富血小板血浆关节腔注射治疗慢性膝关节骨性关节炎对患者疼痛情况及血清基质金属蛋白酶-3、软骨寡聚基质蛋白水平的影响研究  

Effect of intra-articular injection of platelet-rich plasma on pain and serum MMP-3 and COMP in patients with chronic knee osteoarthritis

作　　者：余小夏 何仁健 赵露婷 杨凌 YU Xiaoxia;HE Renjian;ZHAO Luting;YANG Ling(Department of Rehabilitation,Ziyang Hospital,West China Hospital,Sichuan University,Ziyang 641300,China)

机构地区：[1]四川大学华西医院资阳医院资阳市中心医院康复科,四川资阳641300 [2]自贡市第一人民医院骨科,四川自贡643000

出　　处：《陕西医学杂志》2024年第7期918-921,953,共5页Shaanxi Medical Journal

基　　金：四川省青年创新科研计划项目(Q20072);四川省医学科技创新研究会项目(YCH-ZZ2023-009)。

摘　　要：目的:探究富血小板血浆(PRP)关节腔注射治疗慢性膝关节骨性关节炎(KOA)对患者疼痛情况及血清基质金属蛋白酶-3(MMP-3)、软骨寡聚基质蛋白(COMP)水平的影响。方法:选取86例慢性KOA患者,按随机信封法分为透明质酸(HA)组和PRP组,每组43例。HA组予以关节腔注射HA治疗,每次2 ml, PRP组以相同操作注射PRP,每次3.5 ml,两组均每周1次,连续治疗3周。比较两组治疗前后疼痛评分、症状严重程度、膝关节评分、血清炎症因子水平及不良反应发生情况。结果:治疗后3、6个月PRP组疼痛评分低于HA组(均P<0.05);治疗后3、6个月PRP组疼痛不适、步行能力及日常生活受累程度改善情况均优于HA组(均P<0.05);治疗后3、6个月PRP组膝关节评分显著低于HA组(均P<0.05);治疗后3个月PRP组血清中MMP-3及COMP水平低于HA组(均P<0.05);两组不良反应发生情况比较差异无统计学意义(P>0.05)。结论:注射PRP对慢性KOA的远期疗效明显,可减轻其关节疼痛,改善关节功能,减轻膝关节炎症,安全性高。Objective:To explore the effect of intra-articular injection of platelet-rich plasma(PRP)on pain and serum levels of matrix metalloproteinase-3(MMP-3)and cartilage oligomeric matrix protein(COMP)in patients with chronic knee osteoarthritis(KOA).Methods:A total of 86 patients with chronic KOA were selected and divided into hyaluronic acid(HA)group and PRP group by the random envelope method,with 43 cases in each group.The HA group was treated with intra-articular injection of 2 ml of HA every time,and the PRP group was treated with 3.5 ml of PRP every time in the same injection method,and both groups were injected once a week for 3 consecutive weeks.Pain score,symptom severity,knee joint score,serum inflammatory factors levels and occurrence of complications were compared between the two groups before and after treatment.Results:The pain scores in PRP group were lower than those in HA group at 3 and 6 months after treatment(all P<0.05).At 3 and 6 months after treatment,the improvement of pain and discomfort,walking ability and involvement degree of daily life in the PRP group were better than those in the HA group(all P<0.05).The knee joint scores at 3 and 6 months after treatment in PRP group were significantly lower than those in HA group(all P<0.05).The serum levels of MMP-3 and COMP in PRP group were lower than those in HA group at 3 months after treatment(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:PRP injection has obvious long-term efficacy on chronic KOA,and it can relieve the joint pain,improve the joint function,and reduce knee joint inflammation,with high safety.

关 键 词：富血小板血浆 慢性膝关节骨性关节炎 基质金属蛋白酶-3 软骨寡聚基质蛋白 疼痛视觉模拟评分 透明质酸 

分 类 号：R684.3[医药卫生—骨科学]