摘要
[目的]通过荟萃分析比较关节腔内注射富血小板血浆(PRP)与透明质酸(HA)治疗膝关节骨性关节炎的疗效差异。[方法]检索并收集2008年1月～2018年9月公开发表于Embase、Pubmed、Cochrane、中国知网(CNKI)、中文科技期刊全文数据库(VIP)及万方数据库关于关节腔内注射PRP与HA治疗膝关节骨性关节炎的随机对照研究文章,严格按照纳入和排除标准及文献质量评分标准收集数据,运用Review Manager5.3软件对数据进行荟萃分析。[结果]共纳入19篇文献,总计2 114例接受关节腔药物治疗的膝骨关节炎患膝,其中PRP组1 079例,HA组1 035例。治疗后12个月时,PRP组WOMAC评分低于HA组[MD=-10.30, 95%CI (-14.27～-6.34),P<0.01];PRP组IKDC评分高于HA组[MD=7.56, 95%CI (3.61～11.68),P<0.01];PRP组Lequesne指数评分低于HA组[MD=-3.63, 95%CI (-7.16,～-0.11),P=0.04];而两组间VAS评分差异无统计学意义(P>0.05)。[结论]关节腔内注射PRP治疗膝骨关节炎疗效显著,在远期疗效PRP较HA具有更好的优势,可以减轻膝关节疼痛,改善膝关节功能,提高生活质量。
[Objective] To compare the clinical efficacy of intra-articular injection of platelet-rich plasma(PRP) versus hyaluronic acid(HA) for knee osteoarthritis by a meta-analysis.[Methods] Published studies about the intra-articular injection of PRP versus HA for knee osteoarthritis from January 2008 to September 2018 were searched on Embase,Pubmed,Cochrane Library,CNKI,VIP and Wanfang databases.After methodological quality of the trials was critically assessed,meta-analysis of the data was conducted by Review Manager 5.3 software.[Results] A total of 19 articles were included into the study involving2114 patients,including 1 079 patients treated with PRP and 1035 patients treated with HA.At 12 months after treatment,the PRP group had significantly lower WOMAC scores than the HA group [MD=-10.30,95%CI(-14.27^-6.34),P<0.01],whereas the PRP group took significantly higher IKDC scores than the HA group [MD=7.56,95%CI(3.61~11.68),P<0.01].Moreover,the PRP group proved significantly lower Lequesne index than the HA group [MD=-3.63,95%CI(-7.16,^-0.11),P=0.04],despite of the fact that no significant difference was found in VAS between the two groups(P>0.05).[Conclusion] Intra-articular injection of PRP is superior to HA for treatment of knee osteoarthritis,which does relieve knee pain,restore knee function and improve quality of life.
作者
袁涛
席刚
韩鹏飞
刘泽
芦升升
张润杰
王浩浩
张民
YUAN Tao;XI Gang;HAN Peng-fei;LIU Ze;LU Sheng-sheng;ZHANG Run-jie;WANG Hao-hao;ZHANG Min(Department of Orthopaedics, The Second Affiliated Hospital,Shanxi Medical University,Taiyuan 030001,China;Shanxi Key Laboratory of Bone and Soft 'Tissue InjuryRepair,Taiyuan 030001,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2019年第3期235-242,共8页
Orthopedic Journal of China
基金
国家国际科技合作专项项目(编号:2015DFA33050)
山西省科技基础条件平台项目(编号:201705D121010)
山西省卫生计生委基金资助项目(编号:2015039)
