PRP对前交叉韧带患者重建术后膝关节功能及炎症因子水平的影响

Effect of platelet rich plasma on knee joint function and inflammatory cytokine levels in patients undergoing anterior cruciate ligament reconstruction surgery

目的探讨富血小板血浆(PRP)对前交叉韧带(ACL)患者重建术后膝关节功能及炎症因子水平的影响。方法选择2021年1月至2023年1月福建省漳浦县医院收治的100例行ACL重建术患者进行研究,按随机数表法分为对照组和观察组,每组50例。对照组患者接受常规ACL重建术治疗,观察组患者在此基础上接受PRP治疗。术后3个月,比较两组患者的腱骨愈合情况,术前、术后3个月,比较两组患者的视觉模拟评分(VAS)、膝屈曲度、国际膝关节文献委员会膝关节评估表(IKDC)评分及炎症因子指标[白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、红细胞沉降率(ESR)]变化。结果观察组患者术后腱骨愈合状况明显优于对照组,差异有统计学意义(P<0.05);术前,两组患者的VAS评分、膝屈曲度、IKDC评分比较差异均无统计学意义(P>0.05),术后3个月,两组患者的VAS评分均降低,且观察组为(0.91±0.13)分,明显低于对照组的(1.32±0.21)分,而膝屈曲度、IKDC评分均明显升高,且观察组的膝屈曲度、IKDC评分分别为(114.28±18.32)°、(90.64±5.11)分,明显高于对照组的(101.28±17.09)°、(72.28±4.29)分,差异均有统计学意义(P<0.05);术前两组患者的IL-1β、IL-6、TNF-α、CRP及ESR比较差异均无统计学意义(P>0.05),术后3个月,两组患者的IL-1β、IL-6、TNF-α、CRP及ESR均明显降低,且观察组明显低于对照组,差异均有统计学意义(P<0.05)。结论PRP可有效缓解ACL患者重建术后膝关节疼痛感,降低炎症因子水平,有利于患者膝关节功能恢复,具有临床应用价值。

Objective To explore the effects of platelet rich plasma(PRP)on knee joint function and inflamma-tory cytokine levels after anterior cruciate ligament(ACL)reconstruction surgery in patients.Methods One hundred patients who underwent ACL reconstruction surgery in Zhangpu County Hospital from January 2021 to January 2023 were randomly divided into a control group and an observation group according to random number table,with 50 pa-tients in each group.Patients in the control group received routine ACL reconstruction surgery treatment,while those in the observation group received PRP treatment on this basis.The tendon-bone healing status was compared at 3 months after surgery.The changes in Visual Analogue Scale(VAS),knee flexion,Intemational Knee Documentation Committee Knee Form(IKDC),and inflammatory factor indicators[interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),and erythrocyte sedimentation rate(ESR)]were compared before and at 3 months after surgery.Results The postoperative tendon-bone healing status in the observation group was significant-ly better than that of the control group(P<0.05).Before surgery,there was no statistically significant difference in VAS score,knee flexion,and IKDC score between the two groups(P>0.05).After 3 months of surgery,the VAS score of both groups of patients decreased,and the score in the observation group was(0.91±0.13)points,which was significantly low-er than the control group's(1.32±0.21)points;knee flexion and IKDC scores were significantly increased,and the two in-dexes in the observation group were(114.28±18.32)°and(90.64±5.11)points,which were significantly higher than the control group's(101.28±17.09)°and(72.28±4.29)points;the differences were statistically significant(P<0.05).There was no statistically significant difference in IL-1β,IL-6,TNF-α,CRP,and ESR between the two groups before surgery(P>0.05);after 3 months of surgery,the above indexes of the two groups were significantly reduced,and the levels in the observation group were significantly lower than those in the control group(P<0.05).Conclusion PRP can effectively alleviate postoperative knee joint pain in ACL patients,reduce inflammatory cytokine levels,and facilitate knee joint function recovery,which has clinical application value.