| 权香,于洋,边详兵,等.单采富血小板血浆中血小板浓度梯度与膝骨关节炎病人治疗 6个月后疼痛缓解及关节功能改善效果的分析[J].安徽医药,2026,30(6):1166-1171. |
| 单采富血小板血浆中血小板浓度梯度与膝骨关节炎病人治疗 6个月后疼痛缓解及关节功能改善效果的分析 |
| Platelet concentration gradient in apheresis platelet-rich plasma and its association with pain relief and joint function improvement in patients with knee osteoarthritis at 6 months after treatment |
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| DOI：10.3969/j.issn.1009-6469.2026.06.021 |
| 中文关键词: 富血小板血浆 膝骨关节炎 血小板浓度 疼痛评分 关节功能 磁共振成像 |
| 英文关键词: Platelet-rich plasma Knee osteoarthritis Platelet concentration Pain score Joint function Magnetic resonance imaging |
| 基金项目:解放军总医院青年自主创新科学基金项目( 22QNCZ013) |
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| 中文摘要: |
| 目的探讨单采富血小板血浆(PRP)中不同血小板浓度梯度对膝骨关节炎(KOA)病人治疗 6个月后疼痛缓解及关节功能改善的影响。方法前瞻性队列研究。纳入 2023年 1月至 2024年 6月在解放军总医院第一医学中心接受 PRP治疗的 KOA病人 90例，根据 PRP中血小板浓度将病人分为低浓度组( <600×109/L，n=30)、中浓度组［(600~1 000)×109/L，n=30］和高浓度组(>1 000×109/L，n=30)。所有病人均接受 3次 PRP关节腔注射(间隔 2周)，并于治疗前，治疗后 6周、 3个月和 6个月进行随访评估。主要评价指标包括视觉模拟评分法( VAS)评分、膝关节损伤和骨关节炎评分( KOOS)和关节活动度( ROM)，同时采用磁共振成像( MRI)评估软骨厚度变化。结果重复测量方差分析显示，治疗后 6个月三组 VAS评分均显著降低(均 P<0.001)，高浓度组降低幅度最大［低浓度组:(5.63±1.25)分降至( 3.12±0.98)分，中浓度组:(5.79±1.18)分降至( 2.46±0.87)分，高浓度组:(5.71±1.22)分降至( 1.87±0.76)分；均 P<0.05］。 KOOS总分改善程度呈浓度依赖性，高浓度组升高幅度最大［低浓度组:(49.22±9.36)分升至( 67.54±10.48)分，中浓度组:(49.71±9.48)分升至( 76.28±11.41)分，高浓度组:(49.53±9.43)分升至( 83.74± 12.49)分；均 P<0.05］。线性回归分析显示，血小板浓度与 KOOS总分改善呈正相关［β=0.027，95%CI:(0.023，0.031)，R2=0.53，P< 0.001］。 ROM改善方面，高浓度组优于中浓度组和低浓度组( P<0.001)。 MRI评估显示，高浓度组内侧胫骨平台软骨厚度增加［(0.23±0.06)mm］高于中浓度组［(0.15±0.05)mm］和低浓度组［(0.08±0.04)mm］(P<0.001)。 Pearson相关性分析显示， PRP中血小板浓度与 VAS评分改善( r=0.69)、KOOS总分改善(r=0.72)、 ROM增加( r=0.69)及内侧胫骨平台软骨厚度增加( r=0.71)均呈正相关(均 P<0.001)。结论单采 PRP治疗 KOA的临床效果与血小板浓度密切相关，高浓度 PRP(>1 000×109/L)在改善疼痛、提 |
| 英文摘要: |
| Objective To investigate the effects of different platelet concentration gradients in apheresis platelet-rich plasma (PRP)on pain relief and joint function improvement in patients with knee osteoarthritis (KOA) at 6 months after treatment.Methods This was a prospective cohort study. A total of 90 patients with KOA who received PRP treatment at the First Medical Center of the ChinesePLA General Hospital from January 2023 to June 2024 were enrolled. According to the platelet concentration in PRP, patients were di.vided into a low-concentration group (<600×109/L, n=30), a medium-concentration group [(600-1 000)×109/L, n=30], and a high-con. centration group (>1 000×109/L, n=30). All patients received three intra-articular PRP injections at 2-week intervals and were followed up before treatment and at 6 weeks, 3 months, and 6 months after treatment. The main outcome measures included the visual analoguescale (VAS) score, knee injury and osteoarthritis outcome score (KOOS), and range of motion (ROM). Magnetic resonance imaging(MRI) was also used to assess changes in cartilage thickness.Results Repeated-measures analysis of variance showed that VAS scores in all three groups were significantly reduced at 6 months after treatment (all P<0.001), with the greatest reduction observed in the high-concentration group [low-concentration group: (5.63±1.25) to (3.12±0.98); medium-concentration group: (5.79±1.18) to (2.46±0.87); high-concentration group: (5.71±1.22) to (1.87±0.76); all P<0.05]. Improvement in total KOOS showed a concentration-dependent trend, with the largest increase in the high-concentration group [low-concentration group: (49.22±9.36) to (67.54±10.48); medium-con. centration group: (49.71±9.48) to (76.28±11.41); high-concentration group: (49.53±9.43) to (83.74±12.49); P<0.05]. Linear regression analysis showed that platelet concentration was positively correlated with improvement in total KOOS [β =0.027, 95% CI: (0.023, 0.031), R2 =0.53, P<0.001]. Regarding ROM improvement, the high-concentration group was superior to the medium-concentration group and the low-concentration group (P<0.001). MRI assessment showed that the increase in cartilage thickness at the medial tibial plateau in the high-concentration group [(0.23±0.06) mm] was greater than that in the medium-concentration group [(0.15±0.05) mm] and the low-concentration group [(0.08±0.04) mm] (P<0.001). Pearson correlation analysis showed that platelet concentration in PRPwas positively correlated with VAS score improvement (r=0.69), total KOOS improvement (r=0.72), ROM increase (r=0.69), and medial tibial plateau cartilage thickness increase (r=0.71) (all P<0.001).Conclusions The clinical efficacy of apheresis PRP in the treatment of KOA is closely associated with platelet concentration. High-concentration PRP (>1 000×109/L) has more significant advantages in re. lieving pain, improving joint function, and promoting cartilage repair. |
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