ABMSCs移植联合关节镜清理术对KOA患者疼痛程度、膝关节功能及炎性因子的影响  

Effect of Autologous Bone Marrow Mesenchymal Stem Cell Transplantation Combined with Arthroscopic Debridement on Pain,Knee Function and Inflammatory Factors in Patients with Knee Osteoarthritis

作　　者：王力[1] 张净宇[2] 刘建华[1] 赵海勇 温芳 游洋[4] 丁红梅[4] WANG Li;ZHANG Jing-yu;LIU Jian-hua;ZHAO Hai-yong;WEN Fang;YOU Yang;DING Hong-mei(The Third Department of Hand Surgery,the Second Hospital of Tangshan,Tangshan,Hebei 063000,China;the Second Department of Hand Surgery,the Second Hospital of Tangshan,Tangshan,Hebei 063000,China;Department of Laboratory Medicinethe Second Hospital of Tangshan,Tangshan,Hebei 063000,China;Institute of Trauma Surgery,the Second Hospital of Tangshan,Tangshan,Hebei 063000,China;Department of Orthopaedics,Tangshan Workers Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]唐山市第二医院手三科,河北唐山063000 [2]唐山市第二医院手二科,河北唐山063000 [3]唐山市第二医院检验科,河北唐山063000 [4]唐山市第二医院创伤外科研究所,河北唐山063000 [5]唐山市工人医院骨外一科,河北唐山063000

出　　处：《临床误诊误治》2020年第10期81-85,共5页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨应用自体骨髓间充质干细胞(ABMSCs)移植联合关节镜清理术治疗膝骨关节炎(knee osteoarthritis,KOA)的效果及对患者疼痛、膝关节功能、炎性因子的影响。方法选取我院2017年10月-2019年2月收治的110例KOA患者,据治疗方法不同分为观察组57例和对照组53例。两组均行关节镜清理术,观察组在此基础上联合ABMSCs移植治疗。治疗后半年比较两组疗效,治疗前及治疗后3、6个月采用视觉模拟评分法(visual analogue scale,VAS)评价两组疼痛程度和采用Lysholm膝关节评分量表(Lysholm knee score scale,LKSS)评价两组患膝关节功能恢复情况,以及两组治疗前及治疗后3、6个月患膝关节液白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平。结果观察组治疗总有效率为91.23%高于对照组的71.70%(P<0.01)。两组治疗后VAS评分及IL-1β、TNF-α逐渐降低,且观察组治疗后3、6个月VAS评分及IL-1β、TNF-α均低于对照组同时间,差异有统计学意义(P<0.05或P<0.01)。两组治疗后LKSS评分逐渐升高,且观察组治疗后3、6个月LKSS评分均高于对照组同时间,差异有统计学意义(P<0.05或P<0.01)。结论ABMSCs移植联合关节镜清理术治疗KOA效果显著,可显著缓解患者疼痛,促进患膝关节功能的恢复,有效抑制患膝关节液炎症介质释放,且安全性良好。Objective To investigate the effect of autologous bone marrow mesenchymal stem cells(ABMSCs)transplantation combined with arthroscopic debridement in the treatment of knee osteoarthritis(KOA)and its influence on pain,knee joint function and inflammatory factors.Methods A total of 110 patients with KOA treated in our hospital from October 2017 to February 2019 were selected and divided into observation group(n=57)and control group(n=53)according to different treatment methods.Both groups were treated with arthroscopic debridement,and the observation group was treated with ABMSCs transplantation.Visual analogue scale(VAS)was used to evaluate the degree of pain before treatment and 3 and 6 months after treatment,and Lysholm knee score scale(LKSS)was used to evaluate the recovery of knee joint function in the two groups.The levels of interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)in knee joint fluid before and at 3 and 6 months after treatment were compared.Results The total effective rate of the observation group was 91.23%,which was higher than 71.70%of the control group(P<0.01).The VAS score,IL-1β,and TNF-αof the two groups were decreased gradually after treatment,and the above indicators of the observation group were lower than those of the control group at 3 and 6 months after treatment(P<0.05 or P<0.01).The LKSS score of the two groups was increased gradually after treatment,which were higher at 3 and 6 months in the observation group than in the control group at 3 and 6 months after treatment(P<0.05 or P<0.01).Conclusion ABMSCs transplantation combined with arthroscopic debridement in the treatment of KOA has a significant effect,which can significantly relieve the pain of patients,promote the recovery of knee joint function,effectively inhibit the release of inflammatory mediators in knee joint fluid,and has good safety.

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

分 类 号：R684.3[医药卫生—骨科学]