富血小板血浆治疗膝骨关节炎患者的临床研究

Clinical study of platelet-rich plasma in the treatment of patients with knee osteoarthritis

目的观察使用富血小板血浆(PRP)治疗膝骨关节炎的临床疗效。方法选择本院80例膝骨关节炎患者作为研究对象,按照治疗方法的不同,采用随机数字表法将患者分为对照组(40例)和试验组(40例)。对照组采用关节镜下滑膜清理术配合透明质酸(HA)治疗;试验组采用关节镜下滑膜清理术配合PRP治疗。分析2组患者治疗后的临床疗效;评估2组患者治疗前后的视觉模拟疼痛评分(VAS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、膝关节活动度;检测2组患者治疗前后的白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)水平。结果治疗后,试验组和对照组的总有效率分别为92.50%和75.00%,差异有统计学意义(P<0.05)。试验组和对照组的VAS评分分别为(3.68±0.58)和(4.49±0.77)分;这2组的WOMAC评分分别为(38.02±6.87)和(43.89±5.32)分;这2组的膝关节活动度分别为(83.89±8.82)和(78.82±6.80)度;这2组的血清IL-6水平分别为(41.60±16.12)和(50.09±12.87)ng·L^(-1);这2组的血清TNF-α水平分别(22.88±4.55)和(26.88±4.15)ng·L^(-1)。上述指标,对照组与试验组比较,差异均有统计学意义(均P<0.05)。结论在PRP治疗膝骨关节炎前先采用关节镜下滑膜清理术,能有效缓解患者的疼痛,并改善膝关节功能,抑制炎症反应。

Objective To observe the clinical effect of platelet rich plasma(PRP)in the treatment of knee osteoarthritis.Methods Eighty patients with knee osteoarthritis were selected as the research object.According to different treatment methods,patients were divided into control group(40 cases)and treatment group(40 cases)by random number table method.The control group was treated with synovial debridement under arthroscope combined with hyaluronic acid(HA).The treatment group was treated with arthroscopic synovial debridement combined with PRP.The clinical efficacy of the two groups after treatment was analyzed.Visual analogue pain scale(VAS),Western Ontario and McMaster University Osteoarthritis Index(WOMAC)and knee motion were evaluated before and after treatment.The levels of interleukin-6(IL-6)and tumor necrosis factor(TNF-α)in two groups before and after treatment were detected.Results After treatment,the total effective rate of treatment group and control group was 92.50%and 75.00%,respectively and the difference was statistically significant(P<0.05).The VAS scores of two groups were(3.68±0.58)and(4.49±0.77)points,respectively;the WOMAC score of two groups was(38.02±6.87)and(43.89±5.32),respectively;the range of motion of knee joint in two groups was(83.89±8.82)and(78.82±6.80)°,respectively;the levels of serum IL-6 in two groups were(41.60±16.12)and(50.09±12.87)ng·L^(-1),respectively;the levels of serum TNF-αin two groups were(22.88±4.55)and(26.88±4.15)ng·L^(-1),respectively.There were statistically significant differences in the above indexes between control group and treatment group(all P<0.05).Conclusion Arthroscopic slide membrane clearing was performed before PRP for knee osteoarthritis,which can effectively relieve the pain of patients,improve the function of knee joint and inhibit the inflammatory response.