膝关节腔内注射PRP联合间歇性低氧训练治疗早期膝骨关节炎的疗效及安全性

doi:10.11958/20253164

天津医药 ›› 2026, Vol. 54 ›› Issue (4): 384-389.doi: 10.11958/20253164

膝关节腔内注射PRP联合间歇性低氧训练治疗早期膝骨关节炎的疗效及安全性

艾希睿(), 赵亚男, 刘鹏, 闫景明, 朱藜, 苑成浩^△()

北京大学第三医院秦皇岛医院康复医学科（邮编066000）

收稿日期:2025-10-15 修回日期:2025-12-05 出版日期:2026-04-15 发布日期:2026-04-14
通讯作者: ^△E-mail: yuanchenghao2018@163.com
作者简介:艾希睿（1996），女，中级康复治疗师，主要从事膝关节的康复治疗方面研究。E-mail：axr251009@163.com
基金资助:
秦皇岛市科技计划项目(202501A084)

Efficacy and safety of intra-articular injection of platelet-rich plasma combined with intermittent hypoxic training in the treatment of early knee osteoarthritis

AI Xirui(), ZHAO Ya’nan, LIU Peng, YAN Jingming, ZHU Li, YUAN Chenghao^△()

Department of Rehabilitation Medicine, Peking University Third Hospital Qinhuangdao Hospital, Qinhuangdao 066000, China

Received:2025-10-15 Revised:2025-12-05 Published:2026-04-15 Online:2026-04-14
Contact: ^△E-mail: yuanchenghao2018@163.com

艾希睿, 赵亚男, 刘鹏, 闫景明, 朱藜, 苑成浩. 膝关节腔内注射PRP联合间歇性低氧训练治疗早期膝骨关节炎的疗效及安全性[J]. 天津医药, 2026, 54(4): 384-389.

AI Xirui, ZHAO Ya’nan, LIU Peng, YAN Jingming, ZHU Li, YUAN Chenghao. Efficacy and safety of intra-articular injection of platelet-rich plasma combined with intermittent hypoxic training in the treatment of early knee osteoarthritis[J]. Tianjin Medical Journal, 2026, 54(4): 384-389.

摘要/Abstract

摘要：

目的观察膝关节腔内注射富血小板血浆（PRP）联合间歇性低氧训练治疗早期膝骨关节炎（KOA）的疗效及安全性。方法纳入220例早期KOA患者并按照随机数字表法均分为4组，低氧组予以单独间歇性低氧训练，玻璃酸钠+低氧组采取膝关节腔内注射玻璃酸钠联合间歇性低氧训练方案，PRP组予以单独膝关节腔内注射PRP治疗，PRP+低氧组采取膝关节腔内注射PRP联合间歇性低氧训练方案，均连续治疗6周，比较4组治疗前后数字疼痛评分量表（NPRS）评分，炎症疼痛介质[C反应蛋白（CRP）、肿瘤坏死因子α（TNF-α）、白细胞介素（IL）-17、5-羟色胺（5-HT）、P物质]，氧化应激指标[超氧化物歧化酶（SOD）、丙二醛（MDA）]，膝关节骨关节炎结果评分（KOOS）、起立-行走计时测试（TUG）及不良反应。结果治疗后低氧组、PRP组、玻璃酸钠+低氧组、PRP+低氧组NPRS评分、CRP、TNF-α、IL-17、5-HT、P物质及MDA水平依次降低，SOD水平依次升高，KOOS中疼痛、膝关节生活质量、症状、运动与娱乐、日常活动及总分依次升高，TUG时间依次缩短（均P<0.05）；4组不良反应发生率比较差异无统计学意义（P>0.05）。结论膝关节腔内注射PRP联合间歇性低氧训练治疗早期KOA可有效改善患者炎症疼痛介质表达水平及氧化应激水平，减轻疼痛，提高膝关节功能与平衡能力，且安全性高。

关键词: 骨关节炎, 膝, 富血小板血浆, 低氧, 注射, 关节内, 玻璃酸钠, 间歇性低氧训练

Abstract:

