CAJ | 학술논문

目的：比较富血小板血浆（ platelet-rich plasma，PRP）与玻璃酸钠（ hyaluronic acid sodium ，HA）治疗膝关节骨关节炎（ knee osteoarthritis ，KOA）的近期疗效。方法2013年3月～2014年1月，将60例KOA按就诊顺序依次分至A、B、C组，每组20例。 A组膝关节内注射自体PRP 5 ml，B组膝关节内注射HA 2 ml，C组膝关节内先注射PRP 5 ml，10 min后注射HA 2 ml。每周一次，连续5周。治疗结束后4周采用Lysholm膝关节评分系统进行评价。结果 A组、C组各1例注射PRP后出现短暂膝关节炎症反跳，其余患者均未出现并发症。3组治疗后4周Lysholm膝关节评分较治疗前均有明显提高（A组42．3±10．5 vs．54．3±10．4， t＝－7．086， P＝0．000；B组41．6±10．0 vs．54．2±9．1， t＝－5．450， P＝0.000；C组41．8±10．4 vs．66．8±7．2， t＝－12．887， P＝0．000），且C组明显高于A、B组（F＝12．982， P＝0．000）。 C组有效率（60％，12／20）明显高于A组（20％，4／20）和B组（20％，4／20）（χ2＝9．600，P＝0．008）。治疗前后血常规和肝、肾功能均未出现异常。结论膝关节腔注射PRP联合HA可以迅速控制疼痛并改善患者膝关节功能，具有显著的近期疗效，是治疗KOA的一种安全有效的方法，长期疗效有待继续观察。
목적：비교부혈소판혈장（ platelet-rich plasma，PRP）여파리산납（ hyaluronic acid sodium ，HA）치료슬관절골관절염（ knee osteoarthritis ，KOA）적근기료효。방법2013년3월～2014년1월，장60례KOA안취진순서의차분지A、B、C조，매조20례。 A조슬관절내주사자체PRP 5 ml，B조슬관절내주사HA 2 ml，C조슬관절내선주사PRP 5 ml，10 min후주사HA 2 ml。매주일차，련속5주。치료결속후4주채용Lysholm슬관절평분계통진행평개。결과 A조、C조각1례주사PRP후출현단잠슬관절염증반도，기여환자균미출현병발증。3조치료후4주Lysholm슬관절평분교치료전균유명현제고（A조42．3±10．5 vs．54．3±10．4， t＝－7．086， P＝0．000；B조41．6±10．0 vs．54．2±9．1， t＝－5．450， P＝0.000；C조41．8±10．4 vs．66．8±7．2， t＝－12．887， P＝0．000），차C조명현고우A、B조（F＝12．982， P＝0．000）。 C조유효솔（60％，12／20）명현고우A조（20％，4／20）화B조（20％，4／20）（χ2＝9．600，P＝0．008）。치료전후혈상규화간、신공능균미출현이상。결론슬관절강주사PRP연합HA가이신속공제동통병개선환자슬관절공능，구유현저적근기료효，시치료KOA적일충안전유효적방법，장기료효유대계속관찰。
Objective To compare the curative effects between platelet-rich plasma ( PRP ) and hyaluronic acid sodium (HA) intra-articular injection for the treatment of knee osteoarthritis (KOA). Methods From March 2013 to January 2014, 60 cases of KOA were divided into A , B, C groups according to admission sequence , with 20 cases in each group .The Group A was given knee joint injection of PRP 5 ml, Group B was given knee joint injection of HA 2 ml, and Group C received knee joint injection of PRP 5 ml and HA 2 ml at 10 min afterwards, once a week for five weeks .Four weeks after treatment , we evaluated the treatment effect with the Lysholm knee score system . Results One patient in the group A and the group C respectively showed serious and transient inflammation after the injection of PRP .The rest of the all patients had no complications .After treatment , the Lysholm knee scores were obviously improved as compared to before treatment in all the three groups ( Group A: 42.3 ±10.5 vs.54.3 ±10.4, t =-7.086, P=0.000;Group B:41.6 ±10.0 vs.54.2 ±9.1, t=-5.450, P=0.000;Group C:41.8 ±10.4 vs.66.8 ±7.2, t=-12.887, P=0.000).The scores in the Group C were significantly higher than those in the Group A and the Group B (F=12.982, P=0.000).The effective rate of the Group C (60%, 12/20) was significantly higher than that in the Group A (20%, 4/20) and Group B (20%, 4/20) (χ2 =9.600, P=0.008).Routine blood and liver and renal functions were normal before and after treatment . Conclusions Knee joint injection of PRP and HA can quickly control the pain and improve patients ’ joint functions .This treatment has significant short-term effects , being a safe and effective method for the treatment of KOA .However , the long-term efficacy requires further investigations .