Chu Yanchen, Rong Chun, Qu Huili, Zhang Haining, Fang Yuan
Yanchen Chu, Department of Orthopedics, The Affiliated Hospital of Qingdao University, 59 Haier Road, Qingdao, Shandong Province 266000, P.R. China.
Chun Rong, Department of Orthopedics, The Affiliated Hospital of Qingdao University, 59 Haier Road, Qingdao, Shandong Province 266000, P.R. China.
Pak J Med Sci. 2025 May;41(5):1280-1284. doi: 10.12669/pjms.41.5.11518.
BACKGROUND & OBJECTIVE: Steroid-induced avascular necrosis of the femoral head (SANFH) is a serious complication of the overuse of glucocorticoids. Platelet-rich plasma (PRP) is a regenerative technique that has shown to effectively repair damaged blood vessels, promote angiogenesis, restore normal blood supply, and promote osteogenesis of the femoral head. This study aimed to analyze the effect of PRP combined with a commonly used simvastatin in treating SANFH.
In this retrospective single-center study clinical data of all SANFH patients who received simvastatin or PRP combined with simvastatin in The Affiliated Hospital of Qingdao University from June 2022 to April 2024 were retrospectively reviewed. Baseline characteristics, recovery of joint function, treatment effect, and incidence of adverse reactions (ARs) were analyzed.
Clinical data of 146 patients who received simvastatin alone (n=75) or PRP combined with simvastatin (n=71) under the guidance of the treating physician were included in the analysis. After the treatment, the recovery of joint function and the rate of excellent and good therapeutic effect in patients who received PRP combined with simvastatin were significantly higher than in patients who received simvastatin treatment alone (<0.05). Combined treatment was associated with significantly lower levels of total procollagen Type-I N-terminal propeptide (T-PINP), N-terminal molecular fragment (N-MID), and β-isomerized C-terminal telopeptide of Type-I collagen (β-CTX), and higher post-treatment levels of 25 hydroxyvitamin D (25-(OH)-D) compared to simvastatin alone (<0.05). No significant difference was found in the incidence of ARs between the two groups (>0.05).
PRP combined with simvastatin can more effectively restore joint function, regulate bone metabolism state, and improve treatment efficiency in patients with SANFH.
类固醇诱导的股骨头缺血性坏死（SANFH）是糖皮质激素过度使用的严重并发症。富血小板血浆（PRP）是一种再生技术，已显示能有效修复受损血管、促进血管生成、恢复正常血液供应并促进股骨头成骨。本研究旨在分析PRP联合常用的辛伐他汀治疗SANFH的效果。
在这项回顾性单中心研究中，回顾性分析了2022年6月至2024年4月在青岛大学附属医院接受辛伐他汀或PRP联合辛伐他汀治疗的所有SANFH患者的临床资料。分析了基线特征、关节功能恢复情况、治疗效果和不良反应发生率。
分析纳入了146例在治疗医师指导下单独接受辛伐他汀治疗（n = 75）或PRP联合辛伐他汀治疗（n = 71）的患者的临床资料。治疗后，接受PRP联合辛伐他汀治疗的患者关节功能恢复情况及优良治疗效果率显著高于单独接受辛伐他汀治疗的患者（<0.05）。与单独使用辛伐他汀相比，联合治疗使I型前胶原N端前肽（T-PINP）、N端分子片段（N-MID）和I型胶原β-异构化C端肽（β-CTX）水平显著降低，治疗后25羟维生素D（25-(OH)-D）水平升高（<0.05）。两组不良反应发生率无显著差异（>0.05）。
PRP联合辛伐他汀能更有效地恢复SANFH患者的关节功能，调节骨代谢状态，提高治疗效率。
