2024 年第 3 期 第 19 卷

氨基葡萄糖联合膝关节腔注射富血小板血浆治疗膝骨关节炎的临床效果

Clinical efficacy of glucosamine combined with platelet-rich plasma injection in the knee cavity in the treatment of knee osteoarthritis

作者：林伟明1廖红兴1孙剑光1梁传兴1黄略2李惠民2李灏2

英文作者：Lin Weiming1 Liao Hongxing1 Sun Jianguang1 Liang Chuanxing1 Huang Lue2 Li Huimin2 Li Hao2

单位：1广东省梅州市人民医院关节外科广东省梅州市医学科学院，梅州514031；2广东医科大学第一临床医学院，湛江523808

英文单位：1Department of Joint Surgery Meizhou People′s Hospital of Guangdong Province Meizhou Academy of Medical Sciences Guangdong Province Meizhou 514031 China; 2the First Clinical Medical College Guangdong Medical University Zhanjiang 523808 China

关键词：膝骨关节炎；氨基葡萄糖；关节腔注射；富血小板血浆

英文关键词：Kneeosteoarthritis；Glucosamine；Intra-articularinjection；Platelet-richplasma

• 摘要：

• 目的 探讨氨基葡萄糖联合膝关节腔注射富血小板血浆(PRP)治疗膝骨关节炎(KOA)的临床效果。方法 选取2018年1月至2022年3月于广东省梅州市人民医院关节外科就诊的81例KOA患者，按随机数字表法分为观察组（40例）和对照组（41例）。对照组予硫酸氨基葡萄糖胶囊治疗，观察组在对照组基础上联合膝关节腔注射富血小板血浆治疗，2组均连续治疗12个月。比较2组临床疗效以及视觉模拟量表(VAS)评分、美国特种外科医院膝关节评分（HSS）、血液标本指标、关节积液指标水平以及不良反应发生率。结果 观察组总有效率高于对照组［95.0%（38/40）比73.2%（30/41）］（χ2=7.161，P=0.008）。治疗后6、12个月，2组VAS评分均低于治疗前、且观察组低于对照组，2组HSS评分均高于治疗前、且观察组高于对照组（均P<0.05）。治疗后6、12个月，2组C反应蛋白、红细胞沉降率、白细胞介素6、透明质酸结合蛋白水平均低于治疗前、且观察组均低于对照组（均P<0.05）；2组转化生长因子β1及透明质酸合酶1（HAS1）、HAS2、HAS3蛋白及mRNA水平均高于治疗前、且观察组均高于对照组（均P＜0.05）。2组不良反应发生率比较差异无统计学意义（P>0.05）。结论 氨基葡萄糖联合膝关节腔注射PRP治疗KOA的临床效果良好，可明显改善患者膝关节功能、减轻患者炎症反应。

• Objective To investigate the clinical efficacy of glucosamine combined with platelet-rich plasma (PRP) injection in the knee cavity in the treatment of knee osteoarthritis (KOA). Methods From January 2018 to March 2022, 81 patients with KOA in Department of Joint Surgery, Meizhou People′s Hospital of Guangdong Province were enrolled. They were divided into the observation group (40 cases) and the control group (41 cases) according to the random number table method. The control group was treated with glucosamine sulfate capsules and the observation group was treated with PRP joint cavity injection based on the control group. Both groups were treated for 12 months. The clinical efficacy, visual analog scale (VAS) score, the hospital for special surgery knee score (HSS), blood specimen, joint effusion indicators and the incidence of adverse reactions were compared between the two groups. Results The total response rate of the observation group was higher than that of the control group ［95.0%（38/40） vs 73.2%（30/41）］(χ2=7.161，P=0.008). At 6 and 12 months after treatment, the VAS scores in two groups were lower than those before treatment, and that in the observation group was lower than that in the control group; the HSS in two groups were higher than those before treatment, and that in the observation group was higher than that in the control group(all P<0.05). At 6 and 12 months after treatment, the levels of C-reactive protein, erythrocyte sedimentation rate, interleukin-6 and hyaluronic acid-binding protein in two groups were lower than those before treatment, and those in the observation group were lower than those in the control group(all P<0.05). The protein and mRNA levels of transformed growth factor-β1, hyaluronic acid synthase 1(HAS1), HAS2 and HAS3 in two groups were higher than those before treatment, and those in the observation group were higher than those in the control group(all P<0.05). There was no significant difference in the incidence of adverse effects between the two groups (P>0.05). Conclusion Glucosamine combined with PRP injection in the knee cavity has good clinical efficacy on KOA. It can significantly improve the knee function and reduce the inflammatory response in patients.