PRP和HA治疗膝关节早期骨关节炎的临床疗效观察

Clinical observation of iR P and HA in treatment of early osteoarthritis of knee joint

目的:比较关节腔内注射富血小板血浆(PRP)和透明质酸钠(HA)治疗Ⅰ～Ⅲ期膝关节骨性关节炎的临床疗效。方法:选择86例Keligren Lawrence分级(K-L分级)为Ⅰ～Ⅲ期的膝骨关节炎患者,采用随机数字表法将其分为HA组45例和PRP组41例。两组患者分别采用关节镜探查清理后,关节腔内注射2.5 mL HA和3 mL PRP进行治疗。患者在治疗前和完成全部注射后的1、3、6、12个月均进行检查并记录美国西部Ontario与Mc Master大学骨关节炎指数(WOMAC)评分。比较两组治疗效果以及不同时间点的疗效。结果:治疗后,两组患者WOMAC评分较治疗前均明显降低(P<0.05);治疗后1、3个月,两组WOMAC评分无统计学差异(P>0.05);治疗后6个月和12个月,PRP组WOMAC评分明显低于治疗后1个月和3个月时(P<0.05),且PRP组WOMAC评分明显低于HA组(P<0.05)。结论:关节内注射PRP治疗膝关节软骨退行性病变安全有效,可缓解疼痛,改善患者肢体功能,提高患者治疗后长期疗效及其生活质量。

Objective： To compare effects of platelet rich plasma（ PRP） and hyaluronic acid（ HA） in treatment of I-III Knee osteoarthritis. Methods： 86 cases with Knee osteoarthritis（ K-L grade： I-III） were selected and divided into HA group（ 45 cases）and PRP group（ 41 cases） using the random number table method. They are treated with 2.5 mL HA or 3 mL PRP by intra-articular injection after arthroscopy cleaning. All patients were examined before and 1,3,6 and 12 months after the injection,and were also evaluated with United States Ontario MC and Master universities osteoarthritis index（ WOMAC） score. The treatment effects at different time points of the two groups were compared. Results： After the treatment,the WOMAC scores of the two groups were reduced significantly compared to those before the treatment（ P〈0.05）. There were no significant differences in the WOMAC score between the two groups 1 and 3 months after the treatment（ P〈0.05）. 6 and 12 months after the treatment,the WOMAC scores of the PRP group were obviously lower than those 1 and 3 months after the treatment,and the WOMAC scores of the PRP group were obviously lower than those of the HA group（ P〈0.05）. Conclusions： Intra-articular injection of PRP is safe and effective in the treatment of degenerative disease of knee joint. It can relieve pain,improve function and improve the quality of life of the patients,and improve the long-term efficacy.