摘要
目的分析布鲁杆菌性脊柱炎术后不同组织布鲁杆菌病理阳性率和多重PCR检测阳性率差异。方法2018年11月至2019年12月,首都医科大学附属北京地坛医院骨科收治的22例行手术治疗的布鲁杆菌性脊柱炎患者,其中手术部位为颈椎1例、胸椎2例、胸腰椎3例、腰椎16例,其中19例行胸腰椎后路病灶清除、减压、内固定、植骨融合术,1例行颈椎前路病灶清除、减压、内固定、植骨融合术,2例患者行椎间孔镜下病灶清除术,术中收集病灶区不同组织标本(髓核、软组终板、黄韧带、纤维环等),采用Gimesa染色等进行布鲁杆菌病理学观察,同时对各组织标本行布鲁杆菌多重PCR检测,使用Fisher’s精确检验对布鲁杆菌病理阳性率和多重PCR阳性率进行对比。结果Gimesa染色发现病灶区任一部位组织标本中存在布鲁杆菌则认定为病理结果阳性,否则为阴性。多重PCR检测发现病灶区任一部位组织标本中存在任何种属的布鲁杆菌DNA则认定为PCR结果阳性,否则为阴性。22例患者中,多重PCR检测阳性率90.9%(20/22)高于Gimesa染色阳性率[81.8%(18/22)],但差异无统计学意义(P=0.664)。73份组织标本中,多重PCR检测阳性率[43.8%(32/73)]高于Gimesa染色阳性率[32.9%(24/73)],但差异无统计学意义(P=0.173)。其中,22份髓核的多重PCR检测阳性率[86.4%(20/22)]高于Gimesa染色阳性率[72.7%(16/22)],但差异无统计学意义(P=0.240);21份软骨终板的多重PCR检测阳性率[38.1%(8/21)]高于Gimesa染色阳性率[23.8%(5/21)],但差异无统计学意义(P=0.505);19份黄韧带的多重PCR检测阳性率[10.5%(2/19)]与Gimesa染色阳性率[10.5%(2/19)]相同;11份纤维环的多重PCR检测阳性率[18.2%(2/11)]高于Gimesa染色阳性率[9.1%(1/11)],但差异无统计学意义(P=1.000)。但髓核Gimesa染色阳性率和多重PCR检测阳性率高于其他部位组织标本阳性率,差异均具有统计学意义(P均<0.001)。结论多重PCR检测可以作为布�
Objective To compare the positive rates of histopathology and multiple polymerase chain reaction(PCR)detection in different tissue specimens in surgery of brucellosis spondylitis.Methods From November 2018 to December 2019,22 patients with brucellosis spondylitis underwent surgical treatment in Beijing Ditan Hospital,Capital Medical University,whose surgical sites were cervical spine(1 case),thoracic spine(2 cases),thoracolumbar spine(3 cases)and lumbar spine(16 cases);and 19 patients underwent posterior thoracolumbar debridement,decompression,internal fixation,bone graft fusion,1 patient underwent cervical anterior debridement,decompression,internal fixation,bone graft fusion,2 patients underwent foraminal debridement.Different tissue specimens(nucleus pulposus,soft endplate,ligamentum flavum,annulus fibrosus,etc.)were collected for Gimesa staining during the operation.While multiple PCR was performed on the tissue specimens,and the positive rates of both methods were comparatively analyzed by Fisher’s exact test.Results Among the 22 patients,the positive rate of multiplex PCR was 90.9%(20/22),which was higher than Gimesa staining[81.8%(18/22)],but without significant difference(P=0.664).Among the 73 tissue samples,the positive rate of multiplex PCR was 43.8%(32/73),which was higher than that of Gimesa staining[32.9%(24/73)],but without significant difference(P=0.173).There were 22 samples of nucleus pulposus,and the positive rate of multiple PCR detection was 86.4%(20/22),which was higher than that of Gimesa staining[72.7%(16/22)],but without significant difference(P=0.240).Among the 21 cartilage endplates,the positive rate of multiple PCR detection was 38.1%(8/21),which was higher than that of Gimesa staining[23.8%(5/21)],but without significant difference(P=0.505).Among the 19 pieces of ligamentum flavum,the positive rate of multiple PCR was 10.5%(2/19),which was the same as Gimesa staining(2/19).Among the 11 pieces of annulus fibrosus,the positive rate of multiplex PCR was 18.2%(2/11),which was higher than
作者
张耀
陈佳敏
李慢
张强
赵昌松
何杰
马睿
Zhang Yao;Chen Jiamin;Li Man;Zhang Qiang;Zhao Changsong;He Jie;Ma Rui(Department of Orthopedics and Pathology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2021年第6期419-425,共7页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
基金
北京市中西医结合研究所建设项目
首都医科大学附属北京地坛医院院内科研基金“桥梁计划”项目(No.DTQL201803)。
关键词
布鲁杆菌性脊柱炎
病理
多重聚合酶链式反应
Brucellosis spondylitis
Pathology
Multiplex polymerase chain reaction