Objective To observe the efficacy and safety of intra-articular injection of platelet-rich plasma (PRP) combined with intermittent hypoxic training in the treatment of early knee osteoarthritis (KOA). Methods A total of 220 patients with early KOA were enrolled and equally divided into four groups using a random number table. The low oxygen group received intermittent hypoxic training alone, the sodium hyaluronate+low oxygen group received intra-articular injection of sodium hyaluronate combined with intermittent hypoxic training, the PRP group received intra-articular injection of PRP alone and the PRP+low oxygen group received intra-articular injection of PRP combined with intermittent hypoxic training. Patients of all groups were treated continuously for 6 weeks. The numerical pain rating scale (NPRS) score, inflammatory pain mediators [C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-17 (IL-17), 5-hydroxytryptamine (5-HT) and substance P], oxidative stress indicators [superoxide dismutase (SOD), malondialdehyde (MDA)], the knee injury and osteoarthritis outcome scores (KOOS), timed up and go test (TUG) results, and adverse reactions were compared between the four groups. Results After treatment, NPRS scores, CRP, TNF-α, IL-17, 5-HT, substance P and MDA levels were decreased in order in the low oxygen group, the PRP group, the sodium hyaluronate+low oxygen group and the PRP+low oxygen group. SOD levels, the scores for pain, knee-related quality of life, symptoms, exercise and recreation, activities of daily living and total KOOS scores were increased in order in these groups, while the TUG time decreased in order (all P<0.05). There was no significant difference in the incidence of adverse reactions between the four groups (P>0.05). Conclusion Applying intra-articular injection of PRP combined with intermittent hypoxic training to treat early KOA can effectively improve the expression levels of inflammatory pain mediators and oxidative stress level, alleviate pain and enhance knee function and balance ability of patients, with high safety.

Key words: osteoarthritis, knee, platelet-rich plasma, hypoxia, injection, intra-articular, sodium hyaluronate, intermittent hypoxic training

中图分类号:

R684.3

图/表 7

参考文献 26

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组别		性别（男/女）			年龄/岁			体质量指数/（kg/m²）
低氧组		27/28			58.29±10.76			24.14±2.67
PRP组		23/32			55.53±10.30			23.66±2.07
玻璃酸钠+低氧组		24/31			57.95±11.26			23.91±2.45
PRP+低氧组		26/29			58.58±9.60			23.10±2.55
χ²或F		0.733			0.974			1.849
组别	K-L分级					病变侧			病程/月
组别	I		II	III		左侧	右侧		病程/月
低氧组	18		25	12		26	29		22.67±4.16
PRP组	15		29	11		30	25		20.60±4.15
玻璃酸钠+低氧组	17		28	10		28	27		21.44±4.52
PRP+低氧组	15		27	13		31	24		22.25±5.14
χ²或F	1.171					1.075			2.276

组别		性别（男/女）			年龄/岁			体质量指数/（kg/m²）
低氧组		27/28			58.29±10.76			24.14±2.67
PRP组		23/32			55.53±10.30			23.66±2.07
玻璃酸钠+低氧组		24/31			57.95±11.26			23.91±2.45
PRP+低氧组		26/29			58.58±9.60			23.10±2.55
χ²或F		0.733			0.974			1.849
组别	K-L分级					病变侧			病程/月
组别	I		II	III		左侧	右侧		病程/月
低氧组	18		25	12		26	29		22.67±4.16
PRP组	15		29	11		30	25		20.60±4.15
玻璃酸钠+低氧组	17		28	10		28	27		21.44±4.52
PRP+低氧组	15		27	13		31	24		22.25±5.14
χ²或F	1.171					1.075			2.276

组别	治疗前	治疗后
低氧组	5.78±0.96	4.85±0.73	5.886^＊＊
PRP组	5.65±0.75	4.38±0.59^a	9.918^＊＊
玻璃酸钠+低氧组	5.89±1.08	3.78±0.74^ab	12.442^＊＊
PRP+低氧组	6.09±1.13	2.96±0.58^abc	16.703^＊＊
F	1.971	83.157^＊＊

组别	治疗前	治疗后
低氧组	5.78±0.96	4.85±0.73	5.886^＊＊
PRP组	5.65±0.75	4.38±0.59^a	9.918^＊＊
玻璃酸钠+低氧组	5.89±1.08	3.78±0.74^ab	12.442^＊＊
PRP+低氧组	6.09±1.13	2.96±0.58^abc	16.703^＊＊
F	1.971	83.157^＊＊

