自体富含血小板血浆关节腔内注射治疗膝骨性关节炎的初步研究

Autologous platelet-rich plasma intra-articular injection for treatment the knee osteoarthritis: a preliminary study

目的 观察自体富含血小板血浆关节腔内注射治疗膝骨性关节炎的初步临床效果.方法 选择2011年10月至2012年8月于盐城市第一人民医院门诊就诊的82例120膝膝骨性关节炎患者,根据患者的年龄（≥60岁和＜60岁）和膝关节退变的程度（Kellgren-Lawrence Ⅰ-Ⅱ和Ⅳ-Ⅳ级）进行分组,对其进行了自体富含血小板血浆关节腔内注射治疗,每两周注射1次,共计3次.对患者进行随访,对膝关节功能进行WOMAC评分,采用t检验比较治疗后不同时间点的疗效.结果 所有的患者都得到12～18个月的随访,平均随访时间为（12.5±4.8）个月.治疗前和治疗后3、6、12个月所有患者WOMAC评分分别为46.44±9.24,22.58±5.50,21.20±4.93,24.53±8.84,治疗前后比较差异具有统计学意义（F=342.284,P=0.000）.年龄小于60岁、Ⅰ-Ⅱ级与年龄大于或等于60岁、Ⅲ-Ⅳ级患者治疗后3个月比较两者差异无统计学意义（P〉0.05）,6、12个月时相比效果更好,差异具有统计学意义（P〈0.05）.结论 自体富含血小板血浆关节腔内注射治疗膝骨性关节炎安全有效,获得了良好的短期效果;膝关节退变轻、年龄小的患者治疗效果更持久.

Objective To observe the preliminary clinical effect of intra-articular platelet-rich plasma（ PRP） injections in patients with knee osteoarthritis. Methods From October 2011 to August 2012,82 patients with 120 knees who met the study criteria received three platelet-rich plasma injections in the affected knee at 2 weeks intervals. All the patients were followed-up and evaluate the knee function with WOMAC score at pre- and post-treatment. The patients are divided to different sub-groups based on the age（ ≥ 60 and 60 years of age） and the degree of the knee degeneration（ Kellgren-Lawrence Ⅰ-Ⅱ and Ⅳ-Ⅳ grade） and compared the efficacy of treatment at different follow-up time between the sub-groups. Results Minimum follow-up time was 12months [average：（ 12. 5 ± 4. 8） months,12-18 months]. The WOMAC scores has significant difference between pre-and post-treatment（ P = 0. 000）. The patient who 60 years older or Kellgren-Lawrence grade Ⅰ-Ⅱ compare to ≥60 years older or Kellgren-Lawrence grade Ⅲ-Ⅳ,in the 3 months after treatment,there was no significant difference between sub-group. However,the WOMAC score are more improved in the younger and grade Ⅰ-Ⅱ patients in 6、12 months. Conclusions Autologous platelet-rich plasma injections intra-articular for treatment knee osteoarthritis is safe and achieve the good short-term result. The efficacious are more lasting in the patients who are younger and knee mild degeneration.