同种异体骨移植联合PRP治疗HeppleV型距骨骨软骨损伤的临床研究  

Clinical outcomes of allotransplantation combined with platelet-rich plasma in the treatment of Hepple type V osteochondral lesions of the talus

作　　者：赵敬凯[1] 张旭 王建成[1] ZHAO Jing-kai;ZHANG Xu;WANG Jian-cheng(Department of Orthopaedic,People's Hospital of Langfang,Langfang Hebei 065000,China;Department of Rehabilitation Medicine&Physical Therapy,Langfang Health Vocational College,Langfang Hebei 065000,China)

机构地区：[1]廊坊市人民医院骨科,河北廊坊065000 [2]廊坊卫生职业学院,河北廊坊065000

出　　处：《临床和实验医学杂志》2021年第24期2627-2631,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省廊坊市科技局项目(编号:2018013141);河北省医学科学研究项目(编号:20191629)。

摘　　要：目的分析同种异体骨联合富血小板血浆技术(PRP)治疗Hepple V型距骨骨软骨损伤的临床效果。方法前瞻性选取2018年12月至2020年12月廊坊市人民医院收治的Hepple V型距骨骨软骨损伤患者106例。采用随机数字分组法将患者分成对照组和治疗组,各53例。对照组接受同种自体骨柱移植治疗,治疗组患者接受同种异体骨移植联合PRP治疗。比较两组患者疼痛评分和住院时间、踝关节功能和囊肿直径、炎症因子[白介素-6(IL-6)和白介素-8(IL-8)]、生长因子[转化生长因子β(TGF-β1)、血小板衍生生长因子(PDG)、血管内皮生长因子(VEGF)]水平和并发症发生情况。结果治疗后3个月,两组患者视觉模拟量表(VAS)评分较治疗前减少,且治疗组患者VAS(2.06±0.25)分,少于对照组[(3.98±0.23)分],差异均有统计学意义(P<0.05)。治疗组患者住院时间(8.26±2.63)d,少于对照组[(12.47±2.62)d],差异有统计学意义(P<0.05)。治疗后3个月,两组患者踝关节功能评分较治疗前增加,且治疗组患者踝关节功能为(23.98±1.15)分,高于对照组[(19.62±1.19)分],差异均有统计学意义(P<0.05)。治疗后3个月,两组患者囊肿直径较治疗前减少,且治疗组患者囊肿直径(0.98±0.12)mm少于对照组[(2.24±0.16)mm],差异均有统计学意义(P<0.05)。治疗后3个月,两组患者IL-6和IL-8水平较治疗前下降,且治疗组患者IL-6和IL-8水平为(32.19±2.6)、(7.69±1.84)pg/m L,均低于对照组[(50.48±2.61)、(11.98±1.86)pg/m L],差异均有统计学意义(P<0.05)。治疗后3个月,两组患者PDG、VEGF水平较治疗前增加,TGF-β1水平较治疗前下降,且治疗组患者TGF-β1为(40.24±3.09)ng/m L,低于对照组[(68.92±3.02)ng/m L],治疗组患者PDG、VEGF(563.09±18.27)ng/L、(233.14±13.05)pg/m L,高于对照组[(365.41±18.29)ng/L、(205.29±13.09)pg/m L],差异均有统计学意义(P<0.05)。治疗组患者并发症总率为5.66%,低于对照组的20.75%,差异有统计学意义(P<0.05)�Objective To investigate the clinical outcomes of allotransplantation combined with platelet-rich plasma(PRP)in the treatment of Hepple type V osteochondral lesions of the talus.Methods A total of 106 patients with Hepple type V osteochondral lesions of the talus in People's Hospital of Langfang from December 2018 to December 2020 were prospectively enrolled,and divided into two groups by random number table methods,each with 53 cases.The control group received autotransplantation,while the treatment group received allotransplantation combined with platelet-rich plasma.Then the pain score,hospital stay length,ankle function,cyst diameter,levels of inflammatory factors[interleukin 6(IL-6),interleukin 8(IL-8)],growth factor[transforming growth factorβ1(TGF-β1),platelet derived growth factor(PDGF),vascular endothelial growth factor(VEGF)]and the incidence rate of complications were compared between two groups.Results Visual analogue scale(VAS)scores were decreased in both groups at three months after treatment,and the scores in treatment group were(2.06±0.25)pionts,which were lower than those in the control group[(3.98±0.23)pionts],the differences were statistically significant(P<0.05).The hospital stay length in the treatment group was(8.26±2.63)d,which was significantly shorter than that in the control group[(12.47±2.62)d],the difference was statistically significant(P<0.05).Three months after treatment,the ankle function scores were increased in both groups,and the scores in the treatment group were(23.98±1.15)pionts,which were higher than those in the control group[(19.62±1.19)points],the differences were statistically significant(P<0.05).Three months after treatment,the diameter of cyst was decreased in both groups,and the diameter was(0.98±0.12)mm in treatment group,which was significantly smaller than(2.24±0.16)mm in control group,the differences were statistically significant(P<0.05).Three months after treatment,the levels of IL-6 and IL-8 in the two groups were lower than before treatment,and the

关 键 词：距骨骨软骨损伤 同种异体骨移植 富血小板血浆技术 Hepple V 型 临床效果 

分 类 号：R687.3[医药卫生—骨科学]