自体贫白细胞富血小板血浆注射治疗膝骨关节炎短期临床疗效观察及分析  

Autologous leukocyte-poor platelet-rich plasma injection in the treatment of knee osteoarthritis:short-term clinical effect analysis

作　　者：杨雷 景豆豆 刘明玺 郭振业 杨斌爱 林树忠 张德梅 郭凤艳 刘锦 YANG Lei;JING Doudou;LIU Mingxi;GUO Zhenye;YANG Binai;LIN Shuzhong;ZHANG Demei;GUO Fengyan;LIU Jin(Department of Blood Transfusion,Peking University First Hospital Taiyuan Hospital(Taiyuan Central Hospital),Taiyuan 030013,China;The Second Clinical School of Medicine,Shanxi Medical University,Taiyuan 030002,China;Taiyuan Blood Center,Taiyuan 030032,China)

机构地区：[1]北京大学第一医院太原医院(太原市中心医院)输血科,山西太原030013 [2]山西医科大学第二临床医学院,山西太原030002 [3]太原市血液中心,山西太原030032

出　　处：《中国输血杂志》2024年第10期1115-1121,共7页Chinese Journal of Blood Transfusion

基　　金：国家自然科学基金资助项目(82303192)。

摘　　要：目的探讨自体贫白细胞富血小板血浆治疗膝骨关节炎短期临床疗效。方法收集2022-2023年北京大学第一医院太原医院Keligren LawrenceⅠ-Ⅲ级膝骨关节炎患者病例85例,使用血液成份分离机进行自体LP-PRP采集并进行质量评估,所有患者均使用自体LP-PRP进行膝关节腔内注射治疗。分3个等级注射后1、3、6月时应用视觉模拟评分表(VAS)和膝关节炎指数评分表(WOMAC)评估患者膝关节疼痛程度及功能。治疗6个月后行膝关节MRI检查,比较治疗前后MRI影像学改变情况。对治疗结果中不同影响因素进行分组分析,主要有LP-PRP中血小板浓度和膝关节K-L分级2方面,其中:1)按照LP-PRP中血小板浓度进行分级,可分为3个等级,分别为低浓度[(<800)×10^(9)/L]、中浓度[(800-1000)×10^(9)/L]、高浓度[(>1000)×10^(9)/L];2)根据膝骨关节K-L分级,将膝骨关节炎严重程度分为Ⅰ、Ⅱ、Ⅲ3个等级。结果LP-PRP治疗后1、3和6月VAS和WOMAC评分与治疗前比较明显降低,差异有统计学意义(P<0.05)。不同等级血小板浓度治疗效果差异具有统计学意义,血小板浓度>1000×10^(9)/L时,显著疗效最明显(P<0.05),达74.2%(23/31),高于其他2组(50%、0)。MRI检查示,患者治疗后可见关节软骨信号明显改善。结论自体LP-PRP缓解膝骨关节炎疼痛等方面短期临床疗效良好。Objective To investigate short-term clinical efficacy of autologous leukocyte-poor platelet-rich plasma(LP-PRP)treatment of knee osteoarthritis(KOA).Methods 85 cases of patients with Keligren Lawrence gradeⅠ-Ⅲknee osteoarthritis in Peking University First Hospital Taiyuan Hospital(Taiyuan Central Hospital)from 2022 to 2023 were collected for autologous LP-PRP collection and quality assessment using a blood component separator,and all patients were treated with autologous LP-PRP.The degree and function of knee pain were assessed by visual analog scale(VAS)and knee arthritis index scale(WOMAC)at 1,3 and 6 months after injection.Knee MRI was performed after 6 months of treatment,and the MRI imaging changes before and after treatment were compared.Different influencing factors in the treatment results were grouped and analyzed,mainly including platelet concentration in LP-PRP and K-L grading of knee joint.Among them:1)According to the platelet concentration in LP-PRP,it can be was divided into three grades,which are low concentration[(<800)×10^(9)/L],medium concentration[(800-1000)×10^(9)/L],and high concentration[(>1000)×10^(9)/L];2)According to the K-L grade of the knee joint,the severity of knee osteoarthritis was divided into three grades:Ⅰ、Ⅱ、Ⅲ.Results The VAS and WOMAC scores at 1,3 and 6 months after LP-PRP treatment were significantly lower than those before treatment,and the difference was statistically significant(P<0.05).There was a statistically significant difference in the therapeutic effect of different levels of platelet concentration,and when the platelet concentration was more than 1000×10^(9)/L,the significant effect was the most obvious(P<0.05).The therapeutic effect of different levels of platelet concentration was statistically significant(P<0.05).MRI showed that the articular cartilage signal was significantly improved after treatment.Conclusion Autologous LP-PRP injection into knee cavity for the treatment of knee osteoarthritis KOA has a good short-term clinical effect in rel

关 键 词：KOA LP-PRP VAS WOMAC 临床疗效 

分 类 号：R457.14[医药卫生—治疗学] R684.3[医药卫生—临床医学]