富血小板血浆与玻璃酸钠治疗膝骨关节炎的疗效对比  

Comparison of the efficacy of platelet-rich plasma vs.sodium hyaluronate in the treatment of knee osteoarthritis

作　　者：郑赛磊 冷子宽 尚春风 尚国伟[1] 李劲峰[1] 寇红伟[1] 陈向荣 程田[1] 包德明 时利军 王义生[1] 刘宏建[1] Zheng Sailei;Leng Zikuan;Shang Chunfeng;Shang Guowei;Li Jinfeng;Kou Hongwei;Chen Xiangrong;Cheng Tian;Bao Deming;Shi Lijun;Wang Yisheng;Liu Hongjian(Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院骨科,郑州450052

出　　处：《中华实验外科杂志》2023年第1期165-168,共4页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金面上项目(82172484);国家自然科学基金青年项目(82101451)。

摘　　要：目的探讨富血小板血浆(PRP)与玻璃酸钠(SH)治疗膝骨关节炎(KOA)的临床效果。方法选取郑州大学第一附属医院骨科2020年3月至2022年6月符合纳排标准的KOA患者61例,按治疗方式分PRP组30例和SH组31例。比较两组治疗前及治疗4周后的视觉模拟疼痛评分(VAS)、骨关节炎指数(WOMAC)评分、关节液白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α),评估PRP与SH对不同KOA患者治疗的临床疗效,样本数据采用配对t检验和独立样本t检验。结果PRP组治疗4周后WOMAC评分低于治疗前[(76.8±12.1)分比(58.0±14.8)分,t=20.863,P<0.05],治疗4周后VAS评分低于治疗前[(6.0±0.9)分比(4.2±1.1)分,t=48.694,P<0.05];SH组治疗4周后WOMAC评分低于治疗前[(77.4±9.2)分比(65.6±9.5)分,t=20.565,P<0.05],治疗4周后VAS评分低于治疗前[(6.4±0.7)分比(5.1±0.6)分,t=11.180,P<0.05]。PRP组治疗4周后WOMAC评分低于SH组[(58.0±14.8)分比(65.6±9.5)分,t=2.380,P<0.05];PRP组治疗4周后VAS评分低于SH组[(4.2±1.1)分比(5.1±0.6)分,t=3.969,P<0.05]。PRP组治疗4周后IL-6水平低于治疗前[(19.06±1.11)pg/ml比(0.51±0.04)pg/ml,t=91.595,P<0.05],治疗4周后TNF-α水平低于治疗前[(1.97±0.17)pg/ml比(0.51±0.04)pg/ml,t=48.694,P<0.05];SH组治疗4周后IL-6水平低于治疗前[(18.81±1.07)pg/ml比(7.09±0.72)pg/ml,t=57.212,P<0.05],SH组治疗4周后TNF-α水平低于治疗前[(2.02±0.19)pg/ml比(0.73±0.05)pg/ml,t=36.449,P<0.05]。PRP组治疗4周后IL-6水平低于SH组[(0.51±0.04)pg/ml比(7.09±0.72)pg/ml,t=0.899,P<0.05];PRP组治疗4周后TNF-α水平低于SH组[(0.51±0.04)pg/ml比(0.73±0.05)pg/ml,t=19.108,P<0.05]。结论PRP与SH对KOA的治疗均有效果,且PRP效果优于SH。Objective To investigate the clinical efficacy of platelet-rich plasma(PRP)or sodium Hyaluronate(SH)in the treatment of knee osteoarthritis(KOA).Methods A total of 61 KOA patients who met the exclusion standard in the Department of Orthopedics of our hospital from March 2020 to June 2022 were selected,and divided into PRP group(30 cases)and SH group(31 cases)according to treatment methods.Visual analog scale(VAS)and osteoarthritis index(Western Ontario and McMaster Universities Arthritis Index,WOMAC)were compared between the two groups before and 4 weeks after treatment.WOMAC score,interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)were used to evaluate the clinical therapeutic efficacy of PRP and SH in KOA patients.Paired t test and independent sample t test were used for sample data.Results WOMAC score in PRP group after 4 weeks of treatment was lower than that before treatment[(76.8±12.1)vs.(58.0±14.8),t=20.863,P<0.05];The VAS score after 4 weeks of treatment was lower than that before treatment[(6.0±0.9)vs.(4.2±1.1),t=48.694,P<0.05].The WOMAC score in SH group after 4 weeks of treatment was lower than that before treatment[(77.4±9.2)vs.(65.6±9.5),t=20.565,P<0.05];The VAS score after 4 weeks of treatment was lower than that before treatment[(6.4±0.7)vs.(5.1±0.6),t=11.180,P<0.05].WOMAC score was significantly lower in PRP group than in SH group after 4 weeks of treatment[(58.0±14.8)vs.(65.6±9.5),t=2.380,P<0.05].After 4 weeks of treatment,VAS score in PRP group was lower than that in SH group[(4.2±1.1)vs.(5.1±0.6),t=3.969,P<0.05].The level of IL-6 in PRP group after 4 weeks of treatment was lower than that before treatment[(19.06±1.11)vs.(0.51±0.04)pg/ml,t=91.595,P<0.05];After 4 weeks of treatment,the level of TNF-α was lower than that before treatment[(1.97±0.17)vs.(0.51±0.04)pg/ml,t=48.694,P<0.05].The level of IL-6 in SH group after 4 weeks of treatment was lower than that before treatment[(18.81±1.07)vs.(7.09±0.72)pg/ml,t=57.212,P<0.05];After 4 weeks of treatment,the level of TNF-αin

关 键 词：富血小板血浆 玻璃酸钠 膝骨关节炎 

分 类 号：R684.3[医药卫生—骨科学]