Name: mechanical and controlled prp injections in patients affected by androgenetic alopecia
Uploaded: 2018-01-27T14:00:00
Description: Watch this Scientific Journal Video about Mechanical and Controlled PRP Injections in Patients Affected by Androgenetic Alopecia at JoVE.com

作者没有确认。

研究议定书遵守了《赫尔辛基宣言》, 所有病人在参加研究之前都提供了书面的知情同意。
1. 非活化 A-PRP 制剂
<ol><li>根据当地采血协议, 从手臂的外周静脉中采集55毫升自体血液, 用蝶形针管。</li>
	<li>在血液管中加入7毫升柠檬酸盐葡萄糖 (112 毫米柠檬酸) 溶液作为抗凝剂。</li>
	<li>离心机收集的血液在试管中的 260 x g 10 分钟。 注:23 毫升的 a-PRP + 自体血小板不良血浆 (PPP) ?...

<ol>
	<li>Rousso, D. E., Kim, S. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+review+of+medical+and+surgical+treatment+options+for+androgenetic+alopecia.">A review of medical and surgical treatment options for androgenetic alopecia.</a> JAMA Facial Plast Surg. 16, 444-450 (2014).</li><li>Schweiger, E. S., Boychenko, O., Bernstein, R. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Update+on+the+pathogenesis,+genetics+and+medical+treatment+of+patterned+hair+loss.">Update on the pathogenesis, genetics and medical treatment of patterned hair loss.</a> J Drugs Dermatol. 9, 1412-1419 (2010).</li><li>Price, V. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Lack+of+efficacy+of+finasteride+in+postmenopausal+women+with+androgenetic+alopecia.">Lack of efficacy of finasteride in postmenopausal women with androgenetic alopecia.</a> J Am Acad Dermatol. 43, 768-776 (2000).</li><li>Imperato-McGinley, J., Guerrero, L., Gautier, T., Peterson, R. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Steroid+5alpha-reductase+deficiency+in+man:+An+inherited+form+of+male+pseudohermaphroditism.">Steroid 5alpha-reductase deficiency in man: An inherited form of male pseudohermaphroditism.</a> Science. 186, 1213-1215 (1974).</li><li>Drake, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effects+of+finasteride+on+scalp+skin+and+serum+androgen+levels+in+men+with+androgenetic+alopecia.">The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia.</a> J Am Acad Dermatol. 41, 550-554 (1999).</li><li>Van Neste, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Finasteride+increases+anagen+hair+in+men+with+androgenetic+alopecia.">Finasteride increases anagen hair in men with androgenetic alopecia.</a> Br J Dermatol. 143, 804-810 (2000).</li><li>Kaufman, K. D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Finasteride+in+the+treatment+of+men+with+androgenetic+alopecia.">Finasteride in the treatment of men with androgenetic alopecia.</a> J. Am Acad Dermatol. 39, 578-589 (1998).</li><li>Afifi, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Low-level+laser+therapy+as+a+treatment+for+androgenetic+alopecia.">Low-level laser therapy as a treatment for androgenetic alopecia.</a> Lasers Surg Med. 49, 27-39 (2017).</li><li>Uebel, C. O., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+role+of+platelet+plasma+growth+factors+in+male+pattern+baldness+surgery.">The role of platelet plasma growth factors in male pattern baldness surgery.</a> Plast Reconstr Surg. 118, 1458-1466 (2006).</li><li>Cervelli, V., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effect+of+autologous+activated+platelet+rich+plasma+(AA-PRP)+injection+on+pattern+hair+loss:+Clinical+and+histomorphometric+evaluation.">The effect of autologous activated platelet rich plasma (AA-PRP) injection on pattern hair loss: Clinical and histomorphometric evaluation.</a> BioMed Res Int. , 760709 (2014).</li><li>Gkini, M. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Study+of+platelet-rich+plasma+injections+in+the+treatment+of+androgenetic+alopecia+through+an+one-year+period.">Study of platelet-rich plasma injections in the treatment of androgenetic alopecia through an one-year period.</a> J Cutan Aesthet Surg. 7, 213-219 (2014).</li><li>Gentile, P., Garcovich, S., Bielli, A., Scioli, M. G., Orlandi, A., Cervelli, V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effect+of+platelet-rich+plasma+in+hair+regrowth:+A+randomized+placebo-controlled+trial.">The effect of platelet-rich plasma in hair regrowth: A randomized placebo-controlled trial.</a> Stem Cells Transl Med. 4, 1317-1323 (2015).</li><li>Gentile, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+Not-Activated+and+Activated+PRP+in+Hair+Loss+Treatment:+Role+of+Growth+Factor+and+Cytokine+Concentrations+Obtained+by+Different+Collection+Systems.">Evaluation of Not-Activated and Activated PRP in Hair Loss Treatment: Role of Growth Factor and Cytokine Concentrations Obtained by Different Collection Systems.</a> Int J Mol Sci. 18 (2), 14 (2017).</li></ol>

