关节腔内注射自体血小板血浆治疗膝关节骨性关节炎的效果及对患者关节功能、疼痛因子水平的影响

Effect of intra-articular injection of autologous platelet plasma in the treatment of knee osteoarthritis and its influences on joint function and pain factors levels of patients

目的分析关节腔内注射自体血小板血浆治疗膝关节骨性关节炎(KOA)的效果及对患者关节功能、疼痛因子水平的影响。方法选择2020年6月至2021年8月我院收治的82例KOA患者作为研究对象,按照电脑盲选法将其分为对照组(41例,关节腔内注射玻璃酸钠)和研究组(41例,关节腔内注射自体血小板血浆)。比较两组的膝关节功能、疼痛因子、炎症因子水平、不良反应发生情况、关节损伤因子、临床疗效。结果治疗2、4、6周后,两组的膝关节功能评分均升高,且研究组高于对照组(P<0.05)。治疗6周后,两组的血清P物质(SP)、5-羟色胺(5-HT)、前列腺素E2(PGE2)、基质金属蛋白酶-9(MMP-9)、白细胞介素-1β(IL-1β)及环氧合酶-2(COX-2)水平均降低,且研究组低于对照组(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。治疗6周后,两组的抗沉默因子1a(ASF1a)mRNA表达量低于治疗前,沉默信息调节因子1(SIRT1)mRNA表达量高于治疗前,且研究组优于对照组(P<0.05)。研究组的治疗总有效率高于对照组(P<0.05)。结论关节腔内注射自体血小板血浆治疗KOA的效果显著,可促进膝关节功能尽快恢复,改善疼痛因子、炎症因子水平,且未增加不良反应总发生率,值得临床进一步应用。

Objective To analyze the effect of intra-articular injection of autologous platelet plasma in the treatment of knee osteoarthritis(KOA)and its influences on joint function and pain factors levels of patients.Methods A total of 82patients with KOA admitted in our hospital from June 2020 to August 2021 were selected as the research objects.According to the computer blind selection method,the patients were divided into control group(41 cases,intra-articular injection of sodium hyaluronate)and study group(41 cases,intra-articular injection of autologous platelet plasma).The knee joint function,pain factors and inflammatory factors levels,adverse reactions,joint injury factors and clinical efficacy were compared between the two groups.Results After 2,4 and 6 weeks of treatment,the score of knee joint function in the two groups increased,and that in the study group was higher than the control group(P<0.05).After 6 weeks of treatment,the levels of serum substance P(SP),5-hydroxytryptamine(5-HT),prostaglandin E2(PGE2),matrix metalloproteinase-9(MMP-9),interleukin-1β(IL-1β)and cyclooxygenase-2(COX-2)in the two groups decreased,and those in the study group were lower than the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).After 6 weeks of treatment,the expression of anti-silencing factor 1a(ASF1a)m RNA in the two groups was lower than that before treatment,the expression of silent information regulator transcript 1(SIRT1)m RNA was higher than that before treatment,and those in the study group were better than the control group(P<0.05).The total effective rate of treatment in the study group was higher than that in the control group(P<0.05).Conclusion Intra-articular injection of autologous platelet plasma in the treatment of KOA has a significant effect,it can promote the recovery of knee joint function as soon as possible,improve the levels of pain factors and inflammatory factors,and do not increase the total incidence of adverse reactions,which is worthy of further clinical application.