关节腔内注射自体富血小板血浆治疗膝关节骨性关节炎的临床疗效

目的 探讨关节腔内注射自体富血小板血浆(PRP)治疗膝关节骨性关节炎(KOA)的临床疗效.方法 选取KOA患者66例随机为对照组21例、玻璃酸钠组25例及PRP组20例,3组患者均口服依托考昔片,玻璃酸钠组及PRP组给予关节腔内注射玻璃酸钠注射液及PRP.于治疗前和治疗后3、6、9、12个月时采用视觉模拟评分法(VAS)、安大略西部和麦克马斯特大学骨关节炎指数(WOMAC)及日本骨科协会(JOA)评分对患者进行评估,并观察不良反应发生情况.结果 治疗后各个时间点,PRP组的VAS及WOMAC评分均低于其他两组,而JOA评分高于其他两组(P<0.05),治疗后6、9个月,玻璃酸钠组的VAS及WOMAC评分低于对照组,而JOA评分高于对照组(P<0.05).治疗后各个时间点,PRP组的VAS及WOMAC评分均低于治疗前,而JOA评分高于治疗前(P<0.05);玻璃酸钠组及对照组中,治疗后3、6、9个月的VAS评分及治疗后3、6个月的WOMAC评分低于治疗前,而治疗后3、6个月的JOA评分高于治疗前(P<0.05).3组均未发生严重不良反应,PRP组注射后出现局部红肿、疼痛及皮温升高,不良反应发生率为10.43％(12/115).结论 采用关节腔内注射PRP治疗KOA的疗效优于口服药物及关节腔内注射玻璃酸钠,患者的症状缓解更为持久,且不良反应发生率较低.

Clinical efficacy of intraarticular injection of autologous platelet-rich plasma for treatment of knee osteoarthritis

Objective To explore the clinical efficacy of intraarticular injection of autologous platelet-rich plasma ( PRP) for the treatment of knee osteoarthritis ( KOA) .Methods Sixty-six patients with KOA were selected and were randomly divided into control group (n=21),sodium hyaluronate group(n=25) and PRP group(n=20).The three groups were orally administered etoricoxib tablet.Intraarticular injection of sodium hyaluronate and PRP were conducted in the sodium hyaluronate group and PRP group respectively .Visual Analogue Scale (VAS),Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Japanese Orthopaedic Association(JOA) scores were used to assess all patients before treatment,at 3,6,9 and 12 months after treatment.And the incidence of adverse reactions was observed.Results At each time point after treatment,VAS and WOMAC scores were lower and JOA scores were higher in the PRP group compared to the other two groups(P<0.05).At 6 and 9 months after treatment,VAS and WOMAC scores were lower and JOA scores were higher in the sodium hyaluronate group compared to the control group(P<0.05).In the PRP group,VAS and WOMAC scores decreased and JOA scores increased at each time point after treatment compared to the scores before treatment(P<0.05).In the sodium hyaluronate group and control group,VAS scores at 3,6 and 9 months after treatment and WOMAC scores at 3 and 6 months after treatment decreased,JOA scores at 3 and 6 months after treatment increased compared to the scores before the treatment (P<0.05).No severe adverse reactions occurred in the three groups.Local red and swollen,pain,and high cutaneous temperature were observed in the PRP group after injection ,and the incidence rate of adverse reactions was 10.43％(12/115).Conclusion Intraarticular injection of PRP can obtain a better efficacy for KOA compared to oral medication or intraarticular injection of sodium hyaluronate ,can prolong the symptoms relief of patients ,and has a lower incidence rate of adverse reactions .