摘要目的:比较超声引导下关节腔注射自体富白细胞血小板血浆（PRP）与透明质酸钠（HA）治疗膝骨关节炎（KOA）临床疗效。方法:收集2020年2月1日至2022年2月1日在福建医科大学附属第一医院疼痛科门诊收治的56例K-L分级Ⅰ~Ⅲ级KOA患者。其中，PRP组30例，采用超声引导关节腔内注射PRP治疗；HA组26例，采用超声引导关节腔内注射HA治疗。两组患者每次注射3.5 ml PRP或HA，间隔2周，一共注射3次，于治疗后1、3、6个月采用疼痛视觉模拟评分（VAS）及Lysholm膝关节评分量表对患者的临床疗效进行评价。结果:两组患者在治疗过程中均未见严重并发症，治疗后1、3、6个月时，VAS评分均较治疗前改善，差异有统计学意义（ P均<0.05），治疗后1、3个月时，两组间VAS评分差异无统计学意义（ P均>0.05）。治疗后6个月时，PRP组的VAS评分及Lysholm膝关节评分量表总分均优于HA组[（2.3±1.2）比（3.2±1.4），（75.8±9.8）比（59.0±7.6）， P均<0.05]。治疗后6个月时，PRP组优效率、总有效率均较HA组高[33.3%（10/30例）比7.7%（2/26例）， χ2=5.44， P=0.020；90.0%（27/30例）比38.5%（10/26例）， χ2=16.50， P<0.001]。 结论:超声引导PRP注射治疗KOA患者具有确切的临床疗效，持久性方面优于HA注射。

abstractsObjective:To compare the clinical efficacy of ultrasound-guided intra-articular injection of autologous leukocyte and platelet-rich plasma (PRP) or sodium hyaluronate (HA) in the treatment of knee osteoarthritis (KOA).Methods:From February 1, 2020 to February 1, 2022, 56 patients with Keligren Lawrence grade Ⅰ-Ⅲ KOA were collected in the Department of Painology of the First Affiliated Hospital of Fujian Medical University. With ultrasound-guided, 30 patients received 3.5 ml PRP intra-articular injection in PRP group, and 26 patients received 3.5 ml HA intra-articular injection in HA group, every 2 weeks for a total of 3 times. Visual analogue score (VAS) and Lysholm knee joint score were evaluated at 1 month, 3 months and 6 months after the treatment.Results:No serious complications were found in the two groups during the treatment. At 1 month, 3 months and 6 months after the treatment, VAS was improved (all P<0.05). VAS had no significant difference in the two groups at 1 month and 3 months after the treatment. But at 6 months after the treatment, VAS and the total score of Lysholm knee joint in the PRP group were significantly better than those in the HA group[(2.3±1.2) vs. (3.2±1.4), (75.8±9.8) vs. (59.0±7.6), all P<0.05]. At 6 months after treatment, the efficiency rate and total effective rate in PRP group were higher than those in HA group[33.3% (10/30 cases) vs. 7.7% (2/26 cases), χ2=5.44, P=0.020; 90.0% (27/30 cases) vs. 38.5% (10/26 cases), χ2=16.50, P<0.001]. Conclusion:Ultrasound-guided PRP injection has a positive clinical effect in the treatment of KOA, and is better than HA injection in the long term effects.