比较富血小板血浆及透明质酸对临床患者膝关节炎模型中炎症因子IL-1、TNF-α表达的影响

Comparison of the effects of platelet-rich plasma and hyaluronic acid on the expression of inflammatory factors interleuk-1(IL-1)and tumor necrosis factor-α(TNF-α)in clinical knee arthritis models

目的探讨富血小板血浆(PRP)及透明质酸(HA)对临床患者膝关节炎模型中炎症因子白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)水平的影响。方法选取2018年1-12月于该院诊治的40例膝关节骨关节炎患者作为研究对象,根据关节镜下软骨下骨钻孔原位注射不同药物,分成HA组及PRP组,每组20例。采用骨关节炎指数(WOMAC)评分、视觉模拟(VAS)评分及核磁共振检测于治疗前和治疗后1、2、4、8个月时对患者进行评估,通过酶联免疫吸附测定检测两组膝关节液中炎症因子IL-1、TNF-α水平。结果PRP组治疗后WOMAC评分、VAS评分降低,治疗后第1个月IL-1及TNF-α水平均较治疗前低,且随时间呈下降趋势。HA组治疗后第1、2个月WOMAC、VAS评分,IL-1及TNF-α水平降低,治疗后第4、8个月WOMAC评分、VAS评分,IL-1及TNF-α水平回升,且治疗后第8个月接近于治疗前。PRP组治疗后4、8个月WOMAC评分、VAS评分,IL-1及TNF-α水平均低于HA组,差异有统计学意义(P<0.05)。结论PRP通过降低膝关节中炎症因子IL-1、TNF-α水平,从而促进关节炎患者软骨修复。

Objective To investigate the effects of platelet-rich plasma(PRP)and hyaluronic acid(HA)on the levels of inflammatory factors IL-1 and TNF-αlevels in clinical knee arthritis models.Methods A total of 40 patients with knee osteoarthritis who were diagnosed and treated from January to December 2018 were selected as the research objects.According to the arthroscopic subchondral bone drilling,different drugs were injected in situ and divided into HA group and PRP group,with 20 cases in each group.The osteoarthritis index(WOMAC)score,visual analogue(VAS)score and MRI were used to evaluate patients before treatment and 1,2,4,and 8 months after treatment.Enzyme-linked immunosorbent assay was used to detect the expression levels of inflammatory factors IL-1 and TNF-αin the knee joint fluid of the two groups.Results The WOMAC score,VAS score,IL-1 and TNF-αlevels after treatment in the PRP group were lower than before treatment,and they showed a downward trend over time.In the HA group,WOMAC score,VAS score decveased in the 1 and 2 months after treatment,IL-1 and TNF-αlevels scores decreased in the 1 month after treatment,and WOMAC score,VAS score,IL-1 and TNF-αlevels increased in the 4 and 8 months after treatment.And it was close to that before treatment at the 8 months after treatment.The WOMAC score,VAS score,IL-1 and TNF-αlevels of the PRP group were significant lower than those of the HA group at 2,4,and 8 months after treatment(P<0.05).Conclusion PRP can promote cartilage repair in patients with arthritis by reducing the expression levels of inflammatory factors IL-1 and TNF-αin the knee joint.