透明质酸钠治疗不同严重程度膝骨性关节炎的效果观察

目的观察透明质酸钠(HA)治疗不同严重程度膝骨性关节炎(KOA)的效果,探讨KOA严重程度与HA疗效的关系。方法选取K-L分级Ⅰ~Ⅳ级的KOA患者各21例,分别标记为A、B、C、D组,均接受HA膝关节内注射治疗。比较治疗前后四组的视觉模拟疼痛评分(VAS)、VAS差值(ΔVAS)、膝关节HSS评分、HSS评分差值(AHSS)、最小临床重要差异(MCID)和膝关节液中一氧化氮水平(NO)、NO差值(ANO)。结果HA关节腔注射治疗后,四组患者的ΔVAS、ΔNO、ΔHSS、MCID率均随着K-L分级增加而降低(P<0.05)。进一步两两比较,A组和B组的ΔVAS、ΔNO、ΔHSS、MCID率均显著高于C组,C组的ΔVAS、ΔNO、ΔHSS、MCID率均显著高于D组,差异均有统计学意义(P<0.05)。结论K-L分级是影响HA治疗效果的敏感因素,K-L分级4级的HA治疗效果欠佳,需引起临床重视。

Objective To observe the clinical efficacy of sodium hyaluronate(HA)in the treatment of knee osteoarthritis(KOA),and to explore the relationship between the severity of KOA and the efficacy of HA.Methods 21 patients in each group with KOA K-L grade Ⅰ-Ⅳ were selected and labeled as group A,B,C and D,respectively.All patients were given HA intra-articular injection.Visual analogue pain score(VAS),VAS difference(ΔVAS),knee HSS score,HSS score difference(ΔHSS),minimal clinically important difference(MCID),nitric oxide(NO),NO difference(ΔNO)were observed before and after treatment.Results After treatment with HA,ΔVAS,ΔNO,ΔHSS and MCID in 4 groups were decreased with the increase of K-L grade,respectively(P<0.05).Further pairwise comparison showed that ΔVAS,ΔNO,ΔHSS and MCID in group A and B were significantly higher than those in group C,and ΔVAS,ΔNO,ΔHSS and MCID rate in group C were significantly higher than those in group D(P<0.05).Conclusion K-L grade is a sensitive factor affecting the treatment of HA.Patients with K-L grade Ⅳ are less effective in the treatment of HA,which requires clinical attention.