮肤科、口腔颌面外科、整形美容科等领域应用广泛,而在妇科领域应用迄今相对较少。最新研究结果显示,PRP具有促进子宫内膜和卵泡生长作用,在治疗薄型子宫内膜(TE)、改善子宫内膜容受性(ER)、恢复卵巢功能等方面取得较大进展,并为多种妇科疾病治疗提供新的研究方向和手段。笔者拟就PRP的制备及分类、在妇科疾病治疗中的应用及其前景展望等最新研究现状进行阐述。

Platelet-rich plasma (PRP) is a kind of platelet concentrate obtained from whole blood after centrifugation, with amount of growth factors and protein. PRP is widely used in orthopedics, dermatology, oral and maxillofacial surgery, plastic surgery and cosmetology, because of its functions in tissue regeneration, wound healing and scar repair, but PRP is less used in gynecology up to now. Recent studies have shown that PRP can promote growth of endometrium and folliculogenesis. Great progresses had been made in treatment of thin endometrium (TE), improvement of endometrial receptivity (ER) and restoration of ovarian function. PRP has provided new research direction and therapeutic means for many gynecological diseases. The author intends to elaborate on preparation and classification, and current status of clinical application of PRP in gynecological diseases.

[1]
Alves R, Grimalt R. A review of platelet-rich plasma: history, biology, mechanism of action, and classification[J]. Skin Appendage Disord, 2018, 4(1): 18-24. DOI: 10.1159/000477353.
[2]
Wu PI, Diaz R, Borg-Stein J. Platelet-rich plasma[J]. Phys Med Rehabil Clin N Am, 2016, 27(4): 825-53. DOI: 10.1016/j.pmr.2016.06.002.
[3]
Everts P, Onishi K, Jayaram P, et al. Platelet-rich plasma: new performance understandings and therapeutic considerations in 2020[J]. Int J Mol Sci, 2020, 21(20): 7794. DOI: 10.3390/ijms21207794.
[4]
Girijala RL, Riahi RR, Cohen PR. Platelet-rich plasma for androgenic alopecia treatment: a comprehensive review[J]. Dermatol Online J, 2018, 24(7): 13030/qt8s43026c.
[5]
Chen P, Huang L, Ma Y, et al. Intra-articular platelet-rich plasma injection for knee osteoarthritis: a summary of Meta-analyses[J]. J Orthop Surg Res, 2019, 14(1): 385. DOI: 10.1186/s13018-019-1363-y.
[6]
Grassi A, Napoli F, Romandini I, et al. Is platelet-rich plasma (PRP) effective in the treatment of acute muscle injuries? A systematic review and Meta-analysis[J]. Sports Med, 2018, 48(4): 971-989. DOI: 10.1007/s40279-018-0860-1.
[7]
Zhang M, Park G, Zhou B, et al. Applications and efficacy of platelet-rich plasma in dermatology: a clinical review[J]. J Cosmet Dermatol, 2018, 17(5): 660-665. DOI: 10.1111/jocd.12673.
[8]
Riestra AC, Alonso-Herreros JM, Merayo-Lloves J. Platelet rich plasma in ocular surface[J]. Arch Soc Esp Oftalmol, 2016, 91(10): 475-490. DOI: 10.1016/j.oftal.2016.03.001.
[9]
Knezevic NN, Candido KD, Desai R, et al. Is platelet-rich plasma a future therapy in pain management?[J]. Med Clin North Am, 2016, 100(1): 199-217. DOI: 10.1016/j.mcna.2015.08.014.
[10]
卫愉轩,张昭远,范峥莹,等. 中国富血小板血浆临床制备方法的研究进展[J/OL]. 中华关节外科杂志(电子版), 2020, 14(2): 196-200. DOI: 10.3877/cma.j.issn.1674-134X.2020.02.011.
[11]
Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF)[J]. Trends Biotechnol, 2009, 27(3): 158-167. DOI: 10.1016/j.tibtech.2008.11.009.
[12]
Kasius A, Smit JG, Torrance HL, et al. Endometrial thickness and pregnancy rates after IVF: a systematic review and Meta-analysis[J]. Hum Reprod Update, 2014, 20(4): 530-541. DOI: 10.1093/humupd/dmu011.
[13]
Maleki-Hajiagha A, Razavi M, Rouholamin S, et al. Intrauterine infusion of autologous platelet-rich plasma in women undergoing assisted reproduction: a systematic review and Meta-analysis[J]. J Reprod Immunol, 2020, 137: 103078. DOI: 10.1016/j.jri.2019.103078.
[14]
李晓凤,王芳,陶丽梅,等. 宫腔灌注富血小板血浆对薄型子宫内膜不孕患者疗效的Meta分析[J]. 实用妇产科杂志2020, 36(7): 545-549.
