薛雷 张喜明 葛新

【摘要】 目的 探討关节腔注射血小板裂解液联合硫酸软骨素对膝关节炎患者膝关节功能的影响。

方法 选择2018年12月～2020年12月收治的84例膝关节炎患者，应用双色球法随机分为对照组和试验组，各42例。对照组口服氨基葡萄糖、硫酸软骨素治疗，试验组在对照组基础上实施关节腔注射血小板裂解液治疗。比较两组治疗后的临床疗效，治疗前后的膝关节功能及血清因子水平。

结果 对照组总有效率为76.19%，低于试验组的95.24%（P<0.05）。两组治疗后，疼痛、不安定度、闭锁感、肿胀度、楼梯攀爬、蹲姿、跛行、使用支撑物及Lysholm总分均较治疗前提高，相比对照组，试验组更高（P<0.001）。两组治疗后Ⅰ型胶原C端肽（CTX-Ⅰ）水平下降，相比对照组，试验组更低;胰岛素样生长因子（IGF）水平升高，相比对照组，试验组更高（P<0.001）。

结论 应用关节腔注射血小板裂解液联合硫酸软骨素治疗膝关节炎患者效果更佳，可以改善患者膝关节功能和血清因子水平，值得广泛推广。

【关键词】 关节腔注射;血小板裂解液;硫酸软骨素;膝关节炎;膝关节功能

中图分类号：R684.3   文献标志码：A   DOI：10.3969/j.issn.1003-1383.2021.07.009

【Abstract】 Objective To investigate the effect of intra-articular injection of platelet lysate combined with chondroitin sulfate on knee joint function in patients with knee arthritis.

Methods 84 patients with knee arthritis admitted to hospital from December 2018 to December 2020 were randomly divided into control group and experimental group according to double chromosphere grouping method， with 42 cases in each group. The control group were treated with oral glucosamine and chondroitin sulfate， and the experimental group were treated with intra-articular injection of platelet lysate on the basis of the control group. And then， the clinical efficacy， knee joint function and serum factor levels before and after treatment were compared between the two groups.

Results The total effective rate of the control group was 76.19%， which was significantly lower than that of the experimental group （95.24%） （P < 0.05）. After treatment， the total scores of pain， instability， sense of atresia， swelling， stair climbing， squatting， limping， support material using and Lysholm in the two groups significantly improved， which were significantly higher in the experimental group than in the control group （P < 0.001）. After treatment， the levels of CTX-Ⅰ significantly decreased， which were significantly lower in the experimental group than in the control group， and the level of insulin-like growth factor （IGF） significantly increased， and that in the experimental group was significantly higher than that in the control group （P < 0.001）.

Conclusion Intra-articular injection of platelet lysate combined with chondroitin sulfate in the treatment of patients with knee arthritis has better effect， which can significantly improve the knee joint function and serum factor levels， and is worthy of wide promotion.

【Key words】 intra-articular injection; platelet lysate; chondroitin sulfate; knee arthritis; knee function

膝关节炎是指由慢性损伤、肥胖、老化、代谢异常、营养的改变等因素引起的关节炎性病变。其主要的临床症状为关节红肿、疼痛、发热等，若得不到及时治疗，会造成一种病残性的病变[1～2]。目前临床上常用软骨保护剂进行治疗，其中氨基葡萄糖具有抗炎，促进软骨合成，抑制关节软骨分解的作用;硫酸软骨素是连接在蛋白质上形成蛋白聚糖的一类糖胺聚糖，与氨基葡萄糖联用效果更佳[3～5]。但是近年来临床研究表明[6～7]，口服药物治疗膝关节炎效果不佳。血小板裂解液含有高浓度生长因子，能够促进软骨再生，抑制关节内的炎症反应;并且关节腔注射直达病灶，效果更佳。鉴于此，为了探讨关节腔注射血小板裂解液联合硫酸软骨素对膝关节炎患者膝关节功能的影响，我们选择2018年12月～2020年12月收治的84例膝关节炎患者进行研究。……