作者证明, 机械和控制注射的 A-PRP 代表可行的治疗方案, 减少疼痛的过程中, 与手动注射执行的外科医生的手。经本议定书治疗的患者在头发数量和总头发密度上比使用人工注射治疗的患者有更大的增加。
在 PRP 的制备和注射技术的过程中, 要注意各步骤的细节, 才能提高头发的数量和头发的密度。例如, 为了获得良好的头发改?...

非活化的 A-PRP 的临床注射已成为一个有吸引力的资源, 针对头发生长。在这里, 使用机械和控制注射的方法报告了 A-PRP 应用的协议。目前, 只有口服选择性 5-α-还原酶抑制剂, 局部 diaminopirimidilpiperidin n-ossido (2.0% 和 5.0%) 和低水平激光治疗 (LLLT) 被美国食品和药物管理局 (FDA) 批准, 以打击 MPHL1,2.
Diaminopirimidilpiperidin-n-ossido 5% 泡沫也被 FDA 批准为 FPHL。选择性的 5-α-还原酶抑制剂在治疗 FPHL3方面已经证明是无效的, 而且, 由于药物可能导致男性胎儿外生殖器的异常, 因此不适合绝经前妇女使用4。相反, 每天治疗1毫克选择性 5-α-还原酶抑制剂已表明, 以减少血清睾 (DHT) 的水平 70%, 并促进头发生长的生长期头发导致逐渐增加头发直径和头发伸长的男性遗传患者5,6, 通过显著改善头发密度。口服选择性 5-α-还原酶抑制剂的使用可能需要多达一年的治疗和用户可能会发展失去的性冲动, 这可能会坚持后, 药物停止7。
最近, LLLT 的使用已经被提出来刺激毛发再生。Afifi et al.8回顾了现有的研究研究, 以确定 LLLT 是否是一种有效的治疗方法。局部应用活化的自体富血小板血浆 (AA-PRP) 的收获卵泡在植入之前已经表明, 增加他们的存活率为15% 的患者受感染的9, 以及展览增加头发密度3月后, 后期手术与终端头发密度增加19% 在这段时间内,10。在一年的11过程中, 经钙活化的 PRP 治疗后, 研究证实了这些结果。
鉴于 AA-prp12和 A-prp13作为脱发治疗的积极结果, 以及缺乏临床注射系统的数据, 这项工作的主要目的是显示机械和控制的 prp 注射协议。
18男性和5女性患者21-70 岁, 显示 MPHL 在阶段2至阶段5由诺伍德-汉密尔顿分类规模, 和 FPHL 在阶段1到阶段2由路德维希分类规模确定, 被处理的机械和控制注射的 A-PRP。通过病史、trichoscopic 分析、阴性毛发拉力试验、实验室检查、尿检等方法进行临床诊断。
采用诺伍德-汉密尔顿和路德维希尺度对其进行了评价。这项研究的所有参与者都是由一位皮肤病学专业的医生和再生整形外科和脱发的两名整形外科专家评估的。作者考虑了所有患者的局部性和系统性排斥标准。系统标准由血液和/或血小板紊乱, 抗凝血和/或栓治疗, 脓毒症, 免疫抑制, 癌症, 口服选择性 5-α-还原酶抑制剂或 antiandrogens 在过去12月。
局部排除标准的代表是使用 diaminopirimidilpiperidin n-ossido (2.0% 和 5.0%) 或皮质类固醇的局部治疗在过去的12月。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>C-PunT system</td>
			<td>Biomed Device, Modena, Italy</td>
			<td>www.biomeddevice.it</td>
			<td>a closed system medical device to obtain autologous concentrated platelet-rich plasma from the blood</td>
		</tr>
		<tr>
			<td>Ultim Gun</td>
			<td>Anti-Aging Medical System</td>
			<td>www.aamedicalsystems.fr</td>
			<td>a gun medical device to perform a mechanical and controlled injections of autologous platelet-rich plasma in a selected area of the scalp</td>
		</tr>
		<tr>
			<td>Trichoscan</td>
			<td>Tricolog GmbH, Freiburg, Germany).</td>
			<td>www.tricholog.de</td>
			<td>trihoScan is a digital 
			software-supported epiluminescence technique for measuring hair count (number of hairs per 0.65 cm2), hair density (number of hairs per cm2), hair diameter, anagen-to-telogen ratio, and vellus 
			hair-to-terminal hair ratio.</td>
		</tr>
		<tr>
			<td>sodium citrate ACD-A</td>
			<td>S.A.L.F.</td>
			<td>SAAS2205GPO</td>
			<td>anticoagulant for PRP preparation</td>
		</tr>
		<tr>
			<td>&#160;30-Gauge needle&#160;</td>
			<td>Becton Dickinson&#160;</td>
			<td>Z192368</td>
			<td>needle for injections</td>
		</tr>
		<tr>
			<td>10 mL mL Luer-Lock syringe</td>
			<td>Becton Dickinson&#160;</td>
			<td>BD309695</td>
			<td>syringe for PRP collection</td>
		</tr>
	</tbody>
</table>

