关节腔内注射生物制剂修复膝关节骨性关节炎:对关节软骨及功能的影响

Intra-articular injection of biological agents for treatment of osteoarthritis: effects on the articular cartilage and its function

背景:采用透明质酸或复方倍他米松治疗膝关节骨性关节炎,均能减轻关节内的炎性反应,缓解疼痛,保护膝关节功能。目的:观察透明质酸与复方倍他米松联合关节腔内注射治疗中期膝关节骨性关节炎的临床疗效及对关节功能的保护效果。方法:纳入Ⅱ、Ⅲ期膝关节骨性关节炎患者100例,采用随机数字表法均分为2组治疗,对照组膝关节腔内注射透明质酸溶液2 m L,试验组膝关节腔内注射透明质酸2 mL+复方倍他米松1 m L的混合液,1次/周,连续5周完成治疗。对比治疗前后的膝关节目测类比评分、Lysholm膝关节评分及静脉血沉指标。结果与结论:两组治疗后1,3,6个月的膝关节目测类比评分、Lysholm膝关节评分及静脉血沉均较治疗前明显改善(P<0.05)。试验组治疗后1,3,6个月的膝关节目测类比评分、Lysholm膝关节评分及静脉血沉均优于对照组(P<0.05),两组均未发生严重的全身不良反应。表明针对中期膝关节骨性关节炎患者,透明质酸与复方倍他米松联合关节腔内注射可降低炎性反应,减轻疼痛,营养关节软骨,提高关节功能。

BACKGROUND：Hyaluronic acid or compound betamethasone for treatment of knee osteoarthritis can reduce inflammatory reactions in the joints, relieve pain, and protect the function of the knee joint. OBJECTIVE：To investigate the clinical efficacy of intra-articular injection of hyaluronic acid combined with compound betamethasone on middle-stage knee osteoarthritis as wel as protective effect on joint function. METHODS：A total of 100 patients with II, III knee osteoarthritis were randomly divided into two groups： intra-articular injection of hyaluronic acid （2 mL） as control group and intra-articular injection of hyaluronic acid （2 mL） combined with compound betamethasone （1 mL） as testing group. The intra-articular injection was carried out once a week, totaly for consecutive 5 weeks. Visual analog scale score, Lysholm knee joint score and erythrocyte sedimentation rate were compared between two groups before and after treatment. RESULTS AND CONCLUSION：After treatment, the visual analog scale score, Lysholm knee joint score and erythrocyte sedimentation rate were improved significantly in the two groups as compared with those before treatment （P〈0.05）; in addition, these parameters were al better in the testing group than the control group （P 〈 0.05）. No systemic adverse reactions occurred in the two groups. These findings indicate that the intra-articular injection of hyaluronic acid combined with compound betamethasone can reduce inflammatory reactions, relieve pain, and improve joint function.