連續多次注射富血小板血漿對脂肪移植成活率及移植質量的影響_《中國修復重建外科雜志》

作者：

李俊杰 ¹ , 石瀟 ² , 陳煒 ¹

1江蘇大學附屬上海市第八人民醫院醫學美容科（上海，200235）;;
2上海交通大學醫學院附屬第九人民醫院麻醉科;

關鍵詞：

富血小板血漿脂肪移植血管生成成活率裸鼠

DOI：

10.7507/1002-1892.20130104

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的探討連續多次注射富血小板血漿（platelet-rich plasma，PRP）對脂肪移植成活率及移植質量的影響，為臨床應用提供實驗依據。方法取接受吸脂手術的1名25歲健康女性自愿捐贈的大腿后外側區脂肪，采用靜置法純化脂肪顆粒；抽取其外周靜脈血，經兩次200 × g離心10 min收集PRP；將PRP與10%CaCl2溶液以10∶1混合。選取5周齡雌性裸鼠24只，體重（20 ± 3）g，隨機分為實驗組與對照組（n=12）。實驗組于裸鼠左、右側背部皮下各注射脂肪顆粒與PRP（10∶2）混合物0.8 mL，對照組注射相同劑量脂肪顆粒與生理鹽水（10∶2）混合物。在首次移植后5、10 d，兩組再次分別注射PRP與生理鹽水0.14 mL。移植后觀察裸鼠存活情況；于首次移植后15、30、90、180 d，兩組取標本進行大體觀察，測定組織塊重量與體積；組織學觀察組織與細胞形態特征，計算壞死面積比與微血管計數。結果裸鼠均成活至實驗完成，兩組移植部位均未出現感染及破潰。各時間點實驗組組織塊表面血管生成以及橫切面液化、壞死情況均好于對照組。首次移植后15、30、90 d實驗組組織塊重量及體積均顯著大于對照組（P lt; 0.05），180 d時兩組組織塊重量及體積相似（P gt; 0.05）。組織學觀察示實驗組各時間點脂肪細胞形態結構均清晰，中心區空泡逐漸增大，無明顯壞死物質及鈣化發生；對照組脂肪細胞形態結構逐漸紊亂，且出現大量壞死物質，鈣化明顯。實驗組15、180 d時壞死面積比均小于對照組，微血管計數均多于對照組，差異均有統計學意義（P lt; 0.05）。結論180 d內連續多次注射PRP輔助脂肪移植能促進脂肪成活并提高移植質量。

引用本文： 李俊杰,石瀟,陳煒. 連續多次注射富血小板血漿對脂肪移植成活率及移植質量的影響. 中國修復重建外科雜志, 2013, 27(4): 454-459. doi: 10.7507/1002-1892.20130104 復制

