自体脂肪来源血管基质组分治疗膝关节骨关节炎的临床研究

Clinical study of autologous adipose-derived stromal vascular fraction in the treatment of knee osteoarthritis

目的 探讨自体脂肪来源血管基质组分(SVF)治疗膝关节骨关节炎的疗效。方法 选取于北部战区总医院诊治的膝关节骨关节炎患者48例,按照随机数字表法分为观察组(自体脂肪来源SVF关节腔内注射)和对照组(玻璃酸钠关节腔内注射)。比较2组患者术前及术后3、6、12、18个月膝关节WOMAC评分、Lysholm评分、视觉模拟量表(VAS)评分及注射后相关不良反应的发生情况。记录2组患者末次随访时半月板及软骨损伤信号改善情况。结果 48例患者中有45例完成随访,平均随访(19.2±0.9)个月。2组患者术前及术后3个月WOMAC评分、Lysholm评分比较差异无统计学意义(P>0.05);术后6、12、18个月观察组的WOMAC评分、Lysholm评分优于对照组,差异有统计学意义(P<0.05)。2组患者术前及术后3、6、12个月VAS评分比较差异无统计学意义(P>0.05);术后18个月观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。2组患者不良反应发生率比较差异无统计学意义(P>0.05)。观察组末次随访时观察到半月板及软骨损伤信号较治疗前改善,而对照组未观察到损伤信号的改善。结论 自体脂肪来源SVF对膝关节骨关节炎的临床疗效较好,且无严重不良反应的发生。

Objective To investigate the efficacy of autologous adipose-derived stromal vascular fraction(SVF) in the treatment of knee osteoarthritis.Methods A total of 48 patients with knee osteoarthritis diagnosed and treated in the General Hospital of Northern Theater Command were selected and divided into the observation group(intra-articular injection of autologous adipose-derived SVF) and the control group(intra-articular injection of sodium hyaluronate) according to the random number table method. The knee joint WOMAC score, Lysholm score, visual analogue scale(VAS) score before operation and 3,6,12,18 months after operation and incidence of related adverse reactions after injection of the two groups were compared. The improvement of meniscus and cartilage injury signal at the last follow-up of the two groups were recorded.Results Among the 48 patients, a total of 45 patients were followed up for an average of(19.2±0.9) months. There was no statistically significant difference in the WOMAC score or Lysholm score before operation and 3 months after operation between the two groups(P>0.05). The WOMAC score and Lysholm score in the observation group 6,12,18 months after operation were better than those in the control group, and the differences were statistically significant(P<0.05). There was no statistically significant difference in the VAS scores before operation and 3,6,12 months after operation between the two groups(P>0.05). The VAS score in the observation group 18 months after operation was lower than that in the control group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05). At the last follow-up, the meniscus and cartilage injury signal in the observation group was improved compared with that before treatment, while no improvement in injury signal was observed in the control group.Conclusion Autologous adipose-derived SVF has a good clinical effect on knee osteoarthritis without serious adverse reactions.