[15]
Nazari L, Salehpour S, Hoseini S, et al. Effects of autologous platelet-rich plasma on endometrial expansion in patients undergoing frozen-thawed embryo transfer: a double-blind RCT[J]. Int J Reprod Biomed, 2019, 17(6): 443-448. DOI: 10.18502/ijrm.v17i6.4816.
[16]
Eftekhar M, Neghab N, Naghshineh E, et al. Can autologous platelet rich plasma expand endometrial thickness and improve pregnancy rate during frozen-thawed embryo transfer cycle? A randomized clinical trial[J]. Taiwan J Obstet Gynecol, 2018, 57(6): 810-813. DOI: 10.1016/j.tjog.2018.10.007.
[17]
Chang Y, Li J, Wei LN, et al. Autologous platelet-rich plasma infusion improves clinical pregnancy rate in frozen embryo transfer cycles for women with thin endometrium[J]. Medicine (Baltimore), 2019, 98(3): e14062. DOI: 10.1097/md.0000000000014062.
[18]
Agarwal M, Mettler L, Jain S, et al. Management of a thin endometrium by hysteroscopic instillation of platelet-rich plasma into the endomyometrial junction: a pilot study[J]. J Clin Med, 2020, 9(9): 2795. DOI: 10.3390/jcm9092795.
[19]
AAGL Elevating Gynecologic Surgery. AAGL practice report: practice guidelines on intrauterine adhesions developed in collaboration with the European Society of Gynaecological Endoscopy (ESGE)[J]. Gynecol Surg, 2017, 14(1): 6. DOI: 10.1186/s10397-017-1007-3.
[20]
Di Spiezio Sardo A, Calagna G, Scognamiglio M, et al. Prevention of intrauterine post-surgical adhesions in hysteroscopy. A systematic review[J]. Eur J Obstet Gynecol Reprod Biol, 2016, 203: 182-192. DOI: 10.1016/j.ejogrb.2016.05.050.
[21]
Dreisler E, Kjer JJ. Asherman′s syndrome: current perspectives on diagnosis and management[J]. Int J Womens Health, 2019, 11: 191-198. DOI: 10.2147/ijwh.S165474.
[22]
Jang HY, Myoung SM, Choe JM, et al. Effects of autologous platelet-rich plasma on regeneration of damaged endometrium in female rats[J]. Yonsei Med J, 2017, 58(6): 1195-1203. DOI: 10.3349/ymj.2017.58.6.1195.
[23]
Kim JH, Park M, Paek JY, et al. Intrauterine infusion of human platelet-rich plasma improves endometrial regeneration and pregnancy outcomes in a murine model of Asherman′s syndrome[J]. Front Physiol, 2020, 11: 105. DOI: 10.3389/fphys.2020.00105.
[24]
Marini MG, Perrini C, Esposti P, et al. Effects of platelet-rich plasma in a model of bovine endometrial inflammation in vitro[J]. Reprod Biol Endocrinol, 2016, 14(1): 58. DOI: 10.1186/s12958-016-0195-4.
[25]
Zhang S, Li P, Yuan Z, et al. Platelet-rich plasma improves therapeutic effects of menstrual blood-derived stromal cells in rat model of intrauterine adhesion[J]. Stem Cell Res Ther, 2019, 10(1): 61. DOI: 10.1186/s13287-019-1155-7.
[26]
Aghajanova L, Cedars MI, Huddleston HG. Platelet-rich plasma in the management of Asherman syndrome: case report[J]. J Assist Reprod Genet, 2018, 35(5): 771-775. DOI: 10.1007/s10815-018-1135-3.
[27]
Torky AMMAE, Amer MIM, Ahmed MES, et al. The value of using platelet rich plasma after hysteroscopic analysis of severe intrauterine adhesions (a randomized controlled trial)[J]. Egypt J Hosp Med, 2018, 71(4): 2869-2874. DOI: 10.12816/0046137.
[28]
Javaheri A, Kianfar K, Pourmasumi S, et al. Platelet-rich plasma in the management of Asherman′s syndrome: an RCT[J]. Int J Reprod Biomed, 2020, 18(2): 113-120. DOI: 10.18502/ijrm.v18i2.6423.
[29]
Peng J, Li M, Zeng H, et al. Intrauterine infusion of platelet-rich plasma is a treatment method for patients with intrauterine adhesions after hysteroscopy[J]. Int J Gynaecol Obstet, 2020, 151(3): 362-365. DOI: 10.1002/ijgo.13353.
[30]
陈子江,田秦杰,乔杰,等. 早发性卵巢功能不全的临床诊疗中国专家共识[J]. 中华妇产科杂志2017, 52(9): 577-581. DOI: 10.3760/cma.j.issn.0529-567x.2017.09.001.
