摘要
目的研究安徽省江淮地区椎体结核流行特点,为椎体结核病防治提供依据。方法收集2015年6月-2018年12月医院收治的88例椎体结核患者资料。无菌采集患者椎体结核脓液、坏死骨组织,并对结核分枝杆菌进行培养,倍比梯度稀释法测定对临床常用抗生素耐药情况,PCR扩增对基因型进行检测。结果 88例椎体结核患者中男47例,女41例;年龄20～84岁,平均59.14岁。按发病部位分布:胸椎结核40例,腰椎结核26例,脊柱结核16例,颈椎结核3例,胸腰椎结核1例,椎体病变1例,椎间隙结核1例。年龄分布:≤20岁2例,21～岁4例,31～岁3例,41～岁11例,51～岁18例,61～岁30例,71～岁17例,>80岁3例。88例患者病历显示在临床症状上有87例患者有颈、胸、腰椎疼痛,49例患者间断盗汗和35例患者低热;体征上82例存在扣压痛,79例患者腰背部活动受限,31例患者存在畸形;血沉46.19±25.56 mm/hr,C反应蛋白4.97±6.92mg/L。88例患者中分离出耐药菌的患者24例,敏感菌的患者64例。结核分枝杆菌对异烟肼、链霉素、利福平、环丙沙星、乙硫异烟胺和帕司烟肼耐药菌分别为16、10、8、6、5和2株。单一耐药株12株,双重耐药株6株、三重耐药株4株、五重耐药1株和六重耐药1株。分离出耐药菌患者占颈、胸、腰椎疼痛患者中27.59%,盗汗患者中20.41%,低热患者中22.86%,畸形患者中29.03%。颈、胸、腰椎疼痛,盗汗,低热和畸形症状与分离出的结核杆菌是否耐药无相关性。69株属于"北京家族"结核分枝杆菌。结论 61～70岁是椎体结核发病高峰,结核分枝杆菌对异烟肼和链霉素耐药率较高,临床治疗时需谨慎用药。
Objectives To study the epidemiological characteristics of vertebral tuberculosis in the Jianghuai area of Anhui Province and to provide evidence for prevention and treatment of vertebral tuberculosis.Methods Data were collected on 88 patients with vertebral tuberculosis seen at this Hospital from June 2015 to December 2018.Pus and necrotic bone tissue were aseptically collected from patients with vertebral tuberculosis,and drug resistance to commonly used clinical antibiotics was determined using gradient dilution.Genotypes were detected using amplification via PCR.ResultsEighty-eight patients with vertebral tuberculosis consisted of 47 males and 41 females ranging in age from 20 to 84 years with an average age of 59.14 years.By affected site,40 patients had thoracic tuberculosis,26 had lumbar tuberculosis,16 had spinal tuberculosis,3 had cervical tuberculosis,1 had thoracolumbar tuberculosis,1 had vertebral lesions,and 1 has interstitial tuberculosis.Age distribution:2 patients were under the age of 20,4 were ages 21-30,3 were ages 31-40,11 were ages 41-50,18 were ages 51-60,30 were ages 61-70,17 were ages 71-80,and 3 were over the age of 81.The medical records of the 88 patients indicated that 87 had pain in the neck,thorax,and lumbar spine,49 had intermittent sweating,35 had a low fever,82 had tenderness,79 had limited lower back movement,and 31 had a deformity.Laboratory results:The erythrocyte sedimentation rate(ESR)was 46.19(+25.56 mm/hr)and C-reactive protein(CRP)was 4.97(+6.92 mg/L).Twenty-four strains of drug-resistant bacteria and 64 strains of drug-sensitive bacteria were cultured from specimens from the 88 patients.Sixteen strains of Mycobacterium tuberculosis were resistant to isoniazid,10 were resistant to streptomycin,8 were resistant to rifampicin,6 were resistant to ciprofloxacin,5 were resistant to ethionamide,and 2 were resistant to pasiniazid.Of the strains,12 were resistant to 1 antibiotic,6 were resistant to 2 antibiotics,4 were resistant to 3 antibiotics,1 was resistant to 4 antibiotics,an
作者
黄炎
于洋
张文志
贺瑞
胡业丰
许翔
尤涛
李旭
段丽群
李钟奇
孔雷
HUANO Yan;YU Yang;ZHANG Wenzhi;HE Rui;HU Ye-feng;XU Xiang;YOU Tao;LI Xu;DIAN Li-qun;LI Zhong-qi;KONG Lei(The First Hospital Affiliated with the University of Science and Technology of China ,Anhui Provincial Hospital,Hefei,China 230001)
出处
《中国病原生物学杂志》
CSCD
北大核心
2019年第4期444-448,共5页
Journal of Pathogen Biology
关键词
椎体结核
结核分枝杆菌
流行病学
Vertebral tuberculosis
Mycobacterium tuberculosis
epidemiology