mechanical and controlled prp injections in patients affected by androgenetic alopecia

23例 (18 男性和5女性) 岁21-70 岁, 显示男性模式脱发 (MPHL) 在阶段1到阶段 5, 由诺伍德-汉密尔顿分类规模, 和女性模式脱发 (FPHL) 在阶段1到阶段2由路德维希确定分类量表, 采用非活化自体富血小板血浆 (A-PRP) 进行治疗。自体血 (55 毫升) 是用枸橼酸钠作为抗凝剂来收割的。根据输血服务协议, 为所有情况下使用封闭式系统生成 PRP (23 毫升)。离心后 (260 x g 为10分钟) 将 a-prp 插入到激光光选择器中, 在离心后, 收集了9毫升的 a-prp。
雄脱发的患者头皮分为四区 (额、顶叶、顶点、枕部);局部麻醉没有执行。Interfollicular a-PRP 注射 (0.2 毫升 x cm2) 是由控制和机械注射计划在深度为5毫米使用医用注射器枪进行。治疗疗程以30天的间隔进行。对每位患者进行三次治疗。
PRP 被注射在雄激素相关的头皮受脱发影响的地区。安慰剂 (生理盐水溶液) 被装在另一个注射器 (10 毫升) 和注射在毗邻边以相似的方式。

用 tricoscopic 分析法对第三次 a-prp 注射后三月的毛发生长参数进行了比较, 并与基线测量和 A-prp 治疗区和控制区之间进行了对比, 接受生理盐水注射安慰.在第一次治疗之前, 在基线, 没有统计的区别在头发计数 (122 ± 10) 和头发密度 (218 ± 17) 在被瞄准的区域和被控制的区域之间 (126 ±9基线头发计数被控制的区域), (225 ±15基线头发密度控制区)。
结果表明, 三月后的第三个 a-prp 注?...

Watch this Scientific Journal Video about Mechanical and Controlled PRP Injections in Patients Affected by Androgenetic Alopecia at JoVE.com

Mechanical and Controlled PRP Injections in Patients Affected by Androgenetic Alopecia

本文的目的是描述 interfollicular 自体血小板丰富的血浆注射液 (0.20 毫升 x cm2) 的头皮23例受雄脱发的影响, 在深度5毫米使用医用注射器枪装备30针, 三会议.

雄脱发患者的机械和控制 PRP 注射

23 patients (18 male and 5 female) aged 21-70 years who displayed male pattern hair loss (MPHL) in Stage 1 to Stage 5 as determined by the ...

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