注射sPL与类固醇类药物治疗有临床症状的肩袖部分损伤患者的疗效比较

Injection of autologous super-activated platelet lysate versus corticosteroid for the treatment of symptomatic partial rotator cuff tears

目的比较注射超活化血小板裂解液(super-activated platelet lysate,sPL)与皮质类固醇注射治疗有临床症状的肩袖部分损伤患者疗效,以期证明sPL对肩袖治疗的有效性。方法选取2018年9月~2021年9月哈尔滨医科大学附属第一医院门诊及黑龙江省医院门诊就诊的40例肩袖部分损伤患者作为研究对象。通过等量随机化分配,分为sPL组和皮质类固醇组,每组20例。通过美国肩关节外科医生标准化肩关节评估表(American Shoulder and Elbow Surgeons Standardized Shoulder Assessment,ASES)、恒定-murley评分(Constant-Murley Score,CMS)、简单肩关节测试(Simple Shoulder Test,SST)评分对两组患者注射前、注射后6周、12周和18周的情况进行评估。结果与注射前相比,两组随时间推移均显示更好的临床结果,差异有统计学意义(P<0.05)。注射12周后,sPL组在ASES、CMS、SST方面更优于皮质类固醇组,差异具有统计学意义(P<0.05)。结论肩峰下和关节内注射sPL注射液可以替代皮质类固醇注射液,特别是对于有皮质类固醇使用禁忌证的患者。

Objective To compare the results of super-activated platelet lysate(sPL)and with corticosteroid injection therapy in patients with partial rotator cuff tears with clinical symptoms,and to prove the true effectiveness of sPL on rotator cuff therapy.Methods A total of 40 patients with partial rotator cuff tears who received outpatient treatment at the First Affiliated Hospital of Harbin Medical University and the Provincial Hospital of Heilongjiang from September 2018 to September 2021 were selected as the study subjects.They were randomly divided into 2 groups:sPL group and the corticosteroid group,with 20 cases in each group.All patients were assessed before injection,6,12,18 weeks after injection by using the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form(ASES),the Constant-Murley Score(CMS)and the Simple Shoulder Test(SST).Results Both injection groups showed statistically signifificantly better clinical outcomes over time compared with those before injection(P<0.05).After 12 weeks after injection,the sPL group had better ASES,CMS and SST scores,showed statistically significant differences(P<0.05).Conclusion Subacromial and intra-articular SPL injections may be a good alternative to corticosteroid injections,especially in patients with contraindications to corticosteroid use.