1.	Ersek RA. Transplantation of purified autologous fat: a 3-year follow-up is disappointing. Plast Reconstr Surg, 1991, 87(2): 219-228.
2.	Chan CW, McCulley SJ, Macmillan RD. Autologous fat transfer—a review of the literature with a focus on breast cancer surgery. J Plast Reconstr Aesthet Surg, 2008, 61(12): 1438-1448.
3.	Mu DL, Luan J, Mu L, et al. Breast augmentation by autologous fat injection grafting: management and clinical analysis of complications. Ann Plast Surg, 2009, 63(2): 124-127.
4.	Villani F, Caviggioli F, Giannasi S, et al. Current applications and safety of autologous fat grafts: a report of the ASPS Fat Graft Task Force. Plast Reconstr Surg, 2010, 125(2): 758-759.
5.	Delay E, Garson S, Tousson G, et al. Fat injection to the breast: technique, results, and indications based on 880 procedures over 10 years. Aesthet Surg J, 2009, 29(5): 360-376.
6.	Zhong X, Yan W, He X, et al. Improved fat graft viability by delayed fat flap with ischaemic pretreatment. J Plast Reconstr Aesthet Surg, 2009, 62(4): 526-531.
7.	Topcu A, Aydin OE, Ünlü M, et al. Increasing the viability of fat grafts by vascular endothelial growth factor. Arch Facial Plast Surg, 2012, 14(4): 270-276.
8.	Pires Fraga MF, Nishio RT, Ishikawa RS, et al. Increased survival of free fat grafts with platelet-rich plasma in rabbits. J Plast Reconstr Aesthet Surg, 2010, 63(12): e818-822.
9.	Berghoff WJ, Pietrzak WS, Rhodes RD. Platelet-rich plasma application during closure following total knee arthroplasty. Orthopedics, 2006, 29(7): 590-598.
10.	陳素雅, 蔡華雄. 自體來源富血小板血漿對大鼠牙髓細胞增殖作用的研究. 中華老年口腔醫學雜志, 2011, 9(4): 201-204, 209.
11.	Cervelli V, Gentile P, Scioli MG, et al. Application of platelet-rich plasma in plastic surgery: clinical and in vitro evaluation. Tissue Eng Part C Methods, 2009, 15(4): 625-634.
12.	令狐大科, 張海霞, 譚新穎, 等. 富含血小板血漿對組織工程脂肪移植效果的影響. 中國美容醫學, 2012, 21(2): 250-252.
13.	Oh DS, Cheon YW, Jeon YR, et al. Activated platelet-rich plasma improves fat graft survival in nude mice: a pilot study. Dermatol Surg, 2011, 37(5): 619-625.
14.	Por YC, Yeow VK, Louri N, et al. Platelet-rich plasma has no effect on increasing free fat graft survival in the nude mouse. J Plast Reconstr Aesthet Surg, 2009, 62(8): 1030-1034.
15.	袁藝, 魯峰, 高建華. 脂肪來源干細胞促進顆粒脂肪游離移植后再血管化的機制. 中國修復重建外科雜志, 2011, 25(9): 1125-1129.
16.	蘇明寶, 王一平, 王旭飛. 切口脂肪液化20例診治體會. 中國實用外科雜志, 1999, 19(3): 144-145.
17.	張兆祥, 顧紀容, 黃利嗚, 等. 乳腺脂肪壞死的病理變化和臨床診斷. 中國普通外科雜志, 1995, 4(6): 334-336.
18.	Yi CG, Xia W, Zhang LX, et al. VEGF gene therapy for the survival of transplanted fat tissue in nude mice. J Plast Reconstr Aesthet Surg, 2007, 60(3): 272-278.
19.	Gundersen HJ, Bendtsen TF, Korbo L, et al. Some new, simple and efficient stereological methods and their use in pathological research and diagnosis. APMIS, 1988, 96(5): 379-394.
20.	黎洪棉, 柳大烈, 吳濤, 等. 早期應用富血小板血漿凝膠對自體脂肪組織移植存活率的影響. 中國組織工程研究與臨床康復, 2011, 15(31): 5751-5755.
21.	Craft RO, Rophael J, Morrison WA, et al. Effect of local, long-term delivery of platelet-derived growth factor (PDGF) on injected fat graft survival in severe combined immunodeficient (SCID) mice. J Plast Reconstr Aesthet Surg, 2009, 62(2): 235-243.
22.	Chung CW, Marra KG, Li H, et al. VEGF microsphere technology to enhance vascularization in fat grafting. Ann Plast Surg, 2012, 69(2): 213-219.
23.	Park B, Kong JS, Kang S, et al. The effect of epidermal growth factor on autogenous fat graft. Aesthetic Plast Surg, 2011, 35(5): 738-744.
24.	Marra KG, Defail AJ, Clavijo-Alvarez JA, et al. FGF-2 enhances vascularization for adipose tissue engineering. Plast Reconstr Surg, 2008, 121(4): 1153-1164.
25.	張云松, 何井華, 戴麗冰, 等. 富血小板血漿對血管內皮細胞增殖及血管形成的影響. 實用醫學雜志, 2011, 27(7): 1145-1147.
26.	Rodríguez-Flores J, Palomar-Gallego MA, Enguita-Valls AB, et al. Influence of platelet-rich plasma on the histologic characteristics of the autologous fat graft to the upper lip of rabbits. Aesthetic Plast Surg, 2011, 35(4): 480-486.
27.	Bendinelli P, Matteucci E, Dogliotti G, et al. Molecular basis of anti-inflammatory action of platelet-rich plasma on human chondrocytes: mechanisms of NF-kB inhibition via HGF. J Cell Physiol, 2010, 225(3): 757-766.