组别		CRP/（mg/L）				TNF-α/（μg/L）						IL-17/（ng/L）
组别		治疗前	治疗后		t	治疗前		治疗后		t		治疗前	治疗后		t
低氧组		28.88±5.71	11.25±1.94		20.836^＊＊	16.51±2.81		13.76±2.53		8.261^＊＊		6.67±1.26	5.92±1.14		4.962^＊＊
PRP组		28.74±6.62	9.89±1.75^a		19.343^＊＊	15.60±2.83		12.73±1.99^a		6.571^＊＊		6.64±1.35	5.26±1.26^a		7.116^＊＊
玻璃酸钠+低氧组		30.33±5.68	8.30±1.44^ab		27.031^＊＊	15.83±2.98		11.64±2.62^ab		8.132^＊＊		6.38±1.40	4.66±1.05^ab		7.614^＊＊
PRP+低氧组		30.30±4.65	6.86±1.40^abc		38.218^＊＊	15.82±2.40		10.16±1.25^abc		14.631^＊＊		6.47±1.41	3.93±0.87^abc		11.796^＊＊
F		1.279	73.623^＊＊			1.113		27.842^＊＊				0.589	33.311^＊＊
组别	5-HT/（μg/L）								P物质/（nmol/L）
组别	治疗前			治疗后			t		治疗前		治疗后			t
低氧组	876.42±115.70			669.47±112.18			9.344^＊＊		4.43±0.84		3.41±0.57			7.406^＊＊
PRP组	847.00±121.53			589.23±110.17^a			11.870^＊＊		4.67±0.95		2.93±0.43^a			13.168^＊＊
玻璃酸钠+低氧组	865.40±118.07			534.70±84.88^ab			15.987^＊＊		4.40±0.84		2.36±0.47^ab			16.944^＊＊
PRP+低氧组	875.48±129.59			486.11±75.32^abc			19.779^＊＊		4.49±0.77		1.84±0.35^abc			22.318^＊＊
F	0.697			36.176^＊＊					1.082		120.561^＊＊

膝关节腔内注射PRP联合间歇性低氧训练治疗早期膝骨关节炎的疗效及安全性

Efficacy and safety of intra-articular injection of platelet-rich plasma combined with intermittent hypoxic training in the treatment of early knee osteoarthritis

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组别	治疗前	治疗后
低氧组	9.44±1.50	9.36±1.34	0.316
PRP组	9.09±1.51	8.36±1.37^a	2.575^＊
玻璃酸钠+低氧组	9.15±1.76	7.60±1.49^ab	5.309^＊＊
PRP+低氧组	9.44±1.82	6.89±1.20^abc	9.037^＊＊
F	0.689	33.870^＊＊

组别	轻微肿胀	感染	头晕	总发生
低氧组	0	0	0	0（0.00）
PRP组	1	0	1	2（3.64）
玻璃酸钠+低氧组	2	1	0	3（5.45）
PRP+低氧组	2	0	1	3（5.45）
χ²				3.113

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组别	SOD/（U/mL）			MDA/（mmol/L）
组别	治疗前	治疗后	t	治疗前	治疗后	t
低氧组	68.96±12.39	85.54±16.32	5.909^＊＊	78.99±11.04	68.75±12.50	4.692^＊＊
PRP组	70.83±12.57	94.16±17.00^a	7.848^＊＊	77.99±15.43	61.85±11.59^a	6.421^＊＊
玻璃酸钠+低氧组	71.03±14.81	102.68±14.81^ab	11.810^＊＊	80.07±13.81	56.43±10.22^ab	11.513^＊＊
PRP+低氧组	72.90±14.90	112.24±20.76^abc	12.529^＊＊	77.59±15.84	45.04±11.14^abc	12.202^＊＊
F	0.760	23.887^＊＊		0.339	42.528^＊＊

组别	SOD/（U/mL）			MDA/（mmol/L）
组别	治疗前	治疗后	t	治疗前	治疗后	t
低氧组	68.96±12.39	85.54±16.32	5.909^＊＊	78.99±11.04	68.75±12.50	4.692^＊＊
PRP组	70.83±12.57	94.16±17.00^a	7.848^＊＊	77.99±15.43	61.85±11.59^a	6.421^＊＊
玻璃酸钠+低氧组	71.03±14.81	102.68±14.81^ab	11.810^＊＊	80.07±13.81	56.43±10.22^ab	11.513^＊＊
PRP+低氧组	72.90±14.90	112.24±20.76^abc	12.529^＊＊	77.59±15.84	45.04±11.14^abc	12.202^＊＊
F	0.760	23.887^＊＊		0.339	42.528^＊＊

