关节镜清理联合自体骨髓间充质干细胞移植对膝骨关节炎患者疼痛程度、炎症介质及膝关节功能的影响  

Effect of arthroscopic debridement combined with autologous bone marrow mesenchymal stem cells transplantation on the pain level and inflammatory mediators and knee function in patients with knee osteoarthritis

作　　者：白朝奇 封鹏 张雪艳 党华 陈振[2] BAI Chao-qi;FENG Peng;ZHANG Xue-yan;DANG Hua;CHEN Zhen(Department of Orthopedics,Tongchuan People's Hospital,Tongchuan 727000,Shaanxi,CHINA;Department of Orthopaedics,Shangluo Central Hospital,Shangluo 726000,Shaanxi,CHINA)

机构地区：[1]铜川市人民医院骨科,陕西铜川727000 [2]商洛市中心医院骨科,陕西商洛726000

出　　处：《海南医学》2020年第17期2203-2206,共4页Hainan Medical Journal

基　　金：陕西省卫生科研基金(编号:201612E)。

摘　　要：目的探讨膝骨关节炎(KOA)应用关节镜清理术联合自体骨髓间充质干细胞(ABMSCs)移植术治疗的临床效果。方法选取铜川市人民医院骨科2016年3月至2018年1月收治的114例KOA患者为研究对象,采用随机数表法将其随机分为观察组和对照组,每组57例。两组患者均行关节镜清理术治疗,观察组患者在此基础上联合ABMSCs移植术治疗。比较两组患者的临床疗效,治疗前后疼痛程度[视觉模拟评分法(VAS)评分]和患侧膝关节液内炎症介质[白介素(IL)-1β、肿瘤坏死因子(TNF-α)、前列腺素(PG)E2]水平,以及膝关节功能[Lysholm膝关节评分量表(LKSS)评分]变化。结果观察组患者的治疗总有效率为96.49%,明显高于对照组的80.70%,差异有统计学意义(P<0.05);两组患者术前、术后3个月和6个月时的疼痛VAS评分均逐渐降低,术前、术后3个月和6个月时患侧LKSS评分均逐渐升高,且观察组术后3、6个月时疼痛VAS评分较对照组同期均显著更低,患侧LKSS评分则均显著更高,差异均有统计学意义(P<0.05);两组患者术后3、6个月时患侧膝关节液内各项炎性介质(IL-1β、TNF-α、PGE2)水平均逐渐降低,且观察组降低较对照组同期更明显,差异均有统计学意义(P<0.05)。结论关节镜清理术联合ABMSCs移植术治疗KOA能显著减轻患者疼痛程度,下调患侧膝关节液内炎症介质的释放,改善患侧膝关节功能,疗效确切。Objective To investigate the clinical effect of arthroscopic debridement combined with autologous bone marrow mesenchymal stem cells(ABMSCs)transplantation for knee osteoarthritis(KOA).Methods A total of 114 patients with KOA admitted to the Department of Orthopaedics,Tongchuan People's Hospital from March 2016 to January 2018 were enrolled in the study.They were randomly divided into observation group and control group,with 57 patients in each group.Patients in the control group were treated with arthroscopic debridement,and patients in the observation group were treated with ABMSCs transplantation on this basis of control group.The clinical efficacy of patients in the two groups was compared,including the degree of pain(VAS score)before and after treatment,the inflammatory mediators(interleukin-1β[IL-1β],tumor necrosis factorα[TNF-α],prostaglandin[PG]E2)in the knee fluid of the affected side,and the changes in knee function(Lysholm knee score scale[LKSS]score).Results The overall effective rate of the observation group was 96.49%,which was significantly higher than 80.70%of the control group(P<0.05).The pain VAS scores of the two groups were gradually decreased before operation,3 months and 6 months after operation,and the LKSS scores of the affected side were gradually increased.The pain VAS scores of the observation group at 3 and 6 months after operation were significantly lower than those of the control group,and the LKSS scores of the affected group were significantly higher(P<0.05).The levels of inflammatory mediators(IL-1β,TNF-α,PGE2)in the affected knee joint fluid gradually decreased at 3 and 6 months after operation in both groups,and the decrease in the observation group was more significant than that in the control group over the same period(P<0.05).Conclusion Arthroscopic debridement combined with ABMSCs transplantation for the treatment of KOA can significantly reduce the degree of pain in patients,down-regulate the release of inflammatory mediators in the knee joint fluid,and improve the kn

关 键 词：关节镜清理术 自体骨髓间充质干细胞移植 膝骨关节炎 疼痛 炎症介质 膝关节功能 

分 类 号：R684.3[医药卫生—骨科学]