Ububabare bwa Neuropathique bivuga imikorere idasanzwe yo kumva, kumva ububabare hamwe nububabare bwihuse buterwa no gukomeretsa cyangwa indwara ya sisitemu yo mu mutwe.Benshi muribo barashobora guherekezwa nububabare ahantu hajyanye imbere nyuma yo gukuraho ibintu byimvune, bigaragarira nkububabare bwihuse, hyperalgesia, hyperalgesia hamwe no kumva bidasanzwe.Kugeza ubu, imiti igabanya ububabare bwa neuropathique irimo antidepressants ya tricyclic, 5-hydroxytryptamine norepinephrine reuptake inhibitor, anticonvulsants gabapentin na pregabalin, na opioide.Nyamara, ingaruka zo kuvura imiti akenshi usanga ari nke, bisaba gahunda yo kuvura imiti myinshi nko kuvura umubiri, kugenzura imitsi no kubaga.Ububabare budashira hamwe no kugabanya imikorere bizagabanya uruhare rwimibereho yabarwayi kandi bitere abarwayi uburemere bwimitekerereze nubukungu.
Platelet ikungahaye kuri plasma (PRP) nigicuruzwa cya plasma gifite plaque nyinshi zifite isuku ziboneka hamwe na centrifuging maraso autologique.Muri 1954, KINGSLEY yakoresheje bwa mbere ijambo ry'ubuvuzi PRP.Binyuze mu bushakashatsi n’iterambere mu myaka yashize, PRP yakoreshejwe cyane mu kubaga amagufwa no kubaga ingingo, kubaga umugongo, dermatologiya, gusubiza mu buzima busanzwe n’andi mashami, kandi igira uruhare runini mu bijyanye no gusana ingirabuzimafatizo.
Ihame ryibanze ryokuvura PRP nugutera inshinge za platine yibanze aho wakomeretse hanyuma ugatangira gusana ingirabuzima fatizo zirekura ibintu bitandukanye bioaktike (ibintu bikura, cytokine, lysosomes) hamwe na proteine zifata.Ibi bintu bioaktique bifite inshingano zo gutangira reaction ya hemostatike caskade, synthesis ya tissue nshya ihuza no kwiyubaka kwamaraso.
Gutondekanya no gutera ububabare bwa neuropathique Ububanyi n’ubuzima ku isi bwasohoye verisiyo ya 11 ivuguruye y’urwego mpuzamahanga rw’ububabare mu mwaka wa 2018, igabanya ububabare bwa neuropathique n’ububabare bwo hagati bwa neuropathique n’ububabare bwa neuropathique.
Ububabare bwa neuropathique bwa periferique bushyirwa mubikorwa ukurikije etiologiya:
1) Kwandura / gutwika: neuralgia ya postherpetic, ibibembe bibabaza, sifilis / VIH yanduye peripheri neuropathie
2) Kwikuramo imitsi: syndrome ya carpal, ububabare bwumugongo
3) Ihahamuka: ihahamuka / gutwika / nyuma yo gukora / post radiotherapie ububabare bwa neuropathique
4) Ischemia / metabolism: diabete peripheral ububabare bwa neuropathique
5) Ibiyobyabwenge: neuropathie periferique iterwa nibiyobyabwenge (nka chimiotherapie)
6) Abandi: ububabare bwa kanseri, trigeminal neuralgia, glossopharyngeal neuralgia, neuroma ya Morton
Uburyo bwo gutondekanya no gutegura PRP muri rusange bizera ko kwibumbira kwa platel muri PRP bikubye inshuro enye cyangwa eshanu z'amaraso yose, ariko habayeho kubura ibipimo byerekana.Muri 2001, Marx yasobanuye ko PRP irimo byibura miriyoni 1 ya platine kuri microliter ya plasma, nicyo kimenyetso cyerekana ibipimo bya PRP.Dohan n'abandi.yashyize PRP mu byiciro bine: PRP ityoroye, leukocyte ikungahaye kuri PRP, fibrine ikungahaye kuri fibrin, na leukocyte ikungahaye kuri platine ishingiye ku bintu bitandukanye bigize platine, leukocyte, na fibrin muri PRP.Keretse niba byavuzwe ukundi, PRP mubisanzwe yerekeza selile yera ikungahaye kuri PRP.