组别		疼痛						膝关节生活质量						症状
组别		治疗前		治疗后		t		治疗前		治疗后		t		治疗前		治疗后		t
低氧组		18.31±3.72		21.18±4.62		3.448^＊＊		7.20±1.37		8.62±1.81		5.148^＊＊		15.35±3.03		16.18±4.62		1.200
PRP组		17.49±2.75		23.98±4.23^a		9.086^＊＊		7.27±1.11		10.25±1.68^a		10.425^＊＊		15.67±2.99		18.55±3.23^a		4.557^＊＊
玻璃酸钠+低氧组		18.38±3.48		26.67±4.62^ab		11.384^＊＊		7.24±1.49		11.78±1.97^ab		15.315^＊＊		15.82±3.24		20.69±3.56^ab		6.807^＊＊
PRP+低氧组		18.75±3.34		30.16±4.00^abc		15.276^＊＊		7.00±1.40		13.73±1.60^abc		23.719^＊＊		15.53±2.99		22.85±3.22^abc		12.276^＊＊
F		1.382		42.254^＊＊				0.448		83.217^＊＊				0.240		32.916^＊＊
组别	运动与娱乐						日常活动						总分
组别	治疗前		治疗后		t		治疗前		治疗后		t		治疗前		治疗后		t
低氧组	13.35±2.26		15.53±3.52		4.031^＊＊		37.93±7.74		43.84±7.21		4.100^＊＊		92.13±8.84		105.35±12.10		6.920^＊＊
PRP组	13.71±2.40		17.38±2.70^a		7.112^＊＊		39.20±8.27		47.65±7.12^a		5.409^＊＊		93.35±9.21		117.82±10.20^a		12.174^＊＊
玻璃酸钠+低氧组	13.18±2.06		19.75±2.97^ab		12.020^＊＊		37.64±5.99		52.16±7.63^ab		11.197^＊＊		92.25±7.15		131.05±8.95^ab		22.207^＊＊
PRP+低氧组	13.49±2.47		22.31±4.11^abc		13.011^＊＊		38.07±7.29		59.49±5.86^abc		17.711^＊＊		92.84±8.73		148.55±8.92^abc		30.382^＊＊
F	0.519		41.907^＊＊				0.475		50.997^＊＊				0.239		183.685^＊＊

组别		疼痛						膝关节生活质量						症状
组别		治疗前		治疗后		t		治疗前		治疗后		t		治疗前		治疗后		t
低氧组		18.31±3.72		21.18±4.62		3.448^＊＊		7.20±1.37		8.62±1.81		5.148^＊＊		15.35±3.03		16.18±4.62		1.200
PRP组		17.49±2.75		23.98±4.23^a		9.086^＊＊		7.27±1.11		10.25±1.68^a		10.425^＊＊		15.67±2.99		18.55±3.23^a		4.557^＊＊
玻璃酸钠+低氧组		18.38±3.48		26.67±4.62^ab		11.384^＊＊		7.24±1.49		11.78±1.97^ab		15.315^＊＊		15.82±3.24		20.69±3.56^ab		6.807^＊＊
PRP+低氧组		18.75±3.34		30.16±4.00^abc		15.276^＊＊		7.00±1.40		13.73±1.60^abc		23.719^＊＊		15.53±2.99		22.85±3.22^abc		12.276^＊＊
F		1.382		42.254^＊＊				0.448		83.217^＊＊				0.240		32.916^＊＊
组别	运动与娱乐						日常活动						总分
组别	治疗前		治疗后		t		治疗前		治疗后		t		治疗前		治疗后		t
低氧组	13.35±2.26		15.53±3.52		4.031^＊＊		37.93±7.74		43.84±7.21		4.100^＊＊		92.13±8.84		105.35±12.10		6.920^＊＊
PRP组	13.71±2.40		17.38±2.70^a		7.112^＊＊		39.20±8.27		47.65±7.12^a		5.409^＊＊		93.35±9.21		117.82±10.20^a		12.174^＊＊
玻璃酸钠+低氧组	13.18±2.06		19.75±2.97^ab		12.020^＊＊		37.64±5.99		52.16±7.63^ab		11.197^＊＊		92.25±7.15		131.05±8.95^ab		22.207^＊＊
PRP+低氧组	13.49±2.47		22.31±4.11^abc		13.011^＊＊		38.07±7.29		59.49±5.86^abc		17.711^＊＊		92.84±8.73		148.55±8.92^abc		30.382^＊＊
F	0.519		41.907^＊＊				0.475		50.997^＊＊				0.239		183.685^＊＊