标题：富血小板血浆在膝关节骨性关节炎中的应用

      作者：李博，王雷，于晓文，尚鹏，丁彤，韩亚清，姚娟    渭南市骨科医院骨科，陕西 渭南 714000

      卷次： 2020年31卷22期

      【摘要】 目的 评估富血小板血浆(PRP)在膝关节骨性关节炎中的应用效果。方法 回顾性分析2018年7月至2019年12月在渭南市骨科医院骨科治疗的206例膝关节炎患者的临床资料，根据治疗方法分为对照组和观察组，每组103例，对照组患者给予玻璃酸钠治疗，观察组患者给予富血小板血浆治疗，疗程均为5周，比较两组患者的临床治疗效果、治疗前后急性时相蛋白水平[C反应蛋白(CRP)、α1-酸性糖蛋白(AAG)、血红蛋白(HP)]、视觉模拟(VAS)评分，生活质量量表(QOL)评分及治疗后随访 3个月时西安大略和麦克马斯特大学骨关节炎调查量表(WOMAC)评分。结果 治疗后，观察组患者的临床治疗总有效率为91.3%，明显高于对照组的75.7%，差异有统计学意义(P<0.05)；治疗前，两组患者的急性时相蛋白水平比较差异均无统计学意义(P>0.05)，治疗后，观察组患者的CRP、AAG、HP水平分别为(0.71±0.69) mg/L、(0.61±0.25) g/L、(0.36±0.12) g/L，明显低于对照组的(1.04±0.31) mg/L、(0.72±0.20) g/L、(0.76±0.19) g/L，差异均有统计学意义(P<0.05)；治疗前，两组患者的VAS评分比较差异无统计学意义(P>0.05)，治疗后，观察组患者的VAS评分为(3.3±0.2)分，明显低于对照组的(5.8±0.5)分，差异有统计学意义(P<0.05)；治疗前，两组患者的QOL评分比较差异无统计学意义(P>0.05)，治疗后，观察组和对照组患者的整体健康状况评分[(71.39±6.15)分 vs (58.29±5.04)分]、功能量表评分[(79.65±6.39)分 vs (68.59±5.96)分]、症状量表评分[(84.18±6.65)分 vs (73.62±5.31)分]比较，观察组明显高于对照组，差异均有统计学意义(P<0.05)；治疗前，两组患者的WOMAC评分比较差异无统计学意义(P>0.05)，治疗后随访3个月时，观察组患者的WOMAC评分为(21.3±3.1)分，明显低于对照组的(26.7±4.2)分，差异有统计学意义(P<0.05)。结论 膝关节骨性关节炎患者使用富血小板血浆进行关节软骨修复，可以明显改善患者的关节炎指数评分和VAS评分，提高生活质量，其临床治疗效果较为理想，值得推广应用。
      【关键词】 膝关节骨性关节炎；关节软骨修复；富血小板血浆；富血小板血浆；治疗效果
      【中图分类号】 R684.3 【文献标识码】 A 【文章编号】 1003—6350（2020）22—2927—05

Application of platelet-rich plasma in knee osteoarthritis.
LI Bo, WANG Lei, YU Xiao-wen, SHANG Peng, DING Tong,HAN Ya-qing, YAO Juan. Department of Orthopedics, Weinan Orthopedic Hospital, Weinan 714000, Shaanxi, CHINA
【Abstract】 Objective To evaluate the effect of platelet-rich plasma (PRP) in knee osteoarthritis. Methods Theclinical data of 206 patients with knee osteoarthritis treated in the Department of Orthopedics, Weinan Orthopedic Hospitalfrom July 2018 to December 2019 were retrospectively analyzed. According to the treatment methods, the patients were di-vided into a control group and an observation group, with 103 patients in each group. Patients in the control group weregiven sodium hyaluronate for treatment, and those in the observation group were treated with platelet-rich plasma, bothfor 5 weeks. The clinical effect, acute phase protein levels (C response protein [CRP], α1-acid glycoprotein [AAG], he-moglobin [HP], visual analogue scale (VAS), quality of life scale (QOL) score, and The Western Ontario and McMasterUniversities Osteoarthritis Index (WOMAC) were compared before and after treatment. Results After treatment, the to-tal effective rate of clinical treatment in the observation group was 91.3%, which was significantly higher than 75.7% inthe control group (P<0.05). Before treatment, there was no statistically significant difference between the two groups inacute phase protein levels (CRP, AAG, HP), P>0.05. After treatment, the levels of CRP, AAG, and HP in the observationgroup were (0.71±0.69) mg/L, (0.61±0.25) g/L, and (0.36±0.12) g/L, respectively, which were significantly lower than(1.04±0.31) mg/L, (0.72±0.20) g/L, and (0.76±0.19) g/L of the control group (P<0.05). Before treatment, there was nostatistically significant difference in VAS score between the two groups (P>0.05). After treatment, VAS score in the ob-servation group was (3.3±0.2) points, which was significantly lower than (5.8±0.5) points of the control group (P<0.05).Before treatment, there was no statistically significant difference in QOL scores between the two groups (P>0.05). Aftertreatment, the overall health condition score, function scale score, and symptom scale score of the observation groupwere significantly higher than those in the control group: (71.39±6.15) points vs (58.29±5.04) points, (79.65±6.39) pointsvs (68.59±5.96) points, (84.18±6.65) points vs (73.62±5.31) points (P<0.05). Before treatment, there was no statisticallysignificant difference in WOMAC score between the two groups (P>0.05). When patients were followed up for threemonths after treatment, the WOMAC score of the observation group was (21.3±3.1) points, which was significantly low-