中文摘要：

目的富血小板血浆（platelet-rich plasma,PRP）能促进软骨细胞增殖和修复软骨缺损,通过比较膝关节退行性变患者关节内注射PRP及透明质酸钠的疗效,分析PRP治疗关节软骨退行性变的安全性和可行性。方法于2010年1月-6月收治的膝关节软骨退行性变患者中,选择符合标准的30例30膝患者纳入研究。根据注射药物不同,将患者随机分为PRP组（试验组）和透明质酸钠组（对照组）,每组各15例。两组患者性别、年龄、体重指数、Kellgren-Lawrence分级等一般资料比较,差异均无统计学意义（P〉0.05）,具有可比性。试验组患者抽取自体静脉血制备PRP后,于关节腔内均匀注射3.5 mL PRP;对照组注射2 mL透明质酸钠。每3周注射1次,3次为一疗程。记录两组患者注射后不良反应发生情况,并采用国际膝关节文献委员会（IKDC）评分、美国西部Ontario与McMaster大学骨关节炎指数（WOMAC）评分及Lequesne指数评定关节功能。结果两组患者均获随访6个月。两组治疗后IKDC评分、WOMAC评分及Lequesne指数与治疗前比较,差异均有统计学意义（P〈0.05）;试验组治疗后3、4、6个月间比较,差异均无统计学意义（P〉0.05）;对照组治疗后6个月各评价指标较3、4个月差,但差异有统计学意义（P〈0.05）。治疗后3个月及4个月,两组IKDC评分、WOMAC评分及Lequesne指数比较,差异无统计学意义（P〉0.05）;6个月时,试验组各指标均优于对照组（P〈0.05）。试验组患者12例31次出现不良反应,对照组12例30次;两组不良反应起始时间、终止时间及持续时间比较,差异均无统计学意义（P〉0.05）。结论关节内注射PRP治疗关节软骨退行性变安全,可缓解疼痛、肿胀等症状,提高患者生活质量,但需要大样本长期随访观察进一步验证其安全性和远期疗效。

英文摘要：

Objective Platelet-rich plasma（PRP） can enhance the chondrocyte proliferation and repair of cartilage defects.To explore the safety and efficacy of intra-knee-articular injection of PRP to treat knee articular cartilage degeneration by comparing with injecting sodium hyaluronate（SH）.Methods Thirty consecutive patients（30 knees） with knee articular cartilage degeneration were selected between January 2010 and June 2010.According to different injections,30 patients were randomly divided into PRP group（test group,n=15） and SH group（control group,n=15）.There was no significant difference in gender,age,body mass index,and Kellgren-Lawrence grade between 2 groups（P 〉0.05）.Test group received 3.5 mL of PRP intra-knee-articular injections while control group received 2 mL of SH during the same time period.Both treatments were administered in series of 3 intra-knee-articular injections at 3-week intervals.Then,adverse reactions were recorded.International Knee Documentation Committee（IKDC） score,Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC） score,and Lequesne index were used for evaluation of treatment results.Results The patients of 2 groups were followed up 6 months.There were significant differences in IKDC score,WOMAC score,and Lequesne index between pre-and post-injection in 2 groups（P 〈0.05）;no significant difference was found between different time points（3,4,and 6 months） in test group（P 〉0.05）,while significant differences were found between the postoperative 6th month and the postoperative 3rd and 4th months in control group（P 〈0.05）.There was no significant difference in IKDC score,WOMAC score,and Lequesne index between 2 groups within 4 months（P 〉0.05）,but the effectiveness of test group was significantly better than that of control group at 6 months after injection（P 〈0.05）.Adverse reactions occurred in 12 patients（31 injections） of test group and in 12 patients（30 injections） of control group.No significant di