自体PRP注射联合依托考昔治疗膝关节骨性关节炎效果及对细胞因子的影响

Effect of autologous PRP injection combined with etoricoxib in the treatment of knee osteoarthritis and its effect on cytokines

目的研究自体富血小板血浆(platelet rich plasma,PRP)注射联合依托考昔治疗膝关节骨性关节炎(knee osteoarthritis,KOA)的效果及对细胞因子的影响。方法选取KOA患者68例,按照随机数字表法分为单一组和联合组,每组34例。单一组采用依托考昔治疗,联合组采用自体PRP注射联合依托考昔治疗。治疗6周后比较2组疗效,治疗前、治疗6周后比较2组骨关节炎指数[西安大略和麦克马斯特大学骨关节指数(Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC评分)]、膝关节功能Lysholm评分(Lyshom Knee Rsting System)、生活质量[膝关节骨性关节炎严重性指数(Index of Severity Forosteo Arthritis,ISOA评分)]及细胞因子[白细胞介素1β(interleukin-1β,IL-1β)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)],并统计治疗期间不良反应发生情况。结果联合组总有效率高于单一组(P<0.05)。治疗6周后,2组WOMAC评分、ISOA评分、IL-1β、TNF-α、hs-CRP水平低于治疗前,Lysholm评分高于治疗前,联合组WOMAC评分、ISOA评分、IL-1β、TNF-α、hs-CRP水平低于单一组,Lysholm评分高于单一组(P<0.05)。2组不良反应发生率差异无统计学意义(P>0.05)。结论应用自体PRP注射结合依托考昔治疗KOA效果明显,可以缓解骨关节炎症反应,提高膝关节功能和生存质量,并调节细胞因子水平,安全性高。

Objective To study the effect of autologous platelet rich plasma(PRP)injection combined with etoricoxib in the treatment of knee osteoarthritis(KOA)and its impact on cytokines.Methods Sixty-eight patients with KOA were selected and divided into single group(n=34)and combination group(n=34)according to random number table.The single group was treated with etoricoxib,and the combination group was treated with autologous PRP injection and etoricoxib.At 6 weeks after treatment,the efficacy of the two groups was compared.Before treatment and at 6 weeks after treatment,the two groups were compared in terms of osteoarthritis index[Western Ontario and McMaster University Osteoarthritis Index(WOMAC)score],Lyshom Knee Rsting System(Lysholm)score,quality of life[Index of Severity Forosteo Arthritis(ISOA)score]and cytokines[interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)],and incidence of adverse reactions during treatment.Results The total effective rate of combination group was higher than that of single group(P<0.05).At 6 weeks after treatment,WOMAC score,ISOA score,IL-1β,TNF-α,and hs-CRP level were lower than those before treatment,while Lysholm score was higher than that before treatment;WOMAC score,ISOA score,IL-1β,TNF-α,and hs-CRP level were lower in the combination group than in the single group,and the Lysholm score was higher than that of the single group(P<0.05).There was no significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion The application of autologous PRP injection combined with etoricoxib in the treatment of KOA has an obvious effect,which can alleviate the inflammatory reaction of bone joints,improve the function of knee joints and quality of life,and regulate the level of cytokines,with high safety.