富血小板血浆不同注射次数对膝骨关节炎的疗效

目的探讨富血小板血浆(PRP)不同注射次数对膝骨关节炎疗效的影响。 方法纳入2018年2月至2019年2月河南省人民医院90例膝骨关节炎患者为研究对象，纳入标准：符合膝骨关节炎诊断标准、病程大于4个月、X线Kellgren-Lawrence分级(K-L分级)Ⅱ~Ⅲ级；排除标准：合并类风湿性关节炎、近期膝关节外伤或手术史、痛风、血液病、肿瘤等疾病者。按照注射次数不同，随机分为1次组、3次组、5次组，每组30例，分别给予1、3、5次PRP注射，每周1次。于治疗前、治疗后6、12、24周采用视觉模拟疼痛评分(VAS)评分和美国西安大略与麦克马斯特大学骨关节炎指数(WOMAC)评估患者膝关节功能，采用超声半定量分级评分评估患者膝关节软骨状态。VAS评分、WOMAC评分进行重复测量方差分析，超声半定量评分组内治疗前后采用配对样本t检验，组间比较采用单因素方差分析。 结果治疗后6周，与1次组相比，3次组和5次组VAS评分、WOMAC评分均有显著降低(F＝17.922、22.215，均为P<0.01)。治疗后12周，与1次组相比，3次组和5次组VAS评分、WOMAC评分均有显著降低(F＝71.058、39.592，均为P<0.01)。治疗后24周，与1次组相比，3次组、5次组VAS评分、WOMAC评分、超声半定量评分均有显著降低(F＝163.974、86.980、6.781，均为P<0.01)。 结论3次及5次PRP注射治疗膝骨关节炎较1次有更好的疗效，但3次与5次注射未见明显差异。

Effect of different injection times of platelet-rich plasma on knee osteoarthritis

ObjectiveTo explore the effect of different injection frequencies of PRP on the efficacy of knee osteoarthritis. MethodsA total of 90 patients with knee osteoarthritis in Henan Provincial People's Hospital from February 2018 to February 2019 were included in the study. Inclusion criteria: the patient met the diagnostic criteria of knee osteoarthritis, the duration of the disease were more than four months, and the X-ray Kellgren-Lawrence classification (K-L grading) were grade Ⅱ-Ⅲ. Exclusion criteria: patients with rheumatoid arthritis, recent knee trauma or surgical history, gout, blood diseases, tumors and other diseases. According to the frequency of injection, they were randomly divided into the one-time group, three-time group and five-time group, 30 patients in each group receiving one, three and five times PRP injection respectively, once a week. The knee joint function was assessed by visual analogue pain scale (VAS) and Western Ontario and McMaster University osteoarthritis index (WOMAC) before the treatment, and six, 12, 24 weeks after the treatment, and the knee joint cartilage status was assessed by ultrasonic semi-quantitative grading. VAS score and WOMAC score were evaluated by repeated measure ANOVA, paired sample t test was used before and after treatment in ultrasound semi-quantitative evaluation within the group, and one-way ANOVA was used for comparison between groups. ResultsAt six weeks after the treatment, VAS score and WOMAC score in the three-and five-time groups were significantly lower than those in the one-time group (F =17.922, 22.215, both P<0.01). In 12 weeks after the treatment, VAS score and WOMAC score in the three-and five-time groups were significantly lower than those in the one-time group (F=71.058, 39.592, both P<0.01). In 24 weeks after the treatment, VAS score, WOMAC score and ultrasonic semi-quantitative score in the three- and five-time groups were significantly lower than those in the one-time group (F=163.974, 86.980, 6.781, all P<0.01). ConclusionThe efficacy of three and five injections of PRP is better than one injection of PRP, but there is no obvious difference between three and five injections.