摘要
目的探讨不同浓度自体富血小板血浆(APRP)对慢性跟腱损伤的疗效。方法选取2019年9月至2022年2月内江市第一人民医院收治的85例跟腱损伤的患者。所有患者均经超声、MRI、X线等影像学检查提示跟腱损伤,关节疼痛症状明显且伴活动受限,且均接受保守APRP治疗;排除精神或认知障碍、凝血功能异常等患者。采用随机数字表法将患者分为对照组、低浓度、中浓度、中高浓度和高浓度组,每组17例。各组均口服依托考昔片1片,1次/d,并持续1周作为基础治疗。对照组继续常规治疗,APRP治疗各组在常规治疗的基础上予注射2 ml的APRP,低浓度组APRP浓度为(0.9~1.2)×10^(12)/L,中浓度组APRP浓度为(1.2~1.5)×10^(12)/L,中高浓度组APRP浓度为(1.5~1.8)×10^(12)/L,高浓度组APRP浓度为(1.8~2.1)×10^(12)/L。比较5组治疗后肢体活动度、疼痛程度、炎症因子水平及不良反应情况。不良反应情况等计数资料行卡方检验;各项评分指标等计量资料呈正态分布时多组间差异比较行单因素方差分析,组间两两差异比较行LSD检验,组内比较行配对t检验。结果5组治疗后2周及4周的AOFAS评分比较,差异有统计学意义(F=3.213、3.195,均为P<0.05),其中APRP治疗各组在治疗后2周、4周的AOFAS评分较对照组均显著升高(均为P<0.05),且中高浓度组的AOFAS评分明显高于低浓度组、中浓度组和高浓度组(均为P<0.05)。5组治疗后2周及4周的VAS评分比较,差异有统计学意义(F=2.496、3.551,均为P<0.05),其中APRP治疗各组在治疗后2周、4周的VAS评分较对照组均显著降低(均为P<0.05),且中高浓度组的VAS评分明显低于低浓度组、中浓度组和高浓度组(均为P<0.05)。5组治疗前后血清ΔCCL7、ΔPGE2、ΔIL-1β及ΔTNF-α等炎性因子变化程度比较,差异有统计学意义(F=2.501、3.056、5.000、4.762,均为P<0.05);其中APRP治疗各组血清各炎性因子在治疗前后的浓度含量变化程度较对照组�
Objective To investigate the effect of different concentrations of autologous platelet-rich plasma(APRP)on chronic Achilles tendon injury.Methods Eighty-five patients with Achilles tendon injury treated in Neijiang First People's Hospital from September 2019 to February 2022 were selected.All the patients were confirmed as Achilles tendon injury by ultrasound,MRI,X-ray imaging examinations,with obvious symptoms of joint pain accompanied by limited movement,and all received conservative APRP treatment.The patients with mental disorders and coagulation dysfunction were excluded.The patients were randomized into control group,low concentration group,medium concentration group,sub-high concentration group and high concentration group by random number table,17 cases in each group.Each group took one etoposide tablet orally once a day for one week as basic treatment.The control group received the routine treatment,APRP treatment groups were injected with two millilter of APRP on the basis of routine treatment.The APRP concentrations were as follows:(0.9-1.2)×10^(12)/L in the low concentration group;(1.2-1.5)×10^(12)/L in the medium concentration group;(1.5-1.8)×1012/L in the sub-high concentration group;high concentration group-APRP(1.8-2.1)×10^(12)/L.The mobility function and pain of the limb,serum inflammatory factors and adverse reactions of the five groups were compared after treatment.The adverse reactions rate was analyzed by Chi-square test.One-way ANOVA was used for data analyse among multiple groups,LSD t test was used for comparison between groups,and paired t test was used for comparison within groups.Results The AOFAS scores of the five groups at two and four weeks after treatment showed statistically significant differences(F=3.213,3.195,both P<0.05).AOFAS scores in the four APRP treatment groups at two and four weeks after treatment were higher than those of the control group(all P<0.05).The AOFAS score of sub-high concentration group was higher than those of low,medium and high concentration groups(a
作者
詹钦文
靳科
袁家钦
Zhan Qinwen;Jin Ke;Yuan Jiaqin(Neijiang First People's Hospital Orthopedics Neijiang,Neijiang 641000,China;Neijiang First People's Hospital Oncology Neijiang,Neijiang 641000,China;Yongchuan Hospital Affiliated to Chongqing Medical University Yongchuan District,Chongqing 402160,China)
出处
《中华关节外科杂志（电子版）》
CAS
CSCD
2023年第4期500-507,共8页
Chinese Journal of Joint Surgery(Electronic Edition)
基金
四川省医学科研课题(S19098)
关键词
富血小板血浆
跟腱
肌腱损伤
Platelet-rich plasma
Achilles tendon
Tendon injuries
