自体富血小板关节腔内注射治疗晚期膝骨关节炎对疼痛及疼痛介质的影响

Effects of intra-articular injection of platelet-rich plasma on pain and pain mediators in patients with advanced knee osteoarthritis

目的:探讨自体富血小板(platelet-rich plasma,PRP)关节腔内注射治疗晚期膝骨关节炎对疼痛及疼痛介质的影响。方法: 100例晚期膝骨关节炎患者按照随机数字表法分为实验组和对照组,每组各50例。实验组关节腔注射PRP 4 mL,对照组注射复方倍他米松和利多卡因混合液4 mL。评价治疗前后两组患者视觉模拟评分(visual analogue scalescore,VAS),并根据VAS分数评价临床疗效,检测血清疼痛介质(PGE 2、SP、DA、5-HT)、白三烯(LTB4、LTC4、LTD4)、促炎因子(TNF-α、IL-1β)的表达水平。结果:实验组治疗有效率(90%)与对照组(68%)比较,差异有统计学意义( P<0.05)。治疗前,两组患者疼痛介质、白三烯、促炎因子比较,差异无统计学意义(P>0.05);治疗后,两组患者疼痛介质、白三烯、促炎因子均下降,且实验组下降程度大于对照组(P <0.05)。结论: PRP关节腔注射疗法可有效改善晚期膝骨关节炎患者疼痛症状,修复关节软骨,控制炎症反应,适合在临床推广。

Objective: To investigate the effect of platelet-rich plasma (PRP) intra-articular injection on pain and pain mediators in patients with advanced knee osteoarthritis. Methods: 100 patients with advanced knee osteoarthritis were divided into experimental group and control group according to random number table method,50 cases in each group.The experimental group was injected PRP 4ml into the joint cavity,while the control group was injected with compound betamethasone and lidocaine mixture 4ml.VAS was evaluated before and after treatment,and clinical efficacy was evaluated according to VAS score.The expression levels of serum pain mediators (PGE 2,SP,DA,5-HT),leukotrienes (LTB4,LTC4,LTD4) and proinflammatory factors (TNF-α,IL-1β) were detected. Results: The effective rate of the experimental group was 90%,and that of the control group was 68%.There was significant difference between the two groups (P <0.05).Before treatment,there was no significant difference in pain mediators,leukotrienes and proinflammatory factors between the two groups (P >0.05),after treatment,the pain mediators,leukotrienes and proinflammatory factors were decreased in both groups,and the degree of decline in the experimental group was greater than that in the control group (P <0.05). Conclusion: PRP intra-articular injection therapy can effectively improve pain symptoms in patients with advanced knee osteoarthritis,repair articular cartilage,control inflammatory reaction,suitable for clinical promotion.