自体富含血小板血浆(PRP)治疗膝骨关节炎的疗效影响因素研究

Study on the Influencing Factors of the Therapeutic Effect of Autologous Platelet-Rich Plasma (PRP) in the Treatment of Knee Osteoarthritis

摘要: 目的：分析手工与全自动自体富含血小板血浆(PRP)制备方法的质量及对膝骨关节炎患者的治疗效果。方法：采用回顾性研究方式，将2022年9月至2023年11月在重庆市大足区人民医院接受PRP治疗的80例膝骨关节炎作为研究对象，按照PRP制备方式的不同将PRP治疗患者分为手工组与全自动组，手工组共纳入32例患者，全自动组共纳入48例患者。比较两组PRP质量，比较两组治疗前后西安大略麦马斯特大学骨关节炎指数(WOMAC)评分以评估临床疗效，比较两组治疗前后疼痛、膝关节功能，比较两组不良反应发生情况。结果：PRP制品血小板计数(PLT)、红细胞计数(RBC)在两组中比较，手工组高于全自动组，PRP中白细胞计数(WBC)含量，手工组低于全自动组；在治疗后，两组患者疼痛、关节僵硬、生理功能等WOMAC评分均降低，且上述指标手工组均低于全自动组(P < 0.05)；治疗后，两组患者视觉模拟评分法(VAS)评分均降低，且手工组低于全自动组，两组患者Lysholm膝关节评分量表(Lysholm)评分均升高，且手工组高于全自动组(P < 0.05)；两组患者不良反应发生率比较，差异无统计学意义(P > 0.05)。结论：手工制备的PRP中PLT含量较高，PRP质量佳，与全自动制备PRP比较，该制备方法注射治疗膝骨关节炎可显著降低患者WOMAC评分，表现出良好的治疗效果，且能进一步缓解患者疼痛症状，改善膝关节功能。两种PRP制备方法均具有良好的安全性。

Abstract: Objective: To analyze the quality of manually prepared and fully automated autologous platelet-rich plasma (PRP) and their therapeutic effects on patients with knee osteoarthritis. Methods: A retrospective study was conducted, including 80 patients with knee osteoarthritis who received PRP treatment at the People’s Hospital of Dazu District, Chongqing, from September 2022 to November 2023. According to the different PRP preparation methods, patients were divided into a manual group (32 patients) and a fully automated group (48 patients). The quality of PRP in the two groups was compared. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores before and after treatment were compared to evaluate clinical efficacy. Pain and knee joint function before and after treatment were also compared, as well as the incidence of adverse reactions between the two groups. Results: Platelet count (PLT) and red blood cell count (RBC) in PRP were higher in the manual group than in the fully automated group, while white blood cell count (WBC) in PRP was lower in the manual group than in the fully automated group. After treatment, WOMAC scores for pain, joint stiffness, and physical function decreased in both groups, and these scores were lower in the manual group than in the fully automated group (P < 0.05). Visual Analog Scale (VAS) scores decreased in both groups after treatment, with lower scores in the manual group compared to the fully automated group. Lysholm knee scores increased in both groups, with higher scores in the manual group than in the fully automated group (P < 0.05). The incidence of adverse reactions showed no statistically significant difference between the two groups (P > 0.05). Conclusion: PRP manually prepared has a higher platelet content and better quality. Compared with fully automated PRP, this preparation method can significantly reduce WOMAC scores in patients with knee osteoarthritis, showing good therapeutic effects, further relieving pain, and improving knee joint function. Both PRP preparation methods exhibit good safety.