自体富血小板血浆对兔膝关节骨性关节炎的治疗效果观察

Observation on effect of autologous platelet-rich plasma in treating rabbit knee osteoarthosis

目的探讨富血小板血浆(PRP)对膝关节骨性关节炎(KOA)的治疗机制及作用。方法取成年清洁级新西兰大白兔32只,分为空白对照组(A组)、模型对照组(B组)、PRP治疗组(C组)、玻璃酸钠治疗组(D组)。A组行模拟造模,B、C、D组按Hulth方法诱发建立兔KOA动物模型。动物模型建立成功后,C组予PRP 0.5mL关节腔注射治疗,3周1次,共2次;D组予玻璃酸钠注射液关节腔注射,每周1次,连续5周;A、B组于C组同一时间点给予等量无菌生理盐水注射。在普通光学显微镜下观察关节软骨的组织结构、细胞数量、潮线的完整性和甲苯胺蓝染色等情况,比较各组间Mankin′s评分的差异。收集适量关节液测定各组花生四烯酸的表达情况。结果 A组关节软骨结构形态正常,无明显破坏;B、C、D组关节软骨结构形态均有不同程度的破坏,尤以B组软骨结构改变较大,C、D组软骨形态结构虽有改变,但与A组软骨结构较接近。A组Mankin′s评分最低,B组评分最高,C、D组经干预治疗后评分明显降低;B组与C、D组比较,差异有统计学意义(P<0.05),C组与D组比较,差异有统计学意义(P<0.05)。A组花生四烯酸水平最低,B组最高,C、D组水平介于A、B组之间,且C组低于D组(P<0.05)。结论 PRP对KOA具有较为明显的治疗及缓解作用。

Objective To investigate the treatment mechanism and effect of platelet-rich plasma（PRP） in treating rabbit knee osteoarthosis（KOA）. Methods Thirty-two New Zealand adult clean class rabbits were randomly divided into the blank control group（A） ,model control group（B）,PRP treatment group（C） and sodium hyaluronate treatment group（D）. The group A conducted the simulated model construction,while the group B,C and D established the KOA rabbit model by using the H ulth method. After establishing the animal model,the group C was given PRP 0.5roLl by knee articular cavity injection,once every 3 weeks, twice in to- tal;the group D was given sodium hyaluronate by knee articular cavity injection,once per week for 5 continuous weeks. The group A and B were injected with equal amount of normal saline at the same time point in the group C. The histological structure of articular cartilage,cell number,integrity of tidal line, and toluidine blue staining were observed by common optical microscope. The differ- ences of Mankinrs scores were compared among various groups, The proper amount of knee joint fluid was collected for measuring the arachidonic acid expression in each group. Results The structure and morphology of articular cartilage in the group A were nor- mal without obvious damage,while which in the group B,C and D had different degrees of damage, especially the cartilage structure in the group B had greater changes. Although the group B and C had the morphological and structure change of articular cartilage, but which was close to the cartilage structure in the group A. The Mankin＇s score in the group A was lowest, while which in the group B was highest,which in the group C and D was significantly decreased after intervention treatment~ the difference between the group B with the group C and D had statistical significance（P^0.05）. The difference between the group C and D had statistical sig- nificance（P〈0.05）. The arachidonic acid level in the group A was lowest and which in the group B was highest, which in the group C and group D ranged between the group A and B,moreover the group C was lower than the group D （P〈0.05）. Conclusion PRP has obvious therapeutic and alleviated effect in treating KOA.