Uburyo bwa PRP mu kuvura ububabare bwa Neuropathique Nyuma yo gukomeretsa, abakora ibintu bitandukanye ba endogenous na exogenous bazamura ibikorwa bya platel α- Granules ihura na degranulation reaction, ikarekura ibintu byinshi byikura, fibrinogen, cathepsin na hydrolase.Ibintu bikura byasohotse bihuza hejuru yinyuma ya selile ya selile igenewe binyuze muri reseptor ya transembrane kuri selile.Iyakira ya transembrane nayo itera kandi igakora poroteyine za endogenous zerekana ibimenyetso, bikarushaho gukora intumwa ya kabiri mu kagari, itera ikwirakwizwa ry'utugingo ngengabuzima, imiterere ya matrix, synthesis ya poroteyine ya kolagen hamwe n'indi mvugo ya gen.Hariho ibimenyetso byerekana ko cytokine irekurwa na platine hamwe nizindi zanduza zigira uruhare runini mukugabanya / gukuraho ububabare budakira bwa neuropathique.Uburyo bwihariye bushobora kugabanywa muburyo bwa peripheri hamwe nuburyo bukuru.
Uburyo bwa plasma ikungahaye kuri plasma (PRP) mukuvura ububabare bwa neuropathique
Uburyo bwa periferique: ingaruka zo kurwanya inflammatory, neuroprotection no guteza imbere kuvugurura axon, kugenzura ubudahangarwa bw'umubiri, ingaruka zo gusesengura
Uburyo bukuru: gucogora no guhindura sensibilisation yo hagati no kubuza gukora glial selile
Ingaruka zo kurwanya inflammatory
Gukangura periferique bigira uruhare runini muguhuza ibimenyetso byububabare bwa neuropathique nyuma yo gukomeretsa imitsi.Ingirabuzimafatizo zitandukanye, nka neutrophile, macrophage na selile ya mast, zinjiye ahantu hakomeretse imitsi.Kwirundanya gukabije kwingirangingo zitwika bigize ishingiro ryibyishimo byinshi no gusohora guhoraho kwa fibre nervice.Gutwika kurekura umubare munini wabunzi ba chimique, nka cytokine, chemokine naba mediateurs ba lipide, bigatuma nociceptors yunvikana kandi ishimishije, kandi itera impinduka mubidukikije byimiti.Platelets ifite immunosuppressive ikomeye kandi irwanya inflammatory.Mugutunganya no guhisha ibintu bitandukanye bigenga ubudahangarwa bw'umubiri, ibintu bya angiogeneque nimirire yintungamubiri, birashobora kugabanya ingaruka mbi zumudugudu no gutwika, kandi bigasana ibyangiritse bitandukanye mubice bitandukanye.PRP irashobora kugira uruhare mu kurwanya inflammatory binyuze muburyo butandukanye.Irashobora guhagarika irekurwa rya cytokine ziterwa na selile ziva muri selile ya Schwann, macrophage, neutrophile na selile mast, kandi ikabuza imvugo ya gene yibintu byakira ibintu byateza imbere ihinduka ryimiterere yimitsi yangiritse ikava mubintu byaka umuriro ikajya muri leta irwanya inflammatory.Nubwo platine idasohora interleukin 10, platine igabanya umusaruro mwinshi wa interleukin 10 itera selile dendritic idakuze γ- Umusaruro wa interferon ugira uruhare mukurwanya inflammatory.
