富血小板血浆与透明质酸钠修复兔膝骨关节炎  

Platelet-rich plasma with sodium hyaluronate in repair of rabbit knee osteoarthritis

作　　者：吉恒东[1] 霍小燕[2] 张厚庆 王余山 石瑄[3] 霍雷[3] 

机构地区：[1]泰州市人民医院风湿科,江苏省泰州市225300 [2]江苏大学社区卫生服务站,江苏省镇江市212000 [3]南京医科大学附属苏州明基医院骨科,江苏省苏州市215000

出　　处：《中国组织工程研究》2015年第38期6133-6139,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:研究表明,透明质酸钠可抑制膝骨关节炎对软骨的破坏,加速软骨细胞的再生,达到稳定和修复关节软骨的目的。目的:观察富血小板血浆与透明质酸钠治疗兔膝骨关节炎的疗效。方法:将40只新西兰大白兔随机均分为5组,联合组、玻璃酸钠组、富血小板血浆组与模型组制作右侧膝骨关节炎模型,造模后分别向膝关节腔内注射透明质酸钠联合自体富血小板血浆、玻璃酸钠、自体富血小板血浆与生理盐水进行治疗,1次/周,连续5周;对照组不做任何处理,为正常对照。治疗完成1周后,ELISA法检测血液中白细胞介素1、白细胞介素6、肿瘤坏死因子α水平,光镜下观察关节软骨的变化。结果与结论:与对照组比较,其余4组白细胞介素1、白细胞介素6、肿瘤坏死因子α水平均升高(P<0.01);联合组、透明质酸钠组、富血小板血浆组白细胞介素1、白细胞介素6、肿瘤坏死因子α水平均低于模型组(P<0.01或P<0.05),且以联合组下降最显著。模型组关节软骨破坏明显,联合组、透明质酸钠组、富血小板血浆组关节软骨破坏程度轻于模型组,且以联合组破坏程度最轻。表明透明质酸钠配合自体富血小板血浆关节内注射可降低膝骨关节炎的炎症反应,保护关节软骨,效果优于单一药物注射。BACKGROUND： Studies have shown that sodium hyaluronate inhibits cartilage damage in osteoarthritis and accelerates regeneration of cartilage cells, to stabilize and repair the articular cartilage. OBJECTIVE： To investigate the therapeutic effect of sodium-rich plasma combined with platelet-rich plasma（PRP） on rabbit knee osteoarthritis. METHODS： Forty New Zealand white rabbits were randomly divided into five groups, control group, combined group, sodium hyaluronate group, PRP group and model group, and then an osteoarthritis model of the right knee was made in each rabbit. After modeling, sodium hyaluronate＋PRP, sodium hyaluronate, autologous PRP and normal saline were given via the knee joint cavity in the latter four groups, respectively, once a week for 5 weeks. The control group received no treatment, as normal controls. At 1 week after treatment, ELISA assay was used to detect serum interleukin-1, interleukin-6, tumor necrosis factor-α levels, and changes of the articular cartilage were observed under a light microscope. RESULTS AND CONCLUSION： Compared with the control group, the levels of interleukin-1, interleukin-6 and tumor necrosis factor-α were all increased in the other four groups（P〈0.01）. Compared with the model group, the levels of interleukin-1, interleukin-6 and tumor necrosis factor-α were lowered significantly in the combined, sodium hyaluronate and PRP groups（P〈0.01 or P〈0.05）, and the most significant decline was in the combined group. Articular cartilage damage was severest in the model group and mildest in the combined group.Experimental findings indicate that intra-articular injection of sodium hyaluronate＋PRP can reduce inflammation and protect the articular cartilage in knee osteoarthritis, which is better than a single drug injection.

关 键 词：骨关节炎 膝 富血小板血浆 软骨 关节 生物材料 软骨生物材料 膝骨关节炎 透明质酸钠 炎症因子 关节软骨 

分 类 号：R318[医药卫生—生物医学工程]