富血小板血浆联合关节镜下清理术对膝关节骨关节炎患者关节活动度及HA、PGE_(2)、PYD水平的影响

Effects of Platelet Rich Plasma Combined with Arthroscopic Debridement on Range of Motion and HA,PGE_(2) and PYD Levels in Patients with Knee Osteoarthritis

目的:分析富血小板血浆联合关节镜下清理术对膝关节骨关节炎患者关节活动度及血清指标的影响。方法:此次研究选择赣南医学院第二附属医院2021年5月—2023年7月收治的68例膝关节骨关节炎患者作为研究对象,按随机数字表法分为对照组(应用关节镜下清理术)、观察组(在对照组基础上联合应用富血小板血浆),各34例。两组术后随访6个月。比较两组临床疗效、视觉模拟评分法(VAS)、膝关节协会评分(KSS)、关节炎影响测量量表2-短卷(AIMS2-SF)、关节活动度、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶3(MMP-3)、超氧化物歧化酶(SOD)、环氧化酶-2(COX-2)、透明质酸(HA)、前列腺素E2(PGE2)、尿吡啶啉(PYD)水平,以及并发症发生情况。结果:观察组临床总有效率高于对照组,差异有统计学意义(P<0.05);与术前相比,术后6个月两组VAS评分及TNF-α、MMP-3、COX-2、PGE2、PYD水平均降低,且观察组均低于对照组,差异均有统计学意义(P<0.05);与术前相比,术后6个月两组KSS、AIMS2-SF评分及HA、SOD水平均升高,且观察组均高于对照组,各项膝关节活动度均增加,且观察组均大于对照组,差异均有统计学意义(P<0.05)。结论:膝关节骨关节炎患者应用富血小板血浆联合关节镜下清理术治疗,有助于提高膝关节活动度,抑制炎症应激反应,纠正HA、PGE2、PYD水平,改善膝关节功能,减轻疼痛程度,临床效果显著,且并发症少。

Objective:To analyze the effects of platelet rich plasma combined with arthroscopic debridement on range of motion and serum indexes in patients with knee osteoarthritis.Method:In this study,68 patients with knee osteoarthritis admitted to the Second Affiliated Hospital of Gannan Medical College from May 2021 to July 2023 were selected as research objects,and were divided into control group(treated with arthroscopic debridement)and observation group(treated with platelet rich plasma on the basis of the control group)according to random number table method,with 34 cases in each group.Both groups were followed up for 6 months.The clinical efficacy,visual analogue scale(VAS),knee association score(KSS),arthritis impact measurement scale 2-short form(AIMS2-SF),range of motion,the levels of tumor necrosis factor-α(TNF-α),matrix metalloproteinase 3(MMP-3),superoxide dismutase(SOD)and cycoperoxidase-2(COX-2),hyaluronic acid(HA),prostaglandin E2(PGE2),urinary pyridinase(PYD),and the incidence of complications were compared between the two groups.Result:The total clinical effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).Compared with before surgery,VAS scores and the levels of TNF-α,MMP-3,COX-2,PGE2 and PYD of both groups were decreased 6 months after surgery,and those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Compared with before surgery,KSS,AIMS2-SF scores and HA,SOD levels of both groups were increased 6 months after surgery,and those in the observation group were higher than those in the control group,and all range of motion of knee joint were increased,and those in the observation group were greater than those in the control group,the differences were statistically significant(P<0.05).Conclusion:The application of platelet rich plasma combined with arthroscopic debridement in patients with knee osteoarthritis is helpful to improve range of motion of knee joint,inhibit inflammatory stress response,correct HA,PGE2 and PYD levels,improve knee joint function and reduce pain,with significant clinical effects and few complications.