富血小板血浆联合透明质酸关节腔内注射治疗膝骨关节炎疗效分析

Clinical efficacy of autologous platelet-rich plasma combined with intra-articular hyaluronic acid injection forknee osteoarthritis

目的分析自体富血小板血浆(PRP)联合透明质酸(HA)关节腔注射治疗膝骨关节炎(OA)的临床效果。方法收集2009年3月—2015年3月在温州医科大学附属第二医院治疗符合标准的150例膝OA患者的临床资料,随机分为A、B、C 3组,3组患者的一般资料具有可比性,A组单纯采用关节腔注射6 ml HA,B组单纯采用关节腔注射6 ml PRP,C组采用关节腔注射4 ml PRP联合2 ml HA,间隔1周,5周为1个疗程,记录3组患者治疗前和治疗后3、6、12个月美国西部Ontario和Mc Master大学骨关节炎指数评分(WOMAC评分)、国际膝关节文献委员会膝关节评估表(IKDC)评分、Lequesne指数以及注射过程中的不良反应。结果 C组患者治疗后WOMAC评分、Lequesne指数明显低于其余2组,IKDC评分明显高于其余2组,B组患者WOMAC评分、Lequesne指数明显低于A组,IKDC评分明显高于A组,差异均具有统计学意义(P<0.05),3组患者在治疗过程中均未发现严重药物相关的不良反应。结论 PRP联合HA关节腔内注射治疗膝OA患者疗效显著,早期即能缓解疼痛、改善关节功能,同时有较高的安全性,值得临床推广。

Objective To explore the effect of autologous platelet-rich plasma（PRP） combined with intra-articular hyalu- ronic acid（HA）injection in the treatment of knee osteoarthritis. Methods One hundred and fifty cases of knee osteoar- thrifts met criteria in our hospital was collected in March,2009 to March,2015. They were randomly divided into three groups ： the group A, the group B and the group C. The general information of the three groups were comparable. The group A was given knee intra-articular injection of HA 6 ml,the group B was given knee intra-articular injection of PRP 6 ml, and the group C was given knee intra-articular injection of PRP 4 ml and HA 2 ml at 10 rain afterwards,once a week for five weeks. The Western Ontario and McMaster American Universities Osteoarthritis Index score（ WOMAC score） ,the In- ternational Knee Documentation Committee knee evaluation form（IKDC） score, Lequesne index, adverse reactions of three groups were recorded and analyzed before and after the treatment. Results The WOMAC score and Lequesne index of group C were lower than those in the other two groups, while the IKDC score were higher than the other two groups. The WOMAC,IKDC score, Lequesne index score of group B were superior than group A （ P 〈 0.05 ）. Three patients of three groups were not found severe drug related adverse reactions during treatment. Conclusion PRP combined with HA can significantly control the pain and improve the joint function with high safety and efficacy. And it deserved clinical promo- tion.