自体富血小板血浆治疗老年膝关节骨性关节炎的临床疗效研究  

Study on clinical efficacy of autologous platelet-rich plasma in the treatment of knee osteoarthritis in the elderly

作　　者：张珑 赵方 丛宝华 宋飞 ZHANG Long;ZHAO Fang;CONG Bao-hua(Jinqiu Hospital of Liaoning Province,Shenyang 110000,China)

机构地区：[1]辽宁省金秋医院,110000

出　　处：《中国实用医药》2024年第6期52-55,共4页China Practical Medicine

摘　　要：目的 研究自体富血小板血浆(PRP)对老年膝关节骨关性节炎(KOA)的治疗效果。方法 60例老年KOA患者,按照治疗方法不同分为PRP组和玻璃酸钠组,各30例。PRP组采用自体PRP治疗,玻璃酸钠组采用玻璃酸钠注射液(商品名:阿尔治)治疗。比较两组患者治疗前后的视觉模拟评分法(VAS)、西安大略省和麦克马斯特大学骨关节炎评分量表(WOMAC)、膝关节Lysholm评分量表(Lysholm)评分。结果 治疗前和治疗后3、6、12个月, PRP组VAS评分分别为(5.03±0.72)、(1.80±0.66)、(1.53±0.68)、(1.43±1.01)分, WOMAC评分分别为(67.97±17.01)、(36.13±7.82)、(35.73±8.22)、(33.76±10.10)分, Lysholm评分分别为(55.23±13.25)、(76.83±8.67)、(80.10±8.72)、(80.80±10.65)分。玻璃酸钠组VAS评分分别为(4.87±0.73)、(1.77±0.57)、(1.80±0.66)、(2.33±0.96)分, WOMAC评分分别为(66.87±15.36)、(37.03±10.91)、(38.67±14.10)、(46.50±15.59)分, Lysholm评分分别为(53.13±14.40)、(76.63±10.26)、(79.90±9.02)、(75.33±10.31)分。治疗前和治疗后3、6个月,两组患者的VAS、WOMAC、Lysholm评分均未见统计学差异(P>0.05);治疗后3、6、12个月,两组患者的VAS、WOMAC评分均低于治疗前, Lysholm评分高于治疗前(P<0.05)。治疗后12个月, PRP组的VAS、WOMAC评分均低于玻璃酸钠组, Lysholm评分高于玻璃酸钠组(P<0.05)。两组患者均无严重不良反应, PRP组出现轻微不良反应1例(3.33%),玻璃酸钠组出现3例(10.00%),组间比较无差异(P>0.05)。结论 自体PRP与玻璃酸钠注射液对老年KOA(Ⅰ~Ⅲ级)患者在1年期随访中均有疗效,术后前6个月的疗效虽无统计学上的显著差异,但6个月时自体PRP的持续治疗效果已开始体现,随访1年时自体PRP治疗的临床效果优于玻璃酸钠注射液,前者的不良反应发生率也略低于后者。Objective To study the effect of autologous platelet-rich plasma(PRP)in the treatment of knee osteoarthritis(KOA)in the elderly.Methods 60 elderly patients with KOA were divided into PRP group and sodium hyaluronate group according to different treatment methods,with 30 cases in each group.PRP group was treated with autologous PRP,and sodium hyaluronate group was treated with sodium hyaluronate injection(trade name:ARTZ Dispo).The Visual Analogue Scale(VAS)score,Western Ontario and McMaster University Osteoarthritis Index(WOMAC)and Lysholm were compared before and after treatment between the two groups.Results Before treatment and 3,6,and 12 months after treatment,PRP group had VAS scores of(5.03±0.72),(1.80±0.66),(1.53±0.68)and(1.43±1.01)points,WOMAC scores of(67.97±17.01),(36.13±7.82),(35.73±8.22)and(33.76±10.10)points,Lysholm scores of(55.23±13.25),(76.83±8.67),(80.10±8.72)and(80.80±10.65)points;sodium hyaluronate group had VAS scores of(4.87±0.73),(1.77±0.57),(1.80±0.66)and(2.33±0.96)points,WOMAC scores of(66.87±15.36),(37.03±10.91),(38.67±14.10)and(46.50±15.59)points,Lysholm scores of(53.13±14.40),(76.63±10.26),(79.90±9.02)and(75.33±10.31)points.There were no significant differences in VAS,WOMAC and Lysholm scores between the two groups before treatment and 3 and 6 months after treatment(P>0.05).At 3,6 and 12 months after treatment,VAS and WOMAC scores in both groups were lower than those before treatment,and Lysholm score was higher than that before treatment(P<0.05).At 12 months after treatment,VAS and WOMAC scores in PRP group were lower than those in sodium hyaluronate group,and Lysholm score was higher than that in sodium hyaluronate group(P<0.05).There were no serious adverse reactions in both groups,with 1 case(3.33%)of mild adverse reactions in the PRP group and 3 cases(10.00%)in the sodium hyaluronate group,and there was no difference in the comparison between the groups(P>0.05).Conclusion Both autologous platelet-rich plasma and sodium hyaluronate injection have curative eff

关 键 词：自体富血小板血浆 膝关节骨性关节炎 老年 玻璃酸钠注射液 

分 类 号：R684.3[医药卫生—骨科学]