| 摘要: |
| ［摘要］ 目的 分析Schatzker Ⅴ型、Ⅵ型胫骨平台骨折患者术后早期膝关节腔内注射富血小板血浆（PRP）对炎症因子水平和膝关节功能的影响。方法 招募2023年1月至2024年12月内蒙古科技大学包头医学院第一附属医院收治的40例Schatzker Ⅴ型、Ⅵ型胫骨平台骨折患者。采用随机数字表法将患者分为观察组和对照组，各20例。所有患者均行胫骨平台骨折切开复位钢板螺钉内固定术，观察组分别于术后第1周、第3周、第5周向膝关节腔内注射10 mL PRP，对照组分别于术后第1周、第3周、第5周向膝关节腔内注射10 mL生理盐水。分别于术后第3周（注射PRP/生理盐水之前）、第5周（注射PRP/生理盐水之前）、第7周采集患者膝关节液，检测白介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）及白介素-6（IL-6）水平，于术后第3个月采用美国特种外科医院膝关节评分(HSS)评估膝关节功能。结果 术后第3周、第5周、第7周观察组IL-6和TNF-α水平显著低于对照组（P<0.05）。与术后第3周相比，观察组术后第5周、第7周IL-1β和TNF-α水平显著降低（P<0.05），术后第7周IL-6水平显著降低（P<0.05）。观察组在疼痛、功能、活动度、肌力、屈曲畸形、稳定性等6个方面的评分以及HSS总分高于对照组，差异有统计学意义（P<0.05）。结论 Schatzker Ⅴ型、Ⅵ型胫骨平台骨折患者术后早期膝关节腔内注射PRP可降低膝关节液中炎症因子水平，改善膝关节功能。 |
| 关键词: 富血小板血浆 胫骨平台骨折 白介素-1β 肿瘤坏死因子-α 白介素-6 |
| DOI：10.3969/j.issn.1674-3806.2025.05.15 |
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| Effects of early postoperative intra-articular injection of platelet-rich plasma into the knee joint on inflammatory cytokine levels and knee joint function in patients with Schatzker type Ⅴ and Schatzker type Ⅵ tibial plateau fractures |
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WANG Jizhu1, ZHANG Wenlong2, WANG Zhifeng1, ZHANG Zhiyan3
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1.Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014040, China; 2.The Second Department of Trauma, the First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014010, China; 3.Department of Laboratory Medicine, the First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014010, China
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| Abstract: |
| ［Abstract］ Objective To analyze the effects of early postoperative intra-articular injection of platelet-rich plasma(PRP) into the knee joint on inflammatory cytokine levels and knee joint function in patients with Schatzker type Ⅴ and Schatzker type Ⅵ tibial plateau fractures. Methods A total of 40 patients with Schatzker type Ⅴ and Schatzker type Ⅵ tibial plateau fractures who were admitted to the First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology from January 2023 to December 2024 were recruited. The patients were divided into observation group and control group by using random number table method, with 20 cases in each group. All the patients underwent open reduction and internal fixation with plate and screws for tibial plateau fractures. In the observation group, 10 mL of PRP was injected into the knee joint at the 1st week, 3rd week and 5th week after surgery. In the control group, 10 mL of normal saline was injected into the knee joint at the 1st week, 3rd week and 5th week after surgery. The knee joint fluid was collected from the patients at the 3rd week(before injecting PRP/normal saline), 5th week(before injecting PRP/normal saline), and 7th week after surgery to detect the levels of interleukin-1β(IL-1β), tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6). The knee joint function was assessed by using the Hospital for Special Surgery Knee Score(HSS) at the 3rd month after surgery. Results The levels of IL-6 and TNF-α in the observation group were significantly lower than those in the control group at the 3rd week, 5th week, and 7th week after surgery(P<0.05). Compared with those at the 3rd week after surgery, the levels of IL-1β and TNF-α in the observation group were significantly reduced at the 5th week and 7th week after surgery(P<0.05). Compared with those at the 3rd week after surgery, the levels of IL-6 in the observation group were significantly reduced at the 7th week after surgery(P<0.05). The observation group had higher scores in six aspects including pain, function, range of motion, muscle strength, flexion deformity and stability, and higher total HSS scores than the control group, with statistically significant differences between the two groups(P<0.05). Conclusion Early postoperative intra-articular injection of PRP into the knee joint in patients with Schatzker type Ⅴ and Schatzker type Ⅵ tibial plateau fractures can reduce the inflammatory cytokine levels in the knee joint fluid and improve knee joint function. |
| Key words: Platelet-rich plasma(PRP) Tibial plateau fracture Interleukin-1β(IL-1β) Tumor necrosis factor-α(TNF-α) Interleukin-6(IL-6) |
