【摘要】：目的探討關(guān)節(jié)腔注射富血小板血漿(platelet-rich plasma,PRP)治療后,膝骨關(guān)節(jié)炎(osteoarthritis,OA)患者血漿和關(guān)節(jié)滑液中IL-17水平變化。方法以2015年1月—2016年1月接受關(guān)節(jié)腔PRP注射治療(每周1次,連續(xù)3周)的30例膝關(guān)節(jié)OA患者作為研究對象(試驗組),以30例自愿者正常膝關(guān)節(jié)作為對照(對照組)。兩組研究對象性別、年齡、體質(zhì)量指數(shù)比較,差異均無統(tǒng)計學(xué)意義(P0.05)。試驗組治療前后采用膝關(guān)節(jié)學(xué)會評分系統(tǒng)(KSS)及疼痛視覺模擬評分(VAS)分別評價膝關(guān)節(jié)功能及疼痛程度。試驗組患者注射PRP之前及第3次注射后1、3、6及12個月抽取肘前靜脈血以及患側(cè)關(guān)節(jié)滑液,采用ELISA法測量IL-17含量;對照組抽取肘前靜脈血進(jìn)行相應(yīng)檢測并比較。結(jié)果 PRP注射治療過程中,試驗組患者均未出現(xiàn)膝關(guān)節(jié)紅腫、發(fā)熱等局部感染及其他不適癥狀�；颊呔@隨訪,隨訪時間12~15個月,平均13.5個月。PRP注射治療后各時間點VAS評分均較術(shù)前顯著降低,KSS評分較術(shù)前顯著增加,比較差異有統(tǒng)計學(xué)意義(P0.05);治療后各時間點間比較,差異均無統(tǒng)計學(xué)意義(P0.05)。與對照組比較,試驗組PRP治療前后血漿IL-17含量均顯著增高(P0.05)。試驗組治療后各時間點血漿及關(guān)節(jié)滑液IL-17含量均較治療前顯著降低(P0.05),治療后各時間點間比較差異均無統(tǒng)計學(xué)意義(P0.05)。結(jié)論關(guān)節(jié)腔注射PRP治療可顯著改善膝關(guān)節(jié)OA患者疼痛癥狀及關(guān)節(jié)功能,并在一定程度上降低患者體內(nèi)IL-17水平,但未恢復(fù)至正常水平。
[Abstract]:Objective to investigate the changes of IL-17 levels in plasma and synovial fluid of patients with knee osteoarthritis (osteoarthritis,OA) after intra-articular injection of platelet-rich plasma (platelet-rich plasma,PRP). Methods from January 2015 to January 2016, 30 patients with knee joint OA were treated with PRP injection (once a week for 3 weeks) as the subjects (experimental group) and 30 volunteers as control group (control group). There was no significant difference in sex, age and body mass index between the two groups (P 0.05). The knee joint function and pain degree were evaluated by knee joint learning scoring system (KSS) and pain visual simulation score (VAS) before and after treatment in the experimental group. The blood samples of anterior cubital vein and synovial fluid of affected joint were taken before and 1, 3, 6 and 12 months after injection of PRP in the experimental group, and the content of IL-17 was measured by ELISA method, while the blood of the anterior cubital vein was detected and compared in the control group. Results during PRP injection, there were no local infections such as knee joint redness and swelling, fever and other uncomfortable symptoms in the experimental group. All the patients were followed up for 12 to 15 months (mean 13.5 months). The VAS score was significantly lower and the KSS score was significantly higher at each time point after PRP injection than that before operation (P 0.05). There was no significant difference between the time points after treatment (P 0.05). Compared with the control group, the plasma IL-17 content in the experimental group was significantly higher than that in the control group before and after PRP treatment (P 0.05). The content of IL-17 in plasma and synovial fluid of the experimental group was significantly lower than that before treatment at each time point after treatment (P 0.05), but there was no significant difference between the time points after treatment (P 0.05). Conclusion intra-articular injection of PRP can significantly improve the pain symptoms and joint function of patients with knee joint OA, and decrease the level of IL-17 in patients to a certain extent, but does not return to the normal level.
【作者單位】： 滄州市中心醫(yī)院骨二科;滄州市人民醫(yī)院手術(shù)室;獻(xiàn)縣人民醫(yī)院骨科;
【分類號】：R684.3

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