[31]
Gialeraki A, Valsami S, Pittaras T, et al. Oral contraceptives and HRT risk of thrombosis[J]. Clin Appl Thromb Hemost, 2017, 24(2): 217-225. DOI: 10.1177/1076029616683802.
[32]
Rymer J, Brian K, Regan L. HRT and breast cancer risk[J]. BMJ, 2019, 367: l5928. DOI: 10.1136/bmj.l5928.
[33]
Sheikhansari G, Aghebati-Maleki L, Nouri M, et al. Current approaches for the treatment of premature ovarian failure with stem cell therapy[J]. Biomed Pharmacother, 2018, 102: 254-262. DOI: 10.1016/j.biopha.2018.03.056.
[34]
Pantos K, Nitsos N, Kokkali G, et al. Ovarian rejuvenation and folliculogenesis reactivation in peri-menopausal women after autologous platelet-rich plasma treatment[C]// Proceedings of the Abstracts, ESHRE 32nd Annual Meeting, 2016. Helsinki: ESHRE, 2016.
[35]
Sills ES, Rickers NS, Li X, et al. First data on in vitro fertilization and blastocyst formation after intraovarian injection of calcium gluconate-activated autologous platelet rich plasma[J]. Gynecol Endocrinol, 2018, 34(9): 756-760. DOI: 10.1080/09513590.2018.1445219.
[36]
Sfakianoudis K, Simopoulou M, Grigoriadis S, et al. Reactivating ovarian function through autologous platelet-rich plasma intraovarian infusion: pilot data on premature ovarian insufficiency, perimenopausal, menopausal, and poor responder women[J]. J Clin Med, 2020, 9(6): 1809. DOI: 10.3390/jcm9061809.
[37]
Cakiroglu Y, Saltik A, Yuceturk A, et al. Effects of intraovarian injection of autologous platelet rich plasma on ovarian reserve and IVF outcome parameters in women with primary ovarian insufficiency[J]. Aging (Albany NY), 2020, 12(11): 10211-10222. DOI: 10.18632/aging.103403.
[38]
Atkinson L, Martin F, Sturmey RG. Intraovarian injection of platelet-rich plasma in assisted reproduction: too much too soon?[J]. Hum Reprod, 2021, 36(7): 1737-1750. DOI: 10.1093/humrep/deab106.
[39]
Sills ES, Wood SH. Autologous activated platelet-rich plasma injection into adult human ovary tissue: molecular mechanism, analysis, and discussion of reproductive response[J]. Biosci Rep, 2019, 39(6): BSR20190805. DOI: 10.1042/BSR20190805.
[40]
Tehranian A, Esfehani-Mehr B, Pirjani R, et al. Application of autologous platelet-rich plasma (PRP) on wound healing after caesarean section in high-risk patients[J]. Iran Red Crescent Med J, 2016, 18(7): e34449. DOI: 10.5812/ircmj.34449.
[41]
Morelli M, Rocca ML, Venturella R, et al. Adjuvant use of platelet gel for wound breakdown prevention in advanced vulvar cancer surgery: a retrospective study[J]. Int J Gynecol Cancer, 2013, 23(8): 1490-1494. DOI: 10.1097/IGC.0b013e3182a50517.
[42]
Shirvan MK, Alamdari DH, Ghoreifi A. A novel method for iatrogenic vesicovaginal fistula treatment: autologous platelet rich plasma injection and platelet rich fibrin glue interposition[J]. J Urol, 2013, 189(6): 2125-2129. DOI: 10.1016/j.juro.2012.12.064.
[43]
Streit-Cieckiewicz D, Futyma K, Miotla P, et al. Platelet-rich plasma as adjuvant therapy for recurrent vesicovaginal fistula: a prospective case series[J]. J Clin Med, 2019, 8(12): 2122. DOI: 10.3390/jcm8122122.
[44]
Casabona F, Priano V, Vallerino V, et al. New surgical approach to lichen sclerosus of the vulva: the role of adipose-derived mesenchymal cells and platelet-rich plasma in tissue regeneration[J]. Plast Reconstr Surg, 2010, 126(4): 210e-211e. DOI: 10.1097/PRS.0b013e3181ea9386.
[45]
Behnia-Willison F, Pour NR, Mohamadi B, et al. Use of platelet-rich plasma for vulvovaginal autoimmune conditions like lichen sclerosus[J]. Plast Reconstr Surg Glob Open, 2016, 4(11): e1124. DOI: 10.1097/gox.0000000000001124.
[46]
Goldstein AT, Mitchell L, Govind V, et al. A randomized double-blind placebo-controlled trial of autologous platelet-rich plasma intradermal injections for the treatment of vulvar lichen sclerosus[J]. J Am Acad Dermatol, 2019, 80(6): 1788-1789. DOI: 10.1016/j.jaad.2018.12.060.
