超声引导下PRP注射治疗肩袖损伤对局部炎症因子表达的影响  

作　　者：易庆丰 胡华刚 张天元 吴锦华 郭晓洁 朱少明[2] 

机构地区：[1]浙江省东阳市横店文荣医院,322118 [2]浙江大学医学院附属第一医院,310003

出　　处：《浙江临床医学》2021年第3期383-385,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省金华市科学技术研究计划项目(2019-4-124)。

摘　　要：目的探讨超声引导下富血小板血浆(PRP)注射在部分肩袖损伤患者治疗中的安全性和有效性,及其对局部炎症因子表达的影响。方法选择2018年10月至2019年10月部分肩袖损伤患者84例,随机分为对照组和观察组,每组各42例。对照组采用超声引导注射玻璃酸钠,观察组注射等量自体PRP,1次/周,连续3周。比较两组治疗前,治疗结束后1、3和6个月疼痛视觉模拟量表(VAS)评分和上肢功能Fugl-Meyer量表(FMA)评分,治疗前及治疗结束后1周和1个月局部炎症因子白介素(I)-6、肿瘤坏死因子(TNF)-α、IL-10和转化生长因子(TGF)-β,随访6个月肩袖再撕裂率。结果观察组治疗结束后1、3、6个月VAS评分逐渐降低,上肢FMA评分逐渐升高,且同时间点观察组VAS评分比对照组降低,FMA评分比对照组升高,差异有统计学意义(P<0.05)。进一步发现,观察组治疗结束后1周和1个月局部IL-6和TNF-a水平明显低于对照组,而IL-10和TGF-β水平明显高于对照组(P<0.05)。随访观察组肩袖再撕裂率低于对照组(P<0.05)。结论超声引导下PRP注射治疗部分肩袖损伤有较好的安全性和有效性,能显著降低关节疼痛,改善关节功能,降低复发率,可能与抑制局部炎症反应,促进关节修复有关。Objective The study aimed to explore the safety and efficacy of ultrasound-guided platelet rich plasma(PRP)injection in treatment of partial rotator cuff injury,and to understand the effect on the expression of local inflammatory factors.Methods From October 2018 to October 2019,a total of 84 patients with rotator cuff injury were selected in our hospital and randomly divided into the control group and the observation group,42 cases in each group.The control group was injected with sodium hyaluronate under the guidance of ultrasound,and the observation group was injected with the same amount of self PRP once a week for three weeks.The pain visual analogue scale(VAS)and the upper extremity function Fugl Meyer scale(FMA)were compared before treatment,1,3 and 6 months after the treatment.The local inflammatory factors including interleukin(IL)-6,tumor necrosis factor(TNF)-α,IL-10 and transforming growth factor(TGF)-βwere measured before treatment,1 week and 1 month after treatment,the re-tear rate of rotator cuff after 6-month follow-up was compared.Results In the observation group,the pain VAS score decreased gradually after 1,3 and 6 months,and the FMA score increased gradually,what’s more,the VAS score in the observation group at the same time was significantly lower than the control group,and the FMA score was higher than the control group(P<0.05).It was further found that the levels of IL-6 and TNF-αin the observation group were significantly lower than the control group after 1 week and 1 month,while the levels of IL-10 and TGF-αin the observation group were significantly higher than the control group(P<0.05).Lasdy,the re-tear rate of rotator cuff in the observation group was lower than the control group after follow-up(P<0.05).Conclusion It is safe and effective for partial rotator cuff injury under ultrasound-guided PRP injection,which can greatly reduce joint pain,improve joint function and reduce recurrence rate,it may be related to the inhibition of local inflammatory response and the promotion of j

关 键 词：超声 富血小板血浆 肩袖损伤 炎症 

分 类 号：R47[医药卫生—护理学]