自体富血小板血浆关节腔注射治疗膝骨关节炎疗效的影响因素分析  

Analysis of influencing factors on therapeutic effect of intra-articular injection of autologous platelet-rich plasma on knee osteoarthritis

作　　者：苏淼 景海荣 黄珊珊 郝茜 王晓翠 夏爱军 Su Miao;Jing Hairong;Huang Shanshan;Hao Xi;Wang Xiaocui;Xia Aijun(Department of Transfusion,Xi'an Daxing Hospital,Xi'an 710016,China)

机构地区：[1]西安大兴医院输血科,710016 [2]西安大兴医院疼痛科,710016

出　　处：《北京医学》2024年第12期1093-1097,共5页Beijing Medical Journal

摘　　要：目的探讨自体富血小板血浆(platelet-rich plasma,PRP)关节腔注射治疗膝骨关节炎(knee osteoarthritis,KOA)的临床效果及其影响因素。方法选取2021年6~12月西安大兴医院KOA患者72例。根据治疗后6个月时的Lysholm膝关节功能评分分为疗效可靠组(n=53)及疗效不佳组(n=19)。分析两组患者PRP产品中细胞计数,治疗前及治疗后1个月和6个月时的视觉模拟评分(visual analogue scale,VAS)、骨关节炎指数评分(western ontario and McMaster universities osteoarthritis index,WOMAC)及Lysholm膝关节功能评分,采用多因素logistic回归分析KOA患者自体PRP关节腔注射治疗临床疗效的影响因素。结果72例患者中,男16例,女56例,年龄18~78岁,平均(60.5±11.9)岁。治疗后6个月时,自体PRP关节腔注射治疗KOA患者的治疗有效率为73.61%(53/72)。治疗后1个月及6个月时,与疗效不佳组相比,疗效可靠组VAS及WOMAC更低、Lysholm膝关节功能评分更高;与治疗前相比,疗效可靠组治疗后1个月和6个月时VAS及WOMAC更低、Lysholm膝关节功能评分更高,疗效不佳组治疗后1个月时VAS及WOMAC更低、Lysholm膝关节功能评分更高,治疗后6个月时仅VAS更低,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,病程越长(OR=1.014,95%CI:1.002~1.026,P=0.026),PRP产品中PLT越低(OR=0.995,95%CI:0.990~0.999,P=0.009)的KOA患者,PRP关节腔注射疗效越差。结论PRP关节腔注射治疗能有效缓解KOA患者的疼痛程度、改善膝关节功能,且疗效维持时长>6个月。病程和PRP产品中PLT是KOA患者自体PRP关节腔注射治疗临床疗效的影响因素。建议符合条件的KOA患者应尽早进行较高血小板浓度的PRP关节腔注射治疗。Objective To explore the clinical efficacy and influencing factors of intra-articular injection of autologous platelet-rich plasma(PRP)on knee osteoarthritis(KOA).Methods A total of 72 KOA patients in Xi'an Daxing Hospital from June to December 2021 were selected,and were divided into effective group(n=53)and ineffective group(n=19)according to the Lysholm Score at six months after treatment.The cell counts in PRP,visual analogue scale(VAS),western ontario and McMaster universities osteoarthritis index(WOMAC),Lysholm knee joint function score before and one month and six months after treatment were compared.The influencing factors on therapeutic effect of intra-articular injection of autologous platelet-rich plasma on knee osteoarthritis were evaluated by multiple logistic regression analysis.Results Among the 72 patients,there were 16 males and 56 females,aged from 18 to 78 years,with an average of(60.5±11.9)years.The effective rate of autologous PRP intra-articular injections on KOA was 73.61%(53/72)at six months after treatment.At one month and six months after treatment,compared with the ineffective group,the VAS and WOMAC in the effective group were lower and the Lysholm knee joint function score was higher.Compared with before treatment,the VAS and WOMAC were lower and Lysholm knee joint function score was higher in the effective group at one and six months after treatment,while the VAS and WOMAC were lower and Lysholm knee joint function score was higher in the ineffective group at one month after treatment,and only the VAS was lower at six months after treatment,the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that the KOA patients with the longer course of disease(OR=1.014,95%CI:1.002-1.026,P=0.026),and the lower PLT in PRP products(OR=0.995,95%CI:0.990-0.999,P=0.009),had the worse curative effect of joint cavity injection of PRP.Conclusions PRP intra-articular injection can effectively alleviate the pain and improve knee joint function in KOA patie

关 键 词：自体富血小板血浆 膝骨关节炎 关节腔注射 影响因素 视觉模拟评分 骨关节炎指数评分 Lysholm膝关节功能评分 

分 类 号：R68[医药卫生—骨科学]