摘要
目的 探讨富血小板血浆(PRP)注射联合普瑞巴林治疗膝关节骨性关节炎(KOA)对疼痛及膝关节功能的影响。方法 选取本院2020年6月~2022年4月KOA患者220例,随机分为观察组(n=110)与对照组(n=110),观察组给予PRP注射联合普瑞巴林,对照组给予透明质酸钠联合普瑞巴林,比较2组临床疗效、骨关节炎指数(WOMAC量表)、疼痛程度(VAS评分)、膝关节功能(Lysholm-Ⅱ量表、Rasmussen量表)、促修复因子[转化生长因子-β(TGF-β1)、骨形态发生蛋白4(BMP4)、胰岛素生长因子(IGF-1)]、炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)]、氧化应激指标[超氧化物歧化酶(SOD)、一氧化氮(NO)]、血常规[白细胞计数(WBC)、血小板计数(Plt)]水平以及不良反应发生情况。结果 观察组治疗有效率94.55%(104/110)高于对照组83.64%(92/110)(P<0.05);观察组治疗后WOMAC量表评分[(43.39±5.92)分vs(49.40±6.18)分]、VAS评分[(2.50±0.33)分vs(2.87±0.39)分)]低于对照组(P<0.05);观察组治疗后膝关节功能Rasmussen评分[(60.66±6.15)分vs(55.13±5.49)分)]、Lysholm-Ⅱ量表评分[(77.04±6.18)分vs(72.15±7.25)分)]高于对照组(P<0.05);观察组治疗后血清TGF-β1、BMP4、IGF-1水平[(944.80±54.92)ng/L、(126.79±9.81)pg/mL、(96.86±5.15)μg/L vs(901.45±46.82)ng/L、(118.44±8.45)pg/mL、(91.47±5.06)μg/L]高于对照组(P<0.05);观察组治疗后血清IL-6、TNF-α、NO水平[(124.92±20.58)pg/mL、(1.90±0.31)μg/L、(81.05±6.83)μmol/L vs(149.10±22.91)pg/mL、(2.64±0.52)μg/L、(86.22±5.84)]低于对照组,SOD水平[(109.29±10.18)NU/mL vs(102.77±9.98)NU/mL]高于对照组(P<0.05);2组治疗后外周血WBC、Plt水平无差异(P>0.05);2组不良反应发生率无差异(P>0.05)。结论 PRP注射联合普瑞巴林治疗可有效提高KOA患者膝关节功能,减轻疼痛,降低炎性因子水平,减轻氧化应激损伤,促进促修复因子表达。
Objective To explore the effects of platelet-rich plasma(PRP) injection combined with pregabalin on pain and knee function in knee osteoarthritis(KOA). Methods A total of 220 patients with KOA in our hospital, between June 2020 and April 2022, were enrolled and randomly divided into observation group(n=110) and the control(n=110). The observation group was given PRP injection combined with pregabalin, while control group was given sodium hyaluronate combined with pregabalin. The clinical curative effect, osteoarthritis index(WOMAC), pain level(VAS), knee function [Lysholm-Ⅱ scale, Rasmussen scale], levels of repair-promoting factors [transforming growth factor-β1(TGF-β1), bone morphogenetic protein 4(BMP4), insulin growth factor 1(IGF-1)], inflammatory factors [interleukin-6(IL-6), tumor necrosis factor α(TNF-α)], oxidative stress indexes [superoxide dismutase(SOD), nitric oxide(NO)] and blood routine [white blood cell count(WBC), platelet count(Plt)], and the occurrence of adverse reactions in the two groups were compared. Results The response rate of treatment was higher in observation group than control group [94.55%(104/110) vs 83.64%(92/110), P<0.05]. After treatment, scores of WOMAC and VAS were lower in observation group than the control group [points: 43.39±5.92 vs 49.40±6.18, 2.50±0.33 vs 2.87±0.39, P<0.05], and scores of Rasmussen and Lysholm-Ⅱ were higher in observation group [points 60.66±6.15 vs 55.13±5.49, 77.04±6.18 vs 72.15±7.25, P<0.05]. After treatment, levels of serum TGF-β1, BMP4 and IGF-1 were higher in observation group than control group [(944.80±54.92) ng/L vs(901.45±46.82) ng/L,(126.79±9.81) pg/mL vs(118.44±8.45) pg/mL,(96.86±5.15) μg/L vs(91.47±5.06) μg/L, P<0.05]. After treatment, levels of serum IL-6, TNF-α and NO were lower in observation group than control group [(124.92±20.58) pg/mL vs(149.10±22.91) pg/mL,(1.90±0.31) μg/L vs(2.64±0.52) μg/L,(81.05±6.83) μmol/L vs(86.22±5.84) μmol/L], while SOD was higher in observation group [(109.29±10.18) NU/mL vs(102.77±9.98) NU/mL, P<0.05)]. The levels of peripheral blood WBC and PLT in the two groups were similar after treatment(P>0.05). There was no significant difference in incidence of adverse reactions between the two groups(P>0.05). Conclusion PRP injection combined with pregabalin can effectively improve knee function, relieve pain, reduce levels of inflammatory factors and oxidative stress injury, and promote the expressions of repair-promoting factors in KOA patients.
作者
陈娟
李洪兵
陈周
CHEN Juan;LI Hongbing;CHEN Zhou(Department of Blood Transfusion,Qianjiang Central Hospital,Chongqing 409000,China)
出处
《中国输血杂志》
CAS
2022年第12期1239-1243,共5页
Chinese Journal of Blood Transfusion
基金
重庆市卫生健康委医学科研项目(2022WSJK132)。