Ingaruka zo gusesengura
Amashanyarazi akora arekura neurotransmitters nyinshi zitera inflammatory na anti-inflammatory, zishobora gutera ububabare, ariko kandi zikagabanya uburibwe nububabare.Amashanyarazi mashya yateguwe arasinziriye muri PRP.Nyuma yo gukora muburyo butaziguye cyangwa butaziguye, morphologie ya platel irahinduka kandi igateza imbere guteranya platine, kurekura ingirangingo zayo α- Dense hamwe nuduce duto twakanguriwe bizatera irekurwa rya 5-hydroxytryptamine, ifite ingaruka zo kugabanya ububabare.Kugeza ubu, reseptor 5-hydroxytryptamine igaragara cyane mu mitsi ya peripheri.5-hydroxytryptamine irashobora kugira ingaruka kwanduza nociceptive mumyanya ikikije binyuze muri 5-hydroxytryptamine 1, 5-hydroxytryptamine 2, 5-hydroxytryptamine 3, 5-hydroxytryptamine 4 na 5-hydroxytryptamine 7 yakira.
Kubuza ibikorwa bya selile Glial
Ingirabuzimafatizo zifite hafi 70% by'uturemangingo twa sisitemu yo hagati yo hagati, zishobora kugabanywamo ubwoko butatu: astrocytes, oligodendrocytes na microglia.Microglia yakoreshwaga mu masaha 24 nyuma yo gukomeretsa imitsi, na astrocytes ikora nyuma gato yo gukomeretsa imitsi, hanyuma gukora bimara ibyumweru 12.Astrocytes na microglia noneho birekura cytokine kandi bigatera urukurikirane rw'ibisubizo by'utugingo ngengabuzima, nko kugenzura glucocorticoid na glutamate reseptors, biganisha ku mpinduka zo kwishimisha uruti rw'umugongo hamwe na plastike ya neural, bifitanye isano rya bugufi no kubaho k'ububabare bwa neuropathique.
Ibintu bigira uruhare mu kugabanya cyangwa gukuraho ububabare bwa neuropathique muri plasma ikungahaye kuri platel
1) Angiopoietin:
Tera angiogenez;Gukangurira kwimuka kwa endoteliyale kwimuka no gukwirakwira;Shigikira kandi ushimangire iterambere ryimiyoboro yamaraso ushakisha pericytes
2) Iterambere ryimitsi ihuza:
Kangura kwimuka kwa leukocyte;Guteza imbere angiogenez;Ikora myofibroblast kandi itera matrice idasanzwe no gushira
3) Icyorezo cya Epidermal:
Guteza imbere gukira ibikomere no gutera angiogenez mugutezimbere ikwirakwizwa, kwimuka no gutandukanya macrophage na fibroblast;Gukangurira fibroblast gusohora kolagenase no gutesha agaciro matrice idasanzwe mugihe cyo kuvugurura ibikomere;Teza imbere ikwirakwizwa rya keratinocytes na fibroblast, biganisha kuri epithelisation.
4) Impamvu yo gukura kwa Fibroblast:
Gukurura chemotaxis ya macrophage, fibroblast na selile endothelia;Tera angiogenez;Irashobora gutera granulation na tissue kuvugurura kandi ikagira uruhare mukugabanya ibikomere.
5) Impamvu yo gukura kwa Hepatocyte:
Kugenzura imikurire yimikorere ningirabuzimafatizo ya epithelia / endoteliyale;Teza imbere gusana epiteliyale na angiogenez.
6) Insuline nkibintu bikura:
Kusanya hamwe fibre selile kugirango utere intungamubiri za poroteyine.
7) Platelet ikomoka kubintu bikura:
Kangura chemotaxis ya neutrophile, macrophage na fibroblast, kandi ushishikarize ikwirakwizwa rya macrophage na fibroblast icyarimwe;Ifasha kubora collagen ishaje no hejuru kugena imvugo ya matrix metalloproteinase, biganisha ku gutwika, gushinga ingirabuzimafatizo, gukwirakwiza epiteliyale, kubyara matrice idasanzwe no kuvugurura ingirangingo;Irashobora guteza imbere ikwirakwizwa rya adipose yumuntu ikomoka ku ngirabuzimafatizo kandi igafasha kugira uruhare mu kuvugurura imitsi.
