富血小板血浆联合微骨折对比微骨折治疗膝关节软骨病变的Meta分析  

Platelet-rich plasma combined with microfracture versus microfracture in the treatment of knee cartilage lesions:a meta-analysis

作　　者：何祥忠 陈海云 刘军 吕阳 潘建科 杨文斌 何静雯 黄俊翰 He Xiangzhong;Chen Haiyun;Liu Jun;LüYang;Pan Jianke;Yang Wenbin;He Jingwen;Huang Junhan(Second Clinical School of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510006,Guangdong Province,China;Department of Organ Transplantation,Second Hospital of Guangzhou Medical University,Guangzhou 510000,Guangdong Province,China)

机构地区：[1]广州中医药大学第二临床医学院/广东省中医院,广东省广州市510006 [2]广州医科大学第二附属医院器官移植科,广东省广州市510000

出　　处：《中国组织工程研究》2021年第6期964-969,共6页Chinese Journal of Tissue Engineering Research

基　　金：广东省财政厅项目([2014]157号,[2018]8号),项目负责人:刘军。

摘　　要：目的:近年来大量文献报道,采用微骨折联合富血小板血浆治疗骨软骨损伤具有良好的疗效。系统评价关节镜下富血小板血浆联合微骨折对比微骨折治膝关节软骨病变的临床效果。方法:应用计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Embase及Cochrane Library等数据库中有关关节镜下富血小板血浆联合微骨折对比微骨折治疗膝关节软骨病变的随机对照试验,检索时间设为2001年1月至2020年3月。对纳入的文献进行资料提取和质量评价,采用Rev-Man 5.3软件进行Meta分析。结果:①共纳入7篇随机对照试验,改良Jadad量表评价显示有4项研究评分≥4分,为高质量文献,3项研究评分<4分,为低质量文献;②Meta分析显示,富血小板血浆联合微骨折组术后6,12个月的目测类比评分、术后12,24个月的IKDC评分、术后12,24个月的Lysholm评分、术后12个月的WOMAC评分均优于微骨折组[MD=-0.40,95%CI(-0.75,-0.05),Z=2.26,P=0.02;MD=-0.59,95%CI(-0.86,-0.32),Z=4.30,P<0.0001;MD=7.70,95%CI(4.22,11.18),Z=4.34,P<0.0001;MD=10.99,95%CI(6.79,15.19),Z=5.13,P<0.00001;MD=4.98,95%CI(2.31,7.64),Z=3.66,P=0.0003;MD=5.35,95%CI(1.94,8.77),Z=3.07,P=0.002;MD=-9.30,95%CI(-16.50,2.11),Z=2.53,P=0.01],两组术后24个月的目测类比评分、术后6个月的IKDC评分比较差异均无显著性意义(P>0.05)。结论:富血小板血浆联合微骨折治疗膝关节软骨病变可减轻中短期疼痛、增强术后中长期关节功能,提升患者术后体验感。但由于纳入的文献数量有限,故需要更多大样本、高质量的随机对照试验来进一步提供有效数据。OBJECTIVE:A large number of recent studies reported that microfracture combined with platelet-rich plasma has a good effect on osteochondral injury.This study systematically evaluated the clinical effect of arthroscopic platelet-rich plasma combined with microfracture versus microfracture in the treatment of knee cartilage lesions.METHODS:A randomized controlled trial of arthroscopic platelet-rich plasma combined with microfracture in the treatment of knee cartilage lesions was searched in CNKI,Wanfang Database,VIP Database,Chinese Biomedical Literature Database,PubMed,Embase and Cochrane Library.The date was from January 2001 to March 2020.The data were extracted and the quality of the included literature was evaluated,and the Rev-Man5.3 software was used for meta-analysis.RESULTS:(1)A total of seven randomized controlled trials were included,and the modified Jadad scale results showed that the scores of four studies were≥4,which were high-quality literatures,and the scores of three studies were<4,which were low-quality literatures.(2)Meta-analysis showed that the visual analogue scale score at 6 and 12 months,IKDC score at 12 and 24 months,Lysholm score at 12 and 24 months and WOMAC score at 12 months in the plateletrich plasma combined with microfracture group were better than those in the microfracture group[MD=-0.40,95%CI(-0.75,-0.05),Z=2.26,P=0.02;MD=-0.59,95%CI(-0.86,-0.32),Z=4.30,P<0.0001;MD=7.70,95%CI(4.22,11.18),Z=4.34,P<0.0001;MD=10.99,95%CI(6.79,15.19),Z=5.13,P<0.00001;MD=4.98,95%CI(2.31,7.64),Z=3.66,P=0.0003;MD=5.35,95%CI(1.94,8.77),Z=3.07,P=0.002;MD=-9.30,95%CI(-16.50,2.11),Z=2.53,P=0.01].There was no significant difference in visual analogue scale score 24 months after operation and IKDC score 6 months after operation between the two groups(P>0.05).CONCLUSION:Platelet-rich plasma combined with microfracture for knee cartilage lesions can reduce the pain in the short and medium terms,enhance the joint function in the medium and long terms,and improve the postoperative experience.However,due to the

关 键 词：骨 材料 微骨折 富血小板血浆 膝关节 软骨病变 META分析 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学]