连续多次注射富血小板血浆对脂肪移植成活率及移植质量的影响_《中国修复重建外科杂志》

作者：

李俊杰 ¹ , 石潇 ² , 陈炜 ¹

1江苏大学附属上海市第八人民医院医学美容科（上海，200235）;;
2上海交通大学医学院附属第九人民医院麻醉科;

关键词：

富血小板血浆脂肪移植血管生成成活率裸鼠

DOI：

10.7507/1002-1892.20130104

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的探讨连续多次注射富血小板血浆（platelet-rich plasma，PRP）对脂肪移植成活率及移植质量的影响，为临床应用提供实验依据。方法取接受吸脂手术的1名25岁健康女性自愿捐赠的大腿后外侧区脂肪，采用静置法纯化脂肪颗粒；抽取其外周静脉血，经两次200 × g离心10 min收集PRP；将PRP与10%CaCl2溶液以10∶1混合。选取5周龄雌性裸鼠24只，体重（20 ± 3）g，随机分为实验组与对照组（n=12）。实验组于裸鼠左、右侧背部皮下各注射脂肪颗粒与PRP（10∶2）混合物0.8 mL，对照组注射相同剂量脂肪颗粒与生理盐水（10∶2）混合物。在首次移植后5、10 d，两组再次分别注射PRP与生理盐水0.14 mL。移植后观察裸鼠存活情况；于首次移植后15、30、90、180 d，两组取标本进行大体观察，测定组织块重量与体积；组织学观察组织与细胞形态特征，计算坏死面积比与微血管计数。结果裸鼠均成活至实验完成，两组移植部位均未出现感染及破溃。各时间点实验组组织块表面血管生成以及横切面液化、坏死情况均好于对照组。首次移植后15、30、90 d实验组组织块重量及体积均显著大于对照组（P lt; 0.05），180 d时两组组织块重量及体积相似（P gt; 0.05）。组织学观察示实验组各时间点脂肪细胞形态结构均清晰，中心区空泡逐渐增大，无明显坏死物质及钙化发生；对照组脂肪细胞形态结构逐渐紊乱，且出现大量坏死物质，钙化明显。实验组15、180 d时坏死面积比均小于对照组，微血管计数均多于对照组，差异均有统计学意义（P lt; 0.05）。结论180 d内连续多次注射PRP辅助脂肪移植能促进脂肪成活并提高移植质量。

引用本文： 李俊杰,石潇,陈炜. 连续多次注射富血小板血浆对脂肪移植成活率及移植质量的影响. 中国修复重建外科杂志, 2013, 27(4): 454-459. doi: 10.7507/1002-1892.20130104 复制

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.	陈素雅, 蔡华雄. 自体来源富血小板血浆对大鼠牙髓细胞增殖作用的研究. 中华老年口腔医学杂志, 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, 张海霞, 谭新颖, 等. 富含血小板血浆对组织工程脂肪移植效果的影响. 中国美容医学, 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.	袁艺, 鲁峰, 高建华. 脂肪来源干细胞促进颗粒脂肪游离移植后再血管化的机制. 中国修复重建外科杂志, 2011, 25(9): 1125-1129.
16.	苏明宝, 王一平, 王旭飞. 切口脂肪液化20例诊治体会. 中国实用外科杂志, 1999, 19(3): 144-145.
17.	张兆祥, 顾纪容, 黄利呜, 等. 乳腺脂肪坏死的病理变化和临床诊断. 中国普通外科杂志, 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, 吴涛, 等. 早期应用富血小板血浆凝胶对自体脂肪组织移植存活率的影响. 中国组织工程研究与临床康复, 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.	张云松, 何井华, 戴丽冰, 等. 富血小板血浆对血管内皮细胞增殖及血管形成的影响. 实用医学杂志, 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. 陈素雅, 蔡华雄. 自体来源富血小板血浆对大鼠牙髓细胞增殖作用的研究. 中华老年口腔医学杂志, 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, 张海霞, 谭新颖, 等. 富含血小板血浆对组织工程脂肪移植效果的影响. 中国美容医学, 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. 袁艺, 鲁峰, 高建华. 脂肪来源干细胞促进颗粒脂肪游离移植后再血管化的机制. 中国修复重建外科杂志, 2011, 25(9): 1125-1129.
16. 苏明宝, 王一平, 王旭飞. 切口脂肪液化20例诊治体会. 中国实用外科杂志, 1999, 19(3): 144-145.
17. 张兆祥, 顾纪容, 黄利呜, 等. 乳腺脂肪坏死的病理变化和临床诊断. 中国普通外科杂志, 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, 吴涛, 等. 早期应用富血小板血浆凝胶对自体脂肪组织移植存活率的影响. 中国组织工程研究与临床康复, 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. 张云松, 何井华, 戴丽冰, 等. 富血小板血浆对血管内皮细胞增殖及血管形成的影响. 实用医学杂志, 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.

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《中国修复重建外科杂志》

连续多次注射富血小板血浆对脂肪移植成活率及移植质量的影响

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