8) Ingirabuzimafatizo zikomoka:
Hamagara CD34 + selile kugirango itere imuhira, gukwirakwizwa no gutandukana muri selile ya progenitor, hanyuma ukangure angiogenez;Kusanya mesenchymal stem selile na leukocytes.
9) Guhindura ibintu bikura β ：
Ubwa mbere, bifite ingaruka zo guteza umuriro, ariko birashobora no guteza imbere ihinduka ryigice cyakomeretse kuri leta yo kurwanya inflammatory;Irashobora kongera chemotaxis ya fibroblast hamwe ningirabuzimafatizo zoroheje;Tunganya imvugo ya kolagen na kolagenase, kandi uteze imbere angiogenez.
10) Imitsi ikura ya endoteliyale:
Shyigikira kandi uteze imbere imikurire ya fibre fibre ivugururwa uhuza angiogenezi, neurotrophique na neuroprotection, kugirango ugarure imikorere yimitsi.
11) Impamvu yo gukura kw'imitsi:
Ifite uruhare rwa neuroprotective mugutezimbere imikurire ya axon no kubungabunga no kubaho kwa neuron.
12) Ikirere gikomoka kuri neurotrophique:
Irashobora guhindura neza no guhindura poroteyine za neurogeneque kandi ikagira uruhare rwa neuroprotective.
Umwanzuro
1) Plasma ikungahaye kuri plasma ifite ibiranga guteza imbere gukira no kurwanya indwara.Ntishobora gusana gusa imyakura yangiritse gusa, ahubwo irashobora no kugabanya ububabare.Nuburyo bwingenzi bwo kuvura ububabare bwa neuropathique kandi bufite ibyiringiro byiza;
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3) Hariho ubushakashatsi bwinshi kuri plasma ikungahaye kuri plasma mububabare bwa neuropathique buterwa no gukomeretsa umugongo, gukomeretsa imitsi ya peripheri no kwikuramo imitsi.Uburyo hamwe nubuvuzi bwa plasma ikungahaye kuri plasma mubundi bwoko bwububabare bwa neuropathique bugomba gukomeza kwigwa.
Ububabare bwa Neuropathique nizina rusange ryurwego runini rwindwara zamavuriro, zikunze kugaragara mubikorwa byubuvuzi.Nyamara, nta buryo bwihariye bwo kuvura ubu, kandi ububabare bumara imyaka itari mike cyangwa se ubuzima bwose nyuma yuburwayi, butera umutwaro ukomeye abarwayi, imiryango ndetse na societe.Kuvura ibiyobyabwenge ni gahunda y'ibanze yo kuvura ububabare bwa neuropathique.Bitewe no gukenera imiti yigihe kirekire, kubahiriza abarwayi ntabwo ari byiza.Imiti miremire izongera imiti mibi kandi itere abarwayi kwangirika kumubiri no mumutwe.Ubushakashatsi bwibanze nubushakashatsi bwubuvuzi bwerekanye ko PRP ishobora gukoreshwa mu kuvura ububabare bwa neuropathique, kandi PRP ituruka kumurwayi ubwayo, nta reaction ya autoimmune.Uburyo bwo kuvura buroroshye, hamwe nibisubizo bike.PRP irashobora kandi gukoreshwa hamwe ningirangingo ngengabuzima, ifite ubushobozi bukomeye bwo gusana imitsi no kuvugurura ingirabuzimafatizo, kandi ikagira ibyifuzo byinshi byo kuvura ububabare bwa neuropathique mugihe kizaza.
Ibiri muri iyi ngingo byongeye gusubirwamo, kandi ntidutanga ingwate iyo ari yo yose cyangwa yerekana ko ari ukuri, kwiringirwa cyangwa kuzuza ibikubiye muri iyi ngingo, kandi ntabwo dushinzwe ibitekerezo by'iyi ngingo, nyamuneka ubyumve.）
Igihe cyo kohereza: Ukuboza-20-2022