富血小板血浆联合透明质酸钠治疗膝骨关节炎的效果观察

苏鸿年; 司马靓杰; 杨木强; 西立峰

doi:10.16766/j.cnki.issn.1674-4152.002636

富血小板血浆联合透明质酸钠治疗膝骨关节炎的效果观察

doi: 10.16766/j.cnki.issn.1674-4152.002636

1.
河南科技大学第一附属医院疼痛科，河南洛阳 471003
2.
河南科技大学第一附属医院麻醉科，河南洛阳 471003
3.
黄河三门峡医院骨科，河南三门峡 472000

基金项目:

河南医学科技攻关计划项目 LHGJ20191445

详细信息

通讯作者:
苏鸿年, E-mail: smlj54419@163.com

中图分类号: R684.3 R457.14
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出版历程
- 收稿日期: 2021-04-28
- 网络出版日期: 2022-11-29

Effect of platelet-rich plasma combined with sodium hyaluronate in the treatment of knee osteoarthritis

1.
Department of Pain, the First Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan 471003, China

摘要

摘要: 目的探讨注射富血小板血浆、透明质酸钠治疗膝骨关节炎(KOA)患者的效果。方法选取河南科技大学第一附属医院2018年6月—2020年2月收治的120例KOA患者，采用随机数字表进行分组，其中60例患者接受基础治疗+膝关节注射透明质酸钠(常规组)，另外60例在常规组治疗基础上使用富血小板血浆治疗(研究组)；对比治疗前后膝关节液中调节复合因子1α(ASF1α) mRNA、软骨细胞中沉默信息调节因子1(SIRT1) mRNA的变化及相关指标差异。结果治疗后研究组的膝关节肿胀评分为(1.83±0.51)分、疼痛程度评分为(2.87±0.98)分，均低于常规组的(2.28±0.65)分、(3.31±1.20)分，差异有统计学意义(均P＜0.05)；治疗后研究组的ASF1α mRNA表达强度为0.58±0.17，低于常规组的0.71±0.21(P＜0.05)，研究组的SIRT1 mRNA表达为1.41±0.30、超氧化物歧化酶(SOD)为(124.9±28.0)U/L，高于常规组的1.22±0.28、(113.8±24.1)U/L(均P＜0.05)；治疗后研究组的Lysholm评分为(69.84±11.03)分，高于常规组的(65.28±12.26)分(P＜0.05)；研究组的治疗总有效率为98.33%，高于常规组的85.00%(P＜0.05)。结论注射富血小板血浆、透明质酸钠治疗KOA患者能有效调节关节液中ASF1α mRNA、SIRT1 mRNA、SOD水平，对于关节功能恢复、临床症状缓解具有显著作用。
- 富血小板血浆 /
- 透明质酸钠 /
- 膝骨关节炎 /
- 关节液 /
- 软骨细胞中沉默信息调节因子1 /
- 调节复合因子1α
Abstract: Objective To investigate the effect of injection of platelet-rich plasma and sodium hyaluronate on knee osteoarthritis (KOA). Methods A total of 120 patients admitted in the First Affiliated Hospital of Henan University of Science and Technology from June 2018 to February 2020 was selected. The random number table was used to group patients: 60 patients with foundation treatment + knee joint injection of sodium hyaluronate (conventional group) comprised one group, and 60 patients with use of platelet rich plasma treatment on the basis of routine treatment group (study group) comprised the other group. The changes in regulatory complex factor 1α mRNA and silencing information regulator 1 in chondrocytes mRNA in knee joint fluid and other factors were compared before and after treatment. Results After treatment, the knee swelling score of the study group was (1.83±0.51) points and the pain score of the study group was (2.87±0.98) points, which were lower than those of the conventional group (2.28±0.65) points and (3.31±1.20) points; the differences were statistically significant (all P < 0.05). After treatment, the mRNA expression intensity of ASF1α in the study group was 0.58±0.17, which was lower than that in the conventional group (0.71±0.21, P < 0.05). The mRNA expression levels of SIRT1 and superoxide dismutase in the study group were 1.41±0.30 and (124.9±28.0) U/L, respectively, which were higher than those in the conventional group [1.22±0.28 and (113.8±24.1) U/L, all P < 0.05]. After treatment, the Lysholm score of the study group was (69.84±11.03) points, which was higher than that of the conventional group [(65.28±12.26) points, P < 0.05]. The total effective rate of the study group was 98.33%, which was higher than 85.00% of the conventional group (P < 0.05). Conclusion Injection of platelet-rich plasma and sodium hyaluronate in KOA patients can effectively regulate the levels of ASF1α mRNA, SIRT1 mRNA and SOD in the joint fluid, and it has a significant effect on the recovery of joint function and relief of clinical symptoms.
- Platelet-rich plasma /
- Sodium hyaluronate /
- Knee osteoarthritis /
- Synovial fluid /
- Silencing information regulator 1 in chondrocytes /
- Regulatory complex factor 1α

