膝关节内注射自体富血小板血浆对K-LⅠ~Ⅲ级老年膝关节骨关节炎患者的临床效果研究  

Study on clinical effect of intra-articular injection of autologous platelet-rich plasma in elderly patients with K-L gradeⅠ-Ⅲ knee osteoarthritis

作　　者：张珑 赵方 郝峻烽 丛宝华 宋飞 ZHANG Long;ZHAO Fang;HAO Jun-feng(Department of Orthopedics,Jinqiu Hospital of Liaoning Province,Shenyang 110000,China)

机构地区：[1]辽宁省金秋医院骨外一科,110000 [2]广东医科大学附属医院肾内科,524001

出　　处：《中国实用医药》2022年第27期62-65,共4页China Practical Medicine

基　　金：2019年辽宁省自然科学基金面上项目(项目编号:2019-ZD-0426)。

摘　　要：目的 探讨膝关节内注射自体富血小板血浆(PRP)治疗Kellgren-Lawrence(K-L)Ⅰ~Ⅲ级老年膝关节骨关节炎(KOA)患者的临床效果。方法 43例老年KOA患者,根据K-L分级分为轻症组(K-L分级Ⅰ级、Ⅱ级, 23例)和重症组(K-L分级Ⅲ级, 20例)。两组患者均接受膝关节内注射PRP治疗。分析两组患者的不良反应发生情况,比较两组患者治疗前后西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分及膝关节功能评定量表(Lysholm)评分。结果 两组患者均未出现严重不良反应。轻症组患者治疗前的WOMAC评分(59.00±15.16)分低于重症组的(79.93±12.72)分,差异具有统计学意义(P<0.05);重症组患者治疗后3、6、12个月与治疗前WOMAC评分差值分别为(38.45±10.91)、(37.50±10.75)、(40.15±13.56)分,均高于轻症组的(24.40±11.34)、(24.55±11.25)、(27.35±13.80)分,差异具有统计学意义(P<0.05);两组患者治疗后3、6、12个月与治疗前WOMAC评分差值呈略升高趋势,但组内比较差异无统计学意义(P>0.05)。轻症组患者治疗前的Lysholm评分(59.21±9.41)分高于重症组的(46.79±11.30)分,差异具有统计学意义(P<0.05);重症组患者治疗后3、6、12个月与治疗前Lysholm评分差值分别为(24.25±7.32)、(26.80±7.05)、(26.60±6.34)分,均高于轻症组的(18.95±6.72)、(21.25±6.54)、(22.15±7.34)分,差异具有统计学意义(P<0.05);两组患者治疗后3、6、12个月与治疗前Lysholm评分差值呈略升高趋势,但组内比较差异无统计学意义(P>0.05)。结论 膝关节内注射自体PRP治疗老年KOA(K-L分级Ⅰ~Ⅲ级)在治疗后12个月的随访期间均有显著疗效,该治疗对重症(K-L分级Ⅲ级)患者的效果更好,自体PRP不良反应少,使用安全。Objective To discuss the clinical effect of intra-articular injection of autologous platelet-rich plasma(PRP) in elderly patients with Kellgren-Lawrence(K-L) grade Ⅰ-Ⅲ knee osteoarthritis(KOA). Methods 43 elderly KOA patients were divided into a mild group(K-L grade Ⅰ-Ⅱ, 23 patients) and a severe group(K-L grade Ⅲ, 20 patients) according to K-L grading. Patients in both groups were treated with intra-articular injection of PRP. The occurrence of adverse reactions in the two groups was analyzed, and the Western Ontario and McMaster Universities(WOMAC) score and knee function scale(Lysholm) score before and after treatment were compared between the two groups. Results No serious adverse reactions were observed in both groups.Before treatment, the WOMAC score in the mild group was(59.00±15.16) points, which was lower than(79.93±12.72) points in the severe group, and the difference was statistically significant(P<0.05). The difference between the WOMAC scores at 3, 6, and 12 months after treatment and before treatment was(38.45±10.91),(37.50±10.75), and(40.15±13.56) points in the severe group, which were higher than(24.40±11.34),(24.55±11.25), and(27.35±13.80) points in the mild group, and the differences were statistically significant(P<0.05). The difference between the WOMAC scores at 3, 6, and 12 months after treatment compared with before treatment tended to be slightly higher in both groups, but the difference within the groups was not statistically significant(P>0.05). Before treatment, the Lysholm score in the mild group was(59.21±9.41) points, which was higher than(46.79±11.30) points in the severe group, and the difference was statistically significant(P<0.05).The difference between the Lysholm score at 3, 6, and 12 months after treatment and before treatment were(24.25±7.32),(26.80±7.05), and(26.60±6.34) points in the severe group, which were higher than(18.95±6.72),(21.25±6.54), and(22.15±7.34) points in the mild group, and the differences were statistically significant(P<0.05). T

关 键 词：自体富血小板血浆 老年膝关节骨关节炎 Kellgren-Lawrence分级 

分 类 号：R684.3[医药卫生—骨科学]