1. Ersek RA. Transplantation of purified autologous fat: a 3-year follow-up is disappointing. Plast Reconstr Surg, 1991, 87(2): 219-228.
2. Chan CW, McCulley SJ, Macmillan RD. Autologous fat transfer—a review of the literature with a focus on breast cancer surgery. J Plast Reconstr Aesthet Surg, 2008, 61(12): 1438-1448.
3. Mu DL, Luan J, Mu L, et al. Breast augmentation by autologous fat injection grafting: management and clinical analysis of complications. Ann Plast Surg, 2009, 63(2): 124-127.
4. Villani F, Caviggioli F, Giannasi S, et al. Current applications and safety of autologous fat grafts: a report of the ASPS Fat Graft Task Force. Plast Reconstr Surg, 2010, 125(2): 758-759.
5. Delay E, Garson S, Tousson G, et al. Fat injection to the breast: technique, results, and indications based on 880 procedures over 10 years. Aesthet Surg J, 2009, 29(5): 360-376.
6. Zhong X, Yan W, He X, et al. Improved fat graft viability by delayed fat flap with ischaemic pretreatment. J Plast Reconstr Aesthet Surg, 2009, 62(4): 526-531.
7. Topcu A, Aydin OE, Ünlü M, et al. Increasing the viability of fat grafts by vascular endothelial growth factor. Arch Facial Plast Surg, 2012, 14(4): 270-276.
8. Pires Fraga MF, Nishio RT, Ishikawa RS, et al. Increased survival of free fat grafts with platelet-rich plasma in rabbits. J Plast Reconstr Aesthet Surg, 2010, 63(12): e818-822.
9. Berghoff WJ, Pietrzak WS, Rhodes RD. Platelet-rich plasma application during closure following total knee arthroplasty. Orthopedics, 2006, 29(7): 590-598.
10. 陳素雅, 蔡華雄. 自體來源富血小板血漿對大鼠牙髓細胞增殖作用的研究. 中華老年口腔醫學雜志, 2011, 9(4): 201-204, 209.
11. Cervelli V, Gentile P, Scioli MG, et al. Application of platelet-rich plasma in plastic surgery: clinical and in vitro evaluation. Tissue Eng Part C Methods, 2009, 15(4): 625-634.
12. 令狐大科, 張海霞, 譚新穎, 等. 富含血小板血漿對組織工程脂肪移植效果的影響. 中國美容醫學, 2012, 21(2): 250-252.
13. Oh DS, Cheon YW, Jeon YR, et al. Activated platelet-rich plasma improves fat graft survival in nude mice: a pilot study. Dermatol Surg, 2011, 37(5): 619-625.
14. Por YC, Yeow VK, Louri N, et al. Platelet-rich plasma has no effect on increasing free fat graft survival in the nude mouse. J Plast Reconstr Aesthet Surg, 2009, 62(8): 1030-1034.
15. 袁藝, 魯峰, 高建華. 脂肪來源干細胞促進顆粒脂肪游離移植后再血管化的機制. 中國修復重建外科雜志, 2011, 25(9): 1125-1129.
16. 蘇明寶, 王一平, 王旭飛. 切口脂肪液化20例診治體會. 中國實用外科雜志, 1999, 19(3): 144-145.
17. 張兆祥, 顧紀容, 黃利嗚, 等. 乳腺脂肪壞死的病理變化和臨床診斷. 中國普通外科雜志, 1995, 4(6): 334-336.
18. Yi CG, Xia W, Zhang LX, et al. VEGF gene therapy for the survival of transplanted fat tissue in nude mice. J Plast Reconstr Aesthet Surg, 2007, 60(3): 272-278.
19. Gundersen HJ, Bendtsen TF, Korbo L, et al. Some new, simple and efficient stereological methods and their use in pathological research and diagnosis. APMIS, 1988, 96(5): 379-394.
20. 黎洪棉, 柳大烈, 吳濤, 等. 早期應用富血小板血漿凝膠對自體脂肪組織移植存活率的影響. 中國組織工程研究與臨床康復, 2011, 15(31): 5751-5755.
21. Craft RO, Rophael J, Morrison WA, et al. Effect of local, long-term delivery of platelet-derived growth factor (PDGF) on injected fat graft survival in severe combined immunodeficient (SCID) mice. J Plast Reconstr Aesthet Surg, 2009, 62(2): 235-243.
22. Chung CW, Marra KG, Li H, et al. VEGF microsphere technology to enhance vascularization in fat grafting. Ann Plast Surg, 2012, 69(2): 213-219.
23. Park B, Kong JS, Kang S, et al. The effect of epidermal growth factor on autogenous fat graft. Aesthetic Plast Surg, 2011, 35(5): 738-744.
24. Marra KG, Defail AJ, Clavijo-Alvarez JA, et al. FGF-2 enhances vascularization for adipose tissue engineering. Plast Reconstr Surg, 2008, 121(4): 1153-1164.
25. 張云松, 何井華, 戴麗冰, 等. 富血小板血漿對血管內皮細胞增殖及血管形成的影響. 實用醫學雜志, 2011, 27(7): 1145-1147.
26. Rodríguez-Flores J, Palomar-Gallego MA, Enguita-Valls AB, et al. Influence of platelet-rich plasma on the histologic characteristics of the autologous fat graft to the upper lip of rabbits. Aesthetic Plast Surg, 2011, 35(4): 480-486.
27. Bendinelli P, Matteucci E, Dogliotti G, et al. Molecular basis of anti-inflammatory action of platelet-rich plasma on human chondrocytes: mechanisms of NF-kB inhibition via HGF. J Cell Physiol, 2010, 225(3): 757-766.

《中國修復重建外科雜志》

連續多次注射富血小板血漿對脂肪移植成活率及移植質量的影響

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《中國修復重建外科雜志》

連續多次注射富血小板血漿對脂肪移植成活率及移植質量的影響

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