[47]
Gorlero F, Glorio M, Lorenzi P, et al. New approach in vaginal prolapse repair: mini-invasive surgery associated with application of platelet-rich fibrin[J]. Int Urogynecol J, 2012, 23(6): 715-722. DOI: 10.1007/s00192-012-1667-5.
[48]
Medel S, Alarab M, Kufaishi H, et al. Attachment of primary vaginal fibroblasts to absorbable and nonabsorbable implant materials coated with platelet-rich plasma: potential application in pelvic organ prolapse surgery[J]. Female Pelvic Med Reconstr Surg, 2015, 21(4): 190-197. DOI: 10.1097/spv.0000000000000178.
[49]
Behnia-Willison F, Nguyen TTT, Norbury AJ, et al. Promising impact of platelet rich plasma and carbon dioxide laser for stress urinary incontinence[J]. Eur J Obstet Gynecol Reprod Biol X, 2020, 5: 100099. DOI: 10.1016/j.eurox.2019.100099.
[50]
Nikolopoulos KI, Pergialiotis V, Perrea D, et al. Restoration of the pubourethral ligament with platelet rich plasma for the treatment of stress urinary incontinence[J]. Med Hypotheses, 2016, 90: 29-31. DOI: 10.1016/j.mehy.2016.02.019.
[51]
Hersant B, Sidahmed-Mezi M, Belkacemi Y, et al. Efficacy of injecting platelet concentrate combined with hyaluronic acid for the treatment of vulvovaginal atrophy in postmenopausal women with history of breast cancer: a phase 2 pilot study[J]. Menopause, 2018, 25(10): 1124-1130. DOI: 10.1097/gme.0000000000001122.
[1] 欧阳剑锋, 李炳权, 叶永恒, 胡少宇, 向阳. 关节镜联合富血小板血浆治疗粘连性肩周炎的疗效[J]. 中华关节外科杂志(电子版), 2023, 17(06): 765-772.
[2] 许正文, 李振, 侯振扬, 苏长征, 朱彪. 富血小板血浆联合植骨治疗早期非创伤性股骨头坏死[J]. 中华关节外科杂志(电子版), 2023, 17(06): 773-779.
[3] 夏传龙, 迟健, 丛强, 连杰, 崔峻, 陈彦玲. 富血小板血浆联合关节镜治疗半月板损伤的临床疗效[J]. 中华关节外科杂志(电子版), 2023, 17(06): 877-881.
[4] 张中斌, 付琨朋, 朱凯, 张玉, 李华. 胫骨高位截骨术与富血小板血浆治疗膝骨关节炎的疗效[J]. 中华关节外科杂志(电子版), 2023, 17(05): 633-641.
[5] 王泽勇, 覃健. 白细胞含量对富血小板血浆治疗运动系统损伤的影响[J]. 中华关节外科杂志(电子版), 2023, 17(05): 684-688.
[6] 马敏榕, 李聪, 周勤. 宫颈癌治疗研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 497-504.
[7] 林昌盛, 战军, 肖雪. 上皮性卵巢癌患者诊疗中基因检测及分子靶向药物治疗[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 505-510.
[8] 王璐, 樊杨. 子宫内膜癌相关生物标志物研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 511-516.
[9] 罗丹, 孔为民, 陈姝宁, 赵小玲, 谢云凯. 子宫内膜异位症患者在位及异位内膜上皮细胞-间充质转化相关生物标志物的变化[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 530-539.
[10] 韩李念, 王君. 放射性皮肤损伤治疗的研究进展[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 533-537.
[11] 周子慧, 李恭驰, 李炳辉, 王知, 刘慧真, 王卉, 邹利军. 细胞自噬在创面愈合中作用的研究进展[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 542-546.
[12] 陈继秋, 朱世辉. 皮肤牵张装置的临床应用现状[J]. 中华损伤与修复杂志(电子版), 2023, 18(05): 451-453.
[13] 马聪, 李雪靖, 郑晓佐, 张晓阳, 段坤峰, 刘国强, 郄素会. 关节腔内注射富血小板血浆与透明质酸钠治疗Ⅰ-Ⅲ期膝骨关节炎的对比研究[J]. 中华老年骨科与康复电子杂志, 2023, 09(05): 282-288.
[14] 袁媛, 赵良平, 刘智慧, 张丽萍, 谭丽梅, 閤梦琴. 子宫内膜癌组织中miR-25-3p、PTEN的表达及与病理参数的关系[J]. 中华临床医师杂志(电子版), 2023, 17(9): 1016-1020.
[15] 王丁然, 迟洪滨. 自身免疫甲状腺炎对子宫内膜异位症患者胚胎移植结局的影响[J]. 中华临床医师杂志(电子版), 2023, 17(06): 682-688.
阅读次数
全文


摘要