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表 1 2组KOA患者一般资料比较

Table 1. Comparison of general data of two groups of KOA patients

组别	例数	年龄(x±s，岁)	BMI	病程(x±s，年)	性别[例(%)]		高血压[例(%)]		糖尿病[例(%)]		患侧分布[例(%)]
组别	例数	年龄(x±s，岁)	BMI	病程(x±s，年)	男性	女性	是	否	是	否	左侧	右侧
研究组	60	60.5±8.3	23.1±2.4	6.2±1.7	21(35.00)	39(65.00)	13(21.67)	47(78.33)	7(11.67)	53(88.33)	32(53.33)	28(46.67)
常规组	60	61.7±7.9	23.4±2.2	5.9±2.0	24(40.00)	36(60.00)	8(13.33)	52(86.67)	3(5.00)	57(95.00)	27(45.00)	33(55.00)
统计量		0.811^a	0.714^a	0.885^a	0.320^b		1.443^b		1.745^b		0.834^b
P值		0.419	0.477	0.378	0.572		0.230		0.186		0.361
注：^a为t值，^b为χ²值。

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表 2 2组膝骨关节炎患者膝关节肿胀、疼痛程度评分比较(x±s，分)

Table 2. Comparison of knee swelling and pain scores between two groups of knee osteoarthritis patients (x±s, points)

组别	例数	肿胀评分		VAS评分
组别	例数	治疗前	治疗2周后	治疗前	治疗2周后
研究组	60	3.06±0.77	1.83±0.51^a	6.39±1.83	2.87±0.98^a
常规组	60	3.21±0.94	2.28±0.65^a	6.14±1.77	3.31±1.20^a
t值		0.956	4.219	0.761	-2.200
P值		0.341	＜0.001	0.448	0.030
注：与同组治疗前比较，^aP＜0.05。

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表 3 2组膝骨关节炎患者治疗前后的实验室指标比较(x±s)

Table 3. Comparison of laboratory indexes of knee osteoarthritis patients before and after treatment between 2 groups (x±s)

组别	例数	ASF1α mRNA		SIRT1 mRNA		MDA(μmol/L)		SOD(U/L)
组别	例数	治疗前	治疗2周后	治疗前	治疗2周后	治疗前	治疗2周后	治疗前	治疗2周后
研究组	60	1.04±0.22	0.58±0.17^a	0.89±0.32	1.41±0.30^a	8.53±1.77	4.40±1.18^a	87.70±16.40	124.90±28.00^a
常规组	60	0.98±0.24	0.71±0.21^a	0.94±0.30	1.22±0.28^a	8.18±1.83	4.78±1.23^a	90.60±18.00	113.80±24.10^a
t值		1.427	3.727	0.883	3.586	1.065	1.727	0.922	2.327
P值		0.156	＜0.001	0.379	＜0.001	0.289	0.087	0.358	0.022
注：与同组治疗前比较，^aP＜0.05。

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表 4 2组膝骨关节炎患者治疗前后Lysholm评分比较(x±s，分)

Table 4. Comparison of Lysholm score before and after treatment between 2 groups of knee osteoarthritis patients

组别	例数	治疗前	治疗2周后	t值	P值
研究组	60	47.18±9.63	69.84±11.03	11.192	＜0.001
常规组	60	49.60±10.32	65.28±12.26	6.150	＜0.001
t值		1.328	2.142
P值		0.187	0.034

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表 5 2组膝骨关节炎患者治疗后的膝关节功能比较

Table 5. Comparison of knee function between two groups of patients with knee osteoarthritis after treatment

组别	例数	临床控制(例)	有效(例)	无效(例)	总有效[例(%)]
研究组	60	26	33	1	59(98.33)
常规组	60	10	41	9	51(85.00)
注：2组总有效率比较，连续校正χ²=5.345，P=0.021。

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